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In retinopathy of prematurity (ROP) type I, the use of intravitreal bevacizumab (IVB), which is an inhibitor of endothelial growth factor (VEGF), has become popular despite not being a therapy approved by regulatory agencies. However, IVB has shown positive effects in halting disease progression at lower costs compared to other anti-VEGF therapies (ranibizumab or aflibercept). In this report, we present the experience during the treatment with IVB of 102 Colombian children with ROP type I, with a success rate of 98% (100). Complications occurred in 3.9% (4). Finally, we conclude that a single dose of IVB is an effective therapy for the management of ROP type I, with a lower risk of complications and retreatment.

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Introducción: Se presenta un caso clínico de sistema de presión negativa como tratamiento de ventana torácica derecha, realizado en la clínica de heridas. Se describe el tiempo y proceso de cicatrización, desde la llegada del paciente hasta la cicatrización total. Caso: Hombre de 24 años, postoperado de toracotomía, se le colocó terapia de presión negativa inicial a -75mmHg con intensidad media y modalidad continua; se aplicó esponja blanca para proteger el pulmón expuesto y esponja de plata, con tres cambios cada siete días. Posteriormente, se realizaron diez cambios de esponjas cada cuatro días, identificando disminución de las dimensiones de la ventana torácica. En la semana once inició tratamiento con terapia húmeda y fibrina rica en plaquetas, la cual se colocó en el lecho de la herida, aplicándose una vez por semana durante un mes. A partir de la semana quince se realizó curación diaria con aplicación de sulfadiazina de plata. El paciente fue dado de alta en la semana veinte con la herida 100% epitelizada. Conclusiones: El uso de la terapia de presión negativa acelera el proceso de curación, reduce las complicaciones y la carga bacteriana del tejido, debido a que la esponja de plata actúa como barrera antimicrobiana.

Introduction: A clinical case of negative pressure system as a right thoracic window treatment, performed in the wound clinic, is presented. The time and healing process from patient arrival to complete healing is described. Case: A 24-year-old man, postoperative thoracotomy, was placed on negative pressure therapy at -75mmHg with medium intensity and continuous mode; white sponge was applied to protect the exposed lung and silver sponge, with three changes every seven days. Subsequently, ten sponge changes were performed every four days, identifying a decrease in the dimensions of the thoracic window. In week eleven, the patient started treatment with wet therapy and platelet-rich fibrin, which was placed in the wound bed and applied once a week for a month. From week fifteen onwards, daily healing was performed with silver sulfadiazine application. The patient was discharged at week twenty with the wound 100% epithelialized. Conclusions: The use of negative pressure therapy accelerates the healing process, reduces complications and tissue bacterial load, due to the silver sponge acting as an antimicrobial barrier.

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INTRODUCTION: People with epilepsy have multiple barriers to recovery: access to medication, comorbidities and social problems. The aim of this study is to determine psychosocial factors associated with the perception of quality of life in people with epilepsy in the department of Bolivar, Colombia, in the year 2022. SUBJECTS AND METHODS: Descriptive cross-sectional study, correlational, with a sample stratified with a margin of error of 5%, according to the calculation of the average number of people treated for epilepsy in Colombia. 174 people participated with a mean age of 39.55 years, 50% men and 50% women. An instrument was used that determined sociodemographic data, quality of life (Quality of Life in Epilepsy Inventory-10), adherence to treatment (Morisky test), self-care behaviors, perception of disability and provision of health services. All the instruments showed a Cronbach's Alpha greater than 0.686 for this population. RESULTS: 21.3% had focal onset epilepsy; 41% with generalized epilepsy without focal onset; 18.4% with focal onset that generalized; 12.6% did not know their type of epilepsy; and 6.3% reported that they were not informed about their type of epilepsy. Based on correlations, an explanatory model of quality of life is shown, with pillars such as drug adherence, self-care habits, time without seizures, and perceived disability. CONCLUSIONS: Although time without seizures is a fundamental element in recovery, living conditions and mental health problems are key elements to achieve a better quality of life in epilepsy.

TITLE: Calidad de vida en personas con epilepsia. Más allá de las crisis.Introducción. Las personas con epilepsia tienen múltiples barreras para recuperarse: acceso a medicamentos, comorbilidades y problemas sociales. El objetivo del presente estudio es determinar factores psicosociales asociados con la percepción de la calidad de vida en personas con epilepsia en el departamento de Bolívar, Colombia, en el año 2022. Sujetos y métodos. Estudio descriptivo de corte transversal, correlacional, con un muestreo estratificado con un margen de error del 5%, según el cálculo del promedio de personas atendidas por epilepsia en Colombia. Participaron 174 personas con una edad media de 39,55 años, un 50% hombres y un 50% mujeres. Se usó un instrumento que determinó datos sociodemográficos, calidad de vida (Quality of Life in Epilepsy Inventory-10), adhesión al tratamiento (test de Morisky), conductas de autocuidado, percepción de incapacidad y prestación de los servicios de salud. Todos los instrumentos mostraron un alfa de Cronbach superior a 0,686 para esta población. Resultados. El 21,3% contó con epilepsia de inicio focal; el 41%, con epilepsia generalizada sin inicio focal; el 18,4%, con epilepsia de inicio focal que generaliza; el 12,6% desconocía su tipo de epilepsia; y el 6,3% manifestó que no fue informado sobre su tipo de epilepsia. Basándose en correlaciones, se muestra un modelo explicativo de calidad de vida, con pilares como la adhesión farmacológica, los hábitos de autocuidado, el tiempo sin crisis y la incapacidad percibida. Conclusiones. Aunque el tiempo sin crisis constituye un elemento fundamental en la recuperación, las condiciones de vida y los problemas de salud mental constituyen elementos claves para lograr una mejor calidad de vida en epilepsia.

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Resumen: Introducción: las fracturas del radio distal son las más comunes en extremidades superiores. Estandarizar las mediciones radiográficas para su abordaje quirúrgico es importante. Este estudio midió la reproducibilidad intra/interobservador de parámetros radiográficos asociados al éxito quirúrgico en estas fracturas. Material y métodos: diseño transversal retrospectivo con datos secundarios de expedientes clínicos. Se evaluaron radiografías de 112 fracturas en planos posteroanterior y lateral por dos traumatólogos estandarizados en toma de mediciones para calcular cinco parámetros indicativos de éxito postquirúrgico: altura radial, inclinación radial, inclinación volar, varianza cubital y escalón articular. La reproducibilidad de distancias y ángulos se evaluó con el método de Bland-Altman calculando: diferencia media entre mediciones, rango a ± 2 DE y proporción de mediciones fuera de ± 2 DE. El éxito postquirúrgico se comparó en pacientes con/sin obesidad según la media de las dos mediciones de cada evaluador. Resultados: el evaluador 1 tuvo la mayor diferencia intraobservador en altura radial (0.16 mm) y la mayor proporción fuera de ± 2 DE en varianza cubital (8.1%); el evaluador 2 tuvo la mayor diferencia en inclinación volar (1.92o) y la mayor proporción en inclinación radial (10.7%). La mayor diferencia interobservador fue en varianza cubital (1.02 mm) y la mayor proporción fuera de ± 2 DE en altura radial (5.4%). La inclinación radial tuvo la mayor diferencia (1.41o) con 4.5% de mediciones fuera de ± 2 DE. La varianza cubital y la inclinación volar tuvieron la mayor diferencia de éxito postquirúrgico entre evaluadores, sobre todo en pacientes con obesidad. Conclusión: mejorar la calidad radiográfica y estandarizar las mediciones resulta en indicadores más reproducibles.

Abstract: Introduction: distal radius fractures are the most common in upper extremities. Therefore, it is important to standardize radiographic measures for their surgical approach. This study assessed the intra/interobserver reproducibility of radiographic parameters associated with surgical success of distal radius fractures. Material and methods: retrospective cross-sectional design of secondary data extracted from clinical records. Posteroanterior and lateral X-rays of 112 distal radius fractures were assessed by two trauma specialists standardized in the measurements required to compute five parameters indicative of postoperative success: radial height, radial inclination, volar tilt, ulnar variance, and articular stepoff. The reproducibility of distances and angles was evaluated using the Bland-Altman method, calculating the mean of the difference between measurements, the range at ± 2 SD, and the proportion of measurements outside ± 2 SD. Postoperative success was also compared between patients with and without obesity according to the mean of the two measures made by each evaluator. Results: evaluator 1 had the largest intra-observer difference in radial height (0.16 mm) and the largest proportion outside ± 2 SD in ulnar variance (8.1%); evaluator 2 had the largest difference in volar tilt (1.92o) and the highest proportion in radial inclination (10.7%). The largest inter-observer difference was for ulnar variance (1.02 mm) and the largest proportion outside ± 2 SD. for radial height (5.4%). Radial tilt had the largest difference (1.41o) with 4.5% of measurements outside ± 2 SD. Ulnar variance and volar tilt had the largest difference in postoperative success between evaluators, especially in patients with obesity. Conclusion: improving the radiographic quality and standardizing the measurements results in more reproducible indicators.

