Aneurismas de la aorta toracoabdominal. Indicaciones de tratamiento. Cirugía abierta

ResumenEl tratamiento quirúrgico abierto de los aneurismas toracoabdominales supone un reto muy importante para cirujanos, anestesistas y perfusionistas. Se trata de una intervención agresiva, sujeta a multitud de variables no habituales y normalmente poco estandarizada en nuestro medio por su baja incidencia. El objetivo de este artículo es realizar una revisión de las indicaciones actuales de tratamiento de los aneurismas toracoabdominales, así como exponer la vía de abordaje para cirugía abierta, referencias anatómicas y técnicas quirúrgicas y de perfusión más reproducibles en la actualidad. Se expone la técnica quirúrgica paso a paso, así como las estrategias de protección medular y visceral. Por último, se discuten cuáles son resultados postoperatorios de estas técnicas y las alternativas futuras.AbstractOpen surgical treatment of thoracic aneurysms is a great challenge for surgeons, anaesthetists and perfusionists. It is a very aggressive procedure, dealing with a high number of uncommon variables and is usually non-standardised in this area, due to its low incidence. The aim of this article is to conduct a review of current indications of treatment of thoracoabdominal aneurysms and to present the open surgery approach, anatomical references, and the most usual and reliable techniques for surgery and perfusion. Step-by-step planning for the intervention is also explained, as well as the strategies for spine and visceral protection. Finally, results for this surgery and future alternatives are discussed

The Role of the TGF-beta Coreceptor Endoglin in Cancer

Endoglin (CD105) is an auxiliary membrane receptor of transforming growth factor beta (TGF-beta) that interacts with type I and type II TGF-beta receptors and modulates TGF-beta signaling. Endoglin is overexpressed in the tumor-associated vascular endothelium, where it modulates angiogenesis. This feature makes endoglin a promising target for antiangiogenic cancer therapy. In addition, recent studies on human and experimental models of carcinogenesis point to an important tumor cell-autonomous role of endoglin by regulating proliferation, migration, invasion, and metastasis. These studies suggest that endoglin behaves as a suppressor of malignancy in experimental and human epithelial carcinogenesis, although it can also promote metastasis in other types of cancer. In this review, we evaluate the implication of endoglin in tumor development underlying studies developed in our laboratories in recent years

Oligodendrogenesis in iron-deficient rats: Effect of apotransferrin

In rats, iron deficiency produces an alteration in myelinformation. However, there is limited information on theeffects of this condition on oligodendroglial cell (OLGc)proliferation and maturation. In the present study, wefurther analyzed the hypomyelination associated withiron deficiency by studying the dynamics of oligodendrogenesis.Rats were fed control (40 mg Fe/kg) oriron-deficient (4 mg Fe/kg) diets from gestation day 5until postnatal day 3 (P3) or 11 (P11). OLGc proliferation,migration and differentiation were investigatedbefore and after an intracranial injection of apotransferrinat 3 days of age (P3). The proliferating cell populationwas evaluated at P3. Iron-deficient (ID) animalsshowed an increase in the oligodendrocyte precursorscell (OPC) population in comparison with controls. Theoverall pattern of migration of cells labeled with BrdUwas investigated at P11. Iron deficiency increased theamount of BrdU1 cells in the corpus callosum (CC) anddecreased OLGc maturation and myelin formation.Changes in nerve conduction were analyzed by measuringvisual evoked potentials. Latency and amplitudewere significantly disturbed in ID rats compared withcontrols. Both parameters were substantially normalizedwhen animals were treated with a single intracranialinjection of 350 ng apotransferrin (aTf). The currentresults give support to the idea that iron deficiencyincreases the number of proliferating and undifferentiatedcells in the CC compared with the control. Treatmentwith aTf almost completely reverted the effects ofiron deficiency, both changing the migration patternand increasing the number of mature cells in the CCand myelin formation.Fil: Rosato Siri, María Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Badaracco, M. E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini". Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Físico-Química Biológicas; ArgentinaFil: Ortiz, E. H.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini". Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Físico-Química Biológicas; ArgentinaFil: Belforte, Nicolás Adalberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Guardia Clausi, Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini". Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Físico-Química Biológicas; ArgentinaFil: Soto, Eduardo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini". Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Físico-Química Biológicas; ArgentinaFil: Bernabeu, Ramon Oscar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Pasquini, Juana Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini". Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Físico-Química Biológicas; Argentin

Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system

BackgroundDesmoid tumours (DTs) or deep fibromatosis are benign soft-tissue tumours, sometimes locally aggressive, requiring intervention on some cases. Surgery has been the gold standard, but new less invasive techniques such as percutaneous cryoablation have proved their effectiveness, reducing health resources and complications. The study aimed to compare the total cost of percutaneous cryoablation and conventional surgery for patients with extra-abdominal and/or abdominal wall DTs, candidates for local ablative treatment in Spain.MethodsA cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (euro 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery.ResultsThe total cost for percutaneous cryoablation (euro 5774.78/patient-year) was lower than the total cost for conventional surgery (euro 6780.98/patient-year), yielding cost savings up to euro 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results' robustness.ConclusionPercutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain.Critical relevance statementThis manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process.Key points center dot Desmoid tumours are locally aggressive and may require local therapy.center dot Percutaneous cryoablation procedure is less invasive than the conventional surgery.center dot Cost comparison shows savings associated to percutaneous cryoablation use.Key points center dot Desmoid tumours are locally aggressive and may require local therapy.center dot Percutaneous cryoablation procedure is less invasive than the conventional surgery.center dot Cost comparison shows savings associated to percutaneous cryoablation use.Key points center dot Desmoid tumours are locally aggressive and may require local therapy.center dot Percutaneous cryoablation procedure is less invasive than the conventional surgery.center dot Cost comparison shows savings associated to percutaneous cryoablation use

Hunger, misery and disease in Latin America and the Caribbean: the role of nutrition in neglected tropical diseases (NTDs) in Nicaragua

La alimentación y la nutrición adecuadas son el primer y el más importante de los derechos humanos fundamentales y de los determinantes de la salud de las personas. Con el propósito de ayudar a reducir el impacto del hambre y facilitar el control y la eliminación de las enfermedades tropicales desatendidas (ETDs), contribuyendo al alcance de la seguridad alimentaria en la población escolar del Departamento de Chinandega (Nicaragua), se desarrolló el proyecto piloto “Hambre, miseria y enfermedad: el papel de la nutrición en las enfermedades tropicales desatendidas (ETDs) en Nicaragua”. El presente artículo documenta esta experiencia. Para conseguir los objetivos planteados se organizó una jornada científica con expertos en nutrición y en las ETDs, un panel elaboró las conclusiones que sirvieron para la redacción del documento de consenso, en el cual se fundamentó la elaboración de los materiales a ser utilizados en la intervención educativa: “Alimentación para crecer sano”, manual dirigido a los promotores de salud y “Manual de estrategias educativas: alimentación para crecer sano” dirigido a los escolares. Se realizaron cuatro jornadas de capacitación que inicialmente involucró a 80 maestros de 20 escuelas, y que en la última jornada logró sumar 145 docentes. Seguidamente se desarrolló la fase de multiplicación en las escuelas, con la participación de 2.327 niños de entre 7 y 14 años de edad. En esta experiencia la receptividad de los docentes, la mejora en sus habilidades y conocimientos son una garantía para la replicación en los niños y niñas.Food and proper nutrition are the first and most important of fundamental human rights and the determinants of health of people. In order to help reduce the impact of hunger and facilitate the control and elimination of neglected tropical diseases (NTDs), contributing to the extent of food safety in the school population of the Department of Chinandega (Nicaragua), the pilot project “Hunger, misery and disease: the role of nutrition in neglected tropical diseases (NTDs) in Nicaragua” was developed. This article documents this experience. To achieve the goals a scientific conference with experts in nutrition and NTDs was organized, a panel drew conclusions that were used for drafting the consensus document in which the development of the materials was based to be used in the intervention education: A “Food to grow healthy” manual aimed at health promoters and a “Manual of educational strategies: healthy food for growth” aimed at schoolchildren. Four days of training initially involved 80 teachers from 20 schools were made, and on the last day managed to reach 145 teachers. Then the multiplication phase in schools was developed with the participation of 2,327 children between 7 and 14 years old. In this experience the receptivity of teachers, improving their skills and knowledge are a guarantee for replication in children.Este proyecto se ha realizado en el marco del proyecto de cooperación universitaria para el desarrollo “Hambre, miseria y enfermedad en Latinoamérica y el Caribe: el papel de la nutrición en las enfermedades tropicales desatendidas (ETDs) en Nicaragua” (05/13) financiado por el Vicerrectorado de Relaciones Internacionales de la Universidad de Alicante

Daily consumption of a dairy drink enriched with DHA, Vitamins and minerals enhanced nutritional status and cognitive abilities parameters

Preadolescence is a period of growth with special nutritional requirements. In this research we investigated the effects produced by a 5-month consumption of an enriched dairy drink on biochemical and cognitive development parameters in children. Methods: 119 children (8 14y) of both genders (male 49%, female 51%) were randomly distributed into two study groups. The supplemented group (SG, n = 60) consumed 0.6 L/day (breakfast, elevenses and teatime) of an enriched dairy drink containing fish oils (high in DHA), oleic acid, carbohydrates (sugar and honey), vitamins (A, B complex, C, D, and E) and minerals (calcium, phosphorus, zinc) (Puleva Max®). The control group (CG, n = 59) consumed 0.6 L/day of standard whole milk. Both groups received the same dietary advice and consumed the dairy drinks for 5-moths, in addition to their usual diet. Blood samples and psychometric tests (some subscales of W.I.S.C.-IV of Wechsler and EVALUA of Vidal) were taken at 0 and 5 months. RM ANOVA was applied. Data are expressed as mean±SEM. Results: The consumption of the enriched dairy drink (SG) produced significant (p < 0.05) increases in plasma DHA (20%) and calcium (1.5%). Total proteins (1.9%), transferrine (2.1%), total cholesterol (3.3%) and HDLcholesterol (5.2%), but not LDL-cholesterol, decreased significantly in CG. Regarding psychometric parameters, digits span (working memory test), speed reading and reading comprehension scores showed significant increases in SG at the end of the study (16.8%, 19.1%, and 19.0% respectively) whereas CG only showed higher scores in the reading comprehension test (19.2%). Conclusion: The dietary supplementation with the enriched dairy drink improved the nutritional and biochemical status and a number of cognitive performance markers in children of 8 and 14 years. Supported by Puleva Food SA.Universidad e Granada Puleva Biotech S

Polygenic contribution to the relationship of loneliness and social isolation with schizophrenia

Previous research suggests an association of loneliness and social isolation (LNL-ISO) with schizophrenia. Here, we demonstrate a LNL-ISO polygenic score contribution to schizophrenia risk in an independent case-control sample (N = 3,488). We then subset schizophrenia predisposing variation based on its effect on LNL-ISO. We find that genetic variation with concordant effects in both phenotypes shows significant SNP-based heritability enrichment, higher polygenic contribution in females, and positive covariance with mental disorders such as depression, anxiety, attention-deficit hyperactivity disorder, alcohol dependence, and autism. Conversely, genetic variation with discordant effects only contributes to schizophrenia risk in males and is negatively correlated with those disorders. Mendelian randomization analyses demonstrate a plausible bi-directional causal relationship between LNL-ISO and schizophrenia, with a greater effect of LNL-ISO liability on schizophrenia than vice versa. These results illustrate the genetic footprint of LNL-ISO on schizophrenia

Engineered Contrast Agents in a Single Structure for T1-T2 Dual Magnetic Resonance Imaging

[EN] The development of contrast agents (CAs) for Magnetic Resonance Imaging (MRI) with T-1-T-2 dual-mode relaxivity requires the accurate assembly of T-1 and T-2 magnetic centers in a single structure. In this context, we have synthesized a novel hybrid material by monitoring the formation of Prussian Blue analogue Gd(H2O)(4)[Fe(CN)(6)] nanoparticles with tailored shape (from nanocrosses to nanorods) and size, and further protection with a thin and homogeneous silica coating through hydrolysis and polymerization of silicate at neutral pH. The resulting Gd(H2O)(4)[Fe(CN)(6)]@SiO2 magnetic nanoparticles are very stable in biological fluids. Interestingly, this combination of Gd and Fe magnetic centers closely packed in the crystalline network promotes a magnetic synergistic effect, which results in significant improvement of longitudinal relaxivity with regards to soluble Gd3+ chelates, whilst keeping the high transversal relaxivity inherent to the iron component. As a consequence, this material shows excellent activity as MRI CA, improving positive and negative contrasts in T-1- and T-2-weighted MR images, both in in vitro (e.g., phantom) and in vivo (e.g., Sprague-Dawley rats) models. In addition, this hybrid shows a high biosafety profile and has strong ability to incorporate organic molecules on the surface with variable functionality, displaying great potential for further clinical application.Financial support of the Spanish Ministry of Economy and Competitiveness (projects TEC2016-80976-R and SEV-2016-0683) is gratefully acknowledged. Dr E. M. Rivero thanks the Cursol Foundation for a post-doctoral scholarship. A. C. G. also thanks the La Caixa Foundation for a Ph.D. scholarship. We fully appreciate the assistance of the Electron Microscopy Service of the UPV and INSCANNER S.L.Cabrera-García, A.; Checa-Chavarria, E.; Pacheco-Torres, J.; Bernabeu-Sanz, A.; Vidal Moya, JA.; Rivero-Buceta, EM.; Sastre Navarro, GI.... (2018). 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El arte de la violencia

El tercer número de la colección Laboratorio Transmedia (ISSN: 2794-0861) contiene trece relatos escritos durante el curso 2021/2022 por estudiantes del Máster universitario en Escritura Creativa.Unidad Dptal. de Literatura y MediosFac. de Ciencias de la InformaciónTRUEUniversidad Complutense de Madridpu