49 research outputs found
Tumbas de indignos: cementerios no catĂłlicos en Colombia. 1825 â 1991
Resumen: La siguiente tesis expone las circunstancias jurĂdicas, polĂticas e ideolĂłgicas que rodearon la creaciĂłn - durante la primera mitad del siglo XX- de un conjunto de cementerios, destinados a la inhumaciĂłn de sujetos a quienes la Iglesia CatĂłlica prohibiĂł la sepultura eclesiĂĄstica, en diferentes municipios de Colombia. Tomando la creaciĂłn de dichos cementerios como una manifestaciĂłn, en el ĂĄmbito regional y local, de los enfrentamientos ideolĂłgicos - entre integrantes de los partidos liberal y conservador- concernientes con las relaciones entre Iglesia y Estado en esta naciĂłn (primordialmente a partir del escenario polĂtico-jurĂdico derivado de la instauraciĂłn del Acuerdo Concordatario de 1887 y el intento de modificaciĂłn del mismo en la dĂ©cada de los años cuarenta del siglo XX).Abstract: This thesis presents the legal, political and ideological circumstances what surrounding the creation - in the first half of the twentieth century- of a group of cemeteries, for the inhumation of persons to whom the Roman Catholic Church forbade the Christian burial, in different municipalities of Colombia. Taking the establishment of these cemeteries as an expression, at regional and local levels, of the ideological confrontation, between members of the Liberal and Conservative parties, concerning the relations between Church and State in this nation (primarily from the political and legal scene derived from the Concordat of 1887 and the attempt to introduce changes in him of the decade of the forties of the twentieth century)Doctorad
Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu
Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections
Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain
Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217
Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu
Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered âexposedâ. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2â2.0), urgent surgery (OR: 1.6; 95% CI: 1.2â2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1â1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3â2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97â1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03â2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections
Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTICâHF: baseline characteristics and comparison with contemporary clinical trials
Aims:
The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTICâHF) trial. Here we describe the baseline characteristics of participants in GALACTICâHF and how these compare with other contemporary trials.
Methods and Results:
Adults with established HFrEF, New York Heart Association functional class (NYHA)ââ„âII, EF â€35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokineticâguided dosing: 25, 37.5 or 50âmg bid). 8256 patients [male (79%), nonâwhite (22%), mean age 65âyears] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NTâproBNP 1971âpg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTICâHF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressureâ<â100âmmHg (n = 1127), estimated glomerular filtration rate <â30âmL/min/1.73 m2 (n = 528), and treated with sacubitrilâvalsartan at baseline (n = 1594).
Conclusions:
GALACTICâHF enrolled a wellâtreated, highârisk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation
Como en un juego de espejos, metrĂłpolis vs. necrĂłpolis. Una aproximaciĂłn al Cementerio San Pedro de la ciudad de MedellĂn como fuente de refl exiĂłn histĂłrica y antropolĂłgica
Resumen. Este artĂculo propone una aproximaciĂłn al Cementerio San Pedro de la ciudad de MedellĂn como fuente para abordar el estudio antropolĂłgico de los distintos periodos del desarrollohistĂłrico de la ciudad. Presenta como referentes centrales de anĂĄlisis la disposiciĂłn espacial de los diversos bienes localizados en un cementerio, las prĂĄcticas rituales asociadas al culto a los muertos en los campos santos y las manifestaciones lingĂŒĂsticas (especĂfi camente las escritas) asociadas a estos espacios. Un ejemplo etnogrĂĄfi co ilustra todo este desarrollo conceptual.Abstract. This article presents an examination of the San Pedro cemetery in MedellĂn as a source for the anthropological study of the distinct historical periods of the city. It offers the ideas of the spatial disposition of diverse properties located in the cementery, the ritual practices associated with the cult of the dead on sacred ground and the linguistic manifestations, especially written ones, regarding these spaces, as central references for analysis. An ethnographic example illustrates this conceptual development