Host-plant sex and phenology of Buddleja cordata Kunth interact to influence arthropod communities.

Intraspecific variation in plants is expected to have profound impacts on the arthropod communities associated with them. Because sexual dimorphism in plants is expected to provide consistent variation among individuals of the same species, researchers have often studied the effect it has on associated arthropods. Nevertheless, most studies have focused on the effect of sexual dimorphism in a single or a few herbivores, thus overlooking the potential effects on the whole arthropod community. Our main objective was to evaluate effects of Buddleja cordata's plant-sex on its associated arthropod community. We surveyed 13 pairs of male and female plants every 2 months during a year (June 2010 to April 2011). Every sampling date, we measured plant traits (water content and leaf thickness), herbivory, and the arthropod community. We did not find differences in herbivory between plant sex or through time. However, we found differences in water content through time, with leaf water-content matching the environmental seasonality. For arthropod richness, we found 68 morphospecies associated with female and 72 with male plants, from which 53 were shared by both sexes. We did not observe differences in morphospecies richness; however, we found sex-associated differences in the diversity of all species and differences on the diversity of the most abundant species with an interesting temporal component. During peak flowering season, male plants showed higher values on both parameters, but during the peak fructification season female plants showed the higher values on both diversity parameters. Our research exemplifies the interaction between plant-phenology and plant-sex as drivers of arthropod communities' diversity, even when plant sexual-dimorphism is inconspicuous, and highlighting the importance of accounting for seasonal variation. We stress the need of conducting more studies that test this time-dependent framework in other dioecious systems, as it has the potential to reconcile previous contrasting observations reported in the literature.

Controversies in point-of-care 3D printing for oncological and reconstructive surgery with free software in oral and maxillofacial surgery: European regulations, costs, and timeframe.

The aim of this paper is to discuss the controversies surrounding the most recent European regulations, as well as the cost, for a 3D printing workflow using free-source software in the context of a tertiary level university hospital in the Spanish public health system. Computer-aided design and manufacturing (CAD/CAM) for head and neck oncological surgery with the printing of biomodels, cutting guides, and patient-specific implants has made it possible to simplify and make this type of highly complex surgery more predictable. This technology is not without drawbacks, such as increased costs and the lead times when planning with the biomedical industry. A review of the current European legislation and the literature on this subject was performed, and comparisons made with the authors' in-house 3D printing setup using free software and different 3D printers. The cost analysis revealed that for the cheapest setup with free software, it would be possible to amortize the investment from case 2, and in all cases the initial investment would be amortized before case 9. The timeframe ranged from 2 weeks with the biomedical industry to 72 h with point-of-care 3D printing. It is now possible to develop point-of-care 3D printing in any hospital with almost any budget.

Marine debris and associated organic pollutants in surface waters of Chiloé in the Northern Chilean Patagonia (42°-44°S).

We report the occurrence of plastics and associated persistent organic pollutants (POPs) in surface waters from Northern Chilean Patagonia. A total of 200 particles were found during the conducted survey. The highest number of particles found was 0.6 item m-3. We found that 53 % of the collected particles corresponded to plastic, with an average of 0.19 ± 0.18 item m-3. Microplastics (68 %) were the dominant size found in the area, followed by macroplastics (18 %) and mesoplastics (14 %). Most plastic particles were white (55 %) while others were <10 % each. Black and light blue represented 9 %; red, dark blue, and other colors 7 %; and green 6 %. Fragments were the most frequent shape of plastic debris (38 %), followed by Styrofoam (30 %) and fiber (27 %). Higher PBDE levels were found in the central zone, and those were higher than DDT, PeCB, HCB, and PCB levels. This study is the first report on POP occurrence in marine plastic debris from Chiloé Sea in the Northern Chilean Patagonia.

[Translated article] A randomised clinical trial comparing screws and the TighRope® Knotless system in the treatment of acute injuries of syndesmosis.

BACKGROUND AND AIM: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. MATERIAL AND METHODS: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomised to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. RESULTS: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=.93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). CONCLUSIONS: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.

Modified videoendoscopic inguinal lymphadenectomy through suprafascial approach: Technical description and preliminary surgical outcomes.

INTRODUCTION: The videoendoscopic approach to inguinal lymph node dissection (VEIL) has been suggested as an excellent alternative carrying lower morbidity but equivalent oncological control. One of its most difficult steps is the development of an appropriate plane of dissection. A suprafascial approach would allow for better exposure. The objective of this study is to determine the feasibility, in terms of safety and oncological control, of a technical modification to the classical VEIL technique using a suprafascial plane of dissection in an initial series of patients. PATIENTS AND METHODS: A single institution retrospective review of patients undergoing VEIL technique using our modified suprafascial approach was conducted. A step-by-step surgical description is provided. Data collected included demographics; comorbid conditions; disease characteristics; intraoperative factors; and postoperative factors. RESULTS: A total of 7 patients (12 procedures) were included. Average age was 64.42 years old, and 71.42% of the patients were male. The procedure was performed bilaterally in 71.4% of the cases. Median estimated blood loss was 10 mL (range 10-25). Mean operative time was 185 min (range 120-170). Median number of nodes removed was 10.25 nodes (range 7-11). Only one of the patients (8.3%) experienced a Clavien-Dindo grade IIIa complication requiring delayed percutaneous drainage replacement. Median time until drainage removal was 13 days (range 10-16). Median length of stay was 48 hours but ranged from 24-96 hours within the series. CONCLUSIONS: The modified VEIL technique using a suprafascial plane of the dissection, allows a bilateral ILND in highly competitive operative times and with limited morbidity, without compromising its oncological efficacy.

Osimertinib and anti-HER3 combination therapy engages immune dependent tumor toxicity via STING activation in trans.

Over the past decade, immunotherapy delivered novel treatments for many cancer types. However, lung cancer still leads cancer mortality, and non-small-cell lung carcinoma patients with mutant EGFR cannot benefit from checkpoint inhibitors due to toxicity, relying only on palliative chemotherapy and the third-generation tyrosine kinase inhibitor (TKI) osimertinib. This new drug extends lifespan by 9-months vs. second-generation TKIs, but unfortunately, cancers relapse due to resistance mechanisms and the lack of antitumor immune responses. Here we explored the combination of osimertinib with anti-HER3 monoclonal antibodies and observed that the immune system contributed to eliminate tumor cells in mice and co-culture experiments using bone marrow-derived macrophages and human PBMCs. Osimertinib led to apoptosis of tumors but simultaneously, it triggered inositol-requiring-enzyme (IRE1α)-dependent HER3 upregulation, increased macrophage infiltration, and activated cGAS in cancer cells to produce cGAMP (detected by a lentivirally transduced STING activity biosensor), transactivating STING in macrophages. We sought to target osimertinib-induced HER3 upregulation with monoclonal antibodies, which engaged Fc receptor-dependent tumor elimination by macrophages, and STING agonists enhanced macrophage-mediated tumor elimination further. Thus, by engaging a tumor non-autonomous mechanism involving cGAS-STING and innate immunity, the combination of osimertinib and anti-HER3 antibodies could improve the limited therapeutic and stratification options for advanced stage lung cancer patients with mutant EGFR.

A randomized clinical trial comparing screws and the TighRope® Knotless system in the treatment of acute injuries of syndesmosis. / Ensayo clínico comparando el uso de tornillos y del sistema TighRope® Knotless en el tratamiento de las lesiones agudas de la sindesmosis.

BACKGROUND AND AIM: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. MATERIAL AND METHODS: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. RESULTS: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). CONCLUSIONS: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.

Concordance of the ACR TI-RADS.

BACKGROUND: Ultrasonography (US) is the method of choice for evaluating thyroid nodules. In 2017, the American College of Radiology (ACR) created a classification system based on US characteristics. For the system to be adopted, it must be reproducible. OBJECTIVES: To determine the intraobserver and interobserver variability of the ACR TI-RADS. METHODS: Cross-sectional study; three radiologists with different levels of experience used the ACR TI-RADS to classify 100 nodules on two occasions one month apart, and we calculated the intraobserver and interobserver variability. RESULTS: Regarding intraobserver variability, the first radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci; the second radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci, and the third radiologist had nearly perfect concordance for composition, echogenicity, and shape and substantial concordance for margins and echogenic foci. The interobserver concordance was calculated for the two readings; the concordance was substantial except for shape in the first reading and for echogenicity and margins in the second reading, which had moderate concordance. CONCLUSIONS: The ACR TI-RADS classification system is reproducible.

Hypofractionated whole breast irradiation after IORT treatment is safe in patients receiving adjuvant chemotherapy.

INTRODUCTION: Hypofractionated whole breast irradiation (hWBI) and intraoperative radiotherapy (IORT) could be associated in breast cancer patients showing high-risk factors of local recurrence after breast conserving therapy (BSC). The aim of this trial was to evaluate, for the first time, the toxicity and cosmesis of hWBI after photon-IORT in high-risk patients treated by adjuvant chemotherapy. MATERIALS AND METHODS: Thirty-one high-risk localized breast cancer patients treated by BCS, IORT (20 Gy), and adjuvant chemotherapy were included from February 2019 to August 2020 in this prospective trial, of hWBI (40.5 Gy/2.67 Gy/15 fractions). Acute and late toxicity (CTCAEv5.0) and cosmesis (Harvard scale), were assessed after treatment. RESULTS: All patients completed their treatment and were evaluable after treatment. No patients showed severe (G3) acute/late toxicity. Excellent/good cosmesis at least 6 months after completing the treatment, was present in 93.6% of the patients. CONCLUSION: hWBI in high-risk localized breast cancer patients treated by chemotherapy seems to have similar toxicity and cosmetic results than conventionally fractionated WBI in combination to photon-IORT after BCS.

Hypofractionated whole breast irradiation after IORT treatment: evaluation of acute toxicity and cosmesis.

INTRODUCTION: Hypofractionated whole breast irradiation (HWBI) is the current standard of treatment after breast conservative surgery (BCS). Intraoperative radiotherapy (IORT) must be associated to WBI in patients showing high-risk factors of local recurrence in the definitive pathology report. The aim of this trial was to evaluate, for the first time, the acute toxicity and cosmesis of HWBI after photon-IORT. MATERIALS AND METHODS: Twenty-six luminal breast cancer patients treated by BCS and IORT(20 Gy) were included between February and December 2019, in this prospective trial, of adjuvant HWBI (40.5 Gy/2.67 Gy/15 fractions). Acute toxicity (CTCAEv5.0) and cosmesis (Harvard scale), were assessed 3 months after treatment. RESULTS: All patients completed their treatment without interruptions. All cases were evaluable 3 months after treatment showing no toxicity ≥ G3 and excellent/good cosmesis assessment in 88% of the patients. CONCLUSION: HWBI seems to have similar acute toxicity and cosmesis results than conventionally fractionated WBI in combination to photon-IORT after BCS.

Concordance of the ACR TI-RADS. / Concordancia del TIRADS-ACR.

BACKGROUND: Ultrasonography (US) is the method of choice for evaluating thyroid nodules. In 2017, the American College of Radiology (ACR) created a classification system based on US characteristics. For the system to be adopted, it must be reproducible. OBJECTIVES: To determine the intraobserver and interobserver variability of the ACR TI-RADS. METHODS: Cross-sectional study; three radiologists with different levels of experience used the ACR TI-RADS to classify 100 nodules on two occasions one month apart, and we calculated the intraobserver and interobserver variability. RESULTS: Regarding intraobserver variability, the first radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci; the second radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci, and the third radiologist had nearly perfect concordance for composition, echogenicity, and shape and substantial concordance for margins and echogenic foci. The interobserver concordance was calculated for the two readings; the concordance was substantial except for shape in the first reading and for echogenicity and margins in the second reading, which had moderate concordance. CONCLUSIONS: The ACR TI-RADS classification system is reproducible.

Clinical and Functional Results of Broström-Gould Procedure With Suture Tape Augmentation: An Evaluation Using Three Scales.

The mechanical superiority of suture tape augmentation associated with the Broström-Gould procedure for treating lateral ankle instability has been reported. This study aimed to describe functional results using the visual analog scale (VAS), American Orthopedic Foot & Ankle Society (AOFAS) scale, and Short Form of Quality of Life Survey (SF-36) in patients with ankle lateral instability who underwent the modified Broström-Gould repair and suture tape augmentation and to determine the recurrence of injury and the impact on the perception of its stability. This retrospective cohort study included patients with lateral ankle instability treated using the modified Broström-Gould procedure and suture tape augmentation from December 2015 to July 2018 with a 6- to 36-month follow-up. Clinical and functional results were evaluated using the 3 aforementioned scales. p ≤ 0.05 was considered statistically significant. Twenty-eight patients were included, 18 (64%) males and 10 (36%) females (mean ± standard deviation age of 33.25 ± 12.73). The mean pre- and postoperative VAS scores were 6 ± 1.18 and 0.53 ± 0.92, respectively. The average pre- and postoperative AOFAS scores were 65.89 ± 15.08 and 94.60 ± 6.88, respectively; results were excellent (91 to 100) in 18 (64%) patients and good (81 to 90) in 10 (36%). Three patients experienced recurrence of injury treated with physical therapy, and their progress was satisfactory; stability perception was maintained. Excellent clinical and functional results were demonstrated in our study using suture tape augmentation in the modified Broström-Gould procedure, which probably protects against the recurrence of lateral ankle instability.

Use of micafungin as antifungal prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Spain (GETH-MIC).

OBJECTIVE: The fungal infections remain an important problem in the allogeneic stem cell trasnsplantation (allo-SCT) setting and thus, anti-fungal prophylaxis is commonly used. The antifungal drug should offer activity, at least against Candida and Aspergillus spp., a good safety profile and low probability interactions. Micafungin could theoretically fulfill these requisites. The aim of the study was to describe the experience with micafungin as primary prophylaxis in patients undergoing allo-SCT in a cohort of Spanish centres, and to evaluate its efficacy and tolerability in this population. METHODS: Retrospective multicentre observational study including all consecutive adult patients admitted for allo-SCT in participating centres of the Grupo Español de Trasplante Hematopoyético (GETH), from January 2010 to December 2013, who received micafungin as primary prophylaxis during the neutropenic period. RESULTS: A total of 240 patients from 13 centres were identified and 159 patients were included for the analysis. Most patients (95.6%) received 50 mg/day of micafungin. During the follow-up, 7 (4.4%) patients developed breakthrough invasive fungal disease, 1 proven and 6 probable; one patient discontinued the drug because of serious drug interactions. Prophylaxis with micafungin was considered effective in 151 (94.9%) patients. CONCLUSIONS: According to our experience, micafungin is an appropriate alternative for antifungal prophylaxis in patients undergoing an allo-HSCT, because its efficacy, its low profile of drug interactions and side-effects.

[Traumatic Turf-Toe: challenging diagnosis and controversial treatment]. / Turf-Toe traumático: diagnóstico desafiante y tratamiento controvertido.

INTRODUCTION: Turf-Toe includes a wide variety of traumatic injuries of the metatarsophalangeal joint of the first toe (MTF1). It is a potentially severe injury and there is no consensus for surgical management. The objective of this case report was to describe a patient with traumatic Turf-Toe injury grade III with a sesamoid fracture treated surgically. CLINICAL CASE: 24-year-old male with motorcycle fall with hyperflexion of the MTF1 joint, presented pain, edema and functional limitation; the radiographs showed soft tissue edema, lateral displacement of lateral sesamoid with fracture. Traumatic Turf-Toe was established. The ultrasound of the MTF1 joint showed breakage of the plantar plate and collateral ligaments. Patient was surgically managed with sesamoid reduction and plantar plate repair; postoperative evolution was satisfactory. At 8 weeks the patient was assessed with the AOFAS forefoot scale, obtaining 82 points, SF-12 with 87% and VAS of two and returned to his daily activities. CONCLUSION: We describe a patient with traumatic Turf Toe grade III injury, not related to sports practice; first report in the literature of the use of ultrasound in the evaluation of patients with lesion of the metatarso-phalangic joint of the first toe.

INTRODUCCIÓN: Turf-Toe incluye una gran variedad de lesiones traumáticas de la articulación metatarsofalángica del primer dedo del pie (MTF1). Es una lesión potencialmente grave y no existe consenso para el manejo quirúrgico. El objetivo de este reporte fue describir el caso de un paciente con lesión Turf-Toe traumática grado III con fractura sesamoidea tratado quirúrgicamente. CASO CLÍNICO: Masculino de 24 años con caída de motocicleta con hiperflexión de la articulación MTF1 presentó dolor, edema y limitación funcional; las radiografías mostraron edema de tejidos blandos, desplazamiento lateral de sesamoideo lateral con fractura. Se estableció el diagnóstico de Turf-Toe traumático. En el ultrasonido de la articulación MTF1, se demostró rotura de la placa plantar y ligamentos colaterales. Se manejó quirúrgicamente con reducción del sesamoideo y reparación de la placa plantar. La evolución postoperatoria fue satisfactoria; a las ocho semanas el paciente fue valorado con escala AOFAS­ de antepié obteniendo 82 puntos, SF-12 con 87% y EVA de 2 y retornó a sus actividades cotidianas. CONCLUSIÓN: Describimos un paciente con lesión Turf-Toe traumática grado III, no relacionada con la práctica deportiva. Primer reporte en la literatura del uso del ultrasonido en la evaluación de pacientes con lesión de la articulación metatarso-falángica del primer dedo del pie.

[Beliefs, perceptions and experiences in sexuality of Chilean adolescents with HIV acquired by vertical transmission]. / Creencias, percepciones y experiencias en sexualidad de adolescentes chilenos con infección por VIH adquirida por transmisión vertical.

BACKGROUND: Since the incorporation of antiretroviral therapy (ART) HIV has become a chronic condition, improving survival and allowing children with the virus to come in better conditions to adolescence, where they are faced with a series of changes, among them, to sexual awakening. AIM: To explore the main beliefs, perceptions and experiences in sexuality of a group of adolescents with HIV infection acquired through vertical transmission. METHODS: A qualitative research was carried out with exploratory and descriptive scope. Semi-structured interviews were applied to 28 adolescents, under control in hospitals in Santiago and Valparaíso, with HIV infection. The analysis was carried out according to the Grounded Theory. RESULTS: There was a lack of sexual education and a vision that focuses on risks, such as sexually transmissible infections or teenage pregnancy. There are fears about the possibility of rejection by others and of transmitting the virus to the couple or the children and they are invaded by feelings of shame and anger. CONCLUSION: It is important to train health professionals who work with this group, because they are identified as a reliable source of information and education.

Creencias, percepciones y experiencias en sexualidad de adolescentes chilenos con infección por VIH adquirida por transmisión vertical / Beliefs, perceptions and experiences in sexuality of Chilean adolescents with HIV acquired by vertical transmission

Resumen Introducción: Desde la incorporación de la terapia anti-retroviral (TAR) la infección por VIH ha pasado a ser una condición crónica, mejorando la sobrevida y permitiendo que los niños que han sido infectados con el virus lleguen en mejores condiciones a la adolescencia, donde se ven enfrentados a una serie de cambios, entre ellos, al despertar sexual. Objetivo: Explorar las principales creencias, percepciones y experiencias en sexualidad de un grupo de adolescentes con infección por VIH adquirida por transmisión vertical. Pacientes y Métodos: Se realizó una investigación cualitativa con alcance exploratorio y descriptivo. Se aplicaron entrevistas semiestructuradas a 28 adolescentes, bajo control en hospitales de Santiago y Región de Valparaíso, con infección por VIH. El análisis se realizó de acuerdo a la Teoría Fundamentada. Resultados: Se observó falta de educación sexual y una visión que se centra en los riesgos, tales como contagio de infecciones de transmisión sexual o embarazo adolescente. Existen temores frente a la posibilidad de rechazo de los otros y a transmitir el virus a la pareja o a los hijos y los invaden sentimientos de vergüenza y rabia. Conclusión: Es importante capacitar a los profesionales de salud que trabajan con este grupo, pues son identificados como fuente confiable de información y educación.

Background: Since the incorporation of antiretroviral therapy (ART) HIV has become a chronic condition, improving survival and allowing children with the virus to come in better conditions to adolescence, where they are faced with a series of changes, among them, to sexual awakening. Aim: To explore the main beliefs, perceptions and experiences in sexuality of a group of adolescents with HIV infection acquired through vertical transmission. Methods: A qualitative research was carried out with exploratory and descriptive scope. Semi-structured interviews were applied to 28 adolescents, under control in hospitals in Santiago and Valparaíso, with HIV infection. The analysis was carried out according to the Grounded Theory. Results: There was a lack of sexual education and a vision that focuses on risks, such as sexually transmissible infections or teenage pregnancy. There are fears about the possibility of rejection by others and of transmitting the virus to the couple or the children and they are invaded by feelings of shame and anger. Conclusion: It is important to train health professionals who work with this group, because they are identified as a reliable source of information and education.

[Modal analysis of failures and effects in intra-hospital transfers]. / Análisis modal de fallos y efectos en las transferencias intrahospitalarias.

OBJECTIVES: To identify gaps in patient safety during intra-hospital transfers. MATERIAL AND METHODS: A working group was set up and patient transfers carried out in the different healthcare areas of a hospital were identified. Using the Modal Failure and Effects Analysis (FMEA), the risks of each failure mode identified were quantified using the Risk Prioritisation Index (RPI) and establishing improvement measures for all RPIs with scores greater than 100. RESULTS: There were 31 critical points that could lead to failures / deficiencies in 20 types of transfers. A total of 35 safety improvement measures were proposed for the transfers in the different areas analysed. CONCLUSIONS: The use of FMEA has made it possible to objectify the risks for patient safety during internal hospital transfers by providing information to prioritise improvement strategies.

Divertículo rectal sintomático / Symptomatic rectal diverticulum

Resumen Los divertículos rectales son hallazgos inusuales durante la colonoscopia o estudios radiológicos del colon. Se estima una prevalencia aproximada del 1 % y se presenta con mayor frecuencia en hombres entre la sexta y novena década de la vida. En la mayoría de pacientes son asintomáticos, aunque algunos pueden cursar con síntomas o complicaciones relacionadas. Se reporta el caso de una paciente con divertículo rectal grande con dolor abdominal y estreñimiento.

Abstract Rectal diverticula are unusual findings during colonoscopy and radiological studies of the colon. Prevalence is estimated to be approximately 1%, and they occur more frequently in men between the 6th and 9th decade of life. Most patients are asymptomatic, although some may present symptoms or related complications. We report the case of a patient with a large rectal diverticulum with abdominal pain and constipation.

MORPHOLOGICAL CHARACTERIZATION OF VARIETIES OF Chenopodium quinoa CULTIVATED IN THE DEPARTMENT OF BOYACÁ, COLOMBIA / CARACTERIZACIÓN MORFOLÓGICA DE VARIEDADES DE Chenopodium quinoa CULTIVADAS EN EL DEPARTAMENTO DE BOYACÁ, COLOMBIA

ABSTRACT In the department of Boyacá, seeds of Chenopodium quinoa Willd. are planted, which correspond to a mixture of varieties, producing different grain sizes and saponin concentrations, affecting the quality and yield of the derived products, and therefore their commercialization, whenever the buyer requires it for a certain purpose, sweet varieties for bakeries or with high contents of saponin for the detergent industry. The objective was to compare the morphological characters, to identify the six varieties, according to the constant and conspicuous characteristics, as well as physiological parameters in the reproductive and vegetative stages. Observations were made in the different stages of development; in seeds, germination tests were made, the diameter and weight were measured; In the seedling stage, the total height, hypocotyl length, cotyledon lamina length and changes in red pigmentation were determined, qualitatively evaluated by direct observation. In adult plants, reproductive and vegetative characters were reviewed. A taxonomic key was proposed for the identification of the varieties. Blanca Real recorded the highest germination percentage (98%). Amarilla Marangani presented the seeds with the greatest weight and diameter and the longest cotyledons. The height of the Black and Piartal seedlings was below the other varieties. Blanca de Jericó, Blanca Real and Piartal presented weak reddish colorations in the hypocotyl and cotyledons. The identification of each variety will result in better products for growers, marketers, and processors.

