ABSTRACT Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound. causes treatment procedures radiofrequency complications 54yearold yearold 54 year old 2060 20 60 20/60 capsule 2020 20/20 5 206 2 6 20/6 202 20/2 20/

RESUMO: O estudo foi realizado em um ovino, fêmea, de três anos de idade, da raça santa inês, procedente de uma propriedade localizada do município de Santo Antônio de Tauá, oeste do Pará. O animal acometido tinha histórico de exoftalmia no olho esquerdo, secreção nasal e dificuldade respiratória há mais de três meses. Ao exame físico o animal apresentava baixo escore corporal, apatia, assimetria facial unilateral, moderada exoftalmia unilateral esquerda, dispneia mista e exsudação nasal serossanguinolenta profusa unilateral. À necropsia, foi observada grande massa nasal, predominantemente branco-amarelada com áreas vermelho enegrecidas, de superfície irregular, finamente granular, úmida e friável. A massa invadia desde a junção mucocutânea do nariz esquerdo até as coanas, se infiltrava pelos seios nasais frontais, placa cribiforme e alcançava as meninges e a porção frontal do cérebro. À microscopia da superfície do epitélio nasal notou-se severa destruição dos cornetos e dos epitélios, evidenciada por extensas áreas de necrose com muitos debris celulares, ulceração e infecção bacteriana secundária. No sistema nervoso central (SNC) havia meningite piogranulomatosa com acentuada congestão de vasos, focos de necrose e inflamação granulomatosa. O diagnóstico de rinite granulomatosa de origem micótica associada ao fungo Conidiobolus lamprauges foi baseado nos achados da imuno-histoquímica. RESUMO ovino fêmea idade inês Tauá Pará meses corporal apatia esquerda necropsia brancoamarelada branco amarelada enegrecidas irregular granular friável coanas frontais cérebro notouse notou epitélios celulares secundária SNC (SNC vasos imunohistoquímica. imunohistoquímica imuno histoquímica. histoquímica imuno-histoquímica

ABSTRACT: The study was conducted on a 3-year-old female Santa Inês sheep from a property located in the municipality of Santo Antônio de Tauá, west of Pará. The affected animal had a history of exophthalmos in the left eye, nasal discharge, and breathing difficulty for more than three months. On physical examination, the animal had a low body score, apathy, unilateral facial asymmetry, moderate unilateral left exophthalmos, mixed dyspnea and unilateral profuse serosanguinous nasal discharge. At necropsy, a large nasal mass was observed, predominantly yellowish-white with blackish-red areas, with an irregular, finely granular, moist, and friable surface. The mass invaded from the mucocutaneous junction of the left nostril to the choanae, infiltrated the frontal sinuses, the cribiform plate, and reached the meninges and the frontal portion of the brain. Microscopy of the surface of the nasal epithelium showed severe destruction of the turbinates and epithelia, evidenced by extensive areas of necrosis with a large amount of cellular debris, ulceration, and secondary bacterial infection. In the central nervous system there was pyogranulomatous meningitis with marked vessel congestion, as well as foci of necrosis and granulomatous inflammation. Immunohistochemistry showed intense staining of numerous intralesional hyphae for antibodies against Conidiobolus lamprauges. The diagnosis of granulomatous rhinitis of mycotic origin associated with the Conidiobolus lamprauges was based on epidemiological, clinical-pathological, and immunohistochemical data. ABSTRACT 3yearold yearold 3 year old Tauá Pará eye discharge months examination score apathy asymmetry necropsy observed yellowishwhite yellowish white blackishred blackish red irregular granular moist choanae sinuses plate brain epithelia debris ulceration infection congestion inflammation epidemiological clinicalpathological, clinicalpathological clinical pathological, pathological clinical-pathological data

Abstract Shrimp aquaculture has rapidly expanded in the last decades, representing an important economic activity worldwide; however, infections (bacterial and viral) are one of the biggest challenges in aquaculture activity. Acute Hepatopancreatic Necrosis Disease (AHPND) is a bacterial disease that affects shrimp farm ponds and occurs during the first 30 days after stocking in shrimp ponds, causing mortalities of up to 70 - 100 %. Microbiota has an important role in shrimp aquaculture and disease control. In the present study, pirA and pirB genes were amplified by PCR to confirm AHPND and non-AHPND in shrimp hepatopancreas; samples were sequenced using the MiSeq platform targeting the V3-V4 16S ribosomal (rRNA) hypervariable regions. Results demonstrated a diverse microbiota in the non-AHPND group, mainly composed of phyla Proteobacteria, Firmicutes, and Actinobacteria. Furthermore, Proteobacteria was the dominant phyla in the hepatopancreas infected with AHPND, while Firmicutes tended to decrease. Vibrio was the most abundant at the genus level, prevailing in some genera like Corynebacterium, Weissella, Lactobacillus, Photobacterium, and Geobacillus. Results suggest that AHPND causes dysbiosis in the hepatopancreatic microbiota, and the Firmicutes phylum could require to be restored under such scenario.

Resumen La producción acuícola de camarón se ha expandido rápidamente en las últimas décadas, convirtiéndose en una importante actividad económica a nivel mundial. Sin embargo, algunas infecciones bacterianas y virales son un gran desafío para esta actividad. La Necrosis Hepatopancreática Aguda (AHPND) es una enfermedad bacteriana que afecta a los estanques de granjas camaroneras y se presenta durante los primeros 30 días después de la siembra en estanques de camarones, causando una mortalidad del 70 - 100 %. La microbiota tiene un papel importante en la producción del camarón y el control de enfermedades. En el presente estudio, los genes pirA y pirB fueron amplificados por PCR para confirmar tanto organismos positivos como negativos a AHPND en hepatopáncreas de camarones. Posteriormente se secuenciaron las regiones hipervariables ribosómicas (ARNr) V3-V4 del gen 16S utilizando la plataforma MiSeq. Los resultados demostraron una microbiota diversa en el grupo negativo a AHPND, compuesto principalmente por filos Proteobacteria, Firmicutes y Actinobacteria. Además, Proteobacteria fue el filo dominante en el hepatopáncreas infectado con AHPND, mientras que Firmicutes tendió a disminuir. Vibrio fue el género más abundante, prevaleciendo sobre algunos géneros como Corynebacterium, Weissella, Lactobacillus, Photobacterium y Geobacillus. Los resultados sugieren que la enfermedad de AHPND causa disbiosis en la microbiota hepatopancreática, y el filo Firmicutes podría requerir ser restaurado en dicho escenario.

Resumo: A tromboangeíte obliterante (TAO) é uma doença inflamatória segmentar, não aterosclerótica, que afeta artérias, veias e nervos de pequeno e médio calibre nas extremidades. Fumar é o fator patogênico fundamental. É apresentado o caso clínico de um jovem, tabagista, que apresenta necrose seca da 1ª, 2ª e 3ª falange da mão esquerda. A ultrassonografia Doppler arterial mostra artérias radial e ulnar esquerdas ocluídas. Excluindo outras etiologias, e com achados histopatológicos compatíveis, é feito o diagnóstico de TAO, doença rara, devendo ser suspeitada em pacientes jovens, do sexo masculino, fumantes, com história de claudicação intermitente, úlcera ou gangrena. O diagnóstico é clínico e de exclusão. A cessação do tabagismo é o pilar fundamental do tratamento.

Resumen: La tromboangeítis obliterante (TAO) es una enfermedad inflamatoria segmentaria, no aterosclerótica, que afecta a arterias, venas y nervios de pequeño y mediano calibre de las extremidades. El tabaquismo es el factor patogénico fundamental. Se presenta el caso clínico de un hombre joven, tabaquista, que presenta necrosis seca de 1era, 2da y 3era falange de mano izquierda. Ecografía doppler arterial evidencia arteria radial y cubital izquierda ocluidas. Excluidas otras etiologías, y con hallazgos histopatológicos compatibles, se realiza diagnóstico de TAO, enfermedad poco frecuente, se debe sospechar en pacientes jóvenes, de sexo masculino, tabaquistas, con historia de claudicacion intermitente, úlcera o gangrena. El diagnóstico es clínico y de exclusión. El cese del tabaco es el pilar fundamental del tratamiento.

Abstract: Thromboangiitis obliterans (TAO) is a segmental, non-atherosclerotic inflammatory disease that affects small and medium-sized arteries, veins and nerves of the extremities. Smoking is the main pathogenetic factor. We present the clinical case of a young man, a smoker, who presented dry necrosis of the 1st, 2nd and 3rd phalanx of the left hand. Arterial Doppler ultrasound showed occluded left radial and ulnar arteries. After excluding other etiologies and with compatible histopathological findings, a diagnosis of TAO was made. This disease is rare and should be suspected in young, male, smoker patients with a history of intermittent claudication, ulcer or gangrene. Diagnosis is clinical and by exclusion. Smoking cessation is the cornerstone of treatment.

SUMMARY: Cerebral hemorrhage (CH) presents a significant risk for cognitive decline. Our research aimed to assess the impact of Apricot Kernel Oil (AKO) on cognitive function and inflammatory response in a hemorrhagic stroke model using Wistar rats, and to examine their correlation. Fifty Wistar rats were randomly assigned to five groups: a control group, an AKO supplemented group (receiving 400 mg/kg AKO), a CH group (with induced CH), and CH groups supplemented with 200 and 400 mg/kg AKO, each containing 10 rats. Cognitive function was evaluated using the Y-electric maze test across these groups. Additionally, enzyme-linked immunosorbent assay and real-time PCR were utilized to analyze the protein and gene expression profiles of inflammatory and apoptotic factors in the brain. Compared to the control group, rats in the CH group took longer to master the maze criteria (P<0.05). Moreover, the CH group exhibited significantly increased levels of pro-inflammatory cytokines interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α, and decreased levels of anti-inflammatory cytokines IL-4 and IL-10 compared to the control group (P<0.05). Conversely, rats in the CH+400 mg/kg AKO group showed opposite trends in electrical simulation time, inflammatory factor protein, and gene expression profile (Bcl- 2, BAX, Caspase-3, and p53) compared to the CH group (P<0.05). Our findings suggest that AKO extract may ameliorate cognitive dysfunction following CH in rats, potentially through modulation of inflammatory factors secreted by microglia.

RESUMEN: La hemorragia cerebral (HC) presenta un riesgo significativo de deterioro cognitivo. Nuestra investigación tuvo como objetivo evaluar el impacto del aceite de semilla de albaricoque (ASA) en la función cognitiva y la respuesta inflamatoria en un modelo de accidente cerebrovascular hemorrágico utilizando ratas Wistar, y examinar su correlación. Se asignaron aleatoriamente cincuenta ratas Wistar a cinco grupos: un grupo control, un grupo suplementado con ASA (que recibió 400 mg/kg de ASA), un grupo HC (con HC inducido) y grupos HC suplementados con 200 y 400 mg/kg de ASA, cada uno. La función cognitiva se evaluó mediante la prueba del laberinto eléctrico Y en estos grupos. Además, se utilizaron un ensayo inmunoabsorbente ligado a enzimas y una PCR en tiempo real para analizar los perfiles de expresión de proteínas y genes de factores inflamatorios y apoptóticos en el cerebro. En comparación con el grupo de control, las ratas del grupo HC tardaron más en dominar los criterios del laberinto (P<0,05). Además, el grupo HC exhibió niveles significativamente mayores de citocinas proinflamatorias interleucina-1β (IL-1β), IL-6 y factor de necrosis tumoral- α, y niveles reducidos de citocinas antiinflamatorias IL-4 e IL-10 en comparación al grupo control (P<0,05). Por el contrario, las ratas del grupo HC+400 mg/kg ASA mostraron tendencias opuestas en el tiempo de simulación eléctrica, la proteína del factor inflamatorio y el perfil de expresión génica (Bcl-2, BAX, Caspasa-3 y p53) en comparación con el grupo HC (P <0,05). Nuestros hallazgos sugieren que el extracto de ASA puede mejorar la disfunción cognitiva después de la HC en ratas, potencialmente mediante la modulación de factores inflamatorios secretados por la microglia.

Abstract Objective To evaluate the association between inflammatory markers and abdominal fat assessed by ultrasound in prepubertal children with and without excess weight. Methods A cross-sectional study involving 241 prepubertal children, 156 with obesity, 37 with overweight, and 48 with normal weight, aged five to ten years, who were followed at a research unit on Childhood Obesity from a teaching hospital belonging to a public health system. The concentration of interleukin-6, tumor necrosis factor-α and C-reactive protein were assessed and regression analyses, considering outcome variables such as abdominal wall and intra-abdominal fat thickness measured by ultrasound, were performed. Results The findings highlighted an association between abdominal fat and inflammatory markers, even in children at this young age group. Subcutaneous fat showed a stronger association with inflammatory biomarkers compared to intra-abdominal fat when performing logistic regression, with a positive association between tumor necrosis factor-α and abdominal wall thickness equal to or greater than the 75th percentile in adjusted logistic regression (OR: 18.12; CI 95 %: 1.57: 209.55). Conclusions Abdominal wall fat, in contrast to what is often observed in adults, appears to have a greater impact on chronic inflammation related to excessive weight in very young children. crosssectional cross sectional 24 15 obesity 3 overweight 4 years system interleukin6, interleukin6 interleukin 6, 6 interleukin-6 factorα factor α Creactive C reactive analyses intraabdominal intra performed group th OR (OR 18.12 1812 18 12 9 % 1.57 157 1 57 209.55. 20955 209.55 . 209 55 209.55) adults 2 interleukin- 18.1 181 1.5 5 2095 209.5 20 18. 1. 209.

Abstract Introduction. Rectal perforation due to blunt trauma is rare and associated with pelvic fractures. Signs of necrotizing fasciitis in lower limbs have been reported in non-traumatic rectal perforations, in most cases associated with high mortality. Case report. A 36-year-old man presents blunt abdomino-pelvic trauma and perforation of the lower rectum. Surgical management by intestinal diversion and pelvic fixation is performed. 4 days after admission, evolves with over-infected scrotal hematoma, hemodynamic instability, signs of necrotizing fasciitis and septic shock. Results. A sample for culture was taken from a scrotal hematoma that reported E. coli. Pathology of scrotal debridement reported coagulation necrosis in the entire specimen. Discussion. Digital rectal examination should always be performed in the presence of subcutaneous emphysema on physical examination or CT scan for early and multidisciplinary diagnosis and surgical management as appropriate. Conclusion. The presence of subcutaneous emphysema should raise the suspicion of rectal perforation. There are few reports of rectal perforation due to blunt trauma and fasciitis, so the associated mortality is not precisely known.

Resumen Introducción. La perforación del recto por trauma cerrado es poco frecuente y se asocia a fracturas pélvicas. En pacientes con perforaciones de recto no traumáticas se ha reportado fascitis necrosante en miembros inferiores, en la mayoría de los casos asociada a alta mortalidad. Caso clínico. Hombre de 36 años con trauma cerrado abdomino-pélvico y perforación de recto inferior, quien recibió manejo quirúrgico mediante derivación intestinal y fijación pélvica. Evolucionó con hematoma escrotal sobreinfectado, inestabilidad hemodinámica, signos de fascitis necrosante y choque séptico 4 días posterior a su ingreso. Resultados. Se tomó muestra para cultivo del hematoma escrotal que reportó E. coli. La patología del desbridamiento escrotal informó necrosis de coagulación en toda la muestra. Conclusión. El tacto rectal debe realizarse siempre ante la presencia de enfisema subcutáneo al examen físico o en la tomografía, para un diagnóstico temprano y manejo quirúrgico multidisciplinario oportuno, según el caso. La presencia de enfisema subcutáneo debe aumentar la sospecha de perforación de recto. Hay pocos reportes de fascitis secundaria a perforación de recto por trauma cerrado, por lo que no se conoce con precisión la mortalidad asociada.

Resumen El sarcoma de Ewing (ES) y el tumor neuroectodérmi co primitivo (PNET) pertenecen al grupo de neoplasias denominadas tumores de células pequeñas y redondas. Los PNET se dividen en centrales y periféricos. El ES y los PNET periféricos surgen del tejido óseo, de los tejidos blandos o nervios periféricos. Presentamos un caso de ES/PNET hepático en un hombre sano que inició cuatro meses antes de la consulta con síntomas abdominales y pérdida de peso. La endoscopia digestiva alta y la analí tica no revelaron hallazgos relevantes. En la tomografía de abdomen se evidenció hígado aumentado de tamaño a expensas de lesión sólida que comprometía todos sus segmentos con realce al contraste endovenoso y grandes áreas de necrosis. Comprimía y desplazaba estructuras vecinas. Se realizó biopsia con aguja gruesa de la lesión hepática: neoplasia de células pequeñas y redondas. La inmunohistoquímica reveló negatividad para CD45, CKA1/A3, cromogranina, sinaptofisina y citoqueratinas CK7 y CK20. Expresión tenue de CD56 y positividad de CD99, FLI-1 y NKX2. Realizó tratamiento quimioterápico con carboplatino y etopósido por 6 ciclos con mejoría clínica y tolerancia al mismo. En imágenes de control se evidenció reducción de la masa con afección del lóbulo hepático derecho, compromiso de la vena cava inferior, infiltración de la glándula suprarrenal y polo superior del riñón derechos. Se remitió a cirugía hepatobiliar para resección quirúrgica de la lesión residual. El paciente rechazó el procedimiento quirúrgico. Nuestro objetivo es destacar el desafío diagnóstico clínico e histológico de esta entidad que obliga a descartar otras entidades clínicas.

Abstract Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) belong to the group of neoplasms called small round cell tumors. PNETs have been divided into central and peripheral. ES and peripheral PNETs arise from bones, soft tissues, or peripheral nerves. We pres ent a case of hepatic ES/PNET in a healthy man that began four months before consultation with abdominal symptoms and weight loss. Upper gastrointestinal en doscopy and laboratory tests revealed no notable find ings. The abdominal tomography revealed an enlarged liver due to a solid lesion that involved all its segments with intravenous contrast enhancement and large areas of necrosis. It compressed and displaced neighboring structures. Core needle biopsy of the liver lesion was per formed: small round cell neoplasm. Immunohistochemis try revealed negativity for CD45, CKA1/A3, chromogranin, synaptophysin, and cytokeratins CK7 and CK20. Dim CD56 expression and CD99, FLI-1, and NKX2 positivity. He underwent chemotherapy treatment with carboplatin and etoposide for 6 cycles with clinical improvement and tolerance. Control images showed reduction of the mass with involvement of the right hepatic lobe, involvement of the inferior vena cava, infiltration of the right adrenal gland and upper pole of the right kidney. He was referred to hepatobiliary surgery for surgical resection of the residual lesion. The patient rejected the proposed surgi cal procedure. Our objective is to highlight the clinical and histological diagnostic challenge of this entity that requires ruling out other clinical entities.

Resumen Presentamos un paciente con una rara enfermedad autoinflamatoria sistémica (deficiencia de mevalonato quinasa -DMQ-) con la identificación de dos variantes heterocigotas (c.1129G>A y c.32C>T) en el gen Meval onato Quinasa, detectadas por secuenciación masiva en paralelo y una glomerulonefritis de alta prevalencia (nefropatía por IgA). El paciente presentó un cuadro de fiebre periódica recurrente mensual desde los 12 días de vida, acompañada de lesiones mucocutáneas (rash maculopapular en extremidades, estomatitis aftosa), compromiso articular (artralgias en tobillos, muñecas y rodillas), linfoideo (linfoadenopatía cervical, esplenome galia), gastrointestinal (diarrea, dolor abdominal) y renal (hematuria y proteinuria) con repetidas biospias most rando nefropatía por IgA alternando actividad y cronic idad. Durante el seguimiento, tuvo una pobre respuesta terapéutica a múltiples esquemas inmunosupresores utilizados durante 7 años (corticoides, azatrioprina, micofenolato, ciclofosfamida, rituximab y tocilizumab), y buena respuesta finalmente a canakinumab. Cuatro años posteriores al inicio de canakinumab, durante el curso de una infección por un absceso muscular, el cuadro clínico se complica con un evento microvascular renal grave (necrosis cortical renal -NCR-) con fallo renal agudo y necesidad de diálisis. Los episodios recurrentes de inflamación por la DMQ podrían actuar como gatil los para la reactivación de su glomerulonefritis (lo que explicaría la escasa respuesta a inmunosupresores y la progresión rápida a cronicidad histológica) y para gen erar un microambiente que predisponga el desarrollo de una NCR ante una infección no grave. En la DMQ se ha descripto un defecto en las moléculas de IgA, fenómeno también observado en la nefropatía por IgA. Esto plantea la desafiante hipótesis de un vínculo patogénico común entre todas las manifestaciones clínicas del paciente.

Abstract We present a patient with a rare systemic autoinflam matory disease (mevalonate kinase deficiency -MKD-) with the identification of two heterozygous variants (c.1129G>A and c.32C>T) in the Mevalonate Kinase gene, detected by next generation sequencing and a highly prevalent glomerulonephritis (IgA nephropathy). The patient presents clinically with a monthly recurrent periodic fever from 12 days of age, accompanied by mucocutaneous lesions (maculopapular rash in ex tremities, aphthous stomatitis), joint (arthralgias in ankles, wrists and knees), lymphoid (cervical lymph adenopathy, splenomegaly), gastrointestinal (diarrhea, abdominal pain) and kidney (hematuria and protei-nuria) with repeated biopsies showing IgA nephropathy alternating activity with chronicity. During follow-up. The patients presented a poor therapeutic response to multiple immunosuppressive regimens used for 7 years (corticosteroids, azathioprine, mycophenolate, cyclo phosphamide, rituximab and tocilizumab), and finally a good response to canakinumab. Four years after starting canakinumab, during the course of an infection due to a muscle abscess, the clinical presentation is complicated by a severe renal microvascular event (renal cortical necrosis -RCN-) with acute kidney injury and dialysis requirement. Therecurrent episodes of inflammation due to MKD could act as triggers for the reactivation of glomerulonephritis (which would explain the poor response to immunosuppressants and the rapid pro gression to histological chronicity) and to generate a microenvironment that predisposes the development of RCN in the face of a non-serious infection. A defect in IgA molecules has been described in MKD, a phenom enon also observed in IgA nephropathy. This raises the challenging hypothesis of a common pathogenetic link between all the patient’s clinical manifestations.

RESUMEN: El objetivo de este estudio fue comparar y analizar la eficacia clínica de diferentes abordajes de clavo intramedular con tornillos de bloqueo para las fracturas de tibia proximal. Se incluyeron en el estudio 100 casos de fracturas de tibia proximal tratados en el departamento de ortopedia desde abril de 2021 hasta septiembre de 2023 y se dividieron en grupos de control y de tratamiento mediante una tabla de números aleatorios. Un grupo control (n=50) tratado con clavo intramedular infrapatelar con tornillos de bloqueo, y un grupo tratamiento (n=50) tratado con clavo intramedular suprapatelar con tornillos de bloqueo. Observamos excelentes y buenas tasas en ambos grupos, comparamos varios indicadores perioperatorios, cambios en el rango de movimiento articular (ROM), puntuaciones de dolor en la escala visual analógica (EVA), puntuaciones de función Lysholm de la articulación de la rodilla , cambios en factores inflamatorios y varios marcadores óseos, antes y después del tratamiento, y se analizaron las complicaciones postoperatorias. No hubo diferencias significativas en los datos iniciales como edad, sexo, índice de masa corporal, sitio de fractura, fracturas de fíbula concomitantes, tiempo desde la fractura hasta la cirugía, mecanismo de lesión y clasificación de fractura AO/OTA entre los dos grupos (P>0,05). La tasa de excelente y buena en el grupo con tratamiento después del tratamiento fue del 90,00 % (45/50), significativamente mayor que el 72,00 % (36/50) en el grupo control (P<0,05). No hubo diferencias significativas en la pérdida de sangre intraoperatoria y el tiempo de curación de las fracturas entre los dos grupos (P>0,05). Sin embargo, el grupo con tratamiento tuvo tiempos quirúrgicos más cortos y menos tiempos de fluoroscopía que el grupo control (P <0,05). Después del tratamiento, ambos grupos mostraron un aumento de las puntuaciones de ROM y Lysholm, así como una disminución de las puntuaciones de VAS. Además, en comparación con el grupo control, el grupo con tratamiento tuvo puntuaciones ROM y Lysholm más altas y puntuaciones EVA más bajas (P <0,05). Los factores inflamatorios que incluyen interleucina-1β (IL-1β), proteína C reactiva (CRP), factor de necrosis tumoral-α (TNF-α), osteocalcina (BGP) y calcitonina (CT) aumentaron en ambos grupos después del tratamiento, mientras que el total disminuyó el propéptido n-terminal del procolágeno tipo I (Total-PINP) y el telopéptido β-C-terminal del colágeno tipo I (β-CTX). En comparación con el grupo control, el grupo con tratamiento mostró mayores aumentos en los factores inflamatorios y niveles más bajos de Total-PINP y β-CTX, pero niveles más altos de BGP y CT (P <0,05). La incidencia de complicaciones postoperatorias fue del 8 % (4/50) en el grupo de tratamiento y del 24 % (12/50) en el grupo control, con diferencias estadísticamente significativas (P=4,762, X2=0,029). En el tratamiento de las fracturas de tibia proximal, el clavo intramedular con tornillos de bloqueo mediante el abordaje suprapatelar logra una eficacia clínica significativa. Reduce el tiempo quirúrgico, minimiza la exposición a la radiación de los trabajadores de la salud y los pacientes, mejora el rango de movimiento y la función de la articulación de la rodilla, disminuye el dolor postoperatorio y las tasas de complicaciones, suprime las reacciones inflamatorias y promueve la mejora de los marcadores óseos relacionados con la curación de las fracturas.

SUMMARY: The objective of this study was to compare and analyze the clinical efficacy of different approaches of intramedullary nailing with blocking screws for proximal tibial fractures. One hundred cases of proximal tibial fractures treated in the orthopedic department from April 2021 to September 2023 were included in the study and divided into control and treatment groups using a random number table. A control group (n=50) treated with infrapatellar intramedullary nailing with blocking screws, and a treatment group (n=50) treated with suprapatellar intramedullary nailing with blocking screws. We observed the excellent and good rates in both groups, compared various perioperative indicators, changes in joint range of motion (ROM), Visual Analog Scale (VAS) pain scores, Lysholm knee joint function scores, changes in inflammatory factors, and various bone markers before and after treatment, and analyzed postoperative complications. There were no significant differences in baseline data such as age, sex, body mass index, fracture site, concomitant fibular fractures, time from fracture to surgery, injury mechanism, and AO/OTA fracture classification between the two groups (P>0.05). The excellent and good rate in the treatment group after treatment was 90.00 % (45/50), significantly higher than 72.00 % (36/50) in the control group (P<0.05). There were no significant differences in intraoperative blood loss and fracture healing time between the two groups (P>0.05). However, the treatment group had shorter surgical times and fewer fluoroscopy times than the control group (P<0.05). After treatment, both groups showed increased ROM and Lysholm scores, as well as decreased VAS scores. Moreover, compared to the control group, the treatment group had higher ROM and Lysholm scores and lower VAS scores (P<0.05). Inflammatory factors including interleukin-1β (IL-1β), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), osteocalcin (BGP), and calcitonin (CT) increased in both groups after treatment, while total n- terminal propeptide of type I procollagen (Total-PINP) and b-C-terminal telopeptide of type I collagen (β-CTX) decreased. Compared to the control group, the treatment group exhibited greater increases in inflammatory factors and lower levels of Total-PINP and β-CTX, but higher BGP and CT levels (P<0.05). The incidence of postoperative complications was 8.00 % (4/50) in the treatment group and 24.00 % (12/50) in the control group, with statistically significant differences (P=4.762, X2=0.029). In the treatment of proximal tibial fractures, intramedullary nailing with blocking screws using the suprapatellar approach achieves significant clinical efficacy. It reduces surgical time, minimizes radiation exposure to healthcare workers and patients, improves knee joint range of motion and function, decreases postoperative pain and complication rates, suppresses inflammatory reactions, and promotes the improvement of bone markers related to fracture healing.

Resumen La neumatosis intestinal y el neumoperitoneo no son entidades patológicas en sí mismas, son signos radio lógicos que resultan de alguna condición subyacente. En general, estos se asocian con procesos graves intra-abdominales que resultan en cirugías de urgencias con resecciones de intestino. A continuación, presentamos el caso de una mujer de 80 años, con diagnóstico de cáncer de mama estadio IV en tratamiento con ful vestrant y ribociclib, que ingresó a nuestro centro por dolor abdominal y vómitos. Se diagnosticó neumatosis intestinal y neumoperitoneo por lo que se procedió a laparotomía exploradora por sospecha de isquemia intestinal. No hubo evidencia de necrosis o perforación intestinal por lo que no se realizó resección. Evolucionó durante la internación de forma satisfactoria y en el control tomográfico al mes del egreso hubo resolución completa del cuadro. Si bien está descrito esta afectación en relación a los episodios de aumento de presión intraabdominal, como en la emesis, también se describió en pacientes con neoplasias, principalmente del tubo digestivo, ya sea por daño local o por toxicidad asociada a la quimioterapia. No encontramos reportes en la literatura de neumatosis intestinal vinculada a esta medicación antineoplásica en humanos. Probablemente en nuestro caso la etiolo gía haya sido multifactorial. Es posible que el ribociclib haya jugado un rol, ya sea por un mecanismo indirecto asociado a los vómitos y la inmunosupresión o directo sobre el enterocito debido a su mecanismo de acción celular no específico.

Abstract Pneumatosis intestinalis and pneumoperitoneum are not pathological entities in themselves, they are radiological signs that result from some underlying condition. In general, these are associated with serious intra-abdominal processes that result in emergency surgeries with bowel resections. Below, we present the case of an 80-year-old woman, diagnosed with stage IV breast cancer under treatment with fulvestrant and ribociclib, who was admitted to our center due to abdominal pain and vomiting. She was diagnosed with intestinal pneumatosis and pneumoperitoneum, so she underwent exploratory laparotomy for sus pected intestinal ischemia. There was no evidence of intestinal necrosis or perforation, so resection was not performed. She progressed satisfactorily during hospitalization and in the tomographic control one month after discharge there was complete resolution of the condition. Although this condition has been described in relation to episodes of increased intra-abdominal pressure, such as emesis, it has also been described in patients with neoplasms, mainly of the digestive tract, either due to lo cal damage or toxicity associated with chemotherapy. We found no reports in the literature of pneumatosis intesti nalis linked to this antineoplastic medication in humans. Probably in our case the etiology was multifactorial. It is possible that ribociclib played a role, either through an indirect mechanism associated with vomiting and im munosuppression or directly on the enterocyte due to its non-specific cellular mechanism of action.

