Lectura de contexto y abordaje psicosocial desde los enfoques narrativos. Florencia

Este trabajo responde en primer lugar a un acercamiento conceptual a los enfoques narrativos, donde a través del tiempo ha logrado una trayectoria significativa en los abordajes terapéuticos y psicosociales de violencias sistemáticas. Sin embargo, es importante resaltar que en el caso colombiano se resaltan sus aportes desde los marcos diversos y contextuales de nuestra realidad socio-política. Seguidamente se dará un recorrido de relatos de vida, donde le permitirá al futuro profesional enfrentarnos a un caso que describe una situación de la vida real donde se destacarán términos importantes en el proceso de formación de cualquier profesional, generando a su vez estrategias directas en el análisis del discurso resaltando los esfuerzos personales, familiares, colectivos y comunitarios que en él se movilizan para romper ciclos de violencia e injusticia. A través del debate generado a partir de la propuesta de abordaje psicosocial se busca implementar acciones y estrategias destinadas a promover un cambio en la situación actual en la que vive inmersa la comunidad de Pandurí, en él se logran concretar las distintas acciones, el énfasis asignado a los distintos propósitos y la metodología adoptada para estos fines dependerá de dos factores: por una parte, de las estrategias psicosociales y por otra, desde el acompañamiento psicosocial, presentan como fin, la generación de un cambio, desde una situación deficitaria a una condición fortalecida, donde el actor principal es la comunidad y que asume un rol central.This work responds in the first place to a conceptual approach to narrative approaches, where over time it has achieved a significant trajectory in the therapeutic and psychosocial approaches of systematic violence. However, it is important to highlight that in the Colombian case, their contributions are highlighted from the diverse and contextual frameworks of our sociopolitical reality. Next, a journey of life stories will be given, where it will allow the future professional to face a case that describes a real life situation where important terms will be highlighted in the training process of any professional, generating in turn direct strategies in the discourse analysis highlighting the personal, family, collective and community efforts that are mobilized in it to break cycles of violence and injustice. Through the debate generated from the proposal of psychosocial approach seeks to implement actions and strategies aimed at promoting a change in the current situation in which the community of Pandurí is immersed, it is possible to specify the different actions, the assigned emphasis to the different purposes and the methodology adopted for these purposes will depend on two factors: on the one hand, psychosocial strategies and on the other, from the psychosocial accompaniment, they present, as an end, the generation of a change, from a deficit situation to a condition strengthened, where the main actor is the community and that assumes a central role

Genotyping squamous cell lung carcinoma in Colombia (Geno1.1-CLICaP)

Background: Lung cancer is a public health problem, and squamous cell carcinoma (SCC) is the second most prevalent subtype of this neoplasm. Compared to other subtypes, including adenocarcinoma, SCC is less well understood in terms of molecular pathogenesis, limiting therapeutic options among targeted agents approved for other disease subgroups. In this study, we sought to characterize the SCC genomic profile using a validated Next Generation Sequencing (NGS) platform. Methods: The comprehensive NGS assay (TruSight Tumor 170) was used in order to target the full coding regions of 170 cancer-related genes on SCC samples. PD-L1 expression in tumor cells (TCs) was assessed using clone 22C3 (Dako). Clinical outcomes were correlated with molecular profile, including progression free survival (PFS), overall response rate (ORR), and overall survival (OS). Results: A total of 26 samples were included, median age was 67 years (r, 33–83) and 53.8% were men. Tobacco consumption was identified in all subjects (mean 34-year package). For first-line treatment 80.8% of patients received cisplatin or carboplatin plus gemcitabine. In terms of molecular profile, we identified a high prevalence of inactivating mutations in TP53 (61.5%), PIK3CA (34.6%), MLL2 (34.6%), KEAP1 (38.4%), and NOTCH1 (26.9%). PD-L1 expression ranged from negative, 1, 2–49, and ≥50% in 23.1, 38.5, 26.9, and 11.5%, respectively. Interestingly, the genetic alterations did not have an effect in PFS, OS or ORR in this study. However, PDL1 expression was higher among those who had mutations in TP53 (p = 0.037) and greater expression of PDL1 was related to PIK3CA alterations (p = 0.05). Conclusions: The genomic profile of SCC encompasses important genes including TP53, PIK3CA and KEAP1. TP53 mutations could be associated with PDL1 expression, generating hypothesis regarding specific treatment options

Balance de 25 años de jurisprudencia de la Corte Constitucional

La Corte Constitucional de Colombia ha tenido un importante impacto en la vida social, cultural y política del país, a tal punto que, desde su creación, la jurisprudencia de este tribunal se ha convertido en un referente mundial acerca de las diversas materias sobre las que se ha pronunciado . Este libro presenta un balance de la jurisprudencia que durante sus primeros veinticinco años la Corte ha expedido. Con este fin, el magistrado Luis Guillermo Guerrero Pérez y los magistrados auxiliares Miguel Polo Rosero y Claudia Escobar García recogen los trabajos de expertos nacionales e internacionales, funcionarios del Estado y Miembros de la sociedad civil que se presentaron en el XII Encuentro de la Jurisdicción Constitucional, realizado en la ciudad de San Juan de Pasto entre el 27 y el 30 de septiembre de 2017. En ese encuentro, se ratificó que la Corte Constitucional tiene la tarea de velar por la integridad de los compromisos de la Constitución. Los capítulos que conforman este libro ofrecen una mirada multidisciplinaria sobre la eficacia y el impacto de las decisiones de la Corte, específicamente en lo que tiene que ver con la democracia y la participación, el sistema de salud, el sistema pensional, el medio ambiente y el fenómeno discriminatorio con la relación al género y a la condición de discapacidad en Colombia.Bogot

