Endoscopic Third Ventriculostomy for the Management of Obstructive Hydrocephalus in Pregnancy: A Case Report and Review of the Literature.

Introduction Hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal fluid within the brain's ventricular system. It can stem from obstructive and nonobstructive causes. Pregnancy introduces physiopathological changes that may heighten the risk of developing or worsening symptomatic hydrocephalus. Nevertheless, comprehensive reports on this aspect, especially regarding surgical interventions, remain scarce. Case Report A young woman with a history of recurrent headaches experienced a worsening of her symptoms at the onset of her pregnancy. A magnetic resonance imaging (MRI) in the first trimester revealed increased ventricular dilation, indicating an obstructive cause due to aqueduct stenosis. During a neurosurgical board meeting, treatment options were discussed, considering the identifiable obstruction, the heightened intra-abdominal pressure associated with pregnancy, and the risk of ventricular shunt dysfunction. The patient underwent an endoscopic third ventriculostomy (ETV) without complications, leading to both symptom relief and a successful conclusion to the pregnancy. Discussion Neurosurgical procedures in pregnant women are uncommon due to the increased risks to both the mother and the fetus. However, when performed by a qualified multidisciplinary team, they can lead to positive outcomes. In cases of hydrocephalus during pregnancy, ETV appears to be a viable alternative for surgical intervention, particularly when hydrocephalus becomes symptomatic and an obstructive cause is identified, whether in patients with existing shunts or those with newly developed hydrocephalus.

Evaluating the effects of moonlight on the vertical flight profiles of three western palaearctic swifts.

Recent studies have suggested the presence of moonlight mediated behaviour in avian aerial insectivores, such as swifts. Here, we use the combined analysis of state-of-the-art activity logger data across three swift species, the common, pallid and alpine swifts, to quantify flight height and activity in responses to moonlight-driven crepuscular and nocturnal light conditions. Our results show a significant response in flight heights to moonlight illuminance for common and pallid swifts, i.e. when moon illuminance increased flight height also increased, while a moonlight-driven response is absent in alpine swifts. We show a weak relationship between night-time illuminance-driven responses and twilight ascending behaviour, suggesting a decoupling of both crepuscular and night-time behaviour. We suggest that swifts optimize their flight behaviour to adapt to favourable night-time light conditions, driven by light-responsive and size-dependent vertical insect stratification and weather conditions.

Crystal structures of the sulfones of 2,3-diphenyl-2,3-di-hydro-4H-1,3-benzo-thia-zin-4-one and 2,3-diphenyl-2,3-di-hydro-4H-pyrido[3,2-e][1,3]thia-zin-4-one.

The title sulfones, 2,3-diphenyl-2,3-di-hydro-4H-1,3-benzo-thia-zine-1,1,4-trione, C20H15NO3S, and 2,3-diphenyl-2,3-di-hydro-4H-pyrido[3,2-e][1,3]thia-zine-1,1,4-trione, C19H14N2O3S, crystallize in space group P21/n with two mol-ecules in each of the asymmetric units and have almost identical unit cells and extended structures. In both structures, the thia-zine rings exhibit a screw-boat pucker. The inter-molecular inter-actions observed are C-H⋯O-type hydrogen bonds and parallel partial π-π stacking between the fused aromatic rings (benzo- or pyrido-) of the core of the mol-ecules within each asymmetric unit, and also connecting to mol-ecules with translational periodicity in the a-axis direction in what can be described as columns (two per asymmetric unit) of stacked mol-ecules with alternating chirality. The pendant phenyl groups of both mol-ecules do not participate in aromatic ring inter-actions.

Fungi with history: Unveiling the mycobiota of historic documents of Costa Rica.

We studied the physicochemical characteristics and mycobiota associated to five key historic documents from Costa Rica, including the Independence Act of Costa Rica from 1821. We used nondestructive techniques (i.e., ATR-FTIR and XRF) to determine paper and ink composition. Results show that some documents are composed of cotton-based paper, whereas others were made of wood cellulose with an increased lignin content. We also determined that the ink employed in some of the documents is ferrogallic. Cultivation and molecular techniques were used to characterize the fungi inhabiting the documents. In total, 22 fungal isolates were obtained: 15 from the wood-cellulose-based documents and seven from the other three cotton-based. We also tested the cellulolytic activity of the recovered fungi; 95% of the fungi presented cellulolytic activity correlated to their ability to cause deterioration of the paper. Results suggest that cotton-based paper is the most resistant to fungal colonization and that most of the isolates have cellulolytic activity. This work increases the knowledge of the fungal diversity that inhabits historic documents and its relationship with paper composition and provides valuable information to develop strategies to conserve and restore these invaluable documents.

Validity and Reliability of The Smart Groin Trainer for Measuring Hip Adduction Strength.

We analyzed the Smart Groin Trainer device's validity and reliability to measure the isometric hip adduction strength during the adductor squeeze strength test. Fifteen professional soccer players (25.33±4.06 years) and fifteen university students (21.60±1.76 years) participated in this study. All participants performed the squeeze strength test using two portable dynamometers: Smart Groin Trainer and Globus Ergometer. Three maximal isometric hip adduction contractions lasting 5s, interspersed by 3min rest intervals, were performed. Reliability was analyzed with intraclass correlation coefficients, standard error of measurements, and minimal detectable change. The absolute percent error and inter-device accuracy were also analyzed. Correlation analysis assessed the inter-device concurrent validity. The results found no significant differences (p>0.05) between devices in the squeeze strength test values in soccer players and university students. Inter-device comparisons revealed excellent levels of reliability and accuracy in soccer players. Concurrent validity measures revealed strong inter-device relationships in soccer players (r=0.89) and very strong relationships in university students (r=0.99). Intra-device analysis using the Smart Groin Trainer showed excellent relative and absolute reliability in tested soccer players. Our data demonstrated excellent levels of agreement between both dynamometers during the squeeze strength test, suggesting the Smart Groin Trainer as a valid, reliable, and accurate device to measure isometric hip adduction strength.

Guía de práctica clínica para el manejo de cáncer de cuello uterino estadios tempranos / Clinical practice guideline for the management of early-stage cervical cancer

Introducción: Este artículo resume la guía de práctica clínica (GPC) para el manejo de cáncer de cuello uterino estadios tempranos (IA1, IA2, IB1, IB2 o IIA1) en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo de cáncer de cuello uterino estadios tempranos en EsSalud. Material y métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y ­cuando fue considerado pertinente­ estudios primarios en Pubmed, Embase y CENTRAL durante el 2017 - 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y los flujogramas de manejo. Finalmente, la GPC fue aprobada con Resolución N° 27-IETSI-ESSALUD-2020. Resultados: La presente GPC abordó 8 preguntas clínicas abordando el manejo del cáncer de cuello uterino en estadios tempranos. En base a dichas preguntas se formularon 10 recomendaciones (2 recomendaciones fuertes y 8 recomendaciones condicionales), 7 puntos de buena práctica clínica, y 4 flujogramas. Conclusión: El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el manejo del cáncer de cuello uterino en estadios tempranos en EsSalud.

Introduction: This article summarizes the clinical practice guideline (CPG) for the management of early stage cervical cancer (IA1, IA2, IB1, IB2 or IIA1) in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for the management of early stage cervical cancer in EsSalud. Material and methods: A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant- primary studies were performed in Pubmed, Embase and CENTRAL during 2017 - 2018. Evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GEG used the GRADE methodology to review the evidence and formulate recommendations, good clinical practice points, and management flowcharts. Finally, the CPG was approved by Resolution No. 27-IETSI-ESSALUD-2020. Results: This CPG addressed 8 clinical questions on the management of early stage cervical cancer. Based on these questions, 10 recommendations were formulated (2 strong recommendations and 8 conditional recommendations), 7 points of good clinical practice, and 4 flowcharts. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of early stage cervical cancer in EsSalud.

T3P-Promoted Synthesis of a Series of 2-Aryl-3-phenyl-2,3-dihydro-4H-pyrido[3,2-e][1,3]thiazin-4-ones and Their Activity against the Kinetoplastid Parasite Trypanosoma brucei.

A series of fourteen 2-aryl-3-phenyl-2,3-dihydro-4H-pyrido[3,2-e][1,3]thiazin-4-ones was prepared at room temperature by T3P-mediated cyclization of N-phenyl-C-aryl imines with thionicotinic acid, two difficult substrates. The reactions were operationally simple, did not require specialized equipment or anhydrous solvents, could be performed as either two or three component reactions, and gave moderate-good yields as high as 63%. This provides ready access to N-phenyl compounds in this family, which have been generally difficult to prepare. As part of the study, the first crystal structure of neutral thionicotinic acid is also reported, and showed the molecule to be in the form of the thione tautomer. Additionally, the synthesized compounds were tested against T. brucei, the causative agent of Human African Sleeping Sickness. Screening at 50 µM concentration showed that five of the compounds strongly inhibited growth and killed parasites.

Novel biotechnologies for nitrogen removal and their coupling with gas emissions abatement in wastewater treatment facilities.

Wastewaters contaminated with nitrogenous pollutants, derived from anthropogenic activities, have exacerbated our ecosystems sparking environmental problems, such as eutrophication and acidification of water reservoirs, emission of greenhouse gases, death of aquatic organisms, among others. Wastewater treatment facilities (WWTF) combining nitrification and denitrification, and lately partial nitrification coupled to anaerobic ammonium oxidation (anammox), have traditionally been applied for the removal of nitrogen from wastewaters. The present work provides a comprehensive review of the recent biotechnologies developed in which nitrogen-removing processes are relevant for the treatment of both wastewaters and gas emissions. These novel processes include the anammox process with alternative electron acceptors, such as sulfate (sulfammox), ferric iron (feammox), and anodes in microbial electrolysis cells (anodic anammox). New technologies that couple nitrate/nitrite reduction with the oxidation of methane, H2S, volatile methyl siloxanes, and other volatile organic compounds are also described. The potential of these processes for (i) minimizing greenhouse gas emissions from WWTF, (ii) biogas purification, and (iii) air pollution control is critically discussed considering the factors that might trigger N2O release during nitrate/nitrite reduction. Moreover, this review provides a discussion on the main challenges to tackle towards the consolidation of these novel biotechnologies.

Spatial structure and morphometric relationships of the deep-sea shrimp Solenocera acuminata (Decapoda, Solenoceridae) in the Colombian Caribbean.

Given the potential interest in targeting Solenocera acuminata in a new deep-sea fishery in the Colombian Caribbean, biological information is needed to support the management of this species. The objective of this study is to provide biological information about size structure, size at sexual maturity, morphometric relationships, abundances and spatial and bathymetric distribution of S. acuminata in the Colombian Caribbean. Specimens of S. acuminata were collected during four deep-sea prospecting surveys in the Colombian Caribbean Sea, which were conducted between Punta Gallinas and the Gulf of Uraba. A total of 87 exploratory fishing trawls were made between 100 and 550 m depth. Sexual dimorphism was evident, with males being smaller than females. The size at sexual maturity of the females was 95.2 mm total length (23.82 mm CL). Relatively high biomass values were found in the northern zone of the Colombian Caribbean, between Santa Marta and Riohacha. In the southern zone, higher biomass was found between Cartagena and Morrosquillo Gulf. The biomass of S. acuminata was higher at night (mean 1.82 kg/km2) than during daylight (mean 0.15 kg/km2). This species was distributed between 150 and 400 m depth and the highest biomass was associated with depths between 330 and 380 m. Before starting a new fishery, more research is needed to understand the life cycle parameters of deep-sea resources, such as growth, reproduction, recruitment, mortality, spawning areas and times, nursery areas and associated biodiversity.

Comportamiento de algunos indicadores del Programa Materno Infantil en Campechuela durante los años 1980-2018 / Behavior of some indicators of the Maternal and Child Program in Campechuela during the years 1980-2018 / Comportamento de alguns indicadores do Programa Materno Infantil em Campechuela durante os anos 1980-2018

RESUMEN Introducción: el Programa Materno Infantil es un programa muy sensible en el sector de la salud ya que declara la atención integral tanto a la embarazada, a la madre, al niño y al adolescente. Las tasas de mortalidad fetal, en menores de un año y el bajo peso al nacer son indicadores que reflejan las condiciones de vida de la mujer; la morbilidad subyacente y la calidad de vida de una sociedad. Objetivo: determinar el comportamiento de estos dos indicadores en el municipio de Campechuela durante los años 1980 a 2018, período de 39 años. Métodos: se realizó un estudio observacional descriptivo, retrospectivo. El universo comprendió todos los nacimientos en Campechuela en los años de estudio, las muertes en menores de 1 año, las muertes fetales y el bajo peso al nacer. Se representaron los resultados expresados en frecuencias absolutas, frecuencias relativas y tasas. Mediante el empleo de las técnicas de la estadística descriptiva, Resultados: la natalidad ha disminuido a lo largo del período en estudio con variaciones en el tiempo, la tasa de mortalidad infantil ha tenido una disminución considerable, no siendo así, el bajo peso que han tenido fluctuaciones, y las defunciones fetales se ha comportado de forma desfavorable, los resultados permiten valorar que hay que intensificar aún más el control y seguimiento a este grupo priorizado, e incrementar las pesquisa de los factores de riesgo que conllevan a estos indicadores no favorables. Conclusiones: los indicadores del Programa Materno Infantil miden la calidad de vida de una nación, a pesar de todas las estrategias tomadas por el Ministerio de Salud Pública existen algunos resultados que hay que revertir como las muertes fetales, por lo que se requiere de más trabajo desde la Atención Primaria de Salud haciendo énfasis en la promoción y la prevención, trabajar con intención los protocolos de actuación en dicho programa.

ABSTRACT Introduction: the Maternal and Child Program is a very sensitive program in the health sector since it declares comprehensive care for pregnant women, mothers, children and adolescents. Fetal mortality rates in children under one year of age and low birth weight are indicators that reflect the living conditions of women; the underlying morbidity and quality of life of a society. Objective: to determine the behavior of these two indicators in the municipality of Campechuela during the years 1980 to 2018, a period of 39 years. Methods: a retrospective, descriptive, observational study was carried out. The universe included all the births in Campechuela in the study years, deaths in children under 1 year of age, fetal deaths and low birth weight. The results expressed in absolute frequencies, relative frequencies and rates were represented. Through the use of descriptive statistics techniques, Results: the birth rate has decreased throughout the period under study with variations over time, the infant mortality rate has had a considerable decrease, not being the case, the low weight that has fluctuated, and fetal deaths have behaved in a different way. In an unfavorable way, the results allow us to assess that it is necessary to further intensify the control and monitoring of this prioritized group, and to increase the investigation of the risk factors that lead to these unfavorable indicators. Conclusions: the indicators of the Maternal and Child Program measure the quality of life of a nation, despite all the strategies taken by the Ministry of Public Health there are some results that must be reversed, such as fetal deaths, so more work is required from Primary Health Care, emphasizing promotion and prevention, working with intention the protocols of action in said program.

RESUMO Introdução: o Programa Materno-Infantil é um programa muito sensível no setor saúde, pois declara o atendimento integral a gestantes, mães, crianças e adolescentes. As taxas de mortalidade fetal em menores de um ano e o baixo peso ao nascer são indicadores que refletem as condições de vida das mulheres; a morbidade subjacente e a qualidade de vida de uma sociedade. Objetivo: determinar o comportamento desses dois indicadores no município de Campechuela durante os anos de 1980 a 2018, um período de 39 anos. Métodos: foi realizado um estudo retrospectivo, descritivo e observacional. O universo incluiu todos os partos em Campechuela nos anos de estudo, óbitos em crianças menores de 1 ano, óbitos fetais e baixo peso ao nascer. Os resultados expressos em frequências absolutas, frequências relativas e taxas foram representados. Por meio do uso de técnicas de estatística descritiva, Resultados: a taxa de natalidade diminuiuao longo do período de estudo com variações ao longo do tempo, a taxa de mortalidade infantil diminuiu consideravelmente, não sendo o caso, o baixo peso que tem flutuado, e os óbitos fetais têm se comportado de forma diferente. De forma desfavorável, os resultados permitem avaliar que é necessário intensificar ainda mais o controle e monitoramento desse grupo priorizado, e aumentar a investigação dos fatores de risco que levam a esses indicadores desfavoráveis. Conclusões: os indicadores do Programa Materno Infantil medem a qualidade de vida de uma nação, apesar de todas as estratégias do Ministério da Saúde Pública existem alguns resultados que devem ser revertidos, como os óbitos fetais, por isso é necessário mais trabalho Atenção Primária à Saúde, com ênfase na promoção e prevenção, trabalhando intencionalmente os protocolos de ação desse programa.

Pneuma: receta colonial eficaz en el tratamiento de la disnea / Pneuma: colonial prescription effective in treatment of dyspnea

Objetivo: el archivo histórico Cipriano Rodríguez Santa María de la Universidad de La Sabana cuenta con múltiples recetas médicas empleadas por médicos y boticarios en el Nuevo Reino de Granada. Una de ellas prescribe el cacao para disminuir síntomas generados por afecciones del sistema respiratorio. Objetivos: describir el análisis de una receta médica empleada entre los siglos XVIII y XIX para el tratamiento del ahogo y describir la propiedad fitoterapéutica del cacao conocida gracias a la evidencia científica actual. Materiales y métodos: búsqueda documental en el Archivo Histórico Cipriano Rodríguez Santamaría de la Biblioteca Octavio Arizmendi Posada de la Universidad de La Sabana. Transcripción y análisis del documento denominado "Ahogo" y revisión de la literatura científica actual, así como de los textos originales, sin límite de tiempo. Resultados: la receta médica describe las características del cacao (Theobroma cacao) como agente fitoterapéutico con propiedades antiinflamatorias, analgésicas, antioxidantes e inmunomoduladoras aportadas por componentes como los ácidos oleico, esteárico, palmítico y flavonoides entre otros. La teobromina ejerce efectos broncodilatadores y antitusivosConclusiones: el legado histórico colonial conservado en los archivos locales permite comprender racionalmente las propiedades de los agentes herbarios empleados para enfermedades y síntomas asociados. Existe evidencia científica que respalda el uso del cacao para disminuir la sintomatología asociada con el ahogo. Pese a ello, la escasa o nula descripción de la posología y los efectos secundarios, dificulta analizar la eficacia de esta tradición. En consecuencia, no se puede establecer su eficacia científicamente.

Objetive: The Cipriano Rodríguez Santamaria Historical Archive at Universidad de La Sabana includes multiple medical prescriptions used by physicians and apothecaries in the New Kingdom of Granada. Among them, cocoa was prescribed to relieve symptoms generated by respiratory diseases. Objectives: to describe the analysis of a medical prescription used between the 18th and 19th centuries to treat shortness of breath ("ahogo") and to describe the phytotherapeutic properties of cocoa through current scientific evidence. Materials and Methods: a documentary search in the Cipriano Rodríguez Santamaria Historical Archive: Octavio Arizmendi Posada Library, Universidad de La Sabana. Transcription and analysis of the document named "ahogo" and review of the current scientific literature, as well as, of the original texts, with no time limit. Results: the medical prescription describes the characteristics of cocoa (Theobroma cacao) as a phytotherapeutic agent featuring anti-inflammatory, analgesic, antioxidant and immunomodulatory properties provided by components such as oleic, stearic, palmitic and flavonoid acids, among others. Theobromine exerts a bronchodilator and antitussive effect. Conclusions: the colonial historical legacy preserved in local archives allows a rational understanding of the properties of herbal agents as treatment for diseases and their symptoms. There is scientific evidence supporting the use of cocoa to reduce the symptoms associated with dyspnea. However, little or no description of dosage and side effects makes it difficult to analyze the efficacy of this tradition. Consequently, its efficacy cannot be scientifically established.

Comportamiento de algunos indicadores del Programa Materno Infantil en Campechuela durante los años 1980-2018 / Behavior of some indicators of the Maternal and Child Program in Campechuela during the years 1980-2018

Introducción: el Programa Materno Infantil es un programa muy sensible en el sector de la salud ya que declara la atención integral tanto a la embarazada, a la madre, al niño y al adolescente. Las tasas de mortalidad fetal, en menores de un año y el bajo peso al nacer son indicadores que reflejan las condiciones de vida de la mujer; la morbilidad subyacente y la calidad de vida de una sociedad. Objetivo: determinar el comportamiento de estos dos indicadores en el municipio de Campechuela durante los años 1980 a 2018, período de 39 años. Métodos: se realizó un estudio observacional descriptivo, retrospectivo. El universo comprendió todos los nacimientos en Campechuela en los años de estudio, las muertes en menores de 1 año, las muertes fetales y el bajo peso al nacer. Se representaron los resultados expresados en frecuencias absolutas, frecuencias relativas y tasas. Mediante el empleo de las técnicas de la estadística descriptiva. Resultados: la natalidad ha disminuido a lo largo del período en estudio con variaciones en el tiempo, la tasa de mortalidad infantil ha tenido una disminución considerable, no siendo así, el bajo peso que han tenido fluctuaciones, y las defunciones fetales se ha comportado de forma desfavorable, los resultados permiten valorar que hay que intensificar aún más el control y seguimiento a este grupo priorizado, e incrementar las pesquisas de los factores de riesgo que conllevan a estos indicadores no favorables. Conclusiones: los indicadores del Programa Materno Infantil miden la calidad de vida de una nación, a pesar de todas las estrategias tomadas por el Ministerio de Salud Pública existen algunos resultados que hay que revertir como las muertes fetales, por lo que se requiere de más trabajo desde la Atención Primaria de Salud haciendo énfasis en la promoción y la prevención, trabajar con intención los protocolos de actuación en dicho programa(AU)

Introduction: the Maternal and Child Program is a very sensitive program in the health sector since it declares comprehensive care for pregnant women, mothers, children and adolescents. Fetal mortality rates in children under one year of age and low birth weight are indicators that reflect the living conditions of women; the underlying morbidity and quality of life of a society. Objective: to determine the behavior of these two indicators in the municipality of Campechuela during the years 1980 to 2018, a period of 39 years. Methods: a retrospective, descriptive, observational study was carried out. The universe included all the births in Campechuela in the study years, deaths in children under 1 year of age, fetal deaths and low birth weight. The results expressed in absolute frequencies, relative frequencies and rates were represented. Through the use of descriptive statistics techniques. Results: the birth rate has decreased throughout the period under study with variations over time, the infant mortality rate has had a considerable decrease, not being the case, the low weight that has fluctuated, and fetal deaths have behaved in a different way. In an unfavorable way, the results allow us to assess that it is necessary to further intensify the control and monitoring of this prioritized group, and to increase the investigation of the risk factors that lead to these unfavorable indicators. Conclusions: the indicators of the Maternal and Child Program measure the quality of life of a nation, despite all the strategies taken by the Ministry of Public Health there are some results that must be reversed, such as fetal deaths, so more work is required from Primary Health Care, emphasizing promotion and prevention, working with intention the protocols of action in said program(EU)

Sampling of the petrosal sinuses. Indications, results and usefulness / Muestreo de senos petrosos. Indicaciones, resultados y utilidad

Abstract Objectives: to analyze, evaluate and describe the usefulness of petrosal sinus sampling for diagnosing central Cushing's syndrome. Materials and methods: the technical aspects and results of bilateral venous sampling of the petrosal sinuses at the Hospital Universitario San Vicente de Paul in Medellín, Colombia, from January 1, 2012 to December 31, 2018, were analyzed. Results: the average age was 43.3 years, with a range from 19 to 69 years. Laterality could be shown in 68.2% of cases, with a tendency to be located on the left in 53.3%. The central source of ACTH production could be shown in 95.4% of cases, with a basal average central/peripheral ratio of 21.7, and 70.8 after stimulation. All samples at 3, 5 and 10 minutes were confirmatory following stimulation. Conclusion: in our retrospective study, petrosal sinus catheterization provided laboratory confirmation of the central source of ACTH production in a high percentage of patients, with no immediate complications.

Resumen Objetivos: analizar, evaluar y describir la utilidad del muestreo de senos petrosos para diagnóstico del síndrome de Cushing de origen central. Material y métodos: se analizaron los aspectos técnicos y resultados del muestreo bilateral venoso de senos petrosos, desde el 1° de enero de 2012 a 31 de diciembre de 2018 en el Hospital Universitario San Vicente de Paúl en Medellín, Colombia. Resultados: el promedio de edad fue 43.3 años con un rango de edad desde los 19 hasta los 69 años. La lateralidad pudo ser demostrada en 68.2% de los casos con una tendencia a la localización en el lado izquierdo en 53.3%. El origen central de producción de ACTH logró ser demostrado en 95.4% de los casos, con una relación central/periferia basal promedio de 21.7 y postestimulación de 70.8. Todas las muestras a los 3, 5 y 10 minutos fueron confirmatorias tras la estimulación. Conclusión: en nuestro estudio retrospectivo el cateterismo de senos petrosos confirmó la fuente central de producción de ACTH por laboratorio en un alto porcentaje de pacientes sin ninguna complicación inmediata.

Odontología bajo anestesia general en el paciente con epilepsia: Reporte de caso y revisión de literatura / Dentistry under general anesthesia in the patient with epilepsy. Case report and literature review

RESUMEN La atención clínica del paciente portador de epilepsia (EP) asociada a discapacidad intelectual (DI), representa un reto para el estomatólogo por su difícil manejo conductual. Estos pacientes requerirán de alternativas para poder llevar a cabo un tratamiento odontológico exitoso. La anestesia general (AG), es una alternativa ante la falla de las técnicas de manejo conductual, existencia de compromiso sistémico que lo amerite, acceso médico especializado distante al lugar de residencia o por circunstancias particulares de cada caso. Se presenta el caso de un paciente varón de 27 años, con diagnóstico de EP asociada a DI, de difícil manejo conductual atendido bajo anestesia general en el servicio de Estomatología de Pacientes Especiales de la Universidad Peruana Cayetano Heredia. Objetivo : Este artículo busca presentar una revisión de la literatura y el Tratamiento Odontológico Integral bajo anestesia general de un paciente con de Epilepsia asociada a Discapacidad Intelectual moderada. Conclusiones: Los pacientes con estas patologías de fondo son propensos a presentar deterioro del órgano bucal, por lo que requerirán prestaciones estomatológicas constantes. Por la poca colaboración de este tipo de pacientes, se debe considerar a la AG como alternativa para brindar el TOI en un solo acto operatorio.

SUMMARY The clinical care of patients with epilepsy (EP) associated with intellectual disability (ID) represents a challenge for the stomatologist because of its difficult behavioral management. These patients will require alternatives to carry out a successful dental treatment. General anesthesia (AG), is an alternative to the failure of behavioral management techniques, existence of systemic commitment that warrants it, specialized medical access distant from the place of residence or due to particular circumstances of each case. We present the case of a 27-year-old male patient, with a diagnosis of EP associated with ID, of difficult behavioral management treated under general anesthesia in the Special Patients Stomatology service of the Peruvian University Cayetano Heredia. Objective: This article seeks to present a review of the literature and Comprehensive Dental Treatment under general anesthesia of a patient with Epilepsy associated with moderate Intellectual Disability. Conclusions: Patients with these underlying pathologies are prone to present deterioration of the oral organ, so they will require constant stomatological benefits. Due to the low collaboration of this type of patients, the AG should be considered as an alternative to provide the TOI in a single operative act.

Factores biomecánicos asociados al resultado clínico de pacientes tratados con artrodesis lumbar en un centro de alta complejidad en Colombia / Biomechanical factors related to surgical outcomes on patients treated with lumbar arthrodesis in a high complexity center in Colombia

INTRODUCCIÓN: La importancia del manejo del dolor lumbar radica en su recurrencia y en las manifestaciones tanto para el paciente como para la sociedad. Se hace necesario establecer qué factores llevan al éxito en términos de dolor y funcionalidad al momento de realizarse una artrodesis lumbar. MATERIALES Y MÉTODOS: Se realizó un estudio descriptivo retrospectivo que buscó determinar qué parámetros espinopélvicos de balance sagital y sus valores en términos de incidencia pélvica (PI), inclinación pélvica (PT), inclinación sacra, lordosis lumbar (LL), eje sagital vertical (SVA) y la diferencia entre la PI y LL (PI-LL), pueden tener una potencial relación con desenlaces posquirúrgicos favorables. Se incluyeron 44 pacientes tratados en el Hospital Universitario San Ignacio entre enero de 2016 y diciembre de 2017. Se tomaron en cuenta desenlaces de dolor y funcionalidad en términos la escala visual analógica y el Oswestry Disability Index (ODI). Se realizó un seguimiento prequirúrgico, y 2 posquirúrgicos a los 3 y 6 meses. Debido al tamaño de la muestra, los autores no pudieron encontrar una significancia estadística, sin embargo, los resultados son concordantes con lo publicado anteriormente en el área. RESULTADOS: El mayor cambio porcentual se encontró en el grupo de pacientes que tuvieron una PI-LL > 10° con un aumento del 50 % en el grupo de pacientes con buena funcionalidad (ODI: 0-20). En SVA > 5 cm, el rango de pacientes con una buena funcionalidad tuvo un aumento del 44,6 %. El rango de buena funcionalidad en pacientes con una PT < 20° aumentó 54,1 puntos porcentuales. CONCLUSIONES: En la presente cohorte se encontró que los parámetros radiológicos que condicionaron un mayor cambio porcentual en la funcionalidad de los pacientes después de ser llevados a cirugía de columna fueron: SVA de base > 5 cm y una PI-LL base > 10° y PT < 20°

INTRODUCTION: The importance of lumbar pain management lies in its recurrence and manifestations for both the patient and society. It is necessary to establish what factors lead to success in terms of pain and functionality at the time of a lumbar arthrodesis. MATERIAL AND METHODS: A retrospective descriptive study was conducted that sought to determine which spinopelvic parameters and their values in terms of pelvic incidence (PI), pelvic tilt (PT), sacral slope, lumbar lordosis (LL), sagittal vertical axis (SVA), and mismatch (PI-LL) might have a potential relationship with favorable postoperative outcomes. We included 44 patients who underwent MIS spinal approaches in our center between January 2016 to December 2017. Surgical outcomes of pain and functionality were assessed using visual analogue scale and Oswestry Disability Index (ODI). Follow up was conducted through three evaluations: one before surgical intervention and 2 at 3 and 6 months postop. Due to the sample size, the authors were unable to get statistically significant results. RESULTS: In our descriptive retrospective study on 44 patients, we found a big positive functional change in the group of patients who had a PI-LL > 10° with an increase of 50 percentage points in the group of patients with good functionality (ODI: 0-20). In SVA > 5 cm, the range of patients with good functionality had an increase of 44.6 percentage points. The range of good functionality in patients with a PT < 20° increased 54.1 percentage points. CONCLUSIONS: In the present cohort, it was found that the radiological parameters that conditioned greater percentage change in the functionality of the patients after being taken to spine surgery were SVA of base > 5 cm and a PI-LL base > 10° and PT < 20°

Enhanced Surface Activity of MWW Zeolite Nanosheets Prepared via a One-Step Synthesis.

The synthesis of two-dimensional (2D) zeolites has garnered attention due to their superior properties for applications that span catalysis to selective separations. Prior studies of 2D zeolite catalysts demonstrated enhanced mass transport for improved catalyst lifetime and selectivity. Moreover, the significantly higher external surface area of 2D materials allows for reactions of bulky molecules too large to access interior pores. There are relatively few protocols for preparing 2D materials, owing to the difficultly of capping growth in one direction to only a few unit cells. To accomplish this, it is often necessary to employ complex, commercially unavailable organic structure-directing agents (OSDAs) prepared via multistep synthesis. However, a small subset of zeolite structures exist as naturally layered materials where postsynthesis steps can be used to exfoliate samples and produce ultrathin 2D nanosheets. In this study, we selected a common layered zeolite, the MWW framework, to explore methods of preparing 2D nanosheets via one-pot synthesis in the absence of complex organic templates. Using a combination of high-resolution microscopy and spectroscopy, we show that 2D MMW-type layers with an average thickness of 3.5 nm (ca. 1.5 unit cells) can be generated using the surfactant cetyltrimethylammonium (CTA), which operates as a dual OSDA and exfoliating agent to affect Al siting and to eliminate the need for postsynthesis exfoliation, respectively. We tested these 2D catalysts using a model reaction that assesses external (surface) Brønsted acid sites and observed a marked increase in the conversion relative to three-dimensional MWW (MCM-22) and 2D layers prepared from postsynthesis exfoliation (ITQ-2). Collectively, our findings identify a facile and effective route to directly synthesize 2D MWW-type materials, which may prove to be more broadly applicable to other layered zeolites.

Mola invasiva coexistente con feto vivo normal. Reporte de caso / Invasive hydatidiform mole coexistent with normal fetus. Case report

RESUMEN Comunicamos el caso de una gestante referida por sospecha de mola parcial. Las imágenes ultrasonográficas mostraban un feto normal unido a placenta pequeña, adyacente a una masa tumoral en 'panal de abejas'. Se realizó amniocentesis, con resultado de cariotipo normal. Debido a valores de hCG-β superiores a 800 000 UI y crecimiento de la masa de 11% a la resonancia magnética, se realizó biopsia tumoral percutánea guiada por ecografía, la cual alejó la posibilidad de coriocarcinoma. La paciente hizo síntomas de hipertiroidismo que requirieron tratamiento y, al superar la hCG-β el millón de unidades, se decidió dar un curso de quimioterapia. A las 29 semanas inició trabajo de parto; se realizó cesárea-histerectomía, obteniéndose recién nacido vivo, con Apgar 5 y 7. Al examen anatomopatológico, la masa placentaria resultó mola invasiva. De acuerdo con nuestra búsqueda, se comunica el primer caso en la literatura de coexistencia de mola invasiva con feto sano, y resaltamos la importancia de usar las herramientas diagnósticas y de manejo necesarias para lograr la viabilidad del producto de la concepción, sin incrementar el riesgo materno.

ABSTRACT We report the case of a pregnant woman referred to our hospital for suspected partial hydatidiform mole. Ultrasound images showed a normal fetus attached to a small placenta adjacent to a honeycomb-like tumor mass. Amniocentesis revealed a normal karyotype. Due to β-hCG values greater than 800 000 IU and a mass growth of 11% by magnetic resonance imaging, an ultrasound-guided percutaneous tumor biopsy was performed; it ruled out the possibility of choriocarcinoma. The patient had symptoms of hyperthyroidism that required treatment; when the β-HCG levels exceeded one million IU, a course of chemotherapy was prescribed. At 29 weeks, the patient started labor; a cesarean hysterectomy was performed, obtaining a live newborn with Apgar 5 and 7. The pathology report informed the placental mass as an invasive mole. According to our literature search, this is the first case report where an invasive mole coexisted with a healthy fetus. We highlight the importance of using all diagnostic and management tools necessary to achieve fetal viability, without increasing the maternal risk of complications.

Fractura no complicada de corona en un paciente con síndrome de Down / Uncomplicated crown fracture in a Down syndrome patient

RESUMEN Introducción: los traumatismos dentales representan uno de los más serios problemas de salud bucal en niños y adolescentes. Son poco frecuentes en el primer año de vida y aumentan cuando el niño comienza a caminar y correr. Los pacientes con síndrome de Down presentan características psico-motoras y físicas que le confieren una mayor susceptibilidad para sufrir lesiones traumáticas en la cavidad bucal. Presentación del caso: paciente con síndrome de Down de 16 años de edad, masculino, que sufrió una fractura no complicada de corona, para lo cual recibió tratamiento estético y restaurador con técnica directa de restauración con composite por capas. Este proceder permitió conseguir un resultado estético con un acabado muy natural, recobrando el tamaño de la pieza dental sin que fuera necesario su tallado. Conclusiones: se consiguió realizar un tratamiento convencional exitoso a una fractura no complicada de corona en un paciente con síndrome de Down cuyo pronóstico es favorable, teniendo en cuenta que, en Estomatología como en cualquier otra rama de las ciencias médicas, es preciso valorar las particularidades de cada individuo y vincular otras especialidades como la Psicología y la Medicina en el tratamiento integral, para alcanzar una atención de calidad.

ABSTRACT Introduction: dental injuries represent one of the most serious oral health problems in children and adolescents. They are rare in the first year of life and increase when the child begins to walk and run. Patients with Down syndrome have psycho-motor and physical characteristics that make them more susceptible to traumatic injuries in the oral cavity. Case report: 16-year-old male patient with Down syndrome who suffered an uncomplicated crown fracture, he underwent to an esthetic and restorative treatment with a direct layered composite restoration technique. This procedure allowed the achievement of an aesthetic result with a very natural finish, recovering the size of the dental piece without the need to carve it. Conclusions: a successful conventional treatment of an uncomplicated crown fracture was achieved in a patient with Down syndrome having a favorable prognosis, taking into account that, in Dentistry specialty as in any other branch of medical sciences, it is necessary to assess the particularities of each individual and to link other specialties such as Psychology and Medicine in the comprehensive treatment of these patients, in order to reach quality care.

Hydrothermal Synthesis and Structure of a Dinuclear Molybdenum(III) Hydroxy Squarate with a Mo-Mo Bond.

The reaction of molybdenum(II) and chromium(II) acetates with squaric acid in degassed and deionized water under hydrothermal conditions at 150 °C is described. The products have been formulated as M2(µ-OH)2(µ-C4O4)2(H2O)4·2H2O, where M = Cr (1) and Mo (2), based on combustion elemental analysis, infrared spectroscopy, magic angle spinning (MAS) solid-state carbon-13 nuclear magnetic resonance (NMR), and single-crystal X-ray diffraction. The edge-shared bioctahedral structures involve doubly bridging hydroxide ligands and µ-squarate ligands. The chromium compound lacks a direct metal-metal-bonding interaction, while in contrast the molybdenum compound contains a Mo-Mo bond [2.491(2) Å]. The nature of the Mo-Mo-bonding interaction is compared with that of other similar d3-d3 dimers.

Alternating magnetic field mediated release of fluorophores from magnetic nanoparticles by hysteretic heating.

This study explores the use of differential heating of magnetic nanoparticles with different sizes and compositions (MFe2O4 (M = Fe, Co)) for heteroplexed temporal controlled release of conjugated fluorophores from the surface of nanoparticles. By exploiting these differences, we were able to control the amount of hysteretic heating occurring with the distinct sets of magnetic nanoparticles using the same applied alternating magnetic field radio frequency (AMF-RF). Using thermally labile retro-Diels-Alder linkers conjugated to the surface of nanoparticles, the fluorescent payload from the different nanoparticles disengaged when sufficient energy was locally generated during hysteretic heating. 1H, 13C NMR, ESI-MS, and SIMS characterized the thermally responsive fluorescent cycloadducts used in this study; the Diels Alder cycloadducts were modeled using density functional theory (DFT) computations. The localized point heating of the different nanoparticle compositions drove the retro-Diels-Alder reaction at different times resulting in higher release rates of fluorophores from the CoFe2O4 compared to the Fe3O4 nanoparticles.