[Clinical and functional evaluation of pediatric patients with pelvic fracture treated in a third level Hospital]. / Evaluación clínica y funcional de pacientes pediátricos con fractura de pelvis tratados en un Hospital de Tercer Nivel.

INTRODUCTION: pelvic fracture in children is considered one of the most important injuries due to its high mortality. They are rare, but have a major impact on patients' functional outcomes. OBJECTIVE: to evaluate the clinical evolution and functional grade in pediatric patients with pelvic fractures who have already been treated, either conservatively or surgically. MATERIAL AND METHODS: descriptive-cross-sectional-retrospective study. Sample of 24 patients, aged five to 16 years with pelvic fracture, treated from 2016 to 2021. Clinical and functional outcome was assessed using the Barthel index and hip range of motion, as well as surgical or conservative treatment, accompanying lesions and injury mechanism. RESULTS: to find out if there is an association between the Torode and Zieg classifications with the Barthel index and hip range of motion, an association analysis was performed with the 2 statistic, obtaining a 2 value = 19.213. with p = 0.004 for the Barthel index and a 2= 14.253 with p = 0.0026 for hip ranges of motion; these results indicate that there is statistically significant association. CONCLUSION: the most frequent type of pelvic fracture in pediatric patients treated is type III on the Torode and Zieg scale, which according to the Barthel index is associated with a degree of independence and complete hip mobility arches, so the clinical and functional outcome in these patients is high in severe injuries.

INTRODUCCIÓN: la fractura de pelvis en edad pediátrica es considerada de las lesiones más importantes debido a su alta mortalidad; son poco frecuentes, pero tienen gran impacto en el resultado funcional de los pacientes. OBJETIVO: evaluar la evolución clínica y grado funcional en niños con fracturas de pelvis tratados de forma conservadora o quirúrgica. MATERIAL Y MÉTODOS: estudio descriptivo-transversal-retrospectivo. Muestra de 24 pacientes, de cinco a 16 años de edad, con fractura de pelvis, tratados del 2016 al 2021. Se valoró el resultado clínico y funcional mediante el índice de Barthel y arcos de movilidad de cadera, tratamiento quirúrgico o conservador, lesiones acompañantes y mecanismo de lesión. El análisis estadístico se realizó con el software IBM SPSS Statistics®. RESULTADOS: se realizó un análisis de asociación mediante 2 entre las clasificaciones de Torode y Zieg con el índice de Barthel y arcos de movilidad de cadera, obteniendo un valor de 2 = 19.213 con p = 0.004 para índice de Barthel y un valor de 2= 14.253 con p = 0.0026 para arcos de movilidad de cadera; estos resultados indican que hay una asociación estadísticamente significativa. CONCLUSIÓN: el tipo de fractura de pelvis más frecuente en pacientes tratados es el tipo III en la escala de Torode y Zieg, la cual, según el índice de Barthel, se asocia con un grado de independencia y arcos de movilidad de cadera completos, por lo que el resultado clínico y funcional en estos pacientes es alto en lesiones severas.

[Surgical treatment of supracondylar fractures in pediatric patients using AO external lateral fixation technique]. / Tratamiento quirúrgico de fracturas supracondíleas en pacientes pediátricos mediante técnica de fijación externa lateral AO.

INTRODUCTION: Fractures of the distal humerus represent 70% of fractures in children under 12 years. It is necessary to have knowledge about this type of injury, the therapeutic alternatives, and the possible complications. OBJECTIVE: To assess the functional results of the AO fixation technique in the management of humeral supracondylar fractures in pediatric patients. MATERIAL AND METHODS: Patients admitted to the pediatric orthopedics service were surgically treated by external fixation AO method, from July 1 to December 31, 2018. The data were obtained by monitoring from admission of patients until discharge from the outpatient clinic performing the functional clinical evaluation using the Mayo Elbow Performance Score to evaluate the function of the elbow. RESULTS: We included 5 patients with humeral supracondylar fracture treated by external fixation AO method, with an average age of 6 years. Of the 5 cases, 3 (60%) suffered the right upper limb injury and 2 (40%) the upper left limb, 1 patient (20%) had partial radial nerve injury. The score obtained on the Mayo Elbow Performance Score was 80 points on average. CONCLUSIONS: The functional result of the treatment of humeral supracondylar fractures by means of AO external fixation technique, shows good results, positioning it as an alternative therapeutic treatment option.

INTRODUCCIÓN: Las fracturas del húmero distal representan 70% de las fracturas en niños menores de 12 años. Es necesario contar con conocimientos sobre este tipo de lesiones, las alternativas terapéuticas existentes y las posibles complicaciones. OBJETIVO: Valorar los resultados funcionales de la técnica de fijación AO en el manejo de fracturas supracondíleas humerales en pacientes pediátricos. MATERIAL Y MÉTODOS: Se incluyeron los casos ingresados en el Servicio de Ortopedia Pediátrica intervenidos quirúrgicamente mediante fijación externa método AO, del 1o de Julio al 31 de Diciembre de 2018. Los datos fueron obtenidos mediante el seguimiento desde el ingreso hasta su alta de la consulta externa, realizando la evaluación clínica funcional mediante la Mayo Elbow Performance Score para evaluar la función del codo. RESULTADOS: Se incluyeron cinco casos con fractura supracondílea humeral tratados mediante fijación externa método AO, con un promedio de edad de seis años. De los cinco casos, tres (60%) sufrieron la lesión en miembro superior derecho y dos (40%) en miembro superior izquierdo, un paciente (20%) presentó lesión parcial del nervio radial. El puntaje obtenido en la escala Mayo Elbow Performance Score fue de 80 puntos en promedio. CONCLUSIONES: El tratamiento de las fracturas supracondíleas humerales mediante técnica de fijación externa AO muestra resultados buenos, posicionándolo como una opción terapéutica alternativa de tratamiento.

[Congenital radial head dislocation: report of two cases]. / Luxación congénita de cabeza radial: reporte de dos casos.

INTRODUCTION: Congenital dislocation of the Radial head is a condition that has been described in a few cases in the international literature, the anterior and lateral dislocation were the less frequent forms of presentation with 15% of cases, each, and the posterior dislocation the most frequent with 70% of the total cases reported. However, this pathology is considered the most frequent congenital pathology of the elbow in children. The present study describes the case of a patient with congenital dislocation of elbow anterior variety and another case with dislocation lateral variety, both diagnosed at an early age, in which it has been decided for conservative management and an annual follow-up. A bibliographic review of the subject is also carried out. DISCUSSION: The congenital elbow dislocation usually has a benign evolution, being painless and not very limiting for the patient, so it can be managed conservatively. Pain and limited movement are indicative of surgical treatment. There are multiple surgical treatments for this entity, however they are not widely accepted due to the complications and poor results presented by them.

INTRODUCCIÓN: La luxación congénita de cabeza radial es un padecimiento que se ha descrito en contados casos en la literatura internacional, siendo la luxación anterior y lateral las formas de presentación menos frecuentes con 15% de los casos cada una y la luxación posterior la más frecuente con 70% del total de los casos reportados. Sin embargo, esta patología es considerada la patología congénita más frecuente del codo en el niño. Se presenta el caso de un paciente con luxación congénita de codo variedad anterior y otro caso con luxación variedad lateral, ambos diagnosticados a temprana edad, en los que se decidió realizar un manejo conservador y un seguimiento anual. Asimismo, se hizo una revisión bibliográfica del tema. DISCUSIÓN: La luxación congénita de codo tiene por lo general una evolución benigna, siendo indolora y poco limitante para el paciente, por lo que puede ser manejada de manera conservadora. El dolor y la limitación de movimientos son indicativos de un tratamiento quirúrgico; sin embargo, no son ampliamente aceptados debido a las complicaciones y resultados deficientes que presentan.

Manejo ortopédico de la esclerodermia lineal localizada en niños: reporte de un caso / Orthopedic management of localized linear scleroderma in children: a case report

Resumen: Introducción: La esclerodermia localizada es la forma de presentación de esclerosis más frecuente en niños; tiene una incidencia de 2.7 por cada 100,000 habitantes, con predilección por la raza caucásica y el sexo femenino con relación de 2.4 a 4.1 por cada varón. El común denominador es la afección a nivel de tejido conectivo, genera una variedad de presentación clínica que va desde placas escleróticas localizadas circunscritas que afectan la piel hasta afecciones más profundas que atacan al tejido muscular y óseo, dejando secuelas estéticas y/o deformidades incapacitantes en el paciente. Objetivo: Presentación de caso y su manejo quirúrgico. Los datos expuestos se obtuvieron del expediente clínico físico y electrónico, entrevista directa con paciente y familiares y seguimiento y valoración de estudios radiográficos, desde Enero de 2012 hasta Noviembre de 2017. Discusión: El tratamiento quirúrgico está indicado cuando las deformidades y contracturas condicionan incapacidad en el paciente. Los mejores resultados se obtendrán una vez que la enfermedad haya dejado de progresar.

Abstract: Introduction: Localized scleroderma is the most common form of sclerosis in children; it has an incidence of 2.7 per 100,000 inhabitants, with a predilection for the Caucasian and female races of 2.4 to 4.1 per male. The common denominator is the connective tissue-level condition, causing a variety of clinical presentation ranging from localized sclerotic circumscribed plaques affecting the skin, to deeper conditions that attack muscle and bone tissue, leaving aesthetic consequences and/or disabling deformities in the patient. Objective: Case presentation and surgical management. The data presented were obtained from the physical and electronic clinical record, direct interview with patients and family members and monitoring and evaluation of radiographic studies, from January 2012 to November 2017. Discussion: Surgical treatment is indicated when deformities and contractures condition incapacity in the patient. The best results will be obtained once the disease has stopped progressing.

Luxación congénita de cabeza radial: reporte de dos casos / Congenital radial Head dislocation: report of two cases

Resumen: Introducción: La luxación congénita de cabeza radial es un padecimiento que se ha descrito en contados casos en la literatura internacional, siendo la luxación anterior y lateral las formas de presentación menos frecuentes con 15% de los casos cada una y la luxación posterior la más frecuente con 70% del total de los casos reportados. Sin embargo, esta patología es considerada la patología congénita más frecuente del codo en el niño. Se presenta el caso de un paciente con luxación congénita de codo variedad anterior y otro caso con luxación variedad lateral, ambos diagnosticados a temprana edad, en los que se decidió realizar un manejo conservador y un seguimiento anual. Asimismo, se hizo una revisión bibliográfica del tema. Discusión: La luxación congénita de codo tiene por lo general una evolución benigna, siendo indolora y poco limitante para el paciente, por lo que puede ser manejada de manera conservadora. El dolor y la limitación de movimientos son indicativos de un tratamiento quirúrgico; sin embargo, no son ampliamente aceptados debido a las complicaciones y resultados deficientes que presentan.

Abstract: Introduction: Congenital dislocation of the Radial head is a condition that has been described in a few cases in the international literature, the anterior and lateral dislocation were the less frequent forms of presentation with 15% of cases, each, and the posterior dislocation the most frequent with 70% of the total cases reported. However, this pathology is considered the most frequent congenital pathology of the elbow in children. The present study describes the case of a patient with congenital dislocation of elbow anterior variety and another case with dislocation lateral variety, both diagnosed at an early age, in which it has been decided for conservative management and an annual follow-up. A bibliographic review of the subject is also carried out. Discussion: The congenital elbow dislocation usually has a benign evolution, being painless and not very limiting for the patient, so it can be managed conservatively. Pain and limited movement are indicative of surgical treatment. There are multiple surgical treatments for this entity, however they are not widely accepted due to the complications and poor results presented by them.

[Orthopedic management of localized linear scleroderma in children: a case report]. / Manejo ortopédico de la esclerodermia lineal localizada en niños: reporte de un caso.

INTRODUCTION: Localized scleroderma is the most common form of sclerosis in children; it has an incidence of 2.7 per 100,000 inhabitants, with a predilection for the Caucasian and female races of 2.4 to 4.1 per male. The common denominator is the connective tissue-level condition, causing a variety of clinical presentation ranging from localized sclerotic circumscribed plaques affecting the skin, to deeper conditions that attack muscle and bone tissue, leaving aesthetic consequences and/or disabling deformities in the patient. OBJECTIVE: Case presentation and surgical management. The data presented were obtained from the physical and electronic clinical record, direct interview with patients and family members and monitoring and evaluation of radiographic studies, from January 2012 to November 2017. DISCUSSION: Surgical treatment is indicated when deformities and contractures condition incapacity in the patient. The best results will be obtained once the disease has stopped progressing.

