The role of estrogen metabolites in human ovarian function.

Estrogens produced by the ovary play diverse roles in controlling physiological changes in the function of the female reproductive system. Although estradiol acts through classical nuclear receptors, its metabolites (EMs) act by alternative pathways. It has been postulated that EMs act through paracrine-autocrine pathways to regulate key processes involved in normal follicular growth, corpus luteum (CL) development, function, and regression. The present review describes recent advances in understanding the role of EMs in human ovarian physiology during the menstrual cycle, including their role in anovulatory disorders and their action in other target tissues.

An Observation-Based Dataset of Global Sub-Daily Precipitation Indices (GSDR-I).

Precipitation indices based on daily gauge observations are well established, openly available and widely used to detect and understand climate change. However, in many areas of climate science and risk management, it has become increasingly important to understand precipitation characteristics, variability and extremes at shorter (sub-daily) durations. Yet, no unified dataset of sub-daily indices has previously been available, due in large part to the lesser availability of suitable observations. Following extensive efforts in data collection and quality control, this study presents a new global dataset of sub-daily precipitation indices calculated from a unique database of 18,591 gauge time series. Developed together with prospective users, the indices describe sub-daily precipitation variability and extremes in terms of intensity, duration and frequency properties. The indices are published for each gauge where possible, alongside a gridded data product based on all gauges. The dataset will be useful in many fields concerned with variability and extremes in the climate system, as well as in climate model evaluation and management of floods and other risks.

Uso del músculo temporal en reconstrucción periorbitaria post exéresis de carcinoma epidermoide cutáneo del globo ocular izquierdo / Use of the temporal muscle in post exeresis periorbital reconstruction of cutaneous epidermoid carcinoma of the left eyeball

Introducción. El carcinoma epidermoide cutáneo (CEC) es la segunda neoplasia cutánea más frecuente después del carcinoma basocelular. La incidencia del CEC ha aumentado de forma considerable durante los últimos 20 años y predicen un incremento en la próxima década. La mayoría de los CEC están localizados y se resuelven habitualmente mediante la extirpación quirúrgica u otros procedimientos locales. El uso del músculo temporal es una alternativa quirúrgica para corregir el defecto periorbitario tras la extirpación del CEC. Objetivo. Evaluar el resultado de la cobertura del músculo temporal en la corrección del defecto periorbitario. Material y métodos. Se presenta un caso quirúrgico de un paciente masculino, 62 años, que presenta una gran lesión tumoral que compromete el globo ocular, región orbitaria y periorbitaria izquierda, acompañado de dolor, anemia, astenia y pérdida ponderal de aproximadamente 20 libras. Con una evolución de 6 años. Conclusión. El uso del músculo temporal es una alternativa eficaz en la reconstrucción de lesiones craneofaciales, que ha sido utilizado por más de 100 años.

Introduction. Skin epidermoid carcinoma (SEC) is the second most common skin neoplasm after basal cell carcinoma. The incidence of SEC has increased considerably over the past 20 years and predicts an increase over the next decade. Most SECs are located and usually resolved by surgical removal or other local procedures. The use of the temporal muscle is a surgical alternative to correct the peri-orbital defect after removal of the SEC. Objective. To evaluate the result of temporal muscle coverage in the correction of the peri-orbital defect. Material and methods. There is a surgical case of a male patient, 62 years old who has a large tumor injury that compromises the eyeball, orbital region and left periorbital. Accompanied by pain, anemia, asthenia, and weight loss approximately 20 pounds. With an evolution of 6 years. Conclusion. The use of the temporalis muscle is an effective alternative in the reconstruction of craniofacial lesions that has been used for more than 100 years

Effects of the environmental conditions and seasonality on a population survey of the Andean condor Vultur gryphus in the tropical Andes.

Background: Among the New World vultures, the Andean condor is considered one of the most culturally and ecologically important species. However, their populations are declining over their entire distributional range. In response, conservation strategies have been implemented in many countries to reverse the increasing extinction risk of this species. The initiatives rely on extensive population surveys to gather basic information necessary to implement policies and to intervene efficiently. Still, there is a need to standardize the surveys based on seasonality and suitable environmental conditions throughout the species distribution. Here, we provide the first assessment of how daily temperature, rainfall, and seasonality influence surveys of Andean condors on a communal roost in the central Peruvian Andes. Methods: Using an autoregressive generalized linear model, we associated environmental variables with visual surveys of adult and young condors at three different times of the day and three times a week between June 2014 and March 2015. Results: We found that both adults and young Andean condors showed a threefold reduction in the use of the communal roost after the beginning of the rainy season. Colder and drier days (dry season) are preferable for surveying, as we expect the total number of condors using communal roosts to reduce under rainy (rainfall = -0.53 ± 0.16) and warmer days (temperature = -0.04 ± 0.02) days. Therefore, the significant variation in the use of roosts across seasons and hours should be carefully accounted for in national surveys, at the risk of undermining the full potential of the communal roost surveys. Moreover, we also found a strong bias towards immatures (about 76%) in the adult:immature ratio and a remarkable absence of Andean condors during the wet season. These results suggest that the species might be using other unknown communal roosts hierarchically. Such results provide key information for selecting priority areas for conservation and selecting the best time to survey this species in the tropical Andes. Finally, it may open a fruitful avenue for further research on the protection of the Andean condor.

The fungal expel of 5-fluorocytosine derived fluoropyrimidines mitigates its antifungal activity and generates a cytotoxic environment.

Invasive aspergillosis remains one of the most devastating fungal diseases and is predominantly linked to infections caused by the opportunistic human mold pathogen Aspergillus fumigatus. Major treatment regimens for the disease comprise the administration of antifungals belonging to the azole, polyene and echinocandin drug class. The prodrug 5-fluorocytosine (5FC), which is the only representative of a fourth class, the nucleobase analogs, shows unsatisfactory in vitro activities and is barely used for the treatment of aspergillosis. The main route of 5FC activation in A. fumigatus comprises its deamination into 5-fluorouracil (5FU) by FcyA, which is followed by Uprt-mediated 5FU phosphoribosylation into 5-fluorouridine monophosphate (5FUMP). In this study, we characterized and examined the role of a metabolic bypass that generates this nucleotide via 5-fluorouridine (5FUR) through uridine phosphorylase and uridine kinase activities. Resistance profiling of mutants lacking distinct pyrimidine salvage activities suggested a minor contribution of the alternative route in 5FUMP formation. We further analyzed the contribution of drug efflux in 5FC tolerance and found that A. fumigatus cells exposed to 5FC reduce intracellular fluoropyrimidine levels through their export into the environment. This release, which was particularly high in mutants lacking Uprt, generates a toxic environment for cytosine deaminase lacking mutants as well as mammalian cells. Employing the broad-spectrum fungal efflux pump inhibitor clorgyline, we demonstrate synergistic properties of this compound in combination with 5FC, 5FU as well as 5FUR.

Utilidad de la medición del tiempo de aceleración pedal en el diagnósticode enfermedad arterial periférica / Usefulness of the measurement of the pedal acceleration time in the diagnosis of peripheral arterial disease

Introducción: recientemente se ha descrito la evaluación del tiempo de aceleración en las arterias plantares (TAP) mediante ultrasonografía Doppler como una alternativa de diagnóstico no invasivo en pacientes con limitación para la interpretación del ITB. Objetivos: evaluar la correlación del TAP con la medición del ITB en una población de pacientes en Colombia. Métodos: estudio de tipo descriptivo, prospectivo y transversal en dos centros de alta complejidad de Medellín (Colombia) durante un año. Se realizó medición del TAP en los pacientes con sospecha de enfermedad arterial periférica (EAP). Para el análisis de los datos se utilizaron medidas de tendencia central, como la media con su desviación estándar o la mediana con su rango intercuartílico según la distribución de los datos por la prueba de Shapiro Wilk. Para las variables cualitativas se utilizó la distribución de frecuencias absolutas y relativas de las categorías de las variables. Resultados: se incluyeron 68 pacientes (130 extremidades) con una media de 72,4 años. La disminución del ITB se asoció con un incremento del TAP. En pacientes con un ITB normal (1-1,3) se encuentra una media de TAP de 83 ± 21 ms; con un ITB de 0,5-0,89 se encuentra un TAP de 134 ± 48 ms, y en pacientes con un ITB < 0,5 se encontró 193 ± 57 ms con mediciones de la arteria plantar lateral, con una correlación inversa > -0,9 entre los valores de las 4 arterias plantares. Los pacientes severamente enfermos, con un ITB < 0,5, se asociaron con un TAP > 160 ms (AUC = 0,89; IC 95 %, 0,839-0,959). Del mismo modo, los pacientes con un ITB normal se asociaron con unos valores de TAP < 100 ms. Conclusiones: la medición del TAP puede representar una herramienta adicional en la evaluación de la EAP. Sin embargo, se requieren más estudios que permitan evaluar el TAP en poblaciones especiales, como aquellos pacientes con EAP e ITB no valorables.(AU)

Introduction: the assessment of ITB in patients with the peripheral arterial disease has some limitations and does not provide an adequate parameter of distal perfusion. Recently, the assessment of acceleration time in plantar arteries by Doppler ultrasonography has been described, which can correlate with ABI and offer a noninvasive diagnostic alternative in patients with limited interpretation. Objectives: in this study we seek to evaluate the correlation of TAP with ABI measurement in a group of patients in Colombia. Methods: a descriptive, prospective, cross-sectional study in 2 high complexity hospitals in Medellin (Colombia). During a 1-year period, plantar acceleration time was measured in 68 patients (130 extremities) who presented for arterial plethysmography under suspicion of peripheral arterial disease (PAD). For data analysis, measures of central tendency were used, such as the mean with its standard deviation or the median with its interquartile range according to the distribution of the data by the Shapiro-Wilk test. For qualitative variables absolute and relative frequency distribution of categories and variables were used. Results: the decrease in ABI is associated with an increase in PAT. In patients with normal ABI (1-1.3) a mean TAP of 83 ± 21 ms was found, with ITB 0.5-0.89 TAP 134 ± 48 ms was found, and in patients with ABI < 0.5 TAP 193 ± 57 ms was found with lateral plantar artery measurements, with an inverse correlation of -0.9 between the values of the 4 plantar arteries. Severe patients with ABI<0.5 are associated with TAP greater than 160 ms with an (AUC = 0.89; 95% CI, 0.839-0.959), similarly patients with a normal ABI are associated with PAT values < 100 ms. Conclusions: longer PAT values show a high correlation with longer ABI. Low and greater involvement of patients with peripheral arterial disease, as well as lower PAT values, correlate with a normal ABI.(AU)

Uptake of the Siderophore Triacetylfusarinine C, but Not Fusarinine C, Is Crucial for Virulence of Aspergillus fumigatus.

Siderophores play an important role in fungal virulence, serving as trackers for in vivo imaging and as biomarkers of fungal infections. However, siderophore uptake is only partially characterized. As the major cause of aspergillosis, Aspergillus fumigatus is one of the most common airborne fungal pathogens of humans. Here, we demonstrate that this mold species mediates the uptake of iron chelated by the secreted siderophores triacetylfusarinine C (TAFC) and fusarinine C by the major facilitator-type transporters MirB and MirD, respectively. In a murine aspergillosis model, MirB but not MirD was found to be crucial for virulence, indicating that TAFC-mediated uptake plays a dominant role during infection. In the absence of MirB, TAFC becomes inhibitory by decreasing iron availability because the mutant is not able to recognize iron that is chelated by TAFC. MirB-mediated transport was found to tolerate the conjugation of fluorescein isothiocyanate to triacetylfusarinine C, which might aid in the development of siderophore-based antifungals in a Trojan horse approach, particularly as the role of MirB in pathogenicity restrains its mutational inactivation. Taken together, this study identified the first eukaryotic siderophore transporter that is crucial for virulence and elucidated its translational potential as well as its evolutionary conservation. IMPORTANCE Aspergillus fumigatus is responsible for thousands of cases of invasive fungal disease annually. For iron uptake, A. fumigatus secretes so-called siderophores, which are taken up after the binding of environmental iron. Moreover, A. fumigatus can utilize siderophore types that are produced by other fungi or bacteria. Fungal siderophores raised considerable interest due to their role in virulence and their potential for the diagnosis and treatment of fungal infections. Here, we demonstrate that the siderophore transporter MirB is crucial for the virulence of A. fumigatus, which reveals that its substrate, triacetylfusarinine C, is the most important siderophore during infection. We found that in the absence of MirB, TAFC becomes inhibitory by decreasing the availability of environmental iron and that MirB-mediated transport tolerates the derivatization of its substrate, which might aid in the development of siderophore-based antifungals. This study significantly improved the understanding of fungal iron homeostasis and the role of siderophores in interactions with the host.

The Membrane Activity of the Amphibian Temporin B Peptide Analog TB_KKG6K Sheds Light on the Mechanism That Kills Candida albicans.

Temporin B (TB) is a 13-amino-acid-long, cationic peptide secreted by the granular glands of the European frog Rana temporaria. We recently showed that the modified TB peptide analog TB_KKG6K rapidly killed planktonic and sessile Candida albicans at low micromolar concentrations and was neither hemolytic nor cytotoxic to mammalian cells in vitro. The present study aimed to shed light into its mechanism of action, with a focus on its fungal cell membrane activity. We utilized different fluorescent dyes to prove that it rapidly induces membrane depolarization and permeabilization. Studies on model membrane systems revealed that the TB analog undergoes hydrophobic and electrostatic membrane interactions, showing a preference for anionic lipids, and identified phosphatidylinositol and cardiolipin as possible peptide targets. Fluorescence microscopy using fluorescein isothiocyanate-labeled TB_KKG6K in the presence of the lipophilic dye FM4-64 indicated that the peptide compromises membrane integrity and rapidly enters C. albicans cells in an energy-independent manner. Peptide-treated cells analyzed by cryo-based electron microscopy exhibited no signs of cell lysis; however, subcellular structures had disintegrated, suggesting that intracellular activity may form part of the killing mechanism of the peptide. Taken together, this study proved that TB_KKG6K compromises C. albicans membrane function, which explains the previously observed rapid, fungicidal mode of action and supports its great potential as a future anti-Candida therapeutic. IMPORTANCE Fungal infections with the opportunistic human pathogen C. albicans are associated with high mortality rates in immunocompromised patients. This is partly due to the yeast's ability to rapidly develop resistance toward currently available antifungals. Small, cationic, membrane-active peptides are promising compounds to fight against resistance development, as many of them effectuate rapid fungal cell death. This fast killing is believed to hamper the development of resistance, as the fungi do not have sufficient time to adapt to the antifungal compound. We previously reported that the synthetic variant of the amphibian TB peptide, TB_KKG6K, rapidly kills C. albicans. In the current study, the mechanism of action of the TB analog was investigated. We show that this TB analog is membrane-active and impairs cell membrane function, highlighting its potential to be developed as an attractive alternative anti-C. albicans therapeutic that may hinder the development of resistance.

Photocatalytic activity, water absorption capacity, and thermal stability of white cement-based mortars with polysiloxane silicone and different doses of titanium dioxide nanoparticles / Actividad fotocatalítica, absorción de agua y estabilidad térmica de morteros a base de cemento blanco con silicona de polisiloxano y diferentes dosis de nanopartículas de dióxido de titanio

White cement-based mortars in urban areas are usually discolored and altered their esthetic properties due to air pollutants. The addition of nanoparticles in these mortars can provide photocatalytic properties that can decompose pollution agents. Likewise, other hydrophobic agents have been individually studied to improve outdoor building constructions. Therefore, this study presented the photocatalytic and hydrophobic effect of adding nano-TiO2and silicone hydrophobic powder (DOWSILTM) in a white cement matrix. The nano-TiO2 were characterized by X-Ray Diffraction (XRD); afterwards, the mortar was mixed with additions of nano-TiO2 (0.0, 0.5, 1.0, 3.0%) and DOWSILTM (0.0, 0.5%). The mortar's photocatalytic performance was evaluated using a modification of the standard Italian test Ente Nazionale Italiano di Unificazione 11259:2016 based on Rhodamine B (RhB) degradation on the sample exposed to UV irradiation. Therefore, mortar samples were subjected to UV irradiation to degrade the organic dye rhodamine B, monitoring their color variation using a C I E L* a* b* spectrophotometer. Moreover, the water permeability and the contact angle were evaluated. This research demonstrates that the white cement-based mortar samples added with nano-TiO2/DOWSILTM possess photocatalytic activity. The samples with the addition of 1.0%/0.5% and 3.0%/0.5% nano-TiO2/DOWSILTM showed a higher RhB degradation for R4 and R26. Therefore, these two materials can be employed in these proportions to improve the quality of the white cement-based mortars in urban constructions.

