10 research outputs found

    Movimiento de ganado en pastoreo en un sistema silvopastoril del valle cálido del Magdalena tolimense (Colombia)

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    Existe poca información en cuanto a la interacción existente entre cobertura arbórea y comportamiento animal;no obstante, el uso de sensores remotos ha mejorado la posibilidad de establecer estas relaciones, con registros de la ubicación espacial y temporal de los animales en el paisaje. El presente estudio evaluó el movimiento de bovinos en pastoreo y la influencia de diferentes factores bióticos (cobertura arbórea y disponibilidad de forraje) y abióticos (temperatura ambiental) en una pastura de 54 ha, con árboles dispersos, localizado en la hacienda Pajonales (Tolima). Se monitoreó el movimiento de 6 vacas secas con un peso promedio de 480 kg (3 F1 de Holstein por Brahman y 3 Brahman comercial). Para el monitoreo a cada vaca se le colocó un collar equipado con un receptor de sistema de posicionamiento global GPS (Garmin eTrex Vista) durante dos periodos diferenciados por la precipitación y la temperatura ambiente (fresco y caluroso). Los GPS se configuraron para registrar posiciones cada 5 min durante 1 mes en cada periodo de toma de datos. Estos datos se compararon con datos recabados por observadores en el campo. Se encontró que el comportamiento de los bovinos de diferente composición racia, presentan patrones de pastoreo y actividad diferenciados. Los factores abióticos fueron los que más incidieron enlos patrones de movimiento

    Evaluación del control integrado de plagas en el cultivo de tomate de mesa, con énfasis en el gusano cogollero (Scrobipálpula absoluta)

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    El cultivo del tomate, es atacado por diferentes especies de insectos plagas que reducen su rendimiento, especialmente del gusano, el cual se considera como el problema entomológico del cultivo presentándose en cualquier etapa del cultivo, tanto en su fase vegetativa como en la fase reproductiva.Tomate-Solanum lycopersicu

    Global Retinoblastoma Presentation and Analysis by National Income Level.

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    Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

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

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    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

    Propuesta para el mejoramiento de la operación y administración de la base tecnológica de Tuboláminas

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    El presente trabajo, consiste en una propuesta para el mejoramiento de la operación y administración de la base tecnológica para la empresa TUBOLAMINAS S.A. y se divide en tres grandes apartados. En primer lugar, se presenta una descripción de los servicios e infraestructura con los que cuenta la red, la cual permite levantar el mapa de la red de datos. A continuación se describe en detalle la situación actual de la red, con el propósito de elaborar la matriz de impacto, riesgo y amenaza, la cual nos permite concluir cuales son los servicios y recursos a los que se debe prestar atención prioritaria (El servidor, la base de datos CGUNO y el servicio de facturación)

    An International Survey of Classification and Treatment Choices For Group D Retinoblastoma

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    AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism. RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles (CHLA) version, 33% used the Children's Oncology Group (COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center (P<0.0001). CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.WoSScopu

