ABSTRACT Aiming at the search for a new alternative for the sustainability of the properties in the irrigated areas of the Brazilian Northeast, the objective of this study was to identify the ideal irrigation system and depth for a better yield and quality of pear fruits in the Sub-middle São Francisco region. The experiment was conducted in the commercial orchard of the Frutos do Sol farm, located in the municipality of Petrolina, PE, Brazil, from October 2016 to November 2017. The treatments consisted of four irrigation depths (60; 80; 100 and 120% of crop evapotranspiration - ETc), under two irrigation systems (drip and micro-sprinkler), in two crop cycles of ‘Triunfo’ pear. Yield, average fruit weight, water productivity, pulp firmness and titratable acidity, total soluble solids and lightness of the fruits were analyzed. Irrigation depths of 96.04% and 94.84% ETc promote, respectively, the highest marketable yields for the first (43.48 t ha-1) and second (26.55 t ha-1) cycle of ‘Triunfo’ pear in the Brazilian semi-arid region. Drip irrigation system in the warmer period promotes higher yield. The cultivation of ‘Triunfo’ pear irrigated by drip and micro-sprinkler promotes fruits with good commercial quality in the Brazilian semi-arid region.

RESUMO Visando a busca de uma nova alternativa para sustentabilidade das propriedades dos polos irrigados do Nordeste brasileiro, objetivou-se com este estudo identificar o sistema e a lâmina de irrigação ideal para uma melhor produtividade e qualidade dos frutos da pereira, no Submédio São Francisco. O experimento foi conduzido no pomar comercial da fazenda Frutos do Sol, localizado no município de Petrolina - PE, no período de outubro de 2016 a novembro de 2017. Os tratamentos foram constituídos de quatro lâminas de irrigação (60; 80; 100 e 120% da evapotranspiração da cultura - ETc), sob dois sistemas de irrigação (gotejamento e microaspersão), em dois ciclos de cultivos da pereira ‘Triunfo’. Analisou-se a produtividade, peso médio dos frutos, produtividade de água, bem como a firmeza de polpa e a acidez titulável, sólidos solúveis totais e luminosidade dos frutos. As lâminas de irrigação de 96,04% e 94,84% da ETc proporcionam, respectivamente, as maiores produtividades comerciais para o primeiro (43,48 t ha-1) e segundo (26,55 t ha-1) ciclo de cultivo da pereira ‘Triunfo’ no Semiárido brasileiro. O sistema de irrigação por gotejamento no período mais quente proporciona maior produtividade. O cultivo da pereira ‘Triunfo’ irrigada por gotejamento e microaspersão proporcionam frutos com boa qualidade comercial no Semiárido brasileiro.

Abstract Purpose This study analyzes the way that firm-generated content (FGC) was adapted in the accommodation sector through hotel chains' Facebook posts at a time of crisis. Specifically, this research aims to: (1) explore hidden topics in hotel chains' FGC; (2) classify topics according to their promotional or non-promotional content; and (3) compare topics during the first months of the COVID-19 crisis and the same months of 2019. Theoretical framework The method/theoretical approach used in this research is social network analysis. Design/methodology/approach We used content analysis to examine 1,317 Facebook posts from the five hotel chains with the greatest presence in Spain. NodeXL software was used to create a semantic network to reveal the relationships between the ideas embedded in the text collection. Findings 14 latent topics were found in each period, including promotional and non-promotional content. Non-promotional topics increased from one third in 2019 to more than half in 2020, and the most relevant topic in 2020 was “Competitions”. Practical & social implications of the research The findings of our study suggest that during the pandemic, unlike other crises, hotel chains used Facebook to accompany users, entertain them, and maintain the emotional connection with the brand, responding to societal demands. Originality/value This study is novel not only because of its focus on FGC in the tourist accommodation sector, but also because it uses semantic network analysis to study the way in which firms make use of social media in crisis situations.

ABSTRACT The objective of this study was to evaluate the influence of irrigation systems and water depths on physiological, biochemical and production processes of pear trees grown in the Brazilian semi-arid region. The experimental design was randomized blocks, with 2 × 4 factorial scheme, corresponding to two irrigation systems (drip and microsprinkler) and four irrigation depths (60, 80, 100 and 120% of the crop evapotranspiration - ETc), with four replicates. Water deficit and excess applied to plants are harmful to gas exchange as well as to biosynthesis and accumulation of carbohydrates, amino acids and proteins in leaves, compromising the cultivation cycle of pear plants grown in the Sub-Middle São Francisco region. The irrigation depth of 91.8% ETc promotes the highest production of pear (18.49 kg plant-1) under drip and microsprinkler irrigation systems, under the edaphoclimatic conditions of the Sub-Middle São Francisco region.

RESUMO O objetivo deste trabalho foi avaliar a influência de sistemas de irrigação e lâminas de irrigação sobre processos fisiológicos, bioquímicos e produtivos da pereira cultivada no Semiárido brasileiro. O delineamento experimental foi em blocos casualizados, com fatorial 2 x 4, sendo dois sistemas de irrigação (gotejamento e microaspersão) e quatro lâminas de irrigação (60; 80; 100 e 120% da evapotranspiração da cultura - ETc), com quatro repetições. A deficiência e o excesso hídrico aplicados às plantas são prejudiciais às trocas gasosas, bem como à biossíntese e acúmulo de carboidratos, aminoácidos e proteínas nas folhas, comprometendo o ciclo de cultivo de pereiras cultivadas na região do Submédio São Francisco. A lâmina de irrigação de 91,8% ETc promove a maior produção de pereira (18,49 kg planta-1) sob sistemas de irrigação por gotejamento e microaspersão, nas condições edafoclimáticas do Submédio São Francisco.

Abstract The aim of this study was to evaluate, at short term, the physico-chemical and biological quality of residually contaminated soils after the Aznalcóllar mine spill and treated with “tailor-made Technosols”. Two Technosols with different properties (T4 and T6) were used as treatments. Both are composed of ex-situ contaminated soil and two wastes from mining (sludge rich in iron oxyhydroxides and marble sludge); and T4 by a waste from agro-industry (solid olive-mill by-product) and T6 by one from urban activity (vermicompost from gardening). After 6 months of application, samples of Technosols and treated contaminated soils were characterised (soil properties, total, soluble and available concentrations of potentially harmful elements (PHEs), and toxicity bioassay with Lactuca sativa L.) and compared with baseline conditions. Some soils in the Guadiamar Green Corridor presented a significant environmental and human health risk due to their extreme characteristics (pH<4, low fertility and multielemental contamination). After only six months, the application of Technosols on these soils has led to a significant improvement in their physico-chemical and biological properties (pH neutralisation, reduction of mobility PHEs and enrichment in organic carbon). So, in the long term, soil remediation through the Technosols is expected to be effective and proven in future studies.

Resumen Nuestro objetivo fue evaluar, a corto plazo, la calidad fisicoquímica y biológica de suelos contaminados tras el accidente de Aznalcóllar y ser tratados con "Tecnosoles a la carta". Se aplicaron dos Tecnosoles (T4 y T6); ambos compuestos por suelos contaminados ex-situ y dos residuos procedentes de la minería (lodos ricos en oxihidróxidos de hierro y lodos de mármol); y T4 también por uno agrícola (subproductos sólidos de almazara) y T6 por uno urbano (vermicompost de jardinería). Tras 6 meses, se caracterizaron los Tecnosoles y los suelos contaminados tratados (propiedades del suelo, concentraciones totales, solubles y disponibles de elementos potencialmente contaminantes (EPCs), y bioensayo de toxicidad con Lactuca sativa L.) y compararon con las condiciones de partida. Algunos suelos del Corredor Verde del Guadiamar presentaban un importante riesgo ambiental y para la salud humana debido a sus características extremas (pH<4, baja fertilidad y contaminación multielemental). La aplicación de los Tecnosoles ha mejorado significativamente sus propiedades fisicoquímicas y biológicas (neutralización del pH, reducción de la movilidad de los PHE y enriquecimiento en carbono orgánico) en tan solo 6 meses. Así pues, a largo plazo, se espera que la remediación de los suelos mediante los Tecnosoles sea eficaz y demostrada en futuros estudios.

Resumen En las áreas tropicales de Chiapas, México, la producción de frijol es afectada por el mosaico amarillo dorado, la sequía y la acidez de los suelos. El objetivo de esta investigación fue identificar genotipos de frijol resistentes al mosaico amarillo dorado, con mayor productividad que la variedad Negro Jamapa, comúnmente sembrada en Chiapas. En otoño-invierno de 2019-2020 se estableció un experimento en tres localidades del centro de Chiapas, se evaluaron 11 líneas y tres variedades de frijol negro, incluida Negro Jamapa. El diseño experimental fue bloques al azar con tres repeticiones. Se cuantificó la incidencia de mosaico amarillo dorado y el rendimiento de grano. Los datos de las tres localidades se analizaron de manera individual y combinada. También se realizaron análisis de correlación entre la incidencia de mosaico amarillo dorado y el rendimiento de los genotipos. El mosaico amarillo dorado redujo el rendimiento en los tres sitios de evaluación (Villa Corzo, r= -0.562*; CECECH, r= -0.757** y El Gavilán, r= -0.552*). La línea Jamapa Plus/XRAV-187-3-4-1 mostró los mayores daños por esta enfermedad con una calificación promedio de incidencia de 6, significativamente superior al resto de los genotipos; en tanto que, las líneas: Negro Citlali/XRAV-187-3-1-6, Papaloapan/SEN 46-7-7 y Jamapa Plus/XRAV-187-3-4-4 y la variedad Verdín mostraron la mayor resistencia al mosaico amarillo dorado, con calificaciones de incidencia de entre 1.67 y 3.22, estadísticamente inferiores a la del testigo Negro Jamapa. Estos cuatro genotipos también obtuvieron rendimientos promedio significativamente sobresalientes (mayores a 934 kg ha-1) y superiores al de Negro Jamapa.

Abstract In the tropical areas of Chiapas, Mexico, bean production is affected by golden yellow mosaic, drought and soil acidity. The objective of this research was to identify bean genotypes resistant to the golden yellow mosaic, with higher productivity than the Negro Jamapa variety, commonly sown in Chiapas. In the autumn-winter of 2019-20 20, an experiment was established in three localities in central Chiapas, 11 lines and three varieties of black bean, including Negro Jamapa, were evaluated. The experimental design was randomized blocks with three repetitions. The incidence of golden yellow mosaic and grain yield were quantified. Data from the three localities were analyzed individually and in combination. Correlation analyses between the incidence of golden yellow mosaic and genotype yield were also performed. The golden yellow mosaic significantly reduced yield at the three sites of evaluation (Villa Corzo, r= -0.562*; CECECH, r= -0.757** and El Gavilán, r= -0.552*). The Jamapa Plus/XRAV-187-3-4-1 line showed the greatest damage from this disease with an average incidence score of 6, significantly higher than those of the rest of the genotypes, while the lines: Negro Citlali/XRAV-187-3-1-6, Papaloapan/SEN 46-7-7 and Jamapa Plus/XRAV-187-3-4-4 and the Verdín variety showed the highest resistance to the golden yellow mosaic, with incidence scores between 1.67 and 3.22, statistically lower than that of the control Negro Jamapa. These four genotypes also obtained average yields that were significantly outstanding (greater than 934 kg ha-1) and higher than that of Negro Jamapa.

Abstract In 1895, Nicolás Sáenz proposed to the Chilean government to purchase a collection of “Inca” objects brought from Lima. This acquisition was approved in 1897. Despite the difficulties caused by the War of the Pacific, the Museo Nacional de Historia Natural (Chile) continued to acquire Peruvian antiquities, following a tradition of comparative studies of material culture. Within the framework of social evolutionism, these antiquities were a measure of civilization, a reference from which to evaluate the material culture of the pre-Hispanic peoples of Chile. This article analyzes the acquisition of the Sáenz collection as the culmination of a process of transition towards an archeology that focused on the new post-war territorial acquisitions in the Pacific.

Resumen En 1895, Nicolás Sáenz propuso al gobierno chileno la venta de una colección de objetos “incaicos” traídos desde Lima; adquisición aprobada en 1897. Pese a las dificultades ocasionadas por la Guerra del Pacífico, el Museo Nacional (Chile) continuó adquiriendo antigüedades peruanas, siguiendo una tradición de estudios comparados de cultura material. Dentro del marco del evolucionismo social, estas antigüedades servían como medida de civilización, con la cual contrastar la cultura material de los pueblos prehispánicos de Chile. Este artículo analiza la adquisición de la colección Sáenz, como un punto cúlmine de un proceso de tránsito hacia a una arqueología enfocada en las nuevas adquisiciones territoriales post guerra del Pacífico.

The accelerated scientific, technological, and social advances in recent years have posed new challenges for professional training institutions, where universities play a leading role. Medical schools have not been oblivious to this process. This is how Pontificia Universidad Católica de Chile implemented in 2015 a curricular reform derived from the joint work of academics, students and graduates. For this purpose, a model consisting of stages was followed, including the identification of the problem, general assessment of needs, definition of purpose and learning objectives. We worked with surveys, focus groups and committees of academics and students to identify and map content within the mesh, review terminal learning objectives while creating and reviewing courses for the vertically and horizontally integrated delivery of content and competencies. The first cohort of the new curriculum entered in 2015, consisting of 126 students. The implementation required constant follow-up and monitoring, establishing changes and adjustments according to educational needs and unforeseen conditions such as the COVID-19 pandemic. The implementation process of the new curriculum has been positive, adjusting to the defined strategic planning and responding to unexpected events.

Los nuevos desarrollos metodológicos y tecnológicos de la última década permiten resolver, o al menos atenuar, los problemas psicométricos de los test de elección forzosa (EF) para la medición de la personalidad. En estas pruebas, a la persona evaluada se le muestran bloques de dos o más frases de parecida deseabilidad social, entre las que debe elegir aquella que le represente mejor. De esta manera, los test de EF buscan reducir los sesgos de respuesta en pruebas de autoinforme. No obstante, su uso no está exento de riesgos y complicaciones si no se elaboran adecuadamente. Afortunadamente, los nuevos modelos psicométricos permiten modelar las respuestas en este tipo de test, así como optimizar su construcción. Más aún, permiten la construcción de Test Adaptativos Informatizados de EF (TAI-EF) “on-the-fiy”, en los que cada bloque se construye en el mismo momento de aplicación, emparejando óptimamente las frases de un banco previamente calibrado.

The new methodological and technological developments of the last decade make it possible to resolve or, at least, attenuate the psychometric problems of forced-choice (FC) tests for the measurement of personality. In these tests, the person being tested is shown blocks of two or more sentences of similar social desirability, from which he or she must choose which one best represents him or her. Thus, FC tests aim to reduce response bias in self-report questionnaires. However, their use is not without risks and complications if they are not created properly. Fortunately, new psychometric models make it possible to model responses in this type of test and to optimize their construction. Moreover, they allow the construction of “on the fly” computerized adaptive FC tests (CAT-FC), in which each item is constructed on the spot, optimally matching sentences from a previously calibrated bank.

Abstract BACKGROUND: Pseudomyxoma peritonei is very rare; it is characterized by mucinous ascites and peritoneal implants related to rupture and dissemination of the contents of a mucinous tumor. In 80 to 90% of cases the primary tumor is appendicular and the ovary is a truly exceptional location. CLINICALCASE: A 49 year old female patient presented for consultation due to abdominal pain. Imaging tests showed a left adnexal tumor and findings suggestive of pseudomyxoma peritonei. At surgery, the ovarian mass was partially fragmented, with an enlarged appendix and extensive peritoneal implants; in addition to a large amount of free mucin in the peritoneal cavity. The anatomopathological analysis determined the existence of a mucinous adenocarcinoma in the affected ovary, with positive immunohistochemistry for CK7+ and CK20+, multiple mucin implants and an undamaged appendix. Therefore, a diagnosis was made: pseudomyxoma peritoneum of ovarian origin. After two surgical interventions she did not achieve complete cytoreduction. The patient remained stable for seven years, at which time the symptoms of the disease became evident and led to her death. CONCLUSION: Determining the origin of a pseudomyxoma peritonei remains a challenge as often both the appendix and ovaries are affected simultaneously. Therefore, appendectomy and bilateral ovarian exploration should be routine practice. Extensive specimen analysis and immunohistochemistry can facilitate cataloging of these infrequent tumors.

Resumen ANTECEDENTES: El pseudomixoma peritoneal es muy raro; se caracterizada por ascitis mucinosa e implantes peritoneales relacionados con la rotura y diseminación del contenido de un tumor mucinoso. En 80 al 90% de los casos el tumor primario es apendicular y el ovario es una localización realmente excepcional. CASO CLÍNICO: Paciente de 49 años que acudió a consulta debido a un dolor abdominal. En las pruebas de imagen se visualizó una tumoración anexial izquierda y se advirtieron hallazgos sugerentes de pseudomixoma peritoneal. En la cirugía, la masa ovárica se objetivó parcialmente fragmentada, con el apéndice aumentado de tamaño y extensos implantes peritoneales; además de gran cantidad de mucina libre en la cavidad peritoneal. El análisis anatomopatológico determinó la existencia de un adenocarcinoma mucinoso en el ovario afectado, con inmunohistoquímica positiva para CK7+ y CK20+, múltiples implantes de mucina y el apéndice sin daño. Por lo anterior se diagnosticó: pseudomixoma peritoneal de origen ovárico. Luego de dos intervenciones quirúrgicas no se consiguió la citorreducción completa. La paciente permaneció estable durante siete años, momento en el que fue evidente el avance de los síntomas de la enfermedad, circunstancia que la condujo a la muerte. CONCLUSIÓN: Determinar el origen de un pseudomixoma peritoneal sigue siendo un reto pues, con frecuencia, tanto el apéndice como los ovarios se afectan simultáneamente. Por ello, la apendicectomía y la exploración bilateral de los ovarios deben ser prácticas de rutina. El análisis extenso de las muestras y la inmunohistoquímica pueden facilitar la catalogación de estos infrecuentes tumores.

Abstract OBJECTIVE: To expose the surgical outcomes of patients operated on for endometrial cancer, to analyze if there are points of improvement in our clinical practice and to contribute more data to the published evidence, to help advance the surgical treatment of patients with this disease. MATERIALS AND METHODS: Observational, descriptive, and retrospective study carried out in the Gynecologic Oncology Unit of the Virgen Macarena Regional Hospital of Seville, Spain, between June 2013 and February 2020. Surgical reports of patients operated on for any premalignant or malignant endometrial condition were collected. Study variables: age, BMI, previous surgeries, histopathological diagnosis and stage, surgical access route and adjuvant therapy. Outcomes related to surgical complications and cure rate are presented, as well as operation time, surgical access route and hospital stay. RESULTS: 250 patients were studied, the majority (76%) with a diagnosis of endometrioid endometrial adenocarcinoma. The most used surgical access route was laparoscopy (51.6%), with a percentage of intraoperative complications of 10% and postoperative complications of 9.2%. 88.4% of patients remain alive free of disease after treatment, with relapses in only 11.6% and 8% deaths. CONCLUSIONS: The initial treatment of choice in patients with hyperplasia with atypia or early-stage endometrial cancer is surgery, by hysterectomy, double adnexectomy and in some cases associated lymphadenectomy. The choice of surgical approach must be individualized to the conditions of each patient. Laparoscopy offers multiple advantages; it is a technique that is on the rise and is being used more and more frequently.

Resumen OBJETIVO: Exponer los desenlaces quirúrgicos de las pacientes intervenidas por cáncer de endometrio, analizar si existen puntos de mejora en nuestra práctica clínica y aportar más datos a la evidencia publicada, para ayudar al avance en el tratamiento quirúrgico de las pacientes con esta enfermedad MATERIALES Y MÉTODOS: Estudio observacional, descriptivo y retrospectivo llevado a cabo en la Unidad de Oncología Ginecológica del Hospital Regional Virgen Macarena de Sevilla, España, entre junio de 2013 y febrero de 2020. Se reunieron los reportes quirúrgicos de pacientes intervenidas por alguna afección endometrial premaligna o maligna. Variables de estudio: edad, IMC, cirugías previas, diagnóstico histopatológico y estadio, vía de acceso quirúrgico y terapia coadyuvante. Se exponen los desenlaces relacionados con complicaciones quirúrgicas y tasa de curación, así como el tiempo de intervención, vía de acceso quirúrgico y estancia hospitalaria. RESULTADOS: Se estudiaron 250 pacientes, la mayoría (76%) con diagnóstico de adenocarcinoma endometrioide de endometrio. La vía de acceso quirúrgico más utilizada fue la laparoscopia (51.6%), con un porcentaje de complicaciones intraoperatorias del 10% y posoperatorias del 9.2%. El 88.4% de las pacientes permanece viva y libre de enfermedad después del tratamiento, con recaídas solo en el 11.6% y 8% de fallecimientos. CONCLUSIONES: El tratamiento inicial de elección, en pacientes con hiperplasia con atipias o cáncer de endometrio en estadios tempranos, es la cirugía, mediante histerectomía, doble anexectomía y en algunos casos linfadenectomía asociada. La elección de la vía quirúrgica de acceso debe individualizarse a las condiciones particulares de cada paciente. La laparoscopia ofrece múltiples ventajas, es una técnica en auge y cada día más practicada.

Abstract During the dry season in the north of the Ecuadorian coast, there is a grass shortage, aspect that need to be solved. The objective of this research was to evaluate the effect of different cutting intervals on the dry biomass yield, chemical composition and nutritional quality of savoy grass (Panicum maximum Jacq.). During the rainy season transition to dry, in the Viche locality, in the province of Esmeraldas in Ecuador, the dry biomass, organoleptic characteristics, chemical and cell wall composition of savory grass silage cut at ages of 13, 20, 27, 34 and 41 days were evaluated. Treatments were set up in a Complete Random Design for the pasture characteristics and chemical composition of the silage, and in a Randomized Complete Block Design for the organoleptic characteristics of the silage. The statistical analysis was based on the Analysis of Variance and the multiple mean comparisons between treatments with Tukey at 5 %. In this research, the quality of silage organoleptic characteristics was higher at 20 and 34 days. Bromatological analyses showed a content of 8.25 % of crude protein at 27-day silage preparation, being the highest of all treatments, followed by silage preparation at 41-day with 5.53 % of crude protein. The annual dry matter yield ranged from 9.74 to 29.98 t ha-1. Silage prepared at 27 days had the highest nutritional values, while yield was higher at 41 days. None of the treatments reached an optimal level of fermentation (pH, lignification, stem/leaf ratio).

Resumen Durante la época seca en el norte del litoral ecuatoriano, se presenta escasez de pasto aspecto que requiere resolverse. El objetivo de la presente investigación fue evaluar el efecto de diferentes intervalos de corte sobre el rendimiento de biomasa seca, composición química y calidad nutricional de ensilaje del pasto saboya (Panicum máximum Jacq.). Durante la transición de época lluviosa a seca, en la parroquia Viche de la provincia de Esmeraldas en Ecuador, se evaluó la biomasa seca, características organolépticas, composición química y de las paredes celulares del ensilaje de pasto Saboya cortado a edades de 13, 20, 27, 34 y 41 días. Los tratamientos se implementaron en un Diseño Completamente al Azar para las características del pasto y composición química del ensilaje, y en un diseño de Bloques Completos al Azar para las características organolépticas del ensilaje. El análisis estadístico se basó en el Análisis de Varianza y comparación múltiple de medias entre tratamientos usando Tukey al 5 %. En la investigación se determinó que las características organolépticas de los ensilajes a los 20 y 34 días fueron de mejor calidad. En el análisis bromatológico se determinó que el ensilaje a los 27 días contiene una media de 8,25 % de proteína bruta, que es estadísticamente mayor que todos los tratamientos evaluados, seguido por el ensilaje a los 41 días con 5,53 % de proteína bruta. El rendimiento de materia seca anual varió de 9,74 a 29,98 t ha-1. El ensilaje preparado a los 27 días presentó los mejores valores nutricionales, mientras que el mejor rendimiento se presentó a los 41 días. Ningún tratamiento alcanzó un nivel óptimo de fermentación (pH, lignificación relación tallo/hoja).

Background: Thoracoabdominal aortic aneurysm (TAAA) is an infrequent disease and demands a highly specialized and experienced management. Open repair (OR) is the gold standard but it is associated with significant morbidity and mortality. Paraplegia and renal failure are the most important complications. Aim: To report our results with OR treatment of TAAA. Material and Methods: Descriptive study including all patients with TAAA operated electively and consecutively by OR between 1983 and 2019. Main outcomes are operative mortality, renal and neurological morbidity, and long-term survival. Results: We report 45 operated patients aged 33 to 84 years, 74% males. Aneurysm extension according to Crawford classification was I in 18%, II in 18 %, III in 36% and IV in 29%. Operative mortality was 4%. The frequency of paraplegia or paraparesis at discharge was 9%. No patient was discharged on hemodialysis. Survival at 5 and 10 years were 60% and 40% respectively. Conclusions: OR of TAAA is a complex procedure. Our results show perioperative mortality rates comparable to highly experienced centers. Although being a major procedure, OR remains an alternative to treat this serious condition.

Abstract This article explores the belonging of books M and N to the generalprogram of Aristotle's Metaphysics. Books XIII (My) and XIV (Ny) have remained in the background of Metaphysics, as a kind of editorial aggregate, which can be dispensed with for the understanding of the Aristotelian proposal. In this article, however, a different startingpoint is assumed, which consists in integrating these books into the core of the proposal of Metaphysics, understanding that they are key to completing the panorama of the general theory of substance, or ousiology, which guides all metaphysical books. Thus, the discussion of numbers and principles within M and N concludes the question of substance as cause and principle, announced from the beginning of Metaphysics and developed in its central books.

Resumen En el presente artículo se explora la pertenencia de los libros M y N al programa general de la Metafísica de Aristóteles. Los libros XIII (My) y XIV (Ny) han quedado en el trasfondo de la Metafísica, como una suerte de agregado editorial, del cual se puede prescindir para la comprensión de la propuesta aristotélica. En el presente artículo, sin embargo, se asume un punto de partida diferente, que consiste en integrar estos libros al núcleo de la propuesta de la Metafísica, enten diendo que ellos son claves para completar el panorama de la teoría general de la sustancia, o ousiología, que guía todos los libros metafísicos. De este modo, la discusión de M y N sobre números y principios viene a concluir la cuestión de la sustancia como causa y principio, anunciada desde el inicio de la Metafísica y desarrollada en sus libros centrales.

Abstract Hyperkalemia is a common electrical abnormality that can worsen cardiac arrhythmias and significantly increase mortality. The progressive aging of the population added to the higher incidence of entities such as diabetes mellitus (DM), cardiovascular diseases (CVD) or chronic kidney disease (CVD) as well as the increasing use of renin angiotensin aldosterone system inhibitors (RAASi) has caused make it a frequent problem that clinicians have to face in their day-to-day life. We present a case of a patient admitted to the San Juan de Alicante Home Hospitalization Unit who presented a sudden onset and nonspecific clinical picture due to severe hyperkalemia. After prior stabilization in the emergency department, a combination of treatment with RAASi drugs, loop diuretics and cation exchange resins (patiromer) was performed, presenting an improvement in symptoms and control of potassium levels.

Resumen La hiperpotasemia es una anomalía eléctrica común que puede empeorar arritmias cardíacas y aumentar significativamente la mortalidad. El envejecimiento progresivo de la población sumado a la mayor incidencia de entidades como la diabetes mellitus (DM), enfermedades cardiovasculares (ECV) o enfermedad renal crónica (ECV) así como el creciente uso de inhibidores del sistema renina angiotensina aldosterona (RAASi) ha provocado que sea un problema frecuente al que tenga que enfrentarse el clínico en su día a día. Presentamos un caso de un paciente ingresado a cargo de la Unidad de Hospitalización a Domicilio de San Juan de Alicante que presentaba un cuadro de inicio súbito y clínica inespecífica debido a una hiperpotasemia grave. Tras estabilización previa en el servicio de urgencias, se realizó́ una combinación de tratamiento con fármacos RAASi, diuréticos de asa y resinas de intercambio catiónico (patiromero) presentando una mejoría de la sintomatología y control de la potasemia.

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.