Propuesta para la prevención de inundaciones de la quebrada RÍo Seco distrito San Antonio - provincia Huarochirí - departamento de Lima

En los últimos años el desborde de la Quebrada Rio Seco ha generado inundaciones y daños en los pueblos aledaños, sin embargo, no se han tomado medidas preventivas con el fin de evitar que la población se perjudique. La presente investigación tiene como objetivo determinar una propuesta de solución hidráulica que nos proporcione prevenir las inundaciones emergentes de la Quebrada Rio Seco, las cuales afectan directamente al distrito de San Antonio, provincia Huarochiri – Lima. Para la obtención de topográfica se generó un modelo digital de elevación desde una página de la Nasa (Alaska Satellite Facility), y se utilizó Google Earth: a través del complemento CadEarth que permite ubicar los puntos representados para el perímetro del área de trabajo y los puntos de los ruteos expuestos más delante (el estudio se efectuará en base al modelo digital del terreno; no hay topografía). Para la hidrología se obtuvo los datos de precipitaciones de la estación meteorológica del SENAMHI (SANTA EULALIA), y con la ayuda del software Hec Geo HMS se obtendrán los caudales. Se realizo métodos hidráulicos para la obtención del caudal que transcurre como el método del flotador (midiendo el tiempo de una esfera por la superficie). Con los datos obtenidos se procedió al modelamiento hidráulico mediante el software ArcGis, dicho modelamiento corresponderá a la zona crítica en estudio. Por último, se procedió a proponer la construcción de una estructura hidráulica adecuada para el encauzamiento del agua que se llega a desbordar de la Quebrada Rio Seco.In recent years, the overflow of the Quebrada Rio Seco has caused flooding and damage to surrounding villages, however no preventive measures have been taken to prevent the population from being harmed. The objective of this research is to determine a proposed hydraulic solution that will provide us with the prevention of the emerging floods of the Rio Seco Gorge, which directly affect the district of San Antonio, Huarochiri – Lima province. For topographic acquisition, a digital elevation model was generated from a NASA (Alaska Satellite Facility) page, and Google Earth was used: Through the CadEarth add- (the study will be based on the digital model of the terrain; no topography). For hydrology, rainfall data was obtained from the WEATHER station of SENAMHI (SANTA EULALIA), and with the help of the Hec Geo HMS software, the flow rates will be obtainedin, you can locate the points represented for the perimeter of the work area and the points of the exposed ruts ahead. Hydraulic methods were made for obtaining the flow that passes as the method of the float (measuring the time of a sphere across the surface). Using the data obtained, hydraulic modeling was carried out using ArcGIS software, which will correspond to the critical area under study. Finally, it was proposed to propose the construction of a hydraulic structure suitable for the routing of the water that is overflowing from the Quebrada Rio Seco.Tesi

Ezetimibe added to statin therapy after acute coronary syndromes

BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization ( 6530 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit