Extensive and deep granulomatous ulcers as an atypical manifestation of cartilage-hair hypoplasia syndrome: A diagnostic and therapeutic challenge.

Cartilage hypoplasia syndrome is a primary immunodeficiency disease characterized by short stature, hypoplastic hair and a variable degree of immunodeficiency. Noninfectious cutaneous granulomas represent an uncommon yet well-recognized manifestation within the spectrum of primary immunodeficiency diseases. However, cutaneous granulomas as a manifestation of cartilage-hair hypoplasia syndrome, are extremely rare. We present a case of a middle-aged man with cartilage hypoplasia syndrome featuring cutaneous granulomas, manifesting as chronic, extensive and deep cutaneous ulcers. The patient was treated with anti-TNF-alpha adalimumab with partial improvement. Our case underscores the broad spectrum of clinical manifestations associated with cartilage hypoplasia syndrome and adds new evidence to the potential therapeutic efficacy of anti-TNF-alpha drugs in its treatment.

Adherence to treatment guidelines in Ambulatory Heart Failure Patients with Reduced Ejection Fraction in a Latin-American Country: Observational Study of the Colombian Heart Failure Registry (RECOLFACA).

INTRODUCTION: Although several guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF) be treated with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) or angiotensin receptor - neprilysin inhibitors (ARNI), beta-blockers, mineralocorticoid receptor antagonists (MRA), and sodium-glucose cocotransporter-2 inhibitor (SGLT2i), there are still several gaps in their prescription and dosage in Colombia. This study aims to describe the use patterns of HFrEF treatments in the Colombian Heart Failure Registry (RECOLFACA). METHODS: Patients with HFrEF enrolled in RECOLFACA during 2017-2019 were included. Heart Failure (HF) medications prescription and daily dose were assessed using absolute numbers and proportions. Therapeutic schemes of patients treated by internal medicine specialists were compared with those treated by cardiologists. RESULTS: Out of 2528 patients in the registry, 1384 (54.7%) had HFrEF. Among those individuals, 88.9% were prescribed beta-blockers, 72.3% with ACEI/ARBs, 67.9% with MRAs, and 13.1% with ARNIs. Moreover, less than a third of the total patients reached the target doses recommended by the European HF guidelines. No significant differences in the therapeutic schemes or target doses were observed between patients treated by internal medicine specialists or cardiologists. CONCLUSION: Prescription rates and target dose achievement is sub-optimal in Colombia. Nevertheless, RECOLFACA had one of the highest prescription rates of beta-blockers and MRAs compared to some of the most recent HF registries. However, ARNIs remain underprescribed. Continuous registry updates can improve the identification of patients suitable for ARNI and SGLT2i therapy to promote their use in clinical practice.

Looking for Novel Natural Gels to Improve Cleaning Methods for Bronze Leachates on Marble.

Marble is one of the materials most susceptible to copper leaching, resulting in easily identifiable turquoise stains on the marble. This problem is particularly relevant when we are talking about marble structures of heritage value. For this reason, conservators look for cleaning materials that are specific to the structure to be treated without damaging the original surface. Materials such as agar have been studied for a long time. Agar creates a controlled water release system that adapts to the needs of conservators who seek the greatest possible cleanliness without damaging the material to be treated. To improve the cleaning, chelating agents such as EDTA are added to the agar composition. However, the microbiological growth and the damage it produces to the original material are disadvantages to take into account. In order to solve these problems, other natural materials with cleaning potential such as kudzu and konjac gels were studied in combination with other chelating agents such as citrate, oxalate, and gluconic acid. For the characterization and evaluation of copper cleaning, various analytical techniques were used, including Raman spectroscopy, colorimetry, X-ray fluorescence (XRF), and inductively coupled plasma mass spectrometry (ICP-MS). In this study, both konjac and kudzu emerged as promising alternatives to agar, revealing distinctive features such as simplified preparation methods and inherent antimicrobial properties. The EDTA chelator was found to be the most harmful for marble surfaces, as it extracted a greater amount of calcium from the marble during application of the gels doped with it. Citrate and gluconic acid have been identified as a promising substitute to prepare doped gels for the removal of copper stains. These compounds exhibit comparable or potentially superior cleaning capabilities than EDTA, with no negative side effects.

Geochemical characterization of the Martian analogues Enekuri and Fruiz, located in the Basque-Cantabrian Basin, by spectroscopic techniques.

This work presents the geochemical characterization of two Martian analogues located in the Basque-Cantabrian Basin: Enekuri and Fruiz. In contrast to previous works carried out on the coastline analogues Meñakoz and Armintza (Biscay, Spain), these new outcrops are not in contact with sea-water nowadays. Hence, the weathering processes observed in Enekuri and Fruiz (inland) are different from those observed in Armintza and Meñakoz (coastline). In this way, among all the mineral phases found the only ones in common between inland and coastline outcrops are albite and chlorites, minerals that were formed in aqueous conditions. Understanding the differences presented in both types of outcrops could help to interpret the future results from the missions Mars2020 and the ExoMars2022, since coastline outcrops are affected by sea-water weathering and inland outcrops are altered by the high biological activity.

Study of Micro-Samples from the Open-Air Rock Art Site of Cueva de la Vieja (Alpera, Albacete, Spain) for Assessing the Performance of a Desalination Treatment.

In this work, some micro-samples belonging to the open-air rock art site of Cueva de la Vieja (Alpera, Albacete, Spain) were analysed. These samples were collected after and before a desalination treatment was carried out, with the aim of removing a whitish layer of concretion that affected the painted panel. The diagnostic study was performed to study the conservation state of the panel, and to then confirm the effectiveness of the treatment. Micro energy dispersive X-ray fluorescence spectrometry, Raman spectroscopy, and X-ray diffraction were employed for the characterization of the degradation product as well as that of the mineral substrate and pigments. The micro-samples analysis demonstrated that the painted layer was settled on a dolomitic limestone with silicon aggregates and aluminosilicates as well as iron oxides. The whitish crust was composed by sulfate compounds such as gypsum (CaSO4·2H2O) with a minor amount of epsomite (MgSO4·7H2O). An extensive phenomenon of biological activity has been demonstrated since then in almost all of the samples that have been analysed, and the presence of calcium oxalates monohydrate (CaC2O4·H2O) and dehydrate (CaC2O4·2H2O) were found. The presence of both calcium oxalates probably favoured the conservation of the pictographs. In addition, some carotenoids pigments, scytonemin (C36H20N2O4), and astaxanthin (C40H52O4) were characterized both by Raman spectroscopy and by X-ray diffraction. Hematite was found as a pigment voluntarily used for the painting of the panels used in a mixture with hydroxyapatite and amorphous carbon. The results of the analyses of the samples taken after the cleaning treatment confirmed a substantial decrease in sulphate formation on the panel surface.

Validación de técnica de ganglio centinela en cáncer de endometrio en el Hospital de Talca / Validation of sentinel lymph node technique in endometrial cancer at the Hospital de Talca

Objetivo: Validar la técnica de ganglio centinela utilizando verde de indocianina en la estadificación del cáncer de endometrio. Método: Realizamos un estudio prospectivo entre enero y diciembre de 2021. Se incluyeron todas las pacientes portadoras de cáncer de endometrio clínicamente en etapa 1, de todos los grados de diferenciación e histologías. Todas las pacientes fueron sometidas a una estadificación laparoscópica. Se inició el procedimiento con identificación de ganglio centinela utilizando verde de indocianina. Posteriormente, se completó la cirugía de estadiaje estándar en todas las pacientes. Los ganglios centinelas fueron procesados con técnica de ultraestadiaje. Resultados: Se incluyeron 33 pacientes. El 81% presentaron histología endometrioide. El 100% fueron sometida además a una linfadenectomía pelviana estándar y el 20% a una linfadenectomía paraaórtica simultáneamente. Se detectó al menos un ganglio centinela en el 100% de los casos. La detección bilateral ocurrió en el 90,9%. La localización más frecuente fue la fosa obturatriz y la arteria hipogástrica. Obtuvimos una sensibilidad del 90% para detectar enfermedad ganglionar y un valor predictivo negativo del 95,8%. Conclusiones: La técnica de ganglio centinela utilizando verde de indocianina es replicable. Los resultados de nuestra serie nos permiten realizar procedimientos menos agresivos al estadificar el cáncer de endometrio.

Objective: To validate sentinel node mapping using indocyanine green in endometrial cancer staging. Method: A prospective study was conducted between January and December 2021. All patients with clinically stage 1 endometrial cancer, of all grades and histologies were included. All patients underwent laparoscopic staging. The procedure began with identification of the sentinel node using indocyanine green. Subsequently, standard staging surgery was completed in all patients. Sentinel nodes were processed using ultrastaging technique. Results: Thirty-three patients were enrolled. 81% of cases had endometrioid histology. All patients also underwent a standard pelvic lymphadenectomy and in 20% of cases a para-aortic lymphadenectomy. At least one sentinel node was detected in 100% of the cases. Bilateral detection occurred in 90.9%. The most frequent location was obturator fossa and hypogastric artery. Sensitivity to detect lymph node disease was 90% and negative predictive value 95.8%. Conclusions: Sentinel lymph node mapping using indocyanine green is a replicable technique. Our results allows us to perform less aggressive procedures in endometrial cancer staging.

Metals and metalloids in high-altitude Pyrenean lakes: sources and distribution in pre-industrial and modern sediments.

High-altitude Pyrenean lakes are ecosystems far from local pollution sources, and thus they are particularly sensitive to the atmospheric deposition of metals and metalloids. This study aims to quantify the effect of human activity in 18 lakes located in both side of the France-Spain frontier. Sediment cores were collected in summer 2013, sampled at a 1cm resolution and the concentration of 24 elements was measured by ICP-MS. Statistic and chemometric analysis of the results highlights the influence of the geographical position and lithogenic features of each lake basin on trapping pollutants. More than the 80% of the lakes showed values of enrichment factor (EF) above 2 for at least one of the elements investigated in at least one core interval, which corroborates the existence of historical anthropogenic inputs of elements in the studied area. The results demonstrate the natural origin of As and Ti in Pyrenees, together with the significant anthropogenic inputs of Cd, Pb, Sb and Sn from ancient times. The data set points mining activities as the main historical source of pollution and illustrate the large impact of the industrial revolution. The regional variability could reflect also differential long-range transport, followed by dry or wet deposition.

Erythrokeratodermia.

This case report describes well-defined, polycyclic, and geographic hyperkeratotic plaques that involved the axillae, chest, flanks, inguinal folds, and buttocks.

Multiple Yellowish Plaques in a Cobblestone Pattern on the Tongue.

A man in his 80s presents with multiple yellowish to erythematous papules and verrucous cobblestone-like plaques on the mucosal surface on both sides of his tongue. What is your diagnosis?

Elemental imaging approach to assess the ability of subaerial biofilms growing on constructions located in tropical climates as potential biomonitors of atmospheric heavy metals pollution.

Over the last decades, the concern about air pollution has increased significantly, especially in urban areas. Active sampling of air pollutants requires specific instrumentation not always available in all the laboratories. Passive sampling has a lower cost than active alternatives but still requires efforts to cover extensive areas. The use of biological systems as passive samplers might be a solution that provides information about air pollution to assist decision-makers in environmental health and urban planning. This study aims to employ subaerial biofilms (SABs) growing naturally on façades of historical and recent constructions as natural passive biomonitors of atmospheric heavy metals pollution. Concretely, SABs spontaneously growing on constructions located in a tropical climate, like the one of the city of Barranquilla (Colombia), have been used to develop the methodological approach here presented as an alternative to SABS grown under laboratory conditions. After a proper identification of the biocolonizers in the SAB through taxonomic and morphological observations, the study of the particulate matter accumulated on the SABs of five constructions was conducted under a multi-analytical approach based mainly on elemental imaging studies by micro Energy Dispersive X-ray fluorescence spectrometry (µ-EDXRF) and Scanning Electron Microscopy coupled with Energy Dispersive X-ray spectrometry (SEM-EDS) techniques, trying to reduce the time needed and associated costs. This methodology allowed to discriminate metals that are part of the original structure of the SABs, from those coming from the anthropogenic emissions. The whole methodology applied assisted the identification of the main metallic particles that could be associated with nearby anthropogenic sources of emission such as Zn, Fe, Mn, Ni and Ti by SEM-EDS and by µ-EDXRF Ba, Sb, Sn, Cl and Br apart others; revealing that it could be used as a good alternative for a rapid screening of the atmospheric heavy metals pollution.

Compositionally and density stratified igneous terrain in Jezero crater, Mars.

Before Perseverance, Jezero crater's floor was variably hypothesized to have a lacustrine, lava, volcanic airfall, or aeolian origin. SuperCam observations in the first 286 Mars days on Mars revealed a volcanic and intrusive terrain with compositional and density stratification. The dominant lithology along the traverse is basaltic, with plagioclase enrichment in stratigraphically higher locations. Stratigraphically lower, layered rocks are richer in normative pyroxene. The lowest observed unit has the highest inferred density and is olivine-rich with coarse (1.5 millimeters) euhedral, relatively unweathered grains, suggesting a cumulate origin. This is the first martian cumulate and shows similarities to martian meteorites, which also express olivine disequilibrium. Alteration materials including carbonates, sulfates, perchlorates, hydrated silicates, and iron oxides are pervasive but low in abundance, suggesting relatively brief lacustrine conditions. Orbital observations link the Jezero floor lithology to the broader Nili-Syrtis region, suggesting that density-driven compositional stratification is a regional characteristic.

Analytical Techniques Applied to the Study of Industrial Archaeology Heritage: The Case of Plaiko Zubixe Footbridge.

In this work, micro-Raman spectroscopy and micro-energy-dispersive X-ray fluorescence spectroscopy (µ-EDXRF) were applied on microsamples taken from the Plaiko Zubixe footbridge (1927) located in Ondarroa (Basque Country, Spain) in order to investigate the original paint coating and make an evaluation of the conservation state before its restoration. Elemental and molecular images were acquired for the study of the compounds distribution. Some modern pigments such as phthalocyanine blue and green pigments, minium, calcium carbonate, Prussian blue, and hematite were identified. Barium sulfate and titanium dioxide were recognized as opacifier agents. Thanks to the study of the stratigraphies, it has been possible to determine the original paint layer, which includes lead white, ultramarine blue, carbon black, and barium sulfate. In addition, colorimetric analyses made it possible to know the CIELab values of the original layer in order to reproduce the original colour during the planned restoration work. The massive presence of chlorine detected by µ-EDXRF and the corrosion products of the rust layer, in particular akaganeite and hematite, highlighted the atmospheric impact in the conservation of the bridge because they were due to the effect of both marine aerosol and to the presence of acidic components in the environment coming from anthropogenic activity. This work demonstrated the usefulness of a scientific approach for the study of industrial archaeology heritage with the aim to contribute to its conservation and restoration.

Reviewing in situ analytical techniques used to research Martian geochemistry: From the Viking Project to the MMX future mission.

The study of space has always been a field of great interest and thus space missions are becoming more and more ambitious with time. Therefore, with the 50th anniversary of the first spacecraft to land on Mars, a review about how traditional analytical techniques have been adapted to the era of in situ space exploration is presented. From the Viking Project to the future MMX mission, the techniques used for the in situ study of the geochemistry of the Martian surface is described. These techniques have been differentiated according to the type of analysis: elemental and molecular. On the one hand, among the elemental analytical techniques the XRF, APXS, ISE and LIBS stand out. On the other hand, GCMS, TEGA, MBS, XRD, Raman and IR spectroscopy have been the molecular techniques used in the missions to Mars. Miniaturization, real-time measurements, automation, low power consumption and reliability of operation under extreme conditions are some of the major challenges that analytical chemistry has faced as a result of the technological and scientific requirements of space missions. In this way, this review gathers all the in situ analytical techniques that have reached the surface of Mars onboard landers or rovers with the aim of studying its geochemistry.

