The global distribution of plants used by humans.

Plants sustain human life. Understanding geographic patterns of the diversity of species used by people is thus essential for the sustainable management of plant resources. Here, we investigate the global distribution of 35,687 utilized plant species spanning 10 use categories (e.g., food, medicine, material). Our findings indicate general concordance between utilized and total plant diversity, supporting the potential for simultaneously conserving species diversity and its contributions to people. Although Indigenous lands across Mesoamerica, the Horn of Africa, and Southern Asia harbor a disproportionate diversity of utilized plants, the incidence of protected areas is negatively correlated with utilized species richness. Finding mechanisms to preserve areas containing concentrations of utilized plants and traditional knowledge must become a priority for the implementation of the Kunming-Montreal Global Biodiversity Framework.

Search for Gamma-Ray Spectral Lines from Dark Matter Annihilation up to 100 TeV toward the Galactic Center with MAGIC.

Linelike features in TeV γ rays constitute a "smoking gun" for TeV-scale particle dark matter and new physics. Probing the Galactic Center region with ground-based Cherenkov telescopes enables the search for TeV spectral features in immediate association with a dense dark matter reservoir at a sensitivity out of reach for satellite γ-ray detectors, and direct detection and collider experiments. We report on 223 hours of observations of the Galactic Center region with the MAGIC stereoscopic telescope system reaching γ-ray energies up to 100 TeV. We improved the sensitivity to spectral lines at high energies using large-zenith-angle observations and a novel background modeling method within a maximum-likelihood analysis in the energy domain. No linelike spectral feature is found in our analysis. Therefore, we constrain the cross section for dark matter annihilation into two photons to ⟨σv⟩≲5×10^{-28} cm^{3} s^{-1} at 1 TeV and ⟨σv⟩≲1×10^{-25} cm^{3} s^{-1} at 100 TeV, achieving the best limits to date for a dark matter mass above 20 TeV and a cuspy dark matter profile at the Galactic Center. Finally, we use the derived limits for both cuspy and cored dark matter profiles to constrain supersymmetric wino models.

Estudio en fibroblastos humanos del sistema angiotensina en la fisiopatología de la fibrosis pulmonar idiopática / The study of angiotensin system human fibroblasts in the physiopathology of idiopathic pulmonary fibrosis

En el tejido pulmonar de modelos murinos, la angiotensina II induce la proliferación de fibroblastos, su diferenciación a miofibroblastos y la producción de procolágeno tras su unión al receptor I de la angiotensina. Hemos estudiado el comportamiento de fibroblastos pulmonares humanos procedentes de una línea celular comercial tras la estimulación con TGF-β1. Hemos observado que estos fibroblastos, cuando son estimulados, aumentan la expresión de bFGF, colágeno y α-SMA. Tras el bloqueo del receptor de Angiotensina II con Losartan a una concentración de 10 µM y la estimulación con TGF- β1, se produce una disminución, tanto de los niveles de bFGF como de la concentración de colágeno, sin que llegue a alcanzar la significación estadística con respecto a las células no tratadas. En cuanto a la expresión de α-SMA como marcador de transformación a miofibroblastos, no había diferencias entre las células tratadas con TGF-β1 y TGF-β1 más losartán

In murine model lung tissue, angiotensin II induces the proliferation of fibroblasts, their distinction from myofibroblasts and procollagen production after its binding with the type 1 receptor. We have studied the behavior of human lung fibroblasts from a commercial cell line after stimulation with TGF-β1. We observed that those fibroblasts, when stimulated, increased bFGF, collagen and α-SMA expression. After blocking the angiotensin II receptor with losartan at a concentration of 10 µM and stimulation with TGF- β1, there was a decrease in both bFGF levels and collagen concentration, without reaching statistical significance with regard to untreated cells. With regard to α-SMA expression as an indicator of transformation to myofibroblasts, there were no differences between cells treated with TGF-β1 and TGF-β1 with losartan

Producción de factor básico de crecimiento de fibroblastos (Beta-fgf) trasla estimulación de fibroblastos pulmonares humanos in vitro confactor transformador del crecimiento Beta1 (tGf-Beta1). Estudio dosis respuesta / The production of basic fibroblast growth factor following in vitro stimulation of human lung fibroblasts with transforming growth factor Beta1: Dose response Study

Objetivo: Establecer cuál es la dosis de TGF-β1 más adecuada para la estimulación de cultivos de fibroblastos pulmonares humanos y el tiempo necesario de incubación de los mismos para obtener la máxima respuesta. Material y métodos: Diseñamos un estudio de dosis respuesta con TGF-β1 sobre una línea celular de fibroblastos pulmonares humanos. Analizamos la producción de factor básico de crecimiento de fibroblastos (b-FGF) como marcador de estímulo fibrogénico. Para ello se cultivaron fibroblastos humanos procedentes de una línea celular (MRC5) obtenida de la ECCC (European Collection of Cell Culture, UK). Las células se cultivaron en placas de 33cm2, cuando estuvieron confluentes se les estimuló con diferentes dosis de TGF-β1 (Peprotech, USA): 5, 10 ng/ml. Las células se incubaron durante 12, 24, 48 y 72 horas. Se usaron como control células no estimuladas con TGF-β1. Los niveles de factor básico de crecimiento de fibroblastos (b-FGF) se midieron por ELISA (R&D System, Minneapolis, MN). Se analizó la viabilidad celular mediante Azul Trypan a las 24, 48 y 72 horas de la estimulación con TGF-β1. Resultados: La mayor producción de b-FGF se produjo a las 24 horas tras la estimulación con la dosis de 10 ng/ml de TGF-β1, siendo la producción de b-FGF igual a 501 pg/ml. La viabilidad celular tiene su mayor valor a las 48 horas, disminuyendo en horas sucesivas, alcanzando los niveles más bajos a las 72 horas. Conclusiones: Existe un efecto estimulador del TGF-β1 sobre los fibroblastos pulmonares humanos in vitro. Esta acción del TGF-β1 es dosis dependiente y alcanza el nivel máximo de proliferación con la dosis de 10 ng/ml a las 24 horas de su tratamiento (AU)

Objective: To establish the most appropriate dose of TGF-β1 to stimulate human lung fibroblasts cultures and their necessary incubation time to obtain the maximum response. Material and methods: A dose response study was designed with TGF - β1 based on human lung fibroblast cells. The production of basic fibroblast growth factor (b-FGF) was analyzed as a marker for fibrogenic stimulus. Human fibroblasts from a cell line (MRC5) were obtained from the ECCC (European Collection of Cell Culture, UK) and cultivated. Cells were cultured on 33 cm2 plates; once confluent, they were stimulated with various doses of TGF - β1 (Peprotech, USA): 5, 10 ng/ml. The cells were incubated for 12, 24, 48 and 72 hours. Cells not stimulated with TGF - β1 were used as a control. The levels of basic fibroblast growth factor (b-FGF) were measured using ELISA (R&D System, Minneapolis, MN). Cell viability was analyzed using Trypan Blue at 24, 48 and 72 hours following the stimulation with TGF - β1. Results: The greatest production of b-FGF took place 24 hours after the stimulation with the dose of 10ng/ml of TGF - β1, with the production of b-FGF being equal to 501 pg/ml. The cell viability reached its greatest value at the 48 hours, decreasing in the hours thereafter, to reach the lowest levels at 72 hours. Conclusions: TGF-β1 has a stimulating effect on human lugn fibroblasts in vitro. This action of the TGF - β1 is dose dependent and reaches maximum proliferation levels with a dose of 10ng/ml 24 hours following treatment (AU)

Ethical challenges in transplant practice in Latin America: the Aguascalientes Document.

Organ transplants are currently an alternative treatment for a growing number of diseases, which were previously considered terminal. Bioethics has played an important role since the advent of this surgical technique, mainly in defining death criteria and the optimum transplantation conditions. This issue continues being a universal focal point, mainly concerning the equity of access to transplantation, criteria for assigning deceased-donor organs, living-donor safety, risk of commercial trade, fair access to high-quality immunosuppressive drugs and organ transplant legislation. These problems are characteristic of Latin America and the Caribbean, and were the driving force behind the First Latin American Bioethics and Transplant Forum, sponsored by the Latin American and Caribbean Transplant Society (STALYC), and all the transplant societies from subsidiary countries. The "Document of Aguascalientes" is a collection of all the ideas and opinions that were proposed during round tables and analyses. The document is divided into four sections: 1) living donor; 2) organ trading and transplant tourism; 3) the state role in legislation, transplant distribution and coverage; and 4) access to and quality of immunosuppression. The Bioethics and Transplant Forum was created to analyse and find solutions for this complex issue. The "Document of Aguascalientes" aims to serve as an instrument of expression and a vehicle for the ideas put forward during the Forum, so that they can act as transplant practice guidelines in Latin America.

Niveles séricos de mesotelina. Valor pronóstico en mesotelioma pleural maligno / Serum levels of mesothelin. Prognosis value in malignant pleural mesothelioma

El mesotelioma pleural maligno (MPM) es un tumor agresivo que surge del epitelio pleural. Se han detectado concentraciones aumentadas de proteínas solubles relacionadas con la mesotelina (SMRP) en suero de pacientes con MPM (..) (AU)

Malignant pleural mesothelioma (MPM) is an aggressive tumour that arises from pleural epithelium. Increased concentrations of soluble mesothelin related proteins (SMRP)

Enucleación prostática con láser holmium / Prostatic enucleation with holmium laser

Objetivo: La hipertrofia prostática afecta a partir de los 40 años a un porcentaje creciente de varones, aumentando este con la edad, actualmente contamos con una nueva arma terapéutica, el láser Holmium. Método: Recogemos de manera retrospectiva los datos obtenidos de forma retrospectiva de los 300 enfermos intervenidos mediante HoLEP prostático en nuestro centro. Resultados: Obtenemos: una estancia media hospitalaria de 1,8 días (Rango 1-15 días, mediana 1,8), un tiempo medio de cateterismo de 30,6h (Rango 12-312, Mediana 30,3), el tiempo quirúrgico total desde que el enfermo entra hasta que sale del quirófano es de 75 min. (Rango 38-150, Mediana 71), El flujo máximo es de 24,7 ml/seg a 6 meses y de 23,9 ml/seg a 12 meses. El rendimiento quirúrgico, los gramos resecados por minuto es de 0,48 en el grupo completo. Observamos una variación en los datos que afecta a los 20 primeros casos, con un empeoramiento de los resultados en este grupo Conclusiones: en nuestra opinión la enucleación con láser de Holmium es un método adecuado que garantiza unos resultados óptimos, perfectamente comparables a los obtenidos mediante técnicas quirúrgicas endoscópica clásicas y cirugía abierta, con un número de complicaciones bajo y que beneficia al enfermo al disminuir la necesidad de trasfusiones, el tiempo de sondaje vesical y de estancia hospitalaria, en contrapartida, presenta una curva de aprendizaje en torno a 20 procedimientos, en la que se pueden presentar complicaciones que desanimen al cirujano y que paralicen el proyecto de implantación de la técnica en un centro, al tener procedimientos fáciles y asequibles a su alcance ya establecidos (AU)

Objectives: Benign prostatic hyperplasia (BPH) affects a growing percentage of males over the age of 40 years, increasing with age. Currently, we have a new therapeutic tool available: the holmium laser. Methods: We retrospectively collected data of 300 patients undergoing holmium laser enucleation of the prostate (HoLEP) in our center. Results: The results are: mean hospital stay 1,8 days (range 1-15 days, median 1,8); mean bladder catheter time 30.6 hours (range 12-312, median 30.3), total operative room time 75 minutes (range 38-150, median 71), maximal flow rate at six months 24.7 ml/sec. and 23.9 ml/sec. at 12 months. Surgical performance, number of grams resected per minute, is 0.48 for the whole group. We observed a variation in data from the first 20 cases, with worse results in this group. Conclusions: In our opinion holmium laser enucleation is an adequate method that the guarantees optimal results, comparable to those obtained with classic endoscopic and open surgical techniques, with a low rate of complications, which benefits the patient by diminishing the need for transfusions, catheterization time, and hospital stay; conversely, it has a learning curve of around 20 procedures, which may be associated with complications that may discourage the surgeon and stop the project of technique implementation in a center, having easy, accessible, established alternative procedures (AU)

Successful transplant outcomes using pediatric en bloc kidneys into adult recipients.

En bloc pediatric kidneys have been used in adult renal transplantation for over 30 years. Despite the duration of this experience, issues such as increased technical difficulties and associated complications, hyperfiltration injury, and ultimately a limited allograft half-life have limited the use of these organs at many centers. To date, however, the collected experience suggests that these organs may in fact be an excellent source of allografts for adult transplantation. The present paper was a retrospective review of the experience using en bloc kidneys for adult transplantation from two institutions. These results support the use of these kidneys. Actual patient and graft survival at 2 years was 97% and 94% respectively.

[Prostatic enucleation with holmium laser]. / Enucleación prostática con láser holmium.

OBJECTIVES: Benign prostatic hyperplasia (BPH) affects a growing percentage of males over the age of 40 years, increasing with age. Currently, we have a new therapeutic tool available: the holmium laser. METHODS: We retrospectively collected data of 300 patients undergoing holmium laser enucleation of the prostate (HoLEP) in our center. RESULTS: The results are: mean hospital stay 1.8 days (range 1-15 days, median 1.8); mean bladder catheter time 30.6 hours (range 12-312, median 30.3), total operative room time 75 minutes (range 38-150, median 71), maximal flow rate at six months 24.7 ml/sec. and 23.9 ml/sec. at 12 months. Surgical performance, number of grams resected per minute, is 0.48 for the whole group. We observed a variation in data from the first 20 cases, with worse results in this group. CONCLUSIONS: In our opinion holmium laser enucleation is an adequate method that the guarantees optimal results, comparable to those obtained with classic endoscopic and open surgical techniques, with a low rate of complications, which benefits the patient by diminishing the need for transfusions, catheterization time, and hospital stay; conversely, it has a learning curve of around 20 procedures, which may be associated with complications that may discourage the surgeon and stop the project of technique implementation in a center, having easy, accessible, established alternative procedures.

[Laparoscopic surgery training in pelvitrainer and virtual simulators]. / Aprendizaje de la cirugía laparoscópica en pelvitrainer y en simuladores virtuales.

Over the last few decades, there has been a rise in the number of minimally invasive techniques, such as arthroscopy, vascular radiology and our speciality, laparoscopy. Laparoscopy has resulted in a reduction in the damage caused during intervention, with the subsequent reduction in hospital stay, postoperative pain and infections. However, one disadvantage of these techniques is that they require a large investment in instruments and a long and costly training period. In the following chapter, we describe the laparoscopic training process of the medical residents from our Urology Service in the pelvitrainer and virtual simulator.

Basiliximab: a comparative study between the use of the recommended two doses versus a single dose in living donor kidney transplantation.

Basiliximab (Simulect) is a high-affinity chimeric and humanized monoclonal antibody, directed against the alpha chain of human interleukin-2 receptor (CD25). The administration of two doses (20 mg intravenously per dose), one given 2 hours before transplantation and the second on day 4 posttransplant, provides suppression of the interleukin-2 receptor for up to 45 days, reducing the rate of acute rejection in kidney transplantation. This study was designed to compare the efficacy of a single dose of Simulect to the recommended two doses. The other objective was the reduction of the costs related to the standard two dose protocol. Fifty-two patients were included: group I (32 patients) received two doses of Simulect; group II (20 patients) received one dose. There were 39 living related donors and 13 living unrelated. All patients were followed for 1 year. Maintenance immunosuppression consisted of tacrolimus or cyclosporine, mycophenolate mofetil, and steroids. The diagnosis of rejection was made clinically. All episodes were treated with intravenous steroids. The incidence of rejection was similar in both groups; there was no graft loss to rejection. There were two deaths in group I, and one death in group II, yielding graft and patient actual survival rates at 1 year of 93% and 95%, respectively. These results suggest that Simulect is equally effective when administered in two doses or in a single dose in kidney transplantation. The reduction of cost by giving a single dose is significant, especially in developing countries without national health insurance.

Aprendizaje de la cirugía laparoscópica en Pelvitrainer y en simuladores virtuales / Laparoscopic surgery training in pelvitrainer and virtual simulators

En las últimas décadas se han incrementado las técnicas quirúrgicas mínimamente invasivas, como la artroscopia, radiología vascular y en nuestra especialidad la laparoscopia. Con la laparoscopia se ha reducido el daño causado durante la intervención, con la consiguiente disminución del periodo de hospitalización, el dolor postoperatorio y las infecciones. Sin embargo estas técnicas presentan el inconveniente de requerir grandes inversiones en instrumental y un periodo de entrenamiento más largo y costoso. En el siguiente capítulo repasamos el proceso de aprendizaje laparoscópico realizado en el pelvitrainer y en el simulador virtual por parte de los residentes de nuestro Servicio de Urología

Over the last few decades, there has been a rise in the number of minimally invasive techniques, such as arthroscopy, vascular radiology and our speciality, laparoscopy. Laparoscopy has resulted in a reduction in the damage caused during intervention, with the subsequent reduction in hospital stay, postoperative pain and infections. However, one disadvantage of these techniques is that they require a large investment in instruments and a long and costly training period. In the following chapter, we describe the laparoscopic training process of the medical residents from our Urology Service in the pelvitrainer and virtual simulator

Pericarditis neumocócica: presentación de un caso y revisión de la literatura / Pneumococcal pericarditis: presentation of one case and review of the literature

La pericarditis purulenta es una entidad rara en la actualidad, de curso rápidamente fatal en ausencia de tratamiento y de difícil diagnóstico clínico antes de la aparición de taponamiento pericárdico. Producida clásicamente por gérmenes aerobios grampositivos, la incidencia de etiología anaerobia, gramnegativa y fúngica parece aumentar. La etiología neumocócica es hoy excepcional y prácticamente siempre acompañando a una infección pleuropulmonar evidente. Las bases del tratamiento son la pericardiocentesis precoz, la antibioterapia intravenosa de amplio espectro y el tratamiento de soporte en una Unidad de Cuidados Intensivos. La técnica de drenaje pericárdico idónea en estos pacientes continúa siendo tema de controversia, dada la escasa experiencia clínica existente. El pronóstico es bueno si el reconocimiento es precoz, con una tasa de secuelas relativamente baja, generalmente en forma de pericarditis constrictiva. Presentamos un caso de pericarditis purulenta neumocócica primaria y una revisión de la literatura al respecto

Purulent pericarditis is a rare entity at present, with a rapidly fatal course in absence of treatment. Its clinical diagnosis is difficult due to the appearance of pericardial tamponade. Classically produced by Gram positive aerobic germs, the incidence of anaerobic, Gram negative and fungal etiology seems to increase. Pneumococcal etiology is rare today and almost always accompanies a clear pleuropulmonary infection. Treatment bases are early pericardiocentesis, intravenous wide spectrum antibiotic treatment and support treatment in the intensive care unit. The best pericardial drainage technique in these patients continues to be debatable, given the limited existing clinical experience. Prognosis is good if recognized early, with a relatively low sequel rate, generally as constrictive pericarditis. We present a case of primary purulent pneumococcal pericarditis and a review of the literature in this regards

[Octreotide and a serotonin-secreting glomus tumor]. / Octreótido y tumor glómico secretor de serotonina.

Glomus tumors arise in the chemical receptors of vessels in the tympanic and jugular regions. Clinical signs depend on location, the structures invaded and a tumor's ability to secrete active amines and peptides. A 44-year-old woman was scheduled for excision of a serotonin-secreting tympanic glomus tumor. Urinary excretion of 5-hydroxyindolacetic acid (5-HIA) in urine over the previous 24 hours was 80 mg (normal < 10 mg). The patient received oral diazepam, ranitidine, intravenous diphenhydramine and subcutaneous octreotide (150 micrograms). Anesthesia was induced with propofol, alfentanil and vecuronium. The tumor produced an episode of bronchospasm and cutaneous rubor during surgical manipulation of the tumor. Airway pressure increased to 42 cmH2O and SpO2 decreased to 89%. Hypotension and bradycardia appeared. Once it was suspected that the symptoms stemmed from tumoral secretion of active substances, 20 micrograms of intravenous octreotide was administered. The bronchospasm decreased and hemodynamic changes were resolved in three minutes, with no recurrence of symptoms. The patient received 100 micrograms of octreotide subcutaneously every 8 hours throughout the 72 postoperative hours. Urinary excretion of 5-HIA was 12 mg on the fifth day and the patient was released without having experienced complications. Appropriate preoperative preparation is important in patients with such tumors, as are early detection of respiratory and hemodynamic changes that may occur during surgery and correct perioperative treatment. Octreotide, a longer-lasting somatostatin analogue, has facilitated the handling of such cases.

[Intradural anesthesia with a 27-gauge Sprotte needle for arthroscopic knee surgery in ambulatory patients under 40 years of age]. / Anestesia intradural con aguja 27 G de Sprotte para la cirugía de artroscopia de la rodilla en los pacientes ambulatorios menores de 40 años.

OBJECTIVE: To assess the clinical usefulness of intradural anesthesia through a 27 gauge Sprotte ("pencil point") needle for arthroscopic knee surgery in outpatients under 40 years of age. PATIENTS AND METHOD: A retrospective study of 116 patients under 40 scheduled for arthroscopic knee surgery, analyzing the incidence of post-dural puncture headache and backache after anesthesia provided with a 27 gauge (0.4 mm) Sprotte needle. Follow-up assessments were performed 24, 48 and 72 hours after surgery. We also studied technical difficulty and failure rate encountered in achieving blockade with this type of needle. RESULTS: We recorded one case of headache (0.86%) that resolved within 48 hours with conservative treatment. Backache was reported by eight patients (6.8%) and was described as slight in all cases. The small caliber and design of the spinal needle caused no technical difficulties and anesthesia was successfully provided for all patients. Time of hospital stay ranged from 330 to 420 minutes (mean 360 +/- 45 minutes). No patient had to stay overnight. CONCLUSIONS: The results confirm that intradural anesthesia with 27 gauge Sprotte needles is an acceptable anesthetic technique for outpatient surgery in young patients given that the rate of complications is low.

[Anesthesia for cesarean section in a case of Emery-Dreifuss muscular dystrophy]. / Anestesia para cesárea en un caso de distrofia muscular tipo Emery-Dreifuss.

We describe the anesthetic technique used in a patient with Emery-Dreifuss muscular dystrophy, a rare form whose genetic transmission is usually linked to the X-chromosome but which can be dominant, thus occasionally affecting women. A woman with vaginal condylomata was scheduled for elective cesarean. She presented proximal muscle weakness in the upper extremities, flexion contracture of both elbows and neck and, occasionally, respiratory difficulty. Surgery was performed with epidural anesthesia with no noteworthy complications. The anesthetic implications of this clinical picture depend on the likelihood of malignant hyperthermia, difficult intubation, arrhythmias or respiratory insufficiency due to muscle weakness. Continuous epidural or spinal anesthesia provides a more progressive level of blockade and greater control.

[Changes in plasma cortisol and ACTH caused by diazepam, bromazepam, triazolam, and alprazolam in oral premedication]. / Modificaciones de las concentraciones plasmáticas de cortisol y ACTH producidas por diazepam, bromazepam, triazolam y alprazolam en premedicación oral.

INTRODUCTION: Benzodiazepines relieve anxiety and modify the endocrine response to surgical-anesthetic stress. OBJECTIVES: The aim of this study was to evaluate the effects of four benzodiazepines on preoperative secretion of cortisol and ACTH. MATERIAL AND METHODS: We studied 60 patients programmed for abdominal surgery. Patients were randomly allocated into six groups of treatment: control group (placebo), diazepam 10 mg, triazolam 0.5 mg, alprazolam 0.5 mg, bromazepam 6 mg, and bromazepam 12 mg. Blood samples for cortisol and ACTH measurements were obtained at five different stages of the anesthetic-surgical procedure: baseline, preanesthesia, anesthesia, surgery, and postoperative phase. RESULTS: Diazepam and bromazepam (6 and 12 mg) lessened the increase in plasmatic cortisol induced by preanesthesia and anesthesia in control patients. Triazolam attenuated the cortisol response only during preanesthesia. Administration of 12 mg of bromazepam decreased ACTH levels during preanesthesia and anesthesia with respect to the control group. CONCLUSIONS: Benzodiazepines failed to modify cortisol and ACTH levels during surgery and during the immediate postoperative period. The most marked attenuation of adrenocortical response was achieved with 12 mg of bromazepam and the less marked lessening was induced by 0.5 mg of alprazolam.