Resumo Persea lingue Ness é uma árvore que vive principalmente na floresta temperada do centro-sul do Chile. As folhas são usadas na etnomedicina. O fruto é uma drupa similar ao abacate e que nunca foi pesquisada anteriormente. O objetivo deste estudo foi o de avaliar a citotoxicidade em células leucêmicas e as atividades antibacterianas, assim como algumas características químicas do extrato de fruto e da folha do P. lingue. As atividades antibacterianas foram determinadas pelo método da inibição do crescimento bacteriano em meio líquido empregando-se bactérias Gram-positivas e Gram-negativas. As linhagens celulares leucêmicas, Kasumi-1 e Jurkat foram usadas para avaliar a atividade citotóxica em ensaios empregando-se iodeto de propídio e AlamarBlue. Foram avaliados os teores totais de fenóis, flavonóides, taninos condensados, alcalóides e lipídeos presentes nos extratos das folhas e dos frutos. As atividades antioxidantes de ambos os extratos também foram avaliadas. O extrato das folhas foi o que apresentou o maior conteúdo de fenóis, taninos condensados e flavonóides totais e a maior atividade antioxidante. Já o extrato de fruto apresentou a maior quantidade de lipídios e alcaloides e a melhor atividade antibacteriana contra Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus megaterium e Micrococcus luteus. Já o extrato das folhas apresentou apenas atividade contra M. luteus. Em relação à atividade citotóxica, apenas o extrato do fruto apresentou citotoxicidade contra as linhagens celulares Jurkat e Kasumi-1. Em resumo, o extrato do fruto de P. lingue é uma potencial fonte de moléculas com atividade biológica para o desenvolvimento de novos fármacos a serem utilizados em alguns tipos de leucemia, bem como agente antibacteriano.

Abstract Persea lingue Ness is a tree species that lives mainly in temperate forests of south-central Chile. Its leaves are used in ethnomedicine, the fruit is a drupe similar to that of the avocado and has not been studied. The aim of this study was to determine the cytotoxicity in leukemia cell and antibacterial activity, along with some chemical content characteristics of P. lingue fruit and leaf extracts. The antibacterial activity was determined by the inhibition of bacterial growth in liquid medium assay against Gram-positive and Gram-negative bacteria. The leukemia cell lines Kasumi-1 and Jurkat were used to evaluate the cytotoxic activity by using propidium iodide and AlamarBlue assays. Total phenolic, flavonoid, condensed tannin, alkaloid and lipid contents were evaluated in the fruit and in the leaf extracts. The antioxidant activity of both extracts were also elavaluated. Leaf extract presented the highest content of total phenols, condensed tannins and flavonoids, and also the highest antioxidant activity. While the fruit extract has a higher amount of lipids and alkaloids and the high antibacterial activity against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus megaterium and Micrococcus luteus. The leaf extract only showed activity against M. luteus. Concerning the cytotoxic activity, only the fruit extract showed cytotoxicity against the cell lines Jurkat and Kasumi-1. P. lingue fruit extract is a potential source of biologically active molecules for the development of new drugs to be used in some types of leukemia, as well as antibacterial agent.

RESUMEN El fibrohistiocitoma maligno es el sarcoma de partes blandas más frecuente en adultos; es poco frecuente como tumor primario cutáneo. Presenta predilección por el sexo masculino con una mayor incidencia entre la quinta y sexta década de la vida. Se localiza predominantemente en las extremidades. Presentamos a continuación el caso clínico de un paciente con diagnóstico de fibrohistiocitoma maligno localizado en hallux de pie derecho y realizaremos una revisión de la literatura.

ABSTRACT Malignant fibrohistiocytoma is the most frequent soft tissue tumor in adults; it is rare as a primary cutaneous tumor. It presents a predilection for males with the highest incidence between the fifth and sixth decade of life. It is located predominantly on the extremities. We will perform a literature review. We present below the clinical case of a patient diagnosed with malignant fibrohistiocytoma located in hallux of the right foot.

Abstract Mycoplasma hyopneumoniae is the main causal agent of Swine Enzootic Pneumonia, a chronic respiratory disease that occurs worldwide and causes major economic losses to the pig industry. There is no information about the presence of the bacteria in La Pampa province. Therefore, the aim of this study was to carry out an exploratory field research, from nasal swab samples from 20 to 50 kg BW pigs. The PCR diagnostic technique was used to detect the presence of the etiological agent DNA. 218 samples were tested, all of them were negative. Although these outcomes contribute important information for the pig sector, is necessary to continue with further studies to quantify the health impact of this disease, in La Pampa province.

Resumen El Mycoplasma hyopneumoniae es el principal agente causal de la neumonía enzoótica porcina, enfermedad respiratoria ampliamente distribuida y conocida en el mundo por las pérdidas económicas que ocasiona en la producción. No existe información sobre la prevalencia de M. hyopneumoniaeen la provincia de La Pampa, es por eso que el objetivo del presente trabajo fue realizar un estudio exploratorio de campo a partir de muestras de hisopados nasales de cerdos de 20 a 50 kg PV. Se utilizó la técnica diagnóstica molecular PCR para detectar la presencia de ADN del agente etiológico. Se evaluaron 218 muestras que resultaron todas negativas. La información generada es valiosa para el sector porcino pampeano, aunque se remarca la necesidad de continuar con mayores estudios para cuantificar el impacto sanitario de dicha enfermedad en la provincia de La Pampa.

RESUMO Introdução Os trabalhadores de escritório permanecem em posições estacionárias durante longos períodos e estão sujeitos a elevadas cargas laborais que podem interferir com a Qualidade de Vida, em interação com caraterísticas do trabalhador (como personalidade, autonomia, competência e empenho no trabalho). A Qualidade de Vida é um conceito multidimensional influenciado por fatores sociodemográficos, de saúde e trabalho, que se tornou um desafio de Saúde Ocupacional, pela preocupação crescente das organizações que atuam a esse nível. Objetivos Avaliar a perceção da Qualidade de Vida e relacioná-la com variáveis sociodemográficas, condições de saúde e de trabalho. Métodos Trata-se de um estudo observacional analítico transversal, com uma amostra de 119 trabalhadores de escritório (sendo 82 indivíduos do género masculino) de uma empresa fabricante de componentes automóveis. Utilizou-se o questionário SF-36v2 com o objetivo de avaliar a perceção da Qualidade de Vida relacionada com a saúde, bem como um questionário de caracterização da amostra para recolha de dados sociodemográficos, de saúde e trabalho, preenchidos no GoogleForms. Na análise dos dados foi realizada estatística descritiva e inferencial, com nível de significância 0,05, através do IBM SPSS Statistics versão 25.0. Resultados Os trabalhadores de escritório apresentaram em todas as dimensões da Qualidade de Vida pontuações acima de 52 em 100. Os itens físicos foram os que apresentaram maiores pontuações sendo a dimensão Função Física a que apresentou maior pontuação (95,3±7,74), as dimensões mentais apresentaram pontuações menores, nomeadamente o Desempenho Emocional (52,1±43,10) e a Vitalidade (57,9±24,16). Relativamente à análise das variáveis sociodemográficas e Qualidade de Vida, o género masculino apresentou uma melhor perceção da Qualidade de Vida com diferenças estatisticamente significativas nas dimensões Vitalidade (p=0,047) e Dor (p=0,043). Quanto às condições de saúde, verificou-se que a variável Obesidade apresentou diferenças estatisticamente significativas nas dimensões Função Física (p=0,001) e Estado de Saúde Geral (p=0,003), sendo os trabalhadores com obesidade os que apresentaram maior afetação nestas dimensões. Ser portador de doença crónica influenciou negativamente as dimensões Estado de Saúde Geral (p=0,034) e Vitalidade (p=0,047). Assim como estar de baixa médica afetou as dimensões Função Social (p=0,019) e Saúde Mental (p=0,001). Relativamente às condições de trabalho, verificaram-se diferenças significativas entre a variável Função de Direção e a dimensão Desempenho Físico (p=0,001), sendo os trabalhadores que exercem funções de direção os que apresentam valores mais baixos nesta dimensão. Conclusão A perceção da Qualidade de Vida diferiu nos diferentes níveis considerados, tendo-se verificado que as dimensões mentais foram as mais afetadas (Desempenho Emocional e Vitalidade); por outro lado, as dimensões físicas foram as que mais contribuíram para a boa perceção da Qualidade de Vida dos trabalhadores. As ofertas implementadas pela empresa podem ter influenciado positivamente os resultados do estudo e justificar a boa perceção global da Qualidade de Vida destes trabalhadores de escritório.

ABSTRACT Background Computer workers remain in the stationary positions for long periods and are subject to high workloads that can interfere with Quality of Life, taking into account the worker’s characteristics (such as personality, autonomy, competence and commitment to work). Quality of Life is a multidimensional concept influenced by socio-demographic, health and work factors, which has become an occupational health challenge, due to the growing concern of organizations working at this level. Aim(s) To evaluate the perception of Quality of Life and relate it to sociodemographic variables, health and work conditions. Methods This is a cross-sectional observational analytical study, with a sample of 119 office workers (82 male and 37 female) from an automotive components manufacturer. The SF-36v2 questionnaire was used to evaluate the perception of Quality of Life related to health, and a sample characterization questionnaire to collect socio-demographic, health and work data, filled out on Google Forms. In the data analysis, descriptive and inferential statistics, with a significance level of 0.05, were performed through IBM SPSS Statistics version 25.0. Results Office workers scored in all dimensions of Quality of Life scores above 52 out of 100. The physical dimensions were the ones that presented the highest scores, being the Physical Function dimension the one with the highest score (95.3±7.74), the mental dimensions presented lower scores, namely Emotional Performance (52.1±43.10) and Vitality (57.9±24.16). Regarding the analysis of socio-demographic variables and Quality of Life, male gender presented a better perception of Quality of Life with statistically significant differences in Vitality (p=0.047) and Pain (p=0.043) dimensions. Regarding health conditions, it was verified that the variable Obesity presented statistically significant differences in the dimensions Physical Function (p=0.001) and General Health Status (p=0.003), being the workers with obesity the most affected in these dimensions. Being chronically ill negatively influenced the dimensions General Health Status (p=0.034) and Vitality (p=0.047). As well as being on sick leave affected the dimensions Social Function (p=0.019) and Mental Health (p=0.001). Regarding the working conditions, there were significant differences in the variable steering function and the Physical Performance dimension (p=0.001), being the workers with steering functions the ones with lower values in this dimension. Conclusion The perception of the Quality of Life differed in the different dimensions, having been verified that the mental dimensions were the most affected (Emotional Performance and Vitality), on the other hand the physical dimensions were the ones that most contributed to the good perception of the Quality of Life of the workers. The offers implemented by the company may have positively influenced the results of the study and justify a good overall perception of the Quality of Life of these office workers.

ABSTRACT In the present report we present the synthesis and structural analysis of a chalcone derivative of Apocynin, 1-(4-hydroxy-3-methoxyphenyl)-3-(4-nitrophenyl)-2-propenone. The most characteristic feature of its molecular structure is its near-planarity, allowing molecules to be stacked in columns, at graphite intermolecular distances to each other and connected by a large variety of weak intermolecular interactions. The molecule presents structural analogies to related ones with significant pharmacological properties (e.g., Apocynin).

Abstract: Introduction: Medial Collateral Ligament (LCM) instability is associated with multi-ligamentary lesions. There are several procedures for the reconstruction of MCL, we present a percutaneous technique of augmentation. Our goal is to describe a new technique of reconstruction of the LCM by grafting and fixing with biocomposite screws. Material and methods: We present the technique in a total of 21 consecutive patients with MCL injury operated in the period of December 2011 to October 2014. Reconstruction of MCL was performed with long, tibial or long hallux tendon allografts in 18 patients and only one patient was used autograft. Eighteen of the 20 patients had associated lesions: 5 with medial meniscus injury, 8 with anterior cruciate ligament injury, (ACL), 8 with condral injury and 1 with lateral meniscus injury. Conclusion: The surgical technique presented is simple to perform, without damage to other structures and with a strong fixation.

Resumen: Introducción: La inestabilidad del ligamento colateral medial (LCM) se asocia con lesiones multiligamentarias. Existen varios procedimientos para la reconstrucción del LCM, presentamos una técnica percutánea de aumentación. Nuestro objetivo es describir una nueva técnica de reconstrucción del LCM mediante injerto y fijación con tornillos biocompuestos. Material y métodos: Presentamos la técnica en un total de 21 pacientes consecutivos con lesión del LCM operados en el período de Diciembre de 2011 a Octubre de 2014. La reconstrucción del LCM se realizó con aloinjertos del tendón del peroneo largo, tibial posterior o flexor largo del Hallux en 18 pacientes y solamente en un paciente se utilizó autoinjerto. De los 20 pacientes, 18 presentaron lesiones asociadas: cinco con lesión de menisco medial, ocho con lesión del ligamento cruzado anterior, (LCA), ocho con lesión condral y uno con lesión del menisco lateral. Conclusión: La técnica quirúrgica presentada es sencilla de realizar, sin daño a otras estructuras y con una fijación resistente.

Abstract BACKGROUND: Hidradenitis suppurativa is an inflammatory, chronic and recurrent disease with a high impact on patients quality of life, specifically in psychological and sexual aspects, as well as in labor productivity. OBJECTIVE: To generate a consensus document on the clinical management of patients with hidradenitis suppurativa in Mexico, that serves to standardize the diagnosis and treatment of these patients. METHOD: A multidisciplinary group was convened (dermatologists, gynecologists, surgeons, infectologists, proctologists) to analyze the evidence on the integral treatment of hidradenitis suppurativa (quality of life, clinimetry, diagnosis and treatment), located through a systematic review of the literature. The group discussed the issues and the recommendations were generated by unanimous agreement of the participants. RESULTS: Frequently, patients with hidradenitis suppurativa can take a long time to obtain the correct diagnosis and management, mainly due to the lack of evidence about the disease, as well as the lack of criteria to refer the patient to a specialist. Twenty-two recommendations were issued for the treatment of patients with hidradenitis suppurativa, which include diagnosis, staging and clinimetry, as well as clinical management in the first, second and third levels of care. CONCLUSIONS: The recommendations were issued based on the best available evidence, as well as the experience of the multidisciplinary group of experts in the treatment of hidradenitis suppurativa.

Resumen ANTECEDENTES: La hidradenitis supurativa es una enfermedad inflamatoria, crónica y recurrente con gran repercusión en la calidad de vida de los pacientes, específicamente en los aspectos psicológicos y sexuales, así como también en la productividad laboral. OBJETIVO: Generar un documento de consenso sobre el manejo clínico de los pacientes con hidradenitis supurativa en México que sirva para homologar el diagnóstico y tratamiento de estos pacientes. MÉTODO: Se convocó a un grupo multidisciplinario (dermatólogos, ginecólogos, cirujanos, infectólogos, proctólogos) para analizar la evidencia en el tratamiento integral de la hidradenitis supurativa (calidad de vida, clinimetría, diagnóstico y tratamiento), localizada mediante una revisión sistemática de la bibliografía. El grupo discutió sobre los temas y se generaron las recomendaciones por acuerdo unánime de los participantes. RESULTADOS: Con frecuencia los pacientes con hidradenitis supurativa pueden tardar mucho tiempo en obtener el diagnóstico y manejo correctos, principalmente debido a la falta de evidencia sobre la enfermedad, así como a la falta de criterios para referir al paciente con un especialista. Se emitieron 22 recomendaciones para el tratamiento de pacientes con hidradenitis supurativa, que comprenden el diagnóstico, estadificación y clinimetría, así como el manejo clínico en el primer, segundo y tercer nivel de atención. CONCLUSIONES: Se emitieron las recomendaciones con base en la mejor evidencia disponible, así como la experiencia del grupo multidisciplinario de expertos en el tratamiento de hidradenitis supurativa.

Abstract: We studied the relation between the presence of Perkinsus sp. with growth performance (shell height - SH, body weight - BW), condition index, and biochemical composition (triglycerids, proteins, lipids, and carbohydrates) of the oyster Crassostrea gigas cultivated in two farms from Sinaloa, Mexico. Perkinsus sp. Was detected in both farms throughout (June 2013 to June 2014). The oysters had diverse degrees of prevalence fluctuating from 26.7 to 83.3 %. According to the Mackin’s scale, the intensity of infection was light to very light (0.1 to 1.2). There were not significant correlations between the prevalence with all studied parameters. Oyster survival at both farms was not affected by the presence of the protozoan. Intensity of Perkinsus infection was positively correlated with the biochemical composition of oyster. The influence of environmental parameters on the incidence the parasite in C. gigas is discussed. The overall results suggest that the presence of Perkinsus sp. in C. gigas from the two farms did not affect the health of the cultivated oysters, however, periodic monitoring of this pathogen in the farms should be continued.

Resumen: Se estudió la relación entre la presencia de Perkinsus sp. con el crecimiento (altura de la concha, SH, y peso corporal, BW), índice de condición y composición bioquímica (triglicéridos, proteínas, lípidos y carbohidratos) del ostión Crassostrea gigas cultivado en dos granjas del estado de Sinaloa, México. Se detectó a Perkinsus sp. en ambas granjas durante 13 meses (junio 2013 a junio 2014). El grado de prevalencia en los ostiones fluctuó de 26.7 a 83.3 %. La intensidad de la infección de acuerdo a la escala de Mackin, fue de muy ligera a ligera (0.1 to 1.2) y mostró correlación positiva con la composición bioquímica del ostión. No existieron correlaciones significativas entre la prevalencia y todos los parámetros estudiados. La supervivencia del ostión en ambas granjas no fue afectada por la presencia del protozoario. Se discute la incidencia del parásito en C. gigas por la influencia de los parámetros ambientales. Los resultados sugieren que la presencia de Perkinsus sp. no afectó la salud de los ostiones en cultivo, sin embargo, la incidencia de este patógeno en las granjas debe ser monitoreada de forma periódica.

Abstract: Introduction: Primary sacral tumors are rare, treatment in most cases is surgical with or without adjuvant radiotherapy; oncology and functional results are usually adverse with a high rate of complications. Material and methods: We conducted a retrospective, analytical and observational studies that includes 22 cases treated between 2000 and 2017, analyzed their characteristics demographic, the type of treatment received, and the oncological, functional results and the rate of complications were analized. Results: 22 patients were subjected to sacrectomy with posterior approah because of cordoma (13 patients), giant cell tumour (three patients) and other (six patients). Three total sacrectomies, 13 partial sacrectomies, two hemisacrectomies and four sacrectomies enlarged were performed. The mean surgical time was 229 minutes, with an average bleeding of 2,100 cm3, the average tumour size was 13.8 cm (6-30cm); 10 patients were presented with complications, eight by surgical site infection, one sacral hernia and one osteomyelitis. Overall survival was 44.4 months. Conclusions: Treatment of sacral tumors is complex, requires a multidisciplinary team; the oncological result is adequate when you get free margins of neoplasia, the functional results will be determined by the type of resection, and the rate of complications is high however is the best alternative healing in our hospital.

Resumen: Introducción: Los tumores primarios de sacro son poco frecuentes, el tratamiento en la mayoría de los casos es quirúrgico con o sin radioterapia adyuvante; los resultados oncológicos y funcionales suelen ser adversos con una tasa alta de complicaciones. Material y métodos: Se realizó un estudio retrospectivo, analítico y observacional que incluye 22 casos tratados entre el 2000 y 2017, se analizaron sus características demográficas, el tipo de tratamiento en la recidiva y el resultado oncológico y funcional; asimismo, se analizó la tasa de complicaciones. Resultados: 22 pacientes fueron sometidos a sacrectomía, con abordaje posterior por cordoma (13 pacientes), tumor de células gigantes (tres pacientes) y otros (seis pacientes). Se realizaron tres sacrectomías totales, 13 sacrectomías parciales, dos hemisacrectomías y cuatro sacrectomías ampliadas. La media de duración quirúrgica fue de 229 minutos, con un sangrado promedio de 2,100 cm3, el tamaño tumoral promedio fue de 13.8 cm (6-30 cm); presentaron complicaciones 10 pacientes, ocho por infección de sitio quirúrgico, uno por hernia sacra y uno por osteomielitis. La supervivencia global fue de 44.4 meses. Discusión: El tratamiento de los tumores sacros es complejo y requiere un equipo multidisciplinario; el resultado oncológico es adecuado cuando se consiguen márgenes libres de neoplasia, los resultados funcionales estarán determinados por el tipo de resección y la tasa de complicaciones es alta; sin embargo, es la mejor alternativa de curación.

Abstract: Dedifferentiated parosteal osteosarcoma is a variant in which a high grade osteosarcoma coexists with a parosteal osteosarcoma. We report the case of a 20-year-old female patient who presented with six months of evolution of pain and functional limitation of the right forearm, with no apparent cause; radiographs were performed, observing a tumoral lesion in the diaphysis of the right ulna. Physical examination showed pain upon palpation in the diaphysis of the ulna and limitation of prone-supination. Axial computed tomography of the thorax revealed metastatic disease in the upper lobe of the left lung. An incisional biopsy was performed on the right ulna, with a report of dedifferentiated parosteal osteosarcoma. Therefore, the patient was managed with neoadjuvant chemotherapy with cisplatin and doxorubicin until completing three cycles. Surgical treatment consisted of intercalary resection of the diaphysis of the right ulna, plus reconstruction of the microvascularized autologous graft of the right fibular diaphysis and graft stabilization with 3.5 mm dynamic compression plate (DCP) and one-third tubular plate. In the same procedure, pulmonary metastasectomy was performed by thoracoscopy. Post-surgical histopathological report with 100% necrosis. Currently, the patient is asymptomatic, with no evidence of tumor activity. Dedifferentiated parosteal osteosarcoma is a rare pathology, but should be suspected as a differential diagnosis in the presence of a parosteal osteosarcoma; it should be taken into account that this disease can metastasize due to its dedifferentiated pattern. It is important to plan a surgical treatment that allows an adequate functional reconstruction, always taking into account the oncological principle.

Resumen: El osteosarcoma parostal desdiferenciado es una variante en la cual un osteosarcoma de alto grado coexiste con un osteosarcoma parostal. Se presenta el caso de un paciente femenino de 20 años; acudió con seis meses de evolución de dolor y limitación funcional en el antebrazo derecho sin causa aparente; se le realizaron radiografías, donde se observó una lesión tumoral en la diáfisis del cúbito derecho. A la exploración física, presentó dolor a la palpación en la diáfisis del cúbito y limitación a la pronosupinación. La tomografía axial computada de tórax reveló enfermedad metastásica en el lóbulo superior del pulmón izquierdo. Se le efectuó una biopsia incisional de la tumoración en el cúbito derecho, con reporte de osteosarcoma parostal desdiferenciado. Por ello, inició manejo con quimioterapia neoadyuvante con cisplatino y doxorrubicina hasta completar tres ciclos. El tratamiento quirúrgico consistió en resección intercalar de la diáfisis del cúbito derecho más reconstrucción de injerto autólogo microvascularizado de la diáfisis del peroné derecho y estabilización del injerto con placa de compresión dinámica (DCP) 3.5 mm y placa tercio de caña. En el mismo procedimiento se le efectuó metastasectomía pulmonar por toracoscopía. El reporte histopatológico postquirúrgico, con necrosis de 100%. Actualmente, la paciente se encuentra asintomática, sin datos de actividad tumoral. El osteosarcoma parostal desdiferenciado es una patología rara, pero que se debe sospechar como diagnóstico diferencial ante un osteosarcoma parostal; se debe tener en cuenta que esta enfermedad puede generar metástasis por su patrón desdiferenciado. Es importante planificar un tratamiento quirúrgico que permita una adecuada reconstrucción funcional, siempre teniendo en cuenta el principio oncológico.

Abstract BACKGROUND: seminal vesicle cysts are rare entities. Their estimated incidence is 0.005% and they are more frequently diagnosed between the second and fourth decades of life. The majority of cases present as a single lesion, but multiple lesions have been reported. They are congenital or acquired, and the former is associated with mesophrenic duct (Wolffian duct) alterations. Two thirds of the cases include the presence of ipsilateral renal agenesis (Zinner syndrome). The acquired form is associated with obstructive, presumably infectious, causes. CLINICAL CASE: a 43-year-old man sought medical attention for lower urinary tract voiding symptoms, accompanied with hematospermia, rectal tenesmus, and pelvic pain. DISCUSSION: varying forms and degrees of clinical presentation have been observed in patients with seminal vesicle cysts. Some patients are asymptomatic, whereas others present with lower urinary tract symptoms, urinary infections, hematuria, hematospermia, and even infertility. Large cysts can be accompanied with gastrointestinal symptoms, such as constipation and rectal tenesmus. Because it is a rare condition, there is no consensus on the treatment and management of these patients. At present, treatment is reserved for symptomatic patients. Different authors propose the endoscopic approach as first-line treatment, considering vesiculoscopy as the criterion standard in seminal vesicle cyst management.

Resumen ANTECEDENTES: los quistes de vesícula seminal son infrecuentes. Se estima una incidencia de 0.005% y se diagnostican con mayor frecuencia de la segunda a la cuarta décadas de la vida. La mayoría de los casos se manifiesta con lesión única, aunque pueden encontrarse múltiples lesiones. La presentación puede ser congénita o adquirida; la primera se asocia con alteraciones del conducto mesonéfrico (conducto de Wolf). En dos terceras partes de los casos se ha descrito agenesia renal ipsilateral (síndrome de Zinner). La forma adquirida se asocia con causas obstructivas, quizá infecciosas. CASO CLÍNICO: paciente masculino de 43 años de edad, que acudió a consulta por síntomas urinarios bajos, de vaciamiento, acompañados de hematoespermia, tenesmo rectal y dolor pélvico. DISCUSIÓN: en pacientes con quistes en la vesícula seminal se han observado formas y grados variables en su manifestación clínica, algunos cursan asintomáticos y otros con síntomas urinarios obstructivos, infecciones urinarias, hematuria, hematoespermia e incluso infertilidad. Cuando los quistes son de mayor tamaño puede haber síntomas gastrointestinales: estreñimiento y tenesmo rectal. Debido a que estos quistes son infrecuentes, no existe consenso actual acerca de la conducta a seguir y el tratamiento. Hoy el tratamiento se reserva para pacientes sintomáticos; diversos artículos proponen el abordaje endoscópico, como la primera opción de tratamiento, considerando a la vesiculoscopia como el patrón de referencia para el tratamiento de los quistes de la vesícula seminal.

Abstract BACKGROUND: Vulvar cancer is a relatively infrequent disease, that constitutes 1-5% of all gynecological cancers. Surgery is the mainstay treatment is adequate resection, and lymph node evaluation, often have a high risk of relapse that may reach 65%. ADVANCED: Stages are a surgical challenge and multidisciplinary ap proach with plastic surgery will provide adequate surgical margins, less complications, adequate wound closure, and early adjuvant treat ment starting; as well as excellent cosmetic results, with functional, psychological and sexual morbidity decreased. OBJECTIVES: To describe and present the alternatives of vulvoperineal reconstruction in vulvar cancer at Instituto Nacional de Cancerología, Mexico. METHODS: A retrospective descriptive analysis of eleven cases of vulvoperineal reconstruction in vulvar cancer was performed from January 2015 to December 2015, at Instituto Nacional de Cancerología, Mexico; for one plastic surgeon; and demonstrated the algorithm base don their experience. RESULTS: We performed 11 patients of vulvar reconstruction with different reconstructive techniques, such as gracilis flapping, pudend, with a high success rate. as well as, to propose an algorithm based in our experience with vulvar cancer reconstruction at Instituto Nacional de Cancerología, Mexico. CONCLUSION: The present article aims to review the reconstructive alternatives in Vulvar Cancer, several algorithms for surgical treatment have been published before; but they tend to be complex, in part be cause of the low incidence of Vulvar Cancer and the several options of reconstructive procedures.

Resumen ANTECEDENTES: Los estadios clínicos avanzados del cáncer vulvar representan un reto quirúrgico y un abordaje que requiere ser multidisciplinario, con cirugía plástica que provea márgenes quirúrgicos adecuados, con menor tasa de complicaciones, cierre primario de la herida e inicio temprano de la terapia oncológica coadyuvante. OBJETIVOS: Describir y exponer las alternativas de reconstrucción vulvoperineal para pacientes con cáncer vulvar, atendidas en el Instituto Nacional de Cancerología de México. MATERIALES Y MÉTODOS: Análisis descriptivo y retrospectivo de casos de pacientes a quienes se hizo reconstrucción vulvoperineal en el Instituto Nacional de Cancerología, México, entre enero y diciembre de 2015, por el mismo cirujano plástico. Se muestra el algoritmo basado en su experiencia. RESULTADOS: Se analizaron 11 casos de pacientes operadas con diferentes técnicas de reconstrucción vulvoperineal, por defectos quirúrgicos del cáncer vulvar y se expuso el algoritmo utilizado y la experiencia del cirujano. CONCLUSIONES: Se revisaron las diferentes alternativas de reconstrucción para subsanar defectos quirúrgicos en pacientes con cáncer vulvar. Los algoritmos de tratamiento quirúrgico previamente publicados son confusos y complejos, quizá por la baja incidencia del cáncer vulvar y las diversas opciones de procedimientos de reconstrucción.

Abstract BACKGROUND: Preeclampsia is a major cause of maternal and fetal morbidity and mortality. The loss of the balance between pro-angiogenic and antiangiogenic factors precedes the clinical presentation of preeclampsia. This alteration is greater in early and severe forms of the disease and shows association to adverse perinatal outcome. OBJECTIVE: To determine the relationship between serum concentrations of angiogenic factors and the severity of preeclampsia and gestational hypertension with the maternal and perinatal outcome. MATERIALS AND METHODS: A cross-sectional comparative study from September 2013 to August 2015 was performed in the Hospital of Gynecology and Obstetrics No. 4 IMSS Luis Castelazo Ayala. A total of 196 patients were analyzed including singleton pregnancies ≥ 20 weeks’ gestation diagnosed with preeclampsia and gestational hypertension. The patients were divided in five groups: mild gestational hypertension (n = 46), mild preeclampsia (n = 20), severe gestational hypertension (n = 19), severe preeclampsia (n = 89), and severe complicated preeclampsia (n = 22). Additionally the total patients were divided in two groups: with and without adverse maternal outcome and the second group with and without adverse perinatal outcome. The serum concentration of sFlt-1, PlGF and the respective sFlt1/PLGF ratio were determinate with electrochemiluminescence. The management and timing of the termination of pregnancy was performed based on established guidelines for clinical practice. RESULTS: The serum concentration of sFlt-1, PlGF and the respective sFlt1/PLGF ratio were significant different between the 5 groups analyzed (p < 0.001). Moreover, the difference of the concentrations of angiogenic factors are closely associated with the severity of hypertensive disease of pregnancy (p < 0.001). The sFlt1/PLGF ratio was higher in those with adverse maternal and fetal outcomes compared to those who did not had (222.5 vs 112.8 and 158.3 vs 53.1 respectively) p < 0.001. CONCLUSION: Major alteration was observed in the concentration of angiogenic factors as the greater the severity of hypertensive disease in pregnancy. Likewise, the sFlt-1/PlGF ratio was higher in those with adverse maternal and perinatal outcomes compared to those who did not have. Therefore this relationship has potential use as a biochemical marker of severity and risk stratification.

Resumen OBJETIVO: determinar la relación entre las concentraciones séricas de factores angiogénicos con la severidad de la preeclampsia e hipertensión gestacional y con el resultado materno y perinatal adverso. MATERIALES Y MÉTODOS: estudio transversal y comparativo efectuado en pacientes atendidas entre los meses de septiembre de 2013 y agosto de 2015 en la Unidad Médica de Alta Especialidad. La población de estudio se dividió en cinco grupos: 1) hipertensión gestacional leve, 2) preeclampsia leve, 3) hipertensión gestacional severa, 4) preeclampsia severa y 5) preeclampsia severa complicada. Además, el total de pacientes se analizó según el resultado materno o perinatal adverso. Las concentraciones séricas de sFlt-1, PlGF y su relación sFlt1/PlGF se midieron con electroquimioluminiscencia. RESULTADOS: se estudiaron 196 mujeres con embarazo único ≥ 20 semanas de gestación, con hipertensión gestacional y preeclampsia. Las concentraciones de sFlt-1, PlGF y la relación sFlt1/PlGF fueron significativamente diferentes entre los cinco grupos de estudio (p < 0.001). La diferencia en la concentración de los factores angiogénicos fue más marcada conforme mayor fue la severidad de la enfermedad hipertensiva en el embarazo (p < 0.001). La relación sFlt-1/PIGF fue significativamente mayor en las pacientes con resultado materno o perinatal adverso en comparación con quienes no lo tuvieron (222.5 vs 112.8 y 158.3 vs 53.1, respectivamente) p < 0.001. CONCLUSIÓN: conforme mayor fue la severidad de la enfermedad hipertensiva en el embarazo se observó mayor alteración en la concentración de factores angiogénicos (p < 0.001). Así mismo, la relación sFlt-1/PIG fue mayor en pacientes con resultado materno y perinatal adverso (p < 0.001).

La cobertura rápida y eficaz de las lesiones es un factor limitante en el tratamiento de grandes quemados. Los autoinjertos siguen siendo el tratamiento de elección pero no están exentos de riesgos. El uso de sustitutos de piel cultivada (SPC) puede llegar a reducir la morbilidad implícita en el uso de autoinjertos. El objetivo de este estudio es realizar un análisis comparativo de la morbilidad asociada al uso de queratinocitos y autoinjertos en pacientes tratados inicialmente con aloinjertos como cobertura temporal. Realizamos un análisis retrospectivo de morbilidad en 21 pacientes con una superficie corporal quemada (SCQ) mayor o igual al 40% en el Hospital Universitario La Paz, Madrid (España) entre 2011y 2015. Fueron divididos en 2 grupos según la cobertura definitiva utilizada: un primer grupo con sesiones de autoinjerto, y un segundo grupo con cultivos de queratinocitos y áreas menores de autoinjertos. Fueron 5 mujeres y 16 varones con media de edad de 40,38 años, SCQ del 60,43% y SCQ dérmico profunda-subdérmica del 59,05%. La media de cirugías necesarias en pacientes tratados con autoinjertos y SPC fue 5,36 y 6,7 respectivamente. La incidencia de sepsis fue 80 frente a 50%; el fracaso renal agudo del 63,6 frente al 50%; y de neumonía del 27.3 frente al 40%. Entre los pacientes que sobrevivieron la estancia media en Unidad de Cuidados Intensivos fue de 66,16 frente a 50,6 días, la estancia media hospitalaria fue de 75,6 frente a 63,3 días y la media del número de trasfusiones fue de 75,6 frente a 63.3. La complicación del lecho quirúrgico en el grupo de autoinjertos fue del 63% frente al 0% en los tratados con queratinocitos, y las necesidades medias de noradrenalina fueron de 0,1 frente a 0,03 µg/kg/min. Los pacientes con lecho quirúrgico complicado tuvieron unos requerimientos medios de noradrenalina de 0,117 frente a 0,044 en pacientes con lecho quirúrgico no complicado. Como conclusión, los pacientes tratados con autoinjertos precisaron mayor aporte de drogas vasoactivas para mantener la presión de perfusión y tuvieron mayor incidencia de complicaciones del lecho quirúrgico. Los pacientes con lecho quirúrgico complicado tuvieron mayor aporte de noradrenalina durante su ingreso. El resto de variables analizadas fueron peores en los pacientes tratados solo con autoinjertos, aunque sin demostrar diferencias estadísticamente significativas.

Rapid and effective closure of full-thickness burn wounds is a limiting factor in severely burned patients. Autografts remain the treatment of choice, but not without risks. The use of cultured skin substitutes (CSS) can reduce morbidity implicit in the use of autografts. The aim of this study is to conduct a comparative analysis of the use of keratinocytes and autografts in patients who were initially treated with allograft as temporal coverage. We conduct a comparative retrospective analysis of morbidity in 21 patients with a total burned body surface area (TBSA) greater than or equal to 40% at the Hospital Universitario La Paz, Madrid (Spain), between 2011-2015. Two groups were collected: treated with autografts versus CSS+autografts. Patients included 5 women and 16 men with a mean age of 40,38, TBSA 60,43% and TBSA - Full-thickness of 59,05%. The average surgical interventions in patients treated with autograft and CSS was 5,36 and 6,7 respectively. The incidence of sepsis was 80 vs 50%; acute renal failure was 63,6 vs 50%; and 40 % vs 27,3 pneumonia. Among patients who survived the average Intensive Care Unit stay was 50,6 days vs 66,16, the average hospital stay was 75,6 vs 63,3 days and the average number of transfusions was 75,6 vs 63,3. The complication of surgical wound bed in the autograft group was 63% vs 0% in those treated with keratinocytes and the average needs of noradrenaline were 0,1 vs 0,03 ug/kg/min. Patients with complicated surgical wound bed had means noradrenaline requirements of 0,117 vs 0,044 in patients with epithelialized DS. In conclusion, patients treated with autograft were greater in contribution of vasoactive drugs to maintain perfusion pressure and had a higher incidence of complication of surgical wound bed. Patients with surgical wound bed complicated had higher intake of noradrenaline during admission. The remaining outcomes were worse in patients treated only with autografts , but not were shown statistically significant differences.

Oenologists and wine exporters know that a serious problem is to determine the quality of wine after it travels to final market. In fact the last quality controls are made after the bottling and before the trip. Chile is an important exporter of wine and Asiatic markets are a common destination for this exportation, taking long times of traveling. If wine changes it quality due to different stressing situations during the trip, the final costumer will receive a low-quality beverage in spite of the high quality of the original wine. This fact can reduce the interest of the costumer to consume Chilean wine and diminishes the importations of this product.