Computer vision syndrome-related symptoms in presbyopic computer workers.

PURPOSE: To evaluate the prevalence of computer vision syndrome (CVS)-related symptoms in a presbyopic population using the computer as the main work tool, as well as the relationship of CVS with the electronic device use habits and the ergonomic factors. METHODS: A sample of 198 presbyopic participants (aged 45-65 years) who regularly work with a computer completed a customised questionnaire divided into: general demographics, optical correction commonly used and for work, habits of electronic devices use, ergonomic conditions during the working hours and CVS-related symptoms during work performance. A total of 10 CVS-related symptoms were questioned indicating the severity with which they occurred (0-4) and the median total symptom score (MTSS) was calculated as the sum of the symptoms. RESULTS: The MTSS in this presbyopic population is 7 ± 5 symptoms. The most common symptoms reported by participants are dry eyes, tired eyes and difficulties in refocusing. MTSS is higher in women (p < 0.05), in laptop computer users (p < 0.05) and in teleworkers compared to office workers (p < 0.05). Regarding ergonomic conditions, MTSS is higher in participants who do not take breaks while working (p < 0.05), who have an inadequately lighting in the workspace (p < 0.05) and in the participants reporting neck (p < 0.01) or back pain (p < 0.001). CONCLUSION: There is a relationship between CVS-related symptoms, the use of electronic devices and the ergonomic factors, which indicates the importance of adapting workplaces, especially for home-based teleworkers, and following basic visual ergonomics rules.

Análisis del uso de fármacos fuera de indicación autorizada en hematología y oncología / Analysis of the "Off label" drug use in hematology and oncology

Resumen Objetivo: El uso de medicamentos en condiciones diferentes a las autorizadas es el uso de medicamentos en condiciones distintas a las incluidas en su ficha técnica. El objetivo del presente trabajo es analizar las solicitudes de medicamentos fuera de ficha técnica y sus resultados, realizadas por el Servicio de Oncología y Hematología en un hospital de segundo nivel. Materiales y métodos: Se realiza un estudio observacional retrospectivo de todas las peticiones de fármacos "off label" recibidas por el Servicio de Farmacia. Los medicamentos se clasifican según impacto económico, una clasificación propia según el tipo de fármaco y motivo de petición y según su grado de evidencia. Se analiza para cada solicitud los datos demográficos, de diagnóstico y de tratamiento de los pacientes. Se presenta un seguimiento de los efectos adversos, mediana de supervivencia libre de progresión y mediana de supervivencia global. Resultados: Se aprueban 85 solicitudes de tratamiento. La mayoría de los tratamientos son de alto impacto dirigidos principalmente a patologías raras y últimas opciones de tratamiento. Un 22% de las solicitudes presentan alto grado de evidencia. La media de supervivencia libre de progresión (SLP) es de 6,6 meses (IC 95% 5,2-8) y la supervivencia global (SG) es de 9,7 meses (IC95% 8,2-11,2). Un 18,7% de pacientes presentan toxicidad de grado 3-4 al recibir el tratamiento. Conclusiones: A pesar de la heterogeneidad de las patologías, y la baja evidencia, los resultados obtenidos en SLP y SG, junto a la escasa toxicidad obliga a seguir avanzando en la evaluación de este tipo de tratamientos.

Abstract Background and objective: the use of off-label drugs is the use of medications in conditions other than those included in its prescribing information. The objective of this paper is to analyze the off-label drugs applications and their results, performed by the Oncology and Hematology services in a second level hospital. Materials and methods: A retrospective observational study of all requests for "off label" drugs received by the Pharmacy Service is carried out. The drugs are classified according to economic impact, a classification according to the type of drug and the reason for the request and according to the degree of evidence. The demographic, diagnostic and treatment data of the patients are analyzed for each request. A follow-up of adverse effects, median progression-free survival and median overall survival is presented. Results: 85 treatment requests are approved. Most of the treatments are high impact, mainly aimed at rare pathologies and last treatment options. 22% of the requests have a high degree of evidence. Progression free survival (PFS) and overall survival (OS) are 6.6 (95% CI 5.2-8) and 9.7 months (95% CI 8.2-11.2). 18.7% of patients have grade 3-4 toxicity when receiving treatment. Conclusions: Despite the heterogeneity of the pathologies, and the low evidence, the results obtained in SLP and SG, together with the low toxicity, force us to continue advancing in the evaluation of this type of treatments.

