The branched mitochondrial respiratory chain from the jellyfish Stomolophus sp2 as a probable adaptive response to environmental changes.

During their long evolutionary history, jellyfish have faced changes in multiple environmental factors, to which they may selectively fix adaptations, allowing some species to survive and inhabit diverse environments. Previous findings have confirmed the jellyfish's ability to synthesize large ATP amounts, mainly produced by mitochondria, in response to environmental challenges. This study characterized the respiratory chain from the mitochondria of the jellyfish Stomolophus sp2 (previously misidentified as Stomolophus meleagris). The in-gel activity from isolated jellyfish mitochondria confirmed that the mitochondrial respiratory chain contains the four canonical complexes I to IV and F0F1-ATP synthase. Specific additional activity bands, immunodetection, and mass spectrometry identification confirmed the occurrence of four alternative enzymes integrated into a branched mitochondrial respiratory chain of Stomolophus sp2: an alternative oxidase and three dehydrogenases (two NADH type II enzymes and a mitochondrial glycerol-3-phosphate dehydrogenase). The analysis of each transcript sequence, their phylogenetic relationships, and each protein's predicted models confirmed the mitochondrial alternative enzymes' identity and specific characteristics. Although no statistical differences were found among the mean values of transcript abundance of each enzyme in the transcriptomes of jellyfish exposed to three different temperatures, it was confirmed that each gene was expressed at all tested conditions. These first-time reported enzymes in cnidarians suggest the adaptative ability of jellyfish's mitochondria to display rapid metabolic responses, as previously described, to maintain energetic homeostasis and face temperature variations due to climate change.

Development and validation of a real-time PCR assay protocol for the specific detection and quantification of pelagiphages in seawater samples.

Earth is inhabited by numerous adaptations of cellular forms shaped by the persistent scrutiny of natural selection. Thus, as natural selection has fixed beneficial adaptations of functional traits, cellular life has conquered almost all environmental niches on our planet. However, cellular life succumbs in number and genetic diversity to viruses. Among all viruses, phages are highly prevalent in diverse environments, and due to their vast genetic diversity and abundance, their relevant role as significant players in several ecological processes is now fully recognized. Pelagiphages, bacteriophages infecting bacteria of the SAR11 clade, are the most abundant viruses in the oceans. However, the ecological contribution of pelagiphages on populations of Pelagibacterales remains largely underestimated. An essential aspect of estimating the impact of bacteriophages is their absolute and precise quantification, which provides relevant information about the host-virus interactions and the structure of viral assemblages. Consequently, due to its abundance and claimed influence in the biogeochemical cycling of elements, the accurate quantification of pelagiphages results in an essential task. This study describes the development and validation of a sensitive, specific, accurate and reproducible qPCR platform targeting pelagiphages. Moreover, this method allowed the detection and quantification of pelagiphages in the Gulf of California for the first time.

The effects of physical activity on the modulation of gut microbiota composition: a systematic review.

Exercise induces many health benefits, preventing or treating diseases. On the other hand, the intestine houses trillions of microbes with the ability to influence the normal physiology of the organism. The intestinal microbiota is immensely diverse, varies between individuals, and can fluctuate according to various factors, including physical activity. In this sense, the aim of this systematic review is to search through the recent knowledge, in order to elucidate the roles played by different exercise modalities on modulation of the intestinal microbiota of adults. A literature search was performed in the PubMed, SCOPUS and Web of Science databases. The main inclusion criteria were randomised controlled trials involving exercise and microbiota in adults. The initial search identified 1,103 publications of which 13 were finally included. The heterogeneity of the training parameters used in the studies, statistical analyses, and sequencing methods did not allow us to carry out a meta-analysis. However, the results tend to show that modulation of the gut microbiome is related to the type of exercise, the intensity and the time of intervention, where these changes are more significant at the level of specific microbial populations than richness and diversity indices.

Effectiveness of Physical Exercise on Alzheimer's disease. A Systematic Review.

OBJECTIVE: A systematic review of randomized controlled trials was conducted to determine the effect of physical exercise on physical-functional capacity, cognitive performance, neuropsychiatric symptoms, and quality of life in a population of older people with Alzheimer´s disease. DATA SOURCES: Pubmed, Scopus, PEDro, Web of Science, CINAHL, Cochrane Library, grey literature and a reverse search from inception to April 2021 were searched to identify documents. STUDY SELECTION: Publications investigating the effect of any type of physical exercise-based intervention in any of its multiple modalities on physical-functional capacity, cognitive performance, neuropsychiatric symptoms, and quality of life were searched. DATA EXTRACTION: The data were extracted into predesigned data extraction tables. Risk of bias was evaluated through the PEDro scale and its internal validity scale. DATA SYNTHESIS: A total of 8 different randomized controlled trials with a total sample of 562 non-overlap Alzheimer disease patients between 50-90 years and a mean age of 75.2 ± 3.9 years were eligible for analyses. Physical-functional capacity was evaluated in 6 of 8 studies and cognitive performance was evaluated in 5 of 8 studies, all of them showed improvements in these variables when compared with the controls, except for two studies in physical-functional capacity and one study for cognitive performance. In the physical-functional capacity and cognitive performance variables, aerobic physical exercise was used in isolation, or in a multimodal way, combining aerobic, strength and balance exercise, from 2 to 7 weekly sessions with doses between 30 and 90 minutes, and a duration of the program comprised of 9 weeks to 6 months. Neuropsychiatric symptoms and quality of life were evaluated in 2 of 8 studies, which the intervention groups experienced significant improvements when compared with the control groups, except for one study that found similar differences in quality of life between both groups. In the neuropsychiatric symptoms and quality of life variables, only aerobic physical exercise was used, in a more homogeneous way, from 2 to 3 weekly sessions with doses of 30 to 60 minutes, and a total program duration of 9 to 16 weeks. CONCLUSIONS: Despite the scarcity of studies, especially those based on multimodal proposals, and the heterogeneity in the protocols, this systematic review found moderate to limited evidence that aerobic physical exercise on its own or combined in a multimodal program that also includes strength and balance exercise can be a useful tool in the management of patients with Alzheimer's disease with the aim of maintaining and/or improving physical-functional capacity and cognitive performance. In addition, this review found moderate evidence of the positive impact that aerobic physical exercise could have in reducing neuropsychiatric symptoms and improving quality of life in patients with Alzheimer´s disease. PROSPERO registration number: CRD42021229891.

Spatial and Temporal Distribution of Trace Metals in Shallow Marine Sediments of the Yucatan Shelf, Gulf of Mexico.

We investigated the spatial and temporal distribution of V and Cd in surface sediments of the Yucatan Shelf to establish current average values for the area. V and Cd concentrations are similar to those reported internationally for limestone rocks and surface marine sediments. The observed variability of V concentrations between cruises may be the result of changes in ocean current direction in summer (SW-S) and strong prevailing winds in autumn (N-NE). In addition to the hydrodynamics described above, Cd variations may also be associated with inputs of particulate material by upwelling events and subsequent transport and distribution to the shelf by the Yucatan Channel current (autumn). Considering that both metals showed significant spatial and temporal differences, a range of values for V (0.4-1.5 µg g-1) and Cd (0.05-0.2 µg g-1) are proposed as baseline reference for sediments of the Yucatan Shelf.

Vanadium and Cadmium in Shallow Marine Sediments: Spatial and Temporal Behavior in the Tamaulipas Continental Platform, Gulf of Mexico, Mexico.

This study analyzed 27 surface sediment samples from the Tamaulipas Continental shelf to determine the spatial-temporal distribution of V and Cd (spring-summer 2016; summer 2017). Average V concentrations (99 ± 18 mg g-1) were similar to that previously reported values for the area, while average Cd concentrations reflect uncontaminated sediments at surface level of the shelf. Inputs of V and Cd may be related to hydrocarbon and anthropogenic contributions from South and North of the Gulf of Mexico. The variability shown by both elements results from the hydrodynamics and hydrology of the area produced by local currents, eddies of the Loop Current, resuspension of fine sediments and contribution of terrigenous material. Considering that both metals showed significant differences (Shapiro-Wilk, p = 0), baseline concentrations could not be established, instead a reference interval of 79-122 µg g-1 for V and 0.121-0.258 µg g-1 for Cd in sediments from the Tamaulipas platform is suggested.

Vanadium and Cadmium in Water from the Perdido Area, Northwest of the Gulf of Mexico: 2 years' Monitoring and Current Status.

Surface water samples from the Perdido study area presented Cd and V concentrations similar to those reported internationally for waters with: (1) fossil fuel extraction, processing and burning, and (2) sites polluted by anthropogenic wastewater. Results showed an order of magnitude increase in time for Cd, therefore, no general average value was established. For V, however, results of this study suggest a general average value of 1.4 µg L-1 for the area. The observed spatial variation of concentrations could be the result of: (1) temporal variation of external inputs to the area, and coincide with previously reported hydrodynamic patterns of dispersion related to significant river contributions and accumulation areas indicative of eddy circulation or fronts. The Perdido area showed Cd and V concentrations in surface water reflective of anthropogenic impacts, while its spatial and temporal variation could depend significantly on the hydrodynamics of the area.

Spatial and Temporal Variations of Vanadium and Cadmium in Surface Water from the Yucatan Shelf.

Surface water samples from the Yucatan shelf presented Cd concentrations similar to those reported internationally for non-polluted coastal and marine waters. V concentrations, on the other hand, fall within the range of anthropogenically polluted waters (25% of the sampling sites). In the study area, the probable sources of V could be: (1) carbonate sediments leaching V into the water column and co-transported with fine sediments resuspending as a result of the complex hydrodynamics in the area or, (2) accidental spills from cargo ships transporting oil between the Atlantic and the Gulf of Mexico. Significant spatial and temporal differences were found for both metals; therefore, a regional interval concentration is suggested for V from 1.28 to 1.84 µg L-1 and Cd from 0.003 to 0.09 µg L-1. These differences could primarily be the result of the observed hydrology and hydrodynamics created by the Yucatan current, submarine groundwater discharges and upwelling.

Dataset of operating conditions to Isolate Cellulose Nanocrystalline from Sugarcane Bagasse and Pinewood Sawdust as Possible Material to Fabricate Polymer Electrolyte Membranes.

The data shown in this document provides all the experimental data that complement the article published in Carbohydrate Polymers entitled "Influence of operating conditions on Proton Conductivity of Nanocellulose films using two Agroindustrial Wastes: Sugarcane Bagasse and Pinewood Sawdust" [1]. The data of this paper are the result of a large series of experiments to optimize the extraction of cellulose nanocrystalline (CNC) from these two agro-industrial wastes: sugarcane Bagasse (SCB) and pinewood sawdust (PSW). The conditions of pretreatment (5 wt.% or 10 wt.% of NaOH) and hydrolysis temperature (60, 75 and 90°C) in an aqueous solution of 45 wt.% of H2SO4 were analyzed exhaustively. The data includes the characterization by Fourier transform infrared (FT-IR), Differential Scanning Calorimetry/Thermogravimetric Analysis (DSC/TGA), Dynamic Light Scattering (DLS), X-ray diffraction (XRD) patterns, Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM) micrographs with their corresponding SAED patterns and nanoindentation tests. Additionally, photographs during the isolation of cellulose nanocrystalline in dependence of the syntheses parameters. It is also included the data that complement the molecular dynamic simulation generated by GLYCAM carbohydrate builder based on the coordinates for alpha and beta cellulose considering a microfibril of 5, 10 and 20 glucosyl residues (degree of polymerization, DP). Overall data have not been previously published and are available contributing to a better understanding of the CNCs isolation through different pretreatment concentrations and temperatures of processing.

Influence of operating conditions on proton conductivity of nanocellulose films using two agroindustrial wastes: Sugarcane bagasse and pinewood sawdust.

Cellulose nanocrystals (CNCs) were isolated from two-agroindustrial wastes: sugarcane bagasse (SCB) and pinewood sawdust (PWS), to analyze their chemical, structural, morphological, and proton conduction properties in dependence of the synthesis parameters. In both sources, the isolated CNCs correspond to the monoclinic phase of cellulose type I and II. For SCB, the smallest CNCs were isolated, in a range of 3-10 nm, with 5 wt.% of NaOH and 60 °C of acid hydrolysis. PWS displayed the smallest sizes at 75 °C and 10 wt.% NaOH (40-110 nm). Membrane characterization suggests that isolated CNCs, between 75 and 90 °C of acid hydrolysis and 10 wt.% NaOH from both SCB and PWS sources, displayed an important increase in the proton conductivity, 1.23(±0.61)×10-5 and 9.26 (±0.24)×10-5 S-m-1, respectively. Thus, with proper synthesis conditions, CNCs can be potentially used as based element to obtain other proton conductor materials to fabricate PEMs.

The associations between menopausal symptoms and sleep quality in Spanish postmenopausal women.

Objectives: Around the menopause, sleep disturbances frequently occur or worsen and are associated with decreased health quality and physical and psychological problems. The aim of this study was to analyze sleep quality and its association with the impact of menopausal symptoms in Spanish postmenopausal women. Methods: A total of 278 postmenopausal women (age 60.95 ± 8.01 years) participated in this cross-sectional study. The Medical Outcomes Study Sleep Scale (MOS-SS) and the Menopause Rating Scale (MRS) were used to analyze sleep quality and severity of menopausal symptoms, respectively. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Results: The linear regression showed that a greater impact of menopausal symptoms (MRS total score) was associated with worse scores regarding sleep adequacy (p < 0.001, R2 = 0.056), snoring (p = 0.020, R2 = 0.036), awaken short of breath (p < 0.001, R2 = 0.089), and quantity of sleep (p < 0.001, R2 = 0.075) domains. Anxiety (p < 0.001) and worse somatic symptoms (p = 0.001) were related to greater sleep disturbances (R2 = 0.164). We also found relationships of heightened psychological symptoms (p < 0.001) and low physical activity level (p = 0.003) with increased daytime somnolence (R2 = 0.064). Finally, higher MRS total score and anxiety levels were associated with worse sleep quality assessed by MOS-SS Sleep Problems Index I (R2 = 0.179, p < 0.001 and p = 0.001, respectively) and Sleep Problems Index II (R2 = 0.146, p < 0.001 and p = 0.011, respectively). Conclusions: Anxiety and severity of menopausal symptoms were associated with poorer sleep quality. Furthermore, low physical activity level and worse psychological symptoms in menopause were predictors for increased somnolence. Therefore, screening for these factors in postmenopausal women is important, since they may be susceptible for intervention.

Expression and enzymatic activity of phenylalanine ammonia-lyase and p-coumarate 3-hydroxylase in mango (Mangifera indica 'Ataulfo') during ripening.

Phenylalanine ammonia lyase (PAL) and p-coumarate 3-hydroxylase (C3H) are key enzymes in the phenylpropanoid pathway. The relative expression of PAL and C3H was evaluated in mango fruit cultivar 'Ataulfo' in four ripening stages (RS1, RS2, RS3, and RS4) by quantitative polymerase chain reaction. In addition, enzyme activity of PAL and C3H was determined in mango fruits during ripening. The PAL levels were downregulated at the RS2 and RS3 stages, while C3H levels were upregulated in fruits only at RS3. The enzyme activity of PAL followed a pattern that was different from that of the PAL expression, thus suggesting regulation at several levels. For C3H, a regulation at the transcriptional level is suggested because a similar pattern was revealed by its activity and transcript level. In this study, the complexity of secondary metabolite biosynthesis regulation is emphasized because PAL and C3H enzymes are involved in the biosynthesis of several secondary metabolites that are active during all mango ripening stages.

The cytochrome c oxidase and its mitochondrial function in the whiteleg shrimp Litopenaeus vannamei during hypoxia.

Cytochrome c oxidase (COX), which is located in the inner membrane of mitochondria, is a key constituent of the electron transport chain that catalyzes the reduction of oxygen. The Pacific whiteleg shrimp Litopenaeus vannamei is constantly exposed to hypoxic conditions, which affects both the central metabolism and the mitochondrial function. The purpose of this study was to isolate shrimp mitochondria, identify the COX complex and to evaluate the effect of hypoxia on the shrimp mitochondrial function and in the COX activity. A 190 kDa protein was identified as COX by immunodetection techniques. The effect of hypoxia was confirmed by an increase in the shrimp plasma L-lactate concentration. COX activity, mitochondrial oxygen uptake and protein content were reduced under hypoxic conditions, and gradually restored as hypoxia continued, this suggests an adaptive mitochondrial response and a highly effective COX enzyme. Both mitochondrial oxygen uptake and COX activity were completely inhibited by KCN and sodium azide, suggesting that COX is the unique oxidase in L. vannamei mitochondria.

Three nucleus-encoded subunits of mitochondrial cytochrome c oxidase of the whiteleg shrimp Litopenaeus vannamei: cDNA characterization, phylogeny and mRNA expression during hypoxia and reoxygenation.

The mitochondrial cytochrome c oxidase (COX) catalyzes the reduction of oxygen to water playing a key role in the respiratory chain and ATP synthesis. The nucleus-encoded COX subunits do not participate in catalysis, but some are known to play a role in the expression, assembly and activity of the enzyme. Since hypoxia continuously affects the shrimp environment, it is important to study COX to understand their ability to deal with low oxygen levels. The goal of this research was to characterize the complementary DNA (cDNA) sequences of three nucleus-encoded subunits -coxIV, coxVa, and coxVb- and to evaluate the shrimp COX response to hypoxia by measuring their gene expression. The cDNA sequence of coxIV consisted of 532bp, which encodes a 17.47kDa protein, while coxVa cDNA consisted of 460bp and coded a protein of 17.11kDa, and the coxVb coding sequence consisted of 364bp encoding a 13.74kDa protein. Shrimp subunits do not have isoforms, and they are not differentially expressed during hypoxia, as observed in mammals. Coordinated changes were detected in the mRNA amounts of nuclear and mitochondrial subnits; these changes, at the transcriptional level, are suggested to be controlled through transcriptional factors Sp1 and NRF2.

The function of mitochondrial F(O)F(1) ATP-synthase from the whiteleg shrimp Litopenaeus vannamei muscle during hypoxia.

The effect of hypoxia and re-oxygenation on the mitochondrial complex F(O)F(1)-ATP synthase was investigated in the whiteleg shrimp Litopenaeus vannamei. A 660 kDa protein complex isolated from mitochondria of the shrimp muscle was identified as the ATP synthase complex. After 10h at hypoxia (1.5-2.0 mg oxygen/L), the concentration of L-lactate in plasma increased significantly, but the ATP amount and the concentration of ATPß protein remained unaffected. Nevertheless, an increase of 70% in the ATPase activity was detected, suggesting that the enzyme may be regulated at a post-translational level. Thus, during hypoxia shrimp are able to maintain ATP amounts probably by using some other energy sources as phosphoarginine when an acute lack of energy occurs. During re-oxygenation, the ATPase activity decreased significantly and the ATP production continued via the electron transport chain and oxidative phosphorylation. The results obtained showed that shrimp faces hypoxia partially by hydrolyzing the ATP through the reaction catalyzed by the mitochondrial ATPase which increases its activity.

Cathepsin B from the white shrimp Litopenaeus vannamei: cDNA sequence analysis, tissues-specific expression and biological activity.

Cathepsin B is a cystein proteinase scarcely studied in crustaceans. Its function has not been clearly described in shrimp species belonging to the sub-order Dendrobranchiata, which includes the white shrimp Litopenaeus vannamei and other species from the Penaeidae family. Studies on vertebrates suggest that these lysosomal enzymes intracellularly hydrolize protein, as other cystein proteinases. However, the expression of the gene encoding the shrimp cathepsin B in the midgut gland was affected by starvation in a similar way as other digestive proteinases which extracellularly hydrolyze food protein. In this study the white shrimp L. vannamei cathepsin B (LvCathB) cDNA was sequenced, and characterized. Its gene expression was evaluated in various shrimp tissues, and changes in the mRNA amounts were compared with those observed on other digestive proteinases from the midgut gland during starvation. By using qRT-PCR it was found that LvCathB is expressed in most shrimp tissues except in pleopods and eye stalk. Changes on LvCathB mRNA during starvation suggest that the enzyme participates during intracellular protein hydrolysis but also, after food ingestion, it participates in hydrolyzing food proteins extracellularly as confirmed by the high activity levels we found in the gastric juice and midgut gland of the white shrimp.

[Non-compacted cardiomyopathy: an uncommon cause of ventricular tachycardia]. / Miocardiopatía no compactada: una causa poco frecuente de taquicardia ventricular.

We present the case of a patient who was previously diagnosed of hypertrophic cardiomyopathy. The patient was admitted to our coronary unit due to a sustained ventricular tachycardia picture. A coronariography was performed as part of the ventricular tachycardia study protocol. It showed angiographically normal epicardic arteries. In the ventriculography, there was a pattern of dilated cardiomyopathy with prominent left ventricular trabeculation, which suggested the diagnosis of non-compacted cardiomyopathy (NCC). The findings of the transthoracic echocardiography, that showed a dilated and hypertrophic left ventricle, with very depressed systolic function, and ventricular myocardium with a thick internal non-compacted endocardium, with a meshwork of multiple trabeculations and intracardic recesses in communication with the ventricular cavity, confirmed this diagnosis. There continues to be little knowledge on NCC and thus it is probably underdiagnosed. It must be considered in the differential diagnosis of patients diagnosed of hypertrophic or dilated cardiomyopathy.

Miocardiopatía no compactada: una causa poco frecuente de taquicardia ventricular / Non-compacted cardiomyopathy: an uncommon cause of ventricular tachycardia

Presentamos el caso de un paciente, diagnosticado previamente de miocardiopatía hipertrófica, que ingresó en nuestra Unidad Coronaria por un cuadro de taquicardia ventricular sostenida. Como parte del protocolo de estudio de la taquicardia ventricular se le realizó una coronariografía que mostró arterias epicárdicas angiográficamente normales. En la ventriculografía se apreció un patrón de micardiopatía dilatada con llamativa trabeculación del ventrículo izquierdo, sugiriendo el diagnóstico de miocardiopatía no compactada (MNC). Los hallazgos de la ecocardiografía transtorácica, en la que se apreció un ventrículo izquierdo dilatado e hipertrófico con una función sistólica muy deprimida, y un miocardio ventricular con una gruesa capa interna endocárdica no compactada, con una malla de múltiples trabeculaciones y recesos intramiocárdicos en comunicación con la cavidad ventricular, confirmaron este diagnóstico. La MNC sigue siendo una patología poco conocida, y probablemente por ello infradiagnosticada. Hay que considerarla en el diagnóstico diferencial de pacientes afectos de miocardiopatía hipertrófica o dilatada

We present the case of a patient who was previously diagnosed of hypertrophic cardiomyopathy. The patient was admitted to our coronary unit due to a sustained ventricular tachycardia picture. A coronariography was performed as part of the ventricular tachycardia study protocol. It showed angiographically normal epicardic arteries. In the ventriculography, there was a pattern of dilated cardiomyopathy with prominent left ventricular trabeculation, which suggested the diagnosis of non-compacted cardiomyopathy (NCC). The findings of the transthoracic echocardiography, that showed a dilated and hypertrophic left ventricle, with very depressed systolic function, and ventricular myocardium with a thick internal non-compacted endocardium, with a meshwork of multiple trabeculations and intracardic recesses in communication with the ventricular cavity, confirmed this diagnosis. There continues to be little knowledge on NCC and thus it is probably underdiagnosed. It must be considered in the differential diagnosis of patients diagnosed of hypertrophic or dilated cardiomyopathy

[Use of methylene blue in the treatment of vasoplegic syndrome of post-operative heart surgery]. / Utilización de azul de metileno en el tratamiento del síndrome vasopléjico del postoperatorio de cirugía cardíaca.

Vasoplegia is a frequent complication in post-operative heart surgery and determines a significant increase in morbidity-mortality. When vasoplegia persists in spite of optimized fluid therapy with the use of Swan-Ganz catheter, we have a safe, effective and economical alternative, methylene blue. We present the case of a patient who developed vasoplegia refractory to treatment and shock in the scheduled post-operative period of myocardial revascularization. The use of a single dose of methylene blue resolved the hemodynamic instability and allowed for total discontinuation of vasoactive drugs. Thus, we present this new indication of methylene blue, still not approved by the corresponding bodies, for which no national publications have been found and its clinical management and the absence of adverse effects after its use.

Utilización de azul de metileno en el tratamiento del síndrome vasopléjico del postoperatorio de cirugía cardíaca / Use of methylene blue in the treatment of vasoplegic syndrome of post-operative heart surgery

La vasoplejía es una complicación frecuente en el postoperatorio de cirugía cardíaca y determina un importante aumento en la morbi-mortalidad. Cuando a pesar de una fluidoterapia optimizada con el uso del catéter Swan-Ganz y una perfusión de noradrenalina persiste la vasoplejía, disponemos de una alternativa segura, eficaz y económica, el azul de metileno. Presentamos el caso de un paciente que en el postoperatorio programado de revascularización miocárdica desarrolló una vasoplejía refractaria al tratamiento y shock. La utilización de una sola dosis de azul de metileno resolvió la inestabilidad hemodinámica y permitió la suspensión total de los fármacos vasoactivos. Por tanto, se expone esta novedosa indicación del azul de metileno, aún no aprobada por los organismos correspondientes, de la que no hemos encontrado publicaciones nacionales, así como su manejo clínico y la ausencia de efectos adversos tras su utilización

Vasoplegia is a frequent complication in post-operative heart surgery and determines a significant increase in morbidity-mortality. When vasoplegia persists in spite of optimized fluid therapy with the use of Swan-Ganz catheter, we have a safe, effective and economical alternative, methylene blue. We present the case of a patient who developed vasoplegia refractory to treatment and shock in the scheduled post-operative period of myocardial revascularization. The use of a single dose of methylene blue resolved the hemodynamic instability and allowed for total discontinuation of vasoactive drugs. Thus, we present this new indication of methylene blue, still not approved by the corresponding bodies, for which no national publications have been found and its clinical management and the absence of adverse effects after its use