Cambios morfométricos en pacientes con enfermedad renal crónica fallecidos relacionados con diabetes mellitus, hipertensión arterial y obesidad

Fundamento: la enfermedad renal crónica ha incrementado su incidencia, no existen estudios en Cuba ni en la provincia sobre morfometría renal en pacientes con enfermedad renal crónica a los que se les ha practicado autopsia. Objetivo: determinar variaciones morfométricas renales en pacientes fallecidos a los que se les ha practicado autopsia en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Método se realizó un estudio descriptivo, longitudinal y retrospectivo. El universo lo conformaron 85 pacientes fallecidos a los que se les practicó autopsia y que tenían diagnóstico clínico de enfermedad renal crónica en cualquier estadio. Se trabajó con el total del universo. Las variables estudiadas fueron: edad, sexo, peso y talla para el cálculo del índice de masa corporal, antecedentes patológicos personales, el estadio clínico de la enfermedad renal crónica y la morfometría renal a cada órgano por separado, las mensuraciones realizadas fueron: peso, diámetro longitudinal, diámetro transversal, espesor o grosor de la corteza renal. Los datos se procesaron en el paquete estadístico de SSPS v. 11.5 presentándose tablas en números absolutos y porcientos. Resultados predominó el sexo femenino, en edades entre 70-79 años, con estadio clínico I y IV de la enfermedad renal crónica, los obesos representaron el 57,6 %, los hipertensos el 67,1 % y los diabéticos el 25,8 %. Hubo disminución de todas las variables morfométricas en ambos riñones, destacándose el espesor de la corteza renal. Conclusiones: existió relación entre la hipertensión, la diabetes mellitus y la obesidad con las variables morfométricas renales.

Background: chronic kidney disease has increased its incidence, there are no studies in Cuba or in the province on renal morphometry in patients with chronic kidney disease who have undergone autopsy. Objective: to determine renal morphometric variations in deceased patients who have undergone autopsy at the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos. Method: a descriptive, longitudinal and retrospective study was carried out. The universe was made up of 85 deceased patients who underwent autopsy with a clinical diagnosis of chronic kidney disease at any stage. We worked with the whole universe. The variables studied were: age, sex, weight and height for the calculation of the body mass index, personal pathological history, the clinical stage of chronic kidney disease and renal morphometry to each organ separately, the measurements made were: weight, longitudinal diameter, transverse diameter, thickness or thickness of the renal cortex. The data was processed in the statistical package of SSPS v. 11.5 presenting tables in absolute numbers and percentages. Results: the female sex predominated, aged between 70-79 years, with clinical stage I and IV of chronic kidney disease, the obese represented 57.6 %, the hypertensive 67.1 % and the diabetic 25.8 %. There was a decrease in all morphometric variables in both kidneys, highlighting the thickness of the renal cortex. Conclusions: there was a relationship between hypertension, diabetes mellitus and obesity with renal morphometric variables.

Evolución de las cajas de polyetheretherketone (PEEK). Estudio clínico y radiológico / Évolution des cages en polyétheréthercétone (PEEK). Étude clinique et radiologique / Evolution of polyetheretherketone (PEEK) boxes. Clinical and radiological study

Introducción: las cajas cervicales son implantes desarrollados como una alternativa a la utilización del injerto óseo estructural para la fusión cervical anterior. El objetivo de este estudio fue analizar la clínica y los resultados radiológicos en una serie de pacientes sometidos a disectomía y descompresión cervical anterior, a los que se les implantó una caja PEEK. Método: estudio retrospectivo, descriptivo, longitudinal de una serie de 78 pacientes incluidos en el estudio desde el año 2007 al 2013. El control radiológico incluyó radiografía anteroposterior y lateral. El seguimiento clínico y radiológico de los pacientes se llevó a cabo desde los 3 meses hasta los 12 meses. Resultados: 65 pacientes tuvieron una evolución clínica favorable (83,3 por ciento) y la evolución radiológica confirmó que 66 pacientes (84,6 por ciento) tenían una buena colocación del injerto, sin lesiones en espacios adyacentes con una fusión correcta. Conclusiones: hasta la fecha hay pocos estudios descriptivos sobre el implante de las cajas PEEK, los resultados mostrados en este trabajo están acordes a los publicados con anterioridad en este mismo campo, lo que da validez al trabajo presentado. Este estudio confirma los buenos resultados clínicos y radiológicos de pacientes a los que se les implantó una caja PEEK; se muestra su eficacia en la discectomía cervical anterior y artrodesis(AU)

Introduction: Cervical cases are implants developed as an alternative to the use of structural bone graft for anterior cervical fusion. The objective of this study was to analyze the clinical and radiological results in a series of patients submitted to anterior cervical dissectomy and decompression, to whom a PEEK box was implanted. Method: A retrospective, descriptive, longitudinal study was conducted in a series of 78 patients included in the study from 2007 to 2013. Radiological control included anteroposterior and lateral radiographies. Clinical and radiological follow-up of these patients was carried out from 3 months to 12 months. Results: 65 patients had a favorable clinical course (83.3 percent) and the radiological evolution confirmed that 66 patients (84.6 percent) had a good placement of the graft without lesions in adjacent spaces with a correct fusion. Conclusions: To date there are few descriptive studies on the implantation of PEEK boxes. This paper results are in line with those published previously in this same field, which legitimate the presented work. This study confirms the good clinical and radiological results in patients who were implanted with a PEEK box; its effectiveness in anterior cervical discectomy and arthrodesis is shown(AU)

Introduction: Les cages cervicales sont des implants développés comme alternative de la greffe osseuse structurelle pour la fusion cervicale antérieure. Le but de cette étude est d'analyser la technique et les résultats radiologiques dans une série de patients traités par discectomie et décompression cervicale antérieure, et implantation d'une cage PEEK. Méthodes: Étude rétrospective, descriptive et longitudinale d'une série de 78 patients inclus dans une étude depuis l'année 2007 jusqu'à l'année 2013. L'étude radiologique a compris des clichés en position antéro-postérieure et latérale. Le suivi clinique et radiologique des patients a pris de 3 à 12 mois. Résultats: L'évolution clinique a été satisfaisante chez 65 patients (83,3 pourcent), tandis que l'étude radiologique a confirmé que le greffon était bien placé, il n'y avait pas de lésions dans les espaces adjacentes, et la fusion était correcte chez 66 patients (84,6 pourcent). Conclusions: Jusqu'à maintenant, il y a peu d'études descriptives abordant l'implantation des cages PEEK. Le présent travail est validé, car ses résultats sont en concordance avec les travaux publiés auparavant dans ce domaine. Cette étude confirme les bons résultats obtenus chez les patients ayant subi l'implantation d'une cage PEEK ; son efficacité est démontrée dans la discectomie cervicale antérieure et l'arthrodèse(AU)

Prognostic role of genetic biomarkers in clinical progression of prostate cancer

The aim of this study was to analyze the use of 12 single-nucleotide polymorphisms in genes ELAC2, RNASEL and MSR1 as biomarkers for prostate cancer (PCa) detection and progression, as well as perform a genetic classification of high-risk patients. A cohort of 451 men (235 patients and 216 controls) was studied. We calculated means of regression analysis using clinical values (stage, prostate-specific antigen, Gleason score and progression) in patients and controls at the basal stage and after a follow-up of 72 months. Significantly different allele frequencies between patients and controls were observed for rs1904577 and rs918 (MSR1 gene) and for rs17552022 and rs5030739 (ELAC2). We found evidence of increased risk for PCa in rs486907 and rs2127565 in variants AA and CC, respectively. In addition, rs627928 (TT-GT), rs486907 (AG) and rs3747531 (CG-CC) were associated with low tumor aggressiveness. Some had a weak linkage, such as rs1904577 and rs2127565, rs4792311 and rs17552022, and rs1904577 and rs918. Our study provides the proof-of-principle that some of the genetic variants (such as rs486907, rs627928 and rs2127565) in genes RNASEL, MSR1 and ELAC2 can be used as predictors of aggressiveness and progression of PCa. In the future, clinical use of these biomarkers, in combination with current ones, could potentially reduce the rate of unnecessary biopsies and specific treatments.

Porphyria Cutanea Tarda and HFE Gene Mutations in Argentina.

Aims: Porphyria Cutanea Tarda (PCT), the most common of porphyrias is triggered by several factors, including iron overload. Type I Hereditary Hemochromatosis is inherited as an autosomal recessive trait of the mutation p.C282Y or as a compound heterozygous form p.C282Y/p.H63D in HFE gene. Our aim was to study the frequency of HFE mutations in Argentinean PCT patients and in control subjects. Place and Duration of Study: CIPYP, CONICET, Hospital de Clínicas José de San Martín: Av. Córdoba 2351, 1º subsuelo, Buenos Aires, Argentina (1120). Between March 2008 and March 2010. Methodology: We analyzed HFE mutations in 103 PCT patients (67 males, 36 females) and in 93 control subjects (63 males and 30 females). PCT patients were classified as familial, sporadic or Type III PCT measuring URO-D activity in red blood cells. HFE mutations were detected by amplification and automatic sequencing of exons 2 and 4 in the HFE gene. In some cases p.H63D and p.C282Y mutations were also detected by digestion with restriction enzymes (Mbo I for p.H63D and Rsa I for p.C282Y), followed by 3% polyacrilamide gel electrophoresis. Results: In PCT group, 34.9% carried mutation p.H63D (26.2% heterozygous, 5.8% homozygous and 2.9% as p.C282Y/p.H63D) and 7.8% carried mutation p.C282Y (2.9% in heterozygocity, 1.9% in homozygocity and 2.9% as p.C282Y/p.H63D). In the control group, 30.1% carried p.H63D (28% in heterozygous and 2.1% in homozygous), and 5.4% had p.C282Y in heterozygosity. There were no significant differences between sporadic and familial PCT and neither between PCT and control groups. Our findings are in agreement with the prevalence of the Mediterranean origin of our patients, where p.C282Y mutation is less common than p.H63D mutation. Conclusion: We conclude that mutations in HFE gene do not play a relevant role in the triggering of PCT in our country.

A study of the temporomandibular joint during bruxism / 国际口腔科学杂志·英文版

A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue.