Evidence-Based Data Regarding the Use of Antibiotic-loaded Cement in Hip Arthroplasty. A bibliometric analysis of 50 years / Datos basados en la evidencia sobre el uso de cemento con antibióticos en la artroplastia de cadera. Análisis blbliométrico de 50 años

Introduction: The use of antibiotic-loaded cement is an intraoperative tool that has demonstrated potential benefits in hip arthroplasty. However, the global landscape of research on this topic remains unknown. The objective of this study was to analyze the scientific growth, characteristics, and metrics of global and historical research on the use of antibiotic-loaded cement in hip arthroplasty. Material and methods: A cross-sectional bibliometric study was conducted using Scopus as the data source. Results: A total of 523 documents published between 1973 and 2023 were selected. 89.9% (n=470) of the production consisted of original articles, with 11.85% being multi-center. 84.1% of the authors have published a single article, followed by 10.3% who have published two articles. Research has predominantly focused on adults or the elderly, with an emphasis on outcome evaluation (notably reoperation), assessing various antibiotic agents, and frequently employing retrospective designs. Conclusions: There has been a sustained increase in research on the use of antibiotic-loaded cement in hip arthroplasty over the last 50 years. The research trend has shifted towards the evaluation of adult or elderly patients, exploration of antimicrobial agents, techniques, and health outcomes, primarily using observational and retrospective designs. An emerging research-focus is the study of hip arthroplasty in rheumatoid arthritis patients. (AU)

Introducción: El uso de cemento cargado con antibiótico, es una herramienta intraoperatoria que ha demostrado potenciales beneficios en la artroplastia de cadera. Sin embargo, se desconoce el panorama global de la investigación sobre este tópico. El objetivo de este estudio fue analizar el crecimiento científico, características y métricas de la investigación global e histórica sobre el uso de cemento cargado con antibiótico en artroplastia de cadera. Material y métodos: Estudio bibliométrico de corte transversal, que utilizó como fuente de datos la base Scopus. Resultados: Se seleccionaron 523 documentos publicados entre 1973 y 2023. El 89,9% (n=470) de la producción consistió en artículos originales, siendo el 11,85% multicéntricos. El 84,1% de los autores han publicado un único artículo, seguido de un 10,3% que han publicado dos artículos. La investigación se ha centrado predominantemente en adultos o ancianos, con énfasis en la evaluación de resultados (especialmente la reoperación), evaluando diversos agentes antibióticos y empleando con frecuencia diseños retrospectivos. Conclusiones: En los últimos 50 años se ha producido un aumento sostenido de la investigación sobre el uso de cemento cargado con antibióticos en la artroplastia de cadera. La tendencia de la investigación se ha desplazado hacia la evaluación de pacientes adultos o ancianos, la exploración de los agentes antimicrobianos, las técnicas y los resultados sanitarios, utilizando principalmente diseños observacionales y retrospectivos. Un nuevo foco de investigación es el estudio de la artroplastia de cadera en pacientes con artritis reumatoide. (AU)

Performance of Anticorrosive Paint Systems for Carbon Steel in the Antarctic Marine Environment.

This study evaluated the behavior of three paint systems exposed to the Antarctic marine environment for 45 months compared to a control of uncoated carbon steel with a determined corrosion rate. At the study site, all environmental conditions, solar radiation, and the concentration of environmental pollutants (Cl- and SO2) were evaluated. The paint systems differed in terms of the primer and top coat. Coated samples were studied before and after exposure. They were evaluated visually and using SEM to determine adhesion, abrasion, and contact angle; using the Evans X-Cut Tape Test; using ATR-FTIR spectroscopy to analyze the state of aging of the top layer; and using electrochemical impedance spectroscopy (EIS) for coat protection characterization. The corrosion rate obtained for steel was 85.64 µm year-1, which aligned with a C5 environmental corrosivity category. In general, the evaluation in the period studied showed the paint systems had good adhesion and resistance to delamination, without the presence of surface rust, and exhibited some loss of brightness, an increase in the abrasion index, and a decrease in the percentage of reflectance due to aging. EIS showed good protection capability of the three coating schemes. In general, this type of paint system has not previously been evaluated in an extreme environment after 45 months of exposure to the environment. The results showed that the best behavior was found for the system whose top layer was acrylic-aliphatic polyurethane.

Atmospheric corrosion and impact toughness of steels: Case study in steels with and without galvanizing, exposed for 3 years in Rapa Nui Island.

We studied atmospheric corrosion on Rapa Nui Island, using galvanized and non-galvanized SAE 1020 steel samples exposed on racks. We also added Charpy samples of both materials to directly determine the effect of corrosion rate on these materials' impact toughness. The results indicated a correlation between corrosion rate and toughness loss in the studied materials. In the corrosion study, we could also demonstrate the effect from increased insular population growth on contaminants which aid atmospheric corrosivity. Results showed that atmospheric SO2 has tripled compared with similar corrosion studies done 20 years ago (Mapa Iberoamericano de Corrosión, MICAT), increasing corrosion rates. Our results show how human factors can influence changes in environmental variables that strengthen corrosion.

Drug prices in Latin American countries: the case of rheumatoid arthritis Biosimilars.

BACKGROUND: The objective of this paper is to analyze the prices of biological drugs in the treatment of Rheumatoid Arthritis (RA) in three Latin American countries (Brazil, Colombia and Mexico), as well as in Spain and the United States of America (US), from the point of market entry of biosimilars. METHODS: We analyzed products authorized for commercialization in the last 20 years, in Brazil, Colombia, and Mexico, comparing them to the United States of America (USA) and Spain. For this analysis, we sought the prices and registries of drugs marketed between 1999 and October 1, 2019, in the regulatory agencies' databases. The pricing between countries was based on purchasing power parity (PPP). RESULTS: The US authorized the commercialization of 13 distinct biologicals and four biosimilars in the period. Spain and Brazil marketed 14 biopharmaceuticals for RA, ten original, four biosimilars. Colombia and Mexico have authorized three biosimilars in addition to the ten biological ones. For biological drug prices, the US is the most expensive country. Spain's price behavior seems intermediate when compared to the three LA countries. Brazil has the highest LA prices, followed by Mexico and Colombia, which has the lowest prices. Spain has the lowest values in PPP, compared to LA countries, while the US has the highest prices. CONCLUSION: The economic effort that LA countries make to access these medicines is much higher than the US and Spain. The use of the PPP ensured a better understanding of the actual access to these inputs in the countries analyzed.

Drug prices in Latin American countries: the case of rheumatoid arthritis Biosimilars

Abstract Background: The objective of this paper is to analyze the prices of biological drugs in the treatment of Rheumatoid Arthritis (RA) in three Latin American countries (Brazil, Colombia and Mexico), as well as in Spain and the United States of America (US), from the point of market entry of biosimilars. Methods: We analyzed products authorized for commercialization in the last 20 years, in Brazil, Colombia, and Mexico, comparing them to the United States of America (USA) and Spain. For this analysis, we sought the prices and registries of drugs marketed between 1999 and October 1, 2019, in the regulatory agencies' databases. The pricing between countries was based on purchasing power parity (PPP). Results: The US authorized the commercialization of 13 distinct biologicals and four biosimilars in the period. Spain and Brazil marketed 14 biopharmaceuticals for RA, ten original, four biosimilars. Colombia and Mexico have authorized three biosimilars in addition to the ten biological ones. For biological drug prices, the US is the most expensive country. Spain's price behavior seems intermediate when compared to the three LA countries. Brazil has the highest LA prices, followed by Mexico and Colombia, which has the lowest prices. Spain has the lowest values in PPP, compared to LA countries, while the US has the highest prices. Conclusions: The economic effort that LA countries make to access these medicines is much higher than the US and Spain. The use of the PPP ensured a better understanding of the actual access to these inputs in the countries analyzed.(AU)

Policies to Reduce Antibiotic Consumption: The Impact in the Basque Country.

In 2013, a change in copayment rate was introduced in the Basque Country (one year later than in the other regions in Spain), and improvements were made to drug packaging. In 2014, a National Program Against Bacterial Resistance (Spanish abbreviation: PRAN) was approved. The aim of this study is to analyze the impact of change to the copayment rate, the adjustment of drug packaging, and the approval of PRAN on the consumption of antibiotics. Raw monthly data on the consumption of antibiotics (costs, packages, and daily defined doses per thousand people (DID)) were collected from January 2009 to December 2018 in the Basque Country. Counterfactual and intervention analysis (Autoregressive integrated moving average (ARIMA) model) was performed for the total series, disaggregated by group of antibiotics (2019 WHO Access, Watch, and Reserve (AWaRe) Classification) and active substances with the highest cost per prescription (cefditoren and moxifloxacin), the lowest cost per prescription (doxycycline and cloxacillin), and the most prescribed active ingredients (amoxicillin, azithromycin, and levofloxacin). Introduction of copayment led to a 'stockpiling effect' one month before its implementation, equal to 8% in the three consumption series analyzed. Only the adjustment of drug packaging significantly reduced the number of packages dispensed (-12.19%). PRAN approval reduced consumption by 0.779 DID (-4.51%), representing a significant decrease for both 'access' and 'watch' group antibiotics. Despite the delay in implementing changes to copayment, there was a 'stockpiling effect'. With the adjustment of packaging, fewer packs were prescribed but with a higher drug load and price. PRAN approval reduced both the consumption of 'access group antibiotics' (first-line treatment) and 'watch group antibiotics' (second-line treatment).

Hemicolectomía radical laparoscópica: opción de mínima invasión para el cáncer de colon / Laparoscopic radical hemicolectomy: minimally invasive option for colon cancer / Hemicolectomia radical laparoscópica: opcão minimamente invasiva para cãncer de cólon

Introducción. El cáncer de colon es una de las principales causas de morbimortalidad a nivel mundial. En Colombia se presentan cerca de 145,600 casos nuevos al año. Cada vez son más los reportes de este tipo de patologías intervenidas por vía laparoscópica, aunque son pocos en Colombia. El objetivo de este artículo es mostrar el abordaje de esta patología mediante un procedimiento mínimamente invasivo: la colectomía derecha por vía laparoscópica, el cual es poco utilizado en el país. Caso clínico. Paciente de 86 años que consulta por pérdida de peso, adinamia y dolor abdominal en flanco derecho. Presenta además anemia ferropénica y sangre oculta en materia fecal. Las endoscopias digestivas muestran lesión ulcerada vegetante de aspecto neoplásico a nivel del ciego. La biopsia revela adenocarcinoma infiltrante moderadamente diferenciado con áreas de necrosis. Se realiza una colectomía derecha por técnica laparoscópica. Se hace seguimiento con neoadyuvancia por parte de Oncología Clínica. Discusión. El adenocarcinoma es uno de los cánceres primarios más comunes en el colon. La resección quirúrgica es una excelente alternativa para el manejo y tratamiento de estos tumores. En Colombia, la mayoría de estas resecciones se realizan por vía abierta. La resección por vía laparoscópica es un método que demuestra similar eficacia, ofreciendo una disminución en la respuesta inflamatoria, con mejor control del dolor y limitaciones funcionales. Conclusiones. La colectomía por vía laparoscópica para resección de tumores de colon es un método seguro, eficaz y reproducible. Sin embargo, exige tecnología de alto costo y debe ser realizada por un grupo quirúrgico con habilidad y experiencia en sutura manual laparoscópica. Cómo citar: López-Gómez LE, Dominguez ­ Alvarado GA, D ́vera Camargo D, Lozano-Eslava LA, Martínez-Rojas PA. Hemicolectomía radical laparoscópica: opción de mínima invasión para el cáncer de colon. MedUNAB. 2020;23(2): 281-287. doi: 10.29375/01237047.3829

Introduction. Colon cancer is one of the main causes of morbimortality in the world. Colombia counts near 145,600 new cases per year. The reports of laparoscopic intervention in this pathology are growing, but in Colombia there is little recent work on the matter. The aim of this article is to show how this pathology can be addressed through a minimally invasive procedure, laparoscopic right colectomy, which is not frequently used in the country. Clinical case. An 86-year-old patient consults due to weight loss, adynamia and abdominal pain on right side. Iron-deficiency anemia and hidden blood in feces was reported. The digestive endoscopies show the presence of a vegetant and ulcerated lesion of neoplastic appearance in the cecum. A biopsy revealed a moderately differentiated, invasive adenocarcinoma with areas of necrosis. A laparoscopic right colectomy is conducted. Definitive report of moderately differentiated and ulcerated, invasive, mucinous adenocarcinoma, with lesion up to the serous membrane. Follow up is conducted with neoadjuvant therapy by the Clinical Oncology service. Discussion. Adenocarcinoma is one of the most common primary cancers in the colon. Surgical still an excellent alternative for the management of this kind of tumor. In Colombia, the majority of these resections are carried out by open surgery. However, laparoscopic resection is a method that offers similar outcomes to the traditional procedure, while providing a reduction in the inflammatory response, with better pain control and control of functional limitations. Conclusions. Laparoscopic colectomy for the resection of colonic tumors is a safe, effective and reproducible method. However, it requires high-cost technology and it must be conducted by a surgical team skilled and experienced in manual laparoscopic suturing.Cómo citar: López-Gómez LE, Dominguez ­ Alvarado GA, D ́vera Camargo D, Lozano-Eslava LA, Martínez-Rojas PA. Hemicolectomía radical laparoscópica: opción de mínima invasión para el cáncer de colon. MedUNAB. 2020;23(2): 281-287. doi: 10.29375/01237047.3829

Introdução. O câncer de cólon é uma das principais causas de morbimortalidade em todo o mundo. Na Colômbia, há uma incidência aproximada de 145,600 casos novos por ano. Na Colômbia existam poucos trabalhos recentes sobre este tipo de procedimentos. O objetivo deste artigo é mostrar a abordagem de o adenocarcinoma de cólon, através de um procedimento minimamente invasivo: a colectomia direita pela via laparoscópica, pouco utilizada no país. Caso clínico. Paciente de 86 anos que apresenta perda de peso, adinamia e dor abdominal no flanco direito, anemia ferropriva e sangue oculto nas fezes. As endoscopias digestivas evidenciam a presença de uma lesão ulcerada vegetante com aparência neoplásica no nível do ceco. A biópsia revelou adenocarcinoma infiltrante moderadamente diferenciado com áreas de necrose. As imagens de extensão mostram um efeito de massa intraluminal ao nível do ceco com adenomegalia pericecal. Realizou-se uma colectomia direita laparoscópica. Relato definitivo de adenocarcinoma mucinoso infiltrante moderadamente diferenciado e ulcerado, com comprometimento da serosa. O serviço de Oncologia Clínica fez o acompanhamento neoadjuvante. Discussão. O adenocarcinoma é um dos cânceres primários mais comuns no cólon. A ressecção cirúrgica continua sendo uma excelente alternativa para a gestão e tratamento deste tipo de tumores. Na Colômbia, a maioria dessas ressecções é realizada pela via aberta. A ressecção pela via laparoscópica é um método que oferece ressecções semelhantes às do procedimento tradicional, apresentando diminuição da resposta inflamatória, com melhor controle da dor e das limitações funcionais. Conclusão. A colectomia pela via laparoscópica para ressecção de tumores de cólon é um método seguro, eficaz e reprodutível. No entanto, requer tecnologia de alto custo e deve ser realizada por um grupo cirúrgico com habilidade e experiência em sutura manual laparoscópica. Cómo citar: López-Gómez LE, Dominguez ­ Alvarado GA, D ́vera Camargo D, Lozano-Eslava LA, Martínez-Rojas PA. Hemicolectomía radical laparoscópica: opción de mínima invasión para el cáncer de colon. MedUNAB. 2020;23(2): 281-287. doi: 10.29375/01237047.3829

Integrated Analysis of Germline and Tumor DNA Identifies New Candidate Genes Involved in Familial Colorectal Cancer.

Colorectal cancer (CRC) shows aggregation in some families but no alterations in the known hereditary CRC genes. We aimed to identify new candidate genes which are potentially involved in germline predisposition to familial CRC. An integrated analysis of germline and tumor whole-exome sequencing data was performed in 18 unrelated CRC families. Deleterious single nucleotide variants (SNV), short insertions and deletions (indels), copy number variants (CNVs) and loss of heterozygosity (LOH) were assessed as candidates for first germline or second somatic hits. Candidate tumor suppressor genes were selected when alterations were detected in both germline and somatic DNA, fulfilling Knudson's two-hit hypothesis. Somatic mutational profiling and signature analysis were also performed. A series of germline-somatic variant pairs were detected. In all cases, the first hit was presented as a rare SNV/indel, whereas the second hit was either a different SNV (3 genes) or LOH affecting the same gene (141 genes). BRCA2, BLM, ERCC2, RECQL, REV3L and RIF1 were among the most promising candidate genes for germline CRC predisposition. The identification of new candidate genes involved in familial CRC could be achieved by our integrated analysis. Further functional studies and replication in additional cohorts are required to confirm the selected candidates.

Consenso Internacional de Gastroenteritis Aguda en Urgencias. Comité de Emergencias SLACIP (Sociedad Latino Americana de Cuidados Intensivos Pediátricos)

Este documento pretende poner al alcance de todo profesional de salud una guía actualizada en el diagnóstico y manejo de la gastroenteritis aguda en pediatría, ya que esta enfermedad es una de las principales causas de consultas y hospitalizaciones. Se realizó una revisión exhaustiva de la literatura proponiendo una herramienta útil con el objetivo de reducir el impacto de la enfermedad en términos de incidencia, morbilidad y mortalidad. El tratamiento de la gastroenteritis debe ir dirigido a la prevención de la deshidratación y el desequilibrio electrolítico que produce, con líquidos adecuados, sales de rehidratación oral y el mantenimiento de la alimentación oral. La causa de esta enfermedad es principalmente viral y los criterios para el uso de antibióticos es controversial. Los coadyuvantes para disminuir el tiempo de enfermedad así como la frecuencia de la diarrea, en muchos de los casos están en estudio; por lo tanto el manejo guiado, estructurado y sistematizado garantizará en muchos casos el éxito del tratamiento de la gastroenteritis en los niños.

This document aims to provide an updated guideline for the diagnosis and management of acute gastroenteritis in pediatrics, as this disease is one of the main causes of consultations and hospitalizations. By performing an exhaustive review of the literature to produce a useful tool, this proposal aims to reduce the impact of the disease incidence, morbidity and mortality. The goal of gastroenteritis treatment is to prevent dehydration and electrolyte imbalance that it can produce, with adequate liquids, oral rehydration salts and maintenance of oral feeding. The causes of this disease are mostly viral and the criteria for antibiotic use is controversial. Treatment modalities to reduce the time of illness as well as the frequency of diarrhea are, in many cases, currently under study; therefore, guided, structured and systematized management will ensure the successful treatment of gastroenteritis in most children.

[Performance of an abbreviated mini mental examination to detect dementia in older people]. / Evaluación del minimental abreviado de la evaluación funcional del adulto mayor (EFAM) como screening para la detección de demencia en la atención primaria.

BACKGROUND: The usefulness of the abbreviated Mini-Mental State Examination included in the Chilean Functional assessment of elderly people (MM-SE-EFAM) to detect Dementia has not been determined. AIM: To assess the performance of the MMSE-EFAM to detect dementia. MATERIAL AND METHODS: We studied a non-probabilistic sample of subjects older than 65 years who had been assessed by the MMSE-EFAM in a Chilean primary care center during a period of 6 months. Patients underwent clinical evaluation by a neurologist blinded to MMSE-EFAM score, to establish the diagnosis of dementia using DSM-IV-TR criteria. Besides, the full Mini-Mental State Examination (MMSE) was applied. RESULTS: The clinical diagnosis of Dementia was established in 13 of the 54 peoples evaluated. MMSE-EFAM had a sensitivity of 30.8% (95% confidence intervals (CI); 9-61.4) and a specificity of 90.2% (95% CI; 76.9%-97.3%), while MMSE had a sensitivity of 84.6% (95% CI; 54.6-98.1) and a specificity of 58.5% (95% CI; 42.1-73.7). In a receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were 0.77 (95% CI; 0.61-0.93) and 0.82 (95% CI; 0.70-0.95) for MMSE-EFAM and MMSE, respectively. Socio-demographic variables did not influence test performance in both cases. CONCLUSIONS: MMSE-EFAM has a low sensitivity to detect patients with Dementia and it is not an effective screening tool. These results are in agreement with the evidence and international guidelines that do not support the use of cognitive screening tools to detect dementia in the older general population.

Pressure-Responsive, Surfactant-Free CO2-Based Nanostructured Fluids.

Microemulsions are extensively used in advanced material and chemical processing. However, considerable amounts of surfactant are needed for their formulation, which is a drawback due to both economic and ecological reasons. Here, we describe the nanostructuration of recently discovered surfactant-free, carbon dioxide (CO2)-based microemulsion-like systems in a water/organic-solvent/CO2 pressurized ternary mixture. "Water-rich" nanodomains embedded into a "water-depleted" matrix have been observed and characterized by the combination of Raman spectroscopy, molecular dynamics simulations, and small-angle neutron scattering. These single-phase fluids show a reversible, pressure-responsive nanostructuration; the "water-rich" nanodomains at a given pressure can be instantaneously degraded/expanded by increasing/decreasing the pressure, resulting in a reversible, rapid, and homogeneous mixing/demixing of their content. This pressure-triggered responsiveness, together with other inherent features of these fluids, such as the absence of any contaminant in the ternary mixture (e.g., surfactant), their spontaneous formation, and their solvation capability (enabling the dissolution of both hydrophobic and hydrophilic molecules), make them appealing complex fluid systems to be used in molecular material processing and in chemical engineering.

Evaluación del minimental abreviado de la evaluación funcional del adulto mayor (EFAM) como screening para la detección de demencia en la atención primaria / Performance of an abbreviated mini mental examination to detect dementia in older people

Background: The usefulness of the abbreviated Mini-Mental State Examination included in the Chilean Functional assessment of elderly people (MM-SE-EFAM) to detect Dementia has not been determined. Aim: To assess the performance of the MMSE-EFAM to detect dementia. Material and Methods: We studied a non-probabilistic sample of subjects older than 65 years who had been assessed by the MMSE-EFAM in a Chilean primary care center during a period of 6 months. Patients underwent clinical evaluation by a neurologist blinded to MMSE-EFAM score, to establish the diagnosis of dementia using DSM-IV-TR criteria. Besides, the full Mini-Mental State Examination (MMSE) was applied. Results: The clinical diagnosis of Dementia was established in 13 of the 54 peoples evaluated. MMSE-EFAM had a sensitivity of 30.8% (95% confidence intervals (CI); 9-61.4) and a specificity of 90.2% (95% CI; 76.9%-97.3%), while MMSE had a sensitivity of 84.6% (95% CI; 54.6-98.1) and a specificity of 58.5% (95% CI; 42.1-73.7). In a receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were 0.77 (95% CI; 0.61-0.93) and 0.82 (95% CI; 0.70-0.95) for MMSE-EFAM and MMSE, respectively. Socio-demographic variables did not influence test performance in both cases. Conclusions: MMSE-EFAM has a low sensitivity to detect patients with Dementia and it is not an effective screening tool. These results are in agreement with the evidence and international guidelines that do not support the use of cognitive screening tools to detect dementia in the older general population.

Fracturas múltiples de huesos largos en una escolar portadora de picnodisostosis: Reporte de caso / Multiple long bone fractures in a child with pycnodysostosis: A case report

Las fracturas en edad pediátrica son una entidad importante para considerar. Hay enfermedades en que los huesos del niño se fracturan ante traumatismos de menor energía. La picnodisostosis es un tipo inusual de displasia cráneo-metafisaria autosómica recesiva, cuya primera manifestación clínica suele ser una fractura en hueso patológico. Se presenta a una paciente, caucásica, de 9 años de edad, con diagnóstico de picnodisostosis, que ingresó al hospital por fractura del fémur derecho, por un mecanismo de baja energía. Los estudios radiográficos mostraron fracturas del fémur bilateral, fractura proximal de la tibia izquierda y consolidación viciosa en antecurvatum. Esta rara enfermedad se diagnostica a edades tempranas por talla baja, por fracturas repetidas o por traumas de baja energía. Las opciones terapéuticas son limitadas, y no se ha desarrollado una cura definitiva. Es importante, ante un paciente pediátrico con rasgos dismórficos faciales y fracturas en hueso patológico, sospechar displasias óseas, tales como la picnodisostosis y sus diagnósticos diferenciales.

Fractures are an important entity to consider in pediatric patients. There are certain diseases in which bones fracture with a minimal trauma. Pycnodysostosis is an autosomal recessive unusual type of cráneo metaphyseal dysplasia, that presents frequently as fracture in a pathological bone. A 9 year old caucasian female, diagnosed with pycnodysostosis, was admitted with a right femur fracture as a result of a low energy trauma. Radiographic studies showed bilateral femur fractures, proximal fracture and non-union in antecurvatum of the left tibia. Pycnodysostosis is a rare disease, generally diagnosed at an early age by growth restriction, frequent fractures or fractures with low energy trauma. Therapy alternatives are limited, and no permanent cure has been developed. If a patient has dysmorphic facial features and fractures in a pathological bone, it is important to suspect bone dysplasia, such as pycnodysostosis and its differential diagnoses.

[Multiple long bone fractures in a child with pycnodysostosis. A case report]. / Fracturas múltiples de huesos largos en una escolar portadora de picnodisostosis. Reporte de caso.

Fractures are an important entity to consider in pediatric patients. There are certain diseases in which bones fracture with a minimal trauma. Pycnodysostosis is an autosomal recessive unusual type of cráneo metaphyseal dysplasia, that presents frequently as fracture in a pathological bone. A 9 year old caucasian female, diagnosed with pycnodysostosis, was admitted with a right femur fracture as a result of a low energy trauma. Radiographic studies showed bilateral femur fractures, proximal fracture and non-union in antecurvatum of the left tibia. Pycnodysostosis is a rare disease, generally diagnosed at an early age by growth restriction, frequent fractures or fractures with low energy trauma. Therapy alternatives are limited, and no permanent cure has been developed. If a patient has dysmorphic facial features and fractures in a pathological bone, it is important to suspect bone dysplasia, such as pycnodysostosis and its differential diagnoses.

Las fracturas en edad pediátrica son una entidad importante para considerar. Hay enfermedades en que los huesos del niño se fracturan ante traumatismos de menor energía. La picnodisostosis es un tipo inusual de displasia cráneo-metafisaria autosómica recesiva, cuya primera manifestación clínica suele ser una fractura en hueso patológico. Se presenta a una paciente, caucásica, de 9 años de edad, con diagnóstico de picnodisostosis, que ingresó al hospital por fractura del fémur derecho, por un mecanismo de baja energía. Los estudios radiográficos mostraron fracturas del fémur bilateral, fractura proximal de la tibia izquierda y consolidación viciosa en antecurvatum. Esta rara enfermedad se diagnostica a edades tempranas por talla baja, por fracturas repetidas o por traumas de baja energía. Las opciones terapéuticas son limitadas, y no se ha desarrollado una cura definitiva. Es importante, ante un paciente pediátrico con rasgos dismórficos faciales y fracturas en hueso patológico, sospechar displasias óseas, tales como la picnodisostosis y sus diagnósticos diferenciales.

Intraocular pressure and biomechanical corneal properties measure by ocular response analyser in patients with primary congenital glaucoma.

PURPOSE: To measure the differences in corneal hysteresis (CH) and corneal resistance factor (CRF) in primary congenital glaucoma (PCG) and in control subjects using ocular response analyser (ORA) and also to compare intraocular pressure (IOP) measurements given by ORA against IOP given by Perkins tonometer, a handheld version of Goldman applanation tonometer (GAT), to determine correlation. METHODS: One hundred and eighteen eyes of 78 patients with PCG (group I) and 103 eyes of 53 controls (group II) were evaluated using ORA. In all participants, IOP was measured using the Perkins tonometer. The ORA device uses applanation pressure peaks to generate the corneal-compensated IOP (IOPcc), which is reportedly independent of corneal thickness, and the measurement of Goldman-correlated IOP (IOPg), which is influenced by corneal thickness. RESULTS: The measures in group I were as follows: IOPcc 20.92 ± 5.33; IOPg 18.87 ± 6.67; CH 8.51 ± 2.25; CRF 9.85 ± 3.03; and IOP measured by Goldman 18.32 ± 5.13. The measures in group II were as follows: IOPcc 14.33 ± 2.91; IOPg 14.77 ± 3.00; CH 11.37 ± 1.61; CRF 11.02 ± 1.74; and IOP measured by Goldman 13.74 ± 2.42. The differences of all parameters compared between both groups were statistically significant (p < 0.001 for CH and for all IOP measures and p = 0.001 for CRF). The values of IOPcc, IOPg and IOP measured with Goldman were higher in group I than the values in group II. However, CH and CRF values were lower in group I. CONCLUSION: A decrease in CH and CRF has been observed in patients with PCG compared to controls. Future research should assess how these parameters are modified in PCG and whether they could provide more information about progression.

Surfactant-free CO2-based microemulsion-like systems.

The presence of water-rich and water-lean nanodomains in a transparent, pressurized "water-acetone-CO2" mixture was revealed by Raman spectroscopy. This nano-structured liquid can be classified as a surfactant-free microemulsion-like system and has the capacity to dissolve hydrophobic compounds, such as ibuprofen, in the presence of large amounts of water. This finding opens new opportunities in the fields of confined reactions and material templating.

Increase in C-reactive protein and lipids in adolescents with psychiatric disease.

Eighteen adolescent patients with severe psychiatric disorders were compared with healthy, eutrophics adolescents for the presence of inflammation and cardiovascular risk factors. We found significant differences in high-sensitivity C-reactive protein, total cholesterol, and triglycerides. Our results show, evidence of an inflammatory status and a deleterious lipid profile, in a very early state of psychiatric disease.