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INTRODUCTION AND AIM: Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure. Clinical guidelines assess competence in ERCP through a defined number of procedures, but multiple factors are involved. Our aim was to analyze the morphology of the papilla of Vater as an independent factor in selective common bile duct cannulation during resident training. MATERIAL AND METHODS: Patients that underwent ERCP were studied consecutively. All ERCPs were begun by a resident in training. The type of papilla was classified according to Haraldsson, including those with previous sphincterotomy. Cannulation difficulty and success and their relation to the type of papilla were documented. The analysis was divided into three 4-month periods. RESULTS: Of the 429 patients, cannulation was difficult in 101 (23.5%). The residents achieved selective cannulation of the common bile duct in 276 (64.3%) and the cannulation success rate at the end of their training was 81.7%. Cannulation was performed with the least difficulty in papillae with previous sphincterotomy (2.8%), unlike the type 4 papilla, which was difficult to cannulate in 50% of the cases. The lowest overall cannulation success was in the type 2 papilla (81.8%). CONCLUSION: Papilla type can influence cannulation success, but it is not the only related factor. Patients that underwent previous sphincterotomy appear to be the cases in whom ERCP training can be started.

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INTRODUCTION: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterised by attacks of optic neuritis and longitudinally extensive transverse myelitis. The discovery of anti-aquaporin-4 (anti-AQP4) antibodies and specific brain MRI findings as diagnostic biomarkers have enabled the recognition of a broader and more detailed clinical phenotype, known as neuromyelitis optica spectrum disorder (NMOSD). OBJECTIVE: This study aimed to determine the demographic and clinical characteristics of patients with NMO/NMOSD with and without seropositivity for anti-AQP4 antibodies, in 2 quaternary-level hospitals in Bogotá. METHODS: Our study included patients > 18 years of age and diagnosed with NMO/NMOSD and for whom imaging and serology results were available, assessed between 2013 and 2017 at the neurology departments of hospitals providing highly complex care. Demographic, clinical, and imaging data were gathered and compared in patients with and without seropositivity for anti-AQP4 antibodies. RESULTS: The sample included 35 patients with NMO/NMOSD; the median age of onset was 46.5 years (P25-P75, 34.2-54.0); most patients had sensory (n = 25) and motor manifestations (n = 26), and a concomitant autoimmune disease was identified in 6. Twenty patients were seropositive for anti-AQP4 antibodies. Only age and presence of optic nerve involvement showed statistically significant differences between groups (P = .03). CONCLUSIONS: Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.

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SARS-CoV-2 infection has been associated with multiple neurological manifestations. One such manifestation, which has been described since the early stages of the COVID-19 pandemic and is relevant for current neurological practice, is Guillain-Barré syndrome (GBS). The literature describes neurotoxic mechanisms of the virus itself and the possible pathways by which it may affect the peripheral nerves in experimental studies; however, we still lack information on the mechanisms causing the immune response that gives rise to GBS in the context of SARS-CoV-2 infection. Colombia is one of the Latin American countries worst affected by the pandemic, with the third-highest number of cases in the region; thus, it is essential to recognise GBS, as this potential postinfectious complication may severely compromise the patient's functional status in the absence of timely diagnosis and treatment. We present a series of 12 cases of GBS associated with SARS-CoV-2 infection from hospitals in 4 different Colombian cities and describe the clinical presentation, laboratory and electrophysiological study findings, and treatment.

En el año 2020 se declaro la pandemia ocasionada por la infección por el virus SARSCoV-2, virus de la familia del coronavirus, adoptándose el nombre de COVID-19 a la enfermedad 1. En Bogotá, Colombia, se confirmó el primer caso de COVID-19 el 6 de marzo de 2020 (2). Los principales síntomas reportados en la infección por SARSCoV-2 son fiebre (43.8% en la admisión y 88.7% durante la hospitalización) y tos (67.8%) (3). Otros síntomas encontrados son fatiga (38.1%), producción de esputo (33.7%) y cefalea (13.6%). Los principales signos neurológicos reportados en los pacientes con infección severa por SARS-Cov-2 son agitación (69%), compromiso en tracto corticoespinal (67%) y delirium (65%) (4). Las principales complicaciones neurológicas descritas asociadas a Covid 19 son: anosmia, disgeusia, encefalopatia, Síndrome de Guillain Barre, complicaciones cerebrovasculares y daño en musculo esquelético (5­8).En el presente articulo se presenta una serie de casos de pacientes con síndrome de Guillain-Barré asociado a infección por SARS-CoV-2. Se recolectaron casos de diferentes instituciones medicas de Colombia.

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"Serrated polyps" is the term used for epithelial lesions of the colon and rectum that have a "sawtooth" pattern on the polyp's surface and crypt epithelium. The so-called serrated pathway describes the progression of sessile serrated adenomas and traditional serrated adenomas to colorectal cancer. Said pathway is well recognized as an alternative mechanism of carcinogenesis and accounts for 15-30% of the cases of colorectal cancer. It also explains a large number of the cases of interval colorectal cancer. Thus, due to their usually aggressive and uncertain behavior, serrated polyps are of the utmost importance in colorectal cancer screening. Our aim was to review the history, current nomenclature, pathophysiology, morphology, treatment, and surveillance of serrated polyps.

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INTRODUCTION: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterised by attacks of optic neuritis and longitudinally extensive transverse myelitis. The discovery of anti-aquaporin-4 (anti-AQP4) antibodies and specific brain MRI findings as diagnostic biomarkers have enabled the recognition of a broader and more detailed clinical phenotype, known as neuromyelitis optica spectrum disorder (NMOSD). OBJECTIVE: This study aimed to determine the demographic and clinical characteristics of patients with NMO/NMOSD with and without seropositivity for anti-AQP4 antibodies, in 2 quaternary-level hospitals in Bogotá. METHODS: Our study included patients > 18 years of age and diagnosed with NMO/NMOSD and for whom imaging and serology results were available, assessed between 2013 and 2017 at the neurology departments of hospitals providing highly complex care. Demographic, clinical, and imaging data were gathered and compared in patients with and without seropositivity for anti-AQP4 antibodies. RESULTS: The sample included 35 patients with NMO/NMOSD; the median age of onset was 46.5 years (P25-P75, 34.2-54.0); most patients had sensory (n = 25) and motor manifestations (n = 26), and a concomitant autoimmune disease was identified in 6. Twenty patients were seropositive for anti-AQP4 antibodies. Only age and presence of optic nerve involvement showed statistically significant differences between groups (p = .03). CONCLUSIONS: Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.

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More than 30 million persons worldwide take nonsteroidal anti-inflammatory drugs (NSAIDs) on a daily basis, and annual consumption is increasing. In addition to their analgesic and anti-inflammatory properties, NSAIDs also produce well-known gastrointestinal adverse events. There is no consensus in Mexico on the diagnosis, treatment, and prevention of NSAID-induced gastropathy and enteropathy, and so the Asociación Mexicana de Gastroenterología brought together a group of experts to establish useful recommendations for the medical community. Thirty-three recommendations were formulated in the present consensus, highlighting the fact that the risk for NSAID-induced gastrointestinal toxicity varies according to the drug employed and its pharmacokinetics, which should be taken into account at the time of prescription. The risk factors for gastroduodenal complications due to NSAIDs are: a history of peptic ulcer, age above 65 years, high doses of NSAIDs, Helicobacter pylori infection, and the presence of severe comorbidities. The symptoms and gastroduodenal damage induced by NSAIDs vary, ranging from an asymptomatic course to the presentation of iron-deficiency anemia, bleeding, stricture, and perforation. Capsule endoscopy and enteroscopy are direct diagnostic methods in NSAID enteropathy. Regarding prevention, the minimum dose of an NSAID needed to achieve the desired effect, administered for the shortest period of time, is the recommendation. Finally, proton pump inhibitors are the gold standard for the prophylaxis and treatment of gastroduodenal effects, but they are not useful in enteropathy.

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RESUMEN: El correcto sellado apical es un paso importante durante el tratamiento de conductos, para esto, se utilizan puntas de gutapercha y cemento sellador, de este último existen diversas formulaciones químicas en el mercado, por lo cual es importante tomar en cuenta los efectos que estas pueden tener en el proceso de cicatrización periapical. El propósito de este estudio fue evaluar la biocompatibilidad de cuatro cementos selladores con diferente composición química con osteoblastos humanos. Se prepararon extractos de cementos selladores a con dos concentraciones (10 mg/mL y 40 mg/mL) y dos tiempos de exposición (10 min y 8 h), estos fueron colocados en contacto con osteoblastos humanos para evaluar la proliferación y citotoxicidad a 24, 72 y 96 h con sus respectivos controles y blancos. Se realizó un análisis estadístico con ANOVA de un factor y la prueba de comparaciones múltiple de Bonferroni. Los resultados obtenidos, tanto en el ensayo de citotoxicidad como en el de proliferación, indicaron que el cemento a base de resina no es biocompatible con osteoblastos. El cemento a base de poli-dimetilxilosano fue el único que no mostró citotoxicidad a ningún de tiempo de exposición y concentración examinadas en este estudio.

ABSTRACT: Correct apical sealing is an important step during root canal treatment, hence, gutta-percha points and sealant are used. There are several chemical compositions on the market, so it is important to evaluate the effects of these in the periapical healing process. The aim of this study was to evaluate the biocompatibility of four sealer cements with different chemical composition placed in contact with human osteoblast. Different extracts were prepared at two concentrations (10 mg/mL and 40 mg/mL) and two exposure times (10 min and 8 h) these were placed in contact with human osteoblast to evaluate cytotoxicity and proliferation at 24, 48 and 72 h with their respective controls and blanks. A statistical analysis was performed with ANOVA of one factor and Bonferroni post hoc. Results obtained in cytotoxicity and proliferation assays, indicated that the resinbased cement is not biocompatible with osteoblast. The poly-dimethylxilosanbased cement was the only that did not show cytotoxicity at any time of exposure and concentration examined in this study.

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Objetivo: Exponer nuestra experiencia y evaluar la recurrencia en el manejo quirúrgico del angiofibroma nasal juvenil, abordaje abierto contra endoscópico, en el servicio de otorrinolaringología del noroeste del país. Materiales y métodos: Estudio observacional, retrospectivo, analítico. Se revisaron los expedientes clínicos de los pacientes con diagnóstico de angiofibroma nasal juvenil de 2014 a 2017, atendidos en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello de esta institución. Resultados: Un total de 19 pacientes con diagnóstico de angiofibroma nasal juvenil, fueron sometidos a un procedimiento quirúrgico, 14 abiertos y 5 endoscópicos, la recurrencia fue de 50 % y 40 % respectivamente, lo cual no fue estadísticamente significativo (p=0.88). No obstante, se contrastaron otras variables, como la necesidad de la Unidad de Cuidados Intensivos (UCI) para ambos grupos, 71 % en abordaje abierto y 20 % para el endoscópico, en lo cual si encontramos diferencia significativa (p=0.04). Conclusiones: El estudio no muestra una ventaja estadísticamente significativa del abordaje endoscópico frente al abordaje abierto, pero sí una menor necesidad de hospitalización en UCI, lo que reduciría los costos de atención.

Objective: To present our experience and assess the recurrence of juvenile nasopharyngeal angiofibroma after a surgical treatment (open versus endoscopic approach) in the country's northwestern Department of Otorhinolaryngology. Materials and methods: An observational, retrospective, analytical study. The medical records of patients diagnosed with juvenile nasopharyngeal angiofibroma, who were treated at the Department of Otorhinolaryngology - Head and Neck Surgery of this institution from 2014 to 2017, were reviewed. Results: A total of 19 patients diagnosed with juvenile nasopharyngeal angiofibroma underwent a surgical procedure, out of which 14 had an open surgery and 5 an endoscopic one. Recurrence accounted for 50 % and 40 %, respectively, which was not statistically significant (p = 0.88). However, other variables were compared, such as the need for admission to the Intensive Care Unit (ICU), which was represented by 71 % in the case of the open approach and 20 % for the endoscopic approach, where a significant difference was found (p = 0.04). Conclusions: The study shows no statistically significant advantage of the endoscopic approach versus the open approach, but demonstrates less need for ICU admissions, which would reduce healthcare costs.

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The measurement of local temperature in nanoscale volumes is becoming a technological frontier. Photoluminescent nanoparticles and nanocolloids are the natural choice for nanoscale temperature probes. However, the influence of a surrounding liquid on the cryogenic behavior of oxidized Si-nanocrystals (Si-NCs) has never been investigated. In this work, the photoluminescence (PL) of oxidized Si-NCs/alcohol based nanocolloids is measured as a function of the temperature and the molecule length of monohydric alcohols above their melting-freezing point. The results unveil a progressive blue shift on the emission peak which is dependent on the temperature as well as the dielectric properties of the surrounding liquid. Such an effect is analyzed in terms of thermal changes of the Si-NCs bandgap, quantum confinement and the polarization effects of the embedding medium; revealing an important role of the dielectric constant of the surrounding liquid. These results are relevant because they offer a general insight to the fundamental behavior of photoluminescent nanocolloids under a cooling process and moreover, enabling PL tuning based on the dielectric properties of the surrounding liquid. Hence, the variables required to engineer PL of nanofluids are properly identified for use as temperature sensors at the nanoscale.

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Glucose-6-phosphate dehydrogenase deficiency (G6PD) is the most common enzyme pathology in humans; it is X-linked inherited and causes neonatal hyperbilirubinaemia, chronic nonspherocytic haemolytic anaemia and drug-induced acute haemolytic anaemia. G6PD deficiency has scarcely been studied in the northern region of Mexico, which is important because of the genetic heterogeneity described in Mexican population. Therefore, samples from the northern Mexico were biochemically screened for G6PD deficiency, and PCR-RFLPs, and DNA sequencing used to identify mutations in positive samples. The frequency of G6PD deficiency in the population was 0.95% (n = 1993); the mutations in 86% of these samples were G6PD A(-202A/376G), G6PDA(-376G/968C) and G6PD Santamaria(376G/542T). Contrary to previous reports, we demonstrated that G6PD deficiency distribution is relatively homogenous throughout the country (P = 0.48336), and the unique exception with high frequency of G6PD deficiency does not involve a coastal population (Chihuahua: 2.4%). Analysis of eight polymorphic sites showed only 10 haplotypes. In one individual we identified a new G6PD mutation named Mexico DF(193A>G) (rs199474830), which probably results in a damaging functional effect, according to PolyPhen analysis. Proteomic impact of the mutation is also described.

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