A putative new Besnoitia species in the southern black-eared opossum Didelphis aurita.

Besnoitia spp. are cyst-forming coccidian parasites with a broad host range, infecting various wild and domestic animal species. Northamerican opossums (Didelphis virginiana) are severely affected by the infection with B. darlingi. This study presents a case of infection with Besnoitia in a road-killed female southern black-eared opossum (Didelphis aurita) in Misiones, Argentina. Many 0.5-1 mm cysts were observed in several muscles and visceral organs and were microscopically identified in skeletal muscles, tongue, and heart. Histological analysis disclosed multiple spherical cysts with a myriad of bradyzoites like-cells and a well-defined cyst wall. A small number of degenerate and ruptured cysts, surrounded by mild to moderate inflammation were observed. Genomic DNA from an individual cyst and muscle was extracted and ITS1 marker and 18S rRNA gene fragments from sarcocystid protozoa were successfully amplified by PCR and sequenced. The 18S sequence exhibited 100% identity with sequences of B. darlingi and B. oryctofelisi. Comparison of the complete ITS1 sequence (259 bp) revealed an identity of 99.2% with B. oryctofelisi and 97.7% with B. darlingi. This result together with the phylogeny positioning, suggest that the Besnoitia sp. in the present case differ from B. darlingi, being closely related with B. oryctofelisi.

Complications of Silicone Oil as Vitreous Tamponade in Pars Plana Vitrectomy: A Mini Review.

PURPOSE: Silicone oil (SO) has been used as a vitreous tamponade for decades. Surgical complications such as glaucoma, cataract, or emulsification are well known. Despite that, increasing case reports of unexplained visual loss after SO removal is concerning because there is no treatment available. This article describes practical complications related to SO use and advantages/disadvantages for consideration regarding the choice of a vitreous substitute in practice. METHODS: A literature review was conducted for publications related to silicone oil, heavy silicone oil, and vitreous substitutes. RESULTS: This article summarizes the SO chemical and physical properties including both SO and heavy SO and postoperative complications such as corneal decompensation, glaucoma, hypotony, cataract, optic neuropathy. Surgical complications such as over/underfilling, SO migration/emulsification, sticky SO and proliferative vitreoretinopathy (PVR) simulating epiretinal membranes formation, recurrent retinal detachments, SO unexplained visual loss, and permanent SO, are described. A brief overview on potential vitreous substitutes is presented. CONCLUSION: The decision to use SO as vitreous substitute in daily practice is based on the severity of retinal diseases and surgeon experience. SO potential complications must not be underestimated. The pursuit of novel safer vitreous substitutes is imperative.

Ultrasound-guided supracondylar radial nerve block for closed reduction of a distal radius fracture in the emergency department: Case report.

Background: Closed reduction and a closed cast are common treatments for patients with acute distal radius fractures in the emergency room. Many of the common analgesic techniques such as hematoma block may not be effective, which can hinder the stabilization and reduction of fractures. Case report: An 81-year-old woman who had a Colle's fracture (metaphyseal fracture with dorsal angulation) of the left distal radius arrived at the emergency room. Due to intense pain and need for proper pain management, an ultrasound-guided block of the radial nerve prior to its bifurcation into deep and superficial branches was carried out as an alternative to infiltration of the fracture site. The fracture could be reduced and immobilized with a closed cast as a result of the peripheral nerve block, which caused the patient the least amount of discomfort. Conclusions: The reduction of a distal radius fracture in the emergency room can be accomplished with safe and efficient analgesia using an ultrasound-guided supracondylar radial nerve block close to the beginning of the deep and superficial branches. This is, as far as we are aware, the first report of an ultrasound-guided supracondylar nerve block utilized to treat a distal radius fracture in our nation.

Assessing the potential of native copepods in Guatemala for Aedes vector control.

BACKGROUND: In this study we examine the feeding efficiency of copepods locally found in Guatemala on first instar Aedes aegypti larvae. Copepods are a potential tool for Aedes vector control that has shown promising results in the laboratory and in community-based field trials. METHODS: Four different copepod species from different habitat types were included in the laboratory assays of this study. RESULTS: All four tested copepod species decreased the number of the first instar Aedes larvae that were inserted into the glass vessels compared with controls. However, average predation rates between the tested species were highly different, with Thermocyclops crassus and Mesocyclops longisetus achieving the highest, with 31.0% (standard deviation [SD] 18.9) and 28. 9% (SD 11.2), respectively. CONCLUSIONS: The copepod species with identified high predation rates are potential candidates for planned and other future field trials for community-based Aedes vector control with copepods in the region.

Evaluating CD1a Immunohistochemistry for Tegumentary Leishmaniasis Diagnosis in the New World: A Focus on Colombia.

INTRODUCTION: Leishmaniasis, a chronic vector-borne disease caused by parasites of the genus Leishmania, presents diagnostic challenges. Conventional diagnostic methods struggle with accurate visualization of these parasites. Immunostaining with CD1a has demonstrated effectiveness in visualizing Leishmania parasites, particularly in the Old World. However, the application of CD1a immunostaining in Colombian leishmaniasis remains unexplored. OBJECTIVE: To determine the utility of CD1a as an immunomarker in detecting chronic forms of tegumentary leishmaniasis. MATERIALS AND METHODS: This proof-of-concept study involved 48 paraffin-embedded samples categorized into 3 groups: moderate-to-high parasite load (n = 15), low load (n = 15), and chronic granulomatous inflammation (n = 13); 5 samples diagnosed with cutaneous histoplasmosis. These samples were stained with the immunomarker CD1a clone EP3622 for comparative analysis. In addition, CD1a immunohistochemistry was compared with 18S rDNA qPCR and hematoxylin-eosin staining to evaluate its performance in relation to these established methods. RESULTS: CD1a immunohistochemistry was positive in 46.51% of the samples evaluated. This immunomarker showed lower sensitivity and negative predictive value than 18S rDNA qPCR and hematoxylin-eosin staining; specificity and negative predictive value were consistent. ROC indicated inferior discrimination for leishmaniasis compared with 18 s rDNA qPCR and hematoxylin-eosin staining. CONCLUSIONS: Immunohistochemistry for CD1a could be a diagnostic support in the detection of chronic forms of tegumentary leishmaniasis.

Northward migration past the nearctic biogeographical divide; neotropical Gyrodactylus spp. infecting Astyanax have crossed the Trans-Mexican Volcanic Belt.

The neotropical fish genus Astyanax (Characidae) and its associated helminths migrated northward from South America following the Great American Biotic Interchange (GABI): ca. 150 Astyanax spp. are found throughout South and Central America, up to the Mexico-USA border. Most characids are distributed south of the Trans-Mexican Volcanic Belt (TMVB), which bisects the country and represents a major transition zone between the neotropical and nearctic realms. Here, we characterize parasites of the monogenean genus Gyrodactylus infecting Astyanax spp. in Mexico: Astyanax aeneus south of the TMBV, Astyanax mexicanus north of it. Based on morphological, phylogenetic (internal transcribed spacer (ITS) and cytochrome oxidase subunit II (cox 2)) and statistical analyses of morphometric data, we confirmed the validity of Gyrodactylus pakan and Gyrodactylus teken, and erected two new species, Gyrodactylus aphaa n. sp. and Gyrodactylus ricardoi n. sp. These four gyrodactylids are part of a complex of morphologically cryptic species, which are phylogenetically closely related to each other, and sister species to Gyrodactylus carolinae and Gyrodactylus heteracanthus, parasites of characins in Brazil. Four gyrodactylid lineages (G. pakan, G. ricardoi n. sp., G. teken, Gyrodactylus sp. A) are distributed north of the TMVB; G. pakan is also widely distributed south of the TMVB, together with G. aphaa n. sp. Based on the ITS phylogeny, Brazilian parasites form a sister clade to all Mexican gyrodactylids, whose derived clades are distributed in progressively more northerly latitudes in Mexico - the three most-derived species north of the TMVB. This would suggest that gyrodactylid species diverged gradually, presumably as their characid fish hosts colonized and adapted to new environments north of the TMVB.

