The potential of CRISPR-Cas9 prime editing for cardiovascular disease research and therapy.

PURPOSE OF REVIEW: The ability to edit any genomic sequence has led to a better understanding of gene function and holds promise for the development of therapies for genetic diseases. This review describes prime editing - the latest CRISPR-Cas9 genome editing technology. Prime editing enables precise and accurate genome editing in terminally differentiated, postmitotic cells like cardiomyocytes, paving the way for therapeutic applications for genetic cardiomyopathies. RECENT FINDINGS: Prime editing has been used to precisely insert up to 40 bases, create deletions up to 80 base pairs, and can perform all 12 possible transition and transversion base mutations with lower indels and off-target effects than other genome editing methods. The development of several software tools has simplified the experimental design and led to increased efficiency of the process. Improvements in methods for in-vivo delivery of the prime editing components should enable this technology to be used to edit the genome in patients. SUMMARY: Prime editing has the potential to revolutionize the future of biomedical research and transform cardiovascular medicine. Improved understanding of the prime editing process and developments in agent design, efficacy and delivery will benefit scientists and patients and could be an effective way to cure cardiovascular diseases.

Risk factors for surgical failure in patients undergoing surgery for primary hyperparathyroidism.

INTRODUCTION: Primary hyperparathyroidism is the third most common endocrine disease. The aim of our study was to determine long-term outcomes and risk factors for persistence in patients undergoing parathyroidectomy for primary hyperparathyroidism. METHODS: Retrospective study including patients undergoing parathyroidectomy between 2009-2019. Cure was defined as reestablishment of normal calcium homeostasis lasting a minimum of 6 months. Persistence was defined by ongoing hypercalcemia more than 6 months after surgery. Recurrent PHTP was defined by recurrence of hypercalcemia after a normocalcemic interval at more than 6 months after surgery. A more detailed analysis was performed on patients with normocalcemia and persistently elevated PTH levels after surgery. Variables independently related to persistence were analyzed by multivariate analysis. RESULTS: We included 212 patients. Mean age was 59 years and 83% were women. Cure was observed in 204 patients (96.2%), persistence in 8 (3.8%) and recurrence in 3 (1.4%). Four patients (1.9%) presented normocalcemia and persistently elevated PTH after surgery. All presented parathyroid pathology (2 adenomas and 2 hyperplasia). In follow-up we observed that adenoma subgroup presented one patient with CKD and one with vitamin D deficiency while in the hyperplasia subgroup two patients presented CKD. Persistence was independently associated with hyperplasia (Odds ratio = 12.6, IC95% = 1.28-124, p = 0.030) and normal parathyroid tissue (Odds ratio = 188, IC95% = 9.33-379, p = 0.001) on histopathological report. CONCLUSION: Primary hyperparathyroidism is a safe procedure in terms of morbidity and long-term outcomes. Hyperplasia and normal parathyroid tissue on histopathological report are risk factors for persistence. An interdisciplinary diagnostic and therapeutic approach is required to prevent persistence.

Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms.

INTRODUCTION: Microvascular free-flap reconstruction is one of the treatment options after large resection of head and neck neoplasms. The objectives of this study are to identify short-term outcomes and risk factors for flap complication in patients who underwent neoplasms resection of head and neck with microvascular free-flap reconstruction. METHODS: Retrospective study of patients who underwent surgery for head and neck neoplasm with microvascular free-flap reconstruction between January 2014-2020. Complications were studied at 30-days follow-up and divided into medical and flap complications. Factors independently associated with flap complication were analyzed. RESULTS: We included 31 patients (15 men). The mean age was 60 years. Reconstruction was performed with radial-forearm flap in 74% (n=23) and with free-fibula flap in 26% (n=8). Mean surgical time was 420 minutes. Median hospital length of stay was 7 days. Medical complications were of 23%. Minor complications were of 35% and major of 32%. There was no mortality in 30-days follow-up. Flap complications were of 35%. Reintervention was of 29%, surgical site infection of 9%, dehiscence of 29% and flap loss of 9.7%.  Surgical site infection was independently associated with prolonged surgical time (Odds ratio [OR]=1.03, IC95%=0.98-1.04, p=0.02) and body mass index equal to or greater than 30 (OR=1.38, IC95%=0.84-2.26, p=0.04) while flap loss was associated with prolonged surgical time (OR=1.02, IC95%=0.99-1.04, p=0.01). CONCLUSION: Microsurgical free-flap reconstruction should be considered in our population in patients with large head and neck neoplasms. Preoperative assessment of the risk of postoperative complications is essential before selecting patients for this surgery.

Risk factors for surgical failure in patients undergoing surgery for primary hyperparathyroidism. / Factores de riesgo de persistencia en pacientes con tratamiento quirúrgico de hiperparatiroidismo primario.

INTRODUCTION: Primary hyperparathyroidism is the third most common endocrine disease. The aim of our study was to determine long-term outcomes and risk factors for persistence in patients undergoing parathyroidectomy for primary hyperparathyroidism. METHODS: Retrospective study including patients undergoing parathyroidectomy between 2009- 2019. Cure was defined as reestablishment of normal calcium homeostasis lasting a minimum of 6 months. Persistence was defined by ongoing hypercalcemia more than 6 months after surgery. Recurrent PHTP was defined by recurrence of hypercalcemia after a normocalcemic interval at more than 6 months after surgery. A more detailed analysis was performed on patients with normocalcemia and persistently elevated PTH levels after surgery. Variables independently related to persistence were analyzed by multivariate analysis. RESULTS: We included 212 patients. Mean age was 59 years and 83% were women. Cure was observed in 204 patients (96.2%), persistence in 8 (3.8%) and recurrence in 3 (1.4%). Four patients (1.9%) presented normocalcemia and persistently elevated PTH after surgery. All presented parathyroid pathology (2 adenomas and 2 hyperplasia). In follow-up we observed that adenoma subgroup presented one patient with CKD and one with vitamin D deficiency while in the hyperplasia subgroup two patients presented CKD. Persistence was independently associated with hyperplasia (Odds ratio=12.6, IC95%=1.28-124, p=0.030) and normal parathyroid tissue (Odds ratio=188, IC95%=9.33-379, p=0.001) on histopathological report. CONCLUSIóN: Primary hyperparathyroidism is a safe procedure in terms of morbidity and long-term outcomes. Hyperplasia and normal parathyroid tissue on histopathological report are risk factors for persistence. An interdisciplinary diagnostic and therapeutic approach is required to prevent persistence.

The utility of real-world evidence for benefit-risk assessment, communication, and evaluation of pharmaceuticals: Case studies.

PURPOSE: In recent years, novel types of real-world evidence (RWE) have played a role in various decision-making processes relating to medicinal products, including regulatory approval, patient access, health technology assessment, safety monitoring, clinical use, and post-approval lifecycle management. We therefore reviewed the potential utility of RWE in the cycle of medicinal product benefit-risk (BR) assessment, communication/risk minimization and evaluation ("BRACE"). METHODS: A convenience sample of illustrative studies was drawn from the published literature and examined. Specifically, we examined the purpose for using RWE, the type of RWE used, its novelty and how it might be integrated with other data and activities of the BRACE cycle, and how it contributed to regulatory decision-making. RESULTS: Eight studies were selected with each illustrating a different activity in the BRACE cycle ranging from BR assessment in the preapproval setting, post-approval assessment of safety or effectiveness, communicating BR information to patients and healthcare professionals, and evaluating the effectiveness of risk minimization initiatives to support a positive BR balance. CONCLUSIONS: RWE has an important role in informing regulatory decision-making regarding the BR management of medicines. With increasing digitalization, facilitating data collection and stakeholder engagement in health, this role is only expected to expand in the future. To reach the full potential of RWE, both regulators and sponsors will need to be familiar with a range of existing and emerging methods for generating and analyzing such evidence appropriately and achieve convergence regarding how different types of RWE can best be used to inform BR management and decision-making.

Effects of silver nanoparticles on T98G human glioblastoma cells.

Nanotechnology has been well developed in recent decades because it provides social progress and welfare. Consequently, exposure of population is increasing and further increases in the near future are forecasted. Therefore, assessing the safety of applications involving nanoparticles is strongly advisable. We assessed the effects of silver nanoparticles at a non-cytotoxic concentration on the performance of T98G human glioblastoma cells mainly by an omic approach. We found that silver nanoparticles are able to alter several molecular pathways related to inflammation. Cellular repair and regeneration were also affected by alterations to the fibroblast growth factor pathways operating mainly via mitogen-activated protein kinase cascades. It was concluded that, given the relevant role of glia on central nervous system maintenance homeostasis, exposure to silver nanoparticles could eventually lead to severe toxicity in the central nervous system, although current exposure levels do not pose a significant risk.

Challenges facing drug utilization research in the Latin American region.

PURPOSE: The International Society of Pharmacoepidemiology (ISPE) in collaboration with the Latin America Drug Utilization Research Group (LatAm DURG), the Medicines Utilization Research in Africa (MURIA) group, and the Uppsala Monitoring Center, is leading an initiative to understand challenges to drug utilization research (DUR) in the Latin American (LatAm) and African regions with the goal of communicating results and proposing solutions to these challenges in four scientific publications. The purpose of this first manuscript is to identify the main challenges associated with DUR in the LatAm region. METHODS: Drug utilization (DU) researchers in the LatAm region voluntarily participated in multiple discussions, contributed with local data and reviewed successive drafts and the final manuscript. Additionally, we carried out a literature review to identify the most relevant publications related to DU studies from the LatAm region. RESULTS: Multiple challenges were identified in the LatAm region for DUR including socioeconomic inequality, access to medical care, complexity of the healthcare system, limited investment in research and development, limited institutional and organization resources, language barriers, limited health education and literacy. Further, there is limited use of local DUR data by decision makers particularly in the identification of emerging health needs coming from social and demographic transitions. CONCLUSIONS: The LatAm region faces challenges to DUR which are inherent in the healthcare and political systems, and potential solutions should target changes to the system.

Investigación básica experimental para la definición de los parámetros críticos en el proceso de obtención de soluciones concentradas de propóleos (SCP) / Experimental basic research to define critical parameters in the process of obtaining concentrated solutions of propolis (CSP)

Introducción: los procesos de obtención de SCP han sido desarrollados por diferentes investigadores tanto a nivel nacional como internacional. Objetivo: definir los parámetros críticos del proceso de obtención de SCP, para incrementar el rendimiento y la calidad de este producto y sus derivados. Métodos: se utilizó el método de purificación de Pichansky, con algunas modificaciones en las siguientes variables: relación masa/volumen, concentración del etanol y el tiempo de agitación. Los materiales utilizados están avalados por el Sistema de Gestión de Calidad del Centro. Resultados: las variantes #2 y #4 del proceso de extracción, utilizadas a escala de laboratorio, son las de mejores resultados, ya que se obtuvo un rango de porcentaje sólidos totales entre un 12,4 y 14,3 %, con un rendimiento entre un 48,5 y 83,0 %; siendo seleccionada la variante #4 para elaborar los lotes experimentales a escala de reactor. Conclusiones: las variables estudiadas: tiempo de agitación, concentración de etanol y relación masa/volumen, así como el porcentaje de los sólidos totales, el porcentaje del rendimiento y las propiedades organolépticas, respondieron positivamente en las variantes #2 y #4, las cuales permitieron cumplir con los objetivos propuestos en esta investigación, y pueden emplearse en la elaboración de los lotes productivos dependiendo de la concentración de las soluciones alcohólicas de propóleos que se quieran producir.

Introduction: SCP's processes of obtaining Propolis have been developed by different investigators so much nationally like international. Objective: To define SCP's critical parameters of the process of obtaining, to increment the performance and the quality of this product and his by-products. Methods: Pichansky's method of purification, with some modifications was utilized to the variables following: Relation mass/volume, concentration of ethanol and the time of agitation. The utilized materials are guaranteed for the Quality Management System of the Center. Results: The variants #2 and #4 of the process of extraction, utilized to scale of laboratory, gave better results, obtaining percentage's range solid totals between 12.4 and 14.3 %, with a performance between 48.5 and 83.0 %. Variant #4 was selected in order to make the experimental lots at reactor scale. Conclusions: the studied variables: Time agitation, concentration of ethanol and the relation mass/volume, as well as the percentage of the solid totals, the percentage of the performance and organoleptic properties, of variants #2 and #4, allowed carrying out the objectives proposed in this investigation. These variables responded positively in the variants and can be used in the elaboration of the productive lots considering the concentration of alcoholic propolis' solutions required.

Optimización de la extracción alcohólica para la obtención de soluciones concentradas de propóleos / Optimization of the alcoholic extraction to obtain concentrated solutions of propolis

Introducción: existen distintos métodos para la obtención de soluciones concentradas de propóleos, utilizados por diferentes autores tanto en el ámbito nacional como internacional. En este trabajo se propone una variante del método Pichansky que consiste en una secuencia de pasos de extracción/filtración, para optimizar el proceso de obtención de soluciones alcohólicas concentradas de propóleos en el Centro de Inmunología y Biopreparados de Holguín. Objetivo: optimizar el proceso de obtención de las soluciones alcohólicas concentradas de propóleos que contribuya a eliminar contaminantes disueltos y elevar la calidad del producto final. Materiales y métodos: para la obtención de las soluciones se emplearon tres lotes experimentales y se realizaron tres extracciones alcohólicas sucesivas con filtraciones intermedias a temperatura controlada. Los parámetros de calidad se determinaron según procedimientos del Sistema de Gestión implantado, realizándose una comparación entre los lotes experimentales y los lotes elaborados posteriormente en el proceso de producción utilizando la misma variante del método de extracción. La información se procesó estadísticamente mediante un análisis de medias con el software Medcal. Resultados: en los resultados se obtuvieron valores óptimos de concentración de sólidos totales superior al 30% para todos los lotes ensayados de las soluciones concentradas, las propiedades organolépticas se encuentran dentro de los estándares de calidad establecidos. Conclusiones: se logró optimizar el proceso de obtención de la solución concentrada de propóleos manteniendo la conformidad del producto, lográndose un mejor agotamiento de la materia prima, teniendo en cuenta la incorporación de un tercer paso en el proceso de elaboración y la filtración a temperatura controlada.

Introduction: There are different methods to obtain concentrated propolis solution that have used by different national and international authors. In this document a variant of Pichansky method is proposed to optimize the process for obtaining concentrated propolis in the Immunology and Blood by Product Center. Objective: To optimize the process of obtaining concentrated propolis alcoholic solutions through a sequence of steps of extraction/filtration to remove dissolved contaminants and increase the quality of the final product. Materials and methods: To obtain solutions, three experimental plots were performed. This process was executed with three successive extractions using alcohol intermediate to temperature controlled. The quality parameters were determined according to procedures implemented of management system. A comparison was performed between experimental batches and batches subsequently produced with the change. The information was processed statistically by means of (means t-test) with Medcal software. Results: The optimal values of volume of total solids concentration above 30% were obtained for all tested batches of concentrated solutions, the organoleptic properties were found according to the standard quality. Conclusions: It was possible to optimize the process of obtaining the propolis concentrated solution of maintaining product compliance, achieving a better recovery of the first product due to considering the addition of a third step in the process with a controlled temperature.

Resultados del proceso productivo de la solución concentrada de propóleos 2010-2013. Impacto de la innovación tecnológica / Results of the production process of the concentrated solution of propolis 2010-2013. Impact of technological innovation

El proceso productivo de las soluciones concentradas de propóleos en el Centro de Inmunología y Biopreparados, ha sido una tarea esencial desde el 2010; por consiguiente, el objetivo fundamental de este trabajo es mostrar cómo se han comportado los parámetros de calidad de los lotes de estas soluciones desde el 2010 al 2013, teniendo en cuenta los elementos de innovación tecnológica desarrollados. Se analizaron los requisitos de conformidad de las soluciones concentradas de propóleos, según los registros de control de la calidad para este producto. El procesamiento estadístico se realizó de forma automatizada con el programa estadístico Medcal. Las propiedades organolépticas de estas soluciones respondieron de forma positiva y las concentraciones de sólidos totales fueron superiores al 24%. Es importante señalar que en los lotes obtenidos en 2012 y 2013, se logró un agotamiento significativo de la materia prima, debido a la introducción de cambios tecnológicos en el proceso; aspecto este que no afectó la calidad del producto, ya que los sólidos totales están por encima del 16% establecido en el Sistema de Gestión de Calidad del Centro, corroborándose los mismos con el análisis estadístico realizado. Se obtuvo un producto conforme y con calidad, lográndose una mejor recuperación de los principios activos de estas soluciones.

The production process of Propolis Concentrated Solutions Center for Immunology and Biologicals, has been an essential task since 2010, so we have performed show how the parameters of quality of batches of these solutions from 2010 to 2013, is the main objective of this work taking into account the factors of technological innovation developed. Compliance requirements of Propolis Concentrated solutions were analyzed according to the records of Quality Control for this product. The statistical processing was performed automatically using the statistical program Medcal. The organoleptic properties of these solutions responded positively and total solids concentrations were higher than 24%, it is important to note that the lots obtained in 2012 and 2013, a significant depletion of the raw material was obtained, due to the introduction of technological changes in the process, appearance is not affected the quality of the product and the total solids are above the 16% set in the quality Management System of the center, corroborating them with statistical analysis. Conforming product quality and achieving a better recovery of the active ingredients of these solutions were obtained.

Lesión quirúrgica de la vía biliar de la variante anatómica de la confluencia tipo F. Importancia de la colangiografía intra-operatoria sistemática y las alternativas terapéuticas.

Surgical injury of the biliary tract have increased in the laparoscopic cholecystectomy era, anatomic variants of the biliary ducts, mainly the type F, is likely to receive this kind of injury. Cholangiography helps to prevent such complications, so, we recommended the execution of this procedure in a routine way. Treatment usually is complex and requires trained surgeons.

[Complications of conventional and laparoscopic gastric bypass. Prospective and comparative study]. / Complicaciones del bypass gástrico convencional y laparoscópico. Estudio prospectivo y comparativo.

BACKGROUND: Roux-en-y gastric bypass for the management of morbid obesity is currently the safest and more efficient treatment option. the laparoscopic era has shown its benefits in this type of surgery, so some authors advocate its implementation in a practical systematic way. all of which has lead in recent years to the unavoidable change in the surgical approach. OBJECTIVES: To evaluate and compare the complications of laparoscopic gastric bypass and the conventional one in patients with morbid obesity. Application site: self-administration national university hospital. DESIGN: Comparative, prospective no randomized study. POPULATION: Between 2002 and 2011, 420 morbidly obese patients received surgical treatment for the obesity either open (167) or laparoscopic (253) surgery RESULTS: Early postoperative complication rate was 4% in the lbg and 34% in the cbg (p < 05, 95%ci 22-38), mostly represented by seromas (25%) and wall abscesses (5.4%). the percentage of late postoperative complications was 2.8% in the lbg group and 9.6% in the cbg (p=0.004, 95%ci 1.4-12.2), the most frequent being incisional hernias (7.18%). CONCLUSIONS: According to our experience and consulted literature, laparoscopic gastric bypass is a safe, reproducible and with a lower rate of both early and late complications than cbg, and so we consider and offer lbg as the ideal technique for the treatment of patients with morbid obesity.

Antecedentes: el bypass gástrico en y de roux para el tratamiento de la obesidad mórbida representa hoy en día la opción terapéutica más segura y eficiente. la era laparoscópica ha demostrado sus beneficios en este tipo de cirugía, por lo que algunos autores abogan por su implementación en forma casi sistemática, conduciendo en los últimos años al inexorable cambio en la vía de abordaje. Objetivos: evaluar y comparar las complicaciones del bypass gástrico laparoscópico y convencional en pacientes con obesidad mórbida. Lugar de aplicación: hospital nacional universitario de autogestión. Diseño: estudio comparativo, prospectivo no randomizado. Población: entre el 2002 y 2011, 420 pacientes con obesidad mórbida recibieron un tratamiento quirúrgico para la obesidad ya sea en forma laparoscópica (253) o convencional (167). Resultados: el porcentaje de complicaciones postoperatorias tempranas fue del 4% en el grupo bgl y del 34% en el bgc (p <05, ic95% 22 - 38), representadas en su mayoría por seromas (25%) y abscesos de pared (5,4%). el porcentaje de complicaciones postoperatorias tardías fue del 2,8% en el grupo bgl y del 9,6% en el bgc (p= 0.004, ic95% 1,4 - 12,2), siendo las más frecuentes las eventraciones (7,2%). Conclusiones: de acuerdo a nuestra experiencia y a la literatura consultada, el bypass gástrico laparoscópico es un procedimiento seguro, reproducible y con una menor tasa de complicaciones tanto tempranas como tardías que el bg c, por lo que consideramos y ofrecemos al bgl como técnica ideal en el tratamiento de los pacientes con obesidad mórbida.

Complicaciones del bypass gástrico convencional y laparoscópico. Estudio prospectivo y comparativo / [Complications of conventional and laparoscopic gastric bypass. Prospective and comparative study].

BACKGROUND: Roux-en-y gastric bypass for the management of morbid obesity is currently the safest and more efficient treatment option. the laparoscopic era has shown its benefits in this type of surgery, so some authors advocate its implementation in a practical systematic way. all of which has lead in recent years to the unavoidable change in the surgical approach. OBJECTIVES: To evaluate and compare the complications of laparoscopic gastric bypass and the conventional one in patients with morbid obesity. Application site: self-administration national university hospital. DESIGN: Comparative, prospective no randomized study. POPULATION: Between 2002 and 2011, 420 morbidly obese patients received surgical treatment for the obesity either open (167) or laparoscopic (253) surgery RESULTS: Early postoperative complication rate was 4

in the lbg and 34

in the cbg (p < 05, 95

ci 22-38), mostly represented by seromas (25

) and wall abscesses (5.4

). the percentage of late postoperative complications was 2.8

in the lbg group and 9.6

in the cbg (p=0.004, 95

ci 1.4-12.2), the most frequent being incisional hernias (7.18

). CONCLUSIONS: According to our experience and consulted literature, laparoscopic gastric bypass is a safe, reproducible and with a lower rate of both early and late complications than cbg, and so we consider and offer lbg as the ideal technique for the treatment of patients with morbid obesity.

Complicaciones del bypass gástrico convencional y laparoscópico. Estudio prospectivo y comparativo. / [Complications of conventional and laparoscopic gastric bypass. Prospective and comparative study].

BACKGROUND: Roux-en-y gastric bypass for the management of morbid obesity is currently the safest and more efficient treatment option. the laparoscopic era has shown its benefits in this type of surgery, so some authors advocate its implementation in a practical systematic way. all of which has lead in recent years to the unavoidable change in the surgical approach. OBJECTIVES: To evaluate and compare the complications of laparoscopic gastric bypass and the conventional one in patients with morbid obesity. Application site: self-administration national university hospital. DESIGN: Comparative, prospective no randomized study. POPULATION: Between 2002 and 2011, 420 morbidly obese patients received surgical treatment for the obesity either open (167) or laparoscopic (253) surgery RESULTS: Early postoperative complication rate was 4

in the lbg and 34

in the cbg (p < 05, 95

ci 22-38), mostly represented by seromas (25

) and wall abscesses (5.4

). the percentage of late postoperative complications was 2.8

in the lbg group and 9.6

in the cbg (p=0.004, 95

ci 1.4-12.2), the most frequent being incisional hernias (7.18

). CONCLUSIONS: According to our experience and consulted literature, laparoscopic gastric bypass is a safe, reproducible and with a lower rate of both early and late complications than cbg, and so we consider and offer lbg as the ideal technique for the treatment of patients with morbid obesity.

Prisoner's dilemma on real social networks: revisited.

Prisoner's Dilemma is a game theory model used to describe altruistic behavior seen in various populations. This theoretical game is important in understanding why a seemingly selfish strategy does persist and spread throughout a population that is mixing homogeneously at random. For a population with structure determined by social interactions, Prisoner's Dilemma brings to light certain requirements for the altruistic strategy to become established. Monte Carlo simulations of Prisoner's Dilemma are carried out using both simulated social networks and a dataset of a real social network. In both scenarios we confirm the requirements for the persistence of altruism in a population.

Composición química y tamizaje fitoquímico del polvo de hojas y retoños del Anacardium occidentale L (marañón) / Chemical composition and phytochemical screening of leaf and shoot powder of Anacardium occidentale L (cashew tree)

Introducción: la composición química y el tamizaje fitoquímico de una planta medicinal puede definir sus beneficios; la literatura refiere información de estas determinaciones en la fruta del Anacardium occidentale L; no obstante, en cuanto a las hojas y retoños no se encontró información suficiente. Objetivo: determinar la composición química y el tamizaje fitoquímico en el polvo de hojas y retoños del Anacardium occidentale L Métodos: en el polvo de hojas y retoños de Anacardium occidentale L se determinó la composición bromatológica, algunos carbohidratos, material saponificable, fitoesteroles, minerales, ácidos grasos y tamizaje fitoquímico; mediante técnicas del Ministerio de Salud Pública, Official Methods of Analysis, cromatografía gaseosa, espectrofotometría de absorción atómica y cromatografía líquida de alta eficiencia. Resultados: el polvo de hojas y retoños de A occidentale mostró un aceptable contenido de materia seca, proteína bruta, betasitosterol y stigmasterol. El ácido graso saturado octadecanoico y el monoinsaturado gadoleico se detectaron con mayores cuantías en el polvo. Se observó una concentración significativa del potasio y del mineral traza manganeso. En el tamizaje fitoquímico, el extracto etéreo no presentó alcaloides, las coumarinas y quinonas se detectaron en el extracto etanólico y acuoso, respectivamente. Las antocianidinas, triterpenos o esteroides y taninos se observaron en el extracto etanólico. Además en ambos extractos (acuoso y etanólico) se detectaron flavonoides y saponinas. Conclusiones: según la composición química y la presencia de metabolitos secundarios benéficos en el polvo de las hojas y retoños de A. occidentale se recomienda el estudio de este polvo en humanos y animales, como nutracéutico o terapéutico

Introduction: the chemical composition and phytochemical screening of a medicinal plant can define its benefits. The literature covers information about these determinations on the fruit of Anacardium occidentale L but little information was found about its leaves and shoots. Objective: to determine the chemical composition and phytochemical screening in the leaf and shoot powder from Anacardium occidentale L Methods: bromatological composition, some carbohydrates, saponifiable material, phytosterols, minerals, fatty acids and phytochemical screening were determined in leaf and shoot powder from Anacardium occidentale L, using techniques approved by the Ministry of Public Health, Official Methods of Analysis, gas chromatography, atomic absorption spectrophotometer and high-performance liquid chromatography. Results: the leaf and shoot powder from Anacardium occidentale L showed an acceptable content of dry matter, crude protein, beta-sitosterol and stigmasterol. Saturated fatty acid and monounsaturated octadecenoic, gadoleic larger amounts were detected in the powder. There was a significant concentration of potassium and manganese trace mineral. In the phytochemical screening, the ether extract showed no alkaloids, the coumarins and quinones were detected in the ethanol and aqueous extract, respectively. Anthocyanidins, triterpenes or steroids and tannins were observed in the ethanol extract. Also, in both extracts (aqueous and ethanolic) flavanoids and saponins were detected. Conclusions: according to the chemical composition and the presence of beneficial secondary metabolites, it is recommended to study the use of leaf and shoot powder from A occidentale in humans and animals as a nutraceutic or therapeutical agent

Composición química y tamizaje fitoquímico del polvo de hojas y retoños del Anacardium occidentale L (marañón) / Chemical composition and phytochemical screening of leaf and shoot powder of Anacardium occidentale L (cashew tree)

Introducción: la composición química y el tamizaje fitoquímico de una planta medicinal puede definir sus beneficios; la literatura refiere información de estas determinaciones en la fruta del Anacardium occidentale L; no obstante, en cuanto a las hojas y retoños no se encontró información suficiente. Objetivo: determinar la composición química y el tamizaje fitoquímico en el polvo de hojas y retoños del Anacardium occidentale L Métodos: en el polvo de hojas y retoños de Anacardium occidentale L se determinó la composición bromatológica, algunos carbohidratos, material saponificable, fitoesteroles, minerales, ácidos grasos y tamizaje fitoquímico; mediante técnicas del Ministerio de Salud Pública, Official Methods of Analysis, cromatografía gaseosa, espectrofotometría de absorción atómica y cromatografía líquida de alta eficiencia. Resultados: el polvo de hojas y retoños de A occidentale mostró un aceptable contenido de materia seca, proteína bruta, betasitosterol y stigmasterol. El ácido graso saturado octadecanoico y el monoinsaturado gadoleico se detectaron con mayores cuantías en el polvo. Se observó una concentración significativa del potasio y del mineral traza manganeso. En el tamizaje fitoquímico, el extracto etéreo no presentó alcaloides, las coumarinas y quinonas se detectaron en el extracto etanólico y acuoso, respectivamente. Las antocianidinas, triterpenos o esteroides y taninos se observaron en el extracto etanólico. Además en ambos extractos (acuoso y etanólico) se detectaron flavonoides y saponinas. Conclusiones: según la composición química y la presencia de metabolitos secundarios benéficos en el polvo de las hojas y retoños de A. occidentale se recomienda el estudio de este polvo en humanos y animales, como nutracéutico o terapéutico(AU)

Introduction: the chemical composition and phytochemical screening of a medicinal plant can define its benefits. The literature covers information about these determinations on the fruit of Anacardium occidentale L but little information was found about its leaves and shoots. Objective: to determine the chemical composition and phytochemical screening in the leaf and shoot powder from Anacardium occidentale L Methods: bromatological composition, some carbohydrates, saponifiable material, phytosterols, minerals, fatty acids and phytochemical screening were determined in leaf and shoot powder from Anacardium occidentale L, using techniques approved by the Ministry of Public Health, Official Methods of Analysis, gas chromatography, atomic absorption spectrophotometer and high-performance liquid chromatography. Results: the leaf and shoot powder from Anacardium occidentale L showed an acceptable content of dry matter, crude protein, beta-sitosterol and stigmasterol. Saturated fatty acid and monounsaturated octadecenoic, gadoleic larger amounts were detected in the powder. There was a significant concentration of potassium and manganese trace mineral. In the phytochemical screening, the ether extract showed no alkaloids, the coumarins and quinones were detected in the ethanol and aqueous extract, respectively. Anthocyanidins, triterpenes or steroids and tannins were observed in the ethanol extract. Also, in both extracts (aqueous and ethanolic) flavanoids and saponins were detected. Conclusions: according to the chemical composition and the presence of beneficial secondary metabolites, it is recommended to study the use of leaf and shoot powder from A occidentale in humans and animals as a nutraceutic or therapeutical agent(AU)

The estimation of the effective reproductive number from disease outbreak data.

We consider a single outbreak susceptible-infected-recovered (SIR) model and corresponding estimation procedures for the effective reproductive number R(t). We discuss the estimation of the underlying SIR parameters with a generalized least squares (GLS) estimation technique. We do this in the context of appropriate statistical models for the measurement process. We use asymptotic statistical theories to derive the mean and variance of the limiting (Gaussian) sampling distribution and to perform post statistical analysis of the inverse problems. We illustrate the ideas and pitfalls (e.g., large condition numbers on the corresponding Fisher information matrix) with both synthetic and influenza incidence data sets.

Abordaje laparoscópico transperitoneal de feocromocitomas y paragangliomas / Transperitoneal laparsoscopic surgery for pheochromocytomas and paragangliomas

Los feocromocitomas adrenales y extra-adrenales o paragangliomas funcionantes constituyen una causa inusual de hipertensión arterial pasible de ser tratada mediante el tratamiento laparoscópico...El abordaje laparoscópico de feocromacitomas adrenales funcionantes constituye un método seguro y efectivo, siendo considerado actualmente el procedimiento de elección. Los avances de los métodos por imágenes de localización pre-operatoria y el continuo desarrollo quirúrgico laparoscópico permitirán, en un futuro no muy lejano, imponer el acceso laparascópico también como vía de elección en feocromocitomas extra-adrenales o paragangliomas. La alta incidencia de bilateralidad y compromiso extraadrenal justifica, a nuestro entender, la triple evaluación imagenológica (TAC-RMN-Centellografía MIBG) en todos los pacientes.

Hepatectomía izquierda por metástasis insulino-secretantes, a los 15 años de la resección de un insulinoma / Left hepatectomy associated with liver metastases, 15 years after resection of a pancreatic insulinoma

La insulinoma se origina en las células de los islotes pancreáticos. Es un tumor poco común que ocurre en aproximadamente 1 a 6 personas por millones de habitantes por año. Predomina en el sexo femenino, entre los 40 y 60 años de edad. Se estima que aproximadamente entre el 6 al 10% son neoplasias malignas. El objetivo del trabajo es la presentación de un paciente con recurrencia del cuadro clínico (hipoglucemia, hiperinsulinismo) asociado a metástasis hepáticas 15 años después de la resección de un insulinoma pancreático...

Insulinoma is a neoplasm that arises from the pancreatic insulin-producing cells. It is a rare tumor that occurs in approximately 1 to 6 persons per million of population per year. Predominates in females, between 40 and 60 years of age. It is estimated that approximately 6 to 10% are malignant. Objective: the presentation of a patient with recurrence of clinical symptoms (hypoglycemia, hyperinsulinism) associated with liver metastases 15 years after resection of a pancretic insulinoma..