INTRODUCCIÓN: La esclerodermia localizada es la forma de presentación de esclerosis más frecuente en niños; tiene una incidencia de 2.7 por cada 100,000 habitantes, con predilección por la raza caucásica y el sexo femenino con relación de 2.4 a 4.1 por cada varón. El común denominador es la afección a nivel de tejido conectivo, genera una variedad de presentación clínica que va desde placas escleróticas localizadas circunscritas que afectan la piel hasta afecciones más profundas que atacan al tejido muscular y óseo, dejando secuelas estéticas y/o deformidades incapacitantes en el paciente. OBJETIVO: Presentación de caso y su manejo quirúrgico. Los datos expuestos se obtuvieron del expediente clínico físico y electrónico, entrevista directa con paciente y familiares y seguimiento y valoración de estudios radiográficos, desde Enero de 2012 hasta Noviembre de 2017. DISCUSIÓN: El tratamiento quirúrgico está indicado cuando las deformidades y contracturas condicionan incapacidad en el paciente. Los mejores resultados se obtendrán una vez que la enfermedad haya dejado de progresar.

[Congenital Analgesia: report of 2 cases]. / Analgesia congénita: reporte de dos casos.

Congenital analgesia is a rare condition, reporting in the international literature in rare cases since 1932, when it was first described. Its cause has been the subject of development of multiple theories and studies through the years. Currently various studies and experiments as its origin point mutation in the gene encoding SC9NA sodium channels, which have an important role in nociceptive transmission signals in the human body. The purpose of this study is to present two cases that were valued in the department of pediatric orthopedics at UMAE HTYOLV, patients whose insensitivity to pain has produced significant injuries that were once cause for valuation of the hospital.

La analgesia congénita es un padecimiento poco frecuente, en la literatura internacional se ha reportado en contados casos desde 1932, año en el que fue descrita por primera vez. Su causa ha sido motivo del desarrollo de múltiples teorías y numerosos estudios a través de los años. Actualmente diversos estudios y experimentos apuntan como origen la mutación en el gen SCN9A que codifica para los canales de sodio, los cuales tienen un papel muy importante en la transmisión de señales nociceptivas en el cuerpo humano. El motivo del presente estudio es dar a conocer dos casos que fueron valorados en el servicio de ortopedia pediátrica de la UMAE HTYOLV, pacientes en quienes la falta de sensibilidad al dolor ha producido lesiones importantes que fueron en su momento motivo de valoración por parte del hospital.

Analgesia congénita: reporte de dos casos / Congenital Analgesia: report of 2 cases

Resumen: La analgesia congénita es un padecimiento poco frecuente, en la literatura internacional se ha reportado en contados casos desde 1932, año en el que fue descrita por primera vez. Su causa ha sido motivo del desarrollo de múltiples teorías y numerosos estudios a través de los años. Actualmente diversos estudios y experimentos apuntan como origen la mutación en el gen SCN9A que codifica para los canales de sodio, los cuales tienen un papel muy importante en la transmisión de señales nociceptivas en el cuerpo humano. El motivo del presente estudio es dar a conocer dos casos que fueron valorados en el servicio de ortopedia pediátrica de la UMAE HTYOLV, pacientes en quienes la falta de sensibilidad al dolor ha producido lesiones importantes que fueron en su momento motivo de valoración por parte del hospital.

Abstract: Congenital analgesia is a rare condition, reporting in the international literature in rare cases since 1932, when it was first described. Its cause has been the subject of development of multiple theories and studies through the years. Currently various studies and experiments as its origin point mutation in the gene encoding SC9NA sodium channels, which have an important role in nociceptive transmission signals in the human body. The purpose of this study is to present two cases that were valued in the department of pediatric orthopedics at UMAE HTYOLV, patients whose insensitivity to pain has produced significant injuries that were once cause for valuation of the hospital.

Slow and ultra-rapid freezing protocols for cryopreserving mouflon (Ovis musimon) and fallow deer (Dama dama) epididymal sperm.

This study examines the effectiveness of two methods for cryopreserving post-mortem epididymal sperm - conventional slow freezing employing a short equilibration time with glycerol, and ultra-rapid freezing - from the wild ruminant species Ovis musimon (mouflon) and Dama dama (fallow deer). A Tris-citric acid-glucose (TCG) + 12% egg yolk-based medium was used for the conventional slow freezing of the fallow deer sperm, whereas a Tes-Tris-glucose (TEST) + 6% egg yolk-based medium was used for the mouflon sperm. Glycerol was added to a final concentration of 5% to both media. The same diluents were used for ultra-rapid freezing but replacing the glycerol with 100 mM of sucrose. Sperm variables (motility, viability, acrosome integrity, membrane integrity, and morphological abnormalities) were analyzed before and after cryopreservation. Although values were generally better after the thawing of the conventionally cryopreserved sperm, total sperm motility (38.40 ±â€¯4.44% in mouflon and 31.25 ±â€¯3.37% in fallow deer) and total live sperm (47.19 ±â€¯5.18% in mouflon and 43.13 ±â€¯2.43% in fallow deer) were acceptable for the ultra-rapidly cooled sperm. Independent of the cryopreservation method, membrane integrity, acrosome integrity and the percentages of dead sperm and sperms with a damaged acrosome were better for the cryopreserved mouflon sperm than the fallow deer sperm (P < 0.05). Despite exerting a more harmful effect on sperm variables than conventional freezing, ultra-rapid freezing may be a useful alternative for the cryopreservation of these species' epididymal sperm in the field, as this simple technique does not require sophisticated equipment and expertise.

Reconstrucción mínimamente invasiva de la esquina posterolateral con sustitución simultánea del ligamento cruzado anterior para lesiones ligamentarias complejas de rodilla / Minimally invasive reconstruction of the posterolateral corner with simultaneous replacement of the anterior cruciate ligament for complex knee ligament injuries

Resumen: Introducción: Es importante conocer la efectividad del uso de técnicas combinadas para el tratamiento de las lesiones ligamentarias complejas de la rodilla, su evolución y las estrategias utilizadas para su desarrollo. Objetivo: Evaluar y describir los resultados de reconstruir de manera simultánea con una técnica mínimamente invasiva el complejo posterolateral (CPL) y el ligamento cruzado anterior (LCA). Material y métodos: Se realizó la reconstrucción del LCA y el CPL en siete pacientes, mediante la técnica descrita, en el período de Marzo a Noviembre de 2012. Todos los pacientes se evaluaron a los seis meses del procedimiento a través del uso de pruebas subjetivas IKDC, IKSS. Se valoró su retorno a actividades laborales y su índice de satisfacción. Resultados: Seis pacientes fueron del sexo masculino y solo uno del femenino, con rangos de edad entre los 26 y 46 años. La mayoría de las lesiones fueron causadas por accidentes asociados al deporte. Todos los participantes eran personas en la etapa productiva de la vida que requirieron un período promedio de tres meses de incapacidad. A los seis meses, conforme a la escala de IKDC, obtuvimos un paciente con IKDC de A, cuatro con un IKDC de B, uno de C y uno de D. En la escala subjetiva de IKSS, 80% promedió estabilidad de la rodilla por arriba de los 90 puntos, un paciente tuvo escala de 100 puntos y otro de 70 puntos.

Abstract: Objective: To evaluate and describe the results of a simultaneous reconstruction with minimally invasive technique of the posterolateral complex (PLC) and the anterior cruciate ligament (ACL). Material and methods: ACL and PLC reconstruction was performed in seven patients using the technique described, in the period from March to November 2012. All patients were evaluated at six months after the procedure using IKDC and IKSS subjective tests. Their return to work activities and their level of satisfaction were assessed. Results: Six male and one female patients ranging in age between 26 and 46 years were evaluated. The injuries were mostly caused by sports related accidents. All patients were economically active and required an average period of three months of disability. The assessment and outcomes at six months, according to the IKDC scale, were: one patient with IKDC A, four with IKDC B, one patient with C, and one with D. In the subjective scale IKSS, 80% averaged a knee stability of over 90 points, a patient had a 100-point scale and another, of 70 points.

[Minimally invasive reconstruction of the posterolateral corner with simultaneous replacement of the anterior cruciate ligament for complex knee ligament injuries]. / Reconstrucción mínimamente invasiva de la esquina posterolateral con sustitución simultánea del ligamento cruzado anterior para lesiones ligamentarias complejas de rodilla.

