Luxación inveterada del codo en niños: a propósito de un caso

La luxación no reducida del codo es rara y no suele verse en los países desarrollados, salvo en grupos sociales marginados y de forma excepcional. La luxación más frecuentemente es posterior. Entre las 3 semanas y 3 meses, el tratamiento cerrado suele fracasar puesto que la interposición de tejido de granulación y fibroso intraarticular y la retracción de los tejidos blandos, impiden una reducción incruenta y estable. Nosotros recomendamos para luxaciones inveteradas, vistas en este período de tiempo, el abordaje posterior con sección del tendón del músculo tríceps y la reconstrucción de estructuras blandas periarticulares. Presentamos el caso de un niño tratado mediante reducción quirúrgica y cuyo resultado final fue muy bueno.Neglected dislocation of the elbow is a rare entity, very unfrequent in developed countries, affecting mostly marginated groups. The posterior type is the most frequent neglected dislocation of the elbow. When attempted 3 weeks after dislocation, close reduction usually fails or is very unstable due to the interposition of granulomatous or scar tissue within the joint and the retraction of periarticular soft tissues. For neglected dislocations treated from 3 weeks to 3 months after the injury, we recommended open reduction through a posterior approach, including section of the triceps tendon, and reconstruction of the periarticular structures. We present one case of a 10-year-old boy, with neglected dislocation of the left elbow treated procedure and showing a very satisfactory outcome

Social comparison processes and catastrophising in fibromyalgia:A path analysis

Introduction: In addition to coping strategies, social comparison may play a role in illness adjustment. However, little is known about the role of contrast and identification in social comparison in adaptation to fibromyalgia.Aim: To evaluate through a path analysis in a sample of fibromyalgia patients, the association between identification and contrast in social comparison, catastrophising and specific health outcomes (fibromyalgia illness impact and psychological distress).Material and Method: 131 Spanish fibromyalgia outpatients (mean age: 50.15, SD=11.1) filled out a questionnaire.Results: We present a model that explained 33% of the variance in catastrophising by direct effects of more use of upward contrast and downward identification. In addition, 35% of fibromyalgia illness impact variance was explained by less upward identification, more upward contrast and more catastrophising and 42% of the variance in psychological distress by a direct effect of more use of upward contrast together with higher fibromyalgia illness impact.Discussion: We suggest that intervention programmes with chronic pain and fibromyalgia patients should focus on enhancing the use of upward identification in social comparison, and on minimising the use of upward contrast and downward identification in social comparison

La agricultura ecológica a largo plazo en plantaciones de cítricos permite la recuperación del carbono orgánico del suelo

[ES] Se ha demostrado que el manejo del suelo bajo agricultura ecológica puede aumentar el contenido de carbono orgánico en el suelo moderando el incremento de los gases de efecto invernadero, pero hasta la fecha las evaluaciones cuantitativas basadas en mediciones a largo plazo han sido escasas, especialmente bajo condiciones mediterráneas. En esta investigación se examinaron los cambios en el contenido de carbono orgánico como respuesta a la agricultura ecológica con cobertura vegetal en una plantación de cítricos en el área mediterránea, utilizando una base de datos de 21 años. El incremento de contenido de carbono orgánico en el suelo fue más evidente tras cinco años desde el cambio del manejo del suelo, sugiriendo que, para plantaciones de cítricos en ambientes mediterráneos, los estudios deberían tener una duración superior a cinco años. La sata de secuestro de carbono orgánico no cambió significativamente durante los 21 años de observaciones, con valores que oscilaron entre -1.10 Mg C ha-1 a-1 y 1.89 Mg C ha-1 a-1. Tras 21 años, un total de 61 t CO2 ha-1 fueron secuestradas en las áreas de acumulación de carbono en el suelo. Estos resultados demuestran que la agricultura ecológica es una estrategia efectiva para restaurar o incrementar los niveles de carbono orgánico en el suelo en los sistemas de cítricos mediterráneos.[EN] It has been shown that soil management under organic farming can enhance soil organic carbon, thereby mitigating atmospheric greenhouse gas increases, but until now quantitative evaluations based on long term experiments are scarce, especially under Mediterranean conditions. Changes in soil organic carbon (SOC) content were examined in response to organic management with cover crops in a Mediterranean citrus plantation using 21 years of survey data. Soil organic carbon increase was more apparent 5 years after a land management change suggesting that, for citrus plantations on Mediterranean conditions, studies should be longer than five years in duration. Soil organic carbon sequestration rate did not significantly change during the 21 years of observation, with values ranging from -1.10 Mg C ha(-1) y(-1) to 1.89 Mg C ha(-1) y(-1). After 21 years, 61 Mg CO2 ha(-1) were sequestered in long-lived soil C pools. These findings demonstrate that organic management is an effective strategy to restore or increase SOC content in Mediterranean citrus systems.This research was funded by the European Union Seventh Framework Program (FP7/2007-2013) under grant no. 603498 (RECARE Project) and the research projects GL2008-02879/BTE and LEDDRA 243857.Novara, A.; Pulido, M.; Rodrigo-Comino, J.; Di Prima, S.; Smith, P.; Gristina, L.; Giménez Morera, A.... (2019). Long-term organic farming on a citrus plantation results in soil organic carbon recovery. Cuadernos de Investigación Geográfica. 45(1):271-286. https://doi.org/10.18172/cig.3794S27128645

