Factores de riesgo materno-fetales asociado a Ruptura Prematura de membranas en mujeres con embarazo pre término en el Hospital Escuela San Juan de Dios, Estelí Nicaragua durante el año 2013

Con el objetivo de identificar los factores de riesgo materno fetales asociado a ruptura prematura de membranas se realizó un estudio analítico, de casos y controles de Pacientes ingresadas, en la sala de Alto Riesgo Obstétrico (ARO) del Hospital Escuela San Juan de Dios Estelí durante el año 2013, el universo estuvo conformado por 253 pacientes, la muestra fue de acuerdo a los criterios de inclusión, siendo el total de casos de 41 y los controles de 82, para un total de 123 pacientes en estudio. Los factores de riesgo maternos estadísticamente significativos encontrados en el estudio fueron; los antecedentes patológicos se encontró que las que si presentaban al menos uno incrementaba hasta 4 veces más el riesgo de presentar ruptura prematura de membranas, predominando así la presencia de infección urinaria o vaginal (79 y 72% de los casos respectivamente), también se pudo constatar que las pacientes que presentaron el evento el 66% de los casos tenían 4 o menos controles prenatales, por otro lado el 68% de los casos tenían un periodo intergenésico menor de 18 meses. En relación con los factores fetales asociados, se encontró así como factor principal la presencia de polihidramnios con un 64% de los casos. Se determinó en el estudio que los factores de riesgos maternos más importantes y estadísticamente significativos fueron, presentar durante el embarazo infección del tracto genitourinario, tener menos de 4 controles prenatales o un periodo intergenésico menor a 18 meses; en cambio en los factores fetales se encontró como riesgo mayor la presencia de polihidramnios durante la gestación. Al ser los factores de riesgos predominantes encontrados en el estudio las infecciones del tracto genitourinario e infecciones vaginales recomendamos realizar controles prenatales de manera precoz e integral para poder identificar prematuramente los riesgos y dar el monitoreo adecuado de las pacientes

Navigation liver surgery for complex hydatid cyst with biliary tree communication

AbstractIntroductionToday, liver surgery navigation is utilized only in high-specialized centers for patients affected by malignant diseases. However, navigated surgery may also be of great interest for benign diseases such as hydatidosis in particular if the hydatid cyst is communicating with the biliary tree. With navigation we know exactly in each moment during the surgery the relationship of the cyst with the vascular/biliary structures around it.Presentation of caseHerein, we report a case of a 20-year-old W/M affected by hepatic hydatid cyst communicating with the right bile duct, causing recurrent cholangitis. The diagnosis was confirmed by endoscopic retrograde cholangiography and magnetic resonance imaging. The liver cystectomy was easily performed using a navigation system incorporating instrument tracking and three-dimensional CT-reconstruction, thus permitting a selective suture of the bile duct communicating with the cyst.ConclusionsThe navigated system may guide the surgeon in patients with severe and complicated hydatid cysts

The Diabetic Nephropathy and the Development of Hypertension in Rats

The present study was designed to examine the development of hypertension in diabetic rats treated with streptozotocin (STZ, 1mg/g bw). The rats were studied at 3, 6, 9, 12 and 15 weeks. From the third week the rats were divided in diabetic rats according their glycemias and controls, along 15 weeks. After the third week a group, of rats showed increased urinary protein excretion (93, 134, 155 and 191%) compared to controls. In this group of rats the urinary kallikrein excretion was lower than control and the systolic blood pressure became significantly elevated between 3 and 6 weeks and persisted up to 15 weeks. On the other hand a group of diabetic rats were normotensive with urinary protein excretion similar to controls and urinary kallikrein lower compared to control but significantly higher compared diabetic hypertensive rats. These data suggest that the association of progressive diabetic nephropathy with abnormal endothelium-dependent vasodilation may produce a high prevalence of hypertensive diabetes

Point-of-care tests for urinary tract infections : protocol for a systematic review and meta-analysis of diagnostic test accuracy

