ABSTRACT Background: Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population. Objective: To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru). Methods: This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex. Results: An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high. Conclusion: HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic.

Resumo Histórico: Pacientes com DRC apresentam maior risco de doença grave e mortalidade por COVID-19 do que a população geral. Objetivo: Comparar taxas de hospitalização e mortalidade durante a pandemia entre pacientes em hemodiálise crônica (HD) e a população geral em Lima (Peru). Métodos: Esta coorte retrospectiva incluiu avaliação do banco de dados de pacientes em HD crônica dos prestadores de serviços de saúde das redes de benefícios do seguro social de saúde de Lima e Callao, entre 2019–2021. Obteve-se taxas de hospitalização e mortalidade para cada 1.000 indivíduos, e foram calculadas variações nas porcentagens de casos de COVID-19 e óbitos. Estas taxas foram comparadas com os dados da população geral e padronizadas por idade e sexo. Resultados: Uma média de 3.937 pacientes em HD crônica foram avaliados mensalmente. Destes, 4,8% tinham COVID-19, 64,97% eram casos leves. As taxas de hospitalização por 1.000 pacientes foram 19,5; 29,28; e 36,7 em 2019, 2020, e 2021, respectivamente. As taxas de mortalidade por 1.000 pacientes foram 5,9; 9,74 e 11,49 em 2019, 2020, e 2021, respectivamente. Quando comparados à população geral padronizada, os picos das taxas coincidiram com os platôs das ondas da pandemia. A taxa de hospitalização para COVID-19 foi 12 vezes maior em pacientes em HD do que na população geral e a taxa de mortalidade por COVID-19 foi duas vezes maior. Conclusão: Pacientes em HD apresentaram taxas de hospitalização e mortalidade padronizada mais elevadas do que a população geral. Os picos das hospitalizações e mortalidade coincidiram com os platôs da primeira e segunda ondas da pandemia.

Objectives: To examine drug overdose records in Brazil from 2000 to 2020, analyzing trends over time in overdoses and overall sociodemographic characteristics of the deceased. Methods: Using data from the Brazilian Mortality Information System (Sistema de Informações sobre Mortalidade), we identified records from 2000-2020 in which the underlying cause-of-death was one of the following codes: X40-X45 (accidental poisoning), X60-X65 (intentional poisoning), or Y10-Y15 (undetermined intentionality poisoning). The Brazilian dataset included 21,410 deaths. We used joinpoint regression analysis to assess changes in trends over time. Results: People who died of drug overdoses in Brazil between 2000 and 2020 had a mean age of 38.91 years; 38.45% were women, and 44.01% were identified as White. Of the overdose deaths, 44.70% were classified as intentional and 32.12% were classified as unintentional. Among the identified drugs, stimulants were the most common class. However, most records did not report which drug was responsible for death. Conclusion: Sociodemographic trends in overdose deaths in Brazil must guide country-specific policies. Nevertheless, data collection protocols must be improved, particularly regarding the drug used in overdoses.

Activated carbons (ACs) from olive stone were prepared using CO2, steam, KOH, and H3PO4 as activating agents. The resultant activated carbons were characterized by proximate and ultimate analysis, N2 adsorption (Brunauer-Emmett-Teller (BET) method), iodine number, Boehm titration, temperature-programmed desorption (TPD), and Fourier transform infrared spectroscopy (FTIR). Ammonia (NH3) was used as a test molecule to be adsorbed. The BET surface areas of the ACs obtained ranged from 1000 to 1986 m2 g-1. Type I isotherms were obtained for all the samples, although steam and H3PO4 ACs showed a significant mesopore contribution. KOH activation resulted in carbon with a high microporosity (98%) and high iodine adsorption (1030 mg g-1). KOH AC prepared with a KOH/pyrolyzed char weight ratio of 2 and at 900 °C showed the highest NH3 adsorption (252 mg g-1), favored by the high microporosity and adequate acidity. Chemical activation (KOH and H3PO4) promotes higher NH3 adsorption than the physical ACs prepared (CO2 and steam). Langmuir and Freundlich adsorption equilibrium models were used to correlate the NH3 adsorption isotherms, obtaining the best fit for the Freundlich equation. The results indicated that olive stone-based activated carbon could be used for commercial AC to remove NH3 from gaseous streams.

ABSTRACT The study analyzes the association between self-destructive indirect behaviors and social anomie in a sample of 509 fourth grade high school students from Lima. A data sheet, the Kelley et al. (1985) Self-destructive behaviors Scale adapted to Spanish language by Ponce (2007) and the Li et al. (1999) Anomie Scale validated by Vera et al. (2013) were applied. The study found direct and significant association between both variables in the total sample (in cases with and without domestic violence), with moderate effect. In cases without domestic violence, discontent is associated with all self-destructive behaviors’ dimensions, followed by distrust associated to four of them. In teenagers who are victims of domestic violence, discontent is associated with lack of planning and anticipation and neglecting their duties and distrust is associated with neglecting their duties. Finally, in accordance with the results from multivariate logistic regression analyses, the only dimension of social anomie statistically significant (p<.05) to predict self-destructive behaviors is discontent.

RESUMEN El estudio analiza la asociación entre las conductas autodestructivas indirectas y la anomia social en una muestra de 509 escolares de cuarto de secundaria de instituciones educativas de Lima. Se empleó una ficha de datos, la escala de conductas autodestructivas de Kelley et al. (1985) adaptada al español por Ponce (2007) y la escala de anomia social de Li et al. (1999) validada por Vera et al (2013). Se halló asociación directa y significativa entre ambas variables en la muestra total (con y sin violencia familiar), con tamaño del efecto moderado. Cuando no existe violencia, el descontento se asocia con todas las dimensiones de las conductas autodestructivas, seguido de la desconfianza asociada con cuatro de ellas; en adolescentes con violencia, el descontento se asocia con falta de planeación, de anticipación y descuido de deberes y la desconfianza con descuido de deberes. Finalmente, de acuerdo con los resultados de la regresión logística, a nivel multivariado, la única dimensión de la anomia social que resulta estadísticamente significativa (p<.05) en la predicción de las conductas autodestructivas es descontento.

Abstract One of the new waters, and environmentally friendly agriculture initiatives in Peru is to encourage the utilization of agricultural waste, because low agricultural output is a threat to food security there. The purpose of this research was to evaluate the effect of harvest residues on the basidiocarp production of the fungus Pleurotus Ostreatus, in Acobamba-Huancavelica. The trial had a completely randomized design, and the treatments included T1, barley stubbles; T2, wheat stubbles; T3, pea stubbles; T4, broad bean stubbles; and T5, quinoa stubbles. The research was quantitative in nature, taking the form of an experiment with an applied, explanatory level of design. The recorded data was tabulated and analyzed with analysis of variance, as well as Tukey's test (α:0.05), for which the statistical software Infostat was used. The results are presented in tables and graphs for a better interpretation. As main results, it was obtained that the time (colonization), diameter (stem, pileus), length (stem) and weight (basidiocarps), present statistical differences between treatments showing significant enhancement in all parameters. Despite a numerical difference, a Tukey average comparison test revealed that there was no statistically significant difference between the averages for the variable time for fungus colonisation, suggesting that the treatment T5 in which quinoa substrate showed the greatest average. Treatment T4 in which broad bean stubbles were used gave the most low-average. In conclusion, increment in all parámeters were noted in all treatment of Pleurotus basidiocarps ostreatus under Acobamba conditions.

Resumo Uma das novas iniciativas de águas e agricultura ecológica no Peru é incentivar a utilização de resíduos agrícolas, porque a baixa produção agrícola é uma ameaça à segurança alimentar no país. O objetivo desta pesquisa foi avaliar o efeito dos resíduos da colheita na produção de basidiocarpos do fungo Pleurotus ostreatus, em Acobamba-Huancavelica. O ensaio teve um delineamento inteiramente casualizado, e os tratamentos incluíram T1, restolho de cevada; T2, soqueiras de trigo; T3, restolho de ervilha; T4, restolho de fava; e T5, restolho de quinoa. A pesquisa foi de natureza quantitativa, assumindo a forma de experimento com um nível de design aplicado e explicativo. Os dados registrados foram tabulados e analisados com análise de variância, bem como teste de Tukey (α:0,05), para o qual foi utilizado o software estatístico Infostat. Os resultados são apresentados em tabelas e gráficos para melhor interpretação. Como principais resultados, obteve-se que o tempo (colonização), diâmetro (caule, píleo), comprimento (caule) e peso (basidiocarpos) apresentam diferenças estatísticas entre os tratamentos, mostrando melhora significativa em todos os parâmetros. Apesar da diferença numérica, o teste de comparação de médias de Tukey revelou que não houve diferença estatisticamente significativa entre as médias para a variável tempo de colonização do fungo, sugerindo que o tratamento T5 em que usou o substrato quinoa, apresentou a maior média. O tratamento T4, no qual foram usadas restolhos de fava, apresentou a média mais baixa. Em conclusão, incrementos em todos os parâmetros foram observados em todos os tratamentos de Pleurotus basidiocarps ostreatus nas condições de Acobamba.

Resumen La úlcera de Marjolin se define como una neoplasia desarrollada en el seno de una herida que ha sido crónicamente traumatizada. Presentamos el caso de una úlcera venosa crónica con degeneración maligna y realizamos una breve revisión de la literatura. Se trata de una paciente de género femenino, de 50 años de edad, con enfermedad venosa crónica diagnosticada desde los 20 años. Se le realizó ablación farmacológica de vena safena mayor bilateral; dos décadas mas tarde desarrolló una úlcera varicosa en cara medial de pierna derecha presentando recidiva a pesar de tratamiento durante 10 años. Esta úlcera aumentó de tamaño y presentó sangrado, por lo que se decide realizar biopsias. El reporte histopatológico reveló degeneración neoplásica maligna con extensión a planos profundos y adenopatías inguinales. Se realizó amputación supracondílea del miembro pélvico derecho con linfadenectomía inguinal. En conclusión, la úlcera de Marjolin secundaria a una úlcera varicosa puede tener mayor morbilidad debido a su localización, ya que predomina en las extremidades y generalmente es identificada en estadios avanzados, pudiendo conducir a desenlaces sombríos.

Abstract Marjolin’s ulcer is defined as a neoplasm developed within a wound that has been chronically traumatized. We present a case of a chronic venous ulcer with malignant degeneration and a brief review of the literature. A 50-year-old female patient with chronic venous disease diagnosed at the age of 20 years old and treated with pharmacological ablation of the bilateral great saphenous veins. Twenty years later, she developed a varicose ulcer on the medial aspect of her right leg, presenting recurrence despite 10 years of treatment. This lesion increased in size and presented bleeding, therefore we decided to perform biopsies. The histopathological analysis revealed malignant neoplastic degeneration with extension to deep planes and inguinal adenopathies. Supracondylar amputation of the right pelvic limb with inguinal lymphadenectomy was performed. In conclusion, a Marjolin’s ulcer secondary to a varicose ulcer may have higher morbidity due to its location, since it predominates in the extremities and it is generally identified in advanced stages, leading to gloomy outcomes.

Resumen Introducción. Las semillas son estructuras complejas que permiten la propagación biológica y agrícola de plantas. La histología de semillas puede ser utilizada para enseñanza, investigación y para diagnóstico patológico. Los protocolos de histología están divididos en cinco etapas: fijación, procesamiento, corte, tinción y montaje. El xilol es un reactivo peligroso que se usa durante el procesamiento, tinción y montaje de muestras histológicas que puede contaminar el ambiente y es tóxico para los usuarios. Objetivo. Comparar dos protocolos nuevos de histología de semillas acelerados con microondas, en semillas de especies de importancia económica. Materiales y métodos. Los experimentos fueron realizados entre enero y mayo del 2022 en el Centro para Investigaciones en Granos y Semillas de la Universidad de Costa Rica. Los protocolos comparados fueron: uno libre de derivados de benceno (BDF) y uno dependiente de xilol (XD). Se usaron semillas de Carica papaya L. (Caricaceae) var. Pococí, Coffea arabica L. (Rubiaceae) var. Obata, Glycine max L. (Fabaceae) var. CIGRAS-06, Phaseolus vulgaris L. (Fabaceae) var. Tayni, Oryza sativa L. (Poaceae) var. Lazarroz FL, and Zea mays L. (Poaceae) var. EJN-2. Tres réplicas técnicas de cinco semillas de cada una de las especies se procesaron con los protocolos BDF y XD, cada réplica en días distintos. Resultados. Las fotomicrografías obtenidas con ambos protocolos mostraron que las muestras mantuvieron la integridad morfológica del embrión, del endospermo o de los cotiledones y de otras estructuras de la semilla. Los protocolos BDF y XD generaron láminas de histología y fotomicrografías. La tinción PAS- azul de Coomassie hizo una buena diferenciación de los carbohidratos y proteínas. La rapidez de ambos protocolos es un beneficio comparado con otros protocolos de histología vegetal que pueden durar varios días o incluso semanas. Conclusiones. Los protocolos BDF y XD fueron adecuados para el análisis histológico de semillas de frijol, café, maíz, papaya y soya en menos de 5 horas. El protocolo BDF es el primero de procesamiento de tejidos vegetales que no usa derivados de benceno e incorpora parafina como medio de inclusión.

Abstract Introduction. Seeds are complex structures that allow the biological and crop propagation of plants. Seed histology can be used for teaching, researching, and for pathological diagnostic. Histology protocols are commonly divided into 5 different stages: fixation, processing, cutting, staining, and mounting. Xylene is a dangerous reagent used during the processing, staining, and mounting of histological specimens that can contaminate the environment and is toxic for users. Objective. To compare two new protocols for seed histology accelerated with microwave, tested on seeds of economic importance species. Materials and methods. The experiments were done between January and May of 2022 at the Centro de Investigaciones en Granos y Semillas (CIGRAS) of the Universidad de Costa Rica. The compared protocols were: a benzene derivatives-free (BDF) and a xylene-dependent (XD). Seeds of Carica papaya L. (Caricaceae) var. Pococí, Coffea arabica L. (Rubiaceae) var. Obata, Glycine max L. (Fabaceae) var. CIGRAS-06, Phaseolus vulgaris L. (Fabaceae) var. Tayni, Oryza sativa L. (Poaceae) var. Lazarroz FL, and Zea mays L. (Poaceae) var. EJN-2 were used. Three technical replicates of five seeds of each species were tested with the XD and BDF protocols, on different days each replicate. Results. The photomicrographs obtained with both protocols showed that the samples maintained the morphology integrity of embryo, endosperm or cotyledons, and other seed structures. BDF and XD protocols produced seed histology slides and microphotographs. PAS-Coomassie Blue staining made a good differentiation of carbohydrates and proteins. Fastness of both protocols is a benefit compared with other protocols for plant histology that can take several days or even weeks. Conclusions. The BDF and XD protocols were suitable for seed histology analysis of bean, coffee, maize, papaya, and soybean, slides were obtained in less than 5 hours. BDF protocol is the first for plant tissue processing that does not use benzene derivatives and that uses paraffin as embedding medium.

Abstract: The primary aim of this study is to translate, adapt, and validate the E-learning Acceptance Measure (EIAM) scale for university students. A questionnaire is designed with three dimensions. The dimension “professor’s quality” is composed of eight items in which students assess their professor’s performance during online learning. The sample consists of 155 students from the University of Granada and the University of Málaga (Spain). The results show that the EAIM scale is a valid and reliable scale to measure students’ acceptance of online learning. This is supported by the goodness of fit indices obtained by using two models. In conclusion, a valid and reliable scale is presented here that meets recent changes in teaching and learning processes while addressing the need of having a tool in Spanish that measures students’ acceptance of online learning.

Resumen: Este estudio tiene como finalidad la traducción, adaptación y validación de la escala Medida de Aceptación del Aprendizaje en Línea (MAAEL) en estudiantes universitarios. Se diseña un cuestionario con tres dimensiones. La dimensión “calidad del docente” se compone de 8 ítems sobre la valoración de la calidad del docente por parte del alumno durante su proceso de aprendizaje online. La muestra consistió en 155 estudiantes de la Universidad de Granada y la Universidad de Málaga (España). Los resultados muestran que la escala de MAAEL es una escala válida y fiable para medir la aceptación del aprendizaje en línea de los estudiantes. Esto queda soportado por los índices de bondad de ajuste obtenidos mediante dos modelos. En conclusión, se presenta aquí una herramienta validad y confiable en español que considera los cambios recientes en procesos de enseñanza y aprendizaje y que mide la aceptación del alumnado al aprendizaje en línea.

Abstract Objective: To report the case of a patient with Glanzmann’s thrombasthenia who receives management with platelet transfusion with activated factor VII and a literature review regarding the treatment and prognosis of this pathology during pregnancy. Method: We present the case of a 27 year old patient with Glanzmann’s thrombasthenia and a 33-week pregnancy, with a cesarean section at term without complications. Medline databases were searched via PubMed, Lilacs, SciELO and ScienceDirect; case reports, case series and bibliographic reviews were included until 2021. Results: A total of 21 articles were found, with 23 reported cases; the pregnancies occurred between the third and fourth decades of life, the majority being patients with anti-platelet antigen antibodies in 43.4% of the cases. The main management was with platelet transfusion. Conclusions: Glanzmann’s thrombasthenia during pregnancy is rare and is associated with hemorrhagic events. The presence of anti-platelet antigen antibodies conditions management with a higher risk of perinatal complications. It does not have a unified therapeutic approach, with platelet transfusion being the management of choice and activated factor VII as second line.

Resumen Objetivo: Reportar el caso de una paciente con trombastenia de Glanzmann que recibe manejo con transfusión de plaquetas con factor VII activado y realizar una revisión de la literatura referente al tratamiento y el pronóstico de esta patología durante la gestación. Método: Se presenta el caso de una paciente de 27 años con trombastenia de Glanzmann y embarazo de 33 semanas, con cesárea al término sin complicaciones. Se realizó una búsqueda en las bases de datos Medline vía PubMed, Lilacs, SciELO y ScienceDirect; se incluyeron reportes de caso, series de casos y revisiones bibliográficas hasta 2021. Resultados: Se encontraron 21 artículos, con 23 casos reportados. Los embarazos se presentaron entre la tercera y la cuarta décadas de la vida, siendo la mayoría pacientes con anticuerpos frente a antígenos plaquetarios (43,4% de los casos). El principal manejo fue con transfusión plaquetaria. Conclusiones: La trombastenia de Glanzmann durante el embarazo es infrecuente y se asocia a eventos hemorrágicos. La presencia de anticuerpos frente a antígenos plaquetarios condiciona el manejo con mayor riesgo de complicaciones perinatales. No tiene un enfoque terapéutico unificado, siendo el de elección la transfusión de plaquetas y como segunda línea el factor VII activado.

Abstract Background: Perioperative management of Tracheal Resection and Reconstruction (TRR) presents many challenges to the physicians involved in airway management. Factors related to postoperative outcomes can be identified as early as the preoperative setting and can even be linked to demographic characteristics of patients affected by tracheal stenosis. The primary aim of this study is to describe the experience of patients undergoing TRR at our hospital from an anesthesiology perspective, describing as a second aim demography, preoperative conditions, and postoperative complications. Method: This was a single institution retrospective review of patients who underwent TRR between 2009 and 2020. We did a post-hoc exploratory analysis to identify possible associations between perioperative complications and perioperative management. Results: Forty-three ASA I-IV adult patients aged 18–72 years who underwent TRR were included. Prolonged intubation (72%) is the primary cause of tracheal stenosis. Intraoperative management: intravenous induction and laryngeal masks are now the most frequently used for airway management, especially in subglottic stenosis. Perioperative complications were vocal cord paralysis (25.6%), postoperative ventilatory support (20.9%), and need for surgical reintervention (20.9%). One patient (2%) died in the postoperative period due to anastomotic complication. After resection, dexmedetomidine is the preferred choice (48.8%) for sedoanalgesia in the ICU. Conclusion: Perioperative management of TRR at our hospital has a low mortality and high morbidity rate. We did not find an association between perioperative anesthetic interventions and postoperative complications. Further studies are needed to evaluate which anesthetic interventions may be associated with better outcomes.

RESUMEN Introducción: La espondiloartritis axial es una enfermedad reumatológica que afecta a individuos jóvenes y tiene una gran repercusión sociolaboral. El retraso en el diagnóstico y el tratamiento se asocia con un mayor deterioro funcional y un impacto negativo en la calidad de vida, por lo que requiere un abordaje multidisciplinario. Objetivo: Desarrollar y formular un conjunto de recomendaciones específicas basadas en la mejor evidencia disponible para la detección temprana, el diagnóstico, el tratamiento y el seguimiento de los pacientes adultos con espondiloartritis axial. Métodos: Se configuró un grupo desarrollador, se formularon preguntas clínicas contestables, se graduaron los desenlaces y se realizó la búsqueda sistemática de la evidencia. El panel de la guía fue multidisciplinario (incluyendo representantes de los pacientes) y balanceado, minimizando el sesgo por conflictos de intereses. Se utilizó la aproximación Grading of Recommendations Assessment, Development and Evaluation (GRADE) para evaluar la calidad de la evidencia, al igual que la dirección y la fortaleza de las recomendaciones. Se presentan 11 recomendaciones relacionadas con diagnóstico (n = 2), tratamiento farmacológico (n = 6), tratamiento no farmacológico (n = 2) y seguimiento (n = 1). Resultados: Se recomienda la radiografía de articulaciones sacroilíacas como primer método diagnóstico, y el uso de escalas de actividad para el seguimiento de los pacientes (ASDAS o BASDAI). Los antiinflamatorios no esteroideos son la primera opción de tratamiento; en caso de intolerancia o dolor residual se recomienda acetaminofén u opioides. En pacientes con compromiso axial se recomienda abstenerse de utilizar medicamentos antirreumáticos modificadores de la enfermedad convencionales ni glucocorticoides sistémicos o locales. En pacientes con falla a los antiinflamatorios no esteroideos, se recomienda un anti-TNFα o un anti-IL17A. En pacientes con falla a anti-TNFα, se recomienda iniciar un anti-IL17A. El ejercicio y la terapia física y ocupacional se recomiendan como parte del tratamiento. Se recomienda no utilizar las terapias no convencionales como única opción de tratamiento. Conclusiones: Este conjunto de recomendaciones proporciona una guía actualizada sobre el diagnóstico y el tratamiento de la espondiloartritis axial.

Abstract Introduction: Axial spondyloarthritis is a rheumatic condition affecting young patients with social and occupational consequences. Diagnosis delay is associated with functional impairment and impact on quality of life, requiring a multidisciplinary approach. Objective: To develop a set of recommendations based on the best available evidence for the early detection, diagnosis, treatment, and monitoring of adult patients with axial spondy-loarthritis. Methods: A working group was established, questions were developed, outcomes were graded, and a systematic search for evidence was conducted. A multidisciplinary panel of members was established (including patient representatives), minimizing bias in relation to conflicts of interest. The GRADE approach "Grading of Recommendations Assessment, Development and Evaluation" was used to assess the quality of the evidence as well as the direction and strength of recommendations. In total, 11 recommendations on diagnosis (n=2), pharmacological treatment (n=6), non-pharmacological treatment (n=2) and monitoring (n=1) are presented. Results: Sacroiliac joint radiography as the first diagnostic method, and the use of disease activity scales for patient monitoring (ASDAS or BASDAI), are recommended. Nonsteroidal anti-inflammatory drugs are the first treatment option; in case of intolerance or residual pain, acetaminophen or opioids are recommended. In patients with axial involvement, it is recommended not to use conventional disease-modifying antirheumatic drugs or systemic or local glucocorticoids. In patients with failure to non-steroidal anti-inflammatory drugs, anti-TNF or anti-IL17A are recommended. In those patients presenting with anti-TNF failure, starting an anti-IL17A is recommended. Exercise, physical and occupational therapy are recommended as part of treatment. It is recommended not to use unconventional therapies as the only treatment option. Conclusions: This set of recommendations provides an updated guideline for the diagnosis, treatment, and monitoring of patients with axial spondyloarthritis.

RESUMEN La deforestación y degradación de bosques, principalmente en áreas con alta densidad de carbono, es una de las más importantes fuentes de gases de efecto invernadero (GEI). El impacto de la deforestación sobre el almacenamiento de carbono en biomasa total y sus emisiones de CO2 es analizado en cuatro coberturas de la tierra en el Santuario de Fauna y Flora Iguaque (SFFI), Boyacá, Colombia. Un total de 32 parcelas temporales de muestreo (PTM) de 250m2 fueron establecidos para medir los árboles con diámetro a la altura del pecho (dap) ( 10 cm. Mientras que 17 PTM de 36m2 fueron establecidas para medir la altura total y de estípite de todos los frailejones (Espeletia boyacensis Cuatrec, E. tunjana Cuatrec and E. cf. Incana). La biomasa arriba y abajo del suelo fue estimada con modelos alométricos, mientras que el carbono fue estimado usando una fracción de 0.47. El área de muestreo fue proporcional al área de cada cobertura: arbustales abiertos (AA), arbustales densos (AD), bosque denso alto de tierra firme (BDATF) y herbazal denso de tierra firme no arbolado (HDTFNA). El BDATF y AD mostraron el mayor almacenamiento de carbono en biomasa total (55 y 27Mg C/ha, respectivamente). El SFFI almacenó cerca de 135.9Gg C, de los cuales 25-38Gg CO2e podrían ser emitidos a la atmósfera en los próximos 20 años. El BDATF y AA son las coberturas con el mayor potencial de emisiones de CO2 a la atmosfera. Por consecuencia, la priorización de la preservación de estos ecosistemas mediante programas de Reducción de Emisiones por Deforestación y Degradación (REDD+) es clase para contrarrestar los efectos climáticos y asegurar el suministro de servicios ecosistémicos que apoyen a los medios de vida de las comunidades locales.

ABSTRACT Deforestation and forest degradation, mainly in areas with high carbon density, is one of the most important source of greenhouse gases (GHG). The impact of deforestation on carbon storage in total biomass and its CO2 emissions is analyzed in four land covers in the Santuario de Fauna y Flora Iguaque (SFFI), Boyacá, Colombia. A total of 32 temporal sampling plots (TSP) of 250m2 was established to measure trees with diameter at breast height (dbh) ( 10 cm whereas 17 TSP of 36m2 were established to measure total and stipe height of all frailejones (Espeletia boyacensis Cuatrec, E. tunjana Cuatrec and E. cf. Incana). Above and belowground biomass was estimated with allometric models, whereas carbon was calculated using a fraction of 0.47. The sampling area was proportional to the area of each land cover: open heathlands and moorlands (OMH), dense heathlands and moorlands (DMH), broad-leaved forest with continuous canopy, not on mire (BFCC), natural grassland prevailingly without trees and shrubs (NSWT). BFCC and DMH showed higher carbon storage in biomass (55 and 27Mg C/ha, respectively). SFFI stored around 135.9Gg C, from which 25-38Gg CO2e could be emitted to the atmosphere in the 20 next years if the deforestation rates continue. BFCC and OMH are the covers with the highest potential of CO2 emissions to the atmosphere. Therefore, prioritizing the preservation of these ecosystems by Reducing Emissions from Deforestation and Degradation (REDD+) programs, is a key to counter the effects of climate change and ensure the supply of ecosystemic services that support local communities’ livelihoods.

RESUMEN El objetivo del estudio fue investigar la relación entre los grupos sanguíneos A, B y O y la mortalidad en pacientes hospitalizados por una infección grave por SARS-CoV-2. La investigación fue observacional retrospectiva en un hospital de tercer nivel en Lima, Perú. Se incluyó a 203 pacientes, con una edad media de 62,58 ± 16,45 años, y el 71,92 % eran varones. La frecuencia de los grupos sanguíneos O, A y B fue del 75,37 %, 17,24 % y 7,39 %, respectivamente. Se encontró asociación con la mortalidad por infección grave por COVID-19 con los grupos sanguíneos que no son A (grupo O, grupo B), con un PR (razón de prevalencia) de 2,25 IC (intervalo de confianza) 95 % 1,07-4,71. Al ajustar por las principales variables, la asociación con RP persistió en 2,78 IC 95 % 1,06-7,24. En conclusión, en los pacientes hospitalizados por una infección grave por SARS-CoV-2, los grupos sanguíneos O y B estarían asociados con una mayor mortalidad que los pacientes del grupo sanguíneo A.

