Factores asociados a insuficiencia renal postoperatoria en cirugía de revascularización miocárdica

Introducción: La insuficiencia renal postoperatoria (IRP) es una complicación de alta prevalencia y de importancia en la cirugía cardiaca. Se estima que más del 30% de los pacientes sometidos a cirugía cardiaca desarrollan IRP clínicamente importante. Una estrategia razonable a realizar es la identificación de factores de riesgo modificables para intervenir sobre ellos. Objetivos: Determinar cuáles de los antecedentes clínicos del paciente y factores relacionados con el procedimiento quirúrgico se asocian a la aparición de IRP en pacientes sometidos a cirugía de –revascularización miocárdica (RVM). Métodos: Estudio de casos y controles. Casos fueron pacientes sometidos a cirugía de revascularización miocárdica electiva que presentaron insuficiencia renal postoperatoria durante el postoperatorio inmediato hasta el egreso. Controles pacientes sometidos a cirugía de revascularización miocárdica electiva que no presentaron insuficiencia renal postoperatoria durante el postoperatorio inmediato hasta el egreso. Estudio realizado entre enero de 2005 y diciembre de 2013. Se realizó un modelo de regresión logística para determinar los factores asociados a insuficiencia renal posoperatoria. Las asociaciones se expresan en OR con sus respectivos intervalos de confianza. Resultados: Edad avanzada OR 1.03 IC 95% (1.01-1.04), presencia preoperatoria de diabetes mellitus OR 1.8 IC 95% (1.9-3.4), enfermedad pulmonar OR 1.3 IC 95% (1.1-1.6), dislipidemia OR 3.5 IC 95% (1.7-7.1), insuficiencia cardiaca OR 2.7 IC 95% (1.1-6.7) y mayor tiempo de perfusión OR 1.02 IC 95% (1.01-1.03) se asociaron a mayor riesgo de IRP. Mayor hematocrito OR 0.86 IC95% (0.82-0.91) y mayor fracción de eyección OR 0.94 IC 95% (0.92-0.96) se asociaron disminuyendo el riesgo de IRP. Conclusiones: En pacientes sometidos a RVM los factores asociados a la presentación de IRP fueron comorbilidades que se asocian a daño renal progresivo dentro y fuera del contexto de la cirugía. Esto implica que las estrategias para minimizar este evento estarán enfocadas a identificar tempranamente los pacientes y realizar una adecuada nefroprotección.

Análisis de supervivencia en pacientes con prótesis valvular biológica, Fundación Cardioinfantil-Instituto de Cardiología, Colombia, 2005-2013

Introducción: A partir de la década de los cincuenta el manejo de la enfermedad valvular presenta cambios significativos cuando se incorporan los reemplazos valvulares tanto mecánicos como biológicos dentro de las opciones de tratamiento quirúrgico (1). Las válvulas biológicas se desarrollaron como una alternativa que buscaba evitar los problemas relacionados con la anticoagulación y con la idea de utilizar un tejido que se comportara hemodinámicamente como el nativo. Este estudio está enfocado en establecer la sobrevida global y la libertad de reoperación de la válvula de los pacientes sometidos a reemplazo valvular aórtico y mitral biológicos en la Fundación Cardioinfantil - IC a 1, 3, 5 y 10 años. Materiales y métodos: Estudio de cohorte retrospectiva de supervivencia de pacientes sometidos a reemplazo valvular aórtico y/o mitral biológico intervenidos en la Fundación Cardioinfantil entre 2005 y 2013. Resultados: Se obtuvieron 919 pacientes incluidos en el análisis general y 876 (95,3%) pacientes con seguimiento efectivo para el análisis de sobrevida. La edad promedio fue 64años. La sobrevida a 1, 3, 5 y 10 años fue 95%,90%,85% y 69% respectivamente. El seguimiento efectivo para el desenlace reoperación fue del 55% y se encontró una libertad de reoperación del 99%, 96%, 93% y 81% a los 1, 3, 5 y 10 años. No hubo diferencias significativas entre la localización de la válvula ni en el tipo de válvula aortica empleada. Conclusiones: La sobrevida de los pacientes que son llevados a reemplazo valvular biológico en este estudio es comparable a grandes cohortes internacionales. La sobrevida de los pacientes llevados a reemplazo valvular con prótesis biológicas en posición mitral y aortica fue similar a 1, 3, 5 y 10 años.

MusiCam: an instrument to demonstrate chromaphonic synesthesia

Inspired by a type of synesthesia where colour typically induces musical notes the MusiCam project investigates this unusual condition, particularly the transition from colour to sound. MusiCam explores the potential benefits of this idiosyncrasy as a mode of human computer interaction (1-10), providing a host of meaningful applications spanning control, communication and composition. Colour data is interpreted by means of an off-the-shelf webcam, and music is generated in real-time through regular speakers. By making colour-based gestures users can actively control the parameters of sounds, compose melodies and motifs or mix multiple tracks on the fly. The system shows great potential as an interactive medium and as a musical controller. The trials conducted to date have produced encouraging results, and only hint at the new possibilities achievable by such a device.

Vertical ion flow in the polar ionosphere

Outflowing ions from the polar ionosphere fall into two categories: the classical polar wind and the suprathermal ion flows. The flows in both these categories vary a great deal with altitude. The classical polar wind is supersonic at high altitude: at ∼3 RE geocentric, the observed polar wind is H+ dominated and has a Mach number of 2.5–5.1. At 400–600 km, thermal and suprathermal upward O+ ion fluxes frequently occur at the poleward edge of the nightside auroral oval during magnetically active times. Above 500 km, ions are accelerated transverse to the local geomagnetic field. At 1400 km, transversely accelerated ions are frequently observed in winter nights but rarely appear in the summer. In the dayside cleft above ∼2000 km, ions of all species are transversely heated and upwell with significant number and heat fluxes, forming a cleft ion fountain as they convect across the polar cap. Upwelling ions are observed most (least) frequently in the summer (winter). At yet higher altitudes, energetic (>10 eV to several kiloelectron volts) upflowing H+ and O+ ions are frequently observed, their active time occurrence frequency being as high as 0.7 at auroral latitudes and 0.3 in the polar cap. Their composition, intensity, and angular characteristics vary quantitatively with solar activity, being O+ dominant and more intense near solar maximum. Their resulting ion outflow is dominated by ions below 1 keV and reaches 3.5×10^26 O+ and 7×10^25 H+ ions s^{−1} at magnetically active times (Kp≥5) near solar maximum. In comparison, the estimated polar wind ion outflow at times of moderate solar activity is 7×10^25H+ and 4×10^24 He+ ions s^{−1}. The estimated <10-eV cleft ion fountain flow is 3.8×10^25 O+ and 8.6×10^23 H+ ions s^{−1} near solar maximum.

Permanent Genetic Resources added to Molecular Ecology Resources Database 1 May 2009-31 July 2009

This article documents the addition of 512 microsatellite marker loci and nine pairs of Single Nucleotide Polymorphism (SNP) sequencing primers to the Molecular Ecology Resources Database. Loci were developed for the following species: Alcippe morrisonia morrisonia, Bashania fangiana, Bashania fargesii, Chaetodon vagabundus, Colletes floralis, Coluber constrictor flaviventris, Coptotermes gestroi, Crotophaga major, Cyprinella lutrensis, Danaus plexippus, Fagus grandifolia, Falco tinnunculus, Fletcherimyia fletcheri, Hydrilla verticillata, Laterallus jamaicensis coturniculus, Leavenworthia alabamica, Marmosops incanus, Miichthys miiuy, Nasua nasua, Noturus exilis, Odontesthes bonariensis, Quadrula fragosa, Pinctada maxima, Pseudaletia separata, Pseudoperonospora cubensis, Podocarpus elatus, Portunus trituberculatus, Rhagoletis cerasi, Rhinella schneideri, Sarracenia alata, Skeletonema marinoi, Sminthurus viridis, Syngnathus abaster, Uroteuthis (Photololigo) chinensis, Verticillium dahliae, Wasmannia auropunctata, and Zygochlamys patagonica. These loci were cross-tested on the following species: Chaetodon baronessa, Falco columbarius, Falco eleonorae, Falco naumanni, Falco peregrinus, Falco subbuteo, Didelphis aurita, Gracilinanus microtarsus, Marmosops paulensis, Monodelphis Americana, Odontesthes hatcheri, Podocarpus grayi, Podocarpus lawrencei, Podocarpus smithii, Portunus pelagicus, Syngnathus acus, Syngnathus typhle,Uroteuthis (Photololigo) edulis, Uroteuthis (Photololigo) duvauceli and Verticillium albo-atrum. This article also documents the addition of nine sequencing primer pairs and sixteen allele specific primers or probes for Oncorhynchus mykiss and Oncorhynchus tshawytscha; these primers and assays were cross-tested in both species.

NEW CHARACTERIZATIONS OF COMPLETE SPACELIKE SUBMANIFOLDS IN SEMI-RIEMANNIAN SPACE FORMS

In this paper we study n-dimensional complete spacelike submanifolds with constant normalized scalar curvature immersed in semi-Riemannian space forms. By extending Cheng-Yau`s technique to these ambients, we obtain results to such submanifolds satisfying certain conditions on both the squared norm of the second fundamental form and the mean curvature. We also characterize compact non-negatively curved submanifolds in De Sitter space of index p.

Curvature Estimates for Submanifolds in Warped Products

We give estimates of the intrinsic and the extrinsic curvature of manifolds that are isometrically immersed as cylindrically bounded submanifolds of warped products. We also address extensions of the results in the case of submanifolds of the total space of a Riemannian submersion.

Gestão governamental: superando a crise

A publicação Gestão Governamental: Superando a Crise busca contribuir para a análise de medidas adotadas em diversos lugares para a superação da crise econômica mundial e incentivar a troca de experiências entre os setores público e acadêmico. A publicação conta com uma entrevista exclusiva com o Prefeito de São Paulo, Gilberto Kassab, e conferências do governador de São Paulo, José Serra, e dos professores Andrea Calabi, Yoshiaki Nakano, Antônio Lavareda e Fernando Blumenschein.

Três métodos para o cálculo da série zeta(2n) de Riemann

Neste trabalho apresentamos três métodos distintos provando que S(n) = +1 X k=−1 (4k + 1)−n é um múltiplo racional de n para todos os inteiros n = 1, 2, 3, . . . O primeiro utiliza a teoria das função analíticas e funções geradoras. No segundo reduzimos o problema, via mudança de variável devida a E. Calabi, ao cálculo do volume de certos politopos em Rn enquanto que no terceiro usamos a teoria dos operadores integrais compactos. Cada um dos métodos tem um interesse intrínsico e está sujeito a generalizações para aplicações em novas situações.

A indústria na crise: uma comparação entre os setores competitivos e oligopolizados

O objetivo desta dissertação é averiguar o comportamento do setor industrial, destacando as diferenças existentes entre o segmento competitivo e oligopolizado.

Parcerias Público-Privadas no Brasil

Diante das transformações socioeconômicas experimentadas pelo Brasil ao longo da última década e dos desafios provenientes dos grandes eventos esportivos a serem sediados no país a partir deste ano, o desenvolvimento da infraestrutura e as parcerias do Estado com o setor privado tornam-se fatores essenciais. Neste contexto, a 23ª edição dos Cadernos FGV Projetos: Parcerias Público-Privadas no Brasil apresenta algumas das experiências mais bem sucedidas no Brasil, pela visão de especialistas e autoridades dos setores público e privado, como José Múcio, ministro do Tribunal de Contas da União, Luciano Coutinho, presidente do BNDES, Roberto Vellutini, vice-presidente de países do Banco Interamericano de Desenvolvimento, Andrea Calabi, secretário da Fazenda do Estado de São Paulo, e Geraldo Villin, diretor superintendente de Parcerias Públicas da Odebrecht Properties

Permanent Genetic Resources added to Molecular Ecology Resources Database 1 May 2009-31 July 2009

This article documents the addition of 512 microsatellite marker loci and nine pairs of Single Nucleotide Polymorphism (SNP) sequencing primers to the Molecular Ecology Resources Database. Loci were developed for the following species: Alcippe morrisonia morrisonia, Bashania fangiana, Bashania fargesii, Chaetodon vagabundus, Colletes floralis, Coluber constrictor flaviventris, Coptotermes gestroi, Crotophaga major, Cyprinella lutrensis, Danaus plexippus, Fagus grandifolia, Falco tinnunculus, Fletcherimyia fletcheri, Hydrilla verticillata, Laterallus jamaicensis coturniculus, Leavenworthia alabamica, Marmosops incanus, Miichthys miiuy, Nasua nasua, Noturus exilis, Odontesthes bonariensis, Quadrula fragosa, Pinctada maxima, Pseudaletia separata, Pseudoperonospora cubensis, Podocarpus elatus, Portunus trituberculatus, Rhagoletis cerasi, Rhinella schneideri, Sarracenia alata, Skeletonema marinoi, Sminthurus viridis, Syngnathus abaster, Uroteuthis (Photololigo) chinensis, Verticillium dahliae, Wasmannia auropunctata, and Zygochlamys patagonica. These loci were cross-tested on the following species: Chaetodon baronessa, Falco columbarius, Falco eleonorae, Falco naumanni, Falco peregrinus, Falco subbuteo, Didelphis aurita, Gracilinanus microtarsus, Marmosops paulensis, Monodelphis Americana, Odontesthes hatcheri, Podocarpus grayi, Podocarpus lawrencei, Podocarpus smithii, Portunus pelagicus, Syngnathus acus, Syngnathus typhle,Uroteuthis (Photololigo) edulis, Uroteuthis (Photololigo) duvauceli and Verticillium albo-atrum. This article also documents the addition of nine sequencing primer pairs and sixteen allele specific primers or probes for Oncorhynchus mykiss and Oncorhynchus tshawytscha; these primers and assays were cross-tested in both species.

The Euler number of OGradys 10-dimensional symplectic manifold

Wir berechnen die Eulerzahl der 10-dimensionalen exzeptionellen irreduziblen symplektischen Mannigfaltigkeit, die von O Grady konstruiert wurde. Die Idee besteht darin, zunächst eine Lagrangefaserung zu konstruieren und dann die Eulerzahlen der Fasern zu berechnen. Es stellt sich heraus, dass fast alle Fasern die Eulerzahl 0 haben, und deswegen reduziert sich das Problem auf die Berechnung der Eulerzahlen der übrigen Fasern. Diese Fasern sind Modulräume von halbstabilen Garben auf singulären Kurven. Der Hauptteil dieser Dissertation ist der Berechnung der Eulerzahlen dieser Modulräume gewidmet. Diese Resultate sind von unabhängigem Interesse.

Pseudodifferential analysis in Psi*-algebras on transmission spaces, infinite solving ideal chains and K-theory for conformally compact spaces

The present thesis is a contribution to the theory of algebras of pseudodifferential operators on singular settings. In particular, we focus on the $b$-calculus and the calculus on conformally compact spaces in the sense of Mazzeo and Melrose in connection with the notion of spectral invariant transmission operator algebras. We summarize results given by Gramsch et. al. on the construction of $Psi_0$-and $Psi*$-algebras and the corresponding scales of generalized Sobolev spaces using commutators of certain closed operators and derivations. In the case of a manifold with corners $Z$ we construct a $Psi*$-completion $A_b(Z,{}^bOmega^{1/2})$ of the algebra of zero order $b$-pseudodifferential operators $Psi_{b,cl}(Z, {}^bOmega^{1/2})$ in the corresponding $C*$-closure $B(Z,{}^bOmega^{12})hookrightarrow L(L^2(Z,{}^bOmega^{1/2}))$. The construction will also provide that localised to the (smooth) interior of Z the operators in the $A_b(Z, {}^bOmega^{1/2})$ can be represented as ordinary pseudodifferential operators. In connection with the notion of solvable $C*$-algebras - introduced by Dynin - we calculate the length of the $C*$-closure of $Psi_{b,cl}^0(F,{}^bOmega^{1/2},R^{E(F)})$ in $B(F,{}^bOmega^{1/2}),R^{E(F)})$ by localizing $B(Z, {}^bOmega^{1/2})$ along the boundary face $F$ using the (extended) indical familiy $I^B_{FZ}$. Moreover, we discuss how one can localise a certain solving ideal chain of $B(Z, {}^bOmega^{1/2})$ in neighbourhoods $U_p$ of arbitrary points $pin Z$. This localisation process will recover the singular structure of $U_p$; further, the induced length function $l_p$ is shown to be upper semi-continuous. We give construction methods for $Psi*$- and $C*$-algebras admitting only infinite long solving ideal chains. These algebras will first be realized as unconnected direct sums of (solvable) $C*$-algebras and then refined such that the resulting algebras have arcwise connected spaces of one dimensional representations. In addition, we recall the notion of transmission algebras on manifolds with corners $(Z_i)_{iin N}$ following an idea of Ali Mehmeti, Gramsch et. al. Thereby, we connect the underlying $C^infty$-function spaces using point evaluations in the smooth parts of the $Z_i$ and use generalized Laplacians to generate an appropriate scale of Sobolev spaces. Moreover, it is possible to associate generalized (solving) ideal chains to these algebras, such that to every $ninN$ there exists an ideal chain of length $n$ within the algebra. Finally, we discuss the $K$-theory for algebras of pseudodifferential operators on conformally compact manifolds $X$ and give an index theorem for these operators. In addition, we prove that the Dirac-operator associated to the metric of a conformally compact manifold $X$ is not a Fredholm operator.