Notes

Intestinal tract organoid-based 2nd monolayers mimic biological and pathophysiological components of the this halloween intestinal tract.
In optimal and stable responders, a policy of intermittent imatinib treatment is feasible, is successful in about 50% of patients and is safe, as all the patients who relapsed could be brought back to optimal response.Lysozyme is an antimicrobial peptide with a high enzymatic activity and positive charges. Therefore, it has applications in food and pharmaceutical industries as an antimicrobial agent. Lysozyme is ubiquitous in both animal and plant kingdoms. Currently, egg-white lysozyme is the most commercially available form of lysozyme. The main concerns of egg-white lysozyme are high recovery cost, low activity and most importantly the immunological problems to some people. Therefore, human lysozyme production has gained importance in recent years. Scientists have developed transgenic plants, animals and microorganisms that can produce human lysozyme. Out of these, microbial production has advantages for commercial productions, because high production levels are achievable in a relatively short time. It has been reported that fermentation parameters, such as pH, temperature, aeration, are key factors to increase the effectiveness of the human lysozyme production. Moreover, purification of the lysozyme from the fermentation broth needs to be optimized for the economical production. In conclusion, this review paper covers the mechanism of lysozyme, its sources, production methods and recovery of lysozyme.Aluminum nanocrystals and fabricated nanostructures are emerging as highly promising building blocks for plasmonics in the visible region of the spectrum. Even at the individual nanocrystal level, however, the localized plasmons supported by Al nanostructures possess a surprisingly broad spectral response. We have observed that when an Al nanocrystal is coupled to an underlying Al film, its dipolar plasmon resonance linewidth narrows remarkably and shows an enhanced scattering efficiency. This behavior is observable in other plasmonic metals, such as gold; however, it is far more dramatic in the aluminum nanoparticle-film system, reducing the dipolar plasmon linewidth by more than half. A substrate-mediated hybridization of the dipolar and quadrupolar plasmons of the nanoparticle reduces the radiative losses of the dipolar plasmon. While this is a general effect that applies to all metallic nanoparticle-film systems, this finding specifically provides a new mechanism for narrowing plasmon resonances in aluminum-based systems, quite possibly expanding the potential of Al-based plasmonics in real-world applications.This document presents four stages in the history of the Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century) of the Instituto Mexicano del Seguro Social. The first stage started at the end of the third decade of the twentieth century and ended in 1961, it corresponded to the conception, planning and construction of what was to be the Centro Médico del Distrito Federal (Centro Médico of the Distrito Federal) belonging to the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance). The second stage began when the Center was acquired by the Institute, then was known like Centro Médico Nacional (Centro Médico Nacional ), being put into full operation in 1963, more than twenty-two years later, in 1985, an earthquake virtually ended it, immediately began its reconstruction, finishing the second stage. In 1989 began the third stage, different and new buildings complemented or replaced the structures damaged or destroyed by the earthquake which formed the now Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century). In 2004 the fourth stage opened when the four hospitals of the Center were categorized like Unidades Médicas de Alta Especialidad (High Specialized Medical Units).The situs inversus totalis is a rare condition associated with multiple congenital malformations, the most common heart defects and is associated with more complex syndromes such as Kartagener. Most of the time, the defect is found after a physical examination for other reason. We reported the case of a patient diagnosed on the first day of extra-uterine life. It has been the first case reported in the state of Guerrero, with several prenatal history of interest. Our aim is to emphasize that early diagnosis completely changes the future healthcare. Reviewing the literature, it does not have any algorithm on searching protocol of congenital malformations and management attention on common pathologies.
Cochlear implant surgery has a low morbidity and mortality. Postoperative complications can be minor and major. Minor complications require conservative management; major complications require reoperation or implant removal. The aim is to determine our complications and compare them with international and Latin American series.

275 operated cases were retrospectively analyzed from December 2005 to December 2013. Children and adults between 11 months to 82 years old are included. Demographic data, unilateral or bilateral placement, type of surgery and postoperative complications were evaluated. The follow-up was made for 20 months.

The 57.46 % are children and adolescents, youth and adults are 33.81 %; and 8.73 % are seniors. The complication rate is 12 % (n = 33), 6.91 % for women and 5.09 % for men. There are more complications among 19 to 60 years old. Minor complications account for 7.6 % local infection (n = 9), delayed transient facial palsy (n = 7), vertigo (n = 3) and tinnitus (n = 2). These are prevalent in children and adults. Major complications are 4.36 % postoperative hematoma (n = 8), extrusions (n = 2) and inadequate electrode placement (n = 2). These predominate in adults among 19 to 60 years. No deaths or cases of meningitis occurred.

Cochlear implantation has a low incidence of complications. Our results, the only reported at the national level, are comparable with those mentioned in literature.
Cochlear implantation has a low incidence of complications. Our results, the only reported at the national level, are comparable with those mentioned in literature.Cardiopulmonary resuscitation of newborns with perinatal hypoxia faces serious ethical, moral, medical and legal problems, particularly in rural areas. Ethical and moral issues have to do with the medical-parents relationship; with values, preferences and priorities of each of these groups; and with the scarce resources situation. learn more Medical-technical problems are related to asphyxia complications, and their prognostic and therapeutic implications. Legal considerations arising from the fact of killing or letting die. In this article is analyzed the real case of a neonate with severe perinatal hypoxia in order to enhance the understanding of the incorporation of ethics in everyday clinical practice.
From June to November 2013 an elective subject "The doctor before death" was held in a public medical school. The aim of this report is to assess the achievement of the objectives of this course.

The main objectives of the course were to develop competences, aptitude for reflection before death and encourage changes in attitude towards it. Each session was preceded by an article on the content; during sessions the interaction with physicians and patients facing the approach of death was favored; audiovisual, computer resources were used and conducted discussions. The evaluation of the course was a retrospective questionnaire as a quantitative source, and semi structured interviews and essays as qualitative sources.

The development of competences, aptitude for reflection about death and attitude changes showed an increase after the intervention (p < 0.01); competence development had the smallest increase. With qualitative information 11 categories were integrated; all showed positive changes in attitude towards death, aptitude for reflection and developed competences (although in this respect the impact was minor).

The educational intervention evaluated met the objectives, however, for a future intervention is necessary to reinforce competence development.
The educational intervention evaluated met the objectives, however, for a future intervention is necessary to reinforce competence development.
The reorganization of the national health system (SNS), enforces reflection and transformation on medical education in clinical contexts. The study presents an educational model to develop entrusted professionals activities (MEDAPROC) to train human resources in health with reliable knowledge, skills and attitudes to work in the shifting scenario of the SNS.

The paper discusses international and national documents on skills in medicine. Based on the analysis of 8 domains, 50 skills and 13 entrusted professional activities (RPA) proposed by the Association of the American Medical College (AAMC) we propose a curriculum design, with the example of the undergraduate program of Gynecology and Obstetrics, with the intention to advance to internship and residency in a continuum that marks milestones and clinical practices.

The pedagogical design of MEDAPROC was developed within three areas 1) proposal of the AAMC; 2) curricular content of programs in pre and postgraduate education 3) organization of the daily agenda with academic mechanisms to develop the competencies, cover program items and develop clinical practice in deliberate learning activities, as well as milestones.

The MEDAPROC offers versatility, student mobility and curricular flexibility in a system planed by academic units in diverse clinical settings.
The MEDAPROC offers versatility, student mobility and curricular flexibility in a system planed by academic units in diverse clinical settings.Cesarean section has become the most performed surgery and it has been enhanced with the use of antibiotics and improvement in surgical techniques. The aim of this systematic review is to describe and clarify some historical and ethical characteristics of this surgery, pointing out some aspects about its epidemiological behavior, becoming a topic that should be treated globally, giving priority to the prevention and identification of factors that may increase the incidence rates. Today, this "epidemic" reported rates higher than fifty percent, so it is considered a worldwide public health problem. Consequently, in Mexico strategies aimed at its reduction have been implemented. However, sociocultural, economic, medicolegal and biomedical factors are aspects that may difficult this goal. As we decrease the percentage of cesarean section in nulliparous patients, we diminish the number of iterative cesarean and its associated complications. This aim must be achieved through the adherence to the guidelines which promote interest in monitoring and delivery care in health institutions of our country.In our country there is a report of prevalence of Diabetes Mellitus in the adult population of a 10%, occupying one of the first causes of morbidity-mortality, also visual and labor incapacity. Macular edema is the first cause of lost vision in the diabetic patient. There are classic methods to detect it, as the examination with biomicroscope, indirect ophthalmoscopy, fluorangiography (FAR), and the new and gold standard method for diagnostic and sequence examination, Ocular Coherence Tomography (OCT). With OCT had been possible the study of distinct types of macular edema, that could represent distinct clinical states, with specific treatments. The protocol of treatment of macular edema, continues changing. The traditional methods as metabolic control and fotocoagulation with Laser now have more options as intravitreal injection of triamcinolone, or antiangiogenic substances, even surgical treatment with vitrectomy. There are many prospective and randomized studies evaluating this methods, so until now is difficult to determine which treatment is the best.
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