Fístula arteriovenosa postraumática: tratamiento endovascular. Revisión de la literatura y presentación de un caso clínico

ResumenLas fístulas arteriovenosas en la cabeza y el cuello son entidades poco frecuentes. La mayoría es secundaria a heridas penetrantes por arma blanca. Se describe el tratamiento exitoso mediante cirugía endovascular de una fístula postraumática tras una herida penetrante entre la arteria maxilar interna izquierda y la vena yugular externa. A través de este caso clínico y la revisión de la literatura se ilustran las causas, manifestaciones, estudio radiológico y tratamiento de una fístula postraumática entre la arteria maxilar interna y la vena yugular externa. A través de este caso clínico se demuestra la utilidad de los procedimientos endovasculares en el tratamiento de estas complicaciones.AbstractTraumatic arteriovenous fistulas of the head and neck region are uncommon. The majority are due to penetration of blunt injury. We describe a successful endovascular treatment of a posttraumatic fistula between the left maxillary artery and the external jugular vein due to a penetration injury. This case and a review of the literature illustrate the causes, manifestations, image studies and treatment for a posttraumatic fistula between the maxillary artery and the external jugular vein. This case demonstrate the utility of endovascular treatment of head and neck injuries complications

Hemorragia subaracnoidea de la convexidad cerebral causada por telangiectasia hereditaria hemorrágica

Sr. Editor: La hemorragia subaracnoidea de la convexidad cerebral (HSAc) se caracteriza por colecciones hemáticas en uno o varios surcos adyacentes, sin sangrado en el parénquima cerebral, cisura interhemisférica, cisternas basales o ventrículos1, 2, 3. Se ha asociado a múltiples etiologías como traumatismos, enfermedad aneurismática, oclusión de venas corticales, síndrome de leucoencefalopatía posterior reversible, síndrome de vasoconstricción cerebral reversible (SVCR), angiopatía amiloide cerebral (AAC), vasculitis primaria del sistema nervioso central, coagulopatías, consumo de cocaína o etanol, abscesos cerebrales, cavernomas o malformaciones arteriovenosas1, 2, 3, 4. A continuación presentamos un caso de HSAc como manifestación de telangiectasia hereditaria hemorrágica (THH). Varón de 47 años con antecedente de epistaxis repetidas desde la infancia e historia familiar de epistaxis en la madre, tío y abuelo maternos, quienes requirieron cauterización de telangiectasias en la cavidad nasal. Refería una cefalea opresiva frontal izquierda, de intensidad y frecuencia crecientes (hasta hacerse diaria) en los últimos 5 meses. Esta aumentaba con la maniobra de Valsalva, asociando vértigo y vómitos, ..

A Single Amino Acid Substitution, Found in Mammals with Low Susceptibility to Prion Diseases, Delays Propagation of Two Prion Strains in Highly Susceptible Transgenic Mouse Models

Specific variations in the amino acid sequence of prion protein (PrP) are key determinants of susceptibility to prion diseases. We previously showed that an amino acid substitution specific to canids confers resistance to prion diseases when expressed in mice and demonstrated its dominant-negative protective effect against a variety of infectious prion strains of different origins and characteristics. Here, we show that expression of this single amino acid change significantly increases survival time in transgenic mice expressing bank vole cellular prion protein (PrP C ), which is inherently prone to misfolding, following inoculation with two distinct prion strains (the CWD-vole strain and an atypical strain of spontaneous origin). This amino acid substitution hinders the propagation of both prion strains, even when expressed in the context of a PrP C uniquely susceptible to a wide range of prion isolates. Non-inoculated mice expressing this substitution experience spontaneous prion formation, but showing an increase in survival time comparable to that observed in mutant mice inoculated with the atypical strain. Our results underscore the importance of this PrP variant in the search for molecules with therapeutic potential against prion diseases

Lower Rydberg series of methane : A combined coupled cluster linear response and molecular quantum defect orbital calculation

Vertical excitation energies as well as related absolute photoabsorption oscillator strength data are very scarce in the literature for methane. In this study, we have characterized the three existing series of low-lying Rydberg states of CH4 by computing coupled cluster linear response (CCLR) vertical excitation energies together with oscillator strengths in the molecular-adapted quantum defect orbital formalism from a distorted Cs geometry selected on the basis of outer valence green function calculations. The present work provides a wide range of data of excitation energies and absolute oscillator strengths which correspond to the Rydberg series converging to the three lower ionization potential values of the distorted methane molecule, in energy regions for which experimentally measured data appear to be [email protected] [email protected] [email protected]

Optimization by thermal cycling

Thermal cycling is an heuristic optimization algorithm which consists of cyclically heating and quenching by Metropolis and local search procedures, respectively, where the amplitude slowly decreases. In recent years, it has been successfully applied to two combinatorial optimization tasks, the traveling salesman problem and the search for low-energy states of the Coulomb glass. In these cases, the algorithm is far more efficient than usual simulated annealing. In its original form the algorithm was designed only for the case of discrete variables. Its basic ideas are applicable also to a problem with continuous variables, the search for low-energy states of Lennard-Jones clusters.Comment: Submitted to Proceedings of the Workshop "Complexity, Metastability and Nonextensivity", held in Erice 20-26 July 2004. Latex, 7 pages, 3 figure

Agreement between a simple dyspnea-guided treatment algorithm for stable COPD and the GOLD guidelines: A pilot study

Introduction: Guidelines recommendations for the treatment of COPD are poorly followed. This could be related to the complexity of classification and treatment algorithms. The purpose of this study was to validate a simpler dyspnea-based treatment algorithm for inhaled pharmacotherapy in stable COPD, comparing its concordance with the current Global Initiative for Obstructive Lung Disease (GOLD) guideline. Methods: We enrolled patients who had been diagnosed with COPD in three primary care facilities and two tertiary hospitals in Spain. We determined anthropometric data, forced expiratory volume in the 1st second (percent), exacerbations, and dyspnea based on the modified Medical Research Council scale. We evaluated the new algorithm based on dyspnea and exacerbations and calculated the concordance with the current GOLD recommendations. Results: We enrolled 100 patients in primary care and 150 attending specialized care in a respiratory clinic. There were differences in the sample distribution between cohorts with 41% vs 26% in grade A, 16% vs 12% in grade B, 16% vs 22% in grade C, and 27% vs 40% in grade D for primary and respiratory care, respectively (P=0.005). The coincidence of the algorithm with the GOLD recommendations in primary care was 93% and 91.8% in the respiratory care cohort. Conclusion: A simple dyspnea-based treatment algorithm for inhaled pharmacotherapy of COPD could be useful in the management of COPD patients and concurs very well with the recommended schema suggested by the GOLD initiative

Synergistic DNA-damaging effect in multiple myeloma with the combination of zalypsis, bor tezomib and dexamethasone

Despite new advances in multiple myeloma treatment and the consequent improvement in overall survival, most patients relapse or become refractory to treatment. This suggests that new molecules and combinations that may further inhibit important survival pathways for these tumor cells are needed. In this context, zalypsis is a novel compound, derived from marine organisms, with a powerful preclinical anti-myeloma effect based on the sensitivity of malignant plasma cells to DNA-damage induction; and it has already been tested in a phase I/II clinical trial in multiple myeloma. We hypothesized that the addition of this compound to the combination of bortezomib plus dexamethasone may improve efficacy with acceptable toxicity. The triple combination demonstrated strong synergy and higher efficacy compared with double combinations; not only in vitro, but also ex vivo and, especially, in in vivo experiments. The triple combination triggers cell death, mainly through a synergistic induction of DNA damage and a decrease in the nuclear localization of nuclear factor kappa B. Our findings support the clinical evaluation of this combination for relapsed and refractory myeloma patients.This work was in part funded by the Spanish ISCIII-FIS (PI 15/0067 and PI15/02156) and FEDER, the Spanish RTICC (RD12/0036/0058), "Asociación Española Contra el Cancer" (AECC, GCB120981SAN), the regional Council from “Castilla y León” (GRS 1175/A/15 and FIC335U14) and a research grant from Pharmamar SAU. MMS were also supported by the Network of Centers for Regenerative Medicine and Cellular Therapy from Castilla y León, Spain. A-A López-Iglesias was supported by a grant from the Spanish Society of Hematology and Hemotherapy.Peer Reviewe

Motivos de la práctica del pádel en relación a la edad, el nivel de juego y el género

The aim of this study was to determine the motivations that may explain the actual increment in padel practice through different socio-demographic parameters such as sex, age or category. A total of 77 participants (43male and 34female), completed a questionnaire addressing sociodemographic information and the "Measurement Scale Motives for Physical Activity-Revised (MPAM-R)". The results point outed enjoyment (6.07) as the most valued reason for practice. Other appreciated reasons were competition (5.43), fitness / health (5.49) and sociability (5.07), being appearance the least scored (3.97). Significant differences were observed between categories (p<0.05). Current data provide useful information to sports centres managers in designing action plans to improve the quality of services offered, as well as supporting the teaching and learning process in padel.El objetivo de este estudio fue determinar los motivos que han provocado el actual crecimiento en la práctica del pádel en diferentes parámetros sociodemográficos como el género, la edad, el tiempo de práctica y la categoría de juego. Un total de77 participantes (43 hombres y 34 mujeres) respondió a las preguntas de un cuestionario sociodemográfico y de la “Escala de Medida de los Motivos para la Actividad Física-Revisada (MPAM-R)”. Los resultados muestran que el motivo más valorado fue el disfrute (6.07) como causa principal de la práctica del pádel. Otros motivos también valorados han sido la competencia (5.43), el fitness/salud (5.49) y la sociabilidad (5.07), mientras que el menos valorado fue la apariencia (3.97). Se encontraron diferencias significativas en los motivos de práctica en función de la categoría de juego (p<0.05). Estos datos ofrecen información muy útil a la hora de diseñar planes de actuación que aumenten la calidad de servicios ofrecidos en los centros deportivos, así como para la mejora del proceso enseñanza-aprendizaje del pádel

