El verdadero significado del protagonismo de la participación ciudadana en la gestión pública

Este ensayo contiene un esbozo de algunos elementos y características fundamentales de la participación ciudadana, protagónica y responsable de los ciudadanos y ciudadanas en los asuntos del sector público. La nueva Constitución Bolivariana y las reformas en el cuerpo de leyes relativas a la participación protagónica del pueblo y a la gestión pública, conducen a una permanente revisión y adecuación en ambos sentidos. Estas realidades han propiciado la aparición de nuevos escenarios políticos, y condiciones socio-culturales que obligan a reformular la tríada Gobierno-Estado-Sociedad, que viabilice la participación ciudadana, como eje central de la democracia participativa y la gobernabilidad.This essay presents an outline of some elements and fundamental characteristics of the active and responsible participation of citizens in public affairs. The new Bolivarian Constitution and the reforms in the set of laws concerning people`s protagonist participation and public management conduce to a permanent revision and adaptation in both directions. These factors have led to the emergence of new political scenarios and socio-cultural conditions that oblige to reformulate the Government-State-Society relation so as to facilitate citizen partaking, as the central axis of participatory democracy and good governance. Awareness of the real meaning of people`s power has been taken yet

Tuberculosis: A Challenge for All

La tuberculosis (TB) es una enfermedad conocida desde la antigüedad. A nivel mundial, 10.0 millones de personas  desarrollaron la enfermedad en 2017 y  se registraron 1.3 millones de muertes. Según la Organización  Mundial de la Salud (OMS) en 22 países se registró el 87% de los casos del mundo. En Argentina se registró en 2016 una tasa de 26,5 por 100.000 habitantes, en Chile para el mismo año de 14 por 100.000 habitantes, mientras que en Perú para el 2017 se registraron 87,6 casos nuevos de TB por cada 100 mil habitantes, En Brasil para el 2015, se reportaron 84.000 nuevos casos de TB, mientras que en Colombia, para el año 2016 una tasa de incidencia de 32 por cien mil habitantes, para el año 2017 según el Reporte Global de Tuberculosis 2018 Venezuela queda ubicada en el rango de los países entre 25 y 99 casos por 100.000 habitantes. Tuberculosis (TB) is a disease known since ancient times. In the world, 10.0 million people developed the disease in 2017 and 1.3 million deaths were recorded. According to the World Health Organization (WHO) in 22 countries, 87% of global cases were registered. In Argentina, there was a rate of 26.5 per 100,000 inhabitants in 2016, in Chile for the same year of 14 per 100,000 inhabitants, while in Peru for 2017 there were 87.6 new cases of TB per 100 thousand inhabitants, in Brazil for 2015, 84,000 new cases of TB were reported, while in Colombia, for 2016, an incidence rate of 32 per hundred thousand inhabitants, for the year 2017 according to the World TB Report 2018, Venezuela is in the range of countries between 25 and 99 cases per 100,000 inhabitants

Clinical tolerance of processed foods

Objective: To review the effects of technological processing on selected foods of relevance to childhood allergy from the viewpoints of reduced allergenicity, contamination of processed foods by allergens introduced during processing, and ad hoc technologies to produce reduced hypoallergenic products. Data Sources: We searched the literature (PubMed/MEDLINE) for articles published between January 1994 and April 2004 using the following keywords: food allergy AND process* OR heat* OR cooking OR toleran*. Study Selection: We drew on our collective clinical and biological experience to restrict retrieved studies to those of more frequent relevance to a hospital allergy practice. Results: Comparatively few clinical studies address the modification of allergenicity of food through cooking or processing. Dairy foods are largely unaffected by processing and may be contaminated by, or themselves become, hidden allergens. Hypoallergenic formulas based on milk, soy, or rice and homogenized beef are successful applications of allergenicity reduction via technological processing. Egg, fish, condiments, and vegetables all carry heat-resistant allergens and should also be considered contaminants. Cereals and bakery products are generally well tolerated, but their allergenicity may be enhanced by processing; the case of rice is still open. Peanut allergens are stable, and the evidence is scant that thermal processing affects the allergenicity of soybean and soy hydrolysates. The debate is ongoing about the tolerance of vegetable oils. Conclusions: It is too early to systematize clinical studies based on single procedures. Processing affects antigenicity, but this does not always translate into safety recommendations. Industrial processing is liable to contamination, and monitoring and labeling are industry priorities. Clinicians should evaluate foods by as complete a workup as possible before recommending processed foods

Incremental prognostic factors associated with cow's milk allergy outcomes in infant and child referrals : the Milan Cow's Milk Allergy Cohort study

Background: The prognosis for many children with cow's milk allergy (CMA) is remission within 3 years, and the clinical parameters that predict duration of disease have not been measured incrementally. Objective: To prospectively determine prognostic predictors of tolerance in a random cohort of referrals using CMA workup outcomes as covariates and tolerance as the status variable in a duration model of CMA. Methods: The 2001-2006 Milan Cow's Milk Allergy Cohort (MiCMAC) enrolled children referrals using double-blind, placebo-controlled food challenges (DBPCFCs) as study end points (confirmation of CMA; onset of tolerance). The Cox regression model was used to analyze all clinical factors that contributed to tolerance. Covariates analyzed were skin, gastrointestinal, and respiratory symptoms; history and demographics at presentation; age at diagnosis and DBPCFC outcomes; sensitization (skin and serum) by cow's milk protein fractions; sensitization to other food and inhalant allergens; total IgE levels; specific IgE concentrations for cow's milk protein fractions, other ingestants, and aeroallergens; and threshold doses at DBPCFC. Sensitization and DBPCFC were performed at 6-month intervals. Results: A total of 112 infants were enrolled (mean [SD] age, 13.85 [9.84] months), and 59 achieved tolerance (mean [SD] age when tolerance was achieved, 27.58 [11.81] months). On univariate analysis, asthma and/or rhinitis at presentation was an independent predictor of persistence (hazard ratio [HR], 2.19; 95% confidence interval [CI], 1.26-3.82). On multivariate analysis, predictors of persistence were a fresh milk wheal diameter increment of 1 mm (HR, 1.18; 95% CI, 1.07-1.31) and a positive skin prick test result with soy (HR, 6.99; 95% CI, 1.56-31.25). Conclusions: This is the first study, to our knowledge, to identify incremental biological predictors of delayed tolerance to cow's milk in children that should be integrated into DBPCFC schedules for CMA in infants