Editorial: Management and Treatment of Pilonidal Disease: 189 Years After Mayo

...Pilonidal Disease (PD) was first scientifically reported 189 years ago by Herbert Mayo, back in 1833, as a sinus containing hair follicles located in the sacrococcygeal region of a female patien

Knowledge, attitude and behaviours towards recommended vaccinations among healthcare workers

Healthcare workers (HCWs) are an important group of professionals exposed to biological risk during their work activities. So, the aim of this study is to perform a survey on the knowledge, attitude and behaviour of Italian HCWs towards the vaccinations recommended by the Ministry of Health. A cross-sectional study was carried out during the period September 2014-August 2015 in the Lazio region. The study was conducted by recruiting HCWs and biomedical students. The sample was comprised of 571 responders, of whom 12.4% were physicians, 18.9% were nurses, 34.3% were other HCW, and 34.3% were biomedical students (medical and nurses students). Hepatitis B virus (HBV) is perceived as a risk for personal health by 457 (80%) participants; TB is also worrying (434; 76%). Moreover, HBV (70.9%) and tuberculosis (TB) (79.2%) are perceived as a risk for health, while influenza is not considered so by most participants (46.2%). There is an underestimation of the role of influenza, perceived as a risk for 137 respondents (24%). The vaccination rate among these HCWs is highest for Hepatitis B virus (HBV) (82%), and lowest for influenza (28.5%) and varicella (40.3%). The vast majority of responders are in favour of HBV (77.8%) and TB (64.8%) vaccines. For other vaccinations there is less interest (between 33% and 40% for measles, mumps, rubella, pertussis and influenza). This study shows that knowledge of recommended occupational vaccinations is insufficient in HCWs, with few exceptions represented by HBV and TB. There is a need for novel approaches in this field, with the aim of enhancing vaccine coverage among HCW

Operative and nonoperative management for renal trauma. Comparison of outcomes. A systematic review and meta-analysis

INTRODUCTION: Preservation of kidney and renal function is the goal of nonoperative management (NOM) of renal trauma (RT). The advantages of NOM for minor blunt RT have already been clearly described, but its value for major blunt and penetrating RT is still under debate. We present a systematic review and meta-analysis on NOM for RT, which was compared with the operative management (OM) with respect to mortality, morbidity, and length of hospital stay (LOS). METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed for this study. A systematic search was performed on Embase, Medline, Cochrane, and PubMed for studies published up to December 2015, without language restrictions, which compared NOM versus OM for renal injuries. RESULTS: Twenty nonrandomized retrospective cohort studies comprising 13,824 patients with blunt (2,998) or penetrating (10,826) RT were identified. When all RT were considered (American Association for the Surgery of Trauma grades 1-5), NOM was associated with lower mortality and morbidity rates compared to OM (8.3% vs 17.1%, odds ratio [OR] 0.471; 95% confidence interval [CI] 0.404-0.548; P<0.001 and 2% vs 53.3%, OR 0.0484; 95% CI 0.0279-0.0839, P<0.001). Likewise, NOM represented the gold standard treatment resulting in a lower mortality rate compared to OM even when only high-grade RT was considered (9.1% vs 17.9%, OR 0.332; 95% CI 0.155-0.708; P=0.004), be they blunt (4.1% vs 8.1%, OR 0.275; 95% CI 0.0957-0.788; P=0.016) or penetrating (9.1% vs 18.1%, OR 0.468; 95% CI 0.398-0.0552; P<0.001). CONCLUSION: Our meta-analysis demonstrated that NOM for RT is the treatment of choice not only for AAST grades 1 and 2, but also for higher grade blunt and penetrating RT

Hollow viscus injuries. Predictors of outcome and role of diagnostic delay

INTRODUCTION: Hollow viscus injuries (HVIs) are uncommon but potentially catastrophic conditions with high mortality and morbidity rates. The aim of this study was to analyze our 16-year experience with patients undergoing surgery for blunt or penetrating bowel trauma to identify prognostic factors with particular attention to the influence of diagnostic delay on outcome. METHODS: From our multicenter trauma registry, we selected 169 consecutive patients with an HVI, enrolled from 2000 to 2016. Preoperative, intraoperative, and postoperative data were analyzed to assess determinants of mortality, morbidity, and length of stay by univariate and multivariate analysis models. RESULTS: Overall mortality and morbidity rates were 15.9% and 36.1%, respectively. The mean length of hospital stay was 23±7 days. Morbidity was independently related to an increase of white blood cells (P=0.01), and to delay of treatment >6 hours (P=0.033), while Injury Severity Score (ISS) (P=0.01), presence of shock (P=0.01), and a low diastolic arterial pressure registered at emergency room admission (P=0.02) significantly affected postoperative mortality. CONCLUSION: There is evidence that patients with clinical signs of shock, low diastolic pressure at admission, and high ISS are at increased risk of postoperative mortality. Leukocytosis and delayed treatment (>6 hours) were independent predictors of postoperative morbidity. More effort should be made to increase the preoperative detection rate of HVI and reduce the delay of treatment

Transanal minimally invasive surgery for rectal lesions

Background and Objectives: Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to transanal endoscopic microsurgery (TEM). The authors report their experience with TAMIS for the treatment of mid and high rectal tumors. Methods: From November 2011 through May 2016, 31 patients (21 females, 68%), with a median age of 65 years who underwent single-port TAMIS were prospectively enrolled. Mean distance from the anal verge of the rectal tumors was 9.5 cm. Seventeen patients presented with T1 cancer, 10 with large adenoma, 2 with gastrointestinal stromal tumor (GIST) and 2 with carcinoid tumor. Data concerning demographics, operative procedure and pathologic results were analyzed. Results: TAMIS was successfully completed in all cases. In 4 (13%) TAMIS was converted to standard Park’s transanal technique. Median postoperative stay was 3 days. The overall complication rate was 9.6%, including 1 urinary tract infection, 1 subcutaneous emphysema, and 1 hemorrhoidal thrombosis. TAMIS allowed an R0 resection in 96.8% of cases (30/31 cases) and a single case of local recurrence after a large adenoma resection was encountered. Conclusion: TAMIS is a safe technique, with a short learning curve for laparoscopic surgeons already proficient in single-port procedures, and provides effective oncological outcomes compared to other techniques

Efecto de cinco sustratos en la germinación de semillas de cacao criollo (Theobroma cacao L.), bajo condiciones de vivero, San Cristóbal - Cajaruro, 2023

En la presente investigación: “Efecto de cinco sustratos en la germinación de semillas de cacao criollo (Theobroma cacao L.), bajo condiciones de vivero, San Cristóbal - Cajaruro, 2023”. Cuyo problema fue ¿Cuál será el efecto de cinco sustratos en la germinación de semillas de cacao criollo (Theobroma cacao L.) bajo condiciones de vivero, en el Centro Poblado San Cristóbal, Cajaruro?, cuyo objetivo general fue: Evaluar el efecto de cinco sustratos en la germinación de semillas de cacao criollo (Theobroma cacao L.), bajo condiciones de vivero en el Centro Poblado San Cristóbal de Cajaruro. Se ejecutó el diseño de investigación de experimentos puros y verdaderos, con un diseño experimental DCA, con 5 tratamientos incluyendo testigo y cuatro repeticiones. Los tratamientos fueron: T0: Tierra agrícola, T1: Tierra agrícola (70%) + cascarilla de arroz (30%), T2: Tierra agrícola (70%) + aserrín (30%), T3: Aserrín, T4: Cascarilla de arroz. La muestra estuvo conformada por 170 plantones de cacao. El instrumento utilizado fue la guía de observación. Resultados: El mejor tratamiento en lo que respecta a porcentaje de germinación y diámetro de tallo lo obtuvo el T1: Tierra agrícola (70%) + cascarilla de arroz (30%) con 91.67% y 4.78 respectivamente sobresaliendo con respecto al testigo y demás tratamientos. Con respecto a altura de plantas el T2: Tierra agrícola (70%) + aserrín (30%) obtuvo 19.48 mientras que el T1: Tierra agrícola (70%) + cascarilla de arroz (30%) 19.27. Se concluye que el mejor tratamiento es el T1: Tierra agrícola (70%) + cascarilla de arroz (30%)

The effects of MgO, Na2O and SO3 on industrial clinkering process: phase composition, polymorphism, microstructure and hydration, using a multidisciplinary approach

Preprint publicado en: Materials Characterization Volume 155, September 2019, 109809The present investigation deals with how minor elements (their oxides: MgO, Na2O and SO3) in industrial kiln feeds affect (i) chemical reactions upon clinkering, (ii) resulting phase composition and microstructure of clinker, (iii) hydration process during cement production. Our results show that all these points are remarkably sensitive to the combination and interference effects between the minor chemical species mentioned above. Upon clinkering, all the industrial raw meals here used exhibit the same formation temperature and amount of liquid phase. Minor elements are preferentially hosted by secondary phases, such as periclase. Conversely, the growth rate of the main clinker phases (alite and belite) is significantly affected by the nature and combination of minor oxides. MgO and Na2O give a very fast C3S formation rate at T > 1450 K, whereas Na2O and SO3 boost C2S After heating, if SO3 occurs in combination with MgO and/or Na2O, it does not inihibit the C3S crystallisation as expected. Rather, it promotes the stabilisation of M1-C3S, thus indirectly influencing the aluminate content, too. MgO increseases the C3S amount and promotes the stabilisation of M3-C3S, when it is in combination with Na2O. Na2O seems to be mainly hosted by calcium aluminate structure, but it does not induce the stabilisation of the orhtorhombic polymorph, as supposed to occur. Such features play a key role in predicting the physicalmechanical performance of a final cement (i.e. rate of hydration and hardening) when used as a bulding material.The present study has been partly funded by the project PRIN 2017 (2017L83S77), of the Italian Ministry for Education, University and Research (MIUR)

Banca y agricultura en tiempos improductivos: el Banco de Crédito Hipotecario y la exportación agrícola en el Perú, 1866 - 1879

Conoce la importancia e impacto que tuvo el BCH en el resurgimiento y apogeo de la agricultura costeña de exportación entre los años 1866 y 1879

Cultura política de los transportistas de la Interestatal 28 S.A de C.V, del municipio de Ixtapaluca, 2011-2013

Este crecimiento poblacional dentro del municipio fue teniendo necesidades básicas las cuales se fueron cubriendo poco a poco de una forma satisfactoria, como lo era el agua, la energía eléctrica y el drenaje, por mencionar algunos. Sin embargo, este crecimiento demográfico tenía un reto importante que cubrir: “El transporte Público”. Reto que consistía en saber cómo estructurar una red de traslado para toda la gente del municipio y a la gente que, poco a poco, iba llegando a residir en las unidades habitacionales como consecuencia de este crecimiento demográfico. Ahora bien, para conocer y tener un panorama más amplio del transporte público en el municipio de Ixtapaluca, tendríamos que trasladarnos hacia una breve reseña histórica de cómo es que surgieron los primeros transportes colectivos en el municipio. El trasporte público se origina en la década de los años 40`s, con la aparición de automóviles particulares que brindaban un servicio público a la comunidad para cubrir el traslado a comunidades cercanas. De ésta forma y con el transcurso de los años, el servicio fue tomando prestigio y cada vez se requería el servicio, de una forma más continua, por la comunidad que necesitaba trasladarse, por lo que años más tarde, los autos eran obsoletos para cubrir esta necesidad y se dio paso a los camiones que poco a poco lograron un auge significativo dentro del municipio. Años después esos camiones resultaban lentos y muy viejos, ya que los recorridos eran cada vez más largos, por lo tanto los usuarios requerían de una movilización más eficaz y nueva, por consiguiente, se dio paso importante al desarrollo del transporte público, y es así como surgieron las camionetas tipo van, mejor conocidas como “combis” las cuales otorgaron resultados positivos y eficaces a dicha necesidad. Sin embargo, era necesario una reorganización, por lo que los transportistas solicitaron tener una representación ante el estado, y es así que, casi inmediatamente formaron la figura de un líder, el cual debía cumplir con las funciones de un representante capacitado, además de que más tarde no sólo sería representarlos sino también quien los respaldara, por lo que se incorporó a lo que hoy conocemos como “Asociaciones Anónimas de Capital Variable”, (S.A de C.V). Del mismo modo, se llegó a crear lo que hoy conocemos como las “rutas”, la primer ruta sería la Ruta 98 la cual se fundó en la década de los años 60`s