ESTUDIO DE LAS COINFECCIONES POR OTROS PATÓGENOS RESPIRATORIOS EN PACIENTES PEDIÁTRICOS CON DIAGNÓSTICO DE COVID-19 / STUDY OF COINFECTIONS BY OTHER PATHOGENS RESPIRATORY IN PEDIATRIC PATIENTS WITH DIAGNOSTICS FROM COVID-19

Introducción: La coinfección de COVID-19 con otros patógenos respiratorios en pediatría ha sido poco estudiada. Resulta de interés conocer las características y cuadro clínico de pacientes que presenten coinfecciones con COVID-19. Objetivo: Estudiar la coinfección de SARS-CoV-2 con patógenos incluidos en el Panel RP 2.0 FilmArray® en muestras de pacientes pediátricos en un hospital del tercer nivel. Materiales y métodos: Durante abril a agosto de 2021 se realizó un estudio prospectivo descriptivo sobre 21 muestras de Hisopado Nasofaríngeo de pacientes pediátricos positivos para SARS-CoV-2 (iAMP® COVID-19 Detection Kit de Atila Biosystems). Se procesaron por PCR multiplex Filmarray® RP 2.0. Luego se describieron las características y síntomas de los pacientes. Resultados: 12/21 (60%) fueron pacientes ambulatorios y 8/21 (40%) internados. El 57% de los pacientes fueron mayores de 5 años, el 24% menores de 1 año y el 19% entre 1 y 5 años. El síntoma más frecuente fue fiebre 18/21 (86%). El 90,5% (19/21) de las muestras no mostraron detección de otros patógenos. En una muestra se detectó Rhino/enterovirus y en otra Coronavirus NL63; ambas pertenecieron a dos pacientes con enfermedades de base. Conclusión: La tasa de coinfecciones fue del 9,5%. Este número podría deberse a la baja circulación de patógenos respiratorios en un contexto con medidas de prevención de los contagios. En el estado actual de incremento de circulación de virus respiratorios endémicos, es de interés la búsqueda de coinfecciones con COVID-19

Introduction: The co-infection of COVID-19 with other respiratory pathogens in pediatrics has been little studied. It is of interest to know the characteristics and clinical picture of patients who present co-infections with COVID-19. Objective: To study the co-infection of SARS-CoV-2 with pathogens included in the RP Panel 2.0 FilmArray® in samples from pediatric patients in a third-level hospital. Materials and methods: During April to August 2021, a prospective descriptive study was conducted on 21 Nasopharyngeal Swab samples from pediatrics patients positive for SARS-CoV-2 (iAMP® COVID-19 Detection Kit from Attila Biosystems). They were processed by PCR multiplex Filmarray® RP 2.0. The characteristics and symptoms of the patients were then described. Results: 12/21 (60%) were outpatients and 8/21 (40%) were hospitalized. 57% of patients were older than 5 years, 24% under 1 year and 19% between 1 and 5 years. The most frequent symptom was fever 18/21 (86%). 90,5% (19/21) of the samples showed no detection of other pathogens. Rhino/enterovirus was detected in one sample and NL63 in another Coronavirus; both belonged to two patients with underlying diseases. Conclusion: The rate of co-infections was 9,5%. This number could be dueto the low circulation of respiratory pathogens in a context with measures to prevent contagion. In the current state of increased circulation of endemic respiratory viruses, the search for co-infections with COVID-19 is of interest

Amblyopia due a dentigerous cyst. Case report and literature review.

PURPOSE: The goal of this article is to present an infrequent clinical case and to review the available literatura, with an emphasis on ophthalmological symptoms. METHODS: We present the case of a 4-year-old girl with a large dentigerous cyst on the maxillary bone, who had long-standing unilateral epiphora associated with progressive ocular dystopia, facial asymmetry and ipsilateral amblyopia. A multidisciplinary approach was taken by the maxillofacial surgery, ophthalmology and optometry teams. This included systemic antibiotic administration, surgical cyst drainage and amblyopia treatment. The literature review was carried out in the MEDLINE database through the free electronic access to PubMed in March 2020. RESULTS: At the 6-month follow-up, the patient was asymptomatic. The most common symptoms of dentigerous cysts are epiphora 36.8%, ocular dystopia 31.2%, diplopia 21.1%, proptosis, nasolacrimal duct obstruction and blurred vision at 10.5%. Amblyopia has not been reported. CONCLUSIONS: Dentigerous cysts are benign odontogenic cysts, which can be found in the jaw and less frequently on the maxillary bone. They are usually asymptomatic, and the occurrence of ophthalmic complications is very infrequent. Multidisciplinary management is essential to avoiding long-term morbidity of maxillary dentigerous cysts and should include an ophthalmologist.

Geochemical and isotopic study of abiotic nitrite reduction coupled to biologically produced Fe(II) oxidation in marine environments.

Estuarine sediments are often characterized by abundant iron oxides, organic matter, and anthropogenic nitrogen compounds (e.g., nitrate and nitrite). Anoxic dissimilatory iron reducing bacteria (e.g., Shewanella loihica) are ubiquitous in these environments where they can catalyze the reduction of Fe(III) (oxyhydr)oxides, thereby releasing aqueous Fe(II). The biologically produced Fe(II) can later reduce nitrite to form nitrous oxide. The effect on nitrite reduction by both biologically produced and artificially amended Fe(II) was examined experimentally. Ferrihydrite was reduced by Shewanella loihica in a batch reaction with an anoxic synthetic sea water medium. Some of the Fe(II) released by S. loihica adsorbed onto ferrihydrite, which was involved in the transformation of ferrihydrite to magnetite. In a second set of experiments with identical medium, no microorganism was present, instead, Fe(II) was amended. The amount of solid-bound Fe(II) in the experiments with bioproduced Fe(II) increased the rate of abiotic NO2- reduction with respect to that with synthetic Fe(II), yielding half-lives of 0.07 and 0.47 d, respectively. The δ18O and δ15N of NO2- was measured through time for both the abiotic and innoculated experiments. The ratio of ε18O/ε15N was 0.6 for the abiotic experiments and 3.1 when NO2- was reduced by S. loihica, thus indicating two different mechanisms for the NO2- reduction. Notably, there is a wide range of the ε18O/ε15N values in the literature for abiotic and biotic NO2- reduction, as such, the use of this ratio to distinguish between reduction mechanisms in natural systems should be taken with caution. Therefore, we suggest an additional constraint to identify the mechanisms (i.e. abiotic/biotic) controlling NO2- reduction in natural settings through the correlation of δ15N-NO2- and the aqueous Fe(II) concentration.

Manejo de pacientes en cirugía oral y maxilofacial durante el periodo de crisis y de control posterior de la pandemia de COVID-19 / Management of patients in oral and maxillofacial surgery during the stage of crisis and subsequent control of COVID-19 pandemic

La pandemia por la nueva infección respiratoria conocida como enfermedad coronavirus 2019 (COVID-19), causada por el virus SARS-CoV-2, ha desencadenado una perturbación sin precedentes en la actividad habitual de los servicios de cirugía oral y maxilofacial en España, retrasando la atención rutinaria de pacientes e intervenciones quirúrgicas programadas. Los cirujanos orales y maxilofaciales son uno de los colectivos sanitarios con mayor riesgo de infección nosocomial por el estrecho contacto que se produce con los pacientes asintomáticos y sintomáticos con infección por SARS-CoV-2 a través de la cavidad oral y orofaringe. El propósito del presente documento ha sido actualizar la evidencia disponible para el manejo y tratamiento seguro y efectivo en consulta, cirugías ambulatorias, programadas y urgentes y hospitalización, minimizando al mismo tiempo, tanto como sea posible, el riesgo de contagio para el cirujano oral y maxilofacial, personal sanitario y pacientes. Este documento pretende esclarecer los aspectos más significativos y crear un protocolo común de manejo de pacientes con COVID-19 en cirugía oral y maxilofacial durante la fase aguda de propagación y de control posterior de la pandemia en nuestro país

The pandemic due to the new respiratory infection known as coronavirus 2019 disease (COVID-19), caused by the SARS-CoV-2 virus, has triggered an unprecedented disruption in the normal activity of oral and maxillofacial surgery departments in Spain, delaying routine patient care and elective surgical interventions. Oral and maxillofacial surgeons are one of the healthcare groups with the highest risk of nosocomial infection because of the close contact that occurs with asymptomatic and symptomatic patients with SARS-CoV-2 infection through the oral cavity and oropharynx. The purpose of this document has been to update the available evidence for the safe and effective management and treatment in outpatient clinic, ambulatory, elective and emergency surgeries, and hospitalization, while minimizing as much as possible the risk of infection for the oral and maxillofacial surgeon, health workers and patients. This document aims to clarify the most significant aspects and create a common protocol for the management of patients with COVID-19 in oral and maxillofacial surgery during the acute stage of spread and subsequent control of the pandemic in our country

Lymphoepithelial carcinoma of the accessory parotid gland.

Lymphoepithelial carcinoma of the accessory parotid gland is rare, and to our knowledge, only two cases have previously been reported. It has an association with the Epstein-Barr virus and is usually seen in Asians and Greenland Eskimos. We report a case of lymphoepithelial carcinoma of the left accessory parotid gland in a 59-year-old European man who had been raised in the Belgian Congo. After excision of the left accessory parotid gland with preservation of the facial nerve, he recovered well without complication, and there was no evidence of locoregional recurrence or distant metastases after follow up of 3.5 years.

[Non-invasive diagnosis of cardiac amyloidosis due to transthyretin. Case report]. / Diagnóstico no invasivo de amiloidosis cardiaca por transtirretina. Caso clínico.

Amyloidosis due to deposits of transthyretin (ATTR) is currently considered the most frequent form of cardiac amyloidosis and its incidence is increasing thanks to the advances in diagnostic imaging techniques. Some non-invasive diagnostic criteria have recently been published on this entity that due to the development of new drugs for the specific treatment of cardiac ATTR, have prognostic and therapeutic implications. That is why cardiac ATTR could cease to be a rare disease and become a frequent one, and become potentially treatable instead of incurable. We present the case of an 80-year-old male diagnosed with non-hereditary cardiac ATTR by means of gammagraphy with 99mTc diphosfonate scintigraphy (99mTc-DPD) following the new criteria of non-invasive diagnosis.

Predicted environmental concentration of engineering nanomaterials as emerging pollutants: baseline scenario / Predicción de la concentración ambiental de los nanomateriales de ingeniería como contaminantes emergentes: escenario de referencia

Nanotechnology is one of the fastest growing and most promising technologies in our society. Due to its potential to develop new added value products, a growing number of engineered nanomaterials (ENMs) are already available on the market. However, in contrast to their benefits, there is an on-going debate about their potential adverse effects on human health and the environment. Such rapid proliferation however entails a crucial environmental problem due to an expected increase of the concentration of ENMs in the environment. The current concentration of ENMs remains unknown and poorly researched. In addition, toxicological studies pointed out adverse effects on key species and communities. Activities supporting the characterization of the concentration of ENMs in the environment will improve the protection of the environment. This paper conducte a thorough review of current data on the concentration of ENMs in the environment, demonstrating the presence of ENMs in freshwater, where quantities above 76 µg/L were estimated in peer reviewed publications

La nanotecnología es una de las tecnologías de más rápido crecimiento y más prometedoras de nuestra sociedad. Debido a su potencial para desarrollar nuevos productos de valor agregado, un número creciente de nanomateriales de ingeniería (ENM) ya están disponibles en el mercado. No obstante, a diferencia de sus beneficios, hay un debate en curso sobre sus posibles efectos adversos en la salud humana y el medio ambiente. Esta rápida proliferación, sin embargo, conlleva un crucial problema ambiental debido al aumento esperado de la concentración de ENMs en el medio ambiente. La concentración actual de ENMs sigue siendo desconocida y poco investigada. Además, los estudios toxicológicos señalaron efectos adversos en especies clave y comunidades. Las actividades que apoyan la caracterización de la concentración de ENMs en el medio ambiente mejorarán la protección del medio ambiente. Este artículo realizó una revisión exhaustiva de los datos actuales sobre la concentración de ENMs en el medio ambiente, demostrando la presencia de ENMs en agua dulce,donde se estimaron cantidades superiores a 76 µg/L en publicaciones revisadas por pares

[Approach of the unilateral cleft lip with Meara's cheiloplasty technique]. / Abordaje de la fisura labial unilateral mediante la queiloplastia de Meara.

INTRODUCTION: Isolated cleft lip is the mildest form of the cleft lip and palate spectrum; however those patients are often treated with the same surgical techniques that are used for the more severe cases (advancement-rotation flaps, quadrangular flaps). Meara's cheiloplasty technique may be a less aggressive option for lip repair in isolated cleft lip or whenever the gap between labial segments is not wide. MATERIAL AND METHODS: All children that had their cleft lip repaired following Meara's cheiloplasty between May 2014 and December 2015 were retrospectively reviewed. Duration of the surgical procedure, time to hospital discharge and complications were noted. Aesthetic results were evaluated in terms of lip height and symmetry, nose shape and symmetry, and scar appearance. RESULTS: Thirteen patients underwent Meara's cheiloplasty during this period. The average age was 6.11 months (5 to 12 months). A primary rhinoplasty was done at the same time in case of nasal asymmetry. Duration of the lip repair averaged 85 minutes. Oral feeding was started 4 hours after the procedure; bottle-feeding was withheld for 2 weeks postoperatively, as our protocol recommends after other lip repair techniques. In all 13 cases the result was a symmetrical, adequately high upper lip and a well-balanced nose, except for one case of lip scar retraction that was solved with triamcinolone infiltration. There were no other intra or postoperative complications. CONCLUSIONS: Meara's cheiloplasty corrects small or moderate gap cleft lip (usually cleft lip without cleft alveolus). Benefits over other teccniques are a shorter procedure and less geometric, undulate flaps that produce a harmonic lip.

INTRODUCCION: La fisura labial aislada es la forma menos grave de presentación del espectro de las fisuras labiopalatinas; sin embargo, para tratarla, usamos las mismas técnicas quirúrgicas que para las formas más graves (colgajos de avance-rotación, cuadrangulares). Presentamos la técnica de queiloplastia publicada por Meara, como alternativa menos agresiva para la reconstrucción del labio, en la fisura labial aislada o cuando los segmentos labiales están próximos entre sí. MATERIAL Y METODOS: Se realizó una revisión retrospectiva de las queiloplastias con técnica de Meara de mayo 2014 a diciembre 2015. Se revisó el tiempo quirúrgico, tiempo medio de ingreso, complicaciones y resultados estéticos, evaluando la altura y simetría del labio superior, la forma y simetría nasal y el aspecto de la cicatriz. RESULTADOS: Trece pacientes han sido intervenidos. La edad media al momento de la intervención fue de 6,11 meses (rango 5-12 meses). Se asoció una rinoplastia en casos con asimetría nasal. El tiempo quirúrgico medio de la queiloplastia aislada fue de 85 minutos. Se reinició alimentación oral a las 4 horas de la intervención, reanudando la alimentación mediante biberón a las 2 semanas, siguiendo el mismo protocolo que con las otras técnicas. En los 13 casos se consiguió un labio superior simétrico con altura adecuada y nariz armónica (excepto 1 que presentó retracción, tratada con infiltración de triamcinolona). No hubo otras complicaciones intra/postoperatorias. CONCLUSIONES: La queiloplastia de Meara corrige de forma muy armónica la fisura labial con poca o moderada separación de los segmentos labiales (habitualmente la fisura labial sin fisura alveolar). Como ventajas frente a otras técnicas permite, en una intervención más corta, la queiloplastia utilizando colgajos ondulados, que son menos geométricos y aportan armonía al resultado.

Efficacy and safety of eslicarbazepine-acetate in elderly patients with focal epilepsy: Case series.

PURPOSE: Eslicarbazepine-acetate (ESL) is a third generation antiepileptic drug licensed as adjunctive therapy in adults with focal seizures. Efficacy and safety of ESL have been established in real-life setting. However, data about outcomes in elderly patients are scarce. Primary endpoint was to evaluate outcomes of ESL in elderly patients. METHOD: This was a retrospective survey that included patients >65years with focal seizures who started ESL between January 2010 and July 2012 at 12 Spanish Hospitals. ESL was prescribed individually according to real-life practice. Efficacy and safety were evaluated over 1year. These patients were included within the bigger study ESLIBASE. RESULTS: We included 29 patients, most of them males (18). Mean age was 71.2 year-old and epilepsy evolution was 20 years. Eighteen were pharmacorresistant at baseline. At 12 months, the mean dose was 850mg/day, the retention rate 69%, the responder rate 62% and 24.1% were seizure-free. At 12 months, 16 patients (55.2%) had ≥1 adverse effect (AE), that led to discontinuation in 7 patients. Dizziness, nausea and ataxia were the most common AEs. The tolerability profile improved in 4/5 patients who switched from carbamazepine (CBZ) or oxcarbazepine (OXC) to ESL due to AEs. CONCLUSIONS: ESL was well-tolerated and effective in elderly patients in a real-life setting over 1year, with a dose around 800mg/day. AE effects improved in most of who switched from CBZ or OXC to ESL.

Abordaje de la fisura labial unilateral mediante la queiloplastia de Meara / Approach of the unilateral cleft lip with Meara’s cheiloplasty technique

Introducción. La fisura labial aislada es la forma menos grave de presentación del espectro de las fisuras labiopalatinas; sin embargo, para tratarla, usamos las mismas técnicas quirúrgicas que para las formas más graves (colgajos de avance-rotación, cuadrangulares). Presentamos la técnica de queiloplastia publicada por Meara, como alternativa menos agresiva para la reconstrucción del labio, en la fisura labial aislada o cuando los segmentos labiales están próximos entre sí. Material y métodos. Se realizó una revisión retrospectiva de las queiloplastias con técnica de Meara de mayo 2014 a diciembre 2015. Se revisó el tiempo quirúrgico, tiempo medio de ingreso, complicaciones y resultados estéticos, evaluando la altura y simetría del labio superior, la forma y simetría nasal y el aspecto de la cicatriz. Resultados. Trece pacientes han sido intervenidos. La edad media al momento de la intervención fue de 6,11 meses (rango 5-12 meses). Se asoció una rinoplastia en casos con asimetría nasal. El tiempo quirúrgico medio de la queiloplastia aislada fue de 85 minutos. Se reinició alimentación oral a las 4 horas de la intervención, reanudando la alimentación mediante biberón a las 2 semanas, siguiendo el mismo protocolo que con las otras técnicas. En los 13 casos se consiguió un labio superior simétrico con altura adecuada y nariz armónica (excepto 1 que presentó retracción, tratada con infiltración de triamcinolona). No hubo otras complicaciones intra/ postoperatorias. Conclusiones. La queiloplastia de Meara corrige de forma muy armónica la fisura labial con poca o moderada separación de los segmentos labiales (habitualmente la fisura labial sin fisura alveolar). Como ventajas frente a otras técnicas permite, en una intervención más corta, la queiloplastia utilizando colgajos ondulados, que son menos geométricos y aportan armonía al resultado (AU)

Introduction. Isolated cleft lip is the mildest form of the cleft lip & palate spectrum; however those patients are often treated with the same surgical techniques that are used for the more severe cases (advancement-rotation flaps, quadrangular flaps). Meara’s cheiloplasty technique may be a less aggressive option for lip repair in isolated cleft lip or whenever the gap between labial segments is not wide. Materials and methods. All children that had their cleft lip repaired following Meara’s cheiloplasty between May 2014 and December 2015 were retrospectively reviewed. Duration of the surgical procedure, time to hospital discharge and complications were noted. Aesthetic results were evaluated in terms of lip height and symmetry, nose shape and symmetry, and scar appearance. Results. Thirteen patients underwent Meara’s cheiloplasty during this period. The average age was 6.11 months (5 to 12 months). A primary rhinoplasty was done at the same time in case of nasal asymmetry. Duration of the lip repair averaged 85 minutes. Oral feeding was started 4 hours after the procedure; bottle-feeding was withheld for 2 weeks postoperatively, as our protocol recommends after other lip repair techniques. In all 13 cases the result was a symmetrical, adequately high upper lip and a well-balanced nose, except for one case of lip scar retraction that was solved with triamcinolone infiltration. There were no other intra or postoperative complications. Conclusions. Meara’s cheiloplasty corrects small or moderate gap cleft lip (usually cleft lip without cleft alveolus). Benefits over other teccniques are a shorter procedure and less geometric, undulate flaps that produce a harmonic lip (AU)

Distinct Dual C-Cl Isotope Fractionation Patterns during Anaerobic Biodegradation of 1,2-Dichloroethane: Potential To Characterize Microbial Degradation in the Field.

This study investigates, for the first time, dual C-Cl isotope fractionation during anaerobic biodegradation of 1,2-dichloroethane (1,2-DCA) via dihaloelimination by Dehalococcoides and Dehalogenimonas-containing enrichment cultures. Isotopic fractionation of 1,2-DCA (εbulkC and εbulkCl) for Dehalococcoides (-33.0 ± 0.4‰ and -5.1 ± 0.1‰) and Dehalogenimonas-containing microcosms (-23 ± 2‰ and -12.0 ± 0.8‰) resulted in distinctly different dual element C-Cl isotope correlations (Λ = Δδ13C/Δδ37Cl ≈ εbulkC/εbulkCl), 6.8 ± 0.2 and 1.89 ± 0.02, respectively. Determined isotope effects and detected products suggest that the difference on the obtained Λ values for biodihaloelimination could be associated with a different mode of concerted bond cleavage rather than two different reaction pathways (i.e., stepwise vs concerted). Λ values of 1,2-DCA were, for the first time, determined in two field sites under reducing conditions (2.1 ± 0.1 and 2.2 ± 2.9). They were similar to the one obtained for the Dehalogenimonas-containing microcosms (1.89 ± 0.02) and very different from those reported for aerobic degradation pathways in a previous laboratory study (7.6 ± 0.1 and 0.78 ± 0.03). Thus, this study illustrates the potential of a dual isotope analysis to differentiate between aerobic and anaerobic biodegradation pathways of 1,2-DCA in the field and suggests that this approach might also be used to characterize dihaloelimination of 1,2-DCA by different bacteria, which needs to be confirmed in future studies.