Guía de práctica clínica para la prevención, diagnóstico, tratamiento y rehabilitación de la falla cardiaca en población mayor de 18 años, clasificación B, C y D

La falla cardíaca es un síndrome clínico caracterizado por síntomas y signos típicos de insuficiencia cardíaca, adicional a la evidencia objetiva de una anomalía estructural o funcional del corazón. Guía completa 2016. Guía No. 53Población mayor de 18 añosN/

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Levofloxacin induces differential effects in the transcriptome between the gut, peripheral and axial joints in the Spondyloarthritis DBA/1 mice: Improvement of intestinal dysbiosis and the overall inflammatory process.

To analyze the effect of levofloxacin-induced intestinal microbiota modifications on intestinal, joint, and systemic inflammation in the DBA/1 mice with spontaneous arthritis. The study included two groups of mice, one of which received levofloxacin. The composition and structure of the microbiota were determined in the mice's stool using 16S rRNA sequencing; the differential taxa and metabolic pathway between mice treated with levofloxacin and control mice were also defied. The effect of levofloxacin was evaluated in the intestines, hind paws, and spines of mice through DNA microarray transcriptome and histopathological analyses; systemic inflammation was measured by flow cytometry. Levofloxacin decreased the pro-inflammatory bacteria, including Prevotellaceae, Odoribacter, and Blautia, and increased the anti-inflammatory Muribaculaceae in mice's stool. Histological analysis confirmed the intestinal inflammation in control mice, while in levofloxacin-treated mice, inflammation was reduced; in the hind paws and spines, levofloxacin also decreased the inflammation. Microarray showed the downregulation of genes and signaling pathways relevant in spondyloarthritis, including several cytokines and chemokines. Levofloxacin-treated mice showed differential transcriptomic profiles between peripheral and axial joints and intestines. Levofloxacin decreased the expression of TNF-α, IL-23a, and JAK3 in the three tissues, but IL-17 behaved differently in the intestine and the joints. Serum TNF-α was also reduced in levofloxacin-treated mice. Our results suggest that the microbiota modification aimed at reducing pro-inflammatory and increasing anti-inflammatory bacteria could potentially be a coadjuvant in treating inflammatory arthropathies

Reflexiones sobre la educación en diseño en contextos de emergencia

El libro que tiene en sus manos representa el esfuerzo y compromiso que la planta académica de la División de Ciencias y Artes para el Diseño ha asumido durante la pandemia COVID-19, pasar de un aprendizaje tradicional a un aprendizaje digital, para continuar cumpliendo con el compromiso de nuestra institución: formar ciudadanos y profesionistas de alto nivel. Este libro respeta los cinco ejes temáticos propuestos por el comité organizador. 1. Transición de la enseñanza-aprendizaje mediada por tecnologías digitales. 2. Experiencias significativas para los actores (docentes u alumnos). 3. Propuesta pedagógica innovadora. 4. Reflexión sobre la apropiación de las tecnologías digitales y recursos. 5. Diseño de futuros para una educación en diseño. Cada uno de los artículos que integran esta obra está asociado a alguno de estos ejes. En conjunto representan la base de una gran oportunidad que tiene nuestra División para reinventarse y diversificar las experiencias de aprendizaje además de la modalidad presencial. A esta reflexión colectiva también se han sumado las ideas de profesoras y profesores de otras instituciones, con lo cual la experiencia se ha enriquecido aún más al identificar obstáculos y retos compartidos. Hemos descubierto el potencial de la educación digital y dependerá de nosotros el diseñar las estrategias para aprender a convivir también con la educación presencial. Debemos reconocer que las y los profesores no estaban capacitados para un aprendizaje digital, situación no exclusiva de nuestra casa de estudios, en la mayoría de instituciones del sistema de educación superior tampoco estaban preparados. Además de resaltar la falta de políticas de inclusión para favorecer un aprendizaje digital. Estas dos ideas se vuelven elementos centrales para que las universidades asuman un mayor compromiso al respecto.Coordinadoras e [introducción]: Juana Cecilia Ángeles Cañedo y Alma Elisa Delgado Coellar; [Presentación] 2o. Coloquio de Educación en Diseño / Marco Vinicio Ferruzca Navarro; coordinación editorial: Alma Elisa Delgado Coellar y Martha Ivonne Murillo Islas; diseño de interiores, de portada y formación de interiores: Martha Ivonne Murillo Islas; corrección de estilo: Agustina Larrañaga