Eficacia del diagnóstico prenatal no invasivo por células fetales libres en sangre materna 1990-2014. Revisión sistemática

ANTECEDENTES: El aislamiento de células fetales libres o ADN fetal en sangre materna abre una ventana de posibilidades diagnósticas no invasivas para patologías monogénicas y cromosómicas, además de permitir la identificación del sexo y del RH fetal. Actualmente existen múltiples estudios que evalúan la eficacia de estos métodos, mostrando resultados costo-efectivos y de menor riesgo que el estándar de oro. Este trabajo describe la evidencia encontrada acerca del diagnóstico prenatal no invasivo luego de realizar una revisión sistemática de la literatura. OBJETIVOS: El objetivo de este estudio fue reunir la evidencia que cumpla con los criterios de búsqueda, en el tema del diagnóstico fetal no invasivo por células fetales libres en sangre materna para determinar su utilidad diagnóstica.  MÉTODOS: Se realizó una revisión sistemática de la literatura con el fin de determinar si el diagnóstico prenatal no invasivo por células fetales libres en sangre materna es efectivo como método de diagnóstico.  RESULTADOS: Se encontraron 5,893 artículos que cumplían con los criterios de búsqueda; 67 cumplieron los criterios de inclusión: 49.3% (33/67) correspondieron a estudios de corte transversal, 38,8% (26/67) a estudios de cohortes y el 11.9% (8/67) a estudios casos y controles. Se obtuvieron resultados de sensibilidad, especificidad y tipo de prueba. CONCLUSIÓN: En la presente revisión sistemática, se evidencia como el diagnóstico prenatal no invasivo es una técnica feasible, reproducible y sensible para el diagnóstico fetal, evitando el riesgo de un diagnóstico invasivo.

Testing for Hidden Information and Action in Automobile Insurance Market

I test the presence of hidden information and action in the automobile insurance market using a data set from several Colombian insurers. To identify the presence of hidden information I find a common knowledge variable providing information on policyholder s risk type which is related to both experienced risk and insurance demand and that was excluded from the pricing mechanism. Such unused variable is the record of policyholder s traffic offenses. I find evidence of adverse selection in six of the nine insurance companies for which the test is performed. From the point of view of hidden action I develop a dynamic model of effort in accident prevention given an insurance contract with bonus experience rating scheme and I show that individual accident probability decreases with previous accidents. This result brings a testable implication for the empirical identification of hidden action and based on that result I estimate an econometric model of the time spans between the purchase of the insurance and the first claim, between the first claim and the second one, and so on. I find strong evidence on the existence of unobserved heterogeneity that deceives the testable implication. Once the unobserved heterogeneity is controlled, I find conclusive statistical grounds supporting the presence of moral hazard in the Colombian insurance market.

Nongenetic inheritance, linguistic competence, prenatal experience and behavior manipulation: recent contributions from behavioral neurobiology and neuropsychology to the explanation of behavior

This article gives an overview of presuppositions and explanations posed by behaviorist psychology (particularly its radical branch), cognitive–nativist sciences (i.e. psycholinguistics and a branch of cognitive psychology) and other disciplines regarding important psychological events such as anxiety, stress, fear, mood states and language. In relation to the discussion of environment versus genetics, contributions from behavioral neurobiology and neuropsychology are added, showing evidence of traits that can be multigenerationally inherited in a non-genetic way, which have an impact thought the life of organisms and on their way of interacting with the environment; ways in which behavior can be altered by recently unsuspected environmental agents or events, and the overlooked role of prenatal experiences in the explanation of behavior. The evidence calls into question presuppositions made by the academic disciplines listed above, and suggests alternative behavior reinterpretations and explanations

Relación del ingreso en primer trimestre al control prenatal y el número de controles prenatales con el desenlace de prematurez en recién nacidos de mujeres afiliadas a una EPS en la ciudad de Bogotá quienes finalizaron su gestación entre abril y septiembre del 2003.

Con este estudio se espera proporcionar información real para la toma de decisiones que fortalezcan las políticas de promoción y prevención en la organización y similares, determinando y dando respuesta a la pregunta de investigación que se plantea así: ¿Cuál es la relación del ingreso en primer trimestre a control prenatal, el numero de controles prenatales y la aplicación de la estrategia para vigilar la aparición y manejo de las infecciones urinarias y vulvovaginitis (estrategia PVTS) con la prematurez de los recién nacidos de gestantes afiliadas al régimen contributivo de Cafesalud EPS que finalizaron su gestación en los meses comprendidos entre abril y septiembre del 2003 en la ciudad de Bogota?.

Factores asociados a la asistencia al control prenatal en gestantes del municipio de Yopal Casanare, Colombia – 2011

Introducción: Según OMS en 2011, 536.000 mujeres murieron en el mundo por causas relacionadas al embarazo y el parto; obteniendo Colombia índices altos de mortalidad materna (Fondo de Población de las Naciones Unidas, 2010); mientras Casanare reportó cuatro casos en 2009, y Yopal en 2010 alcanzó una tasa de 66,5 por 100.000 NV (Plan de desarrollo municipio de Yopal); por tanto se busca identificar factores que afectan la adherencia al control prenatal. Metodología: Estudio observacional de prevalencia analítica realizado con datos de gestantes de Yopal (Casanare) canalizadas por Intervenciones Colectivas 2011, con una muestra de 621 gestantes en las semanas de gestación 8,12,16,20,24,28,32,36,38 y 40.. Resultados: La adherencia al control prenatal fue del 15% y los factores que mostraron asociación estadísticamente significativa con adherencia al control prenatal fueron: régimen de salud (P=0.010); semana de gestación (p=0.000); trimestre del embarazo, antecedentes de abortos, apoyo económico (OR=1.738; IC=95%; 1.026-2.945); embarazo planeado, soporte familiar, satisfacción de compartir tiempo y espacio con el cónyuge (p=0.009, 0.001, 0.006); convivencia con familia materna (P=0.032), razón de verosimilitud 0.046, y valor OR=0.444; IC=95%; 0.208 – 0.948; y se identificaron barreras como inoportunidad de citas e insatisfacción por los servicios, donde el 98,9% de gestantes que no las encontraron tuvieron adherencia al control prenatal. Conclusión: Es necesario fortalecer programas de promoción de salud materna, control prenatal, prevención del embarazo adolescente y derechos de la mujer; reforzando acciones de vigilancia para disminuir las barreras de aseguramiento y calidad de los servicios.

Measuring and testing for the systemically important financial institutions

This paper analyzes the measure of systemic importance ∆CoV aR proposed by Adrian and Brunnermeier (2009, 2010) within the context of a similar class of risk measures used in the risk management literature. In addition, we develop a series of testing procedures, based on ∆CoV aR, to identify and rank the systemically important institutions. We stress the importance of statistical testing in interpreting the measure of systemic importance. An empirical application illustrates the testing procedures, using equity data for three European banks.

Statistical inference for testing Gini coefficients: an application for Colombia

This paper uses Colombian household survey data collected over the period 1984-2005 to estimate Gini coe¢ cients along with their corresponding standard errors. We Önd a statistically signiÖcant increase in wage income inequality following the adoption of the liberalisation measures of the early 1990s, and mixed evidence during the recovery years that followed the economic recession of the late 1990s. We also Önd that in several cases the observed di§erences in the Gini coe¢ cients across cities have not been statistically signiÖcant.

Testing for Stock Market Integration in a Developing Economy: Colombia

This paper examines the linkage between two parallel stock exchanges trading the same shares in Colombia, namely the Bogotá Stock Exchange and the Medellín Stock Exchange. We provide empirical evidence to support the hypothesis that these two markets can be best described as fully integrated over a period of almost four decades, which is consistent with the view that arbitrage opportunities are only possible in the short but not in the long run. In addition, we find evide

Testing the law of one price in food markets: evidence for Colombia using disaggregated data

This paper applies stationarity tests to examine evidence of market integration for a relatively large sample of food products in Colombia. We Önd little support for market integration when using the univariate KPSS tests for stationarity. However, within a panel context and after allowing for cross sectional dependence, the Hadri tests provide much more evidence supporting the view that food markets are integrated or, in other words, that the law of one price holds for most products.

Genetic testing with primary prevention and moral hazard

We develop a model where a free genetic test reveals whether the individual tested has a low or high probability of developing a disease. A costly prevention effort allows high-risk agents to decrease the probability of developing the disease. Agents are not obliged to take the test, but must disclose its results to insurers. Insurers offer separating contracts which take into account the individual risk, so that taking the test is associated to a discrimination risk. We study the individual decisions to take the test and to undertake the prevention effort as a function of the effort cost and of its e¢ ciency. We obtain that, if effort is observable by insurers, agents undertake the test only if the effort cost is neither too large nor too low. If the effort cost is not observable by insurers, they face a moral hazard problem which induces them to under-provide insurance. We obtain the counterintuitive result that moral hazard increases the value of the test if the effort cost is low enough. Also, agents may perform the test for lower levels of prevention e¢ ciency when effort is not observable