Fractura de trasfondo acetabular en un niño de 14 años con defecto de cierre del cartílago trirradiado: seguimiento de 13 años

Las fracturas acetabulares representan entre el 1 y el 15% de las fracturas pélvicas de los niños. Una de sus complicaciones es el cierre precoz del cartílago trirradiado que puede conducir a una displasia acetabular secundaria, siendo mayores las posibilidades cuanto menor es la edad del niño en el momento de la lesión. Se describe el caso de un niño de 14 años que tras un accidente de tráfico presenta, entre otras lesiones, una fractura de trasfondo acetabular izquierdo que se trató de forma conservadora. Tras 13 años de seguimiento, se aprecia un defecto persistente de fusión del cartílago trirradiado.Acetabular fractures represent between 1 and 15% of pelvic fractures in children. The early closure of the triradiate cartilage is one of its complications that can lead to a secondary acetabular dysplasia, so the chances are higher the lower the child's age at the time of the injury. The case of a child of 14 years old who suffer a traffic accident is described. He presents, among other injuries, a left acetabular background fracture, with non surgical treatment. After 13 years of follow-up, there is a persistent defect of closure of the triradiate cartilage

Enfermedad de Panner y osteocondritis disecante del capitellum: diagnóstico diferencial y abordaje terapéutico

La enfermedad de Panner, es decir, la osteonecrosis del capitellum humeral, y la osteocondritis disecante del capitellum, forman parte del grupo de lesiones que pueden aparecer en el codo del niño debidas a fuerzas de compresión lateral, como ocurre en los deportes de lanzamiento. Sin embargo, son dos patologías diferentes, con una edad de aparición, unas imágenes radiográficas, un pronóstico y un tratamiento totalmente distintos, por lo que es importante realizar un buen diagnóstico diferencial y un correcto seguimiento clínico y radiográfico de la enfermedad. En este artículo se presenta un caso de enfermedad de Panner en un niño de 7 años, y un caso de osteocondritis disecante del capitellum en un niño de 13 años, que nos permitirán apreciar las diferencias entre ambas enfermedades.Panner's disease, avascular necrosis of the humeral capitellum, and osteochondritis dissecans of the capitellum, belong to the group of injuries which may occur in the elbow of the child due to lateral compression forces, as in sports pitch. However, they are two different pathologies, with different median age of onset, radiographic images, prognosis and treatment, so it is important to conduct a proper differential diagnosis and proper monitoring of clinical and radiographic disease. This article presents a case of Panner's disease in a child of 7 years old, and one case of osteochondritis dissecans of the capitellum in a child of 13 years old, which will enable us to appreciate the differences between both diseases

Luxación autorreducida de codo con fractura osteocondral de olécranon en un niño: dificultad diagnóstica

La fractura osteocondral de la articulación cúbito-troclear es una lesión infrecuente del codo del niño. Se describe el caso de un niño de 2 años y 8 meses de edad que tras precipitarse desde un segundo piso sufre poli-traumatismo y entre las lesiones presenta una fractura osteocondral de la cara articular del olécranon en relación, probablemente, con una luxación posterior de codo reducida de forma espontánea. Se realizó una exéresis del fragmento a través de una artrotomía por abordaje medial, y se comprobó, por un abordaje lateral, la interposición del ligamento anular en la cabeza del radio. Tras 5 años de evolución, el niño se encuentra asintomático y la movilidad del codo es completa. Se revisan además los pocos casos descritos en la literatura. Se insiste en la valoración clínica, el seguimiento y otras pruebas diagnósticas, si fueran necesarias en este tipo de pacientes.Osteochondral fracture of the ulno-humeral joint is an uncommon injury of the child's elbow. This is the case of a boy of 2 years and 8 months old hasty from a second floor. As a result he suffers poly traumatism, and between injuries, he presents an osteochondral fracture of the articular surface of olecranon in connection, probably, with a posterior dislocation of the elbow reduced spontaneously. A simple excision of the fragment through an arthrotomy by medial approach was performed, and an interposition of the annular ligament in the head of the radius was verified by a lateral approach. Five years later, the child is asymptomatic and the mobility of the elbow is complete. The few cases reported in the literature are also reviewed. We emphasize on clinical assessment, monitoring and other diagnostic tests that can be needed in these patients

A longitudinal comparative study of a multicouple group and single-couple psychosocial intervention while experiencing infertility

This is a quasi-experimental, nonequivalent design study investigating the efficacy of multicouple group and single-couple intervention formats aimed at diminishing the psychosocial impact of infertility. The review studies carried out to date that have assessed this subject do not show consistent findings and although increasing the efficacy and efficiency of intervention formats more than justifies their analysis, there are no studies making this particular comparison. Eighty-seven infertile couples who were in assessment for their infertility and/or were close to undergoing some kind of assisted reproductive technology process participated in a psychosocial intervention either under the multicouple group or single-couple subconditions, or acted as controls. The variables of depression, anxiety, and fertility quality of life were used for evaluating psychosocial impact. Comparisons were made: (a) between the intervention condition and controls and (b) between the two subconditions. The results support the efficacy of the intervention both in the dyadic latent growth curve models analysis carried out and in the treatment effect calculation. Although in the comparison between the multicouple and single-couple format, some differences generally favoring the single format one were found, they were not conclusive. Therefore, the results are in line with review studies that did not find the group format to be more effective. Although this study provides valuable information, its limitations mean that further research needs to be carried out. When selecting the intervention format, therapists should also weigh up others aspects, such as the intervention goal, patient's needs and characteristics, reproductive history, and current stage of infertility

La acetabuloplastia de Staheli en el tratamiento de la enfermedad de Legg-Calvé-Perthes en mayores de 6 años. Estudio preliminar

Objetivo: Valorar los resultados funcionales y radiográficos de la acetabuloplastia de Staheli como alternativa terapéutica en el tratamiento quirúrgico de la enfermedad de Legg-Calvé-Perthes de debut tardío.Material y método: Estudio retrospectivo de 7 pacientes con enfermedad de Legg-Calvé-Perthes tratados mediante acetabuloplastia de Staheli con un tiempo de seguimiento medio de tres años y tres meses. Se analizan parámetros clínicos (movilidad prequirúrgica y al final del seguimiento) así como parámetros radiográficos (clasificación de Herring, índice acetábulo-cabeza de Heyman-Herndon y el ángulo centro-borde de Wiberg) previos al tratamiento quirúrgico, tras el tratamiento quirúrgico y al final del seguimiento. Resultados: Tras el análisis estadístico de los índices radiográficos (índice acetábulo-cabeza de Heyman-Herndon así como ángulo de Wiberg) se objetivaron diferencias estadísticamente significativas entre la radiografía prequirúrgica y postquirúrgica, pero no se objetivaron diferencias estadísticamente significativas entre la postquirúrgica y la realizada al final del seguimiento. Por lo tanto, los índices radiográficos mostraron una mejora en sus parámetros que además se mantuvo estable en el tiempo. Ningún paciente presentó complicaciones debidas a la cirugía. La exploración física mostró una mejoría media de 10º en la rotación interna de la cadera. Conclusiones: La técnica de acetabuloplastia según Staheli es una opción quirúrgica que conduce a la mejora de los resultados radiográficos y funcionales con pocas complicaciones debidas al procedimiento.Objective: To evaluate the functional and radiographic results of Staheli's acetabuloplasty as therapeutic option in the surgical treatment of Legg-Calvé-Perthes's disease of late debut. Material and method: we did a retrospective study of seven patients with Legg-Calvé-Perthes's disease treated by means of Staheli's acetabuloplasty with an average follow-up of three years and three months. We analyzed clinical parameters (preoperative and "end of the follow-up" mobility) as well as radiographic parameters (Herring's classification, Heyman-Herndon's index and Wiberg's center-edge angle) before the surgical treatment, after the surgical treatment and at the end of the follow-up. Results: Any patients presented complications due to the surgery. The physical exploration showed an average improvement of 10º in the internal rotation of the hip. After the statistical analysis of the radiographic indexes (Heyman-Herndon's index as well as Wiberg's angle), there were statistically significant differences between the preoperative X-ray and the postoperative one, but there were no statistically significant differences between the postoperative one and the X-ray done at the end of the follow-up. Therefore, the radiographic indexes showed an improvement in these parameters that in addition kept stable in time. Conclusions: The technic of acetabuloplasty according to Staheli is a surgical option that leads to a good radiographic and functional result with few complications due to the procedure

Método de Ponseti en el tratamiento del pie equino-varo-adductus asociado a hemimelia peronea tipo IA

La hemimelia peronea es una deficiencia congénita del peroné asociada con otras anomalías de la extremidad inferior de difícil tratamiento. Puede existir un acortamiento de la extremidad afectada, y deformidades y posiciones anormales del pie. Generalmente se asocia a pie equino-valgo, pero también existen casos de pie equinovaro- adductus, como en el caso del niño presentado en este artículo. Para corregir esta deformidad se utilizó el método de Ponseti, consiguiéndose un pie plantígrado. Aunque los resultados no son tan buenos como en los casos idiopáticos, el método de Ponseti proporciona muchas ventajas, puesto que se consigue al menos una corrección parcial, que permitirá una cirugía posterior más limitada.Fibular hemimelia is a congenital deficiency of the fibula associated with other anomalies of the lower limb of difficult treatment. There may be a shortening of the affected limb, and deformities and abnormal positions of the foot. Usually it is associated with equinovalgus deformity of the foot, but there are also cases of clubfoot, as in the case of the child presented in this report. Ponseti´s method was used to correct this deformity, and plantigrade foot was achieved. Although the results are not as good as in idiopathic cases, Ponseti´s method provides many advantages, as a partial correction is achieved, and this will allow a more limited posterior surgery

Subjective well-being and vulnerability related to problematic Internet use among university students with and without disabilities: A comparative study

This study aims to observe whether people with disabilitiesexperience problematic Internet use (PIU) like that of youngpeople without disabilities; to relate PIU to psychological dis-tress in young disabled people and to determine whether theseproblems are similar to or different from those experienced byyoung people without disabilities. The sample comprised 408university students with disabilities and 1386 university stu-dents without disabilities from several Spanish universities. PIUwas evaluated using theInternet Addiction Test(IAT) and psy-chological distress was evaluated using theClinical Outcomes inRoutine Evaluation‐Outcome Measure(CORE‐OM). The groupof university students with disabilities showed less PIU thanthe nondisabled students, but the worst scores in variablesreferencing psychological discomfort were found among thosestudents with disabilities who also had PIU. Although the re-sults are not completely generalizable, PIU is related to biggerproblems in disabled people for whom it represents a higherrisk than for people without disabilities

Tarsal coalitions as a cause of pain in the foot of children: Therapeutic options

Background and objective: The tarsal coalition can be a cause of mid-hindfoot pain in older children. The objective is to analyze the types of coalition treated in our hospital from 2010 to 2019 as well as the treatment carried out. Material and method: Observational, descriptive and retrospective study of 18 patients with tarsal coalition, 8 women and 10 men, aged 11.9±2.6 years. Epidemiological data, clinical findings and imaging tests, and treatment performed were collected. Results: Twenty-five feet (38.8% bilateral) were reviewed. The main symptom was pain. Sixty-four percent were associated with flat-valgus foot. Fifty-two percent were located in the calcaneal-scaphoid joint, and 40% in the calcaneal-talar joint. Treatment was conservative in 44.4% of cases and surgical in 56% (coalition resection). There was only one case of recurrence. The results were mostly excellent or good (88%) after a mean follow-up period of 4 years. Conclusions: The most frequently diagnosed type of tarsal coalition was that located in the calcaneal-scaphoid joint followed by the calcaneal-talar joint, but they can appear in any joint of the foot. Almost half responded well to conservative treatment with mostly good results, but the rest required surgical treatment due to persistence of the symptoms, the results of which were excellent in all cases except one who suffered a recurrence. In cases of calcaneal-talar coalitions associated with severe hindfoot valgus, correction of this deformity, associated or not with resection of the coalition, is recommended

An integrated biochemical system for nitrate assimilation and nitric oxide detoxification in Bradyrhizobium japonicum

Rhizobia are recognized to establish N(2)-fixing symbiotic interactions with legume plants. Bradyrhizobium japonicum, the symbiont of soybeans, can denitrify and grow under free-living conditions with nitrate (NO(3)(−)) or nitrite (NO(2)(−)) as sole nitrogen source. Unlike related bacteria that assimilate NO(3)(−), genes encoding the assimilatory NO(3)(−) reductase (nasC) and NO(2)(−) reductase (nirA) in B. japonicum are located at distinct chromosomal loci. The nasC gene is located with genes encoding an ABC-type NO(3)(−) transporter, a major facilitator family NO(3)(−)/NO(2)(−) transporter (NarK), flavoprotein (Flp) and single-domain haemoglobin (termed Bjgb). However, nirA clusters with genes for a NO(3)(−)/NO(2)(−)-responsive regulator (NasS-NasT). In the present study, we demonstrate NasC and NirA are both key for NO(3)(−) assimilation and that growth with NO(3)(−), but not NO(2)(−) requires flp, implying Flp may function as electron donor to NasC. In addition, bjgb and flp encode a nitric oxide (NO) detoxification system that functions to mitigate cytotoxic NO formed as a by-product of NO(3)(−) assimilation. Additional experiments reveal NasT is required for NO(3)(−)-responsive expression of the narK-bjgb-flp-nasC transcriptional unit and the nirA gene and that NasS is also involved in the regulatory control of this novel bipartite assimilatory NO(3)(−)/NO(2)(−) reductase pathway

Activity, structural features and in silico digestion of antidiabetic peptides

Funding This research was funded by the grant PID2020-114137RB-I00 funded by MCIN/AEI/10.13039/501100011033Food antidiabetic peptides inhibit the enzymes involved in the regulation of the glycemic index (e.g. a-amylase, a-glucosidase and dipeptidyl peptidase-IV (DPP-IV)). This work reviews the antidiabetic peptide sequences reported in the literature, with activity confirmed by using synthetic peptides, and critically discusses their structural features. Moreover, it provides an overview of the potency of in silico analysis tools to predict the in vitro antidiabetic activity of DPP-IV-inhibitory peptides. In addition, the potential degradation of the most active peptides during digestion was evaluated in silico. Therefore, this work advances our understanding on the structure-activity relationship of antidiabetic peptides and provides new insights on their stability during digestion.MCIN/AEI/10.13039/501100011033: PID2020-114137RB-I0