Anestesia peridural continua con bomba de infusión elastomérica en mamoplastia de aumento / Continuous epidural anesthesia with elastomeric infusion pump in augmentation mammoplasty

Introducción: La anestesia y analgesia peridural continua, además de proporcionar un adecuado control del dolor posoperatorio, aportan beneficios como la disminución del riesgo de trombosis y de sangrado intraoperatorio. Objetivo: Describir el comportamiento y los resultados de la aplicación de la anestesia peridural continua mediante bomba de infusión elastomérica en pacientes intervenidas de mamoplastia de aumento. Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, longitudinal en el Hospital Clínico Quirúrgico Hermanos Ameijeiras, entre febrero 2014 y febrero 2016. Resultados: 72,8 fueron las pacientes entre 20 y 29 años, 57,6 por ciento era ASA I y 78,3 por ciento normopeso. El 50 por ciento fueron operadas por hipoplasia mamaria. La frecuencia cardiaca, la tensión arterial sistólica y diastólica disminuyeron a los 5 min después de aplicarse la técnica. La media del dolor fue menor de 3 en todos los momentos evaluados. Las complicaciones inmediatas fueron escasas y leves. El 85,9 por ciento calificó la técnica como buena. Conclusiones: El comportamiento y los resultados de la aplicación de la anestesia peridural continua mediante bomba de infusión elastomérica en la mamoplastia de aumento fue estable y segura. Existieron diferencias significativas en el comportamiento de las variables hemodinámicas intraoperatorias y de la intensidad de dolor, la cual fue leve en todas sus mediciones. Las complicaciones mediatas fueron escasas y no complejas. Más de las tres cuartas partes de las pacientes evaluaron de acuerdo al grado de satisfacción de buena la efectividad de la técnica anestésica para este tipo de procedimiento quirúrgico(AU)

Introduction: Continuous epidural anesthesia and analgesia, in addition to providing adequate control of postoperative pain, provide benefits such as decreased risk of thrombosis and intraoperative bleeding. Objective: To describe the behavior and results of the application of continuous epidural anesthesia by means of an elastomeric infusion pump in patients undergoing augmentation mammoplasty. Methods: An observational, descriptive, prospective, longitudinal study was conducted at Hermanos Ameijeiras Clinical Surgical Hospital, between February 2014 and February 2016. Results: 72.8 percent were patients 20-29 years old, 57.6 percent were ASA I, and 78.3 percent had normal weight. 50 percent were operated for mammary hypoplasia. Heart rate, as well as systolic and diastolic blood pressure decreased 5 minutes after the technique was applied. The average pain was less than 3 in all the moments evaluated. The immediate complications were minimal and mild. 85.9 (AU) described the technique as good. Conclusions: The behavior and results of the application of continuous epidural anesthesia using an elastomeric infusion pump in the augmentation mammoplasty was stable and safe. There were significant differences in the behavior of intraoperative hemodynamic variables and pain intensity, which was slight in all its measurements. The mediate complications were scarce and not complex. More than three quarters of the patients evaluated, based on the degree of satisfaction, the effectiveness of the anesthetic technique as good for this type of surgical procedure(AU)

Molecular docking and in silico studies of the physicochemical properties of potential inhibitors for the phosphotransferase system of Streptococcus mutans.

This study identified potential inhibitory compounds of the phosphoenolpyruvate-sugar. Phosphotransferase system of S. mutans, specifically enzyme II mannose transporter (EIIMan) in its subunits IIA, IIB and IIC by means of a selection protocol and in silico molecular analysis. Intervening the phosphotransferase system would compromise the physiological behavior and the pathogenic expression of S. mutans, and possibly other acidogenic bacteria that use phosphotransferases in their metabolism-making the phosphotransferase system a therapeutic target for the selective control of acidogenic microorganisms in caries control. Several computational techniques were used to evaluate molecular, physicochemical, and toxicological aspects of various compounds. Molecular docking was used to calculate the binding potential (ΔG) between receptor protein subunits and more than 836,000 different chemical compounds from the ZINC database. Physicochemical parameters related to the compounds' pharmacokinetic and pharmacodynamic indicators were evaluated, including absorption, distribution, metabolism, excretion, and toxicity (ADMET), and chemical analysis characterized the compounds structures. Thirteen compounds with EII binding potential of the phosphotransferase system of S. mutans and favorable ADMET properties were identified. Six spirooxindoles and three pyrrolidones stand out from the found compounds; unique structural characteristics of spirooxindoles and pyrrolidones associated with various reported biological activities like anti-microbial, antiinflammatory, anticancer, nootropic, neuroprotective and antiepileptic effects, among other pharmacological effects with surprising differences in terms of mechanisms of action. Following studies will provide more evidence of the action of these compounds on the phosphotransferase system of S. mutans, and its possible applications.

Víctimas del conflicto armado en la ciudad de Medellín: una lectura estética de la participación política / Armed Conflict Victims in the City of Medellin: An Aesthetic Interpretation of Political Participation

Resumen La configuración de perfomancias ligadas a la práctica del plantón, como escenario de participación pública alude por un lado, a la función trágica del teatro al exponer como fenómeno político las desapariciones forzosas y el cuestionamiento del tipo de sociedad y valores que se construyen a su alrededor; así mismo, visibiliza una estética colectiva basada en lo afectivo como envoltura destinada a generar evocaciones emocionales en la esfera pública, y de esta manera ampliar el eco participativo de la organización que incide en la sociedad configurando la posibilidad de una sabiduría política, toda vez que expone la visión trágica de develar los sentidos de las historias singulares de cada familia; es lo que se evidencia en la compresión de los sentidos y significados que la Organización Caminos de Esperanza -Madres de la Candelaria - organización de madres víctimas del conflicto armado, en la ciudad de Medellín - Colombia.

Abstract The configuration of performance, linked to the practice of the sit-in, as the scenario for public participation, refers on the one hand, to the tragic theatre function by exposing as a political phenomenon, the enforced disappearances and the questioning of the kind of society and values, which are built around it. It also makes visible a collective aesthetic based on the affective as a cover aimed at generating emotional evocations in the public sphere and thus, expand the participatory echo of the organization, which influences society, setting up the possibility of a political wisdom, since it exposes the tragic vision of revealing the senses of the unique stories of each family, this is what is made evident in the compression of the senses and meanings of "Roads of Hope Organization" - The Mothers of La Candelaria," which is an organization of mothers of victims of the armed conflict, in the city of Medellín, Colombia.

Neuroactive Steroids in Acute Ischemic Stroke: Association with Cognitive, Functional, and Neurological Outcomes.

Despite several scientific and technological advances, there is no single neuroprotective treatment that can reverse the brain damage after acute ischemic stroke (AIS). Neuroactive steroids are cholesterol-derived hormones that have the ability to modulate the normal and pathologic nervous system employing genomic and nongenomic mechanisms. In this work, we first investigated if AIS affects the plasma concentration of 5 neuroactive steroids (cortisol, estradiol, progesterone, testosterone, and 3α-androstenediol glucuronide). Second, we studied if levels of circulating steroids associate with neurological, cognitive, and functional outcome in a cohort of 60- to 90 year-old male and female patients with AIS. For this purpose, we recruited patients who were hospitalized at the Emergency Room of the Central Military Hospital within the first 24 h after stroke onset. We designed 2 experimental groups, each one composed of 30 control subjects and 30 AIS patients, both males and females. The assessment of neurological deficit was performed with the NIHSS and the tests used for the functional and cognitive status were: (1) modified Rankin Scale; (2) Photo test, and (3) abbreviated Pfeiffer's mental status questionnaire. We observed a significant difference in plasma concentration of cortisol and estradiol between both experimental groups. In the AIS group, higher levels of these neuroactive steroids were associated with more pronounced neurological, cognitive and functional deficits in women compared to men. We propose that in elderly patients, high levels of circulating neuroactive steroids like cortisol and estradiol could potentiate AIS-mediated neuropathology in the ischemic and penumbra areas.

Sugarcane straw as a feedstock for xylitol production by Candida guilliermondii FTI 20037

Abstract Sugarcane straw has become an available lignocellulosic biomass since the progressive introduction of the non-burning harvest in Brazil. Besides keeping this biomass in the field, it can be used as a feedstock in thermochemical or biochemical conversion processes. This makes feasible its incorporation in a biorefinery, whose economic profitability could be supported by integrated production of low-value biofuels and high-value chemicals, e.g., xylitol, which has important industrial and clinical applications. Herein, biotechnological production of xylitol is presented as a possible route for the valorization of sugarcane straw and its incorporation in a biorefinery. Nutritional supplementation of the sugarcane straw hemicellulosic hydrolyzate as a function of initial oxygen availability was studied in batch fermentation of Candida guilliermondii FTI 20037. The nutritional supplementation conditions evaluated were: no supplementation; supplementation with (NH4)2SO4, and full supplementation with (NH4)2SO4, rice bran extract and CaCl2·2H2O. Experiments were performed at pH 5.5, 30 °C, 200 rpm, for 48 h in 125 mL Erlenmeyer flasks containing either 25 or 50 mL of medium in order to vary initial oxygen availability. Without supplementation, complete consumption of glucose and partial consumption of xylose were observed. In this condition the maximum xylitol yield (0.67 g g-1) was obtained under reduced initial oxygen availability. Nutritional supplementation increased xylose consumption and xylitol production by up to 200% and 240%, respectively. The maximum xylitol volumetric productivity (0.34 g L-1 h-1) was reached at full supplementation and increased initial oxygen availability. The results demonstrated a combined effect of nutritional supplementation and initial oxygen availability on xylitol production from sugarcane straw hemicellulosic hydrolyzate.

Sugarcane straw as a feedstock for xylitol production by Candida guilliermondii FTI 20037.

Sugarcane straw has become an available lignocellulosic biomass since the progressive introduction of the non-burning harvest in Brazil. Besides keeping this biomass in the field, it can be used as a feedstock in thermochemical or biochemical conversion processes. This makes feasible its incorporation in a biorefinery, whose economic profitability could be supported by integrated production of low-value biofuels and high-value chemicals, e.g., xylitol, which has important industrial and clinical applications. Herein, biotechnological production of xylitol is presented as a possible route for the valorization of sugarcane straw and its incorporation in a biorefinery. Nutritional supplementation of the sugarcane straw hemicellulosic hydrolyzate as a function of initial oxygen availability was studied in batch fermentation of Candida guilliermondii FTI 20037. The nutritional supplementation conditions evaluated were: no supplementation; supplementation with (NH4)2SO4, and full supplementation with (NH4)2SO4, rice bran extract and CaCl2·2H2O. Experiments were performed at pH 5.5, 30°C, 200rpm, for 48h in 125mL Erlenmeyer flasks containing either 25 or 50mL of medium in order to vary initial oxygen availability. Without supplementation, complete consumption of glucose and partial consumption of xylose were observed. In this condition the maximum xylitol yield (0.67gg(-1)) was obtained under reduced initial oxygen availability. Nutritional supplementation increased xylose consumption and xylitol production by up to 200% and 240%, respectively. The maximum xylitol volumetric productivity (0.34gL(-1)h(-1)) was reached at full supplementation and increased initial oxygen availability. The results demonstrated a combined effect of nutritional supplementation and initial oxygen availability on xylitol production from sugarcane straw hemicellulosic hydrolyzate.

Trastornos neuropsiquiátricos por trauma craneoencefálico / Neuropsychiatric Disorders Due to Traumatic Brain Injuries

Introducción: el traumatismo craneoencefálico representa un grave problema de salud pública, ya que cada vez es mayor el número de personas que por diversas razones se ven afectadas (accidentes de tránsito, caídas, violencia, deportes), más en países como Colombia, donde las tasas de mortalidad y morbilidad son verdaderamente alarmantes. Una de las consecuencias más serias a las que se ven enfrentados tanto el paciente como sus cuidadores son las alteraciones neuropsiquiátricas, ya que impactan de gran manera el tratamiento, el proceso de rehabilitación y a sus cuidadores. Objetivo: intentar dar una visión resumida y práctica de los principales trastornos psiquiátricos después de un traumatismo craneoencefálico (pos-TEC), mencionando algunos elementos fi siopatológicos y de enfoque del tratamiento. Método: se revisan los principales trastornos neuropsiquiátricos pos-TEC, usando textos importantes, conocidos y recientes sobre el tema. Conclusiones: se ha identifi cado que los pacientes pos-TEC presentan anomalías neuropsicológicas y de neuroimágenes sutiles, pero signifi cativas que parecen estar en relación con los síntomas que se refi eren. Las terapias de orientación cognitiva han dado resultados favorables y, de hecho la educación temprana acerca de cómo afrontar las molestias posteriores al TEC disminuye de manera importante el desarrollo de este síndrome.

Introduction: Traumatic brain injury (TBI) is a serious public health problem, affecting more people everyday for various reasons (car accidents, falls, violence, sports), specially in countries like Colombia where morbimortality rates are truly alarming. The patient and caregivers are confronted with serious consequences such as neuropsychiatric disorders that impact heavily on the treatment, the rehabilitation process and the caregivers lives. Objective: To give a practical description of the main psychiatric disorders present after traumatic brain injuries together with available treatments, including also some of the physiopathological elements involved. Method: Review of current, well-known literature on the subject. Conclusions: Post-TBI patients exhibit subtle, although signifi cant, neuropsychological and neuroimaging anomalies, since they appear to be related to the symptoms patients describe. Cognitive oriented therapies have shown good results, and in fact, early education on how to manage discomfort following TBI diminishes the risk of presenting post-concussion syndrome.