Abstract The paper bases the possible profitability and sustainability of the maguey plant from the biomass criterion and business paths, all in the context of the dissimilar logics of intervention, transfer and science that have been applied around the plant. The relevant literature review and the guide for the identification and analysis of the business possibilities of the bioeconomy are the main inputs necessary to achieve this end. Thus, it is possible to affirm that, although the maguey for mead/pulque is perhaps the most studied plant (linked to the indigenous past) since colonial times, today it gravitates in its last programmatic phase of incidence, survival, and preservation of cultural knowledge. Moreover, the paper shows that apart from pulque, it is feasible that the future of maguey embraces its multifunctionality and its multifaceted character, a synergy that will undoubtedly grant business viability to the average producer, especially in minimizing the maturity time factor versus disinterest in growing the plant.

Resumen El texto fundamenta la posible rentabilidad y sustentabilidad de la planta del maguey a partir del criterio biomasa y senderos de negocio, todo ello en el contexto de las disimiles lógicas de intervención, trasferencia y ciencia que se han aplicado alrededor de la planta. La revisión bibliográfica pertinente y la guía para la identificación y análisis de las posibilidades de negocios de la bioeconomía son los principales insumos necesarios para lograr tal finalidad. Así pues, es posible afirmar, pese a que el maguey aguamiel/pulque quizás desde la época colonial es la planta mayor estudiada (ligada al pasado indígena), hoy en día gravita en su última fase programática, de incidencia, sobrevivencia y preservación de saberes culturales. Más aún, el texto demuestra que aparte del pulque, es factible que el futuro del maguey abrase su multifuncionalidad y su carácter polifacético, sinergia que otorgará sin duda viabilidad de negocio al productor promedio, máxime en minimizar el factor tiempo de madurez versus desinterés por cultivar la planta.

RESUMO Os autores relatam um raro caso de uso de Suporte Avançado de Vida no contexto de uma parada cardíaca ocorrida em razão de uma origem aórtica anômala da artéria coronária direita em um paciente de 49 anos de idade. O paciente foi admitido com dor torácica e dispneia, evoluindo rapidamente para taquicardia ventricular sem pulso e parada cardiopulmonar. Considerou-se um infarto agudo do miocárdio e, na ausência de um laboratório de hemodinâmica no hospital, realizou-se trombólise. Subsequentemente, uma angiografia coronária revelou ausência de lesões angiográficas nas artérias coronárias e origem anômala da artéria coronária direita do seio de Valsalva oposto. Uma angiografia coronária por tomografia computadorizada confirmou o achado e determinou um trajeto entre a artéria pulmonar e a aorta. O paciente foi submetido à cirurgia cardíaca com realização de ponte de mamária para a artéria coronária direita, sem qualquer novo episódio de arritmia.

ABSTRACT The authors report a rare case of successful Advanced Life Support in the context of cardiac arrest due to the presence of an anomalous aortic origin of the right coronary artery in a 49-year-old patient. The patient was admitted due to chest pain and dyspnea, with rapid evolution of pulseless ventricular tachycardia and cardiopulmonary arrest. Acute myocardial infarction was considered, and in the absence of a hemodynamic laboratory in the hospital, thrombolysis was performed. Subsequently, coronary angiography revealed no angiographic lesions in the coronary arteries and an anomalous right coronary artery originating from the opposite sinus of Valsalva. Coronary computed tomography angiography confirmed this finding and determined the course between the pulmonary artery and the aorta. The patient underwent cardiac surgery with a bypass graft to the right coronary artery, with no recurrent episodes of arrythmia.

SUMMARY Objectives: Compare the dimension of the upper and lower pharyngeal airspace between the skeletal deformities class I, II and III in cephalometric radiographs. Material and methods: A retrospective type of study was made where there were analyzed 106 side radiogra-phies, taken in the X-ray center of the University health Center of the Peruvian University of Applied Sciences UPC between the years 2011 and 2014. Through the program Nemoceph® the main cephalometrics points and tracings were marked to be able to obtain the skeletal deformity (Steiner) and the dimension of the upper and lower airspace (McNamara). Results: In the upper pharyngeal airspace it was found that the highest aver-age dimension was 17.68 mm founded in the dentofacial deformation class III, and the lowest in class II with a value of 13.71 mm. Fort the lower airspace, the highest average was 15.98mm and the lowest 13.19mm, also founded in skeletal deformation Class III and Class II respectively. While comparing the size of the pharyngeal space between classes of deformity, it was found that there is statistically significant difference between the upper airspace of skeletal deformities class II and III with a value of p = 0.001; and in the lower, between classes III - I and III - II with values of p=0.0236 and p=0.0042 respectively. Conclusions: In this study it was found that there is a statistically significant difference in the upper and lower pharingeal airspace between the three dentofacial skeletal deformities.

RESUMEN Objetivo: Comparar la dimensión del espacio aéreo faríngeo superior e inferior en las deformidades esqueléticas clase I, II y III determinadas en radiografías cefalométricas. Material y métodos: Se realizó un estudio de tipo retrospectivo donde se analizó 106 radiografías cefalométricas, tomadas en el centro radiográfico del Centro Universitario de Salud de la Universidad Peruana de Ciencias Aplicadas entre los años 2011 y 2014. A través del programa Nemoceph® se marcaron los puntos y trazados cefalométricos principales para determinar la de-formidad esquelética (según Steiner) y la dimensión de las vías aéreas superior e inferior (según McNamara). Resultados: La mayor dimensión en promedio (17,68 mm), se encontró en el espacio aéreo faríngeo superior (EAFS) con en la deformidad dentofacial clase III (DDF clase III) y la menor dimensión en promedio (13,71 mm) en la DDF clase II. En el espacio aéreo faríngeo inferior (EAFI), el mayor promedio (15,98mm) se presenta en la DDF clase III y el menor promedio (13,19mm) en la DDF clase II. Al comparar la dimensión del espacio faríngeo (EAF) entre las DDF, se encontró que existe diferencias estadísticamente significativas entre el EAFS de las DDF II y III, con un valor de p = 0,001; y en el inferior entre DDF III con DDF I y DDF III con DDFII con valores de p=0,0236 y p=0,0042 respectivamente. Conclusiones: En este estudio se encontró que existe diferencias estadísticamente significativas en el espacio aéreo faríngeo superior e inferior entre las tres clases de deformidades esqueléticas.

ABSTRACT Objective: The aim of this study was to compare the variation in the size of the oropharyngeal space (OS) in the preoperative, immediate postoperative and post-operative 5 to 24 months according to the amount of mandibular setback. Material and method: Variation were evaluated on cephalometric radiographs taken few days before the surgery (Rx1), immediate postoperative (Rx2) and postoperative long time (5 to 24 months) (Rx3). The subjects were 20 patients (18 - 36 years) in whom dentofacial deformity class III was corrected by bilateral sagittal split ramus osteotomy setback. Surgery was done in two Oral and Maxillofacial specialized institutions, since 2003 to 2010. We examined the size of the oropharyngeal space at different times before and after mandibular setback surgery. Results: These shows no significant difference between the amount of mandibular setback and decrease the size of the oropharyngeal space. It was determined that the oropharyngeal space immediately after surgery increases and decreases over time as a result of soft and hard tissue adaptation. Conclusions: We conclude that there is a slight decreased in the anteroposterior dimension of oropharynx after mandibular setback surgery, however the variations is no statistically significant difference between the moments of evaluation (the amount of mandibular recoil and the decrease in OS).

RESUMEN Objetivos: Comparar la variación de la dimensión del espacio orofaríngeo (EO) en el prequirúrgico, postquirúrgico inmediato y postquirúrgico de 5 a 24 meses después de la cirugía de retroceso mandibular (CRM). Materiales y métodos: Se evaluaron las radiografías cefalométricas prequirúrgicas, postquirúrgicas inmediatas y postquirúrgicas de 5 a 24 meses de 20 pacientes con CRM del Servicio de Cirugía Oral y Maxilofacial de dos instituciones. Se cuantificó la dimensión del EO en diferentes momentos. Resultados: No se encontraron diferencias de significación entre la cantidad de retroceso mandibular y la variación de la dimensión del EO. Conclusiones: Existe una leve disminución de la dimensión del EO después de la CRM. No son estadísticamente significantes entre los momentos de evaluación. No se encontró correlación entre el retroceso mandibular y la disminución del EO.

Background: This infrequent pathology calls for broad experience and knowledge. The paper describes the clinical findings and treatment outcome. Methods: We evaluated 92 brachial plexus birth palsy patients requiring surgical treatment during 25 years; 67 present bone deformities and 31 soft tissue deformities.A retrospective, clinical-functional, analytical and descriptive methodology was used.We reviewed clinical records and personal observations. We followed the Bennett and Christopher algorhitm. When indicated we performed early plexus microsurgery. At 4 years post-op a secondary reconstruction might be necessary in certain cases. The limb was assessed with maneuvers and the DLA. Results: Our goal is to provide active abduction and external rotation. Different procedures were employed: early brachial plexus repair and palliative surgery. For such different pathologies that require varied surgical techniques the results will be considered in overall percentages. We achieved 80% functional improvement in C5-C6 and even C7 lesions. Conclusions: In birth palsy, microsurgical repair improves results. The Roper technique improves limb function. Studies indicate that children with severe injuries do better with both, i.e. primary and secondary surgical treatment. In C5-C6 lesions, it is possible to obtain up to 80% recovery.

Introducción: Es una afección infrecuente; nuestra experiencia consiste en 92 casos tratados en 25 años. Materiales y métodos: De los 92 pacientes operados, 67 presentaron deformidades osteoarticulares y 31, deformidades de las partes blandas. La metodología fue retrospectiva clínico-funcional, analítica y descriptiva considerando las historias clínicas y la valoración personal. Para el tratamiento se utilizó el algoritmo de Bennett y Christopher. Se efectuó en ocasiones la microcirugía temprana del plexo. A los 4 años algunos pacientes pueden requerir cirugías paliativas. Resultados: Con las cirugías del plexo y paliativas, se consiguió, en las lesiones C5-C6, la recuperación hasta en el 80% de los casos. Tratándose de cuadros distintos no comparables que requieren técnicas diversas, se consideraron los resultados en un porcentual global. Conclusiones: La reparación microquirúrgica del plexo braquial, efectuada en tiempo y forma, mejora los resultados en hasta un 75%. Agrupamos las secuelas en dos grandes grupos: uno sin alteraciones en la morfología osteoarticular y uno con ellas (displasia glenoidea, retroversión de la cabeza humeral y aplanamiento de la cabeza humeral). Las técnicas originales de Sever y de Sever- L'Episcopo están proscritas. Destacamos la utilidad del procedimiento de Roper efectuado antes de los 5 años de edad. Entre las cirugías del plexo y paliativas se puede lograr, en las lesiones C5-C6, una recuperación de hasta el 80%.

Background: Endothelial dysfunction is associated to a lower production of nitric oxide and a reduction of endothelium mediated vasodilation. Aim: To study the effects of pharmacological agents that modify nitric oxide synthetase (NOS) activity on tension changes induced by phenylephrine in rings of internal mammary and radial arteries and saphenous vein. Material and methods: Vessel rings of 7 to 10 mm length were obtained from 32 patients subjected to coronary vascular surgery Fourteen samples of radial artery, 12 samples of internal mammary artery and 15 samples of saphenous vein were obtained. A maximal contraction was induced with KC1 and dose response curves for phenylephrine (FE) in the absence or presence of L-arginine and L-arginine methyl ester (L-NAME), were constructed. Results: The tension induced by FE in internal mammary artery and saphenous vein reached a maximum, near 90% of 80 mM KCl-induced contraction, but in the radial artery, it reached a maximum of 63% (p <0.05). In all vessels, the dose response curves were significantly shifted to the right by L-arginine and to the ¡eft by L-NAME. Conclusions: Pre-incubation of human rings with L-ARG or L-NAME, changed the response to FE induced contraction, which may be related to different degrees of endothelial nitric oxide production or NO sensitivity. The basal NO production in radial artery seems to be larger than the other vessels