Risk factors for reamputation in patients with diabetic foot: A case-control study

Background: Reamputation as a complication of diabetic foot ulcers presents a high economic burden and represents a therapeutic failure. It is paramount to identify as early as possible patients in whom a minor amputation may not be the best option. The purpose of this investigation was to do a case-controlled study to determine risk factors associated with re-amputation in patients with DFU (diabetic foot ulcers) at two University Hospitals. Methods: Multicentric, observational, retrospective, case-control study from clinical records of 2 university hospitals. Our study included 420 patients, with 171 cases (re-amputations), and 249 controls. We performed a multivariate logistic regression analysis and time-to-event survival analysis to identify re-amputation risk factors. Results: Statistically significant risk factors were artery history of tobacco use (p = 0.001); male sex (p = 0.048); arterial occlusion in Doppler ultrasound (p = 0.001); percentage of stenosis in arterial ultrasound >50 % (p = 0.053); requirement of vascular intervention (p = 0.01); and microvascular involvement in photoplethysmography (p = 0.033). The most parsimonious regression model suggests that history of tobacco use, male sex, arterial occlusion in ultrasound, and percentage of stenosis in arterial ultrasound >50 % remained statistically significant. The survival analysis identified earlier amputations in patients with larger occlusion in arterial ultrasound, high leukocyte count, and elevated ESR. Conclusion: Direct and surrogate outcomes in patients with diabetic foot ulcers identify vascular involvement as an important risk factor for reamputation

Reconstruction of extensive cranial defects with free flaps

Objetivos: En grandes defectos craneales los tejidos locales no son suficientes. Se requiere tejido que aporte cobertura, volumen suficiente para cerrar espacios intracraneales y adecuada vascularización que permita el control de procesos infeccioso asociados, por ello se presentan 3 casos de pacientes manejados en nuestra institución a quienes se les realizó reconstrucción de defectos craneales extensos de la región frontal, con el uso de colgajos libres o la combinación de colgajo libre y material aloplástico, obteniendo buenos resultados estéticos y funcionales. Materiales y métodos: Se realizó un estudio descriptivo de tipo Serie de Casos, en el cual se reportan 3 pacientes de sexo masculino, con defectos craneales extensos de la región frontal secundarios a osteomielitis de calota posterior a craniectomía descompresiva por trauma craneoencefálico severo, quienes fueron manejados en el Hospital de San José, en un período de marzo de 2013 a marzo de 2014, y a quienes se les realizó reconstrucción con el uso de colgajos libres o la combinación de colgajo libre y material aloplástico. Resultados: Se obtuvo una adecuada y segura obliteración del espacio intracraneal, así como un adecuado contorno y proyección de la región frontal con el uso de un colgajo anterolateral de muslo, un colgajo recto abdominal con isla de piel vertical y un colgajo dorsal ancho. Se realizó seguimiento en el primer año posoperatorio. No se presentó ninguna complicación. Conclusión: Los colgajos libres son la mejor opción para la reconstrucción de grandes defectos craneales y la obliteración de espacios intracraneales, en comparación con el uso exclusivo de materiales aloplásticos, debido a su alto riesgo de extrusión. Su uso requiere un adecuado planeamiento.Objective: In large cranial defects, local tissues are not sufficient and necessary tissue to cover and add volume to close intracranial spaces and adequate blood supply that allows control of associated infectious processes, for which the objective is to present 3 cases of patients managed in our institution who underwent extensive reconstruction of skull defects of the frontal region, with the use of free flaps or a combination of free flap and alloplast, obtaining good aesthetic and functional results. Materials and methods: We performed a descriptive study of serial cases in which three male patients reported with extensive skull defects of the frontal region caused by osteomyelitis of the skull and decompressive craniectomy for severe head trauma who were treated in Hospital San Jose in a period March 2013 to March 2014, and who underwent reconstruction with the use of free flaps or a combination of free flap and alloplast. Results: We obtained an adequate and safe obliteration of intracranial space and a suitable contour and projection of the frontal region using an anterolateral thigh flap, a rectus abdominis flap and Latissimus Dorsi flap. It was followed in the first postoperative year. No complications were presented. Conclusion: Free flaps are the best choice for large skull defect reconstruction and obliteration of intracranial spaces compared to the exclusive use of alloplastic, materials, due to its high risk of .extrusion. Its use requires proper planning

Celulosa : un polímero de siempre con mucho futuro

RESUMEN: Dentro de la gran cantidad de sustancias naturales que han sido de un valor significativo a lo largo de todo el desarrollo científico – tecnológico de la humanidad se destaca sin lugar a dudas la celulosa, considerada como uno de los polímeros naturales de mayor abundancia en la naturaleza, y que puede ser obtenida desde las más variadas fuentes entre las que se encuentran: todo tipo de cuerpos vegetales, en diferentes tipos de algas, de la actividad extracelular de múltiples tipos de microorganismos y en el caparazón o estructura de algunos animales marinos (Zuluaga, 2014)

Experiencias Pedagógicas Interculturales Para Las Memorias Y La Paz Territorial: Sistematización De Experiencias De Cátedras De Paz En Colombia

Sistematizar experiencias pedagógicas (urbanas y rurales) que, desde una perspectiva intercultural, promuevan acciones para la reivindicación de las memorias territoriales y aporten acciones pedagógicas para la pazEs natural que los diferentes territorios de Colombia experimenten diferentes situaciones; es decir que aquellas regiones marginadas y de difícil acceso están directamente articuladas con el conflicto de una u otra manera, en ese orden de ideas, para un maestro educar en este ámbito debe ajustarse a su obligación deontológico como profesional, ya que no solo debe garantizar la pertinencia del proceso de enseñanza y aprendizaje; sino que determine el desarrollo de estrategias para empezar a construir la paz en aquellas regiones donde gobierna el conflicto armado. Así mismo, el siguiente trabajo de investigación Experiencias pedagógicas interculturales para la memoria y la paz territorial, perteneciente a la sub-línea de investigación Procesos educativos para la diversidad y la transformación cultural, se caracteriza por ser un espacio académico con alcances socioeducativos dentro de los procesos de estudios y análisis de experiencias pedagógicas que de una u otra forma están relacionadas con el conflicto armado colombiano

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

Caracterización en la dinámica espacial de los macrohábitats acuáticos en la región de La Mojana

Con el fin de consolidar el levantamiento y análisis de la información sobre ecología en los humedales de La Mojana, este documento describe la biodiversidad asociada a las zonas de transición entre los principales macrohábitats acuáticos naturales identificados en esta región. Caracterizando por sectores desde la transición más húmeda hasta la más seca, identificando y caracterizando los micro-hábitats presentes dentro de cada uno de ellos e identificando la ocupación en el territorio por los distintos grupos biológicos.Bogotá, ColombiaPrograma Gestión Territorial de la Biodiversida

Innovación en las enseñanzas universitarias: experiencias presentadas en las III Jornadas de Innovación Educativa de la ULL

En este libro se recoge un conjunto de experiencias de innovación educativa desarrolladas en la ULL en el curso 2011-12. Se abordan distintos ámbitos y ramas del conocimiento, y ocupan temáticas variadas que han sido desarrolladas con rigor, y con un claro potencial para su extrapolación a efectos de la mejora educativa en el ámbito universitario. Esta publicación constituye una primera edición de una serie que irá recogiendo las experiencias de innovación educativa de la ULL. Este es un paso relevante para su impulso en nuestra institución, como lo es el de su vinculación con la investigación educativa, para potenciar su publicación en las revistas científicas en este ámbito cada vez más pujante y relevante para las universidades. Sobre todo representan el deseo y el compromiso del profesorado de la ULL para la mejora del proceso educativo mediante la investigación, la evaluación y la reflexión compartida de nuestras prácticas y planteamientos docentes

