Mecanismos de acción de los inhibidores de cotransportador de sodio y glucosa tipo 2 —SGLT2—: Más allá del control de la glicemia

Type 2 Sodium-Glucose Cotransporter (SGLT2) Inhibitors exercise their glucose-lowering effect through the inhibition of glucose reabsorption in the kidney. However, the cardiovascular and renal effects, as well as in those of cardiac failure, seem to occur independently from the glucose–lowering effects of these drugs. The principal mechanisms of action that explain their cardiovascular benefits are the hypotensive effect and the decrease in fill pressures, as well as direct effects on the metabolism of the myocardial cell. There is also a reduction in the urine albumin, as well as non-glycaemic effects, and a decrease in adipose tissue, with an increase in haematocrit and urine uric acid. Each one of these novel mechanisms is described in this article. © 201

Caracterización clínica y demográfica de pacientes adultos sometidos a valoración de la presión arterial con monitorización ambulatoria de la presión arterial. Registro EPEDMAPA

Introduction: Arterial hypertension is a public health problem that increases mortality in all clinical situations. It is also the main modifiable risk factor. It is a highly prevalent condition that is suffered by around 25% of the world population. Few patients are aware of it, and few receive the optimum treatment. Objective: To evaluate the characteristics of the patients on whom ambulatory blood pressure monitoring was carried out in a University Hospital, with a view to describing the clinical and demographic profile. Methods: A descriptive retrospective study was conducted on patients subjected to 24-hour ambulatory blood pressure monitoring, during the months of October and December 2015. Results: Hypertension (recently diagnosed or known) was confirmed in 75% of the studies performed. Arterial hypertension was ruled out in 31% of the patients previously classified as hypertensive. Of the patients that were receiving treatment, 61% were well-controlled, with the majority of them with a single drug, mainly an angiotensin II receptor agonist. The dipper was most prevalent circadian pattern, with 48%, followed by the non-dipper pattern in 29%. Conclusions: Ambulatory blood pressure monitoring helps in the evaluation of the blood pressure status accurately in patients with a suspicion of arterial hypertension. This clarifies whether the patients are really normotensive or hypertensive and discriminates between the “white coat” and masked hypertension conditions. This avoids unnecessary treatments and favours a better control of the blood pressure. © 201

COVID-19 and cardiovascular disease

En diciembre de 2019, en Wuhan, provincia de Hubei en China, se reportó un grupo de 27 pacientes con neumonía de etiología desconocida, vinculados con exposición al mercado de mariscos, pescado y animales vivos. El 7 de enero de 2020, se identificó una nueva sepa de coronavirus aislada en estos pacientes (SARS-CoV-2); la enfermedad producida por este virus ha sido denominada COVID-19. Durante las etapas iniciales de la pandemia y dados los pocos estudios publicados al respecto, se creía que este coronavirus causaba síntomas netamente respiratorios; sin embargo, a medida que el número de pacientes aumentó, se observó que la enfermedad cardiovascular tenía un papel fundamental en el desarrollo y pronóstico de la infección. Los factores de riesgo más importantes relacionados con mortalidad son la edad y la presencia de comorbilidades, especialmente de tipo cardiovascular. El incremento en niveles de troponina, péptidos natriuréticos y dímero-D tiene valor pronóstico en pacientes con infección por SARS-CoV-2. Los pacientes con COVID-19 tienen un aumento en el riesgo de infarto agudo del miocardio, miocarditis, insuficiencia cardiaca, choque, arritmias y muerte súbita, en relación con la respuesta sistémica al virus y a los tratamientos necesarios en la fase aguda. En este documento se revisa el compromiso cardiovascular por SARS-CoV-2 (COVID-19).In December 2019, in Wuhan in the province of Hubei in China, there was a report on a group of 27 patients with a pneumonia of unknown origin, linked to exposure in a market with shellfish, fish, and live animals. In January 2020, a new strain of coronavirus (SARS-CoV-2) was isolated in these patients. The disease caused by this virus has been given the name of COVID-19. During the initial stages of the pandemic, and given the scarcity of studies published about this, it was believed that this coronavirus only caused respiratory symptoms. However, as the number of patients increased, it was observed that cardiovascular disease had a fundamental role in the development and prognosis of the infection. The most important risk factors associated with mortality are age and the presence of comorbidities, particularly cardiovascular ones. The increase in the levels of troponin, natriuretic peptides, and D-dimer are of prognostic values in patients with an infection due to SARS-CoV-2. Patients with COVID-19 have an increased risk of acute myocardial infarction, myocarditis, heart failure, shock, arrhythmias, and sudden death, in relation to the systematic response to the virus and to the treatments needed in the acute phase. A review is presented in this article of the cardiovascular involvement due to SARS-CoV-2 (COVID-19)

Clinical Characteristics and Outcomes of Patients with Heart Failure of Hypertensive Etiology: Analysis of Colombian Heart Failure Registry (RECOLFACA)

Introduction: Arterial hypertension represents one of the main comorbidities observed in patients with heart failure (HF) and one of the main risk factors for its development. Despite this, studies assessing this hypertensive etiology are scarce in Latin America. Our objective was to analyze the prevalence of HF of hypertensive etiology and evaluate its prognosis in patients enrolled in the Colombian Heart Failure Registry (RECOLFACA by its Spanish acronym). Methods: RECOLFACA recruited adult patients diagnosed with HF in 60 centers in Colombia between 2017 and 2019. The primary outcome was all-cause mortality. A Cox proportional hazards regression model was used to assess factors associated with primary outcomes in patients with hypertensive HF. A p value <0.05 was considered significant. All statistical tests were two-tailed. Results: Out of the total number of patients evaluated in RECOLFACA (n = 2,514), 804 had a diagnosis of HF with hypertensive etiology (31.9%). These patients were less frequently males and had a significantly older age and lower prevalence of comorbidities than those with HF of other etiologies. Additionally, patients with hypertensive HF had a higher prevalence of HF with preserved ejection fraction (HFpEF) (34.1% vs. 28.3%; p = 0.004). Finally, type 2 diabetes mellitus, chronic obstructive pulmonary disease diagnosis, and NYHA class IV were classified as independent mortality risk factors. Conclusions: Hypertensive HF represents about one-third of the total number of patients with HF in RECOLFACA. Compared with HF of other etiologies, it presents a differential clinical profile – older age and a higher prevalence of HFpEF. RECOLFACA has become a useful tool to characterize patients with HF in Colombia, with which it has been possible to carry out a more specific search and reach the diagnosis of this pathology in our population, and it has served as an example to stimulate registries of patients with HF in other countries in the region

Mecanismos de acción de los inhibidores de cotransportador de sodio y glucosa tipo 2 —SGLT2—: Más allá del control de la glicemia

Type 2 Sodium-Glucose Cotransporter (SGLT2) Inhibitors exercise their glucose-lowering effect through the inhibition of glucose reabsorption in the kidney. However, the cardiovascular and renal effects, as well as in those of cardiac failure, seem to occur independently from the glucose–lowering effects of these drugs. The principal mechanisms of action that explain their cardiovascular benefits are the hypotensive effect and the decrease in fill pressures, as well as direct effects on the metabolism of the myocardial cell. There is also a reduction in the urine albumin, as well as non-glycaemic effects, and a decrease in adipose tissue, with an increase in haematocrit and urine uric acid. Each one of these novel mechanisms is described in this article. © 201

Caracterización del comportamiento emprendedor para los estudiantes de administración de la universidad del rosario proyecto de investigación

El emprendimiento como campo de estudio ha cobrado una creciente relevancia en las agendas académicas y gubernamentales del último quinquenio por su capacidad para empujar el desarrollo económico y los procesos de innovación en los países. Un ejemplo de ello es Colombia, donde el nivel de impacto ha sido tan elevado que se han formalizado desde marcos regulatorios como la ley 1014 del 2006 para el fomento a la cultura empresarial, hasta instituciones de todo tipo para el fomento al emprendimiento empresarial. No obstante, los esfuerzos por estructurar espacios para estimular el emprendimiento deben trascender más allá del simple asistencialismo, para centrarse en la definición de planes estratégicos que permitan la formación de emprendedores de una manera articula y congruente con objetivos y políticas claramente identificadas. Por tal razón, desde el centro de emprendimiento de la Universidad de Rosario se impulsó el desarrollo de un estudio que permitiese la caracterización del perfil emprendedor de los estudiantes, a fin de identificar sus fortalezas y debilidades. Este estudio toma como base la metodología de características del comportamiento emprendedor o CCE para estudiar los alumnos de pregrado de la Facultad de Administración en cada uno de sus tres programas. Al final con estos resultados el Centro Emprendimiento podrá formular cada uno de sus planes, programas y proyectos, así como también políticas asociadas al desarrollo de las cualidades necesarias para formar mejores emprendedores (Pulgarín, S. 2011).Universidad del RosarioEntrepreneurship as a field of study has gained a significant role in the academic and government agendas stated at a five- year term as it consolidates economic development and innovation processes in different countries. One example of this is Colombia, in which the impact has been obvious to get regulatory formal frameworks as 1014 of 2006 Law to foment an entrepreneurial culture, as well as institutions for the development of entrepreneurship. However, all efforts to have spaces to stimulate this aspect should go further the design of strategic planning that allows the formation of entrepreneurs based on articulated aims and policies clearly identified. For this reason, in the entrepreneurship department of Universidad del Rosario a study was made which set up the characterization of the entrepreneur profile of students to identify weaknesses and strengths. This study used the methodology based on the characteristics of entrepreneur behavior to make the study involving Business Administration students in each of the three academic programs. Finally, considering the results of this study, this department can design its programs and projects as well as all the policies to develop the necessary qualities to form better entrepreneurs (Pulgarín, S. 2011)

Caracterización clínica y demográfica de pacientes adultos sometidos a valoración de la presión arterial con monitorización ambulatoria de la presión arterial. Registro EPEDMAPA

