Resumen: La Hipertensión Arterial (HTA) es un factor de riesgo relevante de enfermedad cardiovascular. La prevalencia en pediatría ha ido en aumento, asociado al incremento de sobrepeso y obesidad infantil, entre otros factores. Un diagnóstico adecuado e intervención precoz son determinantes en la prevención de daño de órgano blanco. La Academia Americana de Pediatría recomienda realizar Monitorización Ambulatoria de Presión Arterial (MAPA) en pacientes pediátricos con sospecha o factores de riesgo de HTA para confirmar el diagnóstico y dirigir el tratamiento. Las nuevas recomendaciones recientemente publicadas simplifican la interpretación; se elimina la sobrecarga como determinante para la clasificación, quedando sólo 4 categorías diagnósticas de presión arterial: Normo-tensión, Hipertensión de Delantal Blanco, Hipertensión Enmascarada e Hipertensión Ambulatoria. Asimismo, cambian los valores de corte en adolescentes ≥ 13 años, usándose los valores de referencia de MAPA para adultos recomendados por la American Heart Association en 2017. Ambos cambios aumentan la sensibilidad de este examen para la detección de repercusión sistémica. En este artículo se actualiza el estudio y diagnóstico de la HTA basado en las guías de Monitorización Ambulatoria de Presión Arterial chilenas para pacientes pediátricos, con el objetivo de unificar criterios diagnósticos, mejorar su difusión y ampliar su cobertura nacional. Además, se aporta una actualización en relación a las distintas categorías ambulatorias de presión arterial, al daño de órgano blanco y recomendaciones para el correcto uso de esta herramienta diagnóstica, incluyendo sugerencias de informe.

Abstract: Hypertension is an important risk factor for cardiovascular disease. The prevalence of hypertension in children has risen in last years, secondary to the increase in overweight and obesity in pediatric population, among other factors. An adequate diagnosis and opportune treatment can prevent the development of organ damage. The American Academy of Pediatrics recommends the performance of Ambulatory Blood Pressure Monitorization in children with risk factors or suspected hypertension, in order to confirm the diagnosis and guide treatment. New recommendations recently published simplifies the interpretation; blood pressure load is no longer included in the diagnosis, so only 4 categories remain: Normotension, White Coat Hypertension, Masked Hypertension and Ambulatory Hypertension. They also propose single cut-off values for patients ≥ 13 years, similar to those recommended for adults in 2017 American Heart Association guidelines. Both changes increase sensibility in organ damage diagnosis. This article presents an actualization in pediatric Chilean Ambulatory Blood Pressure Monitorization guidelines in order to unify criteria and attain nationwide broadcast. It also reviews the ambulatory categories of blood pressure and describes target organ damage in children, including recommendations for the correct use of the exam and proposes a report form.

Resumen Los aneurismas de arteria ilíaca solitarios son menos frecuentes que otros aneurismas de grandes vasos, siendo en la mayoría detectados junto con un aneurisma de aorta abdominal concomitante. Comparten la misma etiología aterosclerótica-degenerativa, siendo así que sus factores de riesgo son los mismos que para otros aneurismas. Generalmente son asintomáticos y se detectan incidentalmente, y cuando son sintomáticos, están en relación con la compresión de estructuras adyacentes y la ruptura del aneurisma. Los aneurismas de la arteria ilíaca común son los más comunes, seguidos de los aneurismas ilíacos internos y luego externos. Actualmente existe una variedad de opciones quirúrgicas abiertas, endovasculares e híbridas para tratar los aneurismas de la arteria ilíaca. La anatomía de la arteria ilíaca común con respecto al cuello proximal y distal, la afectación de la bifurcación ilíaca y la elección de preservar la arteria ilíaca interna ipsilateral juegan un papel en el proceso de decisión hacia el método de tratamiento preferido.

Abstract Isolated iliac artery aneurysms are less common than other large-vessel aneurysms, and most are detected together with a concomitant abdominal aortic aneurysm. It shares the same atherosclerotic-degenerative etiology since its risk factors are the same as for other aneurysms. They are generally asymptomatic, being detected incidentally and when they are symptomatic, they are related to the compression of adjacent structures and the rupture of the aneurysm. Common iliac artery aneurysms are the most common, followed by internal and then external iliac aneurysms. Currently, a variety of open, endovascular, and hybrid surgical options exist to treat iliac artery aneurysms. The anatomy of the common iliac artery with respect to the proximal and distal neck, the involvement of the iliac bifurcation, and the choice to preserve the ipsilateral internal iliac artery all play a role in the decision process towards the preferred method of treatment.

Abstract Ca2+ and Mg2+ ions are present in the water of the sulfide flotation process, negatively affecting its floatability and grade of the final concentrates obtained. It has recently been reported that its removal by adding sodium carbonate (Na2CO3) has a beneficial effect on flotation, although the reasons for this behavior are not yet known in detail. This paper presents the results of a study designed to investigate the reaction mechanism between the metal-carbonate ions. The results show that the addition of Na2CO3 to a saturated gypsum solution (0.016 mol/L) containing 50 ppm Mg(II) promotes the precipitation of the Ca2+ ion, such as calcite and vaterite. The kinetic model proposed to describe the reaction’s kinetics suggests that it is about a second order kinetic.

Resumen Los iones Ca2+ y Mg2+ se encuentran presentes en las aguas del proceso de flotación de sulfuros, lo que afecta negativamente su flotabilidad y el grado de los concentrados finales obtenidos. Recientemente se ha reportado que su remoción mediante la adición de carbonato de sodio (Na2CO3) tiene un efecto benéfico en la flotabilidad, aunque las razones de este comportamiento aún no se conocen con detalle. Este documento presenta los resultados de un estudio diseñado para investigar el mecanismo de reacción entre iones metal-carbonato. Los resultados demuestran que la adición de Na2CO3 a una solución saturada de yeso (0.016 mol/L) conteniendo 50 ppm de Mg(II), promueve la precipitación del ión Ca2+, como calcita y vaterita. El modelo cinético propuesto para describir la cinética de reacción sugiere que se trata de una cinética de segundo orden.

Resumen Introducción: La interrupción voluntaria del embarazo es un asunto político que polariza las opiniones y genera controversias entre el sector salud, social, económico y cultural. Objetivo: Determinar el nivel de conocimiento y actitudes sobre la interrupción voluntaria del embarazo en estudiantes de dos programas de Ciencias de la Salud de Cartagena. Materiales y métodos: Estudio descriptivo transversal, se aplicó el cuestionario adaptado por Marceliano y Medrano a 231 estudiantes de Enfermería y Medicina, los datos se analizaron obteniendo frecuencias relativas y absolutas. Resultados: El nivel de conocimiento de los estudiantes fue alto con 92,20% (213). Sin embargo, el 37,2% (86) no sabía cuáles eran las tres causales para que el aborto no se considere un delito. El 56,7% asume actitudes negativas hacia firmar una petición para legalizar el aborto y el 18,8% considera que si una mujer se realiza un aborto debe ir a la cárcel. Conclusión: El nivel de conocimiento de los estudiantes de medicina y enfermería es alto, sin embargo, los patrones muestran desconocimiento sobre las causales de legalización del aborto de acuerdo con la norma vigente y una variabilidad de actitudes positivas y negativas ante la interrupción voluntaria del embarazo.

Abstract Introduction: Voluntary interruption of pregnancy is a political issue that polarizes opinions and generates controversy within the health, social, economic, and cultural sectors. Objective: To determine the level of knowledge and attitudes regarding voluntary interruption of pregnancy in university students from two Health Sciences programs of Cartagena. Materials and methods: A descriptive cross-sectional study; the questionnaire adapted by Marceliano and Medrano was given to 231 students within the Nursing and Medical programs; the data was analyzed through relative and absolute frequencies. Results: The level of knowledge of the students was high with a 92.20% (213). Yet, a 37.2% (86) did not know the three reasons why abortion is not considered a crime. 56.7% have negative attitudes regarding signing a petition to legalize abortion and an 18.8% believe that a woman who has an abortion should go to jail. Conclusion: The level of knowledge in medical and nursing students is high, yet the patterns show lack of knowledge of the reasons for legalization of abortion according to the current laws and a variety of positive and negative attitudes regarding the voluntary interruption of pregnancy.

Abstract The objective of this study was to produce organic fodder based on corn and Yorimón bean as an alternative to conventional fodders in the Lagunera Region. The experiment was conducted in the spring-summer cycle from April to August 2017. In each useful plot, three corn plants and three Yorimón bean plants were harvested, which were finely chopped and mixed to form a balanced compound of which one kilogram was used for bromatological analyses. A randomized block design with four repetitions was used. In the CP of organic and inorganic fodders, no significant differences were observed (p> 0.05) and the values found were within the optimal values for cows in production. CP correlated positively with TDN and NEL (p< 0.01). The quality of the fodder combined between corn and Yorimón bean showed that it is an alternative to conventional fodders.

Resumen El objetivo de este estudio fue producir forraje orgánico a base de maíz y frijol Yorimón como alternativa a los forrajes convencionales en la Región Lagunera. El experimento se realizó en el ciclo de primavera-verano de abril a agosto de 2017. En cada parcela útil se cosecharon tres plantas de maíz y tres de frijol, las cuales fueron finamente picadas y mezcladas para formar un compuesto balanceado del cual se utilizó un kilo para los análisis bromatológicos. Se utilizó un diseño de bloques al azar con cuatro repeticiones. En PC de los forrajes orgánicos e inorgánicos, no se observaron diferencias significativas (p> 0.05) y los valores encontrados estuvieron dentro de los valores óptimos para vacas en producción. PC correlacionó positivamente con la TND y ENL (p< 0.01). La calidad del forraje combinado entre maíz y frijol Yorimón mostró que es una alternativa a los forrajes convencionales.

ABSTRACT: Aim: To evaluate the association between the oral and systemic condition and the oral health-related quality of life of institutionalized older people in a retirement home in Recoleta, Santiago. Material and method: In the present pilot, non-experimental, cross-sectional and descriptive study, an oral examination was performed, alongside with the OHIP-7Sp survey to the individuals that meets the inclusion criteria. In addition, the medical history of the participants was reviewed to record the diseases under treatment and the drugs in use. Results: 20 individuals met the inclusion criteria, 11 men and 9 women with ages ranging between 65 and 88 years. There was a clinical association between oral condition, general health and oral health-related quality of life related to oral health in the oelder people of thefrom the residence retirement home of in Recoleta. A statistical significance was not established. Conclusion: The oral condition, general health and quality of life related to oral health was were deficient. Subsequent studies with a larger sample are required to establish a statistically significant relationship of between the variables in order to propose different solutions.

RESUMEN: Objetivo: Evaluar la asociación entre la condición oral y sistémica con la calidad de vida relacionada a salud bucal de adultos mayores institucionalizados en un hogar en Recoleta, Santiago. Material y método: En el presente estudio piloto de corte transversal, se realizó un examen intraoral y se aplicó la encuesta OHIP-7Sp a adultos mayores internados en la residencia Mi Hogar. Además, se revisaron las fichas médicas de los participantes para el registro de sus enfermedades y fármacos. Los datos fueron analizados a través del test t, test de Mann-Whitney y regresión logística considerando un valor p < a 0.05 como estadísticamente significativo. Resultados: 20 adultos mayores cumplieron los criterios de inclusión, 11 hombres y 9 mujeres, con un rango de edad entre 65 y 88 años. Se encontró asociación clínica entre la condición oral (p=0.06), salud general (p=0.2) y calidad de vida asociada a salud bucal en los adultos mayores. Conclusión: La condición oral, salud general y calidad de vida asociada a salud bucal de los adultos mayores se consideró deficiente. Se requieren estudios posteriores con una mayor muestra para lograr establecer una significancia estadística de las variables y así, proponer intervenciones para mejorar las condiciones de salud de los adultos mayores institucionalizados.

Abstract Rodent models in rats, mice, and guinea pigs have been extremely helpful to gain insight into pregnancy physiology and pathologies-related. Moreover, they have allowed understanding the mechanism that links an adverse intrauterine environment with the origin of adult disease. In this regard, the effects of diverse maternal conditions, such as undernutrition, obesity, hypoxia, and hyperandrogenism on placental function and its long-term consequences for the offspring, have been widely analyzed through rodents models involving dietary manipulations, modifications in environmental oxygen, surgical and pharmacological procedures that reduce uteroplacental blood flow and administrations of exogenous testosterone and dihydrotestosterone (DHT) mimicking maternal androgen excess. Both in human and in rodent models, these interventions induce modifications of placental morphology, transport of glucose, amino acid, and fatty acids, steroid synthesis, and signaling pathways control placental function. These changes are associated with the increase of pro-inflammatory and oxidative stress markers. For its part, offspring exhibit alterations in organs involved in metabolic control such as the hypothalamus, adipose tissue, liver, skeletal muscle, and pancreas altering the intake and preferences for certain foods, the metabolism of glucose and lipid, and hormonal function leading to fat accumulation, insulin resistance, fatty liver, dyslipidemia, and elevated glucose levels. Therefore, the present review discusses the evidence emerging from rodent models that relate maternal nutrition, hypoxia, and androgen exposure to the maternal mechanisms that lead to fetal programming and their metabolic consequences in postnatal life.

ABSTRACT: School engagement is the level of involvement of students with their school, their sense of belonging, and the motivation to learn and achieve academic goals. The purpose of this study was to characterize the role of the family on school engagement from the perspective of students with special educational needs. For this purpose, a qualitative study with a phenomenological focus was carried out. Eight Chilean students from first and second grade of secondary schools from the Biobio region, Chile, participated in the study. The study employed the technique of photo-elicitation, photographic narration, and interviews. Content analysis was performed with the data. The results show that the emotional dimension of school engagement is the most reported one, highlighting subjective experiences related to their families “being present”, providing support, and making company. The behavioral dimension of the engagement appears to a lower extent, through parental actions such as monitoring, reminding school work, and stressing the importance of education. In relation to the cognitive dimension, fewer students mentioned families provided pedagogical support actions. Participants do not mention special educational needs as a relevant issue in their academic experience. Tese results are discussed highlighting the importance of family support on students’ school engagement.

RESUMEN: El compromiso escolar se entiende como el nivel de involucramiento del estudiante con su escuela, su sentido de pertenencia, y la motivación por aprender y obtener logros académicos. En este estudio se busca caracterizar el rol de la familia en el compromiso escolar desde la perspectiva de estudiantes con necesidades educativas especiales. Para tal efecto, se realizó un estudio cualitativo con enfoque fenomenológico. Los participantes son ocho estudiantes de primer y segundo año de enseñanza secundaria de la Región del Biobío, Chile. Se utilizó la técnica de fotoelicitación, narración fotográfica, y entrevistas. Se realizó análisis de contenido con los datos. Los resultados muestran que la dimensión emocional del compromiso escolar es la que más aparece reportada en la experiencia subjetiva de los estudiantes, a través de sentimientos relacionados con el “estar presente”, el apoyo y la acogida. En segundo lugar, aparece la dimensión conductual del compromiso, a través del monitoreo, el uso de recordatorios y la reiteración sobre la importancia de estudiar. Finalmente, sobre la dimensión cognitiva, solo algunos estudiantes mencionan acciones de apoyo pedagógico de forma directa o indirecta. Respecto a las necesidades educativas especiales, estas no aparecen como un tema relevante en la experiencia de los participantes. Se discuten estos resultados respecto de la importancia del apoyo parental en el compromiso escolar de los estudiantes.

Resumo Rubiaceae é uma das cinco famílias mais ricas em espécies de Angiospermas, suas flores são caracterizadas por um disco nectarífero ao redor do estilete. No entanto, quase não há estudos sobre a anatomia destas estruturas na família. O objetivo deste trabalho foi descrever pela primeira vez a anatomia dos nectários na tribo Gardenieae (Rubiaceae). Flores de Cordiera concolor, Genipa americana, Randia calycina, Randia ferox, Randia heteromera, Randia micracantha e Tocoyena formosa foram coletadas, fotografadas e fixadas. Os nectários foram processados utilizando técnicas convencionais de observação em microscopia óptica e microscopia eletrônica de varredura. Em todas as flores o nectário é histologicamente diferenciado em epiderme, parênquima nectarífero, parênquima subnectarífero e traços vasculares. O néctar é exsudado através de estômatos. Os nectários tem função reprodutiva e são estruturados e mesenquimais na fase floral. Após a queda da corola são nectários persistentes com secreção pós-floral e função extranupcial. Também foram registados os visitantes florais que apareceram em flores abertas e após a queda da corola.

Abstract Rubiaceae is one of the five most species-rich families of Angiosperm, its flowers are characterized by a nectariferous disc surrounding the base of the style; however, there are almost no studies on anatomy of these structures in the family. The aim of this study was to describe for the first time the anatomy of the floral nectaries in the tribe Gardenieae (Rubiaceae). Flowers from Cordiera concolor, Genipa americana, Randia calycina, Randia ferox, Randia heteromera, Randia micracantha, and Tocoyena formosawere collected, photographed, and processed using conventional techniques for observation with optical and scanning electron microscopies. In all species the nectary is differentiated histologically into epidermis, nectary and sub-nectary parenchyma, and vascular bundles. Nectar is exuded via nectarostomata. The nectaries have reproductive function, and are structural and mesenchymal during the floral stage. Whereas after corolla has fallen they are persistent nectaries, with post-floral secretion and extranuptial function. In addition, floral visitors that appeared on open flowers and after corolla fall were recorded.

RESUMEN Objetivo Determinar la prevalencia del síndrome de burnout en el personal de enfermería en hospitales del Departamento del Atlántico (Colombia). Materiales y Métodos Se realizó un estudio cuantitativo, descriptivo transversal, en 117 profesionales y 229 auxiliares de enfermería de cuatro hospitales del Departamento del Atlántico (Colombia), dos públicos y dos privados. Se empleó una encuesta anónima con datos sociodemográficos y la escala de Maslach. Resultados La prevalencia global del síndrome de burnout o desgaste profesional fue de 65%. En profesionales de enfermería, fue de 63,2% y en auxiliares de enfermería, de 65,9%. El 13,3% de los participantes presentó un grado elevado de burnout para el cansancio emocional; el 9,2%, para la despersonalización; y el 62,7% obtuvo puntuaciones bajas para la realización personal. En los profesionales de enfermería, el 12,7% obtuvo una puntuación alta para cansancio emocional; 7,4% para despersonalización, y 64,2% obtuvo puntuaciones bajas para la realización personal. Por su parte, en los auxiliares de enfermería el comportamiento en algunas subescalas fue muy similar; el 14,5% obtuvo una puntuación alta para cansancio emocional; 12,8%, para despersonalización y 59,8% obtuvo puntuaciones bajas para la realización personal. Conclusiones La presencia del síndrome de burnout en la población estudiada es alta. Es similar tanto en enfermeros como en auxiliares de enfermería. La dimensión más afectada fue la realización personal en ambos grupos estudiados, lo cual corresponde a sentimientos altos del "quemado".

ABSTRACT Objective To determine the prevalence of burnout syndrome in the nursing staff in four hospitals located in the State of Atlántico (Colombia). Material and Methods A descriptive cross-sectional study was conducted and included as participants 117 nursing professionals and 229 nursing auxiliaries from four hospitals located in the State of Atlantico (Colombia), two public and two privates. An anonymous self-study survey was used on sociodemographic, labor data and Maslach Scale. Results The overall prevalence of Burnout Syndrome or professional burnout was 65%. In nursing professionals it was 63,2% and in nursing auxiliaries 65,9%. At least 13,3% of the participants had a high degree of Burnout from emotional exhaustion, 9.2% for depersonalization, and 62,7% had low scores for personal fulfillment. In nursing professionals, 12,7% had a high score for emotional exhaustion, 7,4% for depersonalization, and 64,2% obtained low scores for personal fulfillment. On the other hand, in nursing auxiliaries the behavior in some subscales was very similar, 14,5% had a high score for emotional exhaustion, 12,8% for depersonalization and 59,8% had low scores for personal fulfillment. Conclusions The presence of burnout syndrome is high in the studied population, it is similar in both, nurses and nursing auxiliaries. The most affected dimension was the personal fulfillment in both groups, which corresponds to high feelings of the "burned".

Resumen Introducción. La malaria representa uno de los mayores desafíos de salud pública, principalmente en los países pobres. Ciertas características sociales de Colombia, como la migración, el trabajo informal y la escasez económica, favorecen la minería ilegal. El análisis de la situación de la malaria en estas áreas permite establecer una guía para la prevención, el control y el tratamiento de la enfermedad en los programas de salud pública existentes. Objetivo. Describir la situación de la malaria en las poblaciones mineras colombianas entre el 2012 y el 2018. Materiales y métodos. Se hizo un estudio descriptivo y retrospectivo que incluyó la creación de gráficos y mapas. Para el análisis estadístico se utilizaron la correlación de Pearson y el índice de Moran. Resultados. Entre el 2012 y el 2018, se notificaron 44.032 casos de malaria en la población minera, 43.900 de malaria no complicada y 132 de malaria complicada, así como tres muertes, dos por Plasmodium vivax y una por infección mixta. Hubo una disminución del 44,7 % de los casos en el período evaluado. La tasa de riesgo en el 2012 fue de 2,5 casos por 1.000 habitantes; el 87,3 % de los casos se presentó en hombres y el 37,9 % en personas entre los 20 y los 29 años, en tanto que el 46,7 % de la población estudiada estaba conformada por afrocolombianos. Se encontró una posible correlación lineal positiva moderada entre mayor la actividad minera, mayor el número de casos de malaria en mineros. El índice de Moran global evidenció una agrupación espacial significativa de los casos de malaria en zonas con industria minera en los municipios del Pacífico colombiano. Conclusiones. La disminución en la notificación de casos durante el período evaluado podría atribuirse a un subregistro del Sistema de Vigilancia en Salud Pública (Sivigila), ya que la mayoría de los mineros no tienen trabajos formales, lo que dificulta su acceso a los servicios de salud. Se recomienda un estudio de cohorte en áreas endémicas para establecer una relación directa entre la explotación minera y la presencia de casos de malaria.

Abstract Introduction: Malaria represents one of the biggest public health challenges, mainly in poor countries. Colombia has social characteristics such as migration, informal work, and economic shortages that favor illegal mining activities. The study of the malaria situation in these areas would allow establishing the bases for its prevention, control, and treatment in the existing public health programs. Objective: To describe the malaria situation in Colombian mining populations between 2012 and 2018. Materials and methods. We conducted a retrospective descriptive study with graphs and maps. For the statistical analysis, we used Pearson's correlation and Moran's index. Results. From 2012 to 2018, 44,032 cases of malaria were reported in the mining population, 43,900 of uncomplicated malaria and 132 of complicated malaria, and three deaths, two due to Plasmodium vivax and one due to mixed infection. During this period, there was a decrease of 44.7% in cases. The risk rate in 2012 was 2.5 cases x 1000 inhabitants; 87.3% of cases were in men, and 37.9% corresponded to the 20 to 29-year-old age group while 46.7% were AfroColombians. We found a possible moderate positive linear correlation: The greater the mining activity, the greater the number of malaria cases. The global Moran index indicated a significant spatial grouping of cases in mining activities in Colombian Pacific municipalities. Conclusions. The case notification decrease during this period could be attributed to an underreporting of the public health surveillance system (Sivigila) system, as most miners do not have formal jobs, which prevents them from accessing health services. A cohort study is recommended in endemic areas to establish a direct relationship between mining exploitation and the occurrence of malaria cases.

Resumen La leptospirosis es una enfermedad zoonótica de distribución mundial causada por la bacteria Leptospira. En Colombia, su reporte es obligatorio desde 2007. Objetivo: realizar un análisis epidemiológico de la leptospirosis humana en Colombia a escala nacional, departamental y municipal en el período comprendido entre enero de 2007 y diciembre de 2015. Metodologia: Se realizó un estudio ecológico retrospectivo de tendencia temporal y distribución espacial de los casos de leptospirosis reportados entre enero de 2007 y diciembre de 2015. Se analizaron las variables de sexo, edad, municipio de residencia, área de residencia (urbana, rural), fecha de inicio de síntomas y letalidad. Resultados: se reportaron un total de 23 994 casos sospechosos, de los cuales se confirmó el 39,51%; el 82,4% proviene de zonas urbanas; el 68.87% se presentaron en hombres; la letalidad fue del 2,66% en los hombres y del 2,04% en las mujeres. Los departamentos con mayor número de casos fueron Valle del Cauca (n=2032), Antioquia (n=1 747), Atlántico (n=1159); la incidencia varió entre 2 (Arauca) y 465,4 (Guaviare) por 100 000 habitantes. A nivel municipal, Cali tiene el mayor número de casos (682), seguido de Barranquilla (n=612) y San José del Guaviare (n=448); la incidencia más alta fue 1 597.6 en Pueblo Rico (Risaralda), seguida por Sabanas de San Ángel (Magdalena) con 883.4 y San José del Guaviare (Guaviare) con 742.5; la mayoría de los municipios tuvieron incidencias entre 0 y 50 por 100 000 habitantes. Conclusiones: la leptospirosis se distribuye en toda Colombia, con el 85% de los casos concentrados en 10 de los 32 departamentos. A escala municipal, existe una gran variación en las incidencias anuales y se identificaron seis puntos calientes para casos, lo que indica que existen área de alto riesgo para la enfermedad.

Abstract Leptospirosis is a zoonotic disease of global distribution caused by the bacterium Leptospira. In Colombia, it has been mandatory to report this disease since 2007. Objective: to perform an epidemiological analysis of human leptospirosis in Colombia at the national, departmental and municipal levels for the period between January 2007 and December 2015. Methodology: A retrospective ecological study of the temporal trend and spatial distribution of leptospirosis cases reported between January 2007 and December 2015 was conducted. The variables of sex, age, municipality of residence, area of residence (urban, rural), date of onset of symptoms, and lethality were analyzed. Results: A total of 23,994 suspected cases were reported, of which 39.51% were confirmed; 82.4% came from urban areas; 68.87% presented in men; the lethality was 2.66% in men and 2.04% in women. The departments with the highest number of cases were Valle del Cauca (n=2032), Antioquia (n=1747), Atlántico (n=1159); the incidence varied between 2 (Arauca) and 465.4 (Guaviare) per 100,000 inhabitants. At the municipal level, Cali had the highest number of cases (n=682), followed by Barranquilla (n=612) and San José del Guaviare (n=448). The highest incidence was 1597.6 in Pueblo Rico (Risaralda), followed by Sabanas de San Ángel (Magdalena) with 883.4 and San José del Guaviare (Guaviare) with 742.5; the majority of municipalities had incidences between 0 and 50 per 100,000 inhabitants. Conclusions: Leptospirosis is distributed throughout Colombia with 85% of the cases concentrated in 10 of its 32 departments. At the municipal level there is a large degree of variation in annual incidences. Six hotspots for cases were also identified, indicating that there are areas of high risk for the disease.

Resumo A leptospirose é uma doença zoonótica de distribuição global causada pela bactéria Leptospira. Na Colômbia, a notificação da doença é obrigatória desde 2007. Objetivo: realizar uma análise epidemiológica da leptospirose humana na Colômbia em escalas nacionais, departamentais e municipais no período entre janeiro de 2007 e dezembro de 2015. Metodologia: Foi conduzido estudo ecológico retrospectivo da tendência temporal e distribuição espacial de casos de leptospirose no período. Variáveis demoráficas (sexo, idade, município de residência, área de residência urbana, rural), data de início dos sintomas e letalidade foram analisadas. Resultados: Foram relatados de 23 994 casos suspeitos, dos quais 39,51% foram confirmados; 82,4% vem de áreas urbanas; 68,87% dos casos em homens; letalidade de 2,66% nos homens e de 2,04% nas mulheres. Os departamentos com maior número de casos foram Valle del Cauca (n=2032), Antioquia (n=1747), Atlántico (n=1159); a incidência variou entre 2 (Arauca) e 465,4 (Guaviare) por 100 000 habitantes. No nível municipal, Cali tem o maior número de casos (n=682), seguido por Barranquilla (n=612) e San José del Guaviare (n=448). A maior incidência foi de 1597,6 por 100 mil em Pueblo Rico (Risaralda), seguida por Sabanas de San Ángel (Magdalena) com 883,4 e San José del Guaviare (Guaviare) com 742,5. A maioria dos municípios tinha incidências entre 0 e 50 por 100 mil habitantes. Conclusões: A leptospirose é distribuída em toda a Colômbia, com 85% dos casos concentrados em 10 dos 32 departamentos. Na escala municipal, há grande variação nas incidências anuais e foram identificados seis pontos quentes para os casos, indicando que existem área de alto risco para a doença.

Abstract The purpose of plant health and protection is to generate actions for the control of agricultural pests and diseases, the use of pesticides and the determination of phytosanitary status for commercialization within the framework of food safety. However, plant protection as a normative and regulatory instrument has remained on the global and national scale, when pest management is mainly local. There is an institutional and territorial disarticulation regarding the regulation of pesticides. At a global level, Integrated Pest Management (IPM) was recognized as the public policy of pest management and control, at the local level, this structure did not arrive and is not applied due to the lack of a phytosanitary extension model. This means that the only means to eradicate agricultural pests is the indiscriminate use of pesticides, some prohibited, in other countries due to the significant effects on human health and the environment. However, Mexico allows its distribution and commercialization. The research was developed in the agricultural valley of Rioverde and Ciudad Fernández, two municipalities in the state of San Luis Potosí, considered an area of great importance in agricultural terms, above all, due to its high productivity of orange cultivation. It has also been characterized by the use of dangerous pesticides, which has affected the health of the population and concern for its most important resource, water. Due to the aforementioned, this work aimed to demonstrate that territorial governance problems constitute the most important challenge to face and solve the pesticide problem in Mexico. The methodological process had a qualitative and quantitative approach based on the extension of innovation through geotechnologies for the identification of areas and plots with greater use of pesticides to combat pests and diseases of crops. The methodological process consisted of two phases: a) the sampling was through the mobile application called “Agroquímicos LAGES” developed by the National Laboratory of Geoprocessing of Phytosanitary Information (LaNGIF), this process was in charge of students of Engineering in Agricultural Innovation Sustainable Institute of the Higher Technological Institute (ITS) and of Agroindustrial Engineering and Agronomic Engineering in Phytotechnics of the Autonomous University of San Luis Potosí (UASLP), generating a database with 22,939 data on producers, crops and pesticides; b) The data analysis consisted, first of all, in making a distinction between permitted and restricted pesticides detected in the area based on the Registry of Canceled Pesticides and Nutrients of the Federal Commission for Protection against Sanitary Risks (COFEPRIS) for later apply the non-parametric statistical hypothesis test Chi square (X2) and thus determine the existence of association between the level of education, type of crop (vegetables, corn and orange) and the taxonomic group with pesticides, likewise an analysis was carried out Multicriteria to identify and classify, through spatial nodes, the areas with restricted pesticide application and in turn, the characterization of the producers, the cultivation and the land tenure. As a result, it was obtained that the “agronomic houses” control the management of pesticides, which are small private businesses that face lax agricultural, environmental and health policies, and act outside the state and national regulations; In statistical terms, the crops with the highest frequency of restricted pesticide use were corn and vegetables, and in spatial terms, restricted pesticides such as: Diazinon, Glyphosate, Carbofuran, Chlorpyrifos Ethyl, Methamidophos, Metomil and Monocrotophos are applied in the El Refugio ejido. all Highly Hazardous Pesticides (HHP). Given this scenario, it is considered necessary to generate inventories according to the phytosanitary status of pests and diseases, in addition to diagnoses on the use of pesticides at a local scale. Without this, actions aimed at solving, remedying and reducing the economic, environmental and health problems caused by said disarticulation are difficult. The methodological triad that consisted of the use of geotechnologies, statistical analysis and spatial analysis allows us to generate diagnoses and monitor the use and management of pesticides, at low cost and at a local scale. It is important to note that the identification of the areas with the greatest application of restricted pesticides does not have the motivation to transfer responsibility to the producer. On the contrary, they are intended to direct phytosanitary extension actions to specific sites.

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Resumen El objetivo de este trabajo es evaluar el efecto que tienen las redes sociales en las decisiones migratorias de los individuos. Se toma como referencia el enfoque de migración de Borjas (1987, 1999) bajo un contexto de información asimétrica en el lugar de origen y el papel de una red migratoria, entendida como el apoyo de amigos, familiares o conocidos que reducen la incertidumbre de llegar a un nuevo destino. Utilizando los datos de la Encuesta Multipropósito para Bogotá y Municipios de Cundinamarca del 2014, se estima un modelo de selección de probabilidad de la decisión de migrar en función de características de las personas y el acceso a redes migratorias. Los resultados muestran que los individuos que prefieren usar el apoyo de una red, siendo la de hogar y la de amigos las más usadas, aumentan sus probabilidades de migrar a la región.

Abstract The objective of this work is to evaluate the effect of social networks on immigration decisions of individuals. The migration approach of Borjas (1987, 1999) is taken as a reference under a context of asymmetric information in the place of origin and the role of a migration network, understood as the support of friends, family or acquaintances that reduce the uncertainty of arriving to a new destination. Using the data from the 2014 Multipurpose Survey for Bogotá and Municipalities of Cundinamarca, a probability selection model for the decision to migrate based on the characteristics of people and access to migratory networks is estimated. The results show that individuals prefer to use the support of a network, being that of home and friends the most used, increase their chances of migrating to the region.

Abstract Usefulness of chondrocutaneous helix flap for defects smaller than 2 cm is widely accepted. This paper attempts to show the outcome of this technique for the management of a large helix and antihelix defect. We performed the Antia-Buch technique, with two chondrocutaneous flaps, to reconstruct in a single surgical stage a 40 mm defect in the middle third of the auricle of an elderly patient who refused more than one surgical time, achieving an appropriate functional and cosmetical outcome.

Resumen La utilidad del colgajo condrocutáneo del hélix para cubrir defectos menores de 2 cm es ampliamente aceptada. Con esta publicación queremos mostrar el resultado de esta técnica para el manejo de un defecto extenso que incluía el tercio medio del hélix y antihelix. Realizamos la técnica de Antia-Buch con doble colgajo condrocutáneo para reconstruir, en un solo tiempo quirúrgico, un defecto de 40 mm en el tercio medio del pabellón auricular de una paciente de avanzada edad, que había rechazado opciones reconstructivas que requirieran varios tiempos de cirugía, obteniendo un resultado funcional y cosmético adecuado.