Megacolon chagásico en Paraguay: aspectos quirúrgicos y perspectivas futuras

La constipación severa o las complicaciones del megacolon chagásico fueron clásicamente de resolución quirúrgica. Numerosos estudios fueron hechos, como así también muchas técnicas quirúrgicas fueron descritas para el abordaje de esta patología. La progresiva disminución del número de pacientes tratados quirúrgicamente es el resultado de la aplicación de las políticas públicas de salud, que evitan los nuevos casos y las complicaciones crónicas de esta entidad

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Description and quantification of the deep-sea megabenthic communities in Ormonde seamount (Gorringe Bank, NE Atlantic) using video analysis

The Gorringe Bank is a seamounts complex located at the eastern tip of the Azores-Gibraltar plate boundary separating Eurasia and Africa. Despite its early discovery at the end of the XIX century, the knowledge of the benthic communities and other associated fauna is still very scarce in this region, particularly in the deep areas below 200 m. The Ormonde seamount is one of the two main summits of Gorringe Bank, which rises from 5000 m to 33 m depth. In this study, we characterised the deep-sea communities in the Ormonde seamount from 900 to 2000 m depth by analysing underwater videos recorded by remotely operated vehicle (ROV) during the MEDWAVES survey (EU H2020 project ATLAS). We provided for the first time, detailed and quantitative information on species composition, densities, spatial distribution and state of conservation compared to other well studied seamounts. The surveyed areas were strongly dominated by sponges, but the presence of patches of cold-water corals were also notable and some other vulnerable marine ecosystems (VMEs) were identified. Spatial patterns in the deep-sea communities were also analysed as a result of the different water masses that bathed the area, exhibiting higher biodiversity in the presence of the Mediterranean Outflow Water (MOW). Studies of deep-sea ecosystems not only improve our knowledge of the deep ocean but also are essential defining an appropriate management plan and conservation measures

Outpatient transplantation during the COVID19 pandemic: stretching the limits for continuing care

COVID-19 has transformed stem cell transplantation (HSCT) dynamics throughout the world. Bone Marrow Transplantation units are facing many challenges complicating admission; deferrals in transplant schedules and even temporary closure. Delay in treatment may have a negative impact in outcomes. Outpatient care has been an alternative to hospital care in patients undergoing HSCT since the 1990s. Potential advantages include improved patient independence and satisfaction, improved quality of life, and less hospital resource utilization, which is of particular importance during this epidemic. In this prospective cohort study, we investigated the impact of the pandemic in our outpatient HSCT progra

Actividades de difusión para la salvaguarda del mariachi

El objetivo de este proyecto fue divulgar el mariachi entre el público joven a través de estrategias creativas. Para lograrlo, se realizó una activación en la Plaza Liberación para que la gente conociera sobre el Encuentro Tradicional del Mariachi y se preparara para su quinceava edición. Además, se trabajó en el diseño de la imagen, que fue aprobada previamente por la Secretaría de Cultura, y en la aplicación gráfica para cada actividad del encuentro. Por otro lado, se realizó un diagnóstico para el Centro de Documentación Internacional del Mariachi, con un manual de buenas prácticas para que les permita generar un buen trabajo en su acervo y en su difusión.ITESO, A.C.Secretaría de Cultura JaliscoCedi

Tonalá Tierra Viva

El objetivo de este proyecto fue contribuir a que los ciudadanos de Tonalá se sientan más identificados con sus raíces y que le den valor al trabajo artesanal que se realiza en su comunidad a través del concepto Tonalá Tierra Viva. Se diseñó una ruta turística para darle valor a la ciudad y a su patrimonio, lo cual derivó en un mapa turístico en el que se señalan los puntos más interesantes de la ciudad. De igual forma, se brindó apoyo en la aplicación gráfica de los servicios turísticos actuales de la Dirección Municipal a partir del concepto de comunicación aprobada en el 2015. Se diseñaron actividades de vinculación con artesanos a través de una propuesta de socialización y se generó una propuesta para la campaña de comunicación del Centro Cultural Herencia Milenaria.ITESO, A.C.Herencia MilenariaDirección de Turismo Tonal