[Clinical and radiographic factors associated with the severity of paraspinal fatty infiltration in patients with degenerative low back disease]. / Factores clínicos y radiográficos asociados a la severidad de infiltración grasa paraespinal en pacientes con enfermedad lumbar degenerativa.

INTRODUCTION: Degenerative lumbar disease (DLE) is a spectrum of pathological changes from disc degeneration, herniated disc, spondylolisthesis and lumbar canal stenosis. The pain associated with it is multifactorial. Muscle cramps are among the most frequent causes. The relationship between muscle degeneration and DLE has already been studied in the past in multiple studies, highlighting the one carried out by Kjaer & cols. OBJECTIVE: to determine the prevalence and severity of fatty degeneration in mutifidus spinae, and to study its relationship with clinical and radiographic factors. MATERIAL AND METHODS: observational and analytical study. Patients diagnosed with: herniated disc, lumbar canal stenosis or degenerative scoliosis were included. They were classified according to the Kjaer scale for paraspinal fatty infiltration in one of three groups. Clinical variables were analyzed: age, smoking, obesity, the presence of axial pain, temporality of pain, severity expressed with a visual analog scale (VAS); and radiographic: number of diseased segments, involved segments, diagnostic imaging and the presence of spondylolisthesis. RESULTS: 56 patients with an average age of 52.5 years (16 to 80) with a predominance of females with 62.5% were included. The diagnoses were nonspecific low back pain (1.8%), herniated disc (42.9%), narrow lumbar duct (46.4%) and lumbar duct with degenerative scoliosis deformity (8.9%). The distribution among the three groups described by Kjaer was as follows: 44.6% were classified with a fat infiltration score of 2. In groups 1 and 0, 39.3% and 16.1% were classified respectively. The variables significantly related to greater fat infiltration were: age > 60 years, diagnoses of lumbar canal stenosis and herniated disc; obesity, spondylolisthesis < 2 vertebral segments involved. Axial pain and VAS > 8 points were not related to greater muscle degeneration. CONCLUSIONS: fatty infiltration is present in all patients with some of the forms of DLE. Most patients > 60 years of age with advanced degenerative processes have a greater severity of infiltration. Other related variables are: obesity, spondylolisthesis and disease of < 2 vertebral segments. There is no relationship between a higher percentage of fatty infiltration and axial pain or higher VAS scores.

INTRODUCCIÓN: la enfermedad lumbar degenerativa (ELD) es un espectro de cambios patológicos desde la degeneración discal, la hernia discal, la espondilolistesis y el conducto lumbar estrecho. El dolor que se le asocia es multifactorial. Los espasmos musculares son de las causas más frecuentes. La relación que guarda la degeneración muscular y la ELD ya ha sido estudiada en múltiples trabajos, destacando el realizado por Kjaer y colaboradores. OBJETIVO: determinar la prevalencia y severidad de la degeneración grasa en el mutifidus spinae, y estudiar su relación con variables clínicas y radiográficas. MATERIAL Y MÉTODOS: estudio observacional y analítico. Se incluyeron pacientes diagnosticados con: hernia discal, conducto lumbar estrecho o escoliosis degenerativa. Se clasificaron de acuerdo con escala de Kjaer para infiltración grasa paraespinal en alguno de tres grupos. Se analizaron variables clínicas: edad, tabaquismo, obesidad, presencia de dolor tipo axial, temporalidad del dolor, severidad del dolor expresada con escala visual análoga (EVA); y radiográficas: número de segmento enfermos, segmentos involucrados, diagnóstico por imagen y presencia de espondilolistesis. RESULTADOS: se incluyeron 56 pacientes con edad promedio de 52.5 años (rango 16 a 80) con predominio del sexo femenino (62.5%). Los diagnósticos fueron lumbalgia inespecífica (1.8%), hernia discal (42.9%), conducto lumbar estrecho (46.4%) y conducto lumbar con deformidad en escoliosis degenerativa (8.9%). La distribución entre los tres grupos descritos por Kjaer fue la siguiente: 44.6% fueron clasificados con un puntaje de infiltración grasa de 2. En los grupos 1 y 0, se clasificaron 39.3 y 16.1%, respectivamente. Las variables relacionadas con mayor infiltración grasa fueron: edad > 60 años, diagnósticos de conducto lumbar estrecho y hernia discal; obesidad, espondilolistesis < 2 segmentos vertebrales involucrados. El dolor mecánico y EVA > 8 puntos no se relacionaron con mayor degeneración muscular. CONCLUSIONES: la infiltración grasa está presente en todos los pacientes con alguna de las formas de ELD. La mayoría de los pacientes > 60 años con procesos degenerativos avanzados tienen mayor severidad de infiltración. Otras variables relacionadas son: obesidad, espondilolistesis y enfermedad < 2 segmentos vertebrales. No hay relación entre mayor porcentaje de infiltración grasa y dolor axial o puntajes más altos de dolor.

Causes of revisional surgery, reoperations, and readmissions after bariatric surgery.

INTRODUCTION AND OBJECTIVES: Bariatric surgery is the most effective treatment for weight loss, with comorbidity control. With low complication rates, the reasons for reoperation are major complications or weight loss failure/weight regain. Nonsurgical problems can also present, such as anemia, dehydration, chronic pain, and malnutrition, among others. Our aim was to analyze the main causes of revisional surgery, reoperation, and hospital readmission, at a specialized bariatric center. METHODS: A retrospective study was conducted on patients that underwent bariatric surgery within the time frame of 2012 and 2019. The baseline analysis included demographic, anthropometric, and perioperative data, as well as a sub-analysis of the main readmission causes and complications. RESULTS: A total of 776 primary surgeries were performed (649 RYGBP, 127 SG, and 10 revisional surgeries), and 99 patients were identified for the study: 10 revisional surgeries, 44 reoperations, and 45 readmissions. The incidence of revisional surgery was 1.2%, reoperation was 5.6%, and readmission 5.8%. Fifty percent of the revisional surgeries were performed due to insufficient weight loss or weight regain; the most frequent causes of reoperation were cholecystitis (38.6%) and internal hernias (9.1%); and the most common causes of readmission were nonspecific abdominal pain (35.5%) and dehydration (24.4%). CONCLUSION: The most frequent causes of postoperative readmission were nonsurgical events, followed by non-bariatric reoperations, and finally revisional surgeries. There was a low incidence of early reoperations. Knowledge of the abovementioned data is important for identifying higher-risk patients, to prevent major complications.

A management algorithm for vertebral destruction syndrome by multiple myeloma and metastatic spinal cord compression.

INTRODUCTION: Multiple myeloma represents 1% of all cancers and 10% of hematological cancers. Up to 80-90% of cases will have skeletal involvement and the spine is the most frequently involved site. Any intervention must be aimed to improve the patients functional prognosis and will impact their quality of life. OBJECTIVE: To describe the clinical presentation of vertebral destruction syndrome due to multiple myeloma and to present the management algorithm used for the study and decision-making in treatment. MATERIAL AND METHODS: Study design: Retrospective cross-sectional. A search was made in the hospitals clinical file in search of patients with a histological diagnosis of multiple myeloma attended by the Spinal Surgery Service. Clinical characteristics of the initial presentation were obtained such as: presence of pain, ASIA scale and it was categorized according to the Durie-Salmon classification at diagnosis; the levels involved and type of surgery were described. RESULTS: The study included ten patients with an average age of 61.4 years, 70% were male subjects. All patients were approach according to the modified protocol for vertebral destruction syndrome and fluoroscopy-guided percutaneous biopsy. Most had pain at diagnosis, after neurologic examination only 30% were classified as ASIA A. Most of the patients were staged III according to Durie Salomon. The most frequently vertebral segment involved was thoracic. In only one patient more than two vertebrae were involved. After diagnosis of multiple myeloma, nine patients were managed according to a NOMS framework. In the majority they were treated with fusion by posterior approach, six of them were augmented with vertebroplasty. Only one patient of the total, was treated with vertebroplasty alone. CONCLUSIONS: The use of systematized management algorithms will allow better decisions to be made in conjunction with a multidisciplinary group for the care of multiple myeloma with vertebral involvement.

INTRODUCCIÓN: El mieloma múltiple representa 1% de todos los tipos de cáncer y 10% de los cánceres hematológicos. Hasta en 80-90% de los casos se involucrará el sistema esquelético, siendo la columna el sitio más frecuentemente afectado. Cualquier intervención planeada deberá ser dirigida a mejorar el pronóstico funcional del paciente e impactará en su calidad de vida. OBJETIVO: Describir la presentación clínica del síndrome de destrucción vertebral por mieloma múltiple y presentar el algoritmo de manejo empleado para el estudio y la toma de decisiones en el tratamiento. MATERIAL Y MÉTODOS: Diseño de estudio: Retrospectivo, transversal. Se realizó una búsqueda en el archivo clínico del hospital en búsqueda de pacientes con diagnóstico histológico de mieloma múltiple atendidos por el Servicio de Cirugía de Columna. Se obtuvieron características clínicas de la presentación inicial como: presencia de dolor, escala de ASIA y se categorizó de acuerdo con la clasificación de Durie-Salmon al diagnóstico; se describen los niveles involucrados y tipo de cirugía. RESULTADOS: El estudio incluyó 10 pacientes con una edad promedio de 61.4 años, 70% de los cuales fueron varones. Todos los pacientes se abordaron de acuerdo al protocolo de síndrome de destrucción vertebral y con biopsia percutánea guiada por fluoroscopía. La mayoría de los pacientes tenían dolor al diagnóstico, tras la exploración neurológica sólo el 30% fueron clasificados como ASIA A. La mayoría de los pacientes se estadificaron como III de acuerdo con Durie-Salmon. El segmento vertebral más comúnmente afectado fue el torácico. En sólo un paciente se involucraba más de dos vértebras. Tras el diagnóstico de mieloma múltiple, nueve pacientes fueron manejados de acuerdo con el marco de trabajo NOMS. La mayoría fueron tratados con fusión por un abordaje posterior, seis de ellos con aumentación con vertebroplastía. Sólo un paciente del total, fue tratado sólo con vertebroplastía. CONCLUSIONES: El empleo de algoritmos de tratamiento sistematizado permitirá la toma de mejores decisiones en conjunto con un grupo multidisciplinario para el tratamiento de mieloma múltiple con afección vertebral.

Oceanographic Variability induced by Tides, the Intraseasonal Cycle and Warm Subsurface Water intrusions in Maxwell Bay, King George Island (West-Antarctica).

We examine the hydrographic variability induced by tides, winds, and the advance of the austral summer, in Maxwell Bay and tributary fjords, based on two recent oceanographic campaigns. We provide the first description in this area of the intrusion of relatively warm subsurface waters, which have led elsewhere in Antarctica to ice-shelf disintegration and tidewater glacier retreat. During flood tide, meltwater was found to accumulate toward the head of Maxwell Bay, freshening and warming the upper 70 m. Below 70 m, the flood tide enhances the intrusion and mixing of relatively warm modified Upper Circumpolar Deep Water (m-UCDW). Tidal stirring progressively erodes the remnants of Winter Waters found at the bottom of Marian Cove. There is a buoyancy gain through warming and freshening as the summer advances. In Maxwell Bay, the upper 105 m were 0.79 °C warmer and 0.039 PSU fresher in February than in December, changes that cannot be explained by tidal or wind-driven processes. The episodic intrusion of m-UCDW into Maxwell Bay leads to interleaving and eventually to warming, salinification and deoxygenation between 80 and 200 m, with important implications for biological productivity and for the mass balance of tidewater glaciers in the area.

Observations and Projections of Heat Waves in South America.

Although Heat Waves (HWs) are expected to increase due to global warming, they are a regional phenomenon that demands for local analyses. In this paper, we assess four HW metrics (HW duration, HW frequency, HW amplitude, and number of HWs per season) as well as the share of extremely warm days (TX95, according to the 95th percentile) in South America (SA). Our analysis included observations as well as simulations from global and regional models. In particular, Regional Climate Models (RCMs) from the Coordinated Regional Climate Downscaling Experiment (CORDEX), and Global Climate Models (GCMs) from the Coupled Model Intercomparison Project Phase 5 (CMIP5) were used to project both TX95 estimates and HW metrics according to two representative concentration pathways (RCP4.5 and RCP8.5). We found that in recent decades the share of extremely warm days has at least doubled over the period December-January-February (DJF) in northern SA; less significant increases have been observed in southern SA. We also found that by midcentury, under the RCP4.5 scenario, extremely warm DJF days (as well as the number of HWs per season) are expected to increase by 5-10 times at locations close to the Equator and in the Atacama Desert. Increases are expected to be less pronounced in southern SA. Projections under the RCP8.5 scenario are more striking, particularly in tropical areas where half or more of the days could be extremely warm by midcentury.

Safety and efficacy of bariatric surgery in Mexico: A detailed analysis of 500 surgeries performed at a high-volume center. / Seguridad y eficacia de la cirugía bariátrica en México: análisis detallado de 500 cirugías en un centro de alto volumen.

