Lisdexamfetamine is a prodrug that is converted to d-amphetamine in the body, mainly used to treat attention deficit hyperactivity disorder in children and adults. Its mechanism involves the enhancement of neurotransmitters such as norepinephrine and dopamine, which are critical for attention and behavioral regulation. With the upcoming patent expiration of Vyvanse®, bioanalytical methods for the quantification of lisdexamfetamine in plasma are needed for use in pharmacokinetic studies. In this work, we developed and validated a sensitive bioanalytical method using liquid chromatography-tandem mass spectrometry (LC-MS/MS) for lisdexamfetamine quantification in human plasma. The method developed was performed for 4 min per sample and using the concentration range of 0.3-100 ng mL-1. Intra-batch, inter-batch and instrument reproducibility, the precision was lower than 10%. The results demonstrated that the method is rapid, sensitive, robust, and suitable for pharmacokinetic studies. damphetamine d amphetamine body adults dopamine regulation Vyvanse Vyvanse® studies work chromatographytandem chromatography tandem LCMS/MS LCMSMS LC MS/MS MS (LC-MS/MS 0.3100 03100 0.3 100 0 3 0.3-10 mL1. mL1 mL 1. 1 mL-1 Intrabatch, Intrabatch Intra batch, batch Intra-batch interbatch inter reproducibility 10 10% rapid robust LCMS MSMS 3100 0.310 0310 03 0. 0.3-1 mL- 310 0.31 031 0.3- 31

Abstract The study of the practice of sacred music in the cities and towns of the viceroyalty of New Spain has been a subject scarcely dealt by musicologists and historians. This void is increased when trying to glimpse what the development of music and its performers became during the nineteenth century, after the independence. This article presents data related to some important aspects of the musical exercise of the time within the temples. The research finds, after the period of emancipation, a continuity in the practice of sacred music, patent both in the books of office and dating of the brotherhoods as in other documents. It also identifies, after the Reform Laws, a series of ecclesiastical provisions that attempted to remove from the sacred halls theatrical and profane music, as well as the participation of women in singing. Through documents from the parish archives and printed sources of the time, the purpose is to show some lines of development that are important to understand religious musical life in nineteenth-century society.

Resumen El estudio de la práctica de la música sacra en las ciudades y los pueblos del virreinato de la Nueva España ha sido un tema poco trabajado por musicólogos e historiadores. Ese vacío se magnifica al tratar de vislumbrar cuál fue el desarrollo de la música y de sus ejecutantes durante el siglo XIX, después de la independencia. El presente artículo expone datos obtenidos sobre algunos aspectos relevantes del ejercicio musical de la época al interior de los templos. La investigación encuentra, tras el periodo de emancipación, una continuidad en la práctica de la música sacra, patente tanto en los libros de cargo y data de las cofradías como en otros documentos. También identifica, después de las Leyes de Reforma, una serie de disposiciones eclesiásticas que intentaron eliminar de los recintos sagrados la música teatral y profana, así como la participación de las mujeres en el canto. Mediante documentos procedentes de los archivos parroquiales y fuentes impresas de la época, se pretende mostrar algunas líneas de desarrollo que son importantes para entender la vida musical religiosa en la sociedad decimonónica.

Abstract Introduction. Paradoxical embolism is a thrombotic event originating in the venous circulation, which manifests as arterial embolism through an anatomical cardiac or pulmonary defect. It is mainly associated with stroke, also presenting as acute myocardial infarction, renal infarction, and other ischemic events. Clinical case. A 47-year-old patient was admitted due to abdominal pain, which required emergency surgical management, finding significant intestinal ischemia. Additional studies found protein S deficiency and evidence of a patent foramen ovale. Discussion. Arterial thrombosis is known as unusual thrombosis; this situation requires to rule out associated thrombophilia or other prothrombotic diseases. Protein S deficiency is a rare thrombophilia, which in adults causes venous thrombosis. In the presence of anatomical defects, such as a patent foramen ovale, it can progress to arterial embolism, presenting a picture of paradoxical embolism. The study work of these patients requires imaging that demonstrates the aforementioned defect, as well as the possible origin of the emboli. Management is based on full anticoagulation, treatment of existing thrombotic manifestations, and management of the anatomical defect. Conclusions. Paradoxical embolism should be suspected in case of unusual thrombosis. It requires exhaustive studies based on imaging, and management should consist of anticoagulation and closure of the defect.

Resumen Introducción. La embolia paradójica es un evento trombótico originado en la circulación venosa, que se manifiesta como embolismo arterial por medio de un defecto anatómico a nivel cardíaco o pulmonar. Se asocia principalmente a eventos cerebrovasculares, aunque se han encontrado casos de infarto agudo de miocardio, infarto renal y otros eventos isquémicos. Caso clínico. Paciente de 47 años, quien consultó por cuadro de dolor abdominal, que requirió manejo quirúrgico de urgencia, donde identificaron isquemia intestinal importante. Los estudios adicionales hallaron déficit de proteína S y persistencia de foramen oval permeable. Resultados. La presencia de trombosis arterial se conoce como trombosis de sitios inusuales y requiere de estudios para descartar trombofilias asociadas u otros estados protrombóticos. El déficit de proteína S es una trombofilia infrecuente, la cual se asocia en la vida adulta a eventos trombóticos de origen venoso. En presencia de defectos anatómicos, como un foramen oval permeable, puede progresar a embolia arterial, configurando un cuadro de embolismo paradójico. La estratificación de estos pacientes requiere imágenes que demuestran el defecto mencionado, así como el posible origen de los émbolos. El manejo se basa en anticoagulación plena, manejo de soporte, resolver las manifestaciones trombóticas existentes y un cierre temprano del defecto anatómico. Conclusiones. El embolismo paradójico debe sospecharse en caso de trombosis de sitios inusuales. Requiere de un estudio exhaustivo con imágenes y su manejo debe basarse en anticoagulación y cierre del defecto.

Abstract Background: Patent Ductus Arteriosus (PDA) is the most common congenital heart disease, particularly prevalent among preterm newborns (PTNB) and those with low birth weight. Surgical closure is traditionally considered after the failure of pharmacological treatment. The aim was to analyze the immediate and long-term outcomes of surgical PDA closure in PTNB. Methods: This analytical study evaluated PTNB who underwent PDA surgery between January 2002 and December 2023 at the Hospital Clínico Regional “Dr. Guillermo Grant Benavente” in Concepción, Chile. The databases were reviewed with prior approval from the Ethical-Scientific Committee. PTNB were defined as those with a gestational age (GA) of less than 37 weeks. Data analysis was performed using SPSS® v29, and survival rates were graphed using the Kaplan-Meier method. Results: Since 1993, a total of 263 cases have been recorded in the PDA protocol registry. During the study period, 167 cases were identified, of which 131 (78.3%) were PTNB. Among them, 65 (49.6%) were male. The average GA was 26.4±2.3 weeks and the average birth weight was 900±348 grams. Pharmacological treatment failed in all cases included. At the time of surgery, the average age was 35.0±43.2 days, and the average weight was 1,443±1,716 grams. A left posterolateral thoracotomy with an extrapleural approach and primary closure with clips was performed. Immediate complications included post-ligation syndrome in 42 (32.1%) cases and atelectasis in 14 (10.7%) cases. There was no intraoperative mortality. The 30-day mortality rate was 15 (11.5%) cases. The 10-year survival rate was 82.4%. Conclusion: Clipping is the preferred technique at our center and has shown results comparable to other series. Mortality was mainly due to medical comorbidities such as sepsis and respiratory tract immaturity.

Resumen Antecedentes: El Ductus Arterioso Persistente (DAP) es la cardiopatía congénita más frecuente. Es más prevalente en recién nacidos de pretérmino (RNPT) y bajo peso al nacer. El cierre quirúrgico está indicado tradicionalmente tras el fracaso del cierre farmacológico. El objetivo es analizar los resultados inmediatos y alejados del cierre quirúrgico del DAP en RNPT. Métodos: Estudio analítico de RNPT operados por DAP en el período desde enero-2002 y diciembre-2023 en el Hospital Clínico Regional “Dr. Guillermo Grant Benavente”, Concepción-Chile. Se revisaron bases de datos previa aprobación de Comité Ético-Científico. Se consideró RNPT <37 semanas de edad gestacional (EG). Se utilizó SPSS® v29, se graficó supervivencia mediante método de KaplanMeier. Resultados: En el período de análisis hubo 167 casos, de es de los cuales 131 (78,3%) eran RNPT. Fueron hombres 65 (49,6%) y la edad gestacional (EG) promedio fue 26,4±2,3 semanas, con peso al nacer de 900±348 gramos. Todos los casos tuvieron tratamiento farmacológico previo. Al momento de la cirugía, la edad promedio era 35,0±43,2 días y el peso promedio 1.443±1.716 gramos. Se realizó una toracotomía posterolateral izquierda, con abordaje extrapleural y cierre principalmente mediante clipaje. Las complicaciones inmediatas fueron: síndrome post ligadura en 42 (32,1%) y atelectasia en 14 (10,7%). No hubo mortalidad intraoperatoria. A 30 días post cirugía fallecieron 15 casos, (11,5%) La supervivencia a 10 años fue 82,4%. Conclusiones: El cierre mediante clipaje es la técnica de elección en nuestro centro y demostró resultados comparables a diferentes series incluidas en la discusión. La mortalidad fue debida principalmente a comorbilidades médicas como sepsis e inmadurez del tracto respiratorio.

ABSTRACT The integration of cutting-edge precision agriculture technologies into avocado production is a promising strategy to boost productivity and profitability in this thriving industry. While previous reviews have explored the application of emerging technologies in avocado cultivation, there is a gap in the analysis of patent production. This research aims to bridge that gap by identifying trends in both scientific and technological innovations related to precision agriculture in avocado. Through a bibliometric analysis using data from Scopus and Lens.org, this study reveals that scientific production is primarily concentrated in industrialized countries, with limited research output from major avocado-producing nations. The focus of research has been on remote sensing and image processing techniques. In terms of technological development, innovations in agricultural data capture, collection, and processing, as well as components for agricultural machinery, have been the most prevalent. Market-available technologies are designed to predict crop yields and assess the impact of abiotic factors such as temperature, humidity, and precipitation. By adopting these precision agriculture tools, avocado farmers can make data-driven decisions to optimize resource use, improve crop health, and ultimately enhance overall farm performance.

RESUMEN La integración de tecnologías de agricultura de precisión de vanguardia en la producción de aguacate es una estrategia prometedora para impulsar la productividad y la rentabilidad en esta próspera industria. Si bien revisiones anteriores han explorado la aplicación de tecnologías emergentes en el cultivo de aguacate, existe un vacío en el análisis de la producción de patentes. Esta investigación tiene como objetivo cerrar esa brecha identificando tendencias en innovaciones científicas y tecnológicas relacionadas con la agricultura de precisión en el aguacate. A través de un análisis bibliométrico utilizando datos de Scopus y Lens.org, este estudio revela que la producción científica se concentra principalmente en los países industrializados, con una producción de investigación limitada de las principales naciones productoras de aguacate. La investigación se ha centrado en las técnicas de teledetección y procesamiento de imágenes. En términos de desarrollo tecnológico, las innovaciones en captura, recolección y procesamiento de datos agrícolas, así como en componentes para maquinaria agrícola, han sido las más predominantes. Las tecnologías disponibles en el mercado están diseñadas para predecir el rendimiento de los cultivos y evaluar el impacto de factores abióticos como la temperatura, la humedad y las precipitaciones. Al adoptar estas herramientas de agricultura de precisión, los productores de aguacate pueden tomar decisiones basadas en datos para optimizar el uso de recursos, mejorar la salud de los cultivos y, en última instancia, mejorar el rendimiento general de la finca.

ABSTRACT Introduction Obstructive azoospermia occurs when there is a blockage in the male reproductive tract, leading to a complete absence of sperm in the ejaculate. It constitutes around 40% of all cases of azoospermia (1, 2). Blockages in the male reproductive tract can arise from either congenital or acquired factors, affecting various segments such as the epididymis, vas deferens, and ejaculatory ducts (3). Examples of congenital causes encompass conditions like congenital bilateral absence of the vas deferens and unexplained epididymal blockages (4). Acquired instances of obstructive azoospermia may result from factors like vasectomy, infections, trauma, or unintentional injuries caused by medical procedures (5). This complex condition affecting male fertility, presents two main treatment options: microsurgical reconstruction and surgical extraction of sperm followed by in vitro fertilization (IVF). Microsurgical reconstruction proves to be the most cost-effective option for treating obstructive azoospermia when compared with assisted reproductive techniques (6, 7). However, success rates of reconstruction defined by patency are as high as 99% for vasovasostomy (VV) but decline to around 65% if vasoepididymostomy (VE) is required (8, 9). Thus, continued refinement in technique is necessary in order to attempt to improve patency for patients undergoing VE. In this video, we show a comprehensive demonstration of microsurgical VE, highlighting the innovative epididymal occlusion stitch. The goal of this innovative surgical technique is to improve outcomes for VE. Materials and Methods The patient is a 39-year-old male diagnosed with obstructive azoospermia who presents for surgical reconstruction via VE. His partner is a 37-years-old female with regular menstrual cycles. The comprehensive clinical data encompasses a range of factors, including FSH levels, results from semen analysis, and outcomes from testicular sperm aspiration. This thorough exploration aims to provide a thorough understanding of our innovative surgical technique and its application in addressing complex cases of obstructive azoospermia. Results The procedure was started on the right, the vas deferens was identified and transected. The abdominal side of the vas was intubated and a vasogram performed, there was no obstruction. There was no fluid visible from the testicular side of the vas for analysis, thus we proceeded with VE. Upon inspection of the epididymis dilated tubules were identified. After selecting a tubule for VE, two 10-0 nylon sutures were placed, and it was incised. Upon inspection of the fluid motile sperm was identified. After VE, we performed a novel epididymal occlusion stitch technique. This was completed distal to the anastomosis by placing a 7-0 prolene through the tunica of the epididymis from the medial to lateral side. This stitch was then tightened down with the goal to largely occlude the epididymis so that sperm will preferentially travel through the anastomosis. The steps were then repeated on the left. At 3-month follow up, the patient had no change in testicular size as compared with preoperative size (18cc), he had no testicular or incisional discomfort, and on semen analysis he had presence of motile sperm. After 3 months post-surgery, the patient had motile sperm seen on semen analysis. Discussion The introduction of a novel epididymal occlusion stitch demonstrates a targeted strategy to enhance the success of microscopic VE. Encouragingly, a 3-month post-surgery follow-up reveals the presence of motile sperm, reinforcing the potential efficacy of our approach. This is promising given the historical lower patency, delayed time to patency, and higher delayed failure rates that patients who require VE experience (10). In total, 40% of all azoospermia cases can be attributed to obstruction. The conventional treatments for obstructive azoospermia involve microsurgical reconstruction and surgical sperm retrieval followed by IVF. While microsurgical reconstruction has proven to be economically viable, the quest for enhanced success rates has led to the exploration of innovative techniques. Historically, the evolution of VV and VE procedures, initially performed in the early 20th century, laid the foundation for contemporary microsurgical approaches (11). Notably, the microscopic VV demonstrated significant improvements in patency rates and natural pregnancy likelihood, as evidenced by the seminal Vasovastomy Study Group study in 1991 (8). In contemporary literature, success rates particularly for VE remain unchanged for the past three decades since the original published success rates by the Vasectomy Reversal Study Group (12). VE is associated with a longer time to patency as well with patients taking 2.8 to 6.6 months to have sperm return to ejaculate as compared to 1.7 to 4.3 months for those undergoing VV. Additionally, of those patients who successfully have sperm return to the ejaculate after VE up to 50% will have delayed failure compared to 12% for those undergoing VV who are patent. Finally, of those who experience delayed failure after undergoing VE it usually occurs earlier with studies reporting as early as 6 months post-operatively (20). Given the lack of improvement and significantly worsened outcomes with VE further surgical refinement is a constant goal for surgeons performing this procedure. Conclusion: In conclusion, this video is both a demonstration and a call to action for commitment to surgical innovation. We aim to raise the bar in VE success rates, ultimately bringing tangible benefits to patients and contributing to the ongoing evolution of reproductive medicine. The novel epididymal occlusion stitch emerges as a beacon of progress, promising not only enhanced safety but also potential reductions in patency time. Surgical excellence and methodological refinement, as exemplified in this video, lay the foundation for a future where male reproductive surgery continues to break new ground. 40 1, 1 (1 2. 2 . 2) 3. (3) 4. 4 (4) vasectomy infections trauma 5. 5 (5) fertility options IVF (IVF) costeffective cost effective 6, (6 7. 7 7) However 99 (VV 65 (VE 8, 8 (8 9. 9 9) Thus 39yearold yearold 39 year old 37yearsold yearsold 37 years cycles levels aspiration right transected obstruction 100 10 0 10- placed incised 70 7- left 3month month 18cc, 18cc cc , (18cc) discomfort postsurgery, postsurgery post surgery, Encouragingly followup approach 10. (10) total viable Historically th century 11. 11 (11) Notably likelihood 199 8. (8) literature 12. 12 (12) 28 66 6. 17 1. 43 Additionally 50 patent Finally postoperatively operatively 20. 20 (20) Conclusion conclusion innovation medicine progress ground ( (3 (4 (5 (IVF (18cc (10 (11 19 (12 (20 (2

Abstract This article discusses the causes behind the patent gender inequality in Brazilian Courts. Based on the seminal work of Maria da Glória Bonelli, it updates data on gender composition of the São Paulo Court of Justice (TJSP) and the Federal Regional Court of the 3rd Region (TRF3). State and federal courts' data evolution is then compared, and Bonelli's previous thesis to explain the findings is discussed. Showing evidence of increasing gender inequality at the federal level and only a small progress at the state level, the article argues this new data contradicts her "professionalism" centered thesis. In addition, two hypotheses are discussed to explain the phenomenon: (i) a greater Executive branch interference in the Federal Justice; and (ii) the effect of subtle legal-related mechanisms both at the entry and the intermediate career levels. Courts Bonelli TJSP (TJSP rd TRF3. TRF3 TRF . (TRF3) courts compared Bonellis s professionalism "professionalism addition phenomenon i (i ii (ii legalrelated legal related levels (TRF3 (TRF

Resumo Este artigo discute as causas da patente disparidade de gênero nos Tribunais brasileiros. Partindo do trabalho seminal de Maria da Glória Bonelli, atualizam-se os dados de composição por gênero do Tribunal de Justiça de São Paulo (TJSP) e do Tribunal Regional Federal da 3ª Região (TRF3). Feito isso, compara-se a evolução dos dados nas justiças estadual e federal, e discute-se a tese proposta por Bonelli para explicá-los. Argumenta-se que sua tese, centrada no ideal do "profissionalismo", é falseada pela evolução recente dos dados, que mostram uma involução na justiça federal e um pequeno progresso no âmbito estadual. Além disso e por fim, discutem-se duas hipóteses para explicar os dados: (i) uma maior interferência do Poder Executivo na Justiça Federal; e (ii) o efeito de mecanismos sutis nas regras de seleção e promoção na carreira. brasileiros atualizamse atualizam se TJSP (TJSP ª TRF3. TRF3 TRF . (TRF3) isso comparase compara discutese explicálos. explicálos explicá los. los explicá-los Argumentase Argumenta profissionalismo, profissionalismo , "profissionalismo" fim discutemse discutem i (i ii (ii carreira (TRF3 "profissionalismo (TRF

Abstract Paradoxical embolism due to an isolated pulmonary arteriovenous malformation (PAVM) is a rare cause of ischemic stroke. PAVMs are abnormal high-flow connec tions between pulmonary arteries and veins, diverting deoxygenated blood into the systemic circulation and they represent a less common source of paradoxical embolisms, especially in young individuals. Endovascular embolization is the preferred treatment for clinically significant PAVMs. We present the case of a 34-year-old woman with a left thalamic ischemic stroke. Severe contrast passage was detected in cerebral arteries through transcranial Doppler. Intracardiac ultrasound did not reveal a patent foramen ovale, prompting further investigation with pulmonary CT angiography, confirming the presence of PAVM. The patient underwent successful endovascular treatment. It is essential to consider PAVM in the etiological di agnosis of ischemic stroke, especially in young patients with signs of abnormal right-to-left communication. Periodic follow-up imaging is recommended to assess potential recurrence or changes in PAVM, emphasizing the importance of appropriate management of these malformations.

Resumen La embolia paradojal debido a una malformación arteriovenosa pulmonar (MAVP) aislada es una causa in frecuente de accidente cerebrovascular (ACV) isquémico. Las MAVP son conductos anómalos de alta circulación entre arterias y venas pulmonares, desviando sangre desoxigenada hacia la circulación sistémica y represen tan una fuente menos común de embolias paradojales, especialmente en personas jóvenes. La embolización endovascular es el tratamiento preferido para MAVP clínicamente significativas. Presentamos el caso de una mujer de 34 años con ACV isquémico talámico izquierdo. Se detectó pasaje de burbujas “en cortina” en arterias cerebrales mediante Doppler transcraneal. En ecografía intracardíaca no se encontró foramen oval permeable, motivo por el cual se avanzó con realización de angiotomografía pulmonar, la cual confirmó la presencia de MAVP. La paciente recibió tratamiento endovascular exitoso. Es esencial considerar la MAVP en el diagnóstico etio lógico del ACV isquémico, especialmente en pacientes jóvenes con signos de comunicación anormal de derecha a izquierda. Se recomienda un seguimiento periódico mediante imágenes para evaluar la posible recurrencia o cambios en la MAVP, resaltando la importancia del manejo adecuado de estas malformaciones.

Abstract Objective: To communicate the experience in an Andean country with the OcclutechTM Duct Occluder device for the closure of patent ductus arteriosus. Method: Observational, retrospective, cross-sectional study with basic statistical analysis. Period: December/2014 to December/2022. Data: medical chart, reports of catheterization. Results: Forty-six patients, female 71.3%, male 28.7%; age: 0.6-38 years-old (median [Me]: 5.2); weight: 6.3-60 kg (Me: 16.5). Origin: andean 91.3%, coast 8.7%. Types of patent ductus arteriosus: E 54.4%, A 32.6%, D 13%. Minimum ductal diameter: 1.8-11.8 mm (Me: 3.5). Mean pulmonary artery pressure prior to occlusion: 14-67 mmHg (Me: 27). Pulmonary vascular resistance index prior to occlusion: 0.28-4.9 WU/m2 (Me: 1.3). Six of them were classified as hypertensive patent ductus arteriosus. Occlusion rate: 47.8% immediate, 81% at 24 hours, 100% after six months. Fluoroscopy time: 2-13.8 minutes (Me: 4). Complications: a migrated device. Follow-up: 1-6.5 years. Conclusions: OcclutechTM Duct Occluder device was effective and safe for the closure of patent ductus arteriosus type E, A and D in low-altitude and high-altitude dwellers, whether they were children or adults, even when these ductus arteriosus were hypertensive.

Resumen Objetivo: Presentar la experiencia en un país andino con el dispositivo OcclutechTM Duct Occluder para el cierre del conducto arterioso persistente. Método: Estudio observacional, retrospectivo, de corte transversal con análisis estadístico básico. Periodo: diciembre/2014 a diciembre/2022. Datos: historia clínica, informes de laboratorio de cateterismo. Resultados: Cuarenta y seis pacientes; de sexo femenino 71.3%, de sexo masculino 28.7%; edad: 0.6-38 años (mediana [Me]: 5.2); peso: 6.3-60 kg (Me: 16.5). Procedencia: andina 91.3%, costa 8.7%. Tipos de conducto arterioso persistente: E 54.4%, A 32.6%, D 13%. Diámetro ductal mínimo: 1.8-11.8 mm (Me: 3.5). Presión media de la arteria pulmonar previo a la oclusión: 14-67 mmHg (Me: 27). Índice de resistencias vasculares pulmonares previo a la oclusión: 0.28-4.9 UW/m2 (Me: 1.3). Fueron catalogados como conductos arteriosos persistentes hipertensivos seis de ellos. Tasa de oclusión: inmediata el 47.8%, a las 24 horas el 81%, a los seis meses el 100%. Tiempo de fluoroscopia: 2-13.8 minutos (Me: 4). Complicaciones: un dispositivo migrado. Seguimiento: 1-6.5 años. Conclusiones: El dispositivo OcclutechTM Duct Occluder fue efectivo y seguro para el cierre de conducto arterioso persistente tipo E, A y D en habitantes de baja y alta altitud, ya sea que estos hubieran sido niños o adultos, incluso cuando estos conductos arteriosos fueron hipertensivos.

Abstract This article examines technological postpandemic trends in Mexico, using the technologies recorded in patent and utility model applications filed with the Mexican Institute of Industrial Property (IMPI). We found that the number of applications decreased by more than 50% in 2020 and 2021 compared to 2018. On the other hand, technologies related to COVID-19 significantly increased in 2020-2021 compared to 2018, but not digital technologies. Interestingly, we found that approximately 90% of utility models have only Mexican inventors and applicants, while in patents, this percentage is halved. This finding suggests that minor inventions related to products or industrial tools are being developed locally, but inventions requiring more significant novelty, including not only objects but also substances or processes, are only half Mexican.

Resumen Este artículo estudia las tendencias tecnológicas en México en el periodo posterior a la pandemia, utilizando las tecnologías registradas en las solicitudes de las patentes y modelos de utilidad del Instituto Mexicano de la Propiedad Industrial (IMPI). Se encontró que el número de solicitudes disminuyó en más del 50% en 2020 y en 2021, respecto a 2018. Por su parte, las tecnologías relacionadas con el COVID-19 aumentaron significativamente en 2020-2021 respecto a 2018, pero no así las de tecnologías digitales. De manera interesante, aproximadamente el 90% de los modelos de utilidad tienen únicamente inventores y solicitantes mexicanos, mientras que en las patentes este porcentaje se reduce a la mitad. Ello indicaría que las invenciones menores de productos o herramientas industriales están siendo desarrollados localmente, pero las invenciones que requieren mayor novedad y que incluyen no sólo objetos, sino también substancias o procesos, sólo la mitad son mexicanas.

Introduction: Extracranial carotid artery aneurysms (ECAA) are rare compared to occlusive disease, less than 1% of all arterial aneurysms and only 10% are considered true aneurysms. Clinical case: A 84-year-old female, active and in excellent general health, with a prior history significant only for hypertension and hyperlipidemia was referred for a right internal carotid artery aneurysm and elongation in the context of contralateral internal carotid artery occlusion. The patient denied neurologic symptoms. Resection of the aneurysm and end-to-end anastomosis, endarterectomy of the ostium and patch angioplasty was performed. The patient had an uneventful recovery, remaining asymptomatic and the reconstruction patent on duplex scan at 6 month follow up. Discussion: The choice of repair alternatives for EICA depend on its morphological characteristics. The presence of extreme tortuosity of the internal carotid artery in this case, on one hand make difficult to consider endovascular alternatives, but facilitates aneurysm resection and primary end-to-end anastomosis. Conclusion: Aneurysmectomy and arterial reconstruction is a treatment alternative for EICA repair.

Resumen Introducción: Los aneurismas de la arteria carótida extracraneal (ACEC) son poco frecuentes en comparación con las lesiones oclusivas. Los ACEC son menos del 1% de todos los aneurismas arteriales y solo el 10% son considerados aneurismas verdaderos. Caso Clínico: Paciente femenina de 84 años, en excelentes condiciones generales, hipertensa e hiperlipidémica, neurológicamente asintomática, con hallazgo de aneurisma de carótida interna derecha en el contexto de una arteria elongada, estenosis moderada ostial y oclusión de arteria carótida interna contralateral. Se realiza resección de aneurisma con anastomosis término terminal, endarterectomía del ostium y angioplastía con parche. Su evolución fue favorable, manteniéndose asintomática y con la reconstrucción permeable a 6 meses de seguimiento en eco duplex. Discusión: La elección del manejo del ACEC va a depender de sus características morfológicas, en este caso la presencia de tortuosidad extrema de la arteria carótida interna dificultaba la posibilidad de manejo endovascular, pero facilitaba la resección del aneurisma con anastomosis primaria término terminal. Conclusión: La aneurismectomía y reconstrucción es una modalidad de manejo disponible para los ACEC.

Abstract A persistent sciatic artery (PSA) is a rare anomaly and it is an embryologic remanent of the internal iliac artery, occurring in five different forms, depending on its relationship with the superficial femoral artery (SFA). Physicians must acknowledge the existence of this anomaly, and it should be included in the differential diagnosis of lower limb ischemia. We present the case of a 56-year-old female who presented with a popliteal artery acute ischemic event. Angiography showed a hypoplastic right SFA with a patent PSA vascularizing the lower extremity. A conventional embolectomy through a P1 popliteal incision was auspiciously performed. A magnetic resonance angiography confirmed a PSA of the right lower extremity during the post-operative period. At 12-month follow-up, the patient is well and asymptomatic.

Resumen Una arteria ciática persistente es una anomalía rara y un remanente embriológico de la arteria ilíaca interna. Se presenta en cinco formas diferentes, dependiendo de su relación con la arteria femoral superficial. Los médicos deben reconocer la existencia de esta anomalía y debe incluirse en el diagnóstico diferencial de isquemia de miembros inferiores. Presentamos el caso de una mujer de 56 años que consultó por un evento isquémico agudo de la arteria poplítea. La angiografía mostró una arteria femoral superficial derecha hipoplásica con una arteria ciática permeable persistente que vascularizaba la extremidad inferior. Se realizó auspiciosamente una embolectomía convencional a través de una incisión poplítea P1. Una angiografía por resonancia magnética confirmó una arteria ciática persistente de la extremidad inferior derecha durante el postoperatorio. A los 12 meses de seguimiento, la paciente se encuentra bien y asintomático.

ABSTRACT Paradoxical cerebral embolism always requires the presence of a patent foramen ovale (PFO); in our case, this event occurred due to a transient phenomenon, which was the acute overload of the right heart chambers and the opening of the PFO due to increased pressures as a consequence of massive pulmonary thromboembolism. After undergoing arthroscopy, this patient presented with visual field loss and progressive dyspnea, ultimately leading to mechanical ventilation and severe obstructive shock. An angiotomography was performed, revealing an obstructive thrombus in the right pulmonary artery. The patient successfully underwent thrombolysis, and she was discharged from the intensive care unit after 45 days. Ultimately, protein C deficiency was diagnosed, and permanent anticoagulation was initiated. The presence of motor deficit and dyspnea in a post-knee surgery patient should raise suspicion of pulmonary thromboembolism. Thrombolysis remains the treatment of choice, and it should be timely prescribed and performed.

RESUMEN La embolia cerebral paradójica siempre requiere la presencia de foramen oval; en nuestro caso, este evento sucedió por un fenómeno temporal, el cual fue la sobrecarga aguda de las cavidades derechas y la apertura del foramen oval debido al aumento de presiones como consecuencia de un tromboembolismo pulmonar masivo. Luego de una artroscopía, nuestra paciente presentó pérdida del campo visual y disnea, esta última progresiva, hasta llegar a la ventilación mecánica y shock obstructivo grave. Se realizó una angiotomografía, la cual evidenció un trombo obstructivo en la arterial pulmonar derecha; la paciente fue trombolizada con éxito y fue dada de alta de la unidad de cuidados intensivos después de 45 días. Finalmente se le diagnosticó una deficiencia de proteína C y se inició anticoagulación de manera permanente. La presencia de déficit motor y disnea en una paciente post-cirugía de rodilla, debe hacer sospechar de una tromboembolia pulmonar, la trombólisis sigue siendo el tratamiento de elección, su indicación debe ser precoz.