10 años de experiencia de pancreaticoduodenectomias en el Hospital Metropolitano de Quito

Background: Since the 1990’s, pancreaticoduodenectomy has become a surgical procedure employed in a diversity of pathologies of the periampullar region. The mortality rate associated with pancreaticoduodenectomy has diminish importantly en the last two decades; never the less, high morbidity rate have persisted regardless the development in the surgical technique and better postoperative patient management. A research was performed at the General Surgery Department of Hospital Metropolitano in order to establish the mayor indications for performing a pancreaticoduodenectomy, the most frequent postoperative complications and ascertain the postoperative mortality rate. Objectives: to determine the major indications, morbidity and mortality associated with pancreaticoduodenectomy procedure. Methodology: A retrospective review was performed, in which, the medical records of patients to whom a pancreaticoduodenectomy was performed between the years of 1998 to 2008 were analyzed. Excel and SPSS were employed for the statistic analysis. Results: ampullary adenocarcinomas (N=5, 20.8%) was the major indication for surgical intervention. The most frequent complication was from pulmonary origin (N=7, 29.2%). The mortality rate was 4.5%. Conclusions: Albeit of being a low volumen institution, the mortality rate is within the acceptable ranges. 50% of the patients presented a postoperative complication; although it is high the ranges are within the international reports.Antecedentes: Antecedentes: A partir de la década de los 90’s, la pancreatoduodenectomía se convirtió en un procedimiento quirúrgico empleado en un amplia gama de patologías, tanto benignas como malignas, de la región periampular. La mortalidad asociada con la pancreatoduodenectomía ha disminuido de forma importante en las últimas dos décadas; sin embargo, la tasa de morbilidad ha permanecido elevada a pesar del progreso en la técnica quirúrgica y mejor manejo postquirúrgico. Se realizó este estudio en el Servicio de Cirugía General del Hospital Metropolitano de Quito para determinar cuáles fueron los principales indicaciones, conocer las complicaciones postoperatorias más frecuentes y establecer la tasa de mortalidad postoperatoria. Objetivos: Determinar las principales indicaciones, morbilidad y mortalidad asociadas con la pancreatoduodenectomía en el Servicio de Cirugía General del Hospital Metropolitano. Metodología: Es un estudio retrospectivo descriptivo de cohorte, en el cual se analizó los expedientes clínicos de pacientes que fueron sometidos a una pancreatoduodenectomía entre los años de 1998 hasta 2008. El Análisis estadístico se lo realizó en Exel y SPSS. Resultados: La principal indicación quirúrgica fue adenocarcinoma del ámpula de Vater (N=5, 20.8%). La complicación más frecuente fue de origen pulmonar (N= 7, 29.2%). La tasa de mortalidad fue del 4.5%. Conclusiones: A pesar de ser una institución con bajo volumen de pacientes, se evidenció que la tasa de mortalidad está dentro de parámetros aceptables. Complicaciones postquirúrgicas se presentaron en el 50% de los pacientes, lo cual es elevada pero está dentro de los rangos esperables según la literatura internacional

Propuesta de mejora de la logística de distribución a puntos de venta y del proceso de producción de la línea de pastelería de la empresa Hansel y Gretel

This thesis project contains an analysis of the production and logistical systems of Hansel y Gretel, a company specialized in baked goods. Since the demand of the company’s products is constantly increasing, there are some methods that should be applied to ensure that the resources of the Production Center and delivery system are utilized to their maximum potential. For the analysis of the Production Center, the production times were studied as well as the behavior of the production system by utilizing tools such as Simulation and Value Stream Mapping. Doing so, the production capacity was found in order to analyze different ways to improve it.En el presente proyecto de tesis se analiza el sistema productivo y logístico de la empresa Hansel y Gretel que se dedica a la Panadería, Pastelería y Galletería. Dado que la demanda de los productos de esta empresa se encuentra en constante aumento, se proponen métodos para aprovechar mejor los recursos con los que se cuenta tanto dentro del Centro de Producción como en el sistema de despachos. Para el análisis del Centro de Producción se determinaron los tiempos de elaboración de productos y se explicó el comportamiento del sistema productivo utilizando herramientas como Simulación y Mapeo de Flujo de Valor. Así, se determinó la capacidad de producción para mejorar los tiempos en que sale el producto

Ciudad y modernización agropecuaria : Río Cuarto como plataforma para la territorialización de las transformaciones agropecuarias

