Complicaciones en cirugía oral menor en pacientes bajo medicación anticoagulante

El presente trabajo retrospectivo y descriptivo, tuvo como objetivo determinar las complicaciones en todos los pacientes bajo tratamiento anticoagulante sometidos a cirugía oral menor ambulatoria en el Servicio de Medicina Oral y Cirugía Buco Máxilo Facial del Departamento de Estomatología del HCFAP entre 2006 y 2007. La suspensión del ácido acetil salicílico y el reemplazo de warfarina por Heparinas de bajo peso molecular, fueron las modificaciones de las dosis del fármaco AC más frecuentes. La frecuencia de complicaciones hemorrágicas fue baja (10%), y las infecciosas 3%. 02 casos (0.9%) de hemorragia post-operatoria tuvieron atención por emergencia hospitalaria. No hubo ningún caso de tromboembolia. El género femenino y masculino tuvieron igual número de complicaciones hemorrágicas. El género femenino tuvo más complicaciones infecciosas. La frecuencia de complicaciones según el tipo de medicación fue baja, 2% tomaban warfarina, 9% de pacientes que tomaban AAS, y 2% tomaban warfarina + AAS. Se concluyó que la frecuencia de complicaciones es baja, y se sugiere la elaboración de un protocolo de atención a este tipo de pacientes.-- This retrospective and descriptive research's aim was to find complications in all anticoagulated patients who underwent minor oral surgery at the Oral Surgery Service of Estomathology Department at the Peruvian Air Force Hospital, during 2006 and 2007. It was found that warfarin replacement by Low-Molecular Weight Heparin and AAS withdrawal was frequent. The bleeding complication rate was low (10%), as well as infectious (3%). 02 cases of post-surgical bleeding required hospitalary emergency treatment. No thromboembolic events were found. Female and male patients had the same number of bleeding complications. Female gender had more infectious complicactions. Frequence of complications related to anticoagulant medication was low, 2% had warfarin, 9% had acetil salicylic acid (ASA), and 2% had warfarin + ASA. It was concluded that the complication rate was low, and elaboration of a treatment protocol is suggestedTesi

Propuesta de mejora integral para reducir la demora vehicular en la intersección de las avenidas Morales Duarez y Universitaria en el distrito de Cercado de Lima, mediante el uso de la herramienta de simulación VISSIM

El incremento vehicular y la consiguiente congestión en las vías de comunicación de Lima Metropolitana es la problemática que da origen a la presente investigación, que tiene como objetivo principal reducir la demora vehicular en la intersección que une las avenidas Universitaria y Morales Duárez en el Cercado e Lima. Esto se proyecta realizarlo a través de la optimización de los tiempos del semáforo, utilizando para ello el programa Vissim. Para ello, primero se realizará un estudio previo que comprenda el análisis de datos de medidas geométricas que permitan observar los días donde concurren la mayor cantidad de autos, esto es, el pico más alto del volumen vehicular. Asimismo, una vez que se tengan estos hallazgos, se procederá a cambiar distintos escenarios, modificando de acuerdo a la propuesta preestablecida, con múltiples corridas y aplicando la reducción de tiempos semafóricos, a fin de conseguir la mejora planteada previamente. Para finalizar, con base en los parámetros obtenidos, se opta por la alternativa más viable. Estos parámetros incluyen el tiempo de recorrido del auto, la longitud de cola, etc. De esta manera, el presente proyecto quiere aportar para brindar una solución eficaz al caos y la congestión vehicular de la zona elegida. Se comparará la situación presente con la propuesta elegida evidenciando cómo se reduce el tiempo y se soluciona el problema de la congestión vehicular.The increase in traffic and the consequent congestion on the communication routes of Metropolitan Lima is the problem that gives rise to this research, whose main objective is to reduce the vehicle delay at the intersection that joins Universitaria and Morales Duárez avenues in Cercado and Lime. This is planned to be done through the optimization of traffic light times, using the Vissim program. To do this, first a preliminary study will be carried out that includes the analysis of data from geometric measurements that allow us to observe the days where the greatest number of cars are present, that is, the highest peak of vehicle volume. Likewise, once these findings are made, different scenarios will be changed, modifying according to the pre-established proposal, with multiple runs and applying the reduction of traffic light times, in order to achieve the previously proposed improvement. Finally, based on the parameters obtained, the most viable alternative is chosen. These parameters include the car's travel time, queue length, etc. In this way, this project wants to contribute to providing an effective solution to the chaos and traffic congestion in the chosen area. The present situation will be compared with the chosen proposal, showing how time is reduced and the problem of traffic congestion is solved.Trabajo de Suficiencia ProfesionalODS 9: Industria, Innovación e InfraestructuraODS 11: Ciudades y Comunidades SosteniblesODS 13: Acción por el Clim

Of Apoptosomes and Oncogenes: Repurposing a Death Machine & Deconstructing the Action of P53 Mutations

It is now well appreciated that the apoptosome, which governs caspase-dependent cell death, also drives nonapoptotic caspase activation to remodel cells. However, determinants that specify whether the apoptosome acts to kill or remodel have yet to be identified. I show here that Tango7 genetically interacts with the apoptotic machinery but instead of regulating cell death, collaborates with the apoptosome to drive caspase-dependent cellular remodeling. Specifically, Tango7 is required for non-apoptotic caspase activity during spermatid remodeling and localizes to the active apoptosome compartment in these cells via its C terminus. Furthermore, Tango7 directly stimulates activity of reconstituted apoptosomes in vitro. These and other data presented here suggest that Tango7 physically recruits the apoptosome to specify this complex for nonapoptotic cellular remodeling. In vivo genetic model systems are powerful tools to deconstruct activity of genes driving human disease. The tumor suppressor p53 is mutated more than any other gene in human cancer, but unlike other tumor suppressors, it acquires missense mutations which encode oncogenic variants. These gain-of-function mutants promote more aggressive and metastatic cancers in vivo but their oncogenic activity is not well understood. To address this problem, I have exploited Drosophila as a platform to study and stratify human p53 (hp53) mutants. I replaced fly p53 with either wild-type hp53 or 5 of the most prevalent hp53 mutations in cancer. In this system, hp53 is under control of endogenous Dp53 regulatory elements and can regulate in vivo transcriptional activation and apoptosis like its fly counterpart. Furthermore, wild-type hp53 forms foci in the germline that localize to the same subnuclear compartment as Dp53 foci. This property is compromised in all of the gain-of-function mutants and can thus be used to distinguish oncogenic variants from wild-type hp53. Future studies aim at finding whether this and other properties shared among the 5 mutants can help stratify oncogenic p53 mutations found in human cancer

Hyperoxia prevents hypoxia-induced bronchial hyperreactivity via a cyclooxygenase-independent mechanism

We tested the hypothesis that prior exposure to alveolar hyperoxia prevents the hypoxia-induced enhancement of bronchial reactivity, possibly via a cyclooxygenase-dependent mechanism. In 15 sheep, specific lung resistance (sRL) was measured before and after 30 min of exposure to either air or a hypoxic gas mixture (13% O2). The sheep then inhaled 50 breaths of aerosolized 5% histamine solution (n = 9) or 10 breaths of 2.5% carbachol solution (n = 9), and measurements of sRL were repeated. On subsequent days the above protocols were repeated after a 30-min exposure to hyperoxia (O2 greater than or equal to 95%), without or after pretreatment with indomethacin (2 mg/kg). After air-sham exposure, carbachol and histamine increased mean sRL to 370 +/- 40 (SE) and 309 +/- 65% of baseline, respectively. Exposure to the hypoxic gas mixture had no effect on baseline sRL but enhanced the airway responsiveness to carbachol and histamine; mean sRL increased to 740 +/- 104 and 544 +/- 76% of baseline, respectively (P less than 0.05). Prior 30-min exposure to hyperoxia prevented the hypoxia-induced enhancement of bronchial reactivity to carbachol (sRL = 416 +/- 66% of baseline) and histamine (sRL = 292 +/- 41% of baseline) without affecting the airway responsiveness to these agents after air. Pretreatment with indomethacin did not reverse the protective effects of hyperoxia or the hypoxia-induced enhancement of bronchial reactivity. We conclude that 1) prior exposure to alveolar hyperoxia prevents the hypoxia-induced enhancement of bronchial reactivity and 2) neither the protective effects of hyperoxia nor the hypoxia-induced enhancement of bronchial reactivity is mediated via a cyclooxygenase-dependent mechanism. </jats:p

The roles of mindfulness and spiritual intelligence in transformational leadership and its ethical dimensions

Hypothesis 1: Spiritual intelligence has a direct effect on transformational leadership. Hypothesis 2: Mindfulness has a direct effect on transformational leadership behavior. Hypothesis 3: Mindfulness mediates the effect of spiritual intelligence on transformational leadership behavior. Hypothesis 4: some control variables have a confounding effect on the model. The research proposes that the constructs of mindfulness and spiritual intelligence have important effects on transformational leadership and its ethical dimensions. The data was gathered from a sample of 525 managers, using self-reported instruments (MLQ-5X, FFMQ, and SISRI-24). The study used SEM with a multiple instrumental variable regression approach to evaluate endogeneity and consistency of the effects in the model. The results suggested that mindfulness fully mediated the effect of spiritual intelligence on transformational leadership. The control variables included relevant demographic variables and social desirability, and reported minor effects with no alteration on the pattern of the results; therefore they were considered inconsequential. The main indirect effects of spiritual intelligence were on the ethical dimensions of transformational leadership. Mindfulness presented important effects on transformational leadership, and spiritual intelligence on mindfulness.The results suggested that by developing mindfulness and spiritual intelligence skills as part of the leadership training programs, the organizations could increase the knowledge transfer rate to the workplace of those ethical and values-driven leadership models.THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV