Patología biliar en el hospital San Vicente de Paúl: revisión estadística añós 67-71

Doctor en Medicina y Cirugía

Symmetry reduction due to gallium substitution in the garnet Li6.43(2)Ga0.52(3)La2.67(4)Zr2O12

Single-crystal structure refinements on lithium lanthanum zirconate (LLZO; Li7La3Zr2O12) substituted with gallium were successfully carried out in the cubic symmetry space group I [Formula: see text]3d. Gallium was found on two lithium sites as well as on the lanthanum position. Due to the structural distortion of the resulting Li6.43(2)Ga0.52(3)La2.67(4)Zr2O12 (Ga-LLZO) single crystals, a reduction of the LLZO cubic garnet symmetry from Ia[Formula: see text] d to I [Formula: see text]3d was necessary, which could hardly be analysed from X-ray powder diffraction data.

MAGIC observations of the February 2014 flare of 1ES 1011+496 and ensuing constraint of the EBL density

Context. In February-March 2014, the MAGIC telescopes observed the high-frequency peaked BL Lac 1ES 1011+496 (z=0.212) in flaring state at very-high energy (VHE, E>100GeV). The flux reached a level more than 10 times higher than any previously recorded flaring state of the source. Aims. Description of the characteristics of the flare presenting the light curve and the spectral parameters of the night-wise spectra and the average spectrum of the whole period. From these data we aim at detecting the imprint of the Extragalactic Background Light (EBL) in the VHE spectrum of the source, in order to constrain its intensity in the optical band. Methods. We analyzed the gamma-ray data from the MAGIC telescopes using the standard MAGIC software for the production of the light curve and the spectra. For the constraining of the EBL we implement the method developed by the H.E.S.S. collaboration in which the intrinsic energy spectrum of the source is modeled with a simple function (< 4 parameters), and the EBL-induced optical depth is calculated using a template EBL model. The likelihood of the observed spectrum is then maximized, including a normalization factor for the EBL opacity among the free parameters. Results. The collected data allowed us to describe the flux changes night by night and also to produce di_erential energy spectra for all nights of the observed period. The estimated intrinsic spectra of all the nights could be fitted by power-law functions. Evaluating the changes in the fit parameters we conclude that the spectral shape for most of the nights were compatible, regardless of the flux level, which enabled us to produce an average spectrum from which the EBL imprint could be constrained. The likelihood ratio test shows that the model with an EBL density 1:07 (-0.20,+0.24)stat+sys, relative to the one in the tested EBL template (Domínguez et al. 2011), is preferred at the 4:6 σ level to the no-EBL hypothesis, with the assumption that the intrinsic source spectrum can be modeled as a log-parabola. This would translate into a constraint of the EBL density in the wavelength range [0.24 μm,4.25 μm], with a peak value at 1.4 μm of λF_ = 12:27^(+2:75)_ (-2:29) nW m^(-2) sr^(-1), including systematics.

Multiwavelength observations of the blazar 1ES 1011+496 in Spring 2008

The BL Lac object 1ES 1011+496 was discovered at Very High Energy (VHE, E>100GeV) γ-rays by MAGIC in spring 2007. Before that the source was little studied in different wavelengths. Therefore a multi-wavelength (MWL) campaign was organized in spring 2008. Along MAGIC, the MWL campaign included the Mets¨ahovi radio observatory, Bell and KVA optical telescopes and the Swift and AGILE satellites. MAGIC observations span from March to May, 2008 for a total of 27.9 hours, of which 19.4 hours remained after quality cuts. The light curve showed no significant variability yielding an integral flux above 200 GeV of (1.3 ± 0.3) × 10^(−11) photons cm^(−2) s^( −1) . The differential VHE spectrum could be described with a power-law function with a spectral index of 3.3 ± 0.4. Both results were similar to those obtained during the discovery. Swift XRT observations revealed an X-ray flare, characterized by a harder-when-brighter trend, as is typical for high synchrotron peak BL Lac objects (HBL). Strong optical variability was found during the campaign, but no conclusion on the connection between the optical and VHE γ-ray bands could be drawn. The contemporaneous SED shows a synchrotron dominated source, unlike concluded in previous work based on non-simultaneous data, and is well described by a standard one–zone synchrotron self–Compton model. We also performed a study on the source classification. While the optical and X-ray data taken during our campaign show typical characteristics of an HBL, we suggest, based on archival data, that 1ES 1011+496 is actually a borderline case between intermediate and high synchrotron peak frequency BL Lac objects.

Insights into the emission of the blazar 1ES 1011+496 through unprecedented broadband observations during 2011 and 2012

Context. 1ES 1011+496 (z = 0.212) was discovered in very high-energy (VHE, E >100 GeV) γ rays with MAGIC in 2007. The absence of simultaneous data at lower energies led to an incomplete characterization of the broadband spectral energy distribution (SED). Aims. We study the source properties and the emission mechanisms, probing whether a simple one-zone synchrotron self-Compton (SSC) scenario is able to explain the observed broadband spectrum. Methods. We analyzed data in the range from VHE to radio data from 2011 and 2012 collected by MAGIC, Fermi-LAT, Swift, KVA, OVRO, and Metsähovi in addition to optical polarimetry data and radio maps from the Liverpool Telescope and MOJAVE. Results. The VHE spectrum was fit with a simple power law with a photon index of 3.69 ± 0.22 and a flux above 150 GeV of (1.46±0.16)×10^(−11) ph cm^(−2) s^(−1) . The source 1ES 1011+496 was found to be in a generally quiescent state at all observed wavelengths, showing only moderate variability from radio to X-rays. A low degree of polarization of less than 10% was measured in optical, while some bright features polarized up to 60% were observed in the radio jet. A similar trend in the rotation of the electric vector position angle was found in optical and radio. The radio maps indicated a superluminal motion of 1.8 ± 0.4 c, which is the highest speed statistically significant measured so far in a high-frequency-peaked BL Lac. Conclusions. For the first time, the high-energy bump in the broadband SED of 1ES 1011+496 could be fully characterized from 0.1 GeV to 1 TeV, which permitted a more reliable interpretation within the one-zone SSC scenario. The polarimetry data suggest that at least part of the optical emission has its origin in some of the bright radio features, while the low polarization in optical might be due to the contribution of parts of the radio jet with different orientations of the magnetic field with respect to the optical emission.

Adaptação de embalagens de produtos de Marca Própria ao Regulamento 1169/2011 de Informação ao Consumidor

A rotulagem é uma forma legal que assegura a defesa e a proteção do consumidor. O rótulo presta todas as informações necessárias e importantes que levam à decisão desse consumidor, consoante as suas necessidades sejam elas de saúde ou nutricionais, por um ou outro género alimentício. Além de favorecer um correto armazenamento, preparação e consumo dos alimentos (aumentando a segurança alimentar). É de elevada importância que a legislação relativa à rotulagem seja atualizada, acompanhando a evolução e as exigências da sociedade. Neste sentido, foi pulicado o Regulamento (UE) n.º 1169/2011 relativo à informação aos consumidores sobre os géneros alimentícios que veio alterar os regulamentos (CE) n.º1924/2006 e (CE) n.º1925/2006 do Parlamento Europeu e do Conselho e revoga as Diretivas 87/250/CEE da Comissão, 90/496/CEE do Conselho, 1999/10/CE da Comissão, 2000/13/CEE do Parlamento Europeu e do Conselho, 2002/67/CE da Comissão e o Regulamento (CE) n.º 608/2004 da Comissão. Este regulamento teve como principais objetivos atualizar e consolidar a legislação sobre rotulagem geral e nutricional, eliminar as incoerências entre diferentes atos legislativos, facilitar a livre circulação dos géneros alimentícios entre Estados Membros e clarificar as responsabilidades dos diferentes intervenientes da cadeia alimentar. A adoção deste novo regulamento consistiu num marco importante na legislação relativa à rotulagem, implicando novas obrigações para as empresas. Foi neste contexto que se desenvolveu este estágio, num curto espaço de tempo alterou-se todos os rótulos “marca Auchan” para permanecerem em conformidade com a lei. A adaptação foi efetuada em cerca de 1000 rótulos, de vários setores da área alimentar, nomeadamente leite e derivados, carne, produtos da pesca, ovos, etc. Todo o trabalho ficou concluído ao final de 1 ano e 4 meses, sendo que o deadline estipulado foi cumprido e todos os rótulos foram corrigidos antes do regulamento ter tido aplicação obrigatória (dia 13 de dezembro de 2014). Conclui-se que a metodologia de correções aplicada teve um grau de sucesso de 100 %, pois não houve alterações posteriores (devido a erros cometidos) ao término de qualquer rótulo. Também se pode afirmar que o regulamento, apesar de vir simplificar e harmonizar o tema da rotulagem de géneros alimentícios, ainda deixou algumas lacunas, remetendo sempre para medidas nacionais.

Practice links [Issue 67, April 2016]

Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.

Resolución 67 del 02 de junio de 2009: ¿Cual es el control de legalidad que tiene la Cámara de Comercio sobre las renuncias de los apoderados especiales en las sucursales?

Servicios registrales

Análisis de la relación bilateral colombo – estadounidense en materia de seguridad y defensa durante el periodo 2002 – 2014, y su incidencia en la diversificación de la política exterior colombiana.

El interés de esta monografía es analizar la transformación de relación bilateral colombo – estadounidense en materia de seguridad y defensa durante el periodo 2002 – 2014, y cómo dicha transformación puede incidir en la formulación de la política exterior colombiana. Se analizará la política exterior de Álvaro Uribe Vélez y la del actual presidente Juan Manuel Santos. Esto se llevará a cabo bajo dos de las teorías de Relaciones Internacionales, el realismo subalterno y neoclásico, las cuales ayudarán a entender el porqué del cambio de la política exterior de colombiana.

Imaginarios sociales de adolescentes y docentes en torno al cuerpo, la corporalidad y la actividad física. Estudio cualitativo en un colegio de Bogotá, 2014-2015.

Problema. Esta investigación se aproxima al entorno escolar con el propósito de avanzar en la comprensión de los imaginarios de los adolescentes y docentes en torno al cuerpo, la corporalidad y la AF, como un elemento relevante en el diseño de programas y planes efectivos para fomento de la práctica de AF. Objetivo. Analizar los imaginarios sociales de docentes y adolescentes en torno a los conceptos de cuerpo, corporalidad y AF. Métodos. Investigación de corte cualitativo, descriptivo e interpretativo. Se realizaron entrevistas semi-estructuradas a docentes y a estudiantes entre los 12 y 18 años de un colegio público de Bogotá. Se realizó análisis de contenido. Se compararon los resultados de estudiantes por grupos de edades y género. Resultados. Docentes y estudiantes definen el cuerpo a partir de las características biológicas, las diferencias sexuales y las funciones vitales. La definición de corporalidad en los estudiantes se encuentra ligada con la imagen y la apariencia física; los docentes la entienden como la posibilidad de interactuar con el entorno y como la materialización de la existencia. La AF en los estudiantes se asocia con la práctica de ejercicio y deporte, en los docentes se comprende como una práctica de autocuidado que permite el mantenimiento de la salud. Conclusiones. Para promover la AF tempranamente como una experiencia vital es necesario intervenir los espacios escolares. Hay que vincular al cuerpo a los procesos formativos con el propósito de desarrollar la autonomía corporal, este aspecto implica cambios en los currículos.

Asociación de las violencias física, sexual y comunitaria con el embarazo en adolescentes: análisis multinivel

Objetivos Determinar si existe asociación entre la exposición a violencia, experimentada a nivel individual o municipal, y el embarazo adolescente en mujeres Colombianas entre 13 y 19 años de edad que contestaron la Encuesta de Demografía y Salud en el año 2010. Métodos Estudio de corte transversal, nacional y multinivel. Se tomaron datos de dos niveles jerárquicos: Nivel- 1: Datos individuales de una muestra representativa de 13.313 mujeres entre 13 y 19 años de edad provenientes de La Encuesta Nacional de Demografía y Salud del año 2010 y Nivel- 2: Datos municipales de 258 municipios provenientes de las estadísticas vitales del DANE. Resultados La prevalencia del embarazo adolescente fue del 16.8% IC 95% [16.2-17.4]. El análisis mostró que la asociación entre embarazo adolescente y violencia tanto individual, representada como violencia sexual [OR= 6.99 IC99% 4.80-10.10] y violencia física [OR= 1.74 IC99% 1.47-2.05] así como la violencia municipal medida con tasas de homicidios altas [OR= 1.99 IC99% 1.29-3.07] y muy altas [OR= 2.10 IC99% 1.21-3.61] se mantuvo estadísticamente significativa después de ajustar por las variables: Edad [OR= 1.81 IC99% 1.71-1.91], ocupación [OR= 1.62 IC99% 1.37-1.93], educación primaria o sin educación [OR= 2.20 IC99% 1.47-3.30], educación secundaria [OR= 1.70 IC99% 1.24-2.32], asistir al colegio [OR= 0.18 IC99% 0.15-0.21], conocimiento en la fisiología reproductiva [OR= 1.28 IC99% 1.06-1.54], el índice de riqueza Q1, Q2, Q3 [OR= 2.18 IC99% 1.42-3.34], [OR= 2.00 IC99% 1.39-2.28], [OR= 1.82 IC99% 1.92-2.25] y alto porcentaje de Necesidades básicas insatisfechas a nivel municipal [OR= 2.34 IC99% 1.55-3.52]. Conclusiones Este estudio mostró una relación significativamente estadística entre la violencia sexual y física con el inicio de relaciones sexuales y embarazo adolescente después de controlar por factores sociodemográficos y conocimientos en reproducción sexual en mujeres colombianas de 13 a 19 años en el año 2010. Esta asociación debe continuar siendo estudiada para lograr optimizar las estrategias de prevención y disminuir la tasa actual de embarazos adolescentes en el país y sus consecuencias.

Egfr Activating Mutations And Their Association With Response To Platinum-doublet Chemotherapy In Brazilian Non-small Cell Lung Cancer Patients.

The aim of the study was to analyze the frequency of epidermal growth factor receptor (EGFR) mutations in Brazilian non-small cell lung cancer patients and to correlate these mutations with response to benefit of platinum-based chemotherapy in non-small cell lung cancer (NSCLC). Our cohort consisted of prospective patients with NSCLCs who received chemotherapy (platinum derivates plus paclitaxel) at the [UNICAMP], Brazil. EGFR exons 18-21 were analyzed in tumor-derived DNA. Fifty patients were included in the study (25 with adenocarcinoma). EGFR mutations were identified in 6/50 (12 %) NSCLCs and in 6/25 (24 %) adenocarcinomas; representing the frequency of EGFR mutations in a mostly self-reported White (82.0 %) southeastern Brazilian population of NSCLCs. Patients with NSCLCs harboring EGFR exon 19 deletions or the exon 21 L858R mutation were found to have a higher chance of response to platinum-paclitaxel (OR 9.67 [95 % CI 1.03-90.41], p = 0.047). We report the frequency of EGFR activating mutations in a typical southeastern Brazilian population with NSCLC, which are similar to that of other countries with Western European ethnicity. EGFR mutations seem to be predictive of a response to platinum-paclitaxel, and additional studies are needed to confirm or refute this relationship.

Lung Age Is Related To Carotid Structural Alterations In Hypertensive Subjects.

Hypertensive patients exhibit higher cardiovascular risk and reduced lung function compared with the general population. Whether this association stems from the coexistence of two highly prevalent diseases or from direct or indirect links of pathophysiological mechanisms is presently unclear. This study investigated the association between lung function and carotid features in non-smoking hypertensive subjects with supposed normal lung function. Hypertensive patients (n = 67) were cross-sectionally evaluated by clinical, hemodynamic, laboratory, and carotid ultrasound analysis. Forced vital capacity, forced expired volume in 1 second and in 6 seconds, and lung age were estimated by spirometry. Subjects with ventilatory abnormalities according to current guidelines were excluded. Regression analysis adjusted for age and prior smoking history showed that lung age and the percentage of predicted spirometric parameters associated with common carotid intima-media thickness, diameter, and stiffness. Further analyses, adjusted for additional potential confounders, revealed that lung age was the spirometric parameter exhibiting the most significant regression coefficients with carotid features. Conversely, plasma C-reactive protein and matrix-metalloproteinases-2/9 levels did not influence this relationship. The present findings point toward lung age as a potential marker of vascular remodeling and indicate that lung and vascular remodeling might share common pathophysiological mechanisms in hypertensive subjects.

Microbial Evaluation Of Traumatized Teeth Treated With Triple Antibiotic Paste Or Calcium Hydroxide With 2% Chlorhexidine Gel In Pulp Revascularization.

Revascularization outcome depends on microbial elimination because apical repair will not happen in the presence of infected tissues. This study evaluated the microbial composition of traumatized immature teeth and assessed their reduction during different stages of the revascularization procedures performed with 2 intracanal medicaments. Fifteen patients (7-17 years old) with immature teeth were submitted to the revascularization procedures; they were divided into 2 groups according to the intracanal medicament used: TAP group (n = 7), medicated with a triple antibiotic paste, and CHP group (n = 8), dressed with calcium hydroxide + 2% chlorhexidine gel. Samples were taken before any treatment (S1), after irrigation with 6% NaOCl (S2), after irrigation with 2% chlorhexidine (S3), after intracanal dressing (S4), and after 17% EDTA irrigation (S5). Cultivable bacteria recovered from the 5 stages were counted and identified by means of polymerase chain reaction assay (16S rRNA). Both groups had colony-forming unit counts significantly reduced after S2 (P < .05); however, no significant difference was found between the irrigants (S2 and S3, P = .99). No difference in bacteria counts was found between the intracanal medicaments used (P = .95). The most prevalent bacteria detected were Actinomyces naeslundii (66.67%), followed by Porphyromonas endodontalis, Parvimonas micra, and Fusobacterium nucleatum, which were detected in 33.34% of the root canals. An average of 2.13 species per canal was found, and no statistical correlation was observed between bacterial species and clinical/radiographic features. The microbial profile of infected immature teeth is similar to that of primarily infected permanent teeth. The greatest bacterial reduction was promoted by the irrigation solutions. The revascularization protocols that used the tested intracanal medicaments were efficient in reducing viable bacteria in necrotic immature teeth.