Regulated Induced Proximity Targeting Chimeras (RIPTACs): a Novel Heterobifunctional Small Molecule Therapeutic Strategy for Killing Cancer Cells Selectively.

While specific cell signaling pathway inhibitors have yielded great success in oncology, directly triggering cancer cell death is one of the great drug discovery challenges facing biomedical research in the era of precision oncology. Attempts to eradicate cancer cells expressing unique target proteins, such as antibody-drug conjugates (ADCs), T-cell engaging therapies, and radiopharmaceuticals have been successful in the clinic, but they are limited by the number of targets given the inability to target intracellular proteins. More recently, heterobifunctional small molecules such as Proteolysis Targeting Chimera (PROTACs) have paved the way for protein proximity inducing therapeutic modalities. Here, we describe a proof-of-concept study using novel heterobifunctional small molecules called Regulated Induced Proximity Targeting Chimeras or RIPTACs, which elicit a stable ternary complex between a target protein selectively expressed in cancer tissue and a pan-expressed protein essential for cell survival. The resulting cooperative protein:protein interaction (PPI) abrogates the function of the essential protein, thus leading to cell death selectively in cells expressing the target protein. This approach not only opens new target space by leveraging differentially expressed intracellular proteins but also has the advantage of not requiring the target to be a driver of disease. Thus, RIPTACs can address non-target mechanisms of resistance given that cell killing is driven by inactivation of the essential protein. Using the HaloTag7-FKBP model system as a target protein, we describe RIPTACs that incorporate a covalent or non-covalent target ligand connected via a linker to effector ligands such as JQ1 (BRD4), BI2536 (PLK1), or multi-CDK inhibitors such as TMX3013 or dinaciclib. We show that these RIPTACs exhibit positive co-operativity, accumulate selectively in cells expressing HaloTag7-FKBP, form stable target:RIPTAC:effector trimers in cells, and induce an anti-proliferative response in target-expressing cells. We propose that RIPTACs are a novel heterobifunctional therapeutic modality to treat cancers that are known to selectively express a specific intracellular protein.

Bibliometric Analysis and thematic review of studies on child consumption from 1974 to 2019 / Análisis bibliométrico y revisión temática de estudios en consumo infantil de 1974 a 2019

Abstract The role of children as consumers has generated great interest in social marketing, especially in aspects related to food. However, there are fields such as the regulation of advertising, digital behavior, and children's attitudes towards products that until now have not been completely studied. To support future research of the social marketing scientific community about this topic, the present bibliometric study aimed to investigate and describe the lines and areas of inquiry in psychology, behavior and social marketing in relation to child consumption, in order to respond the following research question: what have been the most important publications, authors and trends in research on child consumption in the last 45 years? To this end, 1375 articles from 703 journals were analyzed with the Bibliometrix packages (R Studio), under an exploratory and descriptive methodology, analyzing 2588 author keywords and 1265 additional keywords, with 2597 authors hi the Scopus database. Scientometric indicators show the existence of five thematic groups related to child consumption. It is concluded that scientific production on child consumption should address protection and regulation issues oriented to social responsibility, especially in integrated marketing and advertising communications for food brands, with greater and special care in the digital environment, due to the current immersion of the world's child population and its growing autonomy in the choice of digital content, products, and brands.

Resumen El papel de los niños como consumidores ha generado un gran interés en el marketing social, especialmente en los aspectos relacionados con la alimentación; sin embargo, hay campos como la regulación de la publicidad, el comportamiento digital y las actitudes de los niños hacia los productos, que hasta ahora no están completamente estudiados. Para apoyar las futuras investigaciones de la comunidad científica del marketing social sobre este tema, el presente estudio bibliométrico tuvo como objetivo investigar y describir las líneas y áreas de investigación en psicología, comportamiento y marketing social, en relación con el consumo infantil, para responder a la siguiente pregunta de investigación: ¿Cuáles son las publicaciones, autores y tendencias más importantes en la investigación sobre el consumo infantil en los últimos 45 años? Para ello, se analizaron 1375 artículos de 703 revistas con los paquetes Bibliometrix (R Studio), utilizando una metodología exploratoria y descriptiva, analizando 2588 palabras clave de autor y 1265 palabras clave adicionales con 2597 autores en la base de datos Scopus. Los indicadores cienciométricos muestran la existencia de cinco grupos temáticos relacionados con el consumo infantil. Se concluye que la producción científica sobre el consumo de niños y niñas debe abordar cuestiones de protección y regulación orientadas a la responsabilidad social, especialmente en las comunicaciones integradas de marketing y publicidad de las marcas alimentarias, con mayor y especial cuidado en el entorno digital, debido a la actual inmersión de la población infantil mundial y su creciente autonomía en la elección de contenidos, productos y marcas digitales.

[Outcomes of percutaneous balloon pulmonary valvuloplasty in pulmonary valve stenosis in the pediatric population in a single center, Lima - Peru]. / Resultados de la valvuloplastia percutánea con balón en la estenosis valvular pulmonar en población pediátrica en el Instituto Nacional Cardiovascular - INCOR, Lima - Perú.

Objective: To evaluate the effectiveness of the procedure and outcomes during follow-up. Methods: 80 patients with pulmonary valvular stenosis who underwent percutaneous balloon valvuloplasty between January 2014 and December 2019 are described. Demographic, echocardiographic, and hemodynamic characteristics of the procedure were evaluated. Follow-up included clinical, echocardiographic parameters, pulmonary regurgitation severity, and residual pulmonary gradient at each cutoff point. Results: The age range was 2 years (interquartile range: 10.5 months - 6 years), and the predominant sex was male with 56.2%. The transvalvular pulmonary gradient decreased from 61.7 mmHg +- 21.2 to 17 mmHg (interquartile range: 11-26 mmHg). The immediate success rate was 90%. Follow-up time showed a median of 21 months (interquartile range: 5-47.5 months). All patients at follow-up showed some degree of pulmonary insufficiency at each cutoff point; 17% of the cases at the end of their follow-up were found to have severe insufficiency. Three cases of long-term restenosis were found (3.8%), and 6 (7.5%) were admitted for valvuloplasty surgery or pulmonary valve replacement. The complications reported reached 10% of cases, two patients were admitted to surgery during the procedure for major complications. A significant association was found with severe pulmonary insufficiency at the end of follow-up and ring/balloon ratio. Conclusions: Percutaneous transluminal valvuloplasty with balloon is an effective technique in the treatment of pulmonary valvular stenosis, with reported complications but with good results during follow-up.

Does treadmill workstation use affect user's kinematic gait symmetry?

The effects of treadmill workstation use on kinematic gait symmetry and computer work performance remain unclear. The purpose of this pilot study was to analyze the effects of treadmill workstation use on lower body motion symmetry while performing a typing task when compared to overground and treadmill walking. The lower body motion of ten healthy adults (6 males and 4 females) was recorded by a motion capture system. Hip, knee, and ankle joint rotations were computed and compared for each condition. Despite comparable lower body kinematic gait asymmetries across conditions, asymmetric knee flexion motions at early gait cycle were only found in treadmill workstation users (left knee significantly more flexed than the right one). This demonstrates that the interaction between walking and another task is dependent on the task cognitive content. Our findings suggest that lower body kinematic gait symmetry may be influenced by the use of treadmill workstations.

α-Synuclein O-GlcNAcylation alters aggregation and toxicity, revealing certain residues as potential inhibitors of Parkinson's disease.

A compelling link is emerging between the posttranslational modification O-GlcNAc and protein aggregation. A prime example is α-synuclein, which forms toxic aggregates that are associated with neurodegeneration in Parkinson's and related diseases. α-Synuclein has been shown to be O-GlcNAcylated at nine different positions in in vivo proteomics experiments from mouse and human tissues. This raises the possibility that O-GlcNAc may alter the aggregation of this protein and could be both an important biological mediator of neurodegeneration and also a therapeutic target. Here, we expand upon our previous research in this area through the chemical synthesis of six site-specifically O-GlcNAcylated variants of α-synuclein. We then use a variety of biochemical experiments to show that O-GlcNAc in general inhibits the aggregation of α-synuclein but can also alter the structure of α-synuclein aggregates in site-specific ways. Additionally, an α-synuclein protein bearing three O-GlcNAc modifications can inhibit the aggregation of unmodified protein. Primary cell culture experiments also show that several of the O-GlcNAc sites inhibit the toxicity of extracellular α-synuclein fibers that are likely culprits in the spread of Parkinson's disease. We also demonstrate that O-GlcNAcylation can inhibit the aggregation of an aggressive mutant of α-synuclein, indicating that therapies currently in development that increase this modification might be applied in animal models that rely on this mutant. Finally, we also show that the pan-selective antibody for O-GlcNAc does not generally recognize this modification on α-synuclein, potentially explaining why it remains understudied. These results support further development of O-GlcNAcylation tools and therapeutic strategies in neurodegenerative diseases.

Simple and Efficient Preparation of O- and S-GlcNAcylated Amino Acids through InBr3-Catalyzed Synthesis of ß- N-Acetylglycosides from Commercially Available Reagents.

The facile synthesis of serine, threonine, and cysteine ß-glycosides using commercially available peracetylated ß- N-acetylglucosamine (ß-Ac4GlcNAc) and catalytic amounts of indium bromide (InBr3) is described. This method involves only inexpensive reagents that require no further modification or special handling. The reagents are simply mixed, dissolved, and refluxed to afford the GlcNAcylated amino acids in great yields (70-80%). This operationally simple procedure should facilitate the study of O-GlcNAcylation without necessitating expertise in synthetic carbohydrate chemistry.

Linfoma no Hodgkin primario testicular / Non hodgkin primary testicular limphoma

Los linfomas constituyen un grupo diverso de neoplasias malignas, que se originan del sistema linfático(1). Aproximadamente el 85% se agrupan dentro de los denominados Linfomas No Hodgkin (LNH). Los LNH constituyen un numeroso grupo de linfomas derivados de la transformación neoplásica de los linfocitos B, T y Células NK, provenientes de diversas zonas que comprometen los folículos linfáticos en los nódulos linfáticos o en el sistema linfoide extranodal(2). Las localizaciones extra ganglionares primarias representan más de 10% de los casos y los sitios más frecuentes comprenden estómago, intestino delgado, orofaringe, piel, hígado y cerebro; además de otras bastante raras como ano, corazón, músculos y encías. Los linfomas testiculares primarios son muy raros, representan aproximadamente el 5% de todas las neoplasias testiculares malignas, menos del 1% de los LNH y el 4% de los LNH extra nodales(3). Esta neoplasia constituye el tumor maligno testicular más frecuente en sujetos ancianos. La presentación clínica típica es una masa testicular unilateral acompañada en ocasiones de hidrocele y dolor agudo escrotal. A continuación presentamos un caso que requirió de la participación de múltiples especialidades de nuestra institución para un manejo conjunto y finalmente el paciente falleció(AU)

The lymphomas constitute a diverse group of malignant neoplasms, which originate from the lymphatic system(1). Approximately 85% are grouped into the so-called Non-Hodgkin's Lymphomas (NHL). NHL are a large group of lymphomas derived from the neoplastic transformation of B, T and NK cells of different areas with involvement of lymphatic follicles in the lymph nodes or the extranodal lymphoid system(2). The primary extraganglionic sites represent more than 10% of the cases and the most frequent sites include stomach, small intestine, oropharynx, skin, liver and brain; others, quite rare, are anus, heart, muscles and gums.Primary testicular lymphomas are extremely rare, accounting for approximately 5% of all malignant testicular neoplasms, less than 1% of NHL and 4% of extranodal NHL(3). This neoplasm constitutes the most frequent testicular malignant tumor in elderly subjects. The typical clinical presentation is a unilateral testicular mass, sometimes accompanied by hydrocele and acute scrotal pain. We present a case which required the participation of multiple specialties of our institution for management but the patient finally died(AU)

The Sulfur-Linked Analogue of O-GlcNAc (S-GlcNAc) Is an Enzymatically Stable and Reasonable Structural Surrogate for O-GlcNAc at the Peptide and Protein Levels.

Synthetic proteins bearing site-specific posttranslational modifications have revolutionized our understanding of their biological functions in vitro and in vivo. One such modification, O-GlcNAcylation, is the dynamic addition of ß-N-acetyl glucosamine to the side chains of serine and threonine residues of proteins, yet our understanding of the site-specific impact of O-GlcNAcylation remains difficult to evaluate in vivo because of the potential for enzymatic removal by endogenous O-GlcNAcase (OGA). Thioglycosides are generally perceived to be enzymatically stable structural mimics of O-GlcNAc; however, in vitro experiments with small-molecule GlcNAc thioglycosides have demonstrated that OGA can hydrolyze these linkages, indicating that S-linked ß-N-acetyl glucosamine (S-GlcNAc) on peptides or proteins may not be completely stable. Here, we first develop a robust synthetic route to access an S-GlcNAcylated cysteine building block for peptide and protein synthesis. Using this modified amino acid, we establish that S-GlcNAc is an enzymatically stable surrogate for O-GlcNAcylation in its native protein setting. We also applied nuclear magnetic resonance spectroscopy and computational modeling to find that S-GlcNAc is an good structural mimic of O-GlcNAc. Finally, we demonstrate that site-specific S-GlcNAcylation results in biophysical characteristics that are the same as those of O-GlcNAc within the context of the protein α-synuclein. While this study is limited in focus to two model systems, these data suggest that S-GlcNAc broadly resembles O-GlcNAc and that it is indeed a stable analogue in the context of peptides and proteins.

O-GlcNAc modification inhibits the calpain-mediated cleavage of α-synuclein.

The major protein associated with Parkinson's disease (PD) is α-synuclein, as it can form toxic amyloid-aggregates that are a hallmark of many neurodegenerative diseases. α-Synuclein is a substrate for several different posttranslational modifications (PTMs) that have the potential to affect its biological functions and/or aggregation. However, the biophysical effects of many of these modifications remain to be established. One such modification is the addition of the monosaccharide N-acetyl-glucosamine, O-GlcNAc, which has been found on several α-synuclein serine and threonine residues in vivo. We have previously used synthetic protein chemistry to generate α-synuclein bearing two of these physiologically relevant O-GlcNAcylation events at threonine 72 and serine 87 and demonstrated that both of these modifications inhibit α-synuclein aggregation. Here, we use the same synthetic protein methodology to demonstrate that these same O-GlcNAc modifications also inhibit the cleavage of α-synuclein by the protease calpain. This further supports a role for O-GlcNAcylation in the modulation of α-synuclein biology, as proteolysis has been shown to potentially affect both protein aggregation and degradation.

O-GlcNAcylation of α-Synuclein at Serine 87 Reduces Aggregation without Affecting Membrane Binding.

The aggregation of neurodegenerative-disease associated proteins can be affected by many factors, including a variety of post-translational modifications. One such modification, O-GlcNAcylation, has been found on some of these aggregation prone proteins, including α-synuclein, the major protein that plays a causative role in synucleinopathies like Parkinson's disease. We previously used synthetic protein chemistry to prepare α-synuclein bearing a homogeneous O-GlcNAc modification at threonine 72 and showed that this modification inhibits protein aggregation. However, the effects of the other eight O-GlcNAcylation sites that have been identified were unknown. Here, we use a similar synthetic strategy to investigate the consequences of this modification at one of these sites, serine 87. We show that O-GlcNAcylation at this site also inhibits α-synuclein aggregation but to a lesser extent than that for the same modification at threonine 72. However, we also find that this modification does not affect the membrane-binding properties of α-synuclein, which differentiates it from phosphorylation at the same site. These results further support the development of therapies that can elevate O-GlcNAcylation of α-synuclein to slow the progression of Parkinson's disease.

The Frequency and Type of K-RAS Mutations in Mexican Patients With Colorectal Cancer: A National Study.

BACKGROUND: Current metastatic colorectal cancer (mCRC) therapy uses monoclonal antibodies against the epidermal growth factor receptor. This treatment is only useful in the absence of K-RAS gene mutations; therefore the study of such mutations is part of a personalized treatment. The aim of this work is to determine the frequency and type of the most common K-RAS mutations in Mexican patients with metastatic disease by nucleotide sequencing. PATIENTS AND METHODS: We studied 888 patients with mCRC from different regions of Mexico. The presence of mutations in exon 2, codons 12 and 13, of the K-RAS gene was determined by nucleotide sequencing. RESULTS: Patients exhibited K-RAS gene mutations in 35% (310/888) of cases. Mutation frequency of codons 12 and 13 was 71% (221/310) and 29% (89/310), respectively. The most common mutation (45.7%) in codon 12 was c.35G>A (p.G12D), whereas the one in codon 13 was c.38G>A (p.G13D) (78.7%). DISCUSSION: Given the frequency of K-RAS mutations in Mexicans, making a genetic study before deciding to treat mCRC patients with monoclonal antibodies is indispensable.

Hemangioma cutáneo gigante en extremidad inferior fetal con diagnóstico ecográfico prenatal: reporte de un caso / Prenatal diagnosis of a giant-size cutaneous hemangioma

Antecedentes: Los hemangiomas cutáneos son unas de las anomalías congénitas más frecuentes en el recién nacido. La búsqueda bibliográfica revela que la información respecto a su diagnóstico prenatal y actitud terapéutica es muy dispersa. Caso clínico: Presentamos el diagnóstico prenatal de un hemangioma fetal de grandes dimensiones, de 63 x 48 mm, localizado en cara anterior del muslo fetal izquierdo que es detectado inicialmente por ecografía en la semana 28 y confirmado por resonancia nuclear magnética. Conclusiones: Planteamos las alternativas diagnósticas que surgen ante este hallazgo, así como su pronóstico y manejo.

Background: Cutaneous hemangiomas are a really common congenital malformation in neonates. A literature search has revealed a sparsity of information about prenatal diagnosis and management. Case report: We present the prenatal diagnosis of a giant-size cutaneous hemangioma (63 x 48 mm), located in the left thigh by ultrasonography in the 28th week of pregnancy and confirmed by magnetic resonance imaging. Conclusion: We propose diagnostic possible alternatives, prognosis and management.

Antibody Derived Peptides for Detection of Ebola Virus Glycoprotein.

BACKGROUND: Current Ebola virus (EBOV) detection methods are costly and impractical for epidemic scenarios. Different immune-based assays have been reported for the detection and quantification of Ebola virus (EBOV) proteins. In particular, several monoclonal antibodies (mAbs) have been described that bind the capsid glycoprotein (GP) of EBOV GP. However, the currently available platforms for the design and production of full-length mAbs are cumbersome and costly. The use of antibody fragments, rather than full-length antibodies, might represent a cost-effective alternative for the development of diagnostic and possibly even therapeutic alternatives for EBOV. METHODS/PRINCIPAL FINDINGS: We report the design and expression of three recombinant anti-GP mAb fragments in Escherichia coli cultures. These fragments contained the heavy and light variable portions of the three well-studied anti-GP full-length mAbs 13C6, 13F6, and KZ52, and are consequently named scFv-13C6, scFv-13F6, and Fab-KZ52, respectively. All three fragments exhibited specific anti-GP binding activity in ELISA experiments comparable to that of full-length anti-GP antibodies (i.e., the same order of magnitude) and they are easily and economically produced in bacterial cultures. CONCLUSION/SIGNIFICANCE: Antibody fragments might represent a useful, effective, and low cost alternative to full-length antibodies in Ebola related capture and diagnostics applications.

Tratamiento endoscópico de un lipoma duodenal gigante / Endoscopic treatment of giant duodenal lipoma

No disponible

[The first Mexican consensus of endometrial cancer. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México]. / Primer consenso Mexicano de cancer de endometrio.

INTRODUCTION: Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis. CONCLUSIONS: Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.

Modificaciones en el consumo de tabaco durante la gestación y el posparto / Changes in tobacco consumption during pregnancy and the postpartum period

Objetivo: Averiguar el consumo de tabaco y las modificaciones del hábito durante la gestación, y observar las recaídas después del parto. Personas y método: Estudio descriptivo transversal, realizado en el PASSIR «Casagemas», Badalona, desde febrero de 2006 a septiembre de 2007. Se incluyó a 115 gestantes que acudieron a la consulta de control prenatal en el tercer trimestre de gestación, y se excluyeron las que no fumaban al inicio de la gestación. Se recogieron variables sociodemográficas y las relacionadas con el hábito tabáquico a través de un cuestionario en la gestación y otro en el posparto. Resultados: Dejaron de fumar el 26% (30) de las gestantes, y las que continuaron fumando redujeron el consumo de una media de 19,2 (DE= 6,7) a 7,2 (DE= 6) cigarrillos/día. Se observaron diferencias en el abandono del tabaco en aquellas que fumaban un menor número de cigarrillos (p <0,001), en las que iniciaron el tabaquismo más tarde y en las de mayor edad (p= 0,013). Al año del parto, seguían fumando el 73% (70) de las mujeres, y habían recaído en el hábito el 39,2% (11) de las que lo habían abandonado en la gestación. Las mujeres que no fumaban lactaron a sus hijos un 76,9% (20), mientras que las que fumaban lo hicieron un 57,1% (40). La duración media de la lactancia fue inferior en las mujeres que fumaron en el posparto (2,81 meses [DE= 3,4]) en relación con las que no lo hicieron (4,96 meses [DE= 4,1]; p= 0,01). Conclusiones: La tasa de abandono del tabaco durante el embarazo es aún muy baja, y el índice de recaída del hábito tabáquico en el posparto, elevada (AU)

Objective: To find out more about tobacco consumption and the changes in the habit during pregnancy, and to observe the relapses after the delivery. Subjects and method: A cross-sectional descriptive study, carried out in the PASSIR (sexual and reproductive healthcare services) of Casagemas, Badalona, between February 2006 and September 2007. It included 115 pregnant women who attended the third trimester prenatal check-up, and those women who did not smoke at the start of the pregnancy were excluded. Socio-demographic variables as well as variables related to the tobacco habit were collected by means of a questionnaire during the pregnancy and another during the postpartum period. Results: Of the pregnant women 26% (30) stopped smoking, and those who continued to smoke reduced the consumption from an average of 19.2 (DE=6.7) to 7.2 (DE=6) cigarettes/day. Differences were observed in tobacco cessation among those who smoked a smaller number of cigarettes (p <0.001), those who started tobacco smoking later and among older pregnant women (p= 0.013). One year after giving birth, 73% (70) of the women continued to smoke, and 39.2% (11) of those who had stopped smoking during pregnancy had relapsed to smoking. Of the women who didn’t smoke 76.9% (20) Breastfed their babies, while among those who smoked 57.1% (40) breastfedtheir babies. The average duration of the breastfeeding was smaller in the case of the women who smoked during the postpartum period, 2.81 months (DE= 3.4), compared to 4.96 months (DE= 4.1) in the case of those who didn’t smoke; (p= 0.01). Conclusions: The rate of tobacco cessation during pregnancy is still very low, and the rate of relapse to tobacco smoking during the postpartum period is high (AU)

Seis años de cirugía para la obesidad en Panamá / Six years of surgery for obesity in Panamá

El exceso de peso lleva de un mayor a un extremo riesgo de salud. Muchas veces el manejo médico da pobres resultados y es entonces que procedimientos como lo son los restrictivos no derivativos son utilizados para producir un balance energético negativo. Se presenta una casuística obtenida de 1989 a 1995, de 11 pacientes operados en el CHM-CSS con la técnica de gastroplastía vertical con anillo de silastic o con malla de marlex. El grupo de pacientes con obesidad morbosa tenía un exceso de peso de 100 libras o más y un volumen corporal superior de 40. En los dos primeros años, después de la cirugía, hubo un promedio de 100.8 libras perdidas con un rango de 38 a 185 libras. Solamente un paciente ganó peso y se relacionó a un fallo de la técnica quirúrgica. A nuestro pesar tuvimos una defunción; sin embargo, podemos considerar que los resultados han sido alentadores y lo más importante ha sido que la pérdida de peso se ha mantenido (INV.)