Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World.

Background: Skin and soft tissue infections are one of the main causes of consultations worldwide. The objective was to determine the treatment of a group of patients with uncomplicated skin and soft tissue infections in Colombia. Methods: Follow-up study of a cohort of patients with skin infections who were treated in the Colombian Health System. Sociodemographic, clinical and pharmacological variables were identified. Treatments were evaluated using clinical practice guidelines for skin infections. Results: A total of 400 patients were analyzed. They had a median age of 38.0 years and 52.3% were men. The most commonly used antibiotics were cephalexin (39.0%), dicloxacillin (28.0%) and clindamycin (18.0%). A total of 49.8% of the subjects received inappropriate antibiotics, especially those with purulent infections (82.0%). Being cared for in an outpatient clinic (OR: 2.09; 95% CI: 1.06-4.12), presenting pain (OR: 3.72; 95% CI: 1.41-9.78) and having a purulent infection (OR: 25.71; 95% CI: 14.52-45.52) were associated with a higher probability of receiving inappropriate antibiotics. Conclusions: Half of patients with uncomplicated skin and soft tissue infections were treated with antibiotics that were not recommended by clinical practice guidelines. This inappropriate use of antibiotics occurred in the vast majority of patients with purulent infections because the antimicrobials used had no effect on methicillin-resistant Staphylococcus aureus.

Sistematización de una sistematización: aprendizajes sobre el método / Systematization of a systematization: learning about the method / Sistematização de uma sistematização: aprendizagem sobre o método

Resumen Objetivo: presentar los aprendizajes de una sistematización como método, para la construcción de conocimiento basado en la experiencia vivida por los propios investigadores de varios proyectos sobre la educación en crianza, en el campo de la salud pública, llevado a cabo en la vereda Granizal, Antioquia, durante el período 2013-2019. Materiales y método: se empleó la sistematización de experiencias y los participantes fueron los mismos investigadores. Se inició con la organización de los materiales, los diarios de campo de los círculos de investigación temática y relatorías de las reuniones del equipo de investigación y de los actores comunitarios. Se siguió con la elaboración de una matriz con la recuperación histórica. Y, finalmente, de las reflexiones grupales, surgieron categorías y relaciones para la construcción teórica de visión de conjunto. Resultados: se presenta la propuesta teórica de la sistematización y los procedimientos para implementarla, orientada por cinco momentos: vivir la experiencia, formular un plan de sistematización, recuperar el proceso vivido, las reflexiones de fondo y los puntos de llegada. Se destacan cuatro rasgos de la sistematización: una investigación creativa; basada en un proceso de construcción colectiva; para aprender de la práctica y construir conocimiento; y como escenario transformador de esta y de quienes la realizaron. Conclusión: la "sistematización de la sistematización" permitió hacer conciencia sobre la propia praxis investigativa. Muestra la comprensión del grupo acerca de la conceptualización y metodología de esta perspectiva investigativa. Trasciende la recopilación y organización de la información del proceso vivido en la medida en que la reconstrucción de la experiencia es una comprensión más amplia que transforma la práctica de los sujetos involucrados.

Abstract Objective: to present the learning of a systematization as a method, for the construction of knowledge based on the experience lived by the researchers of several projects on parenting education in the field of public health carried out in the rural settlement of Granizal, Antioquia, during the period 2013-2019. Materials and method: the systematization of experiences was used and the participants were the researchers. It began with the organization of the materials, the field diaries of the thematic research circles and reports of the meetings of the research team and community actors. It was continued with the elaboration of a matrix with the historical recovery. And, finally, reflections, categories and relationships emerged from the group for the theoretical construction of the overall vision. Results: the theoretical proposal of the systematization and the procedures to implement it are presented, guided by five moments: living the experience, formulating a systematization plan, recovering the lived process, the background reflections and the arrival points. Four features of systematization stand out: creative research; research based on a process of collective construction; learning from practice and building knowledge; and as a transforming scenario of this research and of those who carried it out. Conclusion: the "systematization of the systematization" allowed raising awareness of the research praxis itself. It shows the understanding of the group on conceptualization and methodology of this research perspective. It transcends the collection and organization of the information of the process lived to the extent that the reconstruction of the experience is a broader understanding that transforms the practice of the subjects involved.

Resumo Objetivo: apresentar as aprendizagens de uma sistematização como método, para a construção de conhecimento baseado na experiência vivida pelos próprios pesquisadores de vários projetos sobre a educação em criação, no campo da saúde pública, levado a cabo no povoado Granizal, Antioquia, durante o período 2013-2019. Materiais e método: utilizou-se a sistematização de experiências os participantes foram os mesmos pesquisadores. Iniciou-se com a organização dos materiais, os diários de campo dos círculos de pesquisa temática e relatorias das reuniões da equipe de pesquisa e dos atores comunitários. Conseguiu-se com a elaboração de uma matriz com a recuperação histórica. E, finalmente, das reflexões grupais, surgiram categorias e relações para a construção teórica de visão de conjunto. Resultados: apresenta-se a proposta teórica da sistematização e os procedimentos para implementá-la, orientada por cinco momentos: viver a experiência, formular um plano de sistematização, recuperar os processos vividos, as reflexões de fundo e os pontos de chegada. Destacam-se quatro rasgos da sistematização: uma pesquisa criativa; baseada em um processo de construção coletiva; para aprender da prática e construir conhecimento; e como cenário transformador desta e de quem a realizaram. Conclusão: a "sistematização da sistematização" permitiu fazer consciência sobre a própria práxis pesquisaria. Amostra a compreensão do grupo acerca da conceptualização e metodologia desta perspectiva pesquisaria. Trascende a recopilação e organização da informação do processo vivido na medida em que a reconstrução da experiência é uma compreensão mais ampla que transforma a prática dos sujeitos envolvidos.

Prescription Patterns of Drugs Given to Hospitalized COVID-19 Patients: A Cross-Sectional Study in Colombia.

The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. Most studies have not shown favorable results for many of these drugs, but they are still used. The aim as to determine the differences and similarities in the hospital pharmacological management of patients with COVID-19 according to sex, age group, and geographical region of Colombia, 2020-2021. Descriptive cross-sectional study was conducted on the prescription patterns of the medications given to patients diagnosed with COVID-19 treated in eight clinics in Colombia between 6 March 2020 and 31 May 2021. We performed a descriptive analysis of the sociodemographic, clinical, and pharmacological variables of the patients. A total of 8596 patients from 170 cities were identified, with a median age of 53.0 years and 53.3% of them men. A total of 24.3% required care in the intensive care unit, and 18.7% required invasive mechanical ventilation. The most commonly used drugs for the treatment of COVID-19 were systemic corticosteroids (63.6%), followed by colchicine (12.8%), azithromycin (8.9%), and ivermectin (6.4%). Corticosteroids, anticoagulants, colchicine, azithromycin, ivermectin, and hydroxychloroquine were prescribed more frequently in men, and their overall use increased with age. There were differences in prescriptions between geographic regions. The majority of patients were managed with medications included in the management guidelines. There were differences between sexes, age groups, and geographical regions.

Experiencia de educación sobre la crianza en un asentamiento de Colombia / A child rearing educational experience in a Colombian settlement / Experiência de educação sobre a criação em um assentamento colombiano

Resumen (analítico) Se presenta la experiencia de un proceso educativo orientado a promover transformaciones en las personas y sus condiciones de vida, a partir de una investigación-acción sobre crianza. Durante dos años se realizaron 40 círculos de investigación temática con mujeres desplazadas por la violencia en un asentamiento periférico colombiano, orientados por la educación popular. Con la información registrada en diarios de campo se hizo un análisis hermenéutico. Los temas generadores fueron machismo, violencia, identidad, sexualidad, afecto, autoridad, norma, castigo, oportunidades, sueños, amor, organización social, entre otros. Partiendo de situaciones límite se construyeron códigos narrativos, los cuales permitieron configurar una problematización. La investigación temática permitió realizar una educación en crianza alternativa y constituyó un proceso pedagógico que motivó cambios en la vida de las participantes.

Abstract (analytical) This paper presents the experience of a child rearing educational process. This work aimed to promote transformations in people and their living conditions and is based on Action Research for child rearing. For two years, 40 Thematic Research circles were held in a peripheral Colombian settlement. The circles were implemented with women displaced by violence and guided using the principles of popular education. A hermeneutical analysis was conducted with information recorded in field diaries. The main topics identified were: sexism, violence, identity, sexuality, affection, authority, norms, punishment, opportunities, dreams, love, social organization and others. Narrative codes were constructed to problematize this data. This Thematic Research facilitated an alternative child rearing education and was an educational process that motivated changes in the lives of participants.

Resumo (analítico) Este artigo apresenta a experiência de um processo educacional que procura promover impacto e mudanças nas pessoas e nas suas condições de vida, com base numa Pesquisa-Ação sobre o cuidado. Durante dois anos, foram realizados 40 círculos de Investigação Temática com mulheres deslocadas pela violência num assentamento periférico colombiano, orientado pela educação popular. Foi efetuada uma análise hermenêutica com as informações registadas em diários de campo. Emergiram temas como o machismo, a violência, a identidade, a sexualidade, o afeto, a autoridade, a norma, a punição, as oportunidades, os sonhos, o amor, a organização social, entre outros. Com as situações-limites, foram construídos códigos narrativos para definir a problemática. A Investigação Temática permitiu uma educação sobre um cuidado alternativo e foi um processo educativo que motivou mudanças na vida dos participantes.

Education, child rearing and social justice / Educación, crianza infantil y justicia social / Educação, educação infantil e justiça social

Abstract Health professionals often teach about child rearing based on traditional and transmissionist educational models that prescribe knowledge and meanings without considering whether families have the means to carry out the type of child rearing they value. This article discusses the meanings that child rearing has for a group of caregivers in a settlement inhabited mainly by people forcibly displaced by the armed conflict in Colombia as a way to go forward in understanding child rearing education. This work is a partial product of an action research and education project based on the strategy of thematic investigation circles. The analysis of the findings from the perspective of justice identified three areas of injustice that caregivers face as they undertake child rearing: structural-material, symbolic and cognitive. Addressing health education initiatives, including child rearing education, from a social justice perspective, entails helping people to overcome the unjust conditions faced by the subaltern population. It is also essential that health professionals learn from the students with whom they interact in order to develop more relevant education that aims to promote individual and social transformation.

Resumen Es común que los profesionales de la salud realicen educación sobre la crianza desde modelos educativos tradicionales y transmisionistas, los cuales imponen conocimientos y significados sin tener en cuenta las oportunidades que tienen las familias para realizar la crianza que valoran. Este artículo presenta los significados que sobre la crianza tiene un grupo de cuidadoras de un asentamiento habitado principalmente por población en situación de desplazamiento forzado debido al conflicto armado que vive Colombia. Es un producto parcial de un proyecto de investigación acción/educación cuya estrategia central fueron los círculos de investigación temática. El análisis de los hallazgos, realizado desde una perspectiva de justicia, identificó tres ámbitos de injusticia que las cuidadoras afrontan a la hora de realizar sus crianzas: estructural-material, simbólica y cognitiva. Abordar las acciones en salud pública y la educación para la salud - en particular la educación sobre la crianza - desde una perspectiva de justicia social, se hace necesario para contribuir a superar las condiciones de injusticia de las poblaciones subalternas; además es fundamental para que los profesionales de salud aprendan de los educandos con los cuales interactúan, como requisito para el desarrollo de procesos educativos más pertinentes tendientes a promover la transformación individual y social.

Resumo É comum que os profissionais da saúde realizam educação sobre a criação desde modelos educativos tradicionais e os professores dedicados, os quais impõem conhecimentos e significados sem ter em conta as oportunidades que têm as famílias para realizar a criação que valoram. Este artigo apresenta os significados que sobre a criação tem um grupo de cuidadoras dum assentamento habitado principalmente por população em situação de êxodo forçado devido ao conflito armado que mora na Colômbia. É um produto parcial dum projeto de pesquisa ação/educação cuja estratégia central foram os círculos de pesquisa temática. O analise dos descobrimentos, realizado desde uma perspectiva de justiça, identificou três âmbitos de injustiça que as cuidadoras afrontam à hora de realizar sua criação: estrutural-material, simbólica e cognitiva. Abordar as ações em saúde pública e a educação para a saúde - em particular a educação sobre a criação - desde uma perspectiva de justiça social, se faz necessário para contribuir a superar as condições de injustiça da população subalterna; além é fundamental para que os professionais de saúde aprendam dos estudantes com os quais interatuam, como requisito para o desenvolvimento de processos educativos mais pertinentes tendentes a promover a transformação individual e social.

Evaluación del retiro progresivo y/o la suspensión de la terapia anti-TNF-alpha en la enfermedad inflamatoria intestinal / Evaluation of de-escalation of anti-TNF-alpha therapy in inflammatory bowel disease

La efectividad de la terapia con fármacos antifactor de necrosis tumoral alpha en la enfermedad inflamatoria intestinal ha sido probada en la práctica clínica. Tras más de una década de uso de este tipo de fármacos, surge la interrogante acerca de si existe un momento apropiado para suspender estas terapias, y de qué manera esta debiera realizarse. Esta revisión tiene por objetivo evaluar la evidencia actual acerca del retiro de la terapia con antifactor de necrosis tumoral alpha y, eventualmente, identificar las condiciones o los subgrupos de pacientes potencialmente candidatos a la suspensión o el retiro de esta

Anti-tumour necrosis factor alpha therapy in inflammatory bowel disease has been shown to be effective in clinical practice. After more than a decade using these therapies the question arises about whether there is an appropriate time to suspend these therapies, and how this should be done. This review aims to evaluate the current evidence on these topics concerning anti-tumour necrosis factor alpha therapies, and eventually identify conditions and subgroups of patients that could potentially be candidates for withdrawal

Evaluation of de-escalation of anti-TNF-α therapy in inflammatory bowel disease. / Evaluación del retiro progresivo y/o la suspensión de la terapia anti-TNF-α en la enfermedad inflamatoria intestinal.

