The Integration of 3D Virtual Reality and 3D Printing Technology as Innovative Approaches to Preoperative Planning in Neuro-Oncology.

Our study explores the integration of three-dimensional (3D) virtual reality (VR) and 3D printing in neurosurgical preoperative planning. Traditionally, surgeons relied on two-dimensional (2D) imaging for complex neuroanatomy analyses, requiring significant mental visualization. Fortunately, nowadays advanced technology enables the creation of detailed 3D models from patient scans, utilizing different software. Afterwards, these models can be experienced through VR systems, offering comprehensive preoperative rehearsal opportunities. Additionally, 3D models can be 3D printed for hands-on training, therefore enhancing surgical preparedness. This technological integration transforms the paradigm of neurosurgical planning, ensuring safer procedures.

Associated factors for mortality in a COVID-19 colombian cohort: is the third wave relevant when Mu variant was predominant epidemiologically?

OBJECTIVES: To evaluate the association between Colombia's third wave when the Mu variant was predominant epidemiologically (until 75%) in Colombia and COVID-19 all-cause in-hospital mortality. METHODS: In this retrospective cohort, we included hospitalized patients ≥18 years with SARS-CoV-2 infection between March 2020 to September 2021 in ten hospitals from three cities in Colombia. Description analysis, survival, and multivariate Cox regression analyses were performed to evaluate the association between the third epidemic wave and in-hospital mortality. RESULTS: A total of 25,371 patients were included. The age-stratified time-to-mortality curves showed differences according to epidemic waves in patients ≥75 years (log-rank test p = 0.012). In the multivariate Cox analysis, the third wave was not associated with increased mortality relative to the first wave (aHR 0.95; 95%CI 0.84-1.08), but there was an interaction between age ≥75 years and the third wave finding a lower HR for mortality (aHR 0.56, 95%CI 0.36-0.86). CONCLUSIONS: We did not find an increase in in-hospital mortality during the third epidemic wave in which the Mu variant was predominant in Colombia. The reduced hazard in mortality in patients ≥75 years hospitalized in the third wave could be explained by the high coverage of SARS-CoV-2 vaccination in this population and patients with underlying conditions.

An Unusual Case of Deep Localized Scleroderma in a Patient with Chronic Kidney Disease.

Localized scleroderma (LS) is a rare fibrosing disorder of skin and underlying tissues. Although it can affect all races, it has a higher prevalence in whites. Deep LS is the least common among seven LS variants, representing less than 5% of cases, and typically affects areas of pressure such as the hips and waist. We report a unique clinical case of bilateral lower extremity deep LS in a 51-year-old Puerto Rican woman with chronic kidney disease (CKD). In patients with CKD, it is important to distinguish LS from nephrogenic systemic fibrosis (NSF). Both can present with skin fibrosis and contractures over joints yet have significantly differing treatment approaches and prognosis. Our case report is unique due to the patient's Puerto Rican ethnicity, CKD history, and isolated anterior lower extremity involvement. In this report, we highlight key clinical and histopathological findings of LS, and how they differ from that of NSF.

The role of DNA repair capacity in melanoma skin cancer risk in a population chronically exposed to high levels of sunlight.

Puerto Rican residents are exposed to some of the highest levels of environmental ultraviolet radiation in the world; paradoxically, the melanoma incidence in Puerto Rico is lower than that of the US mainland. The overall objective of this case-control pilot study was to test the hypotheses that (1) persons with melanoma have a significantly lower DNA repair capacity (DRC) in relation to controls matched by age, (2) decline in DRC is associated with vertical depth of melanoma invasion, and (3) DRC is associated with anatomical tumor location. Controls (n  =  124) were examined by dermatologists; cases (n  =  62) were histopathologically confirmed. The mean DRC ± 1 SE of controls was 6.46% ± 0.3. Melanoma patients (n  =  62) had a mean decrease in DRC of 3% (6.25% ± 0.5), which was not statistically different from controls (P  =  0.697). No significant differences in DRC were evident in participants with either in situ or malignant melanoma tumors; neither were such differences evident when evaluating anatomical location of tumors (ie, non-sun-exposed versus sun-exposed). DRC generally declined in participants with increased depth of melanoma tumor penetration when compared with controls and those with small in situ tumors. These findings should be examined in a larger-scale population study that includes participants with more advanced metastatic melanoma.

Risk factors for atopic dermatitis in southern Puerto Rico.

BACKGROUND: Little is known about the risk factors and exposures to aeroallergens in subjects with atopic dermatitis (AD) in Southern Puerto Rico. The objective was to determine the prevalence of skin reactions to aeroallergens and to analyze self-reported risk factors in AD patients and a nonallergic control population. METHODS: A cross-sectional study was conducted which included 726 AD patients and 313 nonallergic control subjects. Skin tests were conducted and a questionnaire was self-applied to all participants. RESULTS: Seventy six percent of the AD patients showed at least one positive skin reactions to aeroallergens. Of these, half had positive skin reactions to dust mites, and one third to Periplaneta americana. A low prevalence of positive skin reactions to dog, cat, plant and fungal allergens was detected. Co-sensitivitity between mites and cockroaches was 30%. The maximum skin reactivity to mites was at 10-19 years of age declining thereafter while skin reactivity to dogs, and plants increased with age. No significant differences in the prevalence of skin reactions was observed between the male and female AD population. CONCLUSIONS. Of the aeroallergens tested, those derived from dust mites are the most frequent sensitizing agents in the AD patients. Data also showed that the mites B. tropicalis and E. maynei are also important sources of sensitization. Our study show that young patients specially those between the age of 10-19 age group are the most allergic. Being female, or having an asthmatic father are significant risk factors associated with allergen sensitivity in the AD population.

Early-onset of sporadic basal-cell carcinoma: germline mutations in the TP53, PTCH, and XPD genes.

BACKGROUND: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in the Western world. The objective of this study was to examine together germline mutations in the TP53, PTCH, and XPD genes as risk factors for developing BCC at a young age. We hypothesized that mutations in these genes significantly increase the risk of early-onset BCC (< or = 35 years). METHODS: The PCR, DNA sequencing and Restriction Fragment Length Polymorphisms methods were utilized to study eight Puerto Rican patients with a confirmed diagnosis of BCC before age 35. RESULTS: A novel germline mutation (T:A transversion) was identified at the exon 4, codon 50 of the TP53 gene of one BCC patient. No other mutations were found at the TP53 or PTCH genes. The presence of the XPD mutant allele is associated with a seven-fold increase in risk (OR = 7.0, p = 0.03) for developing BCC prior to age 35. In addition, the DNA Repair Capacity (DRC) of these BCC patients showed a 47% reduction that was significant in relation to age-matched controls (p = 0.021). However, the XPD mutant allele was not associated with the decrease in DRC observed in BCC participants. CONCLUSIONS: The evaluated population presented BCC before age 35, a phenomenon that is so rare as to make very difficult the study of this subpopulation with a larger sample size. The results of this study, suggest that the XPD Lys751Gln polymorphism may have a significant role in the development of early-onset BCC in the Puerto Rican population.

UV dose determines key characteristics of nonmelanoma skin cancer.

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), known as nonmelanoma skin cancer (NMSC), are the most common cancers worldwide. Although many factors are involved in the pathogenesis of NMSC, UV radiation is an important risk factor. A fundamental question in skin cancer research is whether varying doses of total UV radiation influence key characteristics of NMSC. The hypothesis that differences in UV doses influence the BCC/SCC ratio, number of tumors, and anatomic location of the tumor was investigated in 311 participants having 326 tumors and with exposure to a broad range of UV doses. An epidemiologic questionnaire was given to each participant soliciting detailed information on exposure to solar radiation. Environmental UVA and UVB doses were measured continually for 6 years at a permanent UV monitoring station. The total ratio of BCC/SCC was 3.5. Participants who received low and high UV doses had a BCC/SCC ratio of 4.2. Those who received very high UV doses had a ratio of 2.1. A very high UV dose was also associated with the doubling of the total number of tumors per person and a significantly increased risk of having SCC, a more aggressive malignancy. Tumors in sun-exposed areas (on the body) were more common in participants who received high and very high UV doses. The tumors in sun-protected areas were associated with exposure to lower levels of UV. This large-scale population study provides evidence that varying doses of UV radiation have a profound influence on key characteristics of NMSC.

DNA repair and nonmelanoma skin cancer in Puerto Rican populations.

BACKGROUND: UV radiation is a risk factor for nonmelanoma skin cancer (NMSC). The relation between DNA damage and oncogenesis suggests that diminished DNA repair capacity (DRC) is involved in tumorigenesis. OBJECTIVE: The purpose of this study was to test the hypothesis that a low DRC is a susceptibility factor for the development of NMSC in Puerto Rico. METHODS: A case-control retrospective clinical study was done to compare the age-adjusted DRC in participants with and without NMSC. DRC was measured using a host cell reactivation assay with a luciferase reporter gene irradiated with UV light and transfected into human peripheral lymphocytes. An epidemiologic questionnaire was used to solicit risk factors. RESULTS: The mean (+/-2 SE) DRC of 177 control patients without skin cancer was 8.6% +/- 0.7. Participants (280) with NMSC had a 42% lower DRC (5.0% +/- 0.3). CONCLUSION: A low DRC is a susceptibility factor for NMSC.

Capacitación en prevención de desastres a las comunidades de Saloya y Pueblo Nuevo ante eventual erupción del Volcán Guagua Pichincha

El Distrito Metropolitano de Quito se encuentra rodeado de varios edificios volcánicos entre los que se citan: el Pichincha, el Cotopaxi, el Antizana, el Pululahua entre otros, cuyos efectos devastadores se han hecho sentir en el pasado. La educación en prevención de desastres es un factor determinante para mitigar los riesgos ante una eventual erupción nuevo en prevención del volcán Guagua Pichincha. Se utiliza un diseño casi experimental de control no equivalente, y para su ejecución el muestreo de dos proporciones con dos grupos uno de control y otro experimental, en 80 sujetos, 40 en cada población objeto, con una edad promedio para la muestra general de 34.6 16.1 años, siendo 51 (63.8 por ciento de sexo masculino), 55 (68.8 por ciento) con instrucción primaria...

Cáncer del endometrio en el Hospital General de México (27 años de experiencia) / Endometrial cancer at Hospital General de Mexico (An experience of 27 years)

Objetivo. Informar la experiencia con cáncer del endometrio de una institución que atiende población abierta. Material y métodos. Análisis de 260 casos de cáncer del endometrio vistos en el Servicio de Oncología del hospital General de México, entre 1966 y 1993 inclusive, destacándose el estudio de factores de riesgo y los resultados del tratamiento, a partir de la clasificiación clínico-quirúrgica vigente, a la que se agregó dentro de la etapa IIIc, la invasión parametrial no contemplada en dicha clasificación. Resultados. Ciento veinte (46.1 por ciento) enfermas fueron obesas, 78 (30.0 por ciento) hipertensas y 65 (25.0 por ciento) diabéticas. Ciento treinta y una (50.3 por ciento) indicaron nuliparidad o baja paridad. Unicamente 116 (48.7 por ciento) de 238 se clasificaron en estadio I. Evolucionaron de 24 a 10 años (media de 30 meses) sin evidencia de enfermedad, 66 (52.3 por ciento) de 128 enfermas clasificadas de la siguiente manera: 39 de 51 en estadio I: 76.4 por ciento (18/20 Ia, 90.0 por ciento; 13/15 Ib, 86.6 por ciento y 8/16 Ic, 50.0 por ciento. P=0.003). Diecisiete de 23 en estadio II, 73.9 por ciento (5/6 IIa, 83.3 por ciento y 12/17 IIb, 70.5 por ciento); 10 de 37 en estadio III, 27.0 por ciento (5/14 IIIa, 35.7 por ciento; 2/6 IIIb, 33.3 por ciento y 3/17 IIIc, 17.6 por ciento) y 1/17 en estadio IV, 5.8 por ciento. Conclusiones. El alto porcentaje de lesiones avanzadas influyó negativamente en los resultados finales. Los factores pronósticos más adversos en tumores pélvicos fueron: La invasión profunda del miometrio en cánceres limitados al cuerpo uterino (etapa Ic) y la invasión parametrial en lesiones más avanzadas

Cáncer del endometrio clasificación clínico-quirúrgica y resultados del tratamiento (Análisis de 134 pacientes) / Endometrial cancer. Clinico-surgical calsification and therapy results. Analisis of 134 patients

Informar los factores pronósticos del cáncer endometrial en pacientes del Hospital General de México, tomando como base la clasificación clínico-quirúrgica vigente de la enfermedad. Etapificación de 134 expediente de pacientes con cáncer endometrial tratadas convencionalmente en el Hospital General de México, en los que se documentaron los factores pronósticos del padecimiento. En 127 casos se tomó como base, la Clasificación clínico-quirúrgica de la Federación Internacional de Ginecología y Obstetricia (FIGO). Evolucionaron de 24 meses a 10 años con una media de 30 meses, sin evidencia de enfermedad, 58 a 105 adenocarcinoam, (55.2 por ciento); 5 de 11 adenoacantomas, (45.4 por ciento) y 4 de 14 carcinomas adenoescamosos, (28.5 por ciento). Asimismo, 36 de 72 pacientes con edad igual o menor a 60 años, (50.0 por ciento) y 17 de 43 con edad igual o mayor a los 61 años, (39.5 por ciento). De acuerdo a la clasificación vigente de la FIGO, se obtuvo una evolución sin evidencia de enfermedad, en 66 de 127 enfermas tratadas, (51.9 por ciento). La cifra incluye 39 de 51 pacientes clasificadas en estadio I: 76.4 por ciento (188 de 21 Ia, 90 por ciento; 13 de 15 Ib, 86.6 por ciento y 8 de 16 Ic, 50.0 por ciento. P=0.003). Diez y siete de 23 en estadio II, 73.9 por ciento (5 de 6 IIa, 83.3 por ciento y 12 de 17 IIb, 70.5 por ciento); 10 de 37 en estadio III, 27.0 por ciento, (5 de 14 IIIa, 35.7 por ciento; 2 de 6 IIIb, 33.3 por ciento y 3 de 17 IIIc, 17.6 por ciento); y 1 de 17 en estadio IV, 5.8 por ciento. P=0.001. La clasificación de la FIGO para el carcinoma del endometrio, ha contribuido a predecir la evolución natural de la enfermedad. En esta serie, los factores pronósticos mas adversos en tumores limitados a la pelvis fueron, la invasión profunda del miometrio (estadio Ic) y la invasión parametrial

Carcinoma del endometrio. Causas de fracaso terapéutico en 69 pacientes / Carcinoma of the endometrium. Treatment failure in 69 patients

El objetivo del presente trabajo fue estudiar las causas de los fracasos terapéuticos en el cáncer endometrial, a partir de la Clasificación Clínico-quirúrgica del padecimiento, en pacientes de una Institución que atiende a población abierta. Se realizó un análisis con la Clasificación actual, de 69/212 casos tratados de forma convencional en el Hospital General de México entre 1966 y 1993, en los que se demostró fracaso de la terapéutica. Se incluyeron ingresos con enfermedad diseminada, muertes postratamiento, residuales tumorales. Los resultados fueron: Diez y seis pacientes (23.1 por ciento) ingresaron con diseminación tumoral; 5 (7.1 por ciento) fallecieron a causa del tratamiento. Diez de 13 con tumor parametrial (76.9 por ciento) y 1 de 5 en estadio IVa, terminó su tratamiento con residual terminal no rescatable. Treinta y cinco pacientes (50.7 por ciento) desarrollaron recurrencias tumorales, el 94.3 por ciento dentro de los 3 primeros años; 19 a nivel locorregional (54.2 por ciento) y 16 con actividad a distancia (45.7 por ciento). Diez de los 49 casos en estadio I (20.4 por ciento), evolucionaron con recurrencias tumorales no rescatables, de los que 8 (80.0 por ciento) fueron estadios Ic. Asimismo, 5/16 (31.3 por ciento) en estadio IIb; 17/27 (62.9 por ciento) en estadio III y 3/5 en estadio IVa. Dos de 14 enfermas manejadas con hormonoterapia (14.2 por ciento), mostraron respuestas objetivas en enfermedad avanzada o recurrente y de 0 a 6 con quimioterapia. Se concluye que los factores pronósticos más adversos en esta serie fueron: La presencia de invasión profunda del miometrio para el estadio I; la invasión parametrial para el estadio III y la diseminación a distancia en el IV

Oxybelis wilsoni, a new species of vine snake from Isla de Roatán, Honduras (Serpentes: Colubridae)

A new species of Oxybelis is described from Isla de Roat n, Honduras. It differs from all species of Oxybelis in its tan to golden yellow coloration, in having a higher number of subcaudals as well as in other details of color and scutellation. The new species is closely related to O. fulgidus and is thought to be derived from a fulgidus-like ancestor (i.e., is the sister species to fulgidus) that has been isolated in the area of its present range probably since the very late Pliocene. The presence of a yellow population of Oxybelis on Isla de Roat n, Honduras, has long been known (Keiser 1969). The status of this insular population has remained uncertain pending the acquisition of additional material (Keiser 1969, Wilson and Meyer 1985). We recently visited Isla de Roatán a number of times and obtained a large series of additional specimens. After examining this new material, and the previously known specimens from this island, we believe that this population represents an undescribed taxon, which should be known as.