Métodos y técnicas de monitoreo y predicción temprana en los escenarios de riesgos socionaturales

Esta obra concentra los métodos y las técnicas fundamentales para el seguimiento y monitoreo de las dinámicas de los escenarios de riesgos socionaturales (geológicos e hidrometeorológicos) y tiene como objetivo general orientar, apoyar y acompañar a los directivos y operativos de protección civil en aterrizar las acciones y políticas públicas enfocadas a la gestión del riesgo local de desastre

The Research Journey as a Challenge Towards New Trends

The academic community of the department of Risaralda, in its permanent interest in evidencing the results of the research processes that are carried out from the Higher Education Institutions and as a product of the VI meeting of researchers of the department of Risaralda held in November 2021 presents its work: “The journey of research as a challenge towards new trends”, which reflects the result of the latest research and advances in different lines of knowledge in Agricultural Sciences, Health Sciences, Social Sciences and Technology and Information Sciences, which seek to solve and meet the demands of the different sectors. This work would not have been possible without the help of each of the teachers, researchers and authors who presented their articles that make up each of the chapters of the book, to them our gratitude for their commitment, dedication and commitment, since their sole purpose is to contribute from the academy and science to scientific and technological development in the search for the solution of problems and thus contribute to transform the reality of our society and communities. We also wish to extend our gratitude to the institutions of the Network that made this publication possible: UTP, UCP, UNAD, UNIREMINGTON; UNISARC, CIAF, Universidad Libre, Uniclaretiana, Fundación Universitaria Comfamiliar and UNIMINUTO, institutions that in one way or another allowed this work to become a reality, which we hope will be of interest to you.Preface............................................................................................................................7 Chapter 1. Technologies and Engineering Towards a humanization in Engineering using soft skills in training in Engineers.............................................................................................................11 Omar Iván Trejos Buriticá1, Luis Eduardo Muñoz Guerrero Innovative materials in construction: review from a bibliometric analysis....................................................................................................................27 Cristian Osorio Gómez, Daniel Aristizábal Torres, Alejandro Alzate Buitrago, Cristhian Camilo Amariles López Bibliometric review of disaster risk management: progress, trends, and challenges.........................................................................................................51 Alejandro Alzate Buitrago, Gloria Milena Molina Vinasco. Incidence of land coverage and geology, in the unstability of lands of the micro-basin of the Combia creek, Pereira, Risaralda....................................73 Alejandro Alzate Buitrago, Daniel Aristizábal Torres. Chapter 2. Arts, Humanities, and Social Sciences Training experience with teachers teaching mathematics using the inquiry methodology ...............................................................................................95 Vivian Libeth Uzuriaga López, Héctor Gerardo Sánchez Bedoya. Interpretation of the multiple representations of the fears associated to the boarding of limited visual patients in the elective I students’ written productions and low vision ...................................................................................113 Eliana Bermúdez Cardona, Ana María Agudelo Guevara, Caterine Villamarín Acosta. The relevance of local knowledge in social sciences............................................131 Alberto Antonio Berón Ospina, Isabel Cristina Castillo Quintero. Basic education students’ conceptions of conflict a view from the peace for the education....................................................................................................143 Astrid Milena Calderón Cárdenas,Carolina Aguirre Arias, Carolina Franco Ossa, Martha Cecilia Gutiérrez Giraldo, Orfa Buitrago. Comprehensive risk prevention in educational settings: an interdisciplinary and socio-educational approach ............................................................................163 Olga María Henao Trujillo, Claudia María López Ortiz. Chapter 3. Natural and Agricultural Sciences Physicochemical characterization of three substrates used in the deep bedding system in swine .......................................................................................175 Juan Manuel Sánchez Rubio, Andrés Felipe Arias Roldan, Jesús Arturo Rincón Sanz, Jaime Andrés Betancourt Vásquez. Periodic solutions in AFM models........................................................................187 Daniel Cortés Zapata, Alexander Gutiérrez Gutiérrez. Phenology in flower and fruit of Rubus glaucus benth. Cv. Thornless in Risaralda: elements for phytosanitary management .........................................199 Shirley Palacios Castro, Andrés Alfonso Patiño Martínez, James Montoya Lerma, Ricardo Flórez, Harry Josué Pérez. Socio-economic and technical characterization of the cultivation of avocado (Persea americana) in Risaralda..............................................................217 Andrés Alfonso Patiño Martínez, Kelly Saudith Castañez Poveda, Eliana Gómez Correa. Biosecurity management in backyard systems in Santa Rosa de Cabal, Risaralda................................................................................................................227 Julia Victoria Arredondo Botero, Jaiver Estiben Ocampo Jaramillo, Juan Sebastián Mera Vallejo, Álvaro de Jesús Aranzazu Hernández. CONTENTS Physical-chemical diagnosis of soils in hillside areas with predominance of Lulo CV. La Selva production system in the department of Risaralda.............241 Adriana Patricia Restrepo Gallón, María Paula Landinez Montes, Jimena Tobón López. Digestibility of three concentrates used in canine feeding....................................271 María Fernanda Mejía Silva, Valentina Noreña Sánchez, Gastón Adolfo Castaño Jiménez. Chapter 4. Economic, Administrative, and Accounting Sciences Financial inclusion in households from socioeconomic strata 1 and 2 in the city of Pereira ..................................................................................................285 Lindy Neth Perea Mosquera, Marlen Isabel Redondo Ramírez, Angélica Viviana Morales. Internal marketing strategies as a competitive advantage for the company Mobilautos SAS de Dosquebradas........................................................................303 Inés Montoya Sánchez, Sandra Patricia Viana Bolaños, Ana María Barrera Rodríguez. Uses of tourist marketing in the tourist sector of the municipality of Belén de Umbría, Risaralda.............................................................................................319 Ana María Barrera Rodríguez, Paola Andrea Echeverri Gutiérrez, María Camila Parra Buitrago, Paola Andrea Martín Muñoz, Angy Paola Ángel Vélez, Luisa Natalia Trejos Ospina. Territorial prospective of Risaralda department (Colombia), based on the SDGS...............................................................................................................333 Juan Guillermo Gil García, Samanta Londoño Velásquez. Chapter 5. Health and Sports Sciences Performance evaluation in times of pandemic. What do medical students think?.......................................................................................................353 Samuel Eduardo Trujillo Henao, Rodolfo A. Cabrales Vega, Germán Alberto Moreno Gómez. The relevance of the therapist’s self and self-reference in the training of psychologists.....................................................................................................371 Maria Paula Marmolejo Lozano, Mireya Ospina Botero. Habits related to oral health which influence lifestyle of elder people in a wellness center for the elderly in Pereira 2020. .............................................387 Isadora Blanco Pérez, Olga Patricia Ramírez Rodríguez, Ángela María Rincón Hurtado. Analysis of the suicide trend in the Coffee Region in Colombia during the years 2012-2018 ..............................................................................................405 Germán Alberto Moreno Gómez, Jennifer Nessim Salazar, Jairo Franco Londoño, Juan Carlos Medina Osorio. Hind limb long bone fractures in canines and felines...........................................419 María Camila Cruz Vélez, Valentina Herrera Morales, Alba Nydia Restrepo Jiménez, Lina Marcela Palomino, Gabriel Rodolfo Izquierdo Bravo. Prevalence of overweight and obesity in children in the rural and urban area of Risaralda....................................................................................................439 Angela María Álvarez López, Angela Liceth Pérez Rendón, Alejandro Gómez Rodas, Luis Enrique Isaza Velásquez. Chapter 6. Architecture, Design and Advertising The artisan crafts of Risaralda, characteristics, importance, and risks within the Colombian Coffee Cultural Landscape, CCCL....................................457 Yaffa Nahir Ivette Gómez Barrera, Javier Alfonso López Morales

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true