Tanto en Argentina como en otros países, determinadas ciudades son sede de las casas matrices o gerencias de las principales empresas vinculadas a los insumos de origen industrial para el sector agropecuario. La ciudad de Río Cuarto se constituye, a través de las empresas allí instaladas, en articuladora del sector agropecuario en los márgenes noroccidentales de la región Pampa Húmeda, en el marco del proceso de avance de la frontera agrícola en áreas marginales y en obediencia con la expansión y densificación de la red global de las empresas transnacionales identificadas en este trabajo. Estas empresas, con sus representantes locales, se convierten en plataformas para la introducción y profundización de la agricultura científica en el espacio agropecuario. Este proceso proceso traccionado por el modelo de agronegocios y atravesado por el régimen de acumulación de capital financiero. El objeto principal de este trabajo es estudiar la actual situación de la ciudad de Río Cuarto como plataforma para la difusión de las nuevas técnicas de producción agropecuaria, por medio de las empresas allí asentadas que comercian agroquímicos y semillas El trabajo se organiza entonces en tres apartados: Materiales y métodos, Resultados y Discusión y Conclusiones. En el primero, se detalla el abordaje metodológico utilizado y las diversas técnicas implementadas especialmente para el reconocimiento de los actores objeto de estudio y las variables a indagar. En Resultados, se realiza un análisis de las características y estrategias territoriales de estas empresas. Por último, en el apartado destinado a la discusión y conclusiones se retomaron aquellos aspectos fundamentales reconocidos que permitan avanzar en la comprensión del rol de la ciudad de Río Cuarto como plataforma para la territorialización de los procesos de modernización agropecuaria.Both in Argentina as others countries, particular cities are the headquarters of the parent companies or managements of the main companies linked to inputs of industrial origin for the agricultural sector. The Río Cuarto city is constituted, through the companies installed there, in articulator of the agricultural sector in the northwestern margin of the Pampa region, in the framework of the process of advancement of the agricultural frontier of marginal areas and inobedience to the expansion and densification of the global network of the transnational companies identified in this work. These companies, with their local representatives, become platforms for the introduction and deepening of scientific agriculture in the agricultural space. This process is pushed by the agribusiness model and crossed by the regime of financial capital accumulation. Thema in objective of this paper is to study the current situation of the city of Río Cuarto as a platform for the diffusion of new techniques of agricultural production, through the companies settled there that trade agrochemicals and seeds. The work is then organized in three sections: Materials and methods, Results and Discussion and Conclusions. In the first one, the methodological approach used and the various technique simplemented especially fort here cognition of the actors studied and the variables to be investigated are detailed. In Results, an analysis of the characteristics and territorial strategies of these companies is carried out. Finally, in the section of discussion and conclusions, the key aspects recognized were taken up, which allow to advance in the understanding of the role of the city of Río Cuarto as a platform for the territorialization of agricultural modernization processes.Fil: Finola, Alfio. Universidad Nacional de Río CuartoFil: Maldonado, Gabriela Inés. Universidad Nacional de Río Cuart

Padrões de acúmulo de proteínas e carboidratos durante a embriogênese somática de Acca sellowiana

The aim of this work was to quantify the protein, starch and total sugars levels during histodifferentiation and development of somatic embryos of Acca sellowiana Berg. For histological observations, the samples were dehydrated in a battery of ethanol, embedded in historesin and stained with toluidine blue (morphology), coomassie blue (protein bodies) and periodic acid-Schiff (starch). Proteins were extracted using a buffer solution, precipitated using ethanol and quantified using the Bradford reagent. Total sugars were extracted using a methanol-chloroform-water (12:5:3) solution and quantified by a reaction with anthrone at 0.2%. Starch was extracted using a 30% perchloric acid solution and quantified by a reaction with anthrone at 0.2%. During the somatic embryogenesis' in vitro morphogenesis and differentiation processes, the total protein levels decreased and the soluble sugars levels increased during the first 30 days in culture and remained stable until the 120th day. On the other hand, total protein levels increased according to the progression in the developmental stages of the somatic embryos. The levels of total sugars and starch increased in the heart and cotyledonary stages, and decreased in the torpedo and pre-cotyledonary stages. These compounds play a central role in the development of somatic embryos of Acca sellowiana. © 2009 Embrapa Informação Tecnológica.O objetivo deste trabalho foi quantificar os teores de proteína, amido e açúcares totais durante a histodiferenciação e desenvolvimento dos embriões somáticos em Acca sellowiana Berg. Para as observações histológicas, as amostras foram desidratadas em uma bateria de etanol, emblocadas em historesina e coradas com azul de toluidina (morfologia), azul de coomassie (corpos proteicos) e reativo ácido periódico de Schiff (amido). As proteínas foram extraídas usando uma solução tampão, precipitadas usando etanol e quantificadas por meio do reativo de Bradford. Os açúcares totais foram extraídos usando uma solução metanol-clorofórmioágua (12:5:3) e quantificados pela reação com antrona a 0,2%. O amido foi extraído usando uma solução de ácido perclórico a 30% e quantificado pela reação com antrona a 0,2%. Durante a diferenciação e morfogênese in vitro da embriogênese somática, os teores de proteínas totais decresceram e os açúcares solúveis aumentaram durante os 30 primeiros dias em cultura e permaneceram constantes até os 120 dias. Por outro lado, os teores das proteínas totais apresentaram incremento de acordo com a progressão nos estádios de desenvolvimento dos embriões somáticos. Os teores de açúcares totais e de amido aumentaram nos estádios cordiforme e cotiledonar e diminuíram nos estádios torpedo e pré-cotiledonar. Esses compostos exercem papel central no desenvolvimento de embriões somáticos de Acca sellowiana.Fil: Cangahuala-Inocente, Gabriela Claudia. Universidade Federal de Santa Catarina; BrasilFil: Steiner, Neusa. Universidade Federal de Santa Catarina; BrasilFil: Maldonado, Sara Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Biodiversidad y Biología Experimental y Aplicada. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Biodiversidad y Biología Experimental y Aplicada; ArgentinaFil: Guerra, Miguel Pedro. Universidade Federal de Santa Catarina; Brasi

Transgenic tobacco plants expressing the Potato virus X open reading frame 3 gene develop specific resistance and necrotic ring symptoms after infection with the homologous virus

Tobacco plants were transformed with the open reading frame 3 gene from Potato virus X (PVX) coding for the p12 protein. Although the transgenic plants exhibited a normal morphological aspect, microscopic examination revealed extensive alterations in leaf tissue structure. After being challenged with PVX, the transgenic plants showed resistance to PVX infection and formation of specific leaf symptoms consisting of concentric rings encircled by necrotic borders. These novel symptoms were accompanied by biochemical changes normally associated with the hypersensitive response (HR) and were absent in noninfected transgenic plants or in PVX-infected nontransgenic plants. No equivalent virus resistance was observed after inoculation with Tobacco mosaic virus or Potato virus Y, suggesting the presence of a specific resistance mechanism. Despite development of HR-like symptoms, systemic acquired resistance was not induced in PVX-infected p12 transgenic plants. No evidence of an RNA-mediated resistance mechanism was found.Fil: Kobayashi, Ken. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Cabral, Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Calamante, Gabriela. Instituto Nacional de Tecnología Agropecuaria. Centro Nacional de Investigaciones Agropecuarias Castelar. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Biotecnología; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Maldonado, Sara Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Mentaberry, Alejandro Nestor. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentin

Transforming Education Through Instructional Coaching in the Mayan Highlands of Guatemala : A Historical Introspection on Policy, Practice and Educational Transformation

Significant efforts have been made to improve the educational system in the Western Highlands of Guatemala to foster economic growth and social development in the country. However, given the country’s linguistic and cultural diversity, challenges in terms of coverage and quality of education persist. Inadequate teacher preparation training, and the absence of an induction and pedagogical coaching system for new teachers are some of the impeding factors. The U.S. Agency for International Development (USAID) has executed targeted educational projects to support the National Ministry of Education in strengthening the human capital in education. A transformative pedagogical leadership and coaching model was developed that focuses efforts from an oversight system to a mentoring system that strengthens leadership and the capacities of teachers in the application of innovative methodologies that contribute to educational improvement. This model allows for a continuous cycle of improvement to teaching by providing new teachers with feedback on teaching practices in the classroom and opportunities for teachers to self-reflect and be empowered in their own learning process and professional growth. This approach has shown positive effects with respect to teaching practices at the school-level; however, additional measures are required to gain the support of stakeholders to expand its implementation to bilingual and multicultural contexts to maximize the country’s potential to improve the quality of education. &nbsp

