Discriminating Glioblastoma from Peritumoral Tissue by a Nanohole Array-Based Optical and Label-Free Biosensor.

In glioblastoma (GBM) patients, maximal safe resection remains a challenge today due to its invasiveness and diffuse parenchymal infiltration. In this context, plasmonic biosensors could potentially help to discriminate tumor tissue from peritumoral parenchyma based on differences in their optical properties. A nanostructured gold biosensor was used ex vivo to identify tumor tissue in a prospective series of 35 GBM patients who underwent surgical treatment. For each patient, two paired samples, tumor and peritumoral tissue, were extracted. Then, the imprint left by each sample on the surface of the biosensor was individually analyzed, obtaining the difference between their refractive indices. The tumor and non-tumor origins of each tissue were assessed by histopathological analysis. The refractive index (RI) values obtained by analyzing the imprint of the tissue were significantly lower (p = 0.0047) in the peritumoral samples (1.341, Interquartile Range (IQR) 1.339-1.349) compared with the tumor samples (1.350, IQR 1.344-1.363). The ROC (receiver operating characteristic) curve showed the capacity of the biosensor to discriminate between both tissues (area under the curve, 0.8779, p < 0.0001). The Youden index provided an optimal RI cut-off point of 0.003. The sensitivity and specificity of the biosensor were 81% and 80%, respectively. Overall, the plasmonic-based nanostructured biosensor is a label-free system with the potential to be used for real-time intraoperative discrimination between tumor and peritumoral tissue in patients with GBM.

Plasmonic Biosensing for Label-Free Detection of Two Hallmarks of Cancer Cells: Cell-Matrix Interaction and Cell Division.

Two key features of cancer cells are sustained proliferation and invasion, which is preceded by a modification of the adhesion properties to the extracellular matrix. Currently, fluorescence-based techniques are mainly used to detect these processes, including flow cytometry and fluorescence resonance energy transfer (FRET) microscopy. We have previously described a simple, fast and label-free method based on a gold nanohole array biosensor to detect the spectral response of single cells, which is highly dependent on the actin cortex. Here we used this biosensor to study two cellular processes where configuration of the actin cortex plays an essential role: cell cycle and cell-matrix adhesion. Colorectal cancer cells were maintained in culture under different conditions to obtain cells stopped either in G0/G1 (resting cells/cells at the initial steps of cell growth) or G2 (cells undergoing division) phases of the cell cycle. Data from the nanohole array biosensor showed an ability to discriminate between both cell populations. Additionally, cancer cells were monitored with the biosensor during the first 60 min after cells were deposited onto a biosensor coated with fibronectin, an extracellular matrix protein. Spectral changes were detected in the first 20 min and increased over time as the cell-biosensor contact surface increased. Our data show that the nanohole array biosensor provides a label-free and real-time procedure to detect cells undergoing division or changes in cell-matrix interaction in both clinical and research settings.

Janus-Nanojet as an efficient asymmetric photothermal source.

The combination of materials with radically different physical properties in the same nanostructure gives rise to the so-called Janus effects, allowing phenomena of a contrasting nature to occur in the same architecture. Interesting advantages can be taken from a thermal Janus effect for photoinduced hyperthermia cancer therapies. Such therapies have limitations associated to the heating control in terms of temperature stability and energy management. Single-material plasmonic nanoheaters have been widely used for cancer therapies, however, they are highly homogeneous sources that heat the surrounding biological medium isotropically, thus equally affecting cancerous and healthy cells. Here, we propose a prototype of a Janus-Nanojet heating unit based on toroidal shaped plasmonic nanoparticles able to efficiently generate and release local heat directionally under typical unpolarized illumination. Based on thermoplasmonic numerical calculations, we demonstrate that these Janus-based nanoheaters possess superior photothermal conversion features (up to [Formula: see text] K) and unique directional heating capacity, being able to channel up over 90% of the total thermal energy onto a target. We discuss the relevance of these innovative nanoheaters in thermoplasmonics, and hyperthermia cancer therapies, which motivate the development of fabrication techniques for nanomaterials.

La inteligencia artificial, una herramienta para la Salud Digital / Artificial intelligence, a tool for Digital Health

El constante avance tecnológico ha permitido la evolución de la práctica médica, generando el concepto denominado salud digital, que consiste en incorporar las tecnologías de información y comunicación a los productos, servicios y procesos de atención sanitaria. Una de las herramientas que permiten este avance es la Inteligencia Artificial (IA), una rama de la informática que desarrolla algoritmos capaces de aprender de los datos y utilizar lo aprendido en la toma de decisiones tal y como lo haría un ser humano. Este estudio se identifica cómo la investigación, las decisiones de diagnóstico, el tratamiento en pacientes y la planificación para la prevención y control de la salud están siendo optimizados gracias a la implementación de la IA, mostrando análisis cuantitativos al nivel de interés y aplicación asociado a estos cuatro procesos con respecto a las enfermedades que más afectan a la población de Perú y Latinoamérica(AU)

The constant technological advance has allowed the evolution of medical practice, generating the concept digital health, which consists of incorporating information and communication technologies into health care products, services and processes. One of the tools that allow this advance is Artificial Intelligence (AI), a branch of computing that develops algorithms capable of learning from data and using what they have learned in decision-making just as a human being would. This study identifies how research, diagnostic decisions, patient treatment and planning for prevention and health control are being optimized thanks to the implementation of AI, showing quantitative analysis at the level of interest and application associated with these four processes with respect to the diseases that most affect the population of Peru and Latin America(AU)

Hemicorporectomy as a life-saving strategy for severe pelvic ring crush injury: a case report.

Hemicorporectomy is an ultra-radical surgery used only in extreme circumstances. Initially used for advanced pelvic neoplastic diseases and intractable pelvic infection, it may also be the only treatment option in patients with crushed pelvic trauma, in cases there are no reconstruction options. This procedure has a high mortality, and its success depends on the multidisciplinary approach, both in the initial phase and in the rehabilitation process. We present the case of a young patient with severe pelvic trauma that required a hemicorporectomy as the only treatment option and review of the literature.

Trauma severity indices / Trauma severity scores

Introduction: Throughout the years, several methods have been developed to help determine injury severity and obtain accurate prognoses in trauma patients. Trauma scores that have been used for more than 40 years are extremely useful in clinical practice as well as in research. Objective: To conduct a review of the most relevant literature on trauma and to make a description of each of the scoring tools, focusing on their limitations and their application in clinical trials. Materials and methods: Narrative review conducted in different databases such as PubMed, ScienceDirect and OVID. A manual search was also conducted of articles on the subject in both English and Spanish. Results: The review articles provided an adequate description of each of the scores, the way they are calculated, the main limitations in their application, and the most relevant findings in the literature. Conclusion: There is a wide range of severity scores used in trauma patients for anticipating clinically significant outcomes with varying degrees of accuracy. Creating and validating a single, universally valid score is a huge challenge; consequently, the selection of the scoring tool is based, to a large extent, on experience, the context and the available evidence.

Introducción: a lo largo de la historia se han creado varios métodos para evaluar la gravedad de las lesiones y brindar un pronóstico exacto en pacientes con trauma. Los puntajes en trauma que se han utilizado por más de 40 años son una herramienta de gran utilidad tanto para el contexto clínico como investigativo. Objetivo: elaborar una revisión de la literatura más relevante sobre los puntajes en trauma y hacer una descripción de cada una de estas herramientas, haciendo énfasis en sus limitaciones y en la aplicación en estudios clínicos. Materiales y Métodos: revisión narrativa, se consultaron diferentes bases de datos como PubMed, ScienceDirect y OVID; además, se hizo búsqueda manual de artículos en inglés y en español sobre el tema. Resultados: los artículos revisados permitieron hacer una descripción adecuada de cada uno de los puntajes, de la forma en que se calculan, sus principales limitaciones al momento de aplicarlos y los hallazgos más notables en la literatura. Conclusión: existe una gran variedad de puntajes de gravedad para pacientes con trauma que permiten anticipar con diferente exactitud los desenlaces clínicamente significativos. La creación y validación de un único puntaje universalmente válido es todo un reto; por ello la selección de esta herramienta está basada en gran parte en la experiencia, el contexto y la evidencia disponible.

[Use of PCR for TB bacteria on BAL in early diagnosis of tubercular lobitis]. / PCR per BK su BAL nella diagnostica precoce di lobite tubercolare.

In June 2008 a 23-year-old immunocompetent came to our observation, without fever and with an occasional cough for 2 months, who showed two chest X-rays and a CT, performed respectively 60, 40 and 20 days earlier, that pointed to a small lobitis at the right lung base. The patient had already undergone several antibiotic therapies that had not changed the X-graphic framework. On presentation, routine blood tests and cultural examinations of sputum were carried out to detect common germs, fungi and TB bacteria (microscopic observation, cultivation and PCR), and a new antibiotic therapy (piperacillin/tazobactam) was started. Since the radiological picture appeared unchanged after 10 days of therapy and the examinations (microscopic observation and PCR) were negative, bronchoscopy with bacteriological evaluation of BAL was performed, which was positive to Mycobacterium tuberculosis, and then tubercular lobitis was diagnosed. Therefore a specific therapy - rifampin (RMP), isoniazid (INH), etambutol (EMB), pyrazinamid (PZA) - was started and changed after 10 days due to the growth of mycobacteria resistant to INH and EMB on examination of sputum. Consequently, the early use of PCR on BAL allows, in skilled hands, small aspecific lobitis to be diagnosed more rapidly than using cultural examination of sputum.

[Sexual exposure to HIV, sexual behaviour and use of pharmacological post-exposure prophylaxis (PEP)]. / Esposizione sessuale al virus HIV, comportamenti sessuali ed utilizzo della profilassi farmacologica post- esposizione (PEP).

In this study we examined the characteristics of 60 subjects (49 M and 11 F, average age 32.3) out of 195 post-exposure pharmacological prophylaxis (PEP) to HIV, taken in our hospital from 2001 to 2008. The above-mentioned subjects are sexually exposed (or presumably exposed) to HIV. We considered both their sexual intercourse behaviour and protective measures, and sought to infer some trends in sexual behaviour in Italy. All the subjects were monitored until 180 days after exposure, as established by the national guidelines. Only one of the 60 people presented a seroconversion (he dropped out after a 15-day follow-up and after an inadequate 19-day prophylaxis). Another subject, a homosexual male, never previously tested, resulted positive at time 0 both for HIV-Ab and syphilis tests (due to previous risk-sexual exposure), which caused the suspension of the prophylaxis. No HBV, HCV or syphilis seroconversion occurred. Two other homosexual males showed a previously latent positivity to syphilis tests at time 0.

Photoconductivity for silver nitrate in nanostructured sol-gel materials.

We report on the photoconductive response of nanostructured sol-gel films in function of the silver nitrate concentration (ions and colloids). Silver colloids were obtained by spontaneous reduction process of Ag+ ions to Ag(0). 2-d hexagonal nanosructured sol-gel thin films were prepared by dip-coating method using the non-ionic diblock copolymer Brij58 to produce channels into the film, which house the silver nanoparticles. An optical absorption band located at 430 nm was detected by optical absorption; it corresponds to the surface plasmon. A fit to this band with modified Gans theory is presented. Photoconductivity studies were performed on films with silver ions and films with silver colloids to characterize their mechanisms of charge transport in the darkness and under illumination at 420 and 633 nm wavelengths. The films with silver colloids exhibit a photovoltaic effect stronger than the films with silver ions. While a photoconductive behaviour is observed in the films with silver ions.

Photoinduced birefringence in nanostructured SiO2:DR1 sol-gel films.

Pump-probe photoinduced birefringence measurements were carried out in amorphous and in nanostructured sol-gel films with Disperse Red 1 (DR1) azochromophores embedded in a SiO2 matrix. X-ray diffraction (XRD) patterns determine the long-range nanostructure order of the films, exhibiting a lamellar nanostructure, with two different d-spacings, due to the presence during the sol-gel process of the Sodium Dodecyl Sulfate (SDS) or of the Cetyltrimethylammonium Bromide (CTAB) ionic surfactants. The photoinduced birefringence measurements were performed on fresh and on heat treated films as a function of the pumping time. The measurements give us information about the effect of the nanostructures on the azochromophores orientation dynamics. As a result, for the same azochromophores concentration, annealed nanostructured films exhibited the largest azochromophore mobilities but by the other side, amorphous films had the largest signal intensities. Besides, we established a phenomenological model for the analysis of the azochromophores orientation in the films as a function of the pumping time.

Clinical case of seroconversion for syphilis following a needlestick injury: why not take a prophylaxis?

A 47-year-old woman was pricked accidentally with a needle previously used for a neurosyphilitic man. At day 0 she had no positive laboratory results for the infection, while the source, at day 1, had TPHA positive, but no post-exposure prophylaxis (PEP) against syphilis was prescribed. The subject missed the day 30 follow-up, and underwent our visit at day 90, when she showed no clinical signs, but she seroconverted (VDRL = positive 1/2; TPHA = positive 1/320; FTA-Abs IgG and IgM = present). She started antibiotic therapy, and currently her serological status is VDRL = positive 1/2, TPHA = positive 1/160, FTA-Abs IgM = negative.

Pielonefritis enfisematosa bilateral en paciente diabético

La Pielonefritis Enfisematosa es una enfermedad poco frecuente, de mal pronóstico y de dificil diagnóstico clínico, que afecta con mayor frecuencia a pacientes diabéticos. Su diagnóstico puede verse retrasado, dada su sintomatología poco específica. Presentamos un caso de pielonefritis enfisematosa bilateral, tratada con antibióticos y nefrectomía de urgencia (AU)

Television digital en Bolivia

El objetivo de este trabajo dirigido es estudiar la nueva tecnologia en Radiodifusion de Television Digital y sugerir un estandar para que adopte Bolivia en un futuro a mediano plazo, ya que en el mundo algunos paises ya han adoptado ya algun estandar.Se analizan los estandares actuales de la TV analogica que estan vigentes en el mundo y particularmente del estadar (M) NTSC que es el que utilizamos en Bolivia.analizamos desde la señal banda hasta la entrada al trasmisor.Se hace un historial en el tiempo de los esfuerzos que se hicieron por desarrollar los estandares de la HDTV, luego explicamos el proceso de Digitalizacion de la señal banda base, la codificacion de la fuente que es el proceso de Comprimir seguido por un estudio detallado del MPEG2.Siguiendo la cadena digital para Radiodifusion digital analizamos la codificacion del canal que comprende la Multiplexion, transporte y Correccion de errores y por ultimo estudiamos los estandares ATSC y DVB.Se explica algo de equipamiento en la trasmision y recepcion de TV digital, tenemos que hacer notar que todavia no existe demanda masiva ya que es una tecnologia naciente, en algunos paises se estan experimentado emisiones de TV digital.Se hace un pequeño analisis en lo economico y social de como impactaria la TVD en Bolivia cuando llegue el momento de que se implemente.