Clima organizacional en una institución prestadora de salud de Montería - Córdoba, 2015 / Organizational climate in a health providing Institution of Monteria - Cordoba, 2015

Objetivo. Determinar el clima organizacional de una Institución Prestadora de Salud (IPS), con el fin de establecer estrategias que permitan mejorar el ambiente laboral. Materiales y métodos. Estudio Descriptivo de corte transversal, con enfoque cuantitativo. La población la representaron el total de empleados de la institución, la muestra se aplicó una fórmula estadística que permitió establecer el total de 193 empleados a los que se les aplicó el instrumento de recolección de la información. Se utilizó la técnica encuesta mediante el instrumento cuestionario establecido por la Encuesta sobre el Clima Organizacional basado en los 4 pilares propuestos por la Organización Panamericana de Salud (OPS). Finalmente después de haber recolectado toda la información mediante las encuestas, se procedió a tabularlas mediante una hoja de Excel, y finalmente a realizar las tablas, gráficos y análisis correspondiente, según los objetivos y variables de estudio. De acuerdo a la resolución 08430 de 1993, el estudio fue clasificado sin riesgo, se respetó la confidencialidad, la anonimicidad del encuestado y la institución. Resultados. Se encontraron niveles de satisfacción por encima del 80% en factores como la comunicación, relaciones interpersonales y valores comunicativos y por debajo del 20% en factores como el bienestar social, nivel de capacitación y la compensación y reconocimiento. Conclusiones. Se realizó el diagnóstico del clima organizacional, el cual evidenció fortalezas en la comunicación, el trabajo en equipo, la coperación y liderazgo, por el contrario se obtuvierion oportunidad de mejora en factores como la promoción y el ascenso.

Objective. To determine the organizational climate of a Health care Provider Institution (HPI) to establish some strategies to improve the work environment. Materials and Methods. This was a quantitative, descriptive, and cross-sectional study. The population consisted of all the Institution's employees. A statistical formula was applied to choose the sample. This procedure allowed for the use of the data collection instrument with all the employees. A questionnaire for the survey established for the organizational climate based on the four pillars proposed by Health Pan-American Organization was used. Finally, once all the information was obtained through the survey, the tabulation was done through an Excel spreadsheet, tables and graphics were created, and data analysis completed according to the study variables. In line with Resolution08430,1993, the study was classified as risk-free. Also, the confidentiality and anonymity of both the research participants and the Institution were respected. Results. Levels of satisfaction higher than 80% were founding factors, such as communication, interpersonal relationships, and communicative values. Levels lower than 20% were found in factors, such as wellbeing, level of training as well as compensation and recognition. Conclusions. The diagnosis of the organizational climate revealed communication strengths, team work, cooperation, and leadership. Improvement opportunities in factors, such as promotion and raise were discovered as well.

Diversidad antigénica de las vacunas antiparotiditicas / Antigenic diversity of vaccines againts mumps

La parotiditis es una enfermedad infecciosa inmunoprevenible  causada por el virus de la parotiditis, miembro del género Rubulavirus, familia Paramyxoviridae, del cual se conocen 12 genotipos confirmados, designados como A-L y otro nuevo genotipo designado como M. Las vacunas anti-parotiditis por lo general,  se fabrican empleando virus vivo atenuado de alguno de estos genotipos y están  disponibles como monovalente (parotiditis) y trivalente (sarampión-rubéola-parotiditis). A pesar de los programas de vacunación implementados por muchos países, se han presentado brotes de parotiditis en forma epidémica en la cual se ha detectado co-circulación de genotipos entre poblaciones vacunadas. Entre las posibles explicaciones  están: el fracaso primario a la vacunación, pérdida de efectividad secundaria e infección por virus heterólogos. Como consecuencia la Organización Mundial de la Salud (OMS) ha recomendado estudios moleculares epidemiológicos, que incluya la genotipificación de cepas circulantes del virus de la parotiditis, como parte del programa de vigilancia. Esto permitirá una mayor información de la distribución de los genotipos en todo el mundo, contribuyendo a la vigilancia de la parotiditis y posiblemente en la reformulación de vacunas más eficaces. Esta revisión muestra la importancia que tiene la caracterización molecular  o genotipificación del virus de la parotiditis, con el propósito de comprender y explicar el comportamiento epidemiológico de esta enfermedad que ha sido ampliamente controlada por la aplicación sistemática de la vacuna a nivel mundial.

Mumps is a vaccine-preventable infectious disease, caused by mumps virus, member of Rubulavirus genus, Paramyxoviridae family, has been classified into 12 confirmed genotypes, designated as A-L and one proposed genotype, M. Usually the anti-mumps vaccines are manufactured using attenuated live virus genotypes and any of these are available as monovalent (mumps) and trivalent (measles-mumps-rubella). Although vaccination programs implemented by many countries, there have been outbreaks of mumps in epidemic form, in which has been detected co-circulation of genotypes among vaccinated populations. Possible explanations are: the primary vaccination failure, loss of high effectiveness and heterologous virus infection. Because of this, the World Health Organization (WHO) has recommended molecular epidemiological studies, including genotyping of circulating strains of mumps virus as part of the monitoring program. This information will allow greater distribution of genotypes worldwide, contributing to monitoring and possibly mumps reformulating more effective vaccines. This review shows the importance of molecular characterization and genotyping of mumps virus, in order to understand and explain the epidemiological behavior of the disease has been largely controlled by the systematic application of the vaccine worldwide.

Petersen's hernia as a complication of bariatric surgery: CT findings.

Referrals for bariatric surgery have currently increased due to the need for more effective interventions in the management of severely obese patients. The Roux-en-Y gastric bypass is currently one of the preferred procedures, and internal hernias are the main causes of late postoperative complication. Petersen's hernia is a less common finding in most published papers compared to transmesocolic hernia, however, it seems to be increasing in incidence (in our service, eight cases which have been tomographic diagnosed in 2 years, were confirmed by laparoscopic surgery). The clinical findings are not specific, usually with abdominal pain, associated or not with abdominal distention and vomiting. In this context, imaging exams have an important role in the early diagnosis and surgery of this condition, with multislice computed tomography being the most accurate method. The aim of this pictorial essay is to the demonstrate the main CT findings associated with Petersen's hernia in patients who underwent Roux-en-Y gastric bypass.

El Virus del Nilo Occidental: Revisión / West Nile Virus: Review

El virus del Nilo Occidental (VNO) es un arbovirus perteneciente a la familia Flaviviridae, filogenéticamente relacionado con el complejo de la encefalitis japonesa y aislado por primera vez en el año 1937 a partir del suero de una paciente febril, nativa del Nilo Occidental en Uganda-África. Al igual que muchos otros arbovirus, el VNO, presenta dos ciclos de transmisión: un ciclo enzoótico primario o ciclo de amplificación que envuelve un grupo de vectores (mosquitos y hospedadores aviares), y un ciclo secundario que involucra diferentes artrópodos, con la correspondiente transmisión del virus a hospedadores como humanos y caballos, entre otros. La infección por el VNO causa un espectro de manifestaciones clínicas que van desde la infección subclínica hasta la muerte. Su amplia distribución geográfica, la transmisión por mosquitos, la relación con aves silvestres como hospedadores en zoóticos y algunas infecciones humanas fueron bien documentadas en los años sesenta. El VNO no había sido considerado como un patógeno humano de importancia porque muchas infecciones resultaban asintomáticas o febriles, sin ninguna complicación. Es a partir del año 1996 cuando se reportan importantes epidemias, en donde un gran porcentaje de pacientes después de algunos días de fiebre, progresaron al síndrome de meningoencefalitis. La emergencia del virus del Nilo Occidental (VNO) en el Este de Estados Unidos en 1999 representó un evento muy importante en la arbovirología moderna, no sólo por el impacto de la enfermedad o por la amenaza potencial que representó, sumado a esto, alertó al mundo que los patógenos podrían emerger en cualquier lugar y momento. En este artículo se hace una revisión bibliográfica relacionada con la emergencia del virus del Nilo Occidental en las Américas, ecología, epidemiología, clínica, diagnóstico, manejo clínico y prevención de la enfermedad.

The West Nile Virus (WNV), an arthropod borne virus belonging to the family Flaviviridae, is phylogenetically related to the Japanese Encephalitis group, and it was firts isolated in 1937 from the blood of a woman with fever in the West Nile province of Uganda-Africa. Like others arboviruses, the West Nile Virus has two transmission cycles: one primary enzootic cycle or amplifying cycle that involves a group of mosquitoes vectors and birds as the main amplifying hosts and a second cycle that comprises differents virus-carring arthropod with virus transmission to susceptibles humans and horses, among others. WNV infection in humans causes a spectrum of manifestations from subclinical infection to death. WNV broad geographic distribution, its transmission by mosquitoes and its circulation in cycles of transmission between wild birds as enzootic hosts and some human infections were well documented in the 1960's years. WNV had not been considered important as a human pathogen due to cases with no symptoms or mild clinical symptoms in cases without severity. Since 1996 have been reported important outbreaks with an important progression to cases of meningoencephalitis. The emergence of WNV in eastern North America in 1999 was a major event in modern arbovirology, not only because of the disease impact or the potential threat it represented, but because it alerted the world that pathogens may turn up anywhere at anytime. This article briefly reviews the emergence of West Nile Virus in the Americas, its ecology and epidemiology, clinic, diagnosis and treatment and prevention of West Nile Virus illness.

Diversity among clinical isolates of penicillin-resistant Streptococcus mitis: indication for a PBP1-dependent way to reach high levels of penicillin resistance.

A total of 12 non-epidemiologically related clinical isolates of Streptococcus mitis that showed different levels of resistance to penicillin were studied. Membrane-protein profiles and penicillin-binding protein (PBP) patterns showed a great polymorphism; and patterns of 4-7 PBPs, with sizes that ranged from approximately 101 kDa to approximately 40 kDa, were detected in each strain. No association could be found between PBP pattern and resistance level to penicillin among these isolates. Arbitrarily primed PCR confirmed the genetic diversity among this group of streptococci. One of the isolates of intermediate level of resistance to penicillin, which showed a PBP pattern similar to that of the high-resistance strains, was used as a laboratory model to analyse the mechanism underlying high-resistance acquisition by these strains. A 14-fold increase in penicillin resistance was obtained after a single selection step, which resulted in a decrease in penicillin affinity for PBP1. The size of this PBP (92 kDa) and the differences in PBP profiles of the penicillin-resistant clinical isolates suggest the existence in S. mitis of PBP-mediated mechanisms to acquire high-level resistance to penicillin, among which alterations in PBP1 seem to play a main role, in contrast to the PBP2X mediated mechanism described for other streptococci.

La cirugía como tratamiento de una entidad recientemente descrita: linfoma B cutáneo de células de la zona marginal / Surgical treatment of a recently described disease: marginal zone cutaneous B-cell lymphoma

Tras la reciente descripción del linfoma B de células de la zona marginal, el papel de la cirugía en el manejo de los linfomas cutáneos ha pasado de ser de meramente diagnóstico a terapéutico. En este artículo se presenta un caso de linfoma B de células de la zona marginal tratado por nuestro grupo en el que este nuevo esquema terapéutico demostró buenos resultados y la ventaja de la administración de una menor dosis de radioterapia (AU)

New genus-specific primers for the PCR identification of members of the genus Saccharomonospora and evaluation of the microbial diversity of wild-type isolates of Saccharomonospora detected from soil DNAs.

Members of the genus Saccharomonospora are isolated infrequently, probably due to the low occurrence of these actinomycetes in the environment. Although members of this genus can easily be identified by micromorphological criteria, the extensive chemotaxonomic characterization of each new isolate is a time-consuming task which cannot always be undertaken when handling large numbers of strains as is the case in natural products screening programmes. In this work, the design of one set of genus-specific oligonucleotides which allows rapid detection of members of the genus Saccharomonospora by means of PCR-specific amplification is presented. The genus specificity of these primers was validated on a wide range of collection and wild-type strains, and subsequently applied to evaluate the presence of representatives of this taxon directly from soil DNAs. Partial 16S rDNA sequencing of representative wild-type strains was used to validate their genus assignment. Further analyses of PCR fingerprinting patterns and 16S-23S internal transcribed spacer sequences were used to determine the diversity of wild-type isolates obtained from soils. This study shows the usefulness of the application of these primers for the direct identification of members of this genus and in assessment of its occurrence within natural microbial habitats.

New genus-specific primers for the PCR identification of members of the genera Pseudonocardia and Saccharopolyspora.

Members of the family Pseudonocardiaceae are difficult to identify on the basis of their micromorphology only. The biochemical characterization of each new isolate is a painstaking and time-consuming task which cannot always be undertaken when handling large numbers of strains as is the case in natural product screening programmes. In this study, two sets of genus-specific oligonucleotides were designed which allow rapid detection of members of the genera Pseudonocardia and Saccharopolyspora by means of PCR-specific amplification. The genus specificity of these primers was validated on a wide range of collection strains and the primers were subsequently used to study a group of 106 wild-type isolates that possessed morphological characteristics of the family. Out of this group, 51 strains could be identified as members of the genus Pseudonocardia and only nine isolates could be assigned to the genus Saccharopolyspora. The diversity indicated by whole-cell fatty acid profiles of both wild-type and reference strains was compared with that identified using the oligonucleotide primers. The partial 16S rDNA sequencing of representative wild-type strains was used to validate their genus assignment by PCR-specific amplification. This study shows the industrial usefulness of the application of these direct identification tools as well as the complementary use of two sources of data, PCR-specific amplification results and fatty acid composition, to assess the diversity of a microbial population.

Actividad larvicida en plantas transgénicas de tabaco / Larvicidad activity in tobacco transgenic plants

La delta-endotoxina producida por el Bacillus thuringiensis variedades berliner y kurstaki durante la esporulación, muestra una potente actividad larvicida en varias familias de lepidópteros. Los genes que codifican para esta toxina han sido clonados y expresados en plantas, y estas plantas transgénicas han mostrado ser tóxinas a las larvas de lepidópteros. El trabajo describe la obtención de plantas transgénicas de Nicotina tabacum var. Petit Havana (SR1), a las cuales se les ha incorporado de forma estable en su genoma el gen de la toxina de B, thuringiensis var. kurstaki empleando el Agrobacterium tumefaciens. Se evaluó la expresión por actividad biológica enfrentando las plantas a una infección con larvas de Heliothis virescens (AU)

Actividad larvicida en plantas transgénicas de tabaco / Larvicidad activity in tobacco transgenic plants

La delta-endotoxina producida por el Bacillus thuringiensis variedades berliner y kurstaki durante la esporulación, muestra una potente actividad larvicida en varias familias de lepidópteros. Los genes que codifican para esta toxina han sido clonados y expresados en plantas, y estas plantas transgénicas han mostrado ser tóxinas a las larvas de lepidópteros. El trabajo describe la obtención de plantas transgénicas de Nicotina tabacum var. Petit Havana (SR1), a las cuales se les ha incorporado de forma estable en su genoma el gen de la toxina de B, thuringiensis var. kurstaki empleando el Agrobacterium tumefaciens. Se evaluó la expresión por actividad biológica enfrentando las plantas a una infección con larvas de Heliothis virescens