    Políticas públicas

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    Amputaci&oacute;n de extremidades superiores: caracterizaci&oacute;n epidemiol&oacute;gicaAn&aacute;lisis comparado de las pol&iacute;ticas de promoci&oacute;n de la salud entre Chile y Catalu&ntilde;aAn&aacute;lisis de los Avisa para la toma de decisiones en pol&iacute;ticas de saludAntecedentes de colelitiasis en pacientes que presentaron colecistitis aguda. &iquest;Se puede prevenir la urgencia?Asociaci&oacute;n entre alcoholemia y traumatismos en Copiap&oacute;, 2009Automedicaci&oacute;n en la poblaci&oacute;n asistente al Cesfam de Puerto NatalesAutotoma vaginal para detecci&oacute;n de VPH para la prevenci&oacute;n de c&aacute;ncer cervicouterino, ChileCalidad de atenci&oacute;n programa Auge- c&aacute;ncer cervicouterino: la perspectiva de los profesionalesCaracterizaci&oacute;n de los casos de traumatismo enc&eacute;falo craneano en la comuna de Til-TilConocimiento de conductores universitarios sobre la alcoholemia permitida para conducir y su equivalencia en bebidas alcoh&oacute;licasDescripci&oacute;n de la consulta dermatol&oacute;gica pedi&aacute;trica en el Hospital Roberto del R&iacute;o (2007-2008)Elementos para un abordaje metodol&oacute;gico de la salud intercultural en la Regi&oacute;n Metropolitana de SantiagoEstudio descriptivo de consultas Sapu Cesfam Angachilla, visi&oacute;n tras dos a&ntilde;os de registro cl&iacute;nico-electr&oacute;nicoEstudio descriptivo de ingresos a Conin Valdivia, una revisi&oacute;n de 10 a&ntilde;os (1998-2008)Estudio descriptivo de pacientes hospitalizados por absceso y celulitis peritonsilar en el hospital de PurranqueEvaluaci&oacute;n de la aceptabilidad y consumo de alimentos del Pacam inscritos en el Cesfam Dr. V.M.FEvaluaci&oacute;n de la interacci&oacute;n de medicinas alternativas o complementarias (MAC) en dos centros APSExposici&oacute;n a humo de tabaco ambiental. Signos y s&iacute;ntomas respiratorios bajos: estudio de prevalenciaFactores relacionados con la rotaci&oacute;n laboral de m&eacute;dicos en consultorios del Gran SantiagoFibrosis qu&iacute;stica como patolog&iacute;a GES: una mirada cr&iacute;ticaHipersensibilidad dentinaria: comparaci&oacute;n de diferentes alternativas terap&eacute;uticasImpacto del GES en c&aacute;ncer mamario: seguimiento a 5 a&ntilde;os en un hospital del SSMSImplementaci&oacute;n de la pol&iacute;tica nacional de medicamentos: percepci&oacute;n del profesional qu&iacute;mico farmac&eacute;uticoLa implementaci&oacute;n de pol&iacute;ticas p&uacute;blicas cambi&oacute; mortalidad de los pacientes gran quemado en Chile&iquest;La infertilidad deber&iacute;a ser considerada un problema de salud p&uacute;blica en el Per&uacute;?Modelo de monitoreo de una pol&iacute;tica de protecci&oacute;n a la infanciaMortalidad materna en el Hospital Dr. Alfredo van Grieken Coro, Estado Falc&oacute;n, Venezuela 2005-2009Objetivos de desarrollo del milenio. Modelaci&oacute;n de la mortalidad infantil Nicaragua - Costa Rica 1978-2008Percepci&oacute;n de riesgo y beneficio respecto del cigarrillo y su relaci&oacute;n con el tabaquismo adolescentePol&iacute;ticas p&uacute;blicas y salud intercultural: la experiencia de la organizaci&oacute;n ind&iacute;gena Tai&ntilde; adkimnPrevalencia de atipias celulares del cuello uterino en mujeres entre 18 y 24 a&ntilde;osProceso de ser histerectomizada: relatos de experiencias de mujeres en un hospital p&uacute;blico de SantiagoProceso de ser histerectomizada: relatos de experiencias de mujeres en un hospital p&uacute;blico de SantiagoPrograma Auge y c&aacute;ncer cervicouterino: calidad de atenci&oacute;n percibida por las usuarias del programaResoluci&oacute;n quir&uacute;rgica por patolog&iacute;a adenoamigdalina: &iquest;Es la poblaci&oacute;n mapuche un grupo de riesgo?Resultados de alcoholemias tanatol&oacute;gicas del Servicio M&eacute;dico Legal de Copiap&oacute; 1999-2009Resultados de la evaluaci&oacute;n de los objetivos sanitarios de la d&eacute;cada 2000-2010Una mirada a los servicios de salud para adolescentes en Puente Alt

    The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries

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    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. Enudeation 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% (524-63-0) 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. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Y

    Global Retinoblastoma Presentation and Analysis by National Income Level

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    This cross-sectional analysis reports the retinoblastoma stage at diagnosis across the world during a single year, investigates associations between clinical variables and national income level, and investigates risk factors for advanced disease at diagnosis. Key PointsQuestionIs the income level of a country of residence associated with the clinical stage of presentation of patients with retinoblastoma? FindingsIn this cross-sectional analysis that included 4351 patients with newly diagnosed retinoblastoma, approximately half of all new retinoblastoma cases worldwide in 2017, 49.1\% of patients from low-income countries had extraocular tumor at time of diagnosis compared with 1.5\% of patients from high-income countries. MeaningThe clinical stage of presentation of retinoblastoma, which has a major influence on survival, significantly differs among patients from low-income and high-income countries, which may warrant intervention on national and international levels. ImportanceEarly diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. ObjectivesTo report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and ParticipantsA total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and MeasuresAge at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. ResultsThe cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4\%) were female. Most patients (n=3685 {[}84.7\%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n=2638 {[}62.8\%]), followed by strabismus (n=429 {[}10.2\%]) and proptosis (n=309 {[}7.4\%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5\%) patients having intraocular retinoblastoma and 2 (0.3\%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1\%) having extraocular retinoblastoma and 94 of 498 (18.9\%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 {[}95\% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 {[}95\% CI, 4.30-7.68]). Conclusions and RelevanceThis study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs
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