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Accumulation of visceral adipose tissue is associated with metabolic syndrome (MS), insulin resistance, and dyslipidemia. Here we examined several morphometric and biochemical parameters linked to MS in a rodent litter size reduction model, and how a 30-day fish oil (FO) supplementation affected these parameters. On day 3 post-birth, pups were divided into groups of ten or three. On day 22, rats were split into control (C) and small litter (SL) until 60 days old. Then, after metabolic disturbance and obesity were confirmed, FO supplementation started for 30 days and the new groups were named control (C), FO supplemented (FO), obese (Ob), and obese FO supplemented (ObFO). Comparison was performed by Student t-test or 2-way ANOVA followed by Tukey post hoc test. At the end of the 60-day period, SL rats were hyperphagic, obese, hypoinsulinemic, normoglycemic, and had high visceral fat depot and high interleukin (IL)-6 plasma concentration. Obese rats at 90 days of age were fatter, hyperphagic, hyperglycemic, hypertriacylgliceromic, hipoinsulinemic, with low innate immune response. IL-6 production ex vivo was higher, but in plasma it was not different from the control group. FO supplementation brought all biochemical changes to normal values, normalized food intake, and reduced body weight and fat mass in obese rats. The innate immune response was improved but still not as efficient as in lean animals. Our results suggested that as soon MS appears, FO supplementation must be used to ameliorate the morpho- and biochemical effects caused by MS and improve the innate immune response.

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Accumulation of visceral adipose tissue is associated with metabolic syndrome (MS), insulin resistance, and dyslipidemia. Here we examined several morphometric and biochemical parameters linked to MS in a rodent litter size reduction model, and how a 30-day fish oil (FO) supplementation affected these parameters. On day 3 post-birth, pups were divided into groups of ten or three. On day 22, rats were split into control (C) and small litter (SL) until 60 days old. Then, after metabolic disturbance and obesity were confirmed, FO supplementation started for 30 days and the new groups were named control (C), FO supplemented (FO), obese (Ob), and obese FO supplemented (ObFO). Comparison was performed by Student t-test or 2-way ANOVA followed by Tukey post hoc test. At the end of the 60-day period, SL rats were hyperphagic, obese, hypoinsulinemic, normoglycemic, and had high visceral fat depot and high interleukin (IL)-6 plasma concentration. Obese rats at 90 days of age were fatter, hyperphagic, hyperglycemic, hypertriacylgliceromic, hipoinsulinemic, with low innate immune response. IL-6 production ex vivo was higher, but in plasma it was not different from the control group. FO supplementation brought all biochemical changes to normal values, normalized food intake, and reduced body weight and fat mass in obese rats. The innate immune response was improved but still not as efficient as in lean animals. Our results suggested that as soon MS appears, FO supplementation must be used to ameliorate the morpho- and biochemical effects caused by MS and improve the innate immune response.

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OBJECTIVE: There are limited studies on urogenital symptoms in women who experience menopause before the age of 40 years due to primary ovarian insufficiency (POI) or bilateral oophorectomy (surgical POI). This study aimed to compare the urogenital symptoms, including sexuality, of women with POI to those without the condition. METHODS: This cross-sectional study conducted was in seven Latin American countries, in which postmenopausal women (with POI and non-POI) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS) and the six-item Female Sexual Function Index (FSFI-6). The association of premature menopause with more urogenital symptoms and lower sexual function was evaluated with logistic regression analysis. RESULTS: Women with POI experience more urogenital symptoms (MRS urogenital score: 3.54 ± 3.16 vs. 3.15 ± 2.89, p < 0.05) and have lower sexual function (total FSFI-6 score: 13.71 ± 7.55 vs. 14.77 ± 7.57 p < 0.05) than women who experience menopause at a normal age range. There were no significant differences in symptoms when comparing women based on the type of POI (idiopathic or surgical). After adjusting for covariates, our logistic regression model determined that POI is associated with more urogenital symptoms (odds ratio [OR]: 1.38, 95% confidence interval [CI] 1.06-1.80) and lower sexual function (OR: 1.67, 95% CI 1.25-2.25). CONCLUSION: POI, whether idiopathic or secondary to bilateral oophorectomy, is associated with symptoms that affect vaginal and sexual health.

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Azithromycin is one of the most widely used macrolide antibiotics in medical treatment. However, there is little information on studies of the ecotoxicity, persistence and mobility of this type of compounds in the environment, although their presence in surfaces and wastewater has already been detected (Hernández et al., 2015). Based on this approach, the present research performs an analysis of the behavior of the adsorption process of azithromycin in soils of different textural classes, with the intention of establishing a first approach to assess the destination and transport of such substances in the biosphere. From the results of the evaluation of the conditions of adsorption of azithromycin, it is established that the Langmuir model has a better fit for clay soils with correlation coefficients R2 between 0.998 and 0.961. In contrast, the Freundlich model fits the soil with higher sand fraction with a higher correlation, R2 of 0.9892. Finally, based on a correlation analysis between the clay content, the percentage of organic matter and the adsorption coefficient K, it was evident that the adsorption of azithromycin is mainly related to the inorganic fraction of the soil.

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El valor de posición es una propiedad básica de los formatos de representación del Sistema de Numera- ción en Base Diez (SNBD), y su comprensión facilita el desempeño matemático de los estudiantes en diferentes grados escolares. Algunas investigaciones sugieren que nociones como la composición aditiva y la equivalencia numérica participan en la emergencia de la comprensión de este principio, sin embargo, pocos estudios han intentado analizar la relación entre estas nociones o se han interesado en indagar ­desde una perspectiva de la transcodificación numérica­, cómo estas afectan la producción de numerales arábigos durante los procesos iniciales del aprendizaje escolar. En tal sentido, esta investigación propone indagar si algunas de las invariantes del SNBD ­composición aditiva y equivalencia numérica­ facilitan la comprensión del valor de posición y la escritura numérica en estudiantes de primer grado de primaria. Participaron 96 estudiantes adscritos a escuelas públicas de Cali, Colombia, en un estudio cuasi-experimental pre-posprueba con grupo control, que involucra la aplicación de un proceso de intervención diferente para cada grupo experimental: composición aditiva y (b) equivalencia numérica. Los resultados plantean que los dos tratamientos apli- cados facilitan la comprensión del valor de posición y generan efectos diferentes en la comprensión y producción de numerales arábigos. Además, los análisis develan cambios significativos entre aplicaciones para los grupos experimentales, pero no para el grupo con- trol, lo cual sugiere que la composición aditiva y la equivalencia numérica son predictores en la escritura correcta de numerales.

The place value is a fundamental property of the base-10 system representation formats, and its under- standing facilitates the mathematical performance of children in different school grades. Some research sug- gests that notions such as additive composition and nu- merical equivalence participate in the emergence of the understanding of this principle. However, few studies have attempted to analyze the relationship between these notions or have been interested in investigating ­from a transcoding perspective numerical­ how these affect the production of Arabic numerals during the initial processes of school learning. This research explores how some invariants of the base-10 system: Additive Composition and Numerical Equivalence, facilitate the place value mastery and the numerical writing of children. First-grade students (n= 96) linked to public schools in the city of Cali, Colombia, in a quasi-experimental experimental study with a control group, which involves the application of different in- tervention processes to each experimental group: (a) numerical equivalence and (b) additive composition. The results suggest that both treatments facilitate the place value understanding and generate differ- ent effects on comprehending and producing Arabic numerals. In addition, analyses reveal significant changes between applications for the experimental groups but not for the group control, which specif- ically evidences both the additive composition and the numerical equivalence are predictors in correct number writing.

O valor posicional é uma propriedade básica dos forma- tos de representação do Sistema de Numeração Base Dez (SNBD), e sua compreensão facilita o desempenho mate- mático de alunos de diferentes séries escolares. Algumas pesquisas sugerem que noções como composição aditiva e equivalência numérica participam do surgimento da compreensão desse princípio, porém, poucos estudos têm tentado analisar a relação entre essas noções ou se interessado em investigar ­a partir de uma perspectiva de transcodificação numérica­ como essas afetam a produção de algarismos arábicos durante os processos iniciais de aprendizagem escolar. Esta investigação se propõe a investigar se alguns dos invariantes do SNBD; a composição aditiva e a equivalência numérica facilitam a compreensão do valor posicional e da escrita numérica em alunos da primeira série. Participaram do experi- mento 96 alunos da primeira série de escolas públicas de Cali, Colômbia; num estudo quase experimental pré/pós-teste com um grupo controle, que envolve a aplicação de um processo de intervenção diferen- te a cada grupo experimental; (a) composição aditiva e (b) equivalência numérica. Os resultados sugerem que os dois tratamentos aplicados facilitam a compreensão do valor posicional e geram efeitos diferentes na com- preensão e produção dos algarismos arábicos. Além disso, as análises revelam mudanças significativas entre as aplicações para os grupos experimentais, mas não para o grupo controle, o que sugere que a composi- ção aditiva e a equivalência numérica são preditores na escrita correta dos numerais.

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INTRODUCTION: Developmental hip dysplasia (DHD) is the most common disorder affecting pediatric hip; screening all neonates clinically, and using ultrasonography selectively for those babies who are at high risk is a widespread recommendation. our goal is to evaluate the impact that USG diagnosis and early treatment of DHD has had on the child population of our unit. MATERIAL AND METHODS: Retrospective, descriptive and cross-sectional study. Records of those children from one to six months of age, with a diagnosis of DHD, without distinction of sex, subjected to ultrasonographic tracking in the period from January 2018 to December 2019 were reviewed. A follow-up of six months was carried out in all patients, from the moment of diagnosis and the start of treatment with harness, weekly visits for relocation, as well as ultrasonographic revision every four weeks to monitor the treatment. RESULTS: 19 cases were reported from the left side (47.5%), 10 cases from the right side (25%) and 11 bilateral cases (27.5%). The main associated risk factors were: product of the first pregnancy, family history of DHD, pelvic presentation, female sex. The results were favorable with a continuous use of harness of 23 hours observing a satisfactory evolution in 99.2% of the patients. CONCLUSION: With the results obtained we can analyze the considerable success rate of the hip clinic of our hospital with the realization of the ultrasound, we find a lower incidence of patients with pain, limitation of function, as well as satisfactory gait patterns.

INTRODUCCIÓN: La displasia del desarrollo de cadera (DDC) es el trastorno más común que afecta la cadera pediátrica; hacer tamizaje a todos los neonatos en forma clínica y utilizar ultrasonografía en forma selectiva para aquellos bebés que se encuentran con alto riesgo es una recomendación muy difundida. Nuestro objetivo es evaluar el impacto que ha tenido el diagnóstico por ultrasonografía (USG) y tratamiento temprano de la DDC en la población infantil de nuestra unidad. MATERIAL Y MÉTODOS: Estudio retrospectivo, descriptivo y transversal. Se revisaron expedientes de aquellos niños de uno a seis meses de edad, con diagnóstico de DDC, sin distinción de sexo, sometidos a rastreo ultrasonográfico en el período de Enero de 2018 a Diciembre de 2019. Se realizó un seguimiento de seis meses en todos los pacientes, a partir del momento del diagnóstico y del inicio de tratamiento con arnés, visitas semanales para recolocación, así como realización de rastreos ultrasonográficos cada cuatro semanas para monitorización del tratamiento. RESULTADOS: Se reportaron 19 casos del lado izquierdo (47.5%), 10 casos del lado derecho (25%) y 11 casos bilaterales (27.5%). Los principales factores de riesgo asociados fueron: producto de la primera gesta, antecedentes familiares de DDC, presentación pélvica, sexo femenino. Los resultados fueron favorables con un uso continuo de arnés de 23 horas, se observó una evolución satisfactoria en 99.2% de los pacientes. CONCLUSIÓN: Con los resultados obtenidos podemos analizar la tasa de éxito considerable de la clínica de cadera de nuestro hospital con la realización del ultrasonido, encontramos una menor incidencia de pacientes con dolor, limitación de la función, así como patrones de marcha satisfactorios.

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INTRODUCTION: Expansive intra-spinal processes usually have an insidious course that makes their early diagnosis difficult. Intra-spinal tumors are classified according to their location in the spinal canal: extradural and intradural, and these are classified as extramedullary and intramedullary. At the beginning, they can cause non-specific pain conditions and, sometimes, root-type pain. The patient may have symptoms such as: loss of strength, loss of balance, loss of sensation, sphincter disorders. Intra-spinal neoplasms, when diagnosed, have an indication for surgical treatment. MATERIAL AND METHODS: The clinical case of a 14-year-old male adolescent is described, pain in the lumbar region for four years, of insidious onset, intermittent, progressive, exacerbated six months ago, with radiation to the lower extremities, which is accompanied by progressive paresthesia and paresis predominantly in the lower right limb. RESULTS: Bilateral L4 and L5 laminotomy is performed, exploration and resection of the tumor and release of nerve roots. Tumor with characteristics similar to adipose tissue is obtained, where a wide vascular network is observed inside, with an approximate size of 14 × 10 × 4 mm, ovoid in shape, flattened with a smooth and shiny surface. CONCLUSION: Spinal tumors are relatively rare tumors, however, of these tumors, the extradural intraspinal location accounts for half of the cases. In our patient, the diagnosis of lipoma of the filum terminale was integrated, which corresponds to less than 1% of all tumors of the spine.

INTRODUCCIÓN: Los procesos expansivos intrarraquídeos suelen tener una evolución insidiosa que dificultan su diagnóstico precoz. Los tumores intrarraquídeos son clasificados de acuerdo con su localización en el conducto raquídeo: extradural e intradural, y éstos se clasifican en extramedular e intramedular. Al comienzo, pueden provocar cuadros de dolor poco específicos y, a veces, dolores de tipo radicular. El paciente podrá tener síntomas como: pérdida de fuerza, pérdida de equilibrio, pérdida de sensibilidad y disturbios esfinterianos. Las neoplasias intrarraquídeas, cuando son diagnosticadas, tienen indicación de tratamiento quirúrgico. MATERIAL Y MÉTODOS: Se describe el caso clínico de adolescente masculino de 14 años, dolor en región lumbar desde hace cuatro años, de inicio insidioso, intermitente, progresivo, que se exacerba hace seis meses, con irradiación a extremidades inferiores, que se acompaña de parestesias y paresias progresivas de predominio en extremidad inferior derecha. RESULTADOS: Se realiza laminotomía L4 y L5 bilateral, exploración y resección de tumoración y liberación de raíces nerviosas. Se obtiene tumor de características similares a tejido adiposo en donde se observa amplia red vascular en su interior, con tamaño aproximado de 14 × 10 × 4 mm de forma ovoide, aplanada con superficie lisa y brillante. CONCLUSIÓN: Los tumores raquimedulares son tumores relativamente raros; sin embargo, de estos tumores, la localización intrarraquídea extradural corresponde a la mitad de los casos. En nuestro paciente, se integró el diagnóstico de lipoma del filum terminale, el cual corresponde a menos de 1% de todos los tumores de la columna vertebral.

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INTRODUCTION: Scoliosis is a complex deformity that affects all three planes of the axis of the spine. The association between neuromuscular pathology and vertebral alignment was initially described in 1960. Neuromuscular pathology is progressive and results in postural abnormalities. Surgical goals in patients with neuromuscular deformity include anatomical correction for sedation and ambulation, as well as functional improvement. The gold standard of treatment is by posterior approach with transpedicular screws. The "hands-free" technique saves surgical time, decreases radiation by reducing the use of fluoroscopy. The advent of 3D printing technology allows precise study of the anatomical area and detail of the deformity in its three planes. This model can be sterilized for transoperative guidance. A 13-year-old female patient who develops thoracolumbar neuromuscular scoliosis secondary to spastic cerebral palsy (CP), with previous instrumentation T11-L3 of which he develops severe proximal curve. After the segmentation of the three-dimensional model, pedicle violation greater than 2 mm towards bilateral medullary canal was detected in the pedicles of L1 and L2 of previous instrumentation, pedicle dysplasia and the morphological characteristics of the pedicles were observed. Three-dimensional planning and the use of surgical guides represent a tool for surgical planning, especially in severe cases and with pedicle dysplasia. It helps as a surgical guide for the placement of hands-free transpedicular screws with possible reduction of radiation and anesthetic time.

INTRODUCCIÓN: La escoliosis es una deformidad compleja que afecta los tres planos del eje de la columna vertebral. La asociación entre patología neuromuscular y la alineación vertebral fue descrita inicialmente en 1960. La patología neuromuscular es progresiva y resulta en anormalidades posturales. Las metas quirúrgicas en pacientes con deformidad neuromuscular engloban la corrección anatómica para la sedestación y deambulación, así como mejoría funcional. El estándar de oro de tratamiento es por vía posterior con tornillos transpediculares. La técnica de "manos libres" ahorra tiempo quirúrgico, disminuye la radiación al reducir el uso de fluoroscopía. El advenimiento de la tecnología de impresión 3D permite estudio preciso del área anatómica y detalle de la deformidad en sus tres planos. Este modelo puede ser esterilizado para guía transoperatoria. Paciente femenino de 13 años de edad que desarrolla escoliosis neuromuscular toracolumbar secundario a parálisis cerebral infantil (PCI) espástica, con instrumentación previa T11-L3 de la cual desarrolla curva severa proximal. Finalizada la segmentación del modelo tridimensional se detectó violación pedicular mayor a 2 mm hacia canal medular bilateral en los pedículos de L1 y L2 de instrumentación previa, displasia pedicular y se observaron las características morfológicas de los pedículos. La planeación tridimensional y el uso de guías quirúrgicas representan una herramienta para la planeación quirúrgica, sobre todo en casos severos y con displasia pedicular. Ayuda como guía quirúrgica para la colocación de tornillos transpediculares a manos libres con posible reducción de radiación y tiempo anestésico.

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Resumen: Introducción: El dolor en columna lumbar afecta a un alto porcentaje de la población y presenta un significativo impacto socioeconómico. El síndrome facetario lumbar tiene una prevalencia entre 15-31% con incidencia a lo largo de la vida de hasta 52% en algunas series. Debido al empleo de distintos tipos de tratamiento y diversos criterios de selección de los pacientes, la tasa de éxito varía en la literatura. Objetivo: Comparar resultados de tratamiento con rizólisis aplicando radiofrecuencia pulsada versus crioablación en pacientes con diagnóstico de síndrome facetario lumbar. Material y métodos: De Enero de 2019 a Noviembre de 2019, ocho pacientes fueron divididos aleatoriamente en dos grupos: el grupo A tratados con radiofrecuencia pulsada y el grupo B tratados con crioablación. Se evaluó el dolor con la escala visual análoga y el índice de discapacidad de dolor lumbar de Oswestry a las cuatro semanas, además de tres y seis meses. Resultados: El seguimiento fue de seis meses. De forma inmediata los ocho pacientes (100%) refirieron mejoría de los síntomas y del dolor. De los cuatro pacientes que se encontraban en limitación funcional intensa, uno pasó a estar sin limitación funcional, dos de ellos pasaron a limitación funcional mínima y uno a limitación funcional moderada al primer mes; se reportaron diferencias estadísticamente significativas. Conclusiones: Ambos tratamientos controlan el dolor en el corto plazo; también hay una mejoría de las capacidades físicas. La morbilidad que acompaña a la neurólisis, ya sea radiofrecuencia o crioablación, es muy baja.

Abstract: Introduction: Lumbar spine pain affects a high percentage of the population and has a significant socioeconomic impact. Lumbar facet syndrome has a prevalence between 15-31% with lifetime incidence of up to 52% in some series. Due to the use of different types of treatment and different patient selection criteria, the success rate varies in the literature. Objective: To compare results of treatment with rhizolysis applying pulsed radiofrequency versus cryoablation in patients diagnosed with lumbar facet syndrome. Material and methods: From January 2019 to November 2019, eight patients were randomly divided into two groups: group A treated with pulsed radiofrequency and group B treated with cryoablation. Pain was assessed with the visual analogue scale and the Oswestry low back pain disability index at four weeks, in addition to three and six months. Results: Follow-up was six months. Immediately the eight patients (100%) reported improvement in symptoms and pain. Of the four patients who were in intense functional limitation, one of them became without functional limitation, and two of them went to minimum functional limitation and one to moderate functional limitation at the first month, statistically significant differences were reported. Conclusions: Both treatments control pain in the short term; there is also an improvement in physical abilities. The morbidity accompanying neurolysis either radiofrequency or cryoablation is very low.

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INTRODUCCIÓN: El Xpert MTB/RIF Ultra (Ultra) ha mejorado dramáticamente el diagnóstico de la tuberculosis (TBC). Con él ha nacido la categoría de trazas, que es la menor carga bacilar detectable por este examen. OBJETIVO: Describir las características clínicas de los pacientes con presencia de trazas en el Ultra y evaluar la confirmación de la TBC como diagnóstico clínico. MATERIALES Y MÉTODOS: Estudio descriptivo de serie de casos. Se extrajo la información de fichas clínicas de pacientes con positividad a trazas. Se confrontaron datos clínicos, microbiológicos e histopatológicos. RESULTADOS: Se analizaron 21 pacientes. La edad promedio fue de 52 años. Todos los casos presentaron baciloscopias negativas. Cuatro cultivos en medio líquido MGIT fueron positivos, dos en pleura parietal, uno en líquido pleural y otro en expectoración. En pleura parietal, tres casos presentaron granulomas con necrosis caseosa y un granuloma esbozos de necrosis. En tejido pulmonar se observaron dos casos con granulomas con esbozos de necrosis y dos con granulomas no necrotizantes. Tres pacientes tenían el antecedente de TBC previa, se interpretó la positividad de trazas en ellos como falsos positivos. Finalmente se diagnosticaron 13 casos como TBC activa, donde cinco de ellos fueron TBC pleurales. La mayor concordancia clínica, microbiológica e histopatológica fue en muestras de líquido y tejido pleural. DISCUSIÓN: Se debe interpretar con cautela los hallazgos de esta prueba en muestras de vía aérea; el análisis multidisciplinario (clínica, imágenes, microbiología, histología) es crucial en las decisiones de nuestras conductas clínicas futuras. El hallazgo de trazas en pleura tiene, a nuestro parecer, un alto valor diagnóstico en el estudio de la tuberculosis en esta localización.

INTRODUCTION: Xpert MTB/RIF Ultra has dramatically changed the diagnosis of tuberculosis. A new category called traces appeared, which is the smallest amount of bacillar load detectable. OBJECTIVE: Describe the clinical characteristics of patients that present traces in Xpert MTB/RIF Ultra test, and to evaluate the confirmation of tuberculosis as clinical diagnosis. METHODS: We perform a descriptive case series study. Information was recovered from clinical records of patients with positive test for traces. Clinical, histopathological and microbiological results were confronted. RESULTS: Twenty one patients were analyzed. The mean age was 52 years-old. All cases had negative smear microscopy and four MGIT cultures were positive, two in pleural fluid and another in sputum. In parietal pleura, three cases presented granulomas with caseous necrosis, and one showed granuloma with very little necrosis. In pleural tissue we observed two cases of granulomas with traces of necrosis and two with non-necrotizing granulomas. Three patients had history of previous tuberculosis and positive traces, the test was interpreted as a false positive result. Finally, active tuberculosis was diagnosed in 13 cases, and five of them were pleural tuberculosis. The highest clinical, microbiological and histopathological agreement was in fluid and pleural tissue samples. DISCUSSION: The findings of Xpert MTB/RIF Ultra in airway samples must be interpreted carefully. Multi-disciplinary analysis is crucial in future clinical decisions. The finding of traces in pleura has, in our opinion, a high diagnostic value in the study of tuberculosis in this location.

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