Estudio de la trabeculación ósea en la artrodesis subastragalina

En este artículo presentamos nuestra casuística en artrodesis artroscópica subastragalina revisando los principios biomecánicos que rigen esta articulación y presentando ésta como una técnica válida para el tratamiento de distintas patologías en el retropié que interesan esta articulación.We present our casuistic on arthroscopic subtalar arthrodesis reviewing the biomechanics of this joint and presenting it as a valid technique for the treatment of some pathologies in the rearfoot that affect this joint.Premio al mejor trabajo en el XXXII Congreso de la Sociedad Ibérica de Biomecánica y BiomaterialesPeer ReviewedAward-winnin

Novedades en la farmacoterapia del dolor óseo de origen maligno y no maligno.

Introducción: El dolor óseo es un síntoma debilitante que puede aparecer en un gran número de trastornos tanto malignos como no malignos y existen indicios que la prevalencia va a aumentar en las próximas décadas. El objetivo de esta revisión es recopilar y resumir la evidencia disponible sobre el tratamiento farmacológico actual del dolor óseo tanto en patologías de origen oncohematológico como de origen no maligno. Método: Para responder al objetivo de nuestro trabajo se realizó una búsqueda exhaustiva de la literatura publicada en las principales bases de datos hasta el 31 de abril de 2016. Resultados: Los fármacos antirresortivos, como los bifosfonatos, y aquellos que estimulan la formación del hueso, como la teriparatida, junto a analgésicos, como los AINEs y lo opioides, son actualmente la base farmacológica para tratar el dolor óseo (dependiendo de qué patología se trate). Existen nuevas hipótesis sobre diferentes mecanismos que pueden estar relacionados con la génesis del dolor, con el consecuente desarrollo de nuevas moléculas con distintos y novedosos mecanismos de acción. Conclusiones: Es necesario que se desarrollen más estudios que aclaren aspectos inciertos relacionados con el tratamiento del dolor óseo y permita el desarrollo de nuevos fármacos. Los farmacéuticos deben de estar actualizados sobre el arsenal terapéutico disponible en la actualidad para el tratamiento del dolor óseo como el primer paso para llevar a cabo una atención farmacéutica de calidad

Novedades en la farmacoterapia del dolor óseo de origen maligno y no maligno.

Introducción: El dolor óseo es un síntoma debilitante que puede aparecer en un gran número de trastornos tanto malignos como no malignos y existen indicios que la prevalencia va a aumentar en las próximas décadas. El objetivo de esta revisión es recopilar y resumir la evidencia disponible sobre el tratamiento farmacológico actual del dolor óseo tanto en patologías de origen oncohematológico como de origen no maligno. Método: Para responder al objetivo de nuestro trabajo se realizó una búsqueda exhaustiva de la literatura publicada en las principales bases de datos hasta el 31 de abril de 2016. Resultados: Los fármacos antirresortivos, como los bifosfonatos, y aquellos que estimulan la formación del hueso, como la teriparatida, junto a analgésicos, como los AINEs y lo opioides, son actualmente la base farmacológica para tratar el dolor óseo (dependiendo de qué patología se trate). Existen nuevas hipótesis sobre diferentes mecanismos que pueden estar relacionados con la génesis del dolor, con el consecuente desarrollo de nuevas moléculas con distintos y novedosos mecanismos de acción. Conclusiones: Es necesario que se desarrollen más estudios que aclaren aspectos inciertos relacionados con el tratamiento del dolor óseo y permita el desarrollo de nuevos fármacos. Los farmacéuticos deben de estar actualizados sobre el arsenal terapéutico disponible en la actualidad para el tratamiento del dolor óseo como el primer paso para llevar a cabo una atención farmacéutica de calidad

