Insulin in combination with pioglitazone prevents advanced cachexia in 256-Walker tumor-bearing rats: effect is greater than treatment alone and is associated with improved insulin sensitivity.

BACKGROUND: Insulin (INS) resistance and hypoinsulinemia commonly observed in cancer-carrying, can contribute to cachexia. However, the effects of INS and INS sensitizers, such as pioglitazone (PIO), particularly when used in combination therapy, on cancer cachexia have not been evaluated sufficiently. We investigated the effects of INS and PIO, at various doses, either isolated or combined, on cachexia in Walker-256 tumor-bearing rats (TB rats). METHODS: INS or INS + PIO were administered in TB rats, for 6 or 12 days, starting from the day of tumor cells inoculation. RESULTS: INS at 18 or 27 U/kg (12-days treatment), but not 9 U/kg, reduced fat loss and slightly prevented weight loss. However, INS 18 U/kg + PIO 5, 10, 20, or 40 mg/kg (6 or 12-day treatment) reduced fat loss and markedly prevented weight loss but did not affect muscle wasting. While TB rats lost weight (37.9% in 12 days), TB rats treated with INS 18 U/kg + PIO 5 mg/kg showed pronounced weight gain (73.7%), which was greater than the sum (synergism) of the weight gains promoted by isolated treatments with INS 18 U/kg (14.7%) or PIO 5 mg/kg (13.1%). The beneficial effect of the INS 18 U/kg + PIO 5 mg/kg on weight loss was associated with improved INS sensitivity, as indicated by the higher blood glucose clearance constant (kITT), decreased levels of free fatty acids and triacylglycerols (INS resistance-inducing factors) in the blood, and increased expression of p-Akt (INS signaling pathway protein) in adipose tissue. CONCLUSIONS: The combined treatment with INS 18 U/kg + PIO 5 mg/kg was more effective in preventing advanced cachexia in TB rats than each treatment alone, emerging as the best approach, considering the lower dosage and higher efficacy. This combination completely preserved adipose mass and markedly reduced weight loss through a synergistic mechanism linked to improved insulin sensitivity. These findings provide new insights into the importance of drug combinations in effectively combating fat loss in advanced cachexia.

Controlled Release of Phycocyanin in Simulated Gastrointestinal Conditions Using Alginate-Agavins-Polysaccharide Beads.

C-phycocyanin (CPC) is an antioxidant protein that, when purified, is photosensitive and can be affected by environmental and gastrointestinal conditions. This can impact its biological activity, requiring an increase in the effective amount to achieve a therapeutic effect. Therefore, the aim of this study was to develop a microencapsulate of a complex matrix, as a strategy to protect and establish a matrix for the controlled release of CPC based on polysaccharides such as agavins (AGV) using ionic gelation. Four matrices were formulated: M1 (alginate: ALG), M2 (ALG and AGV), M3 (ALG, AGV, and κ-carrageenan: CGN), and M4 (ALG, AGV, CGN, and carboxymethylcellulose: CMC) with increasing concentrations of CPC. The retention and diffusion capacities of C-phycocyanin provided by each matrix were evaluated, as well as their stability under simulated gastrointestinal conditions. The results showed that the encapsulation efficiency of the matrix-type encapsulates with complex composites increased as more components were added to the mixtures. CMC increased the retention due to the hydrophobicity that it provides by being in the polysaccharide matrix; CGN enabled the controlled diffusive release; and AGV provided protection of the CPC beads under simulated gastrointestinal conditions. Therefore, matrix M4 exhibited an encapsulation efficiency for CPC of 98% and a bioaccessibility of 10.65 ± 0.65% after the passage of encapsulates through in vitro digestion.

The Effects of Agave Fructans in a Functional Food Consumed by Patients with Irritable Bowel Syndrome with Constipation: A Randomized, Double-Blind, Placebo-Controlled Trial.

Irritable bowel syndrome displays three different subtypes: constipation (IBS-C), diarrhea (IBS-D), and mixed (IBS-M). Treatment with dietary fiber is used, with consideration given both to the chemical composition of the fiber and to the different subtypes of IBS. The IBS-D subtype is usually treated with a low-FODMAPs diet, whereas the IBS-C subtype suggests prebiotics and probiotics to promote microbiota restoration. The aim of this study was to assess the effects of employing agave fructans as the soluble fiber of a jelly (Gelyfun®gastro) containing 8 g per serving in the IBS-C group (n = 50), using a randomized, double-blind, time-limited trial for four weeks. We evaluated changes in the frequency and types of bowel movements through the Bristol scale, and the improvement of the condition was evaluated using quality of life (IBS-QOL) and anxiety-depression (HADS) scales. The main results were that the number of bowel movements increased by more than 80%, with at least one stool per day from fifteen days onwards, without a laxative effect for the group treated. Finally, the quality of life with the prebiotic jelly was significantly improved compared to the placebo in all specific domains, in addition to significantly reducing anxiety and depression.

Effect of Agave Fructans on Changes in Chemistry, Morphology and Composition in the Biomass Growth of Milk Kefir Grains.

Prebiotic effects have been attributed to agave fructans through bacterial and yeast fermentations, but there are few reports on their use as raw materials of a carbon source. Kefir milk is a fermented drink with lactic acid bacteria and yeast that coexist in a symbiotic association. During fermentation, these microorganisms mainly consume lactose and produce a polymeric matrix called kefiran, which is an exopolysaccharide composed mainly of water-soluble glucogalactan, suitable for the development of bio-degradable films. Using the biomass of microorganisms and proteins together can be a sustainable and innovative source of biopolymers. In this investigation, the effects of lactose-free milk as a culture medium and the addition of other carbon sources (dextrose, fructose, galactose, lactose, inulin and fructans) in concentrations of 2, 4 and 6% w/w, coupled with initial parameters such as temperature (20, 25 and 30 °C), % of starter inoculum (2, 5 and 10% w/w) was evaluated. The method of response surface analysis was performed to determine the optimum biomass production conditions at the start of the experiment. The response surface method showed that a 2% inoculum and a temperature of 25 °C were the best parameters for fermentation. The addition of 6% w/w agave fructans in the culture medium favored the growth of biomass (75.94%) with respect to the lactose-free culture medium. An increase in fat (3.76%), ash (5.57%) and protein (7.12%) content was observed when adding agave fructans. There was an important change in the diversity of microorganisms with an absence of lactose. These compounds have the potential to be used as a carbon source in a medium culture to increase kefir granule biomass. There was an important change in the diversity of microorganisms with an absence of lactose, where the applied image digital analysis led to the identification of the morphological changes in the kefir granules through modification of the profile of such microorganisms.

Interleukin 6 acutely increases gluconeogenesis and decreases the suppressive effect of insulin on cAMP-stimulated glycogenolysis in rat liver.

Interleukin 6 (IL6) is an multifunctional cytokine that modulates several biological responses, including glucose metabolism. However, its acute effects on hepatic glucose release are still uncertain. The main purpose of this study was to investigate the effects of IL6 on gluconeogenesis from several glucose precursors (alanine, pyruvate and glutamine) and on the suppressive action of insulin on cAMP-stimulated glycogen catabolism in rat liver. IL6 effect on insulin peripheral sensitivity was also evaluated. IL6 was injected intravenously into rats and, 1 h later, gluconeogenesis and glycogenolysis were assessed in liver perfusion and peripheral insulin sensitivity by insulin tolerance test (ITT). IL6 intravenous injection increased hepatic glucose production from alanine, without changing pyruvate, lactate and urea production. IL6 injection also increased hepatic glucose production from pyruvate and glutamine. In addition, IL6 decreased the suppressive effect of insulin on cAMP-stimulated glucose and lactate production and glycogenolysis, without affecting pyruvate production. Furthermore, IL6 reduced the plasma glucose disappearance constant (kITT), an indicator of insulin resistance. In conclusion, IL6 acutely increased hepatic glucose release (gluconeogenesis and glycogenolysis) by a mechanism that likely involved the induction of insulin resistance in the liver, as evidenced by the reduced suppressive effect of insulin on cAMP-stimulated glycogen catabolism. In consistency, IL6 acutely induced peripheral insulin resistance.

Psychometric Properties of the Generalized Anxiety Disorder 7-item Scale in Adolescents: An Effective Screening Tool for School and Community Settings.

OBJECTIVE: Anxiety disorders are prevalent among children and adolescents. Identifying anxiety symptoms in primary care, school, and community settings has implications for service planning, resource allocation, and prevention and treatment programming. The Generalized Anxiety Disorder 7-item (GAD-7) scale is a commonly used instrument for evaluating anxiety symptoms. Still, it has yet to be validated in vulnerable groups, such as Spanish-speaking adolescents who are at risk due to socioeconomic disadvantages. METHODS: This study aimed to examine the psychometric properties of the Spanish version of the GAD-7 for adolescents in a sample of middle and high school students in Puerto Rico. Secondary data from 566 students in fifth to twelfth grade in Puerto Rico were collected as part of a school-based services program. RESULTS: A confirmatory factor analysis evidenced the 1-factor structure of the GAD-7, while a test of invariance supported the equality of the factor loadings across gender and school level. The scores of the GAD-7 showed positive and significant correlations with the 8-item Patient Health Questionnaire depression scale-providing evidence of convergent validity-and the reliability estimates of the GAD-7 were adequate. CONCLUSION: Thus, the GAD-7 has optimal psychometric properties in terms of construct and convergent validity and internal consistency. It is a useful instrument for assessing anxiety in Spanish speaking youth in Puerto Rico.

El papel del cirujano moderno como líder de los equipos de atención sanitaria: una revisión narrativa sobre una facultad ubicua, pero poco definida.

OBJECTIVE: The objective is to describe the role of leadership in the training of the general surgeon and to point out its relevance. METHOD: A search of the medical literature was carried out to identify studies that reported on topics related to leadership in the context of medical education and surgery. We used the search engine of Medline/PubMed databases including related terms such as "leadership" AND "medicine" OR "surgery". RESULTS: Leadership is a valued characteristic in surgery, it implies professionalism, technical competence, motivation, innovation, teamwork, communication skills, decision making, emotional competence, resilience, and effective teaching. Leadership is measurable and can be developed through experience, observation, and education. CONCLUSIONS: Priority must be given to actions that improve leader traits. This has been shown to create a work environment where efficient work is performed, and failures are minimized. The current vision of the leader must be expanded to reduce the gender gap between the positions as leader occupy in this moment.

OBJETIVO: Describir el papel de liderazgo en la formación del cirujano general y puntualizar su relevancia en nuestro entorno. MÉTODO: Se realizó una búsqueda en la literatura médica para identificar estudios que informaran sobre temas relacionados al liderazgo en el contexto de la enseñanza médica y en cirugía. Se utilizó el motor de búsqueda de las bases de datos Medline/PubMed incluyendo términos relacionados como "leadership" AND "medicine" OR "surgery". RESULTADOS: El liderazgo es una característica valorada en cirugía, que implica profesionalismo, competencia técnica, motivación, innovación, trabajo en equipo, habilidades comunicativas, toma de decisiones, competencia emocional, resiliencia y enseñanza eficaz. Es medible y susceptible de desarrollarse a través de la experiencia, la observación y la educación. CONCLUSIONES: En la formación del cirujano general se deben priorizar las acciones que mejoren los rasgos de líder. Se ha demostrado que esto genera un ambiente de trabajo donde se realiza una labor eficiente y se minimizan las fallas. Se debe expandir la visión actual que se tiene de líder y permitir que se disminuya la brecha de género entre los puestos que hoy se ocupan.

A Mixture of Kaempferol-3-O-sambubioside and Kaempferol-3-O-sophoroside from Malvaviscus arboreus Prevents Ethanol-Induced Gastric Inflammation, Oxidative Stress, and Histologic Changes.

Malvaviscus arboreus is used in traditional Mexican medicine to treat gastrointestinal diseases. Therefore, a mixture of Kaempferol-O-sambubioside and Kaempferol-O-sophoroside (MaSS) isolated from flowers of this species was tested as a preventive treatment on gastric lesions induced with ethanol in rats. MaSS was obtained by chromatographic methods and administered by oral pathway to male Sprague Dawley rats with ethanol-induced gastric lesions. Pretreatment with MaSS at doses of 30, 90, 120, and 180 mg/kg significantly prevents gastric lesions, inhibits the increment in relative stomach weight (%) in gastric IL-6, and also provokes an increment of IL-10 concentration and catalase activity. Finally, MaSS prevented edema in the mucosa and submucosa and diminished microscopic gastric lesions provoked by ethanol.

Kinetics and Mechanisms of Saccharomyces boulardii Release from Optimized Whey Protein-Agavin-Alginate Beads under Simulated Gastrointestinal Conditions.

Encapsulation is a process in which a base material is encapsulated in a wall material that can protect it against external factors and/or improve its bioavailability. Among the different encapsulation techniques, ionic gelation stands out as being useful for thermolabile compounds. The aim of this work was to encapsulate Saccharomyces boulardii by ionic gelation using agavins (A) and whey protein (WP) as wall materials and to evaluate the morphostructural changes that occur during in vitro gastrointestinal digestion. Encapsulations at different levels of A and WP were analyzed using microscopic, spectroscopic and thermal techniques. Encapsulation efficiency and cell viability were evaluated. S. boulardii encapsulated at 5% A: 3.75% WP (AWB6) showed 88.5% cell survival after the simulated gastrointestinal digestion; the bead showed a significantly different microstructure from the controls. The mixture of A and WP increased in the survival of S. boulardii respect to those encapsulated with alginate, A or WP alone. The binary material mixture simultaneously allowed a controlled release of S. boulardii by mostly diffusive Fickian mechanisms and swelling. The cell-release time was found to control the increment of the Damköhler number when A and WP were substrates for S. boulardii, in this way allowing greater protection against gastrointestinal conditions.

Microbial Type IA Topoisomerase C-Terminal Domain Sequence Motifs, Distribution and Combination.

Type IA topoisomerases have highly conserved catalytic N-terminal domains for the cleaving and rejoining of a single DNA/RNA strand that have been extensively characterized. In contrast, the C-terminal region has been less covered. Two major types of small tandem C-terminal domains, Topo_C_ZnRpt (containing C4 zinc finger) and Topo_C_Rpt (without cysteines) were initially identified in Escherichia coli and Mycobacterium tuberculosis topoisomerase I, respectively. Their structures and interaction with DNA oligonucleotides have been revealed in structural studies. Here, we first present the diverse distribution and combinations of these two structural elements in various bacterial topoisomerase I (TopA). Previously, zinc fingers have not been seen in type IA topoisomerases from well-studied fungal species within the phylum Ascomycota. In our extended studies of C-terminal DNA-binding domains, the presence of zf-GRF and zf-CCHC types of zinc fingers in topoisomerase III (Top3) from fungi species in many phyla other than Ascomycota has drawn our attention. We secondly analyze the distribution and combination of these fungal zf-GRF- and zf-CCHC-containing domains. Their potential structures and DNA-binding mechanism are evaluated. The highly diverse arrangements and combinations of these DNA/RNA-binding domains in microbial type IA topoisomerase C-terminal regions have important implications for their interactions with nucleic acids and protein partners as part of their physiological functions.

Production and Characterization of Gelatin Biomaterials Based on Agave Microfibers and Bentonite as Reinforcements.

The objective of this work was to obtain biomaterials as gelatin films or biofilms produced by casting, reinforced with a microfiber (MF) from Agave angustifolia Haw bagasse and bentonite (BN) nanoparticles and evaluate the effect of such reinforcements at different concentrations. Agave microfibers were obtained by a non-abrasive chemical method. Three formulations based on gelatin with glycerol were reinforced with microfiber, bentonite and both materials with 1.5, 3.5 and 5.5% w/w solids content. Physicochemical properties were determined using SEM and FTIR, thickness, soluble matter and moisture. The XRD, barrier, mechanical and thermal properties were measured. The films' micrographs showed agglomerations on the surface. Interactions between its functional groups were found. The solubility increased when the MF concentration increased. The thickness of the films was between 60 and 110 µm. The crystallinity ranged from 23 to 86%. The films with both MF and BN and 3.5% w/w solids had the lowest barrier properties, while the film with 5.5% w/w solids showed the highest mechanical properties, being thermally resistant. Overall, Agave microfibers together with bentonite were able to improve some of the films' properties, but optimized mixing conditions had to be used to achieve good particle dispersion within the gelatin matrix to improve its final properties. Such materials might have the potential to be used as food packaging.

Prevalence of Metabolic Syndrome Among Mexican Adults.

Background: Metabolic syndrome (MetS) has increased worldwide, and since 2012, prevalence of obesity, hypertension, diabetes, and dyslipidemia has increased in Mexico. Objective: To assess the prevalence of MetS, and its relationship with sociodemographic and lifestyle factors among Mexican adults. Methods: Analytical cross-sectional study nationally representative, carried out on Mexican adults (≥20-year-old adults of both sexes; n = 4595). Socioeconomic factors, geographic area, health care coverage and previous medical diagnoses of diabetes and hypertension, and smoking were assessed. Anthropometrics, and triglyceride, total cholesterol, high-density lipoprotein cholesterol (HDL-chol), creatinine, and glucose plasma levels were measured. The ATP III MetS definition was applied. Results: A MetS prevalence of 44.2% was observed, which was higher in males than females, and increased with age, lower school level, and overweight. Hyperglycemia, hypertriglyceridemia, low HDL-chol, abdominal obesity, and hypertension were higher in people with MetS, and were associated with obesity. Conclusions: The prevalence of MetS in the Mexican adult observed in the ENSADER 2007 was high, and mainly in men than women. Specific associations of MetS with age, scholar level, and body mass index have been found. Obesity and MetS were associated.

Anti-arthritic and anti-inflammatory effects of Baccharis conferta Kunth in a kaolin/carrageenan-induced monoarthritis model.

ETHNOPHARMACOLOGICAL RELEVANCE: Popularly known as "escoba" (broom) or "escobilla china" (Chinese brush), Baccharis conferta Kunth (Asteraceae), is a plant widely used in Mexican folk medicine for alleviating muscular and rheumatic pain. A recent study described that dichloromethane extract as well as fractions and isolated compounds, possess anti-inflammatory activity in TPA-induced acute edema. AIM OF THE STUDY: Based on the popular medicinal uses of B. conferta as well as previous studies on its anti-inflammatory activity, the aim of this research was to evaluate the anti-arthritic and anti-inflammatory effects of dichloromethane extract, fractions, and compounds from B. conferta in a monoarthritis model induced with kaolin/carrageenan (K/C). MATERIALS AND METHODS: Aerial parts of B. conferta were collected, dried, and macerated with dichloromethane. The dichloromethane extract (BcD) was separated by open column chromatography to obtain the BcD2 fraction where the diterpene kingidiol (KIN) was isolated and from the BcD3 fraction the flavonoid cirsimaritin (CIR), which are the most active compounds in the TPA model. In addition, the flavonoids acacetin, pectolinaringenin and 6-methoxykaempferide were identified and isolated from the BcD2 fraction. The content of the main compounds was estimated in BcD, BcD2 and BcD3. The anti-arthritic and anti-inflammatory effects of B. conferta were investigated by evaluating ankle joint inflammation, hyperalgesia using the hot plate test, and pro- and anti-inflammatory cytokine levels in the synovial capsule as well as histological changes in ankle joint tissue in a monoarthritis model induced with K/C in Balb/c mice. RESULTS: Oral administration of BcD2 fraction (25 mg/kg) and KIN (10 mg/kg) reduced the ankle thickness induced by K/C and decreased the levels of TNF-α, IL-1ß, IL-6 and IL-17, while BcD2 increased IL-10. In addition, BcD2 and KIN showed significant edema attenuation of the synovial membrane and decreased inflammatory infiltration and cartilage erosion compared to the VEH group. Finally, BcD (50 mg/kg), KIN (10 mg/kg) and CIR (5 mg/kg) decreased hyperalgesia. CONCLUSIONS: B. conferta constitutes a therapeutic or preventive candidate for osteoarthritis, because of decreased articular inflammation and pain accompanied with the modulation of cytokine concentrations, which confirms the anti-arthritic and anti-inflammatory activities of B. conferta and support its popular use.

Corneal Healing and Recovery of Ocular Crystallinity with a Dichloromethane Extract of Sedum dendroideum D.C. in a Novel Murine Model of Ocular Pterygium.

Pterygium is a corneal alteration that can cause visual impairment, which has been traditionally treated with the sap of Sedum dendroideum D.C. The pharmacological effect of a dichloromethane extract of S. dendroideum was demonstrated and implemented in a pterygium model on the healing process of corneal damage caused by phorbol esters. In mice of the ICR strain, a corneal lesion was caused by intravitreal injection of tetradecanoylphorbol acetate (TPA). The evolution of the corneal scarring process was monitored with vehicle, dexamethasone, and dichloromethane extract of S. dendroideum treatments by daily ophthalmic administration for fifteen days. The lesions were evaluated in situ with highlighted images of fluorescence of the lesions. Following treatment levels in eyeballs of IL-1α, TNF-α, and IL-10 cytokines were measured. The effective dose of TPA to produce a pterygium-like lesion was determined. The follow-up of the evolution of the scarring process allowed us to define that the treatment with S. dendroideum improved the experimental pterygium and had an immunomodulatory effect by decreasing TNF-α, IL-1α, and maintaining the level of IL-10 expression, without difference with respect to the healthy control. Traditional medical use of S. dendroideum sap to treat pterygium is fully justified by its compound composition.

Genome-wide SNP analysis to assess the genetic population structure and diversity of Acrocomia species.

Acrocomia (Arecaceae) is a genus widely distributed in tropical and subtropical America that has been achieving economic interest due to the great potential of oil production of some of its species. In particular A. aculeata, due to its vocation to supply oil with the same productive capacity as the oil palm (Elaeis guineenses) even in areas with water deficit. Although eight species are recognized in the genus, the taxonomic classification based on morphology and geographic distribution is still controversial. Knowledge about the genetic diversity and population structure of the species is limited, which has limited the understanding of the genetic relationships and the orientation of management, conservation, and genetic improvement activities of species of the genus. In the present study, we analyzed the genomic diversity and population structure of Acrocomia genus, including 172 samples from seven species, with a focus on A. aculeata with 117 samples covering a wide geographical area of occurrence of the species, using Single Nucleotide Polymorphism (SNP) markers originated from Genotyping By Sequencing (GBS).The genetic structure of the Acrocomia species were partially congruent with the current taxonomic classification based on morphological characters, recovering the separation of the species A. aculeata, A. totai, A. crispa and A. intumescens as distinct taxonomic groups. However, the species A. media was attributed to the cluster of A. aculeata while A. hassleri and A. glauscescens were grouped together with A. totai. The species that showed the highest and lowest genetic diversity were A. totai and A. media, respectively. When analyzed separately, the species A. aculeata showed a strong genetic structure, forming two genetic groups, the first represented mainly by genotypes from Brazil and the second by accessions from Central and North American countries. Greater genetic diversity was found in Brazil when compared to the other countries. Our results on the genetic diversity of the genus are unprecedented, as is also establishes new insights on the genomic relationships between Acrocomia species. It is also the first study to provide a more global view of the genomic diversity of A. aculeata. We also highlight the applicability of genomic data as a reference for future studies on genetic diversity, taxonomy, evolution and phylogeny of the Acrocomia genus, as well as to support strategies for the conservation, exploration and breeding of Acrocomia species and in particular A. aculeata.

Resultado quirúrgico y calidad de vida en reconstrucción auricular autóloga. Hospital General Dr. Manuel Gea González. México / Surgical outcomes and quality in autologous auricle reconstruction. Hospital General Dr. Manuel Gea González. México

INTRODUCCIÓN Y OBJETIVO: La microtia es un problema estético que conlleva una afección psicosocial en el desarrollo del paciente. La reconstrucción auricular mediante injerto costal autólogo es el procedimiento más usado. Determinamos los resultados quirúrgicos en nuestro hospital y el impacto en la calidad de vida de los pacientes con microtia sometidos a reconstrucción auricular con cartílago costal autólogo. MATERIAL Y MÉTODO: Estudio observacional, descriptivo, transversal y prolectivo en pacientes con diagnóstico de microtia uni o bilateral 1 año después de la reconstrucción. Evaluamos el resultado quirúrgico mediante cuestionario desarrollado y publicado por la primera autora, calificando características de apariencia estética de la oreja. Evaluamos la calidad de vida del paciente mediante cuestionario Glasgow Benefit Inventory, versión validada al español, en mayores de 15 años; para pacientes pediátricos utilizamos cuestionario Glasgow's Children's Benefit Inventory, versión traducida y validada por traductor especializado. RESULTADOS: Recogimos 83 pacientes con edad de 8 a 46 años. En la evaluación quirúrgica 13 pacientes (15.6%) tuvieron un resultado excelente, 27 (32.5%) bueno, 29 (34.9%) regular y 14 malo (16.8%). En la evaluación de calidad de vida encontramos en la escala total puntuación positiva en 78 pacientes (93.9%) y negativa en 5 (6%). CONCLUSIONES: El estudio presenta un panorama objetivo de las expectativas del cirujano sobre satisfacción y bienestar del paciente. Si bien solo encontramos resultados buenos y excelentes en el 48%, al revisar la escala de satisfacción encontramos puntaciones positivas, con bienestar en casi el 94%. Es importante que los pacientes conozcan nuestra preocupación por saber el impacto de la intervención y que podamos retroalimentar nuestra práctica quirúrgica. Hasta donde sabemos, este es el primer estudio en México que evalúa ambos aspectos

BACKGROUND AND OBJECTIVE: Microtia is not only an aesthetic problem but involves patient psychosocial development. The gold standard for auricular reconstruction is autologous costal cartilage. Our aim is to evaluate surgical outcomes and impact in quality of life after auricular reconstruction with autologous costal cartilage in microtia patients at our hospital. METHODS: Observational, descriptive, cross an prolective study on patients with uni or bilateral microtia 1 year after auricular reconstruction procedure. Surgical outcome was evaluated with a method previously published by the first author evaluating auricular aesthetic characteristics. Quality of life was evaluated with Glasgow Benefit Inventory, validated in Spanish, for over 15 years old patients; for pediatric patients we used the Glasgow's Children's Benefit Inventory, in a validated translated version. RESULTS: The study group was composed by 83 patients from 8 to 46 years old. Surgical outcome were excellent in 13 cases (15.6%), good in 27 (32.5%), regular in 29 cases (34.9%) and bad in 14 (16.8%). Quality of life had a positive total score in 78 cases (93.9%) and negative in 5 (6%). CONCLUSIONS: The study allows us an objective overview of surgeon's expectations regarding patient satisfaction and well-being. Although we only found good and excellent results in 48% of the patients, when reviewing the satisfaction scale we found positive scores in almost 94%. It`s important that patients know our concern about the impact of our intervention and to provide feedback on our surgical practice. As far as we know, this is the first study in Mexico evaluating both aspects

Anatomic Considerations in Hamstring Tendon Harvesting for Ligament Reconstruction.

Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament reconstruction. Although the technique of hamstring autograft harvest is relatively straightforward, it is critical to pay attention to several technical steps to avoid iatrogenic anatomic or neurovascular damage as well as to reduce the risk of premature amputation of the graft when using a tendon stripper. We describe a technique of hamstring autograft harvesting using only 2 anatomic references that makes it a simple and reproducible technique for surgeons, especially those in training.

Identification and Quantification of ß-Sitosterol ß-d-Glucoside of an Ethanolic Extract Obtained by Microwave-Assisted Extraction from Agave angustifolia Haw.

ß-sitosterol ß-d-glucoside (BSSG) was extracted from "piña" of the Agave angustifolia Haw plant by microwave-assisted extraction (MAE) with a KOH solution such as a catalyst and a conventional maceration method to determine the best technique in terms of yield, extraction time, and recovery. The quantification and characterization of BSSG were done by high-performance thin layer chromatography (HPTLC), Fourier-transform infrared spectroscopy (FT-IR), and high-performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS). With an extraction time of 5 s by MAE, a higher amount of BSSG (124.76 mg of ß-sitosterol ß-d-glucoside/g dry weight of the extract) than those for MAE extraction times of 10 and 15 s (106.19 and 103.97 mg/g dry weight respectively) was shown. The quantification of BSSG in the extract obtained by 48 h of conventional maceration was about 4-5 times less (26.67 mg/g dry weight of the extract) than the yields reached by the MAE treatments. MAE achieved the highest amount of BSSG, in the shortest extraction time while preserving the integrity of the compound's structure.

Improving the production of podophyllotoxin in hairy roots of Hyptis suaveolens induced from regenerated plantlets.

Ten Hyptis suaveolens hairy root lines were established by infecting nodal explants with K599+pGus-GFP+ and ATCC15834+pTDT strains from Agrobacterium rhizogenes. Genetic transformation was confirmed by epifluorescence and plagiotropic hairy root growth in absence of growth regulators. Cytotoxicity was determined using the sulforhodamine B method, and the production of podophyllotoxin (PTOX) was measured by high performance thin layer chromatography scanning. Through these methodologies, HsTD10 was identified as the hairy root line with the highest cytotoxicity and PTOX production, which was corroborated by liquid chromatography-mass spectrometry and micrOTOF-Q II. A suspension culture of HsTD10 was established in which PTOX and carbohydrate consumption during growth kinetics were quantified by high-performance liquid chromatography. Procedures to increase the production and retrieval of PTOX in the HsTD10 line included selection of culture medium, addition of thiamine, and modification of the PTOX extraction method. The best combination of these variables was MS medium at 75% of its components with the addition of 2 mg L-1 of thiamine, extraction with methanol-dichloromethane, and sonication at 40 ± 5°C. During kinetics, growth-associated PTOX accumulation was observed. The specific growth rate (µ) was 0.11 d-1. The highest concentration of PTOX obtained with HsTD10 (5.6 mg g-1 DW) was 100 times higher than that reported for roots of wild plants and 56 times higher than that for in vitro nontransformed roots of H. suaveolens.

Uso y aplicación de la tecnología de impresión y bioimpresión 3D en medicina / Use and application of 3D printing and bioimpression technology in medicine

RESUMEN En el mundo actual, las llamadas "tecnologías de fabricación por adición" o impresión 3D también llamado prototipado rápido, han trascendido las fronteras de casi todos los campos de la ciencia, y su incursión en la medicina es cada vez mayor. Es justamente en el campo médico que esta tecnología de impresión por adición ha evolucionado a la bioimpresión, que incluye un proceso de cultivo celular en laboratorio haciendo posible la formación de órganos y/o tejidos personalizados. Para la impresión tridimensional de órganos en humanos se toman muestras de un tejido o células madre del paciente, para ser cultivadas y expandidas en laboratorio para su posterior diferenciación a una línea celular específica. Para este proceso se utiliza un material sólido como andamio a temperatura ambiente con un punto de fusión conocido. En la creación de un modelo para la fabricación de un órgano o tejido en impresión 3D, se utilizan los estudios de imágenes médicas de los pacientes intentando preservar al máximo la anatomía de las estructuras que se desean reproducir. En este artículo se abordan las bases y el potencial uso de esta tecnología en el área médica.

ABSTRACT In today's world, so-called "addition manufacturing technologies" or 3D printing also called rapid prototyping have transcended the borders of almost every field of science and medicine is no exception. It is not surprising that its exploration for practical uses is increasing. In medicine, this technology of printing by addition has evolved to bioprinting, which occurs by a special process, from cells grown in a laboratory, which makes possible its transformation into a type of organs tailored to the patient. The three-dimensional impression of human organs requires take samples of tissues or stem cells from the patient, which are grown in the laboratory waiting to multiply or differentiate to other cell lines; then, to create said object, a solid material at room temperature and with a known melting point is applied layer by layer. Currently the use of this technology uses the medical images of patients trying to preserve the anatomy of the structures that they want to reproduce. In this article the bases and the potential use of this technology in the medical area will be addressed.