INTRODUCTION AND OBJECTIVES: Bariatric surgery is the best method for treating obesity and its comorbidities. Our aim was to provide a detailed analysis of the perioperative outcomes in Mexican patients that underwent surgery at a high-volume hospital center. MATERIALS AND METHODS: A retrospective study was conducted on all the patients that underwent bariatric surgery at a single hospital center within a time frame of 4 and one-half years. Demographics, the perioperative variables, complications (early and late), weight loss, failure, and type 2 diabetes mellitus remission were all analyzed. RESULTS: Five hundred patients were included in the study, 83.2% of whom were women. Mean patient age was 38.8 years and BMI was 44.1kg/m2. The most common comorbidities were high blood pressure, dyslipidemia, and diabetes. Laparoscopic gastric bypass surgery was performed in 85.8% of the patients, sleeve gastrectomy in 13%, and revision surgeries in 1%. There were 9.8% early complications and 12.2% late ones, with no deaths. Overall weight loss as the excess weight loss percentage at 12 and 24 months was 76.9 and 77.6%. The greatest weight loss at 12 months was seen in the patients that underwent laparoscopic gastric bypass. A total of 11.4% of the patients had treatment failure. In the patients with type 2 diabetes mellitus, 68.7% presented with complete disease remission and 9.3% with partial remission. There was improvement in 21.8% of the cases. CONCLUSIONS: In our experience at a high-volume hospital center, bariatric surgery is safe and effective, based on the low number of adverse effects and consequent weight loss and type 2 diabetes mellitus control. Long-term studies with a larger number of patients are needed to determine the final impact of those procedures.

Evaluación psicológica y cognitiva de autismo en un paciente con síndrome de MOMO: reporte de caso y revisión de la literatura / Psychological and cognitive evaluation of autism in a patient with MOMO syndrome: a case report and literature review

MOMO es un acrónimo para los términos macrosomía, obesidad, macrocefalia y anomalías oculares. El síndrome fue descrito por primera vez en 1993, con un total de nueve pacientes publicados a la fecha. Todos los casos reportaron discapacidad intelectual y en un caso se describió a un paciente con autismo. Presentamos un nuevo caso de paciente con síndrome de MOMO que consultó por fenómenos alucinatorios. Se completó una evaluación neuropsicológica, clínica y cognitiva, en donde se demostró un cociente intelectual limítrofe y se corroboraron los criterios para trastorno del espectro autista. Ésta es la primera evaluación neurocognitiva de un paciente con MOMO, la que apoya el uso de escalas estandarizadas a fin de evaluar el autismo y otras comorbilidades psiquiátricas en pacientes con síndromes genéticos.

MOMO is an acronym for macrosomia, obesity, macrocephaly and ocular abnormalities. The syndrome was first described in 1993, with a total of nine patients published thus far. All the cases presented intellectual disability and in one case autism was described. We present a new case of a patient with MOMO syndrome, who consulted for hallucinatory phenomena. He completed a neuropsychological, clinical and cognitive evaluation, showing a borderline intelligence quotient and fulfilled the criteria for autism spectrum disorder. This is the first neurocognitive evaluation of a patient with MOMO, supporting the use of standardized scales in order to assess the autism and other psychiatric comorbidities in patients with genetics syndromes.

Effects of soiling on photovoltaic (PV) modules in the Atacama Desert.

Soiling by dry deposition affects the power output of photovoltaic (PV) modules, especially under dry and arid conditions that favor natural atmospheric aerosols (wind-blown dust). In this paper, we report on measurements of the soiling effect on the energy yield of grid-connected crystalline silicon PV modules deployed in five cities across a north-south transect of approximately 1300 km in the Atacama Desert ranging from latitude 18°S to latitude 30°S. Energy losses were assessed by comparing side-by-side outputs of four co-planar PV modules. Two of the PV modules of the array were kept clean as a control, while we allowed the other two to naturally accumulate soiling for 12 months (from January 2017 to January 2018). We found that the combination of high deposition rates and infrequent rainfalls led to annual energy losses that peaked at 39% in the northern coastal part of the desert. In contrast, annual energy losses of 3% or less were measured at relatively high-altitude sites and also at locations in the southern part of the desert. For comparison, soiling-induced annual energy losses of about 7% were measured in Santiago, Chile (33°S), a major city with higher rainfall frequency but where urban pollution plays a significant role.

Ultraviolet radiation in the Atacama Desert.

The world's highest levels of surface ultraviolet (UV) irradiance have been measured in the Atacama Desert. This area is characterized by its high altitude, prevalent cloudless conditions, and a relatively low total ozone column. In this paper, we provide estimates of the surface UV (monthly UV index at noon and annual doses of UV-B and UV-A) for all sky conditions in the Atacama Desert. We found that the UV index at noon during the austral summer is expected to be greater than 11 in the whole desert. The annual UV-B (UV-A) doses were found to range from about 3.5 kWh/m2 (130 kWh/m2) in coastal areas to 5 kWh/m2 (160 kWh/m2) on the Andean plateau. Our results confirm significant interhemispherical differences. Typical annual UV-B doses in the Atacama Desert are about 40% greater than typical annual UV-B doses in northern Africa. Mostly due to seasonal changes in the ozone, the differences between the Atacama Desert and northern Africa are expected to be about 60% in the case of peak UV-B levels (i.e. the UV-B irradiances at noon close to the summer solstice in each hemisphere). Interhemispherical differences in the UV-A are significantly lower since the effect of the ozone in this part of the spectrum is minor.

Síndrome de hiper IgE, una enfermedad poco frecuente en edad adulta: Reporte de un caso / Hyper-immunoglobulin E syndrome: Report of one case

The Hyperimmunoglobulin E syndrome (HIES) is a rare sporadic or autosomal dominant immune and connective tissue disorder characterized by chronic eczema, cutaneous abscesses, pneumonias, invasive infections, high levels of Immunoglobulin E, primary teeth retention and bone abnormalities. We report a 24-year-old male with a history of cutaneous abscesses and esophageal candidiasis. He was admitted due to a left gluteal cellulitis. During the fifth day of hospitalization he presented a distal necrosis of the fourth finger of the right hand. Laboratory results showed high levels of IgE and positive cryoglobulins. The patient was discharged and was admitted again five days later with a new gluteal abscess. IgE levels were even higher. Applying Grimbacher scale, the diagnosis of Hyperimmunoglobulin E syndrome was reached.

Movimientos de seguimiento ocular lento y esquizofrenia: revisión de la literatura / Smooth pursuit eye movements and schizophrenia: Literature review

OBJETIVO: Revisar la literatura científica sobre la relación entre las alteraciones en los movimientos oculares de seguimiento lento y la esquizofrenia. MÉTODOS: Revisión narrativa de la literatura que incluye artículos históricos, reportes sobre investigación básica y clínica, revisiones sistemáticas y meta-análisis sobre el tema. RESULTADOS: Hasta el 80% de los pacientes con esquizofrenia tienen alteraciones en los movimientos de seguimiento ocular lento. A pesar de la diversidad de protocolos de evaluación, el 65% de los pacientes y de los controles son clasificados correctamente por su rendimiento global durante dicho seguimiento. Los movimientos de seguimiento ocular lento dependen de la capacidad de anticipar la velocidad del blanco y de la retroalimentación visual, así como del aprendizaje y la atención. La neuroanatomía implicada en el seguimiento lento se superpone en alguna medida con la de ciertas zonas de la corteza frontal relacionadas con algunas características clínicas y neuropsicológicas de la esquizofrenia, de modo que algunos aspectos específicos de la alteración en el seguimiento lento podrían servir como biomarcadores de la enfermedad. Como consecuencia de su acción sedante, los antipsicóticos tienen un efecto deletéreo sobre los movimientos de seguimiento ocular lento, por lo que dichos movimientos no pueden usarse para valorar la eficacia de los fármacos disponibles en la actualidad. CONCLUSIÓN: La evaluación estandarizada de los movimientos de seguimiento ocular lento en la esquizofrenia permitirá utilizar aspectos específicos de dicho seguimiento como biomarcadores para el estudio de su genética, psicopatología o neuropsicología

OBJECTIVE: To review the scientific literature about the relationship between impairment on smooth pursuit eye movements and schizophrenia. METHODS: Narrative review that includes historical articles, reports about basic and clinical investigation, systematic reviews, and meta-analysis on the topic. RESULTS: Up to 80% of schizophrenic patients have impairment of smooth pursuit eye movements. Despite the diversity of test protocols, 65% of patients and controls are correctly classified by their overall performance during this pursuit. The smooth pursuit eye movements depend on the ability to anticipate the target's velocity and the visual feedback, as well as on learning and attention. The neuroanatomy implicated in smooth pursuit overlaps to some extent with certain frontal cortex zones associated with some clinical and neuropsychological characteristics of the schizophrenia, therefore some specific components of smooth pursuit anomalies could serve as biomarkers of the disease. Due to their sedative effect, antipsychotics have a deleterious effect on smooth pursuit eye movements, thus these movements cannot be used to evaluate the efficacy of the currently available treatments. CONCLUSION: Standardized evaluation of smooth pursuit eye movements on schizophrenia will allow to use specific aspects of that pursuit as biomarkers for the study of its genetics, psychopathology, or neuropsychology

Smooth pursuit eye movements and schizophrenia: literature review.

OBJECTIVE: To review the scientific literature about the relationship between impairment on smooth pursuit eye movements and schizophrenia. METHODS: Narrative review that includes historical articles, reports about basic and clinical investigation, systematic reviews, and meta-analysis on the topic. RESULTS: Up to 80% of schizophrenic patients have impairment of smooth pursuit eye movements. Despite the diversity of test protocols, 65% of patients and controls are correctly classified by their overall performance during this pursuit. The smooth pursuit eye movements depend on the ability to anticipate the target's velocity and the visual feedback, as well as on learning and attention. The neuroanatomy implicated in smooth pursuit overlaps to some extent with certain frontal cortex zones associated with some clinical and neuropsychological characteristics of the schizophrenia, therefore some specific components of smooth pursuit anomalies could serve as biomarkers of the disease. Due to their sedative effect, antipsychotics have a deleterious effect on smooth pursuit eye movements, thus these movements cannot be used to evaluate the efficacy of the currently available treatments. CONCLUSION: Standardized evaluation of smooth pursuit eye movements on schizophrenia will allow to use specific aspects of that pursuit as biomarkers for the study of its genetics, psychopathology, or neuropsychology.

Vitamina D y fotoprotección / Vitamin D and photoprotection

La radiación ultravioleta produce fotodaño, por lo que tratamos de evitar su acumulación en nuestra piel. Al mismo tiempo, es esta misma, en su espectro UV-B, la responsable de iniciar la única vía metabólica para la síntesis de vitamina D en el organismo humano. La vitamina D tiene un impacto benéfico en nuestro sistema óseo, inmune, y cardiovascular, entre otros. Es por esto que se genera controversia sobre el uso de fotoprotección, en cuanto a sus beneficios versus su interferencia en la síntesis de esta vitamina liposoluble. No hemos encontrado suficiente evidencia que demuestre que el uso de fotoprotección disminuya significativamente los niveles de vitamina D, como si existe para la protección contra fotodaño que los fotoprotectores proveen. Planteamos mantener la recomendación de uso de fotoprotectores, añadiendo vitamina D como suplemento oral a la dieta encaso de deficiencia.

Ultraviolet radiation generates photodamage. Therefore, we try to avoid its accumulation in our skin. At the same time, this radiation, in its UV-B wavelength, is the only catalyst of the endogenous metabolic pathway of vitamin D synthesis. This vitamin has beneficial impact in our bones, immune and cardiovascular system, among others. This is why controversy arises regarding photoprotection, its benefits versus its interference in this lipid vitamin. We have not found concrete evidence that proves that the use of photoprotection significantly lowers vitamin D levels, though we have found vast evidence of its beneficial effects concerning photodamage prevention. We suggest following the current sunscreen recommendations, and adding vitamin D oral supplements to our diet in case of deficiency.

La radiación UVA-1: un nuevo aporte en la fototerapia dermatológica / Ultraviolet radiation A1 (UVA-1): therapeutic use in dermatology

La radiación ultravioleta ha sido usada durante décadas para el tratamiento de diversas enfermedades cutáneas. La radiación ultravioleta A1 (UVA-1) que tiene una longitud de onda entre los 340nm y 400 nm está disponible desde el año 1981, pero recién en las últimas dos décadas se ha estudiado, publicado y reportado su potencial uso terapéutico en la dermatología. Los primeros beneficios de su uso se reportaron en la dermatitis atópica donde se utilizaron dosis altas de UVA-1 para tratar las exacerbaciones severas de esta condición. Luego, nuevas indicaciones terapéuticas de su uso se fueron expandiendo a otras enfermedades cutáneas tales como: morfea, liquen escleroso, queratosis liquenoide, linfomacutáneo de células T y otras dermatopatías. La radiación UVA-1 al tener una longitud de onda más larga penetra a las capas más profundas de la dermis, lo que le permite una acción en la modificación de la respuesta inflamatoria, la respuesta inmunológica y los mecanismos de reparación cutánea.

Ultraviolet light radiation has been used for decades for the treatment of several cutaneous diseases. The ultraviolet radiation A1 (UVA-1) with a wave length between 340 nm-400 nm has been available since 1981, but only in the last two decades it has been studied and published for therapeutic use in dermatology. The first reported benefits of its use were reported in atopic dermatitis in which high doses of UVA-1were used to treat severe exacerbations of this condition. Thereafter, new therapeutic indications expanded its use for other cutaneous diseases like: morphea, lichen sclerosus, lichenoid keratosis, cutaneous T cell lymphoma and other skin conditions. The UVA-1 radiation has a long wavelength that make possible to reach the deep dermis and to modify the inflammatory response, immunological response and the cutaneous repair mechanisms.

Effect of varying dose and administration of streptozotocin on blood sugar in male CD1 mice.

Streptozotocin (STZ) is used to induce experimental diabetes in rodents. There is however, controversy as to whether STZ induced diabetes models type 1 or 2 diabetes. We show that the grade of STZ-induced hyperglycemia in male CD1 mice is dependent on STZ dose. A single injection of high dose (130 or 150 mg/Kg body weight) or multiple injections (2, 3, 4 or 5) of low dose (40 mg/Kg body weight) STZ was administered intraperitonealy in non-fasted mice. Blood glucose and body weight were measured over 21 days for high dose and 21 and 28 days for low dose administration. On day three, high dose treatment produced hyperglycemia and body weight loss in comparison to mice without STZ, however unstable hyperglycemias and several deaths were observed during treatment. Hyperglycemia and body weight loss were seen with three or more injections of STZ at 21 days, whereas 4 and 5 injections produced severe hyperglycemia but not death. Mild hyperglycemia (250-450 mg/dL) was seen after 28 days following three injections of STZ. Therefore we concluded that a high dose STZ produces severe hyperglycemia in mice similar to a type 1 diabetic, and three successive administrations of STZ induces mild hyperglycemia in mice similar to type 2 diabetics.

Estudio comparativo: prevalencia patologías bucales en pacientes pediátricos oncológicos 1997-2007 / Comparative study: oral pathologies prevalence in pediatric oncology patients 1997- 2007

Los pacientes pediátricos oncológicos con frecuencia presentan lesiones orales debido a su neoplasia o como efecto colateral del tratamiento. El objetivo de este estudio fue comparar la prevalencia de patologías de la mucosa oral en niños con cáncer que fueron hospitalizados y tratados con quimioterapia en el Hospital Regional de Concepción, en los años 1997 y 2007. Se realizó un estudio descriptivo retrospectivo longitudinal en datas de 148 pacientes (74 cada año) con patologías neoplásicas en tratamiento con quimioterapia (Leucemias, linfomas, tumores del Sistema Nervioso Central y otros), registrando sus datos generales y la patología bucal (mucositis (M), candidiasis (C), lesiones por Virus Herpes tipo 1 (VHS) y síndromes hemorragíparos (H) . Los datos se resumieron en tablas anuales y fueron sometidos a análisis estadísticos. Se encontró una disminución significativa del número de pacientes con patologías bucales en el año 2007 en relación al año 1997 (P<0.05, Tet de Fisher). Además se encontró una tendencia a la baja en los pacientes con candidiasis y con mucositis en el año 2007 en comparación con 1997. Es necesario seguir estudiando medidas para prevenir, diagnosticar y/o tratar tempranamente las patologías orales de los pacientes en tratamiento antineoplásico.

Pediatric oncology patients frequently have oral lesions due to malignancy or as a side effect of treatment. The aim of this study was to compare the prevalence of oral pathologies in oncology patients hospitalized and treated at the Regional Hospital of Concepción, Chile, in the years 1997 and 2007. A retrospective study was carried out in 74 patients each year. Patients suffered from acute lymphoblastic leukemia, acute myeloblastic leukemia, central nervous system tumors, lymphomas and other neoplasms. General data (age, gender, oncologic disease) and presence of oral pathologies (candidiasis, mucositis post-chemotherapy, herpetic lesions and hemorrhage) were obtained from their clinical records. Data was analyzed for statistical differences. A significant reduction in the number of patients with oral pathologies was found in 2007 in comparison to 1997 (P<0.05, Fisher´s test). In addition, candidiasis and oral mucositis showed less prevalence in 2007 as compared to 1997, although no significant differences were found. For the relevance of oral pathologies in the chemotherapy it´s important to continue studies about prevention, early detection and treatment of oral pathologies.

Liver transplantation in Medellin, Colombia: initial experience.

