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Background: Intra-abdominal infection (IAI) results in prolonged in-hospital length-of-stay, critical care unit requirements, and multiple surgical procedures. Several antimicrobial agents are available for treatment of IAI. In Colombia, there are no data on the comparative effectiveness of the different regimens used. Patients and Methods: A multicenter retrospective cohort study was completed in four third-level hospitals by comparing treatment effectiveness of five different antibiotic protocols (ampicillin-sulbactam, clindamycin-amikacin, piperacillin-tazobactam, amikacin-metronidazole, and cefuroxime-metronidazole) in patients with a diagnosis of IAI. Analysis was based on a composed outcome of therapeutic failure (change of antibiotic because of no clinical improvement, requirement of surgical re-intervention, post-operative infection, change of antibiotic because of antimicrobial resistance, and in-hospital mortality). Association of each antibiotic protocol to therapeutic failure was assessed through logistic regression analysis. Results: Five hundred ninety-three individuals were included. Two hundred twenty-nine were prescribed ampicillin-sulbactam; 170, clindamycin-amikacin; 77, amikacin-metronidazole; 83, piperacillin-tazobactam; and 34, cefuroxime-metronidazole. Therapeutic failure rate was 22%. Multivariable analysis showed none of the evaluated antibiotic protocols had an association with the primary outcome. Variables having an association for higher risk were age >70 years old (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.04-4.18); complicated IAI (OR, 3.36; 95% CI, 1.4-8.07); and World Society of Emergency Surgery (WSES) Sepsis Severity Score (OR, 1.31; 95% CI, 1.18-1.45). Adequate source control (OR, 0.16; 95% CI, 0.05-0.45) and hospitalization at Health Center 2 (OR, 0.30; 95% CI, 0.14-0.63) were identified as protective factors. Conclusions: There are no differences between the rate of therapeutic failure among the different antibiotic protocols evaluated. This outcome depends heavily on risk factors related to disease severity when surgical intervention occurs.

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La deshumanización es la reducción de las cualidades que distinguen a las personas como seres humanos, llevando al profesional a actuar sin ser capaz de experimentar empatía. La educación en ciencias de la salud enfrenta la dificultad que representa el desarrollar mecanismos que permitan implementar un componente humano óptimo desde la formación profesional. El propósito de no implicarse emocionalmente es, quizá, un mecanismo de defensa que aparta del sufrimiento ajeno. Esta actitud impersonal compromete la empatía, desgasta el ideal y promulga la necesidad de una educación afectiva para conservar la empatía durante los años de formación. Objetivo: identificar el componente humano en estudiantes de un programa de ciencias de la salud en la Fundación Universitaria del Área Andina, Pereira, 2021. Método: estudio cuantitativo, descriptivo, transversal, muestra de 146 estudiantes seleccionados en forma no probabilística. La captura y procesamiento de la información básica según las variables de estudio se realizó a través del programa STATA 15. Resultados: el puntaje de medición de empatía global obtenido en la investigación fue de 97 lo que indica un nivel sobresaliente (88-113). Conclusiones: es importante generar estrategias que impacten desde la academia, que promuevan la empatía y el factor humanístico.

Dehumanization is the reduction of the qualities that distinguish people as human beings, leading the professional to act without being able to experience empathy. Health sciences education faces the difficulty of developing mechanisms to implement an optimal human component from professional training. The purpose of not getting emotionally involved is, perhaps, a defense mechanism that keeps away from the suffering of others. This impersonal attitude compromises empathy, wears out the ideal and promulgates the need for an affective education to preserve empathy during the formative years. Objective: to identify the human component in students of a health sciences program at the Fundación Universitaria del Área Andina, Pereira, 2021. Method: quantitative, descriptive, cross-sectional study, sample of 146 students selected in a non-probabilistic way. The capture and processing of the basic information according to the study variables was carried out through the STATA 15 program. Results: the global empathy measurement score obtained in the research was 97, which indicates an outstanding level (88-113). Conclusions: it is important to generate strategies that have an impact from the academy, which promote empathy and the humanistic factor.

A desumanização é a redução das qualidades que distinguem as pessoas como seres humanos, levando o profissional a atuar sem ser capaz de sentir empatia. O ensino das ciências da saúde enfrenta a dificuldade de desenvolver mecanismos para implementar uma componente humana óptima na formação profissional. O objetivo de não se envolver emocionalmente é, talvez, um mecanismo de defesa que se afasta do sofrimento dos outros. Esta atitude impessoal compromete a empatia, desgasta o ideal e promulga a necessidade de uma educação afectiva para preservar a empatia durante os anos de formação. Objetivo: identificar a componente humana nos estudantes de um curso de ciências da saúde da Fundación Universitaria del Área Andina, Pereira, 2021. Método: estudo quantitativo, descritivo, transversal, amostra de 146 estudantes seleccionados de forma não probabilística. A captura e o processamento das informações básicas de acordo com as variáveis do estudo foram realizados utilizando o programa STATA 15. Resultados: a pontuação global da medida de empatia obtida na investigação foi de 97, o que indica um nível excelente (88-113). Conclusões: É importante gerar estratégias que tenham impacto a partir da academia, que promovam a empatia e o fator humanístico.

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ABSTRACT Regulators and corporate governance activists are lobbying companies to eliminate the CEO duality; however the effectiveness of this recommendation is questioned given that empirical evidence has found conflicting results. This document studied the effects of the CEO's duality on the value of the company in a sample of 104 Mexican companies that were publicly traded between 2000 and 2013. For this, different regression models were estimated using the ordinary least squares technique. The firm value was measured through Tobin's Q and ROA. Empirical results showed that there is no relationship between CEO duality and value after controlling for board characteristics such as size and independence. JEL CLASSIFICATION M10, G32, G34

RESUMEN Los reguladores y los activistas del gobierno corporativo están presionando a las empresas para que eliminen la dualidad del CEO, sin embargo, la efectividad de esta recomendación es cuestionada dado que la evidencia empírica ha encontrado resultados contradictorios. Este documento estudió los efectos de la dualidad del CEO en el valor de la empresa en una muestra de 104 empresas mexicanas que cotizaron públicamente entre 2000 y 2013. Para esto, se estimaron diferentes modelos de regresión utilizando la técnica de mínimos cuadrados ordinarios. El valor de la empresa se midió a través de la Q de Tobin y el ROA. Los resultados empíricos mostraron que no existe una relación entre la dualidad del CEO y el valor de la empresa después de controlar las características de la junta, como el tamaño y la independencia. CLASIFICACIÓN JEL M10, G32, G34

RESUMO Os reguladores e os activistas do governo das sociedades estão a pressionar as empresas para eliminar a dualidade do Presidente da Comissão Executiva, no entanto, a eficácia desta recomendação é posta em causa, uma vez que provas empíricas têm encontrado resultados contraditórios. Este documento estudou os efeitos da dualidade dos CEO no valor da empresa numa amostra de 104 empresas mexicanas negociadas publicamente entre 2000 e 2013. Para tal, foram estimados diferentes modelos de regressão utilizando a técnica dos mínimos quadrados comuns. O valor da empresa foi medido pelo Q de Tobin e o ROA. Os resultados empíricos mostraram que não existe relação entre a dualidade do CEO e o valor da empresa depois de controlar para características do conselho como a dimensão e a independência. CLASSIFICAÇÃO JEL M10, G32, G34

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PURPOSE: To determine the association between mutations in CDKN2A and FGFR3 genes and the diagnosis of bladder carcinoma (BCa). METHODS: A systematic search strategy was carried out through MEDLINE, EMBASE, LILACS, CENTRAL and unpublished literature. We included RCTs, cohort, case-control and cross-sectional studies that involved patients > 18-year-old assessing the association between CDKN2A and FGFR3 mutated genes and BCa. The primary outcome was bladder cancer defined by histology of the sample. We assessed the risk of bias with QUADAS2 and performed a meta-analysis with Review Manager v5.3. RESULTS: We found 97 records with the search strategies. After duplicates were removed, six studies were included in meta-analysis. Regarding the association between mutated FGFR3 and bladder cancer, we found an OR 31 95% CI (15-64). However, there was no association for CDKN2A and BCa. CONCLUSION: There is a strong association between FGFR3 mutated gene and the diagnosis of bladder cancer, which has not been observed with CDKN2A. Such a result supports FGFR3 mutated gene as a promissory bladder cancer screening and monitoring biomarker.

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Objetivo: determinar la magnitud del cambio en la calidad de vida percibida, relacionada con la salud y los recursos administrados en los pacientes egresados de las unidades de cuidado intensivo. Material y métodos: se realizó un estudio multicéntrico de cohorte concurrente en pacientes críticamente enfermos en las unidades de cuidado intensivo (UCI) del Hospital Universitario Clínica San Rafael, Hospital Militar Central, Hospital de San José, Fundación Santa Fe de Bogotá y Clínica del Country, de Bogotá, y la Fundación Valle de Lilly, de Cali. Durante el periodo comprendido entre noviembre de 2004 y octubre de 2006, se enrolaron 291 pacientes, a quienes se les realizaron mediciones de severidad mediante el APACHE II, evaluación de las intervenciones en los primeros tres días mediante el TISS 28, aplicación del SF36 con un recordatorio de cuatro semanas para determinar la calidad de vida relacionada con la salud previa al ingreso a la unidad y posteriormente, a los seis meses de egreso de la unidad, para evaluar el cambio en la calidad de vida relacionada con la salud en cada una de las ocho dimensiones que evalúa el SF36 V.2, determinación de la mortalidad a los 28 días y a los seis meses de egreso de la unidad. El cálculo de tamaño de muestra se efectuó para encontrar diferencias de cinco puntos en cualquiera de las dimensiones, para muestras dependientes y con unas pérdidas por seguimiento y mortalidad estimadas en un 15%. Resultados: la mortalidad al egreso de UCI se situó en un 11,8%, a los 28 días en un 17,1% y finalmente, a los seis meses en un 25%; 176 pacientes contestaron a los seis meses nuevamente la encuesta del SF36. En los tres grupos de pacientes se observó un deterioro tanto clínico como estadísticamente significativo en el rol físico; sin embargo, en la estratificación por grupos de enfermedades por la cual se había ingresado al paciente, se observó que los pacientes de trauma deterioran la calidad de vida en todas las dimensiones con las siguientes diferencias: función física: 33.6, p (0.001); rol físico: 54.5, p <(0.001); dolor corporal: 47.5, p <(0.001); salud general: 32.4, p <(0.001); vitalidad: 32.5, p <(0.001); función social: 42, p <(0.001); rol emocional: 34.4, p <(0.001) y salud mental: 29.1, p <(0.001). En cuanto a los recursos administrados evaluados por la puntuación del TISS 28 y promedios de estancia, se observaron diferencias significativas en los pacientes con trauma, cuando se compararon con los pacientes ingresados por enfermedades de tipo médico y de tipo quirúrgico, teniendo los pacientes de trauma mayor intervención, y por ende mayores costos de atención, pero menores estancias; no se encontraron diferencias significativas en cuanto a la severidad entre los pacientes con enfermedades de tipo médico, de tipo quirúrgico y de trauma. Conclusiones: en nuestro medio, los pacientes de trauma que ingresan a las unidades de cuidado intensivo presentan un significativo deterioro clínico en la calidad de vida relacionada con la salud, en las ocho dimensiones evaluadas seis meses después del egreso, tiempo suficiente en el cual su condición física y mental se ha estabilizado; adicionalmente, estos pacientes consumen de manera significativa mayores recursos cuando se les compara con los pacientes con enfermedades de tipo médico y quirúrgico, lo que demuestra que el trauma en nuestro medio resulta costoso en todos los sentidos: en la atención inicial, demandando mayor uso de recursos, en los resultados obtenidos a largo plazo, en lo referente a la calidad de vida relacionada con la salud y en el tipo de pacientes afectados, quienes por lo general, son pacientes jóvenes con capacidad productiva.

Objective: to determine the magnitude of the change in the perceived quality of life related with health conditions and with the administered resources, in patients discharged from the intensive care units. Methods and material: a multicentric, concurrent cohort study was made in critically ill patients at the intensive care units (ICU) of the Hospital Universitario Clinica San Rafael, Hospital Militar Central, Hospital de San Jose, Fundacion Santa Fe de Bogotá, and Clinica del Country of Bogota, and La Fundacion Valle de Lilly of Cali, Colombia. During the period between November 2004 and October 2006, 291 patients were enrolled. The severity of their condition was assessed by means of APACHE II. The interventions performed during the first three days were assessed by means of TISS 28. The SF36 was applied with a reminder of 4 weeks in order to determine the quality of life with regard to the health condition prior to admission into the unit. It was also applied six months after discharge from the unit, in order to evaluate changes in the quality of life with regard to health in each one of eight dimensions assessed by SF36 V.2. Mortality was determined at 28 days and six months after discharge from the unit. Calculation of the sample size was made to find differences of 5 points in any of the dimensions, for dependent samples and with losses due to follow-up and mortality estimated at 15%. Results: mortality was 11,8% at discharge from the ICU, 17,1% at 28 days, and 25% at six months. 176 patients answered the SF36 survey at six months. Clinical and statistically significant deterioration of the physical role was observed. Nevertheless, when stratification was performed according to the type of disease due to which the patient had been admitted into the ICU, it was found that the quality of life of patients with trauma worsened with regard to all dimensions: physical function: 33.6, p (0.001); physical role: 54.5, p<(0.001); corporal pain: 47.5, p <(0.001); general health: 32.4, p < (0.001); vitality: 32.5, p <(0.001); social function: 42, p<(0.001); emotional role: 34.4 p<(0.001) and mental health: 29.1, p <(0.001). With regard to the administered resources evaluated by the TISS 28 score and averages of stay, significant differences in patients with trauma were observedwith regard to patients admitted due to diseases of medical and surgical type. Trauma patients received more intervention and therefore were more costly, but had shorter ICU stays. There were no significant differences with regard to severity between patients with diseases of medical type, surgical type and trauma. Conclusions: In our milieu, trauma patients admitted into intensive care units show a significant clinical deterioration in their quality of life related with health, in the eight dimensions assessed six months after discharge. This period of time is considered to be enough for the stabilization of their physical and mental condition. Moreover, utilization of resources by these patients is significantly greater than that of patients with diseases of medical of surgical type. This demonstrates that, in our milieu, trauma is expensive in every sense: its initial attention demands greater use of resources; its long-term consequences with regard to quality of life are more serious, taking into account the fact that these patients are generally young people with productive capacity.

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BACKGROUND: Anemic syndrome is a frequent problem in intensive care units. The most probable etiology is the suppression of the erythropoietin response due to the direct effects of cytokines, as well as frequent blood sampling. Transfusions are not free of complications, therefore transfusion reactions are estimated to occur in 2% of the total packed red blood cells (pRBCs) transfused. In the past several years, several trials had tried to compare the restrictive with the more liberal use of transfusions, and they were found to be equally effective. Nosocomial pneumonia is the most common nosocomial infection in intensive care units; the prevalence is 47% with an attributive mortality of 33%. There are multiple risk factors for the development of nosocomial pneumonia. Colonization of the upper airways is the most important pathophysiological factor but there are other factors implicated like, sedation techniques, inappropriate use of antibiotics and recumbent positioning.A secondary analysis of the CRIT study describes transfusion therapy and its practices in the United States. They found that transfusion practice is an independent risk factor for the development of nosocomial pneumonia. METHODS: This is a multicenter, prospective cohort study in different intensive care units in Colombia. A total of 474 patients were selected who had more than 48 hours of mechanical ventilation. The primary objective is to try to demonstrate the hypothetical relationship between the use of transfusions and nosocomial pneumonia.Secondly, we will try to determine which other factors are implicated in the development of pneumonia in intensive care units and describe the incidence of pneumonia and transfusion practices. DISCUSSION: Ventilator associated pneumonia is a primary problem in the intensive care unit, multiple factors have been associated with its presence in this study we try to explore the possible association between pneumonia and transfusion, describe all other factors associated with this, and the possible association with other nosocomial infections.

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