La braquimetatarsia: presentación de un caso

Se presenta el caso de una mujer de 24 años de edad que consultó por una metatarsalgia central y una alteración estética del antepié derecho. Se trató mediante un alargamiento progresivo del metatarsiano con un mini fijador externo, a lo que se asoció una osteotomía distal del primer metatarsiano. Se consiguió un correcto alineamiento del metatarsiano, la desaparición de la metatarsalgia y la corrección del valguismo del primer metatarsiano. La paciente quedó satisfecha aunque persistió una ligera limitación funcional pero sin dolor. Conclusiones: Se aconseja este tipo de intervención en los acortamientos de metatarsianos, utilizando para la misma un fijador externo que permite elongar el metatarsiano corto de forma progresiva, teniendo en cuenta las posibles complicaciones de la técnica y la larga duración que el tratamiento requiere.A case of a 24-year-old woman affected of symptomatic IV brachymetatarsia associated to a cosmetic trouble of the right foot is presented. She was treated by means of a progressive lengthening of the IV metatarsal bone with a mini external fixator and a distal osteotomy of the first metatarsal bone. It was obtained a correct alignment of the IV metatarsal, healing of metatarsalgia, and correction of the valgus deformity of the I metatarsal bone. The patient was very satisfied with the cosmetic result, although a slight functional limitation but without pain persisted. Conclusions: Metatarsal lengthening may be indicated in the management of symptommatic brachymetatarsia. We recommend the use of a mini external fixator that allows progressive lengthening of the short bone, considering the possible complications of the technique and the long duration that the treatment needs

La coxartrosis en los pacientes con osteopetrosis: su tratamiento quirúrgico

Se presentan un caso de osteopetrosis en un paciente de 22 años de edad que consultó por dolor en la cadera izquierda, siendo diagnosticado de coxartrosis izquierda secundaria a la osteopetrosis. Fue tratado inicialmente de forma quirúrgica realizándosele una osteotomía de la cadera afectada. Varios años después, tras la reaparición del dolor se procedió a la implantación de una prótesis total de cadera que evolucionó satisfactoriamente.A case of osteopetrosis in a 22-year-old patient who consulted by pain in the left hip is presented. He was diagnosed of degenerative osteoarthritis of the left hip secondary to osteopetrosis. Initially, it was treated surgically by an osteotomy of the proximal femur. Several years later\ after the pain reappearance, the authors treated the patient by a total hip arthroplasty with satisfactory outcome

Complicaciones de la cirugía sustitutiva de la cadera en los pacientes con osteopetrosis

Se presenta un caso de osteopetrosis en un paciente de 45 años de edad que consultó por dolor en la cadera derecha, siendo diagnosticado de coxar-trosis derecha secundaria a la osteopetrosis. Fue tratado quirúrgicamente realizándosele una prótesis total de cadera no cementada. Dicha inter-vención presentó complicaciones tanto intraoperatorias como postoperato-rias que precisaron el recambio del componente femoral. Tras la reinter-vención, la evolución ha sido satisfactoria, siendo correcta la situación clíni-ca del paciente a los 5 años de evolución.A case of osteopetrosis in a 45-year-old patient that consulted by pain in the right hip is presented. He was diagnosed of degenerative osteoarthritis of the right hip secondary to osteopetrosis. He was managed surgically by a cementless total hip arthroplasty. This mentioned operation presented intra-operative and post-operative complications that were treated by means of a replacement of the femoral component of the arthroplasty. After the revision, the evolution has been satisfactory, with a correct clinical situation of the patient after 5 years of follow-up

Luxación traumática del tendón del tibial posterior asociada a rotura completa del ligamento deltoideo.

Objetivo: La luxación traumática del tendón del tibial posterior (TTP) en el tobillo es una pato - logía infrecuente. El diagnóstico en la fase aguda no es la norma, produciendo cuadros de dolor crónico en la zona media del tobillo que dan lugar a un diagnóstico en la fase crónica. El objetivo es presentar un caso clínico de luxación de TTP asociado a una rotura completa del ligamento deltoideo tratado en la fase aguda. Material y Método: Paciente de 48 años de edad, que tras accidente de motocicleta sufrió una luxación del TTP asociado con rotura completa del ligamento deltoideo. Se realizó sutura directa de las lesiones e inmovilización con yeso durante 6 semanas. Posteriormente estuvo en tratamiento rehabilitador. Resultados: El resultado funcional del paciente fue excelente para todas las actividades personales. Conclusiones: El diagnóstico temprano de esta pa - tología es fundamental para evitar retardos en el tratamiento y posibles repercusiones funcionales en el tobillo y arquitectura del pie.Purpose: Traumatic dislocation of the posterior tibial tendon (PTT) of the ankle is a very rare lesion. It is not common to make the diagnosis during the acute phase. The dalay in diagnosis generates chronic pain symptoms in the middle part of the ankle; it is in the chronic phase when diagnosis is usually made. The aim of the study is to present a case of PTT dislocation associated to a complete tear of the deltoid ligament, which was treated in the acute phase. Material and Method: A 48-year old patient had a PTT dislocation associated to a complete tear of the deltoid ligament, due to a motorcycle accident. Direct suture of the lesions and cast immobi - lization for six weeks was conducted. Afterwards, the patient completed treatment with rehabilitation techniques. Results: Definitive functional outcome was excellent for all normal life activities. Conclusions: T he diagnosis of the posterior tibial tendon dislocation during the acute phase is mandatory to minimize delay in treatment and functional sequels in the ankle and foot architecture

Sinus pilonidal interdigital: una rara enfermedad profesional

Se presenta un caso de sinus pilonidal interdigital de mano de un paciente varón de 27 años de edad y de profesión peluquero, que consultó por presentar secreción y exposición de pelos por orificio fistuloso en segundo espacio interdigital. El tratamiento consistió en la exéresis en cuña de la lesión y cierre directo de la herida quirúrgica. No hubo alteraciones en el periodo postoperatorio. Actualmente, tras 10 años de evolución, el paciente sigue desarrollando su profesión sin haber presentado ninguna recidiva de la lesión y realiza una vida personal sin problemas.We report a case of interdigital pilonidal sinus of the hand of a male patient of 27 years-old and a professional hairdresser, who consulted for a discharge and exposure of hairs fistula second web space of hand. Treatment consisted of wedge excision of the lesion and direct closure of the surgical wound. There were no changes in the postoperative period. Today, after 10 years of evolution, the patient continues to develop their profession without having presented any recurrence of the injury and makes a personal life without problems

SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Bacterial Actins and Their Diversity

For many years bacteria were considered rather simple organisms, but the dogmatic notion that subcellular organization is a eukaryotic trait has been overthrown for more than a decade. The discovery of homologs of the eukaryotic cytoskeletal proteins actin, tubulin, and intermediate filaments in bacteria has been instrumental in changing this view. Over the recent years we gained an incredible level of insight into the diverse family of bacterial actins and their molecular workings. Here we review the functional, biochemical and structural features of the most well-studied bacterial actins