Clinico-pathological conference (CPC) : a previously healthy patient with respiratory insuficiency due to intersticial pneumonia

ABSTRACT: We present the case of a 40-year-old woman, with no remarkable past medical history, who was admitted to San Vicente Foundation University Hospital, in Medellín, Colombia; she complained of respiratory symptoms lasting 20 days. Interstitial pneumonia associated with AIDS was diagnosed, which progressed to respiratory failure that did not respond to therapy directed against the opportunistic infections that were identified. She finally developed multiorgan failure that caused death.RESUMEN: Se presenta y discute el caso de una mujer de 40 años, sin antecedentes relevantes, quien ingresó al hospital Universitario San Vicente Fundación, por presentar síntomas respiratorios durante 20 días. Se diagnosticó sida de novo y neumonía intersticial asociada, todo lo cual progresó hasta la falla ventilatoria, que fue refractaria al tratamiento dirigido hacia los oportunistas identificados, debido a lo cual se produjo una falla orgánica múltiple que causó la muerte

Clinico-pathological conference (CPC): Patient with congenital heart malformation and infective endocarditis

RESUMEN: Se presenta el caso de un hombre de 17 años, sin antecedentes de importancia, quien consultó por deterioro de su clase funcional, fatigabilidad y disnea, de un mes de evolución, además de fiebre y síndrome de respuesta inflamatoria sistémica (SIRS), en quien se documentaron una malformación congénita de novo tipo situs inversus con levocardia y una comunicación interventricular (CIV), asociadas a transposición de grandes vasos; durante la hospitalización recibió varios tratamientos con antibióticos sin aislamiento microbiológico ni identificación de la causa de su descompensación hemodinámica. En el examen posmortem se identificó endocarditis por Aspergillus spp., con embolia a diferentes órganos.ABSTRACT: We present the case of a 17 year-old-man, with no remarkable past medical history, who had a one month history of worsening functional class, fatigability and dyspnea, in addition to fever and systemic inflammatory response syndrome (SIRS); a de-novo congenital heart malformation, situs inversus type, with levocardia and a ventricular septal defect (VSD) associated with transposition of great vessels were documented. During hospitalization he received several antibiotic treatments without microbiological isolation or identification of the cause of hemodynamic decompensation. An Aspergillus endocarditis with emboli to different organs was identified in the post-mortem examination

Análisis de tendencia de temperatura y precipitación para el departamento de Caldas (Colombia), mediante wavelets

Climate change, understood as an alteration of the climate, due or not to human activity, added to climate variability, is a primary area of study at this time. This study was carried out with the objective of generating information on trends of the temperature and precipitation variables for the department of Caldas, Colombia, using the wavelets analysis technique. For this purpose, the Ideam stations, located in the territory, were selected for the periods 1971-2010, in the case of precipitation; and for the period 1981-2010, for temperature. The stations record data daily, which was transformed into monthly data, their trend was calculated by multi resolution analysis (MRA), selecting the Daubechies wavelet (dB5) with six levels of degradation. The analysis shows slow and increasing trends in precipitation for the fifteen stations analyzed. A similar result was obtained for minimum temperature. While, for maximum temperature, slow decreasing trends were recorded in one station. For comprehensive climate change management plans, it is recommended to monitor these trends, if possible with longer historical series, to identify signs of change and possible effects on the regional climate.El cambio climático, entendido como una alteración del clima, debida o no a la actividad humana, sumada a la variabilidad climática, es un área de estudio primordial en estos momentos. Este estudio se hizo con el objetivo de generar información de tendencias de las variables temperatura y precipitación para el departamento de Caldas, Colombia, mediante la técnica de análisis wavelets. Para tal fin, se seleccionaron las estaciones del Ideam, ubicadas en el territorio, para los periodos 1971-2010, en el caso de precipitación; y para el periodo 1981-2010, en temperatura. Las estaciones registran datos diariamente, los cuales fueron transformados en datos mensuales, cuya tendencia se calculó mediante el análisis multirresolución (MRA), seleccionando la wavelet Daubechies (dB5) con seis niveles de descomposición. Los análisis evidencian tendencias lentas y crecientes en precipitación para las quince estaciones analizadas. Resultado similar se obtuvo para temperatura mínima. Mientras que, para temperatura máxima, se registraron tendencias lentas decrecientes, en una estación. Para los planes integrales de gestión de cambio climático, se recomienda el seguimiento a estas tendencias, en lo posible con series históricas de mayor longitud, para identificar señales de cambio y posibles efectos en el clima regional

Estrategia de gobierno digital para la construcción de Estados más transparentes y proactivos

A transparent government is one that publishes timely in open data the activity of its different organizations, either to respond to the requirements of citizens or on its own initiative. This guarantees not only to put an end to corruption but to guarantee the right of citizens to know what governments do with their taxes. This study aims to select and review various sources of information on the subject of digital government, a strategy that involves open data and transparency, in order to identify the most important aspects and trends of the new technologies applied to government entities, as well as the implications that can lead to decision making and the improvement of the services provided by the government to its citizens. The methodological process was carried out following the steps of a documentary review based on different sources according to eight categories associated with digital government.   As a conclusion of the study, it is possible to affirm that the influence and adoption of digital government in different countries contributes to bringing citizens closer to the state, increasing transparency and improving services.Un gobierno transparente es aquel que, oportunamente, publica datos abiertos de las actividades de sus diferentes organismos, bien sea para dar respuesta a los requerimientos de la ciudadanía o bien por iniciativa propia.  Con esto se busca no solo poner un alto a la corrupción sino también garantizar el derecho de los ciudadanos a conocer lo que hacen los gobiernos con sus impuestos. Este estudio tiene como objeto la selección y revisión de diversas fuentes de información acerca del tema del gobierno digital, estrategia que involucra los datos abiertos, y con ello la transparencia, con el fin de identificar los aspectos y tendencias más importantes de las nuevas tecnologías aplicadas a las entidades gubernamentales, así como las implicaciones en cuanto a la toma de decisiones y a la mejora de los servicios que el gobierno presta a sus ciudadanos. El proceso metodológico se llevó a cabo siguiendo los pasos de una revisión documental de diversas fuentes  de acuerdo con ocho categorías asociadas al gobierno digital. Como conclusión del estudio es posible afirmar que la influencia y adopción del gobierno digital en diferentes países contribuye a acercar a los ciudadanos con el estado, aumentado la transparencia y mejorando los servicios

Sistemas de detección y prevención de intrusos

Este trabajo presenta una propuesta de taxonomía experimental basada en código abierto para los Intrusion Detection System/Intrusion Prevention System (IDS/IPS), orientada a la industria 4.0, debido a las necesidades actuales de seguridad de la información en hogares y empresas. Con la transformación digital, el crecimiento exponencial del Internet de las Cosas (IoT, por sus siglasen inglés), las conexiones aInternet y el aumento de amenazas, aumentan los problemas de seguridad de los equipos, que pueden verse vulnerados por los ciberdelincuentes y ser utilizados como intermedio para atacar otros equipos de la red propia, de otras organizaciones o para formar su propio botnet con miras a ataques masivos controlados. Por ello, es necesario contar con IDS/IPS que contribuyan a mejorar su seguridad. En la taxonomía se describe la infraestructura tecnológica en hardware y software para disponer en un ambiente experimental y realizar pruebas en la implementación, administración, gestión e investigación de IDS/IPS de código abierto y comprender las reglas y las anomalías para la detección de intrusos, mediante la base de datos de firmas y la utilización algoritmos de aprendizaje automático

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Consenso colombiano para el manejo de pacientes con Hipofosfatasia

La hipofosfatasia (HPP) es una enfermedad metabólica, de tipo hereditario, causada por mutaciones en el gen ALPL. Teniendo en cuenta los retos del manejo adecuado de los pacientes con HPP, se realizó un consenso interdisciplinario de expertos (endocrocrinólogos pediatras, nefrólogos pediatras, ortopedistas infantiles y genetistas clínicos) con el fin de proponer recomendaciones de utilidad clínica para el diagnóstico, tratamiento y seguimiento de los pacientes colombianos con HPP. Estas sugerencias se realizan en el contexto de los diferentes tipos de presentaciones y las edades de los pacientes.Q41-7Hypophosphatasia (HPP) is a hereditary metabolic disease caused by mutations in the ALPL gene. Taking into account the challenges found in the adequate management of patients with HPP, an interdisciplinary consensus of experts (pediatric endocrinologists, pediatric nephrologists, pediatric orthopedists and clinical geneticists) was carried out, in order to propose recommendations of clinical utility for the diagnosis, treatment and follow-up of Colombian patients with HPP. These suggestions are made in the context of the different types of presentations and the ages of the patients

Resignificando la educación: 12 reflexiones pedagógicas sobre la escuela

208 páginasEste libro reúne 12 artículos de maestros y maestras de la ciudad que reflexionan sobre el rol de la Escuela en la actualidad. Sin duda, la pandemia es un hecho que atraviesa varias de estas páginas, pues esta coyuntura ha hecho que estudiantes, docentes y familias resignifiquen su papel en la educación. Pero este libro no se agota allí, en tanto aparecen iniciativas como las redes de maestros y maestras en torno a la paz, la interculturalidad, así como nuevas miradas sobre la inclusión educativa y la evaluación que aportan al diálogo pedagógico. De esta manera, el Instituto para la Investigación Educativa y el Desarrollo Pedagógico (IDEP) busca que docentes y directivos de las instituciones educativas aporten a la transformación educativa desde sus saberes y experiencias.I. La Escuela en Casa. Página 17: Transitando por la Escuela: realidades y posibilidades. Página 29: Relación Familia- Escuela, Educación Asistida y Ambientes de Aprendizaje en Casa. Página 43: Percepciones de familias sobre su participación en la Escuela. Articulando voces de madres, padres y acudientes de estudiantes en Jardín y Transición. II. Nuevas miradas de la evaluación Página 71: Del pensamiento a la acción: la evaluación en el preescolar. Página 87: La evaluación durante el confinamiento educativo: evidencias investigativas de una crisis en sus prácticas y usos. III. Redes de paz, reconciliación y ciudadanía. Página 103: La Red Elegguá: Abriendo caminos para la tolerancia y la interculturalidad. Página 113: Pedagogías colectivas para la Paz- Tejido de esperanzas de maestras y maestros de la Red Chisua. IV. Inclusión educativa. Página 131: Experiencias de apropiación: Narrativas de maestras desde la inclusión. Página 149: El rol del docente de apoyo frente al reto de una educación inclusiva de calidad para la atención a la población estudiantil con discapacidad. Página 161: La oferta bilingüe-bicultural a nivel distrital, una apuesta en la educación de la persona sorda. V. Estudiantes y maestros en cambio. Página 177: El maestro investigador en el aula y su caracterización pedagógica. Página 195: Los Procesos de Lectura y Escritura Creativa en niños, niñas y adolescentes. Análisis de una experiencia

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