Resumen Objetivo: El objetivo de este estudio es evaluar la asociación entre las complicaciones inducidas por dopaminérgicos y la satisfacción con la vida en pacientes con enfermedad de Parkinson. Métodos: Se realizó un estudio transversal. Los sujetos fueron reclutados de dos clínicas de trastornos del movimiento en México, de mayo a octubre de 2019. Las complicaciones inducidas por fármacos dopaminérgicos se evaluaron con la escala de calificación unificada de la enfermedad de Parkinson de la sociedad de trastornos del movimiento ítems 4.1 al 4.5. La variable desenlace se obtuvo por medio de la escala de satisfacción con la vida. Se utilizaron coeficientes de correlación. Resultados: 68 pacientes fueron incluidos en el estudio. La puntuación media de la escala de satisfacción con la vida fue de 25.7 (DE = 5.3), con un 66.1% de ellos con una puntuación superior a la media. Observamos que la edad al momento del diagnóstico (rs = 0.256, p = 0.035), educación (rs = 0.240, p = 0.048), región geográfica (r2 = 0.180, p = 0.034), escala unificada de calificación de la enfermedad de Parkinson, parte I (rs = −0.378, p = 0.002) y II (rs = −0.280, p = 0.021) y el estadio de Hoehn y Yahr (rs = −0.295, p = 0.015) se correlacionaron significativamente con las puntuaciones de la escala de satisfacción con la vida. El análisis del coeficiente de correlación parcial reveló una correlación estadísticamente significativa pero moderada entre las fluctuaciones motoras y las puntuaciones de la escala de satisfacción con la vida (rs = −0.408, p = 0.001). No se observó una correlación significativa con las discinesias. Conclusiones: Las fluctuaciones motoras, pero no las discinesias, tienen un efecto perjudicial sobre la satisfacción con la vida de los pacientes. Las estrategias para reducir las fluctuaciones motoras y comprender mejor la contribución de estas a la vida de los pacientes pueden ayudar a minimizar el impacto negativo de estas complicaciones en los pacientes con Parkinson.

Abstract Objective: The aim of this study was to assess the association between dopaminergic-induced complications and satisfaction with life in patients with Parkinson’s disease. Methods: A cross-sectional study was carried out. Subjects were recruited from two movement disorders clinics in Mexico, from May to October 2019. Dopaminergic drug-induced complications were assessed with the movement disorders society – unified Parkinson’s disease rating scale items 4.1-4.5 where satisfaction with life scale score was used as the outcome variable. Correlation coefficients were utilized. Results: Sixty-eight patients were included in the study. The mean satisfaction with life scale score was 25.7 (SD = 5.3), with 66.1% of them scoring higher than average scores. Age at diagnosis (rs = 0.256, p = 0.035), education (rs = 0.240, p = 0.048), geographic region (r2 = 0.180, p = 0.034), movement disorders society - unified Parkinson’s disease rating scale part I (rs = −0.378, p = 0.002) and II (rs = −0.280, p = 0.021), and Hoehn and Yahr stage (rs = −0.295, p = 0.015) were significantly correlated with satisfaction with life scale scores. Partial correlation coefficient analysis revealed a statistically significant but moderate correlation between motor fluctuations and satisfaction with life scale scores (rs = −0.408, p = 0.001). No significant correlation was observed with dyskinesias. Conclusions: Motor fluctuations but not dyskinesias have a detrimental effect on patients’ life satisfaction. Strategies to reduce motor fluctuations and better understanding the contribution of these to patients’ lives may help minimize the negative impact of these complications on patients with PD.

Abstract Background: Parkinson's disease (PD) is a neurodegenerative disorder whose treatment in advanced stages is often complex and challenging. The treatment goal at this stage is to provide greater clinical stability, with less "off" time and longer "on" time. Mucuna pruriens (MP) is a legume plant traditionally used in Ayurvedic medicine for Parkinsonian-type diseases. This plant contains a diversity of elements, among which levodopa stands out. Objective: We explored the effect of MP as adjunct therapy to levodopa in a PD patient. Methods: We report the case of a 42-year-old woman with PD in advanced stages due to motor fluctuations and dyskinesias. Due to the progression of her disease, the limitations that it generates and the economic inability to opt for other therapies such as surgical treatments, we used MP as an adjunct therapy to levodopa. Results: MP produces a clinical motor effect similar to conventional levodopa. MP shortened the time to reach the "on" state and prolonged this state without exacerbating dyskinesias. Psychiatric side effects were observed only with high dosages of MP. Conclusions: MP shows to be a promising adjunct therapy to levodopa in advanced PD patients without access to other conventional therapies.

Resumen Antecedentes: La enfermedad de Parkinson (EP) es un trastorno neurodegenerativo cuyo tratamiento en etapas avanzadas suele ser complejo y desafiante. El objetivo del tratamiento en esta etapa es proporcionar una mayor estabilidad clínica, con menos tiempo de "apagado" y más tiempo de "encendido". Mucuna pruriens (MP) es una planta leguminosa utilizada tradicionalmente en la medicina ayurvédica para las enfermedades de tipo parkinsoniano. Esta planta contiene diversidad de elementos, entre los que destaca la levodopa. Objetivo: Exploramos el efecto de la MP como terapia coadjuvante a levodopa en un paciente con EP. Métodos: Presentamos el caso de una mujer de 42 años con EP en estadios avanzados por fluctuaciones motoras y discinesias. Debido a la progresión de su enfermedad, las limitaciones que genera y la imposibilidad económica de optar por otras terapias como los tratamientos quirúrgicos, utilizamos MP como terapia coadyuvante a la levodopa. Resultados: La MP produce un efecto clínico motor similar al de levodopa convencional. MP acortó el tiempo para el estado "on" medicamentoso y lo prolongó este mismo estado sin exacerbar las discinesias. Se observaron efectos secundarios psiquiátricos con dosis altas de MP. Conclusiones: La MP parece ser una terapia coadyuvante prometedora a la levodopa para pacientes con EP avanzada sin acceso a otras terapias convencionales.

Abstract Iso and non-iso architected TiN/Cr multilayers with constant composition were deposited by balanced magnetron sputtering aiming to investigate the influence of different architectures over coatings structures and properties. Glow discharge optical emission spectroscopy analyses were used to determine in-depth constituents and suggested that no diffusion of elements occurred between layers in room temperature. Field emission gun scanning electron microscopy analyses showed that all multilayers presented sharp interfaces and low porosity microstructures, with column-like grain growth influenced by layer sizes. Glancing angle X-ray diffraction analyses showed that multilayers consist of polycrystalline α-Cr and δ-TiN phases with a main peak in Cr(110) plane. The overlapping of TiN onto metallic layers led to the suppression of growth in the TiN(111) plane, although TiN layers thicker than 50 nm demonstrated a growth in plane TiN(200). Nanoindentation tests registered equal hardness values for all multilayers of around 16.2 GPa, on the other hand, a tendency to improve hardness has been identified for hierarchical multilayer. Oxidation tests revealed that architectures with thicker TiN top layers presented an improved oxidation resistance up to 600 ºC, probably due to growth in more compact TiN(200) plane. However, TiN/Cr coatings did not resist integrally to oxidation tests at 750 ºC.

ABSTRACT Ta1-xZrxN thin films were deposited by reactive magnetron sputtering aiming to investigate the influence of zirconium addition on the microstructure, hardness and high temperature oxidation resistance of the coatings. GAXRD showed that all Ta1-xZrxN thin films maintained ZrN crystalline structure, forming a TaZrN solid solution. Zr incorporation did not alter hardness values of Ta1-xZrxN coatings, however, promoted significant improvements in the oxidation resistance when compared to pure TaN thin films.

Abstract: The research investigates the impact of over-education in the Chilean workforce, using data from the PIAAC and CASEN surveys from 2003 to 2015. The results show that on average 37% of workers with higher education are classified as “over-educated” in the period 2003-2015. In addition, the majority of this “over-educated people” come from private universities and perform in technical, administrative and legislative jobs. I also use the 2015 CASEN survey to analyze the probability of being over-educated. The results show that workers with a technical or non-traditional degree in professional education institutes and private universities are those who are more likely to be considered “over-educated”. Moreover, I implemented a propensity score matching methodology using the CASEN survey 2015 to study the impact of over-education on wages and on-the-job training. The results suggest a negative impact of over-education on wages.

Resumen: En esta investigación se aborda la incidencia de la sobreeducación en la fuerza laboral empleada chilena. Los resultados muestran que los trabajadores con estudios superiores catalogados como sobreeducados alcanzan en promedio el 37% del total de trabajadores ocupados con educación superior, en el período 2003-2015. Utilizando la metodología de evaluación de impacto Propensity Score Matching se estima el impacto en la brecha salarial y en la proporción de capacitados (trabajadores que han realizado capacitaciones laborales) entre los trabajadores sobreeducados en relación con los no sobreeducados. Se encuentra evidencia que los sobreeducados perciben menor sueldo.

ABSTRACT Introduction and Objectives: Robotic assisted radical cystectomy (RARC) is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. Materials and Methods: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008. His hospital course at time of transplant was complicated by low-level BK virus viremia. Interestingly his trans-urethral bladder tumor resection specimen at time of bladder cancer diagnosis stained positive for SV40. His native kidneys were anuric so bilateral laparoscopic nephrectomy was performed in a staged fashion 2 weeks prior to RARC. Our surgical technique utilizes 6 trocars, of note a 12-mm assistant trocar is placed 1 cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the stapled enteric anastomosis. Surgical steps include: identification of native ureters bilaterally (removed en bloc with the bladder specimen); identification of the transplanted ureter at the right bladder dome; posterior bladder and prostate dissection along Denonvilliers’ fascia; development of the space of Retzius; ligation and transection of the bladder and prostate vascular bundles; apical prostate dissection and transection of urethra; left pelvic lymphadenectomy; ilium resection for creation of the ileal conduit; stapled enteric anastomosis; ureteroileal anastomosis; maturation of the ileal conduit stoma. Results: The surgery had no intraoperative complications. Operative time was 443 minutes (7.4 hours). Estimated blood loss was 250 cc. Length of hospital stay was 5 days. The patient did not experience any postoperative complications. The patient maintained good renal graft function with no decline in eGFR to date. Conclusions: As surgeon comfort and experience with robotic assisted surgery grows, robotic surgery can successfully be applied to less frequently performed procedures. Here we successfully performed a robotic assisted radical cystoprostatectomy with intracorporeal ileal conduit urinary diversion for a renal transplant recipient.

ABSTRACT Introduction: Augmentation ileocystoplasty is a common treatment in adults with low capacity bladders due to neurogenic bladder dysfunction. We describe here our technique for robotic assisted laparoscopic augmentation ileocystoplasty in an adult with a low capacity bladder due to neurogenic bladder dysfunction. Materials and Methods: The patient is a 35 years-old man with neurogenic bladder due to a C6 spinal cord injury in 2004. Cystometrogram shows a maximum capacity of 96cc and Pdet at maximum capacity of 97cmH2O. He manages his bladder with intermittent catheterization and experiences multiple episodes of incontinence between catheterizations. He experiences severe autonomic dysreflexia symptoms with indwelling urethral catheter. He has previously failed non operative management options of his bladder dysfunction. Our surgical technique utilizes 6 trocars, of note a 12mm assistant trocar is placed 1cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the enteric anastomosis. Surgical steps include: development of the space of Retzius/dropping the bladder; opening the bladder from the anterior to posterior bladder neck; excision of a segment of ileum; enteric anastomosis; detubularizing the ileal segment; suturing the ileal segment to the incised bladder edge. Results: The surgery had no intraoperative complications. Operative time was 286 minutes (4.8 hours). Estimated blood loss was 50cc. Length of hospital stay was 8 days. He did experience a postoperative complication on hospital day 3 of hematemesis, which did not require blood transfusion. Cystometrogram at 22 days post operatively showed a maximum bladder capacity of 165cc with a Pdet at maximum capacity of 10cmH2O. Conclusions: As surgeon comfort and experience with robotic assisted surgery grows, robotic surgery can successfully be applied to less frequently performed procedures. In this case we successfully performed a robotic assisted laparoscopic augmentation ileocystoplasty displaying improvement in measurable functional outcomes.

Resumen: El porocarcinoma ecrino es un tipo muy poco frecuente de cáncer de piel, originado en la porción epidérmica de las glándulas sudoríparas ecrinas. Representa no más del 0.01% de los tumores cutáneos. El 20% de los porocarcinomas ecrinos son recurrentes y el 20% producen metástasis a ganglios linfáticos. Se ha reportado escasos casos de metástasis a distancia. Tiene un índice de mortalidad del 67% de los pacientes con metástasis. El diagnóstico es basado en los hallazgos histopatológicos y los estudios complementarios de inmunohistoquímica, a veces necesarios para el diagnóstico diferencial con otros tipos más frecuentes de cáncer de piel. No existen pruebas de que este tipo de carcinoma responda a la quimioterapia ni la radioterapia. Se considera que el manejo principal debe ser la resección quirúrgica y la electroquimioterapia.

Abstract: Eccrine porocarcinoma is a rare type of skin cáncer arising from the intraepidermal portion of eccrine sweat glands, representing no more tan 0.01% of all cutaneous tumors. 20% of the Eccrine porocarcinoma will recur and 20% will metastasize to regional lymph nodes. Few cases of distant metastases has been reported . There is a mortality rate of 67% in patients with metastases. The diagnosis is primarily based on histopathologic findings and complementary immunohistochemistry for differential diagnosis mainly with more frequent skin cáncer. Neither chemotherapy nor radiation therapy has been proven to be of clinical benefit in treating this type of carcinoma. It is considered that the management should be based on surgical resection and electrochemotherapy.

En este trabajo se obtuvieron nanoparticulas de plata por la ruta de reducción química usando síntesis en un paso. Diferente a otros métodos reportados para nanoparticulas de plata, se usó 1-octanol como solvente y agente reductor, oleilamina y ácido oleico como agentes estabilizantes, mientras que el precursor del metal fue nitrato de plata. El crecimiento de las nanopartículas fue monitoreado por espectroscopia de absorción ultravioleta-visible y Raman, lo cual corroboró la oxidación del alcohol a ácido caprilico. Los ensayos de difracción de rayos X y microscopia electrónica de transmisión permitieron conocer la forma y el tamaño de las nanopartículas. Se encontró que la temperatura y los reactivos empleados fueron apropiados para producir nanopartículas de plata. Se formaron carboxilatos de plata como un paso intermedio en la reacción. Finalmente, el incremento en la concentración de ácido oleico permitió la obtención de nanopartículas de plata de menos de 5nm.

Size controlled silver nanoparticles were obtained via chemical reduction using one-pot synthesis. Differently from other reported methods for silver nanoparticles, 1-octanol was used as both solvent and reduction agent, oleylamine and oleic acid acted as capping agents and silver nitrate was used as the metal precursor. Ultraviolet-visible and Raman spectroscopy were used to monitor the in situ growth of the nanoparticles and to corroborate the oxidation of the alcohol to caprylic acid. X-ray diffraction (XRD) and transmission electron microscopy (TEM) served to find the size and shape of the nanoparticles. It was found that the temperature used and the reagents proportions were appropriated to produce silver nanoparticles. A growth mechanism was proposed including the formation of silver carboxylates as an intermediate step of the reaction. As a systematic use of oleic acid, we could observe that a higher concentration of this capping agent led to smaller and more homogenous nanoparticles, less than 5nm in size.