Síndrome Febril Desconocido, Alta Probabilidad de Brucelosis, Reporte de Caso

La brucelosis, causada por la bacteria gram negativa Brucella spp, es una de las grandes imitadoras en el mundo de las enfermedades infecciosas, puede simular diversas enfermedades multisistémicas, exhibir un amplio polimorfismo clínico que frecuentemente lleva a la pérdida de diagnósticos y falla en el tratamiento, aumentando la tasa de complicaciones asociadas a la misma (1). Se considera la más común enfermedad zoonótica de distribución mundial, con más de 500 000 nuevos casos notificados anualmente, con una prevalencia mayor a 1/100000 habitantes en zonas endémicas como el Mediterráneo, la península Arábiga, India, México, Centro y Sur América, en los que la infección es adquirida principalmente a través del contacto directo con animales infectados (1,2).  El reporte de caso muestra un paciente masculino con diagnóstico final de síndrome febril con alta probabilidad de brucelosis, con diagnósticos relacionado de pielonefritis derecha, orquiepididimitis izquierda, epididimitis derecha. Por medio de IgM, IgG y Antígenos febriles se diagnostica Brucella spp, por lo cual se indica manejo antibiótico con Doxiciclina con resolución total del cuadro. Sobresale la importancia de realizar una historia clínica completa en el ingreso del paciente, con énfasis en antecedentes labores

Herramienta interactiva para el adecuado trazado y ubicación de los puntos cefalométricos en la radiografía posteroanterior (PA)

Introduction: this is a research paper from the “Pedagogical research processes and technology applied to teaching and learning” of the “Odontoposgrados” research group of the Universidad Cooperativa de Colombia at Bogotá. During the learning process on dentofacial deformities, it has been identified some mistakes in cephalometric landmark localization on the posteroanterior X Rays images. For that reason, it was designed a tool to reinforce this learning and to make the localization of the points easier for the students. Objective: to design and develop an interactive tool to help students of orthopedics functional and orthodontics acquire skills to make the correct tracing and cephalometric landmark localization in the posteroanterior X Rays. Materials and methods: a literature review was carried out before doing the design of the cd. Following this, it was organized in three thematic units: recommendations, anatomic tracings, and cephalometric landmarks localization. The tool was developed as a Multimedia Platform: Flash, Language: Actionscript 2.0 Version web: Platform: Html5, swf. Programming: javascript. Styles: css. Results: an interactive tool for the appropriate tracing and cephalometric landmarks localization in the posteroanterior radiography was done. Conclusion: this cd serves as a support for improving diagnosis and treatment planning of pacients with dentofacial deformities.Introducción: artículo de investigación derivado del proyecto de investigación “Procesos de investigación pedagógica y tecnología aplicada a la enseñanza y aprendizaje”, del grupo de investigación “Odontoposgrados” de la Universidad Cooperativa de Colombia, sede Bogotá. Durante el proceso enseñanza-aprendizaje de anomalías dentofaciales (adf) se han identificado fallas en la localización de los puntos cefalométricos en la radiografía posteroanterior, por lo cual se diseñó una herramienta para reforzar y facilitar el trazado y la ubicación de dichos puntos. Objetivo: diseñar y desarrollar una herramienta interactiva que facilite a los estudiantes de ortopedia funcional y ortodoncia la adecuada ubicación de los puntos cefalométricos en la radiografía posteroanterior. Materiales y métodos: para la ejecución del cd-rom se realizó una revisión bibliográfica previa al diseño, y posteriormente se organizaron tres unidades temáticas: recomendaciones del análisis radiográfico, trazado y ubicación de los puntos. El software requirió del uso de los programas Multimedia: Plataforma: Flash, Lenguaje: Actionscript 2.0 Versión web: Plataforma: Html5, swf. Programación: javascript. Estilos: css. Resultados: se diseñó un software interactivo para facilitar el adecuado trazado y ubicación de los puntos cefalométricos en la radiografía posteroanterior. Conclusión: este cd-rom sirve como apoyo para el mejoramiento del diagnóstico y plan de tratamiento en pacientes con anomalías dentomaxilofaciales

