Unlocking sustainable livestock production potential in the Colombian Amazon through paddock division and gender inclusivity.

Low-emissions livestock production can be achieved through scaling production systems integrating trees, forages, and livestock within the same area. Such systems are known as silvopastoral production systems (SPS). However, despite SPS reported benefits, adoption rates globally remain low. This paper, therefore, aims to inform land use policy oriented towards increasing SPS adoption. This study intends to capture this by assessing SPS adoption benefits, identifying determinants of SPS adoption, and thus to contribute to policy for scaling low-emissions livestock production. Data was collected on socioeconomic status, livestock farming technical and economic indicators, and farm and paddock practices through farm-level surveys in four municipalities in the Amazon Piedmont of Colombia. Unlike previous studies that assume homogeneous farm management, when in fact, it is heterogeneous, this study assessed SPS adoption determinants using the paddock (n = 2819) as the unit of analysis. This methodological approach is consistent with paddock-level land use decisions taken by farmers based on socioeconomic and biophysical factors such as soil financial resources, type, and topography. The methodological approach allows us to provide new insights into the determinant of adopting SPS and an understanding of intra-farm level land use decisions. The results show that the adoption of SPS at both paddocks and farm levels in Caquetá is low. The main factors associated with higher SPS adoption levels at the paddock level are framed in gender, resources, and knowledge. We observe that women are more motivated to conserve the environment. Cattle paddocks managed by women, smaller in size, and those with more SPS-related projects show a tendency for medium or high SPS adoption. Furthermore, the positive relationship between access to credit and SPS adoption emphasizes the importance of financial resources tailored to SPS projects. Enhancing gender roles, improving access to finance in land use, and providing training programs on SPS systems can contribute to low-emission livestock production in Colombia. This research paper highlights the significance of implementing diverse management strategies and reaching out to farmers not involved in SPS projects. It emphasizes investments in low-emission livestock production, especially for female heads of households. This approach recognizes the broader benefits of SPS, beyond production and financial gains, promoting the division of paddocks and the adoption of SPS.

Laringología en tiempos de COVID-19 / Laryngology in the COVID­19 era

El tracto aerodigestivo superior es un lugar donde se ha detectado alta concentración y tropismo por el virus SARS-CoV-2. Por esta razón, existe una alta probabilidad de infección nosocomial en la práctica de otorrinolaringología. Los procedimientos en laringología, para exploración y evaluación de la laringe y la faringe, representan un riesgo alto para los pacientes y el equipo médico. Dado esto, consideramos importante resaltar la cuidadosa selección de pacientes, el conocimiento claro del equipo de protección personal necesario, dependiendo de la actividad que deba realizarse, la desinfección correcta de los equipos y los cuidados generales para el personal de la salud y el paciente. Presentamos una serie de recomendaciones e indicaciones de procedimientos frecuentes y pertinentes de patologías relevantes, que pueden requerir una atención prioritaria o urgente, según criterio médico, en consultorio, sala de procedimientos o salas de cirugía.

The aerodigestive tract has been identified as a high concentration and tropism level location for SARS-CoV-2 virus. Hence, there is high risk of nosocomial infection during the practice of Otolaringology procedures. In view of this, we consider the importance to highlight the careful selection of patients as well as having into account the required equipment for personal protection for each procedure. Additionally, we give emphasis to the proper disinfection of the equipment and general safety precautions for health personnel and patients. In the following, we present a series of recommendations and indications of frequent and pertinent procedures for relevant pathologies that might require urgent approach in the office, procedure or operating room according to the physician's discretion.

Manejo abierto de la estenosis laringotraqueal severa. Experiencia en Cali / Open management of severe laryngeal-tracheal stenosis. Cali experience

Valorar los procedimientos abiertos tipo RLT (resección laringo-traqueal) y RCTP (resección cricotraqueal parcial) en la estenosis laringotraqueal severa. Diseño: Estudio retrospectivo de serie de casos. Pacientes y métodos: Seguimiento de casos durante un período de tres años, en varias instituciones de la ciudad de Cali. Resultados: 17 pacientes con estenosis III-IV en un periodo de 36 meses, quince hombres y dos mujeres con promedio de edad de 35 años; promedio de intubación, 16 días. Tipo de cirugía (14/17) RLT y (3/17) RCTP, un paciente con molde laríngeo, ocho de 17 casos sin ningún procedimiento adicional. Decanulación en 16 de 17 pacientes (94%). Dos casos con paresia de pliegue vocal unilateral, con recuperación espontánea, sin lesiones de esófago y con promedio de decanulación de quince meses. Conclusión: La RLT y la RCTP se han convertido en el manejo estándar para las estenosis laringotraqueales severas, debido a la alta tasa de seguridad y de decanulación...

Validation of open surgical techniques like LTR (laryngo-tracheal resection) and PCTR (partial cricotracheal resection) in severe laryngeal-tracheal stenosis. Design: Retrospective case series. Patients and methods: patients from different institutions in the city of Cali and follow up over a period of 3 years. Results: 17 grade III-IV stenosis patients over a period of 36 months, 15 men, 2 women, average age 35 years, average intubation time 16 days, type surgery 14/17 LTR and 3/17 PCTR, 1 patient laryngeal stenting, 8/17 required no further procedures. Decannulation 16/17 patients (94%). 2 patient unilateral vocal fold palsy with spontaneous recovery. No esophageal lesions, average decannulation time 15 months...

Estenosis larinootraqueal revisión de casos en el centro médico imbanaco de cali / Laryngotrachealsstenosis. case studies in centro médico imbanaco in cali, Colombia / Estenose larigottraqueal revisão de casos no centro médico imbanaco de cali

El manejo de la estenosis laringotraqueal continúa siendo un problema difícil para el otorrinolaringólogo por la multiplicidad de hallazgos en los pacientes, su manejo complejo y la falta de un tratamiento único. En el Centro Médico Imbanaco de Cali, Colombia, se realizó un análisis retrospectivo de una serie de pacientes con este diagnóstico tratados entre octubre de 2006 y enero de 2011. Se examinaron los antecedentes, síntomas y signos, tratamientos, enfermedades asociadas, resultados del tratamiento y seguimiento en el tiempo. Se identificaronun total de 44 adultos, con edad promedio de 41,4 años; 24 (55%) eran mujeres y 20 hombres. El promedio de seguimiento fue 19 meses; 28 (63,6%) pacientes mejoraron con el empleo de tratamiento endoscópico y láser de CO2. Los mejores resultados se obtuvieron en el Grupo I (100%) y en el Grupo II (83.3%). La cirugía endoscópica láser, es un tratamiento válido para lesiones delgadas, no complicadas. El uso de técnicas de resección y reconstrucción laringotraqueal es útil en las lesiones complejas y gruesas donde falla el tratamiento endoscópico. No obstante, en casos seleccionados, el tratamiento endoscópico se debe considerar inicialmente. Otras ventajas del tratamiento endoscópico son; pocas complicaciones, baja morbilidad, tiempo quirúrgico y de hospitalización cortos.

The management of laryngotracheal stenosis remains a challenging problem for the otolaryngologist. The complexity of the various preoperative situations implies that no single treatment modality can solve the problem. I performed a retrospective analysis of our experience in Centro Médico Imbanaco in Cali, Colombia, with a series of patients with this condition between October 2006 and January 2011. The study involved retrospective review of the records of patients with laryngotracheal stenosis. Symptoms, antecedents, treatment, associate pathology, outcomes and follow up were examined. A total of 44 adults were identified, the mean age was 41,4 years, 24 were female (55%) and 20 were male. The mean followup time was 19 months. Twenty eight (63.6%) of these cases have been controlled effectively with endoscopy laser techniques. Best results were seen in Group I (100%) and Group II (83.3%). Endoscopic laser surgery is a valid approach for thinner, uncomplicated lesions; patients with thicker, complex lesions in whom endoscopic treatment fails are best managed with laryngotracheal resection a reconstruction, but endoscopic treatment may be considered before tracheal resection in select cases. Endoscopic treatment is associated with few complications, low morbidity, a short operative time, and a short length of hospitalization.

O tratamento da estenose laringotraqueal continua sendo um problema difícil para o otorrinolaringologista pela multiplicidade de descobertas nos pacientes, seu tratamento complexo e a falta de um tratamento único. No Centro Médico Imbanaco de Cali, Colômbia, realizouse uma análise retrospectiva de uma série de pacientes com este diagnóstico, tratados entre outubro de 2006 e janeiro de 2011. Foram examinados os antecedentes, sintomas e signos, tratamentos, doenças associadas, resultados do tratamento e acompanhamento no tempo. Foram identificados um total de 44 adultos, com idade média de 41,4 anos; 24 (55%) eram mulheres e 20 homens. A média de acompanhamento foi 19 meses; 28 (63,6%) pacientes melhoraram com o emprego de tratamento endoscópico e laser de CO2. Os melhores resultados foram obtidos no Grupo I (100%) e no Grupo II (83.3%). A cirurgia endoscópica laser, é um tratamento válido para lesões finas, não complicadas; o uso de técnicas de resecção e reconstrução laringotraqueal são úteis nas lesões complexas e grossas onde falha o tratamento endoscópico; não obstante, em casos selecionados, o tratamento endoscópico deve ser considerado inicialmente. Outras vantagens do tratamento endoscópico são poucas complicações, baixa morbilidade, tempo cirúrgico e de hospitalização curtos.