Corrección quirúrgica del estrabismo en 2 pacientes con el síndrome de Moebius

ResumenSe presentan las características oftalmológicas y clínicas de 2 pacientes (una mujer y un hombre) con diagnóstico de síndrome de Moebius. Esta entidad por lo general bilateral, de causa multifactorial, se caracteriza por marcada esotropía, con gran limitación de la abducción, y otras alteraciones faciales. Se presentan 2 casos clínicos a los que se les realizó corrección quirúrgica.AbstractIt's presented the ophthalmic and clinical characteristic of 2 patients (female and male), with diagnosis of Moebius syndrome. This is a disorder generally bilateral, of multifactorial cause which is characterized by marked esotropia, with large limitation of abduction, with other facial alterations. We presented 2 clinic cases which already underwent surgical correctio

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

Roads as invariants of the landscape

Las carreteras constituyen un elemento esencial en la construcción y morfología de los paisajes. A partir de la exposición de algunas de las principales claves en la evolución de estas infraestructuras desde mediados del siglo XVIII y de la experiencia adquirida en investigaciones previas, el presente artículo tiene por objeto facilitar la lectura de los paisajes configurados por las carreteras en los dos últimos siglos, localizando tramos de corredores históricos de transporte donde trazados viarios de distintos periodos. El desensamblado de los paisajes que han generado estas carreteras ha permitido identificar las transformaciones en la construcción de tales infraestructuras, las actividades que los distintos trazados han propiciado y los cambios sucedidos en las formas de movilidad.Roads are an essential element in the formation of landscapes. This paper, by establishing some of the key aspects of the development of these infrastructures from the mid18th century and according to previous experience, aims to guide the reading of landscapes shaped by roads in the last two century, through the location of stretches of historic transportation landscapes where roads from different periods coexist. The disassembled of landscapes formed by these roads has made it possible to identify the transformation in the design and construction of these infrastructures, the uses and activities provided by the different routes and the changes in the forms of mobility.Proyecto de investigación PID2019-105877RAI00 "Análisis y definición de estrategias para la caracterización, recuperación y puesta en valor del patrimonio de las obras públicas. Una aproximación desde la escala territorial", subvencionado por el Ministerio de Ciencia, Innovación y Universidades.peerReviewe

Functional status, quality of life, and costs associated with fibromyalgia subgroups: A latent profile analysis

<b>Objectives</b>\ud \ud Although fibromyalgia syndrome (FM) is considered a heterogeneous condition, there is no generally accepted subgroup typology. We used hierarchical cluster analysis and latent profile analysis to replicate Giesecke’s classification in Spanish FM patients. The second aim was to examine whether the subgroups differed in sociodemographic characteristics, functional status, quality of life, and in direct and indirect costs.\ud \ud <b>Materials and Methods</b>\ud \ud A total of 160 FM patients completed the following measures for cluster derivation: the Center for Epidemiological Studies-Depression Scale, the Trait Anxiety Inventory, the Pain Catastrophizing Scale, and the Control over Pain subscale. Pain threshold was measured with a sphygmomanometer. In addition, the Fibromyalgia Impact Questionnaire-Revised, the EuroQoL-5D-3L, and the Client Service Receipt Inventory were administered for cluster validation.\ud \ud <b>Results</b>\ud \ud Two distinct clusters were identified using hierarchical cluster analysis (“hypersensitive” group, 69.8% and “functional” group, 30.2%). In contrast, the latent profile analysis goodness-of-fit indices supported the existence of 3 FM patient profiles: (1) a “functional” profile (28.1%) defined as moderate tenderness, distress, and pain catastrophizing; (2) a “dysfunctional” profile (45.6%) defined by elevated tenderness, distress, and pain catastrophizing; and (3) a “highly dysfunctional and distressed” profile (26.3%) characterized by elevated tenderness and extremely high distress and catastrophizing. We did not find significant differences in sociodemographic characteristics between the 2 clusters or among the 3 profiles. The functional profile was associated with less impairment, greater quality of life, and lower health care costs.\ud \ud <b>Discussion</b>\ud \ud We identified 3 distinct profiles which accounted for the heterogeneity of FM patients. Our findings might help to design tailored interventions for FM patients

Memorias semana de la Facultad de Educación. VII semana: historias, saberes y prácticas educativas innovadoras e incluyentes.

Las Memorias de la VII Semana de la Educación “Historias, saberes y prácticas educativas innovadoras e incluyentes”, publicadas por la Editorial de la Corporación Universitaria Minuto de Dios – UNIMINUTO, reúnen las ponencias y resúmenes sobre esta temática presentadas en un evento de realización anual, cuyo propósito es socializar experiencias investigativas y académicas de grupos, semilleros de investigación y trabajos de grado entre estudiantes y profesores de la Facultad de Educación, y con profesores y estudiantes de otras instituciones educativas que gentilmente compartieron experiencias en el campo de la educación, la pedagogía, el arte, la cultura y el deporte. El principal interés de este encuentro radica en recoger la construcción histórica educativa de la Corporación Universitaria Minuto de Dios – UNIMINUTO con respecto a sus orígenes y construcciones académicas; y las experiencias históricas de otras propuestas educativas a nivel de la educación infantil, básica, media y superior con tejido cultural y social, desde un enfoque diferencial y diverso en el cual todas las experiencias enriquecen la formación de maestros desde la innovación e inclusión en los diferentes contextos. En este encuentro participaron las universidades Antonio Nariño, de la Amazonia, del Rosario, La Gran Colombia y Pedagógica Nacional, así como la Corporación Escuela Pedagógica Experimental, el Centro Educativo de Nuestra Señora de la Paz, el Instituto Colombo Sueco y varios docentes de la Secretaría de Educación Distrital de Bogotá D. C

Investigación educativa en las aulas de primaria

Reúne trabajos derivados de la experiencias de diversos docentes en educación primaria en los siguientes temas: Tecnología de Información y Comunicación, educación inclusiva, enseñanza de la música, educación física, enseñanza de la historia, acoso escolar, auto-evaluación, métodos de enseñanza, inteligencia emocional, percepción del alumno, marco cognitivo en comprensión lectora y comunicación escuela-familia

Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort.

Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies

Optimization of adsorptive removal of α-toluic acid by CaO2 nanoparticles using response surface methodology

The present work addresses the optimization of process parameters for adsorptive removal of α-toluic acid by calcium peroxide (CaO2) nanoparticles using response surface methodology (RSM). CaO2 nanoparticles were synthesized by chemical precipitation method and confirmed by Transmission electron microscopy (TEM) and high-resolution TEM (HRTEM) analysis which shows the CaO2 nanoparticles size range of 5–15 nm. A series of batch adsorption experiments were performed using CaO2 nanoparticles to remove α-toluic acid from the aqueous solution. Further, an experimental based central composite design (CCD) was developed to study the interactive effect of CaO2 adsorbent dosage, initial concentration of α-toluic acid, and contact time on α-toluic acid removal efficiency (response) and optimization of the process. Analysis of variance (ANOVA) was performed to determine the significance of the individual and the interactive effects of variables on the response. The model predicted response showed a good agreement with the experimental response, and the coefficient of determination, (R2) was 0.92. Among the variables, the interactive effect of adsorbent dosage and the initial α-toluic acid concentration was found to have more influence on the response than the contact time. Numerical optimization of process by RSM showed the optimal adsorbent dosage, initial concentration of α-toluic acid, and contact time as 0.03 g, 7.06 g/L, and 34 min respectively. The predicted removal efficiency was 99.50%. The experiments performed under these conditions showed α-toluic acid removal efficiency up to 98.05%, which confirmed the adequacy of the model prediction