A first evaluation of the usefulness of Kudzu starch in cultural heritage restoration.

In recent times, the use of natural and harmless products for the environment and restorer is taking place in the field of Cultural Heritage restoration. In this sense, wheat, rice and corn starches as adhesives, have suitable characteristics without toxicity risks. A new starch in this field, is the Kudzu, an almost pure compound (99.5% starch) that is processed by a natural way from a plant called Pueraria lobata. This is a preliminary study of the potential use of Kudzu starch for the restoration of Cultural Heritage, focusing, firstly, in its capacity as adhesive through a comparative evaluation with common starches. The accelerated aging process carried out proved that Kudzu ensures optimal chromatic behaviour. On the other hand, the main problem in starch paste is the biological colonization. The daidzein, a natural antimicrobial compound implicit in Kudzu starch, confirmed the resistance to microorganism in this preliminary approach. The evaluation of the adhesive capacity, and the reversibility of the starches, suggest that Kudzu starch is a valid adhesive in the field of paper restoration. Thus, the potential of this starch in the conservation of Cultural Heritage is evidenced and its use as cleaner, resistance to biological colonization and consolidant is promising.

Melanin and pyomelanin in Aspergillus fumigatus: from its genetics to host interaction.

Aspergillus fumigatus is a worldwide-distributed saprophytic fungus and the major cause of invasive aspergillosis. This fungus can produce two types of melanin-dihydroxynaphthalene melanin (DHN-melanin) and pyomelanin. These pigments are considered important resistance mechanisms to stress, as well as virulence factors. The aim of this review is to present the current knowledge of the genetic basis and metabolic pathways of melanin production, their activation, function, and interaction with the host immune system. The DHN-melanin pathway is encoded in a cluster that includes six genes (abr1, abr2, ayg1, arp1, arp2, and pksP/alb1 genes) whose encoded proteins seem to be the origin of the pigment in endosomes. These vesicles are secreted and the pigment is subsequently located in the wall of the conidium beneath the rodlet layer. Unlike DHN-melanin, pyomelanin does not have its own biosynthetic pathway but is related to the activation of the L-tyrosine/L-phenylalanine degradation pathway that includes a cluster of six genes (hppD, hmgX, hmgA, fahA, maiA, and hmgR). Its production is due to the polymerization of homogentisic acid and is linked to conidial germination. Despite the knowledge gained in recent years, further studies will be necessary to confirm the pathways that produce these pigments and their role in the virulence mechanisms of A. fumigatus.

Oligo p-Phenylenevinylene Derivatives as Electron Transfer Matrices for UV-MALDI.

Phenylenevinylene oligomers (PVs) have outstanding photophysical characteristics for applications in the growing field of organic electronics. Yet, PVs are also versatile molecules, the optical and physicochemical properties of which can be tuned by manipulation of their structure. We report the synthesis, photophysical, and MS characterization of eight PV derivatives with potential value as electron transfer (ET) matrices for UV-MALDI. UV-vis analysis show the presence of strong characteristic absorption bands in the UV region and molar absorptivities at 355 nm similar or higher than those of traditional proton (CHCA) and ET (DCTB) MALDI matrices. Most of the PVs exhibit non-radiative quantum yields (φ) above 0.5, indicating favorable thermal decay. Ionization potential values (IP) for PVs, calculated by the Electron Propagator Theory (EPT), range from 6.88 to 7.96 eV, making these oligomers good candidates as matrices for ET ionization. LDI analysis of PVs shows only the presence of radical cations (M+.) in positive ion mode and absence of clusters, adducts, or protonated species; in addition, M+. threshold energies for PVs are lower than for DCTB. We also tested the performance of four selected PVs as ET MALDI matrices for analytes ranging from porphyrins and phthalocyanines to polyaromatic compounds. Two of the four PVs show S/N enhancement of 1961% to 304% in comparison to LDI, and laser energy thresholds from 0.17 µJ to 0.47 µJ compared to 0.58 µJ for DCTB. The use of PV matrices also results in lower LODs (low fmol range) whereas LDI LODs range from pmol to nmol. Graphical Abstract ᅟ.

La pediatría en las Jornadas Internacionales de Cine Médico de San Sebastián / Pediatrics at the International Medical Film Festival of San Sebastián

Introducción: Las Jornadas Internacionales de Cine Médico de San Sebastián fueron una actividad científica y divulgativa del cine médico (22 ediciones) cuando el acceso a estas proyecciones era muy dificultoso (1969-1991). El objetivo del presente trabajo es analizar la presencia de los temas pediátricos y su repercusión en dichas jornadas. Método: Revisión de la prensa local entre los años 1968 y 1980, los programas de mano entre los años 1981 y 1991, los boletines informativos y las memorias de las Jornadas. Resultados: De las 899 películas entre cine y vídeo presentadas en las Jornadas, 103 fueron de tema pediátrico, lo que supone un 11,4% de las mismas. Se analizan los premios, los ciclos especiales de películas y los ciclos de conferencias relativas a la atención a la infancia y la adolescencia. Conclusiones: A pesar de que la orientación de las Jornadas era eminentemente quirúrgica, la presencia de la pediatría, sobre todo en su vertiente de educación sanitaria, fue importante. La educación sexual, la psicología y la discapacidad infantil fueron los temas más presentes (AU)

Introduction: San Sebastian International Medical Film Journeys were a scientific and educational activity of medical film (22 editions) when the access to these projections was very difficult. The objective of the present study is to analyze the presence of Pediatric subjects and their impact on these journeys. Method: Review of the local press (years 1968-1980), the programs hand (years 1981-1991), newsletters and the memories of the journeys. Results: 899 movies, film or video, were presented in the Journeys. One hundred and three of them were about Pediatric subject, representing 11.4%. We are going to analyze them awards, special cycles of movies and conferences. Conclusions: The orientation of these journeys was eminently surgical, but the presence of the Pediatrics was important, above all in his shed of education health. The themes sex education, psychology, and child disability were the most present (AU)

Discurso de las Armas y las Ciencias: El Coronel Médico D. Antonio Casares Gil (1871-1929) / Discourse on Arms and Sciences: Medical Colonel D. Antonio Casares Gil (1871-1929)

Revisamos la vida y obra científica de D. Antonio Casares Gil (1871-1929), siguiendo una línea cronológica desde su nacimiento en Santiago de Compostela, su paso por Barcelona, la guerra de Cuba, Madrid y la Coruña. Con ello intentamos plantear, simultáneamente, su quehacer profesional asistencial y científico-militar, relacionándolos con sus actividades civiles y académicas. A pesar de la diferencia de métodos y objetivos de la medicina y la botánica, gracias a Laín y Albarracín, conseguimos encontrar un nexo de unión, que podría explicar la dedicación y aptitudes de Casares para ambas ciencias, en el paralelismo entre species morborum y species plantarum, establecido por el gran clínico Thomas Sydenham, padre de la nosología moderna. También hemos fijado la posición de Antonio Casares tanto en la Sanidad militar española como europea, ya que estuvo comisionado en ejércitos extranjeros por el gobierno; como en el concierto de los botánicos nacionales e internacionales. Dado que fue un gran trabajador, exento de obligaciones familiares directas, en su caso, vida y obra se confunden casi por completo

We review the life and scientific labour of Antonio Casares Gil (1871-1929), following a timeline from his birth at Santiago de Compostela, passing through his stay at Barcelona, his intervention in the Spanish-American War, and also referring to his labour in Madrid and La Coruña. It is our intention to present, simultaneously, both his welfare and scientific-militar task and his civil academical activities. Despite the differences between medical and botanic methods and goals we manage to find -thanks to Laín and Albarracín- a nexus which could explain the devotion and ability of Casares for both sciences in the parallelism between species morborum and species planctarum, which was stablished by the famous clinic Thomas Sydenham, father of modern nosology. We also fixed the position of Antonio Casares in both, the Spanish and European Military Health, given that he was commissioned in foreign armies by the government and took part in the concert of national and international botanists. Since he was a hard worker, free of direct family obligations, if any, life and work get confused in his case almost completely

Results of Infrainguinal Bypass in Acute Limb Ischaemia.

OBJECTIVE/BACKGROUND: To assess the outcomes of infrainguinal bypass performed for acute limb ischaemia, as well as the predictors of patency, mortality, and amputation. METHODS: This was a retrospective cohort study of patients undergoing infrainguinal bypass between 1998 and 2014. The cohort was stratified according to the indication for surgery into two groups: group A (acute limb ischaemia) and group B (chronic lower extremity ischaemia). Comparative analysis was performed on comorbidities, surgical technique, and outcomes, as well as prognostic factors in group A. RESULTS: In total, 702 bypasses were performed (group A, n = 107; group B, n = 595). Differences between groups were detected in age (65.9 vs. 70.9 years; p = .03), diabetes (16% vs. 49%; p < .01), renal insufficiency (6% vs. 13%; p = .05), stroke (7% vs. 14%; p = .04), and coronary artery disease (13% vs. 28%; p < .01). Patients with acute limb ischaemia more often required general anaesthesia (47% vs. 12%; p < .01) and a short bypass was more often performed (32% vs. 7%; p < .01). Median follow up was 23 and 24 months for groups A and B, respectively. No differences were found in patency rates at 1, 12, and 24 months between groups, but group B had a higher re-intervention rate during follow up. Primary patency in group A was 84%, 63%, and 58%, and in group B it was 88%, 62%, and 53% at 1, 12, and 24 months, respectively (p = .77). Assisted primary patency in group A was 85%, 72%, and 67%, and in group B it was 90%, 74%, and 66% at 1, 12, and 24 months, respectively (p = .61). Secondary patency in group A was 90%, 78%, and 75%, and in group B it was 94%, 80%, and 74% at 1, 12, and 24 months, respectively (p = .80). The freedom from re-intervention rate in group A was 91%, 74%, and 68%, and in group B it was 92%, 76%, and 71%, respectively (p = .04). Acute limb ischaemia was an independent risk factor for amputation (odds ratio [OR] 4.96, 95% confidence interval [CI] 1.74-14.09; p < .01) and mortality (OR 4.13, 95% CI 1.53-11.14; p = .01) at 30 days. In group A, female sex, prosthetic conduit, and need of distal thrombectomy were independently associated with worse patency rates. Poor intra-operative runoff was correlated with higher amputation rates. CONCLUSION: Among those undergoing infrainguinal bypass, patients who present with acute limb ischaemia constitute a subset showing higher early rates of amputation and death. In this subset of patients, worse outcomes may be expected for women, prosthetic conduits, need for distal thrombectomy, and patients with poor intra-operative runoff.

A 50-gene signature is a novel scoring system for tumor-infiltrating immune cells with strong correlation with clinical outcome of stage I/II non-small cell lung cancer

Purpose: To identify a novel system for scoring intratumoral immune response that can improve prognosis and therapy decisions in early stage non-small cell lung cancer (NSCLC). Methods/patients: Eighty-four completely resected stage I/II NSCLC without adjuvant therapy were classified by expression profiling using whole genome microarrays. An external cohort of 162 tumors was used to validate the results. Immune cells present in tumor microenvironment were evaluated semiquantitatively by CD20, CD79, CD3, CD8, CD4 and CD57 immunostaining. Univariate and multivariate analyses of variables associated with recurrence-free survival were performed. Results: Initial molecular classification identified three clusters, one with significantly better RFS. A reduced two-subgroup classification and a 50-gene predictor were built and validated in an external dataset: high and low risk of recurrence patients (HR = 3.44; p = 0.001). Analysis of the predictor´s genes showed that the vast majority were related to a B/plasma cell immune response overexpressed in the low-risk subgroup. The predictor includes genes coding for unique B lineage-specific genes, functional elements or other genes that, although non-restricted to this lineage, have strong influence on B-cell homeostasis. Immunostains confirmed increased B-cells in the low-risk subgroup. Gene signature (p < 0.0001) and CD20 (p < 0.05) were predictors for RFS, while CD79 and K-RAS mutations showed a tendency. Conclusions: Favorable prognosis in completely resected NSCLC is determined by a B-cell-mediated immune response. It can be differently scored by a 50-gene expression profile or by CD20 immunostaining. That prognosis information not reflected by traditional classifications may become a new tool for determining individualized adjuvant therapies (AU)

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A 50-gene signature is a novel scoring system for tumor-infiltrating immune cells with strong correlation with clinical outcome of stage I/II non-small cell lung cancer.

PURPOSE: To identify a novel system for scoring intratumoral immune response that can improve prognosis and therapy decisions in early stage non-small cell lung cancer (NSCLC). METHODS/PATIENTS: Eighty-four completely resected stage I/II NSCLC without adjuvant therapy were classified by expression profiling using whole genome microarrays. An external cohort of 162 tumors was used to validate the results. Immune cells present in tumor microenvironment were evaluated semiquantitatively by CD20, CD79, CD3, CD8, CD4 and CD57 immunostaining. Univariate and multivariate analyses of variables associated with recurrence-free survival were performed. RESULTS: Initial molecular classification identified three clusters, one with significantly better RFS. A reduced two-subgroup classification and a 50-gene predictor were built and validated in an external dataset: high and low risk of recurrence patients (HR = 3.44; p = 0.001). Analysis of the predictor´s genes showed that the vast majority were related to a B/plasma cell immune response overexpressed in the low-risk subgroup. The predictor includes genes coding for unique B lineage-specific genes, functional elements or other genes that, although non-restricted to this lineage, have strong influence on B-cell homeostasis. Immunostains confirmed increased B-cells in the low-risk subgroup. Gene signature (p < 0.0001) and CD20 (p < 0.05) were predictors for RFS, while CD79 and K-RAS mutations showed a tendency. CONCLUSIONS: Favorable prognosis in completely resected NSCLC is determined by a B-cell-mediated immune response. It can be differently scored by a 50-gene expression profile or by CD20 immunostaining. That prognosis information not reflected by traditional classifications may become a new tool for determining individualized adjuvant therapies.

Rapid and specific detection of section Fumigati and Aspergillus fumigatus in human samples using a new multiplex real-time PCR.

Invasive aspergillosis is an opportunistic infection caused primarily by Aspergillus fumigatus. However, other common fungal pathogens belonging to section Fumigati are often misidentified as A. fumigatus. Thus, we have developed a multiplex real-time PCR (qPCR) assay with primers and specific TaqMan probes based on internal transcribed spacer regions or benA gene to discriminate, in less than 3 h, species of section Fumigati and, specifically, A. fumigatus. The multiplex qPCR showed a limit of detection of 20 and 50 fg of DNA for section Fumigati and A. fumigatus, respectively. Moreover, it enabled detection of a single germinated conidia. The inclusion of some PCR facilitators together with the dilution of samples makes it possible to completely avoid PCR inhibitions in all bronchoalveolar lavage (BAL) samples assayed. This technique may be a useful complementary tool in the diagnosis of invasive pulmonary aspergillosis caused by A. fumigatus using BAL fluid.

Tal como éramos. En el centenario del Primer Congreso Español de Pediatría de Palma de Mallorca (1914-2014) / The way we were. On the centenary of the first Spanish Congress of Paediatrics in Palma de Mallorca (1914-2014)

Entre los días 19 y 25 de abril de 1914 se celebró en Palma de Mallorca el Primer Congreso Español de Pediatría, bajo el lema «Proteged a los niños». La especialidad se había desgajado hacía pocos años de su secular vinculación con la Obstetricia y la Ginecología, tanto en su aspecto docente como asistencial. Con las cátedras de Enfermedades de la Infancia recién creadas, en cierto modo, este Congreso significaba la puesta de largo de la Pediatría en nuestro país. El Prof. Martínez Vargas, catedrático en Barcelona, fue el presidente y el alma del Congreso. Era preciso hacer frente a una elevadísima tasa de mortalidad infantil. El Congreso respondió a aquella demanda social y sanitaria en la que participaron más de 300 pediatras, con representantes extranjeros de Bélgica, Francia, Rusia e Hispanoamérica. Las actividades se distribuyeron en 4 secciones: Puericultura, Medicina Infantil, Cirugía e Higiene, y acreditados profesores impartieron conferencias magistrales sobre los temas de la patología infantil más acuciantes de la época. Cien años después, lo que hoy somos es el fruto recogido de quienes nos precedieron; unos fueron figuras brillantes de la pediatría y otros, la mayoría, pediatras anónimos. Consagraron sus vidas, su ciencia y la mejor de sus sonrisas al cuidado del niño. Así éramos, y así somos. Con satisfacción y legítimo orgullo, es un honor, para el Grupo de Historia de la Pediatría y Documentación de la AEP, celebrar esta conmemoración centenaria en el marco de Anales de Pediatría

