Thrombotic risk assessment in antiphospholipid syndrome: The role of new antibody specificities and thrombin generation assay

Antiphospholipid syndrome (APS) is an autoimmune condition characterized by the presence of antiphospholipid antibodies (aPL) in subjects presenting with thrombosis and/or pregnancy loss. The currently used classification criteria were updated in the international consensus held in Sidney in 2005. Vascular events seem to result of local procoagulative alterations upon triggers influence (the so called “second-hit theory”), while placental thrombosis and complement activation seem to lead to pregnancy morbidity. The laboratory tests suggested by the current classification criteria include lupus anticoagulant, a functional coagulation assay, and anticardiolipin and anti-β2-glycoprotein-I antibodies, generally detected by solid phase enzyme-linked immunosorbent assay. The real challenge for treating physicians is understanding what is the actual weight of aPL in provoking clinical manifestations in each case. As thrombosis has a multi-factorial cause, each patient needs a risk-stratified approach. In this review we discuss the role of thrombotic risk assessment in primary and secondary prevention of venous and arterial thromboembolic disease in patients with APS, focusing on new antibody specificities, available risk scoring models and new coagulation assays

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Revisiting Glycerol Esterification with Acetic Acid over Amberlyst-35 via Statistically Designed Experiments: Overcoming Transport Limitations

Turnover rates for glycerol esterification with acetic acid over Amberlyst-35 were measured under different temperatures, reactants and active sites concentrations, and catalyst particle sizes. Data were collected in a batch reactor. Experiments were done following a sequence of factorial experimental designs

Las relaciones públicas como herramienta para potenciar la gastronomía típica de un país

Este trabajo de grado toma con alto valor, primero que nada, a la gastronomía típica, la cual se convierte en un puente cultural que expone las tradiciones e insumos propios de un país y que reafirma la identidad y el orgullo por lo local, desde lo regional a lo nacional, es por estas razones la escogencia de este tema, ya que se postula a las RRPP para poder otorgar a la cocina, la relevancia que posee la potencialización de un elemento cultural tan importante que brindan las tradiciones de un pueblo y que luego son traducidos en un plato de comida. Así mismo poner en evidencia no sólo el contexto colombiano, sino el de otro países, como lo son Perú y Portugal y demostrar el provecho que estas dos potencias gastronómicas le han dado a la cocina típica, cómo, mediante estrategias de Comunicación y Relaciones Públicas, han logrado posicionarse como líderes en la industria, no solo gastronómica, sino también en la turística y en la consolidación de una marca país clara y destacada en sus respectivos continentes.PregradoComunicador Social y Periodist

DIÁLOGO DE SABERES desde las Ciencias Económicas, Administrativas y Contables II Vol. 1

El diálogo de saberes en las ciencias sociales se ha tornado cada vez más interesante toda vez que la inter y transdisciplinariedad han asumido su papel central en la construcción de conocimiento, dejando atrás la disci plina como eje dominante del saber y del conocer. Las realidades sociales, económicas, políticas y culturales así lo exigen a partir de las relaciones complejas que se entretejen en cada dinámica y contexto donde el hombre está presente. El paradigma de la postmodernidad ha permitido recrear el conoci miento y visibilizar al hombre en sus distintas relaciones; favoreciendo entre otros aspectos, otras miradas y explicaciones de la realidad estudiada. La producción de conocimiento es un proceso complejo, por lo que la ten dencia para poder responder a las distintas necesidades de la sociedad, es agruparse en disciplinas diversas en torno a una idea, problema o situación. Este libro intenta de alguna manera apoyar esa tendencia, pues cada vez se hace más necesario distintas miradas para abordar una realidad obje to de estudio. Lo importante es reconocer, que la disciplina hoy por hoy es insuficiente y requiere de otras para entender desde la complejidad lo que se pretende explicar de forma diversa y distintiva, por lo que cada capítulo de este libro es una realidad en contexto con explicaciones, métodos, suje tos, objetos y significados diversos

Análisis de las condiciones de vida de las familias beneficiarias del programa familias en acción teniendo en cuenta la educación y nutrición en el municipio de Sincelejo - Sucre durante el periodo 2002-2012 /

Un CD-ROM (4.067 KB) : graficas, imágenes, tablas ; 12 cmEl presente trabajo busca realizar un análisis de las condiciones de vida de las familias beneficiarias del programa familias en acción teniendo en cuenta la educación y nutrición en el municipio de Sincelejo- Sucre durante el periodo 2002- 2012, que facilite una mayor profundidad en cuanto al conocimiento de las efectos que trae implícito el programa familias en acción en el mencionado municipio.PregradoEconomistaTrabajo de grado (Economista) -- Corporación Universitaria del Caribe. Facultad de Ciencias Económicas y Administrativas. Programa de Economía, Sincelejo, 2015