Funding: DFN is supported by an NES general practice academic fellowship, AAL is supported by an HDR UK clinical postdoctoral fellowship and VHS is supported by an NRS clinical academic fellowship.Introduction Urinary tract infections (UTIs) are the second most common type of infection worldwide, accounting for a large number of primary care consultations and antibiotic prescribing. Current diagnosis is based on an empirical approach, relying on symptoms and occasional use of urine dipsticks. The diagnostic reference standard is still urine culture, although it is not routinely recommended for uncomplicated UTIs in the community, due to time to diagnosis (48 hours). Faster point-of-care tests have been developed, but their diagnostic accuracy has not been compared. Our objective is to systematically review and meta-analyse the diagnostic accuracy of currently available point-of-care tests for UTIs. Methods and analysis Studies evaluating the diagnostic accuracy of point-of-care tests for UTIs will be included. PubMed, Web of Science, Embase and Cochrane Database of Systematic Reviews were searched from inception to 1 June 2019. Data extraction and risk-of-bias assessment will be assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Meta-analysis will be performed depending on data availability and heterogeneity. Ethics and dissemination This is a systematic review protocol and therefore formal ethical approval is not required, as no primary, identifiable, personal data will be collected. Patients or the public were not involved in the design of our research. However, the findings from this review will be shared with key stakeholders, including patient groups, clinicians and guideline developers, and will also be presented and national and international conferences.Publisher PDFPeer reviewe

Análisis de la situación económica del sector agropecuario en el Municipio de Condega, II semestre 2015

La presente investigación se denomina “Análisis de la situación económica del sector agropecuario en el municipio de Condega, II semestre 2015”, la cual se divide en ocho capítulos que marcan el camino para la correcta consecución de los objetivos propuestos. El primer capítulo aborda de manera general antecedentes, planteamiento del problema y justificación de la investigación; en el segundo, se plantean los objetivos que delimitan el alcance del estudio. En el municipio no se han realizado estudios específicos para determinar en qué situación se encuentra la actividad agropecuaria, por lo que en este trabajo se pretende analizar el sector antes mencionado, específicamente como fue el comportamiento que se presentó durante el segundo periodo del año 201

SafeShift: Safety-Informed Distribution Shifts for Robust Trajectory Prediction in Autonomous Driving

As autonomous driving technology matures, safety and robustness of its key components, including trajectory prediction, is vital. Though real-world datasets, such as Waymo Open Motion, provide realistic recorded scenarios for model development, they often lack truly safety-critical situations. Rather than utilizing unrealistic simulation or dangerous real-world testing, we instead propose a framework to characterize such datasets and find hidden safety-relevant scenarios within. Our approach expands the spectrum of safety-relevance, allowing us to study trajectory prediction models under a safety-informed, distribution shift setting. We contribute a generalized scenario characterization method, a novel scoring scheme to find subtly-avoided risky scenarios, and an evaluation of trajectory prediction models in this setting. We further contribute a remediation strategy, achieving a 10% average reduction in prediction collision rates. To facilitate future research, we release our code to the public: github.com/cmubig/SafeShif

Core Challenges in Embodied Vision-Language Planning

Recent advances in the areas of multimodal machine learning and artificial intelligence (AI) have led to the development of challenging tasks at the intersection of Computer Vision, Natural Language Processing, and Embodied AI. Whereas many approaches and previous survey pursuits have characterised one or two of these dimensions, there has not been a holistic analysis at the center of all three. Moreover, even when combinations of these topics are considered, more focus is placed on describing, e.g., current architectural methods, as opposed to also illustrating high-level challenges and opportunities for the field. In this survey paper, we discuss Embodied Vision-Language Planning (EVLP) tasks, a family of prominent embodied navigation and manipulation problems that jointly use computer vision and natural language. We propose a taxonomy to unify these tasks and provide an in-depth analysis and comparison of the new and current algorithmic approaches, metrics, simulated environments, as well as the datasets used for EVLP tasks. Finally, we present the core challenges that we believe new EVLP works should seek to address, and we advocate for task construction that enables model generalizability and furthers real-world deployment.Comment: 35 page