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Search Results: 1 - 10 of 211430 matches for " López-Soto "
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Connecting Cerebral White Matter Lesions and Hypertensive Target Organ Damage
Cristina Sierra,Alfons López-Soto,Antonio Coca
Journal of Aging Research , 2011, DOI: 10.4061/2011/438978
Abstract: Chronic hypertension leads to concomitant remodeling of the cardiac and vascular systems and various organs, especially the brain, kidney, and retina. The brain is an early target of organ damage due to high blood pressure, which is the major modifiable risk factor for stroke and small vessel disease. Stroke is the second leading cause of death and the number one cause of disability worldwide and over 80% of strokes occur in the elderly. Preclinical hypertensive lesions in most target organs are clearly identified: left ventricular hypertrophy for the heart, microalbuminuria for the kidney, fundus abnormalities for the eye, and intima-media thickness and pulse wave velocity for the vessels. However, early hypertensive brain damage is not fully studied due to difficulties in access and the expense of techniques. After age, hypertension is the most-important risk factor for cerebral white matter lesions, which are an important prognostic factor for stroke, cognitive impairment, dementia, and death. Studies have shown an association between white matter lesions and a number of extracranial systems affected by high BP and also suggest that correct antihypertensive treatment could slow white matter lesions progression. There is strong evidence that cerebral white matter lesions in hypertensive patients should be considered a silent early marker of brain damage. 1. Introduction Chronic hypertension leads to concomitant remodeling of the cardiac and vascular systems, and various organs, especially the brain, kidney, and retina [1, 2]. Early detection of hypertensive target organ damage is important for more-successful prevention of cardiovascular diseases and to improve outcomes [1, 2]. The brain is an early target for organ damage due to high blood pressure (BP) [1, 2], which is the major modifiable risk factor in men and women for ischemic and hemorrhagic stroke [3], as well as small vessel disease [1, 2, 4] predisposing to lacunar infarction, white matter lesions (WML), and cerebral microbleeds, which are frequently silent [1, 2, 5]. Stroke is the second leading cause of death and the leading cause of disability worldwide [6]. For each decade of life after the age of 55 years, the stroke rate doubles in both men and women, and >80% of strokes occur in people aged ≥65 years [6]. Because of the aging population, the burden of stroke will increase greatly in forthcoming years. The increased vulnerability of elderly people to stroke is associated with changes in the aging brain and also with a higher prevalence of well-documented risk factors for stroke such as
Outpatient Quick Diagnosis Units for the evaluation of suspected severe diseases: an observational, descriptive study
Bosch, Xavier;Foix, Anna;Jordan, Anna;Coca, Antonio;López-Soto, Alfonso;
Clinics , 2011, DOI: 10.1590/S1807-59322011000500005
Abstract: background: hospitals in countries with public health systems have recently adopted organizational changes to improve efficiency and resource allocation, and reducing inappropriate hospitalizations has been established as an important goal. aims: our goal was to describe the functioning of a quick diagnosis unit in a spanish public university hospital after evaluating 1,000 consecutive patients. we also aimed to ascertain the degree of satisfaction among quick diagnosis unit patients and the costs of the model compared to conventional hospitalization practices. design: observational, descriptive study. methods: our sample comprised 1,000 patients evaluated between november 2008 and january 2010 in the quick diagnosis unit of a tertiary university public hospital in barcelona. included patients were those who had potentially severe diseases and would normally require hospital admission for diagnosis but whose general condition allowed outpatient treatment. we analyzed several variables, including time to diagnosis, final diagnoses and hospitalizations avoided, and we also investigated the mean cost (as compared to conventional hospitalization) and the patients' satisfaction. results: in 88% of cases, the reasons for consultation were anemia, anorexia-cachexia syndrome, febrile syndrome, adenopathies, abdominal pain, chronic diarrhea and lung abnormalities. the most frequent diagnoses were cancer (18.8%; mainly colon cancer and lymphoma) and iron-deficiency anemia (18%). the mean time to diagnosis was 9.2 days (range 1 to 19 days). an estimated 12.5 admissions/day in a one-year period (in the internal medicine department) were avoided. in a subgroup analysis, the mean cost per process (admission-discharge) for a conventional hospitalization was 3,416.13 euros, while it was 735.65 euros in the quick diagnosis unit. patients expressed a high degree of satisfaction with quick diagnosis unit care. conclusions: quick diagnosis units represent a useful and cost-saving model
