ABSTRACT Background: The primary aim of this study is to assess the survival rates of individuals diagnosed with Community-Acquired Pneumonia (CAP) post-hospitalization in Colombia. Additionally, explore potential risk factors associated with decreased long-term survival. Methods: A retrospective cohort study was conducted in a hospital in Colombia, evaluating survival at 3, 6 and 12 months in CAP patients, using the Kaplan-Meier method. Stratifications were made by age, sex, comorbidity, and severity. The comparison of survival curves was performed using the Log-Rank test, a multivariate analysis with Cox regression was performed to study possible risk factors that affected 12-month survival in patients with CAP. Results: 3688 subjects were admitted, with a mortality of 16.3 % per year. Survival at three, six, and twelve months was 92.9 % (95 % CI 92–93 %), 88.8 % (95 % CI 87–90 %), and 84.2 % (95 % CI 82–85 %), respectively. Analysis stratified by pneumonia severity index, 12-month survival was 98.7 % in Class I, 95.6 % in Class II, 87.41 % in Class III, 77.1 % in Class IV, and 65.8 % in class-V (p < 0.001). Cox-regression showed that being male (HR = 1.44; 95 % CI 1.22–1.70; p < 0.001), an elevated pneumonia severity index (HR = 4.22; 95 % CI 1.89–9.43; p < 0.001), a high comorbidity index (HR = 2.29; 95 % CI 1.89–2.84; p < 0.001) and vasopressor requirement (HR = 2.22; 95 % CI < 0.001) were associated with a lower survival at twelve months of follow-up. Conclusion: Survival in patients with CAP who require hospitalization decreases at 3, 6, and 12 months of follow-up, being lower in patients older than 65 years, men, high comorbidity, and in subjects with severe presentation of the disease. Background CommunityAcquired Community Acquired (CAP posthospitalization post Colombia Additionally longterm long term Methods 3 1 KaplanMeier Kaplan Meier method age sex LogRank Log Rank test 12month month Results 368 admitted 163 16 16. year three six 929 92 9 92. (9 9293 93 92–9 %, , %) 888 88 8 88. 8790 87 90 87–9 842 84 2 84. 8285 82 85 82–8 respectively 987 98 7 98. I 956 95. II 8741 41 87.4 III 771 77 77. IV 658 65. classV class V 0.001. 0001 0.001 . 0 001 Coxregression HR 1.44 144 44 1.22–1.70 122170 22 70 0.001, 4.22 422 4 1.89–9.43 189943 89 43 2.29 229 29 1.89–2.84 189284 2.22 222 followup. followup follow up. up follow-up Conclusion followup, up, years men disease 36 ( 92– 879 87– 828 82– 874 87. 000 0.00 00 1.4 14 1.22–1.7 12217 4.2 42 1.89–9.4 18994 2.2 1.89–2.8 18928 0.0 1. 1.22–1. 1221 4. 1.89–9. 1899 2. 1.89–2. 1892 0. 1.22–1 122 1.89–9 189 1.89–2 1.22– 1.89– 18 1.22 1.89 1.2 1.8

RESUMEN Este artículo da cuenta de las controversias que se han suscitado en el plano jurídico y político en relación con la exploración y explotación minera en los municipios, y las barreras institucionales a las que se han visto enfrentados los ciudadanos en la utilización de este mecanismo de participación ciudadana en relación con temas mineros en los municipios de Pueblorrico (Antioquia), Cajamarca (Tolima) y Córdoba (Quindío). Para la construcción de los casos de estudio, se acudió al tipo de investigación cualitativa con enfoque sociojurídico y se utilizó la estrategia documental acompañada de visitas al territorio con aplicación de entrevistas a los actores involucrados en estos procesos, identificando que los ciudadanos efectivamente se enfrentaron a prácticas desplegadas desde lo institucional, que reflejan la vulneración de las garantías democráticas que el Estado tiene la obligación de proteger.

ABSTRACT This article reports on the controversies that have arisen at the legal and political levels in relation to mining exploration and exploitation in the municipalities, and the institutional barriers that citizens have faced in the use of this mechanism of citizen participation in relation to mining issues in the municipalities of Pueblorrico (Antioquia), Cajamarca (Tolima) and Córdoba (Quindío). For the construction of the case studies, we used qualitative research with a socio-legal approach and a documentary strategy accompanied by visits to the territory with the application of interviews to the actors involved in these processes, identifying that the citizens effectively faced practices deployed from the institutional level, which reflect the violation of the democratic guarantees that the State has the obligation to protect.

RESUMO Este artigo relata as controvérsias que surgiram em nível jurídico e político em relação à exploração e exploração mineira nos municípios, e as barreiras institucionais que os cidadãos têm enfrentado no uso deste mecanismo de participação cidadã em relação às questões de mineração nos municípios de Pueblorrico (Antioquia), Cajamarca (Tolima) e Córdoba (Quindío). Para a construção dos estudos de caso, utilizamos pesquisas qualitativas com uma abordagem sócio-legal e uma estratégia documental acompanhada de visitas ao território com a aplicação de entrevistas aos atores envolvidos nestes processos, identificando que os cidadãos efetivamente enfrentaram práticas implantadas a partir do nível institucional, que refletem a violação das garantias democráticas que o Estado tem a obrigação de proteger.

RESUMEN La administración del riesgo estratégico es un proceso continuo en el cual se identifican los eventos que tienen un impacto en la capacidad de la organización para crear valor y que pueden impedir el logro de sus objetivos estratégicos. Este proceso requiere de un marco que defina una estructura, roles, responsabilidades, políticas, apetito del riesgo y la integración con la estrategia y la gestión organizacional. Por lo anterior, el objetivo de este artículo es describir cómo algunas grandes empresas privadas con operaciones en Colombia realizan la gestión de los riesgos estratégicos. Para esto se empleó una metodología cualitativa y la aplicación de cinco entrevistas semiestructuradas a los líderes de la gestión de riesgos estratégicos en grandes empresas del sector de generación de energía, cervecero, de alimentos y de bebidas no alcohólicas. Dentro de los hallazgos se resalta la importancia de realizar de manera integrada la gestión estratégica de la empresa y la gestión de riesgos, de modo que se logren mitigar los eventos de carácter negativo y aprovechar las oportunidades que se identifiquen de manera oportuna, así como incluir dentro de los análisis información de calidad tanto de carácter cualitativo como cuantitativo que permita disminuir la incertidumbre existente. A partir del conocimiento de estos procesos, este artículo plantea un punto de partida para organizaciones que desean implementar la gestión del riesgo estratégico como movilizador del cumplimiento de los objetivos empresariales.

ABSTRACT Strategic risk management is a continuous activity that identifies the events that affect the capacity of an organization in creating value and which can hinder the attainment of its strategic goals. This activity requires a framework that defines the structure, roles, responsibilities, policies, risk appetite and the integration with strategy and organizational management. The main goal of this article is to describe how some large Colombian private companies do their strategic risk management. Qualitative methods were used and five semi structured interviews were conducted with leaders in strategic risk management from large energy, brewing, food and soft drink companies. One of the main findings was the importance of an integrated strategic and risk managment in the companies, so as to mitigate the impact of negative events and take advantage of the timely identification of opportunities. It was also found that thorough qualitative and quantitative information available in the analysis of risk helps to reduce existing uncertainty. From the knowledge of these processes, this article proposes a starting point for organizations that wish to implement strategic risk management as a mobilizer for the achievement of business objectives.

Introducción: la osteoporosis es la enfermedad ósea metabólica más común. Entre sus causas secundarias se encuentra la deficiencia de vitamina D (VD), la cual predispone además a fracturas por fragilidad e incrementa el riesgo de caídas. También confiere un riesgo incrementado de desarrollar enfermedad cardiovascular, diabetes mellitus tipo 1 y 2. Objetivo: el objetivo principal del estudio fue determinar los niveles de vitamina D en la población y correlacionarlos con diferentes variables clínicas, de laboratorio y densitométricas. Métodos: se realizó un estudio descriptivo de corte transversal, de una cohorte de pacientes donde se analizaron datos secundarios de mujeres posmenopáusicas colombianas con diagnóstico de osteoporosis y osteopenia (N=205). Se analizaron 46 variables donde se calcularon estadísticos descriptivos y regresiones lineales múltiples para determinar correlaciones. Resultados: la prevalencia de niveles insuficientes de vitamina D fue 55.1%, (n=113), deficientes 16.6% (n=34), y adecuados sólo 28.29% (n=58). Al comparar los pacientes con niveles deficientes e insuficientes, se encontró que los pacientes con niveles de vitamina D deficientes fue un factor de riesgo para la presencia de fracturas vertebrales, RR de 1.02 (IC: 0.96 a 1.06) y para la hipertensión arterial RR de 1.47 (IC: 1.36 a 1.58). Conclusión: dos terceras partes de nuestra población de pacientes tienen niveles inadecuados de vitamina D, y se encontró correlación con fracturas vertebrales e hipertensión arterial (Acta Med Colomb 2011; 36: 18-23).

Introduction: osteoporosis is the most common metabolic bone disease. Vitamin D deficiency is an important cause of secondary osteopenia and osteoporosis. It predisposes to fragility fractures and increases the risk of falling, while augmenting the risk of developing cardiovascular disease and diabetes mellitus type 1 and 2. Objective: the objective of this study was to determine the levels of vitamin D in our population study and to correlate them with bone density, vertebral fractures, and other cardiovascular and laboratory variables. Methods: we conducted a cross-sectional study of a cohort (n=205) of postmenopausal Colombian women diagnosed with osteoporosis and osteopenia. We analyzed 46 variables. Descriptive statistics were used, and multiple linear regressions were analyzed in order to determine correlations. Results: it was found that the prevalence of insufficient levels of vitamin D was 55.1% (n=113), deficient levels 16.6% (n=34), and adequate levels in only 28.29% (n=58) of patients. Comparing poor and inadequate levels, we found that deficient levels of vitamin D are a risk factor for vertebral fractures, with an RR of 1.02 (IC: 0,96 a 1.06) and for high blood pressure. with an RR of 1.47 (IC: 1.36 a 1.58). Conclusions: our study shows that inadequate levels of vitamin D are common in our population. This is associated with low bone mass, vertebral fractures, and hypertension. Further studies are needed in our country to confirm our findings (Acta Med Colomb 2011; 36: 18-23).