Characterization of atmospheric aerosols in the Antarctic region using Raman Spectroscopy and Scanning Electron Microscopy.

The non-destructive spectroscopic characterization of airborne particulate matter (PM) was performed to gain better knowledge of the internal structures of atmospheric aerosols at the particle level in the Antarctic region, along with their potential sources. PM and soil samples were collected during the 2016-2017 austral summer season at the surroundings of the Spanish Antarctic Research Station "Gabriel de Castilla" (Deception Island, South Shetland Islands). PM was deposited in a low-volume sampler air filter. Raman spectroscopy (RS) and Scanning Electron Microscopy with Energy-Dispersive X-ray Spectroscopy (SEM-EDS) were used to determine the elemental and molecular composition of the individual aerosol and soil particles. Filter spectra measured by these techniques revealed long-range atmospheric transport of organic compounds (polystyrene and bacteria), local single and cluster particles made of different kinds of black carbon (BC), exotic minerals (polyhalite, arcanite, niter, ammonium nitrate, syngenite and nitrogen, phosphorus, and potassium (NPK) fertilizer), and natural PM (sea salts, silicates, iron oxides, etc.). In addition to the filter samples, forsterite and plagioclase were discovered in the soil samples together with magnetite. This is the first report of the presence of a microplastic fiber in the Antarctic air. This fact, together with the presence of other pollutants, reflects that even pristine and remote regions are influenced by anthropogenic activities.

When Red Turns Black: Influence of the 79 AD Volcanic Eruption and Burial Environment on the Blackening/Darkening of Pompeian Cinnabar.

It is widely known that the vivid hue of red cinnabar can darken or turn black. Many authors have studied this transformation, but only a few in the context of the archeological site of Pompeii. In this work, the co-occurrence of different degradation patterns associated with Pompeian cinnabar-containing fresco paintings (alone or in combination with red/yellow ocher pigments) exposed to different types of environments (pre- and post-79 AD atmosphere) is reported. Results obtained from the in situ and laboratory multianalytical methodology revealed the existence of diverse transformation products in the Pompeian cinnabar, consistent with the impact of the environment. The effect of hydrogen sulfide and sulfur dioxide emitted during the 79 AD eruption on the cinnabar transformation was also evaluated by comparing the experimental evidence found on paintings exposed and not exposed to the post-79 AD atmosphere. Our results highlight that not all the darkened areas on the Pompeian cinnabar paintings are related to the transformation of the pigment itself, as clear evidence of darkening associated with the presence of manganese and iron oxide formation (rock varnish) on fragments buried before the 79 AD eruption has also been found.

Non-Destructive Analytical Investigation of Decorative Wallpapers Samples of the Nineteenth Century before Their Restoration.

In this work, decorative wallpapers (19th century) from an historical palace located in Oiartzun (Basque Country, Spain) were analyzed before their restoration. Micro-energy dispersive X-ray fluorescence spectroscopy, Raman spectroscopy, and attenuated total reflectance infrared spectroscopy were used to investigate the elemental and molecular composition of pigments, the presence of binders, and the state of conservation of the paper support. The aim of the investigation was trying to understand the possible degradation pathways and identify the raw materials in order to choose the best restoration protocol according to the original aspect of wallpapers. As stated from both the elemental distribution and the identification of mineral phases by Raman spectroscopy, the most used pigment was lead chromate. It was mixed with other pigments such as ultramarine blue, zinc chromate, hematite, and atacamite among others to obtain different shades and they were applied mixed with an animal glue. Brass, identified thanks to elemental micro-EDXRF maps, was employed as a shiny decorative element. In addition, a partial degradation of cellulose was detected due to its natural ageing, the acidic nature of lignin, and to a phenomenon of humidity of the walls. Probably the deposition of black particulate matter was the cause of the darkening of the painting surfaces.