Extracción renal en donante cadáver: revisión sistemática de la técnica quirúrgica / Deceased donor kidney procurement: systematic review of the surgical technique

Introducción El proceso de extracción renal debe ser una técnica estandarizada con el fin de optimizar las unidades renales para su posterior implante. Objetivos Revisión de la literatura disponible sobre el proceso de extracción renal. Material y métodos Revisión narrativa de la evidencia disponible sobre la técnica de extracción renal en paciente cadáver tras una búsqueda de los manuscritos relevantes indexados en PubMed, EMBASE y SciELO escritos en español e inglés. Resultados La extracción renal en paciente cadáver se divide en dos grupos, tras muerte encefálica (donation after brain death [DBD]) y tras muerte cardiaca (donation after circulatory death [DCD]). La extracción renal en DBD suele acompañarse de la extracción de otros órganos abdominales y/o torácicos, lo que requiere coordinación quirúrgica multidisciplinar. Durante el proceso de extracción debe asegurarse que los pedículos vasculares renales se mantienen íntegros para su posterior implante y disminuir el tiempo de isquemia. Conclusiones La ejecución adecuada y el perfecto conocimiento de la técnica quirúrgica de extracción y de la anatomía, permite disminuir el índice de pérdidas de injertos relacionados con una incorrecta extracción (AU)

Introduction Kidney procurement procedure must be carried out following a standardized technique in order to optimize kidney grafts for their subsequent implantation. Objectives Review of the available literatura on kidney procurement procedure. Material and methods Narrative review of the available evidence on deceased donor kidney procurement technique after a search of relevant manuscripts indexed in PubMed, EMBASE and Scielo written in English and Spanish. Result Deceased donor kidney procurement can be divided into two groups, donation after brain death (DBD) and donation after circulatory death (DCD). Kidney procurement in DBD frequently includes other chest and/or abdominal organs, requiring multidisciplinary surgical coordination. During the harvesting procedure, the renal vascular pedicle must remain intact for subsequent implantation and reduced ischemia time. Conclusions Adequate execution and perfect knowledge of the technique for surgical removal and anatomy reduces the rate of graft losses associated to inadequate harvesting techniques (AU)

Deceased donor kidney procurement: Systematic review of the surgical technique.

INTRODUCTION: Kidney procurement procedure must be carried out following a standardized technique in order to optimize kidney grafts for their subsequent implantation. OBJECTIVES: Review of the available literature on kidney procurement procedure. MATERIAL AND METHODS: Narrative review of the available evidence on deceased donor kidney procurement technique after a search of relevant manuscripts indexed in PubMed, EMBASE and Scielo written in English and Spanish. RESULTS: Deceased donor kidney procurement can be divided into two groups, donation after brain death (DBD) and donation after circulatory death (DCD). Kidney procurement in DBD frequently includes other chest and/or abdominal organs, requiring multidisciplinary surgical coordination. During the harvesting procedure, the renal vascular pedicle must remain intact for subsequent implantation and reduced ischemia time. CONCLUSIONS: Adequate execution and perfect knowledge of the technique for surgical removal and anatomy reduces the rate of graft losses associated to inadequate harvesting techniques.

Complicaciones posquirúrgicas en los pacientes con tumor renal con trombosis venosa tratados con cirugía / Postsurgical complications in patients with renal tumours with venous thrombosis treated with surgery

Introducción y objetivo: La cirugía de los tumores renales con trombosis venosa está gravada con un porcentaje elevado de complicaciones y con una mortalidad perioperatoria no despreciable. Nuestro objetivo es analizar las complicaciones postoperatorias, su relación con el nivel del trombo y sus posibles factores favorecedores. Materiales y métodos: Análisis retrospectivo de 101 pacientes con tumores renales con trombosis venosa intervenidos entre 1988 y 2017. Se descartaron 2 pacientes por TEP intraoperatorio y exitus (2%). Las complicaciones posquirúrgicas se clasificaron según Clavien-Dindo. Para el contraste de variables cualitativas se ha utilizado el test de la Chi cuadrado. Se realizó un análisis multivariante mediante regresión logística binaria para identificar las variables predictoras independientes. Resultados: En 34 (34,3%) pacientes se produjo algún tipo de complicación posquirúrgica, siendo en 11 (11,1%) graves (Clavien III-IV). Existen diferencias significativas en las complicaciones totales (p = 0,003) y las graves (Clavien≥III) (p = 0,03) según el nivel del trombo tumoral

Background and objective: Surgery on renal tumours with venous thrombosis suffers a high rate of complications and non-negligible perioperative mortality. Our objective was to analyse the postoperative complications, their relationship with the level of the thrombus and its potential predisposing factors. Materials and methods: A retrospective analysis was conducted of 101 patients with renal tumours with venous thrombosis operated on between 1988 and 2017. Two patients were excluded because of intraoperative pulmonary thromboembolism and exitus (2%). The postsurgical complications were classified according to Clavien-Dindo. To compare the qualitative variables, we employed the chi-squared test. We performed a multivariate analysis using binary logistic regression to identify the independent predictors. Results: Some type of postsurgical complication occurred in 34 (34.3%) patients, 11 (11.1%) of which were severe (Clavien III-V). There were significant differences in the total complications (P = .003) and severe complications (Clavien ≥ III; P = .03) depending on the level of the tumour thrombus

Postsurgical complications in patients with renal tumours with venous thrombosis treated with surgery. / Complicaciones posquirúrgicas en los pacientes con tumor renal con trombosis venosa tratados con cirugía.

BACKGROUND AND OBJECTIVE: Surgery on renal tumours with venous thrombosis suffers a high rate of complications and non-negligible perioperative mortality. Our objective was to analyse the postoperative complications, their relationship with the level of the thrombus and its potential predisposing factors. MATERIALS AND METHODS: A retrospective analysis was conducted of 101 patients with renal tumours with venous thrombosis operated on between 1988 and 2017. Two patients were excluded because of intraoperative pulmonary thromboembolism and exitus (2%). The postsurgical complications were classified according to Clavien-Dindo. To compare the qualitative variables, we employed the chi-squared test. We performed a multivariate analysis using binary logistic regression to identify the independent predictors. RESULTS: Some type of postsurgical complication occurred in 34 (34.3%) patients, 11 (11.1%) of which were severe (Clavien III-V). There were significant differences in the total complications (P=.003) and severe complications (Clavien≥III; P=.03) depending on the level of the tumour thrombus.

Conventional and real time RT-PCR assays for the detection and differentiation of variant rabbit hemorrhagic disease virus (RHDVb) and its recombinants.

Since its emergence, variant RHDV (RHDVb/RHDV2) has spread throughout the Iberian Peninsula aided by the apparent lack of cross protection provided by classic (genogroup 1; G1) strain derived vaccines. In addition to RHDVb, full-length genome sequencing of RHDV strains has recently revealed the circulation of recombinant viruses on the Iberian Peninsula. These recombinant viruses contain the RHDVb structural protein encoding sequences and the non-structural coding regions of either pathogenic RHDV-G1 strains or non-pathogenic (np) rabbit caliciviruses. The aim of the work was twofold: firstly to validate a diagnostic real time RT-PCR developed in 2012 for the detection of RHDVb strains and secondly, to design a conventional RT-PCR for the differentiation of RHDVb strains from RHDVb recombinants by subsequent sequencing of the amplicon.

Disfunción de la película lagrimal en pacientes reumatológicos / Disfunction tear film in patients rheumatologic

El síndrome de disfunción de la película lagrimal mejor conocido como ojo seco, por su variación clínico patológica conlleva a un subregistro en los pacientes, por lo que es necesario la valoración en nuestra consulta, para determinar varios aspectos en torno a la patología y su prevalencia en los pacientes del servicio de reumatología del Hospital Universitario de Caracas. Métodos: fue de tipo observacional descriptivo de corte transversal, evaluando pacientes con patologías reumatológicas que acudieron a la consulta en el servicio de oftalmología, la muestra fue de 59 pacientes con antecedentes reumatológicos, que no presentaron síntomas específicos de ojo seco del servicio de reumatología del Hospital Universitario de Caracas, durante el período junio 2013 ­ diciembre 2013.Se empleó la técnica de encuesta mediante un instrumento de recolección de datos tipo cuestionario que permitió identificar signos, síntomas y se logró medir cuantitativa y cualitativamente la secreción lagrimal y el grado de daño epitelial. Resultados: Se observó una prevalencia de 41,9 % del Síndrome Sjögren siendo más común en el sexo femenino y 44,8 % cursaban con SDPL, siendo más frecuente en el Síndrome de Sjögren. Asimismo 64,3 % de los pacientes con SDPL leve se encontraban sin tratamiento. Por su parte, 71,4 % de los pacientes con SDPL pertenecen al Síndrome de Sjögren. Conclusiones: El síndrome de disfunción de la película lagrimal es una entidad muy frecuente que debe tenerse presente siempre en patologías reumatológicas, y su control es esencial para la calidad visual del paciente(AU)

Syndrome of dysfunction of tear film as all too dry eye, for is relation pathologic clinic that begin to sub register in the patients, for that reason in necessary have a register in consult, for determine some aspects in relation with the illness and prevalence of tear film dysfunction in the patients of the rheumatology service University hospital of Caracas. Methods: The investigation was observation type, descriptive court traversal, evaluating patients on rheumatology pathologic that go to our ophthalmologist service. The total patients was 59 with antecedent rheumatologic, without specific symptoms of dry eye of the rheumatology service University Hospital of Caracas between June to December 2013. Using an assessment through an instrument of recollection information for tis way identify tool signs, symptoms were identified and managed quantitatively and qualitatively measure tear secretion and the degree of epithelial damage Results: The prevalence of 41.9 % of Sjögren 's syndrome is more common in females and 44.8 % were enrolled with SDPL, being more common in Sjögren's syndrome was observed. Also 64.3 % of patients with mild SDPL were untreated. Meanwhile, 71.4 % of patients with SDPL belong to Sjögren's syndrome. Conclusions: The syndrome of the tear film dysfunction is a very common condition that must be always present in rheumatologic diseases, and their control is essential for the patient's visual quality(AU)

Fluorescent FYVE Chimeras to Quantify PtdIns3P Synthesis During Autophagy.

Autophagy is the major cellular process of degradation and is modulated by several signaling pathways. Phosphatidylinositol 3-kinase (PtdIns3K) class III (Vps34) and PtdIns3K class I regulate the autophagy pathway positively and negatively, respectively. Both classes of PtdIns3K participate in the synthesis of phosphatidylinositol 3-phosphate (PtdIns3P), which plays a crucial role in autophagosome biogenesis and membrane traffic. PtdIns3P is a membrane phospholipid that is associated with endogenous FYVE domain-containing proteins. Indeed, such interactions facilitate autophagosome fusion with lysosomes and subsequent cargo degradation. During starvation-induced autophagy, the expression of FYVE domain-containing proteins increases, and their binding to PtdIns3P is strengthened. Nonetheless, not all FYVE domain proteins are related to the induction of autophagy. This method report presents the quantification of PtdIns3P synthesis by using cells either transiently transfected with or stably expressing FYVE-dsRed.

Mitochondria-Associated Membranes (MAMs): Overview and Its Role in Parkinson's Disease.

Mitochondria-associated membranes (MAMs) are structures that regulate physiological functions between endoplasmic reticulum (ER) and mitochondria in order to maintain calcium signaling and mitochondrial biogenesis. Several proteins located in MAMs, including those encoded by PARK genes and some of neurodegeneration-related proteins (huntingtin, presenilin, etc.), ensure this regulation. In this regard, MAM alteration is associated with neurodegenerative diseases such as Parkinson's (PD), Alzheimer's (AD), and Huntington's diseases (HD) and contributes to the appearance of the pathogenesis features, i.e., autophagy dysregulation, mitochondrial dysfunction, oxidative stress, and lately, neuronal death. Moreover,, ER stress and/or damaged mitochondria can be the cause of these disruptions. Therefore, ER-mitochondria contact structure and function are crucial to multiple cellular processes. This review is focused on the molecular interaction between ER and mitochondria indispensable to MAM formation and on MAM alteration-induced etiology of neurodegenerative diseases.

Pompe Disease and Autophagy: Partners in Crime, or Cause and Consequence?

Pompe disease or glycogen storage disease type II (OMIM: 232300) is a lysosomal storage disorder resulting from a partial or total lack of acid alphaglucosidase, which may produce muscle weakness, gait abnormalities, or even death by respiratory failure. In the last decade, autophagy has been proposed as a mechanism involved in the severity of symptoms related to this disorder and as a potential therapeutic target to alleviate disease progression. This review summarizes the relationship between autophagy and Pompe disease, including what information has been recently discovered and what remains unclear.

Efficient expression of bioactive murine IL12 as a self-processing P2A polypeptide driven by inflammation-regulated promoters in tumor cell lines.

Interleukin 12 (IL12) is a heterodimeric proinflammatory cytokine that has shown promise as an anticancer agent. However, despite encouraging results in animal models, clinical trials involving IL12 have been unsuccessful due to toxic side effects associated with its systemic administration, prompting investigation into new delivery methods to confine IL12 expression to the tumor environment. In this study we used the self-cleaving property of the 2A peptide to express both codon-optimized murine IL12 subunits (muIL12opt) as a self-processing polypeptide (muIL12opt-P2A). We cloned muIL12opt-P2A driven by different inflammation-induced lentiviral expression systems to transduce murine tumor cell lines commonly employed in syngeneic tumor models. We confirmed the inducibility of these systems in vitro and in vivo and demonstrated the successful expression of both IL12 subunits and the release of bioactive IL12 upon proinflammatory stimulation in vitro. Therefore, IL12 release driven by these inflammation-regulated expression systems might be useful not only to address the impact of IL12 expression in the tumor environment but also to achieve a local IL12 release controlled by the inflammation state of the tumor, thus avoiding toxic side effects associated with systemic administration.

Peri-implantitis: revisión de la literatura / Peri-implantitis: literature review

La implantología oral inicia en la década de los 50s como resultado de experimentos científicos en tejido óseo. Actualmente los implantes dentales son una excelente opción de sustitución a dientes perdidos. Sin embargo, se encuentran expuestos a factores de riesgo que afectan su permanencia como: microbiológicos, ambientales (cigarrillo), genéticos, mecánicos, sistémicos (diabetes y osteoporosis) y farmacológicos. En razón a ello se han clasificado dos patologías peri-implantares: mucositis peri-implantar y peri-implantitis. Según el Sexto Consenso Europeo de Periodoncia se encuentran entre el 80%, y 28 a 56% respectivamente. El clínico debe conocer las causas de la lesión para orientar al paciente, establecer terapias de tratamiento y mantenimiento adecuadas y evitar el fracaso del tratamiento protésico. Las alteraciones que afectan la estabilidad de la oseointegración están determinadas en la planificación, inserción y fase de carga, teniendo en cuenta la presencia de biopelícula. En la actualidad se cuestiona el hecho de que los bifosfonatos interfieran en el éxito del implante y en la subsecuente osteonecrosis de los maxilares, por lo tanto no debe descartarse su análisis

Oral implantology began in the late 50s as a result of scientific experiments in bone tissue. Today dental implants are an excellent replacement option for lost teeth. However, they are exposed to risk factors affecting its continued operation as: microbiological, environmental (smoking), genetic, mechanical, systemic (diabetes and osteoporosis) and pharmacologic. Because it has identified two pathologies peri-implantares: peri-implant mucositis and peri-implantitis. According to the Sixth European Consensus of Periodontology found between 80% and 28-56% respectively. The clinician must know the causes of injury to guide patient treatment choices and establish appropriate maintenance and prevent failure of prosthetic treatment. Alterations that affect the stability of osseointegration are determined in the planning, integration and load step, taking into account the presence of biofilm. At present the fact that bisphosphonates interfere with with the success of the implant and the subsequent osteonecrosis of the jaw, so his analysis should not be dismisses

Effect of fluoxetine on blood concentrations of serotonin, cortisol and dehydroepiandrosterone in canine aggression.

Canine aggression directed towards people is the most frequent reason for referral to behaviour practices. The serotonergic system and the hypothalamic-pituitary-adrenal (HPA) axis are believed to play an important role in controlling aggression. The selective serotonin reuptake inhibitor fluoxetine is the most commonly used drug in canine aggression. The aim of the present study was to assess the effect of a 30-day-long fluoxetine treatment on the peripheral serotonergic system and the HPA axis in canine aggression. To this end, the concentrations of serum serotonin (5-HT) and plasma cortisol and dehydroepiandrosterone (DHEA) were analysed in a group of aggressive (n = 22) and nonaggressive dogs (n = 9) during pre- (day 0) and posttreatment (day 30) conditions. Treatment caused a significant decrease in 5-HT concentrations (46% in the aggressive group and 32% in the control group). There was a trend towards a rise of DHEA/cortisol ratio values after treatment both in the aggressive and the control group. The determination of blood 5-HT and the DHEA/cortisol ratio could have important clinical applications in the future for deciding which animals might benefit from a given treatment as well as for monitoring the response. Further large-scale studies with this aim should be carried out to obtain sound conclusions.

Papel del eje corticotropo en la agresividad canina / No disponible

No disponible

Nervous signs associated with otitis and cranial osteomyelitis and with Ornithobacterium rhinotracheale infection in red-legged partridges (Alectoris rufa).

A case of nervous signs in red-legged partridges (Alectoris rufa) associated with a severe otitis and osteomyelitis is reported. The outbreak was characterized by abnormal head position, torticollis and difficulty in standing, walking and flying. Pathological, microbiological and molecular genetic data supported an association with Ornithobacterium rhinotracheale (ORT) infection. Clinical signs persisted for several days and were accompanied by weight loss leading to death. Morbidity was approximately 20% and most birds died if untreated. Lesions were mainly characterized by a severe osteomyelitis of the cranial bones and purulent inflammation of the external, middle and inner ears. O. rhinotracheale was isolated from ear samples, skull and brain stem in pure culture. Genetic characterization by pulsed-field gel electrophoresis of the clinical isolates showed that the outbreak was caused by a single strain of ORT. This appears to be the first report of otitis associated with ORT in an avian species.

Prevalence and risk factors of behavioural changes associated with age-related cognitive impairment in geriatric dogs.

OBJECTIVES: The aim of this study was to describe the prevalence and severity of behavioural changes associated with age and their relationship to risk factors such as sex, reproductive status, bodyweight and age. METHODS: A cross-sectional study design was chosen. A total of 325 geriatric dogs were included. Owners of dogs older than nine years were interviewed by a veterinary behaviourist. Structured phone interviews were used to gather information about four behavioural categories related to cognitive impairment: sleep/wake cycles, social interaction, learning and house training and signs of disorientation. RESULTS: Signs of cognitive impairment showed a prevalence of 22.5 per cent in geriatric dogs. Sex and age emerged as significant predictor variables. Females and neutered dogs were significantly more affected than males and entire dogs, respectively. Prevalence and severity increased with age. Although weight was not a statistically significant predictor variable, smaller animals had greater odds of showing age-related cognitive impairment. The most impaired behavioural categories were social interaction and house training. CLINICAL SIGNIFICANCE: Age-related behavioural changes should be considered by practicing veterinarians because of their relative high prevalence among geriatric dogs, especially in females.

Prognostic irrelevance of HLA-G in B-cell chronic lymphocytic leukemia.

In the last few years, it has been suggested that the involvement of human leukocyte antigen-G (HLA-G) in several tumoral processes and its likely participation as a factor of immune tolerance in malignant cells. Recently, positive HLA-G surface expression has been associated with a poor prognosis in a small group of patients with B-cell chronic lymphocytic leukemia (B-CLL), a lymphoproliferative disorder characterized by a heterogeneous clinical course. In the present work, 169 patients suffering from B-CLL were analyzed for the expression of HLA-G by flow cytometry in order to verify its prognostic value in a larger cohort. We observed a low expression of this molecule on leukemic B cells and no significant relation to clinical data or progression-free survival time, indicating that this molecule is not as good immunologic prognostic marker for B-CLL as suggested.