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Desde el inicio de la pandemia por COVID-19 (coronavirus disease), en el 2019, se han descrito numerosas manifestaciones clínicas de la enfermedad causada por este virus, destacando el compromiso respiratorio, hematológico, cardiovascular y neurológico. Dentro de las manifestaciones y/o complicaciones neurológicas, se encuentra la mielitis aguda transversa por COVID-19(1), cuyo diagnóstico se ha realizado principalmente clínico-imagenológico y PCR (reacción de polimerasa en cadena), o serología (+) para COVID-19, con manejos y resultados no siempre afortunados. Presentamos el caso de un paciente con mielitis aguda transversa longitudinalmente extensa en relación a COVID-19, tratada con éxito clínico con rituximab.

Since the beginning of the COVID-19 pandemic in 2019, numerous clinical manifestations of the disease caused by this virus have been described, highlighting respiratory, hematological, cardiovascular, and neurological compromise. Among the neurological manifestations and/or complications, there is acute transverse myelitis due to COVID-19(1), whose diagnosis has been made mainly clinical-imaging and PCR or serology (+) for COVID-19, with management and results not always lucky. We present the case of a patient with longitudinally extensive acute transverse myelitis in relation to COVID-19, treated with clinical success with rituximab.

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Three dimensional magnetic textures are a cornerstone in magnetism research. In this work, we analyze the stabilization and dynamic response of a magnetic hopfion hosted in a toroidal nanoring with intrinsic Dzyaloshinskii-Moriya interaction simulating FeGe. Our results evidence that unlike their planar counterparts, where perpendicular magnetic anisotropies are necessary to stabilize hopfions, the shape anisotropy originated on the torus symmetry naturally yields the nucleation of these topological textures. We also analyze the magnetization dynamical response by applying a magnetic field pulse to differentiate among several magnetic patterns. Finally, to understand the nature of spin wave modes, we analyze the spatial distributions of the resonant mode amplitudes and phases and describe the differences among bulk and surface modes. Importantly, hopfions lying in toroidal nanorings present a non-circularly symmetric poloidal resonant mode, which is not observed in other systems hosting hopfions.

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Objetivo: el trastorno de déficit de atención e hiperactividad (TDAH) ha sido descrito como el trastorno del neurodesarrollo más común en la infancia. Esta condición se asocia a un significativo deterioro en calidad de vida, múltiples comorbilidades y, a largo plazo, a menores logros académicos y laborales. A pesar de que se ha evidenciado que en los pacientes de ascendencia latina se presenta un posible subdiagnóstico, que en Colombia se han estimado prevalencias mayores a las descritas en el planeta, y que los efectos de la pandemia por Covid-19 han podido exacerbar esta problemática, el volumen de estudios con estimaciones reproducibles sobre las características, tratamientos recibidos y control de síntomas de estos pacientes aún requiere ampliarse. Este estudio busca establecer los factores sociodemográficos, clínicos y del tratamiento asociados al control de los síntomas nucleares de este trastorno, que consisten en patrones persistentes y generalizados de inatención, impulsividad e hiperactividad. Metodología: estudio descriptivo con intención analítica en una cohorte retrospectiva de pacientes pediátricos con trastorno de déficit de atención e hiperactividad seguidos durante seis meses en un centro especializado de Medellín, Colombia, entre 2018 y 2019. Resultados: se identificó una incidencia de control de síntomas de 46,7% que se asoció de manera significativa con la adherencia al tratamiento y con historia familiar de TDAH. Conclusiones: puede afirmarse que, en pacientes pediátricos con TDAH, estos factores podrían aumentar la probabilidad de lograr el control de los síntomas nucleares.

Objective: Attention Deficit Hyperactivity Disorder (ADHD) has been described as the most common neurodevelopmental disorder in childhood. This condition is associated with significant deterioration in the quality of life, multiple comorbidities and, in the long term, lower academic and work achievements. Despite the fact that it has been shown that patients of Latin descent present a possible underdiagnosis, that in Colombia higher prevalence has been estimated than those described worldwide, and that the effects of the Covid-19 pandemic have been able to exacerbate this problem, the volume of studies with reproducible estimates on the characteristics, treatments received, and symptom control of these patients still needs to be expanded. This study seeks to establish the sociodemographic, clinical and treatment factors associated with the control of the core symptoms of this disorder, which consist of persistent and generalized patterns of inattention, impulsivity and hyperactivity. Methodology: Descriptive study with analytical intent in a retrospective cohort of pediatric patients with attention deficit hyperactivity disorder followed up for 6 months in a specialized center in Medellín, Colombia, between 2018 and 2019. Results: An incidence of symptom control of 46.7% was identified, which was significantly associated with adherence to treatment and with a family history of ADHD. Conclusions: It can be affirmed that, in pediatric patients with ADHD, these factors could increase the probability of achieving control of nuclear symptoms.

Objetivo: o transtorno dedéficit de atenção e hiperatividade (TDAH) tem sido descrito como o transtorno do neurodesenvolvimento mais comum na infância. Esta condição está associada a uma deterioração significativa na qualidade de vida, múltiplas comorbidades e, a longo prazo, menores rendimentos acadêmicos e profissionais. Apesar de ter sido demonstrado que os pacientes de ascendência latina apresentam um possível subdiagnóstico, e que na Colômbia foram estimadas prevalências mais altas do que as descritas no planeta e que os efeitos da pandemia de Covid-19 foram capazes de exacerbar esse problema, o volume de estudos com estimativas reprodutíveis sobre as características, tratamentos recebidos e controle de sintomas desses pacientes ainda precisam ser ampliados. Este estudo busca estabelecer os fatores sociodemográficos, clínicos e de tratamento associados ao controle dos sintomas centrais desse transtorno, que consistem em padrões persistentes e generalizados de desatenção, impulsividade e hiperatividade. Metodologia: estudo descritivo com intenção analítica em uma coorte retrospectiva de pacientes pediátricos com transtorno de déficit de atenção e hiperatividade acompanhados por seis meses em um centro especializado em Medellín, Colômbia, entre 2018 e 2019.Resultados: identificou-se uma incidência de controle dos sintomas de 46,7%, signifi-cativamente associada à adesão ao tratamento e ao histórico familiar de TDAH.Conclusões: Pode-se afirmar que, em pacientes pediátricos com TDAH , esses fatores podem aumentar a probabilidade de controle dos sintomas nucleares.

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Introducción: La pandemia del SARS-CoV-2 ha sido un desafío para la medicina en estos últimos años por su alta tasa de contagios y muertes asociadas. Progresivamente los investigadores han ido dilucidando vías de transmisión y manifestaciones clínicas más frecuentes, que han facilitado la detección el virus. Con el objetivo de optimizar la prevención y tratamiento en pacientes infectados, investigadores de todo el mundo han evaluado la importancia de la respuesta inmune frente al virus, destacando la acción de algunos inmunomoduladores, como por ejemplo, la vitamina D. Desarrollo: Tras invadir el organismo, el SARS-CoV-2 se une a receptores de las células epiteliales del tracto respiratorio, específicamente en el neumocito tipo II, disminuyendo la producción de surfactante y provocando una producción desregulada de citocinas proinflamatorias, principal responsable de los casos más severos. Se ha demostrado que la Vitamina D puede modular la respuesta inmune tras unirse a su receptor VDR, disminuyendo la liberación de citocinas proinflamatorias. Algunos estudios han determinado que el uso de suplementos de vitamina D en dosis altas pudieran producir efectos protectores frente a infecciones respiratorias agudas. Conclusión: Finalmente, pese a los estudios realizados que relacionan el déficit de vitamina D con casos más severos de COVID-19, aún se requiere más evidencia para recomendar suplementación.

Introduction: The SARS-CoV-2 pandemic has been a challenge for medicine in recent years, due to its high contagion rate and associated deaths. Researchers have progressively elucidated transmission methods and most frequent clinical manifestations, that helps the virus detection. With the objective of optimizing prevention and treatment of infected patients, researchers all over the world have evaluated the importance of the immune system response against the virus, highlighting some immunomodulators, such as vitamin D. Body: After SARS-CoV-2 invades the organism, it binds to the receptor located on the respiratory tract epithelial cells, specifically type 2 pneumocyte, decreasing surfactant production and increasing the production of pro inflammatory cytokines, being the main reason for severe cases. Vitamin D has been shown to modulate the immune response after binding to its receptor, decreasing the release of proinflammatory cytokines. Some studies have shown that vitamin D supplementation in high doses may produce protective effects against acute respiratory infections. Conclusion: Finally, even the studies that correlate vitamin D deficiency and COVID-19 severe cases, we still need more evidence to recommend Vitamin D supplementation.

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When the skyrmion dynamics beyond the particle-like description is considered, this topological structure can deform due to a self-induced field. In this work, we perform Monte Carlo simulations to characterize the skyrmion deformation during its steady movement. In the low-velocity regime, the deformation in the skyrmion shape is quantified by an effective inertial mass, which is related to the dissipative force. When skyrmions move faster, the large self-induced deformation triggers topological transitions. These transitions are characterized by the proliferation of skyrmions and a different total topological charge, which is obtained as a function of the skyrmion velocity. Our findings provide an alternative way to describe the dynamics of a skyrmion that accounts for the deformations of its structure. Furthermore, such motion-induced topological phase transitions make it possible to control the number of ferromagnetic skyrmions through velocity effects.

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The prevalence of inflammatory bowel disease (IBD) increased in the last decades. Thus, the number of pregnant women with the condition is also increasing. Given that active disease itself is the main risk factor for complications during pregnancy, it is necessary to achieve a complete remission before planning a pregnancy. Also, pregnant women with IBD must be monitored noninvasively and be treated proactively, including escalated therapies, if needed, to prevent potential flares during pregnancy. Patients can undergo vaginal delivery in most forms of IBD. However, cesarean delivery is still preferable in women with a history of ileal pouch-anal anastomoses (IPAA) or active perianal disease.

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Resumen El colgajo retroauricular en isla (flip-flop flap) fue descrito por Masson en 1972 y consiste en tejido dermoepidérmico irrigado por un pedículo de patrón aleatorio subcutáneo de ramas de la arteria auricular posterior. Proviene de la región mastoidea y retroauricular y aporta buena cobertura para la región anteromedial del pabellón auricular. Se describen dos casos, en que se realizó cobertura inmediata secundario a un defecto de la concha auricular posterior a resección neoplásica, obteniendo resultados satisfactorios y sin complicaciones.

Abstract The retroauricular island flap (flip-flop flap), was described by Masson in 1972 and consists on dermoepidermal tissue irrigated by a random subcutaneous pedicle of branches of the posterior auricular artery. It comes from the mastoid and retroauricular region and provides a good coverage for the anteromedial region of the pinna. Two cases are described, in which immediate coverage was performed secondary to a defect in the auricular concha after a neoplastic resection, obtaining satisfactory results without complications.

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Although, antibiotics are effective in the treatment of bovine mastitis, they do not address the regeneration of mammary glandular tissue and have been associated to the increment in antimicrobial resistance worldwide. Considering the necessity of alternative therapies for this disease of high economic impact and the reported regenerative and antibacterial effects of mesenchymal stem cell (MSCs), we evaluated the safety and efficacy of an allogenic MSC-based intramammary therapy in dairy cows with experimentally induced Staphylococcus aureus clinical mastitis. In a safety trial, heifers were inoculated intramammarily with a 2.5 × 107-suspension of bovine fetal AT-MSCs on experimental days 1 and 10. Animals were evaluated clinically on a daily basis during a 20-day experimental period and blood samples were collected for hemogram determination and peripheral blood leukocytes (PBLs) isolation. In an efficacy trial, Holstein Friesian cows were inoculated with S. aureus and treated intramammarily with vehicle (NEG; days 4 and 10), antibiotics (ATB; days 4 and 5) or a suspension of 2.5 × 107 AT-MSCs (MSC; days 4 and 5). Cows were clinically evaluated daily and milk samples were collected for somatic cell count (SCC) and colony forming units (CFU). Blood samples were collected for serum haptoglobin and amyloid A determination. Intramammary administration of two doses of bovine fetal AT-MSCs in healthy cows did not induce changes in clinical or hematological variables, and gene expression profiles in PBLs associated to activation (CD4, CD8, CD25, CD62L and CD69) and proinflammatory cytokines (CCL2, CCL5, IL2, CXCL3, IFNγ, and TNFα). Quarters of MSC group of cows had similar SCC log/mL in milk compared to infected quarters of ATB or NEG cows. However, quarters of MSC cows had lower CFU log/mL in milk compared to quarters of NEG cows. Intramammarily inoculation of repeated doses of 2.5 × 107 allogenic AT-MSCs did not induce clinical or immunological response in healthy cows. Moreover, MSC-intramammary treatment reduced bacterial count in milk of cows with S. aureus clinical mastitis compared to untreated cows. This work provides initial evidence for the safety and efficacy of an allogenic MSC-based intramammary therapy for the treatment of bovine mastitis.

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The prevalence of inflammatory bowel disease (IBD) increased in the last decades. Thus, the number of pregnant women with the condition is also increasing. Given that active disease itself is the main risk factor for complications during pregnancy, it is necessary to achieve a complete remission before planning a pregnancy. Also, pregnant women with IBD must be monitored noninvasively and be treated proactively, including escalated therapies, if needed, to prevent potential flares during pregnancy. Patients can undergo vaginal delivery in most forms of IBD. However, cesarean delivery is still preferable in women with a history of ileal pouch-anal anastomoses (IPAA) or active perianal disease.

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Background The Diagnosis Related Groups (DRG) constitute a method of classifying hospital discharges. Aim To report its development and implementation in a Chilean University Hospital and global results of 10 years Material and Methods We included 231,600 discharges from 2007 to 2016. In the development we considered the physical plant, clinical record flow, progressively incorporated human resources and computer equipment for coding and analysis to obtain results. The parameters used were: average stay, average DRG weight, mean of diagnosis and codified procedures, behavior of upper outliers, hospital mortality, distribution by severity and its relationship with other variables. Results The global complexity index was 0.9929. The average of diagnoses coded was 4.35 and of procedures was 7.21. The average stay was 4.56 days, with a downward trend. The top outliers corresponded to 2.25%, with stable hospital days and average DRG weight. The median of hospital mortality was 1.65% with a tendency to decrease and stable DRG mean weight. Seventy two percent had a grade 1 severity, with low median hospital stay. They occupied 40% of bed days. Nine percent had a grade 3 severity with high median hospital stay and accounting for 31.5% of bed days. Conclusions DRG methodology is a valuable information tool for decision making and result assessment in hospital management.

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