El procedimiento abreviado: entre la eficacia judicial y el derecho a la no autoinculpación

La crisis del sistema penal y el retardo en la sustanciación de juicios impulsó a que paulatinamente se brinde preferencia a todo mecanismo dirigido a obtener una solución expedita a los conflictos penales. En este sentido, el procedimiento abreviado se consolidó como la fórmula procesal que genera una vertiginosa resolución de causas penales, especialmente, cuando se califica la situación de flagrancia. Si bien el procesado, gracias a su confesión, obtiene una disminución de la pena fruto del acuerdo con el fiscal, y este último queda exento de producir prueba en un juicio oral, público y contradictorio, no es menos cierto que en la aplicación del procedimiento abreviado se produce una tensión entre el principio de eficacia judicial y el derecho fundamental a la no autoinculpación. El propósito de esta obra es evidenciar esa tensión desde una perspectiva teórica y práctica

La aplicación del procedimiento abreviado en la Unidad de Flagrancia de Quito; eficacia judicial vs derecho a la no autoinculpación

La crisis del sistema penal y la recurrente crítica respecto al retardo en la sustanciación de juicios penales, ha obligado a que paulatinamente se brinde preferencia a todo mecanismo dirigido a obtener una solución rápida a los conflictos penales. Una vez que inició su operatividad la Unidad de Flagrancia en la ciudad de Quito, el 29 de octubre de 2012, se incrementaron considerablemente el número de audiencias para calificación de delitos flagrantes y se produjo una vertiginosa resolución de causas penales mediante la aplicación del procedimiento abreviado. Si bien es cierto, el procesado gracias a su confesión obtiene una disminución de la pena fruto del acuerdo con el fiscal y éste último queda exento de producir prueba en un juicio oral, público y contradictorio; no es menos cierto que en la aplicación del procedimiento abreviado se produce una tensión entre el principio de eficacia judicial y el derecho fundamental a la no autoinculpación. El propósito de esta investigación es evidenciar la aplicación del procedimiento abreviado en la nueva Unidad de Flagrancia de Quito, y para ello se analizará su realidad desde la perspectiva de la eficacia judicial y el derecho a la no autoinculpación

Chemical composition, antioxidant, antimicrobial and antiproliferative activity of Laureliopsis philippiana essential oil of Chile, study in vitro and in silico

Chilean Laureliopsis philippiana has been used in traditional medicine by the Mapuche and their ancestors. To evaluate its pharmacological activity, Laureliopsis philippiana leaf essential oil extract (LP_EO) was chemically and biologically characterized in the present study. In vitro antioxidant potential was analyzed, and antitumor activity was evaluated in non-tumor and tumor cell culture lines. Caenorhabditis elegans was used as a model for evaluating toxicity, and the chemical composition of the essential oil was analyzed using gas chromatography–mass spectrometry. The oil contains six major monoterpenes: eucalyptol (27.7 %), linalool (27.6 %), isozaphrol (19.5 %), isohomogenol (12.6 %), α-terpineol (7.7 %), and eudesmol (4.8 %). Based on quantum mechanical calculations, isosafrole and isohomogenol conferred in vitro antioxidant and antimicrobial activity to LP_EO. In addition, LP_EO showed antimicrobial activity against clinical Helicobacter pylori isolates (MIC 64 and MBC > 128 μg·mL−1), Staphylococcus aureus (MIC 32 and MBC > 64 μg·mL−1), Escherichia coli (MIC 8 and MBC 16 μg·mL−1) and Candida albicans (MIC 64 and > 128 μg·mL−1). LP_EO could selectively inhibit the proliferation of epithelial tumor cell lines but showed low toxicity against Caenorhabditis elegans (0.39 to 1.56 μg·mL−1). Therefore, LP_EO may be used as a source of bioactive compounds in novel pharmacological treatments for veterinary and human application, cosmetics, or sanitation.Fil: Bruna, Flavia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; Argentina. Universidad Diego Portales; ChileFil: Fernández, Katia. Universidad Diego Portales; ChileFil: Urrejola, Felipe. Universidad Diego Portales; ChileFil: Touma, Jorge. Universidad Diego Portales; ChileFil: Navarro, Myriam. Universidad Diego Portales; ChileFil: Sepúlveda, Betsabet. Universidad de Chile; ChileFil: Larrazabal Fuentes, María. Universidad de Antofagasta (uantof);Fil: Paredes, Adrián. Universidad de Antofagasta (uantof);Fil: Neira, Iván. Universidad de Antofagasta (uantof);Fil: Ferrando, Matías. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Osorio, José Manuel. Universidad Andrés Bello; Chile. Universidad Diego Portales; ChileFil: Yáñez, Osvaldo. Universidad de Las Américas.; Ecuador. Center of New Drugs for Hypertension; ChileFil: Bravo, Jessica. Universidad Diego Portales; Chil

Evaluación de políticas públicas con relación al hábitat y la vivienda. Caso de estudio: centro histórico de Riobamba

The study assesses the guidelines of the Land Use and Management Plan in the historic center of Riobamba, utilizing the "Reference Framework for Sustainable Cities" (RFSC) to develop a matrix that verifies the comprehensiveness of these guidelines and their applicability in future planning. A qualitative and cross-sectional methodology is adopted, focused on the collection and analysis of information regarding the measures proposed by the plan, evaluating these through five dimensions of sustainable development. The results demonstrate a strategic integration of the plan's elements with the RFSC dimensions, highlighting an adaptation of land use that promotes diversity and vertical densification in key areas. The research concludes that, although considerable multidimensional integration has been achieved, there are areas for improvement in the political and economic dimensions. The significance of the findings underscores the importance of integrated strategies that address all dimensions of urban sustainability to promote comprehensive and sustainable housing development, emphasizing the need for continuous and critical evaluation of the implemented strategies to ensure equitable and sustainable development of the historic center.El estudio evalúa los lineamientos del Plan de Uso y Gestión de Suelo en el centro histórico de Riobamba, utilizando el marco de referencia "Reference Framework for Sustainable Cities" (RFSC) para desarrollar una matriz que verifique la integralidad de estos lineamientos y su aplicabilidad en futuras planificaciones. Se adopta una metodología cualitativa y transversal, centrada en la recolección y análisis de información sobre las medidas propuestas por el plan, evaluando estas a través de cinco dimensiones de desarrollo sostenible. Los resultados muestran una integración estratégica de los elementos del plan con las dimensiones del RFSC, destacando una adaptación del uso del suelo que promueve la diversidad y densificación vertical en áreas clave. La investigación concluye que, aunque se ha logrado una considerable integración multidimensional, existen áreas de mejora en las dimensiones política y económica. La significancia del hallazgo resalta la importancia de estrategias integradas que aborden todas las dimensiones de la sostenibilidad urbana para fomentar un desarrollo habitacional integral y sostenible, subrayando la necesidad de una evaluación continua y crítica de las estrategias implementadas para asegurar un desarrollo equitativo y sostenible del centro histórico. &nbsp

The essential oil from Drimys winteri possess activity: Antioxidant, theoretical chemistry reactivity, antimicrobial, antiproliferative and chemical composition