Rosai-Dorfman sphenoorbital histiocytosis with intraparenchymal invasion: Do we have to consider this skull base pathology as a malignant disease?

Background: Rosai-Dorfman disease (RDD) is a rare type of histiocytosis that can manifest with diverse symptoms. It usually presents with systemic involvement, and only a few cases have been reported at the level of the skull base. RDD typically follows a benign course during the progression of the disease. In this particular case reported, after the skull base invasion, the disease started to infiltrate the brain parenchyma. Our objective for this case report was to present this particular progression pattern and the nuances of its surgical treatment. In addition, a revision of the current literature was performed about skull base RDD with intracranial invasion and brain parenchyma infiltration not previously described. Case Description: We are presenting the case study of a 57-year-old male patient who was experiencing severe headaches and an increase in volume in the right fronto-orbital region. On clinical examination, no neurologic clinical symptoms were observed. Contrast computed tomography and magnetic resonance imaging showed a tumor mass that affected the right orbit, frontal paranasal sinus, greater sphenoid wing, and right frontal lobe with moderate adjacent brain edema. The patient underwent surgery using an extended pterional approach with intracranial, orbital decompression, and frontal sinus cranialization, accompanied by frontal lobe tumor resection. Neuropathologic diagnosis revealed a Rosai-Dorfman histiocytosis disease. Conclusion: The etiopathogenesis of RDD is still not completely understood. The current literature considers this disease to have a predominantly benign course. Nevertheless, as we have shown in this case, it may, in some cases, present direct parenchymal invasion. We consider that prompt surgical treatment should be ideal to avoid the local and systemic progression of the disease.

Subdural drain with Nelaton catheter and latex glove, a low-cost alternative and how to make it.

Background: One of the most commonly encountered surgical pathologies in neurosurgical practice worldwide is subdural hematoma. The use of prefabricated drains following surgical procedures is widely recommended. However, their availability can be inconsistent due to various issues. Methods: An intensive search was conducted regarding the availability and cost of subdural drains. The Medtronic subdural evacuating port system costs between 100 and 150 USD, the Blake drain costs between 35 and 40 USD, and the Jackson-Pratt drain costs between 25 and 35 USD. We present a low-cost alternative and describe how it can be implemented using materials available in almost every hospital. Results: A simple step-by-step guide for crafting handmade subdural drains has been created, aiming to make this affordable alternative accessible to every surgeon who may need one due to the unavailability of prefabricated drains in developing countries. Conclusion: The benefits associated with using a subdural drain during the evacuation of subdural hematomas are well-documented. In cases where prefabricated drains are not available, a handmade alternative can always be utilized. Materials are often readily available in every hospital, and the cost may not exceed 100 MXN (5 USD), making it at least 5 times cheaper than the cheapest prefabricated alternative. This solution is particularly beneficial for developing countries without access to prefabricated drains.

Implementation of an early attention strategy to reduce emergency room overcrowding in an academic institution in Colombia, a pilot study.

Overcrowding is a worldwide problem, and long waiting times are associated with increased morbidity and even mortality of patients regardless of triage classification. Although there are many tools published in the literature that contribute to the reduction of overcrowding, for the Colombian population there are not many tools evaluated to reduce the length of stay of patients in the emergency department. This is a retrospective analytical study that compared whether there was a difference in patient definition time and ED length of stay between a group attended under an early care protocol (PAT) versus the usual protocol. Of the total of 969 patients included it was found that the group attended under the PAT protocol had a shorter definition time than the usual protocol, also the Emergency department length of stay (EDLOS) was significantly lower in the PAT group compared to the usual protocol. The implementation of the PAT protocol performed by emergency physicians allows a faster contact with the patient by the physician, and leads to a significant reduction of EDLOS, contributing to the reduction of overcrowding in the emergency department.

PIWIL1 is recruited to centrosomes during mitosis in colorectal cancer cells and is linked to cell cycle progression.

PIWI proteins, traditionally associated with germline development, have recently gained attention for their expression in various cancers, including colorectal cancer. However, the molecular mechanisms underlying their reactivation and impact on cancer initiation and progression remain elusive. Here, we found that PIWIL1 is expressed at relatively high levels in CRC-derived samples and cell lines, where it undergoes a dynamic relocalization to the centrosome during mitosis. Knockdown of PIWIL1 induces G2/M arrest associated with disruption of the mitotic spindle and aberrant metaphase events, highlighting its role in cell cycle progression. We also found that the expression of PIWIL1 is lost during the differentiation of Caco-2 cells into enterocytes and that PIWIL1 is expressed in cells at the base of the intestinal crypts in normal human colon tissue, where intestinal stem cells are known to reside. Thus, it is possible that the presence of PIWIL1 in cancer cells reflects a physiological role of this protein in stem cell maintenance, which would argue in favor of the proposed stem cell origin of CRC. Supporting this view, dedifferentiation of human fibroblasts into induced pluripotent stem cells (iPSCs) involves the reactivation of PIWIL2 expression, another member of the PIWI protein family. Overall, our findings suggest a role of PIWIL1 in mediating cell cycle dynamics, both in colorectal cancer cells and possibly also in intestinal stem cells. In a broader aspect, we provide evidence supporting an involvement of PIWI proteins in somatic stem cell maintenance, thus expanding the known non-gonadal functions of this protein family.

Rescue, Rehabilitation, and Feeding Schedule of a Franciscana Dolphin (Pontoporia blainvillei) Calf Stranded in Argentina.

The franciscana dolphin (Pontoporia blainvillei) is a small cetacean endemic to the coastal waters of the southwestern Atlantic Ocean. Due to its restricted distribution, it is subject to high bycatch mortality in the gillnets used for commercial and artisanal fishing. The rehabilitation of the franciscana is still a major challenge, as most attempts to rehabilitate stranded animals have failed. This study aims to present the case of the rehabilitation of a franciscana dolphin calf, stranded in San Clemente del Tuyú, Argentina, at the beginning of the predation period. The feeding strategy and nutritional profile at different stages during the 88 days of rehabilitation are meticulously detailed. Its diet was prepared by hand based on studies of milk composition, the feeding ecology of franciscana in Argentinean waters, and previous records of the Fundación Mundo Marino Rehabilitation Center. The diets were designed to meet the nutritional needs of franciscana dolphins. In addition, the hematological, cytological, and fecal analyses recorded during the rehabilitation are presented. Although the animal could not be released, due to its death, this report provides baseline information that can improve the ability of veterinarians to care for debilitated, live-stranded dolphins. This information may also be useful in the implementation and development of healthcare protocols for this species.

Neuroactive hormones and personal growth: associations in Chilean adolescents (ages 12-25) with ovulatory dysfunction.

Introduction: Hormones produced by the hypothalamic-pituitary-adrenal-gonadal (HPAG) axis are crucial for modulating central nervous system (CNS) function and development throughout a person's life. Disruptions in HPAG function can impact psychological development, particularly during adolescence-a period marked by psychological growth and the maturation of the HPAG axis. An early indicator of HPAG alterations is ovulatory dysfunction (OD), a common condition among adolescents. Methods: This study explored the associations between neuroactive hormones and personal growth in adolescents with OD. Female participants aged 12-25 years with OD were recruited, and assessments were conducted to profile their basic hormonal levels and various dimensions of individual development, including self-concept clarity, sense of coherence, self-esteem, perfectionism, self-control, and mood states. Results: Adolescents with OD (n = 117) had lower self-concept clarity and self-esteem compared to reference data. A significant portion of the sample displayed elevated levels of tension (71.25%), confusion (62.5%), fatigue (58.22%), and depression (52.6%). Self-esteem scores were negatively correlated with DHEAS (r = -0.224; p = 0.026) and glucose (r = -0.249; p = 0.010). Higher levels of free testosterone were associated with increased depression scores (coef = 0.2398; p = 0.002), whereas higher estradiol levels were linked to lower aggressiveness scores (coef = -0.0648; p = 0.001). Discussion: These findings indicate that hormonal imbalances in adolescents with OD could affect personal growth. Further research is needed to establish causal relationships between the variables considered.

Intestinal Dysbiosis: Exploring Definition, Associated Symptoms, and Perspectives for a Comprehensive Understanding - a Scoping Review.

Dysbiosis is a clinical condition marked by altered gut microbiota resulting from external and internal host factors. It is strongly associated with gastrointestinal and extraintestinal alterations, so its symptomatology is broad and nonspecific. To date, gaps remain that limit professionals from making a timely diagnosis and prescribing the appropriate treatment. We aim to synthesize existing literature regarding clinical parameters for the early detection of patients with intestinal dysbiosis and the clinical events in which the use of probiotics as adjuvant therapy is most frequently reported. A scoping review of the literature was conducted in PubMed, Embase, Cochrane, and BVS (Biblioteca Virtual en Salud in Spanish) databases for articles published in the last 5 years. Primary studies and literature reviews related to clinical presentation, dysbiosis screening, and probiotics as adjuvant therapy for adult and pediatric patients were included. Twenty-three articles were retrieved in which the most frequently reported symptoms were abdominal distension, abdominal pain, and diarrhea. Chronic and metabolic diseases where the conditions most strongly associated with dysbiosis. Depending on symptomatology and etiology, dysbiosis is often treated with probiotics. Dysbiosis, often linked to diarrhea, should be considered with other symptoms like abdominal distension and pain, along with predisposing conditions and patient risk factors. Probiotics are commonly used as co-adjuvant treatments for antibiotic-associated diarrhea, irritable bowel syndrome, and childhood allergic diseases. The most commonly used probiotics were Weizmannia coagulans (formerly B. coagulans), Alkalihalobacillus clausii (formerly Bacillus clausii), Lacticaseibacillus rhamnosus, Limosilactobacillus reuteri, and Saccharomyces boulardii.

Smoking, all-cause, and cause-specific mortality in individuals with diabetes in Mexico: an analysis of the Mexico city prospective study.

OBJECTIVE: Evidence from low- and middle-income countries regarding the effect of smoking in people with diabetes is lacking. Here, we report the association of smoking with mortality in a large cohort of Mexican adults with diabetes. METHODS: Participants with diabetes mellitus (self-reported diagnosis, use of antidiabetic medications or HbA1c ≥ 6.5%) aged 35-74 years when recruited into the Mexico City Prospective Study were included. Cox regression confounder-adjusted mortality rate ratios (RRs) associated with baseline smoking status were estimated. RESULTS: Among 15,975 women and 8225 men aged 35-74 years with diabetes but no other comorbidities at recruitment, 2498 (16%) women and 2875 (35%) men reported former smoking and 2753 (17%) women, and 3796 (46%) men reported current smoking. During a median of 17 years of follow-up there were 5087 deaths at ages 35-74 years. Compared with never smoking, all-cause mortality RR was 1.08 (95%CI 1.01-1.17) for former smoking, 1.11 (95%CI 1.03-1.20) for current smoking, 1.09 (95%CI 0.99-1.20) for non-daily smoking, 1.06 (95%CI 0.96-1.16) for smoking < 10 cigarettes/day (median during follow-up 4 cigarettes/day), and 1.28 (95% CI 1.14-1.43) for smoking ≥ 10 cigarettes/day (median during follow-up 15 cigarettes/day). Mortality risk among daily smokers was greatest for COPD, lung cancer, cardiovascular diseases, and acute diabetic complications. CONCLUSION: In this cohort of Mexican adults with diabetes, low-intensity daily smoking was associated with increased mortality, despite observing smoking patterns which are different from other populations, and over 5% of total deaths were associated with smoking.

