Influencia del hábito tabáquico en la ocurrencia de complicaciones pulmonares postoperatorias tras lobectomía pulmonar

[ES] La resección pulmonar es el procedimiento quirúrgico en el que se fundamenta el tratamiento del carcinoma broncogénico en los estadios precoces de la enfermedad donde, de acuerdo con las tasas de supervivencia publicadas, puede considerarse un tratamiento curativo. También se indica como tratamiento de otras patologías, por ejemplo, los tumores primarios o secundarios pulmonares y, de forma mucho más ocasional, en enfermedades infecciosas e inflamatorias como bronquiectasias, hidatidosis complicadas e incluso en el tratamiento de alteraciones congénitas. Las complicaciones pulmonares cardiorrespiratorias postoperatorias no son infrecuentes en estos pacientes, pueden causarles la muerte hospitalaria y tienen una repercusión muy importante en el consumo de recursos económicos. En el año 2005, la European Association for Cardiothoracic Surgery (EACTS) y la European Society of Thoracic Surgeons (ESTS) decidieron establecer una base de datos europea cuyo principal objetivo era obtener datos fiables de morbilidad y mortalidad de las intervenciones torácicas. En la actualidad la base de datos pertenece solo a la ESTS y, hasta diciembre de 2014, se han registrado datos de 62.648 pacientes. La morbilidad cardiorrespiratoria de la serie global es del 15.15%, mientras que la mortalidad hospitalaria no ajustada registrada en la base de datos es del 2.5%1. El tabaquismo es la primera causa de muerte prematura prevenible2. La relación causal del hábito de fumar con las enfermedades respiratorias y cardiovasculares, así como su efecto carcinogénico han sido ampliamente demostrados. Además, se sabe que el tabaquismo tiene una gran influencia en la ocurrencia de complicaciones en el postoperatorio tras cualquier tipo de cirugía. Según Bluman et al.3 el riesgo de desarrollar complicaciones pulmonares postoperatorias (CPPs) es 5.5 veces mayor en pacientes fumadores activos comparado con nunca fumadores. El cese del hábito tabáquico es una de las recomendaciones preoperatorias más importantes previa a cualquier tipo de cirugía programada. Sin embargo, la relación entre la duración preoperatoria de la abstinencia tabáquica y el efecto beneficioso en la ocurrencia de complicaciones postoperatorias no está claro. La disminución de las CPPs debido al cese del hábito tabáquico está relacionada con la mejoría fisiológica de la acción ciliar, la actividad de los macrófagos, la función de la vía aérea pequeña y especialmente con la disminución de la producción de esputo. Estos cambios pueden tardar semanas en producirse. Por ello, algunos estudios han sugerido que dejar de fumar sólo unas pocas semanas antes de la cirugía puede conducir a un incremento paradójico e inesperado en el índice de complicaciones pulmonares. Conocer el efecto del tabaquismo activo y de la cesación tabáquica previa a la cirugía en la ocurrencia de complicaciones postoperatorias es de especial interés en pacientes candidatos a cirugía de resección pulmonar programada, especialmente en aquellos con diagnóstico de cáncer de pulmón, donde los beneficios del cese del hábito deben justificar la demora del tratamiento

Caracterización de la organización estructural del factor de intercambio de nucleótido de guanina C3G

[ES]C3G (Crk SH3-domain binding Guanine-nucleotide exchange factor) es un factor intercambiador de nucleótidos de guanina que actúa sobre las GTPasas de la familia Ras: R-Ras y Rap1. C3G desempeña un papel clave en la adhesión celular mediada por integrinas, participa en numerosas rutas de señalización celular y en procesos de apoptosis entre otras funciones. C3G es una proteína con estructura modular en la que se distinguen tres regiones bien diferenciadas entre sí tanto estructural como funcionalmente. La región N-terminal (N-C3G) contiene una región de unión a E-cadherina; la región central contiene varios motivos de secuencia ricos en Pro que constituyen sitios de unión a dominios SH3 implicados en la unión a proteínas adaptadoras como Crk y p130Cas; y la región C-terminal posee un dominio catalítico del tipo CDC25H responsable de la actividad GEF, precedido de un dominio REM. Se ha descrito que la deleción de la región N-terminal activa C3G, lo que sugiere que esta región es un dominio regulador negativo en cis. La fosforilación de C3G en la Tyr504 resulta en su activación. Nada se sabe acerca de la estructura de C3G, al contrario que de otros GEFs homólogos como SOS1, RasGRP1 y Epac2 que están bien caracterizados y que presentan mecanismos de regulación específicos. En este estudio se pone de manifiesto la existencia de una interacción intramolecular de tipo cabeza-cola entre N-C3G y el dominio REM, que probablemente corresponda con un estado autoinhibido que mantiene a la molécula inactiva en ausencia de estímulo. Además se han determinado dos residuos del dominio REM: E731 y E784 que son esenciales para la interacción con el dominio N-C3G. Esta zona de interacción en el dominio REM sugiere un mecanismo de regulación por bloqueo del sitio catalítico pero se requieren estudios adicionales. También se ha analizado el efecto de la mutación Y504E que mimetiza la fosforilación en este residuo, y se ha visto que no es suficiente para inhibir la interacción intramolecular en C3G. La predicción de estructura secundaria sugiere la presencia de un dominio rico en alpha-hélices en el extremo N-terminal, que parece ser una zona de unión a fosfolípidos y que podría favorecer la activación de la molécula. Además, se ha determinado que la región N-C3G experimenta un proceso de homo-asociación que podría estar implicado en la regulación de la actividad de C3G

Endothoracic thyroid. Indications of endothoracic approach

Introduction and objective: The incidence of endothoracic goiter among patients undergoing thyroidectomy ranges from 6% to 30%. Although the cervical approach is sufficient in most cases, the endothoracic approach may be necessary in 1-5.5% of patients. So it is advisable to anticipate it. The objective of this article is to describe the indications if this kind of approach. Synthesis: The main risk factors for performing sternotomy in cases of substernal goiter are the extension below the aortic arch and the retrotracheal or retrovascular location. The thoracic approach will be equally necessary in mediastinal ectopic goiters without connection to the cervical thyroid. The evaluation by a thoracic surgeon in cases of forgotten goitre will be recommended, as well as in patients with a history of radiotherapy or cervical surgery and suspected malignancy with extra-thyroid involvement. The choice of approach will depend on the location, the size of the mass and its relationship with the neighboring organs. Minimally invasive approaches can be safe alternatives to sternotomy or thoracotomy. The most frequent postoperative complications of endothoracic thyroid resection are typical of thyroid surgery: temporary or permanent recurrent paralysis, hypoparathyroidism, respiratory failure and postoperative bleeding. Conclusions: Up to 5% of thyroidectomies, a thoracic approach may be necessary, so it is convenient to anticipate it. The thoracic approach will be necessary in cases of goiter with extension below the arch, retrotracheal or retrovascular location and in mediastinal goiters without connection to the cervical thyroid./n Introducción y objetivo: La incidencia de bocio endotorácico entre los pacientes sometidos a tiroidectomía oscila entre el 6% y el 30%. Aunque el abordaje cervical es suficiente en la mayoría de los casos, el abordaje endotorácico puede ser necesario en el 1-5.5% de los pacientes. Por lo que es recomendable anticiparlo. El objetivo del presente artículo es describir los factores predictivos de necesidad de este tipo de abordaje. Síntesis: Los principales factores de riesgo para la realización de esternotomía en los casos de bocio subesternal son la extensión por debajo del cayado aórtico y la localización retrotraqueal o retrovascular. El abordaje torácico será igualmente necesario en bocios ectópicos mediastínicos sin conexión con el tiroides cervical y se recomendará la valoración por un cirujano torácico en casos de bocio olvidado, así como en pacientes con antecedentes de radioterapia o cirugía cervical y sospecha de malignidad con afectación extra-tiroidea. La elección del abordaje dependerá de la localización, del tamaño de la masa y su relación con los órganos vecinos; los abordajes mínimamente invasivos pueden ser alternativas seguras a la esternotomía o la toracotomía. Las complicaciones postoperatorias más frecuentes de la resección de tiroides endotorácico son típicas de la cirugía tiroidea: parálisis recurrencial temporal o permanente, hipoparatiroidismo, insuficiencia respiratoria y sangrado postoperatorio. Conclusiones: Hasta en un 5% de las tiroidectomías, puede ser necesario un abordaje torácico, por lo que es conveniente anticiparlo. El abordaje torácico será necesario en casos de bocio con extensión por debajo del cayado, localización retrotraqueal o retrovascular y en bocios mediastínicos sin conexión con el tiroides cervical./n

Predictor Model of the Supply Chain Effectiveness based on Critical Success Factors in a Commerce Retail Industry

