Vinculación con la sociedad y universidad saludable / Linkage with society and healthy university

Este es un breve ensayo que intenta compartir el lenguaje académico con la población para integrar junto a los actores locales, de manera colectiva y participativa, los aportes de la investigación individual en acciones concretas que beneficien a los grupos sociales, como sucedió en el siglo pasado, cuando se gestó la revolución solidaria de las mujeres por sus derechos, el ejercicio físico cotidiano para el cuidado del cuerpo y la defensa de la naturaleza. La vinculación con la sociedad es uno de los tres componentes misionales de la Universidad, junto con la docencia y la investigación. Otorga a la universidad la pertinencia como relación de las necesidades de la población con los perfiles de las carreras. Se encarga del nexo entre la academia y el desarrollo humano local, tanto urbano como rural. Este desarrollo no es exclusivamente económico y está en manos de las organizaciones sociales locales, es decir de la población organizada, y dependen del rol del Estado. (AU)

This is a brief essay that tries to share the academic language with the population to inte-grate with the local actors, in a collective and participative way, the contributions of individ-ual research in concrete actions that benefit the social groups, as happened in the last cen-tury., When the solidarity revolution of women was born for their rights, the daily physical exercise for the care of the body and the defense of nature. The link with society is one of the three missionary components of the University, along with teaching and research. It gives the university the pertinence as a relation of the needs of the population with the pro-files of the careers. It is responsible for the link between academia and local human devel-opment, both urban and rural. This development is not exclusively economic, and it is in the hands of the local social organizations, the organized population, and depends on the role of the State. (AU)

Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections.

Since the first description in 1982, totally implanted venous access ports have progressively improved patients' quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique) is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port.

Servicios de Salud en Ecuador, Entre lo Biológico, Cultural y Social

El artículo intenta mostrar la relación entre dos exigencias de la Constitución ecuatoriana de 2008: los principios ancestrales del "Sumak Kawsay" o Buen Vivir y el Sistema Nacional de Salud, el primero equivalente a "salud" como óptima calidad de vida basada en la satisfacción de las necesidades humanas individuales, grupales o culturales y sociales, el segundo como adecuado o no a dichos planteamientos. Se estudió dicha relación mediante una encuesta con los profesionales de salud de los servicios de poblaciones, rurales y urbanas, del sur ecuatoriano. Se encontró que la biomedicina no se coordina con la Atención Primaria de Salud, ni con los principios ancestrales, por lo que el Estado no define aún un adecuado Sistema Nacional de Salud. Se concluye que hay falta de relación entre lo biológico, cultural y social, pues, sólo existen protocolos clínicos pero hay ausencia de normas para lo cultural y lo social. El sistema no es aún integral al no incluir y relacionar lo biomédico con lo cultural y social.

The article intends to show the relationship among two components of the Ecuadorian constitution of 2008: the ancestral "Sumak Kawsay" principles of Well Being and the National Health System, the first one equivalent to health as best quality of life or welfare based on satisfaction of individual, cultural and social needs, and the second the adequacy of the system to such a principles. The relationship was studied through a qualitative survey with health professionals in rural and urban southern Ecuadorian populations. It was founded that biomedicine was not coordinated with Primary Health Care, neither with the ancestral principles, so the State had not already an adequate health system. The conclusion established that there is not a relationship among biological, cultural and social issues. There are only protocols for the clinical issues but not for the cultural and social ones, as protocols were only for clinical purposes, but not for cultural and social cases. The system is not yet integrated with such issues.

A study of mechanical optimization strategy for cardiac resynchronization therapy based on an electromechanical model.

An optimal electrode position and interventricular (VV) delay in cardiac resynchronization therapy (CRT) improves its success. However, the precise quantification of cardiac dyssynchrony and magnitude of resynchronization achieved by biventricular (BiV) pacing therapy with mechanical optimization strategies based on computational models remain scant. The maximum circumferential uniformity ratio estimate (CURE) was used here as mechanical optimization index, which was automatically computed for 6 different electrode positions based on a three-dimensional electromechanical canine model of heart failure (HF) caused by complete left bundle branch block (CLBBB). VV delay timing was adjusted accordingly. The heart excitation propagation was simulated with a monodomain model. The quantification of mechanical intra- and interventricular asynchrony was then investigated with eight-node isoparametric element method. The results showed that (i) the optimal pacing location from maximal CURE of 0.8516 was found at the left ventricle (LV) lateral wall near the equator site with a VV delay of 60 ms, in accordance with current clinical studies, (ii) compared with electrical optimization strategy of E(RMS), the LV synchronous contraction and the hemodynamics improved more with mechanical optimization strategy. Therefore, measures of mechanical dyssynchrony improve the sensitivity and specificity of predicting responders more. The model was subject to validation in future clinical studies.

Emerging agents to combat complicated and resistant infections: focus on ceftobiprole.

Antimicrobial resistance is a global concern. Over the past few years, considerable efforts and resources have been expended to detect, monitor, and understand at the basic level the many different facets of emerging and increasing resistance. Development of new antimicrobial agents has been matched by the development of new mechanisms of resistance by bacteria. Current antibiotics act at a variety of sites within the target bacteria, including the cross-linking enzymes in the cell wall, various ribosomal enzymes, nucleic acid polymerases, and folate synthesis. Ceftobiprole is a novel parenteral cephalosporin with high affinity for most penicillin-binding proteins, including the mecA product penicillin-binding protein 2a, rendering it active against methicillin-resistant staphylococci. Its in vitro activity against staphylococci and multiresistant pneumococci, combined with its Gram-negative spectrum comparable to that of other extended-spectrum cephalosporins, its stability against a wide range of beta-lactamases, and its pharmacokinetic and safety profiles make ceftobiprole an attractive and well tolerated new antimicrobial agent. The US Food and Drug Administration granted ceftobiprole medocaril fast-track status in 2003 for the treatment of complicated skin infections and skin structure infections due to methicillin-resistant staphylococci, and subsequently extended this to treatment of hospital-acquired pneumonia, including ventilator-associated pneumonia due to suspected or proven methicillin-resistant Staphylococcus aureus.

El cóndor, la serpiente y el colibrí. La OPS/OMS y la salud pública en el Ecuador del siglo XX / The Condor, the Snake and the Hummingbird. PAHO/OMS and Public Healht in Ecuador of the Century XX

Contiene la evolución de la salud pública en el Ecuador, los diversos aportes científicos, los personajes que han influido en esta evolución. Además la cooperación técnica que ha realizado OPS en las diferentes instancias de este proceso. Esta obra es el homenaje por el centenario de OPS y los editores aspiran que sea un legado para la posteridad, como una cédula de identidad de los trabajadores de la salud ecuatorianos...

Gestión y Liderazgo: Manual de administración en salud para ministros nuevos / Management and Leadership: Manual of administration in health for new ministers

Contiene las normas y la metodolog¡a para desarrollar una adecuada planificaci¢n, organizaci¢n y administraci¢n en el sector salud. También aborda el proceso gerencial y formaci¢n de l¡deres como determinantes en los cambios estructurales de la salud...

Estudio de las series cronológicas: un caso práctico

Trabajo de investigación sobre series cronológicas y su aplicación a un caso práctico como el volumen de agua potable enviado a la red y líquidos cloacales tratados por la municipalidad de Santa Rosa. Estudia un período de 13 años; determinan tendencias y analiza las correlaciones