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Search Results: 1 - 10 of 87974 matches for " I. Macias Guarasa "
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Eficacia y seguridad de analgesia con remifentanilo en el postoperatorio inmediato de cirugía maxilofacial Efficacy and safety of remifentanil analgesia in the immediate postoperative period of maxillofacial surgery
E. Curiel Balsera,I. Macias Guarasa,M.A. Prieto Palomino,J.L. Mu?oz Mu?oz
Medicina Intensiva , 2012,
Source Localization with Acoustic Sensor Arrays Using Generative Model Based Fitting with Sparse Constraints
Jose Velasco,Daniel Pizarro,Javier Macias-Guarasa
Sensors , 2012, DOI: 10.3390/s121013781
Abstract: This paper presents a novel approach for indoor acoustic source localization using sensor arrays. The proposed solution starts by defining a generative model, designed to explain the acoustic power maps obtained by Steered Response Power (SRP) strategies. An optimization approach is then proposed to fit the model to real input SRP data and estimate the position of the acoustic source. Adequately fitting the model to real SRP data, where noise and other unmodelled effects distort the ideal signal, is the core contribution of the paper. Two basic strategies in the optimization are proposed. First, sparse constraints in the parameters of the model are included, enforcing the number of simultaneous active sources to be limited. Second, subspace analysis is used to filter out portions of the input signal that cannot be explained by the model. Experimental results on a realistic speech database show statistically significant localization error reductions of up to 30% when compared with the SRP-PHAT strategies.
Cholangiocarcinoma: Biology, Clinical Management, and Pharmacological Perspectives
Rocio I. R. Macias
ISRN Hepatology , 2014, DOI: 10.1155/2014/828074
Abstract: Cholangiocarcinoma (CCA), or tumor of the biliary tree, is a rare and heterogeneous group of malignancies associated with a very poor prognosis. Depending on their localization along the biliary tree, CCAs are classified as intrahepatic, perihilar, and distal, and these subtypes are now considered different entities that differ in tumor biology, the staging system, management, and prognosis. When diagnosed, an evaluation by a multidisciplinary team is essential; the team must decide on the best therapeutic option. Surgical resection of tumors with negative margins is the best option for all subtypes of CCA, although this is only achieved in less than 50% of cases. Five-year survival rates have increased in the recent past owing to improvements in imaging techniques, which permits resectability to be predicted more accurately, and in surgery. Chemotherapy and radiotherapy are relatively ineffective in treating nonoperable tumors and the resistance of CCA to these therapies is a major problem. Although the combination of gemcitabine plus platinum derivatives is the pharmacological treatment most widely used, to date there is no standard chemotherapy, and new combinations with targeted drugs are currently being tested in ongoing clinical trials. This review summarizes the biology, clinical management, and pharmacological perspectives of these complex tumors. 1. Primary and Metastatic Liver Cancer Primary liver cancer accounts for approximately 10–12% of deaths due to cancer. Although the incidence of this group of cancers is lower than 6% of new cancers diagnosed each year worldwide, the prognosis is usually very poor. The most frequent of these tumors are adenocarcinomas, which include hepatocellular carcinoma (HCC) derived from parenchymal cells—accounting for almost 85% of liver adenocarcinomas and cholangiocarcinoma (CCA), derived from biliary epithelial cells and accounting for the remaining 15%. Other rare primary liver tumors include hemangiosarcoma, derived from endothelial cells, and hepatoblastoma, derived from embryonic or fetal hepatocyte precursors. Even less frequent primary liver cancers are fibrosarcoma and lymphosarcoma. It should also be considered that the liver is highly vulnerable to tumor invasion from extrahepatic metastasis. The large size of the liver, its abundant blood supply, and its double-source vascularization explain why it is the second most common seat of metastasis after lymph nodes. Among the tumors that most frequently metastasize to the liver are colorectal cancer, breast cancer, melanoma, and lung cancer. 2.
Esofaguectomía: Dilatación gástrica Esophagectomy: Gastric dilatation
I. Macías Guarasa,E. Curiel Balsera,R. Olalla Sánchez
Medicina Intensiva , 2009,
Eficacia y seguridad de la implantación de marcapasos transvenosos transitorios en una unidad de cuidados intensivos Efficacy and safety of non-permanent transvenous pacemaker implantation in an intensive care unit
J. Mu?oz Bono,M.A. Prieto Palomino,I. Macías Guarasa,B. Hernández Sierra
Medicina Intensiva , 2011,
Abstract: Objetivo: Analizar las características clínicas, indicaciones y morbimortalidad asociada a la implantación de marcapasos transvenosos transitorios. Dise o: Estudio observacional y prospectivo. ámbito: Unidad de cuidados intensivos cardiológicos. Pacientes: Se implantó marcapasos transvenoso transitorio a 182 pacientes, en un periodo de 4 a os. Variables recogidas: Se registraron variables demográficas, clínicas, indicaciones, vía de acceso, días de estancia en la unidad y complicaciones. Resultados: El 63% eran hombres, con una media de edad de 78±9,5 a os con bloqueo auriculoventricular sintomático en un 76,9% de los casos. La vía venosa de abordaje habitual fue la femoral (92,3%). El 40,11% sufrió complicaciones, siendo la más frecuente el hematoma en la zona de punción (13,19%). No hubo diferencias entre el profesional que implantó el marcapasos y la aparición de complicaciones. La agitación psicomotriz se asoció a la existencia de hematoma en la zona de punción (p=0,07) y a la necesidad de movilización del catéter (p=0,059). Se identificó la vía de inserción no femoral (p=0,012, OR=0,16; IC del 95%, 0,04-0,66), la agitación (p=0,006; OR=3,2; IC del 95%, 1,4-7,3) y la presencia de factores de riesgo cardiovascular (p=0,042; OR=5; IC del 95%, 1,06-14,2) como predictores de complicaciones. La realización del procedimiento por parte del personal especializado (p=0,0001) y la presencia de complicaciones (p=0,05) incrementaron la estancia en la unidad. Conclusiones: La presencia de agitación, los factores de riesgo cardiovascular y la inserción a través de la vena subclavia o yugular fueron predictores de complicaciones. Estas no se relacionaron con el tipo de profesional implicado en la implantación, pero incrementaron la estancia en la unidad. Objective: To analyze the clinical indications for use, morbidity and mortality associated with a non-permanent transvenous pacemaker. Design: Prospective and observational study. Setting: Cardiac intensive care unit. Method: One hundred and eighty-two patients with non-permanent pacemakers implanted consecutively over a period of four years. Data collected: Main variables of interest were demographic data, clinical indications, access route, length of stay and complications. Results: A total of 63% were men, with a median age of 78±9.5 years and with symptomatic third-degree atrioventricular block in 76.9% of the cases. Femoral vein access was preferred in 92.3% of the cases. Complications appeared in 40.11% of the patients, the most frequent being hematoma at the site of vascular access (13.19%). Restlessness wa
Marta Mu?oz Guarasa
Revista de Estudios Empresariales. Segunda época , 2008,
Réplica A: Implantación de marcapasos endocavitarios transitorios Reply to: "Temporary endocavitary pacemaker implantation"
J. Mu?oz-Bono,E. Curiel-Balsera,M.A. Prieto-Palomino,I. Macías-Guarasa
Medicina Intensiva , 2012,
Computational treatment of traveling-wave solutions of a population model with square-root dynamics
J. E. Macias-Diaz,I. E. Medina-Ramirez
Advanced Studies in Biology , 2013,
Abstract: Motivated by a recent report by R. E. Mickens, we design an efficient,non-standard, two-step, nonlinear, explicit, exact finite-differencemethod to approximate solutions of a population equation with squarerootreaction law. Mickens’ report establishes the existence of nonnegative,traveling-wave solutions of that model which are boundedfrom above by 1, and which are spatially and temporally monotone.As its analytic counterpart, the computational technique proposed inthe present manuscript is capable of preserving the non-negativity andthe boundedness of initial profiles under suitable and flexible conditionson the computational parameters. We provide theoretical results on theexistence and uniqueness of non-negative and bounded solutions of themethod, and we establish that our technique conditionally preserves thespatial and temporal monotonicity of the approximations. The numericalsimulations obtained through a computer implementation of ourfinite-difference scheme support the fact that the method preserves allof the mathematical characteristics of approximations mentioned above.
Determinant Factors in the Internationalization of Knowledge-Intensive Services in a Peripheral Area  [PDF]
Marta Mu?oz-Guarasa, Encarnación Moral Pajares
Journal of Service Science and Management (JSSM) , 2014, DOI: 10.4236/jssm.2014.72012

The objective of this study is to learn some of the determinant factors in the internationalization of knowledge-intensive services in a peripheral zone in accordance with the Eclectic Paradigm [1] [2]. The study will focus on Andalusia in Southern Spain. In the Andalusian region, there are no official data on internationalized companies. We have therefore conducted a survey of 256 service internationalized companies within the region. The results show that the ownership or specific advantages considered by the businesses themselves is the quality of service, training of employees, leadership and management ability, innovation, technology and the image that customers have of the company. Regarding the advantages of locating abroad that are believed to be the most important, those companies that engage in foreign investment highlight customer’ follow-up and look for new customers. As well, they greatly value those factors related to the destination market: size, growth and access to the market as well as other markets.

Tratamientos y dise os alternativos de las instalaciones de riesgo de proliferación de Legionella neumophila Alternatives treatment in the installations for legionellosis risk reduction
José Macias Macias
Revista de Salud Ambiental , 2006,
Abstract: La dilatada experiencia del autor en el campo de la ingeniería de mantenimiento hospitalario, ha servido de base para sugerir distintas alternativas para prevenir la aparición de la bacteria Legionella neumophila en las instalaciones de riesgo. Lo que se pretende con las recomendaciones propuestas de dise o, uso y tratamiento de dichas instalaciones, es crear en ellas entornos hostiles para la vida microbiana y especialmente para la legionela, combinando métodos físicos y químicos. De esta forma lograremos disminuir las poblaciones de la bacteria, por debajo de los niveles que a la luz de los conocimientos actuales, resultan infectivos. Se describen opciones diferentes a los métodos de tratamiento tradicionales, que permiten obtener los mismos resultados minimizando los riesgos, tanto para las personas como para el medio ambiente. También se exponen los resultados de varios experimentos, mediante los cuales se ha intentado conocer como se comportan las instalaciones y los materiales que las componen, frente a la agresión que producen los métodos biocidas. Y por último, se comparan los distintos tipos de instalaciones centralizadas de producción y almacenamiento de agua caliente y se estudian las ventajas e inconvenientes de cada una de ellas. Las propuestas que se formulan pretenden tres cosas y por este orden: controlar las poblaciones de legionela evitando que originen la enfermedad en las personas, proteger las instalaciones en las que puede desarrollarse la bacteria, y en la medida de lo posible, evitar da os al medio ambiente derivados del vertido de sustancias peligrosas. The author's extensive experience in the field of hospital maintenance engineer, has served as a basis to suggest alternatives to prevent the occurrence of Legionella neumophila bacteria in hazard installations. The intention with the recommendations proposed design, use and management of such facilities is to create in them hostile environments for microbial life and especially for legionella, combining physical and chemical methods. In this way we can decrease the bacteria populations, below the levels in light of current knowledge, are infective. Describes different options to traditional treatment methods, which can obtain the same results while minimizing risks for both people and the environment. It also presents the results of several experiments, by which an attempt to know how they behave facilities and materials that compose them, against the aggression that produce biocides methods. Finally, we compare the different types of centralized production and storage of hot wa
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