Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia.

OBJECTIVES: To identify factors associated with poor prognoses in newborns with a prenatal diagnosis of gastroschisis in eight hospitals in Bogota, Colombia, from 2011 to 2022. METHODS: A multi-center retrospective case-control study was conducted on newborns with gastroschisis in eight hospitals in Bogota, Colombia. Poor prognosis was defined as the presence of sepsis, intestinal complications, or death. RESULTS: The study included 101 patients. Preterm newborns under 32 weeks had a poor neonatal prognosis (OR 6.78 95 % CI 0.75-319). Oligohydramnios (OR 4.95 95 % CI 1.15-21.32) and staged closure with silo (OR 3.48; 95 % CI 1.10-10.96) were risk factors for neonatal death, and intra-abdominal bowel dilation of 20-25 mm was a factor for the development of intestinal complications (OR 3.22 95 % CI 1.26-8.23). CONCLUSIONS: Intra-abdominal bowel dilation between 20 and 25 mm was associated with intestinal complications, while oligohydramnios was associated with the risk of perinatal death, requiring increased antenatal surveillance of fetal wellbeing. Management with primary reduction when technically feasible is recommended in these infants, considering that the use of silos was associated with higher mortality.

Monkeypox Virus Infection Resulting from an Occupational Needlestick - Florida, 2022.

In August 2022, the Florida Department of Health notified CDC of a nurse who acquired monkeypox through an occupational exposure while providing care to a patient with monkeypox. To date, occupationally acquired Monkeypox virus (MPXV) infections in health care personnel (HCP) have been rarely reported during the 2022 multinational outbreak (1,2). This report describes the first reported U.S. case and recommends approaches for preventing occupationally acquired MPXV infections in HCP.

Monkeypox Outbreak - Nine States, May 2022.

On May 17, 2022, the Massachusetts Department of Public Health (MDPH) Laboratory Response Network (LRN) laboratory confirmed the presence of orthopoxvirus DNA via real-time polymerase chain reaction (PCR) from lesion swabs obtained from a Massachusetts resident. Orthopoxviruses include Monkeypox virus, the causative agent of monkeypox. Subsequent real-time PCR testing at CDC on May 18 confirmed that the patient was infected with the West African clade of Monkeypox virus. Since then, confirmed cases* have been reported by nine states. In addition, 28 countries and territories,† none of which has endemic monkeypox, have reported laboratory-confirmed cases. On May 17, CDC, in coordination with state and local jurisdictions, initiated an emergency response to identify, monitor, and investigate additional monkeypox cases in the United States. This response has included releasing a Health Alert Network (HAN) Health Advisory, developing interim public health and clinical recommendations, releasing guidance for LRN testing, hosting clinician and public health partner outreach calls, disseminating health communication messages to the public, developing protocols for use and release of medical countermeasures, and facilitating delivery of vaccine postexposure prophylaxis (PEP) and antivirals that have been stockpiled by the U.S. government for preparedness and response purposes. On May 19, a call center was established to provide guidance to states for the evaluation of possible cases of monkeypox, including recommendations for clinical diagnosis and orthopoxvirus testing. The call center also gathers information about possible cases to identify interjurisdictional linkages. As of May 31, this investigation has identified 17§ cases in the United States; most cases (16) were diagnosed in persons who identify as gay, bisexual, or men who have sex with men (MSM). Ongoing investigation suggests person-to-person community transmission, and CDC urges health departments, clinicians, and the public to remain vigilant, institute appropriate infection prevention and control measures, and notify public health authorities of suspected cases to reduce disease spread. Public health authorities are identifying cases and conducting investigations to determine possible sources and prevent further spread. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.¶.

Kinetic Analysis of the Thermal Decomposition of Iron(III) Phosphates: Fe(NH3)2PO4 and Fe(ND3)2PO4.

The hydrothermal synthesis and both the chemical and structural characterization of a diamin iron phosphate are reported. A new synthetic route, by using n-butylammonium dihydrogen phosphate as a precursor, leads to the largest crystals described thus far for this compound. Its crystal structure is determined from single-crystal X-ray diffraction data. It crystallizes in the orthorhombic system (Pnma space group, a = 10.1116(2) Å, b = 6.3652(1) Å, c = 7.5691(1) Å, Z = 4) at room temperature and, below 220 K, changes towards the monoclinic system P21/n, space group. The in situ powder X-ray thermo-diffraction monitoring for the compound, between room temperature and 1100 K, is also included. Thermal analysis shows that the solid is stable up to ca. 440 K. The kinetic analysis of thermal decomposition (hydrogenated and deuterated forms) is performed by using the isoconversional methods of Vyazovkin and a modified version of Friedman. Similar values for the kinetic parameters are achieved by both methods and they are checked by comparing experimental and calculated conversion curves.

Visual Loss after Platelet-rich Plasma Injection into the Face.

Platelet-rich plasma has become one of the most widely used facial cosmetics fillers. We evaluated four patients treated by cosmetologists with platelet-rich plasma injections who developed irreversible blindness due to iatrogenic occlusion of the ophthalmic artery; immediately after the injection in the glabellar area in three cases and in the nasolabial fold in one case. Early after the injections the fundi of all patients demonstrated central retinal artery and choroidal occlusions. Later, two patients developed retinal pigment dispersion and one of them a pigmented optic disc. The scars on the skin showed similar characteristics in all patients, which could constitute an important marker in the presumptive diagnosis of platelet-rich plasma injection associated complications.

A prospective, randomised controlled trial evaluating the effectiveness of the fluid immersion simulation system vs an air-fluidised bed system in the acute postoperative management of pressure ulcers: A midpoint study analysis.

The use of pressure-offloading support surfaces is considered the standard of care for pressure ulcers (PUs) by most surgeons. The fluid immersion simulation system (FIS) has shown significant results in previous studies. We compared it, for the first time, with a representative air-fluidised bed (AFB) for outcomes related to post-surgical flap closures. This trial was performed over 25 months, in which 40 subjects between 18 and 85 years of age with ≤2 PUs and history of <3 surgical closures underwent reconstruction by one surgeon. Subjects were randomly assigned to either treatment group for 2 weeks after closure. The primary endpoint was success of closure after the study period. Secondary endpoints included incidence of complications and nursing and patient acceptability of the device. The FIS group included 19 subjects, and the AFB group included 21. Flap failure rate was similar between groups (15% vs 17%; P = .99). The Minor complications rate, particularly dehiscence, was higher in the FIS group (66.7% vs 15%; P = .02). Nurse and patient self-reported acceptability had better mean numeric scores in the FIS compared with AFB (nurse: 1.5 vs 1.9; P = .12; patient: 1.9 vs 2.2; P = .14). Further analysis will be conducted to gain better insight on the FIS as an alternative treatment for PUs.

The diversity of ant communities (Hymenoptera: Formicidae) and their connections with other arthropods from three temperate forests of Central Mexico.

Ants have been considered useful for bioindication because of their ecological characteristics. Nonetheless, among the characteristics of a bioindicator group, there must be a consistent and replicable response to disturbance. In this sense, divergent reactions have been found, even between taxons narrowly related. The objective of this work was to compare the diversity of the ant communities in three different temperate forests with different levels of disturbance, and to correlate their abundance and diversity of species, with that found in other arthropod communities of the same forests. The work was carried out in three municipalities in the North of the State of Mexico, where three types of different forests were identified by their degree of disturbance. These types include: 1) primary forest (PF), with typical species of a conserved forest; 2) mixed forest (MF), with species of a conserved forest and a reforestation effort; and 3) reforested forest (RF), with species used in reforestation efforts and indicative of disturbance. In each sample, an area of 2 500 m2 was selected. Each area had 16 pitfalls apiece and they were placed 10 m away from each other. Samples were collected twice; one from February through March 2009 (dry season) and another from August through September 2010 (rainy season), which produced a total of 192 traps. Obtained specimens were identified at the most taxonomically specific level. All data captured was transformed to √n + 0.5 and diversity index levels of Shannon and Simpson were calculated, as well as richness of species for ants, beetles, grasshoppers, true bugs, and spiders. The values of richness, diversity, and abundance were correlated with the Pearson coefficient, and to evaluate possible causal relationships between these, a path analysis was performed. Results suggested an important influence of the site over ant communities, and values of richness, abundance and diversity were correlated with the communities of spiders, beetles, grasshoppers and true bugs, but not for all the sites studied. Responses to environmental changes are not only on the numeric proportions of abundance, richness and diversity, but also in the indirect and casual ecological interactions. Finally, the data seems to indicate that the responses of the ants to the environmental changes are not necessarily reflected on other organisms' communities, so the ants' role as bioindicators can be limited.

Retroperitoneal lymphangioma in a pregnant patient: A case report and literature review.

This case report describes the management of a woman diagnosed with a retroperitoneal cystic tumor during pregnancy. The 29-year-old patient presented at 29 weeks of pregnancy with abdominal pain. A retroperitoneal tumor measuring 224 × 156 × 235 mm was identified on ultrasound and magnetic resonance imaging. The patient underwent cesarean section delivery of a healthy neonate at 37 weeks. Uncomplicated laparoscopic surgery was performed during the postpartum period, resulting in a histologic diagnosis of a retroperitoneal lymphangioma. A review of articles published between 2003 and 2023 on the diagnosis, management, and prognosis of gestational lymphangiomas was conducted using the PubMed, SCOPUS and SpringerLink databases. Ten articles, including case reports of lymphangiomas diagnosed during pregnancy, were identified. The most frequent location was the gastrointestinal tract, with no cases reported in the retroperitoneal area. A good perinatal outcome was reported in the majority of cases. Lymphangiomas are rare benign tumors that are even more uncommon during pregnancy. Watchful waiting can offer a good obstetric and perinatal prognosis.

Von Willebrand Disease and Pregnancy: Management Protocol From Labor to the Postpartum Period.

Von Willebrand disease (VWD) is a hemostatic disorder characterized by a quantitative or qualitative deficiency of the Von Willebrand factor (VWF). It affects males and females equally. This pathology has more severe clinical manifestations in females of reproductive age, with a mean age of diagnosis at 19 years. In the pregnant patient, Von Willebrand disease poses an increased risk of complications during labor or the postpartum period, attributed to a higher likelihood of experiencing postpartum hemorrhage and its consequential complications arising from transfusion support and multiorgan injury due to tissue hypoperfusion. We present the case of a 25-year-old G3P2V2A1 patient with a preexisting diagnosis of Von Willebrand disease prior to gestation. The institutional protocol for managing this condition involved the administration of Von Willebrand factor and factor VIII (FVIII) during vaginal delivery and the postpartum period. This resulted in the effective control of perinatal and postpartum bleeding, with an elevation in Von Willebrand factor levels, thereby avoiding the need for blood transfusions and signs of secondary hypoperfusion. This case underscores the significance of specialized management for Von Willebrand disease during pregnancy and childbirth, emphasizing adherence to institutional protocols involving specific hemostatic factors. The collaborative efforts of a multidisciplinary team, including hematologists, obstetricians, and other healthcare professionals, are crucial for the comprehensive care of females with this condition during the perinatal period.

[Health-related quality of life in Mexican women with obesity]. / Calidad de vida relacionada con la salud en mujeres mexicanas con obesidad.

Background: Obesity creates a burden of disease that affects the health-related quality of life (HRQoL) of women and in those between 20 to 59 years of age it implies greater morbidity and mortality compared to men or other age groups. Objective: To evaluate the HRQoL of Mexican women aged 20 to 59 years with obesity. Material and methods: Observational, cross-sectional, prospective, and retrospective study. It was obtained a sample of 104 women from 20 to 59 years of age diagnosed with obesity according to the NOM-008-SSA3-2017 Standard. The participants' main clinical and sociodemographic characteristics were collected, and their HRQoL was evaluated with the SF-36 questionnaire. For the analysis of the collected variables, descriptive statistics were used. To identify the association of these variables with HRQoL, the Kruskal-Wallis test was used. Results: 104 women with a median age of 40.0 years participated. Of these, 66.3% had grade I obesity, 21.2% grade II, and 12.5% grade III. In the overall sample, general health and vitality were the lowest dimensions. In the comparison by groups, the physical role and the emotional role had statistically significant differences (p = 0.007 and p = 0.009, respectively), with the most affected group being obesity grade II. Conclusions: Obesity mainly affected the perception of general health and vitality; likewise, those with grade II had a greater impact on the physical role and the emotional role.

Introducción: la obesidad crea una carga de enfermedad que afecta la calidad de vida relacionada con la salud (CVRS) de las mujeres y en aquellas de 20 a 59 años implica una mayor morbilidad y mortalidad respecto a los hombres u otros grupos etarios. Objetivo: evaluar la CVRS de mujeres mexicanas de 20 a 59 años con obesidad. Material y métodos: estudio observacional, transversal, prospectivo y retrolectivo. Se obtuvo una muestra de 104 mujeres de 20 a 59 años, diagnosticadas con obesidad según la NOM-008-SSA3-2017. Se recabaron las principales características clínicas y sociodemográficas de las participantes y se evaluó su CVRS con el cuestionario SF-36. Para analizar las variables recogidas, se usó estadística descriptiva. Para identificar la asociación de estas variables con la CVRS, se usó la prueba Kruskal-Wallis. Resultados: participaron 104 mujeres con una mediana de edad de 40.0 años. De estas, 66.3% tuvieron obesidad grado I, 21.2% grado II y 12.5% grado III. En la muestra general, la salud general y la vitalidad fueron las dimensiones más bajas. En la comparación por grupos, el rol físico y el rol emocional tuvieron diferencias estadísticamente significativas (p = 0.007 y p = 0.009, respectivamente), y el grupo más afectado fue el de obesidad grado II. Conclusiones: la obesidad afectó principalmente la percepción de la salud general y de la vitalidad; asimismo, aquellas con grado II tuvieron una mayor repercusión en los roles físico y emocional.

Synthesis of controlled-size starch nanoparticles and superparamagnetic starch nanocomposites by microemulsion method.

In this study, a synthesis process based on the microemulsion method (ME) was developed with the aim to produce controlled-size starch nanoparticles (SNPs). Several formulations were tested for the preparation of the W/O microemulsions varying the organic/aqueous phase ratios and co-stabilizers concentrations. SNPs were characterized in terms of size, morphology, monodispersity and crystallinity. Spherical shape particles with mean sizes 30-40 nm were prepared. The method was then used to simultaneously synthesize SNPs and iron oxide nanoparticles with superparamagnetic properties. Starch-based nanocomposites with superparamagnetic properties and controlled size were obtained. Therefore, the microemulsion method developed could be considered an innovative technology for the design and development of novel functional nanomaterials. The starch-based nanocomposites were evaluated in terms of morphology and magnetic properties, and they are being considered as promising sustainable nanomaterials for different biomedical applications.

Immature nasopharyngeal teratoma with prenatal diagnosis: Case report and review of the literature / Teratoma nasofaríngeo inmaduro con diagnóstico prenatal: reporte de un caso y revisión de la literatura

Objectives: To report the case of a pregnant woman with prenatal diagnosis of fetal immature nasopharyngeal teratoma, and to conduct a review of the literature describing the prognosis of this condition. Materials and methods: We report the case of a 27-year-old pregnant woman who received care at the Obstetrics and Gynecology Unit of a reference hospital in Bogotá (Colombia) because of a finding during a prenatal visit of evidence of polyhydramnios, secondary to a nasopharyngeal teratoma. A literature search was conducted in the Medline vía PubMed, Scopus, SciELO and ScienceDirect databases, restricted by language (English and Spanish) and date of publication (January 2001 to January 2021). Case reports and case series covering the prognosis of this condition were included. Results: Overall, 168 titles were retrieved, 55 of which met the inclusion criteria. Perinatal outcomes for a total of 58 fetuses with a diagnosis of immature nasopharyngeal teratoma detected during the prenatal stage were reported. In the identified cases, perinatal mortality was 25.4 % and the percentage of fetal demise was close to 3.6 %. Conclusions: Immature nasopharyngeal teratoma is an infrequent condition. The available literature suggests that fetal prognosis depends on the degree of compromise of intracranial structures and the possibility of resecting the lesion. Further studies are needed to assess the prognosis of fetuses with immature nasopharyngeal teratoma.

Objetivos: reportar el caso de una gestante con diagnóstico de feto con teratoma nasofaríngeo inmaduro y realizar una revisión describiendo el pronóstico de esta patología. Materiales y métodos: se reporta el caso de una gestante de 27 años, atendida en la Unidad de Ginecología y Obstétrica de un centro de referencia en Bogotá (Colombia), por hallazgo durante el control prenatal de un feto con evidencia de polihidramnios secundario a teratoma nasofaríngeo. Se realizó una búsqueda bibliográfica en las bases de datos Medline vía PubMed, Scopus, SciELO y ScienceDirect, restringiendo tipo de idioma (inglés y español) y por fecha de publicación (enero de 2001 a enero de 2021). Se incluyeron reportes de caso y series de casos que abarcaran el pronóstico de esta patología. Resultados: la búsqueda recuperó 168 títulos, de los cuales 55 cumplieron con los criterios de inclusión. En total se reportó el resultado perinatal de 58 fetos con diagnóstico de teratoma nasofaríngeo inmaduro detectado en etapa prenatal. En los casos identificados, la mortalidad perinatal fue del 25,4 % y el porcentaje de óbito fue cercano al 3,6 %. Conclusiones: el teratoma nasofaríngeo inmaduro es una patología poco frecuente. La literatura disponible sugiere que el pronóstico fetal depende del grado de compromiso de las estructuras intracraneales y de la posibilidad de resección de la lesión. Se requieren más estudios que evalúen el pronóstico de los fetos con teratoma nasofaríngeo inmaduro.

Cobalt Minimisation in Violet Co3P2O8 Pigment.

This study considers the limitations of cobalt violet orthophosphate, Co3P2O8, in the ceramic industry due to its large amount of cobalt. MgxCo3-xP2O8 (0 ≤ x ≤ 3) solid solutions with the stable Co3P2O8 structure were synthesised via the chemical coprecipitation method. The formation of solid solutions between the isostructural Co3P2O8 and Mg3P2O8 compounds decreased the toxically large amount of cobalt in this inorganic pigment and increased the melting point to a temperature higher than 1200 °C when x ≥ 1.5. Co3P2O8 melted at 1160 °C, and compositions with x ≥ 1.5 were stable between 800 and 1200 °C. The substitution of Co(II) with Mg(II) decreased the toxicity of these materials and decreased their price; hence, the interest of these materials for the ceramic industry is greater. An interesting purple colour with a* = 31.6 and b* = -24.2 was obtained from a powdered Mg2.5Co0.5P2O8 composition fired at 1200 °C. It considerably reduced the amount of cobalt, thus improving the colour of the Co3P2O8 pigment (a* = 16.2 and b* = -20.1 at 1000 °C). Co3P2O8 is classified as an inorganic pigment (DCMA-8-11-1), and the solid solutions prepared were also inorganic pigments when unglazed. When introducing 3% of the sample (pigment) together with enamel, spreading the mixture on a ceramic support and calcining the whole in an electric oven, a colour change from violet to blue was observed due to the change in the local environment of Co(II), which could be seen in the UVV spectra of the glazed samples with the displacement of the bands towards higher wavelengths and with the appearance of a new band assigned to tetrahedral Co(II). This blue colour was also obtained with Co2SiO4, MgCoSiO4 or Co3P2O8 pigments containing a greater amount of cobalt.

Management of pelvic organ prolapse during pregnancy: Case report.

During pregnancy, pelvic organ prolapse is uncommon and is associated with adverse outcomes such as vaginal infection, cervical ulceration, and preterm delivery. Treatment includes conservative and surgical management during pregnancy. A 32-year-old woman presented with a history of vaginal delivery eight months earlier reported the sensation of a vaginal mass lasting seven months. On physical examination, we noted pelvic organ prolapse and 19-week pregnancy. We treated her conservatively with a Gellhorn pessary and antenatal corticosteroid for fetal lung maturation at 32 weeks due to a high risk of preterm delivery. The pregnancy proceeded with no obstetric complications and vaginal delivery at term of a healthy neonate. Conservative management for patients with pelvic organ prolapse during pregnancy using a pessary is the best option to improve maternal symptomatology and minimize gestational risk; there is no contraindication for vaginal delivery, and cesarean section is reserved for obstetric indications.

Pregnancy and Delivery Management With Recombinant Factor VIIa in a Glanzmann Thrombasthenia Patient: A Case Report.

The management of pregnancy and delivery in patients with Glanzmann thrombasthenia requires platelet transfusion and recombinant activated factor VII. We report two successful pregnancies in a single patient and propose a protocol for monitoring and treatment. The urgent need for controlled trials and other epidemiological studies is also underscored.

Multiple lineages of monkeypox virus detected in the United States, 2021-2022.

Monkeypox is a viral zoonotic disease endemic in Central and West Africa. In May 2022, dozens of non-endemic countries reported hundreds of monkeypox cases, most with no epidemiological link to Africa. We identified two lineages of monkeypox virus (MPXV) among two 2021 and seven 2022 US monkeypox cases: the major 2022 outbreak variant called B.1 and a minor contemporaneously sampled variant called A.2. Analyses of mutations among these two variants revealed an extreme preference for GA-to-AA mutations indicative of human APOBEC3 cytosine deaminase activity among Clade IIb MPXV (previously West African, Nigeria) sampled since 2017. Such mutations were not enriched within other MPXV clades. These findings suggest that APOBEC3 editing may be a recurrent and a dominant driver of MPXV evolution within the current outbreak.

Rotonlike Fulde-Ferrell collective excitations of an imbalanced Fermi gas in a two-dimensional optical lattice.

We address the question of whether superfluidity can survive in the case of fermion pairing between different species with mismatched Fermi surfaces using as an example a population-imbalanced mixture of 6Li atomic Fermi gas loaded in a two-dimensional optical lattice at nonzero temperatures. The collective mode is calculated from the Bethe-Salpeter equations in the general random phase approximation assuming a Fulde-Ferrell order parameter. The numerical solution shows that, in addition to low-energy (Goldstone) mode, two rotonlike minima exist, and therefore, the superfluidity can survive in this imbalanced system.

Ag- and Sr-enriched nanofibrous titanium phosphate phases as potential antimicrobial cement and coating for a biomedical alloy.

Biomaterials and their surfaces regulate the biological response and ultimately the quality of healing at a possible site of implantation. The physical, chemical and topographical properties of implants' surfaces play a decisive role in the biological integration process for their immediate loading and long-term success. Since at this level of biological interaction nano-dimensionality is basically entailed, bio-functional nanostructured composites either as filling/cement or coating to metallic implants are required. This study shows the possibility of synthesizing two phases of nanostructured titanium phosphate (π and ρ polymorphs) and enriching them with silver nanoparticles and strontium. More importantly, Ag-Sr-enriched nanostructured π­titanium phosphate is induced to grow on a commercially available titanium alloy (Ti-6Al-4V), widely used in orthopedic and dental implants, under highly controlled conditions. Structural and microscopic studies, using XRD, HRTEM and SEM altogether confirm the resultant phases and their enrichment with strontium and silver nanoparticles with an average particle size around 6 nm. Using confocal laser scanning microscopy, the surface roughness was measured and is found to lay at the interface between the nanosized and microsized topologies. Ion release assessments showed that the presence of strontium controlled the release rate of silver ions and this could be beneficial in terms of decreasing the accompanied cytotoxicity that is usually encountered at high concentrations of silver release. Antimicrobial and cell proliferation assays have proved that enriching titanium phosphate with strontium and silver nanoparticles has improved their antimicrobial properties, while the cytotoxicity could be controlled.