Historia natural de la enfermedad de tuberculosis

La tuberculosis es una de las enfermedades más antiguas de la humanidad, fue descubierta hace más de 120 años con el bacilo de Koch y solo hacia los 40 años descubrieron varias de las drogas para tratarla. La incidencia de tuberculosis fue disminuyendo, lo que hizo pensar que podía erradicarse, pero factores como la pobreza de algunos países, inequidad, aparición de cepas multiresistentes y la aparición en la década de los 80 del síndrome de inmunodeficiencia adquirida-SIDA, hizo que las tazas de morbilidad y mortalidad aumentaranIn Colombia, tuberculosis continues to be a public health problem. The objective of this study was to describe and analyze the epidemiological behavior of tuberculosis in Colombia during 2002 to identify intervention priorities in its control. The consolidated data of the Quarterly Report of cases and activities of 2002 collected by the National Tuberculosis Program were analyzed. In the last 10 years, the behavior of tuberculosis is clearly fluctuating, specifically until 1997 when a sustained tendency to increas

Em busca de um horizonte : narrativas sobre educação, artes e resistência

"APRESENTAÇÃO - Os textos reunidos no livro Em busca de um Horizonte: narrativas sobre educação, arte e resistência foram inspirados nos debates realizados durante o evento VI Simpósio Internacional Horizontes Humanos, que aconteceu na Faculdade de Educação da Universidade de Brasília, em 2018. O livro está dividido em quatro partes: Resistências cotidianas para além da utopia, Demasiado humano: as diferentes linguagens artísticas e culturais, A educação como um horizonte, Educação ambiental e ancestralidade: para continuar caminhando. Apesar da divisão em seções (sempre arbitrária), as produções - bastante diversas nas temáticas, metodologias e referenciais teóricos adotados – compartilham um alinhamento ao adotar um posicionamento político em defesa da diversidade, dos direitos humanos, da ancestralidade, do meio ambiente, da educação com valores democráticos, dos saberes populares e das diferentes linguagens artísticas. Assim, o livro se apresenta como um convite à resistência em tempos atrozes. Os organizadores

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care