El quiste óseo aneurismático en niños y adolescentes

Desde el año 1981 hasta el año 1996 hemos tratado en nuestro servicio un total de 12 pacientes con diagnóstico de Quiste Óseo Aneurismático (QOA). Esta entidad clínico-patológica continúa hoy teniendo un origen incierto que en la mayoría de las ocasiones no puede reconocerse. Los tratamientos empleados fueron: legrado e injerto óseo en siete casos, resección en bloque en tres casos, y en 2 casos tratamiento expectante. Los resultados del tratamiento quirúrgico fueron satisfactorios en el 75% de los casos, encontrando un 25% de recidivas, que ocurrieron en los pacientes más jóvenes con quistes más agresivos. El tiempo medio de seguimiento fue de 4 años (mínimo 1 - máximo 8). Realizamos en el trabajo, además, una comparación con otros métodos de tratamiento publicados como son la crioterapia intratumoral y la embolizacón arterial selectiva, los cuales encontramos de utilidad relativa ya que requieren una alta especialización y una selección precisa de los casos. También la radioterapia que tiene una utilidad restringida a aquellos casos de inaccesibilidad operatoria.From 1981 to 1996 twelve patients were treated in our orthopaedic department with the diagnosis of Aneurismal Bone Cyst (ABC). This pathologic and clinical entity has an unknown etiology that in the majority of cases it can¿t be elucidated. The threatment was: curettage and bone graft in seven cases; in bloc excision in three cases and expectant in two. Surgical treatment results were satisfactory in 75% of cases, with 25% of local recurrences that took place in younger patients with more aggressive cysts. Mean follow-up was four years (range: 1-8). In this study we make a comparison with other methods of treatment reported like intratumoral criotherapy and selective arterial embolization. We find these methods of relative utility due to their high level of orthopaedist specialization and precise selection of cases. The radiotherapy has restricted application to cases of unresectable tumours

Tratamiento de las fracturas complejas de fémur mediante enclavado intramedular encerrojado de Brooker-Wills

Se realiza un estudio retrospectivo de 19 pacientes con fracturas complejas de fé- mur tratados mediante el clavo bloqueado de Brooker-Wills. La causa más frecuente de dichas fracturas fueron los accidentes de tráfico. Hubo lesiones asociadas en el 63% de los casos. El tiempo medio de seguimiento fue de 27 meses. Nuestros resultados han sido evaluados mediante los criteros de Thorensen, obteniendo un 84% de resultados favorables. Hubo problemas técnicos intraoperatorios en 8 pacientes, la mayoría debidos a la penetración de la cortical femoral distal por una de las aletas. Todas las fracturas consolidaron. La mayor ventaja de este clavo la encontramos en la sencillez del bloqueo distal, lo cual supone una menor exposición a la radiación y un acortamiento del tiempo quirúrgico.A retrospective study of 19 patients with complex fermoral fractures treated with the Brooker-Wills interlocking intramedullary nail is reported. The traffic-accident was the most common cause of these fractures. Associated injuries were found in 63% of cases. The mean time follow-up period was 27 months. Results were assessed according to Thorensen's criteria. We found excellent or good results in 84% of these patients. There were intraoperative technical problems without clinical complications in 8 patients, most of them due to distal femoral cortex penetration with the pins. Union occurred in all fractures. The greatest advantage of this nail comes from the easy insertion of distal pins, providings less exposition to radiation and a shorter operative tim

Histological and immunohistochemical features suggesting aetiological differences in lymph node and (muco)cutaneous feline tuberculosis lesions

Objectives To identify and describe histological and immunohistochemical criteria that may differentiate between skin and lymph node lesions associated with Mycobacterium (M.) bovis and M. microti in a diagnostic pathology setting.Materials and Methods<jats:p/>Archived skin and lymph node biopsies of tuberculous lesions were stained with haematoxylin and eosin, Ziehl‐Neelsen and Masson's Trichrome. Immunohistochemistry was performed to detect the expression of calprotectin, CD3 and Pax5. Samples were scored for histological parameters (i.e. granulomas with central necrosis versus small granulomas without central necrosis, percentage necrosis and/or multinucleated giant cells), number of acid‐fast bacilli (bacterial index) and lesion percentage of fibrosis and positive immunohistochemical staining.Results Twenty‐two samples were examined (M. bovis n=11, M. microti n=11). When controlling for age, gender and tissue, feline M. bovis‐associated lesions more often featured large multi‐layered granulomas with central necrosis. Conversely, this presentation was infrequent in feline M. microti‐associated lesions, where small granulomas without central necrosis predominated. The presence of an outer fibrous capsule was variable in both groups, as was the bacterial index. There were no differences in intralesional expression of immunohistochemical markers.Clinical Significance Differences in the histological appearance of skin and lymph node lesions may help to infer feline infection with either M. bovis or M. microti at an earlier stage when investigating these cases, informing clinicians of the potential zoonotic risk. Importantly, cases of tuberculosis can present with numerous acid‐fast bacilli. This implies that a high bacterial index does not infer infection with non‐zoonotic non‐tuberculous mycobacteria

Phylogeography and Molecular Evolution of Potato virus Y

Potato virus Y (PVY) is an important plant pathogen, whose host range includes economically important crops such as potato, tobacco, tomato, and pepper. PVY presents three main strains (PVYO, PVYN and PVYC) and several recombinant forms. PVY has a worldwide distribution, yet the mechanisms that promote and maintain its population structure and genetic diversity are still unclear. In this study, we used a pool of 77 complete PVY genomes from isolates collected worldwide. After removing the effect of recombination in our data set, we used Bayesian techniques to study the influence of geography and host species in both PVY population structure and dynamics. We have also performed selection and covariation analyses to identify evolutionarily relevant amino acid residues. Our results show that both geographic and host-driven adaptations explain PVY diversification. Furthermore, purifying selection is the main force driving PVY evolution, although some indications of positive selection accounted for the diversification of the different strains. Interestingly, the analysis of P3N-PIPO, a recently described gene in potyviruses, seems to show a variable length among the isolates analyzed, and this variability is explained, in part, by host-driven adaptation

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Starchy Shells: Residue analysis of precolonial northern Caribbean culinary practices

Determining culinary practices is critical for understanding phytocultural complexes, transported landscapes and human niche constructions. Starch analysis is an exemplary method for reconstructing human–plant dependencies. However, certain types of artefacts from the Greater Caribbean region, such as flaked lithics, lithic griddles, coral artefacts and shells, have not been extensively analysed for starch remains. Moreover, there has been no comparison of culinary practices between The Bahama archipelago and the Greater Antilles (the presumed origin of foodways transported to The Bahama archipelago). The paper investigates 60 bivalve shell artefacts for starch remains, which were recovered from three archaeological sites: El Flaco and La Luperona (Dominican Republic), and Palmetto Junction (Turks & Caicos Islands). In contrast to ethnohistorical narratives that characterize shell tools exclusively as manioc peelers, the starch remains recovered in this study suggest a broader suite of plants and functions. The results provide evidence that a diversity of plants (Dioscorea spp., Dioscorea trifida L., Fabaceae, Ipomoea batatas L., Manihot esculenta Crantz, cf. Zea mays L., cf. Acrocomia media O. F. Cook, and Zingiberales) were prepared with these shells. This new evidence contributes to ongoing discussions about culinary practices in the Caribbean and other related late precolonial (c.800–1500 ce) foodways.Horizon 2020(H2020)319209Archaeology of the AmericasNexu

Stapling technology with triple-row and enhanced staple configurations evaluated in a series of 124 consecutive laparoscopic vertical gastrectomies

[eng] Background: Laparoscopic sleeve gastrectomy (LSG) is a procedure frequently used to treat morbid obesity, due to its simplicity compared to other bariatric techniques. However, LSG can lead to serious complications, such as gastric leakage and bleeding from the staple line. To reduce these complications, seroserosal reinforcement of the mechanical suture line after gastrectomy is generally recommended. In recent decades, studies have focused on the safety of anastomosis with staples, especially compared to manual sewing techniques. Since studies on the improvement of stapling technology are limited, this study arises to compare the clinical results of staple line oversewing versus stapling technology with triple-row and enhanced staple configurations in laparoscopic sleeve gastrectomy. Methods: A retrospective review from a prospectively maintained database of 124 laparoscopic vertical gastrectomies performed at single centre between March 2010 and December 2016. Patients were divided into two groups, with comparable anthropometric parameters and inclusion criteria. Seroserosal reinforcement was used in the first group, and stapling technology with triple-row and enhanced staple configurations in the second. Rates of anastomotic leakage, bleeding, reoperation, and 30-day mortality were compared. Results: In Group 1 the average surgical time was 125 min, whereas in Group 2 it was 87 min. No differences were found between the two groups regarding leakage or bleeding of the staple line. Conclusions: The use of triple-row stapling devices during laparoscopic vertical gastrectomy enables surgical time to be reduced. Further high-quality studies to evaluate the efficacy and effectiveness of stapling technology with triple-row and enhanced staple configurations are needed