A novel dissector device that separates anatomic structures during laparoscopic surgery.

OBJECTIVE: To describe a novel dissector device useful in laparoscopy, better definition of anatomic structures to have a better dissection, separation, and cleaning of the structures. METHOD: The endoscopic dissector DisePad was designed and developed at the experimental surgery department of Centro Médico Nacional 20 de Noviembre, and properly patented at Instituto Mexicano de la Propiedad Industrial (title 3512). RESULTS: The tip of the device is the most important component, by its direct contact with the different tissues, consists of a cotton-polyester black cloth impregnated with a special gel immersed into a hot saline solution. Once soaked the tip maintains the solution temperature on itself. CONCLUSIONS: This device has been used in 364 laparoscopic procedures demonstrating, its utility to visualize, separate and clean anatomical structures without thermal lesion, tear, hemorrhage or visceral perforation.

OBJETIVO: Describir un nuevo dispositivo disector en laparoscopia, con una mejor definición de las estructuras anatómicas para obtener una mejor disección,separación y limpieza de las estructuras. MÉTODO: El disector endoscópico DisePad fue diseñado y desarrollado en el servicio de cirugía experimental del Centro Médico Nacional 20 de Noviembre, y patentado ante el Instituto Mexicano de la Propiedad Industrial (registro n.º 3512). RESULTADOS: El componente más importante del disector es la punta que tiene contacto con los tejidos: es una tela de algodón-poliéster negra impregnada en un gel (patentado) que, al ser sumergido en un termo con solución salina caliente, permite retener la temperatura. CONCLUSIONES: Este dispositivo ha sido utilizado en 364 procedimientos quirúrgicos por vía laparoscópica y ha demostrado ser útil para visualizar, separar y limpiar estructuras anatómicas sin producir daño por lesión térmica, desgarre, hemorragia ni perforación visceral.

Epidemiology of human papillomavirus-associated anogenital cancers in Granada: a three-decade population-based study.

Introduction: HPV infection is a common risk factor for all anogenital cancers. However, there are important differences in the epidemiology of anogenital cancers and these have not been compared considering diverse epidemiological indicators over a long period of time. To fill this gap, we investigated incidence, mortality, and survival trends of anogenital cancers over a period of three decades. Methods: We conducted an observational registry-based study using data from the population-based cancer registry of Granada in southern Spain. We collected data on all incident cases of anogenital cancer (cervical, anal, penile, vulvar, and vaginal cancer) diagnosed between 1985 and 2017. We calculated crude and age-standardized incidence and mortality rates, and 1, 3, and 5-year overall and net survival. We further conducted time-trend analysis calculating annual percent changes (APC) for each cancer site. Results: The incidence of anogenital cancers decreased slightly during the past 30 years, with the exception of vulvar cancer, where a slight increase was observed. Mortality decreased significantly for cervical cancer over the study period but increased non-significantly for the remaining cancer sites. Survival rates were similar to those reported in comparable countries and increased for cervical and vulvar cancer. Discussion: Cervical cancer was the greatest contributor to the burden of anogenital cancers and showed a marked improvement in all indicators in comparison to the remaining cancer sites.

Meteorological indicators of dengue epidemics in non-endemic Northwest Argentina.

In the last two decades dengue cases increased significantly throughout the world, giving place to more frequent outbreaks in Latin America. In the non-endemic city of San Ramón de la Nueva Orán, located in Northwest Argentina, large dengue outbreaks alternate with several years of smaller ones. This pattern, as well as the understanding of the underlying mechanisms, could be essential to design proper strategies to reduce epidemic size. We develop a stochastic model that includes climate variables, social structure, and mobility between a non-endemic city and an endemic area. Climatic variables were input of a mosquito population ecological model, which in turn was coupled to a meta-population, spatially explicit, epidemiological model. Human mobility was included into the model given the high border crossing to the northern country of Bolivia, where dengue transmission is sustained during the whole year. We tested different hypotheses regarding people mobility as well as climate variability by fitting numerical simulations to weekly clinical data reported from 2009 to 2016. After assessing the number of imported cases that triggered the observed outbreaks, our model allows to explain the observed epidemic pattern. We found that the number of vectors per host and the effective reproductive number are proxies for large epidemics. Both proxies are related with climate variability such as rainfall and temperature, opening the possibility to test these meteorological variables for forecast purposes.

Incidencia y control de síntomas al final de la vida de pacientes con cáncer

RESUMEN Fundamento: al final de la vida, el paciente con padecimientos oncológicos presenta diversos síntomas físicos, emocionales y espirituales. La medicina paliativa permite un tratamiento continuo e integral para el diagnóstico y control de síntomas. Objetivo: describir la incidencia de síntomas según la localización del tumor inicial y su transición en la última etapa de la enfermedad. Método: se realizó un estudio descriptivo, longitudinal, prospectivo de 100 pacientes con enfermedad terminal, atendidos en el Instituto de Oncología y Radiobiología entre septiembre del 2017 a septiembre del 2019. Se tomó como fuente el registro de la historia clínica con dos evaluaciones, usando la Escala de Evaluación de Síntomas de Edmonton, modificada. Se elaboró un cuestionario mediante la técnica de entrevista en profundidad para recoger la información sobre los síntomas. Con la información se confeccionó una base de datos en Microsoft Excel 16.0 y se procesaron mediante el paquete estadístico de SPSS-PC en su versión 19.0.1 para Windows, que permitió confeccionar tablas y gráficos. Resultados: se describe la incidencia de nueve síntomas, los principales: dolor, cansancio, pérdida de apetito, ansiedad y depresión, independientes a la estructura anatómica afectada por el tumor primario. Se encontró mayor incidencia del dolor de forma general (78 %). Durante la etapa final los síntomas más frecuentes fueron: cansancio, ansiedad, pérdida de apetito y disnea. Conclusión: los síntomas en el paciente terminal con padecimientos oncológicos son múltiples y variables, en ocasiones estrechamente relacionados con la historia natural de su enfermedad. El diagnóstico y control sintomático requiere reconocer las necesidades y generar estrategias colectivas para minimizar el sufrimiento.

ABSTRACT Background: at the end of life, the patient with cancer conditions presents various physical, emotional and spiritual symptoms. Palliative medicine allows a continuous and comprehensive treatment for the diagnosis and control of symptoms. Objective: to describe the incidence of symptoms according to the location of the initial tumor and its transition in the last stage of the disease. Method: a descriptive, longitudinal, prospective study of 100 terminally ill patients treated at the Institute of Oncology and Radiobiology was carried out between September 2017 and September 2019. The medical history record with two evaluations was taken as a source, using Edmonton Symptom Rating Scale, modified. A questionnaire was developed using the in-depth interview technique to collect information on symptoms. With the information, a database was made in Microsoft Excel 16.0 and they were processed using the SPSS-PC statistical package in version 19.0.1 for Windows, which made it possible to make tables and graphs. Results: the incidence of nine symptoms is described, the main ones: pain, fatigue, loss of appetite, anxiety and depression, independent of the anatomical structure affected by the primary tumor. A higher incidence of pain was found in general (78 %). During the final stage, the most frequent symptoms were: fatigue, anxiety, loss of appetite and dyspnea. Conclusion: the symptoms in terminal patients with cancer diseases are multiple and variable, sometimes closely related to the natural history of their disease. Symptomatic diagnosis and control requires recognizing needs and generating collective strategies to minimize suffering.

Dehiscencia de cúpula vaginal y evisceración posquirúrgica: reporte de caso / Vaginal vault dehiscence and postoperative evisceration: case report

RESUMEN La dehiscencia de cúpula vaginal es la separación precoz de la incisión vaginal suturada, que en el 70% de los casos se manifiesta con una evisceración de asas intestinales a través del conducto vaginal. Dentro de sus factores de riesgo, destacan la edad y alteraciones en el lugar postoperatorio de histerectomía. El diagnóstico se realiza mediante un adecuado examen físico, y el tratamiento, netamente quirúrgico, involucra el regresar las vísceras intestinales y corregir la dehiscencia. Describimos el caso de una mujer de 50 años, que presentó dehiscencia de la cúpula vaginal con evisceración de una porción de íleon distal, a quien se le practicó tratamiento quirúrgico y farmacológico.

ABSTRACT Vaginal cuff dehiscence is the premature separation of the sutured vaginal incision, which in 70% of the cases manifests with evisceration of intestinal loops through the vaginal canal. Among its risk factors, age and alterations in the postoperative hysterectomy site stand out. The diagnosis is made by means of an adequate physical examination and the treatment, purely surgical, involves the return of the intestinal viscera and correction of the dehiscence. We describe the case of a 50-year-old woman who presented dehiscence of the vaginal vault with evisceration of a portion of the distal ileum, who underwent surgical and pharmacological treatment.

Independent duplications of the Golgi phosphoprotein 3 oncogene in birds.

Golgi phosphoprotein 3 (GOLPH3) was the first reported oncoprotein of the Golgi apparatus. It was identified as an evolutionarily conserved protein upon its discovery about 20 years ago, but its function remains puzzling in normal and cancer cells. The GOLPH3 gene is part of a group of genes that also includes the GOLPH3L gene. Because cancer has deep roots in multicellular evolution, studying the evolution of the GOLPH3 gene family in non-model species represents an opportunity to identify new model systems that could help better understand the biology behind this group of genes. The main goal of this study is to explore the evolution of the GOLPH3 gene family in birds as a starting point to understand the evolutionary history of this oncoprotein. We identified a repertoire of three GOLPH3 genes in birds. We found duplicated copies of the GOLPH3 gene in all main groups of birds other than paleognaths, and a single copy of the GOLPH3L gene. We suggest there were at least three independent origins for GOLPH3 duplicates. Amino acid divergence estimates show that most of the variation is located in the N-terminal region of the protein. Our transcript abundance estimations show that one paralog is highly and ubiquitously expressed, and the others were variable. Our results are an example of the significance of understanding the evolution of the GOLPH3 gene family, especially for unraveling its structural and functional attributes.

[Procedure for culture and identification of stem cells from human lipoaspirate for research purposes]. / Procedimiento para el cultivo e identificación de células madre obtenidas de lipoaspirado humano con fines de investigación.

Human stem cells are born with the creation of life itself and some of them remain throughout life. Therefore, they can be found in adult tissues and used for basic and applied research. Currently, in our country there is a growing interest in the study and application of stem cells; however, little is known about the identification procedure. For this reason, this study aims to present, from a practical point of view, a procedure for the culture and identification of stem/stromal cells obtained from human lipoaspirate (Adipose Stem Cells), for research purposes. This procedure includes the immunophenotype characterization, cell differentiation potential, gene expression and cell culture quality control; and will serve as support for Peruvian scientific community professionals who wish to develop this line of research.

Las células madre humanas nacen con la creación de la vida misma y algunas de estas permanecen durante toda la vida. Por consiguiente, se pueden hallar en tejidos adultos y utilizarlas para investigaciones a nivel básico y aplicado. Actualmente, en nuestro país existe un creciente interés en el estudio y aplicación de células madre; sin embargo, existe poco conocimiento acerca del procedimiento para su identificación. Es por ello que este artículo tiene como objetivo dar a conocer, desde un punto de vista práctico, un procedimiento para el cultivo e identificación de células madre/estromales obtenidas de lipoaspirado humano (Adipose Stem Cells) con fines de investigación, el cual incluye la caracterización a nivel de inmunofenotipo, el potencial de diferenciación celular, la expresión génica y el control de calidad del cultivo celular, que sirva de apoyo para los profesionales de la comunidad científica peruana que deseen desarrollar esta línea de investigación.

Células madre adiposas humanas disminuyen el daño de la fibrosis hepática con baja persistencia de células trasplantadas en ratas / Human adipose stem cells decrease liver fibrosis damage with low persistence of transplanted cells in rats

RESUMEN: En la enfermedad hepática crónica el trasplante ortotópico es la única alternativa terapéutica actual pero es limitada por falta de donantes. Ensayos con células madre adultas en daño hepático agudo evidencian promisorios resultados. El objetivo de este trabajo fue evaluar en ratas con daño hepático crónico la efectividad de la infusión de células madre adiposas humanas (CMAd-h). Ratas con fibrosis hepática inducida por tioacetamida fueron agrupadas en: grupo I control que no recibió tioacetamida ni células madre, grupo II recibió tioacetamida y suero fisiológico i.v., grupo III recibió tioacetamida y células madre adiposas 1 x 106/kg i.v. vía vena de la cola. La regeneración hepática histológica se evaluó por el index METAVIR, mientras las Macrophagocytus stellatus, células estrelladas a- SMA+ y células colágeno I+ por inmunohistoquímica; el daño funcional se evaluó por los niveles sanguíneos de los analitos Aspartato Aminotransferasa (AST), Alanina Aminotransferasa (ALT), Fosfatasa Alcalina (ALP), úrea y nitrógeno ureico (BUN) y hemograma. Los resultados muestran atenuación del daño estructural hepático evidenciado por disminución de los nódulos, del grado de lesión histológica en el score Metavir, y disminución de Macrophagocytus stellatus, células a-SMA+ y células colágeno tipo I+; funcionalmente hay reducción moderada de AST, ALT, urea, BUN y disminución moderada de células blancas pero efecto favorable sobre el volumen corpuscular media y la hemoglobina corpuscular media. Ocho semanas después de la infusión hay escasa población de CMAd-h en el hígado. En conclusión la infusión intravenosa de CMAd-h en ratas disminuye el daño funcional y estructural de la fibrosis hepática con escasa persistencia de CMAd-h en el parénquima hepático. A nuestro conocimiento este es el primer trabajo que evalúa el efecto de las CMAd-h en el modelo daño hepático crónico murino y la persistencia de las células trasplantadas.

SUMMARY: In chronic liver disease, orthotopic transplantation is the only current therapeutic alternative but it is limited due to lack of donors. Trials with adult stem cells in acute liver damage show promising results. The aim of this work was to evaluate the effectiveness of human adipose stem cell (h-ASC) infusion in rats with chronic liver damage. Rats with thioacetamide- induced liver fibrosis were grouped into: group I control that did not receive thioacetamide and h-ASC, group II received thioacetamide and saline i.v., group III received thioacetamide and h-ASC 1 x 106/ kg i.v. via tail vein. Histological liver regeneration was evaluated by METAVIR index, while Macrophagocytus stellatus (Kupffer cells), stellate cells a-SMA+ and collagen I+ cells by immunohistochemistry; functional damage was evaluated by blood levels of the analytes Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Urea and Blood Urea Nitrogen (BUN) and hemogram. The results show attenuation of structural liver damage evidenced by decreased nodules, degree of histologic injury on Metavir score, and decreased Macrophagocytus stellatus, a-SMA+ cells and type I+ collagen cells; functionally there is moderate reduction of AST, ALT, urea, BUN and moderate decrease of white cells but favorable effect on mean corpuscular volume and mean corpuscular hemoglobin. Eight weeks after infusion there is a small population of h-ASC in the liver. In conclusion, intravenous infusion of h-ASC in rats reduces functional and structural damage of hepatic fibrosis with low persistence of h- ASC in the liver parenchyma. To our knowledge this is the first work that evaluates the effect of h-SC in the model of chronic murine liver damage and the persistence of transplanted cells.

A comparative study of the energy, exergetic and thermo-economic performance of a novelty combined Brayton S-CO2-ORC configurations as bottoming cycles.

This paper presents a comparative study on the energy, exergetic and thermo-economic performance of a novelty thermal power system integrated by a supercritical CO2 Brayton cycle, and a recuperative organic Rankine cycle (RORC) or a simple organic Rankine cycle (SORC). A thermodynamic model was developed applying the mass, energy and exergy balances to all the equipment, allowing to calculate the exergy destruction in the components. In addition, a sensitivity analysis allowed studying the effect of the primary turbine inlet temperature (TIT, PHIGH, rP and TC) on the net power generated, the thermal and exergy efficiency, and some thermo-economic indicators such as the payback period (PBP), the specific investment cost (SIC), and the levelized cost of energy (LCOE), when cyclohexane, acetone and toluene are used as working fluids in the bottoming organic Rankine cycle. The parametric study results show that cyclohexane is the organic fluid that presents the best thermo-economic performance, and the optimization with the PSO method conclude a 2308.91 USD/kWh in the SIC, 0.22 USD/kWh in the LCOE, and 9.89 year in the PBP for the RORC system. Therefore, to obtain technical and economic viability, and increase the industrial applications of these thermal systems, thermo-economic optimizations must be proposed to obtain lower values of the evaluated performance indicators.

Procedimiento para el cultivo e identificación de células madre obtenidas de lipoaspirado humano con fines de investigación / Procedure for culture and identification of stem cells from human lipoaspirate for research purposes

RESUMEN Las células madre humanas nacen con la creación de la vida misma y algunas de estas permanecen durante toda la vida. Por consiguiente, se pueden hallar en tejidos adultos y utilizarlas para investigaciones a nivel básico y aplicado. Actualmente, en nuestro país existe un creciente interés en el estudio y aplicación de células madre; sin embargo, existe poco conocimiento acerca del procedimiento para su identificación. Es por ello que este artículo tiene como objetivo dar a conocer, desde un punto de vista práctico, un procedimiento para el cultivo e identificación de células madre/estromales obtenidas de lipoaspirado humano (Adipose Stem Cells) con fines de investigación, el cual incluye la caracterización a nivel de inmunofenotipo, el potencial de diferenciación celular, la expresión génica y el control de calidad del cultivo celular, que sirva de apoyo para los profesionales de la comunidad científica peruana que deseen desarrollar esta línea de investigación.

ABSTRACT Human stem cells are born with the creation of life itself and some of them remain throughout life. Therefore, they can be found in adult tissues and used for basic and applied research. Currently, in our country there is a growing interest in the study and application of stem cells; however, little is known about the identification procedure. For this reason, this study aims to present, from a practical point of view, a procedure for the culture and identification of stem/stromal cells obtained from human lipoaspirate (Adipose Stem Cells), for research purposes. This procedure includes the immunophenotype characterization, cell differentiation potential, gene expression and cell culture quality control; and will serve as support for Peruvian scientific community professionals who wish to develop this line of research.

Effect of autologous transplant of peripheral blood mononuclear cells in combination with proangiogenic factors during experimental revascularization of lower limb ischemia.

Peripheral blood mononuclear cells (PBMCs) contain a cell fraction of mononuclear progenitor cells (MPCs), which own significant angiogenic potential. Autologous transplant of PBMC and/or platelet-rich plasma (PRP) promotes endothelial cells differentiation in experimental lower limb ischemia, which is considered a safe and effective strategy to support revascularization, either in animal models or clinical trials. In addition, thrombin has been proposed to enrich biological scaffolds, hence increasing MPC viability after intramuscular administration, whereas proangiogenic mediators such as vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNF-α), inhibitor of the plasminogen activator-1 (PAI-1), and chemokine (CXCL1; GRO-α) participate in the endothelial response to ischemia, through their proangiogenic effects over endothelial cells proliferation, survival, migration, endothelial integrity maintenance, and physiologic vascular response to injury. In the present study, we describe the effect of autologous PBMCs transplant and PRP, either with or without thrombin, over proangiogenic mediators (measured by enzyme-linked immunosorbent assay) and revascularization response (angiographic vascular pattern at 30 days after vascular occlusion) in a rat model of lower limb ischemia. The group treated with PBMC + PRP significantly induced PAI-1, an effect that was prevented by the addition of thrombin. Furthermore, treatment with PBMC + PRP + thrombin resulted in the induction of VEGF. GRO-α showed a sensitive induction of all proangiogenic mediators. All treatments significantly stimulated revascularization, according to angiographic assessment, whereas higher effect was observed with PBMC + PRP treatment (p < .0001). In conclusion, autologous PBMC transplant stimulates revascularization during experimental ischemia of the lower limb, whereas particular effects over proangiogenic and fibrinolytic mediators may be attributed to PBMCs and its combination with PRP and thrombin.

Relación entre apiñamiento dentario y terceros molares / Relationship between anterior crowding and third molars

RESUMEN: Introducción: La relación entre terceros molares y el desarrollo o reincidencia de maloclusión y apiñamiento dental tras el tratamiento de ortodoncia, especialmente en el segmento anterior del arco dental, es un tema que ha sido discutido y presentado en la literatura, el cual aún permanece sin resolver. Métodos: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, preparamos tablas de resumen de los resultados utilizando el método GRADE. Resultados: Identificamos 7 revisiones sistemáticas que en conjunto incluyen 31 estudios primarios, de los cuales, 2 son ensayos aleatorizados. Conclusiones: El limitado desarrollo de estudios que relacionan los terceros molares con apiñamiento dental y el bajo nivel de evidencia de éstos no permiten tener claridad respecto a la posible asociación. Son necesarios nuevos estudios sobre el tema.

ABSTRACT: Introduction: The relationship between third molars and the development or recurrence of malocclusion and dental crowding after orthodontic treatment, especially in the anterior segment of the dental arch, is a subject that has been discussed and presented in the literature, which still remains unsolved. Methods: To answer this question we used Epistemonikos, the largest database of systematic health reviews, which combines searches in multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted the data from the identified reviews, reanalyzed them from the primary studies and prepared summary tables of the results using the GRADE method. Results: We identified 7 systematic reviews that together included 31 primary studies, 2 of which were randomized trials. Conclusion: The limited development of studies that relate third molars to dental crowding and their low level of evidence does not allow us to be certain about the possible association. New studies are necessary.

Ultraestructura del inmunofenotipo CD44+/CD24- de una línea de células de cáncer de mama triple negativo / Ultrastructure of the CD44 + / CD24- immunophenotype of a line of triple negative breast cancer cells

RESUMEN: El cáncer de mama es la principal causa de muerte debido al cáncer en mujeres. La microscopía electrónica permite establecer características constitutivas de las células entre diferentes poblaciones celulares. Las células madre del cáncer mamario con inmunofenotipo CD44alta/CD24baja son una población de células intratumorales asociada a la quimioresistencia y metástasis, cuya ultraestructura aún no ha sido bien estudiada. El objetivo de este trabajo fue conocer características ultraestructurales de células con fenotipo de células madre del cáncer de la línea celular MDA-MB-436 de tumor mamario triple negativo comparándolas con células madre adiposas. Se utilizó microscopía electrónica de barrido y de transmisión. Previamente, mediante separación inmunomagnética positiva empleando anticuerpos anti CD44 y anti CD24 unidos a perlas magnéticas, se obtuvo una población de células con fenotipo CD44alta/CD24baja a partir de 10x106 células de la línea MDA-MB-436, la cual igual que las células madre adiposas fue cultivada en cubreobjetos para microscopía electrónica de barrido; en tanto que para microscopía electrónica de transmisión se obtuvo un pellet de células, luego se fijó con glutaraldehído al 2,5 % y post fijó con OsO4 1 %. Para microscopía óptica de alta resolución se usó azul de toluidina como tinción. Luego de obtener el fenotipo de células madre del cáncer se corroboró su pluripotencia detectando la expresión de los genes Oct4 y nanog mediante RT-PCR. Nuestros resultados muestran que las células de este fenotipo son pequeñas, redondeadas, recubiertas por microvellosidades abundantes pero cortas; el citoplasma tiene organelas de secreción celular y abundantes mitocondrias alargadas; el núcleo es excéntrico ocupando la mitad del volumen celular, el nucléolo es voluminoso y la heterocromatina está adosada a la membrana nuclear interna. Se concluye que el inmunofenotipo celular estudiado es una sub población celular dentro de la línea estudiada que difiere en tamaño y ultraestructura de las células madre adiposas.

SUMMARY: Breast cancer is the leading cause of cancer deaths in women. Electron microscopy allows establishing constitutive characteristics of cells between different cell populations. CD44 high / CD24 low mammary cancer stem cells are a population of intratumoral cells associated with chemoresistance and metastasis, whose ultrastructure has not yet been well studied. The objective of this work was to know the ultrastructural characteristics of cells with cancer stem cell phenotype, of the triple negative mammary tumor cell line MDAMB-436 436 using scanning and transmission electron microscopy, and to contrast them with adipose-derived mesenchymal stem cells. Previously, by immunomagnetic purification using anti CD44 and anti CD24 antibodies bound to magnetic beads, cells populations was obtained from 10x106 cells of the MDA-MB-436 line, which, adipose-derived mesenchymal stem whereas cultivated on coverslips for scanning electron microscopy; while for transmission electron microscopy a cell pellet was obtained, then fixed with 2.5 % glutaraldehyde and post fixed with OsO4 1 %. For high resolution optical microscopy, toluidine blue was used as staining. After obtaining the phenotype of cancer stem cells, their pluripotency was corroborated by detecting the expression of the Oct4 and nanog genes by RT-PCR. Our results show that the cells of this phenotype are small, rounded, covered by abundant but short microvilli; the cytoplasm has organelles of cellular secretion and abundant elongated mitochondria; the nucleus is eccentric occupying half of the cellular volume, the nucleolus is bulky and the heterochromatin is attached to the inner nuclear membrane. It is concluded that the cellular immunophenotype studied is a sub-cellular population within the line studied that differs in size and ultrastructure of the adipose stem cells.

[Vascular microsurgery course: 40 years at the Centro Médico Nacional 20 de Noviembre (ISSSTE) and 33 years at the Faculty of Medicine of the UNAM]. / Curso de microcirugía vascular: 40 años en el Centro Médico Nacional 20 de Noviembre del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado y 33 años en la Facultad de Medicina de la Universidad Nacional Autónoma de México.

On June 1977, "Centro Médico Nacional 20 de Noviembre," in Mexico City, implemented the first vascular microsurgery course. The aim was to develop clinical applications of microsurgery focus on surgical specialties, due to the necessity to develop microsurgical skills. On August 1964 we started the program course at the surgical department of the School of Medicine at Universidad Nacional Autónoma de México (UNAM). Actually, our course is given five times a year at 20 de Noviembre hospital, and four times at the UNAM. One June 2017, the Experimental Surgical Department at "Centro Médico Nacional 20 de Noviembre" reached 40 continuous or uninterrupted years of successfully teaching the microsurgical vascular skills. The aim of this study is to evaluate the satisfaction degree among the students. For that propose, a written survey was applied one year later, after successfully completed the course. These results reveal a satisfaction rate of 80% among these students.

El Curso de Microcirugía Vascular (CMV) inició en el Centro Médico Nacional (CMN) 20 de Noviembre en la Ciudad de México, en junio de 1977, con la idea de poder desarrollar aplicaciones clínicas de microcirugía en todas las especialidades quirúrgicas. En vista de la gran demanda hacia la microcirugía como destreza, en agosto de 1984 iniciamos el programa de Microcirugía Vascular en el Departamento de Cirugía de la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM). El CMV se imparte cinco veces al año en el CMN 20 de Noviembre del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado y cuatro en la Facultad de Medicina de la UNAM. En junio de 2017, el Servicio de Cirugía Experimental del CMN 20 de Noviembre cumple 40 años ininterrumpidos de impartir con éxito el CMV. Con el fin de evaluar el CMV de acuerdo con el nivel de satisfacción, a partir de 2016 se implementó el uso de un cuestionario. La finalidad es dar seguimiento repitiendo el cuestionario un año después para valorar las habilidades adquiridas. Los porcentajes demuestran que más del 80% de los alumnos están satisfechos con las destrezas adquiridas en el CMV.

[Risk factors for nosocomial infection in a level III Neonatal Intensive Care Unit]. / Factores de riesgo asociados a infección nosocomial (IN) en una Unidad de Cuidados Intensivos Neonatales (UCIN) de tercer nivel.

INTRODUCTION: Nosocomial infections are a major and a frequent problem in neonatal intensive care units and increase morbidity, mortality, and costs. The objective of this study was to identify the risk factors associated with nosocomial infections in a neonatal intensive care unit. METHODS: Nested case control study. Records from patients were registered: gestational age, sex, birth weight, central venous catheter and other devices, congenital malformations, surgeries, mechanical ventilation, steroid use, H2 blockers, length of stay in neonatal intensive care unit, type of infection, and etiological agent. RESULTS: We studied 188 cases with nosocomial infections and 192 controls without nosocomial infections. The most frequent infection was sepsis (34.8%) and coagulase negative Staphylococcus was the principal etiological agent (37.2%). The risk factors associated with nosocomial infection were central venous catheter (OR: 7.3; 95% CI: 2.3-22.8), duration of neonatal intensive care unit stay>14 days (OR: 3.4; 95% CI: 1.7-6.7), H2 blockers (OR: 2.3; 95% CI: 1.2-4.2), number of surgeries≥2 (OR: 3; 95% CI: 1.1-7.9) and mechanical ventilation>7 days (OR: 2.1; 95% CI: 1.1-4.2). CONCLUSIONS: Some risk factors associated to nosocomial infections in this study are similar to those found previously, with the exception of the number of surgeries that was not reported in previous studies.

A new species of salamander (Caudata: Plethodontidae, Bolitoglossa) from Sierra Nevada de Mérida, Venezuela.

In this article, a new species of salamander of the genus Bolitoglossa (Eladinea) from the cloud forest near La Mucuy in Sierra Nevada de Mérida, Venezuelan Andes, is described. Bolitoglossa mucuyensis sp. nov. differs from all Venezuelan salamanders, except B. orestes, by a larger SVL/TL ratio, and from La Culata salamander B. orestes by a reduced webbing extension of the front and hind limbs. Additionally, B. mucuyensis sp. nov. and B. orestes diverge 3.12% in terms of the nucleotide sequence of the 16S rRNA gene, as previously reported, and in 8.1% for the cytb gene as shown in this study.

Active optics for dynamical correction of fluctuations of atmospheric refraction on a differential optical absorption spectroscopy device.

We have designed and developed a feedback mechanism for continuous monitoring in a long-pass differential optical absorption spectroscopy (LP-DOAS) setup. This allows one to correct photo-thermal deflection due to the local fluctuations refraction index of the air. For this purpose, using an unbalanced beam splitter, a small fraction of the collected DOAS signal is imaged onto a low-cost CCD camera using a biconvex lens, while the other portion of the signal is coupled into a fiber optic for trace gas detection. By monitoring the registered signal at the CCD camera, a feedback mechanism acting on the transversal position of the lens is able to compensate an arbitrary transversal displacement of the collected signal at the focal plane of the receiver telescope, allowing an optimal coupling into the optical fiber.

Genetic make up and structure of Colombian populations by means of uniparental and biparental DNA markers.

Colombia is a country with great geographic heterogeneity and marked regional differences in pre-Columbian native population density and in the extent of past African and European immigration. As a result, Colombia has one of the most diverse populations in Latin America. Here we evaluated ancestry in over 1,700 individuals from 24 Colombian populations using biparental (autosomal and X-Chromosome), maternal (mtDNA), and paternal (Y-chromosome) markers. Autosomal ancestry varies markedly both within and between regions, confirming the great genetic diversity of the Colombian population. The X-chromosome, mtDNA, and Y-chromosome data indicate that there is a pattern across regions indicative of admixture involving predominantly Native American women and European and African men.

Depresión en estudiantes universitarios y su asociación con el estrés académico / Depression in university students and its association with academic stress

Introducción: La salud mental de los estudiantes cuando ingresan a la universidad puede verse afectada por múltiples factores, entre los cuales se encuentran las situaciones académicas generadoras de estrés. Éstas constituyen un factor que puede estar relacionado con la presencia de depresión en los estudiantes universitarios. Es por ello que resulta importante conocer la prevalencia de esta entidad y la posible relación que pueda tener con los estresores académicos en los estudiantes. Métodos: Se aplicó un instrumento auto-administrado a todos los estudiantes matriculados en los programas de pregrado de la Universidad CES que permitió establecer la prevalencia de depresión y el Chi2 de tendencia para ver el comportamiento de la relación entre el nivel de estrés y la depresión. El análisis estadístico se realizó con el programa SPSS®. Resultados: La edad promedio de los estudiantes fue de 20,4 ± 2,6 años. El 68,7% de la población es de género femenino. La prevalencia para depresión encontrada fue del 47,2% y la relación de ésta con la severidad del estrés generado por los estresores académicos fue estadísticamente significativa. Conclusión: Los resultados establecen un diagnóstico de posibles factores que afectan la salud mental de la población estudiantil. Con ello se podrán orientar programas de intervención dirigidos a disminuir los niveles de estrés y por ende la frecuencia de depresión, generados por las diferentes situaciones de la vida universitaria.

Introduction: The mental health of students when entering university might be affected by many factors, among which are academic situations generating stress. They constitute a factor which may be related to the presence of depresión among university students. For this reason it is important to know the prevalence of this condition and the possible relationship that may have academic stressors on students. Methods: We used a self-administered instrument to all students enrolled in undergraduate programs at the University CES which allowed establishing the prevalence of depression and Chi2 tendency to stress and depression. Statistical analysis was performed using SPSS ®. Results: The average age of students was 20.4 ± 2.6; 68.7% of the population is female. The depression prevalence found was 47.2% and the relationship of this with the severity of the stress of academic stressors was statistically significant. Conclusion: The results establish a diagnosis of possible factors affecting the mental health of the student population. This will enable to target intervention programs to reduce stress levels and hence the frequency of depression generated by the different situations of college life.