Tumor growth for remodeling process: A 2D approach.

This paper aims to present a comprehensive framework for coupling tumor-bone remodeling processes in a 2-dimensional geometry. This is achieved by introducing a bio-inspired damage that represents the growing tumor, which subsequently affects the main populations involved in the remodeling process, namely, osteoclasts, osteoblasts, and bone tissue. The model is constructed using a set of differential equations based on the Komarova's and Ayati's models, modified to incorporate the bio-inspired damage that may result in tumor mass formation. Three distinct models were developed. The first two models are based on the Komarova's governing equations, with one demonstrating an osteolytic behavior and the second one an osteoblastic model. The third model is a variation of Ayati's model, where the bio-inspired damage is induced through the paracrine and autocrine parameters, exhibiting an osteolytic behavior. The obtained results are consistent with existing literature, leading us to believe that our in-silico experiments will serve as a cornerstone for paving the way towards targeted interventions and personalized treatment strategies, ultimately improving the quality of life for those affected by these conditions.

Asociación Linfoma-Tuberculosis ganglionar: Un reto diagnóstico y terapéutico

La tuberculosis, una enfermedad infectocontagiosa, de amplia distribución mundial constituye en una de las causas de morbi-mortalidad más frecuentes en países subdesarrollados. Por otra parte, el linfoma de Hodgkin, una neoplasia linfoide maligna, poco frecuente, tiende a tener un diagnóstico diferencial amplio, incluyendo la tuberculosis extrapulmonar. Se presenta el caso de un paciente masculino de 10 años, procedente de un área endémica para tuberculosis, con cuadro de un mes de evolución de aumento de volumen abdominal, asociado a fiebre vespertina y pérdida de peso, tratado inicialmente como cuadro gastroentérico, sin embargo, con múltiples estudios se logró documentar Tuberculosis ganglionar y Linfoma de Hodgkin clásico en su variante esclerosis nodular en estadio IV b, constituyéndose en un reto diagnóstico y terapéutico.   (provisto por Infomedic International)

Tuberculosis, an infectious disease with a wide global distribution, constitutes one of the most frequent causes of morbidity and mortality in underdeveloped countries. On the other hand, Hodgkin lymphoma, a rare lymphoid malignancy, tends to have a wide differential diagnosis, including extrapulmonary tuberculosis. We present the case of a 10-year-old male patient, from an endemic area for tuberculosis, with a one-month history of increased abdominal volume, associated with evening fever and weight loss, initially treated as gastroenteric symptoms, however , with multiple studies it was possible to document lymph node tuberculosis and classical Hodgkin lymphoma in its variant nodular sclerosis in stage IV b, constituting a diagnostic and therapeutic challenge. (provided by Infomedic International)

Reconstruction of a Distal Humeral Fracture with Articular Bone Loss Using Osteochondral Allograft: A Case Report.

CASE: A 31-year-old right-hand-dominant man sustained an open left distal humerus fracture resulting in a complete loss of the lateral column involving 30% of the articular surface and the lateral collateral ligament complex. Reconstructive surgery was conducted in 2 stages, beginning with articulated external elbow fixation followed by reconstruction with a fresh osteochondral allograft. Outcomes were satisfactory with no elbow pain or instability, and osseointegration was demonstrated in radiographs. CONCLUSION: The technique described in this report can be a viable option for treating young patients with a severe distal humerus fracture complicated and can provide favorable clinical and radiological outcomes.

A unified framework of cell population dynamics and mechanical stimulus using a discrete approach in bone remodelling.

Multiphysics models have become a key tool in understanding the way different phenomenon are related in bone remodeling and various approaches have been proposed, yet, to the best of the author's knowledge there is no model able to link a cell population model with a mechanical stimulus model using a discrete approach, which allows for an easy implementation. This article couples two classical models, the cell population model from Komarova and the Nackenhorst model in a 2D domain, where correlations between the mechanical loading and the cell population dynamics can be established, furthermore the effect of different paracrine and autocrine regulators is seen on the overall density of a portion of trabecular bone. A discretization is performed using frame 1D finite elements, representing the trabecular structure. The Nackenhorst model is implemented by using the finite element method to calculate the strain energy as the main mechanical stimulus that determines the bone mass density evolution in time. This density is normalized to be added to the bone mass percentage proposed by the Komarova model, where coupling terms have been added as well that guarantee a stable response. In the simulations, the equations were solved employing the finite element method with a user subroutine implemented in ABAQUS (2017) and by applying a direct formulation. The methodology presented can model the cell dynamics occurring in bone remodelling in accordance with the asynchronous nature of this process, yet allowing to differentiate zones with higher density, the main trabecular groups are obtained for the proximal femur. Finally, the model is tested in pathological cases, such as osteoporosis and osteopetrosis, yielding results similar to the pathology behavior. Furthermore, the discrete modelling technique is shown to be of use in this particular application.

Clay exfoliation method as a route to obtain mesoporous catalysts for CO2 methanation.

A unique method for obtaining a mesoporous catalytic support through the exfoliation of a montmorillonite is reported. This method consisted of the intercalation of Na-clay with Al-Keggin species and polyvinyl alcohol followed by microwave irradiation. The mesoporous support was employed to prepare Ni-catalysts which were used in the natural gas synthesis through CO2 methanation. The synthesis method was validated confirming the clay exfoliation and the main formation of mesopores. Also, the Ni-catalysts have mainly weak basic surface properties lower than 38 µmol.g-1, and containing Ni0 nanoparticles with sizes between 9 and 12 nm which were thermally stable after reduction and methanation reaction. The catalyst with 5% Ni wt. gave conversions between 50 and 80% with temperatures ranging from 200 to 300 °C and selectivities of 100% towards the formation of CH4 without coke formation. The (3 and 5% Ni) Ni-catalysts are stable up to 8 h at 400 °C in the methanation reaction maintaining 100% of selectivity.•Mesoporous catalytic supports are obtained through a unique clay exfoliation method (Al-keggin, PVA, and microwaves).•(3% and 5% wt.) Ni-mesoporous catalysts are thermally stable and Ni0 nanoparticles between 9 and 12 nm are achieved.•5%wt. Ni-catalyst have no deactivation up to 8 h at 400 °C and displays unprecedented performance at low temperatures in CO2-methanation with 100% of selectivity.

Yellow fever surveillance suggests zoonotic and anthroponotic emergent potential.

Yellow fever is transmitted by mosquitoes among human and non-human primates. In the last decades, infections are occurring in areas that had been free from yellow fever for decades, probably as a consequence of the rapid spread of mosquito vectors, and of the virus evolutionary dynamic in which non-human primates are involved. This research is a pathogeographic assessment of where enzootic cycles, based on primate assemblages, could be amplifying the risk of yellow fever infections, in the context of spatial changes shown by the disease since the late 20th century. In South America, the most relevant spread of disease cases affects parts of the Amazon basin and a wide area of southern Brazil, where forest fragmentation could be activating enzootic cycles next to urban areas. In Africa, yellow fever transmission is apparently spreading from the west of the continent, and primates could be contributing to this in savannas around rainforests. Our results are useful for identifying new areas that should be prioritised for vaccination, and suggest the need of deep yellow fever surveillance in primates of South America and Africa.

Factors Associated With Hospitalization or Intensive Care Admission in Children With COVID-19 in Latin America.

Background: Limited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19. Objective: To describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America. Method: Multicenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Outpatient or hospitalized children <18 years of age with COVID-19 confirmed by polymerase chain reaction or antigen detection from the nasopharynx were included. Children with multisystem inflammatory syndrome in children (MIS-C) were excluded. Associations were assessed using univariate and multivariable logistic regression models. Results: A total of 1063 children with COVID-19 were included; 500 (47%) hospitalized, with 419 (84%) to the pediatric wards and 81 (16%) to the ICU. In multivariable analyses, age <1 year (Odds Ratio [OR] 1.78; 95% CI 1.08-2.94), native race (OR 5.40; 95% CI 2.13-13.69) and having a co-morbid condition (OR 5.3; 95% CI 3.10-9.15), were associated with hospitalization. Children with metabolic or endocrine disorders (OR 4.22; 95% CI 1.76-10.11), immune deficiency (1.91; 95% CI 1.05-3.49), preterm birth (OR 2.52; 95% CI 1.41-4.49), anemia at presentation (OR 2.34; 95% CI 1.28-4.27), radiological peribronchial wall thickening (OR 2.59; 95% CI 1.15-5.84) and hypoxia, altered mental status, seizures, or shock were more likely to require PICU admission. The presence of pharyngitis (OR 0.34; 95% CI 0.25-0.48); myalgia (OR 0.47; 95% CI 0.28-0.79) or diarrhea (OR 0.38; 95% CI 0.21-0.67) were inversely associated with hospital admission. Conclusions: In this data analysis reported to the SLIPE research network in Latin America, infants, social inequalities, comorbidities, anemia, bronchial wall thickening and specific clinical findings on presentation were associated with higher rates of hospitalization or PICU admission. This evidence provides data for prioritization prevention and treatment strategies for children suffering from COVID-19.

A simple and effective 1D-element discrete-based method for computational bone remodeling.

In-silico models applied to bone remodeling are widely used to investigate bone mechanics, bone diseases, bone-implant interactions, and also the effect of treatments of bone pathologies. This article proposes a new methodology to solve the bone remodeling problem using one-dimensional (1D) elements to discretize trabecular structures more efficiently for 2D and 3D domains. An Euler integration scheme is coupled with the momentum equations to obtain the evolution of material density at each step. For the simulations, the equations were solved by using the finite element method, and two benchmark tests were solved varying mesh parameters. Proximal femur and calcaneus bone were selected as study cases given the vast research available on the topology of these bones, and compared with the anatomical features of trabecular bone reported in the literature. The presented methodology has proven to be efficient in optimizing topologies of lattice structures; It can predict the trend of formation patterns of the main trabecular groups from two different cancellous bones (femur and calcaneus) using domains set up by discrete elements as a starting point. Preliminary results confirm that the proposed approach is suitable and useful in bone remodeling problems leading to a considerable computational cost reduction. Characteristics similar to those encountered in topological optimization algorithms were identified in the benchmark tests as well, showing the viability of the proposed approach in other applications such as bio-inspired design.

Epidemiological Indicators of SARS-CoV-2 (COVID-19) and Vaccination Effectiveness on the Report of Positive Cases in the Colombian Army.

The description of the epidemiological indicators of SARS-CoV-2 (COVID-19), such as the mortality rate (MR), the case fatality rate (CFR), and the attack rate (AR), as well as the geographical distribution and daily case reports, are used to evaluate the impact that this virus has had within the Colombian Army and its health system. As military forces around the world represent the force that defends sovereignty, independence, the integrity of the national territory, and the constitutional order, while maintaining migration controls in blocked border areas during this critical pandemic times, they must carry out strict epidemiological surveillance to control the situation among the servicemen. Up to date, the Colombian Army has faced a very high attack rate (AR = 8.55%) due, among others, to living conditions where active military personnel share bedrooms, bathrooms, and dining facilities, which facilitate the spread of the virus. However, being a mainly young and healthy population, the MR was 1.82 deaths/1,000 ha, while the CFR = 2.13% indexes consistently low if compared with those values reported for the national population. In addition, the effectiveness of vaccination is shown in daily cases of COVID-19, where, for the third peak, the active military population presented a decrease of positive patients compared to the dynamics of national transmission and the total population of the military forces (active, retired, and beneficiaries).

Estudio multicéntrico retrospectivo de los aspectos epidemiológicos, clínicos y terapéuticos de la enfermedad de Kawasaki en niños de Panamá

Resumen Antecedentes: La enfermedad de Kawasaki (EK) representa la principal causa de cardiopatía pediátrica adquirida en muchos países; sin embargo, hay pocos estudios publicados en Latinoamérica. Objetivo: Describir la epidemiología, los aspectos clínicos y el tratamiento de EK en niños en Panamá como parte del estudio de vigilancia de REKAMLATINA-2 en Latinoamérica. Pacientes y Métodos: Estudio retrospectivo, descriptivo, de pacientes internados con diagnóstico de EK, atendidos en tres hospitales pediátricos de Panamá del 1-enero-2009 al 31-diciembre-2013. Resultados: Se analizaron 111 pacientes, 61(54,9%) eran hombres. Todos fueron hospitalizados, siendo la media de hospitalización de 5,8 (4-7) días. La mediana de edad al ingreso fue de 28,9 (12-38) meses. Un 63,9% recibió antimicrobianos recientemente por otros posibles diagnósticos. Recibieron inmunoglobulina intravenosa (IGIV) 105 (94,6%) pacientes; de éstos, 10 (9,5%) fueron resistentes. Un 11,7% tuvo alteraciones cardiovasculares en el ECO inicial, de las cuales las lesiones coronarias se detectaron en 3 (2,9%) pacientes. Conclusiones: Los datos sugieren que EK en Panamá tiene una incidencia cercana a 2,05 x 100,000 bajo 15 años de edad y una frecuencia 2,6 veces mayor bajo 3 años de edad. Se observó un alto porcentaje de uso de antimicrobianos ambulatoriamente antes de la confirmación diagnóstica, lo cual sugiere reconocimiento tardío de EK en Panamá.

Abstract Background: Kawasaki disease (KD) is the leading cause of pediatric acquired heart disease in many countries, however, there are few published studies from Latin America (LA). Aim: To describe the epidemiology, clinical aspects, and treatment of KD in children from Panama as part of the REKAMLATINA-2 in LA. Methods: Retrospective descriptive review of hospitalized patients diagnosed with KD, attended at three main pediatric hospitals of Panama from January-1-2009 to December-31-2013. Results: 111 patients were analyzed, 61(54.9 %) were male. All children were hospitalized, and had a mean length of hospitalization of 5.8 (4-7) days. Median age at admission was 28.9 (12-38) months. Prior to KD final diagnosis, 63.9% patients received antibiotics for other presumed diagnoses. 105 (94.6%) patients received IGIV, 10 (9.5%) were resistant. On initial echocardiogram, 11.7% of cardiovascular complications were reported, of which coronary artery lesions (CALs) were detected in 3 (2.9 %) patients. Conclusion: The data suggest that KD in Panama has an incidence of about 2.05 x 100,000 in children under 15 years of age, and with a frequency 2.6 times higher in children under 3 years. A high rate of antibiotic misuse on outpatient prior to diagnostic confirmation was observed, suggesting KD unawareness and late recognition in Panamá.

[Multicenter retrospective study about the epidemiological, clinical and therapeutic aspects of Kawasaki disease in children from Panama]. / Estudio multicéntrico retrospectivo de los aspectos epidemiológicos, clínicos y terapéuticos de la enfermedad de Kawasaki en niños de Panamá.

BACKGROUND: Kawasaki disease (KD) is the leading cause of pediatric acquired heart disease in many countries, however, there are few published studies from Latin America (LA). AIM: To describe the epidemiology, clinical aspects, and treatment of KD in children from Panama as part of the REKAMLATINA-2 in LA. METHODS: Retrospective descriptive review of hospitalized patients diagnosed with KD, attended at three main pediatric hospitals of Panama from January-1-2009 to December-31-2013. RESULTS: 111 patients were analyzed, 61(54.9 %) were male. All children were hospitalized, and had a mean length of hospitalization of 5.8 (4-7) days. Median age at admission was 28.9 (12-38) months. Prior to KD final diagnosis, 63.9% patients received antibiotics for other presumed diagnoses. 105 (94.6%) patients received IGIV, 10 (9.5%) were resistant. On initial echocardiogram, 11.7% of cardiovascular complications were reported, of which coronary artery lesions (CALs) were detected in 3 (2.9 %) patients. CONCLUSION: The data suggest that KD in Panama has an incidence of about 2.05 x 100,000 in children under 15 years of age, and with a frequency 2.6 times higher in children under 3 years. A high rate of antibiotic misuse on outpatient prior to diagnostic confirmation was observed, suggesting KD unawareness and late recognition in Panamá.

High temperature CO2 capture of hydroxyapatite extracted from tilapia scales / Captura de CO2 a altas temperaturas, de hidroxiapatitas extraídas de escamas de tilapia / Captura de CO2 a altas temperaturas por hidroxiapatita extraída de escamas de tilápia

Abstract Hydroxyapatite (HAp) was obtained from tilapia scales by two extraction methods: direct calcination and acid-base treatment. The physicochemical characteristics of the obtained HAps were evaluated by thermogravimetric analysis, X-ray fluorescence, X-ray diffraction, scanning electron microscopy, surface area, infrared spectroscopy, and basicity measurement at 298 K by CO2 -pulse titration. Furthermore, the CO2 capture capacity of the solids at high temperature was also determined. Both methods showed the presence of a HAp phase although significant differences in the properties of the solids were found. The HAp obtained by direct calcination, exhibited a lower crystallinity and a greater surface area and basicity than the HAp obtained by the acid-base treatment. These features were correlated with the solid's CO2 capture capacity. In this work, CO2 capture capacity values for HAp yielded by calcination ranged from 2.5 to 3.2 mg CO2 /g captured at 973 K, and for the acid-base treatment-derived HAp, CO2 capture capacity values between 1.2 to 2.5 mg CO2 /g were recorded. These results reveal the potential of HAps extracted from tilapia scales as solids with high CO2 capture capacity, thermal stability, and capture/release cycles reversibility.

Resumen Se obtuvo hidroxiapatita (HAp) de escamas de tilapia por dos métodos de extracción: calcinación directa y tratamiento ácido-base. Las características fisicoquímicas de las HAps obtenidas fueron evaluadas por análisis termogravimétrico, fluorescencia de rayos X, difracción de rayos X, microscopía electrónica de barrido, área superficial, espectroscopia infrarroja y medición de basicidad a 298 K por titulación por pulso de CO2. Adicionalmente, se determinó la capacidad de captura de CO2 de los sólidos a alta temperatura. Ambos métodos mostraron la presencia de una fase de HAp, aunque se encontraron diferencias significativas en las propiedades de los sólidos. La HAp obtenida por calcinación directa exhibió una menor cristalinidad y una mayor área superficial y basicidad que la HAp obtenida con el tratamiento acido-base. Estas características se correlacionaron con la capacidad de captura de CO2 del sólido. En este trabajo, los valores de captura del CO2 con la HAp producidos por calcinación oscilaron entre 2.5 to 3.2 mg CO2/g capturado a 973 K, y con la HAp derivada del tratamiento ácido-base, se registraron valores de captura entre 1.2 to 2.5 mg CO2/g. Estos resultados revelan el potencial de HAps extraídos de escamas de tilapia como sólidos con una alta capacidad de captura de CO2, estabilidad térmica y reversibilidad de los ciclos de captura/liberación.

Resumo A hidroxiapatita (HAp) foi obtida a partir da escama de tilapia usando dois métodos de extração: calcinação direta e tratamento ácido-base. As características físico-químicas das hidroxiapatitas foram avaliadas por análise termogravimétrica, fluorescência de raios-X, difração de raios-X, microscopia eletrônica de varredura, área superficial, espectroscopia de infravermelho e medição de basicidade a 298 K por titulação de pulso de CO2. Além disso, determinou-se a capacidade de captura de CO2 dos sólidos a alta temperatura. Os dois métodos mostraram a presença da fase HAp, no entanto, diferenças significativas foram encontradas nas propriedades dos sólidos, sendo a HAp obtida por calcinação direta a que apresentou menor cristalinidade, maior área superficial e basicidade, características que foram correlacionadas com a capacidade de captura de CO2. Foram encontrados valores entre 2.5 a 3.2 mg CO2/g capturado a 973 K para a HAp obtida por calcinação e, entre 1.2 a 2.5 mg CO2/g para a HAp obtida por tratamento ácido-base. Isto revelou o potencial de HAp's extraídas da escama de tilapia como sólidos com alta capacidade de captura de CO2, estabilidade térmica e reversibilidade na liberação de CO2.

Partial removal and detoxification of Malachite Green and Crystal Violet from laboratory artificially contaminated water by Pleurotus ostreatus / Eliminación parcial y desintoxicación de Verde Malaquita y Cristal Violeta del laboratorio con agua contaminada artificialmente por Pleurotus ostreatus / Extração e desintoxicação de Verde Malaquita e Cristal Violeta de água contaminada artificialmente em laboratório por Pleurotus ostreatus

Abstract The triphenylmethane Malachite Green (MG) and Crystal Violet (CV) dyes are cationic dyes and mix with domestic wastewater when dumped; increasing, among others, the chemical and biological oxygen demand and can cause acute toxicity at different trophic levels. Promoting the removal (decolorization) of MG and CV, and laccase activity (54.8 ± 8.9 and 30.6 ± 2.9 UL-1 respectively) by using P. ostreatus viable biomass needed parameters such as pH (4.5 and 6.0), temperature (25 to 30 °C), stirring speed (120 rpm), percentage of inoculum (2% v/v), and dye concentration (20 and 10 mg L-1). In adsorption studies, it was showed that an acidic pH favors the adsorption of both dyes and the model of pseudo-second order describes best the phenomenon of adsorption. Finally, the germination index (GI), using Lactuca sativa seeds for the initial dyes solutions, was < 50%; demonstrating its high phytotoxic effect. When dye solutions were treated with viable biomass, the GI increased, leaving open the possibility to perform future research to determine if the aqueous solutions, post-treated with P. ostreatus, could be used in treatments that generate less toxic water which could be used in processes that do not require potable water.

Resumen Los colorantes trifenilmetánicos Verde Malaquita (MG) y Crystal Violeta (CV) son catiónicos y al ser vertidos se mezclan con aguas residuales domésticas, incrementando, entre otros, la demanda química y biológica de oxígeno; pudiendo causar toxicidad aguda en diferentes niveles tróficos. En este estudio se encontró que los parámetros pH (4,5 y 6,0), temperatura (25 y 30 °C), velocidad de agitación (120 r.p.m.), porcentaje de inóculo (2 % v/v) y concentración de colorante (20 y 10 mgL-1), presentaron un efecto significativo (p < 0.05) para favorecer la remoción (decoloración) de MG y CV, así como la actividad lacasa (54,76 ± 8,91 y 30,59 ± 2,89 UL-1 respectivamente) al utilizar biomasa viable de P. ostreatus. En los estudios de adsorción se evidenció que pH ácidos favorecen la adsorción de ambos colorantes y que el modelo de Pseudo-segundo orden describe mejor el fenómeno de quimisorción. Finalmente los índices de germinación (IG) empleando semillas de Lactuca sativa, para los colorantes iniciales fueron < 50 %; demostrando su efecto fitotóxico elevado. Cuando las soluciones de colorantes fueron tratadas con biomasa viable, el IG aumentó, dejando abierta la puerta para la realización de investigaciones futuras con la intensión de determinar si las soluciones acuosas, postratadas con P ostreatus, pueden ser utilizadas en tratamientos que generen aguas menos tóxicas y que estas puedan ser empleadas en otros procesos que no requieran agua potable.

Resumen Os corantes de tipo trifenilmetano Verde Malaquita (VM) e Cristal Violeta (CV) são corantes catiônicos e se misturam com águas residuais domésticas quando descartadas; aumentando, entre outros, as demandas químicas e biológicas de oxigênio, podendo causar toxicidade aguda em diferentes níveis tróficos. Promoveu-se a remoção (descoloração) de VM e CV, e atividade da lacase (54.8 ± 8.9 e 30.6 ± 2.9 UL-1 respectivamente) utilizando como parâmetros necessários para a biomassa viável de P. ostreatus como pH (4,5 e 6,0), temperatura (25 a 30 °C), velocidade de agitação (120 RPM), porcentagem de inócuo (2 % v/v), e concentração de corante (20 e 10 mg L-1). Em estudos de absorção, se demonstrou que um pH mais ácido favorece a absorção de ambos corantes e o modelo de pseudo-segunda ordem descreve melhor o fenômeno da absorção. Finalmente, o índice de germinação (IG), utilizando sementes de Lactuca sativa para as soluções iniciais dos corantes, foi < 50 %; demonstrando assim seu alto efeito fitotóxico. Quando as soluções de corante foram tratadas com a biomassa viável, o IG aumentou, deixando em aberto a possibilidade de realizar futuras investigações para determinar se as soluções aquosas, tratadas com P. ostreatus, poderiam ser utilizadas em tratamentos que gerem águas menos tóxicas, que poderia ser utilizada em processos que não requerem água potável.

Clinical and Parasitological Features of Patients with American Cutaneous Leishmaniasis that Did Not Respond to Treatment with Meglumine Antimoniate.

BACKGROUND: American cutaneous leishmaniasis (ACL) is a complicated disease producing about 67.000 new cases per year. The severity of the disease depends on the parasite species; however in the vast majority of cases species confirmation is not feasible. WHO suggestion for ACL produced by Leishmania braziliensis, as first line treatment, are pentavalent antimonial derivatives (Glucantime or Sodium Stibogluconate) under systemic administration. According to different authors, pentavalent antimonial derivatives as treatment for ACL show a healing rate of about 75% and reasons for treatment failure are not well known. METHODS: In order to characterise the clinical and parasitological features of patients with ACL that did not respond to Glucantime, a cross-sectional observational study was carried out in a cohort of 43 patients recruited in three of the Colombian Army National reference centers for complicated ACL. Clinical and paraclinical examination, and epidemiological and geographic information were recorded for each patient. Parasitological, histopathological and PCR infection confirmation were performed. Glucantime IC50 and in vitro infectivity for the isolated parasites were estimated. RESULTS: Predominant infecting Leishmania species corresponds to L. braziliensis (95.4%) and 35% of the parasites isolated showed a significant decrease in in vitro Glucanatime susceptibility associated with previous administration of the medicament. Lesion size and in vitro infectivity of the parasite are negatively correlated with decline in Glucantime susceptibility (Spearman: r = (-)0,548 and r = (-)0,726; respectively). CONCLUSION: A negative correlation between lesion size and parasite resistance is documented. L. braziliensis was found as the main parasite species associated to lesion of patients that underwent treatment failure or relapse. The indication of a second round of treatment in therapeutic failure of ACL, produced by L. braziliensis, with pentavalent antimonial derivatives is discussable.

Infecciones necrotizantes de tejidos blandos: Mionecrosis por Clostridium

Las infecciones necrotizantes de los tejidos blandos varían en su presentación clínica, pero en general son de curso grave y alta mortalidad. El cuadro clínico incluye: fiebre, celulitis, edema, crepitación, bulas, necrosis y sepsis; con frecuencia existe un antecedente traumático o quirúrgico. Como hallazgo operatorio se encuentra necrosis de la piel y tejido subcutáneo, con o sin mionecrosis. El tratamiento debe ir dirigido a compensar el estado general de los pacientes aunado al temprano desbridamiento y remoción de tejido necrótico y contaminado y cobertura antibiótica de amplio espectro. Se expone el caso clínico de un paciente indígena de 2 años, sin antecedentes patológicos previos que desarrolló un proceso compatible con una infección necrotizante de partes blandas (INPB) en miembro superior e inferior izquierdo. Se realizó de urgencia una fasciotomía de miembro superior Derecho y desarticulación de cadera izquierda y se instauró tratamiento antibiótico con meropenem y vancomicina, sesiones con oxígenos hiperbárico.

Necrotizing soft tissue infections vary in their clinical presentation, but are generally severe course and high mortality. The clinical picture includes fever, cellulitis, edema, crepitus, bullae, necrosis and sepsis; there is often a traumatic or surgical history. As surgical finding is necrosis of the skin and subcutaneous tissue, with or without myonecrosis. Treatment should be directed to compensate the general state of patients coupled with early debridement and removal of necrotic tissue and contaminated and broad-spectrum antibiotics.The clinical case of an patient two years, without previous pathological antecedents who developed a process compatible with necrotizing soft tissue infection into upper and lower left limb is exposed. Performed emergency fasciotomy of right upper limb and left hip disarticulation and antibiotic treatment was started with meropenem and vancomycin, hyperbaric oxygen sessions.

Unexpected crosslinking and diglycation as advanced glycation end-products from glyoxal.

Glyoxal-derived advanced glycation end-products (AGEs) are formed in physiological systems affecting protein/peptide function and structure. These AGEs are generated during aging and chronic diseases such as diabetes and are considered arginine glycating agents. Thus, the study of glyoxal-derived AGEs in lysine residues and amino acid competition is addressed here using acetylated and non-acetylated undecapeptides, with one arginine and one lysine residue available for glycation. Tandem mass spectrometry results from a Fourier transform ion cyclotron resonance mass spectrometer showed glycated species at both the arginine and lysine residues. One species with the mass addition of 116.01096 Da is formed at the arginine residue. A possible structure is proposed to explain this finding (Nδ-[2-(dihydroxymethyl)-2H,3aH,4H,6aH-[1,3]dioxolo[5,6-d]imidazolin-5-yl]-L-ornithine-derived AGE). The second species corresponded to intramolecular crosslink involving the lysine residue and its presence is checked with ion-mobility mass spectrometry.

Desafío diagnóstico

Masculino de 6 meses de edad, con historia de fiebre alta, no cuantificada, manejada ambulatoriamente con antipirético, asociada a evacuaciones aguadas, amarillas, sin moco, ni sangre, no fétidas que aparecen al segundo día de iniciado el cuadro clínico. Consulta en Centro de Salud y se prescribe antihistamínico, Ceftriaxona IM, y continuar antipirético. Luego de la segunda dosis de antibiótico intramuscular presenta exantema generalizado, sin cambios en su sintomatología, pero asociado a hiporexia e irritabilidad por lo que acude al Cuarto de Urgencias hospitalario a los once días de evolución. Se realiza punción lumbar a que muestra pleocitosis con predominio de mononucleares y proteinorraquia, y se hospitaliza. Examen Físico Positivo: Paciente irritable, febril (39ºC), inyección conjuntival bilateral, adenopatías cervicales, axilares e inguinales, bilaterales de 0.8 cms, labios hipéremicos y agrietados, con lengua aframbuesada, edema en ambos pies. Eritema perianal. Durante su estadía en sala presenta exfoliación en colgajos periungueales de manos y pies. Exámenes de laboratorios: PCR mayor de 9 mg/dl, hemograma con leucocitosis (31000cel/mm3) con neutrofilia, trombocitosis (1303000) y anemia de 5.6 g/dl. VIH, VDRL, CMV, Mycoplasma y panel viral en moco nasal negativos.

Evaluación de un método de extracción y purificación de DNA a partir de tejido muscular fijado en formaldehido de cadáveres no identificados / Evaluation of a method of extracting and purifying DNA from muscle tissue fixed in formaldehyde unidentified bodies / Avaliação de um método de extracção e purificação de ADN a partir de tecido muscular fixado em formaldeído corpos não identificados

La obtención de DNA humano en buena cantidad y alta pureza a partir de tejido muscular fijado en Formaldehido no tamponado es de suma importancia en la amplificación por la Reacción en Cadena de la Polimerasa (PCR) para su aplicación en estudios de identificación y filiación genética. En este estudio se evaluó la eficiencia del Kit QIAampR DNA FFPE TISSUE y una modificación del mismo basado en lavados con PBS y el tiempo de digestión con proteinasa K, frente a la cantidad y calidad de este ácido nucléico. Las diferencias fueron significativas entre los tiempos de acción con la proteinasa K (PK) en relación a la cantidad y en la pureza producto de los lavados del tejido muscular previa extracción. Estos resultados proporcionan una pauta para el diseño de experimentos de acuerdo con el efecto de la fijación, optimizando recursos humanos e insumos.

Obtaining human DNA in large quantity and high purity from muscle tissue fixed in formaldehyde unbuffered is of utmost importance in amplification by Chain Reaction (PCR) for application in identification studies and genetic affiliation. In this study, the efficiency of DNA FFPE TISSUE QIAampR Kit and a modification thereof based washes with PBS and the time of digestion with proteinase K, compared to the amount and quality of the nucleic acid were evaluated. Differences were significant between the exposure times with proteinase K (PK) in relation to the quantity and purity of the product prior washings muscle tissue extraction. These results provide a guideline for the design of experiments according to the effect of fixing, optimizing human resources and inputs.

A obtenção de DNA humano em grande quantidade e de alta pureza a partir de tecido muscular fixado em formol não tamponado é de extrema importância para a amplificação por Reacção em Cadeia (PCR), para sua aplicação em estudos de identificação e filiação genética. Neste estudo, a eficácia do kit QIAampR DNA FFPE TISSUE e uma modificação do processo por lavagens com PBS e o tempo de digestão com proteinase K, em comparação com a quantidade e a qualidade do ácido nucléico desta base. As diferenças foram significativas entre os tempos de exposição com proteinase K em relação à quantidade e pureza produto das lavagens do tecido muscular extraída previamente. Estes resultados fornecem uma diretriz para o desenho de experimentos de acordo com o efeito de fixação, otimizando recursos humanos e insumos.

Study of an unusual advanced glycation end-product (AGE) derived from glyoxal using mass spectrometry.

Glycation is a post-translational modification (PTM) that affects the physiological properties of peptides and proteins. In particular, during hyperglycaemia, glycation by α-dicarbonyl compounds generate α-dicarbonyl-derived glycation products also called α-dicarbonyl-derived advanced glycation end products. Glycation by the α-dicarbonyl compound known as glyoxal was studied in model peptides by MS/MS using a Fourier transform ion cyclotron resonance mass spectrometer. An unusual type of glyoxal-derived AGE with a mass addition of 21.98436 Da is reported in peptides containing combinations of two arginine-two lysine, and one arginine-three lysine amino acid residues. Electron capture dissociation and collisionally activated dissociation results supported that the unusual glyoxal-derived AGE is formed at the guanidino group of arginine, and a possible structure is proposed to illustrate the 21.9843 Da mass addition.

Tandem mass spectrometry for the study of glyoxal-derived advanced glycation end-products (AGEs) in peptides.

RATIONALE: The post-translational modification known as glycation affects the physiological properties of peptides and proteins. Glycation is particularly important during hyperglycaemia where α-dicarbonyl compounds are generated. These compounds react with proteins to generate α-dicarbonyl-derived glycation products, which are correlated with diabetic complications such as nephropathy, retinopathy, and neuropathy, among others. One of these α-dicarbonyl compounds is ethanedial, also known as glyoxal. Thereby, glyoxal binding to protein/peptides is studied by electron capture dissociation (ECD) and collisionally activated dissociation (CAD). METHODS: Acetylated and non-acetylated undecapeptides containing one lysine and one arginine susceptible of glycation were reacted with glyoxal under pseudo-physiological and MeOH/H2O (50:50) conditions. Two types of glyoxal-derived AGEs were fragmented by ECD and CAD using 12 Tesla Fourier transform ion cyclotron resonance mass spectrometry (FTICRMS). RESULTS: Reaction with glyoxal under different reaction conditions showed the addition of C2O and C2H2O2, which corresponded to a net increase on the peptide mass of 39.9949 Da and 58.0055 Da, respectively. The binding site was assigned within an error <1 ppm, using ECD and CAD. The results indicated that both types of glyoxal-derived AGEs are formed at the side chain of arginine located in position 3. CONCLUSIONS: Types and binding sites of glyoxal-derived AGEs were investigated in peptides containing one arginine-one lysine using FTICRMS. Two net mass additions to the mass of the peptide were assigned as C2O and C2H2O2, which were located at the arginine side chain. In addition, these mass additions (C2O and C2H2O2) observed in the peptides were unaffected by different reaction conditions.