A Differential Thermal Lens Spectrometry Method for Trace Detection.

Thermal lens spectroscopy (TLS) is a high-sensitivity method to determine the concentration of light-absorbing species in samples. Here, we implemented a transient configuration of the technique, with a focused pump and a collimated probe beam coaxially propagating. A Fabry-Perot optical resonator is incorporated allowing multi-passing of the probe beam through the sample to enhance sensitivity. We show how the low detection limit of the method can be reduced approximately by half by making differential measurements of the signal at a far field in the center point of the probe beam spot and that obtained by spatial filtering of the same beam, the so-called eclipsed signal. Measurements were performed in test samples of Deyman's organic dye, Strawberry 2143 v.7, dissolved in ethanol. The thermal lens signal measured as a function of the dye concentration in water at the center of the beam was compared with the differential signal resulting from this and the eclipsed beam.

[Robot-assisted radical prostatectomy with Retzius-Sparing approach vs. modified Frankfurt: comparison of results at 1 year of follow-up]. / Prostatectomía radical asistida por robot con abordaje Retzius-Sparing vs. Frankfurt modificado: comparación de resultados a 1 año de seguimiento.

Background: Robot-assisted radical prostatectomy has positioned itself as the approach of choice in the treatment of prostate cancer. Objective: To compare the outcomes of robot-assisted radical prostatectomy using the Retzius-Sparing (RS) approach against the modified Frankfurt (MF) technique. Method: To describe the perioperative, functional and oncological outcomes of 13 patients with prostate cancer who underwent RS robotic radical prostatectomy compared to MF, evaluating pathological results, urinary continence, sexual function and oncological control in 1 year of follow-up. Results: The average age was 64 years in RS group vs. 61 years in MF group. The values of total prostate antigen were higher in the RS group (25 ng/dl) vs. MF group (11 ng/dl). The volume of gland in RS group was 40.62 ml vs. 63.33 ml in the RS group. All patients were bilaterally neuropreserved, being statistically significant in favor of MF group (p = 0.016). Positive surgical margins were higher in R-S group (38.4%) vs. MF group (33.3%). Conclusions: With RS the same tendency to urinary continence is observed, with a significant difference in erectile function in favor of MF. This preliminary study shows better impact on erectile function.

Antecedentes: La prostatectomía radical asistida por robot se ha posicionado como el abordaje de elección en el tratamiento del cáncer de próstata. Objetivo: Comparar los resultados de la prostatectomía radical asistida por robot utilizando el abordaje Retzius-Sparing (RS) contra el Frankfurt modificado (FM). Método: Se describen los desenlaces perioperatorios, funcionales y oncológicos de 13 pacientes con cáncer de próstata que fueron llevados a prostatectomía radical robótica con RS, en comparación con FM, y se evalúan los resultados patológicos, continencia urinaria, función sexual y control oncológico a 1 año de seguimiento. Resultados: La media de edad fue de 64 años en el grupo RS y de 61 años en el grupo FM. Los valores de antígeno prostático total fueron mayores en el grupo RS (25 ng/dl) que en el FM (11 ng/dl). El volumen de la glándula fue menor en el grupo RS (40.62 ml) que en el FM (63.33 ml). Todos los pacientes fueron neuropreservados bilateralmente, siendo la diferencia estadísticamente significativa a favor de FM (p = 0.016). Los márgenes quirúrgicos positivos fueron mayores en el grupo RS (38.4%) que en el FM (33.3%). Conclusiones: Con RS se observa la misma tendencia a la continencia urinaria, con diferencia significativa en la función eréctil a favor de FM. Este estudio preliminar muestra mejor impacto en la función eréctil.

The Use of Recycled PET for the Synthesis of New Mechanically Improved PVP Composite Nanofibers.

Polyethylene terephthalate (PET) waste has become a major challenge for the conservation of the environment due to difficult degradation. For this reason, it is important to develop new recycling strategies for reusing this waste. In this work, the electrospinning technique was used to synthesize composite nanofibers of polyvinylpyrrolidone (PVP), recycling PET (RPET) that was obtained from the chemical recycling of postconsumer PET with glycolysis and styrene (ST) as a crosslinking agent. The polymer solutions were analyzed by viscosity and frequency sweeping, while the composite nanofibers were characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis/differential scanning calorimetry (TGA/DSC), and nanoindentation to compare their properties. The PVP nanofibers presented an average diameter of 257 nm; the RPET/PVP and RPET/PVP/ST composite nanofibers had average diameters of 361 nm and 394 nm, respectively; and the modulus of elasticity and hardness of the RPET/PVP/ST composite nanofibers were 29 and 20 times larger, respectively, than those of the PVP nanofibers. With the synthesis of these composite nanofibers, a new approach to PET recycling is presented.

Finding and treating early-stage HIV infections: A cost-effectiveness analysis of the Sabes study in Lima, Peru.

Background: Sabes, a treatment-as-prevention intervention among men who have sex with men and transgender women in Lima, Peru, was developed to identify HIV during early primary infection (<3 months from acquisition) through monthly serologic assays and HIV RNA tests. Newly diagnosed individuals were rapidly linked to care and offered to initiate ART. In this study we sought to study the cost-effectiveness of Sabes compared to the standard of care (SOC) for HIV testing and initiation of treatment. Methods: We adapted a compartmental model of HIV transmission to evaluate the cost-effectiveness of the Sabes approach compared to the SOC using a government health care perspective, 20-year time horizon, and 3% annual discounting. We estimated the proportion of cases of HIV detected during early primary infection, reduction in HIV incidence and prevalence, incremental cost-effectiveness ratio (ICER), and net monetary benefit. We analyzed costs using data from the Sabes study, the Peruvian Ministry of Health, published literature, and expert consultation. Findings: The Sabes intervention is projected to identify 9294 early primary HIV infections in Lima, Peru over 20 years. The intervention costs $6,896 per early primary infection diagnosed and by 2038 is expected to decrease the fraction of early infections among prevalent infections by 62%. Sabes is expected to improve health, resulting in greater total discounted QALYs per person than the SOC (16·7 vs 16·4, respectively). Sabes had an ICER of $1431 (22% per capita GDP in Peru) per QALY compared to SOC. Interpretation: Our analysis suggests that in Lima, Peru the Sabes intervention could be a cost-effective approach to reduce the burden of HIV even under stringent cost-effectiveness criteria. This finding suggests that programs that use frequent HIV testing, rapid linkage to care and initiation of ART should be considered as part of a comprehensive HIV prevention strategy. Funding: National Institutes of Health.

Contemporary management of urinary tract stone disease in children within a high volume institution in Mexico.

OBJETIVO: La urolitiasis en pacientes pediátricos es una condición de baja frecuencia, con tendencia hacia el aumento, por lo que es importante actualizar a urólogos sobre las opciones terapéuticas actuales. Describir las características clínicas, las técnicas quirúrgicas y sus resultados usadas para el tratamiento de la urolitiasis en pacientes pediátricos. MATERIALES Y MÉTODOS: El estudio incluyó todos los pacientes menores de 18 años quienes fueron tratados quirúrgicamente por litiasis urinaria desde el año 2017 al 2020, quienes poseían expedientes clínicos completos y seguimiento en el Hospital General de México. RESULTADOS: Veinte y un pacientes menores de 18 años fueron sometidos a procedimientos quirúrgicos para resolver la litiasis urinaria desde el 2017 al 2020. Los pacientes de sexo masculino fueron más afectados que pacientes del sexo femenino con una relación 3:1. El grupo de edad promedio de presentación fue mayor entre los 1-5 años de edad, la mayoría de pacientes poseían un adecuado índice de masa corporal ajustado por edad. El tracto urinario superior fue el mas afectado, solo 9% se localizó en el tracto urinario inferior, la mayoría de casos se resolvieron con técnicas mínimamente invasivas con una tasa de complicaciones de 14%, llegando al estado libre de litiasis en 90.47% de los casos. CONCLUSIONES: La litiasis urinaria es más común en el sexo masculino, generalmente en el grupo de edad pre-escolar. El índice de masa corporal en la mayoría de los casos se encontraba en rangos adecuados para la edad y el abordaje mínimamente invasivo fue utilizado con mayor frecuencia con 14% de complicaciones y un éxito de 90.47%. BACKGROUND: Pediatric urolithiasis is a rare condition around the world. Its presence and incidence are augmenting in developing countries, remarking the importance for urologists to keep updated to latest trends about its management. OBJECTIVE: The aim of this study was to describe the clinical features and therapeutic surgical options and results for urinary tract stone disease in pediatric patients. MATERIALS AND METHODS: This study included all pediatric patients who undergo surgical procedures to manage pediatric urolithiasis between 2017 and 2020 who had complete medical records and adequate follow-up in the General Hospital of México "Dr. Eduardo Liceaga.". RESULTS: Twenty-one pediatric patients undergo surgical treatment for urinary lithiasis between 2017 and 2020. Males were more affected than female with a relation of 3:1. The mean age at the procedure time was between 1 and 5 years old. The majority of the patients had and adequate body mass index (BMI) according to percentile by age. The upper urinary tract was mostly affected by lithiasis, only 9% of cases were located in the lower urinary tract. The majority of cases were treated with minimal invasive techniques with 14% of complications, and success rate of 90.47%. CONCLUSIONS: Urinary lithiasis is more common in male, usually locates at the upper urinary tract, frequently in the group of 1-5 years old, most cases had an adequate BMI, and the most frequently used techniques are minimal invasive, with a lower rate of complications and great success.

A global metagenomic map of urban microbiomes and antimicrobial resistance.

We present a global atlas of 4,728 metagenomic samples from mass-transit systems in 60 cities over 3 years, representing the first systematic, worldwide catalog of the urban microbial ecosystem. This atlas provides an annotated, geospatial profile of microbial strains, functional characteristics, antimicrobial resistance (AMR) markers, and genetic elements, including 10,928 viruses, 1,302 bacteria, 2 archaea, and 838,532 CRISPR arrays not found in reference databases. We identified 4,246 known species of urban microorganisms and a consistent set of 31 species found in 97% of samples that were distinct from human commensal organisms. Profiles of AMR genes varied widely in type and density across cities. Cities showed distinct microbial taxonomic signatures that were driven by climate and geographic differences. These results constitute a high-resolution global metagenomic atlas that enables discovery of organisms and genes, highlights potential public health and forensic applications, and provides a culture-independent view of AMR burden in cities.

Defining the Histopathological Term Atypical Intraepidermal Melanocytic Proliferation: A Retrospective Cross-Sectional Study.

BACKGROUND: Atypical intraepidermal melanocytic proliferation (AIMP) is a general term assigned to melanocytic proliferations of uncertain biological potential when a definitive histopathological diagnosis cannot be achieved. There are few data available describing the possibility of malignancy of AIMP, or ways to further define diagnosis. OBJECTIVE: To determine the rate of diagnostic change of AIMP to melanoma or melanoma in situ (MIS) after conventional excision. In addition, to determine the role of immunohistochemistry (IHC) in defining AIMP biopsies. METHODS: Retrospective cross-sectional, single-center review of biopsies with a diagnosis of AIMP with a follow-up conventional excision from 2012-2016 was performed. In a separate analysis, a search was performed for AIMP biopsied lesions in which IHC was subsequently performed. RESULTS: The rate of diagnostic change of AIMP to MIS was 4.8% (8/167) after excision. Punch biopsy was a risk factor for diagnostic change to MIS (odds ratio 12.94, confidence interval 2.56-65.38, P = 0.008). The rate of diagnostic change of AIMP biopsies after examining with IHC was 21.3% (34/160) to MIS and 4.4% (7/160) to melanoma. CONCLUSION: The possibility of malignancy of AIMP lesions must be taken into consideration when counseling patients and when planning treatment options. IHC is a useful tool and should be used in the evaluation of AIMP specimens.

Non-Melanoma Skin Cancer Tumor's Characteristics and Histologic Subtype as a Predictor for Subclinical Spread and Number of Mohs Stages required to Achieve Tumor-Free Margins.

OBJECTIVE: To describe the behavior of non-melanoma skin cancer (NMSC) based on tumor's characteristics. METHODS: A total of 219 of NMSC were analyzed via a retrospective medical chart review. The data obtained from each record included but was not limited to: number of Mohs micrographic surgery (MMS) stages required for tumor clearance, defect size, repair type and size according to the neoplasm's histopathologic subtype. RESULTS: The mean number of stages required to clear morpheaphorm/infiltrative and micronodular basal cell carcinomas (BCCs) (n= 34) was 2.03, while the nodular and superficial BCCs (n= 125) needed a mean of 1.56 stages (p value= .034). Of the tumors located on a high-risk zone, 59.6% required two or more stages to be cleared while 67.7% of the lesions on a non-high risk zone were cleared with one stage (p value = 0.001). Recurrent tumors required a mean 2.22 MMS stages to be cleared, whereas primary tumors required a mean 1.61 stages (p value= .006). CONCLUSION: Subclinical spread was seen in morpheaform/infiltrative and micronodular BCC histologic subtypes, recurrent tumors, and tumors in high-risk locations. These could help predict aggressive tumor behavior and optimize surgical planning.

Pigmented Lesions of the Nail Unit.

Pigmented lesions of the nail unit are commonly encountered in the clinical setting. Yet, they often present a unique challenge to clinicians because of a broad differential diagnosis or unfamiliarity with clinical and histopathologic features. A wide variety of causes exist ranging from benign lesions such as subungual hemorrhage to malignant lesions such as subungual melanoma. Identifying the underlying cause is key to appropriate management and follow-up in these patients. Although emerging clinical tools such as dermoscopy can be very useful in evaluation of these lesions, histopathologic analysis remains the gold standard. In this review, we discuss and provide a summary of important clinical and histopathological concepts of pigmented lesions of the nail unit with special focus on longitudinal melanonychia, melanotic macule, melanocytic nevus, subungual melanoma, along with discussion of some nonmelanocytic lesions.

Role of Skin Biopsies in the Diagnosis of Hemophagocytic Lymphohistiocytosis.

This is a report of a 15-year-old female who presented with a skin eruption and clinical features consistent with severe sepsis and septic shock. A diagnosis of acquired hemophagocytic lymphohistiocytosis (HLH) was made and confirmed by bone marrow analysis. Skin biopsy showed hemophagocytosis and CD163-positive staining of macrophages. We briefly review the clinical, histologic, and laboratory findings of hemophagocytic lymphohistiocytosis in addition to the potential role of skin biopsies in this condition.

Leprosy in Puerto Rico: insight into the new millennia.

BACKGROUND: Leprosy, or Hansen's disease, is a chronic infectious disease caused by the bacillus Mycobacterium leprae. In 2000, the World Health Organization (WHO) defined the elimination of the disease as a global prevalence of less than one case per 10,000 population. However, disease transmission is an ongoing worldwide public health concern, as evidenced by the more than 220,000 new cases diagnosed each year. METHODS: This study is an update of the incidence and prevalence of leprosy in Puerto Rico for the period of 2000-2014. A retrospective analysis of data was obtained from the Tropical Disease Clinic (TDC) of the University of Puerto Rico School of Medicine. RESULTS: Sixty-three new cases of leprosy are detailed in this study. Disease incidence and prevalence were 1.65 and 5.26 per 100,000 inhabitants (of the island of Puerto Rico), respectively, and an average of 4.2 new cases per year. Most of the male patients in the study suffered from lepromatous leprosy (P = 0.026). In all, 47 (74.6%) patients had been born in Puerto Rico, and 29 (46%) had an affected family member or were in close contact with someone with leprosy. CONCLUSIONS: Compared to those of previous studies, these results demonstrate a decrease in both the incidence and prevalence of leprosy in Puerto Rico over the past 15 years. The relatively high prevalence of leprosy in Puerto Rico means that it remains endemic on the island. Concerted efforts must be undertaken to achieve the goal of the elimination of this old and stigmatized disease.

Sol-Gel PMMA-ZrO2 Hybrid Layers as Gate Dielectric for Low-Temperature ZnO-Based Thin-Film Transistors.

We report a simple sol-gel process for the deposition of poly(methyl methacrylate) (PMMA)-ZrO2 organic-inorganic hybrid films at low temperature and studied their properties as a function of the molar ratios of the precursors in the hybrid sol-gel solution, which included zirconium propoxide as the inorganic (zirconia) source, methyl methacrylate as the organic source, and 3-trimethoxy-silyl-propyl-methacrylate (TMSPM) as the coupling agent to enhance the compatibility between the organic and inorganic phases. The hybrid thin-film deposition was done on glass slide substrates by the dip-coating method. After deposition, the films were heat-treated at 100 °C for 24 h. The analysis of the hybrid films included Fourier transform infrared spectroscopy to identify their chemical groups and thermogravimetric analysis to determine the content of their organic and inorganic components. In addition, capacitance-voltage (C-V) and current-voltage (I-V) curves in metal-insulator-metal structures, using gold as metal contacts, were measured to find the dielectric constant and leakage current of the PMMA-ZrO2 hybrid films. Finally, because of their adequate dielectric characteristics, single hybrid layers were deposited on indium tin oxide-coated glass substrates and were tested as gate dielectric in thin-film transistors (TFTs), using sputtered ZnO layers as the semiconductor active channel. We measured the output electrical response and transfer characteristics of these hybrid dielectric gate-based devices and determined their main electrical parameters as a function of the TMSPM content in the hybrid dielectric gate layer. The better TFT electrical behavior presents field effect mobility of 0.48 cm2/V s, low threshold voltage of 3.3 V, and on/off current ratio of 105, and it was obtained by using PMMA-ZrO2 with 0.3 TMSPM content as the gate dielectric layer. The values obtained for the electrical parameters show that PMMA-ZrO2 hybrid films are quite suitable for dielectric gate applications in TFTs.

Palisaded Granuloma on the Nose: An Atypical Presentation of Granuloma Annulare.

Granuloma annulare (GA) is a common, asymptomatic dermatosis of unknown etiology. Many variants exist, among them widespread papules, papules in photodistribution, papules marked by tiny crusts ("perforating" GA), patches, plaques, and nodules (subcutaneous GA). The histopathological hallmark is a palisaded histiocytic infiltrate surrounding a central area of degenerated collagen with abundant mucin deposits. We report 2 women who presented with persistent nodules on the nose, which, on histopathological examination, showed a palisaded granuloma. We propose that these cases represent an unusual variant of GA occurring on the nose.

Extraocular Sebaceous Carcinoma-A Clinicopathologic Reassessment.

Sebaceous carcinoma is an aggressive adnexal neoplasm with sebaceous differentiation. Few reports have described the histopathologic characteristics of the sebaceous carcinoma occurring extraocularly. Seventy-two cases of extraocular sebaceous carcinoma were identified from the database of a Dermatopathology Laboratory from January 1, 2007 to May 31, 2013. More cases occurred in men (60%), with a mean age at diagnosis of 65.8 years (range 39-99 years). Neoplasms were histopathologically classified as well-differentiated (22%), moderately differentiated (67%), and poorly differentiated (11%). Sixty-seven percent (67%) of cases demonstrated a squamoid growth pattern and thirty-three percent (33%) demonstrated a basaloid growth pattern. A majority of the neoplasms histopathologically classified as well-differentiated (94%) and moderately differentiated (65%) demonstrated a squamoid growth pattern. Ten percent (10%) of cases exhibited cystic histopathologic changes. The histopathological features reported in this study aid in the understanding of extraocular sebaceous carcinoma and its eventual diagnosis and classification.

Rosacea-Like Leukemia Cutis: A Case Report.

Leukemia cutis describes the infiltration and dissemination of neoplastic leukemic cells into the epidermis, dermis, or subcutis, resulting in clinically identifiable cutaneous lesions. Depending on the type of leukemia, a wide range of clinical and histopathological findings may be encountered. This report describes a patient with a rosacea-like eruption as a unique clinical presentation of T-cell prolymphocytic leukemia.

Clear-Cell Atypical Fibroxanthoma: A Combined Immunohistochemistry Analysis.

Atypical fibroxanthoma is considered to be a low-grade sarcoma, characterized by a proliferation of bizarre spindled cells. A case of a rare variant of this tumor, a clear-cell atypical fibroxanthoma, presenting with rapid growth on a 63-year-old female, is reported. The differential diagnosis of a clear cell proliferation and a review of the immunohistochemistry markers used in the diagnosis of atypical fibroxanthoma are discussed. In particular, the usefulness of markers such as CD10, procollagen 1, CD68, CD163, CD99, and S100A6, and the importance of negative markers such as S100, cytokeratin, and desmin are emphasized. Furthermore, the development of a keratoacanthoma at the site of previous Mohs surgery is recounted.

Superior Efficacy and Safety of a Nonemulsive Variant of the NGcGM3/VSSP Vaccine in Advanced Breast Cancer Patients.

NGcGM3 ganglioside is a tumor-specific antigen expressed in human breast tumors. The NGcGM3/VSSP vaccine, consisting in very small-sized proteoliposomes (VSSP) obtained by the incorporation of NGcGM3 into the outer membrane protein complex of Neisseria meningitidis, has been previously tested in a Phase II trial in patients with metastatic breast cancer (MBC) but emulsified with Montanide ISA 51. An Expanded Access study was carried out in MBC patients aiming to find if a nonemulsive formulation of NGcGM3/VSSP, without Montanide ISA 51, could be more safe and effective. A total of 104 patients were vaccinated with the nonemulsive formulation (900 µg), subcutaneously (SC), or with the emulsive formulation (200 µg), intramuscularly (IM). An intent-to-treat analysis of efficacy was performed with all patients, and 93 patients were split off according to the site of metastases (visceral/nonvisceral). Of note, SC-treated patients exhibited a superior median overall survival (OS) than IM-treated patients (23.6 vs. 8.2 months; log rank P = 0.001). Even though in the subset of patients with nonvisceral metastases SC vaccination duplicated the median OS compared to the alternative option (31.6 vs. 16.5 months), this difference did not reach statistical significance (log rank P = 0.118). Curiously, in patients with visceral metastases, the advantage of the nonemulsive formulation was more apparent (median OS 21.0 vs. 6.2 months; log rank P = 0.005). The vaccine was safe for both formulations.