MAPK11 (p38ß) is a major determinant of cellular radiosensitivity by controlling ionizing radiation-associated senescence: An in vitro study.

Background and purpose: MAPKs are among the most relevant signalling pathways involved in coordinating cell responses to different stimuli. This group includes p38MAPKs, constituted by 4 different proteins with a high sequence homology: MAPK14 (p38α), MAPK11 (p38ß), MAPK12 (p38γ) and MAPK13 (p38δ). Despite their high similarity, each member shows unique expression patterns and even exclusive functions. Thus, analysing protein-specific functions of MAPK members is necessary to unequivocally uncover the roles of this signalling pathway. Here, we investigate the possible role of MAPK11 in the cell response to ionizing radiation (IR). Materials and methods: We developed MAPK11/14 knockdown through shRNA and CRISPR interference gene perturbation approaches and analysed the downstream effects on cell responses to ionizing radiation in A549, HCT-116 and MCF-7 cancer cell lines. Specifically, we assessed IR toxicity by clonogenic assays; DNA damage response activity by immunocytochemistry; apoptosis and cell cycle by flow cytometry (Annexin V and propidium iodide, respectively); DNA repair by comet assay; and senescence induction by both X-Gal staining and gene expression of senescence-associated genes by RT-qPCR. Results: Our findings demonstrate a critical role of MAPK11 in the cellular response to IR by controlling the associated senescent phenotype, and without observable effects on DNA damage response, apoptosis, cell cycle or DNA damage repair. Conclusion: Our results highlight MAPK11 as a novel mediator of the cellular response to ionizing radiation through the control exerted onto IR-associated senescence.

Reconstrucción de párpado inferior mediante injerto de pericráneo y colgajo de Mustardé / Lower eyelid reconstruction with pericranium graft and Mustarde flap

Varón de 68 años que acude para valoración de un carcinoma basocelular con diferenciación escamosa en el párpado inferior izquierdo. Se realizó una resección con control de margen de sección congelada y el defecto (canto interno, dos tercios del párpado inferior y 2,5cm de la mejilla) fue reconstruido 2 días después de la cirugía en un solo acto quirúrgico: la lamela posterior con injerto de pericráneo y la anterior con un flap de Mustardé. Después de un año de seguimiento, el paciente tiene un aspecto aceptable, un buen soporte y posición palpebral, tejido vascularizado como el nativo en el párpado, sin recurrencia del tumor

We report the case of a 68-year-old man with a left lower eyelid basal cell carcinoma with squamous differentiation. Resection was performed under frozen section technique and the defect (inner canthus, two thirds of the lower eyelid and 2.5cm of the cheek) reconstructed 2 days after surgery in a single surgical operation: posterior lamella with pericranial graft and anterior lamella with Mustarde flap. After one year of follow-up, the patient has an adequate appearance, good eyelid support and position, vascularized tissue like the native eyelid and no tumor recurrence

Lower eyelid reconstruction with pericranium graft and Mustarde flap. / Reconstrucción de párpado inferior mediante injerto de pericráneo y colgajo de Mustardé.

We report the case of a 68-year-old man with a left lower eyelid basal cell carcinoma with squamous differentiation. Resection was performed under frozen section technique and the defect (inner canthus, two thirds of the lower eyelid and 2.5cm of the cheek) reconstructed 2 days after surgery in a single surgical operation: posterior lamella with pericranial graft and anterior lamella with Mustarde flap. After one year of follow-up, the patient has an adequate appearance, good eyelid support and position, vascularized tissue like the native eyelid and no tumor recurrence.

Sarcoma de Kaposi palpebral bilateral en un paciente virus de la inmunodeficiencia humana negativo / Bilateral eyelid Kaposi's sarcoma in an HIV-negative patient

CASO CLÍNICO: Un varón de 70 años, procedente de Sicilia, acude con una masa palpebral bilateral con afectación tarsal conjuntival, que resultó ser un sarcoma de Kaposi al examen histológico. Se demostró afectación cutánea y pulmonar por el sarcoma de Kaposi. El paciente no tenía un diagnóstico previo de infección por el virus de la inmunodeficiencia humana. Este caso fue tratado con éxito tras 5 ciclos de quimioterapia con doxorrubicina liposomal, con resolución de las lesiones palpebrales, cutáneas y pulmonares. Conclusiones: La localización en el párpado es una posible manifestación inicial, aunque rara, del sarcoma de Kaposi en personas de edad avanzada negativos para el virus de la inmunodeficiencia humana. La doxorrubicina liposomal es un tratamiento seguro y efectivo

CASE REPORT: We report a case of 70-year-old male from Sicily, who presented with a bilateral eyelid mass involving the tarsal conjunctiva, found to be Kaposi's sarcoma on histologic examination. Cutaneous and pulmonary Kaposi's sarcoma involvement was documented. The patient had no prior diagnosis of human immunodeficiency virus infection. This case was managed successfully after the completion of five cycles of chemotherapy with liposomal doxorubicin, and his eyelid, skin and pulmonary lesions disappeared. CONCLUSIONS: Location in the eyelid is a possible, though rare, initial solitary manifestation of Kaposi's sarcoma in elderly HIV-negative patients. Liposomal doxorubicin is a safe and effective treatment

Multiple sclerosis prevalence in Salta City, Argentina.

INTRODUCTION: Multiple Sclerosis (MS) is one of the leading causes of disability in young adults. Its prevalence varies according to different countries. In Argentina there is a wide heterogeneity regarding data published in different areas of the country. Prevalence established in most studies is 17 cases per 100,000 inhabitants; however, most of the available data comes from studies that took place in Buenos Aires. There is little or no information from other provinces, especially from Northwest of Argentina (NOA), where there are no studies of the disease prevalence. The aim of this study is to investigate MS prevalence, phenotypes and epidemiological characteristics in Salta, Argentina, in order to contribute to the current knowledge of MS epidemiology and distribution in our country. METHODS: A descriptive, observational, transversal study was carried out in the capital city of Salta. Researchers from all public and private hospitals with a Neurology Department have participated. Private researchers who are well known leaders in demyelinating diseases in the city provided valuable information. Patients who did not have medical control for the past two years as well as patients whose last address was not registered in Salta were excluded. RESULTS: 120 registries were obtained from the four hospitals that participated and from the 12 private researchers. Ten patients were excluded due to overlapping data. The population of the area based on 2010 census was 535,310, so we estimated an MS prevalence 23.8 cases per 100,000 inhabitants (95% CI 20.1-27.4), 24.1 cases per 100,000 inhabitants in female population (95% CI 21.2-28.6) and 18.2 cases per 100,000 inhabitants (95% CI 15.2-21.1) in male population. In our analysis, 64 (58.2%) were female and the average age was 42.1 years. 81.8% are recurrent remitting forms, 16.4% secondary progressive and 1.8% primary progressive. CONCLUSION: This is the first study that provides epidemiological data on the prevalence and clinical forms of MS in Salta City as well as in the entire Northwest Region of Argentina(NOA). We estimate a prevalence of 23.8 cases per 100,000 inhabitants, which establishes a moderate risk area for MS.

Historia breve de la cirugía de la cavidad anoftálmica y los implantes orbitarios / A brief history of the anophthalmic socket surgical technique and orbital implants

No disponible

Bilateral eyelid Kaposi's sarcoma in an HIV-negative patient. / Sarcoma de Kaposi palpebral bilateral en un paciente virus de la inmunodeficiencia humana negativo.

CASE REPORT: We report a case of 70-year-old male from Sicily, who presented with a bilateral eyelid mass involving the tarsal conjunctiva, found to be Kaposi's sarcoma on histologic examination. Cutaneous and pulmonary Kaposi's sarcoma involvement was documented. The patient had no prior diagnosis of human immunodeficiency virus infection. This case was managed successfully after the completion of five cycles of chemotherapy with liposomal doxorubicin, and his eyelid, skin and pulmonary lesions disappeared. CONCLUSIONS: Location in the eyelid is a possible, though rare, initial solitary manifestation of Kaposi's sarcoma in elderly HIV-negative patients. Liposomal doxorubicin is a safe and effective treatment.

[The severity of rheumatoid arthritis as a timely predictor of instability in the asymptomatic cervical spine]. / La severidad de la artritis reumatoide como predictor oportuno de inestabilidad de la columna cervical asintomática.

INTRODUCTION: Cervical spine involvement is common in patients with RA, risk factors such as disease activity may be related to asymptomatic cervical instability. OBJECTIVE: To determine the associated factors for asymptomatic cervical spine instability in patients with rheumatoid arthritis. MATERIAL AND METHODS: Case and control study from the external spine and rheumatology consultation of a level II trauma center to identify all patients diagnosed with rheumatoid arthritis (RA) and asymptomatic cervical instability. With simple X-rays of the cervical spine, carrying out radiographic measurements, the diagnosis of cervical instability was performed, risk factors such as the presence of rheumatoid factor (FR), previous articular surgeries, elevations of the C-reactive protein (PCR) values were evaluated. The severity and activity of the disease measured in the activity index of 28 articulations (DAS 28) in addition to the index of activity of the simplified disease (SDAI). RESULTS: We assessed 32 patients, nine patients (28.1%) met the criteria for instability of the anterior cervical spine atlantoaxial subluxation (SAAa) (100%), also one patient with SAAa presented vertical subluxation (SV), risk factors more relevant: DAS 28 with an OR = 3.54, SDA with an OR = 2.34 and finally the PCR 1.0 its OR = 2.88. CONCLUSION: The risk factors associated opportunely in our population are the severity of the activity of the disease that we can see in the DAS and SDAI when applied in patients and PCR 1.0.

INTRODUCCIÓN: La afectación de la columna cervical es común en pacientes con artritis reumatoide (AR), factores de riesgo como la actividad de la enfermedad puede estar relacionada con inestabilidad cervical asintomática. OBJETIVO: Determinar los factores asociados a la inestabilidad de la columna cervical asintomáticos en pacientes con artritis reumatoide. MATERIAL Y MÉTODOS: Estudio de casos y controles provenientes de la consulta externa de reumatología y columna de un centro de trauma de nivel II para identificar a todos los pacientes diagnosticados con AR e inestabilidad cervical asintomáticos. Con radiografías simples de la columna cervical que hacen mediciones radiográficas, se realizó el diagnóstico de inestabilidad cervical, se evaluaron los factores de riesgo como la presencia de factor reumatoide (FR), cirugías articulares previas, las elevaciones de los valores de proteína C reactiva (PCR), la severidad y actividad de la enfermedad medida en el índice de actividad de la enfermedad de 28 articulaciones (DAS 28), además del índice de actividad de la enfermedad simplificada (SDAI). RESULTADOS: Se evaluaron 32 pacientes, nueve (28.1%) cumplieron con los criterios para inestabilidad de la columna cervical con subluxación atlantoaxial anterior (SAAa) (100%), también un paciente con SAAa presentaba subluxación vertical (SV), los factores de riesgo más relevantes: el DAS 28 con un OR = 3.54, SDA con un OR = 2.34 y por último el PCR 1.0 su OR = 2.88. CONCLUSIÓN: Los factores de riesgo asociados oportunamente en nuestra población son la severidad de la actividad de la enfermedad que podemos observar en el DAS y SDAI al aplicarlos en los pacientes y PCR 1.0.

Datos Fisiológicos de Baja California: PhysioBC, Resultados en Electrocardiografía 1 / Physiological Data of Baja California: PhysioBC, Electrocardiographic Results 1

Resumen: En la actualidad, el contar con una base de datos que represente fisiológicamente a una región o estado de la república conlleva un esfuerzo en conjunto entre diversas instituciones. Debido a su inexistencia, los investigadores recurren a bases de datos extranjeras organizadas para el desarrollo de estudios. Un ejemplo es el desarrollo de algoritmos matemáticos de detección de patologías en relación a individuos con una población y una forma de vida diferente a la nuestra. PhysioBC®, tiene como objetivo difundir libremente datos fisiológicos adquiridos en la población de Baja California, a fin de que se desarrollen modelos precisos de detección de patologías acorde a la genética y forma de vida de nuestra comunidad. En este trabajo presentamos los pasos de creación de su primera sección de datos electrocardiográficos, debido a que los datos reportados por el INEGI en 2012, de las 14,756 muertes, el 19% tenían origen cardiovascular. Actualmente se cuenta con 50 registros tomados en la industria maquiladora de Mexicali y 64 tomados en voluntarios. Estos se dividen en estándar de 12 derivaciones y de alta resolución de 3 derivaciones. Todos ellos se encuentran libres para su descarga en diversos formatos en la misma plataforma PhysioBC®.

Abstract: Currently, having a database that represents physiologically a region or state of the republic involves a joint effort among research and clinical institutions. Due to their non-existence, researchers normally use foreign international databases organized for research purposes. One example is the development of mathematical algorithms for detecting pathologies in individuals with a population who have a different way of living than ours. PhysioBC®, aims to freely disseminate physiological data acquired in the population of Baja California, in order to develop precise models of pathology detection according to the genetics and way of living of our community. Because the data reported by INEGI in 2012, out of the 14,756 deaths, 19% had cardiovascular origin problems, in this paper, we present the steps of creating PhysioBC® first section, called electrocardiographic data. Currently we have 50 records taken in the manufacturing industry of Mexicali and 64 taken in volunteers. The records are divided into standard 12-lead and high-resolution 3-lead. All of them are free for download in different formats at PhysioBC® website.

Revascularización mediante aterectomía direccional en isquemia crítica de miembro inferior. Primera experiencia ecuatoriana / Revascularization through directional atherectomy in critical inferior limb ischemia: first Ecuadorian experience

Introducción: La aterectomía direccional es una técnica mínimamente invasiva que puede ser utilizada para evitar la amputación de los miembros inferiores en caso de isquemia crítica. Caso: Se presenta la primera experiencia en Ecuador, realizada en una paciente diabética e insuficiente renal. Este procedimiento logró repermeabilizar el segmento femoropoplíteo izquierdo con éxito. Discusión: La aterectomía direccional es una alternativa eficaz, mínimamente invasiva, para evitar la amputación de miembros inferiores en pacientes isquemia crítica y múltiples comorbilidades. Palabras clave: Aterectomía, isquemia, miembro inferior, pie diabético.

Introduction: Directional atherectomy is a minimally invasive technique that can be used to avoid lower limb amputation due to critical ischemia. Case report: This is the first experience in Ecuador, using this technique in a diabetic patient with chronic renal failure. The procedure achieved successful recanalization of the left femoropopliteal artery. Discusion: Directional atherectomy seems to be an alternative to avoid limb amputation in patients with critical ischemia and several comorbidities.

Lesiones y variantes normales de la rodilla pediátrica / Injuries and normal variants of paediatric knee

Abstract. Knee pathology is a reason for consultation and prevalent condition in children, making it important to know the normal variants as well as the most frequent pathologies. This review includes a brief description of the main pathologies and normal variants that affect the knee in children, with their main clinical features, as well as the findings described in the various, most-used, imaging techniques (X-ray, ultrasound, computed tomography, and magnetic resonance (MR).

Resumen. La patología de rodilla es un motivo de consulta y una entidad prevalente en la edad pediátrica, razón por la cual es importante conocer tanto las variantes normales como las patologías más frecuentes. En esta revisión se realiza una breve descripción de las principales patologías y variantes normales que afectan a la rodilla en la edad pediátrica, tanto de sus características clínicas principales como de los hallazgos descritos en las distintas modalidades de imagen más utilizadas (radiografía, ecografía, tomografía computarizada y resonancia magnética (RM).

Las emergencias extrahospitalarias ante la cultura de seguridad / Out of hospital emergencies towards a safety culture

Objetivos. Estudiar el grado de cultura de seguridad (CS) de los profesionales en el ámbito de un servicio de urgencias extrahospitalarias. Analizar las dimensiones que reciben puntuaciones inferiores, con el fin de establecer futuras estrategias de actuación. Material y métodos. Estudio observacional, descriptivo, transversal en el que se distribuyó el cuestionario de la Agency for Healthcare Research and Quality (AHRQ) al universo muestral de los profesionales sanitarios que trabajan en las unidades de soporte vital avanzado del 061 de Aragón, durante el mes de agosto de 2013. Resultados. Se analizaron 80 cuestionarios (tasa de respuesta 55,55%). Principales fortalezas: adecuada dotación de personal (96%), buen clima laboral (89%), apoyo de superiores inmediatos (77%), trabajo en equipo (74%) y ambiente no punitivo hacia los eventos adversos (68%). Áreas de mejora: insuficiente formación en seguridad del paciente (53%), ausencia de feedback (50%). Conclusiones. Las oportunidades de mejora detectadas se centran en la formación de los profesionales, con el fin de procurar una asistencia más segura, extendiendo al mismo tiempo la cultura de seguridad. Así mismo se considera necesaria la puesta en marcha de un sistema de notificación y registro de eventos adversos en nuestro servicio (AU)

Objectives. The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. Material and methods. A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. Results. The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). Conclusions. The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary (AU)

[Out of hospital emergencies towards a safety culture]. / Las emergencias extrahospitalarias ante la cultura de seguridad.

OBJECTIVES: The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. MATERIAL AND METHODS: A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. RESULTS: The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). CONCLUSIONS: The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary.

Parkin loss of function contributes to RTP801 elevation and neurodegeneration in Parkinson's disease.

Mutations in the PARK2 gene are associated with an autosomal recessive form of juvenile parkinsonism (AR-JP). These mutations affect parkin solubility and impair its E3 ligase activity, leading to a toxic accumulation of proteins within susceptible neurons that results in a slow but progressive neuronal degeneration and cell death. Here, we report that RTP801/REDD1, a pro-apoptotic negative regulator of survival kinases mTOR and Akt, is one of such parkin substrates. We observed that parkin knockdown elevated RTP801 in sympathetic neurons and neuronal PC12 cells, whereas ectopic parkin enhanced RTP801 poly-ubiquitination and proteasomal degradation. In parkin knockout mouse brains and in human fibroblasts from AR-JP patients with parkin mutations, RTP801 levels were elevated. Moreover, in human postmortem PD brains with mutated parkin, nigral neurons were highly positive for RTP801. Further consistent with the idea that RTP801 is a substrate for parkin, the two endogenous proteins interacted in reciprocal co-immunoprecipitates of cell lysates. A potential physiological role for parkin-mediated RTP801 degradation is indicated by observations that parkin protects neuronal cells from death caused by RTP801 overexpression by mediating its degradation, whereas parkin knockdown exacerbates such death. Similarly, parkin knockdown enhanced RTP801 induction in neuronal cells exposed to the Parkinson's disease mimetic 6-hydroxydopamine and increased sensitivity to this toxin. This response to parkin loss of function appeared to be mediated by RTP801 as it was abolished by RTP801 knockdown. Taken together these results indicate that RTP801 is a novel parkin substrate that may contribute to neurodegeneration caused by loss of parkin expression or activity.