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BACKGROUND: Accurate diagnosis and treatment of complex cardiac tumors poses challenges, particularly when surgical resection is considered. 3D reconstruction and printing appear as a novel approach to allow heart teams for optimal surgical and post operative care. METHODS: We report two patients with uncommon masses including a cardiac angiosarcoma (CAS) and a IgG4-related disease (IgG4-RD) with exclusive cardiac involvement. In both cases, three-dimensional (3D) reconstruction and 3D-printed models were utilized to aid the surgical team achieve optimal pre-operative planning. Both patients underwent ECG-gated cardiac computed tomography angiography (CCTA) imaging and, due to the complex anatomy of the masses, their large dimensions, proximity to vital cardiac and vascular structures, and unclear etiology, computational and 3D-printed models were created for surgical planning. An exploratory literature review of studies using 3D-printed models in surgical planning was performed. RESULTS: In case 1 (CAS), due to the size and extension of the mass to the right ventricular free wall, surgical intervention was not considered curative and, during thoracotomy, an open biopsy confirmed the imaging suspicion of CAS which guided the initiation of optimal medical treatment with chemotherapy and, after clear tumor retraction, the patient underwent a second surgical intervention, and during the 18 months of follow-up showed no signs of recurrence. In Case 2 (IgG4-RD), the patient underwent uncomplicated total surgical resection; this allowed directed treatment and, at 12 months follow-up, there are no signs of recurrence. Computational and 3D-printed models were used to plan the surgery and to confirm the findings. Limited studies have explored the use of 3D printing in the surgical planning of tumors. CONCLUSIONS: We present two patients with uncommon cardiac tumors, highlighting the significant value of 3D models in the anatomical characterization and assessment of their extension. These models may be essential in surgical planning for complex cardiovascular cases and could provide more information than conventional imaging modalities. Further studies are needed to demonstrate the impact of 3D technologies in studying cardiac tumors.

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Estudio cuasi-experimental desarrollado para disminuir el impacto de la resistencia a los antimicrobianos a través de un programa de prevención de infecciones y optimización del uso de antimicrobianos construido "a medida" según las posibilidades de la institución. Se implementó: vigilan-cia de colonización e infección por enterobacterias pro-ductoras de carbapenemasas (EPC); vigilancia y medidas preventivas para infecciones urinarias asociadas a sonda vesical (ITU); vigilancia e intervenciones para mejorar la higiene de manos; guías locales de tratamiento de enfer-medades infecciosas con evaluación de adherencia a las mismas y consumo de antibióticos (ATB). Resultados: Comparando periodo pre y postintervención: tasa de EPC en muestras clínicas: 1,1 a 0/días paciente; razón de tasas de incidencia (IRR: 0.00, p: 0.033); tasa de colonización: 3,3 a 0,61/días paciente (IRR: 0.18, p: 0.5). Tasa de ITU 8,9 a 7,2/1000 días catéter urinario (IRR: 0.81, p 0.5). Adherencia a higiene de manos: 77,5% a 70,38% (p 0.0067). Consumo de ATB: 376,24 a 176,82 DDD, (disminu-ción 53%). Adherencia a guías en elección de ATB: 57,1% a 95,4% (p 0.00031); duración de ATB: 92,8% a 98,4% (p 0.16); adecuación según rescate microbiológico: 57,1% a 100% (p <0.01). Conclusión: Un programa con medidas simples, a medida, con supervisión externa, redujo en un tiempo relativamente corto las infecciones por EPC, el consumo y uso apropiado de ATB en un hospital público de medianos/bajos recursos

This quasi-experimental study was developed in a public hospital with the goal of reducing the impact of antimicrobial resistance through an infection prevention and antimicrobial stewardship program. The following measures were implemented: surveillance of colonization and infection by carbapenemase-producing Enterobacteriaceae (CPE); surveillance and preventive measures for urinary catheter-associated infections (UTIs); surveillance and interventions for hand hygiene; local guidelines for treatment of infectious diseases with compliance and antibiotic (ATB) consumption metrics.Results: comparing the pre-intervention and post-intervention period, CPE rate in clinical samples 1.1 to 0/patient days, incidence rate ratio (IRR): 0.00, p: 0.033 and colonization of 3.3 to 0.61/days patient, IRR: 0.18, p-value: 0.5. UTI rate 8.9 to 7.2/1000 days urinary catheter IRR: 0.81, p 0.5. Hand Hygiene compliance: 77.5% to 70.38%, p 0.0067. ATB consumption: 376.24 to 176.82 DDD, 53% decrease. Compliance to guidelines in ATB selection: 57.1% to 95.4% p 0.00031, duration of ATB from 92.8% to 98.4% p 0.16, and adequacy to microbiological rescue of 57.1% at 100%, p <0.01. Conclusion: it is possible to reduce CPE infections, the consumption of antimicrobials and optimize their use in a public hospital in a country with medium/low resources through a program with basic and tailored measures

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La hipertensión portal es una de las principales complicaciones de la cirrosis. El papel de la derivación portosistémica transyugular intrahepática (TIPS, por sus siglas en inglés), ha ganado aceptación como tratamiento efectivo en la hipertensión portal. En los últimos años su técnica se ha ido perfeccionando, disminuyendo la morbimortalidad relacionada con este procedimiento. Describimos un caso de un paciente masculino con cirrosis Child-Pugh 8 y MELD 16, con antecedente de descompensación por sangrado variceal recurrente y trombosis parcial de la vena porta, con un gradiente de presión venosa hepática (GPVH) de 20 mmHg, por lo que es llevado a TIPS como profilaxis secundaria, con un gradiente final post-TIPS de 6 mmHg. Posterior al procedimiento, presentó evolución tórpida con deterioro de las pruebas de bioquímica hepática. Se realizó una angiografía demostrando permeabilidad del TIPS sin progresión de la trombosis portal, y hallazgos anormales inespecíficos de la arteria hepática. Se decidió realizar una arteriografía selectiva, demostrando un pseudoaneurisma de la rama derecha de la arteria hepática y una fístula arteriovenosa de la arteria hepática a las colaterales portales. Se realizó embolización selectiva de la fístula con evolución satisfactoria del paciente.

Portal hypertension is a life-threatening complication of cirrhosis. The role of transyugular intrahepatic portosystemic shunt (TIPS) has gained acceptance as an effective treatment for portal hypertension. In the past few years, its technique has been improved, decreasing the mortality related with the procedure. We describe a case of a male with Child-Pugh 8 and MELD 16 cirrhosis, with previous decompensation of recurrent variceal bleeding and partial thrombosis of the portal vein. TIPS was performed due to a hepatic venous pressure gradient (HVPG) of 20 mmHg. The final measure showed HVPG of 6 mmHg. After the procedure, he presented a torpid evolution with deterioration of liver function tests. An angiography was performed demonstrating patency of the TIPS without progression of portal thrombosis and nonspecific abnormal findings of the hepatic artery. Selective arteriography was performed and revealed a pseudoaneurysm of the right branch of the hepatic artery and an arteriovenous fistula (AVF) from the hepatic artery to portal collaterals. Embolization was performed to treat the fistula with satisfactory evolution of the patient.

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Could social context variables prime complex decisions? Could top-down processes impair this priming susceptibility? Complex decisions have been mainly studied from economic and moral perspectives, and Dual Process Theories provide evidence of how these processes could be affected. To address these issues from a political perspective, online experiments were conducted. Participants (n = 252) were asked to choose a face from 4 options, each associated with different frequencies (repetition priming) or with phrases with different emotional valence (emotional priming), for an unspecified task (UST group) or an important task (IMT group). The most repeated face was chosen most in the UST group, and was associated with lower response times. Positive faces were equally chosen by both groups. To compare results in a more ecological situation, a social study was conducted during the 2019 Argentine Presidential Election, including online surveys (n = 3673) and analysis of news media mentioning candidates. The familiarity and trust to each candidate explained the voting-probability for most of them, as well as correlated with their frequency of mentions in the news, their positive associations, and election results. Our results suggest complex decision-making is susceptible to priming, depending on top-down modulation.

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Extracellular vesicles (EVs) participate in cell-stroma crosstalk within the tumor microenvironment and fibroblasts (Fb) contribute to tumor promotion in thyroid cancer. However, the role of tumor-stroma derived EVs still needs to be deciphered. We hypothesized that the interaction of thyroid tumor cells with Fb would liberate EVs with a specific proteomic profile, which would have an impact on EV-functionality in thyroid tumor progression-related events. Tumor (TPC-1, 8505c) and non-tumor (NThyOri) thyroid cells were co-cultured with human Fb. EVs, obtained by ultracentrifugation of conditioned media, were characterized by nanoparticle tracking analysis and western blotting. EV-proteomic analysis was performed by mass-spectrometry, and metalloproteinases (MMPs) were studied by zymography. EV-exchange was evaluated using immunofluorescence, confocal microscopy and FACS. EVs expressed classical exosome markers, with EVs from thyroid tumor cell-Fb co-cultures showing a proteomic profile related to extracellular matrix (ECM) remodeling. Bidirectional crosstalk between Fb and TPC-1 cells produced significantly more EVs than their isolated cells, and potentiated EV-functionality. In line with this, Fb-TPC-1 derived EVs induced MMP2 activation in NThyOri supernatants, and MMP2 activity could be evidenced in Fb and TPC-1 contact-independent co-cultures. Besides, MMP2 interactors allowed us to discriminate between EVs from thyroid tumoral and non-tumoral milieus. Interestingly, Fb internalized more EVs from TPC-1 than from NThyOri producing cells. Fb and thyroid tumor cell crosstalk produces specialized EVs with an ECM remodeling proteomic profile, enabling activation of MMP2 and possibly facilitating ECM-degradation, which is potentially linked with thyroid tumor progression.

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Caroli disease is an infrequent congenital pathology that is part of the spectrum of fibrocystic diseases, characterized mainly by malformation of bile ducts. These patients often have stones and cholangitis, which respond poorly to conventional endoscopic retrograde cholangiopancreatography. To date, there is little evidence on the usefulness of cholangioscopy in this disease, so we describe the experience of performing cholangioscopy in a patient with hepatolithiasis and Caroli disease.

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Abstract Introduction: The diagnosis of schizophrenia has experienced a remarkable increase in recent years. Objective: To determine the prevalence and incidence of schizophrenia in the department of Caldas, Colombia, between 2010 and 2015, and to describe its epidemiological profile in this area of the country. Materials and methods: Retrospective and descriptive study. Information on the number of patients treated and the number of consultations in which the diagnosis or reason for consultation was related to schizophrenia diagnostic codes (ICD-10) in Caldas between 2010 and 2015 was analyzed. Data were obtained from the Territorial Health Management Office of Caldas and the Individual Health Service Provision Records of the Colombian Ministry of Health and Social Protection. Annual incidence and prevalence of schizophrenia for the study period were established and the Mann-Whitney U test was used to compare the number of consultations and the number of patients treated according to the type of schizophrenia, with a significance level of p (α) <0.05. Results: During the study period, 7 583 consultations were made, and 3 264 patients were treated due to schizophrenia in Caldas. The prevalence of schizophrenia in 2010 was 0.03% and in 2015, 0.11%. The cumulative incidence shown a marked upward trend, finding 834 new cases of schizophrenia between 2010 and 2015 (256 vs. 1 090), with an incidence of 70 cases per 100 000 inhabitants in 2015. The most frequent types of schizophrenia were paranoid and undifferentiated schizophrenia (2 250 and 560, respectively). Conclusions: The marked increase in the prevalence and incidence of schizophrenia in the study period may be explained by several factors; thus, it is necessary to review its epidemiological profile in other departments of the country as a first step to identify the factors associated with its occurrence in the Colombian population.

Resumen Introducción. El diagnóstico de esquizofrenia ha experimentado un notable incremento en los últimos años. Objetivos. Determinar la prevalencia e incidencia de esquizofrenia en el departamento de Caldas, Colombia, entre 2010 y 2015 y describir su perfil epidemiológico en esta área. Materiales y métodos. Estudio retrospectivo y descriptivo. Se analizó la información sobre el número de pacientes atendidos y consultas realizadas en Caldas entre 2010 y 2015 y en los que el diagnóstico o el motivo de consulta se relacionó con códigos diagnósticos de esquizofrenia (CIE-10). Los datos se obtuvieron a partir de la Dirección Territorial de Salud de Caldas y los Registros Individuales de Prestación de Servicios del Ministerio de Salud y Protección Social. Se estableció la incidencia y pre-valencia de esquizofrenia anual para el periodo de estudio y se utilizó la prueba U de Mann-Whitney para comparar el número de consultas y pacientes atendidos según el tipo de esquizofrenia, con un nivel de significancia de p (α) <0.05. Resultados. En el periodo de estudio se realizaron 7 583 consultas y se atendieron 3 264 pacientes por esquizofrenia en Caldas. La prevalencia de esta enfermedad en 2010 fue de 0.03% y en 2015, de 0.11%. La incidencia acumulada presentó una tendencia marcada al aumento, reportándose 834 casos nuevos de esquizofrenia entre el 2010 y 2015 (256 vs. 1 090), con una incidencia de 70 casos por cada 100 000 habitantes en 2015. Los tipos de esquizofrenia más frecuentes fueron la esquizofrenia paranoide e indiferenciada (2 250 y 560, respectivamente). Conclusiones. El marcado aumento de la prevalencia e incidencia de esquizofrenia en el periodo de estudio puede obedecer a varios factores, por lo que es necesario revisar su perfil epidemiológico en otros departamentos del país como un primer paso para identificar los factores asociados con su ocurrencia en población colombiana.

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Abstract Maternal cocaine abuse during pregnancy is associated to neglect, abuse, and mother-child bond disruption, which directly affects infant development; therefore, various neurobehavioral problems of children of drug-dependent parents could be attributed to inadequate maternal behavior or prenatal exposure to drugs. Thus, the aim of this research was to analyze the effects of chronic cocaine administration during pregnancy on postpartum maternal behavior. To do this, 21 CD1 pregnant female mice were randomly assigned for administration of saline solution and cocaine (25 mg/kg/day and 50 mg/kg/day), from day 8 to 21 of gestation. After delivery, for 15 minutes a day, during 20 days, the frequency of occurrence of 16 behavioral patterns of maternal behavior was individually recorded, using an ethogram. Cocaine slightly affected maternal behavior frequency, although it may have affected other parameters, such as latency, duration, and sequence of this behavior.

Resumo O abuso materno de cocaína durante a gestação está relacionado com negligência, maltrato, perturbação do vínculo mãe-filho, o que incide diretamente no desenvolvimento das crianças. Por isso, as diversas problemáticas neurocomportamentais dos filhos de pais drogodependentes poderiam ser atribuídas ao inadequado comportamento materno ou à exposição prénatal à droga. O objetivo desta pesquisa foi analisar os efeitos da administração crônica de cocaína durante a gestação no comportamento materno pós-parto de ratos. Para isso, designaram-se aleatoriamente 21 ratos CD1 fêmeas gestantes para a administração de solução salina e cocaína (25 mg/kg/dia e 50 mg/kg/dia), desde o oitavo até o 21° dia de gestação. Após o parto, durante 20 dias (15 minutos diários), registrou-se individualmente a frequência de apresentação de 16 índices de comportamento materno mediante um etograma. Constatou-se que a cocaína afetou levemente a frequência do comportamento materno, embora possivelmente afete outros parâmetros como latência, duração e sequência desse comportamento.

Resumen El abuso materno de cocaína durante la gestación se relaciona con negligencia, maltrato y perturbación del vínculo madre-hijo, lo que incide directamente en el desarrollo de los infantes; por esto, las diversas problemáticas neuroconductuales de los hijos de padres drogodependientes podrían atribuirse a la inadecuada conducta materna o a la exposición prenatal a la droga. El objetivo de esta investigación fue analizar los efectos de la administración crónica de cocaína durante la gestación en la conducta materna postparto de ratones. Para esto se asignaron aleatoriamente 21 ratones CD1 hembras gestantes para la administración de solución salina y cocaína (25 mg/kg/día y 50 mg/kg/día), desde el octavo hasta el día veintiuno de gestación. Después del parto, durante 20 días (15 minutos diarios), se registró individualmente la frecuencia de presentación de 16 índices de conducta materna mediante un etograma. Se encontró que la cocaína afectó levemente la frecuencia de la conducta materna, aunque posiblemente afecte otros parámetros como la latencia, duración y secuencia de esta conducta.

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Resumen Antecedentes: la Ilex laurina K., planta colombiana cuya infusión presenta actividad antioxidante y antiproliferativa, pertenece al género del té de yerba mate. Objetivo: evaluar las propiedades nutricionales y fisicoquímicas de una infusión de hojas de Ilex laurina K. como potencial materia prima, alimento funcional y sustituyente del convencional té de mate Ilex paraguariensis. Materiales y métodos: análisis por HPLC de fitoquímicos y carbohidratos, solubilidad, medición de minerales por espectrofotometría de absorción atómica y análisis sensorial. Resultados: en la infusión de Ilex laurina K. en comparación con la de Ilex paraguariensis se encontraron mayores concentraciones de ácido clorogénico (429,2±20,2 frente a47,4±1,9 mg/kg), de p-cumárico (47,3±2,4 versus 24,4±0,9 mg/kg), de metilxantinas (1,4-1,8 veces), hierro, cobre y zinc, y similares de ácido cafeico (52,6±18,8 versus 47,4±1,9 mg/L) (p>0,05). Se detectaron ácido ferúlico (21,5±1,6 mg/L) y fructosa (0,4±0,003 g/L), mientras en la de Ilex paraguariensis se encontró glucosa (0,8±0,007 g/L) y mayores concentraciones de magnesio y manganeso (p<0,05). La infusión de Ilex laurina K. fue aceptada por el 64 % de los consumidores, independiente del sexo; así como el color (51 %), olor (47 %), sabor (42 %) y dulzor (47 %). Conclusiones: la infusión de Ilex laurina K. además de tener buena aceptación contiene mayor cantidad de compuestos fenólicos, metilxantinas, hierro, cobre, zinc y fructosa que la de Ilex paraguariensis; y menor aporte de glucosa, magnesio y manganeso.

Abstract Background: Ilex laurina K., a Colombian plant whose infusion presents antioxidant and antiproliferative properties, belongs to a species of Yerba Mate tea. Objective: Evaluate the nutritional and physiochemical properties of an infusion using Ilex laurina K. leaves as a potential raw material, functional food and substitute for the conventional Ilex paraguariensis tea. Objective: To evaluate the nutritional and physiochemical properties of an infusion using Ilex laurina K. leaves as a potential raw material, functional food and substitute for the conventional Ilex paraguariensis tea. Materials and Methods: Phytochemicals and carbohydrates by HPLC analysis, solubility, mineral measurement using atomic absorption spectrophotometry, and sensorial analysis. Results: The Ilex laurina K. infusión compared with Ilex paraguariensis infusion found higher concentrations of chlorogenic acid (429.2 ± 20.2 versus 47.4 ± 1.9 mg / kg), p-coumaric (47.3 ± 2.4 versus 24.4 ± 0.9 mg / kg), xanthines (1.4-1.8 times), iron, copper, zinc, and the likes of caffeic acid (52.6 ± 18.8 versus 47.4 ± 1.9 mg / L) (p> 0.05). Ferulic acid (21.5 ± 1.6 mg / L) and fructose (0.4 ± 0.003 g / L) were detected, while glucose (0.8 ± 0.007 g / L) and higher concentrations of magnesium and manganese (p<0.05) we found in the Ilex paraguariensis. Ilex laurina K. infusion was accepted by 64% of consumers, regardless of gender; and respective acceptability of the following characteristics: color (51%), smell (47%), flavor (42%) and sweetness (47%). Conclusions: Ilex laurina K. infusion is well accepted by consumers, and contains a higher concentration of phenol compounds, xanthines, iron, copper, zinc and fructose than Ilex paraguariensis infusion, and contributes less glucose, magnesium and manganese.

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Resumen Con el propósito de evaluar los efectos de la Exposición Prenatal de Cocaína -EPC- (25 y 50 mg/kg/día) desde el 8 hasta el 21 día de gestación, en el consumo de cocaína oral en ratones hembras y machos en la adultez temprana (7ª semana de edad), se realizó un estudio experimental factorial mediante el modelo de "elección libre de dos botellas" que mide el consumo en mililitros. Se evaluó el consumo durante 14 días consecutivos a partir de la 7ª semana de edad. Para el análisis del consumo se utilizó el MANOVA de medidas repetidas y se encontró que la EPC 50mg/kg/día incrementó el consumo de cocaína oral en ratones hembras y machos adultos-jóvenes tanto en la fase de adquisición como la de mantenimiento. Y la EPC 25mg/kg/día aumentó el consumo únicamente en los machos en la fase de mantenimiento, mostrando la mayor susceptibilidad de estos a la EPC, en cambio el alto consumo de cocaína observado en las hembras no fue dosis-relacionado, por lo que se puede atribuir a factores situacionales. De esta forma se ve como la EPC en las dos dosis evaluadas incrementa el consumo de cocaína oral en la adultez temprana en los ratones; la dosis alta (50mg/kg) el consumo de hembras y machos y la dosis baja (25mg/kg) incrementa el consumo únicamente en los machos. Se observa que los efectos están relacionados a la dosis y que los machos son más vulnerables a los efectos de la EPC.

Abstract To evaluate the effects of Prenatal Exposure of Cocaine-EPC- (25 or 50 mg / kg / day) from 8-21 day of gestation, on oral cocaine use in female and male mice in early adulthood, was used the test of "free choice of two bottles" that measures the oral cocaine consumption in milliliters. This was evaluated for 14 consecutive days from the 7th week of age. Repeated measures MANOVA was used for the analysis of consumption. It was found that EPC 50mg/kg/day increased oral cocaine consumption in female and young adult male mice both in the acquisition and maintenance phases. And the EPC 25mg/kg/day increased the consumption only in the males in the maintenance phase, showing the greater susceptibility of these to the EPC, whereas the high cocaine consumption observed in the females was not dose-related, which can be attributed to situational factors. In this way, it is seen how the EPC in the two doses evaluated increases oral cocaine consumption in early adulthood in mice; the high dose (50mg / kg) the consumption of females and males and the low dose (25mg / kg) increases the consumption only in males. It is observed that the effects are related to the dose, and that males are more vulnerable to the EPC effects.

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Resumen La colecistectomía laparoscópica (CL) es la técnica quirúrgica de elección actual para el tratamiento de la colelitiasis sintomática. Sin embargo, este procedimiento acarrea ciertas complicaciones, dentro de las cuales destacamos la perforación de la vesícula biliar con subsiguiente caída de los cálculos y bilis a la cavidad peritoneal, que puede dar origen a la formación de abscesos abdominales tiempo después de dicho procedimiento quirúrgico. Por tal motivo, los cálculos biliares abandonados deben reconocerse como una fuente potencial para la formación de un proceso inflamatorio intraabdominal, en especial cuando se tiene historia de perforación vesicular durante el procedimiento, o en los casos de conversión a colecistectomía abierta y caída de los cálculos a la cavidad peritoneal. Tanto los radiólogos como los cirujanos deben familiarizarse con los hallazgos imagenológicos de las diferentes modalidades diagnósticas, como el ultrasonido, la TC y la resonancia magnética, así como con las diferentes manifestaciones clínicas que pueden presentarse. En esta publicación, presentamos los casos de 7 pacientes con antecedente de colecistectomía laparoscópica que acudieron al servicio de urgencia de nuestro hospital por dolor abdominal y en quienes los hallazgos imagenológicos determinaron la presencia de colecciones perihepáticas por cálculos caídos.

Abstract Laparascopic cholecystectomy (LC) is the current surgical technique of choice for the treatment of symptomatic cholelithiasis. However, this procedure leads to certain complications, of which we highlight gallbladder perforation with the subsequent spillage of stones and bile into the peritoneal cavity, which may give rise to the formation of abdominal abscesses some time after the surgery. For this reason, abandoned gallstones should be recognized as a potential source of intra-abdominal inflammatory processes, especially when there is a history of gallbladder perforation during the procedure, or in cases of conversion to open cholecystectomy and spillage of gallstones into the peritoneal cavity. Both radiologists as well as surgeons should be familiar with the imaging findings of the various diagnostic modalities such as ultrasound, CT and magnetic resonance imaging, as well as the various clinical manifestations that can present. In this publication we present 7 cases of patients with a history of laparascopic cholecystectomy who presented to our hospital´s ER with abdominal pain and in whom the imaging findings showed the presence of perihepatic collections caused by spilled stones.

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Las cardiopatías congénitas complejas se presentan con una gran variedad de malformaciones que pueden afectar el tronco de la arteria pulmonar y las arterias pulmonares. Es infrecuente encontrar de manera aislada la interrupción de una de las mismas. En este caso se explican las ayudas diagnósticas imaginológicas que llevaron al diagnóstico de interrupción proximal de la arteria pulmonar derecha sin asociación con otra malformación congénita, en una paciente a quien se le diagnosticó, inicialmente, síndrome de drenaje venoso anómalo.

The complex congenital heart disease may present with a variety of malformations in the main pulmonary artery. However, it is not common to find in isolation the absence of one of the pulmonary arteries. In this case report, we explain the diagnostic imaging aid that led to the diagnosis of proximal interruption of the right pulmonary artery without association to other congenital malformation in a patient in whom a syndrome of anomalous venous drainage was initially thought.

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El objetivo de este estudio fue analizar los efectos de la Exposición Prenatal a Cocaína (EPC) (0,25 o 50 mg/kg/día) en la conducta emocional de ratones hembras y machos en la adolescencia y la adultez temprana. Se asignaron 27 ratones CD1 hembras gestantes a 3 condiciones experimentales: un grupo control que se le administró solución salina y 2 experimentales a los que se le administró cocaína 25 mg/ kg/día y 50 mg/kg/día, desde el día octavo al veintiunavo de gestación. La conducta emocional de los hijos de estas madres se evaluó en la adolescencia y en la adultez temprana (5.ª y 7.ª semana de edad, respetivamente) por medio del tablero de agujeros y el laberinto en cruz a través de diferentes índices de actividad exploratoria. Los datos se analizaron por medio de MANOVAS y ANOVAS con un valor a de 0.05. La EPC alteró de forma dosis-relacionada la conducta emocional; los sujetos sometidos a EPC 50 mg/kg/día exhibieron mayor ansiedad y temor, en cambio los tratados con EPC 25 mg/kg/día exploraron más, mostrando conductas de alto riesgo, características de la impulsividad e hiperactividad. Los efectos encontrados se mantuvieron en el tiempo, por lo que se concluye que la EPC perturbó permanente y significativamente la emoción.

In order to study the effects of prenatal cocaine exposure (0, 25 or 50 mg/kg/day), on the emotional behavior of young and adult mice of both sexes, 27 CD1 pregnant female mice were assigned to one of three experimental conditions: a control group was given saline solution, a first experimental group that was given 25 mg/kg/day of cocaine and another experimental group with 50 mg/kg/day of cocaine, all between gestational days 8-21. Emotional behavior was evaluated in the offspring (both males and females) of the females at five and seven weeks of age, via the hole board followed by the plus maze with different rates of exploratory activity. Data were analyzed with MANOVAS and ANOVAS with and a of 0.05. Prenatal Cocaine Exposure (PCE) altered dose-related emotional behavior; subjects with PCE of 50 mg/kg/day exhibited more anxiety and fear, in contrast to the 25 mg/kg/day group that explored more and showed greater high-risk behaviors, which are features of impulsivity and hyperactivity. The effects found were maintained over time, so it is concluded that PCE permanently and significantly perturbed emotion.

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Con el advenimiento de la terapia intervencionista se dio campo a una modalidad más de tratamiento que podría brindar la oportunidad a aquellos pacientes que por diferentes motivos no podían ser llevados a tratamientos quirúrgicos. De esta forma, las terapias locorregionales (ablación percutánea y quimioembolización) se han constituido en un apoyo como terapias curativas y paliativas en pacientes sin otra opción. Sin embargo, las terapias locorregionales deben estar enmarcadas en la estratificación clínica del CHC, que nos permite estimar la expectativa de vida, el mejor tratamiento para su estadio y un balance de riesgos y beneficios del tratamiento escogido.

The advent of interventional therapy has given a wider field to a form of treatment that could provide an opportunity to those patients who, for various reasons, cannot undergo surgical treatments. Thus, local and regional therapies such as percutaneous ablation and chemoembolization have become supporting curative and palliative therapies for patients with no other choice. However, local and regional therapies should be framed within the clinical stratification of HCC which allows us to estimate the life expectancy and the best treatment for the patient’s stage and the balance of risks and benefits of the treatment chosen.

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OBJECTIVE: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. METHODS: Twenty-two women with severe COPD (FEV1/FVC ratio < 70% and FEV1 < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities-spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw). RESULTS: There were no significant differences between the two groups in terms of FEV1, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans showed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis. CONCLUSIONS: Female patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO.

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Portal hypertensive biliopathy (PHB) is characterized by anatomical and functional abnormalities of the intrahepatic, extrahepatic and pancreatic ducts, in patients with portal hypertension associated to extrahepatic portal vein obstruction and less frequently to cirrhosis. These morphological changes, consisting in dilatation and stenosis of the biliary tree, are due to extensive venous collaterals occurring in an attempt to decompress the portal venous blockage. It is usually asymptomatic until it progresses to more advanced stages with cholestasis, jaundice, biliary sludge, gallstones, cholangitis and finally biliary cirrhosis. Imaging modalities of the biliary tree such as Doppler ultrasound, computed tomography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are essential to establish the diagnosis and the need of therapeutical interventions. Once the diagnosis is established, treatment with ursodesoxycholic acid seems to be beneficial. Decompression of the biliary tree to dilate, remove stones or implant biliary prosthesis by endoscopic or surgical procedures (hepato-yeyunostomy) usually resolves the cholestatic picture and prevents septic complications. The ideal treatment is the decompression of the portal system, with transjugular intrahepatic porto-systemic shunt or a surgical porto-systemic shunt. Unfortunately, few patients will be candidates for these procedures due to the extension of the thrombotic process. The purpose of this paper is to report the first 3 cases of PHB seen in a Colombian center and to review the literature.

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OBJETIVO: La exposición a humo de leña es factor de riesgo para EPOC. A diferencia de la EPOC por cigarrillo (EPOC-C), para un mismo nivel de obstrucción, en la EPOC por leña (EPOC-L), la DLCO está menos disminuida, sugiriendo menos enfisema. Por tanto, el objetivo de este estudio fue comparar los hallazgos en la TCAR en mujeres con EPOC-L y con EPOC- C. MÉTODOS: Veintidós mujeres con EPOC severa (VEF1/CVF < 70% y VEF1 < 50%) fueron divididas en dos grupos: las expuestas a leña (EPOC-L; n = 12) y las expuestas a cigarrillo (EPOC-C; n = 10). Se compararon los dos grupos con respecto al puntaje de enfisema y el compromiso de la vía aérea en la TCAR, las anormalidades funcionales en la espirometría, la DLCO, los volúmenes pulmonares y la resistencia específica de la vía aérea (sRaw). RESULTADOS: Los dos grupos tuvieron VEF1, sRaw e hiperinflación pulmonar similares. En el grupo EPOC-C, hubo mayor disminución de la DLCO y de la DLCO/VA y mayor puntaje de enfisema. En el grupo EPOC-L, no encontramos enfisema significativo en la TCAR. Los hallazgos principales fueron engrosamiento peribronquial, dilataciones bronquiales y atelectasias subsegmentarias. CONCLUSIONES: En pacientes con EPOC-L severa no hay enfisema en la TCAR. El hallazgo más importante es el compromiso severo de la vía aérea. La disminución de la DLCO y del VA con DLCO/VA normal es probablemente determinada por la obstrucción bronquial severa y la mezcla incompleta del gas inspirado en la maniobra de la respiración única de la prueba de difusión.

OBJECTIVE: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. METHODS: Twenty-two women with severe COPD (FEV1/FVC ratio < 70% and FEV1 < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities-spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw). Results: There were no significant differences between the two groups in terms of FEV1, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans howed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis. CONCLUSIONS: Female patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO.

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