Resultado postnatal de fetos con malformación adenomatoide quística pulmonar en la unidad maternofetal Clínica Colombia

Introducción La Malformación Adenomatoide Quística Pulmonar es una patología que se desarrolla durante estadíos tempranos de desarrollo embriológico y su pronóstico depende del tamaño de la lesión pulmonar. Existen muy pocos estudios que caractericen esta patología, ninguno en nuestro país. Metodología Se realizó una serie de casos para describir el resultado postnatal de los casos registrados en la Clínica Colombia entre 2005 hasta 2013. Resultados: Se incluyeron un total de 20 casos. La malformación más frecuente fue MAQ III con 45% de los casos, de localización izquierda (75%), el 65% nacieron después de la semana 35 y con un peso mayor de 2500 g. Tan solo 30 % desarrollaron hidrops asociado. Hubo una mortalidad de 35% (7 casos). Discusion La MAQ es un patología infrecuente que genera una alta morbimortalidad en la vida perinatal. Se requieren estudios con muestras más amplias para determinar los factores pronósticos para la ocurrencia de los desenlaces adversos como la necesidad de cirugía de urgencia, deterioro respiratorio o mortalidad.

Prevalencia de obesidad y factores de riesgo cardiovascular en estudiantes de ciencias de la salud - universidad del Quindío - 2013

ANTECEDENTES: En Colombia, reportes del año 2010 de la Encuesta Nacional de la Situación en Nutrición ENSIN 2010(2), muestran uno de cada dos colombianos, presentan un índice de masa corporal mayor al esperado (3) METODO: El presente estudio de corte transversal, determino la prevalencia de obesidad y otros factores de riesgo cardiovascular en una población de estudiantes de Ciencias de la Salud de una Universidad regional en el primer periodo académico del año 2013. El tamaño de muestra fue n=113 sujetos que corresponden 60,5% a la carrera de medicina y 39,95% a enfermería. Con el fin de conocer su comportamiento con respecto a hábitos y estilos de vida específicos como el consumo de alcohol, el consumo de tabaco y el sedentarismo, así como su asociación a eventos inflamatorios relacionados con la fisiopatología de los procesos de salud asociados al peso, por medio de instrumentos de medición clínica, antropométrica y sérica, determino un modelo estadístico propicio para entender el comportamiento de la obesidad y la enfermedad Cardiovascular RESULTADOS: La prevalencia estimada de sobrepeso y obesidad por Índice de Masa Corporal (IMC), fue del 27,7% (IC 95%: 19.9%,37.2%); por el perímetro abdominal (OBPABD) se encontró una prevalencia estimada del 27,4% (IC 95%: 19,9% – 36,4%), y la prevalencia con el Índice Cintura Cadera (OBICC) fue de 3,5% (IC 95%:1,3% – 9,3%). CONCLUSIONES: La presencia de hábitos no saludables y la presencia de sobrepeso y obesidad se considera que es necesario en primera instancia una valoración general de estado nutricional de los universitarios de las diferentes facultados y plantear estrategias preventivas ya que la literatura documenta los efectos de los hábitos no saludables sino además documenta los efectos de la prevención de la misma ya que en si se ha encontrado asociación para enfermedades cardiovasculares. Se propone que para obtener mayor información del comportamiento de los factores de riesgo cardiovasculares se deberían realizar estudios retrospectivos en el que intervengan las demás carreras de la universidad y poder evaluar la totalidad de población universitaria

Análisis de la marcha del 4 de febrero de 2008 como ejemplo de las nuevas metodologías de movilización social a la luz de la noopolitik.

La Ciencia Política siempre ha buscado profundizar en el fenómeno del poder y sus causas. Las teorías han cambiado conforme a las circunstancias sociales a lo largo de la historia; no obstante, en la actualidad las dinámicas de comunicación facilitadas por elementos tecnológicos han generado coyunturas sin antecedentes como la ocurrida en Colombia el 4 de febrero de 2008 “Un Millón de voces contra las FARC” La generalización en el uso de Internet y –sobre todo- las redes sociales ha producido un acelerado nivel de activismo debido a la facilidad de cooperación y coordinación que se deriva de estructuras en red. Es sano pensar en una reevaluación de la teoría tradicional del poder vertical y traer al campo teórico nuevos elementos que generen herramientas de análisis sobre comunicación, poder horizontal, activismo y oportunidades políticas. El nacimiento de lo que algunos llaman “sociedad informacional” es lo que permitirá describir el concepto de “noopolitik”. Las que otrora eran movilizaciones políticas costosas y exigentes en recursos de coordinación y tiempo han venido siendo reemplazadas por explosiones de activismo catalizadas por un sentimiento común que han sabido servirse de las ventajas tecnológicas para lograr sus objetivos. Bien habla de ello el caso de estudio de esta investigación al ser la movilización más grande registrada, con más de 12 millones de personas alrededor del mundo y con el uso protagónico de redes sociales. El valor de la información –y por supuesto su difusión-, es ahora uno de los principales asuntos de la Ciencia Política moderna.

Inmunoterapia en pacientes con cáncer de pulmón de células no pequeñas versus terapia convencional. Revisión sistemática

RESUMEN Antecedentes y Justificación: El cáncer de pulmón es la principal causa de muerte relacionada con Cáncer en el mundo. El cáncer pulmonar de células no pequeñas (Non-Small-cell lung cancer NSCLC) representa el 85% de todos los cánceres de pulmón y en un 40% es diagnosticado tardíamente y con los tratamientos disponibles actualmente (cirugía, radioterapia y quimioterapia) presenta una supervivencia a 5 años entre el 10 y el 15%. En los últimos años han surgido nuevos tratamientos basados en la inmunoterapia que prometen mejorar la supervivencia de estos pacientes. Objetivo: Determinar la eficacia de la inmunoterapia en el tratamiento del cáncer de pulmón de células no pequeñas (NSCLC) con el fin de integrar la información disponible para su posterior uso en la clínica. Metodología: Se realizó búsqueda exhaustiva de la literatura disponible del 1 de Enero de 2003 al 31 de Diciembre de 2013. Se examinaron las siguientes bases de datos: Pubmed, Scielo, Medline, Lilacs, EMBASE, Bandolier, peDRO y Cochrane. Se utilizaron los términos MeSH de búsqueda: immunotherapy, NSCLC, clinical trials. Resultados: de 163 referencias identificadas en las bases de datos, 12 fueron seleccionadas para la revisión. Se identificaron 11 estrategias inmunoterapéuticas que fueron complementarias al uso de quimioterapia, radioterapia o ambas. No se encontró diferencia significativa entre la supervivencia global de los grupos de intervención y controles con excepción de 1 artículo. La mayoría de efectos secundarios fueron de leves a moderados y no hubo diferencias significativas entre los grupos. Discusión: no se evidenció un aumento significativo de la supervivencia global con la utilización de inmunoterapias, a excepción de la que emplea células asesinas inducidas por citocinas junto a células dendríticas. Sin embargo es necesario esperar resultados de estudios fase III en curso.

How well do we understand and evaluate climate change feedback processes?

Processes in the climate system that can either amplify or dampen the climate response to an external perturbation are referred to as climate feedbacks. Climate sensitivity estimates depend critically on radiative feedbacks associated with water vapor, lapse rate, clouds, snow, and sea ice, and global estimates of these feedbacks differ among general circulation models. By reviewing recent observational, numerical, and theoretical studies, this paper shows that there has been progress since the Third Assessment Report of the Intergovernmental Panel on Climate Change in (i) the understanding of the physical mechanisms involved in these feedbacks, (ii) the interpretation of intermodel differences in global estimates of these feedbacks, and (iii) the development of methodologies of evaluation of these feedbacks (or of some components) using observations. This suggests that continuing developments in climate feedback research will progressively help make it possible to constrain the GCMs’ range of climate feedbacks and climate sensitivity through an ensemble of diagnostics based on physical understanding and observations.

PtdIns(5)P activates the host cell PI3-kinase/Akt pathway during Shigella flexneri infection

The virulence factor IpgD, delivered into nonphagocytic cells by the type III secretion system of the pathogen Shigella flexneri, is a phosphoinositide 4-phosphatase generating phosphatidylinositol 5 monophosphate (PtdIns(5) P). We show that PtdIns(5) P is rapidly produced and concentrated at the entry foci of the bacteria, where it colocalises with phosphorylated Akt during the first steps of infection. Moreover, S. flexneri-induced phosphorylation of host cell Akt and its targets specifically requires IpgD. Ectopic expression of IpgD in various cell types, but not of its inactive mutant, or addition of short-chain penetrating PtdIns(5) P is sufficient to induce Akt phosphorylation. Conversely, sequestration of PtdIns(5) P or reduction of its level strongly decreases Akt phosphorylation in infected cells or in IpgD-expressing cells. Accordingly, IpgD and PtdIns(5) P production specifically activates a class IA PI 3-kinase via a mechanism involving tyrosine phosphorylations. Thus, S. flexneri parasitism is shedding light onto a new mechanism of PI 3-kinase/Akt activation via PtdIns(5) P production that plays an important role in host cell responses such as survival.

Meal frequency; does it determine postprandial lipaemia?

OBJECTIVE: To determine the effect of altering meal frequency on postprandial lipaemia and associated parameters. DESIGN: A randomized open cross over study to examine the programming effects of altering meal frequency. A standard test meal was given on three occasions following: (i) the normal diet; (ii) a period of two weeks on a nibbling and (iii) a period of two weeks on a gorging diet. SETTING: Free living subjects associated with the University of Surrey. SUBJECTS: Eleven female volunteers (age 22 +/- 0.89 y) were recruited. INTERVENTIONS: The subjects were requested to consume the same foods on either a nibbling diet (12 meals per day) or a gorging diet (three meals per day) for a period of two weeks. The standard test meal containing 80 g fat, 63 g carbohydrate and 20 g protein was administered on the day prior to the dietary intervention and on the day following each period of intervention. MAJOR OUTCOME MEASURES: Fasting and postprandial blood samples were taken for the analysis of plasma triacylglycerol, non-esterified fatty acids, glucose, immunoreactive insulin, glucose-dependent insulinotropic polypeptide levels (GIP) and glucagon-like peptide (GLP-1), fasting total, low density lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol concentrations and postheparin lipoprotein lipase (LPL) activity measurements. Plasma paracetamol was measured following administration of a 1.5 g paracetamol load with the meal as an index of gastric emptying. RESULTS: The compliance to the two dietary regimes was high and there were no significant differences between the nutrient intakes on the two intervention diets. There were no significant differences in fasting or postprandial plasma concentrations of triacylglycerol, non-esterified fatty acids, glucose, immunoreactive insulin, GIP and GLP-1 levels, in response to the standard test meal following the nibbling or gorging dietary regimes. There were no significant differences in fasting total or LDL-cholesterol concentrations, or in the 15 min postheparin lipoprotein lipase activity measurements. There was a significant increase in HDL-cholesterol in the subjects following the gorging diet compared to the nibbling diet. DISCUSSION: The results suggest that previous meal frequency for a period of two weeks in young healthy women does not alter the fasting or postprandial lipid or hormonal response to a standard high fat meal. CONCLUSIONS: The findings of this study did not confirm the previous studies which suggested that nibbling is beneficial in reducing the concentrations of lipid and hormones. The rigorous control of diet content and composition in the present study compared with others, suggest reported effects of meal frequency may be due to unintentional alteration in nutrient and energy intake in previous studies.