The Core-Collapse Supernova Rate in Arp299 Revisited

We present a study of the CCSN rate in nuclei A and B1 of the luminous infrared galaxy Arp299, based on 11 years of Very Large Array monitoring of their radio emission at 8.4 GHz. Significant variations in the nuclear radio flux density can be used to identify the CCSN activity in the absence of high-resolution very long baseline interferometry observations. In the case of the B1-nucleus, the small variations in its measured diffuse radio emission are below the fluxes expected from radio supernovae, thus making it well-suited to detect RSNe through flux density variability. In fact, we find strong evidence for at least three RSNe this way, which results in a lower limit for the CCSN rate of 0.28 +/- 0.16 per year. In the A-nucleus, we did not detect any significant variability and found a SN detection threshold luminosity which allows only the detection of the most luminous RSNe known. Our method is basically blind to normal CCSN explosions occurring within the A-nucleus, which result in too small variations in the nuclear flux density, remaining diluted by the strong diffuse emission of the nucleus itself. Additionally, we have attempted to find near-infrared counterparts for the earlier reported RSNe in the Arp299 nucleus A, by comparing NIR adaptive optics images from the Gemini-N telescope with contemporaneous observations from the European VLBI Network. However, we were not able to detect NIR counterparts for the reported radio SNe within the innermost regions of nucleus A. While our NIR observations were sensitive to typical CCSNe at 300 mas from the centre of the nucleus A, suffering from extinction up to A_v~15 mag, they were not sensitive to such highly obscured SNe within the innermost nuclear regions where most of the EVN sources were detected. (abridged)Comment: 12 pages, 4 figures and 7 tables. Accepted for publication in MNRA

Can robotic-based top-down rehabilitation therapies improve motor control in children with cerebral palsy? A perspective on the CPWalker project

[EN] Cerebral Palsy (CP) is one of the most severe disabilities in childhood, and it demands important costs in health, education, and social services. CP is caused by damage to or abnormalities inside the developing brain that disrupt the brain's ability to control movement and maintain posture. Furthermore, CP is often associated with sensory deficits, cognition impairments, communication and motor disabilities, behavior issues, seizure disorder, pain, and secondary musculoskeletal problems. According to the literature, motor modules are peripheral measurements related to automatic motor control. There is a lack of evidence of change in motor modules in children with CP when different treatment approaches have been evaluated. Thus, new strategies are needed to improve motor control in this population. Robotic-based therapies are emerging as an effective intervention for gait rehabilitation in motor disorders such as stroke, spinal cord injury, and CP. There is vast clinical evidence that neural plasticity is the central core of motor recovery and development, and on-going studies suggest that robot-mediated intensive therapy could be beneficial for improved functional recovery. However, current robotic strategies are focused on the peripheral neural system (PNS) facilitating the performance of repetitive movements (a bottom-up approach). Since CP affects primarily brain structures, both the PNS and the central nervous system (CNS) should to be integrated in a physical and cognitive rehabilitation therapy (a top-down approach). This paper discusses perspectives of the top-down approach based on a novel robot-assisted rehabilitative system. Accordingly, the CPWalker robotic platform was developed to support novel therapies for CP rehabilitation. This robotic platform (Smart Walker + exoskeleton) is controlled by a multimodal interface enabling the interaction of CP infants with robot-based therapies. The aim of these therapies is to improve the physical skills of infants with CP using a top-down approach, in which motor related brain activity is used to drive robotic physical rehabilitation therapies. Our hypothesis is that the CPWalker concept will promote motor learning and this improvement will lead to significant improvements in automatic motor control.Lerma Lara, S.; Martínez Caballero, I.; Bayón, C.; Del Castillo, M.; Serrano, I.; Raya, R.; Belda Lois, JM.... (2016). Can robotic-based top-down rehabilitation therapies improve motor control in children with cerebral palsy? A perspective on the CPWalker project. Biomedical Research and Clinical Practice. 22-26. doi:10.15761/BRCP.1000106S222

Crosstalk Between LXR and Caveolin-1 Signaling Supports Cholesterol Efflux and Anti-Inflammatory Pathways in Macrophages

