Neurologic manifestations of Long COVID in Colombia: a comparative analysis of post-hospitalization vs. non-hospitalized patients.

Objective: To analyze patient-reported outcomes, cognitive function, and persistent symptoms in patients with neurologic post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC) in Colombia. Methods: We recruited patients with laboratory-confirmed COVID-19 and PASC symptoms lasting more than 6 weeks at the CES University and CES Clinic (Medellín, Colombia). We included 50 post-hospitalization Neuro-PASC (PNP) and 50 non-hospitalized Neuro-PASC (NNP) patients. Long-COVID symptoms, cognitive (NIH Toolbox v2.1-Spanish for 18+), patient-reported (PROMIS) outcomes, and relevant medical history were evaluated. Statistical analyses were performed via generalized linear models. Results: Overall, brain fog (60%), myalgia (42%), and numbness or tingling (41%) were the most common neurological symptoms, while fatigue (74%), sleep problems (46%), and anxiety (44%) were the most common non-neurological symptoms. Compared to NNP, PNP patients showed a higher frequency of abnormal neurological exam findings (64% vs. 42%, p = 0.028). Both groups had impaired quality of life (QoL) in domains of cognition, fatigue, anxiety depression and sleep disturbance, and performed worse on processing speed and attention than a normative population. In addition, NNP patients performed worse on executive function than PNP patients (T-score 42.6 vs. 48.5, p = 0.012). PASC symptoms of anxiety and depression were associated with worse QoL and cognitive outcomes. Brain fog and fatigue remained persistent symptoms across all durations of Long COVID. Conclusion: Our findings highlight the high incidence and heterogeneity of the neurologic symptoms and impacts of Long COVID even more than 2 years from disease onset. Early detection, emotional support and targeted management of Neuro-PASC patients are warranted.

Hemangioma congénito rápidamente involutivo: Reporte de un caso clínico

Se presenta el caso de un recién nacido a término que presenta en rodilla derecha masa redondeada, indolora, violácea, no friable ni ulcerada. Se realiza al nacimiento ecografía Doppler compatible con anomalía vascular. La Resonancia Magnética (RM) confirma tumoración anterior en rodilla derecha, isointensa en T2 con escasas estructuras tubulares serpinginosas, que corresponden con vasos sanguíneos. Presenta venas varicosas de drenaje a la Safena Mayor (SM) en cara anterointerna del muslo. Se decidió actitud expectante constatando reducción progresiva del tamaño del hemangioma. Al año de vida, refiere que en ocasiones presenta un bultoma a nivel inguinal derecho que se corresponde en ecografía doppler con cayado de la SM dilatado e incompetente, en probable relación con hiperaflujo de las varicosidades. Se realiza seguimiento en consulta, comprobando involución completa a los dos años, con atrofia cutánea residual en cara anteroexterna de rodilla y vascularización colateral que no aumenta con valsalva. Se trata de un hemangioma congénito rápidamente involutivo (RICH). Según la clasificación ISSVA, es un tumor vascular benigno que involuciona persistiendo leve hiperpigmentación y atrofia cutánea. (provisto por Infomedic International)

We present the case of a newborn at term with a rounded, painless, violaceous, non-friable and non-ulcerated mass in the right knee. Doppler ultrasound was performed at birth, compatible with vascular anomaly. Magnetic Resonance Imaging (MRI) confirms an anterior tumor in the right knee, isointense in T2 with few serpinginous tubular structures, corresponding to blood vessels. It presents varicose veins draining to the greater saphenous vein (MS) in the anterointernal aspect of the thigh. A wait-and-see approach was decided and a progressive reduction in the size of the hemangioma was observed. At one year of life, the patient reported that she occasionally presented a bulge at the right inguinal level that corresponded on Doppler ultrasound with a dilated and incompetent arch of the greater saphenous vein, probably related to hyperflow of varicose veins. The patient was followed up in consultation and complete involution was observed after two years, with residual cutaneous atrophy on the anteroexternal aspect of the knee and collateral vascularization that did not increase with valsalva. It is a rapidly involutive congenital hemangioma (RICH). According to the ISSVA classification, it is a benign vascular tumor that involves with persistent mild hyperpigmentation and cutaneous atrophy. (provided by Infomedic International)

Project portfolio risk management. Bibliometry and collaboration Scientometric domain analysis.

Purpose: ''Project Portfolio Risk Management" is approached through a bibliometry and collaboration networks study determining its dynamics and development as a formal domain that links Project, Risk Management and Portfolio concepts. Design/methodology/approach: To facilitate replicability, a scientometric study under a PRISMA structure is carried out: i) Identification or domain structuring, as well as keywording accuracy; ii) Screening: Search string refinement and outputs review; iii) Eligibility: Several criteria applied to a content analysis, and iv) Inclusion: Consolidation of domain analytics through bibliometry and collaboration networks. Originality and findings: Assessing the field as a formal knowledge domain is novel, contributing to a synthesis of its trends and evolution: For first time, descriptive statistics show increasing attention based on the growing citation scores, participation, H index and productivity of its main journals. Project Portfolio Selection is established as hot topic, the main authors are identified, as well as key concepts such as optimization, mathematical programming, multi-objective optimization, stochastic programming, and robust optimization. Three main research themes are obtained: Incorporation of Risk Assessment into Project Portfolio Selection problem, Risk Management as a Project Portfolio Management process, and Risk Analysis considering social and environmental issues. An accurate match is found in the contrast of the domain's behavior with some bibliometric and linguistic laws. Practical implications: Theoretical richness is achieved in the conjunction of the three terms, presenting dynamics and tendencies and thus contributing to focus related research processes on a unified field for the use of both scholars' and practitioners' perspectives.

Altered B cell phenotype and CD27+ memory B cells are associated with clinical features and environmental exposure in Colombian systemic lupus erythematosus patients.

Background: B lymphocytes are dysregulated in Systemic Lupus Erythematosus (SLE) including the expansion of extrafollicular B cells in patients with SLE of African American ancestry, which is associated with disease activity and nephritis. The population of Colombia has a mixture of European, Native American, and African ancestry. It is not known if Colombian patients have the same B cell distributions described previously and if they are associated with disease activity, clinical manifestations, and environmental exposures. Objective: To characterize B cell phenotype in a group of Colombian Systemic Lupus Erythematosus patients with mixed ancestry and determine possible associations with disease activity, clinical manifestations, the DNA methylation status of the IFI44L gene and environmental exposures. Materials and methods: Forty SLE patients and 17 healthy controls were recruited. Cryopreserved peripheral B lymphocytes were analyzed by multiparameter flow cytometry, and the DNA methylation status of the gene IFI44L was evaluated in resting Naive B cells (rNAV). Results: Extrafollicular active Naive (aNAV) and Double Negative type 2, DN2 (CD27- IgD- CD21- CD11c+) B cells were expanded in severe active patients and were associated with nephritis. Patients had hypomethylation of the IFI44L gene in rNAV cells. Regarding environmental exposure, patients occupationally exposed to organic solvents had increased memory CD27+ cells (SWM). Conclusion: aNAV and DN2 extrafollicular cells showed significant clinical associations in Colombian SLE patients, suggesting a relevant role in the disease's pathophysiology. Hypomethylation of the IFI44L gene in resting Naive B cells suggests that epigenetic changes are established at exceedingly early stages of B cell ontogeny. Also, an alteration in SWM memory cells was observed for the first time in patients exposed to organic solvents. This opens different clinical and basic research possibilities to corroborate these findings and deepen the knowledge of the relationship between environmental exposure and SLE.

Construction of a questionnaire to characterise environmental exposures in patients with systemic lupus erythematosus / Construcción de un cuestionario para caracterizar exposiciones ambientales en pacientes con lupus eritematoso sistémico

ABSTRACT Introduction: As the knowledge of systemic lupus erythematosus (SLE) advances, the need to characterise the burden of environmental exposure in patients becomes increasingly relevant. However, there is currently no tool validated to measure such exposure. For this reason, the objective of this work was the construction of a questionnaire-type tool, in order to detail the exposure to multiple environmental factors previously associated with SLE. Methods: The literature was reviewed to identify relevant environmental factors associated with SLE, and the first version of the questionnaire was constructed. After expert review and feedback, the questionnaire was consolidated and applied to 40 patients and 20 healthy controls. Finally, exploratory Rasch analysis was performed to determine the performance of the tool's response function. Results: The tool showed a favourable performance in the exploratory analysis of its psychometric properties. Additionally, it allowed the characterisation of 10 environmental factors and the differences in the frequencies of exposure between patients with SLE and healthy controls. A high co-occurrence of exposures was identified, as most of the patients had positive exposures to three or more factors simultaneously. Conclusion: A practical and easy-to-apply tool has been constructed, with a favourable performance in its psychometric properties. To our knowledge, this is the first tool in the Spanish language for the characterisation of multiple environmental exposures, and constructed explicitly for patients with SLE with a validation analysis. It enabled us to identify that most of the lupus patients were exposed to the sum of three or more environmental factors.

RESUMEN Introducción: Con el avance en el conocimiento del lupus eritematoso sistémico (LES), se hace relevante la necesidad de caracterizar la carga de la exposición ambiental en los pacientes. Sin embargo, en la actualidad no se dispone de un instrumento validado para medirlo. Por consiguiente, el objetivo de este trabajo fue la construcción de un instrumento tipo cuestionario, a fin de detallar la exposición a múltiples factores ambientales previamente asociados a LES. Métodos: Se llevó a cabo una revisión de la literatura para identificar los factores ambientales asociados a LES y se construyó la primera versión del cuestionario. El instrumento se consolidó luego de la revisión y retroalimentación por expertos y se aplicó a 40 pacientes y 20 participantes sanos. Finalmente, se hizo análisis de Rasch exploratorio para determinar el desempeño en la función de respuesta. Resultados: El instrumento mostró un desempeño favorable en sus propiedades psicométricas. Adicionalmente, permitió la caracterización de 10 factores ambientales y sus diferencias en las frecuencias de exposición entre pacientes con LES y participantes sanos. Se identificó una alta co-ocurrencia de exposiciones reflejada en que la mayoría de los pacientes mostró exposición a tres o más factores simultáneamente. Conclusión: Se construyó un instrumento práctico y de fácil aplicación, con un desempeño favorable en sus propiedades psicométricas. Este instrumento, que es el primero para la caracterización de múltiples exposiciones ambientales específicamente diseñado para pacientes con LES, validado y en idioma español, permitió identificar que la mayoría de los pacientes con lupus estuvieron expuestos a la sumatoria de tres o más factores ambientales.

Diamond Nanoparticles-Porphyrin mTHPP Conjugate as Photosensitizing Platform: Cytotoxicity and Antibacterial Activity.

Conjugation of photosensitizers (PS) with nanoparticles has been largely used as a strategy to stabilize PS in the biological medium resulting in photosensitizing nanoparticles of enhanced photoactivity. Herein, (Meso-5, 10, 15, 20-tetrakis (3-hydroxyphenyl) phorphyryn (mTHPP) was conjugated with diamond nanoparticles (ND) by covalent bond. Nanoconjugate ND-mTHPP showed suitable stability in aqueous suspension with 58 nm of hydrodynamic diameter and Zeta potential of -23 mV. The antibacterial activity of ND-mTHPP was evaluated against Escherichia coli for different incubation times (0-24 h). The optimal activity was observed after 2 h of incubation and irradiation (660 nm; 51 J/cm2) performed right after the addition of ND-mTHPP (100 µg/mL) to the bacterial suspension. The inhibitory activity was 56% whereas ampicillin at the same conditions provided only 14% of bacterial growth inhibition. SEM images showed agglomerate of ND-mTHPP adsorbed on the bacterial cell wall, suggesting that the antimicrobial activity of ND-mTHPP was afforded by inducing membrane damage. Cytotoxicity against murine embryonic fibroblast cells (MEF) was also evaluated and ND-mTHPP was shown to be noncytotoxic since viability of cells cultured for 24 h in the presence of the nanoconjugate (100 µg/mL) was 78%. Considering the enhanced antibacterial activity and the absence of cytotoxic effect, it is possible to consider the ND-mTHPP nanoconjugate as promising platform for application in antimicrobial photodynamic therapy (aPDT).

