Sociodemographic determinants and mortality of premature newborns in a medium and low-income population in Colombia, 2017-2019 / Factores determinantes sociodemográficos y de mortalidad en recién nacidos prematuros en población de medianos y bajos ingresos en Colombia, 2017-2019

Introduction. The birth of premature babies is a public health problem with a high impact on infant morbidity and mortality. About 40% of mortality in children under five years occurs in the first month of life. Objective. To identify the association between maternal sociodemographic factors, premature birth, and mortality in newborns under 37 weeks in Santiago de Cali, 2017-2019. Materials and methods. We conducted a descriptive, cross-sectional study. We evaluated the records of Cali's Municipal Public Health Office. We calculated the crude and adjusted odd ratios and confidence intervals (95%) using the logistic regression model, data processing in Stata 16, and georeferencing the cases in the QGIS software. Results. From 2017 to 2019, premature babies in Cali corresponded to 11% of births. Poor prenatal care increased 3.13 times the risk of being born before 32 weeks (adjusted OR = 3.13; 95% CI = 2.75 - 3.56) and 1.27 times among mothers from outside the city (adjusted OR = 1.27; 95% CI = 1.15-1.41). Mortality was 4.29 per 1,000 live births. The mortality risk in newborns weighing less than 1,000 g increased 3.42 times (OR = 3.42; 95% CI = 2.85-4.12), delivery by cesarean section in 1.46 (OR = 1.46; CI 95% = 1.14-1.87) and an Apgar score - five minutes after birth- lower than seven in 1.55 times (OR = 1.55; CI 95% = 1.23-1.96). Conclusions. We found that less than three prenatal controls, mothers living outside Cali, afro-ethnicity, and cesarean birth were associated with prematurity of less than 32 weeks. We obtained higher mortality in newborns weighing less than 1,000 g.

Introducción. El nacimiento de bebés prematuros es un problema de salud pública con gran impacto en la morbimortalidad infantil: cerca del 40 % de las muertes de niños menores de cinco años sucede en el primer mes de vida. Objetivo. Identificar la asociación entre los factores sociodemográficos maternos, el parto prematuro y la mortalidad en recién nacidos menores de 37 semanas en Santiago de Cali, 2017-2019. Materiales y métodos. Se hizo un estudio descriptivo transversal. Se evaluaron los registros de la Secretaría de Salud Pública Municipal de Cali. Se calcularon las razones de probabilidad y los intervalos de confianza (95 %) crudos y ajustados mediante el modelo de regresión logística, en tanto que los datos se procesaron en Stata 16 y los casos se georreferenciaron con el programa QGIS. Resultados. Entre el 2017 y el 2019, los nacimientos de bebés prematuros en Cali correspondieron al 11 %. El control prenatal deficiente aumentó 3,13 veces el riesgo de nacer con menos de 32 semanas (OR ajustado = 3,13; IC95% = 2,75-3,56) y, en madres de municipios fuera de la ciudad, 1,27 veces (OR ajustado = 1,27; IC95% = 1,15-1,41). La mortalidad fue de 4,29 por 1.000 nacidos vivos. Nacer con un peso menor de 1.000 g aumentó el riesgo de mortalidad en 3,42 veces (OR = 3,42; IC95% = 2,85-4,12) y, un puntaje Apgar menor de siete a los cinco minutos del nacimiento, en 1,55 veces (OR=1,55; IC95% = 1,23-1,96). Conclusiones. Se encontró que tener menos de tres controles prenatales, la procedencia de la madre fuera de Cali, ser afrodescendiente y el parto por cesárea, estaban asociados significativamente con la prematuridad de menos de 32 semanas. Hubo mayor mortalidad en los recién nacidos con menos de 1.000 gramos al nacer.

Bienestar subjetivo y satisfacciones de dominios en estudiantes universitarios colombianos / Subjective well-being and domain satisfactions in Colombian university students

Resumen El concepto de bienestar subjetivo se refiere a la forma global, positiva o negativa, en la que las personas evalúan sus vidas y experiencias. La búsqueda de factores que expliquen el bienestar subjetivo, actualmente uno de los temas de mayor interés en la psicología, condujo al concepto de satisfacciones de dominios, que se entienden como los juicios que las personas hacen al evaluar los mayores dominios de vida. Este estudio correlacional tuvo por objetivo establecer la relación de la satisfacción en los dominios económico, de pareja, familia, amigos, salud, vida universitaria y rendimiento académico, con los componentes cognitivo y emocional del bienestar subjetivo (satisfacción vital y felicidad, respectivamente), identificando cuáles de esos dominios lo predicen. La muestra, no probabilística, estuvo conformada por 344 estudiantes de una universidad pública colombiana (50.9 % mujeres y 49.1 % hombres) con edades entre 18 y 29 años (. = 20.89; DT = 2.52). Los resultados mostraron una fuerte relación de todos los dominios con el bienestar subjetivo. La satisfacción en los dominios económico, de pareja, familia, amigos y vida universitaria explicó la varianza de la satisfacción vital y la felicidad en forma diferenciada. Se concluye que: (a) el bienestar se afecta con la satisfacción de necesidades asociadas a los dominios cercanos e importantes para el individuo; (b) las satisfacciones de dominios impactan más el componente cognitivo del bienestar que el emocional; (c) el dominio económico satisface más necesidades cognitivas, la amistad suple necesidades emocionales, y la pareja, la familia y la vida universitaria satisfacen ambas.

Abstract The concept of subjective well-being refers to the overall positive or negative way in which people evaluate their lives and experiences. It is generally accepted that subjective well-being is made up of a cognitive component usually called satisfaction with life or life satisfaction and an emotional component usually referred to as happiness. The search for factors that explain subjective well-being is currently one of the most interesting topics in psychology and led to the concept of domain satisfactions, which are understood as the judgments that people make when evaluating the major domains of life. It refers to the perceived degree of satisfaction that we obtain from the way in which each of these main domains or areas of our lives are developed. This correlational study with predictive intent aimed at establishing the relationship of satisfaction in the economic, couple, family, friends, health, university life, and academic performance domains, with the cognitive and emotional components of subjective well-being (life satisfaction and happiness, respectively), identifying which of these domains predict well-being. The non-probabilistic sample, for convenience, was made up of 344 women and men (50.9 % and 49.1 % respectively) between 18 and 29 years of age (M = 20.89); SD = 2.52), students from an important Colombian public university based in the city of Palmira. The instruments, which include the Diener's life satisfaction and Lyubomirsky and Lepper's happiness scales, and simple items for each domain satisfaction studied (economic, couple, family, friends, health, university life, and academic performance) were answered in a format printed by 64 % of the participants and in virtual format by 36 %, according to their own choice. The results showed that all domain satisfactions were significantly related to both the cognitive and the emotional components of subjective well-being. The results also showed that except for satisfaction with health and academic performance, all other domain satisfactions predicted at least one of the components of subjective well-being. In general, domain satisfactions explained the variance of satisfaction and happiness much better than sociodemographic variables. Thus, it was confirmed that the psychological significance of events that occur in the main areas of people´s lives have much more relevance to well-being than situational factors such as sociodemographic ones. In a different sense, and order of impact, satisfaction with the economic domain, satisfaction with university life, and satisfaction with the couple emerged as the domains that had the greatest influence on life satisfaction, and satisfaction with friends and satisfaction with university life emerged as the strongest predictors of happiness. The results suggest that well-being is especially affected by the satisfaction of needs associated with the closest domains and more important to the individual. These would include the economic domain and relationships that involve affections, but also other domains that, for specific reasons, occupy a relevant place in the individual's internal hierarchy of importance, which may vary among cultures and even among people of the same culture. The above conclusion could explain, among other findings, the significant impact of satisfaction with university life on subjective well-being. The results also suggest that, in general, domain satisfactions have a greater impact on the cognitive component of well-being than on the emotional component, and that, in particular, domains such as economics fundamentally satisfy cognitive needs, friendship fundamentally satisfy emotional needs, and other domains such as couple, family and university life, satisfy both cognitive and emotional needs. This would demonstrate the importance of applying differentiated instruments to study the cognitive and emotional components of well-being.

Tumores cardíacos benignos operados en un Centro de Cirugía Cardiovascular Regional 2015 - 2021

Introducción: Los tumores cardíacos primarios se caracterizan por su baja prevalencia, son principalmente mixomas y se presentan frecuentemente de forma asintomática. Objetivos: Identificar el tipo histológico más común, edad de presentación, tipo de cirugías y sobrevida de un grupo de pacientes tratados por Tumores Cardíacos Primarios (TCP) en el Hospital Regional de Temuco. Métodos: Revisión de fichas clínicas de 14 pacientes portadores de TCP entre marzo 2015 y diciembre 2021. Resultados: El tipo histológico más común fue el mixoma (85,7%), seguido por el fibroelastomas papilar (14,3%). La edad promedio fue 62 años (39-85), 9 fueron mujeres y 5 hombres. Los antecedentes mórbidos más comunes fueron: Insuficiencia Cardíaca Congestiva (ICC), Hipertensión Arterial (HTA) y Accidente Vascular Encefálico (AVE). La localización anatómica más común fue la Aurícula izquierda (92%). El tratamiento en el 92% de los casos fue resección aislada y en el 7% restante resección y reparación con parche. Conclusiones: Nuestros resultados son concordantes con la literatura.

Background: primary cardiac tumors are characterized by a low prevalence. Most of them are myxomas and asymptomatic. Aim: To describe the most common histological type, the age of presentation, type of surgery performed and survival of a group of patients operated on for Primary Cardiac Tumors (PCT) in the Hospital Regional de Temuco (Chile). Methods: Review of clinical records of 14 patients with PCT operated on between March 2015 and December 2021. Results: By far the most common histological type was a myxoma (85.7%), followed by a papillary fibroelastoma (14.3%). Mean age was 62 years (39-85), 9 were women and 5 men. The most common associated medical conditions were Congestive Heart Failure (CHF), Arterial Hypertension and Stroke The usual anatomical location was the left atrium (92%). Surgical treatment was isolated resection in 92% of cases and along with a patch repair in the remaining patient. Conclusion: good results were obtained, similar to those described in the literature.

Device-associated infections in neonatal care units in a middle-income country, 2016-2018

Abstract Objective: Describe the device-associated infections in the NICUs in Cali - Colombia, a middle-income country, between August 2016 to December 2018. Methods: Observational cross-sectional study evaluating reports of device-associated infections in 10 NICUs in Cali, Colombia, between August 2016 and December 2018. Socio-demographic and microbiological data were obtained from the National Public Health surveillance system, through a specialized notification sheet. The relationship of device-associated infections with several outcomes including birth weight, microorganisms, and mortality was evaluated using OR Cl95%, using the logistic regression model. Data processing was performed using the statistical program STATA 16. Results: 226 device-associated infections were reported. The rate of infection with central line-associated bloodstream infections was 2.62 per 1000 days of device use and 2.32 per 1000 days for ventilator-associated pneumonia. This was higher in neonates under 1000 g; 4.59 and 4.10, respectively. 43.4% of the infections were due to gram-negative bacteria and 42.3% were due to gram-positive bacteria. Time from hospitalization to diagnosis of all device-associated infections had a median of 14 days. When compared by weight, infants with a weight lower than 1000 g had a greater chance of death (OR 3.61; 95% CI 1.53-8.49, p = 0.03). Infection by gram-negative bacteria was associated with a greater chance of dying (OR 3.06 CI 95 1.33-7.06, p = 0.008). Conclusions: These results highlight the need to maintain epidemiological surveillance processes in neonatal intensive care units, especially when medical devices are used.

Salud mental en tiempos de pandemia / Mental health in pandemic times

La enfermedad por coronavirus de 2019 (COVID-19) es una emergencia de salud pública catalogada por la Organización Mundial de la Salud como pandemia, la cual ha generado múltiples síntomas deletéreos en la salud mental a escala global, derivados, en parte, de la incertidumbre sobre la calidad y precisión de los informes ofrecidos al respecto y, en gran medida, por la imposibilidad de saber cuándo el mundo volverá a la normalidad. Por tales razones, con este manuscrito se pretende revelar la importancia de la salud mental de la población durante la pandemia, para lo cual se brindan estrategias de prevención e intervención que contribuyan a superar los desafíos propios a los cuales se han enfrentado los individuos y que inevitablemente, en la mayoría de los casos, han sido abordados de forma inadecuada.

Coronavirus disease 2019 (COVID-19) is an emergency of public health classified by the World Health Organization as pandemic, which has generated multiple deleterious symptoms in mental health at global scale, derived, partly, of the uncertainty about the quality and precision of the reports offered in this respect and, in great extent, for the impossibility of knowing when the world will return to normality. For such reasons, with this manuscript it is sought to reveal the importance of the population mental health during the pandemic, for which strategies of prevention and intervention are offered that contribute the challenges faced by individuals and that inevitably, in most of the cases, have been approached in an inadequate way.

Consideraciones especiales acerca de las intervenciones quirúrgicas durante la COVID-19 / Special considerations about surgical interventions during COVID-19

La pandemia de la COVID-19 ha logrado colapsar los sistemas de salud en los países más afectados, lo cual ha generado cambios en todos los servicios médicos y quirúrgicos. En consecuencia, es importante evaluar adecuadamente si realizar una intervención quirúrgica inmediata o mantener tratamiento conservador hasta que haya un mejor control de la pandemia. De igual forma, se deben seguir protocolos de prestación de servicios intrahospitalarios, que incluyan nuevas conductas y refuercen las ya existentes, en los períodos preoperatorio, peroperatorio y posoperatorio.

The pandemic of COVID-19 has been able to collapse the health systems in the most affected countries, which has generated changes in all the medical and surgical services. Therefore, it is important to evaluate appropriately whether to carry out an immediate surgical intervention or to maintain conservative treatment until there is a better control of the pandemic. Similarly, protocols of services rendered inside the hospital should be followed that include new behaviors and reinforce those that already exist, in the preoperative, peroperative and postoperative periods.

Hallazgos radiográficos asociados a la COVID-19: una mirada desde la atención primaria / Radiographic findings associated with the COVID-19: a glance from the primary health care

La actual pandemia de COVID-19 ha afectado múltiples sectores económicos y sociales a escala mundial, con especial afectación sobre el sector de la salud, ya que constituye un reto adicional para la atención primaria, dada la marcada escasez de recursos. La infección por SARS-CoV-2 ocasiona morbilidad y mortalidad crecientes, por lo que el diagnóstico mediante imágenes es una herramienta imprescindible en la práctica clínica; sin embargo, el acceso limitado a algunos medios como la tomografía axial computarizada en diferentes niveles de atención, justifica el uso de la radiografía de tórax como una opción costo-efectiva y accesible en muchas regiones. En el presente artículo se exponen los hallazgos asociados a procesos infecciosos virales sugestivos de infección por el nuevo coronavirus y una serie de escalas de clasificación que buscan estandarizar la lectura e interpretación radiográfica por parte del personal médico.

The pandemic of COVID-19 has affected multiple economic and social sectors worldwide, with special effects on the health sector, since it constitutes an additional challenge for the primary health care, given the marked lack of resources. The infection due to SARS-CoV-2 causes increasing morbidity and mortality, reason why the diagnosis by means of images is an indispensable tool in the clinical practice; however, the limited access to some means as the computerized axial tomography in different levels of care, justifies the use of the thorax x-ray as a cost-effective and accessible option in many regions. Findings associated with suggestive viral infectious processes of infection due to the new coronavirus and a series of classification scales that seek to standardize reading and radiographic interpretation by the medical staff are exposed in this work.

Prevalencia de bocio y yodo-deficiencia en embarazadas indígenas de cinco áreas no metropolitanas de Colombia 2019 / Prevalence of goiter and iodine deficiency in indigenous pregnant women from five non-metropolitan areas of Colombia 2019

RESUMEN Objetivo: evaluar la prevalencia de yodo deficiencia y de bocio en mujeres indígenas gestantes de cinco áreas no metropolitanas en Colombia. Materiales y métodos: estudio de corte transversal descriptivo. Se incluyeron mujeres embarazadas de cualquier edad gestacional sin condiciones patológicas del embarazo, atendidas en los centros de salud comunitarios o en sus residencias. Se excluyeron aquellas con comorbilidades presentes al momento del embarazo y también a quienes recibían suplementos con yodo. Muestreo aleatorio simple. Se midieron las características sociodemográficas y obstétricas, la concentración de yodo en orina y la presencia de bocio de acuerdo a la metodología de la Organización Mundial de la Salud. Se realizó un análisis descriptivo. Resultados: 189 gestantes indígenas fueron candidatas a ingresar al estudio, de las cuales 2 no aceptaron participar y 62 tenían criterios de exclusión, finalmente se analizaron 125. La concentración urinaria de yodo tuvo una mediana de 184,4 µg/L (min-max: 12,0-390,0). Un total de 42 gestantes (33,6%) tenían yodo deficiencia (< 100 µg/L) y se evidenció bocio (grado 1-2) en 43 (34,4%). No se identificó bocio grados 3 o 4. Conclusiones: embarazadas indígenas residentes en áreas no metropolitanas evidenciaron alta prevalencia de bocio y yodo deficiencia. Se requiere evaluar los efectos materno-perinatales e implementar intervenciones nutricionales.

ABSTRACT Objective: To assess the prevalence of goiter and iodine deficiency in indigenous pregnant women coming from five non-metropolitan areas in Colombia. Materials and methods: Descriptive cross-sectional cohort study that included pregnant women of any gestational age with no pregnancy-related conditions, seen in community health centers or in their homes. Patients with comorbidities at the time of pregnancy and those who were receiving iodine supplementation were excluded. Simple random sampling was used. The sociodemographic and obstetric characteristics, urinary iodine concentration and the presence of goiter were measured in accordance with the World Health Organization methodology. A descriptive analysis was performed. Results: Of 189 indigenous pregnant women who were candidates to enter the study, 2 declined participation, and 62 had exclusion criteria, and 125 were included in the final analysis. The mean urinary iodine concentration was 184.4 µg/L (min-max: 12.0-390.0). A total of 42 women (33.6%) had iodine deficiency (< 100 µg/L), and goiter (grade 1-2) was found in 43 (34.4%). No grade 3 or 4 goiter was identified. Conclusions: A high prevalence of goiter and iodine deficiency was found in indigenous pregnant women living in non-metropolitan areas. There is a need to assess maternal and perinatal effects and to implement nutritional interventions.

Recomendaciones para una conducta temprana en el manejo clínico de los pacientes con Covid-19 / Recommendations for early behavior in the clinical management of patients with COVID-19

Hasta abril de 2020, se contabilizaba una cifra cercana a los dos millones de contagiados con SARS-Cov-2 [1], diseminándose a centenares de países en todo el mundo. El impacto se ha visto reflejado en todos los estratos sociales, afectando a los más carenciados y ha develado las grandes debilidades de las estructuras sanitarias frente a pandemias, en la gran mayoría de los gobiernos. En el mes de diciembre de 2019 aparecen los primeros pacientes con neumonía viral en Wuhan, China. Epidemiológicamente, todos los pacientes habían visitado el mercado de productos exóticos de dicha ciudad. A fines del mismo mes, un joven médico oftalmólogo de Wuhan describe, virtualmente, a siete pacientes con sintomatología similar al SARS y recomienda a sus amigos usar equipos de protección, por este hecho fue castigado por las autoridades policiales y más tarde fallecería por COVID-19. En la primera semana de enero, 2020, las autoridades chinas anuncian que han identificado un nuevo coronavirus (Co-V) en los pacientes que estaban siendo tratados por neumonía viral.

Until April 2020, there was about two million people infected with SARS-Cov-2 [1], spreading to hundreds of countries around the world. The impact has been reflected in all social strata, affecting the neediest people and has revealed the great weaknesses of health structures to face the pandemics in the majority of governments. In December 2019, the first patients with viral pneumonia appear in Wuhan, China. Epidemiologically, all the patients had visited the market with exotic products in that city. At the end of the same month, a young ophthalmologist from Wuhan virtually describes seven patients with symptoms similar to SARS and recommends his friends to wear protective equipment, for this fact he was punished by the police authorities and later died by COVID- 19. In the first week of January, 2020, Chinese authorities announce that they have identified a new coronavirus (Co-V) in patients who were being treated for viral pneumonia. A correct diagnosis of infected people is important in the present pandemic; it is based on three fundamental aspects: clinic, complementary examinations and imaging

La pulsioximetría como herramienta para la tamización de cardiopatías congénitas críticas. Una revisión narrativa / Pulse oximetry as a screening tool for critical congenital heart diseases. A narrative review

Resumen Objetivo: Revisar el concepto de cardiopatía congénita crítica, describir el proceso de consolidación de la pulsioximetría como herramienta para su tamización y llamar la atención sobre la necesidad de implementarla en países de bajos ingresos como Colombia. Métodos: Se hizo una búsqueda en las bases de datos PubMed-MEDLINE y Scholar Google, usando los términos MeSH: "CongenitalAbnormalities", "HeartDefects, Congenital" "Oximetry" y "Neonatal Screening", cruzando el término "HeartDefects, Congenital" con los demás, por medio del operador booleano AND. Se incluyeron publicaciones desde 1992 y no se excluyeron artículos por metodología o idioma. Resultados: El 25% de los casos de recién nacidos vivos con cardiopatía congénita son críticos y la pulsioximetría es una alternativa efectiva para su reconocimiento temprano. Se hizo una revisión sobre el tema, mencionando los estudios con los mayores tamaños de muestra que han permitido la consolidación de la pulsioximetría como herramienta para tamización de cardiopatías congénitas críticas, describiendo el abordaje estadounidense al respecto y llamando la atención sobre la necesidad de implementar dicha tamización en Colombia. Conclusiones: Existe evidencia para la introducción de la pulsioximetría como prueba de tamización para defectos cardiacos congénitos críticos. En Colombia no se han presentado iniciativas oficiales para generalizar la práctica.

Abstract Objective: This article sets out to review the concept of critical congenital heart diseases, as well as to describe the consolidation process with pulse oximetry as a tool for their screening, and to call attention to the need to implement this in low income countries like Colombia. Methods: A search was made in the PubMed-MEDLINE and Google Scholar databases using the MeSH terms: "Congenital Abnormalities", "Heart Defects, Congenital'" "Oximetry" and "Neonatal Screening", crossing the term "Heart Defects, Congenital" with the rest, by means of the Boolean operator AND. Publications since 1992 were included and article were not excluded due to methodology or language. Results: Around one-quarter (25%) of live newborns with a congenital heart disease are critical, and pulse oximetry is an effective alternative for its early recognition. A review was carried out on the subject, mentioning studies with large sample sizes that have allowed the consolidation of pulse oximetry as screening tool for critical congenital heart diseases. The approach used in the USA in this respect is described, as well as calling attention to the need to implement this screening method in Colombia. Conclusions: There is evidence for the introduction of pulse oximetry as a screening test for critical congenital heart disease defects. No official initiatives have been presented in Colombia to generalise the practice.

Estudio descriptivo sobre Cáncer Colorrectal en Cova da Beira, Portugal y el valor pronóstico de BCL2 en asociación con la localización del tumor, Estadificación TNM, y tipo histológico / A descriptive study on Colorectal Cancer in Cova da Beira Portugal and the prognostic value of BCL2 in association with tumor location, TNM Staging, and histological type

Objetivo: realizar un estudio descriptivo sobre Cáncer Colorrectal en Cova da Beira Portugal y el valor pronóstico de BCL2 en asociación con la localización del tumor,Estadificación TNM, y tipo histológico. Materiales y Métodos: se realizó un estudio en 29 pacientes que tuvieron cirugía curativa para la escisión de Cáncer Colon Rectal (CCR) en Centro Hospitalario Cova da Beira con el objetivo de verificar si la presencia de la oncoproteína BCL2 en células neoplásicas es un factor predictivo del pronóstico,verificando también si es predictivo de la estadificación TNM, localización y diferenciación celular en el Cáncer Colon Rectal. Resultados: los hallazgos de este estudio coinciden con lo reportado en la literatura, se encontró que la incidencia del CCR es mayor en hombres que en mujeres, el riesgo de la enfermedad aumenta con la edad y la localización más frecuente de lesión neoplásica es en la porción izquierda del colon,con un total de 26 casos (89,65%). Además, se encontró asociación estadística de la expresión de BCL2 con el pronóstico y con la diferenciación histológica. Conclusión:a pesar de las limitaciones de este estudio, los datos hallados guardan relación con lo reportado en la literatura y establecen una asociación estadística de la expresión de BCL2 con el pronóstico y con la diferenciación histológica..(AU)

Objective: to carry out a descriptive study on Colorectal Cancer in Cova da Beira Portugal and the prognostic value of BCL2 in association with tumor location, TNM Staging, and histological type.Materials and Methods: a study was conducted in 29 patients who had curative surgery for Rectal Colon Cancer (CRC) excision in the Cova da Beira Hospital Center with the objective of verifying whether the presence of the BCL2 oncoprotein in neoplastic cells is a predictive factor of the prognosis, also verifying if it is predictive of TNM staging, localization and cell differentiation in Rectal Colon Cancer. Results: the findings of this study coincide with that reported in the literature,it was found that the incidence of CRC is higher in men than in women, the risk of the disease increases with age and the most frequent location of neoplastic lesion is in the left portion of the colon, with a total of 26 cases (89.65%). In addition, statistical association of BCL2 expression with prognosis and with histological differentiation was found. Conclusion: despite the limitations of this study, the data found are related to that reported in the literature and establish a statistical association of BCL2 expression with prognosis and histological differentiation..(AU)

Comportamiento en la hemodinamia en pacientes con hemorragia controlada por monitor ultrasónico (USCOM) / Behavior in hemodynamics in patients with ultrasonic monitor controlled hemorrhage (USCOM) / Comportamento da hemodinâmica em pacientes com hemorragia controlada pelo monitor ultrasônico (USCOM)

Resumen: Introducción: La hemodinamia es la parte de la biofísica que se encarga del estudio anatómico y funcional del corazón, de la dinámica de la sangre en el interior de las estructuras sanguíneas, así como de la mecánica del corazón. Objetivo: Comparar la hemodinamia con el dispositivo no invasivo USCOM antes y después de presentar hemorragia controlada. Material y métodos: Se realizó un estudio tipo observacional, prospectivo, longitudinal y comparativo en pacientes de entre 16 y 65 años de edad en un periodo de seis meses como fecha corte para este premio académico (marzo de 2016-proyecto aún en curso). Resultados: Se obtuvieron promedios de las diferentes variables hemodinámicas, de precarga, postcarga e inotropismo, observando cambios tempranos a la exanguinación de los pacientes, siendo principalmente las resistencias vasculares sistémicas las que se modifican. Discusión: Existen cambios hemodinámicos tempranos a la exanguinación de pequeñas cantidades de sangre en los pacientes, cambios determinados por el sistema USCOM, sistema fácil de usar, no invasivo y preciso en los resultados ofrecidos. Conclusiones: En este estudio podemos observar cómo las variables relacionadas a la postcarga (resistencias vasculares sistémicas) son las primeras variables que se modifican, por lo que con la pérdida de pequeñas cantidades de sangre llegamos a observar esto.

Abstract: Introduction: Hemodynamics is the part of biophysics that is responsible for the anatomical and functional study of the heart, the dynamics of blood inside the blood structures as well as the mechanics of the heart. Objective: To compare the hemodynamics of our patients with the non-invasive device USCOM, before and after presenting with controlled hemorrhage. Material and methods: An observational, prospective, longitudinal and comparative study was performed in patients between the ages of 16 and 65 in a period of 6 months as a cutoff date for this academic award. (March 2016-ongoing). Results: We obtained averages of the different hemodynamic variables, both preload, afterload and inotropism, observing early changes to the exanguination of the patients, being mainly the systemic vascular resistances that are modified. Discussion: There are early hemodynamic changes to the exanguination of small amounts of blood in the patients, changes determined by the USCOM system, system easy to use, non-invasive and accurate results offered. Conclusions: In this study we can observe how the variables related to afterload (systemic vascular resistance) are the first variables that are modified, so that with the loss of small amounts of blood we get to observe this.

Resumo: Introdução: A hemodinâmica é a parte da biofísica responsável pelo estudo anatômico e funcional do coração, da dinâmica do sangue dentro das estruturas sangüíneas, bem como a mecânica do coração. Objetivo: Comparar a hemodinâmica com o dispositivo USCOM não invasivo, antes e após a apresentação da hemorragia controlada. Material e metodos: Foi realizado um estudo observacional, prospectivo, longitudinal e comparativo em pacientes entre 16 e 65 anos de idade, em um período de 6 meses, como data limite para este prêmio acadêmico (Março de 2016 - projeto ainda em andamento). Resultados: Obtivemos as médias das diferentes variáveis hemodinâmicas, tanto de pré-carga, pós-carga e inotropismo, observando as alterações precoces na exanguinação dos pacientes, sendo principalmente as resistências vasculares sistêmicas aquelas que são modificadas. Discussão: Existem alterações hemodinâmicas precoces na exsanguinação de pequenas quantidades de sangue nos pacientes, mudanças determinadas pelo sistema USCOM fáceis de usar, não invasivas e precisas nos resultados oferecidos. Conclusões: Neste estudo podemos observar como as variáveis relacionadas à pós-carga (resistência vascular sistêmica) são as primeiras variáveis que são modificadas, de modo que com a perda de pequenas quantidades de sangue podemos observar isso.

Características de la tuberculosis en pacientes con SIDA en los Hospitales Vicente Corral Moscoso, Isidro Ayora y Teófilo Dávila en el periodo 2012-2014 / Characteristics of tuberculosis in patients with AIDS in Hospitals Vicente Corral Moscoso, Isidro Ayora and Teófilo Dávila in the period 2012-2014

OBJETIVO: Describir las características de la tuberculosis en los pacientes con SIDA en los hospitales Vicente Corral Moscoso, Isidro Ayora y Teófilo Dávila durante enero de 2012 a diciembre de 2014.METODOLOGÍA: Se realizó una investigación descriptiva y retrospectiva, se obtuvo la información de historias clínicas, se incluyeron los pacientes con coinfección tuberculosis- VIH/SIDA en los hospitales Vicente Corral Moscoso, Isidro Ayora y Teófilo Dávila durante enero de 2012 a diciembre de 2014. Se excluyeron aquellos pa-cientes en cuyos registros la información se encontraba incompleta. Se recolectaron los datos en un formulario y se procesaron utilizando el programa SPSS V 22.0 mediante frecuencia absoluta, porcentaje y medidas de tendencia central.RESULTADOS: Se diagnosticaron 95 casos de tuberculosis en pacientes con VIH/SIDA, de los cuales el 83.2% (79 casos) correspondió al Hospital Teófilo Dávila. La mayo-ría fueron diagnosticados en el año 2012 (38.9%). El grupo de edad más frecuente fue de 16-30 años (41.1%), asimismo el sexo masculino (78.9%) y el lugar de residencia El Oro (85.2%). La mayor cantidad de casos correspondió a tuberculosis pulmonar (74.7%), el 36.8% de los pacientes tenían un tiempo de diagnóstico de 1 a 2 años y el 93.7% no tenían antecedentes de contac-to con personas con tuberculosis. En los casos de tuberculosis pulmonar y extrapulmonar se utilizó como criterio diagnóstico principal la baciloscopía con el 41.4% y el 78.6% respectivamente. El 29.3% tuvo resultado de ba-ciloscopía positivo y el 6.4% tuvo resultado de cultivo positivo. En cuanto a los criterios de diagnóstico clínicos presentaron tos el 47.4%, pérdida de peso el 31.6%, as-tenia el 30.5%, diaforesis el 22.1% y mal estado general el 13.7%. Además, se observaron los valores de CD4, con una media de 234.64 y la carga viral con una media de 134 494.93 copias. Se evidenció una mortalidad de 32.6 % durante los tres años estudiados.CONCLUSIONES: Hubo mayor frecuencia de coinfec-ción tuberculosis- VIH/SIDA en el Hospital Teófilo Dávila, los pacientes jóvenes y de sexo masculino son los más afectados. La baciloscopía es el método diagnóstico más utilizado y es alta la mortalidad asociada a esta patología.

