En esta obra la autora describe el día a día de un enfermo que padece Alzheimer. El libro describe la enfermedad y el relato de los cuidados que la autora dedicó durante más de catorce años a su esposo, un prestigioso médico dedicado a la investigación del cáncer.

En la alocución pronunciada el día de san Braulio de 2010 se exponen los conocimientos de que se dispone en la actualidad sobre el segundo genoma de la célula, el genoma mitocondrial humano, y se explica el camino hacia el descubrimiento de las enfermedades genéticas originadas por daños en dicho genoma. El grupo de investigación al que pertenece el autor lleva más de treinta años trabajando sobre el tema y, aunque es mucho lo que se sabe de él, queda un largo trecho por recorrer para entender por completo todos los procesos en los que interviene y poder desarrollar una terapia adecuada. Texto...

Este libro debe servir como una necesaria advertencia para todos aquellos que padecen el llamado "colon irritable". A partir de un diario de vida, Mujica aborda el relato de su experiencia personal alrededor de la enfermedad de su esposa. Los intentos por ayudarla, a pesar de ser médico, resultaron infructuosos ante el desconocimiento y los errores en la atención profesional, que hicieron que los últimos meses de vida del ser amado fueran más breves y dolorosos.

Objective: Provide an instrument in Spanish for measuring and studying physicians’ career satisfaction in Andalusia, Spain. Method: It followed two general stages: An instrument adaptation and descriptive cross-sectional study. Factor analysis was performed with 16-item scale. Construct validity was verified through a correlation between the summed 16-items scale and the global item, and internal consistency reliability was estimated with a Cronbach’s alpha. Finally, physicians’ career satisfaction was measured and characteristics related to a higher level of satisfaction were explored through a multivariate logistic regression. Results: An instrument adaption into Spanish was developed. Cronbach’s alpha of the instrument was 0.92. The rate response was 40%. Mean career satisfaction was 4.36(SD=0.76) out of a possible score of 6. Multivariate logistic regression showed that physicians who reported having received non-economic incentives during last year have a level of career satisfaction 3.11(IC=1.19–8.13) times higher than those that have not received, and also that foreign physicians have a level of career satisfaction 7.81(IC=1.40–43.48) times higher than Spanish ones, controlling by personal, professional, work, and incentives factors. Conclusions: This study performed the adaptation and validation of an instrument which measures physicians’ career satisfaction in Andalusia, Spain. The methodology to translate and adapt the instrument was successful, making the method replicable in other languages and countries. The instrument demonstrated acceptable levels of internal consistency reliability and construct validity. It was found that foreign physicians have eight times higher career satisfaction, and physicians that referred having received non-economic incentives during the last year have three times higher career satisfaction.

Pregnancy during adolescence is a worldwide public health concern. In developing countries, 14 million adolescents give birth each year, which accounts for 90% of all worldwide pregnancies. The proportion of adolescent women aged 10-19 whom have been pregnant in Mitú, Colombia is of approximately 25%, in comparison to 19.5% at the national level. This report aims to review the effectiveness and identifying best practice of adolescent pregnancy interventions in low and middle income countries and use formative research to make specific recommendations for policy and practice to prevent adolescent pregnancy in Mitú, Colombia. EMBASE, Medline, CINHAL, Cochrane library, GLOBAL HEALTH, ADOLEC, Popline, LILACS and REPRODUCTIVE HEALTH LIBRARY were searched to identify studies examining adolescent pregnancy prevention interventions in developing countries. GOOGLE was searched to identify grey literature. Five semi-structured interviews were also conducted with key service providers in the field of Adolescent Sexual and Reproductive Health in Mitú to explore the needs of the region in regards to adolescent pregnancy prevention and the barriers and facilitators for programme implementation. The literature review found that adolescent pregnancy prevention interventions in developing countries had a positive impact on the knowledge of pregnancy prevention and may contribute to the delay of sexual initiation. However, impact on the use of contraceptive methods and reduction of adolescent pregnancy inconclusive. Interviews revealed key societal, familial and individual factors that were viewed to be linked to adolescent pregnancy in Mitú. Relationships between military personnel and young women appeared to be an important factor in high teenage pregnancy rates. Barriers for the adequate implementation and continuation of programmes included lack of political commitment, lack of financial, human and material resources and lack of inter-institutional collaboration, the high rate of staff turnover and the lack of monitoring programmes. Only few facilitators were mentioned that consisted mainly in the willing of both adolescent and military to collaborate in the implementation of adolescent pregnancy prevention interventions. In conclusion, evidence suggests that adolescent pregnancy prevention strategies are effective in increasing knowledge of pregnancy and might delay sexual initiation in low and middle-income countries. Features of effective programmes were identified and discussed and are important in designing and developing new strategies. However, cultural, environmental and social barriers need to be addressed through political commitment and inter-institutional collaboration in order to develop effective interventions for pregnancy prevention in Mitú.

Abstract: Functional Electrical Stimulation (FES) and robotic gait orthoses are rehabilitation technologies that help patients who have lost their normal gait function due to conditions such as spinal cord injury or stroke. FES promotes active muscle contractions that facilitate the rehabilitation process, while the Lokomat (an automated gait orthosis developed by Hocoma in collaboration with Balgrist University Hospital) provides passive limb movements that help to restore and increase mobility. The goal of this project was to combine both technologies in order to improve the beneficial effects that they provide individually. For that purpose, a control algorithm was developed for real-time Linux using an Iterative Learning Control approach in parallel with feedback control. The system was implemented on the ankle and knee joints. The ankle was controlled using a desired angle based on medical literature, while the knee was controlled using a reference force trajectory measured on subjects inside the Lokomat under high-effort conditions. As an alternative to force control on the knee, angle control was implemented for experiments in the lab. The controllers were tested on healthy subjects with and without the inclusion of voluntary movement. Based on these tests, we show the advantages and disadvantages of the control scheme and the physical setup, and give ideas for further improvement. Resumen: La estimulación eléctrica funcional (FES) y las ortesis de marcha robótica son tecnologías de rehabilitación que ayudan a los pacientes que han perdido su función de marcha normal debido a afecciones como una lesión de la médula espinal o un accidente cerebrovascular. FES promueve contracciones musculares activas que facilitan el proceso de rehabilitación, mientras que Lokomat (una órtesis de marcha automatizada desarrollada por Hocoma en colaboración con el Hospital Universitario Balgrist) proporciona movimientos pasivos de las extremidades que ayudan a restaurar y aumentar la movilidad. El objetivo de este proyecto fue combinar ambas tecnologías para mejorar los efectos beneficiosos que proporcionan individualmente. Para ello, se desarrolló un algoritmo de control para Linux en tiempo real utilizando un enfoque de control por aprendizaje iterativo en paralelo con el control de retroalimentación. El sistema se implementó en las articulaciones del tobillo y la rodilla. El tobillo se controló usando un ángulo deseado basado en la literatura médica, mientras que la rodilla se controló usando una trayectoria de fuerza de referencia medida en sujetos dentro del Lokomat bajo condiciones de alto esfuerzo. Como alternativa al control de fuerza en la rodilla, se implementó el control de ángulo para experimentos en el laboratorio. Los controladores se probaron en sujetos sanos con y sin la inclusión de movimiento voluntario. Con base en estas pruebas, mostramos las ventajas y desventajas del esquema de control y la configuración física, y brindamos ideas para mejoras adicionales.

Background Retinopathy of prematurity is the major cause of blindness in children in Colombia. This cause of childhood blindness is irreversible when stablished, but 100% preventable with the adequate strategies put in place. This raises important questions concerning strategies to reduce the incidence of blindness as a result of ROP, which should ensure that all infants who are at risk of blinding ROP are examined in screening programmes. Aim The aim was to collect data in the neonatal intensive care units. This was used to evaluate the existing human and material resources for preventing, screening and treating ROP and rehabilitation of children suffering from ROP. The data helped to do an analysis of gaps in the service and allowed to present a proposal for a programme to prevent blindness due to ROP in the cities of Manizales, Pereira and Armenia, Colombia. Methods 7 NICUs were visited in the three cities. The study collected quantitative data on neonatal intensive care units, admission and survival of premature babies during 2010, human resources and infrastructure and data on knowledge of the Colombian guidelines on ROP. Results The survival rates vary according to the provider. They are higher in the private sector, and lower in the public sector. Overall, the available data allowed us to estimate that there are approximately 45,000 births per year (2010) in the region (95% occur in hospital) and 1.8% of all the births are less than 2,000g. Therefore, in the region, 810 babies per year weighing less than 2,000g are at risk of developing any type of ROP. The number of places, ventilators and monitors is sufficient. Staffing is adequate in the private NICUs, with a shortage of neonatologists in the public NICUs. The number of nurses monitoring babies is universally adequate, but the lack of knowledge in controlling risk factors of developing ROP such as monitoring oxygen in a constraint. An ROP screening programme is not available in public NICUs and in some of the mixed providers. The Kangaroo Mother programme lack of screening for ROP. Conclusions The unstable health system has allowed (i) unsustainable NICUs and programmes for ROP (ii) If available, programmes running without being monitored or evaluated, and, (iii) no screening in public and some mixed NICUs in Manizales, Pereira and Armenia. (iv) no screening for ROP in the Kangaroo Mother Programe As access and survival rates improve in the NICUS of these cities, ROP is likely to continue to be a significant cause of blindness in the region, despite the progress that has been achieved with the 2010 Colombian guidelines for screening and treating ROP. Recommendations The results suggest that the prevention of blinding ROP is a complex task in Colombia that requires concomitant strategies to be put in place: Firstly, national policies in screening for ROP and oxygen delivery for the babies in the NICUs are needed. Secondly, as a primary preventive strategy, training nurses in the NICUs to control and monitor the delivery of oxygen; as a secondary preventive strategy, ROP programmes offered to the public, mixed, private NICUs and to the Kangaro Mother Programme; as a tertiary strategy, rehabilitation providing a low vision centre for these children Thirdly, running ROP programmes need to be monitored and evaluated.

Las investigaciones relativas a la estructura y funcionamiento del cerebro han progresado con rapidez en los últimos tiempos y el esfuerzo para explicar las bases neurológicas de la mente ha comenzado a proporcionar resultados palpables. Desbordando los límites de su disciplina, muchos neurocientíficos hacen incursiones en el terreno de la antropología y la filosofía. Este libro ha sido elaborado por un grupo de filósofos y científicos empeñados desde hace años en el trabajo interdisciplinar y adscritos a orientaciones doctrinales muy diversas. Expone los avances más recientes y valora hasta qué...

Si engorda o le cuesta mucho adelgazar no es porque coma demasiado, sino porque no le está aportando a su cuerpo los nutrientes que necesita. Sus problemas de peso están ligados a carencias de micronutrientes que son indispensables para su equilibrio. Gracias a este libro, basado en los últimos descubrimientos científicos europeos, podrá disfrutar de las ventajas de la micronutrición para recuperar la línea. Descubra cuál es su perfil y siga un programa de adelgazamiento personalizado. Con consejos prácticos para cocinar light y 64 recetas exprés de brochetas, sopas, papillotes... del entrante al postre: disfrute al estilo de la micronutrición.