Impact of intimate partner violence on quality of life and disease activity in women with systemic lupus erythematosus.

OBJECTIVE: Stress and trauma are psychosocial factors with an impact on the course of systemic lupus erythematosus (SLE). The influence of violence on SLE has not been entirely explored, even though women (including patients with rheumatic diseases) are a vulnerable population to any form of violence. This study aims to assess the prevalence and impact of intimate partner violence (IPV) on health-related quality of life in women with SLE. METHODS: An observational, cross-sectional, and analytical study was conducted at a rheumatology clinic of a university hospital from September 2022 and September 2023. We evaluated the presence of IPV in 85 women with SLE with the Hurt, Insulted, Threatened with Harm and Screamed at (HITS) questionnaire and the Index of Spouse Abuse (ISA), and quality of life with LupusQoL. RESULTS: The prevalence by HITS score of past-year IPV was 24.4% and of lifetime IPV was 36.5%. Past-year non-physical violence was present in 17.1% of patients by ISA, and 27.1% were victims in their lifetime. While in physical violence, 7.3% were victims in the previous year and 21.2% in their lifetime. The total quality of life and the emotional domain by LupusQoL were diminished in victims of past-year IPV, compared to those who weren't exposed (p = .018 and p = .036, respectively). Past-year HITS score correlated with the Physician Global Assessment (PGA) (rho = 0.301, p = .006), while lifetime HITS score correlated with PGA (rho = 0.329, p = .002) and SLEDAI-2K (rho = 0.277, p = .010). CONCLUSION: We found that one in four women suffered IPV in the previous year, and those who were exposed had diminished quality of life. Also, the severity of the abuse correlated with disease activity. Our findings emphasize the importance of comprehensive care for patients with SLE.

Latin America Research Output Within the Top 5 Vascular Surgery Journals.

BACKGROUND: Dedicated studies on patient outcomes are crucial to the development of effective policies aimed at prevention and management of vascular diseases. This study aims to determine the scientific productivity of Latin American countries through a bibliometric analysis of top 5 vascular journals. METHODS: The 5 dedicated vascular journals indexed in the "surgery" category were selected for analysis. These were the European Journal of Vascular and Endovascular Surgery (EJVES), the Journal of Vascular Surgery (JVS), the Journal of Endovascular Therapy (JEVT), the Journal of Vascular Surgery: Venous and Lymphatic Disorders (JVS-VL) and the Annals of Vascular Surgery (AVS). Databases were queried with the combination of each journal's name + each of the 21 Latin American countries. All possible combinations were searched. Inclusion criteria were articles affiliated with a university, medical center, or hospital from any Latin American country. RESULTS: A total of 501 articles were retrieved, 104 (20.7%) were published between 2000 and 2011, and 397 (79.2%) between 2012 and 2022. The journal with the most publications was AVS with 221 (43.9%), followed by JVS with 135 (26.9%), EJVES with 60 (11.9%), JEVT with 49 (9.9%), and JVS-VL with 36 (7.1%). Brazil had the highest volume of publications at 346 (69.0%), followed by Argentina at 54 (10.7%), Chile at 35 (6.9%), and Mexico at 32 (6.3%). JVS had a higher median citation when compared with AVS, JVS-VL, and JEVT, 18 vs. 5, 5.5, and 7, respectively (P = <0.001). Furthermore, JVS had a greater median citation than EJVES, at 18 vs. 12.5, respectively (P = 0.005). Median citation per year from 2000 to 2011 was 1.59 (range: 0-45), and 1.50 (range: 0-114.5) from 2012 to 2022 (P = 0.02). CONCLUSIONS: Latin America's research output within the vascular surgery field has increased over the years. Efforts must be made to increase research output in this region and translate findings into effective interventions for these populations.

Sexual dysfunction and self-perceived sexual health in patients with rheumatoid arthritis and systemic lupus erythematosus: results from a cross-sectional survey.

Sexual dysfunction (SD) has been associated with worse quality of life and higher disease activity in patients with rheumatic diseases, yet it is still not regularly addressed during routine rheumatologic evaluations. This study aimed to determine the prevalence of sexual dysfunction in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and evaluate their perception of their sexual health. We performed a retrospective study in an outpatient rheumatology clinic to evaluate patients over 18 years old with a diagnosis of RA or SLE through the Spanish version of the Arizona Sexual Experiences Scale (ASEX) and the Sexual Health Perception Survey (SHEPS), a questionnaire of 6 items designed in our clinic. Additionally, we applied the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F version 4) and the Hospital Anxiety and Depression Scale (HADS). A total of 567 patients were evaluated with SHEPS, most of whom were women with a median age of 50 years (IQR: 34) and a median disease duration of 5 years (IQR: 9). Through the ASEX, we found that 67% of the patients with RA and 60% of the patients with SLE experienced SD. Patients reported the level of sex drive, arousal, and the ability to achieve orgasms as the areas with the most difficulties. Most patients did not know their disease could affect their sexuality and had never addressed these issues with their rheumatologists, but almost all of them were willing to. Our findings highlight the importance of addressing sexual health issues regularly during rheumatologic evaluations.

Bacteria isolated from explosive contaminated environments transform pentaerythritol tetranitrate (PETN) under aerobic and anaerobic conditions.

Pentaerythritol tetranitrate (PETN) is a nitrate ester explosive that may be persistent with scarce reports on its environmental fate and impacts. Our main objective was to isolate and characterize bacteria that transform PETN under aerobic and anaerobic conditions. Biotransformation of PETN (100 mg L-1) was evaluated using mineral medium with (M + C) and without (M - C) additional carbon sources under aerobic conditions and with additional carbon sources under anaerobic conditions. Here, we report on the isolation of 12 PETN-transforming cultures (4 pure and 8 co-cultures) from environmental samples collected at an explosive manufacturing plant. The highest transformation of PETN was observed for cultures in M + C under aerobic conditions, reaching up to 91% ± 2% in 2 d. Under this condition, PETN biotransformation was observed in conjunction with the release of nitrites and bacterial growth. No substantial transformation of PETN (<45%) was observed during 21 d in M - C under aerobic conditions. Under anaerobic conditions, five cultures could transform PETN (up to 52% ± 13%) as the sole nitrogen source, concurrent with the formation of two unidentified metabolites. PETN-transforming cultures belonged to Alphaproteobacteria, Betaproteobacteria, Gammaproteobacteria, and Actinobacteria. In conclusion, we isolated 12 PETN-transforming cultures belonging to diverse taxa, suggesting that PETN transformation is phylogenetically widespread.

Proteomic analysis reveals stage-specific reprogramed metabolism for the primary breast cancer cell lines MGSO-3 and MACL-1.

Breast cancer is the most prevalent cancer in women worldwide. Its molecular subtypes are based on the presence/absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). MACL-1 and MGSO-3 are cell lines derived from primary tumor sites of patients diagnosed with luminal A subtype carcinoma (ER+/PR+/HER2-) and ductal carcinoma in situ (ER-/PR-/HER2+), respectively. However, these cell lines lost the expression of these markers over cell culturing, and both have triple-negative phenotypes (ER-/PR-/HER2-), which has the poorest prognosis. Here, we sought to study the proteome signature of MGSO-3 and MACL-1, comparing them with the epithelial cell line MCF-10A and the well-established metastatic-derived breast cancer cell line MDA-MB-231. Our results showed that proteins associated with the tricarboxylic acid cycle (TCA) and oxidative phosphorylation (OXPHOS) were upregulated in MGSO-3 and MACL-1 cells. These cell lines also showed upregulation of pro-apoptotic proteins when compared with MDA-MB-231. The molecular differences highlighted in this study may clarify the molecular basis behind cancer cells functioning and may reveal novel signatures across the breast cancer cell models.

Predicting of excess body fat in children.

PURPOSE OF REVIEW: Approximately 370 million children and adolescents worldwide showed overweight or obesity in 2016. The risk of developing severe comorbidities depends on the age of onset and the duration of obesity. This review discusses available methodologies to detect excess body fat in children as well as the early life factors that predict excess body fat and its development. RECENT FINDINGS: Factors, such as parental nutritional status, maternal weight gain during pregnancy, maternal malnutrition, maternal smoking during pregnancy, low and high birth weight, rapid weight gain, and short infant sleep duration have been independently and positively associated with neonatal, infant, and children adiposity. Early detection of excess body fat in children through the use of various tools is the first step in preventing nutrition-related diseases in adulthood. SUMMARY: The early detection of excess body fat and the implementation of efficient interventions to normalize the weight of children and adolescents at obesity risk are essential to prevent diseases in adult life.

EVAR in Patients With Abdominal Aortic Aneurysm and Horseshoe Kidney: A Systematic Review.

PURPOSE: A systematic review of all patients that have been reported in the literature with abdominal aortic aneurysm (AAA) concomitant with horseshoe kidney (HSK) treated electively by endovascular aneurysm repair (EVAR) is presented. A new grouping system for describing HSK vasculature is implemented. MATERIALS AND METHODS: We searched for published manuscripts using the Medical Subject Headings terms "abdominal aortic aneurysm," "AAA," "EVAR," "endovascular aneurysm repair," and "horseshoe kidney" in PubMed, Google Scholar, Scopus, and National Center for Biotechnology Information databases. Inclusion criteria include all published material of patients with AAA with HSK treated electively by an endovascular approach. We excluded patients who were treated by a hybrid or open repair or patients with ruptured AAA. Statistical analysis was carried out using SPSS Statistics version 25 (IBM Corp, Armonk, New York) software. RESULTS: A total of 50 patients from 30 studies were included for analysis. Males made up 88% (n=44) of the population. The median age for this cohort was 70 years (range: 47-86 years). Median aneurysmal diameter was 6.0 cm (range: 4.0-10.3 cm). The median operative time for endovascular repair was 84 minutes (range: 40-332 minutes). The most common graft used was Zenith, used in 40% (n=20) of the cases, followed by Endurant in 14% (n=7). The overall complication rate was 14% (n=7). The median follow-up was 19 months (range: 1-108 months). While comorbidities did not appear to impact outcomes significantly, median operative times for smokers were higher than those in nonsmokers, 84 versus 118 minutes, respectively (p=0.048). Univariate linear regression modeling of aneurysmal size with age, operative time, and length of stay revealed a significant coefficient association between aneurysmal size and operative times. After adjusting for comorbidities and aneurysmal size, prior history of chronic kidney disease significantly increased odds for renal infarction. CONCLUSION: This review presents the most complete data set possible of patients with concomitant HSK and AAA treated by an endovascular approach. Furthermore, the A + B + C classification for grouping the HSK vasculature is implemented. This systematic review suggests EVAR to be an excellent option with low complication rates for the treatment of AAA in patients with HSK.

Discrete Models in Epidemiology: New Contagion Probability Functions Based on Real Data Behavior.

Mathematical modeling is a tool used for understanding diseases dynamics. The discrete-time model is an especial case in modeling that satisfactorily describes the epidemiological dynamics because of the discrete nature of the real data. However, discrete models reduce their descriptive and fitting potential because of assuming a homogeneous population. Thus, in this paper, we proposed contagion probability functions according to two infection paradigms that consider factors associated with transmission dynamics. For example, we introduced probabilities of establishing an infectious interaction, the number of contacts with infectious and the level of connectivity or social distance within populations. Through the probabilities design, we overcame the homogeneity assumption. Also, we evaluated the proposed probabilities through their introduction into discrete-time models for two diseases and different study zones with real data, COVID-19 for Germany and South Korea, and dengue for Colombia. Also, we described the oscillatory dynamics for the last one using the contagion probabilities alongside parameters with a biological sense. Finally, we highlight the implementation of the proposed probabilities would improve the simulation of the public policy effect of control strategies over an infectious disease outbreak.

Esophageal Duplication Cysts in 97 Adult Patients: A Systematic Review.

BACKGROUND: Esophageal duplication cysts are a rare congenital cystic malformation from faulty intrauterine recanalization of the esophagus during the 4-8th weeks of development. They account for 20% of all gastrointestinal duplication cysts and commonly involve the distal esophagus. Presenting symptoms may be related to size and location. MATERIALS AND METHODS: Following the PRISMA guidelines, a systematic review was performed by searching published literature in various databases. Data from 97 reported case reports were pooled to present a descriptive and statistical analysis. RESULTS: Patient population was composed of 51(52.5%) males and 46 (47.5%) females, and mean ages was 42.3 years (18-77). Distal cysts were the most prevalent. Seventy-nine (81.4%) patients were symptomatic; common symptoms included dysphagia, chest pain, cough and weight loss. Fifteen (15.5%) patients were treated conservatively and 75 (84.5%) by surgical treatment, among them thoracotomy in 30 (30.9%) patients and VATS in 17 (17.5%) patients. Mean length of hospital stay was 8.6 days (range: 1-26 days). One fatality was registered. Location, unlike size, was not found to influence presenting symptoms or treatment employed. Frequency of conservative treatment was not significantly different between symptomatic and asymptomatic patients. Open approaches were associated with longer stays than their minimally invasive counterparts. CONCLUSION: Esophageal duplication cysts remain rare in adults and are frequently located in the distal esophagus. Larger cysts are more likely to cause symptoms. Various surgical techniques may successfully be employed in the treatment of this pathology. Minimally invasive procedures have a shorter hospital stay.

Fat-free/lean body mass in children with insulin resistance or metabolic syndrome: a systematic review and meta-analysis.

BACKGROUND: Lean / Fat Free Body Mass (LBM) is metabolically involved in active processes such as resting energy expenditure, glucose uptake, and myokine secretion. Nonetheless, its association with insulin sensitivity / resistance / glucose tolerance and metabolic syndrome remains unclear in childhood. METHODS: The current investigation aimed to examine the differences in fat-free mass /lean body mass according to the presence of insulin sensitivity/insulin resistance/glucose tolerance/metabolic syndrome in children. A systematic search was carried out in Medline/PubMed, Embase, Scopus, Web of Science, and SciELO, covering the period from each database's respective start to 21 June 2021. Two researchers evaluated 7111 studies according to the inclusion criteria: original human studies, written in English or Spanish, evaluating fat-free mass/lean body mass in children and adolescents including both with and without insulin sensitivity/insulin resistance /glucose tolerance and metabolic syndrome and reported the differences between them in terms of fat free mass/lean body mass. The results of the studies were combined with insulin sensitivity, insulin, resistance, glucose tolerance and metabolic syndrome. The standardized mean difference (SMD) in each study was calculated and combined using the random-effects model. Heterogeneity between studies was tested using the index of heterogeneity (I2), leave-one-out sensitivity analyses were performed, and publication bias was assessed using the Egger and Begg tests. RESULTS: Finally, 15 studies which compared groups defined according to different glucose homeostasis criteria or metabolic syndrome out of 103 eligible studies were included in this systematic review and 12 studies in the meta-analysis. Meta-analysis showed lower fat-free mass/lean body mass percentage in participants with insulin resistance/glucose tolerance/metabolic syndrome (SMD -0.47; 95% CI, - 0.62 to - 0.32) while in mass units (kg), higher values were found in the same group (SMD, 1.01; 95% CI, 0.43 to 1.60). CONCLUSIONS: Our results identified lower values of fat-free mass/lean body mass (%) in children and adolescents with insulin resistance/glucose tolerance/metabolic syndrome and higher values of fat-free mass/lean body mass when these are expressed in kg. The evidence of the impact of lean mass on children's glucose homeostasis or metabolic syndrome is limited, so future studies research should focus on explaining the effect of fat-free mass/lean body mass on different metabolic outcomes. Moreover, it may be interesting to evaluate the quality (muscle density) or functional (muscle strength) outcomes in addition to both absolute (kg) and relative (%) values in future studies. The systematic review was prospectively registered at PROSPERO (registration number CRD42019124734; available at: http://www.crd.york.ac.uk/prospero [accessed: 05 April 2019]).

Associations between Spanish children's physical activity and physical fitness with lean body mass: The CALINA study.

The present study investigated the associations between physical activity (PA) and physical fitness (PF) with lean body mass (LBM) and evaluated whether PA mediates the association between PF and LBM. 279 children (150 boys) aged 7.5 ± 0.3 years participated in the study. PA was assessed by accelerometry and PF with handgrip and the standing long jump test. Total lean soft tissue mass index (TLSTMI), muscle cross-sectional area index (MCSAI), and fat-free mass index (FFMI) were evaluated using dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and bioimpedance analysis, respectively.Total (ß = 0.247) and vigorous PA (ß = 0.143) were associated with TLSTMI in girls. In boys, total (ß = 0.337), light (ß = 0.290), vigorous (ß = 0.200), and moderate-vigorous PA (ß = 0.189) were associated with TLSTMI. Total PA was associated with FFMI (ß = 0.299). Handgrip strength does not mediate the relationship between total PA and TLSTMI. Positive associations were found between handgrip strength and TLSTMI, MCSAI, and FFMI in both girls and boys.In children, there is a positive association between total and vigorous PA with TLSTMI. Handgrip strength does not mediate the relationship between total PA and TLSTMI. It was associated with TLSTMI, MCSAI, and FFMI.

Synthesis, Characterization, and Optimization Studies of Starch/Chicken Gelatin Composites for Food-Packaging Applications.

The indiscriminate use of plastic in food packaging contributes significantly to environmental pollution, promoting the search for more eco-friendly alternatives for the food industry. This work studied five formulations (T1-T5) of biodegradable cassava starch/gelatin films. The results showed the presence of the starch/gelatin functional groups by FT-IR spectroscopy. Differential scanning calorimetry (DSC) showed a thermal reinforcement after increasing the amount of gelatin in the formulations, which increased the crystallization temperature (Tc) from 190 °C for the starch-only film (T1) to 206 °C for the film with 50/50 starch/gelatin (T3). It also exhibited a homogeneous surface morphology, as evidenced by scanning electron microscopy (SEM). However, an excess of gelatin showed low compatibility with starch in the 25/75 starch/gelatin film (T4), evidenced by the low Tc definition and very rough and fractured surface morphology. Increasing gelatin ratio also significantly increased the strain (from 2.9 ± 0.5% for T1 to 285.1 ± 10.0% for T5) while decreasing the tensile strength (from 14.6 ± 0.5 MPa for T1 to 1.5 ± 0.3 MPa for T5). Water vapor permeability (WVP) increased, and water solubility (WS) also decreased with gelatin mass rising in the composites. On the other hand, opacity did not vary significantly due to the films' cassava starch and gelatin ratio. Finally, optimizing the mechanical and water barrier properties resulted in a mass ratio of 53/47 cassava starch/gelatin as the most appropriate for their application in food packaging, indicating their usefulness in the food-packaging industry.

Biocompatibility Assessment of Polylactic Acid (PLA) and Nanobioglass (n-BG) Nanocomposites for Biomedical Applications.

Scaffolds based on biopolymers and nanomaterials with appropriate mechanical properties and high biocompatibility are desirable in tissue engineering. Therefore, polylactic acid (PLA) nanocomposites were prepared with ceramic nanobioglass (PLA/n-BGs) at 5 and 10 wt.%. Bioglass nanoparticles (n-BGs) were prepared using a sol-gel methodology with a size of ca. 24.87 ± 6.26 nm. In addition, they showed the ability to inhibit bacteria such as Escherichia coli (ATCC 11775), Vibrio parahaemolyticus (ATCC 17802), Staphylococcus aureus subsp. aureus (ATCC 55804), and Bacillus cereus (ATCC 13061) at concentrations of 20 w/v%. The analysis of the nanocomposite microstructures exhibited a heterogeneous sponge-like morphology. The mechanical properties showed that the addition of 5 wt.% n-BG increased the elastic modulus of PLA by ca. 91.3% (from 1.49 ± 0.44 to 2.85 ± 0.99 MPa) and influenced the resorption capacity, as shown by histological analyses in biomodels. The incorporation of n-BGs decreased the PLA crystallinity (from 7.1% to 4.98%) and increased the glass transition temperature (Tg) from 53 °C to 63 °C. In addition, the n-BGs increased the thermal stability due to the nanoparticle's intercalation between the polymeric chains and the reduction in their movement. The histological implantation of the nanocomposites and the cell viability with HeLa cells higher than 80% demonstrated their biocompatibility character with a greater resorption capacity than PLA. These results show the potential of PLA/n-BGs nanocomposites for biomedical applications, especially for long healing processes such as bone tissue repair and avoiding microbial contamination.

Quantitative peripheral computed tomography to measure muscle area and assess lean soft tissue mass in children.

BACKGROUND: Skeletal muscle is one of the main components of lean soft tissue mass (LSTM). Low levels in children affect locomotion, posture, and increase the risk of metabolic syndrome. AIM: (1) To evaluate the association between muscle cross-sectional area (MCSA) of the lower left leg measured by peripheral quantitative computed tomography (pQCT) and total LSTM; namely, total left leg and left lower leg LSTM assessed by dual-energy X-ray absorptiometry (DXA) in a group of children, (2) to examine if MCSA is a predictor of LSTM, (3) to determine the ability of pQCT to identify children with low LSTM. SUBJECTS AND METHODS: Lower left leg MCSA and LSTM were measured using pQCT and DXA, respectively, in 396 children. RESULTS: Statistically significant positive correlations were found between the lower leg MCSA - total LSTM (r² = 0.789), total leg LSTM (r² = 0.79), and lower leg LSTM (r² = 0.791) (p < .01). MCSA explained 64-68% of the variance in LSTM. Receiver operator characteristic (ROC) curves determined the capacity of the lower left leg MCSA to identify low LSTM in girls (AUC 0.95) and boys (AUC 0.87). CONCLUSIONS: Our results showed that lower left leg MCSA, measured using pQCT, could be a tool to predict low LSTM in children.

Tuning the Acceptor Unit of Push-Pull Porphyrazines for Dye-Sensitized Solar Cells.

A family of four push-pull porphyrazines of A3B type, where each unit A contains two peripheral propyl chains and the unit B is endowed with a carboxylic acid, were prepared. The carboxylic acid was attached to the ß-position of the pyrrolic unit, either directly (Pz 10), or through cyanovinyl (Pz 11) and phenyl (Pz 7) groups. The fourth Pz (14) consisted in a pyrazinoporphyrazine wherein the dinitrogenated heterocycle provided intrinsic donor-acceptor character to the macrocycle and contained a carboxyphenyl substituent. The direct attachment of the carboxylic acid functions and their linkers to the porphyrazine core produces stronger perturbation on the electronic properties of the macrocycle, with respect to their connection through fused benzene or pyrazine rings in TT112 and 14, respectively. The HOMO and LUMO energies of the Pzs, which were estimated with DFT calculations, show little variation within the series, except upon introduction of the cyanovinyl spacer, which produces a decrease in both frontier orbital energetic levels. This effective interaction of cyanovinyl substitution with the macrocycle is also evidenced in UV/Vis spectroscopy, where a large splitting of the Q-band indicates strong desymmetrization of the Pz. The performance of the four Pzs as photosensitizers in DSSCs were also investigated.

Packham's Triumph Pears (Pyrus communis L.) Post-Harvest Treatment during Cold Storage Based on Chitosan and Rue Essential Oil.

Pears (Pyrus communis L.) cv. Packham's Triumph are very traditional for human consumption, but pear is a highly perishable climacteric fruit with a short shelf-life affected by several diseases with a microbial origin. In this study, a protective effect on the quality properties of pears was evidenced after the surface application of chitosan-Ruta graveolens essential oil coatings (CS + RGEO) in four different concentrations (0, 0.5, 1.0 and 1.5 %, v/v) during 21 days of storage under 18 °C. After 21 days of treatment, a weight loss reduction of 10% (from 40.2 ± 5.3 to 20.3 ± 3.9) compared to the uncoated pears was evident with CS + RGEO 0.5%. All the fruits' physical-chemical properties evidenced a protective effect of the coatings. The maturity index increased for all the treatments. However, the pears with CS + RGEO 1.5% were lower (70.21) than the uncoated fruits (98.96). The loss of firmness for the uncoated samples was higher compared to the coated samples. The pears' most excellent mechanical resistance was obtained with CS + RGEO 0.5% after 21 days of storage, both for compression resistance (7.42 kPa) and force (22.7 N). Microbiological studies demonstrated the protective power of the coatings. Aerobic mesophilic bacteria and molds were significantly reduced (in 3 Log CFU/g compared to control) using 15 µL/mL of RGEO, without affecting consumer perception. The results presented in this study showed that CS + RGEO coatings are promising in the post-harvest treatment of pears.

[Ingestion of multiple magnets in pediatrics: endoscopic or surgical emergency?] / Ingestión de múltiples imanes en pediatría: ¿emergencia endoscópica o quirúrgica?

Ingestion of foreign bodies is common in the pediatric population. Most foreign bodies have a benign behavior and are usually eliminated without generating greater morbidity and mortality. In relation to the intake of magnets, its frequency has increased to the point that it currently represents a public health problem in the pediatric population. The ingestion of a single magnet does not generate any risk, but the ingestion of 2 or more of these, or even of magnets and metals in succession is considered an emergency since they can attract each other and can cause serious symptoms of intestinal obstruction, bleeding, fistulas, perforation and even intestinal necrosis. We present 2 pediatric patients, who ingested multiple magnets, in these cases we highlight the variety in the clinical presentation, as well as the complications presented in relation to a late diagnosis.

Synthesis, Characterization, and Histological Evaluation of Chitosan-Ruta Graveolens Essential Oil Films.

The development of new biocompatible materials for application in the replacement of deteriorated tissues (due to accidents and diseases) has gained a lot of attention due to the high demand around the world. Tissue engineering offers multiple options from biocompatible materials with easy resorption. Chitosan (CS) is a biopolymer derived from chitin, the second most abundant polysaccharide in nature, which has been highly used for cell regeneration applications. In this work, CS films and Ruta graveolens essential oil (RGEO) were incorporated to obtain porous and resorbable materials, which did not generate allergic reactions. An oil-free formulation (F1: CS) and three different formulations containing R. graveolens essential oil were prepared (F2: CS-RGEO 0.5%; F3: CS+RGEO 1.0%; and F4: CS+RGEO 1.5%) to evaluate the effect of the RGEO incorporation in the mechanical and thermal stability of the films. Infrared spectroscopy (FTIR) analyses demonstrated the presence of RGEO. In contrast, X-ray diffraction (XRD) and differential scanning calorimetry (DSC) analysis showed that the crystalline structure and percentage of CS were slightly affected by the RGEO incorporation. Interesting saturation phenomena were observed for mechanical and water permeability tests when RGEO was incorporated at higher than 0.5% (v/v). The results of subdermal implantation after 30 days in Wistar rats showed that increasing the amount of RGEO resulted in greater resorption of the material, but also more significant inflammation of the tissue surrounding the materials. On the other hand, the thermal analysis showed that the RGEO incorporation almost did not affect thermal degradation. However, mechanical properties demonstrated an understandable loss of tensile strength and Young's modulus for F3 and F4. However, given the volatility of the RGEO, it was possible to generate a slightly porous structure, as can be seen in the microstructure analysis of the surface and the cross-section of the films. The cytotoxicity analysis of the CS+RGEO compositions by the hemolysis technique agreed with in vivo results of the low toxicity observed. All these results demonstrate that films including crude essential oil have great application potential in the biomedical field.

Nanocomposite Films of Chitosan-Grafted Carbon Nano-Onions for Biomedical Applications.

The design of scaffolding from biocompatible and resistant materials such as carbon nanomaterials and biopolymers has become very important, given the high rate of injured patients. Graphene and carbon nanotubes, for example, have been used to improve the physical, mechanical, and biological properties of different materials and devices. In this work, we report the grafting of carbon nano-onions with chitosan (CS-g-CNO) through an amide-type bond. These compounds were blended with chitosan and polyvinyl alcohol composites to produce films for subdermal implantation in Wistar rats. Films with physical mixture between chitosan, polyvinyl alcohol, and carbon nano-onions were also prepared for comparison purposes. Film characterization was performed with Fourier Transformation Infrared Spectroscopy (FTIR), Thermogravimetric Analysis (TGA), Differential Scanning Calorimetry (DSC), Tensile strength, X-ray Diffraction Spectroscopy (XRD), and Scanning Electron Microscopy (SEM). The degradation of films into simulated body fluid (SBF) showed losses between 14% and 16% of the initial weight after 25 days of treatment. Still, a faster degradation (weight loss and pH changes) was obtained with composites of CS-g-CNO due to a higher SBF interaction by hydrogen bonding. On the other hand, in vivo evaluation of nanocomposites during 30 days in Wistar rats, subdermal tissue demonstrated normal resorption of the materials with lower inflammation processes as compared with the physical blends of ox-CNO formulations. SBF hydrolytic results agreed with the in vivo degradation for all samples, demonstrating that with a higher ox-CNO content increased the stability of the material and decreased its degradation capacity; however, we observed greater reabsorption with the formulations including CS-g-CNO. With this research, we demonstrated the future impact of CS/PVA/CS-g-CNO nanocomposite films for biomedical applications.

Endoscopic retrograde cholangiopancreatography by double-balloon enteroscopy in patients with surgically altered gastrointestinal anatomy.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) allows a diagnostic and therapeutic evaluation of pancreatobiliary diseases. However, the procedure in patients with surgically altered gastrointestinal anatomy represents a technical challenge. OBJECTIVE: to report the diagnostic and therapeutic outcome of device-assisted enteroscopy (DAE) ERCP in patients with a surgically altered gastrointestinal anatomy. METHODS: a prospective cohort of patients with a history of surgically altered gastrointestinal anatomy undergoing DAE-ERCP in a referral center was used. A double-balloon enteroscope was used to reach the papillary area or the bilio-enteric anastomosis. The clinical and endoscopic characteristics, and technical, diagnostic and therapeutic success were described. Clinical and endoscopic differences were evaluated according to diagnostic success, as well as the biochemical response in those patients with therapeutic success. RESULTS: ninety-six procedures were included in the study in 75 patients. Roux-en-Y hepaticojejunostomy (RYHJ) was the main surgical anatomy (82.3%) and cholangitis was the main indication for ERCP (49%). Diagnostic success was obtained in 69.8% of the participants. Of these, therapeutic success was obtained in 83.6% (overall success 58.3%). Cases with a diagnostic success had a higher frequency of cholangiography compared to those without diagnostic success (94% vs 0%, p < 0.001), as well as a lower probability of a failed cannulation (1.5% vs 100%, p < 0.001). A significant improvement was observed in patients with a therapeutic success in bilirubin, transaminases and alkaline phosphatase levels (p < 0.05). CONCLUSIONS: ERCP by means of double-balloon enteroscopy is a useful technique in patients with a surgically altered gastrointestinal anatomy, in whom access to the bile duct is required. However, these procedures are very challenging and diagnostic and therapeutic success where achieved in up to 60% of cases.