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.

A Postbiotic Formulation of Lactiplantibacillus plantarum CRL 759 Attenuates Endotoxin Induced Uveitis.

PURPOSE: To evaluate the anti-inflammatory activity of a cell-free supernatant from Lactiplantibacillus plantarum CRL 759, in phosphate buffer modified according to Sorensen called POF-759. METHODS: The activity of POF-759 administered by means of eye drops was evaluated on animals subcutaneously injected with the lipopolysaccharide animals in which uveitis was induced by a subcutaneous injection of lipopolysaccharide (EIU). Clinical signs of ocular inflammation, cytokines and proteins were examined in the aqueous humor. Additionally, cellular infiltration was evaluated by histopathological analysis. RESULTS: The new postbiotic administered locally decreases signs of ocular damage, the number of infiltrating cells in the anterior and posterior chambers, the proinflammatory mediators and the proteins in the aqueous humor on mice with EIU. CONCLUSIONS: Our results provide an impetus to relieve ocular inflammation and to identify and develop preventive and therapeutic approaches, to avoid deterioration and to maintain healthy eyes on inflammatory processes.

Percepciones sobre la importancia de las ciencias básicas en estudiantes de odontología y medicina

Introducción: El aprovechamiento de los cursos de ciencias básicas puede depender de las percepciones estudiantiles sobre la importancia de estos en su vida profesional, por lo que se hace necesario determinar el grado de importancia que los estudiantes le confieren a este tipo de cursos. Materiales y métodos: Se presentó un cuestionario con 9 declaraciones a 54 estudiantes de odontología y medicina. Las respuestas se pasaron a una escala numérica para su análisis. Se usó una prueba de U de Mann-Whitney con el fin de evaluar diferencias entre estudiantes de ambas facultades. Resultados: Los estudiantes en conjunto mostraron tener una buena opinión de la importancia de las ciencias básicas en la práctica clínica. Se observó también que es mayor la proporción de estudiantes de odontología que consideran que la investigación básica no es útil para su práctica clínica. Conclusión: Los estudiantes consideran las ciencias básicas necesarias para un buen desempeño profesional.

Introduction: The benefit of basic science courses may depend on students' perceptions of the importance of these courses in their professional life, therefore, it's necessary to determine the degree of importance that students give to this type of courses. Materials and methods: A questionnaire with 9 statements was presented to 54 dental and medical students. The responses were converted to a numerical scale for analysis. Using a Mann-Whitney U test, differences between students from both faculties were evaluated. Results: The students showed a good opinion of the importance of basic sciences in clinical practice. It was also observed that the proportion of dental students who consider that basic research is not useful for their clinical practice is higher. Conclusion: Students consider the basic sciences necessary for good professional performance.

Bat Assemblage in an Oil Palm Plantation from the Colombian Llanos Foothills.

The surge of oil palm production in the Neotropics has become a major concern about the potential impacts on biodiversity. In the Colombian Orinoquia, which has shown a massive landscape transformation due to the growth of oil palm plantations, the effects of oil palm agriculture on bats in this region have not been studied up to date. To understand the impact of habitat conversion on bat diversity, we characterised bat assemblages in secondary forest and palm plantations in the Colombian Llanos foothills (Meta, Colombia). We captured 393 individuals (forest = 81, plantation = 312) of 18 species and 3 families. The forest cover presented three exclusive species while the plantation had five. Species diversity (q 1) and evenness (J') were higher in the forest compared to the plantation. These differences derived from the increase in abundances of generalist species (Artibeus sp., Carollia spp.) in the plantation. Despite the habitat simplification caused by oil palm plantations, this monoculture provides a cover that is used by some bats, decreasing their risk of predation and allowing movement between patches of forest habitat as steppingstones. Maintaining forest cover in agricultural landscapes favours diversity by generating a "spillover effect" of the forest towards plantations, which in the case of some bats contributes to the reduction of species isolation and the maintenance of ecosystem services provided by them. It is important to improve management practices of oil palm plantations to minimise negative impacts on biodiversity, considering the expansion of this productive system and the scarcity of protected areas in this region.

Defining High Glycemic Variability in Type 1 Diabetes: Comparison of Multiple Indexes to Identify Patients at Risk of Hypoglycemia.

Background: International consensus on the use of continuous glucose monitoring (CGM) recommends coefficient of variation (CV) as the metric of choice to express glycemic variability (GV) with a cutoff of 36% to define unstable diabetes. Even though, CV is associated with hypoglycemia in type 2 diabetes patients, the evidence on the use of one particular measure of GV in type 1 diabetes (T1DM) patients as a predictor of hypoglycemia is limited. Methods: A cohort of T1DM ambulatory patients was evaluated using CGM. Number and incidence rate of events <54 and <70 mg/dL were calculated. Bivariate and multivariate analysis of different glycemic indexes and clinical variables were performed to identify those associated with hypoglycemia. Receiver operating characteristic (ROC) curve analysis for each of the glycemic indexes was performed to define the best index and its optimal cutoff threshold to discriminate patients with events of hypoglycemia. Results: Seventy-three patients were included. A total of 128 events <54 mg/dL were recorded in 34 patients, and 350 events <70 mg/dL were registered in 51 patients. CV was the only variable significantly associated with hypoglycemia <54 mg/dL in the multivariate analysis (adjusted relative risk [aRR] 1.44, 95% confidence interval [CI]: 1.10-1.88, P = 0.008). CV, HbA1c (glycated hemoglobin), and mean glucose were associated with events <70 mg/dL. ROC curve analysis showed that, among GV metrics, CV had the best performance to discriminate patients with events <54 mg/dL (area under the curve [AUC] 0.87, 95% CI: 0.79-0.95) and events <70 mg/dL (AUC 0.79, 95% CI: 0.68-0.90) with optimal cutoff thresholds values of 34% and 31%, respectively. Among glycemic risk (GR) indexes, low blood glucose index (LBGI) showed the best performance. Conclusions: This analysis shows that CV is the best GV index, and LBGI the best GR index, to identify patients at risk of clinically significant hypoglycemia and hypoglycemia alert events in T1DM patients.

Proteomic analysis of oxidized proteins in the brain and liver of the Nile tilapia (Oreochromis niloticus) exposed to a water-accommodated fraction of Maya crude oil.

Crude oil (CO) is a super mixture of chemical compounds whose toxic effects are reported in fish species according to international guidelines. In the current study a proteomic analysis of oxidized proteins (ox) was performed on the brain and liver of Nile tilapia exposed to WAF obtained from relevant environmental loads (0.01, 0.1 and 1.0 g/L) of Maya CO. Results have shown that oxidation of specific proteins was a newly discovered organ-dependent process able to disrupt key functions in Nile tilapia. In control fish, enzymes involved on aerobic metabolism (liver aldehyde dehydrogenase and brain dihydrofolate reductase) and liver tryptophan--tRNA ligase were oxidized. In WAF-treated liver specimens, fructose-bisphosphate aldolase (FBA), ß-galactosidase (ß-GAL) and dipeptidyl peptidase 9 (DPP-9) were detected in oxidized form. oxDPP-9 could be favorable by reducing the risk associated with altered glucose metabolism, the opposite effects elicited by oxFBA and oxß-GAL. oxTrypsin showed a clear adverse effect by reducing probably the hepatocyte capacity to achieve proteolysis of oxidized proteins as well as for performing the proper digestive function. Additionally, enzyme implicated in purine metabolism adenosine (deaminase) was oxidized. Cerebral enzymes of mitochondrial respiratory chain complex (COX IV, COX5B), of glycosphingolipid biosynthesis (ß-N-acetylhexosaminidase), involved in catecholamines degradation (catechol O-methyltransferase), and microtubule cytoskeleton (stathmin) were oxidized in WAF-treated specimens. This response suggests, in the brain, an adverse scenario for the mitochondrial respiration process and for ATP provision as for ischemia/reoxygenation challenges. Proteomic analysis of oxidized proteins is a promising tool for monitoring environmental quality influenced by hydrocarbons dissolved in water.

Factors associated with hypoglycemia in cardiovascular surgery.

INTRODUCTION: An inadequate glycemic control in cardiovascular postoperative is a predictor of mortality, postoperative infections and a prolonged hospital stay. This study evaluates the incidence of hypoglycemia in the first 72 h of postoperative and its association with different factors, such as tissue perfusion parameters, and the administration of medicines that induct hypoglycemia during surgery, in patients that undergo cardiovascular surgery in a 4th level hospital in Bogota, Colombia. METHODS AND MATERIALS: A nested cases and controls study was developed, taking as cases the patients that presented hypoglycemia episodes (<70 mg/dl) and the controls were the patients without this outcome. A systematic record of the glycemic control in the first 72 h of postoperative was registered. An univariate and multivariate analysis was conducted to determine the factor associated with hypoglycemia. RESULTS: 327 patients were evaluated (35% with coronary bypass and 27% with valvular replacement). 7.65% of the patients presented at least one episode of hypoglycemia <70 mg/dL (25 episodes). The multivariate analysis showed an association with chronic kidney failure in dialysis (OR6,21; IC:0,97-43.27,p:0.05), administration of preoperative steroids (OR4,41; IC:1,27-15,20,p:0.02), intraoperative insulin (OR2,61; IC:1.09-6,22, p:0.03), and postoperative hydrocortisone (OR 7,15; IC 1,46-34,9 p:0.01). CONCLUSIONS: Hypoglycemia is frequent in patients that undergo a cardiovascular surgery. The associated factors were chronic kidney failure in dialysis, administration of preoperative steroids, intraoperative insulin and hydrocortisone during postoperative. Other factors such as tissue perfusion, administration of vasoactive or beta blockers substances, showed no association with hypoglycemia.

Different Indexes of Glycemic Variability as Identifiers of Patients with Risk of Hypoglycemia in Type 2 Diabetes Mellitus.

INTRODUCTION: Recent publications frequently introduce new indexes to measure glycemic variability (GV), quality of glycemic control, or glycemic risk; however, there is a lack of evidence supporting the use of one particular parameter, especially in clinical practice. METHODS: A cohort of type 2 diabetes mellitus (T2DM) patients in ambulatory care were followed using continuous glucose monitoring sensors (CGM). Mean glucose (MG), standard deviation, coefficient of variation (CV), interquartile range, CONGA1, 2, and 4, MAGE, M value, J index, high blood glucose index, and low blood glucose index (LBGI) were estimated. Hypoglycemia incidence (<54 mg/dl) was calculated. Area under the curve (AUC) was determined for different indexes as identifiers of patients with risk of hypoglycemia (IRH). Optimal cutoff thresholds were determined from analysis of the receiver operating characteristic curves. RESULTS: CGM data for 657 days from 140 T2DM patients (4.69 average days per patient) were analyzed. Hypoglycemia was present in 50 patients with 144 hypoglycemic events in total (incidence rate of 0.22 events per patient/day). In the multivariate analysis, both CV (OR 1.20, 95% CI 1.12-1.28, P < .001) and LBGI (OR 4.83, 95% CI 2.41-9.71, P < .001) were shown to have a statistically significant association with hypoglycemia. The highest AUC were for CV (0.84; 95% CI 0.77-0.91) and LBGI (0.95; 95% CI 0.92-0.98). The optimal cutoff threshold for CV as IRH was 34%, and 3.4 for LBGI. CONCLUSION: This analysis shows that CV can be recommended as the preferred parameter of GV to be used in clinical practice for T2DM patients. LBGI is the preferred IRH between glycemic risk indexes.

Oxidative stress response in the skin mucus layer of Goodea gracilis (Hubbs and Turner, 1939) exposed to crude oil: A non-invasive approach.

The skin of the fish is the foremost target of oxidative stress due to the generation of Reactive Oxygen Species (ROS) originated in the environment and in the skin itself. In this study, a non-destructive assay was developed to evaluate the effects of crude oil (0.0001-0.1mg/L, 96h) on oxidative stress response in the Skin Mucus Layer (SML) of the dusky splitfin goodeid (Goodea gracilis). The response in the SML was compared with recognized target organs through the Integrated Biomarker Response (IBRv2) and a slight addition to the method was proposed. Crude oil was extremely toxic and elicited a clear induction of ROS in the SML, as in the brain, liver and muscle. By the exposure to crude, a significant change in the activities of Superoxide Dismutase (SOD), Catalase (CAT), Glutathione Peroxidase (GPx) as well as on lipid peroxidation (TBARS) and carbonyl protein (RCO) levels was detected. Also, increases in the activity of EROD were found. The general IBRv2 proposed in this study (gIBRv2) showed that oil causes the higher oxidative response in the SML (60.049) under different concentrations of petroleum, which was greater in the brain (56.749), muscle (56.561) and liver (55.775). The results of the study revealed an organ-specific antioxidant defense response that was dependent on the load of petroleum. These results contributed to the understanding of the complexity of oxidative stress response in fish exposed to crude oil using the Skin Mucus Layer as a target for environmental monitoring studies.

La homoparentalidad en el quehacer terapéutico: una mirada inclusiva / The homoparentality in the therapeutic task: an inclusive look

La familia, como estructura, ha venido experimentado importantes modificaciones, las cuales alteran considerablemente sus dinámicas relacionales. Dentro de las tipologías familiares existentes, se encuentra la familia homoparental, que ha reclamado incesantemente su lugar dentro de una sociedad aún heterosexista. Sobre éste planteamiento, el artículo pretende establecer una reflexión acerca de cómo los psicólogos se encuentran preparados para asumir el desafío que implica la intervención de éste grupo de familias, resaltando la importancia que tiene su propia subjetividad, y cómo ésta influencia el proceso conversacional terapéutico, cuando subyacen actitudes prejuiciosas frente a la homosexualidad.

The family as a structure has been experimenting huge changes, which significantly disrupt their relational dynamics. Within existing family types, it is the homoparental family, which has consistently claimed its place in a heterosexist society. About that, this article aims to establish a reflection on how psychologists are prepared to take on the challenge of the involvement of this group of families, highlighting the importance of their own subjectivity and how it influence negatively the therapeutic process, when they are underlying skills prejudiced against homosexuality.

Fractura radicular vertical / Vertical root fracture

El propósito de este reporte es presentar el caso de un paciente femenino con presencia de fractura radicular vertical (FRV) de un segundopremolar superior izquierdo, remitida a la clínica de Postgrado de Endodonciade la Universidad De La Salle Bajío para remoción de poste y retratamiento dental. Una vez realizado el diagnóstico se determinó FRV mediante sondeo minucioso irregular en un solo punto con sonda flexible, ligero dolor a la masticación y pérdida ósea radiográfica en forma de halo o gota, se sugirió como tratamiento extracción dental y cirugía exploratoria a petición del paciente

The aim of this report is to present the case of a female patient with a vertical root fracture (VRF) of a maxillary second premolar who was referred to the Postgraduate Endodontic Clinic of De La Salle Bajío University in León, Guanajuato, Mexico for the removal of a metallic post and retreatment of root canals. Examination via thorough irregular periodontal probing at a single point with a fl exible probe resulted in a diagnosis of VRF, slight pain on chewing, and radiographic bone loss in the shape of a halo or droplet, for which the suggested treatment was the extraction of the tooth, a surgical procedure that was subsequently performed at the patient’s request.

Asociación del acceso a la atención dental y el edentulismo / Association between Access to dental care and Edentulism

El acceso a la atención se basa en la capacidad del individuo para obtener atención dental cuando sea necesario, o ante algunas barreras que podrían impedir la atención. Objetivo: Determinar la relación entre el acceso a la atención dental y el edentulismo. Material y métodos: La investigación fue transversal, observacional y descriptiva. La muestra fue de 148 personas adultas entre 18 a 65 años de edad del distrito de Cajabamba, provincia de Cajabamba, departamento de Cajamarca. El acceso a la atención dental se evaluó mediante tres variables que son: razón por la cual la última vez no pudo obtener cuidado dental, razón principal de última visita al dentista y última visita al dentista. Se realizó un análisis univariado para evaluar la distribución de cada una de las variables, de tal manera que se pudo detectar valores fuera de lo previsto. También se efectuó un análisis bivariado, mediante la prueba de Chi cuadrado, para determinar la relación entre las variables componentes de acceso a la atención dental y el edentulismo. Las pruebas se realizaron con el programa Stata Inter Cooled 8.0. Resultados: El 100% de edéntulos totales superiores y parciales inferiores acudieron al dentista por última vez por presentar dolor, mientras que el 100% de edéntulos totales acudió para la confección de prótesis. En mayor proporción los dentados visitaron por última vez al dentista en un tiempo menor a 12 meses siendo el 33,73%, y con un 36,36% los edéntulos totales y edéntulos parcial bimaxilar acudiero en mayor proporcion en un tiempo mayor a 5 años. Conclusion: Existe relacion entre el acceso a la atención dental y el edentulismo.

Access to care refers propensity of the individual to obtain any services, and the capacity of the system to match the patientÆs needs and preferences with appropriate level of services. Objective: Determine the association between access to dental care and edentulism. Material and methods: this was an observational descriptive cross-sectional study. The sample included 18-65 years old adults from the district of Cajabamba, Cajamarca, Peru. Access to dental care was measured using questions. The distribution of each variable was explored in univariate analysis. The association between access to dental care and edentulism were tested using the chi-square test. The outcome of the research was obtained using Stata Inter cooled 8.0. Results: all edentulous maxilla and partially edentulous jaw ??? sought the dentist for the last time due to pain, meanwhile 100% of edentulous patients received dental prosthetic treatments. The majority of the patients visited the dentist one last time in a period less than 12 months being the 33.73%, and 36.36% total edentulous y partial bimaxilar sought dental care in larger proportion in a 5 year time period. Conclusion: there exists a relationship between the access to dental care and edentulism.