Approach and management of patients injured by bullfighting trauma. / Abordaje y manejo médico-quirúrgico del paciente herido por traumatismo taurino.

INTRODUCTION: Bullfighting festivals are attributed to the cultural idiosyncrasies of the Ibero-American people, posing an extreme risk to the physical integrity of the participants. Spain is considered the country with the highest number of bull-related celebrations worldwide and, therefore, with the highest number of patients injured by bullfighting trauma treated, thus justifying a public health problem. The generalities associated with this type of trauma define the people injured as polytraumatised patients. In addition, it is important to know the kinematics of the injuries and their specific characteristics, in order to implement quality medical-surgical care. METHODS: scientific review of the literature to promote a comprehensive guide for the medical-surgical management of patients injured by bullfighting trauma. RESULTS: We described the guidelines to standardise protocols for in-hospital approach of patients injured by bullfighting trauma. CONCLUSIONS: Bullfighting trauma is considered a real health problem in the emergency departments of the ibero-Americans countries, especially in Spain, where bullfighting is part of the national culture. The inherent characteristics of these animals cause injuries with special aspects, so it is important to know the generalities of bullfighting trauma. Because of the multidisciplinary approach, this guidelines are adressed to all healthcare providers involved in the management of these patients. It is essential to establish particular initial care for this type of injury, specific therapeutic action and follow-up based on the medical-surgical management of the trauma patient in order to reduce the associated morbidity and mortality.

Anal trauma caused by bull-horn injury.

BACKGROUND: Bullfighting festivals are commonly performed at Spain. Perineal trauma due to bull-horn injury is associated with high morbidity due to sphincteric associated lesions METHODS: We report a case of 37-year-old male patient with anal trauma due to a bull-horn injury involving the sphincter complex, treated in our Emergency department RESULTS: Urgent surgery was performed with primary sphincteroplasty, without performing a colostomy. The associated complication was a partial dehiscence of the surgical wound (Clavien-Dindo I). No transfusions, re-interventions or readmissions were registered. The degree of incontinence at discharge and after 12 month follow-up, according to the Wexner scale was 8 points and 2 points, respectively. CONCLUSIONS: The main treatment of bull-horn injuries is extensive surgical debridement, antibiotic therapy, and lavage of the area. In cases involving the anal sphincter, primary sphincteroplasty is recommended. The modern trend does not include the systematic performance of a colostomy however, it has been described in cases with catastrophic wounds and urological lesions associated.

The role of single nucleotide variant rs3819817 of the Histidine Ammonia-Lyase gene and 25-Hydroxyvitamin D on bone mineral density, adiposity markers, and skin pigmentation, in Mexican population.

PURPOSE: Vitamin D (VD) deficiency and osteoporosis have become a global public health problem. A variant in the Histidine Ammonia-Lyase (HAL) gene has been associated with VD levels and bone mineral density (BMD). However, whether this variant has an influence on VD levels and BMD in Mexican adults remain unclear. METHODS: This cross-sectional analysis included 1,905 adults participating in the Health Worker Cohort Study and 164 indigenous postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort. The rs3819817 variant was genotyped by TaqMan probe assay. Total 25 hydroxyvitamin D levels were measured by DiaSorin Liaison. BMD at the different sites was assessed through dual-energy X-ray absorptiometry. Linear and logistic regression models were performed to evaluate the associations of interest. RESULTS: The prevalence of VD deficiency was 41%, showing differences between sexes. Obesity and skin pigmentation were associated with lower levels of VD in males and females. rs3819817-T allele was associated with low levels of 25-hydroxyvitamin D, VD deficiency, and hip and femoral neck BMD values (g/cm2). We found two interactions with VD levels, one between adiposity and rs3819817-T allele (P = 0.017) and another between skin pigmentation and rs3819817-T allele (P = 0.019). In indigenous postmenopausal women, we observed higher VD levels in the southern region compared to the northern region (P < 0.001); however, we did not observe differences by genotype. CONCLUSION: Our findings confirm that the genetic variant rs3819817 has an essential function in VD levels and BMD and suggests a role in skin pigmentation in the Mexican population.

Pigmentary mosaicism as a recurrent clinical manifestation in three new patients with mosaic trisomy 12 diagnosed postnatally: cases report and literature review.

BACKGROUND: To date, only twenty-one cases diagnosed postnatally with mosaic trisomy 12 have been reported. The most frequent phenotypic manifestations are developmental delay, dysmorphic facial features, congenital heart defects, digital alterations, and pigmentary disorders. In the present report, detailed clinical and genetic profiles of three unrelated new patients with mosaic trisomy 12 are described and compared with previously reported cases. CASE PRESENTATION: In the present report, we include the clinical, cytogenetic, and molecular description of three Mexican patients diagnosed postnatally with mosaic trisomy 12. At phenotypic level, the three patients present with developmental delay, dysmorphic facial features, congenital heart defects and skin pigmentary anomalies. Particularly, patient 1 showed unique eye alterations as bilateral distichiasis, triple rows of upper lashes, and digital abnormalities. In patient 2 redundant skin, severe hearing loss, and hypotonia were observed, and patient 3 presented with hypertelorism and telecanthus. Hyperpigmentation with disseminated pigmentary anomalies is a common trait in all of them. The cytogenetic study was carried out under the strict criteria of analysis, screening 50-100 metaphases from three different tissues, showing trisomy 12 mosaicism in at least one of the three different tissues analyzed. With SNParray, the presence of low-level mosaic copy number variants not previously detected by cytogenetics, and uniparental disomy of chromosome 12, was excluded. STR markers allowed to confirm the absence of uniparental disomy as well as to know the parental origin of supernumerary chromosome 12. CONCLUSIONS: The detailed clinical, cytogenetic, and molecular description of these three new patients, contributes with relevant information to delineate more accurately a group of patients that show a heterogeneous phenotype, although sharing the same chromosomal alteration. The possibility of detecting mosaic trisomy 12 is directly associated with the sensitivity of the methodology applied to reveal the low-level chromosomal mosaicism, as well as with the possibility to perform the analysis in a suitable tissue.

Treatment of esophageal perforation: A review of our experience at a tertiary referral hospital spanning the past 19 years.

INTRODUCTION AND AIMS: Esophageal perforation is an uncommon event that is a medical/surgical emergency, with a 15-30% mortality rate. The aim of the present study was to communicate our experience in the management of esophageal perforation, evaluating the different strategies utilized, in an effort to establish measures to guide decision-making in selecting treatment. MATERIALS AND METHODS: A retrospective descriptive study was conducted on patients diagnosed with esophageal perforation at our hospital center, within the time frame of 2000 and 2019. RESULTS: Over the past 19 years, 15 patients were diagnosed with esophageal perforation. Surgical treatment was carried out in 80% of the cases. Primary closure, reinforced with plasty, was performed in 67% of the patients, of whom 62.5% had early diagnosis and a 100% survival rate. Diagnosis was late in 37.5% of the cases, with a 33.3% survival rate. Esophagectomy and gastric pull-up were performed on 25% of the patients, 66.6% of whom had early diagnosis and a 100% survival rate. In the 33.3% that had late diagnosis, the mortality rate was 100%. Esophagectomy, with cervical esophagostomy and feeding jejunostomy, was performed on one of the patients (8.3%) that had early diagnosis and a 100% survival rate. CONCLUSIONS: The main survival predictor in esophageal perforation is the interval of time between the injury and its diagnosis, and in turn, the resulting treatment. Each patient with esophageal perforation should have individualized treatment to adequately manage the condition.

Polymorphisms CYP2R1 rs10766197 and CYP27B1 rs10877012 in Multiple Sclerosis: A Case-Control Study.

BACKGROUND: Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease. Low vitamin D levels have been reported to be a risk factor for MS, and genetic variances could be implicated. The aim of this study was to evaluate the association of MS with rs10766197 polymorphism of CYP2R1 gene and rs10877012 polymorphism of CYP27B1 gene. The second aim was to analyse whether these polymorphisms are associated with the severity of the progression of MS. Material and Methods. In a case-control study, we included 116 MS patients and 226 controls, all of whom were Mexican Mestizo. MS was diagnosed by McDonald criteria (2017). A complete neurological evaluation was performed to evaluate the severity of disease progression. Serum 25-hydroxyvitamin D [25(OH) vitamin D] levels were measured by ELISA. Single nucleotide polymorphisms rs10766197 of CYP2R1 gene and rs10877012 SNP of CYP27B1 gene were genotyped by real-time PCR. RESULTS: Serum 25(OH) vitamin D levels were lower in MS patients than in controls (p = 0.009). No differences were observed between serum 25(OH) vitamin D levels of MS patients with severe progression compared to low progression (p = 0.88). A higher frequency of the A allele of CYP2R1 rs10766197 was observed between MS patients and controls (p = 0.05). No differences were observed in the frequency of T allele of CYP27B1 rs10877012 (p = 0.65). In subanalysis, patients with GA + AA genotypes of CYP2R1 rs10766197 had an increased risk of MS compared to controls (p = 0.03). No increased risk was observed in GT + TT genotypes of CYP27B1 rs10877012 (p = 0.63). No differences were observed in allele frequencies of either polymorphism between patients with severe vs. low disease progression. CONCLUSION: Lower serum 25(OH) vitamin D levels were observed in MS patients than in controls, although these levels were not associated with disease progression. Carriers of GA + AA genotypes of CYP2R1 rs10766197 had an increased risk of MS. None of these polymorphisms was associated with severe progression of MS.

Association between vitamin D deficiency and common variants of Vitamin D binding protein gene among Mexican Mestizo and indigenous postmenopausal women.

PURPOSE: Vitamin D deficiency (VDD) and polymorphisms in the group-specific component (GC) gene are known to be associated in different populations. However, the effects of such genetic variants may vary across different populations. Thus, the objective of this study was to estimate the association between Vitamin D-Binding Protein (VDBP) haplotypes and VDD in mestizo postmenopausal women and Mexican Amerindian ethnic groups. METHODS: This was a cross-sectional study of 726 postmenopausal Mexican women from the Health Workers Cohort Study (HWCS) and 166 postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort in Mexico. GC polymorphisms (rs7045 and rs4588) were analyzed by TaqMan probes. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured by Chemiluminescent Microparticle Immuno Assay. RESULTS: The prevalence of VDD serum 25(OH)D < 20 ng/mL was 43.7% in mestizo women and 44.6% in indigenous women. In HWCS, the single nucleotide polymorphisms (SNPs) rs7041 and rs4588 were associated with VDD. In addition, women from the HWCS, carrying the haplotypes GC2/2 and GC1f/2 had higher odds of VDD (OR = 2.83, 95% CI 1.14, 7.02; and OR = 2.30, 95% CI 1.40, 3.78, respectively) compared to women with haplotype 1f/1 s. These associations were not statistically significant in the MAIS cohort. CONCLUSIONS: Our results show genetic association of the analyzed SNPs and related haplotypes, on the GC gene, with VDD in mestizo Mexican postmenopausal women. Moreover, a high prevalence of VDD with high genetic variability within the country was observed. Our results support the need for national policies for preventing VDD.

[Functional results of floating shoulder treatment]. / Resultados funcionales del tratamiento del hombro flotante.

INTRODUCTION: The floating shoulder has an incidence of 0.1% of all fractures, the result of high-energy trauma. There is still no consensus in the literature on the best treatment: surgical versus conservative. MATERIAL AND METHODS: Patients with floating shoulder diagnosis were evaluated from January 2013 to December 2018, collecting initial data from the electronic file. The morphological types of fractures were described using the Allman and AO classifications. Patients were evaluated using the UCLA scale for shoulder functionality. RESULTS: From 14 patients, 4 were excluded due to lack of follow-up. Of the remaining 10, 9 were men, 1 woman. The average age was 29 years (range 15-42 years). Three patients had left injury, and 7 patients, right; 6 patients hurt the dominant limb. The most common morphological pattern was glenoid neck fracture + clavicle fracture in 7 patients. Surgical treatment was indicated in 7 patients; and in 3, conservative. Of the 7 patients treated surgically, 6 were with clavicle and scapula osteosynthesis; 1 just the clavicle. Patients with conservative management used a universal shoulder immobilizer for 4-8 weeks. There were no cases of consolidation delay, pseudoarthrosis, or vicious consolidation. Rehabilitation began in the first 4 weeks, and lasted up to 8 weeks. CONCLUSION: Surgical treatment was predominant due to instability. Conservative treatment was used when injuries are minimally displaced. Both treatments generate a favorable functional result.

INTRODUCCIÓN: El hombro flotante tiene una incidencia de 0.1% de todas las fracturas, resultado de traumatismos de alta energía. Aún no existe consenso en la literatura sobre el mejor tratamiento: quirúrgico versus conservador. MATERIAL Y MÉTODOS: Se evaluaron individuos con diagnóstico de hombro flotante, de Enero 2013 a Diciembre 2018, recabando datos iniciales del archivo electrónico. Los tipos morfológicos de fracturas se describieron utilizando las clasificaciones de Allman y AO. Se valoraron los pacientes mediante la escala de la UCLA para la funcionalidad del hombro. RESULTADOS: De 14 pacientes, se excluyeron cuatro por falta de seguimiento. De los 10 restantes, nueve fueron hombres, una mujer. La edad promedio fue de 29 años (rango 15-42 años). Tres pacientes con lesión izquierda y los otros siete, derecha; seis de ellos se lesionaron la extremidad dominante. El patrón morfológico más común fue fractura de cuello de glenoides + fractura de clavícula en siete pacientes. En siete pacientes se indicó tratamiento quirúrgico; y en tres, conservador. De los siete individuos tratados quirúrgicamente, en seis se fijaron clavícula y escápula; en uno, solamente clavícula. Los pacientes con manejo conservador utilizaron inmovilizador universal de hombro por 4-8 semanas. No hubo casos de retardo en la consolidación, pseudoartrosis, ni consolidación viciosa. La rehabilitación inició en las primeras cuatro semanas y se prolongó hasta ocho semanas. CONCLUSIÓN: El tratamiento quirúrgico fue el predominante por inestabilidad. El tratamiento conservador se usó cuando las lesiones están poco desplazadas. Ambos tratamientos generan un resultado funcional favorable.

Manejo de fractura de cuello femoral en paciente con amputación supracondílea femoral bilateral y revisión de la literatura / Femoral neck fracture management in patient with bilateral femoral supracondylar amputation and literature review

Resumen: El tratamiento de un paciente con amputación supracondílea femoral bilateral, y que ha sufrido una fractura de cuello femoral, es un evento poco común tanto para el cirujano ortopédico como para el equipo de rehabilitación. Presentamos un caso, en el cual se discuten diferentes dificultades en su tratamiento, elección de implante y regreso a sus actividades diarias. Se trata de un joven con diagnóstico de amputación traumática bilateral supracondílea, con fractura de cuello femoral, tratado mediante artroplastía total de cadera primaria no cementada. La evaluación de la funcionalidad de la prótesis total de cadera con escala de Houghton fue al cabo de 12 meses, se obtuvo una puntuación final de 9 puntos, los cuales son el resultado de una rehabilitación satisfactoria.

Abstract: The treatment of a patient with amputation above the knee who has suffered a femoral neck fracture is a challenge for both the orthopedic surgeon and the rehabilitation team. We present a case, in which different difficulties are discussed in their treatment, choice of implant and return to their daily activities. The clinical case of a young man diagnosed with supracondylar bilateral traumatic amputation, with fracture of the femoral neck, treated by total non-cemented hip arthroplasty is presented. The functionality of the total hip prosthesis with Houghton scale after 12 months, obtaining a final score of 9 points which are the result of a satisfactory rehabilitation.

Molecular composition of the paralyzing venom of three solitary wasps (Hymenoptera: Pompilidae) collected in southeast Mexico.

The chemical and biological characterization of peptide and protein components of the paralyzing venom from three Pompilidae solitary spider wasps (Pepsis mexicana, Pepsis terminata, and Anoplius nigritus) is described for the first time. The molecular masses of the most abundant peptides were determined. The N-terminal sequences of two cysteine-rich peptides were obtained from Pepsis. Metalloproteinase and hyaluronidase activities were identified in the venom of P. mexicana. A novel non-lethal method to collect venom is described.

[Femoral neck fracture management in patient with bilateral femoral supracondylar amputation and literature review]. / Manejo de fractura de cuello femoral en paciente con amputación supracondílea femoral bilateral y revisión de la literatura.

The treatment of a patient with amputation above the knee who has suffered a femoral neck fracture is a challenge for both the orthopedic surgeon and the rehabilitation team. We present a case, in which different difficulties are discussed in their treatment, choice of implant and return to their daily activities. The clinical case of a young man diagnosed with supracondylar bilateral traumatic amputation, with fracture of the femoral neck, treated by total non-cemented hip arthroplasty is presented. The functionality of the total hip prosthesis with Houghton scale after 12 months, obtaining a final score of 9 points which are the result of a satisfactory rehabilitation.

El tratamiento de un paciente con amputación supracondílea femoral bilateral, y que ha sufrido una fractura de cuello femoral, es un evento poco común tanto para el cirujano ortopédico como para el equipo de rehabilitación. Presentamos un caso, en el cual se discuten diferentes dificultades en su tratamiento, elección de implante y regreso a sus actividades diarias. Se trata de un joven con diagnóstico de amputación traumática bilateral supracondílea, con fractura de cuello femoral, tratado mediante artroplastía total de cadera primaria no cementada. La evaluación de la funcionalidad de la prótesis total de cadera con escala de Houghton fue al cabo de 12 meses, se obtuvo una puntuación final de 9 puntos, los cuales son el resultado de una rehabilitación satisfactoria.

Identification of up-regulated genes from the metal-hyperaccumulator aquatic fern Salvinia minima Baker, in response to lead exposure.

Lead (Pb) is one of the most serious environmental pollutants. The aquatic fern Salvinia minima Baker is capable to hyper-accumulate Pb in their tissues. However, the molecular mechanisms involved in its Pb accumulation and tolerance capacity are not fully understood. In order to investigate the molecular mechanisms that are activated by S. minima in response to Pb, we constructed a suppression subtractive hybridization library (SSH) in response to an exposure to 40µM of Pb(NO3)2 for 12h. 365 lead-related differentially expressed sequences tags (ESTs) were isolated and sequenced. Among these ESTs, 143 unique cDNA (97 were registered at the GenBank and 46 ESTs were not registered, because they did not meet the GenBank conditions). Those ESTs were identified and classified into 3 groups according to Blast2GO. In terms of metabolic pathways, they were grouped into 29 KEGG pathways. Among the ESTs, we identified some that might be part of the mechanism that this fern may have to deal with this metal, including abiotic-stress-related transcription factors, some that might be involved in tolerance mechanisms such as ROS scavenging, membrane protection, and those of cell homeostasis recovery. To validate the SSH library, 4 genes were randomly selected from the library and analyzed by qRT-PCR. These 4 genes were transcriptionally up-regulated in response to lead in at least one of the two tested tissues (roots and leaves). The present library is one of the few genomics approaches to study the response to metal stress in an aquatic fern, representing novel molecular information and tools to understand the molecular physiology of its Pb tolerance and hyperaccumulation capacity. Further research is required to elucidate the functions of the lead-induced genes that remain classified as unknown, to perhaps reveal novel molecular mechanisms of Pb tolerance and accumulation capacity in aquatic plants.

Estudio RN4CAST en Murcia: características organizacionales de los hospitales y perfiles enfermeros / RN4CAST Study in Murcia: Hospital organizational characteristics and nursing staff profiles

Objetivo. Conocer los perfiles de las enfermeras de los hospitales públicos de Murcia y su percepción sobre el entorno laboral, la calidad de los cuidados y su nivel de burnout (réplica metodológica proyecto RN4CAST). Material y métodos. Estudio descriptivo y transversal realizado en 8 hospitales de Murcia. Se recogieron datos entre 2009 y 2010 a 687 enfermeras (estratificando por tipo de unidades) mediante cuestionario autocumplimentado de 149 ítems con variables sociodemográficas, del trabajo, de la percepción del ambiente laboral (PES-NWI), del burnout (Maslach Burnout Inventory), de la calidad y de la seguridad del paciente. Análisis: pruebas no paramétricas para 2 muestras o k muestras según la comparación. Resultados. Se recogieron 495 encuestas (72%). El 80,4% eran mujeres con una edad media de 34,1 (DE = 7,1) años y de 9,4 (DE = 7,4) años trabajados. El 25,7% ha realizado durante los últimos 24 meses más de 300 h de formación. La ratio paciente/enfermera fue de 11,7 (DE = 3,6) con variabilidad entre hospitales. Dos hospitales tenían un clima desfavorable y 3 hospitales tuvieron clima favorable (los hospitales grandes obtuvieron peores valoraciones); se observó una baja intención de abandonar el trabajo (16,8%). Con respecto al burnout en agotamiento emocional se alcanzó una puntuación de 18,4; en despersonalización de 7,5 y en realización personal de 28,8. La percepción sobre la calidad presentó diferencias entre centros y la de los efectos adversos fue más favorable en los hospitales pequeños. Conclusiones. Los profesionales estudiados estaban satisfechos, pero habría que potenciar los factores que generan bienestar y minimizar los puntos débiles detectados en el análisis del clima laboral (AU)

Objective: To determine the profile of nurses in public hospitals in Murcia and to assess how they perceive their work environment, the quality of care and their level of burnout (the RN4CAST project repetition). Material and methods: A cross-sectional descriptive study was carried out in 8 hospitals in Murcia. Data were collected between 2009 and 2010 from 687 nurses (stratified by the type of unit) using a self-completed questionnaire with 149 items covering variables related to sociodemographics; work; perception of the work place (PES-NWI); burnout (Maslach Burnout Inventory); and the quality of patient care, and patient safety. Analysis: Non parametric tests, for two samples or k samples according to the comparison. Results: A total of 495 questionnaires were collected (72%). Most respondents were female (80.4%) having a mean age of 34.1 (SD = 7.1) years, and they had been working for 9.4 (SD = 7.4) years. Just over one-quarter (25.7%) had carried out more than 300 hours of training in the previous 24 months. The patient/nurse ratio was 11.7 (SD = 3.6), varying between hospitals. The nurses reported 25% of hospitals as having an unfavorable work environment, whereas 37.5% had favorable ones; large hospitals were less highly valued. Few respondents intended to give up their jobs (16.8%). Burnout levels revealed emotional exhaustion in 18.4% of respondents; depersonalization in 7.5%, and personal fulfillment in 28.8%. Perception of quality varied between centers and the perception of adverse effects was more favorable in small hospitals. Conclusions: Our professionals were generally satisfied, but given the unfavorable work environment, measures should be adopted for improving well-being and reducing weaknesses (AU)

[RN4CAST Study in Murcia: Hospital organizational characteristics and nursing staff profiles]. / Estudio RN4CAST en Murcia: características organizacionales de los hospitales y perfiles enfermeros.

