Beyond hyperglycemia: glycaemic variability as a prognostic factor after acute ischemic stroke.

INTRODUCTION: Glycaemic variability (GV) refers to variations in blood glucose levels, and may affect stroke outcomes. This study aims to assess the effect of GV on acute ischaemic stroke progression. METHODS: We performed an exploratory analysis of the multicentre, prospective, observational GLIAS-II study. Capillary glucose levels were measured every 4 hours during the first 48 hours after stroke, and GV was defined as the standard deviation of the mean glucose values. The primary outcomes were mortality and death or dependency at 3 months. Secondary outcomes were in-hospital complications, stroke recurrence, and the impact of the route of insulin administration on GV. RESULTS: A total of 213 patients were included. Higher GV values were observed in patients who died (n = 16; 7.8%; 30.9 mg/dL vs 23.3 mg/dL; p = 0.05). In a logistic regression analysis adjusted for age and comorbidity, both GV (OR = 1.03; 95% CI, 1.003-1.06; p = 0.03) and stroke severity (OR = 1.12; 95% CI, 1.04-1.2; p = 0.004) were independently associated with mortality at 3 months. No association was found between GV and the other outcomes. Patients receiving subcutaneous insulin showed higher GV than those treated with intravenous insulin (38.95 mg/dL vs 21.34 mg/dL; p < 0.001). CONCLUSIONS: High GV values during the first 48 hours after ischaemic stroke were independently associated with mortality. Subcutaneous insulin may be associated with higher VG levels than intravenous administration.

Atypical hemolytic uremic syndrome in a patient with HIV treated with eculizumab: A case report.

Thrombotic microangiopathy defines a group of pathologies characterized by microvascular dysfunction with the concurrence of microangiopathic hemolytic anemia, thrombocytopenia, and organ damage. It represents the most frequent microvascular manifestation of human immunodeficiency virus (HIV) infection. We report the case of a man in the seventh decade of life with a recent diagnosis of infection by HIV, who develops hemolytic uremic syndrome, requiring continuous renal replacement therapy and plasma replacement therapy, without response, ADAMTS13 with preserved activity, ruling out other etiologies (infectious, metabolic, and genetic) with successful response to eculizumab.

Bruxismo y su relación con otorrinolaringología: una revisión de la literatura

Resumen El bruxismo es una condición que se observa frecuentemente en los pacientes y estos a menudo consultan por sus consecuencias físicas, como pueden ser el desgaste o destrucción dentaria, el dolor orofacial, así como también por el deterioro de la calidad de vida tanto de ellos mismos como de las personas cercanas. En la última década han aumentado en forma importante las investigaciones en torno a esta condición, así como los consensos en cuanto a su definición, clasificación y manejo clínico. Los dentistas son quienes actualmente reconocen esta actividad parafuncional y manejan estos problemas, pero es importante que los profesionales de otras áreas de la salud, como médicos y en especial otorrinolaringólogos, puedan identificar los signos, síntomas y consecuencias del bruxismo, ayudando en la detección de esta condición. Así, el objetivo de esta revisión es establecer un estado del arte sobre bruxismo e incentivar la formación de equipos multidisciplinares que ayuden en el diagnóstico y la terapéutica de esta condición.

Abstract Bruxism is a condition that is frequently observed in patients, and they often consult for physical consequences, such as teeth wear or destruction, orofacial pain, as well as for the decrease of the quality of life, of both patients and their loved ones. In the last decade, research on this phenomenon has increased significantly, as well as the consensus in terms of definition, classification and clinical management. Dentists are those who at present recognize this parafunctional activity and manage these problems, but it is important that professionals from other health areas, such as medical doctors, and specially otolaryngologists, can identify signs, symptoms and consequences of bruxism, helping in the detection of this condition. Thus, the objective of this review is to establish a state of the art about bruxism and encourage the formation of multidisciplinary teams that help to in the diagnosis and better management of this condition.

Beyond hyperglycemia: glycaemic variability as a prognostic factor after acute ischemic stroke. / Más allá de la hiperglucemia: la variabilidad glucémica como factor pronóstico en el infarto cerebral agudo.

INTRODUCTION: Glycaemic variability (GV) refers to variations in blood glucose levels, and may affect stroke outcomes. This study aims to assess the effect of GV on acute ischaemic stroke progression. METHODS: We performed an exploratory analysis of the multicentre, prospective, observational GLIAS-II study. Capillary glucose levels were measured every 4 hours during the first 48 hours after stroke, and GV was defined as the standard deviation of the mean glucose values. The primary outcomes were mortality and death or dependency at 3 months. Secondary outcomes were in-hospital complications, stroke recurrence, and the impact of the route of insulin administration on GV. RESULTS: A total of 213 patients were included. Higher GV values were observed in patients who died (n = 16; 7.8%; 30.9 mg/dL vs 23.3 mg/dL; p = 0.05). In a logistic regression analysis adjusted for age and comorbidity, both GV (OR = 1.03; 95% CI, 1.003-1.06; p = 0.03) and stroke severity (OR = 1.12; 95% CI, 1.04-1.2; p = 0.004) were independently associated with mortality at 3 months. No association was found between GV and the other outcomes. Patients receiving subcutaneous insulin showed higher GV than those treated with intravenous insulin (38.95 mg/dL vs 21.34 mg/dL; p < 0.001). CONCLUSIONS: High GV values during the first 48 hours after ischaemic stroke were independently associated with mortality. Subcutaneous insulin may be associated with higher VG levels than intravenous administration.

The effect of post-stroke hyperglycaemia on the levels of brain damage and repair-related circulating biomarkers: the Glycaemia in Acute Stroke Study II.

BACKGROUND AND PURPOSE: The aim was to identify whether post-stroke hyperglycaemia (PSH) influences the levels of circulating biomarkers of brain damage and repair, and to explore whether these biomarkers mediate the effect of PSH on the ischaemic stroke (IS) outcome. METHODS: This was a secondary analysis of the Glycaemia in Acute Stroke II study. Biomarkers of inflammation, prothrombotic activity, endothelial dysfunction, blood-brain barrier rupture, cell death and brain repair processes were analysed at 24-48 h (baseline) and 72-96 h (follow-up) after IS. The associations of the biomarkers and stroke outcome (modified Rankin Scale score at 3 months) based on the presence of PSH were compared. RESULTS: A total of 174 patients participated in this sub-study. Brain-derived neurotrophic factor (BDNF) at admission was negatively correlated with glucose levels. PSH was associated with a trend toward higher levels of endothelial progenitor cells (EPCs) at baseline. The EPCs in the PSH group then decreased in the follow-up samples (-8.5 ± 10.3) compared with the non-PSH group (4.7 ± 7.33; P = 0.024). However, neither BDNF nor EPC values had correlation with the 3-month outcome. Higher interleukin-6 at follow-up was associated with poor outcomes (modified Rankin Scale > 2) independently of PSH. CONCLUSION: Post-stroke hyperglycaemia appears to be associated with a negative regulation of BDNF and a different reaction in EPC levels. However, neither BDNF nor EPCs showed significant mediation of the PSH association with IS outcome, and only higher interleukin-6 in the follow-up samples (72-96 h) was related to poor outcomes, independently of PSH status. Further studies are needed to achieve definite conclusions.

Validation of a novel integral disease index for evaluating the grade of activity in Mexican patients with ulcerative colitis: A prospective cohort study. / Validación de un nuevo índice integral de enfermedad para evaluar el grado de actividad en pacientes mexicanos con colitis ulcerosa: un estudio de cohorte prospectivo.

INTRODUCTION AND AIM: Ulcerative colitis is a chronic condition characterized by inflammation affecting the colon. To objectively and integrally measure disease activity in patients with ulcerative colitis and thus optimize pharmacologic treatment, a novel integral disease index was created that includes the clinical, biochemical, endoscopic, and histologic characteristics necessary for achieving that task. The aim of the present study was to validate the novel integral disease index in patients with ulcerative colitis. MATERIALS AND METHODS: A cohort study on a total of 222 patients with histologic confirmations of ulcerative colitis diagnosis was conducted. The variables included in the disease index were: number of bowel movements per day; values for hemoglobin, high-sensitivity C-reactive protein, and serum albumin; and endoscopic and histologic findings measured through the subscales of the Mayo and Riley scores, respectively. The data analysis was performed utilizing the STATA SE 11.1 statistics program. RESULTS: The correlation of the novel disease index was very good (r=0.817, p <.001 with the Truelove and Witts criteria and r=0.957, p <.0001 with the Mayo score, respectively). Good internal consistency was found with a Cronbach's alpha coefficient of 0.78 and an acceptable mean inter-item correlation (r=0.47, p <.05). The total efficacy of the novel index was 87.2% correctly classified patients, with an AUC according to the three scenarios described of 0.93, 0.92, and 0.96, respectively. CONCLUSIONS: The novel integral disease index (Yamamoto-Furusho Index) provides an integral view of disease activity in patients with ulcerative colitis and is useful for optimizing pharmacologic treatment.

Factors associated with early extubation of patients after corrective tetralogy of Fallot. / Factores asociados a la extubación temprana en pacientes con cirugía correctora de tetralogía de Fallot.

OBJECTIVE: To assess surgical management and postoperative results associated with early extubation in patients undergoing tetralogy of Fallot corrective surgery at a public hospital in Argentina. METHODS: A retrospective review was made from clinical records from patients who underwent corrective surgery for tetralogy of Fallot. A total of 38 clinical records that met the inclusion criteria for the retrospective review were included in the analysis. RESULTS: 16% were extubated early. Milrinone was the only drug that showed differences in patients who were extubated early (p=0.01). Extracorporeal circulation time, aortic clamping time, transfusion with cryoprecipitates, saturation of oxygen pressure, and haematocrit at the end of the surgical procedure showed no differences (p>.05). In the postoperative period, the ICU stay was shorter for the patients who were extubated early (p=0.0007), but there were no differences in the total hospital stay (p=0.26). CONCLUSIONS: Early extubation in the institution, although found to be low frequency, has proved as a safe and effective alternative to shorten these patients' stay in ICU.

Factors related to gastric neuroendocrine tumors. / Factores relacionados a tumores neuroendocrinos gástricos.

INTRODUCTION AND AIMS: An association between long-term use of proton pump inhibitors and the development of gastric neuroendocrine tumors has been reported, but it is still a subject of debate. The aims of the present study were to determine the presence of this association in a Mexican population and to identify the risk factors for developing gastric neuroendocrine tumors. MATERIALS AND METHODS: A case-control study was conducted, in which the cases were patients with a histopathologic diagnosis of gastric neuroendocrine tumor and the controls were patients evaluated through upper endoscopy. The controls were paired by age, sex, and endoscopic examination indication. Proton pump inhibitor use was considered prolonged when consumption was longer than 5 years. RESULTS: Thirty-three patients with gastric neuroendocrine tumor and 66 controls were included in the study. Eighteen (54.5%) patients in the case group were women, as were 39 (59%) of the patients in the control group. The median age of the patients in the case group was 55 years (minimum-maximum range: 24-82) and it was 54 years (minimum-maximum range:18-85) in the control group. A greater number of patients in the gastric neuroendocrine tumor group presented with gastric atrophy (p<0.0001) and autoimmune atrophic gastritis (p=0.0002), compared with the control group. No association between gastric neuroendocrine tumor and prolonged proton pump inhibitor use, sex, smoking, gastroesophageal reflux disease, Helicobacter pylori infection, diabetes mellitus, or autoimmune diseases was found in the univariate analysis. CONCLUSIONS: The results of our study showed no association between proton pump inhibitor use for more than 5 years and the development of gastric neuroendocrine tumor. The presence of gastric atrophy and autoimmune atrophic gastritis was associated with gastric neuroendocrine tumor development.

Unravelling the mysteries of sudden unexpected death in epilepsy. / Desentrañando los misterios de la muerte súbita en epilepsia.

INTRODUCTION: Sudden unexpected death in epilepsy (SUDEP) is the most frequent cause of premature death in epileptic patients. Most SUDEP events occur at night and frequently go unnoticed; the exact pathophysiological mechanisms of this phenomenon therefore remain undetermined. Nevertheless, most cases of SUDEP are attributed to an infrequent yet extremely severe complication of epileptic seizures. DEVELOPMENT: We conducted a systematic literature search on PubMed. Our review article summarises scientific evidence on the classification, pathophysiological mechanisms, risk factors, biomarkers, and prevention of SUDEP. Likewise, we propose new lines of research and critically analyse findings that are relevant to clinical practice. CONCLUSIONS: Current knowledge suggests that SUDEP is a heterogeneous phenomenon caused by multiple factors. In most cases, however, SUDEP is thought to be due to postictal cardiorespiratory failure triggered by generalised tonic-clonic seizures and ultimately leading to cardiac arrest. The underlying pathophysiological mechanism involves multiple factors, ranging from genetic predisposition to environmental factors. Risk of SUDEP is higher in young adults with uncontrolled generalised tonic-clonic seizures. However, patients apparently at lower risk may also experience SUDEP. Current research focuses on identifying genetic and neuroimaging biomarkers that may help determine which patients are at high risk for SUDEP. Antiepileptic treatment is the only preventive measure proven effective to date. Night-time monitoring together with early resuscitation may reduce the risk of SUDEP.

Barrett's esophagus: Ten years of experience at a tertiary care hospital center in Mexico. / Esófago de Barrett: experiencia de 10 años en un centro de tercer nivel en México.

INTRODUCTION: The prevalence of Barrett's esophagus has been calculated at between 1.3 and 1.6%. There is little information with respect to this in Mexico. AIM: To determine the frequency and characteristics of Barrett's esophagus in patients that underwent endoscopy at a national referral center, within a 10-year time frame. MATERIAL AND METHODS: The databases of the pathology and gastrointestinal endoscopy departments of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" were analyzed, covering the period of January 2002 to December 2012. Patients with a histologic diagnosis of Barrett's esophagus were included. The variables of age, sex, the presence of dysplasia/esophageal adenocarcinoma, Barrett's esophagus length, and follow-up were analyzed. RESULTS: Of 43,639 upper gastrointestinal endoscopies performed, 420 revealed Barrett's esophagus, corresponding to a frequency of 9.6 patients for every 1,000 endoscopies. Of those patients, 66.9% (n=281) were men, mean patient age±SD was 57.2±15.3 years, 223 patients (53%) presented with long-segment Barrett's esophagus, and 197 (47%) with short-segment Barrett's esophagus. Dysplasia was not present in 339 patients (80.7%). Eighty-one (19.3%) patients had some grade of dysplasia or cancer: 48/420 (11.42%) presented with low-grade dysplasia, 20/420 (4.76%) with high-grade dysplasia, and 13/420 (3.1%) were diagnosed with esophageal cancer arising from Barrett's esophagus. Mean follow-up time was 5.6 years. CONCLUSIONS: The frequency of Barrett's esophagus was 9.6 cases for every 1,000 upper gastrointestinal endoscopies performed. Dysplasia was not documented in the majority of the patients with Barrett's esophagus and they had no histopathologic changes during follow-up. A total of 19.3% of the patients presented with dysplasia or cancer.

Método para medir densidad ósea a partir de conductividad eléctrica calculada por Tomografía de Impedancia Eléctrica / Method for measuring bone density through the electrical conductivity calculated by Electrical Impedance Tomography

RESUMEN: En este trabajo se presenta un método para medir densidad ósea. El método consiste en la medición de conductividad eléctrica de material óseo por medio de Tomografía de Impedancia Eléctrica (TIE). Se hace uso de una celda de prueba con valores simulados de hueso aplicando corrientes y registrando voltajes, para después usar una reconstrucción por retroproyección y generar mapas de conductividad por medio de gráficas. Los datos obtenidos son analizados y a partir de ellos se obtiene una distribución de la medida de conductividad eléctrica del material óseo, que varía dependiendo del grado de porosidad que presenta en cada región. La ventaja de utilizar el método de tomografía de impedancia es que permite medir la conductividad efectiva del hueso porque se mide en todas las direcciones. Por lo tanto es posible determinar porosidad en material óseo usando mediciones de conductividad eléctrica por medio del método TIE propuesto, lo cual permite calcular un valor numérico de densidad ósea.

ABSTRACT: In this paper a method to measure bone density was developed. The method consists in the measurement of electrical conductivity of bone by Electrical Impedance Tomography (EIT). A phantom with simulated data of bone is used, applying currents and recording voltages; then a backprojection reconstruction is used to generate maps with graphic conductivity values. The data obtained were analyzed and was obtained a distribution of electrical conduc tivity of bone, wich varies according to the bone porosity level in each region. A significant advantage of using this method is that is possible to measure electrical conductivity in several directions of the bone, obtaining an effective conductivity. Therefore it is possible to determine the porosity in the bone with measurements of electrical conductivity using the proposed EIT method, this allows to calculate a numerical value for bone density.

Collagen extraction from mussel byssus: a new marine collagen source with physicochemical properties of industrial interest.

Mussel byssus is a by-product of mussel production and is a potential source of collagen. The goal of this study was to extract collagen from the byssus of Chilean mussel using an enzymatic method and characterize it. A pepsin-aided extraction method was employed where first an enzymatic hydrolysis at two pepsin/substrate ratios (1:50 or 4:50) and times (4 or 24 h) was done. Extraction was conducted at 80 °C for 24 h, in a 0.5 N acetic acid solution. All samples were analyzed for collagen content, amino acid profile, turbidity, viscosity, solubility, denaturation temperature and surface tension. Hydrolysis time had significant effect on collagen content, hydroxyproline content and extraction yield. Hydrolysis with a pepsin/byssus ratio of 4:50 for 24 h gave the better extraction performance with values of 69 mg/g protein, 1.8 mg/g protein and 30%, for collagen content, hydroxyproline content and extraction yield, respectively. No differences were found for the viscosity and surface tension of collagen dispersions, suggesting that the enzymatic hydrolysis did not affect the integrity of the collagen molecule. Denaturation temperature of freeze-dried byssus collagen presented a high value (83-91 °C), making this kind of collagen a very interesting material for encapsulation of bioactive molecules and for biomedical applications.

Stroke-related mortality in a tertiary care hospital in Andalusia: Analysis and reflections. / Mortalidad asociada al ictus en un hospital andaluz de tercer nivel. Análisis y reflexiones.

OBJECTIVES: Stroke is a very common cause of death, especially in southern Spain. The present study analyses in-hospital mortality associated with stroke in an Andalusian tertiary care hospital. METHODS: We gathered the files of all patients who had died at Hospital Universitario Virgen de las Nieves in Granada in 2013 and whose death certificates indicated stroke as the cause of death. We also gathered stroke patients discharge data and compared them to that of patients with acute coronary syndrome (ACS). RESULTS: A total of 825 patients had a diagnosis of stroke (96 deaths, 11.6%); of these, 562 had ischaemic stroke (44 deaths, 7.8%) and 263 haemorrhagic stroke (52 deaths, 19.7%). Patients with haemorrhagic stroke therefore showed greater mortality rate (OR=2.9). Patients in this group died after a shorter time in hospital (median, 4 vs 7 days; mean, 6 days). However, patients with ischaemic stroke were older and presented with more comorbidities. On the other hand, 617 patients had a diagnosis of ACS (36 deaths, 5.8%). The mortality odds ratio (MOR) was 2.1 (stroke/SCA). Around 23% of the patients who died from stroke were taking anticoagulants. 60% of the deceased patients with ischaemic stroke and 20% of those with haemorrhagic stroke had atrial fibrillation (AF); 35% of the patients with ischaemic stroke and AF were taking anticoagulants. CONCLUSIONS: Stroke is associated with higher admission and in-hospital mortality rates than SCA. Likewise, patients with haemorrhagic stroke showed higher mortality rates than those with ischaemic stroke. Patients with fatal stroke usually had a history of long-term treatment with anticoagulants; 2 thirds of the patients with fatal ischaemic stroke and atrial fibrillation were not receiving anticoagulants. According to our results, optimising prevention in patients with AF may have a positive impact on stroke-related in-hospital mortality.

Inflammatory fibroid polyp of the gastrointestinal tract: 10 years of experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. / Pólipo fibroideo inflamatorio del tracto gastrointestinal: 10 años de experiencia del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

BACKGROUND: Inflammatory fibroid polyp (lFP) is a rare, benign, and solitary neoplasm predominantly located in the gastric antrum and small bowel. Its clinical symptoms are heterogeneous and essentially depend on the location and size of the tumor. Definitive diagnosis is made through histopathology and this pathology has excellent long-term prognosis. AIM: To identify the cases of IFP seen at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán over a 10-year period. METHODS: A retrospective, cross-sectional, descriptive, and observational study was conducted that included patients with histopathologic diagnosis of IFP within the time frame of January 2001 and December 2011. RESULTS: Six cases were found and 5/6 (83.3%) of them were women. The median age was 41 years (minimum-maximum range of 19-56 years). The most frequent symptoms were weight loss (n=3), fever (n=2), nausea (n=2), and vomiting (n=2). Three patients presented with iron deficiency anemia and 2 cases with intussusception. The IFPs were located at the following sites: esophagus (n=1), stomach (n=2), small bowel (n=2), and colon (n=1). Treatment was surgical in 5/6 (83.3%) of the patients. CONCLUSIONS: IFPs are extremely rare in our population. They usually present with weight loss and iron deficiency anemia and are more frequently located in the stomach and small bowel. This is the largest reported IFP case series in a Mexican population.

Determinación en terreno de la transmisibilidad de asientos en grúas de horquilla y su efecto en la exposición ocupacional a vibración de cuerpo entero / Determination in field of transmissibility of seats forklift trucks and their effect on occupational exposure to whole body vibration

Se estudió el aislamiento a la vibración, por medio del factor SEAT (Seat Effective Amplitude Transmissibility), de 4 tipos de asientos de grúa de horquilla, los cuales se seleccionaron por poseer distintos sistemas de amortiguamiento a las vibraciones. Los asiento utilizados fueron los modelos GRAMMER MSG71GBLV (SEAT = 0,55 en el eje Z), KAB Seating 21/T1 (SEAT = 0,96 en el eje Z), GENÉRICO BF2-3 (SEAT = 1,01 en el eje Z) y GENÉRICO BFL-3 (SEAT = 0,82 en el eje Z). Para obtener los valores SEAT, se efectuaron mediciones de 30 minutos para 2 condiciones, desplazamiento del vehículo sin carga durante 20 minutos por una ruta de 6 kilómetros y, luego, simulando una condición de trabajo habitual de una grúa de horquilla para trabajo cíclico con carga por un período de tiempo aproximado de 10 minutos. Adicionalmente, se evaluó la exposición a vibración del operador de la grúa de horquilla seleccionada según el D.S. N° 594/1999 y Directiva 2002/44/CE, documentos basados en la norma ISO 2631-1, con el fin de estudiar el efecto de los asientos en la exposición del operador y el nivel de riesgo asociado, para entregar recomendaciones sobre la selección y uso de asientos en grúas de horquilla.

It was studied the isolation of vibration by means of factor SEAT (Seat Effective Amplitude transmissibility) on 4 types of seat forklift truck, which were selected for having different systems of vibration damping. The seat models used were GRAMMER MSG71GBLV (SEAT = 0.55 in the Z axis), KAB Seating 21/T1 (SEAT = 0.96 in the Z axis), Generic BFL-3 (SEAT = 1.01 in the axis Z) and generic BFL-3 (SEAT = 0.82 in the Z axis). To obtain SEAT values, it were performed measurements of 30 minutes for 2 conditions, moving vehicle without load for 20 minutes by a 6 kilometer route and, then, simulating a typical work of a forklift truck to cyclic work with load for a period of time of approximately 10 minutes. Additionally, the exposure to vibration of selected forklift truck operator was evaluated according to the DS N ° 594/1999 and Directive 2002/44/EC documents based on ISO 2631-1, in order to study the effect of the seats in operator exposure and the level of associated risk, to provide recommendations on selection and use of forklift trucks seats.

Lobectomía en ratas: modelo quirúrgico experimental: resultados en la densidad alveolar / Development of a rat model of lung lobectomy

Introducción: En la literatura está documentado que diferentes mamíferos tienen la capacidad de crecimiento compensatorio post resección pulmonar parcial. Objetivo: Crear un modelo quirúrgico de lobectomía en ratas, factible de desarrollar en nuestro medio, exponiendo algunas originalidades en relación a procedimientos de ventilación pulmonar, comunicando los resultados de la densidad alveolar obtenidos. Animales y Métodos: Se utilizaron 47 ratas Rattus norvegicus. Se aplicó como anestesia Atropina, Quetamina y Xilacina. Para el manejo de la vía aérea se diseñó: 1. Un sistema de ventilación con máscara facial tipo ambú evitando así la intubación traqueal. 2. Un protocolo de evaluación anestésica. 3. Un halo para oxigenar. 4. Se modificó un estetoscopio para realizar auscultación animal. Se practicó una lobectomía pulmonar derecha. Los sujetos fueron separados en Grupo Control (n = 7) y Grupo Experimental (n = 40), estos últimos, separados en cuatro grupos (n = 10, cada grupo), que fueron sacrificados en las semana 1, 2, 3 y 4. Resultados: Se logró 100 por ciento de sobrevida. El número de intersecciones alveolares mostró diferencias significativas entre el grupo control y el grupo experimental sacrificado en la semana 3 (p = 0,0016), con un menor número de alvéolos en el grupo experimental. Conclusión: Es factible realizar un modelo de cirugía pulmonar en ratas, con obtención de un 100 por ciento de sobrevida. Esto se logra por adecuaciones en el manejo pre e intra-operatorio. No se pudo demostrar que exista aumento significativo en el número de alvéolos, posiblemente por el bajo número de casos realizados.

Background: Surgical lung resection is required for multiple pulmonary diseases. After these procedures, the lung experiences a compensatory growth, which can be studied in animal models such as rats. Aim: To develop a surgical model of lung lobectomy in rats. Material and Methods: Forty seven rats of the strain Rattus norvegicus were used. Animals were anesthetized with atropine, ketamine and xylacine. The airway was managed with a facial mask to avoid intubation. An anesthetic evaluation protocol was followed and animals were oxygenated using a cephalic veil. Forty rats were subjected to a right lobectomy and seven animals were sham operated. Rats subjected to lobectomy were sacrificed at one, two, three and four weeks after operation. Results: All operated rats survived. There were significant differences in the number of alveolar intersections among rats subjected to lobectomy and sacrificed at three weeks compared to sham operated animals, with a lower number of alveoli among the former. Conclusions: We were able to develop the model of lobectomy, however we failed to demonstrate a compensatory growth among rats subjected to lobectomy.