Síndrome compartimental en joven con alteración hemática

El síndrome compartimental es una patología bien conocida que se produce por un aumento de la presión dentro de un compartimiento miofascial. Presentamos el caso de un paciente con trombopenia que sufrió un traumatismo banal. Necesitó fasciotomía del compartimiento anteroexterno de la pierna y, más tarde, esplenectomía. El diagnóstico y tratamiento tardíos de esta complicación, así como una descomprensión inadecuada, pueden conducir a la pérdida de función en una extremidad.The compartment syndrome is a well described cli- nical entity that results from increased pressure within a myo- fascial compartment. An unusual case of a patient with thrombopenia and a minimal traumatism, is reported. He required fasciotomy of the anterolateral compartment of the leg and, later, splenectomy. Late recognition and treatment of this complication, as well as inadequate decompression, can lead to loss of limb

Binding Potassium to Improve Treatment With Renin-Angiotensin-Aldosterone System Inhibitors: Results From Multiple One-Stage Pairwise and Network Meta-Analyses of Clinical Trials

This manuscript presents findings from the first dichotomous data pooling analysis on clinical trials (CT) regarding the effectiveness of binding potassium. The results emanated from pairwise and network meta-analyses aiming evaluation of response to commercial potassium-binding polymers, that is, to achieve and maintain normal serum potassium (n = 1,722), and the association between this response and an optimal dosing of renin-angiotensin-aldosterone system inhibitors (RAASi) needing individuals affected by heart failure (HF) or resistant hypertension, who may be consuming other hyperkalemia-inducing drugs (HKID) (e.g., b-blockers, heparin, etc.), and frequently are affected by chronic kidney disease (CKD) (n = 1,044): According to the surface under the cumulative ranking area (SUCRA), sodium zirconium cyclosilicate (SZC) (SUCRA >0.78), patiromer (SUCRA >0.58) and sodium polystyrene sulfonate (SPS) (SUCRA 5.1 mEq/L), and, when normokalemia is achieved, patiromer 16.8–25.2 g/day (SUCRA = 0.94) and patiromer 8.4–16.8 g/day (SUCRA = 0.41) can allow to increase the dose of spironolactone up to 50 mg/day in subjects affected by heart failure (HF) or with resistant hypertension needing treatment with other RAASi. The potential of zirconium cyclosilicate should be explored further, as no data exists to assess properly its capacity to optimize dosing of RAASi, contrarily as it occurs with patiromer. More research is also necessary to discern between benefits of binding potassium among all type of hyperkalemic patients, for example, patients with DM who may need treatment for proteinuria, patients with early hypertension, etc.Fil: Lizaraso Soto, Frank. Universidad de Valladolid; EspañaFil: Gutiérrez Abejón, Eduardo. Universidad de Valladolid; EspañaFil: Bustamante Munguira, Juan. Universidad de Valladolid; EspañaFil: Martín García, Débora. Universidad de Valladolid; EspañaFil: Chimeno, María Montserrat. Hospital Virgen de la Concha; EspañaFil: Nava Rebollo, Álvaro. Hospital Virgen de la Concha; EspañaFil: Maurtua Briseño Meiggs, Álvaro. Woodland Medical Practicenhs; Reino UnidoFil: Fernández, Darío. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Universidad Nacional de Cuyo; Argentina. Universidad de Burgos. Departamento de Didácticas Específicas; EspañaFil: Bustamante Munguira, Elena. Universidad de Valladolid; EspañaFil: de Paz, Félix Jesús. Universidad de Valladolid; EspañaFil: Grande Villoria, Jesús. Universidad de Valladolid; España. Universite de Lausanne; SuizaFil: Ochoa Sangrador, Carlos. Sanidad de Castilla y León; EspañaFil: Pascual, Manuel. Universite de Lausanne; SuizaFil: Álvarez, F. Javier. Universidad de Valladolid; EspañaFil: Herrera Gómez, Francisco. Universite de Lausanne; Suiza. Universidad de Valladolid; Españ

High dose chemotherapy and autologous stem cell transplantation in patients with peripheral T-cell lymphoma not achieving complete response after induction chemotherapy. The GEL-TAMO experience

Background and objectives: patients with aggressive non-Hodgkin's lymphomas (NHL) who do not obtain a complete response (CR) after induction chemotherapy have a poor prognosis. However, provided they are sensitive to the first regimen of chemotherapy, 25-40% of them with a B-cell phenotype may achieve long-term survival when treated with high dose chemotherapy and autologous stem cell transplantation (HDC/ASCT). The aim of this study was to analyze the efficacy of this therapy in the corresponding patients with peripheral T-cell lymphoma (PTCL). Design and methods: we retrospectively evaluated the efficacy of ASCT in 35 patients with PTCL from the GEL-TAMO registry, who did not achieve a CR to standard induction chemotherapy regimens for aggressive NHL. Thirty-one patients underwent transplantation after achieving a partial response (PR) and 4 patients were non-responders. Results: following HDC/ASCT, 23 (66%) of the patients achieved a CR, 4 (11%) a PR and in 7 (20%) cases the transplant failed. One patient was not evaluated because of early toxic death. With a median follow-up of the survivors of 37.5 months, 18 patients (51%) are alive and 15 patients (43%) are free of disease. Transplant-related mortality rate at 100 days was 11% and at 5 years the probabilities of survival, freedom from progression and disease-free survival for complete responders were 37%, 36% and 55% respectively. Pre-transplant lactate-dehydrogenase level, age-adjusted International Prognostic Index (aa-IPI) and tumor score correlated with survival. Interpretation and conclusions: one third of the patients with PTCL who fail to achieve CR to the first chemotherapeutic regimen can be rescued with HDC/ASCT. Pre-transplant values of IPI and tumor score risk systems for aggressive lymphomas were useful to predict subsequent survival

Revista de Vertebrados de la Estación Biológica de Doñana

The Osteology of Barbus bocagei (Steindachner, 1866) (Pisces: Cyprinidae).El crecimiento del Cacho (Leuciscus cephalus pyraenaicus Günther, 1862) en el rio Jarama (cuenca del Tajo)Contribución al estudio de la bermejuela, Rutilus arcasi, Steindachner 1866 de la cuenca del Júcar (Osteichthyes: Cyprinidae) 1. MorfometríaDimensiones, estructura, forma y disposición en la cavidad de los nidos de Corvus monedula.Variaciones altitudinales en la composición de las comunidades nidificantes de aves de Sierra Nevada (Sur de España)Ecomorfología de una comunidadde Passeriformes en la Sierra de Cazorla, SE de EspañaLa Distribución del pez-sol (Lepolllis gibbostlS L.) en la Península IbéricaSobre la distribución de Barbus haasi (OSTARIOPHYSI: CYPRINIDAE)La Distribución de Barbus bocagei STEINDACHNER, 1865 (OSTARIOPHYSI: CYPRINIDAE) en la Península IbéricaLighy effects on circadian locomotor activity of Lacerta lepida under constant temperatureEvaluación de diferentes métodos para estimar el área de campeo de dos especies de iguánidos.Un Casal de Cartaxo-Nottenho (Saxicola rubetra) a criar em Portugal.Nidificación de Passer hispaniolensis en antiguos nidos de Dendrocopos major thanneri.Observación de un lince ibérico (Lynx pardina) en la provincia de Lugo. Norte de España.El Visón americano, Mustela vison SCHREBER, 1777 (MAMMALIA, MUSTELIDAE) en Cataluña, N.E. de la Península Ibérica.Peer reviewe

A genome-wide association study follow-up suggests a possible role for PPARG in systemic sclerosis susceptibility

Introduction: A recent genome-wide association study (GWAS) comprising a French cohort of systemic sclerosis (SSc) reported several non-HLA single-nucleotide polymorphisms (SNPs) showing a nominal association in the discovery phase. We aimed to identify previously overlooked susceptibility variants by using a follow-up strategy.<p></p> Methods: Sixty-six non-HLA SNPs showing a P value <10-4 in the discovery phase of the French SSc GWAS were analyzed in the first step of this study, performing a meta-analysis that combined data from the two published SSc GWASs. A total of 2,921 SSc patients and 6,963 healthy controls were included in this first phase. Two SNPs, PPARG rs310746 and CHRNA9 rs6832151, were selected for genotyping in the replication cohort (1,068 SSc patients and 6,762 healthy controls) based on the results of the first step. Genotyping was performed by using TaqMan SNP genotyping assays. Results: We observed nominal associations for both PPARG rs310746 (PMH = 1.90 × 10-6, OR, 1.28) and CHRNA9 rs6832151 (PMH = 4.30 × 10-6, OR, 1.17) genetic variants with SSc in the first step of our study. In the replication phase, we observed a trend of association for PPARG rs310746 (P value = 0.066; OR, 1.17). The combined overall Mantel-Haenszel meta-analysis of all the cohorts included in the present study revealed that PPARG rs310746 remained associated with SSc with a nominal non-genome-wide significant P value (PMH = 5.00 × 10-7; OR, 1.25). No evidence of association was observed for CHRNA9 rs6832151 either in the replication phase or in the overall pooled analysis.<p></p> Conclusion: Our results suggest a role of PPARG gene in the development of SSc

Net contribution and predictive ability of the CUN-BAE body fatness index in relation to cardiometabolic conditions

BACKGROUND: The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). METHODS: The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. RESULTS: The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07-1.21) and MetS (OR 1.48, 1.37-1.60), but not with diabetes (OR 1.05, 0.94-1.16). In subjects with a BMI?<?25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. CONCLUSIONS: The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings.Funding: The ENRICA study was funded and financed by Sanofi-Aventis. Specific funding for this analysis came from the governmental Spain FIS PI12/1166 and PI11/01379 projects and from the “UAM Chair in Epidemiology and Control of Cardiovascular Risk”

Together but not scambled: the concentration of foreign students in schools

La segregación y/o concentración de poblaciones de nacionalidad extranjera en determinadas escuelas es un fenómeno abordado por la producción científica internacional, un tema recurrente para los medios de comunicación y un hecho plasmado en los discursos que, desde la sociedad en general y en concreto desde la comunidad educativa, se plantea como central en el debate sobre la presencia de alumnado "extranjero/inmigrante" en el sistema educativo y que pone en cuestión la capacidad de este para promover la igualdad. Tras presentar de forma general dicho fenómeno, visto por la producción académica y las estadísticas nacionales y regionales, mostramos nuestro trabajo empírico llevado a cabo en dos barrios de dos ciudades andaluzas, donde observamos los procesos de concentración de la población "inmigrante/extranjera" a lo largo de varios cursos escolares. Con la ayuda de los discursos construidos en estos lugares trataremos de interpretar cuál es la lógica de un fenómeno que sigue moldeando un tipo de escuela que, más que gestionar la diversidad, construye la diferencia que termina traduciéndose en desigualdad.Segregation and / or concentration of foreign populations in some schools is a phenomenon raised by the international scientific production, a recurring theme for the media, and an issue discussed in the society at large and among the educational community more specifically. This situation is seen as crucial to the debate about the presence of foreign immigrant students in the educational system, and questions the ability of this system to promote equality. After giving a general idea about this phenomenon as presented by the scientific production and national and regional statistics, in this article we show our empirical work conducted in two neighborhoods in two cities in Andalusia where we observed the concentration process of immigrant / foreign population over several academic years. With the help of the discourses constructed in these places, we will highlight the existence of inequality, interpret the reasons behind it.El presente texto forma parte de una primera aproximación a los datos producidos en algunas investigaciones ya concluidas citadas más adelante, así como de un proyecto iniciado recientemente en el marco del Plan Nacional de I+D+i y que pretende estudiar las trayectorias escolares del alumnado «extranjero» en comparación con el alumnado autóctono: «Éxitos y fracasos escolares. Trayectorias socioculturales de “inmigrantes extranjeros” y escolares autóctonos en el sistema educativo andaluz» (CSO2010-22154-C03-0)

Future voyages to the solar system

CHALLENGE 2: FUTURE VOYAGES TO THE SOLAR SYSTEMPeer reviewe

Neuroimaging and serum biomarkers of neurodegeneration and neuroplasticity in Parkinson’s disease patients treated by intermittent theta-burst stimulation over the bilateral primary motor area: a randomized, double-blind, sham-controlled, crossover trial study

Background and objectivesIntermittent theta-burst stimulation (iTBS) is a patterned form of excitatory transcranial magnetic stimulation that has yielded encouraging results as an adjunctive therapeutic option to alleviate the emergence of clinical deficits in Parkinson’s disease (PD) patients. Although it has been demonstrated that iTBS influences dopamine-dependent corticostriatal plasticity, little research has examined the neurobiological mechanisms underlying iTBS-induced clinical enhancement. Here, our primary goal is to verify whether iTBS bilaterally delivered over the primary motor cortex (M1) is effective as an add-on treatment at reducing scores for both motor functional impairment and nonmotor symptoms in PD. We hypothesize that these clinical improvements following bilateral M1-iTBS could be driven by endogenous dopamine release, which may rebalance cortical excitability and restore compensatory striatal volume changes, resulting in increased striato-cortico-cerebellar functional connectivity and positively impacting neuroglia and neuroplasticity.MethodsA total of 24 PD patients will be assessed in a randomized, double-blind, sham-controlled crossover study involving the application of iTBS over the bilateral M1 (M1 iTBS). Patients on medication will be randomly assigned to receive real iTBS or control (sham) stimulation and will undergo 5 consecutive sessions (5 days) of iTBS over the bilateral M1 separated by a 3-month washout period. Motor evaluation will be performed at different follow-up visits along with a comprehensive neurocognitive assessment; evaluation of M1 excitability; combined structural magnetic resonance imaging (MRI), resting-state electroencephalography and functional MRI; and serum biomarker quantification of neuroaxonal damage, astrocytic reactivity, and neural plasticity prior to and after iTBS.DiscussionThe findings of this study will help to clarify the efficiency of M1 iTBS for the treatment of PD and further provide specific neurobiological insights into improvements in motor and nonmotor symptoms in these patients. This novel project aims to yield more detailed structural and functional brain evaluations than previous studies while using a noninvasive approach, with the potential to identify prognostic neuroprotective biomarkers and elucidate the structural and functional mechanisms of M1 iTBS-induced plasticity in the cortico-basal ganglia circuitry. Our approach may significantly optimize neuromodulation paradigms to ensure state-of-the-art and scalable rehabilitative treatment to alleviate motor and nonmotor symptoms of PD