Flexibilidad y adaptabilidad para las diferentes formas de vivir. Vivienda post pandémica en entorno patrimonial

Artículo de gradoEl articulo expone un proyecto basado en el análisis de la vivienda actual y personal desde la pandemia 2020, donde se identifican algunas necesidades a partir de las nuevas modalidades de estudio, trabajo, y otras actividades identificadas en mi hogar. A partir de ello, se generan conjuntos de vivienda unifamiliares permitiendo una progresividad autónoma, así como dos tipologías de apartamentos flexibles que se repiten, obteniendo como resultado la implantación estratégica de un conjunto residencial colectivo, con el objetivo de frenar la tendencia de producir hogares cada vez más limitados ofreciendo la posibilidad de crear espacios multifuncionales adaptables a las circunstancias y necesidades cambiantes, proponiendo un lugar urbano adecuado. Lo anterior se proyecta del municipio de Villa de Leyva – Monumento nacional, en el casco urbano en la periferia del centro histórico, conectando con la quebrada de San Agustín.Resumen 1. Introducción 2. Hipótesis y objetivos 3. Metodología 4. Resultados 5. Discusión 6. Conclusiones 7. Agradecimientos Referencias AnexosPregradoArquitect

Brief update on diabetes for general practitioners

Diabetes includes a group of metabolic disorders in which there is hyperglycemia. This can be due to impaired insulin secretion, insulin action or both. Chronic hyperglycemia is associated with serious long-term complications in several organs, especially in the eyes, kidneys, nerves, heart and blood vessels. In our country this disorder affects 13.8% of the population. There are several types of diabetes although most patients suffer type 2 diabetes. We set out to review the diagnostic process, screening recommendations, prevention strategies, initial assessment upon diagnosis, therapeutic targets regarding both blood glucose levels and the other vascular risk factors while also considering healthy lifestyles and brief references to medications recommended in each section

Evaluation of prophylaxis in primary prevention with acetylsalicylic acid in people with diabetes: A scoping review

The efficacy and safety of acetylsalicylic acid (ASA) prophylaxis for the primary prevention of atherosclerotic cardiovascular disease (ACVD) remain controversial in people with diabetes (DM) without ACVD, because the possible increased risk of major bleeding could outweigh the potential reduction in the risk of mortality and of major adverse cardiovascular events (MACE) considered individually or together.La eficacia y la seguridad de la profilaxis con ácido acetilsalicílico (AAS) para la prevención primaria de la enfermedad cardiovascular arteriosclerótica (ECVA) siguen siendo controvertidas en personas con diabetes (DM) sin ECVA, ya que el posible aumento del riesgo de hemorragias graves podría superar la posible disminución del riesgo de mortalidad y de los principales episodios adversos cardiovasculares (MACE) considerados individualmente o en conjunto

Response to Combined Antiretroviral Therapy According to Gender and Origin in a Cohort of Naive HIV-Infected Patients: GESIDA-5808 Study

We analyzed differences in response to combined antiretroviral therapy (cART) according to sex and geographic origin in a retrospective comparative study of Spanish-born and immigrant patients initiating cART. The primary endpoint was time to treatment failure (TTF), defined as virological failure, death, opportunistic infection, interruption of cART, or loss to follow-up. Late diagnosis was defined as a CD4+ cell count ≤ 200 cells/mm3 and/or AIDS at initiation of cART. Survival was analyzed using Kaplan-Meier analysis and Cox regression. We followed 1,090 patients, of whom 318 were women (45.6% immigrant women [IW]). At initiation of treatment, women had a higher CD4+ count than men (217 vs 190 cells/mm3), a lower viral load (4.7 vs 5 log), and fewer were late starters (49% vs 59%). The adjusted risk of TTF between women and men was not significantly different (hazard ratio [HR], 1.10; 95% CI, 0.79-1.53). TTF was shorter among IW than Spanish-born women (124 weeks [95% CI, 64-183] vs 151 [95% CI, 127-174]) and loss to follow-up was double that of Spanish-born women (25.5% vs 11.6%). Although response to cART was similar for both sexes, men started treatment later. IW were more frequently lost to follow-up and switched treatment. Measures to improve medical follow-up after initiation of cART should be promoted among this minority group. Response to Combined Antiretroviral Therapy According to Gender and Origin in a Cohort of Naïve HIV-Infected Patients: GESIDA-5808 Study. Available from: https://www.researchgate.net/publication/224971412_Response_to_Combined_Antiretroviral_Therapy_According_to_Gender_and_Origin_in_a_Cohort_of_Naive_HIV-Infected_Patients_GESIDA-5808_Study.2.304 JCR (2012) Q2, 122/261 Pharmacology & pharmacy; Q3, 42/70 Infectious disease

Do HIV-Infected Immigrants Initiating HAART have Poorer Treatment-Related Outcomes than Autochthonous Patients in Spain? Results of the GESIDA 5808 Study

Objective: Currently, 12% of the Spanish population is foreign-born, and a third of newly diagnosed HIV-infected patients are immigrants. We determined whether being an immigrant was associated with a poorer response to antiretroviral treatment. Methods: Historical multicenter cohort study of naive patients starting HAART. The primary endpoint was time to treatment failure (TTF) defined as virological failure (VF), death, opportunistic disease, treatment discontinuation (D/C), or missing patient. Secondary endpoints were TTF expressed as observed data (TFO; censoring missing patients) and time to virological failure (TVF; censoring missing patients and D/C not due to VF). A multivariate analysis was performed to control for confounders. Results: A total of 1090 treatment-naive HIV-infected patients (387 immigrants and 703 autochthonous) from 33 hospitals were included. Most immigrants were from Sub-Saharan Africa (28.3%) or South-Central America/Caribbean (31%). Immigrants were significantly younger (34 y vs 39 y), more frequently female (37.5% vs 24.6%), with less HCV coinfection than autochthonous patients (7% vs 31.3%). There were no differences in baseline viral load (4.95 Log(10) vs 4.98 Log(10)), CD4 lymphocyte count (193.5/mu L vs 201.5/mu L), late initiation of HAART (56.4% vs 56.0%), or antiretrovirals used. Cox-regression analysis (HR; 95%CI) did not show differences in TTF (0.89; 0.66-1.20), TFO (0.95; 0.66-1.36), or TVF (1.00; 0.57-1.78) between immigrants and autochthonous patients. Losses to follow-up were more frequent among immigrants (17.8% vs 12.1; p=0.009). Sub-Saharan African patients and immigrant females had a significantly shorter TTF. Conclusions: The response to HAART among immigrant patients was similar to that of autochthonous patients, although they had a higher rate of losses to follow-up. Sub-Saharan Africans and immigrant females may need particular measures to avoid barriers hindering antiviral efficacy.1.923 JCR (2010) Q3, 23/33 Virology; Q4, 103/134 Immunology, 44/58 Infectious Disease