Pseudoartrosis congénita de clavícula: a propósito de un caso

La pseudoartrosis congénita de clavícula es una entidad infrecuente de etiología aún controvertida. Su diagnóstico es sencillo y su abordaje terapéutico es siempre quirúrgico. Se presenta un nuevo caso de pseudoartrosis congenita de clavícula diagnosticado en un niño de 4 años de edad. El tratamiento consistió en decorticación de los fragmentos y síntesis con aguja de Kirschner. Se efectúa una revisión de la literatura abordando las teorías etiopatogénicas y el tratamiento de esta afección.Congenital pseudoarthrosis of the clavicle is an unfrequent entity with already controversial etiology. The diagnosis is easy and the therapeutic approach allways involves surgery. A new case of congenital pseudoarthrosis of the clavicle in a 4-year-old boy is reported. The treatment consisted in decortication of both fragments of the clavicle and fixation with a Kirschner wire. A review of the literature focused on etiopathogenic theories and treatment is also performed

Transfusión autóloga diferida en cirugía primaria de prótesis total de cadera

Se analizan los resultados obtenidos mediante transfusión autóloga diferida (TAD) en 50 pacientes intervenidos de prótesis total primaria de cadera. Las extracciones de sangre se realizaron con una semana de intervalo, transcurriendo al menos 72 horas entre la última extracción y la intervención. El total de unidades extraídas para TAD ha sido 100, transfundiéndose 77, lo que supuso el 91% de la sangre transfundida a estos pacientes. 8 pacientes precisaron la transfusión de 1 unidad de sangre homóloga. No se produjeron reacciones adversas ni durante la extracción ni tras la transfusión y los pacientes recuperaron sus cifras normales de hemoglobina y hematocrito al cabo de 1 mes de la intervención. La TAD es un procedimiento sencillo y eficaz de reposición de sangre en cirugía programada de cadera.The results of deferred autologous blood transfusion in 50 patients who underwent total hip replacement are analyzed. Patients donated blood in weekly bases, last donation 72 hours before surgery. A total of 100 units were obtained by this method and 77 of them were used, wich means 91% of the blood transfused to these patients. Eight patients were transfused with homologue blood. No adverse reactions could be observed either in relation with the autodonation of blood or the autotransfusion. One month after surgery, all patients showed hemoglobin and hematocrit whitin normal limits. Autologous transfusion is a simple and efficacious procedure of blood replacement in primary hip arthroplasty

Sarcoma de Partes Blandas como Hallazgo Casual: a Propósito de Cuatro Observaciones

Se presentan en este trabajo cuatro pacientes con sarcoma s de partes blandas que fueron diagnosticados de fibrohistiocitoma maligno, osteosarcoma extraesquelético, sarcoma sinovial y sarcoma indiferenciado. En todos ellos el tumor fué un hallazgo casual apreciado en exploraciones orientadas hacia otros procesos por los que acudieron al hospital. Se insiste en el diagnóstico precoz y en el correcto tratamiento de este tipo de sarcomas y se recomienda la punción biopsia ante la presencia de tumoraciones blandas con crecimiento progresivo, aún sin otro tipo de sintomatología.Th e author s hav e colecte d fou r patients diagnose d o f Soft tissu e Sar - comas. Th e histologica l diagnosis was, malignan t fibrou s histiocytoma , extraskele - t a l osteosarcoma , synovia l sarcom a an d no-differentiate d sarcoma . Al l o f the m th e tu m o r wa s a casua l findin g durin g th e exploratio n suspectin g othe r pathology . The y emphasiz e a t th e earl y diagnosis an d correc t managemen t o f this typ e o f sarcomas, a s wel l a s th e needl e biops y (close d biopsy ) o f soft tumor s wit h progresiv e growth , even without clinical symptoms

2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Actualización del Documento Sevilla

La transfusión de sangre alogénica (TSA) no es inocua, y como consecuencia han surgido múltiples alternativas a la misma (ATSA). Existe variabilidad respecto a las indicaciones y buen uso de las ATSA. Dependiendo de la especialidad de los médicos que tratan a los pacientes, el grado de anemia, la política transfusional, la disponibilidad de las ATSA y el criterio personal, estas se usan de forma variable. Puesto que las ATSA tampoco son inocuas y pueden no cumplir criterios de coste-efectividad, la variabilidad en su uso es inaceptable. Las sociedades españolas de Anestesiología y Reanimación (SEDAR), Hematología y Hemoterapia (SEHH), Farmacia Hospitalaria (SEFH), Medicina Intensiva y Unidades Coronarias (SEMICYUC), Trombosis y Hemostasia (SETH) y Transfusiones Sanguíneas (SETS) han elaborado un documento de consenso para el buen uso de la ATSA. Un panel de expertos de las 6 sociedades ha llevado a cabo una revisión sistemática de la literatura médica y elaborado el 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Solo se contempla las ATSA dirigidas a disminuir la transfusión de concentrado de hematíes. Se definen las ATSA como toda medida farmacológica y no farmacológica encaminada a disminuir la transfusión de concentrado de hematíes, preservando siempre la seguridad del paciente. La cuestión principal que se plantea en cada ítem se formula, en forma positiva o negativa, como: «La ATSA en cuestión reduce/no reduce la tasa transfusional». Para formular el grado de recomendación se ha usado la metodología Grades of Recommendation Assessment, Development and Evaluation (GRADE)

Feedback and feeding in the context of galaxy evolution with SPICA: direct characterization of molecular outflows and inflows

A far-infrared observatory such as the {\it SPace Infrared telescope for Cosmology and Astrophysics} ({\it SPICA}), with its unprecedented spectroscopic sensitivity, would unveil the role of feedback in galaxy evolution during the last $\sim10$ Gyr of the Universe ($z=1.5-2$), through the use of far- and mid-infrared molecular and ionic fine structure lines that trace outflowing and infalling gas. Outflowing gas is identified in the far-infrared through P-Cygni line shapes and absorption blueshifted wings in molecular lines with high dipolar moments, and through emission line wings of fine-structure lines of ionized gas. We quantify the detectability of galaxy-scale massive molecular and ionized outflows as a function of redshift in AGN-dominated, starburst-dominated, and main-sequence galaxies, explore the detectability of metal-rich inflows in the local Universe, and describe the most significant synergies with other current and future observatories that will measure feedback in galaxies via complementary tracers at other wavelengths.Comment: This paper belongs to the SPICA Special Issue on PASA. Accepted for publication in PAS

Proteomic analysis of a media conditioned by growing deer antler tissues: identification of its neurite growth promoting proteins

Comunicaciones a congreso

La Cueva de El Sidrón (Piloña Asturias)

Estado de las excavaciones y estudios en la Cueva de El Sidrón (PIloña, Asturias)

Minimising Mortality in Endangered Raptors Due to Power Lines: The Importance of Spatial Aggregation to Optimize the Application of Mitigation Measures

Electrocution by power lines is one of the main causes of non-natural mortality in birds of prey. In an area in central Spain, we surveyed 6304 pylons from 333 power lines to determine electrocution rates, environmental and design factors that may influence electrocution and the efficacy of mitigation measures used to minimise electrocution cases. A total of 952 electrocuted raptors, representing 14 different species, were observed. Electrocuted raptors were concentrated in certain areas and the environmental factors associated with increased electrocution events were: greater numbers of prey animals; greater vegetation cover; and shorter distance to roads. The structural elements associated with electrocutions were shorter strings of insulators, one or more phases over the crossarm, cross-shaped design and pylon function. Of the 952 carcasses found, 148 were eagles, including golden eagle (Aquila chrysaetos), Spanish imperial eagle (Aquila adalberti) and Bonelli's eagle (Aquila fasciata). Electrocuted eagles were clustered in smaller areas than other electrocuted raptors. The factors associated with increased eagle electrocution events were: pylons function, shorter strings of insulators, higher slopes surrounding the pylon, and more numerous potential prey animals. Pylons with increased string of insulators had lower raptor electrocution rates than unimproved pylons, although this technique was unsuccessful for eagles. Pylons with cable insulation showed higher electrocution rates than unimproved pylons, both for raptors and eagles, despite this is the most widely used and recommended mitigation measure in several countries. To optimize the application of mitigation measures, our results recommend the substitution of pin-type insulators to suspended ones and elongating the strings of insulators

Hypermethylated 14-3-3-σ and ESR1 gene promoters in serum as candidate biomarkers for the diagnosis and treatment efficacy of breast cancer metastasis

Background: Numerous hypermethylated genes have been reported in breast cancer, and the silencing of these genes plays an important role in carcinogenesis, tumor progression and diagnosis. These hypermethylated promoters are very rarely found in normal breast. It has been suggested that aberrant hypermethylation may be useful as a biomarker, with implications for breast cancer etiology, diagnosis, and management. The relationship between primary neoplasm and metastasis remains largely unknown. There has been no comprehensive comparative study on the clinical usefulness of tumor-associated methylated DNA biomarkers in primary breast carcinoma and metastatic breast carcinoma. The objective of the present study was to investigate the association between clinical extension of breast cancer and methylation status of Estrogen Receptor1 (ESR1) and Stratifin (14-3-3-σ) gene promoters in disease-free and metastatic breast cancer patients. Methods: We studied two cohorts of patients: 77 patients treated for breast cancer with no signs of disease, and 34 patients with metastatic breast cancer. DNA was obtained from serum samples, and promoter methylation status was determined by using DNA bisulfite modification and quantitative methylation-specific PCR. Results: Serum levels of methylated gene promoter 14-3-3-σ significantly differed between Control and Metastatic Breast Cancer groups (P < 0.001), and between Disease-Free and Metastatic Breast Cancer groups (P < 0.001). The ratio of the 14-3-3-σ level before the first chemotherapy cycle to the level just before administration of the second chemotherapy cycle was defined as the Biomarker Response Ratio [BRR]. We calculated BRR values for the "continuous decline" and "rise-and-fall" groups. Subsequent ROC analysis showed a sensitivity of 75% (95% CI: 47.6 - 86.7) and a specificity of 66.7% (95% CI: 41.0 - 86.7) to discriminate between the groups for a cut-off level of BRR = 2.39. The area under the ROC curve (Z = 0.804 ± 0.074) indicates that this test is a good approach to post-treatment prognosis. Conclusions: The relationship of 14-3-3-σ with breast cancer metastasis and progression found in this study suggests a possible application of 14-3-3-σ as a biomarker to screen for metastasis and to follow up patients treated for metastatic breast cancer, monitoring their disease status and treatment response.This study was supported by a grant from the Ministerio de Ciencia e Innovación: SAF 2004-00889; JL Linares is supported by the Junta de Andalucía (P06-CTS-1385)

Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study

Background & aim: A diet quality index (DQI) is a tool that provides an overall score of an individual''s dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes. Methods: To this purpose, overweight/obese adolescents (n = 117, aged: 13–16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents’ compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI. Results: Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen''s d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes. Conclusions: We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support