Pharmacogenetic studies in Alzheimer disease.

INTRODUCTION: Alzheimer disease (AD) is the most common cause of dementia and is considered one of the main causes of disability and dependence affecting quality of life in elderly people and their families. Current pharmacological treatment includes acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine; however, only one-third of patients respond to treatment. Genetic factors have been shown to play a role in this inter-individual variability in drug response. DEVELOPMENT: We review pharmacogenetic reports of AD-modifying drugs, the pharmacogenetic biomarkers included, and the phenotypes evaluated. We also discuss relevant methodological considerations for the design of pharmacogenetic studies into AD. A total of 33 pharmacogenetic reports were found; the majority of these focused on the variability in response to and metabolism of donepezil. Most of the patients included were from Caucasian populations, although some studies also include Korean, Indian, and Brazilian patients. CYP2D6 and APOE are the most frequently studied biomarkers. The associations proposed are controversial. CONCLUSIONS: Potential pharmacogenetic biomarkers for AD have been identified; however, it is still necessary to conduct further research into other populations and to identify new biomarkers. This information could assist in predicting patient response to these drugs and contribute to better treatment decision-making in a context as complex as ageing.

Botulismo infantil: casuística en 10 años en un hospital de tercer nivel / Infant botulism: casuistries in 10 years in a tertiary hospital

INTRODUCCIÓN: El botulismo infantil es una enfermedad infecciosa rara y potencialmente mortal. Consiste en un síndrome neuroparalítico producido por la acción de la toxina de Clostridium botulinum. Afecta principalmente a menores de un año y la gravedad es variable. El primer caso fue descrito en 1976 y desde entonces se han sucedido los casos; no obstante, su incidencia está probablemente infrestimada. CASOS CLÍNICOS. En este estudio se describe una serie de casos de botulismo infantil en un hospital de tercer nivel español durante el periodo de 2008 a 2018. Se han analizado las características clínicas, diagnósticas y terapéuticas. Además, se ha realizado una revisión de la literatura sobre esta enfermedad

INTRODUCTION: Infant botulism is a rare and life-threatening infectious disease. It consists of neuroparalytic syndrome resulting from the action of a neurotoxin elaborated by the bacterium Clostridium botulinum. It mainly affects children under one year of age, and the severity is variable.The first case was described in 1976 and since then, more cases have been described. However, its incidence is probably underestimated. CLINICAL CASES. This study describes a series of cases of infant botulism in a spanish third level hospital during the period from 2008 to 2018. The clinical, diagnostic and therapeutic features of each one have been analyzed. In addition, a review of the literature on this disease has been carried out

Influencia de las intervenciones realizadas durante el parto en la duración de la lactancia materna / Influence of the interventions during labour on breastfeeding duration

Objetivo: Analizar la influencia de diferentes intervenciones clínicas realizadas durante el parto sobre el inicio y mantenimiento de la lactancia materna (LM) a los 4, 6 y 12 meses. Método: Estudio observacional prospectivo. Se llevó a cabo en el Hospital do Salnés de Vilagarcía de Arousa (Pontevedra). La población de estudio fueron mujeres que dieron a luz entre marzo y diciembre de 2016 con intención de amamantar. Se realizó seguimiento de la muestra durante 12 meses o hasta abandonar la LM. La variable de resultado fue la duración total de la LM. Las variables independientes fueron una serie de intervenciones frecuentes en el proceso perinatal. También se analizó el efecto acumulativo negativo de dichas intervenciones sobre la LM. Resultados: Se obtuvo una muestra de 189 mujeres. El tiempo de LM mediano fue de 12 meses en el grupo sin intervenciones, de 10 meses en el grupo de 1-3 intervenciones y de 5 en el grupo de 4 o más intervenciones, siendo las diferencias estadísticamente significativas (p= 0,014). Los eventuales factores de confusión o ajuste se estudiaron mediante análisis multivariante. Cabe destacar el efecto positivo de no utilizar la epidural para conseguir una LM que se mantenga hasta los 12 meses ( odds ratio 2,1; p= 0,03). Conclusiones: Es necesario un mayor esfuerzo por parte de las instituciones para capacitar y sensibilizar al personal sanitario en cuanto a las normas y prácticas relacionadas con la atención amigable a la madre, así como dar a conocer el efecto acumulativo negativo de las intervenciones realizadas en el parto. Las mujeres que necesiten múltiples intervenciones durante el parto podrían precisar ayuda suplementaria para mejorar sus resultados en la LM