RESUMEN En el departamento de Boyacá, se siembran semillas de Chenopodium quinoa Willd., las cuales, corresponden a una mezcla de variedades, produciendo diferentes concentraciones de saponina y de tamaños de grano, afectando la calidad y el rendimiento de los productos derivados y, por tanto, su comercialización, toda vez que el comprador lo requiere para un determinado fin, como variedades dulces, para las panaderías o, con altos contenidos de saponina, para la industria de detergentes. El objetivo fue comparar los caracteres morfológicos, para identificar las seis variedades, de acuerdo con las características constantes y conspicuas, además de parámetros fisiológicos en etapa reproductiva y vegetativa. Se realizaron observaciones en las diferentes etapas del desarrollo; en semillas, se hicieron pruebas de germinación, se midió el diámetro y el peso; en el estadio de plántula, se determinó la altura total, longitud del hipocótilo, largo de la lámina de los cotiledones y cambios en la pigmentación rojiza, evaluada cualitativamente por observación directa. En plantas adultas, se revisaron caracteres reproductivos y vegetativos. Se propuso una clave taxonómica, para la identificación de las variedades. Blanca Real registró el porcentaje de germinación más alto (98%). Amarilla Maranganí presentó las semillas con el mayor peso y diámetro y los cotiledones más largos. La altura de las plántulas Negra y Piartal estuvo por debajo de las otras variedades. Blanca de Jericó, Blanca Real y Piartal presentaron coloraciones rojizas débiles en el hipocótilo y en los cotiledones. La identificación de cada variedad redundará en mejores productos para los cultivadores, comercializadores y procesadores.

[Clinical and functional results of the Broström-Gould technique for lateral ankle instability: evaluation with three scales]. / Resultados clínicos y funcionales de la plastía Broström-Gould para inestabilidad lateral de tobillo: evaluación con tres escalas.

BACKGROUND: The most frequent sequel to the ankle sprain is the instability of the lateral ligament complex; the results of surgical treatment have not been evaluated with multiple scales simultaneously. The objective of the study was to assess the clinical and functional results with three scales in patients with lateral instability of ankle undergoing Broström-Gould technique, using for fixation, anchors with suture to distal fibula. MATERIAL AND METHODS: The design of the study was cross-sectional and descriptive; we included patients with lateral instability of ankle and partial or complete rupture of the APA or CP ligament subject to repair with Broström-Gould technique. Magnetic resonance imaging was performed to confirm the diagnosis; clinical and functional outcomes were determined with three scales: EVA, SF-36 and AOFAS. Patients were evaluated at six months, or more, after the surgical procedure. RESULTS: We included 13 patients; quality of life (SF-36 questionnaire) showed a good result with average score of 90; 10 (77%) patients showed excellent results in function, absence of pain and alignment of the ankle (AOFAS 90-100). Also found significant improvement in pain (presurgical EVA: 6, compared with 1 in the postoperative period). CONCLUSIONS: The surgical procedure showed excellent results, in the short term with resolution of pain and ankle stability.

ANTECEDENTES: La secuela más frecuente del esguince de tobillo es la inestabilidad del complejo ligamentario lateral; los resultados del tratamiento quirúrgico no han sido evaluados con varias escalas simultáneamente. El objetivo del estudio fue evaluar los resultados clínicos y funcionales con tres escalas en pacientes con inestabilidad lateral de tobillo sometidos a plastía de Broström-Gould, utilizando para su fijación anclas con sutura al peroné distal. MATERIAL Y MÉTODOS: El diseño del estudio fue transversal y descriptivo; se incluyeron pacientes con inestabilidad lateral de tobillo y ruptura parcial o completa del ligamento PAA y/o PC, sometidos a reparación con plastía de Broström-Gould. Se realizó resonancia magnética nuclear para confirmar el diagnóstico; los resultados clínicos y funcionales se determinaron con tres escalas: EVA, SF-36 y AOFAS. Los pacientes fueron evaluados a los seis meses o más posteriores al procedimiento quirúrgico. RESULTADOS: Se incluyeron 13 pacientes; la calidad de vida (cuestionario SF-36) arrojó un resultado bueno con promedio de 90; 10 (77%) pacientes mostraron resultados excelentes en la función, ausencia de dolor y alineación del tobillo (AOFAS 90-100). Asimismo, se observó mejoría importante en el dolor (EVA prequirúrgico: 6, comparado con 1 en el período postquirúrgico). CONCLUSIONES: El procedimiento quirúrgico demostró excelentes resultados en el corto plazo con resolución del dolor y estabilidad del tobillo.