Percepción del riesgo de desastres en habitantes del municipio de Pijao, Quindío, Colombia / Perception of Disaster Risk Among Inhabitants of the Municipality of Pijao, Quindío, Colombia

Resumen La gestión del riesgo de desastres es un proceso social, por ello toda la comunidad debe estar incluida en ella. El objetivo del estudio fue analizar las percepciones del riesgo de desastres en habitantes del municipio de Pijao (Quindio). Para esto se siguió un enfoque cualitativo desde el diseño de la teoría fundamentada. Se realizó un muestreo no probabilístico en los barrios aledaños al recorrido del Río Lejos del municipio de Pijao (Quindío, Colombia). La muestra estuvo compuesta por un total de 60 sujetos. La teoría sustantiva producto de la investigación es la naturalización de la gestión del riesgo de desastres. Se considera que la naturalización de acciones para la mitigación del riesgo de desastres se posibilita por el nivel de conocimiento de conceptos y acciones de la gestión del riesgo, además del nivel de arraigo cultural. El estudio permitió conocer de primera mano sobre los elementos que se deben trabajar para fortalecer la gestión del riesgo a nivel comunitario.

Abstract Disaster risk management is a social process; therefore, the whole community must be included in it. The objective of the study was to analyze the perceptions of disaster risk in the inhabitants of the municipality of Pijao (Quindio). A qualitative approach was followed from the design of the grounded theory. A non‑probabilistic sampling was carried out in the neighborhoods adjacent to the course of the Lejos River in the municipality of Pijao (Quindio, Colombia). The sample was composed of a total of 60 subjects. The substantive theory resulting from the research is the naturalization of disaster risk management. It is considered that the naturalization of actions for disaster risk mitigation is made possible by the level of knowledge of risk management concepts and actions, in addition to the level of cultural rootedness. The study provided first-hand knowledge of which elements level should be worked on in the community to strengthen risk management.

Factores tempranos asociados a apendicectomía negativa / Early factors associated with negative appendectomy

Objetivo: analizar características predictoras de apendicectomía negativa (AN) en una cohorte de pacientes llevados a cirugía durante el año 2018 en una institución de salud de alta complejidad de la ciudad de Medellín, Colombia. Materiales y Métodos: seguimiento retrospectivo a una cohorte basada en registros médicos. Se analizaron pacientes adultos sometidos a apendicectomía. Se estimó la tasa de AN y se describieron características clínicas, paraclínicas y sociodemográficas. Se analizaron predictores de AN mediante el modelo lineal generalizado familia binomial, enlace logarítmico. Se presentan razones de riesgo (RR) observadas y ajustadas junto con intervalos de confianza del 95% (IC95%). Para el modelo multivariado se estimó el área bajo la curva del operador receptor (ROC). Resultados: la tasa de AN fue de 5,2%. No se solicitó tomografía computarizada (TC) de abdomen en el 48,9% de los casos, 4,1% de los pacientes presentaron disuria. Entre los factores estudiados, la disuria, no solicitud de TC, edad y leucocitosis, se asociaron significativamente con mayor riesgo de AN. Resaltan particularmente los pacientes que presentaron disuria y no les fue solicitado TC, en quienes el riesgo ajustado de AN fue de 30,3% (RR = 17,31; IC95% 5,00 ­ 59,87). ROC fue 0,834. Conclusiones: los pacientes llevados a cirugía sin TC y que se presentaron con disuria, particularmente los de mayor edad, concentraron el mayor riesgo de AN. Considerar estas características al definir el manejo quirúrgico del paciente con sospecha de apendicitis aguda, puede contribuir a disminuir las AN..(Au)

Objective: to analyze predictive characteristics of negative appendectomy (NA) in a cohort of patients who underwent surgery during 2018 in a high complexity healthcare institution in the city of Medellín, Colombia. Materials and Methods: retrospective follow-up to a cohort of adult patients who underwent appendectomy. The rate of NA was estimated and the clinical, paraclinical and sociodemographic characteristics were described. The analysis of predictors of NA was carried out using the generalized linear model binomial family, logarithmic link. Observed and adjusted risk ratios (RR) are presented along with 95% confidence intervals (95% CI). For the multivariate model, the area under the receiver operator curve (ROC) was estimated. Results: the NA rate was 5.2%. Abdominal computed tomography (CT) was not requested in 48.9% of the cases, 4.1% of the patients had dysuria. Among the factors studied, dysuria, nonrequest for CT, age and leukocytosis were significantly associated with a higher risk of NA. Is worth noting that the adjusted risk of NA of the patients who presented with dysuria and those in which no CT was requested, was 30.3% (RR = 17.31; 95% CI 5.00 - 59.87). ROC was 0.834. Conclusions: patients who underwent surgery without CT and presented with dysuria, particularly the older ones, had the highest risk of NA. Considering these characteristics when defining the surgical management of patients with suspected acute appendicitis can help reduce NA..(Au)

Componentes mental y físico en universitarios con obesidad / Mental and physical components in college students with obesity

la obesidad se correlaciona con comorbilidades, dentro de la dimensión biopsicosocial, que afectan la calidad de vida. Para confirmar esta hipótesis se organizó un programa de acondicionamiento físico moderado en el que participaron 58 jóvenes con obesidad, estudiantes de la Universidad de Caldas (Colombia). El objetivo de este estudio fue evaluar el impacto de dicho programa en los componentes físico y mental de los participantes, mediante el cuestionario de salud SF-36. Los resultados fueron medidos con la prueba estadística de Wilcoxon y la significancia de las diferencias con una p < 0.05. Por otra parte, el acondicionamiento en los aspectos físicos y mentales fueron valorados como esfuerzos intensos (p=0,034), esfuerzos moderados (p=0,034), autopercepción de salud (p=0,003), autopercepción de enfermedad (p=0,049), vitalidad (p=0,012), salud mental (p=0,09) y transición de salud (p=0,006). En conclusión, los aspectos físicos, cuyos índices eran los más bajos al inicio de la intervención, obtuvieron una mayor mejoría; mientras que los aspectos mentales, los cuales eran percibidos como los menos alterados, presentaron pocas diferencias

the obesity is associated with comorbidities, within the biopsychosocial realm, affecting the quality of life. To confirm this hypothesis a fitness program was organized. The aim of this study was to assess the impact of the program on the physical and mental components of its participants, whose were 58 young students from the University of Caldas (Colombia) with obesity. The results were measured with the Wilcoxon test and statistical significance of differences with p <0.05. On the other hand, the conditioning in physical and mental aspects were valued as extensive efforts (p=0.034), moderate exercise (p=0.034), self-rated health (p=0.003), perception of illness (p=0.049), vitality (p=0.012), mental health (p=0.09) and health transition (p=0.006). In conclusion, the physical aspects, which were the lowest at the beginning of the intervention, obtained more improvement; while the mental aspects, which were perceived as less restrictive, showed little difference.

Effect of niclosamide on basal-like breast cancers.

Basal-like breast cancers (BLBC) are poorly differentiated and display aggressive clinical behavior. These tumors become resistant to cytotoxic agents, and tumor relapse has been attributed to the presence of cancer stem cells (CSC). One of the pathways involved in CSC regulation is the Wnt/ß-catenin signaling pathway. LRP6, a Wnt ligand receptor, is one of the critical elements of this pathway and could potentially be an excellent therapeutic target. Niclosamide has been shown to inhibit the Wnt/ß-catenin signaling pathway by causing degradation of LRP6. TRA-8, a monoclonal antibody specific to TRAIL death receptor 5, is cytotoxic to BLBC cell lines and their CSC-enriched populations. The goal of this study was to examine whether niclosamide is cytotoxic to BLBCs, specifically the CSC population, and if in combination with TRA-8 could produce increased cytotoxicity. Aldehyde dehydrogenase (ALDH) is a known marker of CSCs. By testing BLBC cells for ALDH expression by flow cytometry, we were able to isolate a nonadherent population of cells that have high ALDH expression. Niclosamide showed cytotoxicity against these nonadherent ALDH-expressing cells in addition to adherent cells from four BLBC cell lines: 2LMP, SUM159, HCC1187, and HCC1143. Niclosamide treatment produced reduced levels of LRP6 and ß-catenin, which is a downstream Wnt/ß-catenin signaling protein. The combination of TRA-8 and niclosamide produced additive cytotoxicity and a reduction in Wnt/ß-catenin activity. Niclosamide in combination with TRA-8 suppressed growth of 2LMP orthotopic tumor xenografts. These results suggest that niclosamide or congeners of this agent may be useful for the treatment of BLBC.