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Chagas disease (ChD), caused by Trypanosoma cruzi, has a global prevalence due to patient migration. However, despite its worldwide distribution, long-term follow-up efficacy studies with nifurtimox (NF) are scarce and have been conducted with only small numbers of patients. A retrospective study of a large cohort of ChD treated children and adults with NF. Treatment response was evaluated by clinical, parasitological, and serological after-treatment evaluation. A total of 289 patients were enrolled, of which 199 were children and 90 adults. At diagnosis, 89.6% of patients were asymptomatic. Overall, all symptomatic patients showed clinical improvement. At baseline, parasitemia was positive in 130 of 260 (50%) patients. All but one adult patient had cleared their parasitemia by the end of treatment. That patient was considered a treatment failure. Median follow-up time for children was 37.7 months, with an interquartile range of (IQR25-75 12.2 to 85.3), and for adults was 14.2 months (IQR25-75, 1.9 to 33.8). After treatment, a decrease of T. cruzi antibodies and seroconversion were observed in 34.6% of patients. The seroconversion profile showed that, the younger the patient, the higher the rate of seroconversion (log rank test; P value, <0.01). At least 20% seroreduction at 1 year follow-up was observed in 33.2% of patients. Nifurtimox was highly effective for ChD treatment. Patients had excellent treatment responses with fully resolved symptoms related to acute T. cruzi infection. Clearance of parasitemia and a decrease in T. cruzi antibodies were observed as markers of treatment response. This study reinforces the importance of treating patients during childhood since the treatment response was more marked in younger subjects. (This protocol was registered at ClinicalTrials.gov under registration number NCT04274101).

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PURPOSE: To analyse the distribution of the difference between both eyes in the calculation of the dioptric power of the intraocular lens in a series of 7994 patients and the biometric variables that determine it. METHODS: The data of patients between 3 and 99 years old, residents of the city of Guayaquil and neighbouring sites, who received ocular biometry by partial optical coherence interferometry between 2004 and 2020 were reviewed. Ocular biometrics, including axial length (AL), anterior chamber depth (ACD), and the mean corneal dioptre power (CD), were measured by partial coherence interferometry. Refraction without or with cycloplegia was recorded in spherical equivalent (SE). The Haigis formula from the IOL Master instrument was used to calculate the dioptric power of the intraocular lens in both eyes. RESULTS: Data from the bilateral optical biometry of 7994 patients were analysed. The mean and standard deviation of AL, CD, ACD and dioptre power of the IOL were 23.66 ±â€¯1.25, 43.70 ±â€¯1.49, 3.34 ±â€¯0.40 and +20.46 ±â€¯3.84, respectively. 2538 (31.7%) patients had equal dioptre power of the IOL between both eyes. 3243 (40.6%) patients had a 0.50 D difference; 1162 (14.5%), 1.0 D; 425 (5.3%), 1.5 D. 626 patients (7.8%) had a difference in IOL dioptre of 2 D or more, with a maximum of 24 D. The asymmetry of AL between OU was ≥0.4 mm in 10.49%, while that of CD reached ≥1 D in 1.9%. CONCLUSIONS: 92.16% of patients had a difference within 1.5 D between both eyes in the calculation of the dioptre power of the intraocular lens. In case an eye is programmed in which it is impossible to perform a reliable biometry, either due to trauma or due to white or brunescent cataract, the calculation of the intraocular lens could be done taking as a reference the biometry of the contralateral eye.

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INTRODUCTION: distal radius fractures are the most common in upper extremities. Therefore, it is important to standardize radiographic measures for their surgical approach. This study assessed the intra/interobserver reproducibility of radiographic parameters associated with surgical success of distal radius fractures. MATERIAL AND METHODS: retrospective cross-sectional design of secondary data extracted from clinical records. Posteroanterior and lateral X-rays of 112 distal radius fractures were assessed by two trauma specialists standardized in the measurements required to compute five parameters indicative of postoperative success: radial height, radial inclination, volar tilt, ulnar variance, and articular stepoff. The reproducibility of distances and angles was evaluated using the Bland-Altman method, calculating the mean of the difference between measurements, the range at ± 2 SD, and the proportion of measurements outside ± 2 SD. Postoperative success was also compared between patients with and without obesity according to the mean of the two measures made by each evaluator. RESULTS: evaluator 1 had the largest intra-observer difference in radial height (0.16 mm) and the largest proportion outside ± 2 SD in ulnar variance (8.1%); evaluator 2 had the largest difference in volar tilt (1.92o) and the highest proportion in radial inclination (10.7%). The largest inter-observer difference was for ulnar variance (1.02 mm) and the largest proportion outside ± 2 SD. for radial height (5.4%). Radial tilt had the largest difference (1.41o) with 4.5% of measurements outside ± 2 SD. Ulnar variance and volar tilt had the largest difference in postoperative success between evaluators, especially in patients with obesity. CONCLUSION: improving the radiographic quality and standardizing the measurements results in more reproducible indicators.

INTRODUCCIÓN: las fracturas del radio distal son las más comunes en extremidades superiores. Estandarizar las mediciones radiográficas para su abordaje quirúrgico es importante. Este estudio midió la reproducibilidad intra/interobservador de parámetros radiográficos asociados al éxito quirúrgico en estas fracturas. MATERIAL Y MÉTODOS: diseño transversal retrospectivo con datos secundarios de expedientes clínicos. Se evaluaron radiografías de 112 fracturas en planos posteroanterior y lateral por dos traumatólogos estandarizados en toma de mediciones para calcular cinco parámetros indicativos de éxito postquirúrgico: altura radial, inclinación radial, inclinación volar, varianza cubital y escalón articular. La reproducibilidad de distancias y ángulos se evaluó con el método de Bland-Altman calculando: diferencia media entre mediciones, rango a ± 2 DE y proporción de mediciones fuera de ± 2 DE. El éxito postquirúrgico se comparó en pacientes con/sin obesidad según la media de las dos mediciones de cada evaluador. RESULTADOS: el evaluador 1 tuvo la mayor diferencia intraobservador en altura radial (0.16 mm) y la mayor proporción fuera de ± 2 DE en varianza cubital (8.1%); el evaluador 2 tuvo la mayor diferencia en inclinación volar (1.92o) y la mayor proporción en inclinación radial (10.7%). La mayor diferencia interobservador fue en varianza cubital (1.02 mm) y la mayor proporción fuera de ± 2 DE en altura radial (5.4%). La inclinación radial tuvo la mayor diferencia (1.41o) con 4.5% de mediciones fuera de ± 2 DE. La varianza cubital y la inclinación volar tuvieron la mayor diferencia de éxito postquirúrgico entre evaluadores, sobre todo en pacientes con obesidad. CONCLUSIÓN: mejorar la calidad radiográfica y estandarizar las mediciones resulta en indicadores más reproducibles.

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BACKGROUND: The use of rosuvastatin plus colchicine and emtricitabine/tenofovir in hospitalized patients with SARS-CoV-2 disease (COVID-19) has not been assessed. The objective of this study was to assess the effectiveness and safety of rosuvastatin plus colchicine, emtricitabine/tenofovir, and their combined use in these patients. METHODS: This was a randomized, controlled, open-label, multicentre, parallel, pragmatic study conducted in six referral hospitals in Bogotá, Colombia. The study enrolled hospitalized patients over 18 years of age with a confirmed diagnosis of COVID-19 complicated with pneumonia, not on chronic treatment with the study medications, and with no contraindications for their use. Patients were assigned 1:1:1:1. 1) emtricitabine with tenofovir disoproxil fumarate (FTC/TDF, 200/300 mg given orally for 10 days); 2) colchicine plus rosuvastatin (COLCH+ROSU, 0.5 mg and 40 mg given orally for 14 days); 3) emtricitabine with tenofovir disoproxil plus colchicine and rosuvastatin at the same doses and for the same period of time (FTC/TDF+COLCH+ROSU); or 4) the Colombian consensus standard of care, including a corticosteroid (SOC). The primary endpoint was 28-day all-cause mortality. A modified intention-to-treat analysis was used together with a usefulness analysis to determine which could be the best treatment. The trial was registered at ClinicalTrials.gov: NCT04359095. FINDINGS: Out of 994 candidates considered between August 2020 and March 2021, 649 (65.3%) patients agreed to participate and were enrolled in this study; among them, 633 (97.5%) were included in the analysis. The mean age was 55.4 years (SD ± 12.8 years), and 428 (68%) were men; 28-day mortality was significantly lower in the FTC/TDF+COLCH+ROSUV group than in the SOC group, 10.7% (17/159) vs. 17.4% (28/161) (hazard ratio [HR] 0.53; 95% CI 0.29 to 0.96). Mortality in the FTC/TDF group was 13.8% (22/160, HR 0.68, 95% CI 0.39 to 1.20) and 14.4% in the COLCH+ROSU group (22/153) (HR 0.78, 95% CI 0.44 to 1.36). A lower need for invasive mechanical ventilation was observed in the FTC/TDF+COLCH+ROSUV group than in the SOC group (risk difference [RD] - 0.08, 95% CI 0.11 to 0.04). Three patients presented severe adverse events, one severe diarrhoea in the COLCH+ROSU and one in the FTC/TDF+COLCH+ROSU group and one general exanthema in the FTC/TDF group. INTERPRETATION: The combined use of FTC/TDF+COLCH+ROSU reduces the risk of 28-day mortality and the need for invasive mechanical ventilation in hospitalized patients with pulmonary compromise from COVID-19. More randomized controlled trials are needed to compare the effectiveness and cost of treatment with this combination versus other drugs that have been shown to reduce mortality from SARS-CoV-2 infection and its usefulness in patients with chronic statin use.

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Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.(AU)

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.(AU)

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Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104 , 1.5× 105 , 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107 , while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

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Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

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Abstract Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

Resumo O Aedes aegypti é um culicida que vem ganhando relevância ao longo dos anos devido à sua capacidade de transmitir diversos vírus causadores de doenças em humanos que ao longo dos anos ocasionam altas taxas de mortalidade na população mundial. O principal problema é que Ae. aegypti tem conseguido estabelecer e manter uma relação próxima com o homem e seu habitat, por isso a busca por alternativas para o controle das populações de vetores torna-se imperativa. O objetivo do presente trabalho foi estudar os efeitos de duas cepas de Beauveria bassiana sobre Ae. aegypti. Larvas de terceiro instar de Ae. aegypti em recipientes plásticos de 250 mL foram inoculados com as cepas GHA e NB3 em diferentes concentrações (1.5 × 104, 1.5 × 105, 1.5 × 106 e 1.5 × 107 conídios/mL). A cepa NB3 apresentou os maiores valores de mortalidade com 63% na concentração mais alta, ou seja, 1.5 × 107, enquanto para a cepa GHA o maior valor de mortalidade foi 30.7% na mesma concentração. Os resultados mostraram diferença significativa na mortalidade com relação à cepa e dias pós-tratamento (P = 0.0001), mas não com relação à concentração de conídios (P = 0.634). A mortalidade média de larvas por dia para o NB3 para diferentes concentrações variou de 20 a 25 larvas por dia, enquanto para o GHA a mortalidade diária variou de 5 a 12 larvas. Na mortalidade pós-tratamento, a maior mortalidade foi registrada nas larvas de terceiro estágio para o NB3, enquanto para o GHA o maior percentual de mortalidade foi observado em indivíduos que conseguiram atingir o estado adulto. Os resultados da pesquisa atual retratam o papel notável de B. bassiana no manejo de um importante vetor de doenças humanas.

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Introducción: El método de referencia para diagnosticar el síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) es la polisomnografía, esta no es diagnóstica en otros trastornos respiratorios del sueño, por lo que es necesario la implementación de puntajes predictivos para diferenciar aquellos pacientes que tienen más riesgos de padecer SAHOS y necesiten de una polisomnografía. El objetivo de este estudio fue validar el puntaje NoSAS y la escala de Berlín frente a la polisomnografía tipo 1 en pacientes con sospecha de SAHOS. Materiales y métodos: Estudio de pruebas diagnósticas. A 264 pacientes se les realizó una polisomnografía basal, la aplicación del puntaje NoSAS y la escala de Berlín; luego, se hizo el análisis de las pruebas diagnósticas y se calculó el rendimiento de cada una en relación con el índice de apnea hipopnea (IAH). Resultados: La sensibilidad del puntaje NoSAS para un IAH ≥ 20 fue 88,57% con intervalo de confianza (IC) 95% 80,4-96,74; especificidad 56,70 %; IC 95% 49,47-63,93 y valor predictivo negativo (VPN) de 93,22, IC 95% 91,70- 99,82. Para la escala de Berlín, la sensibilidad fue de 81,43%, IC 95% 71,60-91,25; especificidad de 58,76%, IC 95% 51,58-65,95 y VPN 89,76%, IC 95% 89,08-98,32. Conclusión: Se demostró que el puntaje NoSAS y la escala de Berlín tienen una buena sensibilidad para descartar a las personas con un menor riesgo de SAHOS. Un paciente clasificado de bajo riesgo probablemente está sano o tiene bajo riesgo para SAHOS moderado a severo y no requeriría de una polisomnografía inicial.

Introduction: The gold standard for diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS) is the polysomnography, and it is not a diagnostic tool for another sleep breathing disorders, so that it is necessary to implement predictive scores to differentiate those patients who have more risk of suffering OSAHS, therefore they need a polysomnography. The aim to this study was to validate the NoSAS score and Berlin scale in relation to the polysomnography type 1, in patients who have the clinical suspicion of OSAHS. Material and methods: Diagnostic tests study. 264 patients underwent polysomnography, and the NoSAS score and Berlin scale were applied to them. After that, the diagnostic tests analysis was done and the performance of each one of them was calculated in relation to the apnea- hypopnea index (AHI). Results: The sensitivity of the NoSAS score for an AHI ≥ 20 was 88.57%, confidence interval (CI) 95% (80.4-96.74), specificity 56.70 %, CI 95% (49.47-63.93), and the negative predictive value (NPV) was 93.22, CI 95% (91.70-99.82). For Berlin scale the sensitivity was 81.43%, CI 95% (71.60-91.25), specificity 58.76%, CI 95% (51.58-65.95) and NPV 89.76%, CI 95% (89.08-98.32). Conclusions: It was shown that NoSAS score and Berlin scale have a good sensitivity to rule out people who have less OSAHS risk. A patient classified as low risk, probably is healthy or at low risk for moderate to severe OSAHS and would not require an initial polysomnography.

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Introducción: los pacientes críticos, bajo sedación y apoyo ventilatorio invasivo presentan dolor, la barrera más grande para su detección es la incapacidad de comunicarse; sin embargo, el hecho de que el paciente no pueda referir su dolor, no significa que no lo padezca. Objetivo: describir las respuestas conductuales al dolor durante el cambio postural en pacientes sedados oro intubados. Material y métodos: estudio cuantitativo, descriptivo, observacional, longitudinal. Muestra n= 50 pacientes, se utilizó la escala BPS (Behavioral Pain Scale) como instrumento de valoración del dolor, se midió en tres momentos: 1 minuto antes, durante y 10 minutos después del cambio postural. Resultados: el cambio postural del paciente con sedación y ventilación mecánica provocó dolor en 56% de los pacientes; antes de realizar el cambio postural se identificó una media del dolor de 4.6, durante el cambio postural aumento a 6.5 y posterior al cambio disminuyo a una media de 4, siendo un factor protector. Conclusiones: la movilización del paciente sedado oro intubado requiere de la participación del equipo multidisciplinar, para el manejo de la ventilación mecánica, el cuidado de sondas y catéteres, cuidados de la piel, prevención de caídas y aplicación correcta de la técnica de movilización, la cual demanda experiencia clínica del personal que participa en la valoración y manejo de las respuestas conductuales al dolor.

Introduction: critical patients, under sedation and invasive ventilatory support present pain, the greatest barrier to its detection is the inability to communicate, however, the fact that the patient cannot report their pain does not mean that they do not suffer from it. Objective: to describe the behavioral responses to pain during postural change in sedated or intubated patients. Material and Methods: quantitative, descriptive, observational, longitudinal study. Sample n = 50 patients, the BPS scale (Behavioral Pain Scale) was used as an instrument for assessing pain, it was measured at three moments: 1 minute before, during and 10 minutes after the postural change. Results: the postural change of the patient with sedation and mechanical ventilation caused unacceptable pain in 56% of the patients; Before making the postural change, a mean pain of 4.6 was identified, during the postural change it increased to 6.5 and after the change it decreased to a mean of 4, being a protective factor. Conclusions: the mobilization of the sedated or intubated patient requires the participation of the multidisciplinary team, for the management of mechanical ventilation, care of tubes and catheters, skin care, prevention of falls and correct application of the mobilization technique, which It demands clinical experience from the personnel involved in the assessment and management of behavioral responses to pain.

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Aedes aegypti is a culicide that has gained relevance over the years due to its ability to transmit various viruses that cause diseases in humans that all the years cause high mortality rates in the world population. The main problem is that Ae. aegypti has managed to establish and maintain a close relationship with humans and their habitat, which is why the search for alternatives to control vector populations becomes imperative. The objective of the present work was to study the effects of two Beauveria bassiana strains on Aedes aegypti. Third instar larvae of Ae. aegypti in 250 mL plastic containers were inoculated with the GHA and NB3 strains at different concentrations (1.5 × 104, 1.5× 105, 1.5 × 106 and 1.5 × 107 conidia/mL). The NB3 strain presented highest mortality values ​​with 63% in the highest concentration i.e., 1.5 × 107, while for the GHA strain the highest mortality value was 30.7% at the same concentration. The results showed significant difference in mortality with respect to the strain and days post treatment (P = 0.0001), but not with respect to the conidial concentration (P = 0.634). The average mortality of larvae per day for the NB3 for different concentrations ranged from 20 to 25 larvae per day, while for the GHA daily mortality ranged from 5 to 12 larvae. In post-treatment mortality, the highest mortality was recorded in the third stage larvae for the NB3, while for GHA the highest percentage mortality was observed in individuals who managed to reach the adult state. The findings of the current research depicted the noteworthy role of B. bassiana for the management of an important vector of human disease.

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Nifurtimox (NF) is one of the only two drugs currently available for Chagas disease (ChD) treatment. However, data on NF safety are scarce, and many physicians defer or refuse NF treatment because of concerns about drug tolerance. In a retrospective study of adverse drug reactions (ADRs) associated with NF treatment of ChD, children received NF doses of 10 to 15 mg/kg/day for 60 to 90 days, and adults received 8 to 10 mg/kg/day for 30 days. A total of 215 children (median age, 2.6 years; range, 0 to 17 years) and 105 adults (median age, 34 years; range, 18 to 57 years) were enrolled. Overall, 127/320 (39.7%) patients developed ADRs, with an incidence of 64/105 adults and 63/215 children (odds ratio [OR] = 3.7; 95% confidence interval [CI], 2.2 to 6.3). We observed 215 ADRs, 131 in adults (median, 2 events/patient; interquartile range for the 25th to 75th percentiles [IQR25-75], 1 to 3) and 84 in children (median, 1 event/patient; IQR25-75 = 1 to 1.5) (Padjusted < 0.001). ADRs were mainly mild and moderate. Severe ADRs were infrequent (1.2% in children and 0.9% in adults). Nutritional, central nervous, and digestive systems were the most frequently affected, without differences between groups. Treatment was discontinued in 31/320 (9.7%) patients without differences between groups. However, ADR-related discontinuations occurred more frequently in adults than in children (OR = 5.5, 95% CI = 1.5 to 24). Our study supports the safety of NF for ChD treatment. Delaying NF treatment due to safety concerns does not seem to be supported by the evidence. (This study has been registered in ClinicalTrials.gov under identifier NCT04274101.).

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AIM: The focus of the present study was to evaluate the copper ions treatment on the viability of Mycobacterium avium subsp. paratuberculosis (MAP) and other bacterial communities in cow's milk. METHODS AND RESULTS: A copper ions treatment was evaluated in naturally contaminated cow's milk to assay MAP load and/or viability, and relative abundance of other bacterial communities. In addition, physical-chemical analyses of the milk were also performed. All analyses were carried out before and after a copper ions treatment. After copper ions treatment, pH and copper concentration markedly increased in milk; the numbers of viable MAP significantly decreased. The relative abundance of the four target phyla decreased, with the phyla Bacteroidetes and Firmicutes surviving treatment in higher proportions (4 and 2·1% of original populations, respectively). A progressively higher percentage of dead bacterial cells after 5 and 20 min copper ions treatments was found (12 and 35%, respectively). CONCLUSION: With the exception of some MAP-tolerant strains, we have once again demonstrated that copper ions have a significant inactivating effect on MAP as well as certain other bacterial communities found in naturally contaminated cow's milk. SIGNIFICANCE AND IMPACT OF THE STUDY: This study showed a significant inactivation of both MAP and other bacteria by copper ions in raw cow's milk, information that could be useful as a tool for MAP control.

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Multifunctional biocompatible materials have evoked considerable interest in the field of medical applications. Here we report the thermal decomposition preparation of homogeneous fluorescent-magnetic particles with a composite structure containing CoFe2O4 nanoparticles as nucleation seeds for fluorescent Gd2-xO3:Eux. The composite exhibited a wide range of fluorescence transitions in the whole visible spectrum, displaying 18 different emission peaks when excited at a 250 nm wavelength. Moreover, at low temperature the peaks of the composite were wider than the peaks of the fluorescent material, which may be attributed to a set of new energy levels due to a combination of Stark splitting with the magnetic field of CoFe2O4. Because this material is intended to be used for biomedical applications, the potential toxicity of the composite was tested using an invertebrate hemocyte cell model. The cells showed slight morphological and biochemical changes upon exposure to the composite; however, there was no increase in cell death at concentrations of up to 40 ppm. In addition, the material could be tracked by its fluorescence inside the cells, when excited at a more bio-friendly and less energetic wavelength of 405 nm. Furthermore, MRI showed T1 and T2 dual contrast with relaxivity values in the range of most reported materials.

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Introducción: El síndrome de Meigs consiste en la asociación de tumor benigno de ovario tipo fibroma con ascitis e hidrotórax, que se resuelven tras la extirpación del tumor. El síndrome de pseudo-Meigs secundario al leiomioma uterino es una entidad rara. Presentación de caso: Mujer de 68 años que presentó una historia de un mes con sensación de opresión torácica y disnea. La radiografía de tórax reveló derrame pleural derecho. En la tomografía axial computarizada de abdomen y región pelviana se aprecia ascitis y un gran mioma uterino subseroso. Se sometió a una histerectomía abdominal total con salpingo-ooforectomía bilateral. Conclusiones: La ascitis y el derrame pleural desaparecieron rápidamente en el postoperatorio. Tras 20 meses de seguimiento, no hay recidiva de la enfermedad(AU)

Introduction: Meigs syndrome consists of the association of a benign tumor of the ovary "fibroma type" with ascites and hydrothorax, which resolve after the tumor is removed. The pseudo-Meigs syndrome secondary to uterine leiomyoma is a rare entity. Case report: A 68-year-old woman refered having a month with a sensation of chest tightness and dyspnea. Chest X-ray revealed right pleural effusion. Computed axial tomography of the abdomen and pelvic region shows ascites and a large subserous uterine myoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Conclusions: Ascites and pleural effusion disappeared rapidly in the postoperative period. After 20 months of follow-up, there is no recurrence(AU)

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OBJECTIVE: The presence of anti-citrullinated protein antibodies (ACPAs) in primary Sjögren's syndrome (pSS) ranges from 3% to 9.9%; however, there is no agreement about their clinical significance. Our aim was to systematically review the literature regarding the association of arthritis and ACPAs in pSS and their role in the development of rheumatoid arthritis (RA). METHOD: A comprehensive search of MEDLINE, ISI Web of Knowledge, and Cochrane Library from inception until June 2016 was undertaken using the combination of two or three of the keywords: primary Sjögren's syndrome, Sjögren's syndrome, arthritis, synovitis, arthropathy, anti-cyclic citrullinated peptide antibodies, and anti-citrullinated protein antibody - ACPA. No language restriction was used. Studies were included if they: assessed the association of arthritis and ACPAs, had sufficient data to construct a two-by-two table, tested immunoglobulin G ACPA by any method, and included patients with pSS according to a validated set of classification criteria. We used a random effects model and evaluated the heterogeneity and publication bias. RESULTS: Ten studies were included (involving 1322 patients). We found a pooled odds ratio of 4.42 (95% confidence interval 1.15-16.94, p = 0.03). The test for heterogeneity was I2 = 0.87. Publication bias was not observed. Based on data from three studies, 33 of 58 pSS patients with ACPAs (57%) developed RA compared with none of 598 pSS patients with negative ACPA (p < 0.000001). CONCLUSION: Patients with pSS disclosing ACPAs are prone to arthritis as part of the clinical spectrum of the disease, but are also at risk of developing RA.

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