Implementación de servicios de infraestructura it mediante sistemas operativos GNU/Linux Nethserver

Todas son imágenes propiasEl presente documento contiene el desarrollo de las actividades enmarcadas dentro del Paso 9 - Solucionando necesidades específicas con GNU/Linux, en la cual cada integrante del grupo realizó la configuración y puesta a punto del sistema operativo NethServer (versión 7.9), a su vez, se abordaron cada una de las siguientes temáticas: Temática 1 (DHCP Server, DNS Server y Controlador de Dominio), Temática 2(Proxy), Temática 3(Cortafuegos), Temática 4 (File Server y Print Server) y Temática 5: (VPN). Se realiza cada una de las configuraciones necesarias para el funcionamiento de estas herramientas administrativas y en cada caso se realizan las pruebas respectivas desde un sistema GNU/Linux cliente conectado a este servidor mostrando los resultados obtenidos.This document contains the development of the activities framed within Step 9 - Solving specific needs with GNU/Linux, in which each member of the group carried out the configuration and tuning of the NethServer operating system (version 7.9), in turn, Each of the following topics were addressed: Topic 1 (DHCP Server, DNS Server and Domain Controller), Topic 2 (Proxy), Topic 3 (Firewall), Topic 4 (File Server and Print Server) and Topic 5: (VPN ). Each of the configurations necessary for the operation of these administrative tools is carried out and in each case the respective tests are carried out from a GNU/Linux client system connected to this server, showing the results obtained

Endarterectomía carotídea: resultados perioperatorios y a mediano plazo, experiencia institucional Carotid endarterectomy: perioperative at medium term follow-up and institutional experience

Es de suma importancia para el cirujano general tener conocimiento de la enfermedad aterosclerótica de las carótidas, su impacto epidemiológico, manifestaciones clínicas, abordaje diagnóstico y terapéutico, e indicaciones de cirugía basadas en ensayos clínicos controlados tanto en pacientes sintomáticos como en asintomáticos. La endarterectomía carotídea sigue siendo el método estándar en el manejo de la estenosis carotídea debido principalmente a sus bajas morbilidad y mortalidad perioperatorias y a la reducción significativa en las tasas de enfermedad cerebrovascular ipsilateral y contralateral en el seguimiento a corto y largo plazo. La terapia endovascular mediante angioplastia y stent es promisoria, pero aún no remplaza a la endarterectomía carotídea y en la actualidad sólo está justificada en pacientes con alto riesgo anestésico o quirúrgico.It behooves the general surgeon to possess good knowledge of the atherosclerotic disease of the carotid arteries, its epidemiologic impact, clinical manifestations, diagnostic methods, therapeutic approach, and the indications for surgery based on results of controlled prospective studies both in symptomatic and asymptomatic patients. Carotid endarterectomy remains the standard therapy for carotid stenosis because of its low perioperative morbidity and mortality and the significant reduction of ipsilateral and contralateral cerebrovascular disease, both in the short and late postoperative follow-up. Endovascular therapy by angioplasty and placement of stents appears promising, but it still does not replace carotid endarterectomy, and currently is indicated only in patients of high anesthetic or surgical risk

Letras y Encajes

Letras y Encajes publica su primer número en 1926; esta revista fue fundada por mujeres de la clase dirigente de Medellín, muchas de ellas socias de la institución cultural Centro Femenino de Estudios (Sofía Ospina de Navarro, Teresa Santamaría de González, Ángela Villa de Toro y Alicia Merizalde de Echavarría), a lo largo del tiempo se consolidó como la revista femenina más importante del país, dirigida a mujeres de la clase alta y media, abordaba temas que giraban alrededor del hogar, la religión, la literatura y la moda de la época. La revista circuló mensualmente hasta 1959. Sus principales redactoras eran mujeres, pero contaba con la colaboración ocasional de algunos hombres y con traducciones de autores y autoras extranjeras

Is Resistance Training an Option to Improve Functionality and Muscle Strength in Middle-Aged People with Multiple Sclerosis? A Systematic Review and Meta-Analysis

Background: Currently, it is essential to adopt physical therapy strategies, such as resistance training, to enhance muscle strength and gait in middle-aged individuals (ages 45–65) suffering from Multiple Sclerosis. This is crucial in combating the typical symptoms of neurodegenerative diseases associated with functional loss. The objective of this study is to determine the effects of resistance training interventions on walking and muscle strength in middle-aged people with Multiple Sclerosis. Methods: A systematic review with meta-analysis was conducted by searching specific keywords in the PubMed, Scopus, Cochrane, and Web of Science databases. For inclusion, studies had to incorporate resistance training as a primary or significant component of the overall intervention for middle-aged patients with MS. Out of the 3675 articles identified, 12 randomized clinical trials met the criteria for inclusion in the review, with resistance training being a consistent feature in all of them. Results: Muscle strength and gait were evaluated as the main variables, with fatigue and the quality of life as secondary variables. This review reveals that resistance training significantly improves muscle strength. Resistance training achieves modest and non-significant improvements in gait. Notably, studies combining resistance training with motor control exercises achieve results of greater clinical significance in terms of gait. However, resistance training yields variable positive effects on perceived fatigue and the quality of life. Conclusion: Resistance training is useful for improving muscle strength; however, walking needs to be combined with motor control training

Pathophysiology, Diagnosis and Treatment of Spontaneous Coronary Artery Dissection in Peripartum Women

Spontaneous coronary artery dissection (SCAD) is an infrequent cause of nonobstructive ischemic heart disease in previously healthy young women and therefore is not usually considered in differential diagnoses. The overall incidence of SCAD in angiographic series is between 0.28 and 1.1%, with a clear predominance in young, healthy women (70%) of whom approximately 30% are in the postpartum period. In the United Kingdom, between 2008 and 2012, SCAD was the cause of 27% of acute myocardial infarctions during pregnancy, with a prevalence of 1.81 per 100,000 pregnancies. Regarding the mechanism of arterial obstruction, this may be due to the appearance of an intramural hematoma or to a tear in the intima of the arteries, both spontaneously. Although multiple diagnostic methods are available, it is suggested to include an appropriate anamnesis, an electrocardiogram in the first 10 min after admission to the service or the onset of symptoms, and subsequently, a CT angiography of the coronary arteries or urgent coronary angiography if the hemodynamic status of the patient allows it. Treatment should be individualized for each case; however, the appropriate approach is generally based on two fundamental pillars: conservative medical treatment with antiplatelet agents, beta-blockers, and nitrates, and invasive treatment with percutaneous coronary intervention for stent implantation or balloon angioplasty, if necessary

Trauma cardíaco penetrante: factores pronósticos Penetrating cardiac trauma: Prognostic factors

El pronóstico de los pacientes con herida de corazón depende del tipo y la magnitud de la lesión, el soporte prehospitalario y el estado clínico al ingresar a urgencias. El conocimiento de los factores de riesgo es el paso inicial para sugerir modificaciones en el tratamiento para mejorar el pronóstico. Se presenta un estudio retrospectivo de cohortes. Se estudiaron 204 pacientes con herida de corazón que fueron hospitalizados entre enero de 1997 y diciembre de 1999 en el Hospital Universitario San Vicente de Paúl, Medellín, Colombia. Los desenlaces que se analizaron fueron la mortalidad intraoperatoria y posoperatoria, y las complicaciones posoperatorias. Murió el 10,3% de los pacientes; los pacientes con herida por arma de fuego, de dos o más cámaras y dos o más heridas cardíacas, presentaron mayor riesgo de morir; el riesgo también aumentó con el incremento en el puntaje de los índices de trauma ¿PI?, ¿PTTI? y ¿PCTI?. El choque y la arritmia intraoperatorias se asocian independientemente con la mortalidad (OR=19,6 y 22,3, respectivamente). En 22,1% de los pacientes hubo complicaciones posoperatorias y no se encontró asociación entre ellas y los factores estudiados. En conclusión, se deben utilizar los índices de trauma para comparar los resultados obtenidos en diferentes instituciones. La asociación entre arritmia y choque intraoperatorios con mortalidad obliga a una reanimación más agresiva con el fin de disminuir la mortalidad.Background: The prognosis of patients with cardiac trauma depends on the type and magnitude of their lesions, the prehospital support received and the clinical state at admission to the emergency unit. Knowledge of these factors allows treatment modifications, leading to an improved prognosis. Methods: Retrospective cohort study. Setting: Universidad de Antioquia and San Vicente de Paúl University Hospital, Medellín, Colombia. 204 patients suffering from cardiac trauma were studied between January 1st 1997 and December 31st 1999. Primary outcome was either intra- or postoperative death; secondary outcome was postoperative complications. Results: 90% were men. 10% of the patients died; the following factors increased the risk of death: lesions by firearm; lesions of two or more cardiac chambers, and two or more cardiac lesions; risk also becames, higher as scores in PI, PTTI and PCTI indexes increase. Logistic regression analysis revealed that intraoperative shock and arrhythmia were factors independently associated with mortality (OR: 19.6 and 22.3 respectively). Forty five patients (22%) suffered postoperative complications but no association was found between them and the factors studied. Conclusion: The use of trauma indexes is important when comparing results obtained at different institutions; the association between mortality and intraoperative shock and/or arrhythmia, should lead to more aggressive reanimation attempts in order to reduce the former

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