Características generales de la atención a recién nacidos con malformaciones congénitas en un hospital infantil / General characteristics of care to the newborn with congenital malformations in a children hospital

Se hizo un estudio descriptivo, transversal y retrospectivo de 218 neonatos que presentaron malformaciones congénitas en cualquier aparato o sistema, atendidos en el Servicio Abierto de Neonatología del Hospital Infantil Norte Dr Juan de la Cruz Martínez Maceira, desde enero del 2001 hasta diciembre del 2007, a fin de caracterizarles según variables de interés para la investigación. En la serie predominaron el sexo masculino y los recién nacidos a término con peso normal. Las malformaciones más frecuentes resultaron ser las aisladas y entre ellas las digestivas y cardiovasculares. El diagnóstico prenatal fue de baja efectividad y la mortalidad mínima, generalmente causada por malformaciones congénitas múltiples(AU)

A descriptive, cross-sectional and retrospective study of 218 neonates that presented congenital malformations in any apparatus or system, assisted in the Open Service of Neonatology of Dr Juan de la Cruz Martínez Maceira Northern Children Hospital was carried out, from January , 2001 to December, 2007, in order to characterize them according to variables of interest for the investigation. The male sex and the full- term newborns with normal weight prevailed in the series. The most frequent malformations were the isolated ones and among them the digestive and cardiovascular ones. The prenatal diagnosis was of low effectiveness and mortality was low, generally caused by multiple congenital malformations(AU)

Características generales de la atención a recién nacidos con malformaciones congénitas en un hospital infantil / General characteristics of care to the newborn with congenital malformations in a children hospital

Se hizo un estudio descriptivo, transversal y retrospectivo de 218 neonatos que presentaron malformaciones congénitas en cualquier aparato o sistema, atendidos en el Servicio Abierto de Neonatología del Hospital Infantil Norte Dr Juan de la Cruz Martínez Maceira, desde enero del 2001 hasta diciembre del 2007, a fin de caracterizarles según variables de interés para la investigación. En la serie predominaron el sexo masculino y los recién nacidos a término con peso normal. Las malformaciones más frecuentes resultaron ser las aisladas y entre ellas las digestivas y cardiovasculares. El diagnóstico prenatal fue de baja efectividad y la mortalidad mínima, generalmente causada por malformaciones congénitas múltiples

A descriptive, cross-sectional and retrospective study of 218 neonates that presented congenital malformations in any apparatus or system, assisted in the Open Service of Neonatology of Dr Juan de la Cruz Martínez Maceira Northern Children Hospital was carried out, from January , 2001 to December, 2007, in order to characterize them according to variables of interest for the investigation. The male sex and the full- term newborns with normal weight prevailed in the series. The most frequent malformations were the isolated ones and among them the digestive and cardiovascular ones. The prenatal diagnosis was of low effectiveness and mortality was low, generally caused by multiple congenital malformations

Using heat to characterize streambed water flux variability in four stream reaches.

Estimates of streambed water flux are needed for the interpretation of streambed chemistry and reactions. Continuous temperature and head monitoring in stream reaches within four agricultural watersheds (Leary Weber Ditch, IN; Maple Creek, NE; DR2 Drain, WA; and Merced River, CA) allowed heat to be used as a tracer to study the temporal and spatial variability of fluxes through the streambed. Synoptic methods (seepage meter and differential discharge measurements) were compared with estimates obtained by using heat as a tracer. Water flux was estimated by modeling one-dimensional vertical flow of water and heat using the model VS2DH. Flux was influenced by physical heterogeneity of the stream channel and temporal variability in stream and ground-water levels. During most of the study period (April-December 2004), flux was upward through the streambeds. At the IN, NE, and CA sites, high-stage events resulted in rapid reversal of flow direction inducing short-term surface-water flow into the streambed. During late summer at the IN site, regional ground-water levels dropped, leading to surface-water loss to ground water that resulted in drying of the ditch. Synoptic measurements of flux generally supported the model flux estimates. Water flow through the streambed was roughly an order of magnitude larger in the humid basins (IN and NE) than in the arid basins (WA and CA). Downward flux, in response to sudden high streamflows, and seasonal variability in flux was most pronounced in the humid basins and in high conductivity zones in the streambed.

Transport and fate of nitrate at the ground-water/surface-water interface.

Although numerous studies of hyporheic exchange and denitrification have been conducted in pristine, high-gradient streams, few studies of this type have been conducted in nutrient-rich, low-gradient streams. This is a particularly important subject given the interest in nitrogen (N) inputs to the Gulf of Mexico and other eutrophic aquatic systems. A combination of hydrologic, mineralogical, chemical, dissolved gas, and isotopic data were used to determine the processes controlling transport and fate of NO(3)(-) in streambeds at five sites across the USA. Water samples were collected from streambeds at depths ranging from 0.3 to 3 m at three to five points across the stream and in two to five separate transects. Residence times of water ranging from 0.28 to 34.7 d m(-1) in the streambeds of N-rich watersheds played an important role in allowing denitrification to decrease NO(3)(-) concentrations. Where potential electron donors were limited and residence times were short, denitrification was limited. Consequently, in spite of reducing conditions at some sites, NO(3)(-) was transported into the stream. At two of the five study sites, NO(3)(-) in surface water infiltrated the streambeds and concentrations decreased, supporting current models that NO(3)(-) would be retained in N-rich streams. At the other three study sites, hydrogeologic controls limited or prevented infiltration of surface water into the streambed, and ground-water discharge contributed to NO(3)(-) loads. Our results also show that in these low hydrologic-gradient systems, storm and other high-flow events can be important factors for increasing surface-water movement into streambeds.

Impacto de la investigación en Institutos de Salud / Impact of the reserch in the Health Institute

Se enfatiza los objetivos de los Institutos de Salud en América Latina en el desarrollo de criterios y tecnologías que permitan combatir las consecuencias negativas de la dependencia científica y tecnológicas. En este sentido, se propone que la prestación de servicios y la producción de bienes, deben estar sustentados en la investigación. Para superar el subdesarrollo, el futuro de América Latina debe dirigirse hacia una mayor integración y a un trabajo que responda a las verdaderas necesidades de la región

Impacto de la formación de recursos humanos en los programas de calidad de Instituciones de Salud: Situación en América Latina / Impact of the formation health manpower in Latin America

Es conocido por aquellos que se han incorporado al trabajo en el Sector Salud en America Latina, que entre los puntos críticos para el funcionamiento del sector están el desarrollo de la fuerza de trabajo, formación de recursos humanos e identificación de alternativas de acción. En los últimos años, la magnitud del trabajo en actividades relacionadas con Ciencia y Tecnología, han cambiado significativamente en America Latina. En la década de los noventa, la mayoría de los países del área han modificado las estrategias de desarrollo y se han propuesto la integración de las actividades docentes, asistenciales y de investigación, con objetivos bien definidos como son: Continuar con el desarrollo de nuevas tecnologías mediante investigaciones y docencia; desarrollar un efectivo control de calidad a través de sistemas de indicadores confiables; y priorizar el enfoque epidemiológico en el análisis de los problemas que caracterizan el estado de salud de la población. El Instituto Nacional de Higiene "Rafael Rangel" estructuró una Unidad de Docencia que sirvió para retomar uno de los objetivos establecidos en el Decreto de Creación del Instituto. A partir de 1989, la actual gestión inició un enfoque institucional, el cual está enmarcado dentro del concepto de Calidad Total. Como apoyo a esta concepción se crea la División de Investigación y Docencia, ella a través de una programación completa de Cursos Nacionales e Internacionales, pasantias de entrenamiento y proyectos de investigación, contribuye a mejorar la calidad de los procesos de cada una de las áreas involucradas, todo ello enmarcado dentro del concepto de Calidad Total