História da Cirurgia Geral em Cuba e no mundo

Introducción: la cirugía es tan antigua como la historia de la humanidad, se remonta a los tiempos más lejanos cuando el hombre hace su aparición en el teatro de la historia, a raíz de la individualidad física, psíquica y social. Objetivo: abordar aspectos importantes de la historia de la Cirugía General desde la antigüedad hasta la actualidad y su desarrollo en Cuba. Método: se realizó una revisión bibliográfica en la base de datos de la National Library of Medicine, PubMed, Google Académico, Web of Science, ClinicalKey, Elsevier, ResearchGate y páginas web de distintas especialidades que recomendaron artículos de interés en relación al tópico para la reconstrucción del surgimiento de la cirugía desde la antigüedad hasta la actualidad. Resultados: se recopilaron apuntes cronológicos divididos en: La cirugía en la antigüedad, América precolombina, La Edad Media y el Renacimiento, Desarrollo de la cirugía general en Cuba (breve recorrido 1354 hasta la actualidad). Consideraciones finales: el desarrollo de la cirugía comienza desde la antigüedad como necesidad, la especialización de los cirujanos generales en Cuba comienza a partir del siglo XVIII, cuando se separa de la cátedra de Anatomía para hacer la disciplina quirúrgica, lo cual ha tenido un progreso mantenido a lo largo de la historia, cuya magnitud es consecuente con el grado de desarrollo de la sociedad y de las limitaciones externas e internas, lo que se considera como un hito en el desarrollo de esta especialidad hasta la actualidad, con avances científicos, técnicos y anestésicos quirúrgicos de lo cual Cuba hoy exhibe a nivel mundial.Introduction: surgery is as old as the history of humanity. It goes back to the most distant times when man made his appearance, as a result of physical, mental and social individuality.Objective: to approach important aspects of the history of General Surgery from ancient times to the present and its development in Cuba. Method: a bibliographic review was carried out in the database of the National Library of Medicine, PubMed, Google Scholar, Web of Science, ClinicalKey, Elsevier, ResearchGate and web pages of different specialties that recommended articles of interest in relation to the topic for research, to reconstruct the emergence of surgery from antiquity to the present day. Results: chronological notes were compiled, divided into the next categories: Surgery in antiquity, pre-Columbian Americas, The Middle Ages and the Renaissance, Development of general surgery in Cuba (brief journey from 1354 to the present). Final considerations: the development of surgery begins from antiquity as a necessity; the specialization of general surgeons in Cuba begins in the eighteenth century, when it is separated from the Anatomy chair to perform as the surgical discipline, which has had a sustained progress throughout history. Its magnitude is consistent with the degree of development of society and society´s external and internal limitations. The development of this specialty in Cuba is considered a milestone, exhibiting high standards of scientific, technical and surgical-anesthetic advances today.Introdução: a cirurgia é tão antiga quanto a história da humanidade, remonta aos tempos mais distantes em que o homem faz sua aparição no teatro da história, fruto da individualidade física, mental e social. Objetivo: tratar aspectos importantes da história da Cirurgia Geral desde a antiguidade até o presente e seu desenvolvimento em Cuba. Método: foi realizada revisão bibliográfica na base de dados da National Library of Medicine, PubMed, Google Scholar, Web of Science, ClinicalKey, Elsevier, ResearchGate e páginas da web de diferentes especialidades que recomendavam artigos de interesse em relação ao tema para pesquisa reconstrução do surgimento da cirurgia desde a antiguidade até o presente. Resultados: foram compiladas notas cronológicas divididas em: Cirurgia na antiguidade, América pré-colombiana, Idade Média e Renascimento, Desenvolvimento da cirurgia geral em Cuba (breve viagem de 1354 até o presente). Considerações finais: o desenvolvimento da cirurgia começa desde a antiguidade como uma necessidade, a especialização dos cirurgiões gerais em Cuba começa no século XVIII, quando se separa da cadeira de Anatomia para fazer a disciplina cirúrgica, que teve um progresso mantido ao longo da história , cuja magnitude é compatível com o grau de desenvolvimento da sociedade e limitações externas e internas, que é considerado um marco no desenvolvimento desta especialidade até hoje, com anestésicos científicos, técnicos e cirúrgicos que Cuba hoje exibe em todo o mundo

Centrifugal force assessment in ram sperm: identifying species-specific impact

[EN] Background: Centrifugation is routinely employed in handling the ejaculates of some species, but it is not part of the commonly used protocols in ram. However, the development and implementation of new assisted reproductive technologies, alternative preservation models based on washing sperm from a cellular ageing-accelerating substance such as the seminal plasma, and basic studies in spermatology is associated with the use of centrifugation. This requires a specific evaluation of the centrifugation protocols considering the species-specific relationship with the potential damage produced by this procedure. No previous studies have determined the effect of different centrifugation forces on ram sperm. Therefore, we aimed to assess the performance of three centrifugal forces (600×g, 3000×g, and 6000×g for 10 min at room temperature) and their effects on ram sperm motility and functionality. Results: Sperm motility and functionality parameters were assessed at 0 h and after 2 h of incubation at 37 °C. As expected, a higher cell packaging degree was obtained at high centrifugation forces (P ≤ 0.0001). Cell packaging was unstable at all centrifugal forces. Thus, there was a high cell resuspension rate after less than 2 min. Regarding sperm quality, there was a change in movement pattern of 3000×g and 6000×g centrifuged sperm after 2 h of incubation at 37 °C, characterized by an increase in rapid progressive motility, linearity, straightness, and beat frequency, and a decrease in medium progressive motility, curvilinear velocity, path velocity, and head lateral amplitude. Non-significant differences were obtained among the different treatments concerning the total viability. However, we observed a significant increase (P ≤ 0.05) in the percentage of viable apoptotic sperm in the samples centrifuged at 6000×g at 0 h. Conclusions: Centrifugal forces equal to or greater than 3000×g induced some deleterious effects in ram sperm quality, and lower forces did not provide a successful cell packaging degree.SIThis work was financially supported by MINECO (AGL2017-83098-R) and the University of León. Marta Neila-Montero was supported by MEC (fellowship FPU17/04142) and Marta F Riesco and Rafael Montes-Garrido by Junta de Castilla y León (research contract LE253P18 and fellowship ORDEN EDU/556/2019, respectively)

Frequency of Semen Collection Affects Ram Sperm Cryoresistance

[EN] The improvement of frozen-thawed sperm quality has been mostly approached from the view of cryopreservation protocol optimization in terms of cryoprotectant solutions, freezing-thawing rates and antioxidant supplementation, while the impact of sperm collection frequency remains unknown in rams. In this work, a multiparametric study was carried out in cooled and frozen-thawed semen to evaluate sperm quality after different semen collection frequencies during a month: zero sperm collection (0 CW), four sperm collections per week (4 CW), and ten sperm collections per week (10 CW). Traditional analyses have been applied, in combination with novel technologies related to redox balance. Frozen-thawed semen quality showed a significant decrease (p < 0.05) in 0 CW and 10 CW in comparison to 4 CW, concerning motility and kinetics parameters. However, apoptosis showed a significant increase (p < 0.05) in 10 CW in comparison to 0 CW and 4 CW. The employment methods related to redox balance provided us with the definitive probe to ensure the influence of collection frequency on balance redox after thawing. Specifically, glutathione peroxidase (GPX) and superoxide dismutase (SOD) activity showed a significant decrease (p < 0.05) in 10 CW compared to 0 CW and 4 CW. The characterization of alternative strategies to sperm cryopreservation based on consideration of male sexual regimes, could improve the quality of frozen-thawed sperm.SIThis work was supported by MINECO (AGL2017-83098-R), the Junta de Castilla y León (LE253P18) and Desafio Universidad-Empresa—TCUE 2020 (MejorIA). C.P.-M. was supported by MINECO (PRE2018-086400), M.F.R. and R.M.-G. was supported by Junta de Castilla y León and FSE (research contract LE253P18 and fellowship ORDEN EDU/556/2019, respectively), M.N.-M. was supported by MEC (fellowship FPU17/04142)

ProAKAP4 as Novel Molecular Marker of Sperm Quality in Ram: An Integrative Study in Fresh, Cooled and Cryopreserved Sperm

[EN] To improve artificial insemination protocols in ovine species it is crucial to optimize sperm quality evaluation after preservation technologies. Emerging technologies based on novel biomolecules and related to redox balance and proteins involved in sperm motility such as ProAKAP4 could be successfully applied in ram sperm evaluation. In this work, a multiparametric analysis of fresh, cooled, and cryopreserved ram sperm was performed at different complexity levels. Samples were evaluated in terms of motility (total motility, progressive motility, and curvilinear velocity), viability, apoptosis, content of reactive oxygen species, oxidation-reduction potential, and ProAKAP4 expression and concentration. As expected, cryopreserved samples showed a significant decrease of sperm quality (p < 0.05), evidencing different freezability classes among samples that were detected by ProAKAP4 analyses. However, in cooled sperm no differences were found concerning motility, viability, apoptosis, ROS content, and redox balance compared to fresh sperm that could explain the reported decrease in fertility rates. However, although the proportion of sperm ProAKAP4 positive-cells remained unaltered in cooled sperm compared to fresh control, the concentration of this protein significantly decreased (p < 0.05) in cooled samples. This altered protein level could contribute to the decrease in fertility rates of cooled samples detected by some authors. More importantly, ProAKAP4 can be established as a promising diagnostic parameter of sperm quality allowing us to optimize sperm conservation protocols and finally improve artificial insemination in ovine species.S

Auditoría Forense como herramienta en la prevención y detección del fraude en la ejecución de proyectos con fondos públicos.

Desde un punto de vista social, las prácticas fraudulentas y de corrupción dentro del sector público es un fenómeno costoso para la población de un país, ya que el aprovechamiento de los fondos públicos por parte de funcionarios reduce la eficiencia del gasto público, por lo que, en lugar de permitir el crecimiento económico del país, la confianza de la población es socavada cuando son descubiertas este tipo de prácticas en organismos gubernamentales. En ese sentido, se puede afirmar que la corrupción y el fraude en el sector público gira en torno a tres aspectos importantes: en primer lugar, la administración pública, redireccionando el patrimonio y bienes del Estado, en segundo lugar, el propósito por el que se origina el aprovechamiento de los recursos y finalmente los perjudicados, quién es la población en general. En El Salvador, a lo largo de los años han sido develados casos en los que se han desviado a cuentas particulares recursos del Estado, muchos de los casos conocidos las investigaciones han tardado años en depurar los hallazgos. Descrito lo anterior, el presente trabajo se centra en desarrollar una auditoría forense aplicada al área de ejecución de proyectos realizados con fondos públicos, aplicando procedimientos específicos que faciliten la detección de indicios de fraude, con la finalidad de que el auditor ejecute el encargo y pueda presentar el informe final a las autoridades de la institución, asimismo ellas puedan transparentar el uso de los fondos públicos en su administración. La metodología empleada en la investigación fue bajo un enfoque hipotético deductivo, combinando hechos de observancia general a fin de desarrollar un caso particular, con el propósito de identificar cómo a través de la aplicación de procedimientos de auditoría forense en los ii proyectos con fondos públicos es posible la detección de fraude, además de identificar las actividades que dan lugar a ello, lo cual servirá como base para su prevención. Se evidencia que en las instituciones gubernamentales existe una deficiencia en cuanto a los controles aplicados en la ejecución del proyecto, a pesar de que en El Salvador se cuenta con una regulación especial para normar las compras públicas, la mecánica interna de cada institución pública se basa en la aplicación de controles, sin embargo; carecen del enfoque detectivo que puede aportar el empleo de una auditoría forense. Al analizar y comprender las opiniones de profesionales que han ejercido como auditores forenses, tanto en el sector público y privado, fue posible situarse en la problemática de estudio, de esta manera se logró concretar una propuesta de auditoria forense, en la cual los procedimientos a ejecutar son diseñados en específico para el caso establecido, permitiendo que su realización pueda ser de utilidad al profesional forense al ejecutar un encargo de este tipo

Multiparametric Study of Antioxidant Effect on Ram Sperm Cryopreservation—From Field Trials to Research Bench

The optimization of sperm cryopreservation protocols in ram is a feasible tool to reinforce artificial insemination technologies considering the desirable application of sperm by vaginal/cervical or transcervical deposition. Cryopreservation provokes different types of damage on spermatozoa and many of these detrimental effects are triggered by redox deregulation. For this reason, the antioxidant supplementation in sperm cryopreservation protocols to decrease reactive oxygen species (ROS) levels and to equilibrate redox status has been widely employed in different species. Despite this, more fertility trials are necessary to provide the definitive tool to ensure the antioxidant effectiveness on sperm quality. For this reason, in this work, we performed a multiparametric analysis of some previously tested antioxidants (crocin, GSH and Trolox) on ram sperm cryopreservation from field trials to sperm quality analyses focused on new strategies to measure redox balance. Attending to fertility trial, Trolox supplementation registered an improvement concerning to fertility (when we considered high fertility males) and multiple lambing frequency and other complementary and descriptive data related to lambing performance such as prolificacy and fecundity. This positive effect was more evident in multiple lambing frequency when we considered low fertility males than in global male analysis. In vitro analyses of sperm quality confirmed in vivo trials registering a positive effect on sperm viability and redox balance. In this study, we provided the definitive evidence that the role of trolox on redox balance maintenance has a direct effect on fertility parameters, such as prolificacy. The effectiveness of antioxidant treatments was tested, for the first time in ovine species, using an integrative and multiparametric approach combining in vivo and in vitro analyses and novel approaches, such as RedoxSYS. These types of strategies should be applied to improve sperm conservation methods and optimize AI technologies upgrading the correlation between in vitro and in vivo analyses.SIFunding: This work was financially supported by the Junta de Castilla y León (LE253P18) and MINECO (AGL2017-83098-R) project and the University of León.Acknowledgments: The authors acknowledge the JCyL-LE253P18 research contract and ORDEN EDU/556/2019 fellowship (Junta Castilla y León), FPU17/04142 (MCIU) and PRE2018-086400 (MEC) fellowships, Carlos Palacio Riocerezo, the ITRA-ULE technicians (Ainoa Jordán, Pedro de Vega and Cecilia Pérez), ANCHE and the staff from Ovigén

Sexual and gender-based violence in migration context: Needs, gaps and good practices

The first goal of the present work was to identity needs and gaps in interventions for migrant and refugee victims of sexual and gender-based violence (SGBV) in Spain. The second goal was to develop a guide for itineraries, resources and good practices to address the gaps detected. To produce data pertaining to the first purpose, we used a qualitative approach and focus groups (FGs) with institutional operators and representatives of the Third Sector. In total, six FGs were conducted with 35 key informants. The results of the study showed that existing services and resources are, in general, sufficient to cover the needs of the target group. However, some issues, such as excessive bureaucracy, re-victimization, difficulties regarding legal regularization, cultural barriers and the scant presence of cultural mediators were revealed. Regarding the second goal, a guide was created on the legal framework, itineraries and resources for migrant and refugee victims of SGBV, to ensure good practices and incorporate cultural mediation as an essential element to guarantee optimal use of services.El primer objetivo del presente trabajo fue identificar las necesidades y lagunas en la intervención con migrantes y refugiadas víctimas de violencia sexual y de género (VSG) en España. El segundo objetivo fue desarrollar una guía sobre los itinerarios, recursos y buenas prácticas que permitan solventar las brechas detectadas. Para la producción de datos del primer propósito nos servimos del enfoque cualitativo y la herramienta de los grupos focales con representantes institucionales y operadores del Tercer Sector. Se organizaron seis grupos focales con 35 informantes clave. Los resultados mostraron que los recursos existentes dan cobertura en gran medida a las necesidades del grupo destinatario. Sin embargo, se señalaron algunas limitaciones como la burocracia excesiva, la revictimización, las dificultades en los procesos de regularización, las barreras culturales o la escasa presencia de mediadores/as culturales. Para la consecución del segundo objetivo se partió de un análisis documental y de los datos de los grupos focales. El resultado fue una guía que aúna el marco legal, los itinerarios y los recursos destinados a personas migrantes y refugiadas víctimas de VSG; proporcionando un espacio clave para las buenas prácticas y la incorporación de la mediación cultural para garantizar el mejor aprovechamiento de los servicios

Does Size Matter? Testicular Volume and Its Predictive Ability of Sperm Production in Rams

[EN] Over the years, testicular volume has been used to evaluate the reproductive capacity of rams and the effects of different factors related to reproductive performance. The aim of this study was to determine the most suitable tool and formula to calculate testicular volume under field conditions to guarantee a more accurate determination of sperm production. First, testicles from 25 rams (n = 50) were measured in vivo and postmortem using calipers and ultrasonography during the breeding season (BS). The accurate testicular volume (ATV) was calculated through water displacement. In addition, the sexual status of donor rams was evaluated during a period of four years in a reproduction center, and the three most crucial groups in terms of genetic value and seminal collections were studied in the second part of this experiment: ER-NBS (Elite rams during the non-breeding season), ER-BS-S (Elite rams with a standard frequency of seminal collection), and ER-BS-O (Elite rams with a high frequency of seminal collection). The total testicular volume (TTV), testosterone (T), and total spermatozoa obtained from two consecutive ejaculates in the same day (SPERM) were measured, and the relationship between SPERM and TTV and T was analyzed to predict SPERM. Although all published formulas revealed statistically significant differences (p ≤ 0.05) from the ATV, our proposed formula (ItraULE) (Testicular volume = L × W × D × 0.61) did not show significant differences. In the second part of the study, in the ER as a model donor ram for its high genetic value and high demand from farmers, TTV and T showed strong positive correlations with SPERM (r = 0.587, p = 0.007 NBS; r = 0.684, p = 0.001 BS-S; r = 0.773, p < 0.0001 BS-O). Moreover, formulas were established to predict SPERM in these practical scenarios. In conclusion, the use of ultrasonography and a new formula adapted to rams could improve the prediction of SPERM considering crucial factors such as season and semen collection frequencySIThis research was funded in part by Ministerio de Ciencia e Innovación, PID2021-122470OBI00/ AEI/10.13039/501100011033/FEDER, UE, Junta de Castilla y León, LE253P18, and Universidad de León. The APC was funded by Ministerio de Ciencia e Innovación, PID2021-122470OB-I00. R.M.-G. was supported by Junta de Castilla y León (through the Consejería de Educación and FSE PO 1420–CyL, fellowship ORDEN EDU/556/2019), M.N.-M. was supported by MEC (fellowship FPU17/04142), and C.P.-M. was supported by MINECO (PRE2018-086400

Morphological and ultrasonographic characterization of the three zones of supratesticular region of testicular artery in Assaf rams

[EN] To fully understand the histological, morphometrical and heamodynamic variations of different supratesticular artery regions, 20 mature and healthy Assaf rams were examined through ultrasound and morphological studies. The testicular artery images of the spermatic cord as shown by B-mode analysis indicated a tortuous pattern along its course toward the testis, although it tends to be less tortuous close to the inguinal ring. Doppler velocimetric values showed a progressive decline in flow velocity, in addition to pulsatility and vessel resistivity when entering the testis, where there were significant differences in the Doppler indices and velocities among the different regions. The peak systolic velocity, pulsatility index and resistive index were higher in the proximal supratesticular artery region, followed by middle and distal ones, while the end diastolic velocity was higher in the distal supratesticular region. The total arterial blood flow and total arterial blood flow rate reported a progressive and significant increase along the testicular cord until entering the testis. Histological examination revealed presence of vasa vasorum in the tunica adventitia, with their diameter is higher in the proximal supratesticular zone than middle and distal ones. Morphometrically, the thickness of the supratesticular artery wall showed a significant decline downward toward the testis; meanwhile, the outer arterial diameter and inner luminal diameter displayed a significant increase distally. The expression of alpha smooth muscle actin and vimentin was higher in the tunica media of the proximal supratesticular artery zone than in middle and distal ones.SIThe authors acknowledge the staff members and technicians of Comparative Anatomy and Pathology Department, and Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, León University, Spain, and specially Professor P de Paz for their great help in the practical and laboratory parts of this study. Many thanks are extended to staff member of Anatomy and Embryology Department, Faculty of Veterinary Medicine, Sohag University, for their help with histological and morphometrical analyses. We are thankful and grateful for European Union for the financial support of this study through the project (ERASMUS+ KA107 2019/2020). This work was financially supported by the Junta de Castilla y León (LE253P18) and MINECO (AGL2017-83098-R) project and the University of León, and also by Sohag University, Egypt.This article was funded by Ministerio de Economía, Industria y Competitividad, Gobierno de España (AGL2017-83098-R) and Junta de Castilla y León (LE253P18)

Molecular markers of endometrial carcinoma detected in uterine aspirates.

Endometrial cancer (EC) is the most frequent of the invasive tumors of the female genital tract. Although usually detected in its initial stages, a 20% of the patients present with advanced disease. To date, no characterized molecular marker has been validated for the diagnosis of EC. In addition, new methods for prognosis and classification of EC are needed to combat this deadly disease. We thus aimed to identify new molecular markers of EC and to evaluate their validity on endometrial aspirates. Gene expression screening on 52 carcinoma samples and series of real-time quantitative PCR validation on 19 paired carcinomas and normal tissue samples and on 50 carcinoma and noncarcinoma uterine aspirates were performed to identify and validate potential biomarkers of EC. Candidate markers were further confirmed at the protein level by immunohistochemistry and Western blot. We identified ACAA1, AP1M2, CGN, DDR1, EPS8L2, FASTKD1, GMIP, IKBKE, P2RX4, P4HB, PHKG2, PPFIBP2, PPP1R16A, RASSF7, RNF183, SIRT6, TJP3, EFEMP2, SOCS2 and DCN as differentially expressed in ECs. Furthermore, the differential expression of these biomarkers in primary endometrial tumors is correlated to their expression level in corresponding uterine fluid samples. Finally, these biomarkers significantly identified EC with area under the receiver-operating-characteristic values ranging from 0.74 to 0.95 in uterine aspirates. Interestingly, analogous values were found among initial stages. We present the discovery of molecular biomarkers of EC and describe their utility in uterine aspirates. These findings represent the basis for the development of a highly sensitive and specific minimally invasive method for screening ECs