Resumo Assumindo que as autoridades de América Latina têm níveis baixos de aprovação, essa pesquisa avalia o desempenho do governo de México nos últimos 25 anos com dois indicadores chave da nova governança política, analisando a posição absoluta e relativa do México nos índices de eficácia do governo e a qualidade regulatória com a plataforma Worldwide Governance Indicators (WGI). O quadro teórico foi conformado pelo modelo de governança proposto por duas filosofias de administração estreitamente ligadas com a gestão pública e a nova gestão pública. Os resultados mostram que, na gestão de Ernesto Zedillo, Vicente Fox e Felipe Calderón, os registros podem se considerar positivos, ligados com práticas de gestão adequadas. Do mesmo jeito, o rendimento da gestão de Enrique Peña Nieto e, de jeito particular, o de Andrés Manuel López Obrador, são desfavoráveis. A pesquisa apresenta as variáveis explicativas dos resultados. A conclusão indica que o uso de indicadores e modelos, embora sendo importante, representa somente opções estratégicas, sendo a construção de serviços públicos honestos e profissionais a verdadeira finalidade do Estado. JEL: L38 Política pública.

Resumen Asumiendo que las autoridades de América Latina tienen bajos niveles de aprobación, esta investigación evalúa el desempeño del gobierno de México en los últimos 25 años con dos indicadores clave de la nueva gobernanza política. Se analiza la posición absoluta y relativa de México en los índices de eficacia del gobierno y calidad regulatoria por medio de la plataforma de Worldwide Governance Indicators (WGI). El marco teórico está conformado por el modelo de gobernanza propuesto desde dos filosofías administrativas con las que guardan una vital relación la gerencia pública y la nueva gerencia pública. Los resultados muestran que en las administraciones de Ernesto Zedillo, Vicente Fox y Felipe Calderón los registros se pueden considerar como positivos, asociados a prácticas de gestión apropiadas. De la misma forma, el desempeño del gobierno que encabezó Enrique Peña Nieto y, particulamiente, el que representa Andrés Manuel López Obrador, es desfavorable, se exponen las variables explicativas de estos resultados. Se concluye indicando que el uso de indicadores y modelos, si bien es importante, representa únicamente opciones estratégicas, siendo la construcción de servicios públicos honestos y profesionales el auténtico fin del Estado. JEL: L38 Política pública.

Abstract If the authorities in Latin America have low approval levels, this research assesses the performance of the government of Mexico over the last 25 years with two key indicators of the new political governance, analyzing the absolute and relate positions of Mexico in the efficiency indexes of the government and regulatory quality through the Worldwide Governance Indicators (WGI) platform. The theoretical framework is made up by the governance model proposed by two administration philosophies that have a noteworthy connection with public management and new public management. The results show that, for the administration periods of Ernesto Zedillo, Vicente Fox and Felipe Calderón, the records could be considered positive and associated to appropriate management practices. Similarly, the performance for the government led by Enrique Peña Nieto and the one led by Andrés Manuel López Obrador are not favorable; the explanative variables of this results are also presented. The research concludes by stating that the use of indicators and models, while certainly important, only represents strategic options as the construction of honest, professional public services is the true objective of the State. JEL: L38 Public Policies.

Abstract This systematic review aims to assess the extent to which biomedical engineering has been applied in the rehabilitation of patients suffering from Guillain-Barré Syndrome (GBS), given the scarcity of information on this topic. We conducted a thorough analysis of research articles, conference abstracts, and case reports published between 2000 and 2023, specifically from ScienceDirect, PubMed, IEEE Xplore, Springer, and Dimensions. 19 articles were extensively discussed, complemented by an additional 40 information sources providing supplementary information. Each paper underwent a meticulous review process by the four authors, where each separately examined the title and abstract of the papers and subsequently provided a thorough examination of the full text; when conflicts arose, a clear consensus was reached through discussion. The analysis of the articles revealed a notable improvement in upper and lower limb function of GBS patients that was facilitated by both custom-made and commercial devices. Likewise, a small handful of other devices have been used (e.g., to improve urinary retention issues). There is a clear opportunity for new research, innovation and applications.

Resumen Esta revisión sistemática tiene como objetivo evaluar hasta qué punto se ha aplicado la ingeniería biomédica en la rehabilitación de pacientes que padecen el Síndrome de Guillain-Barré (SGB), dada la escasez de información sobre este tema. Realizamos un análisis exhaustivo de artículos de investigación, resúmenes de conferencias e informes de casos publicados entre 2000 y 2023, específicamente de ScienceDirect, PubMed, IEEE Xplore, Springer y Dimensions. Se discutieron ampliamente 19 artículos, complementados con 40 fuentes de información adicionales. Cada artículo pasó por un meticuloso proceso de revisión por parte de los cuatro autores, donde cada uno examinó por separado el título y el resumen de los artículos y posteriormente proporcionó un examen exhaustivo del texto completo; cuando surgieron conflictos, se alcanzó un consenso mediante la discusión. El análisis de los artículos reveló una mejora notable en la función de las extremidades superiores e inferiores de los pacientes con SGB que fue facilitada por dispositivos tanto hechos a medida como comerciales. Asimismo, se han creado un pequeño puñado de otros dispositivos, (por ejemplo, para mejorar los problemas de retención urinaria). Existe una clara oportunidad para nueva investigación, innovación y aplicaciones.

ABSTRACT The aim of this study was to evaluate the effect of Insulin-Transferrin-Selenium (ITS) supplementation in embryo culture on the blastocyst rate and embryo quality. The bovine zygotes obtained by in vitro maturation (MIV) and fertilization (IVF) were transferred to Evolve medium in 4 groups (T1: Without ITS supplement; T2: ITS the first 48 h of culture (CIV1): T3: ITS after day 2 of culture (CIV2), T4: ITS during all culture time (CIV1+CIV2). All procedures were performed at 38.5 °C,5%CO2and90%relativehumidity. The cleavage and blastocyst rates were determined at 48 h and day 8 of culture. The total cell number and the production of reactive oxygen species (ROS) in the expanded blastocysts were determined by staining the nucleus with Hoechst and the oxidation of the fluorescent probe dichlorodihydrofluorescein diacetate (H2DCFDA). The T4 cultured embryos presented the highest rate of blastocysts (32.6%) and total cell number (145.6) compared to the control group without STI (26.2% and 98.6, respectively; p<0.05). Likewise, the production of ROS in T4 blastocysts was lower (p<0.05) than that obtained in the other study groups. The results show that the addition of the ITS supplement throughout the embryo culture time has beneficial effects on the percentage of blastocysts and embryo quality, assessed by the number of total cells and the production of ROS.

RESUMEN El estudio tuvo como objetivo evaluar el efecto del suplemento Insulina-Transferrina-Selenio (ITS) en el cultivo embrionario sobre la tasa de blastocistos y calidad embrionaria. Los cigotos de bovino obtenidos por maduración (MIV) y fertilización in vitro (FIV) fueron transferidos a medio Evolve en 4 grupos (T1: Sin suplemento ITS; T2: ITS las primeras 48 h de cultivo (CIV1): T3: ITS después del día 2 de cultivo (CIV2), T4: ITS todo el tiempo de cultivo (CIV1 + CIV2). Todos los procedimientos se realizaron a 38.5 °C, 5% de CO2 y 90% de humedad relativa. Las tasas de clivaje y de blastocistos se determinaron a las 48 h y día 8 de cultivo, respectivamente. El número de células totales y la producción de especies reactivas de oxígeno (EROs) en los blastocistos expandidos fueron determinados por tinción del núcleo con Hoechst y la oxidación de la sonda fluorescente diacetato diclorodihidrofluoresceína (H2DCFDA). Los embriones cultivados de T4 presentaron la mayor tasa de blastocistos (32.6%) y número de células totales (145.6) comparada al grupo control sin ITS (26.2% y 98.6, respectivamente; p<0.05). Asimismo, la producción de EROs en los blastocistos de T4 fue menor (p<0.05) que la obtenida en los demás grupos de estudio. Los resultados demuestran que la adición del suplemento ITS durante todo el tiempo de cultivo embrionario tiene efectos benéficos sobre el porcentaje de blastocistos y calidad embrionaria, valorada por el número de células totales y la producción de EROs.

ABSTRACT Introduction: Ectopic pregnancy is any gestation in which the implantation site of the fertilized egg is located outside the endometrial cavity. Abdominal ectopic pregnancy represents 1.4% of these. Case report: 28-year-old patient with two previous cesarean sections; bilateral tubal obstruction during the last operation. The patient was admitted to the hospital with blood pressure of 180/130 mm Hg that did not respond to medical treatment and not progression to labor so it was decided to interrupt the pregnancy by cesarean section. During surgery, a small uterus with extrauterine pregnancy was observed adhered to the serosa of the cecum, ascending colon, and appendix. A live preterm female product was obtained; the mother had a favorable evolution and no postoperative complications. Conclusion: Ectopic pregnancies are rera. An adequate prenatal control by well trained personnel is essential for an accurate diagnosis. The mother and the newborn did not present any complication. It is very important to have and accurate an opportune diagnosis so trained personnel can offer an adequate management.

RESUMEN Introducción: El embarazo ectópico es toda gestación, en la que el sitio de implantación del óvulo fecundado se localiza fuera de la cavidad endometria y representa el 1.4 % de estos. Caso clínico: Paciente de 28 años con dos cesáreas previas, sometida a salpingoclasia durante la última intervención. La paciente ingresó al hospital con presión arterial de 180/130 mm Hg, no respondió a tratamiento médico y presentó falla en la progresión de trabajo de parto, por lo que se decidió interrupción por operación cesárea. Durante la cirugía, se observó un pequeño útero con embarazo extrauterino adherido a la serosa del ciego, el colon ascendente y el apéndice. Se obtuvo un producto femenino pretérmino vivo; la madre cursó con evolución favorable y sin complicaciones posoperatorias. Conclusión: La presentación del embarazo abdominal ectópico es rara, por lo que un control prenatal adecuado por personal capacitado puede orientar a la sospecha diagnóstica. La madre y la recién nacida no presentaron ninguna complicación, a pesar de ser un embarazo abdominal avanzado y la inserción multifocal de la placenta. Se resalta la importancia del manejo oportuno y multidisciplinario cuando se enfrentan embarazos con curso anormal para la mejor evolución de la madre y del producto.

ABSTRACT This study evaluated the quality of AISI 347L stainless steel coating on Cr-Mo steel substrate produced by GMAW process, considering the influence of welding parameters and stress-relieving heat treatments. The Coordinated Point Displacement (CPD) method was used for residual stress analysis. Three (3) specimens with dimensions of 300 × 150 × 12.7 mm were fabricated with variations in shielding gas composition (100% Ar, 98% Ar + 2% CO2, and 96% Ar + 4% CO2), and post-weld heat treatments were performed following ASME BPVC VIII standard. Optical microscopy, macrographic examination, and hardness testing were performed to evaluate the microstructure of the coating. The results indicate that the stress-relieving heat treatments effectively reduce residual stresses and improve coating quality. Optical microscopy analysis revealed a homogeneous microstructure without cracks or porosity, indicating satisfactory performance of the GMAW process. These test results are important for qualifying the welding process and ensuring the quality of the coating in practical applications. L CrMo Cr Mo stressrelieving relieving CPD (CPD 3 (3 30 15 127 12 7 12. 100% 100 (100 98 2 CO2 CO 96 4 , CO2) postweld post weld standard examination porosity applications ( 1 10 (10 9 (1

RESUMO Este estudo avaliou a qualidade do revestimento de aço inoxidável AISI 347L em substrato de aço Cr-Mo produzido pelo processo GMAW, levando em consideração a influência dos parâmetros de soldagem e dos tratamentos térmicos de alívio de tensão. Para a análise de tensão residual, foi utilizado o método de Deslocamento de Pontos Coordenados (DCP). Foram confeccionados três (3) corpos de prova com dimensões de 300 × 150 × 12,7 mm, variando a composição do gás de proteção (100% Ar, 98% Ar + 2%CO2 e 96% Ar + 4% CO2), e realizados tratamentos térmicos pós-soldagem em conformidade com a norma ASME BPVC VIII. Para avaliar a microestrutura do revestimento, foram realizadas análises de microscopia óptica, ensaio macrográfico e ensaio de dureza. Os resultados obtidos indicam que os tratamentos térmicos de alívio de tensão foram eficazes na redução da tensão residual, melhorando a qualidade do revestimento. A análise de microscopia óptica revelou uma microestrutura homogênea e sem trincas ou porosidades, indicando um bom desempenho do processo GMAW. Os resultados desses ensaios são de grande importância para a qualificação do procedimento de soldagem e para garantir a qualidade do revestimento em aplicações práticas. L CrMo Cr Mo GMAW residual DCP. DCP . (DCP) 3 (3 30 15 127 12 7 12, mm 100% 100 (100 98 2CO2 CO 2 CO2 2%CO 96 4 CO2, , CO2) póssoldagem pós VIII dureza porosidades práticas (DCP ( 1 10 (10 9 2CO (1

Coulometry is a well-established technique for certified reference materials (CRM). However, commercial coulometers are currently expensive and utilize outdated software. The National Metrology Institute of Colombia (INMC) has developed a cheaper and modular coulometer with powerful software capable of controlling the instrument, and acquiring pH, the potential difference between generator electrodes, and the electrical current at any stage of the coulometric titration. The results obtained from this new coulometer align well with the novel method for calculating the amount of substance content of potassium hydrogen phthalate (KHP). This method involves the experimental data fitting with the theoretical titration curve TC(NLR), also developed by the INMC. TC(NLR) replaces the traditional empirical W-function (eWf), which has no chemical basis and does not account for CO2 as an impurity. The KHP content of the CRM KHP 84L from NIST was measured using the developed coulometer, resulting in 4.9069 ± 0.0090 mol kg-1 with a bias of 0.21% for the eWf, and a more accurate result of 4.8983 ± 0.0047 mol kg-1 with a bias of 0.041% for the TC(NLR). The challenges during the development of the coulometer, particularly in terms of instrumentation, as well as their impact on uncertainty, are also discussed. wellestablished established CRM. . (CRM) However INMC (INMC instrument pH electrodes KHP. (KHP) TCNLR, TCNLR TC NLR , TC(NLR Wfunction W function eWf (eWf) CO impurity L 49069 4 9069 4.906 00090 0 0090 0.009 kg1 kg 1 kg- 021 21 0.21 48983 8983 4.898 00047 0047 0.004 0041 041 0.041 TCNLR. instrumentation uncertainty discussed (CRM (KHP (eWf 4906 906 4.90 0009 009 0.00 02 2 0.2 4898 898 4.89 0004 004 04 0.04 490 90 4.9 000 00 0.0 0. 489 89 4.8 49 9 4. 48 8

ABSTRACT Few Brazilian rural landowners are aware of the technology available to survey the subsoil of terrains earmarked for aquaculture operations. This study evaluated subsoils of Monte Alegre (area 1) and Montenegro 3 (area 2) aquaculture zones in the geographic region of Bragança (Amazon region, northern Brazil), and the adequacy of these areas for aquaculture. Ground Penetrating Radar, electrical conductivity measurements, and sedimentological analyses were applied to evaluate the subsoil of fish farms. Apparent conductivity values recorded by the Electromagnetic Induction (EMI) in area 1 indicated possible presence of clayey soils. Excavation analysis and sedimentological samples (sand) from this site confirmed the inadequacy of the terrain. The EMI tool in area 2 indicated possible presence of clayey soils. Geophysical and sedimentological results from the site confirmed its suitability. These geophysical tools are recommended for evaluating prospective aquaculture sites, given their capacity to provide reliable data on the subsoil characteristics , which is essential to guarantee the success and sustainability of aquaculture operations. operations Amazon Brazil, Brazil Brazil) Radar measurements farms (EMI soils sand (sand terrain suitability sites

Resumen: La ciprofloxacina es un antibiótico de importancia crítica para la salud humana. El aumento de la resistencia de Escherichia coli a ciprofloxacina es un problema de salud pública global por su importancia en el tratamiento de infecciones urinarias complicadas y otras infecciones graves; sin embargo, su prescripción es alta en el caribe colombiano. El objetivo fue determinar la tendencia de resistencia de E. coli a ciprofloxacina en un hospital colombiano de alta complejidad. A partir de reportes de antibiogramas, los aislados fueron categorizados según los criterios del Instituto de Normas Clínicas y de Laboratorio de los Estados Unidos para cada año estudiado; se calcularon proporciones y se exploraron diferencias en la sensibilidad con pruebas χ2. Se utilizó la prueba de Cochran-Armitage para evaluar la tendencia de la resistencia. Valores de p ≤ 0,05 se consideraron significativos. Se analizaron 6.848 aislados, encontrándose una resistencia de 49,31%. Según el origen, la resistencia más alta fue en muestras comunitarias (51,96% - IC95%: 50,51; 53,41), y por tipo de muestra, en piel y tejidos (61,76% - IC95%: 56,96; 66,35) y orina (48,97% - IC95%: 47,71; 50,23). Se halló una tendencia al aumento en la resistencia por año (p < 0,0001), en muestras comunitarias (p = 0,0002) y en orina (p < 0,0001). La resistencia a ciprofloxacina es alta y tiende al aumento en comunidad y en orina, superando el límite establecido para su uso a nivel ambulatorio, lo que es preocupante por la alta prescripción de fluoroquinolonas en la localidad. Resumen humana graves embargo E complejidad antibiogramas estudiado χ2 χ CochranArmitage Cochran Armitage 005 0 05 0,0 significativos 6848 6 848 6.84 4931 49 31 49,31% origen 51,96% 5196 51 96 (51,96 IC95% IC95 IC 50,51 5051 50 53,41, 5341 53,41 , 53 41 53,41) muestra 61,76% 6176 61 76 (61,76 56,96 5696 56 66,35 6635 66 35 48,97% 4897 48 97 (48,97 47,71 4771 47 71 50,23. 5023 50,23 . 23 50,23) 0,0001, 00001 0,0001 0001 0,0001) 0,0002 00002 0002 0,0001. ambulatorio localidad 00 0, 684 84 6.8 493 4 3 49,31 51,96 519 5 9 (51,9 IC9 50,5 505 534 53,4 61,76 617 7 (61,7 56,9 569 66,3 663 48,97 489 (48,9 47,7 477 502 50,2 2 0000 0,000 000 68 8 6. 49,3 51,9 (51, 50, 53, 61,7 (61, 56, 66, 48,9 (48, 47, 0,00 49, 51, (51 61, (61 48, (48 (5 (6 (4 (

Resumo: A ciprofloxacina é um antibiótico extremamente importante para a saúde humana. O aumento da resistência da Escherichia coli à ciprofloxacina é um problema de saúde pública global devido à sua importância no tratamento de infecções complicadas do trato urinário e outras infecções graves; no entanto, sua prescrição é alta no caribe colombiano. O objetivo foi determinar a tendência de resistência da E. coli à ciprofloxacina em um hospital colombiano de alta complexidade. A partir de relatórios de antibiogramas, os isolados foram categorizados de acordo com os critérios do Instituto de Padrões Clínicos e Laboratoriais dos Estados Unidos para cada ano estudado; as proporções foram calculadas e as diferenças de sensibilidade foram exploradas com os testes χ2. O teste de Cochran-Armitage foi usado para avaliar a tendência de resistência. Os valores de p ≤ 0,05 foram considerados significativos. Um total de 6.848 isolados foi testado e foi encontrada uma taxa de resistência de 49,31%. Por origem, a resistência foi mais alta em amostras comunitárias (51,96% - IC95%: 50,51; 53,41) e, por tipo de amostra, em pele e tecidos (61,76% - IC95%: 56,96; 66,35) e urina (48,97% - IC95%: 47,71; 50,23). Foi encontrada uma tendência de aumento na resistência por ano (p < 0,0001), em amostras da comunidade (p = 0,0002) e na urina (p < 0,0001). A resistência à ciprofloxacina é alta e tende a aumentar na comunidade e na urina, excedendo o limite estabelecido para uso ambulatorial, o que é preocupante, dada a alta prescrição de fluoroquinolonas na localidade. Resumo humana graves entanto E complexidade antibiogramas estudado χ2 χ CochranArmitage Cochran Armitage 005 0 05 0,0 significativos 6848 6 848 6.84 4931 49 31 49,31% origem 51,96% 5196 51 96 (51,96 IC95% IC95 IC 50,51 5051 50 53,41 5341 53 41 amostra 61,76% 6176 61 76 (61,76 56,96 5696 56 66,35 6635 66 35 48,97% 4897 48 97 (48,97 47,71 4771 47 71 50,23. 5023 50,23 . 23 50,23) 0,0001, 00001 0,0001 , 0001 0,0001) 0,0002 00002 0002 0,0001. ambulatorial preocupante localidade 00 0, 684 84 6.8 493 4 3 49,31 51,96 519 5 9 (51,9 IC9 50,5 505 53,4 534 61,76 617 7 (61,7 56,9 569 66,3 663 48,97 489 (48,9 47,7 477 502 50,2 2 0000 0,000 000 68 8 6. 49,3 51,9 (51, 50, 53, 61,7 (61, 56, 66, 48,9 (48, 47, 0,00 49, 51, (51 61, (61 48, (48 (5 (6 (4 (

Abstract: Ciprofloxacin is a critically important antibiotic for human health. The increase of Escherichia coli resistance to ciprofloxacin is a global public health problem due to its importance in the treatment of complicated urinary tract infections and other serious infections; however, its prescription is high in the Colombian Caribbean. The objective was to determine the resistance trend of E. coli to ciprofloxacin in a Colombian hospital of high complexity. From antibiogram reports, isolates were categorized according to Clinical and Laboratory Standards Institute criteria for each year studied; proportions were calculated and differences in sensitivity were explored using the χ2 test. The Cochran-Armitage test was used to evaluate the resistance trend. Significance was considered when p-value ≤ 0.05. In total, 6,848 isolates were analyzed, and 49.31% resistance was found. According to origin, the highest resistance was in community samples (51.96% - 95%CI: 50.51; 53.41), and by type of sample, in skin and tissues (61.76% - 95%CI: 56.96; 66.35) and urine (48.97% - 95%CI: 47.71; 50.23). Increasing trends were observed for resistance per year (p < 0.0001), community samples (p = 0.0002) and urine (p < 0.0001). Resistance to ciprofloxacin is high and tends to increase in the community and in urine, exceeding the limit established for its use at the ambulatory level, which is of concern due to the high prescription of fluoroquinolones in the locality. Abstract however Caribbean E complexity reports studied χ CochranArmitage Cochran Armitage pvalue p value 005 0 05 0.05 total 6848 6 848 6,84 analyzed 4931 49 31 49.31 found origin 51.96% 5196 51 96 (51.96 95%CI 95CI CI 95 50.51 5051 50 53.41, 5341 53.41 , 53 41 53.41) sample 61.76% 6176 61 76 (61.76 56.96 5696 56 66.35 6635 66 35 48.97% 4897 48 97 (48.97 47.71 4771 47 71 50.23. 5023 50.23 . 23 50.23) 0.0001, 00001 0.0001 0001 0.0001) 0.0002 00002 0002 0.0001. level locality 00 0.0 684 84 6,8 493 4 3 49.3 51.96 519 5 9 (51.9 50.5 505 534 53.4 61.76 617 7 (61.7 56.9 569 66.3 663 48.97 489 (48.9 47.7 477 502 50.2 2 0000 0.000 000 0. 68 8 6, 49. 51.9 (51. 50. 53. 61.7 (61. 56. 66. 48.9 (48. 47. 0.00 51. (51 61. (61 48. (48 (5 (6 (4 (

Resumen: La ciprofloxacina es un antibiótico de importancia crítica para la salud humana. El aumento de la resistencia de Escherichia coli a ciprofloxacina es un problema de salud pública global por su importancia en el tratamiento de infecciones urinarias complicadas y otras infecciones graves; sin embargo, su prescripción es alta en el caribe colombiano. El objetivo fue determinar la tendencia de resistencia de E. coli a ciprofloxacina en un hospital colombiano de alta complejidad. A partir de reportes de antibiogramas, los aislados fueron categorizados según los criterios del Instituto de Normas Clínicas y de Laboratorio de los Estados Unidos para cada año estudiado; se calcularon proporciones y se exploraron diferencias en la sensibilidad con pruebas χ2. Se utilizó la prueba de Cochran-Armitage para evaluar la tendencia de la resistencia. Valores de p ≤ 0,05 se consideraron significativos. Se analizaron 6.848 aislados, encontrándose una resistencia de 49,31%. Según el origen, la resistencia más alta fue en muestras comunitarias (51,96% - IC95%: 50,51; 53,41), y por tipo de muestra, en piel y tejidos (61,76% - IC95%: 56,96; 66,35) y orina (48,97% - IC95%: 47,71; 50,23). Se halló una tendencia al aumento en la resistencia por año (p < 0,0001), en muestras comunitarias (p = 0,0002) y en orina (p < 0,0001). La resistencia a ciprofloxacina es alta y tiende al aumento en comunidad y en orina, superando el límite establecido para su uso a nivel ambulatorio, lo que es preocupante por la alta prescripción de fluoroquinolonas en la localidad.

Resumo: A ciprofloxacina é um antibiótico extremamente importante para a saúde humana. O aumento da resistência da Escherichia coli à ciprofloxacina é um problema de saúde pública global devido à sua importância no tratamento de infecções complicadas do trato urinário e outras infecções graves; no entanto, sua prescrição é alta no caribe colombiano. O objetivo foi determinar a tendência de resistência da E. coli à ciprofloxacina em um hospital colombiano de alta complexidade. A partir de relatórios de antibiogramas, os isolados foram categorizados de acordo com os critérios do Instituto de Padrões Clínicos e Laboratoriais dos Estados Unidos para cada ano estudado; as proporções foram calculadas e as diferenças de sensibilidade foram exploradas com os testes χ2. O teste de Cochran-Armitage foi usado para avaliar a tendência de resistência. Os valores de p ≤ 0,05 foram considerados significativos. Um total de 6.848 isolados foi testado e foi encontrada uma taxa de resistência de 49,31%. Por origem, a resistência foi mais alta em amostras comunitárias (51,96% - IC95%: 50,51; 53,41) e, por tipo de amostra, em pele e tecidos (61,76% - IC95%: 56,96; 66,35) e urina (48,97% - IC95%: 47,71; 50,23). Foi encontrada uma tendência de aumento na resistência por ano (p < 0,0001), em amostras da comunidade (p = 0,0002) e na urina (p < 0,0001). A resistência à ciprofloxacina é alta e tende a aumentar na comunidade e na urina, excedendo o limite estabelecido para uso ambulatorial, o que é preocupante, dada a alta prescrição de fluoroquinolonas na localidade.

Abstract: Ciprofloxacin is a critically important antibiotic for human health. The increase of Escherichia coli resistance to ciprofloxacin is a global public health problem due to its importance in the treatment of complicated urinary tract infections and other serious infections; however, its prescription is high in the Colombian Caribbean. The objective was to determine the resistance trend of E. coli to ciprofloxacin in a Colombian hospital of high complexity. From antibiogram reports, isolates were categorized according to Clinical and Laboratory Standards Institute criteria for each year studied; proportions were calculated and differences in sensitivity were explored using the χ2 test. The Cochran-Armitage test was used to evaluate the resistance trend. Significance was considered when p-value ≤ 0.05. In total, 6,848 isolates were analyzed, and 49.31% resistance was found. According to origin, the highest resistance was in community samples (51.96% - 95%CI: 50.51; 53.41), and by type of sample, in skin and tissues (61.76% - 95%CI: 56.96; 66.35) and urine (48.97% - 95%CI: 47.71; 50.23). Increasing trends were observed for resistance per year (p < 0.0001), community samples (p = 0.0002) and urine (p < 0.0001). Resistance to ciprofloxacin is high and tends to increase in the community and in urine, exceeding the limit established for its use at the ambulatory level, which is of concern due to the high prescription of fluoroquinolones in the locality.

Resumen: En este trabajo se estudió la enfermedad articular degenerativa (EAD) y los cambios entesiales (CE) en cuatro colecciones osteoarqueológicas provenientes de los Andes colombianos (2350-450 AP) y de la costa peruana (1350-950 AP) para lograr una aproximación a los niveles de actividad y a la posible división sexual del trabajo. Un total de 334 individuos mayores de 15 años fueron observados sistemáticamente y las frecuencias de EAD y de CE analizadas y comparadas empleando Chi Cuadrado y la prueba de Fisher. Al evaluar las frecuencias por sexo, se obtuvieron perfiles heterogéneos, lo cual sugiere la ejecución de algunas actividades diferentes por parte de individuos masculinos y femeninos. También se hallaron diferencias según los medioambientes en los que habitaron estas comunidades. La evidencia osteológica, sumada a la información arqueológica y etnohistórica permite proponer que, a pesar de que había una cierta división sexual del trabajo, los individuos femeninos parecen haber participado en actividades físicamente demandantes que tradicionalmente han sido vinculadas con el sexo masculino.

Abstract: In this paper, we investigate degenerative joint disease (DJD) and entheseal changes (EC) in four osteoarchaeological series from the Colombian Andes (2350-450 BP) and the Peruvian coast (1350-950 BP) to evaluate activity levels and the possible sexual division of labor. A total of 334 individuals, all over 15 years old, were systematically observed, and the frequencies of DJD and EC were analyzed and compared using Chi Square and Fisher’s exact test. When assessing the frequencies considering sex, the profiles obtained were diverse, suggesting that some physical activities were different between males and females. Results obtained also showed environmental influence. The osteological, archaeological, and ethnohistorical evidence suggest that the sexual division of labor in these groups included the participation of females in physically demanding activities traditionally associated with males.

ABSTRACT Universities are currently evolving their academic content from the most basic stages with giant steps, and as a result, a series of international trends are being proposed in orthodontic graduate schools on the acceleration of dental movement by means of laser transmission, since reducing orthodontic treatment time has been a challenge for the specialist, given that prolonged treatments increase the risk of root resorption, gingivitis and caries, as well as patient abandonment. The objective of the present study is to analyze the capacity of laser energy transmission through the bone and gingiva to accelerate orthodontic movement, for which the PRISMA methodology was used to identify valid information for this study from May 2017 to May 2022 with no language limit. It was possible to conclude that the transmission of laser energy through the bone and gingiva accelerates dental movement in orthodontics, contributing with therapeutic alternatives to specialists and researchers in modern dentistry, as well as new future research topics with clinical/academic benefit for universities around the world.

RESUMEN Las universidades en la actualidad se encuentran evolucionando sus contenidos académicos desde las etapas más básicas con pasos agigantados, resultado de esto es que en las escuelas de posgrado de ortodoncia se proponen una serie de tendencias internacionales acerca de la aceleración del movimiento dental mediante transmisión láser, debido a que, reducir el tiempo del tratamiento de ortodoncia ha sido un reto para el especialista, dado que los tratamientos prolongados aumentan el riesgo de reabsorción radicular, gingivitis y caries, así como también el abandono por parte de los pacientes. El objetivo del presente estudio consiste en analizar la capacidad de la transmisión de energía láser a través del hueso y la encía para acelerar el movimiento ortodóntico, para lo cual, se empleó la metodología PRISMA para la identificación de la información válida para este estudio desde mayo del año 2017 hasta mayo del año 2022 sin límite de idioma. Fue posible concluir que la transmisión de energía láser a través del hueso y encía acelera el movimiento dental en ortodoncia, contribuyendo con alternativas terapéuticas a los especialistas e investigadores en la odontología moderna, así como nuevas temáticas de investigación futuras con beneficio clínico/académico de las universidades alrededor del mundo.

Resumen Introducción: El reemplazo de la válvula aórtica es el tratamiento de elección para la valvulopatía aórtica severa sintomática. Recientemente, la cirugía de reconstrucción valvular aórtica (procedimiento de Ozaki) emerge como una alternativa quirúrgica con buenos resultados a mediano plazo. Métodos: Analizamos retrospectivamente 37 pacientes intervenidos de reconstrucción de válvula aórtica entre enero de 2018 y junio de 2020 en un centro de referencia nacional en Lima, Perú. La mediana de edad fue de 62 años (rango intercuartílico: 42-68). La estenosis de la válvula fue la principal indicación de cirugía (62.2%), en la mayoría de los casos por válvula bicúspide (19 pacientes, 51.4%). 22 (59.4%) pacientes presentaban otra patología con indicación de cirugía, 8 (21.6%) presentaban dilatación de la aorta ascendente con indicación de reemplazo. Resultados: La mortalidad intrahospitalaria fue de 1/38, 2.7%, por infarto de miocardio perioperatorio. Hubo una reducción significativa en las medianas del gradiente máximo (70 mmHg, IC 95% = 50.03-79.86 vs. 14 mmHg, IC 95% = 11.93-17.5, p < 0.0001) y gradiente medio (45.5 mmHg IC 95% = 30.6-49.68 vs. 7 mmHg, IC 95% = 5.93-9.6, p < 0.0001) de la válvula aórtica cuando comparamos las características basales con los resultados de los primeros 30 días. En una media de 19 (± 8.9) meses de seguimiento la sobrevida fue del 97.3%; la sobrevida libre de reoperación por disfunción valvular, 100% y la sobrevida libre de insuficiencia aórtica ≥ II, 91.9%, respectivamente. Se mantuvo una reducción significativa en las medianas de los gradientes máximo y medio de la válvula aórtica. Conclusiones: La cirugía de reconstrucción de válvula aórtica con pericardio autólogo mostró resultados óptimos en términos de mortalidad, supervivencia libre de reoperación y características hemodinámicas de la neo-válvula.

Abstract Background: Aortic valve (AV) replacement is the gold standard treatment for severe symptomatic AV disease. Recently, AV reconstruction surgery (Ozaki procedure) emerges as a surgical alternative with good results in the medium term. Methods: We retrospectively analyzed 37 patients who underwent AV reconstruction surgery between January 2018 and June 2020 in a national reference center in Lima, Peru. The median age was 62 years, interquartile range (IQR: 42-68). The main indication for surgery was AV stenosis (62.2%), in most cases due to bicuspid valve (19 patients, 51.4%). Twenty-two (59.4%) patients had another pathology with surgical indication associated to AV disease, 8 (21.6%) had dilatation of the ascending aorta with indication for replacement. Results: One in-hospital death occurred (1/38, 2.7%) due to perioperative myocardial infarction. There was a significant reduction in the medians of the peak (70 mmHg, CI 95% = 50.03-79.86 vs. 14 mmHg, CI 95% = 11.93-17.5, p < 0.0001) and mean (45.5 mmHg CI 95% = 30.6-49.68 vs. 7 mmHg, CI 95% = 5.93-9.6, p < 0.0001) AV gradients when we compared baseline characteristics with first 30-days results. In an average of 19 (± 8.9) months of follow-up, survival, reoperation-free survival for valve dysfunction, and survival free of AV insufficiency ≥ II were 97.3%, 100% and 91.9%, respectively. Significant reduction in the medians of the peak and mean AV gradients was maintained. Conclusions: AV reconstruction surgery showed optimal results in term of mortality, reoperation-free survival, and hemodynamic characteristics of the neo-AV.

Resumen La disección aórtica representa una afección relativamente poco común pero potencialmente mortal que se debe a un desgarro en la capa íntima de la arteria aorta o sangrado dentro de su pared, lo que da como resultado una separación de las capas de esta. Se han identificado varios factores de riesgo y comparten los mismos que para otras enfermedades cardiovasculares, como la edad, la hipertensión arterial, la dislipidemia y los trastornos genéticos del tejido conectivo. Es muy importante que el clínico pueda realizar un diagnóstico oportuno y un tratamiento adecuado en los pacientes afectados. El tipo de tratamiento depende de la extensión y de la localización de la disección. La reparación quirúrgica abierta suele ser la más usada para aquellas en las que están involucradas la aorta ascendente y el arco aórtico; por otro lado, la intervención endovascular está recomendada para las disecciones de la aorta descendente, que suelen ser complicadas. En este trabajo se revisará la epidemiología, la fisiopatología, las manifestaciones clínicas y finalmente el manejo de la disección aórtica.

Abstract Aortic dissection represents a relatively rare but highly fatal condition that is due to a tear in the intimal layer of the aortic artery or bleeding within its wall, resulting in a separation of its layers. Several risk factors have been identified and share the same as for other cardiovascular diseases such as age, high blood pressure, dyslipidemia and genetic disorders of connective tissue. It is very important that the clinician can make a timely diagnosis and appropriate treatment in patients affected by it; the type of treatment depends on the extent and location of the dissection. Open surgical repair is usually the most used for those that involve the ascending aorta and the aortic arch, on the other hand, endovascular intervention is recommended for dissections of the descending aorta that are usually complicated. In this work, the epidemiology, pathophysiology, clinical manifestations and finally the management of aortic dissection will be reviewed.