Manteniendo el índice de sospecha de absceso hepático en pediatría

Hepatic abscess of pyogenic and amoebic etiology is a predominant pathology in adults. The incidence in pediatrics varies according to risk factors. In recent years, a decrease in its presentation has been evidenced, which potentially generates a loss of sensitivity for timely diagnosis, for which recall is required. The case of an eight-year-old male patient with a diagnosis of liver abscess is described and a review of the literature of the pathology in pediatric age, its etiology, classification, clinical manifestations, diagnosis and management is carried out in order to maintain the index of suspicion in the clinician.El absceso hepático es una patología predominante en adultos. La incidencia en pediatría varía según factores de riesgo. En los últimos años se ha evidenciado una disminución en su presentación, lo cual potencialmente genera una pérdida de la sensibilidad para el diagnóstico oportuno, por lo que se requiere recordación. Se describe el caso de un paciente masculino de ocho años de edad con diagnóstico de absceso hepático y se realiza revisión de la literatura de la patología en la edad pediátrica, su etiología, clasificación, manifestaciones clínicas, diagnóstico y manejo con el objetivo de mantener el índice de sospecha en el clínico

Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia

BackgroundA heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).MethodsA population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff’s spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained.ResultsA total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed.ConclusionsThe identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Diseño de una red publica ATM para Guayaquil que brinde servicios de voz, vídeos y datos, e integración de una red privada ATM ESPOL al diseño propuesto

Presenta aspectos teóricos relacionados con la tecnología ATM tales como arquitectura ATM, formato de celdas, capas AAL, tipos de servicio que ofrece ATM, manejo de tráfico tecnológico de conmutación e internetworking. Se estudia la tecnología SDH, la infraestructura de la red SDA para Guayaquil y su relación con la futura red ATM. Describe un breve estudio de la red privada ATM ESPOL, que brinda servicios al campus prosperina. Se muestra el diseño escogido para la red propuesta. Se realiza el análisis de costos y el cronograma de instalación del proyecto. Las aplicaciones específicas que se presentan fueron orientadas al caso de la ESPOL. Finalmente se declaran las conclusiones y recomendaciones que se han ido recopilando en el desarrollo de este estudio.GuayaquilIngeniero en Electricidad Especialización Electrónic

The impact of the pandemic 2020 on the Brewing Industry

En el presente trabajo de investigación desarrollaremos los efectos de la pandemia Covid-2019 en el sector cervecero en el Perú. Debido a que el sector cervecero se concentra en más del 90% en una sola empresa nos centraremos en ella, Unión de Cervecerías Peruanas Backus y Johnston S.A.A. (en adelante “Backus”). Para ello, revisaremos información disponible en el sector cervecero en el Perú y el mundo, así como las proyecciones en volúmenes, participación de ventas, participación de marcas, consumo de cerveza, entre otros. Actualmente, Backus cuenta con cinco plantas de procesamiento ubicadas en lugares estratégicos y con más de ciento ochenta mil puntos de venta en todo el país con un grupo diversificado de marcas locales e internacionales segmentados para cada tipo de cliente. En cuanto a la situación financiera de Backus, muestra una caída significativa en los ingresos como consecuencia de la pandemia lo cual hizo que la rentabilidad promedio al 2020 se vea afectada haciendo que Backus reduzca el reparto de dividendos en comparación a años anteriores. Finalmente, de la evaluación realizada a través de la valorización de Backus, podemos observar que el sector cervecero, a pesar del impacto económico producto de la pandemia, sigue teniendo una expectativa positiva en el mercado nacional viéndose reflejado en el valor de sus acciones 2019 y 2020, esto como consecuencia del buen trabajo de la compañía que siguen implementando modelos y estándares de calidad en pro de su mejor performance.In this research work we will develop the effects of the Covid-2019 pandemic in the brewing industry in Peru. Since the brewing industry is concentrated in more than 90% in a single company, in this case Unión de Cervecerías Peruanas Backus y Johnston S.A.A. (hereinafter "Backus") so we will focus in it. For that, we will review information available in the brewing industry in Peru and the world, as well as projections in volumes, sales participation, brand participation, brewing consumption, among others. Currently, Backus has five processing plants located in strategic locations and it has more than one hundred and eighty thousand sales points throughout the country with a diversified portfolio of national and international brands segmented for each consumer profile. Regarding the financial situation of Backus, it shows a significant drop in income as a result of the pandemic, which caused the average profitability to 2020 to be affected, causing Backus to reduce the distribution of dividends compared to previous years. Finally, from the evaluation carried out through the valuation of Backus, we can observe that the brewing industry, despite the economic impact caused by the pandemic, continues to have a positive expectation in the national market, being reflected in the value of its shares in 2019 and 2020, this is as a result of the good work of the company that continues to implement models and quality standards in favor of its best performance.Trabajo de investigació

Temporal Alterations in Mitochondrial β-Oxidation and Oxidative Stress Aggravate Chronic Kidney Disease Development in 5/6 Nephrectomy Induced Renal Damage

Five-sixths nephrectomy (5/6Nx) model is widely used for studying the mechanisms involved in chronic kidney disease (CKD) progression, a kidney pathology that has increased dramatically in recent years. Mitochondrial impairment is a key mechanism that aggravates CKD progression; however, the information on mitochondrial bioenergetics and redox alterations along a time course in a 5/6Nx model is still limited and in some cases contradictory. Therefore, we performed for the first time a time-course study of mitochondrial alterations by high-resolution respirometry in the 5/6Nx model. Our results show a decrease in mitochondrial β-oxidation at early times, as well as a permanent impairment in adenosine triphosphate (ATP) production in CI-linked respiration, a permanent oxidative state in mitochondria and decoupling of these organelles. These pathological alterations are linked to the early decrease in complex I and ATP synthase activities and to the further decrease in complex III activity. Therefore, our results may suggest that mitochondrial bioenergetics impairment is an early event in renal damage, whose persistence in time aggravates CKD development in the 5/6Nx model

Mechanisms of Fasting-Mediated Protection against Renal Injury and Fibrosis Development after Ischemic Acute Kidney Injury

Ischemia-reperfusion injury of the kidney may lead to renal fibrosis through a combination of several mechanisms. We recently demonstrated that fasting protects the rat kidney against oxidative stress and mitochondrial dysfunction in early acute kidney injury, and also against fibrosis development. Here we show that preoperative fasting preserves redox status and mitochondrial homeostasis at the chronic phase of damage after severe ischemia. Also, the protective effect of fasting coincides with the suppression of inflammation and endoplasmic reticulum stress, as well as the down-regulation of the mechanistic target of rapamycin (mTOR) and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathways in the fibrotic kidney. Our results demonstrate that fasting targets multiple pathophysiological mechanisms to prevent renal fibrosis and damage that results after renal ischemia-reperfusion injury

Table_1_Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia.xlsx

BackgroundA heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).MethodsA population-based case-control study was conducted. Children ResultsA total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (pConclusionsThe identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.</p

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago /

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann’s procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment’s choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception