Dynamical changes in the expression of GABAergic and purinergic components occur during the polarization of THP-1 monocytes to proinflammatory macrophages.

The monocytes are key components of innate immunity, as they can differentiate into phagocytic cells or macrophages with proinflammatory or anti-inflammatory phenotypes. The gamma-aminobutyric acid (GABA) and adenosine triphosphate (ATP), two known neurotransmitters, are two environmental signals that contribute to the differentiation of monocytes into macrophages and their subsequent polarization into proinflammatory M1 and anti-inflammatory M2 macrophages. Although monocytes and macrophages express proteins related to GABA and ATP-mediated response (GABAergic and purinergic systems, respectively), it is unknown whether changes in their expression occur during monocyte activation or their differentiation and polarization into macrophages. Therefore, we evaluated the expression levels of GABAergic and purinergic signaling components in the THP-1 monocyte cell line and their changes during monocyte activation, differentiation, and polarization to M1 proinflammatory macrophages. Our results showed that activated monocytes are characterized by increased expression of two GABAergic components, the GABA transporter 2 (GAT-2) and the glutamic acid decarboxylase (GAD)-67, an enzyme involved in GABA synthesis. Also, monocytes showed a pronounced expression of the purinergic receptors P2X4 and P2X7. Interestingly, during differentiation, monocytes increased the expression of the ß2 subunit of GABA A-type receptor (GABA-AR), while the purinergic receptors P2X1 and P2X1del were reduced. In contrast, proinflammatory M1 macrophages showed a reduced expression in the α4 subunit of GABA-AR and GAD67, while P2X4 and P2X7 were overexpressed. These results indicate that dynamical changes in the GABAergic and purinergic components occur during the transition from monocytes to macrophages. Since GABA and ATP are two neurotransmitters, our results suggest that monocytes and macrophages respond to neurotransmitter-induced stimulation and may represent a path of interaction between the nervous and immune systems during peripheral inflammation and neuroinflammation development.

Study of the Scattering Effect by SiO2 Nanoparticles, in a Luminescent Solar Concentrator Sensitized with Carbon Dots.

Luminescent solar concentrators (LSCs) have become an attractive way to produce green energy via their integration into buildings as photovoltaic windows. Recently, carbon quantum dots (C-QDs) have become the most studied luminescent material for the manufacture of luminescent solar concentrators due to their advantages, such as low toxicity, sustainability, and low cost. Despite the advantages of carbon quantum dots, they remain a low-efficiency material, and it is difficult to fabricate LSCs with a good performance. To address this problem, some of the research has used SiO2 nanoparticles (Nps) to produce a light-scattering effect that helps to improve the system performance. However, these studies are limited and have not been discussed in detail. In this regard, this research work was designed to evaluate the contribution of the scattering effect in different systems of carbon quantum dots used in a possible luminescent solar concentrator. To carry out this study, C-QDs and SiO2 Nps were synthesized by hydrothermal methods and the Stober method, respectively. We used different concentrations of both materials to fabricate film LSCs (10 × 10 cm2). The results show that the light scattered by the SiO2 Nps has a double contribution, in terms of light redirected towards the edges of the window and as a secondary source of excitation for the C-QDs; thus, an improvement in the performance of the LSC is achieved. The best improvement in photoluminescence is achieved when the films are composed of 20% wt carbon quantum dots and 10% wt SiO2 Nps, reaching a gain of 16% of the intensity of the light incident on the edges of the window with respect to the LSCs where only C-QDs were used.

Validación de la herramienta de tamizaje nutricional para el cáncer infantil SCAN. Versión en español / Validation of the nutritional screening tool for childhood cancer SCAN. Spanish version

Introducción: la prevalencia de la desnutrición en la población con cáncer infantil puede variar notablemente, elemento que influye de manera significativa en el desenlace clínico de los pacientes. No obstante, este es un factor pronóstico potencialmente modificable y para ello se requiere una identificación del riesgo nutricional oportuna que oriente el proceso de cuidado nutricional. Objetivo: evaluar el rendimiento operativo de la versión en español de la escala de tamización nutricional para el cáncer infantil (SCAN-SP) en el marco del proceso de validación del instrumento en un hospital de alta complejidad en la ciudad de Bogotá, Colombia. Métodos: se siguió el diseño metodológico para la validación de una escala diagnóstica. La muestra final fue de 96 pacientes entre los 0 y 17 años con cáncer y hospitalizados en el Centro de Cáncer Infantil de la Fundación HOMI en Bogotá. A cada paciente se le aplicó la SCAN-SP y también se le realizó una valoración nutricional completa (VNC) tomada como patrón de referencia para conocer su estado nutricional. Resultados: el 82,3 % (n = 79) de los pacientes fueron clasificados como “con riesgo de desnutrición” por la SCAN-SP y el 69,8 % (n = 67) del total de la muestra estaban realmente desnutridos. La evaluación del rendimiento operativo de la SCAN-SP contra la VNC mostro excelentes resultados: sensibilidad del 100 %, especificidad del 59 %, VPP del 85 %, VPN del 100 %, RVP de 2,4 y una RVN de 0. Conclusión: la escala SCAN-SP tiene un buen comportamiento como herramienta de tamización nutricional en el paciente pediátrico con cáncer, por lo que se recomienda su uso en la práctica clínica. (AU)

Introduction: the prevalence of undernutrition in the pediatric cancer population can vary considerably, an element that significantly influences the clinical outcome of patients. However, this is a potentially modifiable prognostic factor, which requires timely identification of nutritional risk to guide the nutritional care process. Objectives: to evaluate the operational performance of the Spanish version of the nutritional screening tool for childhood cancer (SCAN) in the context of the validation process of this instrument in a high-complexity hospital in the city of Bogotá, Colombia. Methods: the methodological design for the validation of a diagnostic scale was followed. The final sample consisted of 96 patients between 0 and 17 years with cancer and hospitalized at the Children’s Cancer Center of the HOMI Foundation in Bogota. The SCAN-SP was applied to each patient and a complete nutritional assessment (CNA) was performed as a gold standard to determine nutritional status. Results: 82.3 % (n = 79) of patients were classified “at risk of malnutrition” by SCAN-SP and 69.8 % (n = 67) of the total sample had undernutrition. The evaluation of the operative performance of SCAN-SP against CNA showed excellent results: sensitivity of 100 %, specificity of 59 %, PPV of 85 %, NPV of 100 %, positive likelihood ratio of 2.4, and negative likelihood ratio of 0.Conclusion: the SCAN-SP scale performs well as a nutritional screening tool in pediatric cancer patients, so its use in clinical practice is recommended. (AU)

[Validation of the nutritional screening tool for childhood cancer SCAN. Spanish version]. / Validación de la herramienta de tamizaje nutricional para el cáncer infantil SCAN. Versión en español.

Introduction: Introduction: the prevalence of undernutrition in the pediatric cancer population can vary considerably, an element that significantly influences the clinical outcome of patients. However, this is a potentially modifiable prognostic factor, which requires timely identification of nutritional risk to guide the nutritional care process. Objectives: to evaluate the operational performance of the Spanish version of the nutritional screening tool for childhood cancer (SCAN) in the context of the validation process of this instrument in a high-complexity hospital in the city of Bogotá, Colombia. Methods: the methodological design for the validation of a diagnostic scale was followed. The final sample consisted of 96 patients between 0 and 17 years with cancer and hospitalized at the Children's Cancer Center of the HOMI Foundation in Bogota. The SCAN-SP was applied to each patient and a complete nutritional assessment (CNA) was performed as a gold standard to determine nutritional status. Results: 82.3 % (n = 79) of patients were classified "at risk of malnutrition" by SCAN-SP and 69.8 % (n = 67) of the total sample had undernutrition. The evaluation of the operative performance of SCAN-SP against CNA showed excellent results: sensitivity of 100 %, specificity of 59 %, PPV of 85 %, NPV of 100 %, positive likelihood ratio of 2.4, and negative likelihood ratio of 0. Conclusion: the SCAN-SP scale performs well as a nutritional screening tool in pediatric cancer patients, so its use in clinical practice is recommended.

Introducción: Introducción: la prevalencia de la desnutrición en la población con cáncer infantil puede variar notablemente, elemento que influye de manera significativa en el desenlace clínico de los pacientes. No obstante, este es un factor pronóstico potencialmente modificable y para ello se requiere una identificación del riesgo nutricional oportuna que oriente el proceso de cuidado nutricional. Objetivo: evaluar el rendimiento operativo de la versión en español de la escala de tamización nutricional para el cáncer infantil (SCAN-SP) en el marco del proceso de validación del instrumento en un hospital de alta complejidad en la ciudad de Bogotá, Colombia. Métodos: se siguió el diseño metodológico para la validación de una escala diagnóstica. La muestra final fue de 96 pacientes entre los 0 y 17 años con cáncer y hospitalizados en el Centro de Cáncer Infantil de la Fundación HOMI en Bogotá. A cada paciente se le aplicó la SCAN-SP y también se le realizó una valoración nutricional completa (VNC) tomada como patrón de referencia para conocer su estado nutricional. Resultados: el 82,3 % (n = 79) de los pacientes fueron clasificados como "con riesgo de desnutrición" por la SCAN-SP y el 69,8 % (n = 67) del total de la muestra estaban realmente desnutridos. La evaluación del rendimiento operativo de la SCAN-SP contra la VNC mostro excelentes resultados: sensibilidad del 100 %, especificidad del 59 %, VPP del 85 %, VPN del 100 %, RVP de 2,4 y una RVN de 0. Conclusión: la escala SCAN-SP tiene un buen comportamiento como herramienta de tamización nutricional en el paciente pediátrico con cáncer, por lo que se recomienda su uso en la práctica clínica.

Reaching Visible Light Photocatalysts with Pt Nanoparticles Supported in TiO2-CeO2.

Nanostructured catalysts of platinum (Pt) supported on commercial TiO2, as well as TiO2-CeO2 (1, 5 and 10 wt% CeO2), were synthesized through the Sol-Gel and impregnation method doped to 1 wt% of Platinum, in order to obtain a viable photocatalytic material able to oxidate organic pollutants under the visible light spectrum. The materials were characterized by different spectroscopy and surface techniques such as Specific surface area (BET), X-ray photoelectron spectroscopy (XPS), XRD, and TEM. The results showed an increase in the diameter of the pore as well as the superficial area of the supports as a function of the CeO2 content. TEM images showed Pt nanoparticles ranking from 2-7 nm, a decrease in the particle size due to the increase of CeO2. The XPS showed oxidized Pt2+ and reduced Pt0 species; also, the relative abundance of the elements Ce3+/Ce4- and Ti4+ on the catalysts. Additionally, a shift in the Eg band gap energy (3.02-2.82 eV) was observed by UV-vis, proving the facticity of applying these materials in a photocatalytic reaction using visible light. Finally, all the synthesized materials were tested on their photocatalytic oxidation activity on a herbicide used worldwide; 2,4-Dichlorophenoxyacetic acid, frequently use in the agriculture in the state of Jalisco. The kinetics activity of each material was measured during 6 h of reaction at UV-Vis 190-400 nm, reaching a removal efficiency of 98% of the initial concentration of the pollutant in 6 h, compared to 32% using unmodified TiO2 in 6 h.

Taller de concordancia en la evaluación de imágenes capilaroscópicas / Reliability of nailfold videocapillaroscopy workshop

Introducción: la capilaroscopia es un método no invasivo que permite observar la microvasculatura en el área periungueal. Los resultados informados pueden ser altamente variables entre distintos observadores. A lo largo del tiempo surgieron métodos cuantitativos y semicuantitativos para mejorar la reproducibilidad. Objetivos: conocer el nivel de acuerdo intra e interobservador al informar los diferentes patrones capilaroscópicos en individuos con diferente nivel de entrenamiento. Materiales y métodos: estudio de corte transversal. Participaron médicos reumatólogos especialistas y en formación que habían realizado previamente un curso virtual de capacitación en capilaroscopia. Recibieron 40 imágenes capilaroscópicas proyectadas en una presentación de PowerPoint y debían responder a través de un cuestionario digital. Se evaluó la concordancia de respuestas intra e interobservador. Resultados: se encontró un alto nivel de concordancia global con un kappa 0,66 IC 95% (0,63-0,70) p<0,0000. También en otros grupos como reumatólogos en formación: kappa 0,65 IC 95% (0,60-0,71) p=0,0000, y médicos reumatólogos: kappa 0,67 IC 95% (0,62-0,72) p=0,0000. Conclusiones: el nivel de concordancia encontrado fue globalmente alto, independientemente del nivel de entrenamiento de los profesionales, y de ser o no reumatólogo. La concordancia fue superior cuando se comparó a quienes tenían más de 4 años de experiencia en la realización de videocapilaroscopia.

Introduction: videoapillaroscopy is a non-invasive method that allows the observation of the microvasculature in the periungual area. Reported results can be highly variable between different observers. Over time, quantitative and semi-quantitative methods emerged to improve reproducibility. Objetives: to know the level of intra and interobserver agreement when reporting the different capillaroscopic patterns in individuals with different levels of training. Materials and methods: cross section study. Specialist rheumatologists and those in training who had previously completed a virtual capillaroscopy training course participated. They received 40 capillaroscopic images projected in a PowerPoint presentation and had to issue their response through a digital questionnaire. Concordance of intra and interobserver responses was evaluated. Results: a high level of global agreement was found with a kappa 0.66 CI 95% (0.63-0.70) p<0.0000, also in other groups such as rheumatologists in training: kappa 0.65 CI 95% (0.60-0.71) p=0.0000, physicians rheumatologists: kappa 0.67 95% CI (0.62-0.72) p=0.0000. Conclusions: the level of agreement found was globally high, regardless of the level of training of the professionals, and whether or not they were a rheumatologist. Concordance was higher when compared to those who had more than 4 years of experience performing videocapillaroscopy.

Microalgae Bioactive Compounds to Topical Applications Products-A Review.

Microalgae are complex photosynthetic organisms found in marine and freshwater environments that produce valuable metabolites. Microalgae-derived metabolites have gained remarkable attention in different industrial biotechnological processes and pharmaceutical and cosmetic industries due to their multiple properties, including antioxidant, anti-aging, anti-cancer, phycoimmunomodulatory, anti-inflammatory, and antimicrobial activities. These properties are recognized as promising components for state-of-the-art cosmetics and cosmeceutical formulations. Efforts are being made to develop natural, non-toxic, and environmentally friendly products that replace synthetic products. This review summarizes some potential cosmeceutical applications of microalgae-derived biomolecules, their mechanisms of action, and extraction methods.

Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America.

Background: Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods: This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined "new diagnosis" as patients with no previous diagnosis of cancer, "established diagnosis" as patients with cancer and ongoing treatment and "relapse" as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results: Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age (<-2SD) had higher mortality (28 vs. 3%, p = 0.019). There was statistically significant difference of mortality between patients with new diagnosis (36.7%), established diagnosis (1.4%) and relapse (60%), (p <0.001). Most patients had hematological cancers (69%) and they had higher mortality (18%) compared to solid tumors (6%, p= 0.032). Patients with concomitant bacterial infections had higher mortality (40%, p = 0.001). MIS-C, respiratory distress, cardiovascular symptoms, altered mental status and acute kidney injury on admission were associated with higher mortality. Acidosis, hypoxemia, lymphocytosis, severe neutropenia, anemia and thrombocytopenia on admission were also associated with mortality. A multivariate logistic regression showed risk factors associated with mortality: concomitant bacterial infection OR 3 95%CI (1.1-8.5), respiratory symptoms OR 5.7 95%CI (1.7-19.4), cardiovascular OR 5.2 95%CI (1.2-14.2), new cancer diagnosis OR 12 95%CI (1.3-102) and relapse OR 25 95%CI (2.9-214). Conclusion: Our study shows that pediatric patients with new onset diagnosis of cancer and patients with relapse have higher odds of all-cause mortality in the setting of COVID-19. This information would help develop an early identification of patients with cancer and COVID-19 with higher risk of mortality.

Can maternofetal transfusion provoke adverse outcomes akin to TA-GVHD?

During pregnancy, a bidirectional transfer of molecules and cells takes place through the placenta, which can be considered a transfusion. For decades, we have wondered whether said transfusion can lead to a true TA-GVHD. We propose several factors that may influence production of TA-GVHD during pregnancy. In order to achieve this, we shall take into account possible destinations for transfused leukocytes, which represent extremely different scenarios and may include transfusion associated-graft versus host disease (TA-GVHD).

Case Report: Three Case Reports of Rapidly Progressive Dementias and Narrative Review.

Rapidly progressive dementia (RPD) is a heterogeneous group of diseases characterized by cognitive impairment and other neurological disorders developed in a short span of fewer than 2 years. Currently viewed as new and infrequent entities, most medical personnel have little understanding of it. Nevertheless, they significantly compromise many patients' quality of life. Here, we drive 3 clinical cases that evolve as RPD with different etiologies. Case 1: 70-year-old woman presented to the emergency with neuropsychiatric syndrome for 18 days. The researchers identified inflammatory cerebrospinal fluid (CSF), protein 14-3-3-positive T-tau protein, MRI: T2 and FLAIR hyperintensities in bilateral caudate nuclei with diffusion restriction, EEG shows a generalized periodic pattern with triphasic wave morphology. Case 2: 29-year-old man with cognitive impairment and faciobrachial dystonia seizure. The diagnosis was confirmed by achieving elevated antibodies against voltage-gated potassium channels. Case 3: A 49-year-old woman with encephalopathy and myoclonic seizures; EEG and MRI showed subtle changes. The patient also had a normal CSF but a positive CBA serologic NMDA-R antibody test. We described fundamental aspects of RPD to allow made differential diagnoses in patients with cognitive impairment and encephalopathy. Establishing an early and accurate diagnosis can benefit patients with RPD etiologies that are treatable and even reversible, decreasing in morbidity and mortality.

Plasma concentrations of persistent organic pollutants and pancreatic cancer risk.

BACKGROUND: Findings and limitations of previous studies on persistent organic pollutants (POPs) and pancreatic cancer risk support conducting further research in prospective cohorts. METHODS: We conducted a prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Participants were 513 pancreatic cancer cases and 1020 matched controls. Concentrations of 22 POPs were measured in plasma collected at baseline. RESULTS: Some associations were observed at higher concentrations of p, p'-DDT, trans-nonachlor, ß-hexachlorocyclohexane and the sum of six organochlorine pesticides and of 16 POPs. The odds ratio (OR) for the upper quartile of trans-nonachlor was 1.55 (95% confidence interval 1.06-2.26; P for trend = 0.025). Associations were stronger in the groups predefined as most valid (participants having fasted >6 h, with microscopic diagnostic confirmation, normal weight, and never smokers), and as most relevant (follow-up ≥10 years). Among participants having fasted >6 h, the ORs were relevant for 10 of 11 exposures. Higher ORs were also observed among cases with microscopic confirmation than in cases with a clinical diagnosis, and among normal-weight participants than in the rest of participants. Among participants with a follow-up ≥10 years, estimates were higher than in participants with a shorter follow-up (for trans-nonachlor: OR = 2.14, 1.01 to 4.53, P for trend = 0.035). Overall, trans-nonachlor, three PCBs and the two sums of POPs were the exposures most clearly associated with pancreatic cancer risk. CONCLUSIONS: Individually or in combination, most of the 22 POPs analysed did not or only moderately increased the risk of pancreatic cancer.

Proximity and High Density of Convenience Stores Was Associated With Obesity in Children of a Rural Community of Mexico: Using a Geographic Information System Approach.

BACKGROUND: Food environment (FE) has been linked to obesity in urban areas, but there is limited information in rural areas, particularly in developing countries, where prevalence of obesity is high. OBJECTIVE: To determine the association between FE and childhood obesity using Geographic Information Systems (GIS). METHODS: A total of 218 (8-10 years) children participated in a cross-sectional study. Weight, height, and body fat were measured. Geolocation of convenience stores (CS) and participants' households was collected, and the amount of processed food (PF) in the stores was measured. The proximity to the nearest CS and the number of CS within a 250-m buffer from each participant's household was calculated using GIS. Linear regression models between obesity measurements and FE were performed. RESULTS: The combined prevalence of overweight and obesity was 32%. A total of 91% of the children had access to a CS within 250 m. On average, 48% of the shelf-space of the CS were occupied with PF. A positive association between the density of CS with body fat % (ß = .145; 95% CI, 0.048-0.241, P = .004), abdominal fat % (ß = .206; 95% CI, 0.048-0.241, P = .003), and body mass index (BMI)-for-age z-score (BMIz; ß = .028; 95% CI, 0.005-0.062, P = .005) was found. Living closer to CS was associated with increases in body fat % (ß = -0.009; 95% CI, -0.017 to -0.001, P = 0.025), abdominal fat % (ß = -0.012; 95% CI, -0.023 to -0.001, P = 0.033), and BMIz (ß = -0.002, 95% CI, -0.004 to -0.001, P = 0.003). CONCLUSION: In a rural community in Mexico, a high density and low proximity to CS is associated with obesity in school-aged children.

Neuropsychiatric Aspects in a Patient Diagnosed with Frontotemporal Dementia: Clinical Case of Low Incidence and Prevalence Disease in Colombia.

Frontotemporal dementia (FTD) is a neuropsychiatric pathology characterized by dysfunctions in the frontal lobe of the brain, especially in planning, execution, and inhibition tasks, with an inability to make decisions and handle different sequences, also affecting the temporal lobe. The patient presents alterations to store, consolidate, and recall information. These neurocognitive deficits are accompanied by neurobehavioral disorders such as depression, anxiety, and apathy that contribute to the worsening of the quality of life, with a high impact on the individual, social, and family level. To identify the neurobehavioral disorders and neurocognitive deterioration that present a patient diagnosed with FTD: clinical case of low incidence and prevalence disease in Colombia. A 40-year-old man, with progressive deterioration of his immediate verbal memory, low verbal fluency, aberrant motor behavior, sexual impulsivity, alterations in his executive functions, especially in planning tasks, decision-making, and inhibition was found to have a lesser degree of affectation in his visuospatial functioning and visuoconstructive abilities. It was found that the patient presents a severe dysexecutive syndrome associated with a clinical picture of FTD, correlated with an inability to process and recall information, accompanied by disorders such as depression, anxiety, and apathy. It is necessary to generate a functional neurorehabilitation plan that aims to improve the quality of life in these patients. In the same way, it is necessary to create new lines of research and intervention that have the purpose to create a greater field of heuristics or new questions in this type of neurodegenerative pathologies.

Results of the implementation of the PETHEMA LPA 99 protocol for treating children with acute promyelocytic leukemia in Bogotá, Colombia / Resultados de la implementación del protocolo PETHEMA LPA 99 en el tratamiento de niños con leucemia promielocítica aguda en Bogotá, Colombia

Abstract Introduction: In the United States, between 4 and 8% of children with acute myeloid leukemia have acute promyelocytic leukemia (APL), but a higher incidence of this malignancy has been reported in Latin America (20%-28%). The implementation of the PETHEMA LPA 99 protocol, designed for the treatment of APL in adults, has shown an overall survival (OS) >80%. Objective: To describe the results obtained after the implementation of the PETHEMA LPA 99 protocol to treat children with APL at the Fundación Hospital Pediátrico La Misericordia in Bogotá, D.C., Colombia. Materials and methods: Descriptive and retrospective cohort study. The medical records of 30 pediatric patients (<18 years) with APL, who were treated using the PETHEMA LPA 99 protocol between January 2005 and December 2012, were reviewed. Data on the following variables were obtained: early death, death during induction therapy, OS, event-free survival (EFS), and relapse. Results: The male sex was predominant (60%) among the 30 patients included in the study. Regarding risk classification, 13 (43%) were classified as high-risk patients, 12 (40%) as medium-risk, and 5 (17%) as low-risk. Seven individuals died: 2 before receiving cancer treatment, 2 during induction therapy, and 3 after relapse. Relapse was reported in 5 patients. There were no deaths during the consolidation or maintenance phases. OS was 75.4% (95%CI: 55.1-87.5) and EFS was 64.3% (95%CI: 40-80.5). Moreover, OS at 11 years was 80%, 91.7%, and 59.2% for low-risk, intermediate-risk, and high-risk patients, respectively. The median follow-up time was 6.35 years (0-11.43 years). Conclusions: In general, the implementation of the PETHEMA LPA 99 protocol to treat APL in the study population showed very satisfactory results. Therefore, its use in pediatric population is recommended, taking into account the adjustments described in the protocol regarding the characteristics of this age group.

Resumen Introducción. En Estados Unidos de América, entre 4 y 8% de niños con leucemias mieloides agudas tienen leucemia promielocítica aguda (LPA), mientras que en Latinoamérica se ha descrito una mayor incidencia de esta neoplasia (20-28%). La implementación del protocolo PETHEMA LPA 99, diseñado para el tratamiento de LPA en adultos, ha mostrado una supervivencia global (SG) >80%. Objetivo. Describir los resultados de la aplicación del protocolo PETHEMA LPA 99 en el tratamiento de niños con LPA en la Fundación Hospital Pediátrico la Misericordia, en Bogotá D.C., Colombia. Materiales y métodos. Estudio de cohorte descriptivo y retrospectivo. Se revisaron las historias clínicas de 30 pacientes pediátricos (<18 años) con LPA que recibieron tratamiento mediante el protocolo PETHEMA LPA 99 entre enero de 2005 y diciembre de 2012. Se obtuvieron datos sobre las siguientes variables: muerte temprana, muerte en terapia de inducción, SG, supervivencia libre de evento (SLE) y recaída. Resultados. De los 30 pacientes, la mayoría eran de sexo masculino (60%). Respecto a la clasificación de riesgo, 13 (43%) fueron clasificados como pacientes de riesgo alto; 12 (40%), de riesgo intermedio, y 5 (17%), de riesgo bajo. 7 individuos murieron: 2 antes del tratamiento oncológico, 2 durante la terapia de inducción y 3 luego de presentar recaída. Se reportó recaída en 5 pacientes. No hubo muertes durante las fases de consolidación o de mantenimiento. La SG fue de 75.4% (IC95%: 55.1-87.5) y la SLE fue de 64.3% (IC95%: 40-80.5). La SG a 11 años fue de 80%, 91.7% y 59.2% para los pacientes de riesgo bajo, riesgo intermedio y riesgo alto, respectivamente. La mediana de seguimiento fue 6.35 años (0-11.43 años). Conclusiones. En general, la implementación del protocolo PETHEMA LPA 99 en el tratamiento de la LPA en la población de estudio mostró resultados muy satisfactorios, por lo que se recomienda su uso en población pediátrica, teniendo en cuenta los ajustes recomendados por el protocolo en relación con las características de este grupo etario.

Neuropsychiatric Aspects in a Patient Diagnosed with Corticobasal Degeneration: Clinical Case of Low Incidence and Prevalence in Colombia.

Corticobasal degeneration (CBD) is a pathology of low incidence and prevalence worldwide; it is accompanied by symptoms such as dystonia, rigid akinetic syndrome (bradykinesia), gait disturbances, neurological deterioration associated with severe cortical subcortical atrophy, and progressive to moderate to severe neurocognitive deficits, especially in immediate verbal memory and dorsolateral or dysexecutive syndrome. We identified neurocognitive impairment and neuropsychiatric symptoms in a patient diagnosed with CBD. Participant was a 70-year-old female patient, single; she presented progressive memory loss of an immediate verbal nature. Initially, she was diagnosed with Alzheimer's disease and Lewy body dementia, finding that she had no characteristic signs and symptoms of these pathologies. The patient presented conciliation insomnia, gait disturbances, and severe neurocognitive deficit, especially in executive functions, immediate verbal memory, and visuospatial functioning. It was found that the patient presented neurocognitive alterations of the executive type (frontal lobe) such as decision making, planning, inhibition and operative memory, correlated with a severe alteration in her basic, instrumental and advanced activities of daily life, with a high risk factor for developing dementia. It is necessary to diagnose in an assertive and timely manner in order to generate functional neurorehabilitation plans in people diagnosed with CBD, with the main objective of positively impacting quality of life, at the individual, family, and social level.

Fracturas inestables de radio distal intra y extraarticulares: análisis comparativo de resultados a mediano plazo del tratamiento quirúrgico con placas volares / Intra- and extra-articular distal radius unstable fractures: comparative analysis of the medium-term results of volar plate surgical treatment

Introducción Comparar los resultados radiológicos y recuperación postoperatoria de la función de la muñeca a mediano plazo en las fracturas inestables extra e intra articulares de radio distal, después de la reducción abierta con abordaje palmar y osteosíntesis con placa volar. Materiales y métodos Estudio de casos y controles en 52 pacientes divididos en los grupos de fracturas extra o intra articulares de acuerdo a la clasificación AO. Las radiografías preoperatorias y postoperatorias fueron evaluadas para determinar la restauración anatómica de la longitud radial, ángulo radial e inclinación palmar del radio. Se evaluó además el resultado, seis meses después de la cirugía, del rango activo de movimiento y la fuerza de agarre, a la vez, que se hizo evaluación del puntaje de QuickDASH. Resultados La edad promedio fue 53,7±16,8 (DE) años; el 63% mujeres. Las fracturas extra articulares fueron más frecuentes en las mujeres, pero las intra articulares presentaron distribución similar por sexo (p=0.023). La fuerza de agarre de la mano operada fue 73.7% y 67.5% de la mano opuesta en las fracturas extra e intra articulares, respectivamente. El puntaje QuickDASH promedio fue 2.36 (DE 2.01) y 4.16 (DE 3.82) en fracturas extra e intra articulares respectivamente (p=0.111). Discusión Para fracturas de radio distal la reducción abierta con abordaje palmar y estabilización con placa volar ofrece resultados funcionales satisfactorios tanto para las fracturas extra articulares como para las intra articulares, con una leve, aunque esperada, ventaja en las primeras debido a su menor complejidad.

Background To examine and compare the radiological results and postoperative recovery of the medium-term wrist function in unstable extra- and intra-articular fractures of distal radius, after open reduction with a palmar approach and osteosynthesis with a volar plate. Materials and methods Retrospective case control study in 52 patients, divided into groups according to the Orthopaedic Association (AO) classification as extra- or intra-articular fractures. The pre-operative and post-operative radiographs were evaluated to determine the anatomical restoration of the radial length, radial angle, and palmar inclination of the radius. The medium-term results of the active range of motion and the grip strength, as well as the Quick DASH score, were evaluated six months after surgery. Results The mean age was 53.7±16.8 (SD) years and 63% were women. Extra-articular fractures were more frequent in women, but intra-articular fractures had a similar distribution by gender (P=.023). The grip strength of the operated hand was 73.7% and 67.5% of the opposite hand in the extra- and intra-articular fractures, respectively. The mean Quick DASH score was 2.36 (SD 2.01) and 4.16 (SD 3.82) in extra- and intra-articular fractures, respectively (P=.111). Discussion For unstable distal radius fractures, open reduction with palmar approach and volar plate stabilisation offers satisfactory functional results for both extra-articular and intra-articular fractures, with a slight, but expected, advantage in the former due to its lesser complexity.

Applications of the European Parkinson's Disease Association sponsored Parkinson's Disease Composite Scale (PDCS).

This study was addressed to determine the presence of Parkinson disease (PD) manifestations, their distribution according to motor subtypes, and the relationships with health-related quality of life (QoL) using the recently validated European Parkinson's Disease Association sponsored Parkinson's Disease Composite Scale (PDCS). Frequency of symptoms was determined by the scores of items (present if >0). Using ROC analysis and Youden method, MDS-UPDRS motor subtypes were projected on the PDCS to achieve a comparable classification based on the PDCS scores. The same method was used to estimate severity levels from other measures in the study. The association between the PDCS and QoL (PDQ-39) was analyzed by correlation and multiple linear regression. The sample consisted of 776 PD patients. We found that the frequency of PD manifestations with PDCS and MDS-UPDRS were overlapping, the average difference between scales being 5.5% only. Using the MDS-UPDRS subtyping, 215 patients (27.7%) were assigned as Tremor Dominant (TD), 60 (7.7%) Indeterminate, and 501 (64.6%) Postural Instability and Gait Difficulty (PIGD) in this cohort. With this classification as criterion, the analogous PDCS-based ratio provided these cut-off values: TD subtype, ≥1.06; Indeterminate, <1.06 but >0.65; and PIGD, <0.65. The agreement between the two scales on this classification was substantial (87.6%; kappa = 0.69). PDCS total score cut-offs for PD severity were: 23/24 for mild/moderate and 41/42 for moderate/severe. Moderate to high correlations (r = 0.35-0.80) between PDCS and PDQ-39 were obtained, and the four PDCS domains showed a significant independent influence on QoL. The conclusions are: (1) the PDCS assessed the frequency of PD symptoms analogous to the MDS-UPDRS; (2) motor subtypes and severity levels can be determined with the PDCS; (3) a significant association between PDCS and QoL scores exists.

Trypanosoma cruzi en donantes que acuden al banco de sangre "Dr. Julio García Álvarez" del hospital Dr. Luis Razetti, estado Barinas, Venezuela / Trypanosoma cruzi in donors who go to the "Dr. Julio Garcia Alvarez" Blood Bank of the Dr. Luis Razetti Hospital, in the Barinas city, Venezuela

Trypanosoma cruzi is the causative agent of Chagas disease; this is considered one of the main parasitosis in Latin America. Blood transfusions occupy the second place of transmission of this parasite, after vector transmission and usually occur in urban areas through infected donors from endemic rural areas, generally asymptomatic and ignorant of their condition. In Venezuela, Barinas state is recognized as an important endemic area of T. cruzi transmission. In this sense, was to evaluate parasitological and serological techniques in donors who go to the "Dr. Julio Garcia Alvarez" Blood Bank in the Barinas city. To this end, 240 blood samples were collected from an equal number of donors and were assessed with fresh examination techniques, capillary microcentrifugation, colored smears, and ELISA anti-T. cruzi IgG. In none of the samples circulating parasites were observed, while 3 donors resulted positive with ELISA anti-T. cruzi IgG (1.25% seroprevalence). Direct parasitological tests were not effective for the determination of T. cruzi because there was no evidence of blood trypomastigotes in any of the cases studied