Determinantes socio-económicos en los fenómenos de pobreza y desigualdad en Colombia: análisis a nivel departamental 2008 – 2017

Trabajo de investigaciónEn este documento se estudia el efecto del PIB per cápita y de la tasa global de participación (TGP), como determinantes socioeconómicos de ingreso y mercado laboral, sobre la desigualdad y la pobreza, a nivel departamental usando un modelo de datos panel con efectos fijos. Se emplean datos del índice de Gini, como medida de desigualdad, y de la pobreza monetaria y la pobreza extrema.INTRODUCCIÓN 1. MARCO TEÓRICO 2. REVISIÓN DE LITERATURA 3. HECHOS ESTILIZADOS 4. DATOS Y METODOLOGÍA 5.RESULTADOS 6. CONCLUSIONES BIBLIOGRAFÍA ANEXOSPregradoEconomist

Coronary steal by left atrial myxoma: a case report

This report describes a 41-year-old man who had atypical angina resulting from coronary steal by left atrial myxoma. The tumor was completely excised and the patient was symptoms free after operation

Is distortion of the bioprosthesis ring a risk factor for early calcification ?

<p>Abstract</p> <p>Background</p> <p>As the population ages, bioprosthesis are increasingly being used in cardiac valve replacement. Pericardial bioprosthesis combine an excellent hemodynamic performance with low thrombogenicity, but valve failure associated with calcification remains a concern with these valves. We describe distortion of the bioprosthesis ring as a risk factor for early calcification.</p> <p>Methods</p> <p>A total of 510 patients over the age of 70 years underwent isolated aortic valve replacement with the Mitroflow (A12) pericardial bioprosthesis. Thirty two patients (6,2%) have undergone a second aortic valve replacement due to structural valve dysfunction resulting from valve calcification. In all patients a chest radiography and coronary angiography was performed before reoperation. A 64 Multidetector Computed Tomography (MDCT) with retrospective ECG gating study was performed in four patients to evaluate the aortic bioprosthesis.</p> <p>Results</p> <p>Chest radiography showed in all patients an irregular bioprosthesis ring. At preoperative coronary angiography a distorted bioprosthesis ring was detected in all patients. Macroscopic findings of the explanted bioprostheses included extensive calcification in all specimens.</p> <p>Conclusion</p> <p>There was a possible relationship between early bioprosthetic calcification and radiologic distortion of the bioprosthesis ring.</p

Concepciones y actitudes de estudiantes de básica secundaria hacia el uso de los recursos energéticos en el departamento del Huila

Este proyecto de investigación pretende caracterizar las concepciones y actitudes que tienen los estudiantes sobre los recursos energéticos. Para ello, hemos aplicado un cuestionario el cual consta de preguntas tipo abiertas, selección múltiple y escala Likert en relación a la temática y se ha sistematizado bajo el método de análisis de contenido, para establecer posibles relaciones entre los valores de media de las categorías identificadas en las respuestas del estudiantado y realizar una propuesta didáctica. Para este apartado, presentamos las concepciones de 339 estudiantes de grado sexto, vinculados a 6 Instituciones Educativas oficiales de diferentes municipios del departamento del Huila. Destacamos que son pocos los estudios en el campo temático a nivel regional, a pesar de contar la zona de estudio, con dos proyectos hidroeléctricos que suministran energía eléctrica tanto a la región como a poblaciones en el país y en el exterior. Así mismo, es importante reconocer las ideas que se tejen y las perspectivas que se construyen desde las escuelas, frente a temas coyunturales como es el ambiente, la conservación de los recursos y las posibles estrategias para mitigar el impacto ambiental que ya se vive en el planeta Tierra. Dentro de los hallazgos, observamos que el 85.3% de la población, reconoce que lavar un solo día a la semana o el lavado tradicional contribuye a un ahorro energético y al medio ambiente. Por otro lado, el 54.9% consideran que al momento de comprar una lavadora se debe tener en cuenta los factores económicos, funcionalidad del electrodoméstico y el tamaño, en este caso no se relaciona en ningún momento con el ahorro de energía eléctrica y el 32.74% consideran que gran parte de los problemas de impacto ambiental son causados en gran parte por el uso desmesurado de los aparatos eléctricos.&nbsp

Glove perforation and sternal wound infection in open heart surgery

Introducción y objetivos: La perforación de los guantes rompe la barrera entre la microbiota de las manos del cirujano y los tejidos estériles del paciente. El objetivo de este trabajo fue evaluar el efecto de la perforación de los guantes sobre la contaminación de la herida de esternotomía y las complicaciones infecciosas postoperatorias. Métodos: Se realizó un estudio prospectivo en 139 pacientes intervenidos de cirugía cardíaca mediante esternotomía media y en 7 cirujanos. Se evaluaron la presencia y la localización de las perforaciones, y la contaminación de la herida de esternotomía al final de la intervención. Se realizó un seguimiento para detectar complicaciones infecciosas postoperatorias. Resultados: La frecuencia de perforaciones en los guantes fue del 23%, siendo más frecuentes en los dedos índice y pulgar de la mano no dominante. La tasa de contaminación de la herida de esternotomía fue del 7,91%, siendo Staphylococcus epidermidis el microorganismo más frecuente. Ninguno de los pacientes donde se detectó perforación de los guantes o contaminación de la herida quirúrgica desarrolló infección postoperatoria del sitio quirúrgico. Conclusiones: No existe correlación entre perforación de los guantes y la contaminación de la herida de esternotomía ni con la aparición de complicaciones infecciosas postoperatorias. El desarrollo de una infección del sitio quirúrgico es un proceso complejo que depende de muchos otros factores además de los estudiados.Background and objectives: Surgical glove puncture breaks the barrier between the surgeon hands and the patient sterile wound tissues. The purpose of this work was to evaluate the effect of glove perforation on contamination of the sternal wound and postoperative infectious complications. Methods: A prospective study included 139 patients undergoing open heart surgery through a median sternotomy and seven cardiac surgeons. Glove puncture frequency and localization as well as wound contamination were evaluated at the end of the operation. Short and medium-term follow up was carried out to detect surgical site infections. Results: Glove perforation rate was 23% of the samples being more frequent in the index and thumb of the nondominant hand. The rate of contamination of the sternotomy wound was 7.91% being Staphylococcus epidermidis the most frequent microorganism. None of the patients with either glove punctures or wound contamination presented any surgical site infection. Conclusions: There is no correlation between glove perforation and sternal wound contamination and postoperative infectious complications. Surgical site infection is a more complex problem than it seems and depends of many other factors.S

Internal mammary artery dilatation in a patient with aortic coarctation, aortic stenosis, and coronary disease. Case report

The ideal surgical approach is unclear in adult patients with coarctation of the aorta that is associated with other cardiovascular pathologies that require intervention. Standard median sternotomy allows simultaneous, coronary revascularization surgery, valve replacement and repair of aortic coarctation. However the collateral circulation and the anatomy of the mammary arteries must be determined, to avoid possible complications. We report a case of a 69 year-old man with aortic coarctation, aortic stenosis, coronary artery disease and internal mammary artery dilatation who underwent concomitant surgical procedures through a median sternotomy

Impact of SARS-Cov-2 infection in patients with hypertrophic cardiomyopathy : results of an international multicentre registry

To describe the natural history of SARS-CoV-2 infection in patients with hypertrophic cardiomyopathy (HCM) compared with a control group and to identify predictors of adverse events. Three hundred and five patients [age 56.6 ± 16.9 years old, 191 (62.6%) male patients] with HCM and SARS-Cov-2 infection were enrolled. The control group consisted of 91 131 infected individuals. Endpoints were (i) SARS-CoV-2 related mortality and (ii) severe clinical course [death or intensive care unit (ICU) admission]. New onset of atrial fibrillation, ventricular arrhythmias, shock, stroke, and cardiac arrest were also recorded. Sixty-nine (22.9%) HCM patients were hospitalized for non-ICU level care, and 21 (7.0%) required ICU care. Seventeen (5.6%) died: eight (2.6%) of respiratory failure, four (1.3%) of heart failure, two (0.7%) suddenly, and three (1.0%) due to other SARS-CoV-2-related complications. Covariates associated with mortality in the multivariable were age {odds ratio (OR) per 10 year increase 2.25 [95% confidence interval (CI): 1.12-4.51], P = 0.0229}, baseline New York Heart Association class [OR per one-unit increase 4.01 (95%CI: 1.75-9.20), P = 0.0011], presence of left ventricular outflow tract obstruction [OR 5.59 (95%CI: 1.16-26.92), P = 0.0317], and left ventricular systolic impairment [OR 7.72 (95%CI: 1.20-49.79), P = 0.0316]. Controlling for age and sex and comparing HCM patients with a community-based SARS-CoV-2 cohort, the presence of HCM was associated with a borderline significant increased risk of mortality OR 1.70 (95%CI: 0.98-2.91, P = 0.0600). Over one-fourth of HCM patients infected with SARS-Cov-2 required hospitalization, including 6% in an ICU setting. Age and cardiac features related to HCM, including baseline functional class, left ventricular outflow tract obstruction, and systolic impairment, conveyed increased risk of mortality

The Caldera. No. 23

La pandemia, sin lugar a dudas, nos ha cambiado la vida a todos; un viernes nos fuimos para nuestros hogares, en el marco de una educación presencial; al lunes siguiente, después de dos días, estábamos iniciando el camino hacia una educación remota, una educación virtual, que se ha convertido en una gran alternativa para seguir contribuyendo con la formación de nuestros niños y jóvenes caldistas y al mejoramiento de nuestra calidad de vida que halla, en la educación, nuevamente la respuesta; han sido meses de cambios drásticos, inimaginables pero, cambios positivos que nos han permitido crecer como individuos, como familia, como escuela y como sociedad.Especial pandemia. Una generación Resiliente por promoción DINASTIA…06 VII Concurso Intercolegiado departamental de Oratoria. Ulibro 2020…51 Deporte en el Caldas…64 Expresiones Caldistas…71 Celebremos la palabra…93 Nuestros Maestros…102 Galería de Imágenes…107The pandemic, without a doubt, has changed the lives of all of us; One Friday we went to our homes, as part of a face-to-face education; The following Monday, after two days, we were starting the path towards a remote education, a virtual education, which has become a great alternative to continue contributing to the training of our children and young Caldistas and to the improvement of our quality of life. that finds, in education, the answer again; They have been months of drastic changes, unimaginable but positive changes that have allowed us to grow as individuals, as a family, as a school and as a society

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat