Dynamic Contrast-Enhanced Magnetic Resonance Lymphangiography for Diagnosis and Treatment of Chylopericardium After Cardiac Transplantation.

Chylopericardium is a rare complication after cardiac transplantation. We report a case of a 69-year-old woman with persistent chylopericardium after a heart transplantation due to Chagas disease. Failure of conservative treatment led to dynamic contrast-enhanced magnetic resonance lymphangiography and percutaneous radiologic intervention of the lymphatic leakage and symptoms resolution.

Phase unwrapping for phase imaging using the plug-and-play proximal algorithm.

Phase unwrapping (PU) is essential for various scientific optical applications. This process aims to estimate continuous phase values from acquired wrapped values, which are limited to the interval (-π,π]. However, the PU process can be challenging due to factors such as insufficient sampling, measurement errors, and inadequate equipment calibration, which can introduce excessive noise and unexpected phase discontinuities. This paper presents a robust iterative method based on the plug-and-play (PnP) proximal algorithm to unwrap two-dimensional phase values while simultaneously removing noise at each iteration. Using a least-squares formulation based on local phase differences and reformulating it as a partially differentiable equation, it is possible to employ the fast cosine transform to obtain a closed-form solution for one of the subproblems within the PnP framework. As a result, reliable phase reconstruction can be achieved even in scenarios with extremely high noise levels.

Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia.

Background: Colombia hosts a large number of Venezuelan migrants and refugees who are uniquely vulnerable and have been markedly impacted by the COVID-19 pandemic. It is necessary to understand their experiences to inform future policy decisions both in Colombia and during disease outbreaks in other humanitarian contexts in the future. As part of a larger study focused on HIV among Venezuelans residing in Colombia, qualitative interviews were conducted to understand this population's experiences and access to healthcare. Methods: Interviews were conducted with Venezuelan migrants and refugees as well as stakeholders such as care providers, humanitarian workers, and government officials. Interviews were recorded, transcribed, and coded using thematic content analysis. Select quotes were translated and edited for length and/or clarity. Results: Venezuelan migrants and refugees reported high levels of housing instability, job instability, increased barriers to accessing healthcare, and complications in engaging in the HIV care continuum, among other impacts of the COVID-19 pandemic. Stakeholders reported complications in provision of care and obtaining medicines, difficulty maintaining contact with patients, increased discrimination and xenophobia targeting Venezuelan migrants and refugees, increased housing instability among Venezuelan migrants and refugees, and other impacts as a result of the COVID-19 pandemic. Conclusions: This study demonstrates the unique impacts of the COVID-19 pandemic among Venezuelans residing in Colombia by both compounding extant vulnerabilities and introducing new challenges, such as high rates of eviction. Colombia has enacted increasingly inclusive migration policies for Venezuelan refugees and migrants within the country; findings from this study underscore the necessity for such policies both in and outside of the Colombian context.

Sepsis por citomegalovirus en el paciente pediátrico / Cytomegalovirus Sepsis in the Pediatric Patient

Introducción: La infección severa por citomegalovirus resulta inusual en pacientes inmunocompetentes, sin embargo, cuando se presenta tiene una alta carga de morbilidad. Objetivo: Examinar el caso de un paciente nacido a término, con desnutrición aguda severa que presentó sepsis secundaria a una infección por citomegalovirus. Presentación del caso: Paciente de 2 meses y 7 días de edad que se llevó al servicio de urgencias por cuadro de un día de evolución de inapetencia, y fiebre. Sin antecedentes de prematurez o de infecciones oportunistas, y adecuado desarrollo para su edad. Se trasladó a un centro de mayor complejidad por deshidratación. En dicho centro el paciente presentó deterioro pulmonar con hallazgo de bronconeumonía, deterioro gastrointestinal por distensión severa de asas, deposiciones sanguinolentas, y deterioro hematológico por anemia hemolítica. Se descartó infección de origen bacteriano y fúngico, y se estableció que la etiología presentada se debía a citomegalovirus. Se trató con valganciclovir con una buena evolución clínica. Se discutió la fisiopatología, el diagnóstico, y tratamiento en relación con el caso presentado. Conclusiones: La infección grave por citomegalovirus en el periodo posnatal resultó muy rara, sin embargo, de presentar síntomas, son principalmente gastrointestinales o pulmonares; y ante la no respuesta al tratamiento convencional de enfermedades más comunes, se debe sospechar de manera oportuna una infección por este agente, dada la alta carga de morbilidad que produce(AU)

Introduction: Severe cytomegalovirus infection is unusual in immunocompetent patients; however, when it occurs it has a high burden of morbidity. Objective: To examine the case of a patient born at term who presented sepsis secondary to cytomegalovirus infection. Presentation of the case: A 2 months and 7 days old patient was taken to the emergency department for one day of evolution of inappetence and fever, with no history of prematurity or opportunistic infections and adequate development for his age. The patient was transferred to a more complex center due to dehydration, and in that center the patient presented pulmonary deterioration with bronchopneumonia, gastrointestinal deterioration due to severe distension of the loops, bloody stools, and hematologic deterioration due to hemolytic anemia. Bacterial and fungal infection was ruled out and the etiology was established as cytomegalovirus. She was treated with valganciclovir with a good clinical evolution. The pathophysiology, diagnosis and treatment are discussed in relation to the presented case. Conclusions: Severe cytomegalovirus infection in the postnatal period was very rare, however, if symptoms are present, they are mainly gastrointestinal or pulmonary; and in the absence of response to conventional treatment of more common diseases, an infection by this agent should be suspected in a timely manner, given the high burden of morbidity it produces(AU)

HIV Surveillance and Research for Migrant Populations: Protocol Integrating Respondent-Driven Sampling, Case Finding, and Medicolegal Services for Venezuelans Living in Colombia.

BACKGROUND: Epidemiologic research among migrant populations is limited by logistical, methodological, and ethical challenges, but it is necessary for informing public health and humanitarian programming. OBJECTIVE: We describe a methodology to estimate HIV prevalence among Venezuelan migrants in Colombia. METHODS: Respondent-driven sampling, a nonprobability sampling method, was selected for attributes of reaching highly networked populations without sampling frames and analytic methods that permit estimation of population parameters. Respondent-driven sampling was modified to permit electronic referral of peers via SMS text messaging and WhatsApp. Participants complete sociobehavioral surveys and rapid HIV and syphilis screening tests with confirmatory testing. HIV treatment is not available for migrants who have entered Colombia through irregular pathways; thus, medicolegal services integrated into posttest counseling provide staff lawyers and legal assistance to participants diagnosed with HIV or syphilis for sustained access to treatment through the national health system. Case finding is integrated into respondent-driven sampling to allow partner referral. This study is implemented by a local community-based organization providing HIV support services and related legal services for Venezuelans in Colombia. RESULTS: Data collection was launched in 4 cities in July and August 2021. As of November 2021, 3105 of the target 6100 participants were enrolled, with enrollment expected to end by February/March 2022. CONCLUSIONS: Tailored methods that combine community-led efforts with innovations in sampling and linkage to care can aid in advancing health research for migrant and displaced populations. Worldwide trends in displacement and migration underscore the value of improved methods for translation to humanitarian and public health programming. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36026.

Hernia incisional y pérdida de dominio con neumoperitoneo progresivo preoperatorio más separacion de componentes. Un reporte de caso / Progressive preoperative pneumoperitoneum and components separation in incisional hernia with loss of domain. A case study report

Introducción: Una hernia con pérdida de dominio tiene un contenido de saco herniario de 50% o más del contenido de la cavidad abdominal, que conlleva a efectos locales y sistémicos. Reporte de Caso: Presentamos el caso de una paciente con hernia incisional y pérdida de dominio de 30 años de evolución, quien fue sometida a neumoperitoneo preoperatorio y durante acto quirúrgico, para evitar el cierre del defecto herniario con tensión, se realizó separación de componentes. Conclusión: El neumoperitoneo progresivo preoperatorio es un método recomendable en el manejo de pacientes con hernias gigantes y pérdida de dominio, porque es de bajo costo, seguro, fácil de realizar y evita las posibles complicaciones a las que el cierre del defecto con tensión conlleva.

Background:Ahernia with loss of domain has a hernia sac content of 50% or more than the content of the abdominal cavity, which leads to local and systemic effects. The case of a patient with an incisional hernia Report case: with loss of domain and 30 years of evolution is presented, she underwent preoperative pneumoperitoneum and during surgery, anterior component separation was performed to avoid tension in the closure of the hernia defect. Conclusion:Preoperative progressive neumoperitoneum is a recommended method in the management of patients with giant hernias and loss of domain, because it is low cost, safe and easy to perform and avoids the possible complications that the closure of the defect with tension entails

Simple citric acid-catalyzed surface esterification of cellulose nanocrystals.

A simple straightforward route for the surface esterification of cellulose nanocrystals (CNC) is herein proposed. CNC obtained from microcrystalline cellulose were acetylated using as catalyst citric acid, a α-hydroxy acid present in citrus fruits and industrially produced by certain molds in sucrose or glucose-containing medium. No additional solvent was added to the system; instead, the acylant (acetic anhydride) was used in sufficient excess to allow CNC dispersion and proper suspension agitation. By tuning the catalyst load, CNC with two different degree of substitution (i.e. DS=0.18 and 0.34) were obtained. Acetylated cellulose nanocrystals were characterized in terms of chemical structure, crystallinity, morphology, thermal decomposition and dispersion in a non-polar solvent. Results illustrated for the first time the suitability of the protocol proposed for the simple surface acetylation of cellulose nanocrystals.

Acetylation of bacterial cellulose catalyzed by citric acid: Use of reaction conditions for tailoring the esterification extent.

Bacterial cellulose (BC) nanoribbons were partially acetylated by a simple direct solvent-free route catalyzed by citric acid. The assay of reaction conditions within chosen intervals (i.e. esterification time (0.5-7h), catalyst content (0.08-1.01mmol/mmol AGU), and temperature (90-140°C)), illustrated the flexibility of the methodology proposed, with reaction variables which can be conveniently manipulated to acetylate BC to the required degree of substitution (DS) within the 0.20-0.73 interval. Within this DS interval, characterization results indicated a surface-only process in which acetylated bacterial cellulose with tunable DS, preserved fibrous structure and increased hydrophobicity could be easily obtained. The feasibility of reusing the catalyst/excess acylant in view of potential scale-up was also illustrated.

Organocatalytic acetylation of starch: effect of reaction conditions on DS and characterisation of esterified granules.

Starch acetates with varying degree of substitution (DS) were prepared by a novel solvent-free organocatalytic methodology. The acetylation protocol involved a non-toxic biobased α-hydroxycarboxylic acid as catalyst, and proceeded with high efficiency in absence of solvents. The effect of reaction conditions including reaction temperature (90-140 °C), catalyst load (0-2.3 g/g starch), acetic anhydride/starch weight ratio (6.5-13.5 g/g), and starch moisture content (0.6-14.8%) on the DS of the esters was evaluated. The analysis performed showed that the increase of temperature and catalyst concentration resulted in higher DS values, and evidenced a beneficial contribution of native starch moisture content on the substitution level achieved. Variation of reaction conditions allowed starch esters to be obtained with DS in the 0.03-2.93 range. Starch esters were characterised in terms of morphology, chemical structure, thermal properties, and distribution in polar/non polar liquid systems.

Surface esterification of cellulose nanofibers by a simple organocatalytic methodology.

Bacterial cellulose nanofibers were esterified with two short carboxylic acids by means of a simple and novel organic acid-catalyzed route. The methodology proposed relayed on the use of a non-toxic biobased α-hydroxycarboxylic acid as catalyst, and proceeded under moderate reaction conditions in solventless medium. By varying the esterification interval, acetylated and propionized bacterial cellulose nanofibers with degree of substitution (DS) in the 0.02-0.45 range could be obtained. Esterified bacterial cellulose samples were characterized by means of Solid-State CP/MAS (13)C Nuclear Magnetic Resonance spectroscopy (CP/MAS (13)C NMR), Fourier Transform Infrared spectroscopy (FTIR), X-ray Diffraction (XRD), Thermogravimetric Analysis (TGA) and chosen hydrophobicity test assays. TGA results showed that the esterified nanofibers had increased thermal stability, whereas XRD data evidenced that the organocatalytic esterification protocol did not alter their crystallinity. The analysis of the ensuing modified nanofibers by NMR, FTIR, XRD and TGA demonstrated that esterification occurred essentially at the surface of bacterial cellulose microfibrils, something highly desirable for changing their surface hydrophilicity while not affecting their ultrastructure.

Acompañamiento psicosocial a jóvenes marginados para prevención de la farmacodependencia / Psychosocial accompaniment from human ecology toyoung marginalized people to prevent drug dependence

Introducción: Se presenta un análisis cualitativo del acompañamiento psicosocial a jóvenes en condiciones de vulnerabilidad desde la ecología humana durante 12 meses entre 2010 a 2011; utilizando técnicas pedagógicas evaluativas participativas. Éstas, son una alternativa para crear espacios reflexivos con el propósito de potenciar la resiliencia en las relaciones comunicativas y formar en el respeto. Objetivo: Generar bienestar, prevenir la farmacodependencia y contribuir a la promoción de la salud. Material y Métodos: Se revisaron los antecedentes temáticos, fueron seleccionados 100 estudiantes entre 11 y 19 años de dos instituciones educativas públicas en condiciones vulnerables;se desarrollaron cuatro talleres reflexivos y cuatro prácticas lúdicas y se realizaron tres grupos focales con estudiantes, profesores y padres de familia. Resultados y Discusión: El contexto social de la población intervenida, revela problemas de abuso sexual, violencia intrafamiliar y eventos violentos en el vecindario por grupos armados ilegales, entre otros, que constituyen factores de riesgo importantes para la farmacodependencia. Conclusión: Se infiere que lo psicosocial incide en la farmacodependencia, afectando la convivencia de la población estudiada por múltiples causas del orden psicoafectivo, sociocultural, económico y político que van desde el consumo cultural hasta la seguridad alimentaria.

Introduction: A qualitative analysis of the psycho-social support to young people in situations of vulnerability from human ecology is presented for 12 months between 2010 to 2011; using participatory evaluative pedagogical techniques. These are an alternative to create reflective spaces with the purpose of enhancing resilience in communicative relationships and working in respect. Objective: to generate well-being, prevent drug abuse and contribute to the health promotion. Material aids and methods: the thematic background was reviewed, 100 students between 11 and 19 years of two public schools in vulnerable conditionswere selected; four reflective workshops and four playful practices were developed and three focus groups with students, teachers and parentswere conducted. Results and discussion: the social context of the manipulated population reveals sexual abuse problems, domestic violence and violent events in the neighborhood by illegal armed groups, among others, which constitutemajor risk factors for drug abuse. Conclusion: It can be inferred that the psychosocial factors impact on drug dependence, affecting the coexistence of the population studied by multiple causes of the psychological, socio-cultural, economic and political order, ranging from cultural consumption to food security.

Miocarditis por clozapina: reporte de caso y revisión de tema / Myocarditis due to clozapine: case report and topic review

Introducción: La miocarditis es definida como la inflamación del músculo cardiaco. A pesar de que existen síntomas que pueden ayudar a realizar su diagnóstico, el paciente puede encontrarse asintomático o debutar con muerte súbita. La clozapina es un medicamento indicado para el tratamiento de la esquizofrenia refractaria, el cual puede producir cardiopatías. Objetivo: Presentar el caso de un paciente de 20 años, quién falleció debido a una miocarditis por clozapina. Método: Reporte de caso. Resultados: Se describe un caso asintomático y fatal de miocarditis por clozapina; se presentan las placas histológicas de miocardio con infiltrado eosinofílico, característico de la entidad. Discusión: Se describen las características de la entidad y la forma de realizar su diagnóstico. Conclusión: Aunque la miocarditis por clozapina es bastante rara (prevalencia: del 0,015% al 0,188%), puede producirse en mayor medida durante las primeras 8 semanas de tratamiento, período durante el cual debe investigarse de manera activa...

Introduction: Myocarditis is a heart muscle inflammation. There are signs that can help make the diagnosis but, the patient may be asymptomatic or presented with sudden death. Clozapine is indicated for the treatment of refractory schizophrenia, it may cause cardiomyopathies. Objective: To report the case of a 20-year-old who died of myocarditis due to clozapine. Methods: Case report. Results: We describe an asymptomatic case of fatal myocarditis due to clozapine, and we show histological slides of the heart with characteristic eosinophilic infiltration. Discussion: We discuss the manifestations of the entity and how to diagnose it. Conclusions: Although clozapine myocarditis is rare (prevalence: 0,015% - 0,188%). It may occur within 8 weeks of treatment, time which should be actively investigated...

Prevalence of multiple sclerosis in Bogotá, Colombia.

Among Latin American countries, Colombia is considered a low-risk area for multiple sclerosis (MS) and no studies on MS prevalence have been conducted in any of the country's large urban settings. To fill this gap and assess the prevalence of MS in Bogotá as of December 31, 2002, this study reviewed the clinical records of patients diagnosed with MS in most Bogotá hospitals. This review produced a sample of 296 patients with an MS diagnosis whose reliability was verified by a neurologist with expertise in MS. The total prevalence rate identified for December 2002 was 4.41/100,000 inhabitants (95% CI 3.9-4.9), including a rate of 5.98/100,000 (95% CI 5.2-6.8) for women and 2.71/100,000 (95% CI 2.2-3.3) for men (differences measured at p < 0.001). The prevalence estimates for Bogotá, confirm the city's status as a low-risk area for MS.