Revisión narrativa sobre la cirugía bariátrica en la población infantojuvenil con obesidad

INTRODUCCIÓN. La prevalencia de la obesidad infantojuvenil ha aumentado exponencialmente e implica serias comorbilidades, por lo que es importante conocer las estrategias preventivas y terapéuticas frente a ella. En cuanto a la prevención es fundamental dirigir el estilo de vida hacia una dieta saludable y mayor actividad física. La opción farmacológica únicamente es efectiva acompañada de las estrategias preventivas. El principal medicamento es Orlistat, y Metformina en caso de obesidad en presencia de diabetes. La intervención quirúrgica es una buena opción cuando todo lo anterior fracasa, y en ningún caso puede aplicarse como única estrategia. OBJETIVO: revisar la información disponible sobre las indicaciones, técnicas, efectos adversos y resultados de la cirugía bariátrica en la población infantojuvenil con obesidad. MÉTODOS. Se realizó una búsqueda en bases de datos informatizadas y páginas web de organismos oficiales de artículos sobre la cirugía de la obesidad infantojuvenil. RESULTADOS. La cirugía bariátrica se aplica a pacientes maduros física y mentalmente, con obesidad severa (IMC>35 kg/m2) y comorbilidades graves, en los que la intervención basada en cambios en el estilo de vida o fármacos no ha sido efectiva. Las técnicas restrictivas son la cirugía gástrica de bandas ajustables (CGBA), la gastrectomía vertical (GV) y la plicatura de la curvatura mayor del estómago (PCVE).Las mixtas-malabsortivas implican mayor déficit nutricional y son el bypass gástrico en Y de Roux (BGYR) y la novedosa técnica de Elbanna (TE). Todas son efectivas en la reducción del peso, pero la GV y la TE no han sido muy investigadas aún en niños. La CGBA y la PCVE son reversibles. Las técnicas mínimamente invasivas son cada vez más utilizadas por su rápida recuperación y menor tasa de complicaciones. DISCUSIÓN Y CONCLUSIÓN. La cirugía bariátrica surge como una opción en el tratamiento de la obesidad infantojuvenil, siendo efectiva en la reducción del exceso de peso y mejoría de las comorbilidades asociadas. Hay falta de estudios sobre la obesidad infantil, cuyas estrategias preventivas son de bajo coste, y sobre los resultados a largo plazo de las intervenciones quirúrgicas. PALABRAS CLAVE: Obesidad Infantil, Cirugía, Cirugía Bariátrica

Planeamiento estratégico de Empresa Volcan Compañía Minera S.A.A

Volcan Compañía Minera S.A.A., es una empresa peruana que se dedica a la exploración, explotación, tratamiento de minerales no ferrosos, así como a la comercialización de sus concentrados, constituyéndose en una de las diez principales productoras de plata, plomo, y zinc del mundo y con ventas anuales que alcanzan aproximadamente los US $1,200 millones. Para la empresa en mención se ha diseñado un planeamiento estratégico contemplando sus aspiraciones teniendo claro el rubro del negocio y a quienes se deben, que serán alcanzadas en el 2023 con el cumplimiento de los objetivos a largo plazo. El proceso estratégico, planteado, que ayudará alcanzar la visión establecida, contempla las etapas de formulación, implementación y evaluación. Todo el proceso estratégico se caracteriza por ser interactivo e iterativo, iniciándose el modelo con el análisis de la situación actual para luego seguir con el establecimiento de la visión, misión, valores, y código de ética. Seguidamente se desarrolla la evaluación externa (PESTE) e interna (AMOFHIT ) para identificar las oportunidades, amenazas y fortalezas y debilidades respectivamente que ayudará a desarrollar una serie de matrices (MFODA); (MPEYEA); (MBCG); (MIE); (MGE) de la cual se diseñará una serie de estrategias que permitirá elaborar la matriz de decisión estratégica (MDE) y luego la matriz (MCPE). Finalmente, se revisará lo mencionado líneas arriba, con las matrices (MR) y (ME) y se evaluará si las estrategias de la mano con la visión alcanzarán los objetivos de largo plazo (OLP) utilizando para ello la matriz (MIO) y luego la (MPC), teniendo como última etapa del proceso estratégico la evaluación de los resultados en base a las perspectivas de control en el Tablero de Control Integrado (BSC) para monitorear el logro de los OCP y OLP y tomar las acciones correctivas de ser necesarioVolcan Mines Company S.A.A is a Peruvian company dedicated to the exploration, exploitation, processing of non-ferrous minerals, as well as the marketing of concentrates, becoming one of the top ten producers of silver, lead, and zinc in the world and with annual sales of approximately U.S.$ 1.200 million. For the company in question is designed strategic planning aspirations contemplating having a clear line of business and who are due to be reached in 2023 with the implementation of the long-term objectives. The strategic process, raised, which will help achieve the vision set, includes the steps of formulation, implementation and evaluation. All the strategic process is characterized as interactive and iterative, starting the model with the analysis of the current situation and then continue with the establishment of vision, mission, values, and ethics. Then the internal external evaluation (FEVER) and (AMOFHIT) is developed to identify opportunities, threats and strengths and weaknesses respectively to help develop a series of matrices (MWOTS); (MSPACE); (MBCG); (MIE); (MGE) from which a number of strategies that will prepare the decision matrix will be designed Finally, the review mentioned above, the matrices (MR) and (ME) and assess whether strategies in hand with the vision to achieve long-term objectives (PLO) using this matrix (MIO) and then the (MPC), with the last stage of the strategic process evaluation results based on the prospects for control in the Dashboard Integrated Control (BSC) to monitor the achievement of the OCP and PLO and take corrective action if necessaryTesi

Predictores de la repitencia escolar en la institución educativa Domingo Benkos Biohó zona insular de Cartagena de Indias

El objetivo de este estudio investigativo es analizar los factores asociados a la repitencia escolar de los estudiantes de la Institución Educativa Domingo Benkos Biohó de Bocachica, zona rural de Cartagena de Indias. La metodología correspondió a un enfoque cuantitativo no experimental, de tipo correlacional – explicativo. El estudio se hizo con una muestra de 1360 estudiantes matriculados en la Institución educativa Domingo Benkos Biohó, en el año 2021 distribuidos en los niveles de preescolar, primaria, secundaria y media, en tres jornadas: mañana 46%, tarde 47% y noche 7%. El procesamiento de los datos se realizó mediante la utilización del paquete estadístico SPSS de IBM versión 26.0 para Windows; para determinar los predictores de la repitencia de la institución educativa, se construyó un modelo de regresión logístico-binaria, el cual permite medir la probabilidad de ocurrencia o no de un evento según los valores de un conjunto de datos predictores. Dentro de los resultados los factores predictores de la repitencia escolar que aumentan la probabilidad de que ésta se presente se encuentran los siguientes: la extra-edad con un 56.6%, estar matriculado en la jornada académica por la tarde, cursar preescolar y los grados de secundaria: sexto, séptimo y octavo. Al culminar este estudio investigativo se concluye que, la identificación de cada uno de estos factores ofrece la posibilidad de delinear estrategias que brinden posibles soluciones a las instituciones educativas, para que su accionar se más eficiente y oportuno a la hora de abordar esta problemática que se encuentra inmersa en el proceso educativo

DISEÑO DE UN SISTEMA DE MONITOREO IN SITU DE CONTAMINACIÓN POR DERIVADOS DEL PETRÓLEO

El sistema de monitoreo in situ de derivados del petróleo busca detectar fácilmente en donde se da mal uso a los derivados del petróleo y con qué frecuencia. Al tener una zona afectada se pueden tomar medidas de prevención y mejorar no solo los beneficios propios sino la calidad de vida de los demás. El proyecto basado en espectrometría demostrara la forma en la que se desea trabajar, algunos pasos básicos y en miras a replantear un sistema de bajo costo y resultados garantizados para el beneficio de la comunidad

3D Spectroscopy of Blue Compact Galaxies. Diagnostic Diagrams

Here we present the analysis of 3D spectroscopic data of three Blue Compact Galaxies (Mrk324, Mrk370, and IIIZw102). Each of the more than 22500 spectra obtained for each galaxy has been fitted by a single gaussian from which we have inferred the velocity dispersion (sigma), the peak intensity (Ipeak), and the central wavelength (lambda_c). The analysis shows that the sigma vs Ipeak diagrams look remarkably similar to those obtained for giant extragalactic HII regions. They all present a supersonic narrow horizontal band that extends across all the range of intensities and that result from the massive nuclear star-forming regions of every galaxy. The sigma vs Ipeak diagrams present also several inclined bands of lower intensity and an even larger sigma, arising from the large galactic volumes that surround the main central emitting knots. Here we also show that the sigma vs lambda_c and lambda_c vs Ipeak diagrams, are powerful tools able to unveil the presence of high and low mass stellar clusters, and thus allow for the possibility of inferring the star formation activity of distant galaxies, even if these are not spatially resolved.Comment: 15 pages, 3 figures, accepted for publication in The Astronomical Journa

Impact of cow's milk intake on exercise performance and recovery of muscle function: a systematic review

Dairy products are thought to improve recovery after both resistance and endurance exercises due to their nutritional proprieties. We systematically reviewed the effects of dairy product intake on exercise performance and recovery of muscle function in humans. A literature search was conducted in the MEDLINE (via PubMed) and Web of Science databases from their inception to 15th April 2018. The initial search retrieved 7708 articles, and a total of 11 studies were finally included after applying inclusion and exclusion criteria. All the selected studies were conducted with cow's milk. Whereas some studies found significant positive effect of cow's milk on exercise performance and recovery of muscle function, others did not find any effect. These controversies could be due to the heterogeneity of cow's milk ingestion (e.g., amount of cow's milk, timing of consuming the cow's milk), to the type of intervention, and to the large heterogeneity of outcomes measured. Limited studies exist examining the effects of cow's milk consumption and its influence on exercise performance and recovery of muscle function, therefore further studies are needed to draw more definitive conclusions.The study was supported by the Spanish Ministry of Education (FPU 13/04365 and 15/04059), by the Redes temáticas de investigación cooperativa RETIC (Red SAMID RD16/0022), and by the University of Granada Plan Propio de Investigacion 2016 -Excellence actions: Unit of Excellence on Exercise and Health (UCEES) - and Plan Propio de Investigación 2018 - Programa Contratos-Puente, and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (ERDF: ref. SOMM17/6107/UGR), and by the Interprofessional Dairy Organization (INLAC) of Spain

Association of shivering threshold time with body composition and brown adipose tissue in young adults

Purpose: Brown adipose tissue (BAT) increases metabolic heat production in response to cold exposure. Body size and composition are involved in the human cold response, yet the influence of BAT herein have not fully been explored. Here, we aimed to study the association of the cold-induced shivering threshold time with body composition, BAT, the perception of shivering and skin temperature in young adults. Methods: 110 young healthy adults (81 females; age = 21.7 ± 2.1 years, BMI = 24.2 ± 4.3 kg/m2) underwent 2 h of individualized cooling, followed by the quantification of BAT using a18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography-computed tomography (PET-CT) scan. Body mass index (BMI), lean mass, fat mass and body surface area (BSA) were also measured. Shivering threshold time was defined as the time until shivering occurred using an individualized cooling protocol. Results: The shivering threshold time was on average 116.1 min for males and 125.8 min for females, and was positively associated to BMI (β = 3.106; R2 = 0.141; p = 0.001), lean mass (β = 2.295; R2 = 0.128; p = 0.001) and fat mass (β = 1.492; R2 = 0.121; p = 0.001) in females, but not in males (all p ≥ 0.409). The shivering threshold time was positively associated with BSA in males (p = 0.047) and females (p = 0.001), but it was not associated with BAT volume or [18F]FDG uptake nor with the perception of shivering and skin temperature perception in both sexes. Conclusion: The shivering threshold time is positively associated with whole-body adiposity and lean mass in females, but not in males. The shivering threshold time was positively associated with BSA, but no association was observed with BAT nor with the perception of shivering or skin temperature. Future research should consider the influence of body composition when applying cooling protocols among individuals with different phenotypical features.Spanish Government PI13/01393 PTA 12264-IRetos de la Sociedad DEP 2016-79512-REuropean CommissionSpanish Government FPU 13/03410Fundacion Iberoamericana de Nutricion (FINUT)Redes Tematicas de Investigacion Cooperativa RETIC Red SAMID RD16/0022AstraZenecaUniversity of Granada Plan Propio de Investigacion 2016 - Excellence actions: Unit of Excellence on Exercise and Health (UCEES)Plan Propio de Investigacion 2018: Programa ContratosPuenteJunta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades (ERDF) SOMM17/6107/UGRFundacion Carolina C.2016-574,961Fundacion Alfonso Martin EscuderoMinisterio de Universidades y la Union Europea-NextGenerationEU RR_C_2021_0

New energy sources: Blue energy study in Central America

The following article has been submitted to/accepted by Journal of Renewable and Sustainable Energy. After it is published, it will be found at http://dx.doi.org/10.1063/1.4976326.Blue energy or salinity difference energy takes advantage of the free energy released in the mixture of two solutions with different salinity concentrations as it happens continuously in river mouths. Among the large number of available techniques that aim to harness blue energy, capmix (or capacitive mixing) methods allow to directly extract electrical energy without the need of any electromechanical converter such as turbines or heat engines. The main goal of this article is to analyze the potential of blue energy by capmix methods in Central America. So far, blue energy studies have been principally carried out in countries from the global North. Therefore, we describe experimental results with real sea and river waters from the Gulf of Fonseca, an area of special interest due to its hydrographic richness, which is situated among Honduras, El Salvador and Nicaragua. An electrochemical cell, which consists of a pair of activated carbon electrodes coated with cationic and anionic polyelectrolyte layers respectively, is used in the experiments. The cell voltage in open circuit (OCV) is used as a measure of the performance of the capmix process. It is found that the OCV is larger when natural river water is used instead of low salinity NaCl solutions. The rainy season in which the experiments were performed reduced the ionic content of the river, increasing the salinity difference with ocean waters. The feasibility of capmix as a means of clean energy production is discussed.Eureka SD Project (agreement number 2013-2591), Erasmus Mundus programme of the European Union.Ministerio de Economía y Competitividad of Spain (Project FIS2013-47666-C3- 1-R)Junta de Andalucía (Spain) project PE-2012- FQM0694EU FEDER FUND

Seed production and recruitment in primary and harvested <i>Nothofagus pumilio</i> forests: Influence of regional climate and years after cuttings

Aim of study: Harvesting proposals (e.g. variable retention) for Nothofagus pumilio forests are based on canopy opening, to increase recruitment and enhance seedling growth, by modifying light and soil moisture. Seed production and seedling recruitment will define the success of harvesting, where remnant forest structure are the main influence factors, as well as biotic and abiotic factors. The objective was to analyse seed production, seedling recruitment and recruitment efficiency in primary and harvested forests through variable retention along the first 10 years after harvesting, as well as the influence of regional climate. Area of study: The study were conducted in a pure Nothofagus pumilio forest located in central Tierra del Fuego (54°18’ S, 67°49’ W), where harvested stands with variable retention and unmanaged forests were sampled in long-term permanent plots. Material and methods: Data of forest regeneration plots were used (n = 72) (2007 a 2014), and forest structure and seed production (2006 a 2013) were also measured. Regional climate was characterised for these years from satellite images (Sea Surface Temperature) and climate re-analysis models (rainfall and temperature of land surface). Main results: Harvesting modified forest structure; however, aggregated retention maintained some characteristics of the primary unmanaged forests. These changes influenced seed production and recruitment. Seed production and recruitment were related to crown cover and the amount of seed production; however, recruitment efficiency was not affected by harvesting. The studied variables significantly changed along the years after harvesting. Seed production and recruitment were also related to regional climate factors, where it was possible to explain their variations through temperature (e.g. summer temperature) and rainfall (e.g. winter rainfall) for the different retention types in harvested forests and the primary forests. Research highlights: Variable retention harvesting generated different micro-conditions that influence seed production and recruitment. These variables were related to canopy cover. However, recruitment efficiency was not affected by harvesting. Seed production and recruitment (primary forests and harvested stands) were related to regional climate factors and their variations can be explained from variables related to temperature and rainfall.Facultad de Ciencias Agrarias y ForestalesLaboratorio de Investigación de Sistemas Ecológicos y Ambientale

Seed production and recruitment in primary and harvested <i>Nothofagus pumilio</i> forests: Influence of regional climate and years after cuttings

Aim of study: Harvesting proposals (e.g. variable retention) for Nothofagus pumilio forests are based on canopy opening, to increase recruitment and enhance seedling growth, by modifying light and soil moisture. Seed production and seedling recruitment will define the success of harvesting, where remnant forest structure are the main influence factors, as well as biotic and abiotic factors. The objective was to analyse seed production, seedling recruitment and recruitment efficiency in primary and harvested forests through variable retention along the first 10 years after harvesting, as well as the influence of regional climate. Area of study: The study were conducted in a pure Nothofagus pumilio forest located in central Tierra del Fuego (54°18’ S, 67°49’ W), where harvested stands with variable retention and unmanaged forests were sampled in long-term permanent plots. Material and methods: Data of forest regeneration plots were used (n = 72) (2007 a 2014), and forest structure and seed production (2006 a 2013) were also measured. Regional climate was characterised for these years from satellite images (Sea Surface Temperature) and climate re-analysis models (rainfall and temperature of land surface). Main results: Harvesting modified forest structure; however, aggregated retention maintained some characteristics of the primary unmanaged forests. These changes influenced seed production and recruitment. Seed production and recruitment were related to crown cover and the amount of seed production; however, recruitment efficiency was not affected by harvesting. The studied variables significantly changed along the years after harvesting. Seed production and recruitment were also related to regional climate factors, where it was possible to explain their variations through temperature (e.g. summer temperature) and rainfall (e.g. winter rainfall) for the different retention types in harvested forests and the primary forests. Research highlights: Variable retention harvesting generated different micro-conditions that influence seed production and recruitment. These variables were related to canopy cover. However, recruitment efficiency was not affected by harvesting. Seed production and recruitment (primary forests and harvested stands) were related to regional climate factors and their variations can be explained from variables related to temperature and rainfall.Facultad de Ciencias Agrarias y ForestalesLaboratorio de Investigación de Sistemas Ecológicos y Ambientale