Cirugía de salvamento de extremidad con endóprotesis tumoral de rodilla en un paciente con osteosarcoma ewing / Salvage surgery limb with knee tumor endoprosthesis in a patient with osteosarcoma ewing

La cirugía de salvamento de extremidad luego de la resección de sarcomas óseos ha demostrado mejoría en el resultado funcional de los pacientes y la sobrevida libre de enfermedad. El reemplazo total de la rodilla es una cirugía infrecuente. Este es el reporte del primer reemplazo total de rodilla con endoprótesis tumoral de rodilla en Bolivia. El sarcoma de Ewing es un tumor poco frecuente, de gran agresividad que puede aparecer en relación con otras lesiones óseas, de pronóstico infausto y supervivencias cortas. Para el tratamiento, actualmente se acepta que debe administrarse quimioterapia preoperatoria y favorecer la aparición de calcificaciones. La cirugía debe ser amplia; la contribución con la colaboración de este tipo de implantes, es que el paciente pudo sanar de su afección sin perder la funcionalidad del miembro afectado.

Limb salvage surgery after resection of bone sarcomas has shown improvement in the functional outcome of patients and disease-free survival. Total knee replacement is a rare surgery. This is the report of the first total knee replacement with tumor knee endoprosthesis in Bolivia. Ewing's sarcoma is a rare, highly aggressive tumor that can appear in relation to other bone lesions, with an unfortunate prognosis and short survivals. For treatment, it is currently accepted that preoperative chemotherapy should be administered and favor the appearance of calcifications. The surgery must be extensive.The contribution with the collaboration of this type of implants is that the patient was able to heal from his condition without losing the functionality of the affected limb.

Lic. María Elena Jiménez Arias (1948˗2021): artífice de la revista Medisan / Lic. María Elena Jiménez Arias (1948-2021): author of Medisan magazine

Con este artículo se desea honrar la memoria de la Lic. María Elena Jiménez Arias, fundadora del Centro Provincial de Información de Ciencias Médicas de Santiago de Cuba y artífice de la revista Medisan, quien, desde un profundo conocimiento de la lengua española y el amor por su profesión, se dedicó a revisar y mejorar estilísticamente documentos biomédicos de muy variada índole durante cuatro décadas. Asimismo, fue loable su interés y placer en enseñar a redactar y publicar sobre medicina y otras ciencias afines, lo cual le concedió un meritorio lugar en la comunidad de profesionales de la salud de esta provincia y en el grupo de editores científicos de toda Cuba.

With this work it is wanted to honor the memory of the Lic. María Elena Jiménez Arias, founder of the Information Provincial Center of Medical Sciences from Santiago de Cuba and author of Medisan magazine, who, from a deep knowledge of the Spanish language and the love for her profession, devoted her life to stylistically revise and improve biomedical documents of very varied nature during four decades. Also, her interest and pleasure in teaching how to edit and publish on medicine and other similar sciences was commendable, that granted her a meritorious place in the community of health professionals from this province and in the group of scientific editors of all Cuba.

Fecal Immunologic Test Results and Diagnostic Colonoscopy in a Mexican Population at Average Risk for Colorectal Cancer.

Colorectal cancer is preventable and treatable by screening and early detection. Fecal immunochemical tests (FIT) for average risk individuals is an effective strategy for screening. Incidence and mortality in Mexico is increasing and large-scale screening programs do not yet exist. The aim of this study was to evaluate the feasibility of FIT-based colorectal cancer screening program in Mexico City. For more than 15 months, average risk individuals in Mexico City were invited to participate at Mexico's Instituto Nacional de Cancerologia (INCan, Mexico City, Mexico). Participants received an FIT kit for stool collection, results ≥20 ng/mL were referred for high quality colonoscopy. Participants' results were classified according to the most advanced clinical finding as: adenocarcinoma, high-risk adenomas, low-risk adenomas, serrated lesions, hyperplastic polyps, and no polyps. Sequential analyses were performed to assess the positive predictive value (PPV) of FIT. A total of 810 participants were eligible, 737 (91.0%) returned the FIT and 112 (15.2%) had an abnormal result. Of these participants, 87 (77.7%) completed colonoscopy. Clinical findings of participants included: seven (8.1%) adenocarcinomas, 18 (20.7%) high-risk adenomas, 23 (26.4%) low-risk adenomas, one (1.2%) serrated lesions, 14 (16.1%) hyperplasic polyps, and 24 (27.6%) no polyps. The PPV of FIT using the ≥20 ng/mL was 8.1% for cancer and 20.7% for high-risk adenomas. In conclusion, colorectal cancer screening with FIT is feasible at INCan in Mexico City, where resources are available. Further studies are needed to determine feasibility of colorectal cancer screening in other settings, as well as optimal hemoglobin detection cut-off points to maximize the population benefits of colorectal cancer screening with FIT in Mexico.

La desigualdad en Colombia no cede / Inequality in Colombia does not yield

Aunque los datos están disponibles, en el país no ha habido un análisis de la distribución del ingreso en las ciudades, que podría ofrecer elementos de política pública para que los alcaldes identifiquen cuáles son los mejores caminos para reducir la desigualdad. Investigación de la URosario comienza ese camino.

Although the data are available, in the country there has not been an analysis of the distribution of income in the cities, which could offer elements of public policy for mayors to identify the best ways to reduce inequality. URosario research begins that path.

Narcoestética, la capa superficial de un problema complejo / Narco-aesthetics, the surface layer of a complex problem

El flagelo del narcotráfico ha marcado a países como Colombia y México, tal vez mucho más que a cualquier otro de América Latina o del mundo. Sus efectos, en términos de violencia, inseguridad en las calles y atentados, sumados a los impactos económicos, sociales y culturales, han dejado una huella muy difícil de borrar en las personas, comunidades, ciudades y naciones que tuvieron y tienen que seguir lidiando con una problemática que se resiste a desaparecer, y menos cuando la demanda de drogas en el ámbito mundial continúa siendo muy alta. Juan Pablo Aschner, decano de la facultad de Creación de la Universidad del Rosario, quiso abordar este tema desde hace unos años, pero con una mirada diferente, relacionada con el espacio en el que se desarrolla esta modalidad ilícita.

The scourge of drug trafficking has marked countries like Colombia and Mexico, perhaps much more than any other in Latin America or the world. Its effects, in terms of violence, insecurity in the streets and attacks, added to the economic, social and cultural impacts, have left a very difficult mark to erase on the people, communities, cities and nations that had and have to continue to deal with a problem that refuses to disappear, especially when the demand for drugs in the world continues to be very high. Juan Pablo Aschner, dean of the Faculty of Creation at the Universidad del Rosario, wanted to address this issue for a few years, but with a different perspective, related to the space in which this illicit modality takes place.

La legislación para regular los cigarrillos electrónicos no da espera / Legislation to regulate electronic cigarettes does not wait

Aunque en Colombia cursan dos proyectos de ley que abordan esta problemática, todavía falta mucho para frenar este fenómeno de alta prevalencia. Dos profesores de la Facultad de Economía de la Universidad del Rosario siguen los pasos a las discusiones que se dan en Colombia y el mundo. La conclusión: debe tomarse el marco que existe para consumo y venta de tabaco.

Although there are two bills in Colombia that address this problem, there is still a long way to go to stop this highly prevalent phenomenon. Two professors from the Faculty of Economics of the Universidad del Rosario follow in the footsteps of the discussions taking place in Colombia and the world. The conclusion: the framework that exists for the consumption and sale of tobacco must be taken.

Proponen mecanismo para reactivar el agro y dignificar al campesino / They propose a mechanism to reactivate agriculture and dignify the peasant

Cuando se iniciaron las negociaciones del proceso de paz, uno de los puntos álgidos en las discusiones fue la reforma rural. Quedó convenido que esta fuera integral, pero aún no se tiene claridad de cómo lograr ese cometido. Los investigadores Tatiana Oñate Acosta, Luisa Fernanda García y Francisco Ternera, profesores de la Facultad de Jurisprudencia de la Universidad del Rosario, tienen algunas ideas para conseguirlo. Tras analizar las diferentes aristas en el grupo de Derecho Privado de la Facultad de Jurisprudencia y llevar varios años estudiando los temas que están vinculados con la propiedad y, particularmente, a la propiedad estatal, consideran que la respuesta está en la figura del Derecho llamada enfiteusis, derecho real que consiste en dar la propiedad de un predio a una persona y la posibilidad de sacar provecho económico de esta a un tercero, con la obligación de cancelar una renta anual.

When the peace process negotiations began, one of the high points in the discussions was rural reform. It was agreed that this would be comprehensive, but it is still not clear how to achieve this task. Researchers Tatiana Oñate Acosta, Luisa Fernanda García and Francisco Ternera, professors at the Faculty of Jurisprudence of the Universidad del Rosario, have some ideas to achieve this. After analyzing the different edges in the Private Law group of the Faculty of Jurisprudence and having spent several years studying the issues that are linked to property and, particularly, to state property, they consider that the answer lies in the figure of Law called emphyteusis , real right that consists of giving the property of a property to a person and the possibility of taking economic advantage of this to a third party, with the obligation to cancel an annual rent.

En China y América Latina, las redes de investigación de universidades aportan a la innovación / In China and Latin America, university research networks contribute to innovation

En China, los estudios que realizan las universidades, especialmente las públicas, forman parte de los elementos a los que acuden las autoridades para formular políticas nacionales y regionales en ciencia, tecnología e innovación. En Latinoamérica (Latam), una región que integra veinte países, la mayor producción científica también la tienen las universidades públicas, y Brasil es el que lleva el liderazgo. Sin embargo, a diferencia de China, los resultados no tienen la misma consideración en asuntos públicos y el volumen de investigaciones no es tan alto.

In China, the studies carried out by universities, especially public ones, are part of the elements used by the authorities to formulate national and regional policies in science, technology and innovation. In Latin America (Latam), a region that integrates twenty countries, the largest scientific production is also held by public universities, and Brazil is the one that leads. However, unlike China, the results do not have the same consideration in public affairs and the volume of investigations is not as high.

El raro caso de una joven con colitis ulcerativa crónica inespecífica grave y atrofia cerebral / The rare case of a young girl with ulcerative colitis and cerebral atrophy

Resumen La enfermedad inflamatoria intestinal es un grupo de enfermedades caracterizadas por inflamación crónica gastrointestinal y en ocasiones con repercusión extraintestinal. Las manifestaciones neurológicas y psiquiátricas corresponden a menos de 3%. Se comunica el caso de una mujer joven con colitis ulcerativa y atrofia cerebral como inicio.

Abstract Inflammatory bowel disease is a group of diseases characterized by chronic gastrointestinal inflammation and occasionally with extraintestinal repercussion. The neurological and psychiatric manifestations correspond to less than 3%. This paper reports the case of a young woman with ulcerative colitis and cerebral atrophy as debut.

[Characteristics of chronic obstructive pulmonary disease due to tobacco consumption in pneumology patients in lima and callao]. / Características de enfermedad pulmonar obstructiva crónica por consumo de tabaco en pacientes de servicios de neumología de Lima y Callao.

The aim of the study was to describe the clinical characteristics of patients with COPD receiving treatment at the pneumology units of specialized care centers in Lima and Callao. A cross-sectional study was performed on 196 patients, with a mean age of 69 years, interquartile range of 63-75 years. Of these patients, 31.1% was classified in the GOLD 1/ mild group (FEV1 ≥80%); 41.8% in the GOLD 2/moderate group (50%≤FEV1<80%); 22.5% in the GOLD 3/severe group (30%≤FEV1<50%), and 4.6% in the GOLD 4/very severe group (FEV1 <30%). A 93.9% of patients used some type of medication for COPD. The most-frequently used therapy was the combination of long-acting beta agonists and inhaled corticosteroids (LABA/ICS) (31.1%). A preliminary characterization has been obtained for COPD patients treated in these centers, but it is essential to complement these findings with longitudinal studies.

El objetivo del estudio fue describir las características clínicas de pacientes con enfermedad pulmonar obstructiva crónica (EPOC), atendidos en los servicios de Neumología de centros especializados de Lima y Callao. Se realizó un estudio transversal en 196 pacientes, con una mediana de edad de 69 años, rango intercuartil 63-75 años. El 31,1 % de los pacientes se encontró en el grupo GOLD 1/leve (VEF1 ≥80 %), el 41,8 % en el grupo GOLD 2/moderado (50 %≤VEF1<80 %), el 22,5 % en el grupo GOLD 3/severo (30 %≤VEF1<50 %), y el 4,6 % en el grupo GOLD 4/muy severo (VEF1 <30 %). El 93,9 % usaba algún tipo de medicación para EPOC, la terapia más usada fue la combinación de beta agonistas de acción larga/corticoides inhalados (LABA/ICS) con 31,1 %. Se ha obtenido una primera caracterización de pacientes con EPOC atendidos en estos centros. Es imprescindible complementar lo encontrado con estudios longitudinales.

[Divertículo de Meckel con tejido pancreático ectópico en un niño de 12 años con invaginación intestinal. Reporte de caso y revisión de la literatura]. / Meckel diverticulum with ectopic pancreatic tissue in a 12-year-old boy with intestinal invagination. Case report and review of the literature.

INTRODUCCIÓN: El divertículo de Meckel es un remanente del conducto onfalomesentérico y su prevalencia es del 2%. CASO CLÍNICO: Niño de 12 años con dolor abdominal, acompañado de evacuaciones mucosanguinolentas y hematemesis, con masa en cuadrante inferior derecho. En la laparotomía quirúrgica se encontró invaginación, y se realizó desinvaginación y resección del divertículo de Meckel. CONCLUSIÓN: La asociación de divertículo de Meckel con tejido pancreático heterotópico en niños es poco frecuente. Clínicamente, su principal manifestación es la invaginación intestinal en la literatura revisada, y el ultrasonido constituye el mejor estudio para el diagnóstico de invaginación intestinal, no así para el divertículo de Meckel o el tejido pancreático heterotópico, en los que la tomografía sería una opción. INTRODUCTION: Meckel's diverticulum is a remnant of the omphalomesenteric duct and its prevalence is 2%. CLINICAL CASE: A 12-year-old male with abdominal pain, accompanied by muco-sanguineous evacuations and hematemesis, with right lower quadrant mass. In the laparotomy, invasion was found; intussusception reduction and resection of the Meckel's diverticulum was performed. CONCLUSION: The association of Meckel's diverticulum with heterotopic pancreatic tissue in children is rare, its main manifestation is intussusception and ultrasound is an option for diagnosis.

Características de enfermedad pulmonar obstructiva crónica por consumo de tabaco en pacientes de servicios de neumología de Lima y Callao / Characteristics of chronic obstructive pulmonary disease due to tobacco consumption in pneumology patients in lima and callao

RESUMEN El objetivo del estudio fue describir las características clínicas de pacientes con enfermedad pulmonar obstructiva crónica (EPOC), atendidos en los servicios de Neumología de centros especializados de Lima y Callao. Se realizó un estudio transversal en 196 pacientes, con una mediana de edad de 69 años, rango intercuartil 63-75 años. El 31,1 % de los pacientes se encontró en el grupo GOLD 1/leve (VEF1 ≥80 %), el 41,8 % en el grupo GOLD 2/moderado (50 %≤VEF1<80 %), el 22,5 % en el grupo GOLD 3/severo (30 %≤VEF1<50 %), y el 4,6 % en el grupo GOLD 4/muy severo (VEF1 <30 %). El 93,9 % usaba algún tipo de medicación para EPOC, la terapia más usada fue la combinación de beta agonistas de acción larga/corticoides inhalados (LABA/ICS) con 31,1 %. Se ha obtenido una primera caracterización de pacientes con EPOC atendidos en estos centros. Es imprescindible complementar lo encontrado con estudios longitudinales.

