Panorama de la ectasia coronaria en el Instituto Nacional de Cardiología Ignacio Chávez: un estudio transversal / Outlook of coronary ectasia at the National Institute of Cardiology Ignacio Chávez: a cross-sectional study

Resumen Introducción: La ectasia coronaria (EC) es una remodelación patológica con una prevalencia mundial baja. Se define como una dilatación difusa mayor a 1.5 veces el diámetro de los segmentos adyacentes de esta o diferentes arterias coronarias. Objetivo: Documentar las características clínicas y angiográficas, y el tratamiento médico que reciben los pacientes con diagnóstico de EC en el Instituto Nacional de Cardiología (INC). Métodos: Estudio de tipo transversal con diseño no experimental descriptivo, con un muestreo por conveniencia no probabilístico. Resultados: De 69 pacientes que asistieron al INC con diagnóstico de EC la mayor parte eran hombres, con una media de edad de 56 ± 11 años, el factor de riesgo coronario más común en los pacientes con EC fue el tabaquismo, en 40 (58%); se asoció un infarto agudo de miocardio con elevación del segmento ST (IAMCEST) en 45 (65.2%), de localización frecuente en la cara inferior 18 (40%), relacionado con la arteria más afectada, la coronaria derecha 48 (69.6%), seguida de la circunfleja 39 (56.5%). Destaca el uso preferente de la terapia antiplaquetaria dual con anticoagulante (APD+ACO) en 40 (58%) al egreso de cada paciente del INC. Conclusión: La EC es una remodelación patológica no infrecuente en el INC. En este estudio se evidenció que el SCA-IAMCEST es la manifestación más típica de la EC, la coronariografía diagnóstica identificó un Markis tipo 3, por lo que se esperaría una tasa baja de mortalidad y recurrencia de eventos cardiovasculares y a pesar de no existir un consenso sobre la terapia ideal, en el INC se prefiere el tratamiento individualizado, recomendando modificación en el estilo de vida y empleando como tratamiento médico el uso de la triple terapia (APD+ACO) solo al momento de egreso del paciente.

Abstract Introduction: Coronary Ectasia (CE) is a pathological remodeling with a low worldwide prevalence. It is defined as a diffuse dilatation greater than 1.5 times the diameter of the adjacent segments of the same or different coronary arteries. Objective: To document the clinical and angiographic characteristics, and medical treatment at the discharge of patients diagnosed with coronary ectasia who attended the National Institute of Cardiology (INC). Methods: Cross-sectional study with a non-experimental descriptive design, with a non-probabilistic convenience sampling. Results: Of 69 patients who attended the INC with a diagnosis of CD, most were men, with a mean age of 56 + 11 years, the most common coronary risk factor in patients with CE was smoking 58% (40); it was associated mostly with an acute myocardial infarction ST-segment elevation (STEMI) 65.2% (45), of frequent location in the lower face 40% (18), correlated with the most affected artery is the Right Coronary Artery (CD) 69.6% (48), followed by the circumflex (Cx) 56.5% (39). A mean LVEF of 47 + 9.72 was evident within the ventricular function. As well as the preferential use of dual antiplatelet therapy with anticoagulant (DAP + OAC) in 58% (40) at the discharge of each patient from the INC. Conclusion: CE is a not uncommon pathological remodeling in INC. This study showed that STEMI is the most typical manifestation of CE, diagnostic coronary angiography identified a type 3 Markis, so a low rate of mortality and recurrence of cardiovascular events would be expected, and despite the lack of consensus on the ideal therapy, at the INC individualized treatment is preferred, recommending lifestyle changes, and using triple therapy (DAP + OAC) as a medical treatment only at the time of patient discharge.

Therapeutic effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in 31 patients / 中国基层医药

Objective:To investigate the clinical effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in patients. Methods:Sixty-two patients with post-stroke depression who received treatment in Zhongda Hospital of Southeast University from October 2020 to April 2022 were included in this study. They were randomly treated either with traditional Chinese medicine decoction (control group, n = 31) or Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction (combined group, n = 31) based on routine medication. All patients were treated for 4 weeks. Depressive state, neurological function, and activities of daily living were compared between the two groups. Results:Before treatment, there were no significant differences in the Hamilton Depression Scale (HAMD) score, National Institutes of Health Stroke Scale (NIHSS) score, and Barthel index between the two groups (all P > 0.05). After 4 weeks of treatment, the HAMD and NIHSS scores in the control group were (13.88 ± 3.92) points and (8.56 ± 1.82) points, respectively, and they were (8.72 ± 2.48) points and (6.67 ± 1.14) points in the combined group. There were significant differences in HAMD and NIHSS scores between the two groups ( t = 2.14, 2.43, both P < 0.05). The Barthel index in the combined group was (69.53 ± 13.29) points, which was significantly higher than (62.34 ± 15.67) points in the control group ( t = 2.23, P < 0.05). Conclusion:Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction can reduce depressive symptoms and improve neurological function and activities of daily living in patients with post-stroke depression. The combined therapy has obvious efficacy in the treatment of post-stroke depression.

Mechanism and enlightenment of public participation in the NICE health technology assessment in England / 中国药房

OBJECTIVE To analyze the public participation mechanism of National Institute for Health and Care Excellence （NICE） health technology assessment in England and to provide experience for the dynamic adjustment of Chinese medical insurance catalog. METHODS By retrieving related literature and official websites， types and mechanisms of public participation （management organization， selection method， participation mode， evaluation feedback） in NICE health technology assessment were analyzed comprehensively； and based on this， suggestions were put forward to adjust the public participation in Chinese medical insurance catalog. RESULTS & CONCLUSIONS The current public participation types of NICE health technology assessment were patient and carer organizations， HTA committee lay members， patient expert and public observers. At the management level， NICE has set up a public participation team and made guidelines on public participation matters. For different public participation types， NICE has established different selection procedures， such as expression of interest， NICE invitation， open recruitment， nomination， NICE decision， etc. The public participation types are various and in the whole assessing process from the initial determination of the scope of the health technology assessment to the final appeal. Also， NICE has established a flexible and dynamic evaluation feedback system to optimize the way of public participation and the health technology assessment process； NICE has undertaken extensive international cooperation and exchanges to promote public participation at the national and international levels. It is suggested that our country should combine the national conditions， clarify the channel of public participation in health technology evaluation， set up a working group of public participation affairs， strengthen patients’ participation in evaluation and feedback， improve decision-making transparency， and improve the public participation mechanism of health technology evaluation from the aspects of channel opening， management mechanism， evaluation feedback， information disclosure and so on.

Health psychology on long COVID: Strategies based on NICE and WHO guidelines recommendations / Psicología de la salud y COVID persistente: Estrategias basadas en las guías de recomendación NICE y OMS

Abstract Background The chronic aspect that begins to characterize long COVID appeals to the need for interventions proposed by institutions such as the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) to manage the disease, emphasizing behavioral change and self-care. Objective To perform a narrative review of the psychological literature that offers intervention strategies in alignment with the recommendations of the long COVID management guidelines proposed by WHO and NICE. Method MEDLINE, EBSCO, Google Scholar, SciELO, PsycINFO, PubMed, Cochrane, and CONRICYT databases were consulted, using Boolean operators and keywords for an exhaustive search. Results The contributions of the studies were categorized into five intervention strategies based on WHO and NICE recommendation guidelines: Psychoeducation, Self-care, Support networks, Relaxation, and Goal setting. These are given a brief introduction and their relevance to the management of long COVID symptomatology is described. Discussion and conclusion The persistent condition of COVID-19 symptoms makes it necessary to recognize that lifestyle changes must be made, primarily focused on health care and prevention of worsening disease sequelae. These lifestyle changes can be achieved through behavior modification, focusing on protective factors such as education, self-care, support networks, relaxation techniques and, setting appropriate goals.

Resumen Antecedentes El aspecto crónico que empieza a caracterizar al COVID persistente hace un llamado a la propuesta de intervenciones desde instituciones como la Organización Mundial de la Salud (OMS) y el National Institute for Health and Care Excellence (NICE) para lograr un manejo de la enfermedad, el cambio conductual y el autocuidado. Objetivo Elaborar una revisión narrativa sobre la literatura psicológica que ofrece estrategias de intervención acordes a las recomendaciones de las guías de manejo del COVID persistente propuestas por la OMS y el NICE. Método Se consultaron las bases de datos MEDLINE, EBSCO, Google Scholar, SciELO, PsycINFO, PubMed, Cochrane y CONRICYT. Se utilizaron operadores booleanos y palabras claves para una búsqueda exhaustiva. Resultados Las aportaciones de los estudios fueron categorizadas en cinco estrategias de intervención basadas en las guías de recomendación de la OMS y el NICE: Psicoeducación, Autocuidado, Redes de apoyo, Relajación y Establecimiento de metas. En ellas se realiza una breve introducción y se expone su relevancia para el manejo de la sintomatología del COVID persistente. Discusión y conclusión El padecimiento persistente de los síntomas del COVID-19 hace necesario reconocer que deben realizarse cambios en el estilo de vida, principalmente enfocados en el cuidado de la salud y la prevención del empeoramiento de las secuelas de la enfermedad. Estos cambios en el estilo de vida podrán lograrse mediante la modificación de la conducta, orientándola a factores protectores como la educación, el autocuidado, las redes de apoyo, las técnicas de relajación y el establecimiento de metas adecuadas.

Strike Omicron before you Captures It !

Omicron is currently shaking the world to its core. The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol) that infected people exhale as they breathe, talk, cough, sneeze, or sing. “UK becomes first country in Europe to pass 1,50,000 COVID deaths Omicron clouds forecasts for Covid end game.Omicron is a variant of nSARS-CoV-2 that has been identified initially in COVID19 patients in Botswana and South Africa. The chief of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, has said that the combination of Delta and Omicron variants of coronavirus is driving a tsunami of COVID-19 cases. The statement came as record new cases were reported from the United States and countries across Europe. France recorded the highest ever daily numbers in Europe for the second consecutive day, at 208,000 new cases.Vaccines offer strong protection from serious illness.

As transformações recentes no programa de reabilitação profissional do INSS / Recent changes in the Brazilian Social Security Institute's professional rehabilitation program / Las recientes transformaciones en el programa de rehabilitación profesional del Instituto Brasileño de Seguridad Social

Resumo Neste artigo, analisam-se as transformações ocorridas no Programa de Reabilitação Profissional do Instituto Nacional do Seguro Social desde 2009. Considera-se que o referido serviço foi concebido e operacionalizado com base no chamado campo da Saúde do Trabalhador, mas sofreu, a partir de 2018, um processo de desestruturação. As características desse processo são reveladas por meio da análise dos manuais técnicos de procedimentos (2011, 2016 e 2018), pois neles se encontram concepções teóricas, regras de organização e objetivos do serviço. O artigo é desenvolvido em três partes que evidenciam, sequencialmente, a construção do campo da Saúde do Trabalhador, sua inserção na política pública de Previdência Social e, enfim, sua operacionalização e suas transformações por meio dos manuais de procedimentos. Os resultados revelam um processo de desestruturação do programa, que se afasta de uma concepção multidimensional da saúde do trabalhador, ao mesmo tempo que a dimensão biológica se torna central.

Abstract This article analyses the transformations that have taken place in the Professional Rehabilitation Program of the Brazilian Institute of Social Security since 2009. It is considered that the aforementioned service was conceived and operated based on the so-called field of Workers' Health, but since 2018 suffered a process of disruption. The characteristics of this process are revealed through the analysis of technical manuals of procedures (2011, 2016 and 2018), as they contain theoretical concepts, organization rules and service objectives. The article is developed in three parts that sequentially show the construction of the Workers' Health field, its insertion in the Social Security public policy and, finally, its operationalization and its transformations through manuals of procedures. The results reveal a process of de-structuring of the program, which moves away from a multidimensional conception of worker's health, while the biological dimension becomes central.

Resumen En el presente artículo, se analizan las transformaciones que se han producido en el Programa de Rehabilitación Profesional del Instituto Brasileño de Seguridad Social desde 2009. Se considera que el dicho servicio fue concebido y operado en función del llamado campo de la Salud del Trabajador, pero sufrió, desde 2018, un proceso de desestructuración. Las características de este proceso son reveladas en el análisis de los manuales técnicos de procedimientos (2011, 2016 e 2018), pues en ellos se encuentran concepciones teóricas, reglas de organización y objetivos de servicio. El artículo se desarrolla en tres partes que evidencian, en secuencia, la construcción del campo de la Salud del Trabajador, su inserción en la política pública de Seguridad Social y, al fin, su puesta en marcha y sus transformaciones a través de los manuales de procedimientos. Los resultados revelan un proceso de desestructuración del programa, que se distancia de una concepción multidimensional de la salud del trabajador, mientras que la dimensión biológica se vuelve central.

Producción científica de los investigadores del Instituto de Endocrinología indizada en SciELO Cuba/2014-2018 / Scientific production of researchers from the Institute of Endocrinology indexed in SciELO Cuba/2014-2018

Introducción: El estudio del comportamiento de la producción científica es clave para diagnosticar el estado de los centros de investigaciones. Objetivos: Analizar la producción científica de los investigadores del Instituto de Endocrinología indizada en la base de datos SciELO Cuba /2014-2018. Métodos: Estudio cuantitativo, descriptivo y transversal que incluyó todas las publicaciones de los investigadores del Instituto de Endocrinología durante el período 2014-2018 indizadas en SciELO Cuba. Se describió el comportamiento de la producción y colaboración científica mediante indicadores bibliométricos. Resultados: Se confirmó que la producción científica de los investigadores de la institución estuvo presente en 12 revistas especializadas indizadas en la base de datos SciELO Cuba. La autoría múltiple y el artículo original predominaron en la tipología de autoría y en la forma de salida en la muestra de artículos analizados. En la colaboración científica la Doctora Emma Domínguez Alonso fue la autora con mayor grado nodal y la Doctora Daysi Antonia Navarro Despaigne la de mayor grado de intermediación. El Instituto de Endocrinología (INEN) fue la institución que registró mayores niveles de colaboración y mayor grado nodal. La palabra clave con mayor representatividad fue diabetes mellitus. En la productividad por tipología de colaboración predominó la nacional y el año más productivo resultó el 2017(AU)

Introduction: The study of scientific production´s behavior is key for diagnosing the state of research centers. Objectives: Analyze the scientific production of researchers from the Institute of Endocrinology which is indexed in SciELO Cuba /2014-2018 database. Methods: Quantitative, descriptive and cross-sectional non-experimental design study that included all publications of researchers of the Institute of Endocrinology during the period 2014-2018 indexed in SciELO Cuba. The behaviour of scientific production and collaborations was described using bibliometric indicators. Results: It was confirmed that the scientific production of the institution's researchers was present in 12 specialized journals indexed in SciELO Cuba database. Multiple authorship and the original articles predominated in the type of authorship and in the output form in the sample of analyzed articles. In the scientific collaborations, Dr. Emma Dominguez Alonso was the author with the highest nodal degree and Dr. Daysi Antonia Navarro Despaigne had the highest degree of intermediation. The Institute of Endocrinology (INEN, by its acronym in Spanish) was the institution that recorded higher levels of collaborations and higher nodal degree. The most representative keyword was diabetes mellitus. National collaborations predominated in productivity by typology of collaboration, and the most productive year turned out to be 2017(AU)

Reliability of C-reactive protein as a predictor of early neurological deficit in acute ischemic stroke: is it only to be blamed? a retrospective observational study

Background: Ischemic Stroke is a common cause of morbidity and mortality. Various parameters, both clinical and laboratory have been studied as markers of Early Neurological Deterioration (END) out of which CRP has been the most important. This retrospective study of ours is an attempt to study its influence on END by minimizing other variables as much as possible.Methods: 50 patients were chosen retrospectively strictly according to laid down inclusion and exclusion criteria, their data recorded and analyzed with 17.0 SPSS software. Any p value <0.05 was taken as significant.Results: Significantly raised CRP values were found in elderly patients (p=0.0001) and in males (p=0.003). Higher incidences of ENDs were also found in elderly patients (p=0.326) and males (p=0.846) and patients with raised CRP levels (p=0.057).Conclusions: Higher Values of CRP are associated with increased frequency of ENDs. But in patients with multiple factors which can influence both CRP and END, CRP alone should not be thought of as the only culprit.

Especialistas graduados en el Instituto Nacional de Higiene "Rafael Rangel", tutoría y trabajos especiales de grado en el área de vigilancia sanitaria de medicamentos durante el periodo 2007 ­ 2014 / Specialists graduated in the National Institute of Hygiene "Rafael Rangel", tutorship and degree theses in the area of drug sanitary vigilance, period 2007 ­ 2014

El Instituto Nacional de Higiene "Rafael Rangel" (INHRR) inició las actividades académicas de la Especialización en Vigilancia Sanitaria de Medicamentos en septiembre de 2007. En los primeros ocho años de actividad, el Instituto ha concluido tres cohortes de especialistas. El objetivo del presente trabajo fue presentar una descripción de los especialistas graduados en el INHRR, los tutores y los trabajos especiales de grado (TEG) en el área de vigilancia sanitaria de medicamentos durante el periodo 2007 ­ 2014. Para ello, se realizó una investigación documental y de tipo descriptiva, revisando los expedientes resguardados en los archivos de la Coordinación de Postgrado de la Gerencia de Docencia e Investigación del INHRR. Con este programa de postgrado, el Instituto graduó a 27 especialistas en vigilancia sanitaria de medicamentos con un elevado índice académico (17,1 puntos). La mayoría de los egresados de la especialización fueron mujeres farmacéuticas egresadas de la Universidad Central de Venezuela, quienes laboraban en entes públicos al momento de iniciar el programa. El 70% de los TEG defendidos se realizaron dentro de dos de las líneas de investigación que lleva adelante la Gerencia Sectorial de Registro y Control del INHRR, a saber: las buenas prácticas regulatorias y la farmacovigilancia. Catorce profesionales fueron los encargados de dirigir los TEG, bajo la figura de tutor: dos se destacaron por haber dirigido el 44% de los TEG y otros dos por ser egresados de la especialización. Solo el 29% de los tutores fueron externos al Instituto

The National Institute of Hygiene "Rafael Rangel" (INHRR) began the academic activities of the Drug Sanitary Vigilance Specialization in September 2007. In the first eight years, the Institute has graduated three cohorts of specialists. The aim of this work was to present a description of the specialists graduated in the INHRR, their advisors and degree theses (DT) in the field of drug sanitary vigilance, during the period 2007 ­ 2014. Documentary and descriptive research were carried out; reviewing the records kept in the Postgraduate Coordination archives of the Management for Teaching and Research, INHRR. With this program, the Institute graduated 27 specialists in drug sanitary vigilance with a high academic score (17.1 points). Most of the specialists were female pharmacists graduated from the Central University of Venezuela, who worked in public entities when the program began. Seventy percent of the PT was conducted in two of the research lines carried out by the Management of Control and Registry, INHRR, namely: good regulatory practices and pharmacovigilance. Fourteen professionals supervised the PT, under the figure of tutor. Two tutors excelled for supervising 44% of the PT and another two tutors for being graduates of the specialization. Only 29% of the tutors were external to the Institute

Reseña historica de la Gerencia de Seguridad Industrial, ambiente e higiene ocupacional del Instituto Nacional de Higiene "Rafael Rangel" / Historical Overview Industrial Safety, environment and occupational of The National Institute of Hygiene "Rafael Rangel"

La Seguridad Industrial en el INHRR nace con la conformación del primer Comité de Higiene y Seguridad Industrial en el año 1997, cumpliendo con la Norma COVENIN 2270-95 "Conformación de Comités de Seguridad Industrial". En el año 1999, se asigna la creación de la Unidad de Seguridad Laboral y Ambiente a partir del Programa de Seguridad Laboral y Ambiente. Esta Unidad estaba adscrita a la Gerencia de Recursos Humanos del INHRR. El personal que conformó esta Unidad desde sus inicios hasta la actualidad, se ha caracterizado por ser un equipo multidisciplinario con experiencia en distintas áreas técnicas de la Institución y con conocimientos sólidos en trabajos como seguridad de laboratorio químico y biológico, entre otros. Profesionales altamente capacitados, comprometidos, con entrega, ética, mística de trabajo, calidad de servicio y sentido de pertenencia por la Institución. Posteriormente se integra al equipo de trabajo un Médico Ocupacional y una Enfermera Laboral con la finalidad de prestar la atención a los trabajadores y trabajadores de la Institución. En el año 1999, aproximadamente se crea la Brigada de Control de Emergencias de la Institución cumpliendo con la normativa nacional vigente. Dichos integrantes de esta brigada siempre han contado con capacitación o actualización continua en áreas de Combate y Supresión de Incendio Nivel I y II, Materiales Peligrosos Nivel Respondedor y Operaciones, Rescate Básico Nivel I, Primeros Auxilios Nivel I, Técnicas de Desalojo, Reanimación Cardio Pulmonar, entre otros. El 1ero de septiembre del 2013, mediante Punto de Cuenta al Consejo N° 01, Sesión N° 30 de fecha 10/10/2013, fue creada funcional y organizacionalmente la Gerencia de Seguridad Industrial, Ambiente e Higiene Ocupacional, adscrita a la Presidencia del Instituto, cuya función principal es velar por la seguridad laboral, industrial y ambiental tanto de las trabajadoras, trabajadores como instalaciones y el entorno de la Institución, enfatizando en las acciones preventivas, promoviendo la cultura de seguridad y prevención en la Institución, asesorando a las diferentes unidades en materia de seguridad laboral, salud y ambiente, realizando gestiones de manejo de desechos bioinfecciosos, planes de reciclaje de papel, capacitando al personal de la Institución en materia de seguridad, laboral y ambiente, apoyo e intercambio de saberes con Organismos del Estado, en otras actividades, todas estas enmarcadas en el fiel cumplimiento de las leyes, normativas y reglamentaciones vigentes en el País.

The Industrial Safety in the INHRR was born with the conformation of the first Committee of Hygiene and Industrial Safety in the year 1997, fulfilling with the Norm COVENIN 2270-95 "Conformation of Committees of Industrial Security". In 1999, the creation of the Occupational Safety and Environment Unit was assigned based on the Workplace Safety and Environment Program. This Unit was attached to the Human Resources Management of the INHRR. The staff that made up this Unit from its beginnings to the present, has been characterized as a multidisciplinary team with experience in different technical areas of the Institution and with solid knowledge in safe chemical and biological laboratory work, among others. Highly trained professionals, committed, with dedication, ethics, work mystique, quality of service and sense of belonging by the Institution. Later, an Occupational Physician and a Labor Nurse were integrated into the work team in order to provide care to the workers and workers of the Institution. In 1999 approximately the Emergency Control Brigade of the Institution was created, complying with the current national regulations. These members of this Brigade have always had training or continuous updating such areas of Combat and Suppression of Fire Level I and II, Hazardous Materials Level Responder and Operations, Basic Rescue Level I, First Aid Level I, Techniques of Eviction, Cardio Pulmonary Resuscitation among others. On September 1, 2013, through Point of Account to the Board N ° 01, Session N ° 30 dated 10/10/2013 the Management of Industrial Safety, Environment and Occupational Hygiene was created functionally and organizationally, attached to the Presidency of the Institute , whose main function is to ensure the occupational, industrial and environmental safety of both workers, workers and facilities and the environment of the institution, emphasizing preventive actions, promoting the culture of safety and prevention in the institution, advising the different units in matters of occupational safety, health and environment, carrying out management of bioinfectious waste management, paper recycling plans, training the staff of the institution on safety, labor and environment, support and exchange of knowledge with the State Agency, in other activities, all activities framed in faithful compliance with the laws, regulations and regulations in force in the country.

Bibliografía anatómica utilizada en la formación de médicos en Chile entre 1758 y 1840 / Anatomical bibliography used in the training of physicians in Chile between 1758 and 1840

El estudio de la enseñanza de la medicina, desde una perspectiva histórica, es importante para explicar el desarrollo de esta profesión. Considerando el valor de los libros en el currículo universitario su estudio permite comprender la influencia sociopolítica del momento histórico. El objetivo de este trabajo fue determinar y analizar la primera bibliografía utilizada en la formación de médicos en Chile entre 1758 y 1840 (desde la fundación de la Universidad de San Felipe a la muerte del Dr. Pedro Morán). A través de una investigación histórica se logró encontrar los ocho libros de textos utilizados durante este periodo. De ellos, se realizó un análisis descriptivo que abarcó la identificación del autor, el título de la obra, el año, idioma y lugar de publicación. Además, se clasificaron según extensión y enfoque. También se realizó un análisis cuantitativo para determinar la cantidad de información que presentan estos libros en comparación con la literatura moderna. Los resultados se ordenaron en tablas y gráficos para su posterior análisis. Los textos encontrados fueron principalmente editados en España y en idioma español (62,5 %), aunque una parte importante fueron editados en Francia y en francés (37,5 %). Mayoritariamente se utilizó bibliografía de autores franceses (50 %), aunque también se incluyeron libros de autores españoles (37,5 %) y alemanes (12,5 %). Con respecto a la extensión de los textos, tanto los libros de mediana y gran extensión estuvieron representados de igual forma (37,5 %) y los compendios representaron un porcentaje menor (12,5 %). Este trabajo es un aporte a la comprensión del origen de la formación de médicos en Chile y ayuda a comprender el nacimiento de la identidad profesional, que ha sido de gran influencia en la historia político - social de Chile, describiendo la bibliografía que marco el nacimiento de la Historia de la Anatomía en nuestro país.

The study of the teaching of medicine, from a historical perspective, is important to explain the development of this profession. Considering the value of books in the university curriculum, its study allows us to understand the socio-political influence of the historical moment. The objective of this work was to determine and analyze the first bibliography used in the training of doctors in Chile between 1758 and 1840 (from the foundation of the University of San Felipe to the death of Dr. Pedro Morán).Through a historical investigation it was possible to find the eight textbooks used during this period. Of these, a descriptive analysis was carried out that included the identification of the author, the title of the work, the year, language and place of publication. In addition, they were classified according to extension and focus. A quantitative analysis was also carried out to determine the amount of information presented in these books compared to modern literature. The results were arranged in tables and graphs for later analysis. The texts found were mainly published in Spain and in Spanish (62.5 %), although an important part was published in France and in French (37.5 %). The bibliography of French authors was used mainly (50 %), although books by Spanish authors (37.5 %) and Germans (12.5 %) were also included. With respect to the extension of the texts, both the medium and large extension books were represented in the same way (37.5 %) and the compendiums represented a smaller percentage (12.5 %). This work is a contribution to the understanding of the origin of the training of doctors in Chile and helps to understand the birth of professional identity, which has been of great influence in the political - social history of Chile, describing the bibliography that marked the birth of the History of Anatomy in our country.

Prevalence Of Paandu (anaemia) Amongst Patients Reporting At Outpatient Department Of National Institute Of Siddha

Anaemia is the most common nutritional problem in the world .In the outpatient department of National institute of Siddha the significant numbers of anaemia cases are reporting for treatment. As the part of partial completion of 1st year MD degree the investigator select the minor project to determine the data about prevalence of Paandu (Anaemia) in NIS OPD patients. This study includes 500 OPD patients. OPD patients in the age between 13-74 years were randomly selected daily (Systematic random sampling method). A pre-designed self-administrated questionnaire interview method is used for collecting data about the patients. Information on personal characteristics, socio economic status, diet, lab investigations, clinical profiles are obtained. The study results showed that the prevalence of anemia amongst patients reporting at NIS OPD were 45.6%. The mean haemoglobin concentration was 11.4g/dl in female and 12.8g/dl in male. Majority of female in reproductive age (15-49 years) had the highest prevalence of anemia. And the high proportion of microcytic hypochromic anaemia (22.2%) was founded in the selected samples which indicate that Iron deficiency was the main cause of anaemia. Effect of socio economic status on anemic patients reported in NIS also calculated according to ‘Modified Kuppusamy socio economic scale’ which results that patients belongs to the upper lower status (12.2%) are more prone to anemia. Therefore the results of this study can be used to design target interventions aimed at reducing the prevalence of anemia in NIS OPD and to help conduct the interactive educational programs for improve disease awareness in female patients especially. And further studies are needed for clarify prevalence and etiology of anaemia in school going children (Below 13 years) at NIS OPD.

‘Obesageing’: Linking obesity & ageing

Obesity is one of the leading causes of preventable mortalities in many parts of the globe. The rise in geriatric population due to better treatment opportunities has also emerged as a major public health challenge. Both of these health challenges have impacted developed as well as developing countries. Obesity is attributed as a powerful risk factor of a variety of health problems such as cardiovascular diseases, hypertension, type 2 diabetes, dementia, neuropsychiatric diseases and many more. On the other hand, ageing is a natural process involving a gradual decline in physiological functions and is associated with similar co-morbidities as obesity. This review discusses about the commonalities (termed as ‘Obesageing') between the pathological phenomenon of obesity and normal physiological process of ageing. A unique rodent model of obesageing has been developed (WNIN/Ob) that has characteristics of morbid obesity as well as premature ageing. Such a novel animal model would facilitate the understanding of the complex interplay of different mechanisms that are common to obesity and ageing and help to devise strategies in future to tackle the growing burden of obesity and ageing.

A Clinical Audit: Intrapartum Care in Third Stage of Labor

Introduction: The third stage of labor is the time from the birth of the baby to the expulsion of the placenta and membranes.Management is normally categorized into two types; active management and physiological management. Active managementof the third stage involves a package of care comprising the following components: Routine use of uterotonic drugs, deferredclamping, and cutting of the cord controlled cord traction after signs of separation of the placenta. Most common complicationsof the third stage of labor are postpartum hemorrhage and retained placenta.Aims and Objectives: The present clinical audit aims to improve the care of healthy women and their babies during the thirdstage of child and to review the practices regarding the third stage of labor and to develop and implement action plan regardingmanagement strategies.Materials And Methodology: The audit was carried out on 218 pregnant women admitted in Rajarajeswari Medical Collegeand Hospital from April 2018 to September 2018. The inclusion criteria, exclusion criteria, and data collection on the excel sheetwere based on the National Institute for Health and Care Excellence (NICE) guidelines.Results: Among 218 cases, vaginal blood loss was recorded in 181 (83%) cases whereas the color, respiration, and generalcondition were recorded in all 218 cases. In all 218 cases, active management of the third stage was carried out, and decisionregarding the same was recorded. The time of cord clamping was recorded in only 6% of the cases. The management ofpostpartum hemorrhage and retained placenta met audit standard in all 218 cases.Conclusion and Recommendations: The present clinical audit suggests that there is a need to follow specific guidelines andtreatment strategies to avert the complications. Recording of vaginal blood loss in all cases, instructions for the compulsoryrecording of the cord clamping time following the birth of a baby and continue to follow the remaining steps according to theNICE guidelines to reduce the complications of the third stage of labor.

Una breve historia de la Quinta de Segovia / A brief history of the Quinta de Segovia

En la Quinta de Segovia, que desde 1830 fue propiedad del señor Alejandro Carrasquilla, funcionó el Instituto Nacional de Agricultura y, posteriormente, a finales del siglo XIX, operó el Instituto Carrasquilla destinado a la investigación y estudio de enfermedades como la lepra.

In the Quinta de Segovia, which since 1830 was owned by Mr. Alejandro Carrasquilla, the National Institute of Agriculture worked and, later, at the end of the 19th century, the Carrasquilla Institute operated for the research and study of diseases such as leprosy.

Theranostics in Bangladesh: Current Status, Challenges, and Future Perspective / 대한핵의학회잡지

BACKGROUND AND CURRENT STATUS OF THERANOSTICS: Therapeutic nuclear medicine (NM) in Bangladesh began in the early 1980s with the application of radioactive iodine for treatment of thyroid cancer and primary hyperthyroidism. Since then, NM practice has remarkably developed in the country with the advancement of instrumentation, radiopharmacy, and information technology. The government took the initiative to establish four PET-CTcenters at different NMcenters, including one at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS). A further development is the installation of a cyclotron center (18-MeV cyclotron) at NINMAS by the government's fund. Currently, NM is providing good health services to oncology patients throughout the country. More than 20 NM centers are functioning in different parts of the country, and therapeutic NM has an important place. However, conventional radioactive iodine still remains the major theranostic application.CHALLENGES AND FUTURE PERSPECTIVE: The expansion and development of therapeutic NM for other cancers have been limited due to a number of challenging factors. A brief overview of the history and current status ofNMin Bangladesh is presented here with an examination of factors that pose as obstacles to the introduction and development of new therapeutic technologies. Finally, future perspectives are discussed with ways to mitigate existing problems and challenges.

The including and recommendation of acupuncture in NGC and NICE / 中国针灸

The diseases recommended to be treated by acupuncture and the recommendation in the National Guideline Clearinghouse (NGC) and the National Institute for Health and Care Excellence (NICE) were summarized, and the diseases recommended were analyzed. The guidelines which mentioned acupuncture in NICE and NGC were searched and classified according to the types of diseases and intensity of recommendations. As a result, 45 guidelines in NGC were included, involving 59 recommendations; 29 guidelines in the NICE, involving 29 recommendations. The diseases recommended by NICE and NGC were mainly pain-related diseases, and the diseases recommended by NGC were wider. However, both needed to further describe the specific operation methods of acupuncture.

Prognostic significance of hs-CRP in acute ischemic stroke patients

Background: Stroke, a serious neurological disease is a major cause of death and disability throughout world. The pathophysiology of stroke involves inflammatory pathways, oxidative damage, apoptosis, angiogenesis and neuroprotection. High sensitivity C - reactive protein (hs-CRP) is associated with atherosclerosis and predict incident stroke in many patients. Objective of present study was to find out change in pattern of hs-CRP in acute ischemic stroke (AIS) patients during 3-months follow up and its prognostic significance.Methods: Single centre prospective cross-sectional time bound study. 256 were screened and 130 meet the inclusion and exclusion criteria, of which 100 gave informed consent and 80 patients completed the study at 3 months. Demographic, clinical parameters including NIHSS scoring, biochemical analysis was collected at enrolment, discharge and at end of the study.Results: hs-CRP levels in AIS increased significantly (within 24 hours of stroke) and continued to increase further at discharge, while decreased significantly during 3 months follow up. >7mg/dl hs-CRP at admission had 3.5 fold higher risk of mortality. Age >60 years, metabolic syndrome, hyperlipidemic, SBP >160mmHg and hs-CRP > 7 mg/dL increases relative risk in AIS stroke patients by 1.42, 1.09, 1.11, 1.577 and 3.23 fold respectively.Conclusions: hs-CRP increased significantly in AIS patients during 1st weeks of stroke with subsequent gradual decrease by the end of 3 months, the severity scoring system could determine prognosis on admission to ICU while hs-CRP is the main factor determining short as well as long term prognosis. We recommend serial measurements of hs-CRP for prognostication in AIS subjects.

Diez años de la regulación de los productos de uso y consumo humano en el Instituto Nacional de Higiene "Rafael Rangel" (2008-2018) / Ten years of the sanitary regulation of the products of use and human consumption in the National Institute of Hygiene "Rafael Rangel" (2008-2018)

La Gerencia Sectorial de Registro y Control se crea en el año 1993 con el objetivo de proteger la salud y la vida de la población Venezolana, estando conformada por la División de Control de Medicamentos y Cosméticos, la División de Control de Alimentos y la División de Control Nacional de Productos Biológicos. Esta Gerencia viene a llenar un vacío legal existente en materia de salud y entre sus funciones se encuentran: •Otorgar el Registro Sanitario, Renovación y Cambios Post- Registro a los Medicamentos (Especialidades Farmacéuticas y Productos Biológicos) comercializados en el país, previa evaluación de su calidad, seguridad y eficacia. •Realizar el Control Sanitario de los medicamentos. •Evaluar con fines de registro y control sanitario los alimentos, productos naturales, cosméticos, productos médicos y otros productos de uso y consumo humano. •Evaluar los Protocolos de Investigación Clínica de Medicamentos. •Efectuar la Farmacovigilancia de los medicamentos distribuidos a nivel nacional. •Evaluar el desempeño en Serología de los Bancos de Sangre del país. •Coordinar la Red Venezolana de Laboratorios de Análisis de Alimentos. •Participar en las Redes Internacionales de Armonización y Cooperación en el área de competencia.

The Sectorial Management of Registration and Control was created in 1993 with the objective of protecting the health and life of the Venezuelan population, being formed by the Division of Control of Medicines and Cosmetics, the Division of Food Control and the Division of National Control of Biological Products. This Management comes to fill an existent legal void in matter of health and between its functions they are: •Grant the Sanitary Registration, Renewal and Post-Registration Changes to Drugs (Pharmaceutical Specialties and Biological Products) marketed in the country, after evaluating their quality, safety and efficacy. •Carry out the Sanitary Control of medicines. •Evaluate for sanitary registration and control purposes food, natural products, cosmetics, medical products and other products for human use and consumption. •Evaluate the Clinical Drug Resechar Protocols. •Carry out pharmacovigilance of medicines distributed nationwide. •Evaluate the performance in Serology of the Blood Banks of the country. •Coordinate the Venezuelan Network of Food Analysis Laboratories. •Participate in the International Networks of Harmonization and Cooperation in the eaar of competence

Desarrollo histórico y logros de la Gerencia de Docencia e Investigación del Instituto Nacional de Higiene "Rafael Rangel" / Historical development and achievements of the Teaching and Research Management of the National Institute of Hygiene "Rafael Rangel"

La Gerencia de Docencia e Investigación es creada en el año 1992. Actualmente está conformada por la Coordinación de Postgrado, Coordinación de Investigación, Coordinación de Extensión, Pasantías, Campus Virtual, Departamento de Información y Divulgación Científica. La Gerencia tiene las siguientes funciones fundamentales: Programar, diseñar, coordinar y asesorar líneas de investigación, proyectos de investigación y producción de conocimiento científico de acuerdo a las políticas institucionales y del estado en el Sector Salud. Planificar y ejecutar programas docentes de 4to y 5to nivel, conducentes y no conducentes a grado académico en las áreas de competencia del Instituto. Programar y ejecutar la formación y capacitación del talento humano especializado, mediante diplomados, talleres, entrenamientos, simposia, jornadas, ampliación, actualización, perfeccionamiento profesional y extensión en el área de Salud. Gestionar y evaluar la formación y capacitación de talento humano procedente de instituciones educativas y de salud, mediante pasantías académicas y profesionales. Planificar, programar, coordinar, ejecutar y supervisar todas aquellas actividades, espacios y aulas virtuales de interacción, aprendizaje e-learning, trabajos en red, consultorías y tutorías telemáticas, acceso a materiales didácticos on-line, telebibliotecas, entre otros, tanto para el campus virtual de la Institución, como del Campus Virtual de Salud Pública Nodo Venezuela (éste último con otros organismos y apoyo de la Organización Panamericana de la Salud), enfocado a la formación y desarrollo de las competencias técnico-profesionales de los trabajadores en servicio y de las capacidades de las instituciones dedicadas a la prestación de servicios de salud pública en un formato virtual/semipresencial, brindando nuevas posibilidades de aprendizajes en entornos innovadores. Suministrar información especializada en el área de la salud, a través de servicios de divulgación, bibliotecarios, de documentación, edición de publicaciones e interactuar con otros centros de información científica para el cumplimiento de estos objetivos. Desarrollar y participar en las actividades de la Biblioteca Virtual en Salud de la OPS/BIREME. Preservación del Acervo Histórico Institucional. Este artículo contiene los siguientes aspectos: Antecedentes históricos de la Gerencia de Docencia e Investigación. Logros y desarrollo en el período 2008-2018. Reflexiones sobre la Política y los Planes de Formación del Instituto Nacional de Higiene "Rafael Rangel".

The Teaching and Research Management was created in 1992. It is currently made up of the Postgraduate Coordination, Research Coordination, Extension Coordination, Internships, Virtual Campus, Department of Information and Scientific Dissemination. Management has the folwloing fundamental functions: Schedule, design, coordinate and advise on research lines, research projects and production of scientific knowledge according to institutional and state policies in the Health Sector. Plan and execute teaching programs of 4th and 5th level, conducive and not conducive to academic degree in the areas of competence of the Institute. Schedule and execute the training and training of specialized human talent, through diplomas, workshops, training, symposia, conferences, expansion, updating, professional development and extension in the area of Health. Manage and evaluate the training and training of human talent from educational and health institutions, through academic and professional internships. Plan, program, coordinate, execute and supervise all those activities, spaces and virtual classrooms for interaction, e-learning learning, networking, consultancies and telematics tutorials, access to on-line teaching materials, tele-libraries, among others, for both the institution's virtual campus, such as the Virtual Campus of Public Health Nodo Venezuela (the latter with other organizations and support of the Pan American Health Organization), focused on the training and development of technical-professional skills of workers in service and of the capacities of the institutions dedicated to the provision of public health services in a virtual / blended format, providing new possibilities for learning in innovative environments. Provide specialized information in the area of health, through outreach services, librarians, documentation, publishing publications and interact with other scientific information centers for the fulfillment of these objectives. Develop and participate in the activities of the Virtual Health Library of PAHO / BIREME. Preservation of the Historical Institutional Collection. This article contains the following aspects: Historical background of the Teaching and Research Management. Achievements and development in the period 2008-2018. Reflections on the Policy and Training Plans of the National Institute of Hygiene "Rafael Rangel".