The present study confirms the technical feasibility and acceptable morbidity associated with LapEn. Intra-operative lymph node sampling and frozen-section examination should be performed at the time of LapEn; when a malignancy is confirmed, oncologically appropriate lymph node dissection should be performed.

There is a variety of BIM brands present in the Latin American market, there are several questions about their performance in the Spanish language. BIM software companies with a presence in Latin America were appointed to a series of structured and sequenced workshop. At the end of each talk, a specialized audience responded to a series of structured surveys on both theoretical and practical aspects of the software presented. The demonstration consisted of two areas: one theoretical and one practical. The theory presented relevant historical attributes, brand visibility data and some known examples of its use. In the practical part, a live demonstration of the use of the basic tools and functions of the interface was requested. It was derived that: The companies fulfilled the expectation on the agenda in a dissimilar way, the responses to the surveys revealed a similar performance in general terms (modeling, prices), the workshops showed significant differences in theoretical aspects such as known examples, certification. There is a need to advance in the dissemination of the performance of the different BIM brands in the AEC industry in Latin America, the level of individual experience strongly influences the evaluation of the software, the user's profile and the type of project will determine the software to use.

Objetivo: el objetivo primario es determinar si los estudiantes de medicina de la Universidad Mayor de San Simón (UMSS) sufren de somnolencia diurna excesiva mediante el uso de la Escala de somnolencia de Epworth (ESE). Métodos: Se trata de un estudio transversal, descriptivo. Estudiantes de medicina de la UMSS completaron una encuesta la cual incluía datos demográficos, escala del sueño de Epworth traducida al español, número de horas nocturnas de sueño, siestas y uso de estimulantes del SNC durante el mes anterior a la realización de la encuesta. Resultados: el universo consistió en 1923 estudiantes y la muestra en 324 estudiantes del primer al quinto curso de carrera de medicina (5% margen de error, 95% nivel de confianza); 57% del sexo femenino, media de edad de 21 años (±2,1), la media de la escala de Epworth fue de 9 (±3,3) (95% IC 8,46-9,54); 23,6% presentó algún grado de somnolencia diurna excesiva; 67% de los estudiantes indican dormir 4-6 hrs diarias; 79% goza entre 5 – 90 minutos de siesta cada día durante el mes anterior a la encuesta; 76% reporta usar algún tipo de estimulante del sistema nervioso central.  Conclusiones: un porcentaje menor pero relevante de estudiantes de medicina de la UMSS tiene algún grado de somnolencia diurna excesiva. Este menor porcentaje puede deberse al uso de siestas; habito comúnmente practicado en nuestro país.

Emergency total gastrectomy for patients with gastric cancer who are in shock carries a high risk of esophagojejunal anastomosis leakage. No alternatives have been reported to reduce this risk. This study reports two patients with gastric cancer who were in shock and underwent emergency gastrectomy and two-stage esophagojejunal anastomosis with good results. In the first stage, immediately after gastrectomy, the esophagus was attached to a Roux-en-Y jejunal loop that prevented retraction of the esophagus into the mediastinum. In the second stage, in a second surgery, the esophagojejunal anastomosis was completed under better clinical conditions.

Introduction: Clear cell carcinoma of the ovary (CCC) is the 2nd most common ovarian cancer and is histologically and clinically distinct from other subtypes. Late stage CCC have a worse prognosis than other ovarian cancer histotypes as they are inherently resistant to the standard platinum/taxane chemotherapy. Deep endometriosis of the ovary, known as endometrioma or chocolate cyst, is the most common precursor for CCC. However, how transformation from endometriosis to CCC and, in particular, the important role of the hypoxic and ROS-rich microenvironment of endometriotic cysts are not well understood. As the molecular mechanisms pertinent to the genesis and progression of CCC are largely unknown, there are few, if any, therapeutic strategies for patients with advanced stage disease. Identifying factors that shape the development, progression and metastasis of CCC which can be targeted therapeutically could have tremendous potential to improve outcomes in this disease. Our recent findings identified cystathionine gamma-lyase (CTH), a key enzyme in the transsulfuration pathway, as a marker of Mullerian tract derived ciliated cells and CCC of both the ovary and uterus regardless of which mutations are present. Also, CTH is highly expressed both in CCC and the endometriosis adjacent to this cancer. Whether and how the transsulfuration pathway, notably CTH, enables CCC to adapt to the hostile microenvironment of an endometriotic cyst and ultimately to promote metastasis remain unanswered. Methods: We generated CTH knockout (KO) cells using CRISPR/Cas9. We assessed effects of CTH loss in vitro -under ambient and stress conditions- and in vivo on cell viability, cell proliferation, ROS levels, migration, invasion, and metastasis. Further, we used an organoid model system to assess the impact of CTH loss in primary endometrial cells on organoid growth and response to stress conditions including exposure to endometriotic cyst contents. Results: Our in-vitro, in-vivo data as well as data derived from the organoid modelling system show that CTH is critical for adaptive response to hypoxia. Further, it underpins the growth of CCC cells in-vitro and the growth of CTH in a mouse model of CCC. These data highly indicate that expression of the transsulfuration pathway enzyme CTH enables cells to survive in endometriotic cysts then upon transformation both marks CCC and potentiates tumor progression and metastasis. Conclusion: Targeting CTH in CCC and potentially other cancers might represent a novel and impactful therapeutic approach. Citation Format: Amal M. El-Naggar, Yuchen Ding, Genny Trigo-Gonzalez, Lucy Li, Shary Chen, Busra Turgu, Forouh Kalantari, Rodrigo Vallejos, Kiran Parmar, Cindy Shen, Gian Luca Negri, Paul Yong, Gregg Morin, David G. Huntsman. On the verge of metastasis: CTH defines a cell-state-dependent adaptive response to microenvironmental stresses [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2482.