Micropropagation of Agave angustifolia "Espadín" Used in the Production of Mezcal.

This chapter presents the methodological approach for the in vitro propagation of Agave angustifolia "espadin," the base material to produce mezcal. The protocol used in each stage of the crop is addressed in detail, considering the changes in the culture medium and the characteristics of the plant material at each stage. The importance of integrated management between the multiplication and growth phase, as part of the in vitro selection strategy, is mentioned.

BioMINT: A Temporary Immersion System for Agave Micropropagation.

Agaves are cultivated in Mexico as a source of industrial products such as fibers, nutritional supplements, and alcoholic beverages. Due to the demand for plant material, its long-life cycle, and the need to avoid predation on its natural populations, in vitro micropropagation represents a good option for agaves. Plant tissue culture has been successfully used to micropropagate selected elite individuals from plants of various Agave species of economic interest. However, it is necessary to implement systems that lower production costs without losing the quality of the plantlets obtained. This chapter describes the BioMINT™ bioreactor as an alternative for the micropropagation of agaves in the different stages of the micropropagation process.

Socioeconomic Inequalities in Alcohol and Tobacco Consumption: A National Ecological Study in Mexican Adolescents.

Alcohol and cigarettes are the psychoactive substances that adolescents use most frequently. When both addictions are combined, they carry the worst burden of disease globally. The objective of this study was to identify whether socioeconomic factors correlate with alcohol and tobacco consumption in Mexican adolescents aged 10 years or more and to establish the relationship in the consumption between the two substances. This ecological study utilized data describing alcohol and tobacco consumption among adolescents aged 10-16 years (n = 48,837 ≈ N = 11,621,100). Having ever consumed any alcohol-containing beverage constituted alcohol consumption. Smoking a cigarette within 30 days constituted cigarette consumption. For both variables, the state-level percentages reported in the survey were used. Diverse socioeconomic variables were collected from official sources. Data on the prevalence of tobacco use and alcohol consumption were entered into an Excel database estimated for each of the states of the Mexican Republic, as well as the socioeconomic variables. We performed the analysis using Stata 14. Consumption prevalence was 15.0% for alcohol and 4.2% for tobacco. Alcohol consumption was not correlated with any studied socioeconomic variable (p > 0.05). The prevalence of tobacco consumption among elementary school students correlated (p < 0.05) with the portion of the population living in private dwellings without sewage, drainage, or sanitation (r = 0.3853). The prevalence of tobacco consumption among middle-school adolescents correlated with the portion of the employed population that earned up to two minimum wages (r = 0.3960), the percentage in poverty by income 2008 (r = 0.4754) and 2010 (r = 0.4531), and the percentage in extreme poverty by income 2008 (r = 0.4612) and 2010 (r = 0.4291). Positive correlations were found between tobacco consumption and alcohol consumption among both elementary (r = 0.5762, p=0.0006) and middle-school children (r = 0.7016, p=0.0000). These results suggest that certain socioeconomic factors correlate with tobacco consumption but not alcohol consumption. A correlation between alcohol consumption and tobacco consumption was observed. The results can be used for developing interventions in adolescents.

Monoclonal antibody generated against Nile tilapia (Oreochromis niloticus) IgT heavy chain using a peptide-based strategy.

Teleost IgT/Z plays a principal role in the defense mechanisms against infectious agents in the mucosal compartments and in systemic immunity. Previously, Nile tilapia (Oreochromis niloticus) IgT was discovered and characterized at transcription level. In this work, we generated a monoclonal antibody (mAb) that specifically recognized the Nile tilapia IgT. BALB/c mice were immunized with three synthetic peptides conjugated to KLH. The sequences of these peptides derived from the constant region of the Nile tilapia IgT heavy chain. ELISA and Western blotting confirmed the specificity of the polyclonal sera and the culture supernatant from a positive hybridoma clone. We observed immunoreactivity against a recombinant IgT fragment and native IgT in skin mucus. The anti-IgT mAb did not cross-react with purified tilapia IgM. Direct ELISA analysis allowed the quantification of skin mucus IgM and IgT concentrations. Flow cytometry analysis revealed differences in the percentage of IgT+ B cell populations between juveniles and adults in peripheral blood, head kidney and spleen lymphocytes and among the tissues analyzed. For further validation of the anti-IgT mAb utility, a recombinant vaccine candidate against sea lice (TT-P0 Ls) was injected into juvenile tilapia. Direct ELISA results revealed a differential secretion of skin mucus IgT and IgM after immunostimulation. In addition, the percentages of IgT+ B cells were determined at 7 days after booster and ex-vivo stimulation by flow cytometry. This mAb constitutes an important immunological tool to study the biological function and structural characteristics of tilapia IgT.

Lip and Oral Cavity Cancer Incidence and Mortality Rates Associated with Smoking and Chewing Tobacco Use and the Human Development Index in 172 Countries Worldwide: An Ecological Study 2019-2020.

Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations.

Protocolo de recuperación intensificada durante la cirugía del plexo braquial (RIPLEX) / ntensified Recovery Protocol during Brachial Plexus Surgery (RIPLEX)

La restauración de la función del miembro superior en los pacientes que sufren lesiones del plexo braquial para favorecer la mejoría en su calidad de vida. Así como su reinserción social y laboral, se puede optimizar mediante la implementación de programas de recuperación intensificada o mejorada, multimodales, multidisciplinarios, y de elevados estándares cualitativos, denominados protocolos ERAS (Enhanced Recovery After Surgery), se recomienda la utilización de métodos fundamentados en la mejor evidencia científica disponible. El protocolo que se expone, aplicado en el Complejo Científico Ortopédico Internacional "Frank Paísˮ, derivado de una investigación institucional en curso. Objetivos: Contribuir en el desarrollo del conocimiento científico imprescindible para favorecer la introducción y sistematización de los cuidados perioperatorios multimodales durante las intervenciones quirúrgicas del plexo braquial.

Introduction: Restoration of upper limb function in patients suffering from brachial plexus injuries, in view of favoring improvement in their quality of life or their social and labor reinsertion, can be optimized by means of implementing multimodal, multidisciplinary, intensified or enhanced recovery programs with high qualitative standards, called ERAS (enhanced recovery after surgery) protocols. The use of methods based on the best available scientific evidence is recommended. The protocol presented here is applied at Complejo Científico Ortopédico Internacional "Frank Paísˮ and derived from an ongoing institutional research. Objective: To contribute to the development of scientific knowledge essential to favor the introduction and systematization of multimodal perioperative care during brachial plexus surgical interventions.

Use of Thin Cell Layer Technique for Induction of Somatic Embryogenesis of Agave fourcroydes.

Agave fourcroydes (henequén) is a plant used for the extraction of hard fiber from its leaves. Due to its long-life cycle, it is very difficult to genetically improve. Somatic embryogenesis (SE) is a very useful micropropagation technique, that can be used for genetic improvement programs and increase the micropropagation of this species. SE is a morphogenic process by which somatic embryos are generated from somatic cells reprogramming. To initiate the regeneration program, the loss of cell-cell communication is suggested to be important. The Thin Cell Layer (TCL) technique allows for the isolation of specific cell or tissue layers, and in conjunction with strictly controlled growth conditions, may lead to the in vitro induction of specific morphogenic programs. Here, we describe a new protocol for the induction of somatic embryogenesis through TCL culture technique, from stem of elite clonal A. fourcroydes vitroplants previously generated through micropropagation of adventitious shoots.

La tentación de las revistas depredadoras / The temptation of predatory journals

RESUMEN Probablemente, varios de los lectores de este artículo en determinado momento han recibido correos electrónicos "seductores", en los cuales, de forma encomiástica, cordial y sospechosamente entusiasta, quizás haciendo referencia a investigaciones anteriores del destinatario, el editor ejecutivo de una revista foránea les invita a contribuir con algún informe científico en la confección de un número cuya publicación es inminente. Este tipo de invitación puede resultar un molesto incidente para múltiples profesionales o tal vez, una oferta tentadora para otros, pues la perciben como una oportunidad rápida y facilista para optimizar su gestión curricular. Tales mensajes constituyen una intrusión en la privacidad de los usuarios, consecuencias de políticas de difusión fraudolentas, agresivas e indiscriminadas, carentes de transparencia, promotoras del plagio y transgresoras de la ética científica, practicadas por pseudorevistas conocidas con el término despectivo de "revistas depredadoras". Estas revistas constituyen una amenaza a la ética de las publicaciones científicas, pues tienen como objetivo obtener reconocimiento y beneficios económicos, a expensas de prácticas deshonestas, que fomentan el plagio y ocasionan perjuicios sobre los autores, pacientes e instituciones académicas. El presente artículo de opinión tuvo como objetivo describir las características de las revistas depredadoras y la pseudopublicación científica en general(AU)

ABSTRACT Probably, several of the readers of this article at a certain time have received "seductive" emails, in which, in a commendable, cordial and suspiciously enthusiastic way, perhaps referring to previous research of the recipient, the executive editor of a foreign journal invites them to contribute with some scientific report in the preparation of an issue whose publication is imminent. This type of invitation can be an annoying incident for multiple professionals or perhaps, a tempting offer for others, as they perceive it as a quick and easy opportunity to optimize their curricular management. Such messages constitute an intrusion into the privacy of users, the result of fraudulent, aggressive and indiscriminate dissemination policies, lacking transparency, promoters of plagiarism and transgressors of scientific ethics, practiced by pseudo-journals known with the derogatory term of "predatory journals". These journals constitute a threat to the ethics of scientific publications, since they aim to obtain recognition and economic benefits, at the expense of dishonest practices, which encourage plagiarism and cause harm to authors, patients and academic institutions. This opinion piece aimed to describe the characteristics of predatory journals and scientific pseudo-publishing in general(AU)

Alternativa factible para la neuroestimulación intraoperatoria durante la cirugía del plexo braquial / Feasible alternative for intraoperative neurostimulation during brachial plexus surgery

Introducción: La neuroestimulación intraoperatoria constituye una técnica esencial durante la cirugía del plexo braquial, pues permite la identificación específica de las estructuras neurales. En determinadas circunstancias, la intensidad precisa de la estimulación nerviosa y la respuesta motora evocada, las cuales son fundamentales para la toma de decisiones críticas durante el acto quirúrgico. Objetivo: Describir la utilización de un neuroestimulador de anestesia regional para la localización neural intraoperatoria durante la cirugía del plexo braquial en dos pacientes. Presentación de casos: Caso 1: paciente con diagnóstico de lesión del fascículo lateral del plexo braquial derecho y lesión alta del nervio radial homolateral. La estimulación neural, con estímulos graduales y progresivos, permite la diferenciación adecuada de los nervios mediano, cubital, musculocutáneo y cutáneo braquial lateral, el fascículo motor del nervio cubital que inerva el músculo cubital anterior, y el fascículo motor del nervio musculocutáneo que inerva el bíceps, lo que posibilita la neurotización entre ambos fascículos. Caso 2: paciente con diagnóstico de lesión total del plexo braquial izquierdo, posganglionar. Luego de la exploración y neurólisis, se identificó el tronco superior, se efectuó la estimulación eléctrica gradual, lo que requirió una elevada intensidad, y se registó, únicamente, como respuesta motora evocada la contracción débil del músculo pectoral mayor ipsilateral. Conclusiones: La utilización de un neuroestimulador de anestesia regional para la localización neural durante la cirugía del plexo braquial, presenta ventajas prácticas relevantes en relación con los neuroestimuladores desechables, así como una relación costo-beneficio apropiada para su implementación en entornos y naciones de recursos limitados(AU)

Introduction: Intraoperative neurostimulation is an essential technique during brachial plexus surgery, as it allows the specific identification of neural structures. In certain circumstances, the precise intensity of nerve stimulation and the evoked motor response are fundamental for making critical decisions during the surgical act. Objective: Describe the use of a neurostimulator of regional anaesthesia for intraoperative neural localization during brachial plexus surgery in two patients. Case presentation: Case 1: patient diagnosed with lesion of the lateral fasciculus of the right brachial plexus and high lesion of the homolateral radial nerve. Neural stimulation, with gradual and progressive stimuli, allows the adequate differentiation of the median, ulnar, musculocutaneous and lateral brachial cutaneous nerves, the motor fasciculus of the ulnar nerve that innervates the anterior ulnar muscle, and the motor fasciculus of the musculocutaneous nerve that innervates the biceps, which enables neurotization between both fascicles. Case 2: patient diagnosed with total lesion of the left brachial plexus, postganglionic. After the exploration and neurolysis, the upper trunk was identified, the gradual electrical stimulation was carried out, which required a high intensity, and the weak contraction of the ipsilateral pectoralis major muscle was recorded only as an evoked motor response. Conclusions: The use of a neurostimulator of regional anesthesia for neural localization during brachial plexus surgery presents relevant practical advantages in relation to disposable neurostimulators, as well as an appropriate cost-benefit ratio for their implementation in environments and nations of limited resources(AU)

Controversia justificada acerca de los esteroides particulados epidurales / A justified controversy about epidural particulate steroids

Introducción: La administración epidural de esteroides constituye un pilar del tratamiento del dolor radicular cervical y lumbosacro. Objetivo: Describir los mecanismos fisiológicos y características farmacológicas de los corticosteroides utilizados en el tratamiento del dolor, así como las complicaciones derivadas de la administración epidural de esteroides particulados. Métodos: Se realizó una revisión no sistemática de la literatura en bases de datos científicas como Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID y el buscador académico Google Scholar, en los meses de julio a septiembre del año 2020. Desarrollo: Los corticoides utilizados en la medicina del dolor son derivados de la prednisolona. Estos se clasifican en particulados (de depósito, de suspensión) o no particulados (de dilución), en función de la presencia o ausencia de un componente molecular sólido (moléculas tipo éster, insolubles en agua). Los fármacos más empleados son la dexametasona, betametasona, triamcinolona y metilprednisolona. Conclusiones: La administración epidural de esteroides particulados está relacionada con la incidencia de complicaciones graves, aunque poco frecuentes, como paraplejía, tetraplejía, infarto de la médula espinal, hemorragia y edema cerebral. La evidencia disponible muestra una efectividad analgésica similar a los compuestos no particulados. Por lo tanto, no se recomienda su utilización rutinaria durante el abordaje del espacio epidural(AU)

Introduction: Epidural administration of steroids is a cornerstone for the treatment of cervical and lumbosacral radicular pain. Objective: To describe the physiological mechanisms and pharmacological characteristics of the corticosteroids used for pain treatment, as well as the complications derived from the epidural administration of particulate steroids. Methods: A nonsystematic review of the literature was carried out, from July to September 2020, in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID and the academic search engine Google Scholar. Development: The corticoids used in pain medicine are derived from prednisolone. These are classified into particulate (deposit, suspension) or non-particulate (dilution), depending on the presence or absence of a solid molecular component (ester-type molecules, insoluble in water). The most commonly used drugs are dexamethasone, betamethasone, triamcinolone, and methylprednisolone. Conclusions: The epidural administration of particulate steroids is related to the incidence of serious, although infrequent, complications, such as paraplegia, tetraplegia, spinal cord infarction, hemorrhage and cerebral edema. Available evidence shows analgesic effectiveness similar to that of non-particulate compounds. Therefore, its routine usage is not recommended during the managment of the epidural space(AU)

Infusiones controladas por objetivo y sistemas de circuito cerrado. Límites en expansión / Target-controlled infusions and closed-loop systems: expansion limits

Introducción: La administración manual en bolo ha evolucionado desde la infusión volumétrica basada en regímenes farmacológicos estandarizados, hasta los sistemas de infusión controlada por objetivo y los más sofisticados sistemas de circuito cerrado. Objetivo: Describir los principios tecnológicos y aplicaciones clínicas extendidas de la infusión controlada por objetivo y los sistemas de circuito cerrado. Métodos: Se realizó una revisión no sistemática de la literatura, en bases de datos científicas como Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, Science Direct, OVID y el buscador académico Google Scholar, en el mes de septiembre del año 2020. Desarrollo: La disponibilidad y portabilidad de dispositivos electrónicos con capacidad de procesamiento avanzado a precios relativamente accesibles, el perfeccionamiento del aprendizaje automático e inteligencia artificial aplicado a las decisiones médicas, y las iteraciones tecnológicas complejas incorporadas en los sistemas de circuito abierto y cerrado, desarrollados originalmente en el campo de la Anestesiología, han posibilitado su expansión a otras especialidades y entornos clínicos tan disímiles como el tratamiento de la diabetes mellitus, administración de fármacos antineoplásicos, ventilación mecánica, control de las variables hemodinámicas y la terapia antimicrobiana en pacientes críticos. Conclusiones: La infusión controlada por objetivo y los sistemas de circuito cerrado se han convertido en tecnologías maduras, seguras y viables, aplicadas clínicamente en múltiples naciones y escenarios, con un desempeño superior a los sistemas manuales tradicionales(AU)

Introduction: Manual bolus administration has evolved from volumetric infusion based on standardized pharmacological regimens to target-controlled infusion systems and the most sophisticated closed-loop systems. Objective: To describe the technological principles and extended clinical applications of target-controlled infusion and closed-loop systems. Methods: A nonsystematic review of the literature was carried out, during September 2020, in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, Science Direct, OVID and the academic search engine Google Scholar. Development: The availability and portability of electronic devices with advanced processing capacity at relatively affordable prices, the refinement of machine learning and artificial intelligence applied to medical decisions, as well as the complex technological iterations incorporated into open and closed-loop systems, originally developed in the field of anesthesiology, have enabled their expansion to other specialties and clinical settings so diverse as treatment of diabetes mellitus, administration of antineoplastic drugs, mechanical ventilation, control of hemodynamic variables and antimicrobial therapy in critical patients. Conclusions: Target-controlled infusion and closed-loop systems have become mature, safe and viable technologies, applied clinically in multiple nations and settings, with superior performance compared to traditional manual systems(AU)

Growth hormone secretagogue peptide-6 enhances oreochromicins transcription and antimicrobial activity in tilapia (Oreochromis sp.).

Growth Hormone-Releasing Peptide 6 (GHRP-6) (His-(D-Trp)-Ala-Trp-(D-Phe)-Lys-NH2) is an agonist of the growth hormone secretagogue receptor. GHRP-6 mimics the effect of ghrelin. The present study focuses on the immunomodulatory effects of GHRP-6 in tilapia with and without the presence of Pseudomonas aeruginosa infection. GHRP-6 up-regulated the transcription levels of three piscidin-like antimicrobial peptides (Oreochromicins I, II, and III) and granzyme in a tissue-dependent manner. Antimicrobial activity stimulation in serum (lysozyme and anti-protease activity) was also confirmed. Besides, GHRP-6 enhanced the in vitro antimicrobial activity against P. aeruginosa in tilapia gills mucus and serum samples and decreased the bacterial load in vivo after infection with this Gram-negative bacterium. Our results evidenced, for the first time, a direct link between a growth hormone secretagogue ghrelin mimetic in fish and the enhancement of antimicrobial peptides transcription, which suggests that this secretagogue is capable to lead the activation of microbicidal activity in tilapia. Thus, these results open new possibilities for GHRP-6 application in aquaculture to stimulate the teleost immune system as an alternative treatment against opportunistic bacteria.

Anestesia peridural caudal en neonatos: una alternativa segura para el anestesiólogo / Caudal peridural anesthesia in neonates: a safe alternative for the anesthesiologist

Introducción: Las técnicas de anestesia y analgesia regional en la población pediátrica garantizan la estabilidad hemodinámica y respiratoria. El uso de la anestesia caudal ha aumentado enormemente sobre todo para cirugías de abdomen inferior lo que ofrece ventajas sobre la anestesia general. Objetivo: Argumentar sobre la base de la mejor evidencia científica, la opinión de los autores en relación a la efectividad del uso de la anestesia caudal en los pacientes neonatos. Método: El marco inicial de búsqueda bibliográfica se constituyó por los artículos publicados acerca de la utilización de la anestesia caudal en neonatos. Las fuentes de información que se utilizaron fueron: Registro Cochrane central de ensayos clínicos controlados, Pubmed, LILACS, SciELO, Ebsco, Science, Google académico. Resultados: El bloqueo caudal es la aplicación de un anestésico local en el espacio peridural, pero a nivel sacro, lo que ocasiona un bloqueo de conducción en las raíces nerviosas que cubre la analgesia, no solo el período intraoperatorio sino también el posoperatorio, lo cual permite una adecuada estabilidad hemodinámica, reduce el sangrado, evita el uso de opioides, anestésicos generales y relajantes musculares. La necesidad de asistencia respiratoria se ve reducida. Conclusiones: Es una técnica segura y económica en ocasiones subvalorada en el recién nacido. Esto, junto a una más rápida recuperación, lleva a considerar la anestesia regional como una alternativa a la anestesia general(AU)

Introduction: Regional anesthesia and analgesia techniques in the pediatric population guarantee hemodynamic and respiratory stability. The use of caudal anesthesia has increased enormously, especially for lower abdominal surgeries, which offers advantages over general anesthesia. Objective: To argue, based upon the best scientific evidence, the opinion of the authors regarding the effectiveness of the use of caudal anesthesia in neonatal patients. Method: The initial framework for the bibliographic search consisted of the articles published about the use of caudal anesthesia in neonates. The sources of information were the Cochrane Central Register of Controlled Trials, Pubmed, LILACS, SciELO, Ebsco, Science, Google Scholar. Results: Caudal block is the application of a local anesthetic into the epidural space, but at the sacral level, which causes a conduction block in the nerve roots that covers analgesia, not only in the intraoperative period but also in the postoperative one, which allows adequate hemodynamic stability, reduces bleeding, avoids the use of opioids, general anesthetics and muscle relaxants. The need for respiratory support is reduced. Conclusions: It is a safe and economical technique, sometimes undervalued in the newborn. This, together with a faster recovery, leads to considering regional anesthesia as an alternative over general anesthesia(AU)

PACAP modulates the transcription of TLR-1/TLR-5/MyD88 pathway genes and boosts antimicrobial defenses in Clarias gariepinus.

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a multifunctional neuropeptide that belongs to the secretin/glucagon/GHRH/VIP superfamily. Some of these molecules have antimicrobial activity and they are capable of stimulating the immune system. The present work studied the antibacterial and immunostimulatory activity of PACAP-38 from African catfish Clarias gariepinus against the Gram-negative bacterium Pseudomonas aeruginosa in an in vivo test. PACAP-38 improved antimicrobial activity of skin mucus molecules against P. aeruginosa. The peptide modulates the gene expression profile of TLR-1, TLR-5, MyD88, IL-1ß, TNF-ɑ, IL-8, pardaxin, hepcidin and G/C-type lysozymes in skin, spleen and head kidney. The influenced exerted depended on the time after infection and tissue analyzed. This study provides the first evidence of a link between PACAP and antimicrobial peptides hepcidin and pardaxin. Our results suggest further use of PACAP as antimicrobial agent that could potentially be used to control disease in aquaculture.

Ventajas y limitaciones del uso del torniquete en ortopedia y traumatología / Advantages and Limitations of the Use of Tourniquet in Orthopedics and Traumatology

Introducción: El torniquete es ampliamente usado en la cirugía ortopédica y traumatológica con el objetivo de disminuir las pérdidas sanguíneas intraoperatorias y mejorar la visibilidad de las estructuras anatómicas, aunque su empleo es controversial. Objetivo: Describir las aplicaciones prácticas y las limitaciones del torniquete en la cirugía ortopédica y traumatológica. Método: Se realizó una revisión no sistemática de la literatura en bases de datos científicas como Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID y el buscador académico Google Scholar, en el mes de septiembre de 2020. Conclusiones: Aunque el torniquete es ampliamente utilizado durante la cirugía ortopédica y traumatológica, debido a que contribuye a reducir las pérdidas hemáticas intraoperatorias, se ha demostrado su efecto en el aumento de las pérdidas sanguíneas totales, así como su asociación con dolor perioperatorio, pérdida de la fuerza muscular del miembro, lesiones de nervios periféricos, trombosis venosa profunda y daño a órganos a distancia por el fenómeno de isquemia-reperfusión(AU)

Introduction: Although controversial, tourniquets are widely used in orthopedic and trauma surgery with the aim of reducing intraoperative blood losses and improving the visibility of anatomical structures. Objective: To describe the practical applications and limitations of tourniquets in orthopedic and trauma surgery. Method: A non-systematic review of the literature was carried out, in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed / Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID and the academic search engine Google Scholar, in the month of September 2020. Conclusions: Although tourniquets are widely used during orthopedic and trauma surgery, since they contribute to reducing intraoperative blood loss, the effect on increasing total blood loss has been demonstrated, as well as the association with perioperative pain, blood loss, limb muscle strength, peripheral nerve injuries, deep vein thrombosis and damage to distant organs due to the ischemia-reperfusion phenomenon(AU)

La toracotomía axilar vertical. Consideraciones anestésicas incluidas en la aplicación de modificaciones / Vertical axillary thoracotomy, anesthetic considerations included in the application of modifications

RESUMEN La toracotomía axilar vertical es un procedimiento quirúrgico que permite realizar múltiples técnicas para el diagnóstico y tratamiento de enfermedades del tórax, área que implica consideraciones anestésicas especiales. El presente estudio pretende exponer determinantes para el manejo anestésico de pacientes intervenidos quirúrgicamente por toracotomías axilares. Se realizó una revisión bibliográfica, mediante la búsqueda en bases de datos (Medline/Pubmed e Hinari), incluyendo los términos: toracotomía axilar vertical, manejo anestésico y cirugía torácica. Las determinantes identificadas dentro del manejo anestésico durante la toracotomía axilar vertical fueron la evaluación preoperatoria, monitorización, manejo de la vía aérea, estrategia de ventilación, tratamiento anestésico y la analgesia postoperatoria inmediata. Se determinó, de acuerdo con la necesidad y condiciones del equipo, establecer como prioritaria la defensa del momento óptimo de relajación muscular. El control hemodinámico del paciente, el aislamiento pulmonar, la relajación muscular para el abordaje quirúrgico, la ventilación pulmonar y la analgesia perioperatoria, siguen siendo hoy día la piedra angular del manejo anestésico en la toracotomía axilar vertical.

ABSTRACT Vertical axillary thoracotomy is a surgical procedure that allows multiple techniques to be performed for the diagnosis and treatment of chest diseases, an area that involves special anesthetic considerations. The present study aims to expose determinants for the anesthetic management of patients operated on for axillary thoracotomies. A bibliographic review was carried out by searching databases (Medline / Pubmed and Hinari), including the terms: vertical axillary thoracotomy, anesthetic management and thoracic surgery. The determinants identified within anesthetic management during vertical axillary thoracotomy were preoperative evaluation, monitoring, airway management, ventilation strategy, anesthetic treatment, and immediate postoperative analgesia. According to the needs and conditions of the team, it was determined to establish as a priority the defense of the optimal moment of muscle relaxation. Hemodynamic control of the patient, pulmonary isolation, muscle relaxation for the surgical approach, pulmonary ventilation, and perioperative analgesia continue to be the cornerstone of anesthetic management in vertical axillary thoracotomy today.

Monoclonal antibody against Nile tilapia (Oreochromis niloticus) IgM heavy chain: A valuable tool for detection and quantification of IgM and IgM+ cells.

Nile tilapia (Oreochromis niloticus) is a freshwater fish, which is extensively cultivated worldwide and constitutes one of the model species for the study of fish immunology. Monoclonal antibodies are very advantageous molecular tools for studying teleost immune system. Specifically, monoclonal antibodies that react with immunoglobulins are used successfully in the study of the humoral immune response of several fish species. In the present study, we produced and characterized a monoclonal antibody against tilapia IgM heavy chain using a peptide-based strategy. The peptide sequence was selected from the surface-exposed region between CH3-CH4 domains. The specificity of the polyclonal serum and the hybridoma culture supernatant obtained by immunization with the peptide conjugated to keyhole limpet hemocyanin were evaluated by western blotting, both showing reactivity against tilapia serum IgM. The purified mAb was able to recognize secreted IgM by western blotting and ELISA and membrane IgM by flow cytometry. We also demonstrated that the antibody doesn't cross-react with a recombinant IgT fragment. This tool allowed us to study for the first time the stimulation of mucosal immunity after Pituitary Adenylate Cyclase Activating Polypeptide administration. Overall, the results demonstrated the utility of this mAb to characterize humoral immune response in O. niloticus.

Laringoespasmo reflejo en cirugía urológica pediátrica / Reflex laryngospasm in pediatric urologic surgery

Introducción: El laringoespasmo es una complicación temida por los anestesiólogos. Se asocia a broncoespasmo, hipoxia, arritmias, aspiración del contenido gástrico y paro cardiaco. Es más frecuente en neonatos y lactantes. Está estrechamente vinculado al tipo de cirugía y consiste en un cierre intenso y prolongado de la glotis en respuesta a la estimulación glótica directa o refleja. Objetivo: Describir el tratamiento del laringoespasmo parcial reflejo en un paciente pediátrico durante una intervención urológica. Presentación del caso: Paciente de 18 meses de edad al cual se le realiza meatotomía. Durante la cirugía presenta laringoespasmo parcial reflejo tratado con maniobras físicas. Sin la necesidad de usar medicamento ni vía área mecánica. Conclusiones: Las maniobras utilizadas son seguras y efectivas en el tratamiento del laringoespasmo reflejo sin la necesidad de abordar la vía aérea ni uso de medicamentos, se lograron resultados satisfactorios con una relación riesgo beneficio a favor del paciente(AU)

Introduction: Laryngospasm is a complication feared by anesthesiologists. It is associated with bronchospasm, hypoxia, arrhythmias, aspiration of gastric contents, and cardiac arrest. It is more common among neonates and infants. It is closely related to the type of surgery and consists in an intense and prolonged closure of the glottis in response to direct or reflex glottic stimulation. Objective: To describe the management of reflex partial laryngospasm in a pediatric patient during a urological intervention. Case presentation: 18-month-old patient who received meatotomy. During surgery, he presented reflex partial laryngospasm managed with physical maneuvers, without the need to use medication or the mechanic airways ventilation. Conclusions: The maneuvers used are safe and effective for the management of reflex laryngospasm without the need to address the airway or using of medications. Satisfactory outcomes were achieved with a risk-benefit ratio in favor of the patient(AU)