La Universidad Privada del Valle (UNIVALLE), situada en un contexto de constante transformación social y cultural, se ha afianzado como una de las instituciones de educación superior más relevantes en el país y Latinoamérica. Su origen se remonta a 1988, época en la cual se constituyó con el ánimo de contribuir al desarrollo integral del Estado Plurinacional de Bolivia. Desde su fundación, UNIVALLE no solo ha experimentado un aumento en su matrícula estudiantil, sino que también ha ampliado su oferta académica, consolidando un impacto significativo en la comunidad y en el ámbito educativo nacional e internacional (Univalle, 2016).
Klebsiella pneumoniae is a Gram-negative bacterium that requires oxygen and is capable of fermenting lactose. It can cause serious infections such as pneumonia, bacteremia, and liver abscesses. There are two main subtypes: the classic strain (cKP) and the hypervirulent strain (hvKP), the latter being identified by its highly viscous mucus phenotype and its remarkable ability to invade.The most common hvKP lineage is ST23-K1, although K2 lineages (ST65, ST86, ST66) have also been recognized in different parts of the world, including South America. hvKP can affect healthy individuals and those with additional diseases, with diabetes mellitus being a relevant risk factor due to its association with immune dysfunction and hyperglycemia, conditions that favor bacterial growth and spread through the circulatory system. The case presented concerns a 45-year-old diabetic woman who was admitted with severe diabetic ketoacidosis and pneumonia caused by Klebsiella pneumoniae. Despite intensive treatment that included antibiotics and respiratory support, the patient developed multiple lung abscesses and a possible septic embolism, dying after 18 days in intensive care unit.
This paper presents the design and development of an integrated support system for the initial evaluation and rehabilitation of patients with rheumatoid arthritis, based on biomedical instrumentation, computer vision, and telemedicine. The system incorporates a wireless hand dynamometer developed from a repurposed load cell calibrated with certified standard weights, achieving a relative error between $0 \%$ and $0.12 \%$, which corresponds to an accuracy greater than $99.9 \%$ and a precision above $99.4 \%$, ensuring reproducible and clinically reliable measurements. Complementarily, joint range of motion (ROM) estimation using MediaPipe Pose was validated against a clinical goniometer, yielding mean absolute errors below 0.5° across representative angles. The RheumAlly web platform integrates these components into a unified clinical environment that records anamnesis, functional parameters, and automated computation of the Clinical Disease Activity Index (CDAI), enabling quantitative and standardized monitoring of the patient’s functional status. In addition, the platform incorporates a telerehabilitation module based on validated exercises from the SARAH protocol, guided through computer vision using the Mediapipe HandLandmarker library to remotely supervise therapeutic execution and enhance patient adherence. This work presents a pilot clinical validation of a TRL-6 integrated system for rheumatoid arthritis functional assessment and rehabilitation. Real-world validation demonstrated significant functional improvements and reductions in inflammatory activity of up to $88 \%$, evidencing the system’s capability to strengthen continuity of care, reduce clinical subjectivity, and provide an objective, accessible, and scalable tool for rheumatologic management.
BACKGROUND AND AIMS:Adults with obesity undergoing gastrointestinal endoscopy under sedation are at increased risk of hypoxemia. We evaluated nasal continuous positive airway pressure (nCPAP) and noninvasive positive pressure ventilation (NIPPV) versus conventional oxygen therapy in this population. METHODS:We searched six databases from inception through May 2026 for randomized controlled trials evaluating nCPAP or NIPPV in adults with obesity undergoing gastrointestinal endoscopy. The review followed PRISMA guidelines and was registered in PROSPERO (CRD420261391143). The primary outcome was oxygen desaturation, defined as SpO2 <90% or ≤90% according to study definitions. Rescue airway maneuvers were secondary. Random-effects meta-analysis, trial sequential analysis, and GRADE were performed. RESULTS:Four RCTs comprising 457 participants were included. Positive airway pressure strategies reduced oxygen desaturation (RR 0.27; 95% CI 0.14-0.53; p<0.01; I2=0%), with moderate-certainty evidence. Rescue airway maneuvers were also reduced (RR 0.45; 95% CI 0.23-0.89; p=0.03; I2=46.5%); however, certainty was very low, and the prediction interval included no effect. Trial sequential analysis crossed the monitoring boundaries for benefit for both outcomes. Oxygen-delivery protocols differed across trials, and effective FiO2 was not directly measured. CONCLUSIONS:NCPAP or NIPPV may reduce oxygen desaturation during sedated gastrointestinal endoscopy in adults with obesity. The effect on rescue airway maneuvers remains uncertain. Larger trials using standardized oxygen-delivery and airway-rescue protocols are warranted.
Este proyecto constituye un ejemplo del valor que la cooperación científica cuando se concibe como un espacio de intercambio, aprendizaje mutuo y construcción conjunta, a partir de la generación de herramientas que permitan fortalecer la calidad de la educación superior y el acceso al conocimiento, la innovación institucional, y la integración regional fomentando una educación superior más pertinente y articulada con las necesidades sociales y de los países iberoamericanos.