OBJECTIVE: The goal of this article is to present the experience of a new liver transplant team. MATERIALS AND METHODS: This review includes all patients who received a liver transplant between March 15, 2000 and March 15, 2003. RESULTS: We performed 87 transplantations on 84 patients; 39 were females and 45 were males of average age 43.6 years, including 6 children. The majority of the patients were from Colombia with time on the waiting list of less than 1 month. The average donor age was 26.7 years. The preservation solutions included Wisconsin, HTK-Brettschneider (Custodiol), and Corpaúl (similar to Henn-Ross). In this study, 95.4% were whole livers, with 97.7% using the piggyback method. We placed 23 arterial grafts and 2 venous grafts for vascular reconstructions; 95.4% were duct-to-duct anastomosis (95.4%). Among the cohort, 8.3% experienced acute rejection and 1.2% experienced chronic rejection. Two patients required retransplantation due to hepatic artery thrombosis with biliary tree necrosis. CONCLUSIONS: We consider that we have passed the crisis of beginning a new program with a reduction in postoperative complications and improving patient and graft survival. At present, we are a center that performs liver transplantations in adults and children, with a good organ donation culture in our city that allows us to offer a waiting time on the list less than one month. Neither a veno-venous bypass nor a T-tube were necessary for our cases. We also have developed a new, less expensive form of perfusing the liver in the donor.

Relationship between internal phase volume and emulsion stability: the cetyl alcohol/stearyl alcohol system.

The main objective of this study was to optimize the stability of cetyl alcohol/stearyl alcohol emulsions in terms of percentage of internal phase volume, emulsifier type and concentration, and amount of external phase (water). Creams (o/w emulsions) were prepared by phase inversion and physical properties as particle size of the internal phase, apparent viscosity, and sedimentation volume evaluated. Stability was performed at room temperature, 40 degrees C, 50 degrees C, and under stress conditions. High hydrophilic lipophilic balance (HLB) nonionic surfactants as tween 80, tween 20, Myrj 52, Brij 35, and low HLB span 60 were used as emulsifying agents. The percentage of internal phase components (cetyl alcohol and stearyl alcohol), percentage of emulsifying agents, and percentage of aqueous external phase were varied, and stability was investigated. As the level of emulsifier agent (tween 80 and span 60) increased from 3% to 15%, and the percent of the internal phase remained constant at 30%, the particle size of the internal phase decreased and the cream became more stable. Formulations of the same composition, but prepared using Myrj 53 and tween 20 as emulsifiers, showed a larger particle size than formulations prepared using tween 80 and Brij 35. As the level of the internal phase volume increased and consequently the amount of water decreased, emulsion viscosity increased. The best formulation containing 30% internal phase (50% cetyl alcohol, 35% stearyl alcohol), 15% emulsifying agents (tween 80/span 60 ratio of 3:1), and 70% water was selected, and effects of process temperature and cooling rate on emulsion stability investigated. This formulation was further investigated in terms of stability of a 1% hydrocortisone addition by varying the percentage (30%, 35%, 40%, and 45%) of internal phase and percentage of water (70%, 65%, 60%, and 55%). The best formulation contained 45% internal phase (22.5 g cetyl alcohol, 15.75 g stearyl alcohol, 15% emulsifying agent, which is equivalent to 5 g tween 80 and 1.7 g span 60), and 55% w/w water, was manufactured under different manufacturing processes. Emulsions prepared by homogenization at the beginning of the process of emulsification were stable with small internal phase particle diameter. This study demonstrates that at every cetyl alcohol/stearyl alcohol ratio there is a phase volume/emulsifier HLB ratio, which results in optimum stability.

Uso de fibra dietética de nopal en la formulación de un polvo para flan / Use of nopal dietary fiber in a powder dessert formulation

The development of diverse types of foods of low caloric value and with high content in dietary fiber have occupied a preponderant place in the food industry in the last years, due to the growing interest of the consumers for a healthy and nutritious diet. Pre-cooked or quick to prepare foods are attractive for the time they save; if to this you add their nutritious value, the attractiveness is even greater. For this reason, this study analyzes different formulations of a powder to prepare a dessert (flan), with different percentages of incorporation of nopal flour, as a source of dietary fiber (16 per cent, 18 per cent, 20 per cent). Two flavors (melon and banana) were tried. It was observed that the flan flavored with banana and with 16 per cent of nopal flour, reached better sensorial characteristics. Greater percentages of nopal flour negatively affected the sensorial characteristics, mainly flavor, color and texture. The analysis showed that the powder presented 5.7 per cent of moisture, low water activity (0.48) and therefore a low total recount of microorganisms. The content of protein was high (27.2 per cent), the ether extract low (2.0 per cent) similar to the caloric contribution (40 Kcal/portion). The flan showed a 9.8 per cent of total dietary fiber, being greater the contribution of soluble fiber (6.1 per cent) than that of insoluble fiber (3.7 per cent). Due to these characteristics this formulation could be considered as a food that provides benefits for the human health.