Víctor Zambrano Rincones - Academia.edu (original) (raw)
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Papers by Víctor Zambrano Rincones
Http Www Theses Fr, 2007
The manner of this investigation is to better understand and explain the way in which the space i... more The manner of this investigation is to better understand and explain the way in which the space in central and southern Peru has been occupied since 1532, the year of the Spanish conquest up until the present day; stressing the year 1876 the date of the first census. Our work has three parts. Beginning with a general view of the changing demographics during the colonial period of 1532 to1821, displaying the break down of the pre-Hispanic model, which was based on the use of the great kingdoms and the access to and use of different yet complimentary agro-ecological land. The colonial system using the capitalistic logic of income and thus control through taxation as well as evangelization, created a model based on the "reduction of the indigenous peoples" and then on "administrative divisions" which gave origin to the current political departments. Since 1876, based on six censuses, the importance of the principal poles has become obvious as originally more than 100,000 inhabitants occupied the land and by the second census there was a dramatic drop to between only 50,000 to100,000 inhabitants. Thus these primary poles have been understood as the great organizers of space, exercising a function of attraction and influence on their closely interconnected areas through integration while dually engendering a simultaneous process of territorial fracturing, which was expressed through the cooperation of complementary sub-regions. In short, through the creation and division of political departments these sub-regions form mega-spaces, which are very articulated and differ enormously in their natural resources and scale. The focus based on this construction, starting with the local actors and the role of agriculture, will be useful for further decentralization.
3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capit... more 3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capital. 3.14 Coeficiente Beneficio-Costo. 3.15 Resumen de criterios financieros. 3.16 Cronograma de implementación. 3.17 Conclusiones. 3.18 Recomendaciones.
Gastrointestinal Endoscopy, 2013
Http Www Theses Fr, 2007
The manner of this investigation is to better understand and explain the way in which the space i... more The manner of this investigation is to better understand and explain the way in which the space in central and southern Peru has been occupied since 1532, the year of the Spanish conquest up until the present day; stressing the year 1876 the date of the first census. Our work has three parts. Beginning with a general view of the changing demographics during the colonial period of 1532 to1821, displaying the break down of the pre-Hispanic model, which was based on the use of the great kingdoms and the access to and use of different yet complimentary agro-ecological land. The colonial system using the capitalistic logic of income and thus control through taxation as well as evangelization, created a model based on the "reduction of the indigenous peoples" and then on "administrative divisions" which gave origin to the current political departments. Since 1876, based on six censuses, the importance of the principal poles has become obvious as originally more than 100,000 inhabitants occupied the land and by the second census there was a dramatic drop to between only 50,000 to100,000 inhabitants. Thus these primary poles have been understood as the great organizers of space, exercising a function of attraction and influence on their closely interconnected areas through integration while dually engendering a simultaneous process of territorial fracturing, which was expressed through the cooperation of complementary sub-regions. In short, through the creation and division of political departments these sub-regions form mega-spaces, which are very articulated and differ enormously in their natural resources and scale. The focus based on this construction, starting with the local actors and the role of agriculture, will be useful for further decentralization.
3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capit... more 3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capital. 3.14 Coeficiente Beneficio-Costo. 3.15 Resumen de criterios financieros. 3.16 Cronograma de implementación. 3.17 Conclusiones. 3.18 Recomendaciones.
Gastrointestinal Endoscopy, 2013
Gastrointestinal Endoscopy, 2013
Annals of Surgery, 1976
The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs p... more The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs prepared with chronic pancreatic and gastric fistulae. After completion of control studies 6 were subjected to antrectomy and 2 to antroneurolysis (to interrupt submucosal nerve connections); secretory studies were repeated. With the animals secreting in response to secretin(0.03 u per kg-min) or secretin with cholecystokinin (0.05 u per kg-min), the following were administered: 1) insulin 0.2 u/kg; 2) atropine 0.2 and 0.4 mg/kg; 3) insulin after atropine. Insulin hypoglycemia elicited a marked enzyme response. Both antrectomy and antroneurolysis markedly reduced (80%) the enzyme response to insulin hypoglycemia. Atropine 0.2 mg/kg abolished the insulin response and at 0.4 mg/kg inhibited (50%) the enzyme response to cholecystokinin; these effects were unaltered by antrectomy or antroneurolysis. These experiments suggest that the pancreatic enzyme response to insulin hypoglycemia is predominantly mediated through the vagal release of antral gastrin. Furthermore, antrectomy and antroneurolysis do not affect the enzyme response to cholecystokinin nor do they alter the inhibitory effects of atropine. The inhibitio- by atropine suggests that a cholinergic background exerts a permissive effect on CCK-mediated enzyme secretion.
Cirugía y Cirujanos
To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997... more To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997 to 2002 at the Autonomous University Hospital Service of Maracaibo, Venezuela. We carried out 18 hepatic resections for benign and/or malignant lesions; traumatic and infectious lesions were excluded. The female sex prevailed with 77.7% and age ranged between third and fourth decade. Three asymptomatic patients (16.6%) and 83.3% symptomatic; pain in upper hemiabdomen 80%. Ultrasonography was employed in 94.4% of cases, CT 83.3%, FNAB 27.7%, arteriography 22.2%, Echo-Doppler 16.6%, laparoscopy 11.1%, hepatic scintigraphy and ERCP, 5.5%. Minor resections represented 61.1%. Major hepatic resections represented 38.8%, with prevalence of left hepatectomy (33.3%). Blood loss was greatest in major hepatic resections with average of 1,242.9 +/- 827.8 ml. Pringles maneuver was carried out in 90% with duration average of 8.5 min; morbidity was 16.6%. Benign tumours prevailed with 66.6%. The techn...
Cirugia Y Cirujanos, 2004
OBJECTIVE: To evaluate hepatic resections in patient with benign and malignant lesions during the... more OBJECTIVE: To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997 to 2002 at the Autonomous University Hospital Service of Maracaibo, Venezuela. MATERIALS: We carried out 18 hepatic resections for benign and/or malignant lesions; traumatic and infectious lesions were excluded. RESULTS: The female sex prevailed with 77.7% and age ranged between third and fourth decade. Three asymptomatic patients (16.6%) and 83.3% symptomatic; pain in upper hemiabdomen 80%. Ultrasonography was employed in 94.4% of cases, CT 83.3%, FNAB 27.7%, arteriography 22.2%, Echo-Doppler 16.6%, laparoscopy 11.1%, hepatic scintigraphy and ERCP, 5.5%. Minor resections represented 61.1%. Major hepatic resections represented 38.8%, with prevalence of left hepatectomy (33.3%). Blood loss was greatest in major hepatic resections with average of 1,242.9 +/- 827.8 ml. Pringles maneuver was carried out in 90% with duration average of 8.5 min; morbidity was 16.6%. Benign tumours ...
![Research paper thumbnail of [Evaluation of hepatic resections in patients with benign and malignant lesions]](https://attachments.academia-assets.com/82570043/thumbnails/1.jpg)
](Cirugía y cirujanos
To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997... more To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997 to 2002 at the Autonomous University Hospital Service of Maracaibo, Venezuela. We carried out 18 hepatic resections for benign and/or malignant lesions; traumatic and infectious lesions were excluded. The female sex prevailed with 77.7% and age ranged between third and fourth decade. Three asymptomatic patients (16.6%) and 83.3% symptomatic; pain in upper hemiabdomen 80%. Ultrasonography was employed in 94.4% of cases, CT 83.3%, FNAB 27.7%, arteriography 22.2%, Echo-Doppler 16.6%, laparoscopy 11.1%, hepatic scintigraphy and ERCP, 5.5%. Minor resections represented 61.1%. Major hepatic resections represented 38.8%, with prevalence of left hepatectomy (33.3%). Blood loss was greatest in major hepatic resections with average of 1,242.9 +/- 827.8 ml. Pringles maneuver was carried out in 90% with duration average of 8.5 min; morbidity was 16.6%. Benign tumours prevailed with 66.6%. The techn...
Gastrointestinal Endoscopy
Endoscopy has evolved to become first-line therapy for the treatment of post-bariatric leaks; how... more Endoscopy has evolved to become first-line therapy for the treatment of post-bariatric leaks; however, many sessions are often required with variable success rates. Due to these limitations, the use of the cardiac septal defect occluder (CSDO) has recently been reported in this population. This is a multicenter retrospective series in patients with post-bariatric surgical leaks who underwent treatment with CSDO placement. Data were collected including type of surgery, previous treatment details, fistula dimensions, success rate, and adverse events. Leaks were grouped according to the International Sleeve Gastrectomy Expert Panel Consensus. Outcomes included technical and clinical success and safety of the CSDO. Additionally, regression was performed to determine predictors of response. Forty-three patients with leaks were included (31 sleeve gastrectomy and 12 Roux-en-Y gastric bypass [RYGB]). They were divided into acute (n=3), early (n=5), late (n=23), and chronic (n=12). Forty patients had failed previous endoscopic treatment and 3 patients had CSDO as the primary treatment. Median follow-up was 34 weeks. Technical success was achieved in 100% and clinical success in 39 patients (90.7%). All chronic, late, and early leaks had successful closure, except one undrained late leak. The 5 patients with early leaks had an initial satisfactory response, but within 30 days, drainage recurred. The CSDO were removed and replaced for larger diameter devices leading to permanent defect closure. All 3 patients with acute leaks were not successful. Regression analysis showed that chronicity and previous treatment were associated with fistula closure, additionally, success rates for late/chronic leaks versus acute/early leaks were 97.1% and 62.5%, respectively (p = 0.0023). This first observational study found the CSDO to have a high efficacy rate in patients with non-acute leaks, with no adverse events. All cases of early, late and chronic leaks were successful, except for one undrained late leak. However, early leaks required a second placement of a larger CSDO in all cases. These results suggest that the CSDO should be considered for non-acute fistula and that traditional closure methods are likely preferred in the acute and early settings.
Gastrointestinal Endoscopy
Journal of Hepato-Biliary-Pancreatic Surgery
Without Abstract
Http Www Theses Fr, 2007
The manner of this investigation is to better understand and explain the way in which the space i... more The manner of this investigation is to better understand and explain the way in which the space in central and southern Peru has been occupied since 1532, the year of the Spanish conquest up until the present day; stressing the year 1876 the date of the first census. Our work has three parts. Beginning with a general view of the changing demographics during the colonial period of 1532 to1821, displaying the break down of the pre-Hispanic model, which was based on the use of the great kingdoms and the access to and use of different yet complimentary agro-ecological land. The colonial system using the capitalistic logic of income and thus control through taxation as well as evangelization, created a model based on the "reduction of the indigenous peoples" and then on "administrative divisions" which gave origin to the current political departments. Since 1876, based on six censuses, the importance of the principal poles has become obvious as originally more than 100,000 inhabitants occupied the land and by the second census there was a dramatic drop to between only 50,000 to100,000 inhabitants. Thus these primary poles have been understood as the great organizers of space, exercising a function of attraction and influence on their closely interconnected areas through integration while dually engendering a simultaneous process of territorial fracturing, which was expressed through the cooperation of complementary sub-regions. In short, through the creation and division of political departments these sub-regions form mega-spaces, which are very articulated and differ enormously in their natural resources and scale. The focus based on this construction, starting with the local actors and the role of agriculture, will be useful for further decentralization.
3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capit... more 3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capital. 3.14 Coeficiente Beneficio-Costo. 3.15 Resumen de criterios financieros. 3.16 Cronograma de implementación. 3.17 Conclusiones. 3.18 Recomendaciones.
Gastrointestinal Endoscopy, 2013
Http Www Theses Fr, 2007
The manner of this investigation is to better understand and explain the way in which the space i... more The manner of this investigation is to better understand and explain the way in which the space in central and southern Peru has been occupied since 1532, the year of the Spanish conquest up until the present day; stressing the year 1876 the date of the first census. Our work has three parts. Beginning with a general view of the changing demographics during the colonial period of 1532 to1821, displaying the break down of the pre-Hispanic model, which was based on the use of the great kingdoms and the access to and use of different yet complimentary agro-ecological land. The colonial system using the capitalistic logic of income and thus control through taxation as well as evangelization, created a model based on the "reduction of the indigenous peoples" and then on "administrative divisions" which gave origin to the current political departments. Since 1876, based on six censuses, the importance of the principal poles has become obvious as originally more than 100,000 inhabitants occupied the land and by the second census there was a dramatic drop to between only 50,000 to100,000 inhabitants. Thus these primary poles have been understood as the great organizers of space, exercising a function of attraction and influence on their closely interconnected areas through integration while dually engendering a simultaneous process of territorial fracturing, which was expressed through the cooperation of complementary sub-regions. In short, through the creation and division of political departments these sub-regions form mega-spaces, which are very articulated and differ enormously in their natural resources and scale. The focus based on this construction, starting with the local actors and the role of agriculture, will be useful for further decentralization.
3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capit... more 3.12 Determinación del Valor Actual Neto. 3.13 Determinación del Tiempo de recuperación del capital. 3.14 Coeficiente Beneficio-Costo. 3.15 Resumen de criterios financieros. 3.16 Cronograma de implementación. 3.17 Conclusiones. 3.18 Recomendaciones.
Gastrointestinal Endoscopy, 2013
Gastrointestinal Endoscopy, 2013
Annals of Surgery, 1976
The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs p... more The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs prepared with chronic pancreatic and gastric fistulae. After completion of control studies 6 were subjected to antrectomy and 2 to antroneurolysis (to interrupt submucosal nerve connections); secretory studies were repeated. With the animals secreting in response to secretin(0.03 u per kg-min) or secretin with cholecystokinin (0.05 u per kg-min), the following were administered: 1) insulin 0.2 u/kg; 2) atropine 0.2 and 0.4 mg/kg; 3) insulin after atropine. Insulin hypoglycemia elicited a marked enzyme response. Both antrectomy and antroneurolysis markedly reduced (80%) the enzyme response to insulin hypoglycemia. Atropine 0.2 mg/kg abolished the insulin response and at 0.4 mg/kg inhibited (50%) the enzyme response to cholecystokinin; these effects were unaltered by antrectomy or antroneurolysis. These experiments suggest that the pancreatic enzyme response to insulin hypoglycemia is predominantly mediated through the vagal release of antral gastrin. Furthermore, antrectomy and antroneurolysis do not affect the enzyme response to cholecystokinin nor do they alter the inhibitory effects of atropine. The inhibitio- by atropine suggests that a cholinergic background exerts a permissive effect on CCK-mediated enzyme secretion.
Cirugía y Cirujanos
To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997... more To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997 to 2002 at the Autonomous University Hospital Service of Maracaibo, Venezuela. We carried out 18 hepatic resections for benign and/or malignant lesions; traumatic and infectious lesions were excluded. The female sex prevailed with 77.7% and age ranged between third and fourth decade. Three asymptomatic patients (16.6%) and 83.3% symptomatic; pain in upper hemiabdomen 80%. Ultrasonography was employed in 94.4% of cases, CT 83.3%, FNAB 27.7%, arteriography 22.2%, Echo-Doppler 16.6%, laparoscopy 11.1%, hepatic scintigraphy and ERCP, 5.5%. Minor resections represented 61.1%. Major hepatic resections represented 38.8%, with prevalence of left hepatectomy (33.3%). Blood loss was greatest in major hepatic resections with average of 1,242.9 +/- 827.8 ml. Pringles maneuver was carried out in 90% with duration average of 8.5 min; morbidity was 16.6%. Benign tumours prevailed with 66.6%. The techn...
Cirugia Y Cirujanos, 2004
OBJECTIVE: To evaluate hepatic resections in patient with benign and malignant lesions during the... more OBJECTIVE: To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997 to 2002 at the Autonomous University Hospital Service of Maracaibo, Venezuela. MATERIALS: We carried out 18 hepatic resections for benign and/or malignant lesions; traumatic and infectious lesions were excluded. RESULTS: The female sex prevailed with 77.7% and age ranged between third and fourth decade. Three asymptomatic patients (16.6%) and 83.3% symptomatic; pain in upper hemiabdomen 80%. Ultrasonography was employed in 94.4% of cases, CT 83.3%, FNAB 27.7%, arteriography 22.2%, Echo-Doppler 16.6%, laparoscopy 11.1%, hepatic scintigraphy and ERCP, 5.5%. Minor resections represented 61.1%. Major hepatic resections represented 38.8%, with prevalence of left hepatectomy (33.3%). Blood loss was greatest in major hepatic resections with average of 1,242.9 +/- 827.8 ml. Pringles maneuver was carried out in 90% with duration average of 8.5 min; morbidity was 16.6%. Benign tumours ...
Cirugía y cirujanos
To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997... more To evaluate hepatic resections in patient with benign and malignant lesions during the years 1997 to 2002 at the Autonomous University Hospital Service of Maracaibo, Venezuela. We carried out 18 hepatic resections for benign and/or malignant lesions; traumatic and infectious lesions were excluded. The female sex prevailed with 77.7% and age ranged between third and fourth decade. Three asymptomatic patients (16.6%) and 83.3% symptomatic; pain in upper hemiabdomen 80%. Ultrasonography was employed in 94.4% of cases, CT 83.3%, FNAB 27.7%, arteriography 22.2%, Echo-Doppler 16.6%, laparoscopy 11.1%, hepatic scintigraphy and ERCP, 5.5%. Minor resections represented 61.1%. Major hepatic resections represented 38.8%, with prevalence of left hepatectomy (33.3%). Blood loss was greatest in major hepatic resections with average of 1,242.9 +/- 827.8 ml. Pringles maneuver was carried out in 90% with duration average of 8.5 min; morbidity was 16.6%. Benign tumours prevailed with 66.6%. The techn...
Gastrointestinal Endoscopy
Endoscopy has evolved to become first-line therapy for the treatment of post-bariatric leaks; how... more Endoscopy has evolved to become first-line therapy for the treatment of post-bariatric leaks; however, many sessions are often required with variable success rates. Due to these limitations, the use of the cardiac septal defect occluder (CSDO) has recently been reported in this population. This is a multicenter retrospective series in patients with post-bariatric surgical leaks who underwent treatment with CSDO placement. Data were collected including type of surgery, previous treatment details, fistula dimensions, success rate, and adverse events. Leaks were grouped according to the International Sleeve Gastrectomy Expert Panel Consensus. Outcomes included technical and clinical success and safety of the CSDO. Additionally, regression was performed to determine predictors of response. Forty-three patients with leaks were included (31 sleeve gastrectomy and 12 Roux-en-Y gastric bypass [RYGB]). They were divided into acute (n=3), early (n=5), late (n=23), and chronic (n=12). Forty patients had failed previous endoscopic treatment and 3 patients had CSDO as the primary treatment. Median follow-up was 34 weeks. Technical success was achieved in 100% and clinical success in 39 patients (90.7%). All chronic, late, and early leaks had successful closure, except one undrained late leak. The 5 patients with early leaks had an initial satisfactory response, but within 30 days, drainage recurred. The CSDO were removed and replaced for larger diameter devices leading to permanent defect closure. All 3 patients with acute leaks were not successful. Regression analysis showed that chronicity and previous treatment were associated with fistula closure, additionally, success rates for late/chronic leaks versus acute/early leaks were 97.1% and 62.5%, respectively (p = 0.0023). This first observational study found the CSDO to have a high efficacy rate in patients with non-acute leaks, with no adverse events. All cases of early, late and chronic leaks were successful, except for one undrained late leak. However, early leaks required a second placement of a larger CSDO in all cases. These results suggest that the CSDO should be considered for non-acute fistula and that traditional closure methods are likely preferred in the acute and early settings.
Gastrointestinal Endoscopy
Journal of Hepato-Biliary-Pancreatic Surgery
Without Abstract