Radiología Forense

La radiología forense es una forma de necropsia no invasiva, donde se utilizan métodos diagnósticos como los Rayos x (Rx), Tomografías computarizadas (Tc), Ecografías (Eco) y resonancia magnética (Rm), los cuales ayudan a dar soporte al dictamen forense de forma veraz y brinda información valiosa para ayudar al médico legista a tener resultados confiables y rápidos, dependiendo el caso, tipo de estudio, tipo de cadáver y teniendo en cuenta los elementos materiales probatorios (EMP) , evidencias físicas (EF), los cuales deben ser materiales inalterables y tener una cadena de custodia para mantener su integridad, además de complementar con los métodos de identificación como indiciaria, fehaciente, comparación fotográfica y métodos radiológicos, todos estos procesos ayudan al éxito de una investigación judicial, cabe resaltar que para el desarrollo de estos estudios radiológicos se debe tener en cuenta las normas de bioseguridad y radioprotección, y con los criterios y principios de humanización. En el desarrollo de esta actividad se integraran todos estos conocimientos, aplicándolo en un caso forense de cadáveres víctimas de una explosiónForensic radiology is a form of non-invasive autopsy, where diagnostic methods such as x-rays (Rx), computed tomography (CT), ultrasound (echo) and magnetic resonance imaging (MRI) are used, which help to support the forensic opinion. truthfully and provides valuable information to help the legal doctor to have reliable and fast results, depending on the case, type of study, type of corpse and taking into account the material evidence (EMP), physical evidence (EF), which they must be unalterable materials and have a chain of custody to maintain their integrity, in addition to complementing with the identification methods such as index, reliable, photographic comparison and radiological methods, all these processes help the success of a judicial investigation, it should be noted that for the The development of these radiological studies must take into account the biosafety and radioprotection regulations, and with the criteria and principles ios of humanization. In the development of this activity, all this knowledge will be integrated, applying it in a forensic case of corpses victims of an explosion

Bienestar y buen vivir: un aporte para la felicidad del ser humano

La sensible preocupación que ha tenido la humanidad entera luego de la pandemia de la Covid-19, ha alcanzado los aspectos más susceptibles de la convivencia de la sociedad. En este contexto, la Universidad Politécnica Salesiana, por iniciativa del Grupo de Investigación en Comunicación, Educación y Ambiente (GICEA), de la Carrera de Comunicación, se ha hecho eco de los diferentes aspectos que circundan lo que ha denominado “nueva normalidad”, abordando vivencias y referentes que tienen que ver con el acceso a la educación, la salud, al trabajo, etc. Sin embargo, los autores de esta publicación, Bienestar y buen vivir: un aporte para la felicidad del ser humano reúnen textos diversos con la intención de descubrir el bienestar en el servicio de los demás… o entender la felicidad como camino de decisión personal —íntima diría yo— y familiar, que sin duda trae grandes satisfacciones; sobre todo, cuando entregamos algo a los demás, especialmente si lo hacemos como una práctica desde el corazón. Además, esta publicación es una segunda parte del libro publicado por el mismo Grupo de Investigación en Comunicación, Educación y Ambiente (GICEA), de la Carrera de Comunicación, intitulado Pandemia desde la academia: experiencias transdisciplinarias de la universidad cuencana en tiempos de COVID-19, que salió a la luz en 2021, momento en que la pandemia arreciaba en contra de la humanidad. Luis Álvarez Roda

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030