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INTRODUCTION: bone defects drastically alter the patient's quality of life, and can produce serious sequelae such as dysfunctional shortening, angular deformity, joint stiffness and irreversible gait disorder. OBJECTIVE: to describe the experience of managing post-traumatic bone defects of long bones treated with the membrane induction technique. MATERIAL AND METHODS: retrospective observational study of patients with bone defects greater than 3 cm in diaphyseal pseudoarthrosis of long bones, who underwent the Masquelet technique. Period taken from January 2019 to January 2021. All patients underwent vigorous debridement and stabilization of the fracture, to then place the cement spacer. Spacer removal was at 4-6 weeks. The degree of consolidation was assessed, as well as the evolution of the treatment. RESULT: 25 patients were included in the study; the mean age was 36.8 ± 8.9 years. Diameter of bone losses was 3 to 10 cm (84%) and > 10 cm (16%). Bone consolidation occurred in patients with a defect < 10 cm (16%). 32% of patients presented some complication. CONCLUSIONS: bone union was achieved only in a few patients with defects smaller than 10 cm, requiring alternative procedures in most cases. Proper selection of patients is required.

INTRODUCCIÓN: los defectos óseos alteran drásticamente la calidad de vida del paciente y pueden producir serias secuelas como acortamiento disfuncional, deformidad angular, rigidez articular y trastorno irreversible de la marcha. OBJETIVO: describir la experiencia clínica en el manejo de defectos óseos postraumáticos de huesos largos tratados con la técnica de inducción de membrana. MATERIAL Y MÉTODOS: estudio observacional, retrospectivo, de pacientes con defectos óseos mayores de 3 cm con pseudoartrosis diafisaria de huesos largos, a los que se aplicó la técnica de Masquelet. En el período de Enero de 2019 a Enero de 2021. A todos los pacientes se les realizó desbridamiento enérgico y estabilización de la fractura, para posteriormente colocar el espaciador de cemento. El retiro del espaciador fue a las 4-6 semanas. Se valoró el grado de consolidación y la evolución del tratamiento. RESULTADOS: se incluyeron 25 pacientes, la media de edad fue de 36.8 ± 8.9 años. El diámetro de las pérdidas óseas fue de 3 a 10 cm (84%) y > 10 cm (16%). La consolidación ósea se presentó en pacientes con un defecto < 10 cm (16%). Treinta y dos por ciento de los pacientes presentó alguna complicación. CONCLUSIONES: la consolidación ósea se logró sólo en aquellos pacientes con defectos < 10 cm, requiriendo procedimientos alternativos a la técnica de inducción de membrana en la mayoría de los casos. Se requiere una selección adecuada de pacientes para lograr la consolidación ósea por medio de esta técnica.

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Plastic particle occurrence in the digestive tracts of fishes from a tropical estuarine system in the Gulf of California was investigated. A total of 1095 fish were analysed, representing 15 species. In total 1384 particles of plastic debris were recovered from the gastrointestinal tracts of 552 specimens belonging to 13 species, and all consisted of threads, the majority of which were small microplastics (0.23 to 1.89), followed by large microplastics (2.07 to 4.49), and few mesoplastics (5.4 to 19.86). Plastic particles were identified using ATR-FTIR spectroscopy. The mean frequency of occurrence of plastics in the gastrointestinal tracts of fishes from this system was 50.5%, which is higher than frequencies reported in similar systems in other areas. The polymers identified by ATR-FTIR were polyamide (51.2%), polyethylene (36.6%), polypropylene (7.3%), and polyacrylic (4.9%). These results show the first evidence of plastic contamination for estuarine biota in the Gulf of California.

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The increasing use of metal oxide nanoparticles (MONPs) as TiO2 NPs or ZnO NPs has led to environmental release and human exposure. The respiratory system, effects on lamellar bodies and surfactant protein A (SP-A) of pneumocytes, can be importantly affected. Exposure of human alveolar epithelial cells (A549) induced differential responses; a higher persistence of TiO2 in cell surface and uptake (measured by Atomic Force Microscopy) and sustained inflammatory response (by means of TNF-α, IL-10, and IL-6 release) and ROS generation were observed, whereas ZnO showed a modest response and low numbers in cell surface. A reduction in SP-A levels at 24 h of exposure to TiO2 NPs (concentration-dependent) or ZnO NPs (the higher concentration) was also observed, reversed by blocking the inflammatory response (by the inhibition of IL-6). Loss of SP-A represents a relevant target of MONPs-induced inflammatory response that could contribute to cellular damage and loss of lung function.

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INTRODUCTION: The pregnancy period represents the most intense period of growth and development. Pre-pregnancy weight influences weight gain during pregnancy. Leptin is a hormone mainly derived from white adipose tissue, during pregnancy leptin is also produced by the placenta. It has been suggested that the effects of placental leptin on the mother may contribute to endocrine-mediated alterations in energy balance; a dysregulation in leptin levels or its receptors may lead to poor birth outcomes. Therefore, the main goal of the present study was to analyze the differences in birth outcomes by maternal weight with the expression level of leptin receptor in maternal peripheral blood mononuclear cell (PBMC) and placental tissue. METHODS: Women with full-term gestation and its offspring were enrolled. Total RNA from maternal PBMC and placenta was obtained to perform the analysis of expression of the leptin receptor (LEPR) gene trough real-time PCR technique. Data were analyzed using one-way ANOVA or Mann-Whitney u test when applicable. Pearson correlation coefficient was used to determine the relationship between continuous variables (Stata v.13); p ≤ 0.05 was considered statistically significant. RESULTS: No statistically significant differences were found between LEPR expression level and the BMI studied groups in maternal PBMC and placental tissue. Interaction between gestational weight gain (GWG) and LEPR in maternal PBMC explain in a 32% the variability of the newborn weight. CONCLUSIONS: LEPR expression level in maternal PBMC correlates with newborn measurements independent from sex. GWG can affect fetal development by increasing fetal birth weight.

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INTRODUCTION: Cases of invasive Trichosporon infections have increasingly emerged; it is now the second leading cause of yeast bloodstream infections after Candida spp., particularly in the immunosuppressed population, where it often causes breakthrough fungemia with high mortality. METHODS: We present a case report of a breakthrough Trichosporon asahii infection in a patient with acute myeloid leukemia and review all of the cases of breakthrough Trichosporon spp. infections published in the literature to date. RESULTS: We extracted 68 cases of breakthrough Trichosporon spp. infections, wherein 95.5% patients had hematological malignancy, 61.8% of them occurred in the presence of echinocandins, 22% of triazoles, 13.2% of amphotericin and 3% of other combinations of antifungals. The most prevalent manifestation was fungemia (94%); 82.8% of these were associated with the presence of a central venous catheter. The overall mortality was 68.7%; the patients who survived recovered from the neutropenic event. CONCLUSIONS: Invasive trichosporonosis is an acute fatal condition that occurs in immunosuppressed patients, usually under antifungal selective pressure. Typically, neutropenia and its underlying diseases are associated with adverse outcomes.

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INTRODUCTION: As button batteries have become worldwide used, there have been an increase in its ingest cases, mostly in pediatric population. Also, it is in this group where most complications and death cases are presented according to latest publications. In Colombia there are not public programs that pursuit to prevent the ingestion of this kind of foreign body. We report our experience in the management of these patients in a pediatric hospital. MATERIALS AND METHODS: We performed a retrospective review of cases where patients attend to the emergency room for suspected foreign body ingestion between January 2007 and December 2015. In a total of 46 cases the foreign body was a battery. RESULTS: 85% where under 5 years old. 68% present symptoms. The most frequent location and with the worst complications was the esophagus. All patients that required ICU in the postoperative period where also in that group. There was one case of mortality. DISCUSSION: There must be an education plan for health personal and general population regarding the danger that represent button batteries at the reach of children, and the urgency that implies its attention once an ingestion has occurred. It is important to establish protocols in each institution for an appropriate and urgent extraction.

INTRODUCCION: Con la popularización del uso de pilas de botón se ha visto una tendencia al aumento en los casos de ingesta de estas, principalmente en la población pediátrica. Además, es en esta población en donde las mayores secuelas se presentan y en la que se ubican la mayoría de los casos de mortalidad publicados en estudios internacionales. En Colombia, aún no se disponen de estadísticas completas al respecto. No se tiene una cultura ni políticas de prevención de ingesta de este tipo de cuerpos extraños. En este trabajo reportamos nuestra experiencia en el manejo de estos pacientes. MATERIAL Y METODOS: Se realizó una revisión retrospectiva de los casos de pacientes que consultaron por sospecha de ingesta de cuerpos extraños desde enero de 2007 hasta diciembre de 2015. Se obtuvieron 46 casos que correspondían a ingesta de pilas. RESULTADOS: El 85% eran pacientes menores de 5 años y el 68% presentaba algún síntoma previo al ingreso. La localización más frecuente y con mayor morbilidad fue el esófago. Todos los pacientes que requirieron UCI (Unidad de Cuidados Intensivos) post-extracción pertenecían a ese grupo. Hubo un caso de mortalidad relacionado. DISCUSION: Se debe educar a la población y al personal en salud respecto al peligro que representa que las pilas de botón estén al alcance de los niños y la urgencia que debe tener su atención una vez se ha ingerido este cuerpo extraño. Es importante establecer protocolos de manejo en las instituciones para lograr la extracción de estos dispositivos de manera urgente.

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Extensive molecular dynamics simulations in the equilibrium isobaric-isothermal (NPT) ensemble were developed to determine the coexistence temperatures of the water hydrogen mixture using the direct coexistence method. The water molecules were modeled using the four-site TIP4P/Ice analytical potential, and the hydrogen molecules were described using a three-site potential. The simulations were performed at different pressures (p = 900, 1500, 3000, and 4000 bars). At each pressure, a series of simulations were developed at different temperatures (from 230 to 270 K). Our results followed a line parallel to the experimental coexistence temperatures and underestimated these temperatures by approximately 25 K in the investigated range. The final configurations could or could not contain a fluid phase depending on the pressure, in accordance with the phase diagram. In addition, we explored the dynamics of the H2 molecules through clathrate hydrate cages and observed different behaviors of the H2 molecules in the small cages and the large cages of the sII structure.

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The objective of this study was to analyze by Raman and UV-Vis-NIR Spectroscopic techniques, Mexican honey from Apis Mellífera, using representative samples with different botanic origins (unifloral and multifloral) and diverse climates. Using Raman spectroscopy together with principal components analysis, the results obtained represent the possibility to use them for determination of floral origin of honey, independently of the region of sampling. For this, the effect of heat up the honey was analyzed in relation that it was possible to greatly reduce the fluorescence background in Raman spectra, which allowed the visualization of fructose and glucose peaks. Using UV-Vis-NIR, spectroscopy, a characteristic spectrum profile of transmittance was obtained for each honey type. In addition, to have an objective characterization of color, a CIE Yxy and CIE L*a*b* colorimetric register was realized for each honey type. Applying the principal component analysis and their correlation with chromaticity coordinates allowed classifying the honey samples in one plot as: cutoff wavelength, maximum transmittance, tones and lightness. The results show that it is possible to obtain a spectroscopic record of honeys with specific characteristics by reducing the effects of fluorescence.

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A latent tuberculosis infection (LTBI) prevalence survey was conducted using tuberculin skin test (TST) and Quantiferon test (QFT) in 1218 healthcare workers (HCWs) in Medellín, Colombia. In order to improve the prevalence estimates, a latent class model was built using a Bayesian approach with informative priors on the sensitivity and specificity of the TST. The proportion of concordant results (TST+,QFT+) was 41% and the discordant results contributed 27%. The marginal estimate of the prevalence P(LTBI+) was 62·1% [95% credible interval (CrI) 53·0-68·2]. The probability of LTBI+ given positive results for both tests was 99·6% (95% CrI 98·1-99·9). Sensitivity was 88·5 for TST and 74·3 for QFT, and specificity was 87·8 for TST and 97·6 for QFT. A high LTBI prevalence was found in HCWs with time-accumulated exposure in hospitals that lack control plans. In a context of intermediate tuberculosis (TB) incidence it is recommended to use only one test (either QFT or TST) in prevalence surveys or as pre-employment tests. Results will be useful to help implement TB infection control plans in hospitals where HCWs may be repeatedly exposed to unnoticed TB patients, and to inform the design of TB control policies.

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Solid organ transplantation is an accepted therapy for end-stage diseases of the kidneys, liver, heart, and lungs. Unfortunately, transplantation is associated with infectious complications. Here, we present a case report of Prototheca wickerhamii olecranon bursitis and review all of the cases in solid organ transplant (SOT) recipients published in the literature to date. In our patient, the infection resolved with surgical therapy and limited antifungal therapy, and no symptoms have recurred over 24 months of follow-up. A review of the literature suggests that 50% of SOT recipients with Prototheca infection present with disseminated infection, and the overall mortality is 75%. More studies are required to determine the optimal management of protothecosis in this population.

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