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La investigación que se plantea en las líneas subsecuentes, propone estudiar el proceso de urbanización demográfica existente en la estructura poblacional de la villa de Pachuca, a partir de los registros de bautizo parroquiales de la iglesia de Nuestra Señora de La Asunción; los cuales permiten observar periodos diferenciados de crecimiento poblacional, a partir de los repuntes en la estructura demográfica patentes en la primera y segunda mitad del siglo XVIII respectivamente. En dicha tónica, la hipótesis central de este trabajo sostiene que, la villa de Pachuca observó de forma diferencial un proceso de auge demográfico basado en la actividad minera durante la primera mitad del siglo XVIII (1725-1735), y de urbanización demográfica a finales del mismo siglo y principios del siglo XIX (1768-1807). Esto, con fundamento en el análisis de tres variables tomadas de la teoría de Jan De Vries (urbanización demográfica, crecimiento económico y urbanización estructural), a fin de estudiar dicho proceso, verificado a finales del periodo de estudio, el cual da cuenta del alcance e impacto de la implementación de las reformas borbónicas, las cuales establecieron un nuevo orden, el cual impactó al binomio población - estructura urbana, objeto de este estudio.

Introducción. La ingestión por cáusticos es un problema de salud pública a nivel mundial debido a la alta carga de morbilidad, mortalidad y costos. Por eso, es indispensable tener conocimientos claros sobre la situación en la población adulta, sin extrapolar datos de manejo de población pediátrica. Métodos. Se realizó una revisión crítica de la información disponible con el fin de establecer los datos importantes en el manejo de la esofagitis por cáusticos en población adulta, incluyendo un análisis del tipo de ingesta, volumen, intencionalidad y edad, para ayudar a identificar de manera temprana las complicaciones susceptibles de manejo quirúrgico. Resultados. La endoscopia tiene un rol importante en las primeras 24- 48 horas para establecer la severidad del daño según la clasificación de Zargar, que combinada con la clasificación imagenológica permite alcanzar un mejor pronóstico. No hay un beneficio demostrado con el uso de inhibidores de bombas de protones, mitomicina C, sonda nasogástrica o prótesis esofágica para prevenir las estenosis. Los esteroides tienen beneficio en Zargar ≥ 2B (pero con compromiso de vía aérea) y hay datos prometedores con el uso de sucralfato a altas dosis. En complicaciones derivadas de estenosis se prefiere la dilatación con Savary-Guillard de manera temprana. Luego de 10 años de la ingesta se debe hacer seguimiento endoscópico cada 2 -3 años para tamización de cáncer escamocelular de esófago. Conclusión. La esofagitis por cáusticos es una condición con alta carga de morbilidad, cuyo pronóstico depende de las intervenciones tempranas y un manejo y seguimiento multidisciplinario.

El sangrado del intestino delgado es una causa poco frecuente de sangrado en el tracto gastrointestinal. La mayoría de casos son secundarios a angiodisplasias; sin embargo, rara vez se asocia a hemangiomas del intestino delgado, los cuales son una neoplasia vascular benigna que se diagnostica principalmente con cápsula endoscópica y enteroscopia asistida por balón en pacientes estables de forma preoperatoria. Hasta la fecha solo se había publicado un caso con inestabilidad hemodinámica al momento del diagnóstico. Se reporta el caso de una mujer de 21 años que debuta con sangrado agudo y choque hemorrágico secundario a hemangioma capilar del yeyuno, el cual fue diagnosticado mediante una enteroscopia intraoperatoria y manejado con resección quirúrgica de forma exitosa.

Introducción: la endoscopia digestiva alta es el método estándar para diagnosticar el cáncer gástrico en etapas tempranas. Sin embargo, su precisión puede verse afectada por la variabilidad en su realización, y se estiman hasta 20% de tumores no detectados. En Colombia, la mayoría de los diagnósticos se realizan en etapas avanzadas, lo que agrava el problema. Para abordar la variabilidad, se han propuesto protocolos con el fin de asegurar la observación completa de áreas propensas a lesiones premalignas. Objetivo: construir y validar un sistema de auditoría automática para endoscopias usando técnicas de inteligencia artificial. Metodología: en este estudio, 96 pacientes de un hospital universitario se sometieron a endoscopias documentadas en video, abarcando 22 estaciones reorganizadas para minimizar solapamientos y mejorar la identificación de 13 regiones gástricas clave. Se utilizó una red convolucional avanzada para procesar las imágenes, extrayendo características visuales, lo que facilitó el entrenamiento de la inteligencia artificial en la clasificación de estas áreas. Resultados: el modelo, llamado Gastro UNAL, fue entrenado y validado con imágenes de 67 pacientes (70% de los casos) y probado con 29 pacientes distintos (30% de los casos), con lo que alcanzó una sensibilidad promedio del 85,5% y una especificidad del 98,8% en la detección de las 13 regiones gástricas. Conclusiones: la eficacia del modelo sugiere su potencial para asegurar la calidad y precisión de las endoscopias. Este enfoque podría confirmar las regiones evaluadas, alertando puntos ciegos en la exploración a los endoscopistas con menos experiencia o en entrenamiento, de tal forma que se aumente la calidad de estos procedimientos.

In the Orinoco and Amazon regions, a nut from a tree called cacay is cultivated, from which oil and cacay seed cake flour (CF) with promising industrial properties are obtained. The CF composition and flow type of aqueous suspensions of CF were analyzed before and after the pasting test. Also, physical, hydration and spectroscopic properties in the near and mid-infrared region were determined. The results showed that each 100 g of CF contained 34.75 g of protein, 12.46 g of lipids and 20.10 g of dietary fiber. Rheological analysis showed that before and after the pasting test the suspensions had a pseudoplastic type behavior at all concentrations. Furthermore, a significant increase in consistency was observed with increasing concentration. Likewise, it was found that CF had a low water absorption index (4.7 g/g), and a water solubility index in the order of that reported for other flours in the literature. Finally, characteristic bands of CF component vibrations in the near-infrared region were identified as well as secondary structures of proteins such as β-sheet, Random coil, α-helix and β-turns mainly. It is concluded that, due to its nutritional content and techno-functional properties, CF could be used in different applications in the food industry.

Background: Endocrine disruptors (EDs) have emerged as potential contributors to the development of type-2 diabetes. Perfluorooctane sulfonate (PFOS), is one of these EDs linked with chronic diseases and gathered attention due to its widespread in food. Objective: To assess at baseline and after 1-year of follow-up associations between estimated dietary intake (DI) of PFOS, and glucose homeostasis parameters and body-mass-index (BMI) in a senior population of 4600 non-diabetic participants from the PREDIMED-plus study. Methods: Multivariable linear regression models were conducted to assess associations between baseline PFOS-DI at lower bound (LB) and upper bound (UB) established by the EFSA, glucose homeostasis parameters and BMI. Results: Compared to those in the lowest tertile, participants in the highest tertile of baseline PFOS-DI in LB and UB showed higher levels of HbA1c [β-coefficient(CI)] [0.01 %(0.002 to 0.026), and [0.06 mg/dL(0.026 to 0.087), both p-trend ≤ 0.001], and fasting plasma glucose in the LB PFOS-DI [1.05 mg/dL(0.050 to 2.046),p-trend = 0.022]. Prospectively, a positive association between LB of PFOS-DI and BMI [0.06 kg/m2(0.014 to 0.106) per 1-SD increment of energy-adjusted PFOS-DI was shown. Participants in the top tertile showed an increase in HOMA-IR [0.06(0.016 to 0.097), p-trend = 0.005] compared to participants in the reference tertile after 1-year of follow-up. Discussion: This is the first study to explore the association between DI of PFOS and glucose homeostasis. In this study, a high baseline DI of PFOS was associated with a higher levels of fasting plasma glucose and HbA1c and with an increase in HOMA-IR and BMI after 1-year of follow-up.

Background Excessive alcohol consumption has been associated with increased risk of atrial fibrillation, although the underlying mechanisms remain unclear. An enlarged left atrium and impaired left atrial function may lead to atrial fibrillation. The association of alcohol consumption with structural and functional left atrial measures, however, has received limited attention. Methods and Results We studied 503 participants from the PREDIMED‐Plus (Prevención con Dieta Mediterránea) trial, a randomized trial testing intensive weight loss intervention with an energy‐reduced Mediterranean diet and physical activity promotion in preventing cardiovascular disease in adults with metabolic syndrome. Participants underwent transthoracic echocardiography at baseline, year 3, and year 5 of the study. Outcomes of interest included volume index and reservoir, conduit, and contractile strains of the left atrium. Alcohol consumption was calculated through food frequency questionnaires and presented as drinks consumed per day. Multiple linear regression and mixed models estimated the association of alcohol consumption with left atrial measurements at baseline and through follow‐up. Cross‐sectionally, higher alcohol consumption (per 1 drink/day increases) was associated with larger left atrial volume (0.65 mL/m2 [95% CI, 0.18–1.11]) and lower left atrial reservoir and contractile strain (−0.44% [95% CI, −0.87 to −0.01]; and −0.44% [95% CI, −0.75 to −0.14]). Baseline alcohol consumption was not associated with changes in left atrial measurements, but increases in alcohol consumption (per 1 drink/day increase) during follow‐up were associated with left atrial enlargement (0.71 mL/m2 [95% CI, 0.17–1.26]). Conclusions In a population at high cardiovascular risk, increased alcohol consumption was associated with left atrial enlargement and worsening atrial function. Registration URL: http://www.controlled‐trials.com; Unique identifier: ISRCTN89898870.

Se trata del caso de un paciente con estenosis poscáusticas que requirió manejo quirúrgico y cuya anastomosis se estenosó, por lo que requirió dilataciones con Savary, estricturoplastia y terapia de inyección, sin éxito. Ante la recurrencia se decidió darle un entrenamiento para que se hiciera autodilataciones, lo cual fue exitoso dado que le paciente pudo reasumir sus actividades diarias. El reporte de caso muestra, además de las fotos, un video donde se explica paso a paso los métodos que se usaron en el manejo del paciente.

Abstract Background Cross-sectionally, older age and obesity are associated with increased coronavirus disease-2019 (COVID-19) risk. We assessed the longitudinal associations of baseline and changes in adiposity parameters with COVID-19 incidence in older adults at high cardiovascular risk. Methods This analysis included 6874 men and women (aged 55–75 years) with overweight/obesity and metabolic syndrome in the PREDIMED-Plus lifestyle intervention trial for cardiovascular risk reduction. Body weight, body-mass-index (BMI), waist circumference, waist-to-height ratio (WHtR), and a body shape index (ABSI) were measured at baseline and annual follow-up visits. COVID-19 was ascertained by an independent Event Committee until 31 December 2021. Cox regression models were fitted to evaluate the risk of COVID-19 incidence based on baseline adiposity parameters measured 5–6 years before the pandemic and their changes at the visit prior to censoring. Results At the time of censoring, 653 incident COVID-19 cases occurred. Higher baseline body weight, BMI, waist circumference, and WHtR were associated with increased COVID-19 risk. During the follow-up, every unit increase in body weight (HRadj (95%CI): 1.01 (1.00, 1.03)) and BMI (HRadj: 1.04 (1.003, 1.08)) was associated with increased COVID-19 risk. Conclusions In older adults with overweight/obesity, clinically significant weight loss may protect against COVID-19. Trial registration This study is registered at the International Standard Randomized Controlled Trial (ISRCT; http://www.isrctn.com/ISRCTN89898870 ).

Abstract Background Ex vivo lung perfusion (EVLP) constitutes a tool with great research potential due to its advantages over in vivo and in vitro models. Despite its important contribution to lung reconditioning, this technique has the disadvantage of incurring high costs and can induce pulmonary endothelial injury through perfusion and ventilation. The pulmonary endothelium is made up of endothelial glycocalyx (EG), a coating of proteoglycans (PG) on the luminal surface. PGs are glycoproteins linked to terminal sialic acids (Sia) that can affect homeostasis with responses leading to edema formation. This study evaluated the effect of two ex vivo perfusion solutions on lung function and endothelial injury. Methods We divided ten landrace swine into two groups and subjected them to EVLP for 120 min: Group I (n = 5) was perfused with Steen® solution, and Group II (n = 5) was perfused with low-potassium dextran-albumin solution. Ventilatory mechanics, histology, gravimetry, and sialic acid concentrations were evaluated. Results Both groups showed changes in pulmonary vascular resistance and ventilatory mechanics (p

Abstract Background Metabolic syndrome (MetS) has become a growing risk factor of some non-communicable diseases. Increase of greenhouse gas emissions affects the planet. Aims To assess the association between MetS severity and amount of carbon dioxide (CO2) emitted in an adult population. Design Cross-sectional study (n = 6646; 55-76-year-old-men; 60-75-year-old-women with MetS). Methods Dietary habits were assessed using a pre-validated semi quantitative 143-item food frequency questionnaire. The amount of CO2 emitted due to the production of food consumed by person and day was calculated using a European database, and the severity of the MetS was calculated with the MetS Severity Score. Results Higher glycaemia levels were found in people with higher CO2 emissions. The risk of having high severe MetS was related to high CO2 emissions. Conclusions Low CO2 emissions diet would help to reduce MetS severity. Advantages for both health and the environment were found following a more sustainable diet. Trial registration ISRCTN, ISRCTN89898870 . Registered 05 September 2013.

Background In acute pulmonary embolism (PE), echocardiographic identification of right ventricular (RV) dysfunction will inform prognostication and clinical decision-making. Registro Informatizado Enfermedad TromboEmbolica (RIETE) is the world's largest registry of patients with objectively confirmed PE. The reliability of site-reported RV echocardiographic measurements is unknown. We aimed to validate site-reported key RV echocardiographic measurements in the RIETE registry.

La gastrostomía endoscópica percutánea es un procedimiento realizado con alta frecuencia en nuestro medio; por lo general, sus complicaciones son escasas y en su mayoría menores, pero hay un 2,4% de incidencia de complicaciones mayores, en especial el desplazamiento anormal del disco interno de la gastrostomía, conocido como síndrome de Buried Bumper (SBB), y también se pueden presentar infecciones graves, desgarros y fístulas. En este trabajo se presentan 5 casos en los que se ilustran complicaciones graves de la gastrostomía endoscópica percutánea.

Las propiedades funcionales del almidón nativo tienen limitantes en sus propiedades tecnológicas. El almidón, al ser modificado, puede corregir estos problemas y, por lo tanto, mejorar sus propiedades para uso agroindustrial. El objetivo del presente estudio fue evaluar el efecto de las modificaciones con ácido acético e hidróxido de calcio sobre las propiedades funcionales y reológicas del almidón de ñame. Las modificaciones se realizaron agregando al almidón aislado a soluciones con concentraciones de 0.15, 0.20 y 0.30 % p/p de hidróxido de calcio y 5, 10 y 20 % v/v de ácido acético. Una porción de la muestra se dejó como testigo (sin modificar). Para determinar los efectos morfológicos se realizaron análisis de SEM, se analizaron el poder de hinchamiento, el índice de solubilidad en agua y el índice de absorción de agua. A los geles de las muestras se les midió el módulo de almacenamiento (G’), el módulo de pérdida (G’’) y la viscosidad. Con los resultados obtenidos se demostró que la modificación no afectó la superficie de las micropartículas de almidón. Se presentó un aumento en el poder de hinchamiento para los almidones modificados con ácido y una disminución con los tratamientos alcalinos. El índice de solubilidad en agua aumentó con todos los tratamientos. El índice de absorción de agua solamente cambió con los tratamientos 10 % de ácido y 0.30 % de hidróxido. El G’ y G’’ fueron mayores para el almidón nativo que para cualquiera de las modificaciones. De acuerdo con los anteriores resultados se concluyó que los almidones modificados amplían la gama de productos que pueden ser elaborados por los productores de ñame.

Abstract Objective: To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms. Design: An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used. Setting: Spanish older adults with metabolic syndrome (MetS). Participants: A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS. Results: Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)). Conclusions: According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.

Sr. Editor: En el cierre de orejuela izquierda (COI), el acceso venoso es usualmente predecible. Presentamos 2 casos de enfermedad venosa detectada durante el COI y alternativas para su resolución. Ambos pacientes dieron su consentimiento para la publicación. En el caso 1, un varón de 88 años portador de marcapasos, con fibrilación auricular permanente, disfunción ventricular y fractura sacra no reintervenida, fue remitido para COI por hemorragias recidivantes. Previa punción venosa ecoguiada, se avanzó en el sistema transeptal experimentando una notable resistencia en la curvatura ilíaca, dificultad de torsión en la aurícula derecha y pérdida de empuje en la fosa oval (figura 1, vídeos 1-4 del material adicional). Se logró la punción transeptal mediante la parte rígida de una guía de angioplastia de 0,014 pulgadas, intercambiando por la parte flexible y avanzando la vaina hasta la vena pulmonar. Tras el intercambio por la vaina de 14 Fr y el pigtail sobre una guía de alto soporte, se apreció de nuevo una gran resistencia en la retracción y la rotación. No obstante, se logró posicionar en la orejuela y realizar angiografías. En la retirada del pigtail, la resistencia fue muy acusada u se evidenció torsión grave en continuidad con la cirugía lumbosacra previa. Ante...

To the Editor, In left atrial appendage closure (LAAC), venous access is often predictable. These are 2 cases of venous disease found during LAAC and the alternatives proposed for its resolution. Both patients gave their informed consent for publication purposes. In case #1, an 88-year-old man who was a pacemaker carrier, with permanent atrial fibrillation, ventricular dysfunction, and non-surgical sacral fracture was referred for LAAC due to recurrent hemorrhages. Through previous ultrasound-guided venous puncture a transseptal system was advanced that experienced significant resistance in the iliac curvature, difficult torsion at the right atrium, and loss of driving force in the fossa ovalis (figure 1, videos 1-4 of the supplementary data). Transseptal puncture was achieved through the rigid section of a 0.014 in angioplasty guidewire by exchanging the flexible section and advancing the sheath towards the pulmonary vein. Afterwards, it was exchanged for a 14-Fr sheath, and the pigtail catheter was mounted over the high-support guidewire. However, significant resistance during retraction and rotation maneuvers was reported. Nevertheless, it was successfully placed in the left atrial appendage and several angiographies were performed. During pigtail catheter withdrawal, resistance was very significant with evidence of severe torsion following the previous lumbosacral surgery. Since it was impossible to...

Introducción: una buena preparación intestinal es fundamental para una colonoscopia de calidad. Por eso es importante evaluar los factores de riesgo asociados a una mala preparación. Este problema no se ha abordado ampliamente en Colombia, por lo cual el objetivo de este estudio es identificar los factores asociados a una mala preparación intestinal. Métodos: estudio observacional, analítico, transversal, multicéntrico en pacientes > 18 años sometidos a colonoscopia que asistieron a los servicios de gastroenterología entre enero y junio de 2020 en la ciudad de Bogotá. Se definió como buena preparación una escala de Boston > 6, y como mala preparación una escala de Boston ≤ 6. Resultados: se incluyeron a 265 pacientes, de los cuales 205 (77,4%) estaban bien preparados y 60 (22,6%) tenían una preparación inadecuada. Los factores asociados a mala preparación intestinal fueron edad mayor de 60 años (odds ratio [OR]: 1,359; intervalo de confianza [IC] del 95%: 1,059-1,745; p = 0,026); sexo masculino (OR: 1,573; IC 95%: 1,128-2,194; p = 0,012); obesidad (IMC > 30 kg/m2; OR: 2,539; IC 95%: 1,388-4,645; p = 0,002); estreñimiento (OR: 1,924; IC 95%: 1,154-3,208; p = 0,014); el uso de antidepresivos (OR: 2,897; IC 95%: 1,199-6,997; p = 0,014) y antagonistas del calcio (OR: 2,445; IC 95%:1,292-4,630; p = 0,005) y tener cirugías abdominopélvicas (OR: 1,325; IC 95%: 1,042-1,684; p = 0,034). En cuanto al procedimiento, hubo una menor cantidad de detección de pólipos por paciente (p = 0,04) y menor detección de pólipo diminuto (p = 0,020) y plano (p = 0,047) en el grupo de mala preparación intestinal. Conclusiones: este es el primer estudio en Colombia en el cual se describen los factores asociados a la mala preparación intestinal e incluye variables no exploradas en otros estudios. Los resultados encontrados son similares a los reportados en la literatura. Se debe impulsar este tipo de estudios con una mayor cantidad de pacientes y plantear un puntaje de predicción de mala preparación.

Abstract Background Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment. Aim To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population. Design and population Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed. Methods Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expressed in kg/day: Q1 (≤2.01 kg CO2), Q2 (2.02-2.34 kg CO2), Q3 (2.35-2.79 kg CO2) and Q4 (≥2.80 kg CO2). Results More men than women induced higher dietary levels of CO2 emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO2 through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO2 emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference). Conclusions The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO2 emissions. Mediterranean Diet index may be used as a pollution level index.

Abstract Buildings are one of the largest consumers of electrical energy, making it important to develop different strategies to help to reduce electricity consumption. Building energy consumption forecasting strategies are widely used to support demand management decisions, but these strategies require large data sets to achieve an accurate electric consumption forecast, so they are not commonly used for buildings with a short history of record keeping. Based on this, the objective of this study is to determine, through continuous hourly electricity consumption forecasting strategies, the amount of data needed to achieve an accurate forecast. The proposed forecasting strategies were evaluated with Random Forest, eXtreme Gradient Boost, Convolutional Neural Network, and Temporal Convolutional Network algorithms using 4 years of electricity consumption data from two buildings located on the campus of the University of Valladolid. For performance evaluation, two scenarios were proposed for each of the proposed forecasting strategies. The results showed that for forecasting horizons of 1 week, it was possible to obtain a mean absolute percentage error (MAPE) below 7% for Building 1 and a MAPE below 10% for Building 2 with 6 months of data, while for a forecast horizon of 1 month, it was possible to obtain a MAPE below 10% for Building 1 and below 11% for Building 2 with 10 months of data. However, if the distribution of the data captured in the buildings does not undergo sudden changes, the decision tree algorithms obtain better results. However, if there are sudden changes, deep learning algorithms are a better choice.