De curandis hominum morbis : an 18th century prescription for stroke management by volatile alkali in the new Kingdom of Granada

boticarios, barberos, médicos y protomédicos, es consecuencia de la experiencia de individuos anónimos de las poblaciones locales, que fueron capaces de percibir directamente en la naturaleza elementos útiles a la terapia, así como de la existencia de principios activos no validados, o bien de efectos placebo. Objetivo: Presentar y analizar desde la perspectiva de la medicina moderna, una receta médica del siglo XVIII en el Nuevo Reino de Granada, en la cual se prescribe el álkali volátil para disminuir síntomas generados por afecciones del sistema musculoesquelético. Desarrollo: En el periodo Colonial, pese a la carencia de estudios o evidencia que respaldara, se utilizaban términos como fármacos, con una dosificación establecida e indicaciones. Se presenta y analiza a la luz de la medicina moderna una receta mÈdica del siglo XVIII para el tratamiento de la apoplexia con efectos benéficos al aumentar el flujo sanguÌneo al cerebro y la disponibilidad de oxÌgeno asÌ mismo aumentando el metabolismo neuronal. El amoníaco puede inducir hiperexcitabilidad neuronal, bloqueo de la actividad de la glutaminasa, reducir la descomposición de glutamina en glutamato y amonÌaco en las terminaciones nerviosas, sin embargo, dosis elevadas podrÌan llegar a producir muerte celular o fallo respiratorio. Conclusiones: El advenimiento de nuevas tecnologías ha permitido avances en el diagnóstico, prevención y tratamiento de múltiples enfermedades. En este contexto, los tratamientos del pasado se han visto relegados a curiosidades históricas. El legado terapéutico colonial conservado en los archivos locales permite viajar al pasado para intentar comprender racionalmente los medicamentos de nuestros predecesores. Existe evidencia cientÌfica que respalda la efectividad del alkali volátil para diversas enfermedades, entre estas la apoplejía. No obstante, una descripción vaga o ausente de la posología, signos, síntomas y comorbilidades, dificulta analizar la eficacia de este tratamiento histórico.The use of medicinal plants and mineral resources in the New Kingdom of Granada in colonial times by apothecaries, barbers, doctors and protomedics, is a consequence of the experience of anonymous individuals from the local populations, who were able to perceive directly in nature elements useful to the therapy, as well as the existence of non-validated active principles, or even placebo effects. Objective: To present and analyze from the perspective of modern medicine, a medical prescription from the 18th century in the New Kingdom of Granada. In which volatile alkali is prescribed to reduce symptoms generated by conditions of the musculoskeletal system. AIM: In the Colonial period, despite the lack of studies or evidence to support, terms were used as drugs, with an established dosage and indications. An 18th century medical prescription for the treatment of stroke is presented and analyzed in the light of modern medicine beneficial effects by increasing blood flow to the brain and the availability of oxygen also increasing neuronal metabolism. Ammonia can induce neuronal hyperexcitability, block glutaminase activity, reduce glutamine breakdown in glutamate and ammonia in nerve endings, however, high doses could lead to cell death or respiratory failure. Conclusions: The advent of new technologies has enabled advances in the diagnosis, prevention and treatment of multiple diseases. In this context, past treatments have been relegated to historical curiosities. The colonial therapeutic legacy preserved in the local archives allows us to travel to the past and try to rationally understand the medicines of our predecessors. There is scientific evidence supporting the effectiveness of volatile alkali for various diseases, including stroke. However, a vague or even absent description of dosage, signs, symptoms and comorbidities, makes it difficult to analyze the effectiveness of this historical treatment.N/

Clinical Audits in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Workflow

Objectives: Previous clinical audits for chronic obstructive pulmonary disease (COPD) have provided valuable information on the clinical care delivered to patients admitted to medical wards because of COPD exacerbations. However, clinical audits of COPD in an outpatient setting are scarce and no methodological guidelines are currently available. Based on our previous experience, herein we describe a clinical audit for COPD patients in specialized outpatient clinics with the overall goal of establishing a potential methodological workflow.Methods: A pilot clinical audit of COPD patients referred to respiratory outpatient clinics in the region of Andalusia, Spain (over 8 million inhabitants), was performed. The audit took place between October 2013 and September 2014, and 10 centers (20% of all public hospitals) were invited to participate. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The usefulness of formally scheduled regular follow-up visits was assessed. Two different databases (resources and clinical database) were constructed. Assessments were planned over a year divided by 4 three-month periods, with the goal of determining seasonal-related changes. Exacerbations and survival served as the main endpoints.Conclusions: This paper describes a methodological framework for conducting a clinical audit of COPD patients in an outpatient setting. Results from such audits can guide health information systems development and implementation in real-world settings.This study was financially supported by an unrestricted grant from Laboratorios Menarini, SA (Barcelona, Spain)

Comunicación educación un campo de resistencias

El presente libro obedece a la imperiosa necesidad de desplegar la potencia de la Facultad de Ciencias de la Comunicación en la Corporación Universitaria Minuto de Dios -UNIMINUTO, de otras comunidades académicas y de los espacios de movimiento social interesados en deconstruir los discursos de comunicación y educación desde la perspectiva del pensamiento crítico. En este caso entendemos potencia como la fuerza individual y colectiva capaz de rebasar la racionalidad dominante en la sociedad contemporánea, colonizada por la economía como única mirada del mundo; esto es, potencia como ímpetu insospechado por el poder. Por otra parte, el libro tiene como eje articulador el concepto de resistencia, definido este como el acto de recrear la realidad a partir de las posibilidades que ofrece la comunicación, para generar producción de sentido y dinamizar el cambio social. Propone realizar el ejercicio de concebir el mundo desde una perspectiva diferente a la hegemónica y de crear multiplicidades que trabajen unidas, reconociendo sus diferencias pero vinculándose en un “lugar común” del cual, cada una de ellas, regrese a su lugar cotidiano transformada por la acción colectiva del campo de Comunicación - Educación

Comunicación educación un campo de resistencias

El presente libro obedece a la imperiosa necesidad de desplegar la potencia de la Facultad de Ciencias de la Comunicación en la Corporación Universitaria Minuto de Dios -UNIMINUTO, de otras comunidades académicas y de los espacios de movimiento social interesados en deconstruir los discursos de comunicación y educación desde la perspectiva del pensamiento crítico. En este caso entendemos potencia como la fuerza individual y colectiva capaz de rebasar la racionalidad dominante en la sociedad contemporánea, colonizada por la economía como única mirada del mundo; esto es, potencia como ímpetu insospechado por el poder. Por otra parte, el libro tiene como eje articulador el concepto de resistencia, definido este como el acto de recrear la realidad a partir de las posibilidades que ofrece la comunicación, para generar producción de sentido y dinamizar el cambio social. Propone realizar el ejercicio de concebir el mundo desde una perspectiva diferente a la hegemónica y de crear multiplicidades que trabajen unidas, reconociendo sus diferencias pero vinculándose en un “lugar común” del cual, cada una de ellas, regrese a su lugar cotidiano transformada por la acción colectiva del campo de Comunicación - Educación

GA4GH: International policies and standards for data sharing across genomic research and healthcare.

The Global Alliance for Genomics and Health (GA4GH) aims to accelerate biomedical advances by enabling the responsible sharing of clinical and genomic data through both harmonized data aggregation and federated approaches. The decreasing cost of genomic sequencing (along with other genome-wide molecular assays) and increasing evidence of its clinical utility will soon drive the generation of sequence data from tens of millions of humans, with increasing levels of diversity. In this perspective, we present the GA4GH strategies for addressing the major challenges of this data revolution. We describe the GA4GH organization, which is fueled by the development efforts of eight Work Streams and informed by the needs of 24 Driver Projects and other key stakeholders. We present the GA4GH suite of secure, interoperable technical standards and policy frameworks and review the current status of standards, their relevance to key domains of research and clinical care, and future plans of GA4GH. Broad international participation in building, adopting, and deploying GA4GH standards and frameworks will catalyze an unprecedented effort in data sharing that will be critical to advancing genomic medicine and ensuring that all populations can access its benefits

World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

BACKGROUND: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. METHODS: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. FINDINGS: Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629-0·741) to 0·833 (0·783-0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. INTERPRETATION: We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. FUNDING: World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Educación ambiental y sociedad. Saberes locales para el desarrollo y la sustentabilidad

EL LIBRO PERMITE REFLEXIONAR SOBRE LA IMPORTANCIA DE FOMENTAL LA EDUCACIÓN AMBIENTAL PARA RESOLVER LA PROBLEMÁTICA AMBIENTALEL LIBRO PRESENTA DIFERENTES TRABAJOS QUE ESTUDIAN EL TEMA D ELA SUSTENTABILIDAD, ENFATIZANDO LA IMPORTANCIA DE LA EDUCACIÓN AMBIENTAL Y LA TRANSDISCIPLINANINGUN

Trastorno de estrés postraumático en una cohorte de militares con trauma de guerra

14 páginasIntroduction: People who are part of the armed forces worldwide have been susceptible to the development of post-traumatic stress disorder, due to exposure to conditions that predispose its development. Objective: To establish the frequency and possible associated risk factors of post-traumatic stress disorder in subjects with chest injuries, suffered in combat. Methods: Comparative study between subjects with chest trauma suffered in combat and military without thoracic injury with experience in combat, by evaluating a 24-question diagnostic questionnaire, validated for Colombia, of post-traumatic stress disorder. Military population older than 18 years and younger than 55 years, with chest trauma who underwent medical or surgical management (thoracotomy or laparotomy) were included. Results: 45 subjects entered the study, 25 with a history of chest trauma and 20 healthy with combat experience. Of the trauma subjects, 25 were evaluated at 3 months and 11 at 5 months. In the subjects wounded in combat, the average age was 24,1 years (SD: 4,99). At the 3-month evaluation, 36 % (p = 0,025) of the subjects with a history of chest trauma met the diagnostic criteria for post-traumatic stress disorder, which shows an increase of 9,5 % at the 6-month follow-up. Conclusion: There is a higher frequency of post-traumatic stress disorder in subjects exposed to traumatic chest events in areas of armed conflict. Young age and low educational levels could be factors associated with the appearance of the disorder.Introducción: Las personas que forman parte de las fuerzas armadas a nivel mundial han sido susceptibles al desarrollo del trastorno de estrés postraumático, debido a la exposición a condiciones que predisponen su desarrollo. Objetivo: Establecer la frecuencia y posibles factores de riesgo asociados del trastorno de estrés postraumático en sujetos con lesiones en tórax, sufridas en combate. Métodos: Estudio comparativo entre sujetos con trauma de tórax sufrido en combate y militares sin lesión torácica con experiencia en combate, mediante la evaluación de un cuestionario diagnóstico de 24 preguntas, validado para Colombia del trastorno de estrés postraumático. Se incluyó población militar de mayores de 18 años y menores de 55 años, con trauma de tórax que tuvieron manejo médico o quirúrgico (toracotomía o laparotomía). Resultados: Ingresaron al estudio 45 sujetos, 25 con antecedente de trauma de tórax y 20 sanos con experiencia en combate. De los sujetos con trauma, 25 se evaluaron a los 3 meses y 11 a los 5 meses. En los sujetos heridos en combate el promedio de edad fue de 24,1 años (DE: 4,99). A los 3 meses de valoración, el 36 % (p= 0,025) de los sujetos con antecedente de trauma de tórax cumplían criterios diagnósticos de trastorno de estrés postraumático, lo cual evidencia un aumento del 9,5 % a los 6 meses de seguimiento. Conclusión: Existe mayor frecuencia del trastorno de estrés postraumático en sujetos expuestos a eventos traumáticos de tórax en áreas de conflictos armados. La corta edad y los bajos niveles educativos podrían ser factores asociados a la aparición del trastorno