Edificio de Oficinas Mixtas: Coworking y convencionales en San Isidro

El proyecto se inscribe en el campo de la arquitectura corporativa y comercial. Se trata de diseñar un proyecto arquitectónico, de un “Edificio de Oficinas mixtas: Coworking y convencionales en San Isidro” en los límites de San Isidro con Lince, donde se integran usos de oficina y un área de comercio menor. El aporte diferencial del tema está en la propuesta no convencional del proyecto, la cual plantea permeabilidad espacial del proyecto con su entorno por lo que permite una comunicación entre dos avenidas importantes, además propone una tipología de oficina alternativa al grueso de lo que ofrece el mercado. El proyecto de un “Edificio de Oficinas mixtas: Coworking y convencionales en San Isidro” que busca solucionar la demanda de espacio laboral del usuario emprendedor, sin descuidar la integración eficaz entre el proyecto y su entorno inmediato, rompiendo el paradigma de edificios que se posicionan como un bloque divisorio entre calles y avenidas.Tesi

Clinical Impact of the Polypill for Cardiovascular Prevention in Latin America: A Consensus Statement of the Inter-American Society of Cardiology.

The burden of cardiovascular diseases (CVD) is increasing, particularly in low-middle-income countries such as most of Latin America. This region presents specific socioeconomic characteristics, generating a high incidence of CVD despite efforts to control the problem. A consensus statement has been developed by Inter-American Society of Cardiology with the aim of answering some important questions related to CVD in this region and the role of the polypill in cardiovascular (CV) prevention as an intervention to address these issues. A multidisciplinary team composed of Latin American experts in the prevention of CVD was convened by the Inter-American Society of Cardiology and participated in the process and the formulation of statements. To characterize the prevailing situation in Latin American countries, we describe the most significant CV risk factors in the region. The barriers that impair the use of CV essential medications are also reviewed. The role of therapeutic adherence in CV prevention and how the polypill emerges as an effective strategy for optimizing adherence, accessibility, and affordability in the treatment of CVDs are discussed in detail. Clinical scenarios in which the polypill could represent an effective intervention in primary and secondary CV prevention are described. This initiative is expected to help professionals involved in the management of CVD and public health policymakers develop optimal strategies for the management of CVDs

Urothelial bladder carcinoma with major clinical presentation as overactive bladder, without hematuria: case report and literature review

The urothelial carcinoma is the most common type of bladder cancer, comprising approximately 90% of cases in the United States. The most common symptom of bladder cancer is macroscopic hematuria, increased urinary frequency, urgency, or irritative symptoms may occur. Generally, occurs in elderly people, about 9 out of 10 people are over 55 years old, with the average age at diagnosis of 73 years. Males are more likely than women to have this neoplasm with a probability of 1 in 27 (for women the probability is 1 in 89). Most bladder cancers begin in the inner layer, also called the urothelium or transitional epithelium. As it advances, it invades the layers of the bladder and can invade adjacent structures, often metastasizing to distant lymph nodes, bones, lungs or the liver. Among the cancers that originate in the bladder authors have: Urothelial carcinoma (transitional cell carcinoma), squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma. Hematuria occurs in the majority of patients with urothelial carcinoma. Symptoms such as dysuria, frequency, urgency and pain may also occur, or it may also be asymptomatic.  In this case report, an atypical presentation of bladder cancer is shown, simulating the symptomatology of a Hyperactive Bladder Syndrome

Is skin grafting in the patient with cutaneous sporotrichosis the definitive therapy?

Sporotrichosis is a subacute to chronic infection caused by the dimorphic fungal genus Sporothrix. The infection usually affects the skin and subcutaneous tissues, but occasionally it can occur at other sites, mainly in immunocompromised patients. The symptoms of extracutaneous sporotrichosis can be subtle and diagnosis is often delayed. A 54-year-old male was received, originally from Huajuapan de León, Oaxaca; who was with an established diagnosis of type 2 diabetes mellitus; later admitted by the general surgery service with a diagnosis of necrotizing fasciitis of the left and right thoracic limb. When culture was collected with Sporothrix schenckii report, management was established with itraconazole, potassium iodide and with subsequent addition of amphotericin B, with antibiotic therapy directed for superinfection by opportunistic agents. After multiple surgical cleanings with degradation of necrotic tissue, implementation of negative pressure system and amputation of nonviable fingers, it was decided to proceed with the application of skin autografts, despite the persistence of the agent in subsequent culture reports, which are fully integrated, without evidence of new ulcerodular lesions so far. Although there are currently no parameters defined in the literature that guide the time or the appropriate conditions to perform skin grafts in the areas affected by cutaneous sporotrichosis, there are, on the contrary, reports of successful cases where surgical management has been effective even in the presence of positive cultures for Sporothrix schenckii. We consider that these results open the panorama of options for the current management of cutaneous sporotrichosis, making it necessary to consider surgical management in the therapeutic range of the same, allowing the deliberation on other more conservative options before the failure of classical therapy and the imminence of amputation

Refractory hyperactive bladder treated with sacral neuromodulator: case report and literature review

The overactive bladder syndrome is a chronic medical condition that affects the quality of life of patients whether men or women, has a prevalence of 16.5%, however, it is known to increase with age, affecting up to 25% of women older than 65 years and up to 80% in the elderly. More than 90% of cases have no apparent cause.  The OAB (Overactive Bladder) It is a condition with characteristic symptoms of urinary urgency, usually accompanied by frequency and nocturia, with or without urge incontinence, in the absence of urinary tract infection or other obvious pathology. The different therapeutic steps are not always sufficient to restore the quality of life

Impacto del número de controles periódicos en la salud bucal de los pacientes atendidos en la Clínica de Odontopediatría

La Clínica de Odontopediatría desarrolla un modelo de atención con énfasis en promoción, educación y rehabilitación destacándose su control y mantenimiento. No hay información sobre el impacto de los controles periódico

A ventromedial prefrontal dysrhythmia in obsessive-compulsive disorder is attenuated by nucleus accumbens deep brain stimulation

Background: Obsessive-compulsive disorder (OCD) has consistently been linked to abnormal frontostriatal activity. The electrophysiological disruption in this circuit, however, remains to be characterized. Objective/hypothesis: The primary goal of this study was to investigate the neuronal synchronization in OCD patients. We predicted aberrant oscillatory activity in frontal regions compared to healthy control subjects, which would be alleviated by deep brain stimulation (DBS) of the nucleus accumbens (NAc). Methods: We compared scalp EEG recordings from nine patients with OCD treated with NAc-DBS with recordings from healthy controls, matched for age and gender. Within the patient group, EEG activity was compared with DBS turned off vs. stimulation at typical clinical settings (3.5 V, frequency of stimulation 130 Hz, pulse width 60 ms). In addition, intracranial EEG was recorded directly from depth macro electrodes in the NAc in four OCD patients. Results: Cross-frequency coupling between the phase of alpha/low beta oscillations and amplitude of high gamma was significantly increased over midline frontal and parietal electrodes in patients when stimulation was turned off, compared to controls. Critically, in patients, beta (16-25 Hz)-gamma (110-166 Hz) phase amplitude coupling source localized to the ventromedial prefrontal cortex, and was reduced when NAc-DBS was active. In contrast, intracranial EEG recordings showed no beta-gamma phase amplitude coupling. The contribution of non-sinusoidal beta waveforms to this coupling are reported. Conclusion: We reveal an increased beta-gamma phase amplitude coupling in fronto-central scalp sensors in patients suffering from OCD, compared to healthy controls, which may derive from ventromedial prefrontal regions implicated in OCD and is normalized by DBS of the nucleus accumbens. This aberrant cross-frequency coupling could represent a biomarker of OCD, as well as a target for novel therapeutic approaches. (C) 2021 The Authors. Published by Elsevier Inc.This work was supported by Project grants SAF2015-65982-R from the Spanish Ministry of Economy and Competitiveness to BS and PSI2014-58654-JIN to JGR, an FPI Predoctoral Fellowship (BES-2016-079470) to ST, and BIAL Foundation Grant 119/12 to BS. This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (ERC-2018-COG 819814)

Detection of hepatitis C virus RNA in saliva of patients with active infection not associated with periodontal or liver disease severity

BACKGROUND: Hepatitis C virus (HCV) is mainly transmitted by parenteral route, being blood transfusion and intravenous drug use the most frequent risk factors. However, it has been suggested that there are other routes of transmission. There are several studies where HCV RNA has been detected in saliva of patients infected with HCV, and epidemiological studies have proposed the dental treatments as possible risk factors for HCV transmission. The purpose of this study was to detect the presence of HCV RNA in saliva of patients with active infection and associating with periodontal or liver disease. METHODS: Patients with quantifiable HCV-RNA in serum were enrolled in the study. Periodontal disease was assessed using the modified gingival index (MGI). Presence of dental plaque was assessed with the use of disclosing tablets. Patients were clinically and laboratory evaluated to identify the stage of liver disease, the HCV RNA was determinate in saliva by nested RT-PCR. To determine associations between different parameters univariate and multivariate analysis were used. RESULTS: A total of 45 patients were included. Of these patients, 21 (46.6%) had hepatitis, 23 (51.1%) had cirrhosis and one patient (2.4%) presented hepatocellular carcinoma (HCC). Viral loads in serum ranged from 2.31–6.68 log IU/ml with a mean of 5.46 log IU/ml (95% CI 5.23–5.70). HCV RNA was positive in saliva of 29 patients (64.4%) and was not detected in 16 (35.6%). For univariate analysis three independent variables were associated with the detection of HCV-RNA in saliva: gender, viral load and dental plaque and multivariate analysis only one independent variable viral load >5.17 log IU/mL remained significantly associated with the detection of HCV in saliva (p = 0.0002). A statistical difference was observed when viral load was analyzed, log 5.85 IU/mL (95% CI 5.67–6.02) for patients with HCV in saliva vs. log 4.77 IU/mL (95% CI 4.35–5.19) for patients without HCV in saliva (p = 0.0001). The detection of HCV-RNA in saliva was more frequent in patients with relatively high serum viral loads. CONCLUSION: HCV-RNA in saliva was associated with the level of serum viral load but not with periodontal or liver disease severity

Identificación de variables que impactan en la Eficiencia Energética de Secadoras de ropa.

Este artículo presenta el estudio de identificación de variables que mayor impacto tienen en la eficiencia energética de una secadora de ropa de tipo doméstico. También se presenta un análisis funcional donde se describen los procesos físicos que se llevan a cabo durante un ciclo de secado, desde la generación de calor a través de un calentador eléctrico, hasta le extracción de la humedad de ropa a través de tubos de escape. Posteriormente, se delimita el “Proceso de Secado” dentro del tambor de la secadora, como el fenómeno a entender, explicar y modelar para mejorar su eficiencia. Por medio de un diagrama de parámetro (Diagrama P) y un panel de expertos es que se entiende el proceso de secado de ropa, y son determinadas las variables de entrada que el sistema necesita; así como las de salida que el sistema entrega. A través de estudios teóricos previos es como se explica que variables físicas deberán controlarse para obtener una mejor eficiencia energética. Para validar dichos estudios teóricos previos, se plantea modelar experimentalmente el fenómeno de secado, a través de la construcción de un prototipo funcional y un diseño de experimentos (DOE). Con estas actividades se logra determinar que variables tienen el mayor impacto sobre la eficiencia energética en el proceso de secado; logrando identificar que una disminución en 15% de la humedad relativa del aire que entra a la secadora, podría ayudar a disminuir hasta en un 17% el consumo energético. También el estudio reveló las variables físicas que podrían hacer un ciclo de secado de ropa más rápido

Analysis of Pyrolysis Kinetic Parameters Based on Various Mathematical Models for More than Twenty Different Biomasses: A Review

Today, energy use is an important and urgent issue for economic development worldwide. It is expected that raw material in the form of biomass and lignocellulosic residues will become increasingly significant sources of sustainable energy in the future because they contain components such as cellulose, hemicellulose, lignin, and extractables with high energy-producing potential. It is then essential to determine the behavior of these materials during thermal degradation processes, such as pyrolysis (total or partial absence of air/oxygen). Pyrolyzed biomass and its residual fractions can be processed to produce important chemical products, such as hydrogen gas (H2). Thermogravimetric (TGA) analysis and its derivative, DTG, are analytical techniques used to determine weight loss as a function of temperature or time and associate changes with certain degradation and mass conversion processes in order to evaluate kinetic properties. Applying kinetic methods (mathematical models) to degradation processes permits obtaining several useful parameters for predicting the behavior of biomass during pyrolysis. Current differential (Friedman) and integral (Flynn–Wall–Ozawa, Kissinger–Akahira–Sunose, Starink, Popescu) models vary in their range of heating speeds (β) and degree of advance (α), but some (e.g., Kissinger’s) do not consider the behavior of α. This article analyzes the results of numerous kinetic studies using pyrolysis and based on thermogravimetric processes involving over 20 distinct biomasses. The main goal of those studies was to generate products with high added value, such as bio-char, methane, hydrogen, and biodiesel. This broad review identifies models and determines the potential of lignocellulosic materials for generating bioenergy cleanly and sustainably