¿El héroe es realmente culpable? aproximación a la antropología fundamental de René Girard

Este trabajo interpreta y analiza la teoría mimética de René Girard, sus matices, conceptos y alcances de cara a lo que el pensador francés pretende desarrollar como una antropología fundamental. El mencionado análisis se lleva a cabo a partir de tres momentos, que considero principales en el pensamiento y obra de R. Girard. En el primero de ellos, relacionado con el concepto de deseo mimético, se plantea el problema de los conflictos y las rivalidades interpersonales como consecuencia de la mímesis más exacerbada, así como el papel del otro en la constitución y desarrollo de la subjetividad. En el segundo, teniendo como marco el concepto de chivo expiatorio, se analiza el salto de la violencia mimética de las relaciones interindividuales a las relaciones sociales, donde se potencian nociones tales como: crisis mimética, sacrificio, víctima propiciatoria, rito y mito. Finalmente, en el tercero, se sigue con aquello que, según el propio Girard, el Evangelio y la figura de Cristo aportan a un saber antropológico y filosófico de interés planetario, a partir de lo cual se abre la tremenda posibilidad de sustraernos a nuestra propia violencia, desenmascarando aquello que se encuentra oculto desde la fundación del mundo.This project interprets and analyzes René Girard's Mimetic Theory, its nuances, concepts and reaching in terms of what the French thinker aims to develop as a fundamental anthropology. The aforementioned analysis is carried out in three moments which I consider essential in R. Girard s thinking and work. First, the one related to the concept of mimetic desire, when the problem about conflicts and interpersonal rivalries is set out as a consequence of the most exacerbated mimesis, as well as the other s role in the subjectivity constitution and development. Second, in the light of the concept of scapegoating, there is an examination of the jump from the mimetic violence of interindividual relationship to the social relationships, where notions as these of mimetic crisis, sacrifice, arbitrary victim, rituals and myths are promoted. Finally, it is developed that what Girard s himself sees as The Gospel and Christ contribution to an anthropological and philosophical knowledge of planetary interest, from which the huge opportunity to shrink ourselves to our own violence is exposed, revealing what is hidden since the foundation of the world.Filósofo (a)Pregrad

La medicina rural, un imperativo en los países en vías de desarrollo

La medicina rural es una etapa de servicio a la comunidad, de carácter obligatorio para todos los egresados de la formación médica de pregrado. Su puesta en práctica es un elemento esencial para el desarrollo social y económico en las comunidades. En Ecuador, los graduados de la carrera de Medicina, al no ser formados bajo el modelo de atención integral de salud y la filosofía de la atención primaria de salud se enfrentan durante la ruralidad a algunos inconvenientes laborales y profesionales. Este trabajo se orienta a reflexionar sobre la situación actual de la medicina rural en los países en vías de desarrollo. Se presentan algunas alternativas de mejora que pueden implementarse en los países para lograr la formación rural de un profesional comprometido con la atención primaria de salud. &nbsp

Modelo para la Autoevaluación de la Condición Financiera de las MIPYMES del sector de Tecnologías de Información en Costa Rica

Proyecto de graduación (Licenciatura en Administración de Empresas. Enfasis en Finanzas) Instituto Tecnológico de Costa Rica, Escuela de Administración de Empresas, 2015Las MIPYMES del sector de tecnologías de información han ido creciendo notoriamente en Costa Rica constituyendo una fuente importante de empleo, actualmente hay carencia de modelos financieros para este tipo de empresas, por esta razón se desarrolla un modelo de autoevaluación financiera para que los propietarios sean capaces de evaluar su negocio y asi facilitar la toma de decisiones

Dermatoglyphic profile and somatotype of university athletes

El presente estudio caracterizó el perfil dermatoglífico y somatotipo de 12 atletas universitarios, pertenecientes a la selección de atletismo de la universidad Santo Tomás, sede Bogotá. Se identificaron las características dermatoglíficas, acorde al protocolo de Cummins & Midlo (1942) para obtener los tipos de diseños de las impresiones digitales (A= 0,3; ± 0,7; L= 6,9 ± 2,6 y W= 2,8 ± 2,9) y a su vez la suma de la cantidad total de líneas ( SCTL= 170,6 ± 95,1) y por último, el índice delta (D10= 12,4 ± 3,3). Para el somatotipo, se tuvo en cuenta el protocolo de Heath & Carter (1990). Endomorfia en (2,5 ± 0,9); Mesomorfia (5,3 ± 0,9) y Ectomorfia (3,1 ± 1). El perfil dermatoglífico de cada uno de los deportistas, evidenció la presencia del somatotipo ectomorfo sobre los otros. Esto determinó la importancia de esta técnica como herramienta genética en la optimización de estrategias y orientaciones deportivas. La necesidad de seguir con estos procesos investigativos es fundamental para la academia, los procesos deportivos, los deportistas y al deporte Colombiano, universitario y profesional.This study characterized the dermatoglyphic profile and somatotype of 12 university athletes, belonging to the athletics team of the Santo Tomás University, Bogotá Campus. The dermatoglyphic characteristics were identified, according to the Cummins & Midlo (1942) protocol, to obtain the types of designs of digital impressions (A = 0.3; ± 0.7; L = 6.9 ± 2.6 and W = 2.8 ± 2.9) and, in turn, the sum of the total number of lines (SCTL = 170.6 ± 95.1), and finally, the delta index (D10 = 12.4 ± 3.3). For the somatotype, the Heath & Carter protocol (1990) was taken into account. Endomorphy in (2.5 ± 0.9); Mesomorphy (5.3 ± 0.9) and Ectomorphy (3.1 ± 1). The dermatoglyphic profile of each of the athletes evidenced the presence of the ectomorphic somatotype over the others. This determined the importance of this technique as a genetic tool in the optimization of sports strategies and orientations. The need to continue with these reseach processes are fundamental for the academy, sports processes, athletes, and Colombian university professional sport.Facultad de Humanidades y Ciencias de la Educació

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

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

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

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