Graphene oxide increases the viability of C2C12 myoblasts microencapsulated in alginate.

Cell microencapsulation represents a great promise for long-term drug delivery, but still several challenges need to be overcome before its translation into the clinic, such as the long term cell survival inside the capsules. On this regard, graphene oxide has shown to promote proliferation of different cell types either in two or three dimensions. Therefore, we planned to combine graphene oxide with the cell microencapsulation technology. We first studied the effect of this material on the stability of the capsules and next we analyzed the biocompatibility of this chemical compound with erythropoietin secreting C2C12 myoblasts within the microcapsule matrix. We produced 160 µm-diameter alginate microcapsules with increasing concentrations of graphene oxide and did not find modifications on the physicochemical parameters of traditional alginate microcapsules. Moreover, we observed that the viability of encapsulated cells within alginate microcapsules containing specific graphene oxide concentrations was enhanced. These results provide a relevant step for the future clinical application of graphene oxide on cell microencapsulation.

Cystic adventitial disease of the popliteal artery: Two case reports and a review of the literature.

Two cases of cystic adventitial disease treated at our institution over the last year are presented. They were middle-aged and apparently healthy patients, and the symptoms begin with a sudden onset of unilateral claudication. After performing a magnetic resonance angiography, a cystic formation attached to the adventitia of the popliteal artery was identified. Both patients were treated in the same manner, with resection of the affected arterial segment and vein bypass interposition. Both remain asymptomatic after one year of follow-up in one case and six months in the other. Cystic adventitial disease is a rare entity, which presents in patients without cardiovascular risk factors, so sometimes it takes long to reach a definitive diagnosis. Concerning the different treatment options, cyst excision together with the affected arterial segment seems to offer better mid- and long-term results when compared with other treatment options such as cyst aspiration or endovascular techniques, although there are no multicenter trials evidencing the superiority of one against the others.

SU-8 microprobe with microelectrodes for monitoring electrical impedance in living tissues.

This paper presents a minimally invasive needle-shaped probe capable of monitoring the electrical impedance of living tissues. This microprobe consists of a 160 microm thick SU-8 substrate containing four planar platinum (Pt) microelectrodes. We design the probe to minimize damage to the surrounding tissue and to be stiff enough to be inserted in living tissues. The proposed batch fabrication process is low cost and low time consuming. The microelectrodes obtained with this process are strongly adhered to the SU-8 substrate and their impedance does not depend on frequency variation. In vitro experiments are compared with previously developed Si and SiC based microprobes and results suggest that it is preferable to use the SU-8 based microprobes due to their flexibility and low cost. The microprobe is assembled on a flexible printed circuit FPC with a conductive glue, packaged with epoxy and wired to the external instrumentation. This flexible probe is inserted into a rat kidney without fracturing and succeeds in demonstrating the ischemia monitoring.

Endovascular treatment of splenic and renal aneurysms.

Four cases (three women and one man) of embolization of visceral artery aneurysms are presented, of which two affected the splenic artery and two the renal artery. The two renal aneurysms were related to hypertension; one of the splenic aneurysms was diagnosed in the context of hypertension, and the other affected a woman of a fertile age. Microguides, microcatheters, and Guglielmi platinum coils, liberated by electrolysis, with different lengths and characteristics, were used. Also, one of the renal aneurysm cases was related to the placing of a stent due to the existence of a stenosis of the renal artery adjacent to the aneurysmatic neck. Immediate occlusion of the aneurysm was achieved in the four cases. Evaluation with nuclear magnetic resonance angiography carried out 3 months later confirmed the sealing of the aneurysm and the patency of the native artery. Currently available devices provide a good therapeutic option for the embolization of visceral aneurysms with low morbidity and mortality rates.

Encuesta epidemiológica sobre la insuficiencia venosa crónica en España: estudio DETECT-IVC 2006 / An epidemiological survey on chronic venous insufficiency in Spain: the DETECT-IVC 2006 study

Introducción. Se ha desarrollado el estudio DETECT-IVC 2006, con los objetivos de verificar los elevados datosde prevalencia de insuficiencia venosa crónica (IVC) obtenidos en la encuesta DETECT-IVC del año 2000 y comprobar si seha modificado el patrón del tratamiento de esta patología entre los médicos de atención primaria (AP). Sujetos y métodos.Se ha realizado una encuesta con fines epidemiológicos, de tipo transversal, que debía incluir 16.770 sujetos que acudíanpor cualquier motivo a una consulta de AP. Participaron como investigadores 1.118 médicos de AP, con 37 coordinadores especialistasen Angiología y Cirugía Vascular. Se ha seguido con cada paciente el protocolo del estudio. Resultados. El 71%refería algún síntoma o signo dependiente de la IVC, especialmente la pesadez de piernas y las varículas. Un 62% de los encuestadospresentaban algún tipo de signo de IVC en el examen físico. Se identificaron úlceras cutáneas en un 2% de los examinados.Un 38% de los sujetos se encontraba dentro de los grupos del 2 al 6 de la clasificación CEAP, y un 88% de sujetossalían de la cita con tratamiento. Conclusión. Los resultados de la encuesta confirmaron la elevada prevalencia de la IVC enEspaña, muy superior a las cifras comunicadas por los estudios referenciales. En los seis años transcurridos entre uno y otroestudio ha variado el patrón de tratamiento de la IVC por los médicos de AP, que han incrementado las recomendaciones delas diversas terapias, adecuándolas a los estadios evolutivos de la enfermedad

Introduction. The DETECT-IVC 2006 study was developed with the aim of verifying the high figures for theprevalence of chronic venous insufficiency (CVI) that were obtained in the DETECT-IVC survey carried out in the year2000 and to determine whether any modifications have been made to the pattern of treatment of this condition employedby primary care (PC) physicians. Subjects and methods. A cross-sectional epidemiological survey was carried outinvolving 16,770 subjects who visited a PC clinic, regardless of the reason for doing so. The researchers who took partin the survey were 1,118 PC physicians, with 37 coordinators who were specialised in Angiology and Vascular Surgery.The study protocol was followed in the case of each patient. Results. Seventy-one per cent reported some CVI-relatedsymptom or sign, the most frequent being heaviness in the legs and variculae. In the physical examination 62% of therespondents presented some sign of CVI. Skin ulcers were identified in 2% of those submitted to examination. Thirtyeightper cent of the subjects belonged to groups 2 to 6 in the CEAP classification and 88% of the subjects left the visitwith some kind of treatment. Conclusions. The results of the survey confirm the elevated prevalence of CVI in Spain,which is much higher than the figures reported in the reference studies. In the six years separating the two studies,changes have taken place in the pattern of treatment of CVI by PC physicians, who have increased the recommendationsof the different therapies in order to adapt them to the different stages of the progression of the disease

Controversias en las úlceras de las extremidades inferiores / Controversial issues regarding lower extremity ulcers

No disponible

Búsqueda de neoplasia oculta asociada a trombosis venosa profunda idiopática / Screening of hidden neoplasm in idiophatic deep venous thrombosis

Introducción. La dificultad de cualquier programa de detección de patología oculta estriba en encontrar una prueba diagnóstica sensible, específica, inocua y barata. Objetivo. Evaluar la eficacia diagnóstica de un protocolo diagnóstico (concreto) de cáncer oculto en pacientes ingresados por trombosis venosa profunda (TVP) idiopática. Pacientes y métodos. Estudio prospectivo sobre 209 pacientes consecutivos, con edad igual o menor a 80 años, diagnosticados de TVP idiopática mediante técnicas de imagen, entre enero 1995 y diciembre 1999. La distribución por sexos fue: 128 varones y 81 mujeres. Realizamos una búsqueda de neoplasia oculta ampliando el protocolo básico (historia clínica y pruebas diagnósticas básicas) mediante ecografía abdominopélvica y marcadores biológicos tumorales. El seguimiento clínico (repitiendo pruebas diagnósticas si era necesario) se llevó a cabo a los 3, 6, 12 y 24 meses (media: 21,2 meses), se produjeron 11 pérdidas de seguimiento (5,6 por ciento). Resultados. Se encontraron 14 neoplasias ocultas (6,7 por ciento). Seis presentaban algún síntoma o signo clínico de sospecha. El primer signo de alarma fue: ecografía en 6 casos, marcadores tumorales positivos en 6 ( 3 prostáticos, 2 CEA, Ca 195 y uno Ca 19,9, Ca 125) y radiografía de tórax en 2. Ocho de 14 (57,14 por ciento) con enfermedad metastásica al diagnóstico. Falsos positivos: 3 ecografías y 12 marcadores tumorales sin tumor en investigación posterior o seguimiento. En el seguimiento, solo un tumor no fue detectado inicialmente. Conclusiones. El porcentaje de tumores detectados (6,7 por ciento) y de tumores en estadio temprano (43,8 por ciento) justifica el protocolo diagnóstico establecido de cáncer oculto. La sensibilidad del protocolo diagnóstico fue del 93,33 por ciento (14/15). Casuísticas más amplias podrían acotar la sistemática futura en la investigación de tumores ocultos asociados a TVP idiopática (AU)

