Fisiopatología del síndrome de apnea-hipopnea obstructiva del sueño (SAHOS)

El síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) es una enfermedad caracterizada por la obstrucción recurrente de la vía aérea superior (VAS), con disminución en el flujo de aire, hipoxemia intermitente y despertares durante el sueño. En la fisiopatología del SAHOS se presentan dos factores esenciales: las alteraciones anatómicas y la disminución o ausencia del control neural.Durante el estudio del SAHOS se debe identificar el sitio o sitios de obstrucción de la VAS, que pueden ir desde las alas nasales hasta la hipofaringe. Otro factor importante en este síndrome es el influjo nervioso en el tono muscular de la hipofaringe, así como los cambios en el pH sanguíneo y secundarios a los microdespertares. La posición corporal y el estadio de sueño son factores determinantes de la severidad. La fisiopatología del SAHOS debe ser entendida para poder estudiar de forma adecuada a un paciente y darle la mejor opción de tratamiento.Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a disease characterized by recurrent upper airway obstruction (UAO), with decreased airflow, intermittent hypoxemia, and awakening during sleep. Two essential factors are related to the pathophysiology of OSAHS: anatomical alterations and reduction or absence of neural control.While studying OSAHS, the site or sites of obstruction of the UA should be identified; they may extend from the nasal wings to the hypopharynx. Another important factor in this syndrome is the nervous influence on muscle tone of the hypopharynx, as well as the changes in blood pH, which are secondary to micro-arousals. Body position and sleep stage determine the severity. The pathophysiology of OSAHS should be understood to properly study a patient and provide the best treatment option

Microcrédito: un perfil a socios de los bancos comunales del cantón Cevallos

Microcredit is an instrument mitigates poverty and promotes the economic and social development of low-income families, as long as the performance of certain administrative and operational processes is improved. In Ecuador, this service focus on social responsibility has been managed by non-governmental organizations (NGOs) that deploy their activities through communal banks in rural and periurban areas of the country. The aim of this investigation is to describe the economic and personal profiles members of these banks in the Cevallos canton. Therefore, seven communal banks supported by “Caritas Social Pastoral” were studied and through the surveys to 48 members, a statistical descriptive analysis was carried out; in which, it’s determined that communal banking is essential for the economic impulse of the members; since, it allows to mitigate needs, such as: housing, education, health and food. A relevant aspect of the study, is the data provided is one-way; it means, they were obtained exclusively from communal bank members of the communal banks. Consequently, the paper becomes an instrument to consider key performance indicators (KPI) that help to control the dropout and forsaking of members. URL: https://revistas.uta.edu.ec/erevista/index.php/bcoyu/article/view/1159El microcrédito constituye un instrumento que mitiga la pobreza e impulsa el desarrollo económico y social de familias de escasos recursos, siempre y cuando, se mejore el desempeño de ciertos procesos administrativos y operacionales. En Ecuador, este servicio con enfoque de responsabilidad social ha sido manejado por Organizaciones no gubernamentales (ONG’s) que despliegan su accionar a través de los bancos comunales en zonas rurales y periurbanas del país. El trabajo busca describir los perfiles económicos y personales de los socios de estos bancos en el cantón Cevallos. Para lo cual, se estudió siete bancos comunales abanderados por la Pastoral Social Cáritas y mediante la aplicación de encuestas a 48 socios, se realizó el análisis descriptivo estadístico; en el cual, se determina que la banca comunal es imprescindible para el impulso económico de los socios; puesto que, permite atenuar necesidades, como: vivienda, educación, salud y alimentación. Como un aspecto relevante del estudio, se indica que los datos proporcionados son de una solo vía; es decir, que se obtuvieron exclusivamente de socios de los bancos comunales. Por consiguiente, el estudio se convierte en un instrumento que permite considerar indicadores de desempeño que ayuden a controlar la deserción y abandono de los socios.  URL: https://revistas.uta.edu.ec/erevista/index.php/bcoyu/article/view/115

Métodos diagnósticos en el síndrome de apnea-hipopnea obstructiva del sueño (SAHOS)

El síndrome de apnea-hipopnea obstructiva del sueño siempre requiere una evaluación médica completa y una confirmación del diagnóstico, así como la estimación de la severidad por medios diagnósticos. Ambas cosas se logran mediante el polisomnograma basal que monitoriza el sueño durante la noche. Este es un estudio estandarizado que necesita parámetros mínimos de calidad, los cuales deben cumplirse en todos los casos.El test de latencias múltiple de sueño también está estandarizado con el debido cuidado y su indicación es la cuantificación de la somnolencia diurna excesiva. Por su parte, el polisomnograma para titulación de presión positiva sobre la vía aérea permite hallar la presión terapéutica mínima, en la cual se corrigen los eventos respiratorios obstructivos. El polisomnograma de noche partida intenta mejorar la oportunidad de citas en los demás y trata de hacer los dos exámenes anteriores en una noche. No obstante, tiene sus limitaciones.Los estudios de sueño en casa se clasifican de acuerdo a su nivel de complejidad y atención. Estos buscan disminuir la oportunidad de citas y se consideran estudios de tamizaje o cribado. Además, el test de mantenimiento de la vigilia se usa para controlar las terapias enfocadas en mejorar la somnolencia diurna excesiva.Obstructive sleep apnea-hypopnea syndrome (OSAHS) requires a thorough medical evaluation and diagnosis confirmation, as well as the estimation of its severity using diagnostic means. These conditions are fulfilled by the basal polysomnogram, which monitors sleep throughout the night; this is a standardized study that requires minimum quality parameters that must be met in all cases.The multiple sleep latency test has been standardized with due care and is indicated for quantifying excessive daytime sleepiness. On the other hand, positive airway pressure titration by polysomnography allows to find the minimum therapeutic pressure to correct all obstructive respiratory events. The split-night polysomnogram tries to improve appointment opportunities, which contrasts with the studies mentioned above, since both of them can be done in one night, although, it has its own limitations.Home sleep studies are classified according to their level of complexity and care; they seek to diminish the opportunity of appointments and are considered as screening studies. In addition, the psychomotor vigilance test is used to control therapies focused on improving excessive daytime sleepiness

Sistemas de compensación de servicios ambientales para los robldales de la Cordillera de Talamanca

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Estrategias de marketing digital y el posicionamiento en tiendas de ropa de la empresa Chikitines SAC. Trujillo – 2023

El marketing digital es una herramienta actual muy poderosa para las empresas y aplicar estrategias dentro de ese entorno contribuyen bastante al posicionamiento de una empresa, sin embargo, no se aplica en todas por falta de conocimiento o por desconfianza en que si se aplica estas estrategias resultará beneficioso. El estudio se realizó en una empresa pequeña dedicada a la comercialización de ropa infantil con el objetivo de determinar el nivel de relación entre la estrategia de marketing digital y el posicionamiento en los clientes de productos textiles de la empresa Chikitines SAC. Para hallar dicha relación se elaboró un cuestionario de 35 ítems acerca de marketing digital y posicionamiento, asimismo se identificó una población de 450 clientes, de los cuáles como muestra fueron 208 individuos que fueron encuestados virtual y presencialmente. Con ello se determinó que la relación entre ambas variables es positiva muy alta con un Rho de Spearman igual a 0.901 y una significancia <0.01 Lo que evidencia que las estrategias de marketing digital tienen un impacto directo y significativo en el posicionamiento de la empresa en la mente de sus clientes

Prevention of oral cancer through the implementation of a teledentistry platform for the elderly

Objective: To contribute to early diagnosis of lesions in older patients, including potentially malignant lesions or those suspected of oral cancer by support of a web-based teledentistry platform. Material and Methods: This report contains information from 27 patients with oral lesions out of a total of 135 who received mobile dental care. Specialists who participated in the study involved professionals from the disciplines of periodontics, temporomandibular disorders, oral implantology, oral radiology, oral pathology and geriatrics. Referral consultations were carried out synchronously or asynchronously. Clinical information sent to oral pathology specialists involved a medical history and a traditional description of the lesion which considered size, color, limits, symptomatology, type of surface, consistency, location, and evolution. This information was complemented with a three-dimensional representation of the lesion, simulating an extra/intra oral clinical examination including a marker tool that allows to perform the anatomical-referencing of oral lesions. Results: 27 consultations from 26 patients were evaluated for oral pathology lesions. 12 lesions were diagnosed as reactive, 5 were infectious lesions, 4 of vascular etiology, 3 pigmented lesions (amalgam tattoo and smoking-related melanosis) and 3 potentially malignant lesions. The most frequent location was the tongue with 8 cases, followed by the gingiva and jugal mucosa, each with 5 cases. Four lesions required biopsy and histopathological report. Conclusion: A teledentistry platform including digital representations of oral lesions using different digital markers, also associated with a mobile system to provide dental care, constitutes an excellent tool to treat patients that present oral lesions with potential cancer risk

Clinicopathological And Immunohistochemical Evaluation Of Oral And Oropharyngeal Squamous Cell Carcinoma In Chilean Population.

In oral and oropharyngeal squamous cell carcinoma (OCSCC and OPSCC) exist an association between clinical and histopathological parameters with cell proliferation, basal lamina, connective tissue degradation and surrounding stroma markers. We evaluated these associations in Chilean patients. A convenience sample of 37 cases of OCSCC (n=16) and OPSCC (n=21) was analyzed clinically (TNM, clinical stage) and histologically (WHO grade of differentiation, pattern of tumor invasion). We assessed the expression of p53, Ki67, HOXA1, HOXB7, type IV collagen (ColIV) and carcinoma-associated fibroblast (α-SMA-positive cells). Additionally we conducted a univariate/bivariate analysis to assess the relationship of these variables with survival rates. Males were mostly affected (56.2% OCSCC, 76.2% OPSCC). Patients were mainly diagnosed at III/IV clinical stages (68.8% OCSCC, 90.5% OPSCC) with a predominantly infiltrative pattern invasion (62.9% OCSCC, 57.1% OPSCC). Significant association between regional lymph nodes (N) and clinical stage with OCSCC-HOXB7 expression (Chi-Square test P < 0.05) was observed. In OPSCC a statistically significant association exists between p53, Ki67 with gender (Chi-Square test P < 0.05). In OCSCC and OPSCC was statistically significant association between ki67 with HOXA1, HOXB7, and between these last two antigens (Pearson's Correlation test P < 0.05). Furthermore OPSCC-p53 showed significant correlation when it was compared with α-SMA (Kendall's Tau-c test P < 0.05). Only OCSCC-pattern invasion and OPSCC-primary tumor (T) pattern resulted associated with survival at the end of the follow up period (Chi-Square Likelihood Ratio, P < 0.05). Clinical, histological and immunohistochemical features are similar to seen in other countries. Cancer proliferation markers were associated strongly from each other. Our sample highlights prognostic value of T and pattern of invasion, but the conclusions may be limited and should be considered with caution (small sample). Many cases were diagnosed in the advanced stages of the disease, which suggests that the diagnosis of OCSCC and OPSCC is made late.75968-7

Water consumption and preliminary crop coefficients of two Populus ×canadensis clones (‘I-214’ and ‘I-488’) grown at low planting density

Aim of study: The productivity of poplar plantations in Mediterranean climates might be reduced due to lower precipitations in a climate change scenario. Therefore, understanding the water consumption in these plantations is essential for their management. The objective of this study was to estimate water consumption and preliminary crop coefficients (kc) of two universally used poplar clones (Populus x Canadensis ‘I-214’ and ‘I-488’).Area of study: Central Chile (36º 05 'LS; 72º 47' LW; 470 m.a.s.l.).Materials and methods: Commercial stands of poplar clones established in 2009 and 2010 at low density (6×6 m) were used to experiment during the 2016-2017 growing season. In each of them, water balance was measuring, by determining evaporation using micro lysimeters and transpiration using the sap flow. Additionally, the water status and the leaf area index (LAI) were measured to understand the behaviour of both clones.Main results: Although the water supplied to both clones was the same, the transpiration (T) was higher for ‘I-488’ than ‘I-214’, at those moments in which the evapotranspiration (ETr) and the vapour pressure deficit (VPD) was higher. On the other hand, differences were observed in plant water status, ‘I-488’ had more negative xilematic water potential (Ψx) compared to ‘I-214’. In turn, I-214 proved to have a higher Leaf Area Index (LAI) than I-488 and grew more during the season, refuting its greater efficiency.Research highlights: These results allow characterizing the water behaviour of both clones in Mediterranean climate condition, but it is necessary to extend the study to more seasons and different age ranges.Keywords: Crop coefficient; water consumption; water balance; poplar