Neutropenia febril en el trópico: una descripción de los hallazgos clínicos y microbiológicos y el impacto de la terapia inapropiada que utilizan en un centro de referencia oncológica en Colombia

Introduction. Febrile neutropenia is a common complication of chemotherapy treatment of malignant hematological diseases. However, there is insufficient information regarding the infectious complications of febrile neutropenia in our country. Objective. We will evaluate the microbial characteristics of bacterial and fungal isolates and the clinical outcome of patients with febrile neutropenia who received medical attention at an oncological reference center in Colombia. Materials and methods. A prospective case series included patients with histologically confirmed oncological disease, who were admitted because of febrile neutropenia or presented with febrile neutropenia during hospitalization. Patients with benign hematological diseases were excluded. Demographic, microbiological, and clinical features as well as treatment and outcome information from patients with febrile neutropenia were obtained. We performed univariate and multivariate analyses, with mortality defined as the outcome. Results. One hundred and thirty episodes of febrile neutropenia were identified in 104 patients. The mean patient age was 19, and 53% of the patients were male. Approximately 86% of the episodes occurred in patients with hematological disorders. An infectious site was identified in 65% of patients; 41% and 24% of the febrile neutropenia pateints´ episodes exhibited a localized infectious focus and developed bloodstream infections, respectively. The majority of infections were found in blood, urine, gastrointestinal tract, and soft tissue. Distribution analysis of microbiological isolates revealed 46.4% Gram-negative bacilli, 38.4% Gram-positive cocci, 8% fungi, and 7.1% parasites; there was a 7.7% mortality rate. Appropriate empirical antimicrobial therapy was a protection-related factor in multivariate analyses (OR= 0.17; 0.034 – 0.9 95% CI; p= 0.037). Conclusions. The mortality rate was relatively low and comparable to the rate reported by developed countries. Inappropriate empirical antimicrobial therapy was the main factor associated with mortality. doi: http://dx.doi.org/10.7705/biomedica.v33i1.815 Introducción. La neutropenia febril es una complicación frecuente de la quimioterapia para las neoplasias hematológicas. Se dispone de escasa información de sus complicaciones infecciosas en nuestro medio. Objetivo. Evaluar las características clínicas y microbiológicas de pacientes con neutropenia febril, así como su resultado clínico en una institución de referencia oncológica en Colombia. Materiales y métodos. Se conformó prospectivamente una serie de casos con pacientes con enfermedad oncológica confirmada, que consultaron o presentaron neutropenia febril durante la hospitalización. Se excluyeron aquellos con enfermedad hematológica benigna. Se recolectaron datos sobre variables demográficas, microbiológicas, clínicas, de tratamiento y de resultado de los pacientes. Se llevaron a cabo un análisis univariado y uno multivariado, con la mortalidad como resultado. Resultados. Se identificaron 130 episodios de neutropenia febril en 104 pacientes, con una edad media de 19 años y 53 % masculinos. El 86 % de los episodios ocurrieron en pacientes con alteraciones hematológicas. Se demostró infección en 65 % de los casos: 41 % con un foco infeccioso localizado y 27,7 % con bacteriemia. Los principales focos infecciosos se localizaron en el torrente sanguíneo, el aparato urinario, el sistema gastrointestinal, la piel y los tejidos blandos. De los aislamientos microbiológicos, 46,4 % fueron bacilos Gram negativos, 38,4 %, cocos Gram positivos, 9 %, hongos y, 7,1%, parásitos. La mortalidad global fue de 7,7 %. En el análisis multivariado la utilización de un tratamiento empírico apropiado se correlacionó con una menor mortalidad, de forma independiente (OR=0,17; IC95% 0,034-0,9; p=0,037). Conclusiones. La tasa de mortalidad fue relativamente baja y fue comparable con lo reportado en países desarrollados. El tratamiento antimicrobiano inapropiado fue el principal factor asociado con mortalidad. doi: http://dx.doi.org/10.7705/biomedica.v33i1.81

Evaluación de riesgos laborales del área de distribución y entregas de la distribuidora sur de coca cola en Bogotá D.C. durante el segundo semestre de 2022

Apéndice A. Operacionalización de variables, Apéndice B. Instrumento de recolección de la información, Apéndice C. Encuesta en Google DriveEl siguiente texto proporciona un resumen del proyecto de investigación sobre los riesgos laborales notados en los trabajadores del área de distribución y entregas de la compañía Coca Cola en Bogotá D.C. durante el segundo semestre de 2022. La propuesta tiene como objetivo examinar los riesgos laborales presentes es sus labores de los trabajadores de Coca Cola, indicando la relación sociolaboral, las condiciones de las instalaciones del área e identificando los diferentes tipos de riesgos a los que están expuestos, específicamente diagnosticando la situación de los empleados en la compañía. En consecuencia, se realizó la investigación a través de una encuesta virtual que permite la identificación de las principales causas de riesgos laborales notados de los trabajadores en el área de entregas de la distribuidora sur de Coca-Cola en Bogotá, como resultados que conducen al mejoramiento de la capacidad científica nacional, se encuentran las características sociolaborales como: la edad, el género, cargo, antigüedad y el nivel escolar del personal involucrado en el estudio, y como productos dirigidos a la adquisición social del conocimiento, encontramos las condiciones del área y los tipos de riesgo laboral de los colaboradores. Las propuestas y/o preguntas presentadas en este trabajo son respaldadas por la encuesta sobre la exposición de riesgos laborales en los colaboradores del área de distribución y entrega de la distribuidora sur de Coca-Cola en Bogotá para la segunda mitad de 2022. De acuerdo con lo anterior, adquirimos nuevos conocimientos en cuanto a las características sociolaborales, condiciones del área y exposición de riesgos laborales de los trabajadores basados en la metodología de la investigación aplicada y los resultados y análisis obtenidos. Palabras claves: área, laboral, SSST, trabajador, Compañía.The following text provides a summary of the research project on the occupational risks noted in the workers of the distribution and delivery area of the Coca Cola company in Bogotá D.C. during the second semester of 2022. The proposal aims to examine the labor risks present in the work of Coca Cola workers, indicating the socio-labor relationship, the conditions of the area's facilities and identifying the different types of risks to which they are exposed, specifically diagnosing the situation of employees in the company. Consequently, the research was conducted through a virtual survey that allows the identification of the main causes of occupational risks noted of the workers in the delivery area of the southern Coca-Cola distributor in Bogotá, as results that lead to the improvement of the national scientific capacity, are the socio-labor characteristics such as: age, gender, position, seniority and school level of the personnel involved in the study, and as products aimed at the social acquisition of knowledge, we found the conditions of the area and the types of occupational risk of the collaborators. The proposals and/or questions presented in this work are supported by the survey on occupational risk exposure in the collaborators of the distribution and delivery area of the Coca-Cola South Distributor in Bogota for the second half of 2022. According to the above, we acquired new knowledge regarding the socio-labor characteristics, area conditions and occupational risk exposure of workers based on the applied research methodology and the results and analysis obtained. Key words: area, labor, SSST, worker, Company

Radical scavenging and cellular antioxidant activity of the cocoa shell phenolic compounds after simulated digestion

The cocoa industry generates a considerable quantity of cocoa shell, a by-product with high levels of methylxanthines and phenolic compounds. Nevertheless, the digestion process can extensively modify these compounds’ bioaccessibility, bioavailability, and bioactivity as a consequence of their transformation. Hence, this work’s objective was to assess the influence of simulated gastrointestinal digestion on the concentration of phenolic compounds found in the cocoa shell flour (CSF) and the cocoa shell extract (CSE), as well as to investigate their radical scavenging capacity and antioxidant activity in both intestinal epithelial (IEC-6) and hepatic (HepG2) cells. The CSF and the CSE exhibited a high amount of methylxanthines (theobromine and caffeine) and phenolic compounds, mainly gallic acid and (+)-catechin, which persisted through the course of the simulated digestion. Gastrointestinal digestion increased the antioxidant capacity of the CSF and the CSE, which also displayed free radical scavenging capacity during the simulated digestion. Neither the CSF nor the CSE exhibited cytotoxicity in intestinal epithelial (IEC-6) or hepatic (HepG2) cells. Moreover, they effectively counteracted oxidative stress triggered by tert-butyl hydroperoxide (t-BHP) while preventing the decline of glutathione, thiol groups, superoxide dismutase, and catalase activities in both cell lines. Our study suggests that the cocoa shell may serve as a functional food ingredient for promoting health, owing to its rich concentration of antioxidant compounds that could support combating the cellular oxidative stress associated with chronic disease developmentThis research was funded by the COCARDIOLAC project from the Spanish Ministry of Science and Innovation (RTI 2018-097504-B-I00) and the Excellence Line for University Teaching Staff within the Multiannual Agreement between the Community of Madrid and the UAM (2019–2023). M. Rebollo-Hernanz received funding from the FPU program of the Ministry of Universities for his predoctoral fellowship (FPU15/04238) and a grant for the requalification of the Spanish university system (CA1/RSUE/2021-00656

Propuesta de prevención en población con riesgo de alteraciones cerebrovascular (ACV) con edades entre los 20 y 35 años o adultos jóvenes en Bogotá - Colombia

Las enfermedades cerebrovasculares representan un desafío significativo para la salud pública en todo el mundo, en el caso específico de la población joven de 20 a 35 años. En Bogotá, esta problemática adquiere relevancia especial debido a la presencia cada vez mayor de enfermedades cerebrovasculares en jóvenes adultos, en la que destaca el accidente cerebrovascular (ACV). Los principales factores de riesgo son el ritmo de vida urbana, hipertensión, sedentarismo y el acceso limitado a una atención médica oportuna. En este trabajo, abordaremos los factores de riesgo, así como las medidas preventivas y hábitos saludables que pueden adoptarse para reducir la incidencia y minimizar las consecuencias de estas afecciones. Esperamos que este trabajo contribuya a concientizar sobre la importancia de la prevención de enfermedades cerebrovasculares en adultos jóvenes en Bogotá, entendiendo que la prevención y el conocimiento son pilares fundamentales para salvaguardar la salud cerebral de las personas en esta etapa de su vida.Cerebrovascular diseases represent a significant challenge for public health worldwide, specifically in the young population between 20 and 35 years of age. In Bogota, this problem is especially relevant due to the increasing presence of cerebrovascular diseases in young adults, in which cerebrovascular accident (CVA) stands out. The main risk factors are the pace of urban life, hypertension, sedentary lifestyle, and limited access to timely medical care. In this paper, we will address the risk factors, as well as the preventive measures and healthy habits that can be adopted to reduce the incidence and minimize the consequences of these conditions. We hope that this work will contribute to raise awareness of the importance of cerebrovascular disease prevention in young adults in Bogotá, understanding that prevention and knowledge are fundamental pillars to safeguard the brain health of people at this stage of their lives

Mortars Modified with Geothermal Nanosilica Waste: Effect on the Electrochemical Properties of Embedded Steel Rods

Nowadays, it is a common practice the incorporation of industrial wastes as alternative materials to replace ordinary Portland cement in the concrete manufacture. This technological implementation has as main objectives, the enhancement of concretes properties as well as mitigation of durability problem related to the corrosion phenomena; in order to increase the service life of reinforced concrete structures. Therefore, in this research was studied the electrochemical properties of black steel embedded in mortars. Mortars were fabricated using as a partial substitute of cement (0, 10, 20 and 30 wt. %) a geothermal nanosilica waste composed of amorphous nanosilica of ~20ηm and chlorides (0 and 0.4 wt. %). Mortars were subjected to a cure at 20°C (80% of relative humidity) and 60ºC (100% of relative humidity). The corrosion behaviour was periodically monitorized up to 65 days using electrochemical techniques of corrosion potential (Ecorr) and corrosion current density (icorr). Values of current density (icorr) were obtained by linear polarization resistance (LPR) technique applying Stern-Geary relation to Rp values. Electrochemical results were validated by comparing with gravimetric losses. The porosity, pH and loss of the evaporated water were also evaluated in mortars. Results obtained showed that the integrity of reinforcement rods was affected with the increase of GNW at high temperatures as well as the total chlorides content in mortars

Inclusión laboral de personas con discapacidad : una perspectiva desde la gestión del talento humano

En la realidad empresarial colombiana aún persisten prácticas discriminatorias en relación con los procesos de vinculación de personas con algún tipo de discapacidad. La premisa “A igual trabajo, igual salario” no se cumple en algunas organizaciones; muchas de ellas consideran, equivocadamente, que a las personas con discapacidad se les hace un favor al ofrecerles un trabajo, por lo que cualquier salario es justo para ellas. Inclusión laboral de personas con discapacidad. Una perspectiva desde la gestión del talento humano indaga por los enfoques de los procesos de gestión humana relacionados con la inclusión laboral de personas con discapacidad. La obra muestra ese tenso equilibrio entre lo que puede permanecer y lo que debe ser modificado en las prácticas empresariales a este respecto: la planificación del talento humano, la selección, la contratación, la formación, la gestión del desempeño y la calidad de vida laboral, y sustenta todos estos ajustes en un proceso claro de gestión de la diversidad en la empresa.Esta obra hace parte del grupo de textos seleccionados en la Convocatoria 2016 de publicación de libros derivados de proyectos de investigación en la Universidad de Antioquia, un proyecto de la Editorial Universidad de Antioquia® para apoyar la difusión de la investigación universitaria

Lack of Association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and Carotid Intima-Media Thickness, Carotid Plaques, and Cardiovascular Disease in Patients with Rheumatoid Arthritis

Introduction. Rheumatoid arthritis (RA) is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV) mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordingly, we evaluated the potential relationship between these 5 polymorphisms and subclinical atherosclerosis (assessed by carotid intima-media thickness (cIMT) and presence/absence of carotid plaques) and CV disease in RA. Material and Methods. 2140 Spanish RA patients were genotyped for the 5 polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 620 of these patients by carotid ultrasonography technology. Results. No statistically significant differences were found when each polymorphism was assessed according to cIMT values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV disease after adjusting for potential confounders. Conclusion. Our results do not confirm association between ABO rs579459, PPAP2B rs17114036, ADAMTS7 rs3825807, PIK3CG rs17398575, and EDNRA rs1878406 and subclinical atherosclerosis and CV disease in RA.European Union FEDER Funds and “Fondo de Investigación Sanitaria” (Grants PI06/0024, PS09/00748, and PI12/00060) from “Instituto de Salud Carlos III” (ISCIII, Health Ministry, Spain). It was also partially supported by RETICS Programs RD12/0009/0013 and RD12/0009/0004 (RIER) from “Instituto de Salud Carlos III” (ISCIII, Health Ministry, Spain) and in part by grants from the European IMI BTCure Program.Peer reviewe

Lack of association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and carotid intima-media thickness, carotid plaques, and cardiovascular disease in patients with rheumatoid arthritis

Introduction. Rheumatoid arthritis (RA) is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV) mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordingly, we evaluated the potential relationship between these 5 polymorphisms and subclinical atherosclerosis (assessed by carotid intima-media thickness (cIMT) and presence/absence of carotid plaques) and CV disease in RA. Material and Methods. 2140 Spanish RA patients were genotyped for the 5 polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 620 of these patients by carotid ultrasonography technology. Results. No statistically significant differences were found when each polymorphism was assessed according to cIMT values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV disease after adjusting for potential confounders. Conclusion. Our results do not confirm association between ABO rs579459, PPAP2B rs17114036, ADAMTS7 rs3825807, PIK3CG rs17398575, and EDNRA rs1878406 and subclinical atherosclerosis and CV disease in RA

Lack of Association between ABO, PPAP2B, ADAMST7, PIK3CG, and EDNRA and Carotid Intima-Media Thickness, Carotid Plaques, and Cardiovascular Disease in Patients with Rheumatoid Arthritis

Introduction. Rheumatoid arthritis (RA) is a polygenic disease associated with accelerated atherosclerosis and increased cardiovascular (CV) mortality. Recent studies have identified the ABO rs579459, PPAP2B rs17114036, and ADAMTS7 rs3825807 polymorphisms as genetic variants associated with coronary artery disease and the PIK3CG rs17398575 and EDNRA rs1878406 polymorphisms as the most significant signals related to the presence of carotid plaque in nonrheumatic Caucasian individuals. Accordingly, we evaluated the potential relationship between these 5 polymorphisms and subclinical atherosclerosis (assessed by carotid intima-media thickness (cIMT) and presence/absence of carotid plaques) and CV disease in RA. Material and Methods. 2140 Spanish RA patients were genotyped for the 5 polymorphisms by TaqMan assays. Subclinical atherosclerosis was evaluated in 620 of these patients by carotid ultrasonography technology. Results. No statistically significant differences were found when each polymorphism was assessed according to cIMT values and presence/absence of carotid plaques in RA, after adjusting the results for potential confounders. Moreover, no significant differences were obtained when RA patients were stratified according to the presence/absence of CV disease after adjusting for potential confounders. Conclusion. Our results do not confirm association between ABO rs579459, PPAP2B rs17114036, ADAMTS7 rs3825807, PIK3CG rs17398575, and EDNRA rs1878406 and subclinical atherosclerosis and CV disease in RA

Osteoprotegerin CGA Haplotype Protection against Cerebrovascular Complications in Anti-CCP Negative Patients with Rheumatoid Arthritis

INTRODUCTION: Rheumatoid arthritis is an inflammatory disease with high incidence of cardiovascular disease due to accelerated atherosclerosis. Osteoprotegerin (OPG) has been associated with increased risk of atherosclerotic disease in the general population. Several polymorphisms in the OPG gene with functional effects on cardiovascular disease in non-rheumatic individuals have been described. Therefore, we aimed to analyze the effect of three of these functional OPG polymorphisms on the risk of cardiovascular disease in a large and well-characterized cohort of Spanish patients with rheumatoid arthritis. METHODS: Three OPG gene variants (rs3134063, rs2073618 and rs3134069) were genotyped by TaqMan assays in 2027 Spanish patients with rheumatoid arthritis. Anti-cyclic citrullinated peptide (anti-CCP) antibody testing was positive in 997 of 1714 tested. Also, 18.3% of the whole series had experienced cardiovascular events, including 5.4% with cerebrovascular accidents. The relationship between OPG variants and cardiovascular events was assessed using Cox regression. RESULTS: No association between OPG gene variants and cardiovascular disease was observed in the whole group of rheumatoid arthritis patients or in anti-CCP positive patients. Nevertheless, a protective effect of CGA haplotype on the risk of cardiovascular disease in general, and specifically in the risk of cerebrovascular complications after adjusting for sex, age at disease diagnosis and traditional cardiovascular risk factors was disclosed in anti-CCP negative patients (HR = 0.54; 95%CI: 0.31-0.95; p = 0.032 and HR = 0.17; 95%CI: 0.04-0.78; p = 0.022, respectively). CONCLUSION: Our results indicate a protective effect of the OPG CGA haplotype on cardiovascular risk, mainly due to a protective effect against cerebrovascular events in anti-CCP negative rheumatoid arthritis patients