Propuesta de mejora en los procesos de producción y medio ambiente para reducir los costos operativos de la empresa Curtiduría Orión S.A.C

RESUMEN Este trabajo tiene como finalidad en reducir los costos operativos mediante una propuesta de mejora en los procesos de producción y medio ambiente a la empresa curtiduría Orión S.A.C dedicada a la producción de cueros. Por lo cual, se aplicó herramientas de ingeniería industrial para reducir los costos operativos en la empresa Orión, para el desarrollo de esta investigación se recolecto información para realizar un diagnóstico de la situación actual de la empresa, luego se llegó a identificar los problemas que enfrenta la empresa llegando a la conclusión; que no se estaba haciendo un buen uso de los recursos. En los botales cuando hacían cambio de lote en los procesos de remojo, pelambre, curtido y recurtido, específicamente en las actividades de pesado y traslado de insumos se observaba que estos trabajos lo realizaban cuando el botal estaba parado, cuando debería realizarse cuando el botal esta en movimiento. Para este problema se implementó la herramienta de lean manufacturing, con la ayuda de esta herramienta se puedo reducir 36 minutos por cada cambio de lote de pieles, que equivalen un ahorro de S/. 22,430.60 soles anuales con una inversión S/. 1,420.00 soles. También se observó paradas de producción por fallas en los equipos, por lo cual se hizo un análisis de criticidad de equipos para darle más prioridad a los equipos críticos dando como resultados a los botales, se planteó un plan de mantenimiento preventivo para elevar la disponibilidad de los equipos en mención así evitar las paradas intempestivas de producción, llegando a un ahorro de S/. 51,954.416 soles anuales, con una inversión de S/. 13,105.00 soles. Además, la empresa se encuentra notificada sobre una potencial multa equivalente a S/ 30,3750.00 soles, debido a una inspección ambiental que la OEFA realizó según resolución Sub directoral Nº 400-2016-OEFA/DFSAI/SDI, según OEFA la norma incumplida por la empresa es el DS N.º 019-97-ITINCI Reglamento de protección ambiental para el desarrollo de actividades de manufactura, por lo cual se hizo uso de la herramienta de ingeniería el plan de manejo ambiental operativo, en el cual ayudó a identificar los aspectos ambientales significativos dentro de los procesos analizando pudimos determinar los desechos generados por estos procesos, para poder aplicarles medida de control, así evitamos una multa, también ahorramos 20 % del consumo actual de agua de la empresa al recircular y se incrementaría la retención de solidos orgánicos para incrementar la venta de este sub producto, esto se daría con una propuesta de inversión de S/. 20,599.00 soles. Finalmente, se plantean las conclusiones y recomendaciones como resultados del presente estudio.ABSTRACT This work aims to reduce operating costs through a proposal to improve the production processes and the environment to the tannery company Orión S.A.C dedicated to the production of leather. Therefore, it was applied industrial engineering tools to reduce operating costs in the company Orion, for the development of this research was collected information to make a diagnosis of the current situation of the company, then came to identify the problems it faces the company concluding; that they were not making good use of resources. In the bottlers when doing lot change in the processes of soaking, tanning, tanning and retanning, specifically in the activities of heavy and transfer of inputs, it was observed that these works were carried out when the botal was stopped, when it should be done when the botal is moving. For this problem was implemented the lean manufacturing tool, with the help of this tool I can reduce 36 minutes for each change of batch of skins, which equals a saving of S /. 22,430.60 annual soles with an investment S /. 1,420.00 soles. There were also production stoppages due to equipment failures, which made a criticality analysis of equipment to give priority to critical equipment giving results to the bots, a preventive maintenance plan was proposed to increase the availability of the teams in this way to avoid untimely stops of production, reaching a saving of S /. 51,954,416 soles per year, with an investment of S /. 13,105.00 soles. In addition, the company is notified of a potential fine equivalent to S / 30,3750.00 soles, due to an environmental inspection carried out by the OEFA according to Sub-Directorial Resolution No. 400-2016-OEFA / DFSAI / SDI, according to OEFA. the company is the DS No. 019-97-ITINCI Regulation of environmental protection for the development of manufacturing activities, which made use of the engineering tool the operational environmental management plan, in which it helped to identify the significant environmental aspects within the processes analyzed were able to determine the waste generated by these processes, to be able to apply control measures, thus avoiding a fine, we also save 20% of the company's current water consumption by recirculating and increasing the retention of solids organic to increase the sale of this sub product, this would be with an investment proposal of S /. 20,599.00 soles. Finally, the conclusions and recommendations are presented as results of the present study

Presentación de un caso de secuestro pulmonar intralobar A case presentation of intralobar pulmonary sequestrum

Las malformaciones pulmonares congénitas se muestran con una incidencia de 2,2 %. La mayoría son malformaciones del intestino anterior y las más frecuentes son los quistes broncogénicos, la malformación quística adenomatoide y el secuestro pulmonar. Se presentó un caso de secuestro pulmonar intralobar en un paciente de 15 años de edad, resuelto mediante acto quirúrgico. Se exponen datos clínicos y estudios imaginológicos. Se revisó el tema.The congenital pulmonary malformations showed an incidence of the 2,2%. Most of anterior intestine malformations and the more frequent ones are: bronchogenic cysts, the adenomatoide cystic malformation and the pulmonary sequestrum. This is the case of a patient aged 15 presenting with intralobar pulmonary sequestrum operated on. Clinical data and imaging studies are exposed. There was a subject review

Effect of Hypoxia in the Transcriptomic Profile of Lung Fibroblasts from Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is an aging-associated disease characterized by exacerbated extracellular matrix deposition that disrupts oxygen exchange. Hypoxia and its transcription factors (HIF-1α and 2α) influence numerous circuits that could perpetuate fibrosis by increasing myofibroblasts differentiation and by promoting extracellular matrix accumulation. Therefore, this work aimed to elucidate the signature of hypoxia in the transcriptomic circuitry of IPF-derived fibroblasts. To determine this transcriptomic signature, a gene expression analysis with six lines of lung fibroblasts under normoxia or hypoxia was performed: three cell lines were derived from patients with IPF, and three were from healthy donors, a total of 36 replicates. We used the Clariom D platform, which allows us to evaluate a huge number of transcripts, to analyze the response to hypoxia in both controls and IPF. The control′s response is greater by the number of genes and complexity. In the search for specific genes responsible for the IPF fibroblast phenotype, nineteen dysregulated genes were found in lung fibroblasts from IPF patients in hypoxia (nine upregulated and ten downregulated). In this sense, the signaling pathways revealed to be affected in the pulmonary fibroblasts of patients with IPF may represent an adaptation to chronic hypoxia

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London