Caracterización histológica del melanoma cutáneo en reportes de patología en la ciudad de Cali, 2016-2021 / Histological characterization of cutaneous melanoma in pathology reports in the city of Cali, 2016-2021

Introducción. El melanoma es la proliferación maligna de melanocitos asociado a un comportamiento agresivo. El objetivo de este estudio fue determinar las variables histológicas del melanoma cutáneo. Métodos. Estudio observacional retrospectivo, transversal descriptivo, realizado con reportes de patologías de pacientes con diagnóstico de melanoma cutáneo en un laboratorio de patología en Cali, Colombia, entre 2016-2021. Se incluyeron las variables edad, sexo, localización, subtipo, espesor de Breslow, ulceración, márgenes, mitosis, invasión linfovascular, neurotrofismo, regresión tumoral, nivel de Clark e infiltración tumoral por linfocitos. Resultados. Se obtuvieron 106 reportes y fueron excluidos 54 por duplicación. Se incluyeron 52 registros, la media de edad fue de 61 años, con una mayor frecuencia de mujeres (55,8 %). De los 33 casos donde se especificó el subtipo histológico, el más frecuente fue el de extensión superficial (66,6 %), seguido del acral lentiginoso (18,1 %) y nodular con (15,2 %). La localización más frecuente fue en extremidades (61,5 %). El espesor de Breslow más común fue IV (34,6 %) y el nivel de Clark más frecuente fue IV (34,6 %). La ulceración estuvo en el 40,4 %. El subtipo nodular fue el de presentación más agresiva, donde el 100 % presentaron espesor de Breslow IV. Conclusiones. El subtipo de melanoma más común en nuestra población fue el de extensión superficial; el segundo en frecuencia fue el subtipo acral lentiginoso, que se localizó siempre en extremidades. Más del 50 % de los melanomas tenían espesor de Breslow mayor o igual a III, lo que impacta en el pronóstico.

Background. Melanoma is the malignant proliferation of melanocytes associated with aggressive behavior. The objective of this study was to determine the histological variables of cutaneous melanoma. Methods. Observational, cross-sectional, descriptive, retrospective study carried out with reports of pathologies with a diagnosis of cutaneous melanoma in a pathology laboratory in Cali between 2016-2021. The variables were age, sex, location, subtype, Breslow thickness, ulceration, margins, mitosis, lymphovascular invasion, neurotropism, tumoral regression, Clark level and tumor infiltration by lymphocytes. Results. One hundred and six reports were obtained and 54 were excluded due to duplication. A descriptive analysis was made on the 52 records that were included, the mean age was 61 years, with a higher frequency in women with 55.8%. Of the 33 cases where the histological subtype was specified, the most frequent was superficial extension with 66.6%, followed by acral lentiginous with 18.1% and nodular with 15.2%. The most frequent location was in the extremities (61.5%); the most common Breslow was IV (34.6%), and the most frequent Clark was IV (34.6%). Ulceration was in 40.4%. The nodular subtype was the most aggressive presentation where 100% presented Breslow IV. Conclusions. The most common subtype of melanoma was that of superficial extension. In our population, the second most frequent was the acral lentiginous subtype, which was always located on the extremities. More than 50% of the melanomas had Breslow greater than or equal to III, which affects the prognosis.

Caracterización de consorcios microbianos lixiviantes de sulfuro de cobre aislados de drenajes ácidos de minas altoandinas

La biolixiviación, usando consorcios microbianos, es considera una alternativa ecoeficiente y de bajo costo para la recuperación de metales a partir de minerales de baja ley. En este estudio, se realizó la caracterización fisiológica y molecular de consorcios microbianos psicrotolerantes lixiviantes (CMPL), aislados de drenajes ácidos de minas de cuatro localidades mineras de las provincias de Pasco y Huarochirí, Perú, ubicados sobre los 4200 m de altitud. Se aislaron seis consorcios adaptados a medio 9K con ion ferroso y medio basal 9K con CuS al 0.5% p/v a 15 °C. Se evidenció la liberación de cobre en todos los consorcios. El CMPL con mejor crecimiento, presentó una recuperación de cobre de 12.47% en 30 días de evaluación. Los análisis de la secuenciación del gen ARNr 16S de la comunidad bacteriana, mostraron que los CMPL están dominados por el género Acidithiobacillus, seguido de Acidiphilium. En conclusión, se obtuvieron consorcios que pueden ser aplicados en biolixiviación de cobre en la minería altoandina.

Bioleaching, using microbial consortia, is regarded as an eco-efficient and cost-effective alternative for the recovery of metals from low-grade ores. In this study, we conducted physiological and molecular characterization of psychrotolerant leaching microbial consortia (PLMC) isolated from acid mine drainage in four mining sites within the Pasco and Huarochirí provinces of Peru, situated at altitudes above 4200 meters. Six consortia adapted to a medium containing ferrous ions (9K medium) and a basal medium with 0.5% w/v CuS at 15°C were isolated. All consortia exhibited copper release. The PLMC with the most robust growth achieved a copper recovery of 12.47% within 30 days of evaluation. 16S rRNA gene sequencing analysis of the bacterial community revealed that the PLMCs were predominantly dominated by the genus Acidithiobacillus, followed by Acidiphilium. In conclusion, consortia suitable for copper biolixiviation in high-altitude mining contexts were successfully obtained.

Mortality and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) associated with covid-19 in critically ill patients: an observational multicenter study (MISCO study).

BACKGROUND: The clinical presentation and severity of Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C) is widespread and presents a very low mortality rate in high-income countries. This research describes the clinical characteristics of MIS-C in critically ill children in middle-income countries and the factors associated with the rate of mortality and patients with critical outcomes. METHODS: An observational cohort study was conducted in 14 pediatric intensive care units (PICUs) in Colombia between April 01, 2020, and January 31, 2021. Patient age ranged between one month and 18 years, and each patient met the requirements set forth by the World Health Organization (WHO) for MIS-C. RESULTS: There were seventy-eight children in this study. The median age was seven years (IQR 1-11), 18 % (14/78) were under one year old, and 56 % were male. 35 % of patients (29/78) were obese or overweight. The PICU stay per individual was six days (IQR 4-7), and 100 % had a fever upon arrival to the clinic lasting at least five days (IQR 3.7-6). 70 % (55/78) of patients had diarrhea, and 87 % (68/78) had shock or systolic myocardial dysfunction (78 %). Coronary aneurysms were found in 35 % (27/78) of cases, and pericardial effusion was found in 36 %. When compared to existing data in high-income countries, there was a higher mortality rate observed (9 % vs. 1.8 %; p=0.001). When assessing the group of patients that did not survive, a higher frequency of ferritin levels was found, above 500 ngr/mL (100 % vs. 45 %; p=0.012), as well as more cardiovascular complications (100 % vs. 54 %; p = 0.019) when compared to the group that survived. The main treatments received were immunoglobulin (91 %), vasoactive support (76 %), steroids (70.5 %) and antiplatelets (44 %). CONCLUSIONS: Multisystem Inflammatory Syndrome in Children due to SARS-CoV-2 in critically ill children living in a middle-income country has some clinical, laboratory, and echocardiographic characteristics similar to those described in high-income countries. The observed inflammatory response and cardiovascular involvement were conditions that, added to the later presentation, may explain the higher mortality seen in these children.

Clarification Processes of Orange Prickly Pear Juice (Opuntia spp.) by Microfiltration.

In this study, fresh orange prickly pear juice (Opuntia spp.) was clarified by a cross-flow microfiltration (MF) process on a laboratory scale. The viability of the process-in terms of productivity (permeate flux of 77.80 L/h) and the rejection of selected membranes towards specific compounds-was analyzed. The quality of the clarified juice was also analyzed for total antioxidants (TEAC), betalains content (mg/100 g wet base), turbidity (NTU) and colorimetry parameters (L, a*, b*, Croma and H). The MF process permitted an excellent level of clarification, reducing the suspended solids and turbidity of the fresh juice. In the clarified juice, a decrease in total antioxidants (2.03 TEAC) and betalains content (4.54 mg/100 g wet basis) was observed as compared to the fresh juice. Furthermore, there were significant changes in color properties due to the effects of the L, a*, b*, C and h° values after removal of turbidity of the juice. The turbidity also decreased (from 164.33 to 0.37 NTU).

Systematic Review of Microthrombi in COVID-19 Autopsies.

BACKGROUND: Histopathological analysis can provide additional clues in COVID-19 understanding. During the last year, autopsy reports have revealed that diffuse alveolar damage (DAD) is the most significant observed finding. The aim of this study is to review cases in the literature about COVID-19 autopsies that reported microthrombi in different organs. METHODS: We performed a systematic literature review in PubMed, Virtual Health Library (VHL), and Google Scholar. RESULTS: In total, 151 autopsies were included, and 91 cases presented microthrombi in the lung (73%), heart (11.2%), kidney (24%), and liver (16.3%). The age range was between 27 and 96 years. Males were 64.8%. The patients with microthrombi had more comorbidities such as arterial hypertension (62%), obesity or overweight (64%), diabetes mellitus type 2 (51%), and heart disease (53%). The most common histopathological changes found in patients with lung microthrombosis were DAD in exudative phase (78%), pulmonary embolism (59%), and lung infarct (81%). Presence of microthrombi was associated with arterial hypertension (p < 0.0001) and DAD in exudative and proliferative phases (p = 0.02). DISCUSSION: The analysis of these results shows that microthrombi in COVID-19 autopsies may be found in different organs and are more frequent in patients with comorbidities, pulmonary embolism, and lung infarct.

Fifth-Generation (5G) mmWave Spatial Channel Characterization for Urban Environments' System Analysis.

In this work, the channel characterization in terms of large-scale propagation, small-scale propagation, statistical and interference analysis of Fifth-Generation (5G) Millimeter Wave (mmWave) bands for wireless networks for 28, 30 and 60 GHz is presented in both an outdoor urban complex scenario and an indoor scenario, in order to consider a multi-functional, large node-density 5G network operation. An in-house deterministic Three-Dimensional Ray-Launching (3D-RL) code has been used for that purpose, considering all the material properties of the obstacles within the scenario at the frequency under analysis, with the aid of purpose-specific implemented mmWave simulation modules. Different beamforming radiation patterns of the transmitter antenna have been considered, emulating a 5G system operation. Spatial interference analysis as well as time domain characteristics have been retrieved as a function of node location and configuration.

Cuidado peri-operatorio integral centrado en el paciente: un paso más hacia la ampliación de los horizontes de la anestesiología / Comprehensive patient-centered perioperative care: another step towards expanding horizons in anesthesiology

Abstract We must change the current perioperative care model and expand the horizons of our specialty, as the results are unsatisfactory, health systems are unviable, and an imminent crisis is predicted. Although the contributions made by anesthetists have improved the safety of care and have contributed to increase the life expectancy and the quality of life of the population, it is necessary to adopt a comprehensive, patient-centered care model. This involves adapting to new settings of clinical practice, extending anesthetist intervention times, and rethinking the professional competencies that must be demonstrated by those who will practice in the near future. Therefore, we must identify our training deficiencies and start working immediately on overcoming them. The objective of this article is to reflect on the problems of the current model, the solutions proposed by the new models and the successes, difficulties, and opportunities that have been observed during its implementation.

Resumen Debemos cambiar el modelo de atención perioperatoria actual y ampliar los horizontes de nuestra especialidad, porque los resultados son insatisfactorios, los sistemas sanitarios son inviables y se predice una crisis inminente. A pesar de que los aportes hechos por los anestesiólogos han mejorado la seguridad de la atención y han contribuido a incrementar la calidad y la duración de la vida de la población, se hace necesario adoptar un modelo integral, centrado en el paciente, que implica adaptarse a nuevos escenarios de práctica clínica, ampliar los tiempos de intervención del anestesiólogo y replantear las competencias profesionales que deben demostrar quienes ejercerán en un futuro próximo. Por ello, debemos identificar nuestras deficiencias formativas y empezar de inmediato a superarlas. El objetivo de este artículo es hacer una reflexión sobre los problemas del modelo actual, las soluciones propuestas por los nuevos modelos y los aciertos, dificultades y oportunidades que se han observado durante su implementación.

A preliminary survey of Trichinella spp. in pigs raised under controlled housing conditions in Colombia: 2014-2016.

A preliminary survey of Trichinella spp. infection was conducted in Colombian swine herds between 2014 and 2016. A total of 1,773 pigs reared on farms under controlled housing conditions and processed in 34 slaughterhouses were tested either by the artificial digestion of pooled muscle samples (n = 1,173) or by serology (n = 600). In addition, 550 rats trapped on 29 swine farm premises were also tested by artificial digestion. No positive pig samples were detected. Similarly, no Trichinella spp. muscle larvae were detected in rats. These results are in agreement with the lack of historical Trichinella infection reports in domestic and wild animals and humans in Colombia. However, a more extensive epidemiological investigation and a continuous surveillance program are needed to continue declaring swine herds in Colombia free of Trichinella infection.

Método clínico en la detección de la enfermedad de Paget de la mama en cuidado primario / Clinical method for detecting Paget disease of the breast in primary care

La enfermedad de Paget de la mama es una manifestación cutánea infrecuente de cáncer de mama que tiene mejor pronóstico cuando se detecta de manera temprana. Se presenta el caso de una mujer de 56 años, que asistió a consulta en cuidado primario en la ciudad de Cali para la evaluación del resultado de una citología cervicouterina. Se le realizó examen mamario preventivo y se encontró una lesión en areola-pezón de características eritematodescamativas de dos años de evolución. Los estudios anatomopatológicos y de inmunotipificación confirmaron enfermedad de Paget. El reporte histológico de la pieza quirúrgica extraída durante la cuadrantectomía con resección del complejo areola-pezón, diagnosticó un carcinoma intraductal subyacente. La utilización del método clínico en cuidado primario, en una paciente sin lesión palpable y con mamografías negativas para malignidad, fue la clave del éxito en la detección temprana y recuperación de la paciente que ha evolucionado de manera favorable. (Acta Med Colomb 2013; 38: 277-281).

Paget's disease of the breast is a rare cutaneous manifestation of breast cancer which has a better prognosis when detected early. We report the case of a 56 year-old woman who attended consultation in primary care in the city of Cali to evaluate the result of uterine cervical cytology. She underwent preventive breast exam and a descamative erythematous nipple-areola lesion of two years of evolution was found. Pathological and immunotyping studies confirmed Paget's disease. The histological report of the surgical specimen removed during lumpectomy with resection of the nipple-areola complex, diagnosed an underlying intraductal carcinoma. The use of the clinical method in primary care in a patient without palpable lesion and malignancy negative mammograms, was the key to success in early detection and recovery of the patient who has performed well. (Acta Med Colomb 2013; 38: 277-281).

Estabilidad enzoótica de babesiosis bovina en la región de Puerto Berrío, Colombia / Enzootic Stability of Bovine Babesiosis at Puerto Berrio Region, Colombia

En Colombia, la industria ganadera representa el tercer renglón de importancia económica después de la explotación petrolera y la agricultura. Este recurso económico se encuentra afectado por enfermedades hemoparasitarias como la babesiosis bovina. Su transmisión se encuentra determinada por la relación vector-parásito- hospedador y está condicionada por factores bióticos y abióticos. El estado de equilibrio entre el proceso infeccioso y la adquisición de inmunidad por parte de los hospedadores bovinos es conocido como estabilidad enzoótica. Para la determinación de la estabilidad enzoótica en la babesiosis bovina se ha utilizado como indicador anticuerpos tipo IgG específicos para cada especie de Babesia en bovinos entre 3 y 9 meses de edad. Así, una zona es estable para babesiosis cuando al menos 75% de los bovinos entre 3 y 9 meses de edad son serorreactivos para Babesia spp. Se diseñó un estudio descriptivo prospectivo de corte transversal, con una n de 282 bovinos, para evaluar el nivel de estabilidad enzoótica en nueve hatos ganaderos de la región de Puerto Berrío, a través de un muestreo probabilístico aleatorio simple, estratificado por género y pareado por edad. Se utilizó la técnica de inmunofluorescencia indirecta (IFI) para la detección de anticuerpos tipo IgG específicos contra Babesia bovis y Babesia bigemina. Se obtuvo un nivel de serorreactividad por hato para B. bovis superior al 75% en la población estudiada en cuatro de los nueve hatos. En los hatos con estabilidad enzoótica se encontró una relación positiva entre la frecuencia del tratamiento garrapaticida y la serorreactividad. En particular, cuando la frecuencia de baños es de 90 días o más, el nivel de serorreactividad es el doble frente a la frecuencia de baños de 60 días o menos.

In Colombia, cattle industry is the third level of economic importance after oil and agriculture exploitation systems. This economic resource is affected by hemoparasitic diseases like bovine babesiosis. Transmission of babesiosis is determined by the vector-parasitic-host relation and biotic and abiotic conditional factors. Equilibrium between infection and acquired immunity on bovine hosts is called enzootic stability. To determine enzootic stability levels of bovine babesiosis it has been used the detection of IgG specific antibodies for bovine babesias in calves between 3 and 9 months of age. Thus, a geographic region has enzootic stability when 75% or more of calves between 3 and 9 months of age are seroreactive for Babesia spp. A descriptive prospective cross sectional study was carried out. A sample of 282 calves was tested to determine enzootic stability level in cattle ranches of Puerto Berrio Region. A simple random probabilistic sampling was designed, stratified by sex and age. The sample was distributed in nine cattle ranches and was evaluated by indirect immunofluorescence antibodies technique to detection of IgG specific antibodies against Babesia bovis and Babesia bigemina. A level of seroreactivity higher than 75% to B. bovis in four of nine cattle farms was obtained. In the cattle farms with enzootic stability, a positive relation between acaricide treatment frequency and seroreactivity was found. Specifically, 90 days or more of acaricide treatment frequency induce a double level of seroreactivity than 60 days or less frequency.

Evaluación productiva y análisis microeconómicodel maní forrajero perenne (Arachis pintoi) en un sistema de levante- ceba de porcinos en confinamiento / Productive evaluation and micro-economic analysis of perennial Arachis pintoi for raising and fattening pigs in confinement

Con el fin de evaluar la respuesta productiva y microeconómica del maní forrajero (Arachis pintoi) como reemplazo parcial de la proteína cruda en cerdos en las etapas de levante y ceba, se realizó una investigación con 12 hembras, divididas al azar en cuatro tratamientos: T1. Grupo testigo, alimentado con concentrado comercial; T2, T3 y T4, con 10, 20 y 30 por ciento respectivamente, de reemplazo de la proteína de la dieta a partir de maní. Las variables evaluadas fueron consumo de alimento, peso corporal, ganancia diaria de peso, grasa dorsal, conversión alimenticia y la relación valor del alimento/valor de la ganancia de peso. No se encontró diferencia estadística significativa entre los diferentes tratamientos para todas las variables evaluadas, excepto para el promedio de la ganancia diaria de peso durante la etapa de levante (p < 0.01), la cual reportó los mayores valores para el T1 (1.01 kg) y los menores para T4 (0.78 kg /animal/día ). En el análisis microeconómico se observó que el menor costo asociado con la producción de 1 kg de cerdo en pie se obtuvo para el T3, siendo 45 por ciento más bajo con respecto al T1. El comportamiento de la utilidad parcial bruta fue superior para el T3, estando un 46 por ciento más alta en relacióncon el T1, que fue el tratamiento que mejor desempeño presentó en la conversión alimenticia.

Chromosomal evolution trends of the genus Panstrongylus (Hemiptera, Reduviidae), vectors of Chagas disease.

The genus Panstrongylus includes 14 species widely distributed from Mexico to Argentina, some of them with great epidemiological significance as vectors of Chagas disease. We study the karyotype and the male meiotic process of Panstrongylus chinai, P. geniculatus, P. herreri, P. lignarius, P. megistus, P. rufotuberculatus and P. tupynambai. All species present the same sex mechanism (X(1)X(2)Y in males and X(1)X(1)X(2)X(2) in females) and they also have 20 autosomes, with the exception of P. megistus that only presents 18 autosomes. The analysis of C-banding patterns and meiotic chromosome behaviour show a great level of variability allowing the identification of three clearly differentiated groups. In the first group, we only include P. megistus because of its unusual number of autosomes. The second group includes P. chinai, P. herreri, P. lignarius and P. rufotuberculatus. Their autosomes present terminal heterochromatic regions that appear scattered throughout the nucleus and associated with the sex chromosomes. Actually, P. herreri and P. lignarius can be considered cytogenetically identical. Our results are in agreement with morphological, ecological and molecular data indicating that they should be regarded as the same species. The third group only includes P. tupynambai that shows autosomes without C-positive regions. Panstrongylus geniculatus shares characters will all the three groups. Its karyotypic features are extremely polymorphic depending on their geographic origin. Some populations do not show any heterochromatic regions, while others exhibit few or several heterochromatic blocks. The chromosomal variability observed, together with its wide distribution and phenetic variability, suggest that P. geniculatus is a species complex comprising at least two distinct species. Considering the entire subfamily, the level of cytogenetic variation in Panstrongylus is lower than that observed in Triatoma but considerably more than that of Rhodnius, which is a very homogenous genus in terms of chromosome appearance and behaviour. This would endorse the closer relationship between Panstrongylus and Triatoma, and their divergence from Rhodnius, in accordance with current tribal classification.

Estudio comparativo del efecto de la hidroxicina la terfenadina y el astemizol en ninos con dermatitis atopica: Hospital General de Medellin-Centro de Especialistas C.E.S. 1986-1988 / Comparative study of the effect of the hidroxicina the terfenadina and the astemizol in children with atopic demratitis: Hospital General de Medellin-Centro de Especialistas C.E.S. 1986-1988

La dermatitis atopica es una enfermedad frecuente en nuestro medio. Tiene tres periodos clinicos caracteristicos y es una dermatosis muy cronica y pruriginosa. La histamina ha sido implicada en la etiopatogenesis del prurito, y, los antihistaminicos han sido usados indiscriminadamente en esta enfermedad. En un estudio simple ciego se evaluo el efecto del antagonista H1 de accion periferica y uno de accion central en 52 ninos de 2 a 6 anos con dermatitis atopica; estudiandose la respuesta clinica global y la respuesta de diferentes entidades eczema agudo, eczema cronico, prurito y extension. En 12 ninos se analizaron los siguientes parametros de laboratorio: leucocitos totales, eusinofilos en sangre y moco nasal, poblaciones de linfocitos T y B, inmunoglobulina E. Se encontro que la terfenadina fue efectiva en la mejoria clinica en todos los pacientes, pero un caso recayo al suspenderla. El astemizol fue efectivo en 13 de 19 pacientes (68%), y aun continuaba obrando a la semana de suspendida en 2 pacientes. La hidroxina fue menos efectiva, solo en 9 de 24 ninos. Durante el tratamiento hubo que retirar 8 ninos por empeoramiento: 2 del grupo de Astemizol y 6 de Hidroxicina. De los analisis de laboratorio no se hallo alteracion en los leucocitos totales ni hubo eosinofilia. El 33% fueron eosinofilos altos en moco nasal, hubo poca alteracion en los linfocitos B (15%), pero el 85% tenia disminucion de linfocitos T y aumento de la IgE que no cambiaba con la mejoria clinica. En conclusion se pudo observar la efectividad mayor de los antihistaminicos de accion..

Lecciones de Aymara

Contiene: Nota sobre el alfbeto usado por el presente texto - Signos del alfabeto usados en el presente texto y sus diferencias con el alfabeto usado por "CALA" para el Aymara - Nomenclatura de los órganos de articulación - Iskwilar sarkasa - Alwirtumpi jusiampi - Pa uywa mink'asir tata - Janir klasir mantkasa - Ijlishat kasarasiña - Paulumpi tiopampi - Ma Kunphisasiwi - Ma tisik usun jaqe - Qhatuna - Tata lurinsun jiwawipjjata - Ma Alwa.