280 results on '"Cristina Sierra"'
Search Results
2. Twenty-four-hour ambulatory blood pressure monitoring–from silent to whispering brain damage
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Teodora Yaneva-Sirakova, Ivo Petrov, Latchezar Traykov, Antonio Coca, Pedro G. Cunha, Dariusz Gasecki, Bushra Farukh, Vasilios Kotsis, Augusto Vicario, Efstathis Manios, Cristina Sierra, and Dagmara Hering
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hypertension ,blood pressure ,ambulatory blood pressure monitoring ,brain damage ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2023
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3. Is there sufficient evidence to justify changes in dietary habits in heart failure patients? A systematic review
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Alejandra García-García, Luis A. Alvarez-Sala-Walther, Hae-Young Lee, Cristina Sierra, Domingo Pascual-Figal, and Miguel Camafort
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heart failure ,diet ,sodium-restricted ,diet therapy ,Medicine - Abstract
The incidence and prevalence of heart failure (HF) is increasing worldwide, leading to high morbidity and mortality. The global management of HF involves lifestyle changes in addition to pharmacological treatments. Changes include exercise and dietary recommendations, mainly salt and fluid restriction, but without any clear evidence. We conducted a systematic review to analyse the degree of evidence for these dietary recommendations in HF. Only randomized controlled trials (RCT), and observational studies in humans were selected. Studies were considered eligible if they included participants with HF and sodium and/or fluid restriction. Publications in languages other than English or Spanish were excluded. We included 15 studies related to sodium or fluid restriction. Nine RCT and six observational studies showed some improvements in symptoms and quality of life and a degree of reduction in new hospitalizations, but the results are based on limited population groups, applying different methodologies, and with different restriction goals. We found a lack of clear evidence of the benefits of sodium/fluid restriction in chronic HF. The evidence is limited to few studies with conflicting results. Randomized clinical trials are needed to fill this gap in our knowledge.
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- 2022
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4. The Role of Arterial Stiffness in the Estimation of Cardiovascular Risk in Liver Transplant Recipients
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Lydia Sastre, MD, Raquel García, RN, Julián-Gonzalo Gándara, MD, Patricia Fernández-Llama, MD, Antonio J. Amor, MD, Cristina Sierra, MD, Laia Escudé, MD, Pablo Ruiz, MD, Jordi Colmenero, MD, Emilio Ortega, MD, Miquel Navasa, MD, and Gonzalo Crespo, MD
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Surgery ,RD1-811 - Abstract
Background. Long-term cardiovascular (CV) events are a frequent cause of death and disability after liver transplant (LT). Although a more in-depth, risk-adapted control of CV risk factors may result in improved post-LT CV outcomes, an accurate stratification of the CV risk of LT recipients to better implement preventive strategies is lacking. Aortic pulse wave velocity (aPWV) is a surrogate of arterial stiffness that has been suggested as a biomarker of CV risk; it has never been evaluated in adult LT recipients. Methods. In a single-center prospective study, we included 122 LT recipients at 12 (n = 39), 60 (n = 45), or 120 (n = 38) mo after LT. aPWV estimation by oscillometry, clinical assessment of CV risk factors, and CV risk estimation by standard clinical scores (systematic coronary risk evaluation and pooled cohort equation) were performed. The incidence of CV events during prospective follow-up was registered. Results. aPWV was independently associated with age and the grade of control of blood pressure. After a median follow-up of 35 mo, 15 patients (12%) presented a CV event. Higher aPWV, diabetes, past or present smoking habit, previous CV events, lower eGFR, being in systematic coronary risk evaluation or pooled cohort equation high-risk groups, and higher levels of total cholesterol, LDL-cholesterol, creatinine, and triglycerides were associated with the incidence of CV events at univariate analysis; aPWV, past or present smoking habit, and triglycerides were independent predictors of CV events. Conclusions. According to our results, aPWV mirrors CV risk in LT recipients and thus may be a useful CV risk biomarker in this population. Considering these preliminary results, its accuracy in stratifying risk requires confirmation in further studies.
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- 2022
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5. Effect of blood contamination of cerebrospinal fluid on amino acids, biogenic amines, pterins and vitamins
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Marta Batllori, Mercedes Casado, Cristina Sierra, Maria del Carmen Salgado, Laura Marti-Sanchez, Joan Maynou, Guerau Fernandez, Angels Garcia-Cazorla, Aida Ormazabal, Marta Molero-Luis, and Rafael Artuch
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Cerebrospinal fluid ,Amino acids ,Biogenic amines ,Pterins ,Vitamins ,Blood contamination ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background Cerebrospinal fluid (CSF) metabolomic investigations are a powerful tool for studying neurometabolic diseases. We aimed to assess the effect of CSF contamination with blood on the concentrations of selected biomarkers. Methods CSF samples were spiked in duplicate with increasing volumes of whole blood under two conditions: (A) pooled CSF spiked with fresh whole blood and frozen to cause red blood cell (RBC) lysis; (B) pooled CSF spiked with fresh blood and centrifuged (the supernatant with no RBCs was frozen until the moment of analysis). CSF concentrations of amino acids, biogenic amines, pterins, and vitamins were analysed by HPLC coupled with tandem mass spectrometry, electrochemical and fluorescence detection. Results Aspartate, glutamate, taurine, ornithine, glycine, citrulline, pyridoxal 5´-phosphate, 5-methyltetrahydrofolate, and thiamine showed higher values when RBCs were lysed when compared with those of CSF with no RBC, while arginine, 5-hydroxyindoleacetic and homovanillic acids showed lower values. When RBCs were removed from CSF, only some amino acids, thiamine and pyridoxal 5´-phosphate showed moderately higher values when compared with the non-spiked CSF sample. Conclusions CSF-targeted metabolomic analysis is feasible even when substantial RBC contamination of CSF has occurred since CSF centrifugation to remove RBC prior to freezing eliminated most of the interferences observed.
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- 2019
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6. Una experiencia de innovación docente: el debate académico en Administración de Empresas
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Francisca Orihuela-Gallardo and Cristina Sierra-Casanova
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Innovación docente, debate universitario ,competencias transversales ,rendimiento ,asistencia a clase ,satisfacción ,Education - Abstract
Este trabajo muestra una experiencia en la que se ha planteado el debate académico como elemento motivador y dinamizador en el aula, además de canalizador en la adquisición y mejora de las competencias asociadas a la asignatura “Administración de Empresas” del Grado en Relaciones Laborales y Recursos Humanos de la UCA, en un contexto caracterizado por un alumnado que muestra apatía, falta de asistencia y participación en clase y con algunas dificultades a la hora de abordar y afrontar la realización de trabajos genuinos y realizados en equipo. Como resultados cabe destacar el interés despertado entre el alumnado, mostrando una alta satisfacción y una mejora tanto en su percepción sobre el nivel de competencias adquiridos como en las calificaciones finales obtenidas.
- Published
- 2020
7. Hypertension and the Risk of Dementia
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Cristina Sierra
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essential hypertension ,cognitive function ,cognitive impairment ,dementia ,high blood pressure ,antihypertensive treatment ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Hypertension, particularly midlife high blood pressure, has been related to a higher risk of cognitive decline and dementia, including Alzheimer disease. However, these associations are complex and not fully elucidated. Cerebral small vessel disease emerges as one of the most important causes. Several observational studies have shown the potential beneficial role of antihypertensive treatment in preventing cognitive decline. However, randomized clinical trials (RCTs) have shown controversial results without proving nor disproving the association. On the other hand, in very elderly or frail people some studies have observed a relationship between low blood pressure and worse cognitive function. The optimal systolic and diastolic blood pressure values for protecting cognitive function, especially in elderly people, are not known.
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- 2020
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8. White matter microstructural damage in early treated phenylketonuric patients
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María Julieta González, Mónica Rebollo Polo, Pablo Ripollés, Rosa Gassió, Aída Ormazabal, Cristina Sierra, Roser Colomé Roura, Rafael Artuch, and Jaume Campistol
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Neuroimaging ,Phenylketonuria ,Paediatric ,Early treatment ,Diffusion tensor imaging ,Urine monoamines ,Medicine - Abstract
Abstract Background Despite dietary intervention, individuals with early treated phenylketonuria (ETPKU) could present neurocognitive deficits and white matter (WM) abnormalities. The aim of the present study was to evaluate the microstructural integrity of WM pathways across the whole brain in a cohort of paediatric ETPKU patients compared with healthy controls (HCs), by collecting DTI-MRI (diffusion tensor magnetic resonance imaging) data and diffusion values (mean diffusivity (MD), radial diffusivity (RD) and fractional anisotropy (FA)). Methods DTI-MRI data and diffusion values (MD, RD, FA) from WM tracts across the whole brain were analized using Tract Based Spatial Statistics (TBSS), in 15 paediatrics TPKU patients (median age: 12 years) and compared with 11 HCs. Areas showing abnormal values in the patient group were correlated (Pearson) with age, lifetime Phe values, last year median and mean Phe, concurrent Phe values in plasma, urine neurotransmitters status biomarkers, and with a processing speed task. Results ETPKU showed bilaterally decreased MD values compared with HCs in the body and splenium of the corpus callosum, superior longitudinal fasciculus, corona radiata and in the posterior limb of the internal capsule. RD values followed a similar pattern, although decreased RD values in PKU patients were also found in the anterior limb of the internal capsule and in the cerebral peduncle. Decreased MD and RD values within the aforementioned regions had significant negative correlations with age, last year median and mean Phe and concurrent Phe values. No correlations were found with monoamines in urine or processing speed task. Conclusions ETPKU patients showed MD and RD values significantly decreased across the whole brain when compared with HCs, and this damage was associated with high Phe values and the age of patients. Despite this microstructural damage, no affectation in processing speed was observed in patients with good metabolic control. DTI-MRI sequences could be used as a technique to quantify WM damage that is difficult to be detect in T1 or T2-weighted images, but also to quantify damage of WM through the follow up of patients with poor metabolic control in prospective studies.
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- 2018
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9. Cuff-Based Oscillometric Central and Brachial Blood Pressures Obtained Through ABPM are Similarly Associated with Renal Organ Damage in Arterial Hypertension
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Patricia Fernández-Llama, Júlia Pareja, Sergi Yun, Susana Vázquez, Anna Oliveras, Pedro Armario, Pedro Blanch, Francesca Calero, Cristina Sierra, and Alejandro de la Sierra
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Aortic blood pressure ,Albuminuria ,Glomerular filtration rate ,Dermatology ,RL1-803 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background/Aims: Central blood pressure (BP) has been suggested to be a better estimator of hypertension-associated risks. We aimed to evaluate the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of renal organ damage in hypertensive patients. Methods: Brachial and central (calculated by an oscillometric system through brachial pulse wave analysis) office BP and ambulatory BP monitoring (ABPM) data and aortic pulse wave velocity (PWV) were measured in 208 hypertensive patients. Renal organ damage was evaluated by means of the albumin to creatinine ratio and the estimated glomerular filtration rate. Results: Fifty-four patients (25.9%) were affected by renal organ damage, displaying either microalbuminuria (urinary albumin excretion ≥30 mg/g creatinine) or an estimated glomerular filtration rate (eGFR)
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- 2017
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10. Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
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Jürgen Rehm, Peter Anderson, Jose Angel Arbesu Prieto, Iain Armstrong, Henri-Jean Aubin, Michael Bachmann, Nuria Bastida Bastus, Carlos Brotons, Robyn Burton, Manuel Cardoso, Joan Colom, Daniel Duprez, Gerrit Gmel, Antoni Gual, Ludwig Kraus, Reinhold Kreutz, Helena Liira, Jakob Manthey, Lars Møller, Ľubomír Okruhlica, Michael Roerecke, Emanuele Scafato, Bernd Schulte, Lidia Segura-Garcia, Kevin David Shield, Cristina Sierra, Konstantin Vyshinskiy, Marcin Wojnar, and José Zarco
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Hypertension ,Blood pressure ,Alcohol use ,Primary healthcare ,Europe ,Screening ,Medicine - Abstract
Abstract Background Hazardous and harmful alcohol use and high blood pressure are central risk factors related to premature non-communicable disease (NCD) mortality worldwide. A reduction in the prevalence of both risk factors has been suggested as a route to reach the global NCD targets. This study aims to highlight that screening and interventions for hypertension and hazardous and harmful alcohol use in primary healthcare can contribute substantially to achieving the NCD targets. Methods A consensus conference based on systematic reviews, meta-analyses, clinical guidelines, experimental studies, and statistical modelling which had been presented and discussed in five preparatory meetings, was undertaken. Specifically, we modelled changes in blood pressure distributions and potential lives saved for the five largest European countries if screening and appropriate intervention rates in primary healthcare settings were increased. Recommendations to handle alcohol-induced hypertension in primary healthcare settings were derived at the conference, and their degree of evidence was graded. Results Screening and appropriate interventions for hazardous alcohol use and use disorders could lower blood pressure levels, but there is a lack in implementing these measures in European primary healthcare. Recommendations included (1) an increase in screening for hypertension (evidence grade: high), (2) an increase in screening and brief advice on hazardous and harmful drinking for people with newly detected hypertension by physicians, nurses, and other healthcare professionals (evidence grade: high), (3) the conduct of clinical management of less severe alcohol use disorders for incident people with hypertension in primary healthcare (evidence grade: moderate), and (4) screening for alcohol use in hypertension that is not well controlled (evidence grade: moderate). The first three measures were estimated to result in a decreased hypertension prevalence and hundreds of saved lives annually in the examined countries. Conclusions The implementation of the outlined recommendations could contribute to reducing the burden associated with hypertension and hazardous and harmful alcohol use and thus to achievement of the NCD targets. Implementation should be conducted in controlled settings with evaluation, including, but not limited to, economic evaluation.
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- 2017
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11. Early detection and management of the high-risk patient with elevated blood pressure
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Cristina Sierra and Alejandro de la Sierra
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Cristina Sierra, Alejandro de la SierraHypertension Unit, Department of Internal Medicine, Hospital Clinic. University of Barcelona, SpainAbstract: Severe or important blood pressure elevations are associated with the risk of cardiovascular disease. However, a significant proportion of myocardial infarctions and strokes occur in subjects with only slight elevations or even with normal blood pressure. Both the coexistence of other cardiovascular risk factors, such as diabetes or dyslipidemia, or those recently recognized, such as elevations of C-reactive protein or abdominal obesity and metabolic syndrome, or the presence of target organ damage, such as microalbuminuria, left ventricular hypertrophy, mild renal dysfunction or increased intima-media thickness, all indicate the existence of a high cardiovascular risk in mild hypertensives or in subjects with normal or high-normal blood pressure. Unfortunately, these high-risk patients are often not recognized and thus under-treated. The 2003 European Societies of Hypertension and Cardiology guidelines emphasize the importance of a complete risk assessment and stratifi cation in subjects at all blood pressure categories. The search for other cardiovascular risk factors and target organ damage should be encouraged. Identification of these high-risk patients may allow an earlier indication for antihypertensive treatment and for correction of all cardiovascular risk factors. The objective would be to impair the progression or to induce the regression of silent vascular damage before a clinical event develops.Keywords: essential hypertension, target organ damage, cardiovascular risk
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- 2008
12. Visión del maltrato al anciano desde atención primaria Primary care doctors' and nurses' opinion of elder abuse and neglect
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Coma Montserrat, Julio Muñoz, Pilar Postigo, Manuela Ayuso, Cristina Sierra, and Teresa Sayrol
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Maltrato ,Anciano ,Cualitativo ,Elder abuse ,Elderly person ,Qualitative research ,Public aspects of medicine ,RA1-1270 - Abstract
Objetivo: Identificar la opinión de los profesionales sanitarios de atención primaria (AP) sobre el maltrato al anciano (MA) y su abordaje, mediante un estudio cualitativo de grupos focales. Sujetos y métodos: Participaron 27 sanitarios de AP. Se llevó a cabo un análisis del contenido temático de los datos, la codificación, la segmentación y la creación de categorías del corpus textual. Resultados: Consideraron más frecuentes los abusos psicológicos y económicos. La negligencia se relacionó con el estilo de vida actual. Los abusos físicos y sexuales se consideraron anecdóticos, aunque posiblemente infradiagnosticados. Entre los factores de riesgo destacan la desestructuración familiar, la sobrecarga, la escasa formación del cuidador y la hostilidad del anciano. El maltratador se asoció con determinadas variables, como enfermedad mental, drogodependencia, violencia familiar previa en abusos físicos y económicos; no había un perfil definido en situaciones de negligencia o abandono. Los recursos sociales y sanitarios son insuficientes y limitan la intervención, haciendo infructuosa la detección. La formación, la supervisión y el asesoramiento de los profesionales respecto al MA se consideraron recursos necesarios puesto que, con apoyos externos y bien coordinados, la AP podría actuar eficazmente en estas situaciones. Conclusiones: Aunque los profesionales demostraron un buen conocimiento del problema, se puso de manifiesto la necesidad de disponer de pautas consensuadas de detección e intervención. Afloraron carencias de recursos y dificultades en la delimitación de responsabilidades en el abordaje del MA, que han de tenerse en cuenta a la hora de planificar estrategias. Los profesionales se consideraron a sí mismos un recurso de actuación sin rehuir su implicación.Objective: To identify primary care health professionals' opinion of elder abuse and its management. Qualitative study through focus groups. Participants: Twenty-seven health professionals in primary care. Analyses of the thematic content of data, codification, segmentation and creation of categories of the text corpus. Results: The most frequent types of abuse were psychological and financial. Neglect was associated with current lifestyles. Physical and sexual abuse was considered infrequent, but possibly under-detected. Important risk factors were dysfunctional families, stressed and under-trained caregivers, and elder hostility. The profile of the abuser was associated with mental disorders, drug addiction and prior family violence in physical and financial abuse, but no clear profile was identified in the categories of neglect and abandonment. Social and health resources were insufficient and limited intervention, thus making detection fruitless. Education, monitoring and counseling of health professionals in elder abuse was considered necessary because, given external and well coordinated support, primary care could intervene effectively in situations of elder abuse. Conclusions: Although the phenomenon of elder abuse is well known, consensus guidelines for its detection and intervention need to be defined. The lack of resources and the difficulties of delimiting responsibilities in the management of elder abuse should be taken into account when planning strategies. The health professionals considered themselves as a resource and did not avoid involvement.
