Morphological heterogeneity of neurons in the human central amygdaloid nucleus.

The central amygdaloid nucleus (CeA) has an ancient phylogenetic development and functions relevant for animal survival. Local cells receive intrinsic amygdaloidal information that codes emotional stimuli of fear, integrate them, and send cortical and subcortical output projections that prompt rapid visceral and social behavior responses. We aimed to describe the morphology of the neurons that compose the human CeA (N = 8 adult men). Cells within CeA coronal borders were identified using the thionine staining and were further analyzed using the "single-section" Golgi method followed by open-source software procedures for two-dimensional and three-dimensional image reconstructions. Our results evidenced varied neuronal cell body features, number and thickness of primary shafts, dendritic branching patterns, and density and shape of dendritic spines. Based on these criteria, we propose the existence of 12 morphologically different spiny neurons in the human CeA and discuss the variability in the dendritic architecture within cellular types, including likely interneurons. Some dendritic shafts were long and straight, displayed few collaterals, and had planar radiation within the coronal neuropil volume. Most of the sampled neurons showed a few to moderate density of small stubby/wide spines. Long spines (thin and mushroom) were observed occasionally. These novel data address the synaptic processing and plasticity in the human CeA. Our morphological description can be combined with further transcriptomic, immunohistochemical, and electrophysiological/connectional approaches. It serves also to investigate how neurons are altered in neurological and psychiatric disorders with hindered emotional perception, in anxiety, following atrophy in schizophrenia, and along different stages of Alzheimer's disease.

The state of art of awake craniotomy in Latin American countries: a scoping review.

BACKGROUND AND OBJECTIVE: Awake craniotomy (AC) is a valuable technique for surgical interventions in eloquent areas, but its adoption in low- and middle-income countries faces challenges like limited infrastructure, trained personnel shortage, and inadequate funding. This scoping review explores AC techniques in Latin American countries, focusing on patient characteristics, tumor location, symptomatology, and outcomes. METHODS: A scoping review followed PRISMA guidelines, searching five databases in English, Spanish, and Portuguese. We included 28 studies with 258 patients (mean age: 43, range: 11-92). Patterns in AC use in Latin America were analyzed. RESULTS: Most studies were from Brazil and Mexico (53.6%) and public institutions (70%). Low-grade gliomas were the most common lesions (55%), most of them located in the left hemisphere (52.3%) and frontal lobe (52.3%). Gross-total resection was achieved in 34.3% of cases. 62.9% used an Asleep-Awake-Asleep protocol, and 14.8% used Awake-Awake-Awake. The main complication was seizures (14.6%). Mean post-surgery discharge time was 68 h. Challenges included limited training, infrastructure, and instrumentation availability. Strategies discussed involve training in specialized centers, seeking sponsorships, applying for awards, and multidisciplinary collaborations with neuropsychology. CONCLUSION: Improved accessibility to resources, infrastructure, and adequate instrumentation is crucial for wider AC availability in Latin America. Despite disparities, AC implementation with proper training and teamwork yields favorable outcomes in resource-limited centers. Efforts should focus on addressing challenges and promoting equitable access to this valuable surgical technique in the region.

Intestinal obstruction due to bariolith impaction.

"Bariolith" is defined as the concretion of barium sulfate in the intestine after performing a radiological study with said contrast. Complications derived from the use of barium are exceptional, but appendicitis, intussusception, volvulus, ulceration, ischemia and perforation have been described. We present the case of a 62 years old woman, who underwent a EGD exploration on the 15th of January 2021 as a part of her study for suspected GERD.

De Novo Prediction of Drug Targets and Candidates by Chemical Similarity-Guided Network-Based Inference.

Identifying drug-target interactions is a crucial step in discovering novel drugs and for drug repositioning. Network-based methods have shown great potential thanks to the straightforward integration of information from different sources and the possibility of extracting novel information from the graph topology. However, despite recent advances, there is still an urgent need for efficient and robust prediction methods. Here, we present SimSpread, a novel method that combines network-based inference with chemical similarity. This method employs a tripartite drug-drug-target network constructed from protein-ligand interaction annotations and drug-drug chemical similarity on which a resource-spreading algorithm predicts potential biological targets for both known or failed drugs and novel compounds. We describe small molecules as vectors of similarity indices to other compounds, thereby providing a flexible means to explore diverse molecular representations. We show that our proposed method achieves high prediction performance through multiple cross-validation and time-split validation procedures over a series of datasets. In addition, we demonstrate that our method performed a balanced exploration of both chemical ligand space (scaffold hopping) and biological target space (target hopping). Our results suggest robust and balanced performance, and our method may be useful for predicting drug targets, virtual screening, and drug repositioning.

Open versus minimally invasive sphincter-sparing surgery for rectal cancer: a single-center retrospective cohort study in Peru.

OBJECTIVE: The study aimed to describe and compare minimally invasive surgery (MIS) and open surgery for rectal cancer in Peru. MATERIAL AND METHODS: A retrospective single-center analysis was performed for all patients who underwent sphinctersparing surgery for non-metastatic rectal cancer at Instituto Nacional de Enfermedades Neoplásicas in Peru between January 2016 and December 2020. Clinical, perioperative, pathological, and survival outcomes were compared between both groups. A propensity score matching method was used to minimize bias. RESULTS: 162 patients were included in the final analysis. 124 had open surgery and 38 had MIS. Patients, clinical tumour, pathological characteristics, and perioperative were similar between groups after matching. Similar circumferential resection margin (CRM) with optimal quality of the mesorectum (p=1.000) but higher number of lymph nodes resected in open surgery group (p=0.741) was described. The leakage rate was slightly higher in the MIS group (p=0.358) with 10.5%, while the postoperative hospital stay was longer in the open surgery group after matching (p=0.001; OR 95% 5.2 CI: 1.8-15.6). The estimated recurrence-free survival (RFS) and overall survival (OS) at 3 years in open surgery and MIS was 71.8% (95% CI; 0.58-0.89) and 70% (95% CI; 0.56-0.88) (p=0.431) and 77.7% (95% CI; 0.64-0.94) and 88.9% (95% CI; 0.79-0.99) (p=0.5), respectively. CONCLUSIONS: Shorter postoperative hospital stay in the minimally invasive surgery group was reported. RFS, OS, and recurrence rates were similar between both groups. This approach is for non-metastatic rectal cancer in referral centers in Peru.

A Hybrid Artificial Intelligence Model for Aeneolamia varia (Hemiptera: Cercopidae) Populations in Sugarcane Crops.

Sugarcane spittlebugs are considered important pests in sugarcane crops ranging from the southeastern United States to northern Argentina. To evaluate the effects of climate variables on adult populations of Aeneolamia varia (Fabricius) (Hemiptera: Cercopidae), a 3-yr monitoring study was carried out in sugarcane fields at week-long intervals during the rainy season (May to November 2005-2007). The resulting data were analyzed using the univariate Forest-Genetic method. The best predictive model explained 75.8% variability in physiological damage threshold. It predicted that the main climatic factors influencing the adult population would be, in order of importance, evaporation; evapotranspiration by 0.5; evapotranspiration, cloudiness at 2:00 p.m.; average sunshine and relative humidity at 8:00 a.m. The optimization of the predictive model established that the lower and upper limits of the climatic variables produced a threshold in the population development rate of 184 to 267 adult insects under the agroecological conditions of the study area. These results provide a new perspective on decision-making in the preventive management of A. varia adults in sugarcane crops.

Nursing Interventions in Children Living Under Armed Conflict Situations and Quality of Life: A Scoping Review.

PROBLEM: Today, one in four children in the world lives in an area of conflict or disaster, and more than 30 million have been displaced, enslaved or trafficked, abused, and exploited. However, there is little recognition of nursing interventions in this context and their impact on the quality of life. ELIGIBILITY CRITERIA: Studies that (1) Described nursing interventions in children under situations of armed conflict. (2) Identified the impact of the interventions in the Quality of Life. (3) identify research trends in the field by nursing professionals. (4) Summarized concepts associated and nursing interventions proposed in armed conflict to address this problem. SAMPLE: From June to November 2019, electronic databases such as Embase, MEDLINE, LILACS, BIREME library, CINAHL, and ProQuest were accessed. Eleven papers were included in the review. RESULTS: The studies described the positive effects of nursing interventions on mental health and mortality. No studies were found reporting the impact of the interventions on quality of life. The topics of significant research in nursing focus on mental health. Care practices based on leadership, health management, advocacy, and intermediation in public policies should be a matter of interest for nurses. CONCLUSIONS: Future research is required to generate a comprehensive and accurate understanding of the nursing interventions in children under armed conflict situations. IMPLICATIONS: Recognizing the applied interventions and proposing a frame of reference justifies present and future research to children's attention under armed conflict situations.

[Appendicular desmoid tumor: unusual case and review of the literature]. / Fibromatosis tipo desmoide de apéndice cecal: reporte de caso inusual y revisión de la literatura.

BACKGROUND: Desmoid type fibromatosis is a benign neoplastic process non-encapsulated locally invasive and aggressive, which arises from a proliferation of bland-looking fibroblasts and myofibroblasts. The most frequent location of fibromatosis is extraabdominal (60%), abdominal wall (25%) and intra-abdominal (8-15%), rarely can originate in the viscera (0.73%), such as the pancreas, gastroesophageal junction, diaphragm and appendix. The annual incidence of desmoid tumor is estimated at 2 to 5 cases per million. In this article, we report a case of unusual presentation, originated in the cecal appendix. CASE: A 41-year-old female patient with acute pelvic pain, admitted to surgical ward with a clinical and ultrasound diagnosis of probably ovarian pedicle tumor. An explorative laparotomy revealed a solid mass of 15 cm in diameter arising from the cecal appendix, with the anatomopathological study corresponding to a desmoid tumor of the cecal appendix. CONCLUSIONS: The desmoid tumor can arise from several extra and intra-abdominal locations, the latter being the rarest and most aggressive. Accurate preoperative diagnosis is very difficult and almost always patients enter to surgery with suspected diagnosis of intraabdominal tumor of unknown etiology. The risk factors associated to its appearance are not yet characterized. The complete surgical resection of the tumor -with free surgical margins (R0)- is the treatment of choice; however, the risk of recurrence is high even with optimal tumor removal.

Synthesis and Explosion Hazards of 4-Azido-l-phenylalanine.

A reliable, scalable, cost-effective, and chromatography-free synthesis of 4-azido-l-phenylalanine beginning from l-phenylalanine is described. Investigations into the safety of the synthesis reveal that the Ullman-like Cu(I)-catalyzed azidation step does not represent a significant risk. The isolated 4-azido-l-phenylalanine product, however, exhibits previously undocumented explosive characteristics.

[Prognostic value of lymph node ratio (LNR) in patients who underwent radical gastrectomy]. / Valor pronóstico de la razón de ganglios metastásicos en pacientes con cáncer gástrico operados.

The study objective was to evaluate the prognostic value of lymph node ratio (LNR) in patients with gastric cancer who underwent radical gastrectomy D2. MATERIALS AND METHODS: We reviewed retrospectively 498 medical records of patients with gastric cancer who were attended at the National Institute of Neoplastic Diseases (INEN) between 2008 and 2011and met the inclusion and exclusion criteria. They were distributed into 4 groups according to their LNR, LNR0: 0, LNR1: 0-0.13, LNR2: 0.14-0.4 and LNR3: = 0.4. RESULTS: The median of resected lymph nodes was 42 [range; 8.153] and 494 (99.2%) patients had more than 15 lymph nodes retrieved. 340 (68.5%) patients had lymph node involvement and 175 (35.1%) cases (35.1%) were classified as pN3, 94 (18.5%) pN2 and 72 (14.5%) were pN1. 285 (57.2%) patients had stage III disease. There was a significant difference between groups of LNR in overall survival (OS) and disease-free survival (DFS) curves (p <0.05). According to the LNR groups there was significant differences according to age, lesion size, lymph node involvement (pN), Lauren classification, vascular invasion and lymphatic invasion (p <0.05). LNR is an important prognostic factor to explain the time of death (LNR3: HR: 6.77, 95% CI: 3.346-13.706, p <0.05) and recurrence time (LNR3: 95% CI: 2.104-13.439, p <0.05). CONCLUSION: LNR remains as an important independent prognostic factor in patients undergoing radical gastrectomy and D2 lymphadenectomy for gastric cancer.

Conservative management of splenic abscess septic emboli after tooth extractions.

Splenic abscesses are rare but may be associated with high mortality. Usually they occur in patients with systemic infection related to some immunocompromised state. The symptoms are nonspecific and the diagnosis is often late, but the development of better imaging techniques has enabled better diagnosis of splenic abscess and percutaneous drainage is a valid and safe complementary treatment option. We report a case of a patient with splenic abscess secondary to septic emboli after tooth extractions, managed conservatively with antibiotics and percutaneous drainage.

Method for the stabilization and immobilization of enzymatic extracts and its application to the decolorization of textile dyes.

Peroxidases from Pleurotus eryngii have been investigated for their ability to degrade recalcitrant, phenolic pollutants. The use of crude enzymatic extracts can reduce the high costs associated with enzyme purification, and enzyme immobilization can enhance enzyme stability and recovery. The present study tests the effectiveness of various conditions for crude enzyme stabilization in polyethylene glycol and glycine solutions, and immobilization on monofunctional and heterofunctional agarose solid supports. Glycine at 0.5 M at 4 °C and pH 4 was most effective stabilization agent for the crude enzymatic extracts, and enzyme immobilization efficiency was greatest for heterofunctional supports. MANA-glyoxyl heterofunctional supports were demonstrated to have the greatest enhancement of decolorization (1.3-fold) and velocity of substrate consumption (fivefold). Therefore, the application of crude enzymatic extracts to industrial processes, such as dye decolorization, represents a cost-effective alternative to purified enzymes.

