Fractura luxación posterior de cadera asociada a fractura parcelar de la cabeza femoral: a propósito de un caso

La asociación de luxación posterior traumática de cadera con fractura de la cabeza femoral, es relativamente poco frecuente. Presentamos un varón de 33 años de edad que sufrió un accidente vial con resultado de luxación posterior asociada a fractura de la cabeza femoral craneal a la fovea centralis (tipo II de la clasificación de Pipkin). El tratamiento realizado fue una reducción abierta sin osteosíntesis, dentro de las seis primeras horas. A los dos años el paciente camina con mínina claudicación y sin dolor. El ultimo estudio radiográfico realizado no muestra signos de necrosis cefálica. Pensamos que en estas lesiones, cuando la reducción cerrada no es posible, la realización de una reducción abierta puede ser suficiente para la aposición del fragmento sin necesidad de llevar a cabo ninguna osteosíntesis.The posterior traumatic dislocation of the hip associated to femoral head fracture is an unfrequent lesion. The present report describe a 33-year-old man who sustained a traffic accident with posterior dislocation of the hip associated to a marginal fracture of the femoral head located cranealy to the fovea centralis (tipe two of Pipkin's clasification). Open reduction and inmovilization was performed. At 2-year follow-up the patient is walking with slight limp and no pain. At this time, radiographic evaluation showed no signs of cephalic necrosis. In this tipe of traumatic lesions, when closed reduction is unsuccesfull, open reduction can be an adequate alternative treatment to reduce the cephalic fragment without any osteosinthesis

Características de la canal y calidad instrumental de la carne en cabritos y corderos lechales

Meat from very young, milk-fed, small ruminants is an appreciated product in Mediterranean countries where milk is the main product derived from the herds. Nevertheless, many aspects of the quality of the products are virtually unknown for many goat breeds, especially among those that are reared for their meat. In this study, the quality from 50 animals from 5 local goat breeds (one dairy purpose and 4 meat purpose) and 19 lambs (from Churra, a dairy breed) was compared at commercial cold carcass weights of 4.4-6.6 kg. Carcass quality, ultimate pH and meat colour were assessed following standard procedures. Statistical differences (p < 0.05) were found in all of the variables analysed. Some of these differences might have been due to the influence of the genotype, the dam’s production potential, or differences in carcass weight and age, but most were species dependent. Lambs differed from the kids, especially from those of meat purpose breeds, due to their high proportion of bone (25.0 vs. 21.3 to 23.7%), and a more intense meat colour (higher hue: 29.2 vs. 23.4 to 28.7, and chroma: 14.6 vs. 12.1 to 14.6). Among the goat breeds, Murciano Granadina (dairy breed) and Blanca Celtibérica (meat breed) were the most different in terms of carcass morphology, fatness, and meat colour. The other three local meat-purpose goat breeds (Moncaína, Negra Serrana, and Pirenaica) differed little. To obtain a better understanding of goat species, the differences among breeds, in kids or in their most common products, require further studies. Additional key words: carcass morphology; colour; goat; pH; sheep; tissue composition.La carne de lechal es muy apreciada en los países mediterráneos, en los que la leche es una producción fundamental. Además, muchos aspectos de los productos de las razas caprinas locales son prácticamente desconocidos. En este estudio se analizó la calidad de 50 animales de 5 razas caprinas (una lechera y 4 de aptitud cárnica) y de 19 corderos (raza Churra de tipo lechero), a pesos comerciales de 4,4-6,6 kg de canal fría. Se evaluaron la calidad de la canal, el pH último y el color de la carne, siguiendo metodologías estandarizadas. Se encontraron diferencias significativas (p < 0,05) en todas las variables analizadas. Algunas de estas diferencias se podrían justificar por diferencias raciales, potencial lechero de las madres o peso canal final, pero la mayor parte fueron debidas a la especie considerada. Los corderos fueron diferentes, especialmente de los cabritos de razas con orientación predominantemente cárnica, en la proporción de hueso (25,0 vs. 21,3-23,7%) y color de carne más intenso (superiores valores de tono: 29,2 vs. 23,4-28,7 y saturación: 14,6 vs. 12,1-14,6). Entre las razas caprinas, la Murciano Granadina (raza de aptitud lechera) y la Blanca Celtibérica (raza cárnica) fueron las más diferentes en morfología de la canal, engrasamiento y color de carne. Las otras tres razas de aptitud cárnica (Moncaína, Negra Serrana y Pirenaica) fueron poco diferentes entre sí. Para conocer mejor a la especie caprina, las diferencias entre razas y la calidad de sus productos, son necesarios una mayor cantidad de estudios

Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study

Type 2 diabetes mellitus (T2DM) and obesity have become two of the main threats to public health in the Western world. In addition, obesity is the most important determinant of the sleep apnea-hypopnea syndrome (SAHS), a condition that adversely affects glucose metabolism. However, it is unknown whether patients with diabetes have more severe SAHS than non-diabetic subjects. The aim of this cross-sectional case-control study was to evaluate whether obese patients with T2DM are more prone to severe SAHS than obese non-diabetic subjects.Thirty obese T2DM and 60 non-diabetic women closely matched by age, body mass index, waist circumference, and smoking status were recruited from the outpatient Obesity Unit of a university hospital. The exclusion criteria included chronic respiratory disease, smoking habit, neuromuscular and cerebrovascular disease, alcohol abuse, use of sedatives, and pregnancy. Examinations included a non-attended respiratory polygraphy, pulmonary function testing, and an awake arterial gasometry. Oxygen saturation measures included the percentage of time spent at saturations below 90% (CT90). A high prevalence of SAHS was found in both groups (T2DM:80%, nondiabetic:78.3%). No differences in the number of sleep apnea-hypopnea events between diabetic and non-diabetic patients were observed. However, in diabetic patients, a significantly increase in the CT90 was detected (20.2+/-30.2% vs. 6.8+/-13,5%; p = 0.027). In addition, residual volume (RV) was significantly higher in T2DM (percentage of predicted: 79.7+/-18.1 vs. 100.1+/-22.8; p<0.001). Multiple linear regression analyses showed that T2DM but not RV was independently associated with CT90.T2DM adversely affects breathing during sleep, becoming an independent risk factor for severe nocturnal hypoxemia in obese patients. Given that SAHS is a risk factor of cardiovascular disease, the screening for SAHS in T2DM patients seems mandatory

Safety, Tolerability, and Efficacy of Raltegravir in a Diverse Cohort of HIV-Infected Patients: 48-Week Results from the REALMRK Study

The racial diversity and gender distribution of HIV-infected patients make it essential to confirm the safety and efficacy of raltegravir in these populations. A multicenter, open-label, single-arm observational study was conducted in a diverse cohort of HIV-infected patients (goals: ≥25% women; ≥50% blacks in the United States), enrolling treatment-experienced patients failing or intolerant to current antiretroviral therapy (ART) and treatment-naive patients (limited to ≤20%). All patients received raltegravir 400 mg b.i.d. in a combination antiretroviral regimen for up to 48 weeks. A total of 206 patients received study treatment at 34 sites in the United States, Brazil, Dominican Republic, Jamaica, and South Africa: 97 (47%) were female and 153 (74%) were black [116 (56%) in the United States]. Of these, 185 patients were treatment experienced: 97 (47%) were failing and 88 (43%) were intolerant to current therapy; 21 patients (10%) were treatment naive. Among treatment-intolerant patients, 55 (63%) had HIV-1 RNA<50 copies/ml at baseline. Overall, 15% of patients discontinued: 13% of men, 18% of women, 14% of blacks, and 17% of nonblacks. At week 48, HIV RNA was <50 copies/ml in 60/94 (64%) patients failing prior therapy, 61/80 (76%) patients intolerant to prior therapy, and 16/21 (76%) treatment-naive patients. Response rates were similar for men vs. women and black vs. nonblack patients. Drug-related clinical adverse events were reported by 8% of men, 18% of women, 14% of blacks, and 9% of nonblacks. After 48 weeks of treatment in a diverse cohort of HIV-infected patients, raltegravir was generally safe and well tolerated with potent efficacy regardless of gender or race

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment