Abstract Objective: To define normal blood pressure at first trimester of pregnancy by performance for pre-eclampsia prediction. Method: A cohort study in singleton pregnancies, according to the competing risks model for pre-eclampsia. Blood pressure was measured according to a standardized method at 11 to 14 weeks’ gestation. Results: Among 797 pregnancies included, there were 40 (5.0%, IC95 3.6; 6.4) deliveries with pre-eclampsia. The systolic, diastolic, and mean arterial blood pressures were respectively of 101(9), 68(8) and 79(8) mmHg in pregnant women who did not develop pre-eclampsia, against 109(10), 75(8) and 86(8) in those who did (p < 0.001, t-test). The areas under the curves were 0.707 (0.637; 0.777), 0.728 (0.661; 0.795), and 0.738 (0.673; 0.803). At a 3% of false positive rate, the cut-off points were 119, 83 and 94 mmHg with predictive values of negative of 95.6%. Conclusions: It is feasible to define the normal values for blood pressure in pregnancy on biostatistic and clinical basis.

Resumen Objetivo: Definir la presión arterial normal en el primer trimestre de la gestación según el desempeño para predecir preeclampsia. Método: Estudio de cohorte en embarazos de feto único, según el modelo de riesgos en competencia para preeclampsia. La presión arterial se midió de manera estandarizada entre las 11 y 14 semanas de gestación. Resultados: En 797 embarazos incluidos hubo 40 (5.0%, intervalo de confianza del 95% [IC 95%]: 3.6-6.4) partos con preeclampsia. Las presiones arteriales sistólica, diastólica y media fueron respectivamente de 101 (9), 68 (8) y 79 (8) mmHg en las embarazadas que no desarrollaron preeclampsia, frente a 109 (10), 75 (8) y 86 (8) mmHg en las que sí (p < 0.001, prueba t de Student). Las áreas bajo la curva fueron 0.707 (0.637-0.777), 0.728 (0.661-0.795) y 0.738 (0.673-0.803). A 3% de falsos positivos, los puntos de corte fueron 119, 83 y 94 mmHg con valores predictivos negativos del 95.6%. Conclusiones: Es factible definir normalidad para la presión arterial en el embarazo con base bioestadística y clínica.

Abstract: The primary objective of this study is to identify the variables that influence the development of a sustainable management, which contributes to the solution of social, environmental, and economic issues of both the environment and the company, enhancing its competitiveness through the creation of shared value. A relational model with eight hypotheses is proposed by using structural equations through the partial least squares method. Sustainable management has five causal variables that act simultaneously, which have a positive, direct, and indirect influence; 1) environmental factors, 2) organizational factors, 3) sustainable leadership, 4) organizational commitment to sustainability, and 5) sustainable management. They explain 44.8% the variance of the competitiveness of companies in the sector. It is concluded that a strategic budget must be built to finance the action plans that each company needs to execute in order to ensure that sustainable management is effectively implemented year after year.

Resumen: El objetivo de este estudio es identificar las variables que influyen en el desarrollo de una gerencia sustentable que contribuya a la solución de problemáticas sociales, ambientales y económicas tanto del entorno como de la misma empresa, potenciando su competitividad por medio de la creación de valor compartido. Para ello, se propone un modelo relacional con ocho hipótesis, utilizando ecuaciones estructurales a través del método de mínimos cuadrados parciales. La gerencia sustentable tiene cinco variables causales que actúan simultáneamente, las que influyen positiva, directa e indirectamente: 1) factores del entorno, 2) factores organizacionales, 3) liderazgo sustentable, 4) compromiso organizacional con la sustentabilidad y 5) gerencia sustentable. Estos explican en un 44.8% la varianza de la competitividad de las empresas del sector. Se concluye que se debe construir un presupuesto estratégico para financiar los planes de acción que cada empresa pertinentemente necesita ejecutar para lograr que la gerencia sustentable se implemente efectivamente año a año.

Abstract Process optimization of multiphase chemical and/or photochemical reactor means a challenge not only at laboratory scale but also while scaling-up is intended towards industrial applications. Using computational tools, such as Computational Fluid Dynamics, is essential to assess the transport limitations of the heterogeneous process to verify the kinetic regime while the reaction and the reactor engineering are studied. Computational Fluid Dynamics, together with Genetic Algorithms, have been currently applied to verify fluid behavior and turbulence. The latter device has been self-designed and is planned to be constructed for CO2 reduction. The results of the Computational Fluid Dynamics simulations are presented and discussed to optimize the operation of a multi-inlet vortex photoreactor. By considering the catalytic particle features, the residence time distribution in the multi-inlet photoreactor has been verified and optimized.

Abstract Background: No preeclampsia screening test has been validated in our country. Objective: To assess the fit and performance of the FMF 4.0 Bayesian algorithm in a Mexican population. Method: Cohort study in singleton pregnancies, according to the competing risks model for preeclampsia. A priori risk was calculated based on medical history. Mean blood pressure (MBP), uterine artery mean pulsatility index (UtAmPI) and pregnancy-associated plasma protein A (PAPP-A) were measured at 11-14 weeks of gestation using standardized methodology. The value of each marker was transformed into multiples of the median (MoM) by the originala algorithm and by the population correctionb. Multivariate normal distribution and Bayes theorem were applied to obtain the post-test probabilities. Results: There was 5.0% (40/807) preeclampsia. Distributions in women without preeclampsia were MBP = 0.927a vs. 0.991b, UtAmPI = 0.895a vs. 1.030b, and PAPP-A = 0.815a vs 0.963b (p < 0.001). The AUC was 0.821a and 0.823b. For a detection rate of 69%, cutoff points were 1 in 240a and 1 in 120b, with false positive rates of 31%a and 29%b. Conclusions: The model has to be adjusted to the target population.

Resumen Antecedentes: Ninguna prueba de tamiz de preeclampsia ha sido validada en nuestro país. Objetivo: Evaluar el ajuste y rendimiento del algoritmo bayesiano FMF 4.0 en una población mexicana. Método: Estudio de cohorte en embarazos de feto único, según el modelo de riesgos en competencia para preeclampsia. El riesgo a priori se calculó por historia clínica. La presión arterial media (PAM), el índice de pulsatilidad medio de la arteria uterina (IPmAUt) y la proteína plasmática A asociada al embarazo (PAPP-A) se midieron a las 11-14 semanas de gestación con metodología estandarizada. El valor de cada marcador se transformó en múltiplos de la mediana (MoM) por el algoritmo originala y el corregidob a la población. Se aplicaron la distribución normal multivariante y el teorema de Bayes para las probabilidades posprueba. Resultados: Hubo un 5.0% (40/807) de preeclampsia. Las distribuciones sin preeclampsia fueron PAM 0.927a vs. 0.991b, UtAmPI 0.895a vs. 1.030b y PAPP-A 0.815a vs. 0.963b (p < 0.001). El área bajo la curva fue 0.821a vs. 0.823b. Para una detección del 69%, los puntos de corte fueron 1 en 240a y 1 en 120b, a falsos positivos del 31%a y 29%b. Conclusiones: El modelo debe ajustarse a la población diana.

The sugarcane borer, Diatraea saccharalis (Fabricius), is the major pest insect attacking sugarcane crops in Brazil. Population control by insecticide treatment is not efficient due to simultaneous presence of all developmental stages of the insect throughout the year, and alternative control methods are needed. Two female-produced sex pheromone components, (Z,E)-hexadeca-9,11-dienal and (Z)-hexadec-11-enal, have previously been reported to elicit antennal activity and behavioral response of males in flight tunnel experiments. However, the attractiveness of these compounds in field tests has been very low. In this study, two additional female-produced compounds in D. saccharalis eliciting consistent antennal response in males were identified as (Z)-hexadec-9-enal and hexadecanal. In flight tunnel assays, the behavioral response to a quaternary blend was significantly higher when compared with the previously identified binary blend. Subtracting (Z)-hexadec-9-enal or hexadecanal from the full blend did not reduce attraction, indicating redundancy in the communication channel. We conclude that additional compounds are part of the sex pheromone of D. saccharalis, which may improve the efficiency of trap lures for monitoring of this pest.

Background and aims: In 2013, blooms similar to those produced by Didymosphenia geminata (Lyngbye) M. Schmidt around the world, were detected in the Grande River basin, Tierra del Fuego province, and in 2014 in de las Vueltas River in Santa Cruz province. The aim of this paper is to analyze the valve morphology and morphometry of these materials to establish if they correspond to D. geminata or to other species of the genus that is producing the massive growth in southern Patagonia. M&M; Samples were collected at Grande River in 2013 and 2015 and, in de las Vueltas River in 2015 and 2016. Samples were analyzed with light and electron microscopy. For morphometric analyses 100 specimens from each sample were measured and statistical analyses were carried out using the R statistical package. Results; The studied populations have the same fine morphology described for other populations collected in Patagonia. Nevertheless, in some sampling sites from Santa Cruz province, we found a morphotype with a markedly smaller size, subcapitated poles, little marked constrictions of the poles, a broad central area (relative to cell size) and 1 to 3 stigmata, that was never reported in South America. Conclusions; The studied populations correspond to D. geminata ssp. geminata Metzeltin & Lange-Bertalot. From a morphological point of view the smaller morphotype present in Santa Cruz belongs to the same subspecies but can be easily misidentified during the routine monitoring programs carried out with light microscope due its size and valve outline.

Introducción y objetivos: En 2013 floraciones similares a las producidas por Didymosphenia geminata (Lyngbye) M. Schmidt en distintos lugares del mundo fueron detectadas en la Cuenca del Río Grande, provincia de Tierra del Fuego y, en 2014 en el río de las Vueltas en la provincia de Santa Cruz. El objetivo del trabajo fue analizar la morfología y morfometría valvar de estos materiales para establecer si corresponden a D. geminata o a otra especie del género que está produciendo floraciones masivas en la Patagonia sur. M&M; Las muestras fueron colectadas en el Río Grande en 2013 y 2015 y en el Río de las Vueltas en 2015 y 2016. El material fue analizado con microscopía óptica y electrónica. Para los análisis morfométricos fueron medidos 100 especímenes por muestra y los análisis estadísticos fueron llevados a cabo con el programa estadístico R. Resultados; Las poblaciones estudiadas presentan las mismas características morfológicas descriptas para poblaciones de distintos lugares de Patagonia. Sin embargo, en Santa Cruz observamos un morfotipo marcadamente más pequeño, con polos subcapitados, constricción suavemente marcada, un área central amplia con 1 a 3 estigmas, que no había sido descripto antes para Sudamérica. Conclusiones; Las poblaciones estudiadas corresponden a D. geminata ssp. geminata Metzeltin & Lange-Bertalot. Desde un punto de vista morfológico, los especímenes pequeños presentes en Santa Cruz pertenecen a la misma subespecie pero por su tamaño y contorno valvar pueden ser confundidos con otros taxones durante los programas de monitoreo llevados a cabo con microscopía óptica.

Introduction: Thyroid cancer has generally a good prognosis after surgical and/or radioactive iodine (RAI) treatment; however, these tumors that persist or that are not candidate to these treatments have a worse prognosis, which makes the use of tyrosine kinase inhibitors (TKIs) a good management alternative, since it has demonstrated progression-free survival (PFS) and response rate benefits, and it is, therefore, important to describe new markers and future therapies for this type of tumors. Materials and methods: The purpose of this review is to describe the current state of the treatment of advanced or relapsing thyroid cancer that is not susceptible to management with surgery or RAI, the benefits, and limitations of the use of TKIs, as well as an analysis of this tumor’s molecular biology and its clinical repercussion. Results: The use of sorafenib and lenvatinib in differentiated thyroid carcinoma that is refractory to RAI, and cabozantinib and vandetanib for advanced medullary carcinomas, has demonstrated benefit in this type of patients, with an impact on PFS, response rates, and disease control. There are ongoing studies with immunotherapy, and we will be alert for their results. Conclusion: The treatment with TKI in metastatic thyroid cancer, has shown benefit, the determination of mutations and markers will determine which is the best TKI for the different subtypes of thyroid cancer.

Abstract Introducción: El cáncer de tiroides generalmente tiene un buen pronóstico después del tratamiento quirúrgico y/o de yodo radioactivo (RAI); sin embargo, los tumores que persisten o que no son candidatos para estos tratamientos tienen un peor pronóstico, lo que hace del uso de inhibidores de la tirosina cinasa (TKI) una buena alternativa de manejo, ya que ha demostrado supervivencia libre de progresión (SLP) y beneficios en la tasa de respuesta. Por lo tanto es importante describir nuevos marcadores y futuras terapias para este tipo de tumores. Materiales y métodos: El propósito de esta revisión es describir el estado actual del tratamiento del cáncer de tiroides avanzado o recidivante que no es susceptible para el tratamiento con cirugía o RAI, los beneficios y limitaciones del uso de TKI, así como un análisis de la biología molecular de este tumor y su repercusión clínica. Resultados: El uso de sorafenib y lenvatinib en el carcinoma diferenciado de tiroides que es refractario al RAI, y cabozantinib y vandetanib para carcinomas medulares avanzados, ha demostrado beneficio en este tipo de pacientes, con un impacto en la SLP, las tasas de respuesta y el control de la enfermedad. Hay estudios en curso con inmunoterapia, y estaremos atentos a sus resultados. Conclusión: El tratamiento con TKI en el cáncer de tiroides metastásico ha demostrado beneficios, la determinación de mutaciones y marcadores determinará cuál es el mejor TKI para los diferentes subtipos de cáncer de tiroides.

Resumo Embora evidências crescentes apoiem a monitoração da perfusão periférica em pacientes sépticos, nenhuma revisão sistemática foi feita para explorar a força da associação entre a má perfusão avaliada na microcirculação dos tecidos periféricos e a mortalidade. Uma busca nas bases de dados mais importantes foi feita para encontrar artigos publicados até fevereiro de 2018 que correspondessem aos critérios deste estudo, com diferentes palavras-chave: sepse, mortalidade, prognóstico, microcirculação e perfusão periférica. Os critérios de inclusão foram estudos que avaliaram a associação entre perfusão/microcirculação periférica e mortalidade em sepse. Os critérios de exclusão adotados foram os seguintes: artigos de revisão, estudos com animais/pré-clínicos, metanálises, resumos, anais de congressos, editoriais, cartas, relatos de casos, artigos duplicados e artigos que não continham resumos e/ou texto. Foram selecionados 26 artigos nos quais 2465 pacientes com sepse foram avaliados com pelo menos um método reconhecido para monitorar a perfusão periférica. A revisão demonstrou um grupo heterogêneo de pacientes gravemente enfermos com uma taxa de mortalidade entre 3% e 71% (mediana = 37% [28%-43%]). Os métodos de avaliação mais comumente usados foram a espectroscopia na região do infravermelho próximo (Near-Infrared Spectroscopy - NIRS) (7 artigos) e a análise de imagens em campo escuro (Sidestream Dark-Field - SDF) (5 artigos). O leito vascular mais avaliado foi a microcirculação sublingual/bucal (8 artigos), seguida pela ponta do dedo (4 artigos). A maioria dos estudos (23 artigos) demonstrou uma clara relação entre má perfusão periférica e mortalidade. Em conclusão, o diagnóstico de hipoperfusão/anormalidades microcirculatórias em órgãos não vitais periféricos foi associado ao aumento da mortalidade. No entanto, estudos adicionais devem ser feitos para verificar se essa associação pode ser considerada um marcador da gravidade ou um fator desencadeante da falência de órgãos na sepse.

Abstract Although increasing evidence supports the monitoring of peripheral perfusion in septic patients, no systematic review has been undertaken to explore the strength of association between poor perfusion assessed in microcirculation of peripheral tissues and mortality. A search of the most important databases was carried out to find articles published until February 2018 that met the criteria of this study using different keywords: sepsis, mortality, prognosis, microcirculation and peripheral perfusion. The inclusion criteria were studies that assessed association between peripheral perfusion/microcirculation and mortality in sepsis. The exclusion criteria adopted were: review articles, animal/pre-clinical studies, meta-analyzes, abstracts, annals of congress, editorials, letters, case-reports, duplicate and articles that did not present abstracts and/or had no text. In the 26 articles were chosen in which 2465 patients with sepsis were evaluated using at least one recognized method for monitoring peripheral perfusion. The review demonstrated a heterogeneous critically ill group with a mortality-rate between 3% and 71% (median = 37% [28%-43%]). The most commonly used methods for measurement were Near-Infrared Spectroscopy (NIRS) (7 articles) and Sidestream Dark-Field (SDF) imaging (5 articles). The vascular bed most studied was the sublingual/buccal microcirculation (8 articles), followed by fingertip (4 articles). The majority of the studies (23 articles) demonstrated a clear relationship between poor peripheral perfusion and mortality. In conclusion, the diagnosis of hypoperfusion/microcirculatory abnormalities in peripheral non-vital organs was associated with increased mortality. However, additional studies must be undertaken to verify if this association can be considered a marker of the gravity or a trigger factor for organ failure in sepsis.

Abstract Circumscribed choroidal hemangiomas (CCHs) are relatively rare. We report the response of a symptomatic CCH to photodynamic therapy (PDT). A 70-year-old male presented with blurred vision of the left eye (OS). Best-corrected visual acuity (BCVA) was 20/60 right eye and 20/160 OS. Biomicroscopy revealed bilateral cataracts. Diagnosis of CCH was made fundoscopically for OS and confirmed with optical coherence tomography (OCT). One session of PDT with individualized parameters was administered. After 2 months, anatomical improvement was evidenced with OCT and BCVA was 20/60. After cataract surgery, his BCVA was of 20/25 and remained stable. PDT showed excellent anatomic and visual results after a 2-year follow-up.

Resumen Los hemangiomas coroideos circunscritos son relativamente raros. Reportamos la respuesta de uno sintomático con terapia fotodinámica. Un hombre de 70 años presentó visión borrosa en el ojo izquierdo. La mejor agudeza visual corregida fue de 20/60 en el ojo derecho y de 20/160 en el izquierdo. La biomicroscopía demostró catarata en ambos ojos. En el ojo izquierdo se diagnosticó un hemangioma coroideo circunscrito confirmado con tomografía de coherencia óptica. Se administró una sesión de terapia fotodinámica con parámetros individualizados. Dos meses después se observó mejoría anatómica en la tomografía de coherencia óptica, y la mejor agudeza visual corregida fue de 20/60. Después de la cirugía de catarata, la mejor agudeza visual corregida fue de 20/25 y tuvo estabilidad. La terapia fotodinámica mostró excelentes resultados anatómicos y funcionales a los 2 años.

Abstract We present the characterization of the main properties of a sample of 98 AGN host galaxies, both type-II and type-I, in comparison with those of ≈2700 non-active galaxies observed by the MaNGA survey. We found that AGN hosts are morphologically early-type or early-spirals. AGN hosts are, on average, more massive, more compact, more centrally peaked and more pressure-supported systems. They are located in the intermediate/transition region between star-forming and non-starforming galaxies (i.e., the so-called green valley). We consider that they are in the process of halting/quenching the star formation. The analysis of the radial distributions of different properties shows that the quenching happens from inside-out involving both a decrease of the efficiency of the star formation and a deficit of molecular gas. The data-products of the current analysis are distributed as a Value Added Catalog within the SDSS-DR1411.

Resumen Presentamos la caracterización de las propiedades de 98 galaxias que albergan AGN, tanto de Tipo-I como de Tipo-II, en comparación con ≈2700 galaxias no activas extraídas del mapeado MaNGA. Las galaxias con AGN son de tipo temprano y espirales tempranas. Las galaxias con AGN son, en promedio, más masivas, compactas y concentradas en las partes centrales que las no activas, además de estar más soportadas por presión. Las galaxias con AGN se encuentran en la zona de transición entra las galaxias con formación estelar y las que no forman estrellas (valle verde), estando en el proceso de inhibir/detener su formación estelar. Las distribuciones radiales de diferentes propiedades muestran que esta inhibición ocurre desde dentro hacia fuera, debido a un decremento tanto de la eficiencia de la formación estelar como del gas molecular. Los productos de este análisis están disponibles como un Catálogo de Valor Añadido incluido en el SDSS-DR1411.

Abstract BACKGROUND: Testicular cancer is the most frequent malignant process in males between 15 and 35 years of age. A history of germ cell testicular tumor is the main risk factor for presenting with contralateral testicular cancer. AIM: To describe the clinical and histopathologic characteristics of patients with synchronous or metachronous bilateral testicular tumors. MATERIALS AND METHODS: A retrospective, descriptive, crosssectional study was conducted on patients diagnosed with testicular tumor, seen at the Urology Division of the Hospital General “Dr. Manuel Gea González” within the time frame of January 1989 and January 2016. The demographic, clinical, and histopathologic characteristics of those patients were evaluated through a descriptive analysis. RESULTS: The study included 346 patients with testicular cancer, 9 (2.6%) of whom presented with bilateral tumors and had a mean age of 40.2 years: 7 (77.7%) of those patients had synchronous tumors and 2 (22.2%) had metachronous tumors. The reported histopathologic types were classic seminoma in 5 (55.5%) patients, lymphoma in 2 (22.2%) patients, mixed germ cell in 1 (11.1%) patient, and spermatocytic seminoma in 1 (11.1%) patient. All 9 patients (100%) underwent bilateral orchiectomy, 8 (88.8%) of the patients had neoadjuvant treatment with chemotherapy, and 6 (66.6%) of the patients accepted hormone therapy. CONCLUSIONS: Bilateral testicular tumors are rare. Once the diagnosis is made, management should be multidisciplinary (urologist/ oncologist). Regardless of bilaterality, outcome depends on tumor type and stage. The cure rate is high in the majority of cases.

Resumen ANTECEDENTES: el cáncer de testículo representa el proceso maligno más frecuente en varones de 15 a 35 años de edad. El antecedente de tumor testicular germinal es el principal factor de riesgo para padecer cáncer testicular contralateral. OBJETIVO: describir las características clínicas e histopatológicas de los pacientes con tumores testiculares bilaterales sincrónicos y metacrónicos. MATERIALES Y MÉTODOS: estudio retrospectivo, descriptivo, transversal, realizado en pacientes con diagnóstico de tumor testicular, atendidos en la División de Urología del Hospital General Dr. Manuel Gea González, entre enero de 1989 a enero de 2016. Se evaluaron las características demográficas, clínicas e histopatológicas, con la finalidad de efectuar el análisis descriptivo. RESULTADOS: se incluyeron 346 pacientes con cáncer de testículo, de los que solo se identificaron 9 (2.6%) casos con tumores bilaterales, con edad promedio de 40.2 años: 7 (77.7%) de manifestación sincrónica y 2 (22.2%) metacrónica. El resultado histopatológico más frecuente fue seminoma clásico (n = 5; 55.5%), linfoma (n = 2; 22.2%), tumor germinal mixto (n = 1; 11.1%) y seminoma espermatocítico (n = 1; 11.1%). El tratamiento consistió en orquiectomía radical bilateral (n = 9; 100%); terapia neoadyuvante con quimioterapia (n = 8; 88.8%) y tratamiento hormonal androgénico (n = 6; 66.6%). CONCLUSIÓN: los tumores testiculares bilaterales son poco frecuentes. El diagnóstico implica la participación de un equipo multidisciplinario (urólogo-oncólogo). Independientemente de la bilateralidad, el pronóstico depende del tipo histológico y estadificación tumoral, que en la mayoría de los casos supone alto porcentaje de curación.

Desde el inicio de los servicios electrónicos, los usuarios de Internet han enviado su información personal y financiera a diferentes servidores web, perdiendo el control sobre su información. Años más tarde, con la popularización de los sitios de redes sociales, la información personal de los usuarios se encuentra disponible y fluye rápidamente entre miembros de la comunidad, exponiendo su privacidad. Por lo tanto, varios investigadores han estudiado la percepción de los usuarios acerca de la privacidad y seguridad en Internet, mundos virtuales y sitios de redes sociales desde. En este sentido, la primera contribución del presente trabajo es la exposición de problemas de privacidad y seguridad existentes en el proceso de registro. Además, se describen los problemas que pueden ocasionar la falta de seguridad y privacidad en sitios de redes sociales. Finalmente, se presentan los resultados de una encuesta sobre privacidad y seguridad de usuarios mexicanos, coincidiendo con trabajos previos.

Since the beginning of electronic services, Internet users have disclosure their personal and financial information to different web servers, losing control over their information. Years later, with the popularization of social networking sites, users' personal information is available and flows quickly among community members, exposing their privacy. Therefore, several researchers have studied the perception of users about privacy and security in the Internet, virtual worlds, and social networking sites since. In this sense, the first contribution of the present work is the exposition of problems of privacy and security existing in the process of registration. In addition, it describes the problems that can cause the lack of security and privacy on social networking sites. Finally, the results of a survey on privacy and security of Mexican users, coinciding with previous work, are presented.

Resumen La revisión teórica y conceptual de la que se ocupa este artículo tiene su origen en la investigación realizada dentro de la disertación doctoral Direccionamiento estratégico para la competitividad de las pymes del sector textil-confecciones de la ciudad de Bogotá: un análisis frente a la competencia china realizada en la Universidad de Celaya en México, que a su vez se constituyó como base del proyecto de análisis y explicación de las deficiencias estructurales que impiden el desarrollo competitivo de las pymes del sector textil-confección de Bogotá frente a la competencia china desde un enfoque sistémico, desarrollado en la Universidad EAN. La variable de análisis en torno a la cual gira este texto es la política macroeconómica, razón por la cual se analiza su relación con la competitividad de las pymes del sector, la importancia de la política económica en Colombia en los dos últimos periodos presidenciales y la política económica en China en el último quinquenio.

Resumo A revisão teórica e conceitual da que se ocupa este artigo tem sua origem na pesquisa realizada dentro da tese doutoral Direcionamento estratégico para a competitividade das pequenas e médias empresas (PMEs) do setor têxtil-confecções da cidade de Bogotá: uma análise frente à concorrência chinesa, realizada na Universidade de Celaya, México, que se constituiu como base do projeto de análise e explicação das deficiências estruturais que impedem o desenvolvimento competitivo das PMEs do setor têxtil-confecção de Bogotá frente à concorrência chinesa a partir de um enfoque sistêmico, desenvolvido na Universidade EAN. A variável de análise em torno da qual gira este texto é a politica macroeconômica, razão pela qual se analisa sua relação com a competitividade das PMEs do setor, a importância da política econômica na Colômbia nos dois últimos períodos presidenciais e a política econômica na China no último quinquenio.

Abstract This article aims at making a theoretical review based on research, which has taken place as part of a doctoral dissertation entitled Strategic Management to Achieve Competitiveness in the Textile Sector in Bogota. This research paper analyzes the impact of Chinese competition on the textile sector, which also sets the bases for a project done at Universidad EAN. This study analyzes and describes structural differences that stop competitive development of PyMEs from the textile- manufacturing sector in Bogota facing a strong Chinese competition. Its variable for the analysis made is the macroeconomic policy, a reason to study its direct relation with competitiveness of PyMes from the textile sector, the importance of the economic policy in Colombia during the last two presidential periods and the economic policy of China in the last five years.

Resumé L'analyse théorique et conceptuelle que nous offre cet article a pour origine la thèse doctorale "Directionnement stratégique pour la compétitivité des PME du secteur textile-confection de la viile de Bogotá: analyse face à la concurrence chinoise" réalisée par l'Université de Celaya, au Mexique, et constituant la base du projet d'analyse et d'explication des déficiences structurelles qui retardent le développement compétitif des PME du secteur textile-confection de Bogotá. La variable d'analyse prise en compte dans ce document sont la politique macroéconomique qui sera analysée sous l'angle de la compétitivité des PME du secteur et 'importance de la politique économique en Colombie lors des deux derniers mandas présidentiels ainsi que la politique économique chinoise du dernier quinquennat.

Introduction: The treatment of chronic noncancer pain (CNCP) with opioids is controversial because its effectiveness on the long-term outcomes has not been proven. The few trials focusing on dependence and addiction demonstrated increased mortality among CNCP patients receiving high doses of opioids. We therefore decided to analyze patients living in the northern area of the province of Cadiz who had exceeded the defined daily dose (DDD). The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. Materials and methods: The northern area of Cadiz has a population of 360,000 inhabitants. Patients who exceeded the DDD of opioid in December 2014 were identified. The clinical history of each of these patients was studied retrospectively. Results: Twenty-three patients were identified who at least needed to double the DDD of their opioids. Consequently, the incidence of patients exceeding the DDD in the area under consideration was 1 per 15,000 inhabitants. Four of these were cancer patients (17 %) while the others suffered from CNCP (83 %). CNCP in these patients predominantly was of the osteo-articular type of pain (65 %), with the failed back syndrome, occurring in 8 cases (35 %), representing the most frequent diagnosis. Patient ages ranged from 34 to 84 Y with a median of 58 Y. The youngest of these (34 Y) requiring the largest amounts of drugs. The daily consumption of this youngest patient corresponded to 34 times the DDD, two other patients took 8 times the DDD, 1 four times, 4 three times and, finally, 11 patients needed to double the DDD. Most of the patients were taking opioids for breaktrough pain, the vast majority of these (17 patients) using transmucosal fentanyl citrate formulations, i.e. Effentora® or Actiq®. Most of the patients took oxycodone (7) or transdermal fentanyl (8), as delayed action opioid. Two patients were not taking opioids with delayed action. It was noted that 11 patients (47 %) had a psychiatric history, 2 of them had a suicide attempt. Conclusions: The inappropriate use of opioids occurs mainly in non-cancer patients. There was a clear relationship with psychiatric disorders. There are relations of misuse and abuse of fast-acting drugs, especially fentanyls. Although the abuse of opioids is rare, so we must be cautious about starting treatment CNCP. It shoulf be bourne in mind that in these patients the effectiveness of opioids needs to be reassessed periodically, considering referral to the pain unit when opioid requirements exceeding 180 mg of morphine or its equivalent.

Introducción: La utilización de opioides en dolor crónico no oncológico (DCNO) es controvertida porque no está demostrada su utilidad a largo plazo. Hay pocos estudios sobre dependencia y adicción; del mismo modo se ha descrito un aumento de mortalidad en pacientes que reciben altas dosis de opioides en DCNO. Por esto, nos propusimos analizar a los pacientes que superaban la dosis diaria definida, DDD, en el área norte de la provincia de Cádiz. La DDD es la dosis diaria de mantenimiento media en adultos. Material y métodos: El área norte de la provincia de Cádiz tiene una población aproximada de 420.000 habitantes. Se detectaron a los pacientes que superaban la DDD de opiáceos en diciembre de 2014. Estudiamos la historia clínica de todos estos pacientes. Resultados: Se encontraron 23 pacientes que, por lo menos, duplicaban la DDD del opiáceo utilizado. Por tanto, la incidencia en nuestra área era de un paciente por cada 18.000 habitantes. Cuatro de ellos son pacientes oncológicos (17 %), el resto de dolor crónico no oncológico (83 %). Predomina claramente el dolor tipo osteo-articular (65 %), siendo el diagnóstico más frecuente el síndrome postlaminectomía con 8 casos (35 %). La edad media era de 58 años, oscilando entre la más joven, 34 años, que era la que más dosis consumía, y la de más edad con 84 años. La DDD/día mayor es la de la paciente más joven con 34 veces la DDD, 2 con ocho veces la DDD, 2 con siete veces la DDD, dos con cinco veces la DDD, 1 con cuatro veces, 4 con tres veces y, por último, 11 pacientes que consumían el doble de la DDD. Todos los pacientes tomaban un opiáceo para el dolor irruptivo, la gran mayoría (17 pacientes) tomaban comprimidos de fentanilo oral transmucoso (Effentora® o Actiq®). La mayoría de los pacientes tomaban oxicodona (7) o fentanilo transdérmico (8), como opioide de acción retardada. Dos pacientes no tomaban ningún opioide de acción retardada. Se observó que once pacientes (47 %) tenían algún antecedente psiquiátrico, dos de ellos tuvieron algún intento de autolisis. Conclusiones: El uso inadecuado de opioides se da sobre todo en pacientes no oncológicos. Había una relación clara con patología psiquiátrica. Hay relaciones de uso inadecuado y abuso de opiáceos con los de acción rápida, sobre todo fentanilos, aunque el abuso de opioides es poco frecuente, con lo que hay que ser cautos en iniciar tratamiento en DCNO. Hay que reevaluar de manera periódica la eficacia de los opioides, considerando la derivación a la Unidad de Dolor cuando la dosis de morfina supere los 180 mg de morfina o equivalente.

Abstract The main goal of this research was the synthesis of enantiopure R(-)-3-aminoisobutyric acid from dihydrothymine with good yield, high stereospecificity and relative simplicity. Seventy two percent yield of the product was obtained in three steps. Step one consisted of dihydrothymine racemization. Step two was a dihydropyrimidinase reaction involving the Pseudomonas aeruginosa 10145 bacterial strain as the biocatalyst. Step three was performed with a diazotization reaction. The bacteria's enzymes determined the stereochemistry of the process since the diazotization reaction did not interfere at this point. The results of this work provide an interesting method for the production of commercial β-amino acids from other substituteddihydrothymines.