Resumo O amarelecimento letal (LY) é uma doença que afecta o coqueiro e outras espécies de palmeiras. Está associada a fitoplasmas do grupo 16SrIV e o único vector de insectos notificado até agora para este patogéneo é o Haplaxius crudus. O H. crudus está presente no México e foi associado aos fitoplasmas do grupo 16SrIV, no entanto, não foi detectável durante um surto de LY na costa de Yucatan, México, sugerindo a existência de outras espécies de vectores. Para testar esta hipótese foi realizado um levantamento de insectos e um total de 3074 insectos foram capturados durante um ano de amostragem mensal. Dez ordens taxonómicas foram identificadas nesta amostra, sendo Hemiptera a mais abundante (N=2094), e estas foram classificadas em nove famílias. A colpoptera sp. da família Nogodinidae era a mais abundante, representando 56% do número total de insectos amostrados e 23% destas amostras resultaram positivos para o fitoplasma LY por detecção por PCR. A comparação BLAST, RFLP virtual e análises filogenéticas dos amplicons sequenciados relacionam o fitoplasma detectado com o subgrupo 16SrIV-A. Os resultados aqui apresentados sugerem que Colpoptera sp. poderia ser considerado como um novo vector putativo dos fitoplasmas causadores de LY no México e um candidato a investigação adicional.

Abstract Lethal yellowing (LY) is a disease that affects coconut and other palm species. It is associated to phytoplasmas of the group 16SrIV and the only reported insect vector for this pathogen so far is Haplaxius crudus. H. crudus is present in Mexico and has been associated to 16SrIV phytoplasmas, however, it was not detectable during a LY outbreak in the coast of Yucatan, Mexico, suggesting the existence of other vector species. To test this hypothesis a survey of insects was carried out and a total of 3074 insects were captured during a year of monthly sampling. Ten taxonomic orders were identified in this sample, Hemiptera being the most abundant (N=2094), and these were classified into nine families. The leafhopper Colpoptera sp. from to the Nogodinidae family was de most abundant representing 56% of the total number of insects sampled and 23% of these samples resulted positive for LY phytoplasma by PCR detection. The BLAST comparison, virtual RFLP and phylogenetic analyses of the sequenced amplicons relate the detected phytoplasma to the subgroup 16SrIV-A. The findings presented herein suggest that Colpoptera sp. could be considered as a new putative vector of the LY-causing phytoplasmas in Mexico and a candidate for further research.

RESUMEN La quitina es un polisacárido lineal producido por especies animales y fúngicas. Una de sus principales fuentes de obtención es el hongo Aspergillus niger, cultivado en biorreactores industriales. Es un biopolímero neutro que modifica las propiedades eléctricas de los materiales compuestos, una característica muy útil para algunos dispositivos electrónicos. Nuestro objetivo en este trabajo fue la caracterización fisicoquímica de películas de quitina, extraída de dicho hongo por un método químico asistido por ondas de choque y calor, así como también determinar su resistividad eléctrica al aplicarle altos voltajes (entre 10 y 20 kV). Las ondas de choque se utilizaron en este estudio porque se sabe que inducen poros en las células y podrían promover la entrada de álcali en la hifa, permitiendo una mejor eliminación de los componentes celulares residuales. La quitina fue neutralizada, secada y se formaron películas. Los valores de proteína residual se cuantificaron con la técnica de ácido bicinconínico (BCA), obteniendo películas con bajas cantidades de proteína. La caracterización del morfotipo específico extraído se estimó mediante infrarrojo transformado de Fourier (FTIR) y difracción de rayos X (XRD). Para evaluar la resistividad ante voltajes elevados, se diseñó un circuito especial que permitió detectar variaciones significativas de esta con respecto al voltaje aplicado, es decir, la quitina mostró un comportamiento coincidente con un varistor no lineal y, hasta donde sabemos, este es el primer informe de dicho comportamiento para la quitina.

ABSTRACT Chitin is a linear polysaccharide produced by animal and fungal species. One of its sources is the fungus Aspergillus niger, which is culturable in industrial bioreactors. Chitin is a neutral biopolymer that modifies the electrical properties of composite materials. These are useful features in some electronic devices. This study aimed to carry out physicochemical characterizations of chitin films obtained from the above-mentioned fungus, using a chemical method enhanced with exposure to heat and shock waves, and to determine their electrical resistivity at high voltages (between 10 and 20 kV). Shock waves were used in this study because they are known to induce pores into cells and could promote alkali entry into the hypha, allowing better removal of residual cellular components. Chitin was neutralized, dried, and films were produced. Residual protein values were quantified by bicinchoninic acid assay (BCA). The films obtained had low amounts of protein. The characterization of the specific morphotype extracted was done by FTIR and XRD. An especially designed circuit revealed significant variations of the resistivity as the voltage was varied. This behavior is typical of a non-linear varistor and, to the best of our knowledge, has not been reported for chitin.

Abstract 24-year-old man with positive HIV, with a giant exofitic anal condyloma, with a clinical presentation of a painfull suppurative anal condyloma with a pathology report of an in situ squamous cell carcinoma. The purpose of the investigation is a case report and the procedure was observational. The finding was a Buschke-Lowenstein tumor.

Resumen Varón de 24 años, con infección por el virus de la inmunodeficiencia humana, que presenta una tumoración exofítica, dolorosa y supurativa, con reporte positivo de virus de papiloma humano y reporte histopatológico de carcinoma espinocelular sin evidencia de diseminación (in situ). El propósito de la investigación es un reporte de caso y el procedimientos fue observacional. El hallazgo fue un tumor de Buschke-Lowenstein.

Resumen Introducción: La cirugía pediátrica en la atención del recién nacido es una de las ramas más especializadas y demandantes debido a las particulares características anatómicas y fisiológicas de este vulnerable grupo de pacientes. El objetivo de este estudio fue presentar la experiencia de diez años de manejo quirúrgico neonatal en un hospital perinatal de segundo nivel de atención en México. Métodos: Se llevó a cabo un estudio descriptivo, observacional, transversal y retrospectivo, en un hospital perinatal de Toluca, México, del 01 de agosto de 2012 al 31 de julio de 2022. Se incluyeron los pacientes sometidos a cirugía dentro de las instalaciones del hospital por parte del servicio de Cirugía Pediátrica. Se estudiaron variables demográficas, clínicas y quirúrgicas, realizando estadística descriptiva e inferencial. Resultados: Un total de 551 pacientes fueron intervenidos quirúrgicamente en este periodo, con una prevalencia de 0.5%. La cantidad de pacientes operados en el periodo neonatal fue de 497 (90.1%). Se presentaron 48 patologías con predominio de las congénitas en el 64.6% y diagnóstico prenatal en el 40.5% de los casos. La supervivencia de los pacientes fue del 89.7%. En el análisis bivariado de mortalidad se encontró una relación inversa con el peso y edad gestacional (p < 0.05). Conclusiones: En el hospital donde se realizó el estudio, a pesar de no ser un centro de referencia local o nacional, se atiende una amplia diversidad de padecimientos congénitos y adquiridos, con una mortalidad con tendencia a disminuir cercana a la media internacional y menor que los reportes nacionales.

Abstract Background: Neonatal surgery is one of the most specialized and demanding areas of pediatric surgery due to the specific anatomical and physiological characteristics of this vulnerable group of patients. This study aimed to present the experience of 10 years of neonatal surgical management in a secondary care perinatal hospital in Mexico. Methods: We conducted a descriptive, observational, cross-sectional, and retrospective study in a perinatal hospital in Toluca, Mexico, from August 01, 2012, to July 31, 2022. We included patients who underwent surgery within the hospital facilities by the Service of Pediatric Surgery. We studied demographic, clinical, and surgical variables and performed descriptive and inferential statistics. Results: A total of 551 patients underwent surgery during this period with a prevalence of 0.5%. The number of patients operated in the neonatal period was 497 (90.1%). Forty-eight pathologies were recorded, with a predominance of congenital malformations in 64.6% and prenatal diagnosis in 40.5% of cases. The survival rate was 89.7%. In the bivariate analysis of mortality, we found an inverse relationship between weight and gestational age (p < 0.05). Conclusion: Although not a local or national reference center, the hospital where the study was conducted treats various congenital and acquired diseases, with a mortality rate that tends to decrease, close to the international average, and lower than national reports.

Abstract. 22. Apparent digestibility is a useful technique for measuring nutritional resources in different animal species, requiring an inert marker such as titanium dioxide (TiO2). However, TiO2 has never been tested for digestibility studies in Apis mellifera. This work aimed to investigate different TiO2 concentrations as inert marker in the feeds (sucrose syrup and bee pollen) commonly consumed by honeybees. We assessed consumption variables, apparent digestibility, mortality rate, and body part weights. TiO2 did not significantly affect the mentioned variables, except for water consumption and apparent digestibility. Both variables exhibited an inverse relationship with the concentration of TiO2 added to the feeds. This observation could be attributed to a potential toxic effect of TiO2 or the analytical procedure. Based on our findings, we conclude that the optimal concentration of TiO2 for future digestibility studies is 0.1% w/w on a dried mass basis. The addition of TiO2 to sugary preparations and bee pollen holds promise as a valuable method for investigating apparent digestibility in Apis mellifera when studying these types of feeds.

Resumen 18. Una forma de evaluar la capacidad de aprovechamiento de los recursos nutricionales en varias especies animales es mediante la digestibilidad aparente. Para esta determinación, suele utilizarse una sustancia marcadora como el dióxido de titanio (TiO2). Sin embargo, este compuesto nunca ha sido probado en Apis mellifera en estudios de digestibilidad. En este trabajo, se emplearon diferentes concentraciones de TiO2 como sustancia marcadora en los alimentos consumidos (jarabe de sacarosa y polen apícola) por esta especie. Se evaluaron variables relacionadas con el consumo, la digestibilidad aparente, la mortandad y pesos de las partes corporales. Los resultados de este trabajo demostraron que el TiO2 no tuvo efectos sobre las variables estudiadas, excepto en el consumo de agua y de la digestibilidad aparente. Ambas mostraron una relación inversa con la concentración de TiO2 agregada en los alimentos, posiblemente debido a un efecto tóxico de esta sustancia o al procedimiento analítico utilizado. Se concluye que la concentración más adecuada para posteriores estudios de digestibilidad es 0,1% p/p base materia seca. Asimismo, podemos decir que el uso de TiO2 en sustancias azucaradas y polen apícola podría ser una herramienta útil para investigar la digestibilidad aparente en A. mellifera cuando se estudian este tipo de alimentos.

RESUMEN Antecedentes : las ventajas de la hepatectomía videolaparoscópica (HVL) hicieron que gane cada vez más campo para el tratamiento de los tumores hepáticos benignos (THB). Objetivo : comparar los resultados perioperatorios de pacientes sometidos a HVL con los de los operados con hepatectomía abierta (HA) por THB, emparejados con propensity score matching (PSM). Material y métodos : estudio descriptivo, retrospectivo y comparativo de HA y HVL por THB entre agosto de 2010 y junio de 2021. Se analizaron variables demográficas, preoperatorias, intraoperatorias y posoperatorias. Para evitar sesgos de las distintas covariables entre los grupos se realizó un PSM 1:1. Resultados : de 403 hepatectomías, se analizaron 82 por THB. De ellas 36 (44%) fueron HA y 46 (56%) HVL. Edad media 45 ±14 años, 65% mujeres. Tras realizar el PSM, quedaron dos grupos de 28 pacientes cada uno. En HA, 5 (18%) pacientes requirieron transfusiones y ninguno en HVL (p = 0,01). Las complicaciones mayores se presentaron en 4 (14%) pacientes en HA, y ninguna en HVL (p = 0,03). Se reoperaron 4 (14%) pacientes con HA y ningún paciente con HVL (p = 0,03). La estadía hospitalaria total fue significativamente mayor en las HA (p = 0,04). No se registraron muertes a los 90 días en ninguno de los dos grupos. Conclusión : la HVL por THB es una técnica segura y eficaz, ya que los pacientes presentaron menor requerimiento transfusional, número de reoperaciones, de complicaciones mayores y de estadía hospitalaria que con HA. Por las ventajas encontradas, la HVL podría ser considerada la técnica de elección en cirugía por THB.

ABSTRACT Background : The advantages of laparoscopic liver resection (LLR) have increased its use for the treatment of benign liver tumors (BLTs). Objective : The aim of this study was to compare the perioperative outcomes of patients undergoing LLR with those operated on with open liver resection (OLR) for BLTs using propensity score matching (PSM). Material and methods : We conducted a descriptive and retrospective study comparing OLRs with LLRs performed between August 2010 and June 2021. The demographic, perioperative, intraoperative and postoperative variables were analyzed. We used PSM with 1:1 matching to avoid biases of the different covariates between the groups. Results : Of 303 liver resections, 82 corresponded to BLTs and were included in the analysis; 36 (44%) were OLRs and 46 (56%) were LLRs. Mean age was 45 ±14 years and 65% were women. After PSM, two groups of 28 patients each were constituted. Five patients (18%) in the OLR group and none in the LLR required transfusions (p = 0.01). Major complications, occurred in 4 (14%) patients in the OLR group and in no cases in the LLR group (p = 0.03). Four (14%) undergoing OLR required reoperation versus no patients with LLR (p = 0.03). Total length of hospital stay was significantly longer in OLR (p = 0.04). There were no deaths in any of the groups within 90 days. Conclusion : LLR for BLTs is a safe and effective technique, with lower requirement for transfusions, fewer reoperations and major complications and shorter length of hospital stay than OLR, Therefore, LLR could be considered the surgical technique of choice for BLTs.

Abstract Introduction: The purpose of this study is to determine the incidence of intraoperative iatrogenic radial nerve injury after osteosynthesis of the diaphysis and distal end of the humerus, identify associated risk factors, and determine the prognostic factors involved in its recovery. Materials and Methods: We retrospectively assessed 82 humerus osteosynthesis cases between 2005 and 2021 who had normal radial nerve function before surgery. We evaluated the fixation systems used, the type of surgery (primary versus revision), and the intervals between surgeries. The diagnosis of postoperative radial palsy was made by clinical examination. All patients were treated with wrist extension splint, physiotherapy, and vitamins B1, B6, and B12. Results: After humerus fixation, 9 patients developed motor palsy. Seven cases were fixed with plates, one with a cable-plate system, and one with an anterograde locking intramedullary nail. Seven cases (22%) occurred after primary procedures, while two occurred during revisions. Within 6 months, 88% had regained full motor function. In the remaining 22% of patients with definite palsy, electromyography revealed no excitability of the radial nerve. Conclusions: The use of an osteosynthesis plate, as well as intraoperative dissection and neurolysis of the radial nerve, were identified as risk factors for the development of radial palsy. Reoperations on the humerus, on the other hand, are a risk factor that increases the likelihood of postoperative radial nerve palsy. A radial nerve with no excitability on the postoperative electromyogram has a poor prognosis of spontaneous radial nerve function recovery.

Resumen Introducción: Los objetivos de este estudio fueron determinar la incidencia de lesión iatrogénica intraquirúrgica del nervio radial durante la osteosíntesis de la diáfisis y el extremo distal del húmero, distinguir factores de riesgos asociados y reconocer elementos pronósticos que participan de su recuperación. Materiales y Métodos: Se evaluó, en forma retrospectiva, a 82 pacientes con osteosíntesis de húmero entre 2005 y 2021, sin parálisis radial preoperatoria. Se consideraron los sistemas de fijación utilizados, y se compararon las cirugías primarias con las reoperaciones y el tiempo transcurrido entre estas. El diagnóstico de parálisis radial posoperatorio fue clínico. Todos los pacientes fueron tratados con férula en extensión de muñeca, electroestimulación, kinesiología y vitaminas B1, B6, B12. La electromiografía se solicitó a los fines del pronóstico. Resultados: Nueve pacientes tuvieron déficit motor del nervio radial en el posoperatorio inmediato. El sistema de fijación era una placa (7 casos), sistema de cable-placa (1 caso) y clavo endomedular acerrojado anterógrado (1 caso). Siete ocurrieron en cirugías primarias y dos en reoperaciones. El 88% recuperó su función motora completamente antes de los 6 meses después de la parálisis. La electromiografía reveló un nervio radial no excitable en el 22% restante con parálisis definitiva. Conclusiones: El uso de placa de osteosíntesis, la disección intraoperatoria del nervio radial y las reoperaciones aumentan la incidencia de parálisis. Un nervio radial no excitable se relaciona con un peor pronóstico de recuperación espontánea.

Resumen El objetivo de este artículo es identificar componentes metacognitivos de la competencia “aprender a aprender” en los programas docentes de las titulaciones de Pedagogía e Ingeniería en Telecomunicaciones de España. Estos componentes implican el manejo del conocimiento de sí, de la tarea y las estrategias para abordarla, la planificación, organización y gestión del tiempo, la autoevaluación, el control y autorregulación, y la resolución de problemas durante el propio proceso de aprendizaje, aspectos clave para la formación profesional de aprendices autónomos. La metodología consistió en la revisión de 1,896 programas docentes de estas titulaciones desde una perspectiva cualitativo documental. Mediante un análisis de contenido cualitativo, se efectuó la codificación de los componentes de la dimensión metacognitiva que propone el modelo teórico de la competencia aprender a aprender de Gargallo et al. (2020a). Los resultados muestran que las competencias aparecen atomizadas en habilidades, conocimientos y muy escasamente incorporan actitudes y elementos contextuales, por lo que se concluye que difícilmente la propuesta curricular, como se encuentra expresada, pueda desarrollar la dimensión metacognitiva de la citada competencia.

Abstract This article aims to detect metacognitive components of learning-to-learn competence in the teaching programs of Pedagogy and Telecommunications Engineering degrees in Spain. These components involve such as knowledge of the task and strategies to approach it, planning, organization and time management, self-assessment, control and self-regulation and problem-solving during the learning process itself, key aspects for the professional training of autonomous learners. The methodology consisted of a qualitative documentary review of 1,896 teaching programs. We employed a qualitative content analysis to code the components of the metacognitive dimension proposed by the Theoretical Model of learning-to-learn competence by Gargallo et al. (2020a). The results show that the competencies appear atomized in knowledge and skills, but hardly incorporate attitudes and contextual elements. So, we concluded that it is difficult for the curricular proposal, as it is expressed, to develop the metacognitive dimension of the learning-to-learn competence.

Abstract Liver rupture secondary to preeclampsia represents a complication that, if is not recognized early, can be fatal. Its presentation is rare, but very complex to treat, having options that are not clearly protocolized and usually derive from the experience of the surgeon who faces it. We present a case of liver rupture of a patient from Toluca, State of Mexico who was admitted by emergency air transfer with immediate puerperium complicated by severe preeclampsia, postpartum hemorrhage, liver rupture with hemodynamic instability, it was necessary to intervene surgically for a total of seven occasions to control the hemorrhage, as well as pharmacological, medical measures and multiple transfusions; however, she died on the eighteenth day of his hospitalization for septic shock.

Abstract This study evaluates litterfall production, forest floor mass and leaf-litter decomposition and growth in an 8-year- old Eucalyptus grandis stand and 467 treesha-1 and in another 16-year-old Pinus elliottii stand with 533 treesha-1, in the northeast of Corrientes, Argentina. In each stand, three permanent plots of 1000 m2 were established. Four collectors of 1.0 m2 and 12 litterbags of 20 cm2 were randomly distributed in each plot. The measurements were made over 3 years. The relationship between environmental factors and leaf-litterfall was analyzed using the Pearson correlation coefficient (r). The E. grandis stand showed an annual increment (IMA) of 25.2 m3ha-1year-1, a mean annual litter production (PAL) of 10.1 Mgha-1, an annual decomposition constant (K) of 0.7 and a half-life time (THL) of 1.0 years. The P. elliottii stand presented an IMA of 26.1 m3ha-1year-1, a PAL of 14.3 Mgha-1, a K of 0.6 and a THL of 1.15 years. The highest material fall occurred during the summer for both species with maximum monthly mean values of 1.5 Mgha-1 for E. grandis and 2.3 Mgha-1 for P. elliottii. The leaves were the most representative component of the fallen material. The climatic variable that presented the highest correlation with material fall was the average monthly temperature. The dynamics observed in the stands, production, formation of mulch and its decomposition are characteristic of subtropical forests.

Resumen Este estudio evalúa la producción de hojarasca, la acumulación y descomposición del mantillo y el crecimiento en un rodal de Eucalyptus grandis de 8 años de edad y 467 árbolesha-1 y en otro de Pinus elliottii de 16 años de edad y 533 árbolesha-1, en el nordeste de Corrientes, Argentina. En cada rodal fueron instaladas 3 parcelas permanentes de 1000 m2. Se distribuyeron 4 canastos de 1,0 m2 y 12 litterbags de 20 cm2, por parcela. Las mediciones fueron realizadas durante 3 años. La relación entre factores ambientales y caída de hojarasca se analizó mediante el coeficiente de correlación de Pearson (r). El rodal de E. grandis presentó un incremento medio anual (IMA) de 25,2 m3ha-1año-1, una producción de hojarasca anual media (PHA) de 10,1 Mgha-1, una constante de descomposición anual (K) de 0.7 y un tiempo de media vida (TMV) de 1,0 año. El rodal de P. elliottii presentó un (IMA) de 26,1 m3ha-1año-1, PHA de 14,3 Mgha-1, K de 0,6 y un TMV de 1,15 años. La mayor caída de material se presentó durante el verano para ambas especies con valores medios mensuales máximos de 1,5 Mgha-1 para E. grandis y de 2,3 Mgha-1 para P. elliottii. Las hojas fueron el componente más representativo del material caído. La variable climática que presentó mayor correlación con la caída de material fue la temperatura media mensual. La dinámica observada en los rodales, producción, formación de mantillo y su descomposición es característica de los bosques subtropicales.

Abstract Background: A high incidence of acute kidney injury (AKI) has been reported in coronavirus disease 2019 (COVID-19) patients in critical care units and those undergoing invasive mechanical ventilation (IMV). The introduction of dexamethasone (DXM) as treatment for severe COVID-19 has improved mortality, but its effects in other organs remain under study. Objective: The objective of this study was to evaluate the association between DXM and AKI in COVID-19. Methods: In this prospective observational cohort study, we evaluated the incidence of AKI in critically ill COVID-19 patients undergoing mechanical ventilation, and the association of DXM treatment with the incidence, severity, and outcomes of AKI. The association between DXM treatment and AKI was evaluated by multivariable logistic regression. The association of the combination of DXM treatment and AKI on mortality was evaluated by Cox-regression analysis. Results: We included 552 patients. AKI was diagnosed in 311 (56%), of which 196 (63%) corresponded to severe (stage 2 or 3) AKI, and 46 (14.8%) received kidney replacement therapy. Two hundred and sixty-seven (48%) patients were treated with DXM. This treatment was associated to lower incidence of AKI (Odds Radio 0.34, 95% Confidence intervals [CI] 0.22-0.52, p < 0.001) after adjusting for age, body mass index, laboratory parameters, SOFA score, and vasopressor use. DXM treatment significantly reduced mortality in patients with severe AKI (HR 0.63, 95%CI 0.41-0.96, p = 0.032). Conclusions: The incidence of AKI is high in COVID-19 patients under IMV. DXM treatment is associated with a lower incidence of AKI and a lower mortality in the group with severe AKI.

Resumen Términos como “parásitos”, “patógenos” o “virus” se utilizan en el campo de la medicina para la identificación de organismos que producen daño sobre otros. Sin embargo, en el campo de la veterinaria y su interacción con la ecología el contexto es diferente: la utilización indiscriminada de estos términos ha producido que muchas veces los mismos se utilicen como sinónimos. Al estudiar la bibliografía disponible sobre apicultura o conservación de abejas nativas, podemos observar que solamente unos pocos y recientes estudios se focalizan en esta necesaria reconceptualización de los términos basada en la ecología. A lo largo de esta revisión buscaremos diferenciar los conceptos de “parásito”, “patógeno” y“virus”, y redefinir los conceptos de “virulencia” y “patogenicidad” bajo un contexto ecológico. Esta revisión, propone demostrar que las interacciones parásito/hospedador pueden expresarse de forma diferencial en función del contexto micro (hospedador) y macro ambiental (ambiente del hospedador). Aunque utilizaremos a las abejas melíferas (Apis mellifera) como modelo, la teoría aquí abordada podría ser extrapolada por el lector a otros sistemas parasitarios.

Abstract Parasitism and bees: a concept revision from an ecological perspective. From the beginning all, parasites, pathogens and viruses are organisms that have a negative connotation in the field of medicine. However, the use of methodologies and terms of medicine in the field of ecology and, above all, veterinary medicine, led to this understanding of "pathogenic" organisms reaching such studies. When we look into the apicultural research bibliography, we find that these concepts sometimes are poorly distinguished and only a few early studies have been focused on bringing light on this conflictive conceptualization. Today we find a large number of scientific articles that misuse these terms and often consider them as synonyms. Throughout this review we will seek to differentiate each of these terms and generate consensus that avoids the confusion of such important ecological concepts.

Resumen Objetivo: Demostrar la experiencia adquirida desde la implementación del programa de donación renal pareada, el cual aumenta un 25-30% la tasa de donación en los centros hospitalarios sin inferioridad en la sobrevida del injerto comparado con el trasplante renal de donante vivo dirigido. Método: Estudio observacional, analítico, longitudinal y prospectivo de diciembre de 2018 a julio de 2021. Se incluyeron todos los enfermos renales crónicos G5 KDIGO que en el protocolo pretrasplante resultaron HLA o ABO incompatibles con sus donantes originales y que fueron trasplantados bajo el programa de donación renal pareada. Resultados: Se realizaron 22 trasplantes renales bajo este programa. La sobrevida del injerto y del paciente a 1 año postrasplante fue del 100%. La tasa de filtración glomerular postrasplante fue de 72.5 ± 17 ml/min/1.73 m2 de superficie corporal. Fueron trasplantados exitosamente el 36.3% de pacientes hipersensibilizados. La tasa de donación intrahospitalaria aumentó un 33.33%. Conclusiones: El trasplante bajo programa de donación renal pareada constituye una modalidad real de trasplante exitoso cuando existe incompatibilidad con el donante original. La mayor utilización y la socialización de este programa pueden aumentar la tasa de trasplante renal nacional, disminuyendo la lista de espera. Nuestro hospital representa la mayor experiencia publicada en México con este programa de trasplante.

Abstract Objective: To demonstrate the experience since the transplant program under paired kidney donation implementation; program that increases the donation rate by 25-30% in hospitals with no inferior graft survival compared to directed living donor kidney transplantation. Method: Observational, analytical, longitudinal and prospective study from December 2018 to July 2021. All G5 KDIGO chronic kidney patients who were HLA or ABO incompatible with their original donors in the pretransplant protocol and who were transplanted under the paired kidney donation program, were included. Results: 22 kidney transplants were performed under this program. Survival of the graft and the patient 1 year after transplantation was 100%. The post-transplant glomerular filtration rate was 72.5 ± 17 ml/min/1.73 m2 body surface. 36.3% of hypersensitized patients were successfully transplanted. The in-hospital donation rate increased by 33.33%. Conclusions: Transplantation under the kidney paired donation program constitutes a real modality of successful transplantation when there is incompatibility with the original donor. The greater use and socialization of this program can increase the country kidney transplantation rate, reducing the waiting list. Our hospital represents the largest experience published in Mexico with this transplant program.

ABSTRACT CRISPR/Cas genes evolved in prokaryotic organisms as a mechanism of defense designed to identify and destroy genetic material from threatening viruses. A breakthrough discovery is that CRISPR/Cas system can be used in eukaryotic cells to edit almost any desired gene. This comprehensive review addresses the most relevant work in the CRISPR/Cas field, including its history, molecular biology, gene editing capability, ongoing clinical trials, and bioethics. Although the science involved is complex, we intended to describe it in a concise manner that could be of interest to diverse readers, including anyone dedicated to the treatment of patients who could potentially benefit from gene editing, molecular biologists, and bioethicists. CRISPR/Cas has the potential to correct inherited diseases caused by single point mutations, to knock-in the promoter of a gene whose expression is highly desirable or knockout the gene coding for a deleterious protein. CRISPR/Cas technique can also be used to edit ex vivo immune cells and reinsert them in patients, improving their efficiency in attacking malignant cells, limiting the infectious potential of viruses or modulating xenotransplant rejection. Very important bioethical considerations on this topic include the need to internationally regulate its use by ad hoc expert committees and to limit its use until safety and bioethical issues are satisfactorily resolved.

Resumen Introducción: La prueba genómica de recurrencia de 21 genes (PGR21) permite determinar la utilidad de la quimioterapia adyuvante en pacientes con cáncer de mama temprano luminal (CMTL). Se han desarrollado modelos predictivos adicionales, como las ecuaciones de Magee (EM), el modelo Predict (MP) y la puntuación del nomograma de la Universidad de Tennessee (NT). Objetivo: Evaluar la concordancia entre PGR21, EM, MP y NT. Métodos: Se incluyeron pacientes con CMTL unifocal y con resultados de PGR21, EM, MP y NT. Se efectuó subanálisis de mujeres mayores de 50 años. La concordancia se evaluó mediante índice kappa de Cohen (IK). Resultados: Se incluyeron 122 mujeres. La concordancia entre PGR21 y EM (IK = 0.35) y MP (IK = 0.24) fue aceptable (p < 0.001); entre PGR21 y NT fue inferior (IK = 0.16, p = 0.04). Se incluyeron 80 pacientes mayores de 50 años con datos suficientes para calcular los tres modelos. Se encontró concordancia entre la clasificación de bajo riesgo mediante PGR21 y los tres modelos combinados en 36/37 pacientes (valor predictivo negativo de 97.3 %). Conclusión: Se puede omitir la PGR21 en las mujeres mayores de 50 años con CMTL que se clasifica de bajo riesgo en los tres modelos predictivos.

Abstract Introduction: The genomic-based 21-gene recurrence score assay (21-GRSA) allows to determine the usefulness of adjuvant chemotherapy in patients with luminal-type early breast cancer (LTEBC). Additional predictive models have also been developed, such as Magee equations (ME), the Predict model (PM), and the Tennessee nomogram score (TNS). Objective: To evaluate the concordance between 21-GRSA, ME, PM and TNS. Methods: Patients with unifocal LTEBC and 21-GRSA, ME, PM and TNS results were included. A subgroup analysis of women older than 50 years was carried out. Concordance between the models and 21-GRSA was evaluated using Cohen's kappa index (KI). Results: One-hundred and twenty-two women were included. Concordance between 21-GRSA and ME (KI = 0.35) and PM (KI = 0.24) was fair (p < 0.001). Concordance between 21-GRSA and TNS was inferior (KI = 0.16, p = 0.04). Eighty patients older than 50 years with sufficient data to calculate all three predictive models were included. Concordance was found between the low-risk classification on 21-GRSA and all three combined models in 36/37 patients (negative predictive value of 97.3%). Conclusion: 21-GRSA can be omitted in women older than 50 years with LTEBC classified with low risk scores on all three predictive models.