Abstract Cardiac tumors are rare in children, having a maximum reported incidence of 0.027% in prenatal diagnosis, increasing the incidence in necropsy diagnosis; rhabdomyomas are the most frequent cardiac tumors, some cases are associated with tuberous sclerosis. We present the report of two cases in our unit that were diagnosed prenatal with follow-up after birth and one of them was associated with tuberous sclerosis. Both cases were admitted in a third level center, uncomplicated, without requiring surgical treatment, and could be discharged.

Resumen Los tumores cardiacos son raros en la población infantil, teniendo una incidencia máxima reportada del 0.027% en el diagnóstico prenatal, incrementándose la incidencia en el diagnóstico por necropsia. Los rabdomiomas son los tumores cardiacos más frecuentes, algunos casos pueden asociarse con esclerosis tuberosa. Presentamos el reporte de dos casos en nuestra unidad a los cuales se les realizó diagnóstico prenatal con seguimiento posterior al nacimiento y asociándose uno de ellos a esclerosis tuberosa. Ambos casos recibieron atención en un centro de tercer nivel, sin complicaciones, sin requerir tratamiento quirúrgico, pudiendo ser egresados.

RESUMO Objetivo - Ao longo dos anos, a filosofia lean tem mostrado resultados satisfatórios empresas de diversos setores em diferentes países. Com o objetivo de contribuir para a base de conhecimento acerca da referida filosofia, este estudo tem como objetivo verificar a percepção dos funcionários do chão de fábrica em relação ao apoio da alta administração nos projetos lean e sua relação com iniciativas de sucesso. Design/metodologia/abordagem Por meio de uma revisão da literatura, 18 aspectos de uma jornada lean foram identificados e divididos em quatro construtos via um painel de especialistas. Essas informações foram utilizadas na estruturação de um questionário e uma survey foi realizada com 198 funcionários de duas empresas de autopeças. A análise dos dados foi feita por meio da Modelagem de Equações Estruturais. Resultados Como resultado geral, foi possível comprovar que quando os funcionários percebem um apoio mais significativo da alta administração nos projetos lean, maior é a percepção do sucesso das iniciativas. Torna-se interessante, assim, que o envolvimento da alta administração ocorra em todas as etapas do projeto. Originalidade/valor Os resultados aqui descritos aqui têm implicações práticas principalmente para gerentes interessados em implementar projetos enxutos; eles devem estar cientes da importância do apoio da alta administração para o sucesso dos projetos mencionados.

ABSTRACT Purpose Over the years, the lean production philosophy has shown satisfactory results for companies from different sectors in different countries. Aiming to contribute to the knowledge base on the mentioned philosophy, this study aims to verify the perception of shop floor employees regarding senior management support in lean projects and its relationship with initiatives success. Design/methodology/approach Through a literature review, 18 aspects of a lean journey were identified and divided into four constructs by a panel of specialists. This information was used to compose a questionnaire, and a survey was conducted with 198 shop floor employees of two auto parts companies. Data analysis was done via Structural Equation Modeling. Findings As a general result, it was possible to prove that when employees perceive more significant support from senior management in lean projects, the greater is the perception of initiatives success. Therefore, it is interesting that the involvement of senior management occurs at all stages of the project. Originality/value The results described here have practical implications, especially for managers interested in implementing lean projects; they must be aware of the importance of senior management support for the success of previous projects.

RESUMEN Objetivo: Determinar el tiempo transcurrido desde que pacientes de Colombia con artritis reumatoide (AR) en tratamiento con fármacos antirreumáticos modificadores de enfermedad no biológicos (FAMEs) cambian a terapia con biológicos. Materiales y métodos: Estudio de cohorte retrospectiva que recogió información sobre inicio de tratamiento antirreumático en pacientes de todas las edades con diagnóstico de AR hasta que pasaron a terapia con FAMEs biológicos. Se hizo un análisis de sobrevida, utilizando curvas de Kaplan-Meier, desde el 1 de enero de 2007 hasta el 31 de diciembre de 2013 mediante SPSS 23.0 para Windows. Resultados: Un total de 3880 pacientes iniciaron terapia con FAMEs no biológicos, (75,3% fueron mujeres) con una edad media de 51,3 anos. Tras cinco años de seguimiento, 234 pacientes (6,0%) iniciaron FAMEs biológicos en promedio a los 17,5 ± 13,9 meses. El uso de corticoides (OR: 2,49; IC95%: 1,658-3,732; p<0,001), recibir alguna comedicación (OR: 1,83; IC95%: 1,135-2,966), ser tratado en Bogotá (OR: 2,30; IC95%: 1,585-3,355), en las ciudades de la costa Atlántica (OR: 2,848; IC95%: 1,468-5,524) estuvieron asociados con una mayor probabilidad de inicio de biológicos mientras que el uso de metotrexate (OR: 0,04; IC95%: 0,014-0,108) o cloroquina (OR: 0,13; IC95%: 0,092-0,187) o recibir medicación antihipertensiva (OR: 0,64; IC95%: 0,421-0,960) redujeron la posibilidad. Conclusiones: Después de cinco años de terapia antirreumática convencional, un 6,0% de pacientes con AR inició terapia con FAMEs biológicos. Recibir corticoides, recibir comedicación, ser tratado en Bogotá o la costa Atlántica afectan la probabilidad de cambiar a terapia biológica.

ABSTRACT Aims: To determine the time Colombian patients with rheumatoid arthritis (RA) are treated with non-biological disease-modifying antirheumatic drugs (DMARDs) before changing to biological therapy. Methods: A retrospective cohort study that collected information about the start of antirheumatic treatment in patients of all ages with a diagnosis of RA until the change to biological DMARD therapy. Survival analysis using Kaplan-Meier curves, from 1 January 2007 until 31 December 2013 by SPSS 23.0 for Windows, was made. Results: A total of 3880 patients (75.3% women) with a mean age of 51.3 years started non-biological DMARDs. After 5 years, 234 patients (6.0%) initiated biological DMARD therapy in 17.5 ± 13.9 months. The use of glucocorticoids (OR: 2.49; 95% CI: 1.658-3.732), having any comedication (OR: 1.83; 95%CI: 1.135-2.966) and being treated in the city of Bogota (OR: 2.30; 95%CI: 1.585-3.355) or in the cities of the Colombian Atlantic coast (OR: 2.848; 95%CI: 1.468-5.524) were associated with a higher likelihood of biological DMARD initiation. Whereas the initiation of therapy with methotrexate (OR: 0.04; 95% CI: 0.014-0.108; p < 0.001) or chloroquine (OR: 0.13; 95% CI: 0.092-0.187; p < 0.001) or receiving antihypertensive medication (OR: 0.64; 95% CI: 0.421-0.960; p = 0.031) was associated with a significant reduce in likelihood. Conclusion: After 5 years of non-biological DMARD therapy, 6.0% of people with RA started biological DMARDs. Receiving glucocorticoids, having any comedication, being treated in Bogota City or cities of the Colombian Atlantic coast affected the probability of switching to biological therapy in these patients.

In México, strawberry dry wilt (Fragaria x ananassa) has been associated with a fungus complex in which only the implication of Fusarium oxysporum (Fox) is evident. Therefore, in the present study the association of fungi and pseudofungi with the disease was determined in different systems of agronomical management, and pathogenicity was verified. Two samplings were made in the 2002/03 season and three in 2003/04 in 16 localities of the Valley of Zamora, Michoacán, México, where 2640 sections of roots and 365 of necrotic crowns were sown, along with 400 sections of asymptomatic tissue in potato-dextrose-agar (PDA) culture medium and a selective medium with antibiotics and PCNB (PARPH) fungicide. Fox, F. solani (Fso), Cylindrocarpon sp. (Cyl), Pythium aphanidermatum (Pyt), Phytophthora sp. (Phy), Rhizoctonia fragariae (Rhi), Verticillium albo-atrum (Ver) and Colletotrichum sp. (Col) were associated with the dry wilt. Fox was the most frequent species (p=0.05) and the only one that showed an increase from flowering to fructification of 47 to 62% in root and 77 to 83% in crown. In plantations with plastic mulch and drip irrigation (A + G), Fox decreased by 18% with respect to unmulched soil with gravity irrigation, whereas Cyl increased by 15% in A + G (p=0.05). The clay and clay loam soil contrasted in the detection of Fox (46.8 and 12.4%) and Rhi (9.1 and 43.7%). Symptoms of wilting with necrosis in root and crown and general death were reproduced with individual inoculations of Fox (100%), Pyt (100%), Phy (100%), Rhi (60%) and combinations of Fox with Rhi (100%), Pyt (100%) and Cyl (100%). This is the first report that implies Phytophthora sp., P. aphanidermatum and R. fragariae as causal pathogens of dry wilt in México. The morphological identification of Fox and Rhi was confirmed by sequencing of the intergenic region of the rDNA.

En México, la secadera de la fresa (Fragaria x ananassa) se ha asociado con un complejo fungoso demostrándose únicamente la implicación de Fusarium oxysporum (Fox). Por tanto, en el presente estudio se determinó la asociación de hongos y pseudohongos con la enfermedad en diferentes sistemas de manejo agronómico y se verificó la patogenicidad. Dos muestreos se realizaron en el ciclo 2002/03 y tres en 2003/04 en 16 localidades del Valle de Zamora, Michoacán, México. Se sembraron 2640 secciones de raíces y 365 de coronas necróticas y 400 secciones de tejido asintomático en medio de cultivo papa-dextrosa-agar (PDA) y uno selectivo con antibióticos y fungicida PCNB (PARPH). Fox, F. solani (Fso), Cylindrocarpon sp. (Cyl), Pythium aphanidermatum (Pyt), Phytophthora sp. (Phy), Rhizoctonia fragariae (Rhi), Verticillium alboatrum (Ver) y Colletotrichum sp. (Col) se asociaron a la secadera. Fox fue la especie más frecuente (p<0.05) y la única que aumentó de floración a fructificación de 47 a 62% en raíz y 77 a 83% en corona. En plantaciones con acolchado plástico y riego por goteo (A+G), Fox disminuyó 18% respecto a suelo sin acolchado con riego por gravedad, mientras que Cyl aumentó 15% en A+G (p<0.05). El suelo arcilloso y franco arcilloso contrastó en la detección de Fox (46.8 y 12.4%) y Rhi (9.1 y 43.7%). Síntomas de marchitez con necrosis en raíz, corona y muerte general se reprodujeron con inoculaciones individuales de Fox (100%), Pyt (100%), Phy (100%), Rhi (60%) y combinaciones de Fox con Rhi (100%), Pyt (100%) y Cyl (100%). Este es el primer reporte que implica a Phytophthora sp., P. aphanidermatum y R. fragariae como patógenos causales de secadera en México. La identificación morfológica de Fox y Rhi se confirmó por secuenciación de la región intergénica del rADN.