OBJECTIVE: To determine the profile of nurses in public hospitals in Murcia and to assess how they perceive their work environment, the quality of care and their level of burnout (the RN4CAST project repetition). MATERIAL AND METHODS: A cross-sectional descriptive study was carried out in 8 hospitals in Murcia. Data were collected between 2009 and 2010 from 687 nurses (stratified by the type of unit) using a self-completed questionnaire with 149 items covering variables related to sociodemographics; work; perception of the work place (PES-NWI); burnout (Maslach Burnout Inventory); and the quality of patient care, and patient safety. ANALYSIS: Non parametric tests, for two samples or k samples according to the comparison. RESULTS: A total of 495 questionnaires were collected (72%). Most respondents were female (80.4%) having a mean age of 34.1 (SD=7.1) years, and they had been working for 9.4 (SD=7.4) years. Just over one-quarter (25.7%) had carried out more than 300 hours of training in the previous 24 months. The patient/nurse ratio was 11.7 (SD=3.6), varying between hospitals. The nurses reported 25% of hospitals as having an unfavorable work environment, whereas 37.5% had favorable ones; large hospitals were less highly valued. Few respondents intended to give up their jobs (16.8%). Burnout levels revealed emotional exhaustion in 18.4% of respondents; depersonalization in 7.5%, and personal fulfillment in 28.8%. Perception of quality varied between centers and the perception of adverse effects was more favorable in small hospitals. CONCLUSIONS: Our professionals were generally satisfied, but given the unfavorable work environment, measures should be adopted for improving well-being and reducing weaknesses.

Retención de orina en un paciente inmunocompetente: mielitis transversa aguda / Urinary retention in immunocompetent patient: acute transverse myelitis

La diabetes MODY-5 es un tipo de diabetes monogenica infrecuente, causada por mutación en el gen del factor de transcripción nuclear hepático 1-beta (HNF-1¦Â). Esta mutación puede ser de tipo puntual o bien corresponder a delecciones grandes, y a su vez, puede aparecer de novo por mutación espontanea o bien ser transmitida de forma hereditaria con caracter autosomicodominante. Está asociada con un alto riesgo de complicaciones microvasculares de aparición temprana en las personas afectas, así como con alteraciones renales características del tipo quistes y anomalías del tracto genital, que estan presentes incluso antes del nacimiento. Por ello, está justificado hacer pruebas de detección para las mutaciones de HNF-1 en diabíticos no obesos, sobre todo, cuando existen alteraciones renales o genitales asociadas, sin tener en cuenta los antecedentes familiares (AU)

MODY-5 diabetes is an infrequent type of monogenic diabetes, caused by mutation in the gene of the nuclear hepatic transcription factor 1-beta (HNF-1¦Â).This mutation can be of a momentary type or it might correspond to big deletions, and, in its turn, it can appear due to spontaneous de novo mutation or it can be transmitted by hereditary with an autosomal dominant character. It is associated with a high risk of microvascular complications that appear early in affected people, as well as with characteristic renal alterations of the cyst type, and anomalies of the genital tract, which are present even before birth. That is why it is justified to carry out detection tests for HNF-1¦Â mutations in non-obese diabetics, above all when there are associated renal or genital alterations, without consideration of family antecedents (AU)

Novel Crystalline SiO(2) Nanoparticles via Annelids Bioprocessing of Agro-Industrial Wastes.

The synthesis of nanoparticles silica oxide from rice husk, sugar cane bagasse and coffee husk, by employing vermicompost with annelids (Eisenia foetida) is reported. The product (humus) is calcinated and extracted to recover the crystalline nanoparticles. X-ray diffraction (XRD), transmission electron microscopy (TEM), high-resolution transmission electron microscopy (HRTEM) and dynamic light scattering (DLS) show that the biotransformation allows creating specific crystalline phases, since equivalent particles synthesized without biotransformation are bigger and with different crystalline structure.

Antagonism of Bacillus spp. isolated from marine biofilms against terrestrial phytopathogenic fungi.

We aimed at determining the antagonistic behavior of bacteria derived from marine biofilms against terrestrial phytopathogenic fungi. Some bacteria closely related to Bacillus mojavensis (three isolates) and Bacillus firmus (one isolate) displayed antagonistic activity against Colletotrichum gloeosporioides ATCC 42374, selected as first screen organism. The four isolates were further quantitatively tested against C. gloeosporioides, Colletotrichum fragariae, and Fusarium oxysporum on two culture media, potato dextrose agar (PDA) and a marine medium-based agar [yeast extract agar (YEA)] at different times of growth of the antagonists (early, co-inoculation with the pathogen and late). Overall antagonistic assays showed differential susceptibility among the pathogens as a function of the type of culture media and time of colonization (P < 0.05). In general, higher suppressive activities were recorded for assays performed on YEA than on PDA; and also when the antagonists were allowed to grow 24 h earlier than the pathogen. F. oxysporum was the most resistant fungus while the most sensitive was C. gloeosporioides ATCC 42374. Significant differences in antagonistic activity (P < 0.05) were found between the different isolates. In general, Bacillus sp. MC3B-22 displayed a greater antagonistic effect than the commercial biocontrol strain Bacillus subtilis G03 (Kodiak). Further incubation studies and scanning electronic microscopy revealed that Bacillus sp. MC3B-22 was able to colonize, multiply, and inhibit C. gloeosporioides ATCC 42374 when tested in a mango leaf assay, showing its potential for fungal biocontrol. Additional studies are required to definitively identify the active isolates and to determine their mode of antifungal action, safety, and biocompatibility.

The Pb-hyperaccumulator aquatic fern Salvinia minima Baker, responds to Pb(2+) by increasing phytochelatins via changes in SmPCS expression and in phytochelatin synthase activity.

The relationship between accumulation of Pb(2+) and the activation of chelation and metal sequestration mechanisms mediated by phytochelatins (PC) was analyzed in the Pb(2+) hyperaccumulator aquatic fern Salvinia minima, after exposure to 40microM Pb(NO(3))(2). The tissue accumulation pattern of lead and the phytochelatin biosynthesis responses were analyzed in both, S. minima submerged root-like modified fronds (here named "roots"), and in its aerial leaf-like fronds ("leaves"). S. minima roots accumulated a significantly higher concentrations of Pb(+2) than leaves did. Accumulation of Pb(2+) in roots was bi-phasic with a first uptake phase reached after 3h exposure and a second higher uptake phase reached after 24h exposure. In leaves, a single delayed, smaller uptake phase was attained only after 9h of exposure. In roots lead accumulation correlated with an increased phytochelatin synthase (PCS) activity and an enhanced PC production. A higher proportion of polymerized PC(4) was observed in both tissues of exposed S. minima plants relative to unexposed ones, although a higher concentration of PC(4) was found in roots than in leaves. PCS activity and Pb(2+) accumulation was also higher in roots than in leaves. The expression levels of the S. minima PCS gene (SmPCS), in response to Pb(2+) treatment, were also evaluated. In S. minima leaves, the accumulation of Pb(2+) correlated with a marked increase in expression of SmPCS, suggesting a transcriptional regulation in the PCS activation and PC accumulation in this S. minima tissue. However, in roots, the basal expression of SmPCS was down-regulated after Pb(2+) treatment. This fact did not correlate with the later but strong increase in both, PCS activity and PC production; suggesting that the PC biosynthesis activation in S. minima roots occurs only by post-translational activation of PCS. Taken together, our data suggest that the accumulation of PC in S. minima is a direct response to Pb(2+) accumulation, and phytochelatins do participate as one of the mechanism to cope with Pb(2+) of this Pb-hyperaccumulator aquatic fern.

Derrame pleural fetal. Etiología, manejo y pronóstico / Fetal pleural effusion. Etiology, management and prognosis)

Introducción. El derrame pleural fetal (DPF) es una entidad rara que puede amenazar la viabilidad fetal. El objetivo es revisar el DPF analizando su etiología, manejo y pronóstico.Métodos. Estudio retrospectivo de 16 casos de DPF de16.971 partos (0,094%) realizados en el Hospital Maternal La Fe en el período 2003-2006. Se valora la etiología, manejo, uso de técnicas invasivas, forma de parto y evolución neonatal.Resultados. La edad gestacional media del diagnósticofue 25±1 semanas (14-38), y la de finalización del embarazo fue 28±1 semanas (rango: 16-39). El DPF asoció hidrops en 8 casos (50%), ascitis en 14 casos (87,5%), cardiopatías 5 casos (31,25 %) y polihidramnios en 6 casos (37,5 %). La amniocentesis demostró aneuploidía en 3 casos (18,75%). El sexo fue varón en 12 casos, hembra en 3 y ambiguo en 1 (p<0,05). De las 16 gestaciones: 2 fueron abortos tardíos y 2 interrupciones voluntarias del embarazo (IVE). Sólo en 12 casos se controló la gestación, desapareciendo el DPF en 3 casos (25%). La finalización de la gestación fue: 7 cesáreas(58 %), y 5 partos vaginales (42 %). Solo en 5 casos (41%) hubo recién nacidos vivos, los 3 casos de desaparición y 2 casos sin desaparición. La tasa de mortalidad durante el embarazo fue del 58,3% y perinatal del 66,6%.Conclusiones. El derrame pleural fetal se asocia a unaalta morbimortalidad perinatal, siendo más frecuente en varones. Son factores de buen pronóstico la reabsorción durante la gestación y la finalización tardía

Introduction. Fetal pleural effusion (FPE) is an uncommoncondition that is life-threatening to the fetalviability. This study has aimed to review FPE, analyzingetiology, management and prognosis.Methods. Retrospective study (2003-2006) of 16 FPEfrom among 16,971 deliveries (0.094%) performed in theMaternity Hospital La Fe. Etiology, management, use ofinvasive techniques, delivery method and neonatal outcomewere studied.Results. Mean gestational age at diagnosis was 25±1(14-38) weeks, and gestational age at delivery was 28±1(16-39) weeks. FPE was associated to hydrops in 8 cases(50 %), ascitis 14 cases (87.5 %), heart disease 5 cases(31.25%), polyhydramnias 6 cases (37.5%). The amniocentesis showed aneuploidy in 3 cases (18.75%). Gender was male in 12 case, female in 3 and ambiguous in one (p<0.05). Among 16 pregnancies, 2 were late miscarriages and 2 Voluntary Termination of Pregnancy. The pregnancies were controlled in only 12 cases, the FPE disappearing in 3 cases (25%). The end of the pregnancy was by cesarean section in 7 (58%) and vaginal deliveries in 5 (42%). There were live newborns in only 5 cases (41%) (5/12), 3 cases of disappearance and 2 without disappearance. Mortality rate in pregnancy was 58.3% and perinatal mortality rate was 66.6%.Conclusions. Fetal pleural effusion is associated to ahigh perinatal morbidity-mortality, this being more frequent in males. Good prognostic factors are reabsorption during pregnancy of late birth

Farmacología en atención estomatológica en menores de 19 años / Presence of Pharmacology in stomatologic care in children aged under 19

Se presenta una revisión bibliográfica actualizada basada en evidencias científicas del uso de antimicrobianos, antiinflamatorios, analgésicos, antisépticos bucales y medicina natural y tradicional en estomatología, realizada por Medline, Doyma y otras fuentes bibliográficas. Se reporta que más de la mitad de la población mundial consume en un momento de su vida algunos de estos fármacos, indicados por diferentes patologías de orígenes infecciosos, inflamatorios, incluso como tratamiento prevenivos y preoperatorios. La edad pediátrica constituye un grupo de difícil manejo terapéutico dada la inmadurez física, fisiológica (sistema pulmonar, cardiovascular, inmunológico y metabólico) y emocional, lo que exige que el uso de estas drogas requieren un conocimiento actualizado por parte del personal médico. En tal sentido, presentamos una revisión con el objetivo de exponer lo más actual sobre el uso de antibióticos, antiinflamatorios, analgésicos y antisépticos bucales en cuanto a farmacología para estomatólogos generales que brindan atención a menores de 19 años con afecciones estomatológicas(AU)

A updated bibliographic review is presented based on scientific evidences on use of antimicrobials, anti-inflammatory, analgesics agents, oral antiseptics and natural and folk medicine in Stomatology, performed by Medline Doyma, and other bibliographic sources. Authors reports that more than half of world population, in any moment of its life, has been a consumer of these drugs, prescribed from different pathologies of infectious, inflammatory nature, even as a preventive preoperative treatment. Pediatric age is a difficult therapeutic management group due to physical, physiological ( pulmonary, cardiovascular, immunologic, and metabolic system) and emotional immaturity, requiring that medical staff must to have a updated knowledge on use of these drugs. In this context, we presented a revision to expose the more updated features on use of antibiotics, anti-inflammatory, and oral antiseptics, as for a Pharmacology for general stomatologists giving care to children ages under 19 presenting with stomatologic affections(AU)