Clinical characteristics, imaging findings, management, and outcomes of patients with scimitar syndrome at a tertiary referral healthcare center in Colombia.

Scimitar Syndrome is part of a complex spectrum of congenital cardiovascular anomalies related to anomalous pulmonary venous return. Depending on the extent of involvement, treatment can be either expectant or surgical. Prognosis and survival have been controversial, with some results supporting early surgical management. This research aims to disclose the outcomes and describe the management, clinical and imaging characteristics of patients diagnosed with Scimitar Syndrome treated in a tertiary referral healthcare center. Longitudinal descriptive observational study. The study included all patients diagnosed with scimitar syndrome in our institution between January/2011 and December/2022. A description of the sociodemographic and clinical characteristics, diagnostic tools used, treatment features, and patient outcomes is provided. Eleven patients were included, with a mean age at diagnosis of five years (CI 0-17), six of which were female (54.55%). Nine (81.82%) patients had evidence of a scimitar vein on the chest radiograph, six (54.55%) cardiac dextroposition, six (54.55%) pulmonary hypoplasia, five (45.45%) right pulmonary artery hypoplasia, and three (27.27%) had aortopulmonary collaterals. Four (36.36%) patients had horseshoe lungs, and four (36.36%) had bronchopulmonary sequestration. In the associations, two (18.18%) patients were found to have an atrial septal defect, three (27.27%) ventricular septal defect, and one (9%) had Tetralogy of Fallot. Pulmonary hypertension was demonstrated in two (18.18%) patients. Seven (63.64%) required surgical management to correct the scimitar vein, and two patients died due to unrelated complications. Scimitar syndrome presents diagnostic and treatment challenges, necessitating a multidisciplinary approach for timely care. Chest radiography and CT scans are primary diagnostic tools, with surgical intervention often warranted alongside other heart defects or significant hemodynamic repercussions. Medical management is effective for mild to moderate cases. Long-term patient outcomes remain uncertain due to study limitations, but improved life expectancy is anticipated with ongoing care.

Experience of percutaneous closure of small to large patent ductus arteriosus with Nit-Occlud® device in a tertiary referral hospital in Colombia.

Background: The decision to close patent ductus arteriosus should always be individualized and taken together with the child's family once the risks and benefits of both choices have been exposed. Objective: This study aims to report the experience and outcomes in patients undergoing endovascular closure of small to medium-size PDA with a Nit-Occlud® device in a tertiary referral hospital in Colombia. Methods: Longitudinal descriptive study, which included all patients under 18 years of age who underwent percutaneous ductal closure with Nit-Occlud® device between January 1, 2011, and February 1, 2023. Patients with associated complex congenital heart disease requiring surgical management, pregnant patients, and patients with incomplete data regarding studied variables were excluded from the study. Results: Eighty-seven patients were documented, with a mean age, weight, and height at closure of 51 months, 14 kg, and 95.83 cm, respectively. About 70% of the patients (n = 61) were female, 76% were under 6-years-old and only one patient was over 15. The average size of the ductus at the pulmonary end was 2 mm. Four of the total number of patients did not achieve PDA closure during the procedure. Of the remaining 83, complete immediate closure was achieved in 81 patients. A device exchange for a larger device was required during the same procedure in one of the cases. Two patients presented residual shunt of 0.5 mm during follow-up, and one required a new procedure for device closure 10 months later. Only one device presented repeatedly embolization to the aorta, requiring surgical removal. As a technical difficulty, one device presented repeated passage into the aorta, so it was decided to remove it before releasing it to avoid complications, and given the complex anatomy of the ductus, surgical closure was indicated. Among the complications, one patient presented a hematoma of the subcutaneous tissue in the right thigh, which improved with medical management, and no deaths related to the procedure were registered. Conclusions: Using the Nit-Occlud® device to close small to moderate-sized ductus remains a safe and effective strategy with successful closure rates at 1-year follow-up irrespective of age, weight, height, or whether it involves a small or medium-sized duct. Despite our limitations, results concerning adverse effects are comparable to those observed in multicentric studies conducted in other regions.

Antecdentes: La decisión de cerrar el conducto arterioso permeable (CAP) siempre debe ser individualizada y tomada en conjunto con la familia del niño una vez expuestos los riesgos y beneficios de ambas opciones. Objetivo: Este estudio tiene como objetivo informar la experiencia y los resultados en pacientes sometidos a cierre endovascular del CAP de tamaño pequeño a mediano con un dispositivo Nit-Occlud® en un hospital de tercer nivel de referencia en Colombia. Método: Estudio descriptivo longitudinal, que incluyó a todos los pacientes menores de 18 años a quienes se les realizó cierre ductal percutáneo con dispositivo Nit-Occlud® entre el 1 de enero de 2011 y el 1 de febrero de 2023. Se excluyeron: pacientes con cardiopatía congénita compleja asociada que requirieron manejo quirúrgico, pacientes embarazadas y pacientes con datos incompletos sobre las variables estudiadas. Resultados: Se documentaron 87 pacientes, con edad, peso y talla promedio al cierre de 51 meses, 14 kg y 95.83 cm, respectivamente. El 70% de los pacientes (n = 61) eran mujeres, el 76% tenían menos de seis años y solo un paciente tenía más de 15 años. El tamaño medio del conducto en el extremo pulmonar fue de 2 mm. Cuatro del total de pacientes no lograron el cierre del CAP durante el procedimiento. De los 83 restantes, se logró el cierre inmediato completo en 81 pacientes. En uno de los casos fue necesario cambiar el dispositivo por uno más grande durante el mismo procedimiento. Dos pacientes presentaron shunt residual de 0.5 mm durante el seguimiento y uno requirió un nuevo procedimiento para cierre del dispositivo diez meses después. Solo un dispositivo presentó embolización repetida en la aorta, requiriendo extracción quirúrgica. Como dificultad técnica, un dispositivo presentó paso repetido hacia la aorta, por lo que se decidió retirarlo antes de liberarlo para evitar complicaciones y dada la compleja anatomía del ductus se indicó cierre quirúrgico. Entre las complicaciones, un paciente presentó un hematoma del tejido subcutáneo en el muslo derecho, que mejoró con el manejo médico, y no se registraron muertes relacionadas con el procedimiento. Conclusiones: El uso del dispositivo Nit-Occlud® para cerrar conductos de tamaño pequeño a moderado sigue siendo una estrategia segura y eficaz con tasas de cierre exitoso al año de seguimiento, independientemente de la edad, el peso, la altura o si se trata de un conducto de tamaño pequeño o mediano. A pesar de nuestras limitaciones, los resultados sobre los efectos adversos son comparables a los observados en estudios multicéntricos realizados en otras regiones.

Phytochemical analysis for ten Peruvian Mentheae (Lamiaceae) by liquid chromatography associated with high resolution mass spectrometry.

The profile of secondary metabolites in ten members of tribe Mentheae (Nepetoideae, Lamiaceae) from Peru by liquid chromatography associated with high resolution mass spectrometry, is presented. Salvianolic acids and their precursors were found, particularly rosmarinic acid, caffeic acid ester derivatives, as well as a diversity of free and glycosylated flavonoids as main substances. At all, 111 structures were tentatively identified.

Phytochemical profile and rosmarinic acid purification from two Peruvian Lepechinia Willd. species (Salviinae, Mentheae, Lamiaceae).

The phytochemical profile of Lepechinia meyenii (Walp.) Epling and Lepechina floribunda (Benth.) Epling obtained by liquid chromatography associated with high-resolution mass spectrometry is presented. Forty eight compounds were detected exhibiting a variety of salvianolic acids and abietane phenolic diterpenoids. A simple procedure by cold evaporative crystallization to purify rosmarinic acid from these botanical species was also shown.

Fatal Monocytic Ehrlichiosis in Woman, Mexico, 2013.

Human monocytic ehrlichiosis is a febrile illness caused by Ehrlichia chaffeensis, an intracellular bacterium transmitted by ticks. In Mexico, a case of E. chaffeensis infection in an immunocompetent 31-year-old woman without recognized tick bite was fatal. This diagnosis should be considered for patients with fever, leukopenia, thrombocytopenia, and elevated liver enzyme levels.

Linfoma de linfocitos pequeños/leucemia linfocítica crónica(AU) / Lymphoma of small lymphocytes / Chronic lymphocytic leukemia cells

Se trata de una paciente femenina de 70 años, con antecedentes patológicos personales de asma bronquial, hipertensión arterial y diabetes mellitus tipo 2, con insuficiencia renal crónica estadio V secundaria a la diabetes, múltiples ingresos por cuadro de sepsis respiratoria y necesidad de diálisis peritoneal. Se constató esplenomegalia gigante en estudio imagenológico durante uno de los ingresos. Evolucionó desfavorablemente con hipotensión, fiebre y dolor abdominal difuso. Los hallazgos anatomopatológicos mostraron un linfoma de linfocitos pequeños/leucemia linfocítica crónica, estadio IV, con infiltración a múltiples vísceras: ganglios linfáticos, hígado, bazo, pulmón, riñones y serosas. La presencia de pseudofolículos se considera un rasgo morfológico casi absolutamente patognomónico de la enfermedad(AU)

Matrix-assisted laser desorption/ionization mass spectrometric analysis of aliphatic biodegradable photoluminescent polymers using new ionic liquid matrices.

In this study, two novel ionic liquid matrices (ILMs), N,N-diisopropylethylammonium 3-oxocoumarate and N,N-diisopropylethylammonium dihydroxymonooxoacetophenoate, were tested for the structural elucidation of recently developed aliphatic biodegradable polymers by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). The polymers, formed by a condensation reaction of three components, citric acid, octane diol, and an amino acid, are fluorescent, but the exact mechanism behind their luminescent properties has not been fully elucidated. In the original studies, which introduced the polymer class (J. Yang et al., Proc. Natl. Acad. Sci. USA 2009, 106, 10086-10091), a hyper-conjugated cyclic structure was proposed as the source for the photoluminescent behavior. With the use of the two new ILMs, we present evidence that supports the presence of the proposed cyclization product. In addition, the new ILMs, when compared with a previously established ILM, N,N-diisopropylethylammonium α-cyano-3-hydroxycinnimate, provided similar signal intensities and maintained similar spectral profiles. This research also established that the new ILMs provided good spot-to-spot reproducibility and high ionization efficiency compared with corresponding crystalline matrix preparations. Many polymer features revealed through the use of the ILMs could not be observed with crystalline matrices. Ultimately, the new ILMs highlighted the composition of the synthetic polymers, as well as the loss of water that was expected for the formation of the proposed cyclic structure on the polymer backbone.

Black box linearization for greater linear dynamic range: the effect of power transforms on the representation of data.

Power transformations are commonly used in image processing techniques to manipulate image contrast. Many analytical results, including chromatograms, are essentially presented as images, often to convey qualitative information. Power transformations have remarkable effects on the appearance of the image, in chromatography, for example, increasing apparent resolution between peaks by the factor √n and apparent column efficiency (plate counts) by a factor of n for an nth-power transform. The profile of a Gaussian peak is not qualitatively changed, but the peak becomes narrower, whereas for an exponentially tailing peak, asymmetry at the 10% peak height level changes markedly. Using several examples we show that power transforms also increase signal-to-noise ratio and make it easier to discern an event of detection. However, they may not improve the limit of detection. Power responses are intrinsic to some detection schemes, and in others they are imbedded in instrument firmware to increase apparent linear range that the casual user may not be aware of. The consequences are demonstrated and discussed.

Development of aliphatic biodegradable photoluminescent polymers.

None of the current biodegradable polymers can function as both implant materials and fluorescent imaging probes. The objective of this study was to develop aliphatic biodegradable photoluminescent polymers (BPLPs) and their associated cross-linked variants (CBPLPs) for biomedical applications. BPLPs are degradable oligomers synthesized from biocompatible monomers including citric acid, aliphatic diols, and various amino acids via a convenient and cost-effective polycondensation reaction. BPLPs can be further cross-linked into elastomeric cross-linked polymers, CBPLPs. We have shown representatively that BPLP-cysteine (BPLP-Cys) and BPLP-serine (BPLP-Ser) offer advantages over the traditional fluorescent organic dyes and quantum dots because of their preliminarily demonstrated cytocompatibility in vitro, minimal chronic inflammatory responses in vivo, controlled degradability and high quantum yields (up to 62.33%), tunable fluorescence emission (up to 725 nm), and photostability. The tensile strength of CBPLP-Cys film ranged from 3.25 +/- 0.13 MPa to 6.5 +/- 0.8 MPa and the initial Modulus was in a range of 3.34 +/- 0.15 MPa to 7.02 +/- 1.40 MPa. Elastic CBPLP-Cys could be elongated up to 240 +/- 36%. The compressive modulus of BPLP-Cys (0.6) (1:1:0.6 OD:CA:Cys) porous scaffold was 39.60 +/- 5.90 KPa confirming the soft nature of the scaffolds. BPLPs also possess great processability for micro/nano-fabrication. We demonstrate the feasibility of using BPLP-Ser nanoparticles ("biodegradable quantum dots") for in vitro cellular labeling and noninvasive in vivo imaging of tissue engineering scaffolds. The development of BPLPs and CBPLPs represents a new direction in developing fluorescent biomaterials and could impact tissue engineering, drug delivery, bioimaging.

Síndrome SAPHO (sinovitis, acné, pústulas, hiperostosis, y osteítis) con lesión esternal primaria inicial / Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome presenting as a primary sternal lesion

El síndrome SAPHO, acrónimo de Sinovitis, Acné, Pústulas, Hiperostosis y Osteítis, es una entidad nosológica que engloba múltiples afecciones que tienen un común compromiso osteoarticular y cutáneo. Se presenta una enferma de 59 años de edad que consulta por intenso dolor esternal y luego de un año padece exantema pustular palmo-plantar, acné y fiebre. Se le realiza una Tomografía computada, gamagrafía ósea y biopsia de las lesiones cutáneas, con lo cual se llega al diagnóstico de síndrome SAPHO. Se efectúa una reseña histórica de las distintas publicaciones sobre patologías encuadradas en el síndrome y se realiza una revisión bibliográfica de las teorías sobre su posible etiología, la cual continúa en discusión, aunque la tendencia actual es considerarla una artropatía seronegativa de similar fisiopatología al síndrome de Reiter

Síndrome SAPHO (sinovitis, acné, pústulas, hiperostosis, y osteítis) con lesión esternal primaria inicial / Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome presenting as a primary sternal lesion

El síndrome SAPHO, acrónimo de Sinovitis, Acné, Pústulas, Hiperostosis y Osteítis, es una entidad nosológica que engloba múltiples afecciones que tienen un común compromiso osteoarticular y cutáneo. Se presenta una enferma de 59 años de edad que consulta por intenso dolor esternal y luego de un año padece exantema pustular palmo-plantar, acné y fiebre. Se le realiza una Tomografía computada, gamagrafía ósea y biopsia de las lesiones cutáneas, con lo cual se llega al diagnóstico de síndrome SAPHO. Se efectúa una reseña histórica de las distintas publicaciones sobre patologías encuadradas en el síndrome y se realiza una revisión bibliográfica de las teorías sobre su posible etiología, la cual continúa en discusión, aunque la tendencia actual es considerarla una artropatía seronegativa de similar fisiopatología al síndrome de Reiter (AU)

Nefritis bacteriana aguda focal: un problema diagnóstico / Bacterial acute focal nephritis

Se realiza una puesta al día desde el punto de vista fisiopatológico e imagenológico de la nefritis bacteriana aguda focal (NBAF) con presentación de casos propios, analizando las variantes lesionales de presentación de esta enfermedad

Nefritis bacteriana aguda focal: un problema diagnóstico / Bacterial acute focal nephritis

Se realiza una puesta al día desde el punto de vista fisiopatológico e imagenológico de la nefritis bacteriana aguda focal (NBAF) con presentación de casos propios, analizando las variantes lesionales de presentación de esta enfermedad