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Innovation is widely regarded as a key factor for the economic development and competitiveness of companies and countries. It is, therefore, widely considered a policy instrument in various sectors, such as agriculture. In this sector, agricultural innovation is seen as a systemic and interactive phenomenon, which is the result of interactions between innovators and knowledge-generating organisations, as well as social and economic aspects of the context. This paper studies the social structures of multi-actor partnerships involved in interactive innovation processes in agricultural innovation systems, analysing the type of actors involved and the roles they play in the innovation process. For this purpose, 17 case studies were analysed in the framework of the Liaison project, an H2020 project, using social network analysis (SNA) and descriptive statistics. The results show that the studied multi-actor partnerships have been mostly funded by outside sources of funding, highlighting European funds. The innovation networks have a heterogeneous composition, but when we analyse the frequency of interactions there is a tendency to establish greater interaction between organisations that are of the same type. In the “core” of innovation networks, research entities and farmers are central actors with the main role of technician expert and case study field workers, respectively.

La pandemia COVID-19 desestructuró las cadenas mundiales de suministros agroalimentarios, afectando a todas las empresas rurales locales. Con este trabajo, se propone resignificarlas como estructuras sociales generadoras de capacidades hetero-reactivas de vinculación e innovación social, con el objetivo de buscar estrategias de recuperación del tejido social de las economías locales rurales. Para esto, se utilizó el análisis de redes sociales. Los resultados evidenciaron distintas composiciones en las fuentes de recursos e insumos sociales. Se concluyó que estas estructuras de vinculación permiten identificar estrategias de resiliencia para el sector agroalimentario mexicano.

La gestion del agua en El Salvador es un territorio social de disputa entre la normativa neoliberal y la dinamica autogestiva de las comunidades. En este contexto, la calidad del agua se define como una construccion social determinada por el tiempo y ambito social de los consumidores, por lo que la apropiacion y monitoreo de su calidad es un espacio de conformacion de ciudadania. El analisis comparativo de los datos obtenidos en los anos 2008 y 2017 en Las Vueltas, Chalatenango, en El Salvador, permitio comprender la evolucion de un sistema de agua autogestionado a partir de la percepcion directa de la poblacion usuaria de la calidad de dicho sistema. Los resultados indican que el aumento en la calidad de la cobertura del servicio de agua es proporcional a la percepcion del aumento de la inversion publica en el mejoramiento de los sistemas de agua; sin embargo, la calidad del liquido distribuido tanto en centros urbanos como rurales ha ido mermando. Estos hallazgos coinciden con la tendencia nacional que indica que pese a la mejoria en la cobertura, los problemas de acceso y calidad del agua impactan diferencialmente a la poblacion, agudizandose en las areas rurales.

La gestión del agua en El Salvador es un territorio social de disputa entre la normativa neoliberal y la dinámica autogestiva de las comunidades. En este contexto, la calidad del agua se define como una construcción social determinada por el tiempo y ámbito social de los consumidores, por lo que la apropiación y monitoreo de su calidad es un espacio de conformación de ciudadanía. El análisis comparativo de los datos obtenidos en los años 2008 y 2017 en Las Vueltas, Chalatenango, en El Salvador, permitió comprender la evolución de un sistema de agua autogestionado a partir de la percepción directa de la población usuaria de la calidad de dicho sistema. Los resultados indican que el aumento en la calidad de la cobertura del servicio de agua es proporcional a la percepción del aumento de la inversión pública en el mejoramiento de los sistemas de agua; sin embargo, la calidad del líquido distribuido tanto en centros urbanos como rurales ha ido mermando. Estos hallazgos coinciden con la tendencia nacional que indica que pese a la mejoría en la cobertura, los problemas de acceso y calidad del agua impactan diferencialmente a la población, agudizándose en las áreas rurales.

Objetivos: analizar la emergencia de la agroecología como una narrativa glotopolítica agroalimentaria en América Latina. Metodología: se seleccionaron investigaciones sobre agroecología publicadas entre 2011 y 2018 y se deconstruyeron a través de un acercamiento lexicométrico para distinguir conceptos superlativos agroecológicos por medio de nubes semánticas. Resultados: se obtuvieron torrentes semánticos a nivel de regiones y países, que mostraron la complejidad sistémica de la agroecología latinoamericana. Limitaciones: se requieren más instrumentos metodológicos para ampliar el análisis semántico. Valor: el acercamiento a la complejidad semántica agroecológica de América Latina usando consorcios epistemológicos diversos es pertinente en estos tiempos en que la agroecología emerge dentro de las narrativas institucionales de reguladores globales del sistema agroalimentario. Conclusiones: el campo semántico de la agroecología es un área de contingencias entre una plétora de actores sociales locales, regionales y globales que luchan por determinar la propia narrativa de la sustentabilidad del sistema agroalimentario y, por lo tanto, incidir en la biopolítica mundial.

El capitalismo neoliberal rebasó la verosimilitud sustentable de los biotopos, generando disfuncionalidades eco-sistémicas climático-glocales, y desestructurando los sistemas agroalimentarios. Ante tal escenario, la agroecología emerge como un campo de análisis, a raíz de su codificación como concepto del sistema internacional ONU-FAO, para implementar una agenda mundial para el desarrollo y la seguridad alimentaria. Esto apunta a generar un rizoma social dinamizado por innumerables actores locales que buscan reconvertir al sistema agroalimentario convencional, en sistema agroecológico. Lo anterior expone la necesidad de discutir el campo semántico de la agroecología, como un relato planteado ante dos posibles vías: como una semántica y praxis decolonizadora devenida en espacio polisintético de una gramática social contestataria, o como versión desarraigada y despolitizada de un mainstream extractivista agroalimentario emergente, vulnerador de derechos. Ante esto ¿Es posible que la agroecología logre "desguazar" la cuestionada epistemología de la agricultura neoliberal y proponga una alternativa más promisoria? La pandemia COVID-19 expuso la fragilidad de los sistemas agroalimentarios globales, así como la urgencia de responder a dichos cuestionamientos. Para esto, se analizaron superlativos conceptuales, presentes en investigaciones agroecológicas, como parte de semánticas manifestadas durante la década 2010-2020 en dicho campo, y como una muestra acotada del pensamiento agroecológico en Latinoamérica. The neoliberal capitalism exceeded the sustainable boundaries of biotopes, generating eco-systemic dysfunctionalities, and deconstructing agri-food systems. In front of such scenario, agroecology emerges as analysis field, as a result of its codification, as a concept of the UN-FAO international system, to implement a worldwide agenda for development and food security. This aims to generate a social rhizome by innumerable local actors who seek to re-convert the conventional agri-food system into an agro ecological system. The latest exposed the need to analyze the agroecology's semantic as a modernity story in front of two possible paths: become a decolonizing semantics and representative of a contestatory social grammar, or become in an uprooted and depoliticized version of an agri-food extractivist mainstream violator of rights. Given this, is possible that agroecology manages to "scrap" the neoliberal agriculture epistemology and propose a more promising alternative? Problems, as the COVID-19, exposed the high fragility of the global agri food systems, thus the immediately urgency to look for concrete answers. To do this, conceptual superlatives present in agroecological researchs were analyzed as part of different agroecology semantics expressed, along the decade 2010-2020, and as a bounded sample of agroecological thinking in Latin America.

