294 research outputs found

    Clinical and etiological characterization of a sam-ple of children and adults with dysphagia treated in two healthcare centers in Medellín/Colombia: a retrospective study

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    Introduction: Dysphagia is a frequent disorder throughout the life cycle, which has different etiolo-gies in relation to its clinical type in oropharyngeal or esophageal.Objective: Clinical and etiological characterization of a sample with dysphagia attended in two health care centers in the city of Medellín (Colombia), showing the etiology and clinical type of dysphagia according to age groups. Methods: Observational, descriptive, and retrospective study, through the review and analysis of and clinical records of patients with a diagnosis of dysphagia, treated between 2012 and 2018 in a university hospital and a speech therapy center in swallowing. Results: Sample of 527 patients. Distributed in tho-se under 18 years 45.4% (239/527); 18 to 59: 20.1% (106/527) and over 60: 34.5% (182/527). Clinical type, etiology, and most frequent health condition in the entire sample: oropharyngeal dysphagia, functional etiology, and neurological diseases. The most frequent conditions causing dysphagia in children under 18 years of age were childhood development disorders; group 18 to 59 years, cancer and, in those over 60 years of age, neurodegenerative processes. Conclusion: Oropharyngeal dysphagia due to functional etiology is common throughout the life cycle, and neurological diseases seem to largely explain its pathophysiology. In older adults it is associated with neurodegenerative disorders, and in those under 60 years of age (including children) the etiology is diverse. Its causes and clinical characteristics must be considered for promotion, diagnosis, treatment, and rehabilitation processes

    University Issues. Year 3. Number 3. Journal of the Center for Research in Social Sciences and Arts

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    Las opiniones contenidas en los artíuclos de esta revista no vinvulan la institución sono que son exclusiva responsabilidad de los autores, dentro de los principios demacráticos de cátedar libre y libertad de expresión, consagrados en el artículo 3° Estatuto Genral de la Corporación Autónoma de Bucaramanga.Presentación. - 5 Investigación científica y tecnológica. - 8 Reflexión derivada de la investigación. -50 Anaquel. -120 Anexos. -122The opinions contained in the articles of this journal do not vindicate the institution but are the sole responsibility of the authors, within the democratic principles of free cattery and freedom of expression, enshrined in Article 3 General Statute of the Autonomous Corporation of Bucaramanga

    Impact of Arterial Stiffness on All-Cause Mortality in Patients Hospitalized With COVID-19 in Spain

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    Older age and cardiovascular comorbidities are well-known risk factors for all-cause mortality in patients with coronavirus disease 2019 (COVID-19). Hypertension and age are the 2 principal determinants of arterial stiffness (AS). This study aimed to estimate AS in patients with COVID-19 requiring hospitalization and analyze its association with all-cause in-hospital mortality. This observational, retrospective, multicenter cohort study analyzed 12 170 patients admitted to 150 Spanish centers included in the SEMI-COVID-19 Network. We compared AS, defined as pulse pressure ≥60 mm Hg, and clinical characteristics between survivors and nonsurvivors. Mean age was 67.5 (±16.1) years and 42.5% were women. Overall, 2606 (21.4%) subjects died. Admission systolic blood pressure (BP) <120 and ≥140 mm Hg was a predictor of higher all-cause mortality (23.5% and 22.8%, respectively, P<0.001), compared with systolic BP between 120 and 140 mm Hg (18.6%). The 4379 patients with AS (36.0%) were older and had higher systolic and lower diastolic BP. Multivariate analysis showed that AS and systolic BP <120 mm Hg significantly and independently predicted all-cause in-hospital mortality (adjusted odds ratio [ORadj]: 1.27, P=0.0001; ORadj: 1.48, P=0.0001, respectively) after adjusting for sex (males, ORadj: 1.6, P=0.0001), age tertiles (second and third tertiles, ORadj: 2.0 and 4.7, P=0.0001), Charlson Comorbidity Index (second and third tertiles, ORadj: 4.8 and 8.6, P=0.0001), heart failure, and previous and in-hospital antihypertensive treatment. Our data show that AS and admission systolic BP <120 mm Hg had independent prognostic value for all-cause mortality in patients with COVID-19 requiring hospitalization

    Resultados Semilleros de Investigación 2009-2010

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    La publicación recoge los doce informes finales de investigación presentados por los estudiantes de ocho Semilleros 1 y cuatro Semilleros 2, correspondientes a la convocatoria 2009–2010 y se constituye en el Número 25 de la Serie de Investigaciones en Construcción, si bien este es el primer Número publicado en formato digital que UNIJUS se permite poner a disposición no sólo de la comunidad universitaria, sino también de la sociedad colombiana e internacional, interesada en los temas estudiados por los jóvenes investigadores de la Facultad de Derecho, Ciencias Políticas y Sociales de la Universidad Nacional de Colombia

    Perspectivas de innovación en gestión, educación ambiental para la adaptación y la mitigación

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    Esta publicación del libro-foro sobre ciudad y cambio climático responde al aporte de los diferentes profesionales de las entidades públicas y privadas que participaron en calidad de conferencistas, ponentes, panelistas y expositores y compartieron sus experiencias en la ciudad como una contribución al conocimiento de las comunidades acerca de la creciente importancia y consideración de la adaptación y mitigación. Se consideraron acciones de políticas públicas por parte de las administraciones públicas, los sectores económicos y la sociedad, grupos ecológicos y fundaciones ecológicas y de igual forma las acciones y grandes esfuerzos realizados por el Ministerio del Ambiente, el IDEAM, la CAR, la Secretaría de Ambiente, el Jardín Botánico, la Red RAUS y de los grupos de investigación de las universidades

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    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

    Studies of the mass composition of cosmic rays and proton-proton interaction cross-sections at ultra-high energies with the Pierre Auger Observatory

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    In this work, we present an estimate of the cosmic-ray mass composition from the distributions of the depth of the shower maximum (Xmax) measured by the fluorescence detector of the Pierre Auger Observatory. We discuss the sensitivity of the mass composition measurements to the uncertainties in the properties of the hadronic interactions, particularly in the predictions of the particle interaction cross-sections. For this purpose, we adjust the fractions of cosmic-ray mass groups to fit the data with Xmax distributions from air shower simulations. We modify the proton-proton cross-sections at ultra-high energies, and the corresponding air shower simulations with rescaled nucleus-air cross-sections are obtained via Glauber theory. We compare the energy-dependent composition of ultra-high-energy cosmic rays obtained for the different extrapolations of the proton-proton cross-sections from low-energy accelerator data

    Study of downward Terrestrial Gamma-ray Flashes with the surface detector of the Pierre Auger Observatory

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    The surface detector (SD) of the Pierre Auger Observatory, consisting of 1660 water-Cherenkov detectors (WCDs), covers 3000 km2 in the Argentinian pampa. Thanks to the high efficiency of WCDs in detecting gamma rays, it represents a unique instrument for studying downward Terrestrial Gamma-ray Flashes (TGFs) over a large area. Peculiar events, likely related to downward TGFs, were detected at the Auger Observatory. Their experimental signature and time evolution are very different from those of a shower produced by an ultrahigh-energy cosmic ray. They happen in coincidence with low thunderclouds and lightning, and their large deposited energy at the ground is compatible with that of a standard downward TGF with the source a few kilometers above the ground. A new trigger algorithm to increase the TGF-like event statistics was installed in the whole array. The study of the performance of the new trigger system during the lightning season is ongoing and will provide a handle to develop improved algorithms to implement in the Auger upgraded electronic boards. The available data sample, even if small, can give important clues about the TGF production models, in particular, the shape of WCD signals. Moreover, the SD allows us to observe more than one point in the TGF beam, providing information on the emission angle

    Measuring the muon content of inclined air showers using AERA and the water-Cherenkov detector array of the Pierre Auger Observatory

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    Combined fit to the spectrum and composition data measured by the Pierre Auger Observatory including magnetic horizon effects

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    The measurements by the Pierre Auger Observatory of the energy spectrum and mass composition of cosmic rays can be interpreted assuming the presence of two extragalactic source populations, one dominating the flux at energies above a few EeV and the other below. To fit the data ignoring magnetic field effects, the high-energy population needs to accelerate a mixture of nuclei with very hard spectra, at odds with the approximate E2^{-2} shape expected from diffusive shock acceleration. The presence of turbulent extragalactic magnetic fields in the region between the closest sources and the Earth can significantly modify the observed CR spectrum with respect to that emitted by the sources, reducing the flux of low-rigidity particles that reach the Earth. We here take into account this magnetic horizon effect in the combined fit of the spectrum and shower depth distributions, exploring the possibility that a spectrum for the high-energy population sources with a shape closer to E2^{-2} be able to explain the observations
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