Latirismo

Se hac e una revisión bibliográfica de est e cuadro neurotóxico en lo que hac e referencia a datos epidemiológicos, enfatizando los especiale s condicionamientos socioeconómicos y como consecuencia, su condicionada presentación "geográfica". Se estudian los posible s mecanismo s patogénicos, no definitivament e aclarados, y se comentan sus relacione s con otros cuadros neurotóxicos provocados por e l consumo de legumbres. Se dedica un apartado a la utilización de los latirógenos en la preparación de modelos experimentale s diversos en investigación básica. Se aborda el tratamiento considerando las medidas profilácticas a tomar aún conociendo las dificultades de su puesta en práctica y se señalan las características de las secuelas neurológica y ortopé- dica, así como las posibilidades operatorias de minimizarlas.The authors carried out a bibliographic review about this neurotoxic diseas e with referenc e to epidemiological data, emphasizing the special socioeconomi c factors and therefore, its "geographic" presentation. The authors have studied the posibl e pathogeni c mechanismes, no definitively explained, and the relationship wit h anothe r neurotoxi c syndrome s brought about food legume s consumption. They hav e made too an analysis with regard to utilization of lathyrogens on different experimental models in basic research. They approach the managment considering preventer measures and point out the caracteristic of neurologic and orthopaedic sequelae, and surgical possibilities

Aspectos clínicos del síndrome de Ehlers-Danlos

Se realiza una revisión bibliográfica de conjunto de los aspectos clínicos más significativos del síndrome de Ehlers-Danlos. Se recogen datos estadísticos, características raciales, morfotipo e interpretación patogénica actual. Se ha prestado especial atención a su comportamiento hereditario y su fácil confusión con otras afecciones musculares o neurogénicas. Se analizan sus síntomas más característicos, formas clínicas y complicaciones neurológicas, intestinales, cardíacas, vasculares y cutáneas.A review of the literature concerning the most significant clinical aspects of the Ehlers-Danlos syndrome is presented. Statistical data, race characteristics, morphotype and current pathogenic theories are summarised. Special atention has been paid to the hereditary behaviour and the easy misdiagnosis with other muscular and neurological entities. The usual symptoms, clinical types, neurological, cardiac, vascular and cutaneous complications are discussed

Artropatía neuropática diabética múltiple: aportación de un caso

Se presenta un caso de artropatía neuropática múltipl e en un varón de 35 años de edad afecto de una diabetes mellitus tipo I grave y mal controlada, de larga evolución. La artropatía debutó a los 30 años con una fractura espontáne a del cuello de l astrágal o y fractur a de l maleól o media l tra s un traumatism o bana l de tobillo . Posteriormente , cuatro años y medio más tarde, presenta una fractura espontánea del calcáneo contralateral y tres mese s despué s una fractura del platillo tibial interno de la rodilla izquierda. Los autores analizan los factores de riesgo para desarrollar una artropatía neuropática severa, así como el tratamiento más apropiado.We present a cas e of multipl e neuropathi c arthropaty in a 35 year-old male with a grave and poorly controlled mellitus diabetes Type I, of long duration. The arthropaty began at age 30 with a spontaneous fracture of the neck of the talus and fracture of the medial maleolo following a slight trauma of the ankle. Four and a half year s later he presented a spontaneous fracture of the contralateral calcaneous, and three months later a fracture of the internal tibial plateau of the left knee. The authors analyze the risk factors for developing a severe neuropathi c arthropaty, as well as the most appropriate treatment

Síndrome de Kniest: aportación de 2 casos

Se comunican dos casos de síndrome de Kniest, con distinta evolución, ya que el primero fallece a los 3 meses y medio de vida en tanto que el segundo evoluciona normalmente. Se discute su etiopatogenia, se valora la anomalía de la colágena tipo II, como posible factor causal de las alteraciones metafisoepifisarias, enanismo y lesiones oculares. Se revisa la anatomía patológica de ambos pacientes en un caso por biopsia de cartílago condrocostal y en el otro de cartílago accesorio de la cresta ilíaca. Se insiste en el diagnóstico diferencial con aquellas formas de displasia que posiblemente se le parecen más, tales como el enanismo metatrópico y la displasia disegmentaria en su forma más leve o tipo Rolland-Desbuqois.Two cases of Kniest's Syndrome with different evolution are reported. One died before reaching the fourth month of life, while the other is still alive at 6 years of age. The etiology and pathogenesis of this syndrome are discussed, paying special attention to the type II colagen. A defect of this colagen would induce physes and epiphyses alterations, dwarfism and ocular lesions. The chondrocostal cartilage in one case and accesory cartilage of iliac bone in the other were biopsied, showing in both cases cytoplasmatic vacuolization of chondrocytes. The differential diagnosis with metatropic dwarfism and disegmentarie dysplasia, in its midler from or Rolland-Desbuqois type, is presented

Rotura bilateral espontánea del tendón rotuliano asociado a Lupus Eritematoso Sistémico

La rotura bilateral simultánea y espontánea del tendón rotuliano es un hecho poco frecuente, que suele asociarse a enfermedad sistémica y corticoterapia de larga duración. Presentamos el caso de una paciente de 28 años diagnosticada de lupus eritematoso sistémico, recibiendo tratamiento con corticoides durante 10 años. Sufrió de forma espontánea rotura de ambos tendones rotulianos. Se efectuó la reparación quirúrgica de ambos tendones mediante sutura directa apoyada con puntos transóseos y plastia de fascia lata. Se mantuvieron las rodillas inmovilizadas en extensión durante 55 días, comenzando posteriormente la rehabilitación. A los 3 meses de intervención alcanzó los 90 ° de flexión y la extensión completa. Se discute el efecto de la colagenopatía y de la corticoterapia prolongada sobre la degeneración tendinosa, así como las distintas posibilidades de reparación quirúrgica.Simultaneous bilateral rupture of the patellar tendon is unfrequent and commonly associate to systemic disease and long-term corticotherapy. We described the case of a 28-year-old woman with systemic lupus erythematous receiving steroids since 10 years. Spontaneously, she had bilateral rupture of patellar tendons. Surgical repair was performed by primary suture augmented with transosseous suture and tendon plasty using fascia lata. Both knees were immobilized in extension during 55 days, starting a physiotherapy program afterwards. Three months after surgery the patients regaired 90 degrees knee flexion and extension had no restrictions. The effect of the colagen disease and the prolonged corticotherapy on the tendinous degeneration and the different options for surgical repair are discussed

Synchronous unilateral parotid neoplasms. : a case report

The parotid gland is the most usual location of benign neoplasms affecting major salivary glands and quite often the recurrence of these tumours is noticed, specially in the case of pleomorphic adenoma. The occurrence of multiple tumours in the parotid glands is rare and the majority of these are multifocal Warthin`s tumors (papillary cystadenoma lymphomatosum). The simultaneous development of tumours with different histological types is unusual and when it occurs, the most common combination is a pleomorphic adenoma and a Warthin`s tumor. There are many articles about Multiple Parotid Tumors (MPT) but only a few of them are focused on unilateral synchronous benings tumors, being pleomorphic adenoma and Warthin´s these tumors. The report describes a 55 year old female with a pleomorphic adenoma occurring synchronously with a Warthin`s tumor within the superficial lobe of her left parotid gland

Hemangioma intramuscular: (aportación de 6 casos y revisión de la literatura)

Se presentan seis casos de hemangioma intramuscular. Se discute la etiología, histopatología, métodos diagnósticos y el tratamiento óptimo. El tratamiento de elección debe ser la escisión ampliada siempre que ésta sea posible, siendo los resultados satisfactorios.Six cases of haemangioma arising in skeletal muscle are described. The aetiology, pathology, diagnosis and treatment of thes e tumours are discussed. Wide excision remains the treatment of choice whereve r possible with satisfactory results

Associations of e-cigarette experimentation with support for tobacco control policies in the European Union, 2012-2014

Introduction: There are limited data on the potential effects of e-cigarette experimentation on support for tobacco control policies. To bridge this gap, we assessed associations between e-cigarette experimentation and support for tobacco control policies in the European Union 2012-2014. We also investigated variations across tobacco-use status, e-cigarette experimentation and sociodemographic characteristics. Methods: Datasets were used from the Special Eurobarometer for Tobacco surveys performed in 2012 (n=26 751) and 2014 (n=27 801). Tobacco control policies assessed were: banning advertising, policies to keep tobacco out of sight, banning online sales, banning flavors, standardized packaging, tax increases, and policies to reduce illicit trade in tobacco. We use multilevel logistic regression models to assess variations in socio-demographics and tobacco/e-cigarette use with support for these policies in 2014, and examined changes in support for these policies, between 2012 and 2014, separately by tobacco-use status (never, current, and former smokers). Results: Population support for tobacco control policies was high in 2014: policies to reduce illicit trade had the highest level of support at 70.1%, while tax increases were the least likely measure to be supported with 52.3% support. Among never and former smokers, experimentation with e-cigarettes was associated with reduced support for all tobacco control policies assessed. For example, never smokers who had experimented with e-cigarettes were less likely to support either tobacco advertising bans (adjusted odds ratio aOR=0.57, 95% confidence interval 0.46-0.71) or standardized packaging for tobacco (aOR=0.58, 95% CI: 0.47-0.71). Former smokers who had experimented with e-cigarettes were less likely to either support standardized packaging for tobacco (aOR=0.70, 95% CI: 0.60-0.82) or keeping tobacco out of sight (aOR=0.77, 95% CI: 0.65-0.90). Among current smokers, e-cigarette experimentation was not associated with support for the tobacco control policies assessed. Conclusions: E-cigarette experimentation was consistently associated with reduced support for tobacco control policies among never and former smokers but not among current smokers. The implications of these findings for tobacco control are unknown, but the data support concerns that e-cigarette experimentation may affect public support for established tobacco control policies within specific subgroups. Further research is needed to assess potential long-term impacts on tobacco control policies

Electromyography: a simple and accessible tool to assess physical performance and health during hypoxia training. A systematic review

Hypoxia causes reduced partial pressure of oxygen in arterial blood and induces adaptations in skeletal muscle that may affect individuals’ physical performance and muscular health. These muscular changes are detectable and quantifiable by electromyography (EMG), an instrument that assesses electrical activity during active contraction at rest. EMG is a relatively simple and accessible technique for all patients, one that can show the degree of the sensory and motor functions because it provides information about the status of the peripheral nerves and muscles. The main goal of this review is to evaluate the scientific evidence of EMG as an instrument for monitoring different responses of skeletal muscles subjected to external stimuli such as hypoxia and physical activity. A structured search was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in Medline/PubMed, Scielo, Google Scholar, Web of Science, and Cochrane Library Plus. The search included articles published in the last 25 years until May 2020 and was restricted to English- and Spanish-language publications. As such, investigators identified nine articles that met the search criteria. The results determined that EMG was able to detect muscle fatigue from changes in the frequency spectrum. When a muscle was fatigued, high frequency components decreased and low frequency components increased. In other studies, EMG determined muscle activation increased during exercise by recruiting motor units and by increasing the intensity of muscle contractions. Finally, it was also possible to calculate the mean quadriceps quadratic activity used to obtain an image of muscle activation. In conclusion, EMG offers a suitable tool for monitoring the different skeletal muscle responses and has sufficient sensitivity to detect hypoxia-induced muscle changes produced by hypoxic stimuli. Moreover, EMG enhances an extension of physical examination and tests motor-system integrity

Effect of Iron Supplementation on the Modulation of Iron Metabolism, Muscle Damage Biomarkers and Cortisol in Professional Cyclists

Background: The intense efforts made during 3-week stage races may reduce iron metabolism and hematological parameters. These efforts may increase the levels of circulating muscle damage markers and some hormones. All of these physiological changes may have negative consequences not only for the performance of athletes but also for their health. The main aim of this study was to evaluate the effects of supplementation with 80 mg/day of iron on haematological parameters, serum cortisol and biochemical muscle indicators on elite male cyclists during the 3-week stage race the Vuelta a España. Our secondary aim was to examine whether the hematological profile is associated with muscular damage parameters and cortisol. Methods: Eighteen elite male cyclists from two teams were randomly assigned to one of two groups: (1) control group (CG, n = 9; age: 26.1 ± 4.6 years; maximum oxygen uptake per kg: 78.0 ± 5.4 mL/kg/min) or (2) group treated with 80 mg/day iron (800 mg of iron protein succinylate, ITG, n = 9; age: 25.7 ± 6.4 years; maximum oxygen uptake per kg: 77.6 ± 6.5 mL/kg/min). The cyclists were subjected to blood tests one week before the start of the race (T1) and after 4 weeks of treatment, coinciding with the end of the competition (T2). Iron metabolism parameters, muscle damage indicators and serum cortisol were assessed. Repeated-measures ANOVA with group as a factor (GC and ITG) were used to examine the differences between groups throughout the study (time × group) after iron supplementation treatment. Results: Significant differences were observed between groups throughout the study in the group-by-time interaction and changes in serum iron (GC: -8.93 ± 10.35% vs. ITG: 0.60 ± 8.64%; p = 0.018), ferritin (GC: -13.88 ± 23.53% vs. ITG: 91.08 ± 118.30%; p = 0.004), haemoglobin (GC: 10.00 ± 3.32% vs. ITG: 13.04 ± 5.64%; p < 0.001), haematocrit (GC: -1.17 ± 3.78% vs. ITG: 7.32 ± 3.92%; p < 0.001) and cortisol (GC: 24.74 ± 25.84% vs. ITG: ⁻13.54 ± 13.61%; p = 0.005). However, no significant group-by-time interaction was observed for the circulating muscle biomarkers. Additionally, significant negative correlations of serum iron, haemoglobin and haematocrit with muscle circulating biomarkers and cortisol (p < 0.05) were observed. Conclusions: Oral iron supplementation with 80 mg/day iron (800 mg of iron protein succinylate) effectively prevented a decline in haematological parameters (serum iron, ferritin, haemoglobin and haematocrit) and maintained optimal levels of recovery in elite cyclists during the Vuelta a España. Moreover, the hematological values were shown to have relationship with muscular recovery parameters