Fundamento: la hiperreactividad cardiovascular en los jóvenes se ha asociado a diferentes factores de riesgo y a la historia familiar de hipertensión arterial.
Objetivo: determinar la asociación ...entre la historia familiar de hipertensión y los factores de riesgo cardiovasculares, con el estado de hiperreactividad cardiovascular.
Método: se realizó un estudio descriptivo, correlacional y de corte transversal con un universo de 77 jóvenes entre 18 y 40 años, de la parroquia Churuguara, Estado Falcón en Venezuela. Se analizaron como variables: edad, sexo, color de la piel, antecedentes familiares de hipertensión arterial, antecedentes personales de hipertensión arterial y de diabetes mellitus, ingestión de bebidas alcohólicas y de sal, actividad física e índice de masa corporal. Se determinaron como variables hemodinámicas: presión arterial diastólica, presión arterial sistólica, antes y después de la respuesta presora desencadenada por la aplicación un ejercicio isométrico
Resultados: el 13 % de los individuos presentó reactividad vascular ante la prueba del peso sostenido. Es tres veces mayor la hiperreactividad cardiovascular en las personas con historia familiar de hipertensión arterial, el 60 % de las personas con un índice de masa corporal mayor o igual a 27 kg/m2 son hiperreactivos cardiovasculares, en la medida que se ingiere más alcohol aumenta la respuesta cardiovascular a la prueba del peso sostenido, son hiperreactivos el 33,3 % de los que fuman.
Conclusión: existe una asociación significativa entre la historia familiar de hipertensión arterial, la obesidad, la ingestión de sal, el consumo de bebidas alcohólicas y la hiperreactividad vascular.
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Since the beginning of the pandemic, morbidity and mortality in emergency care of surgical patients have been the subject of several studies. However, most of these have compared this ...variable with that of the pre-COVID period, ignoring its evolution during the pandemic itself. In order to analyze this possible change, we performed a comparative study of morbidity and mortality in emergency surgery between the first and second waves of the pandemic in our center.
Retrospective longitudinal study including all patients over the age of 18 admitted and/or operated in the emergency setting in the two maximum incidence periods (MIP) of COVID-19 infection (1st MIP: 22/03/2020-31/05/2020; 2nd MIP: 26/08/2020-30/11/2020). The incidence of SARS-CoV-2 infection, treatment received, early morbidity and mortality and possible risk factors for complications were analyzed.
A total of 173 patients were analyzed (1st MIP: 66; 2nd MIP: 107). The incidence of COVID-19 was higher in the second period (14.95% vs. 4.54%). SARS-CoV-2 infection was associated with a higher rate of complications; however, no statistically significant differences were observed in morbimortality rate, either in the total sample (P = .746) or in patients with a positive COVID-19 test (P = .582) between both periods. Surgical treatment was found to be associated with a lower complication rate in both the first (P = .006) and second waves (P = .014), and it was more frequent in the second MIP (70.1% vs 57.6%), although statistical significance was not reached (P = .065).
No significant differences were observed in morbidity and mortality of patients admitted and/or operated in the emergency setting in the two periods of maximum incidence of SARS-CoV-2 at our center. Surgical treatment was associated with lower morbidity and mortality rates, and it was more frequent in the second MIP.
Desde el comienzo de la pandemia, la morbimortalidad en la atención urgente al paciente quirúrgico ha sido objeto de estudio. Sin embargo, la mayoría de los estudios compararon dicha variable con la propia de la época pre-COVID, obviando la evolución de la misma durante la propia pandemia. Con el objetivo de analizar este posible cambio, realizamos un estudio comparativo de morbimortalidad en cirugía de urgencias entre la primera y segunda ola de la pandemia en nuestro centro.
Estudio retrospectivo longitudinal que incluyó a todos los pacientes mayores de 18 años ingresados y/o intervenidos quirúrgicamente de forma urgente en los dos períodos de máxima incidencia (PMI) de infección por COVID-19 (1ºPMI: 22/03/2020-31/05/2020; 2ªPMI: 26/08/2020-30/11/2020). Se analizó la incidencia de infección por SARS-CoV2, el tratamiento recibido, la morbimortalidad precoz y los posibles factores de riesgo de complicaciones.
Se analizaron 173 pacientes (1ºPMI: 66; 2ºPMI: 107). La incidencia de COVID-19 fue mayor en el segundo periodo (14,95% vs. 4,54%). La infección por SARS-CoV-2 se asoció a una mayor tasa de complicaciones, sin embargo, no se observaron diferencias estadísticamente significativas en la morbimortalidad general (p = 0,746) ni en la de los pacientes COVID positivos (p = 0,582) entre ambos períodos. El tratamiento quirúrgico se asoció con una menor tasa de complicaciones tanto en la primera (p = 0,006) como en la segunda ola (p = 0,014). Dicho tratamiento quirúrgico fue más frecuente en el segundo PMI (70,1% vs 57,6%) aunque no se alcanzó la significación estadística al respecto de esta afirmación (p = 0,065).
No se observaron diferencias significativas en la morbimortalidad de los pacientes ingresados y/o intervenidos quirúrgicamente de urgencias en los dos períodos de máxima incidencia de SARS-CoV-2 en nuestro centro. El tratamiento quirúrgico se asoció con una menor morbimortalidad, siendo este más frecuente en el segundo PMI.
