Distribución espacial de una necrópolis de la Edad del Hierro: la Zona I de la Osera en Chamartin de la Sierra, Ávila

Sin resume

Hernia perineal en el perro. Combinación de tres técnicas para la corrección quirúrgica. Tres casos clínicos

En este trabajo se presentan cuatro cirugías de hernia perineal en el perro, realizadas con una combinación de tres técnicas: elevación del músculo obturador interno, interposición de una malla de polipropileno y transposición con rotación del músculo glúteo superficial. Con esta combinación de técnicas intentamos asegurar el menor índice de recidivas a largo plazo posible. También realizamos una aproximación a la controvertida etiología de este problema, todavía no suficientemente aclarada, pero sí orientada hacia una predisposición genética que alteraría la función de los receptores androgénicos en la musculatura del diafragma pélvico. Discutimos las alternativas quirúrgicas y tratamientos complementarios como la orquiectomía.

Ectopia ureteral bilateral intra y extra mural : caso clínico

La ectopia ureteral es una malformación congénita consistente en una apertura errónea del uréter que sobre pasa la vejiga urinaria y termina en otro lugar. Se presenta con mucha mayor frecuencia en hembras y hay algunas razas predispuestas como el Husky siberiano, el Caniche o el Retriever. En la práctica clínica se distinguen 3 situaciones: ectopia extramural a uretra, ectopia intramural y ectopia a útero. Describimos un caso clínico en el que se dio un tipo de uréter ectópico diferente en cada uréter, intramural el derecho y extramural el izquierdo.

Risks Associated with the Use of Garcinia as a Nutritional Complement to Lose Weight

Nowadays, obesity is one of the great nutritional problems facing public health. The prevalence of this pathology has increased in a worrying way over recent years, currently reaching epidemic proportions. In this context, nutritional supplements are presented as a therapeutic alternative to which more and more people are turning to. Nutritional supplements to lose weight based on the Garcinia plant, specifically on Garcinia cambogia, are commonly used. The active principle of this plant to which these properties have been attributed, is hydroxycitric acid (HCA). The aim of the present review is to gather reported data concerning the effectiveness of nutritional supplements based on Garcinia extracts on weight loss and their possible negative effects. Contradictory results have been observed regarding the effectiveness of the supplements. While statistically significant weight loss was observed in some studies, no changes were found in others. Regarding safety, although Garcinia supplements have been revealed as safe in the vast majority of the studies carried out in animal models and humans, some cases of hepatotoxicity, serotonin toxicity and mania have been reported. In conclusion, the results suggest that Garcinia-based supplements could be effective in short-term weight loss, although the data are not conclusive. In addition, the safety of the complement should be further studied.This study was funded by Instituto de Salud Carlos III (CIBERobn) under Grant CB12/03/30007 and University of the Basque Country under Grant GIU18-173

Methodology to calibrate the dissection properties of aorta layers from two sets of experimental measurements

Aortic dissection is a prevalent cardiovascular pathology that can have a fatal outcome. However, the mechanisms that trigger this disease and the mechanics of its progression are not fully understood. Computational models can help understand these issues, but they need a proper characterisation of the tissues. Therefore, we propose a methodology to obtain the dissection parameters of all layers in aortic tissue via the computational modelling of two different delamination tests: the peel and mixed tests. Both experimental tests have been performed in specimens of porcine aorta, where the intima-media and media-adventitia interfaces, as well as the medial layer, were dissected. These two tests have been modelled using a cohesive zone formulation for the separating interface and a hyperelastic anisotropic material model via an implicit static analysis. The dissection properties of each interface have been calibrated by reproducing the force-displacement curves obtained in the experimental tests. The values of peak and mean force of the experiments were fitted with an error below 10%. With this methodology, we intend to contribute to the development of reliable numerical tools for simulating aortic dissection and aortic aneurysm rupture. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Factors affecting decision making in children with complex care needs:a consensus approach to develop best practice in a UK children’s hospital

BACKGROUND: Children with complex care needs are a growing proportion of the sick children seen in all healthcare settings in the UK. Complex care needs place demands on parents and professionals who often require many different healthcare teams to work together. Care can be both materially and logistically difficult to manage, causing friction with parents. These difficulties may be reduced if common best practice standards and approaches can be developed in this area. OBJECTIVE: To develop a consensus approach to the management of complexity among healthcare professionals, we used a modified Delphi process. The process consisted of a meeting of clinical leaders to develop candidate statements, followed by two survey rounds open to all professionals in a UK children’s hospital to measure and establish consensus recommendations. RESULTS: Ninety-nine professionals completed both rounds of the survey, 69 statements were agreed. These pertained to seven thematic areas: standardised approaches to communicating with families; processes for interprofessional communication; processes for shared decision-making in the child’s best interests; role of the multidisciplinary team; managing professional–parental disagreement and conflict; the role of clinical psychologists; and staff support. Overall, the level of consensus was high, ranging from agreement to strong agreement. CONCLUSIONS: These statements provide a consensus basis that can inform standardised approaches to the management of complexity. Such approaches may decrease friction between parents, children and healthcare professionals

The trimer interface in the quaternary structure of the bifunctional prokaryotic FAD synthetase from Corynebacterium ammoniagenes

Bifunctional FAD synthetases (FADSs) fold in two independent modules; The C-terminal riboflavin kinase (RFK) catalyzes the RFK activity, while the N-terminal FMN-adenylyltransferase (FMNAT) exhibits the FMNAT activity. The search for macromolecular interfaces in the Corynebacterium ammoniagenes FADS (CaFADS) crystal structure predicts a dimer of trimers organization. Within each trimer, a head-to-tail arrangement causes the RFK and FMNAT catalytic sites of the two neighboring protomers to approach, in agreement with active site residues of one module influencing the activity at the other. We analyze the relevance of the CaFADS head-to-tail macromolecular interfaces to stabilization of assemblies, catalysis and ligand binding. With this aim, we evaluate the effect of point mutations in loop L1c-FlapI, loop L6c, and helix a1c of the RFK module (positions K202, E203, F206, D298, V300, E301 and L304), regions at the macromolecular interface between two protomers within the trimer. Although none of the studied residues is critical in the formation and dissociation of assemblies, residues at L1c-FlapI and helix a1c particularly modulate quaternary architecture, as well as ligand binding and kinetic parameters involved with RFK and FMNAT activities. These data support the influence of transient oligomeric structures on substrate accommodation and catalysis at both CaFADS active sites

The origin of the Acheulean: the 1.7 million-year-old site of FLK West, Olduvai Gorge (Tanzania)

The appearance of the Acheulean is one of the hallmarks of human evolution. It represents the emergence of a complex behavior, expressed in the recurrent manufacture of large-sized tools, with standardized forms, implying more advance forethought and planning by hominins than those required by the precedent Oldowan technology. The earliest known evidence of this technology dates back to c. 1.7 Ma. and is limited to two sites (Kokiselei [Kenya] and Konso [Ethiopia]), both of which lack fauna. The functionality of these earliest Acheulean assemblages remains unknown. Here we present the discovery of another early Acheulean site also dating to c. 1.7 Ma from Olduvai Gorge. This site provides evidence of the earliest steps in developing the Acheulean technology and is the oldest Acheulean site in which stone tools occur spatially and functionally associated with the exploitation of fauna. Simple and elaborate large-cutting tools (LCT) and handaxes co-exist at FLK West, showing that complex cognition was present from the earliest stages of the Acheulean. Here we provide a detailed technological study and evidence of the use of these tools on the butchery and consumption of fauna, probably by early Homo erectus sensu lato

Metastasis of spindle cell malignant melanoma in gallbladder

Malignant melanoma is an aggressive neoplasm with a high tendency to metastasize. Gastrointestinal metastases, although described in the literature, are infrequent. We present the case of a 51-year-old male patient with a surfcial spreading melanoma stage IIIc with BRAF mutation who presented a gallbladder outgrowth lesion, compatible with a polyp. A signifcant growth of the lesion was observed in subsequent TC studies and a laparoscopic cholecystectomy was performed. The anatomopathological study of the specimen confrmed the diagnosis of gallbladder metastasis due to epithelioid and spindle cell malignant melanoma. The presence of a gallbladder lesion in the context of a patient diagnosed with melanoma should establish the diagnostic suspicion of metastasis, and an early extension study and laparoscopic cholecystectomy should be considered. The palliative surgical approach to avoid hepatobiliary symptomatology can be considered

Ensayo de hormigones endurecidos de cemento portland mediante microscopía

Not availableEn los laboratorios de control de materiales de construcción se presenta, en determinadas ocasiones, la necesidad de investigar las posibles causas que han motivado los fallos en hormigones endurecidos. Este problema, muy complejo en su esencia, ha despertado el interés de numerosos investigadores, afrontándole desde diferentes puntos de vista y empleando técnicas diversas