[Solitary bone epithelioid hemangioendothelioma. Case report and literature review]. / Hemangioendotelioma epiteloide óseo solitario. A propósito de un caso y revisión de la literatura.

We report the case of a 54 year-old male with a solitary bone epithelioid hemangioendothelioma located in the right iliopubic ramus. Clinical manifestations included right inguinal pain without functional limitation. We stress the importance of the anatomopathologic study to make the diagnosis and determine the histologic grade of the malignancy. This helps decide which is the most appropriate treatment and provides the prognosis.

Eficacia de un programa de escuela de espalda. Análisis de factores asociados a la actividad laboral de los participantes / Effectiveness of a back school program. Analysis of factors related to work activity participants

Introducción. A pesar de la relación existente entre la exposición a carga física en el trabajo y la incidencia de lesiones, los aspectos relacionados con la actividad laboral no han sido suficientemente considerados en los estudios sobre la eficacia de las escuelas de espalda (EE). El objetivo del presente trabajo es analizar el efecto de las variables asociadas a la exposición a carga física en el trabajo sobre la eficacia de un programa de EE orientado a trabajadores. Material y métodos. Se incluyó a 319 sujetos con lumbalgia o cervicalgia que participaron en la Escuela de Espalda de Ibermutuamur durante un periodo de 3 años (2006-2009). La efectividad de la EE se ha evaluado mediante cuestionarios de satisfacción, así como a partir de la mejora funcional y el dolor. Resultados. Se han identificado dos factores asociados a la carga física relacionados con la incapacidad y el dolor al iniciar el tratamiento. La comparación entre los valores iniciales y finales de las puntuaciones de la escala visual analógica (EVA) y del cuestionario de Oswestry muestra una mejora significativa tras el programa de EE. Sin embargo, dicha mejora está relacionada con la situación inicial y con la exposición a los factores de carga en el trabajo. Conclusiones. Es posible que las mejoras asociadas a medidas generales, como la formación y los ejercicios propuestos en una escuela de espalda, no sean igualmente eficaces para trabajadores que parten de una situación funcional peor o que están expuestos a mayor carga física en el trabajo (AU)

Introduction. In spite of the relationship existing between exposure to physical workload and incidence of injuries, the aspects related with work activity has been sufficiently considered in studies on the effectiveness of back schools. This study has aimed to evaluate the effectiveness of a back school program oriented at workers, analyzing variables associated with exposure to physical workload. Material and methods. A total of 319 subjects with low back pain or neck pain participating in the back school between November 2006 and November 2009 were included. The effectiveness of the back school was evaluated by means of a patient satisfaction questionnaire, and by assessment of pain and impairment with the Visual Analogue Scale (VAS) and Oswestry questionnaire, respectively. Results. We have identified two workload factors related to pain and impairment at the beginning of the treatment. The comparison of VAS and Oswestry scores before and after the program shows significant improvement. However, this improvement is associated with the initial scores and with physical workload factors. Conclusions. It is possible that the improvement with unspecific measures as training and exercises in a back school may not be equally effective for patients who are exposed to greater physical demands at work (AU)

Aneurisma de arteria mesentérica superior por displasia fibromuscular / Aneurysm of the superior mesenteric artery due to fibromuscular dysplasia

Introducción. Los aneurismas de arterias viscerales son patologías poco comunes, estimándose su incidenciaen un 0,01-2%. Su localización más frecuente es la arteria esplénica (60%), seguida de la arteria hepática (20%). La localizaciónen la mesentérica superior supone menos de un 5% de todos los aneurismas viscerales. Rara vez son sintomáticos,por lo que su diagnóstico suele ser un hallazgo casual. Su origen más frecuente es infeccioso, siendo la displasia fibromuscularuna de las causas más raras. El tratamiento de elección es el quirúrgico, ya sea mediante cirugía abierta otécnica endovascular, por el riesgo de rotura que supone una alta mortalidad. Caso clínico. Mujer de 27 años diagnosticadade un aneurisma de arteria mesentérica superior tras varios episodios de dolor abdominal cuyo origen fue una displasiafibromuscular. Conclusión. La paciente fue tratada quirúrgicamente mediante interposición de un injerto de venasafena, con buen resultado(AU)

Introduction. Aneurysms of the visceral arteries are uncommon conditions with an estimated incidence of0.01-2%. They are most frequently found in the splenic artery (60%), followed by the hepatic artery (20%). Less than 5%of all visceral aneurysms are located in the superior mesenteric artery. They are rarely symptomatic and therefore theyare usually diagnosed following a chance finding. They most commonly originate from an infection, fibromusculardysplasia being one of the rarest causes. Preferred treatment is surgical, either by open surgery or by using endovasculartechniques, due the risk of rupture, which has a high mortality rate. Case report. A 27-year-old female diagnosedwith an aneurysm in the superior mesenteric artery following several bouts of abdominal pain caused by fibromusculardysplasia. Conclusion. The patient was treated surgically by placement of a saphenous vein graft, with a good outcome(AU)

Plasmodium vivax CS peptides display conformational preferences for folded forms in solution.

Spectroscopic techniques have been used to study the conformations of several synthetic peptides with sequences corresponding to the repeat regions of the circumsporozoite proteins of Plasmodium vivax, variants vk-210 and vk-247. As has previously been shown for P. falciparum, turn-like folded conformations are observed, in rapid dynamic equilibrium with extended-chain forms. These results are consistent with the known similarity of the structural, biosynthetic and immunological properties of the circumsporozoite proteins of different plasmodial species. Additionally, the observation of folded conformers provides a rationale for the effectiveness of these peptides as immunogens and potential vaccines.

Laboratory diagnosis of Schistosomiasis in areas of low transmission: a review of a line of research.

After 57 years of successful control of schistosomiasis in Venezuela, the prevalence and intensity of infection have declined. Approximately 80% of the individuals eliminate less than 100 eggs/g of stools, therefore morbidity is mild and the majority are asymptomatic. The sensitivity of Kato-Katz decreases to approximately 60%. Available serological methods for the detection of circulating antigens only reach a 70% of sensitivity. Tests based on the detection of antibodies by immunoenzymatic assays have been improved. The circumoval precipitine test has shown a high sensitivity (97%), specificity (100%), and correlation with oviposition, being considered the best confirmatory diagnostic test. Additionally to the classical immunoenzymatic assays, the development of the alkaline phosphatase immunoassay, allowed to reach a 100% specificity with an 89% sensitivity. Recently, we have developed a modified ELISA in which the soluble egg antigen is treated with sodium metaperiodate (SMP-ELISA) in order to eliminate the glycosilated epitopes responsible for the false positive reactions. The specificity and sensitivity reaches 97% and 99%, respectively. Synthetic peptides from the excretory-secretory enzymes, cathepsin B (Sm31) legumain (Sm32) and cathepsin D (Sm45), have been synthesized. The combination of two peptides derived from the Sm31 have been evaluated, reaching a sensitivity of 96% when analyzed independently and with a 100% specificity. Antibodies raised in rabbits against peptides derived from the Sm31 and Sm32 are currently evaluated in two different antigen-capture-based assays. The development of a simple, cheap and reliable test that correlates with parasite activity is a major goal.

Laboratory diagnosis of Schistosomiasis in areas of low transmission. A review of a line of research

After 57 years of successful control of schistosomiasis in Venezuela, the prevalence and intensity of infection have declined. Approximately 80 percent of the individuals eliminate less than 100 eggs/g of stools, therefore morbidity is mild and the majority are asymptomatic. The sensitivity of Kato-Katz decreases to approximately 60 percent. Available serological methods for the detection of circulating antigens only reach a 70 percent of sensitivity. Tests based on the detection of antibodies by immunoenzymatic assays have been improved. The circumoval precipitine test has shown a high sensitivity (97 percent), specificity (100 percent), and correlation with oviposition, being considered the best confirmatory diagnostic test. Additionally to the classical immunoenzymatic assays, the development of the alkaline phosphatase immunoassay, allowed to reach a 100 percent specificity with an 89 percent sensitivity. Recently, we have developed a modified ELISA in which the soluble egg antigen is treated with sodium metaperiodate (SMP-ELISA) in order to eliminate the glycosilated epitopes responsible for the false positive reactions. The specificity and sensitivity reaches 97 percent and 99 percent, respectively. Synthetic peptides from the excretory-secretory enzymes, cathepsin B (Sm31) legumain (Sm32) and cathepsin D (Sm45), have been synthesized. The combination of two peptides derived from the Sm31 have been evaluated, reaching a sensitivity of 96 percent when analyzed independently and with a 100 percent specificity. Antibodies raised in rabbits against peptides derived from the Sm31 and Sm32 are currently evaluated in two different antigen-capture-based assays. The development of a simple, cheap and reliable test that correlates with parasite activity is a major goal

Diabetes mellitus II. Homocisteína basal y factores asociados

Introducción. La hiperhomocisteinemia es considerada un factor de riesgo independiente de la aterosclerosis. Existen pocos trabajos sobre este tema en la población diabética, por lo que nos propusimos estudiar qué factores podían relacionarse con la elevación de la homocisteína en un grupo de diabéticos tipo 11.Material y métodos. Los pacientes debían estar diagnosticados de diabetes tipo 11 pero no debían presentar insuficiencia renal. Resultados. Participaron 133 sujetos (85 mujeres y 45 varones). Los niveles de homocisteína basa¡ se correlacionaron positivamente con la tensión arterial sistólica, la urea, la creatinina, el ácido úrico, la edad y la microalbuminuria, y negativamente, con la HbAlc. En el estudio de correlación múltiple se perdió la significación para la tensión arterial sistólica y la urea. Discusión. Las asociaciones más fuertes fueron encontradas con parámetros relacionados con la función renal (urea, creatinina, ácido úrico y microalbuminuria). La asociación con la tensión arterial sistólica, el ácido úrico y la edad puede relacionarse con el síndrome de resistencia a la insulina. La asociación con la edad es posible que traduzca una mayor frecuencia de déficit de ácido fólico, vitaminas B12 y B6 en la edad avanzada. La asociación entre el control glucémico y el nivel de homocisteína basal se mantuvo en el análisis de regresión múltiple. En resumen, hemos encontrado que en nuestros diabéticos tipo 11 la homocisteína se relaciona positivamente con la edad, sus niveles de creatinina, microalbuminuria y ácido úrico, y negativamente con el valor de HbA1c (AU)