Resumen Objetivo: Evaluar un dispositivo automatizado para la asistencia ventilatoria basado en un AMBU manufacturado en Marzo del 2020. Métodos: El ESSI-1 INC fue evaluado por medio de parámetros fisiológicos y mecánica pulmonar a través de pruebas de espirómetro compensatorios (TISSOT); pulmón artificial (Modelo 5600i Dual Adult PNEU VIEW SYSTEM); así como su desempeño comparado a la máquina de anestesia (AEONMED 7500) en modelos porcinos, midiendo criterios ventilatorios, hemodinámicos y gasométricos. Resultados: Este equipo (ESSI-1 INC) fue exitosamente probado por modelos mecánicos y biológicos, tales como cerdos donde su desempeño fue evaluado en términos de la variabilidad del volumen tidal, frecuencia ventilatoria, y relación I/E versus el desempeño manual de dos médicos. Todos los resultados finalizaron como se esperaba de forma satisfactoria. Conclusiones: Es un equipo seguro y efectivo, el cual debería ser probado y usado en distintas condiciones clínicas para estandarizar la seguridad ventilatoria y cuidado de pacientes que lo requieran.

Abstract Objective: The objectives of this study were to evaluate an automated device for ventilatory support based on AMBU manufactured in March 2020. Methods: The ESSI-1 INC was evaluated through pulmonary mechanics and physiology parameters through compensatory spirometer tests (TISSOTs), and an artificial lung Model5600i Dual Adult PNEU VIEW SYSTEM; it was also compared to the anesthetic ventilatory support equipment (AEONMED 7500) in porcine models, measuring ventilatory, hemodynamic and gasometric parameters. Results: This equipment (ESSI-1 INC) was successfully tested by mechanical and biological models, such as pigs in which its performance was evaluated in terms of variability of tidal volume, ventilation frequency, and I/E relationship versus the manual performance of two medical interns. All the results turned out as expected and were satisfactory. Conclusions: It is safe and effective equipment and should be tested and used in diverse clinical conditions to standardize the ventilatory safety and care of patients who require it.

Resumen La literatura de factores de la eficiencia de proyectos se Manufactura Esbelta y Seis Sigma es extensa, incluye reportes de sus cuestionables resultados y se observa la falta de explicaciones razonables, objetivas ellos. En la búsqueda de los factores de los proyectos ME/SS la literatura no es concluyente. Por ello, el objetivo de este proyecto de investigación es determinar esos factores. Para ese propósito, se realizó una revisión de literatura, determinado una lista de 29 factores en 48 artículos, dicha lista se redujo a 21 por Meta-Análisis. Con los factores se construyó un cuestionario, con 4 constructos y 25 indicadores, mismo que se validó con las pruebas de KMO y Bartlett. El cuestionario se aplicó a una muestra de 225 ingenieros con experiencia en proyectos de ME/SS desarrollados en plantas industriales que operan tecnologías de alto nivel. La especificación del modelo estructural inicia con un Análisis Factorial Exploratorio con rotación oblicua y por el método de Componentes Principales con rotación Promax y se aplicaron varios indicadores para la evaluación empírica. Se determinaron los factores críticos del éxito de proyectos de ME/SS y se comprobó la bondad de los métodos de ecuaciones estructurales. Se presenta y discute el modelo estructural y sus componentes.

Abstract Literature is extensive regarding the increases of efficiency by Six Sigma and Lean Manufacturing (SS/LM) projects, including reports of questionable results and the lack of reasonable explanations about those cases. In the search of the factors influencing the success of the projects, the literature is inconclusive. Therefore, the objective of this work is to determine the factors influencing the success of those projects. For which, a literature review was carried out finding that 48 publications gave a list of 29 factors, which is reduced to 21 by a Meta-Analysis study. These factors are used for the development of a questionnaire with 4 constructs and 25 indicators, which is validated with KMO and Bartlett’s tests. To identify the factors used in the industrial practice and their contributions to success, the questionnaire was applied to a sample of 225 engineers with experience in Six Sigma and Lean Manufacturing projects working in high tech manufacturing companies. The specification of the structural model starts with an exploratory factorial analysis-oblique rotation and the method of Principal Axes with Promax rotation, afterward for the empirical evaluation several indexes were used. The critical success factors and the usefulness of SEM for these purposes were determined. The structural model and its components are presented in this paper.

Resumo A literatura sobre os fatores de eficiência do projeto Lean Manufacturing e Seis Sigma é extensa, inclui relatórios de seus resultados questionáveis e carece de explicações razoáveis e objetivas para eles. Na busca dos fatores dos projetos ME/SS, a literatura não é conclusiva. Portanto, o objetivo deste projeto de pesquisa é determinar esses fatores. Para tanto, foi realizada uma revisão da literatura, determinando uma lista de 29 fatores em 48 artigos, esta lista foi reduzida para 21 por Meta-Análise. Foi construído um questionário com os fatores, com 4 construtos e 25 indicadores, o qual foi validado com os testes KMO e Bartlett. O questionário foi aplicado a uma amostra de 225 engenheiros com experiência em projetos de ME/SS desenvolvidos em plantas industriais que operam tecnologias de alto nível. A especificação do modelo estrutural inicia-se com uma Análise Exploratória de Fatores com rotação oblíqua e pelo método de Componentes Principais com rotação Promax e vários indicadores foram aplicados para avaliação empírica. Foram determinados os fatores críticos para o sucesso de projetos de ME/SS e verificada a qualidade dos métodos de equações estruturais. O modelo estrutural e seus componentes são apresentados e discutidos.

Abstract Introduction: Congenital heart diseases are the most common congenital disorders in the world population, they generally manifest after birth. Altitudes between 2,500-3,500 meters above sea level have been linked to the high incidence of congenital heart diseases such as patent ductus arteriosus, atrial septum defects, and ventricular septum defects. Objetives: To characterize clinically and sociodemographically the patients diagnosed with congenital heart disease from low, moderate and high altitudes in a regional hospital in Colombia. Methodology: Observational, descriptive retrospective study. All patients under 18 years of age with a diagnosis of congenital heart disease, treated at the San Rafael de Tunja University Hospital between 2015 and 2021, were included. Results: 51.9% of the patients were male, 16.3% had a history of prematurity and 9.1% had a diagnosis of Down syndrome. The most frequent heart diseases were: persistent ductus arteriosus 35.1%, followed by ventricular communication representing 21.6% and intra-atrial communication with 19.7%). Conclusions: They must eestablish strategies such as screening and timely diagnosis of congenital heart disease in at-risk populations in order to improve the life prognosis of patients and the outcome of the disease.

Resumen Introducción: Las cardiopatías congénitas son los trastornos congénitos más frecuentes en la población mundial, se manifiestan generalmente después del nacimiento. Las altitudes entre 2,500 y 3,500 metros sobre el nivel del mar se han relacionado con la alta incidencia de cardiopatías congénitas como el ductus arterioso persistente, los defectos del septum auricular y los defectos del septum ventricular. Objetivo: Caracterizar clínica y sociodemográficamente los pacientes con diagnóstico de cardiopatías congénitas procedentes de altitudes bajas, moderadas y altas en un hospital regional de Colombia. Metodología: Estudio observacional, descriptivo retrospectivo. Se incluyeron todos los pacientes menores de 18 años con diagnóstico de cardiopatías congénitas, atendidos en el Hospital Universitario San Rafael de Tunja entre el 2015 y 2021. Resultados: El 51.9% de los pacientes eran de sexo masculino, el 16.3% tenían antecedente de prematurez y el 9.1% tenían diagnóstico de síndrome de Down. Las cardiopatías más frecuentes fueron: ductus arterioso persistente (35.1%), seguido de comunicación interventricular (21.6%) y comunicación intrauricular (19.7%). Conclusiones: Se deben establecer estrategias como el tamizaje y diagnóstico oportuno de las cardiopatías congénitas en poblaciones de riesgo con el fin de mejorar el pronóstico de vida de los pacientes y desenlace de la enfermedad.

Abstract Rapunzel syndrome is an unusual and rare disease that occurs in young people, caused by intragastric accumulation of ingested hair (gastric trichobezoar) that keeps stuck in the gastric lumen and extends to the small intestine, associated with trichophagia. We report the case of a 25-year-old female patient with a history of trichophagia who is admitted in our institution with abdominal pain, distention, nausea, weight loss and concomitant upper gastrointestinal bleeding. Preoperative diagnosis was made by prior abdominal computed tomography scan with duodenal extension. Success surgical laparotomy and multimodal psychiatric follow up was made. This entity must be considered as a differential diagnosis with Acute Abdomen with Bowel obstruction and upper gastrointestinal bleeding.

Resumen El síndrome de Rapunzel es una enfermedad inusual y rara que se presenta en personas jóvenes, caracterizada por un acúmulo de cabello ingerido (tricobezoar gástrico) y confinado generalmente a la cámara gástrica que se extiende al intestino delgado, asociada a tricofagia. Reportamos el caso de una paciente de 25 años con antecedente de tricofagia que ingresa a un centro de salud en curso de dolor, distensión abdominal y datos de obstrucción intestinal asociado a hemorragia digestiva alta. Con documentación preoperatoria por tomografía computada abdominal de un tricobezoar con extensión duodenal, el cual se extrae por laparotomía. La paciente se remite para manejo multimodal por servicio de psiquiatría. Es una afección para tener en cuenta como diagnóstico diferencial en los cuadros de abdomen agudo quirúrgico, de la mano con obstrucción intestinal y sangrado gastrointestinal.

Abstract Torsion of the umbilical cord as a cause of fetal death is a rare occurrence, with few reported cases. The cause is not clearly known, and it transpires mainly in the second trimester of pregnancy; the risk factors described are the length of the umbilical cord with increased number of twists. The case of a 37-year-old woman is reported, gravida 2 para 1, 23 weeks pregnant with ultrasound diagnosis of fetal death. Histopathology revealed hypercoiled umbilical cord torsion at the point where the umbilical cord attaches to the fetus, with occlusion of the lumen of the umbilical vein, as a cause of fetal death. Further research of this pathology is required to determine the risk factors and risk of recurrence in future pregnancies that will allow the preparation of antenatal fetal surveillance methods.

Resumen La torsión del cordón umbilical como causa de muerte fetal es rara, con pocos casos reportados. No se conoce con claridad la causa y se presenta principalmente en el segundo trimestre de embarazo. Los factores de riesgo descritos son la longitud del cordón umbilical y el aumento del número de giros. Se reporta el caso de una paciente de 37 años, grávida 2, para 1 con embarazo de 23 semanas, con hallazgo ecográfico de muerte fetal. En el estudio de histopatología se evidenció el cordón umbilical con hiperenrollamiento y torsión a nivel de la unión feto-umbilical con oclusión de la luz de los vasos umbilicales como causa de muerte fetal. Se requiere la investigación de esta patología para determinar los factores de riesgo y el riesgo de recurrencia en futuros embarazos con el fin de establecer métodos de vigilancia fetal antenatal.

Abstract INTRODUCTIONSARS-CoV-2 infection can produce endothelial injury and microvascular damage, one cause of the multiorgan failure associated with COVID-19. Cerebrovascular endothelial damage increases the risk of stroke in COVID-19 patients, which makes prompt diagnosis important. Endothelial dysfunction can be evaluated by using transcranial Doppler ultrasound to study cerebral hemodynamic reserve, but there are few of these studies in patients with COVID-19, and the technique is not included in COVID-19 action and follow-up guidelines nationally or internationally. OBJECTIVEEstimate baseline cerebral hemodynamic patterns, cerebral hemodynamic reserve, and breath-holding index in recovered COVID-19 patients. METHODWe conducted an exploratory study in 51 people; 27 men and 24 women 20–78 years of age, divided into two groups. One group comprised 25 recovered COVID-19 patients, following clinical and epidemiological discharge, who suffered differing degrees of disease severity, and who had no neurological symptoms or disease at the time they were incorporated into the study. The second group comprised 26 people who had not been diagnosed with COVID-19 and who tested negative by RT-PCR at the time of study enrollment. Recovered patients were further divided into two groups: those who had been asymptomatic or had mild disease, and those who had severe or critical disease. We performed transcranial Doppler ultrasounds to obtain baseline and post-apnea tests of cerebral hemodynamic patterns to evaluate cerebral hemodynamic reserve and breath-holding indices. We characterized the recovered patient group and the control group through simple descriptive statistics (means and standard deviations). RESULTSThere were no measurable differences in baseline cerebral hemodynamics between the groups. However, cerebral hemodynamic reserve and breath-holding index were lower in those who had COVID-19 than among control participants (19.9% vs. 36.8% and 0.7 vs. 1.2 respectively). These variables were similar for patients who had asymptomatic or mild disease (19.9% vs.19.8%) and for those who had severe or critical disease (0.7 vs. 0.7). CONCLUSIONSPatients recovered from SARS-CoV-2 infection showed decreased cerebral hemodynamic reserve and breath-holding index regardless of the disease’s clinical severity or presence of neurological symptoms. These abnormalities may be associated with endothelial damage caused by COVID-19. It would be useful to include transcranial Doppler ultrasound in evaluation and follow-up protocols for patients with COVID-19.

Resumen La temperatura es la principal variable ambiental de la que dependen las lagartijas para mantener sus procesos metabólicos, esta influencia el desempeño locomotor. Debido a esto, si la temperatura ambiental aumenta como consecuencia del cambio climático, los lacertilios podrían verse afectados fisiológica y ecológicamente. Evaluamos la eficiencia térmica y el desempeño locomotor de 3 poblaciones de Microlophus indefatigabilis. Registramos las temperaturas corporales, seleccionadas y críticas de los organismos, su desempeño locomotor y temperaturas operativas durante la temporada fría de 2017. Analizamos las temperaturas ambientales durante el fenómeno de El Niño de 1997 y 2015. Calculamos sus horas de restricción térmica durante el muestreo y ante los posibles aumentos en la temporada fría durante El Niño. Encontramos que las temperaturas corporales variaron significativamente entre poblaciones, pero conservan sus temperaturas seleccionadas, las cuales son cercanas a su temperatura óptima. Microlophus indefatigabilis tiende a termorregular y el extremo superior de su amplitud térmica está cercano a la temperatura crítica máxima. En años sin influencia de El Niño, la población con escasa cobertura vegetal presentó horas de restricción, pero con el aumento de las temperaturas ambientales, la especie podría incrementar sus horas de restricción, limitando sus horas de alimentación.

Abstract Temperature is the main environmental variable that lizards depend on to maintain their metabolic processes, this influence locomotor performance. Thereafter, if the environmental temperature increases, because of climate change, the lizards could be affected physiologically and ecologically. We evaluated the thermal efficiency and locomotor performance of 3 populations of Microlophus indefatigabilis. We recorded body, selected and critical temperatures of the organisms, their locomotor performance, and operative temperatures during the cold season of 2017. We obtained the environmental temperatures during the El Niño 1997 and 2015 events. We calculated their restriction hours during the sampling year and in possible increases in the cold season during El Niño. We found that body temperatures varied significantly among populations, but keep their selected temperatures, which are close to their optimum temperature for locomotor performance. Microlophus indefatigabilis is a thermoregulator in which its maximum values are close to its critical maximum temperature. Under normal years without El Niño event, the population with scarce vegetation cover presented hours of restriction, but with the increase in environmental temperatures, the species could increase its hours of restriction, limiting its feeding hours.

Resumen Los murciélagos son reservorios importantes de virus que pueden causar diversos problemas económicos y de salud en diferentes sectores. El propósito de este estudio fue determinar la prevalencia del virus de la rabia en murciélagos vampiro. También se evaluó la prevalencia de 3 virus zoonóticos más en el tejido recolectado. Se capturó un total de 45 individuos, los cuales fueron medidos y sexados bajo parámetros estándar. Se efectuó la reacción de RT-PCR para amplificar los productos virales de 4 tipos de virus: chikungunya (CHIKV), dengue (DENV), rabia (RABV) y Zika (ZIKV) de tejido cerebral. Se obtuvo un amplicón de 100 pb para ZIKV en 2 muestras, lo que representa una prevalencia del 4.4%. Para el caso de RABV, se obtuvo un amplicón de 581 pb en 9 individuos, lo que equivale al 20% de la muestra. Se obtuvieron 4 haplotipos diferentes para RABV y un solo haplotipo para ZIKV. También se evaluó la presencia de virus del dengue (DENV) y virus de chikungunya (CHIKV), pero no se encontraron muestras positivas. Se corroboró la presencia de la familia Rhabdoviridae en el murciélago vampiro y se registró por primera vez la presencia de ZIKV en Desmodus rotundus.

Abstract Bats are important reservoirs of viral entities that cause diverse economical and health problems in several sectors. The purpose of this study was to determine the prevalence of the rabies virus in vampire bats. We also tested for 3 other zoonotic viruses in the collected tissue. We captured 45 vampire bats (Desmodus rotundus), which were measured and sexed under standard parameters. We followed an RT-PCR reaction to amplify the viral products of four virus types: chikungunya (CHIKV), dengue (DENV), rabies (RABV) and Zika virus (ZIKV) from cerebral tissue. We obtained an amplicon of 100 bp for ZIKV in 2 samples, representing a prevalence of 4.4%. An amplicon of 581 bp for RABV was observed in 9 individuals, which is equivalent to 20% of our sample. We obtained 4 different haplotypes for RABV and a single haplotype for ZIKV. We did not record the presence of DENV and CHIKV. We corroborated the presence of the family Rhabdoviridae in the vampire bat and recorded the presence of ZIKV for the first time in this bat species.

Resumen Introducción: Las lesiones condrales de la rótula son un reto para el cirujano, principalmente en pacientes jóvenes y activos. La mayoría de los defectos condrales de la rótula son lesiones superficiales y pueden ser manejadas con técnicas de preservación articular; sin embargo, las lesiones profundas pueden requerir otro tipo de manejo. El objetivo de este artículo es comunicar el tratamiento de defectos osteocondrales de la rótula en pacientes jóvenes, mediante la técnica de aloinjerto fresco de donante cadavérico. Materiales y Métodos: Se seleccionaron pacientes con dolor anterior de rodilla, lesión condral de la rótula grado III-IV y que habían recibido o no algún tipo de manejo médico o quirúrgico. En estos pacientes, se usó un aloinjerto fresco de rótula con el fin de solucionar el cuadro y mejorar la función. Resultados: Todos los pacientes recuperaron la función y los arcos de movilidad, y no refirieron dolor. Se comprobó la integración del aloinjerto fresco al área receptora, sin evidencia de rechazos del tejido o infecciones. Conclusiones: El uso de aloinjerto fresco de rótula para tratar defectos osteocondrales amplios es una técnica quirúrgica valiosa, fácil de implementar, que no requiere una curva de aprendizaje extensa y que mejora considerablemente el dolor y la función en pacientes jóvenes.

Abstract Introduction: Chondral lesions of the patella are a challenge for the surgeon, mainly in young and active patients. Most patellar chondral defects are superficial injuries and can be managed with joint preservation techniques; however, deep injuries may require other types of management. The objective of this article is to manage osteochondral defects of the patella in young patients, using the technique of fresh allograft from a cadaveric donor. Materials and Methods: Patients with anterior knee pain, with grade III- IV chondral lesion of the patella and who had or had not undergone some type of medical or surgical management were included. They received a fresh patellar allograft that sought to provide a solution and improvement of the functionality. Results: In all cases, recovery of functionality and mobility, absence of pain and integration of the fresh allograft into the recipient area were achieved, without evidence of tissue rejection or infection. Conclusions: The advent of fresh osteochondral grafts allows adequate management and evolution of patients, with the aim of favoring joint preservation and avoiding total knee arthroplasty over time.

Abstract Background: In the present study, we have tested whether specimens of the medically relevant scorpion Tityus pachyurus, collected from two climatically and ecologically different regions, differ in the biological activities of the venom. Methods: Scorpions were collected in Tolima and Huila, Colombia. Chemical profiles of the crude venom were obtained from 80 scorpions for each region, using SDS-PAGE and RP-HPLC. Assays for phospholipase A2, direct and indirect hemolytic, proteolytic, neuromuscular, antibacterial, and insecticidal activities were carried out. Results: The electrophoretic profiles of venom from the two regions showed similar bands of 6-14 kDa, 36-45 kDa, 65 kDa and 97 kDa. However, bands between 36 kDa and 65 kDa were observed with more intensity in venoms from Tolima, and a 95 kDa band occurred only in venoms from Huila. The chromatographic profile of the venoms showed differences in the intensity of some peaks, which could be associated with changes in the abundance of some components between both populations. Phospholipase A2 and hemolytic activities were not observable, whereas both venoms showed proteolytic activity towards casein. Insecticidal activity of the venoms from both regions showed significant variation in potency, the bactericidal activity was variable and low for both venoms. Moreover, no differences were observed in the neuromuscular activity assay. Conclusion: Our results reveal some variation in the activity of the venom between both populations, which could be explained by the ecological adaptations like differences in feeding, altitude and/or diverse predator exposure. However more in-depth studies are necessary to determine the drivers behind the differences in venom composition and activities.

Abstract Background: At present benign and malignant pancreatobiliar diseases, required a multidisciplinary management, and the different techniques to solve this pathology has been improve with new technology and surgeons training. Objective: The purpose of this article is to describe that de minimally invasive surgery on benign and malignant pancreatobiliar diseases is feasible and offer good results. Method: In Hospital regional ISSSTE Puebla from July 2013 to July 2018, 30 consecutive patients with different pancreas and biliary pathologies have been operated by totally laparoscopic, by the same surgeon and surgical team, and following for up to 4 years. Results: None all the patients presented sever complications during surgery or after immediate surgery and no reoperations. Surgical time and blood loss was acceptable. Conclusion: The results we obtained are positive and encouraging because the morbidity and mortality are similar to the different sources we reviewed, nevertheless, this study is our initial experience and we required more cases to obtain a significant sample.

Resumen Antecedentes: En la actualidad las enfermedades benignas y malignas de las vías biliares y del páncreas requieren un manejo multidisciplinario, y las técnicas para resolver este tipo de padecimientos han avanzado gracias al mejoramiento en la tecnología y la capacidad del personal humano. Objetivo: El propósito de este trabajo es presentar varios casos y demostrar que la cirugía de mínima invasión en patología benigna y maligna pancreatobiliar es viable y se pueden obtener adecuados resultados. Método: De julio de 2013 a julio de 2018, 30 pacientes consecutivos han sido intervenidos quirúrgicamente por vía laparoscópica por diversas enfermedades que involucran páncreas y vías biliares, por el mismo cirujano y equipo quirúrgico, con un seguimiento de hasta 4 años. Resultados: Ninguno de los pacientes intervenidos presentó complicaciones graves en el transoperatorio ni en el posquirúrgico inmediato, ninguno fue sometido a una segunda cirugía y los tiempos quirúrgicos y el sangrado fueron aceptables. Conclusión: Los resultados son positivos y muy alentadores, ya que la morbilidad fue muy similar a la de las series que se revisaron; sin embargo, este estudio es nuestra experiencia inicial y requerimos aumentar el número de casos para obtener una muestra significativa.

Abstract Background: Bioprospecting includes the search for secondary metabolites to be used as drugs, fungicides or insecticides. Secondary metabolites in plants may vary according to their phenological stage, sex and environment, therefore, these elements should be considered in bioprospecting. Questions: 1) Are the Baccharis conferta phenophases different between organisms of different sexes and along an altitudinal gradient? and, 2) Do the different concentrations of ethanolic extracts of different sex, phenophases and altitudes of B. conferta on the in vitro growth of Myrothecium roridum and Alternaria solani have biological activity? Species studied: Baccharis conferta Kunth, Myrothecium roridum Tode ex Fr. and Alternaria solani Sor. Study site and dates: Cofre de Perote National Park, September 2017 to October 2018. Methods: Monthly registration of phenophases in plants of both sexes of B. conferta in three altitudes of the Cofre de Perote. In vitro antifungal activity of extracts of B. conferta on Myrothecium roridum and Alternaria solani. Results: We observed differences (p < 0.05) in the presence and duration of the B. conferta phenophases between sexes and altitudes. There were also significant differences in extracts from organisms of different altitudes and phenophases on the growth of M. roridum and A. solani. Conclusions: The phenophases of Baccharis conferta are different between sexes and through altitude, and its extracts (between sexes and altitude) also have differential effects on in vitro growth of Myrothecium roridum and Alternaria solani.

Resumen Antecedentes: La bioprospección incluye la búsqueda de metabolitos secundarios para ser usados como fármacos, fungicidas o insecticidas. Los metabolitos secundarios en plantas pueden variar de acuerdo con su estado fenológico, sexo y por el ambiente, por lo tanto, estos elementos deben ser considerados en la bioprospección. Preguntas: 1) ¿Son diferentes las fenofases de Baccharis conferta entre organismos de diferente sexo y a lo largo de un gradiente altitudinal? y 2) ¿Tienen actividad biológica las diferentes concentraciones de extractos etanólicos de diferente sexo, fenofases y altitudes de B. conferta sobre el crecimiento in vitro de Myrothecium roridum y Alternaria solani? Especies estudiadas: Baccharis conferta Kunth, Myrothecium roridum Tode ex Fr. y Alternaria solani Sor. Sitio de estudio y fechas: Parque Nacional Cofre de Perote, septiembre 2017 a octubre 2018. Métodos: Registro mensual de fenofases en plantas de ambos sexos de B. conferta en tres altitudes del Cofre de Perote. Actividad antifúngica in vitro de extractos de B. conferta sobre Myrothecium roridum y Alternaria solani. Resultados: Observamos diferencias (p < 0.05) en la presencia y duración de las fenofases de B. conferta entre sexos y altitudes. También hubo diferencias significativas de los extractos provenientes de organismos de diferentes altitudes y fenofases sobre el crecimiento de M. roridum y A. solani. Conclusiones: Las fenofases de Baccharis conferta son diferentes entre sexos y a través de la altitud, además sus extractos (entre sexos y altitud) tienen efectos diferenciales sobre el crecimiento in vitro de Myrothecium roridum y Alternaria solani.

ABSTRACT Tropical gar (Atractosteus tropicus) is freshwater and estuarine fish, inhabiting the Earth since the Mesozoic era and undergoing limited physiological variation ever since. Besides its recognized cultural and scientific relevance, the species has seen remarkable growth in its economic impact due to pisciculture. In this study, we present the first report of the whole taxonomic composition of microbial communities in gut contents in juveniles and adults of A. tropicus, by sex and origin (wild and cultivated). For this study, 508 genera were identified, with the most and least abundant being Cetobacterium and Paludibacter, respectively. Fusobacteria, Proteobacteria, Firmicutes, and Bacteroidetes phyla are the core gut microbiome of A. tropicus juvenile and adult by sex and origin. Deinococcus-Thermus phylum sequence was only identified in wild-type males. In the phylogenetic trees reconstruction Lactococcus lactis strains CAU929 and CAU6600, Cp6 and CAU9951, Cetobacterium strain H69, Aeromonas hydrophila strain P5 and WR-5-3-2, Aeromonas sobria strain CP DC28 and Aeromonas hydrophila were identified, some of them with probiotic potential within the three dominant phyla in core gut microbiome in A. tropicus adults, especially in wild-type organisms. Myroides genus was recognized in microbiota gut of the cultivated juvenile A. tropicus. Nevertheless, Alpha diversity indicated that the highest gut microbiota abundance and richness is found in cultivated juvenile and wild-type adult A. tropicus female, rather than adult wild-type males and the least gut microbiota abundance and richness is found in a cultivated adult of A. tropicus for both sexes.

Abstract Background: Pancreatoduodenectomy or Whipple’s operation, is the elective surgical procedure to treat different periampullary diseases. Through the years this surgery has been doing open, but in the lasts decades thanks to the improve technology and trained surgeons, today is feasible doing it laparoscopic with good results. Objective: To present the initial experience and results in totally laparoscopic pancreatoduodenectomy in Hospital Regional ISSSTE Puebla, reporting the second number of cases in México. Method: Since July 2014-July 2018, 8 patients has been operated by totally laparoscopic pancreatoduodenectomy, 7 in Hospital Regional ISSSTE Puebla and 1 in a private Hospital. Results: Evaluating all the patients, not one had mortality during operation, no morbidity or immediate reoperation, so the results are favourable. Conclusion: Laparoscopic pancreatoduodenectomy is a very complex procedure but feasible, and good results depends on various factors, like the appropriate patient selection.

Resumen Antecedentes: La pancreatoduodenectomía o cirugía de Whipple es el procedimiento de elección en el tratamiento de las enfermedades periampulares. A través de los años se ha realizado de manera abierta, y actualmente, gracias a la mejora de los recursos humanos y tecnológicos, se realiza este procedimiento por mínima invasión con buenos resultados. Objetivo: Presentar la experiencia inicial en la pancreatoduodenectomía totalmente laparoscópica en el Hospital de Alta Especialidad del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) de Puebla, dando a conocer la segunda serie de casos reportada en México. Método: De julio de 2014 a julio de 2018 se han realizado ocho pancreatoduodenectomías totalmente laparoscópicas, siete en el hospital de alta especialidad ISSSTE Puebla y una en un hospital privado. Resultados: En todos los pacientes intervenidos los resultados son favorables, sin mortalidad transoperatoria y sin presentar complicaciones graves ni reintervención. Conclusión: La pancreatoduodenectomía laparoscópica es un procedimiento de alta complejidad que, teniendo una adecuada selección de pacientes y un manejo multidisciplinario, se puede llevar a cabo con excelentes resultados.