Functional Echocardiographic and Serum Biomarker Changes Following Surgical and Percutaneous Atrial Septal Defect Closure in Children

BACKGROUND: Ventricular performance is temporarily reduced following surgical atrial septa! defect closure. Cardiopulmonary bypass and changes in loading conditions are considered important factors, but this phenomenon is incompletely understood. We aim to characterize biventricular performance following surgical and percutaneous atrial septal defect closure and to relate biomarkers to ventricular performance following intervention. METHODS AND RESULTS: In this multicenter prospective study, children scheduled for surgical or percutaneous atrial septal defect closure were included. Subjects were assessed preoperatively, in the second week postintervention (at 2-weeks follow-up), and 1-year postintervention (1-year follow-up). At each time point, an echocardiographic study and a panel of biomarkers were obtained. Sixty-three patients (median age, 4.1 [interquartile range, 3.1-6.1] years) were included. Forty-three patients underwent surgery. At 2-weeks follow-up, right ventricular global longitudinal strain was decreased for the surgical, but not the percutaneous, group (-17.6 +/- 4.1 versus -27.1 +/- 3.4; P CONCLUSIONS: Right, and to a lesser degree left, ventricular performance was reduced early after surgical atrial septal defect closure. Right ventricular performance at 1-year follow-up remained below baseline levels. Several biomarkers showed a pattern over time similar to ventricular performance. These biomarkers may provide insight into the processes that affect ventricular function

Cardiac Function and Serum Biomarkers throughout Staged Fontan Palliation:A Prospective Observational Study

Fontan patients undergo multiple cardiothoracic surgeries in childhood. Following these procedures, ventricular function is temporarily decreased, and recovers over months. This is presumably related to cardiopulmonary bypass, but this is incompletely understood. Throughout the Fontan palliation, cardiac function is also affected by volume unloading. We aimed to gain insight into the biological processes related to impaired ventricular function and recovery following Fontan palliations using a panel of biomarkers. Furthermore, we described changes in ventricular function across the Fontan palliation due to volume unloading. We performed a prospective multicenter observational study in patients undergoing partial (PCPC) or total cavo-pulmonary connection (TCPC). Patients underwent assessment-including echocardiography and blood sampling-before surgery (T1), at first follow-up (T2), and 1 year after their procedures (T3). Blood samples were analyzed using a biomarker panel (OLINK CVD-III). Ninety-two biomarkers were expressed as principal components (PC) to limit multiple statistical testing. We included 32 PCPC patients aged 7.2 [5.3-10.3] months, and 28 TCPC patients aged 2.7 [2.2-3.8] years. The single ventricular longitudinal strain (SV GLS) temporarily decreased for PCPC patients at T2 (-15.1 ± 5.6 (T1) to -13.5 ± 5.2 (T2) to -17.3 ± 4.5 (T3), p &lt; 0.047 for all differences), but not following TCPC. The serum biomarkers were expressed as 4 PCs. PC1, including biomarkers of cell-cell adhesion, was not related to any patient characteristic. PC2, including biomarkers of superoxide anion regulation, increased at T2. PC3, including biomarkers of cardiovascular development, related to the stage of Fontan palliation. PC4 was of uncertain biological or clinical significance. No PC was found that related to ventricular performance. The SV GLS was temporarily diminished following PCPC, but not following TCPC. Several biomarkers were related to post-operative stress and adaptation to the PCPC or TCPC circulation, but none were related to the outcome. </p

Vitamin D effects on human colon normal and tumour organoids

Trabajo presentado en FEBS Open Bio, celebrado en Lisboa (Portugal) del 09 al 14 de julio de 2022.Many studies indicate an association between vitamin D deficiency and increased colorectal cancer risk and, specially, mortality. Accordingly, the active vitamin D metabolite 1a,25-dihydroxyvitamin D3 (calcitriol) inhibits the proliferation and promotes the differentiation of colon carcinoma cells and of other tumour cell types, and also has antitumour effects in animal models of colon cancer. These results prompted us to analyse the effects of calcitriol on human colon normal and cancer stem cells. To this end, we established a living biobank of patient-derived colon organoids generated from the tumour mass and from the adjacent healthy tissue obtained from surgical biopsies. Organoids are a three-dimensional culture system of normal or cancer stem cells and their progeny with a self-organized multicellular structure. By immunohistochemistry and RNAscope in situ hybridization, we found that vitamin D receptor is expressed in LGR5+ colon stem cells in human tissue and in normal and tumour organoid cultures. RNA-sequencing assays showed that both organoid types respond differentially to calcitriol with profound and contrasting changes in their transcriptomic profiles. This was confirmed in an independent series of patient-derived organoids by RT-qPCR assays. In normal organoids, calcitriol upregulates stemness-related genes and inhibits cell proliferation. In contrast, in tumour organoids calcitriol has little effect on stemnessrelated genes, while it induces differentiation-associated genes, and variably reduces cell proliferation. Concordantly, electron microscopy analyses showed that calcitriol does not affect the blastic cell phenotype in normal organoids, but it induces a series of differentiated features in tumour organoids. These results indicate that calcitriol maintains the undifferentiated phenotype of human normal colon stem cells (homeostatic action), while it promotes the differentiation of colon cancer stem cells (anticancer action).

Sur8, a determinant protein in colorectal cancer tumor progression

Resumen del trabajo presentado en el 43rd Annual Meeting of the SEBBM, celebrado en Barcelona (España) del 19 al 21 de julio de 2021.Colorectal cancer (CRC) has the highest incidence rate in the Spanish population. The most important challenge consists on the discovery of efficient disease treatments, due to high mortality rates in highly developed stages. Sur8 is a scaffold protein that positively modulates ERK signaling pathway, which has a major role in the progression and metastasis in colorectal cancer. The main goals of our research are to determine the role that Sur8 plays in the development and progression of CRC and to analyze its possible therapeutic potential. For this purpose, our group has developed an inducible conditional mouse model msur8f/fVillinCreERT2. In order to determine Sur8 action in the colonic tissue, we have developed organoids from the colon epithelium of healthy mice and have analyzed gene expression pattern by an RNAseq approach. Sur8 KO affects oncogenic CRC transcription factors expression, as well as the modulation of some Wnt pathway regulators. In regard to miRNA data, we have observed deregulation of miRNAs related to CRC in Sur8 KO organoids. To determine the role that Sur8 plays in the development and progression of CRC, we have subjected our inducible conditional mice to chemical carcinogenesis and we have observed that Sur8 KO males display less and smaller tumors and do not present any adenocarcinoma. In addition, we have carried out Sur8 silencing in human CRC cell lines by infection with constitutive shRNA lentiviruses. We have observed that Sur8 silencing produces decreases of cell tumor proliferation, and reduction of p-ERK levels. Finally, we are evaluating the effects of putative therapeutic agents against Sur8 in human CRC cell lines. Concretely, we are testing Celastrol, which has been described that binds and blocks the action of Sur8 in vitro. We have observed that Celastrol treatment diminishes the cell tumor proliferation in this model. Altogether, our results indicate that Sur8 may have a determinant role in CRC progression and that Sur8 could be a potential molecular target for the design of novel strategies against CRC

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand.

OBJECTIVE: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. DESIGN: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. METHODS: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. RESULTS: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. CONCLUSION: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression

New treatment options offering enhanced activity in elderly, newly diagnosed patients with multiple myeloma are required. One strategy is to combine melphalan and prednisone with novel agents. We previously reported an 89% response rate, including 32% complete responses and 11% near complete responses, in our phase 1/2 study of bortezomib plus melphalan and prednisone (VMP) in 60 newly diagnosed multiple myeloma patients with a median age of 75 years. Here, we report updated time-to-events data and the impact of poor prognosis factors on outcome