ABSTRACT The aim of the study was to describe the clinical characteristics of patients with COPD receiving treatment at the pneumology units of specialized care centers in Lima and Callao. A cross-sectional study was performed on 196 patients, with a mean age of 69 years, interquartile range of 63-75 years. Of these patients, 31.1% was classified in the GOLD 1/ mild group (FEV1 ≥80%); 41.8% in the GOLD 2/moderate group (50%≤FEV1<80%); 22.5% in the GOLD 3/severe group (30%≤FEV1<50%), and 4.6% in the GOLD 4/very severe group (FEV1 <30%). A 93.9% of patients used some type of medication for COPD. The most-frequently used therapy was the combination of long-acting beta agonists and inhaled corticosteroids (LABA/ICS) (31.1%). A preliminary characterization has been obtained for COPD patients treated in these centers, but it is essential to complement these findings with longitudinal studies.

Efficacy of a New Recrystallized Enrofloxacin Hydrochloride-Dihydrate against Leptospirosis in a Hamster Model.

A trial on Syrian hamsters (Mesocricetus auratus) infected with Leptospira interrogans serovar Canicola was established to compare treatment efficacies of daily intramuscular (i.m.) injections of either 10 mg/kg of 5% enrofloxacin (Baytril [BE]; Bayer Animal Health, Mexico) or the same dose of enrofloxacin hydrochloride-dihydrate (enro-C). Hamsters were experimentally infected via the oral submucosa with 400 microorganisms/animal, in a sequential time schedule aligned to the initial treatment day, and were treated in groups as follows: a group treated with 5% enrofloxacin daily for 7 days after 24 h of infection (group BE24); a group treated as described for group BE24 but with enro-C (enro-C24); a group also treated with 5% enrofloxacin but starting at 72 h after infection (BE74); a group treated as described for group BE74 but with injection of enro-C (enro-C74). An untreated-uninfected control group (group CG-) and an infected-untreated control group (group CG+) were assembled (n = 18 in all groups). Weights and temperatures of the hamsters were monitored daily for 28 days. After hamsters were euthanatized or following death, necropsy, histopathology, macroscopic agglutination tests (MAT), bacterial culture, and PCR were performed. The mortality rates were 38.8% in group BE24 and 100% in group BE74 No mortality was observed in group enro-C24, and 11.1% mortality was recorded in group enro-C74 The mortality rates in groups CG+ and CG- were 100% and zero, respectively. Combined necropsy and histopathologic findings revealed signs of septicemia and organ damage in groups BE24, BE72, and CG+ Groups enro-C24 and CG- showed no lesions. Moderated lesions were registered in 3 hamsters in group enro-C72 MAT results were positive in 83.3% of BE24 hamsters (83.3%) and 100% of BE72 and CG+ hamsters; MAT results were positive in 16.7% in group Enro-C24 and 38.9% in group enro-C72 Only 4/18 were PCR positive in group enro-C72 and only 1 in group enro-C24 (P < 0.05). It can be concluded that enro-C may be a viable option to treat leptospirosis in hamsters and that this may be the case in other species.

[Letal endocarditis due to Corynebacterium pseudodiphtheriticum]. / Endocarditis infecciosa fatal por Corynebacterium pseudodiphtheriticum.

We present a case report of a infective endocarditis by Corynebacterium pseudodiphtheriticum in a young patient eight years old with bicuspid aortic valve that led to a severe neurological embolism and death. Corynebacterium pseudodiphtheriticum is part of the nasopharyngeal and skin flora. However, there are cases reported of endocarditis usually associated with immunocompromised patients that mostly presented a poor clinical outcome.

Endocarditis infecciosa fatal por Corynebacterium pseudodiphtheriticum / Letal endocarditis due to Corynebacterium pseudodiphtheriticum

We present a case report of a infective endocarditis by Corynebacterium pseudodiphtheriticum in a young patient eight years old with bicuspid aortic valve that led to a severe neurological embolism and death. Corynebacterium pseudodiphtheriticum is part of the nasopharyngeal and skin flora. However, there are cases reported of endocarditis usually associated with immunocompromised patients that mostly presented a poor clinical outcome.

Se presenta el caso clínico de una endocarditis infecciosa por Corynebacterium pseudodiphtheriticum en un niño de 8 años, portador de una valvulopatía aórtica bicúspide, que falleció por una embolia cerebral grave. Corynebacterium pseudodiphtheriticum forma parte de la microbiota de la piel y nasofaringe. Sin embargo, se han descrito casos de endocarditis en pacientes inmunocomprometidos, asociados, en su mayoría, a una mala evolución clínica.

Management of extreme ametropia after penetrating keratoplasty: a series of surgical procedures for high myopia and astigmatism.

A series of surgical interventions - relaxing corneal incisions, intraocular lens, and intrastromal rings - were used to correct a case of extreme ametropia in a thin cornea after a penetrating keratoplasty in an 18-year-old patient who presented with a -10.25 -8.50 × 120 preoperative refraction and 20/200 best-corrected visual acuity (BCVA). After a series of surgical procedures, the patient's BCVA in his left eye improved to 20/30 with +0.50 -1.00 × 170, the slit lamp examination showed no significant findings, and the patient's visual complaints disappeared. At the 1-year follow-up, the BCVA was 20/25, without visual complaints. The process of individualizing the surgical procedure in the present case was employed in an outcome-based approach, that is, the next surgical procedure was defined after the surgery and postoperative evaluation. The patient did not present complications during the follow-up period of 2.5 years.

Hernia diafragmática de Bochdalek a propósito de un caso y revisión de literatura / Diafragmatica of Bochdalek to hernia purpose of a case anmd review of literature

Es una patología neonatal por persistencia del canal pleuroperitoneal ó la agenesia total ó parcial del diafragma con introducción de las vísceras abdominales: (estómago, intestino delgado y grueso, incluso bazo, riñón y páncreas) en el tórax, asociado a una hipoplasia pulmonar uni o bilateral. Este defecto ocurre entre la octava y décima semana de la vida fetal (7) su inocencia en de 1:2000 a 5000, con mayor incidencia en el sexo masculino, y de causa no establecida. En un 40 û 50 por ciento de los casos (1) se asocian malformaciones congénitas como son: defectos cardíacos (conducto arterioso permeable, tetralogía de Fallot) e hipoplasia pulmonar y/o secuestro pulmonar, por disminución del desarrollo debido a la ocupación por vísceras abdominales.

It is a neonatal pathology due to pleuroperitoneal duct persistency or the total or partial diaphragm agenesis with abdominal organs introduction (stomach, small and large intestines, and even the spleen, kidney and pancreas) into the thorax, associated to an unilateral or bilateral lung hipoplasia. This defect occurs between the 8 th and 10 th weeks of fetal life; its incidence is 1:2000 to 5000 newborns; there is prevalent in male sex, of non-established cause. In a 40-50 percent of cases, congenital malformation such as: heart defects (persistency of artheriosus duct, tetralogy of Fallot) and ipsicontralateral lung hipoplasia or pulmonary secuestrum, due to decrease in its development due to abdominal visceral occupation.

Influenza por H1N1 con neumonia complicada en niño de 1 año / H1N1 influenza and complicated pnuemonia in a boy of one year old

Reportamos el caso de una paciente con influenza H1N1 y neumonía complicada con empiema, que ingresa con Dx de Síndrome doloroso abdominal, con exámenes auxiliares nos orientamos al diagnóstico final, se le dio tratamiento para influenza además de tratamiento antibiótico y videotoracoscopia mas decorticación y drenaje para el empiema agregado, la evolución fue favorable. El rol del procedimiento videotoracoscopia endoscópica es especialmente importante en el diagnóstico y localización de la efusión pleural con tabicaciones.

We report a pediatric case of influenza H1N1 and complicated pneumonia with enphiema, respiratory symptoms with feeding, he was diagnosed with abdominal pain syndrome but with the final exams we find the correct diagnosis. We give him the treatment for influenza H1N1 and the antibiotics; the videothoracoscospy procedure and decortications and drainage for the enphiema, the evolution was favorable. The videothoracoscospy procedure is very important in the diagnosis and localization of the pleural effusion and tabications.