Neuritis por virus zoster simulando una lesión yatrogénica del nervio ciático

Se describe un caso de fractura-luxación posterior de cadera sin alteraciones neurovasculares asociadas, que a las 2 semanas de la intervención se presentó un cuadro de radiculalgia. Inicialmente se sospechó una lesión neurológica relacionada con el acto quirúrgico con el proceso de cicatrización de la herida. El estudio electromiográfico, las características clínicas y la respuesta al tratamiento con aciclovir permitieron identificar la neuritis del nervio ciático por virus varicela zoster. Ante una radiculopatía postoperatoria no se debe olivar la posibilidad de un origen inflamatorio o infeccioso. El acto quirúrgico puede provocar una reactivación de la infección latente por virus varicela zoster.One case of posterior fracture-dislocation of the hip without neurovascular injury is presented. Radicular pain bean two weeks after surgery. It was initially attributed to surgery, or to the would healing process. Electromyography, clinical appearance and response to the treatment with acyclovir led to the diagnosis of neuritis of the sciatic nerve by varicela-zoster virus. Whenever a postoperative radiculalgia appears, one must consider the possibility of an inflammatory or infectious origin. Surgical manipulation could induce the reactivation of a latent infection by varicela-zoster virus

Fracturas periprotésicas de fémur en pacientes portadores de prótesis total de cadera: Tratamiento mediante doble placa

Una técnica de osteosíntesis, combinación de placa metálica atornillada en cara externa del fémur y placa-cerclaje de Partridge en cara anterior, ha sido aplicada con criterio selectivo en 6 pacientes mayores de 60 años con fracturas periprotésicas tipo III de Johanson y vástago femoral estable. En cuatro, la fractura consolidó en un tiempo medio de 4 meses, y los otros dos se produjo una rotura de la placa metálica, que requirió una nueva intervención. Un hecho relevante fue el hallazgo en estos pacientes de una gran reacción fibrosa alrededor de la placa-cerclaje de Partridge, atribuible al nylon con que está fabricado este implante. Por lo que, aunque la asociación de placas, constituya una aportación en el tratamiento de estas fracturas, no recomendamos la utilización de este tipo de implantes. En nuestra serie 5 de las 6 fracturas correspondían a prótesis con vástago cementado, y el tiempo entre el implante de la prótesis y la fractura fue muy corto, entre 1 y 3 meses, inferior al descrito en la literatura; y en todos los casos la fractura se produjo inmediatamente por debajo del tapón para el cemento. Estas observaciones nos hacen considerar la existencia de una posible relación causal.An osteosynthesis technique, combination o fan ASIF plate on the lateral surface of the femur and one Partridge plate on the anterior, has been used with selective criteria in 6 patients over 60 years old with type III Johanson's periprosthetic femoral fracture and stable prosthesis. In four patients, primary union was achieved at an average time of four months, in the other two the plate were broken and a new surgery was needed. A relevant fact was the finding in these patients of a great fibrous reaction around the Partridge plate, attributable to the nylon with which the implant was manufactured. Therefore, although the plates association, constitute a contribution in the treatment of these fractures, we do not recommend the used of this implant. In our series five of the six fractures were corresponding to cemented prostheses, and the time to fracture after implantation was very short, between 1 and 3 months, inferior to the literature have described; and in all cases the fracture was produced immediately below of the cement plug. These observations make us to consider the existence of a possible casual relationship

Luxación traumática bilateral de cadera

Se presenta un caso de luxación bilateral simultánea de caderas, una anterior y otra posterior, asociada a fractura del acetábulo derecho, fractura de la diáfisis femoral derecha y una subluxación del raquis cervical.A case of simultaneous bilateral anterior and posterior dislocation of the hip joints associated with a fracture of the right acetabulum and right femoral shaft, and a subluxation of the cervical spine, is reported

Fracturas diafisarias de húmero : enclavijamiento intramedular con agujas de Hackethal por vía epicondílea lateral

Presentamos un estudio de 58 pacientes con fracturas diafisarias de húmero tratados mediante enclavijamiento intramedular con agujas de Hackethal por la vía epicondílea lateral. Se analizan las indicaciones quirúrgicas y la técnica empleada y se valoran los resultados finales tanto clínica como radiológicamente, obteniendo buenos resultados en el 85% de los casos y malos en el 15%. La causa principal de estos malos resultados fue la aparición de pseudoartrosis, relacionándose ésta con diástasis del foco de fractura después de la reducción y la existencia de fuerzas distractoras y rotacionales en los métodos de inmovilización postquirúrgica.This study was based on 58 patients with diaphyseal fractures of the humerus, treated by Hackethal fascicular intramedullary pinning inserted at the lateral humeral epicondyle. We analysed the indications for the operation using the modified Hackethal technique. We evaluated the final clinical and radiological results, obtaining 85% good results and 15% poor results. The main cause for these poor results was the appearance of no-union due to diastasis of the fracture focus after reduction and the presence of traction and rotational forces in the postoperative inmobilization methods

El presente de la cirugía artroscópica. ¿Dónde está el límite?

La cirugía artroscópica ha supuesto un importante avance en las técnicas terapéuticas y diagnósti - cas dentro del campo de la cirugía ortopédica, convirtiéndose en estas dos últimas décadas en uno de los grandes pilares de la cirugía mínimamente invasiva de grandes y pequeñas articulaciones, permitiendo la realización de técnicas quirúrgicas que hace unos años hubiese sido impensable. El objetivo de este trabajo es analizar las indicaciones y técnicas quirúrgicas artroscópicas que actualmente realizamos en nuestro equipo basándonos en niveles de evidencia científica y una valoración del futuro de la cirugía artroscópica.Arthroscopic surgery has involved a great advance in diagnostic and therapeutic techniques within orthopedic surgery field. For twenty years now, it has become as one of the great pillars of minimally invasive surgery of large and small joints, allowing the realization of surgical techniques that a few years ago would be unthinkable. Aim of this study is to analyze currently indications and arthroscopic surgical techniques performed in our work team based on levels of scientific evidence and the assessment of arthroscopic surgery in the future

Sowing date, transplanting, plant density and nitrogen fertilization affect indigo production from Isatis species in a Mediterranean region of Spain

The increasing interest in natural products from a renewable source has encouraged growers to reintroduce indigo-producing crops into the European agriculture. We studied agronomic conditions (sowing date, plant density, nitrogen fertilization, irrigation rate, seedling transplanting) influencing production of the blue pigment indigo, from Isatis tinctoria and I. indigotica crops in a Mediterranean region of Spain (Valencia). I. tinctoria was more suitable for cultivation in our climate conditions than I. indigotica. Indigo yield from Spanish I. tinctoria trials was greater than in Northern and Central Europe. Furthermore, indigo production was maintained when water and nitrogen supplies were significantly restricted, showing that I. tinctoria is not a high-demanding crop. © 2005 Elsevier B.V. All rights reserved

Peutz-Jeghers syndrome and duodeno-jejunal adenocarcinoma-therapeutic implications

The Peutz-Jeghers syndrome (PJS) is an autosomal dominant hamartomatous poliposis describred in 1921. Hemminki in 1997 described the presence of LKB-1 mutation tumor-suppressor gen.The patients with PJS develop a higher cumulative incidence of gastrointestinal, pancreas and extraintestinal tumors, being occasion of a renew interest on hamartomatous polyposis syndromes regarding the clinical care, cancer surveillance treatment and long term follow-up.We report the case of a 38 years old male, diagnosed of PJS who developed a multiple adenocarcinoma in duodenum and yeyunum. Surgically treated and with a long-term free disease survival of 11 years represents the sixth case reported in the spanish literature of PJS associated with a gastrointestinal tumor.A critical review, molecular alterations and the established criteria of tumor screening and surveillance are reviewed

Impact of perineural invasion on the outcome of patients with synchronous colorectal liver metastases treated with neoadjuvant chemotherapy and surgery

Purpose: To analyze the prognostic value of variables of the primary tumor in patients with synchronous liver metastases in colorectal cancer (CLRMs) treated with neoadjuvant chemotherapy and surgery. Methods/patients: From a prospective database, we retrospectively identified all patients with synchronous CLRMs who were treated with neoadjuvant chemotherapy and liver resection. Using univariate and multivariate analyses, we identified the variables associated with tumor recurrence. Overall survival and disease-free survival were calculated using the Kaplan-Meier method with differences determined by the Cox multiple hazards model. Results were compared using the log-rank test. Results: Ninety-eight patients with synchronous CLRMs were identified. With a median follow-up of 39.8 months, overall survival and disease-free survival at 5 and 10 years were 53%, 41.7%, 29% and 29%, respectively. Univariate analysis identified three variables associated with tumor recurrence: location in the colon (p = 0.025), lymphovascular invasion (p = 0.011) and perineural invasion (p = 0.005). Multivariate analysis identified two variables associated with worse overall survival: perineural invasion (HR 2.36, 95% CI 1.162-4.818, p = 0.018) and performing frontline colectomy (HR 3.286, 95% CI 1.256-8.597, p = 0.015). Perineural invasion remained as the only variable associated with lower disease-free survival (HR 1.867, 95% CI 1.013-3.441, p = 0.045). Overall survival at 5 and 10 years in patients with and without perineural invasion was 68.2%, 54.4% and 29.9% and 21.3%, respectively (HR 5.920, 95% CI 2.241-15.630, p < 0.001). Conclusions: Perineural invasion in the primary tumor is the variable with most impact on survival in patients with synchronous CLRMs treated with neoadjuvant chemotherapy and surgery

Evaluation of Textural and Sensory Properties on Typical Spanish Small Cakes Designed Using Alternative Flours

[EN] The objective of this study was to evaluate the effect of wheat flour substitution with toasted corn, quinoa, and sorghum flours on the overall perception and texture of typical Spanish small cakes named madeleine. In order to evaluate these characteristics, a texture profile analysis (TPA) and a sensory analysis were carried out. TPA showed that the replacement of wheat flour by sorghum flour did not affect significantly texture parameters of cakes. Hedonic sensory tests were also conducted revealing that the cake prepared with sorghum flour was highly appreciated by the consumers as it got scores similar to traditional cakes made with wheat flour.Casas Moreno, MDM.; Barreto Palacios, VJ.; González Carrascosa, R.; Iborra Bernad, MDC.; Andrés Bello, MD.; Martínez Monzó, J.; García-Segovia, P. (2015). Evaluation of Textural and Sensory Properties on Typical Spanish Small Cakes Designed Using Alternative Flours. Journal of Culinary Science and Technology. 13(1):19-28. doi:10.1080/15428052.2014.952475S1928131Baldwin, R. R., Baldry, R. P., & Johansen, R. G. (1972). Fat systems for bakery products. Journal of the American Oil Chemists’ Society, 49(8), 473-477. doi:10.1007/bf02582482Beleia, A., Miller, R. A., & Hoseney, R. C. (1996). Starch Gelatinization in Sugar Solutions. Starch - Starke, 48(7-8), 259-262. doi:10.1002/star.19960480705Brannan, G. L., Setser, C. S., Kemp, K. E., Seib, P. A., & Roozeboom, K. (2001). Sensory Characteristics of Grain Sorghum Hybrids with Potential for Use in Human Food. Cereal Chemistry Journal, 78(6), 693-700. doi:10.1094/cchem.2001.78.6.693Cauvain, S. P., & Young, L. S. (Eds.). (2006). Baked Products. doi:10.1002/9780470995907Chieh, C. (s. f.). Water. Bakery Products, 211-232. doi:10.1002/9780470277553.ch11Conforti, F. D. (s. f.). Cake Manufacture. Bakery Products, 393-410. doi:10.1002/9780470277553.ch22Ghotra, B. S., Dyal, S. D., & Narine, S. S. (2002). Lipid shortenings: a review. Food Research International, 35(10), 1015-1048. doi:10.1016/s0963-9969(02)00163-1Kiosseoglou, V., & Paraskevopoulou, A. (s. f.). Eggs. Bakery Products, 161-172. doi:10.1002/9780470277553.ch8Lai, H.-M., & Lin, T.-C. (s. f.). Bakery Products: Science and Technology. Bakery Products, 3-68. doi:10.1002/9780470277553.ch1Lau, M. ., Tang, J., & Paulson, A. . (2000). Texture profile and turbidity of gellan/gelatin mixed gels. Food Research International, 33(8), 665-671. doi:10.1016/s0963-9969(00)00111-3LINDLEY, M. G. (1987). Sucrose in baked products. Nutrition Bulletin, 12(1), 41-45. doi:10.1111/j.1467-3010.1987.tb00011.xMastromatteo, M., Chillo, S., Iannetti, M., Civica, V., & Del Nobile, M. A. (2011). Formulation optimisation of gluten-free functional spaghetti based on quinoa, maize and soy flours. International Journal of Food Science & Technology, 46(6), 1201-1208. doi:10.1111/j.1365-2621.2011.02613.xOreopoulou, V. (s. f.). Fat Replacers. Bakery Products, 193-210. doi:10.1002/9780470277553.ch10Peressini, D., Pin, M., & Sensidoni, A. (2011). Rheology and breadmaking performance of rice-buckwheat batters supplemented with hydrocolloids. Food Hydrocolloids, 25(3), 340-349. doi:10.1016/j.foodhyd.2010.06.012Sanz, T., Salvador, A., Baixauli, R., & Fiszman, S. M. (2009). Evaluation of four types of resistant starch in muffins. II. Effects in texture, colour and consumer response. European Food Research and Technology, 229(2), 197-204. doi:10.1007/s00217-009-1040-1Taylor, J. R. N., Schober, T. J., & Bean, S. R. (2006). Novel food and non-food uses for sorghum and millets. Journal of Cereal Science, 44(3), 252-271. doi:10.1016/j.jcs.2006.06.009Wilderjans, E., Luyts, A., Brijs, K., & Delcour, J. A. (2013). Ingredient functionality in batter type cake making. Trends in Food Science & Technology, 30(1), 6-15. doi:10.1016/j.tifs.2013.01.001Wilderjans, E., Pareyt, B., Goesaert, H., Brijs, K., & Delcour, J. A. (2008). The role of gluten in a pound cake system: A model approach based on gluten–starch blends. Food Chemistry, 110(4), 909-915. doi:10.1016/j.foodchem.2008.02.079Wilson, N. L. W. (2011). How the Cookie Crumbles: A Case Study of Gluten-Free Cookies and Random Utility. American Journal of Agricultural Economics, 94(2), 576-582. doi:10.1093/ajae/aar081Zhu, J.-H., Yang, X.-Q., Ahmad, I., Li, L., Wang, X.-Y., & Liu, C. (2008). Rheological properties of κ-carrageenan and soybean glycinin mixed gels. Food Research International, 41(3), 219-228. doi:10.1016/j.foodres.2007.11.00

T cells with dysfunctional mitochondria induce multimorbidity and premature senescence

The effect of immunometabolism on age-associated diseases remains uncertain. In this work, we show that T cells with dysfunctional mitochondria owing to mitochondrial transcription factor A (TFAM) deficiency act as accelerators of senescence. In mice, these cells instigate multiple aging-related features, including metabolic, cognitive, physical, and cardiovascular alterations, which together result in premature death. T cell metabolic failure induces the accumulation of circulating cytokines, which resembles the chronic inflammation that is characteristic of aging (“inflammaging”). This cytokine storm itself acts as a systemic inducer of senescence. Blocking tumor necrosis factor-a signaling or preventing senescence with nicotinamide adenine dinucleotide precursors partially rescues premature aging in mice with Tfam-deficient T cells. Thus, T cells can regulate organismal fitness and life span, which highlights the importance of tight immunometabolic control in both aging and the onset of age-associated diseases.This study was supported by the Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI16/02188 and PI19/00855; and PI16/02110 to B.I.), the European Regional Development Fund (ERDF), and the European Commission through H2020-EU.1.1 and European Research Council grant ERC-2016-StG 715322-EndoMitTalk. This work was partially supported by Comunidad de Madrid (S2017/BMD-3867 RENIM-CM). M.M. is supported by the Miguel Servet Program (CPII 19/00014). G.S.-H. is supported by FPI-UAM, J.O. (FJCI-2017-33855) and E.G.-R. (IJC2018-036850) by Juan de la Cierva, and E.C. by Atracción de Talento Investigador 2017-T2/BMD-5766 (Comunidad de Madrid and UAM). B.I. was supported by ERC research grant ERC-2018-CoG 819775-MATRIX