Resumen Este estudio tuvo como objetivo determinar las concentraciones salivales de interleucina (IL)-1β, IL-2, IL-10, IL-23, factor de crecimiento transformante (TGF)-β y factor de necrosis tumoral (TNF)-α, nitrato (subproducto de la oxidación del óxido nítrico) y cortisol en pacientes con liquen plano oral (OLP). En este estudio transversal se incluyeron veinte pacientes diagnosticados con OLP y 20 voluntarios sanos (HV) del mismo sexo. Saliva entera no estimulada Se recolectó por la mañana, se determinaron las concentraciones de citocinas y cortisol en saliva mediante ensayo inmunoabsorbente ligado a enzimas (ELISA), se determinó nitrato mediante un analizador de óxido nítrico, se encontraron concentraciones salivales mayores de IL-2 (p<0,003), IL- 23 (p<0,04) y TGF-β (p=0,05) en pacientes con OLP en comparación con HV. No se encontraron diferencias significativas en los niveles salivales de TNF-α, IL-1β e IL-10. Las concentraciones de nitrato fueron marcadamente aumentó en pacientes con OLP (1227,0 ± 738,8 µM/mg de proteína total), en comparación con HV (261,6 ± 166,8 µM/mg; p<0,0001). Los niveles de cortisol salival también fueron más altos en los pacientes con OLP que en los controles (2,79 ± 1,39 vs. 1,94 ±1,21 ng/mg; p<0,048). Los niveles de óxido nítrico en saliva aumentaron notablemente en pacientes con OLP, lo que sugiere una relación de esta molécula con la muerte celular y el daño tisular observado en las lesiones de OLP.

Abstract This study aimed to determine salivary concentrations of interleukin (IL)-1β, IL-2, IL-10, IL- 23, transforming growth factor (TGF)-β, tumor necrosis factor (TNF)-α, nitrate (a by-product of nitric oxide oxidation), and cortisol in patients with oral lichen planus (OLP). Twenty patients diagnosed with OLP and 20 sex-matched healthy volunteers (HV) were included in this cross-sectional study. Unstimulated whole saliva was collected in the morning. Salivary cytokine and cortisol concentrations were determined by enzyme-linked immunosorbent assays (ELISA). Nitrate was measured in a nitric oxide analyzer. We found higher salivary concentrations of IL-2 (p<0.003), IL-23 ( p<0.04), and TGF-β (p=0.05) in patients with OLP compared to HV. No significant differences were found in salivary levels of TNF-α, IL-1β, or IL-10. Nitrate concentrations were markedly increased in OLP patients (1,227.0 ± 738.8 µM/mg total protein) when compared to HV (261.6 ± 166.8 µM/mg; p<0.0001). Salivary cortisol levels were also higher in OLP patients (2.79 ± 1.39 vs. 1.94 ±1.21 ng/mg; p<0.048). The markedly increased salivary levels of nitric oxide in patients with OLP suggest a relationship of this molecule with the cell death and tissue damage observed in these lesions.

ABSTRACT Hop stunt viroid (HSVd) is the causal agent of citrus cachexia, which can lead to significant crop losses. As part of a preventive management strategy, it is essential to use healthy plants from a certification program. This study aimed to evaluate the healthiness of 17 citrus cultivars against HSVd using both biological and molecular diagnostics. For biological diagnosis, Etrog citron (Citrus medica L.) clone Arizona 861 S1 was used as an indicator plant, incorporating negative and positive controls for HSVd infection. For molecular diagnosis, reverse transcription polymerase chain reaction (RT-PCR) technique was employed with specific primers for viroid detection. Results indicated that six months after inoculation, the positive control exhibited symptoms associated with viroid infection, such as necrosis in the petiole and stem, leaf epinasty, and necrosis in the midvein. In contrast, both the negative control and evaluated citrus cultivars showed no symptoms. These findings were supported by molecular analysis, which allowed the amplification of a viroid genome region only in the positive control. Both biological and molecular diagnosis confirmed the absence of HSVd in the citrus varieties assessed. This study will allow the evaluation of the citrus plant collections used in the foundation category as a source of buds for plant multiplication of registered and certified seeds for citrus propagation nurseries in Colombia.

RESUMEN El viroide del enanismo del lúpulo (HSVd) es el agente causal de la cachexia de los cítricos, que puede provocar pérdidas significativas en el cultivo. Como parte de una estrategia de manejo preventivo, es indispensable utilizar plantas sanas provenientes de un programa de certificación. Este estudio tuvo como objetivo evaluar la sanidad de 17 cultivares de cítricos frente a HSVd, utilizando diagnósticos biológico y molecular. Para el diagnóstico biológico, se empleó como planta indicadora cidro Etrog (Citrus medica L.) clon Arizona 861 S1, incluyendo controles negativos y positivos para la infección por HSVd. Para el diagnóstico molecular se utilizó la técnica de Reacción en Cadena de la Polimerasa con Transcriptasa Inversa (RT-PCR) con cebadores específicos para la detección del viroide. Los resultados indicaron que seis meses después de la inoculación, el control positivo mostró síntomas asociados con la infección por el viroide, como necrosis en el peciolo y tallo, epinastia foliar y necrosis en vena media. Por el contrario, tanto el control negativo como los cultivares de cítricos evaluados no presentaron síntomas. Estos resultados fueron corroborados por el análisis molecular, que permitieron amplificar una región del genoma del viroide, únicamente en el control positivo. Ambos diagnósticos biológico y molecular confirmaron la ausencia de HSVd en las variedades de cítricos evaluadas. Este estudio permitirá la evaluación de las colecciones de plantas de cítricos utilizadas en la categoría fundación como fuente de yemas para la multiplicación de semilla registrada y certificadapara los viveros productores de material de propagación de cítricos en Colombia.

Abstract In commercial soursop orchards in the state of Nayarit, Mexico, trees with apparent symptoms of root rot are observed, without the causal agent being known. Therefore, the objective of the research was to identify the fungi that cause soursop root rot. From January 2020 to January 2021, in orchards of Compostela and San Blas, Nayarit, from two trees with symptoms of possible root rot, root sections with rot were collected. Microorganisms associated with the disease were isolated and identified to carry out pathogenicity tests in one-year-old soursop trees. Fusarium falciforme and Lasiodiplodia theobromae were identified as root pathogens, both fungi are reported for the first time in this fruit tree and for Mexico.

Resumen En huertos comerciales de guanábana del estado de Nayarit, México, se observan árboles con síntomas aparentes por pudrición radicular, sin que se conozca el agente causal. Por lo que, el objetivo de la investigación fue, identificar a los hongos causantes de la pudrición de raíz de guanábana. De enero de 2020 a enero de 2021, en huertos de Compostela y San Blas, Nayarit, de árboles con síntomas por posible pudrición radicular, se recolectaron secciones de raíz con pudrición. Se aislaron e identificaron a los microorganismos asociados a la enfermedad para realizar las pruebas de patogenicidad en árboles de guanábana de un año de edad. Se identificó a Fusarium falciforme y a Lasiodiplodia theobromae como patógenos de raíz, ambos hongos son reportados por primera vez en este frutal y para México.

Abstract Objective: To investigate the incidence, clinical and genetic characteristics of pediatric lymphoma patients of China with inborn errors of immunity (IEI)-related gene mutations, which have not been fully studied. Method: From Jan. 2020 to Mar. 2023, IEI-related genetic mutations were retrospectively explored in 108 children with lymphomas admitted to Beijing Children’s Hospital by NGS. Genetic rule and clinical characteristics as well as treatment outcomes were compared between patients with or without IEI-related gene mutations. Results: A total of 17 patients (15.7 %) harbored IEI-associated mutations, including 4 cases with X-linked lymphoproliferative syndrome (XLP), 3 cases had mutations in tumor necrosis factor receptor superfamily 13B (TNFRSF13B), 2 cases with Activated p110 syndrome (APDS). Patients with IEI all had alteration of immunocompetence with decreased levels of immunoglobulin and lymphocyte subsets. Recurrent infection existed in 41.2 % of patients. The 18-month event-free survival (EFS) and the overall response rate (ORR) of patients with IEI are significantly lower than those without IEI (33.86% vs. 73.26 %, p = 0.011; 52.94% vs. 87.91 %, p = 0.002, respectively). In addition, patients with IEI had a higher progression disease (PD) rate of 23.5 % than those without IEI of 4.4% (p = 0.006). Conclusion: The present study demonstrated that IEI-associated lymphomas were much more common than originally appreciated in pediatric lymphomas, and those were insensitive to treatment and more likely to progress or relapse. The genomic analysis and a thorough review of the medical history of IEI can be used to distinguish them from pediatric lymphomas without IEI, which are beneficial for the early diagnosis and direct intervention. Objective incidence IEIrelated related studied Method Jan 202 Mar 2023 10 Childrens Children s NGS Results 1 15.7 157 15 7 (15. IEIassociated associated Xlinked X linked XLP, XLP , (XLP) B TNFRSF13B, TNFRSF13B TNFRSFB TNFRSF (TNFRSF13B) p11 APDS. APDS . (APDS) subsets 412 41 41. 18month month 18 eventfree event free EFS (EFS ORR (ORR 33.86% 3386 33 86 (33.86 vs 7326 73 26 73.2 0.011 0011 0 011 5294 52 94 52.94 8791 87 91 87.9 0002 002 0.002 respectively. respectively respectively) addition PD (PD 235 23 5 23. 44 4.4 0.006. 0006 0.006 006 0.006) Conclusion relapse intervention 20 15. (15 (XLP (TNFRSF13B p1 (APDS 33.86 338 8 (33.8 732 73. 0.01 001 01 529 9 52.9 879 87. 000 00 0.00 4. (1 33.8 (33. 0.0 52. ( 33. (33 0. (3