Tumores óseos del pie

El manejo de los tumores óseos es difícil, debido a sus diferentes formas y comportamientos y a su baja incidencia. El pie no escapa a este axioma, ya que los tumores en esta región anatómica son particularmente infrecuentes y pueden mostrar un comportamiento clínico y radiológico diferente del que evidencian en otras regiones del esqueleto. Los autores revisan, en primer lugar, los aspectos generales de los tumores óseos del pie, considerando su epidemiología, el proceder diagnóstico y pronóstico y las opciones terapéuticas, para luego pasar a examinar las particularidades regionales e histológicas de estas neoplasias en relación con su tratamiento.The management of bone tumours is difficult, both because of their varying forms and behaviours and because of their low incidence. The foot is no exception to this axiom, as tumours in this particular anatomic region are particularly infrequent and may exhibit a clinical and radiological behaviour completely at variance to that in other skeletal regions. The authors first review the general aspects of the bobe tumours of the foot, considering their epidemiology, the diagnostic procedure and prognosis and the therapeutic options, and then examine the regional and histologic peculiaritiesof these neoplasms as related to their therapeutic management

Deformación plástica del antebrazo: revisión y caso clínico

La deformidad plástica de un hueso es una rara entidad, que en ocasiones pasa desapercibida. Se trata de una lesión típica del niño, con un hueso más elástico que los adultos. La mayoría de las deformidades plásticas del antebrazo se producen por caídas con el brazo en extensión, causando deformidad, dolor y una limitación de la pronosupinación. Para reducir la curvatura del hueso se precisan fuerzas contrarias a las que produjeron la lesión, mantenidas en el tiempo. En niños menores de 4 años, con enorme capacidad de remodelación, sólo grandes deformidades >20º deberían ser reducidas. En los mayores de 10 años, con escaso potencial remodelador, deben manipularse aquellas angulaciones >10-15º. La mayor complicación derivada de una mala reducción es la limitación de la pronosupinación, que en la mayoría de las ocasiones no altera la funcionalidad de la extremidad.Plastic bowing of a bone is a rare entity that some- times goes unnoticed. It’s a typical injury in children, who have more elastic bones than adults. Most of the plastic bowing of the forearm take place by falls with an outstretched arm, causing deformities, pain and a limitation of pronation and supination. In order to reduce the curvature of the bone, opposing forces to those that produced the injury are needed, maintained for a long time. In children younger than 4 years, with an enormous remodelling capacity, only great deformi- ties >20º should be reduced. For those older than 10 years, with little remodelling capacity, angulations >10-15º must be manipulated. The greatest complication derived from a bad reduction is the limitation of the pronation and supination, which in most cases does not modify the functionality of the extremity

Incidencia de tuberculosis osteoarticular en el área sanitaria del Hospital de León. 1997-2001

Introducción y objetivos: Nos proponemos en este trabajo estudiar la incidencia de tuberculosis en su forma osteoarticular en el área sanitaria del Hospital de León durante los años 1997 a 2001, ambos inclusive. Material y método: Dieciséis casos de tuberculosis osteoarticular confirmados por cultivo microbiológico y/o análisis anatomopatológico fueron incluidos. De ellos, cinco afectaron a columna vertebral, cuatro a rodilla y el resto a otras localizaciones más inusuales. Resultados: De las cinco columnas vertebrales afectadas, tres requirieron tratamiento quirúrgico para descomprimir y estabilizar. En una rodilla se realizó sinovectomía abierta y en otra por artroscopia. Se drenaron abscesos fríos en diferentes localizaciones. Todos los casos recibieron tratamiento médico. Se reflejan los diferentes resultados, desde la restitución ad integrum hasta la anquilosis. Discusión y conclusiones: La incidencia de tuberculosis osteoarticular en nuestra área sanitaria en el periodo 1997-2001 fue del 2% al 4% de todos los cascos de tuberculosis. Hubo una alta incidencia de localizaciones inusuales (muñeca, codo, sacroilíaca).Introduction: Current issue is to study the incidence of osteoarticular tuberculosis, within the sanitary area of the Hospital of Leon. Material and Method: Sixteen cases of osteoarticular tuberculosis confirmed by culture and pathological analysis were included. Five of them involved the raquis and knee. Another cases in unusual local sites. Results: Three of five raquis were managed by decompression and stabilization. One knee was treated by open synovectomy and another one by arthroscopy synovectomy. Cold abscesses were drained in different sites. All cases were treated with drugs. Different results are showed since restitutio ad integrum to anquilosis. Discussion: Osteoarticular tuberculosis incidence in our sanitary area between 1997 to 2001 was 2% to 4%. There was a high incidence for unusual localizations (wrist, elbow and sacroiliaca joints)

Osteoblastoma del sacro. A propósito de dos casos clínicos.

El osteoblastoma es un tumor óseo primitivo de frecuente localización en los elementos posteriores de la columna vertebral, aunque raro en el sacro. Se presentan dos osteoblastomas del sacro, con un seguimiento medio de ocho años, tratados mediante resección intralesional que, sin morbilidad, deparó un excelente resultado. El curetaje sería un procedimiento de resección válido en osteoblastomas sacros no agresivos, si bien obliga a un seguimiento prolongado del paciente para vigilar la posibilidad de recidivas locales.Osteoblastoma is a primary neoplasm of bone fre- quently located in the posterior elements of the spine, alt- hough rarely affecting the sacrum. Two cases in this location are reported, with a mean follow-up of eight years, treated with an intralesional resection that, without any morbidity, has provided an excellent result. Curettage should be a valid re- section procedure for nonagressive osteoblastomas of the sacrum, although it makes necessary a long follow-up in or- der to watch over the possibility of a local recurrence

Nuestra experiencia con el minivástago femoral de disco a compresión y el cotilo Hedrocel (tantalio)

Durante los años 2000 a 2002 intervinimos 18 pacientes de artrosis o necrosis sintomática de cadera, con minivástago de fijación metafisiaria de Disco a Compresión (Sulzer) y cotilo monobloque de tantalio Hedrocel (Zimmer), con par de fricción alúmina-polietileno. La edad media de los pacientes fue de 46,7 años (rango 35-61), y el seguimiento medio de 42 meses. La valoración clínica se realizó con la escala de Merle D'Augbigné Postel obteniendo 38,8% de resultados excelentes, 22,2 de resultados buenos, 11,1% regulares y 27,4% malos (5 casos). Cuatro casos necesitaron reintervención por aflojamiento del tallo femoral. No hubo ningún fracaso del cotilo. La sustitución protésica de la cadera en los pacientes jóvenes requieren soluciones con la menor resección del hueso, pero este modelo de tallo femoral, no da un resultado satisfactorio, por lo que lo hemos abandonado.Between 2000 2002 we treated 18 patients with symptomatic osteoarthritis or osteonechrosis of hip, with uncemneted Thrust Plate Protesis (Sulzer) and tantalium acetabular componente Hedrocel (Zimmer), with ceramic-pol- yethylene pair. The average age of the patients was 46,7 years (range:35-61), and the average follow-up of 42 months. Clinical evaluation was done with Merle D'Augbigné Postel's scale obtaining 38,8 % of excellent results, 22,2 % of good results, 11,1 % fair and 27,4 % poor (5 cases). Four cases needed re-operation for loosening of the femoral stem. There was no failure of the acetabular component. The hip artrhroplasty in the young patients need solutions with the minor resection of bone, but this model of femoral stem does not give a satisfactory result, therefore we have abandoned it

Waist circumference percentiles for Hispanic-American children and comparison with other international references

Introduction Waist circumference (WC) constitutes an indirect measurement of central obesity in children and adolescents. Objective To provide percentiles of WC for Hispanic-American children and adolescents, and compare them with other international references. Materials and methods The sample comprised 13 289 healthy children between 6 and 18 years coming from public schools of middle and low socioeconomic levels in different parts of Argentina, Cuba, Spain, Mexico, and Venezuela. The LMS method to calculate WC percentiles was applied. Sex and age differences were assessed using Student'sttest and ANOVA (SPSS v.21.0). Comparisons were established with references from the United States, Colombia, India, China, Australia, Kuwait, Germany, Tunisia, Greece, and Portugal. Results WC increases with age in both sexes. Boys show higher WC in P3, P50, and P97. Comparison of 50th and 90th percentiles among populations from diverse sociocultural and geographical contexts shows high variability, not all justified by the measurement method. Discussion and conclusions Specific WC percentiles for sex and age, and P90 cut-off points are provided; these values are potentially useful to assess central obesity in Hispanic-American adolescent children

Photogrammetric measurement of 3D freeform millimetre-sized objects with micro features: an experimental validation of the close-range camera calibration model for narrow angles of view

The measurement of millimetre and micro-scale features is performed by high-cost systems based on technologies with narrow working ranges to accurately control the position of the sensors. Photogrammetry would lower the costs of 3D inspection of micro-features and would be applicable to the inspection of non-removable micro parts of large objects too. Unfortunately, the behaviour of photogrammetry is not known when photogrammetry is applied to micro-features. In this paper, the authors address these issues towards the application of digital closerange photogrammetry (DCRP) to the micro-scale, taking into account that in literature there are research papers stating that an angle of view (AOV) around 10° is the lower limit to the application of the traditional pinhole close-range calibration model (CRCM), which is the basis of DCRP. At first a general calibration procedure is introduced, with the aid of an open-source software library, to calibrate narrow AOV cameras with the CRCM. Subsequently the procedure is validated using a reflex camera with a 60mm macro lens, equipped with extension tubes (20 and 32mm) achieving magnification of up to 2 times approximately, to verify literature findings with experimental photogrammetric 3D measurements of millimetresized objects with micro-features. The limitation experienced by the laser printing technology, used to produce the bi-dimensional pattern on common paper, has been overcome using an accurate pattern manufactured with a photolithographic process. The results of the experimental activity prove that the CRCM is valid for AOVs down to 3.4° and that DCRP results are comparable with the results of existing and more expensive commercial techniques.Percoco, G.; Sánchez Salmerón, AJ. (2015). Photogrammetric measurement of 3D freeform millimetre-sized objects with micro features: an experimental validation of the close-range camera calibration model for narrow angles of view. Measurement Science and Technology. 26(9):1-9. doi:10.1088/0957-0233/26/9/095203S19269Mitchell, H. L., Kniest, H. T., & Won‐Jin, O. (1999). Digital Photogrammetry and Microscope Photographs. The Photogrammetric Record, 16(94), 695-704. doi:10.1111/0031-868x.00148Chen, Z., Liao, H., & Zhang, X. (2014). Telecentric stereo micro-vision system: Calibration method and experiments. Optics and Lasers in Engineering, 57, 82-92. doi:10.1016/j.optlaseng.2014.01.021Stamatopoulos, C., & Fraser, C. S. (2011). Calibration of long focal length cameras in close range photogrammetry. The Photogrammetric Record, 26(135), 339-360. doi:10.1111/j.1477-9730.2011.00648.xYang, X., & Fang, S. (2014). Effect of field of view on the accuracy of camera calibration. Optik, 125(2), 844-849. doi:10.1016/j.ijleo.2013.07.089Strobl, K. H., Sepp, W., & Hirzinger, G. (2009). On the issue of camera calibration with narrow angular field of view. 2009 IEEE/RSJ International Conference on Intelligent Robots and Systems. doi:10.1109/iros.2009.5354776Ricolfe-Viala, C., & Sanchez-Salmeron, A.-J. (2010). Lens distortion models evaluation. Applied Optics, 49(30), 5914. doi:10.1364/ao.49.005914Ricolfe-Viala, C., Sanchez-Salmeron, A.-J., & Valera, A. (2013). Efficient Lens Distortion Correction for Decoupling in Calibration of Wide Angle Lens Cameras. IEEE Sensors Journal, 13(2), 854-863. doi:10.1109/jsen.2012.2229704Zhang, Z. (2000). A flexible new technique for camera calibration. IEEE Transactions on Pattern Analysis and Machine Intelligence, 22(11), 1330-1334. doi:10.1109/34.888718Percoco, G., Lavecchia, F., & Salmerón, A. J. S. (2015). Preliminary Study on the 3D Digitization of Millimeter Scale Products by Means of Photogrammetry. Procedia CIRP, 33, 257-262. doi:10.1016/j.procir.2015.06.046Ricolfe-Viala, C., & Sanchez-Salmeron, A.-J. (2011). Camera calibration under optimal conditions. Optics Express, 19(11), 10769. doi:10.1364/oe.19.010769Guidi, G. (2013). Metrological characterization of 3D imaging devices. Videometrics, Range Imaging, and Applications XII; and Automated Visual Inspection. doi:10.1117/12.2021037Herráez, J., Martínez-Llario, J., Coll, E., Rodríguez, J., & Martin, M. T. (2013). Design and calibration of a 3D modeling system by videogrammetry. Measurement Science and Technology, 24(3), 035001. doi:10.1088/0957-0233/24/3/03500

Detection of kinase domain mutations in BCR::ABL1 leukemia by ultra-deep sequencing of genomic DNA

The screening of the BCR::ABL1 kinase domain (KD) mutation has become a routine analysis in case of warning/failure for chronic myeloid leukemia (CML) and B-cell precursor acute lymphoblastic leukemia (ALL) Philadelphia (Ph)-positive patients. In this study, we present a novel DNA-based next-generation sequencing (NGS) methodology for KD ABL1 mutation detection and monitoring with a 1.0E−4 sensitivity. This approach was validated with a well-stablished RNA-based nested NGS method. The correlation of both techniques for the quantification of ABL1 mutations was high (Pearson r = 0.858, p < 0.001), offering DNA-DeepNGS a sensitivity of 92% and specificity of 82%. The clinical impact was studied in a cohort of 129 patients (n = 67 for CML and n = 62 for B-ALL patients). A total of 162 samples (n = 86 CML and n = 76 B-ALL) were studied. Of them, 27 out of 86 harbored mutations (6 in warning and 21 in failure) for CML, and 13 out of 76 (2 diagnostic and 11 relapse samples) did in B-ALL patients. In addition, in four cases were detected mutation despite BCR::ABL1 < 1%. In conclusion, we were able to detect KD ABL1 mutations with a 1.0E−4 sensitivity by NGS using DNA as starting material even in patients with low levels of disease.Tis project was funded in part by CRIS CANCER FOUNDATION

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality