Micro-elimination of Hepatitis C in Low- and Middle-Income Settings: Challenges and Windows of Opportunity.

Content available: Author Interview and Audio Recording.

A multi-locus approach to elucidating the evolutionary history of the clingfish Tomicodon petersii (Gobiesocidae) in the Tropical Eastern Pacific.

Marine species that are widely distributed in the Tropical Eastern Pacific (TEP) has served as a model for studying biogeographic patterns resulting from the effects of intraregional habitat discontinuities and oceanographic processes on the diversification and evolution of cryptobenthic reef fishes. Tomicodon petersii, a clingfish (Gobiesocidae) endemic to the TEP, is found on very shallow rocky reefs from central Mexico to northern Peru, and in the Cocos and Galapagos islands. We evaluated the effect of likely biogeographic barriers in different parts of the TEP on the diversification process of this species. We used one mitochondrial and three nuclear DNA markers from 112 individuals collected across the distribution range of T. petersii. Our phylogenetic results showed the samples constituted a monophyletic group, with three well-supported, allopatric subgroups: in the Mexican province, the Panamic province (from El Salvador to Ecuador), and the Galapagos Islands. The split between the Mexican and more southerly clades was estimated to occur at the end of the Miocene ca. 5.74 Mya, and the subsequent cladogenetic event separating the Galapagos population from the Panamic population at the junction of the Pliocene and Pleistocene, ca. 2.85 Mya. The species tree, Bayesian species delimitation tests (BPP), STACEY, and substantial genetic distances separating these three populations indicate that these three independent evolutionary units likely include two unnamed species. The cladogenetic events that promoted the formation of those genetically differentiated groups are consistent with disruptive effects on gene flow of habitat discontinuities and oceanographic processes along the mainland shoreline in the TEP and of ocean-island isolation, in conjunction with the species intrinsic life-history characteristics.

THE EVOLVING HISTORY OF THE REVISTA DE INVESTIGACIóN CLíNICA.

The Revista de Investigación Clínica (RIC) was established in 1948. It has been published continuously for 73 years. Until 2009, it was the journal of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (formerly Hospital de Enfermedades de la Nutrición, and later named Instituto Nacional de la Nutrición), and thereafter it became the official journal of the Mexican National Institutes of Health. The history of this journal may be divided into four eras or periods, each distinctly characterized by the trends, and particular editorial policies imposed by the Editor-in-Chief and Editorial Committee in turn. The RIC, since 2015 known as RIC -Clinical and Translational Investigation-, is currently a nationally and internationally recognized scientific journal. This article briefly reviews the most outstanding historical features of the RIC since its foundation.

Robotic surgery at ABC Medical Center: first 500 procedures experience.

BACKGROUND: Robotic surgery is a technological advance that is used in multiple surgical specialties in the world. Its acceptance in various areas has been supported by comparative studies with laparoscopic surgery and open surgery. OBJECTIVE: To document the robotic surgery program initial experience in a private hospital of Mexico City by analyzing its results and complications. MATERIAL AND METHOD: The first 500 robotic surgeries practiced at ABC Medical Center were included, covering a three-year period (January 2017 to December 2019). The following was documented: specialties involved, surgeries broken down by specialty and type of surgery, surgical times, complications and number of doctors involved in the initial experience. RESULTS: Out of 500 patients, 367 (73.4 %) were males and 133 (26.4 %) were females. The three most common surgeries were radical prostatectomy (269), hysterectomy (64) and inguinal repair (33). Average age was 58 years (range: 18 to 90 years). A total of 40 certified surgeons from five specialties performed all the procedures. CONCLUSIONS: Starting a program in a private medical center has several implications. The creation of a robotic surgery committee made up of certified robotic surgery specialists from each specialty and hospital authorities for the accreditation of guidelines for both certification and recertification of their doctors can benefit programs like ours by creating a center of excellence in robotic surgery and thus reduce complications and improve results.

ANTECEDENTES: La cirugía robótica se utiliza en múltiples especialidades quirúrgicas a nivel mundial. OBJETIVO: Documentar la experiencia inicial del programa de cirugía robótica en un hospital de práctica privada. MATERIAL Y MÉTODO: Se incluyen las primeras 500 cirugías robóticas realizadas en el Centro Médico ABC, abarcando un periodo de tres años. Se documentan especialidades involucradas así como datos transoperatorios principales. RESULTADOS: De 500 pacientes, 367 (73.4%) fueron de sexo masculino y 133 (26.4%) de sexo femenino. Las tres cirugías más realizada fueron prostatectomía radical (269), seguido de histerectomía (64) y plastia inguinal (33). Un total de 40 médicos certificados de cinco especialidades realizaron la totalidad de los procedimientos. CONCLUSIONES: El iniciar un programa en un centro médico privado tiene diversas implicaciones. La creación de un comité de cirugía robótica integrado por médicos especialistas certificados en cirugía robótica de cada especialidad y autoridades del hospital para la acreditación de lineamientos tanto para la certificación como la recertificación de sus médicos puede beneficiar a programas como el nuestro por crear un centro de excelencia de cirugía robótica, disminuyendo complicaciones y mejorando resultados.

Cirugía robótica en el Centro Médico ABC: experiencia en los primeros 500 procedimientos realizados / Robotic surgery at ABC Medical Center: first 500 procedures experience

Resumen Antecedentes: La cirugía robótica se utiliza en múltiples especialidades quirúrgicas a nivel mundial. Objetivo: Documentar la experiencia inicial del programa de cirugía robótica en un hospital de práctica privada. Material y método: Se incluyen las primeras 500 cirugías robóticas realizadas en el Centro Médico ABC, abarcando un periodo de tres años. Se documentan especialidades involucradas así como datos transoperatorios principales. Resultados: De 500 pacientes, 367 (73.4%) fueron de sexo masculino y 133 (26.4%) de sexo femenino. Las tres cirugías más realizada fueron prostatectomía radical (269), seguido de histerectomía (64) y plastia inguinal (33). Un total de 40 médicos certificados de cinco especialidades realizaron la totalidad de los procedimientos. Conclusiones: El iniciar un programa en un centro médico privado tiene diversas implicaciones. La creación de un comité de cirugía robótica integrado por médicos especialistas certificados en cirugía robótica de cada especialidad y autoridades del hospital para la acreditación de lineamientos tanto para la certificación como la recertificación de sus médicos puede beneficiar a programas como el nuestro por crear un centro de excelencia de cirugía robótica, disminuyendo complicaciones y mejorando resultados.

Abstract Background: Robotic surgery is used in different surgical specialties worldwide. Objective: To documents the initial experience in a private hospital in the use robotic surgery in different surgical areas. Material and Methods: We included the first 500 robotic surgeries in our hospital in a 3 year period, documenting specialty and operative information. Results: Of the 500 patients, 367 (73.4%) were male and 133 (26.4%) female. The three most frequent surgeries performed were Radical Prostatectomy (269), Hysterectomy (64) an inguinal repair (33). A total of 40 certified surgeons ranging from 5 specialties performed the total number of surgeries. Conclusions: There are several implications in starting a robotic program in a private hospital setting. The creation of a robotic committee, formed by robotic certified physicians and hospital authorities, has helped in the certification process of its staff, lowering the complication rate and obtaining better surgical results.

El retiro digno del médico.

Retirement of physicians from their professional activity is a subject of global interest. In Mexico, there is no official regulation that determines the age at which physicians should retire from their profession as in other countries. This symposium presents the measures implemented at the ABC Medical Center in recent years about physicians' retirement, with the establishment of a committee. This has been achieved in part also with the creation of group medical practices that integrate doctors in their different specialties, whose interest among other aspects of individual and collective interest, is the establishment of a retirement fund.

El retiro del médico de su actividad profesional es un tema de interés global. En México no existe una regulación oficial que determine la edad a la que el médico debe retirarse de su profesión como sucede en otros países. En este simposio se presentan las medidas realizadas en el Centro Médico ABC en los últimos años en lo que al retiro médico se refiere, con el establecimiento de un comité. Lo anterior se ha logrado en parte también con la creación de prácticas médicas grupales que integran a los médicos en sus distintas especialidades, cuya intención, entre otros aspectos de interés individual y colectivo, es el establecimiento de un fondo para el retiro.

[Priority actions towards a national program for detection, treatment, and monitoring of patients with hepatitis C.] / Acciones prioritarias para un programa nacional de detección, tratamiento y seguimiento de pacientes con hepatitis C.

In the Mexican health scenario, the hepatitis C virus epidemic is present, along with its comorbidities and premature mortality. Acting immediately will allow its containment in short term with the proper implementation of the current available tools for prevention, diagnosis and highly effective pharmacological therapies. The Coalition for the study of hepatitis C in Mexico has developed a position paper that takes advantage of these containment measures and presents the development of a National program for the detection, timely treatment and follow-up of patients with hepatitis C.

En el escenario de la salud mexicana, la epidemia por virus de la hepatitis C se encuentra presente junto con sus comorbilidades y mortalidad prematura. Actuar de manera inmediata permitirá una contención de la misma en el corto plazo dada la existencia de herramientas de prevención, diagnóstico y terapias farmacológicas altamente eficaces. La Coalición para el estudio de la hepatitis C en México ha desarrollado una postura donde aprovecha esas medidas de contención y presenta el desarrollo de un programa nacional para la detección, tratamiento oportuno y seguimiento de pacientes con hepatitis C.

Acciones prioritarias para un programa nacional de detección, tratamiento y seguimiento de pacientes con hepatitis C / Priority actions towards a national program for detection, treatment, and monitoring of patients with hepatitis C

Resumen: En el escenario de la salud mexicana, la epidemia por virus de la hepatitis C se encuentra presente junto con sus comorbilidades y mortalidad prematura. Actuar de manera inmediata permitirá una contención de la misma en el corto plazo dada la existencia de herramientas de prevención, diagnóstico y terapias farmacológicas altamente eficaces. La Coalición para el estudio de la hepatitis C en México ha desarrollado una postura donde aprovecha esas medidas de contención y presenta el desarrollo de un programa nacional para la detección, tratamiento oportuno y seguimiento de pacientes con hepatitis C.

Abstract: In the Mexican health scenario, the hepatitis C virus epidemic is present, along with its comorbidities and premature mortality. Acting immediately will allow its containment in short term with the proper implementation of the current available tools for prevention, diagnosis and highly effective pharmacological therapies. The Coalition for the study of hepatitis C in Mexico has developed a position paper that takes advantage of these containment measures and presents the development of a National program for the detection, timely treatment and follow-up of patients with hepatitis C.

Diversification of the genus Apogon (Lacepède, 1801) (Apogonidae: Perciformes) in the tropical eastern Pacific.

We examined the role of geographic barriers and historical processes on the diversification of Apogon species within the tropical eastern Pacific (TEP). Mitochondrial and nuclear DNA sequences were used in Bayesian and Maximum likelihood analyses to generate a phylogenetic hypothesis for Apogon species. Bayesian inferences were used to date the cladogenetic events. Analyses with BioGeoBEARS were conducted to reconstruct the biogeographic history and ancestral ranges. The phylogenetic results show a monophyletic clade of TEP Apogon species with A. imberbis from the eastern Atlantic as sister species. The two lineages diverged during the Miocene. Within the TEP clade, two subclades diverged at around 11.1 million years ago (Mya): one clusters the coastal continental species (A. pacificus, A. retrosella and A. dovii), and the second clusters the oceanic island species (A. atradorsatus, A. atricaudus and A. guadalupensis). The estimated diversification times of these subclades were 9.8 and 7.1 Mya, respectively. Within each subclade, species divergences occurred during the Pliocene-Pleistocene epochs. The divergent event between the Atlantic A. imberbis and Apogon TEP clade corresponds to the first closure event of the Central American Seaway. The biogeographic history of Apogon within the TEP appears to be the result of vicariant, dispersal and founder events that occurred during the last 11 million years. The vicariant and dispersal events occurred along the mainland and were associated with the origin of the Central American Gap. The founder events could have allowed the invasion of Apogon to TEP island areas and could have been driven by ancient warming oceanic waters, changes in circulation of marine currents, and the presence of seamounts in ancient marine ridges that allowed the settlement of marine biota. These factors may have allowed Apogon lineages to cross the TEP biogeographic barriers at different times, with subsequent genetic isolation.

Mueller matrix polarimetry on plasma sprayed thermal barrier coatings for porosity measurement.

Yttria-stabilized zirconia (YSZ) is the most widely used material for thermal plasma sprayed thermal barrier coatings (TBCs) used to protect gas turbine engine parts in demanding operation environments. The superior material properties of YSZ coatings are related to their internal porosity level. By quantifying the porosity level, tighter control on the spraying process can be achieved to produce reliable coatings. Currently, destructive measurement methods are widely used to measure the porosity level. In this paper, we describe a novel nondestructive approach that is applicable to classify the porosity level of plasma sprayed YSZ TBCs via Mueller matrix polarimetry. A rotating retarder Mueller matrix polarimeter was used to measure the polarization properties of the plasma sprayed YSZ coatings with different porosity levels. From these measurements, it was determined that a sample's measured depolarization ratio is dependent on the sample's surface roughness and porosity level. To this end, we correlate the depolarization ratio with the samples' surface roughness, as measured by a contact profilometer, as well as the total porosity level, in percentage measured using a micrograph and stereological analysis. With the use of this technique, a full-field and rapid measurement of porosity level can be achieved.

Checklist of the inland fishes of El Salvador.

The inland fish fauna of El Salvador and its distribution was originally described in 1925 by Samuel Hildebrand. That work has been the main source of information for freshwater fishes of El Salvador up to today. Based on the combination of an intensive literature review, electronic database searches, re-identification of museum specimens, and fieldwork, we hereby provide an updated checklist of the inland fishes of El Salvador. This checklist provides distributional data at the Salvadoran hydrographical and political (by department) levels. The checklist is systematically arranged at the ordinal and familial level and then alphabetically therein. The freshwater fish fauna of El Salvador includes 101 species divided into 64 genera, 29 families, and 14 orders. According to their supposed tolerance to salinity, 73% of these species are peripheral, 23% secondary, and only 4% are primary freshwater fishes. One species is endemic to the country, Amatitlania coatepeque. The low number of primary freshwater fishes and endemics is comparable to the Central American Pacific slope in particular, as well as northern Central America in general.

[Physician retirement from clinical practice: how and when]. / El retiro clinicoquirúrgico del médico en México.

In Mexico there is no legislation as to when a physician should retire from active practice as it is the case in other countries. The Mexican Social Security for instance, in its global working contract between the authorities and the employees, for the period 2009-2011 clearly stated that after 30 years of service for men and 27 for women the employee may retire but the physician can still work in another institution or in private practice for as long as he or she wants. In this article, the experience of distinguished Mexican surgeons who had written in the past in relation to this topic is acknowledged. A brief description of the retirement of physicians in Spain where the National Health System retire physicians from practice at age 65 and in some cases at age 70 is discussed. The author analyzes what happens in other activities of human mankind such as in the arts, painting, architecture, music, physics and philosophy, where there are plenty of outstanding examples of men and women doing their best work well over the age of 65. The names of some distinguished Mexican physicians past presidents of the Academy of Medicine are mentioned, all of them legends in the field of medicine who worked or continue to work many, many years after the age of 65. The author recognizes the process of accreditation and certification of medical specialists in Mexico that is carried out by the 47 specialty councils that have the recognition of the National Committee for Medical Specialties: CONACEM. Finally he offers his personal thoughts about what a physician may do when he or she is thinking of retiring and urges them not to throw away their personal experiences of many years in medical practice but instead to utilize the social networks such as Twitter or Facebook in order to continue to provide their expertise to young physicians who may benefit greatly.

Discursos e intervenciones del C. Subsecretario de Servicios de Salud, Dr. Enrique Wolpert Barraza, durante el año de 1992 / Dircuses and interventions of the Subsecretary of Health Services, Dr. Enrique Wolpert Barraza, During the year 1992

En este documento se reúnen diversos documentos relativos a: discursos, intervenciones y presentaciones, del Subsecretario de los Servicios de Salud, de la Secretaría de Salud (SSA), Dr. Enrique Wolpert Barraza, con motivo de la realización de diferentes eventos, todos relativos a los servicios de salud, durante el año de 1992. Estos documentos o discursos reflejan la política que en materia de salud desarrolla el Estado Mexicano a través de la SSA

Discursos e intervenciones del C. Subsecretario de Servicios de Salud, Dr. Enrique Wolpert Barraza, durante el año de 1991 / Discurses and interventions of the Subsecretary of Healtl Services, Dr. Enrique Wolpert Barrza, during the year 1991

En este documento se reúnen diversos documentos relativos a: discursos, intervenciones y presentaciones, del Subsecretario de los Servicios de Salud, de la Secretaría de Salud (SSA), Dr. Enrique Wolpert Barraza, con motivo de la realización de diferentes eventos, todos relativos a los servicios de salud, durante el año de 1991. Estos documentos o discursos reflejan la política que en materia de salud desarrolla el Estado Mexicano a través de la SSA

Discursos e intervenciones del C. Subsecretario de Servicios de Salud, Dr. Enrique Wolpert Barraza, durante el año de 1990 / Discouses and interventions of the Subsecratary of Healthl Services, Dr. Enrique Wolpert Barraza, during the year 1990

En este documento se reúnen diversos documentos relativos a: discursos, intervenciones y presentaciones, del Subsecretario de los Servicios de Salud, de la Secretaría de Salud (SSA), Dr. Enrique Wolpert Barraza, con motivo de la realización de diferentes eventos, todos relativos a los servicios de salud, durante el año de 1990. Estos documentos o discursos reflejan la política que en materia de salud desarrolla el Estado Mexicano a través de la SSA

Discursos e intervenciones del C. Subsecretario de Servicios de Salud, Dr. Enrique Wolpert Barraza durante el año de 1989 / Discourses and interventions of the Subsecretary of Health Services, Dr. Enrique Wolpert Barraza, during the year 1989

En este documento se reúnen diversos documentos relativos a: discursos, intervenciones y presentaciones, del Subsecretario de los Servicios de Salud, de la Secretaría de Salud (SSA), Dr. Enrique Wolpert Barraza, con motivo de la realización de diferentes eventos, todos relativos a los servicios de salud, durante el año de 1989. Estos documentos o discursos reflejan la política que en materia de salud desarrolla el Estado Mexicano a través de la SSA