Anti-tumour necrosis factor α therapy in inflammatory bowel disease has been shown to be effective in clinical practice. After more than a decade using these therapies the question arises about whether there is an appropriate time to suspend these therapies, and how this should be done. This review aims to evaluate the current evidence on these topics concerning anti-tumour necrosis factor α therapies, and eventually identify conditions and subgroups of patients that could potentially be candidates for withdrawal.

Descripción clínica y epidemiológica de los pacientes con colitis ulcerativa en un hospital universitario de Colombia / Clinical and epidemiological description of patients with ulcerative colitis in a university hospital in Colombia

Introducción y objetivo: La colitis ulcerativa (CU) es una enfermedad inflamatoria intes-tinal crónica limitada a la mucosa del colon, caracterizada por ser difusa y continua. El objetivo es identificar las principales características de los pacientes con diagnóstico de CU. Métodos: Estudio observacional, descriptivo, de corte transversal retrospectivo. La población de estudio fueron pacientes del hospital universitario. Resultados: Un total de 30 pacientes fueron analizados. El promedio de edad fue de 53,86 años. El 46,7% fueron hombres. Los pacientes presentaron diarrea (90%), hematoquecia (86,7%), dolor abdominal (83,3%), fiebre (26,7%), astenia y adinamia (26,7%), pérdida de peso (16,7%). En un paciente se asoció a espondilitis anquilosante y otro a colangitis esclerosante primaria.

Parámetros hematológicos y recuento de células T-CD4+ en pacientes VIH con síntomas digestivos en Bucaramanga, Colombia / Haematological parameters and T-CD4+ cells count in HIV patients with digestive symptoms in Bucaramanga, Colombia

Introducción: La anemia, las citopenias y la sintomatología digestiva son hallazgos frecuentes en la población con infección por el virus de la inmunodeficiencia humana, VIH. Objetivo: Describir los parámetros hematológicos y el recuento de linfocitos T- CD4 en pacientes con VIH hospitalizados por síntomas digestivos a los que se realizaron estudios endoscópicos. Métodos: Se realizó un estudio observacional y descriptivo en 54 pacientes con VIH que se consultaron por síntomas digestivos y que requirieron procedimientos endoscópicos digestivos altos o bajos durante el año 2014 en un Hospital Universitario de tercer nivel en Bucaramanga, Colombia.Se tomaron datos sociodemográficos, se indagó sobre el uso de terapia antirretroviral altamente efectiva (TARAE), se registró la sintomatología digestiva, el tipo de procedimiento realizado, los datos del hemograma, el recuento de linfocitos T-CD4, la realización de mielograma, biopsia de médula ósea y la mortalidaddurante la estancia hospitalaria. Resultados: La prevalencia de anemia, leucopenia y trombocitopenia fue de 83.3 por ciento, 37 por ciento y 20.3 por ciento, respectivamente. Se encontró bicitopenia y pancitopenia en 25.9 por ciento y 14.8 por ciento.De los pacientes con bicitopenia y pancitopenia se les realizó estudio de médula ósea a 57.1 por ciento y 87.5 por ciento, respectivamente. Se encontró una tendencia de conteo de linfocitos T-CD4 menor en aquellos pacientes con anemia. Conclusiones: Las alteraciones hematológicas son frecuentes en pacientes con VIH y síntomas digestivos, con alta prevalencia de anemia. Los recuentos de linfocitos T-CD4 encontrados fueron notoriamente bajos(AU)

Introduction: Anemia, cytopenias and gastrointestinal symptoms are common findings in the population that are infected by the HIV. Objective: To describe hematological parameters and the T-CD4 cell counts in HIVpatients hospitalized for gastrointestinal symptoms that were taken to endoscopy. Methods: A descriptive study in 54 HIV patients who consulted for digestive symptoms and requiring high or low digestive endoscopy during 2014 in a third level University Hospital of Bucaramanga, Colombiawas carried out. Sociodemographicdata were questioned, it was the use of highly active antiretroviral therapy (HAART), it was registered digestive symptoms, type of procedure, data from blood count, T-CD4 count, myelogram, bone marrow biopsy and mortality during hospital stay were recorded. Results: The prevalence of anemia, leucopenia and thrombocytopenia were 83.3 percent, 37 percent and 20.3 percent, respectively. Bicytopenia and pancytopenia were found in 25.9 percent and 14.8 percent. Bicytopenia patients with pancytopenia and underwent bone marrow study to 57.1 percent and 87.5 percent, respectively. A trend of lower T-CD4 lymphocyte count was found in patients with anemia. Conclusions: Hematological disorders are common in patients with HIV and digestive symptoms, with high prevalence of anemia. T-CD4 counts were found notoriously low(AU)

Cirrosis hepática por hepatitis autoinmune: Serie de casos y revisión de la literatura / Liver cirrhosis secondary to autoimmune hepatitis: Case series and literature review

Las enfermedades hepáticas autoinmunes constituyen una causa importante de cirrosis hepática y dado que un tratamiento oportuno impacta en su pronóstico y desenlace, es muy importante conocer sus formas de presentación, diagnóstico y tratamiento, para ofrecer a los pacientes las mejores opciones terapéuticas de una manera oportuna. El objetivo del presente artículo fue describir las características de un grupo de pacientes adultos con cirrosis hepática por hepatitis autoinmune atendidos en el Hospital Universitario de Santander en la ciudad de Bucaramanga, Colombia y hacer una revisión de la literatura sobre las principales características de la hepatitis autoinmune. Para dicho propósito, se presentan cinco casos de cirrosis hepática secundaria a hepatitis autoinmune, de los cuales se analizaron las características epidemiológicas, clínicas y de laboratorio y se comparó con lo encontrado en la literatura médica después de una revisión del tema. MÉD.UIS. 2016;29(2):175-82.

Autoimmune liver diseases are important causes of liver cirrhosis, because an early treatment impact on prognosis and outcomes, it is very important to know their forms of presentation, diagnosis and treatment, to offer patients the best treatment options in a timely manner. The aim of this article was to describe the characteristics of a group of adult patients with liver cirrhosis secondary to autoimmune hepatitis treated in the Hospital Universitario de Santander in Bucaramanga, Colombia, and to do a review of the literature on the main features of the autoimmune hepatitis. For this purpose we present five cases of liver cirrhosis secondary to autoimmune hepatitis, of which the epidemiological, clinical and laboratory characteristics were analyzed and compared with those found in the literature after a review about this topic. MÉD.UIS. 2016;29(2):175-82.

Las necesidades sociales como eje de la formación médica / Necessidades sociais como eixo da formação médica / Medical education based on social needs

Esta reflexión pedagógica surge de una experiencia académica que se ha desarrollado desde 2004 en la Facultad de Medicina de la Universidad de Antioquia, está enmarcada en el trabajo comunitario con los habitantes de la vereda Granizal (Bello, Antioquia). Se propone avanzar en la estructuración de un currículo integrado teniendo en cuenta las limitaciones del currículo actual. Para lograrlo se plantea la formación profesional de los médicos en los escenarios extramurales diferentes a los tradicionales como el salón de clase y el hospital. Se busca desarrollar en el estudiante habilidades clínicas, reflexivas, pensamiento crítico, actitud investigativa y de comunicación, reforzando la competencia de aprender a aprender y el aprendizaje significativo. Adicionalmente se favorece la interdisciplinariedad, la integración entre básicas-clínicas y teoría-práctica para resolver las necesidades sociales y generar conciencia ético-política y valores de los estudiantes en formación...

A presente reflexão pedagógica começou a partir de uma experiência acadêmica concreta que teve lugar, em 2004, na Faculdade de Medicina da Universidade de Antioquia, e foi desenvolvida com base no trabalho com os moradores da comunidade Granizal, zona rural do município de Bello, Antioquia. Propõe-se mudar o currículo atual (que tem limitações) para um currículo integrado. A principal estratégia para atingir tal mudança é priorizar as comunidades como o foco central da formação, além das aulas e os hospitais. Na comunidade, os discentes desenvolvem habilidades clínicas de reflexão e investigativas, obtendo a competência de aprender a aprender e a aprendizagem significativa. Finalmente, na comunidade, o estudante interage com uma equipe interdisciplinar, integra o conhecimento teórico-prático e básico-clínico, além da oportunidade de alcançar consciência ético-política e valores...

This pedagogical reflection originated from academic experience at the School of Medicine, University of Antioquia, based on community work among the inhabitants of the Granizal community, in the rural zone of the municipality of Bello, Antioquia, which started in 2004. It is proposed to move towards an integrated curriculum, given the limitations of the current one. To achieve this change, the main strategy is to prioritize communities as the central focus of the training, thus going beyond the classroom and the hospital. It is sought to develop reflective clinical skills, critical thinking and investigative and communicative attitudes among the students, thus strengthening their capacity for learning to learn and meaningful learning. Additionally, interdisciplinarity and integration between basic and clinical subjects and between theory and practice are favored, in order to resolve social needs and to create ethical-political awareness and values among the medical students...

Activity of 2-aryl-2-(3-indolyl)acetohydroxamates against drug-resistant cancer cells.

Many types of tumor, including glioma, melanoma, non-small cell lung, esophageal, and head and neck cancer, among others, are intrinsically resistant to apoptosis induction and poorly responsive to current therapies with proapoptotic agents. In addition, tumors often develop multidrug resistance based on the cellular efflux of chemotherapeutic agents. Thus, novel anticancer agents capable of overcoming these intrinsic or developed tumor resistance mechanisms are urgently needed. We describe a series of 2-aryl-2-(3-indolyl)acetohydroxamic acids that are active against apoptosis- and multidrug-resistant cancer cells as well as glioblastoma neurosphere stemlike cell cultures derived from patients. Thus, the described compounds serve as a novel chemical scaffold for the development of potentially highly effective clinical cancer drugs.

Comportamiento del virus de la bronquitis infecciosa aviar en aves con sintomatología respiratoria provenientes de granjas de producción del Departamento de Cundinamarca / Avian Infectious Bronchitis virus behavior in birds from commercial farms with a history of respiratory disease, located in the department of Cundinamarca

Objetivo. Evaluar la dinámica serológica contra el virus de bronquitis infecciosa aviar y su relación con la presentación y/o antecedentes de signos clínicos y hallazgos patológicos, bajo condiciones de campo. Materiales y métodos. Se realizó un muestreo al azar en dos fases, en pollo de engorde y reproductoras de granjas del Departamento de Cundinamarca. En la primera fase se tomó muestra de sangre a un total de 224 aves, distribuidas en 7 granjas. En la segunda fase, realizada 20 días posteriores al primer muestreo, se tomó una segunda muestra al mismo número de aves empleadas inicialmente. Las muestras de los sueros obtenidos se emplearon para la realización del inmunoensayo ligado a enzima (ELISA), diseñado para detectar anticuerpos frente al virus de la bronquitis infecciosa aviar en suero sanguíneo. Resultados. Se obtuvo que del total de las granjas analizadas el 85.72% mostró reactividad serológica al virus de la Bronquitis Infecciosa aviar (VBIA), con correlación ante la presencia de los signos clínicos o antecedentes respiratorios en granja.

Objective. Evaluate the serological dynamics against avian infectious bronchitis virus and its relationship with the presentation and / or a history of clinical signs and pathological findings, under field conditions. Materials and methods. A random sampling was conducted in two phases, in broiler and breeder farms located in the Department of Cundinamarca. In the first phase blood sample were taken from a total of 224 birds, distributed over the 7 farms. In the second phase, carried out 20 days after the first, a second sample was collected from the same number of birds used in the first phase. The serum samples were used to carry out the enzyme linked immunoassay (ELISA) intended to detect antibodies against avian infectious bronchitis virus in blood serum. Results. As a result it was found that from the total farms analyzed the 85.72% showed serologic reactivity against Avian Infectious Bronchitis Virus (AIBV) that correlated to the presence of clinical signs or previous history of respiratory disease in the farm.

Carbon nanotube-loaded Nafion film electrochemical sensor for metal ions: europium.

A Nafion film loaded with novel catalyst-free multiwalled carbon nanotubes (MWCNTs) was used to modify a glassy carbon (GC) electrode to detect trace concentrations of metal ions, with europium ion (Eu(3+)) as a model. The interaction between the sidewalls of MWCNTs and the hydrophobic backbone of Nafion allows the MWCNTs to be dispersed in Nafion, which was then coated as a thin film on the GC electrode surface. The electrochemical response to Eu(3+) was found to be ∼10 times improved by MWCNT concentrations between 0.5 and 2 mg/mL, which effectively expanded the electrode surface into the Nafion film and thereby reduced the diffusion distance of Eu(3+) to the electrode surface. At low MWCNT concentrations of 0.25 and 0.5 mg/mL, no significant improvement in signal was obtained compared with Nafion alone. Scanning electron microscopy and electrochemical impedance spectroscopy were used to characterize the structure of the MWCNT-Nafion film, followed by electrochemical characterization with Eu(3+) via cyclic voltammetry and preconcentration voltammetry. Under the optimized conditions, a linear range of 1-100 nM with a calculated detection limit of 0.37 nM (signal/noise = 3) was obtained for determination of Eu(3+) by Osteryoung square-wave voltammetry after a preconcentration time of 480 s.

Condiciones sociales y de salud de los recicladores de Medellín / Social conditions and health profile of recyclers from Medellín

Objetivo Los recicladores en la ciudad de Medellín (Colombia) son un grupo social de gran tradición que en una gran mayoría han trabajado en sectores informales de la economía. Este estudio tiene como objetivo analizar la situación social y económica, el perfil de morbilidad y las condiciones de acceso a los servicios de salud en una población de recicladores y sus familias. Métodos Estudio descriptivo, mediante encuestas de caracterización socioeconómica en recicladores y familiares (515 personas) y su valoración médica (174 personas). Se describieron las variables estudiadas por edad y sexo. El área de estudio estuvo constituida por los recicladores del sector de Guayaquil (Medellín). Resultados El 71,6 por ciento de la población analizada habita en barrios de estratos medio bajo y bajo, en su mayoría población joven. Se establecen principalmente (83 por ciento) por uniones libres y matrimonios con un promedio de 5,3 ± 2,7 personas por familia. El 42 por ciento viven en situación de pobreza. Se reportan infecciones respiratorias (32,5 por ciento) y diarreicas (10,5 por ciento) y en la valoración médica, se encuentran enfermedades crónicas (47,1 por ciento), entre ellas enfermedades del sistema nervioso y órganos de los sentidos (20,1 por ciento). El 37 por ciento no están cubiertos por un seguro de salud. Conclusiones Se presentan condiciones de vida y de salud deficientes, que requieren soluciones concretas para este grupo que permitan el mejoramiento del nivel social, la generación de empleo, el aumento de la cobertura en salud y la realización de campañas de promoción de la salud y prevención de la enfermedad.

Objective Recyclers in the city of Medellin (Colombia) are social groups having a long-standing tradition; many of them have worked in informal economy sectors. This study was aimed at analysing their economic and social situation, health profile and health service accessibility (i.e. for a recycler group and their families). Methods A descriptive study was carried out by means of socioeconomic characterisation surveys of recyclers and relatives (515) and 174 medical examinations. The variables were described by age and gender. The area being studied was the locality of Guayaquil (Medellín) and its recyclers who accepted participating in the study. Results 71,6 percent of the population being analysed inhabited lower and middle-lower class neighbourhoods; most were young people. The main household organisation consisted of living with a partner and marriage (83 percent), having 5,3 ± 2,7 people per family. 42 percent were living in conditions of poverty (1-2 dollars per day income). Respiratory (32,5 percent) and diarrheic infections (10,5 percent) were reported. Medical examination revealed chronic diseases (47,1 percent), nervous system and sense organ diseases (20,1 percent). 37 percent had no health insurance. Conclusion The recyclers and their relatives were living in deficient social conditions. Public health action for the benefit of this group is required by means of generating employment, increasing health insurance cover and promoting specific health promotion and disease prevention strategies.

[Social conditions and health profile of recyclers from Medellín]. / Condiciones sociales y de salud de los recicladores de Medellín.

OBJECTIVE: Recyclers in the city of Medellin (Colombia) are social groups having a long-standing tradition; many of them have worked in informal economy sectors. This study was aimed at analysing their economic and social situation, health profile and health service accessibility (i.e. for a recycler group and their families). METHODS: A descriptive study was carried out by means of socioeconomic characterisation surveys of recyclers and relatives (515) and 174 medical examinations. The variables were described by age and gender. The area being studied was the locality of Guayaquil (Medellín) and its recyclers who accepted participating in the study. RESULTS: 71.6 % of the population being analysed inhabited lower and middle-lower class neighbourhoods; most were young people. The main household organisation consisted of living with a partner and marriage (83 %), having 5.3 +/- 2.7 people per family. 42 % were living in conditions of poverty (1-2 dollars per day income). Respiratory (32.5 %) and diarrheic infections (10.5 %) were reported. Medical examination revealed chronic diseases (47.1 %), nervous system and sense organ diseases (20.1 %). 37 % had no health insurance. CONCLUSION: The recyclers and their relatives were living in deficient social conditions. Public health action for the benefit of this group is required by means of generating employment, increasing health insurance cover and promoting specific health promotion and disease prevention strategies.

Condiciones de trabajo y salud de los recicladores urbanos de Medellín (Colombia) / Working conditions and health among urban recycling workers in Medellín (Colombia)

Objetivos. Analizar la situación laboral, socio-económica, y las condiciones de salud y acceso a la seguridad social de los recicladores de basura de Medellín (Colombia). Métodos. Estudio descriptivo combinando técnicas cuantitativas (encuestas sociodemográficas y de salud, revisiones médicas) y cualitativas (la observación participante del recorrido del reciclador en la jornada de trabajo y entrevistas sobre los aspectos más relevantes de su oficio). Resultados. Los recicladores tienen una jornada laboral mucho más intensa que la población general (el 58% trabajan más de ocho horas), el 64% llevan trabajando en el oficio más de seis años, y el 74% de los familiares han trabajado en la misma ocupación. Están expuestos a factores de riesgo físicos, químicos, relacionados con el orden público, la seguridad y con el tránsito vehicular; la mayoría (87%) tiene un salario inferior a los 8 € diarios, insuficiente para cubrir necesidades básicas La cobertura en salud es deficiente. Presentan con frecuencia infecciones respiratorias y enfermedades de los órganos de los sentidos. Conclusiones. Este grupo cumple una función importante dentro del proceso social y ambiental de la ciudad, en un entorno laboral con numerosos factores de riesgo y unas condiciones sociales y de salud menoscabadas en comparación con los indicadores para la población general. Se requieren estrategias que contribuyan a la mejora de sus condiciones de trabajo a través de políticas públicas, educación, prevención de riesgos y de la institución formal de organizaciones de trabajo que agrupen a este colectivo como son las cooperativas o asociaciones

Objectives. To analyze socioeconomic, occupational and health conditions of recycling workers in the city of Medellín (Colombia). Methods. A descriptive study, examining risk factors by means of quantitative techniques such as sociodemographic and health surveys, and clinical examinations, and qualitative techniques such as field observations of recycling workers, coupled with in-depth interviews about relevant aspects of their jobs. Results. Results show that recycling workers labor longer hours than the general population (58% work more than 8 hours per day). Sixty-four per cent have been working as recyclers for more than six years and 74% of their relatives have worked in the same job. They are exposed to various physical and chemical risk factors, as well as to risks associated with traffic or assaults. The majority (87%) have low salaries (less than 8 € per day), insufficient to cover basic necessities, and they present various health disorders, including respiratory infections and disorders of the senses. Conclusions. Recycling workers fulfill an important social function related to social and environmental processes in the city. Their work is performed under highly deficient health and safety conditions, with high risk exposures and social conditions worse than in the general population. Strategies are required in order to improve their job situation, through public polices, risk education and prevention, and their formal organization through cooperatives or workers’ associations

Controle de danos após trauma torácico contuso com lesão cardíaca em criança - relato de caso / damage control after abdominal trauma

O objetivo é descrever o caso de um traumatismo torácico contuso que cursou com grave lesão da artériapulmonar, tipo laceração, que conduziu o paciente ao choque hipovolêmico refratário às medidas de suporte,sendo adotado o controle de danos torácicos. A cirurgia de controle de danos tem sido muito difundida na literatura que aborda trauma, especialmente quando se trata detrauma abdominal. Entretanto, esse relato pretende demonstrar que também é possível adotar a cirurgia de controle de danos quando se aborda um traumatismo torácico grave em pacientes com pouca reserva fisiológica.

The objective is to describe a case of blunt chest trauma causing severe laceration-type injury in the pulmonary artery, which led the patient to developrefractory hypovolemic shock to the support measures, with the adoption of chest damage control. Damage control surgery has been quite spread in the literature on trauma, especially when dealing with abdominal trauma.Nevertheless, this report is aimed to demonstrate that it is also possible to adopt damage control surgery whentreating severe chest trauma in patients with reduced physiological reserve.

Adherencia al tratamiento. Implicaciones de la no-adherencia / Compliance with the treatment. Implications of non-compliance. Hot Topic

Objetivo: revisar la definición actual y los factores asociados a la no-adherencia al tratamiento y las metodologías que mejoran la adherencia a la terapia. Contexto: los pacientes que inadvertidamente omiten varias dosis y los médicos que atribuyen a falta de eficacia del medicamento pueden no ser conscientes que el problema subyacente es una pobre adherencia con el tratamiento prescrito.La no-adherencia es un fenómeno mundial de graves consecuencias, que se presenta en todas las edades, desde los niños hasta los ancianos. Se observa en casi todas los estados de las enfermedades crónicas y tiende a empeorar a medida que el paciente lleva más tiempo con la terapia.La complejidad del fenómeno de no-adherencia a la terapia involucra factores asociados al paciente, a la enfermedad, al ambiente, al medicamento y a la interacción médico-paciente, que requiere un abordaje multidimensional. Conclusión: han pasado más de 35 años y la no-adherencia se mantiene en cifras preocupantes (59 porciento), al igual que la proporción de hospitalizaciones derivadas del incumplimiento con el tratamiento (33 al 69 porciento). La mortalidad relacionada a la no adherencia registra cifras alarmantes que se mantienen en la misma proporción desde hace más de 15 años.

La expresión gráfica en la fabricación de prototipos. Descripción del proceso de un prototipo de mano derecha / The proficiency in dreafting oriented to the fabrication of prototipe. Description of prototype fabrication process

El avance vertiginoso de los sistemas en programas de 3-D y el maquinado de control numérico, han revolucionado el expresión gráfica como herramienta de excepción para la expresión del pensamiento abstracto ingenieril y guía de procesos de manufacturado. Mediante la aplicación del dibujo técnico: ensamblado y en explosión, y posteriormente pasado por dibujo asistido por computador (CAD) se diseña el prototipo de una mano derecha que incluye el equivalente a la articulación del cuerpo, para luego proceder a maquinado manual y evaluación mecánica comparada del modelo, el cual cumple con el 92 por ciento de los movimientos de la mano...