Análisis de las inundaciones en la planicie tabasqueña en el periodo 1995-2010

Se analizan los factores que influyen en las inundaciones de la planicie tabasqueña, como la ausencia de ordenamiento territorial adecuado, la deforestación de la parte alta de las cuencas, un falso concepto de disminución del régimen hidrológico asociado con la construcción de las grandes presas en el río Grijalva y el cambio climático. Para el periodo 1995-2010 se hace una revisión de las precipitaciones, escurrimientos, manejo de las presas de la cuenca del río Grijalva e inundaciones; se presentan las acciones que se han tomado para reducir los riesgos de inundación a la población durante ese periodo, incluyendo el Programa Integral de Control de Inundaciones y el Programa Hídrico Integral de Tabasco, señalando la diferencia conceptual entre ellos. El objeto del presente artículo es describir la evolución de las aproximaciones de solución al problema de reducción de desastres por inundación en la planicie Tabasqueña, la gestión de embalses y una propuesta de gestión del territorio basado en la aplicación de un modelo numérico hidráulico bidimensional y un nomograma de resistencia al vuelco

Visión panorámica de las precipitaciones pluviales combinadas por los efectos de los ciclones tropicales Ingrid-Manuel

Se presenta un análisis panorámico de las precipitaciones pluviales que generaron los ciclones tropicales Ingrid y Manuel durante los días en que actuaron de forma simultánea sobre México, con énfasis en las características que no corresponden a la simple superposición de los campos de lluvias que cada uno de ellos hubiese generado de manera individual. Se muestra que la circulación combinada de la humedad alrededor de ambos vórtices explica conceptualmente las extensiones anómalas de la zona lluviosa que se manifestaron hacia el noreste de México, en el caso de Ingrid, y hacia el sureste de México, en el caso de Manuel. Se muestra que el evento combinado resultó mucho mayor que el referente previo en la zona del Pacífico (huracán Pauline, en 1997). Para tres cuencas específicas cercanas a Acapulco, Guerrero, se calcularon los periodos de retorno de las lluvias ocurridas durante este evento, identificando que, aunque las acumulaciones diarias resultaron extremas, las secuencias ocurridas de 2 a 5 días consecutivos corresponden a un periodo de retorno mucho mayor

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care