The Mapuche and their ancestors have used D. winteri in traditional medicine. In the present study, the essential oil extract of D. winteri leaves (DW_EO) were characterized chemically and biologically to evaluate its pharmacological activity. In vitro antioxidant activity was assayed, and antitumor activity was evaluated in non-tumor and tumor-cell culture lines. Caenorhabditis elegans was used as a model to evaluate toxicity, and the chemical composition of the essential oil was analyzed by gas chromatography-mass spectrometry. The chemical oil composition was characterized principally of five major terpenes: 4 sesquiterpenes γ-Eudesmol (39.7%), β-Caryophyllene (33.7%), Elemol (25.9%), α-Eudesmol (0.3%) and 1 diterpene Kaunene (0.4%). By quantum calculations, it was determined that all oils have the ability to capture and yield electrons, which is consistent with the moderate antioxidant activity of DW_EO detected in vitro. Furthermore, by molecular docking is estimated that these oils can bind to proteins involved in the production of oxygen radicals. Of these proteins, CYP2C9 could bind energetically, reaching binding energy between −6.8 and −9.2 kCal/mol for the 5 terpenes studied, highlighting among these β-Caryophyllen and γ-Eudesmol. DW_EO has effect against H. pylori (MIC 32 μg/ml), S. aureus (MIC 8 μg/ml), E. coli (MIC 32 μg/ml) and C. albicans (MIC 64 μg/ml), β-Caryophyllen and γ -Eudesmol (MIC 64 μg/ml) and could selectively inhibit the proliferation of epithelial tumor cell lines but showed low against C. elegans (0.39–1.56 μg mL−1). Therefore, DW_EO may be used as a source of bioactive compounds in novel pharmacological treatments for medical application, agronomics, sanitation, and food.Fil: Bruna, Flavia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; Argentina. Universidad Diego Portales; ChileFil: Fernández, Katia. Universidad Diego Portales; ChileFil: Urrejola, Felipe. Universidad Diego Portales; ChileFil: Touma, Jorge. Universidad Diego Portales; ChileFil: Navarro, Myriam. Universidad Diego Portales; ChileFil: Sepúlveda, Betsabet. Universidad de Chile; ChileFil: Larrazabal Fuentes, María. Universidad de Antofagasta (uantof);Fil: Paredes, Adrián. Universidad de Antofagasta (uantof);Fil: Neira, Iván. Universidad de Antofagasta (uantof);Fil: Ferrando, Matías. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Osorio, José Manuel. Universidad Diego Portales; Chile. Universidad Andrés Bello; ChileFil: Yañez, Osvaldo. Universidad de Las Américas.; Ecuador. Center of New Drugs for Hypertension; ChileFil: Bravo, Jessica. Universidad Diego Portales; Chil

The chemical compositions of essential oils derived from cryptocarya alba and laurelia sempervirens possess antioxidant, antibacterial and antitumoral activity potential

Cryptocarya alba (Peumo; CA) and Laurelia sempervirens (Laurel; LS) are herbs native to the Chilean highlands and have historically been used for medicinal purposes by the Huilliches people. In this work, the essential oils were extracted using hydrodistillation in Clevenger apparatus and analyzed by GC-MS to determine their composition. The antioxidant capacity (AC) was evaluated in vitro. The cytotoxicity was determined using cell line cultures both non tumoral and tumoral. The toxicity was determined using the nematode Caenorhabditis elegans. The antimicrobial activity was evaluated against 52 bacteria using the agar disc diffusion method and the minimum inhibitory concentrations (MICs) were determined. The principal compounds found in C. alba essential oil (CA_EO) were α-terpineol (24.96%) and eucalyptol (21.63%) and were isazafrol (91.9%) in L. sempervirens essential oil (LS_EO). Both EOs showed antioxidant capacity in vitro. Both EO showed antibacterial activity against bacteria using. LS_EO showed more inhibitory effect on these cell lines respect to CA_EO. Both EOs showed toxicity against the nematode C. elegans at 3.12–50 mg/mL. The essential oils of CA and LS have an important bioactive potential in their antioxidant, antibacterial and cytotoxicity activity. Both essential oils could possibly be used in the field of natural medicine, natural food preservation, cosmetics, sanitation and plaguicides among others.Fil: Touma, Jorge. Universidad Diego Portales; ChileFil: Navarro, Myriam. Universidad Diego Portales; ChileFil: Sepúlveda, Betsabet. Universidad de Chile; ChileFil: Pavon, Alequis. Universidad Autónoma de Chile; ChileFil: Corsini, Gino. Universidad Autónoma de Chile; ChileFil: Fernández, Katia. Universidad Diego Portales; ChileFil: Quezada, Claudia. Universidad Austral de Chile; ChileFil: Torres, Angelo. Universidad Austral de Chile; ChileFil: Larrazabal Fuentes, María José. Universidad de Antofagasta; ChileFil: Paredes, Adrian. Universidad de Antofagasta; ChileFil: Neira, Ivan. Universidad de Antofagasta; ChileFil: Ferrando, Matías. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Bruna, Flavia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Venegas, Alejandro. Universidad Diego Portales; ChileFil: Bravo, Jessica. Universidad Diego Portales; Chil

Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities.

Funder: American College of Rheumatology Research and Education Foundation; FundRef: http://dx.doi.org/10.13039/100000960Funder: National Institute of Arthritis and Musculoskeletal and Skin Diseases; FundRef: http://dx.doi.org/10.13039/100000069Funder: European League Against Rheumatism; FundRef: http://dx.doi.org/10.13039/501100008741OBJECTIVES: The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 Classification Criteria for systemic lupus erythematosus (SLE) have been validated with high sensitivity and specificity. We evaluated the performance of the new criteria with regard to disease duration, sex and race/ethnicity, and compared its performance against the Systemic Lupus International Collaborating Clinics (SLICC) 2012 and ACR 1982/1997 criteria. METHODS: Twenty-one SLE centres from 16 countries submitted SLE cases and mimicking controls to form the validation cohort. The sensitivity and specificity of the EULAR/ACR 2019, SLICC 2012 and ACR 1982/1997 criteria were evaluated. RESULTS: The cohort consisted of female (n=1098), male (n=172), Asian (n=118), black (n=68), Hispanic (n=124) and white (n=941) patients; with an SLE duration of 1 to <3 years (n=196) and ≥5 years (n=879). Among patients with 1 to <3 years disease duration, the EULAR/ACR criteria had better sensitivity than the ACR criteria (97% vs 81%). The EULAR/ACR criteria performed well in men (sensitivity 93%, specificity 96%) and women (sensitivity 97%, specificity 94%). Among women, the EULAR/ACR criteria had better sensitivity than the ACR criteria (97% vs 83%) and better specificity than the SLICC criteria (94% vs 82%). Among white patients, the EULAR/ACR criteria had better sensitivity than the ACR criteria (95% vs 83%) and better specificity than the SLICC criteria (94% vs 83%). The EULAR/ACR criteria performed well among black patients (sensitivity of 98%, specificity 100%), and had better sensitivity than the ACR criteria among Hispanic patients (100% vs 86%) and Asian patients (97% vs 77%). CONCLUSIONS: The EULAR/ACR 2019 criteria perform well among patients with early disease, men, women, white, black, Hispanic and Asian patients. These criteria have superior sensitivity than the ACR criteria and/or superior specificity than the SLICC criteria across many subgroups

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) SLE classification criteria item performance.

BACKGROUND/OBJECTIVES: The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 classification criteria for systemic lupus erythematosus system showed high specificity, while attaining also high sensitivity. We hereby analysed the performance of the individual criteria items and their contribution to the overall performance of the criteria. METHODS: We combined the EULAR/ACR derivation and validation cohorts for a total of 1197 systemic lupus erythematosus (SLE) and n=1074 non-SLE patients with a variety of conditions mimicking SLE, such as other autoimmune diseases, and calculated the sensitivity and specificity for antinuclear antibodies (ANA) and the 23 specific criteria items. We also tested performance omitting the EULAR/ACR criteria attribution rule, which defines that items are only counted if not more likely explained by a cause other than SLE. RESULTS: Positive ANA, the new entry criterion, was 99.5% sensitive, but only 19.4% specific, against a non-SLE population that included other inflammatory rheumatic, infectious, malignant and metabolic diseases. The specific criteria items were highly variable in sensitivity (from 0.42% for delirium and 1.84% for psychosis to 75.6% for antibodies to double-stranded DNA), but their specificity was uniformly high, with low C3 or C4 (83.0%) and leucopenia 80% for all items, explaining the higher overall specificity of the criteria set

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570