Impact of High-Flow Nasal Cannula Use in Subjects With COVID-19 ARDS at High Altitudes: Clinical Presentation and Prognostic Factors.

BACKGROUND: High-flow nasal cannula (HFNC) reduces the need for intubation in adult subject with acute respiratory failure. Changes in hypobaric hypoxemia have not been studied for subject with an HFNC in ICUs at altitudes > 2,600 m above sea level. In this study, we investigated the efficacy of HFNC treatment in subjects with COVID-19 at high altitudes. We hypothesized that progressive hypoxemia and the increase in breathing frequency associated with COVID-19 in high altitudes affect the success of HFNC therapy and may also influence the performance of the traditionally used predictors of success and failure. METHODS: This was a prospective cohort study of subjects >18 y with a confirmed diagnosis of COVID-19-induced ARDS requiring HFNC who were admitted to the ICU. Subjects were followed up during the 28 d of HFNC treatment or until failure. RESULTS: One hundred and eight subjects were enrolled. At admission to the ICU, FIO2 delivery between 0.5-0.8 (odds ratio 0.38 [95% CI 0.17-0.84]) was associated with a better response to HFNC therapy than oxygen delivery on admission between 0.8-1.0 (odds ratio 3.58 [95% CI 1.56-8.22]). This relationship continued during follow-ups at 2, 6, 12, and 24 h, with a progressive increase in the risk of failure (odds ratio 24 h 13.99 [95% CI 4.32-45.26]). A new cutoff for the ratio of oxygen saturation (ROX) index (ROX ≥ 4.88) after 24 h of HFNC administration was demonstrated to be the best predictor of success (odds ratio 11.0 [95% CI 3.3-47.0]). CONCLUSIONS: High-altitude subjects treated with HFNC for COVID-19 showed a high risk of respiratory failure and progressive hypoxemia when FIO2 requirements were > 0.8 after 24 h of treatment. In these subjects, personalized management should include continuous monitoring of individual clinical conditions (such as oxygenation indices, with cutoffs adapted to those corresponding to high-altitude cities).

Caracterización de la productividad de las ebanisterías de Quibdó, Chocó-Colombia

El objetivo de esta investigación es caracterizar la productividad de los talleres de transformación secundaria de madera de la ciudad de Quibdó, Chocó. El tipo de investigación utilizado en el estudio es descriptivo y el método es observacional, como muestra se seleccionaron 50 talleres de ebanisterías del sector de fabricación de muebles de madera. Los instrumentos empleados para recabar la información fueron: encuesta semiestructurada, visitas observacionales y conversaciones informales con propietarios y trabajadores del gremio. La productividad de las ebanisterías se analizó desde los procesos operacionales, recurso humano e indicadores económicos y financieros. En términos económicos y financieros, la productividad de los talleres se caracterizó por ser rentable, siendo la relación beneficio/costo superior a uno (1); los indicadores evaluados demuestran que los procesos operacionales se realizan conforme con los planes de cada taller y el recurso humano tiene las habilidades y destrezas para realizar los trabajos, además de cumplir con sus funciones. La investigación permite concluir que el sector de fabricación de muebles tiene potencial de desarrollo y factores que están a su favor para mejorar los niveles de productividad obtenidos, y de este modo puedan ser competitivos en los mercados regional y nacional.

The aim of this study is to characterize the cabinetmaking in Quibdó, Chocó, using descriptive research and observational method, 50 cabinetmaker's workshops were selected as sample. The instruments used to collect data were: semistructured survey observational visits and informal discussions with cabinetmaking owners and cabinetmakers. The cabinetmaking productivity was analyzed from operational processes, human resources and economic and financial indicators. From an economic and financial point of view the cabinetmaker's workshops productivity was profitable; the cost-benefit ratio was greater than 1. Evaluated indicators show that operational processes are carried out according to each cabinetmaking's plan; human resource has the skills to perform this kind of work. The investigation allows to conclude that the sector of furniture manufacture has development potential and factors that are in its favor to improve the levels of productivity obtained, and thus could be competitive on the regional and national market.

O objetivo desta pesquisa é caracterizar a produtividade da oficina de madeira secundária da cidade de processamento de Quibdo, Choco. O tipo de pesquisa usado no estudo é o método descritivo e observacional, como mostrado ebanisterías foram selecionados 50 oficinas de fabricação da indústria de móveis de madeira. Os instrumentos utilizados para a coleta de dados foram: questionário semi-estruturado, visitas de observação e discussões informais com os proprietários e trabalhadores de união. produtividade Ebanisterías foi analisado a partir de processos operacionais, recursos humanos e indicadores económicos e financeiros. Em termos económicos e financeiros, a produtividade das oficinas foi caracterizado como o custo-benefício, o benefício / relação de custo (1) superior a um; os indicadores avaliados demonstram que os processos operacionais são realizados em conformidade com os planos de cada oficina e de recursos humanos tem as habilidades para realizar o trabalho, além de cumprir os seus deveres. A pesquisa apoia a conclusão de que o setor de fabricação de móveis tem potencial de desenvolvimento e factores estão a seu favor para melhorar os níveis de produtividade alcançados, e, portanto, pode ser competitivo nos mercados regionais e nacionais.

Actitudes hacia la sexualidad de estudiantes de enfermería menores de 20 años de una universidad colombiana / Attitudes towards sexuality of nursing students under 20 years old from a Colombian university

Objetivo: Para describir las actitudes hacia la sexualidad de los alumnos de enfermería de una universidad colombiana, en el año 2009 se realizó un estudio de corte transversal en el cual participaron todos los estudiantes menores de 20 años. Metodología: Se utilizó una encuesta de carácter anónimo que contenía información sobre la edad y el sexo, además de la escala Trueblood Sexual Attitudes Questionnaire (TSAQ) que evalúa las actitudes ante la sexualidad propia (yo) y la de los demás (otros); se obtuvo un puntaje promedio máximo de 9, que equivaldría a la mayor liberalidad. Resultados: Participaron 44 alumnos, cuyo promedio de edad fue de 18 años; el 77% de los participantes era de sexo femenino. El puntaje promedio total fue = 4,6; los puntajes promedio por subescala fueron: heterosexualidad = 5,7; comercio sexual = 4,8; autoerotismo = 4,7; variación sexual = 4,1 y homosexualidad = 3,6. Los puntajes de las actitudes hacia la sexualidad propia fueron menores que los de la sexualidad de los demás. Conclusión: Se concluyó para esta investigación que los estudiantes de enfermería tuvieron una moderada liberalidad frente a las actitudes hacia la sexualidad propia y de los otros.

Objetivo: Descrever as atitudes da sexualidade dos alunos de enfermagem de uma universidade colombiana. Estudo de corte transversal com a participação de todos os estudantes menores de 20 anos em 2009. Metodologia: Utilizou-se uma enquete de caráter anônima que continha informação sobre a idade e o sexo, além da escala Trueblood Sexual Attitudes Questionnaire (TSAQ), que avalia as atitudes ante a sexualidade própria (eu) e a dos demais (outros); tem uma porcentagem média máxima de 9, que equivaleria à maior liberalidade. Resultados: Participaram 44 alunos, média de idade: 18 anos, sexo feminino: 77%. Porcentagem média total = 4,6. Porcentagens média por subescala: heterosexualidad = 5,7; comércio sexual = 4,8; autoerotismo = 4,7; variação sexual = 4,1 e homossexualidade = 3,6. As porcentagens das atitudes para a sexualidade própria foram menores do que os da sexualidade dos demais. Conclusão: A conclusão é: os estudantes de enfermagem têm uma moderada liberalidade frente às atitudes para a sexualidade própria e dos outros.

Objetive: In order to describe attitudes towards sexuality of nursing students from a Colombian university, a cross sectional study was made in 2009. Method: Participants where all students under 20 years. An anonymous survey with information about age, gender, as well as the Trueblood Sexual Attitudes Questionnaire (TSAQ) which assess attitudes towards your own (me) and the others (others) sexuality. It had an average maximum score of 9, which matches with greater liberalism. Results: 44 students participated. The average age was 18 years old; 77% of the participants were females. Average total score was = 4,6. Average scores by subscale were: heterosexuality = 5,7; sexual trade = 4,8; self-eroticism = 4,7; sexual variation = 4,1 and homosexuality = 3,6. Scores of attitudes towards self-sexuality were lower than the ones from the others sexuality. Conclusion: To this study the conclusion was that nursing students had a moderate liberalism towards self and other's sexuality attitudes.

Representaciones culturales del proceso de enfermedad en pacientes provenientes del área rural / Cultural performances of the process illness in patients from the rural area

El objetivo de esta investigación es conocer las representaciones culturales frente al proceso de enfermedad en los pacientes provenientes del área rural de Norte de Santander, que egresaron del servicio de Urgencias del Hospital Universitario Erasmo Meoz (ESE HUEM). EL estudio es de enfoque cualitativo de abordaje etnográfico. Se definió la muestra de tres informantes, de modo intencional. El método para la recolección de la información que se utilizó en esta investigación fue la observación, las notas de campo y la entrevista a profundidad, que permitió aprender y conocer mas a fo n d o cómo los pacientes del área rural conceptualizan la experiencia de estar enfermos y cuáles son los cuidados culturales que aplican durante este proceso. Los resultados de esta investigación permitieron observar que la enfermedad es un enemigo común para las personas del área rural, para mantener el equilibrio de la persona con el entorno natural estos pueden atravesar cuatro fases: fase tomásica, fase de rituales culturales, fase auxilio multidisciplinario y fase reestructuración del cuidado. La cultura es definitivamente el juez que califica las acciones de las personas, para unos la enfermedad es un castigo, por el mal comportamiento que han tenido en un momento de su vida y para otros es simplemente una prueba para que Dios perdone sus pecados; así que el acontecimiento puede ser el mismo pero la cultura transforma la definición del evento.

The target of this investigation is to know the cultural representations opposite to the illness process in the patients originated from the rural area of North of Santander, which went away(graduated) from the first aid service of the University Hospital Erasmo Meoz (THIS HUEM). The study is of qualitative approach of ethnographic collision. There was defined the sample of three informants, of an intentional way. The method for the compilation of the information that is used in this investigation was the observation, the field notes and the interview to depth, which allowed to learn and know more thoroughly like the patients of the rural area conceptualize the experience of being sick and what is the cultural care that apply during this process. The results of this investigation allowed to observe that the illness is a common enemy for the persons of the rural area, to support the balance of the person with the natural environment these can to travesar four phases: tomásica phase, phase of cultural rituals, phase multidisciplinary help and phase restructuring of the care. The culture is definitely the judge who qualifies the actions of the persons, for some the illness is a punishment, for the bad behavior that they have had in a moment of his life and for others it is simply a test so that God excuses his sins; so the event can be the same but the culture transforms the definition of the event.