ABSTRACT Cardiovascular diseases continue to be the leading cause of morbidity and mortality worldwide. Although there are therapeutic and pharmacological tools that help control the incidence of cardiovascular outcomes by reducing cardiovascular risk, inequities in timely access to healthcare services and social determinants of health prevent the entire population in need from receiving this therapeutic assistance. Thus, non-pharmacological interventions are prioritized, among which the diet stands out, as it has been shown to significantly influence cardiovascular health and life expectancy. Particularly, the Mediterranean diet, primarily based on the consumption of fruits, vegetables, grains, legumes, olive oil, spices, followed by fish and seafood-derived protein, has demonstrated a certain degree of protection against cardiometabolic diseases. However, the impact on a population with high cardiovascular risk and established cardiovascular disease remains uncertain. Considering the evolving evidence on dietary patterns and the need to understand how viable diets in our context affect individuals with a higher risk of morbidity and mortality from cardiovascular disease, the objective of this review is to present updated evidence on the benefits of the Mediterranean diet in individuals with high cardiovascular risk. For this purpose, a literature search was performed in the PubMed, Science Direct, and Scielo databases.

RESUMEN Las enfermedades cardiovasculares siguen siendo la principal causa de morbilidad y mortalidad en el mundo. Y aunque existen herramientas terapéuticas y farmacológicas que ayudan a controlar la incidencia de desenlaces cardiovasculares con la reducción del riesgo cardiovascular, las inequidades en el acceso oportuno a servicios de salud y de determinantes sociales de la salud impiden que toda la población con esta necesidad pueda recibir esta ayuda terapéutica. Es así, como se da prioridad a las intervenciones no farmacológicas, dentro de las que se destaca, la dieta, la cual ha demostrado influir significativamente en la salud cardiovascular y en la expectativa de vida del ser humano. Particularmente, la dieta mediterránea, basada esencialmente en el consumo de frutas, vegetales, granos, legumbres, aceite de oliva, especias, seguido de proteína derivada de pescado y comida de mar, ha demostrado proveer cierto grado de protección frente a enfermedades cardiometabólicas. Sin embargo, se desconoce con certeza cuál es el impacto en la población con elevado riesgo cardiovascular y, por ende, enfermedad cardiovascular establecida. Considerando la evolución de la evidencia en los patrones dietarios, así como la necesidad de conocer qué tanto impactan las dietas viables en nuestro medio, sobre todo en aquellos con mayor riesgo de morbilidad y mortalidad por enfermedad cardiovascular, el objetivo de esta revisión consiste en exponer evidencia actualizada sobre los beneficios de la dieta mediterránea en individuos con elevado riesgo cardiovascular. Para esto, se realizó una búsqueda bibliográfica en las bases de datos PubMed, Science Direct y Scielo.

Resumen. Los modelos alométricos son de vital importancia ya que permiten estimar la biomasa aérea en cada uno de sus componentes (hojas, ramas, fuste y total) del árbol. El objetivo del estudio fue ajustar modelos alométricos para estimar biomasa aérea por componentes en árboles individuales de Tectona grandis L. f. en Tizimín, Yucatán. La biomasa aérea se estimó mediante el método directo, se derribó en campo un total de 32 individuos, cada árbol se separó por componente; hojas, ramas y fuste y se determinó el peso verde, se extrajeron submuestras de los componentes para determinar la relación peso seco-peso verde. Para obtener la biomasa se multiplicó el peso verde total de cada componente por su relación correspondiente. Para cada componente se ajustaron ecuaciones lineales y no lineales, mediante el método de mínimos cuadrados ordinarios. El modelo no lineal (potencial) mostró mejor ajuste, presentando el componente fuste y total registraron un R2 de 0.96 en T. grandis L. f. La proporción de biomasa en cada uno de sus componentes fue diferente, siendo el fuste el de mayor porcentaje con un 48%, seguido de ramas con 35 y 17% en hojas.

Abstract. Allometric models are of vital importance since they allow estimating the aerial biomass in each of its components (leaves, branches, stem and total) of the tree. The objective of the study was to adjust allometric models to estimate aerial biomass by components in individual trees of Tectona grandis L. f. in Tizimin, Yucatan. Aerial biomass was estimated using the direct method, a total of 32 individuals were shot down in the field, each tree was separated by component; leaves, branches and stem and the green weight was determined, subsamples of the components were extracted to determine the dry weight-green weight relationship. To obtain the biomass, the total green weight of each component was multiplied by its corresponding ratio. Linear and non-linear equations were adjusted for each component, using the method of ordinary least squares. The non-linear (potential) model showed a better fit, presenting the stem and total component they registered an R2 of 0.96 in T. grandis L. f. The proportion of biomass in each of its components was different, being the stem the one with the highest percentage with 48%, followed by branches with 35 and 17% leaves.

Resumen: Introducción: la proteína C ultrasensible (PCRus) es un biomarcador inflamatorio producido principalmente en el hígado. La obesidad ha sido ligada a un proceso inflamatorio crónico y tiene una conexión cercana con dicho biomarcador al sobreexpresar citocinas proinflamatorias derivadas del tejido adiposo. Objetivo: estudiar la asociación de la obesidad con la elevación de la PCRus como marcador proinflamatorio en población mexicana. Material y métodos: estudio retrospectivo y transversal. Se utilizaron registros de PCRus en pacientes de la clínica de medicina preventiva en un hospital privado de la Ciudad de México, de enero a junio de 2019. Población: 672 pacientes mayores de 20 años; 419 hombres y 253 mujeres, con datos de índice de masa corporal (IMC) y PCRus < 10 mg/L. Se realizó regresión lineal múltiple con transformaciones logarítmicas de PCRus, IMC y sexo. Resultados: el coeficiente para el logaritmo natural de IMC resultó positivo y estadísticamente significativo (p < 0.001), el coeficiente para sexo masculino resultó negativo y estadísticamente significativo (p < 0.001), el modelo obtuvo una R(2) = 0.17. Conclusiones: la elevación de PCRus se encontró asociada de manera positiva con el IMC y positiva con el sexo femenino; sin embargo, el modelo es poco explicativo, ya que existen elevaciones del PCRus en ambos grupos, aunque fue mayor en pacientes con obesidad, con o sin comorbilidades, esto sugiere que la PCRus es un marcador inflamatorio asociado a obesidad en población mexicana.

Abstract: Introduction: usCRP is an inflammatory biomarker produced in the liver. Obesity has been associated with a chronic inflammatory process and linked with said biomarker by overexpressing pro-inflammatory cytokines produced in adipose tissue. Objectives: study the association between elevated usCRP as a pro-inflammatory marker in patients with a diagnosis of obesity in the Mexican population. Material and methods: retrospective and cross-sectional study; registries of usCRP in patients of the preventive medicine clinic in a private hospital in Mexico City were reviewed from January to June 2019. The population included 672 patients, of which 419 were male and 253 female at least 20 years of age, in whom usCRP values < 10 mg/L. We performed a multiple linear regression with logarithmic transformations of usCRP, BMI, and sex. Results: the coefficient for the natural logarithm for the BMI was positive and statistically significant (p < 0.001), the coefficient for the male sex turned a negative and statistically significant result (p < 0.001), and the model obtained an R(2) = 0.17. Conclusions: a positive association between elevated usCRP, female sex, and BMI were found; however, this model does not manage to explain all elevations in usCRP, meaning that we found elevations in both groups. More significant elevations were found in obese patients, with or without comorbidities, thus suggesting that usCRP is an inflammatory marker associated with obesity in Mexican population.

Abstract: The main objective of this study was to design and develop a mobile application that contains the Kudo Box to promote intrinsic motivation among employees, using personalized cards with motivating messages, to improve organizations’ efficiency. The methodologies applied during the design and development stage were the incremental model and the technological acceptance model (TAM). The outcome was the design and development of a mobile application, which contains the management 3.0 tool named Kudo Box. This application can be used on Android devices at any place and time to send and receive personalized motivational cards among colleagues at a given organization. The mobile application complies with key TAM constructs and has an intuitive and attractive environment design for the user. In conclusion, the mobile application Kudo Box is easy to use and has a simple structure, as well as a good performance on mobile devices.

Resumen: El principal objetivo de este estudio fue diseñar y desarrollar una aplicación móvil que contiene la Caja Kudo para promover la motivación intrínseca de los empleados, por medio de tarjetas personalizadas con mensajes motivadores, y mejorar la eficiencia de las organizaciones. La metodología utilizada durante el diseño y desarrollo fue el modelo incremental y el modelo de aceptación tecnológica (TAM). Como resultado se diseñó y desarrolló una aplicación móvil que contiene la herramienta de administración 3.0 llamada Caja Kudo. Esta aplicación puede utilizarse en dispositivos Android en cualquier lugar y hora para enviar y recibir tarjetas motivacionales personalizadas entre compañeros de una organización. La aplicación móvil cumple con los constructos clave del TAM y cuenta con un diseño de entorno intuitivo y atractivo para el usuario. En conclusión, la aplicación Caja Kudo es fácil de usar y cuenta con una estructura simple, además de un buen rendimiento en el dispositivo móvil.

Resumen ANTECEDENTES: Las duplicaciones del aparato digestivo son una variante poco frecuente de malformación congénita. Si bien la mejora de los equipos de ecografía ha aumentado la tasa diagnóstica, solo el 30% se diagnostican antes del nacimiento. El diagnóstico diferencial de lesiones quísticas intraabdominales es amplio e incluye, por ejemplo, a los quistes de ovario, colédoco, mesenterio o pseudoquistes de meconio. El tratamiento es quirúrgico mediante la resección y restauración de la continuidad intestinal. CASO CLÍNICO: Paciente de 32 años, con un embarazo previo y en el segundo trimestre del actual, con sospecha de un quiste de duplicación intestinal. El estudio genético no evidenció anomalía alguna. La lesión, de morfología quística tubular, fue aumentando progresivamente de tamaño conforme avanzaban las semanas de embarazo. En la semana 39 se indicó, por diabetes gestacional insulinodependiente, la inducción del parto. Nació un varón, asintomático, mediante parto eutócico, sin complicaciones. La ecografía abdominal, resonancia magnética nuclear y estudio del tránsito intestinal del periodo neonatal temprano confirmó el diagnóstico prenatal de sospecha. Mediante una laparoscopia exploradora, a las dos semanas de vida se practicó la resección del defecto que se reportó como: duplicación intestinal ileal, sin comunicación con la luz intestinal. El curso posoperatorio fue favorable. CONCLUSIONES: El diagnóstico prenatal de quistes de duplicación en el aparato digestivo está en aumento debido a la mejoría en las técnicas de diagnóstico prenatal. La valoración multidisciplinaria es decisiva para procurar una adecuada vigilancia médica del embarazo y del recién nacido.

Abstract BACKGROUND: Duplications of the digestive tract are a rare variant of congenital malformation that can occur anywhere in the digestive tract. Although improved ultrasound equipment has increased the diagnostic rate, only 30% are diagnosed before birth. The differential diagnosis of intra-abdominal cystic lesions is broad and includes, for example, cysts of the ovary, common bile duct, mesentery or meconium pseudocysts. Treatment is surgical by resection and restoration of intestinal continuity. CLINICAL CASE: 32-year-old patient, with a previous pregnancy and in the second trimester of the current pregnancy, with suspicion of an intestinal duplication cyst. The genetic study did not reveal any abnormality. The lesion, of tubular cystic morphology, progressively increased in size as the weeks of pregnancy progressed. Induction of labour was indicated in week 39 due to insulin-dependent gestational diabetes. An asymptomatic male was born by euthecological delivery, without complications. Abdominal ultrasound, nuclear magnetic resonance imaging and intestinal transit study of the early neonatal period confirmed the suspected prenatal diagnosis. By means of exploratory laparoscopy, at two weeks of life, resection of the defect was performed, which was reported as: ileal intestinal duplication, without communication with the intestinal lumen. The postoperative course was favourable. CONCLUSIONS: Prenatal diagnosis of duplication cysts in the digestive tract is increasing due to improved prenatal diagnostic techniques. Multidisciplinary assessment is crucial to ensure adequate medical surveillance of the pregnancy and the newborn.

Abstract Background Sepsis is an uncontrolled inflammatory response against a systemic infection that results in elevated mortality, mainly induced by bacterial products known as endotoxins, producing endotoxemia. Disseminated intravascular coagulation (DIC) is frequently observed in septic patients and is associated with organ failure and death. Sepsis activates endothelial cells (ECs), promoting a prothrombotic phenotype contributing to DIC. Ion channel mediated calcium permeability participates in coagulation. The transient reception potential melastatin 7 (TRPM7) non-selective divalent cation channel that also contains an α-kinase domain, which is permeable to divalent cations including Ca2+, regulates endotoxin-stimulated calcium permeability in ECs and is associated with increased mortality in septic patients. However, whether endothelial TRPM7 mediates endotoxemia-induced coagulation is not known. Therefore, our aim was to examine if TRPM7 mediates coagulation during endotoxemia. Results The results showed that TRPM7 regulated endotoxin-induced platelet and neutrophil adhesion to ECs, dependent on the TRPM7 ion channel activity and by the α-kinase function. Endotoxic animals showed that TRPM7 mediated neutrophil rolling on blood vessels and intravascular coagulation. TRPM7 mediated the increased expression of the adhesion proteins, von Willebrand factor (vWF), intercellular adhesion molecule 1 (ICAM-1), and P-selectin, which were also mediated by the TRPM7 α-kinase function. Notably, endotoxin-induced expression of vWF, ICAM-1 and P-selectin were required for endotoxin-induced platelet and neutrophil adhesion to ECs. Endotoxemic rats showed increased endothelial TRPM7 expression associated with a procoagulant phenotype, liver and kidney dysfunction, increased death events and an increased relative risk of death. Interestingly, circulating ECs (CECs) from septic shock patients (SSPs) showed increased TRPM7 expression associated with increased DIC scores and decreased survival times. Additionally, SSPs with a high expression of TRPM7 in CECs showed increased mortality and relative risk of death. Notably, CECs from SSPs showed significant results from the AUROC analyses for predicting mortality in SSPs that were better than the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA) scores. Conclusions Our study demonstrates that sepsis-induced DIC is mediated by TRPM7 in ECs. TRPM7 ion channel activity and α-kinase function are required by DIC-mediated sepsis-induced organ dysfunction and its expression are associated with increased mortality during sepsis. TRPM7 appears as a new prognostic biomarker to predict mortality associated to DIC in SSPs, and as a novel target for drug development against DIC during infectious inflammatory diseases.

Abstract One of the main problems to be solved in the commercial production of Nile tilapia is the use of large volumes of steroids during the sex reversion process. The precise evaluation of the time after hatching to start the steroid treatment could help reduce its use in the short-term. The main objective of this work was to evaluate the sex proportion and the growth obtained in a mixed population of Nile tilapia fed fluoxymesterone at different days (3, 6, 9, 12, and 15) after hatching. A one-factor experiment was designed, with the day, after hatching, that the fluoxymesterone (5 mg) began to be supplied as factor (3, 6, 9, 12 and 15). Initial stocking density was 0.4 larvae L-1. All groups were evaluated by triplicate. Steroid treatment finished at day 25 after larvae stocking. Squash technique was used to determine sex proportion at the end of the experiment (45 days). Growth evaluation was performed based on wet weight and total length obtained from each biometry. The results showed the highest percentage of males (92%) in the fish fed fluoxymesterone from day three after hatching. No anabolic effect on growth was observed in any steroid-treated fish. A negative effect on growth was observed after withdrawal of the steroid in the fish that were fed fluoxymesterone for the longest time. These results show that it is necessary to supply the fluoxymesterone prior to the onset of sex differentiation (5-6 days after hatching) to achieve a permanent reversion of the sex differentiation process.

Resumen El estigma es un fenómeno caracterizado por una respuesta negativa hacia una persona poseedora de un atributo diferente dentro del grupo social en el que se desarrolla. Se han descrito dos tipos de estigma: el percibido (sentido o interiorizado) y el promovido (social o promulgado). Dentro de las enfermedades con más carga asociada a estigma se encuentra la epilepsia, una de las enfermedades neurológicas más prevalentes a nivel mundial y de curso crónico. En los últimos años, se ha mostrado mayor interés en el estudio de este fenómeno, ya que afecta de manera directa la calidad de vida de las personas con epilepsia, influyendo en su desarrollo personal, escolar, laboral y pronóstico.

Abstract Stigma is a phenomenon characterized by a negative response to a person possessing a different attribute within the social group it develops. Two types of stigmas have been described: perceived (felt) and promoted (enacted). Among the diseases with the greatest burden associated with stigma is epilepsy, one of the most prevalent neurological diseases worldwide and with a chronic course. In recent years, greater interest has been shown in the study of this phenomenon since it directly affects the quality of life of people with epilepsy, influencing their personal, academic and work development and prognosis.

Resumen Introducción: El objetivo del estudio fue validar el Cuestionario de Climas Motivacionales Empowering y Disempowering (Empowering and Disempowering Motivational Climate Questionnaire-Coach, EDMCQ-C) en jóvenes deportistas mexicanos a través del análisis de sus propiedades psicométricas, fiabilidad, validez convergente-discriminante, concurrente y factorial (de primero y segundo orden). Método: Participaron un total de 1243 jóvenes deportistas mexicanos de 12 a 17 años. Resultados: Los análisis mostraron adecuadas propiedades psicométricas, tanto de fiabilidad por dimensiones y factores, como de validez, convergente-discriminante, concurrente, factorial, de dos dimensiones (AFC de primer orden) y de cinco factores con sus respectivas dos dimensiones (AFC de segundo orden). Conclusión: Estos datos sugieren que la versión adaptada al contexto mexicano es un instrumento válido y fiable para evaluar la percepción de los climas motivacionales que generan los entrenadores en jóvenes deportistas mexicanos.

Abstract Abstract Introduction: The aim of the study was to validate the Empowering and Disempowering Motivational Climate Questionnaire-Coach (EDMCQ-C) in young Mexican athletes through the analysis of its psychometric properties, reliability, convergent-discriminant, concurrent and factorial (first and second order) validity. Method: A total of 1243 young Mexican athletes aged 12 to 17 years participated. Results: Analysis showed adequate psychometric properties, both reliability by dimensions and factors, as well as convergent-discriminant, concurrent, factorial, two-dimensional (first-order CFA) and five-factor validity with their respective two dimensions (second-order CFA). Conclusion: These data suggest that the version adapted to the Mexican context is a valid and reliable instrument to assess the perception of motivational climates generated by coaches in young Mexican athletes.

Abstract Background: Fibrous Dysplasia/McCune-Albright Syndrome (FD/MAS) is characterized by a spectrum of manifestations that may include fibrous dysplasia of bone and multiple endocrinopathies. Aim: To describe the clinical spectrum, the study and follow-up of patients with FD/MAS cared at our institution. Material and Methods: Review of medical records of 12 pediatric and adult patients (11 women) who met the clinical and genetic diagnostic criteria for FD/ MAS. Results: The patients’ mean age at diagnosis was 4.9 ± 5.5 years. The most common initial clinical manifestation was peripheral precocious puberty (PPP) in 67% of patients and 75% had café-au-lait spots. Fibrous dysplasia was present in 75% of patients and the mean age at diagnosis was 7.9 ± 4.7 years. Ten patients had a bone scintigraphy, with an age at the first examination that varied between 2 and 38 years of age. The most frequent location of dysplasia was craniofacial and appendicular. No patient had a recorded history of cholestasis, hepatitis, or pancreatitis. In four patients, a genetic study was performed that was positive for the pathogenic variant of guanine nucleotide binding protein, alpha stimulating (GNAS). Conclusions: These patients demonstrate the variable nature of the clinical presentation and study of FD/MAS. It is essential to increase the index of diagnostic suspicion and adherence to international recommendations.

Resumen: El avance en los cuidados médicos ha aumentado la supervivencia de los Niños con Patología Crónica Compleja (NPCC). Objetivo: analizar las características epidemiológicas y clínicas de una cohorte de NPCC. Pacientes y Método: Estudio descriptivo retrospectivo realizado en un hospital terciario entre junio de 2017 y junio de 2020, incluyendo pacientes con criterios NPCC. Se recogieron y analizaron datos epidemiológicos, clínicos, ingresos y servicios implicados. El análisis estadístico se realizó me diante el programa SPSS v22.0. Resultados: Se incluyeron 323 pacientes (mediana de edad 7 años). El 93,1% presentaba una enfermedad multisistémica, siendo las condiciones crónicas más frecuentes neurológicas (87,3%) y gastrointestinales (34,1%). El 39,9% era dependiente de tecnología. Los diag nósticos principales fueron Parálisis Cerebral Infantil (23,5%) y Encefalopatía epiléptica (13,9%). Cada paciente mantenía seguimiento por una mediana de 5 especialistas. El 85,1% de los pacientes ingresó en alguna ocasión, registrando 739 ingresos totales. La estancia media fue de 8,7 días. Los pa cientes dependientes de tecnología representaron el 54,7% de las hospitalizaciones. El motivo de in greso fue: enfermedad aguda (64,3%), cirugía (20,3%) y procedimiento diagnóstico (15%). El 23,1% precisaron UCI. 62 ingresos fueron llevados a cabo parcialmente por la Unidad de Hospitalización a Domicilio. Conclusiones: Los NPCC precisan un número incrementado de ingresos y múltiples especialistas. La implementación de unidades especializadas de referencia puede resultar útil para mejorar su atención.

Abstract: Advances in medical care have increased the survival of children with complex chronic pathology (CCP). Objective: to analyze the epidemiological and clinical characteristics of a cohort of children with CCP. Patients and Method: retrospective descriptive study performed in a tertiary hospital between June 2017 and June 2020, which included patients with CCP criteria. Epidemiological, clinical, admissions, and services involved data were collected and analyzed. Statistical analysis was performed using SPSS v22.0 software. Results: 323 patients (mean age 7 years) were included. 93.1% had a multisystem disease, with neurological (87.3%) and gastrointestinal (34.1%) as the most frequent chronic conditions. 39.9% were technology dependent. The main diagnoses were Infantile Cerebral Palsy (23.5%) and Epileptic Encephalopathy (13.9%). Each patient was in follow-up by 5 specialists on average. Of the patients, 85.1% were admitted at some time, with a total of 739 admissions. The mean length of stay was 8.7 days. Technology-dependent patients accounted for 54.7% of hospitalizations. The reasons for admission were acute illness (64.3%), surgery (20.3%), and diagnostic procedure (15%). ICU was required in 23.1%. 62 admissions were partially carried out by the Home Hospitalization Unit. Conclusions: Children with CCP require an increased number of admissions and multiple specialists. The implementation of specialized referral units may be useful to improve their care.

Abstract Description of the clinical case: A 67-year-old man with history of radical cystectomy due to a muscle-invasive bladder tumor presented with an acute erythema and swelling in the left periorbital region accompanied by tenderness and decreased ocular motility. Initially, a periorbital cellulitis was suspected and empirical antibiotics treatment with initiated. As there was no improvement with the antibiotic regimen, it was decided to biopsy the lesion. The biopsy results were consistent with metastasis of bladder carcinoma. Relevance: Bladder carcinoma represents one of the most common urological tumors, affecting predominantly males. The most frequent sites of metastasis are the lymph nodes, lungs, and bones; metastatic involvement of the orbit by bladder carcinoma is rare. Clinical implications: Although metastatic involvement of the orbit by urothelial tumors is very rare, it is important to know the characteristics of the lesion in order to make a timely diagnosis and thus provide adequate treatment. Conclusion: In patients with a history of bladder cancer who present periorbital cellulitis without improvement of symptoms despite adequate antibiotic treatment, orbital involvement due to bladder tumor metastasis should be suspected.

Resumen Descripción del caso clínico: Varón de 67 años con antecedente de cistectomía radical por tumor vesical músculo invasivo, presenta un cuadro agudo de edema y eritema periorbitario izquierdo acompañado de dolor y disminución de la motilidad ocular, inicialmente se sospechó una celulitis periorbitaria por lo que se inició tratamiento empírico con antibiótico. Al no presentar mejoría clínica tras completar correctamente el tratamiento se decide biopsiar la lesión, siendo los resultados de la biopsia compatibles con metástasis de carcinoma vesical. Relevancia: El carcinoma de vejiga representa unos de los tumores urológicos más frecuente, afectando con mayor frecuencia al sexo masculino; los sitos más frecuentes de metástasis son los ganglios linfáticos, pulmones y huesos, sin embargo, la afectación metastásica de la órbita es rara. Implicaciones clínicas: A pesar de que la afectación metastásica de la órbita por tumores uroteliales es muy infrecuente, es importante conocer las características de la lesión para poder realizar un diagnóstico oportuno y de esta manera brindar un tratamiento adecuado. Conclusión: En pacientes con antecedentes de cáncer vesical que presenten celulitis periorbitaria sin mejoría clínica a pesar de un tratamiento antibiótico adecuado, se debe sospechar la afectación orbitaria por metástasis del tumor vesical.

Abstract Objectives: in Colombia, sedation by non-anesthesiologists for endoscopic procedures outside the operating room has been implemented. A description of an experience in the gastroenterology unit of a tertiary referral hospital in Cali, Colombia, was conducted. Materials and methods: an analytical cohort observational study to describe the frequency and type of adverse events associated with sedation procedures performed by general practitioners and evaluate the factors related to their occurrence in patients who attended the endoscopy unit of Fundación Valle del Lili for endoscopic studies under intravenous sedation. Between November 2018 and June 2019, non-anesthesiologist physicians performed this procedure due to the minimal risk implied. A descriptive analysis was completed, and the median and interquartile range were calculated for numerical variables and frequencies for qualitative variables. Results: There were 1506 participants, 59.4% ASA I and 40.6% ASA II in this study. On average, the starting dose of propofol was 60 mg, and the total dose was 140 mg. Forty-six patients (3.05%) reported non-severe adverse events; the most common occurrence was transient desaturation (80.4%). No patients experienced severe adverse events. The average initial Aldrete scale score was 8, while at discharge, the average score was 10. Conclusions: sedation for endoscopic procedures performed by non-anesthesiologists is safe provided that it is performed by trained personnel conducting a correct assessment of the patient’s (cardiovascular, gastrointestinal, and neurological) history and risk factors within the framework of the current institutional guidelines.

Resumen Objetivos: en Colombia se ha venido implementando la sedación por médicos no anestesiólogos para procedimientos endoscópicos fuera del quirófano. Se describió la experiencia en la unidad de gastroenterología de una clínica de alto nivel de atención en Cali, Colombia. Materiales y métodos: estudio observacional, de tipo cohorte analítica para describir la frecuencia y el tipo de eventos adversos asociados a los procedimientos de sedación por médicos generales, y evaluar los factores asociados a su ocurrencia en pacientes que acudieron a la unidad de endoscopia de la Fundación Valle del Lili para la realización de estudios endoscópicos bajo sedación intravenosa que, por ser de bajo riesgo, fue aplicada por un médico no anestesiólogo entre noviembre de 2018 y junio de 2019. Se realizó análisis descriptivo, se calcularon mediana y rango intercuartílico para las variables numéricas, y frecuencias para las variables cualitativas. Resultados: se incluyeron 1506 participantes, 59,4 % ASA I y 40,6 % ASA II. En promedio, la dosis inicial de propofol fue de 60 mg y la dosis total, de 140 mg. Se registraron eventos adversos no serios en 46 pacientes (3,05 %) y el más común fue la desaturación transitoria (80,4 %). Ningún paciente presentó eventos adversos serios. El puntaje inicial promedio de la escala de Aldrete fue 8, mientras que al alta el puntaje promedio fue de 10. Conclusiones: la sedación para procedimientos endoscópicos dada por médicos no anestesiólogos es segura, siempre y cuando sea realizado por personal entrenado que realice una adecuada valoración de los antecedentes (cardiovasculares, gastrointestinales y neurológicos) y factores de riesgo del paciente dentro del marco de los lineamientos institucionales vigentes.

Resumen La actividad bufalina ha ido en aumento en los últimos años, mostrando cada vez más productores enfocados al sistema de producción de esta especie en América Latina. El objetivo de esta revisión fue recopilar conocimientos existentes en la literatura sobre el manejo y las biotecnologías reproductivas disponibles para los machos y las hembras de la especie Bubalus bubalis. La información fue seleccionada de libros y artículos científicos en bases de datos académicas y Google Scholar, durante un periodo de cinco meses (marzo-julio 2020). Se abarcaron los temas de manejo reproductivo de la hembra, el macho y las biotecnologías aplicadas a la especie. Se determinó que la eficiencia productiva de los búfalos está fuertemente relacionada con el manejo a nivel nutricional, reproductivo y de bienestar animal, asimismo de los factores climáticos en el que se desarrollan. Se evidenciaron avances de las biotecnologías aplicadas a la reproducción bufalina

Abstract Buffalo production has increased mainly over the past years, more farmers have been dedicated to the production system of this species in Latin America. The objective of this review is to compile scientific literature corresponding to reproductive management and biotechnologies available for Bubalus bubalis bulls and cows. The information was gathered from books and scientific articles from academic databases and Google Scholar in a span of 5 months (MarchJuly). Reproductive management of cows, bulls and biotechnologies applied to the species were covered. It was determined that productive efficiency of buffalos is strongly related to nutritional, reproductive, and animal welfare management, as well as environmental factors were this species develops. Improvements in biotechnologies applied to the buffalo reproduction were evince.