Experience with the use of intravitreal bevacizumab in cases with type I retinopathy of prematurity in a Latin American country.

In retinopathy of prematurity (ROP) type I, the use of intravitreal bevacizumab (IVB), which is an inhibitor of endothelial growth factor (VEGF), has become popular despite not being a therapy approved by regulatory agencies. However, IVB has shown positive effects in halting disease progression at lower costs compared to other anti-VEGF therapies (ranibizumab or aflibercept). In this report, we present the experience during the treatment with IVB of 102 Colombian children with ROP type I, with a success rate of 98% (100). Complications occurred in 3.9% (4). Finally, we conclude that a single dose of IVB is an effective therapy for the management of ROP type I, with a lower risk of complications and retreatment.

Beach litter in three South American countries: A baseline for restarting monitoring and cleaning after COVID-19 closure.

The COVID-19 pandemic caused that most countries established the closure of many beaches, affecting the scientific monitoring of thousands of coastal sectors. This article shows the status of beach litter in South America before and after COVID-19 closure. The data were obtained during the years 2019, 2020 and 2022 on 25 beaches using a technique BLAT-QQ. The results show that cigarette butts were the most frequent type of litter, meanwhile Brazil should improve cleanliness of general gross litter and gross polystyrene. Colombia gross vegetation litter and small vegetation litter, and Ecuador organic litter from animals. The results shown in qualitative and quantitative manner facilitate their understanding for managers, scholars and activists interested on beach litter monitoring. This baseline is useful to analyse regional and worldwide marine litter trends with the purpose to start or restart monitoring of tourist beaches from a science-based method.

Guillain-Barré syndrome associated with SARS-CoV-2 infection: A case series from 4 Colombian cities during the pandemic.

SARS-CoV-2 infection has been associated with multiple neurological manifestations. One such manifestation, which has been described since the early stages of the COVID-19 pandemic and is relevant for current neurological practice, is Guillain-Barré syndrome (GBS). The literature describes neurotoxic mechanisms of the virus itself and the possible pathways by which it may affect the peripheral nerves in experimental studies; however, we still lack information on the mechanisms causing the immune response that gives rise to GBS in the context of SARS-CoV-2 infection. Colombia is one of the Latin American countries worst affected by the pandemic, with the third-highest number of cases in the region; thus, it is essential to recognise GBS, as this potential postinfectious complication may severely compromise the patient's functional status in the absence of timely diagnosis and treatment. We present a series of 12 cases of GBS associated with SARS-CoV-2 infection from hospitals in 4 different Colombian cities and describe the clinical presentation, laboratory and electrophysiological study findings, and treatment.

En el año 2020 se declaro la pandemia ocasionada por la infección por el virus SARSCoV-2, virus de la familia del coronavirus, adoptándose el nombre de COVID-19 a la enfermedad 1. En Bogotá, Colombia, se confirmó el primer caso de COVID-19 el 6 de marzo de 2020 (2). Los principales síntomas reportados en la infección por SARSCoV-2 son fiebre (43.8% en la admisión y 88.7% durante la hospitalización) y tos (67.8%) (3). Otros síntomas encontrados son fatiga (38.1%), producción de esputo (33.7%) y cefalea (13.6%). Los principales signos neurológicos reportados en los pacientes con infección severa por SARS-Cov-2 son agitación (69%), compromiso en tracto corticoespinal (67%) y delirium (65%) (4). Las principales complicaciones neurológicas descritas asociadas a Covid 19 son: anosmia, disgeusia, encefalopatia, Síndrome de Guillain Barre, complicaciones cerebrovasculares y daño en musculo esquelético (5­8).En el presente articulo se presenta una serie de casos de pacientes con síndrome de Guillain-Barré asociado a infección por SARS-CoV-2. Se recolectaron casos de diferentes instituciones medicas de Colombia.

How does the beach ecosystem change without tourists during COVID-19 lockdown?

Urban tourist beach ecosystems provide the essential service of recreation. These ecosystems also support critical ecological functions where biodiversity conservation is not usually a priority. The sudden lockdown due to the COVID-19 pandemic created a unique opportunity to evaluate the effects of human absence in these urban-coastal ecosystems. This study examined bioindicators from 29 urban tourist beaches in seven Latin-American countries and assesses their response to lockdown about some relevant anthropogenic stressors such as pollution, noise, human activities, and user density. The presence of animals and plants, as well as the intensity of stressors, were assessed through a standardized protocol during lockdown conditions. Additionally, the environmental conditions of the beaches before and during lockdown were qualitatively compared using multivariate non-parametric statistics. We found notable positive changes in biological components and a clear decrease in human stressors on almost all the beaches. Dune vegetation increased on most sites. Similarly, high burrow densities of ghost crabs were observed on beaches, except those where cleaning activity persisted. Because of the lockdown, there was an exceptionally low frequency of beach users, which in turn reduced litter, noise and unnatural odors. The observed patterns suggest that tourist beaches can be restored to natural settings relatively quickly. We propose several indicators to measure changes in beaches once lockdown is relaxed. Adequate conservation strategies will render the recreational service of tourist beaches more environmental-friendly.

Dataset of human interventions as anthropogenic perturbations on the Caribbean coast of Colombia.

Human interventions on coastal areas are always causing environmental impact; however, most of the times inventories of those interventions are possibly not well structured, and surely without a specific standard. The raw data presented shows an exhaustive and systematic revision of satellite images on 1700 km of the Caribbean coast of Colombia, where 2743 human interventions were identified. These interventions are classified in 38 categories in order to assess their environmental impact at a regional scale. The filtered data shows the environmental impact obtained for each category and the values allotted to each of the four parameters used for this evaluation. Moreover, the data is filtered for each of the five environmental coastal units in which the Caribbean coast of Colombia is divided by national regulations. Finally, the filtered and processed data shows the analysis done to obtain the graphical results of a previously paper (An evaluation of human interventions in the anthropogenically disturbed Caribbean Coast of Colombia [1]). Therefore, this dataset comprises three spreadsheets (xlsx) and two geographical files (kmz), which are ready to be used for any researcher, decision maker, land planner or practitioner interested in making further analysis on environmental impact assessment in coastal areas. Additionally, the dataset is carefully organised for educational exercises in such a manner that professors or lecturers can repeat the same steps in this study area or in their own, from the inventory to the final results.

Litter assessment on 99 Cuban beaches: A baseline to identify sources of pollution and impacts for tourism and recreation.

Litter presence was assessed on the entire Cuban coastline, and includes 99 beaches from all Cuban regions, during field work carried out in 2012 and 2015. A standard method verified in several countries was applied, which classified beaches for nine types of litter into four grades (A-excellent to D-poor). Almost half of the Cuban beaches obtained excellent cleanliness scores, although many needed to be better managed. In this baseline, the most common types of residue were general litter (8% grade D and 35% grades B/C) and potentially harmful litter (<68% with grade A). Resort beaches and those with international visitors showed the best litter management. Tourism Impacts seems to be related to visitor origin therefore choices to develop sustainable tourism in rural and village beaches (64%) appears low, if beach cleaning gross investment is focused on resort beaches (24%). Finally, this paper highlights geographical distribution and types of litter patterns.

Developments and trends in fruit bar production and characterization.

Fruits serve as a source of energy, vitamins, minerals, and dietary fiber. One of the barriers in increasing fruit and vegetables consumption is time required to prepare them. Overall, fruit bars have a far greater nutritional value than the fresh fruits because all nutrients are concentrated and, therefore, would be a convenience food assortment to benefit from the health benefits of fruits. The consumers prefer fruit bars that are more tasted followed by proper textural features that could be obtained by establishing the equilibrium of ingredients, the proper choosing of manufacturing stages and the control of the product final moisture content. Fruit bar preparations may include a mixture of pulps, fresh or dried fruit, sugar, binders, and a variety of minor ingredients. Additionally to the conventional steps of manufacturing (pulping, homogenizing, heating, concentrating, and drying) there have been proposed the use of gelled fruit matrices, dried gels or sponges, and extruders as new trends for processing fruit bars. Different single-type dehydration or combined methods include, in order of increasing process time, air-infrared, vacuum and vacuum-microwave drying convective-solar drying, convective drying, and freeze drying are also suggested as alternative to solar traditional drying stage. The dehydration methods that use vacuum exhibited not only higher retention of antioxidants but also better color, texture, and rehydration capacity. Antioxidant activity resulting from the presence of phenolic compounds in the bars is well established. Besides this, fruit bars are also important sources of carbohydrates and minerals. Given the wide range of bioactive factors in fresh fruits that are preserved in fruit bars, it is plausible that their uptake consumption have a positive effect in reducing the risk of many diseases.

Amplifying the benefits of agroecology by using the right cultivars.

Tropical soils are particularly vulnerable to fertility losses due to their low capacity to retain organic matter and mineral nutrients. This urges the development of new agricultural practices to manage mineral nutrients and organic matter in a more sustainable way while relying less on fertilizer inputs. Two methods pertaining to ecological engineering and agroecology have been tested with some success: (1) the addition of biochar to the soil, and (2) the maintenance of higher earthworm densities. However, modern crop varieties have been selected to be adapted to agricultural practices and to the soil conditions they lead to and common cultivars might not be adapted to new practices. Using rice as a model plant, we compared the responsiveness to biochar and earthworms of five rice cultivars with contrasted selection histories. These cultivars had contrasted responsivenesses to earthworms, biochar, and the combination of both. The mean relative increase in grain biomass, among all treatments and cultivars, was 94% and 32%, respectively, with and without fertilization. Choosing the best combination of cultivar and treatment led to a more than fourfold increase in this mean benefit (a 437% and a 353% relative increase in grain biomass, respectively, with and without fertilization). Besides, the more rustic cultivar, a local landrace adapted to diverse and difficult conditions, responded the best to earthworms in terms of total biomass, while a modern common cultivar responded the best in term of grain biomass. This suggests that cultivars could be selected to amplify the benefit of biochar- and earthworm-based practices. Overall, selecting new cultivars interacting more closely with soil organisms and soil heterogeneity could increase agriculture sustainability, fostering the positive feedback loop between soils and plants that has evolved in natural ecosystems.

Total intravenous anesthesia with a propofol-ketamine combination during coronary artery surgery.

OBJECTIVE: To evaluate the cardiovascular effects of a propofol-ketamine combination in patients undergoing coronary artery surgery. DESIGN: Prospective, randomized study. SETTING: Tertiary care teaching hospital, single center. PARTICIPANTS: Seventy-eight adult patients. INTERVENTIONS: Patients were randomly allocated to receive propofol-ketamine for induction and maintenance of anesthesia (n = 36) or fentanyl-enflurane (controls, n = 42). MEASUREMENTS AND MAIN RESULTS: Hemodynamics and other variables were recorded during and after surgery and for 24 hours in the intensive care unit. Before cardiopulmonary bypass (CPB), there was similar incidence of treatment for hypotension (42% of patients in both groups), tachycardia (propofol-ketamine, 6%; controls, 5%), and myocardial ischemia (propofol-ketamine, 3%; controls, 12%). In the propofol-ketamine group, there was a decreased requirement for inotropic agents after CPB (22% of patients) compared with controls (49% of patients; p = 0.02). There was a reduced incidence of myocardial infarctions (creatine kinase myocardial band >133 U/L) in the propofol-ketamine group compared with the control group (0% v 14%; p = 0.02; Fisher's exact test). Patients in the propofol-ketamine group were more likely to have their tracheas extubated within 8 hours of arrival in the intensive care unit compared with controls (33% v 7%; p = 0.01; Cochran-Mantel-Haenzel test). CONCLUSIONS: The propofol-ketamine combination was associated with a similar incidence of pre-CPB hypotension and ischemia, a decreased need for inotropes after CPB, an earlier time to tracheal extubation, and a reduced incidence of myocardial infarctions compared with controls.

Rocuronium versus vecuronium during fentanyl induction in patients undergoing coronary artery surgery.

OBJECTIVE: To evaluate the neuromuscular, ventilatory, and cardiovascular effects of rocuronium and vecuronium. DESIGN: Randomized, prospective, blinded study. SETTING: Tertiary care teaching center, single institution. PARTICIPANTS: Patients undergoing elective coronary artery bypass graft procedure. INTERVENTIONS: Patients received rocuronium, 1.0 mg/kg (n = 17), or vecuronium, 0.15 mg/kg (n = 15), during fentanyl induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Measures consisted of time to visual loss of orbicularis oculi twitches in response to facial nerve stimulation, ease of mask ventilation, hemodynamics, need for vasoactive drugs, and tracheal intubating conditions. Median time to twitch loss was faster (p < 0.05) after rocuronium (60 s) than after vecuronium (>84 s). Within 45 seconds, only 3 of 17 patients in the rocuronium group had moderate-to-severe difficulty with mask ventilation versus 12 of 15 patients in the vecuronium group (p < 0.05). Tracheal intubating conditions were excellent in all patients after rocuronium. In the vecuronium group, intubating conditions were excellent in 46%, good in 27%, and poor in 27% (p < 0.05 vrocuronium). Patients receiving vecuronium were more likely to require ephedrine and phenylephrine for hypotension (10/15 patients v 5/17 patients for rocuronium, p < 0.05). There were no clinically important differences in hemodynamic variables, oxygen metabolism, or myocardial ischemia between groups. CONCLUSION: During narcotic induction of anesthesia, rocuronium was associated with lower requirement for vasopressors, faster onset of neuromuscular blockade, and better conditions for mask ventilation and tracheal intubation compared with vecuronium.

Anemia and perioperative myocardial ischemia in a Jehovah's Witness patient.

We present a case in which an anemic patient with religious objections to blood transfusion experienced three episodes of severe myocardial ischemia during the perioperative period. The first episode of ischemia was successfully treated by discontinuing isoflurane and resolving the hypotension. The second and third episodes were successfully treated by heart rate control with esmolol and neostigmine.

Frecuencia de marcadores serológicos del virus B en maternas

Se estudiaron 175 madres y sus hijos determinando los marcadores del virus de Hepatitis B, para establecer la frecuencia de portadores de esta infección, que fue del 8.5 por ciento. Se determinó la ausencia de relación entre la seropositividad y los factores de riesgo de ser portador. No se encontraron marcadores en la sangre del cordon umbilical de los neonatos. Se hacen recomendaciones tanto en el control prenatal como sobre las medidas terapéuticas a ser tomadas