La construcción simbólica de un sango y un cantar

To think of the Patía Valley from another place, that of ethnography, is to insist on the contingency of a world in the middle of other worlds, on the need for that heterogeneity, on the longing for a diverse palette of colors to paint life. It is to share through the text, a time lived so that the Other matters, so that the we can be conjured, a time that allows contemplation and the joy of life. It is also to establish a bridge with the beings that inhabit this legendary valley of luminous green and ocher color. My ancestors have lived on this earth and have left many traces, and with them the possibility of opening the paths of memory. The word is the footprint and the path to enter that world, on this occasion, during the celebration of Holy Week in the village of El Tuno, from where a group of black people have built forms of Re-existence through a particular feeling-doing in a state of grouping and of a singing-living as experiential wisdom that configures the Being from Tunisia. It is not only a task carried out within the framework of the Process of Recovery of Cultural Traditions of the Valle del Patía, it is a commitment to an anthropology that somehow can walk alongside the people and serve the struggles that its protagonists give, who allow us together in the common task of finding ways for the conversation, for life itself.Pensar el valle del Patía desde otro lugar, el de la etnografía, es insistir en la contingencia de un mundo en medio de otros mundos, en la necesidad de esa heterogeneidad, en el anhelo de una diversa paleta de colores para pintar la vida. Es compartir a través del texto, un tiempo vivido para que el Otro importe, para que el nosotros pueda conjurarse, un tiempo que permite la contemplación y el gozo de la vida. Es también, establecer un puente con los seres que habitan este valle legendario de luminoso color verde y ocre. Mis ancestros han vivido en esta tierra y han dejado muchas huellas, y con ellas la posibilidad de abrir los caminos de la memoria. La palabra es la huella y la senda para adentrarnos a ese mundo, en esta ocasión, durante la celebración de la Semana Santa en la vereda El Tuno, desde donde un grupo de gente negra ha construido formas de Re-existencia a través de un particular sentir-hacer en estado de agrupamiento y de un cantar-vivir como sabiduría experiencial que configura el Ser tuneño. No se trata sólo de una tarea realizada en el marco del Proceso de Recuperación de Tradiciones Culturales del Valle del Patía, es una apuesta por una antropología que de alguna manera pueda caminar junto a la gente y servir a las luchas que dan sus protagonistas, que nos permita la juntanza en la tarea común de encontrar maneras para la conversa, para la vida misma

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk