Colon Interposition in Children after Failed Tracheoesophageal Fistula Repair

The most common surgical procedure used to manage tracheoesophageal fistula is the primary anastomosis of the esophagus. However, in the case of failed anastomosis, replacing the esophagus with another organ is necessary. We performed two procedures of colon interposition after failure of tracheoesophageal fistula repair. In those cases, stomach replacement was not possible because of a failed Ivor Lewis operation in one case and duodenal atresia in the other

Implementación de un sistema de mezclado industrial para bebidas preparadas en la Planta de Lácteos de la ESPOCH.

El presente trabajo de titulación fue desarrollado para dar una óptima solución en cuanto a precisión de cantidades a mezclar, tiempos de mezclado y temperatura del producto final para el “Mezclado de Bebidas Preparadas en la Planta de Lácteos de la ESPOCH”, se recopiló y analizó la información necesaria, y se determinó que los productos alimenticios en su mayoría son fluidos no newtonianos de media y baja viscosidad por lo que un agitador de tipo paletas es el más adecuado para la mezcla de bebidas, se diseñó los sistemas mecánicos, electrónicos, neumáticos e hidráulicos más apropiados para el proceso, tratando de optimizar los recursos disponibles. El sistema en su totalidad está construido en Acero Inoxidable 304, y está siendo controlado por un PLC trabajando conjuntamente con el microcontrolador Arduino, los cuales son encargados de recibir los datos de los sensores de nivel, sensores de temperatura, pulsadores, procesarlos y controlar los actuadores del sistema como electroválvulas hidráulicas, cilindro neumático, resistencia calefactora, motor DC, mediante el uso de relés, circuitos de potencia y relés de estado sólido. El sistema en su totalidad es controlado por una Interfaz de Usuario (HMI) diseñada en el sistema operativo de código abierto Android, haciendo uso de la herramienta oficial de Google para el desarrollo de aplicaciones en dispositivos Android, esta interfaz de usuario se comunica con el sistema mediante tecnología inalámbrica Bluetooth 2.0 y permite un control más cómodo del Sistema. Logrando reducir el tiempo hasta en un 50% en la preparación de bebidas, con el sistema implementado frente a la forma manual. El diseño de los contenedores del equipo facilita su limpieza y evita que se acumulen desperdicios de procesos anteriores, así como la proliferación de bacterias.The actual work’s tittle was developed to give an optimal solution to the precise amount of mixing times, and the final product temperature for the “Mixing of Prepared Beverages in the Lacteos site at the ESPOCH” we compiled and analized all the necessary information and it was determined that the food products in their mayority are fluids not Newtonians of medium and low viscosity, therefore an agitator of pallet type is the most appropriate to mix beverage. The mechanic, electronic, pneumatic and hydraulic system desing, was the most appropriate for the process, trying to optimize the available resources. The system in its totally was built in stainless steel 304, and it has been controlled by a PLC working together with the Arduino microcontroller, which are in charge of received the data from de the level’s sensors, temperature’s sensors, buttons, processing and controlling the system’s started as a electrovalves hydraulics, pneumatic cylinder, heating resistant, DC motor, throughout to use of relay, circuit potency, and relays of solid state. The system in its totally is controlled by an user interface (HMI) designed in the open system from Android open code, making use of Google’s official tool to develop the applications in the Android Device, this interface communicates with the system through the wireless technology Bluetooth 2.0 and allows a better control of the System. Thereby reducing the time up to a 50% in the preparation of beverages, with the implemented system against the manual form. The design of equipment containers makes it easy to clean and prevents from old waste accumulation, as much as bacteria proliferation

Experimental numerical correlation of the delamination of composite structures subjected to low speed impact

In this work, we have analyzed the delamination caused by a low velocity impact on carbon-epoxy laminates made with balanced 0/90 braided fabrics and made by resin infusion. The items have been tested with a fall drop system. The numerical simulation was performed using the Explicit Non-Lineal Finite Element Method (NASTRAN SOL700). Delamination was analyzed using cohesive zone models (CZM). The parameters of the Tvergaard and Hutchinson constitutive law have been defined based on experimental fracture data of the laminate and mechanical properties of the resin used. The results show a good correlation (error<2%) regarding the maximum force, contact time and residual stiffness. The good correlation in evaluating the residual stiffness after impact has special interest since it allows the designer to evaluate the integrity level of a structure that has suffered an impact, generating damage.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

