Patrimonio cultural gastronómico, turismo y signos distintivos de calidad: innovaciones para el desarrollo económico territorial en Actopan, Hidalgo

Es hasta finales de los ochenta, sobre todo durante los noventa —en un contexto de globalización acelerada—, cuando los enfoques alternativos del desarrollo alcanzaron notoriedad, en especial la emergencia del desarrollo humano y sostenible, así como un reencuentro con la perspectiva territorial/local del desarrollo. Este enfoque espacial posibilitó que cuestiones sociales, particularmente la lucha contra la pobreza, ocuparan un lugar prioritario en las estrategias de desarrollo. De esta manera, se evitó que lo anterior quedara reducido al “efecto cascada” del crecimiento económico. Todo ello abrió las puertas al redimensionamiento de la economía del desarrollo en el centro de la economía política. En este punto, factores externos e internos, económicos y no económicos, estructurales y coyunturales, históricos y geográficos, humanos e inmateriales, otorgaron a la economía del desarrollo la apertura para referirse a una interacción de distintas disciplinas que intervienen en el objeto de estudio. Desde una perspectiva distinta, se comienza a abrir el debate sobre el entorno territorial y las economías externas generadas por las interdependencias locales. Allí existen y se reproducen un cúmulo de conocimientos humanos que se combinan con diferentes factores y características tanto materiales como inmateriales. Entre los diferentes planteamientos que han ido surgiendo más o menos durante el período que va de 1985 al 2005, ha tenido gran importancia la revitalización del enfoque que considera al desarrollo como un proceso territorial y no funcional. De hecho, las políticas de desarrollo han resultado ser más eficaces cuando las realizan los actores locales. Desde esa línea de ideas, el territorio es concebido a partir de sus aspectos físicos y naturales. Por añadidura, el concepto es construido con base en aspectos humanos, culturales, en donde se desarrollan un conjunto de relaciones sociales que se corresponden con la producción, la distribución, el consumo, la organización político-social, tradiciones e historia..

Ruta gastronómica y certificación de calidad para la barbacoa típica y tradicional en Actopan, Hidalgo, como iniciativas de desarrollo local

El autor, hace un recorrido de tipo teórico sobre el desarrollo local y endógeno, para posteriormente describir el proceso de elaboración de la barbacoa y los elementos naturales (borregos criollos, pastos naturales, maguey de la región), así como el saber hacer de los maestros barbacoyeros, lo que constituye la base para ofertar un producto de calidad, unido a la oferta de otros bienes territoriales como el patrimonio arquitectónico, el patrimonio cultural inmaterial de la religiosidad popular y el natural de la región. Frente a las alternativas de una denominación de origen a la manera europea, pero que excluiría a numerosos barbacoyeros, el autor explora la construcción de una certificación participativa para avanzar en acuerdos legales e institucionales sobre los componentes de la calidad y como un paso previo a la conformación de circuitos de valor, asociados a la oferta natural y patrimonial de la región de Actopan en el marco de una posible indicación geográfica o denominación de origen.Universidad Nacional Autónoma de México/Programas de Apoyo a Proyectos de Investigación e Innovación Tecnológica/"PAPIIT IN 303117"//[“Gobernanza y desarrollo territorial. El papel de las políticas públicas. Un estudio comparativo"]Capítulos de libr

Lactate levels as a prognostic predict in cardiogenic shock under venoarterial extracorporeal membrane oxygenation support

