Acute pancreatitis associated with scoliosis surgery: Could opioids be a determinant factor in its development?

Varias complicaciones médicas pueden ocurrir después de la cirugía de columna en la población pediátrica. Las técnicas quirúrgicas actuales han permitido un mayor grado de corrección de la escoliosis, pero al mismo tiempo se han descrito complicaciones inusuales que parecen estar asociadas y tienen una etiología multifactorial. Presentamos una serie de casos de tres pacientes pediátricos que se sometieron a cirugía de corrección de escoliosis con uso continuo de opioides a dosis tope, que durante la hospitalización y vigilancia postoperatoria desarrollaron pancreatitis aguda. La asociación entre la exposición prolongada a dosis altas de opioides y la aparición de pancreatitis en el contexto de una cirugía mayor espinal sugiere una relación potencial que justifica un mayor estudio.Various medical complications can occur after spinal surgery in the pediatric population. Current surgical techniques have allowed a greater degree of scoliosis correction, but at the same time, unusual complications have been described that seem to be associated and have a multifactorial etiology. We present a case series of three pediatric patients who underwent scoliosis correction surgery with continuous use of full-dose opioids, and during hospitalization and post-operative surveillance developed acute pancreatitis. The association between prolonged exposure to high-dose opioids and the onset of pancreatitis in the context of major surgery suggests a potential relationship that warrants further study.Instituto Roosevelt, Bogotá – Colombia

Genetic Characterization of Venezuelan Equine Encephalitis Virus from Bolivia, Ecuador and Peru: Identification of a New Subtype ID Lineage

Venezuelan equine encephalitis virus (VEEV) has been responsible for hundreds of thousands of human and equine cases of severe disease in the Americas. A passive surveillance study was conducted in Peru, Bolivia and Ecuador to determine the arboviral etiology of febrile illness. Patients with suspected viral-associated, acute, undifferentiated febrile illness of <7 days duration were enrolled in the study and blood samples were obtained from each patient and assayed by virus isolation. Demographic and clinical information from each patient was also obtained at the time of voluntary enrollment. In 2005–2007, cases of Venezuelan equine encephalitis (VEE) were diagnosed for the first time in residents of Bolivia; the patients did not report traveling, suggesting endemic circulation of VEEV in Bolivia. In 2001 and 2003, VEE cases were also identified in Ecuador. Since 1993, VEEV has been continuously isolated from patients in Loreto, Peru, and more recently (2005), in Madre de Dios, Peru. We performed phylogenetic analyses with VEEV from Bolivia, Ecuador and Peru and compared their relationships to strains from other parts of South America. We found that VEEV subtype ID Panama/Peru genotype is the predominant one circulating in Peru. We also demonstrated that VEEV subtype ID strains circulating in Ecuador belong to the Colombia/Venezuela genotype and VEEV from Madre de Dios, Peru and Cochabamba, Bolivia belong to a new ID genotype. In summary, we identified a new major lineage of enzootic VEEV subtype ID, information that could aid in the understanding of the emergence and evolution of VEEV in South America

A focus on selected perspectives of the NUMEN project

The use of double charge exchange reactions is discussed in view of their application to extract information that may be helpful to determinate the nuclear matrix elements entering in the expression of neutrinoless double beta decay half-life. The strategy adopted in the experimental campaigns performed at INFN - Laboratori Nazionali del Sud and in the analysis methods within the NUMEN project is briefly described, emphasizing the advantages of the multi-channel approach to nuclear reaction data analysis. An overview on the research and development activities on the MAGNEX magnetic spectrometer is also given, with a focus on the chosen technological solutions for the focal plane detector which will guarantee the performances at high-rate conditions

Recent results on Heavy-Ion induced reactions of interest for 0νββ decay

An updated overview of recent results on Heavy-Ion induced reactions of interest for neutrinoless double beta decay is reported in the framework of the NUMEN project. The NUMEN idea is to study heavy-ion induced Double Charge Exchange (DCE) reactions with the aim to get information on the nuclear matrix elements for neutrinoless double beta (0νββ) decay. Moreover, to infer the neutrino average masses from the possible measurement of the half- life of 0νββ decay, the knowledge of the nuclear matrix elements is a crucial aspec

Recent results on heavy-ion direct reactions of interest for 0νββ decay at INFN LNS

Neutrinoless double beta decay of nuclei, if observed, would have important implications on fundamental physics. In particular it would give access to the effective neutrino mass. In order to extract such information from 0νββ decay half-life measurements, the knowledge of the Nuclear Matrix Elements (NME) is of utmost importance. In this context the NUMEN and the NURE projects aim to extract information on the NME by measuring cross sections of Double Charge Exchange reactions in selected systems which are expected to spontaneously decay via 0νββ. In this work an overview of the experimental challenges that NUMEN is facing in order to perform the experiments with accelerated beams and the research and development activity for the planned upgrade of the INFN-LNS facilities is reported

Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

New results from the NUMEN project

NUMEN aims at accessing experimentally driven information on Nuclear Matrix Elements (NME) involved in the half-life of the neutrinoless double beta decay (0νββ), by high-accuracy measurements of the cross sections of Heavy Ion (HI) induced Double Charge Exchange (DCE) reactions. First evidence about the possibility to get quantitative information about NME from experiments is found for the (18O,18Ne) and (20Ne,20O) reactions. Moreover, to infer the neutrino average masses from the possible measurement of the half-life of 0νββ decay, the knowledge of the NME is a crucial aspect. The key tools for this project are the high resolution Superconducting Cyclotron beams and the MAGNEX magnetic spectrometer at INFN Laboratori Nazionali del Sud in Catania (Italy). The measured cross sections are extremely low, limiting the present exploration to few selected isotopes of interest in the context of typically low-yield experimental runs. A major upgrade of the LNS facility is foreseen in order to increase the experimental yield of at least two orders of magnitude, thus making feasible a systematic study of all the cases of interest. peerReviewe

A look at Mayan artificial cranial deformation practices: Morphological and cultural aspects

Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time

Acute pancreatitis associated with scoliosis surgery: Could opioids be a determinant factor in its development?

Varias complicaciones médicas pueden ocurrir después de la cirugía de columna en la población pediátrica. Las técnicas quirúrgicas actuales han permitido un mayor grado de corrección de la escoliosis, pero al mismo tiempo se han descrito complicaciones inusuales que parecen estar asociadas y tienen una etiología multifactorial. Presentamos una serie de casos de tres pacientes pediátricos que se sometieron a cirugía de corrección de escoliosis con uso continuo de opioides a dosis tope, que durante la hospitalización y vigilancia postoperatoria desarrollaron pancreatitis aguda. La asociación entre la exposición prolongada a dosis altas de opioides y la aparición de pancreatitis en el contexto de una cirugía mayor espinal sugiere una relación potencial que justifica un mayor estudio.Various medical complications can occur after spinal surgery in the pediatric population. Current surgical techniques have allowed a greater degree of scoliosis correction, but at the same time, unusual complications have been described that seem to be associated and have a multifactorial etiology. We present a case series of three pediatric patients who underwent scoliosis correction surgery with continuous use of full-dose opioids, and during hospitalization and post-operative surveillance developed acute pancreatitis. The association between prolonged exposure to high-dose opioids and the onset of pancreatitis in the context of major surgery suggests a potential relationship that warrants further study.Instituto Roosevelt, Bogotá – Colombia