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia, Departamentos de Tolima y Caquetá

En el presente documento, se abordan diferentes temáticas teniendo en cuenta la importancia del enfoque narrativo y el camino reflexivo que este ha logrado ampliar desde los diferentes contextos significantes en los procesos terapéuticos o con carácter psicosocial en los escenariosde violencia que se presentan en los sistemas. Tomando como referencia las diferentes técnicas de acción, se puede hablar de lafoto voz o (Photovoice), la cual permite ahondar en una situación problémica desde la exposiciónde diferentes imágenes que pueden generar significados a través del poder metafórico y generarcambios notorios en comunidades completas. Es imprescindible para los profesionales en psicología, el aprender a intervenir enlas diversas situaciones de violencia y los relatos de las victimas con los diferentes métodos de creación de preguntas y estrategias que aporten a la vida de las personas de manera significativa;Es por esto que se trabajara en base a casos de importancia encuadrados en problemáticas de violencia y desplazamientos forzados a causa del conflicto armado y la fuerza pública y grupos al margen de la ley como el Caso Peñas Coloradas, con los cuales se pretende adquirir diferentes fortalezas en la apropiación de conocimientos nuevos. Las diferentes teorías psicológicas como la de White, M (1998) y otros autores dan al presente trabajo académico una contextualización argumentada y con carácter científico elcual hace una invitación a seguir investigando y reflexionar acerca de lo que el conflicto le ocasiona a todo un país.In this document, different topics are addressed, taking into account the importance of the narrative approach and the reflective path that it has managed to expand from the different significant multi-contexts in therapeutic processes or with a psychosocial nature in the scenarios of violence that occur in the systems. Taking the different action techniques as a reference, we can talk about the photo you or (Photovoice), which allows delving into a problematic situation from the exposure of different images that can generate meanings through metaphorical power and generate notorious changes in communities. complete. It is essential for professionals in psychology to learn to intervene in various situations of violence and the stories of the victims with the different methods of creating questions and strategies that contribute to the lives of people in a significant way. will work based on important cases framed in problems of violence and forced displacements due to the public force and groups outside the law SUCH AS THE CASE OF PEÑAS COLORADAS, with which it is intended to acquire different strengths in the appropriation of new knowledge. The different psychological theories such as White, M (1998) and other authors give this academic work an argued and scientific contextualization which invites us to continue investigating and reflecting on what the conflict causes to an entire country

Modelos de financiación para acceder a la educación superior en Colombia: diagnóstico y recomendaciones

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De la impotencia al poder-no. Tópicos de la resistencia en la cultura iberoamericana

La pujante presencia de Iberoamérica en el ámbito geopolítico, así como en la literatura y las artes a nivel global, es indiscutible en nuestros días. A partir de ello, cobra vigencia analizar ciertos tópicos culturales de la demarcación. El marco teórico posestructuralista añade grandes posibilidades reflexivas al escrutinio investigativo. Gilles Deleuze y Félix Guattari, junto con Giorgio Agamben son los principales pensadores que introducen los ejes paradigmáticos de los estudios aquí reunidos, los cuales son producto de la colaboración internacional entre académicos de la Universidad Autónoma del Estado de México y la Universidad Pontificia Bolivariana de Medellín, Colombia, a través de la Red de investigación “Crítica a las manifestaciones del poder: violencia y resistencia”.Universidad Autónoma del Estado de Méxic

Medios de comunicación y derecho a la información en Jalisco 2013

En el primer apartado, dedicado al sistema de medios en general, se presentan tres artículos: “Nuevos medios de comunicación en Jalisco”, “c7 ¿medio público o vocero del gobierno?” y “Réquiem por un ombudsman”. El segundo apartado está dedicado al tema de la libertad de expresión; se presentan aquí dos textos: “La vulnerabilidad en un ambiente de cambio. Los ataques a los medios de comunicación en Jalisco durante el año” y “Violaciones a la libertad de expresión de periodistas y trabajadores de medios en Jalisco, 1995-2013”. En el apartado “Derecho a la información, comunicación y política” se ofrecen cuatro textos de índole muy diversa: “La estrategia de comunicación del Gobierno del Estado”, “Diálogos públicos: la discusión de una nueva ley de transparencia para Jalisco”, “Cuando un niño desaparece, el peor enemigo es el tiempo…”, sobre la alerta Amber, y “2013: un año marcado por despidos en diversos periódicos de Guadalajara”. En la sección “Los que se fueron” se presenta la semblanza de Felipe Vicencio. Y en el apartado de “La investigación del observatorio de medios” se comparten los resultados de un trabajo sobre los columnistas de opinión jaliscienses que escriben en la prensa local.ITESO, A.C

Ultra-processed foods consumption as a promoting factor of greenhouse gas emissions, water, energy, and land use: A longitudinal assessment

Background: Dietary patterns can produce an environmental impact. Changes in people's diet, such as the increased consumption of ultra-processed food (UPF) can not only influence human health but also environment sustainability. Objectives: Assessment of the impact of 2-year changes in UPF consumption on greenhouse gas emissions and water, energy and land use. Design: A 2-year longitudinal study after a dietary intervention including 5879 participants from a Southern European population between the ages of 55-75 years with metabolic syndrome. Methods: Food intake was assessed using a validated 143-item food frequency questionnaire, which allowed classifying foods according to the NOVA system. In addition, sociodemographic data, Mediterranean diet adherence, and physical activity were obtained from validated questionnaires. Greenhouse gas emissions, water, energy and land use were calculated by means of the Agribalyse® 3.0.1 database of environmental impact indicators for food items. Changes in UPF consumption during a 2-year period were analyzed. Statistical analyses were conducted using computed General Linear Models. Results: Participants with major reductions in their UPF consumption reduced their impact by -0.6 kg of CO2eq and -5.3 MJ of energy. Water use was the only factor that increased as the percentage of UPF was reduced. Conclusions: Low consumption of ultra-processed foods may contribute to environmental sustainability. The processing level of the consumed food should be considered not only for nutritional advice on health but also for environmental protection

Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

[EN] Background. The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ). Methods. Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed. Results. Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15. Conclusion. Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistanceS

Effect of a nutritional intervention based on an energy-reduced Mediterranean diet on environmental impact

[EN]To estimate the environmental impact of a dietary intervention based on an energy-reduced Mediterranean diet (MedDiet) after one year of follow-up. Methods Baseline and 1-year follow-up data were used for 5800 participants aged 55–75 years with metabolic syndrome in the PREDIMED-Plus study. Food intake was estimated through a validated semiquantitative food consumption frequency questionnaire, and adherence to the MedDiet was estimated through the Diet Score. Using the EAT-Lancet Commission tables we assessed the influence of dietary intake on environmental impact (through five indicators: greenhouse gas emissions (GHG), land use, energy used, acidification and potential eutrophication). Using multivariable linear regression models, the association between the intervention and changes in each of the environmental factors was assessed. Mediation analyses were carried out to estimate to what extent changes in each of 2 components of the intervention, namely adherence to the MedDiet and caloric reduction, were responsible for the observed reductions in environmental impact. Results We observed a significant reduction in the intervention group compared to the control group in acidification levels (−13.3 vs. -9.9 g SO2-eq), eutrophication (−5.4 vs. -4.0 g PO4-eq) and land use (−2.7 vs. -1.8 m2). Adherence to the MedDiet partially mediated the association between intervention and reduction of acidification by 15 %, eutrophication by 10 % and land use by 10 %. Caloric reduction partially mediated the association with the same factors by 55 %, 51 % and 38 % respectively. In addition, adherence to the MedDiet fully mediated the association between intervention and reduction in GHG emissions by 56 % and energy use by 53 %.SIPublicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL