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

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

Estudio de la ballena yubarta Megaptera novaeangliae (Borowski,1781), en el Pacifico colombiano : aspectos poblacionales, de estructura social y de conservación

IP 6282-09-034-93Incluye resumenes de articulos sobre el temasouthwestern hemisphere humpback whales within eastern tropicalpacific waters - winters 1986-1993 / L. Florez;Gonzalez ... [et.al]. -- En: Biennial Conference on the Biologyof MarineMammals (11 : 1995 Dec. 14-18 :;Orlando, USA) -- Patterns of occurance of bottlenose dolphinsinbahia Malaga, Colombian Pacific : preliminary;observations / B. Rengifo, J.J. Capella, L. Martinez Florez. --En: Biennial Conference on the Biology of;Marine Mammals (11 : 1995 Dec. 14-18 : Orlando, USA) -- ARTICULO(S) EN REVISTA: Attack of killer whales;(Orcinus orca) on humpback whales (Megaptera novaeangliae)onasouth american pacific breeding ground /;cm. -- (Informe Museo del Mar ; no. 39) -- CAPITULO(S) ENLIBRO:Las Ballenas / Lilian Florez Gonzalez, Juan;Capella A. -- p. 37-47. -- En: Colombia Pacifico Tomo I /editado por Pablo Leyva. -- Santafe de Bogotá :;Fondo para la Proteccion del Medio Ambiente, 1993. -- p. -'- isBN9589129277. -- PONENCIA(S) EN CONGRESO:;Natalidad y frecuencia estacionaria de crias de ballena jorobada, Megaptera novaeangliae, en el Pacifico;Colombiano / G.A. Bravo, L Florez Gonzalez, J. Capella A.'-- en:Reuniao de Trabalho de Especialistas em;Mamiferos Aquaticos da America do Sul (6 : 1994 : Brasil)--Residencia ehistoria de reavistamientos de;Lilian Florez Gonzalez, Juan C. Capella, Howard C. Rosenbaum.--En MarineMammal Science. -- Vol. 10, no. 2;(Apr. 1994); p. 218-222. -- ISSN 08240469. -- Avistamientodeballenas : ñotro negocio fugaz? / Lilian Florez;Gonzalez, Gustavo A. Bravo. -- En: Tierra Verde : el buenusodel recurso.-- No. 10 (nov.-dic. 1994); p.;36-40 -- ISSN 01225936 -- Las yubartas o Ballenas Jorobadas /Lilian Florez Gonzalez, Juan Capella A. -- En:;Revista Hispanoamericana : organo de difusion de la FundaciónHispanoamericana Santiago de Cali. -- No. 15 ();p. 44-49. -- ISSN 01210173 -- Ballenas Jorobadas : soplosde vida / MairaLuz Martelo. -- En: Revista;Positiva. -- (junio. 1994); p. 62-65. -- ISSN 01223399 --CARTILLA(S): Reconocimiento de las Yubartas y;recomendaciones para observacion turistica de ballenas / JuanCapella, Lilian Florez Gonzalez. -- Fundación yu;1996.;ballenas jorobadas, Megaptera novaeangliae, en el PacificoColombiano / J.Capella A., L. Florez Gonzalez,;G.A. Bravo. -- En: Reuniao de Trabalho de Especialistas emMamiferos Aquaticos da America do Sul (6 : 1994 :;Brasil) -- Movimiento de ballenas jorobadas Megaptera novaeangliae en la costa oeste de Suramerica / L. Florez;Gonzalez ... [et.al]. -- En: Reuniao de Trabalho de Especialistas em Mamiferos Aquaticos da America do Sul (6;: 1994 : Brasil) -- Presencia de ballena tropical Balaenopteraedeni y bayena yubarta Megaptera novaeangliae;en la region de Santa Marta, Caribe Colombiano / L FlorezGonzalez, D Torres. -- En: Reuniao de Trabalho de;Especialistas em Mamiferos Aquaticos da America do Sul (6: 1994: Brasil)'-- Presencia de La ballena Tropical;Balaenoptera edeni y ballena yubarta Megaptera novaeangliae enla region de Santa Marta, Caribe Colombiano /;LIBRO(S): Mamiferos acuaticos de colombia : una revision ynuevas observaciones sobre su presenca, estado;del conocimiento y conservacion / Por Lilian Florez Gonzalez,Juan CapellaAlzueta. ; editado por Elvira Maria;Alvarado Chacon -- Santafe de Bogotá : Fundación Universidad deBogotá Jorge Tadeo Lozano, 1995. -- 29 h. ; 28;Lilian Florez Gonzalez. -- En: Seminario Nacional de CienciasyTecnologias del mar y Congreso Latinoamericano;en Ciencias del Mar (1, : 1994 nov. 21-25 : Medellin) -- Movimiento de ballenas jorobadas Megaptera;novaeangliae en la costa Oeste de Suramerica / Lilian Florez Gonzalez ...[et.al]. -- En: Reuniao de Trabalho;de Especialistas em Mamiferos Aquaticos da America do Sul(6 :1994 : Brasil) -- Residencia y retorno;reproductivo de ballenas jorobadas Megaptera novaeangliae,enelPacificoColombiano / Juan Capella A., Lilian;Florez Gonzalez, G.A. Bravo. -- En: Seminario Nacional deCiencias y Tecnologias del mar y Congreso;Latinoamericano en Ciencias del Mar (1, : 1994 nov. 21-25: Medellin) -- Frecuencia estacional de crias y;natalidad de ballenas jorobadas Megaptera novaeangliae, enelPacifico Colombiano / G.A. Bravo, Lilian Florez,;J. Capella. -- En: Seminario Nacional de Ciencias y Tecnologiasdel mar yCongreso Latinoamericano en Ciencias;del Mar (1, : 1994 nov. 21-25 : Medellin) -- Site fidelityandseasonal residence of humpback whales around;isla Gorgona, a breeding ground in the Colombian Pacific /J.J.Capella, L. Florez Gonzalez, G.A. Bravo. --;En: Biennial Conference on the Biology of Marine Mammals (0,4583333333333331995 Dec. 14-18 : Orlando, USA) -- Movements o

Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients

Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding

Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort.

Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies