Sigmoid Volvulus Due Chagas Disease

American Trypanosomiasis, also known as Chagas disease, is a parasitic disease caused by Trypanosoma cruzi and transmitted by hematophagous vectors, occupies the fourth place as a cause of loss of potential years of life between infectious and parasitic diseases, and has an acute presentation form and chronic, in which it can present complications at cardiac and digestive levels, among others. The development of megacolon with subsequent development of volvulus is an important cause of acute abdomen and intestinal obstruction that requires urgent treatment, as it presents an axial rotation of the intestinal loop with obstruction in a closed loop and subsequent ischemia. According to the World Health Organization, there are between 16 and 18 million infected people in the world, of which the majority is located in Latin American territory, and it is estimated that approximately only 1% receives adequate diagnosis and complete treatment

Digestive Disorders in Chagas Disease: Megaesophagus and Chagasic Megacolon

Chagas disease, also known as American trypanosomiasis, caused by Trypanosoma cruzi and transmitted by hematophagous vectors, is a parasitic disease, which according to the WHO ranks fourth as a cause of loss of potential years of life due to complications that can occur in multiple body systems. According to the reports presented by the World Health Organization, there are between 16 and 18 million infected people in the world, predominantly in endemic areas of Latin America, of which only 1% receives an adequate diagnosis and full treatment, thereby that the chronic phase comes to present digestive disorders that are one of the main causes of loss in the quality of life of patients, as well as complications that can lead to life-threatening surgical emergencies

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 2

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, es el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. En este sentido, partiendo de los aportes teóricos y prácticos que presentan los autores, resultados de sus trabajos de investigación, análisis de diversas teorías, propuestas, enfoques, así como experiencias que se han dado a nivel del tema de gestión del conocimiento, presentamos a la comunidad internacional el libro Gestión del conocimiento. Perspectivas multidisciplinarias, que permitirá un mayor conocimiento y aplicación de estos conceptos, traduciéndose en una mejor aplicación y posicionamiento de las organizaciones en la utilización del conocimiento, la apropiación y transformación del mismo

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Enterprises and entrepreneurs in Colima and Villa de Alvarez: A paradox or Schumpeter anti law

On the basis of the Schumpeterian conception about the characteristics of the innovating entrepreneur, this article offers a general explanation for the weak economic performance followed by the small firm sector within the municipalities of Colima and Villa de Alvarez. The analysis, which considers entrepreneurship as the main variable of explanation, suggests that the small firms have few Schumpeterian characteristics, while prevails a low propensity to innovate and compete, and a high risk aversion

Índices de extremos térmicos en las Llanuras Costeras del Golfo Sur en México

limate change is already widely studied, showing increases in maximum and minimum temperatures, but increases were also reported related to the extreme daily maximum and minimum temperatures, which has led to the need to determine the behaviour of these extremes at regional level in order that decision-makers can develop adaptation measurements. The aim of this study was to evaluate the tendencies of the climate indices of weather extremes based on the maximum and minimum daily temperatures for the South Gulf Coastal Plains region. Featuring the database of daily maximum temperature and daily minimum temperature of 31 weather stations located in this area. After making an analysis of the quality of the series and homogenizing on them when necessary, we obtained thirteen out of the twenty seven indices established by the Expert Panel on Detection, Monitoring and Indices of Climate Change (EPDMICC). We applied a principal component analysis and a cluster analysis. Regional tendencies of the significant climate variation indices of the area were obtained and finally an analysis of stationality of these indices was performed in the region. The results show an increase in several of the extreme indices, being the most significant, the frequency of warm nights and hot days frequency which show higher increase during summer and autumn.El cambio climático ya ampliamente estudiado, muestra incrementos en las temperaturas máximas y mínimas, pero también se indican incrementos en los extremos relacionados con las temperaturas máximas y mínimas diarias, lo que ha llevado a la necesidad de determinar el comportamiento de estos extremos a escala regional con la finalidad de que los tomadores de decisiones puedan desarrollar medidas de adaptación. El objetivo de este trabajo fue evaluar las tendencias de los índices climáticos de extremos meteorológicos basados en las temperaturas máxima y mínima diaria para la región Llanuras Costeras del Golfo Sur. Se contó con la base de datos de temperatura máxima diaria y temperatura mínima diaria de 31 estaciones climáticas localizadas en esta zona. Una vez que se realizó un análisis de la calidad de las series y homogeneización de las mismas, en los casos necesarios, se obtuvieron trece de los veintisiete índices de extremos establecidos por el Equipo de Expertos para la Detección, Monitoreo e Índices de Cambio Climático (ETCCDMI). Se aplicó un análisis de componentes principales y análisis de agrupamiento. Se obtuvieron tendencias regionales de los índices más significativos en la variación climática de la zona y por último se realizó un análisis de estacionalidad de estos índices en la región. Los resultados muestran un incremento en varios de los índices de extremos siendo los más significativos la frecuencia de noches cálidas y frecuencia de días calurosos los cuales muestran mayor incremento durante las estaciones de verano y otoño

<i>Peumus boldus</i> Used in the Synthesis of ZnO Semiconductor Nanoparticles and Their Evaluation in Organic Contaminants

The high demand for nanomaterials in the field of industry and science has forced researchers to develop new synthesis methods that are more efficient, economical, and environmentally friendly. At present, the application of green synthesis has taken a great advantage over conventional synthesis methods because it helps with the control of the characteristics and properties of the resulting nanomaterials. In this research, ZnO nanoparticles (NPs) were synthesized by biosynthesis using dried boldo (Peumus boldus) leaves. The resulting biosynthesized NPs had a high purity, quasi-spherical shape with average sizes ranging from 15 to 30 nm and a band gap of ~2.8–3.1 eV. These NPs were used in the photocatalytic activity of three organic dyes. The results showed degradation of 100% methylene blue (MB) in 180 min, 92% methyl orange (MO) in 180 min, and 100% Rhodamine B (RhB) in 30 min of exposure. These results show that the Peumus boldus leaf extract is effective in the biosynthesis of ZnO NPs with good photocatalytic properties