ABSTRACT This study aimed to determine the relationship between ABO blood groups and mortality in patients hospitalized for severe SARS-CoV-2 infection. An observational and retrospective research was conducted in a tertiary care hospital in Lima, Peru. A total of 203 patients with a mean age of 62.58 ± 16.45 years were included in the research, out of whom 71.92 % were males. The frequency of O, A and B blood groups were 75.37 %, 17.24 % and 7.39 %, respectively. An association with mortality from severe COVID-19 infection was found with non-A blood groups (O group or B group), with a PR (prevalence ratio) of 2.25 and 95% CI (confidence interval) of 1.07 - 4.71. When adjusting the main variables, the association with PR remained in 2.78 and 95% CI in 1.06 - 7.24. In conclusion, patients hospitalized for severe SARS-CoV-2 infection with O and B blood groups seem to be associated with higher mortality rates than those with A blood group.

ABSTRACT Background: One of the impact indicators of priorities in health research-setting is the scientific production that refers to these priorities. EsSalud raised nine priority research topics (PRT) and 20 priority research questions (PRQ) for the 2017-2019 period. We assess the alignment to these research priorities in the scientific articles published during the 2017-2020 period by EsSalud, and we characterize those financed by this institution. Material and Methods: Analysis of the scientific articles registered in the EsSalud scientific production database for the period 2017-2020. We used a standardized methodology and in duplicate to evaluate the alignment of a scientific article to the PRT and PRQ 2017-2019 of EsSalud. The evaluation of the alignment to the PRQs is only carried out in original articles and congress summaries. We report alignment frequencies to each PRT and PRQ, and we report the frequency of alignment to at least one PRT according to the articles' characteristics. In addition, the characteristics of the articles financed by EsSalud were reported. Results: 170 out of 1283 articles were aligned to at least one PRT. Eight of the twenty PRQs went unanswered. Articles with authors who belong to or received funding from IETSI-EsSalud had the highest alignment rate. Finally, the highly cited articles financed by EsSalud were mainly observational studies, clinical practice guidelines and systematic reviews. Conclusion: The articles published by EsSalud during 2017 to 2020 have low alignment with institutional research priorities. Furthermore, it is necessary a process of implementation, monitoring, and evaluation of research priorities in the institution.

RESUMEN Introducción: Uno de los indicadores del impacto del establecimiento de prioridades en investigación en salud es la producción científica. EsSalud planteó nueve temas de investigación prioritarios (TIP) y 20 preguntas de investigación prioritarias (PIP) 2017-2019. Evaluamos el alineamiento a estas prioridades de investigación en los artículos científicos publicados con filiación de EsSalud durante 2017-2020, y caracterizamos aquellos financiados por esta institución. Material y Métodos: Análisis de los artículos científicos registrados en la base de datos de producción científica de EsSalud 2017-2020. Empleamos una metodología estandarizada y por duplicado para evaluar el alineamiento a los TIP y PIP 2017-2019 de EsSalud. La evaluación del alineamiento a las PIP sólo lo realizamos en artículos originales y resúmenes de congreso. Reportamos frecuencias de alineamiento a cada TIP y PIP, y frecuencia de alineamiento a por lo menos un TIP según características de los artículos. Además, se reportó las características de los artículos financiados por EsSalud. Resultados: Un total de 170 de 1283 artículos se alinearon a al menos un TIP. Ocho de las veinte PIP no fueron respondidas. Los artículos con autores que pertenecen o recibieron financiamiento del IETSI-EsSalud tuvieron la mayor tasa de alineación. Finalmente, los artículos financiados por EsSalud fueron principalmente estudios observacionales, guías de práctica clínica y revisiones sistemáticas. Conclusión: Los artículos científicos publicados con filiación de EsSalud durante el 2017 al 2020 tienen baja alineación con las prioridades de investigación de la institución. Por lo tanto, es necesario generar un proceso de gestión de implementación, seguimiento y evaluación de las prioridades de investigación en la institución.