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Background Doege-Potter syndrome is a rare paraneoplastic phenomenon associated with solitary fibrous tumors of the pleura (SFTPs). It is characterized by the presence of severe, sustained, and treatment-refractory hypoglycemia. Hypoglycaemia, which may be the sole symptom at disease onset, is mediated by the secretion of high-molecular-weight insulin-like growth factor (IGF-2). Most tumors exhibit benign behavior, with a 100% survival rate at 5 years. However, 10% of these tumors may display aggressive behavior with local or metastatic recurrence. We present a clinical case of a patient with a benign solitary fibrous tumor of the pleura who presented with symptomatic hypoglycemia and required pulmonary and pleural surgical resection to control the paraneoplastic phenomenon. Case presentation A Hispanic 46-year-old man presented with a 15-day history of transient alterations in consciousness worsened by fasting. The relevant medical history included obstructive sleep apnea treated with continuous positive air pressure (CPAP) and previous smoking. In-hospital studies revealed noninsulinemic hypoglycemia and a benign SFTP. Complete surgical resection was performed while the patient received dextrose fluids and corticosteroids perioperatively for hypoglycemia. Subsequently, the hypoglycemia resolved, and the patient was followed-up without disease recurrence. Conclusion Doege-Potter syndrome is challenging to recognize. However, effective treatment can be achieved with a high survival rate. Raising awareness among healthcare professionals about the recognition of this paraneoplasic syndrome patients will improve diagnostic suspicion, biochemical confirmation, the development of diagnostic and therapeutic guidelines, and the creation of predictive indices for aggressive presentations requiring closer monitoring.

The combined treatment of beta-blockers with ablation and Implanted cardioverter defibrillation therapy, continues to be the mainstay treatment for ventricular arrhythmias (VAs). Despite treatment, some patients remain refractory. Recent studies have shown success rates using video-assisted thoracoscopic (VATS) cardiac denervation as an effective therapeutic option for these patients.

The possibility of ending the armed conflict in Colombia will depend, to a large extent, on the state's ability to prevent multiple criminal economies, and inhibit the actors who participate in them from damaging the implementation of the final peace agreements. This article analyzes criminal economies' ability to destabilize and thereby damage the post-conflict phase, and identifies dilemmas the state must confront in responding to this situation. The article's objective is to provide an analytical model to understand the complex relationship between actors involved in the peace process and criminal economies, and to thereby identify risks and possible models for intervention. The theoretical referent of this work is the discussion about peacebuilding in fragile states and literature that identifies organized crime as a spoiler. This is the first attempt to apply this perspective to Colombia, and to take the particular characteristics of the country into account while making comparisons with other countries that exhibit similar features in their own post-conflict and transitional phases. The article comes to the conclusion that in Colombia it is necessary to consider Interim Stabilization Measures, which allow the state to provide an effective response that takes advantage of available resources without losing sight of the need to strengthen local institutions in the mid-term.

Study objectives: Minimal-access thymectomy has become increasingly popular as surgical treatment for patients with nonthymomatous myasthenia gravis (NTMG) because of its comparable efficacy, safety, and lesser degree of tissue trauma compared with conventional open surgery. We reviewed and analyzed our data on video-assisted thoracic surgery (VATS) thymectomy and present the clinical outcomes according to the Myasthenia Gravis Foundation of America classification. Design: A retrospective review of VATS thymectomy for NTMG in a university hospital over a 12-year period. Data were collected from the medical records and supplemented with telephone surveys. The impact of surgery and other variables potentially affecting complete stable remission (CSR) were calculated using Kaplan-Meier survival curves; comparisons between survival curves was performed using the log-rank test. Results: A total of 38 consecutive patients underwent VATS thymectomy for NTMG. Median postoperative stay was 3 days. Pathologic examination revealed thymic hyperplasia in 61.1% of cases, normal thymus in 22.2%, and thymic atrophy in 16.6%. There was no perioperative mortality; complications occurred in four patients. After a median follow-up of 69 months, 91.6% of patients experienced improvement, with crude CSR achieved in 22.2%. Kaplan-Meier survival curve demonstrated a 75% CSR rate at 10-year follow-up. On univariate analysis, only disease duration ≤ 12 months (p = 0.03) was associated with a statistically significant improvement in CSR. Conclusions: VATS thymectomy for NTMG results in symptomatic improvement in the vast majority of patients, with a high rate of CSR. The procedure is associated with low morbidity and no perioperative mortality. Future studies on thymectomy for myasthenia gravis should be reported in a standardized manner to allow accurate comparisons between results in the absence of randomized prospective trials.

Introduction: In developing countries where talc may not be readily available, video-assisted thoracoscopic (VATS) iodopovidone pleurodesis offers an excellent alternative for the treatment of malignant pleural effusions (MPEs). Methods: This study analyzes a retrospective experience using VATS iodopovidone pleurodesis for malignant pleural effusions at a single cardiothoracic center in the capital of Colombia evaluating success according to LENT (Lactate, Eastern Cooperative Oncology Group-ECOG, Neutrophil-Lymphocyte ratio, Tumor type) scores. A total of 75 records of patients taken to VATS iodopovidone pleurodesis for MPEs were retrieved from our institutional database during a 5-year period from 2014-2019. Of these, 45 had complete clinical history data necessary to analyze both LENT scores and post-op follow-up imaging. Results: Of the 45 patients evaluated, 93.3% (42 patients) had either complete resolution of pleural effusions or partial resolution with an asymptomatic recovery within the first month post op. Chest pain was the most common postoperative complaint, which was present in 20% of patients. The mean postoperative ECOG score was 2±1.7. Patients with moderate to high-risk LENT scores had success rates of 96.7% and 92.3% respectively. Conclusion: Video-assisted thoracoscopic pleurodesis using Iodopovidone-iodine is an effective approach for MPEs. In developing countries where Iodopovidone iodine is readily available and affordable, patients may benefit from this agent with excellent results and minimal complications.

This article seeks to explore a speculative design practice that emerges from a modern understanding of animism. Design as it is taught in most universities around the world, perpetuates an Eurocentric view of the world and promotes unsustainability. Faced with the massive changes to earthly habitation brought upon by the Anthropocene, design must be transformed into a practice based on care. The Western construction of the concept of nature that was imposed over others via colonialism can be revised. Other understandings of nature offer interesting possibilities for human habitation and can open a pathway to reframe what it means to be human. Animism is thus presented as a way of thinking from the borderlands and a platform from where design can be transformed.

Diffuse pulmonary lymphangiomatosis (DLP) is an extremely rare silent disease, characterized by proliferation and thickening of abnormal pulmonary, pleural, and mediastinal soft tissue lymphatic channels. Its clinical presentation is nonspecific symptoms such as cough, dyspnea, and hemoptysis. Tomographic findings for DLP include thickening of the interlobular septa and peribronchovascular interstitium and ground glass opacities. Nevertheless, the anterior mediastinal mass, associated with thickening of interlobular septa and peribronchovascular interstitial, ground glass opacities, pleural effusion, diffuse infiltration of the mediastinum and pleural thickening in a patient with lymphangiomas, DLP should be suspected as a differential diagnosis.

This dissertation explores Early Modern cosmographical imagining and historical writing in the Andean region of the Americas. Following the European invasion of the Americas in the sixteenth century, prominent Western cosmographical and historical treatises like Sacro Bosco's de Sphera Mundi and the Nuremberg Liber Chronicarum became outdated regional works that lacked any information about American landmasses and indigenous people. The voids shown by these previously authoritative sources create a need for new ideas.In this dissertation, analyzing written and visual sources, I investigate how Indigenous, mestizo, and European scholars in the Early Modern Andes from the 1550s to the 1650s reinvented cosmographical and antiquarian practices to envision the world as an integrated entity in time and space. They combined non-written pre-Columbian structures, ruins, fossils, monoliths, megaliths, mythical landscapes, and indigenous narratives with ancient Biblical and Classical knowledge. By doing so, they established a new archive that became the foundation for further antiquarian and cosmographical knowledge, and revealing the that the so-called New World was full of history.I examine how innovative imaginings of historical time and cosmographical spaces were created in the Early Modern Andes. Authors demonstrated how the world was one since the very beginning of time by tracing connected world landscapes (worldscapes) to explain the geographical unity of the different continents and entangled chronological architectures (chronotectures) that linked the ancient ages of various societies, including places and people previously unthought of as part of the same world history.

El geógrafo británico David Harvey es conocido por ser uno de los teóricos sociales más influyentes de las últimas décadas, uno de los autores más citados del mundo y uno de los críticos más agudos del sistema capitalista. Actual profesor distinguido de Antropología en el Graduate Center de la Universidad de la Ciudad de Nueva York (CUNY) y director del Centro Nacional de Estrategia para el Derecho al Territorio del Instituto de Altos Estudios Nacionales en Ecuador, cuenta con una de las obras más prolíficas en el pensamiento geográfico, en la cual, ha abordado tanto el urbanismo y la teoría social contemporánea, como “la teoría social clásica y la economía política donde la reflexión sobre la obra de Marx, ha sido uno de sus ejes centrales, así como sus detallados análisis de la expresión espacial del modelo capitalista” (Navarrete Cardona, 2015).

El artículo presenta los desarrollos iniciales de una propuesta metodológica, dirigida a las organizaciones sociales, para aportar en los procesos de transformación desde sus propias visiones de futuros sostenibles. Esta metodología de carácter cualitativo emerge de contextos latinoamericanos y es el resultado de procesos de investigación-acción en un curso de diseño de la Universidad de Ibagué. El texto está dividido en cinco apartados. En el primero se plantean tres puntos para concebir el diseño de transiciones: la coyuntura socioambiental, la insuficiencia de las soluciones planteadas ante ella y el lugar de enunciación de la propuesta. En el segundo se interroga el papel del diseño en el proyecto capitalista y se traza un papel coherente con la búsqueda de cambio social. El tercero describe la propuesta metodológica en términos de las fases que la comprenden, seguido de la experiencia pedagógica de donde emerge, así como las reflexiones en torno a las prácticas de diseño. Por último, se esbozan algunas recomendaciones y reflexiones en torno al diseño de transiciones a través de las microutopías.