[Efficacy of transdermal lidocaine 5% patches in postoperative analgesia following knee arthroscopy]. / Efectividad del parche transdérmico de lidocaína 5% en la analgesia postoperatoria después de la artroscopía de rodilla.

INTRODUCTION: knee arthroscopy is a common orthopedic procedure associated with postoperative pain, so optimizing pain management is essential for patient recovery and satisfaction. Lidocaine, a local anesthetic with well-established safety profiles, offers a potential alternative to traditional analgesic methods. Research regarding lidocaine patches has been conducted in several types of surgeries (laparoscopy, gynecological surgery, prostatectomy, etc.) showing promising results for some. This study investigates the effectiveness of transdermal lidocaine 5% patches as a novel approach to postoperative analgesia after knee arthroscopy. MATERIAL AND METHODS: a randomized, single-blind, placebo-controlled trial was conducted with participants undergoing knee arthroscopy. Patients were divided into two groups: one receiving transdermal lidocaine 5% patches and the other a placebo, both along traditional postoperative pain management, and using opioid only in cases with moderate-severe pain. Pain scores, opioid consumption, and patient-reported outcomes were assessed at various postoperative intervals. RESULTS: there was a significant reduction in pain scores and opioid consumption in the lidocaine patch group compared to the placebo group. CONCLUSIONS: transdermal lidocaine 5% patches emerge as a promising adjunct to postoperative pain management in knee arthroscopy patients. Their ease of application, minimal side effects, and opioid-sparing effects contribute to a multifaceted analgesic approach. This study underscores the potential of transdermal lidocaine patches in enhancing the overall postoperative experience for knee arthroscopy patients, advocating for their consideration in clinical practice.

INTRODUCCIÓN: la artroscopía de rodilla es un procedimiento ortopédico común asociado con dolor postoperatorio, por lo que optimizar el manejo del dolor es esencial para la recuperación y la satisfacción del paciente. La lidocaína, un anestésico local con perfiles de seguridad bien establecidos, ofrece una alternativa potencial a los métodos analgésicos tradicionales. Se ha llevado a cabo investigación sobre los parches de lidocaína en diversos tipos de cirugías (laparoscopía, cirugía ginecológica, prostatectomía, etcétera), mostrando resultados prometedores en algunos casos. MATERIAL Y MÉTODOS: se realizó un ensayo clínico aleatorizado, ciego simple y controlado con placebo que incluyó participantes sometidos a artroscopía de rodilla. Los pacientes fueron divididos en dos grupos: uno recibió parches transdérmicos de lidocaína al 5% y otro un placebo, ambos junto con el manejo tradicional del dolor postoperatorio y utilizando opioides sólo en casos de dolor moderado a severo. Se evaluaron las puntuaciones de dolor, el consumo de opioides y los resultados informados por los pacientes en varios intervalos postoperatorios. RESULTADOS: se registró una reducción significativa en las puntuaciones de dolor y el consumo de opioides en el grupo de parches de lidocaína en comparación con el grupo de placebo. CONCLUSIONES: los parches transdérmicos de lidocaína al 5% emergen como un complemento prometedor para el manejo del dolor postoperatorio en pacientes sometidos a artroscopía de rodilla. Su facilidad de aplicación, mínimos efectos secundarios y efectos ahorradores de opioides contribuyen a un enfoque analgésico multifacético. Este estudio destaca el potencial de los parches de lidocaína transdérmica para mejorar la experiencia postoperatoria general de los pacientes con artroscopía de rodilla, abogando por su consideración en la práctica clínica.

Waning and boosting of antibody Fc-effector functions upon SARS-CoV-2 vaccination.

Since the emergence of SARS-CoV-2, vaccines targeting COVID-19 have been developed with unprecedented speed and efficiency. CoronaVac, utilising an inactivated form of the COVID-19 virus and the mRNA26 based Pfizer/BNT162b2 vaccines are widely distributed. Beyond the ability of vaccines to induce production of neutralizing antibodies, they might lead to the generation of antibodies attenuating the disease by recruiting cytotoxic and opsonophagocytic functions. However, the Fc-effector functions of vaccine induced antibodies are much less studied than virus neutralization. Here, using systems serology, we follow the longitudinal Fc-effector profiles induced by CoronaVac and BNT162b2 up until five months following the two-dose vaccine regimen. Compared to BNT162b2, CoronaVac responses wane more slowly, albeit the levels remain lower than that of BNT162b2 recipients throughout the entire observation period. However, mRNA vaccine boosting of CoronaVac responses, including response to the Omicron variant, induce significantly higher peak of antibody functional responses with increased humoral breadth. In summary, we show that vaccine platform-induced humoral responses are not limited to virus neutralization but rather utilise antibody dependent effector functions. We demonstrate that this functionality wanes with different kinetics and can be rescued and expanded via boosting with subsequent homologous and heterologous vaccination.

Shear stress induced by fluid flow produces improvements in tissue-engineered cartilage.

Tissue engineering aims to create implantable biomaterials for the repair and regeneration of damaged tissues. In vitro tissue engineering is generally based on static culture, which limits access to nutrients and lacks mechanical signaling. Using shear stress is controversial because in some cases it can lead to cell death while in others it promotes tissue regeneration. To understand how shear stress works and how it may be used to improve neotissue function, a series of studies were performed. First, a tunable device was designed to determine optimal levels of shear stress for neotissue formation. Then, computational fluid dynamics modeling showed the device applies fluid-induced shear (FIS) stress spanning three orders of magnitude on tissue-engineered cartilage (neocartilage). A beneficial window of FIS stress was subsequently identified, resulting in up to 3.6-fold improvements in mechanical properties of neocartilage in vitro. In vivo, neocartilage matured as evidenced by the doubling of collagen content toward native values. Translation of FIS stress to human derived neocartilage was then demonstrated, yielding analogous improvements in mechanical properties, such as 168% increase in tensile modulus. To gain an understanding of the beneficial roles of FIS stress, a mechanistic study was performed revealing a mechanically gated complex on the primary cilia of chondrocytes that is activated by FIS stress. This series of studies places FIS stress into the arena as a meaningful mechanical stimulation strategy for creating robust and translatable neotissues, and demonstrates the ease of incorporating FIS stress in tissue culture.

Blood transfusion in children at a university hospital in a middle-income country: The need to reinforce adherence to current guidelines.

OBJECTIVES: Blood component transfusion is a common procedure used during hospital admissions; however, it is not risk-free. The evaluation of correct use of blood products (BP) is of vast importance considering the risks and costs implied in their use. Our principal objective was to evaluate the adherence to national guidelines for blood transfusion in pediatric patients at a third level university hospital. MATERIAL AND METHODS: A prospective and retrospective descriptive analytical study was conducted to report the incidence of incorrect use of BP in pediatric patients (1 month to 16 years of age). In a timeline period of 4 years, 579 medical records were randomly selected from a total of 6575 transfusions realized to create a statistically significant sample. The variables studied were volume, infusion time, and transfusion criteria. Indications were evaluated in patient's medical records according to national guidelines. RESULTS: Of the transfusions analyzed, 54% were classified as incorrect mainly due to lack of transfusion criteria fulfillment. Blood transfusion indications in pediatric patients adhered poorly to national guidelines. CONCLUSION: The implementation of effective programs for education and information on the use of BP are needed to increase compliance with current guidelines.

Costo-efectividad de furoato de mometasona tópica nasal para el tratamiento de la rinosinusitis aguda en México / Cost-effectiveness of nasal topical mometasone furoate for the treatment of acute rhinosinusitis in Mexico

Resumen Introducción: La rinosinusitis aguda (RSA) es frecuente en primer nivel de atención y los pacientes pueden mejorar sin antibióticos.Objetivo: Análisis de costo efectividad de furoato de mometasona spray nasal (FMSN) comparado con amoxicilina en tratamiento de rinosinusitis aguda en México desde punto de vista del Sistema Nacional de Salud. Método: Análisis costo-efectividad comparando FMSN 200 mg dos veces al día y amoxicilina 500 mg tres veces al día. Resultados en términos de eficacia modelados como cambios en sistema de Calificación de Síntomas Mayores (MSS por siglas inglés). MSS consiste en cinco preguntas: rinorrea, goteo retro nasal, congestión, cefalea sinusal y dolor facial. Datos clínicos obtenidos de ensayo clínico aleatorizado. Costos expresados en pesos mexicanos 2016. Se realizó análisis de sensibilidad univariable y multivariables para algunos parámetros utilizados en el modelo. Resultados: Los costos proyectados fueron de $3,261 pesos con FMSN y $3,438 pesos con amoxicilina. FMSN fue asociado con ahorro de costos por paciente de $177 pesos comparado con amoxicilina en un periodo de dos semanas. La tasa incremental de costo-efectividad del FMSN lo ubica como dominante frente a amoxicilina. El análisis de sensibilidad confirma los ahorros globales de costos y la superioridad en términos de la eficacia. Conclusión: En pacientes con rinosinusitis aguda, no complicada, el tratamiento del, FMSN 200 mcg dos veces al día, produjo mejoras significativas de los síntomas en comparación con amoxicilina en pacientes sin infecciones bacterianas y es una alternativa costo efectiva para el Sistema Nacional de Salud Mexicano. Comentario editorial al finalizar el artículo.

Abstract Introduction: Acute rhinosinusitis (RSA) is a common cause of consultation on first level of attention and it can be solved without antibiotics use. Objective: Analysis of cost effectiveness of nasal spray mometasone furoate (NSMF) compared to amoxicillin in treatment of acute rhinosinusitis in Mexico from a National Mexican Health System perspective. Methods: Cost-effectiveness analysis comparing NSMF 200µg twice daily and amoxicillin 500mg three time daily. The effectiveness outcomes of the study were modeled as changes in the Major Symptom Score (MSS). MSS consists of five questions concerning rhinorrhea, post-nasal drip, nasal congestion, sinus headache, and facial pain. Clinical data were obtained from a randomized clinical trial. Cost were expressed in Mexican pesos 2016. Sensitivity analysis was conducted univariable and multivariable for some model parameters. Results: The projected costs were $3,261 pesos with NSMF and $3,438 pesos with amoxicillin. NSMF was associated with a cost savings per patient of $177 pesos versus amoxicillin over a 2 weeks period. The incremental cost-effectiveness ratio for NSMF dominated amoxicillin. The sensitivity analysis confirms overall cost savings and superiority in terms of effectiveness. Conclusion: In patients with non-complicated acute rhinosinusitis NSMF 200 µg twice daily produce significantly an improvement in symptoms compared to amoxicillin in patients without bacterial infections and is a cost-effective alternative for the National Health Mexican System. Editorial comment at the end of this article.

Reduction of enterotoxin induced fluid accumulation in ileal loops of neonatal calves with anti-F5 fimbriae recombinant antibody.

Neonatal calf colibacillosis caused by enterotoxigenic Escherichia coli (ETEC) is an economically significant problem in most parts of the world. The most common ETEC found in calves express the F5 (K99) fimbriae, which are necessary for the attachment of the bacteria to the ganglioside receptors on enterocytes. It is known that prevention of ETEC F5(+) adhesion to its ganglioside receptors with specific antibodies protects calves from colibacillosis. Previously we have described the development and characterization of a mouse recombinant antibody fragment (moRAb) that prevents F5 fimbrial protein induced agglutination of horse red blood cells (HRBC), which exhibit the same gangloside receptor for F5 fimbriae. Here we demonstrate that this recombinant antibody fragment inhibits in vitro the attachment of ETEC F5(+) bacteria to HRBC as well as isolated calf enterocytes, and in vivo it decreases fluid accumulation in intestinal loops of calves. Thus, correct oral administration of this anti-F5 moRAb may serve as an immunoprophylactic for cost effective control of colibacillosis in calves.

Frequency of infection by Neospora caninum in wild rodents associated with dairy farms in Aguascalientes, Mexico.

The purpose of this study was to detect the presence of Neospora caninum in tissues from wild rodents associated with dairy farms in Aguascalientes, Mexico. Individuals from Mus musculus, Rattus novergicus and Spermophilus variegatus were caught in dairy farms with history of positive status to N. caninum. A total of 33 rodents were caught from which samples were taken of brain, spinal cord, liver and heart and were tested with nested PCR and Immunohistochemistry (IHC). Results obtained with PCR showed that M. musculus had 77% (10/13) positive samples to N. caninum, S. variegatus had 71% (10/14) and R. novergicus had 50% (3/6). The results obtained with IHC showed that 15% (2/13) of M. musculus individuals were positive, while 43% (6/14) of S. variegatus and 33% (2/6) R. novergicus were also positive. This is the first report of the presence of N. caninum in S. variegatus.

Pretreatment with glycomacropeptide reduces allergen sensitization, alleviates immediate cutaneous hypersensitivity and protects from anaphylaxis.

Allergic disorders are characterized by the involvement of allergen-specific immunoglobulin (Ig)E antibodies and T helper type 2 (Th2) cells. The search for new therapies for allergic diseases has been the primary focus of interest for many investigators in recent years. Glycomacropeptide (GMP) is a biologically active component of milk that exhibits a range of immunomodulatory functions. We examined whether oral administration of GMP could affect the development of allergic sensitization and the severity of immediate cutaneous hypersensitivity reactions and of anaphylaxis. Rats treated with or without GMP were ovalbumin (OVA)-sensitized and several indicators of allergy were evaluated. Pretreatment with GMP resulted in reduction of antigen-specific IgE titre in rats when sensitized with OVA. GMP administration also markedly suppressed the proliferative response of splenocytes to antigen and the production of interleukin (IL)-13 by splenocytes of sensitized animals. In addition, GMP pretreatment attenuated the intensity of the immediate cutaneous reaction induced by antigen and protected the sensitized rats from severe anaphylaxis. These data demonstrate, for the first time, that the administration of GMP prevents allergen sensitization and reduces the severity of the early-phase reaction induced by antigen in cutaneous hypersensitivity and in anaphylaxis. GMP may be used as a novel prophylactic agent for the control of allergic diseases.

Mast cell activation by conidia of Sporothrix schenckii: role in the severity of infection.

Mast cells are abundant in the skin and other peripheral tissues, where they are one of the first immune cells to make contact with invading pathogens. As a result of pathogen recognition, mast cells can be activated and release different preformed and de novo-synthesized mediators. Sporothrix schenckii is the fungus that causes sporotrichosis, a worldwide-distributed subcutaneous mycosis considered as an important emerging health problem. It remains unknown whether or not mast cells are activated by S. schenckii. Here, we investigated the in vitro response of mast cells to conidia of S. schenckii and their in vivo involvement in sporotrichosis. Mast cells became activated after interaction with conidia, releasing early response cytokines as TNF-α and IL-6. Although histamine release was not significantly stimulated by S. schenckii, we determined that conidia potentiate histamine secretion induced by compound 48/80. Furthermore, functional depletion of peritoneal mast cells before S. schenckii infection significantly reduced the severity of cutaneous lesions of the sporotrichosis. These data demonstrate that mast cells are important contributors in the host response to S. schenckii infection, suggesting a role of these cells in the progress of clinical manifestations in sporotrichosis.

Development of a flow-through system for the fish embryo toxicity test (FET) with the zebrafish (Danio rerio).

The acute fish test is still a mandatory component in chemical hazard and risk assessment. However, one of the objectives of the new European chemicals policy (REACH - Registration, Evaluation, Authorization and Restriction of Chemicals) is to promote non-animal testing. For whole effluent testing in Germany, the fish embryo toxicity test (FET) with the zebrafish (Danio rerio) has been an accepted and mandatory replacement of the fish test since January 2005. For chemical testing, however, further optimization of the FET is required to improve the correlation between the acute fish test and the alternative FET. Since adsorption of the test chemical to surfaces may reduce available exposure concentrations, a flow-through system for the FET using modified commercially available polystyrene 24-well microtiter plates was developed, thus combining the advantages of the standard FET with those of continuous delivery of test substances. The advantages of the design presented include: small test footprint, availability of adequate volumes of test solution for subsequent chemical analysis, and sufficient flow to compensate for effects of non-specific adsorption within 24h. The flow-through test system can also be utilized to conduct longer-term embryo larval fish tests, thus offering the possibility for teratogenicity testing.

Highly quasi-monodisperse ag nanoparticles on titania nanotubes by impregnative aqueous ion exchange.

Silver nanoparticles were homogenously dispersed on titania nanotubes (NT), which were prepared by alkali hydrothermal methodology and dried at 373 K. Ag(+) incorporation was done by impregnative ion exchange of aqueous silver nitrate onto NT. First, Ag(+) ions incorporate into the layers of nanotube walls, and then, upon heat treatment under N(2) at 573 and 673 K, they migrate and change into Ag(2)O and Ag(0) nanoparticles, respectively. In both cases, Ag nanoparticles are highly dispersed, decorating the nanotubes in a polka-dot pattern. The Ag particle size distribution is very narrow, being ca. 4 +/- 2 nm without any observable agglomeration. The reduction of Ag(2)O into Ag(0) octahedral nanoparticles occurs spontaneously and topotactically when annealing, without the aid of any reducing agent. The population of Ag(0) nanoparticles can be controlled by adjusting the annealing temperature. An electron charge transfer from NT support to Ag(0) nanoparticles, because of a strong interaction, is responsible for considerable visible light absorption in Ag(0) nanoparticles supported on NT.

Trophozoites of Entamoeba histolytica express a CD59-like molecule in human colon.

In vitro studies have proved the presence of epitopes of CD59 in the surface of trophozoites of Entamoeba histolytica (E. histolytica). However, it has not been proved if CD59 molecules are expressed in the surface during the trophozoites' tissue invasion. The aim of the present study was to determine whether the complement-regulatory protein CD59 is present on trophozoites of E. histolytica in human colon. Eleven specimens of amoebic colitis were studied by immunohistochemistry and electron microscopy techniques with a monoclonal antibody against human CD59 molecule. Our results show that a CD59-like molecule is expressed in trophozoites of E. histolytica found in colonic amebic lesions. Also, a CD59-like molecule was detected by western blot analysis in whole lysate of E. histolytica as well as on the plasma membrane by immunocytochemistry. These results suggest that E. histolytica can use CD59-like protein against the lytic action of membrane attack complex.

Allergen-sensitization increases mast-cell expression of the exocytotic proteins SNAP-23 and syntaxin 4, which are involved in histamine secretion.

BACKGROUND: Activation of mast cells (MCs) via aggregation of immunoglobulin E (IgE) bound to its high affinity receptor (FcepsilonRI) results in release of inflammatory mediators from secretory granules. Histamine is one of the critical biological mediators released in the allergic response. Synaptosomal-associated protein of 23 kDa (SNAP-23) and syntaxin 4 are plasma membrane proteins that have been associated with exocytosis in MCs. Studies with monoclonal IgEs indicate that binding of IgE to FcepsilonRI induces molecular and biological changes in OBJECTIVES: The aim of this study was to investigate changes in the expression of SNAP-23 and syntaxin 4 by MCs following rat sensitization with ovalbumin (OVA). In addition, we assessed whether these proteins were involved in histamine secretion. METHODS: SNAP-23 and syntaxin 4 expression was analyzed by Western blot using MCs from control and sensitized animals. Successful sensitization was confirmed based on the passive cutaneous anaphylaxis reaction. To test the role of these exocytotic proteins in histamine secretion, permeabilized MCs were incubated with SNAP-23 and syntaxin 4 antibodies. RESULTS: Expression of SNAP-23 and syntaxin 4 was significantly higher in MCs from OVA-sensitized rats than in cells from control animals. In addition, incubation of permabilized cells with antibodies to SNAP-23 and syntaxin 4 led to a marked reduction of histamine secretion in stimulated cells. CONCLUSIONS: Sensitization with OVA increases the expression of SNAP-23 and syntaxin 4 in MCs. Furthermore, our data suggest that these exocytotic proteins participate in histamine secretion.

Seroepidemiological study of Neospora caninum infection in dogs found in dairy farms and urban areas of Aguascalientes, Mexico.

The objective of this study was to describe the seroepidemiology of Neospora caninum infection in dogs in close contact with dairy cattle and dogs from urban areas of Aguascalientes, Mexico, as well as to estimate the possible association between age, gender and size of these groups and seroprevalence. Sera were obtained from samples of 152 dogs in dairy farms and 116 in the urban area, and were subjected to ELISA test. General seroprevalence reached 32%, while the seroprevalence in farm dogs (41%) was significantly higher than in dogs from the urban area (20%) (p<0.05). Regarding age groups, general seroprevalence was greater among dogs between 11 and 15 years of age (67%) remaining equal between males and females (32 and 31%, respectively). Nevertheless, females resident in farms had a higher seroprevalence (42%) than female resident in the urban area. Regarding size, large-sized animals had greater seroprevalence in farms (58%), while in the urban area medium-sized animals were those that had the highest seroprevalence (27%). It was found that dairy farm dogs had a higher risk of infection (OR=2.79; p=0.0004), and that in said group, the age range from <1 to 5 years of age was identified as a risk factor (OR=3.11, p=0.001).

Ultrastructural analysis and identification of membrane proteins in the free-living amoeba Difflugia corona

Syntaxin-1 and 25-kDa Synaptosome-associated Protein (SNAP-25) are present in the plasma membrane of several different secretory cell types and are involved in the exocytosis process. In this work, the free-living amoeba Difflugia corona was studied in relation to ultrastructure, structural membrane proteins, and proteins such as Syntaxin-1 and SNAP-25. Our results obtained by scanning electron microscopy in the amoeba without its theca, showed many membrane projections and several pore-like structures. Using immunocytochemistry, we found structural proteins Syntaxin-1 and SNAP-25.(AU)

Ultrastructural analysis and identification of membrane proteins in the free-living amoeba Difflugia corona

Syntaxin-1 and 25-kDa Synaptosome-associated Protein (SNAP-25) are present in the plasma membrane of several different secretory cell types and are involved in the exocytosis process. In this work, the free-living amoeba Difflugia corona was studied in relation to ultrastructure, structural membrane proteins, and proteins such as Syntaxin-1 and SNAP-25. Our results obtained by scanning electron microscopy in the amoeba without its theca, showed many membrane projections and several pore-like structures. Using immunocytochemistry, we found structural proteins Syntaxin-1 and SNAP-25.

A predictive model to correlate fuel specifications with on-road vehicles emissions in Mexico.

Mexico is currently in the process of implementing its third air management program, which includes control measures targeting emissions reductions from mobile, point, and area sources. Achieving the program goals will require changes in the composition and in physical properties of gasoline and implementing an emissions reduction schedule. For that purpose a study was undertaken to support understanding of the effect of gasoline fuel parameters on exhaust emissions. Specifically, the relative impacts of Reid vapor pressure, distillation parameters, oxygen, sulfur, olefins, and aromatic contents on the exhaust emissions of in-use vehicles of the metropolitan area of Mexico City were investigated. The results were used to develop a model to predict CO, nitrogen oxides, total hydrocarbons, and toxic emissions such as benzene, 1,3-butadiene, formaldehyde, and acetaldehyde. Also a statistical model that predicts evaporative emissions was built. Results of the present model are compared with those obtained using the complex model of the United States Environmental Protection Agency.

Assessment of new vehicles emissions certification standards in the metropolitan area of Mexico City.

Light duty gasoline vehicles account for most of CO hydrocarbons and NOx emissions at the Metropolitan Area of Mexico City (MAMC). In order to ameliorate air pollution from the beginning of 2001, Tier 1 emission standards became mandatory for all new model year sold in the country. Car manufacturers in Mexico do not guarantee the performance of their exhaust emissions systems for a given mileage. The purpose of this study was to assess whether the Tier 1 vehicles will stand the certification values for at least 162000 km with the regular fuel available at the MAMC. Mileage accumulation and deterioration show that certified carbon monoxide emissions will stand for the useful life of the vehicles but in the case of non-methane hydrocarbons will be shorter by 40%, and nitrogen oxides emissions above the standard will be reached at one third of the accumulated kilometers. The effect of gasoline sulfur content, on the current in use Tier 1 vehicles of the MAMC and the impact on the emissions inventory in year 2010 showed that 31000 extra tons of NOx could be added to the inventory caused by the failure of the vehicles to control this pollutant at the useful life of vehicles.

Lipoescultura no tumescente / Non tumescent liposculpture

En este trabajo, debido a los serios cuestionamientos que tenemos con el "dogma" de la "Tumescencia" como requisito para hacer la liposucción convencional, planteamos como alternativa una nueva técnica denominada por nosotros "lipoescultura no tumescente" que se basa en dos principios: 1) uso de solución vasoconstrictora 2A, 2) Técnica de infiltración suprafascial. Nuestro trabajo es de tipo prospectivo y es el producto de 18 meses de observación, análisis y puesta en marcha de una hipótesis que finalmente confirmó nuestras sospechas: reducción muy importante de los riesgos de una lipoescultura, resultados estéticos de mejor calidad y convicción de lo innecesario y poco racional que, a nuestro juicio, resulta la tumescencia en la lipoescultura; por lo tanto creemos que su vigencia está seriamente cuestionada en estos momentos. Sin embargo debemos reconocer la importancia que tuvo en tanto no hubo un cuestionamiento serio y una alternativa razonable (AU)

In this work, due to the serious questions that we have with the "dogma" of "Tumescencia" as a requirement to make the conventional liposuction, we suggest as an alternative a new technique named by us "non tumescent liposcultpture", based in two principles: 1) use of solution 2A, 2) suprafascial infiltration. Our work is prospective and it is the result of 18 months observation, analysis and development of a hypothesis that has finally confirmed our suspicions: very important reduction of the risks of a liposculture, aesthetic results of better quality and the conviction about how unnecessary and not very rational "tumescencia" can be in the liposculture; therefore we believe that its validity is seriously questioned now, however we should recognize the importance that it had as long as there were not serious questions nor a reasonable alternative (AU)