Diseño y construcción del programa de inducción y entrenamiento para el personal administrativo de la Alcaldía municipal de Cimitarra, en el año 2021

El talento humano, en una empresa es el principal pilar y el más importante, teniendo en cuenta que al asegurarse el crecimiento personal y profesional de los colaboradores también se aseguran los logros y los objetivos de la empresa. La mejora en la calidad de vida de los trabajadores hace que el desempeño en sus funciones y tareas se dé una manera más competente y con más motivación, lo que conlleva a obtener unos resultados de sobrecumplimiento, generando también un ambiente laboral formidable y confiable para ambas partes. La investigación busca proponer soluciones a la Administración Municipal de Cimitarra, de manera que se opte por ejecutar el programa de inducción y entrenamiento para el personal, aprobando su persistencia organizacional. El objetivo de esta investigación es garantizar la estructura, diseño y puesta en marcha de un proceso de inducción y entrenamiento del personal administrativo optimo y eficiente en la Alcaldía Cimitarra Santander, que dé solución a una problemática presente en una entidad pública y que afecta el desempeño de los empleados administrativos de forma directa e indirecta. Se presentará en un estudio con enfoque mixto, compilando datos numéricos y específicos para estudiar e integrar la investigación de manera cuantitativa y cualitativa.Human talent in a company is the main and most important pillar, taking into account that by ensuring the personal and professional growth of employees, the achievements and objectives of the company are also ensured. The improvement in the quality of life of the workers makes the performance in their functions and tasks more competent and motivated, which leads to obtaining over-compliance results, also generating a formidable and reliable work environment for both parts. The investigation seeks to propose solutions to the Municipal Administration of Cimitarra, so that it chooses to execute the induction and training program for the personnel, approving their organizational persistence. The objective of this research is to guarantee the structure, design and implementation of a process of induction and training of optimal and efficient administrative staff in the Cimitarra Santander Mayor's Office, which provides a solution to a problem present in a public entity and that affects performance of administrative employees directly and indirectly. It will be presented in a study with a mixed approach, compiling numerical and specific data to study and integrate the research in a quantitative and qualitative way

A genetically modified Plasmodium berghei parasite as a surrogate for whole-sporozoite vaccination against P. vivax malaria

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Two malaria parasite species, Plasmodium falciparum (Pf) and P. vivax (Pv) are responsible for most of the disease burden caused by malaria. Vaccine development against this disease has focused mainly on Pf. Whole-sporozoite (WSp) vaccination, targeting pre-erythrocytic (PE) parasite stages, is a promising strategy for immunization against malaria and several PfWSp-based vaccine candidates are currently undergoing clinical evaluation. In contrast, no WSp candidates have been developed for Pv, mainly due to constraints in the production of Pv sporozoites in the laboratory. Recently, we developed a novel approach for WSp vaccination against Pf based on the use of transgenic rodent P. berghei (Pb) sporozoites expressing immunogens of this human-infective parasite. We showed that this platform can be used to deliver PE Pf antigens, eliciting both targeted humoral responses and cross-species cellular immune responses against Pf. Here we explored this WSp platform for the delivery of Pv antigens. As the Pv circumsporozoite protein (CSP) is a leading vaccine candidate antigen, we generated a transgenic Pb parasite, PbviVac, that, in addition to its endogenous PbCSP, expresses PvCSP under the control of a strictly PE promoter. Immunofluorescence microscopy analyses confirmed that both the PbCSP and the PvCSP antigens are expressed in PbviVac sporozoites and liver stages and that PbviVac sporozoite infectivity of hepatic cells is similar to that of its wild-type Pb counterpart. Immunization of mice with PbviVac sporozoites elicits the production of anti-PvCSP antibodies that efficiently recognize and bind to Pv sporozoites. Our results warrant further development and evaluation of PbviVac as a surrogate for WSp vaccination against Pv malaria.A.D. and J.C.S. were supported by the National Institute of Allergy and Infectious Diseases, National Institutes of Health (U19AI110820 and R01AI141900). A.M.M. acknowledges Fundação para a Ciência e Tecnologia, Portugal (FCT) for Grant PTDC-BBB-BMD-2695-2014. M.P. acknowledges the “la Caixa” Foundation for Grant HR21-848, the GSK OpenLab Foundation for grant TC269, and FCT for grant PTDC-SAU-INF-29550-2017. D.M. acknowledges FCT for grant SFRH/BD/144817/2019.info:eu-repo/semantics/publishedVersio

La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia: Ciudad de New York, Municipios de Fusagasugá, Granada y Arbeláez

En el presente trabajo, expondremos los recursos de afrontamiento psicosocial frente a los hechos traumáticos desde el enfoque narrativo del caso Historias que retornan - Capítulo 4 – Nelson y Masacre en El Salado: relatos de resiliencia después de 20 años. También, comprende la foto voz desde diferentes perspectivas y contextos. Frente al caso de Nelson, se realiza un análisis sobre los emergentes psicosociales identificados, su posición de víctima o sobreviviente, las experiencias subjetivas sobre el significado de violencia, sus recursos de afrontamiento y los elementos de resiliencia encontrados en el discurso; además, se formula una serie de preguntas orientadas a un acercamiento psicosocial y superación de la revictimización. En el caso de la masacre en el Salado, se evidencio los emergentes psicosociales identificados en el contexto cotidiano y sociohistórico de las víctimas, los impactos en el ámbito bio-psico-socio- cultural y los elementos simbólicos desde la violencia, la resiliencia y la transformación. Para este suceso, se plantean 3 estrategias encaminadas desde lo psicosocial, para potencializar los recursos de afrontamiento de la comunidad del Salado. Por último, se abarcan ejercicios de foto voz desde la imagen y la narrativa, realizados en la provincia del Sumapaz en la localidad 20 rural de Bogotá D.C y los municipios de Fusagasugá, Arbeláez y Granada, expresando por medio de un informe analítico y reflexivo entorno a la subjetividad, lo simbólico, la memoria colectiva y las manifestaciones resilientes observadas en la comunidad.In the present work, we will expose the psychosocial coping resources in the face of traumatic events from the narrative approach of the case Histories that return Chapter 4 - Nelson and Massacre in El Salado: stories of resilience after 20 years. It also understands the photovoice from different perspectives and contexts. Regarding the case of Nelson, an analysis is carried out on the identified psychosocial emergent, their position as victims or survivors, the subjective experiences on the meaning of violence, their coping resources and the elements of resilience found in the discourse; In addition, a series of questions aimed at a psychosocial approach and overcoming re-victimization are formulated. In the case of the massacre in El Salado, the psychosocial emergent found in the daily and socio-historical context of the victims were showed, the impacts in the bio-psycho-socio- cultural field and the symbolic elements from violence, resilience, and the transformation. For this event, 3 strategies directed from the psychosocial are proposed, with the purpose of potentiating the coping resources of the Salado community. Finally, photovoice exercises are covered from the image and the narrative, carried out in the province of Sumapaz in the rural locality 20 of Bogotá D.C and the municipalities of Fusagasugá, Arbeláez and Granada, expressing through an analytical and reflective report the environment to subjectivity, the symbolic, collective memory and resilient community manifestations

Factores no farmacológicos asociados al control de la diabetes mellitus tipo 2

Objetivo: determinar los factores asociados al control no farmacológico de los adultos con diabetes mellitus tipo 2 en la poblaciónamericana. Metodología: se realizó una revisión sistemática en diferentes bases de datos con palabras clave acerca de los factoresasociados al control de la diabetes mellitus tipo 2 bajo diferentes criterios de inclusión y exclusión, que posteriormente fueron revisados,para un total de 21 estudios analizados y categorizados; teniendo en cuenta para la discusión solo aquellas variables que permitieranestablecer asociaciones estadísticamente significativas. Se tomó como variable de referencia para el control glicémico la hemoglobina Aglicosilada. Resultados: los factores asociados con el control glicémico fueron la edad, sexo, raza, hemoglobina glicosilada base, idioma,duración de la enfermedad, dieta (ingesta de carbohidratos, lípidos y proteínas, así como costumbres de tabaquismo y alcoholismo),lípidos, peso, índice de masa corporal, perímetro abdominal, presión arterial sistólica, ejercicio (tipo aeróbico, de resistencia ó combinado;consumo de oxígeno en ml/kg/min; umbral ventilatorio frente a hemoglobina glicosilada), programas de educación (número y tipo grupaló personal), conocimiento de la enfermedad, visita al nutricionista, autocuidado, seguridad social, empleo, estados de ánimo depresivos,nivel socioeconómico y educativo y funcionalidad familiar, los cuales fueron estadísticamente significativos (p< 0,05); sin embargo, los quefueron mayormente asociados en varios de los artículos fueron la hemoglobina glicosilada de base, los programas de educación al pacientediabético y la edad. Discusión: las anteriores variables establecidas a nivel estadístico como factores de riesgo permiten clasificarlas comomodificables y no modificables, lo cual es fundamental para plantear y definir estrategias que permitan alcanzar el máximo control dela enfermedad, así como para amortiguar los efectos deletéreos de los procesos celulares de envejecimiento celular; evitando así lascomplicaciones microangiopáticas y neuromusculares típicas de esta endocrinopatía. (MÉD.UIS. 2012;25(1):29-43).Palabras clave: Dieta. Ejercicio. Educación. Obesidad. Diabetes. Hb A1c. Seguridad social. Autocuidado.  Nonpharmacological factors associated with diabetes mellitus type 2Objective: determine the factors associated with nonpharmacologic of adults with diabetes mellitus type 2 in the American population.Method: we conducted a systematic review in different databases with key words about the factors associated with diabetes mellitustype 2 under different inclusion and exclusion criteria, which were subsequently revised to a total of 21 studies analyzed and categorized ,allowing for discussion only those variables that establish statistically significant associations. Was taken as the reference variable glycemiccontrol glycosylated hemoglobin A. Results: factors associated with glycemic control were age, sex, race, glycosylated hemoglobin basis,language, duration of illness, diet (intake of carbohydrates, lipids and proteins as well as smoking and drinking habits), lipids, weight ,body mass index, waist circumference, systolic blood pressure, exercise (aerobic, resistance or combined, oxygen consumption in ml / kg/ min, ventilatory threshold versus glycosylated hemoglobin), education (number and type or group staff), knowledge of the disease, visitthe nutritionist, self care, social security, employment, depressive moods, socioeconomic and educational level and family functioning,which were statistically significant (p <0.05), but which were mostly associated in several of the articles were glycosylated hemoglobinbasic education programs for diabetic patients and age. Discussion: above variables statistically established risk factors allow classified asmodifiable and non modifiable, which is essential to raise and define strategies to achieve maximum control of the disease and to mitigatethe deleterious effects of the processes aging cell phone, thus avoiding complications and neuromuscular microangiopathic typical of thisendocrinopathy. (MÉD.UIS. 2012, 25 (1): 29-43).Keywords: Diet. Exercise. Education. Obesity. Diabetes. Hb A1c. Social security. Self Care. &nbsp

Genetic diversity of HLA system in four populations from Baja California, Mexico: Mexicali, La Paz, Tijuana and rural Baja California

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 250 Mexicans from the states of Baja California Norte and Baja California Sur living in Mexicali (N = 100), La Paz (N = 75), Tijuana (N = 25) and rural communities (N = 50) to obtain information regarding allelic and haplotypic frequencies. The most frequent haplotypes for the Baja California region include nine Native American and five European haplotypes. Admixture estimates revealed that the main genetic components are European (50.45 ± 1.84% by ML; 42.03% of European haplotypes) and Native American (43.72 ± 2.36% by ML; 40.24% of Native American haplotypes), while the African genetic component was less apparent (5.83 ± 0.98% by ML; 9.36% of African haplotypes)

First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR)

Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an 'overarching' treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.Fil: Pons Estel, Bernardo A.. Centro Regional de Enfermedades Autoinmunes y Reumáticas; ArgentinaFil: Bonfa, Eloisa. Universidade de Sao Paulo; BrasilFil: Soriano, Enrique R.. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Cardiel, Mario H.. Centro de Investigación Clínica de Morelia; MéxicoFil: Izcovich, Ariel. Hospital Alemán; ArgentinaFil: Popoff, Federico. Hospital Aleman; ArgentinaFil: Criniti, Juan M.. Hospital Alemán; ArgentinaFil: Vásquez, Gloria. Universidad de Antioquia; ColombiaFil: Massardo, Loreto. Universidad San Sebastián; ChileFil: Duarte, Margarita. Hospital de Clínicas; ParaguayFil: Barile Fabris, Leonor A.. Hospital Angeles del Pedregal; MéxicoFil: García, Mercedes A.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Amigo, Mary Carmen. Centro Médico Abc; MéxicoFil: Espada, Graciela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Catoggio, Luis J.. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Sato, Emilia Inoue. Universidade Federal de Sao Paulo; BrasilFil: Levy, Roger A.. Universidade do Estado de Rio do Janeiro; BrasilFil: Acevedo Vásquez, Eduardo M.. Universidad Nacional Mayor de San Marcos; PerúFil: Chacón Díaz, Rosa. Policlínica Méndez Gimón; VenezuelaFil: Galarza Maldonado, Claudio M.. Corporación Médica Monte Sinaí; EcuadorFil: Iglesias Gamarra, Antonio J.. Universidad Nacional de Colombia; ColombiaFil: Molina, José Fernando. Centro Integral de Reumatología; ColombiaFil: Neira, Oscar. Universidad de Chile; ChileFil: Silva, Clóvis A.. Universidade de Sao Paulo; BrasilFil: Vargas Peña, Andrea. Hospital Pasteur Montevideo; UruguayFil: Gómez Puerta, José A.. Hospital Clinic Barcelona; EspañaFil: Scolnik, Marina. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Pons Estel, Guillermo J.. Centro Regional de Enfermedades Autoinmunes y Reumáticas; Argentina. Hospital Provincial de Rosario; ArgentinaFil: Ugolini Lopes, Michelle R.. Universidade de Sao Paulo; BrasilFil: Savio, Verónica. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Drenkard, Cristina. University of Emory; Estados UnidosFil: Alvarellos, Alejandro J.. Hospital Privado Universitario de Córdoba; ArgentinaFil: Ugarte Gil, Manuel F.. Universidad Cientifica del Sur; Perú. Hospital Nacional Guillermo Almenara Irigoyen; PerúFil: Babini, Alejandra. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Cavalcanti, André. Universidade Federal de Pernambuco; BrasilFil: Cardoso Linhares, Fernanda Athayde. Hospital Pasteur Montevideo; UruguayFil: Haye Salinas, Maria Jezabel. Hospital Privado Universitario de Córdoba; ArgentinaFil: Fuentes Silva, Yurilis J.. Universidad de Oriente - Núcleo Bolívar; VenezuelaFil: Montandon De Oliveira E Silva, Ana Carolina. Universidade Federal de Goiás; BrasilFil: Eraso Garnica, Ruth M.. Universidad de Antioquia; ColombiaFil: Herrera Uribe, Sebastián. Hospital General de Medellin Luz Castro de Gutiérrez; ColombiaFil: Gómez Martín, DIana. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Robaina Sevrini, Ricardo. Universidad de la República; UruguayFil: Quintana, Rosana M.. Hospital Provincial de Rosario; Argentina. Centro Regional de Enfermedades Autoinmunes y Reumáticas; ArgentinaFil: Gordon, Sergio. Hospital Interzonal General de Agudos Dr Oscar Alende. Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas; ArgentinaFil: Fragoso Loyo, Hilda. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Rosario, Violeta. Hospital Docente Padre Billini; República DominicanaFil: Saurit, Verónica. Hospital Privado Universitario de Córdoba; ArgentinaFil: Appenzeller, Simone. Universidade Estadual de Campinas; BrasilFil: Dos Reis Neto, Edgard Torres. Universidade Federal de Sao Paulo; BrasilFil: Cieza, Jorge. Hospital Nacional Edgardo Rebagliati Martins; PerúFil: González Naranjo, Luis A.. Universidad de Antioquia; ColombiaFil: González Bello, Yelitza C.. Ceibac; MéxicoFil: Collado, María Victoria. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Sarano, Judith. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Retamozo, Maria Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Sattler, María E.. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Gamboa Cárdenas, Rocio V.. Hospital Nacional Guillermo Almenara Irigoyen; PerúFil: Cairoli, Ernesto. Universidad de la República; UruguayFil: Conti, Silvana M.. Hospital Provincial de Rosario; ArgentinaFil: Amezcua Guerra, Luis M.. Instituto Nacional de Cardiologia Ignacio Chavez; MéxicoFil: Silveira, Luis H.. Instituto Nacional de Cardiologia Ignacio Chavez; MéxicoFil: Borba, Eduardo F.. Universidade de Sao Paulo; BrasilFil: Pera, Mariana A.. Hospital Interzonal General de Agudos General San Martín; ArgentinaFil: Alba Moreyra, Paula B.. Universidad Nacional de Córdoba. Facultad de Medicina; ArgentinaFil: Arturi, Valeria. Hospital Interzonal General de Agudos General San Martín; ArgentinaFil: Berbotto, Guillermo A.. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Gerling, Cristian. Hospital Interzonal General de Agudos Dr Oscar Alende. Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas; ArgentinaFil: Gobbi, Carla Andrea. Universidad Nacional de Córdoba. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gervasoni, Viviana L.. Hospital Provincial de Rosario; ArgentinaFil: Scherbarth, Hugo R.. Hospital Interzonal General de Agudos Dr Oscar Alende. Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas; ArgentinaFil: Brenol, João C. Tavares. Hospital de Clinicas de Porto Alegre; BrasilFil: Cavalcanti, Fernando. Universidade Federal de Pernambuco; BrasilFil: Costallat, Lilian T. Lavras. Universidade Estadual de Campinas; BrasilFil: Da Silva, Nilzio A.. Universidade Federal de Goiás; BrasilFil: Monticielo, Odirlei A.. Hospital de Clinicas de Porto Alegre; BrasilFil: Seguro, Luciana Parente Costa. Universidade de Sao Paulo; BrasilFil: Xavier, Ricardo M.. Hospital de Clinicas de Porto Alegre; BrasilFil: Llanos, Carolina. Universidad Católica de Chile; ChileFil: Montúfar Guardado, Rubén A.. Instituto Salvadoreño de la Seguridad Social; El SalvadorFil: Garcia De La Torre, Ignacio. Hospital General de Occidente; MéxicoFil: Pineda, Carlos. Instituto Nacional de Rehabilitación; MéxicoFil: Portela Hernández, Margarita. Umae Hospital de Especialidades Centro Medico Nacional Siglo Xxi; MéxicoFil: Danza, Alvaro. Hospital Pasteur Montevideo; UruguayFil: Guibert Toledano, Marlene. Medical-surgical Research Center; CubaFil: Reyes, Gil Llerena. Medical-surgical Research Center; CubaFil: Acosta Colman, Maria Isabel. Hospital de Clínicas; ParaguayFil: Aquino, Alicia M.. Hospital de Clínicas; ParaguayFil: Mora Trujillo, Claudia S.. Hospital Nacional Edgardo Rebagliati Martins; PerúFil: Muñoz Louis, Roberto. Hospital Docente Padre Billini; República DominicanaFil: García Valladares, Ignacio. Centro de Estudios de Investigación Básica y Clínica; MéxicoFil: Orozco, María Celeste. Instituto de Rehabilitación Psicofísica; ArgentinaFil: Burgos, Paula I.. Pontificia Universidad Católica de Chile; ChileFil: Betancur, Graciela V.. Instituto de Rehabilitación Psicofísica; ArgentinaFil: Alarcón, Graciela S.. Universidad Peruana Cayetano Heredia; Perú. University of Alabama at Birmingahm; Estados Unido

Recommendations for treatment with recombinant human growth hormone in pediatric patients in Colombia

En Colombia, actualmente no existen parámetros claros para el diagnóstico de pacientes con talla baja, ni sobre el tratamiento de esta población con hormona de crecimiento recombinante humana (somatropina), lo cual se ve favorecido por la diversidad de programas de formación de profesionales en endocrinología pediátrica. En respuesta a esta problemática se realizó el primer acuerdo colombiano de expertos en talla baja liderado por la Asociación Colegio Colombiana de Endocrinología Pediátrica (ACCEP); este trabajo contó con la participación y el aval de expertos clínicos de importantes instituciones de salud públicas y privadas del país, además de expertos metodológicos del instituto Keralty, quienes garantizaron la estandarización del uso de la somatropina. Después de realizar una minuciosa revisión de la literatura, se propone la unificación de definiciones, un algoritmo diagnóstico, los parámetros de referencia de las pruebas bioquímicas y dinámicas, una descripción de las consideraciones de uso de la somatropina para el tratamiento de las patologías con aprobación por la entidad regulatoria de medicamentos y alimentos en Colombia y, por último, un formato de consentimiento informado y de ficha técnica del medicamento.In Colombia there are no guidelines for diagnosis and management of patients with short stature and for the use of recombinanthuman growth hormone, mainly caused by the diversity of training centers in pediatric endocrinology. In response to this situation,the Asociación Colegio Colombiana de Endocrinología Pediátrica leds the first colombian short stature expert committee in order tostandardize the use of human recombinant growth hormone. This work had the participation and endorsement of a consortium ofclinical experts representing the Sociedad Colombiana de Pediatría, Secretaría Distrital de Salud de Bogotá- Subred Integrada deServicios de Salud Suroccidente, Fundación Universitaria Sanitas, Universidad de los Andes and some public and private healthinstitutions in the country, in addition to the participation of methodological experts from the Instituto Global de Excelencia ClínicaKeralty. By reviewing the literature and with the best available evidence, we proposed to unify definitions, a diagnostic algorithm,biochemical and dynamic tests with their reference parameters, a description of the considerations about growth hormone use amongthe indications approved by regulatory agency for medications and food in Colombia and finally a proposal for an informed consentand a medication fact sheet available for parents and patients.https://orcid.org/0000-0002-7856-7213https://orcid.org/0000-0003-2241-7854Revista Nacional - Indexad

Drug-induced anaphylaxis, elicitors, risk factors, and management in Latin America

Nonsteroidal anti-inflammatory drugs were the most frequent triggers of drug-induced anaphylaxis in Latín America, whereas antibiotics elicited faster onset and more scvere reactions. An improvement was observed in epinephrinc use and adherence to guidelines in the emergency department treatment of anaphylaxis in Latín America compared with our last report.Facultad de Ciencias Médica

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

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality