Manejo quirúrgico del trauma hepático en adultos, en el Hospital Nacional Daniel Alcides Carrión del Callao, 2002-2006

Da a conocer la forma de presentación, causas más frecuentes, tratamiento quirúrgico instaurado, así como la evolución de los pacientes con Trauma Hepático y de esta manera estandarizar el manejo de estos pacientes, en concordancia a lo reportado por las revisiones bibliográficas. Es un estudio descriptivo, retrospectivo, transversal se incluyen 48 pacientes con trauma Hepático de los cuales se manejan quirúrgicamente a 35 de ellos, en la Emergencia del Hospital Nacional Daniel Alcides Carrión desde enero 2002 a diciembre del 2006. Resultados: 35 pacientes necesitaron manejo quirúrgico, mayor porcentaje en el sexo masculino, edad predominante entre 20 y 39 años, 23 con trauma abdominal abierto y 12 con trauma abdominal cerrado, lesiones grado II y IV en el 30.55%, segmentos derechos más afectados en el 81.1%, técnica más usada compresión 30.95% y rafia con catgut crómico 0 28.57%, el examen auxiliar más usado fue la ecografía en 57.14%, complicaciones en el 17,14% de pacientes la más frecuente el absceso subfrénico. Se concluye que el sexo masculino es el más afectado, la mayoría entre la segunda y tercera décadas de vida, las lesiones más frecuentes de necesidad quirúrgica son las de arma blanca, seguidas por las de arma de fuego y los accidentes de tránsito. La sutura con catgut crómico, el electro cauterización y el hemocolágeno son los procedimientos más realizados.Trabajo académic

REFLEXIONES SOBRE LA CONCEPCIÓN TEÓRICA COMO RESULTADO CIENTÍFICO

In this article a review of the term of conception is from scientific research, treated by different authors, from different positions depending on the area of ​​knowledge, which is defined as theoretical, methodological, didactic, educational, theoretical or methodological. Some overlap in the definitions, structure and purpose, which must be realized in practice, so it is understood that the concept is a theoretical basis and is realized through systems, methodologies, strategies  and other practical results were seen.En el presente artículo se realiza una valoración sobre el término de concepción desde la investigación científica, tratado por diferentes autores, desde diferentes posiciones según el área de conocimiento, donde es definida como teórica, metodológica, didáctica, educativa, o teórico-metodológica. Se aprecia cierta coincidencia en las definiciones,  estructura y la finalidad, que debe concretarse en la práctica, por lo que se entiende que la concepción es un sustento teórico y se materializa, mediante sistemas, metodologías, estrategias y otros resultados prácticos

Simuladores de Planificadores de Sistemas en Tiempo Real

En este artículo se presenta un simulador desarrollado que permite ejecutar diferentes planificadores de Tiempo Real, como el algoritmo de planificación cíclica, Algoritmo de la Razón Monótona (RMA) y EDF (Earliest Deadline First) para un conjunto de procesos con unos datos dados y muestra los resultados obtenidos. Mediante este simulador se facilita a los alumnos el aprendizaje de los algoritmos de planificación.This paper presents a simulator that has been developed to allow the execution of scheduling algorithms such as the Cyclic Non­preemptive Executive, Rate­monotonic scheduling (RMS) and Earliest Deadline First (EDF) for a given set of processes with different values and the simulator displays the results. With this simulator, students are able to learn about scheduling algorithms.Universidad de Granada: Departamento de Arquitectura y Tecnología de Computadores; Vicerrectorado para la Garantía de la Calidad

Propuesta de indicadores antropométricos, físicos y morfofuncionales para la selección e iniciación deportiva en la natación (Original)

This research deals with the need of designing anthropometrical, physical and morpho functional indicators for the selection and sports beginning of swimmers,  and it  will contribute to  perfect this process in the multi- sports centers because in the last decades talent selection in swimming in the country, have been made based on tests which at present are able to suffer changes according to the demands of swimming  and the characteristics of each territory or multi-sports center among others. In its development were used different scientific methods such as the theoretical, analysis, synthesis, empirical such as observation, measurement and the experimental one. The greatest significance of the thesis lies on the proposal of anthropometrical, physical and morpho functional indicators with their corresponding percents used for the selection and beginning of seven years old swimmers.La investigación responde a la necesidad de diseñar indicadores antropométricos, físicos y morfofuncionales para la selección e iniciación deportiva en la Natación, que contribuyan al perfeccionamiento de este proceso desde los Combinados Deportivos, ya que en las últimas décadas, la selección de talentos para la Natación en el País se ha realizado sobre la base de pruebas, que en los momentos actuales son susceptibles a cambios en correspondencia a las exigencias vigentes del deporte y a las particularidades de cada territorio o Combinado Deportivo entre otros. En su desarrollo se utilizaron diferentes métodos científicos, como los teóricos: análisis, síntesis; empíricos: la observación, la medición y el experimento. En esta indagación el grado de significación radica en la propuesta de indicadores antropométricos, físicos y morfofuncionales con sus percentiles, puestos en práctica para la selección e iniciación deportiva en la Natación en la categoría de 7 años. Estas pruebas cualitativas y cuantitativas, con los rangos y escalas establecidos permiten una evaluación de mayor confiabilidad de este sistema de selección deportiva

Leveraging Task-Parallelism in Energy-Efficient ILU preconditioners

We analyze the energy-performance balance of a task-parallel computation of an ILU-based preconditioner for the solution of sparse linear systems on multi-core processors. In particular, we elaborate a theoretical model for the power dissipation, and employ it to explore the effect of the processor power states on the time-power-energy interaction for this calculation. Armed with the insights gained from this study, we then introduce two energy-saving mechanisms which, incorporated into the runtime in charge of the parallel execution of the algorithm, improve energy efficiency by 6.9%, with a negligible impact on performance.Peer ReviewedPostprint (published version

Hydrolysis and methanolysis of silanes catalyzed by iridium(III) bis-N-heterocyclic carbene complexes: Influence of the wingtip groups

New [Ir(CH3CN)2(I)2{κC,C′-bis(NHC)}]BF4 complexes featuring bis-NHC ligands with a methylene bridge and different N substitution (−CH2CH2CH2CH3 and −CH2CH2OPh) were synthesized. NMR studies and X-ray diffraction structures evidenced that the wingtip group −CH2CH2OPh presents a hemilabile behavior in solution, with the oxygen atom coordinating and dissociating at room temperature, which contrasts with the strong coordination of the ether functions in the complex [Ir(I)2{κC,C′,O,O′-bis(NHCOMe)}]BF4 (bis(NHCOMe) = methylenebis(N,N′-bis(2-methoxyethyl)imidazol-2-ylidene)), previously reported by us. These complexes proved to be efficient catalysts for the hydrolysis and methanolysis of silanes, affording molecular hydrogen and silyl alcohols or silyl ethers as the main reaction products in excellent yields. The hydrogen generation rates were very much dependent on the nature of the hydrosilane and the coordination ability of the wingtip group. The latter also played a key role in the recyclability of the catalytic system.This work was supported by the Spanish Ministry of Economy and Competitiveness (MINECO/FEDER) (CONSOLIDER INGENIO CSD2009-0050, CTQ2011-27593 projects, and “Juan de la Cierva” (M.I.) and Ramón y Cajal (P.J.S.M.) programs) and the DGA/FSE-E07. The authors express their appreciation to the support from the Ministry of Higher Education, Saudi Arabia, in establishment of the Center of Research Excellence in Petroleum Refining & Petrochemicals at King Fahd University of Petroleum & Minerals (KFUPM) and the support from KFUPM-University of Zaragoza research agreement.Peer Reviewe

Quality of life in elderly people after a hip fracture: a prospective study

ANTECEDENTES: La fractura de cadera es un importante problema social y médico por su creciente prevalencia, las consecuencias para la salud y el impacto económico en el sistema sanitario, pero no cabe duda de que también repercute en la calidad de vida relacionada con la salud (CVRS). De ahí la importancia de conocer y determinar el impacto de la enfermedad en la vida cotidiana desde la perspectiva del bienestar físico, emocional y social del paciente. PROPÓSITO: Determinar el impacto de la fractura de cadera en la CVRS de las personas mayores de 65 años un mes después de la cirugía, los factores relacionados y los efectos en la capacidad funcional y el estado de ánimo. MÉTODOS: Estudio observacional prospectivo realizado en las unidades de traumatología de dos hospitales universitarios de la provincia de Cáceres con muestreo consecutivo de todos los pacientes mayores de 65 años ingresados por cirugía de fractura de cadera durante el periodo de estudio. Se registraron datos sociodemográficos y clínicos en el momento del ingreso y de forma prospectiva en la visita de seguimiento 1 mes después. Se recogieron variables clínicas, sociales, de calidad de vida (EQ-5D-), de capacidad funcional e instrumental básica (Índice de Barthel (BI) y Escala de Lawton y Brody) y de depresión geriátrica (Yesavage). RESULTADOS: El estudio incluyó 224 pacientes con una edad media de 84,6 años (DE ± 6,1), el 76,3% eran mujeres. La comorbilidad de Charlson fue de 5,3 (DE ± 1,2). El índice EQ-5D disminuyó de 0,62 (DE ± 0,35) a 0,16 al mes de seguimiento (DE ± 0,20) p < 0,001. La puntuación media de la Escala Visual Analógica (EVA) del EQ-5D disminuyó de 72,8 (DE ± 15,8) a 48,3 (DE ± 17,2) p < 0,001. Todas las dimensiones de la EQ-5D mostraron una reducción significativa desde el momento del estado previo a la fractura hasta 1 mes después de la cirugía. Los factores independientes asociados con la CVRS 1 mes después de la cirugía fueron la puntuación del Índice de Barthel antes de la fractura, la escala de Lawton y Brody, la presencia de depresión y el tipo de cirugía. CONCLUSIONES: Después de una fractura de cadera, los pacientes experimentan un deterioro considerable de su CVRS, especialmente en el cuidado personal, las actividades diarias y la movilidad. También se produce una disminución significativa de la capacidad funcional para las actividades básicas e instrumentales de la vida diaria. Un mes después de la cirugía, la CVRS está muy lejos de los niveles previos a la fractura.BACKGROUND: Hip fracture is an important social and medical problem due to its increasing prevalence, the consequences for health and the economic impact on the health care system, but there is no doubt that it also has repercussions on health-related quality of life (HRQoL). Hence the importance of understanding and determining the impact of the condition on everyday life from the perspective of the patient’s physical, emotional and social well-being. PURPOSE: To determine the impact of hip fracture on HRQoL of people over the age of 65 1 month after surgery, related factors and the effects on functional ability and mood. METHODS: Prospective observational study conducted in the traumatology units of two university hospitals in the province of Cáceres with consecutive sampling of all patients over the age of 65 admitted for hip fracture surgery during the study period. Sociodemographic and clinical data were recorded at the time of admission and prospectively at the follow-up visit 1 month later. Clinical, social, quality of life (EQ-5D-), basic functional and instrumental capacity (Barthel Index (BI) and Lawton & Brody Scale), and geriatric depression (Yesavage) variables were collected. RESULTS: The study included 224 patients with a median age of 84.6 years (SD ± 6.1), 76.3% were female. Charlson’s comorbidity was 5.3 (SD ± 1.2). The EQ-5D index decreased from 0.62 (SD ± 0.35) to 0.16 at 1 month follow up (SD ± 0.20) p < 0.001. The mean Visual Analog Scale (VAS) score of EQ-5D decreased from 72.8 (SD ±15.8) to 48.3 (SD ± 17.2) p < 0.001. All dimensions of EQ-5D showed a significant reduction from the time of pre-fracture status to 1 month after surgery. Independent factors associated with HRQoL 1 month after surgery were pre-fracture status Barthel Index score, Lawton and Brody scale, presence of depression, and type of surgery. CONCLUSIONS: After a hip fracture, patients experience considerable deterioration in their HRQoL, especially in selfcare, daily activities, and mobility. There is also a significant decline in functional capacity for both the basic and instrumental activities of daily living. One month after surgery, HRQoL is a long way from pre-fracture levels.peerReviewe

Retreatment predictions in odontology by means of CBR Systems

The field of odontology requires an appropriate adjustment of treatments according to the circumstances of each patient. A follow-up treatment for a patient experiencing problems from a previous procedure such as endodontic therapy, for example, may not necessarily preclude the possibility of extraction. It is therefore necessary to investigate new solutions aimed at analyzing data and, with regard to the given values, determine whether dental retreatment is required. In this work, we present a decision support system which applies the case-based reasoning (CBR) paradigm, specifically designed to predict the practicality of performing or not performing a retreatment. Thus, the system uses previous experiences to provide new predictions, which is completely innovative in the field of odontology. The proposed prediction technique includes an innovative combination of methods that minimizes false negatives to the greatest possible extent. False negatives refer to a prediction favoring a retreatment when in fact it would be ineffective. The combination of methods is performed by applying an optimization problem to reduce incorrect classifications and takes into account different parameters, such as precision, recall, and statistical probabilities. The proposed system was tested in a real environment and the results obtained are promising

Diagnosis delay and follow-up strategies in colorectal cancer. Prognosis implications: a study protocol

<p>Abstract</p> <p>Background</p> <p>Controversy exists with regard to the impact that the different components of diagnosis delay may have on the degree of invasion and prognosis in patients with colorectal cancer. The follow-up strategies after treatment also vary considerably. The aims of this study are: a) to determine if the symptoms-to-diagnosis interval and the treatment delay modify the survival of patients with colorectal cancer, and b) to determine if different follow-up strategies are associated with a higher survival rate.</p> <p>Methods/Design</p> <p>Multi-centre study with prospective follow-up in five regions in Spain (Galicia, Balearic Islands, Catalonia, Aragón and Valencia) during the period 2010-2012. Incident cases are included with anatomopathological confirmation of colorectal cancer (International Classification of Diseases 9th revision codes 153-154) that formed a part of a previous study (n = 953).</p> <p>At the time of diagnosis, each patient was given a structured interview. Their clinical records will be reviewed during the follow-up period in order to obtain information on the explorations and tests carried out after treatment, and the progress of these patients.</p> <p>Symptoms-to-diagnosis interval is defined as the time calculated from the diagnosis of cancer and the first symptoms attributed to cancer. Treatment delay is defined as the time elapsed between diagnosis and treatment. In non-metastatic patients treated with curative intention, information will be obtained during the follow-up period on consultations performed in the digestive, surgery and oncology departments, as well as the endoscopies, tumour markers and imaging procedures carried out.</p> <p>Local recurrence, development of metastases in the follow-up, appearance of a new tumour and mortality will be included as outcome variables.</p> <p>Actuarial survival analysis with Kaplan-Meier curves, Cox regression and competitive risk survival analysis will be performed.</p> <p>Discussion</p> <p>This study will make it possible to verify if the different components of delay have an impact on survival rate in colon cancer and rectal cancer. In consequence, this multi-centre study will be able to detect the variability present in the follow-up of patients with colorectal cancer, and if this variability modifies the prognosis. Ideally, this study could determine which follow-up strategies are associated with a better prognosis in colorectal cancer.</p

Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP

Exclusive enteral nutrition (EEN) has been shown to be more effective than corticosteroids in achieving mucosal healing in children with Crohn´s disease (CD) without the adverse effects of these drugs. The aims of this study were to determine the efficacy of EEN in terms of inducing clinical remission in children newly diagnosed with CD, to describe the predictive factors of response to EEN and the need for treatment with biological agents during the first 12 months of the disease. We conducted an observational retrospective multicentre study that included paediatric patients newly diagnosed with CD between 2014–2016 who underwent EEN. Two hundred and twenty-two patients (140 males) from 35 paediatric centres were included, with a mean age at diagnosis of 11.6 ± 2.5 years. The median EEN duration was 8 weeks (IQR 6.6–8.5), and 184 of the patients (83%) achieved clinical remission (weighted paediatric Crohn’s Disease activity index [wPCDAI] 15 mg/L and ileal involvement tended to respond better to EEN. EEN administered for 6–8 weeks is effective for inducing clinical remission. Due to the high response rate in our series, EEN should be used as the first-line therapy in luminal paediatric Crohn’s disease regardless of the location of disease and disease activityS