140 research outputs found

    Encuentros solidarios en épocas revolucionarias. La revolución cubana y el Frente Sandinista de Liberación Nacional ante la causa palestina

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    El presente ensayo examina los puentes políticos del gobierno de la Revolución Cubana y el Frente Sandinista de Liberación Nacional (FSLN) de Nicaragua con la causa palestina y las mutuas expresiones solidarias emanadas de los encuentros sostenidos en el ámbito diplomático y militar. Se analizan los condicionantes que permitieron las relaciones de estos actores con la lucha palestina contra el sionismo, en especial la emergencia del discurso del tercermundismo, así como los móviles, características principales y ejemplos más destacables del apoyo brindado a los palestinos en consonancia con el hecho de que la Cuba revolucionaria y el sandinismo simbolizaron los momentos más destacables de los encuentros solidarios de América Latina con Palestina en el siglo XX

    Los escuadrones de la muerte en América Latina. Aportes para la identificación de un fenómeno represivo

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     El presente artículo analiza el fenómeno de los es­cuadrones de la muerte en América Latina durante la Guerra Fría. A partir del muestreo de varios casos nacionales, presentados entre las décadas del sesenta y del ochenta, se establece un esquema de análisis que permite identificar las principales característi­cas y especificidades de estos actores en cuanto a su armado y desempeño represivo, según el paradigma de la contrainsurgencia que reguló la represión de los regímenes autoritarios contra las disidencias po­líticas y sociales. Se plantea, entre otras cuestiones, que los escuadrones fueron fuerzas paraestatales, cuyo accionar privilegió la aniquilación de la real o supuesta base social y redes de apoyo de las organi­zaciones armadas —la llamada subversión desarma­da— y que, a diferencia de otros actores represivos, su violencia fue selectiva, aunque no menos cruenta, al expresarse bajo la forma de ejecuciones extrajudi­ciales de carácter público, las cuales se perpetraron en ambientes urbanos, principalmente en las capita­les nacionales y estatales o provinciales

    El trabajo misional de fray Pedro de Gante en los inicios de la Nueva España

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    This article is intended to recover the evangelical and educational work of Friar Pedro de Gante in sixteenth-century New Spain. Less well known than other missionary figures, Gante was the first to take as serious commitment with the education and the conversion of the natives of the New World, which is why many aspects of it are attended: the first school of European studies in the city of Texcoco, the school and the open chapel of San José de los Naturales and various mechanisms for their evangelizing labour demonstrating the cultural syncretism that should proceed to their task. The problems they faced in his mission, mainly the complaint of the trustees abuses that prevented the indigenous conversion to Christianity, and the impact of his legacy in later missionary works are also presented.Este artículo tiene como propósito recuperar la obra evangélica y educativa del fraile Pedro de Gante en la Nueva España del siglo xvi. Menos conocido que otras figuras misioneras, Gante fue el primero en asumir como compromiso serio la enseñanza y la conversión de los indígenas del Nuevo Mundo, razón por la cual se atienden varios de sus aspectos: la primera escuela de enseñanza europea en la ciudad de Texcoco, el colegio y capilla abierta de San José de los Naturales y los diversos mecanismos utilizados para su labor evangelizadora que demuestran el sincretismo cultural al que debió proceder para su tarea. Se presentan también los problemas a los que se enfrentó en su misión, principalmente, la denuncia de los abusos encomenderos que impedían la conversión indígena al cristianismo, así como el impacto de su legado en las posteriores acciones misionales

    Los estudios de la represión, discusiones y agendas de investigación actuales : Reseña de: Gabriela Águila, Santiago Garaño y Pablo Scatizza (coords.), La represión como política de Estado. Estudios sobre la violencia estatal en el siglo XX, Buenos Aires, Imago Mundi, 2020.

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    La represión como política de Estado. Estudios sobre la violencia estatal en el siglo XX es el emprendimiento editorial más reciente de la Red de Estudios sobre Represión y Violencia Política (RER), fundada en 2014 con el propósito de crear un espacio de reunión y de debate que contribuyera a la conformación de un novedoso campo de estudios en el mundo académico. En tal sentido, esta obra y su contenido testifican los fructíferos avances desarrollados en los últimos años, con una red de investigadores en crecimiento y un campo de estudios que, además de consolidado, goza de innovaciones constantes en los enfoques de interpretación, propuestas analíticas y temas, los cuales han sido formulados en distintas escalas y contextos que superan el ámbito de la historia reciente argentina. [Extracto a modo de resumen]Facultad de Humanidades y Ciencias de la Educació

    Clinical Utility of HeartLogic, a Multiparametric Telemonitoring System, in Heart Failure

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    Telemonitoring through multiple variables measured on cardiac devices has the potential to improve the follow-up of patients with heart failure. The HeartLogic algorithm (Boston Scientific), implemented in some implantable cardiac defibrillators and cardiac resynchronisation therapy, allows monitoring of the nocturnal heart rate, respiratory movements, thoracic impedance, physical activity and the intensity of heart tones, with the aim of predicting major clinical events. Although HeartLogic has demonstrated high sensitivity for the detection of heart failure decompensations, its effects on hospitalisation and mortality in randomised clinical trials has not yet been corroborated. This review details how the HeartLogic algorithm works, compiles available evidence from clinical studies, and discusses its application in daily clinical practice

    Izaña Atmospheric Research Center. Activity Report 2019-2020

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    Editors: Emilio Cuevas, Celia Milford and Oksana Tarasova.[EN]The Izaña Atmospheric Research Center (IARC), which is part of the State Meteorological Agency of Spain (AEMET), is a site of excellence in atmospheric science. It manages four observatories in Tenerife including the high altitude Izaña Atmospheric Observatory. The Izaña Atmospheric Observatory was inaugurated in 1916 and since that date has carried out uninterrupted meteorological and climatological observations, contributing towards a unique 100-year record in 2016. This reports are a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues.[ES]El Centro de Investigación Atmosférica de Izaña (CIAI), que forma parte de la Agencia Estatal de Meteorología de España (AEMET), representa un centro de excelencia en ciencias atmosféricas. Gestiona cuatro observatorios en Tenerife, incluido el Observatorio de Izaña de gran altitud, inaugurado en 1916 y que desde entonces ha realizado observaciones meteorológicas y climatológicas ininterrumpidas y se ha convertido en una estación centenaria de la OMM. Estos informes resumen las múltiples actividades llevadas a cabo por el Centro de Investigación Atmosférica de Izaña. El liderazgo del Centro en materia de investigación y desarrollo con respecto a las técnicas de medición, calibración y validación de última generación, así como la cooperación internacional, le han otorgado una reputación sobresaliente en lo que se refiere al tiempo, el clima, la hidrología y otros temas ambientales afines

    Instantaneous Wave-Free Ratio for the Assessment of Intermediate Left Main Coronary Artery Stenosis: Correlations With Fractional Flow Reserve/Intravascular Ultrasound and Prognostic Implications: The iLITRO-EPIC07 Study

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    Background: There is little information available on agreement between fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) in left main coronary artery (LMCA) intermediate stenosis. Besides, several meta-analyses support the use of FFR to guide LMCA revascularization, but limited information is available on iFR in this setting. Our aims were to establish the concordance between FFR and iFR in intermediate LMCA lesions, to evaluate with intravascular ultrasound (IVUS) in cases of FFR/iFR discordance, and to prospectively validate the safety of deferring revascularization based on a hybrid decision-making strategy combining iFR and IVUS. Methods: Prospective, observational, multicenter registry with 300 consecutive patients with intermediate LMCA stenosis who underwent FFR and iFR and, in case of discordance, IVUS and minimal lumen area measurements. Primary clinical end point was a composite of cardiovascular death, LMCA lesion-related nonfatal myocardial infarction, or unplanned LMCA revascularization. Results: FFR and iFR had an agreement of 80% (both positive in 67 and both negative in 167 patients); in case of disagreement (31 FFR+/iFR- and 29 FFR-/iFR+) minimal lumen area was & GE;6 mm(2) in 8.7% of patients with FFR+ and 14.6% with iFR+. Among the 300 patients, 105 (35%) underwent revascularization and 181 (60%) were deferred according to iFR and IVUS. At a median follow-up of 20 months, major adverse cardiac events incidence was 8.3% in the defer group and 13.3% in the revascularization group (hazard ratio, 0.71 [95% CI 0.30-1.72]; P=0.45). Conclusions: In patients with intermediate LMCA stenosis, a physiology-guided treatment decision is feasible either with FFR or iFR with moderate concordance between both indices. In case of disagreement, the use of IVUS may be useful to indicate revascularization. Deferral of revascularization based on iFR appears to be safe in terms of major adverse cardiac events

    Rationale and design of the Concordance study between FFR and iFR for the assessment of lesions in the left main coronary artery. The ILITRO-EPIC-07 Trial

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    Introduction and objectives: Patients with left main coronary artery (LMCA) stenosis have been excluded from the trials that support the non-inferiority of the instantaneous wave-free ratio (iFR) compared to the fractional flow reserve (FFR) in the decision-making process of coronary revascularization. This study proposes to prospectively assess the concordance between the two indices in LMCA lesions and to validate the iFR cut-off value of 0.89 for clinical use. Methods: National, prospective, and observational multicenter registry of 300 consecutive patients with intermediate lesions in the LMCA (angiographic stenosis, 25% to 60%. A pressure gudiewire study and determination of the RFF and the iFR will be performed: in the event of a negative concordant result (FFR > 0.80/iFR > 0.89), no treatment will be performed; in case of a positive concordant result (FFR 0.80/iFR 0.89), an intravascular echocardiography will be performed and revascularization will be delayed if the minimum lumen area is > 6 mm(2). The primary clinical endpoint will be a composite of cardiovascular death, LMCA lesion-related non-fatal infarction or need for revascularization of the LMCA lesion at 12 months. Conclusions: Confirm that an iFR-guided decision-making process in patients with intermediate LMCA stenosis is clinically safe and would have a significant clinical impact. Also, justify its systematic use when prescribing treatment in these potentially high-risk patients

    Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

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    The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

    Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study

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    Background The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd
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