Los morteros a base de cemento blanco generalmente se decoloran y alteran sus propiedades estéticas debido a los contaminantes del aire en las áreas urbanas. Nanopartículas añadidas a estos morteros pueden proporcionar propiedades fotocatalíticas que descomponen estos contaminantes. Asimismo, otros agentes hidrofóbicos se han estu-diado individualmente para mejorar las construcciones a la intemperie. Por lo tanto, se presenta el efecto fotocatalítico e hidrofóbico al incorporar nano-TiO2 y silicona hidrofóbica de polisiloxano (DOWSILTM) en una matriz de cemento blanco. El nano-TiO2 se caracterizó por medio de Difracción de Rayos X (DRX); luego, el mortero se mezcló con adiciones de nano-TiO2 (0.0, 0.5, 1.0, 3.0%) y DOWSILTM (0.0, 0.5%). Los morteros se sometieron a irradiación UV, para degradar el colorante orgánico rodamina B, monitoreando su variación de color usando un espectrofotómetro C I E L* a* b*. La eficiencia fotocatalítica del mortero se evaluó utilizando una modificación de la norma italiana Ente Nazionale Italiano di Unificazione 11259:2016 basada en la degradación de la rodamina B (RhB) en el mortero expuesto a la radiación UV. Además, se evaluó la permeabilidad al agua y el ángulo de contacto. Esta investigación demostró que el mortero de cemento con nano-TiO2/ DOWSILTM posee actividad fotocatalítica. Las muestras con 1.0%/0.5% y 3.0%/0.5% nano-TiO2/DOWSILTM mostraron una mayor eficiencia de degradación de RhB para R4 y R26. Por lo tanto, estos materiales tienen potencial para mejorar la calidad de los morteros en construcciones urbanas.

Enzymatic hydrolysis as a tool to improve total digestibility and techno-functional properties of pigeon pea (Cajanus cajan) starch.

Recent studies have indicated that starch from legumes can potentially be used as an alternative to commercial flour with applications in food and biomaterials; however, some modifications may be required first to improve their functionality, as they show relatively lower solubility and functional properties compared to commonly marketed flours (e.g. good water retention capacity). This work used multiple enzymes in flour extracts of pigeon pea (Cajanus cajan), a legume, to optimize the enzyme hydrolysis process of such extracts by the Response Surface Method (RSM), to increase the digestibility and obtain desirable functional attributes at the nutritional level. The pH, temperature, time and enzyme/substrate (E/S) ratio were evaluated, and the degree of hydrolysis (DH) was calculated as well as the reducing sugar content (%RS), used as response variable. According to the experimental design, the best pH, temperature, time and E/S ratio were 6.8, 43 °C, 1.84% m/m and 270 min, respectively. The %RS for the samples under optimal conditions was 3.49 ± 0.02%, and the in vitro digestibility yielded values of 39.2 ± 0.4, 58.6 ± 0.3 and 2.2 ± 0.2 for slowly digestible starch (SDS), rapidly digestible starch (RDS) and resistant starch (RS), respectively. Total digestibility (TD) was 97.8 ± 0.5. The statistical analysis revealed a strong positive relationship for E/S ratio followed by pH: (E/S) ratio, temperature and pH. Enzymatic hydrolysis carried out on pigeon pea showed an increase in TD. Viscosity, water retention capacity (WRC) and solubility were evaluated showing good response for future applications at the industrial level.

Inducible Selectable Marker Genes to Improve Aspergillus fumigatus Genetic Manipulation.

The hygromycin B phosphotransferase gene from Escherichia coli and the pyrithiamine resistance gene from Aspergillus oryzae are two dominant selectable marker genes widely used to genetically manipulate several fungal species. Despite the recent development of CRISPR/Cas9 and marker-free systems, in vitro molecular tools to study Aspergillus fumigatus, which is a saprophytic fungus causing life-threatening diseases in immunocompromised hosts, still rely extensively on the use of dominant selectable markers. The limited number of drug selectable markers is already a critical aspect, but the possibility that their introduction into a microorganism could induce enhanced virulence or undesired effects on metabolic behavior constitutes another problem. In this context, here, we demonstrate that the use of ptrA in A. fumigatus leads to the secretion of a compound that allows the recovery of thiamine auxotrophy. In this study, we developed a simple modification of the two commonly used dominant markers in which the development of resistance can be controlled by the xylose-inducible promoter PxylP from Penicillium chrysogenum. This strategy provides an easy solution to avoid undesired side effects, since the marker expression can be readily silenced when not required.

Development of a PHBV nanoparticle as a peptide vehicle for NOD1 activation.

