Fístula colovesical secundaria a enfermedad diverticular: cirugía laparoscópica electiva

Indexación: Web of Science; ScieloAim: Colovesical fistula is a severe complication associated to neoplastic or inflammatory colon disease. Most common procedure is open surgery. We report a case of colovesical fistula secondary to diverticular disease treated with a laparoscopic approach. Methods: A 64-year-old man was seen with a known colonic diverticular disease, type 2 diabetes mellitus and recurrent urinary tract infection. He complained of lower abdominal pain, dysuria, and pneumaturia. A CT scan revealed a sigmoid diverticular perforation into the bladder (colovesical fistula). A left hemicolectomy with partial cystectomy was performed by laparoscopy means. Results: There was no morbidity related to the surgical procedure, and the final pathology confirmed a colonic diverticular disease with bladder compromise. The patient is asymptomatic at 24 months of follow up. Conclusion: The laparoscopic approach is a feasible alternative for the treatment of colovesical fistula with low morbidity.Objetivos: La fístula colovesical es una complicación relacionada con procesos inflamatorios y neoplá-sicos del colon. El manejo tradicional de esta patología es quirúrgico bajo técnica abierta. Presentamos un caso de fístula colovesical secundaria a enfermedad diverticular con tratamiento quirúrgico laparoscópico. Materiales y Métodos: Paciente masculino de 64 años de edad, portador de enfermedad diverticular de larga data con antecedente de diabetes mellitus tipo 2 e infecciones urinarias a repetición, quien consulta por presentar dolor en hipogastrio, disuria y neumaturia. Se realiza tomografía computada que revela perforación diverticular de colon sigmoides a vejiga (fístula colovesical). Se realizó hemicolectomía izquierda más cistectomía parcial, con resección del trayecto fistuloso, y cierre vesical y anastomosis colónica laparoscópica. Resultados: No hubo complicaciones intra ni postoperatorias. El estudio anatomopatológico de la pieza operatoria demostró enfermedad diverticular. El paciente se encuentra asintomático a los 24 meses de seguimiento. Conclusión: El abordaje laparoscópico es una alternativa factible para el tratamiento de fístula colovesical, con baja morbilidad.http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-40262012000300010&nrm=is

Characteristics of patients diagnosed with acute pancreatitis treated between january 2008 and december 2011 at a fourth level medical center

Introducción: la pancreatitis aguda (PA) es causa frecuente de consulta y se asocia con una importante morbimortalidad. En Colombia hay poca información publicada sobre las características clínicas de la PA. Consideramos importante hacer una revisión para establecer las características demográficas, clínicas, manejo recibido y desenlaces de los pacientes con PA en un centro hospitalario de cuarto nivel. Métodos: estudio descriptivo de tipo corte transversal. Se revisaron las historias de los pacientes adultos con PA hospitalizados entre enero de 2008 y diciembre de 2011. Resultados: se incluyeron 222 pacientes, 60% mujeres, con edad promedio de 52 años. Los síntomas más frecuentes fueron dolor abdominal (99%), vómitos (65%) e ictericia (13%). El 99% presentaba un cuadro clínico compatible. La alteración enzimática se encontró en el 96% de los casos y solo en el 7% se necesitó el criterio imagenológico para confirmar el diagnóstico. La etiología biliar fue la más frecuente en el 67% de los casos y solo en el 6% se estableció etiología alcohólica. Un 63% de los pacientes fueron clasificados como PA severa. El 32% requirió manejo en cuidados intensivos; en el 10% de los casos fue necesario soporte vasopresor y la mortalidad global fue del 4%. Conclusión: las características clínicas, demográficas y la etiología son similares a las descritas en otras series de centros de similar complejidad. No obstante, tenemos un porcentaje alto de pacientes con PA severa que podría obedecer a la relativamente baja especificidad de las escalas usadas. A pesar de este porcentaje elevado de severidad, la mortalidad global no fue alta. Dado que la severidad orienta algunas intervenciones terapéuticas, podría ser útil definir criterios de clasificación que sean más útiles en nuestra población.Artículo original171-176Introduction: Acute pancreatitis (AP) is a frequent reason for patients to consult with physicians and is a condition that is often associated with significant morbidity and mortality. Since little information has been published on the clinical characteristics of AP in Colombia, we consider it important to establish the demographic and clinical characteristics of patients as well as the types of treatment received and the outcomes of patients with AP at a fourth level hospital. Methods: This is a cross-sectional study based on a review of the medical histories of adult patients with AP who were hospitalized between January 2008 and December 2011. Results: The study included 222 patients 60% of whom were women. Their mean age was 52 years. The most frequent symptoms were abdominal pain (99%), vomiting (65%) and jaundice (13%). The clinical characteristics of 99% of these patients were compatible with AP. Enzymatic alterations were found in 96% of the cases and imaging criteria were needed to confirm the diagnosis in only 7% of the cases. Biliary etiology was the most common (67% of cases), and only 6% had alcoholic etiology. Severe AP was diagnosed in 63% of the patients. 32% required intensive care, 10% of patients required vasopressor support, and overall mortality was 4%. Conclusion: The clinical, demographic and etiological characteristics of these patients were similar to those described in other series from medical centers of similar complexity. Nevertheless, the percentage of patients with severe AP was high which may have been due to the relatively low specificity of the staging used. Despite this high percentage severe cases, overall mortality was not high. Since severe cases require specific therapeutic interventions, it might be useful to define classification criteria that are more useful in our population

Tailoring the magnetocaloric, magnetic and thermal properties of Dy6(Fe,Mn)X2 intermetallics (X==Sb, Te, Bi)

[EN] The structural, magnetic, magnetocaloric (MCE) and thermal properties of seven Fe2P-type Dy6(Fe,Mn)X2 (X=Sb, Bi, Te) intermetallics (space group P 6 over line 2 m, N 189, hP9) have been experimentally studied. They present a paramagnetic to ferromagnetic transition (in the range 129-370 K), followed, as temperature decreases, by a spin-reorientation one (from 52 to 170 K) and a ground magnetic state at 2 K with anti-ferromagnetic components. This state turns into a ferromagnetic state when a magnetic field is applied. The critical exponents beta,gamma,delta related to the PM-FM transition point to long range order interactions but in most compounds their values severely deviate from the Mean Field class, presenting an unconventional critical behavior, probably due to magnetocrystalline anisotropies. This magnetic complexity has the consequence that in every intermetallic three MCE effects arise: Two direct magnetocaloric effects (DMCE) with a table-like effect in between (from 40 K to more than 400 K), with moderate values of the magnetic entropy maxima (up to 6.9 J/kgK for 140 Delta H = 5 T, with the tableau in-between being around 4 J/kgK, for Dy6FeSb2 and Dy6FeSbTe). The calculation of the Thermal Average Entropy Change allows to place the properties of two compounds (Dy6FeSb2 and Dy6FeSbTe) close to other rare earth based high entropy alloys described in literature. The seven compounds present a relevant third MCE, inverse, below 25 K, with a value as high as 17.8 J/kgK (140 Delta H = 5 T) for Dy6FeSbTe. The maximum of the magnetic entropy change at the Curie tem-perature has been shown to scale with the critical exponents found and universal curves have been built. Finally, the thermal diffusivities in the range of the DMCE have been measured, with the result that they present good values (between 1 and 3 mm2/s) to be used in real magnetocaloric refrigeration systems.This work has been supported by Universidad del Pais Vasco UPV/EHU (project GIU19/058) and the Russian Fund for Basic Research (project No 20-03-00209-a). A. Herrero thanks the Department of Education of the Basque Government as grantee of the programme "Programa Predoctoral de Formacion de Personal Investigador No Doctor". The authors thank for technical and human support provided by SGIker of UPV/EHU, specially the fruitful discussions with Dr. I. Orue

Innovación educativa en las maestrías: Facultad de Medicina de la Universidad de El Salvador, año 2022

The master’s degree in Community Clinical Psychology (MPCC) at the Faculty of Medicine of the University of El Salvador (FM-UES), was held from February 2019 to December 2020 and was one of the university training strategies of the Agua Futura project , «Training and research activity completed on the monitoring and modeling of the quality and quantity of water resources and on psychosocial and pedagogical aspects, associated in the areas of El Salvador and Guatemala» whose objectives were: • Improving the quality of sustainable management of water resources and related social conflicts in El Salvador and Guatemala. • Contribute to improving the theoretical and practical knowledge of the resources, the comprehensive sustainable management of water and the community, and the detection of obstacles and psychosocial resources (Consiglio Nazionale delle Ricerche – Istituto di Geoscienze e Georisorse, 2017). • Contribute product of the investigations, in the improvement of the pedagogical activities, to contribute that they have a high level of scientificity. • Transdisciplinarity, its cooperation and integration in the training of professionals, the continuous training of community leaders in the component of social projection. • The quality of the twelve works presented with a high scientific level and the publication of two articles. The project was developed in the municipality of Colima, in the department of San Salvador, with the objective of integrating the elements of educational innovation for the improvement of master’s programs; achieving a graduate who meets the expectations of the Salvadoran people, for the solution of the most pressing problems of the communities, where the focus of the three components that those who participate in such hard work must have is vital.La maestría en Psicología Clínica de la Comunidad (MPCC) en la Facultad de Medicina de la Universidad de El Salvador (FM-UES), ejecutó un primer cohorte de febrero 2019 a diciembre de 2020 y constituyó una de las estrategias de formación universitaria del proyecto «Agua Futura», «Actividad de formación e investigación dirigida al monitoreo y al modelado de la calidad y cantidad de los recursos hídricos y los aspectos psicosociales y pedagógicos asociados en zonas de El Salvador y Guatemala» cuyos objetivos fueron: • La mejora de la calidad de la gestión sostenible de los recursos hídricos y los conflictos sociales relacionados en El Salvador y Guatemala. • Contribuir a mejorar el conocimiento teórico y práctico de los recursos, la gestión integral sostenible del agua y de la comunidad y la detección de obstáculos y recursos psicosociales (Consiglio Nazionale delle Ricerche – Istituto di Geoscienze e Georisorse, 2017). • Aportar producto de las investigaciones, en la mejora de las actividades pedagógicas, para contribuir a que las mismas tengan un alto nivel de cientificidad. • Fomentar la transdisciplinariedad, cooperación e integración en la formación de profesionales, la formación continua de los líderes comunitarios en el ámbito de la proyección social. Con ello se alcanzaron mejoras en la calidad de los doce trabajos presentados con un alto nivel científico y la publicación de dos artículos por parte de los docentes. El proyecto se desarrolló en el municipio Colima, del departamento de San Salvador, con el objetivo de integrar los elementos de la innovación educativa para el mejoramiento de los programas de maestrías; logrando un egresado que cumpla con las expectativas del pueblo salvadoreño, para la solución de los problemas más apremiantes de las comunidades. Palabras clave: innovación educativa, transdisciplinariedad, sinergia institucional, componente laboral, componente científico, componente investigativ

Selecting optimal R6TX2 intermetallics (R = Gd, Tb, Dy; T = Mn, Fe, Co, Ni; X = Sb, Te) for magnetic refrigeration

A complete experimental study of the physical properties playing a relevant role on magnetic refrigeration application (structural, magnetic, magnetocaloric and thermal) has been performed over nine selected Fe2P-type R6TX2 (R= Gd, Tb, Dy; T= Mn, Fe, Co, Ni; X=Sb, Te) intermetallic compounds, to work close to room temperature. Two magnetic phase transitions are present on these materials: a paramagnetic to ferromagnetic transition in the range 182-282 K and a spin reorientation transition in the range 26-76 K. As a consequence, two peaks related to a direct magnetocaloric effect (DMCE) appear in the magnetic entropy change, generating a wide table-like plateau region in between both peaks, which is required to improve the efficiency of refrigerators following an Ericsson cycle. The highest magnetic entropy peak value for μ0ΔH = 5 T is found for Tb2Dy4FeSb2, with 7.72 J/kg K around 182 K. For the same applied field the other compounds show moderate values around room temperature (2.88-4.53 J/Kg K). However, the superposition of the two peaks results in huge refrigerant capacity values, up to RCFWHM(5 T)=1103.04 J/kg in the case of Tb2Dy4FeSb2. The thermal diffusivity, effusivity conductivity and specific heat have been measured at room temperature, and the temperature dependence of the former has been obtained around the relevant magnetic phase transition region, with values in the range 1.3-2.3 mm2/s, which are good for magnetic refrigerators under high working frequencies. The study is completed with a rigorous critical behavior analisis of the second order PM-FM transition. The critical exponent γ points to long range order interactions, in general, while β values are in the range (0.59-0.90), indicating a deviation from theoretical models as a reflection of the magnetic complexity in these compounds. The critical exponents have been used to confirm the scaling relations of magnetocaloric properties, and the scaling of refrigerant capacity (RC) values in materials presenting two magnetic phase transitions is addressed, concluding that for a correct scaling of RC the magnetic entropy change peak must be considered symmetric. The role of each atom on the properties of the compounds is discussed.This work was supported by Departamento de Educación del Gobierno Vasco (project IT1430-22) and the Russian Fund for Basic Research through the project no. 20-03-00209-a, as well as by an ICDD (International Centre for Diffraction Data) (USA) grant n 05-07

High-Gradient Test of a Tungsten-Iris X-Band Accelerator Structure at NLCTA

The CLIC study group at CERN has built two X-band accelerating structures to be tested at SLAC in NLCTA. The structures consist of copper cells with insert irises made out of molybdenum and tungsten, clamped together and installed in a vacuum tank. These structures are exactly scaled versions from structures tested previously at 30 GHz and with short pulses (16 ns) in the CLIC Test Facility at CERN. At 30 GHz these structures reached gradients of 150 MV/m for tungsten and 195 MV/m for molybdenum. These experiments were designed to provide data on the dependence of rf breakdown on pulse length and frequency. This paper reports in particular on the high-gradient test of the tungsten-iris structure. At the shortest possible pulse length of 22 ns a gradient of 125 MV/m was reached at X-band, 20 % lower than the 150 MV/m measured at 30 GHz in the CLIC Test Facility. The pulse length dependence and the dependence of the break down rate as a function of gradient were measured in detail. The results are compared to data obtained from the molybdenum-iris experiment at X-band which took place earlier as well as to 30 GHz data

Manual Moodle 3.1 para el profesor

El presente manual es el fruto del trabajo y la experiencia de los técnicos del Gabinete de Tele-Educación de la Universidad Politécnica de Madrid que desde el año 2005 vienen gestionando y prestando soporte a la herramienta Moodle para toda nuestra comunidad universitaria. Se trata de una actualización del manual realizado en 2012 para la versión 2.2. Anteriormente, este equipo realizó un manual para el profesor adaptado hasta la versión 1.9. Ese manual tenía como partida el libro “Using Moodle” y se completó con la documentación existente en su momento y las aportaciones del personal de nuestro equipo. Para tener una visión general de la información de este manual, siga leyendo la descripción que se presenta a continuación

2-DE proteomics analysis of drought treated seedlings of Quercus ilex supports a root active strategy for metabolic adaptation in response to water shortage

Holm oak is a dominant tree in the western Mediterranean region. Despite being well adapted to dry hot climate, drought is the main cause of mortality post-transplanting in reforestation programs. An active response to drought is critical for tree establishment and survival. Applying a gel-based proteomic approach, dynamic changes in root proteins of drought treated Quercus ilex subsp. Ballota [Desf.] Samp. seedlings were followed. Water stress was applied on 20 day-old holm oak plantlets by water limitation for a period of 10 and 20 days, each followed by 10 days of recovery. Stress was monitored by changes in water status, plant growth, and electrolyte leakage. Contrary to leaves, holm oak roots responded readily to water shortage at physiological level by growth inhibition, changes in water status and membrane stability. Root proteins were extracted using trichloroacetate/acetone/phenol protocol and separated by two-dimensional electrophoresis. Coomassie colloidal stained gel images were analyzed and spot intensity data subjected to multivariate statistical analysis. Selected consistent spots in three biological replicas, presenting significant changes under stress, were subjected to MALDI-TOF mass spectrometry (peptide mass fingerprinting and MS/MS). For protein identification, combined search was performed with MASCOT search engine over NCBInr Viridiplantae and Uniprot databases. Data are available via ProteomeXchange with identifier PXD002484. Identified proteins were classified into functional groups: metabolism, protein biosynthesis and proteolysis, defense against biotic stress, cellular protection against abiotic stress, intracellular transport. Several enzymes of the carbohydrate metabolism decreased in abundance in roots under drought stress while some related to ATP synthesis and secondary metabolism increased. Results point at active metabolic adjustment and mobilization of the defense system in roots to actively counteract drought stress