Propuesta de Prevención-Intervención de la Violencia con Parejas Adolescentes.

La adolescencia comprende una etapa vital repleta de cambios a nivel personal, biológico y social. Dentro de los principales hitos de esta etapa se encuentra la formación de relaciones fuera del ámbito familiar. Es en este contexto en el que tienen lugar las relaciones románticas. La violencia en la pareja es una grave problemática que se extiende independientemente de la edad, el origen o el estatus socioeconómico. No siendo menos las parejas adolescentes. Es por ello que se propone una intervención en esta población para así, en primer lugar, evitar la propagación y normalización de la violencia en estas edades y, por otro, evitar que la espiral de violencia culmine con vidas en edades adultas. <br /

Expresión clínica del Síndrome de Sjögren primario en pacientes adultos diagnosticados a edad menor o igual a 35 años versus mayores de 35 años

Objetivo: describir y comparar las manifestaciones clínicas en pacientes adultos diagnosticados con Síndrome de Sjögren primario (SSp) a edad menor o igual a 35 años versus mayores a 35 años. Materiales y métodos: Se incluyeron pacientes mayores de 18 años de edad, con diagnóstico de SSp de acuerdo a los criterios de clasificación ACR - EULAR 2002 / 2016, registrados en la base de datos GESSAR (Grupo de Estudio Síndrome de Sjögren Sociedad Argentina de Reumatología). Resultados: se incluyeron 665 pacientes. Cien (15,04%) con edad al diagnóstico ≤ 35 años, 92% mujeres. El promedio de edad del grupo > 35 años, fue de 54 + 11 años, 96% mujeres. Se encontraron diferencias estadísticamente significativas entre 35 años, en xeroftalmia (90,72% vs 95,64%, p: 0,04) y xerodermia (42,35% vs 57,36%, p: 0,03) y en los siguientes dominios del ESSDAI (EULAR Activity Index for primary Sjögren’s syndrome) sistema nervioso periférico (4,05 vs 11,32, p: 0,03), respiratorio (6% vs 15,40%, p: 0,01) y renal (6% vs 1,59%, p: 0,02). Conclusión: Nuestro estudio sugiere un menor compromiso glandular en pacientes con SSp diagnosticados a menor edad, sin un patrón diferencial característico en cuanto al compromiso sistémico

Procesos de aplicación conceptual y práctico de la normatividad tributaria en contextos investigativos procedimentales tributarios para el fortalecimiento de las competencias disciplinares y profesionales

La presente investigación planteó como objetivo realizar las memorias con las temáticas investigativas que se desarrollaron en el Seminario de Investigación Aplicada, con el fin de actualizar en los participantes y fortalecer sus conocimientos específicos en materia tributaria con base en los temas investigativos dispuestos y orientados por cada docente desde su inicio, elaboración, construcción y presentación ante los docentes evaluadores. Los trabajos cumplen su fin primordial con es fortalecer con los desarrollos temático de cada módulo visto en el SIA sus capacidades y competencias profesionales especialmente en el contexto tributario, en cumplimiento al requerimiento para otorgar al título de Especialistas en Gerencia Tributaria. Luego las memorias compiladas son el resultado de los trabajos presentados y evaluados oportunamente por cada docente comprometido con la calidad en cuanto a las temáticas investigativas, calidad de los contenidos, talleres teóricos prácticos, elementos metodológicos y de más lineamentos institucionales y del programa. La importancia de las memorias radica en su contenido el cual desglosa definiciones, conceptos, desarrollos teóricos prácticos, constituyéndose en un ejemplar de consulta investigativa en áreas de conocimiento fiscal y tributario en el marco de la Ley 1819 de 2016 y sus decretos reglamentarios, en síntesis al interior encontraremos fundamentos teóricos prácticos, procedimentales y resolutivos de casos especiales de Gravamen a los Movimientos Financieros, Monotributo, Renta Personas Naturales, Renta Personas Jurídicas, Procedimiento Tributario, Impuestos Distritales, Normas internacionales de Información Financiera Pymes, entre otros temas

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

XVI International Congress of Control Electronics and Telecommunications: "Techno-scientific considerations for a post-pandemic world intensive in knowledge, innovation and sustainable local development"

Este título, sugestivo por los impactos durante la situación de la Covid 19 en el mundo, y que en Colombia lastimosamente han sido muy críticos, permiten asumir la obligada superación de tensiones sociales, políticas, y económicas; pero sobre todo científicas y tecnológicas. Inicialmente, esto supone la existencia de una capacidad de la sociedad colombiana por recuperar su estado inicial después de que haya cesado la perturbación a la que fue sometida por la catastrófica pandemia, y superar ese anterior estado de cosas ya que se encontraban -y aún se encuentran- muchos problemas locales mal resueltos, medianamente resueltos, y muchos sin resolver: es decir, habrá que rediseñar y fortalecer una probada resiliencia social existente - producto del prolongado conflicto social colombiano superado parcialmente por un proceso de paz exitoso - desde la tecnociencia local; como lo indicaba Markus Brunnermeier - economista alemán y catedrático de economía de la Universidad de Princeton- en su libro The Resilient Society…La cuestión no es preveerlo todo sino poder reaccionar…aprender a recuperarse rápido.This title, suggestive of the impacts during the Covid 19 situation in the world, and which have unfortunately been very critical in Colombia, allows us to assume the obligatory overcoming of social, political, and economic tensions; but above all scientific and technological. Initially, this supposes the existence of a capacity of Colombian society to recover its initial state after the disturbance to which it was subjected by the catastrophic pandemic has ceased, and to overcome that previous state of affairs since it was found -and still is find - many local problems poorly resolved, moderately resolved, and many unresolved: that is, an existing social resilience test will have to be redesigned and strengthened - product of the prolonged Colombian social conflict partially overcome by a successful peace process - from local technoscience; As Markus Brunnermeier - German economist and professor of economics at Princeton University - indicates in his book The Resilient Society...The question is not to foresee everything but to be able to react...learn to recover quickly.Bogot

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

From space flights to osteoporosis

Space missions (microgravity) alter the balance between bone formation/resorption and induce bone loss. This effect represents a major limiting step in the realization of long-term space missions. A similar picture is induced by prolonged immobilization in bed (bed rest). The Osteoporosis and Muscular Atrophy project (OSMA) was a research program sponsored by the Italian Space Agency which included 35-day bed rest experiments in healthy young men. Anthropometric data of these experiments indicated the expected bone mass reduction in some segments of the leg and body mass redistribution from non-fat mass to fat mass. According to the current view, the bone mass reduction due to microgravity/bed rest is associated with the release of calcium from the bone into the bloodstream (hypercalcemia) which, in turn, lowers the secretion of parathyroid hormone and increases urinary calcium excretion. One of the main unsolved issues in this view is that hypercalcemia is mild and transient during microgravity/bed rest whereas parathyroid hormone reduction is sustained. Bone mass reduction could also be dependent on parathyroid hormone reduction as this hormone affects both formation and resorption of bone tissue. The research on the mechanisms underlying bone mass loss during microgravity/bed rest could be of help, not only to space medicine, but hopefully also for prevention and control of bone ageing and osteoporosis