Analysis of Trace Impurities in Lithium Carbonate.

Lithium carbonate (Li2CO3) is a critical raw material in cathode material production, a core of Li-ion battery manufacturing. The quality of this material significantly influences its market value, with impurities potentially affecting Li-ion battery performance and longevity. While the importance of impurity analysis is acknowledged by suppliers and manufacturers of battery materials, reports on elemental analysis of trace impurities in Li2CO3 salt are scarce. This study aims to establish and validate an analytical methodology for detecting and quantifying trace impurities in Li2CO3 salt. Various analytical techniques, including X-ray diffraction (XRD), scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX), X-ray photoelectron spectroscopy (XPS), and inductively coupled plasma optical emission spectroscopy (ICP-OES), were employed to analyze synthetic and processed lithium salt. X-ray diffraction patterns of Li2CO3 were collected via step-scanning mode in the 5-80° 2θ range. SEM-EDX was utilized for particle morphology and quantitative impurity analysis, with samples localized on copper tape. XPS equipped with a hemispherical electron analyzer was employed to analyze the surface composition of the salt. For ICP-OES analysis, a known amount of lithium salt was subjected to acid digestion and dilution with ultrapure water. Multielemental standard solutions were prepared, including elements such as Al, Cd, Cu, Fe, Mn, Ni, Pb, Si, Zn, Ca, K, Mg, Na, and S. Results confirmed the presence of the zabuyelite phase in XRD analysis, corresponding to the natural form of lithium carbonate. SEM-EDX mapping revealed impurities of Si and Al, with low relative quantification values of 0.12% and 0.14%, respectively. XPS identified eight potential impurity elements, including S, Cr, Fe, Cl, F, Zn, Mg, and Na, alongside Li, O, and C. Regarding ICP-OES analysis, performance parameters such as linearity, limit of detection (LOD), and quantification (LOQ), variance, and recovery were evaluated for analytical validation. ICP-OES results demonstrated high linearity (>0.99), with LOD and LOQ values ranging from 0.001 to 0.800 ppm and 0.003 to 1.1 ppm, respectively, for different elements. The recovery rate exceeded 90%. In conclusion, the precision of the new ICP-OES methodology renders it suitable for identifying and characterizing Li2CO3 impurities. It can effectively complement solid-state techniques such as XRD, SEM-EDX, and XPS.

Resultados de un programa educativo orientado a la promoción de la independencia y autonomía funcional

Introducción: El envejecimiento es un proceso fisiológico que genera cambios en la salud de los adultos mayores. Una de las esferas que con mayor frecuencia se afecta es la psicosocial, en la cual se presenta pérdida de la independencia y autonomía funcional. Objetivo: Evaluar los resultados de un programa educativo orientado a la promoción de la independencia y autonomía funcional. Métodos: Se realizó un estudio cuasiexperimental de intervención antes - después. El universo fue de 697 adultos mayores residentes en las parroquias rurales del cantón Penipe, en la provincia Chimborazo. La muestra quedó conformada por 249 ancianos. Se aplicó un programa educativo durante 8 meses que incluyó como variable el nivel de conocimiento sobre hábitos y estilos de vida saludables y la dependencia. Se utilizó la prueba de McNemar para identificar cambios en el nivel de conocimiento sobre hábitos y estilos de vida. Resultados: Promedio de edad de 68,32 años, predominio del sexo femenino (55,02 %) y con comorbilidades (73,49 %). En el 42,97 % de los sujetos se identificó algún tipo de dependencia, con predominio de la dependencia escasa (45,79 %). Durante el pretest se identificó un nivel de conocimiento bajo en el 63,05 %, durante el postest solo el 15,66 % mantenía un nivel bajo (p= 0,02). Conclusiones: El programa educativo mejora el nivel de conocimiento sobre la importancia de adoptar hábitos y estilos de vida saludables para promocionar la independencia y la autonomía funcional.

