Aportes al diseño de estrategias para la formación de profesionales reflexivos en instrumentación quirúrgica.

El ejercicio de las profesiones de la salud actualmente se desarrolla dentro de un marco que busca potenciar las competencias relacionadas con el pensamiento crítico y reflexivo y la capacidad resolutiva de los profesionales, para de esta forma dar solución a la diversas y complejas problemáticas en salud de las comunidades, por tal motivo se hace necesario fortalecer dentro de los procesos formativos en los estudiantes, habilidades, destrezas y actitudes que den cuenta de la mejora en la calidad de la educación desde referentes como Donald Schön.Practice of the health professions currently develops within a framework that tends to strengthen skills related to critical and reflexive thinking and problem solving capacity of professionals, in order to provide a solution to the diverse and complex problems related with health of communities, for this reason it is necessary to strengthen within the formative processes of students, skills and attitudes that improves the quality of education from referents such as Donald Schön.Magister enDocencia e Investigación UniversitariaMaestrí

Estimation of future emission scenarios for analysing the impact of traffic mobility on a large Mediterranean conurbation in the Barcelona Metropolitan Area (Spain)

Emission modelling permits us to quantitatively assess the effects of emission abatement strategies. In urban areas, such strategies are designed mainly to reduce the emissions from the on–road traffic sector. This work analyses the impact of several mobility strategies on urban emissions in the coastal city of Barcelona, Spain, when the High Elective Resolution Modelling Emission System (HERMES) is applied at a very high resolution (1 km × 1 km and 1 h). The analysis was conducted by projecting the emissions data obtained from a base case scenario in 2004 onto three future scenarios set in 2015, where each future scenario represented a set of traffic mobility management measures. Specific developments were considered per emission sector, including power generation, industrial activities, domestic– commercial, solvents, on–road traffic, biogenic emissions, ports and airports, to best compare the present base case scenario with the future mobility scenarios generated for 2015. These emission scenarios for 2015 take into account the population projections and the variations in port and airport activities among other factors, while the main focus is on the on–road traffic sector, the types of vehicles used, such as technologically improved buses and hybrid vehicles, as well as the types of fuels used, including natural gas and biofuels. The results of the emission model indicate that the mobility management strategies, the technological improvements and the use of alternative fuels reduce the emissions from on–road traffic by approximately 75% (in terms of nitrogen oxides emission reductions in the city centre of Barcelona). This decrease leads to a 35% reduction in overall nitrogen oxides emissions, even if some sectors individually experience increases based on their specific projections.Postprint (published version

ASPEBI: A MATLAB Tool for Motion Analysis of Non-Specific Low Back Pain Patients

Low back pain is one of the most common health issues worldwide, and non-specific low back pain (NLBP), whose causes are unknown, represents 85% of these cases. Hamstring Extension in Bipedal Position (PEBI) is a clinical sign designed to discriminate the cause of the pain of NLBP as of muscular origin due to the stiffness of the hamstring. Currently, PEBI lacks quantitative assessment, which is required to be utilized in primary care. To support the process of getting such information, in this work, we present ASPEBI, a customized MATLAB® app developed to provide researchers and clinicians with a tool for the visualization of the kinematic and spatiotemporal gait parameters of patients examined with PEBI. This objective information is processed from data collected with the Xsens MTw Awinda system, which can be analyzed by the final users. Lastly, this tool is user-friendly with a modular design that allows integration of other physiological technologies to conduct multimodal analysis, and it could be utilized to explore issues related to older populations or populations with neurodegenerative diseases, among others

Expresión inmunohistoquímica de la proteína citoqueratina 19 en quistes dentígeros asociados a terceros molares incluidos

In included teeth the remnants of the follicular sac originate from odontogenic cysts such as the dentigerous cyst. This cyst is generated by alteration of the epithelium of the enamel organ after the complete formation of the crown due to the accumulation of liquid between the layers of the adamantine epithelium. Radiographic and histopathological studies are used for the diagnosis of these entities, however, the use of some of the odontogenic immunohistochemistry markers can be a diagnostic aid. The aim of this study was to determine the expression of Cytokeratin 19 protein in biopsies processed during 2018 - 2020 of dentigerous cysts and follicular sacs from the Oral and Maxillofacial Pathology service of the School of Dentistry of the Universidad Nacional de Colombia. A case series study was carried out with 20 blocks with a previous histopathological diagnosis of dentigerous cyst. Hematoxylin and eosin staining was performed and later immunohistochemical labeling with Cytokeratin 19 was performed. The results obtained demonstrate the usefulness of cytokeratin as an immunomarker, particularly for the diagnosis of incipient lesions.como el quiste dentígero. Este quiste se origina por alteración del epitelio del órgano del esmalte después de la formación completa de la corona debido a la acumulación de líquido entre las capas del epitelio adamantino. Para el diagnóstico de estas entidades se utiliza la radiografía y el estudio histopatológico, sin embargo, la utilización de algunos de los marcadores de inmunohistoquímica odontogénicos pueden ser una ayuda diagnóstica. El objetivo de este estudio fue determinar la expresión de la proteína Citoqueratina 19 en las biopsias procesadas durante el 2018 - 2020 de quistes dentígeros y sacos foliculares del servicio de Patología Oral y maxilofacial de la Facultad de Odontología de la Universidad Nacional de Colombia. Se realizó un estudio de serie de casos, con 20 bloques con diagnóstico histopatológico previo de quiste dentígero, se realizaron coloraciones de hematoxilina y eosina y posteriormente se hicieron marcaciones inmunohistoquímicas con Citoqueratina 19. Se obtuvo una asociación positiva entre el diagnóstico y la intensidad de las células positivas al marcador (p= 0,0016). Los resultados obtenidos demuestran la utilidad de la citoqueratina como inmunomarcador particularmente para el diagnóstico de lesiones incipientes

Función sexual y conductas sexuales de riesgo en mujeres que usan cocaína

El consumo de sustancias psicoactivas es considerado un problema de salud pública que afecta diariamente a mujeres y hombres. Con el paso de los años el uso de cocaína en mujeres se ha venido incrementando y dado a sus efectos “potenciadores” en el desempeño sexual no es inusual su consumo dentro de las relaciones sexuales, donde las mujeres frecuentemente desarrollan más rapidamente Trastornos por Uso de Sustancias, disfunciones sexuales femeninas y comportamientos sexuales de riesgo, ubicándolas en una situación de vulnerabilidad importante. El objetivo de este trabajo fue revisar la literatura que relaciona el uso de cocaína y las implicaciones en la función sexual y en la conducta sexual de las mujeres. La búsqueda arrojó 2005 artículos que se ajustaban a los criterios de busqueda que relacionaban estas variables, de los cuales se seleccionaron 66 que cumplían con los criterios de inclusión y exclusión. Se encontró que la cocaína presenta efectos favorables y perjudiciales en el funcionamiento sexual de las mujeres, asimismo, una mayor probabilidad de verse involucradas en conductas sexuales de riesgo. Se discute sobre la necesidad de retomar la investigación y realizar evaluaciones e intervenciones integrales que abarquen el uso de drogas y la sexualidad de las mujeres.Use of psychoactive substances is considered a public health problem that affects men and women daily. Over the years the use of cocaine in women has been increasing and given to its “enhancing” effects on sexual performance is not unusual for use within sexual intercourse, where women often develop substance use disorders, female sexual dysfunctions and risky sexual behaviors more quickly, placing them in a situation of significant vulnerability. The aim of this work was to review the literature linking cocaine use and the implications on sexual function and sexual behavior of women. The search showed 2005 papers that matched the search criteria that related these variables, however 66 papers was selected. Cocaine was found to have favorable and detrimental effects on women’s sexual functioning, as well as a higher likelihood of being involved in risky sexual behaviors. Discussions are made on the need for greater appropriation since research and comprehensive assessments and interventions covering women’s drug use and sexuality

Guía de actuación farmacéutica en pacientes con esquizofrenia

Revisado por: Ramón Eduardo Lopera LoperaLa guía de actuación farmacéutica en pacientes con esquizofrenia pretende favorecer la vinculación y aportes del farmacéutico al grupo de atención integral al paciente con Esquizofrenia, con la finalidad de contribuir al uso efectivo y seguro a los medicamentos antipsicóticos y, con ello, al logro de los mejores resultados terapéuticos posibles. Se compilan a lo largo de estos cinco capítulos, conceptos teóricosy prácticos organizados de manera sencilla y gráfica para que, el profesional farmacéutico integre el equipo de atención ambulatoria u hospitalaria de los pacientes con enfermedades mentales, integre a su trabajo tanto elementos clínicos como terapéuticos que le permitan contribuir a la obtención de los mejores resultados posibles en la solución de este problema de salud, mediante la identificación, prevención y solución de los problemas de proceso y resultado de los medicamentos y, con ello, de los problemas de efectividad y seguridad de la farmacoterapia

Development of anatomic models through plastination techniques as an alternative to the use of animals in teaching and as an essential resource in the teaching-learning process

La implantación del principio de las 3Rs (Reducción, Refinamiento y Reemplazo), descritas por Russell y Burch en 1959, fue el punto de partida de numerosos cambios en la utilización de los animales, tanto en el ámbito de la investigación como de la docencia. Por tanto, es necesario ir propiciando el empleo de alternativas y que el profesorado disponga de recursos y de una buena información. Este proyecto se propone como objetivo esencial la elaboración de modelos animales mediante técnicas de plastinación como recurso docente alternativo al uso de animales vivos, y proporcionando al profesorado la disposición de medios y recursos esenciales en el proceso de enseñanza-aprendizaje del alumnado. Los alumnos podrán disponer de una variedad de modelos animales en las sesiones prácticas, y/o teórico/prácticas de las distintas disciplinas en las que sea necesario el uso de animales. Podrán trabajar con un modelo fiel al original sin necesidad de utilizar modelos vivos y podrán desarrollar las distintas técnicas y procedimientos que realizarían in vivo sin necesidad de generar un estrés innecesario a los animales por su manejo por personal aún no capacitado para ello, evitando situaciones que hagan peligrar el bienestar animal (RD 53/2003). El desarrollo de estos modelos plastinados supondrá recurso docente esencial para la adquisición de las habilidades específicas en distintas disciplinas Biomédicas que conlleven el uso de animales, tales como los Grados en Veterinaria, Biología, Medicina, Enfermería, etc.The implementation of the 3Rs principles (Reduction, Refinement and Replacement), described by Russell and Burch in 1959, was the starting point of numerous changes in the use of animals in the fields of research and teaching. Therefore, it is necessary to foster the use of alternative methods and provide teachers with resources and good information. This project aims to develop animal models through the application of plastination techniques as an alternative teaching resource to the use of animals. In this way, the project aims to provide teaching staff with tools and resources that are essential in the teaching-learning process. The students will be able to use a variety of animal models in practical and/or theoretical-practical sessions of the different subject areas, in which the use of animals is necessary. They will be able to work with animal models that are similar to the original, while avoiding the use of animals. Moreover, they will be able to learn and practice different techniques and procedures that they would carry out in vivo, without generating unnecessary stress to the animals caused by their management by untrained personnel. This approach is therefore in full conformity with existing animal welfare regulations (i.e. RD 53/2003). Plastinated models will become a an essential teaching resource for the acquisition of the specific skills in different Biomedical and Science disciplines that involve the use of animals, such as Veterinary Science, Biology, Environmental Sciences, Medicine, Nursing, etc

Escrituras de una incertidumbre colectiva

Esta antología literal estudiantil reúne los textos ganadores del concurso: Escrituras de una incertidumbre colectiva. El lector encontrará un contenido variado, creativo, equilibrado en los géneros de poesía, cuento microcuento, crónica y diccionario. Toda esa valiosa creación joven tiene un eje central común: fue escrita en el duro contexto del aislamiento social obligatorio y preventivo por la crisis sanitaria de la pandemia.Esta antología literal estudiantil reúne los textos ganadores del concurso: Escrituras de una incertidumbre colectiva. El lector encontrará un contenido variado, creativo, equilibrado en los géneros de poesía, cuento microcuento, crónica y diccionario. Toda esa valiosa creación joven tiene un eje central común: fue escrita en el duro contexto del aislamiento social obligatorio y preventivo por la crisis sanitaria de la pandemia

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

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