Este artículo recoge reflexiones de un equipo que realiza extensión universitaria desde una perspectiva integral sobre las relaciones sociedad–naturaleza en un área protegida del noreste de Uruguay. El equipo integrado por personas con formación de base en biología y antropología desarrolla desde 2013 una propuesta de formación de grado para diferentes carreras de la Universidad de la República como plataforma a partir de la cual se han desplegado diferentes acciones de vínculo con el medio y se ha abierto camino para procesos de diálogo de saberes con pobladores locales. De manera transversal, desde el inicio de la experiencia ha habido un componente permanente y sostenido de producción de conocimiento que se ha vehiculizado en diferentes estrategias (investigaciones estudiantiles en el marco del curso, presentaciones del equipo docente en otros cursos y eventos científicos, artículos, tesis de grado y de posgrado, proyectos de investigación) que permiten hoy reconstruir una trayectoria integral.
There is ample evidence that the pharmacokinetics of drugs in infants and children may differ markedly from those in adults. The goals of phannacokinetics is to maximize efficacy, minimize toxicity and drug interactions, enhance compliance, and reduce cost of medications. Studies with drugs including anticonvulsants, antimicrobials, digoxin, methotrexate and theophylline have demonstrated that these goals are achievable. Genetic and racial background, underlying disease, concurrent drugs, and nutritional status can influence pharmacokinetics. Population pharmacokinetics can provide useful data even when limited number of samples are available from a large number of patients. Pharmacokinetic monitoring is influenced by numerous factors including dose and dosage form, method of drug administration, times of sample collection, analytical and forecasting methods, and implementation of dosage recommendations. The future of pharmacokinetics, in large part would depend on correlating its parameters to the markers of efficacy and/or toxicity of medications. The ultimate goal of pharmacokinetics should be to improve the quality of life and health outcomes in infants and children.
Resumen El artículo discute sobre la neoliberalización de la naturaleza a partir del estudio de la reestatización de los servicios de distribución del agua potable y saneamiento en Uruguay durante el gobierno progresista del Frente Amplio. Se propone el concepto de “resiliencia neoliberal” para entender la reproducción de una lógica neoliberal en la gestión de estos servicios a pesar del reconocimiento del derecho humano al agua en la Constitución del país. A partir de una metodología cualitativa y cuantitativa, se reconstruye el proceso de privatización de los servicios hídricos y sus repercusiones sociales. Se identifican cuatro procesos que frenan la vuelta a servicios públicos y estatales: la permanencia de concesiones con capitales privados, la fragilización del sistema de subsidios cruzados, la desmovilización de la oposición y la inserción en un modelo de desarrollo económico neoliberal.
BACKGROUND: The IBD National Patient Registry is an initiative of the GEDIIB (Brazilian Study Group of Inflammatory Bowel Disease) who aims to survey the epidemiological profile of IBD patients through the creation of a centralized registry with data on patients monitored in public and private health services which will allow the planning of actions by the GEDIIB to facilitate the diagnosis and access to treatment of IBD, enabling the implementation of actions of the GEDIIB and the partnership with government agencies to improve care and, consequently, the quality of life of patients with IBD. This study aims to show the results of the IBD National Patient Registry. METHODS: A cohort study was performed. Data were collected from July 2020 to August 2021. Data were obtained from medical records and/or from patients during the regular follow-up visit and stored in pre-established records for further analysis. Only patients with an established diagnosis of CD and UC were included. The study was approved by the local ethical committees and all patients signed the consent form. RESULTS: In total, 797 patients were included, 60% with UC and 40% with CD; 52.9% from University Hospitals. The mean age was 44.75 ± 16.11 (12 - 92y), 59.9% female, 59.3% married, 76.4% Caucasian, 85.1% non-smokers, 30.5% completed higher education, 14.9% presented familial history of IBD. The age of onset of symptoms ranged from 3 - 79 years (32.94 ± 14.22) and 33.2% presented diarrhea as an initial manifestation. The age of diagnosis ranged from 4 - 81 years (35.07 ± 14.60) and the time from symptoms to diagnosis ranged from 1 to 2 years. The Montreal classification of CD patients were A1: 6.3%, A2: 59.9%, A3: 33.8%; L1: 38%, L2: 16.7%, L3: 43.9%, B1: 51.5%, B2: 27.8%, B3: 7.8%; perianal 12.8%. In UC, 47.8% presented pancolitis, 30.3% left-sided and 21.8% distal colitis. EIMs were present in 45.7% of patients, the most frequent being rheumatological 21.8%. Comorbidities were present in 72%, the most frequent were high blood pressure (15.3%) and diabetes (6.3%); 50% were with BMI > 25 Kg/m2. Most of the patients were in use of medical therapy (95.5%), of which 81.3% salicylate, 70.3% biological therapy, 49% immunosuppressor, 25.6% corticosteroid and 1.2% tofacitinib. Regarding biological therapy, the following medications were used: infliximab 47.6%, adalimumab 28.4%, vedolizumab 9.5%, ustekinumab 7.5%, certolizumab 2.2% and golimumab 1.3%. Eleven women used the medication during pregnancy. IBD surgery-related was performed in 69.7%, 77.2% abdominal and 22.8% perianal. Almost 30% performed more than one surgery. In 62% of patients, at least one complication was reported; most of them were infective disorders, demanding prolonged hospitalizations. CONCLUSION: To date, there is no IBD epidemiologic study covering the entire Brazilian territory. The results found with the registry will be fundamental to show the epidemiology of a country with continental dimensions such as Brazil. The greater the number of researchers included and from different regions of the country, the greater the representativeness of the data and may even help direct government actions on behalf of IBD patients.
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