Introduction: Aging is a physiological process that generates changes in the health of people over 60 years of age. One of the spheres that is most frequently affected is psychosocial, in which there is loss of independence and functional autonomy. Objective: To evaluate the results of an educational program aimed at promoting independence and functional autonomy. Methods: A quasi-experimental before-after intervention study was carried out. The universe was 697 older adults residing in the rural parishes of the Penipe canton in the Chimborazo province. The sample was made up of 249 elderly people. An educational program was applied for 8 months that included as a variable the level of knowledge about healthy habits and lifestyles and dependency. The McNemar test was used to identify changes in the level of knowledge about habits and lifestyles. Results: Average age of 68.32 years, predominance of female sex (55.02%) and with associated comorbidities (73.49%). Some type of dependency was identified in 42.97% of the subjects, with a predominance of low dependency (45.79%). During the pretest, older adults with a low level of knowledge about healthy habits and lifestyles predominated (63.05%). During the posttest, the average level of knowledge predominated (51.81%). Conclusions: The educational program improves the level of knowledge about the importance of adopting healthy habits and lifestyles to promote independence and functional autonomy.

The importance of the pretreatment of samples in Nd quantification from NdFeB magnets through inductively coupled plasma atomic emission spectroscopy (ICP-OES)-a rapid and streamlined methodology.

In this study, we emphasize the critical role of sample pretreatment. We report on the behavior of NdFeB magnet samples exposed to four different acid media for digestion. NdFeB magnets are becoming a significant source of neodymium, a rare-earth element critical to many technologies and a potential substitute for traditional mining of the element. To address this, we meticulously tested nitric acid, hydrochloric acid, acetic acid, and citric acid, all at a concentration of 1.6 M, as economical and environmentally friendly alternatives to the concentrated mineral acids commonly used in the leaching of these materials. The pivotal stage involves the initial characterization of samples in the solid state using SEM-EDX and XPS analysis to obtain their initial composition. Subsequently, the samples are dissolved in the four aforementioned acids. Finally, neodymium is quantified using ICP-OES. Throughout our investigation, we evaluated some analytical parameters to determine the best candidate for performing the digestion, including time, limits of detection and quantification, accuracy, recovery of spike samples, and robustness. After careful consideration, we unequivocally conclude that 1.6 M nitric acid stands out as the optimal choice for dissolving NdFeB magnet samples, with the pretreatment of the samples being the critical aspect of this report.

Effect of Aloe vera gel coating on organoleptic and nutritional quality of minimally processed carrot.

Demand for fresh vegetables has led to development studies in postharvest area mainly focused on minimizing and look for alternatives to chemical additives for food preservation. The use of natural derived edible coatings emerges as a promising alternative for maintaining quality of vegetables. The objective of this study was to evaluate the effect of Aloe vera gel in minimally processed carrot during postharvest storage. Samples with different degrees of processing were immersed in Aloe vera gel, packaged polyolefin bags, and stored in refrigerated chambers at 5 °C for 12 days. Different organoleptic and quality parameters were evaluated. In general, the samples treated with Aloe vera gel showed less quality loss and a lower increment in the bleaching index. Moreover, sensory analysis allowed to establish that carrots processed in slices and shredded and coated with the gel had a more flavorful taste and higher moisture content. Aloe vera treatment did not influence the microbiological growth of bacteria and fungi during storage. Regarding nutritional quality, the treated samples showed a higher accumulation or lower degradation of phenols, flavonoids, and carotenoids, probably generating in this way, a higher antioxidant capacity in these samples. Finally, Aloe vera gel treatment did not influence sugar dynamics in any of the samples. It can be concluded that the treatment with Aloe vera gel allows maintaining a better organoleptic and nutritional quality of carrots with different degrees of processing during refrigerated storage.

Linfoma de células T/NK primario de testículo. Caso clínico y revisión de la literatura

Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.

[Primary testicular NK/T cell lymphoma. Case report and review of literature]. / Linfoma de células T/NK primario de testículo. Caso clínico y revisión de la literatura.

Natural killer/T cell lymphomas chiefly involving the midline facial structures including the nasal cavity or nasopharyns are a relatively rare type of non-Hodgkin's lymphoma. Apart from the upper respiratory tract, the disease occasionally presents in certain extranodal sites, such as the central nervous system, skin, gastrointestinal tract, or testes. We report a case of natural killer NK/T cell lymphoma as a testicular tumor in a 36-year-old man with a history of progressive swelling of his right testicle. Histologically, the testicular mass showed a diffuse infiltrate of medium-sized and atypical large lymphoid cells with angiocentric infiltration and areas of coagulative necrosis. Immunohistochemical studies demonstrated tumor cells staining positively with CD3, TIA-1, and Granzyme B. The Epstein-Barr virus genoma was detected by in situ hybridization. There were no abnormal findings in the nasal and nasopharyngeal regions. Classified as stage IEA, the patient received involved-field irradiation to contralateral testis (45 Gy), followed by systemic chemotherapy with a combination regimen ofL-asparaginase, methotrexate and dexamethasone. Relevant literature is reviewed, and the clinicopathologic features, natural history, and treatment options for primary testicular NK/T cell lymphoma are discussed.

Cuidados de enfermería a la mujer con aborto por automedicación / Nursing care for women with self-medication abortion

El aborto inducido es el resultado de maniobras practicadas con la intención de interrumpir el embarazo. Esta acción puede provocar complicaciones que ponen en riesgo la vida de la mujer, lo que muestra la importancia de los cuidados de enfermería para minimizar el riesgo de complicaciones en el posaborto. El propósito del estudio es describir los cuidados de enfermería a implementar en las mujeres con aborto por automedicación. Se realizó una revisión bibliográfica que incluyó la búsqueda, selección, revisión, interpretación y síntesis de la evidencia científica publicada relacionada con el problema de investigación. Se revisaron documentos publicados en los últimos 5 años en bases de datos regionales y de alto impacto como son Scielo, Redalyc, Latindex y PudMed. Se usaron descriptores de salud relacionados con el tema propuesto en idioma español, inglés y portugués. Se identificó un total de 83 documentos, de los cuales se usaron 46 en la investigación realizada. Los restantes 37 manuscritos fueron excluidos por presentar deficiencias metodológicas que limitaban su uso, o que su eje central no se ajustaba al tema de investigación planteado. Los cuidados de enfermería desempeñan un papel fundamental en la prevención o detección precoz de complicaciones en las mujeres con abortos por automedicación. La prevención de este tipo de actos debe fomentarse antes de la concepción de la gestación, basado en una adecuada educación sexual a las mujeres en edad fértil(AU)

Induced abortion is the result of maneuvers performed with the intention of interrupting pregnancy. This action can generate complications that put the woman's life at risk, which shows the importance of nursing care to minimize the risk of post-abortion complications. To describe the nursing care to be implemented in women with self-medication abortion. A bibliographic review was carried out that included the search, selection, review, interpretation and synthesis of the published scientific evidence related to the research problem. Documents published in the last 5 years in regional and high-impact databases such as Scielo, Redalyc, Latindex and PudMed were used. Health descriptors related to the proposed theme were used in Spanish, English and Portuguese. A total of 83 documents were identified, of which 46 were used in the research carried out. The remaining 37 manuscripts were excluded due to methodological deficiencies that limited their use; or that its central axis did not fit the proposed research topic. Nursing care plays a fundamental role in the prevention or early detection of complications in women with self-medication abortions. The prevention of this type of acts should be encouraged before the conception of pregnancy, based on adequate sexual education for women of childbearing age(AU)

Phenylalanine ammonia lyase is more relevant than Chalcone synthase and Chalcone isomerase in the biosynthesis of flavonoids during postharvest senescence of broccoli.

Broccoli contains a high content of nutraceutical compounds, such as glucosinolates and flavonoids. In this work, the effect of different treatments that modulate postharvest senescence of broccoli was evaluated and flavonoid metabolism during postharvest storage was analyzed at 20°C. A decrease in hue angle (HUE°) and chlorophylls and an increase in flavonoid content were detected during senescence. It observed that most of the treatments that delayed senescence also decreased flavonoid content, except visible light and UV-C treatments. In all cases, a direct correlation between those treatments that increased flavonoid biosynthesis and BoPAL gene expression was detected. This response was not detected in the expression of the other two flavonoid synthesis relevant genes BoCHS and BoCHI, suggesting that BoPAL has a greater influence on the regulation of the via, during broccoli senescence. PRACTICAL APPLICATIONS: Broccoli is a vegetable with valuable nutritional properties. Because it is in full development at the time of harvest, it has a short shelf life. In this work, it is showed that visible light and UV-C treatments not only delayed the senescence of broccoli, but also increased flavonoid content. Our results suggest that the most important enzyme in the phenylpropanoid biosynthesis pathway during broccoli postharvest is phenylalanine ammonia lyase, and that this may be a key point in regulating the biosynthesis of these nutritionally valuable compounds.

Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.

INTRODUCTION: Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining fatal outcomes in septic patients. OBJECTIVE: Evaluate whether the mean platelet volume (MPV) and mean platelet volume-to-platelet count (MPV/P) ratio are predictors of clinical severity and mortality in patients with sepsis. METHODS: A prospective population cohort of 163 patients aged 18-97 years was recruited at the Intensive Care Unit of Pablo Arturo Hospital, Quito, Ecuador from 2017-2019 and followed up for 28 days. Patients were diagnosed with sepsis based on SEPSIS-3 septic shock criteria; in which the MPV and the MPV/P ratio were measured on days 1, 2, and 3. Sequential organ failure assessment (SOFA) score and presence of septic shock assessed clinical severity. Mortality on day 28 was considered the fatal outcome. RESULTS: The average age of the patients was 61,15 years (SD 20,94) and female sex was predominant. MPV cutoff points at days 1, 2 and 3 were >9,45fL, >8,95fL and >8, 85fL; and (MPV/P) ratio >8, 18, >4, 12 y >3, 95, respectively. MPV at days 2 (9,85fL) and 3 (8,55fL) and (MPV/P) ratio at days 1 (4,42), 2 (4,21), and 3 (8,55), were predictors of clinical severity assessed by septic shock, which reached significance in the ROC curves. MPV and (MPV/P) ratio were also predictors of clinical severity determined by SOFA at days 1, 2, and 3, where higher values were observed in non-survivors reaching significance in all categories. MPV and MPV/P ratio at days 1, 2 and 3 were independent predictor factors of mortality using Cox proportional hazards model (HR 2,31; 95% CI 1,36-3,94), (HR 2,11; 95% CI 1,17-3,82), (HR 2,13; 95% CI 1,07-4,21) and (HR 2,38; 95% CI 1,38-4,12), (HR 2,15; 95% CI 1,14-4,06), (HR 4,43; 95% CI, 1,72-11,37) respectively. CONCLUSIONS: MPV and the MPV/P ratio are predictors of clinical severity and mortality in sepsis. The MPV and its coefficient are indicators of the biological behavior of platelets in sepsis. They should be considered as a cost-effective and rapidly available tool that guides the treatment.

Peptidases from Maclura Pomifera for Preparation of Food Protein Hydrolysates: Purification by Single-Step Chromatography and Characterization of Pomiferin I.

Our objective was to isolate peptidases from the latex of Maclura pomifera fruits and use them to hydrolyze food proteins, as well as to purify and characterize the main peptidase. Two partially purified proteolytic extracts were prepared by ethanol (EE) and acetone (AE) precipitation from an aqueous suspension of exuded fruit latex. EE was used to hydrolyze food proteins with a ratio of 0.19 caseinolytic units (Ucas) per mg of substrate. Different values of hydrolysis degree were observed for hydrolysates of egg white, soy protein isolate, and casein at 180 min (9.3%, 31.1%, and 29.1%, respectively). AE was employed to purify a peptidase which exhibited an isoelectric point (pI) of 8.70 and whose abundance in AE was 28.3%. This enzyme was purified to homogeneity using a single-step procedure by cation-exchange chromatography, achieving an 8.1-fold purification and a yield of 16.7%. The peptidase was named pomiferin I and showed a molecular mass of 63,177.77 Da. Kinetic constants (KM 0.84 mM, Vmax 27.50 uM s-1, kcat 72.37 s-1, and kcat/KM 86.15 mM-1 s-1) were determined employing N-α-carbobenzoxy-L-alanyl-p-nitrophenyl ester as substrate. Analysis by PMF showed only partial homology of pomiferin I with a serine peptidase from a species of the same family.

Expression of BoNOL and BoHCAR genes during postharvest senescence of broccoli heads.

BACKGROUND: Chlorophyll is the most abundant pigment on Earth, essential for the capture of light energy during photosynthesis. During senescence, chlorophyll degradation is highly regulated in order to diminish toxicity of the free chlorophyll molecule due to its photoactivity. The first step in the chlorophyll degradation pathway is the conversion of chlorophyll b to chlorophyll a by means of two consecutive reactions catalyzed by enzymes coded by NYC1 (NON-YELLOW COLORING 1), NOL (NYC1-LIKE) and HCAR. RESULTS: In this work, we studied the expression of NOL and HCAR genes during postharvest senescence of broccoli. We found that the expression of BoNOL increase during the first days of storage and then decrease. In the case of BoHCAR, its expression is maintained during the first days and then it also diminishes. Additionally, the effect of different postharvest treatments on the expression of these genes was also analyzed. It was observed that the expression of BoNOL is lower in the treatments performed with 1-methylcyclopropene (1-MCP), 6-benzylaminopurine (6-BAP) and modified atmospheres, while BoHCAR expression showed an increase in these same treatments, and a decrease in the treatment with ethylene. There were no variations in the expression of both genes in heat treatment, UV-C treatment and visible light treatment. CONCLUSIONS: These results suggest that both BoHCAR and BoNOL show a lower regulation of their expression than other genes involved in chlorophyll degradation during senescence. © 2020 Society of Chemical Industry.

The time of the day to harvest affects the degreening, antioxidant compounds, and protein content during postharvest storage of broccoli.

Harvesting of broccoli at several moments of the day affects the rate of senescence during storage. In this work, broccoli heads were harvested at several moments and then kept at 20°C in order to analyze protein metabolism and antioxidant compounds. Almost no differences were detected in the contents of total and soluble proteins, and free amino acids. Only an increment in free amino acids was detected by day 3 in samples obtained at 8:00 hr. With reference to antioxidants, the contents of ascorbic acid, carotenoids and xanthophylls, phenols, and flavonoids were similar in samples harvested at different moments. However, an increment was detected in carotenoids, phenols, and flavonoids during storage of samples collected at 18:00 hr on day 3 and samples collected at 13:00 hr on day 5. The combination of delay of senescence and increment in antioxidants suggest harvesting at 12:00 or 18:00 hr. PRACTICAL APPLICATION: Broccoli is a vegetable with an important level of nutrients. However, it is also highly perishable and suffers a high rate of senescence and loss of quality during postharvest. In this work, it is demonstrated that the simple practice of harvests in different moments of the day can affect the postharvest behavior of broccoli, and it is suggested to carry out the harvest toward the end of the day.

Preparation of soy protein hydrolysates with antioxidant activity by using peptidases from latex of Maclura pomifera fruits.

A partially purified proteolytic extract prepared from Maclura pomifera latex was employed in hydrolyzing a soybean-protein isolate (4.2 mg/mL). The hydrolysis-product formation, monitored by tricine-sodium-dodecyl-sulfate-polyacrylamyde-gel electrophoresis and reverse-phase high-performance liquid chromatography, indicated that after 10 min of reaction the main soybean proteins disappeared. The maximum degree of hydrolysis was 36.2% after a 180-min digestion. The 90-min hydrolysate presented an IC50 of 31.6 ±â€¯0.2 µg/mL, and a trolox equivalent antioxidant capacity of 157.6 and 176.9 µmoles TE per g of peptide determined by two different methods. Analysis by matrix-assisted-laser-desorption-ionization-time-of-flight mass spectrometry (MALDI-TOF MS), followed by the application of bioinformatics tools, enabled the deduction of fourteen theoretical peptide sequences containing antioxidant amino acids at >60%, none of which sequences had been previously reported as antioxidants. Finally, we consider that this 90-min hydrolysate would constitute a promising ingredient in the manufacture of functional foods.

Smdrome de Horner congénito: Caso clmico / Congenital Horner syndrome: Case report

El síndrome de Horner está caracterizado por la siguiente tríada de signos clínicos: miosis, ptosis y anhidrosis facial. A su vez, pueden aparecer heterocromía del iris, inyección conjuntival, eritema facial, mucosa nasal congestiva y enoftalmos aparente secundario a la disminución de la hendidura palpebral. Es causado por una interrupción de la vía simpática, que se extiende desde el hipotálamo hasta la órbita. Debido a que dicha vía no se decusa, los signos son homolaterales a la lesión de esta. Tradicionalmente, se lo clasifica en congénito y adquirido. En ocasiones, se asocia a neoplasias, como el neuroblastoma. Sigue siendo controversial qué estudios de imágenes se deberían solicitar en forma protocolizada frente a un paciente con este síndrome neurológico. Se presenta el caso de un lactante de 45 días de vida con síndrome de Horner congénito.

Horner syndrome is characterized by the following triad of clinical signs: miosis, ptosis and facial anhidrosis. In addition, iris heterochromia, conjunctival injection, facial erythema, congestive nasal mucosa and apparent enophthalmos secondary to the reduction of the palpebral fissure can appear. It is caused by an interruption of the sympathetic pathway that extends from the hypothalamus to the orbit. Because there is no decussation, the signs are homolateral to the lesion. Traditionally, it is classified as congenital and acquired. Occasionally, it is associated with neoplasias such as neuroblastoma. It remains controversial what imaging studies should be requested as a protocolized workup of this neurological syndrome in a patient. We report the case of a 45-day-old infant with congenital Horner syndrome.

Evidencia empírica de la miel como tratamiento eficaz. En la dehiscecia de sutura tras vulvectomía radical / Empirical evidence of honey as an effective treatment for wound dehiscence after a radical vulvectomy

El cáncer de vulva es uno de los tumores ginecológicos menos frecuentes. La mutilación producida por cirugías radicales, como la vulvectomía, pueden ocasionar importantes secuelas físicas, psíquicas y sexuales en la mujer. El caso clínico que presentamos es el de una mujer de 83 años diagnosticada de cáncer de vulva, a la que se intervino en nuestro centro por recidiva local y que presentó dehiscencia de la cicatriz pocos días después de la cirugía. Nuestro objetivo es mostrar que la cura con miel es una alternativa eficaz, por sus propiedades curativas, en la cura de dehiscencias en las vulvectomías, además de ser una terapia barata, accesible y fácil de aplicar (AU)

Vulvar cancer is one of the less common gynecological tumors. Nevertheless, the mutilation produced by a radical surgery such as the vulvectomy can cause important sequels in women, both physical and psychological. We present a clinical case of an 83-year-old woman diagnosed with vulvar cancer, who underwent a radical vulvectomy after local recurrence at our hospital. She presented a wound dehiscence a few days after the surgery. Our aim is to discuss that honey is an effective alternative cure of wound dehiscence in vulvectomy due to its healing properties; it is also a cheaper treatment, accessible, and easy to apply (AU)

[Congenital Horner syndrome. Case report]. / Símdrome de Horner congénito. Caso clínico.

Horner syndrome is characterized by the following triad of clinical signs: miosis, ptosis and facial anhidrosis. In addition, iris heterochromia, conjunctival injection, facial erythema, congestive nasal mucosa and apparent enophthalmos secondary to the reduction of the palpebral fissure can appear. It is caused by an interruption of the sympathetic pathway that extends from the hypothalamus to the orbit. Because there is no decussation, the signs are homolateral to the lesion. Traditionally, it is classified as congenital and acquired. Occasionally, it is associated with neoplasias such as neuroblastoma. It remains controversial what imaging studies should be requested as a protocolized workup of this neurological syndrome in a patient. We report the case of a 45-day-old infant with congenital Horner syndrome.

El síndrome de Horner está caracterizado por la siguiente tríada de signos clínicos: miosis, ptosis y anhidrosis facial. A su vez, pueden aparecer heterocromía del iris, inyección conjuntival, eritema facial, mucosa nasal congestiva y enoftalmos aparente secundario a la disminución de la hendidura palpebral. Es causado por una interrupción de la vía simpática, que se extiende desde el hipotálamo hasta la órbita. Debido a que dicha vía no se decusa, los signos son homolaterales a la lesión de esta. Tradicionalmente, se lo clasifica en congénito y adquirido. En ocasiones, se asocia a neoplasias, como el neuroblastoma. Sigue siendo controversial qué estudios de imágenes se deberían solicitar en forma protocolizada frente a un paciente con este síndrome neurológico. Se presenta el caso de un lactante de 45 días de vida con síndrome de Horner congénito.

¿Es el volumen medio plaquetario un predictor de mortalidad en sepsis? / Is mean platelet volume a predictor of mortality in sepsis?

Introducción: la sepsis es la respuesta del huésped a una infección sistémica; sus formas severas (sepsis grave y choque séptico) afectan a millones de personas en el mundo, provocando la muerte a uno de cada cuatro pacientes (campaña de sobrevida a la sepsis). Pese a los avances tecnológicos que implican nuevos fármacos, investigación molecular, biomarcadores y estrategias terapéuticas, los logros alcanzados no permiten predecir la severidad del cuadro y anticipar la mortalidad. Objetivo: validar al volumen medio plaquetario (VMP), un valor reportado rutinariamente en el hemograma como predicitor de mortalidad en pacientes sépticos. Material y métodos: se realizó un estudio prospectivo no experimental, en la unidad de terapia intensiva del hospital Pablo Arturo Suárez de Quito en el periodo julio de 2012 hasta octubre de 2014; el universo lo conforman todos los pacientes ingresados con diagnóstico de sepsis que cumplieron los criterios de inclusión. Se consideraron las variables: VMP, contaje leucocitario, sitio de la infección, edad, género y condición al egreso. Resultados: el grupo de estudio se conformó con 87 pacientes; el sitio de infección más frecuente fue a nivel abdominal, seguido de pulmón y vías urinarias. El porcentaje de supervivencia fue 63,2%, dato que coincide con la mortalidad promedio a nivel mundial. Las curva ROC (AUC: 85,4) y la correlación lineal de Pearson (contaje leucocitario­VMP) (r: 0,94), confirman la utilidad del VMP como predictor de mortalidad en casos de sepsis. Conclusión: el volumen medio plaquetario igual o mayor a 8.5 fl predice adecuadamente la mortalidad en pacientes con sepsis. (AU)

Context: Sepsis is the host's response to a systemic infection. Its severe forms (severe sepsis and septic shock) affect millions of people worldwide, leading to death in one in four patients (sepsis survival campaign). Despite technological advances involving new drugs, molecular research, biomarkers and therapeutic strategies, achievements do not allow predicting the severity of the condition and anticipate mortality. Objective: to validate the mean platelet volume (VMP), a value routinely reported in the blood count as a predictor of mortality in septic patients. Materials and methods: a non-experimental prospective study was conducted at the intensive care unit of the Pablo Arturo Suárez Hospital in Quito from July 2012 to October 2014. Universe is made up of all patients admitted with a diagnosis of sepsis who met the inclusion criteria. The following variables were considered: VMP, leukocyte count, site of infection, age, gender and condition at discharge. Results: the study group consisted of 87 patients. The most frequent site of infection was at the abdominal level, followed by lung and urinary tract. The survival rate was 63.2%, which coincides with the average mortality worldwide. The ROC curve (AUC: 85.4) and the linear correlation of Pearson (WBC count-VMP) (r: 0.94) confirm the utility of VMP as a predictor of mortality in sepsis cases. Conclusion: mean platelet volume equal to or greater than 8.5 fl adequately predicts mortality in patients with sepsis. (AU)