472 research outputs found
IMPACT OF THE CAP REFORM ON THE SPANISH AGRICULTURAL SECTOR
This paper analyses the impact of the 2003 CAP reform on Spanish agricultural sector in the context of the recent CAP Health Check and high food prices, using PROMAPA, a positive mathematical programming model for representative farms. The analysis compares the model results for base year 2002 to the findings for a scenario with the CAP reform measures in place, taking into account recent modifications. The effect of adopting a full decoupling scheme instead of the present partial decoupling is also studied. Brief descriptions are given of the PROMAPA model, the representative farm considered and the assumptions about both price variations and the policy measures simulated. The findings showed that the farming area for cereals grew substantially after abolition of the compulsory set-aside and that the impact of transition to full decoupling was scant, except in the sheep and rearing cattle sub-sectors, where it considerably steepened the already sizeable decline in livestock numbers induced by the partial decoupling scheme.CAP reform, CAP Health Check, Decoupling, Spanish agricultural sector., Agricultural and Food Policy, Q10, Q12, Q18,
Colgajo de vasto lateral de pedículo distal para cobertura de lesiones complejas de rodilla
El tratamiento de las heridas complejas articulares se muestra siempre complicado, el abordaje razonable conjunto por traumatólogos y cirujanos plásticos mejora el resultado clínico, funcional y estético. Presentamos el caso de un paciente politraumatizado con pérdida de sustancia a nivel de la rodilla secundaria a artritis séptica, necrosis de patela y exposición de cóndilos femorales que fue tratado mediante colgajo muscular de vastus lateralis de pedículo distal. El vastus lateralis permite la cobertura eficiente de l articulación expuesta sin afectar la extensión de la rodilla y dejando mínima secuela estética.The treatment of the joint complex wounds is difficult. A good clinic, functional and aesthetic outcome is possible when multidisciplinary approach by orthopaedics and
plastic surgeons is carried out. We report a case of a patient
with multiple fractures who presents a severe loss of soft tissue at the knee. This lesion was due to a septic arthritis with
patellar necrosis and condillar exposition. The treatment was
made by a distally pedicled vastus lateralis muscular flap.
This flap lets efficient coverage for the exposed joint as well
as the integrity of the extensión knee function without aesthetic seque
Osteomielitis crónica de extremidades inferiores en pacientes ancianos: colgajo sóleo, una opción efectiva
La osteomielitis crónica (OC) en extremidades inferiores afecta al hueso y tejidos blandos circundantes, produciéndose úlceras crónicas que exponen el hueso necrosado. El tratamiento de la OC combina: antibióticos, desbridamiento-estabilización ósea, y una adecuada cobertura cutánea. La reconstrucción de las pérdidas de sustancia localizadas en el tercio medio de la pierna puede realizarse con colgajos fasciocutáneos, colgajos libres, colgajos en piernas cruzadas y colgajos locales musculares. La edad avanzada del paciente es un factor importante a considerar para la indicación de la técnica reparadora. El colgajo sóleo tiene múltiples ventajas: rica vascularización, corto tiempo quirúrgico, postoperatorio cómodo para el paciente y mínima limitación funcional. Presentamos 2 casos de pacientes ancianos con defectos osteocutáneos tibiales secundarios a OC, en ambos casos la cobertura del defecto se realizó con el colgajo muscular sóleo, la evolución clínica fue favorable y la recuperación funcional total.Cronic osteomyelitis (CO) in lower legs involves
tibial-fibular bones and soft tissues around, with cronic ulcers
by necrosed bone exposure. CO treatment combines: antibiotics, removes necrotic bone, bony stabilization and an adequate soft tissue coverage. Soft tissue loss reconstruction in
the medium third of the legs can be made with fasciocutaneous flaps, free flaps, cross leg flaps and local muscle flaps.
Elderly age is an important condition for the reconstruction
procedure indication. Soleus muscle flap has multiple advantages: great blood supply, short surgical time, comfortable
postoperative and minimum functional sequels. Two cases:
Both elderly patients with osteocutaneous defects in tibia, by
CO. Treatment coverage was performed with soleus muscle
flap. Clinic course increased positively and the patients got
completely functional restitution
Traumatismos de partes blandas en la muñeca: cobertura fasciocutánea
Las pérdidas de sustancia traumática localizadas en la muñeca afectan frecuentemente a los tendones, vasos y nervios. Estas lesiones requieren un tratamiento reparador de las estructuras lesionadas y una cobertura adecuada que permita el deslizamiento de los tendones, y proporcione protección neurovascular segura. El colgajo fasciocutáneo basado en perforantes de la arteria cubital aporta piel, tejido subcutáneo y fascia sobre las estructuras expuestas en la muñeca tanto en la cara palmar como dorsal. Presentamos cuatro casos de traumatismos de partes blandas en la muñeca, en ellos tras la reparación neurotendinosa requerida, se optó por la cobertura final mediante el colgajo fasciocutáneo cubito-dorsal. Destacamos la versatilidad de estos colgajos, su fácil ejecución, mínima secuela estética y la posibilidad de iniciar precozmente el tratamiento rehabilitador, consiguiendo así una mejor recuperación funcional del paciente.Traumatic soft tissue loss in wrist usually involves
tendons, vessels and nerves. These injuries need the adequate reconstructive treatment and the safe coverage which
lets to slide the tendons and it gives a safe protection to neurovascular structures. The fasciocutaneous flap based in perforator branches of the ulnar artery brings skin, fat and fascia
enough over the exposed tissues in the dorsal or volar surface of the wrist.
We report four cases of traumatic lesions in soft tissues of the
wrist, in all of them the fasciocutaneous dorsal cubital flap
was the option for the end coverage.
We emphasize the versatility of these flaps, its easy ejecution,
the minimal aesthetic sequel and the early rehabilitation beginning, so we obtain the best functional restitution for the patien
Úlceras por presión en pacientes traumatológicos: prevención basada en la evidencia médica
Las úlceras por presión (UPP) suponen una complicación importante que puede afectar a pacientes cuya movilidad está limitada. El tratamiento quirúrgico de las fracturas en pacientes ancianos y el encamamiento prolongado pueden ser predisponentes de lesiones por decúbito. En este trabajo de revisión buscamos las medidas de prevención de UPP basadas en la evidencia médica. La Medicina Basada en la Evidencia (MBE) propone utilizar la mejor evidencia científica y clínica sobre las UPP, según la cual, la prevención es el objetivo fundamental en estos pacientes. Se destaca en la literatura relativa a las úlceras por presión que las medidas de prevención con evidencia médica probada incluyen: valoración integral del paciente, identificación del riesgo, reconocer el estadio de la UPP, aminorar el efecto de la presión, evaluar el estado nutricional, eliminar el exceso de humedad (incontinencia), evitar encamamientos prolongados y preservar la integridad de la piel.Pressure sores are an important complication,
which can affects to patients with restricted motion. Surgical
treatment of elderly people with fractures in addition prolonged time lying in same position are able to develop bedsores.
This review paper searches the prevention features of pressure sores in evidence based medicine. Evidence Based
Medicine proposes the best clinical and scientifical evidence
available about to pressure sores, being prevention the main
goal in these patients. The results founded in the literature
relative to pressure sores affirms these are the facts in evidence based medicine: the general approach of the patient,
recognising risk, staging pressure sores, reducing pressure
effect, assessing nutritional status, avoiding excess moisture
(incontinence) reducing bed rest and preserving the integrity
of the skin
Glucocerebrosidase expression patterns in the non-human primate brain
Glucocerebrosidase (GCase) is a lysosomal
enzyme encoded by the GBA1 gene. Mutations in GBA1
gene lead to Gaucher’s disease, the most prevalent lysosomal storage disorder. GBA1 mutations reduce GCase
activity, therefore promoting the aggregation of alphasynuclein, a common neuropathological finding underlying
Parkinson’s disease (PD) and dementia with Lewy bodies.
However, it is also worth noting that a direct link between
GBA1 mutations and alpha-synuclein aggregation indicating cause and effect is still lacking, with limited experimental evidence to date. Bearing in mind that a number of
strategies increasing GCase expression for the treatment of
PD are currently under development, here we sought to
analyze the baseline expression of GCase in the brain of
Macaca fascicularis, which has often been considered as
the gold-standard animal model of PD. Although as with
other lysosomal enzymes, GCase is expected to be ubiquitously expressed, here a number of regional variations
have been consistently found, together with several specific
neurochemical phenotypes expressing very high levels of
GCase. In this regard, the most enriched expression of
GCase was constantly found in cholinergic neurons from
the nucleus basalis of Meynert, dopaminergic cells in the
substantia nigra pars compacta, serotoninergic neurons
from the raphe nuclei, as well as in noradrenergic neurons
located in the locus ceruleus. Moreover, it is also worth
noting that moderate levels of expression were also found
in a number of areas within the paleocortex and archicortex, such as the entorhinal cortex and the hippocampal
formation, respectively
VDR gene polymorphisms on risk of osteoporotic hip fracture in an adult population spanish
La osteoporosis es una enfermedad esquelética compleja multifactorial con un fuerte componente
genético, caracterizada por un deterioro en la microestructura ósea que causa fragilidad ósea y un
incremento en el riesgo de fracturas osteoporóticas. El gen VDR podría estar fuertemente involucrado
en el riesgo de fractura. El objetivo de este trabajo fue investigar la asociación entre polimorfismos del
gen VDR y la susceptibilidad a fractura de cadera (FC). Se reclutaron 147 pacientes andaluces (102
con factores de riesgos de fracturas osteoporóticas y 45 con metabolismo óseo normal). El aislamiento
de ADN se realizó a partir de 300 mL de sangre, genotipando 2 SNPs: BsmI y FokI mediante PCRRFLP
(PCR-Restriction Fragment Length Polymorphism). Todas las fracturas fueron confirmadas por
rayos-X mientras que el riesgo de fracturas a través de la escala FRAX y DMO. Los resultados se
evaluaron estadísticamente, considerando significativo valores de p<0,05. La edad media de los
pacientes fracturados fue de 68,5 años, cuyas frecuencias alélicas fueron 64.7% G y 68.6% C para
BsmI y FokI, respectivamente. La prevalencia de estos SNPs en la población caso fueron: 43,3% GA,
43.3% GG y 13,7% AA para BsmI y 49,0% CC, 39,20% CT, 11,8% TT para FokI. Las frecuencias de
los alelos y genotipos no mostraron diferencias entre pacientes con riesgo de fracturas y pacientes
control. Las frecuencias están acorde con las demostradas en HapMap para población europeacaucásica.
No se encontró ninguna asociación significativa entre estos SNPs y la susceptibilidad a las
FC en la población adulta andaluza.Osteoporosis is a multifactorial complex skeletal disease with strong genetic component, characterized
by a deterioration of bone microstructure that causes bone fragility and an increased risk of
osteoporotic fractures. VDR gene could be strongly involved in the risk of fracture. The aim of this
study was to investigate the association between VDR gene polymorphisms and susceptibility to hip
fracture (HF). 147 Andalusian patients were recruited (102 with risk factors for osteoporotic fractures
and 47 with normal bone metabolism). DNA isolation was performed from 300 mL of blood,
genotyping 2 SNPs: BsmI and FokI by PCR-RFLP (PCR-Restriction Fragment Length
Polymorphism). All fractures were confirmed by X-rays while the risk of fractures through FRAX
level and BMD. The results were statistically evaluated, considering significant p-values <0.05. The
average age of fractured patients was 68.5 years, whose allele frequencies were 64.7% G and 68.6% C
for BsmI and FokI, respectively. Prevalence of these SNPs in the case population were: 43.3% GA,
43.3% GG and 13.7% AA BsmI and 49.0 % CC, 39.2% CT, 11.8% TT for FokI. The frequencies of alleles and genotypes showed no differences between patients with and without risk of hip fracture.
The frequencies are agree to HapMap for European-Caucasian population. It was found no significant
association between these SNPs and susceptibility to HF in the adult population of Andalusia
Calbindin content and differential vulnerability of midbrain efferent dopaminergic neurons in macaques
Calbindin (CB) is a calcium binding protein reported to protect dopaminergic neurons from
degeneration. Although a direct link between CB content and differential vulnerability of
dopaminergic neurons has long been accepted, factors other than CB have also been
suggested, particularly those related to the dopamine transporter. Indeed, several studies
have reported that CB levels are not causally related to the differential vulnerability
of dopaminergic neurons against neurotoxins. Here we have used dual stains for
tyrosine hydroxylase (TH) and CB in 3 control and 3 MPTP-treated monkeys to visualize
dopaminergic neurons in the ventral tegmental area (VTA) and in the dorsal and ventral
tiers of the substantia nigra pars compacta (SNcd and SNcv) co-expressing TH and CB.
In control animals, the highest percentages of co-localization were found in VTA (58.2%),
followed by neurons located in the SNcd (34.7%). As expected, SNcv neurons lacked CB
expression. In MPTP-treated animals, the percentage of CB-ir/TH-ir neurons in the VTA
was similar to control monkeys (62.1%), whereas most of the few surviving neurons in
the SNcd were CB-ir/TH-ir (88.6%). Next, we have elucidated the presence of CB within
identified nigrostriatal and nigroextrastriatal midbrain dopaminergic projection neurons. For
this purpose, two control monkeys received one injection of Fluoro-Gold into the caudate
nucleus and one injection of cholera toxin (CTB) into the postcommissural putamen,
whereas two more monkeys were injected with CTB into the internal division of the globus
pallidus (GPi). As expected, all the nigrocaudate- and nigroputamen-projecting neurons
were TH-ir, although surprisingly, all of these nigrostriatal-projecting neurons were negative
for CB. Furthermore, all the nigropallidal-projecting neurons co-expressed both TH and
CB. In summary, although CB-ir dopaminergic neurons seem to be less prone to MPTPinduced
degeneration, our data clearly demonstrated that these neurons are not giving rise
to nigrostriatal projections and indeed CB-ir/TH-ir neurons only originate nigroextrastriatal
projections
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