Combined Percutaneous and Endoscopic Ureterolithotripsy of Calcified Double J Stent.

In urological practice, the routine procedure of placing a double J stent aims to facilitate drainage of the upper urinary system. Despite its temporary nature and the necessity for timely removal, approximately 12% of these stents are retained in patients for extended durations due to various reasons. Forgotten ureteral stents can lead to complications that increase the morbidity and mortality of patients. This report discusses a case of the double J stent that became calcified due to prolonged use and needed to be removed in a combined procedure.

In vitro evaluation of surface roughness of titanium abutments after air polishing with different abrasive powders.

OBJECTIVES: The purpose of this study was to evaluate the effects of air polishing with sodium bicarbonate and erythritol powders on surface roughness and morphological changes in titanium abutments. METHODS: A total of 45 grade V titanium discs were divided in three groups: Group A (Control) air polished with air/water; Group B, air polished with sodium bicarbonate powder; and Group C, air polished with erythritol powder. After air polishing, the samples' roughness (Sa) in micrometres were analysed with an optical profilometer. The samples' surface morphology study was conducted via scanning electronic microscope (SEM). Data were described using mean and standard deviation of roughness values (Sa). Inferential analysis was performed using the ANOVA multiple comparison test followed by Tukey's post hoc test. Both tests used a 5% level of significance. RESULTS: After air polishing, average roughness of group A, B and C were 0.036, 0.046 and 0.037 µm, respectively, with statistically significant differences between groups A and B (p < 0.05). No statistically significant differences were found between group A and group C, as well as between group B and C (p > 0.05). As for the morphology analysis, damages to the titanium surface were only observed in group B. CONCLUSIONS: The study indicates that air polishing with erythritol powder maintains titanium abutment integrity better than sodium bicarbonate, which increased surface roughness and caused damage. Erythritol is preferable for minimizing surface alterations and maintaining morphological stability.

Septic Shock After Intravesical Therapy With Bacillus Calmette-Guerin: A Case Report of a Rare Life-Threatening Complication.

Intravesical therapy with Bacillus Calmette-Guerin (BCG) is the mainstay treatment for high-risk non-muscle invasive bladder cancer. The side effects are usually local and mild. Systemic dissemination of BCG is rare, typically develops soon after instillation, and may present as a severe life-threatening condition. We present a case of a 49-year-old man under chronic haemodialysis who developed septic shock after the first BCG maintenance instillation for bladder carcinoma in situ (CIS). Supportive measures and empiric broad-spectrum antibiotic therapy were promptly started after sample collection for cultures. Lastly, the recurrence of fever raised the initial suspicion of BCG dissemination. The diagnosis was confirmed by the identification of the Mycobacterium tuberculosis complex in blood samples collected and anti-tuberculosis therapy was then initiated. We would like to highlight the need for early recognition of a systemic BCG infection and the importance of starting anti-tuberculosis treatment as early as possible.

A penile fracture hidden behind a urethral bleeding.

Penile fracture with urethral injury is uncommon. Diagnosis is usually based on clinical history and physical examination. Nonetheless, atypical presentation obliges complementary examinations to be performed. We report a case of a 45-years-old man with urethral bleeding after a blunt penile trauma that was ultimately diagnosed as having a cavernous body laceration on top of an urethral rupture.

The Influence of Perceived Security in Childhood on Adult Self-Concept: The Mediating Role of Resilience and Self-Esteem.

Secure attachment, developed through consistent relationships with attachment figures in childhood, is a crucial factor in fostering healthy interpersonal relationships and a positive self-perception. Part of the positive parenting approach and the theory of affect is taken as a basis to assess how perceived security, as an indicator of secure attachment, predicts adult self-concept through the mediating effects of resilience and positive self-esteem. A quantitative, cross-sectional, and nonprobabilistic study was conducted with 383 participants. We unveiled significant positive associations between perceived security, self-concept, resilience, and positive self-esteem. Path analysis demonstrated that resilience and positive self-esteem sequentially mediate the relationship between perceived security during childhood and adult self-concept. Findings suggest that the ability to cope with adversity and personal acceptance underlie the impact of perceived security on self-concept. It is recommended to promote family intervention programs framed within positive parenting that focus on fostering secure attachment given its influence on adult life. It is also deemed essential to incorporate the promotion of resilience and self-esteem into programs aimed at youths, and adult role models can enhance their self-perception and resilience in the face of potential effects stemming from insecure parenting practices.

A Review on Reinforcements and Additives in Starch-Based Composites for Food Packaging.

The research of starch as a matrix material for manufacturing biodegradable films has been gaining popularity in recent years, indicating its potential and possible limitations. To compete with conventional petroleum-based plastics, an enhancement of their low resistance to water and limited mechanical properties is essential. This review aims to discuss the various types of nanofillers and additives that have been used in plasticized starch films including nanoclays (montmorillonite, halloysite, kaolinite, etc.), poly-saccharide nanofillers (cellulose, starch, chitin, and chitosan nanomaterials), metal oxides (titanium dioxide, zinc oxide, zirconium oxide, etc.), and essential oils (carvacrol, eugenol, cinnamic acid). These reinforcements are frequently used to enhance several physical characteristics including mechanical properties, thermal stability, moisture resistance, oxygen barrier capabilities, and biodegradation rate, providing antimicrobial and antioxidant properties. This paper will provide an overview of the development of starch-based nanocomposite films and coatings applied in food packaging systems through the application of reinforcements and additives.

Smelling Peppers and Pout Submitted to Convective Drying: Mathematical Modeling, Thermodynamic Properties and Proximal Composition.

Pepper (Capsicum spp.) is among the oldest and most cultivated crops on the planet. Its fruits are widely used as natural condiments in the food industry for their color, flavor, and pungency properties. Peppers have abundant production; on the other hand, their fruits are perishable, deteriorating within a few days after harvesting. Therefore, they need adequate conservation methods to increase their useful life. This study aimed to mathematically model the drying kinetics of smelling peppers (Capsicum chinense) and pout peppers (Capsicum chinense Jacq.) to obtain the thermodynamic properties involved in the process and to determine the influence of drying on the proximal composition of these peppers. Whole peppers, containing the seeds, were dried in an oven with forced air circulation, at temperatures of 50, 60, 70, and 80 °C, with an air speed of 1.0 m/s. Ten models were adjusted to the experimental data, but the Midilli model was the one that provided the best values of coefficient of determination and lowest values of the mean squared deviation and chi-square value in most of the temperatures under study. The effective diffusivities were well represented by an Arrhenius equation, appearing in the order of 10-10 m2·s-1 for both materials under study, since the activation energy of the smelling pepper was 31.01 kJ·mol-1 and was 30.11 kJ·mol-1 in the pout pepper, respectively. Thermodynamic properties in both processes of drying the peppers pointed to a non-spontaneous process, with positive values of enthalpy and Gibbs free energy and negative values of entropy. Regarding the influence of drying on the proximal composition, it was observed that, with the increase in temperature, there was a decrease in the water content and the concentration of macronutrients (lipids, proteins, and carbohydrates), providing an increase in the energy value. The powders obtained in the study were presented as an alternative for the technological and industrial use of peppers, favoring obtaining a new condiment, rich in bioactives, providing the market with a new option of powdered product that can be consumed directly and even adopted by the industry as a raw material in the preparation of mixed seasonings and in the formulation of various food products.

Public views on tourist beach environment from multinational countries and ensuing changes during global epidemic.

The continuous endemic of the new SARS-CoV-2 virus brought a halt to the world's activities from February 2020. Our study intends to gauge public perceptions on the consequences of post-pandemic changes on the marine environment, particularly as they are related to tourist beach amenities. Totally, 16 nations' knowledge and views on various environmental viewpoints over the effects of epidemic were gathered through public polls live on social media during social confinement in 2020. The results indicate that around 85% of respondents were most concerned about the alarming sights of widespread plastic trash and the increase of dangerous biomedical wastes through wastewater in the marine ecosystem. The outcomes of this study will undoubtedly aid in the establishment of a management strategy and for future studies on the consequences of any epidemic on the beaches.

Is Your Kid Actin Out? A Series of Six Patients With Inherited Actin-Related Protein 2/3 Complex Subunit 1B Deficiency and Review of the Literature.

BACKGROUND: Hereditary actin-related protein 2/3 complex subunit 1B deficiency is characterized clinically by ear, skin, and lung infections, bleeding, eczema, food allergy, asthma, skin vasculitis, colitis, arthritis, short stature, and lymphadenopathy. OBJECTIVE: We aimed to describe the clinical, laboratory, and genetic features of six patients from four Mexican families. METHODS: We performed exome sequencing in patients of four families with suspected actinopathy, collected their data from medical records, and reviewed the literature for reports of other patients with actin-related protein 2/3 complex subunit 1B deficiency. RESULTS: Six patients from four families were included. All had recurrent infections, mainly bacterial pneumonia, and cellulitis. A total of 67% had eczema whereas 50% had food allergies, failure to thrive, hepatomegaly, and bleeding. Eosinophilia was found in all; 84% had thrombocytopenia, 67% had abnormal-size platelets and anemia. Serum levels of IgG, IgA, and IgE were highly increased in most; IgM was normal or low. T cells were decreased in 67% of patients, whereas B and NK cells were increased in half of patients. Two of the four probands had compound heterozygous variants. One patient was successfully transplanted. We identified 28 other patients whose most prevalent features were eczema, recurrent infections, failure to thrive, bleeding, diarrhea, allergies, vasculitis, eosinophilia, platelet abnormalities, high IgE/IgA, low T cells, and high B cells. CONCLUSION: Actin-related protein 2/3 complex subunit 1B deficiency has a variable and heterogeneous clinical spectrum, expanded by these cases to include keloid scars and Epstein-Barr virus chronic hepatitis. A novel deletion in exon 8 was shared by three unrelated families and might be the result of a founder effect.

Maternal diet in pregnancy and acute leukemia in infants: a case-control study in Mexico City.

Introduction: Epidemiological studies around the world on acute leukemia (AL) and risk factors in infants are scarce. Infant AL has been proposed to originate in utero, which facilitates its study by establishing a short exposure time in pregnant women to environmental and dietary factors that could contribute to the risk of or protection against leukemia. We hypothesized that maternal diet during pregnancy may be an important factor involved in AL in offspring. Methods: We conducted a hospital-based case-control study from 2010 to 2019 on maternal diet during pregnancy in nine high-specialty public hospitals of different health institutions that diagnose and offer treatment to children with AL in Mexico City. Cases (n=109) were children ≤24 months of age with de novo diagnosis of AL, and controls (n=252) were children obtained in hospitals from second-level medical care matched for age, sex, and health institution. Maternal diet during pregnancy was obtained by a semiquantitative food frequency questionnaire. Unconditional logistic regression models were used to assess the association between food groups and infant AL. Potential confounders were assessed by constructing directed acyclic graphs (DAGs) with Dagitty software in which adjusted options were identified for the construction of unconditional logistic regression models. Results: Cases were slightly predominantly female (52.3%). The years of education of the mother in cases and controls was 0-9 on average, and those who reported smoking cigarettes and consuming alcohol during pregnancy did so at a low frequency. Regarding the mother's diet, the main findings were that the consumption of allium vegetables during pregnancy was inversely associated with AL for medium and high consumption (OR=0.26, 95% CI 0.14-0.46; P-trend< 0.001). In contrast, the high consumption of high-fat dairy products had a positive association with AL (OR=2.37, 95% CI 1.30-4.34; P-trend<0.001). No association was found between consumption of topoisomerase II inhibitor foods during pregnancy and AL. Conclusion: The results suggest that maternal intake during pregnancy of allium vegetables, specifically garlic, is inversely associated with the development of AL in children ≤24 months old. On the other hand, consumption of high-fat dairy products is positively associated with AL in children ≤24 months old.

Peutz-Jeghers syndrome in pediatric patients: experience in a tertiary care institution in Mexico.

BACKGROUND: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant inherited disease characterized by the development of polyps in the gastrointestinal tract, mucocutaneous pigmentation, and the risk of developing malignant neoplasms. This study aimed to analyze the epidemiological, clinical, and histopathological data of patients with PJS treated in a tertiary pediatric hospital. METHODS: We conducted a retrospective observational study to describe the epidemiological, clinical, endoscopic, and histological characterization of patients with PJS treated in a tertiary pediatric hospital in Mexico. RESULTS: We included 13 cases with a male-female ratio of 1.16:1. Abdominal pain was the main reason for consultation, followed by rectorrhagia. Patients showed mucocutaneous pigmentation and polyps in the gastrointestinal tract, frequently of the hamartomatous type, although inflammatory polyps, follicular hyperplasia, and adenomatous polyps were also found. Among the complications, there was a high prevalence of emergency surgery secondary to abdominal obstructive processes, the main reason for first-time consultation in these patients. CONCLUSIONS: The main clinical manifestations were mucocutaneous pigmentation, abdominal pain, and rectorrhagia. PJS should be included in the differential diagnosis in the presence of intestinal obstruction. The diagnosis of PJS should not be excluded if hamartomatous polyps are not evident on the first endoscopy. Nutritional assessment should be included due to the risk of presenting some degree of malnutrition.

INTRODUCCIÓN: El síndrome de Peutz-Jeghers es una enfermedad hereditaria autosómica dominante poco frecuente, caracterizada por el desarrollo de pólipos en el tubo digestivo, pigmentación mucocutánea y riesgo de desarrollar neoplasias malignas. El objetivo de este estudio fue analizar los datos epidemiológicos, clínicos e histopatológicos de los pacientes con SPJ atendidos en un hospital pediátrico de tercer nivel. MÉTODOS: Se llevó a cabo un estudio observacional retrospectivo, para describir las características epidemiológicas, clínicas, endoscópicas e histopatológicas de los pacientes con SPJ atendidos en un hospital pediátrico de tercer nivel de atención en México. RESULTADOS: Se recopilaron 13 casos con una relación masculino-femenino de 1.16:1. El dolor abdominal fue el principal motivo de consulta, seguido por rectorragia. Los pacientes presentaban pigmentación mucocutánea y pólipos en el tubo digestivo, la mayoría del tipo hamartomatoso, aunque también se hallaron pólipos inflamatorios, hiperplasia folicular y adenomatosos. Dentro de las complicaciones se encontró una alta prevalencia de cirugías de emergencia secundarias a procesos obstructivos abdominales, motivo principal de consulta de primera vez en estos pacientes. CONCLUSIONES: Las principales manifestaciones clínicas fueron pigmentación mucocutánea, dolor abdominal y rectorragia. Ante un cuadro de obstrucción intestinal se debe considerar el SPJ en el diagnóstico diferencial. No se debe excluir el diagnóstico de SPJ si no se evidencian pólipos hamartomatosos en la primera endoscopia. Se debe incluir la valoración nutricional por el riesgo de presentar algún grado de desnutrición.

Peutz-Jeghers syndrome in pediatric patients: experience in a tertiary care institution in Mexico / Síndrome de Peutz-Jeghers en pacientes pediátricos: experiencia en una institución de tercer nivel de atención en México

Abstract Background: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant inherited disease characterized by the development of polyps in the gastrointestinal tract, mucocutaneous pigmentation, and the risk of developing malignant neoplasms. This study aimed to analyze the epidemiological, clinical, and histopathological data of patients with PJS treated in a tertiary pediatric hospital. Methods: We conducted a retrospective observational study to describe the epidemiological, clinical, endoscopic, and histological characterization of patients with PJS treated in a tertiary pediatric hospital in Mexico. Results: We included 13 cases with a male-female ratio of 1.16:1. Abdominal pain was the main reason for consultation, followed by rectorrhagia. Patients showed mucocutaneous pigmentation and polyps in the gastrointestinal tract, frequently of the hamartomatous type, although inflammatory polyps, follicular hyperplasia, and adenomatous polyps were also found. Among the complications, there was a high prevalence of emergency surgery secondary to abdominal obstructive processes, the main reason for first-time consultation in these patients. Conclusions: The main clinical manifestations were mucocutaneous pigmentation, abdominal pain, and rectorrhagia. PJS should be included in the differential diagnosis in the presence of intestinal obstruction. The diagnosis of PJS should not be excluded if hamartomatous polyps are not evident on the first endoscopy. Nutritional assessment should be included due to the risk of presenting some degree of malnutrition.

Resumen Introducción: El síndrome de Peutz-Jeghers es una enfermedad hereditaria autosómica dominante poco frecuente, caracterizada por el desarrollo de pólipos en el tubo digestivo, pigmentación mucocutánea y riesgo de desarrollar neoplasias malignas. El objetivo de este estudio fue analizar los datos epidemiológicos, clínicos e histopatológicos de los pacientes con SPJ atendidos en un hospital pediátrico de tercer nivel. Métodos: Se llevó a cabo un estudio observacional retrospectivo, para describir las características epidemiológicas, clínicas, endoscópicas e histopatológicas de los pacientes con SPJ atendidos en un hospital pediátrico de tercer nivel de atención en México. Resultados: Se recopilaron 13 casos con una relación masculino-femenino de 1.16:1. El dolor abdominal fue el principal motivo de consulta, seguido por rectorragia. Los pacientes presentaban pigmentación mucocutánea y pólipos en el tubo digestivo, la mayoría del tipo hamartomatoso, aunque también se hallaron pólipos inflamatorios, hiperplasia folicular y adenomatosos. Dentro de las complicaciones se encontró una alta prevalencia de cirugías de emergencia secundarias a procesos obstructivos abdominales, motivo principal de consulta de primera vez en estos pacientes. Conclusiones: Las principales manifestaciones clínicas fueron pigmentación mucocutánea, dolor abdominal y rectorragia. Ante un cuadro de obstrucción intestinal se debe considerar el SPJ en el diagnóstico diferencial. No se debe excluir el diagnóstico de SPJ si no se evidencian pólipos hamartomatosos en la primera endoscopia. Se debe incluir la valoración nutricional por el riesgo de presentar algún grado de desnutrición.

In Vitro Hydrolytic Degradation of Polyester-Based Scaffolds under Static and Dynamic Conditions in a Customized Perfusion Bioreactor.

Creating biofunctional artificial scaffolds could potentially meet the demand of patients suffering from bone defects without having to rely on donors or autologous transplantation. Three-dimensional (3D) printing has emerged as a promising tool to fabricate, by computer design, biodegradable polymeric scaffolds with high precision and accuracy, using patient-specific anatomical data. Achieving controlled degradation profiles of 3D printed polymeric scaffolds is an essential feature to consider to match them with the tissue regeneration rate. Thus, achieving a thorough characterization of the biomaterial degradation kinetics in physiological conditions is needed. Here, 50:50 blends made of poly(ε-caprolactone)-Poly(D,L-lactic-co-glycolic acid (PCL-PLGA) were used to fabricate cylindrical scaffolds by 3D printing (⌀ 7 × 2 mm). Their hydrolytic degradation under static and dynamic conditions was characterized and quantified. For this purpose, we designed and in-house fabricated a customized bioreactor. Several techniques were used to characterize the degradation of the parent polymers: X-ray Photoelectron Spectroscopy (XPS), Gel Permeation Chromatography (GPC), Scanning Electron Microscopy (SEM), evaluation of the mechanical properties, weigh loss measurements as well as the monitoring of the degradation media pH. Our results showed that flow perfusion is critical in the degradation process of PCL-PLGA based scaffolds implying an accelerated hydrolysis compared to the ones studied under static conditions, and up to 4 weeks are needed to observe significant degradation in polyester scaffolds of this size and chemical composition. Our degradation study and characterization methodology are relevant for an accurate design and to tailor the physicochemical properties of polyester-based scaffolds for bone tissue engineering.

Inferring pollution records in sediment cores from transitional environments of Marquelia coast, Guerrero, Mexico.

The vertical distribution pattern and concentrations of elements (Fe, Al, Ca, Mg, Mn, Cr, Cu, Ni, Co, Pb, Zn, and As) in the estuarine and lagoon region of Marquelia coast, Guerrero, Mexico, were studied to comprehend the origin and pollutant phases of geochemical elements. Henceforth, two sediment core samples [C1 (127 cm) and C2 (110 cm)] were collected to assess the pollution status using geochemical indices, namely anthropogenic factor (AF), enrichment factor (EF), and geoaccumulation index (Igeo). Additionally, the elemental concentrations were compared with the sediment quality guidelines (SQGs) to examine the potential risks to biota. Among the two depositional environments, the sediments of lagoon Apozahualco exhibited higher concentrations of elements. The granulometry characteristics of sediment grains also attested that the concentration and mobilization of metals are largely governed by the fine-grained fractions. Major elemental concentration and grain size changes were identified at several depths (30-40, 60-70, and 90-100 cm) revealing the internal hydrodynamic condition. The overall assessment of geochemical indices revealed that the sediments were unpolluted to moderately polluted. The anthropogenic factor indicated that the upper portion of the sediments were affected by anthropogenic influences. The comparison of trace element concentration with SQGs denoted that Cr, Ni, and As could pose potential adverse effect to the organisms that live in and near the sedimentary environment. Factor analysis revealed the origin and behaviour of the studied elements during transportation and deposition processes in both the ecosystems (i.e. estuary and lagoon). The results of this study provided an in-depth understanding of variations in elemental concentration and pollution status of sediment profile in coastal transitional environments that would aid in sustainable management.

Vulcano: A new robotic challenge for legged robots.

The Vulcano challenge is a new and innovative robotic challenge for legged robots in a physical and simulated scenario of a volcanic eruption. In this scenario, robots must climb a volcano's escarpment and collect data from areas with high temperatures and toxic gases. This paper presents the main idea behind this challenge, with a detailed description of the simulated and physical scenario of the volcano ramp, the rules proposed for the competition, and the conception of a robot prototype, Vulcano, used in the competition. Finally, it discusses the performance of teams invited to participate in the challenge in the context of Azorean Robotics Open, the Azoresbot 2022. This first test for this challenge provided insights into what the participants found exciting and positive and what they found less positive.