OBJECTIVE: To describe the characteristics of tuberculo-sis in patients with AIDS in the Vicente Corral Moscoso, Isidro Ayora and Teófilo Dávila Hospitales during January 2012 and December 2014.METHODOLOGY: A descriptive and retrospective investi-gation was carried out, clinical records information was obtained, and patients with HIV / AIDS were included in the Vicente Corral Moscoso, Isidro Ayora and Teófi-lo Dávila Hospitals during January 2012 and December 2014. Patients whose records were incomplete were ex-cluded. Data were collected on a form and processed using the SPSS V 22.0 program using absolute frequency, percentage and measures of central tendency.RESULTS: A total of 95 cases of tuberculosis were diag-nosed in patients with HIV / AIDS from which the 83.2% (79 cases) corresponded to Teófilo Dávila Hospital. The majority were diagnosed in 2012 (38.9%). The most fre-quent age group was 16-30 years (41.1%), the male sex (78.9%) and the place of residence the Province of El Oro (85.2%). The most cases were pulmonary tuberculo-sis with (74.7%), a 36.8% of patients had a diagnosis time of 1 to 2 years and 93.7% had no history of contact with people with tuberculosis.In the cases of pulmonary and extrapulmonary tuber-culosis, bacilloscopy was used as the main diagnostic criterion, with 41.4% and 78.6%, respectively. The 29.3% had positive bacilloscopy results and 6.4% had a posi-tive culture result. As for the clinical diagnostic criteria presented cough 47.4%, weight loss 31.6%, asthenia 30.5%, diaphoresis 22.1%, and poor general condition 13.7%. In addition, CD4 values were observed, with a mean of 234.64 and viral load with an average of 134 494.93 copies. A mortality of 32.6% was evidenced du-ring the three years studied.CONCLUSIONS: There was a greater frequency of tuber-culosis-HIV / AIDS co-infection at the Teófilo Dávila Hos-pital. Young and male patients were the most affected. The smear microscopy is the most used diagnostic me-thod and the mortality associated with this pathology is high.

Risk factors associated with the development of perinatal asphyxia in neonates at the Hospital Universitario del Valle, Cali, Colombia, 2010-2011 / Factores de riesgo asociados con el desarrollo de asfixia perinatal en neonatos en el Hospital Universitario del Valle, Cali, Colombia, 2010-2011

Abstract Introduction: Perinatal asphyxia is one of the main causes of perinatal mortality and morbidity worldwide and it generates high costs for health systems; however, it has modifiable risk factors. Objective: To identify the risk factors associated with the development of perinatal asphyxia in newborns at Hospital Universitario del Valle, Cali, Colombia. Materials and methods: Incident cases and concurrent controls were examined. Cases were defined as newborns with moderate to severe perinatal asphyxia who were older than or equal to 36 weeks of gestational age, needed advanced resuscitation and presented one of the following: early neurological disorders, multi-organ commitment or a sentinel event. The controls were newborns without asphyxia who were born one week apart from the case at the most and had a comparable gestational age. Patients with major congenital malformations and syndromes were excluded. Results: Fifty-six cases and 168 controls were examined. Premature placental abruption (OR=41.09; 95%CI: 4.61-366.56), labor with a prolonged expulsive phase (OR=31.76; 95%CI: 8.33-121.19), lack of oxytocin use (OR=2.57; 95% CI: 1.08 - 6.13) and mothers without a partner (OR=2.56; 95% CI: 1.21-5.41) were risk factors for the development of perinatal asphyxia in the study population. Social difficulties were found in a greater proportion among the mothers of cases. Conclusions: Proper control and monitoring of labor, development of a thorough partograph, and active searches are recommended to ensure that all pregnant women have adequate prenatal care with the provision of social support to reduce the frequency and negative impact of perinatal asphyxia.

Resumen Introducción: La asfixia perinatal constituye una de las principales causas de morbilidad y mortalidad perinatal en el mundo, tiene factores de riesgo modificables y genera altos costos para los sistemas de salud. Objetivo: Determinar los factores de riesgo asociados al desarrollo de asfixia perinatal en recién nacidos en el Hospital Universitario del Valle, Cali, Colombia. Materiales y métodos: Se llevó a cabo un estudio de casos incidentes y controles concurrentes. Los casos se definieron como neonatos con asfixia perinatal moderada a grave, de edad de gestación mayor o igual a 36 semanas, que requirieron reanimación avanzada y presentaron, al menos, una de las siguientes condiciones: alteraciones neurológicas tempranas, falla orgánica múltiple o aparición de un evento centinela. Los controles se definieron como neonatos sin diagnóstico de asfixia, nacidos hasta con una semana de diferencia con respecto al caso y de edad de gestación comparable. Se excluyeron los pacientes con malformaciones congénitas mayores y síndromes. Resultados: Se estudiaron 56 casos y 168 controles. El desprendimiento prematuro de la placenta (odds ratio, OR=41,09; IC95% 4,61-366,56), un trabajo de parto con fase expulsiva prolongada (OR=31,76; IC95% 8,33-121,19), no usar oxitocina (OR=2,57; IC95% 1,08-6,13) y ser madre soltera (OR=2,56; IC95% 1,21-5,41) fueron factores de riesgo para el desarrollo de asfixia perinatal en la población bajo estudio. En las madres de los casos se encontraron dificultades sociales en mayor proporción. Conclusiones: Se recomienda un control adecuado y una vigilancia apropiada del trabajo de parto, hacer un estricto partograma, y una búsqueda activa, de manera que cada mujer embarazada tenga un adecuado control prenatal y reciba apoyo social.

Selección de color dentario: comparación de los métodos visual y espectrofotométrico / Selection of tooth colour: comparison of visual and spectrophotometric methods

Introducción En odontología la selección de color se realiza mediante métodos visuales o instrumentales: el primero, ampliamente utilizado, es subjetivo e influenciado por diversos factores, en tanto el instrumental con espectrofotómetro es objetivo y simple, pero poco utilizado. Objetivo Comparar los resultados en la selección del color utilizando los métodos visual y el espectrofotómetro Easyshade Compact, para verificar si existen diferencias. Material y método Cincuenta odontólogos, 25 hombres y 25 mujeres, seleccionaron el color de una pieza dentaria anterior sana con el muestrario Vitapan 3D Master, y se compararon los resultados con los obtenidos al utilizar el espectrofotómetro. Los datos se analizaron mediante Chi-cuadrado. Resultados El 18% de los odontólogos (el 24% de las mujeres y el 12% de los hombres) coincidió en la selección visual del color con lo obtenido con espectrofotómetro. Un 76% de las mujeres y un 88% de los hombres no concordaron en la selección visual con respecto a los resultados obtenidos con el espectrofotómetro. Conclusiones Existen diferencias estadísticamente significativas entre la selección del color dentario con el método visual y el espectrofotómetro (p < 0,0005). El género no parecería ser un factor determinante en la selección del color (p < 0,232).

Introduction In cosmetic dentistry the selection of colour can be performed by visual or instrumental methods. The former is subjective, influenced by multiple factors and widely used by dentists, whilst the latter, using a spectrophotometer, is objective and simple but little used. Objective To compare the results in the selection of colour by a visual method and using the Easyshade Compact spectrophotometer, to verify whether there are differences between them. Material and method A total of 50 dentists, 25 men and 25 women, were asked to select the colour of a healthy anterior tooth using the 3D Master Vitapan, and the results were compared with those obtained when using the Easyshade Compact spectrophotometer. The data obtained were analysed using the Chi-squared statistical test. Results The colour obtained by the visual colour selection matched that obtained with spectrophotometer by 18% of dentists. The colour selection by the visual method was different to that obtained with the spectrophotometer for 76% of women and 88% of men. Conclusions There are statistically significant differences between the selection of colour with the visual method and with spectrophotometer (P < .0005). Gender does not seem to be a determining factor in the selection of colour (P < .232).

Relación entre la Satisfacción Vital y otras Variables Psicosociales de Migrantes Colombianos en Estados Unidos / Relationship between Life Satisfaction and Other Psychological Variables of Colombian Immigrants in the United States / Relação entre a Satisfação Vital e outras Variáveis Psicossociais de Migrantes Colombianos nos Estados Unidos

Investigación cuantitativa que buscó establecer la relación entre la satisfacción vital (variable principal) y las variables autoestima personal, bienestar material percibido, prejuicio grupal percibido, discriminación personal percibida e identidad nacional, identificando cuáles, entre estas últimas, podían predecir la primera. La muestra, no probabilística, estuvo conformada por 171 colombianos, hombres y mujeres, residentes en Estados Unidos. Los resultados indicaron que la autoestima y el bienestar material percibido fueron las variables más estrechamente relacionadas con la satisfacción vital, siendo, además, las únicas predictoras positivas de esta. Las expresiones de prejuicio no impactaron significativa-mente la satisfacción vital, mientras que la identidad nacional presentó un impacto nulo.

This quantitative investigation aimed at establishing the relationship between life satisfaction (main variable) and the variables personal self-esteem, perceived material well-being, perceived group prejudice, perceived personal discrimination and ethnic identity. The sample, not probabilistic, was comprised of 171 Colombians, men and women, who reside in the United States. Results indicated that self-esteem and perceived material well-being were the variables most closely related to life satisfaction, being, moreover, the only positive predictors in the model. Expressions of prejudice did not significantly impact life satisfaction while ethnic identity showed not impact at all.

Trata-se de pesquisa quantitativa que buscou estabelecer a relação entre a satisfação vital (variável principal) e as variáveis: autoestima pessoal, bem-estar material percebido, preconceito grupal percebido, discriminação pessoal percebida e identidade nacional, bem como identificar quais, entre estas últimas, podiam predizer a primeira. A amostra, não probabilística, foi conformada por 171 colombianos, homens e mulheres, residentes nos Estados Unidos. Os resultados indicaram que a autoestima e o bem-estar material percebidos foram as variáveis mais estreitamente relacionadas com a satisfação vital; além disso, foram as únicas preditoras positivas desta. As expressões de preconceito não impactaram significativamente a satisfação vital, enquanto a identidade nacional apresentou um impacto nulo.

Factores psicosociales relacionados con la intención migratoria externa de colombianos residentes en varios municipios vallecaucanos / Psychosocial Factors Related with External Migratory Intention of Colombian People in Municipalities of the Valle del Cauca / Fatores psicossociais relacionados com a intenção migratória externa de colombianos residentes em vários municípios do Valle del Cauca (Colômbia)

Objetivo. Estudiar la relación entre las variables psicosociales satisfacción con la vida, importancia del vínculo familiar, identidad nacional, importancia del dinero y apertura al cambio y la intención migratoria externa de colombianos residentes en varios municipios del Valle del Cauca para identificar cuáles son las mayores predictoras de la intención migratoria. Método. Estudio empírico con metodología cuantitativa-correlacional e intención predictiva, con 969 participantes seleccionados de manera no probabilística mediante la técnica bola de nieve, en la que contactos personales e institucionales iniciales condujeron al resto. Resultados. Los resultados indicaron que un porcentaje significativo de los participantes manifestaron intención de emigrar y mostraron una relación negativa y significativa de las variables satisfacción con la vida, importancia del vínculo familiar e identidad nacional con la intención migratoria, así como una relación positiva y significativa de las variables apertura al cambio e importancia del dinero con la misma intención migratoria. La identidad nacional emergió como el mayor predictor negativo y la apertura al cambio como el mayor predictor positivo de la intención migratoria. Conclusión. La intención migratoria es un fenómeno multivariado en el que los factores psicológicos juegan un importante papel.

Objective. To study the relationship between psychosocial variables: life satisfaction, importance of family ties, national identity, importance of money and openness to change, and external migratory intention of Colombian residents in several municipalities of the Valley of Cauca, identifying which, among the first, are the major predictors of migratory intention. Method. Empirical study with quantitative-correlational methodology and predictive intention, with 969 participants selected in non-probabilistic manner using the technique known as snowball, in which personal and institutional initial contacts led the rest. Results. The results indicated that a significant percentage of the participants showed intention to emigrate and also showed a negative and significant relationship between the variables life satisfaction, importance of family ties and national identity, with migratory intention and a positive and significant relationship of variables openness to change and importance of money with the same migratory intention. National identity emerged as the most negative predictor and openness to change as the most positive predictor of migratory intention. Conclusion. The main conclusion is that migratory intention is a multivariate phenomenon in which psychological factors play an important role.

Escopo. Estudar a relação entre variáveis psicossociais satisfação com a vida, importância do vínculo familiar, identidade nacional, importância do dinheiro e apertura para as mudanças com a intenção migratória externa de colombianos residentes em vários municípios do Valle del Cauca para identificar quais são as maiores preditoras da intenção migratória. Metodologia. Estudo empírico com metodologia quantitativa-correlacional e intenção preditiva, com 969 participantes selecionados de forma não probabilística mediante a técnica de "bola de neve", na que contatos pessoais e institucionais iniciais dirigiram ao resto. Resultados. Os resultados indicaram que uma porcentagem significativa dos participantes manifestaram uma intenção de emigrar e mostraram uma relação negativa e significativa das variáveis satisfação com a vida, importância do vínculo familiar e identidade nacional com a intenção, e uma relação positiva e significativa das variáveis apertura para a mudança e importância do dinheiro com a mesma intenção migratória. A identidade nacional emergiu como o maior preditor negativo e a apertura para a mudança como o maior preditor positivo da intenção migratória. Conclusão. A intenção migratória é um fenómeno multivariado no que os fatores psicológicos têm um papel importante.

La satisfacción vital: su relación con el prejuicio, la identidad nacional, la autoestima y el bienestar material, en inmigrantes / Life satisfaction: its relationship with prejudice, national identity, self-esteem and material well-being in immigrants / A satisfação vital: sua relação com o preconceito, a identidade nacional, a autoestima e o bem-estar material, em imigrantes

El propósito de esta investigación fue estudiar la relación de la satisfacción vital con varios factores psicosociales corrientemente vinculados a los procesos de migración internacional. En concreto, este estudio exploró la relación de la satisfacción vital - componente cognitivo del bienestar subjetivo - con las variables prejuicio grupal percibido, discriminación personal percibida, autoestima global personal, identidad nacional y bienestar material percibido. La investigación, de tipo empírico y cuantitativo, se realizó através de un muestreo no probabilístico con inmigrantes colombianos en varias ciudades del Ecuador (N = 185). Confirmando las hipótesis, se halló una relación positiva entre la satisfacción vital, el bienestar material percibido y la autoestima. Se confirmó así mismo una relación negativa entre la satisfacción vital, la discriminación personal percibida y la identidad nacional. Estas mismas variables; la autoestima, el bienestar material percibido, la discriminación personal percibida y la identidad nacional, emergieron como predictoras de la satisfacción vital. No se confirmó, en cambio, la relación negativa hipotetizada entre la satisfacción vital y el prejuicio grupal percibido. Se hace un análisis de dichos resultados desde la literatura psicosocial.

The aim of this research was to study the relationship between life satisfaction and various psychosocial variables usually linked to international migration processes. Specifically, this study explored the relationship between life satisfaction-a cognitivedimension of subjective well-being- and perceived group prejudice, perceived personal discrimination, global personal self-esteem, national identity and perceived material well- being. The research, of empirical quantitative type, was conducted with a non-probabilistic sample of Colombian migrants at several cities of Ecuador. As expected, the hypothesis that life satisfaction was positively related to self -esteem and perceived material well-being was confirmed. Also, a negative correlation was confirmed between life satisfaction, perceived personal discrimination and national identity. Results show that the variables self-esteem, perceived material well-being, perceived personal discrimination and national identity are significant predictors of life satisfaction. Findings didn·t confirm the expected negative association between life satisfaction and perceived group prejudice. Results are analyzed from a psychosocial perspective.

O propósito desta pesquisa foi estudar a relação da satisfação vital com vários fatores psicossociais correntemente vinculados aos processos de migração internacional. Em concreto, este estudo explorou a relação da satisfação vital - componente cognitivo do bem-estar subjetivo - com as variáveis preconceito grupal percebido, discriminação pessoal percebida, autoestima global pessoal, identidade nacional e bem-estar material percebido. A pesquisa, de tipo empírica e quantitativa, foi realizada através de um amostra não probabilística com imigrantes colombianos em várias cidades do Equador (N = 185). Confirmando as hipóteses, foi encontrada uma relação positiva entre a satisfação vital, o bem-estar material percebido e a autoestima. Foi confirmada assim uma relação negativa entre a satisfação vital, a discriminação pessoal percebida e a identidade nacional. Estas mesmas variáveis; a autoestima, o bem-estar material percebido, a discriminação pessoal percebida e a identidade nacional, emergiram como preditoras da satisfação vital. Contudo, não foi confirmada a relação negativa hipotética entre a satisfação vital e o preconceito grupal percebido. É feita uma análise desses resultados desde a literatura psicossocial.

Ciencias de la complejidad y caos como herramientas en el análisis de la proliferación de vectores y zoonosis / Sciences of complexity and chaos to analyze vectors and zoonosis

En el presente trabajo se discuten los fundamentos de las ciencias de la complejidad y caos como herramientas en el análisis la proliferación de vectores y zoonosis. En la primera parte del artículo se describen los fundamentos y antecedentes de las ciencias de la complejidad, como una visión diferente para entender y analizar a los sistemas dinámicos, conceptos que han existido desde hace varios siglos y están relacionados con las ideas acerca del origen de la vida misma, que romperán con los paradigmas de la linealidad y el reduccionismo. Se ejemplifica con la utilización de la geometría fractal, mundo pequeño y los análisis de series de tiempo, entre otras herramientas, para entender el comportamiento de los sistemas caóticos que se presentan en la diseminación de enfermedades de origen zoonótico. Se concluye que la mayoría de los contagios, así como la diseminación de enfermedades transmitidas por los animales, tienen tendencia caótica. Dado que 75 % de las enfermedades emergentes son de origen zoonótico, las herramientas de las ciencias de la complejidad y la no linealidad resultan indispensables para entender el dinamismo y comportamientode la diseminación de estas patologías.

The present paper discusses the fundamentals of the sciences of complexity and chaos as tools in the proliferation of vectors and zoonosis. The first part of the article discusses the rationale and history of the sciences of complexity, a different view as to understand and analyze dynamic systems. These concepts explain the dynamics of the origin of life itself and break the paradigms of linearity and reductionism. This is exemplified by using fractal geometry, the law of the small world and time series analysis among other tools to understand the behavior of chaotic systems, which are presented in the form of the spread of zoonotic diseases. We conclude that most infections and the spread of diseases transmitted by animals tend towards being chaotic, and it is mentioned that 75% of emerging diseases are zoonotic in origin. Therefore, the tools are not linear. They are indispensable for understanding the dynamic behavior of the spread of these diseases.