Efecto del cuidado profesional de enfermería en el estilo de vida del adulto mayor que vive con diabetes

El cuidado de enfermería del adulto mayor que vive con DM2 representa un reto para el abordaje integral por parte del profesional, que debe ser capaz de efectuar el reconocimiento de la situación personal, de su familia y del contexto, así como las condiciones en las cuales se desenvuelve, con el fin de generar intervenciones oportunas (Vargas et al., 2014: 151). El cuidado como esencia del ser y en el área de la salud, la esencia de Enfermería (Waldow, 2014) es otorgado mediante el método del proceso de enfermería y con fundamento en diferentes teorías disciplinares (Reina, 2010: 23). Por otra parte, otorgar el cuidado profesional con fundamento en un modelo o en una teoría de enfermería, como el Modelo de Promoción de la Salud, así como la utilización del proceso de enfermería y el lenguaje estandarizado, favorece el empoderamiento de los profesionales, enriqueciendo la ciencia del cuidado. Para finalizar, el presente proyecto contribuye a la Línea de Generación y Aplicación de Conocimiento (LGAC) “Cuidado de enfermería y el paradigma profesional de la educación en salud”, de la Facultad de Enfermería y Obstetricia de la Universidad Autónoma del Estado de México

Nail psoriasis treated with pulsed dye laser

Nail changes are present in about 50% of psoriasis patients and tend to be refractory to conventional treatments. Pulsed dye laser has emerged as an alternative therapy. Our aim is to evaluate the efficacy of pulsed dye laser in nail psoriasis and the impact of treatment on quality of life. Fourteen patients were treated in monthly sessions for three months. The outcome assesment was made by the Nail Psoriasis Severity Index (NAPSI). The median improvement in the scores of the overall NAPSI, nail bed NAPSI, and nail matrix NAPSI were 44.2% (P = 0.002), 50% (P = 0.033) and 65.1% (P = 0.024), respectively

Cyclins A and B associate with chromatin and the polar regions of spindles, respectively, and do not undergo complete degradation at anaphase in syncytial Drosophila embryos

Maternally contributed cyclin A and B proteins are initially distributed uniformly throughout the syncytial Drosophila embryo. As dividing nuclei migrate to the cortex of the embryo, the A and B cyclins become concentrated in surface layers extending to depths of approximately 30-40 microns and 5-10 microns, respectively. The initiation of nuclear envelope breakdown, spindle formation, and the initial congression of the centromeric regions of the chromosomes onto the metaphase plate all take place within the surface layer occupied by cyclin B on the apical side of the blastoderm nuclei. Cyclin B is seen mainly, but not exclusively, in the vicinity of microtubules throughout the mitotic cycle. It is most conspicuous around the centrosomes. Cyclin A is present at its highest concentrations throughout the cytoplasm during the interphase periods of the blastoderm cycles, although weak punctate staining can also be detected in the nucleus. It associates with the condensing chromosomes during prophase, segregates into daughter nuclei in association with chromosomes during anaphase, to redistribute into the cytoplasm after telophase. In contrast to the cycles following cellularization, neither cyclin is completely degraded upon the metaphase-anaphase transition

Cyclins A and B associate with chromatin and the polar regions of spindles, respectively, and do not undergo complete degradation at anaphase in syncytial Drosophila embryos

Maternally contributed cyclin A and B proteins are initially distributed uniformly throughout the syncytial Drosophila embryo. As dividing nuclei migrate to the cortex of the embryo, the A and B cyclins become concentrated in surface layers extending to depths of approximately 30-40 microns and 5-10 microns, respectively. The initiation of nuclear envelope breakdown, spindle formation, and the initial congression of the centromeric regions of the chromosomes onto the metaphase plate all take place within the surface layer occupied by cyclin B on the apical side of the blastoderm nuclei. Cyclin B is seen mainly, but not exclusively, in the vicinity of microtubules throughout the mitotic cycle. It is most conspicuous around the centrosomes. Cyclin A is present at its highest concentrations throughout the cytoplasm during the interphase periods of the blastoderm cycles, although weak punctate staining can also be detected in the nucleus. It associates with the condensing chromosomes during prophase, segregates into daughter nuclei in association with chromosomes during anaphase, to redistribute into the cytoplasm after telophase. In contrast to the cycles following cellularization, neither cyclin is completely degraded upon the metaphase-anaphase transition