Between the 19th and 25th April 1914, the First Spanish Congress of Paediatrics was held in Palma de Mallorca under the slogan ''Protect the Children''. The specialty had broken away a few years earlier from its secular connection with Obstetrics and Gynaecology, both in its teaching aspect as well as regarding healthcare. With the newly created Chairs in Childhood Diseases, in a way this Congress meant the coming-of age and debut int society of paediatrics in our country. Prof. Martínez Vargas, a university professor in Barcelona, was the Chairman, and soul of the congress. There was a need to face a very high rate of infant mortality. The Congress responded to that social and sanitary/health demand with the participation of over three hundred pediatricians, including foreign representatives from Belgium, France, Russia and Latin America. The activities were divided into four sections: Childcare, Child Medicine, Surgery and Health, and accredited lecturers gave master classes on the most pressing issuesof child pathology of the time. One hundred years on, what we are today is the fruit gatheredby those who preceded us. Some were brilliant figures in paediatrics and others, the majority, anonymous paediatricians. They dedicated their lives, their science and their best smile to child care. The way we were and the way we are. With legitimate pride and satisfaction, it is an honour for the Group on the History of Paediatrics and AEP Documentation to celebrate this centennial commemoration in the framework of the Annals of Paediatrics

[The way we were. On the centenary of the first Spanish Congress of Paediatrics in Palma de Mallorca (1914-2014)]. / Tal como éramos. En el centenario del Primer Congreso Español de Pediatría de Palma de Mallorca (1914-2014).

Between the 19th and 25th April 1914, the First Spanish Congress of Paediatrics was held in Palma de Mallorca under the slogan "Protect the Children". The specialty had broken away a few years earlier from its secular connection with Obstetrics and Gynaecology, both in its teaching aspect as well as regarding healthcare. With the newly created Chairs in Childhood Diseases, in a way this Congress meant the coming-of age and debut int society of paediatrics in our country. Prof. Martínez Vargas, a university professor in Barcelona, was the Chairman, and soul of the congress. There was a need to face a very high rate of infant mortality. The Congress responded to that social and sanitary/health demand with the participation of over three hundred pediatricians, including foreign representatives from Belgium, France, Russia and Latin America. The activities were divided into four sections: Childcare, Child Medicine, Surgery and Health, and accredited lecturers gave master classes on the most pressing issues of child pathology of the time. One hundred years on, what we are today is the fruit gathered by those who preceded us. Some were brilliant figures in paediatrics and others, the majority, anonymous paediatricians. They dedicated their lives, their science and their best smile to child care. The way we were and the way we are. With legitimate pride and satisfaction, it is an honour for the Group on the History of Paediatrics and AEP Documentation to celebrate this centennial commemoration in the framework of the Annals of Paediatrics.

