Evolución histórica de la formación del residente de Anestesiología y Reanimación

Introducción: Desde el principio el hombre trató de buscar la forma de mitigar el dolor. Empleó disimiles métodos como la magia, extractos de plantas, alcohol y otros químicos que tuvieran algún efecto analgésico. Así pasaron miles de años hasta que en el siglo XIX se hizo un descubrimiento que revolucionó la medicina y en especial a la cirugía (la anestesia). Objetivo: Describir la evolución histórica de la formación del residente de Anestesiología y Reanimación. Métodos: Se realizó una búsqueda bibliográfica actualizada acerca de los antecedentes que propiciaron el inicio de la residencia de la anestesiología en el mundo y en Cuba, así como un análisis histórico-lógico, de manera cronológica. Resultados: En Cuba, no existía formación de posgrado en anestesia antes de 1959 y los médicos tenían que ir a especializarse en otros países. No es hasta después del triunfo de la Revolución que se comienza el desarrollo docente de la anestesiología en Cuba. En 1963, se crea el primer programa docente de la especialidad por el Dr. Fraga y una vez que se formaron los primeros especialistas se llevó la docencia a todas las provincias del país. En la actualidad se forman en los hospitales cubanos anestesiólogos de muchos países del mundo. Conclusiones: La Revolución en Cuba permitió la creación de un programa de formación de especialistas en anestesiología y en pocos años se desarrollaron anestesiólogos de alto nivel con lo que se cubrieron las necesidades asistenciales, docentes e investigativas del país.

Introduction: From the beginning, the mankind tried to find a way to mitigate pain. Different methods were used, such as magic, plant extracts, alcohol and other chemicals with some analgesic effect. Thousands of years passed until a discovery was made in the nineteenth century, which revolutionized medicine, especially surgery: anesthesia. Objective: To describe the historical evolution of the anesthesiology and resuscitation resident training. Methods: An updated bibliographic search was carried out on the antecedents that gave rise to the anesthesiology residence in the world and in Cuba, together with a historical-logical analysis in a chronological way. Results: In Cuba there was no postgraduate training in anesthesia before 1959 and physicians had to go to other countries to receive that specialization. It was not until after the triumph of the Revolution that the development of anesthesiology teaching began in Cuba. In 1963, the first teaching program of the specialty was created by Dr. Fraga and, once the first specialists were trained, teaching was taken to all the provinces of the country. At present, anesthesiologists from many countries of the world are trained in Cuban hospitals. Conclusions: The Revolution in Cuba allowed the creation of a training program for specialists in anesthesiology and, in few years, high-level anesthesiologists were developed, thus covering the country's healthcare, teaching and research needs.

Estenosis traqueal postintubación después de neumonía grave por coronavirus / Postintubation Tracheal Stenosis after Severe Coronavirus Pneumonia

Introducción: La rápida propagación del SARS­CoV­2 ha provocado una pandemia mundial. Si bien puede salvar vidas, la intubación traqueal presenta el riesgo inherente de inducir daño en la mucosa traqueal con estenosis, con una incidencia estimada de 4,9 casos por millón cada año. Objetivo: Caracterizar la presentación de una estenosis traqueal por intubación prolongada en un paciente que sufrió neumonía grave por coronavirus. Presentación del caso: Se asiste a un paciente de 55 años que sufrió neumonía grave por coronavirus y necesitó intubación orotraqueal prolongada. Una vez recuperado comienza con disnea de empeoramiento progresivo. Se diagnostica una estenosis traqueal y se decide tratamiento quirúrgico donde se realiza resección y anastomosis. El paciente no presentó complicaciones y evolucionó satisfactoriamente. Conclusiones: La estenosis traqueal debe reconocerse como una complicación potencial, aun cuando los pacientes se recuperan de una neumonía grave por COVID-19. El diagnóstico definitivo de estenosis traqueal se realiza mediante fibrobroncoscopia. La resección traqueal con anastomosis entre tráquea y tráquea es el procedimiento más comúnmente realizado(AU)

Introduction: The rapid spread of SARS-CoV-2 has resulted in a global pandemic. Although tracheal intubation can save lives, it presents the inherent risk of inducing tracheal mucosal damage with stenosis, with an estimated annual incidence of 4.9 cases per million. Objective: To characterize a case of tracheal stenosis due to prolonged intubation in a patient with severe coronavirus pneumonia. Case presentation: A 55-year-old patient who suffered severe coronavirus pneumonia and required prolonged orotracheal intubation was attended. Once recovered, the patient began with progressively worsening dyspnea. Tracheal stenosis was diagnosed and surgical treatment was decided, in which resection and anastomosis were performed. The patient did not present any complications and evolved satisfactorily. Conclusions: Tracheal stenosis should be recognized as a potential complication, even when patients recover from severe COVID-19 pneumonia. A definitive diagnosis of tracheal stenosis is made by fibrobronchoscopy. Tracheal resection with anastomosis between trachea is the most commonly performed procedure(AU)

Consideraciones anestésicas en recién nacido con atresia y fístula traqueoesofágica / Anesthetic Considerations in Newborns with Tracheoesophageal Fistula and Atresia

Introducción: La atresia esofágica es una malformación congénita poco frecuente, que consiste en un defecto en el desarrollo del intestino anterior hacia el esófago y la tráquea que se produce aproximadamente en la cuarta semana de gestación. Objetivo: Describir los resultados de la actuación anestesiológica en un paciente con atresia esofágica y fístula traqueoesofágico, así como las consideraciones anestésicas para el tratamiento de la entidad. Presentación de caso: Paciente a término, femenina, blanca, peso al nacer 2880 g, Apgar 8-9 al min de vida, con diagnóstico de atresia esofágica ante la presencia de distrés respiratorio al nacimiento, salivación excesiva con crisis de atragantamiento a las 6 h de nacida e imposibilidad de introducir una sonda nasogástrica lo que fue confirmado en una radiografía de tórax. Fue anunciada por cirugía pediátrica y se efectuó reparación de la fístula. Se exponen las consideraciones anestésicas a seguir en el manejo de este caso, relacionadas con: los fármacos anestésicos, reposición de volumen y la estrategia de ventilación mecánica. Conclusiones: La urgente resolución quirúrgica en recién nacidos con atresia esofágica es importante para su supervivencia, para disminuir las complicaciones, los efectos adversos por la posición y el tipo de intervención que pueden presentar los pacientes. Por tanto, es imprescindible una detallada conducta anestésica. Representa un reto el manejo anestésico porque se requiere un abordaje multimodal en el pre-, intra- y posoperatorio; la seguridad de la vía aérea y una ventilación efectiva son las pautas en estas enfermedades(AU)

Introduction: Esophageal atresia is a rare congenital malformation, which consists of a defect in the development of the anterior intestine towards the esophagus and the trachea that occurs approximately in the fourth week of gestation. Objective: to describe the results of the anesthesiological intervention in a patient with EA and TEF, as well as the anesthetic considerations for the treatment of the entity. Case presentation: Term patient, female, white, birth weight 2880g, Apgar 8-9 at minute of life, diagnosed with esophageal atresia in the presence of respiratory distress at birth, excessive salivation with choking crisis at 6 hours of birth, and impossibility of inserting a nasogastric tube and confirmed by chest X-ray. She was announced for pediatric surgery and fistula repair was performed. The anesthetic considerations to be followed in the management of this case are exposed, related to: anesthetic drugs, volume replacement and the mechanical ventilation strategy. Favorable results were obtained. Conclusions: The urgent surgical resolution in newborns with esophageal atresia is important for their survival, to reduce complications, adverse effects due to the position and the type of intervention that patients may present, a detailed anesthetic conduct is essential. Anesthetic management represents a challenge because a multimodal approach is required pre, intra and postoperatively; airway safety and effective ventilation are the guidelines in these diseases(AU)

Analgosedación con propofol y fentanilo en las colonoscopia / Analgosedation with propofol and fentanyl in colonoscopy

Introducción: La comodidad durante la colonoscopia es una condición importante si se quiere que el paciente acepte procedimientos repetidos. Por lo tanto, se necesita de una buena sedación que pudiera combinar la analgesia con amnesia. Objetivo: Describir la utilidad de la analgosedación balanceada con propofol/fentanilo en colonoscopia ambulatoria. Métodos: Se realizó un estudio observacional descriptivo longitudinal prospectivo en pacientes a los que se les realizó colonoscopia de forma ambulatoria en el Hospital General Universitario Dr. Gustavo Aldereguía Lima en el período entre enero de 2017 y diciembre de 2018. Resultados: El 34,2 por ciento de los pacientes tenía entre 50 y 59 años, el 62,9 por ciento eran mujeres. El 73,3 por ciento de los pacientes se clasificó como ASA II según el estado físico. Los valores medios de frecuencia cardiaca y tensión arterial media tuvieron una disminución ligera después de aplicada la anestesia y se mantuvieron constantes en el resto de los momentos evaluados. Los valores medios de saturación de oxígeno de la hemoglobina se mantuvieron relativamente constantes en todos los momentos y resultaron algo superiores a la llegada del paciente a recuperación. La calidad de la sedación fue adecuada en 86,2 por ciento de los pacientes. La calidad de la analgesia y la recuperación fue buena en 88,4 por ciento y 96,2 por ciento , respectivamente. Se presentaron complicaciones en el 16,5 por ciento de los pacientes. Conclusiones: La analgosedación con propofol y fentanilo resultó una alternativa anestésica de utilidad en los pacientes a los que se les realizó colonoscopia ambulatoria con gran estabilidad hemodinámica en la serie estudiada(AU)

Introduction: Comfort during colonoscopy is an important condition if the patient is expected to accept repeated procedures. Therefore, good sedation that could combine analgesia with amnesia is needed. Objective: To describe the usefulness of balanced analgosedation with propofol/fentanyl in outpatient colonoscopy. Methods: A prospective, longitudinal, descriptive and observational study was carried out with patients who received outpatient colonoscopy at Dr. Gustavo Aldereguía Lima General University Hospital in the period between January 2017 and December 2018. Results: 34.2 percent of the patients were between 50 and 59 years old, while 62.9 percent were women. 73.3 percent of patients were classified as ASA II, according to their physical status. The mean values for heart rate and mean arterial blood pressure had a slight decrease after anesthesia was applied and remained constant for the rest of the evaluated times. The mean values of hemoglobin-oxygen saturation remained relatively constant at all the evaluated times and were slightly higher on the patient's arrival to recovery. The quality of sedation was adequate in 86.2 percent of the patients. The quality of analgesia and recovery was good in 88.4 percent and 96.2 percent, respectively. Complications occurred in 16.5 percent of the patients. Conclusions: Analgosedation with propofol and fentanyl proved to be a useful anesthetic alternative in patients undergoing outpatient colonoscopy, with high hemodynamic stability in the studied series(AU)

Historia de la Anestesiología y Reanimación en Cienfuegos / History of Anestesiology ad Resuscitation in Cienfuegos

RESUMEN A partir de la introducción de la anestesia en la isla, el 11 de marzo de 1847 se diò un progresivo avance en el desarrollo de la cirugía. En Cienfuegos sería un hito cuando el cirujano Alfredo Méndez la introdujo entre 1901 y 1902; y su uso se ha incrementado en la actualidad. Se describieron las principales acciones que se han desarrollado por la especialidad de Anestesiología y Reanimación en sus hospitales generales en Cienfuegos. Se revisó el libro de la cátedra Anestesiología Clínica, en su primera y segunda ediciones. Se realizaron entrevistas a protagonistas que formaron parte del desarrollo de la especialidad en Cienfuegos. Se encontraron los principales hechos que fueron desarrollando la especialidad de Anestesiología y Reanimación en la provincia desde principios del siglo xx con la aplicación de cloroformo y éter por parte del cirujano Alfredo Méndez y cómo continúa su desarrollo con médicos dedicados a la anestesia en el comienzo de la segunda mitad de la década del 50; el desarrollo en el Hospital civil y las clínicas privadas, hasta llegar al triunfo de la Revolución y hasta nuestros días en pleno siglo xxi. La anestesia en Cienfuegos se introdujo a comienzos del siglo xx, teniendo un quehacer constante en el desarrollo de la esta disciplina, así como la integración de la especialidad a la Sociedad Cubana de Anestesiología, Reanimación y Dolor, constituyendo su grupo provincial.

ABSTRACT As of the introduction of anesthesia on the Island, on March 11, 1847 there was a progressive advance in the development of surgery. In Cienfuegos it would be a milestone when the surgeon Alfredo Méndez introduced it between 1901 and 1902; and its use has increased at present. The main actions that have been developed by the Anesthesiology and Resuscitation specialty in the general hospitals in Cienfuegos were described. The book of the Clinical Anesthesiology, in its first and second editions, was revised. Interviews were conducted with protagonists who were part of the development of the specialty in Cienfuegos. The main facts that were developing the specialty of Anesthesiology and Resuscitation in the province were found since the beginning of the 20th century with the application of chloroform and ether by Alfredo Méndez surgeon and how it continues its development with doctors dedicated to anesthesia in the beginning of the second half of the 1950s; the development in the Civil Hospital and private clinics, until the triumph of the Revolution and until nowadays in the XXI century. Anesthesia in Cienfuegos was introduced at the beginning of the 20th century, having a constant task in the development of this discipline, as well as the integration of the specialty to the Anesthesiology Resuscitation and Pain Cuban Society, being its provincial group and chapter.

Guía para la enseñanza del apoyo vital avanzado a la emergencia clínica. Consenso para el proyecto de formación e investigación en apoyo vital. Cienfuegos, 2018 / Guideline for advance life support in clinical emergency. Consensus for the project of training and research for life support. Cienfuegos, 2018

Fundamento: Las emergencias médicas clínicas constituyen un problema de salud a nivel mundial; una de las soluciones para reducir su letalidad es que los profesionales de este campo puedan disponer de los conocimientos básicos y avanzados en su diagnóstico precoz y atención. El proyecto para la formación e investigación en apoyo vital en emergencias y desastres puede ser un marco académico para lograrlo.Objetivo: actualizar para el proyecto, las guías y estrategia docente para la enseñanza del apoyo vital avanzado a las emergencias clínicas.Método: se desarrolló un Taller nacional con 14 expertos, que sesionó los días 10 y 11 de julio del 2018 en Cienfuegos. Se aplicó la técnica de tormenta de ideas y la de grupo nominal, así como el cuestionario semiestructurado y la revisión documental previa.Desarrollo: fueron propuestos, para la enseñanza del apoyo vital avanzado a la emergencia clínica, los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se definió la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusión: las propuestas académicas para el curso Apoyo vital avanzado a la emergencia clínica, permiten el mejor abordaje de la enseñanza del apoyo vital avanzado a las diferentes emergencias clínicas, por profesionales de la salud que se dedican a la atención de pacientes con estas enfermedades.

Foundation: Medical clinical emergencies constitute a Health problem worldwide; one of the solutions for reducing its lethality is that professionals of this field know the basics and advanced elements for its early diagnosis and care. The project for training and research in life support in emergencies and disasters may be an academic framework to achieve it.Objective: to update for the Project, the guidelines and teaching strategies for training advanced life support to clinical emergencies.Method: a workshop was developed with 14 experts, which was hold during the days 10th and 11th 2018 in Cienfuegos. The techniques of brain storming and nominal group were applied, so as the semi structured questionnaire.Development: the objectives, teaching aspects, contents, scope, skills to be developed, future research and areas of institutional collaboration were proposed. It was defined the structure for a model course for teaching the topic and the main elements for its execution.Conclusion: academic proposals for the course advanced life support allow a better approach for teaching advanced life support to different clinical emergencies, for health professionals who are in charge of caring to patients with these diseases.

AFLP and MS-AFLP analysis of the variation within saffron crocus (Crocus sativus L.) germplasm.

The presence and extent of genetic variation in saffron crocus are still debated, as testified by several contradictory articles providing contrasting results about the monomorphism or less of the species. Remarkably, phenotypic variations have been frequently observed in the field, such variations are usually unstable and can change from one growing season to another. Considering that gene expression can be influenced both by genetic and epigenetic changes, epigenetics could be a plausible cause of the alternative phenotypes. In order to obtain new insights into this issue, we carried out a molecular marker analysis of 112 accessions from the World Saffron and Crocus Collection. The accessions were grown for at least three years in the same open field conditions. The same samples were analysed using Amplified Fragment Length Polymorphism (AFLP) and Methyl Sensitive AFLP in order to search for variation at the genetic (DNA sequence) and epigenetic (cytosine methylation) level. While the genetic variability was low (4.23% polymorphic peaks and twelve (12) effective different genotypes), the methyl sensitive analysis showed the presence of high epigenetic variability (33.57% polymorphic peaks and twenty eight (28) different effective epigenotypes). The pattern obtained by Factorial Correspondence Analysis of AFLP and, in particular, of MS-AFLP data was consistent with the geographical provenance of the accessions. Very interestingly, by focusing on Spanish accessions, it was observed that the distribution of the accessions in the Factorial Correspondence Analysis is not random but tends to reflect the geographical origin. Two clearly defined clusters grouping accessions from the West (Toledo and Ciudad Real) and accessions from the East (Cuenca and Teruel) were clearly recognised.

Bioactive compounds from transformed root cultures and aerial parts of Bethencourtia hermosae.

A chemical study of Bethencourtia hermosae, aerial parts and in vitro root cultures, transformed by Agrobacterium rhizogenes, afforded the hitherto unreported sesquiterpenes ceratopicanol angelate (1), 8ß-hydroxy-african-4(5)-en-3-one tiglate (4), 8ß-hydroxy-african-4(5)-en-3-one 3'-angeloxy-2'-methylbutanoate (5), 1α,8ß-dihydroxy-african-4(5)-en-3-one 8ß-angelate (7) and 6α,8ß-dihydroxy-african-4(5)-en-3-one 8ß-angelate (8). In addition, 8ß-hydroxy-african-4(5)-en-3-one (6) was isolated for the first time from a natural source, along with the rare sesquiterpenoid senecrassidiol (10) and two jacaranone derivatives 14 and 16. Known pyrrolizidine alkaloids, together with previously unreported hermosine (23), have also been isolated from this plant. The insect antifeedant activities of the extracts and compounds were studied together with their cytotoxic effects against insect (Sf9) and mammalian (CHO) cell lines.

Valorization of essential oils from Moroccan aromatic plants.

The chemical composition and biological activity of cultivated and wild medicinal and aromatic plants from Morocco (Artemisia herba-alba, Lippia citriodora, Mentha pulegium, M. spicata, Myrtus communis, Rosmarinus officinalis, and Thymus satureioides) are described. The essential oils (EOs) of these species have been analyzed by GC-MS. The antifeedant, nematicidal and phytotoxic activities of the EOs were tested on insect pests (Spodoptera littoralis, Myzus persicae and Rhopalosiphum padi), root-knot nematodes (Meloydogine javanica) and plants (Lactuca sativa, Lolium perenne and Lycopersicum esculentum). EOs from A. herba-alba, M. pulegium and R. officinalis were strong antifeedants against S. littoralis, M. persicae and R. padi. EOs from L. citriodora, M. spicata and T. satureioides showed high nematicidal activity. These biological effects are explained by the activity of the major EO components and/or synergistic effects.

Anestesia y seguridad del paciente. Un llamado urgente… / Anesthesia and patient safety. An urgent call…

Introducción: el desarrollo de la Anestesiología dio un vuelco significativo en las últimas décadas, dado fundamentalmente por el cambio de la visión y misión de la especialidad. No se trata de dormir y despertar un paciente como en los años 50 del siglo pasado. Hoy se trata de cuidar la integridad de un ser humano que entrega su vida y esto lleva implícito velar por la hipnosis, la analgesia, el bloqueo neuromuscular, el control hemodinámico, neurovegetativo y la prevención del dolor. Se trata de una especialidad con mayor alcance. Objetivo: realizar una puesta al día de las posibles causas de errorores médicos en la prevención de complicaciones anestésicas. Desarrollo: los comisionados de salud están cada vez más conscientes de los problemas inherentes a la seguridad del paciente durante algún procedimiento quirúrgico. Se han creado múltiples iniciativas como la denominada «Check List o lista de verificación quirúrgica de la OMS. Existen diferentes fuentes de riesgo, en el quirófano y se agrupan en las siguientes categorías: electrocución, quemaduras de la piel, asfixia, barotrauma, sobredosis, embolismo, fuego y aplastamiento, por solo citar algunas. Durante la anestesia, la mayoría de los errores por administración de drogas son total o parcialmente atribuidos al error humano, que es una parte inherente de la psicología humana y de la actividad, de ahí la aparición de errores sólo se puede reducir, no eliminar. Conclusiones: se hace imperioso proponer elementos objetivos que relacionen los procedimientos anestésicos con la seguridad, de la misma forma que se trata de lograr un proceder quirúrgico seguro, en un ambiente idóneo y una transfusión segura en los cuales todos estemos imbuidos en un mismo fin: velar por la integridad y la seguridad del paciente anestesiado.

Background: the development of Anesthesiology changed significantly in the last decades, mainly because of the change of vision and mission of the specialty. It does not mean to sleep and wake the patient up as in the 50´s during the last Century. Today, it is about the caring for the integrity of a human being that gives his life and this implies ensuring hypnosis, analgesia, neuromuscular block, hemodynamic and neurovegetative control and pain prevention. It is a far-reaching specialty. Objective: to perform an update of the possible causes of medical errors in the prevention of anesthetic complications Development: health commissioners are increasingly aware of the problems that are inherent in the patients' safety during a surgical procedure. Many initiatives have been created such as the called "Checklist" or WHO surgical checklist. There are different risk sources in the operating room which are grouped in the following categories: electrocution, skin burns, asphyxia, barotraumas, overdose, embolism, fire and lethargy, just to mention some of them. During anesthesia, the majority of errors in drug administration are totally or partially attributed to human error which is an inherent part in human psychology and activity; hence, the occurrence of errors can only be reduced, not eliminated. Conclusions: it is imperative to propose objective elements that relate safe anesthetic procedures; similarly, it is intended to achieve a safe surgical procedure in an ideal ambient and a safe transfusion in which all of us are imbued with the same purpose: to ensure the integrity and safety of a patient under anesthesia.

Anestesia y seguridad del paciente. Un llamado urgente / Anesthesia and patient safety. An urgent call

Introducción: el desarrollo de la Anestesiología dio un vuelco significativo en las últimas décadas, dado fundamentalmente por el cambio de la visión y misión de la especialidad. No se trata de dormir y despertar un paciente como en los años 50 del siglo pasado. Hoy se trata de cuidar la integridad de un ser humano que entrega su vida y esto lleva implícito velar por la hipnosis, la analgesia, el bloqueo neuromuscular, el control hemodinámico, neurovegetativo y la prevención del dolor. Se trata de una especialidad con mayor alcance.Objetivo: realizar una puesta al día de las posibles causas de errorores médicos en la prevención de complicaciones anestésicas. Desarrollo: los comisionados de salud están cada vez más conscientes de los problemas inherentes a la seguridad del paciente durante algún procedimiento quirúrgico. Se han creado múltiples iniciativas como la denominada «Check List o lista de verificación quirúrgica de la OMS. Existen diferentes fuentes de riesgo, en el quirófano y se agrupan en las siguientes categorías: electrocución, quemaduras de la piel, asfixia, barotrauma, sobredosis, embolismo, fuego y aplastamiento, por solo citar algunas. Durante la anestesia, la mayoría de los errores por administración de drogas son total o parcialmente atribuidos al error humano, que es una parte inherente de la psicología humana y de la actividad, de ahí la aparición de errores sólo se puede reducir, no eliminar. Conclusiones: se hace imperioso proponer elementos objetivos que relacionen los procedimientos anestésicos con la seguridad, de la misma forma que se trata de lograr un proceder quirúrgico seguro, en un ambiente idóneo y una transfusión segura en los cuales todos estemos imbuidos en un mismo fin: velar por la integridad y la seguridad del paciente anestesiado(AU)

Background: the development of Anesthesiology changed significantly in the last decades, mainly because of the change of vision and mission of the specialty. It does not mean to sleep and wake the patient up as in the 50´s during the last Century. Today, it is about the caring for the integrity of a human being that gives his life and this implies ensuring hypnosis, analgesia, neuromuscular block, hemodynamic and neurovegetative control and pain prevention. It is a far-reaching specialty. Objective: to perform an update of the possible causes of medical errors in the prevention of anesthetic complications Development: health commissioners are increasingly aware of the problems that are inherent in the patients' safety during a surgical procedure. Many initiatives have been created such as the called "Checklist" or WHO surgical checklist. There are different risk sources in the operating room which are grouped in the following categories: electrocution, skin burns, asphyxia, barotraumas, overdose, embolism, fire and lethargy, just to mention some of them. During anesthesia, the majority of errors in drug administration are totally or partially attributed to human error which is an inherent part in human psychology and activity; hence, the occurrence of errors can only be reduced, not eliminated. Conclusions: it is imperative to propose objective elements that relate safe anesthetic procedures; similarly, it is intended to achieve a safe surgical procedure in an ideal ambient and a safe transfusion in which all of us are imbued with the same purpose: to ensure the integrity and safety of a patient under anesthesia(AU)

Cardiac hormones are c-Jun-N-terminal kinase 2-inhibiting peptides.

BACKGROUND: Four cardiac peptide hormones, namely vessel dilator, long-acting natriuretic peptide (LANP), kaliuretic peptide, and atrial natriuretic peptide (ANP) have anticancer effects. MATERIALS AND METHODS: The effects of these four cardiac hormones on human c-Jun-N-terminal kinase 2 (JNK2) were examined in human small cell lung cancer and human prostate cancer cells. RESULTS: Vessel dilator, LANP, kaliuretic peptide and ANP maximally reduced expression of JNK2 by 89%, 56%, 45%, and 28%, respectively (each at p<0.0001) in human small cell lung cancer cells. In human prostate adenocarcinoma cells, JNK2 was maximally decreased 76%, 56%, 45%, (each at p<0.0001), and 28% (p<0.01) secondary to vessel dilator, LANP, kaliuretic peptide and ANP, respectively. CONCLUSION: These results indicate that four cardiac hormones are significant inhibitors (by up to 89%) of JNK2 in human small cell lung cancer cells and up to 76% in human prostate adenocarcinoma cells as part of their anticancer mechanism(s) of action.

Antifeedant activity of fatty acid esters and phytosterols from Echium wildpretii.

Crude extracts and fractions from Echium wildpretii H. Pearson ex Hook. f. subsp. wildpretii (Boraginaceae) have been tested against insect species Spodoptera littoralis, Leptinotarsa decemlineata, and the aphids Myzus persicae, Diuraphis noxia, Metopolophium dirhodum, Rhopalosiphum maidis, and Rhopalosiphum padi. The EtOH extract and the lipid and steroidal fractions of E. wildpretii exhibited significant antifeedant activities against the aphids and L. decemlineata. Two bioactive mixtures composed of fatty acid esters and n-alkanes were obtained from the lipid fraction. The bioguided fractionation of the steroidal fraction resulted in the isolation of glutinol, ß-sitosterol, (3ß,7α)-stigmast-5-ene-3,7-diol, and (3ß,7α)-7-methoxystigmast-5-en-3-ol. The latter two compounds exhibited potent antifeedant activities against L. decemlineata indicating that the presence of an O-bearing C(7) was responsible for the activities of these molecules.

Defensive sesquiterpenes from Senecio candidans and S. magellanicus, and their structure-activity relationships.

Eleven eremophilanolides, 1-3 and 6-13, and two eremophilanes, 24 and 25, were isolated from Senecio candidans and S. magellanicus from the Magallanes Region (Chile). Compounds 2, 3, 9, and 10 have not been previously reported as natural products. Their structures were established by NMR spectroscopic analysis and chemical transformations. The X-ray analysis of compounds 11, 13, and 17 were also performed. Different semisynthetic analogs from eremophilanolide 11 were generated to carry out a structure-activity relationship study. Their possible plant defensive role was tested against herbivorous insects (Spodoptera littoralis, Rhopalosiphum padi, and Myzus persicae) and plants (Lactuca sativa). Additionally, their effects on insect (Sf9) and mammalian (CHO) cell lines were tested.

Neospora caninum: Detección de ADN en sangre durante la primera gestación de vaquillas infectadas naturalmente / Neospora caninum: DNA detection in blood during first gestation of naturally infected heifers

The aim of the study was to detect the DNA presence of N. caninum in naturally infected animals, at two moments of their first gestation and at parturition, as well as to record the presentation of abortions. Twenty females between 12 to 14 months of age, seropositive to ELISA test, were selected from a dairy farm with presence of this parasitosis. The females were artificially inseminated and blood samples were taken in the first and second third of gestation and during parturition; DNA was isolated and it was analyzed by a single tube nested PCR with specific primers. In the sampling corresponding to the first third of gestation, 7/20 positive cases were observed (35%), in the second 15/20 (75%) and during parturition 10/20 positive cases (50%). From the total of the animals included in this study, three stayed negative to the test in the three samplings (15%), four were always positive (20%), eight were positive in the second sampling but negative in first (40%) and five were positive in the second and negative in first and the third sampling (25%). All animals remained seropositive during the study; four aborted in the last third of gestation. All the live born calves were seropositive to N. caninum.

El objetivo del trabajo fue detectar la presencia de ADN de N. caninum en animales infectados naturalmente, en dos tiempos de su primera gestación y al parto, así como registrar la presentación de abortos. Se seleccionó, en un establo, con presencia de parasitosis, un lote de 20 hembras de entre 12 y 14 meses de edad, seropositivas en ELISA, las hembras fueron inseminadas artificialmente y se tomaron muestras de sangre en el primero y segundo tercios de gestación y al parto; se aisló ADN y se sometió a PCR anidado en un solo tubo con iniciadores específicos. En el muestreo correspondiente al primer tercio de la gestación, se observaron 7/20 casos positivos (35%), en el segundo 15/20 (75%) y al parto 10/20 casos positivos (50%). De los animales incluidos en el estudio, tres se mantuvieron negativos a la prueba en los tres muestreos (15%), cuatro fueron siempre positivos (20%), ocho fueron positivos en el segundo muestreo pero negativos en el primero (40%) y cinco fueron positivos en el segundo y negativos en el primero y tercero muestreos (25%). No se presentó seroconversión en ningún animal durante el estudio; cuatro de ellos presentaron aborto en el último tercio de gestación. Todas las crías nacidas vivas resultaron seropositivas a N. caninum.

3-O-Acetyl-narcissidine, a bioactive alkaloid from Hippeastrum puniceum Lam. (Amaryllidaceae).

In the context of the study on plant defensive compounds we have isolated the main alkaloid from Hippeastrum puniceum (Amaryllidaceae), 3-O-acetyl-narcissidine (1), and its biological activities tested against two divergent insect species and several plant species. 1 was isolated from the bioactive alkaloidal fraction of H. puniceum. Its chemical structure was established by spectroscopic analysis. The biological activity tests showed that 1 is an antifeedant against the polyphagous insect Spodoptera littoralis but not against the olyphage Leptinotarsa decemlineata. Furthermore, the root growth of Amaranthus hypochondriacus, Rottboellia cochinchinensis, Panicum maximum and Solanum lycopersicum was significantly affected by 1. These results suggest a plant protective role for H. puniceum alkaloids.