74 research outputs found
Investigación en Común-Unidad: la Paz Como Experiencia Vital.
Para los autores de esta publicación, la paz como objeto de estudio
académico representa un interés investigativo común que ratifica el poder
transformador de la educación en contextos de violencia emergentes en las
comunidades. Esto resulta valioso si se considera que Colombia, y en
particular departamentos como Norte de Santander, presentan un reto
formativo en lo que atañe a la concepción de herramientas para asumir los
conflictos cotidianos y al fortalecimiento de competencias sociopolíticas en
las nuevas generaciones. Por esta razón se considera de gran urgencia
fortalecer en las personas un pensamiento crítico y creativo frente a las
dinámicas de su propia realidad.
Desde esta perspectiva se ratifica como presupuesto epistemológico la
posibilidad de construir paz desde los escenarios cotidianos, develando el
imperante liderazgo que cada ser humano —para el caso de esta obra,
maestros y jóvenes líderes— tiene frente a su comunidad. Desde esta óptica
se presentan elementos útiles para la reflexión sobre esta problemática, tales
como el reconocimiento de los espacios, tiempos, lenguajes diversos y
relaciones en el marco de prácticas sociales que construyen, desde la
experiencia misma de sus actores, una nueva configuración de la convivencia
Investigación en Común-Unidad: la Paz Como Experiencia Vital.
Para los autores de esta publicación, la paz como objeto de estudio
académico representa un interés investigativo común que ratifica el poder
transformador de la educación en contextos de violencia emergentes en las
comunidades. Esto resulta valioso si se considera que Colombia, y en
particular departamentos como Norte de Santander, presentan un reto
formativo en lo que atañe a la concepción de herramientas para asumir los
conflictos cotidianos y al fortalecimiento de competencias sociopolíticas en
las nuevas generaciones. Por esta razón se considera de gran urgencia
fortalecer en las personas un pensamiento crítico y creativo frente a las
dinámicas de su propia realidad.
Desde esta perspectiva se ratifica como presupuesto epistemológico la
posibilidad de construir paz desde los escenarios cotidianos, develando el
imperante liderazgo que cada ser humano —para el caso de esta obra,
maestros y jóvenes líderes— tiene frente a su comunidad. Desde esta óptica
se presentan elementos útiles para la reflexión sobre esta problemática, tales
como el reconocimiento de los espacios, tiempos, lenguajes diversos y
relaciones en el marco de prácticas sociales que construyen, desde la
experiencia misma de sus actores, una nueva configuración de la convivencia
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
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
A multicenter study on the prevalence and spectrum of mutations in the otoferlin gene (OTOF) in subjects with nonsyndromic hearing impairment and auditory neuropathy
Q1Q1Artículo original823-831Hearing impairment (HI) is a highly heterogeneous group of disorders caused by environmental and genetic factors, with a global incidence of about 1 in every 650-1,000 newborns [Morton, 1991; Mehl and Thomson, 2002]. When the onset of the HI takes place before speech acquisition (prelingual HI), it represents a serious handicap for normal communication and social integration. In developed countries, over 60% of all cases result from a genetic cause [Petit et al., 2001]. Nonsyndromic HI (NSHI) encompasses a variety of disorders, the common feature of which is that the hearing deficit is not associated with any other clinical sign (about 70% of all inherited HI). Different patterns of inheritance are observed in NSHI, but autosomal recessive forms are by far the most frequent
Open-label phase I/II clinical trial of SARS-CoV-2 receptor binding domain-tetanus toxoid conjugate vaccine (FINLAY-FR-2) in combination with receptor binding domain-protein vaccine (FINLAY-FR-1A) in children
Objectives: To evaluate a heterologous vaccination scheme in children 3-18 years old (y/o) combining two SARS-CoV-2r- receptor binding domain (RBD)protein vaccines. Methods: A phase I/II open-label, adaptive, and multicenter trial evaluated the safety and immunogenicity of two doses of FINLAY-FR-2 (subsequently called SOBERANA 02) and the third heterologous dose of FINLAY-FR-1A (subsequently called SOBERANA Plus) in 350 children 3-18 y/o in Havana Cuba. Primary outcomes were safety (phase I) and safety/immunogenicity (phase II) measured by anti-RBD immunoglobulin (Ig)G enzyme-linked immunoassay (ELISA), molecular and live-virus neutralization titers, and specific T-cells response. A comparison with adult immunogenicity and predictions of efficacy were made based on immunological results. Results: Local pain was the unique adverse event with frequency >10%, and none was serious neither severe. Two doses of FINLAY-FR-2 elicited a humoral immune response similar to natural infection; the third dose with FINLAY-FR-1A increased the response in all children, similar to that achieved in vaccinated young adults. The geometric mean (GMT) neutralizing titer was 173.8 (95% confidence interval [CI] 131.7; 229.5) vs Alpha, 142 (95% CI 101.3; 198.9) vs Delta, 24.8 (95% CI 16.8; 36.6) vs Beta and 99.2 (95% CI 67.8; 145.4) vs Omicron. Conclusion: The heterologous scheme was safe and immunogenic in children 3-18 y/o. Trial registry: https://rpcec.sld.cu/trials/RPCEC0000037
Biodiversidad en la cuenca del Orinoco. Bases científicas para la identificación de áreas prioritarias para la conservación y uso sostenible de la biodiversidad
Es un placer para el Instituto de Investigación de Recursos Biológicos Alexander von Humboldt presentar a la comunidad científica, conservacionista y autoridades ambientales de Colombia y Venezuela la obra Biodiversidad de la cuenca del Orinoco: bases científicas para la identificación de áreas prioritarias para la conservación y el uso sostenible de la biodiversidad. Este libro es fruto de un esfuerzo de una década de trabajo y recoge numerosos proyectos de carácter institucional que han venido desarrollándose en la Orinoquia, incluyendo el Plan de acción en biodiversidad para la cuenca del Orinoco (2005-2015), además de los resultados
de reuniones técnicas de carácter binacional
3er. Coloquio: Fortalecimiento de los Colectivos de Docencia
Las memorias del 3er. Coloquio de Fortalecimiento de Colectivos de Docencia
deben ser entendidas como un esfuerzo colectivo de la comunidad de académicos de la División de Ciencias y Artes para el Diseño, en medio de la pandemia COVID-19, con el fin de:
• Analizar y proponer acciones concretas que promuevan el mejoramiento de la calidad docente en la División.
• Proponer acciones que permitan continuar fortaleciendo los cursos con modalidad a distancia (remotos).
• Ante un escenario que probablemente demandará en el mediano plazo, transitar del modelo remoto a un modelo híbrido, proponer acciones a considerar para la transición de los cursos.
• Planear y preparar cursos de nivelación de conocimientos, para cuando se transite a la impartición de la docencia de manera mixta o presencial, dirigidos a los alumnos que no hayan tenido oportunidad de desarrollar actividades relevantes para su formación, como prácticas de talleres y laboratorios, visitas, o alguna otra actividad relevante
Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort
Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective
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