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- 2007
13. White Matter Lesions and Cognitive Impairment as Silent Cerebral Disease in Hypertension
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Cristina Sierra and Antonio Coca
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Technology ,Medicine ,Science - Abstract
Although the pathogenesis and clinical significance of cerebral white matter lesions remain controversial, it is well established that age and hypertension are the most important factors related to the presence of these lesions. Hypertension is known to be the most important factor for developing stroke and vascular dementia. In addition, the presence of cerebral white matter lesions is an important prognostic factor for the development of stroke, and also for cognitive impairment and dementia. The mechanisms underlying hypertension-related cognitive changes are complex and are not yet fully understood. Correlations between cerebral white matter lesions and elevated blood pressure provide indirect evidence that structural and functional changes in the brain over time may lead to lowered cognitive functioning when blood pressure control is poor or lacking.Some authors have suggested that the presence of white matter lesions in hypertensive patients could be considered an early marker of brain damage.
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- 2006
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14. Erratum to: Review and evaluation of the methodological quality of the existing guidelines and recommendations for inherited neurometabolic disorders
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Linda Cassis, Elisenda Cortès-Saladelafont, Marta Molero-Luis, Delia Yubero, Maria Julieta González, Aida Ormazábal, Carme Fons, Cristina Jou, Cristina Sierra, Esperanza Castejon Ponce, Federico Ramos, Judith Armstrong, M. Mar O’Callaghan, Mercedes Casado, Raquel Montero, Silvia Meavilla-Olivas, Rafael Artuch, Ivo Barić, Franco Bartoloni, Cinzia Maria Bellettato, Fedele Bonifazi, Adriana Ceci, Ljerka Cvitanović-Šojat, Christine I. Dali, Francesca D’Avanzo, Ksenija Fumic, Viviana Giannuzzi, Christina Lampe, Maurizio Scarpa, and Ángels Garcia-Cazorla
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Medicine - Published
- 2016
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15. Diabetes and Stroke Prevention: A Review
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Jonathan Hewitt, Luis Castilla Guerra, María del Carmen Fernández-Moreno, and Cristina Sierra
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Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Stroke and diabetes mellitus are two separate conditions which share multiple common threads. Both are increasing in prevalence, both are diseases which affect blood vessels, and both are associated with other vascular risk factors, such as hypertension and dyslipidemia. Abnormal glucose regulation, of which diabetes is one manifestation, is seen in up to two-thirds of people suffering from an acute stroke. Surprisingly, aggressive management of glucose after an acute stroke has not been shown to improve outcome or reduce the incidence of further strokes. More encouragingly, active management of other cardiovascular risk factors has been demonstrated to prevent stroke disease and improve outcome following a stroke in the diabetic person. Hypertension should be treated with a target of 140/80 mmHg, as a maximum. The drug of choice would be an ACE inhibitor, although the priority is blood pressure reduction regardless of the medication chosen. Lipids should be treated with a statin whatever the starting cholesterol. Antiplatelet treatment is also essential but there are no specific recommendations for the diabetic person. As these conditions become more prevalent it is imperative that the right treatment is offered for both primary and secondary prevention in diabetic people, in order to prevent disease and minimize disability.
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- 2012
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16. Connecting Cerebral White Matter Lesions and Hypertensive Target Organ Damage
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Cristina Sierra, Alfons López-Soto, and Antonio Coca
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Geriatrics ,RC952-954.6 - Abstract
Chronic hypertension leads to concomitant remodeling of the cardiac and vascular systems and various organs, especially the brain, kidney, and retina. The brain is an early target of organ damage due to high blood pressure, which is the major modifiable risk factor for stroke and small vessel disease. Stroke is the second leading cause of death and the number one cause of disability worldwide and over 80% of strokes occur in the elderly. Preclinical hypertensive lesions in most target organs are clearly identified: left ventricular hypertrophy for the heart, microalbuminuria for the kidney, fundus abnormalities for the eye, and intima-media thickness and pulse wave velocity for the vessels. However, early hypertensive brain damage is not fully studied due to difficulties in access and the expense of techniques. After age, hypertension is the most-important risk factor for cerebral white matter lesions, which are an important prognostic factor for stroke, cognitive impairment, dementia, and death. Studies have shown an association between white matter lesions and a number of extracranial systems affected by high BP and also suggest that correct antihypertensive treatment could slow white matter lesions progression. There is strong evidence that cerebral white matter lesions in hypertensive patients should be considered a silent early marker of brain damage.
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- 2011
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17. Associations between Ambulatory Blood Pressure Parameters and Cerebral White Matter Lesions
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Cristina Sierra
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Silent cerebral white matter lesions (WMLs) are a common finding on magnetic resonance imaging of the brain in the elderly. However, in patients with hypertension, WMLs tend to occur earlier in life and appear to be more severe. There is a body of evidence that supports the idea that WMLs in asymptomatic hypertensive patients should be considered a silent early marker of brain damage. It is known that ambulatory blood pressure monitoring (ABPM) correlates more closely with hypertension-related organ damage than office blood pressure. This paper focuses on the associations between blood pressure parameters obtained by 24-hour ABMP and cerebral WMLs.
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- 2011
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18. PERCEPÇÃO DE MULHERES ATLETAS QUE VIVENCIARAM A GESTAÇÃO
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Costa, Maria Antonia Ramos, primary, Carvalho, Carla Eduarda dos Santos, additional, Soares, João Pedro Rodrigues, additional, Labegalini, Célia Maria Gomes, additional, Peruzzo, Hellen Emília, additional, Christinelli, Heloá Costa Borim, additional, Melo, Willian Augusto de, additional, Spigolon, Dandara Novakowski, additional, Souza, Flávia Cristina Sierra de, additional, Pesce, Giovanna Brichi, additional, Varela, Patrícia Louise Rodrigues, additional, and Borim, Maria Luiza Costa, additional
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- 2023
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19. CONSUMO DE ALIMENTOS CONSIDERADOS MARCADORES DE PADRÕES SAUDÁVEIS EM INDIVÍDUOS COM E SEM DÉFICIT COGNITIVO
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Souza, Flávia Cristina Sierra de, primary, Bennemann, Rose Mari, additional, Milani, Rute Grossi, additional, Silva, Eraldo Schunk, additional, Labegalini, Célia Maria Gomes, additional, Christinelli, Heloá Costa Borim, additional, Costa, Maria Antonia Ramos, additional, Stevanato, Kely Paviani, additional, Spigolon, Dandara Novakowski, additional, Pesce, Giovanna Brichi, additional, Varela, Patrícia Louise Rodrigues, additional, and Spigolon, Lara Novakowski, additional
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- 2023
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20. Universidade aberta para pessoa idosa: ações e contribuições da enfermagem
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Antonia Ramos Costa, Maria, primary, Maria Gomes Labegalini, Celia, additional, Costa Borim Christinelli, Heloá, additional, Pissioli Lourenço, Mariana, additional, Cristina Sierra de Souza, Flávia, additional, Francisqueti Marquete, Verônica, additional, and Regina Dias Pereira, Cássia, additional
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- 2023
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21. EduKhándonos para la vida: bienestar y ciudadanía
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Nancy Lizeth Ramírez-Roncancio, Virgelina Castellanos-Páez, Lady Mayerli Vergara-Estupiñán, David Eduardo Cuesta-Bernal, Andrea Pilar del Hernández-Angarita, Gina Alejandra Díaz-Espinosa, Aura Cristina Sierra-Ariza, Liseth Natalia Camargo-Castillo, Laura Daniela López-Arévalo, Dilsa Yamile Rodríguez and Nancy Lizeth Ramírez-Roncancio, Virgelina Castellanos-Páez, Lady Mayerli Vergara-Estupiñán, David Eduardo Cuesta-Bernal, Andrea Pilar del Hernández-Angarita, Gina Alejandra Díaz-Espinosa, Aura Cristina Sierra-Ariza, Liseth Natalia Camargo-Castillo, Laura Daniela López-Arévalo, Dilsa Yamile Rodríguez
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- 2023
22. Violencias de género: entre la guerra y la paz
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Sánchez Muñoz, Cristina, Sierra González, Ángela, Maquieira D'Angelo, Virginia and Sánchez Muñoz, Cristina, Sierra González, Ángela, Maquieira D'Angelo, Virginia
- Published
- 2021
23. IDENTIFICACION DE TENDENCIAS DE OFERTA Y DEMANDA TURISTICA EN EL CANTON IBARRA
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Francisco, Vallejos Cazar Alex, Merlo, Oswaldo Xavier Torres, Morán, Johana Cristina Sierra, Yaselga, Andrés Roberto León, and Zumba, Gina Real
- Published
- 2019
24. Repensemos Coderch a través de una experiencia etnográfica
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Noé Gras Aura, Laia Rutllant Guàrdia, Ana Maria Hernández López, Iván Timoteo Berzosa, and Cristina Sierra Caraballo
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Materials Chemistry - Abstract
La Casa Coderch de Sant Feliu de Codines, diseñada por el prestigioso arquitecto Josep Antoni Coderch en 1972 representa una perfecta unión entre el funcionalismo que profesaba el propio arquitecto y la modernidad. Su relevancia arquitectónica, cultural y patrimonial destaca frente a su poco conocimiento fuera de la arquitectura. Dentro de este marco, en el presente artículo los estudiantes del seminario de teorías e investigaciones avanzadas del grado de Antropología Social y Cultural de la Universidad Autónoma de Barcelona quieren narrar su experiencia etnográfica en la aproximación que realizaron a la casa.
- Published
- 2022
25. The 2021 guidelines on the diagnosis of von Willebrand disease: A comparison with current clinical practice in Spanish centers
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María Teresa Álvarez‐Román, Cristina Sierra‐Aisa, and Víctor Jiménez‐Yuste
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Hematology ,General Medicine ,Genetics (clinical) - Published
- 2023
26. Perceived quality of life and associated factors in long COVID syndrome among older Brazilians: A cross‐sectional study.
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Salci, Maria Aparecida, Carreira, Lígia, Baccon, Wanessa Cristina, Marques, Francielle Renata Danielli Martins, Höring, Carla Franciele, Oliveira, Magda Lúcia Félix de, Milan, Natália Simeão, de Souza, Flávia Cristina Sierra, Gallo, Adriana Martins, Covre, Eduardo Rocha, Dixe, Maria Anjos, Querido, Ana, Vissoci, João Ricardo Nickenig, Facchini, Luiz Augusto, and Laranjeira, Carlos
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PERSONALITY ,MUSCULOSKELETAL system diseases ,WELL-being ,COVID-19 ,POST-acute COVID-19 syndrome ,CROSS-sectional method ,MULTIPLE regression analysis ,SELF-evaluation ,BEHAVIOR ,RACE ,HOME ownership ,SURVEYS ,SCREEN time ,QUALITY of life ,SYMPTOMS ,EMPLOYMENT ,RESEARCH funding ,DESCRIPTIVE statistics ,SOCIODEMOGRAPHIC factors ,ANXIETY ,DATA analysis software ,BRAZILIANS ,OLD age - Abstract
Aims and objectives: This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL. Background: Given the inherent vulnerabilities of the ageing process, the older people are an at‐risk group for both contagion of SARS‐CoV‐2 and the perpetuation of residual symptoms after infection, the so‐called long COVID or post‐COVID syndrome. Design: A cross‐sectional survey design using the STROBE checklist. Methods: Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL. Results: The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID‐19 survivors. Conclusions: Knowledge about the persistence of physical, emotional, and social symptoms of COVID‐19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society. Relevance to clinical practice: Given the novelty of long‐COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns. Patient or Public Contribution: No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Effect of a repeated educational intervention versus an initial intervention on blood pressure control in hypertensive patients
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Dolors, Estrada, Rosa Mª, Soriano, Ana Isabel, Jordán, Carolina, Fernández, Miguel, Camafort, and Cristina, Sierra
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Male ,Time Factors ,Hypertension ,Humans ,Blood Pressure ,Female ,General Medicine ,Antihypertensive Agents ,Aged ,Body Mass Index - Abstract
Hypertension is one of the main cardiovascular risk factors. An educational intervention, aimed at increasing or reinforcing the patient's knowledge, can contribute to better control of their blood pressure. Our goal was to evaluate the efficacy of a continuing therapeutic education versus an initial intervention in hypertensive patients.Experimental study of multicenter community intervention, through the application of a therapeutic education program in hypertension.980 patients on antihypertensive treatment were included, 490 in each group, with a mean age of 65 years, and 50% women, baseline mean SBP in both groups was136 mmHg. Regarding knowledge about hypertension, although a similar initial improvement was observed in both groups, at the end of the study, in the continuous intervention group (CIG) an average of 23.06 correct answers was observed, while in the Initial intervention group (IIG) the mean was 20.91, being the difference statistically significant (p0.001). At the end of the study, the mean SBP was 127.5 mmHg in the CIG and 136.57 mmHg in the IIG group. Likewise, a lower percentage of patients with a BMI ≥25 was observed in the CIG (78.2%) than in the IIG 82.6%, this difference being statistically significant (p0.001). This same effect was observed on the abdominal perimeter, observing an increased abdominal perimeter in 46.3% of the CIG compared to 68.8% in the IIG (p0.001). CONCLUSIóN: A continuous educational intervention increases the degree of knowledge about hypertension compared to an initial intervention. Likewise, this intervention is associated with an improvement in blood pressure, weight, body mass index and abdominal girth figures.
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- 2022
28. Efecto de una intervención educativa repetida frente a una intervención inicial sobre el control de la presión arterial en pacientes hipertensos
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Ana Isabel Jordán, Miguel Camafort, Cristina Sierra, Dolors Estrada, Rosa M.a Real Soriano, and Carolina Fernández
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Blood pressure control ,Gynecology ,medicine.medical_specialty ,business.industry ,Medicine ,General Medicine ,business - Abstract
Resumen Introduccion y objetivos La hipertension es uno de los principales factores de riesgo cardiovascular. Una intervencion educativa, destinada a aumentar o reforzar los conocimientos del paciente, puede contribuir a un mejor control de su presion arterial. Nuestro objetivo fue evaluar la eficacia de una educacion terapeutica continuada frente a una intervencion inicial en hipertensos. Metodos Estudio experimental, de intervencion comunitaria multicentrica, mediante la aplicacion de un programa de educacion terapeutica en hipertension arterial (HTA). Resultados Se incluyeron 980 pacientes en tratamiento antihipertensivo, 490 en cada grupo, con edad media de 65 anos, y un 50% mujeres siendo la presion arterial sistolica (PAS) media inicial en ambos grupos de 136 mmHg. Respecto a los conocimientos sobre la hipertension, aunque se observo una mejoria inicial similar en ambos grupos, al finalizar el estudio, en el grupo de intervencion continuado (GIC) se observo una media de 23,06 respuestas acertadas, mientras que en el grupo de intervencion inicial (GII) la media fue de 20,91, siendo la diferencia estadisticamente significativa (p Conclusion Una intervencion educativa continuada aumenta el grado de conocimiento sobre la hipertension respecto a una intervencion inicial. Asimismo, esta intervencion se asocia a una mejoria en las cifras de presion arterial, peso, indice de masa corporal y perimetro abdominal.
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- 2022
29. Perceived quality of life and associated factors in long COVID syndrome among older Brazilians: A cross‐sectional study
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Salci, Maria Aparecida, primary, Carreira, Lígia, additional, Baccon, Wanessa Cristina, additional, Marques, Francielle Renata Danielli Martins, additional, Höring, Carla Franciele, additional, Oliveira, Magda Lúcia Félix de, additional, Milan, Natália Simeão, additional, de Souza, Flávia Cristina Sierra, additional, Gallo, Adriana Martins, additional, Covre, Eduardo Rocha, additional, Dixe, Maria Anjos, additional, Querido, Ana, additional, Vissoci, João Ricardo Nickenig, additional, Facchini, Luiz Augusto, additional, and Laranjeira, Carlos, additional
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- 2023
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30. Imagen de Responsabilidad Social Corporativa e Intención de Compra Millennial
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Lucirene Rangel-Lyne, Jessica Ivonne Hinojosa-López, and Johana Cristina Sierra-Morán
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El objetivo de investigación es analizar los efectos del altruismo y la credibilidad en las percepciones de la imagen de RSC, y a la vez, la influencia de ésta sobre en la intención de compra. El método consistió en un análisis de ecuaciones estructurales con una muestra de 309 jóvenes universitarios. Los hallazgos sugieren que cuando las comunicaciones de RSC son percibidas como legítimas, el consumidor crea una percepción altruista y creíble, potenciando una imagen socialmente responsable que motiva la intención de compra millennial. La originalidad consiste en presentar un análisis de la generación millennials quienes se muestran como una tendencia socialmente responsable. La principal limitación es la inclusión de millenials universitarios de una sola universidad
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- 2022
31. Perceived quality of life and associated factors in long <scp>COVID</scp> syndrome among older Brazilians: A cross‐sectional study
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Maria Aparecida Salci, Lígia Carreira, Wanessa Cristina Baccon, Francielle Renata Danielli Martins Marques, Carla Franciele Höring, Magda Lúcia Félix de Oliveira, Natália Simeão Milan, Flávia Cristina Sierra de Souza, Adriana Martins Gallo, Eduardo Rocha Covre, Maria Anjos Dixe, Ana Querido, João Ricardo Nickenig Vissoci, Luiz Augusto Facchini, and Carlos Laranjeira
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General Medicine ,General Nursing - Published
- 2023
32. EduKhándonos para la vida: bienestar y ciudadanía
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Nancy Lizeth Ramírez-Roncancio, Virgelina Castellanos-Páez, Lady Mayerli Vergara-Estupiñán, David Eduardo Cuesta-Bernal, Andrea del Pilar Hernández-Angarita, Gina Alejandra Díaz-Espinosa, Aura Cristina Sierra-Ariza, Liseth Natalia Camargo-Castillo, Laura Daniela López-Arévalo, Dilsa Yamile Rodríguez Ochoa, and Nelly Estella Pardo Espejo
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La estrategia ‘Edu K hándonos para la Vida: bienestar y ciudadanía’ surge del ejercicio reflexivo de las coordinadoras de esta colección académica sobre las prácticas psicológicas en el área educativa. Actividad que evidencia la necesidad de abordar con los diversos agentes escolares el fortalecimiento de factores protectores, que se orienten a favorecer el crecimiento personal y a mejorar el ajuste en niños y adolescente en diferentes esferas de funcionamiento. Su construcción aborda como eje central la comprensión del desarrollo psicológico como un proceso complejo, no lineal, dinámico, multidimensional, caracterizado por la relación dialéctica entre factores externos e internos, a través de la cual se entienden las transformaciones y se captura la variabilidad del desarrollo psicológico. La estrategia está conformada por 5 tomos constituidos por doce sesiones, cada sesión con un tiempo de aplicación estimado entre 90 a 120 minutos. Los tomos se organizan ofreciendo las generalidades de la estrategia, el factor protector privilegiado (identidad personal; autoeficacia; vínculo afectivo; pensamiento crítico; resolución de problemas; regulación emocional; comunicación asertiva; identidad colectiva; manejo emocional y pensamiento creativo), las nociones centrales que fundamentan teóricamente el desarrollo de las sesiones, las técnicas necesarias para aplicación y la descripción de diez sesiones dirigidas a estudiantes, una sesión para el trabajo con padres/cuidadores y otra para el trabajo con docentes. Cada sesión cuenta con: objetivo(s), meta(s), indicadores, habilidades para ser fortalecidas, descripción de la sesión, tiempo de ejecución, tarea de refuerzo y herramientas tanto para la evaluación como el seguimiento.
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- 2023
33. Consejo de administración e innovación empresarial
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Johana Cristina Sierra Morán, Cabeza García, Laura, González Álvarez, Nuria, Organizacion de Empresa, and Facultad de Ciencias Economicas y Empresariales
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5311 Organización y Dirección de Empresas ,Empresas ,Características del Consejo de Administración - Abstract
262 p. [ES] Considerando el papel que el consejo de administración puede jugar a la hora de adoptar las decisiones estratégicas en una empresa, tales como la innovación, en esta tesis doctoral se ha analizado el rol de este órgano de gobierno como determinante de la innovación empresarial y como elemento moderador de la relación entre la innovación y el valor de la empresa. Para ello, en primer lugar, se realizó una exhaustiva revisión de la literatura previa sobre consejo de administración e innovación para identificar posibles preguntas de investigación aún no resueltas en los estudios existentes, y plantear así los objetivos e hipótesis a contrastar. En este sentido, después del Capítulo introductorio en donde se contextualiza la temática objeto de análisis y se presentan los principales conceptos y los objetivos de este estudio, en el Capítulo 1 se integran los resultados de la revisión de la literatura en un meta-análisis considerando las características del consejo de administración más frecuentemente utilizadas en los estudios previos, agrupadas, por un lado, en aquellas que distinguen a un consejo de otro tales como su tamaño, composición (internos, externos e independientes), participación accionarial de los consejeros, acumulación de los cargos de máximo directivo y de presidente del consejo (dualidad) y frecuencia de reuniones bajo la denominación de diversidad estructural. Por otro lado, se agrupan aquellas características a nivel individual y que difieren de un consejero a otro (género, capital social, antigüedad en el cargo y edad) bajo la denominación de diversidad demográfica. Al igual que con las características del consejo, los diferentes tipos de innovación se agruparon en inputs (recursos e incentivos que se destinan a financiar las tareas innovadoras) y outputs o resultados de dichas actividades innovadoras (nuevos productos, procesos, patentes, citas de patentes, entre otros). Esto permite concluir que varios elementos del consejo pueden influir en la innovación empresarial dependiendo de la dimensión de la innovación analizada (inputs u outputs). Los resultados del meta-análisis sugieren que la diversidad estructural del consejo se asocia positivamente con los outputs de la innovación (excepto en el caso de la participación accionarial, cuya asociación es negativa). En cuanto a la relación entre la diversidad estructural y los inputs, destacan dos asociaciones: una asociación negativa con el tamaño del consejo y una asociación positiva con la dualidad. En lo que respecta a la diversidad demográfica, se encuentra una asociación positiva entre el género y el capital social con los inputs de innovación. También existe una asociación positiva entre la permanencia en el cargo de los consejeros y los outputs de la innovación. En el Capítulo 2, se ha estudiado el efecto del consejo de administración sobre la innovación empresarial en el contexto español. Concretamente se ha analizado como influye la independencia del consejo sobre la innovación en una muestra de 124 empresas españolas para el periodo 2008-2019. Considerando que la independencia del consejo es una de las recomendaciones de gobierno corporativo más frecuentes en los códigos de buen gobierno y que a su vez el meta-análisis previo puso de manifiesto que es una de las variables que también la literatura previa más ha vinculado a la innovación, se decidió profundizar en ella y contrastar si el hecho de ser un consejero independiente es suficiente para determinar la innovación empresarial (medida como el número de patentes) o si la diversidad a nivel individual de cada consejero independiente (en términos de diversidad de género y de nacionalidad) puede a ayudar a entender mejor el efecto de la independencia del consejo sobre la innovación. A partir de un análisis binomial negativo de datos de panel se concluye que los consejeros independientes parecen tener un efecto negativo sobre la innovación empresarial. Sin embargo, cuando hay altos niveles de diversidad de género y nacionalidad entre dichos consejeros independientes, este efecto negativo disminuye. En otras palabras, no solo basta con ser un consejero independiente para fomentar la innovación, sino que también hacen falta una serie de características únicas que cada individuo aporta gracias a sus relaciones personales, sus experiencias, su forma de analizar y resolver los problemas, y que permiten mejorar el proceso de toma de decisiones relacionadas con la innovación. En el Capítulo 3, se ha investigado si el consejo de administración, además de ejercer un efecto directo sobre la innovación, puede jugar también un papel moderador en la relación entre la innovación y el desempeño empresarial. Específicamente, se contrasta si el número de consejeros interconectados modera la relación entre las inversiones de I+D y el valor de la empresa utilizando un panel de datos de 106 compañías españolas (periodo 2008-2019). Los resultados del Método Generalizado de los Momentos (GMM) realizado permiten concluir que la existencia de un mayor número de consejeros interconectados en una empresa modera negativamente la relación positiva entre las inversiones de I+D y el valor empresarial. Es decir, un número elevado de consejeros interconectados podría limitar la capacidad del consejo para asesorar de manera efectiva en temas relacionados con las inversiones de I+D. Finalmente, se presentan algunas conclusiones e implicaciones generales de esta tesis doctoral, así como las futuras líneas de investigación. Además, en la sección del anexo se puede encontrar un resumen de la revisión de la literatura realizada sobre artículos de carácter empírico que relacionan al consejo de administración con la innovación empresarial (inputs u outputs) de alguna forma (relación directa, moderación o mediación) a lo largo de más de tres décadas. [EN] Considering the role that the board of directors can play when a firm adopts strategic decisions on topics such as innovation, in this doctoral thesis we analyse the role of this governing body as a determinant of firm innovation and as a moderator of the relation between firm innovation and value. For this purpose, we perform a thorough review of the prior literature on boards of directors and innovation in order to identify possible research questions that have not yet been resolved and to propose objectives and hypotheses to be tested. In the Introduction section, we contextualise the topics to be analysed and present the main concepts and goals of the study. In Chapter 1, the results of the literature review are integrated into a meta-analysis, considering the board characteristics that have most frequently been used in prior studies. We group such characteristics under two headings: structural diversity, that is, those that distinguish one board from another, such as size, composition (internal, external and independent directors), board equity, accumulation of positions between the chairman of the board and the CEO (duality) and meeting frequency; and demographic diversity, that is, individual characteristics that differ from one director to another (gender, social capital, tenure and age). The different types of innovation are also grouped as either inputs (resources and incentives allocated to funding innovation tasks) or outputs of such innovation activities (new products, processes, patents, patent citations, etc.). This allows us to establish whether different elements of the board can affect a firm’s innovation, depending on the type of innovation analysed (inputs or outputs). The results of the meta-analysis suggest that board structural diversity is positively associated with innovation outputs (except in the case of board equity, for which the association is negative). Between structural diversity and innovation inputs, we find two associations: for board size a negative one, and for duality a positive one. For demographic diversity and inputs, a positive association between gender and social capital is found, and for demographic diversity and outputs a negative one for tenure. In Chapter 2, we study the effect of the board of directors on firm innovation in the Spanish context, and specifically how board independence influences innovation in a sample of 124 Spanish firms over the period 2008-2019. Considering that board independence is one of the recommendations that is most frequently found in codes of good governance and that the prior meta-analysis showed that board independence is one of the variables that the literature has most often related to innovation, we decided to delve into this topic. Our aim was to analyse if being an independent director is a sufficient condition for determining innovation in a firm (measured as the number of patents) or if the diversity at an individual level of each independent director (in terms of gender and nationality diversity) can help explain the effect of board independence on firm innovation. A negative binomial analysis of panel data leads to the conclusion that independent directors may have a negative effect on a firm’s innovation. However, when there are high levels of gender and nationality diversity among such independent directors, this negative effect decreases. In other words, it is not sufficient for a director to be independent to promote innovation; there must also be a set of unique characteristics provided by each individual such as their personal relations, experience and approach to problems. In Chapter 3, we consider whether the board of directors, in addition to exerting a direct effect on innovation, can also play a moderating role in the relation between firm innovation and performance. Specifically, we test whether the number of interlocking directors moderates the relation between research and development (R&D) investments and firm value, using a data panel of 106 Spanish companies (over the period 2008-2019). The results of the Generalised Method of the Moments (GMM) performed lead to the conclusion that the existence of a larger number of interlocking directors in a firm negatively moderates the positive relation between R&D investments and firm value. That is, a large number of interlocking directors might limit the board’s capacity for providing effective advice on topics related to R&D investments. Finally, some conclusions and general implications of this doctoral thesis are presented, as well as avenues for future research. Also, Appendix offer a summary of the literature review covering articles of an empirical nature that somehow (directly, or through moderation or mediation) relate the board of directors to firm innovation (inputs or outputs) over a period of more than three decades.
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- 2022
34. Clinical and Subclinical Arteriosclerotic Disease in Octagenarians With Hip Fracture. A Case – Control Study
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Aina Capdevila-Reniu, Margarita Navarro-López, Cristina Sierra-Benito, Victor Sapena, Ana Suárez-Lombraña, Bryan David Solari, Marta Arroyo, Miguel Camafort-Babkowski, and Alfonso López-Soto
- Abstract
Background: Osteoporosis and cardiovascular diseases share risk factors and pathophysiological mechanisms. Hip fracture and cardiovascular diseases are very common in older people. Objectives: Evaluate clinical and subclinical arteriosclerotic disease in older patients with hip fracture compared with patients without fracture in order to increase knowledge about the relation between both diseases in old patients. Method: Age- and sex matched case-control study of octogenarians with and without recent hip fracture. Vascular risk factors, subclinical vascular diseases (assessed by carotid plaques, carotid intima media thickness and arterial stiffness) as well as cardiovascular diseases were analyzed. Univariate and multivariate logistic models were used to estimate Odds Ratios (OR) with their 95% confidence intervals (CI) to assess the association arteriosclerosis and hip fracture. Results: We analyzed 95 patients per group with a median age of 82 [79-87] years of whom 77.9% were female. Patients in both groups have elevated rates of vascular disease (25%) without differences between them. Patients with hip fracture had higher subclinical arteriosclerotic alterations with higher percentage of carotid plaques (OR 3.25 [1.06 - 9.97]) compared with the control group. Conclusions: Old patients with hip fracture had significantly higher presence of subclinical alterations but not increase on rate of cardiovascular arteriosclerotic disease compared with those without hip fracture. Is mandatory to increase our knowledge in shared risk factors for both diseases to enhance fracture prevention or vice versa.
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- 2022
35. Abstract 081: Pulse Wave Velocity And Blood Pressure Variability As Prognostic Indicators In Very Elderly Patients With Advanced Chronic Conditions
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Alejandro De La Sierra, Cristina Sierra, Marcos Murillo, Tommaso-Francesco Aiello, Aina Mateu, and Pedro Almagro
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Internal Medicine - Abstract
The prognostic value of BP elevation in very old patients with other chronic comorbidities is uncertain. We aimed to assess the prognostic impact of 24-hour BP (both brachial and central), BP variability, and pulse wave velocity (PWV) in very elderly patients hospitalized due to a chronic disease decompensation. We included 249 patients older than 80 years, admitted to the hospital due to decompensation of congestive heart failure (149), chronic obstructive pulmonary disease (60), chronic kidney disease with acute kidney injury (26), or other decompensated chronic conditions (14). During hospital stay, 24-h BP monitoring was performed (Mobil-O-Graph PWV). Mean values of brachial and central BP, aortic PWV, and BP variability (24-hour SD) were obtained in all participants. After discharge, patients were followed-up for one year. The primary outcome was total mortality. Hazard ratio (HR) of BP estimates (for 1 SD increase) were obtained through Cox models, adjusted for clinical confounders. During follow-up 72 patients (29%) died. Progression of heart failure (58%) was the most frequent cause of death. No differences were observed in 24-h BP between those who died or remained alive. Systolic BP-SD, and PWV were higher in patients who subsequently died, while 24-hour HR- SD was lower (Table). In fully adjusted models, PWV (HR: 3.54; 95%CI: 2.37-5.28), SD of 24-h brachial systolic BP (1.29; 1.00-1.67) and SD of 24-h heart rate (0.65; 0.46-0.91) were associated with the risk of mortality. We conclude that PWV, SBP and heart rate variabilities, but not the level of BP are associated with mortality in very old patients with advanced chronic conditions
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- 2022
36. Expert opinion paper on the treatment of hemophilia B with albutrepenonacog alfa
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Maria Isabel Canaro, Cristina Sierra Aisa, Víctor Jiménez-Yuste, Olga Benitez, José Mateo Arranz, Ramiro Núñez, Maria Fernanda Lopez Fernandez, Manuel Rodríguez López, María Teresa Álvarez Román, and Francisco J López Jaime
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medicine.medical_specialty ,Albutrepenonacog alfa ,Treatment adherence ,Recombinant Fusion Proteins ,Clinical Biochemistry ,Hemophilia B ,Factor IX ,Quality of life ,Drug Discovery ,medicine ,Humans ,In patient ,Dosing ,Intensive care medicine ,Expert Testimony ,Serum Albumin ,Pharmacology ,business.industry ,blood coagulation factors ,Coagulation Factor IX ,Expert opinion ,Quality of Life ,hemophilia B ,business ,qualitative research ,Half-Life ,medicine.drug - Abstract
Introduction: Current guidelines recommend prophylactic treatment of hemophilia B with the missing coagulation factor IX, either with standard half-life or extended half-life products. Extended half-life products have half-lives three to six times longer than the former, allowing a reduction in the number of weekly injections and therefore, potentially impacting on treatment adherence and quality of life. Albutrepenonacog alfa is an extended half-life fusion protein of coagulation factor IX with recombinant human albumin, indicated for both on-demand and prophylactic treatment for bleeding in patients with hemophilia B of all ages.Areas covered: The authors review the clinical and pharmacokinetic characteristics of albutrepenonacog alfa, as well as the available information regarding trough levels and real-world evidence. Given the availability of other factor IX products in the market, indirect comparisons of clinical and pharmacokinetic characteristics are presented.Expert opinion: The authors exhibit their expert opinion on which patient profiles are candidates for prophylactic treatment with albutrepenonacog alfa, and on the management of patients in terms of dosing, regimens of administration and protocols for switching the treatment.
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- 2021
37. El reto del diagnóstico en síndrome de embolia grasa
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Elsy Cristina Sierra and Jaime Alberto Gómez-Rosero
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General Medicine - Abstract
El síndrome de embolia grasa es una complicación inusual del trauma ortopédico. Las manifestaciones clínicas son inespecíficas y no hay una prueba diagnóstica de oro, por lo que se debe tener un alto índice de sospecha. Se describen cuatro pacientes quienes luego de presentar fractura de huesos largos se complicaron con síndrome de embolia grasa. La manifestación común en todos ellos fue la hipoxemia. Los hallazgos más frecuentes en la tomografía de tórax fueron opacidades en vidrio esmerilado, compromiso del pulmón derecho y de los lóbulos inferiores, y derrame pleural laminar. La evolución clínica fue satisfactoria en tres pacientes; el cuarto presentó extenso compromiso pulmonar, requirió ventilación mecánica invasiva y tuvo una hospitalización prolongada. Ningún paciente falleció ni quedó con secuelas. Esta es la primera serie de casos en Colombia que muestra el comportamiento clínico e imagenológico de pacientes con síndrome de embolia grasa.
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- 2021
38. Identification By Longread Nanopore Sequencing of a Complex Structural Variant in ITGB3 with a Founder Effect Causing Glanzmann's Thrombasthenia in Two Unrelated Patients
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Maria Luisa Lozano, Ana Zamora-Cánovas, Belen De La Morena-Barrio, Cristina Sierra, Christoph Male, Jose Padilla, Maria Eugenia de la Morena-Barrio, Veronica Palma-Barqueros, Ana Sánchez-Fuentes, Agustín Rodriguez-Alen, Ana Marín-Quílez, Nuria Revilla Calvo, Vicente Vicente, Jose Maria Bastida, Javier Corral, and Jose Rivera Pozo
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Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
39. Effects of Job Referrals on Labor Market Outcomes in Brazil
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Christopher O’Leary, Túlio Cravo, Ana Cristina Sierra, and Leandro Justino
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Political Science and International Relations ,Business and International Management ,General Economics, Econometrics and Finance - Abstract
This paper is the first to use program administrative data from Brazil’s National Employment System (SINE) to assess the impact of SINE job interview referrals on labor market outcomes. We use data from a five-year period (2012–16) to evaluate the impact of SINE job referrals on reemployment, time until reemployment, job tenure, and wage rates. Causal impact estimates based on propensity score matching suggest that a SINE job interview referral increases the probability of finding a job within three months of the referral and reduces the number of months needed to find reemployment, the average job tenure of the next job, and the reemployment wage. Subgroup analysis suggests that SINE is particularly effective at helping less educated workers find work in a timely fashion. Finally, the evidence suggests that the self-service online labor exchange is less effective than the in-person job interview referrals provided at SINE offices.
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- 2021
40. AMBULATORY BLOOD PRESSURE MEASUREMENT AS A PREDICTOR OF HYPERTENSION MEDIATED TARGET ORGAN DAMAGE IN VERY ELDERLY POPULATION: THE MAPACHESS STUDY
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Sanchez, Marcos Sanchez, primary, Qin, Jiwei Chen, additional, Viñas-Esmel, Esther, additional, Mas, Miriam Costafreda, additional, Torres, Manuel, additional, Ferre, Rosa Martinez, additional, Benitez, Cristina, additional, Benito, Cristina Sierra, additional, Payeras, Antonio Coca, additional, and Babkowski, Miguel Camafort, additional
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- 2022
- Full Text
- View/download PDF
41. Pulse Wave Velocity and Blood Pressure Variability as Prognostic Indicators in Very Elderly Patients
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Alejandro de la Sierra, Cristina Sierra, Marcos Murillo, Tomasso F. Aiello, Aina Mateu, and Pedro Almagro
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arterial stiffness ,decompensated chronic conditions ,pulse wave velocity ,blood pressure variability ,General Medicine ,mortality ,very old population - Abstract
There is scarce evidence for the prognostic importance of hemodynamic measures, such as blood pressure (BP), BP variability, and arterial stiffness, in the very elderly population with advanced chronic conditions. We aimed to evaluate the prognostic importance of 24 h BP, BP variability, and arterial stiffness in a cohort of very elderly patients admitted to the hospital due to a decompensated chronic disease. We studied 249 patients older than 80 (66% women; 60% congestive heart failure). Noninvasive 24 h monitoring was used to determine 24 h brachial and central BP, BP and heart rate variabilities, aortic pulse wave velocity, and BP variability ratios during admission. The primary outcome was 1-year mortality. Aortic pulse wave velocity (3.3 times for each SD increase) and BP variability ratio (31% for each SD increase) were associated with 1-year mortality, after adjustments for clinical confounders. Increased systolic BP variability (38% increase for each SD change) and reduced heart rate variability (32% increase for each SD change) also predicted 1-year mortality. In conclusion, increased aortic stiffness and BP and heart rate variabilities predict 1-year mortality in very elderly patients with decompensated chronic conditions. Measurements of such estimates could be useful in the prognostic evaluation of this specific population.
- Published
- 2023
42. Colitis ulcerativa para no gastroenterólogos
- Author
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Luis Gonzalo Guevara Casallas, Juan Camilo Diaz Coronado, Nicolás Zuluaga Arbelaez, and Elsy Cristina Sierra Vargas
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03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,General Medicine - Abstract
La colitis ulcerativa es una enfermedad intestinal inflamatoria crónica, de etiología idiopática y fisiopatología multifactorial, caracterizada por la inflamación de la mucosa rectal, con extensión proximal, continua y simétrica a través del colon. Su diagnóstico se establece a partir de los hallazgos clínicos, endoscópicos e histológicos. La meta terapéutica es lograr la remisión clínica y endoscópica, reducir el riesgo de colectomía, cáncer colorrectal y mejorar la calidad de vida de los pacientes. Se realizó una búsqueda de artículos científicos y se exponen los aspectos más relevantes y actualizados sobre la enfermedad; con el objetivo de proporcionar elementos para su abordaje diagnóstico y terapéutico.
- Published
- 2020
43. Therapeutic strategies for Helicobacter pylori in Colombia
- Author
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Elsy Cristina Sierra-Vargas, Luis Gonzalo Guevara-Casallas, Nicolás Zuluaga Arbelaez, and Santiago Pérez-Viana
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tratamiento ,stomach neoplasms ,Helicobacter pylori ,treatment ,gastritis ,cáncer gástrico ,General Medicine ,Colombia - Abstract
Resumen El amplio espectro de enfermedades causadas por la infección Helicobacter pylori obliga a un diagnóstico oportuno y dar un tratamiento altamente eficaz, reduciendo el riesgo de morbilidad y aumentando la probabilidad de erradicación. Son varias las terapias que tienen respaldo en la literatura, por lo que se deben conocer sus ventajas y limitaciones, incluyendo las resistencias bacterianas locales y seleccionar la mejor opción. Este artículo revisa los esquemas de tratamiento más utilizados y ofrece pautas para el manejo y seguimiento del paciente con infección por Helicobacter pylori en Colombia. Abstract The wide spectrum of diseases caused by Helicobacter pylori infection requires a timely diagnosis and a highly effective treatment, reducing the risk of morbidity and increasing the probability of eradication. There are several therapies that are supported in the literature, therefore, its advantages and limitations, including our local resistances, must be known to select the best option. This article reviews the most widely used treatment regimens and offers guidelines for the management and follow-up of patients with Helicobacter pylori infection in Colombia.
- Published
- 2022
44. Grado de conocimiento de la hipertensión en pacientes hipertensos
- Author
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Carolina Fernández, Ana Isabel Jordán, Cristina Sierra, Dolors Estrada, Nuria Plaza, and Rosa María Soriano
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03 medical and health sciences ,0302 clinical medicine ,030212 general & internal medicine ,General Medicine ,030204 cardiovascular system & hematology ,General Nursing - Abstract
Resumen Objetivo Evaluar el grado de conocimientos de la hipertension en pacientes hipertensos. Metodo Estudio multicentrico descriptivo transversal, realizado en centros de atencion primaria y especializada de Espana. Participaron 980 pacientes hipertensos, mayores de 18 anos, con tratamiento farmacologico. Variables principales: anos de diagnostico, factores de riesgo, presion arterial, perimetro abdominal, indice de masa corporal, adherencia a la medicacion (test de Morisky-Green), y los items de un cuestionario validado sobre conocimientos. Resultados El 50% mujeres, edad media 65 anos. El 46% con mas de 10 anos del diagnostico de hipertension. En relacion a la adherencia a la medicacion, el 56,6% no lo era, siendo el olvido la primera causa. Al analizar los conocimientos sobre la hipertension el 41,7% referia que nadie les habia informado, el 35,8% no consideraba que la hipertension fuera para toda la vida y solo el 42,3% conocia los objetivos de presion arterial. El mayor desconocimiento sobre los riesgos que provoca la hipertension en el organismo fue el relacionado con el rinon, donde solo el 48,6% afirmaba conocer ese dato. En relacion a la medicacion, solo el 41,4% conocia que era para toda la vida. Tambien se observo que hay diferencias estadisticamente significativas entre nivel de conocimientos y nivel de estudios (p Conclusion Los conocimientos basicos sobre la hipertension siguen siendo bajos en estos pacientes. Estos resultados permiten orientar futuras intervenciones. orientando la educacion terapeutica al paciente y mejorar su participacion en la enfermedad para controlar mejor su hipertension.
- Published
- 2020
45. Grade of knowledge of hypertension in hypertensive patients
- Author
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Carolina Fernández, Ana Isabel Jordán, Cristina Sierra, en nombre del equipo investigador, Rosa María Soriano, Dolors Estrada, and Nuria Plaza
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medicine.medical_specialty ,business.industry ,Abdominal circumference ,Psychological intervention ,Mean age ,General Medicine ,Disease ,Blood pressure ,Basic knowledge ,Internal medicine ,medicine ,Lack of knowledge ,business ,Body mass index - Abstract
Aims To evaluate the grade of knowledge of hypertension in hypertensive patients. Method Cross-sectional descriptive multicentre study. Primary and specialised care centres in Spain. Participants: 980 hypertensive patients, older than 18 years, with pharmacological treatment. Main variables: Years of diagnosis, risk factors, blood pressure, abdominal circumference, body mass index, adherence to medication (Morisky–Green test) and the items of a validated questionnaire on knowledge. Results 50% were women, mean age 65 years. Seventy-eight percent lived with family, 46% over 10 years old diagnosed with hypertension. In relation to adherence to medication, 56.6% were not compliant, forgetting being the first cause. Knowledge about hypertension 41.7% said that no one had explained it, 35.8% did not consider hypertension a lifelong process, and only 42.3% knew the objectives of blood pressure. The area of major lack of knowledge of the risk of hypertension was the problems caused by hypertension in the kidney, only 48.6% answered affirmatively. In relation to medication, only 41.4% knew it is for life. Statistically significant differences were also observed between the level of knowledge and the level of studies (p Conclusions Basic knowledge about hypertension remains low in these patients. These results enable future interventions to be oriented by promoting therapeutic education to the patient and improving their involvement in the disease in order to better control their hypertension.
- Published
- 2020
46. Social entrepreneurship innovation: A study from Mexico
- Author
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Eugenio Guzmán-Soria, María Teresa e la Garza Carranza, Ana Cristina Sierra Martínez, and Jorge Armando López-Lemus
- Subjects
Economic growth ,Strategy and Management ,Economics, Econometrics and Finance (miscellaneous) ,Social entrepreneurship ,Sociology ,Business and International Management - Published
- 2020
47. Neutrosophic statistics applied to the analysis of socially responsible participation in the community
- Author
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Morán, Johana Cristina Sierra, Chuga, Jenny Fernanda Enríquez, Collaguazo, Wilmer Medardo Arias, and Gudiño, Carlos Wilman Maldonado
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Social capital, Participatory development, Social integration, Community participation, Neutrosophic statistics ,lcsh:Mathematics ,lcsh:Electronic computers. Computer science ,lcsh:QA1-939 ,lcsh:QA75.5-76.95 - Abstract
Previous research points to the importance of the active and socially responsible participation of companies as members of the society to contribute to their economic and social development, i.e., a step beyond philanthropy. In this sense, this study aims to analyze the role played by the different organizations in the business sector of Imbabura in Ecuador, and its relationship with the community where they operate. The analysis was based on the different areas suggested within the ISO 26000 standards, such as education, culture, job creation, among others. The qualitative-quantitative approach was used, with descriptive scope. The survey and the interview were used as data collection techniques for which the respective instruments were designed and applied to different companies in the sector. The results of the instruments are quantified using neutrosophic statistics, which is useful for the quantitative analysis of citizens’ participation in various activities developed in the community. According to the present study, the participation of the companies within the community is not significant and therefore, it is required to foment the responsibility of them in the social development and integration. Concepts like sustainability should be included in the company strategies, when trust and commitment want to be generated from communities in which companies develop their activities.
- Published
- 2019
48. The Role of Arterial Stiffness in the Estimation of Cardiovascular Risk in Liver Transplant Recipients
- Author
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Lydia Sastre, Raquel García, Julián-Gonzalo Gándara, Patricia Fernández-Llama, Antonio J. Amor, Cristina Sierra, Laia Escudé, Pablo Ruiz, Jordi Colmenero, Emilio Ortega, Miquel Navasa, and Gonzalo Crespo
- Subjects
Transplantation ,RD1-811 ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Surgery ,Liver Transplantation - Abstract
Supplemental Digital Content is available in the text., Background. Long-term cardiovascular (CV) events are a frequent cause of death and disability after liver transplant (LT). Although a more in-depth, risk-adapted control of CV risk factors may result in improved post-LT CV outcomes, an accurate stratification of the CV risk of LT recipients to better implement preventive strategies is lacking. Aortic pulse wave velocity (aPWV) is a surrogate of arterial stiffness that has been suggested as a biomarker of CV risk; it has never been evaluated in adult LT recipients. Methods. In a single-center prospective study, we included 122 LT recipients at 12 (n = 39), 60 (n = 45), or 120 (n = 38) mo after LT. aPWV estimation by oscillometry, clinical assessment of CV risk factors, and CV risk estimation by standard clinical scores (systematic coronary risk evaluation and pooled cohort equation) were performed. The incidence of CV events during prospective follow-up was registered. Results. aPWV was independently associated with age and the grade of control of blood pressure. After a median follow-up of 35 mo, 15 patients (12%) presented a CV event. Higher aPWV, diabetes, past or present smoking habit, previous CV events, lower eGFR, being in systematic coronary risk evaluation or pooled cohort equation high-risk groups, and higher levels of total cholesterol, LDL-cholesterol, creatinine, and triglycerides were associated with the incidence of CV events at univariate analysis; aPWV, past or present smoking habit, and triglycerides were independent predictors of CV events. Conclusions. According to our results, aPWV mirrors CV risk in LT recipients and thus may be a useful CV risk biomarker in this population. Considering these preliminary results, its accuracy in stratifying risk requires confirmation in further studies.
- Published
- 2021
49. Validity and reliability of 1-h automated office blood pressure measurement for the diagnosis of hypertension
- Author
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Luis González-de Paz, Cristina Colungo, Silvia Roura, Maria del Carme Alvira-Balada, Berta de Andres, Cristina Sierra-Benito, Noemí García, Jaume Benavent-Àreu, Antoni Sisó-Almirall, Esther Blat, and Belchin Kostov
- Subjects
medicine.medical_specialty ,Ambulatory blood pressure ,Receiver operating characteristic ,Physiology ,business.industry ,Reproducibility of Results ,Validity ,Blood Pressure ,Blood Pressure Determination ,Blood Pressure Monitoring, Ambulatory ,Confidence interval ,Masked Hypertension ,Blood pressure ,Internal medicine ,Hypertension ,Internal Medicine ,Cardiology ,medicine ,Humans ,Blood pressure monitoring ,Cardiology and Cardiovascular Medicine ,business ,Kappa - Abstract
Aims The objective of this study was to examine the validity of 1 h automated office blood pressure measurement for the diagnosis of hypertension. Methods We included patients requiring a hypertension diagnostic test. Participants underwent ambulatory blood pressure monitoring, 1 h automated office blood pressure measurement, office blood pressure measurement and home blood pressure monitoring. The prevalence of hypertension and subtypes were calculated. Mean values of ambulatory blood pressure monitoring were compared with 1 h automated office blood pressure measurement using the correlation coefficient and Bland-Altman graphs. The Kappa concordance index, sensitivity, specificity and diagnostic accuracy were calculated, and the area under the receiver operating characteristic curve was used to establish the diagnostic threshold of the 1-h measurement. Results Of 562 participants, 438 (87.6%) completed the four diagnostic methods. The 1-h method had a sensitivity of 76.6 [95% confidence interval (95% CI): 71.1-81.5], a specificity of 64.8% (95% CI: 57-72.1) and the best diagnostic accuracy (72.1%, 95% CI: 67.7-76.3) compared with the office and home measurements. Moderate-high correlations were observed between DBP (r = 0.73) and SBP (r = 0.58) readings. The 1-h method classified more patients as normotensive (24.4%) and fewer patients with white-coat hypertension (13.3%). A diagnostic threshold of at least 133/83 mmHg for the 1-h method could improve diagnostic accuracy by 2.3%. Conclusion One-hour automated blood pressure measurement is a valid, reliable method for the diagnosis of hypertension in undiagnosed patients. The diagnostic accuracy permits detection of white-coat and masked hypertension. To diagnose hypertension, the 1-h method or conventional home blood pressure monitoring should be used rather than office measurements. Trial registration ClinicalTrials.gov Identifier: NCT03147573.
- Published
- 2021
50. Delimitación y tipificación de humedales costeros: implicaciones para la gestión ambiental del Caribe continental colombiano
- Author
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Santiago Millán, Paula Cristina Sierra-Correa, and Jenny Alexandra Rodríguez-Rodríguez
- Subjects
0106 biological sciences ,Bosques inundables costeros ,geography.geographical_feature_category ,Flood frequency analysis ,010604 marine biology & hydrobiology ,Water bodies ,Geographic Information Systems (GIS) ,Wetland ,Aquatic Science ,Oceanography ,010603 evolutionary biology ,01 natural sciences ,Normalized Difference Vegetation Index ,Protected areas ,Áreas protegidas ,Geography ,Mangroves ,Cuerpos de agua ,Animal Science and Zoology ,Sistemas de Información Geográfica (SIG) ,Physical geography ,Coastal floodplains forest ,Scale (map) ,Manglares ,Water Science and Technology - Abstract
This article describes the cartographic layer construction process of Colombian Caribbean coastal wetlands at a scale of 1:100,000 and the results obtained in terms of their quantification and typing. Two cartographic layers were constructed and subsequently joined, one of the permanent water bodies and another of temporary water bodies and associated coverages. The layers were generated by multitemporal analysis of 45 Landsat 8-OLI satellite images, based on the NDVI index, uncertainty models by superposition of cartographic attributes, and a flood frequency consultation model on ALOS PALSAR 1 images. As a result, 576,279 ha of coastal wetlands were delimited (1.9 % of total wetlands in Colombia), of which 20.4 % are within protected areas. The cartographic legend makes it possible to typify wetlands based on the coverage and temporality of water bodies; discriminates permanent wetlands (42.7 %) with five categories and temporary wetlands (57.3 %) with 15 categories, mostly distributed in seven large complexes. This study is the first description of the colombian Caribbean coastal wetlands based on a cartographic construction, is methodologically replicable, and will support decision-making in the planning of colombian Caribbean coastal areas, especially for risk management and ecosystem-based adaptation to climate change. RESUMEN Este estudio describe el proceso de construcción cartográfica de humedales costeros del Caribe colombiano a escala 1:100 000 y los resultados obtenidos en cuanto a su cuantificación y tipificación. Se construyeron dos capas cartográficas que posteriormente se unieron, una de cuerpos de agua permanentes y otra de cuerpos de agua temporales y sus coberturas asociadas. Las capas fueron generadas mediante análisis multitemporal de 45 imágenes de satélite Landsat 8-OLI, a partir del índice de vegetación-NDVI, modelos de incertidumbre por superposición de atributos cartográficos y la consulta de un modelo de frecuencias de inundación basado en imágenes ALOS PALSAR 1. Como resultado se delimitaron 576 627 ha de humedales costeros (1,9 % del total de humedales de Colombia), de los cuales el 20,4 % se encuentra dentro de áreas protegidas. La leyenda cartográfica obtenida permitió tipificar los humedales con base en la cobertura y temporalidad de los cuerpos de agua; discriminando los permanentes (42,7 %) en cinco categorías, y los temporales (57,3 %) con 15 categorías, la mayor parte distribuidos en siete grandes complejos. Este estudio es la primera descripción de los humedales costeros del Caribe colombiano basada en una construcción cartográfica, es metodológicamente replicable y apoyará la toma de decisiones en la planificación de las zonas costeras del Caribe colombiano, especialmente la gestión del riesgo y la adaptación al cambio climático basada en los ecosistemas.
- Published
- 2021
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