"Introduction: Arterial hypertension is a public health problem that increases mortality in all clinical situations. It is also the main modifiable risk factor. It is a highly prevalent condition that is suffered by around 25% of the world population. Few patients are aware of it, and few receive the optimum treatment. Objective: To evaluate the characteristics of the patients on whom ambulatory blood pressure monitoring was carried out in a University Hospital, with a view to describing the clinical and demographic profile. Methods: A descriptive retrospective study was conducted on patients subjected to 24-hour ambulatory blood pressure monitoring, during the months of October and December 2015. Results: Hypertension (recently diagnosed or known) was confirmed in 75% of the studies performed. Arterial hypertension was ruled out in 31% of the patients previously classified as hypertensive. Of the patients that were receiving treatment, 61% were well-controlled, with the majority of them with a single drug, mainly an angiotensin II receptor agonist. The dipper was most prevalent circadian pattern, with 48%, followed by the non-dipper pattern in 29%. Conclusions: Ambulatory blood pressure monitoring helps in the evaluation of the blood pressure status accurately in patients with a suspicion of arterial hypertension. This clarifies whether the patients are really normotensive or hypertensive and discriminates between the “white coat” and masked hypertension conditions. This avoids unnecessary treatments and favours a better control of the blood pressure. © 2019

Complicaciones del uso del angioseal vs compresión manual en cateterismo cardíaco mediante punción femoral

Objetivo: Comparar las complicaciones del uso de Angioseal® versus compresión manual en los pacientes llevados a cateterismo cardíaco en el Servicio de Hemodinamia de la Fundación Santa Fe de Bogotá, del 1º de enero de 2005 al 31 de diciembre de 2010, mediante punción arterial femoral percutánea. Metodología: Se realizó un Estudio Observacional, Analítico, de tipo Cohorte Retrospectiva. Partiendo de dos grupos de personas con indicación de cateterismo cardíaco por cualquier causa, uno expuesto al procedimiento con Angioseal® y el otro con compresión manual. Resultados: Con el uso de Angioseal® versus compresión manual la aparición de complicaciones fue 7,3% vs 4,1%, estas diferencias no fueron significativas (OR 1,81 IC95 0,96-3,40; RR 1,75 IC95 0,96-3,18) . La enfermedad coronaria (OR 2,27 IC95 1,07-4,79; RR 2,18 IC95 1,06-4,46) y a la colocación de stent (OR 3,49 IC95 1,82-6,69; RR 3,25 IC95 1,75-6,02 si se relacionaron significativamente con la aparición de complicaciones menores. Conclusión: No encontramos soporte para aprobar o desaprobar el uso de Angioseal® o compresión manual como manejo de la hemostasia, con respecto a las complicaciones. Sin embargo, se encontró que la colocación de stents está fuertemente relacionada con el desarrollo de complicaciones menores, lo cual hace que estos pacientes deban ser objeto de monitorización estrecha.Objective: To compare the complications of using Angioseal ® versus manual compression in patients undergoing cardiac catheterization at the Service Hemodynamics of the Fundación Santa Fe de Bogotá, from 1 January 2005 to 31 December 2010, by femoral artery puncture percutaneously. Methodology: An observational, analytical, retrospective cohort study. Based on two groups of people with cardiac catheterization indication for any reason, one exposed to Angioseal ® procedure and the other with manual compression. Results: With the use of manual compression Angioseal ® versus the occurrence of complications was 7.3% vs 4.1%, these differences were not significant (OR 1.81 CI95 0.96 to 3.40, RR 1.75 CI95 0.96 to 3.18). Coronary heart disease (OR 2.27 CI95 1.07 to 4.79, RR 2.18 CI95 1.06 to 4.46) and stent placement (OR 3.49 CI95 1.82 to 6.69, RR CI95 3.25 1.75 to 6.02 were significantly associated with occurrence of minor complications. CONCLUSION: We found no support to approve or disapprove the use of Angioseal ® or manual compression as hemostasis management, respect to complications . However, we found that the stent is strongly related to the development of minor complications, which makes that these patients must be closely monitored

Tools for the monitoring, user characterization, and their applications to the public integrated transport system due to the COVID 19 disease effects: A case study in Bogotá, TransMilenio company

Trabajo presentado en: R-Evolucionando el transporte, XIV Congreso de Ingeniería del Transporte (CIT 2021), realizado en modalidad online los días 6, 7 y 8 de julio de 2021, organizado por la Universidad de BurgosThe pandemic made the transport system administration switch the way decisions were made in topics such as the response speed, resilience to shifts in the demand, and the new policy needs. Therefore, public transport requires monitoring tools, such as dashboards, and an emphasis in user characterization, in addition to traditional modeling and supply-demand indicators historically used by TransMilenio in order to command the operation of the public transport system of Bogotá D.C. This study employed descriptive spatial and statistical analysis to comprehend the relations among the registers of contagion waves, user polls and the boarding information on SITP. Complementarily, the article shows the shifts in the demand towards the regulatory milestones for the pandemic, and how short-term changes in bus supply were made due to these set of regulations. The paper also provides a recap of the international discussion about the occupation, efficiency, and biosecurity of massive public transport systems. The main results for TransMilenio were some supply changes, among others