Osteoartritis luética de rodilla

Se presenta el caso de un varón de 59 años, con antecedente de contacto sexual sospechoso entre 3 y 5 años antes, que desarrolló episodios de derrame articular indoloro en rodilla izquierda con una lesión osteítica destructiva en meseta tibial interna. Tras descartar otras patologías, el diagnóstico se efectuó por la intensa actividad treponéndca demostrada en la serología específica y la buena respuesta al tratamiento antibiótico. Los derrames desaparecieron, persistiendo únicamente la deformidad residual. No conseguimos identificar espiroquetas en el material obtenido por biopsia osteoarticular.We report a 59 years old man with a suspicious sexual contact between 3-5 years ago, who developed repeated painless swelling in his left knee, and a progressive destructive osteitis in his tibia. After rejecting other pathologies, the diagnosis arrived by the high treponemic activity proved by specific serology and the clinical recovery with antibiotic treatment. The swelling disappeared and only the residual deformity persisted. We didn't find any treponema in the biopsy

Application of foodborne disease outbreak data in the development q and maintenance of HACCP systems

Abstract Five-hundred and thirty general foodborne outbreaks of food poisoning reported in England and Wales between 1992 and 1996 were reviewed to study their application to the development and maintenance of HACCP systems. Retrospective investigations of foodborne disease outbreaks provided information on aetiological agents, food vehicles and factors that contributed to the outbreaks. Salmonella spp. and foods of animal origin (red meat, poultry and seafood) were most frequently associated with outbreaks during this period. Improper cooking, inadequate storage, cross-contamination and use of raw ingredients in the preparation of food were the most common factors contributing to outbreaks. Classification and cross tabulation of surveillance information relating to aetiological agents, food vehicles and contributory factors facilitates hazard analysis. In forming control measures and their corresponding critical limits, this approach focuses monitoring on those aspects that are critical to the safety of the product. Incorporation of epidemiological data in the documentation of HACCP systems provides assurance that the system is based on the best scientific information available

Inusual evolución de artritis reactiva tras inmunoterapia endovesical con BCG

La instilación intravesical de BCG (Bacilo de Calmette-Guerin) es una terapia preparada con cepas debilitadas de Mycobacterium bovis y constituye un tratamiento complementario eficaz para el cáncer de vejiga superficial (no musculoinfiltrante o no invasivo) de alto riesgo. Aunque la seguridad para su uso clínico es alta, la inmunoterapia endovesical no está exenta de complicaciones. La artralgia y la artritis son complicaciones infrecuentes, pero potencialmente severas, cuyo diagnóstico temprano puede permitir un tratamiento médico adecuado y evitar la cronificación de la patología. El presente caso muestra el manejo terapéutico de la artrosis coxofemoral en una mujer de 59 años, una complicación grave e infrecuente, secundaria a una patología poco común como la artritis reactiva debida a la instilación de BCG. Intravesical instillation of BCG (Bacille Calmette-Guerin) is a therapy prepared with weakened strains of Mycobacterium bovis and is an effective complementary treatment for high-risk (non-musculoinfiltrating or non-invasive) bladder cancer. Although its safety for clinical use is high, endovesical immunotherapy is not without complications. Arthralgia and arthritis are infrequent, but potentially severe, complications, the early diagnosis of which can allow adequate medical treatment and avoid chronification of the pathology. This case shows the therapeutic management of hip osteoarthritis in a 59-year-old woman, a rare and serious complication, secondary to a rare pathology such as reactive arthritis due to BCG instillation

Combined intermittent hypoxia and surface muscle electrostimulation as a method to increase peripheral blood progenitor cell concentration

Background: Our goal was to determine whether short-term intermittent hypoxia exposure, at a level well tolerated by healthy humans and previously shown by our group to increase EPO and erythropoiesis, could mobilizehematopoietic stem cells (HSC) and increase their presence in peripheral circulation. Methods: Four healthy male subjects were subjected to three different protocols: one with only a hypoxic stimulus (OH), another with a hypoxic stimulus plus muscle electrostimulation (HME) and the third with only muscle electrostimulation (OME). Intermittent hypobaric hypoxia exposureconsisted of only three sessions of three hours at barometric pressure 540 hPa (equivalent to an altitude of 5000 m) for three consecutive days, whereas muscular electrostimulation was performed in two separate periods of 25 min in each session. Blood samples were obtained from an antecubital vein on three consecutive days immediately before the experiment and 24 h, 48 h, 4 days and 7 days after the last day of hypoxic exposure. Results: There was a clear increase in the number of circulating CD34+ cells after combined hypobaric hypoxia and muscular electrostimulation. This response was not observed after the isolated application of the same stimuli. Conclusion: Our results open a new application field for hypobaric systems as a way to increase efficiency in peripheral HSC collection

Autosomal dominant polycystic kidney disease with diffuse proliferative glomerulonephritis - an unusual association: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Autosomal dominant polycystic kidney disease is an inherited disorder that is characterized by the development and growth of cysts in the kidneys and other organs. Urinary protein excretion is usually less than 1 g/24 hours in autosomal dominant polycystic kidney disease, and an association of nephrotic syndrome with this condition is considered rare. There are only anecdotal case reports of autosomal dominant polycystic kidney disease associated with nephrotic syndrome, with focal segmental glomerulosclerosis being the most commonly reported histopathological diagnosis. Nephrotic-range proteinuria in the presence of autosomal dominant polycystic kidney disease, with or without an accompanying decline in renal function, should be investigated by open renal biopsy to exclude coexisting glomerular disease. To the best of our knowledge, this is the first case of autosomal dominant polycystic kidney disease with histologically proven diffuse proliferative glomerulonephritis presenting with nephrotic-range proteinuria. No other reports of this could be found in a global electronic search of the literature.</p> <p>Case presentation</p> <p>We report the case of a 35-year-old Indo-Aryan man with autosomal dominant polycystic kidney disease associated with nephrotic syndrome and a concomitant decline in his glomerular filtration rate. Open renal biopsy revealed diffuse proliferative glomerulonephritis. An accurate diagnosis enabled us to manage him conservatively with a successful outcome, without the use of corticosteroid which is the standard treatment and the drug most commonly used to treat nephrotic syndrome empirically.</p> <p>Conclusion</p> <p>Despite the reluctance of physicians to carry out a renal biopsy on patients with autosomal dominant polycystic kidney disease, our case supports the idea that renal biopsy is needed in patients with polycystic kidney disease with nephrotic-range proteinuria to make an accurate diagnosis. It also illustrates the importance of open renal biopsy in planning appropriate treatment for patients with autosomal dominant polycystic kidney disease with nephrotic-range proteinuria. The treatment for various histological subtypes leading to nephrotic syndrome is different, and in this modern era we should practice evidence-based medicine and should avoid empirical therapy with its associated adverse effects.</p

Periprosthetic DXA after total hip arthroplasty with short vs. ultra-short custom-made femoral stems

Background and purpose Dual-energy X-ray absorptiometry (DXA) analysis of the 7 periprosthetic Gruen zones is the most commonly used protocol to evaluate bone remodeling after the implantation of conventional femoral stems. We assessed the value of DXA after cementless primary total hip arthroplasty (THA) by comparing the effect of progressive shortening of the stem of two femoral implants on periprosthetic bone remodeling using a specifically developed protocol of analysis with 5 periprosthetic regions of interest (ROIs)

Distribució Geogràfica de l’Esforç Pesquer i Captures de la Flota d’Encerclament Catalana (ICATMAR, 20-02)

23 pages, 15 figuresEn aquest informe es presenta la metodologia d’anàlisi i primers resultats de la distribució geogràfica de l’esforç i captures de la flota d’encerclament catalana a partir de dades VMS (Vessel Monitoring System) i ha estat realitzat per l’Institut Català de Recerca per a la Governança del Mar (ICATMAR), un òrgan de cooperació entre la Direcció General de Pesca i Afers Marítims del Departament d’Agricultura, Ramaderia, Pesca i Alimentació (DARP) de la Generalitat de Catalunya i l’Institut de Ciències del Mar (ICM) del Consejo Superior de Investigaciones Científicas (CSIC)Peer reviewe