PREVALENCIA DE LA HIPERTENSION PULMONAR COMO COMPLICACION EN PACIENTES CON ENFERMEDAD RENAL CRONICA TERMINAL EN HEMODIALISIS EN EL HOSPITAL GENERAL DE ECATEPEC “DR. JOSE MARIA RODRIGUEZ”

RESUMEN ANTECEDENTES: La Enfermedad Renal Crónica presenta múltiples complicaciones Cardiovasculares y de estas una de las menos estudiadas es la HIPERTENSION PULMONAR, la cual se presenta más aun en los pacientes con terapia sustitutiva de Hemodiálisis. MATERIAL Y METODOS: Se realizó un estudio Descriptivo, Retrospectivo y Transversal. En base al estudio de 46 pacientes que se encuentran con el diagnostico de Enfermedad Renal Crónica Terminal en terapia sustitutiva de la función renal a base de Hemodiálisis a los cuales se les realizo un Ecocardiograma Transtoracico Tisular y Pulsado para valorar la existencia de hipertensión pulmonar. RESULTADOS: De los 46 pacientes en Hemodiálisis, solo uno fue excluido del estudio por presentar datos compatibles con hipocinesia miocardica, así un total de 45 estudios fueron incluidos. Se reporta que 13 pacientes (19.11%) No presentaron hipertensión Pulmonar y que 55 pacientes (80.88%) presentaron hipertensión pulmonar, de los cuales 41 pacientes (74.54%%) siendo hipertensión Pulmonar Leve, 11 pacientes (20%) de hipertensión Pulmonar Moderada y 3 paciente (5.45%) de hipertensión Pulmonar Severa. CONCLUSIONES: De los pacientes de la Unidad de Hemodiálisis del Hospital General de Ecatepec “Dr. José María Rodríguez” un alto porcentaje (Incidencia) presentan hipertensión pulmonar y que estos se encuentran Sub-diagnosticados

El rol del Ombudsman en el fenómeno de desplazamiento forzado interno en El Salvador

En El Salvador el desplazamiento forzado interno es un fenómeno de carácter multi-causal y estructural, con causas económicas, familiares y laborales que lo fomentan o en todo caso, coadyuvan al desplazamiento y se caracteriza por su invisibilidad y reconocimiento incipiente por parte del Estado, en un contexto en el cual consideraciones de seguridad interna y de protección son las más mínimas, y se desconocen las necesidades humanitarias de las víctimas. En ese contexto, resultó de vital importancia conocer el rol del encargado de velar y promover la defensa de los derechos humanos de las víctimas de desplazamiento forzado interno por Violencia Social; por la poca o nula capacidad del Estado de brindar alternativas de protección y resguardo a las personas en situación de peligro inminente. El Ombudsman o Defensor del Pueblo nació, en el país bajo la figura denominada Procurador para la Defensa de los Derechos Humanos, representante de la instancia denominada Procuraduría para la Defensa de los Derechos Humanos -PDDH-. Para el cumplimiento de los objetivos de la investigación se utilizó un enfoque cualitativo con alcance exploratorio-descriptivo, como método más idóneo para la comprensión de la realidad y del fenómeno elegido objeto de estudio; realizando visitas a la PDDH, organizaciones sociales e instituciones estatales, entrevistas con actores claves vinculados a la problemática, sistematización de experiencias. Lo anterior permitió conocer la realidad del rol que desempeñó en Ombudsman en el fenómeno, determinado que ha sido limitado, porque únicamente generó informes estadísticos de casos, reconoció la existencia del fenómeno y recomendó a la institucionalidad del Estado la atención de los casos; pese a que constitucionalmente el mandato resultó ser más amplio y suficiente para velar por el respeto y garantía de los derechos humanos de las personas víctimas, de desplazamiento forzado interno provocado por violencia

Prophylactic Activated Recombinant Factor VII in Liver Resection and Liver Transplantation: Systematic Review and Meta-Analysis

Intraoperative blood loss is a frequent complication of hepatic resection and orthotopic liver transplantation. Recombinant activated coagulation factor VII (rFVIIa) is a coagulation protein that induces hemostasis by directly activating factor X. There is no clear information about the prophylactic value of rFVIIa in hepatobiliary surgery, specifically in liver resection and orthotopic liver transplantation. The aim of this study was to assess the effect of rFVIIa prophylaxis to prevent mortality and bleeding resulting from hepatobiliary surgery.Relevant randomized trials were identified by searching The Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index. Randomized clinical trials comparing different rFVIIa prophylactic schemas against placebo or no intervention to prevent bleeding in hepatobiliary surgery were included. Adults undergoing liver resection, partial hepatectomy, or orthotopic liver transplantation were included. Dichotomous data were analyzed calculating odds ratios (ORs) and 95% confidence intervals (CIs). Continuous data were analyzed calculating mean differences (MD) and 95% CIs.Four randomized controlled trials were included. There were no significant differences between rFVIIa and placebo for mortality (OR 0.96; 95% CI 0.35-2.62), red blood cell units (MD 0.32; 95% CI -0.08-0.72) or adverse events (OR 1.55; 95% CI 0.97-2.49).The available information is limited, precluding the ability to draw conclusions regarding bleeding prophylaxis in hepatobiliary surgery using rFVIIa. Although an apparent lack of effect was observed in all outcomes studied, further research is needed

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Forward-central two-particle correlations in p-Pb collisions at root s(NN)=5.02 TeV

Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5 2GeV/c. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B. V.Peer reviewe

Event-shape engineering for inclusive spectra and elliptic flow in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

Peer reviewe

Glotopolítica latinoamericana : Tendencias y perspectivas

Glotopolítica latinoamericana: tendencias y perspectivas recoge el resultado de presentaciones y deliberaciones del IV Congreso Latinoamericano de Glotopolítica, realizado en la Universidad de San Pablo (Brasil) en septiembre de 2019, que convocó a numerosos y destacados especialistas en el área. Su inscripción en una serie (los anteriores se realizaron en Chile, Colombia y Alemania) nos permite apreciar los grandes ejes de los que da cuenta el cuidadoso e inteligente armado del libro decidido por los editores, y fundamentado en la Presentación. El tramo que hemos recorrido como especialistas, en el cual los eventos internacionales son hitos significativos, ha ido mostrando la amplitud de un campo que se construye apelando a tradiciones académicas variadas, que insiste en su carácter interdisciplinario y crítico y que no deja de tener una dimensión militante que se expone en las reflexiones teóricas, las investigaciones empíricas y las prácticas institucionales

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe