[In silico analysis of Cit s 2: A highly conserved profilin]. / Análisis in silico de cit s 2: una profilina altamente conservada.

OBJECTIVE: Analyze phylogenetic relationships and molecular mimicry of Cit s 2 and other plant profilins. METHODS: Online bioinformatics tools including Basic Local Alignment Search Tool (BLASTP), PRALINE and MEGA were used for multiple alignments and phylogenetic analysis. A 3D-homology model of Cit s 2 was predicted. Models were calculated with MODELLER. The best model was selected with the model scoring option of MAESTRO. Conserved regions between Cit s 2 and other profilins were located on the 3D model and antigenic regions were predicted by ElliPro server (3-5). RESULTS: Cit s 2 amino acid sequence (Uniprot code:P84177) was compared with other 30 profilins from different allergenic sources. The identity between Cit s 2 and other profilins ranged between 82 and 99%. The highest identity was observed with Cucumis melo (99%) followed by Prunus persica (98%) and Malus domestica (92%). High conserved antigenic regions were observed on the 3D predicted model. Seven lineal and six discontinuous epitopes were found in Cit s 2. CONCLUSION: High conserved antigenic regions were observed on the 3D predicted model of Cit s 2, which might involve potential cross-reactivity between Cit s 2 and other profilins. Future studies are needed to further analyze these results.

OBJETIVO: Analizar las relaciones filogenéticas y el mimetismo molecular de Cit s 2 y otras profilinas vegetales. MÉTODOS: Se utilizaron herramientas bioinformáticas en línea, incluida la de búsqueda de alineación local básica (BLASTP), PRALINE y MEGA, para alineamientos múltiples y análisis filogenético. Se predijo un modelo de homología 3D de Cit s 2. Los modelos se calcularon con MODELLER. El mejor modelo fue seleccionado con la opción de puntuación de modelo de Maestro. Las regiones conservadas entre Cit s 2 y otras profilinas se ubicaron en el modelo 3D y las regiones antigénicas fueron predichas por el servidor ElliPro (3-5). RESULTADOS: La secuencia de aminoácidos de Cit s 2 (código Uniprot: P84177), se comparó con otras 30 profilinas de diferentes fuentes alergénicas. La mayor identidad se observó con Cucumis melo (99%) seguida de Prunus persica (98%) y Malus domestica (92%). Se observaron regiones antigénicas altamente conservadas en el modelo predicho en 3D. Se encontraron siete epítopes lineales, y seis epítopes discontinuos en Cit s 2. CONCLUSIÓN: Se observaron regiones antigénicas altamente conservadas en el modelo 3D predicho de Cit s 2, lo que podría implicar una posible reactividad cruzada entre Cit s 2 y otras profilinas. Se necesitan estudios futuros para analizar más a fondo estos resultados.

Current state and future perspectives for palliative care in Latin America with a special focus on Peru.

The evolution of palliative care in Latin America has been slow compared with other parts of the world, especially developed countries. Current data show inequality in the development of palliative care in the region and those differences are also evident within countries between urban and rural populations. Peru is situated in the low-ranking group in terms of palliative care services in Latin America. The main reasons are a lack of education and funding and misconceptions about palliative care. Limited access to the use of opioids and regulatory barriers are also common features. The development of more palliative care units in Peru, as well as in other Latin American countries, is needed to ensure access to adequate and timely treatment for patients receiving palliative care.

Process for Assembly and Transformation into Saccharomyces cerevisiae of a Synthetic Yeast Artificial Chromosome Containing a Multigene Cassette to Express Enzymes That Enhance Xylose Utilization Designed for an Automated Platform.

A yeast artificial chromosome (YAC) containing a multigene cassette for expression of enzymes that enhance xylose utilization (xylose isomerase [XI] and xylulokinase [XKS]) was constructed and transformed into Saccharomyces cerevisiae to demonstrate feasibility as a stable protein expression system in yeast and to design an assembly process suitable for an automated platform. Expression of XI and XKS from the YAC was confirmed by Western blot and PCR analyses. The recombinant and wild-type strains showed similar growth on plates containing hexose sugars, but only recombinant grew on D-xylose and L-arabinose plates. In glucose fermentation, doubling time (4.6 h) and ethanol yield (0.44 g ethanol/g glucose) of recombinant were comparable to wild type (4.9 h and 0.44 g/g). In whole-corn hydrolysate, ethanol yield (0.55 g ethanol/g [glucose + xylose]) and xylose utilization (38%) for recombinant were higher than for wild type (0.47 g/g and 12%). In hydrolysate from spent coffee grounds, yield was 0.46 g ethanol/g (glucose + xylose), and xylose utilization was 93% for recombinant. These results indicate introducing a YAC expressing XI and XKS enhanced xylose utilization without affecting integrity of the host strain, and the process provides a potential platform for automated synthesis of a YAC for expression of multiple optimized genes to improve yeast strains.

Sustainable conversion of coffee and other crop wastes to biofuels and bioproducts using coupled biochemical and thermochemical processes in a multi-stage biorefinery concept.

The environmental impact of agricultural waste from the processing of food and feed crops is an increasing concern worldwide. Concerted efforts are underway to develop sustainable practices for the disposal of residues from the processing of such crops as coffee, sugarcane, or corn. Coffee is crucial to the economies of many countries because its cultivation, processing, trading, and marketing provide employment for millions of people. In coffee-producing countries, improved technology for treatment of the significant amounts of coffee waste is critical to prevent ecological damage. This mini-review discusses a multi-stage biorefinery concept with the potential to convert waste produced at crop processing operations, such as coffee pulping stations, to valuable biofuels and bioproducts using biochemical and thermochemical conversion technologies. The initial bioconversion stage uses a mutant Kluyveromyces marxianus yeast strain to produce bioethanol from sugars. The resulting sugar-depleted solids (mostly protein) can be used in a second stage by the oleaginous yeast Yarrowia lipolytica to produce bio-based ammonia for fertilizer and are further degraded by Y. lipolytica proteases to peptides and free amino acids for animal feed. The lignocellulosic fraction can be ground and treated to release sugars for fermentation in a third stage by a recombinant cellulosic Saccharomyces cerevisiae, which can also be engineered to express valuable peptide products. The residual protein and lignin solids can be jet cooked and passed to a fourth-stage fermenter where Rhodotorula glutinis converts methane into isoprenoid intermediates. The residues can be combined and transferred into pyrocracking and hydroformylation reactions to convert ammonia, protein, isoprenes, lignins, and oils into renewable gas. Any remaining waste can be thermoconverted to biochar as a humus soil enhancer. The integration of multiple technologies for treatment of coffee waste has the potential to contribute to economic and environmental sustainability.

Granuloma periférico de células gigantes: recidiva postquirúrgica. Revisión de la literatura y reporte de un caso clínico / Giant cell peripheral granuloma: post-surgical recurrence. Literature review and clinical case report

El granuloma periférico de células gigantes se define como una lesión de tejidos blandos no neoplásica, ocasionada por una reacción hiperplásica como consecuencia de un traumatismo o inflamación local. Clínicamente se observa como un nódulo asintomático, generalmente de coloración rojiza azulada de diámetro variable y que afecta frecuentemente la encía marginal. Histológicamente se caracteriza por la proliferación de células gigantes mononucleadas y multinucleadas. En general, su tratamiento consiste en la exéresis quirúrgica más legrado de las paredes óseas afectadas, pudiendo existir la posibilidad de recidiva. A continuación se presenta una revisión de la literatura y se describe un caso clínico diagnosticado como granuloma periférico de células gigantes en un paciente de 14 años, cuya lesión fue removida quirúrgicamente utilizando electrobisturí, y con recidiva de la lesión. Se discute la epidemiología, características clínicas, radiográficas e histológicas de dicha patología, así como las posibles opciones terapéuticas y protocolos. Además, se comentan brevemente los aspectos relacionados al diagnóstico diferencial de las lesiones reactivas hiperplásicas del complejo periodontal, priorizando las posibles causas de la recidiva.

Giant cell peripheral granuloma is defined as a non-neoplastic soft-tissue lesion caused by a hyperplastic reaction resulting from trauma or local inflammation. Clinically it can be observed as an asymptomatic nodule, generally exhibiting a reddish-bluish hue and variable diameter. It frequently affects marginal gingival tissue. Histologically, it is characterized by the proliferation of mono-nucleated and multi-nucleated giant cells. In general, treatment consists of surgical extirpation and curettage of affected bone walls. Recurrence is a distinct possibility. In the present paper, a scientific literature review is presented along with the presentation of a clinical case of a 14 year old patient diagnosed with Giant cell peripheral granuloma: the lesion was surgically removed using an electric scalpel. The lesion recurred 4 weeks after surgery. Epidemiology of the case was reviewed, along with its clinical, radiographic and histological characteristics. Available therapeutic options and protocols were equally reviewed as well as issues related to differential diagnosis of hyperplastic reactive lesions of the periodontal complex. Priority was given to the causes of the lesion's recurrence.

Automated UV-C mutagenesis of Kluyveromyces marxianus NRRL Y-1109 and selection for microaerophilic growth and ethanol production at elevated temperature on biomass sugars.

The yeast Kluyveromyces marxianus is a potential microbial catalyst for fuel ethanol production from a wide range of biomass substrates. To improve its growth and ethanol yield at elevated temperature under microaerophilic conditions, K. marxianus NRRL Y-1109 was irradiated with UV-C using automated protocols on a robotic platform for picking and spreading irradiated cultures and for processing the resulting plates. The plates were incubated under anaerobic conditions on xylose or glucose for 5 mo at 46 °C. Two K. marxianus mutant strains (designated 7-1 and 8-1) survived and were isolated from the glucose plates. Both mutant strains, but not wild type, grew aerobically on glucose at 47 °C. All strains grew anaerobically at 46 °C on glucose, galactose, galacturonic acid, and pectin; however, only 7-1 grew anaerobically on xylose at 46 °C. Saccharomyces cerevisiae NRRL Y-2403 did not grow at 46 °C on any of these substrates. With glucose as a carbon source, ethanol yield after 3 d at 46 °C was higher for 8-1 than for wild type (0.51 and 0.43 g ethanol/g glucose, respectively). With galacturonic acid as a carbon source, the ethanol yield after 7 d at 46 °C was higher for 7-1 than for wild type (0.48 and 0.34 g ethanol/g galacturonic acid, respectively). These mutant strains have potential application in fuel ethanol production at elevated temperature from sugar constituents of starch, sucrose, pectin, and cellulosic biomass.

Checklist of the inland fishes of El Salvador.

The inland fish fauna of El Salvador and its distribution was originally described in 1925 by Samuel Hildebrand. That work has been the main source of information for freshwater fishes of El Salvador up to today. Based on the combination of an intensive literature review, electronic database searches, re-identification of museum specimens, and fieldwork, we hereby provide an updated checklist of the inland fishes of El Salvador. This checklist provides distributional data at the Salvadoran hydrographical and political (by department) levels. The checklist is systematically arranged at the ordinal and familial level and then alphabetically therein. The freshwater fish fauna of El Salvador includes 101 species divided into 64 genera, 29 families, and 14 orders. According to their supposed tolerance to salinity, 73% of these species are peripheral, 23% secondary, and only 4% are primary freshwater fishes. One species is endemic to the country, Amatitlania coatepeque. The low number of primary freshwater fishes and endemics is comparable to the Central American Pacific slope in particular, as well as northern Central America in general.

Cirugía abdominal en la unidad oncológica del Hospital General Santa Rosa / Abdominal surgery in the cancer unit of the General Hospital Santa Rosa

La Unidad Oncológica del Hospital General Santa Rosa, es el primer servicio descentralizado para atención de Cáncer en el Perú, por convenio con el Instituto Nacional de Enfermedades Neoplásicas. Se presenta una serie de casos de cáncer digestivo operados, como un reporte piloto en un Hospital General. 50 casos fueron incluídos, siendo los más frecuentemente tratados: cáncer gástrico (38%), cáncer de colon (19%), cáncer de recto (14%) y otras localizaciones (29%). Se presentaron complicaciones en 18% de los casos, y un caso de mortalidad post operatoria asociado a comorbilidad. Se concluye que en el Hospital General Santa Rosa puede realizarse cirugía de alta complejidad, con baja morbi-mortalidad.

Hospital General Santa Rosa, to set up the first Oncology Departament with agreement to pay attention in cancer in association with Instituto Nacional de Enfermedades Neoplásicas, Lima-Perú. We present the cases of abdominal cancer trated with surgery in this Department. 50 cases was included: Gastric cancer (38%), colonic cancer (19%), rectal cancer (14%), and others (29%). Complications in 18% of cases and one case of PO mortatlity.

[Influence of pulmonary recruitment on exogenous surfactant effects]. / Influencia del reclutamiento alveolar sobre los efectos del surfactante exogeno.

An experimental model was devised to study the effects of a sustained insufflation maneuver on the immediate response to exogenous surfactant administration and the effects of baseline pulmonary volume subsequently used in 20 adult albino rats. Lung-injury was induced by repeated lavages with saline solution. Gas exchange, hemodynamic status, lung mechanics and histopathology were assessed. The rats were divided into four experimental groups. Group 1 was delivered 30 cm H2O sustained insufflation over 15 seconds prior to the surfactant. It was subsequently ventilated at positive end-expiratory pressure (PEEP) of 10 cm H2O. Group 2 did not receive sustained insufflation and was ventilated at PEEP of 10 cm H2O. Group 3 was delivered sustained insufflation and was ventilated with PEEP of 4 cm H2O; and group 4 did not receive sustained insufflation and was ventilated with PEEP of 4 cm H2O. The surfactant immediate effect was not modified by previous sustained insufflation administration. Increased PaO2 associated to high functional residual capacity (FRC) (Group 1 p = 0.0001; Group 2 p = 0.0001), regardless of sustained insufflation, was observed. The use of sustained insufflation prior to surfactant administration along with high FRC ventilation was associated with polymorphonuclear infiltrates beneath the bronchiolar epithelium (p = 0.008). Our results do not advocate the use of sustained insufflation prior to the administration of exogenous surfactant.

Influencia del reclutamiento alveolar sobre los efectos del surfactante exogeno / Influence of pulmonary recruitment on exogenous surfactant effects

Se investigaron los efectos producidos por una maniobra de insuflación sostenida previa a la administraciónde surfactante exógeno y los producidos por diferentes patrones ventilatorios sobre la respuesta al mismo. Se estudiaron 20 ratas albinas adultas a las que se les produjo una injuria pulmonar por repetidos lavados con solución fisiológica. Se evaluó el pH, PaO2, PaCO2, la presión arterial sistólica, la compliance toracopulmonar y la histología. Los animales se dividieron en 2 grupos según se les hubiera aplicado o no insuflación sostenida para evaluar el efecto inmediato de la misma. Posteriormente los grupos citados fueron subdivididos en función de la capacidad residual funcional (CRF) aplicada, quedando conformados 4 grupos experimentales. El grupo 1 recibió previo al surfactante una insuflación sostenida de 30 cm H2O durante 15 segundos y se ventiló posteriormente con presión al final de la espiración (PEEP) de10 cm H2O. El grupo 2, no recibió insuflación sostenida y se ventiló con PEEP 10 cm H2O. El grupo 3, recibió insuflación sostenida y se ventiló con PEEP 4 cm H2O y el grupo 4, sin insuflación sostenida se ventiló con PEEP 4 cm H2O. Los efectos inmediatos del surfactante no fueron modificados por la aplicación previa de insuflación sostenida. Se verificó durante el transcurso de la experiencia un aumento de la PaO2 asociada al aumento de la capacidad residual funcional (Grupo1 p=0.0001; Grupo2 p= 0.0001), e independiente de la insuflación sostenida. El uso de insuflación sostenida previo a la administración de surfactante sumado a la ventilación con capacidad residual funcional alta se asoció con infiltración de polimorfonucleares debajo del epitelio bronquiolar (p = 0.008). Nuestros resultados no avalan el uso de insuflación sostenida previo a la administración de surfactante exógeno.

Estrategias ventilatorias de alta frecuencia con respirador neonatal convencional: evaluación del intercambio gaseoso, estado hemodinamico y lesion pulmonar / High frequency ventilation strategies with neonatal conventional ventilator. Assessment of gas exchange, hemodynamic state and lung injury

Se realizó un diseño experiemntal a fin de considerar el uso de respiradores neonatales convencionales con mecanismo de espiración asistida utilizando estrategias ventilatorias de alta fecuencia. Se evaluó el intercambio gaseoso, el estado hemodinámico y la injuria pulmonar. Se estudiaron 20 ratas tipo Wistar albino, a las que se les provocó lesión pulmonar aguda mediante lavado pulmonar con solución fisiológica. Posteriormente se distribuyeron en 4 grupos según diferentes estrategias ventilatorias basadas en los cambios de presión y volumen corriente, el vomumen pulmonar basal y la frecuencia respiratoria. El grupo 1 Ventilación de Alta Frecuencia, con volúmenes pulmonares basales altos (VAFva), el grupo 2 Ventilación mecánica convencional, con volúmenes pulmonares basales altos (VMCva), el grupo 3 Ventilación de alta frecuencia, con volúmenes pulmonares basales bajos (VAFvb) y el grupo 4 Ventilación mecánica convencional, con volúmenes pulmonares basales bajos (VMCvb). Se obtuvieron diferencias significativas entre el grupo 1 (VAFva) y los grupos 2 (VMCva), 3 (VAFvb) y 4 (VMCvb) en cuanto a la pO2, cociente arterio/Alveolar de O2 (a/A), pCO2, presión arterial y lesión histopatológica pulmonar. Se verificó la hipótesis del rol decisivo que cumple el mantenimiento del volumen pulmonar basal en la disminución de la progresión del daño provocado por la ventilación mecánica sobre un pulmón previamente lesionado, en la medida que acompañe la estrategias ventilatorias que generen pequeños cambios cíclicos de presión y volumen. Concluímos que es posible la ventilación mecánica de alta frecuencia con respiradores neonatales convencionales con mecanismo de espiración asistida.

Cardiomioplastia, una alternativa al manejo de la falla cardíaca / Cardiomyoplasty, an alternative in heart failure management

Sin lugar a dudas el trasplante cardíaco constituye la terapia de elección para el manejo de los pacientes con falla cardíaca terminal refractaria al tratamiento médico. Sin embargo,la escasez de donantes,las crecientes listas de espera y los problemas relacionados con su manejo postoperatorio han llevado a la búsqueda de alternativas terapéuticas,que desde hace algunos años se han venido desarrollando en distintos centros del mundo. Una de las más interesantes es la cardiomioplastia,en la que se encuentra trabajando nuestro equipo de cirugía cardiovascular.En esta revisión tocaremos algunos de los aspectos más importantes de su evolución y desarrollo clínico.

Falla cardíaca congestiva: conceptos actuales / Congestive heart failure: present concepts

La falla cardíaca congestiva sigue siendo uno de los más grandes problemas de salud. Por esta razón,se ha venido desarrollando una labor de investigación tendiente a conocer mejor las características del síndrome para apoyar en este conocimiento nuevas posibilidades terapéuticas. En esta revisión discutiremos algunos de esos recientes conocimientos y haremos un enfoque de las posibilidades actuales de manejo de la falla cardíaca.