Resumen Introducción: La hipertensión pulmonar del recién nacido secundario con cierre en el útero del ductus arterioso es una complicación frecuente en las pacientes gestantes que usan analgésicos no esteroideos durante el embarazo. Se presenta un caso de secuencia de la perfusión arterial reversa en el embarazo gemelar con evidencia de supervivencia del gemelo acárdico con el flujo sanguíneo del gemelo bomba. El tratamiento es la cirugía con fetocoagulación láser al gemelo acárdico, previniendo complicaciones mayores para el gemelo sano. Caso clínico: Gemelo con secuencia twin reversed arterial perfusion. A las 22 semanas de gestación se le practicó fotocoagulación con láser al feto acárdico. La madre recibió por dos días acetaminofén y analgésicos no esteroideos para manejo del dolor. Se le realizó ecocardiograma fetal a las 31 semanas de gestación, con evidencia de disfunción diastólica del ventrículo derecho y cierre del ductus arterioso. Se le realizó cesárea de urgencia obteniendo recién nacido que presentó hipertensión pulmonar en el período neonatal, quien con manejo médico tiene resolución de la misma. Conclusión: La hipertensión pulmonar del recién nacido secundario a cierre del ductus arterioso en el útero por ingesta de medicamentos, es una entidad que pone en riesgo la vida del feto, por lo cual su diagnóstico y tratamiento oportuno es indispensable para mejorar la sobrevida de nuestros pacientes.

Abstract Introduction: Pulmonary hypertension of the newborn secondary to in utero closure of the ductus arteriosus is a frequent complication in pregnant patients taking non-steroidal antiinflammatory drugs during pregnancy. We present a case of reversed arterial perfusion sequence in a twin pregnancy with evidence of survival of the acardiac twin with the blood flow of the pump twin. The treatment of choice is surgery with intrafetal laser coagulation on the acardiac twin, to prevent further complications on the healthy twin. Clinical case: Twin with reversed arterial perfusion sequence. At 22 weeks gestation intrafetal laser coagulation on the acardiac twin was performed. The mother received acetaminophen for two days and non-steroidal anti-inflammatory drugs for the management of pain. Fetal echocardiogram was conducted at 31 weeks gestation, evidencing diastolic dysfunction of the right ventricle and ductus arteriosus closure. She underwent an emergency c-section; the newborn had pulmonary hypertension during the neonatal period that was solved with medical management. Conclusion: Pulmonary hypertension of the newborn secondary to in utero closure of the ductus arteriosus due to drug consumption is an entity that poses a risk to the fetus, so a timely diagnosis and treatment is essential to improve survival of our patients.

The production of bioethanol from pretreated lignocellulosic materials requires the utilization of microorganisms adapted to ferment the materials in conditions were high consistency, temperatures and inhibitors concentrations were commonly found. The yeast immobilization in calcium alginate capsules has been reported to enhance the yeast protection and increase the efficiency in the fermentation process. In this work, it was investigated the use Saccharomyces cerevisiae immobilized in calcium alginate and its performance in simultaneous saccharification and fermentation (SSF) of diluted-acid-pretreated Pinus radiata. Results showed that when immobilized yeast was used, the bioethanol yield from pretreated wood was higher than with free yeast cells during a SSF process. Maximum ethanol yield obtained from the acid pretreated and milled wood chips was 153 L/ton wood, while from the hydrolysate fraction it was 18 L/ton wood. The sum of ethanol produced from dilute acid pretreated P. radiata for both solid and liquid fractions was 171 L ethanol/ton wood from a maximum theoretical of 236 L/ ton pretretated wood (or 72% of conversion).

This article addresses an emerging issue in health care systems: the impact of judicial rulings on public policy regarding financing and delivery of health care services, and the attendant tensions, contradictions and questions. In Colombia, HIV/AIDS patients' use of a legal instrument called tutela, or writ of protection, has produced abundant jurisprudence and prompted health authorities to respond with decisions about HIV/AIDS service coverage that do not consider epidemiologic criteria and sustainability, introducing distortions in the health care system with respect to financing, priority-setting and universality.

Cellulose nanocrystals appeared as important bio-based products and the collected information in term of production, characterization and application suggest that this nanomaterial could be easily extrapolated to bioethanol production. This review describes recent published syntheses using chemical and enzymatic hydrolyses and different preparations such as high pressure homogenization. Their industrial and medical applications, such as controled of delivery carriers, suggest a large projection of this nanomaterial. The most important aspect in this collected data is the potential to decrease significantly the final cost of the enzymes or the hydrolysis pre-treatment of lignocellulosic materials of all bioethanol processes in such a way that it could be economically feasible from materials such as bagasse, straw or wood resources.