The business environments of the globalized economy present increasing complexity under highly variable conditions of volatility, risk, and uncertainty that exert intense pressures on retailers; some of them develop programs for the improvement of the supply chain. This paper is about determining the factors of the supply chain and the development of a structural equation model. The first section presents the background, the description of the problem and a literature search of the Supply Chain factors and their classification. The Methodology section explains the development of a questionnaire as a measuring instrument based on the identified factors. The validation of the questionnaire was with the Cronbach alpha index, and then it applied to a sample of retailers in central Mexico. Using the Partial Least Squares Structural Equation Modelling Approach, the development of a structural model identified the key driver factors related to the improvement of the Supply Chain. In results report the most important factors: 1) supplier’s quality of the goods, 2) internal factors, 3) after-sale service, and 4) road infrastructure and 5) commercial environment, for commerce retail industry in México.Os ambientes de negócios da economia globalizada apresentam complexidade crescente sob condições altamente variáveis ​​de volatilidade, risco e incerteza que exercem intensa pressão sobre os varejistas; alguns deles desenvolvem programas para a melhoria da cadeia de suprimentos. Este artigo trata da determinação dos fatores da cadeia de suprimentos e do desenvolvimento de um modelo de equação estrutural. A primeira seção apresenta os antecedentes, a descrição do problema e uma pesquisa bibliográfica dos fatores da Cadeia de Suprimentos e sua classificação. A seção Metodologia explica o desenvolvimento de um questionário como instrumento de medição baseado nos fatores identificados. A validação do questionário foi com o índice alfa de Cronbach e, em seguida, aplicado a uma amostra de varejistas na região central do México. Utilizando a Abordagem de Modelagem de Equações Estruturais de Mínimos Quadrados Parciais, o desenvolvimento de um modelo estrutural identificou os principais fatores impulsionadores relacionados à melhoria da Cadeia de Suprimentos. Nos resultados relatam os fatores mais importantes: 1) qualidade do fornecedor das mercadorias, 2) fatores internos, 3) serviço pós-venda, e 4) infraestrutura rodoviária e 5) ambiente comercial, para o setor de comércio varejista no México

A Multi-Disciplinary Approach to Remote Sensing through Low-Cost UAVs

The use of Unmanned Aerial Vehicles (UAVs) based on remote sensing has generated low cost monitoring, since the data can be acquired quickly and easily. This paper reports the experience related to agave crop analysis with a low cost UAV. The data were processed by traditional photogrammetric flow and data extraction techniques were applied to extract new layers and separate the agave plants from weeds and other elements of the environment. Our proposal combines elements of photogrammetry, computer vision, data mining, geomatics and computer science. This fusion leads to very interesting results in agave control. This paper aims to demonstrate the potential of UAV monitoring in agave crops and the importance of information processing with reliable data flow.We wish to acknowledge the Consejo Nacional de Ciencia y Tecnologia (CONACYT) for its financial support to the PhD studies of Gabriela Calvario. We are grateful to Cubo Geoespacial S.A .de C.V. and special to Ing. Jordan Martinez for the stimulus to this work, more information about this Company is available at: http://www.cubogeoespacial.com/. In addition, we are grateful to the support of the Tequila Regulatory Council (CRT), which has allowed us to monitor several crops. This paper has been supported by the Spanish Ministerio de Economia y Competitividad, contract TIN2015-64395-R (MINECO/FEDER, UE), as well as by the Basque Government, contract IT900-16. This work was also supported in part by CONACYT (Mexico), Grant 258033

A Multi-Disciplinary Approach to Remote Sensing through Low-Cost UAVs

The use of Unmanned Aerial Vehicles (UAVs) based on remote sensing has generated low cost monitoring, since the data can be acquired quickly and easily. This paper reports the experience related to agave crop analysis with a low cost UAV. The data were processed by traditional photogrammetric flow and data extraction techniques were applied to extract new layers and separate the agave plants from weeds and other elements of the environment. Our proposal combines elements of photogrammetry, computer vision, data mining, geomatics and computer science. This fusion leads to very interesting results in agave control. This paper aims to demonstrate the potential of UAV monitoring in agave crops and the importance of information processing with reliable data flow.We wish to acknowledge the Consejo Nacional de Ciencia y Tecnologia (CONACYT) for its financial support to the PhD studies of Gabriela Calvario. We are grateful to Cubo Geoespacial S.A .de C.V. and special to Ing. Jordan Martinez for the stimulus to this work, more information about this Company is available at: http://www.cubogeoespacial.com/. In addition, we are grateful to the support of the Tequila Regulatory Council (CRT), which has allowed us to monitor several crops. This paper has been supported by the Spanish Ministerio de Economia y Competitividad, contract TIN2015-64395-R (MINECO/FEDER, UE), as well as by the Basque Government, contract IT900-16. This work was also supported in part by CONACYT (Mexico), Grant 258033

Integration of biogas in the natural gas grid: thermodynamic characterization of a biogas-like mixture

Producción CientíficaThe composition of biogas may vary significantly due to the diversity of production sources, making essential to have a detailed knowledge of their thermophysical properties in order to develop and validate methods for the estimation of density, heat capacity and calorific value of biogas and biomethane. In this work the thermodynamic behavior of a synthetic biogas-like mixture, composed by methane (50%), carbon dioxide (35%), nitrogen (10%) and carbon monoxide (5%), is studied through accurate (p,ρ,T) experimental data obtained by using a single sinker densimeter with magnetic suspension coupling. The mixture was prepared by the gravimetric method at the Spanish National Metrology Institute (Centro Español de Metrología, CEM) and the accurate density measurements have been performed in the temperature range from (275 to 400) K and pressures up to 20 MPa. This work is part of the research project ‘Metrology for Biogas’ supported by the European Metrology Research Program. Experimental data are compared with the densities calculated with the GERG-2008 equation of state. Deviation between experimental and estimated densities is within a ±0.2% band at all temperatures, except at the lower temperature, 275 K, and pressures from (6 to 15) MPa, which shows a higher deviation.MEC ENE2013-47812-RJunta de Castilla y León VA391A12-1European Metrology Research Program ENG5

Carotenoids and their derivatives: A “Swiss Army knife-like” multifunctional tool for fine-tuning plant-environment interactions

Plants have to cope with different biotic and abiotic stresses, such as the attacks of pathogens and herbivores, high irradiance, droughts, salt stress or nutrient deficiencies throughout their lifetime. These environmental perturbations lead to the regulation of the “primary” and “secondary” carotenoid network. The formers are produced and stored in plastids and they are necessary for photosynthesis and related functions. Otherwise, secondary carotenoids are derivatives of primary carotenoids. They perform other important functions not related to the photosynthetic process but essential for plant survival as regulators of growth and development or as signal molecules at all levels of plant organization. This review provides a complete revision of the status of all these carotenoids, highlighting their newly discovered functions involved in plant-environment interaction. Concurrently, this review covers recent information on how carotenoids perform critical functions for the survival of animals (including humans) and the way they are suitable diagnostic tools for assessing the functioning of terrestrial ecosystems.This work was supported in part by the grant UPV/EHU-GV IT-1648–22 (from the Basque Government, Spain), Phy2SUDOE SOE4/P5/E1021 project supported by the European Union through Interreg SUDOE Program and the projects PID2020–113244GA-C22 (funded by MCIN/ AEI /10.13039/501100011033), PID2019–110055RB-C22 (funded by MCIN/ AEI /10.13039/501100011033), PGC2018–093824-B-C44 (funded by MCIN/AEI/ 10.13039/501100011033 and by “ERDF A way of making Europe”). Open Access funding was provided thanks to the CRUE-CSIC agreement with Elsevier

An Agave Counting Methodology Based on Mathematical Morphology and Images Acquired through Unmanned Aerial Vehicles

Blue agave is an important commercial crop in Mexico, and it is the main source of the traditional mexican beverage known as tequila. The variety of blue agave crop known as Tequilana Weber is a crucial element for tequila agribusiness and the agricultural economy in Mexico. The number of agave plants in the field is one of the main parameters for estimating production of tequila. In this manuscript, we describe a mathematical morphology-based algorithm that addresses the agave automatic counting task. The proposed methodology was applied to a set of real images collected using an Unmanned Aerial Vehicle equipped with a digital Red-Green-Blue (RGB) camera. The number of plants automatically identified in the collected images was compared to the number of plants counted by hand. Accuracy of the proposed algorithm depended on the size heterogeneity of plants in the field and illumination. Accuracy ranged from 0.8309 to 0.9806, and performance of the proposed algorithm was satisfactory.This research was supported by the Spanish Ministerio de Economía y Competitividad, contract TIN2015-64395-R (MINECO/FEDER, UE), as well as by the Basque Government, contract IT900-16. This work was also supported in part by CONACYT (Mexico), grant 258033