Evaluation of doxorubicin and ß-lapachone analogs as anticancer agents, a biological and computational study.

We have conducted an experimental and computational evaluation of new doxorubicin (4a-c) and ß-lapachone (5a-c) analogs. These novel anticancer analogs were previously synthesized, but had not been tested or characterized until now. We have evaluated their antiproliferative and DNA cleavage inhibition properties using breast (MCF-7 and MDA-MB-231) and prostate (PC3) cancer cell lines. Additionally, cell cycle analysis was performed using flow cytometry. Computational studies, including molecular docking, pharmacokinetic properties, and an analysis of DFT and QTAIM chemical descriptors, were performed to gain insights into the electronic structure and elucidate the molecular binding of the new ß-lapachone and doxorubicin analogs with a DNA sequence and Topoisomerase II (Topo II)α. Our results show that 4a analog displays the highest antiproliferative activity in cancer cell lines by inducing cell death. We observed that stacking interactions and hydrogen bonding are essential to stabilize the molecule-DNA-Topo IIα complex. Moreover, 4a and 5a analogs inhibited Topo's DNA cleavage activity. Pharmacodynamic results indicated that studied molecules have favorable adsorption and permeability properties. The calculated chemical descriptors indicate that electron accumulation in quinone rings is relevant to the reactivity and biological activity. Based on our results, 4a is a strong candidate for becoming an anticancer drug.

[Overweight and obesity in children aged 5-11 years in Mexico - Why is necessary an interdisciplinary approach?] / Sobrepeso y obesidad en niños de 5 a 11 años en México en el periodo 1999-2021: ¿por qué es necesario un abordaje interdisciplinario?

Introduction: Introduction: overweight and obesity in children are serious public health problems in Mexico. Objective: to analyze the behavior of the prevalence of overweight and obesity in children from 5 to 11 years of age and to present projections on the prevalence for the period 2022-2026. Methodology: ecological and retrospective study whose units of analysis were groups of children of Mexico with overweight and obesity in the period 1999-2021, according to information collected from six National Health and Nutrition Surveys. For the projections the classical method of least squares was used, for a trend analysis of both conditions for the period 2022-2026. Results: overweight in girls and obesity in boys shows a high prevalence in the period 1999-2021, even though the trend analysis for the period 2022-2026 shows a slight decrease in overweight for the group of boys and a slight increase in overweight for girls, as well in obesity for both groups. Conclusions: due to the high prevalence of overweight and obesity in children from 5 to 11 years of age in Mexico, an interdisciplinary approach is required to identify which dimensions (biochemical, psychological, interpersonal and social) participate in the problem, considering three environments contributing for psychological and social development of children, the ecological-social, the family and the school.

Introducción: Introducción: el sobrepeso y la obesidad en niños son serios problemas de salud pública en México. Objetivo: analizar el comportamiento de la prevalencia de sobrepeso y obesidad en niños de 5 a 11 años y presentar proyecciones sobre su prevalencia para el periodo 2022-2026. Metodología: estudio ecológico y retrospectivo cuyas unidades de análisis fueron grupos de niños con sobrepeso y obesidad en el periodo 1999-2021, de acuerdo con información recabada en seis Encuestas Nacionales de Salud y Nutrición en México. Para las proyecciones se utilizó el método clásico de mínimos cuadrados, con el que se realizó un análisis de tendencia de ambas condiciones para el periodo 2022-2026. Resultados: el sobrepeso en niñas y la obesidad en niños muestra una elevada prevalencia en el periodo 1999-2021, aun cuando el análisis de tendencia para el periodo 2022-2026 muestra un ligero decremento en el sobrepeso para el grupo de niños y un ligero incremento en el sobrepeso para las niñas, así como en la obesidad para ambos grupos. Conclusión: Debido a la elevada prevalencia de sobrepeso y obesidad en niños de 5 a 11 años en México, se precisa de su abordaje interdisciplinario para identificar qué dimensiones (bioquímica, psicológica, interpersonal y social) participan en el problema, considerando tres ambientes que contribuyen al desarrollo psicológico y social de los niños, el ecológico-social, el familiar y el escolar.

Synthesis, In Silico Study, and In Vitro Antifungal Activity of New 5-(1,3-Diphenyl-1H-Pyrazol-4-yl)-4-Tosyl-4,5-Dihydrooxazoles.

The increase in multi-drug resistant Candida strains has caused a sharp rise in life-threatening fungal infections in immunosuppressed patients, including those with SARS-CoV-2. Novel antifungal drugs are needed to combat multi-drug-resistant yeasts. This study aimed to synthesize a new series of 2-oxazolines and evaluate the ligands in vitro for the inhibition of six Candida species and in silico for affinity to the CYP51 enzymes (obtained with molecular modeling and protein homology) of the same species. The 5-(1,3-diphenyl-1H-pyrazol-4-yl)-4-tosyl-4,5-dihydrooxazoles 6a-j were synthesized using the Van Leusen reaction between 1,3-diphenyl-4-formylpyrazoles 4a-j and TosMIC 5 in the presence of K2CO3 or KOH without heating, resulting in short reaction times, high compound purity, and high yields. The docking studies revealed good affinity for the active site of the CYP51 enzymes of the Candida species in the following order: 6a-j > 4a-j > fluconazole (the reference drug). The in vitro testing of the compounds against the Candida species showed lower MIC values for 6a-j than 4a-j, and for 4a-j than fluconazole, thus correlating well with the in silico findings. According to growth rescue assays, 6a-j and 4a-j (like fluconazole) inhibit ergosterol synthesis. The in silico toxicity assessment evidenced the safety of compounds 6a-j, which merit further research as possible antifungal drugs.

Simultaneous unilateral central retinal vein occlusion and branch retinal artery occlusion after Coronavirus Disease 2019 (COVID-19) mRNA vaccine / Oclusão unilateral simultânea da veia retiniana central e artéria retiniana ramificada após vacina mRNA COVID-19

ABSTRACT A 51-year-old non-obese woman presented with a one-week history of progressive blurry vision within the inferior visual field of her left eye. Her only relevant past medical history was long-standing hypothyroidism and recent vaccination against Coronavirus Disease 2019 (COVID-19) with an mRNA vaccine 12 days before the onset of symptoms. At examination, the anterior segment was unremarkable, but the retinal fundus revealed a central retinal vein occlusion associated with a branch retinal artery occlusion of the superior temporal branch in her left eye. Ancillary tests to rule out thrombophilia, hyperviscosity, hypercoagulability, or inflammation were negative. Ultrasound tests were also negative for a cardiac or carotid origin of the branch retinal artery occlusion. At two-month follow-up, no new retinal vascular occlusive events were observed. Although the best-corrected visual acuity at presentation was 8/10 in the left eye, the final best-corrected visual acuity remained 3/10.

RESUMO Uma mulher de 51 anos, não obesa, apresentou história de uma semana de visão embaçada progressiva no campo visual inferior do olho esquerdo. Seu único histórico médico anterior relevante era hipotireoidismo de longa data e uma recente vacinação contra a Doença de Coronavírus 2019 (COVID-19), com vacina de mRNA, 12 dias antes do início dos sintomas. O exame mostrou segmento anterior normal, mas o fundo da retina revelou uma oclusão da veia central da retina associada a uma oclusão de ramo arterial da retina do ramo temporal superior no olho esquerdo. Testes auxiliares para descartar trombofilia, hiperviscosidade, hipercoagulabilidade ou inflamação apresentaram resultados negativos. Testes de ultrassom também foram negativos quanto a uma origem cardíaca ou da carótida da oclusão do ramo da artéria da retina. Após dois meses de acompanhamento, nenhum novo evento vascular oclusivo retiniano foi observado. Embora, a acuidade visual melhor corrigida na apresentação tenha sido de 8/10 no olho esquerdo, a acuidade visual final melhor corrigida permaneceu em 3/10.

Paracoccidoidomicosis: Reporte de 4 casos

La paracoccidioidomicosis (PCM) es una infección causada por hongos patógenos humanos del género Paracoccidioides. Es una micosis sistémica que puede afectar cualquier órgano. Se describen con este reporte cuatro casos de paracoccidioidomicosis con diferentes presentaciones clínicas, tiempo de evolución, con afectación mucocutánea, pulmonar, glándulas suprarrenales, sistema nervioso entre otros, principalmente en adultos varones de diferentes edades y profesiones, tanto inmunosuprimidos como inmunocompetentes, teniendo en común el contacto con el suelo. Se demuestra de esta manera la importancia de considerar esta patología ante una sospecha clínica de micosis sistémica para así realizar una confirmación temprana y tratamiento oportuno ya que presenta buena respuesta terapéutica antimicótica y mejoría clínica.

Paracoccidioidomycosis (PCM) is an infection caused by human pathogenic fungi of the genus Paracoccidioides. This report describes: 4 cases of paracoccidioidomycosis diagnosed with different clinical presentations, different times of evolution, with mucocutaneous, pulmonary, adrenal gland, and nervous system involvement, among others, mainly in male adults of different ages and professions, both immunosuppressed and immunocompetent, having in common contact with the ground. In this way, PCM is a systemic mycosis that can affect any organ and therefore the importance of considering this pathology when a diagnostic suspicion of systemic mycosis is presented in order to make an early diagnosis and timely treatment since it presents a good therapeutic response, antifungal and clinical improvement.

Republication of "First Metatarsophalangeal Joint Arthrodesis: Functional Outcomes Using 2 Different Fixation Techniques. Is More Expensive Better?"

Background: First metatarsophalangeal (MTP) joint arthrodesis can be fixed using either a dorsal plate or crossed screws. However, there is considerable difference in the cost of these implants, and it is not known if there is sufficient difference in outcome that might justify this cost difference. Our aim was to compare the functional results and patient satisfaction rates after first MTP joint arthrodesis in a group of patients using the same surgical technique except for the fixation devices. Methods: A prospective cohort of 27 patients who underwent first MTP joint fusion by the same surgeon using 2 crossed screws or a single screw with a dorsal plate was recruited over a 3-year period. Demographic information, patient satisfaction rates, complications, and union rates were evaluated. American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scoring systems were used pre- and postoperatively to compare the functional outcomes. Thirty consecutive procedures (screws, n = 15; plate, n = 15) were performed. Age (55.8 ± 11.1 vs 63.3 ± 12.4 years for screws and plate respectively; P = .091) and female gender percentages (80% and 73%, P = .666) were similar between groups. Results: The overall union rate was 93% with no differences between groups. AOFAS and VAS scores improved significantly postoperatively for each technique, and no differences were found between the two in the improvement in AOFAS (42.4 ± 8.0 vs 44.3 ± 8.2, screws and plate respectively; P = .520) and VAS scores (66.0 ± 5.4 vs 69.0 ± 6.9;P = .195). The implant cost for screws was $40 and for dorsal plate, $328. Conclusions: First MTP joint fusion using either screws or plate fixation results in an improvement in AOFAS and VAS scores. Functional improvement and patient satisfaction did not differ between the 2 techniques, despite a considerable difference in cost between the two methods of fixation. Level of Evidence: Level III, prospective comparative study.

Pluronic F127 and P104 Polymeric Micelles as Efficient Nanocarriers for Loading and Release of Single and Dual Antineoplastic Drugs.

The potential application of biodegradable and biocompatible polymeric micelles formed by Pluronic F127 and P104 as nanocarriers of the antineoplastic drugs docetaxel (DOCE) and doxorubicin (DOXO) is presented in this work. The release profile was carried out under sink conditions at 37 °C and analyzed using the Higuchi, Korsmeyer-Peppas, and Peppas-Sahlin diffusion models. The cell viability of HeLa cells was evaluated using the proliferation cell counting kit CCK-8 assay. The formed polymeric micelles solubilized significant amounts of DOCE and DOXO, and released them in a sustained manner for 48 h, with a release profile composed of an initial rapid release within the first 12 h followed by a much slower phase the end of the experiments. In addition, the release was faster under acidic conditions. The model that best fit the experimental data was the Korsmeyer-Peppas one and denoted a drug release dominated by Fickian diffusion. When HeLa cells were exposed for 48 h to DOXO and DOCE drugs loaded inside P104 and F127 micelles, they showed lower IC50 values than those reported by other researchers using polymeric nanoparticles, dendrimers or liposomes as alternative carriers, indicating that a lower drug concentration is needed to decrease cell viability by 50%.

Cuerpos jóvenes y control de territorios en el triángulo del huachicol / Youth bodies and control of territories in the Huachicol triangle / Corpos jovens e controle de territórios no triângulo Huachicol

Resumen (analítico) Esta es una investigación antropológica con metodología etnográfica que muestra las dinámicas de violencia que buscan controlar los cuerpos jóvenes y sus territorios, provocando miedo y muerte en el llamado "triángulo del huachicol" en Guanajuato, México. Se analiza la experiencia de siete jóvenes sobrevivientes de un evento de ejecuciones donde asesinaron a dos de sus amigos. Los hallazgos evidencian que los cuerpos de los jóvenes están siendo disputados por los distintos poderes de los grupos del crimen organizado y por las fuerzas armadas del Estado mexicano. Las conclusiones explican que dichos jóvenes están vinculándose de forma cotidiana a efectos de lo que autores han llamado necropolítica ante un sistemático juvenicidio.

Abstract (analytical) This is an anthropological investigation that uses an ethnographic methodology to enquire about the dynamics of violence that control young bodies and their territories, producing fear and death in the so-called "Huachicol Triangle" in Guanajuato, Mexico. The experiences of 7 young survivors of an execution event in which two of their friends were murdered is analyzed. The findings show that control over the bodies of young people in this region are being disputed by different organized crime groups and the Armed Forces of the Mexican State. The conclusions identify that these young people are subject to necropolitical forces on a daily basis due to the systematic extermination of young people that occurs in this zone.

Resumo (analítico) Esta é uma investigação antropológica com metodologia etnográfica, que mostra as dinâmicas de violência que buscam controlar os corpos jovens e seus territórios, causando medo e morte no chamado "triângulo huachicol" em Guanajuato, México. É analisada a experiência de 7 jovens sobreviventes de um evento de execução onde dois de seus amigos foram assassinados. Os resultados mostram que os corpos dos jovens estão sendo disputados pelos diferentes poderes dos grupos do crime organizado e pelas forças armadas do Estado mexicano. As conclusões explicam que esses jovens estão ligados diariamente para fins do que os autores chamaram de necropolítica diante de um assassinato sistemático de jovens.

Simultaneous unilateral central retinal vein occlusion and branch retinal artery occlusion after Coronavirus Disease 2019 (COVID-19) mRNA vaccine.

A 51-year-old non-obese woman presented with a one-week history of progressive blurry vision within the inferior visual field of her left eye. Her only relevant past medical history was long-standing hypothyroidism and recent vaccination against Coronavirus Disease 2019 (COVID-19) with an mRNA vaccine 12 days before the onset of symptoms. At examination, the anterior segment was unremarkable, but the retinal fundus revealed a central retinal vein occlusion associated with a branch retinal artery occlusion of the superior temporal branch in her left eye. Ancillary tests to rule out thrombophilia, hyperviscosity, hypercoagulability, or inflammation were negative. Ultrasound tests were also negative for a cardiac or carotid origin of the branch retinal artery occlusion. At two-month follow-up, no new retinal vascular occlusive events were observed. Although the best-corrected visual acuity at presentation was 8/10 in the left eye, the final best-corrected visual acuity remained 3/10.

A System-on-a-Chip Implementation of a Post-Quantum Cryptography Scheme for Smart Meter Data Communications.

The security of Smart Meter (SM) systems will be a challenge in the era of quantum computing because a quantum computer might exploit characteristics of well-established cryptographic schemes to reach a successful security breach. From a practical perspective, this paper focuses on the feasibility of implementing a quantum-secure lattice-based key encapsulation mechanism in a SM, hardware-constrained equipment. In this regard, the post-quantum cryptography (PQC) scheme, FrodoKEM, an alternate candidate for the National Institute for Standards and Technology (NIST) post-quantum standardization process, is implemented using a System-on-a-Chip (SoC) device in which the Field Programmable Gate Array (FPGA) component is exploited to accelerate the most time-consuming routines in this scheme. Experimental results show that the execution time to run the FrodoKEM scheme in an SoC device reduces to one-third of that obtained by the benchmark implementation (i.e., the software implementation). Also, the attained execution time and hardware resource usage of this SoC-based implementation of the FrodoKEM scheme show that lattice-based cryptography may fit into SM equipment.

Perception on phone medical report to family members of patients admitted by COVID-19 to emergency observation rooms of a tertiary hospital: A cross-sectional study. / Percepción sobre informe médico telefónico a familiares de pacientes ingresados por COVID-19 en salas de observación de emergencias de un hospital terciario: estudio transversal.

Introduction: Medical reports of patients admitted to the emergency services has been modified due to the social distancing needed in the COVID-19 epidemic. For this reason, it is essential to know the family members' perceptions about telephone medical reports. Objective: To determine the perception of care by family members of patients hospitalized due to COVID-19 on telephone medical reports in a tertiary hospital's emergency room in Lima, Peru. Methods: A non-experimental cross-sectional study, through a survey of family members of patients with COVID-19 admitted during July and August 2020. The "External user satisfaction survey of the Ministry of Health" adapted to this setting was used due to the absence of similar studies. Information, respect for the user, efficiency, accessibility, suitability, security, and overall satisfaction were considered. The sample size for finite populations was selected from 2 936 family members, obtaining 347 surveys from 641 calls. Relatives were called by phone, and after acceptance, the survey was sent to them via WhatsApp in Google Forms format. Once the survey was received, it was analyzed using descriptive statistical techniques. Results: We made 641 telephone calls with a response rate of 54.1%, obtaining 347 surveys. The mean age was 40.12 years (standard deviation: 11.93 years), with 61.4% of females and 38.0% married. We found that 65.1% received higher education and that Chorrillos was the most prevalent district (10.1%). Moreover, 42.4% of those surveyed were children of hospitalized patients, 17.3% were spouses, and 85% were not health personnel. We found a high level of agreement in overall satisfaction (73.2%) and in most dimensions, including information (88.8%), respect for the user (82.1%), efficiency (70.3%), accessibility (75.8%), suitability (79.0%), and security (87.9%). Conclusion: The telephone medical reports to relatives of patients hospitalized due to COVID-19 in the emergency room found an overall satisfaction of 73.2% . Telephone medical reports are essential alternatives to improve the quality of care during the COVID-19 epidemic.

Introducción: El informe médico sobre el estado de salud del paciente ingresado a los servicios de emergencia se ha modificado, debido al necesario distanciamiento por la epidemia de COVID-19. Por esto, es importante conocer la percepción que tienen los familiares informados sobre el reporte médico telefónico implementado. Objetivo: Determinar la percepción de los parientes sobre la atención de pacientes internados por COVID-19, a través del informe médico telefónico entregado a las familias en el servicio de emergencia de un hospital terciario del Seguro Social de Salud (EsSalud), Lima, Perú. Métodos: Estudio transversal observacional, mediante encuesta a familiares de pacientes con COVID-19 ingresados durante los meses de julio y agosto del año 2020. Se usó como base la "Encuesta de satisfacción de usuario externo del Ministerio de Salud" adaptada a esta realidad, no habiéndose realizado ningún trabajo similar a este en forma previa. Se consideraron las dimensiones información, respeto al usuario, eficacia, accesibilidad, oportunidad, seguridad y satisfacción global. Se seleccionó la muestra para poblaciones finitas de 2936 familiares, obteniéndose 347 encuestas de 641 llamadas realizadas. Se les llamó telefónicamente y, previa aceptación, se les envió la encuesta vía en formato . Recibida la encuesta, se procedió a su análisis mediante técnicas de estadística descriptiva. Resultados: Se realizaron 641 llamadas telefónicas con una tasa de respuesta de 54,1% obteniéndose 347 encuestas. La edad promedio fue de 40,12 años (desviación estándar de 11,93), de los cuales 61,4% era del sexo femenino y 38% estaban casados. El 65,1% de los entrevistados tenía educación superior. Dentro de los distritos de procedencia, Chorrillos tuvo más encuestados con 10,1%. El 42,4% de los encuestados fueron hijos de los pacientes internados, 17,3% fueron cónyuges y el 85% no era personal de salud. Las dimensiones con percepción de acuerdo fueron: información 88,8%, respeto de usuario 82,1%, eficacia 70,3%; accesibilidad 75,8%; oportunidad 79,0% y seguridad 87,9%. La satisfacción global obtuvo un 73,2% de acuerdo. Conclusiones: La información médica telefónica entregada a los familiares de pacientes internados por COVID-19 en las salas de emergencia, encontró una satisfacción global de 73,2% de acuerdo. La información médica telefónica es una alternativa importante para mejorar la calidad de atención durante la epidemia por COVID-19.

[Time of care and its impact in the evolution of laryngeal cancer]. / El tiempo de atención y su impacto en la evolución del cáncer laríngeo.

Background: Laryngeal carcinoma is the 22nd most common cause of cancer in men worldwide and the second most common head and neck malignancy. The care of these patients is multidisciplinary. Factors such as tumor stage and initiation of treatment 60 days after diagnosis have been associated with worse survival. Objective: To know the overall time of care in laryngeal cancer and its impact on the outcome of patients in a tertiary health center. Material and methods: In July 2020, a retrospective study was carried out of 173 patients with laryngeal cancer diagnosed in the Department of Otorhinolaryngology from January 2014 to December 2018. Odds ratio and Fisher's exact test were calculated with a p value of 0.05. Results: 2 out of 77 patients started treatment at the recommended time. The total attention time (TAT) was 246 ± 159 days. 56% of the patients were still alive, 43% disease-free and 10% with progression. Control of the disease was achieved in 69% of early tumors and only 26% in advanced ones. Conclusions: The overall time of care impacts on the health status, affecting survival and control of disease. The stage of the tumor at the time of diagnosis is a decisive prognosis factor. Strategies towards multidisciplinary management and early detection in primary care should be created.

Introducción: el carcinoma de laringe es la vigésima segunda causa más común de cáncer en hombres a nivel mundial y la segunda malignidad más común en cabeza y cuello. La atención de estos pacientes es multidisciplinaria. Factores como el estadio del tumor y el inicio del tratamiento 60 días después del diagnóstico han sido asociados a una peor sobrevida. Objetivo: conocer el tiempo integrado de atención del cáncer de laringe y su impacto en el estado de salud de los pacientes en un centro terciario de atención. Material y métodos: en julio de 2020 se llevó a cabo un estudio retrospectivo de 173 pacientes con cáncer de laringe diagnosticados en el Servicio de Otorrinolaringología de enero de 2014 a diciembre de 2018. Se calculó la razón de momios y la prueba exacta de Fisher con valor de p = 0.05. Resultados: dos de 77 pacientes iniciaron tratamiento en tiempo recomendado. El tiempo total de atención fue de 246 +/- 159 días. El 56% de los pacientes continuaban con vida, 43% libres de enfermedad y 10% con progresión. El control de la enfermedad se logró en el 69% de los tumores tempranos y solo el 26% en los avanzados. Conclusiones: el tiempo integrado de atención impactó en el estado de salud, lo cual afectó en la sobrevida y el control de la enfermedad. El estadio de la enfermedad al momento del diagnóstico es un factor decisivo para el pronóstico. Deberán crearse estrategias para el manejo multidisciplinario y la detección temprana en la atención primaria.

Percepción sobre informe médico telefónico a familiares de pacientes ingresados por COVID-19 en salas de observación de emergencias de un hospital terciario: estudio transversal / Perception on phone medical report to family members of patients admitted by COVID-19 to emergency observation rooms of a tertiary hospital: a cross-sectional study

Introducción: El informe médico sobre el estado de salud del paciente ingresado a los servicios de emergencia se ha modificado, debido al necesario distanciamiento por la epidemia de COVID-19. Por esto, es importante conocer la percepción que tienen los familiares informados sobre el reporte médico telefónico implementado. Objetivo: Determinar la percepción de los parientes sobre la atención de pacientes internados por COVID-19, a través del informe médico telefónico entregado a las familias en el servicio de emergencia de un hospital terciario del Seguro Social de Salud (EsSalud), Lima, Perú. Métodos: Estudio transversal observacional, mediante encuesta a familiares de pacientes con COVID-19 ingresados durante los meses de julio y agosto del año 2020. Se usó como base la "Encuesta de satisfacción de usuario externo del Ministerio de Salud" adaptada a esta realidad, no habiéndose realizado ningún trabajo similar a este en forma previa. Se consideraron las dimensiones información, respeto al usuario, eficacia, accesibilidad, oportunidad, seguridad y satisfacción global. Se seleccionó la muestra para poblaciones finitas de 2936 familiares, obteniéndose 347 encuestas de 641 llamadas realizadas. Se les llamó telefónicamente y, previa aceptación, se les envió la encuesta vía en formato . Recibida la encuesta, se procedió a su análisis mediante técnicas de estadística descriptiva. Resultados: Se realizaron 641 llamadas telefónicas con una tasa de respuesta de 54,1% obteniéndose 347 encuestas. La edad promedio fue de 40,12 años (desviación estándar de 11,93), de los cuales 61,4% era del sexo femenino y 38% estaban casados. El 65,1% de los entrevistados tenía educación superior. Dentro de los distritos de procedencia, Chorrillos tuvo más encuestados con 10,1%. El 42,4% de los encuestados fueron hijos de los pacientes internados, 17,3% fueron cónyuges y el 85% no era personal de salud. Las dimensiones con percepción de acuerdo fueron: información 88,8%, respeto de usuario 82,1%, eficacia 70,3%; accesibilidad 75,8%; oportunidad 79,0% y seguridad 87,9%. La satisfacción global obtuvo un 73,2% de acuerdo. Conclusiones: La información médica telefónica entregada a los familiares de pacientes internados por COVID-19 en las salas de emergencia, encontró una satisfacción global de 73,2% de acuerdo. La información médica telefónica es una alternativa importante para mejorar la calidad de atención durante la epidemia por COVID-19.

Introduction: Medical reports of patients admitted to the emergency services has been modified due to the social distancing needed in the COVID-19 epidemic. For this reason, it is essential to know the family members' perceptions about telephone medical reports. Objective: To determine the perception of care by family members of patients hospitalized due to COVID-19 on telephone medical reports in a tertiary hospital's emergency room in Lima, Peru. Methods: A non-experimental cross-sectional study, through a survey of family members of patients with COVID-19 admitted during July and August 2020. The "External user satisfaction survey of the Ministry of Health" adapted to this setting was used due to the absence of similar studies. Information, respect for the user, efficiency, accessibility, suitability, security, and overall satisfaction were considered. The sample size for finite populations was selected from 2 936 family members, obtaining 347 surveys from 641 calls. Relatives were called by phone, and after acceptance, the survey was sent to them via WhatsApp in Google Forms format. Once the survey was received, it was analyzed using descriptive statistical techniques. Results: We made 641 telephone calls with a response rate of 54.1%, obtaining 347 surveys. The mean age was 40.12 years (standard deviation: 11.93 years), with 61.4% of females and 38.0% married. We found that 65.1% received higher education and that Chorrillos was the most prevalent district (10.1%). Moreover, 42.4% of those surveyed were children of hospitalized patients, 17.3% were spouses, and 85% were not health personnel. We found a high level of agreement in overall satisfaction (73.2%) and in most dimensions, including information (88.8%), respect for the user (82.1%), efficiency (70.3%), accessibility (75.8%), suitability (79.0%), and security (87.9%). Conclusion: The telephone medical reports to relatives of patients hospitalized due to COVID-19 in the emergency room found an overall satisfaction of 73.2% . Telephone medical reports are essential alternatives to improve the quality of care during the COVID-19 epidemic.

Manejo anestésico de una gestante con síndrome de Morquio / Anesthetic Management for a pregnant woman with Morquio syndrome Sobre los autores:

Introducción: El síndrome de Morquio es una enfermedad hereditaria autosómica recesiva con distintos grados de afectación al metabolismo de los glúcidos, lo que genera incapacidad para romper los enlaces de las cadenas largas de glucosamiglicanos, esto provoca acumulación de mucopolisacáridos en distintos tejidos del cuerpo humano. Objetivo: Describir el manejo anestésico de una gestante con síndrome de Morquio. Presentación del caso: Gestante primigesta de 30 años de edad, de raza negra, de 103 cm de estatura y 33 Kg de peso. Acude a consulta preoperatoria por presentar embarazo a término, baja talla y se realizó interrupción del embarazo por vía alta. Se procede a la valoración preanestésica donde se recoge antecedentes de enfermedad genética e ingreso previo por presentar cifras elevadas de tensión arterial. La paciente padecía de alergia a la dipirona. Conclusiones: Los pacientes con mucopolisacaridosis tienen una alta incidencia de dificultad para la ventilación y la intubación endotraqueal asociada con insuficiencia cardiopulmonar. La afectación de la columna presenta dificultades adicionales para los anestesiólogos. Cualquier cirugía electiva requiere una evaluación preoperatoria de los factores de riesgo anestesiológicos y la disponibilidad de un espectro de equipos para el manejo de las vías respiratorias. La anestesia debe ser realizada por un equipo con experiencia en el manejo de la vía aérea(AU)

Introduction: Morquio syndrome is an autosomal recessive hereditary disease that affects, to different extents, carbohydrate metabolism, which obstructs the ability to break bonds of long chains of glycosaminoglycans, causing mucopolysaccharides accumulation in different tissues of the human body. Objective: To describe the anesthetic management of a pregnant woman with Morquio syndrome. Case presentation: This is the case of a 30-year-old primigravid pregnant woman, of black skin, 103 cm of height and 33 kg of weight. She came for preoperative consultation because she was pregnant at term and had low body size; the pregnancy was terminated through the abdominal route. A preanesthetic assessment was performed, which permitted to observe a history of genetic disease and previous admission for high blood pressure. The patient was allergic to dipyrone. Conclusions: Among patients with mucopolysaccharidosis, there is a high incidence of difficulty for ventilation and endotracheal intubation associated with cardiopulmonary insufficiency. Spinal involvement represents additional difficulties for anesthesiologists. Any elective surgery requires preoperative assessment of anesthesiologic risk factors and the availability of a spectrum of airway management equipment. Anesthetic managment should be performed by a team experienced in airway management(AU)

Afrontando la tercera ola de COVID-19 en el departamento de emergencia del Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú, 2021

Perú ha sido uno de los países más afectados por la pandemia de COVID-19. Luego de haber sufrido dos olas epidémicas devastadoras, el departamento de emergencia del Hospital Nacional Edgardo Rebagliati Martins mantuvo como reto la preparación, de forma constante y dinámica, para afrontar una tercera ola que ya azotó a muchos países del mundo. Para esto, el departamento se preparó en todos los ámbitos para contribuir a la reducción del impacto de la enfermedad, garantizando no solo la calidad en la atención, sino también la seguridad del personal de salud, modulando la carga laboral y mental generada por la sobredemanda de la pandemia. De esta manera, el departamento estuvo mejor preparado cuando ocurrió la tercera ola. En conclusión, la preparación constante y dinámica es fundamental para afrontar el aumento de casos; así como también, garantizar la seguridad y bienestar del personal de salud.

Peru has been one of the countries most affected by the COVID-19 pandemic. After having suffered two devastating epidemic waves, the emergency department of the Edgardo Rebagliati Martins National Hospital maintained the challenge of constantly and dynamically preparing to face a third wave that has already hit many countries around the world. For this, the department prepared itself in all areas, to contribute to reducing the impact of the disease, guaranteeing not only the quality of care, but also the safety of health personnel, modulating the work and mental load generated by the pandemic over-demand. In this way, the department was better prepared when the third wave occurred. In conclusion, constant and dynamic preparation is essential to face the increase in cases; as well as to guarantee the safety and well- being of health personnel.

3D Printed Parahydrophobic Surfaces as Multireaction Platforms.

Parahydrophobic surfaces (PHSs) composed of arrays of cubic µ-pillars with a double scale of roughness and variable wettability were systematically obtained in one step and a widely accessible stereolithographic Formlabs 3D printer. The wettability control was achieved by combining the geometrical parameters (H = height and P = pitch) and the surface modification with fluoroalkyl silane compounds. Homogeneous distribution of F and Si atoms onto the pillars was observed by XPS and SEM-EDAX. A nano-roughness on the heads of the pillars was achieved without any post-treatment. The smallest P values lead to surfaces with static contact angles (CAs) >150° regardless of the H utilized. Interestingly, the relationship 0.6 ≤ H/P ≤ 2.6 obtained here was in good agreement with the H/P values reported for nano- and submicron pillars. Furthermore, experimental CAs, advancing and receding CAs, were consistent with the theoretical prediction from the Cassie-Baxter model. Structures covered with perfluorodecyltriethoxysilane with high H and short P lead to PHSs. Conversely, structures covered with perfluorodecyltrimethoxysilane exhibited a superhydrophobic behavior. Finally, several aqueous reactions, such as precipitation, coordination complex, and nanoparticle synthesis, were carried out by placing the reactive agents as microdroplets on the parahydrophobic pillars, demonstrating the potential application as chemical multi-reaction array platforms for a large variety of relevant fields in microdroplet manipulation, microfluidics systems, and health monitoring, among others.

Early discharge for patients with benign pleural effusions using a Wayne catheter (pigtail) chest drain - analysis of safety, complications, and quality of life.

OBJECTIVE: to assess safety, efficacy and quality of life in patients with benign pleural effusions undergong pleural drainage with Wayne pleural catheter (DW) in an outpatient setting. METHOD: this is a prospective study, in which 47 patients were evaluated between July 2017 and October 2018. Patients with non-malignant pleural effusions underwent pleural drainage with clinical evolution compatible with outpatient care were included. Patients who underwent drainage due to other conditions and patients were excluded. RESULTS: after catheter placement, the mean length of hospital stay was 3.14 (± 3.85) days, and 21 patients (44.68%) were discharged within 24 hours. The mean time with the catheter was 12.63 (± 7.37) days. The analysis of the pleural fluid was transudate in 87.3% of cases and exudate in 12.3%. The causes of pleural effusion were heart failure (72.3%), renal failure (19.1%), liver failure (6.3%) and pneumonia (8.5%). The quality of life, analyzed according to the parameters of the questionnaire SF 36, showed low average values when compared to other studies. Analyzing each descriptor, the average was greater only in the limitation related to physical aspects. In the other descriptors, the results were similar, but smaller. CONCLUSION: the outpatient use of pleural catheters of the Wayne type (pigtail) proved to be feasible, safe and with a low associated infection rate. This is a viable option for selected patients.

Early discharge for patients with benign pleural effusions using a Wayne catheter (pigtail) chest drain - analysis of safety, complications, and quality of life / Alta precoce para pacientes com derrames pleurais benignos em uso de dreno pleural de Wayne (pigtail) - análise de segurança, complicações e qualidade de vida

ABSTRACT Objective: to assess safety, efficacy and quality of life in patients with benign pleural effusions undergong pleural drainage with Wayne pleural catheter (DW) in an outpatient setting. Method: this is a prospective study, in which 47 patients were evaluated between July 2017 and October 2018. Patients with non-malignant pleural effusions underwent pleural drainage with clinical evolution compatible with outpatient care were included. Patients who underwent drainage due to other conditions and patients were excluded. Results: after catheter placement, the mean length of hospital stay was 3.14 (± 3.85) days, and 21 patients (44.68%) were discharged within 24 hours. The mean time with the catheter was 12.63 (± 7.37) days. The analysis of the pleural fluid was transudate in 87.3% of cases and exudate in 12.3%. The causes of pleural effusion were heart failure (72.3%), renal failure (19.1%), liver failure (6.3%) and pneumonia (8.5%). The quality of life, analyzed according to the parameters of the questionnaire SF 36, showed low average values when compared to other studies. Analyzing each descriptor, the average was greater only in the limitation related to physical aspects. In the other descriptors, the results were similar, but smaller. Conclusion: the outpatient use of pleural catheters of the Wayne type (pigtail) proved to be feasible, safe and with a low associated infection rate. This is a viable option for selected patients.

RESUMO Objetivo: avaliar a segurança, a eficácia, as complicações e a qualidade de vida da alta precoce e acompanhamento ambulatorial de pacientes com derrames pleurais benignos submetidos à drenagem pleural com dreno de Wayne (DW). Método: estudo prospectivo, em que foram avaliados 47 pacientes entre julho de 2017 e outubro de 2018. Foram incluídos os pacientes com derrames pleurais não malignos, submetidos a drenagem pleural com evolução clínica compatível com o cuidado ambulatorial. Foram excluídos os pacientes submetidos a drenagem por outras afecções. Resultados: após a drenagem, a média do tempo de internação dos pacientes foi de 3,14 (±3,85) dias, sendo que 21 pacientes (44,68%) tiveram alta em até 24 horas após a drenagem. O tempo médio de permanência com o dreno foi de 12,63 (±7,37) dias. A análise do líquido pleural mostrou tratar-se de transudato em 87,3% dos casos e de exsudato em 12,3%. Dentre as causas do derrame pleural, destacaram-se insuficiência cardíaca (72,3%), insuficiência renal (19,1%), hepatopatias (6,3%) e pneumonias (8,5%). A qualidade de vida, analisada segundo os parâmetros do questionário SF 36, teve valores médios baixos, principalmente em relação a outros estudos. Na análise de cada descritor, a média apresentou-se maior somente na limitação por aspectos físicos. Nos demais descritores, os resultados foram semelhantes, mas menores. Conclusão: o uso ambulatorial de cateteres pleurais do tipo Wayne (pigtail) mostrou-se factível, seguro e com baixa taxa de infecções associadas. Trata-se de opção viável para pacientes selecionados.