Active microscopic colitis precipitated by fluoxetine.

Microscopic colitis is a form of chronic and recurrent inflammatory bowel disease characterized by non-bloody, watery diarrhea, macroscopically normal colonic mucosa, and characteristic histopathological findings. Some drugs have been described as triggers of colonic inflammation in predisposed individuals, while others may exacerbate microscopic colitis that evolves on its own. We present the case of a patient diagnosed with active microscopic colitis in relation to taking fluoxetine at high doses.

EUS-guided gallbladder drainage as second option of biliary decompression after failed ERCP for the management of malignant distal biliary obstruction.

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is recommended as a rescue treatment of malignant distal biliary obstruction (MBDO) after failed ERCP and endoscopic ultrasound-guided biliary drainage (EUS-BD). A 64-year-old male was admitted for painless obstructive jaundice and anemia. For religious reasons, he refused any blood transfusions. Abdominal computed tomography scan showed a pancreatic tumor with dilation biliary tree and liver metastasis. ERCP failed and advanced biliary cannulation technique such as precut were avoided due to a high risk of bleeding. We avoided the two transmural EUS-BD approaches, which include EUS-guided choledochoduodenostomy and EUS-guided hepaticogastrostomy, due to smaller targets and considered riskier in this patient. Since the gallbladder was markedly distended and the cystic duct was patent, we performed a cholecystogastrostomy with a 15x10 mm electrocautery lumen-apposing metal stent (EC-LAMS) as a second option of biliary drainage. After a week, the serum bilirubin levels decreased to normal values and the patient was uneventfully discharged. At follow-up, he refused to receive chemotherapy and died six months later due to cancer progression.

Longitudinal Study of Cognitive Functioning in Adults with Juvenile Idiopathic Arthritis.

OBJECTIVE: To prospectively evaluate possible decline of cognitive functions in adult patients with juvenile idiopathic arthritis (JIA) and identify associated factors. PATIENTS AND METHODS: We performed a 24-month prospective observational study of adults (≥16 years) with JIA. The primary outcome measure was decline in cognitive function defined as a worsening of ≥2 points on the scales of the subsets administered to evaluate the different cognitive areas using the Wechsler Adult Intelligence Scale (WAIS) after 24 months: attention/concentration (digit span); verbal function (vocabulary); visual-spatial organization (block design); working memory (letter-number sequencing); and problem solving (similarities). Other variables included average inflammatory activity using C-reactive protein and composite activity indexes, comorbidity, and treatment. Logistic regression was performed to identify factors associated with cognitive decline. RESULTS: The study population comprised 52 patients with JIA. Of these, 15 (28.8%) had cognitive decline at V24. The most affected functions were working memory (17.3%), attention/concentration (9.6%), verbal function (7.7%), visual-spatial organization (7.7%), and problem solving (3.8%). There were no significant differences in the median direct or scale scores for the cognitive functions evaluated between V0 and V24 for the whole sample. The factors associated with cognitive decline in patients with JIA were average C-reactive protein (OR [95% CI], 1.377 [1.060-1.921]; p = 0.039), depression (OR [95% CI], 3.691 [1.294-10.534]; p = 0.015), and treatment with biologics (OR [95% CI], 0.188 [0.039-0.998]; p = 0.046). CONCLUSION: Cognitive decline was detected in almost one third of adults with JIA after 24 months of follow-up. Systemic inflammatory activity in JIA patients was related to cognitive decline. Patients treated with biologics had a lower risk of decline in cognitive functions.

Inverted urethral flap reconstruction after partial penectomy: Long-term oncological and functional outcomes.

INTRODUCTION: Penile aesthetics after partial penectomy (PP) for penile cancer (PC), significantly affect a patient's health-related quality of life (HRQoL), self-esteem, and sexual function. Satisfactory reconstruction has become a major milestone in the treatment of these patients. METHODS: Clinical charts of all patients that underwent PP and reconstruction with an inverted urethral flap (IUF) were reviewed. The primary endpoints were recurrence-free survival (RFS), overall survival (OS), and progression-free survival (PFS) which were graphically represented by Kaplan-Meier estimates. The key secondary endpoints were Health-related quality of life (HRQoL), erectile function, and lower urinary tract symptoms. RESULTS: Between May 2007 and December 2019, 74 patients with PC underwent PP and IUF reconstruction. The median age was 62 years (IQR 52-76), median follow-up was 72 months (IQR 38-121). Twenty-nine patients (39.2%) underwent inguinal lymph node dissection, 62 (83.8%) underwent dynamic sentinel lymph node biopsy. Kaplan-Meier estimates of OS, RFS, and PFS showed a 6-year OS of 86.5%, 6-year RFS of 90.5%, and a 6-year PFS of 85.1%. Regarding functional outcomes, we found a mean global health score of 84.6% ± 10.4 at the EQ-5D-3L-VAS. The mean Voiding score of the ICIQ-MLUTS was 1.7 ± 3.2 and a mean IIEF-5 score of 17.3 ± 7. CONCLUSIONS: To the best of our knowledge, we report the largest cohort in the literature of PP with IUF reconstruction. These results are important since early-stage PC is the most common stage at diagnosis. In carefully selected patients' preservation of a longer urethral stump to allow for the inverted flap is safe and does not compromise oncological outcomes while preserving HRQoL.

The cognitive and psychiatric subacute impairment in severe Covid-19.

Neurologic impairment persisting months after acute severe SARS-CoV-2 infection has been described because of several pathogenic mechanisms, including persistent systemic inflammation. The objective of this study is to analyze the selective involvement of the different cognitive domains and the existence of related biomarkers. Cross-sectional multicentric study of patients who survived severe infection with SARS-CoV-2 consecutively recruited between 90 and 120 days after hospital discharge. All patients underwent an exhaustive study of cognitive functions as well as plasma determination of pro-inflammatory, neurotrophic factors and light-chain neurofilaments. A principal component analysis extracted the main independent characteristics of the syndrome. 152 patients were recruited. The results of our study preferential involvement of episodic and working memory, executive functions, and attention and relatively less affectation of other cortical functions. In addition, anxiety and depression pictures are constant in our cohort. Several plasma chemokines concentrations were elevated compared with both, a non-SARS-Cov2 infected cohort of neurological outpatients or a control healthy general population. Severe Covid-19 patients can develop an amnesic and dysexecutive syndrome with neuropsychiatric manifestations. We do not know if the deficits detected can persist in the long term and if this can trigger or accelerate the onset of neurodegenerative diseases.

Instalación ecoguiada del balón de contrapulsación intraaórtico (BCPIA) vía arteria axilar por abordaje extratorácico en pacientes en espera de trasplante cardíaco / Echo-guided installation of Inta aortic balloon counterpulsation via the extra thoracic axillary artery

Resumen El balón de contrapulsación intraaórtico (BCPIA) es el dispositivo más frecuentemente utilizado para otorgar soporte mecánico en pacientes con insuficiencia cardíaca terminal y compromiso hemodinámico refractario al soporte inotrópico. Se han utilizado diferentes tipos de abordajes para la instalación del BCPIA a través de las extremidades superiores, ya sea vía arteria subclavia o últimamente vía arteria axilar. Con el objetivo de evitar la inmovilidad física asociada al BCPIA instalado vía arteria femoral, aumentar la comodidad del paciente, simplificar la técnica de instalación del catéter y facilitar los cuidados de enfermería necesarios para su mantención, hemos diseñado y utilizado un abordaje simple y seguro para su inserción. Bajo técnica ecoguiada y utilizando un set de micro punción, se realizó la canulación de la arteria axilar en su porción externa (lateral al borde externo del músculo pectoral menor). Con la ayuda de fluoroscopía, el BCPIA fue avanzado hasta posicionarlo en la aorta descendente bajo la emergencia de la arteria subclavia izquierda. En dos pacientes con insuficiencia cardíaca terminal INTERMACS 2, con deambulación restringida debido a la necesidad permanente de soporte inotrópico y BCPIA femoral, bajo visión ecoguiada se realizó la reinstalación de este catéter a través de la arteria axilar izquierda, utilizando anestesia local y fluoroscopía en el laboratorio de hemodinamia. La rehabilitación fue posible rápidamente en ambos pacientes, realizándose el transplante cardíaco ortotópico después de 10 y 69 días de soporte mecánico con BCPIA, sin mayores efectos adversos.

Abstract Intra aortic balloon counterpulsation (IABP) is the most frequently used procedure to give mechanic support in patients with terminal heart failure and hemodynamic compromise refractory to inotropic support. Different approaches have been utilized to install upper extremity IABP, via either the axillary or subclavian arteries. In order to circumvent the limitations associated to long lasting femoral IABP support, simplify the technique, increase patient comfort and facilitate nursing care, we designed a simplified approach. Using echo guidance, the axillary artery was accessed with a micropuncture set just outside the external margin of the pectoral minor muscle. With the help of fluoroscopy the IABP catheter was advanced and its correct position in the descending aorta was confirmed. Two patients in INTERMACS 2 end stage heart failure, bedridden due to permanent inotropic support and femoral IABP, underwent echo guided axillary IABP placement under local anesthesia and fluoroscopy in the catheterization laboratory. Both patients gained rapid access to rehabilitation and received orthotopic heart transplantation after 10 and 69 days of uneventful IABP support.

Real World Data of Penile Cancer Treatment at a High-Volume Center in South America: Insights and Survival Trends.

OBJECTIVE: To report survival trends and oncological outcomes of penile cancer surgically treated patients, at a high-volume center, treating more than 25 patients each year, in a high incidence country. METHODS: Clinical charts of all patients that underwent surgical management for penile cancer were reviewed. The primary end points were cancer specific survival (CSS), progression-free survival, and local recurrence free survival. Kaplan-Meier plots were used for survival analyses. Multivariate analysis was performed using cox proportional hazard age-adjusted models to determine the effect of pN, pT, lymphovascular invasion for CSS. RESULTS: A total of 209 patients were identified, with a median follow up of 96 months (IQR 49-133). Organ-sparing surgerywas performed in 72.7%, 56.9% underwent dynamic sentinel lymph node biopsy, 110 patients underwent inguinal lymph node dissection, and 45 (21.5%) pelvic lymph node dissection. A total of 75 (35.8%) of patients relapsed, median time to relapse of 12 months (IQR 6-25). Overall estimates of CSS showed an 8-year CSS of 68.9%. Eight-year CSS was 90.5% for N0, and 32.8% in pN3 (P <.001). The Cox proportional hazard model showed that pN1-3, pT2-4, lymphovascular invasion and positive dynamic sentinel lymph node biopsy were the variables associated with worse 8-year CSS. CONCLUSION: To the best of our knowledge, we report one of the largest cohorts on the survival outcomes of penile cancer surgical treatment, in a single institution, over a long period of time, were most patients are referred with high-risk, locally advanced or nodal disease.

Renal fossa recurrence with synchronous port site and appendicular metastases after laparoscopic nephrectomy: Role of metastases and abdominal wall en bloc resection.

Isolated renal fossa recurrence and port site metastasis after laparoscopic nephrectomy are two different entities, and despite being rare, in selected cases would benefit from surgical resection. We report the case of a 61-year-old male with local renal fossa recurrence with synchronous metastasis involving the port site, the abdominal wall and the appendix, which was successfully treated with open surgical resection and is free of metastasis or recurrence. To conclude opportune treatment of similar cases, remain a safe and curative option, and should be considered after reviewing the case within a multidisciplinary team.

Effect of sterilization on 3-point dynamic response to in vitro bending of an Mg implant.

BACKGROUND: The aim of the study is to characterize a biomedical magnesium alloy and highlighting the loss of mechanical integrity due to the sterilization method. Ideally, when using these alloys is to delay the onset of degradation so that the implant can support body loads and avoid toxicological effects due to the release of metal ions into the body. METHODS: Standardized procedures according to ASTM F-1264 and ISO-10993-5 were used, respecting detailed methodological controls to ensure accuracy and reproducibility of the results, this testing methodology is carried out in accordance with the monographs of the Pharmacopoeia for the approval of medical devices and obtaining a health registration. An intramedullary implant (IIM) manufactured in magnesium (Mg) WE43 can support loads of the body in the initial period of bone consolidation without compromising the integrity of the fractured area. A system with these characteristics would improve morbidity and health costs by avoiding secondary surgical interventions. RESULTS: As a property, the fatigue resistance of Mg in aggressive environments such as the body environment undergoes progressive degradation, however, the autoclave sterilization method drastically affects fatigue resistance, as demonstrated in tests carried out under in vitro conditions. Coupled with this phenomenon, the relatively poor biocompatibility of Mg WE43 alloys has limited applications where they can be used due to low acceptance rates from agencies such as the FDA. However, Mg alloy with elements such as yttrium and rare earth elements (REEs) have been shown to delay biodegradation depending on the method of sterilization and the physiological solution used. With different sterilization techniques, it may be possible to keep toxicological effects to a minimum while still ensuring a balance between the integrity of fractured bone and implant degradation time. Therefore, the evaluation of fatigue resistance of WE43 specimens sterilized and tested in immersion conditions (enriched Hank's solution) and according to ASTM F-1264, along with the morphological, crystallinity, and biocompatibility characterization of the WE43 alloy allows for a comprehensive evaluation of the mechanical and biological properties of WE43. CONCLUSIONS: These results will support decision-making to generate a change in the current perspective of biomaterials utilized in medical devices (MDs), to be considered by manufacturers and health regulatory agencies. An implant manufactured in WE43 alloy can be used as an intramedullary implant, considering keeping elements such as yttrium-REEs below as specified in its designation and with the help of a coating that allows increasing the life of the implant in vivo.

Correlation of cooking time with water absorption and changes in relative density during boiling of cassava roots.

Consumers prefer cassava roots that cook quickly during boiling. Current methods to evaluate cooking time (CT) are slow and labour-intensive. This article describes improved protocols for assessing CT in roots. We evaluated CT in 36 genotypes monthly at 8-11 months after planting. CT showed differences for plant age at harvest and among genotypes. During boiling, roots absorbed water (WAB) and thus reduced their relative density (DEN). We classified three groups of genotypes with increasing CT (≤25 min, 25-40 min and >40 min), associated with decreasing WAB, respectively, 15.3 ± 3.1, 10.7 ± 1.7 and 4.9 ± 3.8% of initial root weight. A similar trend was observed for changes in DEN (46.3 ± 9.8, 54.5 ± 11.1 and 75.9 ± 6.9% of initial DEN, respectively). The highest correlations between WAB and DEN with CT (r 2 > 0.6) were found at 30-min boiling. These alternative protocols facilitate screening large numbers of cassava genotypes for CT.

Evaluation of cognitive function in adult patients with juvenile idiopathic arthritis.

OBJECTIVE: To evaluate cognitive function in adult patients with juvenile idiopathic arthritis (JIA) and associated factors. PATIENTS AND METHODS: We performed a cross-sectional observational study of adult patients with JIA and a healthy control group (no inflammatory diseases) matched for age, gender, and educational level. Cognitive function was assessed using Wechsler Adult Intelligence Scale-III. The cognitive domains measured were attention/concentration, verbal function, visuospatial organization, working memory, and problem solving (Similarities). Other measures included clinical-epidemiological characteristics, comorbid conditions, and treatment. We performed a descriptive bivariate analysis and logistic regression to identify factors associated with visuospatial involvement. RESULTS: The study population comprised 104 subjects (52 with JIA and 52 healthy controls). Patients with JIA had poorer results for visuospatial function, with a lower median scaled score on the Block Design test (5.0 [4.0-8.0] vs 8.0 [5.0-10.0]; P = .014). The number of patients with scaled scores below the average range (<8) in visuospatial organization was significantly greater in the JIA group (67.3% vs 40.4%; P = .006). The multivariate analysis revealed time since diagnosis (odds ratio [95% CI], 1.03 [1.01-1.06]), inflammatory activity according to Juvenile Arthritis Disease Activity Score 27-joint count (1.94 [1.01-3.75]), and educational level (0.28 [0.08-0.94]) to be factors associated with visuospatial function. CONCLUSION: Cognitive function in adult patients with JIA is poorer than in healthy controls at the expense of visuospatial function. Visuospatial function in JIA patients was inversely associated with disease duration, inflammatory activity, and lower educational level.

Neuroplasticity and Epilepsy Surgery in Brain Eloquent Areas: Case Report.

Introduction: Neuronal plasticity includes changes in any component of the central nervous system in response to intrinsic or extrinsic stimuli. Brain functions that depend on the epileptogenic cortex pose a challenge in epilepsy surgery because many patients are excluded from pre-surgical evaluation for fear of the possible sequelae. Some of these patients may be rescued by enhancing neuronal plasticity with brain neuromodulation techniques. Case Report: We describe a 6-year-old child with refractory focal motor seizures symptomatic to a neuroepithelial dysembryoblastic tumor in the left temporo-parietal region. He underwent limited resection of the lesion in order to avoid sequelae in his language function. A functional study at age of 17 years revealed an overlap of Wernicke's area with the tumor and areas of incipient language reorganization in the contralateral hemisphere. An invasive neuromodulation procedure was designed to enhance neuroplasticity. After craniotomy, he underwent language training and simultaneous electrical inhibition of language using an electrode grid placed over the lesion. The intensity of the language inhibitory stimulus was increased every day to force the use of accessory language areas in the right hemisphere by neuroplasticity. Results: The language of the patient improved for six consecutive days until he was able to speak and understand while undergoing maximum electrical inhibition. The tumor was resected using a cortical mapping guide. Discussion: Application of direct cortical stimulation techniques and language pre-habilitation before epilepsy surgery can be useful to rescue patients excluded from resective surgery, especially young patients with long-term lesions.

Spatial analysis of PM2.5 concentrations in Bogotá according to the World Health Organization air quality guidelines for cardiopulmonary diseases, 2014-2015 / [Análisis espacial de las concentraciones de PM2,5 en Bogotá según los valores de las guías de la calidad del aire de la Organización Mundial de la Salud para enfermedades cardiopulmonares, 2014-2015].

Introduction: The World Health Organization (WHO) points out that 3 million deaths per year caused by cardiopulmonary diseases are related to exposure to air pollution. Objective: To estimate areas of concentration of PM2.5 in Bogotá according to the WHO Air Quality Guidelines (AQG) for cardiopulmonary diseases during the period 2014-2015. Materials and methods: We conducted an ecological study with geostatistical techniques. We calculated the PM2.5 averages for six hour-periods distributed throughout the day in four time slots, which were classified according to daily and annual WHO AQG. Results: The locality of Kennedy presented the highest concentrations of PM2.5 in all time slots. The values registered in this area classified within the daily and annual AQG showed that the locality would present an increase of 1.2% and 9% in cardiopulmonary mortality in the short and long term, respectively. Conclusion: The time slots from 0:00 to 6:00 h y from 12:00 to 18:00 h met the annual AQG value of 10 µg/m3 in a part of the eastern zone of the city; in the rest of the city, in these same time slots, intermediate objectives 2 and 3 were met, which means increases by 9% and 3% in the cardiopulmonary mortality according to the AQG, respectively.

Introducción. La Organización Mundial de la Salud señala que tres millones de muertes al año por enfermedades cardiopulmonares están relacionadas con la exposición a la contaminación del aire. Objetivo. Estimar las superficies de concentración de partículas en suspensión de menos de 2,5 µm (Particulate Matter, PM2,5) en Bogotá entre el 2014 y el 2015, clasificándolas según las guías de calidad del aire de la Organización Mundial de la Salud para enfermedades cardiopulmonares. Materiales y métodos. Se hizo un estudio ecológico mediante técnicas geoestadísticas. Se calcularon los promedios de PM2,5 en lapsos de seis horas a lo largo del día en cuatro franjas horarias. Las concentraciones se clasificaron según los valores diarios y anuales de las guías de calidad del aire de la OMS. Resultados. La localidad de Kennedy presentó las mayores concentraciones de PM2,5 en todas las franjas horarias. Los valores registrados en esta zona y clasificados según las guías diarias y anuales de calidad del aire, evidenciaron que la localidad presentaría un incremento de 1,2 % en la mortalidad cardiopulmonar en el corto plazo y de 9 % en el largo plazo. Conclusión. Las franjas horarias de las 0:00 a las 6:00 h y de las 12:00 a las 18:00 h, cumplieron con el valor anual de las guías de calidad del aire de 10 µg/m3 en una parte de la zona oriental de la ciudad. En el resto de la ciudad, en las franjas horarias de las 6:00 h a las 12:00 h y de las 18:00 h a las 24:00 h se registraron valores que cumplían los objetivos intermedios 2 y 3, lo que representa incrementos de 9 y 3 % en la mortalidad cardiopulmonar, respectivamente.

Análisis espacial de las concentraciones de PM2,5 en Bogotá según los valores de las guías de la calidad del aire de la Organización Mundial de la Salud para enfermedades cardiopulmonares, 2014 - 2015 / Spatial analysis of PM2,5 concentrations in Bogotá according to the World Health Organization air quality guidelines for cardiopulmonary diseases, 2014 - 2015

Introducción. La Organización Mundial de la Salud señala que tres millones de muertes al año por enfermedades cardiopulmonares están relacionadas con la exposición a la contaminación del aire. Objetivo. Estimar las superficies de concentración de partículas en suspensión de menos de 2,5 pm (Particulate Matter, PM25) en Bogotá entre el 2014 y el 2015, clasificándolas según las guías de calidad del aire de la Organización Mundial de la Salud para enfermedades cardiopulmonares. Materiales y métodos. Se hizo un estudio ecológico mediante técnicas geoestadísticas. Se calcularon los promedios de PM25 en lapsos de seis horas a lo largo del día en cuatro franjas horarias. Las concentraciones se clasificaron según los valores diarios y anuales de las guías de calidad del aire de la OMS. Resultados. La localidad de Kennedy presentó las mayores concentraciones de PM25 en todas las franjas horarias. Los valores registrados en esta zona y clasificados según las guías diarias y anuales de calidad del aire, evidenciaron que la localidad presentaría un incremento de 1,2 % en la mortalidad cardiopulmonar en el corto plazo y de 9 % en el largo plazo. Conclusión. Las franjas horarias de las 0:00 a las 6:00 h y de las 12:00 a las 18:00 h, cumplieron con el valor anual de las guías de calidad del aire de 10 µg/m3 en una parte de la zona oriental de la ciudad. En el resto de la ciudad, en las franjas horarias de las 6:00 h a las 12:00 h y de las 18:00 h a las 24:00 h se registraron valores que cumplían los objetivos intermedios 2 y 3, lo que representa incrementos de 9 y 3 % en la mortalidad cardiopulmonar, respectivamente.

Introduction: The World Health Organization (WHO) points out that 3 million deaths per year caused by cardiopulmonary diseases are related to exposure to air pollution. Objective: To estimate areas of concentration of PM2.5 in Bogotá according to the WHO Air Quality Guidelines (AQG) for cardiopulmonary diseases during the period 2014-2015. Materials and methods: We conducted an ecological study with geostatistical techniques. We calculated the PM2.5 averages for six hour-periods distributed throughout the day in four time slots, which were classified according to daily and annual WHO AQG. Results: The locality of Kennedy presented the highest concentrations of PM25 in all time slots. The values registered in this area classified within the daily and annual AQG showed that the locality would present an increase of 1.2% and 9% in cardiopulmonary mortality in the short and long term, respectively. Conclusion: The time slots from 0:00 to 6:00 h y from 12:00 to 18:00 h met the annual AQG value of 10 µg/m3 in a part of the eastern zone of the city; in the rest of the city, in these same time slots, intermediate objectives 2 and 3 were met, which means increases by 9% and 3% in the cardiopulmonary mortality according to the AQG, respectively.

Bio-inspired biomaterial Mg-Zn-Ca: a review of the main mechanical and biological properties of Mg-based alloys.

The toxicity of alloying elements in magnesium alloys used for biomedical purposes is an interesting and innovative subject, due to the great technological advances that would result from their application in medical devices (MDs) in traumatology. Recently promising results have been published regarding the rates of degradation and mechanical integrity that can support Mg alloys; this has led to an interest in understanding the toxicological features of these emerging biomaterials. The growing interest of different segments of the MD market has increased the determination of different research groups to clarify the behavior of alloying elements in vivo. This review covers the influence of the alloying elements on the body, the toxicity of the elements in Mg-Zn-Ca, as well as the mechanical properties, degradation, processes of obtaining the alloy, medical approaches and future perspectives on the use of the Mg in the manufacture of MDs for various medical applications.

Immobilization of antimicrobial and anti-quorum sensing enzymes onto GMA-grafted poly(vinyl chloride) catheters.

Catheter-associated infections still represent a challenging thread because of the likelihood of biofilm formation. The aim of this work was the surface modification of catheters to immobilize lysozyme and acylase under mild conditions while preserving antimicrobial and anti-quorum sensing performances. Glycidyl methacrylate (GMA) was grafted onto poly(vinyl chloride) (PVC) catheters by a pre-irradiation method. The effects of monomer concentration, pre-irradiation dose, reaction time, monomer concentration and reaction temperature were investigated. The grafting process was monitored using FTIR-ATR spectroscopy, differential scanning calorimetry, thermogravimetric analysis, and swelling data. Lysozyme was directly immobilized onto PVC-g-GMA maintaining the hydrolytic activity, which hindered Staphylococcus aureus adhesion. For acylase immobilization, the PVC-g-GMA catheters were reacted with ethylenediamine and glutaraldehyde in order to facilitate acylase covalent binding. Free acylase in solution demonstrated notably capability to act as quorum sensing inhibitor, as observed using Chromobacterium violaceum as biosensor, by degrading a wide variety of acylated homoserine lactones (AHLs), including those produced by Pseudomonas aeruginosa and Acinetobacter baumannii. Acylase-immobilized PVC-g-GMA catheters were challenged against degradation of AHLs and the activity monitored using both the biosensor and HPLC-MS. Relevantly, the functionalized catheters completely degraded all tested AHL signals, opening new ways of preventing biofilm formation on medical devices.

Endovascular aspiration of a symptomatic free-floating common carotid artery thrombus.

Free-floating thrombi of the common carotid artery (CCA) are a very rare cause of ischemic stroke. To date, only a few reports have been described in the academic literature. Revascularization is indicated due to the risk of thromboembolic disease and hemodynamic-related stroke syndromes. Medical treatment typically includes anticoagulation and, in some circumstances, open surgical thrombectomy is an additional option. Although rarely described in the literature, endovascular thrombectomy is a viable treatment alternative in these patients.

Identifying crop research priorities based on potential economic and poverty reduction impacts: The case of cassava in Africa, Asia, and Latin America.

It is widely recognized that increasing agricultural production to the levels needed to feed an expanding world population requires sharply increased public investment in research and development and widespread adoption of new technologies, but funding for national and international agricultural research has rather declined in recent years. In this situation, priority setting has become increasingly important for allocating scarce research resources among competing needs to achieve greater impacts. Using partial equilibrium economic surplus models and poverty impact simulations, this paper assesses cassava research priorities in Africa, Latin America and Caribbean, and Asia based on the potential economic and poverty reduction impacts of alternative research and technology options. The results showed that efficient planting material production and distribution systems and sustainable crop and soil fertility management practices have the greatest expected economic and poverty reduction impacts in the three regions. Lack of clean planting materials is a major constraint to adoption and it is envisaged that efficient production and distribution systems for planting material can accelerate technology adoption by farmers. Similarly, sustainable crop and soil fertility management practices play a key role in closing the observed yield gaps, especially in Africa. The paper discusses the results of the priority assessment for key cassava research options and concludes with the implications for cassava research priorities.

Short-Term Effects of Air Pollution on Respiratory and Circulatory Morbidity in Colombia 2011⁻2014: A Multi-City, Time-Series Analysis.

Few studies have been conducted on the effect of air pollution on morbidity in Latin America. This study analyzed the effects of air pollution on respiratory and circulatory morbidity in four major cities in Colombia. An ecological time-series analysis was conducted with pollution data from air quality monitoring networks and information on emergency department visits between 2011 and 2014. Daily 24-h averages were calculated for NO2, PM10, PM2.5, and SO2 as well as 8-h averages for CO and O3. Separate time-series were constructed by disease group and pollutant. Conditional negative binomial regression models were used with average population effects. Effects were calculated for the same day and were adjusted for weather conditions, age groups, and their interactions. The results showed that effects of some of the pollutants differed among the cities. For NO2, PM10, and PM2.5, the multi-city models showed greater and statistically significant percentage increases in emergency department visits for respiratory diseases, particularly for the 5 to 9-year-old age group. These same pollutants also significantly affected the rate of emergency department visits for circulatory diseases, especially for the group of persons over 60 years of age.