Cirugía de reducción de volumen pulmonar en el enfisema severo. controversias técnicas / Lung volume reduction surgery in severe emphysema. Technical controversies

La cirugía de reducción de volumen pulmonar es una alternativa al tratamiento médico y de rehabilitación en el enfisema pulmonar difuso en pacientes seleccionados. En este trabajo se hace una revisión de los aspectos técnicos de la intervención, concluyéndose en que la utilización de suturas mecánicas superan al láser. El abordaje bilateral ofrece mayor mejoría funcional que el abordaje unilateral, con una morbimortalidad similar. La indicación de reducción de volumen unilateral quedaría limitada a la afectación enfisematosa unilateral o a la contraindicación del abordaje bilateral por la pleurodesis o toracotomías previas contralaterales. La cirugía videotoracoscópica es un abordaje por lo menos tan efectivo como la esternotomía media para la reducción de volumen bilateral, siendo la elección de uno u otro método variable respecto a la experiencia de cada grupo. El refuerzo de la línea de sutura puede tener un papel en la reducción de las fugas aéreas, principal complicación en este tipo de cirugía (AU)

[Eating disorders]. / Trastornos de la conducta alimentaria. Revisión y actualización.

At the present time, research into Eating Disorders is being carried out in very different areas: clinical and diagnostic, epidemiological, comorbidity, aetiopathogeny, treatment and forms of care. This paper reviews this type of pathology, and aims to update the most important data in the different fields. The epidemiological studies of recent decades would indicate a considerable increase in the rates of incidence and prevalence of both Nervous Anorexia and Nervous Bulimia. On the other hand, there is increasing confirmation of an early appearance of these disorders. Similarly, the discovery of certain physiopathological appetite markers and/or regulators opens a new path for understanding this phenomenon. Research into these problems has reached a certain consensus in aspects such as: a multidimensional consideration of the ethiopathogeny, increasingly purified diagnostic criteria, care and therapeutic procedures and resources to be used in treatment.

[Pulsatile perineal hematoma after transrectal prostatic biopsy]. / Hematoma perineal pulsátil tras biopsia prostática transrectal.

OBJECTIVE: A case of pulsatile perineal hematoma following transrectal biopsy of the prostate is presented. METHODS: A patient who had undergone transrectal biopsy of the prostate a few days earlier complained of a pulsatile sensation in the perineal region caused by a pseudoaneurysm of a left hypogastric artery. Patient evaluation included echo Doppler, pelvioabdominal CT and arteriography. Transcatheter intraarterial embolization with Gianturco-Wallace coils was performed. RESULTS: Excellent results were achieved. Filling of the aneurysm was immediately reduced and symptoms disappeared. CONCLUSION: This technique is gaining importance in the treatment of pelvic hemorrhage because it is relatively simple and carries a low morbidity and mortality.

[Legal disability in patients with mental disorders]. / La incapacidad laboral en pacientes con trastornos psíquicos.

This article offers an approach to the present juridical situation of the processes of occupational incapacity - in the contributive and non-contributive types - for patients with psychological disorders, taking into account the wide range of nuances that this implies. Finally, some verdicts of the Spanish Superior Court of Justice are added, in order to illustrate the present situation about the jurisprudence referring to permanent contributive incapacity.