Factores asociados a infección de fracturas abiertas de extremidades por accidentes de tránsito. Bogotá, 2012-2013

Los traumatismos por accidentes de tránsito, constituyen un problema de salud pública, a nivel mundial. Las lesiones más frecuentes son las fracturas de extremidades (84.3%). Las fracturas tienen un elevado riesgo de presentar infecciones, secuelas e incapacidades permanentes. Objetivo : Determinar si los factores asociados con la patología (lugar de fractura, clasificación de fractura, comorbilidades del paciente) y/o los factores relacionados con la atención médica (uso de profilaxis antibiótica diferente al protocolo institucional, tiempo prolongado para remisión, demoras en manejo quirúrgico) se asocian a mayor probabilidad de presentar infección de fracturas abiertas, en población mayor a 15 años, atendidos por accidente de tránsito, en una clínica de Bogotá de tercer nivel especializada en atención de SOAT, durante el período Octubre de 2012 a Octubre de 2013. Metodología: Estudio de casos y controles no apareado, relación 1:3, conformado por 43 casos (fracturas abiertas infectadas) y 129 controles (fracturas abiertas no infectadas). Resultados: La edad media de los casos fue de 39.42 +/- 16.82 años (med=36 años) y la edad media de los controles fue de 33.15 +/- 11.78 años (med=30 años). El 83.7% de los casos y el 78.3% de los controles corresponden al sexo masculino. Predominaron los accidentes en motocicleta en el 81.4% de los casos y el 86% de los controles. En el análisis bivariado se encuentra que la edad mayor a 50 años (p=0.042), una clasificación de la fractura grado IIIB o IIIC (p=0.02), cumplimiento del protocolo antibiótico institucional según el grado de fractura (p=0.014) y un tiempo mayor a 24 horas desde el momento del accidente al centro especializado en trauma (p=0.035) se asociaron significativamente con infección de la fractura abierta. En el análisis multivariado se encuentra únicamente que la clasificación de la fractura grado IIIB o IIIC se asocia con infección de la fractura OR 2.6 IC95% (1.187 – 5.781) (p=0.017). La duración de hospitalización fue mayor en los casos (32.37+/- 22.92 días, med=26 días) que en los controles (8.81 +/- 7.52 días, med=6 días) (p<0.001). El promedio de lavados quirúrgicos fue mayor en los casos (4.85±4.1, med=4.0) que en el grupo control (1.94±1.26, med=2) (p<0.001). Conclusiones: La infección posterior a una fractura abierta, implica costos elevados de atención con hospitalizaciones prolongadas y mayor frecuencia de intervenciones quirúrgicas como se evidencia en el presente estudio. Se debe fortalecer el sistema de remisión y contra remisión para acortar los tiempos de inicio de manejo especializado de los pacientes con fracturas abiertas. Se debe incentivar dentro de las instituciones, el cumplimiento de protocolos de profilaxis antibiótica según el grado de la fractura para disminuir el riesgo de complicación infecciosa.

Relación entre los hallazgos radiográficos y la sintomatología respiratoria en trabajadores expuestos a polvo de carbón en minería de socavón en el departamento de Boyacá, Colombia 2015

Introducción: La inhalación de polvo de carbón favorece el desarrollo de neumoconiosis, causa daños irreversibles al pulmón que se identifican radiológicamente. Los síntomas son tardíos y la patología se puede desarrollar tras varios años de exposición. Objetivo: Caracterizar los hallazgos radiográficos según la metodología de la Organización Internacional del Trabajo (OIT) 2000 y relacionarlos con la sintomatología respiratoria en trabajadores expuestos a polvo de carbón en las labores de minería de socavón en el departamento de Boyacá, Colombia, 2015. Materiales y métodos: Estudio de corte transversal realizado en 232 mineros, se indagó características sociodemográficas, signos y síntomas del sistema respiratorio. Se realizó radiografías de tórax y se aplicó la metodología OIT para describir los hallazgos. Se estableció asociación estadística a través de la prueba Chi cuadrado de Pearson. Para el procesamiento de la información se utilizó el programa SPSS statistics 2.3 Resultados: Toda la población fue de sexo masculino, con una edad promedio de 40,8 años. El cargo de picador fue el más frecuente en 72,4% de los trabajadores. Las radiografías mostraron opacidades pequeñas redondeadas (q/q) en 42%. La expectoración fue el síntoma más frecuente 66,4%. Se encontró una relación estadísticamente significativa entre el tabaquismo con las anomalía parenquimatosas (p=0,002).Conclusión: La prevalencia de neumoconiosis para el departamento de Boyacá fue de 29.7% entre los trabajadores valorados según los criterios OIT para lectura de radiografías de tórax, por lo que se requiere poner en práctica medidas de control a fin de reducir al mínimo la exposición de los trabajadores.

Relatório Profissional

O presente Relatório traduz o percurso profissional por nós realizado no turismo desde o ano de 1980 até ao presente. O Relatório demonstra a amplitude do percurso profissional que desenvolvemos no turismo. Percurso realizado no sector empresarial do Estado, em gabinete ministerial, no sector privado, na gestão de fundo comunitário, no associativismo empresarial e intermunicipal, no ensino superior e como profissional em regime liberal. O Relatório descreve as áreas funcionais, as responsabilidades assumidas, as tarefas realizadas e os resultados alcançados nos diferentes organismos onde prestámos colaboração. Enfatizam-se as competências adquiridas no decurso do percurso profissional, nas áreas pública, privada, associativa e académica, nas vertentes técnica, organizacional, de negócio, interpessoal, intelectual e comportamental. Por último expressam-se os contributos por nós prestados e depositados nos organismos a quem prestámos serviço.

CPLP : a cultura como principal factor de coesão

CPLP – A Cultura Como Principal Factor de Coesão é uma dissertação que analisa a história da Comunidade dos Países de Língua Portuguesa (CPLP), no sentido de descobrir qual será o elemento mais preponderante na sua unidade e coesão. Incentivar a difusão da língua portuguesa, da criação intelectual e artística, e contribuir para o reforço da solidariedade e fraternidade entre todos os povos que têm essa língua como um dos fundamentos da sua identidade específica são os seus objectivos. Investigou-se o grau e o modo do cumprimento desses propósitos. Da comparação dos dados ressaltou uma conclusão inequívoca: a cultura é o elo mais forte na coesão da CPLP, embora não se vislumbrem estratégias assumidas com rigor quer da política da língua portuguesa, quer da política das culturas lusófonas. Confirmou-se que a CPLP nasceu como Comunidade de língua e culturas e não como comunidade económica. Tentou-se caracterizar a «identidade» lusófona. Para tal, percorreu-se a história da expansão, os processos de colonização, as características de miscigenação física e intercultural, enquanto se chamavam as mais recentes teorias sociológicas para uma caracterização do conceito de cultura «lusófona»: «ecológica de saberes», «de fronteira», «intercultural» e «tradutora de culturas». São apontadas melhorias estratégicas.

El peso de las ausencias (Testimonios)

El autor recuerda, desde la nostalgia por las ausencias de mayor peso, los contextos de una larga entrevista que él realizara a Alfredo Pareja Diezcanseco a fines de la década de los 80 -la cual ha sido ampliamente reseñada con posterioridad. El presente artículo es una semblanza que integra diversas facetas del intelectual Pareja y del hombre que fue, reseña su temperamento y la disciplina que lo impulsaron en su vocación de autodidacta. Finalmente alude a los diversos intereses temáticos de Pareja, que rebasaron los ámbitos de lo literario y lo histórico. La propuesta del autor está marcada por la lucidez, el afecto y la nostalgia, para dar rostro al personaje «de carne y hueso», al sobreviviente del Grupo de Guayaquil que fue Alfredo Pareja Diezcanseco.

Molecular evidence from ascidians for the evolutionary origin of vertebrate cranial sensory placodes

Cranial sensory placodes are specialised areas of the head ectoderm of vertebrate embryos that contribute to the formation of the cranial sense organs and associated ganglia. Placodes are often considered a vertebrate innovation, and their evolution has been hypothesised as one key adaptation underlying the evolution of active predation by primitive vertebrates. Here, we review recent molecular evidence pertinent to understanding the evolutionary origin of placodes. The development of vertebrate placodes is regulated by numerous genes, including members of the Pax, Six, Eya, Fox, Phox, Neurogenin and Pou gene families. In the sea squirt Ciona intestinalis (a basal chordate and close relative of the vertebrates), orthologues of these genes are deployed in the development of the oral and atrial siphons, structures used for filter feeding by the sessile adult. Our interpretation of these findings is that vertebrate placodes and sea squirt siphon primordia have evolved from the same patches of specialised ectoderm present in the common ancestor of the chordates.

Local roles of TGF-beta superfamily members in the control of ovarian follicle development

Members of the transforming growth factor-beta (TGF-beta) superfamily have wide-ranging influences on many tissue and organ systems including the ovary. Two recently discovered TGF-beta superfamily members, growth/differentiation factor-9 (GDF-9) and bone morphogenetic protein-15 (BMP-15; also designated as GDF-9B) are expressed in an oocyte-specific manner from a very early stage and play a key role in promoting follicle growth beyond the primary stage. Follicle growth to the small antral stage does not require gonadotrophins but appears to be driven by local autocrine/paracrine signals from both somatic cell types (granulosa and theca) and from the oocyte. TGF-beta superfamily members expressed by follicular cells and implicated in this phase of follicle development include TGF-beta, activin, GDF-9/9B and several BMPs. Acquisition of follicle-stimulating hormone (FSH) responsiveness is a pre-requisite for growth beyond the small antral stage and evidence indicates an autocrine role for granulosa-derived activin in promoting granulosa cell proliferation, FSH receptor expression and aromatase activity. Indeed, some of the effects of FSH on granulosa cells may be mediated by endogenous activin. At the same time, activin may act on theca cells to attenuate luteinizing hormone (LH)-dependent androgen production in small to medium-size antral follicles. Dominant follicle selection appears to depend on differential FSH sensitivity amongst a growing cohort of small antral follicles. Activin may contribute to this selection process by sensitizing those follicles with the highest "activin tone" to FSH. Production of inhibin, like oestradiol, increases in selected dominant follicles, in an FSH- and insulin-like growth factor-dependent manner and may exert a paracrine action on theca cells to upregulate LH-induced secretion of androgen, an essential requirement for further oestradiol secretion by the pre-ovulatory follicle. Like activin, BMP-4 and -7 (mostly from theca), and BMP-6 (mostly from oocyte), can enhance oestradiol and inhibin secretion by bovine granulosa cells while suppressing progesterone secretion; this suggests a functional role in delaying follicle luteinization and/or atresia. Follistatin, on the other hand, may favor luteinization and/or atresia by bio-neutralizing intrafollicular activin and BMPs. Activin receptors are expressed by the oocyte and activin may have a further intrafollicular role in the terminal stages of follicle differentiation to promote oocyte maturation and developmental competence. In a reciprocal manner, oocyte-derived GDF-9/9B may act on the surrounding cumulus granulosa cells to attenuate oestradiol output and promote progesterone and hyaluronic acid production, mucification and cumulus expansion.(C) 2003 Elsevier Science B.V. All rights reserved.

Sibling interaction of children with autism: development over 12 months

While deficits in social interaction are central to autism, the sibling relationship has been found to provide a key medium for the development of such skills. Naturalistic observations of sibling pairs including children with autism and controls with Down syndrome were made across two time periods, twelve months apart. Consistent with the evidence on typically developing children, the amount and rate of initiations of both prosocial and agonistic interaction increased, but further analysis suggested that these interactions were stage-managed by the typically developing children. Results show social interaction and imitation in children with autism and the special role that sibling interactions can play. Longitudinal research on the acquisition of social skills in children with developmental disabilities is needed.

Extracts of tropical African spices are active against Plutella xylostella

Extracts from Piper guineense, Aframomum melegueta, Aframomum citratum and Afrostyrax kamerunensis were investigated for their antifeedant, lethal and developmental effects against Plutella xylostella larvae through laboratory dual-choice tests and topical application. Water and ethanol extracts of P. guineense were dose-dependent antifeedants at concentrations ≥300 and 500 ppm, respectively, whilst methanol extracts required ≥1,000 ppm. Methanol and hexane extracts of A. melegueta acted at ≥100 ppm and water extracts at ≥300 ppm, but ethanol extracts were deterring feeding only slightly at ≥1,000 ppm. Hexane and methanol extracts of A. citratum inhibited feeding at ≥300 ppm and water extracts did so at ≥500 ppm. None of the Afrostyrax kamerunensis extracts deterred feeding at any of the concentrations tested. No mortality was observed at any of the concentrations after topical application of the extracts on the larvae. However, the effects on larval development varied with extract concentration and larval age. Ingestion of the water and ethanol extracts of P. guineense caused 100% mortality of second instars at ≥100 ppm two to three days after infestation (DAI). Methanol and water extracts of A. melegueta and A. citratum, respectively, achieved ≥80% mortality of larvae at concentrations of ≥500 ppm and ≥1,000 ppm, respectively. With third instars, the mortalities were significantly lower; however, the P. guineense water or ethanol extracts caused 100% mortality two to four DAI. Larvae that survived till pupation had significantly longer larval periods compared with the control after application of A. melegueta extracts. We concluded that potent extracts from Aframomum melegueta, Aframomum citratum and especially P. guineense could be used as complementary measures in the management of P. xylostella by subsistence farmers.

‘The Pages are Bugged': the politics of listening in the poetry of W.S. Graham

This paper probes the public dimensions of the work of the twentieth-century Scottish poet W. S. Graham. It draws upon the public contacts and contexts that Graham's lyrics structure and reconfigure, in texts that have appeared to critics to demonstrate the poet's textual aloneness, his intellectual and geographical banishment. Repeatedly addressing his St Ives community of artists and writers, lovers and companions, Graham's work sets up strategic routes through a succession of publicly-minded verbal engagements. Refusing to allow one passively to listen in to the poet's isolation, the lyrics invite, rebuff, tease, avoid, dally with, and proposition audiences and interlocutors. Graham's poetry speaks from within and without tradition, location and heritage, subtly attuning readers to the politics of its handling of national allegiance, identity, class and patronage.

Are patterns of growth adaptive?

Models which define fitness in terms of per capita rate of increase of phenotypes are used to analyse patterns of individual growth. It is shown that sigmoid growth curves are an optimal strategy (i.e. maximize fitness) if (Assumption 1a) mortality decreases with body size; (2a) mortality is a convex function of specific growth rate, viewed from above; (3) there is a constraint on growth rate, which is attained in the first phase of growth. If the constraint is not attained then size should increase at a progressively reducing rate. These predictions are biologically plausible. Catch-up growth, for retarded individuals, is generally not an optimal strategy though in special cases (e.g. seasonal breeding) it might be. Growth may be advantageous after first breeding if birth rate is a convex function of G (the fraction of production devoted to growth) viewed from above (Assumption 5a), or if mortality rate is a convex function of G, viewed from above (Assumption 6c). If assumptions 5a and 6c are both false, growth should cease at the age of first reproduction. These predictions could be used to evaluate the incidence of indeterminate versus determinate growth in the animal kingdom though the data currently available do not allow quantitative tests. In animals with invariant adult size a method is given which allows one to calculate whether an increase in body size is favoured given that fecundity and developmental time are thereby increased.

Roman public libraries

This thesis aims to investigate the development and functions of public libraries in Rome and the Roman world. After a preface with maps of libraries in Rome, Section I discusses the precursors for public library provision in the private book collections of Republican Rome, and their transfer into the public domain with the first public libraries of Asinius Pollio and Augustus. Section II contains three 'case studies' of public libraries' different roles. The Augustan library programme is used in Ch.II.l to examine the role of imperial public libraries in literary life and the connections between Rome's libraries and those of Alexandria. Chapter II.2 concentrates on the libraries of Trajan's Forum to explore the intersection of imperial public libraries and monumental public architecture. This chapter responds to an important recent article by arguing for the continued identification of the Forum's libraries with twin brick buildings at its northern end, and suggests a series of correspondences between these libraries and its other monumental components. The conclusions of this chapter are important when considering the public libraries of the wider empire, several of which seem to have been inspired by the Trajanic libraries. Chapter II.3 considers imperial public libraries and leisure by looking at the evidence for libraries within bath-house complexes, concluding that their presence there is consistent with the archaeological and epigraphic evidence and fits in well with what we know of the intellectual and cultural life of these structures. Section III examines various aspects of the practical function of Roman public libraries: their contents (books and archives), division into Latin and Greek sections, provisions for shelving and cataloguing, staff, usership, architectural form, decoration, and housing of works of art. The picture that emerges is of carefully designed and functional buildings intended to sustain public, monumental, and practical functions. Section IV uses a variety of texts to examine the way in which libraries were viewed and used. Ch. IV. 1 discusses the evidence for use of libraries by scholars and authors such as Gellius, Galen, Josephus, and Apuleius. Ch. IV.2 examines parallels between library collections and compendious encyclopaedic elements within Roman literature and considers how library collections came to be canon-forming institutions and vehicles for the expression of imperial approval or disapproval towards authors. The channels through which this imperial influence flowed are investigated in Ch. IV.3, which looks at the directors and staff of the public libraries of Rome. The final section (V) of the thesis concerns public libraries outside the city of Rome. Provincial libraries provide a useful case study in 'Romanisation': they reveal a range of influences and are shown to embody local, personal, and metropolitan imperial identities. There follows a brief conclusion, and a bibliography. There are also five appendices of numismatic and epigraphic material discussed in the text. This material has not been adequately or completely gathered elsewhere and is intended to assist the reader; where appropriate it includes illustrations, transcriptions, and translations.