Manejo de antitrombóticos en pacientes que requieren procedimientos endoscópicos

ResumenExiste una importante proporción de pacientes en tratamiento con anticoagulantes o antiagregantes plaquetarios que requieren procedimientos endoscópicos electivos o de urgencia. Es deseable que los endoscopistas tengan conocimiento de la farmacología básica de los antitrombóticos, sus indicaciones, las condiciones que definen el riesgo de trombosis al suspender el tratamiento y el riesgo de sangrado de los procedimientos endoscópicos. La importancia de este conocimiento radica en la optimización de los desenlaces de tromboembolismo y hemorragia, por lo que el objetivo de esta revisión es mostrar la evidencia sobre las recomendaciones para llevar a cabo un procedimiento endoscópico seguro en pacientes que se encuentran bajo tratamiento antitrombótico.AbstractA significant proportion of patients treated with anticoagulants or platelet aggregation inhibitors may require elective or urgent endoscopic procedures. It is desirable that endoscopists have knowledge of the basic pharmacology of antithrombotic agents and their indications, as well as the risk of thrombosis after discontinuation of therapy and the risk of bleeding due to endoscopic procedures. The importance of this information lies in optimising the outcomes of thromboembolism and bleeding. The aim of this review is to present the evidence on the recommendations to conduct a safe endoscopic procedure in patients on antithrombotic treatment

Proyecto de inversión pública: Instalación del servicio de estimulación temprana en el Centro de Salud la Victoria II, distrito La Victoria, Chiclayo – Lambayeque 2018

En el presente proyecto: Instalación del servicio de estimulación temprana en el Centro de Salud la Victoria II, Distrito La Victoria, provincia de Chiclayo, Región Lambayeque, con una población de 771 niños menores de 3 años, se desarrollará basándose en la atención integral, con el fin de estimularlos desde temprana edad para reducir los casos de retraso o déficit en el desarrollo psicomotor, aprovechando al máximo sus capacidades a través de nuevos y tecnificados métodos de enseñanza dentro de un ambiente moderno que permita su mejor desempeño en la sociedad; puesto que la estimulación temprana constituye un reto del próximo milenio, acometerla es responsabilidad no solo del profesional de enfermería, sino también se rescata la participación activa de los padres en esta labor. El objetivo general del proyecto es incrementar el acceso al servicio de estimulación temprana a los niños menores de 36 meses. Al finalizar, se habrá logrado: fortalecer las competencias del personal de salud para una adecuada atención integral; dotar de equipamiento suficiente en los servicios de salud y desarrollar conocimientos apropiados a las familias para el cuidado integral del niño menor de 3 años; también se habrá fortalecido las capacidades de los agentes comunitarios en los sistemas de vigilancia comunitaria, para una adecuada atención integral. Se concluye que dicho proyecto brindará un servicio que beneficiará en el crecimiento y desarrollo al niño menor de 36 meses, en el periodo horizonte del proyecto que es de 10 años, los mismos que garantizaran la ejecución, seguimiento y monitoreo del proyecto

Values, Environmental Beliefs, and Connection With Nature as Predictive Factors of the Pro-environmental Vote in Spain

This research analyzes the predictive capacity of psychosocial variables that can influence the decision to vote for political parties that include pro-environmental measures in their program. To this end, a study was carried out with a sample of 414 people of legal age who could exercise their right to vote (mean age = 26.92, SD = 10.53). The participants were divided into two groups: (1) Pro-environmental voters, those who during the last elections in Spain based their voting decision on whether the political party included pro-environment measures in its electoral program (n = 190), and (2) Non-pro-environmental voters, those other people who voted for a political party without considering whether pro-environment measures were included in its electoral program (even if such environmental protection measures had been included) (n = 224). The results indicate that, in comparison with their counterparts who do not vote for pro-environmental parties, those who voted for political parties during the last elections by considering the inclusion of pro-environment measures in their electoral program showed the highest scores on the biospheric and socio-altruistic values of ecocentrism, anthropocentrism, connectivity with nature and environmental concern, and scored lower on self-centered values. With the exception of connectivity with nature, biospheric values and beliefs were good predictors of pro-environmental voting behavior.University of Granada (Spain) PPJIB2018-04Andalusian research plan of the Andalusian government HUM-19

Scaffold-free bioprinting of mesenchymal stem cells using the Regenova printer: Spheroid characterization and osteogenic differentiation

Limitations in scaffold material properties, such as sub-optimal degradation time, highlight the need for alternative approaches to engineer de novo tissues. One emerging solution for fabricating tissue constructs is scaffold-free tissue engineering. To facilitate this approach, three-dimensional (3D) bioprinting technology (Regenova Bio 3D Printer) has been developed to construct complex geometric shapes from discrete cellular spheroids without exogenous scaffolds. Optimizing spheroid fabrication and characterizing cellular behavior in the spheroid environment are important first steps prior to printing larger constructs. Here, we characterized spheroids of immortalized mouse bone marrow stromal cells (BMSCs) that were differentiated to the osteogenic lineage. Immortalized BMSCs were seeded in low attachment 96-well plates in various numbers to generate self-aggregated spheroids either under the force of gravity or centrifugation. Cells were cultured in control or osteogenic media for up to 28 days. Spheroid diameter, roundness and smoothness were measured. Cell viability, DNA content and alkaline phosphatase activity were assessed at multiple time points. Additionally, expression of osteogenic markers was determined using real time qPCR. Spheroids formed under gravity with 20 K, 30 K and 40 K cells had average diameters of 498.5 ± 8.3 μm, 580.0 ± 32.9 μm and 639.2 ± 54.0 μm, respectively, while those formed under 300G centrifugation with the same numbers of cells had average diameters of 362.3 ± 3.5 μm, 433.1 ± 6.4 μm and 491.2 ± 8.0 μm. Spheroids formed via centrifugation were superior to those formed by gravity, as evidenced by better roundness and smoothness and double the retention of DNA (cellular) content. Cells in spheroids exhibited a robust osteogenic response to the differentiation medium, including higher mRNA expression of alkaline phosphatase, collagen type I, and osteocalcin than those cultured in control medium, as well as greater alkaline phosphatase activity. The optimal spheroid fabrication technique from this study was to aggregate 40 K cells under 150–300G centrifugation. In future investigations, these spheroids will be 3D printed into larger tissue constructs

Scaffold-free bioprinting of mesenchymal stem cells with the regenova printer: Optimization of printing parameters

The Kenzan bioprinting method provides a high-resolution biofabrication process by facilitating the fusion of submillimeter cell aggregates (spheroids) into larger tissue constructs on a needle array that is removed upon spheroid fusion. Although the method is relatively straightforward in principle, Kenzan method bioprinting relies on a complex 3D bioprinter (Regenova Bio 3D Printer, Cyfuse, K.K., Japan) implementing an advanced vision system to verify the microscopic spheroids’ geometry and high-precision mechatronics to aseptically manipulate the spheroids into position. Due to the complexity of the operation, the need for aseptic conditions, and the size of the spheroids, proficiency with the Regenova Bio 3D Printer and the Kenzan method requires development of best practices and troubleshooting techniques to ensure a robust print and minimize the use of resources. In addition, managing the construct post-bioprinting both in culture and for surgical implantation requires careful consideration and workflow design. Here, we describe methods for generating a competent tissue construct and optimizing the bioprinting process. Optimization resulted in a 4-fold reduction in print times, a 20-fold reduction in the use of bioprinting nozzles, and more robust constructs. The results and procedures described herein will have potential applications for tissue engineering, research, and clinical uses in the future

Taller de serigrafia para los pobladores del asentamiento humano las Torres de San Borja - Moche- La Libertad

RESUMEN Se realizó un proyecto de responsabilidad social sobre serigrafía en el Asentamiento Humano “Las Torres de San Borja”, con la finalidad de generar una idea de negocio para los pobladores de dicha zona, con la participación de los estudiantes de la Universidad Privada del Norte. El objetivo de este taller es fabricar polos personalizados para brindar facilidad y comodidad al cliente elaborando diseños originales, a la vanguardia en continua interacción con las tendencias de la moda. Para llevar a cabo este taller: primero, se realizó una lluvia de ideas y se escogió la propuesta más factible. Luego, se realizaron capacitaciones al equipo monitor. Después, se hizo la difusión del taller en la zona para la respectiva inscripción de los interesados. Por último, se logró realizar el taller con gran éxito en la transmisión de la idea de negocio a la comunidad.ABSTRACT A project of social responsibility about serigraphy took place in the human settlement Las Torres de San Borja, in order to generate a business idea for the people of that area, with the participation of students from the Universidad Privada del Norte. The objective of this workshop is to manufacture custom t-shirts to provide ease and comfort to the customer elaborating original designs, in continuous interaction with fashion trends. To carry out this workshop: first, a brainstorming took place and the most feasible proposal was chosen. Then, training was made to collaborators. After, the workshop was disseminated in the area for the respective registration of the interested parties. Finally, the workshop was done with great success for the transmission of the business idea to the community. Keyword: serigraphy, business idea, trainings, community

thrombosis of the portal venous system in cirrhotic patients

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Skeletal adaptations in young male mice after 4 weeks aboard the International Space Station

Gravity has an important role in both the development and maintenance of bone mass. This is most evident in the rapid and intense bone loss observed in both humans and animals exposed to extended periods of microgravity in spaceflight. Here, cohabitating 9-week-old male C57BL/6 mice resided in spaceflight for ~4 weeks. A skeletal survey of these mice was compared to both habitat matched ground controls to determine the effects of microgravity and baseline samples in order to determine the effects of skeletal maturation on the resulting phenotype. We hypothesized that weight-bearing bones would experience an accelerated loss of bone mass compared to non-weight-bearing bones, and that spaceflight would also inhibit skeletal maturation in male mice. As expected, spaceflight had major negative effects on trabecular bone mass of the following weight-bearing bones: femur, tibia, and vertebrae. Interestingly, as opposed to the bone loss traditionally characterized for most weight-bearing skeletal compartments, the effects of spaceflight on the ribs and sternum resembled a failure to accumulate bone mass. Our study further adds to the insight that gravity has site-specific influences on the skeleton

Recuperación mejorada después de cirugía en cáncer colorrectal. Instituto Nacional de Enfermedades Neoplásicas

Objetivo: Describir y analizar la seguridad de la aplicación del programa de “Recuperación Mejorada Después de Cirugía” (ERAS) para cirugía electiva por cáncer colorrectal. Materiales y Métodos: Estudio observacional retrospectivo de 272 pacientes con cáncer colorrectal operados con cirugía electiva entre enero 2019 y setiembre 2020 en el Instituto Nacional de Enfermedades Neoplásicas, Perú. Se utilizó la Prueba U de Mann-Whitney, Chi-cuadrado de Pearson, y odds ratios (OR) para el análisis estadístico. Resultados: 90 pacientes ingresaron al programa ERAS con una mediana de estancia hospitalaria postoperatoria de 3 días (rango 3-19). La cirugía laparoscópica se realizó en el 53 % de los casos, con una estancia hospitalaria significativamente menor que los pacientes con cirugía convencional (p=0,035). El inicio de la tolerancia oral < 24 horas se realizó en el 91 % de casos y la deambulación temprana en 89 %. La incidencia de complicaciones postoperatorias fue de 29 %, mayor en los pacientes con resección de recto/ano que en el grupo con resección de colon (40 % vs 20 %, p=0,043) (OR=2,67, IC del 95 %: 1,02 – 7,01). Ocho pacientes presentaron complicación mayor, 4 con dehiscencia de anastomosis y 4 requirieron readmisión hospitalaria. Conclusiones: El manejo según ERAS para cirugía electiva por cáncer colorrectal es seguro y factible con un riesgo de morbimortalidad perioperatoria aceptable

Ecological and Physiological Studies of Gymnodinium catenatum in the Mexican Pacific: A Review

This review presents a detailed analysis of the state of knowledge of studies done in Mexico related to the dinoflagellate Gymnodinium catenatum, a paralytic toxin producer. This species was first reported in the Gulf of California in 1939; since then most studies in Mexico have focused on local blooms and seasonal variations. G. catenatum is most abundant during March and April, usually associated with water temperatures between 18 and 25 ºC and an increase in nutrients. In vitro studies of G. catenatum strains from different bays along the Pacific coast of Mexico show that this species can grow in wide ranges of salinities, temperatures, and N:P ratios. Latitudinal differences are observed in the toxicity and toxin profile, but the presence of dcSTX, dcGTX2-3, C1, and C2 are usual components. A common characteristic of the toxin profile found in shellfish, when G. catenatum is present in the coastal environment, is the detection of dcGTX2-3, dcSTX, C1, and C2. Few bioassay studies have reported effects in mollusks and lethal effects in mice, and shrimp; however no adverse effects have been observed in the copepod Acartia clausi. Interestingly, genetic sequencing of D1-D2 LSU rDNA revealed that it differs only in one base pair, compared with strains from other regions