Background: The reference values for lung function are associated to anatomical and lung morphology parameters, but anthropometry it is not the only influencing factor: altitude and genetics are two important agents affecting respiratory physiology. Altitude and its influence on respiratory function has been studied independently of genetics, considering early and long-term acclimatization. Objective: The objective of this study is to evaluate lung function through a spirometry study in autochthonous Kichwas permanently living at low and high-altitude. Methodology: A cross-sectional study of spirometry differences between genetically matched lowland Kichwas from Limoncocha (230 m) at Amazonian basin and high-altitude Kichwas from Oyacachi (3,180 m) in Andean highlands. Chi-square method was used to analyze association or independence of categorical variables, while Student's t test was applied to comparison of means within quantitative variables. ANOVA, or in the case that the variables didn't meet the criteria of normality, Kruskal Wallis test were used to compare more than two groups. Results: People from Oyacachi (high altitude) showed a higher predicted values than those from Limonocha (low altitude). The FVC and the FEV1 were significantly greater among highlanders than lowlanders (p value < 0.001). The FEV1/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants. Conclusion: Residents of Oyacachi had greater lung capacity than their peers from Limoncocha, a finding physiologically plausible according to published literature. When analyzing the spirometric patterns obtained in these populations, it was evident that no person had an obstructive pattern, while on the other hand, the restrictive pattern appeared in Limoncocha and Oyacachi populations in 12.9% although it is clear that there is a predominance of this in the individuals belonging to Limoncocha

Hematological parameters, lipid profile and cardiovascular risk analysis among genotype-controlled indigenous Kichwa men and women living at low and high altitudes

Introduction: Human adaptation to high-altitude is due to characteristic adjustments at every physiological level. Differences in lipid profile and cardiovascular risk factors in altitude dwellers have been previously explored, nevertheless there are no reports available on genotype-controlled matches among different altitude adapted indigenous populations. Objective: To explore the possible differences in plasma lipid profile and cardiovascular risk among autochthonous Kiwcha people inhabitants of low and high-altitude locations. Methodology: A cross-sectional analysis of plasmatic lipid profiles and cardiovascular risk factors in lowland Kiwchas from Limoncocha (230 m) and high-altitude Kiwchas from Oyacachi (3,800 m). Results: In the low altitude group, 66% were women (n=78) and 34% (n=40) were men, while at high altitude, 59% (n=56) were women and 41% (n=41%) were men. We found the proportion of overweight and obese individuals to be higher among low altitude dwellers (p<0.05). Red blood cells (RBC), Hemoglobin concentration and SpO2% were higher among high altitude dwellers and erythrocyte's size was found to be smaller at high altitude .The group located at low altitude showed also lower levels of plasma cholesterol, LDL and HDL but most of these differences are not influenced by gender or elevation. Conclusions: Living at altitude elicits well-known adaptive physiological changes such as erythrocyte count, hemoglobin concentration, hematocrit, and serum glucose. We report also clinical differences in the plasma lipid profile, with higher levels of cholesterol and high density and low-density lipoproteins in Andes Mountain inhabitants versus their Amazonian basin peers. Despite we found altered underlying physiological pathways between the populations, this does not allow in a different cardiovascular risk

Molecular characterization of infectious bronchitis virus in laying hen farms located in Tungurahua province, Ecuador

La bronquitis infecciosa aviar genera importantes pérdidas económicas y, si bien la vacunación disminuye dichas mermas, el surgimiento continuo de nuevas cepas virales complica el control de la infección. El objetivo de esta investigación fue caracterizar, mediante técnicas moleculares, las cepas del virus de la bronquitis infecciosa aviar circulantes en explotaciones de gallinas ponedoras de la provincia de Tungurahua, Ecuador. Se trabajó con muestras de hisopados y de órganos de 47 granjas y las secuencias obtenidas fueron comparadas con las correspondientes a 17 vacunas a virus vivo empleadas en la zona. Se encontraron 16 granjas positivas al amplificar la región 5’UTR y un segmento de S1. La construcción de un árbol filogenético mostró que cinco de las secuencias se ubicaron en el mismo clado de las cepas de tipo Massachusetts, linaje GI-1; siete se encontraron en el clado del linaje GI-13 o cepas tipo 793B y cuatro secuencias se agruparon en un clado de cepas tipo Q1, linaje G1-16. Si bien se requieren estudios moleculares más completos en los que se amplifique la totalidad del gen S a fin de obtener datos más concluyentes, se logró determinar que existen tres tipos de cepas circulando en la provincia de Tungurahua, dos posiblemente vacunales y otra de origen desconocido.Avian infectious bronchitis (IBV) generates significant economic losses. While vaccination decreases these losses, new viral strains are continually emerging. The objective of this research was to perform molecular characterization of IBV strains circulating in laying hen farms in Tungurahua province, Ecuador. Swabs and organ samples from 47 farms were collected and sequenced, and results were compared to 17 live vaccines used in the area Sixteen farms were positive for IBV as determined by amplification of the 5'UTR region and a S1 segment. The construction of a phylogenetic tree showed that 5 samples were in the same clade as the Massachusetts-type strains, linage GI-1; 7 samples were in the GI-13 lineage clade of vaccine type 793B strains, and 4 samples were into a clade of Q1 type strains. In conclusion, although studies that include the entire protein S sequence are necessary, we were able to detect three types of strains circulating in the province of Tungurahua, two of which are probably vaccine-derived and one has an unknown origin.Fil: Revelo Cueva, María Del Carmen. Universidad Central del Ecuador; EcuadorFil: Vinueza Burgos, Christian Vinicio. Universidad Central del Ecuador; EcuadorFil: Metz, German Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Departamento de Microbiología. Cátedra de Virología; Argentina. Centro de Microbiologia Basica y Aplicada (cemiba) ; Facultad de Cs.veterinarias ; Universidad Nacional de la Plata;Fil: Toapanta, Ricardo Lenin. Universidad Central del Ecuador; EcuadorFil: Echeverria, Maria Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Departamento de Microbiología. Cátedra de Virología; Argentina. Centro de Microbiologia Basica y Aplicada (cemiba) ; Facultad de Cs.veterinarias ; Universidad Nacional de la Plata

Percepción del Cuidado del Agua de Estudiantes Secundarios Chilenos. La Construcción de un Nuevo Mundo está en la Juventud

El presente estudio buscó conocer la percepción de estudiantes secundarios de Chile respecto al significado del cuidado del agua. 1Para ello se realizó un estudio descriptivo, que consistió en una aplicación on line de una encuesta a 120 estudiantes (65% mujeres, una media de edad de 15,8 años, dt=1,64 años). Un 78,9% de las y los estudiantes consideran que el agua es un recurso que debe ser cuidado. Un 68,6% considera que el ahorro del agua es importante, Un 44,3% de los participantes señala que ha recibido orientación respecto a cómo cuidar el recurso. Un 31,6% señala que ahora agua porque no dispone el recurso como agua potable. Los resultados muestran que se debe generar mayor educación respecto al cuidado del agua, por un lado. Resulta preocupante que un porcentaje importante no tenga acceso a agua potable.This study sought to know the perception of secondary students in Chile regarding the meaning of water care.&nbsp; For this purpose, a descriptive study was carried out, consisting of an online application of a survey of 120 students (65% female, an average age of 15.8 years, SD: 1.64 years). 78.9% of students consider water to be a resource that needs to be cared for.&nbsp; 68.6% believe that water savings are important, 44.3% of participant’s report that they have received guidance on how to take care of the resource. 31,6% say that water now because it does not provide for the resource as drinking water. The results show that more education should be generated regarding water care on the one hand.&nbsp; Worryingly, a significant percentage do not have access to safe drinking water

Microsatellites’ mutation modeling through the analysis of the Y-chromosomal transmission: Results of a GHEP-ISFG collaborative study

The Spanish and Portuguese Speaking Working Group of the International Society for Forensic Genetics (GHEP-ISFG) organized a collaborative study on mutations of Y-chromosomal short tandem repeats (Y-STRs). New data from 2225 father-son duos and data from 44 previously published reports, corresponding to 25,729 duos, were collected and analyzed. Marker-specific mutation rates were estimated for 33 Y-STRs. Although highly dependent on the analyzed marker, mutations compatible with the gain or loss of a single repeat were 23.2 times more likely than those involving a greater number of repeats. Longer alleles (relatively to the modal one) showed to be nearly twice more mutable than the shorter ones. Within the subset of longer alleles, the loss of repeats showed to be nearly twice more likely than the gain. Conversely, shorter alleles showed a symmetrical trend, with repeat gains being twofold more frequent than reductions. A positive correlation between the paternal age and the mutation rate was observed, strengthening previous findings. The results of a machine learning approach, via logistic regression analyses, allowed the establishment of algebraic formulas for estimating the probability of mutation depending on paternal age and allele length for DYS389I, DYS393 and DYS627. Algebraic formulas could also be established considering only the allele length as predictor for DYS19, DYS389I, DYS389II-I, DYS390, DYS391, DYS393, DYS437, DYS439, DYS449, DYS456, DYS458, DYS460, DYS481, DYS518, DYS533, DYS576, DYS626 and DYS627 loci. For the remaining Y-STRs, a lack of statistical significance was observed, probably as a consequence of the small effective size of the subsets available, a common difficulty in the modeling of rare events as is the case of mutations. The amount of data used in the different analyses varied widely, depending on how the data were reported in the publications analyzed. This shows a regrettable waste of produced data, due to inadequate communication of the results, supporting an urgent need of publication guidelines for mutation studies.info:eu-repo/semantics/publishedVersio

ECAMulticapa: Effectiveness of double-layered compression therapy for healing venous ulcers in primary care: a Study Protocol

Background: Chronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload. Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated. Method/design: Randomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable. The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up. The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations. The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder. Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat. Discussion: The study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions. Trial registration: This study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.This study was funded by PN of I + D + I 2013–2016 and the ISCIII – Subdirección General de Evaluación y Fomento de la Investigación and FEDER funds (PI13/01975). Ministerio de Economia y Competitividad

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie