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ABSTRACT Introduction: Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of all urothelial tumors (1). Radical nephroureterectomy (RNU) remains the standard treatment for high, and low-grade UTUC (2). Although the open approach has been considered the gold standard, robotic techniques have shown comparable oncological outcomes with potential advantages in terms of peri-operative morbidity (3). Materials and Methods: We present a novel “Keyhole” technique for management of distal ureter and bladder cuff during robotic RNU. This technique allows the surgeon to directly visualize the ureteric orifices, delineate resection borders, and maintain oncologic principles of en-bloc excision without necessitating secondary cystotomy incision or concomitant endoscopic procedure. Descriptive demographic characteristics, surgical, pathological, and oncological outcomes were analyzed. Complications were reported using the Clavien-Dindo classification system. Results: Between 2015 and 2020, ten patients underwent robotic RNU with bladder cuff excision using the Keyhole technique (single-dock, single-position). Median age was 75 years. Eight patients underwent surgery for right-sided tumors. Median operative time, estimated blood loss, and length of hospital stay were 287 min, 100 mL, and 3 days, respectively. No intraoperative complications occurred, and one grade II complication occurred during the 90-day postoperative period. All patients had high-grade UTUC, being 90% pure urothelial. Bladder recurrences occurred in 30% of patients with an overall median follow-up of 11.2 months. Conclusions: Keyhole technique for the management of distal ureter and bladder cuff during RNU represents a feasible approach with minimal 90-day complications and low bladder recurrence rate at centers of experience.

https://doi.org/10.1590/s1677-5538.ibju.2022.0147

Acute kidney injury and renal replacement therapy: terminology standardization
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Reis, Thiago

; Colares, Vinicius Sardão

; Rocha, Eduardo

; Younes-Ibrahim, Mauricio

; Lima, Emerson Quintino de

; Andrade, Lucia da Conceição

; Ponce, Daniela

; Suassuna, José H. Rocco

; Yu, Luis

Brazilian Journal of Nephrology

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Set 2022, Volume 44 Nº 3 Páginas 434 - 442

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo O Departamento de Injúria Renal Aguda (IRA) da Sociedade Brasileira de Nefrologia elaborou o presente documento para fins de padronização da terminologia em IRA e modalidades dialíticas na língua portuguesa para o Brasil. Diversos termos com significados semelhantes têm sido empregados em IRA e suas modalidades dialíticas, causando confusão e disparidades entre pacientes, nefrologistas, instituições de saúde, empresas privadas de assistência, seguradoras e entidades governamentais. Essas disparidades podem impactar a assistência médica, a organização e o atendimento hospitalares, assim como o financiamento e reembolso dos procedimentos relacionados com a IRA. Assim, nomenclatura e definições consensuais foram elaboradas, incluindo-se as definições de IRA, doença renal aguda (DRA) e doença renal crônica (DRC). Adicionalmente, todas as modalidades dialíticas e os procedimentos extracorpóreos relacionados a IRA, atualmente aprovados e disponíveis no país, foram abordados. A Sociedade Brasileira de Nefrologia espera que este Consenso possa padronizar a nomenclatura e prover suporte técnico para todos os atores envolvidos na assistência à IRA no Brasil.

Abstract The Department of Acute Kidney Injury (IRA) of the Brazilian Society of Nephrology prepared this document for the purpose of standardizing AKI terminology and dialysis modalities in the Portuguese language for Brazil. Several terms with similar meanings have been used in AKI and its dialysis modalities, causing confusion and disparities among patients, nephrologists, health institutions, private care companies, insurance companies and government entities. These disparities can impact medical care, hospital organization and care, as well as the funding and reimbursement of AKI-related procedures. Thus, consensual nomenclature and definitions were developed, including the definitions of AKI, acute kidney disease (AKD) and chronic kidney disease (CKD). Additionally, we addressed all dialysis modalities and extracorporeal procedures related to AKI, currently approved and available in the country. The Brazilian Society of Nephrology hopes that this Consensus can standardize the terminology and provide technical support to all involved in AKI care in Brazil.

https://doi.org/10.1590/2175-8239-jbn-2021-0284en

Evaluating TIMP-2 and IGFBP-7 as a predictive tool for kidney injury in ureteropelvic junction obstruction
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Mello, Marcos Figueiredo

; Bessa Júnior, José de

; Reis, Sabrina T.

; Kondo, Enzo Yagi

; Yu, Luis

; Dénes, Francisco Tibor

; Lopes, Roberto Iglesias

International braz j urol

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Abr 2022, Volume 48 Nº 2 Páginas 284 - 293

Resumo: En | Texto: En | PDF: En

ABSTRACT A major challenge in the management of ureteropelvic junction obstruction (UPJO) is the selection of patients who would benefit from surgical treatment. Tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) indicate renal cell stress and are associated with cell cycle arrest. The [TIMP-2] [IGFBP7] ratio (Nephrocheck®) has been recently applied in patients in intensive care units patients to predict the development of acute kidney injury. In this study, we evaluated the performance of these biomarkers performance to distinguishing obstructive hydronephrosis (HN) from non-obstructive HN. Materials and Methods: Consecutive patients with UPJO were enrolled in this study. Urinary [TIMP-2] [IGFBP7] and clinical characteristics (hydronephrosis grade, differential renal function, and drainage half-time) were measured in the following groups: 26 children with obstructive HN at initial diagnosis (group 1A) and after six months of dismembered pyeloplasty (group 1B); 22 children with non-obstructive HN (group 2), and 26 children without any urinary tract condition, as the control group (group 3). Results: Comparing the initial samples, [TIMP-2] [IGFBP7] had higher levels in the HN groups and lower levels in the control group; however, no difference was observed between the HN groups (obstructive vs. non-obstructive). After six months of follow-up, patients who underwent dismembered pyeloplasty showed stability in the urinary concentration of [TIMP-2] [IGFBP7]. All patients with [TIMP-2] [IGFBP7] higher than 1.0 (ng/mL)2/1000 had diffuse cortical atrophy on ultrasonography. Conclusions: We showed that urinary levels of urinary [TIMP-2] [IGFBP7] are higher in children with HN than controls. Nephrocheck® is not reliable in predicting the need for surgical intervention for pediatric patients with UPJO.

https://doi.org/10.1590/s1677-5538.ibju.2021.0340

Procesos de cambio educativo en contextos de segregación escolar: Una investigación basada en el diseño
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Zhang-Yu, Cristina

; Camps-Orfila, Silvia

; Lalueza, Jose Luís

; García-Díaz, Sarai

; Viñas-i-Rodríguez, Domitila

Psicoperspectivas

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Mar 2022, Volume 21 Nº 1 Páginas 124 - 136

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract The processes of racial and socioeconomic school segregation, the inequalities that generates in learning opportunities and its relationship with low compulsory school completion rates, constitute a serious obstacle to social and educational equity. In this article we report a design-based research currently under development and lasting more than four years, which is part of a set of actions for educational change in an institute-school from Barcelona (Catalonia), Our aim is to carry out a historical analysis of the transformations and tensions in this system of activity and among its participants: educational team and school students, undergraduate students and researchers. We observe that the legitimization and negotiation of their reasons and goals have led to processes of appropriation and agency of the project, and we identify tensions and contradictions that are analyzed under the power relations that happens in schools.

Resumen Los procesos de segregación educativa por motivos raciales y socioeconómicos, las desigualdades que genera en las oportunidades de aprendizaje y su relación con las bajas tasas de finalización de estudios obligatorios constituyen un serio obstáculo para la equidad social y educativa. En este artículo damos cuenta de una investigación basada en el diseño, actualmente en desarrollo y con más de cuatro años de duración, que forma parte de un conjunto de medidas para el cambio educativo en un instituto-escuela en la ciudad de Barcelona. Nuestro objetivo es realizar un análisis histórico atendiendo a las transformaciones y tensiones en este sistema de actividad y entre sus participantes: equipo educativo y alumnado del centro, estudiantes universitarias e investigadoras. Observamos que la legitimación y negociación de sus motivos y metas han llevado a procesos de apropiación y agencia del proyecto e identificamos tensiones y contradicciones que son analizadas a la luz de las relaciones de poder en las escuelas.

https://doi.org/10.5027/psicoperspectivas-vol21-issue1-fulltext-2544 17 downloads

IgA nephropathy in patients with serum anti-neutrophil cytoplasmic autoantibody (ANCA) positivity: case series
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Dias, Cristiane Bitencourt

; Jorge, Lectícia Barbosa

; Woronik, Viktoria

; Cavalcante, Lívia Barreira

; Yu, Luis

Brazilian Journal of Nephrology

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Mar 2022, Volume 44 Nº 1 Páginas 42 - 47

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Alguns casos clínicos de biópsia renal diagnóstica de nefropatia por IgA em pacientes com títulos séricos positivos de anticorpo anticitoplasma de neutrófilos (ANCA) vêm sendo publicados. Descreve-se uma série de casos de nefropatia por IgA com ANCA positivo de centro único da cidade de São Paulo, Brasil, no período de 1996 a 2016. No período estudado, houve 111 pacientes com biópsia renal com diagnóstico de nefropatia por IgA; destes, 5 tinham ANCA positivo ao diagnóstico com média de idade de 45 ± 15,3 anos, predominando o sexo feminino, com média de proteinúria de 2,2 ± 0,9 g/dia, hematúria presente em 100% dos casos e mediana de creatinina sérica de 2,5 (2,0 - 8,6) mg/dL. O cANCA foi o padrão mais encontrado, em 4 dos 5 casos (80%), com os níveis séricos das frações de complemento C3 e C4 normais em todos e FAN positivo em 80% dos casos. Houve associação com infecções em um caso, mas sem associação com medicações. À microscopia óptica, um dos pacientes tinha granuloma e outro, lesão colapsante. Em resumo, descreve-se cinco casos de pacientes com biopsia renal diagnóstica de nefropatia por IgA com ANCA sérico positivo predominando cANCA, destacando um paciente desse grupo com microscopia óptica com lesão colapsante que, apesar disso, teve boa evolução.

Abstract Some cases of patients with IgA nephropathy diagnosed via kidney biopsy and antineutrophil cytoplasmic antibody (ANCA) positivity have been reported. This article describes a case series comprising patients with IgA nephropathy and ANCA positivity seen at a medical center in the city of São Paulo, Brazil, from 1996 to 2016. A total of 111 patients underwent diagnostic kidney biopsies for IgA nephropathy. Five were ANCA-positive at the time of diagnosis; their mean age was 45 ± 15.3 years and they were predominantly females with a mean proteinuria of 2.2 ± 0.9 g/day and a median serum creatinine level of 2.5 (2.0 - 8,6) mg/dL; all had hematuria. Four of the five were cANCA-positive (80%); all had normal serum C3 and C4 levels; and 80% were positive for ANA. One case presented an association with infection, but no associations were found with medication. One patient had granuloma and another had a collapsing lesion. This article describes the cases of five ANCA-positive patients (with predominantly cANCA positivity) submitted to diagnostic kidney biopsies for IgA nephropathy; one patient had a collapsing lesion, but progressed well.

https://doi.org/10.1590/2175-8239-jbn-2021-0018

Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
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Ávila, Maria Olinda Nogueira

; Rocha, Paulo Novis

; Perez, Caio A.

; Faustino, Tássia Nery

; Batista, Paulo Benigno Pena

; Yu, Luis

; Zanetta, Dirce Maria T.

; Burdmann, Emmanuel A.

Clinics

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2021, Volume 76 elocation e1924

Resumo: En | Texto: En | PDF: En

OBJECTIVES: Positive fluid balance is frequent in critically ill patients and has been considered a potential biomarker for acute kidney injury (AKI). This study aimed to evaluate positive fluid balance as a biomarker for the early detection of AKI in critically ill patients. METHODS: This was a prospective cohort study. The sample was composed of patients ≥18 years old who stayed ≥3 days in an intensive care unit. Fluid balance, urinary output and serum creatinine were assessed daily. AKI was diagnosed by the Kidney Disease Improving Global Outcome criteria. RESULTS: The final cohort was composed of 233 patients. AKI occurred in 92 patients (40%) after a median of 3 (2-6) days following ICU admission. When fluid balance was assessed as a continuous variable, a 100-ml increase in fluid balance was independently associated with a 4% increase in the odds of AKI (OR 1.04; 95% CI 1.01-1.08). Positive fluid balance categorized using different thresholds was always significantly associated with subsequent detection of AKI. The mixed effects model showed that increased fluid balance preceded AKI by 4 to 6 days. CONCLUSION: These results suggest that a positive fluid balance might be an early biomarker for AKI development in critically ill patients.

https://doi.org/10.6061/clinics/2021/e1924 461 downloads

The rediscovery of nephropathology with artificial intelligence
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Rodrigues, Luís

; Sarder, Pinaki

; Jen, Kuang-Yu

; Ginley, Brandon

; Pratas, Jorge

; Sousa, Vitor

; Figueiredo, Arnaldo

; Alves, Rui

Portuguese Journal of Nephrology & Hypertension

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Dez 2020, Volume 34 Nº 4 Páginas 195 - 297

Resumo: En | Texto: En | PDF: En

https://doi.org/10.32932/pjnh.2021.01.096 169 downloads

Technical note and clinical instructions for Acute Kidney Injury (AKI) in patients with Covid-19: Brazilian Society of Nephrology and Brazilian Association of Intensive Care Medicine
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Suassuna, José Hermógenes Rocco

; Lima, Emerson Quintino de

; Rocha, Eduardo

; Castro, Alan

; Burdmann, Emmanuel de Almeida

; Carmo, Lilian Pires de Freitas do

; Yu, Luis

; Ibrahim, Mauricio Younes

; Betônico, Gustavo Navarro

; Cuvello Neto, Américo Lourenço

; Ávila, Maria Olinda Nogueira

; Gonçalves, Anderson R. Roman

; Costa, Ciro Bruno Silveira

; Bresolin, Nilzete Liberato

; Abreu, Andrea Pio de

; Lobo, Suzana Margareth Ajeje

; Nascimento, Marcelo Mazza do

Brazilian Journal of Nephrology

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2020, Volume 42 Nº 2 Páginas 22 - 31

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Este documento foi desenvolvido para trazer informações pertinentes à prática nefrológica em relação ao conhecimento sobre o acometimento renal da COVID-19, conduta frente aos casos de injúria renal aguda e orientações práticas sobre a provisão do suporte dialítico.Como as informações sobre a COVID-19 evoluem a uma velocidade jamais vista na ciência médica, as orientações apresentadas, embora baseadas em evidências científicas recentes, referem-se ao momento presente. Essas orientaços poderão ser atualizadas à medida que dados publicados e outras informações relevantes venham a ser disponibilizadas.

ABSTRACT We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.

https://doi.org/10.1590/2175-8239-jbn-2020-s107 3467 downloads

The impact of extreme weather events on community risk planning and management: the case of San Juan, Puerto Rico after hurricane Maria
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Santiago, Luis

; Flores, David

; Hong, Chang-Yu

urbe. Revista Brasileira de Gestão Urbana

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2020, Volume 12 elocation e20190062

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Soluções técnicas que são projetadas de cima para baixo (top-down) para lidar com o controle de enchentes, como a canalização, são cada vez mais inacessíveis. Neste trabalho, explorou-se como os líderes comunitários enquadram o conceito de risco, particularmente devido a inundações, e documentamos soluções de baixo para cima (bottom-up), em vez de soluções de cima para baixo, no contexto do furacão Maria e da atual crise financeira. Esta pesquisa visou entrevistar líderes organizacionais de conservação ambiental para avaliar a questão mais ampla do que torna San Juan habitável, e o papel que o gerenciamento de risco de inundação desempenha na definição da habitabilidade. Na percepção dos líderes, abordagens ascendentes para o controle de enchentes, incluindo o papel da infraestrutura verde, é de particular interesse, dada a inviabilidade das atuais medidas de engenharia e do histórico de estratégias de enfrentamento local de curto prazo. A equipe responsável enquadra a pesquisa usando soluções estruturais em contraste com soluções não-estruturais para explorar até que ponto os líderes comunitários se baseiam em visões verdes da cidade ou enfatizam a transição para estratégias mais alinhadas com processos e funções ecológicas. Os resultados da pesquisa podem ajudar a informar os esforços atuais para envolver as comunidades em nível local sobre soluções alternativas para canalização e outras medidas de gerenciamento de enchentes urbanas.

Abstract Top-down technical or engineered solutions to deal with flood control such as channelization are increasingly unaffordable. We explored how community leaders’ frame the concept of risk, particularly due to flooding, and documented bottom-up rather than top-down solutions within the context of Hurricane Maria and the current financial crisis. This research aimed to interview environmental conservation organizational leaders to assess the broader question of what makes San Juan livable, and the role that flooding risk management plays in defining livability. Their perception of bottom-up approaches for flood control, including the role of green infrastructure, is of particular interest given the infeasibility of current engineered measures and their history of short term local coping strategies. Our research team frames the research using structural versus non-structural solutions to explore to what extent community leaders draw upon green visions of the city or emphasize transitioning towards strategies more closely aligned with ecological processes and functions. The research results help to inform current efforts of local community engagement about alternative solutions to channelization and other urban flood management measures.

https://doi.org/10.1590/2175-3369.012.e20190062 1448 downloads

10.

Factor Structure of a Social-Emotional Screening Instrument for Preschool Children
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Anunciação, Luis

; Chen, Chieh-Yu

; Pereira, Danilo Assis

; Landeira-Fernandez, J.

Psico-USF

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Set 2019, Volume 24 Nº 3 Páginas 449 - 461

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Instrumentos de rastreio em saúde e educação oferecem indicadores rápidos que antecipam a avaliação diagnóstica e o tratamento. Frente às competências socioemocionais infantis, o Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) foi utilizado na população de crianças matriculadas em pré-escolas públicas do município do Rio de Janeiro durante 2011. Posto isso, o objetivo desse trabalho foi investigar aspectos de validade e fidedignidade desse instrumento. Dados de 23.334 crianças (50.6% meninos), com idade média de 5 anos de idade (DP: 3 meses) e matriculadas em 625 pré-escolas foram analisados. A partir da Análise Fatorial Exploratória e Confirmatória, os resultados foram favoráveis ao modelo com um fator emocional e outro social: χ2 (463) = 46363.495, p < 0,001; RMSEA = 0,067; CFI = 0,918; TLI = 0,913. Indicadores de fidedignidade foram adequados. Os resultados evidenciaram aspectos de validade do ASQ:SE e possibilitam seu uso em crianças com 5 anos de idade.

Abstract Screening tools in health and education provide quick indicators that anticipate diagnostic evaluation and treatment. Faced with the socio-emotional competences of children, the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) was used in the population of children enrolled in public pre-schools in the city of Rio de Janeiro during 2011. The objective of this work was to investigate aspects of its validity and reliability. Data from 23,334 children (50.6% boys) being an average age of 5 years old (SD: 3 months) and enrolled in 625 pre-schools were analyzed. After an intensive data analysis, the Exploratory and Confirmatory Factor Analysis, the results were favorable to the multidimensional model with a social and emotional dimension: χ2 (463) = 46363.495, p <0.001; RMSEA = 0.067; CFI = 0.918; TLI = 0.913. Reliability indicators were adequate. The results confirmed validity aspects of the ASQ:SE, thereby verifying its use for children aged 5 years old.

Resumen Instrumentos de rastreo en salud y educación ofrecen indicadores rápidos que anticipan la evaluación de diagnóstico y tratamiento. Ante las competencias socio-emocionales infantiles, el Ages & Stages Cuestionarios: Social-Emocional (ASQ:SE) fue utilizado con la población de niños preescolares de escuelas públicas del municipio de Rio de Janeiro en el año 2011. El objetivo de este trabajo fue investigar aspectos de validez y veracidad de este instrumento. Fueron analizados datos de 23.334 niños (50.6% de sexo masculino) con edad promedio de 5 años(DE: 3 meses) matriculados en 625 escuelas preescolares. A partir del Análisis Factorial Exploratorio y Confirmatorio, los resultados fueron favorables al modelo con un factor emocional y otro social: X2(463) = 46363.495, p<0,001;RMSEA = 0,067;CFI =0,918;TLI =0,913. Los indicadores de veracidad fueron adecuados y los resultados señalaron aspectos válidos del ASQ:SE que posibilitan su uso en niños con 5 años de edad.

https://doi.org/10.1590/1413-82712019240304 1733 downloads

11.

Guía de manejo de terapia antitrombótica durante procedimientos endoscópicos
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Peláez-Luna, Mario

; Blanco-Vela, Claudia Isabel

; Martínez-García, Clara Luz

; Hernández-Guerrero, Angélica I.

; Solana-Sentíes, Sergio

; Bada-Yllán, Orlando

; Cerna-Cardona, Jony

; Espino-Cortés, Héctor

; Lee-Tsai, Yu Ling

; Leytón-Rivera, Hugo Roberto

; Martínez-Camacho, Claudia

; Murcio-Pérez, Enrique

; Ovando-Zambrano, Francisco Alejandro

; Pérez-Aguilar, Fernando

; Ramos-González, Roberto

; Reyes-Dorantes, Ángel Andrés

; Reyes-Gómez, Carlos Alberto

; Sánchez-Chávez, Xochiquetzal

; Vinageras-Barroso, Javier Ignacio

; Zamora-Nava, Luis Eduardo

Endoscopia

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Jun 2019, Volume 31 Nº 2 Páginas 58 - 76

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract The use of antithrombotic therapies and non-steroid anti-inflammatory drugs has increased worldwide and with it the risk of presenting a bleeding complication. The group of patients undergoing an invasive procedure such as a gastrointestinal endoscopy are at a higher risk of peri-procedural bleeding complications. However, in those patients receiving anti-thrombotic therapy scheduled for a gastrointestinal endoscopy the risk of bleeding must be weighted against the risk of a thrombo-embolic event while the patients are off the antithrombotic treatment. Antithrombotic drug management in the peri-endoscopic time has become more complex due to the appearance of the new direct action anticoagulants. Although several international guidelines and systematic reviews on the topic are available, its applicability and availability in Mexico are limited, considering language barriers and drug and technology availability, among others. This lead the Asociación Mexicana de Endoscopia Gastrointestinal to summon a group of gastroenterologists, endoscopists, cardiologists and hematologists to assess and review current scientific evidence with the aim to develop and propose a series of recommendations for the management of anti-thrombotic therapy before, during and after and endoscopic procedure.

Resumen El uso de terapias antitrombóticas y de antiinflamatorios no esteroideos ha aumentando progresivamente, lo cual incrementa el riesgo de hemorragia. Entre las causas y sitios de hemorragia asociada a estas terapias están aquellos que suceden alrededor de un procedimiento invasivo como la endoscopia. En los pacientes que reciben terapia antitrombótica y que serán sometidos a algún procedimiento endoscópico se debe equilibrar el riesgo de hemorragia frente al riesgo trombótico, para minimizar el tiempo en que el paciente estará sin la debida protección antiplaquetaria o anticoagulante. El manejo de la terapia antitrombótica durante una endoscopia se ha hecho más complejo debido al desarrollo de anticoagulantes de acción directa. Aunque existen guías y revisiones internacionales sobre el manejo de estos fármacos en relación con procedimientos endoscópicos, el idioma de publicación, y la disponibilidad y accesibilidad de medicamentos limitan el acceso a ellas, así como su aplicabilidad ad integrum; esto justifica su revisión y adaptación a México. La Asociación Mexicana de Endoscopia Gastrointestinal convocó a un grupo de gastroenterólogos, cardiólogos, hematólogos y endoscopistas para revisar y evaluar de manera crítica la evidencia científica para proponer estrategias de manejo de la terapia antitrombótica antes, durante y después de algún procedimiento endoscópico. El objetivo es sugerir alternativas de acuerdo con la disponibilidad de recursos humanos y tecnológicos en nuestro país basadas en la evidencia científica disponible en la actualidad.

https://doi.org/10.24875/end.m19000007 90 downloads

12.

Los Fondos de Identidad y el tercer espacio. Una estrategia de legitimación cultural y diálogo para la escuela intercultural
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Lalueza, José Luis

; Zhang-Yu, Cristina

; García-Díaz, Sarai

; Camps-Orfila, Sílvia

; García-Romero, David

Estudios pedagógicos (Valdivia)

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2019, Volume 45 Nº 1 Páginas 61 - 81

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT: The inclusion in the school of students from immigrant and racialized groups entails facing the challenges related with discontinuities between school and family culture, which are indicators of asymmetric power relations for which the student's family and community culture are not legitimized. It remains outside the classroom and is stigmatized. This paper analyzes an intervention with high school students based on Funds of Identity as a strategy to incorporate and legitimize the personal referents of the students. Our aim is to create a third space in which intercultural dialogue is the driving force of learning processes and school inclusion.

RESUMEN: La inclusión en la escuela de alumnos procedentes de la inmigración y de grupos racializados supone afrontar los retos planteados por las discontinuidades entre la cultura escolar y la familiar, indicadoras de unas relaciones de poder asimétricas por las que la cultura familiar y comunitaria del alumno no es legitimada en tanto que se mantiene fuera del aula e incluso es estigmatizada. En este trabajo se analiza una intervención con alumnos de secundaria basada en los Fondos de Identidad como estrategia para incorporar y legitimar los referentes personales de los alumnos con el objetivo de crear un tercer espacio en el que el diálogo intercultural es motor de los procesos de aprendizaje e inclusión escolar.

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13.

Prevalencia de cardiopatía isquémica asintomática en pacientes con diabetes mellitus tipo 2
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Pineda-De Paz, Dulman O

; Pineda-De Paz, Mario R.

; Lee-Tsai, Yu L.

; Chang, Clara E.

; Torres-Salazar, Lissette C.

; Barrios-Lupitou, Luis C.

Revista Colombiana de Cardiología

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Abr 2018, Volume 25 Nº 2 Páginas 116 - 123

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: La enfermedad cardiovascular es la causa principal de muerte en pacientes con diabetes mellitus. La prevalencia de cardiopatía isquémica asintomática es más alta en pacientes diabéticos que en no diabéticos y se asocia a peor pronóstico. Objetivo: Identificar la prevalencia de cardiopatía isquémica asintomática en pacientes con diabetes mellitus tipo 2 en un hospital de tercer nivel de atención de Guatemala y analizar la posible asociación de dicha enfermedad con características epidemiológicas, clínicas y metabólicas. Métodos: Estudio de corte transversal en el que se estudió una muestra de 92 pacientes diabéticos seleccionados de forma aleatoria simple. Se realizó electrocardiograma, que cuando fue negativo para isquemia ameritó prueba de esfuerzo, o de lo contrario, ecocardiograma de estrés con dobutamina. Resultados: La edad media de los participantes fue de 57 años, 88% de los cuales eran mujeres; la duración media de la diabetes fue 7 años. Se encontró cardiopatía isquémica asintomática en el 22,8% de los casos. No se hallaron posibles asociaciones entre cardiopatía isquémica asintomática y edad, sexo, enfermedad arterial periférica, índice de masa corporal, índice tobillo-brazo, hipertensión arterial, dislipidemia, tabaquismo activo, sedentarismo, sobrepeso/obesidad, alcoholismo, glucosa en ayunas, hemoglobina glicosilada, colesterol total, colesterol HDL, colesterol LDL, ácido úrico, creatinina, tasa de filtrado glomerular y microalbuminuria. Conclusiones: La prevalencia de cardiopatía isquémica asintomática en la población estudiada con diabetes mellitus tipo 2 fue de 22,8%. No se encontraron posibles asociaciones de cardiopatía isquémica asintomática con las variables estudiadas.

Abstract Introduction: Cardiovascular disease is the main cause of death in patients with diabetes mellitus. The prevalence of asymptomatic ischaemic heart disease is higher in diabetic patients than in non-diabetic ones, and is associated with a worse prognosis. Objective: To determine the prevalence of asymptomatic ischaemic heart disease in patients with type 2 diabetes mellitus in a third level of care hospital in Guatemala, as well as to analyse the possible relationship of this disease with epidemiological, clinical, and metabolic characteristics. Methods: A cross-sectional study was conducted on a sample of 92 randomly selected diabetic patients. An electrocardiogram was performed, which when it was negative for ischaemia, an exercise stress test or a dobutamine stress echocardiogram was performed. Results: The mean age of the participants was 57 years, 88% of whom were women. The mean duration of the diabetes was 7 years. Asymptomatic ischaemic heart disease was found in 22.8% of case. No significant associations were found between ischaemic heart disease and age, gender, peripheral arterial disease, body mass index, ankle-brachial index, arterial hypertension, dyslipidaemia, active smoking, sedentarism, overweight/obesity, alcoholism, fasting glucose, glycosylated haemoglobin, total cholesterol, HDL-cholesterol, LDL-cholesterol, uric acid, creatinine, glomerular filtration rate, and urine microalbumin. Conclusions: The prevalence of asymptomatic ischaemic heart disease was 22.8% in the population studied with type 2 diabetes mellitus. No significant associations were found between ischaemic heart disease and the variables studied.

https://doi.org/10.1016/j.rccar.2017.08.012 809 downloads

14.

3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology
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Gualandro, Danielle Menosi

; Yu, Pai Ching

; Caramelli, Bruno

; Marques, André Coelho

; Calderaro, Daniela

; Fornari, Luciana Savoy

; Pinho, Claudio

; Feitosa, Alina Coutinho Rodrigues

; Polanczyk, Carisi Anne

; Rochitte, Carlos Eduardo

; Jardim, Carlos

; Vieira, Carolina L. Z.

; Nakamura, Debora Y. M.

; Iezzi, Denise

; Schreen, Dirk

; Adam, Eduardo Leal

; D’Amico, Elbio Antonio

; Lima, Emerson Q. de

; Burdmann, Emmanuel de Almeida

; Mateo, Enrique Indalecio Pachón

; Marcondes-Braga, Fabiana Goulart

; Machado, Fabio S.

; Paula, Flavio J. de

; Carmo, Gabriel Assis Lopes do

; Feitosa-Filho, Gilson Soares

; Prado, Gustavo Faibischew

; Lopes, Heno Ferreira

; Fernandes, João R. C.

; Lima, José J. G. de

; Sacilotto, Luciana

; Drager, Luciano Ferreira

; Vacanti, Luciano Janussi

; Rohde, Luis Eduardo Paim

; Prada, Luis F. L.

; Gowdak, Luis Henrique Wolff

; Vieira, Marcelo Luiz Campos

; Monachini, Maristela Camargo

; Macatrão-Costa, Milena Frota

; Paixão, Milena Ribeiro

; Oliveira Junior, Mucio Tavares de

; Cury, Patricia

; Villaça, Paula R.

; Farsky, Pedro Silvio

; Siciliano, Rinaldo F.

; Heinisch, Roberto Henrique

; Souza, Rogerio

; Gualandro, Sandra F.M.

; Accorsi, Tarso Augusto Duenhas

; Mathias Júnior, Wilson

Arquivos Brasileiros de Cardiologia

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Set 2017, Volume 109 Nº 3 Páginas 1 - 104

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20170140 100302 downloads

15.

Acomodo de figuras irregulares en áreas irregulares para el corte de cuero
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Guevara-Palma, Luis

; Santillán-Gutiérrez, Saúl Daniel

; Tang-Yu, Xu

; Dorador González, Jesús-Manuel

; Lara-Jiménez, Claudia Ivette

Ingeniería, investigación y tecnología

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Mar 2015, Volume 16 Nº 1 Páginas 25 - 34

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

The nesting problem of irregular shapes within irregular areas has been studied from several approaches due to their application in different industries. The particular case of cutting leather involves several restrictions that add complexity to this problem, it is necessary to generate products that comply with the quality required by customers This paper presents a methodology for the accommodation of irregular shapes in an irregular area (leather) considering the constraints set by the footwear industry, and the results of this methodology when applied by a computer system. The scope of the system is to develop a working prototype that operates under the guidelines of a commercial production line of a sponsor company. Preliminary results got a reduction of 70% of processing time and improvement of 5% to 7% of the area usage when compared with manual accommodation.

El problema del acomodo de figuras irregulares dentro de áreas irregulares se ha estudiado desde varios enfoques debido a su aplicación en diferentes industrias. El caso particular del corte de cuero implica varias restricciones que hacen difícil la automatización de este problema, pues es necesario cumplirlas para poder generar productos con la calidad requerida por los clientes. El presente documento presenta una metodología para el acomodo de figuras irregulares en un área irregular (piel) considerando las restricciones establecidas por la industria del calzado, así como los resultados de dicha metodología al aplicarlos mediante un sistema de cómputo. El alcance del sistema es desarrollar un algoritmo que pueda integrarse en un prototipo funcional, que opere bajo los lineamientos de una línea de producción de una industria patrocinadora. Pruebas de laboratorio del sistema de cómputo arrojan reducciones del tiempo de 70% con respecto a sistemas comerciales y una mejora de 5 a 7% del área que puede lograr utilizar un operario.

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