Miopatías RYR1 en la infancia: correlación fenotipo-genotipo e incidencia / RYR1 myopathies in childhood: phenotype-genotype correlation and incidence

Introducción: Las miopatías relacionadas con el receptor de rianodina de tipo 1 (RYR1-RM) constituyen la categoría más frecuente de miopatías congénitas. La introducción de técnicas genéticas ha cambiado el paradigma diagnóstico y sugiere la prioridad de estudios moleculares sobre biopsias. Este estudio busca explorar las características clinicoepidemiológicas de pacientes con variantes del gen RYR1 en un hospital pediátrico de tercer nivel con el objetivo de ampliar la comprensión de la correlación genotipo-fenotipo en las RYR1-RM. Pacientes y métodos: Estudio observacional, descriptivo y transversal, de pacientes menores de 14 años con síntomas miopáticos y variantes potencialmente patógenas del gen RYR1 entre enero de 2013 y diciembre de 2023, considerando variables como sexo, edad, desarrollo motor, variantes genéticas, patrón de herencia y otras manifestaciones. Todas las variables fueron tabuladas frente a la variante genética. Resultados: De los nueve pacientes incluidos, la incidencia estimada fue de aproximadamente 1/10.000 nacidos vivos. La mediana en el momento del diagnóstico fue de 6 años, con una variabilidad fenotípica significativa. Se observaron síntomas comunes, como debilidad y retraso del desarrollo motor. Las variantes genéticas afectaron al gen RYR1 de manera diversa, y hubo cinco variantes previamente no descritas. La biopsia muscular se realizó en cinco pacientes, en dos de ellos de tipo miopatía central core; en uno, multiminicore; en uno, desproporción congénita de fibras; y en otro, de patrón inespecífico. Conclusiones: Las RYR1-MR de nuestra serie ofrecieron variabilidad fenotípica y de afectación, con una incidencia en nuestra área de en torno a 1/10.000 recién nacidos. La mayoría de los casos fueron varones, de variantes missense dominantes. Aportamos cinco variantes genéticas no descritas con anterioridad.(AU)

Introduction: Ryanodine receptor type 1-related myopathies (RYR1-RM) represent the most prevalent category of congenital myopathies. The introduction of genetic techniques has shifted the diagnostic paradigm, suggesting the prioritization of molecular studies over biopsies. This study aims to explore the clinical and epidemiological characteristics of patients with RYR1 gene variants in a tertiary pediatric hospital, intending to enhance the understanding of the genotype-phenotype correlation in RYR1-RM. Patients and methods: An observational, descriptive, and cross-sectional study was conducted on patients under 14 years old with myopathic symptoms and potentially pathogenic RYR1 gene variants from January 2013 to December 2023. Variables such as gender, age, motor development, genetic variants, inheritance pattern, and other manifestations were considered. All variables were tabulated against the genetic variant. Results: Of the nine included patients, the estimated incidence was approximately 1 in 10,000 live births. The median age at diagnosis was six years, with significant phenotypic variability. Common symptoms such as weakness and delayed motor development were observed. Genetic variants affected the RYR1 gene diversely, including five previously undescribed variants. Muscle biopsy was performed in five patients, revealing central core myopathy in two, multiminicore in one, congenital fiber-type disproportion in one, and a nonspecific pattern in another.(AU)

[RYR1 myopathies in childhood: phenotype-genotype correlation and incidence]. / Miopatías RYR1 en la infancia: correlación fenotipo-genotipo e incidencia.

INTRODUCTION: Ryanodine receptor type 1-related myopathies (RYR1-RM) represent the most prevalent category of congenital myopathies. The introduction of genetic techniques has shifted the diagnostic paradigm, suggesting the prioritization of molecular studies over biopsies. This study aims to explore the clinical and epidemiological characteristics of patients with RYR1 gene variants in a tertiary pediatric hospital, intending to enhance the understanding of the genotype-phenotype correlation in RYR1-RM. PATIENTS AND METHODS: An observational, descriptive, and cross-sectional study was conducted on patients under 14 years old with myopathic symptoms and potentially pathogenic RYR1 gene variants from January 2013 to December 2023. Variables such as gender, age, motor development, genetic variants, inheritance pattern, and other manifestations were considered. All variables were tabulated against the genetic variant. RESULTS: Of the nine included patients, the estimated incidence was approximately 1 in 10,000 live births. The median age at diagnosis was six years, with significant phenotypic variability. Common symptoms such as weakness and delayed motor development were observed. Genetic variants affected the RYR1 gene diversely, including five previously undescribed variants. Muscle biopsy was performed in five patients, revealing central core myopathy in two, multiminicore in one, congenital fiber-type disproportion in one, and a nonspecific pattern in another. CONCLUSIONS: RYR1-RM in our series exhibited phenotypic and involvement variability, with an incidence in our area of around 1 in 10,000 live births. Most cases were male, with dominant missense variants. We contribute five previously undescribed genetic variants.

TITLE: Miopatías RYR1 en la infancia: correlación fenotipo-genotipo e incidencia.Introducción. Las miopatías relacionadas con el receptor de rianodina de tipo 1 (RYR1-RM) constituyen la categoría más frecuente de miopatías congénitas. La introducción de técnicas genéticas ha cambiado el paradigma diagnóstico y sugiere la prioridad de estudios moleculares sobre biopsias. Este estudio busca explorar las características clinicoepidemiológicas de pacientes con variantes del gen RYR1 en un hospital pediátrico de tercer nivel con el objetivo de ampliar la comprensión de la correlación genotipo-fenotipo en las RYR1-RM. Pacientes y métodos. Estudio observacional, descriptivo y transversal, de pacientes menores de 14 años con síntomas miopáticos y variantes potencialmente patógenas del gen RYR1 entre enero de 2013 y diciembre de 2023, considerando variables como sexo, edad, desarrollo motor, variantes genéticas, patrón de herencia y otras manifestaciones. Todas las variables fueron tabuladas frente a la variante genética. Resultados. De los nueve pacientes incluidos, la incidencia estimada fue de aproximadamente 1/10.000 nacidos vivos. La mediana en el momento del diagnóstico fue de 6 años, con una variabilidad fenotípica significativa. Se observaron síntomas comunes, como debilidad y retraso del desarrollo motor. Las variantes genéticas afectaron al gen RYR1 de manera diversa, y hubo cinco variantes previamente no descritas. La biopsia muscular se realizó en cinco pacientes, en dos de ellos de tipo miopatía central core; en uno, multiminicore; en uno, desproporción congénita de fibras; y en otro, de patrón inespecífico. Conclusiones. Las RYR1-MR de nuestra serie ofrecieron variabilidad fenotípica y de afectación, con una incidencia en nuestra área de en torno a 1/10.000 recién nacidos. La mayoría de los casos fueron varones, de variantes missense dominantes. Aportamos cinco variantes genéticas no descritas con anterioridad.

Clinical and Sociodemographic Features of Alopecia Areata in Five Colombian Cities: An Analysis of the RENAAC Registry.

BACKGROUND: Alopecia areata (AA) is an autoimmune disease characterized by non-scaring hair loss and preservation of hair follicles. The information available on disease course, and clinical features of AA is scarce worldwide, and almost nonexistent in Colombia. OBJECTIVE: To determine the clinical and sociodemographic characteristics of patients diagnosed with AA who presented to a dermatology consultation in five Colombian cities. MATERIAL AND METHODS: This was a retrospective and multicenter study on data from an ongoing National Registry of Alopecia Areata in Colombia (RENAAC) collected in Bogota, Cali, Cartagena, Barranquilla, and Medellin, Colombia from March 2022 through April 2023. Data was recorded in a standardized form by trained physicians. The variables were expressed as measures of central tendency and dispersion, and absolute and relative frequencies. RESULTS: A total of 562 patients were included, 59.4% of whom were women, aged between 15 and 49 years (63.9%) with a mean disease course of 1.7 years. The most common finding was multiple plaque (53.2%), the predominant AA subtype was patchy (71.4%), and 29.5% of the patients had a past dermatological history, 18.3% had a past endocrinological history, and 8.9% had a past psychiatric history. The treatments most widely used were steroid injections (76.4%), 5% topical minoxidil (46.4%), followed by high-potency corticosteroids (42.5%). STUDY LIMITATIONS AND CONCLUSIONS: AA was slightly predominant in women. As seen in other populations, this disease had an earlier onset in men vs women. Presentation in pediatric age was uncommon. The previous history of other dermatological diseases was checked in almost one third of the patients. Analysis of the co-presentation of AA with other autoimmune diseases is biased due to excluding patients with systemic erythematous lupus from the study.

Kombucha analogs from maqui juice: Consortium age and sugar concentration effects on anthocyanin stability and its relationship with antioxidant activity and digestive enzyme inhibition.

The fermentation of maqui juice (MJ), by incorporating kombucha as a starter culture, produces beverages with variable and stable anthocyanin contents. The metabolic effect of kombucha starter cultures obtained at different fermentation times was explored on the anthocyanin stability of maqui (Aristotelia chilensis (Mol.) Stuntz) juice supplemented at different concentrations of sucrose and fermented at different times. The stability of anthocyanins was associated with the levels of catechin detected in the fermentation system. This study concludes that the fermentation of MJ with sucrose (10%) and kombucha consortium of 7-days old, promotes the release and accumulation of phenolic compounds that act as co-pigments, with the best response in quality parameters of beverages such as color intensity, tone, hyperchromic effect, and a significant bathochromic shift. Finally, the additive effect of phenolic constituents with stable anthocyanins, confers to kombucha analogs an outstanding antioxidant quality and inhibitory effects on key enzymes in digestive processes.

Inhibition of X52 Corrosion in CO2-Saturated Brine by a Dialkyl-Diamide from Coffee Bagasse Oil.

This work reports the performance of a green corrosion inhibitor with double hydrocarbon chain. The evaluated inhibitor was a dialkyl-diamide from coffee bagasse oil and its electrochemical behavior was evaluated on an API-X52 steel in CO2-saturated brine at 60 °C. The electrochemical behavior was determined by measurements of open circuit potential, polarization resistance, and electrochemical impedance spectroscopy. In addition, the thermodynamic parameters of the corrosion process were obtained in the temperature range from 40 °C to 80 °C. Electrochemical studies showed that the inhibitor is capable of suppressing metal dissolution by up to 99% at 25 ppm. On the other hand, the thermodynamic parameters indicate that when adding the inhibitor, there is a strong increase in both Ea and ΔH° values, and that as time increases, they decrease until reaching similar values to those observed in the absence of the inhibitor. Furthermore, ΔS° values tend to become more negative with immersion time because of the formation of a stable film on the metal surface.

[Willingness to receive the COVID-19 vaccine in the population aged 80 years and older in Colombia 2021]. / Disposición a recibir la vacuna contra COVID-19 en población de 80 y más años en Colombia 2021.

Objective: Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The aim study was to know the willingness to accept the vaccination against COVID-19. Methods: A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried. The respondents were the affiliates or their relatives or caregivers. Results: The average age was 85.0 years (SD: 4.5), with no differences between sexes; 3,344 (28.5%) referred a previous diagnostic test for COVID-19 and 73 were positive for an incidence of 622.8 per 100,000 people (95%CI: 491-778). Regarding the attitude with the vaccination against SARS-CoV-2, 1/4 respondents refrained from giving an opinion or was neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI: 59.5-61.3) with differences by gender: men 62.2% (95% CI: 60.8-63.6) and women of 59.2 (95% CI: 58.0-60.3), P < 0.05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI: 59.4-64.0) and also differed by gender: 70.2% in men (95% CI: 66, 9-73.5) and 55.1% in women (95% CI: 52.0-58.3), P < 0.05. Conclusion: The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that allows control of the pandemic.

Environmental refuges increase performance of juvenile mussels Mytilus chilensis: Implications for mussel seedling and farming strategies.

Estuarine ecosystems are characterized by a wide physical-chemical variation that in the context of global change scenarios may be exacerbated in the future. The fitness of resident organisms is expected to be influenced by such variation and, hence, its study is a priority. Some of that variation relates to water vertical stratification, which may create "environmental refuges" or distinct layers of water with conditions favoring the fitness of some individuals and species. This study explored the performance of juvenile mussels (M. chilensis) settled in two distinctive water depths (1 m and 4 m) of the Reloncaví fjord (southern Chile) by conducting a reciprocal transplants experiment. Salinity, saturation state and the contents of CO3 in seawater were among the factors that best explained the differences between the two layers. In such environmental conditions, the mussel traits that responded to such variation were growth and calcification rates, with significantly higher values at 4 m deep, whereas the opposite, increased metabolic stress, was higher in mussels raised and transplanted to the surface waters (1 m). Such differences support the notion of an environmental refuge, where species like mussels can find better growth conditions and achieve higher performance levels. These results are relevant considering the importance of M. chilensis as a shellfish resource for aquaculture and a habitat forming species. In addition, these results shed light on the variable responses exhibited by estuarine organisms to small-scale changes in the characteristics of the water column, which in turn will help to better understand the responses of the organisms to the projected scenarios of climate global change.

Water-in-oil organogel based emulsions as a tool for increasing bioaccessibility and cell permeability of poorly water-soluble nutraceuticals.

The use of organogels in food and pharmaceutical sciences has several technical problems related with restricted diffusion of the drugs and lack of a proper gelator molecule. These features are important into the new product design. An alternative to improve technological properties in organogels is the use of emulsions. However, there is a lack of knowledge about the behavior on bioaccessibility and permeability of bioactives loaded into organogel-based emulsions. The objective of the present experimental work was to study the physical properties of organogel-based emulsions made with vegetable oil loaded with three different bioactives (betulin, curcumin and quercetin) and the influence on their bioaccessibility. Organogels were made of canola or coconut oils and myverol as gelator (10% w/w). Water-in-oil emulsions (at 5, 10 and 12.5 wt% of water content) were prepared by mixing the melted proper organogel and water (80 °C) under high shear conditions (20,000 rpm). Micrographs, rheological tests (amplitude, frequency, temperature sweeps and creep-compliance measurements), DSC and particle size analysis were performed to samples. In vitro digestion (oral, gastric and intestinal phase), lipolysis assays, bioaccessibility and permeability tests by cell culture of Caco-2 were made. Organogels of coconut oil have shown poor emulsification properties.

Parasitic copepods affect morphospace and diet of larvae of a temperate reef fish.

The effects of ectoparasites on larvae of the clingfish Gobiesox marmoratus were evaluated at the dietary and morphometric levels. The larvae and ectoparasites were collected by nearshore plankton samplings during October, November and December 2013 off El Quisco Bay, central Chile. The standardized abundance of total larvae and those ectoparasitized larvae (PL) was positively related and high parasite prevalence was found throughout the sampling period (up to 38%). Geometric morphometrics analyses indicate main changes in the shape through early ontogeny and subtle but significant variations between PL and non-parasitized larvae (NPL). Prey composition varied between PL and NPL; small size (<6 mm standard length, LS ) parasitized larval G. marmoratus ate mostly gastropod larvae, whereas small non-parasitized specimens ate mainly cirripede nauplii. All larger (>8 mm LS ), pre-settlement stages parasitized by Trifur and, or Caligus copepods had content in their gut, suggesting that ectoparasites did not diminish prey capture in host with larger size. Morphometric and dietary changes occurring during larval development were decoupled, both for PL and NPL. The maintenance of a slender, more hydrodynamic body through pelagic development and the ingestion of less-mobile prey in PL suggests non-lethal effects of ectoparasitism on rocky-reef fish larvae.

Effect of ultrasound pre-treatment on the physicochemical composition of Agave durangensis leaves and potential enzyme production.

Approximately 1 million tons of agave plants are processed annually by the Mexican tequila and mezcal industry, generating vast amounts of agroindustrial solid waste. This type of lignocellulosic biomass is considered to be agroindustrial residue, which can be used to produce enzymes, giving it added value. However, the structure of lignocellulosic biomass makes it highly recalcitrant, and results in relatively low yield when used in its native form. The aim of this study was to investigate an effective pre-treatment method for the production of commercially important hydrolytic enzymes. In this work, the physical and chemical modification of Agave durangensis leaves was analysed using ultrasound and high temperature as pre-treatments, and production of enzymes was evaluated. The pre-treatments resulted in modification of the lignocellulosic structure and composition; the ultrasound pre-treatment improved the production of inulinase by 4 U/mg and cellulase by 0.297 U/mg, and thermal pre-treatment improved ß-fructofuranosidase by 30 U/mg.

Sharing morphospaces: early ontogenetic shape changes in two clingfish larvae (Pisces: Gobiesocidae) from the south-east Pacific Ocean.

Larval body shape changes and developmental timing were examined in two clingfish species from the south-east Pacific Ocean, Gobiesox marmoratus and Sicyases sanguineus. Ontogenetic allometry showed no interspecific variation and <7 mm standard length (LS ) larvae of both species occupied similar morphospace, but larger G. marmoratus showed increased body depth while larvae of S. sanguineus developed a flattened head and maintained a hydrodynamic body. Estimated developmental timing suggests that larval body shape changes were faster in G. marmoratus than in S. sanguineus prior to settlement.

Oak kombucha protects against oxidative stress and inflammatory processes.

Black tea infusion is the common substrate for preparing kombucha; however other sources such as oak leaves infusions can be used for the same purpose. Almost any white oak species have been used for medicinal applications by some ethnic groups in Mexico and could be also suitable for preparing kombucha analogues from oak (KAO). The objective of this research was to investigate the antioxidant activity and anti-inflammatory effects of KAO by examining its modulation ability on macrophage-derived TNF-alpha and IL-6. Herbal infusions from oak and black tea were fermented by kombucha consortium during seven days at 28 °C. Chemical composition was determined by LC-ESI-MS/MS. The antioxidant activity of samples against oxidative damage caused by H2O2 in monocytes activated (macrophages) was explored. Additionally, it was determined the anti-inflammatory activity using lipopolysaccharide (LPS) - stimulated macrophages; in particular, the nitric oxide (NO), TNF-alpha, and IL-6 production was assessed. Levels of pro-inflammatory cytokines IL-6 and TNF-alpha were significantly reduced by the sample treatment. Likewise, NO production was lower in treatment with kombucha and KAO compared with LPS-stimulated macrophages. Fermented beverages of oak effectively down-regulated the production of NO, while pro-inflammatory cytokines (TNF-alpha and IL-6) in macrophages were stimulated with LPS. Additionally, phytochemical compounds present in KAO decrease oxidative stress.

Motor associations of iron accumulation in deep grey matter nuclei in Parkinson's disease: a cross-sectional study of iron-related magnetic resonance imaging susceptibility.

BACKGROUND AND PURPOSE: To determine whether iron deposition in deep brain nuclei assessed using high-pass filtered phase imaging plays a role in motor disease severity in Parkinson's disease (PD). METHODS: Seventy patients with mild to moderate PD and 20 age- and gender-matched healthy volunteers (HVs) underwent susceptibility-weighted imaging on a 3 T magnetic resonance imaging scanner. Phase shifts (radians) in deep brain nuclei were derived from high-pass filtered phase images and compared between groups. Analysis of clinical laterality and correlations with motor severity (Unified Parkinson's Disease Rating Scale, Part III, UPDRS-III) were performed. Phase shifts (in radians) were compared between HVs and three PD subgroups divided according to UPDRS-III scores using analysis of covariance, adjusting for age and regional area. RESULTS: Parkinson's disease patients had significantly (P < 0.001) higher radians than HVs bilaterally in the putamen, globus pallidus and substantia nigra (SN). The SN contralateral to the most affected side showed higher radians (P < 0.001) compared to the less affected side. SN radians positively correlated with UPDRS-III and bradykinesia-rigidity subscores, but not with tremor subscores. ancova followed by post hoc Bonferroni-adjusted pairwise comparisons revealed that SN radians were significantly greater in the PD subgroup with higher UPDRS-III scores compared to both lowest UPDRS-III PD and HV groups (P < 0.001). CONCLUSIONS: Increased nigral iron accumulation in PD appears to be stratified according to disease motor severity and correlates with symptoms related to dopaminergic neurodegeneration. This semi-quantitative in vivo iron assessment could prove useful for objectively monitoring PD progression, especially in clinical trials concerning iron chelation therapies.

[Ankle fracture in adolescents: triplanar injury associated to fracture of leg]. / Fractura de tobillo en adolescentes: fractura triplanar de tobillo asociada a fractura de pierna.

INTRODUCTION: the vast mayority of epiphyseal children fractures could be classified according to Salter Harris. There are other types of patterns such as triplanar and Tillaux fractures. The former is a complex type with fracture lines in sagital, axial and frontal planes. These fractures have main complications such as early epiphyseal closure, mechanical axis malalignment and gait disturbances. A clinical case is pictured which had a tibial shaft and ipsilateral triplanar fracture, this complex scenario of rare ocurrence was treated with reduction and osteosynthesis of both fractures. This clinical case is shown to help in the management of these injuries that with the early sport practice initiation, could appear more frequently.

la gran mayoría de fracturas epifisiarias pediátricas pueden categorizarse según la clasificación de Salter Harris. Existen otros tipos de patrones como la fractura triplanar y la de Tillaux, la primera es un patrón de fractura complejo con rasgos de fractura en planos sagital, transverso y frontal. Estos tipos de fractura pueden estar asociados a complicaciones importantes como cierre fisiario precoz, desejes y alteraciones de la marcha. Presentamos el caso de un paciente que además de tener una fractura triplanar presentó una fractura de pierna ipsilateral, este complejo escenario de rara ocurrencia fue tratado mediante reducción y osteosíntesis de ambas fracturas. Presentamos este caso para ayudar en el manejo de estas lesiones que como consecuencia de las actividades deportivas a edades tempranas pueden tornarse cada vez más frecuentes.

Fractura de tobillo en adolescentes: fractura triplanar de tobillo asociada a fractura de pierna / Ankle fracture in adolescents: triplanar injury associated to fracture of leg

Resumen: Introducción: la gran mayoría de fracturas epifisiarias pediátricas pueden categorizarse según la clasificación de Salter Harris. Existen otros tipos de patrones como la fractura triplanar y la de Tillaux, la primera es un patrón de fractura complejo con rasgos de fractura en planos sagital, transverso y frontal. Estos tipos de fractura pueden estar asociados a complicaciones importantes como cierre fisiario precoz, desejes y alteraciones de la marcha. Presentamos el caso de un paciente que además de tener una fractura triplanar presentó una fractura de pierna ipsilateral, este complejo escenario de rara ocurrencia fue tratado mediante reducción y osteosíntesis de ambas fracturas. Presentamos este caso para ayudar en el manejo de estas lesiones que como consecuencia de las actividades deportivas a edades tempranas pueden tornarse cada vez más frecuentes.

Abstract: Introduction: the vast mayority of epiphyseal children fractures could be classified according to Salter Harris. There are other types of patterns such as triplanar and Tillaux fractures. The former is a complex type with fracture lines in sagital, axial and frontal planes. These fractures have main complications such as early epiphyseal closure, mechanical axis malalignment and gait disturbances. A clinical case is pictured which had a tibial shaft and ipsilateral triplanar fracture, this complex scenario of rare ocurrence was treated with reduction and osteosynthesis of both fractures. This clinical case is shown to help in the management of these injuries that with the early sport practice initiation, could appear more frequently.

Dolor cervical como presentación de neumomediastino espontáneo en urgencia pediátrica. Caso clínico / Cervical pain as presentation of spontaneous pneumomediastinum in pediatric emergency. Case report

Spontaneous Pneumomediastinum is a rare clinical situation in pediatric emergency services, sometimes it presents with guiding symptoms, but in other occasions in a very nonspecific way. Definitely, needs to be highly suspected, emphasizing in the anamnesis the antecedent of intense physical exercise before the development of the triggering symptoms that determinates the consult, generally having a good evolution that gets solved in 3-4 days. There is a pediatric clinical case presented, that permits us to discuss the more relevant aspects of the clinical presentation, diagnosis methods and the updated management, in pediatric emergency services.

Economic Impact of Meningococcal Outbreaks in Brazil and Colombia.

Background. The impact of meningitis outbreaks is substantial. We aim to calculate the costs of meningococcal outbreaks in Brazil and Colombia from the healthcare system perspective. Methods. A review of the literature was performed on costs associated with meningococcal outbreak in Latin America. Structured interviews capturing information about the use of resources, expenses allocated to treatment of infection, immunization campaigns, and response activities during the outbreak and disease surveillance pre- and postoutbreak were directed at local health authorities in Brazil and Colombia to foster a greater understanding of the economic impact of meningococcal outbreaks. All costs were expressed in 2014 US values. Results. The Vila Brandina outbreak in Brazil reported 3 cases that were associated with a total investigation and outbreak management cost of $34 425 ($11 475 per notified case), representing 2.7 more than the annual gross domestic product per capita in Brazil. In contrast, the outbreak in Cartagena de Indias in Colombia reported 6 cases at a cost of the disease response phase of $735 or 9.5% of the annual gross domestic product per capita ($123 per notified case). For the disease surveillance phase, the costs ranged from $3935 (in Cartagena de Indias) to $6667 (in Vila Brandina). Serogroups B and C were responsible for the majority of meningococcal outbreaks reported in Brazil and Colombia. Conclusions. Findings of this study underscore the importance of meningococcal disease in the region. Future research should focus on a more detailed investigation of costs of meningococcal outbreaks covering all phases of an outbreak.

Morphological and release characterization of nanoparticles formulated with poly (dl-lactide-co-glycolide) (PLGA) and lupeol: In vitro permeability and modulator effect on NF-κB in Caco-2 cell system stimulated with TNF-α.

Lupeol exhibits anti-inflammatory effects; unfortunately it shows low water solubility. An alternative to overcome this is the development of nanomaterials. Several methods for nanomaterial production are available. One of them is emulsification/solvent-evaporation. The objective of the present work was to evaluate physical properties, transport and in vitro modulator effects on NF-κB of poly (lactide-co-glycolide) (PLGA) nanoparticles loaded with lupeol. Nanonutraceuticals were prepared with 16% (w/v) of lupeol. Size distribution and morphology were measured by particle size analyzer and TEM. In vitro release of lupeol was studied by three different models: Higuchi, Siepmann & Peppas, and Power law. Transport of nanonutraceutical was studied in a Caco-2 cell model and by GC-MS. Modulator effect on NK-κB was studied by western blot analysis. Nanonutraceuticals were 10% larger than the nanoparticles without lupeol (372 vs 337 nm) and presented a broader size distribution (0.28 vs 0.22). TEM results displayed spherical structures with a broader size distribution. Entrapment efficiency of lupeol was 64.54% and it in vitro release data fitted well to the Power law and Higuchi equation (R > 0.84-0.84). Strong regulation of NF-κB of nanonutraceutical was observed. It was not observed any transport across the Caco-2 cell model at the different experimental conditions.

Gastroprotective potential of Buddleja scordioides Kunth Scrophulariaceae infusions; effects into the modulation of antioxidant enzymes and inflammation markers in an in vivo model.

ETHNOPHARMACOLOGICAL RELEVANCE: A common plant used to treat several gastric disorders is Buddleja scordioides Kunth, commonly known as salvilla. AIM OF THE STUDY: To detect inflammatory markers, in order to evaluate the gastroprotective potential of salvilla infusions, as this could have beneficial impact on the population exposed to gastric ulcers and colitis. MATERIALS AND METHODS: The present work attempted infusions were prepared with B. scordioides (1% w/w) lyophilized and stored. Total phenolic content and GC-MS analysis were performed. Wistar rats were divided into five groups (n=8), a negative vehicle control, an indomethacin group, and three experimental groups, named preventive, curative, and suppressive. All rats were sacrificed under deep ether anesthesia (6h) after the last oral administration of indomethacin/infusion. The rat stomachs were promptly excised, weighed, and chilled in ice-cold and 0.9% NaCl. Histological analysis, nitrites quantification and immunodetection assays were done. RESULTS: B. scordioides infusions markedly reduced the visible hemorrhagic lesions induced by indomethacin in rat stomachs, also showed down-regulation of COX2, IL-8 and TNFα and up-regulation of COX-1 with a moderate down-regulation of NFkB and lower amount of nitrites. However, this behavior was dependent on the treatment, showing most down-regulation of COX-2, TNFα and IL-8 in the curative treatment; more down-regulation of NF-kB in the preventive treatment; and more up-regulation of COX-1 for the suppressor and preventive treatments. CONCLUSION: The anti-inflammatory potential of B. scordioides infusions could be related with the presence of polyphenols as quercetin in the infusion and how this one is consumed.

Hidatidosis vertebral: a propósito de un caso / Vertebral hydatidosis: case report

La hidatidosis causada por el echinococcus granulosus puede afectar cualquier órgano del cuerpo siendo el pulmón y el hígado los más comúnmente afectados. El compromiso vertebral por el echinococcus granulosus es de escasa prevalencia, comprendiendo con menos de 1% del compromiso óseo. Presentamos el caso de una mujer de 50 años que consultó en Servicio de Traumatología por cuadro de dolor lumbar progresivo, de cinco meses de evolución, irradiado a extremidad inferior derecha y posterior compromiso neurológico de extremidad. El estudio imagenológico reveló espondilodiscitis T12-L1 que posterior a estudio de biopsia confirmó este cuadro. El tratamiento es mixto, tanto ortopédico como quirúrgico. El nivel de recurrencia es alto, reportándose entre 30 y 40%. El objetivo de este caso es proponer diagnóstico diferencial de masa vertebral de origen desconocido y detallar el manejo de esta patología.

Hydatidosis caused by echinococcus granulosus may affect any organ in the body, with the lungs and the liver as the most commonly affected organs. Vertebral compromise resulting from echinococcus granulosus has a low prevalence and accounts for less than 1% of bone compromise. We report the case of a 50 year-old female who presented at the Trauma Service with progressive low back pain with 5 months of duration that irradiated to the right lower limb, and led to neurologic compromise of the limb. Imaging studies showed spondylodiscitis at T12-L1, confirmed by a biopsy. Treatment of this condition is both orthopedic and surgical. The recurrence rate is high, between 30 and 40%. The objective of describing this case is to propose the differential diagnosis of a vertebral mass of unknown origin and provide details as to how to manage this condition.