Abnormalities in liver enzyme levels during Salmonella enteritidis enterocolitis Alteraciones en los niveles séricos de enzimas hepáticos durante la enterocolitis por Salmonella enteritidis
A. González-Quintela,J. Campos,R. Alende,A. López-Soto
Revista Espa?ola de Enfermedades Digestivas , 2004,
Abstract: Objective: to evaluate the prevalence, associated factors, and time-course changes of abnormal liver enzyme serum levels in adult patients with Salmonella enteritidis enterocolitis. Methods: the clinical records of 104 patients (age range 15-86 years, 46.2% males) admitted to hospital because of S. enteritidis enterocolitis were reviewed. The prevalence of abnormal liver enzyme levels was evaluated, as well as its possible relationship to data of systemic inflammatory response, severe sepsis, and bacteremia. In addition, time-course changes in serum levels of liver enzymes were studied in 16 cases with available follow-up after hospital discharge. Results: in patients without a pre-existing cause for liver enzyme abnormalities (n = 84), the prevalence of serum AST elevation was 23.0% (95% CI 15.4-34.5%), of serum ALT elevation was 17.9% (95% CI 0.6-20.0%), and of GGT elevation was 19.0% (95% CI 11.6-29.3%). The prevalence of abnormality for any of these enzymes (AST, ALT, or GGT) was 35.7% (95% CI 25.7-46.8%). The prevalence of altered serum alkaline phosphatase was lower. Alteration in liver enzyme serum levels was moderate in the majority of cases, and was found in association with the presence of fever. Serum enzyme levels decreased during the convalescence period after hospital discharge. Conclusions: abnormalities in liver enzyme levels are frequent during severe enterocolitis due to S. enteritidis in adult patients. These abnormalities are moderate and self-limited. Objetivo: evaluar la prevalencia, los factores asociados y la evolución de las anormalidades en los niveles séricos de enzimas hepáticos en pacientes adultos con enterocolitis por S. enteritidis. Métodos: se revisaron los historiales de 104 pacientes (de edades comprendidas entre 15 y 86 a os, 46,2% varones), ingresados en un hospital por enterocolitis aguda por S. enteritidis. Se evaluó la prevalencia de alteración en los niveles séricos de enzimas hepáticos y su asociación con datos de respuesta inflamatoria sistémica, de sepsis grave y con la presencia de bacteriemia detectable. Asimismo, se estudió la evolución de los parámetros de función hepática en 16 casos en los que se dispuso de seguimiento pasada la fase aguda tras el alta hospitalaria. Resultados: en los pacientes sin causa previa de hepatopatía (n=84), la prevalencia de elevación de la AST fue 23,0% (IC 95% 15,4-34,5%), de ALT 17,9% (IC 95% 10,6-20,0%), y de GGT 19,0% (IC 95% 11,6-29,3%). La prevalencia de alteración en alguno de esos parámetros (AST, ALT, o GGT) fue 35,7% (IC 95% 25,7-46,8%). La prevalencia de alteración
Variables relacionadas con la satisfacción del paciente de los servicios odontológicos
López-Soto,Olga Patricia; Cerezo-Correa,María del Pilar; Paz-Delgado,Alba Lucía;
Revista Gerencia y Políticas de Salud , 2010,
Abstract: this study aimed at relating sociodemographic variables, anxiety levels and oral health beliefs with the level of patient satisfaction in oral health. a sample of 342 patients was selected by systematic sampling. dissatisfied patients were characterized by using a total prosthesis, by considering that oral diseases can be serious and treatments are costly and by recognizing that dental diseases affect self-esteem and that they are afraid of visiting the dentist. dissatisfaction was related to sociodemographic characteristics, severe anxiety, general and dental health condition, perceived susceptibility and benefits, self-efficacy, fear to visit the dentist, easy access to a dentist and the need to visit the dentist for a check-up.
Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study
Emilio Sacanella, Joan Manel Pérez-Castejón, Josep Maria Nicolás, Ferran Masanés, Marga Navarro, Pedro Castro, Alfonso López-Soto
Critical Care , 2011, DOI: 10.1186/cc10121
Abstract: We prospectively studied 112/230 healthy elderly patients (≥65 years surviving at least 12 months after ICU discharge) with full functional autonomy without cognitive impairment prior to ICU entry. The main diagnoses at admission using the Acute Physiology and Chronic Health Evaluation III (APACHE III) classification diagnosis and length of ICU stay and ICU scores (APACHE II, Sepsis-related Organ Failure Assessment (SOFA) and OMEGA) at admission and discharge were collected. Comprehensive geriatric assessment included the presence of the main geriatric syndromes and the application of Lawton, Barthel, and Charlson Indexes and Informant Questionnaire on Cognitive Decline to evaluate functionality, comorbidity and cognitive status, respectively. The EuroQol-5D assessed quality of life. Data were collected at baseline, during ICU and ward stay and 3, 6 and 12 months after hospital discharge. Paired or unpaired T-tests compared differences between groups (continuous variables), whereas the chi-square and Fisher exact tests were used for comparing dichotomous variables. For variables significant (P ≤ 0.1) on univariate analysis, a forward multiple regression analysis was performed.Only 48.9% of patients (mean age: 73.4 ± 5.5 years) were alive 12 months after discharge showing a significant decrease in functional autonomy (Lawton and Barthel Indexes) and quality of life (EuroQol-5D) compared to baseline status (P < 0.001, all). Multivariate analysis showed a higher Barthel Index and EQ-5D vas at hospital discharge to be associated factors of full functional recovery (P < 0.01, both). Thus, in patients with a Barthel Index ≥ 60 or EQ-5D vas ≥40 at discharge the hazard ratio for full functional recovery was 4.04 (95% CI: 1.58 to 10.33; P = 0.005) and 6.1 (95% CI: 1.9 to 19.9; P < 0.01), respectively. Geriatric syndromes increased after ICU stay and remained significantly increased during follow-up (P < 0.001).The survival rate of elderly medical patients 12 months after dis
Abnormalities in liver enzyme levels during Salmonella enteritidis enterocolitis
González-Quintela,A.; Campos,J.; Alende,R.; López-Soto,A.; Tomé,S.; Otero,E.; Torre,J. A.;
Revista Espa?ola de Enfermedades Digestivas , 2004, DOI: 10.4321/S1130-01082004000800005
Abstract: objective: to evaluate the prevalence, associated factors, and time-course changes of abnormal liver enzyme serum levels in adult patients with salmonella enteritidis enterocolitis. methods: the clinical records of 104 patients (age range 15-86 years, 46.2% males) admitted to hospital because of s. enteritidis enterocolitis were reviewed. the prevalence of abnormal liver enzyme levels was evaluated, as well as its possible relationship to data of systemic inflammatory response, severe sepsis, and bacteremia. in addition, time-course changes in serum levels of liver enzymes were studied in 16 cases with available follow-up after hospital discharge. results: in patients without a pre-existing cause for liver enzyme abnormalities (n = 84), the prevalence of serum ast elevation was 23.0% (95% ci 15.4-34.5%), of serum alt elevation was 17.9% (95% ci 0.6-20.0%), and of ggt elevation was 19.0% (95% ci 11.6-29.3%). the prevalence of abnormality for any of these enzymes (ast, alt, or ggt) was 35.7% (95% ci 25.7-46.8%). the prevalence of altered serum alkaline phosphatase was lower. alteration in liver enzyme serum levels was moderate in the majority of cases, and was found in association with the presence of fever. serum enzyme levels decreased during the convalescence period after hospital discharge. conclusions: abnormalities in liver enzyme levels are frequent during severe enterocolitis due to s. enteritidis in adult patients. these abnormalities are moderate and self-limited.
Digestion and energy value of macerated sudangrass hay used in growing-finishing diets for feedlot cattle
Jorquera, Alejandro Plascencia;Ponce, José Gerardo Serrano;Sánchez-Mendoza, Berenice;Serrano, Alberto Barreras;Calderón-Cortés, José Fernando;López-Soto, María Alejandra;Monta?o Gómez, Martín Francisco;Zinn, Richard Avery;
Scientia Agricola , 2011, DOI: 10.1590/S0103-90162011000600001
Abstract: mechanical maceration enhances site and extent of digestion of low-moisture, low-quality forages. four holstein steers (172 ± 8 kg) with cannulas in rumen and proximal duodenum were used in 4x4 latin square design to evaluate the process of mechanical maceration of sudangrass hay on the characteristics of ruminal and total tract digestion. treatments consisted of a steam-flaked corn-based growing diet supplemented with 21 % forage (dm basis) as: i) wheat straw (triticum aestivum, strw), ii) sudangrass hay (sorghum sudanense, sg), iii) macerated sg at intensity of 4,134 kpa (mac600) and 4) macerated sg at intensity of 6,200 kpa (mac900). all forages were ground to pass through a 3.8 cm screen before incorporation into complete mixed diets (21:79 forage to concentrate ratio). maceration did not affect (p ≥ 0.17) on site and extent of om, n and adf, and de of sudangrass supplemented diets. characteristics of ruminal digestion of om, adf, starch, as well as, microbial efficiency (microbial n, g kg-1 of om fermentad) and protein efficiency (nonammonia n, g g-1 of n intake) were not different (p ≥ 0.11) for wheat straw versus sudangrass supplemented diets. however, total tract digestion of om, adf, n, and de diet were greater (p ≤ 0.05) for sudangrass than for wheat straw supplemented diets. using the replacement technique, de value of sg averaged 9.59 mj kg-1, very close to the expected value given its chemical composition. mechanical maceration did not enhance the feeding value of sudangrass hay. increase the intensity of maceration from 4,134 to 6,200 kpa did not altered ruminal or total tract digestion of om, ndf or energy value of processed hay
Agro y controversia Agro and controversy
López Soto Nilson
Agronomía Colombiana , 2002,
Abstract: La agricultura nacional ha vivido periodos recurrentes de crisis en los últimos 20 a os; las cifras - no exentas de polémica - muestran puntos altos y bajos en el crecimiento del producto sectorial y las áreas sembradas. El modelo económico del país en la última década, con una apertura más acelerada del comercio exterior y cambios en la intervención del Estado, a no dudarlo, ha tenido que ver con el desenvolvimiento reciente del sector. En el cuatrenio que termina para muchos analistas la crisis agraria persiste y se agrava; el gobierno piensa lo contrario, habla de recuperación y muestra los niveles de crecimiento, en especial del a o 2000. Se intenta en este artículo presentar puntos de vista de uno y otro enfoque, y hacer una evaluación de la situación en general. In the last twenty years the national agriculture has been had various crisis; the numbers present points high and low of growth of sectorial product and area seed. The economic opening and changes in the state's actions have influence on recent development of sector. In the last fourth years, for some people the agrarian crisis continues; the government thinks different, and speaks of recuperation. The purpose in this article is to present the two approaches, and to make an evaluation of general situation.
Competitividad y administración agropecuaria Competitiueness and farm business management
López Soto Nilson
Agronomía Colombiana , 1998,
Abstract: La competitividad de las naciones y de las empresas, constituye un tema de particular importancia en la actualidad; inclusive, en el caso del sector agropecuario en nuestro país, parecería desplazar por momentos como preocupación central, la ya larga crisis sectorial. En esta oportunidad se hace un análisis del concepto de competitividad, de los factores que inciden sobre ella y de la controversia que genera en sus alcances. En seguida, por un interés específico se parte de la base de que la Administración Agropecuaria influye sobre la competitividad, se hace un breve análisis del uso de la primera en el país, se ilustran los casos de flores y café, así como alguna referencia a otros rubros de producción. Varios estudios de especialistas y aún de países, reconocen la importancia de la gestión empresarial y del incremento de la productividad laboral, para mejorar la competitividad de las empresas agropecuarias. Por último, se miran las políticas y acciones recientes del gobierno y del sector privado, con el fin de promover una cultura empresarial y poner en marcha los denominados "Acuerdos Sectoriales de Competitividad". The competitiveness of nations and enterprises is a subject of particular importance at the present time; in our country ofthe agricultural sector competitiveness is considerated key for the development. This article presents an analysis of competitiveness and its relation with farm Business Management; our argument is that the second influences in the first by trying to achieve the objetive of increasing productivity and prolits of the agricultural enterprises. Likewise, a briel analysis is pursued on the situacion off. B.M. in this country and for that purpose case studies of flowers, colee and other crops management. Finally, govermment and private sector policies and programs on these areas are examined.
La coyuntura en el sector agropecuario
López Soto Nilson
Agronomía Colombiana , 1984,
Abstract: En términos generales, la función de la agricultura en el desarrollo económico y los instrumentas de política más indicados para al efecto, son tópicos conocidos y sobre ellos no hay mayor discusión. Lo primero tiene que ver con el crecimiento del producto agrícola, la ampliación del mercado interno, la generación de excedentes de capital, una fuente de bienestar social, la generación de empleos productivos y transferencia de mano de obra a otros sectores, la provisión de divisas. De otro lado, existe un cuerpo genérico de políticas, al cual periódicamente se le hacen ajustes; más adelante se explicitarán algunas de ellas.
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