Cuba entre los escenarios por la Paz de Colombia

La firma de los acuerdos de Paz para Colombia implica un paso importante de la histórica relación colombo-cubana. Educar en ello, corresponde significar y erigir el valor a la memoria de los hombres y mujeres latinoamericanos en su sentido de pertenencia, unidad y deseos de progreso. Éste conocimiento permite entender por qué para los cubanos, la iniciativa de convertir La Habana en epicentro del análisis y la firma de los Diálogos de Paz entre el gobierno colombiano y la Farc Epl fue acogida con beneplácito como gesto de educación y fortaleza humanas pero también política entre los de la Isla y la región

La dialéctica amorosa como juego dramático

In this article, the conceptions that Plautus’ Miles gloriosus characters have about love and women are analized. The age and social class of these characters are the factors that determine their visions and attitudes which oppose and contrast dialectically through the comedy, they configuring love teme as the centre of Plautus’ dramatic game

Circulating tumor cells for the staging of patients with newly diagnosed transplant-eligible multiple myeloma

[Purpose]: Patients with multiple myeloma (MM) may show patchy bone marrow (BM) infiltration and extramedullary disease. Notwithstanding, quantification of plasma cells (PCs) continues to be performed in BM since the clinical translation of circulating tumor cells (CTCs) remains undefined. [Patients and methods]: CTCs were measured in peripheral blood (PB) of 374 patients with newly diagnosed MM enrolled in the GEM2012MENOS65 and GEM2014MAIN trials. Treatment included bortezomib, lenalidomide, and dexamethasone induction followed by autologous transplant, consolidation, and maintenance. Next-generation flow cytometry was used to evaluate CTCs in PB at diagnosis and measurable residual disease (MRD) in BM throughout treatment. [Results]: CTCs were detected in 92% (344 of 374) of patients with newly diagnosed MM. The correlation between the percentages of CTCs and BM PCs was modest. Increasing logarithmic percentages of CTCs were associated with inferior progression-free survival (PFS). A cutoff of 0.01% CTCs showed an independent prognostic value (hazard ratio: 2.02; 95% CI, 1.3 to 3.1; P = .001) in multivariable PFS analysis including the International Staging System, lactate dehydrogenase levels, and cytogenetics. The combination of the four prognostic factors significantly improved risk stratification. Outcomes according to the percentage of CTCs and depth of response to treatment showed that patients with undetectable CTCs had exceptional PFS regardless of complete remission and MRD status. In all other cases with detectable CTCs, only achieving MRD negativity (and not complete remission) demonstrated a statistically significant increase in PFS. [Conclusion]: Evaluation of CTCs in PB outperformed quantification of BM PCs. The detection of ≥ 0.01% CTCs could be a new risk factor in novel staging systems for patients with transplant-eligible MM.Supported by grants from the Centro de Investigación Biomédica en Red—Área de Oncología—del Instituto de Salud Carlos III (CIBERONC; CB16/12/00369, CB16/12/00400, and CB16/12/00284); Instituto de Salud Carlos III/Subdirección General de Investigación Sanitaria (FIS No. PI19/01451, PI20/00048, and PI21/01816); the Cancer Research UK (C355/A26819); FCAECC and AIRC under the Accelerator Award Program (EDITOR); the ISCIII and FEDER foundations (AC17/00101) together with FCAECC for iMMunocell Transcan-2; the European Research Council (ERC) 2015 Starting Grant (MYELOMANEXT/680200); the CRIS Cancer Foundation (PR_EX_2020-02), the Leukemia Lymphoma Society, the Black Swan Research Initiative of the International Myeloma Foundation; and the Riney Family Multiple Myeloma Research Program Fund

NGS-Based Molecular Karyotyping of Multiple Myeloma: Results from the GEM12 Clinical Trial

Simple Summary Multiple Myeloma (MM) is considered an incurable chronic disease, which prognosis depends on the presence of different genomic alterations. To accomplish a complete molecular diagnosis in a single essay, we have designed and validated a capture-based NGS approach to reliably identify pathogenic mutations (SNVs and indels), genomic alterations (CNVs and chromosomic translocations), and IGH rearrangements. We have observed a good correlation of the results obtained using our capture panel with data obtained by both FISH and WES techniques. In this study, the molecular classification performed using our approach was significantly associated with the stratification and outcome of MM patients. Additionally, this panel has been proven to detect specific IGH rearrangements that could be used as biomarkers in patient follow-ups through minimal residual disease (MRD) assays. In conclusion, we think that MM patients could benefit from the use of this capture-based NGS approach with a more accurate, single-essay molecular diagnosis. Next-generation sequencing (NGS) has greatly improved our ability to detect the genomic aberrations occurring in multiple myeloma (MM); however, its transfer to routine clinical labs and its validation in clinical trials remains to be established. We designed a capture-based NGS targeted panel to identify, in a single assay, known genetic alterations for the prognostic stratification of MM. The NGS panel was designed for the simultaneous study of single nucleotide and copy number variations, insertions and deletions, chromosomal translocations and V(D)J rearrangements. The panel was validated using a cohort of 149 MM patients enrolled in the GEM2012MENOS65 clinical trial. The results showed great global accuracy, with positive and negative predictive values close to 90% when compared with available data from fluorescence in situ hybridization and whole-exome sequencing. While the treatments used in the clinical trial showed high efficacy, patients defined as high-risk by the panel had shorter progression-free survival (p = 0.0015). As expected, the mutational status of TP53 was significant in predicting patient outcomes (p = 0.021). The NGS panel also efficiently detected clonal IGH rearrangements in 81% of patients. In conclusion, molecular karyotyping using a targeted NGS panel can identify relevant prognostic chromosomal abnormalities and translocations for the clinical management of MM patients

Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry

Background and Purpose In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Methods Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score 85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score 3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups' criteria). Results Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3). Conclusions Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors

Post-Hospital Syndrome and Hyponatremia

Introduction: Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and may be related to the appearance of PHS. Objective: The objective is to estimate the prevalence of PHS that is assessed as the rate of readmissions in the first 30 days after discharge, in patients with hyponatremia. Material and Methods: It is a descriptive observational study of patients with hyponatremia who were discharged from 1 September 2010 to 2 February 2020 at the Internal Medicine Service of the Hospital University of San Juan (Alicante, Spain). Results: Of the 25 included patients, 5 (20%) were readmitted within a month of discharge, after a mean of 11.4 days (standard deviation [SD] 5.1). The overall mortality of the study was 20% (n = 5), with one case of death in the first 30 days post-hospitalization (4%). In 12 patients (48%) the origin of the hyponatremia was undetermined. The most frequently recorded etiology for the condition was pharmacological (n = 7, 28%), and there was pronounced variability in its clinical and laboratory study. The most widely used corrective measure was drug withdrawal, in 16 patients (64%). Water intake restriction was the most common treatment after discharge (5 patients, 20%), followed by urea (2 patients, 8%), while tolvaptan was not used. Conclusion: Hyponatremia may be the cause of PHS, which could increase the rate of early readmission. Hyponatremia is an underdiagnosed and undertreated entity, so it is necessary to apply an appropriate system to optimize its management and, in future studies, to assess its impact on PHS

Manual de la prueba diagnóstica de Lectura (Comprensión de textos oralizados), Escritura y Matemática, 1er. grado de primaria

En este manual, se brindan las pautas para la aplicación de las pruebas y para el registro de las respuestas de los estudiantes, así como algunos ejemplos para la retroalimentación y orientaciones para el análisis de los resultados. Es necesario señalar que el análisis pedagógico de los resultados de estas pruebas es solo un insumo de un diagnóstico más amplio e integral. Para realizar un diagnóstico adecuado, también deben considerarse otras evidencias de aprendizaje, como el portafolio del estudiante u otros instrumentos generados por la escuela, las instancias de gestión descentralizada o el Ministerio de Educación. Toda esta información debería ser útil para tomar decisiones respecto de la planificación curricular con vistas a la continuidad de los aprendizajes durante el 2021

Manual de uso de las pruebas de Lectura y Escritura 1. ° grado de secundaria : kit de evaluación de diagnóstico. Conozcamos nuestros aprendizajes

La pandemia de la COVID-19 ha afectado el desarrollo de nuestra vida diaria y la forma en que nos relacionamos con los demás. En este contexto, la educación ha sido uno de los ámbitos más afectados. Nuestros estudiantes se vieron impedidos de iniciar y desarrollar regularmente el año escolar, por lo que se tomaron medidas para garantizar su salud y la continuidad del servicio educativo. Esto último se está logrando gracias a la educación a distancia. En este contexto, es importante contar con instrumentos de evaluación que ayuden a conocer el estado de los aprendizajes de nuestros estudiantes. Con este propósito, usted ha recibido un kit de evaluación diagnóstica que contiene, además del presente manual, las pruebas de Lectura y Escritura, y sus respectivos registros. En este manual, se brindan las pautas para la aplicación de las pruebas y para el registro de las respuestas de los estudiantes, así como algunos ejemplos para la retroalimentación y orientaciones para el análisis de los resultados. Es necesario señalar que el análisis pedagógico de los resultados de estas pruebas es solo un insumo de un diagnóstico más amplio e integral. Para realizar un diagnóstico adecuado, también deben considerarse otras evidencias de aprendizaje, como el portafolio del estudiante, u otros instrumentos generados por la escuela, las instancias de gestión descentralizada o el Ministerio de Educación

Manual de uso de las pruebas de Lectura y Escritura 2. ° grado de secundaria : kit de evaluación de diagnóstico. Conozcamos nuestros aprendizajes

La pandemia de la COVID-19 ha afectado el desarrollo de nuestra vida diaria y la forma en que nos relacionamos con los demás. En este contexto, la educación ha sido uno de los ámbitos más afectados. Nuestros estudiantes se vieron impedidos de iniciar y desarrollar regularmente el año escolar, por lo que se tomaron medidas para garantizar su salud y la continuidad del servicio educativo. Esto último se está logrando gracias a la educación a distancia. En este contexto, es importante contar con instrumentos de evaluación que ayuden a conocer el estado de los aprendizajes de nuestros estudiantes. Con este propósito, usted ha recibido un kit de evaluación diagnóstica que contiene, además del presente manual, las pruebas de Lectura y Escritura, y sus respectivos registros. En este manual, se brindan las pautas para la aplicación de las pruebas y para el registro de las respuestas de los estudiantes, así como algunos ejemplos para la retroalimentación y orientaciones para el análisis de los resultados. Es necesario señalar que el análisis pedagógico de los resultados de estas pruebas es solo un insumo de un diagnóstico más amplio e integral. Para realizar un diagnóstico adecuado, también deben considerarse otras evidencias de aprendizaje, como el portafolio del estudiante, u otros instrumentos generados por la escuela, las instancias de gestión descentralizada o el Ministerio de Educación