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The assessment of constructed wetlands (CWs) has gained interest in the last 20 years for wastewater treatment in Latin American regions. However, the effects of culture systems with different ornamental species in CWs for phytoremediation are little known. In this study, some chemical parameters such as total suspended solids (TSS), chemical oxygen demand (COD), phosphate (PO4-P), and ammonium (NH4-N) were analyzed in order to prove the removal of pollutants by phytoremediation in CWs. The environmental impact index based on eutrophication reduction (EI-E) was also calculated to estimate the cause-effect relationship using CWs in different culture conditions. C. hybrids and Dieffenbachia seguine were used in monoculture and polyculture (both species mixed) mesocosm CWs. One hundred eighty days of the study showed that CWs with plants in monoculture/polyculture conditions removed significant amounts of organic matter (TSS and COD) (p > 0.05; 40-55% TSS and 80-90% COD). Nitrogen and phosphorous compounds were significantly lower in the monoculture of D. seguine (p < 0.05) than in monocultures of C. hybrids, and polyculture systems. EI-E indicator was inversely proportional to the phosphorous removed, showing a smaller environmental impact with the polyculture systems (0.006 kg PO43- eq removed) than monocultures, identifying the influence of polyculture systems on the potential environmental impacts compared with the phytoremediation function in monocultures (0.011-0.014 kg PO43- eq removed). Future research is required to determine other types of categories of environmental impact index and compare them with other wastewater treatment systems and plants. Phytoremediation with the ornamental plants studied in CWs is a good option for wastewater treatment using a plant-based cleanup technology.

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BACKGROUND: Health care-associated infections (HAIs) are a common cause of morbidity and mortality. There is little information on the risk factors associated with HAI in surgical newborns. OBJECTIVE: To identify the risk factors associated with healthcare-associated infections in surgical newborns. METHODS: Nested case-control study carried out during 2016-2017. Cases were newborns with healthcare-associated infections and controls were newborns without infection. Perinatal characteristics, use of antimicrobial prophylaxis, use of central venous catheter (CVC), mechanical ventilation, parenteral nutrition, age, and weight at the time of surgery, type of surgery, surgical wound classification, duration of surgery, number of surgical procedures, postsurgical HAIs and type of infection were registered. Univariate and multivariate analyses were performed. RESULTS: Seventy-one cases and 142 controls were included. The most frequent HAI was bloodstream infection (36.6%); the main microorganisms isolated in blood cultures were gram-positive cocci. Independent risk factors associated with HAIs in the multivariate analysis were CVC duration > 8 days (aOR = 17.2, 95% CI = 3.8-49.1), ≥ 2 surgeries (aOR = 16.5, 95% CI 5.8 -42.1) and abdominal surgery (aOR = 2.6, 95% CI = 1.2-6.6). CONCLUSION: Newborns undergoing surgery, mainly those with risk factors, require close monitoring during the postoperative period. CVC should be withdrawn as soon as possible.

ANTECEDENTES: Las infecciones asociadas a la atención de la salud (IAAS) son causa frecuente de morbilidad y mortalidad. OBJETIVO: Identificar los factores de riesgo para el desarrollo de IAAS en recién nacidos (RN) sometidos a cirugía. MATERIAL Y MÉTODOS: Estudio de casos y controles anidado en una cohorte. Los casos fueron RN sometidos a cirugía, con IAAS y los controles, RN sometidos a cirugía sin IAAS. Se registraron datos perinatales, uso de profilaxis antimicrobiana, de catéter venoso central (CVC), ventilación mecánica, nutrición parenteral y sondas; edad y peso al momento de la cirugía, tipo de cirugía, clasificación de la herida quirúrgica, duración de la cirugía, número de procedimientos quirúrgicos y tipo de infección. Se realizó análisis univariado y multivariado. RESULTADOS: Se incluyeron 71 casos y 142 controles. Las IAAS más frecuentes fueron las infecciones sanguíneas (36.6 %); los principales microorganismos aislados en hemocultivos fueron cocos grampositivos. Los factores de riesgo asociados a IAAS en el análisis multivariado fueron duración del CVC > 8 días (RMa = 17.2), ≥ 2 intervenciones quirúrgicas (RMa = 16.5) y cirugía abdominal (RMa = 2.6). CONCLUSIONES: Los RN sometidos a cirugía, principalmente aquellos con factores de riesgo, requieren vigilancia estrecha durante el posoperatorio. El CVC debe ser retirado tan pronto sea posible.

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Resumen Antecedentes: Las infecciones asociadas a la atención de la salud (IAAS) son causa frecuente de morbilidad y mortalidad. Objetivo: Identificar los factores de riesgo para el desarrollo de IAAS en recién nacidos (RN) sometidos a cirugía. Material y métodos: Estudio de casos y controles anidado en una cohorte. Los casos fueron RN sometidos a cirugía, con IAAS y los controles, RN sometidos a cirugía sin IAAS. Se registraron datos perinatales, uso de profilaxis antimicrobiana, de catéter venoso central (CVC), ventilación mecánica, nutrición parenteral y sondas; edad y peso al momento de la cirugía, tipo de cirugía, clasificación de la herida quirúrgica, duración de la cirugía, número de procedimientos quirúrgicos y tipo de infección. Se realizó análisis univariado y multivariado. Resultados: Se incluyeron 71 casos y 142 controles. Las IAAS más frecuentes fueron las infecciones sanguíneas (36.6 %); los principales microorganismos aislados en hemocultivos fueron cocos grampositivos. Los factores de riesgo asociados a IAAS en el análisis multivariado fueron duración del CVC > 8 días (RMa = 17.2), ≥ 2 intervenciones quirúrgicas (RMa = 16.5) y cirugía abdominal (RMa = 2.6). Conclusiones: Los RN sometidos a cirugía, principalmente aquellos con factores de riesgo, requieren vigilancia estrecha durante el posoperatorio. El CVC debe ser retirado tan pronto sea posible.

Abstract Background: Healthcare-associated infections (HAIs) are a common cause of morbidity and mortality. Objective: To identify the risk factors for the development of HAIs in newborns (NBs) undergoing surgery. Material and methods: Nested case-control study. Cases were NBs undergoing surgery with HAIs, while controls were NBs undergoing surgery with no HAIs. Perinatal data, use of antimicrobial prophylaxis, use of central venous catheter (CVC), mechanical ventilation, parenteral nutrition, and other medical devices were recorded, as well as age and weight at the time of surgery, type of surgery, surgical wound classification, duration of surgery, number of surgical procedures, and type of infection. Univariate and multivariate analyses were performed. Results: Seventy-one cases and 142 controls were included. The most frequent HAI was bloodstream infection (36.6%); the main microorganisms isolated in blood cultures were gram-positive cocci. The risk factors associated with HAIs in the multivariate analysis were CVC duration > 8 days (aOR = 17.2), ≥ 2 surgical interventions (aOR = 16.5) and abdominal surgery (aOR = 2.6). Conclusions: NBs undergoing surgery, mainly those with risk factors, require close monitoring during the postoperative period. CVC should be withdrawn as soon as possible.

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INTRODUCTION: Neonates with congenital heart disease can develop neurological problems, which is why it is important to know the time and extent at which these lesions occur in order to elucidate their causes and implications. OBJECTIVE: To describe brain morphological alterations in autopsies of neonates with congenital heart disease. METHODS: The cases of neonates with congenital heart disease and complete autopsy registered in the pathology department from 2009 to 2019 were included. Descriptive statistics were used with the calculation of frequencies and percentages. RESULTS: Of a total of 21 patients, 61.9% were full-term males; median weight and age at admission were 2500 g and five days, respectively; mean hospital stay was seven days. The predominant heart disease was aortic arch pathology. Fifteen patients (71.3%) underwent surgery; 50% died of cardiogenic shock, 100% had hypoxic-ischemic brain lesions, 71% had incipient lesions, and 33.3%, parenchymal hemorrhage. CONCLUSIONS: There are various risk factors for neurological damage in patients with complex congenital heart disease, which is impossible to be entirely controlled. This study allows us to know, for the first time in our milieu, the changes in the central nervous system that could exist in these patients.

INTRODUCCIÓN: Los neonatos con cardiopatía congénita pueden desarrollar problemas neurológicos, por lo que es importante conocer el momento en el que ocurren dichas lesiones y su extensión, para dilucidar sus causas e implicaciones. OBJETIVO: Describir las alteraciones morfológicas cerebrales en autopsias de neonatos con cardiopatía congénita. MÉTODOS: Se incluyeron los casos de neonatos con cardiopatía congénita y autopsia completa registrados en un servicio de patología, de 2009 a 2019. Se utilizó estadística descriptiva con el cálculo de frecuencias y porcentajes. RESULTADOS: De 21 pacientes, 61.9 % fue a término del sexo masculino; las medianas del peso y edad al ingreso fueron 2500 g y cinco días, respectivamente; la media de la estancia hospitalaria fue siete días. La cardiopatía predominante fue la patología de arco aórtico. Quince pacientes (71.3 %) fueron sometidos a cirugía; 50 % falleció por choque cardiogénico, 100 % presentó lesiones hipóxico-isquémicas cerebrales; 71 %, lesiones incipientes; 33.3 %, hemorragia parenquimatosa. CONCLUSIONES: Existen diversos factores de riesgo para daño neurológico en los pacientes con cardiopatía congénita compleja, los cuales es imposible controlar en su totalidad. Este estudio permite conocer, por primera vez en nuestro medio, los cambios en el sistema nervioso central que podrían existir en estos pacientes.

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Resumen Introducción: Los neonatos con cardiopatía congénita pueden desarrollar problemas neurológicos, por lo que es importante conocer el momento en el que ocurren dichas lesiones y su extensión, para dilucidar sus causas e implicaciones. Objetivo: Describir las alteraciones morfológicas cerebrales en autopsias de neonatos con cardiopatía congénita. Métodos: Se incluyeron los casos de neonatos con cardiopatía congénita y autopsia completa registrados en un servicio de patología, de 2009 a 2019. Se utilizó estadística descriptiva con el cálculo de frecuencias y porcentajes. Resultados: De 21 pacientes, 61.9 % fue a término del sexo masculino; las medianas del peso y edad al ingreso fueron 2500 g y cinco días, respectivamente; la media de la estancia hospitalaria fue siete días. La cardiopatía predominante fue la patología de arco aórtico. Quince pacientes (71.3 %) fueron sometidos a cirugía; 50 % falleció por choque cardiogénico, 100 % presentó lesiones hipóxico-isquémicas cerebrales; 71 %, lesiones incipientes; 33.3 %, hemorragia parenquimatosa. Conclusiones: Existen diversos factores de riesgo para daño neurológico en los pacientes con cardiopatía congénita compleja, los cuales es imposible controlar en su totalidad. Este estudio permite conocer, por primera vez en nuestro medio, los cambios en el sistema nervioso central que podrían existir en estos pacientes.

Abstract Introduction: Neonates with congenital heart disease can develop neurological problems, which is why it is important to know the time and extent at which these lesions occur in order to elucidate their causes and implications. Objective: To describe brain morphological alterations in autopsies of neonates with congenital heart disease. Methods: The cases of neonates with congenital heart disease and complete autopsy registered in a pathology department from 2009 to 2019 were included. Descriptive statistics were used with the calculation of frequencies and percentages. Results: Of a total of 21 patients, 61.9% were full-term males; median weight and age at admission were 2500 g and five days, respectively; mean hospital stay was seven days. The predominant heart disease was aortic arch pathology. Fifteen patients (71.3%) underwent surgery; 50% died of cardiogenic shock, 100% had hypoxic-ischemic brain lesions, 71% had incipient lesions, and 33.3%, parenchymal hemorrhage. Conclusions: There are various risk factors for neurological damage in patients with complex congenital heart disease, which is impossible to be entirely controlled. This study allows us to know, for the first time in our milieu, the changes in the central nervous system that could exist in these patients.

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Introducción: La vulnerabilidad cardiometabólica por adiposidad corporal puede ser un indicador de utilidad durante el embarazo y después del parto, en la prevención de eventos cardiovasculares. Objetivo: Describir posibles asociaciones de la vulnerabilidad cardiometabólica por adiposidad corporal con cambios de la presión arterial en el posparto a corto plazo. Métodos: Se realizó un estudio observacional descriptivo transversal en el período enero 2017-agosto 2018, en 119 mujeres pertenecientes al policlínico Chiqui Gómez Lubián. Se aplicó la prueba de peso sostenido, se determinó la media y desviación estándar de la presión arterial sistólica, diastólica y media calculada; en reposo y dos minutos después de la primera medición. Se analizaron los cambios cuantitativos de la presión arterial en reposo y con estimulación física posterior, según vulnerabilidad cardiometabólica por adiposidad corporal, 18 meses después del parto. Se clasificaron las mujeres en tres grupos según su respuesta vascular ante la estimulación física, evaluada por los cambios de la presión arterial: normorreactivas, hiperreactivas y con respuesta hipertensiva. Se aplicó la prueba de Kruskal-Wallis para la comparación de muestras independientes. Resultados: Incremento de los valores medios de presión arterial en mujeres con VGlobal Extrema AGA/CA (PAD, PAS_2min, PAD_2min y PAM-2min) y con VAGI (TAS Y TAM). De las mujeres con respuesta hiperreactiva, 36,4 por ciento tenía VAGI y el 45,5 por ciento con VAGA. El único caso con respuesta hipertensiva tenía VGlobal Extrema AGA/CA. Conclusiones: La caracterización temprana de la vulnerabilidad cardiometabólica por adiposidad corporal puede alertar sobre cambios en la reactividad vascular la cual conduce a eventos cardiovasculares posteriores(AU)

Introduction: Cardiometabolic vulnerability due to body fat can be a useful indicator during pregnancy and after delivery, in the prevention of cardiovascular events. Objective: To describe possible associations of cardiometabolic vulnerability due to body adiposity with changes in blood pressure in the short-term postpartum. Methods: A cross-sectional descriptive observational study was carried out from January 2017 to August 2018, in 119 women at Chiqui Gómez Lubián community clinic. The sustained weight test was applied, the mean and standard deviation of the calculated systolic, diastolic and mean arterial pressure were determined at rest and two minutes after the first reading. The quantitative changes in blood pressure at rest and with subsequent physical stimulation were analyzed, according to cardiometabolic vulnerability due to body fat, 18 months after delivery. These women were classified into three groups according to their vascular response to physical stimulation, evaluated by changes in blood pressure: normoreactive, hyperreactive and with a hypertensive response. The Kruskal-Wallis test was applied for the comparison of independent samples. Results: Increase in mean blood pressure values in women with VGlobal Extrema AGA / CA (DBP, PAS_2min, DBP_2min and MAP-2min) and with VAGI (TAS and TAM). 36.4 percent of the women with a hyperreactive response, had VAGI and 45.5 percent had VAGA. The only case with a hypertensive response had VGlobal Extrema AGA / CA. Conclusions: The early characterization of cardiometabolic vulnerability due to body adiposity can alert about changes in vascular reactivity which leads to later cardiovascular events(AU)

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RESUMEN Introducción: La terapia con ondas de choque extracorpórea de baja intensidad ha demostrado ser útil en el tratamiento de los pacientes con angina de pecho refractaria. Objetivo: Valorar los resultados de este tipo de terapia en pacientes con angina refractaria al tratamiento farmacológico. Método: Se realizó un estudio cuasiexperimental en 30 pacientes con angina de pecho refractaria a tratamiento, seleccionados de forma no probabilística a partir de los criterios de inclusión. A todos los pacientes se les aplicó terapia con ondas de choque extracorpórea de baja intensidad en el Cardiocentro Ernesto Guevara de Santa Clara, en el período comprendido de enero a diciembre de 2017. Se analizaron variables epidemiológicas, clínicas y ecocardiográficas al inicio del tratamiento y 6 meses después de concluido este. Resultados: Los resultados obtenidos demostraron una mejoría de la clase funcional (CF) de la Canadian Cardiovascular Society (CCS). Previo al tratamiento el 76,7% de los pacientes tenían una CF III y un 23,3% una CF IV, y a los 6 meses de concluida la terapia el 73,3% mejoró a la CF II y solo un 26,7% quedó en CF III. También se evidenció mejoría con respecto a parámetros ecocardiográficos como la motilidad regional y la fracción de eyección del ventrículo izquierdo, la cual, en los hombres, de una media al inicio de la terapia de un 37,81% alcanzó 44,14% a los 6 meses de concluida; y en las mujeres, de una media de 37,11% inicial llegó a 47,22% a los 6 meses después. Conclusiones: El tratamiento con ondas de choque constituye una alterativa terapéutica para los pacientes con angina refractaria.

ABSTRACT Introduction: Low intensity extracorporeal shock wave therapy has proven useful in the treatment of patients with refractory angina pectoris. Objective: To assess the results of this type of therapy in patients with refractory angina to drug treatment. Method: A quasi-experimental study was carried out in 30 patients with refractory angina pectoris to treatment, selected in a non-probabilistic way, taking into account the following inclusion criteria. All patients were applied low intensity extracorporeal shock wave therapy in the Cardiocentro Ernesto Guevara of Santa Clara, in the period from January to December 2017. Epidemiological, clinical and echocardiographic variables were analyzed at the beginning of the treatment and six months after it was completed. Results: The results obtained demonstrated an improvement of the functional class (FC) of the Canadian Cardiovascular Society (CCS). Previous to treatment, 76.7% of patients had a FC III and 23.3% a FC IV, and after six months of completed therapy, 73.3% improved to FC II and only 26.7 % remained in FC III. There was also an improvement with respect to echocardiographic parameters such as regional motility and left ventricular ejection fraction, which, in men, of an average at the start of therapy of 37.81% it reached 44.14% at six months of completed; and in women, of an average of 37.11% initially, it reached 47.22 % six months later. Conclusions: The treatment with shock waves represents a therapeutic alternative for patients with refractory angina.

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Rhizoctonia foliar blight, caused by Rhizoctonia solani, is an important disease of Brachiaria spp. in tropical America. Host-plant resistance is an attractive option for disease management. In this study, we evaluated three inoculum types (mycelium-infected agar disc, microdiscs suspensions, and microencapsulated-mycelium suspensions) in order to identify a rapid and accurate method for mass screening of Brachiaria genotypes for resistance to Rhizoctonia spp. in greenhouse trials. Visual damage score, area under the disease progress curve, and percent chlorophyll loss were estimated to determine the most accurate and precise method for evaluating Rhizoctonia resistance. The microencapsulated-mycelium solution (0.75 g/ml in potato dextrose broth sprayed on plants 30 days after planting) caused greater foliar damage than the other inoculum types and allowed effective discrimination between resistant and susceptible genotypes. The effectiveness of spray-applied, microencapsulated-mycelium was further corroborated by the evaluation of 350 genotypes not previously selected for resistance to Rhizoctonia spp., which varied significantly in their reaction to R. solani. The microencapsulated-mycelium methodology has several advantages over existing methods, including its high-throughput capacity, efficient use of time and space, ease of quantification of inoculum, and consistent results over replicate trials. This methodology could be applied to assess resistance to Rhizoctonia spp. in other crops.

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The Dipteran Prodiplosis longifila is a severe pest, mainly of Solanaceae, in South America and some years ago it damaged Tahiti lime crops in the United States. It is a potential invasive pest. Despite its presence in Colombia, nothing is known regarding the taxonomic identification of P. longifila or the characteristics of the damage it produces. Moreover, the current and potential distributions of this pest are unknown. To determine these factors, P. longifila was sampled in several Solanaceae- and Citrus (x) latifolia (Tahiti lime)-producing areas in Colombia. The larvae consumed tender foliage, flowers and fruits in tomato, fruits in sweet pepper, and buds in Tahiti lime. P. longifila was not found in asparagus or in potatoes. Its presence in Tahiti lime was previously unknown in Colombia. Adults recovered in the laboratory were taxonomically identified using male morphological characteristics such as the shapes of the genitalia, antenna and wing. P. longifila was found in the Andean region of Colombia. The ecological niche model for populations found in tomato suggests that P. longifila is limited in its distribution by altitude and variables associated with temperature and precipitation. The highest probability of occurrence is in areas where tomato, sweet pepper and the new host, Tahiti lime, are grown. Therefore, it is necessary to implement preventive measures, such as planting tomato materials free of P. longifila larvae, in areas where the pest is not yet present but where there is the potential for its development.

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Se presenta una paciente de 21 años de edad recibida en el Centro de Urgencias del Instituto Superior de Medicina Militar Dr Luis Díaz Soto por presentar un cuadro clínico de hemorragia subaracnoidea durante la semana 30,4 de su embarazo. En los estudios realizados se detectó la presencia de 2 aneurismas cerebrales, uno en cada arteria oftálmica, localizados ambos por debajo de la clinoide correspondiente. Se expone la conducta médica y quirúrgica efectuada. La paciente evolucionó satisfactoriamente

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