¿POR QUÉ Y PARA QUÉ? DOS PROPUESTAS ANALÍTICAS PARA LOS ESTUDIOS DE FAMILIA

Objetivo. Proponer desde un marco histórico y sociológico algunas razones e intenciones del tema de familia. Metodología. Construcción argumental entre dos voces expertas en este campo a la luz de dos preguntas metodológicas: el por qué y el para qué, mediante el desarrollo de una espiral hermenéutica. Resultados y conclusión. Los trazos argumentativos a partir de algunos historiadores y sociólogos clásicos y contemporáneos permiten evidenciar, por una parte, el por qué del tema y sus razones analíticas; y por otra, el para qué, desde la intención de marcar su panorama actual como un asunto público y político. Se concluye que la puesta en escena de esta conversación provoca direccionar busquedas investigativas y analíticas frente a los nuevos tiempos para las familias y las familias para los nuevos tiempos

Why and what for?: two analytical proposals for family studies

Objetivo. Proponer desde un marco histórico y sociológico algunas razones e intenciones del tema de familia. Metodología. Construcción argumental entre dos voces expertas en este campo a la luz de dos preguntas metodológicas: el por qué y el para qué, mediante el desarrollo de una espiral hermenéutica. Resultados y conclusión. Los trazos argumentativos a partir de algunos historiadores y sociólogos clásicos y contemporáneos permiten evidenciar, por una parte, el por qué del tema y sus razones analíticas; y por otra, el para qué, desde la intención de marcar su panorama actual como un asunto público y político. Se concluye que la puesta en escena de esta conversación provoca direccionar busquedas investigativas y analíticas frente a los nuevos tiempos para las familias y las familias para los nuevos tiempos.Objective. To propose, from a historical and sociological framework, some reasons and intentions related to the topic of family. Methodology. Argumentative construction between two expert voices in this field in the light of two methodological questions, the why and the what for, through the development of a hermeneutic spiral. Results and conclusion. The argumentative lines of some classic and contemporary historians and sociologists make it possible to demonstrate on the one hand, the why of the subject and its analytical reasons and, on the other hand, the what for, from the intention of marking its current panorama as a public and political issue. It is concluded that the staging of this conversation provokes investigative and analytical research directed against the new times for families, families for new times.Fil: Cicerchia, Hector Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto de Historia Argentina y Americana "Dr. Emilio Ravignani". Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Historia Argentina y Americana "Dr. Emilio Ravignani"; ArgentinaFil: Palacio Valencia, María Cristina. Universidad de Caldas; Colombi

Local delivery of thrombolytics before thrombectomy in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention — The DISSOLUTION randomized trial

Background: Ranolazine decreases the frequency of arrhythmias during the acute phases of ischemic heart disease (IHD), but it remains unknown if it has similar effects in the chronic phase of the disease. We performed a prospective, randomized, cross-over pilot trial to test the hypothesis that chronic treatment with ranolazine can reduce the incidence of documented arrhythmias and the related symptoms of palpitation in stable patients with IHD. Methods: We randomized 105 patients with stable IHD and symptoms of angina and palpitations already on therapy with betablockers and/or calcium antagonists to ranolazine (750 mg bid, N = 53) or placebo (N = 52) for 30 days (until T-1). After a washout period to avoid any carryover effect, cross-over was performed,and patients were switched to the other drug which was continued for 30 days (until T-2). All patients underwent symptomlimited exercise stress testing and 48-hour ECG Holter monitoring at T1 and T2. During the study period, patients were told to use a OmronN® portable ECG monitor HCG-801 device in case of symptoms of palpitations. Results: Ranolazine reduced the number of anginal episodes more commonly than placebo (5 ± 8 episodes/30 days vs. 21 ± 24 episodes/30 day, p = 0.001) and increased exercise durations at 1 mm ST-segment depression (514 ± 211 s vs. 402 ± 287 s, p = 0.025) and at onset of angina (614 ± 199 s vs. 519 ± 151 s, p = 0.007) at stress testing. These effects were coupled by significant decreases with ranolazine as compared with placebo treatment periods in the occurrence of frequent (N1000 beats) supraventricular arrhythmias (33% vs 52%, p = 0.01) and complex ventricular arrhythmias (17% vs 30%, p = 0.045). Complete resolution of symptoms of palpitations was significantly more common with ranolazine than placebo (31/53 vs 16/52 patients, p = 0.008). Also, portable ECG recordings showed that arrhythmias were less common during ranolazine vs. placebo, with significant decreases in number (7 ± 10 episodes/30 days vs. 23 ± 29 episodes/30 day, p = 0.001) and duration (10 ± 18 min/ 30 days vs. 19 ± 21 min/30 day, p = 0.021) of symptomatic arrhythmic episodes. No severe side effects were recorded during the trial period. Conclusion: The antianginal and antiischemic properties of ranolazine are paralleled by significant decreases in the occurrence of both arrhythmias and the related symptoms of palpitations in stable patients with IHD. (ClinicalTrials.gov identifier: NCT01495520)

