Surgical management of enchondroma with joint transfer: a case report

The enchondromas are the most common benign bone tumor in the hands, mainly in young patients and its treatment is surgical in most cases due to its possible complications avoided through different procedures such as joint transfer, which allows to maintain a good quality of life for the patient. We present the case of a 42-year-old woman who came to the clinic for blunt trauma in the right hand where she was incidentally diagnosed with enchondroma on the third finger of the proximal interphalangeal joint of the right hand. Articular transfer of the proximal interphalangeal joint was performed. Second toe on the right, at 6 weeks corroborates correct evolution with bone consolidation of the articular transfer grade III and donor zone grade II, without infection complications, the correct recovery of the extensor movement range of this joint improving so their state of life should be the main objective of these procedures

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Objetivo: determinar propiedades psicométricas de los instrumentos desarrollados por la OPS para evaluar  la calidad y la efectividad potencial de material educativo. Materiales y métodos: se utilizaron instrumentos  diseñados por la OPS para evaluar la calidad de material educativo en salud, diseñado durante el primer  semestre del 2010. La evaluación fue realizada por grupos de usuarios del material, así: para material  audiovisual, n=74; material impreso, n=116; material sonoro, n=37; material visual: n=71. Para cada  instrumento se evaluó la factoriabilidad mediante las pruebas de Kaiser-Meyer-Olkin y de esfericidad de  Bartlett. Posteriormente, se determinó la consistencia interna y estructura factorial del instrumento  mediante la estimación del alfa de Cronbach, y el análisis factorial por el método de extracción de  componentes principales. Resultados: todos los instrumentos fueron factorizables. El alfa de Cronbach para  material audiovisual fue 0,687; la extracción de ejes principales reportó cuatro factores. Para material  impreso: alfa de Cronbach de 0,83; la extracción de componentes principales arrojó un solo factor  Cronbach  = 0,73 y se extrajeron tres componentes principales. Para el material visual se encuentra alfa de Cronbach =  0,66 con tres componentes principales. Conclusiones: los instrumentos diseñados por la OPS para evaluar  material educativo constituyen una herramienta confiable para evaluar los criterios de atracción,  entendimiento, identificación y aceptación; se hace necesario profundizar en el análisis estructural de estos;  no evalúan el criterio de inducción a la acción que otros autores referencian.Objective: to determine psychometric properties of the instruments developed by PAHO to assess quality  and potential effectiveness of educational material. Materials and methods: instruments designed by PAHO  to assess the quality of health educational materials designed during the first semester 2010 were used. The  evaluation was carried out through materials user groups as follows: audiovisual material, n = 74; printed  material, n = 116; audio recordings, n = 37; visual material, n = 71. Factorability was evaluated for each one of  the instruments by using Kaiser -Meyer-Olkin`s test and sphericity was evaluated with Bartlett’s test. Internal  consistency and factorial structure of the instrument were determined later using Cronbach’s alpha estimate  and the factorial analysis was carried out using the main components extraction method. Results: all  instruments were factorable. Cronbach’s alpha for audiovisual material was 0.687; extraction of principal  axes reported 4 factors. For printed material: 0.83Cronbach’s alpha; the extraction of principal components  showed a single factor which explains 45.1% of the variance. In the audio material it was found 0.73  Cronbach`s alpha and three major components were extracted. For visual material Cronbach’s alpha is = 0.66  with three main components. Conclusions: the instruments designed by PAHO to assess educational  materials are a reliable tool for assessing the attraction, understanding, identifying and accepting criteria;  however, it is necessary to go deeper in their structural analysis. The do not assess the induction to action  criterion referenced by other authors

The LSD1 inhibitor iadademstat (ORY-1001) targets SOX2-driven breast cancer stem cells: a potential epigenetic therapy in luminal-B and HER2-positive breast cancer subtypes

SOX2 is a core pluripotency-associated transcription factor causally related to cancer initiation, aggressiveness, and drug resistance by driving the self-renewal and seeding capacity of cancer stem cells (CSC). Here, we tested the ability of the clinically proven inhibitor of the lysine-specific demethylase 1 (LSD1/KDM1A) iadademstat (ORY-100) to target SOX2-driven CSC in breast cancer. Iadademstat blocked CSC-driven mammosphere formation in breast cancer cell lines that are dependent on SOX2 expression to maintain their CSC phenotype. Iadademstat prevented the activation of an LSD1-targeted stemness-specific SOX2 enhancer in CSC-enriched 3-dimensional spheroids. Using high-throughput transcriptional data available from the METABRIC dataset, high expression of SOX2 was significantly more common in luminal-B and HER2-enriched subtypes according to PAM50 classifier and in IntClust1 (high proliferating luminal-B) and IntClust 5 (luminal-B and HER2-amplified) according to integrative clustering. Iadademstat significantly reduced mammospheres formation by CSC-like cells from a multidrug-resistant luminal-B breast cancer patient-derived xenograft but not of those from a treatment-naive luminal-A patient. Iadademstat reduced the expression of SOX2 in luminal-B but not in luminal-A mammospheres, likely indicating a selective targeting of SOX2-driven CSC. The therapeutic relevance of targeting SOX2-driven breast CSC suggests the potential clinical use of iadademstat as an epigenetic therapy in luminal-B and HER2-positive subtypes

Use of rivaroxaban and acetylsalicylic acid as a combined treatment for peripheral arterial disease in Central Military Hospital

Background: The objective of this research was to evaluate the behavior of 3 risk indicators for peripheral arterial disease in patients under oral treatment with rivaroxaban 2.5 mg every 12 hours plus, acetylsalicylic acid 100 mg every 24 hours. It was hypothesized that the oral combination of rivaroxaban and acetylsalicylic acid presents a therapeutic advantage over other treatments.Methods: A prospective longitudinal and non-randomized study of a single center was performed. 59 patients with peripheral arterial disease were included and treated with acetylsalicylic acid + rivaroxaban. Peak systolic velocity, ankle-brachial index and C reactive protein index were evaluated.Results: Significant changes were found at month 1 and 3 of follow-up in maximum systolic velocity, ankle-arm index and C-reactive protein index. The baseline peak systolic velocity (PSV) in the anterior tibial artery had significant differences after one month of treatment (p=0.001) and after 3 months (p=0.001). The baseline PSV in the posterior tibial artery had significant differences compared to the values found at the month of treatment (p=0.001) and 3 months (p=0.001). In the ankle-brachial index a baseline median of 0.790 was found, one month after the treatment of 0.795 (p=0.147) and 3 months after 0.800 (p=0.019). The mean baseline C-reactive protein obtained was 73.142 mg/l, at one month 87.233 mg/l (p=0.001) and at 3 months at 79.009 mg/l (p=0.294) with a standard deviation of 67.18, 74.78 and 69.69 respectively.Conclusions: The combined use of acetylsalicylic acid and rivaroxaban allows a clinical improvement in patients with peripheral arterial disease

Antropic fires promotes the increase of alien species cover in the understory of Nothofagus antarctica (Forster f.) Oersted forests under management

Se analizó la respuesta temprana del sotobosque de Nothofagus antarctica (ñire) luego de un incendio, particularmente, la potencialidad de invasión por parte de especies exóticas. Se establecieron transectas permanentes (n=6 por sitio) de 10 m de longitud antes (2008) y después del fuego (2009 a 2014) en bosques maduros con manejo silvopastoril. Se evaluó la riqueza y cobertura de especies con el método de intersección puntual y se analizaron los datos mediante ANOVAs de medidas repetidas. La composición del sotobosque de N. antarctica se modificó debido a: (a) el aumento de la cobertura de hierbas y pastos exóticos, (b) el ingreso de especies exóticas nuevas ausentes en la situación pre-incendio, (c) la menor cobertura de algunas especies de hierbas nativas, d) el ingreso de especies nativas de Tierra del Fuego, pero no propias del bosque y que estaban ausentes en la situación pre-incendio.We examined the early response of Nothofagus antarctica (ñire) understory after a fire, including the potential for invasion by exotic species. Permanent transects (n =6 per site) 10m length were surveyed before (2008) and after fire (2009 to 2014). In each transect, vegetation (species richness and cover) was recorded at by the point-intercept method. Data were analyzed using repeated measures ANOVAs. The composition of N. antarctica understory was significantly modified from: (a) increasing the coverage of alien species of herbs and grasses, (b) the income of new alien species that were absent in the pre-fire situation, (c) the lowest coverage of some native species of herbs, (d) the income of native species of Tierra del Fuego, which are typical from other habitat types (e.g., grasslands), and which were absent in the pre-fire situation.Laboratorio de Investigación de Sistemas Ecológicos y Ambientale

Análisis de la sensibilidad barorefleja arterial mediante la aplicación de fenilefrina y nitroprusiato sódico en pacientes con trastorno depresivo mayor

La depresión mayor se ha asociado fuertemente con un riesgo aumentado de desarrollar enfermedades cardiovasculares (ECV) y con una tasa de mortalidad de dos a cuatro veces mayor después de un infarto agudo del miocardio. A pesar de la gran evidencia epidemiológica que soporta la relación entre la depresión y las ECV, los mecanismos fisiopatológicos de esta conexión permanecen poco conocidos. Las alteraciones en la función del sistema nervioso autónomo se han postulado como una de las causas probables del riesgo cardiovascular aumentado en pacientes con depresión. Diversos autores han mostrado que los síntomas depresivos están asociados con aberraciones en la regulación autonómica cardíaca, caracterizadas por una actividad simpática aumentada y un tono parasimpático disminuido, que aumentan el riesgo de isquemia miocárdica, taquicardia ventricular, fibrilación ventricular y muerte cardíaca súbita. Los barorreceptores arteriales son mecanorreceptores localizados en el arco aórtico y en el seno carotídeo, que sirven para regular la presión arterial mediante cambios rápidos en la frecuencia y contracción cardíacas y en la capacitancia venosa. El barorreflejo cardíaco muestra un equilibrio entre la actividad simpática y vagal para el mantenimiento de una presión arterial adecuada. Las alteraciones en la sensibilidad barorefleja se han asociado a un mayor riesgo de presentar arritmias ventriculares y muerte cardíaca súbita en sujetos con ECV. Recientemente, diversos estudios han mostrado que la sensibilidad de los barorreceptores arteriales está disminuida en sujetos con trastorno depresivo mayor (TDM) y ECV asociadas. Sin embargo, existen dudas razonables acerca de que estas alteraciones están mas relacionadas con la presencia de las ECV o con efectos secundarios de medicamentos antidepresivos que con el TDM mismo. Por lo tanto, el objetivo del presente estudio fue analizar la sensibilidad barorefleja arterial mediante la aplicación de fenilefrina y nitroprusiato de sódio en pacientes con TDM de novo sin ECV asociada y antes de la instauración de tratamiento antidepresivo. Salud UIS 2008; 40: 160-16

Análisis de la sensibilidad barorefleja arterial mediante la aplicación de fenilefrina y nitroprusiato sódico en pacientes con trastorno depresivo mayor

La depresión mayor se ha asociado fuertemente con un riesgo aumentado de desarrollar enfermedades cardiovasculares (ECV) y con una tasa de mortalidad de dos a cuatro veces mayor después de un infarto agudo del miocardio. A pesar de la gran evidencia epidemiológica que soporta la relación entre la depresión y las ECV, los mecanismos fisiopatológicos de esta conexión permanecen poco conocidos. Las alteraciones en la función del sistema nervioso autónomo se han postulado como una de las causas probables del riesgo cardiovascular aumentado en pacientes con depresión. Diversos autores han mostrado que los síntomas depresivos están asociados con aberraciones en la regulación autonómica cardíaca, caracterizadas por una actividad simpática aumentada y un tono parasimpático disminuido, que aumentan el riesgo de isquemia miocárdica, taquicardia ventricular, fibrilación ventricular y muerte cardíaca súbita. Los barorreceptores arteriales son mecanorreceptores localizados en el arco aórtico y en el seno carotídeo, que sirven para regular la presión arterial mediante cambios rápidos en la frecuencia y contracción cardíacas y en la capacitancia venosa. El barorreflejo cardíaco muestra un equilibrio entre la actividad simpática y vagal para el mantenimiento de una presión arterial adecuada. Las alteraciones en la sensibilidad barorefleja se han asociado a un mayor riesgo de presentar arritmias ventriculares y muerte cardíaca súbita en sujetos con ECV. Recientemente, diversos estudios han mostrado que la sensibilidad de los barorreceptores arteriales está disminuida en sujetos con trastorno depresivo mayor (TDM) y ECV asociadas. Sin embargo, existen dudas razonables acerca de que estas alteraciones están mas relacionadas con la presencia de las ECV o con efectos secundarios de medicamentos antidepresivos que con el TDM mismo. Por lo tanto, el objetivo del presente estudio fue analizar la sensibilidad barorefleja arterial mediante la aplicación de fenilefrina y nitroprusiato de sódio en pacientes con TDM de novo sin ECV asociada y antes de la instauración de tratamiento antidepresivo. Salud UIS 2008; 40: 160-16

Competence in metered-dose inhaler technique among healthcare workers of three general hospitals in Mexico: it is not good after all these years

Introduction: Inhaled medication is the cornerstone of pharmacological treatment for chronic respiratory diseases. Therefore, it is important to use a metered-dose inhaler (MDI) correctly to get the appropriate dosage and benefit from the drug. Health-care workers (HCW) are responsible for teaching the correct MDI technique. Unfortunately, numerous studies consistently show that HCW have poor MDI technique. This study aimed to evaluate the current knowledge of MDI technique in HCW working in three general hospitals. Material and methods: A hospital-based, cross-sectional descriptive study was conducted in three general hospitals in Aguascalientes, México. Three surveyors simultaneously scored through a 14 dichotomic questions list as bad, regular, good, and very good MDI technique. Data were analyzed with SPSS version 16. Statistical analyses were performed using chi-square test or unpaired t-tests. An analysis of one-way ANOVA was used for comparison of three independent general hospitals. Values of p < 0.05 were considered to indicate statistical significance. Results: A total of 244 HCWs were surveyed: 78.3% were nurses whereas 21.3% were physicians. The inter-observer concor-dance analysis among observers was 0.97. We observed that 32.4% (79) performed a bad technique, 51.6% (126) a regular technique, 13.5% (33) a good one, and 2.5% HCW (6) a very good technique. No difference between gender, labor category, schedule, service, age, seniority, and education degree between the three hospitals was observed. The most common mistakes were “insufficient expiration prior to activation of the device”, and “the distance the inhaler was placed for inhalation” (83 and 84% respectively). Conclusion: We observed that a high percentage of HCW do not follow the MDI technique correctly, being this percentage even higher than the reported in other studies. These observations suggest the urgent need to establish frequent training programs for the correct use of MDI

Extra Virgin Olive Oil Contains a Phenolic Inhibitor of the Histone Demethylase LSD1/KDM1A

The lysine-specific histone demethylase 1A (LSD1) also known as lysine (K)-specific demethylase 1A (KDM1A) is a central epigenetic regulator of metabolic reprogramming in obesity-associated diseases, neurological disorders, and cancer. Here, we evaluated the ability of oleacein, a biophenol secoiridoid naturally present in extra virgin olive oil (EVOO), to target LSD1. Molecular docking and dynamic simulation approaches revealed that oleacein could target the binding site of the LSD1 cofactor flavin adenosine dinucleotide with high affinity and at low concentrations. At higher concentrations, oleacein was predicted to target the interaction of LSD1 with histone H3 and the LSD1 co-repressor (RCOR1/CoREST), likely disturbing the anchorage of LSD1 to chromatin. AlphaScreen-based in vitro assays confirmed the ability of oleacein to act as a direct inhibitor of recombinant LSD1, with an IC50 as low as 2.5 umol/L. Further, oleacein fully suppressed the expression of the transcription factor SOX2 (SEX determining Region Y-box 2) in cancer stem-like and induced pluripotent stem (iPS) cells, which specifically occurs under the control of an LSD1-targeted distal enhancer. Conversely, oleacein failed to modify ectopic SOX2 overexpression driven by a constitutive promoter. Overall, our findings provide the first evidence that EVOO contains a naturally occurring phenolic inhibitor of LSD1, and support the use of oleacein as a template to design new secoiridoid-based LSD1 inhibitors.Work in the Menendez laboratory is supported by the Spanish Ministry of Science and Innovation (Grant SAF2016-80639-P, Plan Nacional de l+D+I, founded by the European Regional Development Fund, Spain) and by an unrestricted research grant from the Fundació Oncolliga Girona (Lliga catalana d’ajuda al malalt de càncer, Girona). The Spanish Ministry of Economy and Competitiveness (MINECO, Project RTI2018-096724-B-C21) and the Generalitat Valenciana (PROMETEO/2016/006) supports work in the Encinar laborator

Burden of Respiratory Failure in Pediatric Patients: Analysis of a Prospective Multicenter Cohort in Bogotá, Colombia

BACKGROUND AND AIMS: The approach to the burden of disease is a demographic, economic, and a health problem, which requires the design and application of specific measures of cost of the disease, such as disability-adjusted life years (DALYs), to establish better public health policies in the pediatric population. The aim of this study is to approach the burden of disease in children with acute respiratory failure (ARF) through the calculation of DALYs. METHODS: This study was conducted in the framework of a prospective, multicenter cohort in Bogotá, Colombia. Inclusion criteria were all pediatric patients admitted to the emergency department, hospitalization, and intensive care unit with respiratory distress; eligible patients were all those who developed ARF between April 2020 and December 2021. They were followed-up during hospitalization, at 30 and 60 days after admission. The Infant/Toddler Quality of Life Questionnaire and KIDSCREEN quality of life scales were applied for follow-up according to the age group. The results were used to calculate DALYs. RESULTS: Six hundred and eighty-five eligible patients, 296 (43.08%) developed ARF, of these 22 (6.08%) patients died (mortality rate = 7.43%). The total DALYs was 277.164 years. For younger than 9 years, the DALYs were 302.64 years, while for older than 10 years were 40.49 years. CONCLUSION: ARF is one of the main causes of preventable mortality in pediatrics, its progression to respiratory failure is a highly prevalent condition in pediatric age, a condition that has a great impact on mortality, morbidity, and disability in our patients