Innovación turística y desarrollo regional

Libro que se compila 14 capítulos asociados a las temáticas de innovación y desarrollo tecnológico en el sector turístico, emprendimiento y tecnologías emergentes, políticas estratégicas y tácticas para mejorar la competitividad en las empresas, políticas públicas y educación para el desarrollo regional y responsabilidad social ambientalBook that compiles 14 chapters associated to the themes of innovation and technological development in the tourism sector, entrepreneurship and emerging technologies, strategic and tactical policies to improve competitiveness in companies, public policies and education for regional development and environmental social responsibilityInnovación social como estrategia para el desarrollo de las poblaciones palafíticas de la ciénaga grande de santa marta mediante la oferta de productos turísticos / Gregoria Polo de Lobatón; José Luis Rosenstiehl Martínez; Daulis Lobatón Polo -- Uso de las tic para mejorar la competitividad turística en San Basilio de Palenque / Jesús Llerena Cabrera; Raúl José Martelo Gómez; David Franco Borré -- Plataforma web niu (nuevo, ideas y usados) / Néstor José Ocampo Ardila -- Posicionamiento estratégico del turismo urbano de eventos como atributo de la personalidad del espacio territorial de la ciudad de santa marta / Zuleidy María Ruíz Torres -- Identificación competitiva de la oferta exportadora de la región ariari para fortalecer el desarrollo social y económico en zonas de posconflicto basado en el comercio exterior y logística / Keyla Karina González Martínez -- Tecnologías integradas en gestión sostenible de operadores turísticos en zonas de posconflicto del departamento del meta / Carlos Hernán Cruz Castro; óscar Eduardo Sarmiento Saavedra -- Herramienta online de control de ingresos y facturación: una solución dinámica para las pequeñas y medianas empresas / Esmerlis Camargo Torres; Antonio José González Liñán; Marieth Orcasitas Peñaloza; Yerson Monroy Contreras -- Modelo de cadena productiva dinamizado a través de la educación y las estrategias TIC para el desarrollo regional sostenible en Risaralda / Beatriz Elena Franco Cárdenas; Patricia Henao Montoya; Marco Aurelio Aristizabal Valencia -- Evaluación físico - química de adhesivo de yuca (manihot esculenta) como alternativa comercial para la Orinoquia / Yarithza Molina Caro; Wilfran Hernán Cortes Conde -- Formulaciones nutracéuticas alimenticias para estilos de vida saludables / Daldo Araujo Vidal; Daniel Mendoza Cujia; Maresa Anaya de oro -- Competencias tecnológicas como estrategia formativa en los aprendices de gestión de redes de datos del SENA regional guajira / Carlos Antonio Salas Solano; Alejandro Jesús Osorio Amaya; Alda Pérez Campuzano; Duvan Andrés rondón bravo -- Uso y apropiación del computador como herramienta para las prácticas educativas de los docentes / Alda Pérez Campuzano; Carlos Antonio Salas Solano; Elkin Fuentes Jiménez; Kira Rodríguez Moscote -- El aviturismo como eje transformador de cultura ambiental y desarrollo sustentable / Lina María Gamarra Pineda; Néstor Alejandro Tascón Arias -- Huella ecológica (he), indicador de condición ambiental para evaluar la sostenibilidad en instituciones de educación (ie) / Cristian David Trujillo CardonaPrimera ediciónna169 página

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Confianza inversionista: inversión extranjera directa en Colombia. Sector minero-energético, seguros, comercio, restaurantes y turismo. Periodo 2002-2010

Es preciso destacar que el periodo comprendido entre 2002 y 2010 bajo el mandato del ex presidente Álvaro Uribe, consolida una serie de políticas de Estado; además de la creación y reestructuración de nuevos entes reguladores. Así mismo, muestra un ambiente y clima propicio para incentivar la Inversión Extranjera Directa (IED) y activar las locomotoras productivas del país.In President‟s Alvaro Uribe Vélez period comprehended between 2002 to 2010, the Government established the "Renewal Program for Public Administration",plus the creation and restructuring of new regulating organisms, made possible to achieve the proper environment to encourage Foreign Direct Investment and restart the engine of our country's productive locomotives

Antibiotics impair immune checkpoint inhibitor effectiveness in Hispanic patients with non‐small cell lung cancer ( AB‐CLICaP

