Downbeat Nystagmus Induced by Sedation in Lasik

Nystagmus was elicited during lasik under sedation in two patients that were treated for depression. Nystagmus was not present before or after surgery. Nystagmus can be pharmacologically induced and can be a hazard to refractive surgery

Hemobilia. A case report

We present the case of a 88 years old male, with a history of melena, demonstrated by repeated endoscopys to be secondary to hemobilia, and after endoscopic retrograde cholangiopancreatography we could demonstrate the presence of bleeding intraductal choledocus polyps with histopathological report of intraepitelial adenoma. Hemobilia is a rare cause of upper gastrointestinal hemorrhage with an increasing incidence because of the widespread use of invasive hepatobiliary procedures and improved recognition. In the majority of cases the cause is iatrogenic. The classical presentation of hemobilia is with biliary colic, jaundice, hematemesis, and melena. The diagnosis and evaluation of hemobilia is facilitated by the use of sonography, computed tomography and endoscopic retrograde cholangiopancreatography. Persistent bleeding sometimes requires urgent therapeutic intervention, such as angiography or surgery

Causales de la rotación de personal en el cargo de cajero caso Jumbo Bogotá - Hayuelos

Práctica EmpresarialEl presente trabajo pretende determinar las causas de rotación de personal del cargo cajeros en Jumbo Bogotá, para formular estrategias que permitan la minimización del índice de rotación de personal en la sección entendiendo el nivel de confiabilidad y responsabilidad que exige la misma dado que es la encargada de manejar el dinero de la compañía.Práctica Empresarial1. RESUMEN 2. MARCO REFERENCIAL 3. DESCRIPCIÓN DE LA ENTIDAD 4. OBJETO DE LA PRÁCTICA 5. FUNCIONES DESEMPEÑADAS POR LAS PRACTICANTES DE GERENCIA NACIONAL DE CAJAS 6. METODOLOGÍA EMPLEADA 7. RESULTADOS DE LA INVESTIGACIÓN 8. CONCLUSIONES 9. RECOMENDACIONES 10. REFERENCIAS 11. APÉNDICESPregradoEconomist

Correlación entre la resistencia a la insulina y T3 en adolescentes con factores de riesgo para el desarrollo de diabetes

Objetivo. Establecer la correlación entre las concentraciones séricas de triyodotironina y la resistencia a la insulina a través del índice HOMA en un grupo de hombres adolescentes con factores de riesgo para el desarrollo de diabetes. Materiales y métodos: estudio descriptivo de corte transversal. Participaron adolescentes con algún factor de riesgo para diabetes. Se determinó la presencia de síndrome metabólico empleando los criterios de ATPIII modificada por Cook. Se determinaron T3, T4, TSH e insulina basal. Se calculó el índice HOMA para resistencia a la insulina. Resultados. Se estudiaron 36 hombres con una edad promedio de 15.97±0.9 años. En la población total existió correlación positiva entre T3 y HOMA-IR (r=0.380 p=0.022), cuando se analizó en el grupo de SM la correlación se incrementó entre T3 y HOMA-IR (r=0.647 p=0.031). Determinando que existe correlación positiva entre los índices de resistencia a la insulina y las concentraciones de hormona tiroidea

Oculocardiac Reflex During Intravitreal Injection

Oculocardiac reflex (OCR) has been described to occur with mechanical manipulation of the eye, eyelids or orbit. There are no reports in the literature of OCR during intravitreal injection (IVI). This may be due to the fact that heart rate is not monitored during the procedure. We aimed to evaluate OCR during IVI. A total of 532 patients were enrolled in the study in Asociacion para Evitar la Ceguera en Mexico. Mexico City, Mexico. IVI was performed on one eye in every patient with diabetic retinopathy (DR), age related macular degeneration (AMD) or choroidal neovascularization (CNV) secondary to pathological myopia. Heart rate was monitored with a pulse oximeter before, during and after injection. OCR was defined as a 20% decrease or more of basal heart rate. The population enrolled included 270 females and 262 males with mean age of 63.8 years. A decrease in heart rate of 20% or more occurred in 18 patients during IVI (3.3%; 95% confidence interval 1.85% and 4.92%). OCR was asymptomatic in these patients. OCR occurred in 3.3% of our patients during IVI. Hence, OCR must be considered when performing IVI

Genotyping of Human Papillomavirus in cervical Squamous Intraepitelial Lesions in Méxica Women

Approximately 40 genotypes of the human papillomavirus (HPV) have been identified in cervical mucosa. In particular, HPV-16 and HPV-18 have been associated with cervical neoplasia. Squamous intraepithelial lesions (SILs) are precursors of cervical cancer. This study aimed to identify the HPV by genotype in SILs using a line ar array genotyping test in a population in the State of México. We performed a cross-sectional study of 129 patients (women of the State of México) who completed a risk factor questionnaire and were diagnosed as being with or without SIL by colposcopy. We obtained cervical swab samples from these patients and genotyped them using a Linear Array HPV Genotyping assay from ROCHE®. Forty-nine (37.98%) samples were positive for the HPV, and 24 genotypes were found among these samples. The most common genotype was HPV-16. The 12 genotypes found in both high- and low-grade SILs were HPV-6, 16, 31, 39, 51, 52, 53, 58, 59, 61, 67, and 84, 7 of which were high risk: HPV-16, 31, 39, 51, 52, 58, and 59. In the population studied, the most frequent genotype was HPV-16, multiple infections were found, and four patients without injury tested positive for the HPV

Thyroid function is associated with insulin resistance markers in healthy adolescents with risk factors to develop diabetes

Introduction: The prevalence of obesity and Type 2 diabetes mellitus (T2DM) among children and adolescents is rising. Thyroid function has been associated with insulin resistance. There is scarce information about how thyroid function could be related with cardiovascular risk or glucose homeostasis in adolescent. Aim: To analyze how thyroid function is associated with insulin resistance and another cardiovascular risk factors in healthy adolescents with risk factors to develop diabetes. Methods: A prospective cross-sectional analysis was carried out on euthyroid, adolescents. considered at high risk to develop Type 2 diabetes. Fasting blood samples were obtained. Thyroid function test and another cardiometabolic parameters were assessed. A 75 grams oral glucose tolerance test was performed to calculate insulin resistance. Results: One hundred adolescents were evaluated. The mean age was 15.9 ± 0.8 years, There is a negative correlation between Fasting insulin, post glucose load insulin and HOMA IR. There were no correlation with Matsuda index. We could not found any correlation with TSH values. Conclusions: We found a correlation between fasting insulin, HOMA IR and serum thyroid hormones, we did not find any relation with serum TSH. In euthyroid adolescents with risk factors to develop diabetes

Surface textures of detrital pyroxenes in coastal dune sands (western Gulf of Mexico, Mexico): implications for their preservation and geoenvironmental processes

This work investigates how the surface textures and morphology of pyroxene grains evolve during their source‐to‐sink history. This study applies to detrital clinopyroxenes concentrated in coastal dune sands of the Gulf of Mexico which were sourced in the Trans Mexican Volcanic Belt then transported and deposited in environments subject to limited chemical weathering. The composition and morphology of the pyroxenes was characterised using single‐grain geochemical analysis and surface texture imagery with a novel approach based on the compactness property to assess the shape of minerals. This reveals heterogenous diopside‐augite populations, displaying mineral morphologies dominantly controlled by impact breakage along cleavages, little physical abrasion along their edges and with limited evidence for chemical weathering. Mechanical surface textures dominate over mechanical/chemical and chemical surface textures. These mechanical surface textures are preserved primarily as flat cleavage surfaces and rounded edges inherited from fluvial‐intertidal and aeolian transport, respectively. Mechanically/chemically induced surface textures are preserved as elongated depressions. Chemical surface textures are sparse and mostly represented by mammillated textures that suggest local dissolution under subaqueous conditions. The scarcity of chemical surface textures is attributed to frequent fragmentation of the clinopyroxenes along cleavages and limited chemical weathering during transport of the observed populations. Clinopyroxene grains in the coastal dune sands primarily retain surface characteristics from fluvial transport. Although the breakage of minerals along cleavages can obscure their original morphology under a weathering‐limited erosion regime, this study shows how surface textures and morphology of pyroxene grains is used to determine episodes of transport and deposition close to volcanic environments. The use of the compactness property as a shape descriptor measurement of particles provides an alternative approach to observe how clinopyroxene remains unaltered despite the high energy conditions of the coastal area

Expresión de interferón gamma en la infección por el virus del papiloma humano y por Chlamydia trachomatis en muestras cervicales.

infecciónpor VPH y por Chlamydia trachomatis en pacientes con lesión intraepitelial escamosa.Método: Se incluyeron 100 muestras de pacientes diagnosticadas por colposcopía, con y sin lesiónintraepitelial escamosa, en quienes se efectuó el diagnóstico de infección por VPH y/o C. trachomatis. Se cuantificó la expresión relativa de interferón gamma con la prueba de transcriptasa reversa-PCR entiempo real (RT-PCR).Resultados: Las unidades relativas de la expresión de interferón gamma fueron de 13, 1,8 y 0,3 en lacoinfección por VPH y C. trachomatis, en la infección por VPH y en la infección por C. trachomatis, respec-tivamente.Conclusión: La infección por VPH y por C. trachomatis puede constituir un factor estimulante de la expre-sión de interferón gamma.Este trabajo fue financiado por la Secretaría de Investigación y Estudios Avanzados Universidad Autónoma del Estado de México (número de proyecto 3097)

Implementación del sistema de control de calidad en la Industria de Cementos Guapán

Indica las políticas y objetivos de la Empresa, así como la teoría del control de calidad, inspección y su importancia, describe las etapas del proceso, realiza una evaluación inicial del sistema de control de calidad, introducción, fundamento, norma INEN. Describe las características en caliza, arcilla, yeso, papel, combustible y estas a su vez son materias primas. Realiza también una evaluación final del sistema de control de calidad de la Empresa e indica el plan de implementaciónIngeniero QuímicoCuenc