© 2021 Ramírez, Torrecilla-Parra, Pardo-Marqués, de-Frutos, Pérez-García, Tabraue, de la Rosa, Martín-Rodriguez, Díaz-Sarmiento, Nuñez, Orizaola, Través, Camps, Boscá and Castrillo.Macrophages are immune cells that play crucial roles in host defense against pathogens by triggering their exceptional phagocytic and inflammatory functions. Macrophages that reside in healthy tissues also accomplish important tasks to preserve organ homeostasis, including lipid uptake/efflux or apoptotic-cell clearance. Both homeostatic and inflammatory functions of macrophages require the precise stability of lipid-rich microdomains located at the cell membrane for the initiation of downstream signaling cascades. Caveolin-1 (Cav-1) is the main protein responsible for the biogenesis of caveolae and plays an important role in vascular inflammation and atherosclerosis. The Liver X receptors (LXRs) are key transcription factors for cholesterol efflux and inflammatory gene responses in macrophages. Although the role of Cav-1 in cellular cholesterol homeostasis and vascular inflammation has been reported, the connection between LXR transcriptional activity and Cav-1 expression and function in macrophages has not been investigated. Here, using gain and loss of function approaches, we demonstrate that LXR-dependent transcriptional pathways modulate Cav-1 expression and compartmentation within the membrane during macrophage activation. As a result, Cav-1 participates in LXR-dependent cholesterol efflux and the control of inflammatory responses. Together, our data show modulation of the LXR-Cav-1 axis could be exploited to control exacerbated inflammation and cholesterol overload in the macrophage during the pathogenesis of lipid and immune disorders, such as atherosclerosis.We thank MINECO FPI predoctoral fellowship granted to MCO (BES-2015-075339). Experimental work was supported by grants from Ministerio de Ciencia, Investigación y Universidades, y Fondo Europeo de Desarrollo Regional (FEDER) Grant REF: PID2019-104284RB-I00/AEI/10.13039/501100011033 (to AC) and support from Networks of Excellence from MINECO (Nuclear Receptors in Cancer, Metabolism and Inflammation [NuRCaMeIn] SAF2017-90604-REDT to AC. Ministerio de Economía, Industria y Competitividad, Ministerio de Ciencia, Investigación y Universidades, and Agencia Estatal de Investigación (SAF2017-82436-R, RTC2017-6283-1), Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CB16/11/00222), Consorcio de Investigación en Red de la Comunidad de Madrid, S2017/BMD-3686 and Fondo Europeo de Desarrollo Regional (to LB). Ministerio de Ciencia, Investigación y Universidades, and Agencia Estatal de Investigación Proyectos de I+D+i Retos Investigación 2018 (RTI2018-095061-B-I00); TALENTO Grant from Madrid Government, Spain (2017-T1/BMD-5333); Consejería de Ciencia, Universidades e Innovación Comunidad de Madrid, Spain (PEJD-2018-POST/BMD-8900 and PEDJ-2018-AI/BDM-9724) to CMR

La estructura sísmica de la corteza de la Zona de Ossa Morena y su interpretación geológica

El experimento de sísmica de reflexión profunda IBERSEIS ha proporcionado una imagen de la corteza del Orógeno Varisco en el sudoeste de Iberia. Este artículo se centra en la descripción de la corteza de la Zona de Ossa Morena (OMZ), que está claramente dividida en una corteza superior, con reflectividad de buzamiento al NE, y una corteza inferior de pobre reflectividad. Las estructuras geológicas cartografiadas en superficie se correlacionan bien con la reflectividad de la corteza superior, y en la imagen sísmica se ven enraizar en la corteza media. Ésta está constituida por un cuerpo muy reflectivo, interpretado como una gran intrusión de rocas básicas. La imagen de las suturas que limitan la OMZ muestra el carácter fuertemente transpresivo de la colisión orogénica varisca registrada en el sudoeste de Iberia. La Moho actual es plana y, en consecuencia, no se observa la raíz del orógeno

Platform for the automatic extraction and coding of concepts within the scope of Oncohematology (COCO Project)

El proyecto COCO tiene como objetivo diseñar, desarrollar y validar un sistema de extracción de conocimiento que, a partir de los textos de la Historia de Salud Electrónica, codifique automáticamente los diagnósticos de Oncohematología mediante Tecnologías del Lenguaje basada en un estándar de pipeline interoperable. La necesidad de normalizar el conocimiento de la Historia Clínica constituye un gran desafío. Puesto que la CIE-10 presenta limitaciones para representar esta información, se desarrolló la norma CIE-O-3, para dar soporte a este tipo de patologías. Se propone desarrollar el primer pipeline de Procesamiento del Lenguaje Natural de componentes interoperables, así como, el primer codificador automático CIE-O-3 y CIE-10. Nuestro sistema servirá de apoyo a la decisión, investigación y gestión clínica en este campo.The COCO project aims to design, develop and validate a knowledge extraction system that, based on the texts of the Electronic Health Record, automatically codes Oncohematology diagnostics using Language Technologies based on an interoperable pipeline standard. The need to standardize knowledge of the Electronic Health Record is a major challenge. Since ICD-10 has limitations in representing this information, ICD-O-3 was developed to support this type of pathology. It is proposed to develop the first Natural Language Processing pipeline of interoperable components, as well as the first ICD-O-3 and ICD-10 automatic encoder. Our system will support clinical decision making, research and management in this field.Esta investigación ha sido financiada en parte por la Plataforma de Innovación en Tecnologías Médicas y Salud (Plataforma ITEMAS, PT13/0006/0036) financiado por el Instituto de Salud Carlos III y por el proyecto COCO (PIN-0121-2017) financiado por la consejería de Salud de la Junta de Andalucía ambos cofinanciados a través de los Fondos Europeos de Desarrollo Regional (FEDER)

Diagnosis of Tuberculosis in the Wild Boar (Sus scrofa): A Comparison of Methods Applicable to Hunter-Harvested Animals

To obtain robust epidemiological information regarding tuberculosis (TB) in wildlife species, appropriate diagnostic methods need to be used. Wild boar (Sus scrofa) recently emerged as a major maintenance host for TB in some European countries. Nevertheless, no data is available to evaluate TB post-mortem diagnostic methods in hunter-harvested wild boar. METHODOLOGY/PRINCIPAL FINDINGS: Six different diagnostic methods for TB were evaluated in parallel in 167 hunter-harvested wild boar. Compared to bacteriological culture, estimates of sensitivity of histopathology was 77.8%, gross pathology 72.2%, PCR for the MPB70 gene 66.7%, detection of acid-fast bacilli (AFB) in tissue contact smears 55.6% and in histopathology slides 16.7% (estimated specificity was 96.7%, 100%, 100%, 94.4% and 100%, respectively). Combining gross pathology with stained smears in parallel increased estimated sensitivity to 94.4% (94.4% specificity). Four probable bacteriological culture false-negative animals were identified by Discriminant Function Analysis. Recalculating the parameters considering these animals as infected generated estimated values for sensitivity of bacteriology and histopathology of 81.8%, gross pathology 72.7%, PCR for the MPB70 gene 63.6%, detection of AFB in tissue contact smears 54.5% and in histopathology slides 13.6% (estimated specificity was 100% for gross pathology, PCR, bacteriology and detection of AFB in histopathology slides, 96.7% for histopathology and 94.4% for stained smears). CONCLUSIONS/SIGNIFICANCE: These results show that surveys for TB in wild boar based exclusively on gross pathology considerably underestimate prevalence, while combination of tests in parallel much improves sensitivity and negative predictive values. This finding should thus be considered when planning future surveys and game meat inspection schemes. Although bacteriological culture is the reference test for TB diagnosis, it can generate false-negative results and this should be considered when interpreting data.This study was funded by laboratory funds from Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript

Contribution of Candida biomarkers and DNA detection for the diagnosis of invasive candidiasis in ICU patients with severe abdominal conditions

BACKGROUND: To assess the performance of Candida albicans germ tube antibody (CAGTA), (1 → 3)-ß-D-glucan (BDG), mannan antigen (mannan-Ag), anti-mannan antibodies (mannan-Ab), and Candida DNA for diagnosing invasive candidiasis (IC) in ICU patients with severe abdominal conditions (SAC). METHODS: A prospective study of 233 non-neutropenic patients with SAC on ICU admission and expected stay ≥ 7 days. CAGTA (cutoff positivity ≥ 1/160), BDG (≥80, 100 and 200 pg/mL), mannan-Ag (≥60 pg/mL), mannan-Ab (≥10 UA/mL) were measured twice a week, and Candida DNA only in patients treated with systemic antifungals. IC diagnosis required positivities of two biomarkers in a single sample or positivities of any biomarker in two consecutive samples. Patients were classified as neither colonized nor infected (n = 48), Candida spp. colonization (n = 154) (low-grade, n = 130; high-grade, n = 24), and IC (n = 31) (intra-abdominal candidiasis, n = 20; candidemia, n = 11). RESULTS: The combination of CAGTA and BDG positivities in a single sample or at least one of the two biomarkers positive in two consecutive samples showed 90.3 % (95 % CI 74.2–98.0) sensitivity, 42.1 % (95 % CI 35.2–98.8) specificity, and 96.6 % (95 % CI 90.5–98.8) negative predictive value. BDG positivities in two consecutive samples had 76.7 % (95 % CI 57.7–90.1) sensitivity and 57.2 % (95 % CI 49.9–64.3) specificity. Mannan-Ag, mannan-Ab, and Candida DNA individually or combined showed a low discriminating capacity. CONCLUSIONS: Positive Candida albicans germ tube antibody and (1 → 3)-ß-D-glucan in a single blood sample or (1 → 3)-ß-D-glucan positivity in two consecutive blood samples allowed discriminating invasive candidiasis from Candida spp. colonization in critically ill patients with severe abdominal conditions. These findings may be helpful to tailor empirical antifungal therapy in this patient population