Reinserción del colgajo fibroperióstico en la luxación de los tendones peroneos

La luxación de los tendones peroneos es una patología rara. Esta lesión pasa frecuentemente desapercibida y en su forma aguda es diagnosticada de esguince lateral de tobillo. Ocurre habitualmente en deportistas jóvenes y especialmente en accidentes de esquí. La presentación más frecuente es el despegamiento y elevación del retináculo junto con el periostio del margen lateral del extremo distal del peroné formando una bolsa que aloja los tendones luxados. Presentamos tres pacientes con luxación traumática de los tendones peroneos tratados quirúrgicamente según la técnica descrita por Meary, que consiste en la reinserción del colgajo fibroperióstico en el margen posterior del peroné por medio de unos puntos tránseseos. Los pacientes han sido evaluados con una evolución media de cinco años, con resultado excelente.Recurrent dislocation of the peroneal tendons over the lateral malleolus is an uncommon injury. Acute dislocation is frequently unrecognized and often misdiagnosed as an ankle sprain. Occurs in young athletes. Is usually the results of a skiing accident. The retinaculum is elevated from the lateral malleolus along with the periosteum with the tendons lying between periosteum and bone. We present three patients with a traumatic peroneal-ten-don dislocation treated surgically by reconstruction of the retinaculum with transosseous reattachement, described by Meary, were clinically evaluated after an average follow-up interval of five years, with excellent results

Valoración de las pérdidas sanguíneas en cirugía protésica primaria de cadera: estudio comparativo entre abordaje posterolateral y lateral

La artroplastia total de cadera se caracteriza por una pérdida sanguínea considerable. El propósito de nuestro estudio es valorar si existen diferencias en las pérdidas sanguíneas perioperatorias esperadas en prótesis totales de cadera (PTC) según el abordaje utilizado. Se planificó un estudio prospectivo en 33 pacientes divididos en dos grupos en función del abordaje utilizado: Grupo A abordaje posterolateral y grupo B abordaje lateral de Hardinge. El análisis de los datos recogidos no mostraba diferencias significativas ni en las pérdidas sanguíneas totales (p-0,4881), ni en los descensos de hemoglobina (p-0,6707), ni de hematocrito (p-0,9416).Blood loss in primary total hip arthroplasty is important. The aim of our research is to study if there are differences between blood losses in total hip replacement according to the surgical approach used. We have designed a prospective study in 33 patients divided into two groups depending on surgical approach: Group A posterolateral approach and group B Hardinge ́s lateral approach. The results show no difference either in total blood loss (P-0,4881) or in hemoglobine decrease (P-0,6707) and hematocrite decrease (P-0,9416)

Endocistectomía como tratamiento quirúrgico de elección en hidatidosis muscular primaria: caso clínico

Se presenta el caso clínico de una hidatidosis muscular primaria localizada a nivel del vasto externo del cuádriceps, describiéndose los hallazgos clínicos, analíticos y de estudios de imagen característicos. Y a propósito del mismo se describe y defiende el tratamiento mediante endocistectomía y albendazol, que permite mantener la funcionalidad completa del músculo. A los dos años de evolución la paciente se encuentra asintomática.We report a case of primary hydatíd disease. It ¡s located in the vastus lateralís of the quadriceps. We describe the clinical, serological and radiological features of this dísease. And then we argüe for the use of the surgical endocystectomy and albendazol as the best treatment; thinking that this allows to sustain the complete function of the muscle. Two years later, the patient is asymptomatic

Contrasting growth and water use strategies in four co-occurring Mediterranean tree species revealed by concurrent measurements of sap flow and stem diameter variations

Drought limits tree water use and growth of Mediterranean trees. However, growth and water use strate-gies are rarely addressed simultaneously across species and drought conditions. Here, we investigatethe link between stem diameter variations and sap flow in four co-existing Mediterranean trees (Pinushalepensis Mill., Quercus pubescens Willd., Quercus ilex L. and Arbutus unedo L.), under relatively wet (2011)and dry (2012) conditions. Continuous stem diameter variations were converted to basal area increment(BAI) and de-trended to estimate tree water deficit ( W), an indicator of stem hydration. P. halepensis andQ. pubescens showed the most and the least conservative sap flow density (JS) regulation under drought,respectively, with Q. ilex and A.unedo showing intermediate drought responses. All species, except A.unedo, showed some between-year variability in the environmental control of JS. Seasonal stem shrink-age in response to drought (i.e., increasing W) and subsequent trunk rehydration after rainfall (i.e.,decreasing W) occurred in all species. Vapor pressure deficit (VPD) and soil moisture ( ) interacted todetermine seasonal variation in W. Interestingly, in the dry year, 2012, more species-specific differ-ences were found in the responses of W to and VPD. Across species, JSand W began to decline atsimilar soil moisture thresholds, underpinning the tight link between JSand W under varying droughtconditions. Annual BAI decreased proportionally more than tree-level transpiration (JT) between the wet(2011) and the dry (2012) year, hence growth-based WUE (WUEBAI= BAI/JT) decreased for all species,albeit less acutely for P. halepensis. Overall, despite their contrasting leaf habit and wood type, the stud-ied Mediterranean tree species show coordinated responses of transpiration, water storage dynamicsand growth-based WUE which allow them to cope with seasonal and interannual drought

Evaluation of susceptibility of pear and plum varieties and rootstocks to Ca. P. pyri and Ca. P. prunorum using Real-Time PCR

Real-time PCR was used to quantify phytoplasma concentration in fifty inoculated trees from five Prunus rootstocks and in forty-eight symptomatic pear and Japanese plum trees from orchards. Seasonal fluctuation of Ca. P. prunorum in different Prunus rootstocks, over three years, showed that the highest percentage detected by nested-PCR was in the ‘Garnem’ rootstock on nearly all sampling dates. Intra-varietal differences were also observed. Phytoplasma titer could be estimated by real time PCR in some trees of the rootstocks ‘Garnem’, ‘Barrier’, ‘GF-677’ and ‘Marianna’, and ranged from 4.7x105 to 3.18x109 phytoplasmas per gram of tissue. Quantification by real-time PCR was not possible in the ‘Cadaman’ trees analyzed, probably due to a lower phytoplasma titer in this variety. Samples from infected trees from commercial plots had different phytoplasma concentration and detection percentage depending on the variety, both being lower in ‘Fortune’ and ‘606’ Japanese plum and in ‘Blanquilla’ pear trees.Keywords: Candidatus Phytoplasma pyri, Candidatus Phytoplasma prunorum, real time PCR, detectio

Geology of the Cerro Quema Au-Cu deposit (Azuero Peninsula, Panama)

The Cerro Quema district, located on the Azuero Peninsula, Panama, is part of a large regional hydrothermal system controlled by regional faults striking broadly E-W, developed within the Río Quema Formation. This formation is composed of volcanic, sedimentary and volcano-sedimentary rocks indicating a submarine depositional environment, corresponding to the fore-arc basin of a Cretaceous–Paleogene volcanic arc. The structures observed in the area and their tectono-stratigraphic relationship with the surrounding formations suggest a compressive and/or transpressive tectonic regime, at least during Late Cretaceous–Oligocene times. The igneous rocks of the Río Quema Formation plot within the calc-alkaline field with trace and rare earth element (REE) patterns of volcanic arc affinity. This volcanic arc developed on the Caribbean large igneous province during subduction of the Farallon Plate. Mineralization consists of disseminations of pyrite and enargite as well as a stockwork of pyrite and barite with minor sphalerite, galena and chalcopyrite, hosted by a subaqueous dacitic lava dome of the Río Quema Formation. Gold is present as submicroscopic grains and associated with pyrite as invisible gold. A hydrothermal alteration pattern with a core of advanced argillic alteration (vuggy silica with alunite, dickite, pyrite and enargite) and an outer zone of argillic alteration (kaolinite, smectite and illite) has been observed. Supergene oxidation overprinted the hydrothermal alteration resulting in a thick cap of residual silica and iron oxides. The ore minerals, the alteration pattern and the tectono-volcanic environment of Cerro Quema are consistent with a high sulfidation epithermal system developed in the Azuero peninsula during pre-Oligocene time

TP53-inducible Glycolysis and Apoptosis Regulator (TIGAR) Metabolically Reprograms Carcinoma and Stromal Cells in Breast Cancer.

A subgroup of breast cancers has several metabolic compartments. The mechanisms by which metabolic compartmentalization develop in tumors are poorly characterized. TP53 inducible glycolysis and apoptosis regulator (TIGAR) is a bisphosphatase that reduces glycolysis and is highly expressed in carcinoma cells in the majority of human breast cancers. Hence we set out to determine the effects of TIGAR expression on breast carcinoma and fibroblast glycolytic phenotype and tumor growth. The overexpression of this bisphosphatase in carcinoma cells induces expression of enzymes and transporters involved in the catabolism of lactate and glutamine. Carcinoma cells overexpressing TIGAR have higher oxygen consumption rates and ATP levels when exposed to glutamine, lactate, or the combination of glutamine and lactate. Coculture of TIGAR overexpressing carcinoma cells and fibroblasts compared with control cocultures induce more pronounced glycolytic differences between carcinoma and fibroblast cells. Carcinoma cells overexpressing TIGAR have reduced glucose uptake and lactate production. Conversely, fibroblasts in coculture with TIGAR overexpressing carcinoma cells induce HIF (hypoxia-inducible factor) activation with increased glucose uptake, increased 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 (PFKFB3), and lactate dehydrogenase-A expression. We also studied the effect of this enzyme on tumor growth. TIGAR overexpression in carcinoma cells increases tumor growth in vivo with increased proliferation rates. However, a catalytically inactive variant of TIGAR did not induce tumor growth. Therefore, TIGAR expression in breast carcinoma cells promotes metabolic compartmentalization and tumor growth with a mitochondrial metabolic phenotype with lactate and glutamine catabolism. Targeting TIGAR warrants consideration as a potential therapy for breast cancer

Estado actual de las metástasis óseas

Los tumores óseos primarios representan solo un pequeño porcentaje comparado con las metás - tasis óseas. Pero, mientras que los tratamientos neo-adyuvantes y las técnicas de reconstrucción han mejorado la supervivencia y la calidad de vida de los pacientes afectos de tumores óseos primarios, el tratamiento primario de las metástasis óseas sigue siendo paliativo. Siendo el objetivo del tratamiento de las metástasis óseas: evitar el dolor y restaurar al máximo la actividad funcional del paciente, hasta su muerte. Y todo ello con la ayuda del tratamiento médico, de la quimioterapia, los bifosfonatos, denosumab, la radioterapia y la cirugía. En la actuali - dad las recientes mejoras en nuestra comprensión de los mecanismos biológicos y moleculares implicados en la metástasis ósea pueden conducir a mejores y más precoces métodos de diagnóstico y tratamiento. Se intenta dar una pequeña pincelada sobre la fisiopatología actual de las metástasis óseasPrimary bone tumors represent only a small percentage compared to bone metastases. But while neo-adjuvants treatments and reconstruction techniques have improved survival and quality of life of patients with primary bone tumors, primary treatment of bone metastases remains palliative. The goals of treatment for bone metastases are pain relief and maximal functional restoration of the patient, until his death. And of all this, with the help of medical treatment with chemotherapy, bisphosphonates, denosumab, radiotherapy and surgery. At present the recent improvements in our understanding of the biological and molecular mechanisms involved in bone metastasis may lead to better and earlier diagnosis and treatment methods. We try to give a small sample of the current pathophysiology of bone metastases