1000 resultados para Análisis cluster


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The Firmicutes bacteria participate extensively in virulence and pathological processes. Enterococcus faecalis is a commensal microorganism; however, it is also a pathogenic bacterium mainly associated with nosocomial infections in immunocompromised patients. Iron-sulfur [Fe-S] clusters are inorganic prosthetic groups involved in diverse biological processes, whose in vivo formation requires several specific protein machineries. Escherichia coli is one of the most frequently studied microorganisms regarding [Fe-S] cluster biogenesis and encodes the iron-sulfur cluster and sulfur assimilation systems. In Firmicutes species, a unique operon composed of the sufCDSUB genes is responsible for [Fe-S] cluster biogenesis. The aim of this study was to investigate the potential of the E. faecalis sufCDSUB system in the [Fe-S] cluster assembly using oxidative stress and iron depletion as adverse growth conditions. Quantitative real-time polymerase chain reaction demonstrated, for the first time, that Gram-positive bacteria possess an OxyR component responsive to oxidative stress conditions, as fully described for E. coli models. Likewise, strong expression of the sufCDSUB genes was observed in low concentrations of hydrogen peroxide, indicating that the lowest concentration of oxygen free radicals inside cells, known to be highly damaging to [Fe-S] clusters, is sufficient to trigger the transcriptional machinery for prompt replacement of [Fe-S] clusters.

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Objective: Compared historical overview and systematic description of the distribution, features and public health implication of incidents occurred in swimming pools associated with exposure to chemicals, during the period 2008-2012 in Spain. Method: Retrospective observational design, using information reported to the digital mass media internetbased. Records of chemical incidents from a database of 5-year were analyzed to categorize main features. We examined the following variables: year, frequency and geographical location of incidents, class of swimming pool, settings lead to the event, causal factors, chemicals released, exposure ways, balance of victims, attending hospital and evacuated people. Results: 41 chemical incidents were identified in 5 years with a balance of 428 victims, 119 in-patient and 1750 people evacuated. Common profile of a chemical incident in a swimming pool was featured as a municipal setting where a release or hazardous chemical leak, mainly chlorine or mixed with acids occurred. An average of 10 exposed people per event, mostly children, exposed by respiratory airway, needed to be attended in hospital or community health center an annual average of 24 people, including bathers, employees or users. Conclusions: Swimming pools display scenarios with chemical risks that must be evaluated. Planning and implementing preventive measures are priority to mitigate a negative impact for public health. Our findings suggest the convenience of the regulation of a coordinated information system for ongoing surveillance of incidents in swimming pools to enable a safe management of chemical hazards.

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En los últimos años la industria camaronera ha adquirido mucha importancia en Brasil y genera presiones sobre ecosistemas y comunidades tradicionales que viven en equilibrio con su entorno. En Cumbe, una comunidad tradicional del municipio de Aracati, Ceará, Brasil, el ecosistema que rodea a su población es el manglar. Debido a esta fuerte presión, tanto el manglar como los servicios ambientales que la población local se beneficia, están transformándose. En este trabajo, la población local de Cumbe identifica, valora y caracteriza los servicios ambientales que les proporciona el manglar dándole así una vital importancia, que puede servir de precedente para una posible protección. Por otra parte, se hace una aproximación en términos económicos de la pesca artesanal y las granjas de camarón para discutir a corto y a largo plazo cuál es el modelo más sostenible a seguir.

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El primer objetivo del TFC es la revisión de las características definitorias de calidad y eficiencia del software libre frente a soluciones privativas de uso amplio en ambientes educativos o de ingeniería.

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BACKGROUND It has been identified differences of medical care practice in primary care related to physician's sex. Simultaneously, there are gender inequalities in the assignment of health resources. Both aspects give rise to an increasing growing interest in the management and provision of health services. OBJECTIVES To examine the differences in the referral practice made by female and male primary care physicians working in health centers in Andalusia, to consider whether there are disparities in referrals received by men and women, and to examine the interaction between patient's sex and physician's sex. METHODS Observational, cross-sectional, and multicenter study. POPULATION 4 health districts in Andalucía and their physicians. SAMPLE 382 physicians. MEASUREMENTS referral rate per visit (RV), referral rate per patient quota (RQ), patient's sex, physician: sex, age, postgraduate family medicine specialty, size of the patient quota by sex, mean number of patients/day by sex, mean age of the patient quota by sex, and proportion of men in the quota. Health center: urban / rural, size of the team, enrolled population, and postgraduate family medicine specialty's accreditation. SOURCES databases of health districts. PERIOD OF STUDY 2010. ANALYSIS Bivariate and multivariate multilevel analysis of the referral rate per visit with mixed Poisson model. RESULTS In 2010 382 physicians made 129,161 referrals to specialized care. The RQ was 23.47 and the RV was 4.92. The RQ in women and men was 27.23 and 19.78 for women physicians, being 27.37 and 19.51 for male physicians. The RV in women and men was 4.92 and 5.48 for women physicians, being 4.54 and 4.93 for male physicians. CONCLUSION There are no differences in referral according to physician's sex. However, there are signs that might indicate the existence of gender inequality, and women patient received less referrals. There are no physician-patient's sex interaction.

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Aquest treball analitza, des d’una perspectiva econòmica, l’impacte de la reforma laboral en el mercat de treball espanyol. S’intentarà valorar l’efectivitat de les mesures proposades per el govern per fer front a la, cada cop més elevada, taxa d’atur, mitjançant la reforma laboral del 2012. El treball està estructurat en dos capítols. Un primer capítol que intentarà valorar el context en el que es troba Espanya y un segon capítol que valorarà les mesures i l’impacte d’aquestes en l’economia i en els drets i deures dels treballadors

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Les propietats inherents al art eren la bellesa, la immortalitat i la creativitat humana. Aquestes característiques del art han estat abandonades en la postmodernidad, per exposar-ne un art sense valor estètic, objecte de consum prefabricat i comercial o bé un art conceptual i abstracte; que dista força de la obra humana pensada per perdurar a través del temps. Havent rebutjat el que era tradicionalment essencial al art, podem seguint parlant d’art, doncs? De què es tracta llavors?

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INTRODUCTION: The onset of post-transplant diabetes mellitus (PTDM) among kidney recipients is associated with an increased risk of graft failure and high rates of morbidity and mortality. Minimize the risk of PTDM is a priority for improving long-term survival rates. Aims. This study aims to assess the prevalence of PTDM in a renal transplant patient population, to identify risk factors and assess the graft and patient survival. METHODS: The sample consisted of 112 renal transplant patients , 69 men and 43 women , renal transplant , who attended for five years post-transplant consultation. Were analyzed as potential risk factors for PTDM : age , sex, body mass index (BMI ) , obesity , VHC , hypertension, dyslipidemia , total cholesterol (TC) , serum triglyceride and immunosuppressive therapy ( cyclosporine , tacrolimus , mycophenolate mofetil and sirolimus ), also the prevalence of acute rejection episodes was evaluated. RESULTS: The prevalence of PTDM was 24.2 %, compared with 85 patients (75.8%) with standard glucose (PGN) . PTDM patients showed a higher BMI , a higher percentage of overweight , dyslipidemia , total cholesterol levels , triglycerides and performed a greater percentage of patients with PDMPT including Mycophenolate mofetil was administered. CONCLUSIONS: There is a high incidence of PTDM in kidney recipients , the importance of weight control and strict adherence to all identified risk factors , as well as in minimizing the doses of immunosuppressive therapies to prevent the onset of PTDM.

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BACKGROUND The rate of avoidable caesarean sections (CS) could be reduced through multifaceted strategies focusing on the involvement of health professionals and compliance with clinical practice guidelines (CPGs). Quality improvements for CS (QICS) programmes (QICS) based on this approach, have been implemented in Canada and Spain. OBJECTIVES Their objectives are as follows: 1) Toto identify clusters in each setting with similar results in terms of cost-consequences, 2) Toto investigate whether demographic, clinical or context characteristics can distinguish these clusters, and 3) Toto explore the implementation of QICS in the 2 regions, in order to identify factors that have been facilitators in changing practices and reducing the use of obstetric intervention, as well as the challenges faced by hospitals in implementing the recommendations. METHODS Descriptive study with a quantitative and qualitative approach. 1) Cluster analysis at patient level with data from 16 hospitals in Quebec (Canada) (n = 105,348) and 15 hospitals in Andalusia (Spain) (n = 64,760). The outcome measures are CS and costs. For the cost, we will consider the intervention, delivery and complications in mother and baby, from the hospital perspective. Cluster analysis will be used to identify participants with similar patterns of CS and costs based, and t tests will be used to evaluate if the clusters differed in terms of characteristics: Hospital level (academic status of hospital, level of care, supply and demand factors), patient level (mother age, parity, gestational age, previous CS, previous pathology, presentation of the baby, baby birth weight). 2) Analysis of in-depth interviews with obstetricians and midwives in hospitals where the QICS were implemented, to explore the differences in delivery-related practices, and the importance of the different constructs for positive or negative adherence to CPGs. Dimensions: political/management level, hospital level, health professionals, mothers and their birth partner. DISCUSSION This work sets out a new approach for programme evaluation, using different techniques to make it possible to take into account the specific context where the programmes were implemented.

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El projecte s’emmarca dins els estudis que fa el Ministerio de Ciencia Tecnología y Medio Ambiente de Cuba. Aquest organisme realitza un monitoreig ambiental integral de les platges, avaluant aspectes estructurals, morfològics i dinàmics, estat de la vegetació i qualitat de l’aigua. El projecte es centra en el monitoreig ambiental de l’aigua de les platges, que té com a propòsit fonamental valorar, observar i controlar el recurs aigua per protegir, conservar i millorar la seva qualitat. Es pretén analitzar puntualment i evolutivament la qualitat sanitària de les platges utilitzant la Norma Cubana com a límit establert. Per determinar aquesta qualitat es tenen en compte diferents indicadors físico-químics i microbiològics i també aspectes estètics

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L’objectiu és proporcionar a la població de l’àrea d’estudi (Girona i municipis propers), eines i vies necessàries per tal que puguin ser eficients energèticament i efectius en la seva mobilitat quotidiana. Es crea un mapa d’aptitud per determinar la connexió idònia entre la ciutat de Girona i els municipis inclosos en l’àrea d’estudi mitjançant una xarxa de vies ciclistes, s’analitza el mapa d’aptitud amb la xarxa actual i futura de vies ciclistes, es proposen nous carrils bici per tal d’unir zones exemptes de vies ciclables i s’analitza l’opció de combinar el transport públic (tren i autobús) amb la bicicleta. Per definir la xarxa s’utilitza el programa SIG, considerant uns determinats paràmetres, en un radi de 15 km des de l’Ajuntament de Girona i es compara amb la xarxa de vies ciclables actuals i les propostes de futur. També s’inclou un pressupost

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En el presente trabajo se describe en detalle el funcionamiento del nuevo modelo de financiación regional aprobado en 2009, se analizan sus propiedades dinámicas y se ofrece una valoración crítica del mismo. También se cuantifican los resultados financieros a competencias homogéneas del nuevo sistema en sus dos primeros años de aplicación, 2009 y 2010.