NOD1 is an intracellular receptor that, when activated, induces gene expression of pro-inflammatory factors promoting macrophages and neutrophils recruitment at the infection site. However, iE-DAP, the dipeptide agonist that promotes this receptor's activation, cannot permeate cell membranes. To develop a nanocarrier capable of achieving a high and prolonged activation over time, iE-DAP was encapsulated in nanoparticles (NPs) made of poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). The physicochemical properties, colloidal stability, encapsulation efficiency, and cellular uptake of iE-DAP-loaded PHVB NPs were analyzed. Results evidenced that physicochemical properties of iE-DAP-loaded NPs remained stable over time, and NPs were efficiently internalized into cells, a process that depends on time and concentration. Moreover, our results showed that NPs elicited a controlled cargo release in vitro, and the encapsulated agonist response was higher than its free form, suggesting the possibility of activating intracellular receptors triggering an immune response through the release of NOD1 agonist.

ZnO nucleation into trititanate nanotubes by ALD equipment techniques, a new way to functionalize layered metal oxides.

In this contribution, we explore the potential of atomic layer deposition (ALD) techniques for developing new semiconductor metal oxide composites. Specifically, we investigate the functionalization of multi-wall trititanate nanotubes, H2Ti3O7 NTs (sample T1) with zinc oxide employing two different ALD approaches: vapor phase metalation (VPM) using diethylzinc (Zn(C2H5)2, DEZ) as a unique ALD precursor, and multiple pulsed vapor phase infiltration (MPI) using DEZ and water as precursors. We obtained two different types of tubular H2Ti3O7 species containing ZnO in their structures. Multi-wall trititanate nanotubes with ZnO intercalated inside the tube wall sheets were the main products from the VPM infiltration (sample T2). On the other hand, MPI (sample T3) principally leads to single-wall nanotubes with a ZnO hierarchical bi-modal functionalization, thin film coating, and surface decorated with ZnO particles. The products were mainly characterized by electron microscopy, energy dispersive X-ray, powder X-ray diffraction, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy. An initial evaluation of the optical characteristics of the products demonstrated that they behaved as semiconductors. The IR study revealed the role of water, endogenous and/or exogenous, in determining the structure and properties of the products. The results confirm that ALD is a versatile tool, promising for developing tailor-made semiconductor materials.

Manejo quirúrgico de la duplicación patelar bilateral en displasia epifisiaria múltiple recesiva. Reporte de caso / Surgical management of bilateral duplication of the patella in multiple recessive epiphyseal dysplasia. A case report

Introducción La displasia epifisiaria múltiple (DEM) es una enfermedad poco frecuente y con gran variedad clínica y se caracteriza por deformidades en las articulaciones, dolor, y trastornos de la marcha. La duplicación patelar se asocia con DEM recesiva y consiste en dos segmentos patelares escalonados separados por tejido blando entre ellos. Caso clínico Paciente masculino de 30 años con cuadro clínico de DEM recesiva con duplicación patelar, presenta dolor crónico bilateral de cadera y rodilla, y trastorno de la marcha. Tras el examen físico, se evidenció derrame articular, dificultad para la flexión de las rodillas y un cuerpo libre intra-articular bilateral. Se identificaron dos segmentos patelares, displasia acetabular y de cabeza femoral bilateral con imágenes diagnósticas. El manejo quirúrgico de la duplicación patelar fue resección de los segmentos óseos accesorios, conduciendo a un resultado clínico satisfactorio al año de seguimiento. Discusión Aunque no se realiza el diagnóstico genético de la DEM, nuestro paciente presenta las características fenotípicas y radiológicas de esta entidad. Para la duplicación patelar, se realizó la resección de las patelas accesorias, considerando el alto riesgo de no unión. Sin embargo, existen varios reportes donde unieron los dos segmentos patelares, pero principalmente en niños. Este es el primer reporte publicado sobre el manejo quirúrgico de esta patología en Colombia. La duplicación patelar puede manejarse con éxito mediante la resección de la patela accesoria en adultos. Aunque los hallazgos imagenológicos son muy sugestivos de esta patología, se requiere un adecuado examen físico para evitar un diagnóstico equivoco y tardío.

Background Multiple epiphyseal dysplasia (MED) is a rare disease with a great clinical variation, and is characterised by deformities in the joints, pain, and gait disorders. Duplication of the patella is associated with recessive MED, and consists of two staggered patellar segments separated by soft tissue between them. Clinical case A 30-years-old male patient with a clinical manifestation of recessive MED with duplication of the patella, chronic bilateral hip and knee pain, as well as gait disorder. After the physical examination, joint effusion, difficulty in flexing the knees, and a bilateral intra-articular free body were evident. Two patellar segments, acetabular dysplasia and bilateral femoral head, were identified with diagnostic imaging. The surgical management of duplication of the patella was resection of the accessory bone segments, leading to a satisfactory clinical result at one year of follow-up. Discussion Although the genetic diagnosis of the MED was not made, our patient presented with the phenotypic and radiological characteristics of this disease. For duplication of the patella, the accessory patella resection was performed, considering the high risk of non-union. However, there are several reports where the two patellar segments are joined; but mainly in children. This is the first report published about the surgical management of this pathology in Colombia. Duplication of the patella can be managed successfully by resecting accessory patella in adults. Although the imaging findings are very suggestive of this pathology, an adequate physical examination is required to avoid a false and late diagnosis.

Nefritis tubulointersticial aguda. Revisión bibliográfica / Acute interstitial nephritis. Literature review

RESUMEN La nefritis tubulointersticial aguda hace referencia a un tipo de daño renal que afecta principalmente el intersticio y ocasiona la lesión renal aguda, potencialmente reversible. Su curso puede ser subclínico, con deterioro progresivo hasta evolucionar hacia la insuficiencia renal crónica. La nefritis tubulointersticial aguda tiene múltiples etiologías, las más frecuentes son los medicamentos, productos herbales, las infecciones y las enfermedades autoinmunes. Las principales manifestaciones clínicas son la poliuria, polaquiuria, nocturia, dolor lumbar, microhematuria y leucocituria, aunque puede ser totalmente asintomática. El tratamiento depende de la causa de base y los esteroides juegan un papel importante cuando la condición es de origen medicamentoso o autoinmune. El pronóstico generalmente es bueno, si el problema se identifica de forma oportuna y se trata adecuadamente.

SUMMARY Acute tubulointerstitial nephritis is a kidney lesion that mainly affects the interstitium and can lead to a reversible acute kidney injury. It can progress subclinically, with progressive development towards chronic renal failure. Acute tubulointerstitial nephritis has several causes, being the most common medications, herbal products, infections and autoimmune diseases. The main clinical manifestations are polyuria, polaquiuria, nycturia, lumbar pain, microhematuria, leukocyturia, although the patients also can be completely asymptomatic. Treatment is determined by the underlying cause. Steroids play an important role when tubulointerstitial nephritis is caused by medication or autoimmune diseases. The prognosis is usually good if the problem is detected early and treated properly.

Diabetic Ketoacidosis Associated with Thyroxine (T4) Toxicosis and Thyrotoxic Cardiomyopathy.

Thyrotoxicosis and diabetic ketoacidosis (DKA) both may present as endocrine emergencies and may have devastating consequences if not diagnosed and managed promptly and effectively. The combination of diabetes mellitus (DM) with thyrotoxicosis is well known, and one condition usually precedes the other. Furthermore, thyrotoxicosis is complicated by some degree of cardiomyopathy in at least 5% de patients; but the coexistence of DKA, thyroxin (T4) toxicosis, and acute cardiomyopathy is extremely rare. We describe a case of a man, previously diagnosed with DM but with no past history of thyroid disease, who presented with shock and severe DKA that did not improve despite optimal therapy. The patient evolved with acute pulmonary edema, elevated troponin levels, severe left ventricular systolic dysfunction, and clinical and laboratory evidence of thyroxin (T4) toxicosis and thyrotoxic cardiomyopathy. Subsequently, the patient evolved favorably with general support and appropriate therapy for DKA and thyrotoxicosis (hydrocortisone, methimazole, Lugol's solution) and was discharged a few days later.

Satisfacción de usuarios en servicios recreativos y deportivos en el contexto universitario / Satisfaction of users in recreational and sports services in the university context / Satisfação de usuarios em servicios recreativos e deportivos en el contexto universitário

Se aborda la prestación del servicio desde un enfoque basado en la calidad, con la finalidad de conocer el grado de satisfacción de usuarios en programas recreativos, deportivos y de formación continua en un centro de extensión universitario. En perspectiva cuantitativa, empleó un estudio no experimental descriptivo, de corte transversal, que diseñó, validó y aplicó un cuestionario identificando la dimensión profesor como la de mayor valoración, y la de costo del servicio, sin ser negativa, como la más baja. En prospectiva, genera rutas para la calidad del servicio como tendencia y preocupación actual en organizaciones e instituciones de educación superior. Permite continuar indagaciones desde la mejora continua, el cambio y la planificación estratégica desde dimensiones como: curso, profesor, instalaciones, inscripciones y matrículas, comunicación y costo. Brinda a directivos la posibilidad de reconocer sus habilidades en la toma de decisiones basada en evidencias científicas.

The provision of the service is approached from a quality-based approach, in order to know the degree of satisfaction of users in recreational, sports and continuing education programs in a university extension center. In quantitative perspective, it used a non-experimental, descriptive, cross-sectional study that designed, validated and applied a questionnaire identifying the teacher dimension as the highest value and the cost of service, without being negative, the lowest. In prospective, it generates routes for quality of service as a trend and current concern in higher education organizations and institutions. It allows to continue inquiries from continuous improvement, change and strategic planning from dimensions such as: course, teacher, facilities, registration, communication and cost. Provides managers with the possibility of recognizing their decision-making skills based on scientific evidence.

A prestação do serviço é abordada a partir de uma abordagem de qualidade, a fim de conhecer o grau de satisfação dos usuários em programas recreativos, esportivos e de educação continuada em um centro de extensão universitária. No ponto de vista quantitativo, é usado um descritivo, em corte transversal, que concebida, validado e aplicado um questionário identificando a dimensão professor quanto maior valorização e custo do serviço, sem ser negativo, o menor não experimental. Em perspectiva, gera rotas de qualidade de serviço como tendência e atual preocupação em organizações e instituições de ensino superior. Permite continuar as investigações de melhoria contínua, mudança e planejamento estratégico a partir de dimensões como: curso, professor, instalações, inscrição, comunicação e custo. Fornece aos gerentes a possibilidade de reconhecer suas habilidades de tomada de decisão com base em evidências científicas.

Effects of Liposomes Contained in Thermosensitive Hydrogels as Biomaterials Useful in Neural Tissue Engineering.

Advances in the generation of suitable thermosensitive hydrogels for the delivery of cells in neural tissue engineering demonstrate a delicate relationship between physical properties and capabilities to promote cell proliferation and differentiation. To improve the properties of these materials, it is possible to add liposomes for the controlled release of bioactive elements, which in turn can affect the physical and biological properties of the hydrogels. In the present investigation, different hydrogels based on Pluronic F127 have been formulated with the incorporation of chitosan and two types of liposomes of two different sizes. The rheological and thermal properties and their relation with the neurite proliferation and growth of the PC12 cell line were evaluated. Our results show that the incorporation of liposomes modifies the properties of the hydrogels dependent on the concentration of chitosan and the lipid type in the liposomes, which directly affect the capabilities of the hydrogels to promote the viability and differentiation of PC12 cells.

Neisseria gonorrhoeae Challenge Increases Matrix Metalloproteinase-8 Expression in Fallopian Tube Explants.

Background:Neisseria gonorrhoeae (Ngo) is the etiological agent of gonorrhea, a sexually transmitted infection that initially infects the female lower genital tract. In untreated women, the bacteria can ascend to the upper genital reproductive tract and infect the fallopian tube (FTs), which is associated with salpingitis and can lead to impaired FT function and infertility. The extracellular matrix (ECM) plays an important role in cell migration and differentiation in the female genital tract, and some pathogens modify the ECM to establish successful infections. The ECM is regulated by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), their endogenous inhibitors; MMP deregulation causes pathological conditions in a variety of tissues. Results: The aim of this work was to analyze the expression and localization of MMP-3, MMP-8, MMP-9, and TIMP-1 in FT explants during Ngo infection using real-time PCR, immunohistochemistry, zymography and ELISA. No significant variations in MMP-3, MMP-9, and TIMP-1 transcript levels were observed. In contrast, a significant increase (p < 0.05) was observed for MMP-8 expression and was accompanied by stromal immunoreactivity in infected explants. ELISA results supported these findings and showed that MMP-8 release increased upon gonococcal infection. Conclusions: Our results indicate that gonococcal infection induces increased MMP-8 expression, which might contribute to FT damage during infection.