Código Cáncer: resultados preliminares

Antecedentes: Los retrasos en la atención de personas con cáncer impactan negativamente su calidad de vida y aumentan los costos al sistema de salud. / Objetivo: Describir las fases del proyecto Código Cáncer y sus resultados preliminares. / Métodos: Se organizaron siete grupos de investigación para: a) entender las causas de los retrasos que enfrentan las personas con cáncer en México, sus trayectorias y costos asociados; b) conocer los mecanismos de referencia formales e informales que constituyen su trayectoria en el sistema de salud, y c) entender la infraestructura existente y la necesaria para responder a las necesidades epidemiológicas del país. / Resultados: Estos resultados sientan las bases para la implementación de un programa de referencia rápida de pacientes. / Conclusión: Las políticas de diagnóstico y tratamiento oportuno del cáncer basadas en la evidencia son imprescindibles para atender los retrasos en la atención. Código Cáncer representa un proyecto innovador para lograr este objetivo en México

Eco-epidemiological analysis of rickettsial seropositivity in rural areas of Colombia: A multilevel approach

ABSTARCT: Rickettsiosis is a re-emergent infectious disease without epidemiological surveillance in Colombia. This disease is generally undiagnosed and several deadly outbreaks have been reported in the country in the last decade. The aim of this study is to analyze the eco-epidemiological aspects of rickettsial seropositivity in rural areas of Colombia where outbreaks of the disease were previously reported. A cross-sectional study, which included 597 people living in 246 households from nine hamlets in two municipalities of Colombia, was conducted from November 2015 to January 2016. The survey was conducted to collect sociodemographic and household characteristics (exposure) data. Blood samples were collected to determine the rickettsial seropositivity in humans, horses and dogs (IFA, cut-off = 1/128). In addition, infections by rickettsiae were detected in ticks from humans and animals by real-time PCR targeting gltA and ompA genes. Data was analyzed by weighted multilevel clog-log regression model using three levels (person, household and hamlets) and rickettsial seropositivity in humans was the main outcome. Overall prevalence of rickettsial seropositivity in humans was 25.62% (95%CI 22.11-29.12). Age in years (PR = 1.01 95%CI 1.01-1.02) and male sex (PR = 1.65 95%CI 1.43-1.90) were risk markers for rickettsial seropositivity. Working outdoors (PR = 1.20 95%CI 1.02-1.41), deforestation and forest fragmentation for agriculture use (PR = 1.75 95%CI 1.51-2.02), opossum in peridomiciliary area (PR = 1.56 95%CI 1.37-1.79) and a high proportion of seropositive domestic animals in the home (PR20-40% vs 40% vs <20% = 3.14 95%CI 2.43-4.04) were associated with rickettsial seropositivity in humans. This study showed the presence of Rickettsia antibodies in human populations and domestic animals. In addition, different species of rickettsiae were detected in ticks collected from humans and animals. Our results highlighted the role of domestic animals as sentinels of rickettsial infection to identify areas at risk of transmission, and the importance of preventive measures aimed at curtailing deforestation and the fragmentation of forests as a way of reducing the risk of transmission of emergent and re-emergent pathogens

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

The European Solar Telescope

The European Solar Telescope (EST) is a project aimed at studying the magnetic connectivity of the solar atmosphere, from the deep photosphere to the upper chromosphere. Its design combines the knowledge and expertise gathered by the European solar physics community during the construction and operation of state-of-the-art solar telescopes operating in visible and near-infrared wavelengths: the Swedish 1m Solar Telescope, the German Vacuum Tower Telescope and GREGOR, the French Télescope Héliographique pour l'Étude du Magnétisme et des Instabilités Solaires, and the Dutch Open Telescope. With its 4.2 m primary mirror and an open configuration, EST will become the most powerful European ground-based facility to study the Sun in the coming decades in the visible and near-infrared bands. EST uses the most innovative technological advances: the first adaptive secondary mirror ever used in a solar telescope, a complex multi-conjugate adaptive optics with deformable mirrors that form part of the optical design in a natural way, a polarimetrically compensated telescope design that eliminates the complex temporal variation and wavelength dependence of the telescope Mueller matrix, and an instrument suite containing several (etalon-based) tunable imaging spectropolarimeters and several integral field unit spectropolarimeters. This publication summarises some fundamental science questions that can be addressed with the telescope, together with a complete description of its major subsystems

The European Solar Telescope

The European Solar Telescope (EST) is a project aimed at studying the magnetic connectivity of the solar atmosphere, from the deep photosphere to the upper chromosphere. Its design combines the knowledge and expertise gathered by the European solar physics community during the construction and operation of state-of-the-art solar telescopes operating in visible and near-infrared wavelengths: the Swedish 1m Solar Telescope, the German Vacuum Tower Telescope and GREGOR, the French Télescope Héliographique pour l’Étude du Magnétisme et des Instabilités Solaires, and the Dutch Open Telescope. With its 4.2 m primary mirror and an open configuration, EST will become the most powerful European ground-based facility to study the Sun in the coming decades in the visible and near-infrared bands. EST uses the most innovative technological advances: the first adaptive secondary mirror ever used in a solar telescope, a complex multi-conjugate adaptive optics with deformable mirrors that form part of the optical design in a natural way, a polarimetrically compensated telescope design that eliminates the complex temporal variation and wavelength dependence of the telescope Mueller matrix, and an instrument suite containing several (etalon-based) tunable imaging spectropolarimeters and several integral field unit spectropolarimeters. This publication summarises some fundamental science questions that can be addressed with the telescope, together with a complete description of its major subsystems

EDUCACIÓN AMBIENTAL Y SOCIEDAD. SABERES LOCALES PARA EL DESARROLLO Y LA SUSTENTABILIDAD

Este texto contribuye al análisis científico de varias áreas del conocimiento como la filosofía social, la patología, la educación para el cuidado del medio ambiente y la sustentabilidad que inciden en diversas unidades de aprendizaje de la Licenciatura en Educación para la Salud y de la Maestría en Sociología de la SaludLas comunidades indígenas de la sierra norte de Oaxaca México, habitan un territorio extenso de biodiversidad. Sin que sea una área protegida y sustentable, la propia naturaleza de la región ofrece a sus visitantes la riqueza de la vegetación caracterizada por sus especies endémicas que componen un paisaje de suma belleza

Global urban environmental change drives adaptation in white clover

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Efectos de la leptina en el inicio de la pubertad en animales machos Efeitos da leptina no inicio da puberdade em animais machos Effects of the leptin in the onset of puberty in animal males

La leptina es una hormona de 16 KDa producida principalmente por el tejido adiposo, codificada por el gen ob y compuesta por 146 aminoácidos. Cumple sus funciones en la periferia del organismo en el eje hipotálamo - hipófisis - gónadas. En varias especies se ha estudiado el efecto de esta hormona en la reproducción; los cambios en su concentración y en su expresión podrían estar asociados con el inicio de la pubertad en diferentes especies animales y en los humanos. El rol de la leptina en la reproducción del macho ha sido estudiado especialmente en ratas y ratones, pero también se han realizado investigaciones en humanos y otras especies animales. En las células de Leydig, en los túbulos seminíferos, las espermatogonias y los espermatozoides, entre otros tipos de células, hay expresión de los receptores y el RNAm de receptores de leptina, lo que indica que puede haber una función importante de la leptina en los testículos. En general, se ha hallado un efecto inhibitorio de la testosterona con la secreción de leptina y viceversa, lo cual indica que la leptina puede regular la esteroidogénesis en el testículo. La leptina también puede actuar en células no diferenciadas del testículo para permitir su diferenciación en espermatocitos y puede asistir a la célula a través de toda su diferenciación y maduración hacia espermátides. A través de todos estos resultados obtenidos, se observa a la leptina como una importante hormona que puede estar involucrada en funciones vitales del eje neuroendocrino y reproductivo del macho.<br>A leptina é um hormônio de 16 KDa produzida principalmente pelo tecido adiposo, codificada pelo gene ob e composta por 146 aminoácidos. Cumpre suas funções na periferia do organismo no eixo hipotálamo - hipófise - gônadas. Em varias espécies tem-se estudado o efeito deste hormônio na reprodução; as mudanças na concentração e em sua expressão poderiam estar associadas com o inicio da puberdade em diferentes espécies animais e em humanos. O papel da leptina na reprodução em machos tem sido estudado especialmente em ratas e ratos, porém também tem sido realizadas pesquisas em humanos e outras espécies animais. Nas células de Leydig, nos túbulos seminíferos, as espermatogônias e os espermatozóides, entre outros tipos de células, existe expressão dos receptores e o RNAm de receptores de leptina, o que indica que pode existir uma função importante da leptina nos testículos. Em geral, tem sido encontrado um efeito inibitório da testosterona com a secreção da leptina e vice versa, o qual indica que a leptina pode regular a esteroidogénese no testículo. A leptina também pode atuar nas células não diferenciadas do testículo para permitir sua diferenciação em espermatócitos e pode ajudar à célula a través de toda sua diferenciação e maturação até espermátides. A análise de todos estes resultados obtidos, permite considerar a leptina como um importante hormônio que pode estar envolvido em funções vitais do eixo neuroendócrino e reprodutivo do macho.<br>The leptin is a 16 KDa hormone principally produced by the adipose tissue, codified by the ob gene and composed by 146 amino acids. This hormone carries out its functions at peripheral levels and in the hypothalamic- hypophysis - gonadal axis. In several species the effect of this hormone on reproduction and their concentration and expression changes might be associated with the onset of puberty in different animal species and in human beings. The role of leptin in male reproduction has been studied especially in rats, mice, human beings, and other animal species. Leptin receptor and mRNA expression has been found in Leydig cells, seminiferous tubules, spermatogonies, spermatozoa, among other cells, indicating that leptin could have an important role in testicular function. An inhibitory effect of testosterone on leptin secretion has been found and vice versa, which indicates that leptin can regulate testicular steroidogenesis. Leptin can also act in non differentiated cells of the testis, promoting spermiogenesis. Then, leptin appears to be an important hormone probably involved in vital functions of the male neuroendocrine and reproductive axis

Jurisprudencia de la Corte Suprema de Justicia / por Juan B. Quintero C. e Ignacio V. Espinosa

El presente libro contiene los puntos de derecho resueltos por la Suprema Corte de Justicia, desde 1886 hasta el año que terminó en 1895, y que versan sobre los códigos civil, penal, comercial, de minas y la parte importante de las resoluciones sobre procedimientos judiciales y código fiscal. Doctrinas legales sentadas de una cuidadosa y fecunda labor : decimos fecunda, porque en su mayoría las cuestiones resueltas son de grande importancia, no sólo por la materia sobre que versan, sino por la claridad de la doctrina con que reemplazan disposiciones oscuras de nuestras leyes ; y decimos cuidadosa, porque no llegan á tres las sentencias en que el alto Tribunal se haya contradicho, y eso no en toda la doctrina sino en parte de ella. Estos hechos ponen en evidencia cómo los jurisconsultos que han sido Magistrados poseen las cualidades que la ley requiere para desempeñar la elevada función de supremos juzgadores, y cómo han correspondido de un modo brillante á la confianza que el Gobierno y la Nación han depositado en ellos. Por lo demás, hemos trabajado el presente libro impulsados por el deseo de servirle al foro colombiano, y por lo mismo hemos cuidado de ser exactos en la expresión de la doctrina, y tanto, que la mayoría de las resoluciones han sido transcritas como las sintetizó la CorteAdvertencias -- Dos palabras -- Primera parte : cuestiones relativas al derecho civil -- Segunda parte : cuestiones de derecho penal -- Tercera parte : cuestiones relativas al código de comercio198 p