Abstract Lung cancer is the leading cause of death due to cancer worldwide; representing 18.4% of cancer mortality. Taking into account the impact of this pathology and the increase in the tendency of using immune checkpoint inhibitors PD-1/PD-L1 for the treatment of non-small cell lung cancer (NSCLC), a brief review was conducted of the evidence that evaluates the efficacy and safety of these drugs. Finding that there is a benefit in using immune checkpoint inhibitors PD-1/PD-L1 for the treatment of patients with metastatic NSCLC evaluated by overall survival, progression-free survival and adverse effects when used as monotherapy compared to chemotherapy. Although in combination therapy the adverse effects are increased when compared to chemotherapy without immunotherapy. In addition, some predictive factors of hyperprogressive disease have been found, which can be used to identify patients who will not benefit from immune therapy, although there is room for further investigation.

Resumen El cáncer de pulmón es la principal causa de muerte debida a cáncer a nivel mundial; representando el 18.4% de la mortalidad por cáncer. Teniendo en cuenta el impacto de esta patología y el aumento en la tendencia de utilización de los inhibidores de punto de control inmunitario PD-1/PD-L1 (programmed death-ligand 1, molécula de muerte programada 1, y su ligando PD-L1) para el tratamiento del cáncer de pulmón de célula no pequeña (CPCNP) se realizó una revisión breve de la evidencia que evalúa la eficacia y seguridad de estos medicamentos. Se encontró que existe un beneficio al utilizar los inhibidores del punto de control inmunitario PD-1/PD-L1 para el tratamiento de pacientes con CPCNP metastásico evaluado por la supervivencia global, supervivencia libre de progresión y los eventos adversos al utilizarse como monoterapia comparada con quimioterapia; aunque en terapia combinada los eventos adversos aumentan al compararlo con quimioterapia sin inmunoterapia. Además, se han encontrado algunos factores predictores de enfermedad hiperprogresiva que sirven para identificar los pacientes que no se beneficiarán de la terapia inmunitaria, aunque aún hay espacio para investigar al respecto.

ASBTRACT Objectives Adherence to continuous positive airway pressure (CPAP) devices in patients with obstructive sleep apnea (OSA) determines the effectiveness of the treat-ment. Likewise, the assessment of the control of the disease must consider the information referred by the patient, among other value-based health measures related to the satisfaction of the intervention. The objectives of this study were a) Determine the factors related to adherence to CPAP devices in subjects with OSA affiliated to an insurance company of the healthcare system in Colombia. b) Assess symptom control associated to the disease from the individual's perspective and his/her satisfaction with the treatment received. Materials and Methods 1,501 subjects with OSA were surveyed by telephone to explore: sociodemographic factors, habits and lifestyles, use of CPAP and its adverse events, control of the disease, comorbidities, access to care and therapy satisfaction. Using multilevel logistic regression techniques, the influence of the various factors on adherence to CPAP was analyzed, using Stata 13 software. Results Adherence to CPAP therapy was of 58% and the control of symptoms was of 41.7%. The factors that determined the use of CPAP were knowledge on how the device operates, and the disturbances during sleep due to the mask or nasal pad. The-rapy satisfaction was predominantly very good or good. Conclusion Even with moderate adherence values and a good experience with CPAP therapy, symptomatic control of the disease is poor. Many of the factors that affect the use of CPAP are modifiable with a proper approach by the devices' service provider.

RESUMEN Objetivos La adherencia a los dispositivos de presión positiva continua de la vía aérea (CPAP) en pacientes con síndrome de apnea obstructiva del sueño (SAOS) define la efectividad del tratamiento. Los objetivos de este estudio fueron: a) Determinar los factores relacionados con la adherencia al CPAP en pacientes con SAOS de una aseguradora del Sistema General de Seguridad Social en Salud colombiano y b) evaluar el control de los síntomas de la enfermedad desde la perspectiva del individuo y su satisfacción con la terapia. Materiales y Métodos Mediante encuesta telefónica a 1 501 pacientes con SAOS se exploraron factores sociodemográficos, hábitos y estilos de vida, uso del CPAP y eventos adversos relacionados, control de la enfermedad, comorbilidad, acceso a la atención y satisfacción con la terapia. Utilizando técnicas de regresión logística mul-tinivel, se analizó la influencia de los distintos factores sobre la adherencia al CPAP mediante el software Stata 13. Resultados La adherencia al CPAP fue del 58% y el control de los síntomas del 41,7%. Los factores que determinaron el uso del CPAP fueron el conocimiento del funcionamiento del equipo y la dificultad para dormir debida a la mascarilla o la almohadilla nasal. La satisfacción con la terapia fue buena o muy buena predominantemente. Conclusiones Aún con valores de adherencia moderados y una buena experiencia con la terapia CPAP, el control sintomático de la enfermedad es pobre, pues varios de los factores afectan el uso del CPAP. Dichos factores se pueden intervenir con un adecuado abordaje por parte del prestador de servicios del dispositivo.

ABSTRACT OBJECTIVE To analyze the emergency hospitalizations trend for ambulatory care sensitive conditions between 2011 and 2015 in a health insureance company of the Colombian Social Security General System. METHODS A log-linear analysis based on age-adjusted hospitalization rates for ambulatory care sensitive conditions in the Entidad Promotora de Salud Sanitas was used to estimate the annual percentage change in these rates and to identify joinponts of the rates. Data was collected from administrative sources. RESULTS There were 38,530 hospitalizations for ambulatory care sensitive conditions in 26,501 Entidad Promotora de Salud Sanitas enrollees, with a significant decrease in hospitalization rates. The annual percentage change estimated for the period was -9.5% with no significant joinpoints throughout the time interval. CONCLUSIONS A significant reduction in hospital admissions due to ambulatory care sensitive conditions in Entidad Promotora de Salud Sanitas enrollees were reported for the last five years in this study.

ABSTRACT OBJECTIVE To analyze the emergency hospitalizations trend for ambulatory care sensitive conditions between 2011 and 2015 in a health insureance company of the Colombian Social Security General System. METHODS A log-linear analysis based on age-adjusted hospitalization rates for ambulatory care sensitive conditions in the Entidad Promotora de Salud Sanitas was used to estimate the annual percentage change in these rates and to identify joinponts of the rates. Data was collected from administrative sources. RESULTS There were 38,530 hospitalizations for ambulatory care sensitive conditions in 26,501 Entidad Promotora de Salud Sanitas enrollees, with a significant decrease in hospitalization rates. The annual percentage change estimated for the period was -9.5% with no significant joinpoints throughout the time interval. CONCLUSIONS A significant reduction in hospital admissions due to ambulatory care sensitive conditions in Entidad Promotora de Salud Sanitas enrollees were reported for the last five years in this study.

Abstract The daily precipitation concentration index (CI) was evaluated as an indicator to characterize the sub-basins in the hydrological basin, which represent different degrees of pluviometric torrentiality. The CI was estimated using the Lorenz curve to evaluate the relative weight of the rainiest days in the series of daily precipitation data, which was recorded in 34 conventional meteorological stations (CWS) in and near the Río Grande de Morelia basin, from its source upstream of the Cointzio Dam, to its mouth in Lake Cuitzeo. The Río Grande passes through the city of Morelia, which has been affected by floods in a cyclical manner, resulting in serious damage: human losses, damage to infrastructure and deterioration in agricultural, livestock and forestry production. A platform was developed in a GIS for the delimitation and characterization of the basin and its 23 sub-basins. The CI for each CWS was calculated, with which isopleths were generated with intervals of 0.01, as well as a raster layer of the CI. The CI average was calculated for the 23 sub-basins and for the basin. Based on the results, a CI torrentiality scale is proposed, such as: Low torrential (0.476-0.515), medium torrential (0.515-0.538), torrential (0.538-0.560) and high torrential (0.560-0.607). Weighted average for the basin resulted in a CI = 0.55, which corresponds to a torrential basin, and the CI was related to the climate of the basin.

Resumen Se realizó una evaluación del índice de concentración de precipitación diaria (CI), como un indicador para caracterizar las subcuencas de la cuenca hidrológica, que representan diferentes grados de torrencialidad pluviométrica. El CI se estimó por medio de la curva de Lorenz, para evaluar el peso relativo de los días más lluviosos en series de datos de precipitación diaria, que se registró en 34 estaciones meteorológicas convencionales (EMC), dentro y próximas a la cuenca del Río Grande de Morelia desde su origen, aguas arriba de la presa Cointzio, hasta su desembocadura en el lago de Cuitzeo. El Río Grande pasa por la ciudad de Morelia, la cual se ha visto afectada por inundaciones de forma cíclica, que han dejado como consecuencias graves daños: pérdidas humanas y afectaciones a la infraestructura, así como deterioro en la producción agrícola, pecuaria y forestal. Se elaboró una plataforma en un sistema de información geográfica (SIG), para la delimitación y caracterización de la cuenca, y sus 23 subcuencas. Se calculó el CI para cada EMC, con el que se generaron isopletas con intervalos de 0.01 y una capa ráster del CI; se calculó el promedio del CI para las 23 subcuencas y para la cuenca. Con base en los resultados se propone una escala de torrencialidad del CI, esto es: bajo torrencial (0.476-0.515); medio torrencial (0.515-0.538); torrencial (0.538-0.560), y altamente torrencial (0.560-0.607). El promedio ponderado para la cuenca resultó un CI = 0.55, que corresponde a una cuenca torrencial; el CI se relacionó con el clima de la cuenca.