Emotional Impact of COVID-19 and Emotional Eating and the Risk of Alcohol Use Disorder in Peruvian Healthcare Students.

BACKGROUND: This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students. METHODS: We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman's correlations were calculated and two multiple linear regression models were developed. RESULTS: 68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder. CONCLUSIONS: To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling.

Genetic variants in triglyceride metabolism genes among individuals with hypertriglyceridemia in Colombia.

BACKGROUND: The genetic substrate of severe hypertriglyceridemia (sHTG) in Latin America is insufficiently understood. OBJECTIVE: To identify genetic variants in genes related to triglyceride (TG) metabolism among adults with sHTG from Colombia. METHODS: In individuals with plasma TG≥880 mg/dL at least once in their lifetime, we amplified and sequenced all exons and intron/exon boundaries of the genes LPL, APOC2, APOA5, GPIHBP1 and LMF1. For each variant we ascertained its location, zygosity, allelic frequency and pathogenicity classification according to American College of Medical Genetics (ACMG) criteria. RESULTS: The study included 166 participants (62 % male, mean age 50), peak TG levels ranged between 894 and 11,000 mg/dL. We identified 92 variants: 19 in LPL, 7 in APOC2, 11 in GPIHBP1, 38 in LMF1, and 17 in APOA5. Eighteen of these variants had not been reported. We identified a new pathogenic variant in LMF1 (c.41C>A; p.Ser14*), a new likely pathogenic variant in LMF1 (c.1527 C > T; p.Pro509=, also expressed as c.1447C>T; p.Gln483*), and a known pathogenic variant in LMF1 (c.779G>A; p.Trp260*). Four participants were heterozygous for variant c.953A>G; p.Asn318Ser in LPL, a known risk factor for hypertriglyceridemia. Participants with variants of unknown significance (VUS) in LMF1 had significantly higher peak TG than those with VUS in other genes. Peak TG were 4317 mg/dL in participants with a history of pancreatitis, and 1769 mg/dL in those without it (p = 0.001). CONCLUSION: Our study identified variants associated with sHTG among Latinos, and showed that genetic variation in LMF1 may be frequently associated with sHTG in this population.

Effect of Citric Acid Hard Anodizing on the Mechanical Properties and Corrosion Resistance of Different Aluminum Alloys.

Hard anodizing is used to improve the anodic films' mechanical qualities and aluminum alloys' corrosion resistance. Applications for anodic oxide coatings on aluminum alloys include the space environment. In this work, the aluminum alloys 2024-T3 (Al-Cu), 6061-T6 (Al-Mg-Si), and 7075-T6 (Al-Zn) were prepared by hard anodizing electrochemical treatment using citric and sulfur acid baths at different concentrations. The aim of the work is to observe the effect of citric acid on the microstructure of the substrate, the mechanical properties, the corrosion resistance, and the morphology of the hard anodic layers. Hard anodizing was performed on three different aluminum alloys using three citric-sulfuric acid mixtures for 60 min and using current densities of 3.0 and 4.5 A/dm2. Vickers microhardness (HV) measurements and scanning electron microscopy (SEM) were utilized to determine the mechanical characteristics and microstructure of the hard anodizing material, and electrochemical techniques to understand the corrosion kinetics. The result indicates that the aluminum alloy 6061-T6 (Al-Mg-Si) has the maximum hard-coat thickness and hardness. The oxidation of Zn and Mg during the anodizing process found in the 7075-T6 (Al-Zn) alloy promotes oxide formation. Because of the high copper concentration, the oxide layer that forms on the 2024-T6 (Al-Cu) Al alloy has the lowest thickness, hardness, and corrosion resistance. Citric and sulfuric acid solutions can be used to provide hard anodizing in a variety of aluminum alloys that have corrosion resistance and mechanical qualities on par with or better than traditional sulfuric acid anodizing.

Genomic Landscape in Prostate Cancer in a Latin American Population.

PURPOSE: This study aims to describe genomic characteristics of patients with metastatic prostate cancer (mPC). PATIENTS AND METHODS: This study is a retrospective, multicenter cohort study of patients with mPC and reports on genomic testing. Patients were included from 12 academic centers in five countries. RESULTS: A total of 349 patients with PC were included in this study. Most patients (209, 59.9%) were de novo metastatic. Genomic analysis was performed in 233 (66.6%) patients in the metastatic castration-resistant prostate cancer (mCRPC) setting, and only 115 (32.8%) patients had a tumor evaluation in the metastatic hormone sensitive prostate cancer scenario. The evaluation of somatic and/or germline mutations was performed through multigene panel analyses in 290 (83.09%) patients, and next-generation sequencing of BRCA1 and BRCA2 genes was performed in 59 (16.91%) patients. Analyzing the mCRPC subgroup, with a median follow-up of 15.6 months (IQR, 14-19.06), the median progression-free survival (PFS) was not reached (NR) and the PFS at 16 months was 58.7% (95% CI, 50.8 to 67.8). When comparing patients with BRCA mutations with those who are not BRCA-mutated in the mCRPC scenario, the median PFS was NR (95% CI, 14 to NR) and 26.3 months (95% CI, 16.7 to 36.5; P = .2), respectively. Two of six patients with BRCA mutations were treated with targeted therapies (poly-ADP-ribose polymerase inhibitors). CONCLUSION: Our study, to the best of our knowledge, represents one of the larger data sets for somatic testing in patients with PC in Latin America (LATAM). It adds valuable information to the growing body of knowledge about the genomic landscape of advanced PC in real-world daily practice scenarios in LATAM countries, which are not always well-represented in large-scale randomized clinical trials.

Surgical planning aided with 3D technologies for management of complex paracardiac tumors.

BACKGROUND: Accurate diagnosis and treatment of complex cardiac tumors poses challenges, particularly when surgical resection is considered. 3D reconstruction and printing appear as a novel approach to allow heart teams for optimal surgical and post operative care. METHODS: We report two patients with uncommon masses including a cardiac angiosarcoma (CAS) and a IgG4-related disease (IgG4-RD) with exclusive cardiac involvement. In both cases, three-dimensional (3D) reconstruction and 3D-printed models were utilized to aid the surgical team achieve optimal pre-operative planning. Both patients underwent ECG-gated cardiac computed tomography angiography (CCTA) imaging and, due to the complex anatomy of the masses, their large dimensions, proximity to vital cardiac and vascular structures, and unclear etiology, computational and 3D-printed models were created for surgical planning. An exploratory literature review of studies using 3D-printed models in surgical planning was performed. RESULTS: In case 1 (CAS), due to the size and extension of the mass to the right ventricular free wall, surgical intervention was not considered curative and, during thoracotomy, an open biopsy confirmed the imaging suspicion of CAS which guided the initiation of optimal medical treatment with chemotherapy and, after clear tumor retraction, the patient underwent a second surgical intervention, and during the 18 months of follow-up showed no signs of recurrence. In Case 2 (IgG4-RD), the patient underwent uncomplicated total surgical resection; this allowed directed treatment and, at 12 months follow-up, there are no signs of recurrence. Computational and 3D-printed models were used to plan the surgery and to confirm the findings. Limited studies have explored the use of 3D printing in the surgical planning of tumors. CONCLUSIONS: We present two patients with uncommon cardiac tumors, highlighting the significant value of 3D models in the anatomical characterization and assessment of their extension. These models may be essential in surgical planning for complex cardiovascular cases and could provide more information than conventional imaging modalities. Further studies are needed to demonstrate the impact of 3D technologies in studying cardiac tumors.