[Dynamic transpedicular instrumentation with S14 system (B-FUS) in lumbar spine. Experience in 32 cases]. / Instrumentación transpedicular dinámica con sistema s14 (B-FUS) en columna lumbar. Experiencia en 32 casos.

OBJECTIVE: To evaluate functional and radiographic results in patients with diagnosis of degenerative disease of the lumbar column subject to treatment with transpedicular fixing plus the application of system S14 (B-FUS), and to evaluate the disease development of adjacent disk associated with the method of selected treatment. MATERIAL AND METHODS: A transversal descriptive retrospective study in which a total of 32 patients with diagnosis of the degenerative pathology of the column lumbar was included, including 12 patients with lumbar degenerative discopathy (37.50%), 11 patients intervertebral lumbar instability (34.38%), seven with narrow lumbar channel (21.88%) and two patients with adjacent discreet disorder disease (6.25%). Of the sample of 32 patients, 17 belong to the male gender and 15 to the female gender; the middle age of the group was 52 years old with a range of age (26-80 years). Patients operated in the period of January 2015 to December 2016 were included. The procedures were assigned and carry out randomly by two specialist surgeons in column with standardization of surgical technique. clinical and radiographic monitoring was performed by the external consultation of column surgery in the two weeks and after a monthly period during a period of at least nine months, presenting a monitoring range between nine and 33 months, with clinical and radiographic valuation. RESULTS: 17 belonged to male gender and 15 to female gender; the average age was 52 years with a range of 26-80 years. To the 32 patients was performed an assessment of pain prior to surgery (eva) with an average of 7.6 Points and a post-surgical assessment of 1.2 Points on average, having a significant decrease, the qualitative radiographic evaluation by surgeons without development of adjacent disk disease in none of the cases even in those that were valued above 20 months after surgery. Complications: 1 rupture of transpedicular screw post-traumatic (3.1%), 1 Surgical reoperation by discopathy of l3-l4 (3.1%) and 3 cases of wound infection that remitted with antibiotic use (10%), the total complications corresponded to (15.6%) and none is associated with the disease of the adjacent disk. CONCLUSIONS: The s14 system (b-fus) in our series of cases as a treatment for degenerative lumbar spine disease has proven to be an effective therapeutic option by reducing the risk of disease development of the adjacent disk.

OBJETIVO: Evaluar los resultados funcionales y radiográficos en pacientes con diagnóstico de enfermedad degenerativa de la columna lumbar tratados con fijación transpedicular más aplicación de sistema S14 (B-FUS) y evaluar el desarrollo de enfermedad del disco adyacente asociada. MATERIAL Y MÉTODOS: Estudio retrospectivo descriptivo transversal de 32 pacientes con diagnóstico de patología degenerativa de la columna lumbar operados en el período de Enero de 2015 a Diciembre de 2016. Se incluyeron 12 pacientes con discopatía degenerativa (37.50%), 11 pacientes con inestabilidad intervertebral (34.38%), siete con canal lumbar estrecho (21.88%) y dos pacientes con enfermedad de disco adyacente sobre agregada (6.25%). Los procedimientos fueron asignados y realizados aleatoriamente por dos cirujanos especialistas en columna con estandarización de técnica quirúrgica. Seguimiento clínico y radiográfico en la consulta de cirugía de columna a las cuatro semanas y posteriormente cada tres meses, presentando un rango de seguimiento entre nueve y 33 meses. RESULTADOS: 17 pertenecían al género masculino y 15 al género femenino; la edad media fue de 52 años con un rango de 26-80 años. A los 32 pacientes se les realizó una valoración del dolor previo a la cirugía (EVA) con promedio de 7.6 puntos y una valoración postquirúrgica de 1.2 puntos en promedio, teniendo una disminución significativa, la valoración radiográfica cualitativa por los cirujanos sin desarrollo de enfermedad de disco adyacente en ninguno de los casos, incluso en quienes fueron valorados por encima de los 20 meses del postquirúrgico. Complicaciones: una ruptura de tornillo transpedicular postraumática (3.1%), una reintervención quirúrgica por discopatía de L3-L4 (3.1%) y tres casos de infección de herida que remitió con antibioticoterapia (10%), el total de complicaciones correspondió a 15.6% y ninguna se encuentra asociada a la enfermedad del disco adyacente. CONCLUSIONES: El sistema S14 (B-FUS) como tratamiento para la enfermedad degenerativa de la columna lumbar ha demostrado ser una opción terapéutica eficaz al disminuir el riesgo de desarrollar enfermedad del disco adyacente.

Instrumentación transpedicular dinámica con sistema S14 (B-FUS) en columna lumbar. Experiencia en 32 casos / Dynamic transpedicular instrumentation with S14 system (B-FUS) in lumbar spine. Experience in 32 cases

Resumen: Objetivo: Evaluar los resultados funcionales y radiográficos en pacientes con diagnóstico de enfermedad degenerativa de la columna lumbar tratados con fijación transpedicular más aplicación de sistema S14 (B-FUS) y evaluar el desarrollo de enfermedad del disco adyacente asociada. Material y métodos: Estudio retrospectivo descriptivo transversal de 32 pacientes con diagnóstico de patología degenerativa de la columna lumbar operados en el período de Enero de 2015 a Diciembre de 2016. Se incluyeron 12 pacientes con discopatía degenerativa (37.50%), 11 pacientes con inestabilidad intervertebral (34.38%), siete con canal lumbar estrecho (21.88%) y dos pacientes con enfermedad de disco adyacente sobre agregada (6.25%). Los procedimientos fueron asignados y realizados aleatoriamente por dos cirujanos especialistas en columna con estandarización de técnica quirúrgica. Seguimiento clínico y radiográfico en la consulta de cirugía de columna a las cuatro semanas y posteriormente cada tres meses, presentando un rango de seguimiento entre nueve y 33 meses. Resultados: 17 pertenecían al género masculino y 15 al género femenino; la edad media fue de 52 años con un rango de 26-80 años. A los 32 pacientes se les realizó una valoración del dolor previo a la cirugía (EVA) con promedio de 7.6 puntos y una valoración postquirúrgica de 1.2 puntos en promedio, teniendo una disminución significativa, la valoración radiográfica cualitativa por los cirujanos sin desarrollo de enfermedad de disco adyacente en ninguno de los casos, incluso en quienes fueron valorados por encima de los 20 meses del postquirúrgico. Complicaciones: una ruptura de tornillo transpedicular postraumática (3.1%), una reintervención quirúrgica por discopatía de L3-L4 (3.1%) y tres casos de infección de herida que remitió con antibioticoterapia (10%), el total de complicaciones correspondió a 15.6% y ninguna se encuentra asociada a la enfermedad del disco adyacente. Conclusiones: El sistema S14 (B-FUS) como tratamiento para la enfermedad degenerativa de la columna lumbar ha demostrado ser una opción terapéutica eficaz al disminuir el riesgo de desarrollar enfermedad del disco adyacente.

Abstract: Objective: To evaluate functional and radiographic results in patients with diagnosis of degenerative disease of the lumbar column subject to treatment with transpedicular fixing plus the application of system S14 (B-FUS), and to evaluate the disease development of adjacent disk associated with the method of selected treatment. Material and methods: A transversal descriptive retrospective study in which a total of 32 patients with diagnosis of the degenerative pathology of the column lumbar was included, including 12 patients with lumbar degenerative discopathy (37.50%), 11 patients intervertebral lumbar instability (34.38%), seven with narrow lumbar channel (21.88%) and two patients with adjacent discreet disorder disease (6.25%). Of the sample of 32 patients, 17 belong to the male gender and 15 to the female gender; the middle age of the group was 52 years old with a range of age (26-80 years). Patients operated in the period of January 2015 to December 2016 were included. The procedures were assigned and carry out randomly by two specialist surgeons in column with standardization of surgical technique. clinical and radiographic monitoring was performed by the external consultation of column surgery in the two weeks and after a monthly period during a period of at least nine months, presenting a monitoring range between nine and 33 months, with clinical and radiographic valuation. Results: 17 belonged to male gender and 15 to female gender; the average age was 52 years with a range of 26-80 years. To the 32 patients was performed an assessment of pain prior to surgery (eva) with an average of 7.6 Points and a post-surgical assessment of 1.2 Points on average, having a significant decrease, the qualitative radiographic evaluation by surgeons without development of adjacent disk disease in none of the cases even in those that were valued above 20 months after surgery. Complications: 1 rupture of transpedicular screw post-traumatic (3.1%), 1 Surgical reoperation by discopathy of l3-l4 (3.1%) and 3 cases of wound infection that remitted with antibiotic use (10%), the total complications corresponded to (15.6%) and none is associated with the disease of the adjacent disk. Conclusions: The s14 system (b-fus) in our series of cases as a treatment for degenerative lumbar spine disease has proven to be an effective therapeutic option by reducing the risk of disease development of the adjacent disk.

A Lotus japonicus E3 ligase interacts with the Nod Factor Receptor 5 and positively regulates nodulation.

BACKGROUND: Post-translational modification of receptor proteins is involved in activation and de-activation of signalling systems in plants. Both ubiquitination and deubiquitination have been implicated in plant interactions with pathogens and symbionts. RESULTS: Here we present LjPUB13, a PUB-ARMADILLO repeat E3 ligase that specifically ubiquitinates the kinase domain of the Nod Factor receptor NFR5 and has a direct role in nodule organogenesis events in Lotus japonicus. Phenotypic analyses of three LORE1 retroelement insertion plant lines revealed that pub13 plants display delayed and reduced nodulation capacity and retarded growth. LjPUB13 expression is spatially regulated during symbiosis with Mesorhizobium loti, with increased levels in young developing nodules. CONCLUSION: LjPUB13 is an E3 ligase with a positive regulatory role during the initial stages of nodulation in L. japonicus.

MicroRNA-199a is induced in dystrophic muscle and affects WNT signaling, cell proliferation, and myogenic differentiation.

In patients with Duchenne muscular dystrophy (DMD), the absence of a functional dystrophin protein results in sarcolemmal instability, abnormal calcium signaling, cardiomyopathy, and skeletal muscle degeneration. Using the dystrophin-deficient sapje zebrafish model, we have identified microRNAs (miRNAs) that, in comparison to our previous findings in human DMD muscle biopsies, are uniquely dysregulated in dystrophic muscle across vertebrate species. MiR-199a-5p is dysregulated in dystrophin-deficient zebrafish, mdx(5cv) mice, and human muscle biopsies. MiR-199a-5p mature miRNA sequences are transcribed from stem loop precursor miRNAs that are found within the introns of the dynamin-2 and dynamin-3 loci. The miR-199a-2 stem loop precursor transcript that gives rise to the miR-199a-5p mature transcript was found to be elevated in human dystrophic muscle. The levels of expression of miR-199a-5p are regulated in a serum response factor (SRF)-dependent manner along with myocardin-related transcription factors. Inhibition of SRF-signaling reduces miR-199a-5p transcript levels during myogenic differentiation. Manipulation of miR-199a-5p expression in human primary myoblasts and myotubes resulted in dramatic changes in cellular size, proliferation, and differentiation. MiR-199a-5p targets several myogenic cell proliferation and differentiation regulatory factors within the WNT signaling pathway, including FZD4, JAG1, and WNT2. Overexpression of miR-199a-5p in the muscles of transgenic zebrafish resulted in abnormal myofiber disruption and sarcolemmal membrane detachment, pericardial edema, and lethality. Together, these studies identify miR-199a-5p as a potential regulator of myogenesis through suppression of WNT-signaling factors that act to balance myogenic cell proliferation and differentiation.

Prader-Willi syndrome associated with fetal goiter: a case report.

We describe a unique case of a newborn with Prader-Willi syndrome who presented with fetal goiter as well as neonatal thyroid abnormalities, marked hypotonia, and thrombocytopenia. These new clinical observations may correlate with the uniparental monodisomy form of inheritance of this genetic condition.

A study of the association between epistaxis and the severity of hypertension.

Hypertension (HTN) has frequently been cited as a general risk factor for epistaxis. However, studies dealing with this association have yielded equivocal results. In this study, a sample of 121 hypertensives (blood pressure > or = 140/90 mmHg) was selected to evaluate the association between the severity of HTN and a previous history of epistaxis. Patients with an average blood pressure > or = 160/100 mmHg were classified as suffering from a more severe form of HTN and were compared with those with a less severe form of the disease (160/100 mm Hg < or = blood pressure > or = 140/90 mm Hg). The frequency of epistaxis did not differ among patients categorized by the severity of HTN. Users of aspirin were found to be twice as likely to have a history of epistaxis. In addition, there was a statistical tendency for an association between a history of epistaxis and the duration of hypertension. We conclude that the severity of HTN and a history of epistaxis were not associated in a cohort of hypertensive patients. The identification of other risk factors for epistaxis, including the duration of HTN, deserves further study.

Malaria y leishmaniasis cutanea en Ecuador: un estudio interdisciplinario: aspectos históricos, epidemiológicos, antropológicos, entomológicos y método de control / Malaria and cutaneous leishmaniasis in Ecuador: an interdisciplinary study: historical, epidemiological, anthropological aspects and entomological monitoring method

Parte A :Contexto y objetivos del estudio: las areas de trabajo. El contexto nacional y provincial del proyecto y los objetivos de estudio; Situacion socio-economica, ecologica y demografica de las areas de estudio. Parte B: La malaria y su control: Metodologia del estudio de la malaria. Historia de malaria en El Ecuador. La malaria en las Americas y Ecuador: los programas de control. Caracteristicas de los vectores. La epidemiologia de la malaria en las areas de estudio. el impacto economico y social de la malaria. Conceptos y actitudes de la poblacion frente a la malaria y los programas de control. Resultados de la intervencion educativa. Eficacia y efectividad de la impregnacion de mosquiteros con permetrin, del uso de repelentes y del BTI. Resumen del estudio de malaria y recomendaciones para los programas de control. Parte C: La leishmaniasis cutanea y su control: Metodologia del estudio de la leishmaniasis cutanea; epidemiologia de la leishmaniasis cutanea y alguns aspectos clinico-parasitologicos; Conceptos y actitudes de la poblacion frente a la leishmaniasis cutanea; Resutlados delensayo clinico con la pomada PR. (AU)

Effects on school children of prophylaxis of mothers with iodized oil in an area of iodine deficiency.

The results of tests of intellectual and psychomotor performance and school performance in a group of school children from a rural impoverished and iodine deficient Andean community whose mothers received injections of iodinated oil prior to the end of the first trimester of pregnancy have been compared with results in children from a neighboring comparable community whose mothers had received no iodinated oil. Subjects between ages 8 and 15 were studied. Statistically significant differences were not observed between the two groups in tests of intellectual function, but children of mothers who had received iodinated oil performed better on tests of psychomotor maturation. The group whose mothers had received oil performed distinctly better when assessed in terms of school drop-out rates, grades achieved, grades repeated, and in overall performance as judged by teacher notes in school records. Performance of both groups on standard tests of intellectual and psychomotor function was lower than standard scores. This may be a result of social and cultural deprivation, the general malnutrition prevailing in the region or other unidentified factors. The improved scoring and school performance exhibited by the children of mothers who received iodinated oil underlines the importance of prophylaxis with iodine in iodine deficient regions as one important contributor to community development.

Terapeutica grupal nos transtornos psicopatologicos

As reacoes individuais frente aos estimulos vivenciais quando destoantes da expectativa humana, de forma geral caracterizam o disturbio mental, do ponto de vista psicologico. Aos doentes mentais muito empenho se tem despendido no sentido de serem formuladas proposicoes dos mais variados planos de acao para o seu restabelecimento. Muitas variaveis, como o espaco fisico e equipe especializada, algumas vezes se tornam impossiveis de ser controladas na pratica, como requerem estas proposicoes, e por isso alguns planejamentos fantasticos apresentam resultados aquem do esperado. Por conhecermos as limitacoes que naturalmente nos seriam impostas, por trabalharmos em um hospital de modelo classico, procuramos adequar nossos anseios a realidade e partimos entao para uma concreta e possivel proposta de trabalho: nao modificariamos o ambiente fisico, nao requisitariamos cursos de treinamento dos funcionarios em contato constante com as pacientes e nem almejariamos um programa ideal de trabalho, mas procurariamos contar, acima de tudo, com a colaboracao das proprias doentes mentais. Fez-se o esquema: uma equipe com psiquiatra, psicologa e assistente social, reunioes semanais fornecendo explicacoes de nossas finalidades, palestras com temas socio-educativos, discussoes de grupo e ensaios comportamentais. Embasando tudo: a nossa crenca no potencial humano e o respaldo das tecnicas de modificacoes de comportamento. Ao fim de uma fase intensa de empenho, o resultado: muitas pacientes se tornaram mais bem preparadas para o convivio social, com remissao dos comportamentos que lhes exacerbavam os quadros da doenca mental e nos permitiam supor, inicialmente, maior gravidade e cronicidade dos disturbios. Comportamentos de higiene, responsabilidade, honestidade, sociabilidade e muitos outros passaram a integrar seus repertorios, e o que a nosso ver e mais fantastico: as mesmas doentes antes repulsivas a muitos, passaram a naturalmente fornecer modelos de conduta adequados, facilitando-nos assim a continuidade do programa e o treinamento da equipe de funcionarios. Como vimos, a simples atuacao de uma restrita equipe de trabalho, aliada ao potencial inerente do ser humano, mesmo quando adoecido, e a formulacao de um plano racional de trabalho, pode levar a recompensadores resultados. Isso e possivel.