Aneurismas de la aorta toracoabdominal. Indicaciones de tratamiento. Cirugía abierta

ResumenEl tratamiento quirúrgico abierto de los aneurismas toracoabdominales supone un reto muy importante para cirujanos, anestesistas y perfusionistas. Se trata de una intervención agresiva, sujeta a multitud de variables no habituales y normalmente poco estandarizada en nuestro medio por su baja incidencia. El objetivo de este artículo es realizar una revisión de las indicaciones actuales de tratamiento de los aneurismas toracoabdominales, así como exponer la vía de abordaje para cirugía abierta, referencias anatómicas y técnicas quirúrgicas y de perfusión más reproducibles en la actualidad. Se expone la técnica quirúrgica paso a paso, así como las estrategias de protección medular y visceral. Por último, se discuten cuáles son resultados postoperatorios de estas técnicas y las alternativas futuras.AbstractOpen surgical treatment of thoracic aneurysms is a great challenge for surgeons, anaesthetists and perfusionists. It is a very aggressive procedure, dealing with a high number of uncommon variables and is usually non-standardised in this area, due to its low incidence. The aim of this article is to conduct a review of current indications of treatment of thoracoabdominal aneurysms and to present the open surgery approach, anatomical references, and the most usual and reliable techniques for surgery and perfusion. Step-by-step planning for the intervention is also explained, as well as the strategies for spine and visceral protection. Finally, results for this surgery and future alternatives are discussed

Use of Natural Light vs. Cold LED Lighting in Installations for the Recovery of Victims of Gender Violence: Impact on Energy Consumption and Victims’ Recovery

The efficiency of lighting installations is a major challenge concerning Governments, productive sectors and individuals. However, the importance of accurate lighting in some areas, especially those related to Health and Wellbeing is so critical that the constraints of energy efficiency and sustainability are not always a priority. This situation has become more critical with the current boom in the application of non-visual effects of light to these areas. In this study, the effects oftwo different kinds of lighting on femalevictims of gender violence are compared and analyzed in terms of positive results and impact on energy consumption and sustainability. The lighting technologies used are integrated in facilities where these women carry out different activities aimed at their integration into daily life after their traumatic experiences. The results are expected to become a tool for professionals working with these collectives and for installation designers. In spite of the well-known effects of cold light, especially for tasks involving arousal, sleepiness and other critical variables, it is demonstrated that daylight, which is obviously cheaper from productive and environmental perspectives, is better for this application.This work was conducted under funding from CAPES (Coordination of Improvement of Higher Education Personnel—Brazil) which has granted scholarships Doctoral number BEX 0947/14-8

The Use of Led Technology and Biomass to Power Public Lighting in a Local Context: The Case of Baeza (Spain)

The impact of public lighting on consumed energy, financial cost, use of raw materials, and the environment is a major concern nowadays. The high amounts of energy needed to satisfy the increasing demands of cities around the world has led researchers to look for alternatives to classical fossil sources, with low implementation in public lighting up to date. In this context, circular economy (CE) proposes a new perspective of engineering based on smart design for the future life of products where even wastes have an added value as technological nutrients for other applications. A convergent consideration of CE and the urgent necessity of more sustainable public lighting leads to this proposal. The ad hoc use of a local biomass plant for powering the public lighting of one small city is considered, and important conclusions reinforcing the link between lighting and CE are presented.This research was supported by the European Regional Development Fund (European Union), the Government of Spain (Research Project ECO2013-47027-P and ECO2017-84138-P), the Regional Government of Andalusia (Research Project P11-SEJ-7294), and SEJ 232 Research Group Management and Organization for Competitiveness

Método de preparación de muestras pulverulentas para su análisis en un difractómetro de rayos X de monocristal

Número de publicación: 2 330 396 Número de solicitud: 200601801 51 Int. Cl.: G01N 1/28 (2006.01) G01N 23/207 (2006.01)Método de preparación de muestras pulverulentas para su análisis en un difractómetro de rayos X de monocristal. El método consiste en moler una muestra del sólido a analizar para alcanzar un tamaño de partícula comprendido entre 1 y 50 micras, formar una pasta (1) homogénea consistente mediante adición y mezclado del sólido molido con un líquido de mayor densidad que el agua, introducir la pasta en una cámara (2) y comprimirla hasta eliminar parcialmente el líquido mezclado y obtener así una barrita de muestra consistente. Finalmente se extrae dicha barrita de la cámara (2) y se pega con resina en la punta de un capilar de vidrio de tamaño adecuado para su análisis en el difractómetro de rayos X de monocristal. Generalmente la cámara (2) utilizada es tubular abierta en sus bases, y la compresión de la pasta (1) dentro de la cámara (2) se realiza mediante émbolos (4) introducidos a través de dichas bases abiertas.Universidad de Almerí

Proposal for Sustainable Dynamic Lighting in Sport Facilities to Decrease Violence among Spectators

Violence among spectators at sports events has become a serious problem, not only for its evident impact on safety, but also from the perspective of environmental, cultural, economic and social sustainability. Although it could be considered a purely social problem, some solutions could come from a smart and efficient design and management of the lighting installations. Thus, the management of sports installations requires deep considerations of lighting technology for three reasons: (1) accurate illumination allows the users to achieve their visual task with comfort and safety; (2) the energy consumption of sports facilities can be decreased with an efficient design of the lighting installation; and (3) the lighting impacts some psychological and physiological aspects such as arousal, stress or relaxation which are directly related to violence. In this work, the recent advances on the matter of light sources and non-visual effects of light are deployed within a new proposal of dynamic Light-emitting diode (LED) lighting to decrease violence among spectators. Here, sustainable sports facilities are considered from a global perspective where accurate illumination in each zone (court, bleachers, training rooms and surrounding streets) plays an important role in violence avoidance.This research was partially implemented with financial support provided by CAPES, Higher Education Personnel Improvement Coordination—Brazil, through the Doctoral scholarship (BEX 0947/14-8)

Endocarditis trombótica no bacteriana (Libman-Sacks)

Mujer de 47 años ingresada en 2002 por ictus. Se diagnosticó masa valvular aórtica. Se intervino realizándose exéresis de trombo no bacteriano (Fig 1a, b). Durante el estudio de trombofilia fue diagnosticada de síndrome antifosfolípido primario (SAP), inciándose anticoagulación. Hasta la fecha, ha padecido múltiples accidentes cerebrovasculares, isquémicos y hemorrágicos. Está en diálisis peritoneal con probable origen en SAP. SAP es un trastorno autoinmune caracterizado por fenómenos trombóticos iterativos y alargamiento de tiempos de coagulación. La cirugía cardiaca conlleva morbimortalidad por tromboembolias, suponiendo un reto en el manejo de la circulación extracorpórea. Las complicaciones tromboembólicas son frecuentes durante el seguimiento.A 47-year-old woman was admitted in 2002 due to stroke. An aortic valve mass was diagnosed and surgical removal of non-bacterial thrombus performed (Fig. 1a, b). During the study for thrombophilia, primary antiphospholipidic syndrome (PSA) was diagnosed and oral anticoagulation started. Up to date, she presented with multiple episodes of cerebrovascular accident, ischemic and hemorrhagic. She is on peritoneal dialysis. PAS is an autoimmune disorder characterized by recurrent thrombotic phenomena and prolonged coagulation time. Cardiac surgery carries morbidity and mortality due to thromboembolic events, representing a challenge in the management of extracorporeal circulation. Thromboembolic complications are frequent during the follow-up

Importancia de la enseñanza aprendizaje sobre el origen y las raíces de las danzas folklóricas nicaragüenses en el componente de danza de la asignatura de taller de Arte y Cultura del quinto grado del colegio Adventista del Reparto Shick, del distrito V de Managua, durante el II semestre del 2022

En la presente investigación, se presentará cada uno de los aspectos que están contenidos en el foco, el cual cuenta con una introducción, cuestiones de investigación, propósitos de la investigación, marco teórico, matriz de descriptores, perspectiva de la investigación, análisis e interpretación de los resultados, conclusiones, recomendaciones, referencias bibliográficas y anexos. La información obtenida en esta investigación, muestra la falta de estrategias didácticas en el componente de danza de la asignatura de Taller de Arte y Cultura, para enseñar sobre el origen y las raíces de las danzas folklóricas nicaragüenses, a los estudiantes del quinto grado del colegio adventista del Reparto Shick. Los resultados muestran la necesidad que hay de que los estudiantes aprendan más sobre esta temática, ya que no poseen ningún conocimiento previo sobre el origen y las raíces de las danzas folklóricas nicaragüenses. Por lo que se recomienda tomar conciencia de la importancia que tiene que los estudiantes no solo dramaticen las danzas, sino que también, conozcan sobre sus orígenes y raíce

Progression of Early Subclinical Atherosclerosis (PESA) Study: JACC Focus Seminar 7/8.

Atherosclerosis starts early in life and progresses silently for decades. Considering atherosclerosis as a "systemic disease" invites the use of noninvasive methodologies to detect disease in various regions before symptoms appear. The PESA-(Progression of Early Subclinical Atherosclerosis) CNIC-SANTANDER study is an ongoing prospective cohort study examining imaging, biological, and behavioral parameters associated with the presence and progression of early subclinical atherosclerosis. Between 2010 and 2014, PESA enrolled 4,184 asymptomatic middle-aged participants who undergo serial 3-yearly follow-up examinations including clinical interviews, lifestyle questionnaires, sampling, and noninvasive imaging assessment of multiterritorial subclinical atherosclerosis (carotids, iliofemorals, aorta, and coronaries). PESA tracks the trajectories of atherosclerosis and associated disorders from early stages to the transition to symptomatic phases. A joint venture between the CNIC and the Santander Bank, PESA is expected to run until at least 2029, and its significant contributions to date are presented in this review paper.The PESA study is funded by the CNIC and Santander Bank. The study has also received funding from the Carlos III Institute of Health (ISCIII, PI15/02019, PI17/00590, and PI20/00819) and the European Regional Development Fund. The CNIC is supported by the ISCIII, the MICIN, and the Pro CNIC Foundation. Dr Ibanez is the recipient of a European Research Council grant MATRIX (ERC-COG-2018-ID: 819775). Dr Andrés is supported by grant PID2019-108489RB-I00 from the Spanish Ministerio de Ciencia e Innovación (MICIN), with cofunding from the European Regional Development Fund/Fondo Europeo de Desarrollo Regional (ERDF/FEDER, “A way to build Europe”). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.S

Proposal to Foster Sustainability through Circular Economy-Based Engineering: A Profitable Chain from Waste Management to Tunnel Lighting

The increasing demands of infrastructures in terms of energy consumption, raw material demand, greenhouse gas emissions, waste management, treatment of components after their lifetime period, and financial costs are nowadays a serious threat for sustainability. Given that the resources are limited, it is difficult to ensure an accurate level of well-being for future generations. For this reason, new perspectives in design, production and consumption are necessary. In this work, the principles of circular economy are applied to concrete branches of engineering. Departing from a design orientated to new uses after life period of infrastructures, a circular economy-aimed engineering makes possible the connection and mutual profit of such different branches like waste management and tunnel lighting. The benefits in environmental and financial terms are a strong argument in favor of a stronger link between engineering and circular economy.This study has been supported and co-financed by projects from the Spanish Ministry of Economy and Competitiveness ECO2010-15885 and ECO2013-47027-P, Andalusian Government P11-SEJ-7294 and European Union (ERDF funds)