Abstract Introduction. Gastric duplications are rare congenital entities that are diagnosed primarily in early life, and rarely in adult patients. The objective of this article was to present the case of an adult with this pathology, successfully treated by surgery. Clinical case. A 26-year-old woman with chronic epigastralgia refractory to medical management, who during upper digestive endoscopy was identified with a cystic lesion suggestive of gastro-intestinal stromal tumor, confirmed by endoscopic ultrasound. Results. A laparoscopic surgical resection assisted by endoscopy was performed, with good postoperative evolution. The anatomopathological study reported the presence of a gastric duplication cyst. Conclusions. Despite the diagnostic adjuncts currently available, this pathology represents an important diagnostic challenge that, in many cases, can only be confirmed through pathology. In asymptomatic patients, the controversy continues between observing them or taking them to surgery due to the risk of malignancy. Currently, the management of gastric duplications in adults is considered eminently surgical. Laparoscopic resections and the use of intraoperative endoscopy ensure complete resection of the lesion, preserving the greatest amount of adjacent healthy tissue and preventing gastric stenosis or deformities that affect its proper functioning.

Resumen Introducción. Las duplicaciones gástricas son entidades congénitas poco frecuentes que se diagnostican principalmente en las etapas tempranas de la vida, y rara vez en pacientes adultos. El objetivo de este artículo fue presentar el caso de un adulto con esta patología, tratado exitosamente mediante cirugía. Caso clínico. Mujer de 26 años de edad con epigastralgia crónica refractaria a manejo médico, a quien durante endoscopia digestiva superior se le identificó una lesión quística sugestiva de tumor estromal gastrointestinal, confirmada por ultrasonido endoscópico. Resultados. Se realizó una resección quirúrgica laparoscópica asistida por endoscopia, con buena evolución postoperatoria. El estudio anatomo-patológico informó la presencia de un quiste de duplicación gástrica. Conclusiones. A pesar de las ayudas diagnósticas disponibles en la actualidad, esta patología representa un reto diagnóstico importante que, en muchas ocasiones solo puede ser confirmado mediante el estudio anatomo-patológico. En paciente asintomático, continúa la controversia entre observarlo o llevarlo a cirugía, por el riesgo de malignidad. Actualmente, el manejo de las duplicaciones gástricas en adultos se considera eminentemente quirúrgico. Las resecciones laparoscópicas y el uso de endoscopia intraoperatoria permiten garantizar la resección completa de la lesión, preservando la mayor cantidad de tejido sano adyacente y previniendo estenosis o deformidades gástricas que afecten su adecuado funcionamiento.

Abstract This study addresses the problem of cognitive injustice that persists in Mexico, despite the mechanisms proposed to guarantee the rights of indigenous peoples. Given that higher education is fundamental for the generation and transmission of knowledge, theoreticalnarrative research was carried out to examine how this problem is manifested from the discourse of people from indigenous peoples immersed in the educational system. The theoretical framework proposes solutions based on concepts such as inclusion and university autonomy. The results indicate that the participants understand the problem from perspectives more relevant to their context, referring to historical errors of the colonial era, and offer measures so that the school reflects the social system. It is found that one of the manifestations of cognitive injustice is in official curricular designs, given the close relationship between culture, language and knowledge. Together with the participants, the limited participation of indigenous peoples in the development of academic plans and programs is questioned.

Resumen Este estudio aborda el problema de la injusticia cognitiva que persiste en México, a pesar de los mecanismos propuestos para garantizar los derechos de los pueblos indígenas. Dado que la educación superior es fundamental para la generación y transmisión del conocimiento, se realizó una investigación teórico-narrativa para examinar cómo se manifiesta esta problemática desde el discurso de personas de pueblos originarios inmersas en el sistema educativo. El marco teórico propone soluciones basadas en conceptos como inclusión y autonomía universitaria. Los resultados indican que los participantes entienden el problema desde perspectivas más pertinentes a su contexto, remitiendo a errores históricos de la época colonial, y ofrecen medidas para que la escuela refleje el sistema social. Se encuentra que una de las manifestaciones de la injusticia cognitiva está en los diseños curriculares oficiales, dada la estrecha relación entre cultura, lengua y conocimientos. Junto a los participantes, se cuestiona la limitada participación de los pueblos originarios en la elaboración de planes y programas académicos.

RESUMO O cultivo comercial de goiabeira (Psidium guajava L.) ocorre em todas as regiões brasileiras, onde moscas-das-frutas causam perdas diretas na produção e afetam as exportações de frutas frescas devido a restrições quarentenárias. Objetivou-se determinar a incidência, diversidade e flutuações populacionais de espécies de moscas frugívoras que infestam goiabeira e levantar seus parasitoides associados, no estado do Espírito Santo, Brasil. Frutos e moscas capturadas por armadilhas foram amostrados em três regiões produtoras de goiaba. Anastrepha fraterculus (Wied.) foi a principal espécie associada a goiabeiras, principalmente na região litorânea. Anastrepha chiclayae foi registrada pela primeira vez associada a goiabeiras no Brasil. Medfly não foi uma espécie importante. Neosilba zadolicha foi a espécie de Lonchaeidae mais comum, mas com baixa importância. Maiores populações de moscas frugívoras foram encontradas em regiões quentes e úmidas. Dois picos populacionais de A. fraterculus foram observados em outubro (primavera) e de março a abril (verão-outono). Tefritídeos ocorreram em todas as regiões pesquisadas, com maiores infestações na área litorânea, seguida da norte e serrana, respectivamente. Doryctobracon areolatus e Aganaspis pelleranoi foram as espécies de parasitoides mais comuns; no entanto, o controle biológico natural de moscas frugívoras em goiabeira foi muito baixo e apresentou controle populacional de baixo impacto. Psidium L. L brasileiras moscasdasfrutas das quarentenárias Objetivouse Objetivou se incidência associados Santo Brasil goiaba Wied. Wied (Wied. litorânea importante comum importância úmidas A primavera (primavera verãooutono. verãooutono verão outono . (verão-outono) pesquisadas serrana respectivamente comuns entanto impacto (Wied (verão-outono

ABSTRACT The commercial cultivation of guava tree (Psidium guajava L.) occurs in all Brazilian regions, where fruit flies cause direct losses to production and affect fresh fruit exports due to quarantine restrictions. This study aimed to determine the incidence, diversity and population fluctuations of frugivorous fly species that infest guava trees, as well as to survey their associated parasitoids, in the Espírito santo state, Brazil. Fruits and flies captured in traps were sampled in three guava-producing regions. Anastrepha fraterculus (Wied.) was the main species associated with guava trees, particularly in the coastal region. Anastrepha chiclayae was recorded for the first time associated with guava trees in Brazil. Medfly was not considered an important species. Neosilba zadolicha was the most common Lonchaeidae species collected, but with low importance. Higher populations of frugivorous flies were found in hot and humid areas. Two population peaks of A. fraterculus were observed during October (spring) and from March to April (summer-autumn). Tephritid flies occurred in all surveyed regions, with higher infestations in the coastal area, followed by the northern and mountain regions, respectively. Doryctobracon areolatus and Aganaspis pelleranoi were the most common species of parasitoids; however, the natural biological control of frugivorous flies in guava trees was very low and had little impact on fruit fly populations. Psidium L. L regions restrictions incidence parasitoids state Brazil guavaproducing producing Wied. Wied (Wied. region collected importance areas A spring (spring summerautumn. summerautumn summer autumn . (summer-autumn) area respectively however (Wied (summer-autumn

RESUMO Objetivos: Avaliar a mortalidade hospitalar de pacientes idosos com fratura de fêmur submetidos ao tratamento cirúrgico durante o período pandêmico de covid-19. Avaliar se a infecção pelo vírus do covid-19 e os fatores clínicos e ortopédicos interferiram na mortalidade. Material e Métodos: Realizou-se um estudo retrospectivo por levantamento de prontuários. Foram incluídos pacientes acima de 60 anos associados a fratura da extremidade proximal do fêmur e que submetidos a tratamento cirúrgico. Calculou-se a mortalidade geral e também aquela cuja causa principal ou secundária foi a infeção pelo covid-19 para determinar se essa influenciou na mortalidade dos pacientes. Foram avaliados se os fatores clínicos e ortopédicos interferiram na mortalidade e variáveis categóricas foram comparadas pelo teste de Qui-quadrado ou exato de Fisher, utilizando tanto o teste t não pareado (variáveis paramétricas) como o teste de Teste Mann-Whitney (variáveis não paramétricas). Por fim, construiu-se a curva de mortalidade de Kaplan-Meier. Conclusão: A taxa de mortalidade de pacientes idosos com fratura de fêmur submetidos ao tratamento cirúrgico durante a pandemia de Covid foi de 4,2%. Pacientes do sexo masculino, idosos e os que foram submetidos à transfusão sanguínea evoluíram com maior mortalidade. Pacientes infectados pelo Covid tiveram dez vezes mais chance de evoluir para óbito e de forma duas vezes mais rápida que a população não infectada. Nível de Evidência II, Estudo Retrospectivo. Objetivos covid19. covid19 covid 19. 19 covid-1 Métodos Realizouse Realizou prontuários 6 Calculouse Calculou Quiquadrado Qui quadrado Fisher paramétricas MannWhitney Mann Whitney paramétricas. . fim construiuse construiu KaplanMeier. KaplanMeier Kaplan Meier. Meier Kaplan-Meier Conclusão 42 4 2 4,2% masculino infectada II Retrospectivo covid1 1 covid- 4,2 4,

ABSTRACT Objectives: Evaluate the prevalence of hospital mortality in older adult patients with femoral fracture undergoing surgical treatment during the COVID-19 pandemic period, and to evaluate whether COVID-19 infection, clinical, and orthopedic factors interfered with mortality. Material and Methods: A retrospective study was conducted by reviewing medical records. Patients over 60 years of age with proximal femoral fracture undergoing surgical treatment were included. Overall mortality was calculated, as well as mortality whose primary or secondary cause was COVID-19 infection, to determine if infection influenced patient mortality. Clinical and orthopedic factors that interfered with mortality were evaluated. Categorical variables were compared using the Chi-square test or Fisher’s exact test. Both unpaired t-test (parametric variables) and Mann-Whitney test (non-parametric variables) were used. The Kaplan-Meier mortality curve was constructed. Conclusion: The mortality of older adult patients with femoral fracture undergoing surgical treatment during the COVID-19 pandemic was 4.2%. Male sex, older age, and those who underwent blood transfusion had higher mortality rates. COVID-infected patients had ten times more chance of death and died twice as fast as the non-infected population. Level of Evidence II, Retrospective Study. Objectives COVID19 COVID 19 COVID-1 period clinical Methods records 6 included calculated evaluated Chisquare Chi square Fishers Fisher s ttest t parametric MannWhitney Mann Whitney nonparametric non used KaplanMeier Kaplan Meier constructed Conclusion 42 4 2 4.2% sex rates COVIDinfected infected noninfected population II Study COVID1 1 COVID- 4.2 4.

ABSTRACT It is recognized that the recreational activities used in the teaching-learning process contribute to the motivation and desire to learn in children. The objective of the research is to develop a methodological strategy to promote interculturality with the use of recreational activities. A quantitative approach is presented, of the correlational, experimental and longitudinal type and is based on applying theoretical research methods in the search for regularities and good practices in Ecuadorian conditions and a diagnosis in which empirical methods are used. A methodological strategy based on gamification is proposed for the development of interculturality and its effectiveness is verified by applying the Net Promoters Index to the participating teachers and subsequently, a verification is proposed for the students that evaluates the results and allow for continuous improvement. The proposal guarantees the development of interculturality (Montubia Culture) based on the use of gamification and the achievement of significant learning by incorporating autonomous learning, the use of technologies, promoting teamwork and the development of field research, conceive evaluation as learning and the development of expository skills.

RESUMEN Se reconoce que las actividades lúdicas utilizadas en el proceso de enseñanza- aprendizaje contribuyen a la motivación y el deseo de aprender en los niños. El objetivo de la investigación consiste en desarrollar una estrategia metodológica para fomentar la interculturalidad con el uso de actividades lúdicas. Se presenta un enfoque cuantitativo, del tipo correlacional, experimental y longitudinal y se parte de aplicar métodos teóricos de investigación en la búsqueda de regularidades y buenas prácticas en las condiciones ecuatorianas y de un diagnóstico en el que se emplean métodos empíricos. Se propone una estrategia metodológica sustentada en la gamificación para el desarrollo de la interculturalidad y se comprueba su efectividad por medio de la aplicación a los docentes participantes del Índice de Promotores Netos y posteriormente, se propone, una comprobación a los estudiantes que evalúe los resultados y permita la mejora continua. La propuesta garantiza el desarrollo de la interculturalidad (Cultura Montubia) basada en el uso de la gamificación y el logro de aprendizajes significativos al incorporar el aprendizaje autónomo, el uso de las tecnologías, fomentar el trabajo en equipo y el desarrollo de investigaciones de campo, concebir la evaluación como aprendizaje y el desarrollo de habilidades expositivas.

INTRODUCTION: Breast cancer, in particular, is a significant concern in public health due to its high mortality rate. This research focuses on understanding the factors related to the 3-year survival of women with breast cancer in Cali, contributing to addressing this health challenge. OBJECTIVE: To determine the socio-demographic, clinical, and healthcare-related factors associated with the 3-year survival of women with breast cancer affiliated with an insurance provider in Cali from 2017 to 2020. This study aims to generate scientific evidence for decision-making within the insurance provider and the region. METHODOLOGY: A study was conducted in women with breast cancer in Cali to identify factors linked to 3-year survival. Data from a cohort of women with breast cancer affiliated with an insurance provider were analyzed, applying inclusion and exclusion criteria. Socio-demographic, clinical, and healthcare-related factors were assessed. Data were collected from secondary sources and analyzed to determine variables associated with survival. Ethical and confidentiality considerations were adhered to throughout the process. RESULTS: The most significant finding of our study, based on a three-year follow-up of 140 women with breast cancer, is the alarming mortality rate of 21.4%. We emphasize the importance of diagnosing the disease at its early stages, which can make a difference in the survival and prognosis of patients. CONCLUSION: The study highlights the high vulnerability of the cohort of women with breast cancer affiliated with the insurance provider. Although a longer survival time was observed in certain groups, the mortality rate remains significant.

INTRODUCCIÓN: El cáncer de mama, en particular, es una preocupación significativa en la salud pública debido a su alta mortalidad. Esta investigación se centra en comprender los factores relacionados con la supervivencia a 3 años de mujeres con cáncer de mama en Cali, contribuyendo a abordar este desafío de salud. OBJETIVO: determinar los factores socio demográficos, clínicos y de atención en salud asociados a la supervivencia a 3 años de mujeres con cáncer de mama afiliadas a una aseguradora en Cali 2017-2020, generando evidencia científica para la toma de decisiones tanto en la aseguradora como en la región. METODOLOGIA: Se realizó un estudio en mujeres con cáncer de mama en Cali para identificar factores vinculados a la supervivencia a 3 años. Se analizaron datos de una cohorte de mujeres con cáncer de mama afiliadas a una aseguradora, aplicando criterios de inclusión y exclusión. Se evaluaron factores sociodemográficos, clínicos y de atención en salud. Los datos se recopilaron de fuentes secundarias y se analizaron para determinar las variables relacionadas con la supervivencia. Se cumplieron consideraciones éticas y de confidencialidad en el proceso. RESULTADOS: El hallazgo más significativo de nuestro estudio, basado en un seguimiento de tres años a 140 mujeres con cáncer de mama, es la alarmante tasa de mortalidad del 21.4%. Destacamos la importancia de diagnosticar la enfermedad en sus estadios iniciales, lo que puede marcar la diferencia en la supervivencia y el pronóstico de las pacientes. CONCLUSION: Estudio destaca la alta vulnerabilidad de la cohorte de mujeres con cáncer de mama afiliadas a la EAPB. Aunque se observó un mayor tiempo de supervivencia en ciertos grupos, la tasa de mortalidad sigue siendo significativa.

Abstract: The main objective of the fast postoperative recovery strategies in surgery is to provide efficient treatment based on the best available scientific evidence to shorten the postoperative recovery of patients, decrease the incidence of complications associated with hospitalization and surgical intervention; and therefore, reduce hospital costs. In our country, more than 50% of thyroidectomies are performed by low-volume surgeons, fact that has already been shown to be a risk factor associated with increased rate of postsurgical complications such as transient or permanent hypoparathyroidism or vocal cord paralysis. Understanding that achieving the availability of high-volume surgical human resources throughout the national territory is a non-viable objective in the short term, despite the efforts to train high specialists in endocrine surgery, one of the initiatives proposed by the Mexican Association of General Surgery, A.C., is to provide a series of recommendations to guide national surgeons for achieving better surgical results, with the unique objective of increasing the quality of care of the Mexican population. Until now, in Mexico there was no established recovery protocols for patients undergoing thyroid surgery. The purpose of this work was to create a series of recommendations for the preoperative, intraoperative, and postoperative periods, to improve the outcomes of patients undergoing thyroidectomy. All these recommendations are based on the best scientific evidence available and are aimed to general surgeons with both high and low thyroidectomy volume.

Resumen: Los programas de recuperación mejorada en cirugía tienen como principal objetivo brindar un tratamiento eficiente basado en la mejor evidencia científica con la finalidad de acortar el tiempo de recuperación postoperatoria de los pacientes, disminuir la incidencia de complicaciones inherentes a la hospitalización y tratamiento quirúrgico; y por consecuencia reducir los costos hospitalarios. En nuestro país, más de 50% de las tiroidectomías son realizadas por cirujanos de bajo volumen, lo que ya se ha demostrado que incrementa la posibilidad de complicaciones postquirúrgicas, tales como hipoparatiroidismo y parálisis cordal transitoria o permanente. En el entendimiento de que alcanzar la disponibilidad de recursos humanos quirúrgicos de alto volumen en todo el territorio nacional es un objetivo no viable a corto plazo, a pesar de los esfuerzos de formar altos especialistas en cirugía endocrina, una de las iniciativas de la Asociación Mexicana de Cirugía General, A.C., es la de emitir una serie de recomendaciones que apoyen a los cirujanos nacionales a tener mejores resultados quirúrgicos, con el objetivo único de incrementar la calidad de atención de la población mexicana. Hasta la fecha actual, en México no existía, un protocolo establecido para los pacientes que son intervenidos de cirugía tiroidea. El presente trabajo tuvo como finalidad realizar un consenso de expertos para emitir recomendaciones en el periodo preoperatorio, intraoperatorio y postoperatorio para mejorar los desenlaces de los pacientes intervenidos de tiroidectomía. Todas estas recomendaciones basadas en la mejor evidencia científica disponible y orientadas a cirujanos tanto de alto como de bajo volumen quirúrgico en cuanto a tiroidectomía se refiere.

Abstract The aim of this study was to develop and achieve consensus on a cariology teaching framework for dental schools in Latin American Spanish-speaking countries. The Delphi process, with a ≥8 0% pre-defined participants’ agreement, included three phases and a Coordinating Group. During the Preparation phase three panels of experts were selected and invited to participate: a) Regional academic/professional Dental Associations (Associations-Panel): n = 12; b) Regional Dental Schools (Dental-Schools-Panel): existing dental schools (n = 263) from the 19 Spanish-speaking regional countries; c) International academic/professional associations Peer Experts (Peer-Panel): n = 4. Based on consensus documents from Europe, Colombia, the Caribbean, USA, Chile and Spain, and updated scientific evidence, the Coordinating Group developed a baseline framework proposal of domains, main competencies (MC) and specific competencies (SC). The Consultation-Agreement and Consensus phases included three rounds of questionnaires with a step-wise sharing of the MC updated version of the consensus framework with the Dental-Schools-Panel and including SC with the Associations-Panel. Diverse communication strategies were used ( e.g ., independent google-form questionnaires and workshops). Consensus was reached after an on-site Associations-Panel workshop and secret voting, followed by an online meeting with the Peers-Panel. A total of 127 academic/professional institutions participated (Associations-Panel: 11, 91.6%; Dental-Schools-Panel: 112, 42.6%, all countries; Peers-Panel: 4, 100%). The baseline Cariology teaching framework of 5 domains, 10 MC and 92 SC underwent modifications after agreements for a final consensus framework consisting of 5 domains, 10 MC and 85 SC. A Core Cariology curriculum framework in Spanish for Latin American Dental Schools was successfully developed and agreed upon with regional dental academic and professional institutions. Spanishspeaking speaking countries process 8 ≥ 0 predefined pre defined participants agreement participate academicprofessional AssociationsPanel Panel (Associations-Panel) 12 b DentalSchoolsPanel (Dental-Schools-Panel) 263 1 c PeerPanel (Peer-Panel) 4 Europe Colombia Caribbean USA Spain evidence domains (MC . (SC) ConsultationAgreement Consultation Agreement stepwise step wise AssociationsPanel. Panel. eg e g googleform google form workshops. workshops workshops) onsite site voting PeersPanel. PeersPanel Peers Peers-Panel (Associations-Panel 11 91.6% 916 91 6 112 426 42 42.6% 100%. 100 100% 100%) 9 (Dental-Schools-Panel 26 (Peer-Panel (SC 91.6 42.6 2 91. 42.

ABSTRACT The development of new technologies and uses of electrical energy, such as distributed energy resources, pose new challenges and business opportunities for the electricity industry. In favor of making better use of information so that companies can efficiently manage their assets (minimizing investment and operating costs while improving service quality) and users rationally managing their demand (making efficient use of available energy resources). In this sense, Chile is experiencing a paradigm shift in the electricity sector, mainly seeking to improve energy efficiency. In this work, a survey of particularities and problems of the Electricity Distribution Systems is carried out so that these are considered as inputs in the Transmission Planning models used in Chile, specifically of the Zonal Transmission.

RESUMEN El desarrollo de nuevas tecnologías y usos de la energía eléctrica, como los recursos energéticos distribuidos, plantean nuevos desafíos y oportunidades de negocio para la industria eléctrica. Ello en pro de realizar un mejor uso de la información para que las empresas puedan gestionar de forma eficiente sus activos (minimizando los costes de inversión y operación, mejorando a su vez la calidad del servicio) y que los usuarios gestionen racionalmente su demanda (haciendo un uso eficiente de los recursos energéticos disponibles). En este sentido, Chile está experimentando un cambio de paradigma en el sector eléctrico, buscando principalmente mejorar la eficiencia energética. En este trabajo se presenta un análisis de las principales problemáticas de los recursos presentes en los Sistemas de Distribución Eléctrica, y se proponen algunas métricas con el fin de que estos sean considerados como insumos (inputs) en los modelos de Planificación de la Transmisión, específicamente en la Transmisión Zonal (o subtransmisión) en Chile.

Abstract: Objective: To analyze new 2015 guidelines from the American Thyroid Association (ATA) compared to 2009, and their impact on thyroidectomy extension in patients with papillary thyroid carcinoma. Material and methods: Retrospective study of patients with papillary thyroid cancer, who had surgery in two different periods, 2013-2016 (group A) and 2017-2018 (group B), comparing the number of hemithyroidectomies (HT) vs total thyroidectomies (TT), whether or not to perform lymph node dissection (DG), hospital stay, and perioperative complications. Results: 108 patients were studied, 54 in each group, comparing group A to group B: there were no differences in the number of HT (3 vs 2) and TT (51 vs 52). Performing a higher number of central DG (22 vs 32) and modified radical 7 vs 9. No significant difference was found in HT surgery time (100.0 ± 29.4 vs 135.0 ± 15.0 min [p = 0.569]), nor in TT (114.0 ± 40.9 vs 127.9 ± 63.8 min [p = 0.877]), bleeding (28.5 ± 45.2 vs 28.9 ± 89.6 mL [p = 0.977]) and length of stay (2.1 ± 1.3 vs 1.9 ± 0.9 [p = 0.374]). Conclusions: The recommendations of the extension in surgery had no impact on the surgical attitude. Complications were similar.

Resumen: Objetivo: Analizar nuevas guías 2015 de la Asociación Americana de Tiroides (ATA, por sus siglas en inglés) comparadas con las de 2009 y su impacto en extensión de tiroidectomía en pacientes con carcinoma papilar tiroideo. Material y métodos: Estudio retrospectivo de pacientes con cáncer papilar de tiroides operados en dos periodos distintos, 2013-2016 (grupo A) y 2017-2018 (grupo B), comparando número de hemitiroidectomías (HT) versus tiroidectomías totales (TT), realización o no disección ganglionar (DG), estancia hospitalaria y complicaciones perioperatorias. Resultados: Se estudiaron 108 pacientes, 54 en cada grupo, comparando grupo A con grupo B: no hubo diferencias en número de HT (tres versus dos) y TT (51 versus 52). Se realizó un número mayor de DG central (22 versus 32), y radical modificada siete versus nueve. No se encontró diferencia significativa en tiempo operatorio de HT (100.0 ± 29.4 versus 135.0 ± 15.0 min [p = 0.569]) ni en TT (114.0 ± 40.9 versus 127.9 ± 63.8 min [p = 0.877]), sangrado (28.5 ± 45.2 versus 28.9 ± 89.6 mL [p = 0.977]) y días de estancia hospitalaria (2.1 ± 1.3 versus 1.9 ± 0.9 [p = 0.374]). Conclusiones: Las recomendaciones de la extensión en cirugía no ha tenido impacto en la actitud quirúrgica. Las complicaciones fueron similares.

Resumen Objetivo: Identificar y sintetizar los procesos y actividades realizados por el farmacéutico en la farmacia comunitaria y hospitalaria durante la pandemia por COVID-19. Método: Revisión sistemática exploratoria en PubMed/Medline de artículos publicados hasta el 30 de junio de 2021, siguiendo las recomendaciones PRISMA para este tipo de revisiones. Los artículos incluidos se clasificaron según sus principales características y resultados, acorde con la estructura: población, concepto y contexto. Los procesos y las actividades identificados se agruparon en tres categorías: realizados en farmacia comunitaria y hospitalaria, llevados a cabo esencialmente en farmacia comunitaria y realizados esencialmente en farmacia hospitalaria. Resultados: Se identificaron 629 artículos, de los cuales se excluyeron 454 por no estar en relación con el objeto de la revisión y 81 por los criterios de exclusión; por tanto, se incluyeron 94 en la revisión y análisis. La mayoría de los estudios se desarrollaron en Europa y Estados Unidos. Entre los procesos y actividades llevados a cabo por el farmacéutico durante la pandemia, tanto en farmacia comunitaria como en hospitalaria, destacaron: atención farmacéutica, gestión eficiente y oportuna de los servicios, información y educación, apoyo psicológico, farmacovigilancia y telefarmacia. En farmacia comunitaria destacaron también los relacionados con la detección de COVID-19 y derivación de pacientes, inmunización en farmacias, recomendaciones de cuidados en el hogar e indicación farmacéutica. Entre los procesos realizados esencialmente en farmacia hospitalaria destacaron los relacionados con la participación en investigaciones de tratamientos farmacológicos, desarrollo de guías de utilización de medicamentos basadas en evidencia y manejo de medicamentos en indicaciones no aprobadas. Conclusiones: Durante la pandemia por COVID-19, los farmacéuticos han liderado e implantado procesos orientados a mitigar su impacto en la salud de la población. Atención farmacéutica, gestión eficiente y oportuna de los servicios, información y educación, apoyo psicológico, farmacovigilancia y telefarmacia fueron los principales procesos y actividades realizados en farmacia comunitaria y hospitalaria durante la pandemia por COVID-19. Dichos procesos y actividades buscaron, además de contribuir al control, prevención y tratamiento efectivo y seguro de la COVID-19, asegurar la implantación de medidas de bioseguridad, la dispensación y uso adecuado de los medicamentos y la información y educación basadas en la mejor evidencia disponible.

Abstract Objective: To identify and summarize the processes implemented and the activities performed by community and hospital-based pharmacists during the COVID-19 pandemic. Method: A scoping review was carried out of the PubMed/Medline database with the aim of identifying articles published until 30 June 2021. The PRISMA recommendations for this type of review were followed. The articles included were reviewed and classified according to their main characteristics and outcomes, according to population, concept and context. The processes and activities identified were grouped into three categories: those performed in community and hospital pharmacies, those performed essentially in community pharmacies, and those performed essentially in hospital pharmacies. Results: A total of 629 articles were identified, of which 454 were excluded because they were unrelated to the object of the review and 81 due to meeting the exclusion criteria. So, 94 articles were included in the analysis. Most studies were conducted in Europe and the United States. During the COVID-19 pandemic, the processes implemented and the activities carried out in both community and hospital-based pharmacies included pharmaceutical care, efficient and timely management of services, information and education, psychological support, pharmacovigilance and telepharmacy. Processes implemented and activities carried out essentially in community pharmacies were those related to the detection and referral of COVID-19 patients, testing and immunization, home care recommendations, and drug indications. Finally, processes and activities essentially occurring in hospital pharmacies included those related to participation in drug treatment research, drug evaluation and guidelines development, and to managing off-label drugs. Conclusions: During the COVID-19 crisis, pharmacists have led and implemented processes aimed at mitigating the impact of the pandemic on the population´s health. Pharmaceutical care, efficient and timely management of services, information and education, psychological support, pharmacovigilance and telepharmacy, both in community and hospital pharmacies, are the main processes implemented by pharmacists during the COVID-19 pandemic. These processes and activities, in addition to contributing to the control, prevention and effective and safe treatment of COVID-19; have ensured the implementation of biosecurity measures, proper dispensing of medication, the drug rational use, and the provision of evidence-based information and education.

Abstract Background: Vitiligo is characterized by an autoimmune response targeting melanocytes, thus resulting in skin depigmentation. There are several genetic components involved in the development of vitiligo, of which various gene polymorphisms are currently considered as risk factors. For example, the CTLA4 (T-lymphocyte antigen 4) +49A/G (rs231775) and CT60 (rs3087243) gene variants have been associated with a predisposition for autoimmune diseases in different populations; however, their involvement in the development of vitiligo remains controversial. Objective: We evaluated the association between vitiligo and the CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants in a Mexican population. Methods: A total of 116 vitiligo patients and 117 control subjects from northeast Mexico were included in the study and analyzed through PCR-RFLP to determine whether there is an association between vitiligo and CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants. Results: No statistical difference was observed for both gene polymorphisms between vitiligo patients and controls (p > 0.05). Otherwise, vitiligo activity, family history of vitiligo, personal history of autoimmune diseases, or sex did not show any difference (p > 0.05). Conclusion: As suggested by the analysis of a northeastern Mexican population, the CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants do not constitute a risk factor in the development of vitiligo.

Abstract Objective: to describe the clinical presentation, diagnosis, and surgical treatment of a patient with superior mesenteric artery syndrome or Wilkie syndrome combined with the nutcracker syndrome or left renal vein compression syndrome in a tertiary referral center in a Latin American country. Case description: a 25-year-old male patient from the United States who attended for a year of weight loss and intestinal obstruction episodes of unknown etiology after multiple imaging studies. Endoscopic studies were performed without findings. While in the recovery room, he developed abdominal pain requiring admission to the emergency service. The CT enterography showed dilation of the colon loops and small intestine with a decrease of the aortomesenteric (AOM) angle and the gastrointestinal series with the filiform passage of the contrast medium. Conservative management was attempted as initial therapy with intolerance to enteric nutritional support. Finally, we initially opted for surgical treatment, with a slow recovery process, but in the end, with a resolution of symptoms and weight gain. Conclusion: Wilkie syndrome is a rare disease and a diagnostic challenge in patients with weight loss and abdominal pain. We described a superior mesenteric artery compression case in which diagnosis was achieved with multiple diagnostic strategies and complete resolution after surgical treatment. The decreased aortomesenteric angle may compress the superior mesenteric artery and the left renal vein. In this case, it resulted in a combined Wilkie and nutcracker syndrome.

Resumen Objetivo: describir la presentación clínica, el diagnóstico y el tratamiento quirúrgico de un paciente con síndrome de la arteria mesentérica superior o síndrome de Wilkie combinado con síndrome de cascanueces o síndrome de compresión de la vena renal izquierda, en un centro de alta complejidad de un país latinoamericano. Descripción del caso: paciente masculino de 25 años, procedente de Estados Unidos, quien consultó por un año de pérdida de peso y episodios de obstrucción intestinal de etiología desconocida tras múltiples estudios de imagen. Se le realizaron estudios endoscópicos sin hallazgos; en la sala de recuperación desarrolló dolor abdominal que requirió ingreso al servicio de urgencias. La enterotomografía mostró dilatación de asas de colon e intestino delgado, con disminución del ángulo aortomesentérico y la serie gastrointestinal con paso filiforme del medio de contraste. Se intentó el manejo conservador como terapia inicial, con intolerancia al soporte nutricional entérico. Finalmente, se optó por el tratamiento quirúrgico, con un proceso de recuperación tórpido inicialmente, pero al final con resolución de los síntomas y aumento de peso. Conclusión: el síndrome de Wilkie es una enfermedad rara y un desafío diagnóstico en pacientes con pérdida de peso y dolor abdominal. Describimos un caso de compresión de la arteria mesentérica superior en el que se logró el diagnóstico con múltiples estrategias diagnósticas y resolución completa luego del tratamiento quirúrgico. La disminución del ángulo aortomesentérico puede comprimir la arteria mesentérica superior, así como la vena renal izquierda, que en ese caso resultó en un síndrome combinado de Wilkie y de cascanueces.

Abstract: The state of Veracruz is one of the greatest diversity of mammals in Mexico, so conducting studies in this group is a priority to assess its conservation status, given the accelerated transformation and loss of ecosystems. The objective of the study was to evaluate the taxonomic diversity of the community of medium and large mammals of the Ejido Zomajapa and its adjoining areas within the municipality of Zongolica, Veracruz. Between October 2019 and October 2020, through photo-trapping techniques, interviews with residents and transect searches, a richness of 27 species of mammals was recorded, distributed in 7 orders, 15 families and 24 genera. One species is critically endangered, one is considered threatened, and three species are near threatened. For the dry season a diversity of 25 effective species was estimated and for the rainy season it was 24 effective species, with no significant difference between them. The relative abundance of Dasyprocta mexicana stands out, endemic species of Mexico and with potential for use by managing its population. The presence of T. pecari through interviews is relevant, as it's a species considered extinct in the region. To conserve the richness and abundance of mammals recorded in this study, it is necessary to promote Units for the Conservation, Management and Sustainable Use of Wildlife (UMA) from a multidisciplinary perspective to promote the economic development of rural communities and minimize the anthropogenic impact on mammalian populations.

Resumen: El estado de Veracruz es uno de los de mayor diversidad de mamíferos en México, por lo que realizar estudios en este grupo es una prioridad para evaluar su estado de conservación, dada la acelerada transformación y pérdida de los ecosistemas. El objetivo del estudio fue evaluar la diversidad taxonómica de la comunidad de mamíferos medianos y grandes del Ejido Zomajapa y sus áreas anexas dentro del municipio de Zongolica, Veracruz. Entre octubre 2019 y octubre 2020, mediante técnicas de foto trampeo, entrevistas a pobladores y búsqueda por transectos, se registró una riqueza de 27 especies de mamíferos, distribuidos en 7 órdenes, 15 familias y 24 géneros. Una especie se encuentra en peligro crítico, una se considera amenazada y tres especies se encuentran casi amenazadas. Para la temporada seca se estimó una diversidad de 25 especies efectivas y para la temporada de lluvias fue 24 especies efectivas, sin diferencia significativa entre ellas. Destaca la abundancia relativa de Dasyprocta mexicana, especie endémica de México y con potencial de aprovechamiento mediante el manejo de su población. La presencia de T. pecari por medio de entrevistas es relevante, ya que es una especie considerada extinta en la región. Para conservar la riqueza y abundancia de mamíferos registrada en este estudio, es necesario el fomento de Unidades para la Conservación, Manejo y Aprovechamiento Sustentable de la Vida Silvestre (UMA) desde una perspectiva multidisciplinaria para impulsar el desarrollo económico de las comunidades rurales y minimizar el impacto antropogénico hacia las poblaciones de mamíferos.