Association of Healthcare Fragmentation and the Survival of Patients With Colorectal Cancer in Colombia.

OBJECTIVES: The objective of this study was to identify the association between healthcare fragmentation and survival for patients with colorectal cancer in Colombia. METHODS: A retrospective cohort study was performed using administrative databases, with an electronic algorithm to identify patients with colorectal cancer based on codes. The patients were enrolled between January 1, 2013, and December 31, 2016. The exposure variable was fragmentation, which was measured based on the number of different healthcare institutions that treated a patient during the first year after diagnosis. Matching was performed using propensity scores to control for confounding, and the hazard ratio for exposure to higher fragmentation was calculated for the matched sample. RESULTS: A total of 5036 patients with colorectal cancer were identified, 2525 (49.88%) of whom were women. The mean number of network healthcare institutions for the total sample was 5.71 (SD 1.98). The patients in the quartile with higher fragmentation had the highest mortality rate, 35.67 (95% CI 33.63-38.06) per 100 patients. The comparison of higher and lower quartiles of fragmentation resulted in an incidence rate ratio of 1.23 (95% CI 1.04-1.45; P = .02). Of the 5036 patients, 422 (8.38%) were classified as the exposed cohort (higher fragmentation). The total matched sample consisted of 844 subjects, and an HR of 1.26 (95%CI; 1.05-1.51) was estimated. CONCLUSIONS: Exposure to more highly fragmented healthcare networks decreases overall 4-year survival for patients with colorectal cancer in Colombia.

Age, period and cohort effects on mortality from cervical cancer in Colombia between 1985 and 2014.

Objective: To analyze the cervix cancer mortality in Colombia, based on age, period and cohort effects. Methods: The mortality and population data were taken from the official databases of the National Administrative Department of Statistics, DANE. Five models were adjusted, the significance of the effects was obtained by comparing them through the likelihood ratio test. Results: The age-adjusted mortality rate, in deaths was 15.09/100,000 woman, at 1985-1989 period, and 10.21 at 2010-2014 period. The annual percentage average change was -1.45% (95% CI: -1.57% to -1.34%). Age, period and cohort effects were found. Conclusions: Demographic factors could explain the behavior of cervical cancer mortality in Colombia, as well as the establishment of public health measures in the last two decades.

Objetivo: Analizar las tendencias de la mortalidad por cáncer de cuello uterino en Colombia, teniendo en cuenta los efectos de edad, periodo y cohorte. Métodos: Los datos de mortalidad y de población se tomaron de las bases oficiales del Departamento Administrativo Nacional de Estadísticas, DANE. Se ajustaron cinco modelos, la significancia de los efectos se obtuvo comparándolos a través de la prueba de razón de verosimilitud. Resultados: La tasa de mortalidad ajustada por edad, en muertes fue de 15.09/100,000 mujeres, para el periodo 1985-1989 y 10.21 para el periodo 2010-2014. El cambio promedio porcentual anual fue de -1.45% (IC 95%: -1.57% a -1.34%). Se encontraron efectos de edad, periodo y cohorte. Conclusiones: Los factores demográficos podrían explicar el comportamiento de la mortalidad por cáncer de cuello uterino en Colombia, al igual que la instauración de medidas de salud pública en las dos últimas décadas.

Curvas de crecimiento en ovino de pelo colombiano en los departamentos de Córdoba y Cesar, Colombia

La producción ovina en los últimos años en Colombia, se considera como una actividad con miras a exportación de carne, por lo cual, es necesario conocer el desempeño productivo de las diferentes razas dedicadas a este propósito en las regiones, con un número considerable de animales respecto al inventario nacional; por lo tanto, el objetivo de esta investigación fue describir el crecimiento en ovinos de pelo colombiano en los departamentos de Córdoba y Cesar, Colombia. Se utilizaron 99 animales de los biotipos Sudán y Etíope. Fueron evaluados los modelos Gompertz, Von Bertalanffy, Brody y Logístico. Los parámetros para obtener las curvas de crecimiento fueron estimados por medio del procedimiento NLIN de SAS. Utilizando el modelo de mejor ajuste, se determinó el porcentaje y la edad de madurez. El modelo Brody fue el que mejor ajustó los datos. El sexo no tuvo efecto significativo sobre los parámetros estimados, mientras que el biotipo racial fue significativo para todos los parámetros estimados, con la excepción de ß 1 ; la zona presentó efecto significativo sobre ß 0 y ß 2 y la época solo para ß 1. De acuerdo con los parámetros de la curva Brody estimados y a los porcentajes y edades a la madurez, en las poblaciones en estudio, se debe mejorar la alimentación de los animales e implementar un programa de selección, con el fin de mejorar los pesos de los animales, al llegar a la edad adulta.

Sheep production in recent years in Colombia is considered as an activity for the exportation of meat, therefore, it is necessary to know the productive performance of the different breeds dedicated to this purpose in the regions with a considerable number of animals with respect to national inventory. Therefore, the purpose of this research was to describe the growth in Colombian hair sheep in the departments of Cordoba and Cesar, Colombia. 99 animals of the Sudan and Ethiopian biotypes were used. The Gompertz, Von Bertalanffy, Brody and Logistic models were evaluated. The parameters of the growth curves were estimated by the procedure NLIN of SAS. Using the best fit model, the percentage and age of maturity were determined. The Brody model was the one that best fit the data. Sex had no significant effect on the estimated parameters, while racial biotype was significant for all estimated parameters, with the exception of ß 1; the zone presented a significant effect on ß 0 and ß 2; and the season only for ß 1. According to the estimated parameters of the Brody curve and the percentages and ages at maturity, in the populations under study, the feeding of the animals should be improved and a conduct a selection program, in order to improve the weights of the animals at reach adulthood.

Ovarian sex cord tumor with annular tubules: case report and review of the literature / Tumor de ovario de los cordones sexuales con túbulos anulares: reporte de caso y revisión de la literatura.

Objectives: To report a case of ovarian sex cord tumor with annular tubules (SCTAT) and conduct a literature review on diagnosis, treatment and prognosis of this condition. Material and methods: Case report of a woman with a final diagnosis of advanced SCTAT seen at the National Cancer Institute in Bogota (Colombia) who received surgical treatment and chemotherapy with a satisfactory course after 6 months. A literature search was conducted in the Medline via PubMed, LILACS and Scielo databases, including case reports and series of women diagnosed with SCTAT published since 1990, not using age ranges. Information about diagnosis, treatment and reported prognosis was retrieved. A narrative summary of the findings was prepared. Results: Fourteen publications with 26 patients were included. Mean age at diagnosis was 22.5 years. The main symptoms were menstruation abnormalities and pelvic pain. Computed tomography (CT) was the imaging technology most frequently used. Surgical treatment was used in all cases, together with chemotherapy in 29 %; 2 patients received radiotherapy. Recurrence occurred in 20 % of cases. Mortality was 12.5 %, with all deaths occurring within the first year. Conclusions: There is a paucity of information about the diagnostic utility of imaging, tumor markers and histochemical studies, as well as prognosis of this disease condition. Surgery is the treatment of choice, taking into consideration the patient's wishes regarding fertility, as well as the stage of the tumor. Further studies are needed to provide more detailed information about this condition.

Objetivos: reportar un caso de Tumor de Ovario de los Cordones Sexuales con Túbulos Anulares (TCSTA), hacer una revisión de la literatura acerca del diagnóstico, tratamiento y pronóstico de esta condición. Materiales y métodos: se informa el caso de una mujer que consultó al Instituto Nacional de Cancerología, Bogotá (Colombia), con diagnóstico final de TCSTA avanzado, quien recibió tratamiento quirúrgico y quimioterapia con evolución satisfactoria a los 6 meses. Se realizó una búsqueda de la literatura en las bases de datos Medline vía PubMed, LILACS y Scielo, que incluía reportes y series de caso de mujeres con diagnóstico de TCSTA, publicados desde 1990, sin incluir rango de edad. Se extrajo información sobre el diagnóstico, tratamiento y pronóstico reportado. Se realizó resumen narrativo de los hallazgos. Resultados: se incluyeron 14 publicaciones que incluían 26 pacientes. La edad media al diagnóstico fue de 22,5 años. Los síntomas principales fueron Tumor de ovario de los cordones sexuales con túbulos anulares: reporte de caso y revisión de la literatura alteraciones de la menstruación y dolor pélvico. La tomografía computarizada fue la tecnología de imágenes más frecuentemente utilizada. El tratamiento fue quirúrgico, siempre usado, acompañado de quimioterapia (29 %); 2 casos recibieron radioterapia. Hubo recaída en el 20 % de los casos. La mortalidad fue del 12,5 %, toda en el primer año. Conclusiónes: la información sobre la utilidad diagnóstica de las imágenes, marcadores tumorales y estudios de histoquímica es escasa, como también los datos sobre el pronóstico de la entidad. El tratamiento quirúrgico es el de elección, teniendo en cuenta el deseo de fertilidad de la paciente y el estadio tumoral. Se requieren más estudios que documenten de manera más detallada el manejo de esta condición.

Tumor de ovario de los cordones sexuales con túbulos anulares: reporte de caso y revisión de la literatura / Ovarian sex cord tumor with annular tubules: case report and review of the literature

RESUMEN Objetivos: Reportar un caso de Tumor de Ovario de los Cordones Sexuales con Túbulos Anulares (TCSTA), hacer una revisión de la literatura acerca del diagnóstico, tratamiento y pronóstico de esta condición. Materiales y métodos: Se informa el caso de una mujer que consultó al Instituto Nacional de Cancerología, Bogotá (Colombia), con diagnóstico final de TCSTA avanzado, quien recibió tratamiento quirúrgico y quimioterapia con evolución satisfactoria a los 6 meses. Se realizó una búsqueda de la literatura en las bases de datos Medline vía PubMed, LILACS y Scielo, que incluía reportes y series de caso de mujeres con diagnóstico de TCSTA, publicados desde 1990, sin incluir rango de edad. Se extrajo información sobre el diagnóstico, tratamiento y pronóstico reportado. Se realizó resumen narrativo de los hallazgos. Resultados: Se incluyeron 14 publicaciones que incluían 26 pacientes. La edad media al diagnóstico fue de 22,5 años. Los síntomas principales fueron alteraciones de la menstruación y dolor pélvico. La tomografía computarizada fue la tecnología de imágenes más frecuentemente utilizada. El tratamiento fue quirúrgico, siempre usado, acompañado de quimioterapia (29 %); 2 casos recibieron radioterapia. Hubo recaída en el 20 % de los casos. La mortalidad fue del 12,5 %, toda en el primer año. Conclusiones: La información sobre la utilidad diagnóstica de las imágenes, marcadores tumorales y estudios de histoquímica es escasa, como también los datos sobre el pronóstico de la entidad. El tratamiento quirúrgico es el de elección, teniendo en cuenta el deseo de fertilidad de la paciente y el estadio tumoral. Se requieren más estudios que documenten de manera más detallada el manejo de esta condición.

ABSTRACT Objectives: To report a case of ovarian sex cord tumor with annular tubules (SCTAT) and conduct a literature review on diagnosis, treatment and prognosis of this condition. Material and methods: Case report of a woman with a final diagnosis of advanced SCTAT seen at the National Cancer Institute in Bogota (Colombia) who received surgical treatment and chemotherapy with a satisfactory course after 6 months. A literature search was conducted in the Medline via PubMed, LILACS and Scielo databases, including case reports and series of women diagnosed with SCTAT published since 1990, not using age ranges. Information about diagnosis, treatment and reported prognosis was retrieved. A narrative summary of the findings was prepared. Results: Fourteen publications with 26 patients were included. Mean age at diagnosis was 22.5 years. The main symptoms were menstruation abnormalities and pelvic pain. Computed tomography (CT) was the imaging technology most frequently used. Surgical treatment was used in all cases, together with chemotherapy in 29 %; 2 patients received radiotherapy. Recurrence occurred in 20 % of cases. Mortality was 12.5 %, with all deaths occurring within the first year. Conclusions: There is a paucity of information about the diagnostic utility of imaging, tumor markers and histochemical studies, as well as prognosis of this disease condition. Surgery is the treatment of choice, taking into consideration the patient's wishes regarding fertility, as well as the stage of the tumor. Further studies are needed to provide more detailed information about this condition.

Status of gastrointestinal nematode infections and associated epidemiological factors in sheep from Córdoba, Colombia.

Gastrointestinal nematodes cause serious economic losses in sheep production systems. To determine the prevalence and risk factors associated with these parasites, a study was conducted on 595 sheep in Córdoba, Colombia. Prevalence and parasite burden were determined using the McMaster technique. Larvae were cultured from feces to identify the nematode genera. For the analysis of associated factors and parasite burden, data means, medians, and confidence intervals were compared. A georeferenced data analysis was performed and an epidemiological map was constructed. An overall prevalence of 88.2% was found, with the highest prevalence and parasite burden for Strongylida (83.2%) and Strongyloides (41%) nematodes. The mean parasite burden was 1255 eggs per gram. The gastrointestinal nematode genera identified were Trichostrongylus, Strongyloides, Haemonchus, Oesophagostomum, Bunostomum, and Cooperia. In general, a significant association was found between parasite burden and dewormed animals, anthelmintic used, date of last deworming, and breeds. The FAMACHA® method and body condition showed a significant association with the Strongylida parasite burden. Clusters with higher intensity of gastrointestinal nematode burden and high prevalence were observed in the regions of Bajo Sinú, Sinú Medio, and San Jorge.

Radiation Oncology Residency Training in Latin America: A Call to Attention.

Purpose: Despite the call to increase the number of radiation oncologists in Latin America, the quality, similarity, and number of residency training programs are unknown. We seek to describe the current state of residency programs in radiation oncology in Latin America. Methods and Materials: Latin American Residents in Radiation Oncology performed a cross-sectional analysis of universities and training centers for radiation oncologists in Latin America. Latin American Residents in Radiation Oncology members identified and contacted current residents and specialists at each center to obtain information and documents that described their training curricula. Results: As of 2020, 13 of 23 (56.5%) Latin American countries have radiation oncology training. Seventy-three training centers were identified (59 active and 14 inactive), associated with 28 universities. On average, each active center trains 2.6 new residents per year, and in total, 156 residents are trained annually. The average length of training programs is 3.6 years. Brazil and Mexico comprise 31 (52.5%) and 7 (11.9%) of active programs, respectively, and 64 (41.8%) and 50 (32.7%) residents, respectively. Training is available in 38 cities in 13 countries, and outside Brazil and Mexico, only 13 cities in 11 countries (9 capitals and 4 noncapital cities). Individualized curriculum documents were provided by 20 (83.3%) of 24 non-Brazilian programs, while 1 standardized guideline was provided for Brazilian training programs. These demonstrated variation between subjects taught, their devoted time, outside specialty rotations, and experiences in modern techniques. Seventy-five percent include volumetric modulated arc therapy, 70% stereotactic radiosurgery, and 55% stereotactic body radiation therapy training. One-hundred percent include gynecologic brachytherapy education and <50% brachytherapy education in other disease sites. Conclusions: Training is highly centralized in capital cities. The number of trainees is insufficient to close the current human resource divide but is limited by available job openings. Over 50% of training programs now include technological training in stereotactic radiosurgery, stereotactic body radiation therapy, or volumetric modulated arc therapy; however, substantial variation still exists. The development of radiation oncology specialists must be improved and modernized to address the escalating demand for cancer care.

Age, period and cohort effects on mortality from cervical cancer in Colombia between 1985 and 2014 / Efectos de edad, periodo y cohorte en la mortalidad por cáncer de cuello uterino en Colombia entre 1985 y 2014

Abstract Objective: To analyze the cervix cancer mortality in Colombia, based on age, period and cohort effects. Methods: The mortality and population data were taken from the official databases of the National Administrative Department of Statistics, DANE. Five models were adjusted, the significance of the effects was obtained by comparing them through the likelihood ratio test. Results: The age-adjusted mortality rate, in deaths was 15.09/100,000 woman, at 1985-1989 period, and 10.21 at 2010-2014 period. The annual percentage average change was -1.45% (95% CI: -1.57% to -1.34%). Age, period and cohort effects were found. Conclusions: Demographic factors could explain the behavior of cervical cancer mortality in Colombia, as well as the establishment of public health measures in the last two decades.

Resumen Objetivo: Analizar las tendencias de la mortalidad por cáncer de cuello uterino en Colombia, teniendo en cuenta los efectos de edad, periodo y cohorte. Métodos: Los datos de mortalidad y de población se tomaron de las bases oficiales del Departamento Administrativo Nacional de Estadísticas, DANE. Se ajustaron cinco modelos, la significancia de los efectos se obtuvo comparándolos a través de la prueba de razón de verosimilitud. Resultados: La tasa de mortalidad ajustada por edad, en muertes fue de 15.09/100,000 mujeres, para el periodo 1985-1989 y 10.21 para el periodo 2010-2014. El cambio promedio porcentual anual fue de -1.45% (IC 95%: -1.57% a -1.34%). Se encontraron efectos de edad, periodo y cohorte. Conclusiones: Los factores demográficos podrían explicar el comportamiento de la mortalidad por cáncer de cuello uterino en Colombia, al igual que la instauración de medidas de salud pública en las dos últimas décadas.

Availability and accessibility of opioids for pain and palliative care in Colombia: a survey study / Disponibilidad y accesibilidad de los opioides para manejo del dolor y cuidado paliativo en Colombia: estudio tipo encuesta

Abstract Introduction: Access to essential medicines, including opioids, is a component of the right to health. Objective: To identify barriers to opioid availability and accessibility for pain and palliative care. Methods: Online survey with Colombian prescribers. Availability barriers were analyzed for each facility (distribution and/or dispensing). Accessibility barriers were analyzed by type. Descriptive analyses were conducted using relative frequencies. Significance within categories and regions was measured using Fisher's exact test. Results: Out of 1,208 prescribers invited, 806 (66.7%) completed the survey. Availability: 76.43% reported barriers. The most cited barrier was "Pharmacies authorized by health insurance companies", where opioids are frequently unavailable. Accessibility: 74.6% reported barriers. Most frequently cited was "Difficulty securing payment authorization for medication from health insurance companies". Significant differences were observed in terms of regions and "Cost" (p=0.02). Lack of coordination among procuring and distributing agencies affects availability. Limited awareness and bureaucratic procedures affect accessibility. Conclusions: There are barriers to opioid availability and access in Colombia, related to the existing structure for guaranteeing equitable supply. From the perspective of healthcare providers, problems related to pharmacy availability, prescription and cost of medicines hinder pain treatment.

Resumen Introducción: El acceso a medicamentos esenciales, incluidos los opioides, es un componente del derecho a la salud. Objetivo: Identificar las barreras de disponibilidad y acceso a los opioides para dolor y cuidados paliativos. Métodos: Encuesta virtual a prescriptores colombianos. Las barreras de disponibilidad se analizaron para cada centro (distribución y/o dispensación) y las barreras de acceso se analizaron por tipo. Los análisis descriptivos se realizaron utilizando frecuencias relativas. La significancia dentro de categorías y regiones se midió utilizando la prueba exacta de Fischer. Resultados: De los 1208 prescriptores invitados, 806 (66.7%) respondieron la encuesta. Disponibilidad: el 76,43% reportó barreras. La barrera más citada fue la relacionada con las "farmacias autorizadas por las aseguradoras de salud", donde los opioides con frecuencia no están disponibles. Acceso: el 74,6% reportó barreras. Se citó con mayor frecuencia la "Dificultad para obtener la autorización de pago de medicamentos por parte de las aseguradoras". Se observaron diferencias significativas entre regiones y "costos" (p=0,02). La falta de coordinación entre las entidades de adquisición y distribución afecta la disponibilidad. La limitada conciencia y los procedimientos burocráticos afectan la accesibilidad. Conclusiones: Existen barreras de disponibilidad y acceso a los opioides en Colombia, las cuales están relacionadas con la estructura disponible para garantizar un suministro equitativo. Desde el punto de vista de los prescriptores, los problemas relacionados con la disponibilidad de las farmacias, la prescripción y el costo de los medicamentos, obstaculizan el tratamiento adecuado del dolor.

A Comparison of Intensity-Modulated Radiotherapy With Simultaneous Integrated Boost With Three-Dimensional Conformal Radiotherapy With Sequential Boost for Locally Advanced Cervical Cancer: A Dosimetric Study.

Objective The aim of this study was to compare the dosimetric criteria between the intensity-modulated radiation therapy (IMRT) technique with a simultaneous integrated boost (SIB) and the three-dimensional conformal radiation therapy (3DCRT) technique with a sequential boost (SB) plans for patients with locally advanced cervical cancer (LACC). Materials and methods A retrospective dosimetric comparison was performed in 15 patients with locally advanced cervical cancer who had previously been treated with fractions of 1.8 Gy up to doses of 45, 54-55.8, and 59.4 Gy in 28-33 sessions using the three-dimensional conformal radiation therapy (3DCRT) technique with a sequential boost (SB) and who had a new planning that was made using the intensity-modulated radiation therapy (IMRT) technique with a simultaneous integrated boost (SIB) in 25 sessions. The conformity index, quality of coverage, homogeneity index, mean doses, maximum doses, and different organ at risk (OAR) dose constraints were calculated for the dosimetric comparison of treatment plans. Descriptive analysis was performed using measures of central tendency and dispersion for the quantitative variables and absolute and relative frequencies for the qualitative variables. The comparison was made using the Wilcoxon signed rank sum test for a type I error level of 0.05. The statistical software Stata 11 (StataCorp LLC, College Station, Texas, USA) was used in the analysis. Results The mean age of the patients was 52 years, 33% were stage IIIB, and 67% had squamous cell carcinomas. The conformity index was 0.74 and 0.46 (difference: 0.28; p<0.01), the quality of coverage was 0.84 and 0.94 (difference: -0.10; p<0.01), and the homogeneity index was 0.12 and 0.070 (difference: 0.052; p<0.01) for IMRT-SIB and 3DCRT-SB, respectively. When the mean doses of the OARs were compared, all were lower with the IMRT-SIB technique, with statistically significant differences in the rectum and bladder. Conclusions The IMRT-SIB technique achieves a greater conformation of the doses on the treatment volumes with a significant reduction of the doses on the bladder and rectum.

Efecto de la suplementación con semilla de algodón y maíz en el desempeño productivo y calidad de la carne de ovinos / Effect of supplementation with cottonseed and corn on the productive performance and quality of sheep meat

RESUMEN La alimentación de los ovinos para producción de carne en la región Caribe colombiana, se fundamenta en el uso de gramíneas, en virtud de sus bajos costos; sin embargo, los rendimientos y la calidad nutricional, se ven afectados por la estacionalidad de las lluvias, por lo que se presentan bajas ganancias de peso. El objetivo de este trabajo fue evaluar el efecto de la suplementación con semilla de algodón y de maíz sobre el desempeño productivo y calidad de la carne de ovinos criollos de pelo. El estudio, se realizó en la Facultad de Medicina Veterinaria y Zootecnia de la Universidad de Córdoba, Ciénaga de Oro-Colombia. Se utilizaron 24 ovinos, distribuidos aleatoriamente en cuatro tratamientos consistentes en: T0: pastoreo; T1: pastoreo + 25% SA + 75% M; T2: pastoreo + 50 SA + 50% M y T3: pastoreo + 75% SA + 25% M. Los animales, se pesaron al inicio de la fase experimental y cada 15 días. Se estudiaron las siguientes variables: peso de la canal caliente y fría, rendimiento canal fría, longitud de la canal, perímetro de pierna, perímetro torácico, grasa de cobertura, índice de compacidad, humedad, pH, capacidad de retención de agua y color. La ganancia de peso difirió (p≤0,05) entre tratamiento, presentando valores medios de 0,053; 0,126; 0,128; 0,130kg, para T0, T1, T2 y T3, respectivamente. De igual forma, se detectaron diferencias (p≤0,05) para los pesos y rendimientos en canal. Los animales suplementados con 75% de semilla de algodón y 25% de maíz generaron las mayores ganancias de peso, viéndose reflejado en un mayor peso al sacrificio y rendimientos.

ABSTRACT The feeding of sheep for meat production in the Colombian Caribbean Region is based on the use of grasses by virtue of their low costs. However, the yields and nutritional quality are affected by the seasonality of the rains, so there are low weight gains. The objective of this work was to evaluate the effect of the supplementation with cotton seed and corn grain on the productive performance and quality of the meat of sheep creole of Colombian hair. The study was carried out in the the Faculty of Veterinary Medicine and Zootechnics of the University of Córdoba, Ciénaga de Oro-Colombia. Twenty four male creole lambs with initial weight of 16 ± 2 kg were used, which were randomly distributed in four experimental treatments consisting of: T0: Grazing, T1: Grazing + 25% cottonseed (CS) + 75% corn (C), T2: Grazing + 50CS+50%C and T3: Grazing + 75% CS+25%C. Animals were weighed at the start of the experimental phase and every 15 days. The following variables were studied: weight of the hot and cold carcass, performance of the cold carcass, carcass length, leg perimeter, thoracic perimeter, covering fat, compactness index, humidity, pH, water retention capacity and color. The weight gain differed (p≤0.05) between treatment, presenting mean values of 0.053; 0.126; 0.128; 0.130kg for T0, T1, T2 and T3, respectively. Similarly, differences (p≤0.05) were detected for carcass weights and yields. The supplementation with cottonseed and corn improved the productive performance of the animals, being reflected in greater gains of weights and yields.

Estudio de prevalencia de automedicación en niños que consultan por infección respiratoria aguda y enfermedad diarreica aguda a una clínica universitaria / Self Medication Prevalence in Child's who Consult for Respiratory Tract Diseases and Acute Diarrheal Disease to Clínica Universidad de la Sabana

RESUMEN Objetivo: La automedicación en niños tiene una prevalência mundial del 50 %. La enfermedad diarreica aguda y la infección del tracto respiratorio son enfermedades prevalentes de la infancia, y se ven afectadas por esta práctica. El objetivo fue establecer la prevalencia de automedicación en niños que consultan a un servicio de pediatría y explorar posibles factores asociados. Materiales y métodos: Se realizó un estudio de corte transversal. Se incluyeron niños que consultaron por infección respiratoria aguda y/o enfermedad diarreica aguda. Se desarrolló un instrumento (encuesta) para la recolección de la información. Con el objetivo de explorar los posibles factores asociados con la automedicación se realizaron análisis bivariados y se construyó un modelo de regresión logística. Se estimó como medida de efecto el OR con su intervalo de confianza. Se estableció el valor de significancia estadística con un valor de p< 0,05. Resultados: Se incluyeron 300 menores. La prevalencia de automedicación fue del 46 %. Los medicamentos más usados fueron el acetaminofén (78 %) y el ibuprofeno (15 %). Se encontró posible asociación de la automedicación con el antecedente de previo de automedicación y la edad del niño. Conclusiones: La prevalencia de automedicación es alta y similar a la encontrada en la literatura. Los posibles factores asociados a la automedicación en niños son la experiencia previa de automedicación y la edad del niño. Desde la atención primaria se deben realizar campañas educativas a la población de los riesgos de la automedicación.

ABSTRACT Objective: Self-medication in children has a worldwide prevalence of 50%. Acute diarrheal disease and respiratory tract infection are prevalent childhood diseases and are affected by this practice. The objective was established the prevalence of self-medication in children who consult a pediatric service and explore possible associated factors. Materials and methods: A cross-sectional study was conducted, children who consulted for acute respiratory disease or acute diarrheal disease were included. An instrument for information collection was developed and applied. In order to explore the possible risk factors associated with self-medication, bivariate analyzes were performed and a logistic regression model was constructed. The OR with its confidence interval was estimated as an effect measure. The statistical significance value was established with a value of p <0.05. Results: 300 children were included. The prevalence of self-medication was 46 %. The most used medications were acetaminophen (78 %) and ibuprofen (15 %). Association of self-medication was found with the history of prior self-medication and the child's age. Conclusions: The prevalence of self-medication is high and like that found in the literature. Possible associated factors are previous self-medication experience and the child's age. From primary care it is appropriate to carry out educational campaigns to the population of the risks of self-medication.

Comportamiento ingestivo diurno y desempeño productivo de corderos suplementados con semilla de algodón y maíz molido / Daytime Ingestion Behavior and Performance in the Production of Lambs Supplemented with Cotton Seed and Ground Corn (GC) / Comportamento ingestivo diurno e desempenho produtivo de cordeiros suplementados com semente de algodão e molho moído

Resumen El estudio del comportamiento ingestivo es importante para conocer el desempeño de los animales y es especialmente imprescindible cuando se evalúan diferentes regímenes de alimentación. El objetivo del presente estudio fue evaluar la conducta ingestiva diurna y la respuesta productiva de corderos criollos suplementados con semilla de algodón (SA) y maíz molido (MM). Se emplearon 16 corderos criollos machos enteros con peso inicial de 16 ± 2 kg, los cuales fueron distribuidos aleatoriamente en cuatro tratamientos experimentales consistentes en: T0 = Pastoreo, T1 = Pastoreo + 25 % SA + 75 % MM, T2 = Pastoreo + 50 SA + 50 % MM y T3 = Pastoreo + 75% SA + 25 % MM. En los forrajes se determinó la composición nutricional y en los animales el consumo de materia seca a través de marcadores externos e internos, el comportamiento ingestivo y el desempeño productivo. El consumo de materia seca total presentó diferencias estadísticas (p < 0.05), con menor consumo para los animales del tratamiento control. Asimismo, se detectaron diferencias estadísticas (p < 0.05) entre los tratamientos para las actividades de pastoreo, rumia, consumo de agua y caminata para las variables número de bocados por minuto y total. El peso final y la ganancia de peso obtenida por los animales que recibieron suplementación fueron superiores en un 28.4 % y 50.3 %, respectivamente. La suplementación con SA y MM promovió un mayor consumo de nutrientes y, en consecuencia, mejoró el desempeño productivo de los corderos.

Abstract The study of the ingestion behavior is important to know the animal production performance and is a must when evaluating different feeding regimes. This work aims to evaluate the daytime ingestion behavior and the productive answer in criollo lambs receiving supplement with cotton seeds (CS) and ground corn (GC). Sixteen complete male criollo lambs were used having a starting weight of 16 ± 2 Kg. They were distributed randomly into four experimental treatments consisting in: T0 = shepherding, T1 = shepherding + 25% CS + 75% GC, T2 = shepherding + 50% CS + 50% GC, and T3 = shepherding + 75% CS + 25% GC. Using both external and internal markers, the nutritional composition of the forages and the dry mass consumption in the animals were determined, i.e., the ingestion behavior and the productive performance. The total dry mass consumption showed statistical differences (p < 0.05), with lower consumption among the control animals. Likewise, statistical differences were detected (p < 0.05) between the treatments for shepherding activities, cud, water consumption and walking regarding variables like mouthfuls per minute and total ingestion. The final weight and the weight gain in the animals receiving supplements were higher in 28.4 % and 50.3 %, respectively. The CS and GC supplements led to a greater consumption of nutrients and, therefore, improved the ovine production performance.

Resumo O estudo do comportamento ingestivo é importante para conhecer o desempenho dos animais e é especialmente essencial quando se avaliar diferentes regimes alimentares. O objetivo do presente estudo foi avaliar a conduta ingestiva diurna e a resposta produtiva de cordeiros crioulos suplementados com semente de algodão (SA) e molho moído (MM). Foram usados 16 cordeiros crioulos machos inteiros com peso inicial de 16 ± 2 kg, os quais foram distribuídos aleatoriamente em quatro tratamentos experimentais consistentes em: T0 = Pastejo, T1 = Pastejo + 25% SA + 75% MM, T2 = Pastejo + 50% SA + 50% MM e T3 = Pastejo + 75% SA + 25% MM. Nas forrageiras determinou-se a composição nutricional e nos animais o consumo de matéria seca através de marcadores externos e internos, o comportamento ingestivo e o desempenho produtivo. O consumo total de matéria seca apresentou diferenças estatísticas (p < 0.05), com menor consumo nos animais do tratamento controle. Mesmo, detectaram-se diferenças estatísticas (p < 0.05) entre os tratamentos para as atividades de pastoreio, ruminação, consumo de agua e caminhada para a variável número de lanches por minuto e total. O peso final e o ganho de peso obtido pelos animais que receberam suplementação foram superiores em 28.4% e 50.3%, respectivamente. A suplementação com SA e MM promoveu maior consumo de nutrientes e consequentemente, melhorou o desempenho produtivo dos cordeiros.

Características de crecimiento y medidas del área del ojo del lomo en ovinos criollos del departamento de Córdoba, Colombia / Growth traits and measures of loin eye area in Creole sheep of the Cordoba department, Colombia

RESUMEN De la raza ovina criolla, desarrollada en el departamento de Córdoba, Colombia, existen pocas investigaciones sobre características de desarrollo, por tal razón, el objetivo del presente estudio fue evaluar características asociadas al crecimiento de los ovinos criollos de pelo, en dos poblaciones de Córdoba, Colombia. Se utilizaron 55 animales provenientes de dos sistemas de producción. El pesaje, se realizó cada 15 días, desde el nacimiento hasta los 6 meses de edad y las mediciones del área del ojo del lomo (AOL), se tomaron por ultrasonografía, a los 4 y 6 meses de edad. Las características evaluadas fueron peso al nacer (PN), peso al destete (PDA90), peso a los seis meses (PA6M), ganancia de peso predestete (GPPRD) y posdestete (GPPOD) y AOL. El promedio para PN fue de 2,63 ± 0,65 kg; para PDA90, de 11,19 ± 3,78 kg; para PA6M, de 15,61 ± 3,93 kg y para GPPRD y GPPOD, de 0,095 ± 0,04 y 0,06 ± 0,3 kg/d, respectivamente. Se encontró que el sexo del cordero afectó (P≤0,05) las variables PDA90, PA6M y GPPRD. El tipo de finca tuvo influencia (P≤0,05) sobre todas las características de crecimiento evaluadas. Los resultados sugieren que habría que mejorar los sistemas de alimentación en las poblaciones estudiadas e iniciar un proceso de selección, con el fin de mejorar las características evaluadas.

ABSTRACT The Creole sheep breed developed in the department of Córdoba, Colombia has little research on growth traits, for this reason the objective of this study was to evaluate traits associated with the growth of Creole hair sheep in two populations of Córdoba, Colombia. Fifty-five Creole animals from two production systems were used. Weighing was performed every 15 days from birth to 6 months of age and loin eye area (LEA) measurements were taken by ultrasound at 4 and 6 months of age. The traits evaluated were birth weight (BW), weaning weight (WW90), weight at six months of age (W6M), preweaning (PWWG) and postweaning weight gain (POWWG) and LEA. The average for BW was 2.63 ± 0.65 kg, for WW90 it was 11.19 ± 3.78 kg, for W6M it was 15.61 ± 3.93 kg and for PWWG and POWWG it was 0.095 ± 0.04 and 0.06 ± 0.03 kg/d, respectively. It was found that the sex of the lamb affected (P≤0.05) the variables PDA90, PA6M and GPPRD. The type of farm had influence (P≤0.05) on all the growth traits evaluated. The results suggest that, it would be necessary to improve the feeding systems in the populations studied and initiate a selection process in order to improve the evaluated traits.

Leaf economics and slow-fast adaptation across the geographic range of Arabidopsis thaliana.

Life history strategies of most organisms are constrained by resource allocation patterns that follow a 'slow-fast continuum'. It opposes slow growing and long-lived organisms with late investment in reproduction to those that grow faster, have earlier and larger reproductive effort and a short longevity. In plants, the Leaf Economics Spectrum (LES) depicts a leaf-level trade-off between the rate of carbon assimilation and leaf lifespan, as stressed in functional ecology from interspecific comparative studies. However, it is still unclear how the LES is connected to the slow-fast syndrome. Interspecific comparisons also impede a deep exploration of the linkage between LES variation and adaptation to climate. Here, we measured growth, morpho-physiological and life-history traits, at both the leaf and whole-plant levels, in 378 natural accessions of Arabidopsis thaliana. We found that the LES is tightly linked to variation in whole-plant functioning, and aligns with the slow-fast continuum. A genetic analysis further suggested that phenotypic differentiation results from the selection of different slow-fast strategies in contrasted climates. Slow growing and long-lived plants were preferentially found in cold and arid habitats while fast growing and short-lived ones in more favorable habitats. Our findings shed light on the role of the slow-fast continuum for plant adaptation to climate. More broadly, they encourage future studies to bridge functional ecology, genetics and evolutionary biology to improve our understanding of plant adaptation to environmental changes.

Adaptive diversification of growth allometry in the plant Arabidopsis thaliana.

Seed plants vary tremendously in size and morphology; however, variation and covariation in plant traits may be governed, at least in part, by universal biophysical laws and biological constants. Metabolic scaling theory (MST) posits that whole-organismal metabolism and growth rate are under stabilizing selection that minimizes the scaling of hydrodynamic resistance and maximizes the scaling of resource uptake. This constrains variation in physiological traits and in the rate of biomass accumulation, so that they can be expressed as mathematical functions of plant size with near-constant allometric scaling exponents across species. However, the observed variation in scaling exponents calls into question the evolutionary drivers and the universality of allometric equations. We have measured growth scaling and fitness traits of 451 Arabidopsis thaliana accessions with sequenced genomes. Variation among accessions around the scaling exponent predicted by MST was correlated with relative growth rate, seed production, and stress resistance. Genomic analyses indicate that growth allometry is affected by many genes associated with local climate and abiotic stress response. The gene with the strongest effect, PUB4, has molecular signatures of balancing selection, suggesting that intraspecific variation in growth scaling is maintained by opposing selection on the trade-off between seed production and abiotic stress resistance. Our findings suggest that variation in allometry contributes to local adaptation to contrasting environments. Our results help reconcile past debates on the origin of allometric scaling in biology and begin to link adaptive variation in allometric scaling to specific genes.

Determinación de la curva de crecimiento en ovinos criollos de pelo, mediante la utilización del modelo gompertz, en el trópico bajo colombiano / Growth curve determination for creole hair sheep using the gompertz model in the low colombian tropic

En Colombia existe una diversidad de ovinos, denominados ovinos criollos, resultado del cruce de diferentes razas, desde la época de la colonización y que se adaptaron a diferentes regiones del país. En el caso particular de este estudio, se hace referencia a los ovinos criollos de pelo, que se acomodaron a las condiciones biogeográficas de la Costa Caribe colombiana. Estos animales, por su adaptabilidad, han tenido un importante papel en el desarrollo de la ovinocultura del país; sin embargo, es muy poca la información que se tiene, a nivel nacional, sobre las características crecimiento de la raza o especie. El objetivo del presente estudio fue determinar la curva de crecimiento de dos poblaciones de ovinos criollos del trópico bajo colombiano, a través del uso del modelo no lineal Gompertz. Se utilizaron 55 animales, con 13 pesajes cada uno, perteneciente a dos sistemas de producción del departamento de Córdoba, Colombia. Se realizó un ajuste del modelo, mediante el procedimiento NLIN de Statistical Analysis Software (SAS), para la estimación de los parámetros del modelo. Se estimó β0, β1 y β2, cuyos valores fueron 25,97 ± 9,3, 2,1 ± 0,5 y 0,010 ± 0,004, respectivamente. Los estimados de madurez a los 4 y 6 meses fueron de 55,8 y 70,6%, respectivamente, y la edad al 75 de madurez fue de 7,0 meses y al 95% de madurez, de 13,1 meses. El modelo de Gompertz permitió describir el crecimiento de ovinos criollos, en condiciones de pastoreo, en el trópico bajo.

The Colombian Creole sheep has an important role in the development of sheep farming in the country, as this breed is distributed in most of the territory, being animals with significant features that make it widely used in farms with different productive purposes. To assess growth characteristics in animals have been used mathematical models, which describe the relationship between the age of the animal, its rate of growth and maturity. These models are equations that allow the construction of continuous curves of one biological variable according to another. This study aimed to determine the growth curve of two populations of crossbred sheep through the use of nonlinear Gompertz model. 55 animals with 13 measures of weight each were used, pertaining to two production systems of the department of Córdoba, Colombia. Estimaste for β0, β1 y β2 were 25.97 ± 9.3, 2.1 ± 0.5 and 0.010 ± 0.004, respectively. Estimates of maturity at 4 and 6 months were 55.8 and 70.6%, respectively; age 75% of maturity was of 7.0 months and at 95% of maturity was of 13.1 months. Gompertz model allowed describing the growth of creole sheep in conditions of grazing in the low tropics.

Primer registro de Typhlocoelum cucumerinum (Trematoda: Typhlocoelidae) en Cairina moschata domestica (aves: Anatidae) en Colombia / First record of Typhlocoelum cucumerinum (trematode: Typhlocoelidae) in Cairina moschata domestica (birds: Anatidae) in Colombia / Primeiro registro de Typhlocoelum cucumerinum (Trematódeo: Typhlocoelidae) em Cairina moschata doméstica (aves: Anatidae) na Colômbia

Resumen: En el presente estudio se registra por primera vez para Colombia el trematodo Typhlocoelum cucumerinum (Rudolphi, 1809) en el pato criollo doméstico (Cairina moschata domestica). Se colectaron un total de 210 trematodos en 42 individuos adultos, 26 machos y 16 hembras. Se encontró una frecuencia parasitaria del 57,14 % y una intensidad parasitaria promedio de 8,75 parásitos por animal. Los resultados obtenidos demuestran la presencia del trematodo en ecosistemas acuáticos del departamento de Córdoba, Colombia.

Abstract: This study records for the first time in Colombia the presence of trematode Typhlocoelum cucumerinum (Rudolphi, 1809) in domestic Muscovy ducks (Cairina moschata domestica). A total of 210 trematodes were collected from 42 adult individuals, 26 males and 16 females. Parasitic frequency was 57.14% and mean parasitic intensity was 8.75 parasites per animal. Results show the presence of trematodes in aquatic ecosystems in the Department of Córdoba (Colombia).

Resumo: Neste estudo se registra pela primeira vez para a Colômbia o trematódeo Typhlocoelum cucumerinum (Rudolphi, 1809) no pato-do-mato (pato de Muscovy) doméstico (Cairina moschata doméstica). Coletaram-se um total de 210 trematódeos em 42 indivíduos adultos, 26 machos e 16 fêmeas. Se encontrou uma frequência parasitária do 57,14 % e uma intensidade parasitária em média de 8,75 parasitas por animal. Os resultados obtidos demonstram a presença do trematódeo em ecossistemas aquáticos do departamento de Córdoba, na Colômbia.

Funciones esenciales de salud pública: su implementación en Argentina y desafíos hacia salud universal

[Extraído del Prólogo] El 1 de noviembre de 2016, en el Salón Biblioteca de la Academia Nacional de Medicina se llevó a cabo el lanzamiento del Foro Argentino sobre Funciones Esenciales de Salud Pública (FESP) y Federalismo. Esta publicación representa el inicio del proceso de diálogo y debate en torno a las FESP, liderado por la Asociación Argentina de Salud Pública, con el apoyo de la Representación Argentina de la Organización Panamericana de la Salud / Organización Mundial de la Salud. Durante ese encuentro se expuso y se debatió sobre política gubernamental y el fortalecimiento de la rectoría; federalismo y salud; y las FESP en el contexto de la salud universal y los Objetivos de Desarrollo Sostenible (ODS). Junto con la transcripción de las ponencias y opiniones recogidas en dicha ocasión, que constituyen el capítulo final de este libro, esta publicación reúne además aportaciones conceptuales y experiencias con respecto a las funciones esenciales de distinguidos académicos, salubristas y funcionarios gubernamentales en la Argentina

Funciones esenciales de salud pública: su implementación en Argentina y desafíos hacia salud universal

[Extraído del Prólogo] El 1 de noviembre de 2016, en el Salón Biblioteca de la Academia Nacional de Medicina se llevó a cabo el lanzamiento del Foro Argentino sobre Funciones Esenciales de Salud Pública (FESP) y Federalismo. Esta publicación representa el inicio del proceso de diálogo y debate en torno a las FESP, liderado por la Asociación Argentina de Salud Pública, con el apoyo de la Representación Argentina de la Organización Panamericana de la Salud / Organización Mundial de la Salud. Durante ese encuentro se expuso y se debatió sobre política gubernamental y el fortalecimiento de la rectoría; federalismo y salud; y las FESP en el contexto de la salud universal y los Objetivos de Desarrollo Sostenible (ODS). Junto con la transcripción de las ponencias y opiniones recogidas en dicha ocasión, que constituyen el capítulo final de este libro, esta publicación reúne además aportaciones conceptuales y experiencias con respecto a las funciones esenciales de distinguidos académicos, salubristas y funcionarios gubernamentales en la Argentina