8 research outputs found
Privacidad y vivienda masiva
Partiendo del estudio inicial realizado por todo el taller profesional de vivienda masiva a cargo del arquitecto Alexis Mosquera; sobre la vivienda, sus orígenes, elementos que la conforman, características y la transformación de la misma a lo largo del tiempo; nace la intención de encontrar un término que refleje la idea básica y esencial de la vivienda, que distinga su función, un término director que haya ligado la existencia de la misma con el hombre durante tanto tiempo; de donde surge una necesidad intrínseca y natural como es la búsqueda de la protección
Development and validation of a clinical score to estimate progression to severe or critical state in Covid-19 pneumonia hospitalized patients
The prognosis of a patient with Covid-19 pneumonia is uncertain. Our objective was to establish a predictive model of disease progression to facilitate early decision-making.
A retrospective study was performed of patients admitted with Covid-19 pneumonia, classified as severe (admission to the intensive care unit, mechanic invasive ventilation, or death) or non-severe. A predictive model based on clinical, analytical, and radiological parameters was built. The probability of progression to severe disease was estimated by logistic regression analysis. Calibration and discrimination (receiver operating characteristics curves and AUC) were assessed to determine model performance.
During the study period 1,152 patients presented with Covid-19 infection, of whom 229 (19.9%) were admitted for pneumonia. During hospitalization, 51 (22.3%) progressed to severe disease, of whom 26 required ICU care (11.4); 17 (7.4%) underwent invasive mechanical ventilation, and 32 (14%) died of any cause. Five predictors determined within 24 hours of admission were identified: Diabetes, Age, Lymphocyte count, SaO2, and pH (DALSH score). The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤5%, 6-25%, and >25% exhibited disease progression, respectively.
A simple risk score based on five factors predicts disease progression and facilitates early decision-making according to prognosis.Carlos III Health Institute, Spain, Ministry of Economy and Competitiveness (SPAIN) and the European Regional Development Fund (FEDER)Instituto de Salud Carlos II
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children
We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2
Summary of Spanish recommendations on intensive care to facilitate organ donation.
With the aim of consolidating recommendations about the practice of initiating or continuing intensive care to facilitate organ donation (ICOD), an ad hoc working group was established, comprising 10 intensivists designated by the Spanish Society of Intensive Care and Coronary Units (SEMICYUC) and the Spanish National Transplant Organization (ONT). Consensus was reached in all recommendations through a deliberative process. After a public consultation, the final recommendations were institutionally adopted by SEMICYUC, ONT, and the Transplant Committee of the National Health-Care System. This article reports on the resulting recommendations on ICOD for patients with a devastating brain injury for whom the decision has been made not to apply any medical or surgical treatment with a curative purpose on the grounds of futility. Emphasis is made on the systematic referral of these patients to donor coordinators, the proper assessment of the likelihood of brain death and medical suitability, and on transparency in communication with the patient's family. The legal and ethical aspects of ICOD are addressed. ICOD is considered a legitimate practice that offers more patients the opportunity of donating their organs upon their death and helps to increase the availability of organs for transplantation
Proyecto de compensación educativa
Con este proyecto se pretende reestructurar el Centro y hacer frente a la mayoritaria población de minorías y de bajo nivel socioeconómico que forma la comunidad educativa. Los objetivos son discriminar el absentismo; evitar el abandono de la escolarización obligatoria; mejorar la convivencia; aumentar el nivel de competencia curricular de los alumnos; y abrir el centro a otros sectores de la población. En septiembre los tutores y profesores de compensatoria del ciclo evalúan a los alumnos para repartirlos en 15 grupos de 9 niveles por competencia y edades, dando respuesta a las necesidades de todo el alumnado. A lo largo del curso se readapta según el nivel de consecución de objetivos. Se determinan los objetivos y contenidos de cada nivel y la metodología. Se inicia la elaboración de materiales currucilares con especial atención a la cultura gitana y a los inmigrantes. Es esencial la acción tutorial con el niño y su familia. El trabajo se realiza en el propio aula y en la biblioteca, invernadero y aula de informática. Se organizan talleres que resulten atractivos y funcionales, y se propone crear una biblioteca sobre el pueblo gitano. Para la evaluación se tiene en cuenta la elaboración de materiales y la repercusión en el alumno y en el entorno.Madrid (Comunidad Autónoma). Consejería de EducaciónMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES
Etiologia da baixa visão e cegueira em sete centros de referência na Colômbia entre os anos de 2012 a 2017
Introduction: Low vision and blindness have high global prevalence, with categories of disability common in Colombia. Studies that characterize the etiology of permanent visual impairments are required. Objective: To identify and characterize the different causes of low vision and blindness in seven reference centers for the visually impaired population in Colombia, attended between 2012 and 2017 in six capital cities. Materials and methods: retrospective, case series, descriptive and multicenter study. Results: A sample of 879 records of visually impaired patients was available. Low vision is more prevalent for all age groups. 70% (612/879) low vision and 30% (267/879) blindness. The most common etiology in patients with low vision was age-related macular degeneration (DMAE) (24%, 144/612); in patients with blindness it was glaucoma (17%, 45/267). Discussion: Possibly in Colombia the causes of low vision and blindness go beyond cataracts, un corrected refractive errors and infectious blindness. Conclusions: The most common etiologies found are chronic and diverse eye conditions, which require specific interventions to decrease their prevalence and prevent cases of low vision and blindness.
How to cite this article: Suárez Escudero Juan Camilo, Oviedo Cáceres María del Pilar, Llano Naranjo Yuliana, Arias Uribe Johana, Villegas Mesa José Daniel, Zapata Vásquez María Camila, Ferreira Morales Jorge Luis, Reyes Cisneros Jessica Tatiana, Cano Calle Karen, Goldfeder de Gracia Sydney, González Franco Juan Felipe, Astudillo Valverde Esau. Etiología de baja visión y ceguera en siete centros de referencia en Colombia entre los años 2012 a 2017. Revista Cuidarte. 2022;13(2):e2036. http://dx.doi.org/10.15649/cuidarte.2036 Introducción: la baja visión y la ceguera tienen alta prevalencia mundial, siendo categorías de discapacidad frecuentes en Colombia. Se requieren estudios que caractericen la etiología de las deficiencias visuales permanentes. Objetivo: Identificar y caracterizar las diferentes causas de baja visión y ceguera en siete centros de referencia para la población con discapacidad visual en Colombia, atendida entre los años 2012 a 2017 en seis ciudades capitales. Materiales y métodos: estudio retrospectivo, serie de casos, descriptivo y multicéntrico. Resultados: Se contó con una muestra de 879 registros de pacientes con discapacidad visual. El 70% (612/879) con baja visión y 30% (267/879) con ceguera. Para todos los grupos de edad es más prevalente la baja visión. La etiología más frecuente en pacientes con baja visión fue la degeneración macular asociada a la edad (DMAE) (24%, 144/612); en pacientes con ceguera fue el glaucoma (17%, 45/267). Discusión: Posiblemente en Colombia las causas de baja visión y ceguera van más allá de las cataratas, errores de refracción no corregidos y ceguera infecciosa. Conclusiones: las etiologías más frecuentes encontradas son condiciones oculares crónicas y diversas, que requieren intervenciones específicas para disminuir su prevalencia y prevenir casos de baja visión y ceguera.
Como citar este artículo: Suárez Escudero Juan Camilo, Oviedo Cáceres María del Pilar, Llano Naranjo Yuliana, Arias Uribe Johana, Villegas Mesa José Daniel, Zapata Vásquez María Camila, Ferreira Morales Jorge Luis, Reyes Cisneros Jessica Tatiana, Cano Calle Karen, Goldfeder de Gracia Sydney, González Franco Juan Felipe, Astudillo Valverde Esau. Etiología de baja visión y ceguera en siete centros de referencia en Colombia entre los años 2012 a 2017. Revista Cuidarte. 2022;13(2):e2036. http://dx.doi.org/10.15649/cuidarte.2036 Introdução: Baixa visão e cegueira têm alta prevalência global, com categorias de incapacidade comuns na Colômbia. São necessários estudos que caracterizem a etiologia das deficiências visuais permanentes. Objetivo: Identificar e caracterizar as diferentes causas de baixa visão e cegueira em sete centros de referência para a população deficiente visual na Colômbia, atendidos entre 2012 e 2017 em seis capitais. Materiais e métodos: estudo retrospectivo, série de casos, descritivo e multicêntrico. Resultados: Uma amostra de 879 registros de pacientes com deficiência visual estava disponível. 54% (478/879) homens. A baixa visão é mais prevalente para todas as faixas etárias. 70% (612/879) baixa visão e 30% (267/879) cegueira. A etiologia mais comum em pacientes com baixa visão foi a degeneração macular relacionada à idade (DMAE) (24%, 144/612); em pacientes com cegueira foi glaucoma (17%, 45/267). Discussão: Possivelmente na Colômbia as causas da baixa visão e cegueira vão além da catarata, erros refrativos não corrigidos e cegueira infecciosa. Conclusões: As etiologias mais comuns encontradas são condições oculares crônicas e diversas, que requerem intervenções específicas para diminuir sua prevalência e prevenir casos de baixa visão e cegueira.
Como citar este artigo: Suárez Escudero Juan Camilo, Oviedo Cáceres María del Pilar, Llano Naranjo Yuliana, Arias Uribe Johana, Villegas Mesa José Daniel, Zapata Vásquez María Camila, Ferreira Morales Jorge Luis, Reyes Cisneros Jessica Tatiana, Cano Calle Karen, Goldfeder de Gracia Sydney, González Franco Juan Felipe, Astudillo Valverde Esau. Etiología de baja visión y ceguera en siete centros de referencia en Colombia entre los años 2012 a 2017. Revista Cuidarte. 2022;13(2):e2036. http://dx.doi.org/10.15649/cuidarte.2036