Photoprotective activity of zirconia nanoparticles.

The increasing incidence of diseases caused by the harmful effects of UV radiation in skin, predominantly skin cancer, induce the search for more efficient photoprotector agents. Nowadays, titanium dioxide (TiO2) and zinc oxide (ZnO) are the most widely used photoprotectors and therefore form the main components of commercially available sunscreens. Although the outstanding efficiency in absorbing and scattering UV radiation, mainly as nanoparticles, recent studies have raised concerns regarding the safe use of these nanoparticles, especially due to their high generation of reactive oxygen species (ROS). Thereby, this work focus on the evaluation of the photoprotective activity of zirconia nanoparticles (ZrO2 NPs) and their cytotoxicity study in the presence and absence of UV irradiation. The ZrO2 NPs were synthesized by hydrothermal method and their hydrodynamic diameter, Zeta potential and colloidal stability were characterized by dynamic light scattering. The morphology and size were observed by transmission electron microscopy. The synthesis resulted in ZrO2 NPs with 50 nm of diameter and 56 nm of hydrodynamic diameter. The high colloidal stability was evidenced by the high value of Zeta potential (+48 mV) and low polydispersity index (0.09). The UV-vis spectrum of the ZrO2 NPs in aqueous suspension showed an intense light scattering below 250 and a wide absorption band at 285 nm. The poor generation of ROS by ZrO2 NPs was confirmed by the absence of photodegradation of methylene blue after long periods of irradiation. The in vitro assays performed with HaCaT cell line showed that the cell viability did not decrease in the absence of irradiation. However, after 24 h of incubation, the cell viability decreased under UV-irradiation in comparison with irradiated cells that were not incubated with ZrO2 NPs. Notably, in these assays, the cells were incubated with the ZrO2 NPs and after 24 h, they were replaced by fresh culture medium before the cell viability assay. Nevertheless, another in vitro assay was performed in order to evaluate the photoprotective activity of ZrO2 NPs. The cells were irradiated in the presence of ZrO2 NPs suspension. In this case, cell viability did not decrease even after long period of UV-irradiation and at higher concentration of ZrO2 NPs. The present results showed that ZrO2 NPs could be an interesting material to be used for skin photoprotection since they showed low cytotoxicity, absence of ROS generation and protection under UV irradiation. Additionally, the ZrO2 NPs suspension was transparent as usually required for applications in sunscreens.

Bioglass-based scaffolds coated with silver nanoparticles: Synthesis, processing and antimicrobial activity.

Over the past few years, several tridimensional synthetic bone grafts, known as scaffolds, are being developed to overcome the autologous grafts limitations. Among the materials used on the production of scaffolds, the 45S5 bioglass stands out due to its capacity of bonding to hard and soft tissues. Silver nanoparticles are well-known for their antimicrobial properties and their incorporation on the scaffold may promote its antimicrobial response, avoiding microorganism proliferation on the materials surface. This study proposes a simple way to coat 45S5 bioglass-based scaffolds with silver nanoparticles. The scaffolds were obtained by the sponge replication technique and the silver nanoparticles were incorporated by soaking under ultrasonic stirring. The antimicrobial activity of the scaffolds was analyzed against three different microbial strains: S. aureus, P. aeruginosa, and C. albicans. Due to the heat treatment during the scaffold production, the bioglass crystalized mainly in a sodium calcium silicate phase, forming a glass-ceramic scaffold. The silver nanoparticles were coated in a well-distributed manner throughout the scaffold, while avoiding their aggregation. The coated scaffold inhibited the growth of all the analyzed microorganism. Therefore, the use of ultrasonic stirring to coat the bioglass scaffold with silver nanoparticles showed to be an efficient way to promote its antimicrobial response.

Presence and interaction of free-living amoebae and amoeba-resisting bacteria in water from drinking water treatment plants.

Free-living amoebae (FLA) are ubiquitous and many isolates have been shown to be infected with amoeba-resisting bacteria, as the example of Acanthamoeba and Legionella interaction. Due to the high environmental prevalence of Acanthamoeba. in the Castilian Plateau (Spain), the aims of this work were to investigate the occurrence of Acanthamoeba and other FLA in water from several sampling points from four Drinking Water Treatment Plants (DWTP) and to investigate the presence of Legionella spp. and other amoeba-resisting bacteria in biofilms in raw and finished water, taking into account that no legislation exists for this protozoa control. Acanthamoeba was detected at different sampling points, and sand filters seemed to contribute to amoebic enrichment. After ozonation, a temporary decrease in viable amoebae was observed. The genotypes detected were T3, T4, and T5, revealing the first report of genotype T5 in waters from this region. Moreover, Balamuthia mandrillaris, Vermamoeba vermiformis and Paravahlkampfia sp. were detected. Regarding Legionella, PCR detection in raw and finished water was higher than by agar culture, but even higher after Acanthamoeba co-culture. Also, Legionella's presence was higher in raw water than in finished water. The decrease of free Legionella observed from raw (27.5%, by PCR) to finished water (3.4% by PCR) contrasted with the increase of Legionella-infected FLA from raw (30.7%) to finished water (52%). At biofilm, free Legionella was not detected, and the percentage of infected FLA was low (3.8%). Legionella species identified in these samples were L. drozanskii, L. donaldsonii and L. feeleii. Additionally, Acanthamoeba co-culture led to the isolation of Pseudomonas aeruginosa, P. stutzeri, P. fluorecens, Achromobacter xylosoxidans and Stenotrophomonas maltophilia. The highly disseminated presence of Acanthamoeba and the detection of amoeba-resisting bacteria inside amoebae highlight the importance of developing methods for controlling FLA in order to limit human pathogenic amoeba-resisting bacteria survival to the water purification processes.

DNA methylation changes on immune cells in Systemic Lupus Erythematosus.

DNA methylation as a process that regulates gene expression is crucial in immune cells biology. Global and gene specific methylation changes have been described in autoimmunity, especially in Systemic Lupus Erythematosus. These changes not only contribute to the understanding of the disease, but also some have been proposed as diagnostic or disease activity biomarkers. The present review compiles the most recent discoveries on this field on each type of immune cells, including specific changes in signalling pathways, genes of interest and its possible applications on diagnosis or treatment.

Conflictos territoriales y patrimoniales en "el pesebre de oro de Colombia / Terriorial and ppatrimonial conflicts in marmato "the gold manger in Colombia"

El artículo presenta los resultados de la investigación realizada durante los dos últimos años: "¿Neo-extractivismo o desarrollo local? Conflictos territoriales y patrimoniales en el pueblo minero de Marmato (Colombia)"³, que tuvo como objetivo analizar los conflictos en torno al manejo del territorio y el patrimonio entre la visión de desarrollo neo-extractivista promovida por agentes transnacionales-gubernamentales frente a la visión de desarrollo local de los agentes comunitarios. Para tal efecto, se tuvo como referentes teóricos los conceptos y procesos sociales de "territorio", "cultura", "patrimonio" y "desarrollo" como un derecho social; y como enfoque metodológico la "teoría de los campos" de Pierre Bourdieu, que propone un modelo analítico a partir de dos momentos: momento diacrónico u objetividad del primer orden y momento sincrónico u objetividad del segundo orden. Para legitimar la visión de desarrollo neo-extractivista los agentes transnacionales y gubernamentales han elaborado y puesto en práctica diversos discursos y estrategias conservadoras en torno a la illusio o idea de que el crecimiento económico y el desarrollo sostenible solo puede ser efectuado por capital privado y transnacional. No obstante, los agentes comunitarios también han generado discursos y estrategias de resistencia desde abajo en defensa del territorio, el patrimonio cultural y la visión de desarrollo local basada en la minería tradicional, con el apoyo de diversos sectores sociales. Pero los conflictos territoriales y patrimoniales además de enfrentar dos visiones de desarrollo, están enfrentado a diferentes agentes sociales, dotados con capitales e intereses diversos, quienes compiten por la forma legítima de autoridad específica para conservar o transformar el orden actual en Marmato. Finalmente, se sugiere que los conflictos territoriales y patrimoniales en torno al desarrollo podrían constituirse en un campo, de acuerdo con los postulados del sociólogo francés Pierre Bourdieu, con características del campo político.

This paper shows the results of a two years investigation named "Neo-extractivism or local development? Territorial and patrimonial conflicts in the minning town of Marmato (Colombia)", which had the objective of analyzing conflicts related to territory and patrimony management between the neo-extractivist development viewpoint promoted by transnational-governmental agents and the local development viewpoint promoted by community agents. For this end, concepts and social processes of "territory", "culture", "patrimony",and "development" as a social right were taken as theoretical referents. As methodological approach Pierre Bordieu's "field theory" that proposes an analytical model from two moments: diachronic moment or objectivity of first-order, and synchronic moment or objectivity of second-order was used. To legitimate the neo-extractivist development viewpoint, the transnational-governmental agents have developed and implemented different speeches and conservative strategies around the illusion or idea that economic development and sustainable development only can be led by private and transnational capital. However, community agents have also developed speeches and resistance strategies from the people in defense of their territory, cultural heritage and local development viewpoint based on traditional mining with the support of different social sectors. But territorial and patrimonial conflicts in addition to facing two visons of development are facing different social agents with different capitals and interests, who compete for the legal authority to preserve or transform the current order in Marmato. Finally, it is suggested that territorial and patrimonial disputes around development, could be established, according to the postulates of the French sociologist Pierre Bordieu, as a field with the characteristics of a political field.

Hipoplasia foveal aislada: presentación de un caso y revisión de la literatura / Hypoplasia isolated foveal: presentation of a case and review literature

Presentación de un caso de hipoplasia foveal como hallazgo ocular aislado. Presentación observacional de casos. Se diagnosticó hipoplasia foveal aislada a en un joven de 17 años con disminución de la visión desde la infancia, nistagmus, ausencia de reflejo foveolar, y capilares cruzando el meridiano horizontal, utilizando fotografía del fondo ocular y tomografía de coherencia óptica (OCT) en la fóvea central. El diagnóstico clínico se complementó con tomografía de coherencia óptica de alta resolución, la cual mostró extensión de todas las capas neurosensoriales de la retina en el área en la cual debería estar normalmente la fóvea. La tomografía de coherencia óptica puede complementar el diagnóstico clínico en la hipoplasia foveal.

Nevus gigante congénito (1) / Congenital large nevi (1)

En 1978, el Servicio de Cirugía Plastica inició un programa para el tratamiento del nevus gigante congénito. La estadística está integrada por 21 niños y predominaron las hembras sobre los varones en una proporción de 1,6 a 1. La degeneración maligna ocurrió en un solo paciente (4,7%). En todos los casos, el tratamiento consistió en la exéresis de las lesiones y las áreas cruentas residuales fueron reparadas mediante el cierre directo, autoinjerto de piel o colgajos cutáneos