Background The intestinal microbiota is an important factor in modulating immune‐mediated tumor cell destruction. Alterations in the microbiome composition have been linked to reduced efficacy of immune checkpoint inhibitor (ICI) therapies. Therefore, antibiotic treatment (ATB), which modifies the diversity of the gut bacteria populations, could lead to a reduced efficacy of ICI treatments. Methods This was a retrospective cohort study. Patients with advanced non‐small cell lung cancer (NSCLC) treated with anti‐programmed cell death ligand‐1 (PD‐L1) alone, or in combination in three different countries in Latin America were included. After identification, patients were placed into three groups: Non‐ATB exposed (no‐ATB), exposed within 30 days of the first dose of ICI (pre‐ICI ATB) and patients receiving ATB concomitantly with ICI (ICI‐ATB). Progression‐free survival (PFS), overall survival (OS) and response rates to treatment with ICI were assessed. Results A total of 140 patients were included, of which 32 patients (23%) received ATB treatment. The most common ATB types were fluoroquinolones and B‐lactams. No differences in survival according to antibiotic type were identified. Median OS in patients not exposed to ATB was 40.6 months (95% CI: 32–67.7), compared with 20.3 months (95% CI: 12.1‐non‐reached [NR]) for patients with pre‐ICI ATB treatment and 24.7 months (95% CI: 13‐NR) for patients treated with ATB concomitantly with ICI. There were no significant differences in terms of PFS, or response rates across all treatment groups. Conclusions Antibiotic treatment was associated with reduced OS in Hispanic patients with NSCLC treated with ICIs

A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma

Purpose Patients with recurrent glioblastoma (rGBM) have a poor prognosis, with survival ranging from 25 to 40 weeks. Antiangiogenic agents are widely used, showing a variable response. In this study, we explored the efcacy of carmustine plus bevacizumab (BCNU/Bev) for treating rGBM. Methods/patients In this study, we assessed 59 adult patients with histologically confrmed rGBM who were treated with BCNU/Bev as second-line regimen. The response rate (RR), progression-free survival (PFS) and overall survival (OS) were evaluated according to their molecular expression profle, including CD133 mRNA expression, MGMT methylation (pMGMT), PDGFR amplifcation, YKL40 mRNA expression, IDH1/2 condition, p53 and EGFRvIII mutation status. Results Median follow-up was 18.6 months, overall RR to the combination was 56.3%, and median PFS was 9.0 months (95% CI 8.0–9.9). OS from time of diagnosis was 21.0 months (95% CI 13.2–28.7) and from starting BCNU/Bev it was 10.7 months (95% CI 9.5–11.8). IDH1/2 mutations were found in 30.5% of the patients, pMGMT in 55.9% and high CD133 mRNA expression in 57.6%. Factors which positively afected PFS included performance status (p=0.015), IDH+ (p=0.05), CD133 mRNA expression (p=0.009) and pMGMT+ (p=0.007). OS was positively afected by pMGMT+ (p=0.05). Meanwhile, YKL40 negatively afected PFS (p=0.01) and OS (p=0.0001). Grade≥3 toxicities included hypertension (22%) and fatigue (12%). Conclusions BCNU/Bev is a safe and tolerable treatment for rGBM. Patients with MGMT+/IDH+ derive the greatest beneft from the treatment combination in the second-line setting. Nonetheless, high YKL40 expression discourages the use of antiangiogenic therapy

Immunotherapy at any line of treatment improves survival in patients with advanced metastatic non‐small cell lung cancer (NSCLC) compared with chemotherapy (Quijote‐CLICaP)

Background: To compare survival outcomes of patients with advanced or metastatic non-small cell lung cancer (NSCLC) who received immunotherapy as first-, second- or beyond line, versus matched patients receiving standard chemotherapy with special characterization of hyperprogressors. Methods: A retrospective cohort study of 296 patients with unresectable/metastatic NSCLC treated with either, first-, second-, third- or fourth-line of immunotherapy was conducted. A matched comparison with a historical cohort of first-line chemotherapy and a random forest tree analysis to characterize hyperprogressors was conducted. Results: Median age was 64 years (range 34–90), 40.2% of patients were female. A total of 91.2% of patients had an Eastern Cooperative Oncology Group (ECOG) performance score ≤ 1. Immunotherapy as first-line was given to 39 patients (13.7%), second-line to 140 (48.8%), and as third-line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67–14 months) and progression-free survival (PFS) of 4.27 months (95% CI 3.97–5.0). Factors associated with increased survival included treatment with immunotherapy as first-line (P < 0.001), type of response (P < 0.001) and PD-L1 status (P = 0.0039). Compared with the historical cohort, immunotherapy proved to be superior in terms of OS (P = 0.05) but not PFS (P = 0.2). A total of 44 hyperprogressors were documented (19.8%, [95% CI 14.5–25.1%]). Leukocyte count over 5.300 cells/dL was present in both hyperprogressors and long-term responders. Conclusions: Patients who receive immune-checkpoint inhibitors as part of their treatment for NSCLC have better overall survival (OS) compared with matched patients treated with standard chemotherapy, regardless of the line of treatment