Síndrome de Marfan de presentación atípica, reflejo de una nueva mutación

Marfan syndrome (MS) is an inherited connective tissue disorder that affects the skeletal, cardiovascular, andmuscular systems of the eye. We present a MS case with an atypical presentation as acute lung edema thatreflects a new FBN1 mutation.El síndrome de Marfan (SM) es un desorden del tejido conectivo que afecta a los sistemas musculoesquelético, cardiovascular y ocular. Presentamos el caso de una paciente diagnosticada de SM tras sufrir un cuadro de edema pulmonar agudo, objetivándose a posteriori una nueva mutación del gen FBN1

Mujeres y cultura en la Argentina del siglo XIX

Este libro es el resultado de buscar y rebuscar, acuciadas en un primer momento por una natural curiosidad hacia el siglo XIX, en el baúl de nuestras abuelas o incluso bisabuelas. Y nos encontramos no sólo con el pasado sino con nuestro pasado, rico, complejo, sorprendente en su infinita variedad de hallazgos. Experimentamos un sentimiento de ternura por esas mujeres y de profunda solidaridad ante el esfuerzo que realizaron, muchas veces en condiciones inhóspitas, incomprendidas por sus contemporáneos, varones y mujeres. No sólo mujeres con nombre propio sino mujeres generalmente anónimas forman una parte esencial de la historia no contada, oculta(da) en el polvo acumulado durante el transcurso de los años. Nuestra tarea, nuestra pasión es desenvolverla, descubrirla, deconstruirla. Un acto compartido entre muchas mujeres y algunos varones. En mayor o menor grado, cada artículo en Mujeres y cultura en la Argentina del siglo XIXcontribuye a este fin y también al de la construcción –la re-construcción- de la historia de mujeres en la Argentina. Hay todavía mucho por revolver en esos arcones. Sabemos que hay nombres escondidos todavía en publicaciones que debemos encontrar. Nombres de mujeres, sus labores, que han sido muy poco investigadas o que sencillamente desconocemos. Se trata de hacer visible una producción ignorada y una tradición desdibujada

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

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

Mappatura delle professioni culturali emergenti e loro percorsi formativi

La ricerca, commissionata dalla Fondazione Compagnia di San Paolo, ha avuto come territorio di riferimento il Piemonte, la Liguria e la Valle d’Aosta, regioni d'azione della Fondazione. La ricerca ha mirato a produrre tre output: - una mappatura delle professioni culturali, con particolare focus sulle emergenti; - una mappatura dell’offerta formativa ad oggi; - la definizione delle competenze necessarie nel settore culturale sul medio - lungo periodo. L’obiettivo generale della ricerca è stato quindi quello di costruire un quadro del lavoro e delle professioni culturali, con una particolare attenzione a quelle emergenti e di approfondire le caratteristiche dei percorsi formativi ad esse collegati. Tali obiettivi generali, sono stati poi declinati nei seguenti obiettivi specifici: - la ricognizione delle definizioni di “professione culturale”; - un approfondimento e un’analisi delle caratteristiche delle figure professionali presenti ed emergenti nel settore con un’attenzione sia all’individuazione delle competenze necessarie sia alle caratteristiche e alle condizioni dei lavoratori, alle loro traiettorie e identità; - un approfondimento e un’analisi dell’o erta formativa esistente (formale e non formale), nonché l’individuazione di fabbisogni formativi e di eventuali gap tra l’attuale o erta e le figure professionali e competenze nel prossimo triennio. Nella ricerca è stato assunto come angolo di osservazione privilegiato il punto di vista dei principali protagonisti del mondo culturale nelle tre regioni in cui opera la Fondazione Compagnia di S. Paolo (Piemonte, Liguria e Valle d’Aosta). In particolare sono stati coinvolti gli enti beneficiari e proponenti dell’attività istituzionale ed erogativa della Compagnia di San Paolo - Obiettivo Cultura, le società fornitrici della Fondazione e i loro lavoratori e alcuni esperti del mondo della cultura