Seroprevalence of IgM and IgG anti-SARS-COV-2 and associated factors among agricultural workers in Colombia.

Background: The population of South America has been severely affected by the COVID-19 pandemic. In this region, during the year 2020, high seroprevalence percentages were reported, which have been associated with the socioeconomic characteristics of the population, mainly in urban areas. However, a relative lack of information on the dynamics of the pandemic in rural areas of these countries, where the population is more vulnerable, is still present. This study determined antibody prevalence against SARS-CoV-2 in urban and rural food producing workers in Colombia. Methods: A total of 1242 workers, urban and rural, linked to poultry, dairy, and meat production and supply chains, were analyzed through a sociodemographic survey and two serological tests against S and N proteins of SARS-CoV-2. Results: 78.7% were male. 50.9% of the participants were rural inhabitants, with an average age of 40.9 years old. 39.2% had IgM and IgG against SARS-CoV-2 S protein and 31.3% against N protein for the same virus; 83.6% had not been tested with an RT-PCR test for COVID-19 and 75.7% did not report symptoms related to the disease. The associated risk factors were low education, OR: 1.46, greater number of cohabitants, OR: 1.36, and contact with people infected with COVID-19, OR: 2.03. Conclusions: The seroprevalences found suggest an important interconnectivity between rural and urban areas, where asymptomatic subjects and sociodemographic factors facilitate the virus' spread in the population.

Potential Use of Waste Activated Sludge Hydrothermally Treated as a Renewable Fuel or Activated Carbon Precursor.

In this work, dewatered waste activated sludge (DWAS) was subjected to hydrothermal carbonization to obtain hydrochars that can be used as renewable solid fuels or activated carbon precursors. A central composite rotatable design was used to analyze the effect of temperature (140-220 °C) and reaction time (0.5-4 h) on the physicochemical properties of the products. The hydrochars exhibited increased heating values (up to 22.3 MJ/kg) and their air-activation provided carbons with a low BET area (100 m2/g). By contrast, chemical activation with K2CO3, KOH, FeCl3 and ZnCl2 gave carbons with a well-developed porous network (BET areas of 410-1030 m2/g) and substantial contents in mesopores (0.079-0.271 cm3/g) and micropores (0.136-0.398 cm3/g). The chemically activated carbons had a fairly good potential to adsorb emerging pollutants such as sulfamethoxazole, antipyrine and desipramine from the liquid phase. This was especially the case with KOH-activated hydrochars, which exhibited a maximum adsorption capacity of 412, 198 and 146 mg/g, respectively, for the previous pollutants.

Mycoviruses in Biological Control: From Basic Research to Field Implementation.

Mycoviruses from plant pathogens can induce hypovirulence (reduced virulence) in their host fungi and have gained considerable attention as potential biocontrol tools. An increasing number of mycoviruses that induce fungal hypovirulence, from a wide variety of taxonomic groups, are currently being reported. Successful application of these viruses in disease management is greatly dependent on their ability to spread in the natural populations of the pathogen. Mycoviruses generally lack extracellular routes of transmission. Hyphal anastomosis is the main route of horizontal mycovirus transmission to other isolates, and conidia of vertical transmission to the progeny. Transmission efficiencies are influenced by both the fungal host and the infecting virus. Interestingly, artificial transfection methods have shown that potential biocontrol mycoviruses often have the ability to infect a variety of fungi. This expands their possible use to the control of pathogens others than those where they were identified. Mycovirus research is also focused on gaining insights into their complex molecular biology and the molecular bases of fungus-virus interactions. This knowledge could be exploited to manipulate the mycovirus and/or the host and generate combinations with enhanced properties in biological control. Finally, when exploring the use of mycoviruses in field conditions, the pathogen life style and the characteristics of the disease and crops affected will deeply impact the specific challenges to overcome, and the development of biocontrol formulations and delivery methods.

Valorization of microalgal biomass by hydrothermal carbonization and anaerobic digestion.

The potential of hydrothermal carbonization (HTC) as a novel choice for treating microalgal biomass (MAB) was assessed. The hydrochar obtained at 210 °C had a carbon content and a higher heating value (HHV) 1.09 and 1.1 times greater, respectively, than that of the feedstock. Also, washing the hydrochar with HCl efficiently removed ash and increased its carbon content 1.40-fold. Energy recovery in the liquid fraction from the hydrothermal treatment (LF) by anaerobic digestion (AD) allowed methane yields of 188-356 mL STP CH4 g-1 VSadded, to be obtained. As a result, the amount of energy recovered from MAB was increased from about 4 MJ kg-1 (20% in terms of HHV) to 15.4, 12.1 and 10.4 MJ kg-1 by combining HTC at 180, 210 and 240 °C, respectively, with AD. Therefore, HTC at 180 °C in combination with AD seemingly provides an effective method for valorizing MAB.

Mesophilic anaerobic co-digestion of the organic fraction of municipal solid waste with the liquid fraction from hydrothermal carbonization of sewage sludge.

In the present study, the influence of substrate pre-treatment (grinding and sieving) on batch anaerobic digestion of the organic fraction of municipal solid waste (OFMSW) was first assessed, then followed by co-digestion experiments with the liquid fraction from hydrothermal carbonization (LFHTC) of dewatered sewage sludge (DSS). The methane yield of batch anaerobic digestion after grinding and sieving (20 mm diameter) the OFMSW was considerably higher (453 mL CH4 STP g-1 VSadded) than that of untreated OFMSW (285 mL CH4 STP g-1 VSadded). The modified Gompertz model adequately predicted process performance. The maximum methane production rate, Rm, for ground and sieved OFMSW was 2.4 times higher than that of untreated OFMSW. The anaerobic co-digestion of different mixtures of OFMSW and LFHTC of DSS did not increase the methane yield above that of the anaerobic digestion of OFMSW alone, and no synergistic effects were observed. However, the co-digestion of both wastes at a ratio of 75% OFMSW-25% LFHTC provides a practical waste management option. The experimental results were adequately fitted to a first-order kinetic model showing a kinetic constant virtually independent of the percentage of LFHTC (0.52-0.56 d-1) and decreasing slightly for 100% LFHTC (0.44 d-1).

[The tired adolescent: Evaluation and management in the family practice]. / El adolescente «cansado¼: evaluación y manejo en la consulta de medicina familiar.

The narrative review is used as a methodological tool for the presentation of this article. A search was made in the PubMed, Elsevier, Ebsco, and Medline databases using temporal limits (publications from 2005 to 2016), in the Spanish, English, and Portuguese language, and by the type of persons analysed in the study (adolescents), along with the keywords in English: Adolescent/teen, tiredness, fatigue, sleepiness, drowsiness. A total of 33 articles of relevance were obtained for the diagnostic and therapeutic approach of the tired adolescent in Primary Care. It was found that the main cause of excessive daytime sleepiness and drowsiness in adolescents is insufficient or inadequate sleep. For this reason, a sleep assessment should be a routine component of the clinical evaluation of adolescents, and as the initial approach to dismiss secondary causes.

Osteogenic potential of platelet-rich plasma in dental stem-cell cultures.

The purpose of this study was to analyse the potential of platelet-rich plasma (PRP) culture media to induce osteogenic differentiation of periodontal ligament stem cells and dental pulp stem cells compared with four other methods of culture. Both types of cell were collected from 35 healthy patients and cultured in five different media (Dulbecco's modified eagle's medium (DMEM); DMEM and melatonin; DMEM and PRP; DMEM and ascorbic acid 200µmol; DMEM and l-ascorbate 2-phosphate 50µmol). Cells were characterised by flow cytometry. Alizarin Red stain, alkaline phosphatase stain, and the expression of collagen type 1 (Col-1), runt-related transcription factor (RUNX2), osteoprotegerin, and osteopontin (quantified by qRT-PCR) were used to detect the osteogenic profile in each culture. Flow cytometry showed that both types of stem cell were a homogeneous mixture of CD90(+), CD105(+), STRO-1(+), CD34 (-), and CD45 (-) cells. Dental pulp stem cells that were cultured with PRP showed the best osteogenic profile (RUNX2 p=0.0002; osteoprotegerin p=0.001). The group of these stem cells that showed the best osteogenic profile was also cultured with PRP (osteoprotegerin p=0.001). Medium five (with l-ascorbate 2-phosphate 50µmol added) showed an increase in all osteogenic markers for periodontal ligament stem cells after PRP, while the best culture conditions for osteogenic expression of dental pulp stem cells after PRP was in medium four (ascorbic acid 200µmol added). These results suggested that culture in PRP induces osteogenic differentiation of both types of stem cell, modulating molecular pathways to promote bony formation.

Treatment time, ease of use and cost associated with use of Equashield™, PhaSeal® , or no closed system transfer device for administration of cancer chemotherapy to a dog model.

This prospective experimental simulation study evaluated the efficiency, ease of use (EOU) and cost of administering chemotherapy with two closed system transfer devices (CSTD, Equashield™ and PhaSeal® ) and no CSTD. Forty-six veterinary technicians (VT) working in oncology specialty practices were timed during chemotherapy administration simulated with water and a model canine limb 10 times with each system and with no CSTD. EOU and likelihood of recommending each system were rated by VT using visual analog scales. Costs were obtained from veterinary distributors. Administration was fastest with Equashield™ (P = 0.0003), but the difference was not enough to affect case flow. Equashield™ was easier to use than PhaSeal® or no CSTD (P = 0.002), however VT recommended both CSTD more strongly than no CSTD (P < 0.0001). Equashield™ cost less than PhaSeal® but was sold only in bulk quantities. CSTD did not decrease efficiency in administering chemotherapy and were readily accepted by VT.

Fouling control in membrane bioreactors with sewage-sludge based adsorbents.

The potential application of powdered activated carbon (PAC) to mitigate membrane fouling has been tested in membrane bioreactors (MBRs) fed with cosmetic wastewater. Inexpensive powder activated carbon was prepared from sewage sludge biosolids (B-PAC) by pyrolysis (750 °C; 0.5 h) and air-activation (400 °C; 2 h). Adsorption capacities of 143 and 570 mg g-1 were reached for carbohydrates and proteins, respectively, quite similar to those of a commercial activated carbon (C-PAC). To check the effect of PAC addition on membrane fouling, three MBRs were simultaneously operated without (control-MBR) and with PAC (B-MBR and C-MBR) for 150 days in continuous mode at 8 L m-2 h-1 flux. Similar COD removal efficiencies were achieved in these three MBR systems. After 100 days of operation, the effect of the PACs on the sludge filterability was studied in the MBRs for 10 days. B-MBR showed stable transmembrane pressure (TMP) after 9 days of operation, unlike of control-MBR and C-MBR, where the TMP increased after the 2nd and 5th days, respectively. Therefore, operational cost saving can be achieved in the membrane cleaning due to decrease of fouling rate. Operating at stable state condition the addition of PAC gave rise to an increase of the critical flux of 25%. In an extra shear test, carried out at the end of the continuous experiment, a clear reduction in mean size of the flocs from 45 to 28 µm was observed in control-MBR. However, the extra shear led to a slight reduction of the mean size of flocs (less than 5%) in MBRs with PAC, with average sizes of 62 and 71 µm in C-MBR and B-MBR, respectively. The molecular weight fractionation of the MBR demonstrated a higher selectivity of B-PAC toward the adsorption of proteins smaller than 1 µm which prevents the irreversible fouling of the membranes. The membranes lifetime was increased because the B-PAC extended the filtration for a longer period than C-PAC, probably due to its easier in-situ regeneration.

Identification of the most common cutaneous neoplasms in dogs and evaluation of breed and age distributions for selected neoplasms.

OBJECTIVE-To identify the most common cutaneous neoplasms in dogs and evaluate breed and age distributions for selected neoplasms. DESIGN-Retrospective epidemiological study. SAMPLE-Records available through the Veterinary Medical Database of dogs examined at veterinary teaching hospitals in North America between 1964 and 2002. PROCEDURES-Information on tumor type and patient breed and age was collected. Incidence and odds ratios with 95% confidence intervals were calculated. RESULTS-Records of 1,139,616 dogs were reviewed. Cutaneous neoplasms were diagnosed in 25,996 of these dogs; records for the remaining 1,113,620 dogs did not indicate that cutaneous neoplasms had been diagnosed, and these dogs were considered controls. The most frequent age range for dogs with cutaneous neoplasms was 10 to 15 years. Lipoma, adenoma, and mast cell tumor were the most common skin tumor types. CONCLUSIONS AND CLINICAL RELEVANCE-Results supported previously reported data regarding cutaneous neoplasia in dogs but provided updated information on the most common skin tumors and on age and breed distributions.

Evaluation of satraplatin in dogs with spontaneously occurring malignant tumors.

BACKGROUND: Satraplatin is the 1st orally bioavailable platinum anticancer drug. OBJECTIVE: Our objectives were to evaluate efficacy in vitro against a canine cancer cell line, to determine the maximally tolerated dose (MTD) of satraplatin in tumor-bearing dogs, to identify the dose-limiting and other toxicities in dogs, and to record pharmacokinetics (PK). ANIMALS: Dogs with macro- or microscopic malignant neoplasia. METHODS: D17 canine osteosarcoma cells first were evaluated in a clonogenic survival assay. Then, dogs with a diagnosis of malignant neoplasia were prospectively entered in standard 3 + 3 cohorts. Additional patients were entered at the MTD to assess efficacy. Total and free platinum (by ultrafiltrate) concentrations were determined with inductively coupled plasma mass spectroscopy. RESULTS: Satraplatin inhibited clonogenic survival in vitro at clinically relevant and achievable concentrations. Twenty-three dogs were treated, 14 with PK evaluation. The MTD was 35 mg/m(2)/d for 5 days, repeated every 3-4 weeks. Bioavailability was 41%. PK variables (mean ± SD) at the MTD included T(max) 1.8 (± 0.7) hours, C(max) 72 (± 26) ng/mL, area under concentration (AUC)(0-24 h) 316 (± 63) h × ng/mL, and MRT 7 (± 1.3) hours. Higher AUC after the 5th versus the 1st dose suggested drug accumulation. Interestingly, platelets consistently reached nadir sooner than did neutrophils (day 14 versus 19). Myelosuppression was dose-limiting and gastrointestinal toxicity was mild. CONCLUSIONS AND CLINICAL IMPORTANCE: Satraplatin was well tolerated in tumor-bearing dogs, thus warranting further investigation in a phase II trial.

Recent trends in feline intestinal neoplasia: an epidemiologic study of 1,129 cases in the veterinary medical database from 1964 to 2004.

A retrospective epidemiologic study evaluated 1,129 feline intestinal tumor patients via data entered into the Veterinary Medical Database (VMDB) from 1964 to 2004. Cases were analyzed by breed, age, yr of diagnosis, tumor type, and location. The VMDB incidence of all intestinal tumors reported during this 40 yr period was 0.4%, with small intestinal tumors predominating. The most common intestinal tumor was lymphoma, but the most common nonlymphoid tumor was adenocarcinoma. The Siamese breed and increasing age after 7 yr conferred an increased risk. Intact males and females appeared to have a decreased risk compared with neutered patients, but this may be explained by the age difference among these patients as older patients were more likely to be neutered. Prospective studies evaluating neuter status predilection and prognosis are warranted.

Cloning and expression of canine CD25 for validation of an anti-human CD25 antibody to compare T regulatory lymphocytes in healthy dogs and dogs with osteosarcoma.

T regulatory cells (Tregs) are a unique subset of T helper cells that serve to modify/inhibit effector cells of the immune system and thus are essential to prevent autoimmunity. Overzealous Treg activity may contribute to impaired immune responses to cancer. Tregs can be phenotypically identified by proteins expressed on the cell surface (CD4 and CD25) and inside the cell (forkhead box3 (FoxP3)), although in dogs, no anti-canine CD25 antibody exists. We hypothesized that a mouse anti-human CD25 antibody definitively recognizes the canine protein and can be used to identify Tregs in dogs. We describe cloning and transfection of the canine CD25 gene into human HeLa cells with subsequent expression of the canine protein on the cell surface detected using an anti-human CD25 antibody in a flow cytometric assay. Validation of this antibody was used to identify CD4+CD25+FoxP3+ Tregs in 39 healthy dogs and 16 dogs with osteosarcoma (OSA). Results were expressed in five different ways and showed significantly fewer %CD4+CD25+ T lymphocytes expressing FoxP3 in blood of older dogs (>/=7 years) compared with the other two age groups (<2 and 2-6 years) (p<0.001) and fewer %CD4+CD25+FoxP3+ Tregs in the tumor draining lymph nodes of OSA patients compared to the unrelated lymph node (p=0.049). However, there was no significant difference in % Tregs in the peripheral blood or lymph nodes between the control dogs and those with OSA. While the CD25 antibody can be successfully used in a flow cytometric assay to identify Tregs, this study does not support clinical utility of phenotypic recognition of Tregs in dogs with OSA.

Disseminated melanoma in a dog with involvement of leptomeninges and bone marrow.

An 11-year-old, Black and Tan Coonhound dog was presented with a history of lameness of the right hind leg for 2 months, osteolysis in the right distal femur, a pulmonary mass, and a presumptive diagnosis of osteosarcoma. By cytologic examination, neoplastic melanocytes were noted from fine needle aspirates of the femoral and pulmonary masses. Postmortem examination revealed a disseminated melanoma involving the right femoral bone marrow, lung, multiple lymph nodes, and adrenal gland, with diffuse infiltration of the leptomeninges of the brain and spinal cord. This case report describes a unique presentation of canine melanoma, which in some ways resembles leptomeningeal melanomatosis, a rare human melanoma variant.

Hormonal and sex impact on the epidemiology of canine lymphoma.

The Surveillance Epidemiology and End Results data demonstrate that the risk of non-Hodgkin lymphoma is lower for women, but that the incidence increases after fifty years of age, at which menopause is regularly reached, suggesting that female hormones may be protective for NHL. This study examines the influence of sex on lymphoma risk in a relevant large animal model. Records for dogs in the Veterinary Medical Database were analyzed from 1964 to 2002. Risk ratios were calculated to evaluate associations between sex, neutering status, and lymphoma occurrence. A total of 14,573 cases and 1,157,342 controls were identified. Intact females had a significantly lower risk of developing lymphoma, Odds Ratio 0.69 (0.63-0.74) with a P < .001. We conclude that there is a sex effect on NHL risk in dogs similar to humans. We hypothesize that the hormone levels of intact females lower the risk of NHL. The possibility of a protective role of endogenous estrogens in the etiology of NHL should be investigated.

Relationships between demographic variables and lead toxicosis in cattle evaluated at North American veterinary teaching hospitals.

OBJECTIVE: To determine associations between age, sex, breed, and month and year of admission and the diagnosis of lead toxicosis in cattle. DESIGN: Retrospective case-control study. Sample Population-Records of all cattle evaluated at North American veterinary teaching hospitals during the years 1963 to 2002, which were available through the Veterinary Medical Database. PROCEDURES: Logistic regression was used to evaluate the associations between postulated risk factors and the occurrence of lead toxicosis in cattle and predict the occurrence of the diagnosis of lead toxicosis in cattle. RESULTS: 413 cases of lead intoxication and 202,363 control cattle were identified and met the inclusion criteria. Cattle < 4 years of age were at increased risk for the diagnosis of lead intoxication relative to cattle > or = 4 years of age. Cattle > or = 2 months and < 6 months of age had the greatest risk for lead intoxication (odds ratio, 12.3). Angus cattle were at greater risk for toxicosis (odds ratio, 1.95), compared with other breeds. The risk of lead toxicosis was greater before 1985 (odds ratio, 1.94) than the risk thereafter. The risk of lead toxicosis diagnosis was greatest in the months of May, June, July, and August. CONCLUSIONS AND CLINICAL RELEVANCE: Lead toxicosis in cattle was associated with age < 4 years and the Angus breed. A seasonal pattern existed with peak occurrence in the late spring and summer. The occurrence of lead toxicosis has declined over time.

Problemática del gusano barrenador del ganado, Cochliomyia hominivorax (Coquerel, 1858) en Colombia / The problem of screwworm, Cochliomyia hominivorax (Coquerel, 1858), in Colombia

Cochliomyia hominivorax es una mosca que en su etapa de larva es parásito obligado de animales de sangre caliente, incluyendo a humanos, causando una condición clínica conocida como ‘miasis traumática’. Dado que la hembra se aparea una sola vez y el macho lo puede hacer varias veces más, en los años 1950 se estableció la erradicación de esta plaga, a partir de esterilización de los machos. El programa de erradicación de C. hominivorax ha sido exitoso en Norte y Centroamérica. Sin embargo, América del Sur aún se encuentra naturalmente infestada. El costo económico, el largo plazo que exige y las consecuencias indeseables del programa de erradicación, propenden por la búsqueda de alternativas de control efectivas. El inicio de la erradicación en Colombia, podría encontrar dificultades geográficas, políticas y, principalmente, económicas. Es fundamental en este proceso la cooperación del Departamento de Agricultura de los Estados Unidos de América, de las organizaciones de cooperación internacional, de las autoridades sanitarias, de las instituciones educativas, y de los productores de ganado. Las áreas de investigación prioritarias en C. hominivorax en Colombia deberán ser la biología, la epidemiología y la dinámica de poblaciones, a la par con el mejoramiento de los métodos de vigilancia y técnicas de monitoreo. Antes de emprender un programa de erradicación en Colombia, se recomienda la realización de estudios previos para establecer la viabilidad técnica, política, económica y ambiental. Con esta información, una comisión conformada por entes públicos y privados, determinará los verdaderos beneficios y costos de la erradicación.

Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs.

OBJECTIVE-To evaluate prevalence of and risk factors for hip dysplasia (HD) and cranial cruciate ligament deficiency (CCLD) in dogs and determine change in prevalence over time. DESIGN-Cross-sectional study. ANIMALS-1,243,681 Dogs for which information was reported to the Veterinary Medical Database between 1964 and 2003. PROCEDURES-Information on breed, sex, and age was collected, and prevalences and odds ratios were calculated. RESULTS-Castrated male dogs were significantly more likely than other dogs to have HD (odds ratio [OR], 1.21), and castrated male (OR, 1.68) and spayed female (OR, 2.35) dogs were significantly more likely to have CCLD. Dogs up to 4 years old were significantly more likely to have HD (OR for dogs 2 months to 1 year old, 1.22; OR for dogs > 1 to 4 years old, 1.48), whereas dogs > 4 years old were significantly more likely to have CCLD (OR for dogs > 4 to 7 years old, 1.82; OR for dogs > 7 years old, 1.48). In general, large- and giant-breed dogs were more likely than other dogs to have HD, CCLD, or both. Prevalences of HD and CCLD increased significantly over the 4 decades for which data were examined. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that sex, age, and breed were risk factors for HD, CCLD, or both in dogs and that prevalences of HD and CCLD have increased over time.

La salud animal y la globalización: el desafío de políticas sostenibles y equitativas en el contexto de los países en desarrollo / Animal health and globalization: the challenge of equitable and sustainavle policies in the context of developing countries

La globalización es una megatendencia que impacta de manera diferenciada a los países en desarrollo. La salud animal y la salud pública veterinaria son analizadas en el contexto de la globalización con especial atención en países en desarrollo. Se señalan las implicaciones de la salud animal en relación a la salud humana, la sociedad del conocimiento, el desarrollo urbano, la percepción del consumidor, los sistemas productivos, las políticas agropecuarias, el comercio internacional y la educación. Se resalta la necesidad de adaptarse a los retos y oportunidades que ofrece la globalización, destacando la labor de las universidades en la formación de profesionales preparados para responder a los desafíos del nuevo escenario y la interacción con diferentes actores...

Ecología y epidemiología del Gusano Barrenador del Ganado, Cochliomyia hominivorax (Coquerel, 1858) / Ecology and epidemiology of screwworm, Cochliomyia Hominivorax (Coquerel, 1858)

La miasis por cochliomyia hominivorax se caracteriza por áreas manchadas con exudados sanguinolentos alrededor de las heridas de los animales. Sus efectos patológicos van desde la irritación mecánica por la alimentación de las larvas hasta la muerte del hospedero en infestaciones sucesivas. En condiciones naturales, las densidades de las poblaciones de la mosca del Gusano Barrenador del Ganado son bajas. Se distribuyen en relación con los cursos de agua, la proximidad de hospederos potenciales y la densidad de la vegetación. Los climas húmedos y calientes favorecen el incremento de las poblaciones del gusano Barrenador del ganado. Dentro de los animales domésticos, la principal especie afectada es la bovina. Los factores de riesgo en los animales están relacionados, principalmente, con prácticas de manejo. En seres humanos, los niños y los ancianos, en condiciones de abandono y desaseo, son los individuos más vulnerables.Se señalan algunos aspectos técnicos que deben ser analizados en la planeación de estudios ecológicos y epidemiológicos en Colombia...