Müller cyst: report of a case in pregnancy

Müller cysts are alterations in the development of sexual cords and remain as malformations associated with them. They can occur in many morphological varieties. In the case of pregnancy, vaginal tumors can complicate labor because they cause obstruc-tion of the canal. During labor, these alterations can complicate the diagnosis and proper management of pregnancy. A 22-year-old female, who came to the hospital at 30.1 weeks of gestation for the first time, due to obstetric pain, vaginal tumor was detected, the patient triggered preterm labor, which did not address medical management based on oral and intravenous uteroinhibitors, so a cesarean is decided, later in the puerperium magnetic resonance was performed finding a defect in the vaginal wall, compatible with probable Müller's cyst. Due to its low frequency but high impact on pregnancy, vaginal tumors are a diagnostic and therapeutic challenge, due to their embryological origin should be detected and advise on the consequences of them. As a result, some other alterations may coexist, which is why complementary studies are essential. In the pregnancy protocol, the proper location of the cysts guides us to a specific embryological origin, as well as a preventive intervention can be planned in cases like this. If these patients are asymptomatic, surgical intervention is not required, much less during pregnancy unless an obstetric indication for interruption is determined

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

Design and characterization of a magneto-dielectric composite in high frequency with aligned magnetite powders

A magneto-dielectric material composed of a polyester resin-based microstrip (P115A), copper sheets and magnetite powders was designed in concentrations of 10, 20 and 30% Wt and with filters of 200, 325 and 500. The particles were aligned vertically and horizontally during the curing process using 300 mT magnetic fields. From a complete factorial design of 33, 27 microstrip-type circuits of 4 mm width, 70 mm length and 0.93 mm thickness were manufactured, characterized by scanning electron microscopy and vector network analysis. The cross-matrix analysis determined an optimal circuit response from the magneto-dielectric material with a concentration of 20% magnetite and an average particle size of 21.48 μm in horizontal alignment to the applied magnetic field and to the transmission line, obtaining a relative dielectric constant of Er 3.88 with a low dielectric loss of 0.054, within an operating range of 150 KHz to 4 GHz

Stellar Population gradients in galaxy discs from the CALIFA survey

While studies of gas-phase metallicity gradients in disc galaxies are common, very little has been done in the acquisition of stellar abundance gradients in the same regions. We present here a comparative study of the stellar metallicity and age distributions in a sample of 62 nearly face-on, spiral galaxies with and without bars, using data from the CALIFA survey. We measure the slopes of the gradients and study their relation with other properties of the galaxies. We find that the mean stellar age and metallicity gradients in the disc are shallow and negative. Furthermore, when normalized to the effective radius of the disc, the slope of the stellar population gradients does not correlate with the mass or with the morphological type of the galaxies. Contrary to this, the values of both age and metallicity at $\sim$2.5 scale-lengths correlate with the central velocity dispersion in a similar manner to the central values of the bulges, although bulges show, on average, older ages and higher metallicities than the discs. One of the goals of the present paper is to test the theoretical prediction that non-linear coupling between the bar and the spiral arms is an efficient mechanism for producing radial migrations across significant distances within discs. The process of radial migration should flatten the stellar metallicity gradient with time and, therefore, we would expect flatter stellar metallicity gradients in barred galaxies. However, we do not find any difference in the metallicity or age gradients in galaxies with without bars. We discuss possible scenarios that can lead to this absence of difference.Comment: 24 pages, 17 figures, accepted for publication in A&

Effects of PACK guide training on the management of asthma and chronic obstructive pulmonary disease by primary care clinicians: a pragmatic cluster randomised controlled trial in Florianópolis, Brazil

Introduction The Practical Approach to Care Kit (PACK) guide was localised for Brazil, where primary care doctors and nurses were trained to use it. Methods Twenty-four municipal clinics in Florianópolis were randomly allocated to receive outreach training and the guide, and 24 were allocated to receive only the guide. 6666 adult patients with asthma or chronic obstructive pulmonary disease (COPD) were enrolled, and trial outcomes were measured over 12 months, using electronic medical records. The primary outcomes were composite scores of treatment changes and spirometry, and new asthma and COPD diagnosis rates. Results Asthma scores in 2437 intervention group participants were higher (74.8%, 20.4% and 4.8% with scores of 0, 1 and 2, respectively) than in 2633 control group participants (80.0%, 16.8% and 3.2%) (OR for higher score 1.32, 95% CI 1.08 to 1.61, p=0.006). Adjusted for asthma scores recorded in each clinic before training started, the OR was 1.24 (95% CI 1.03 to 1.50, p=0.022). COPD scores in 1371 intervention group participants (77.7%, 17.9% and 4.3% with scores of 0, 1 and 2) did not differ from those in 1181 control group participants (80.5%, 15.8% and 3.7%) (OR 1.21, 95% CI 0.94 to 1.55, p=0.142). Rates of new asthma and COPD diagnoses, and hospital admission, and indicators of investigation, diagnosis and treatment of comorbid cardiovascular disease, diabetes and depression, and tobacco cessation did not differ between trial arms. Conclusion PACK training increased guideline-based treatment and spirometry for asthma but did not affect COPD or comorbid conditions, or diagnosis rates

OT Modeling: The Enterprise Beyond IT

Enterprises are composed of an enormous number of elements (e.g., organizational units, human resources, production processes, and IT systems) typically classified in the business or the IT domain. However, some crucial elements do not belong in either group: they are directly responsible for producing and delivering the company’s goods and services and include all the elements that support day to day operations. Collectively, these elements have been called operational technologies (OT) and have been conspicuously excluded from enterprise modeling (EM) approaches which traditionally have focused on the business and IT dimensions. Evidence of this is the absence of OT elements in languages and metamodels for EM. This is in line with the historical division between IT and OT in organizations that has led to information silos, independent teams, and disparate tech- nologies that only recently have started to be reconciled. Considering that OT is critical to most productive organi- zations, and the benefits that EM brings to its understand- ing and improvement, it makes sense to expand EM to include OT. For that purpose, this paper proposes an extension to ArchiMate 3.0 which includes crucial OT elements. On top of that, this paper also proposes an approach to further expand ArchiMate to address specific industries where more specific OT elements are required. This is illustrated in the paper with an extension for the Oil and Gas case that was validated with experts belonging to five companies in the sector

Salmonella Typhimurium Type III Secretion Effectors Stimulate Innate Immune Responses in Cultured Epithelial Cells

Recognition of conserved bacterial products by innate immune receptors leads to inflammatory responses that control pathogen spread but that can also result in pathology. Intestinal epithelial cells are exposed to bacterial products and therefore must prevent signaling through innate immune receptors to avoid pathology. However, enteric pathogens are able to stimulate intestinal inflammation. We show here that the enteric pathogen Salmonella Typhimurium can stimulate innate immune responses in cultured epithelial cells by mechanisms that do not involve receptors of the innate immune system. Instead, S. Typhimurium stimulates these responses by delivering through its type III secretion system the bacterial effector proteins SopE, SopE2, and SopB, which in a redundant fashion stimulate Rho-family GTPases leading to the activation of mitogen-activated protein (MAP) kinase and NF-κB signaling. These observations have implications for the understanding of the mechanisms by which Salmonella Typhimurium induces intestinal inflammation as well as other intestinal inflammatory pathologies