Background Few studies have examined the benefits of pulmonary rehabilitation in patients with fibrotic idiopathic pulmonary pneumonia (f-IIP). Here, we report the results of an observational study in routine clinical practice of home-based pulmonary rehabilitation for f-IIP patients. Methods A total of 112 consecutive patients (61 with idiopathic pulmonary fibrosis and 51 with fibrotic nonspecific interstitial pneumonitis) were enrolled, of whom 65 had mild-to-moderate disease (forced vital capacity (FVC) ≥50% predicted and diffusing capacity of the lung for carbon monoxide (DLCO) ≥30% predicted) and 47 had severe disease (FVC Results 6MST strokes, HADS Anxiety score and VSRQ score were each significantly improved at T2 (n=101), T8 (n=76) and T14 (n=62) compared with T0 values. The improvements in outcomes were not influenced by disease severity or subtype. Patients who completed the study had significantly better baseline FVC and DLCO values than those who did not. Conclusions Home-based pulmonary rehabilitation provides long-term benefits in exercise tolerance, anxiety and QoL for patients with f-IIP. Pulmonary rehabilitation should be prescribed systematically as part of the therapeutic arsenal for these patients.

https://openres.ersjournals.com/content/erjor/5/2/00045-2019.full.pdf

Long-term evaluation of home-based pulmonary rehabilitation in patients with fibrotic idiopathic interstitial pneumonias.

To develop a set of actionable quality indicators for critical care suitable for use in low- or middle-income countries (LMICs).A list of 84 candidate indicators compiled from a previous literature review and stakeholder recommendations were categorised into three domains (foundation, process, and quality impact). An expert panel (EP) representing stakeholders from critical care and allied specialties in multiple low-, middle-, and high-income countries was convened. In rounds one and two of the Delphi exercise, the EP appraised (Likert scale 1-5) each indicator for validity, feasibility; in round three sensitivity to change, and reliability were additionally appraised. Potential barriers and facilitators to implementation of the quality indicators were also reported in this round. Median score and interquartile range (IQR) were used to determine consensus; indicators with consensus disagreement (median < 4, IQR ≤ 1) were removed, and indicators with consensus agreement (median ≥ 4, IQR ≤ 1) or no consensus were retained. In round four, indicators were prioritised based on their ability to impact cost of care to the provider and recipient, staff well-being, patient safety, and patient-centred outcomes.Seventy-one experts from 30 countries (n = 45, 63%, representing critical care) selected 57 indicators to assess quality of care in intensive care unit (ICU) in LMICs: 16 foundation, 27 process, and 14 quality impact indicators after round three. Round 4 resulted in 14 prioritised indicators. Fifty-seven respondents reported barriers and facilitators, of which electronic registry-embedded data collection was the biggest perceived facilitator to implementation (n = 54/57, 95%) Concerns over burden of data collection (n = 53/57, 93%) and variations in definition (n = 45/57, 79%) were perceived as the greatest barrier to implementation.This consensus exercise provides a common set of indicators to support benchmarking and quality improvement programs for critical care populations in LMICs. 

https://link.springer.com/content/pdf/10.1007/s00134-022-06818-7.pdf

Development of a quality indicator set to measure and improve quality of ICU care in low- and middle-income countries

Hemos comparado las prevalencias de grupos sanguineos entre los pacientes que acudieron al Servicio de Emergencia del Hospital Nacional Cayetano Heredia (Lima, Peru) durante el mes de abril de 1991 con diarrea aguda severa con aislamiento de Vibrio cholerae en los coprocultivos, con la de un grupo control conformado por los donantes del Banco de Sangre del mismo hospital, apareados por distritos de residencia. La prevalencia de grupo sanguineo O entre los 136 pacientes con coprocultivos positivos (todo a V. Cholerae O1 biotipo Inaba) fue de 94.9% mientras que entre los 544 controles fue de 79.2% (similar a la reportada en otros estudios sobre prevalencia de grupos sanguineos en nuestra poblacion). Aunque el diseno del estudio tiende a subestimar el real riesgo relativo, encontramos un riesgo relativo estimado de 4.832 (IC95=2.196, 10.628) de presentar diarrea aguda severa por V.cholerae entre las personas con grupo sanguineo O (p<0.00002). Queda por descubrir la base fisiopatologica de esta asociacion y el impacto que puede tener en la morbilidad y mortalidad de la presente epidemia de colera en el Peru, pais con alta prevalencia de grupo sanguineo O.

Relación entre grupo sanguíneo ABO y enfermedad diarreica aguda severa causada por Vibrio cholerae

Introduction: Community-acquired pneumonia (CAP) is a major health problem worldwide and in Cuba. Its incidence and lethality make this desease a real challenge for healthcare services. Objective: to identify the incidence of Klebsiella pneumoniae isolated from sputum samples in patients with community-acquired pneumonia. Method: a descriptive and cross-sectional study was carried out in the microbiology laboratory of the Provincial Hygiene, Epidemiology and Microbiology Center of Guantanamo from January to June 2016. The universe of study consisted of 88 patients. The laboratory procedure proposed by Exposito et al. Results: 72 samples of productive sputum were identified, of which 56 samples were positive for bacterial culture, Klebsiella pneumoniae was isolated in 34, which resulted in the study sample, showing marked resistance to amoxicillin and ceftriaxone. This microorganism was framed as a pathogen that emerged as responsible for the etiology of respiratory infections acquired in the community. Conclusions: Klebsiella pneumoniae, due to its frequency of isolation, due to its pathogenic and resistance mechanisms, is considered an opportunistic pathogen that emerges as responsible for the etiology of respiratory infections acquired in the community.

/pdf/klebsiella-pneumoniae-aisladas-de-pacientes-con-neumonia-aq6k0lijaz.pdf

Klebsiella pneumoniae aisladas de pacientes con neumonía adquirida en la comunidad

Email: pedro.rolande.lopez1942@gmail.com ABSTRACT Introduction: Vaginal infection is a disease with a high incidence in pregnancy. It is associated with maternal-fetal complications, being early diagnosis and fundamental treatment. Objective: To clinically and epidemiologically characterize pregnant women with vaginal infection belonging to the “Orlando Matos Mosquera” Polyclinic in the period 2019-2021. Method: Observational, descriptive and cross-sectional study of pregnant women with vaginal infection. The arithmetic mean and standard deviation of the quantitative variables and the absolute frequencies and percentages in qualitative variables whose association was obtained through the Chi-square with 5% significance were obtained. Results: 245 pregnant women were analyzed. The mean age was 25 years. 42.4% were mestizo, 56.4% accompanied or single, 41.2% had an upper secondary level, and 12.7% were housewives. At least 7 out of 10 smoked or had unprotected sex. 80.8% of the examined had vaginal discharge. 75 pregnant women suffered infection by Candida albicans and the average gestational age was 18.58 ± 8.48 weeks of pregnancy, with 37.6% of vaginal infections occurring in the first trimester. 73.0% of the mixed infections had vaginal changes and 66.7% of the infections due to infrequent germs were complicated. 3 out of 10 presented premature rupture of membranes, abortion or preterm delivery. Conclusions: Adolescents and young adults, mestizos, accompanied and with a higher secondary level prevailed. Vaginal discharge as a symptom and Candida albicans infection predominated. There was an association between the variables analyzed and complications.

/pdf/clinical-epidemiological-characterization-of-vaginal-1leenzmn.pdf

Clinical Epidemiological Characterization of Vaginal Infection in Pregnant. “Orlando Matos Mosquera” Polyclinic, 2019 -2021

Voucher specimens were deposited in the herbarium IZTA at the Facultad de Estudios Superiores Iztacala (voucher Manual de Microbiologia Clinica Medica. Title, Manual de microbiologia y parasitologia medica. Author, Arquimedes Canese. Publisher, Arquimedes Canese, 1983. Length, 933 pages. Export Citation. Editor: Sergio Sanchez and Arnold L. Demain, Departamento de Biologia European Manual of Clinical Microbiology (2012) Publisher: Societe Francaise de ISBN: 9780323030656/, Tratado SEIMC de enfermedades infecciosas y microbiologia clinica. Ausina Metodos basicos de laboratorio en Parasitologia Medica.

Manual De Microbiologia Medica

/pdf/comparison-between-quantitative-and-qualitative-culture-of-32op3i6d3l.pdf

Comparison between quantitative and qualitative culture of tracheal aspirates in the diagnosis of ventilator associated pneumonia

/pdf/pressure-support-ventilation-versus-bilevel-positive-airway-13uiqbf7el.pdf

Pressure support ventilation versus bilevel positive airway pressure for acute exacerbation of chronic obstructive pulmonary disease: a randomized trial

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Manual De Microbiologia Medica

Comparison between quantitative and qualitative culture of tracheal aspirates in the diagnosis of ventilator associated pneumonia

Pressure support ventilation versus bilevel positive airway pressure for acute exacerbation of chronic obstructive pulmonary disease: a randomized trial