Surgical treatment for liver haematoma following endoscopic retrograde cholangiopancreatography: An unusual case

AbstractBackgroundEven in expert hands, there can be serious complications when performing an endoscopic retrograde cholangiopancreatography. The most frequent complications are pancreatitis, cholangitis, bleeding, perforation, and acute cholecystitis. The hepatic subcapsular haematoma is a rare complication, with few cases described worldwide.ObjectiveA case is presented of an extremely rare complication of endoscopic retrograde cholangiopancreatography, which required surgical treatment for its resolution without success. This is second case of mortality reported in the literature.Clinical caseFemale patient of 30 years old, with indication for endoscopic retrograde cholangiopancreatography due to benign strictures. A hydro-pneumatic dilation and stent placement of 2 gauge 10Fr was performed. She presented abdominal pain after the procedure and significant decline in haemoglobin with no evidence of haemodynamic instability so an abdominal tomography scan was performed, showing no evidence of liver injury. The patient was haemodynamic unstable within 72h. A laparotomy was required for damage control, with fatal outcome in the intensive care unit due to multiple organ failure.ConclusionSubcapsular hepatic haematoma after endoscopic retrograde cholangiopancreatography is a rare complication, with few cases reported in the literature. Treatment described in the literature is conservative, resulting in a satisfactory resolution

Análisis bibliometrico de la análitica de datos en la educación superior mediante los sistemas de administración de aprendizaje

This article provides a bibliometric analysis of the current state of the research of data analytics applied to learning based on the use of ICT in higher education, so aspects of the research landscape of the subject will be known as, authors and more productive countries, analysis of publications, co-citations, cooperation between authors, co-occurrences of keywords and research clusters for the visualization of the conceptual structure of the field of knowledge. The Scopus database was used to search for publications using the selected keywords, giving this search a total of 153 articles. The following keywords were selected: learning analytics, higher education, e-learning, which define the area of knowledge and the fields of action of the subject under investigation. A more thorough review of the investigations is recommended, in order to identify current tools and fields of application.El presente artículo brinda un análisis bibliométrico del estado actual de la investigación de la analítica de datos aplicados al aprendizaje mediada por Tecnologías de Información y Comunicación, con el objetivo de conocer aspectos del panorama de investigación del tema como, autores y países más productivos, análisis de publicaciones, co-citas, cooperación entre autores, coocurrencias de palabras claves y los clústeres de investigación para la visualización de la estructura conceptual del campo de conocimiento. Se utilizó la base de datos Scopus para realizar la búsqueda de publicaciones mediante las palabras claves seleccionadas, arrojando esta búsqueda un total de 153 artículos. Se seleccionaron las palabras claves siguientes: learning analytics, higher education, e-learning, las cuales definen el área de conocimiento y los campos de acción del tema investigado. Se recomienda, una revisión más exhaustiva de las investigaciones, para así poder identificar las herramientas y campos de aplicación actuales

Selective production of Dihydroxyacetone and Glyceraldehyde by Photo-assisted Oxidation of Glycerol

Glycerol is a by-product during biodiesel production and represents a potential low-cost raw material for obtaining high-cost products like Dihydroxyacetone (DHA) and glyceraldehyde (GCD) amongst others. In this work, Fe-Pillared clay (Fe-PILC) was assessed as catalyst of the selective photo-oxidation of glycerol to obtain DHA and GCD at moderate conditions (298 K and atmospheric pressure). This was conducted in a 100 mL Pyrex glass batch reactor where a Pen-Ray lamp of mercury of 5.5 Watts UV light (UVP) was placed at the centre. The Fe-PILC was prepared by ion exchange. The pillaring was confirmed by XRD, and a 17% w/w of Fe was determined by Atomic Absorption Spectroscopy. The active phases were established by XPS and found to be FeO and Fe3O4. The specific surface area of the clay (bentonite), determined by N2 physisorption, increased from 34 m2/g to 227 m2/g and the pore volume increased from 0.058 cm3/g to 0.106 cm3/g. The studied variables were catalyst loading and glycerol initial concentration. An experiment with TiO2 Degussa P25 was also performed as reference. It was found that by adding Fe-PILC to the glycerol oxidation system, selectivity towards DHA or GCD can be tuned. A selectivity towards DHA was found to be 87% with 0.1 g/L of Fe-Pillared after 8 h reaction. The in situ production ofH2O2 was observed and therefore concluded that the glycerol oxidation occurs via a Fenton process, i.e. via free radicals.CONAYCT project 269093 UAEM project 437

Monitoring Physiological Responses in Giant Toad (Rhinella marina) from Coatzacoalcos, Mexico: A Comparative Study after 8 Years

The objective of this chapter is to present the results of a monitoring study carried out with physiological responses (biomarkers) in Rhinella marina (giant toad) for two different years, inhabiting the low basin of Coatzacoalcos river, one of the most contaminated regions in Mexico. A decrease in delta aminolevulinic acid dehydratase (δ-ALAD) (considered inhibition) and in the condition factor (1.2–1.5 times) found in toads of the industrial zone compared with reference organisms, each year. As for the hematological parameters, the mean corpuscular hemoglobin concentrations (MCHC), in the amphibians of industrial zone of the first sampling year show a decrease, while for the second sampling year, show an increment of 1.5 times than organisms of reference site. These effects could be associated with exposure to pollutants such as heavy metals (mainly Pb), which have been registered in different studies. This study demonstrates the usefulness of giant toads as biomonitors of contaminated sites

Gallbladder agenesis in a patient with choledochoduodenal fistula, report of an exceptional case

Vesicular agenesis refers to the congenital absence of the gallbladder, however, vesicular agenesia is a very scarce condition worldwide, so there is little information available on its clinical presentation and surgical data. This is a 79-year-old male patient, with a history of diabetes mellitus of long evolution, without a surgical history, who comes for colic pain of 15 days of evolution in right hypochondrium, as well as unquantified fever and jaundice, during its initial evaluation in the emergency room para clinics were requested observing leukocytosis, hyperbilirubinemia and elevation of liver enzymes, ultrasound of liver and bile ducts reported common anatomical situation gallbladder, occupied entirely by multiple hyperechogenic images, configuring sign of W.E.S. and common bile duct of 7.2 mm, concluding gallbladder scleroatrophic and vesicular agenesia during trans-surgery. Vesicular agenesis is an extremely rare condition that is mostly diagnosed during surgery, which can lead to erroneous diagnosis and unnecessary surgery in patients with symptoms including biliary colic, choledocholithiasis with or without cholangitis, and an ultrasound showing a scleroatrophic gallbladder. Surgeons In situations where there is clinical evidence consistent with biliary colic in a context of gallbladder agenesis, and the symptoms persist without finding any other cause, a surgical approach to release adhesions could be considered; since, as observed, this may result in improved symptoms, although the explanation is not yet completely clear

La percepción en Tepic, sobre la producción audiovisual

The perception people have of audiovisual production in Tepic, Nayarit, is based on the different types of production that is performed and the relationship between the cost - benefit these entail. In the present study the social context in which the audiovisual production in the State of Nayarit, the perception of audiovisual producers and socio - political - economic conditions of this industry develops addressed.La percepción que se tiene de la producción audiovisual en Tepic, Nayarit, se basa en los diferentes tipos de producción que se realiza y la relación entre el costo – beneficio que estas conllevan. En el presente estudio se aborda el contexto social en el que se desarrolla la producción audiovisual en el Estado de Nayarit, la percepción de los productores audiovisuales y las condiciones socio-políticas-económicas de esta industria

Impacto psicológico en estudiantes universitarios mexicanos por confinamiento durante la pandemia por Covid-19

The objective was to evaluate the levels of anxiety, depression, stress and the perception of the health status of Mexican university students during 7 weeks of confinement due to the Covid-19 pandemic. Method: Observational and cross-sectional study, the sample was made up by convenience and not random. N = 644 (276 women and 368 men) with an average age of 21.95 years (σ = 3.56), who completed an online survey to detect psychological symptoms, the content of which was composed by the Inventory of State Anxiety, Perceived Stress Scale (PSS-14) and the General Health Questionnaire (GHQ-28) and sociodemographic data. Results: symptoms (moderate to severe): stress (31.92%), psychosomatics (5.9%), sleep problems (36.3%), social dysfunction in daily activity (9.5%) and depressive (4.9%), especially in the group of women and the youngest students (18-25 years). In this latter group, anxiety (40.3%) was also detected with higher levels in men. Conclusions: It is necessary to implement prevention, control and reduction programs for the psychological effects generated by confinement during pandemics with the aim of guaranteeing the well-being and mental health of the university students.El objetivo de esta investigación consistió en evaluar los niveles de ansiedad, depresión, estrés y la percepción del estado de salud de estudiantes universitarios mexicanos durante 7 semanas de confinamiento por la pandemia de Covid-19. Método: estudio observacional-transeccional, la muestra se conformó por conveniencia y no aleatoria. N= 644 (276 mujeres y 368 hombres) con edad promedio de 21.95 años (σ= 3.56), quienes llenaron una encuesta en línea para la detección de síntomas psicológicos, cuyo contenido se estructuró por el Inventario de Ansiedad Estado, Escala de Estrés percibido (PSS-14), Cuestionario General de Salud (GHQ-28) y datos sociodemográficos. Resultados: se encontraron síntomas (moderados a severos): estrés (31.92%), psicosomáticos (5.9%), problemas para dormir (36.3%), disfunción social en la actividad diaria (9.5%) y depresivos (4.9%), especialmente en el grupo de las mujeres y en los estudiantes más jóvenes (18-25 años). En este último grupo, también se detectó ansiedad (40.3%) con mayores niveles en los hombres. Conclusiones: es necesario implementar programas de prevención, control y disminución de los efectos psicológicos generados por el confinamiento durante las pandemias con el objetivo de garantizar el bienestar y la salud mental de los estudiantes universitarios

Erosivity indicators based on rainfall in Northwestern Mexico

This study is motivated by the problem of erosivity (R), exacervated in semiarid zones by intense seasonal storms. The purpose was to estimate the spatial variation of R in a coastal area covering 37500 km2 which is one of the most important agricultural areas in northwestern Mexico. Four methods were used. Rainfall data from 11 SMNCONAGUA weather stations (from 1966 to 2013) were used to calculate R. The annual average R1 was 1181.08, and R2 was 1084.51 MJ mm ha–1 h–1 with ranges of 2.35–5220.55 and 2.93–4711.38 MJ mm ha–1 h–1. Statistical tests showed that a transformation of the data of the form y = log (x), was appropriate for an ANOVA analysis of the data. The value of the test statistic was F = 1.77 with p = 0.149, showing interdependence between the indicators P (α = 0.05). The values of the correlation coefficients for the data were P vs. R1 = 0.96, P vs. R2 = 0.99, P vs. AIm = 0.98, P vs. MFI = 0.99. The classification of risk in this region showed that 2017.5 km2 of the study area was at a very high risk of rain erosion, 2407.5 km2 under high risk, 5662.5 km2 under medium to high risk, and 14250 km2 under low risk. The results are shown on 1:10,000 maps. Results are a set of useful information for soil management programs and for cultivation planning that takes the seasonal variation of R into account in this region where large volumes of extensive crops are grown.

Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis

AIM: To determine if subclinical abnormal glucose tolerance (SAGT) has influence on survival of non-diabetic patients with liver cirrhosis. METHODS: In total, 100 patients with compensated liver cirrhosis and normal fasting plasma glucose were included. Fasting plasma insulin (FPI) levels were measured, and oral glucose tolerance test (OGTT) was performed. According to OGTT results two groups of patients were formed: those with normal glucose tolerance (NGT) and those with SAGT. Patients were followed every three months. The mean follow-up was 932 d (range of 180-1925). Survival was analyzed by the Kaplan-Meyer method, and predictive factors of death were analyzed using the Cox proportional hazard regression model. RESULTS: Of the included patients, 30 showed NGT and 70 SAGT. Groups were significantly different only in age, INR, FPI and HOMA2-IR. Patients with SAGT showed lower 5-year cumulated survival than NGT patients (31.7% vs 71.6%, P = 0.02). Differences in survival were significant only after 3 years of follow-up. SAGT, Child-Pugh B, and high Child-Pugh and Model for EndStage Liver Disease (MELD) scores were independent predictors of death. The causes of death in 90.3% of cases were due to complications related to liver disease. CONCLUSION: SAGT was associated with lower survival. SAGT, Child-Pugh B, and high Child-Pugh and MELD scores were independent negative predictors of survival

Factores de riesgo, síntomas y conducta ante adolescentes con intentos suicidas

Las tentativas de suicidio antes de los 20 años de edad se han incrementado considerablemente en las últimas décadas, por lo que se considera el arribo a la adolescencia como el mayor factor de riesgo. Debido a ello se realizó esta revisión bibliográfica con el objetivo de describir los factores de riesgo, síntomas y conductas más adecuadas ante adolescentes con intentos suicidas; para la cual se examinó un total de 21 referencias bibliográficas. La conducta suicida se asocia a múltiples factores biopsicosociales y culturales, aunque estos no están muy bien dilucidados y aun persisten contradicciones respecto a la influencia del alcohol, la estructura familiar y autoestima. La depresión, la distimia, la desesperanza y otros, son síntomas que se asocian a los adolescentes con instinto suicida. La terapia cognitivo-conductual y una estrategia nacional de prevención se han mostrado eficaces para reducir esos intentos, desafortunadamente, muchas veces irreversibles, pues, aunque no terminen con la muerte, sí pueden dejar lesiones graves.AbstractAttempts to commit suicide before the age of 20 have increased considerably in the last decades, which is why the advent of adolescence is considered the greatest risk factor. As a result, this bibliographic review was carried out with the objective of describing the risk factors, symptoms and behaviors most appropriate to adolescents with suicidal attempts; For which a total of 21 bibliographic references were examined. Suicidal behavior is associated with multiple biopsychosocial and cultural factors, although these are not well understood and there are still contradictions regarding the influence of alcohol, family structure and self-esteem. Depression, dysthymia, hopelessness and others are symptoms associated with adolescents with suicidal instinct. Cognitive-behavioral therapy and a national prevention strategy have proven effective in reducing these unfortunately unrecoverable attempts, for although they do not end with death, they can leave serious injuries