Resumen Introducción y objetivo. Con la evolución de la experiencia en el uso de la toxina botulínica tipo A para tratamientos estéticos se necesitan guías actualizadas de buenas prácticas clínicas. El objetivo de este trabajo fue desarrollar recomendaciones actualizadas para buenas prácticas en el uso clínico diario, con el fin de optimizar el manejo del paciente estético y los resultados obtenidos con la toxina botulínica tipo A. Material y método. Un panel de 44 participantes con amplia experiencia en el uso de la toxina Abobotulinum se reunió para revisar y discutir la evidencia disponible y la práctica clínica en la aplicación estética de la toxina Abobotulinum A. Resultados. Los temas discutidos para la creación de este consenso incluyeron cuestiones directamente relacionadas con el uso y las propiedades de la toxina botulínica tipo A (Azzalure®) y temas generales relativos a la práctica clínica: precisión y campo de efecto de la toxina botulínica tipo A, duración del efecto, rapidez en el inicio de acción, protocolos de tratamiento, tratamientos combinados de toxina botulínica tipo A y ácido hialurónico para mayor satisfacción del paciente y armonía facial, recomendaciones post-tratamiento, diagnóstico y valoración previa del paciente para un efecto óptimo, edad en la que los pacientes comienzan a ser tratados con la toxina y su recomendación como tratamiento preventivo según las escalas de envejecimiento Glogau I o II, manejo de las expectativas del paciente y valoración de la satisfacción del mismo. Conclusiones. Este consenso ha recogido las opiniones, consejos y experiencia de médicos estéticos con amplia experiencia en el uso de la toxina botulínica tipo A para ayudar a los profesionales a conseguir los mejores resultados posibles en términos de eficacia y satisfacción del paciente.

Abstract Background and objective. With the evolution of the experience in the use of botulinum toxin type A for aesthetic treatments, updated guidelines of good clinical practices are needed. The objective of this work was to develop updated recommendations for good practices in daily clinical use, in order to optimize the mana- gement of the aesthetic patient and the results obtained with botulinum toxin type A. Methods. A panel of 44 participants with extensive experience in the use of Abobotulinum toxin met to review and discuss the available evidence and clinical practice in the aesthetic application of Abobotulinum toxin A. Results. The topics discussed for the creation of this consensus included questions directly related to the use and properties of botulinum toxin type A (Azzalure®) and general topics related to clinical practice: precision and field of effect of botulinum toxin type A, duration of effect, speed of onset of action, treatment protocols, combined treatments of botulinum toxin type A and hyaluronic acid for greater patient satisfaction and facial harmony, post-treatment recommendations, diagnosis and prior assessment of the patient for optimal effect, age at which patients begin to be treated with the toxin and its recommendation as a preventive treatment according to the Glogau I or II aging scales, management of patient expectations and assessment of patient satisfaction. Conclusions. This consensus has collected the opinions, advice and experience of aesthetic doctors with extensive experience in the use of botulinum toxin type A to help professionals achieve the best possible results in terms of efficacy and patient satisfaction.

Abstract Background: Chronic heart failure (CHF) is a global health problem. Increased sympathetic outflow, cardiac arrhythmogenesis and irregular breathing patterns have all been associated with poor outcomes in CHF. Several studies showed that activation of the renin-angiotensin system (RAS) play a key role in CHF pathophysiology. Interestingly, potassium (K+) supplemented diets showed promising results in normalizing RAS axis and autonomic dysfunction in vascular diseases, lowering cardiovascular risk. Whether subtle increases in dietary K+ consumption may exert similar effects in CHF has not been previously tested. Accordingly, we aimed to evaluate the effects of dietary K+ supplementation on cardiorespiratory alterations in rats with CHF. Methods: Adult male Sprague–Dawley rats underwent volume overload to induce non-ischemic CHF. Animals were randomly allocated to normal chow diet (CHF group) or supplemented K+ diet (CHF+K+ group) for 6 weeks. Cardiac arrhythmogenesis, sympathetic outflow, baroreflex sensitivity, breathing disorders, chemoreflex function, respiratory– cardiovascular coupling and cardiac function were evaluated. Results: Compared to normal chow diet, K+ supplemented diet in CHF significantly reduced arrhythmia incidence (67.8 ± 15.1 vs. 31.0 ± 3.7 events/hour, CHF vs. CHF+K+), decreased cardiac sympathetic tone (ΔHR to propranolol: - 97.4 ± 9.4 vs. - 60.8 ± 8.3 bpm, CHF vs. CHF+K+), restored baroreflex function and attenuated irregular breathing patterns. Additionally, supplementation of the diet with K+ restores normal central respiratory chemoreflex drive and abrogates pathological cardio-respiratory coupling in CHF rats being the outcome an improved cardiac function. Conclusion: Our findings support that dietary K+ supplementation in non-ischemic CHF alleviate cardiorespiratory dysfunction.

Abstract The Mexicali valley is an important region in the production of meat and milk of bovine origin with acceptance in other countries, mainly the United States of America, Japan and Korea. For this reason, quality forage is required to feed cattle such as triticale, used in various areas of Mexico; however, in the Mexicali valley, there is no information on agronomic behavior. The objective of this study was to evaluate the dry biomass and grain yield of 10 varieties of triticale in the 2014-2015 and 2015-2016 A-W cycles, in the Mexicali valley. The experimental design was randomized complete blocks with three replications. 10 varieties of triticale of different growth types were evaluated, 4 spring, 2 facultative, 4 winter and oats. In the first evaluation cycle, the highest total biomass production corresponded to the variety AN105 and AN125 with 10.7 and 10.5 t ha-1, in grain yield the varieties AN105, AN38, AN125, AN31B, ABT and Eronga produced from 7.3 to 5.4 t ha-1. For the second cycle, the superior varieties in total biomass were AN31B, ABT, AN38, AN34, AN31P and Eronga with 6 to 4.9 t ha-1 and in grain yield AN38, AN123, Eronga and AN125 from 4.1 to 3.1 t ha-1. In conclusion, the winter varieties AN31B and AN34 showed potential for the production of total biomass, the facultative variety AN38 and the spring varieties AN125 and Eronga, showed superiority in grain yield in the two evaluation cycles.

Resumen El valle de Mexicali es una región importante en la producción de carne y leche de origen bovino con aceptación en otros países principalmente Estados Unidos de América, Japón y Corea. Por tal motivo, se requiere forraje de calidad para la alimentación del ganado como el triticale, utilizado en diversas zonas de México; sin embargo, en el valle de Mexicali no se tiene información del comportamiento agronómico. El objetivo de este estudio fue evaluar el rendimiento de biomasa seca y grano de 10 variedades de triticale en los ciclos O-I 2014-2015 y 2015-2016, en el Valle de Mexicali. El diseño experimental fue bloques completos al azar con tres repeticiones. Se evaluaron 10 variedades de triticale de diferentes tipos de crecimiento, 4 primaverales, 2 facultativos, 4 invernales y avena. En el primer ciclo de evaluación, la mayor producción de biomasa total correspondió a la variedad AN105 y AN125 con 10.7 y 10.5 t ha-1, en rendimiento de grano las variedades AN105, AN38, AN125, AN31B, ABT y Eronga produjeron de 7.3 a 5.4 t ha-1. Para el segundo ciclo, las variedades superiores en biomasa total fueron AN31B, ABT, AN38, AN34, AN31P y Eronga con 6 a 4.9 t ha-1 y en rendimiento de grano AN38, AN123, Eronga y AN125 de 4.1 a 3.1 t ha-1. En conclusión, las variedades invernales AN31B y AN34 mostraron potencial para la producción de biomasa total, la variedad facultativa AN38 y las variedades primaverales AN125 y Eronga, presentaron superioridad en rendimiento de grano en los dos ciclos de evaluación.

ABSTRACT While the outbreak has reached every region of the world, it is undeniable that countries in the southern hemisphere seem to be less affected, where cases have been reported, these have been imported and travel related. We analyzed the climate temperature from various regions according to their current ongoing human-to-human transmission status. We studied 3 groups; Group 1, 10 provinces from China with majority of COVID-19 cases; Group 2, areas where continuous horizontal transmission outside of China had been reported; and group 3, areas where imported cases had been detected and no horizontal transmission had been documented after at least seven days since the first case was reported. The regions without ongoing human-to-human transmission showed significantly higher temperatures when compared to China and countries with ongoing human-to-human transmission, with over an 11-degree difference. The average rainfall during the study period was significantly higher in those regions without OHHT when compared to the Chinese provinces with ongoing human-to-human transmission and the regions with active transmission of SARS-CoV-2. Our findings show statistically significant differences between regions with ongoing human-to-human transmission of COVID-19 cases compared to those regions without horizontal transmission. This phenomenon could have implications in the behavior of the ongoing COVID-19 outbreak in the following months.

Abstract The Coronavirus pandemic (COVID-19) is one of the most devastating in this century. It originated in China in December 2019 caused by the SARS-Cov-2 virus, and in less than a month it had been classified as an "International Public Health Emergency". To date there are nearly 3 million people infected and more than 250,000 deaths caused by the disease worldwide. Initially it affects the respiratory tract with atypical pneumonia and in severe cases it produces systemic inflammation with cytokine storm that can cause rapid deterioration with circulatory and respiratory failure, coagulopathy and a lethality rate of approximately 7%. In Mexico, the first case was detected in February 2020, and to date there are 26,616 confirmed cases and 2,961 deaths throughout the country. The low number of diagnostic tests conducted in our country clearly underestimates the real incidence and impact of the disease. The most affected groups are those with risk factors such as age over 60, presence of hypertension, diabetes or cardiovascular disease. Of the confirmed cases, 15% are healthcare workers. There is no specific treatment or vaccine yet, so it is important to have hygiene, social isolation and personal protection measures. Health, social and economic consequences could have great impact in the near future.

Resumen La pandemia del Coronavirus (COVID-19) es una de las más devastadoras de este siglo. Originada en China en diciembre de 2019 y causada por el virus SARS-CoV-2, en menos de 1 mes ya había sido catalogada como "Emergencia de Salud Pública de Alcance Internacional". A la fecha hay cerca de 3 millones de personas con infección confirmada y ha provocado más de 250,000 fallecimientos en el mundo. Inicialmente afecta las vías respiratorias con neumonías atípica y en casos graves provoca inflamación sistémica con liberación de citoquinas que pueden provocar un rápido deterioro, insuficiencia circulatoria, respiratoria y alteraciones de coagulación con una letalidad cercana al 7%. En México, el primer caso se detectó en febrero del 2020, y a la fecha de esta publicación se cuenta con 29,616 casos confirmados y 2,961 fallecimientos en toda la extensión de país. La baja tasa de muestreo diagnóstico en nuestro país claramente subestima la incidencia e impacto de esta enfermedad. Los grupos mas afectados son aquéllos con factores de riesgo como lo son la edad mayor a 60 años, hipertensión, diabetes o historia de enfermedad cardiovascular. De los casos confirmados, 15% son trabajadores del sector salud. No existe hasta ahora un tratamiento específico o vacuna, de tal manera que es importante contar con las medidas de higiene, aislamiento social y protección personal. Las consecuencias en salud, sociales y económicas podrían ser de gran impacto en los tiempos por venir.

Existem vários fatores que explicam a desigual distribuição da riqueza que prevalece na Argentina e o resto da região. Um deles está relacionado, sem dúvida, ao processo de concentração e ao permanente encarecimento da propriedade imóvel. Também existem amplas experiências que demonstram as dificuldades (ou falta de interesse) que o Estado teve (ou demonstrou) em implementar políticas públicas que reverteram esse flagelo ligado ao uso e gozo de bens imóveis. Este artigo demonstra como o uso desigual e ineficiente de um imposto cobrado sobre bens imóveis, em um município da província de Buenos Aires, gera condições que perpetram e exacerbam essa situação de desigualdade.

There are several factors that explain the unequal distribution of wealth that prevails in Argentina and the rest of the region. One of them is related to the process of concentration and the permanent increase in real estate property. There are also plenty of experiences that demonstrate the difficulties (or disinterest) that the State has had (or demonstrated) in implementing public policies that reverse this scourge linked to the use and usufruct of real property. This paper demonstrates how the inequitable and inefficient use of a tax levied on real estate property in a municipality of the Province of Buenos Aires generates conditions that perpetrate and exacerbate this situation of inequality.

Existen varios factores que explican la desigual distribución de la riqueza que impera en Argentina y el resto de la región. Uno de ellos se relaciona, sin lugar a dudas, con el proceso de concentración y el encarecimiento permanente que ha experimentado la propiedad inmueble. Existen asimismo sobradas experiencias que demuestran las dificultades (o desinterés) que ha tenido (o demostrado) el Estado para implementar políticas públicas que reviertan este flagelo vinculado con el uso y usufructo de la propiedad inmueble. En este trabajo se demuestra cómo el uso inequitativo e ineficiente de un tributo que grava la propiedad inmobiliaria en un municipio de la provincia de Buenos Aires genera condiciones que perpetran y agudizan dicha situación de inequidad.

ABSTRACT A historical account of the 30 years of the medical major of Health Management at Universidad Nacional Mayor de San Marcos is presented. The major was created in 1988 as Comprehensive General Medicine in response to the shortage of management specialists. The name of the major remained until 1994, when it changed to Integral Medicine and Health Management to emphasize its managerial orientation. In 2002, the curricular plan was modified considering the importance of having an exclusive medical specialization in management for the health sector. The specialty is a pioneer in a gradual education in three levels: micro-management, meso-management, and macro-management. The new curricular plan allowed residents the possibility to access better rotations at public and private institutions. Since 2007, the major is labeled Health Management, and its specialists maintain their solid training that enables them to perform in the decision-making, management, administration, and operation processes of the health systems. The vision of the creators of this major is current to this day; Health Management specialists work in the different institutions of the health system, contributing their knowledge and skills, and generating an impact on the health of the Peruvian population.

RESUMEN Se presenta un recuento histórico de los 30 años de la especialidad médica de Gestión en Salud en la Universidad Nacional Mayor de San Marcos. La especialidad fue creada en 1988 como Medicina General Integral en respuesta a la escasez de médicos especialistas en gestión. El nombre de la especialidad se mantuvo hasta 1994, cuando cambia a Medicina Integral y Gestión en Salud para enfatizar su orientación gerencial. En 2002, se modifica el plan curricular considerando la importancia de tener una especialización médica exclusiva de gestión para el sector salud. La especialidad es pionera en una formación gradual en tres niveles: microgestión, mesogestión y macrogestión. El nuevo plan curricular permitió a los residentes la posibilidad de mejores rotaciones en instituciones públicas y privadas. A partir del 2007, la especialidad es denominada Gestión en Salud, cuyos médicos especialistas mantienen su sólida formación para desempeñarse en los procesos de decisión, conducción, dirección y operatividad de los sistemas de salud. La visión de los creadores de la especialidad se encuentra vigente, los especialistas de Gestión en Salud se desempeñan en las diferentes instituciones del sistema de salud, aportando sus conocimientos y habilidades, y generando un impacto en la salud de la población peruana.

A historical account of the 30 years of the medical major of Health Management at Universidad Nacional Mayor de San Marcos is presented. The major was created in 1988 as Comprehensive General Medicine in response to the shortage of management specialists. The name of the major remained until 1994, when it changed to Integral Medicine and Health Management to emphasize its managerial orientation. In 2002, the curricular plan was modified considering the importance of having an exclusive medical specialization in management for the health sector. The specialty is a pioneer in a gradual education in three levels: micro-management, meso-management, and macro-management. The new curricular plan allowed residents the possibility to access better rotations at public and private institutions. Since 2007, the major is labeled Health Management, and its specialists maintain their solid training that enables them to perform in the decision-making, management, administration, and operation processes of the health systems. The vision of the creators of this major is current to this day; Health Management specialists work in the different institutions of the health system, contributing their knowledge and skills, and generating an impact on the health of the Peruvian population.

Se presenta un recuento histórico de los 30 años de la especialidad médica de Gestión en Salud en la Universidad Nacional Mayor de San Marcos. La especialidad fue creada en 1988 como Medicina General Integral en respuesta a la escasez de médicos especialistas en gestión. El nombre de la especialidad se mantuvo hasta 1994, cuando cambia a Medicina Integral y Gestión en Salud para enfatizar su orientación gerencial. En 2002, se modifica el plan curricular considerando la importancia de tener una especialización médica exclusiva de gestión para el sector salud. La especialidad es pionera en una formación gradual en tres niveles: microgestión, mesogestión y macrogestión. El nuevo plan curricular permitió a los residentes la posibilidad de mejores rotaciones en instituciones públicas y privadas. A partir del 2007, la especialidad es denominada Gestión en Salud, cuyos médicos especialistas mantienen su sólida formación para desempeñarse en los procesos de decisión, conducción, dirección y operatividad de los sistemas de salud. La visión de los creadores de la especialidad se encuentra vigente, los especialistas de Gestión en Salud se desempeñan en las diferentes instituciones del sistema de salud, aportando sus conocimientos y habilidades, y generando un impacto en la salud de la población peruana.

Abstract: A 67-year-old female patient with a diagnosis of heart failure with preserved ejection fraction secondary to severe mitral regurgitation in treatment with metoprolol, spironolactone, and digoxin. She was diagnosed systemic lupus erythematosus (SLE) because of the presence of arthritis, alopecia, thrombocytopenia, direct positive Coombs +++, positive ANAs 1:1,280 and positive lupus anticoagulant. The rheumatology service indicated hydroxychloroquine 200 mg every 24 hours. She presented atrial fibrillation, and amiodarone was initiated. Two weeks later the patient was admitted because of presyncope, electrocardiogram showed sinus bradycardia with long QT interval. A temporary pacemaker was placed, and hydroxychloroquine and amiodarone suspended. Twenty-four hours later, a new electrocardiogram was taken showing pacemaker rhythm with reduction of the QT interval. After 72 hours the temporary pacemaker was removed and on the fifth day the patient was discharged with an electrocardiogram in sinus rhythm with a corrected QT (Bazett) of 456 miliseconds. The hydroxychloroquine was reinitiated following discharge. She presented another episode of atrial fibrillation, and was treated with amiodarone, hydroxychloroquine was suspended previously, and she did not present prolongation of QT interval. The long QT syndrome was present when amiodarone and hydroxychloroquine interacted.

Resumen: Paciente femenina de 67 años, con diagnóstico de insuficiencia cardiaca con fracción de expulsión preservada, secundaria a insuficiencia mitral severa, en tratamiento con metoprolol, espironolactona y digoxina. Le fue diagnosticado lupus eritematoso sistémico, debido a la presencia de artritis, alopecia, trombocitopenia, Coombs directo positivo +++, anticuerpos antinucleares positivos 1:1,280 y anticoagulante lúpico positivo. El Servicio de Reumatología indicó hidroxicloroquina 200 mg cada 24 horas. Presentó fibrilación auricular, por lo que se le inició amiodarona. Dos semanas posteriores la paciente es ingresada debido a un episodio de presíncope, se le realizó electrocardiograma que demostró bradicardia sinusal con un intervalo QT prolongado. Se le colocó un marcapasos temporal, además de que se suspendió hidroxicloroquina y amiodarona. Después de 72 horas se retiró el marcapasos, y al quinto día se egresó con un electrocardiograma en ritmo sinusal con el intervalo QT corregido por Bazett de 456 milisegundos. La hidroxicloroquina fue reiniciada al egreso. La paciente presentó otro episodio de fibrilación auricular y fue tratada con amiodarona, previa suspensión de hidroxicloroquina, sin presentar prolongación del intervalo QT. El síndrome de QT largo sólo se presentó con la interacción de amiodarona con hidroxicloroquina.

Introducción. La peritonitis tuberculosa es un tipo de presentación poco frecuente de la tuberculosis en población pediátrica, con enfermedades concomitantes que favorecen una inmunosupresión crónica. En el presente artículo, se presenta un caso de peritonitis tuberculosa manejado en nuestra institución y se hace una revisión crítica de la literatura científica. Materiales y métodos. Se llevó a cabo un estudio observacional y descriptivo de los pacientes que fueron sometidos a cirugía con hallazgo intraoperatorio de peritonitis generalizada, y con diagnóstico confirmado de peritonitis tuberculosa, desde el 1° de junio del 2004 hasta el 30 de junio del 2015. Resultados. Se revisaron 486 pacientes con peritonitis generalizada, de los cuales solo a un paciente masculino de cuatro años, con síndrome nefrótico y tuberculosis pulmonar, se le hizo diagnóstico de peritonitis tuberculosa, con perforación intestinal y necesidad de cirugía de urgencia. Falleció el día 51 de hospitalización en la unidad de cuidados intensivos. Discusión y conclusiones. La tuberculosis peritoneal es una entidad poco frecuente en la población pediátrica, pero debe considerarse en pacientes con factores de riesgo para inmunosupresión, nexo de contagio para tuberculosis y ascitis, acompañados de dolor abdominal y fiebre. El diagnóstico temprano mejora el pronóstico del paciente y la biopsia peritoneal es la prueba estándar para confirmar esta entidad. Su incidencia en nuestra institución es de 0,2 %.

Introduction: Tuberculous peritonitis is a rare type of presentation of tuberculosis in pediatric patients with comorbidities associated with chronic immunosuppression. In this article, we present a case of tuberculous peritonitis managed at our institution and a critical review of the literature. Materials and methods: Descriptive observational study of patients who underwent surgery with the intraoperative finding of generalized peritonitis in the period June 1, 2004 to June 30, 2015. Only one patient was confirmed with tuberculous peritonitis. Results: 486 patients with generalized peritonitis were studied. The diagnosis of tuberculous peritonitis was confirmed only in a 4 year old male patient with nephrotic syndrome and pulmonary tuberculosis. The patient had intestinal perforation and required an emergency surgical intervention. He died on day 51 of hospitalization in the ICU. Discussion and conclusions: Peritoneal tuberculosis is a rare entity in the pediatric population, but it should be considered in patients with risk factors for immunosuppression, nexus of tuberculosis infection and ascites, accompanied by abdominal pain and fever. Early diagnosis improves the patient´s prognosis, and peritoneal biopsy is the gold standard to confirm this entity, whose incidence is 0.2% at our institution.

ABSTRACT In this work is studied the relationship between morphological characteristics of grain and hardness of aluminum alloys AA5083-H116, which has been submitted to several isothermal treatments. For analysis development were used optical and scanning electron microscopy, chemical microanalysis, hardness measurements, differential scanning calorimetry (DSC) curves, computational thermodynamics calculations, and image digital analysis, aiming to determine the recrystallization and abnormal grain growth temperatures, as well as phase transformations associated to thermal cycles. It was determined that static recrystallization start temperature is between 150° to 180°C, which was observed as heterogeneous process at whole rolled structure of material, while a possible abnormal grain growth process is initiated at 300°C, approximately. The results of this work are important because helping to understand the microstructure evolution due to processes of fabrication, which have similar thermal cycles, such as welding and heat treatments applied on this kind of material.

RESUMEN En este trabajo se estudia la relación entre las características morfológicas del grano y la dureza de la aleación de aluminio AA5083-H116 cuando se somete a la acción de tratamientos isotérmicos diversos no acumulativos. Para el análisis se usaron las técnicas de microscopia óptica y electrónica de barrido, microanálisis químico, medición de durezas, barridos de calorimetría diferencial, cálculos con termodinámica computacional y análisis de imágenes con el objetivo de estimar las temperaturas de inicio de la recristalización y de crecimiento de grano, así como las transformaciones de fase asociadas a estos ciclos térmicos. Se determinó que la temperatura de inicio de recristalización estática del material está entre 150° y 180°C, ocurriendo como un proceso heterogéneo, mientras que un posible crecimiento anormal del grano inicia aproximadamente a los 300°C. Estos resultados son importantes para entender lo que ocurre en la microestructura durante los procesos de fabricación en los cuales se presenten ciclos térmicos similares, como en soldadura por fusión y tratamientos térmicos aplicados sobre este tipo de material y su relación con los cambios en propiedades locales.

Abstract The ultramicroanalytic system (SUMA), created in the 1980s, is a complete system of reagents and instrumentation to perform ultramicroassays combining the sensitivity of the micro-enzyme-linked immunosorbent assay (ELISA) tests with the use of ultramicrovolumes. This technology permitted establishing large-scale newborn screening programs (NSPs) for metabolic and endocrine disorders in Cuba. This article summarizes the main results of the implementation during the 30 years of SUMA technology in NSP for 5 inherited metabolic diseases, using ultramicroassays developed at the Department of Newborn Screening at the Immunoassay Center. Since 1986, SUMA technology has been used in the Cuban NSP for congenital hypothyroidism, initially studying thyroid hormone in cord serum samples. In 2000, a decentralized program for the detection of hyperphenylalaninemias using heel dried blood samples was initiated. These successful experiences permitted including protocols for screening congenital adrenal hyperplasia, galactosemia, and biotinidase deficiency in 2005. A program for the newborn screening of CH using the thyroid-stimulating hormone Neonatal ultramicro-ELISA was fully implemented in 2010. Nowadays, the NSP is supported by a network of 175 SUMA laboratories. After 30 years, more than 3.8 million Cuban newborns have been screened, and 1002 affected children have been detected. Moreover, SUMA technology has been presented in Latin America for over 2 decades and has contributed to screen around 17 million newborns. These results prove that developing countries can develop appropriate diagnostic technologies for making health care accessible to all.

Eucalyptus globulus wood chips were subjected to autohydrolysis pretreatment at 175°C at three different residence times. Part of the recovered solids were submitted to alkaline extraction with NaOH solution to remove leachable lignin. The chemical composition of the fibrous material was analyzed by HPLC, Py-GCMS and 2D-NMR HSQC, while morphological changes were evaluated by SEM and LSCM. The pretreated materials were hydrolyzed with cellulases at a substrate loading of 10% (w/v) for up to 72 h. Glucose yields (based on dry wood) obtained in the enzymatic hydrolysis ranged between 38% and 65%, depending on reaction time in the autohydrolysis pretreatment. After the alkaline extraction, no significant change was observed in the yields in the enzymatic hydrolysis at 72 h, but at the lower severities, the initial rates of saccharification increased. The main effect of the hydrothermal pretreatment was removal of hemicelluloses, resulting in enriched cellulose pulps. SEM and LSCM images of the hydrothermal pretreated samples showed a disruption of the fiber surface, mainly in those samples obtained at the higher severity. Py-GC/MS and HSQC analysis showed that no major changes in the lignin structure occurred in the samples obtained by autohydrolysis and further alkaline extraction. By autohydrolysis at the higher severity (So=4.02), the lateral chains in lignin were cleaved and the formation of lignin droplets was observed. Hemicelluloses removal and lignin redeposition as droplets in certain regions of the fiber surface was associated with the higher accessibility of cellulose and the yield increase of the enzymatic hydrolysis.