Introduction and objectives: Lactate and its evolution are associated with the prognosis of patients in shock, although there is little evidence in those assisted with an extracorporeal venoarterial oxygenation membrane (VA-ECMO). Our objective was to evaluate its prognostic value in cardiogenic shock assisted with VA-ECMO. Methods: Study of patients with cardiogenic shock treated with VA-ECMO for medical indication between July 2013 and April 2021. Lactate clearance was calculated: [(initial lactate - 6 h lactate) / initial lactate × exact time between both determinations]. Results: From 121 patients, 44 had acute myocardial infarction (36.4%), 42 implant during cardiopulmonary resuscitation (34.7%), 14 pulmonary embolism (11.6%), 14 arrhythmic storm (11.6%), and 6 fulminant myocarditis (5.0%). After 30 days, 60 patients (49.6%) died, mortality was higher for implant during cardiopulmonary resuscitation than for implant in spontaneous circulation (30 of 42 [71.4%] vs 30 of 79 [38.0%], P=.030). Preimplantation GPT and lactate (both baseline, at 6hours, and clearance) were independently associated with 30-day mortality. The regression models that included lactate clearance had a better predictive capacity for survival than the ENCOURAGE and ECMO-ACCEPTS scores, with the area under the ROC curve being greater in the model with lactate at 6 h. Conclusions: Lactate (at baseline, 6h, and clearance) is an independent predictor of prognosis in patients in cardiogenic shock supported by VA-ECMO, allowing better risk stratification and predictive capacity.Sin financiaciónNo data JCR (2021)0.385 SJR (2021) Q3, 1499/2489 Medicine (miscellaneous)No data IDR 2020UE

Lactate levels as a prognostic predict in cardiogenic shock under venoarterial extracorporeal membrane oxygenation support

Introducción y objetivos El lactato y su evolución se asocian con el pronóstico de los pacientes en shock, si bien es escasa la evidencia en aquellos asistidos con oxigenador extracorpóreo de membrana venoarterial (ECMO-VA). Nuestro objetivo es evaluar su valor pronóstico en shock cardiogénico asistido con ECMO-VA. Métodos Estudio de pacientes tratados con ECMO-VA por shock cardiogénico de indicación médica entre julio de 2013 y abril de 2021. Se calculó el aclaramiento de lactato: (lactato inicial − lactato 6 h) / lactato inicial × tiempo exacto entre ambas determinaciones. Resultados De 121 pacientes, 44 (36,4%) tenían infarto agudo de miocardio; 42 (34,7%), implante intraparada; 14 (11,6%), tromboembolia pulmonar, 14 (11,6%), tormenta arrítmica y 6 (5,0%), miocarditis fulminante. A los 30 días habían fallecido 60 pacientes (49,6%); la mortalidad fue mayor con el implante intraparada que con el implante en circulación espontánea (30 [71,4%] de 42 frente a 30 [38,0%] de 79; p = 0,030). Se asociaron de manera independiente con la mortalidad a 30 días la alanina aminotransferasa (ALT) antes del implante y el lactato (tanto basal como a las 6 h y el aclaramiento). Los modelos de regresión que incluían el lactato presentaron mejor capacidad predictiva de la supervivencia que las puntuaciones ENCOURAGE y ECMO-ACCEPTS, con mayor área bajo la curva ROC en el modelo con lactato a las 6 h. Conclusiones El lactatoSin financiación6.975 JCR (2021) Q1, 33/143 Cardiac & Cardiovascular Systems0.407 SJR (2021) Q3, 205/356 Cardiology and Cardiovascular MedicineNo data IDR 202

Ethno-pharmacological relevance/features of some latin american wild medicinal plants, in ethnopharmacology of wild plants

The traditional herbal healers, along with wild medicinal plants and the knowledge they have about them, in certain regions of Latin America, are the prevalent alternatives for some people/communities to cover any primary health care requirements (e.g., treatment to prevent/improve/release pain/symptoms/disorders/diseases). traditional (plant-based) medicine has gained worldwide acceptance because the plants used for this purpose have been apparently efficacious and safe for a long time (decades/centuries), these being some reasons why the WHO created the traditional, complementary and integrative unit. (WHO 2019). Despite this, it is important to remember (i) what “ethnopharmacology” studies are about, which are, shortly, the uses, possible action modes, and bioproperties of plant-based preparations; and (ii) the contribution made by phytochemistry and pharmacology along with other related sciences (botany, pharmacy, microbiology, virology, parasitology, etc.) to find/check any biologically active drugs (molecules/fractions/extracts). In that sense, traditional medicine systems need more evidence-based studies that allow establishing the pharmacological potential together with the validation of therapeutic uses of medicinal plants and its chemical constituents [isolated or mixtures (fractions/extracts)] in such a way that safety and effectiveness are verified, as well as to reveal/understand their preventive and/or therapeutic mechanisms (Mukherjee et al. 2010, Schmidt and Klaser-Cheng 2017)

Adipose-derived regenerative cells in patients with ischemic cardiomyopathy:The PRECISE Trial

Aims Adipose-derived regenerative cells (ADRCs) can be isolated from liposuction aspirates and prepared as fresh cells for immediate administration in cell therapy. We performed the first randomized, placebo-controlled, double-blind trial to examine the safety and feasibility of the transendocardial injections of ADRCs in no-option patients with ischemic cardiomyopathy. Methods and results Procedural, postoperative, and follow-up safety end points were monitored up to 36 months. After baseline measurements, efficacy was assessed by echocardiography and single-photon emission computed tomography (6, 12, and 18 months), metabolic equivalents and maximal oxygen consumption (MVO2) (6 and 18 months), and cardiac magnetic resonance imaging (6 months). We enrolled 21 ADRC-treated and 6 control patients. Liposuction was well tolerated, ADRCs were successfully prepared, and transendocardial injections were feasible in all patients. No malignant arrhythmias were seen. Adverse events were similar between groups. Metabolic equivalents and MVO2 values were preserved over time in ADRC-treated patients but declined significantly in the control group. The difference in the change in MVO2 from baseline to 6 and 18 months was significantly better in ADRC-treated patients compared with controls. The ADRC-treated patients showed significant improvements in total left ventricular mass by magnetic resonance imaging and wall motion score index. Single-photon emission computed tomography results suggested a reduction in inducible ischemia in ADRC-treated patients up to 18 months. Conclusion Isolation and transendocardial injection of autologous ADRCs in no-option patients were safe and feasible. Our results suggest that ADRCs may preserve ventricular function, myocardial perfusion, and exercise capacity in these patients. © 2014 Mosby, Inc

Sistemas agroalimentarios localizados : análisis y políticas públicas

El lector interesado en los estudios sobre el territorio podrá aproximarse en las páginas de esta obra colectiva por medio de diversas escalas. La primera de ellas: los Sistemas Agroalimentarios Localizados (SIAL), y en su intersección disciplinaria, con la gobernanza y la acción pública en el nivel teórico y conceptual, así como diversos estudios de caso en América Latina. La segunda, se relaciona con la valoración de las formas de proximidad que están presentes en los sistemas agroalimentarios periurbanos y las relaciones de confianza que establecen productores y consumidores por medio de las cadenas cortas agroalimentarias, ligadas a la conservación y valoración de los productos de la agrodiversidad. La siguiente escala de análisis destaca la relación de los SIAL con las políticas públicas y las formas de gobernanza, que se construyen en los territorios. Los capítulos presentan avances y/o resultados de investigaciones cualitativas, discusiones en torno a los tipos de gobernanza y sus alcances, las diferencias e implicaciones de la gobernanza territorial e importancia que tiene para el territorio esa construcción política y social. Paralelamente, los análisis alertan sobre procesos de exclusión social cuando un grupo logra obtener ventajas territoriales no generalizadas al sistema agroalimentario local y donde la gestión de políticas públicas es imprescindible a fin de regular y favorecer la inclusión. En este sentido, se observa como la acción colectiva puede llegar a ocupar un papel protagónico en la construcción de gobernanza territorial. En una cuarta escala de análisis se estudia la presencia dominante en el mercado de las corporaciones globales y sus efectos en los territorios, por la corrupción en las relaciones gobierno-empresa, que anulan o subordinan las posibilidades de un desarrollo territorial en los ámbitos: económico, ambiental, alimentario y cultural, así como respuestas de innovación social.Trabajo realizado con el apoyo del Programa UNAM DGAPA-PAPIIT IN303117Libro

Mexican Asthma Guidelines: GUIMA 2017

Background: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. Methods: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was adjusted by physicians from 12 national medical societies in several rounds of a Delphi process and 3 face-to-face meetings to reach the final version. Results: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015 (2016 updates included). After 3 Delphi-rounds we developed an evidence-based document taking into account patient characteristics, including age, treatment costs and safety and best locally available medication. Conclusion: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care