Bibliografía española de algunos síndromes malformativos. Las primeras descripciones / Malformation syndromes in the spanish literature: The first descriptions

Introducción: Los síndromes malformativos o dismórficos son entidades que se definen por la asociación característica de un conjunto de malformaciones mayores y menores que, generalmente, tienen un origen genético. Hemos investigado las primeras descripciones españolas de un amplio número de entidades sindrómicas. Material y métodos: Se partió de la definición que aparece en un tratado clásico sobre el tema. Entre los 60 síndromes escogidos, se estudiaron, al menos, 2 artículos de cada entidad entre los publicados en España y el primero en el tiempo que figura en el Índice Médico Español. Para los años previos a 1970, se amplió la búsqueda en PubMed. Resultados: Se han reunido 64 artículos que corresponden a 58 síndromes. Cuatro artículos se escribieron durante la primera mitad del siglo XX . En la década de los setenta aparecieron casi la mitad de los trabajos (n = 30). Los trabajos se publicaron en 10 revistas pediátricas españolas, en 9 españolas no pediátricas, en 3 pediátricas no españolas y en 2 no pediátricas y no españolas. Las revistas con más artículos publicados fueron Anales de Pediatría y Revista Española de Pediatría. Los hospitales que firmaron artículos con más frecuencia fueron La Paz de Madrid y el Clínico de Barcelona. El resto de los trabajos se escribieron en 30 hospitales pediátricos españoles más y en 2 extranjeros. El número de autores se fue incrementando con el paso del tiempo. Conclusiones: Aunque con posibles limitaciones, hemos localizado las que pueden ser las primeras descripciones de 58 síndromes, entre los 60 escogidos inicialmente (AU)

Introduction: Malformation or dysmorphic syndromes are conditions that are defined by the combination of a set of major and minor malformations that generally have a genetic origin. We investigated the early Spanish descriptions of a large number of sydromes. Material and methods: We started the study from the definition in a classic treatise on the subject. Among the 60 selected syndromes studied, at least two articles of each syndrome among those published in Spain and for the first time were listed in the Spanish Medical Index. For years prior to 1970, it expanded The search was expanded to PubMed, for the years before1970.Results: We collected 64 articles that referred to 58 syndromes. Four articles were written during the first half of the twentieth century. Almost half of the works (n = 30) appeared in the 1970’s. The papers were published in ten Spanish pediatric, nine Spanish non pediatric, three pediatric non-Spanish and two non-Spanish non-pediatric Journals. The Journals with the most articles published were Anales de Pediatría y Revista Española de Pediatría. The hospitals where the articles originate more often were Hospital La Paz, Madrid and Hospital Clinic, Barcelona. The rest of the works were written in 30 pediatric hospitals and two more in non-Spanish hospitals. The number of authors increased with the passage of time. Conclusions: Although there were potential limitations, we have identified what may be the first descriptions of 58 syndromes, among the 60 chosen initially (AU)

Evolución de la función renal en la cirugía del aneurisma de aorta abdominal con clampaje suprarrenal / Evolution of renal function in abdominal aortic aneurysm surgery with suprarenal cross-clamping

Objetivo: Analizar los efectos del clampaje suprarrenal (CSR) frente al clampaje infrarrenal (CIR) en la evolución de la función renal en la cirugía del aneurisma de aorta abdominal (AAA). Material y método: Estudio de cohortes retrospectivo de los AAA tratados mediante cirugía abierta electiva entre 1998 y 2011. Se analizó la creatinina sérica (mg/dl) preoperatoria y a las 24, 48, 72, 96 h postoperatorias y al alta. Se definió deterioro de la función renal como una creatinina > 2 mg/dl en los pacientes con una creatinina basal normal o un aumento del doble de la creatinina basal en los pacientes con IRC previa. Se definió deterioro del filtrado glomerular (FG) como una disminución > 25%. Análisis multivariable de la evolución de la función renal. Resultados: Se analizaron 464 AAA, 359 (77,4%) con CIR y 105 (22,6%) con CSR. La prevalencia de IRC preoperatoria fue similar entre ambos grupos. El tipo de clampaje no se asoció a deterioro de la función renal (CSR = 8,6% vs. CIR = 4,7%; p = 0,13) y sí al deterioro del FG (CSR = 27,6% vs. CIR = 13,4%; p = 0,001). El tiempo de clampaje, la pérdida sanguínea y la IRC preoperatoria fueron factores de riesgo independientes para deterioro de la función renal. El tipo de clampaje aumentó el riesgo de deterioro de la función renal a partir de los 30 min (p = 0,001), asociándose a deterioro del FG (OR 2,04; IC 95% 0,94-4,47) de forma independiente. Conclusión: Con CSR inferiores a 30 min, en pacientes con creatinina normal, no es previsible un deterioro de la función renal. Con IRC previa o si se espera un CSR prolongado, es esperable un deterioro de la función renal, por lo que deberían valorarse métodos de protección renal (AU)

Objective: To analyse the effects of suprarenal cross-clamping (SC) as opposed to the infrarenal position (IC) in the evolution of the renal function abdominal aorta aneurysm (AAA) surgery. Material and method: A retrospective cohort study of AAAs treated by elective open surgery between 1998 and 2011. The preoperative level of serum creatinine (mg/dL) was determined and compared to postoperative level at 24, 48, 72 and 96 hours, and on discharge. A deterioration in the renal function was defined as a creatinine > 2 mg/dL in patients with a normal baseline creatinine level or an increase of double the baseline creatinine in patients with a previous chronic renal insufficiency (CRI). A deterioration of the glomerular filtrate (GF) was defined as a > 25% decrease. Multivariable analysis was performed on the evolution of the renal function. Results: A total of 464 AAA’s were analysed, 359 (77.4%) with IC, and 105 (22.6%) with SC. The prevalence of preoperative CRI was similar in both groups. The type of clamp was not associated with a deterioration in the renal function (SC = 8.6% vs. IC = 5.7%; p = 0.13) but was associated with a deterioration of the GF (SC = 27.6% vs. IC = 13.4%; p = 0.001). The time the clamp was in place, the blood loss, and the preoperative CRI were independent risk factors for the deterioration of the renal function. The type of clamp increased the risk of deterioration of the renal function beyond 30 minutes (p = .001), being independently associated with a deterioration in the GF (OR 2.04; 95% CI: 0.94-4.47). Conclusion: With SC less than 30 min, in patients with a creatinine level, a deterioration in the renal function is not foreseeable. With prior CRI, or if a prolonged SC is foreseen, a deterioration in the renal function can be expected, thereby making it necessary to evaluate methods for renal protection (AU)

Paraplejía tardía transitoria tras reparación de aneurismas torácico y toracoabdominal / Transient delayed paraplegia after repair of thoracic and thoracoabdominal aneurysms

El aneurisma toracoabdominal requiere de un manejo multidisciplinar debido a su complejidad tanto en la técnica quirúrgica como en el tratamiento anestésico. La complicación postoperatoria más temida es la isquemia medular, que se presenta con una clínica e instauración variable, a su vez que su recuperación puede ser parcial o completa. El manejo postoperatorio de la isquemia medular se basa en medidas que aumentan la perfusión medular, principalmente la optimización hemodinámica y el drenaje de líquido cefalorraquídeo (LCR). Presentamos 2 casos de paraplejía tardía, uno tras reparación abierta de aneurisma aórtico toracoabdominal y otro después del tratamiento endovascular de aneurisma de la aorta torácica descendente, con recuperación completa del déficit neurológico tras drenaje de LCR (AU)

Thoracoabdominal aneurysm requires multidisciplinary management due to its complexity both in surgical technique and anesthetic considerations. One of the most feared postoperative complication is spinal cord ischemia. It can be presented as different clinical patterns, and its recovery may be partial or complete. The postoperative management of spinal cord ischemia is mainly based on techniques to increase spinal cord perfusion, above all, hemodynamic stability and cerebrospinal fluid drainage. We present two cases of delayed paraplegia after an open repair of a thoracoabdominal aneurysm and a descending thoracic aortic aneurysm repair using an endovascular stent graft. They both had a complete neurological recovery after cerebrospinal fluid drainage (AU)

La plaqueta como célula inflamatoria: modificación de la expresión proteica del citoesqueleto y sistema contráctil de la pared vascular / The platelet as a inflammatory cell: modification of cytoskeletal and contractile protein expression of the vascular wall

A pesar de su sencillez estructural, las plaquetas son células funcionalmente muy complejas debido a su capacidad para producir y liberar biomoléculas. De aquí su importancia en el desarrollo de la arteriosclerosis. Se realizó un experimento in vitro para estudiar la actividad de las plaquetas sobre la pared vascular observando los cambios en la expresión proteica del citoesqueleto en segmentos de aorta bovina incubados con plasma rico en plaquetas. Para intentar simular un estado inflamatorio (arteriosclerosis), se realizaron estas mismas determinaciones en segmentos preestimulados con factor de necrosis tumoral. Se observó una modulación de la expresión de la mayoría de las proteínas del citoesqueleto en los segmentos de aorta sana. Sin embargo, en los segmentos preestimulados el número de proteínas fue menor, pudiendo reflejar una capacidad dual de las plaquetas para alterar la contractilidad vascular en función del estado inflamatorio de la pared vascular (AU)

Despite its structural simplicity, platelets are functionally complex cells due to their ability to produce and release biomolecules. Hence its importance in the development of atherosclerosis. An in vitro experiment was conducted to study the effect of the platelets on the vascular wall by observing changes in the cytoskeletal protein expression in bovine aortic segments incubated with platelet rich plasma. With the aim of simulating an inflammatory state (atherosclerosis), these same measurements were performed on aortic segments pre-stimulated with tumour necrosis factor. We observed a modulation of the expression of most of the cytoskeletal proteins in healthy aorta segments. However, the number of modified proteins was less in pre-stimulated segments. These results may reflect a dual platelet capacity to alter vascular contractility in relation to the inflammatory condition of the vascular wall (AU)

[Malformation syndromes in the spanish literature: The first descriptions]. / Bibliografía española de algunos síndromes malformativos. Las primeras descripciones.

INTRODUCTION: Malformation or dysmorphic syndromes are conditions that are defined by the combination of a set of major and minor malformations that generally have a genetic origin. We investigated the early Spanish descriptions of a large number of sydromes. MATERIAL AND METHODS: We started the study from the definition in a classic treatise on the subject. Among the 60 selected syndromes studied, at least two articles of each syndrome among those published in Spain and for the first time were listed in the Spanish Medical Index. For years prior to 1970, it expanded The search was expanded to PubMed, for the years before 1970. RESULTS: We collected 64 articles that referred to 58 syndromes. Four articles were written during the first half of the twentieth century. Almost half of the works (n=30) appeared in the 1970's. The papers were published in ten Spanish pediatric, nine Spanish non-pediatric, three pediatric non-Spanish and two non-Spanish non-pediatric Journals. The Journals with the most articles published were Anales de Pediatría y Revista Española de Pediatría. The hospitals where the articles originate more often were Hospital La Paz, Madrid and Hospital Clinic, Barcelona. The rest of the works were written in 30 pediatric hospitals and two more in non-Spanish hospitals. The number of authors increased with the passage of time. CONCLUSIONS: Although there were potential limitations, we have identified what may be the first descriptions of 58 syndromes, among the 60 chosen initially.

Stent-graft repair for blunt traumatic aortic injury: functional and survival outcomes.

AIM: Traumatic aortic injury is usually lethal, most often because of serious associated wounds. The short- and midterm outcome of endovascular exclusion was assessed as the current treatment of choice due to a lower mortality and morbidity than open surgical treatment. METHODS: We reviewed the cases of 8 patients (5 male, mean age 33 years) undergoing endovascular repair of a traumatic thoracic aortic lesion, confirmed by computed tomographic angiography, at our centre. Most patients showed a contained lesion limited to the aortic isthmus and severe associated injuries. RESULTS: Intrahospital mortality was 37.5% (N.=3) and mostly due to posttraumatic brain injury (N.=2). Most patients were hemodynamically stable at the time of endovascular repair (N.=6). The median time to surgery was 12 hours (3-48 hours). The endografts used were TAG® (W.L. Gore and Associates, Flagstaff) in three patients, and Valiant® (Medtronic, Santa Rosa, CA) in four. The technical success rate was 100%. In one case, the left subclavian artery was occluded without signs of arm ischemia. There were no cases of paraplegia or stroke related to treatment. No revision procedures were needed during follow-up. CONCLUSION: Endovascular repair shortly after injury seems to be effective and safe with a low associated morbidity and mortality.