The compact city and the residential developer

Although the compact city is widely promoted as a sustainable form of urban development, little attention has been paid to the feasilibity of its implementation in practice. This paper addresses this isse by presenting the findings of a questionnaire study into the viability of the compact city from the perspective of the volume housebuilder. The study shows that, although well aware of the inherent problems witht the compact city, most were generally positive about the need to redirect more development back into urban areas. In addition, they suggested a large number of strategies for change, including i) a role for public sector agencies in overcoming the condstraints on urban sites; ii) the need for an upward reveision of acceptable densities in local plans and design guides; and iii) the creation of a separate, or revised, Use Class Order to enable mixed use development to compete on a level playing field. It is concluded that the residential developer could be engaged in the process of urban containment provided proposals for implementing the compact city of devised. The need for continuing research to test the actual effects of specific schemes is emphasised.

Enhanced MALDI MS sensitivity by weak base additives and glycerol sample coating

The concept of rationally designing MALDI matrices has been extended to the next “whole sample” level. These studies have revealed some unexpected and exploitable insights in improving MALDI sensitivity. It is shown that (i) additives which only provide additional laser energy absorption are best to be avoided; (ii) the addition of proton donors in the form of protonated weak bases can be highly beneficial; (iii) the addition of glycerol for coating crystalline samples is highly recommended. Overall, analytical sensitivity has been significantly increased compared to the current “gold” standards in MALDI MS, and new insights into the mechanisms and processes of MALDI have been gained.

An overview on the urban boundary-layer atmosphere network in Helsinki

The Helsinki Urban Boundary-Layer Atmosphere Network (UrBAN: http://urban.fmi.fi) is a dedicated research-grade observational network where the physical processes in the atmosphere above the city are studied. Helsinki UrBAN is the most poleward intensive urban research observation network in the world and thus will allow studying some unique features such as strong seasonality. The network's key purpose is for the understanding of the physical processes in the urban boundary layer and associated fluxes of heat, momentum, moisture, and other gases. A further purpose is to secure a research-grade database, which can be used internationally to validate and develop numerical models of air quality and weather prediction. Scintillometers, a scanning Doppler lidar, ceilometers, a sodar, eddy-covariance stations, and radiometers are used. This equipment is supplemented by auxiliary measurements, which were primarily set up for general weather and/or air-quality mandatory purposes, such as vertical soundings and the operational Doppler radar network. Examples are presented as a testimony to the potential of the network for urban studies, such as (i) evidence of a stable boundary layer possibly coupled to an urban surface, (ii) the comparison of scintillometer data with sonic anemometry above an urban surface, (iii) the application of scanning lidar over a city, and (iv) combination of sodar and lidar to give a fuller range of sampling heights for boundary layer profiling.

En quoi la narration dans le romanL’Élégance du hérisson permet de bien rendre lamétaphore du « bocal à poissons »? : Une analyse narratologique

Sur la base des travaux de Gérard Genette, en particulier Figures III, uneanalyse narratologique du roman L’Élégance du hérisson (2006) de l’auteur MurielBarbery a été effectuée afin de comprendre les liens qu’il y a entre les spécificités dumode narratif et leurs effets sur l’espace du récit, soit « le bocal à poissons », unemétaphore importante du roman. Ultimement nous répondons à la question suivante :En quoi la narration dans le roman L’Élégance du hérisson permet-elle de bien rendrela métaphore du « bocal à poissons »?

Collective bargaining in Brazilian manufacturing, 1978-95

Collective bargaining, it is widely claimed, has been on the increase in Brazil since the late 1970s. This is seen as part of a broader change in Brazilian industrial relations towards a hybrid system of interest representation, in which elements of both the old state corporatism and pluralism now coexist. However, there is little or no systematic empirical evidence available to support this conclusion. This thesis addresses the question of the strengthening of collective bargaining as a method of job regulation in Brazil by providing a detailed empirical study. The questions of this study are: (a) how important has collective bargaining become in establishing provisions on the terms and conditions of the employment relationship which are not simply reproducing rules established via state regulation?; and (b) what factors accounted for changes in the content of these provisions? An analysis of 10,734 provisions in 287 collective agreements in manufacturing industries in the Metropolitan Area of Porto Alegre, the capital of the southernmost state of Rio Grande do Sul, was carried out for the period of 1978-95. This analysis offers support for the thesis that the significance of collective bargaining has increased. It shows that: (a) most substantive provisions created rules that were not established in other forms of regulation; (b) provisions that replicate the contents of regulatory legislation accounted for one out of seven substantive provisions, but in spite of being a copy of the law, these provisions are not entirely neutral for job regulation; (c) collective agreements also laid down substantive provisions benefiting employers, and not simply employees; and (d) the pace of change in bargaining outcomes oscillated with changes in the economic, legal and judicial contexts. This pace of change was mostly affected by (i) the rate of unemployment, (ii) the degree of openness of the economy to foreign competition, (iii) the capacity of employers to pass on costs to costumers, (iv) stabilisation policies aimed at curbing inflation, (v) the Federal Constitution made in 1988, (vi) the official rate of minimum wages, and (vii) the conduct of the labour judicial system in settling collective disputes.

Dinâmica monetária eficiente sob encontros aleatórios: uma classe de métodos numéricos que exploram concavidade

A dificuldade em se caracterizar alocações ou equilíbrios não estacionários é uma das principais explicações para a utilização de conceitos e hipóteses que trivializam a dinâmica da economia. Tal dificuldade é especialmente crítica em Teoria Monetária, em que a dimensionalidade do problema é alta mesmo para modelos muito simples. Neste contexto, o presente trabalho relata a estratégia computacional de implementação do método recursivo proposto por Monteiro e Cavalcanti (2006), o qual permite calcular a sequência ótima (possivelmente não estacionária) de distribuições de moeda em uma extensão do modelo proposto por Kiyotaki e Wright (1989). Três aspectos deste cálculo são enfatizados: (i) a implementação computacional do problema do planejador envolve a escolha de variáveis contínuas e discretas que maximizem uma função não linear e satisfaçam restrições não lineares; (ii) a função objetivo deste problema não é côncava e as restrições não são convexas; e (iii) o conjunto de escolhas admissíveis não é conhecido a priori. O objetivo é documentar as dificuldades envolvidas, as soluções propostas e os métodos e recursos disponíveis para a implementação numérica da caracterização da dinâmica monetária eficiente sob a hipótese de encontros aleatórios.

Governança,alavancagem e ciclicidade: a eficiência do modelo brasileiro de private equity

Este trabalho objetiva analisar a eficiência dos comitês de investimento no modelo de investimento em private equity através de FIPs (Fundos de Investimento em Participações) que não utilizam alavancagens em suas aquisições. Tal análise é feita através de uma comparação com o modelo americano, no qual tipicamente o gestor do fundo tem o poder de decisão sobre os investimentos e as aquisições são realizadas utilizando financiamento de terceiros. A dissertação é iniciada com uma revisão bibliográfica não-exaustiva dos trabalhos da academia brasileira sobre o tema de private equity. Em seguida, levanta-se as particularidades do modelo dos FIPs, principalmente a decisão de investimento feita em conjunto pelo gestor e seus investidores através de comitês de investimento e a rara utilização de alavancagem nas aquisições, e demonstra-se como o impacto destas características altera o equilíbrio do modelo proposto por Axelson, Strömberg e Weisbach. Conclui-se que as particularidades do modelo dos FIPs que não utilizam alavancagens nas aquisições oferecem: (i) melhor proteção aos interesses dos investidores, e uma representativade similar aos conselhos de administração de companhias abertas, e (ii) permitem que o gestor aproveite os períodos nos quais as transações ocorrem a um múltiplo mais baixo, resultando num modelo mais eficiente de investimento e que evita a multiplicação dos ciclos econômicos. Tais conclusões, no entanto, estão sujeitas à observação das seguintes condições: (i) o comitê deve ter qualificação igual ou superior ao do gestor; (ii) o comitê deve ter disponibilidade de tempo e corpo suficientes para analisar os investimentos nas mesma profundidade que o gestor, (iii) a existência do comitê de investimento não deve acarretar numa desvantagem para o gestor em termos de agilidade de resposta nas negociações. Finalmente, são levantadas algumas situações de ponteciais conflitos de interesse nas quais os membros dos comitês de investimento podem se encontrar.