Diagnóstico de la eficiencia en la ejecución del plan mensualizado de caja de la Secretaría de Educación Distrital: 2013-2015

Trabajo de investigaciónEsta investigación permite visualizar el panorama real de la ejecución mensual de los gastos de Inversión de la secretaria de Educación y determinar cuál de los rubros presupuestales, presenta una mayor y menor grado de eficiencia, en cada uno de los años comprendidos 2013- 2015.INTRODUCCIÓN 1. MARCO TEÓRICO 2. ANÁLISIS RADAR Y MODELO DEA 3. CONCLUSIONES 4. BIBLIOGRAFÍA 5. ANEXOSEspecializaciónEspecialista en Análisis y Administración Financier

El ingreso a la cultura escrita en el grado transición : supuestos y enfoques en situaciones didácticas de una práctica destacada

Licenciado (a) en Pedagogía InfantilPregrad

A clinically compatible drug-screening platform based on organotypic cultures identifies vulnerabilities to prevent and treat brain metastasis

We report a medium‐throughput drug‐screening platform (METPlatform) based on organotypic cultures that allows to evaluate inhibitors against metastases growing in situ. By applying this approach to the unmet clinical need of brain metastasis, we identified several vulnerabilities. Among them, a blood–brain barrier permeable HSP90 inhibitor showed high potency against mouse and human brain metastases at clinically relevant stages of the disease, including a novel model of local relapse after neurosurgery. Furthermore, in situ proteomic analysis applied to metastases treated with the chaperone inhibitor uncovered a novel molecular program in brain metastasis, which includes biomarkers of poor prognosis and actionable mechanisms of resistance. Our work validates METPlatform as a potent resource for metastasis research integrating drug‐screening and unbiased omic approaches that is compatible with human samples. Thus, this clinically relevant strategy is aimed to personalize the management of metastatic disease in the brain and elsewhere

Manejo Multidisciplinario del Adenocarcinoma de Páncreas: Guía de Práctica Clínica AUNA

Introduction: This article provides recommendations for the Multidisciplinary Management of Pancreatic Adenocarcinoma in the RED AUNA. Methods: A systematic search of clinical practice guidelines (CPG) similar to topics of interest was developed, it was assessed with the AGREE II instrument, a list of questions was elaborated under the PICO structure, a de novo search was carried out prioritizing reviews systematic with or without meta-analysis, followed by primary studies, the elaboration of the evidence tables and the evaluation of the global quality for the outcomes of the clinical questions was carried out following the GRADE methodology. Results: 5 PICO questions corresponding to initial management and systemic management were formulated with 18 recommendations regarding the most effective method for pathological diagnosis, biliary drainage and the most effective and safe systemic treatment in the neoadjuvant, adjuvant and metastatic setting. Conclusions: This article summarizes the methodology and evidence-based recommendations of the CPG for the multidisciplinary management of pancreatic adenocarcinoma of the AUNA Clinic Network.Introducción: Este artículo brinda recomendaciones para el Manejo Multidisciplinario del Adenocarcinoma de Páncreas en la RED AUNA. Métodos: Se desarrolló una búsqueda sistemática de guías de práctica clínica (GPC) similares al tópico de interés, se valoró con el instrumento AGREE II, se elaboró un listado de preguntas bajo la estructura PICO, se realizó una búsqueda de novo priorizando revisiones sistemáticas con o sin meta-análisis, seguida de estudios primarios, la elaboración de las tablas de evidencia y la evaluación de la calidad global para los desenlaces de las preguntas clínicas se realizó siguiendo la metodología GRADE. Resultados: Se formularon 5 preguntas PICO correspondientes al manejo inicial y manejo sistémico con 18 recomendaciones respecto al método más efectivo para el diagnóstico patológico, el drenaje biliar y el tratamiento sistémico más efectivo y seguro en el escenario neoadyuvante, adyuvante y metastásico. Conclusiones: El presente artículo resume la metodología y las recomendaciones basadas en evidencia de la GPC para el manejo multidisciplinario del Adenocarcinoma de páncreas de la Red de Clínicas AUNA

The fatal contribution of serine protease-related genetic variants to COVID-19 outcomes

IntroductionSerine proteases play a critical role during SARS-CoV-2 infection. Therefore, polymorphisms of transmembrane protease serine 2 (TMPRSS2) and serpine family E member 1 (SERPINE1) could help to elucidate the contribution of variability to COVID-19 outcomes.MethodsTo evaluate the genetic variants of the genes previously associated with COVID-19 outcomes, we performed a cross-sectional study in which 1536 SARS-CoV-2-positive participants were enrolled. TMPRSS2 (rs2070788, rs75603675, rs12329760) and SERPINE1 (rs2227631, rs2227667, rs2070682, rs2227692) were genotyped using the Open Array Platform. The association of polymorphisms with disease outcomes was determined by logistic regression analysis adjusted for covariates (age, sex, hypertension, type 2 diabetes, and obesity).ResultsAccording to our codominant model, the GA genotype of rs2227667 (OR=0.55; 95% CI = 0.36-0.84; p=0.006) and the AG genotype of rs2227667 (OR=0.59; 95% CI = 0.38-0.91; p=0.02) of SERPINE1 played a protective role against disease. However, the rs2227692 T allele and TT genotype SERPINE1 (OR=1.45; 95% CI = 1.11-1.91; p=0.006; OR=2.08; 95% CI = 1.22-3.57; p=0.007; respectively) were associated with a decreased risk of death. Similarly, the rs75603675 AA genotype TMPRSS2 had an OR of 1.97 (95% CI = 1.07-3.6; p=0.03) for deceased patients. Finally, the rs2227692 T allele SERPINE1 was associated with increased D-dimer levels (OR=1.24; 95% CI = 1.03-1.48; p=0.02).DiscussionOur data suggest that the rs75603675 TMPRSS2 and rs2227692 SERPINE1 polymorphisms are associated with a poor outcome. Additionally, rs2227692 SERPINE1 could participate in hypercoagulable conditions in critical COVID-19 patients, and this genetic variant could contribute to the identification of new pharmacological targets and treatment strategies to block the inhibition of TMPRSS2 entry into SARS-CoV-2

Guía de práctica clínica para la prevención, diagnóstico, tratamiento y rehabilitación de la falla cardiaca en población mayor de 18 años, clasificación B, C y D

La falla cardíaca es un síndrome clínico caracterizado por síntomas y signos típicos de insuficiencia cardíaca, adicional a la evidencia objetiva de una anomalía estructural o funcional del corazón. Guía completa 2016. Guía No. 53Población mayor de 18 añosN/

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Educación cooperativa: experiencias escolares significativas

Fil: Ferreyra, Horacio Ademar. Universidad Católica de Córdoba. Facultad de Educación; Argentin

Educación cooperativa : experiencias escolares significativas

Fil: Ferreyra, Horacio Ademar. Universidad Católica de Córdoba. Facultad de Educación; Argentin

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe