Epibiotic ciliate communities on the crayfish Procambarus (Austrocambarus) sp. cultivated in a rustic aquaculture in southern Mexico.

Rustic aquaculture systems represent a sustainable production alternative in the world, providing appropriate conditions for the establishment of epibiotic ciliates on crayfish. However, the impact of epibiotic ciliates on the aquaculture production has been insufficiently studied hitherto. The objective of this work was to identify the epibiotic ciliates on the surface of the crayfish Procambarus (Austrocambarus) sp. and analyze whether there is any correlation between seasonality and environmental conditions in an artificial pond in Chiapas, Mexico. The crayfish were collected during dry and rainy seasons to investigate their ciliate epibionts. Some physical and chemical parameters of the sampled water were measured and correlation matrix analyses were applied to detect possible relationships between the presence of ciliates and environmental parameters. Thirteen species belonging to the subclasses Peritrichia and Suctoria were identified. Significant differences were found for some environmental parameters and species recorded in both seasons. The present data could help to better understand the relationship bewteen the epibiotic ciliate community on crayfish and some environmental parameters in aquaculture systems.

Role of Nitrogen and Yttrium Contents in Manufacturing (Cr, Y)Nx Film Nanostructures.

The high-power impulse magnetron sputtering (HiPIMS) technique was applied to deposit multilayer-like (Cr, Y)Nx coatings on AISI 304L stainless steel, using pendular substrate oscillation and a Cr-Y target and varying the nitrogen flow rate from 10 to 50 sccm. The microstructure, mechanical and tribological properties were investigated by scanning and transmission electron microscopy, X-ray photoelectron spectroscopy, X-ray diffraction, instrumented nano-hardness, and wear tests. The columnar grain structure became highly segmented and nanosized due to pendular substrate oscillation and the addition of yttrium. The deposition rate increased continuously with the growing nitrogen flow rate. The increase in nitrogen flow from 10 to 50 sccm increased the hardness of the coatings (Cr, Y)Nx, with a maximum hardness value of 32.7 GPa for the coating (Cr, Y)Nx with a nitrogen flow of 50 sccm, which greatly surpasses the hardness of CrN films with multilayer-like (Cr, Y)Nx coatings architecture. The best mechanical and tribological performance was achieved for a nitrogen flow rate of 50 sccm. This was enabled by more elevated compressive stresses and impact energies of the impinging ions during film growth, owing to an increase of HiPIMS peak voltage with a rising N2/Ar ratio.

Hypermucoviscous Klebsiella pneumoniae invasive syndrome in a patient with diabetes without liver abscess.

Klebsiella pneumoniae is part of the human gastrointestinal microbiota. It is also a well-known cause of community and nosocomial infections, involving mainly the lung and urinary tract. An invasive syndrome with liver abscess due to a new hypervirulent strain of K. pneumoniae was recently described. Several cases have been reported, mainly in Asia. Here, we show a case of a patient with an extrahepatic involvement affecting the lung and prostate.

Tall Cell Carcinoma With Reversed Polarity of the Breast.

Tall cell carcinoma with reversed polarity (TCCRP) of the breast is a rare entity with low potential for malignancy that exhibits some morphological similarities to the tall cell variant of papillary thyroid carcinoma. Immunohistochemical and molecular studies help establish the mammary origin of this neoplasm. Here, we describe the case of a 63-year-old woman with a finding of a nodular lesion during a screening mammogram, whose morphological findings and immunohistochemical studies confirmed the diagnosis of papillary high cell carcinoma with the reverse polarity of the mammary gland.

Checklist of ciliates (Alveolata: Ciliophora) that inhabit in bromeliads from the Neotropical Region.

Species from almost all classes of ciliates are prone to be found inhabiting bromeliads in the Neotropics, from Mexico to Brazil, and the Antilles. Studies of ciliates recorded from bromeliads have been carried out from few bromeliad species, mainly in tropical forest. We compiled all available data of free living and sessile ciliates from bromeliads, including their geographic distribution and bromeliad identity. We provide a list of 170 ciliate species that have been recorded in 52 epiphytic and terrestrial bromeliad species, distributed in ten Neotropical countries . Most of the species belong to the Classes Oligohymenophorea, Colpodea and Spirotrichea. The largest number of ciliate species has been recorded in Brazil and Mexico. Bromeliothrix metopoides and Glaucomides bromelicola were the two species with the widest geographical distribution, 19 species have been recorded only in Mexico, 11 in the Antillean islands, and 89 only in Southamerica. Free living species prevailed over sessile species, and both represent 2% of the total ciliate species number. Sixteen ciliate species have been recorded only inhabiting in bromeliads. Although bromeliads show a high endemicity, their specificity is low in relation to ciliates.

Recomendaciones para el diagnóstico, tratamiento y seguimiento del cáncer de mama durante la pandemia de SARS-Cov-2/COVID-19 en Colombia / Recommendations for the diagnosis, treatment and monitoring of breast cancer during the SARS-Cov-2/COVID-19 pandemic in Colombia

Resumen Bajo las nuevas condiciones generadas por la pandemia de COVID-19, los tratamientos para el cáncer de mama requieren algunas reorientaciones y cuidados que se exponen en este artículo. Se consideran aquí las tres fases de gravedad de la pandemia y los respectivos tratamientos que demandan en función de los lineamientos dictados por el Ministerio de Salud y Protección Social de Colombia. Se trata de un conjunto de referencias para orientar las terapias y tratamientos, inspiradas en las políticas de salud regionales, nacionales e institucionales.

Abstract Under the new conditions generated by the COVID-19 pandemic, breast cancer treatments requires some reorientations and cares that are discussed in this article. The three phases of severity of the pandemic and the respective treatments they require -based on the guidelines issued by the Ministry of Health and Social Protection of Colombia- are considered here. It is a set of references to guide therapies and treatments, inspired by regional, national and institutional health policies.

Panorama científico de la relación entre la violencia intrafamiliar y de género y la resiliencia familiar: posibilidades, retos y límites / Scientific Overview of the Relation between Domestic and Gender Violence and Family Resilience: Possibilities, Challenges and Limits

Resumen En el marco de la investigación titulada "Resiliencia en víctimas de violencia intrafamiliar y de género Fase 1", realizada por el programa de Psicología de la Universidad Santo Tomás de Aquino (Bogotá, Colombia), se realizó una revisión de literatura, que describió el estado del arte de las investigaciones y estudios reflexivos publicados entre los años de 2015 y 2019 con respecto a la resiliencia familiar frente a la violencia intrafamiliar y de género (vifg). Se obtuvieron resultados preliminares de 3160 documentos, que fueron depurados a 74 artículos, que respondieron a criterios de inclusión como: Artículos Originales, de Reflexión, Revisión de literatura, Estudios Cualitativos, Cuantitativos o Mixtos publicados entre 2015 y 2019. La búsqueda se realizó en las bases de datos: PubMed, Ebsco Host, Science Direct, Scopus, Psyinfo, sage, Sprinter, y Taylor & Francis. Se encontró una tendencia de estudios aplicados, cualitativos, descriptivos con población participante femenina, infantil y adolescente con reporte de violencia intrafamiliar, realizados en Estados Unidos, Reino Unido y Canadá. Sin embargo, se pudo observar que la literatura hace referencia indirecta a la resiliencia familiar, pues en mayor medida se refiere al afrontamiento, recuperación y factores protectores, como fenómenos de interés relacionados con la vifg. Se concluye que aún son pocos los estudios en los que se incluya explícitamente el fenómeno del género en la vif, que describen la emergencia de la resiliencia familiar y alternativas de intervención para su desarrollo.

Abstract In the frame of the first phase of the research titled "Resilience in Victims of Domestic and Gender Based Violence", carried out by the Psychology academic program at the Santo Tomas University (Bogota, Colombia), a literature review was carried out which described the State of the Art of studies published between 2015 and 2019 regarding Family Resilience against Domestic and Gender-based Violence. There were preliminary results gathered from 3160 documents, which were later reduced to 74 articles according to the following criteria: original articles, rational thinking, literature review, and qualitative data, quantitative data, or mixed methods research published between 2015 and 2019. The research was carried out using the following Databases: PubMed, Ebsco Host, Science Direct, Scopus, PsyINFO, sage, Sprinter, and Taylor & Francis. A particular trend has been identified as a result of the research, with a large set of studies using mostly applied, qualitative and descriptive data of female, child and teenager participants who have reported cases of domestic violence, conducted in the United States, the United Kingdom, and Canada. However, it was observed that the literature makes indirect reference to family resilience, since for the most part it refers to coping mechanisms, recovery, and protective factors as phenomena of interest related to Domestic and Gender-based Violence. It is concluded that there are still very few studies which, while describing the emergence of family resilience and intervention alternatives for its development, explicitly include a gender approach or gender-related elements in cases of domestic violence.

Efectividad de los programas computorizados en rehabilitación cognitiva de pacientes con esquizofrenia / Effectiveness of Computerized Programs in Cognitive Rehabilitation of Patients with Schizophrenia / Efetividade dos programas computorizados em reabilitação cognitiva de pacientes com esquizofrenia

Resumen Objetivo. Establecer la eficacia de los programas computarizados en la rehabilitación cognitiva de pacientes con esquizofrenia. Método. Se revisaron los materiales bibliográficos publicados en las bases de datos Medline, PubMed, Assia, PsycInfo y Journals@Ovid, entre 2005 y 2017, que incluyeran las palabras clave plataforma virtual o programa computarizado y rehabilitación cognitiva o rehabilitación neuropsicológica y esquizofrenia. Resultados. De un total de 356 artículos, solo 20 de ellos cumplieron los criterios de inclusión. Se encontró que la intervención con programas computarizados suele generar mejorías tanto en los procesos de atención, memoria, velocidad de procesamiento y funciones ejecutivas como en la dimensión de cognición social y la esfera afectiva. Conclusión. Si bien la rehabilitación cognitiva a través de programas computarizados parece efectiva para mejorar el funcionamiento cognitivo de pacientes con esquizofrenia, no es clara la transferencia y generalización de esta mejora a la cotidianidad de los pacientes.

Abstract Objective. The cognitive deficits present in schizophrenia have been intervened through cognitive rehabilitation, and the use of computerized software is a current trend. This intervention has been the focus of attention of several studies, so, this investigation aims to give an account of the effectiveness of computerized software in the cognitive rehabilitation of patients with schizophrenia. Method. To do this, the databases of MEDLINE, PUBMED, ASSIA, PsycINFO and Journals@Ovid were examined from 2005 until 2017, in a search for papers that include in their keywords virtual platforms or computers software and cognitive rehabilitation or neuropsychological rehabilitation and Schizophrenia. Results. Of a total of 356 research papers, only 20 of them met inclusion criteria. These studies included cognitive rehabilitation that uses software improved attention, memory, processing speed, executive functions, as well as social cognition, and affective functioning. Conclusion. Even though the use of software in cognitive rehabilitation had proved to improve general cognitive functioning of patients with schizophrenia, it is not clear that this kind of intervention assures the transfer of learning and generalization of this improvement in the daily life of patients.

Resumo Escopo. Os déficits cognitivos presentes na esquizofrenia tem sido intervindos com a reabilitação cognitiva, sendo o uso de programas computorizados uma tendência nos últimos tempos. Em esta pesquisa, foi importante estabelecer a eficácia de estes programas na reabilitação cognitiva de pacientes com esquizofrenia. Metodologia. Para isto, foram revisados os materiais bibliográficos publicados nas bases de dados MEDLINE, PUBMED, ASSIA, PsycINFO e Journals@Ovid, entre 2005 e 2017, que incluíram nas suas palavras-chave plataforma virtual ou programa computorizado e reabilitação cognitiva ou reabilitação neuropsicológica e esquizofrenia. Resultados. De um total de 365 artigos, só 20 de eles cumpriram os critérios de inclusão. Sua revisão encontrou que a intervenção com programas computorizadas normalmente gera melhoras nos processos de atenção, memória, velocidade de processamento, funções executivas, assim como na dimensão de cognição social e a esfera afetiva. Conclusão. Embora a reabilitação cognitiva a través de programas computorizadas parece efetiva para melhorar o funcionamento cognitivo de pacientes com esquizofrenia, não é clara a transferência e generalização de esta melhora na cotidianidade dos pacientes.

Adenoma pleomórfico de vulva / Vulvar Pleomorphic Adenoma

El adenoma pleomórfico (AP) es el tumor benigno más prevalente de las glándulas salivales mayores; sin embargo, esta no es su localización anatómica exclusiva. Las células mioepiteliales, tapizan la membrana basal de las porciones terminales de diferentes tejidos glandulares exocrinos incluyendo los salivales, lacrimales, mamarios y sudoríparos; por esta razón, no es insólito que este tumor se origine en tejidos glandulares diferentes a los salivales. El adenoma pleomórfico de la vulva es un hallazgo infrecuente, con pocos casos reportados en la literatura, siendo este caso el primero reportado en Colombia y Latinoamérica(AU)

Pleomorphic Adenoma is the most prevalent benign tumor among the major salivary glands; nevertheless, this is not the exclusive anatomic localization. Myoepithelial cells cover the basal membrane of the terminal portions of different exocrine glandular tissues including the salivary glands, lacrimal glands, mammary tissue and sweat glands. Consequently, it is not rare that this kind tumor originate in tissues different from the salivary glands. The vulvar pleomorphic adenoma is an uncommon finding, with few reported cases in literature. Actuality this the first case reported in Colombia and Latin America(AU)

Ocular Exposure to Particulate Matter and Development of Pterygium: A Case-Control Study.

BACKGROUND: Formation of pterygium has been mainly attributed to exposure to the ultraviolet (UV) radiation. Other factors such as dry weather, wind exposure and microtrauma with dust particles, have been linked to development of pterygium. OBJECTIVE: To determine the association between ocular exposure to particulate matter and development of pterygium. METHODS: This case-control study was conducted in a company dedicated to the production and marketing of toilets. We included a total of 90 cases identified in November 2013 and 184 controls. The diagnosis of pterygium was based on clinical examination. Variables studied included age and job tenure of the participants. Logistic regression analysis was used to assess the effect of exposure on developing pterygium. RESULTS: All study participants were male. The mean age of the cases and controls was 39.9 (SD 9.5) and 37.8 (SD 7.3) years, respectively. 115 (42%) of the participants had a job tenure of 5-8 years. The percentages of cases and controls exposed to particulate matter were 31.1% (n=28) and 30.4% (n=56), respectively (OR 1.08, 95% CI 0.61 to 1.91). CONCLUSION: We could not observe any association between ocular exposure to particulate matter and development of pterygium.

Ciliate species from tank-less bromeliads in a dry tropical forest and their geographical distribution in the Neotropics.

The study of ciliate diversity in tropical environments remains scarce. In Neotropical forests, bromeliads are a common component of the vascular flora; bromeliads with tank morphology intercept rain water and detritus, resulting in the formation of a phytotelm, where heterotrophic protist communities like ciliates can establish. However, it is not known if ciliates inhabit tank-less bromeliads. For this reason, the goal of the present study was to investigate if ciliates can establish between the leaf axils of five terrestrial and epiphytic tank-less bromeliad species in a dry tropical forest in west Mexico. We collected samples of rain water and detritus from the leaf axils during the humid season of years 2015 and 2016. For ciliate taxonomical identification, we used optical microscopy, in vivo observation, and silver impregnation techniques. To summarize information about geographical distribution of ciliates identified at species level in the Neotropics, we provided their records from previous works, at country level with locality and georeferenciation. We recorded 27 taxa of ciliates, where the class Oligohymenophorea contained the largest richness of taxa. Drepanomonas revoluta, Leptopharynx bromeliophilus, and Tetrahymena sp. were recorded from all the species of bromeliads. Bromelia karatas was the species that hosted the largest number of ciliate taxa (22). Our results indicated that Glaucomides bromelicola, Gonostomum bromelicola, Leptopharynx bromelicola and L. bromeliophilus, species which are considered endemic to tank bromeliads, can also inhabit tank-less bromeliads. We provided previous records of 19 ciliate species from eleven countries within the Neotropical region, and Bromeliothrix metopoides was the species most frequently recorded in Neotropical countries (9). Therefore, tank-less bromeliads can constitute a temporal habitat for ciliates, and function as cysts reservoirs in environments with a pronounced seasonality like dry tropical forests.

Factores de riesgo, diagnóstico histológico y concentraciones de beta-hCG en pacientes con mola hidatiforme / Risk factors, histological diagnosis and beta-hCG concentrations in patients with hydatidiform mole

Resumen Introducción: La mola hidatiforme es la forma más común de enfermedad trofoblástica gestacional. La cuantificación de beta-hCG sérica tiene importante valor en su diagnóstico y pronóstico, no obstante en Colombia no se cuenta con referencias de sus niveles según el tipo de mola o factores de riesgo. Objetivo: Estudiar el comportamiento de los valores de beta-hCG según el tipo de mola y los factores de riesgo. Materiales y Métodos: Se estudiaron 74 casos con diagnóstico de mola hidatiforme en el departamento de patología de la Universidad Industrial de Santander entre los años 2005 y 2014. Se registró a partir de los datos proporcionados por la historia clínica: hábito de fumar, hemoclasificación, indicación de régimen EMA-CO, antecedentes sociodemográficos y ginecoobstétricos y la concentración de beta-hCG previa al tratamiento evacuador. Resultados: 63 casos presentaron mediciones válidas de beta-hCG. En el análisis se utilizaron pruebas no paramétricas con un nivel de significancia del 10%. La mediana de beta-hCG para mola completa y parcial fue 270 852 UI/L y 40 379 UI/L respectivamente. Hubo una diferencia significativa para los valores de beta-hCG entre grupos de mola (p<0,0001). Para el diagnóstico de mola completa un punto de corte de 170 000 U/L presentó una sensibilidad del 91,5% y una especificidad del 75%. La indicación de EMA-CO presentó una asociación significativa con los valores de beta-hCG (p=0,066); no alcanzaron significancia las asociaciones con el tabaquismo (p=0,118) y la multiparidad (p=0,111). Conclusión: La cuantificación de beta-hCG ayuda a clasificar el tipo de mola aunque su rendimiento diagnóstico es modesto. MÉD.UIS. 2018;31(1):39-46.

Abstract Introduction: Hydatidiform mole is the most common form of gestational trophoblastic disease. The quantification of serum beta-hCG has important value in its diagnosis and prognosis, however in Colombia there are no references of its values according to the type of mole or risk factors. Objective: To study the behavior of beta-hCG values according to the type of mole and the risk factors. Materials and Methods: 74 cases with diagnosis of hydatidiform mole were studied in the pathology department of the Industrial University of Santander between 2005 and 2014. It was recorded from the data provided by the clinical history: smoking habit, blood sample, indication of the EMA-CO regimen, sociodemographic and gyneco-obstetric antecedents and the beta-hCG concentration prior to the evacuation treatment. Results: 63 cases presented valid measurements of beta-hCG. In the analysis nonparametric tests with a level of significance of 10% were used. The median beta-hCG for complete and partial mole was 270 852 IU / L and 40 379 IU / L respectively. There was a significant difference for beta-hCG values between mola groups (p <0.0001). For the diagnosis of complete mole, a cut-off point of 170,000 U / L showed a sensitivity of 91.5% and a specificity of 75%. The EMA-CO indication showed a significant association with beta-hCG values (p = 0.066); associations with smoking (p = 0.118) and multiparity (p = 0.111) were not significant. Conclusion: The quantification of beta-hCG helps to classify the type of mole although its diagnostic performance is modest. MÉD.UIS. 2018;31(1):39-46.

Extraction of Dysprosium Ions with DTPA Functionalized Superparamagnetic Nanoparticles Probed by Energy Dispersive X-ray Fluorescence and TEM/High-Angle Annular Dark Field Imaging.

The extraction of dysprosium (Dy3+) ions from aqueous solution was carried out successfully, using magnetite (Fe3O4) nanoparticles functionalized with diethylenetriaminepentaacetic acid (MagNP@DTPA). The process was monitored by energy dispersive X-ray fluorescence spectroscopy, as a function of concentration, proceeding according to a Langmuir isotherm with an equilibrium constant of 2.57 × 10-3 g(MagNP) L-1 and a saturation limit of 63.2 mgDy/gMagNP. The presence of paramagnetic Dy3+ ions attached to the superparamagnetic nanoparticles led to an overall decrease of magnetization. By imaging the nanoparticles surface using scanning transmission electron microscopy equipped with high resolution elemental analysis, it was possible to probe the binding of the Dy3+ ions to DTPA, and to show their distribution in a region of negative magnetic field gradients. This finding is coherent with the observed decrease of magnetization, associated with the antiferromagnetic coupling between the lanthanide ions and the Fe3O4 core.

Manejo biológico del tamo de arroz bajo diferentes relaciones C:N empleando consorcios microbianos y promotores de crecimiento vegetal / Bio-based management of rice straw under different C:N ratios using microbial consortia and plant growth promoters

Resumen El tamo de arroz es uno de los residuos agrícolas lignocelulósicos más abundantes en el planeta, luego de los residuos producidos por los cultivos de maíz y trigo, con una producción mundial estimada de 1000 millones de toneladas según estadísticas de la FAO. En el contexto de la agricultura moderna es determinante lograr un manejo ambientalmente sostenible de este recurso mediante su incorporación al suelo, de tal forma que se logre el reciclaje de nutrientes, evitando la incorporación de patógenos al sistema y la inmovilización de elementos como el nitrógeno por la comunidad microbiana. El objetivo de este trabajo consistió en la evaluación de un inoculo microbiano mixto a partir de productos comerciales basados en hongos del género Trichoderma y bacterias aerobias formadoras de endosporas, con potencial degradador del tamo de arroz, así como el empleo de bacterias promotoras de crecimiento vegetal al momento de la siembra, que pudieran aprovechar los nutrientes del proceso de descomposición del tamo de arroz, potenciando su actividad biológica. Los tratamientos fueron evaluados bajo diferentes relaciones C:N del tamo de arroz que favorecieran el proceso de degradación, mediante la adición de nitrógeno inorgánico. Los resultados del trabajo permitieron identificar que la aplicación de una enmienda de nitrógeno a una relación C:N 35 más una dosis adicional de urea al momento de la siembra de las semillas de arroz, fue el tratamiento más adecuado para potenciar el efecto de los microorganismos e incrementar las variables agronómicas obtenidas mediante un esquema de fertilización convencional del cultivo.

Abstract Rice straw is one of the most abundant lignocellulosic agricultural residues on the world, after residues produced by maize and wheat crops, with an estimated global production of 1000 million tones according to FAO statistics. In the context of modern agriculture, it is essential to achieve an environmentally sustainable management of this resource, through the incorporation of rice straw into the soil, in order to achieve nutrient recycling avoiding the incorporation of pathogens into the system and the losses of nitrogen due to soil microbial biomass immobilization. In this context, the objective of this work consisted in the evaluation of a mixed microbial inoculum with degrading potential of rice straw from commercial products based on the fungus Trichoderma spp. and aerobic endospore forming bacteria. It was also used a plant growth promoting bacteria at the time of planting, in order to take advantage of nutrients released from RS decomposition and improve its biological activity. These microbial treatments, were evaluated at different concentrations of inorganic nitrogen amendments that allowed different levels of rice straw´s C:N ratio, favoring the degradation process. Overall results allowed to identify that the application of a nitrogen amendment to rice straw up to C:N 35, plus an additional dose of urea at the time of rice seeds planting, was the most adequate treatment to potentiate the effect of the microorganisms and to increase or maintain the agronomic variables obtained through a conventional fertilization management of the crop.

Reconstrucción peniana mediante microcirugía en Costa Rica / (Penile reconstruction with microsurgery)

ResumenEl pene tradicionalmente se ha considerado un símbolo de poder, masculinidad y fertilidad, por lo cual toda patología peniana congénita o adquirida, que eventualmente culmine en la amputación parcial o total del falo, constituye un evento catastrófico para cualquier hombre, presentando efectos devastadores, tanto físicos como psicológicos. Los diferentes niveles de amputación peniana en un individuo pueden definir su capacidad de miccionar y de concretar el coito, lo que perjudica directamente su virilidad y desempeño sexual y, por ende, su bienestar psicológico. Todo esto justifica el esfuerzo reconstructivo que se pueda ofrecer con el fin de mejorar la calidad de vida del paciente. El colgajo libre radial de antebrazo se ha considerado por muchos años el estándar de oro en reconstrucción peniana, ya que ha demostrado buenos resultados funcionales y estéticos. Esta técnica microquirúrgica representa un gran avance reconstructivo, lo cual se traduce en un rescate de la autoestima y de la masculinidad del paciente, con mejoría significativa de su calidad de vida. A continuación se presenta el caso clínico de un paciente masculino de 35 años de edad, quien requirió una amputación casi total de pene, secundaria a una quemadura eléctrica severa, y posteriormente fue sometido a la primera reconstrucción peniana microquirúrgica con colgajo libre radial de antebrazo, en Costa Rica.

AbstractThe penis has traditionally been considered a symbol of power, masculinity and fertility, so any congenital or acquired penile pathology that eventually culminates in partial or total amputation of the phallus constitutes a catastrophic event for any man, presenting both physical and psychological devastating effects. The different levels of penile amputation in an individual can define their ability to micturate and to concretize sexual intercourse, which directly impairs their virility and sexual performance and thus their psychological well-being. All this finally justifies any reconstructive effort that can be offered in order to improve the patient's quality of life. The free radial forearm flap has been considered for many years the gold standard in penile reconstruction as it has demonstrated good functional and aesthetic results. This microsurgical technique represents a great reconstructive advance, which results in a rescue of the patient's self-esteem and masculinity with a significant improvement in his quality of life. The authors present the clinical case of a 35-year-old male patient who required an almost total amputation of the penis, secondary to a severe electrical burn and who subsequently underwent the first microsurgical penile reconstruction with a free radial forearm flap in Costa Rica.

Reconstrucción facial con colgajo libre lateral del brazo / Facial reconstruction with free lateral arm flap

ResumenLas lesiones faciales malignas complejas o muy extensas, tratadas mediante resección quirúrgica, a menudo constituyen un reto para el cirujano plástico, debido a la gran exposición social del sitio, así como la escasa oferta de tejido para la reconstrucción del defecto cutáneo residual. En estos casos es imperativa la obtención de márgenes libres de malignidad; en segundo lugar, intentar recuperar la funcionalidad del área quirúrgica, y por último, buscar resultados estéticos favorables. Cuando sea posible, la ausencia de cobertura cutánea debe ser restaurada con tejido de similar grosor, color y textura, para lo cual el cirujano debe evaluar cuidadosamente el tamaño del defecto, la localización, las capas de tejido involucradas, la relación con estructuras aledañas y la cantidad de tejido donador disponible, con el fin de conseguir el mejor resultado final. Para deformidades de gran extensión que involucran múltiples capas de tejido, el concepto del triángulo reconstructivo de Mathes y Nahai, puede brindar mejores resultados, dándole opción al cirujano de escoger entre transposición de colgajos locoregionales, colgajos libres o expansión tisular. Los colgajos libres pueden satisfacer mejor las necesidades de forma y función facial, y permiten una considerable oferta de tejido con adecuada vascularidad, similitud de color, textura y grosor. A continuación se presenta el caso clínico de un paciente masculino de 21 años con el diagnóstico de carcinoma basocelular de mejilla derecha recidivante, quien fue sometido a resección completa y reconstrucción del defecto mediante transferencia libre de un colgajo lateral del brazo derecho, con excelentes resultados anatómicos y funcionales.

AbstractComplex or very extensive malignant facial lesions that are treated by surgical resection are often challenging for the plastic surgeon because of the large social exposure of the site as well as for the limited supply of tissue for reconstruction of the residual skin defect. In these cases it is imperative to first obtain free margins from malignancy, secondly try to recover the functionality of the surgical area and finally seek for favorable aesthetic results. Whenever possible, the facial defect should be restored with tissue of similar thickness, color and texture, for which the surgeon should carefully evaluate the size of the defect, location, tissue layers involved, the relationship with surrounding structures and the available donor tissue, in order to obtain the best final result. For large deformities involving multiple layers of tissue, the Mathes and Nahai concept of the reconstructive triangle can provide better outcomes, giving the surgeon a choice among transposition of locoregional flaps, free flaps, or tissue expansion. Free flaps can better satisfy the need of facial contour and function, they allow a considerable supply of tissue with adequate vascularity, similarity of color, texture and thickness. The authors present a clinical case of a 21-year-old male patient with the diagnosis of recurrent basal cell carcinoma of the right cheek who underwentcomplete resection and reconstruction of the facial defect with a free right lateral arm flap with excellent anatomical and functional results.

Colgajo Perforante en Propela de la Arteria Tibial Posterior: Reporte de un caso / Posterior Tibial Artery Perforator Propeller Flap. A Case Report

ResumenHistóricamente la reconstrucción de tejidos blandos del tercio distal de la pierna ha constituido un gran desafío quirúrgico para el cirujano plástico, a pesar de los múltiples avances en materia de colgajos pediculados y libres. En la actualidad los colgajos perforantes en propela son una excelente opción reconstructiva muy utilizada para cubrir defectos de tejidos blandos a este nivel con o sin exposición ósea, tendinosa, vascular y/o nerviosa. Esta técnica reconstructiva tiene como ventajas que no requiere anastomosis microquirúrgicas lo cual reduce el tiempo operatorio y que la localización precisa de los vasos perforantes puede realizarse fácilmente con un doppler manual por parte de los cirujanos en sala de operaciones.Se presenta el caso clínico de un paciente masculino de 14 años de edad a quien se le realizó un colgajo perforante en propela de la Arteria Tibial Posterior para cubrir un defecto de tejidos blandos producido por la resección de una contractura cicatrizal a nivel del tercio distal de la pierna derecha y del dorso del pie derecho, que le afectaba funcional y estéticamente. Se pretende dar a conocer el procedimiento y sus resultados, con el fin de difundir otra opción reconstructiva de dicha zona anatómica, que no involucre técnicas microquirúrgicas.

AbstractHistorically soft tissue reconstruction of the distal third of the leg has been a significant surgical challenge for the plastic surgeon despite the many advances in pedicled and free flap subject. Among the various surgical alternatives to rebuild lower limb defects, reverse flow sural flap and the soleus flap may be mentioned and in many cases are viable options, taking into account the area to rebuild and the assessment by the surgeon. Nonetheless, at present, propeller perforator flaps are an excellent reconstructive option widely used in lower limbs to cover soft tissue defects with or without bone, tendon, vascular and/or nervous exposure. These techniques have the main advantage that they do not require performing vascular anastomosis, therefore, knowledge in microsurgery is not indispensable, it requires the precise location of the perforating arteries to use through a manual doppler, this represents less difficulty and operative time when performing the procedureThe authors present a clinical case of a 14-year-old male patient, who underwent a propeller perforator flap from the Posterior Tibial Artery to cover a soft tissue defect produced by the excision of a scar contracture of the third distal of the right leg and dorsal right foot that affected him functionally and esthetically. The authors intend to create awareness of the procedure and its results, in order to disclose another reconstructive option for foot and distal leg that does not involve microsurgical techniques.

Fabrication and Optical Properties of Strain-free Self-assembled Mesoscopic GaAs Structures.

We use a combined process of Ga-assisted deoxidation and local droplet etching to fabricate unstrained mesoscopic GaAs/AlGaAs structures exhibiting a high shape anisotropy with a length up to 1.2 µm and a width of 150 nm. We demonstrate good controllability over size and morphology of the mesoscopic structures by tuning the growth parameters. Our growth method yields structures, which are coupled to a surrounding quantum well and present unique optical emission features. Microscopic and optical analysis of single structures allows us to demonstrate that single structure emission originates from two different confinement regions, which are spectrally separated and show sharp excitonic lines. Photoluminescence is detected up to room temperature making the structures the ideal candidates for strain-free light emitting/detecting devices.

Metaplasia ósea endometrial / Endometrial osseous metaplasia

La metaplasia ósea endometrial es una patología que se presenta con poca frecuencia y causa una gran variedad de síntomas como: sangrado uterino, dolor pélvico e infertilidad. Esta última, generalmente es secundaria y junto con el antecedente previo de aborto, constituyen una pieza clave en la sospecha diagnóstica. En el estudio de esta enfermedad, es necesario el uso de ecografía transvaginal y radiografía simple abdominal. El tratamiento definitivo se realiza mediante la extracción histeroscópica del material óseo, el cual es enviado a patología para corroborar el diagnóstico. La infertilidad revierte con la extracción del tejido óseo y no se han demostrado complicaciones en gestaciones futuras. Presentamos el caso de una paciente con metaplasia ósea endometrial por su rareza e importancia en el diagnóstico diferencial de sangrado uterino(AU)

Endometrial osseous metaplasia is a rare pathology that causes a variety of symptoms such as uterine hemorrhage, pelvic pain and infertility. This last consequence is generally secondary, and along with a history of abortions, represents a key element in suspected diagnosis. It is necessary to use transvaginal ultrasound and simple abdominal radiography for the study of the disease. The final treatment is performed by hysteroscopic removal of the bone material, which is sent to the pathology laboratory to confirm diagnosis. The infertility may be eliminated with the removal of the bone material and no further complications in future pregnancies have been observed. This is the case of a patient with endometrial osseous metaplasia, which is reported because of its infrequency and importance in the differential diagnosis of uterine bleeding(AU)

Descripción clínica, anatomopatológica y de tratamiento de pacientes con cáncer de mama en una unidad de mastología de la ciudad de Medellín, Colombia. 2006- 2013 / Description of clinic, anatomopathologic and treatment characteristics of pacients with breast cancer a senology unit in Medellin, Colombia; 2006- 2013

Introducción: la investigación del cáncer de mama se ha centrado en el estudio de las características biológicas e inmuno-histoquímicas del tumor, como elementos pronósticos de la sobrevida libre de enfermedad, la sobrevida global y como elementos predictivos de respuesta a las terapias. Metodología: estudio descriptivo y retrospectivo de características biológicas y anatomopatológicas de pacientes con cáncer de mama atendidas desde enero de 2006 a junio de 2013 en Medellín. Resultados: descripción de 1 480 casos de cáncer de mama, el promedio de edad fue de 54 años. El carcinoma in situ se diagnosticó en el 10 % de los casos y el carcinoma invasivo en el 83 %. Este último se presentó como forma no específica en el 80 %, como lobulillar infiltrante en el 7 % y como tipo especial en el 3 %. La positividad para los receptores de estrógeno fue de 73 %, receptores de progesterona en 64 % y para el receptor HER2 neu fue de 15 %. El carcinoma infiltrante de mama se diagnosticó en el 48 % en estadíos localmente avanzados y el 3 % en estadíos metastásicos. El 11 % de los pacientes recibió manejo quirúrgico conservador de la mama más biopsia de ganglio centinela, 7 % recibió manejo quirúrgico conservador con vaciamiento axilar. En el 58 % de los casos se realizó mastectomía simple más biopsia de ganglio centinela; de éstas, al 5 % se les realizó reconstrucción inmediata. En el 15 % de las pacientes se les practicó mastectomía radical modificada. El 65 % requirió adyuvancia con quimioterapia. Conclusiones: este trabajo permite aproximarse al conocimiento más detallado de los aspectos biológicos de los casos de cáncer de mama de una unidad de mastología de Colombia y pone en evidencia la necesidad de implementación de estrategias clínicas e imaginológicas para diagnosticar en mayor proporción el cáncer de mama en estadíos tempranos en las mujeres de nuestra población.

Introduction: The research in breast cancer has been focused in the study of the biological and immunohistochemically characteristics, as elements for prognostic factors of disease free survival and overall survival and as predictive elements in response to therapies. This study describes the clinical and pathologic features of patients treated for breast cancer in a breast unit in Medellin during the years 2006-2013. Methods: A descriptive and retrospective trial was performed evaluating variables from medical records of breast cancer patients who attended a breast cancer unit in Medellín, Colombia between January 2006 and June 2013. Results: There were 1,480 cases of breast cancer patients, with mean age of 54 years old. In situ carcinoma was diagnosed in 10 %, and invasive carcinoma was diagnosed in 83%; 80% of the cases was carcinoma non-specified type, invasive lobular carcinoma 7% and special types 3%. Estrogen receptor was positive in 73%, progesterone receptor was positive in 64% and HER 2 neu was positive in 15%. Early stage breast cancer was observed in 32%, locally advanced in 48% and metastatic stage in 3% of the cases. In 7% of the cases did not found information about this. 11% of the patients had conservative breast surgery (BCS) plus sentinel lymph node biopsy (SNB) and 7 % had BCS with axillary lymph node dissection (ALND). 58% had simple mastectomy plus SNB and of these patients, 5% had immediate reconstruction. 15% had modified radical mastectomy (MRM) and 7% of these patients had immediate reconstruction. In 65% adyuvant chemotherapy was performed and in 57% had adyuvant radiotherapy. Adyuvant endocrine therapy was received by 63% specially with Tamoxifen. Conclusions: The results of this study allows more detailed approach to the biological aspects of cases of breast unit of Colombia awareness and highlights the necessity for implementation of clinical and imaging strategies to diagnose greater proportion of breast cancer in early stages in our women population.