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  1. Article ; Online: La planeación por escenarios como herramienta para la construcción de paz en el Caquetá

    Parcival Peña-Torres / Claritza Marlés-Betancourt / Orlando Valera-Alfonso

    Revista Científica General José María Córdova, Vol 20, Iss

    2022  Volume 37

    Abstract: Este artículo busca determinar los escenarios de futuro, como una alternativa para la construcción de paz en el Caquetá, una de las regiones más afectadas por el conflicto armado en Colombia y que enfrenta grandes retos en el posconflicto. Para ello se ... ...

    Abstract Este artículo busca determinar los escenarios de futuro, como una alternativa para la construcción de paz en el Caquetá, una de las regiones más afectadas por el conflicto armado en Colombia y que enfrenta grandes retos en el posconflicto. Para ello se presenta una investigación descriptiva con enfoque mixto basada en las fases de la técnica prospectiva de matriz de impacto cruzado, con una muestra conformada por actores del desarrollo regional de los sectores del saber, del poder, productivo y la comunidad. Los resultados revelan que los eventos de futuro en cuatro dimensiones: capacidades institucionales, problema de cultivos ilícitos, víctimas del conflicto e influencia de la educación superior, constituyen el escenario más dinamizador para la construcción de paz en la región.
    Keywords acuerdo de paz ; desarrollo ; escenarios ; estudios de futuro ; prospectiva ; Military Science ; U
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Escuela Militar de Cadetes “General José María Córdova”
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Curriculum and informational criticism

    Orlando Valera Alfonso

    Historia y Memoria, Vol 0, Iss 8, Pp 341-

    2014  Volume 342

    Keywords History (General) and history of Europe ; D ; Latin America. Spanish America ; F1201-3799
    Language Spanish
    Publishing date 2014-01-01T00:00:00Z
    Publisher Universidad Pedagógica y Tecnológica de Colombia
    Document type Article ; Online
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  3. Article ; Online: Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy.

    Sevillano, Angel M / Caravaca-Fontán, Fernando / Cordero Garcia-Galan, Lucia / Fernandez-Juarez, Gema / Lopez-Revuelta, Katia / Guzmán, Diomaris A / Martín-Reyes, Guillermo / Quintana, Luis F / Rodas, Lida M / Sanchez de la Nieta, Maria Dolores / Rabasco, Cristina / Espinosa, Mario / Diaz-Encarnación, Monserrat / San Miguel, Luz / Barrios, Clara / Rodriguez, Eva / Garcia, Patricia / Valera, Alfonso / Peña, Jessy-Korina /
    Shabaka, Amir / Velo, Mercedes / Sierra, Milagros / Gonzalez, Fayna / Fernandez-Reyes, Maria José / Heras, Manuel / Delgado, Patricia / Gutierrez, Eduardo / Moreno, Juan Antonio / Praga, Manuel

    Kidney international reports

    2023  Volume 8, Issue 8, Page(s) 1596–1604

    Abstract: Introduction: Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, ...

    Abstract Introduction: Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes.
    Methods: This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression.
    Results: The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events.
    Conclusions: Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications.
    Language English
    Publishing date 2023-06-05
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2023.05.027
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  4. Article ; Online: Predictors of response and relapse in patients with idiopathic membranous nephropathy treated with tacrolimus.

    Caro, Jara / Gutiérrez-Solís, Elena / Rojas-Rivera, Jorge / Agraz, Irene / Ramos, Natalia / Rabasco, Cristina / Espinosa, Mario / Valera, Alfonso / Martín, Mónica / Frutos, Miguel Ángel / Perea, Lara / Juárez, Gema Fernández / Ocaña, Javier / Arroyo, David / Goicoechea, Marian / Fernández, Laura / Oliet, Aniana / Hernández, Yolanda / Romera, Ana /
    Segarra, Alfons / Praga, Manuel

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2015  Volume 30, Issue 3, Page(s) 467–474

    Abstract: Background: Although tacrolimus is recommended by KDIGO Clinical Practice Guideline for Glomerulonephritis for the treatment of idiopathic membranous nephropathy (MN), little is known about factors that influence response and relapse of the disease ... ...

    Abstract Background: Although tacrolimus is recommended by KDIGO Clinical Practice Guideline for Glomerulonephritis for the treatment of idiopathic membranous nephropathy (MN), little is known about factors that influence response and relapse of the disease after tacrolimus therapy.
    Methods: Multicentre study that collected 122 MN patients with nephrotic syndrome and stable renal function treated with tacrolimus. Duration of treatment was 17.6 ± 7.2 months, including a full-dose and a tapering period.
    Results: The percentage of remission was 60, 78 and 84% after 6, 12 and 18 months of treatment, respectively. The amount of proteinuria at baseline significantly predicted remission, the lower the baseline proteinuria the higher the probability of remission. Only 10 patients (8%) received concomitantly corticosteroids, and their rate of remission was similar (80% at 18 months). Among responders, 42% achieved complete remission (CR) and 58% partial remission (PR). Almost half (44%) of the responder patients relapsed. The amount of proteinuria at the onset of tacrolimus tapering was significantly higher in relapsing patients. By multivariable analysis, the presence of a PR versus CR at the onset of tacrolimus tapering and a shorter duration of the tapering period significantly predicted relapses. Tolerance was good and the number of adverse events low.
    Conclusions: Tacrolimus monotherapy is an effective and safe option for the treatment of MN with stable renal function. Relapses are frequent in patients with PR and can be partially prevented by a longer tapering period.
    MeSH term(s) Case-Control Studies ; Female ; Glomerulonephritis, Membranous/drug therapy ; Humans ; Immunosuppressive Agents/therapeutic use ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Prognosis ; Proteinuria/diagnosis ; Proteinuria/epidemiology ; Recurrence ; Remission Induction ; Retrospective Studies ; Tacrolimus/therapeutic use
    Chemical Substances Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
    Language English
    Publishing date 2015-03
    Publishing country England
    Document type Comparative Study ; Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfu306
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  5. Article: Atorvastatin in dyslipidaemia of the nephrotic syndrome.

    Valdivielso, Pedro / Moliz, Manuel / Valera, Alfonso / Corrales, Miguel A / Sanchez-Chaparro, Miguel A / Gonzalez-Santos, Pedro

    Nephrology (Carlton, Vic.)

    2004  Volume 8, Issue 2, Page(s) 61–64

    Abstract: The combined dyslipidaemia that accompanies the nephrotic syndrome increases the cardiovascular risk and appears to worsen long-term renal function. Our aim was to determine the efficacy and safety of 10 mg atorvastatin in the control of dyslipidaemia in ...

    Abstract The combined dyslipidaemia that accompanies the nephrotic syndrome increases the cardiovascular risk and appears to worsen long-term renal function. Our aim was to determine the efficacy and safety of 10 mg atorvastatin in the control of dyslipidaemia in these patients. We carried out a prospective, open, 6 month study of 10 patients with primary or secondary nephrotic syndrome (proteinuria >3.5 g/day, hypoalbuminaemia, oedema and hyperlipidaemia). The changes in lipids and plasma lipoproteins were measured, as well as the safety profile (transaminases, creatine phosphokinase, fibrinogen and antithrombin III activity) and parameters of renal function. The addition of 10 mg atorvastatin daily for 6 months resulted in a 41% reduction in low density lipoprotein (LDL) cholesterol and 31% in triglycerides (both P < 0.05), and a 15% increase in high density lipoprotein (HDL) cholesterol (NS). The drug was well tolerated and there was no change in the safety profile or deterioration in renal function. In fact, the levels of proteinuria fell in all but one patient (6.2 +/- 2.6 vs 4.8 +/- 2.5 g/24 h; P < 0.05). Atorvastatin, at the above dose, and for the time used proved to be a safe drug that effectively reduced dyslipidaemia in patients with nephrotic syndrome.
    MeSH term(s) Adult ; Aged ; Anticholesteremic Agents/therapeutic use ; Atorvastatin ; Female ; Heptanoic Acids/therapeutic use ; Humans ; Hyperlipidemias/drug therapy ; Hyperlipidemias/etiology ; Male ; Middle Aged ; Nephrotic Syndrome/complications ; Prospective Studies ; Pyrroles/therapeutic use
    Chemical Substances Anticholesteremic Agents ; Heptanoic Acids ; Pyrroles ; Atorvastatin (A0JWA85V8F)
    Language English
    Publishing date 2004-01-01
    Publishing country Australia
    Document type Clinical Trial ; Journal Article
    ZDB-ID 1303661-0
    ISSN 1440-1797 ; 1320-5358
    ISSN (online) 1440-1797
    ISSN 1320-5358
    DOI 10.1046/j.1440-1797.2003.00143.x
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    Zs.A 4822: Show issues Location:
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  6. Article ; Online: Association of C4d deposition with clinical outcomes in IgA nephropathy.

    Espinosa, Mario / Ortega, Rosa / Sánchez, Marina / Segarra, Alfons / Salcedo, Maria Teresa / González, Fayna / Camacho, Rafael / Valdivia, Miguel Angel / Cabrera, Rocio / López, Katia / Pinedo, Fernando / Gutierrez, Eduardo / Valera, Alfonso / Leon, Miryam / Cobo, Maria Angeles / Rodriguez, Rosa / Ballarín, Jose / Arce, Yolanda / García, Beatriz /
    Muñoz, María Dolores / Praga, Manuel

    Clinical journal of the American Society of Nephrology : CJASN

    2014  Volume 9, Issue 5, Page(s) 897–904

    Abstract: Background and objectives: Several studies have suggested that activation of the complement system is a contributing pathogenic mechanism in IgA nephropathy (IgAN). C4d staining is an inexpensive and easy-to-perform method for the analysis of renal ... ...

    Abstract Background and objectives: Several studies have suggested that activation of the complement system is a contributing pathogenic mechanism in IgA nephropathy (IgAN). C4d staining is an inexpensive and easy-to-perform method for the analysis of renal biopsies. This study aimed to assess the clinical and prognostic implications of C4d staining in IgAN.
    Design, setting, participants, & measurements: This retrospective cohort study included 283 patients with IgAN in 11 hospitals in Spain who underwent a renal biopsy between 1979 and 2010. The primary predictor was mesangial C4d staining. Secondary predictors included demographic, clinical, and laboratory characteristics, and Oxford pathologic classification criteria. The primary end point was the cumulative percentage of patients who developed ESRD, defined as onset of chronic dialysis or renal transplantation. C4d was analyzed by immunohistochemical staining using a polyclonal antibody. Kaplan-Meier and Cox proportional hazards analyses were performed to evaluate the effect of C4d staining on renal survival.
    Results: There were 109 patients (38.5%) and 174 patients (61.5%) who were classified as C4d positive and C4d negative, respectively. Renal survival at 20 years was 28% in C4d-positive patients versus 85% in C4d-negative patients (P<0.001). Independent risk factors associated with ESRD were as follows: proteinuria (hazard ratio [HR] per every 1 g/d increase. 1.16; 95% confidence interval [95% CI], 1.03 to 1.31; P=0.01), eGFR (HR per every 1 ml/min per 1.73 m(2) increase, 0.96; 95% CI, 0.94 to 0.97; P<0.001), T2 Oxford classification (tubular atrophy/interstitial fibrosis, >50%; HR, 4.42; 95% CI, 1.40 to 13.88; P=0.01), and C4d-positive staining (HR, 2.45; 95% CI, 1.30 to 4.64; P=0.01).
    Conclusions: C4d-positive staining is an independent risk factor for the development of ESRD in IgAN. This finding is consistent with the possibility that complement activation is involved in the pathogenesis of this disease.
    MeSH term(s) Adult ; Biopsy ; Complement C4b/analysis ; Disease Progression ; End Stage Liver Disease/etiology ; End Stage Liver Disease/metabolism ; End Stage Liver Disease/pathology ; End Stage Liver Disease/physiopathology ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/complications ; Glomerulonephritis, IGA/metabolism ; Glomerulonephritis, IGA/pathology ; Glomerulonephritis, IGA/physiopathology ; Humans ; Hypertelorism/complications ; Immunohistochemistry ; Kaplan-Meier Estimate ; Kidney/chemistry ; Kidney/pathology ; Male ; Mesangial Cells/chemistry ; Middle Aged ; Peptide Fragments/analysis ; Prognosis ; Proteinuria/etiology ; Retrospective Studies ; Risk Factors ; Young Adult
    Chemical Substances Peptide Fragments ; Complement C4b (80295-50-7) ; complement C4d (80295-52-9)
    Language English
    Publishing date 2014-02-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.09710913
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  7. Article ; Online: IgA Nephropathy in Elderly Patients.

    Sevillano, Angel M / Diaz, Monserrat / Caravaca-Fontán, Fernando / Barrios, Clara / Bernis, Carmen / Cabrera, Jimena / Calviño, Jesus / Castillo, Lorena / Cobelo, Carmen / Delgado-Mallén, Patricia / Espinosa, Mario / Fernandez-Juarez, Gema / Fernandez-Reyes, Maria Jose / Garcia-Osuna, Rosa / Garcia, Patricia / Goicoechea, Marian / Gonzalez-Cabrera, Fayna / Guzmán, Diomaris A / Heras, Manuel /
    Martín-Reyes, Guillermo / Martinez, Alberto / Olea, Teresa / Peña, Jessy Korina / Quintana, Luis F / Rabasco, Cristina / López Revuelta, Katia / Rodas, Lida / Rodriguez-Mendiola, Nuria / Rodriguez, Eva / San Miguel, Luz / Sanchez de la Nieta, Maria Dolores / Shabaka, Amir / Sierra, Milagros / Valera, Alfonso / Velo, Mercedes / Verde, Eduardo / Ballarin, Jose / Noboa, Oscar / Moreno, Juan Antonio / Gutiérrez, Eduardo / Praga, Manuel

    Clinical journal of the American Society of Nephrology : CJASN

    2019  Volume 14, Issue 8, Page(s) 1183–1192

    Abstract: Background and objectives: Some studies suggest that the incidence of IgA nephropathy is increasing in older adults, but there is a lack of information about the epidemiology and behavior of the disease in that age group.: Design, setting, ... ...

    Abstract Background and objectives: Some studies suggest that the incidence of IgA nephropathy is increasing in older adults, but there is a lack of information about the epidemiology and behavior of the disease in that age group.
    Design, setting, participants, & measurements: In this retrospective multicentric study, we analyzed the incidence, forms of presentation, clinical and histologic characteristics, treatments received, and outcomes in a cohort of 151 patients ≥65 years old with biopsy-proven IgA nephropathy diagnosed between 1990 and 2015. The main outcome was a composite end point of kidney replacement therapy or death before kidney replacement therapy.
    Results: We found a significant increase in the diagnosis of IgA nephropathy over time from six patients in 1990-1995 to 62 in 2011-2015 (
    Conclusions: The diagnosis of IgA nephropathy among older adults in Spain has progressively increased in recent years, and anticoagulant therapy may be partially responsible for this trend. Prognosis was poor.
    Podcast: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2019_07_16_CJASNPodcast_19_08_.mp3.
    MeSH term(s) Adult ; Aged ; Female ; Glomerulonephritis, IGA/diagnosis ; Glomerulonephritis, IGA/epidemiology ; Glomerulonephritis, IGA/therapy ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2019-07-16
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.13251118
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