Design Of A Minicomputer Separator Of Urban Solid Waste (RSU)

In Mexico, the society in general lacks the habit and ethics of properly disposing garbage or in taking care of the environment. This paper focuses on analyzing and disposing garbage in an automated way. The present study also seeks to create and promote care for the planet. The minicomputer (GreenScanProcess) is an automated system whose process is based on an algorithm that stands out for its functionality. GreenScanProcess has sensors that allow the analysis and scanning of garbage. It also measures the weight and humidity of the garbage. The minicomputer also examines the garbage to know its composition. Likewise, GreenScanProcess takes the garbage to the container according to the garbage. The benefits obtained when conducting the research were: environmental, economic, technological, and educational

La fauna del pleistoceno inferior de la sierra de Quibas (Abanilla, Murcia)

El yacimiento kárstico cuaternario de la Sierra de Quibas (Abanilla, Murcia) ha proporcionado una amplia lista faunística constituida por 53 especies repartidas entre gasterópodos, miriápodos, anfibios, reptiles, aves y mamíferos. En el conjunto de los gasterópodos destaca Palaeoglandina, un género que se extingue en el resto de Europa durante el Plioceno y que se mantiene como relicto en el Pleistoceno de la Península Ibérica. Dos de las especies de aves determinadas, Gypaetus barbatus y Gerontieus eremita, y una de las serpientes, Elaphe cf. E. sealaris, apenas se hallan representadas en el registro fósil. Hay además varias especies de aves cuya aparición en Quibas supone la primera cita en el Pleistoceno inferior de la Península Ibérica. Entre los mamíferos posee una especial relevancia la presencia del cercopitécido Macaca sylvanus. La asociación de los taxones Arvieola deuealíon, Castillomys rivas rivas, Elíomys intermedius, Equus altidens y Capra sp. aff. C. alba permite la correlación con Plines 1, Orce 3 y Venta Micena, entre otros. El yacimiento de Quibas puede situarse, por tanto, antes del final del Pleistoceno inferior, con una antigüedad entre 1.3 y 1 Ma. Por lo que se refiere a las condiciones paleoclimáticas, podemos inferir a partir de la asociación faunística un régimen xerófilo, muy semejante al actual en el área geográfica, aunque quizás con valores de humedad y temperatura algo superiores. El entorno de la cavidad kárstica estaba formado por roquedo calcáreo con áreas abiertas de matorral, pero en las proximidades se desarrollaron humedales y zonas arboladas, como así lo atestigua la presencia de aves y micromamíferos típicos de estos hábitats.The Quaternary karstic site of Sierra de Quibas (Abanilla, Murcia, Spain) has provided a wide faunallist with 53 species distributed among gastropods, myriapods, amphibians, reptiles, birds and mammals. Especially interesting among the gastropods is Palaeoglandina that became extinct in Europe during the Pliocene. It remains as a relict genus in the Pleistocene of the Iberian Peninsula. Two of the birds, Gypaetus barbatus and Geronticus eremita, and a snake, Elaphe cf. E. sealaris, are scarcely represented in the fossil record. For several birds, it is the first record in the Lower Pleistocene of the Iberian Peninsula. Among the mammals, the presence of the Cercopithecine Macaca sylvanus is especially relevant. The assemblage of the taxa Arvicola deucalion, Castillomys rivas rivas, Eliomys intermedius, Equus altidens and Capra sp. aff. C. alba allows the correlation with Plines 1, Orce 3 and Venta Micena, among other sites. Therefore Quibas can be clated before the end of Lower Pleistocene, between 1.3 and 1 Ma. A dry paleoclimatic regime, very similar to the current climate in the geographical area, though perhaps slightly wetter and warmer, can be inferred from the faunal assemblage. The environment of the karstic cavity was a rocky place with open brushwood areas, but in the proximities there were wetlands and woodlands, as can be inferred from the presence of birds and micromammals characteristic of these [email protected] [email protected]