Diarrea por Campylobacter fetus jejuni y otros agentes infecciosos en niños del área rural de Puriscal, Costa Rica

artículo -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1984Between September 1979 and September 1981 a field study was conducted on the etiology of diarrhea' disease in the area of Puriscal, Costa Rica. The presence of enteric pathogens was investigated in the stools of 267 diarrheic children and 190 healthy controls. Both soups belong to yearly cohorts recruited at birth as part of a longitudinal multidisciplinary study of mothers and children. Campylobacter fetus lefuni was identified as the only pathogen in the stools of 24 diarrheic children (9%) and in four healthy controls (2% ), a significant difference (p< 0,05). The clinical features of the episodes were: irritability (77%), blood in stools (35%), anorexia (38,5%), and fever and vomiting (36%). Dehydration was not important among infected children (only one with 5% dehydration). All children received oral salt solutions and only two were treated with antibiotics. Rotaviruses were the main etiologic agents (17%) and Campylobacter ranked second (10,5% ). The frecuency of enterotoxigenic Enterobacteriaceae was similar in sick children and in controls (10%and 12%respectively).Entre setiembre de 1979 y setiembre de 1981, estudiamos 267 niños con diarrea aguda y 190 testigos, con el objeto de determinar la etiología y evaluar la importancia de Campylobacter fetus jejuni como agente etiológico y su influencia sobre el estado nutritional. Todos los niños tenían entre 0 y 24 meses de edad y pertenecen a las falanges anuales de un estudio longitudinal que realiza el INISA en el cantón de Puriscal, Costa Rica. Campylobacter fue el único agente en 24 niños con diarrea (9% ) y en cuatro niños sanos (2% ), encontrándose una diferencia significativa entre ambos grupos (x 2 = 9,05; p < 0,05). Además, se le encontró asociado a rotavirus o enterobacteriáceas toxigénicas en cuatro niños enfermos (1,5% ) y en dos testigos (1% ). El cuadro clínico se caracterizó por la evacuación de cinco a diez deposiciones líquidas al día, con sangre visible macroscópicamente en 39% de los casos. Los niños mostraron irritabilidad (77% ), anorexia (38,5% ), fiebre (36%) y vómitos (36%). Solo un niño presentó deshidratación del 5% y únicamente dos recibieron antibioticoterapia. El resto de los niños se recuperó satisfactoriamente mediante la administración de SUERORAL. El principal agente etiologico fue el rotavirus (17% ), seguido de Campylobacter (10,5%). La frecuencia de enterobacteriáceas toxigénicas fue similar en niños con diarrea y testigos (10% y 12% respectivamente).Universidad de Costa Rica, Instituto de investigaciones en SaludUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones en Salud (INISA

Estudio de Puriscal IX. Estado nutricional y supervivencia del niño lactante

artículo -- Universidad de Costa Rica. Instituto Investigaciones en Salud, 1982. Parte de estudios consecutivos realizados en la localidad de Puriscal.There is no evidence of malnutrition in the Canton of Puriscal as revealed by careful prospective study of all children born from September 19 of 1979 onwards. Several factors may account for this remarkable situation. First, many years of systematic and sustanied work by the Ministry of Health to extend coverage of health services, has resulted in a high technological sanitary level of the population and art almost universal coverage of vaccinations. Secondly, there has been a strenghtening of health practices as a result of programs by the Ministries of Education and Helath, the mass communication media, the Costa Rican Association of Demography and other national entities, with the added benefit of many international organizations such as the Pan American Health Organization and UNICEF. Thirdly, there has been a major protection of the neonate against infections in the last five years, by promoting human milk consumption with rooming—in and other hospital practices; INISA stimulated these actions and extended them into the postnatal period by a closefollow—up of mothers and their children. Fourthly, an important socioeconomic development has been recorded in Puriscal in recent years which translated into a higher level of information, employment, and income. Finally, effective community organization has enabled INISA to coordinate efforts to identify high—risk families for problem— solving using government and community resources. Accepting that these factors are responsible for the good nutrition and health of the infant population of Puriscal, one should ask what specific circumstances and interventions made possible its dramatic decline in infant mortality in recent years (to about 9 per 1000 live births), which is more pronounced than that of the country as a whole. The decline may not be totally dependent on the orthodox rural and community health programs, and the interrelation of several factors superimposed on the above mentioned improvements may explain it These are: better prenatal care and maternal nutrition; spacing of pregnancies; provision of human colostrum and milk to all neonates; and improved medical practice to diagnose and treat the high •risk neonate. The current crisis could result in a deterioration of the excellent health situation of Puriscal, but this does not seem to be occurring. Monthly evaluations of the population by weight/heght, weight/age and heghtiage indices with regard to the NCHS growth curves, reveal that Puriscal anthropometry scores better than the rest of the rural area of Costa Rica. A recent evaluation (September, 1982) did not show stunting or wastage, and according to the severe criterion of weight/age, only one malnourished child was discovered and this had a serious underlying problem. The signficance of these findings for national development, and the possible contribution of INISA to their occurrence is discussed in the present paper. It is recommended that the Puriscal Study be continued for addtionai years and that it be reproduced in other areas of the country, using the infrastructure of the existing rural health programs.Como se indicara en otros trabajos de esta serie, no existe evidencia de que Ia desnutrición sea un problema prioritario en el Cantón de Puriscal, según revela el seguimiento cuidadoso de todos los niños nacidos de mujeres de Puriscal a partir de septiembre de 1979. En la búsqueda de una posible explicación de tan deseable resultado, varios factures parecen tener importancia. En primer termino, los resultados observados han sido influenciados por muchos años de trabajo sistemático y sostenido por el Ministerio de Salud para ampliar Ia cobertura de servicios de salud, lo que se refleja en el alto nivel tecnológico sanitario de la población y en la excelente cobertura de inmunizaciones, pare mencionar kilo dos aspectos de los programas del Gobierno. En segundo termino, ha habido un robustecimiento de Ia practica de salud en la población, labor en la que ha participado el Ministerio de Educación. Ministerio de Salud, los medios de comunicación, Ia Asociacion Demográfica Costarricense. y otras entidades , con amplia colaboración de la Organizacion Panamericana de la Salud y el Unicef En tercer Iugar, ha habido una mayor protección del neonato contra las infecciones, gracias al fomento de la lactancia materna desde temprana edad en las sales de maternidad -estimulado por la labor del INISA extendiéndose postnatalmente con el fomento de la lactancia materna en forma casi universal durante el primer semestre de vida, labor en la que ha participado el INISA en to que concierne a Puriscal. En cuarto lugar, ha habido un buen desarrollo socioeconomico en Puriscal en los últimos arias, que se ha traducido en un alto nivel de information, empleo, e ingreso. Finalmente, la buena organizcion comunitaria ha permitido que el INISA coordine esfuerzos pare identificar familial de alto riesgo y asi tratar de solucionar sus problemas. Aceptando estos factores como responsabtes de Ia buena nutricion y salad de la población infantil de Puriscal, cabe preguntarse que circunstancias e intervenciones han hecho posible el dramático descenso en la tasa de mortalidad infantil (a 9 por 1000 nacidos vivos) en fecha reciente, y que ha lido mils rápido que en el resto del pais sin que parezca deberse exclusivamente a los programas ortodoxos de salud rural y comunitaria. La Unica explicación viable en el momento es Ia conjunción de cuatro factores mayor nutricion materna y atencion prenatal; mayor espaciamiento entre los embarazos; provisión de Calostro a prácticamente todos los neonato; una mayor atencion medica del neonato de alto riesgo. La crisis económicos actual podría resultar en un deterioro de la magnifica situación de Puriscal, pero ese no parece set el caso. Evaluaciones mensuales de la población mediante los indices de peso/talla, peso/edad y talla/ edad empleando las curves del NCHS han revelado indices mils bajos de déficit ponderal y estatural que en el resto del pais_ Una evaluación reciente (septiembre bre, 1982) no revelo ni achicamiento ni desgaste. y segun el estricto criterio de Gomez solo se observa un niño con déficit de mils del 400/o de peso/edad. La significación de los hallazgos pare el pais, y la posible contribución del INISA a esos logros mediante las intervenciones en el hospital y en el campo, se discuten en el presente trabajo. Se recomienda continuar el Estudio de Puriscal y tratar de reproducirlo en otras áreas del pais, así como emplear Ia infraestructura de salud rural existente en el pais para implementar programas de seguimiento similares al Estudio de Puriscal.Universidad de Costa Rica, Instituto de Investigaciones en Salud. Hospital Nacional de Niños Carlos Sáenz.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones en Salud (INISA

REMAS: Greenhouse gas emissions risk management in forest fires

Trabajo presentado en World Forestry Congress, celebrado en Seúl (Corea del Sur) del 02 al 06 de mayo de 2022.REMAS is an Interreg SUDOE project, an innovative project, both in terms of subject matter and territorial approach. Through transnational cooperation, REMAS addresses the risk management of emitting carbon contained in forest ecosystems into the atmosphere due to forest fires, with a multidisciplinary and integrative character. REMAS proposes prevention and post-fire measures to minimise damage and accelerate the recovery of carbon stocks. The project also works to ensure that this emission risk is included in the design of prevention plans and in taking measures to restore sinks in soil and vegetation at a transnational level. Therefore, through transnational cooperation, REMAS is fostering strong partnerships in which regional and local authorities, academia, NGOs and forest sector companies work together to address the transboundary risk of greenhouse gas emissions from forest fires in the SUDOE territory, whose forest ecosystems are particularly vulnerable to climate change impacts. REMAS is a project co-financed by the Interreg Sudoe Program through the European Regional Development Fund (ERDF) which involves 8 partners and 9 associated partners

Psicoterapia y problemas actuales. Debates y alternativas

Ante la proliferación de fenómenos psicosociales, como el suicidio, la violencia sexual, los trastornos del comportamiento alimenticio y las crisis de identidad, emerge esta obra, como una respuesta reflexiva que aborda desde una pluralidad de perspectivas el quehacer psicoterapéutico, para favorecer una comprensión amplia de estas situaciones problema y ofrecer, desde la experiencia de sus autores, alternativas de entendimiento y de desarrollo de tratamientos para la atención de quienes las viven. El objetivo es compartir una comprensión innovadora de la práctica del psicoterapeuta, desde una mirada caracterizada por el diálogo interdisciplinario. Ello a partir de la recuperación de las estrategias implementadas frente a distintas coyunturas, así como a través de la reflexión personal en torno a la formación y el ejercicio profesional del psicoterapeuta, que pueden favorecer la retroalimentación y la generación de formas de intervención más adecuadas a la realidad de algunos dilemas contemporáneos y de los entornos en que estos se desenvuelven. Un libro recomendable para estudiantes, docentes y profesionales en el campo de la psicoterapia y la salud psicosocial.ITESO. A.C

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Projeto REMAS: Gestão do risco de emissões de gases com efeito de estufa em incêndios florestais

Trabajo presentado en el 9º Congresso Florestal Nacional Portugal, celebrado en Funchal (Portugal) del 10 al 14 de Octubre de 2022.O fogo é uma parte essencial na formação da paisagem mediterrânica e de alguns processos ecológicos que aí ocorrem. Dependendo das características do fogo, as características da vegetação e as propriedades do solo podem alterar-se significativamente. Os efeitos do fogo a longo prazo ainda não são bem compreendidos, principalmente na região mediterrânica. O SUDOE, espaço que compreende o Sudoeste da Europa, necessita de florestas saudáveis e funcionais que garantam o fornecimento de bens e serviços para as sociedades rurais. O projeto REMAS-SUDOE, cujos parceiros são a Universidade Politécnica de Valência (UPV, ES), Universidade de Valência (UV-CIDE, ES), Diputación de Valencia (DIVAL, ES), Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA, ES), Município de Loulé (CML, PT), Instituto Superior de Agronomia (ISA/Ulisboa, PT), Ecole Nationale Supérieure des Sciences Agronomiques de Bordeaux Aquitaine (Bordeaux Sciences Agro, FR), e coordenação da AMUFOR - Asociación de Municipios Forestales de la Comunidad Valenciana (ES), visa melhorar a ligação e a eficácia dos planos de prevenção e recuperação de incêndio, incluindo a gestão de risco de emissões de gases com efeito estufa resultantes de incêndios florestais nas regiões do espaço SUDOE, que são as mais vulneráveis aos impactes das alterações climáticas. O projeto tem como objetivo (i) quantificar orisco de emissão de gases com efeito de estufa (GEE) em áreas sujeitas a incêndios florestais; (ii) quantificar e desenvolver cartografia de armazenamento de carbono; (iii) propor medidas de recuperação pós incêndio, com vista à minimização do dano e à aceleração da recuperação dos stocks de carbono; e (iv) contribuir para incluir a gestão do risco de emissões de GEE por incêndios florestais no planeamento nacional, e das regiões SUDOE. As áreas de estudo do projeto estão situadas em Chelva (Comunidade Valenciana, Espanha), Parque Natural do Alto TajoTejo (Guadalajara, Espanha), e em Landes de Gascogne (Aquitânia, França). Em Portugal, a área de estudo é a Serra do Caldeirão no Algarve, onde domina o sobreiral. No âmbito do projeto, a estimativa do risco de emissão de GEE tem sido feita com deteção remota, sistemas de informação geográfica (SIG) e com base em informação recolhida em campo dos stocks de carbono na vegetação e solos, tanto em áreas ardidas como não ardidas, com e sem gestão, para analisar os efeitos do fogo e da gestão na dinâmica do carbono. Os principais resultados apontam para uma perda instantânea de carbono de 0 a 89% após o fogo, sendo mais elevada na área de estudo francesa (dominada por pinheiro-bravo). A perda de carbono no tempo é entre 200 e 530 kg C ha-1 ano-1, sendo maior em Chelva. A recuperação total da capacidade de sequestro de carbono foi avaliada em 3 anos após o fogo na Serra do Caldeirão, sendo a recuperação mais rápida de todas as áreas de estudo, o que mostra uma elevada resiliência das florestas de sobreiro ao fogo. Os resultados preliminares para a Serra do Caldeirão indicam que o stock de carbono na vegetação é de cerca de 16 ton C ha-1 e mostram uma boa recuperação das propriedades físicas e químicas dos solos, 8 e 16 anos após os incêndios. Estes resultados irão permitir identificar as melhores práticas para diminuir o risco de emissão de GEE e para ações de restauro de áreas ardidas.Estudo desenvolvido no âmbito do projeto REMAS-SUDOE “Gestão do risco de emissões de gases com efeito de estufa por incêndios florestais”, financiado pelo Programa INTERREG SUDOE, FEDER (UE), referência REMAS – SOE3/P4/E0954

Un examen actualizado de la percepción de las barreras para la implementación de la farmacogenómica y la utilidad de los pares fármaco/gen en América Latina y el Caribe

La farmacogenómica (PGx) se considera un campo emergente en los países en desarrollo. La investigación sobre PGx en la región de América Latina y el Caribe (ALC) sigue siendo escasa, con información limitada en algunas poblaciones. Por lo tanto, las extrapolaciones son complicadas, especialmente en poblaciones mixtas. En este trabajo, revisamos y analizamos el conocimiento farmacogenómico entre la comunidad científica y clínica de ALC y examinamos las barreras para la aplicación clínica. Realizamos una búsqueda de publicaciones y ensayos clínicos en este campo en todo el mundo y evaluamos la contribución de ALC. A continuación, realizamos una encuesta regional estructurada que evaluó una lista de 14 barreras potenciales para la aplicación clínica de biomarcadores en función de su importancia. Además, se analizó una lista emparejada de 54 genes/fármacos para determinar una asociación entre los biomarcadores y la respuesta a la medicina genómica. Esta encuesta se comparó con una encuesta anterior realizada en 2014 para evaluar el progreso en la región. Los resultados de la búsqueda indicaron que los países de América Latina y el Caribe han contribuido con el 3,44% del total de publicaciones y el 2,45% de los ensayos clínicos relacionados con PGx en todo el mundo hasta el momento. Un total de 106 profesionales de 17 países respondieron a la encuesta. Se identificaron seis grandes grupos de obstáculos. A pesar de los continuos esfuerzos de la región en la última década, la principal barrera para la implementación de PGx en ALC sigue siendo la misma, la "necesidad de directrices, procesos y protocolos para la aplicación clínica de la farmacogenética/farmacogenómica". Las cuestiones de coste-eficacia se consideran factores críticos en la región. Los puntos relacionados con la reticencia de los clínicos son actualmente menos relevantes. Según los resultados de la encuesta, los pares gen/fármaco mejor clasificados (96%-99%) y percibidos como importantes fueron CYP2D6/tamoxifeno, CYP3A5/tacrolimus, CYP2D6/opioides, DPYD/fluoropirimidinas, TMPT/tiopurinas, CYP2D6/antidepresivos tricíclicos, CYP2C19/antidepresivos tricíclicos, NUDT15/tiopurinas, CYP2B6/efavirenz y CYP2C19/clopidogrel. En conclusión, aunque la contribución global de los países de ALC sigue siendo baja en el campo del PGx, se ha observado una mejora relevante en la región. La percepción de la utilidad de las pruebas PGx en la comunidad biomédica ha cambiado drásticamente, aumentando la concienciación entre los médicos, lo que sugiere un futuro prometedor en las aplicaciones clínicas de PGx en ALC.Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region’s continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the “need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics”. Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%–99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC

An Updated Examination of the Perception of Barriers for Pharmacogenomics Implementation and the Usefulness of Drug/Gene Pairs in Latin America and the Caribbean

Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region’s continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the “need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics”. Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%–99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Memoria del II Coloquio Internacional sobre Diversidad Cultural y Estudios Regionales

Desde la Sede de Occidente y, específicamente, en el seno de la Coordinación de Investigación y con el apoyo de la Dirección de la Sede y las Coordinaciones de Docencia, Administración y Acción Social, así como de la Vicerrectoría de Investigación, se han celebrado en el 2011 y en el 2012 dos coloquios internacionales sobre diversidad cultural y estudios regionales. El propósito de ambos consistió principalmente en motivar a investigadores e investigadoras de las distintas unidades académicas de la Universidad de Costa Rica y de otras instituciones de Educación Superior, así como a representantes de Centros e Institutos de Investigación nacionales e internacionales, a presentar resultados de investigaciones que contribuyeran a un mayor conocimiento de los procesos culturales y que dieran a conocer resultados que permitieran la comprensión de las realidades de distintos sectores y regiones. En el 2011 se presentaron cuarenta y seis ponencias y se dictaron tres conferencias magistrales, y en el 2012 se expusieron cincuenta ponencias y se impartieron tres conferencias magistrales.UCR::Sedes Regionales::Sede de Occidente::Recinto San Ramón::Centro de Investigaciones sobre Diversidad Cultural y Estudios Regionales (CIDICER