Anxiety and resilience in palliative medicine physicians.

OBJECTIVE: To identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians. METHODS: Cross-sectional analytical study with non-probability sampling. We included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale. RESULTS: 42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. Less than half of the participants considered demonstrated high levels of resilience. We found an inverse and significant correlation between the factors that make up the Resilience Scale and the manifestation of psychological and physical symptoms of anxiety. CONCLUSION: Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.

Transcriptomic analysis of subarachnoid cysts of Taenia solium reveals mechanisms for uncontrolled proliferation and adaptations to the microenvironment.

Subarachnoid neurocysticercosis (SANCC) is caused by an abnormally transformed form of the metacestode or larval form of the tapeworm Taenia solium. In contrast to vesicular parenchymal and ventricular located cysts that contain a viable scolex and are anlage of the adult tapeworm, the subarachnoid cyst proliferates to form aberrant membranous cystic masses within the subarachnoid spaces that cause mass effects and acute and chronic arachnoiditis. How subarachnoid cyst proliferates and interacts with the human host is poorly understood, but parasite stem cells (germinative cells) likely participate. RNA-seq analysis of the subarachnoid cyst bladder wall compared to the bladder wall and scolex of the vesicular cyst revealed that the subarachnoid form exhibits activation of signaling pathways that promote proliferation and increased lipid metabolism. These adaptions allow growth in a nutrient-limited cerebral spinal fluid. In addition, we identified therapeutic drug targets that would inhibit growth of the parasite, potentially increase effectiveness of treatment, and shorten its duration.

Left gastric vein to adrenal vein anastomosis: intraoperative solution for gastric venous congestion following extended distal pancreatectomy.

Extended distal pancreatectomy often requires resection of vascular structures and adjacent organs, potentially leading to gastric venous congestion. This case report describes a 49-year-old female who underwent radical antegrade modular pancreatosplenectomy for pancreatic ductal adenocarcinoma. During the procedure, segmental gastric venous congestion was observed and resolved by anastomosing the left gastric vein to the left adrenal vein. The in-hospital postoperative recovery was initially uneventful; however, the patient was readmitted because of intra-abdominal fluid collection that was managed with antibiotics. Pathological examination confirmed moderately differentiated ductal adenocarcinoma with lymphovascular invasion. The patient received adjuvant mFOLFIRINOX therapy and remains disease-free 12 months after surgery with adequate patency of the anastomosis. This case highlights the importance of recognizing and addressing gastric venous congestion during radical antegrade modular pancreatosplenectomy to prevent complications, such as delayed gastric emptying or gastric necrosis, and proposes left gastric vein to left adrenal vein anastomosis as an effective intraoperative solution.

Postsurgical Outcomes of Mesial Temporal Lobe Epilepsy due to Hippocampal Sclerosis Associated with Calcified Neurocysticercosis.

The aim of this study was to analyze postsurgical outcomes for individuals with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) who underwent anterior temporal lobectomy, based on the presence of calcified neurocysticercosis (cNCC). A retrospective cross-sectional study was conducted on 89 patients with MTLE-HS who underwent anterior temporal lobectomy between January 2012 and December 2020 at a basic epilepsy surgery center located in Lima, Peru. We collected sociodemographic, clinical, and diagnostic information. The postsurgical results were analyzed using bivariate analysis according to the Engel classification. We included 89 individuals with a median age of 28 years (interquartile range [IQR]: 24-37), and more than half (55.1%) were male. Seventeen (19.1%) were diagnosed with cNCC. A greater number of patients with cNCC had lived in rural areas of Peru during their early life compared with those without cNCC (12 [70.6%] versus 26 [36.1%]; P = 0.010). Patients with cNCC exhibited a greater median frequency of focal to bilateral tonic-clonic seizures per month (1 [IQR: 0-2] versus 0 [0-0.5]; P = 0.009). Conversely, a lower proportion of patients with cNCC reported a history of an initial precipitating injury in comparison to the group without cNCC (4 [23.5%] versus 42 [58.3%]; P = 0.014). At the 1-year follow-up, most patients (82.4%) with cNCC were categorized as Engel IA. Similarly, at the 2-year follow-up, nine (75.0%) were classified as Engel IA. Our findings suggest that most patients diagnosed with cNCC exhibit favorable postsurgical outcomes, comparable to those without cNCC. Additionally, it can be postulated that cNCC may play a role as an initial precipitating injury.

Transclival endoscopic approach for prepontine cistern neurocysticercosis causing trigeminal neuralgia: illustrative case.

BACKGROUND: Neurocysticercosis (NCC) is a public health problem in most of the world. Approximately 50 million people worldwide experience this disease, and it remains one of the most important causes of neurological morbidity. Extraparenchymal NCC (basal cisterns) is associated with high rates of morbidity and mortality. Currently, minimally invasive approaches, including the endoscopic endonasal approach, are used with good functional results. OBSERVATIONS: A 25-year-old patient presented with headache and pain in the left hemiface. Magnetic resonance imaging (MRI) showed cystic lesions in the prepontine basal cisterns compressing and displacing the left trigeminal nerve. The cysticercal lesions were excised using a transclival endoscopic approach. There were no complications during surgery, and pathology confirmed the diagnosis of NCC. The pain subsided after surgery. No residual cysts were observed on control MRI. LESSONS: Minimally invasive approaches can be used to treat tumor and infectious problems of the skull base, as in this case, with good functional results. https://thejns.org/doi/10.3171/CASE24223.

Feeding practices and anthropometric classification of nutritional status in low-birth-weight infants at term. A prospective cohort study.

BACKGROUND: About 50 % of LBW occurs in term newborns, which is associated with higher infant mortality rates compared to infants of average birth weight. Analysis of feeding practices in at-risk groups is essential to address malnutrition and stunting in infancy. AIM: To identify feeding practices and anthropometric classification of nutritional status in a cohort of low-birth-weight term infants. METHODS: Methods: Cohort study. A prospective follow-up of 73 term newborns with low birth weight up to six months of age was performed. Feeding practices and anthropometric classification of nutritional were analysed. Data were processed by univariate analysis and multivariate linear regression. RESULTS: The most common feeding practice was exclusive breastfeeding. Breast milk substitutes are frequent in this population group. The risk of undernutrition ranged from 2.7 % to 19.2 % and of overweight from 4.1 % to 11.0 % during the first six months of life. Low height-for-age risk was the most frequent anthropometric classification during the follow-up period. Average head circumference was consistent in infants with low birth weight. Gestational risk classification, breastfeeding during the first hour of life, and sex of the newborn were predictors of variations in anthropometric indicators. CONCLUSIONS: Exclusive breastfeeding is the most common feeding practice in the population group studied, but using breast milk substitutes is also prevalent. Low height-for-age is the most frequent anthropometric classification. The weight growth rate seems reasonable, but further studies are needed based on gender differences, analysis of the composition of breast milk, and socio-environmental factors involved in growth.

Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries.

BACKGROUND: A progressive decrease in exclusive breastfeeding (BF) is observed in Latin America and the Caribbean compared with global results. The possibility of being breastfed and continuing BF for > 6 months is lower in low birth weight than in healthy-weight infants. AIM: To identify factors associated with BF maintenance and promotion, with particular attention to low- and middle-income countries, by studying geographic, socioeconomic, and individual or neonatal health factors. METHODS: A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States. The extracted data with common characteristics were synthesized and categorized into two main themes: (1) Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America; and (2) individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants. RESULTS: This study identified maternal age, educational level, maternal economic capacity, social stratum, exposure to BF substitutes, access to BF information, and quality of health services as mediators for maintaining BF. CONCLUSION: Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.

Functional EPAS1/HIF2A missense variant is associated with hematocrit in Andean highlanders.

Hypoxia-inducible factor pathway genes are linked to adaptation in both human and nonhuman highland species. EPAS1, a notable target of hypoxia adaptation, is associated with relatively lower hemoglobin concentration in Tibetans. We provide evidence for an association between an adaptive EPAS1 variant (rs570553380) and the same phenotype of relatively low hematocrit in Andean highlanders. This Andean-specific missense variant is present at a modest frequency in Andeans and absent in other human populations and vertebrate species except the coelacanth. CRISPR-base-edited human cells with this variant exhibit shifts in hypoxia-regulated gene expression, while metabolomic analyses reveal both genotype and phenotype associations and validation in a lowland population. Although this genocopy of relatively lower hematocrit in Andean highlanders parallels well-replicated findings in Tibetans, it likely involves distinct pathway responses based on a protein-coding versus noncoding variants, respectively. These findings illuminate how unique variants at EPAS1 contribute to the same phenotype in Tibetans and a subset of Andean highlanders despite distinct evolutionary trajectories.