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En el presente trabajo se estudia el fenómeno jurídico de la sustitución de la constitución, el cual se presenta cuando un elemento definitorio de la esencia de la Constitución de 1991, en lugar de ser modificado, es reemplazado por uno opuesto o integralmente diferente. En este orden de ideas, la sustitución de la constitución es una figura creada por la Corte Constitucional de Colombia mediante la sentencia C-551 de 2003. Así pues, el objetivo del trabajo se orienta a identificar el origen y desarrollo de la teoría de la sustitución de la constitución en la jurisprudencia constitucional.

espanolEn el presente articulo se estudia el control fiscal establecido en la Constitucion Politica de Colombia desde un enfoque hermeneutico juridico, a partir del analisis de los principales fundamentos y modalidades de este mecanismo de control, tales como el control posterior y el concomitante frente a los actos y decisiones de la administracion publica. Posteriormente se pasara a identificar algunos de los principios que guian la ejecucion de esta actividad de control, para luego plantear la incorporacion de la vigilancia fiscal dentro del sistema de pesos y contrapesos. Por ultimo, se concluye que el control fiscal es un mecanismo constitucional para proteger el patrimonio publico en el marco de un ejercicio activo del principio de pesos y contrapesos y la intervencion ciudadana. EnglishIn this article, the fiscal oversight established in the Political Constitution of Colombia is studied from a legal hermeneutic approach, from the analysis of the main foundations and modalities of this control mechanism, such as subsequent and concomitant control against acts and decisions of the public administration. Subsequently, some of the principles that guide the execution of this control activity will be identified, and then the identification of fiscal surveillance within the system of checks and balances will be planted. Finally, it is concluded that fiscal control is a constitutional mechanism to protect public patrimony within the framework of an active exercise of the principle of checks and balances and citizen intervention.

RESUMEN Introducción: La fibromialgia es una causa común de dolor crónico en el mundo, con una prevalencia en la población general del 0,2% al 6,4%. Estos pacientes tienen una mayor probabilidad de presentar trastornos neuropsiquiátricos. El objetivo fue describir el perfil sociodemográfico y clínico de pacientes con fibromialgia y comorbilidad neuropsiquiátrica. Métodos: Estudio transversal, descriptivo. Se recolectó información de las historias clínicas de pacientes con fibromialgia y comorbilidad neuropsiquiátrica, de una institución especializada en Antioquia, durante los años 2010 al 2016. Se aplicaron herramientas de estadística descriptiva. Resultados: De 1.106 registros médicos con diagnóstico confirmado de fibromialgia, 497 presentaban comorbilidad neuropsiquiátrica. La mediana de edad fue de 54 años (RIC 15), la mayoría eran mujeres, residían en zona urbana y estaban casados o convivían con su pareja. Estatus socioeconómico bajo-medio y nivel educativo básico-medio, fueron los más reportados. Los síntomas más frecuentes fueron alteraciones del sueño (70,6%), mialgias (66,4%) y fatiga crónica (55,9%). Los trastornos neuropsiquiátricos más frecuentes fueron depresión (85,7%), migraña (35%) y ansiedad (14,7%). Los fármacos más utilizados fueron los inhibidores de la recaptación de serotonina y duales, acetaminofén y gabaérgicos. Manejo con terapias complementarias e intervención psicológica se observaron en baja proporción. Conclusiones: La fibromialgia y las enfermedades neuropsiquiátricas son patologías que coexisten con frecuencia; la presentación sociodemográfica y clínica es similar a lo descrito en la literatura, sin embargo, la presencia de depresión en esta población fue mayor. Un enfoque terapéutico transdisciplinario, favorecería la calidad de vida de los pacientes y el curso de la enfermedad. ABSTRACT Introduction: Fibromyalgia is a common cause of chronic pain in the world, with a prevalence of 0.2% to 6.4% in the general population. These patients are more likely to have neuropsychiatric disorders. The objective of this study was to describe the sociodemographic and clinical profile of patients with fibromyalgia and neuropsychiatric comorbidity. Methods: A cross-sectional, descriptive study was conducted in which Information was collected from the medical records of patients with fibromyalgia and neuropsychiatric comorbidity, from specialist institution in Antioquia, during the years 2010 to 2016. Descriptive statistics tools were applied. Results: Of the 1,106 medical records with a confirmed diagnosis of fibromyalgia, 497 had neuropsychiatric comorbidity. The median age was 54 years (IQR 15), and the majority were women, residing in an urban area, and were married or living with their partner. Low-medium socioeconomic status and basic-medium educational level were the most reported. The most frequent symptoms were sleep disturbances (70.6%), myalgia (66.4%), and chronic fatigue (55.9%). The most frequent neuropsychiatric disorders were depression (85.7%), migraine (35%), and anxiety (14.7%). The most commonly used drugs were serotonin and dual reuptake inhibitors, acetaminophen, and GABAergic drugs. A low percentage was managed with complementary therapies and psychological intervention. Conclusions: Fibromyalgia and neuropsychiatric diseases are diseases that frequently coexist. Although the sociodemographic and clinical presentation is as described in the literature, the presence of depression was greater in this population. A multidisciplinary therapeutic approach would favour the quality of life of the patients and the course of the disease.

Introduction Fibromyalgia is a common cause of chronic pain in the world, with a prevalence of 0.2–6.4% in the general population. These patients are more likely to have neuropsychiatric disorders. The objective of this study was to describe the sociodemographic and clinical profile of patients with fibromyalgia and neuropsychiatric comorbidity. Methods A cross-sectional, descriptive study was conducted in which Information was collected from the medical records of patients with fibromyalgia and neuropsychiatric comorbidity, from specialist institution in Antioquia, during the years 2010 to 2016. Descriptive statistics tools were applied. Results Of the 1106 medical records with a confirmed diagnosis of fibromyalgia, 497 had neuropsychiatric comorbidity. The median age was 54 years (IQR 15), and the majority were women, residing in an urban area, and were married or living with their partner. Low-medium socioeconomic status and basic-medium educational level were the most reported. The most frequent symptoms were sleep disturbances (70.6%), myalgia (66.4%), and chronic fatigue (55.9%). The most frequent neuropsychiatric disorders were depression (85.7%), migraine (35%), and anxiety (14.7%). The most commonly used drugs were serotonin and dual reuptake inhibitors, acetaminophen, and GABAergic drugs. A low percentage was managed with complementary therapies and psychological intervention. Conclusions Fibromyalgia and neuropsychiatric diseases are diseases that frequently coexist. Although the sociodemographic and clinical presentation is as described in the literature, the presence of depression was greater in this population. A multidisciplinary therapeutic approach would favor the quality of life of the patients and the course of the disease.

In this article, the fiscal oversight established in the Political Constitution of Colombia is studied from a legal hermeneutic approach, from the analysis of the main foundations and modalities of this control mechanism, such as subsequent and concomitant control against acts and decisions of the public administration. Subsequently, some of the principles that guide the execution of this control activity will be identified, and then the identification of fiscal surveillance within the system of checks and balances will be planted. Finally, it is concluded that fiscal control is a constitutional mechanism to protect public patrimony within the framework of an active exercise of the principle of checks and balances and citizen intervention., En el presente artículo se estudia el control fiscal establecido en la Constitución Política de Colombia desde un enfoque hermenéutico jurídico, a partir del análisis de los principales fundamentos y modalidades de este mecanismo de control, tales como el control posterior y el concomitante frente a los actos y decisiones de la administración pública. Posteriormente se pasará a identificar algunos de los principios que guían la ejecución de esta actividad de control, para luego plantear la incorporación de la vigilancia fiscal dentro del sistema de pesos y contrapesos. Por último, se concluye que el control fiscal es un mecanismo constitucional para proteger el patrimonio público en el marco de un ejercicio activo del principio de pesos y contrapesos y la intervención ciudadana.

La investigación realizada pretender analizar el impacto que tiene la ausencia de pausas saludables en las incapacidades relacionadas con DME de la columna, de los trabajadores de línea de frente de una de las sedes de una empresa de servicios de salud ubicada en la ciudad de Bogotá, durante el segundo semestre del año 2019. El tipo de investigación es cuantitativo no experimental transeccional-correlacional. Se obtiene que la patología con mayor afectación es la lumbalgia con un 62% de las incapacidades tabuladas, seguido de la cervicalgia con un 31% y, por último, la dorsalgia con 7%. The research carried out aims to analyze the impact that the absence of healthy pauses has in the disabilities related to DME of the spine, of the front line workers of one of the headquarters of a health services company located in the city of Bogotá, during the second semester of 2019. The type of research is quantitative non-experimental transectional-correlational. It is obtained that the pathology with the greatest affectation is low back pain with 62% of the tabulated disabilities, followed by neck pain with 31% and, finally, back pain with 7%. Planteamiento del Problema 5 Descripción del Problema (Contextualización) 5 Tabla 1 7 Pregunta de Investigación 8 Objetivo General 8 Objetivos Específicos 8 Justificación 9 Tabla 2 9 Marcos de Referencia 14 Estado de Arte 14 Marco Teórico 29 ¿Cómo funcionan las EPS? 29 Tipos de EPS en Colombia 30 Figura 1 31 Patología 32 Pausas Activas o Pausas Saludables 35 Pausas Activas de Calistenia 35 Pausas Activas Mentales 36 Pausas Activas de Estiramiento y/o Fortalecimiento Muscular 36 Pausas Activas Recreativas 36 Pausas Saludables Preparatorias 37 Pausas Saludables Compensatorias 37 Pausa Saludable de Relajación 37 Movimiento Articular 37 Estiramientos 38 Mentales y Visuales 38 Beneficios Fisiológicos 39 Beneficios Psicológicos 39 Beneficios Sociales 40 Beneficios Organizacionales 40 Marco Legal 43 Marco Metodológico 44 Paradigma 44 Tipo y Diseño de la Investigación 45 Tabla 3 49 Tabla 4 49 Técnica de Análisis de Instrumentos 50 Fases de investigación 51 Hipótesis 51 Resultados 53 Tabla 5 53 Figura 2 54 Tabla 6 54 Tabla 7 55 Tabla 8 56 Figura 3 56 Tabla 9 58 Figura 4 58 Análisis de Resultados 59 Conclusiones 64 Recomendaciones 65 Bibliografía 67 ANEXOS 72 Anexo 1 72 Figura 5 72 Figura 6 72 Figura 7 73 Figura 8 74 Figura 9 74 Anexo 2 75 Especialización Especialista en Gerencia de la Seguridad y Salud en el Trabajo

En este estudio se presenta un análisis sobre el alcance del concepto de paz, especialmente como proceso político y sobre quién debe decidir definitivamente sobre la aprobación de un proceso de paz, para lo cual se hace referencia general al caso colombiano. El artículo se desarrolla desde un enfoque jurídico en dos partes. La primera, examina los principales elementos del concepto de paz en el marco de un Estado social de derecho; la segunda, explora la función de la revisión judicial y la democracia (popular o legislativa) en la aprobación o no de un acuerdo de paz, así como postula quién es el legitimado para adoptar estas decisiones. Finalmente, se expone una breve conclusión sobre la necesidad de que prime la práctica democrática popular. Al efecto, se utiliza un método bibliográfico, así como analítico descriptivo con un enfoque cualitativo y hermenéutico.

Background Pediatric-onset Systemic Erythematosus Lupus (pSLE) is known to be more aggressive than adult-onset SLE. The disease is extremely rare under the age of 5 years and with severe course. Another big difference is the association of pSLE with monogenic primary immune deficiencies (PID). Some PIDs have been associated with SLE or lupus-like manifestations: deficiencies of the classical complement pathway, female carriers of X-linked chronic granulomatous disease, IgA deficiency (present in 5% of pSLE). It is important to consider PIDs in patients with severe manifestations in pSLE, in our country there are no studies of this association. Objectives To describe the clinical manifestations, laboratory features, characteristics and therapeutics of patients with diagnosis of SLE before 6 years of age at National Institute of Pediatrics in Mexico City Methods This is a retrospective study with the review of the patient’s records with diagnosis of SLE before 6 years old, from the Immunology department between January 2005 and December 2016 at National Institute of Pediatrics in Mexico City. Results Between 2005-2016 there were 295 newly patients diagnosed with pediatric Systemic Lupus Erythematosus (pSLE) at our hospital, from these patients 2.7% (8) were diagnosed with pSLE before 6 years of age. According to this, 7 (87.5%) were female. The youngest patient was 26 months at moment of diagnosis. Every patient had at least 4 criteria of the ACR classification for SLE. Only 2 (25%) had malar rash at diagnosis, and 1 (12.5%) presented discoid rash. Seventy-five percent of patients presented glomerulonephritis at diagnosis and also 75% had an Hematological disorder. In terms of serology, 37.5% had positive native DNA antibody, 37.5% antibody to Sm protein and 37.5% antiphospholipid antibodies. One hundred percent of patients had presence of antinuclear antibody (ANA) at moment of diagnosis. Conclusion During 2005-2016 we found 295 newly patients with diagnosis of pediatric Systemic Erythematosus Lupus (pSLE), from these, eight patients (2.7%) were diagnosed before 6 years of age. Seventy-five percent presented recurrent infections and 50% with severe infections, and one patient died due to septic shock. Systemic erythematosus lupus with an early onset has a more severe phenotype and has been associated with monogenic primary immune deficiency, presenting with severe infections and higher mortality. In our country, we do not have genetic testing to help us determine the endless monogenic defects associated with early-onset SLE, being necessary to determine etiology and specific treatment as needed. We recommended that in every patient with severe pSLE who develops life-threatening, infections or due to unusual germs, associated with hypocomplementemia and/or consanguinity, to perform an approach to rule out any primary immune deficiency. References [1] Levy, D. Kamphuis Systemic Lupus Erythematosus in Children and Adolescents. Pediatr Clin North Am. 2012April; 59(2): 345–364 [2] F.Rivas-Larrauri, M.A.Yamazaki-Nakashimada. Lupus eritematoso sistemico: ?es una sola enfermedad?Reumatol Clin. 2016;12(5):274–281 [3] Carneiro M, Understanding Systemic Lupus Erythematosus Physiopathology in the Light of Primary Immunodeficiencies J Clin Immunol (2008) 28 (Suppl 1):S34–S41 [4] G. Tsokos, K. Sullivan, New insights into de immunopathogenesis of systemic lupus erythematosus. Nature Reviews (2016) 10.1038 Disclosure of Interests None declared

Background Fibromyalgia is a common cause of chronic musculoskeletal pain in the world, with diverse clinical manifestations and with a ruinous effect on the quality of life of patients. The estimations of prevalence in the general population are very variable (0.2% - 6.4%) as well as the clinical presentation. Objectives This study aims to describe the sociodemographic and clinical characteristics of patients with fibromyalgia treated in a specialized institution between 2010 and 2016, in Medellin, Colombia. Methods We performed a retrospective, descriptive, secondary source study of patients diagnosed with fibromyalgia from a specialized institution between 2010 and 2016. Descriptive statistics and period prevalence tools were applied for the variables studied, among which was evaluated the use of the diagnostic criteria (1990 or 2010) of the American College of Rheumatology. Results We evaluated 1106 records of patients diagnosed with fibromyalgia. The median age was 54 years (IQR 16), the age of greatest presentation is between 40 and 65 years for both sexes, 95.1% were women and a 51.1% were married or living with their partner. 23.6% of the patients had a basic and middle level education (secondary and technological level), 93% of the population came from the department of Antioquia (for a prevalence for this institution in the period 2010 to 2016 of 0.017%), and 54% resided in the city of Medellin. The proportion of people with low and medium low socioeconomic status was 26.3%, while 41.4% reported being active in a job. The symptoms most frequently presented among the patients were myalgia (70.2%), sleep disturbances (59.9%), chronic fatigue (48.5%), headache (47.3%) and muscular weakness (40.5%). When analyzing by sex, headaches were more frequent in women (48.8%) than in men (24.1%). The most commonly reported comorbidities were psychiatric disorders (31.1%, where depression was the most recorded with 24.1%), migraine (30.9%) and hypertension (27.9%). The most used criteria to make the diagnosis of fibromyalgia were those of 1990 with 62.2%. Regarding treatment, the most used were serotonin reuptake inhibitors and dual inhibitors (52.6%), along with acetaminophen (41.2%) and pregabalin (39%); only 8.2% of patients received non-pharmacological interventions (physical and psychological therapy). Conclusion Fibromyalgia is an important pathology in specialized medical consultation, accompanied by myalgia, sleep disturbances, chronic fatigue, headaches and muscle weakness. Psychiatric pathologies are the most frequently associated comorbidities and the 2010 criteria of the American College of Rheumatology are not yet widely applied. The treatment of fibromyalgia is complex and probably more effective with a transdisciplinary approach involving both pharmacological and non-pharmacological interventions. References [1] Wolfe F, Walitt B, Perrot S, Rasker JJ, Hauser W. Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. PLoS One [Internet]. Public Library of Science; 2018 Sep 13; 13(9): e0203755. [2] Marques AP, Santo AdSdE, Berssaneti AA, Matsutani LA, Yuan SLK. Prevalence of fibromyalgia: literature review update. Revista Brasileira de Reumatologia (English Edition). 2017;57(4):356-63. [3] Hauser W, Ablin J, Fitzcharles M-A, Littlejohn G, Luciano JV, Usui C, et al. Fibromyalgia. Nature Reviews Disease Primers. 2015;1:15022. [4] Queiroz LP. Worldwide epidemiology of fibromyalgia. Current pain and headache reports. 2013;17(8):356. Acknowledgement This study was financed with funds from CONADI of the Universidad Cooperativa de Colombia. [Reference: 2042] Disclosure of Interests None declared