Personalized learning through blended learning is emerging as an educational practice with promising potential to close the academic achievement gap in high school mathematics and produce ...post-secondary ready mathematics learners. National data indicates mathematics growth has stagnated over the past several decades leaving opportunity for innovation to permeate the high school mathematics classroom to influence change. Examining the influence of blended learning on post-secondary readiness and academic achievement in a large urban school district in the southeast region of Texas indicated that blended learning instruction was meeting the promise of personalized learning for all students. The sequential mixed methods study provided observable and teacher perceived characteristics evident in the blended learning classroom while quantitative data measured the influence of blended learning on post-secondary readiness and academic achievement using an independent t-test. Blended learning was further investigated using Chi-squared test of Independence and cross tabulations to investigate the relationship between blended learning and post-secondary readiness as well as academic achievement. Paired samples t-test measured the difference in PSAT scores. Although no statistical significance was found when measuring post-secondary readiness, pockets of promise emerged when measuring academic achievement. Mean score differences were higher for students participating in blended learning when compared with students participating in traditional learning. Trends in the blended learning classroom demonstrate evidence of self-directed learning orchestrated by the teacher acting as a facilitator. Further evidence of personalization collected during classroom observations and teacher interviews demonstrated that in the blended learning classroom the needs of every student were considered instead of holding all students’ hostage to the pacing of the teacher. The promise of closing the achievement gap in mathematics has great potential as the blended learning model of instruction continues to grow in implementation in the participating district and across the United States.
Minimal siphons in the class of
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nets have become a conceptual and practical central tool for the study of the resource allocation related aspects in discrete event dynamic systems as, for ...example, the existence of deadlocks. Therefore the availability of efficient algorithms to compute the minimal siphons is essential. In this paper we try to take advantage of the particular properties of the siphons in
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4
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to obtain an efficient algorithm. These properties allow us to express minimal siphons as the union of pruned minimal siphons containing only one resource. The pruning operation is built from the binary pruning relation defined on the set of minimal siphons containing only one resource. This pruning relation is represented by means of a directed graph. The computation of the minimal siphons is based on the maximal strongly connected components of this graph. The algorithm is highly economic in memory in all intermediate steps when compared to the classical algorithms.
El deporte es un fenómeno cultural y social que ayuda al desarrollo integralde las personas. El alto poder social y educativo del deporte justifica su inclusióndentro del currículum de Educación ...Secundaria. Por ello, el presente trabajo desarrollauna unidad didáctica dirigida a alumnos de 2º de ESO para el desarrollo dela táctica y capacidad colaborativa a través del deporte colectivo. La unidad didácticaestá compuesta por un total de 7 clases. Además, se pretende que el docentesea consciente de la importancia de involucrarse dentro de la espiral de acciónreflexiónpara mejorar la propuesta didáctica en el futuro. Una vez desarrolladala unidad didáctica, se ha reforzado la importancia que tienen tener en cuenta losintereses del alumnado, partir de las ideas previas, fomentar la autonomía y el usode las TICS para enriquecer el proceso de enseñanza aprendizaje. Por tanto, resultainteresante tener en cuenta estos aspectos en el futuro para promover la implicaciónde los alumnos en las clases de Educación Física y fomentar así la práctica deportivade nuestros alumnos.
Rectocele is defined as a herniation of the anterior rectal wall through the posterior vaginal wall into the vaginal lumen caused by rectovaginal septum weakness. This entity is more common in ...postmenopausal female patients. Approximately one-third of adult women affected with pelvic organ prolapse have a significant impact on their quality of life and emotional well-being. Up to more than 90% of woman can be asymptomatic. In symptomatic cases, constipation, defecatory disorders such as obstructed syndrome (ODS) or incontinence, vaginal mass, and pelvic discomfort are the main complaints. Surgical treatment is indicated after failure of conservative management. Talking about ODS, nearly 20% of the patients need surgery. Surgical options can be classified as abdominal (being laparoscopic colposacropexy the technique of choice) or perineal approach. In the latter group, the alternatives are transanal (TA), transperineal (TP), and transvaginal (TV) approaches with or without prosthetic material or grafts. Native-tissue transvaginal approach should be preferentially performed as it has shown better results. Nowadays, there is no consensus on what the gold-standard technique is given the lack of strong evidence.
Homeostasis constitutes a key concept in physiology and refers to self-regulating processes that maintain internal stability when adjusting to changing external conditions. It diminishes internal ...entropy constituting a driving force behind evolution. Natural selection might act on homeostatic regulatory mechanisms and control mechanisms including homeodynamics, allostasis, hormesis and homeorhesis, where different stable stationary states are reached. Regeneration is under homeostatic control through hormesis. Damage to tissues initiates a response to restore the impaired equilibrium caused by mild stress using cell proliferation, cell differentiation and cell death to recover structure and function. Repair is a homeorhetic change leading to a new stable stationary state with decreased functionality and fibrotic scarring without reconstruction of the 3-D pattern. Mechanisms determining entrance of the tissue or organ to regeneration or repair include the balance between innate and adaptive immune cells in relation to cell plasticity and stromal stem cell responses, and redox balance. The regenerative and reparative capacities vary in different species, distinct tissues and organs, and at different stages of development including ageing. Many cell signals and pathways play crucial roles determining regeneration or repair by regulating protein synthesis, cellular growth, inflammation, proliferation, autophagy, lysosomal function, metabolism and metalloproteinase cell signalling. Attempts to favour the entrance of damaged tissues to regeneration in those with low proliferative rates have been made; however, there are evolutionary constraint mechanisms leading to poor proliferation of stem cells in unfavourable environments or tumour development. More research is required to better understand the regulatory processes of these mechanisms.