RESUMEN: El objetivo del presente estudio es analizar los efectos de la actividad locomotriz voluntaria gestacional, como un tipo de entrenamiento físico, sobre la morfología de la bomba cardíaca de la cría, en modelo murino de la cepa CF-1. 12 hembras gestantes fueron divididas aleatoriamente en un grupo control y un grupo que realizó actividad locomotriz voluntaria, accediendo a una rueda de actividad durante los primero 12 días de gestación. Se evaluó la morfología cardiaca mediante cortes transversales, midiendo espesor y área de las paredes del ventrículo derecho, ventrículo izquierdo y septum, tanto en valores absolutos como en valores relativos a la masa corporal del individuo. Se observó que la masa corporal de las crías control (GC) fue significativamente mayor que las del grupo cuyas hembras accedieron a la rueda de actividad (GE) (p

There are multisystemic consequences secondary to SARS- CoV-2 infection.To characterize neurological complications in patients admitted due to SARS-CoV-2 infection.Review of medical records of patients aged over 15 years with COVID-19 evaluated by the neurology team between April and August 2020 at a university hospital. Severity of the infection, referral reasons, neurological diagnoses and laboratory results were registered. The diagnoses were defined by consensus among the members of the hospital neurology group. Cerebrovascular and inflammatory diseases of the central and peripheral nervous system were defined as "probably associated" or "possibly associated" to COVID-19.Ninety-six patients had at least 1 new neu- rological complication. 74% were admitted due to pneumonia and 20% due to a neurological disease. The most common reasons for neurological referral were impaired consciousness (39%), focal neurological deficit (24%), headache (9%) and seizures (5%). The most relevant neurological diagnoses were delirium in 48 patients, stroke in 24, critical illness polyneuropathy and myopathy in 17, seizures in 14, brachial plexopathy in 3, compressive neuropathies in 5, encephalitis in 1, possible vasculitis in 1 and Guillain-Barré syndrome in 1. Stroke and epilepsy were associated with increased length of hospital stay, but without differences in mortality.The spectrum of neurological complications of COVID-19 is wide. There are clinical entities typical of critically ill patients and also diseases associated directly and indirectly with the SARS-CoV2 infection.

Spanish Abstract: La resiliencia social es un proceso multiorganizacional que involucra capacidades de innovacion, soporte, proteccion y recuperacion, en comunidades e instituciones. Aqui se presenta el analisis del Colegio de Postgraduados, como una experiencia institucional y de vinculacion academica. El objetivo principal fue determinar sus capacidades de resiliencia, desde el actuar de cada uno de sus miembros como comunidad. Se utilizo el enfoque de redes sociales, analizando las actividades de colaboracion academica reportadas por el 86% de la poblacion docente de la institucion. Se obtuvo una valiosa informacion sobre la capacidad resiliente de este tipo de instituciones en Mexico, de las dinamicas sociales involucradas en su construccion, asi como una perspectiva general sobre la posibilidad de gestionar los capitales intelectuales institucionales. English Abstract: Social resilience is a multi-organizational process that involves innovation, support, protection and recovery capacities, from communities and institutions. Here we present the analysis of Colegio de Postgraduados, as an institutional experience of academic linkage. The principal goal was determine its resilience capacities, derived from each of its members like community. The social networks approach was used, analyzing the academic collaboration activities reported by 86% of the teaching population. It was got an invaluable information, about resilience capacities from this kind of Mexican institution, concerning the social dynamics involved in their generation, as well a point of view dealing with the management possibilities of this intellectual capital at the research institutions.

The guerrillas are social phenomena and expressions of our societies. According to their social and human composition, the guerrillas offers two perspectives: a) they have inside of themselves a sociocultural complexity which it is very difficult to analyze, because the data an information about that is not always available, b) each guerrilla is a social and organic structure organized to generated a local war strategy. Therefore each Guerrilla is integrated through reticulated dynamics that make them capable of being reviewed by the Social Network Analysis. In this context, the FMLN guerrilla was monitored by the army of El Salvador, between July and August 1987, getting information about it´s social composition and some dynamics of association between member and organizations that were part of the movement., Las guerrillas son fenómenos sociales y expresiones de nuestras sociedades que, de acuerdo a su composición social y humana, ofrecen dos perspectivas: a) una complejidad sociocultural y política interna que es muy difícil de analizar, dada la poca información disponible, y b) es una estructura social y orgánica orientada hacia la generación de una estrategia de guerra local. Cada Guerrilla se integra a través de dinámicas reticulares que las vuelven susceptibles de ser analizadas por medio del Análisis de Redes Sociales. En este contexto, la guerrilla del FMLN fue monitoreada por el ejército salvadoreño entre julio y agosto de 1987, levantando información sobre su composición social y algunas dinámicas de asociación entre miembros y organizaciones que conformaron a dicho movimiento.

Latin America systematic breakdown processes are being approached by a myriad of researchers coming from different places of the region, users of a complex diversity of epistemological frameworks. This allows the observation of common interests: social, economic, political, cultural and environmental vulnerability processes. This work purpose is to develop a conceptual map, from the papers presented in the 9th ALASRU Congress (Mexico City, 2014), through social network analysis, in order to synthetize the reticular construction in Latin America of development and sociology discourse and group it at a “glocal” level, per region, institution and researcher. This was done by analyzing two types of co-occurrences: words from a given text and actor per words. This allowed to restructure (in semantic terms) every and each abstract presented in the Congress, regarding their concepts and grammatical connectors, which generated a casual grid for each paper discourse.

Endothelial dysfunction is crucial in endotoxaemia-derived sepsis syndrome pathogenesis. It is well accepted that lipopolysaccharide (LPS) induces endothelial dysfunction through immune system activation. However, LPS can also directly generate actions in endothelial cells (ECs) in the absence of participation by immune cells. Although interactions between LPS and ECs evoke endothelial death, a significant portion of ECs are resistant to LPS challenge. However, the mechanism that confers endothelial resistance to LPS is not known. LPS-resistant ECs exhibit a fibroblast-like morphology, suggesting that these ECs enter a fibrotic programme in response to LPS. Thus, our aim was to investigate whether LPS is able to induce endothelial fibrosis in the absence of immune cells and explore the underlying mechanism. Using primary cultures of ECs and culturing intact blood vessels, we demonstrated that LPS is a crucial factor to induce endothelial fibrosis. We demonstrated that LPS was able and sufficient to promote endothelial fibrosis, in the absence of immune cells through an activin receptor–like kinase 5 (ALK5) activity–dependent mechanism. LPS-challenged ECs showed an up-regulation of both fibroblast-specific protein expression and extracellular matrix proteins secretion, as well as a down-regulation of endothelial markers. These results demonstrate that LPS is a crucial factor in inducing endothelial fibrosis in the absence of immune cells through an ALK5-dependent mechanism. It is noteworthy that LPS-induced endothelial fibrosis perpetuates endothelial dysfunction as a maladaptive process rather than a survival mechanism for protection against LPS. These findings are useful in improving current treatment against endotoxaemia-derived sepsis syndrome and other inflammatory diseases.

Las comunidades de investigadores en el mundo son de los pocos conglomerados que están permanentemente abiertos, en y con su entorno; por lo tanto ofrecen información valiosa sobre su génesis, desarrollo y prospectiva, y tal vez indicios de posibles paradigmas que estén, en forma embrionaria, generándose en el interior de dichos colectivos. Si bien el ARS es un enfoque que se ha venido desarrollando poco a poco durante los últimos 50 años, en la actualidad se puede observar, alrededor de este tema, una comunidad de investigadores en ciernes, buscando su propio proceso de maduración en las ciencias sociales. Una de las vías de búsqueda de este grupo es la construcción reticular dada a través del intercambio de insumos de conocimiento que se ha generado entre sus miembros por medio de diversos canales, por ejemplo, el uso de las llamadas TIC´s. En esta dirección, conviene llamar la atención sobre este tipo de comunidades nuevas que intentan construir una plataforma de conocimiento al interior de una de las disciplinas que se ha caracterizado, por norma y obligatoriedad, deconstruir continuamente el trabajo epistemológico., Research communities in the world are among the few social conglomerates that are permanently open with their surroundings, therefore they offer valuable information about its origins, development and future, and probably evidence about possible scientific paradigms that are in embryonic form in such groups. Although NSA is an approach that has been developed over the last 50 years, actually is possible see, around this topic, a budding research community which is looking its own maturation process in the social sciences. One way to search for this group is with the lattice construction through exchange of knowledge´s inputs that were generated among its members with the help of different social channels and the use of information and communication technologies. In this direction, it should draw attention to these new communities trying to build a platform of knowledge within a discipline that has been characterized as a deconstructor of the epistemological work.

Introduction Preeclampsia (PE) is an often fatal cardiovascular complication related to pregnancy with no current effective way of treatment. Evidence of early increased circulating anti-angiogenic factors (AAFs) support the onset of a multi-systemic disorder and widespread maternal endothelial dysfunction in PE. However, the molecular mechanisms are still not well understood. Objectives To determine the potential early metabolic perturbations and mitochondrial bioenergetics effects of sFlt-1 in bovine aortic endothelial cells (ECs) and first trimester extravillous trophoblasts (HTR-8/SVneo). Also, to evaluate the potential use of sepiapterin (SE), a precursor of eNOS’s cofactor tetrahydrobiopterin (BH4), in abrogating the effects of sFlt-1 in cells. Methods Metabolic perturbations and mitochondrial bioenergetics were assessed in ECs and HTR-8/SVneo in an in-vitro model of preeclampsia using exogenous sFlt-1 and serum from preeclamptic women. Mitochondrial bioenergetics was assessed using an XFe24 Extracellular Flux Analyzer. Nitric oxide (NO) was determined by chemiluminescence. Mitochondrial function and metabolism in sFlt-1-treated cells was evaluated also in galactose media. Mitochondrial membrane potential and superoxide was evaluated by JC-1 and Mito-Sox, respectively, by flow cytometry. Results We found that treatment with sFlt-1 affected the mitochondrial maximal respiration and spare respiratory capacity in ECs in a dose dependent manner leading to a metabolic phenotype switch to glycolysis. In contrast, HTR-8/SVneo, displayed an unexpected strong glycolytic metabolism. sFlt-1 was found not to disturb the trophoblast mitochondrial metabolic and bioenergetics profile even at relatively high doses. In addition, we found that sFlt-1 treatment caused concentration dependent decreases in mitochondrial membrane potential and diminished NO levels in ECs. Moreover, treatment of ECs with sFlt-1 in galactose strongly impaired cell viability suggesting the role of sFlt-1 as a mitochondrial disruptor. SE, protected ECs and HTR8/SVneo cells from sFlt-1-induced superoxide formation and restored the NO levels and metabolic phenotype switch induced by sFlt-1 and maternal PE serum in ECs. Conclusions sFlt-1 disrupts mitochondria bioenergetics and metabolism in both, ECs and HTR-8/SVneo. This evidence could explain the potential detrimental effects of AAFs in the maternal endothelium and the hallmark of hypertension in PE. Hence, we demonstrate that SE, by enhancing BH4/NO bioavailability and diminish mitochondrial superoxide formation, restored the metabolic phenotype switch induced by sFlt-1 and PE serum. Based on this evidence, we postulate the use of SE as a potential therapeutic approach to prevent or treat PE.

Los Grupos Ganaderos de Validación y Transferencia de Tecnología (GGAVATT), se han evaluado en términos técnicos, productivos y económicos, pero existen pocos estudios sobre los aspectos sociales que influyen en la adopción de tecnología. Esta investigación tuvo como objetivo conocer los cambios en la estructura de la red, en las interacciones sociales y las características socioeconómicas de los productores que implementaron el modelo GGAVATT y su relación con la adopción de tecnología. La hipótesis planteada fue que los cambios en la adopción de tecnología en productores que implementaron los GGAVATT están influenciados por cambios en la estructura de la red, las interacciones sociales y las características socioeconómicas. Se entrevistó a 26 productores de los GGAVATT "Tepetzintla", "Vía Corta" y "Caprinocultores Unidos Región Montañosa de Veracruz". Se encontró que la adopción de tecnología estuvo asociada al incremento del tamaño de la red e interacciones sociales, y con pocos cambios en los actores centrales. La adopción de tecnología se asocia positivamente con la educación, y es inversamente proporcional a la edad de los productores; y está influenciada por la escala de producción y manejo. Se concluye que el modelo GGAVATT dinamizó la adopción de tecnología, incrementando la red e interacciones sociales, proceso influenciado por las características socioeconómicas y técnico productivas.

Success in cancer chemotherapy is based on the selectivity of some drugs to induce tumor cell death without affecting normal cells. In that respect, some metal-based drugs appear to be promising in the development of efficient anticancer agents. Here, we evaluate the efficacy of the anionic hexa-iodo rhenium selenide cluster, Re6Se8I63−, which was predicted some years ago to be luminescent, to selectively increase tumor cell death, leaving non-tumoral cells unaffected. Thus, here we explore its intracellular localization by taking advantage of its revealed luminescence. Comparative studies of the cytotoxic effects of the Re6Se8I63− cluster when exposed to the tumorigenic cell line HepG2, endothelial cell-derived cell line (EA cells) and non-tumor primary endothelial cells (HUVEC) revealed that the cytotoxicity was highest for HepG2 and lowest for HUVEC. In addition, cells tend to uptake the cluster into their nuclei, where we found significant evidence of direct non-intercalating DNA binding. Finally, DNA laddering experiments suggested that the cluster induced apoptotic-like cell death. Our results suggest that the Re6Se8I63− cluster could be useful for the development of novel and efficient metal-based antitumor drugs for the diagnosis and treatment of cancers. The findings reported here represent the first attempts of a new and exciting field of research of inorganic multinuclear clusters in cancer research.

To assess the mechanisms involved in lipopolysaccharide (LPS)-induced neuronal cell death, we examined the cellular consequences of LPS exposure in differentiated PC12 neurons and primary hippocampal neurons.Our data show that LPS is able to induce PC12 neuronal cell death without the participation of glial cells. Neuronal cell death was mediated by an increase in cellular reactive oxygen species (ROS) levels. Considering the prevalent role of specific ion channels in mediating the deleterious effect of ROS, we assessed their contribution to this process. Neurons exposed to LPS showed a significant intracellular Ca(2+) overload, and nonselective cationic channel blockers inhibited LPS-induced neuronal death. In particular, we observed that both LPS and hydrogen peroxide exposure strongly increased the expression of the transient receptor protein melastatin 7 (TRPM7), which is an ion channel directly implicated in neuronal cell death. Further, both LPS-induced TRPM7 overexpression and LPS-induced neuronal cell death were decreased with dithiothreitol, dipheniliodonium, and apocynin. Finally, knockdown of TRPM7 expression using small interference RNA technology protected primary hippocampal neurons and differentiated PC12 neurons from the LPS challenge.This is the first report showing that TRPM7 is a key protein involved in neuronal death after LPS challenge.We conclude that LPS promotes an abnormal ROS-dependent TRPM7 overexpression, which plays a crucial role in pathologic events, thus leading to neuronal dysfunction and death.

Aims Endothelial dysfunction is decisive in the progression of cardiovascular diseases. Lipopolysaccharide (LPS)-induced reactive oxygen species (ROS)-mediated endothelial cell death is a main feature observed in inflammation secondary to endotoxaemia, emerging as a leading cause of death among critically ill patients in intensive care units. However, the molecular mechanism underlying LPS-induced endothelial cell death is not well understood. Transient receptor protein melastatin 4 (TRPM4) is an ion channel associated with cell death that is expressed in endothelium and modulated by ROS. Here, we investigate the role of TRPM4 in LPS-induced endothelial cell death, testing whether suppression of the expression of TRPM4 confers endothelial cell resistance to LPS challenge. Methods and results Using primary cultures of human umbilical vein endothelial cells (HUVEC), we demonstrate that TRPM4 is critically involved in LPS-induced endothelial cell death. HUVEC exposed to LPS results in Na+-dependent cell death. Pharmacological inhibition of TRPM4 with 9-phenanthrol or glibenclamide protects endothelium against LPS exposure for 48 h. Furthermore, TRPM4-like currents increase in cells pre-treated with LPS and inhibited with glibenclamide. Of note, suppression of TRPM4 expression by siRNA or suppression of its activity in a dominant negative mutant is effective in decreasing LPS-induced endothelial cell death when cells are exposed to LPS for 24–30 h. Conclusion TRPM4 is critically involved in LPS-induced endothelial cell death. These results demonstrate that either pharmacological inhibition of TRPM4, suppression of TRPM4 expression, or inhibition of TRPM4 activity are able to protect endothelium against LPS injury. These results are useful in sepsis drug design and development of new strategies for sepsis therapy.

Antiretroviral therapy (ART) administered to pregnant women infected with HIV diminishes the rate of perinatal viral transmission. This is true for mono-, bi-, or tri-therapy (HAART), with the greatest effects being seen in the latter case. Nevertheless, when these therapies are employed, potential risks to the mother and fetus must be considered. These risks include hyperglycemia, lactic acidosis, mitochondrial toxicity, cutaneous rash, hepatitis, hypertension, and premature labor. Elective caesarean section reduces the perinatal transmission of HIV in patients with or without monotherapy, but has not shown a benefit in patients on tri-therapy (HAART). This article reviews the evidence for and against antiretroviral therapy and elective caesarean section in the setting of HIV in pregnancy and proposes treatment guidelines for these patients.

La terapia anti-retroviral utilizada durante el embarazo en madres infectadas con VIH disminuye la transmisión perinatal del virus. Esto es válido para mono, bi y tri-terapia (HAART), siendo mayor el efecto de esta última. Sin embargo, cuando se utilizan dichas terapias se debe tener en consideración riesgos potenciales para la madre e hijo (hiperglicemia, acidosis láctica, toxicidad mitocondrial, rash cutáneo, daño hepático, síndrome hipertensivo y parto prematuro). La operación cesárea electiva reduce la transmisión perinatal del virus en pacientes sin terapia o monoterapia. Con tri-terapia este beneficio no está demostrado. Este artículo revisa la evidencia de efectos benéficos y adversos de la terapia anti-retroviral y de la operación cesárea y propone una pauta de manejo de las pacientes infectadas con VIH en el embarazo [Human immunodeficiency virus (HIV) infection in pregnancy: antiretroviral treatment (ART) and mode of delivery] Antiretroviral therapy (ART) administered to pregnant women infected with HIV diminishes the rate of perinatal viral transmission. This is true for mono-, bi-, or tri-therapy (HAART), with the greatest effects being seen in the latter case. Nevertheless, when these therapies are employed, potential risks to the mother and fetus must be considered. These risks include hyperglycemia, lactic acidosis, mitochondrial toxicity, cutaneous rash, hepatitis, hypertension, and premature labor. Elective caesarean section reduces the perinatal transmission of HIV in patients with or without monotherapy, but has not shown a benefit in patients on tri-therapy (HAART). This article reviews the evidence for and against antiretroviral therapy and elective caesarean section in the setting of HIV in pregnancy and proposes treatment guidelines for these patients.

Diseñar un método que seleccione con cierta confiabilidad entre tumores benignos y malignos, de estos últimos poder seleccionar cuales verdaderamente requieren otros exámenes complementarios o de extensión.