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In the digitization era, the battery consumption factor plays a vital role for the devices that operate Android software, expecting them to deliver high performance and good maintainability.The study aims to analyze the Android-specific code smells, their impact on battery consumption, and the formulation of a mathematical model concerning static code metrics hampered by the code smells. We studied the impact on battery consumption by three Android-specific code smells, namely: No Low Memory Resolver (NLMR), Slow Loop (SL) and Unclosed Closable, considering 4,165 classes of 16 Android applications. We used a rule-based classification method that aids the refactoring ideology. Subsequently, multi-linear regression (MLR) modeling is used to evaluate battery usage against the software metrics of smelly code instances. Moreover, it was possible to devise a correlation for the software metric influenced by battery consumption and rule-based classifiers. The outcome confirms that the refactoring of the considered code smells minimizes the battery consumption levels. The refactoring method accounts for an accuracy of 87.47% cumulatively. The applied MLR model has an R-square value of 0.76 for NLMR and 0.668 for SL, respectively. This study can guide the developers towards a complete package for the focused development life cycle of Android code, helping them minimize smartphone battery consumption and use the saved battery lives for other operations, contributing to the green energy revolution in mobile devices.
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Ensuring the effective management of every rhinoceros population is crucial for securing a future for the species, especially considering the escalating global threat of poaching and the challenges faced in captive breeding programs for this endangered species. Steroid hormones play pivotal roles in regulating diverse biological processes, making fecal hormonal determinations a valuable non-invasive tool for monitoring adrenal and gonadal endocrinologies and assessing reproductive status, particularly in endangered species. The purpose of this study was to develop a statistical model for predicting the sex of white rhinoceroses using hormonal determinations obtained from a single fecal sample. To achieve this, 562 fecal samples from 15 individuals of the Ceratotherium simum species were collected, and enzyme immunoassays were conducted to determine the concentrations of fecal cortisol, progesterone, estrone, and testosterone metabolites. The biological validation of the method provided an impressive accuracy rate of nearly 80% in predicting the sex of hypothetically unknown white rhinoceroses. Implementing this statistical model for sex identification in white rhinoceroses would yield significant benefits, including a better understanding of the structure and dynamics of wild populations. Additionally, it would enhance conservation management efforts aimed at protecting this endangered species. By utilizing this innovative approach, we can contribute to the preservation and long-term survival of white rhinoceros populations.
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The commonly accepted definition of sustainability considers the availability of relevant resources to make an activity feasible and durable while also recognizing users' support as an essential part of the social side of sustainability. IoT represents a disruption in the general scenario of computing for both users and professionals. The real expansion and integration of applications based on IoT depend on our capacity of exploring the necessary skills and professional profiles that are essential for the implementation of IoT projects, but also on the perception of relevant aspects for users, e.g., privacy, legal, IPR, and security issues. Our participation in several EU-funded projects with a focus on this area has enabled the collection of information on both sides of IoT sustainability through surveys but also by collecting data from a variety of sources. Thanks to these varied and complementary sources of information, this article will explore the user and professional aspects of the sustainability of the Internet of Things in practice.
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Internet de las Cosas , Humanos , Privacidad , Encuestas y Cuestionarios , Europa (Continente)RESUMEN
The escape behaviour, measured as flight initiation distance (FID; the distance at which individuals take flight when approached by a potential predator, usually a human in the study systems), is a measure widely used to study fearfulness and risk-taking in animals. Previous studies have shown significant differences in the escape behaviour of birds inhabiting cemeteries and urban parks in European cities, where birds seem to be shyer in the latter. We collected a regional dataset of the FID of birds inhabiting cemeteries and parks across Latin America in peri-urban, suburban and urban parks and cemeteries. FIDs were recorded for eighty-one bird species. Mean species-specific FIDs ranged from 1.9 to 19.7 m for species with at least two observations (fifty-seven species). Using Bayesian regression modelling and controlling for the phylogenetic relatedness of the FID among bird species and city and country, we found that, in contrast to a recent publication from Europe, birds escape earlier in cemeteries than parks in the studied Latin American cities. FIDs were also significantly shorter in urban areas than in peri-urban areas and in areas with higher human density. Our results indicate that some idiosyncratic patterns in animal fearfulness towards humans may emerge among different geographic regions, highlighting difficulties with scaling up and application of regional findings to other ecosystems and world regions. Such differences could be associated with intrinsic differences between the pool of bird species from temperate European and mostly tropical Latin American cities, characterized by different evolutionary histories, but also with differences in the historical process of urbanization.
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Cementerios , Ecosistema , Animales , Humanos , América Latina , Filogenia , Parques Recreativos , Teorema de Bayes , Aves , Ciudades , Europa (Continente)RESUMEN
Designing and developing artificial intelligence (AI)-based systems that can be trusted justifiably is one of the main issues aviation must face in the coming years. European Union Aviation Safety Agency (EASA) has developed a user guide that could be potentially transformed as means of compliance for future AI-based regulation. Designers and developers must understand how the learning assurance process of any machine learning (ML) model impacts trust. ML is a narrow branch of AI that uses statistical models to perform predictions. This work deals with the learning assurance process for ML-based systems in the field of air traffic control. A conflict detection tool has been developed to identify separation infringements among aircraft pairs, and the ML algorithm used for classification and regression was extreme gradient boosting. This paper analyses the validity and adaptability of EASA W-shaped methodology for ML-based systems. The results have identified the lack of the EASA W-shaped methodology in time-dependent analysis, by showing how time can impact ML algorithms designed in the case where no time requirements are considered. Another meaningful conclusion is, for systems that depend highly on when the prediction is made, classification and regression metrics cannot be one-size-fits-all because they vary over time.
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Inteligencia Artificial , Aviación , Algoritmos , Aviación/métodos , Certificación , Aprendizaje AutomáticoRESUMEN
Introducción: El hígado se lesiona con mayor frecuencia en un trauma de abdomen de alta energía, con una incidencia entre 1 % y 8 %. Las lesiones traumáticas de las vías biliares son muy raras. Casos clínicos: Presentamos dos pacientes con trauma hepático grave, y compromiso ex-trahepático vascular y de la vía biliar; y el abordaje quirúrgico para preservar funcional-mente ambos lóbulos: Masculino de 1 año, trauma hepático grado V, lesión incompleta de vena porta derecha, a nivel de la bifurcación y del conducto biliar hepático izquierdo. Se reparó el daño portal y de la vía biliar. Femenina de dos años, trauma cerrado de abdomen, lesión del parénquima de lóbulo derecho del hígado, sección total del conducto hepático izquierdo, y contusión pancreática asociada. En ambos casos se realizó una hepáticoyeyunostomía en Y de Roux y conservación de ambos lóbulos. Conclusión: En los traumas complejos hepáticos que involucran ambos lóbulos, la evolución depende de calidad de la masa residual. La cirugía conservadora con reconstrucciones vasculares y biliares, evita un fallo hepático agudo, permite ganar tiempo hasta la regeneración funcional del parénquima y proteger de una eventual insuficiencia hepática post-operatoria.
Introduction: The liver is more frequently injured in high-energy abdominal trauma, with an incidence between 1% and 8%. Traumatic injuries to the bile ducts are infrequent. Clinical cases: We present two patients with severe liver trauma and extrahepatic vascular and bile duct involvement and the surgical approach to preserve both lobes functionally: 1-year-old male, grade V liver trauma, incomplete injury to the right portal vein, at the level of the bifurca-tion and the left hepatic bile duct. The portal and bile duct damage was repaired. Two-year-old female, blunt abdominal trauma, injury to the parenchyma of the right lobe of the liver, whole section of the left hepatic duct, and associated pancreatic contusion. In both cases, a Roux-en-Y hepatic jejunostomy was performed, and both lobes were preserved. Conclusion: In complex liver trauma involving both lobes, the evolution depends on the quality of the residual mass. Conservative surgery with vascular and biliary reconstructions avoids acute liver failure, allows time to gain until the funct.
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Humanos , Preescolar , Historia del Siglo XX , Informes de Casos , Anastomosis en-Y de Roux , Niño , Hígado , Hepatectomía , Traumatismos AbdominalesRESUMEN
Introducción. El síndrome lumbocostovertebral es una anomalía poco frecuente, que afecta a los cuerpos vertebrales, las costillas y músculos de la pared abdominal, y puede estar asociada a múltiples anomalías congénitas. Requiere un manejo multidisciplinario y tratamiento quirúrgico temprano para evitar complicaciones. Caso clínico. Se reporta el caso de un neonato masculino de 10 días de edad, que presentó desde el nacimiento 2 tumoraciones lumbares derechas, una que aumentaba de tamaño con el llanto, correspondió a una hernia lumbar, y la otra, a mielomeningocele. En estudios complementarios se evidenció fusión de costillas, fusión de cuerpos vertebrales lumbares, sacros (hemivértebras) y defecto de pared abdominal con protrusión de contenido intestinal. Se realizó cierre de la hernia lumbar con refuerzo protésico de pericardio bovino, sin complicaciones. Conclusión. En defectos extensos, como el que se reporta en este paciente, puede ser recomendable emplear material protésico. El pericardio bovino aparece como una opción segura, bien tolerada y eficaz para estos pacientes en particular. Este síndrome es una entidad rara, que amerita un equipo multidisciplinario para la resolución quirúrgica temprana y con ello evitar complicaciones.
Introduction. Lumbocostovertebral syndrome is a rare anomaly that affects the vertebral bodies, ribs and muscles of the abdominal wall, and can be associated with multiple congenital abnormalities. It requires multidisciplinary management and early surgical treatment to avoid complications. Clinical case. The case of a 10-day-old male neonate is reported, who presented from birth 2 right lumbar tumors, one that increased in size with crying, corresponded to a lumbar hernia, and the other, to myelomeningocele. In complementary studies, rib fusion, fusion of lumbar and sacral vertebral bodies (hemivertebrae), and abdominal wall defect with protrusion of intestinal contents were evidenced. The lumbar hernia was closed with prosthetic reinforcement with a bovine pericardium, without complications. Conclusion. In extensive defects, such as the one reported in this patient, it may be advisable to use prosthetic material. The bovine pericardium appears as a safe, well tolerated and effective option for these patients in particular. This syndrome is a rare entity, which requires a multidisciplinary team for early surgical resolution and thus avoid complications.
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Humanos , Anomalías Congénitas , Meningomielocele , Síndrome , Hernia Abdominal , Hernia , Vértebras LumbaresRESUMEN
Hormone patterns tailor cell fate decisions during plant organ formation. Among them, auxins and cytokinins are critical phytohormones during early development. Nitric oxide (NO) modulates root architecture by the control of auxin spatial patterns. However, NO involvement during the coordination of shoot organogenesis remains unclear. Here, we explore the effect of NO during shoot development by using a phenotypic, cellular, and genetic analysis in Arabidopsis thaliana and get new insights into the characterization of NO-mediated leaf-related phenotypes. NO homeostasis mutants are impaired in several shoot architectural parameters, including phyllotactic patterns, inflorescence stem elongation, silique production, leaf number, and margin. Auxin distribution is a key feature for tissue differentiation and need to be controlled at different levels (i.e., synthesis, transport, and degradation mechanisms). The phenotypes resulting from the introduction of the cue1 mutation in the axr1 auxin resistant and pin1 backgrounds exacerbate the relationship between NO and auxins. Using the auxin reporter DR5:GUS, we observed an increase in auxin maxima under NO-deficient mutant backgrounds and NO scavenging, pointing to NO-ASSOCIATED 1 (NOA1) as the main player related to NO production in this process. Furthermore, polar auxin transport is mainly regulated by PIN-FORMED 1 (PIN1), which controls the flow along leaf margin and venations. Analysis of PIN1 protein levels shows that NO controls its accumulation during leaf development, impacting the auxin mediated mechanism of leaf building. With these findings, we also provide evidence for the NO opposite effects to determine root and shoot architecture, in terms of PIN1 accumulation under NO overproduction.
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Introducción: La infección del tracto urinario es una afectación frecuente en niños, y su recurrencia predispone a patologías crónicas que disminuyen la sobrevida de pacientes hospitalizados. El objetivo del presente estudio fue determinar la prevalencia de infección del tracto urinario y factores asociados en niños hospitalizados de 0 a 5 años. Métodos: El presente estudio es transversal analítico, el universo lo constituyó los niños hospitalizados en pediatría de 0 -5 años del Hospital ¨José Carrasco Arteaga¨ de Cuenca-Ecuador, la muestra fue probabilística 147 casos, el muestreo fue aleatorio simple. Las variables fueron presencia de ITU, edad, sexo, nivel socio-económico, balanitis, estreñimiento, antecedentes de ITU. En el análisis bivariado se determinó asociación mediante chi cuadrado y se midió la intensidad de asociación por Razón de prevalencia (RP) con un Intervalo de confianza del 95% y un valor significativo de P< 0.05. Resultados: Fueron 147 casos. La prevalencia de ITU fue 10.6%, se presentaron como factores protectores: edad < 1 año RP 0.21 (IC 95% 0.16-0.42, P<0.001) y el sexo masculino RP 0.28 (IC 0.18-0.471, P<0.001). Los factores de riesgo fueron: el nivel socioeconómico medio-bajo RP 1.70 (IC 1.01-2.86, P=0.04), balanitis RP 3.23 (IC 2.48-4.21, P=0.012), fimosis RP 29.37 (IC 6.34-136.3., P<0.001), sinequias RP 1.43 (IC 1.14-1.79, P=0.02), el antecedente de infección del tracto urinario RP 78.91 (IC 10.72-580.7, P<0.001) y estreñimiento RP 4.51 (IC 2.16-9.50, P<0.001). La hidronefrosis fue el hallazgo ecográfico más frecuente RP 78.9 (IC 10.7-580.7, P<0.001). Conclusiones: El sexo masculino fue un factor protector, y alteraciones anatómicas del tracto urinario fueron los mayores factores de riesgo.
Introduction: Urinary tract infection is a frequent affliction in children, and its recurrence predisposes the patient to chronic pathologies that decrease the survival of hospitalized patients. The objective of the present study was to determine the prevalence of urinary tract infection and associated factors in hospitalized children aged 0 to 5 years. Methods: The present study is cross-sectional analytical. The universe was made up of children hospitalized in pediatrics, aged 0-5 years, at "José Carrasco Arteaga" Hospital in Cuenca-Ecuador. The sample was probabilistic, with 147 cases, while the sampling was simple random. The variables were the presence of UTI, age, sex, socioeconomic status, balanitis, constipation, and history of UTI. In the bivariate analysis, the association was determined using chi-square, and the intensity of the association was measured by prevalence ratio (PR) with a 95% confidence interval and a significant value of P <0.05. Results: There were 147 cases. The prevalence of UTI was 10.6%. The following were presented as protective factors: age <1 year PR 0.21 (95% CI 0.16-0.42, P <0.001) and male sex PR 0.28 (CI 0.18-0.471, P <0.001). The risk factors were: low-middle socioeconomic level PR 1.70 (CI 1.01-2.86, P = 0.04), balanitis PR 3.23 (CI 2.48-4.21, P = 0.012), phimosis PR 29.37 (CI 6.34-136.3., P <0.001), synechiae PR 1.43 (CI 1.14-1.79, P= 0.02), history of urinary tract infection PR 78.91 (CI 10.72-580.7, P <0.001), and constipation PR 4.51 (CI 2.16-9.50, P <0.001 ). Hydronephrosis was the most frequent ultrasound finding PR 78.9 (CI 10.7-580.7, P <0.001). Conclusions: Male sex was a protective factor, and anatomical alterations of the urinary tract were the major risk factors.
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Pediatría , Infecciones Urinarias , Enfermedades Urológicas , Factores de RiesgoRESUMEN
Steroidal hormone interaction in pregnancy is crucial for adequate fetal evolution and preparation for childbirth and extrauterine life. Estrone sulphate, estriol, progesterone and cortisol play important roles in the initiation of labour mechanism at the start of contractions and cervical effacement. However, their interaction remains uncertain. Although several studies regarding the hormonal mechanism of labour have been reported, the prediction of date of birth remains a challenge. In this study, we present for the first time machine learning algorithms for the prediction of whether spontaneous labour will occur from week 37 onwards. Estrone sulphate, estriol, progesterone and cortisol were analysed in saliva samples collected from 106 pregnant women since week 34 by enzyme-immunoassay (EIA) techniques. We compared a random forest model with a traditional logistic regression over a dataset constructed with the values observed of these measures. We observed that the results, evaluated in terms of accuracy and area under the curve (AUC) metrics, are sensibly better in the random forest model. For this reason, we consider that machine learning methods contribute in an important way to the obstetric practice.
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Hormonas/metabolismo , Parto , Embarazo/metabolismo , Saliva/metabolismo , Adolescente , Biomarcadores/metabolismo , Femenino , Humanos , Valor Predictivo de las PruebasRESUMEN
INTRODUCCIÓN: El corazón es el órgano más comúnmente afectado por anormalidades congénitas, con una incidencia de 0.8 por cada 100 nacidos vivos. Cerca de dos tercios de todos los procedimientos son en la actualidad realizados antes del año de edad, lo que mejora la sobrevida y la calidad de vida. Este estudio busca determinar cuáles son las principales intervenciones quirúrgicas realizadas para tratar las cardiopatías congénitas y sus complicaciones. MATERIALES Y MÉTODOS: Se realizó un estudio observacional, descriptivo de corte transversal; con 70 pacientes pediátricos diagnosticados y tratados quirúrgicamente por cardiopatías congénitas. Los datos fueron tomados de las historias clínicas mediante un formulario. El análisis estadístico se realizó utilizando el programa SPSS versión 15. RESULTADOS: La mediana de la edad fue de 1.1 años, el 60% fueron de sexo femenino. El 90% de las cardiopatías fueron no cianógenas. El diagnóstico más frecuente fue la persistencia del conducto arterioso (58.57%), seguido de la comunicación interventricular (12.86%). Según el tipo de procedimiento el 58.57% se realizaron para cierre de persistencia del conducto arterioso y un 12.86% fueron reparaciones quirúrgicas para cierre de comunicación interventricular. La mediana de estadía en la unidad de cuidados intensivos fue de 4 días y la mediada de estadía en la sala general de 5 días. La principales complicaciones observadas en esta población pediátrica sometida a un procedimiento quirúrgico fueron: la neumonía (11.4%) y la sepsis de origen no especificado (8.6%). CONCLUSIÓN: Los tratamientos para las cardiopatías congénitas se realizaron a edades tempranas (Media =2.5 ± 3.2 años). Más de la mitad de los procedimientos quirúrgicos realizados para cardiopatías quirúrgicas fueron para corregir la persistencia del conducto arterioso y la principal complicación fue la neumonía.
BACKGROUND: The heart is the most commonly affected organ by congenital diseases, with and incidence of 0.8 per 100 newborns. Nearly two thirds of all the surgical procedures are now a days performed before the first year of life, improving survival rate and life quality. This study aims to determine the frequency of the surgical interventions performed to treat congenital heart diseases and its complications. METHODS: An observational, descriptive cross sectional study was carried out; with 70 pediatric patients diagnosed and surgically treated for congenital heart diseases. The data was collected from the patient's medical records using a form. Statistical analysis was performed using SPSS version 15 software. RESULTS: The median age was 1.1 years, 60% of the sample were women. 90% of the heart diseases were non-cyanogenic. The most frequent diagnosis was: persistence of the arterial duct (58.57%), followed by interventricular communication (12.86%). The type of procedures corresponds to the heart disease, thus 58.57% were performed for closure of arterial duct persistence and 12.86% were surgical repairs for closure of interventricular communication. The median stay in the intensive care unit was 4 days and the median stay in general hospitalization room was 5 days. The main complications in this pediatric population undergoing a surgical procedure were: pneumonia (11.4%) and sepsis of unspecified origin (8.6%). CONCLUSION: Treatment for heart diseases were performed at early ages (average age= 2.5±3.2). More than half of the surgical procedures for congenital heart disease were performed to correct the persistence of the ductus arteriosus, the main complication was pneumonia.
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Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Pediatría/métodos , Cirugía Torácica/clasificación , Cateterismo Cardíaco/estadística & datos numéricos , Cardiopatías Congénitas/complicacionesRESUMEN
BACKGROUND: The interaction of hormonal factors are crucial for good foetal development. During the second trimester of gestation, most of the main physiological processes of foetal development occur. Therefore, the aim of this study was to determine the variations in the physiological levels of cortisol, estriol, estrone sulphate, and progesterone during the second trimester (weeks 12-26) in order to establish normal ranges that can serve as indicators of foetal well-being and good functioning of the foetal-placental unit. METHODS: Saliva samples from 106 pregnant women were collected weekly (from week 12 to week 26 of gestation), and hormonal measurements were assayed by an enzyme immunoassay. The technique used for hormone measurements was highly sensitive and served as a non-invasive method for sample collection. RESULTS: The results revealed a statistically significant (p<0.05) difference between cortisol, progesterone, and oestrogens throughout the second trimester, with a more substantial relationship between oestrogens and progesterone [P4-E3 (r=0.427); P4-E1SO4 (r=0.419)]. By analysing these hormone concentrations, statistically significant (p<0.05) elevations in progesterone, cortisol, and estriol levels were found at the 16th [(P4 (0.78±0.088), C(1.99±0.116), E3(2.513±0.114)]; 18th [(P4 (1.116±0.144), C(3.409±0.137), E3(3.043±0.123)] and 23rd week of gestation [(P4(1.36±0.153), C(1.936±0.11), E3(2.657±0.07)]. Estrone sulphate levels appeared to increase progressively throughout the second trimester [from 1.103±0.03 to 2.244±0.09]. CONCLUSION: The 18th week of gestation seems to constitute a very important week during foetal adrenal development, and the analysis of the main hormones involved in foetal development, provided more precise information regarding the proper functioning of the foetal unit and foetal development.
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Desarrollo Fetal , Segundo Trimestre del Embarazo/metabolismo , Adulto , Estriol/metabolismo , Estrona/análogos & derivados , Estrona/metabolismo , Femenino , Humanos , Hidrocortisona/metabolismo , Estudios Longitudinales , Embarazo , Progesterona/metabolismo , Saliva/metabolismoRESUMEN
The expected growth of air traffic in the following decades demands the implementation of new operational concepts to avoid current limitations of the air traffic management system. This paper focuses on the strategic conflict management for four-dimensional trajectories (4DT) in free-route airspace. 4DT has been proposed as the future operational concept to manage air traffic. Thus, aircraft must fulfil temporary restrictions at specific waypoints in the airspace based on time windows. Based on the temporary restrictions, a strategic conflict management method is proposed to calculate the conflict probability of an aircraft pair (that intersects in the air) and to calculate temporary-blocking windows that quantify the time span at which an aircraft cannot depart because one conflict could occur. This methodology was applied in a case-study for an aircraft pair, including the uncertainty associated with 4DT. Moreover, a sensitivity analysis was performed to characterise the impact of wind conditions and speed control on the temporary-blocking windows. The results concluded that it is feasible to propose 4DT strategic de-confliction based on temporary-blocking windows. Although, uncertainty variables such as wind and speed control impact on the conflict probability and the size of the temporary-blocking windows.
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The cue1 nitric oxide (NO) overproducer mutants are impaired in a plastid phosphoenolpyruvate/phosphate translocator, mainly expressed in Arabidopsis thaliana roots. cue1 mutants present an increased content of arginine, a precursor of NO in oxidative synthesis processes. However, the pathways of plant NO biosynthesis and signaling have not yet been fully characterized, and the role of CUE1 in these processes is not clear. Here, in an attempt to advance our knowledge regarding NO homeostasis, we performed a deep characterization of the NO production of four different cue1 alleles (cue1-1, cue1-5, cue1-6 and nox1) during seed germination, primary root elongation, and salt stress resistance. Furthermore, we analyzed the production of NO in different carbon sources to improve our understanding of the interplay between carbon metabolism and NO homeostasis. After in vivo NO imaging and spectrofluorometric quantification of the endogenous NO levels of cue1 mutants, we demonstrate that CUE1 does not directly contribute to the rapid NO synthesis during seed imbibition. Although cue1 mutants do not overproduce NO during germination and early plant development, they are able to accumulate NO after the seedling is completely established. Thus, CUE1 regulates NO homeostasis during post-germinative growth to modulate root development in response to carbon metabolism, as different sugars modify root elongation and meristem organization in cue1 mutants. Therefore, cue1 mutants are a useful tool to study the physiological effects of NO in post-germinative growth.
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INTRODUCCIÓN: La pentalogía de Cantrell abarca la presencia de cinco defectos congénitos que representan un gran desafío para los cirujanos. Las anomalías del corazón, pericardio, diafragma, esternón y pared abdominal anterior son los hallazgos principales. Su incidencia es baja, sin embargo, es fundamental identificarla oportunamente para adoptar una terapia adecuada para todos los defectos descritos, puesto que se reporta una mortalidad elevada. CASO CLÍNICO: Se trató de un recién nacido a término, de sexo masculino, con antecedentes de defecto de la pared abdominal compatible con onfalocele detectado mediante ecografía prenatal. Tras cesárea programada, se evidenció defecto en la pared abdominal a través del cual emergían el lóbulo hepático izquierdo, intestinos y corazón; el esternón además presentaba una fisura baja. En ecocardiograma se evidenció foramen oval permeable, insuficiencia tricuspídea leve e hipertensión pulmonar severa. EVOLUCIÓN: Se decidió su manejo quirúrgico inmediato. Se colocó silo, con cierre progresivo de la línea media en 7 días. En segundo tiempo quirúrgico, se corrigió el defecto diafragmático y pericárdico con prótesis de pericardio bovino. Pese a la evolución adecuada de la cirugía, a los 28 días, el paciente presentó cianosis súbita, sin responder a maniobras de reanimación y falleció. CONCLUSIÓN: La Pentalogía de Cantrell es una enfermedad rara, con características clínicas, anatómicas y embriológicas peculiares, representa un desafío único para los cirujanos. Su diagnóstico temprano, así como el seguimiento durante el embarazo, la planificación de una cesárea en un centro de alto nivel y la aproximación quirúrgica inmediata con un equipo multidisciplinario, son componentes clave en el manejo integral de pacientes con Pentalogía de Cantrell.
BACKGROUND: Cantrell's pentalogy includes the presence of five birth defects that represent a great challenge for surgeons. Abnormalities of the heart, pericardium, diaphragm, sternumand anterior abdominal wall are the main findings. Its incidence is low, however, it is essential to identify Cantrell´s pentalogy timely to adopt an adequate therapy for all specific defects, since it has high mortality. CASE REPORT: The patient was a full- term male newborn, with a history of abdominal wall defect compatible with an omphalocele detected by prenatal ultrasound. After the caesarean section, the abdominal wall defect was notable, the left liver lobe, intestines and heart emerged through it, the sternum also had a low fissure. The echocardiogram revealed a permeable oval foramen, mild tricuspid regurgitation, and severe pulmonary hypertension. EVOLUTION: Immediate surgical management was decided. Silo was placed, with progressive closure of the midline in 7 days. During the second surgical procedure, the diaphragmatic and pericardial defect was corrected with a bovine pericardial prosthesis. Despite the adequate evolution after surgery, at day 28 he presented with sudden cyanosis and didn't respond to cardiopulmonary resuscitation and died. CONCLUSIONS: Cantrell's Pentalogy is a rare disease, with peculiar clinical, anatomical and embryological characteristics, it represents a unique challenge for surgeons. Early diagnosis, as well as follow-up during pregnancy, planning a cesarean section in a high-level center and immediate surgical approach with a multidisciplinary team, are the key components in the management of patients with Cantrell's Pentalogy.
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Humanos , Masculino , Recién Nacido , Anomalías Congénitas , Pentalogía de Cantrell , Hernia Umbilical , Cuidados Posteriores , Pared AbdominalRESUMEN
BACKGROUND: In Mexico, neither the pathological profile nor the health/illness conditions of the cycle rickshaw taxi drivers have been studied. Therefore, the factors that influence the physical and mental health of this labor group are unknown. OBJECTIVE: To describe the characteristics of working and health/illness conditions that influence the stress level of the cycle rickshaw taxi drivers from Mexico City's Historic Downtown. MATERIAL AND METHODS: 90% (n = 110) of the workers participated in a cross-sectional study of a correlational type, in which a survey on working conditions and health was applied. Stress was analyzed using the Aro Symptomatic Scale, and vital signs, somatometry and a blood test were measured to analyze lipids and glucose. RESULTS: 16% of drivers were assessed with a high level of stress. No association was found with conditions related to physical and behavioral health, such as hypertension, dyslipidemia, diabetes, overweight, smoking and alcohol consumption. Therefore, the perception of violence risk (odds ratio [OR]: 1.19), the risks associated with the vehicle (OR: 1.18), having had a work accident (OR:38.2) and musculoskeletal complaints mainly, in the elbow (OR: 1.20) and wrists (OR: 1.11) are the factors that most influence the level of stress. CONCLUSIONS: The main cause of stress in drivers is related to the risks of their activity and musculoskeletal conditions, so interventions and action protocols are suggested to help preventing and face the risks of workers.
INTRODUCCIÓN: En México no han sido estudiados el perfil patológico ni las condiciones de salud/enfermedad de los conductores de bicitaxis, por lo que se desconocen los factores que influyen en la salud física y mental de este colectivo laboral. OBJETIVO: Describir las características del trabajo y las condiciones de salud/enfermedad que influyen en el nivel de estrés de los conductores de bicitaxis del Centro Histórico de la Ciudad de México. MATERIAL Y MÉTODOS: El 90% (n = 110) de los trabajadores participaron en un estudio transversal correlacional, en el que se aplicó una encuesta sobre las condiciones de trabajo y salud. Se analizó el estrés mediante la Escala Sintomática de Aro y se tomaron signos vitales, somatometría y muestras de sangre para analizar lípidos y glucosa. RESULTADOS: El 16% de los conductores presentaron un nivel de estrés elevado. No se encontró asociación con padecimientos afines a la salud física y conductual, como hipertensión, dislipidemias, diabetes, sobrepeso, tabaquismo o consumo de alcohol. Por lo tanto, la percepción de riesgo de agresiones en la vía pública (razón de momios [RM]: 1.19), los riesgos asociados al vehículo (RM: 1.18), haber tenido un accidente laboral (RM: 38.2) y las dolencias musculoesqueléticas -principalmente en el codo (RM: 1.20) y las muñecas (RM: 1.11)- son los factores que más influyen en el nivel de estrés. CONCLUSIONES: La principal causa de estrés en los conductores se relaciona con los riesgos de su actividad y con los padecimientos musculoesqueléticos, por lo que se sugieren intervenciones y protocolos de acción que ayuden a prevenir y a enfrentar los riesgos de estos trabajadores.
Asunto(s)
Conducción de Automóvil , Estrés Laboral , Estudios Transversales , Humanos , México/epidemiología , Estrés Laboral/epidemiología , Factores de RiesgoAsunto(s)
Ciclismo , Estado de Salud , Salud Laboral , Transportes , Adulto , Femenino , Humanos , Masculino , México , Salud UrbanaAsunto(s)
Humanos , Masculino , Femenino , Adulto , Transportes , Ciclismo , Estado de Salud , Salud Laboral , Salud Urbana , MéxicoRESUMEN
This article details the treatment of lymphangioma of the face with intralesional bleomycin: with a case report and literature review. Surgical treatment of lymphangioma of the face is a difficult task to achieve, due to close vicinity of the lesion to the facial nerve and possibility of scar tissue formation. Inefficient surgical removals generally will give rise to high recurrence rates because of infiltrative and diffuse extension of the lesion. However, complete cure has been described by non-surgical methods with intralesional bleomycin injection under ultrasonographic guidance. Lymphangioma is a rare congenital malformation of the lymphatic system, frequently seen in the head and neck. Percutaneous sclerotherapy of lymphangioma involves the injection of sclerosing substances into the lymphangioma. This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of lymphangioma, and to determine the incidence of complications in the treatment. Intralesional bleomycin therapy was very effective in the treatment of lymphangioma. Bleomycin administered as intralesional injection was found to be safe as there was no lesions complicating or side effects observed in the study.