Cooperation and international economic integration between China and Colombia

The paper presents an assessment of the recent evolution of the economic integration between Colombia and China during the 21th century from different perspectives: evolution of international trade with emphasis on exports and import, the behavior of foreign direct investment (FDI) considering technical, economic, and cultural cooperation agreements under the scheme of South-South cooperation, towards a more profound international economic integration that favors the free movement of goods and services. In addition, the potential benefits of this economic integration are analyzed and conclude that China is an important actor in the economic development prospects of Colombia. Finally, the paper emphasizes the main challenges ahead in a scenario of international economic integration.Este artigo apresenta uma discussão sobre a evolução da integração econômica entre Colômbia e China no século XXI sob diferentes perspectivas: evolução do comércio exterior com ênfase nas principais exportações e importações; comportamento do investimento estrangeiro direto (IED) levando em consideração acordos de cooperação técnica, econômica e cultural no âmbito do esquema de cooperação internacional Sul-Sul/ e que demonstrem interesse conjunto em avançar para uma integração econômica profunda que favoreça a livre circulação de bens e serviços. Além disso, são analisados ​​os benefícios potenciais de uma maior integração econômica entre os dois países, e se confirma que a economia chinesa é considerada um ator relevante no desenvolvimento econômico da Colômbia. Por fim, destacam-se os principais desafios que a Colômbia deve enfrentar neste cenário de maior integração e cooperação internacional.El documento presenta una discusión de la evolución de la integración económica entre Colombia y China en el siglo XXI desde distintas perspectivas: evolución del comercio exterior con énfasis en las principales exportaciones e importaciones; comportamiento de la inversión extranjera directa (IED), teniendo en consideración los acuerdos de cooperación técnica, económica y cultural bajo el esquema de cooperación internacional Sur-Sur; evidencia de un interés conjunto en avanzar hacia una integración económica profunda que favorezca la libre circulación de bienes y servicios. Además, se analizan los beneficios potenciales de una mayor integración económica entre ambos países, y se confirma que la economía China se considera como un actor relevante en el desarrollo económico de Colombia. Por último, se destacan los principales retos que debe enfrentar Colombia en este escenario de mayor integración y cooperación internacional

Cooperation and international economic integration between China and Colombia

The paper presents an assessment of the recent evolution of the economic integration between Colombia and China during the 21th century from different perspectives: evolution of international trade with emphasis on exports and import, the behavior of foreign direct investment (FDI) considering technical, economic, and cultural cooperation agreements under the scheme of South-South cooperation, towards a more profound international economic integration that favors the free movement of goods and services. In addition, the potential benefits of this economic integration are analyzed and conclude that China is an important actor in the economic development prospects of Colombia. Finally, the paper emphasizes the main challenges ahead in a scenario of international economic integration.Este artigo apresenta uma discussão sobre a evolução da integração econômica entre Colômbia e China no século XXI sob diferentes perspectivas: evolução do comércio exterior com ênfase nas principais exportações e importações; comportamento do investimento estrangeiro direto (IED) levando em consideração acordos de cooperação técnica, econômica e cultural no âmbito do esquema de cooperação internacional Sul-Sul/ e que demonstrem interesse conjunto em avançar para uma integração econômica profunda que favoreça a livre circulação de bens e serviços. Além disso, são analisados ​​os benefícios potenciais de uma maior integração econômica entre os dois países, e se confirma que a economia chinesa é considerada um ator relevante no desenvolvimento econômico da Colômbia. Por fim, destacam-se os principais desafios que a Colômbia deve enfrentar neste cenário de maior integração e cooperação internacional.El documento presenta una discusión de la evolución de la integración económica entre Colombia y China en el siglo XXI desde distintas perspectivas: evolución del comercio exterior con énfasis en las principales exportaciones e importaciones; comportamiento de la inversión extranjera directa (IED), teniendo en consideración los acuerdos de cooperación técnica, económica y cultural bajo el esquema de cooperación internacional Sur-Sur; evidencia de un interés conjunto en avanzar hacia una integración económica profunda que favorezca la libre circulación de bienes y servicios. Además, se analizan los beneficios potenciales de una mayor integración económica entre ambos países, y se confirma que la economía China se considera como un actor relevante en el desarrollo económico de Colombia. Por último, se destacan los principales retos que debe enfrentar Colombia en este escenario de mayor integración y cooperación internacional

Externado de Medicina Interna - ME212 - 202101

Curso de la carrera de medicina, de carácter teórico-práctico del ciclo 9, en el que los estudiantes presentan una historia clínica con su respectivo plan diagnóstico, terapéutico y de procedimientos en un paciente con una condición médica, a través de la realización de actividades de simulación y metodología activa. El curso del externado de medicina interna busca desarrollar la competencia general de comunicación escrita (nivel 3) y las competencias específicas de práctica clínica-diagnóstico(nivel 3) y profesionalismo-sentido ético y legal y responsabilidad profesional(nivel 3). El externado de medicina al estudiante le permitirá plantear un adecuado tratamiento y plan de trabajo según el diagnóstico de los principales problemas médicos que le servirá en su futura vida profesional

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research