Bases anatomoradiológicas de los abordajes quirúrgicos para fracturas posteriores de la meseta tibial

Las fracturas de la meseta tibial en cirugía ortopédica son una de las más complejas en abordaje y planificación. El objetivo de este trabajo es realizar un estudio anatomoradiológico de las relaciones anatómicas entre las estructuras de la meseta tibial posterior con el fin de sugerir modificaciones en los abordajes actuales que disminuyan el daño iatrogénico.Grado en Medicin

RELEVANCIA DEL DIAGNÓSTICO DIFERENCIAL ENTRE EL SÍNDROME AÓRTICO AGUDO Y EL SÍNDROME CORONARIO AGUDO EN PACIENTES CON DOLOR TORÁCICO Y CRISIS HIPERTENSIVA: REVISIÓN A PROPÓSITO DE 2 CASOS / Relevance of the differential diagnosis between acute aortic syndrome and acute coronary syndrome in patients with thoracic pain and hypertensive crisis: review on 2 case reports

Acute aortic syndrome is a pathological process with low incidence compared with acute coronary syndrome, although with a worse prognosis in the short term, which is why its early diagnosis and urgent treatment are essential to the favorable evolution of thepatient. Electrocardiographic changes suggestive of myocardial ischemia, with acute evolution, are rare in acute aortic syndrome. Even in the presence of a suggestive thoracic pain and high levels of blood pressure, an adequate differential diagnosis is of utmost importance, since the administration of anticoagulation and antiplatelet therapy in high doses can have a dramatic impact on patient outcome. Two cases are presented in which electrocardiographic changes determined the action to take in patients with acute aortic syndrome

Vasoespastic angina, plaque erosion, ischemia and cardiac arrest: four of a kind or straight?

A 56-year-old woman, current smoker with a history of arterial hypertension and dyslipidemia was previously studied due to recurrent syncope with chest pain associated in recent months. Normal cardiac morphology and function was assessed by echocardiography and a coronary computed tomography angiography showed a noncalcified plaque with a 40% stenosis in the left anterior descending coronary artery (LAD). Single antiplatelet therapy and a statin were started..

Impact of moderate coronary atherosclerosis on long-term left ventricular remodeling after aortic valve replacement

Background: The role of coronary atherosclerosis (CA+) in ventricular remodeling after aortic valve replacement (AVR) for isolated aortic stenosis (AS) is not well defined. We sought to evaluate the impact of not revascularized moderate coronary atherosclerosis in long-term left ventricular (LV) remodeling after AVR. Methods: We assessed by coronariography the coronary artery disease in 66 patients referred for AVR and evaluated morphological and functional LV data by echocardiography both preoperatively and postoperatively (3 ± 1.2 years). Results: In patients without coronary atherosclerosis, hypertrophy regression was more intense and the absolute reverse remodeling was higher in LV mass index (–55.8 ± 36 g/m2 vs –28.4 ± 34 g/m2, p = 0.004), reduction of LV dimensions (LV end-diastolic diameter [LVEDD]: –4.1 ± 7.4 mm vs –2.2 ± 8.3 mm, p = 0.04), and regression of wall thickness (interventricular septum [IVS]: –3.3 ± 2.6 mm vs –1.6 ± 2.2 mm, p = 0.01; and posterior wall thickness [PWT]: –2.1 ± 2.1 mm vs 0.6 ± 2.1 mm, p = 0.012). Conclusions: After AVR for AS, not revascularized moderate coronary atherosclerosis determines a long-term lesser degree of LV hypertrophy regression and a worse absolute reverse remodeling of LV mass index, LVEDD, IVS and PWT. (Cardiol J 2011; 18, 3: 277–281

Multimerization of Zika Virus-NS5 Causes Ciliopathy and Forces Premature Neurogenesis

Zika virus (ZikV) is a flavivirus that infects neural tissues, causing congenital microcephaly. ZikV has evolved multiple mechanisms to restrict proliferation and enhance cell death, although the underlying cellular events involved remain unclear. Here we show that the ZikV-NS5 protein interacts with host proteins at the base of the primary cilia in neural progenitor cells, causing an atypical non-genetic ciliopathy and premature neuron delamination. Furthermore, in human microcephalic fetal brain tissue, ZikV-NS5 persists at the base of the motile cilia in ependymal cells, which also exhibit a severe ciliopathy. Although the enzymatic activity of ZikV-NS5 appears to be dispensable, the amino acids Y25, K28, and K29 that are involved in NS5 oligomerization are essential for localization and interaction with components of the cilium base, promoting ciliopathy and premature neurogenesis. These findings lay the foundation for therapies that target ZikV-NS5 multimerization and prevent the developmental malformations associated with congenital Zika syndrome.The work in E.M.’s laboratory was supported by grants BFU2016-77498-P, BFU2016-77498-P, and La Maratò de TV3 foundation 201833-10. M.S. holds a Ramón Y Cajal fellowship (RYC2018-025379-I). J.B.-A is a recipient of a BES-2017-080050 PhD scholarship. The work in N.V.’s laboratory was supported by grants BIO2017-83906-P, Maria de Maeztu Unit of Excellence MDM-2014-0435 (MCIU), and La Maratò de TV3 foundation 201833-10. The work in N.A.’s laboratory was supported by NIH/NINDS R00NS089859 and IDDRC-NPDA (CHOP/Penn)

Sustained benefit of left ventricular remodelling after valve replacement for aortic stenosis

Background: Valve replacement for aortic stenosis (AS) determines negative ventricular remodelling. We used cross sectional and Doppler echocardiography to check how rapidly it occurs and to assess if these changes are sustained over time. Methods: We evaluated in 34 patients subjected to aortic valve replacement for AS morphological and functional (ejection fraction and E:A ratio) left ventricular data by echocardiography prior to surgery and 2 postoperative studies: early after surgery (pQ1) and at mid-term evolution (pQ2). Results: Left ventricular mass index was reduced at pQ1 (from 152 &#177; 47 g/m2 to 113 &#177; 31 g/m2; p < 0.01) as well as end-diastolic (from 51.3 mm to 48.3 mm; p < 0.03), end-systolic (from 32.2 mm to 29.4 mm; p < 0.02), interventricular septum (from 12.9 mm to 10.3 mm; p < 0.01), and posterior wall (from 12.5 mm to 11 mm; p < 0.01) dimensions. Left ventricular ejection fraction (from 61.2% to 65.2%; p < 0.04) and E:A ratio (from 0.94 to 0.98; p < 0.01) increased significantly at pQ1. There were no significant differences in measurements between pQ1 and pQ2. Conclusions: Aortic valve replacement surgery leads to a rapid negative left ventricular remodelling during the first 7 months, including a decrease in myocardial hypertrophy and an improvement in systolic and diastolic function. These beneficial hemodynamic changes are sustained for at least 3 years

Wpływ umiarkowanej miażdżycy tętnic wieńcowych na przebudowę lewej komory serca u chorych po wymianie zastawki aortalnej

Wstęp: Znaczenie miażdżycy tętnic wieńcowych (CA+) w procesie przebudowy lewej komory po wymianie zastawki aortalnej (AVR) z powodu izolowanej stenozy aortalnej (AS) jest wciąż przedmiotem badań. Celem pracy była ocena wpływu niepoddanych rewaskularyzacji umiarkowanych zmian miażdżycowych tętnic wieńcowych na odległy proces remodelingu lewej komory serca (LV) po AVR. Metody: Za pomocą koronarografii oceniono stopień nasilenia choroby wieńcowej u 66 pacjentów zakwalifikowanych do AVR i pozyskano dane echokardiograficzne dotyczące budowy i funkcji LV zarówno przed-, jak i pooperacyjnie (3 &#177; 1,2 roku). Wyniki: U pacjentów bez miażdżycy tętnic wieńcowych ustąpienie przerostu i całkowite odwrócenie remodelingu były większe niż w grupie chorych z miażdżycą, gdy porównano indeks masy LV (&#8211;55,8 &#177; 36 g/m2 v. &#8211;28,4 &#177; 34 g/m2; p = 0,004). Ponadto w grupie osób bez choroby wieńcowej obserwowano istotne zmniejszenie wymiarów LV [wymiar końcoworozkurczowy LV (LVEDD): &#8211;4,1 &#177; 7,4 mm v. &#8211;2,2 &#177; 8,3 mm; p = 0,04] oraz grubości ścian [przegrody międzykomorowej (IVS): &#8211;3,3 &#177; 2,6 mm v. &#8211;1,6 &#177; 2,2 mm; p = 0,01; i ściany tylnej (PWT): &#8211;2,1 &#177; 2,1 mm v. 0,6 &#177; 2,1 mm; p = 0,012]. Wnioski: Brak rewaskularyzacji umiarkowanych zmian miażdżycowych w nasierdziowych tętnicach wieńcowych u pacjentów poddanych AVR z powodu AS prowadzi w odległej obserwacji do zwolnienia procesu regresji przerostu lewej komory i zaburzenia odwrócenia remodelingu w analizie następujących parametrów: indeksu masy LV, LVEDD, IVS i PTW. (Folia Cardiologica Excerpta 2011; 6, 3: 162&#8211;167

Soil and Freshwater Bioassays to Assess Ecotoxicological Impact on Soils Affected by Mining Activities in the Iberian Pyrite Belt

This study aims to use geochemical, mineralogical, ecotoxicological and biological indicators for a comprehensive assessment of the ecological risks related to the mobility, ecotoxicity and bioavailability of potentially harmful elements in the Lousal mining district. Particularly, toxicity was evaluated using four assays: algae, cytotoxicity assays with HaCaT cell line (dermal), earthworms and Daphnia magna. The geochemical and mineralogical characterization of the studied area shows that the mine wastes underwent intense weathering processes, producing important contamination of the adjacent soils, which also led to the release and mobilization of PHEs into nearby water courses. Total PTE results indicate that the soils affected by mining activities were highly contaminated with As and Cu, while Zn and Pb content ranged from low to very high, depending on the analyzed samples. Cadmium levels were found to be very low in most of the soil samples. The test using Daphnia magna was the most sensitive bioassay, while the Eisenia foetida test was the least sensitive. Except for the LOS07 soil sample, the rest of the soils were classified as “High acute toxicity” and “Very high acute toxicity” for aquatic systems. The results in HACaT cells showed results similar to the ecotoxicological bioassays. The application of biotests, together with geochemical and mineralogical characterization, is a very useful tool to establish the degree of contamination and the environmental risk of potentially harmful elements

Evaluación del riesgo ecotoxicológico en suelos afectados por actividades mineras en la Faja Pirítica mediante aplicación de bioensayos

Depto. de Geodinámica, Estratigrafía y PaleontologíaDepto. de Mineralogía y PetrologíaFac. de Ciencias GeológicasTRUEMinisterio de Ciencia e Innovación (MICINN) MCIN AEI/10.13039/501100011033pu