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The development of hysteroscopic techniques has led to an advance in submucous myoma treatment, offering a safe and effective minimally invasive alternative. Our objective was to compare the results of hysteroscopic myomectomy when using whether the mini-resectoscope or the MyoSure morcellator, as well as patient satisfaction after the procedure.A prospective, cross-sectional, observational study including 80 patients distributed into two groups: Mini-Resectoscope group (MRG) or MyoSure group (MSG), depending on the instrument used for the in-office hysteroscopic myomectomy. Resection time, pain during entry, pain during resection, number of resections required, complete resection, and total satisfaction were recorded.MSG had statistically significant shorter time of entrance. There were no other statistically significant differences between groups.In-office hysteroscopic myomectomy is associated with high levels of patient satisfaction, without differences between the mini-resectoscope or the MyoSure, allowing high rates of complete resection using both instruments. Thus, it is a feasible technique which could be performed with both instruments, depending on the operator's expertise.

Background and Purpose: To evaluate the use of prostaglandins and oxytocin in labour induction according to different indications. Perinatal outcomes, rate of vaginal delivery and complation of labour were studied and compared. Methods: Cross-sectional descriptive study from January 2012 to December 2012. 530 women who required labour induction were included. Seven groups were created according to the methods of induction. Women with twin pregnancies, induction of dead foetus, two previous caesarean sections or an incomplete clinical history were excluded. Results: The rate of vaginal deliveries in women that only received prostaglandins the first day was 84.6%; similar in women with prolonged pregnancies, 85.2%. The induction with oxytocin directly showed the highest rate of caesarean section. The rate of vaginal deliveries was 50% in women with previous caesarean section. Conclusions: A high rate of vaginal deliveries with a single dose of prostaglandin and within 24 hours of beginning induction. Administration of prostaglandins must be used when cervix is unfavorable and previous to oxytocin stymulation.

Background::A retrospective study that analysed data for three consecutive years from the Hysteroscopy Clinic at the Department of Obstetrics and Gynecology, Valme University Hospital.Objective::To analyse the data of lesions removed in the hysteroscopy clinic in comparison with those scheduled for the operating room to show that hysteroscopy could be a more effective procedure.Method::Patients undergoing operative hysteroscopy for various indications were included. The 5 mm Bettocchi hysteroscopes and the 5.8 mm Palex Mini-Resectoscope were used.Results::A total of 1233 patients were seen in the hysteroscopy clinic between 2015 and 2017. In 2015, 344 hysteroscopies were performed, of which 57 (16.5%) were performed in the operating room. In 2016, 445 hysteroscopies were performed and 46 (10.3%) were scheduled in the operating room. During 2017, a total of 444 hysteroscopies were performed, of which only 6 (1.3%) were performed in the operating room (P < 0.001). Five large fibroids and one case of complex polyp were removed in the operating room in 2017. The mini-resector was used in 202 cases (45.4%). Paracervical local anaesthesia was given to 383 (86.2%) patients.Conclusion::The data obtained in our study shows a significant reduction in the number of hysteroscopies scheduled for surgery in 2017 (1.3%) and, therefore, hysteroscopy has been shown to be a more effective procedure. This trend may be due to the introduction of the mini-resectoscope and the use of paracervical local anaesthesia.

RESUMEN Objetivo: Determinar si la ansiedad preoperatoria supone un factor de riesgo independiente para la percepción de dolor severo durante la realización de una histeroscopia quirúrgica ambulatoria. Material y métodos: Estudio de cohortes en el que incluimos179 pacientes. Se ha aplicado el formulario STAI-S para valorar la ansiedad preoperatoria de las pacientes y distribuirlas en dos cohortes: Pacientes con ansiedad (STAI-S >50) y pacientes sin ansiedad (STAI-S7. Se ha calculado la asociación y el riesgo entre ambas variables mediante el Test X2 y el Riesgo Relativo (RR). Se ha utilizado el test de correlación de Pearson para valorar la correlación entre ambas variables. Se ha considerado estadísticamente significativo un valor de p

Introducción. La adolescencia es una etapa crítica para actuar a nivel preventivo, teniendo en cuenta que en ella suelen iniciarse conductas de riesgo para la salud, como el consumo de tabaco y alcohol.Método. En este contexto, 106 adolescentes (54 chicas y 52 chicos; edad media de 14,10 años, tanto en chicos, como en chicas) participaron en esta investigación, cuyos objetivos fue-ron analizar las relaciones que mantienen el estilo de afrontamiento y la positividad con el consumo de tabaco y alcohol, así como las posibles diferencias debidas al sexo y la edad.Resultados. Los resultados mostraron, primero, la presencia de relaciones significativas entre estilo de afrontamiento, positividad y consumo de tabaco y alcohol; segundo, el papel modulador de la edad y el sexo; finalmente, la positividad fue uno de los factores predictivos más significativos del consumo de alcohol y tabaco, destacando su papel protector.Conclusión. Los resultados relativos a la significación del estilo de afrontamiento, la edad y el género en la explicación del consumo de tabaco y alcohol en la adolescencia, tienden a ser consistentes con la investigación existente sobre el tema. Suponen, al mismo tiempo, una aportación novedosa a la investigación en este ámbito los resultados relativos a la dimensión de positividad, que sugieren su significativo papel protector ante el desarrollo de conductas de riesgo como las consideradas en nuestro estudio.

El comportamiento negativista desafiante hace referencia a la presencia de un patrón de conducta persistente, repetitivo e inadecuado que se caracteriza por manifestar problemas en el comportamiento y en la regulación de las emociones. Se traduce en el incumplimiento de las normas sociales básicas de convivencia y por la oposición a los requerimientos de las figuras de autoridad, generando como consecuencia un deterioro en las relaciones personales y/o sociales. En este trabajo se presenta el caso clínico de una niña de 6 años que manifiesta comportamiento negativista desafiante en el ámbito familiar. A partir del análisis funcional del caso, los objetivos de la intervención fueron, mejorar la comunicación familiar, ignorar las conductas perturbadoras poco importantes, manejar el estrés y entrenar el autocontrol, establecer límites a la conducta: órdenes eficaces y reglas familiares y aplicar técnicas de resolución de problemas. La intervención terapéutica se basa en la aplicación del Programa EmPeCemos, que consta de 12 sesiones en las que se lleva a cabo un entrenamiento a los padres en habilidades eficaces para potenciar las conductas prosociales de la niña y para reducir sus comportamientos problemáticos. Durante la aplicación del programa se van consiguiendo los objetivos de la intervención. Se mejora la comunicación familiar, se establecen normas familiares eficaces y aumenta el control de las conductas disruptivas. Todo ello permitió obtener positivos avances en el comportamiento de la niña, así como en las habilidades parentales. El análisis de los resultados indica como la mayoría de los objetivos propuestos en las sesiones del tratamiento han sido cumplidos. Este estudio muestra la importancia que tiene en la práctica clínica el entrenamiento de habilidades parentales para el manejo eficaz de las conductas infantiles disruptivas. Family intervention in a case of defiant negativistic behavior. Defiant negative behavior refers to the presence of a pattern of persistent, repetitive behavior that is characterized by a manifest problem in the behavior and regulation of emotions. It translates into the breach of basic social norms of coexistence and the opposition to the requirements of authority figures, generating as a consequence a deterioration in personal and / or social relationships. In this paper, the clinical case of a 6-year-old girl, who manifests negative defiant behavior in the family, is presented. From the functional analysis of the case, the objectives of the intervention were to improve family communication, ignore unimportant disturbing behaviors, manage stress and establish self-control, and establish limits to problem-solving behavior. The therapeutic intervention is based on the application of the EmPeCemos Program, which consists of 12 sessions for training parents on effective skills to enhance the prosocial behaviors of the girl and to reduce her problematic behaviors. During the application of the program the objectives of the intervention are achieved. Family communication is improved, effective family norms are established and control of disruptive behavior increases. All this is a way to achieve positive results in the behavior of the girl. The analysis of the results indicated as most of the objectives proposed in the treatment sessions have been fulfilled. This study shows the importance of parental skills training in the clinical practice for the effective management of disruptive childhood behaviors.

A crossing family is a collection of pairwise crossing segments, this concept was introduced by Aronov et. al. (1994). They prove that any set of $n$ points (in general position) in the plain contains a crossing family of size $\sqrt{n/12}$. In this paper we present a generalization of the concept and give several results regarding this generalization., 23 pages, 16 figures

How to draw the vertices of a complete multipartite graph $G$ on different points of a bounded $d$-dimensional integer grid, such that the sum of squared distances between vertices of $G$ is (i) minimized or (ii) maximized? For both problems we provide a characterization of the solutions. For the particular case $d=1$, our solution for (i) also settles the minimum-2-sum problem for complete bipartite graphs; the minimum-2-sum problem was defined by Juvan and Mohar in 1992. Weighted centroidal Voronoi tessellations are the solution for (ii). Such drawings are related with Laplacian eigenvalues of graphs. This motivates us to study which properties of the algebraic connectivity of graphs carry over to the restricted setting of drawings of graphs with integer coordinates., Appears in the Proceedings of the 26th International Symposium on Graph Drawing and Network Visualization (GD 2018)

Let R be a set of red points and B a set of blue points on the plane. In this paper we introduce a new concept, which we call coarseness, for measuring how blended the elements of S=R@?B are. For X@?S, let @?(X)=||X@?R|-|X@?B|| be the bichromatic discrepancy of X. We say that a partition @P={S"1,S"2,...,S"k} of S is convex if the convex hulls of its members are pairwise disjoint. The discrepancy of a convex partition @P of S is the minimum @?(S"i) over the elements of @P. The coarseness of S is the discrepancy of the convex partition of S with maximum discrepancy. We study the coarseness of bicolored point sets, and relate it to well blended point sets. In particular, we show combinatorial results on the coarseness of general configurations and give efficient algorithms for computing the coarseness of two specific cases, namely when the set of points is in convex position and when the measure is restricted to convex partitions with two elements.

A decomposition of a non-empty simple graph $G$ is a pair $[G,P]$, such that $P$ is a set of non-empty induced subgraphs of $G$, and every edge of $G$ belongs to exactly one subgraph in $P$. The chromatic index $\chi'([G,P])$ of a decomposition $[G,P]$ is the smallest number $k$ for which there exists a $k$-coloring of the elements of $P$ in such a way that: for every element of $P$ all of its edges have the same color, and if two members of $P$ share at least one vertex, then they have different colors. A long standing conjecture of Erd\H{o}s-Faber-Lov\'asz states that every decomposition $[K_n,P]$ of the complete graph $K_n$ satisfies $\chi'([K_n,P])\leq n$. In this paper we work with geometric graphs, and inspired by this formulation of the conjecture, we introduce the concept of chromatic index of a decomposition of the complete geometric graph. We present bounds for the chromatic index of several types of decompositions when the vertices of the graph are in general position. We also consider the particular case in which the vertices are in convex position and present bounds for the chromatic index of a few types of decompositions., Comment: 18 pages, 5 figures

Consider a set of mobile clients represented by n points in the plane moving at constant speed along n different straight lines. We study the problem of covering all mobile clients using a set of k disks centered at k fixed centers. Each disk exists only at one instant and while it does, covers any client within its coverage radius. The task is to select an activation time and a radius for each disk such that every mobile client is covered by at least one disk. In particular, we study the optimization problem of minimizing the maximum coverage radius. First we prove that, although the static version of the problem is polynomial, the kinetic version is NP-hard. Moreover, we show that the problem is not approximable by a constant factor (unless P = NP). We then present a generic framework to solve it for fixed values of k, which in turn allows us to solve more general optimization problems. Our algorithms are efficient for constant values of k.

Let S be a bicolored set of n points in the plane. A subset I of S is an island if there is a convex set C such that I=C@?S. We give an O(n^3)-time algorithm to compute a monochromatic island of maximum cardinality. Our approach is adapted to optimize similar (decomposable) objective functions. Finally, we use our algorithm to give an O(logn)-approximation for the problem of computing the minimum number of convex polygons that cover a class region.

We study the following combinatorial property of point sets in the plane: For a set S of n points in general position and a point p ∈ S consider the points of S − p in their angular order around p. This gives a star-shaped polygon (or a polygonal path) with p in its kernel. Define c ( p ) as the number of convex angles in this star-shaped polygon around p, and c ( S ) as the sum of all c ( p ) , for p ∈ S . We show that for every point set S, c ( S ) is always at least 1 2 n 3 2 − O ( n ) . This bound is shown to be almost tight. Consequently, every set of n points admits a star-shaped polygonization with at least n 2 − O ( 1 ) convex angles.

Resumen Presentamos un caso clinico que pone de manifiesto los desafios que plantea la endometriosis profunda del tabique rectovaginal. Se trata de una paciente intervenida en nuestro servicio de histerectomia total en mayo de 2011 por utero miomatoso sintomatico, sin hallazgos clinicos ni anatomopatologicos de endometriosis. La paciente continua con dolor pelvico invalidante, disquecia y sintomas urinarios hasta febrero de 2012, momento en el que comienza con obstruccion ureteral, hidronefrosis bilateral y pseudoobstruccion intestinal, que obliga a realizar una cirugia radical de una tumoracion fibrosa pelvica, fija a recto y que comprime ambos ureteres. Resultado histologico: endometriosis. Resaltamos las dificultades diagnosticas que presenta y el tratamiento agresivo que requiere.

Nowadays, the synthesis of applicable products in everyday life is an increasing research topic. Knoevenagel condensation presents a broad range of applications in synthesis of multiple substances involving domino reactions to obtain five- and six-membered heterocycles such as polysubstituted pyrrolidines, dihydrothiophenes and 1,4-dihydropyridines. Chitosan has been employed as support of metallic catalysts in hydrogenation of ethyl cinnamate, Suzuki cross coupling or to transform nitriles into amides. Very recently, this polymer has been used in several reactions (e.g. aldol, Henry o Michael reactions) as heterogeneous catalyst using simple aldehydes. We report here, the synthesis of new Knoevenagel switchable products obtained from malononitrile and highly modified aldehydes owning different steric hindrance and electronic effects. The heterogeneous chitosan catalyst role has been studied to improve on conversion, time and yields compared with non-catalyzed reactions.We thank the AECID (Projects A/023577/09 and A/030422/10) and the 'Junta de Andalucia' (FQM 142 and Project P09-AGR-4597) for financial support.

The pseudoachromatic index of a graph is the maximum number of colors that can be assigned to its edges, such that each pair of different colors is incident to a common vertex. If for each vertex its incident edges have different color, then this maximum is known as achromatic index. Both indices have been widely studied. A geometric graph is a graph drawn in the plane such that its vertices are points in general position, and its edges are straight-line segments. In this paper we extend the notion of pseudoachromatic and achromatic indices for geometric graphs, and present results for complete geometric graphs. In particular, we show that for $n$ points in convex position the achromatic index and the pseudoachromatic index of the complete geometric graph are $\lfloor \tfrac{n^2+n}{4} \rfloor$., 21 pages, 10 figures

Combinatorics, Let f(n,k) be the minimum number of edges that must be removed from some complete geometric graph G on n points, so that there exists a tree on k vertices that is no longer a planar subgraph of G. In this paper we show that ( 1 / 2 )n2 / k-1-n / 2≤f(n,k) ≤2 n(n-2) / k-2. For the case when k=n, we show that 2 ≤f(n,n) ≤3. For the case when k=n and G is a geometric graph on a set of points in convex position, we completely solve the problem and prove that at least three edges must be removed.

Let $S$ be a finite set of geometric objects partitioned into classes or \emph{colors}. A subset $S'\subseteq S$ is said to be \emph{balanced} if $S'$ contains the same amount of elements of $S$ from each of the colors. We study several problems on partitioning $3$-colored sets of points and lines in the plane into two balanced subsets: (a) We prove that for every 3-colored arrangement of lines there exists a segment that intersects exactly one line of each color, and that when there are $2m$ lines of each color, there is a segment intercepting $m$ lines of each color. (b) Given $n$ red points, $n$ blue points and $n$ green points on any closed Jordan curve $\gamma$, we show that for every integer $k$ with $0 \leq k \leq n$ there is a pair of disjoint intervals on $\gamma$ whose union contains exactly $k$ points of each color. (c) Given a set $S$ of $n$ red points, $n$ blue points and $n$ green points in the integer lattice satisfying certain constraints, there exist two rays with common apex, one vertical and one horizontal, whose union splits the plane into two regions, each one containing a balanced subset of $S$., Comment: This paper was published in Discrete Applied Mathematics, 181:21--32, 2015

Combinatorics, Let P be a set of n points in general position in the plane. A subset I of P is called an island if there exists a convex set C such that I = P \C. In this paper we define the generalized island Johnson graph of P as the graph whose vertex consists of all islands of P of cardinality k, two of which are adjacent if their intersection consists of exactly l elements. We show that for large enough values of n, this graph is connected, and give upper and lower bounds on its diameter.