Resumen En algunos Estados altamente garantistas, a la libertad de información y a la libertad de expresión, quizás por el temor de sus gobiernos a caer en cualquier tipo de censura, se le ha dejado un amplio margen considerativo respecto a su legislación al punto de creerse jurídicamente que se da un desequilibrio en su ejecución respecto de otra pluralidad de derechos fundamentales, enmarcados en el Debido Proceso. Abstract In some States, which provide high protection of the right of information and freedom of expression, most likely out of fear of their governments falling into any form of censorship, there is a wide margin of consideration with regard to their legislation which has reached the point of creating the judicial belief that there is an imbalance in their execution with respect to another fundamental right, such as the right to Due Process. Résumé Dans certains États hautement garanties, la liberté d'information et la liberté d'expression, peut-être à cause de la crainte de leurs gouvernements de tomber dans une forme de censure, ont laissé une grande marge de manœuvre concernant leur législation, au point de se croire juridiquement qui conduit à un déséquilibre dans son exécution d'accord d'autre pluralité de droits fondamentaux encadré dans le procédure régulière. Resumo Em alguns Estados altamente garantistas, à liberdade de informação e à liberdade de expressão, quiçá pelo temor de seus governos a cair em qualquer tipo de censura, tem-lhe deixado uma ampla margem considerativo com respeito a sua legislação no ponto de crer-se juridicamente que se dá um desequilíbrio em sua execução respeito de outra pluralidade de direitos fundamentais, enquadrados no Devido Processo.

En la monografía se analizará los factores que han afectado el pluralismo político como lineamiento fundamental para generar una cultura política y participación ciudadana efectiva en la democracia, teniendo como referencia las elecciones parlamentarias del año 2014. Así mismo, se identificarán los componentes fundamentales para la elaboración de una política pública en Colombia que pueda servir de guía para éste u otro periodo de gobierno. Así las cosas, se evidencia que en el País las políticas públicas se formulan como propuestas débiles respondiendo a solucionar diferentes problemas del momento y no atacan la causa raíz, como deberían ser en un contexto de política madura y transparente. Por ende, al ser reformas que responden a la solución de problemas en momentos determinados, se afecta la estructura del Estado y de sus instituciones. En este sentido, es importante analizar los factores que han afectado el pluralismo político como lineamiento esencial para generar una cultura política y participación ciudadana efectiva en la democracia, permitiendo dejar una guía a los próximos gobiernos para la elaboración de una Política Pública en Colombia en esta materia a través de la identificación de los componentes fundamentales. The monograph will analyze the factors that have affected political pluralism as a fundamental guideline to generate a political culture and effective citizen participation in democracy, taking as reference the parliamentary elections of 2014. Likewise, the fundamental components for the elaboration will be identified of a public policy in Colombia that can serve as a guide for this or another period of government. Thus, it is evident that in the country public policies are formulated as weak proposals responding to solve different problems of the moment and do not attack the root cause, as they should be in a mature and transparent policy context. Therefore, being reforms that respond to the solution of problems at certain times, the structure of the State and its institutions is affected. In this sense, it is important to analyze the factors that have affected political pluralism as an essential guideline to generate a political culture and effective citizen participation in democracy, allowing to leave a guide to the next governments for the elaboration of a Public Policy in Colombia in this matter through the identification of the fundamental components.

En el presente escrito se hace una descripción analítica de algunos de los principales elementos que componen la denominada cláusula democrática en la Constitución política de Colombia, partiendo de la premisa según la cual es componente necesario para la calidad de la democracia. Al efecto se estructurarán conceptos y fundamentos que se consideran centrales en esta propuesta, para así obtener una conclusión sobre lo indagado.

Dentro de los grupos armados vinculados en el conflicto político que existe en Colombia desde la década de los sesenta hasta la fecha, han sido partícipes las Fuerzas Armadas Revolucionarias de Colombia FARC, Unión Camilista- Ejército de Liberación Nacional UC-ELN, Ejército Popular de Liberación EPL, Movimiento 19 de abril M-19, Autodefensas Unidas de Colombia AUC, entre otros; además de grupos llamados de ultraderecha y militares al servicio del Estado. Se sostiene entonces que la violencia política se originó en diversos factores relacionados con los problemas agrarios, la exclusión política, la inequidad, etc.; causas que a mediados del siglo XX confluyeron para la conformación de los grupos subversivos y, por ende, para la gestación del conflicto armado interno más largo en la historia del mundo. Para el desarrollo del texto se utilizó el método bibliográfico o documental que consistió en recopilar, organizar, sistematizar y analizar la información encontrada en libros, sentencias, artículos, etc., sobre la violencia política en Colombia. Como conclusión se dirá que el Estado colombiano se encuentra en vilo y, por ende, requiere solucionar definitivamente el conflicto armado que padece.