Objective: To evaluate the influence of different clinical procedures (operations) during labour on the beginning and maintenance of breastfeeding at 4, 6 and 12 months. Method: An observational-prospective study was carried out at the Salnés Hospital (Vilagarcía de Arousa, Pontevedra). The study population were women who had given birth between March and December 2016 and had the intention of breastfeeding their babies. The sample of 189 women were followed for 12 months or until breastfeeding was ceased. The result variable was the total length of breastfeeding. Independent variables were a series of frequent procedures during labour. The negative accumulative effect on breastfeeding was also analysed. Results: The average breastfeeding time was 12 months in the group undergoing no procedures, 10 months in the group undergoing 1-3 procedures and 5 months in the group undergoing 4 or more procedures. The statistical differences are significant (p= 0.014). The potential confusion or adjustment factors were analysed by means of multivariate analysis. It is worth highlighting the positive effect of not using the epidural to achieve an LM that is maintained until 12 months (odds ratio 2.1; p= 0.03). Conclusions: A greater effort is necessary on behalf of the institutions to not only train and sensitize their staff about the guidelines and practice related to offering kind care to the mother, but also making them aware of the negative accumulative effect of the procedures carried out during labour. Women who undergo several procedures during labour may need extra support in order to improve their breastfeeding results

Next generation sequencing for rapid diagnosis of a rare early onset spastic paraplegia: A novel pathological variant in FA2H gene / Secuenciación de nueva generación para el diagnóstico rápido de una paraparesia espástica rara de aparición infantil: nueva variante patológica en el gen FA2H

Introduction: Hereditary spastic paraplegia is a group of inherited neurological disorders with predominant manifestations of lower extremity weakness and severe spasticity. This is a genetically heterogeneous disorder very difficult to distinguish clinically with many genes described. Few patients with this condition have been previously reported. Patient and methods: We present a case of a 5 years old girl, born from consanguineous parents, with severe ataxia and progressive spasticity of low limbs. Due to the severity of the symptoms and the need for early diagnosis, next generation sequencing study of 37 genes implicated in spastic paraplegia was performed. Results: A novel pathological variant in FA2H gene was discovered. Father, mother and brother were heterozygous carriers. Conclusions: Spastic paraplegia due to mutations in FA2H is an under diagnosed condition, and it should always be considered in childhood onset of progressive pyramidal dysfunction. Next Generation Sequencing allows a simultaneous analysis of many genes, enables a fast diagnosis in complex disorders

Introducción: La paraparesia espástica es un grupo de enfermedades neurológicas hereditarias que cursan con debilidad de las extremidades inferiores y espasticidad severa. Es una enfermedad muy heterogénea, con muchos genes descritos y muy difícil de distinguir clínicamente. Hay pocos pacientes descritos con esta enfermedad. Pacientes y métodos: Se presenta un caso de una niña de 5 años, de padres consanguíneos, con una ataxia severa y espasticidad progresiva de los miembros inferiores. Dada la gravedad de la clínica y la necesidad de un diagnóstico temprano, se decide realizar un panel de secuenciación masiva de 37 genes implicados en paraparesia espástica. Resultados: Los resultados muestran una variante patológica no descrita previamente en el gen FA2H. El padre, la madre y el hermano resultan portadores heterocigotos. Conclusiones: La paraparesia espástica debida a mutaciones en el gen FA2H está infradiagnosticada y debería ser considerada siempre que aparezcan síntomas en la infancia de disfunción piramidal grave y progresiva. Los paneles de secuenciación masiva con el análisis simultáneo de varios genes están permitiendo un diagnóstico más rápido en enfermedades complejas

Valoración subjetiva de los padres en el manejo de las bronquiolitis / Subjective assessment of parents on the management of bronchiolitis

Introducción: Numerosos estudios concluyen que no hay diferencias significativas entre los distintos aerosoles utilizados en el tratamiento de las bronquiolitis. Sin embargo, en protocolos recientes, la adrenalina ha demostrado mayor eficacia que el placebo y los beta-2 agonistas a corto plazo, con una mejoría en los síntomas en los primeros 60 minutos. Objetivos: Demostrar que el uso de adrenalina nebulizada en los pacientes ingresados por bronquiolitis produce una mejoría subjetiva percibida por los cuidadores (en calidad del sueño, ingesta y estado general) e interfiere en los días de ingreso, respecto al uso de suero salino fisiológico (SSF). Pacientes y métodos: Estudio experimental, prospectivo, aleatorizado y simple ciego, en el que se incluyeron lactantes menores de 12 meses ingresados en nuestro hospital entre el 15 de octubre de 2015 y el 31 de marzo de 2016. Resultados: La muestra final fue de 58 niños, un 62% varones. La mediana de edad al ingreso fue de 2 meses (rango intercuartílico: 3), el 62% recibió adrenalina y el 38% SSF. No se hallaron diferencias en el número de días de oxigenoterapia ni en el de días de ingreso entre ambos grupos. Respecto a la apreciación de los padres sobre la ingesta, el sueño y el estado general, no encontramos diferencias estadísticamente significativas entre ambos aerosoles. Conclusiones: El uso de adrenalina no produce una mejoría subjetiva percibida por los cuidadores frente al uso de SS

Introduction: Several studies have concluded that there are no significant differences between the different aerosols used in the treatment of bronchiolitis. However, in recent protocols epinephrine has shown more short-term efficiency than the placebo and beta2-agonists, with an improvement of symptoms within the first 60 minutes. Objectives: To prove that the use of nebulized epinephrine in patients admitted with bronchiolitis leads to a subjective improvement as perceived by caregivers (regarding quality of sleep, food intake and general state of health) and that it affects the days of hospitalization, compared with the use of physiological saline solution (PSS). Patients and methods: Experimental, prospective, randomized, single-blind study. It includes breastfed babies <12 months old who were admitted in our hospital from 15th October 2015 to 31st March 2016. Results: 58 patients, 62% male in total. The median age at admission was 2 months (interquartile range 3). 62% received epinephrine and 38% were given PSS. No differences were found regarding the days of oxygen therapy or the days of admission between both groups. With regard to the parents' assessment of food intake, sleeping and general state of health, we did not find statistically significant differences between different aerosols. Conclusions: The use of epinephrine does not lead to a subjective improvement perceived by the caregivers compared with the use of PSS

Criterios de armonía funcional entre gastronomía y salud: una visión desde la comunidad científica / Functional harmony criteria between gastronomy and health: the scientific community vision

Introducción: en los últimos años ha habido un incremento en el número de estudios que evalúan cambios nutricionales en los alimentos debidos al cocinado. No obstante, la mayoría de ellos se refieren a experimentos muy específicos, generalmente con alimentos vegetales, y no extrapolables a otros grupos de alimentos. Objetivos: el objetivo es resumir la evidencia disponible sobre técnicas culinarias habituales y más adecuadas para diseñar "dietas saludables", conciliando el adecuado aporte nutricional con el valor gastronómico y el mantenimiento de las propiedades organolépticas. Métodos: se realizó un análisis bibliográfico de los artículos publicados sobre la asociación entre las técnicas culinarias más habituales y el cambio en el valor nutritivo de los alimentos, en español e inglés y sin restricción de fecha. Resultados: las técnicas culinarias mejor estudiadas y descritas, en cuanto a fundamentos y a efectos generales sobre el valor nutricional de los alimentos, son las técnicas de cocción realizadas en medio húmedo, en medio seco y mixtas, con sus diferentes modalidades. En las pérdidas reales de nutrientes en un alimento específico, intervienen múltiples factores, principalmente el binomio tiempo-temperatura, pero también el tipo y el estado del alimento, la manipulación previa y el método de cocción. Hasta el momento, la forma más precisa de calcular estas pérdidas nutricionales es aplicar factores de retención de nutrientes establecidos por convenio según grupos de alimentos y técnicas culinarias. Conclusiones: los estudios de revisión y actualización del conocimiento de los diferentes métodos culinarios más comúnmente empleados, así como los de otros más innovadores, son fundamentales y deberían llevarse a cabo regularmente para asegurar una mejora continua de la calidad, tanto nutricional como gastronómica, de las diferentes elaboraciones

Introduction: in recent years, there has been an increase in the number of studies evaluating how cooking affects the nutrient content of foods. However, most of them refer to very specific experiments usually with vegetable foods, which cannot be extrapolated to other food groups. Objectives: the objective is to summarize the available evidence on typical and most suitable culinary techniques for designing healthy diets, reconciling an adequate nutritional contribution with the gastronomic value and the maintenance of the organoleptic properties. Methods: an analysis was conducted of articles published on the association between the most common cooking methods and changes in the nutritional value of the food, without year restriction. Results: culinary techniques best studied and described, are moist heat, dry heat and mixed heat cooking methods, with their different modalities. Real nutrient losses in a specific food are associated to multiple factors, mainly the time-temperature binomial, but also the type and state of the food, the previous manipulation and the cooking method itself. So far, the most accurate way to calculate these nutrient losses is to apply the nutrient retention factors established by agreement, according to food groups and culinary methods. Conclusions: updated reviews on the knowledge of the most commonly used cooking methods, as well as more innovative ones, are essential and should be carried out regularly, so that they serve as a reference that ensures a continuous improvement of the quality, both nutritional and gastronomic, of the different elaborations

Pharmacogenetic studies in Alzheimer disease. / Estudios farmacogenéticos en la enfermedad de Alzheimer.

INTRODUCTION: Alzheimer disease (AD) is the most common cause of dementia and is considered one of the main causes of disability and dependence affecting quality of life in elderly people and their families. Current pharmacological treatment includes acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine; however, only one-third of patients respond to treatment. Genetic factors have been shown to play a role in this inter-individual variability in drug response. DEVELOPMENT: We review pharmacogenetic reports of AD-modifying drugs, the pharmacogenetic biomarkers included, and the phenotypes evaluated. We also discuss relevant methodological considerations for the design of pharmacogenetic studies into AD. A total of 33 pharmacogenetic reports were found; the majority of these focused on the variability in response to and metabolism of donepezil. Most of the patients included were from Caucasian populations, although some studies also include Korean, Indian, and Brazilian patients. CYP2D6 and APOE are the most frequently studied biomarkers. The associations proposed are controversial. CONCLUSIONS: Potential pharmacogenetic biomarkers for AD have been identified; however, it is still necessary to conduct further research into other populations and to identify new biomarkers. This information could assist in predicting patient response to these drugs and contribute to better treatment decision-making in a context as complex as aging.

CSF analysis for protein biomarker identification in patients with leptomeningeal metastases from CNS lymphoma.

INTRODUCTION: Leptomeningeal metastases (LM) from lymphoma remain a difficult complication for oncologist due to the high incidence in morbidity and mortality. Early diagnostic and initiation of treatment are essential to prevent neurological deterioration. Areas covered: In this review, several proteomic approaches are described in order to help and provide the basis for the identification of biomarkers useful in early diagnosis, also in discovery novel targets for therapeutic agents. In fact, the identification of biomarkers will have a high potential to detect leptomeningeal lymphoma, as well as to predict its progression and treatment response. Expert commentary: In the case of LM by Central nervous system (CNS) lymphoma, these studies generated the first insights into the utility of proteomic analysis for biomarker identification and will be demonstrated that identifying specific proteins in cerebrospinal fluid (CSF) had much greater sensitivity for detecting LM in comparison to standard cytological protocols.

In vitro and in vivo Methods for the Evaluation of Natural Products against Dermatophytes.

Dermatomycoses are infections caused by fungi called dermatophytes; these affect 20-25% of the world population and the incidence continues to grow each year. Recently, an alternative for the treatment of these diseases is the use of natural products, thanks to the fact that they possess great chemical diversity and thus biological activity. However, to understand the therapeutic potential of natural products, their microbiological assessment presents certain limitations. Currently, there is no established reference method to determine the antifungal capacity in vitro and in vivo of natural products (i.e., essential oils). This review focuses on describing the various microbiological methods as well as the many adaptations used to evaluate the antifungal activity of natural products both in vitro and in vivo. In addition, the antifungal evaluation of natural products formulated in creams, gels, nanoemulsions, nanocapsules and solid lipid nanoparticles is included.

[THE INFLUENCE OF THE POLYUNSATURATED FATTY ACIDS IN THE PREVENTION AND PROMOTION OF CANCER]. / INFLUENCIA DE LOS ÁCIDOS GRASOS POLIINSATURADOS EN LA PREVENCIÓN Y PROMOCIÓN DEL CÁNCER.

INTRODUCTION: each year, almost eight million people die in the world due to cancer. Carcinogenesis is a process that involves a series of structural alterations of the DNA which affect its stability and prevents proper cell reproduction and development. There are many factors that influence the cancer etiology. Nutritional factors are included among them. The polyunsaturated fatty acids (PUFA) intake is associated more and more with the prevention and development of chronic diseases with an inflammatory component such as cancer. OBJECTIVE: this work reviews the latest bibliography on the PUFA and its relationship with the cancer, mainly of prostate, breast and colon cancer. METHODS: the preliminary search resulted in 92 selected references. But, after their review, 40 experimental studies, in animals and in vitro, and epidemiological studies have been included. RESULTS: experimental studies in animals and in vitro reviewed show a protective effect of ω3 PUFA against cancer. However, human studies are contradictory; although it is clear there is evidence of the protective effect of the ω3 PUFA in colon cancer prevention. CONCLUSION: the relationship between ω6 and ω3 PUFA of the diet against the cancer risk is becoming increasingly important, but further studies are needed to confirm their influence on the development of this disease.

Introducción: alrededor de ocho millones de personas mueren anualmente en el mundo debido al cáncer. La carcinogénesis es un proceso que conlleva, entre otras, una serie de alteraciones de la estructura del ADN, afectando su estabilidad e impidiendo la correcta proliferación celular. Son muchos los factores que influyen en la etiología del cáncer. Dentro de dichos factores están los nutricionales. La ingesta de ácidos grasos poliinsaturados (AGPI) se relaciona cada vez más con la prevención y el desarrollo de enfermedades crónicas con un componente inflamatorio, como el cáncer. Objetivo: revisar la bibliografía más reciente de los últimos cinco años sobre la ingesta de AGPI y su relación con el cáncer, principalmente de próstata, mama y colon, para concretar la posible existencia de una evidencia científica concluyente al respecto. Método: la búsqueda preliminar en la literatura proporcionó 92 referencias. Finalmente, tras su revisión, se han incluido 40 estudios directamente relacionados, conformados por estudios experimentales, en animales e in vitro, así como estudios epidemiológicos. Resultados: los estudios experimentales en animales e in vitro revisados concluyen un efecto protector de los AGPI omega-3 frente al cáncer. Sin embargo, los estudios en humanos son contradictorios, aunque sí parece existir una clara evidencia del efecto protector de los AGPI 3 en la prevención del cáncer de colon. Conclusión: la relación entre AGPI 6 y AGPI 3 de la dieta frente al riesgo de padecer cáncer cobra cada vez más importancia, si bien se necesitan más estudios para confirmar su influencia en el desarrollo de esta enfermedad.

Influencia de los ácidos grasos poliinsaturados en la prevención y promoción del cáncer / The influence of the polyunsaturated fatty acids in the prevention and promotion of cancer

Introducción: alrededor de ocho millones de personas mueren anualmente en el mundo debido al cáncer. La carcinogénesis es un proceso que conlleva, entre otras, una serie de alteraciones de la estructura del ADN, afectando su estabilidad e impidiendo la correcta proliferación celular. Son muchos los factores que influyen en la etiología del cáncer. Dentro de dichos factores están los nutricionales. La ingesta de ácidos grasos poliinsaturados (AGPI) se relaciona cada vez más con la prevención y el desarrollo de enfermedades crónicas con un componente inflamatorio, como el cáncer. Objetivo: revisar la bibliografía más reciente de los últimos cinco años sobre la ingesta de AGPI y su relación con el cáncer, principalmente de próstata, mama y colon, para concretar la posible existencia de una evidencia científica concluyente al respecto. Método: la búsqueda preliminar en la literatura proporcionó 92 referencias. Finalmente, tras su revisión, se han incluido 40 estudios directamente relacionados, conformados por estudios experimentales, en animales e in vitro, así como estudios epidemiológicos. Resultados: los estudios experimentales en animales e in vitro revisados concluyen un efecto protector de los AGPI omega-3 frente al cáncer. Sin embargo, los estudios en humanos son contradictorios, aunque sí parece existir una clara evidencia del efecto protector de los AGPI ω3 en la prevención del cáncer de colon. Conclusión: la relación entre AGPI ω6 y AGPI ω3 de la dieta frente al riesgo de padecer cáncer cobra cada vez más importancia, si bien se necesitan más estudios para confirmar su influencia en el desarrollo de esta enfermedad (AU)

Introduction: each year, almost eight million people die in the world due to cancer. Carcinogenesis is a process that involves a series of structural alterations of the DNA which affect its stability and prevents proper cell reproduction and development. There are many factors that influence the cancer etiology. Nutritional factors are included among them. The polyunsaturated fatty acids (PUFA) intake is associated more and more with the prevention and development of chronic diseases with an inflammatory component such as cancer. Objective: this work reviews the latest bibliography on the PUFA and its relationship with the cancer, mainly of prostate, breast and colon cancer. Methods: the preliminary search resulted in 92 selected references. But, after their review, 40 experimental studies, in animals and in vitro, and epidemiological studies have been included. Results: experimental studies in animals and in vitro reviewed show a protective effect of ω3 PUFA against cancer. However, human studies are contradictory; although it is clear there is evidence of the protective effect of the ω3 PUFA in colon cancer prevention. Conclusion: the relationship between ω6 and ω3 PUFA of the diet against the cancer risk is becoming increasingly important, but further studies are needed to confirm their influence on the development of this disease (AU)

Resultados del tratamiento endovascular de los aneurismas de arteria poplítea / Results of endovascular treatment of popliteal artery aneurysms

Objetivo: Evaluar los resultados a largo plazo del tratamiento endovascular de los aneurismas de arteria poplítea (AAP). Pacientes y métodos: Análisis retrospectivo de una serie de 27 AAP intervenidos en 24 pacientes entre enero de 2004 y diciembre de 2010. Parámetros a valorar: complicaciones, salvamento de extremidad y permeabilidad según el método de Kaplan-Meier. Resultados: La edad media fue de 69±12 años. El diámetro medio de los AAP era de 29,5±13mm, con salida por 3 troncos distales en la mitad. Seis casos eran sintomáticos. Se utilizó técnica híbrida en 25 casos, mediante abordaje de la arteria femoral superficial proximal, y percutánea en 2. Se emplearon endoprótesis Fluency en 21 casos y Viabahn/Hemobahn en 6. Promedio de endoprótesis por caso: 2. Éxito técnico inicial: 100%. Morbimortalidad postoperatoria nula. Estancia media: 2,6±2 días. Control periódico clínico y ecográfico en todos los casos. Con una media de seguimiento de 51±24 meses se produjeron 9 oclusiones, 7 el primer año. Otras complicaciones: 2 migraciones con endoleak tipo I, 2 fracturas y una rotura contenida. Hubo 6 conversiones a cirugía abierta, la mayoría por trombólisis fallida, estando todos los bypass funcionantes. Permeabilidad primaria y secundaria a 4 años: 66 y 72%, respectivamente. Salvamento de la extremidad: 100%. No hubo pérdidas de seguimiento, durante el cual se produjeron 2 exitus por neoplasia. Conclusiones: El tratamiento endovascular de los AAP presenta una baja morbimortalidad y puede ser una alternativa terapéutica a la cirugía convencional(AU)

Objective: To evaluate the long term results of the endovascular treatment of popliteal aneurysms. Patients and methods: A retrospective analysis of 27 popliteal aneurysms in 24 patients operated on between January 2004 and December 2010. Endpoints: Complications, limb salvage and patency using the Kaplan-Meier method. Results: The mean age of the patients was 69±12 years. The mean diameter of aneurysms: 29.5±13mm. There were three run-off vessels patency in 52%. Six aneurysms were symptomatic. The technique with dissection of the proximal superficial femoral artery was used in 25 cases, and percutaneous in two. Fluency endografts were used in 21 cases, and Viabahn/Hemobahn in 6. The average number of stent-grafts per case was two. Initial tecnical success was obtained in 100%. There was no postoperative morbidity or mortality. The average in-hospital stay was 2.6±2 days. Clinical and duplex follow-up was possible in all patients. Nine occlusions (seven during the first year) were documented, with an average follow-up of 51±24 months. Other complications: two migrations with endoleak type I, two fractures, and one contained rupture. There were six conversions to bypass surgery, most of them due to failed thrombolysis, all remaining patent. Primary and secondary patency at 4 years was 66 and 72%, and limb salvage was 100%. No patient was lost in the follow-up, and two died of neoplasia. Conclusions: Endovascular treatment of popliteal aneurysms is a feasible and safe therapeutic alternative to conventional bypass surgery, with low morbidity and mortality(AU)

New technologies in cancer. Protein microarrays for biomarker discovery

The emergence of proteomic techniques and methodological approaches to study disease has kindled the quest for new biomarkers. Thus, the use of protein microarrays has surged as a powerful tool for large-scale testing of biological samples. In this mini-review, we will discuss the application of protein microarray technologies that offer unique opportunities to find novel biomarkers (AU)

Variabilidad de la medición de la presión arterial en Pediatría. Estudio de práctica clínica / Variability of the blood pressure measurement in Pediatrics. A clinical practice study

Objetivo. Estudiar la precisión y concordancia de la medición de presión arterial en pacientes pediátricos con dispositivos aneroides y oscilométricos de uso común. Métodos. Estudio transversal de evaluación de medidas repetidas con distintos dispositivos y diferentes observadores de la presión arterial en una muestra consecutiva de 121 pacientes pediátricos mayores de 4 años ingresados. Análisis de la adecuación del tamaño del manguito empleado a las medidas de perímetro y longitud del brazo y su repercusión en la concordancia entre medidas. Estimación de medias y diferencias de medidas repetidas, coeficientes de correlación intraclase y análisis de Bland-Altman. Resultados. Las mediciones realizadas con el dispositivo oscilométrico superaron a las del aneroide (2,6 unidades para la sistólica y 1,5 para la diastólica). La diferencia entre métodos se asociaba discretamente a un desajuste con respecto al perímetro del brazo, tanto para la presión sistólica(sobreestimación media 2,55 mmHg) como para la diastólica(sobrestimación media de 2,44 mmHg). La concordancia entre medidas repetidas fue alta y aceptable entre dispositivos. Las diferencias medias y sus intervalos de concordancia fueron para la tensión sistólica de 2,6 mmHg (-8,3 a +13,5) y para la diastólica 1,5 mmHg (-11,4 a +14,4).Todas las diferencias se adecuaban al grado A de la British Hypertension Society, salvo para el criterio de 5 mmHg de la presión arterial diastólica (grado C).Conclusiones. Considerando la aceptable precisión, la facilidad de aplicación y la objetividad de los dispositivos oscilométricos parece recomendable su uso como método de cribado habitual, aunque, mientras no esté aclarada la validez de sus mediciones, si éstas se sitúan en valores anormales,deberían confirmarse con otros instrumentos (AU)

Objective. To study the reliability and consistency of measuring blood pressure in pediatric patients with aneroid and oscillometric devices of common use. Methods. A cross-sectional was carried out, with evaluation of repeated measurements of blood pressure by different devices and observers in a sample of 121 consecutive pediatric hospitalised patients over 4 years old. The adequacy of cuff size used to the measures of perimeter and length of arm and its impact on the consistency between measures were analyzed. Means and differences of repeated measurements, intraclass correlation coefficients and Bland-Altman analysis were estimated. Results. The measurements with the oscillometric device exceeded those of the aneroid (2.6 units for systolic and 1.5 for diastolic). The difference between methods was associated discreetly to a mismatch with respect to arm circumference, both for systolic pressure (mean overestimation of 2.55 mmHg) and for diastolic (mean overestimation of 2.44 mmHg). The agreement between repeated measures was high and between devices acceptable. Mean differences and their concordance intervals ranges were for systolic blood pressure of 2.6 mmHg (-8.3 to +13.5) and for diastolic 1.5 mmHg (-11.4 to 14.4). All differences were suitable for the A grade of the British Hypertension Society, except for the criterion of 5 mm Hg of the diastolic blood pressure (Grade C). Conclusions. Considering the acceptable accuracy, ease of application and the objectivity of oscillometric devices, they seem recommendable for use as a common screening method, though, while the validity of their measurements was not clarified, whether they are at abnormal levels, should be confirmed with other instruments (AU)

[Endonasal tubes as cause of pressure ulcers in the critical patient]. / Sondas endonasales como causa de las úlceras por presión en el paciente crítico.

INTRODUCTION: One of the risks of using endonasal tubes (ET) is the appearance of pressure ulcers (PU). OBJECTIVE: To ascertain the proportion of patients with nasal PU, study the risk factors of appearance, and find predictive variables. MATERIAL AND METHODS: A six-month prospective, observational study of intensive care unit patients with ET. VARIABLES: Variable response: "the appearance of pu as a result of the use of ET". Explanatory variables: age, duration of stay, length of time with ET, gender, sedation, norepinephrine perfusion, mechanical ventilation, anemia, nutritional state. ANALYSIS: multivariate statistical techniques (multiple logistical regression). Statistics program g-stat 2.0. Significance level p < 0.05. RESULTS: Sample of 48 patients. Proportion of patients with PU: 29.2%. Those patients with PU had similar ages, duration of stay and longer length of time with ET. Results of the Logistic Regression model: only the variable "time with ET" was statistically significant (p = 0.03; odds ratio: 1.047). CONCLUSIONS: The length of time the patient is using an ET influences the appearance of nasal PU (risk increases 1.047 for each day with ET). None of the variables dealt with could be used as a predictive factor in the appearance of PU.