OBJECTIVE: To evaluate and describe the results of a simultaneous reconstruction with minimally invasive technique of the posterolateral complex (PLC) and the anterior cruciate ligament (ACL). MATERIAL AND METHODS: ACL and PLC reconstruction was performed in seven patients using the technique described, in the period from March to November 2012. All patients were evaluated at six months after the procedure using IKDC and IKSS subjective tests. Their return to work activities and their level of satisfaction were assessed. RESULTS: Six male and one female patients ranging in age between 26 and 46 years were evaluated. The injuries were mostly caused by sports related accidents. All patients were economically active and required an average period of three months of disability. The assessment and outcomes at six months, according to the IKDC scale, were: one patient with IKDC A, four with IKDC B, one patient with C, and one with D. In the subjective scale IKSS, 80% averaged a knee stability of over 90 points, a patient had a 100-point scale and another, of 70 points.

INTRODUCCIÓN: Es importante conocer la efectividad del uso de técnicas combinadas para el tratamiento de las lesiones ligamentarias complejas de la rodilla, su evolución y las estrategias utilizadas para su desarrollo. OBJETIVO: Evaluar y describir los resultados de reconstruir de manera simultánea con una técnica mínimamente invasiva el complejo posterolateral (CPL) y el ligamento cruzado anterior (LCA). MATERIAL Y MÉTODOS: Se realizó la reconstrucción del LCA y el CPL en siete pacientes, mediante la técnica descrita, en el período de Marzo a Noviembre de 2012. Todos los pacientes se evaluaron a los seis meses del procedimiento a través del uso de pruebas subjetivas IKDC, IKSS. Se valoró su retorno a actividades laborales y su índice de satisfacción. RESULTADOS: Seis pacientes fueron del sexo masculino y solo uno del femenino, con rangos de edad entre los 26 y 46 años. La mayoría de las lesiones fueron causadas por accidentes asociados al deporte. Todos los participantes eran personas en la etapa productiva de la vida que requirieron un período promedio de tres meses de incapacidad. A los seis meses, conforme a la escala de IKDC, obtuvimos un paciente con IKDC de A, cuatro con un IKDC de B, uno de C y uno de D. En la escala subjetiva de IKSS, 80% promedió estabilidad de la rodilla por arriba de los 90 puntos, un paciente tuvo escala de 100 puntos y otro de 70 puntos.

Polimorfismos en genes implicados en el desarrollo de cáncer gástrico: revisión / A Review of Polymorphisms in Genes Involved in the Development of Gastric Cancer

El carcinoma o linfoma gástrico es una de las principales causas de mortalidad por cáncer en el mundo. Esta enfermedad es el resultado final de un largo proceso multifactorial en el que interviene un elevado número de factores ambientales y genéticos. Como enfermedad genética, la variación individual en riesgo de cáncer ha sido asociada con variantes alélicas específicas de diferentes genes (polimorfismos), en los cuales se hallan los mecanismos moduladores que dan respuesta a la carcinogénesis y el riesgo de progreso de la misma. De esta manera, las investigaciones a nivel molecular se han enfocado en la detección de las alteraciones en la conformación de bases sobre genes de predisposición al desarrollo y progresión del cáncer gástrico. Estos estudios fueron realizados en diversas poblaciones donde la enfermedad es recurrente, basados inicialmente en la selección individual de polimorfismo de nucleótido simple (SNP) en genes candidatos. Importantes marcadores moleculares han sido descritos y propuestos como marcadores pronóstico en este tipo de pacientes y permiten así el avance en el entendimiento del proceso neoplásico. Esta revisión pretende dar una mirada de actualización en los estudios recientes en polimorfismos de genes implicados en procesos inmunogenéticos, en mecanismos de reparación de ADN, en la respuesta a la desintoxicación de compuestos carcinógenos y en mecanismos de supresión tumoral o que intervienen en la apoptosis, procesos que están involucrados en el desarrollo de cáncer gástrico. Datos de marcadores moleculares asociados con esta enfermedad de genomas de colombianos y foráneos ya almacenados en las bases de datos del proyecto 1000 Genomes son también reportados

Gastric carcinoma and lymphoma are leading causes of cancer mortality throughout the world. This disease is the end result of a long multifactorial process involving a large number of environmental and genetic factors. As a genetic disease, individual variation in cancer risk has been associated with specific alleles of different genes (polymorphisms) in which the modulatory mechanisms of carcinogenesis and the risk of its progression are found. Research at the molecular level has focused on the detection of genetic alterations predisposing to the development and progression of gastric cancer. These studies have been conducted in various populations in which the disease recurs and have been initially based on individual selection of single nucleotide polymorphisms (SNPs) in candidate genes. Important molecular markers have been described and proposed as prognostic markers in this type of patients which has allowed for advances in the understanding of the neoplastic process. This review intends to provide an up to date look at recent studies on gene polymorphisms involved in immunogenic processes, DNA repair mechanisms, responses to detoxification of carcinogenic compounds, mechanisms of tumor suppression and apoptosis which are all processes involved in the development of gastric cancer. Data are also reported from molecular markers associated with this disease from Colombian and foreign genomes already stored in the database of the 1000 Genomes Project.

Phenotypic and molecular characterization of intrauterine fetal growth restriction in interspecies sheep pregnancy.

Interspecies pregnancies between closely related species are usually performed in livestock to obtain improved and enriched offspring. Indeed, different hybrids have been obtained for research purposes since many years ago, and the maternal-fetal interactions have been studied as a possible strategy for species preservation. The aim of this study was to characterize by physiological and molecular approaches the interspecies pregnancy between bighorn sheep () and domestic sheep (). Hybrids were obtained by artificial insemination; the blood pressure and protein urine levels were measured during the last two-thirds of gestation. After parturition, offspring and placentas were weighed and measured and cotyledons were counted and weighed and their surface area determined. Plasma samples were obtained between wk 8 and 21 of gestation to assess progesterone (P4), vascular endothelial growth factor (VEGF), and placental growth factor (PlGF) levels and cell-free RNA was isolated during the same period to assess hypoxia-inducible factor-1 α (α) gene expression. Hybrid and normal pregnancies were analyzed using physiological and molecular parameters during the last two-thirds of gestation (wk 8-21). The results show that during the measurement period, ewes with a hybrid pregnancy presented normal blood pressure and no alteration in urinary protein content. However, compared with sheep with a normal pregnancy, those with a hybrid pregnancy had a decrease in fetal and placental growth as well as in the cotyledonary surface area. Furthermore, in the hybrid group, there was placental insufficiency, characterized by a decrease in P4 production, as well as indications of endothelial dysfunction, characterized an increase in plasma levels of VEGF and PlGF as well as in plasma gene expression of α. Overall, the results indicate that hybrids of and presented intrauterine growth restriction, essentially due to altered endothelial function and chronic placental insufficiency. Further studies are necessary to overcome this primary placental dysfunction and thus obtain improved offspring for future molecular and genomic evaluations.

Dietary fatty acids affect mitochondrial phospholipid compositions and mitochondrial gene expression of rainbow trout liver at different ages.

Mitochondria are among the first responders to various stressors that challenge the homeostasis of cells and organisms. Mitochondrial decay is generally associated with impairment in the organelle bioenergetics function and increased oxidative stress, and it appears that deterioration of mitochondrial inner membrane phospholipids (PL), particularly cardiolipin (CL), and accumulation of mitochondrial DNA (mtDNA) mutations are among the main mechanisms involved in this process. In the present study, liver mitochondrial membrane PL compositions, lipid peroxidation, and mtDNA gene expression were analyzed in rainbow trout fed three diets with the same base formulation but with lipid supplied either by fish oil (FO), rapeseed oil (RO), or high DHA oil (DHA) during 6 weeks. Specifically, two feeding trials were performed using fish from the same population of two ages (1 and 3 years), and PL class compositions of liver mitochondria, fatty acid composition of individual PL classes, TBARS content, and mtDNA expression were determined. Dietary fatty acid composition strongly affected mitochondrial membrane composition from trout liver but observed changes did not fully reflect the diet, particularly when it contained high DHA. The changes were PL specific, CL being particularly resistant to changes in DHA. Some significant differences observed in expression of mtDNA with diet may suggest long-term dietary effects in mitochondrial gene expression which could affect electron transport chain function. All the changes were influenced by fish age, which could be related to the different growth rates observed between 1- and 3-year-old trout but that could also indicate age-related changes in the ability to maintain structural homeostasis of mitochondrial membranes.

Loss of epithelial p53 and αv integrin cooperate through Akt to induce squamous cell carcinoma yet prevent remodeling of the tumor microenvironment.

Most of the squamous cell carcinomas (SCCs) of the skin and head and neck contain p53 mutations. The presence of p53 mutations in premalignant lesions suggests that they represent early events during tumor progression and additional alterations may be required for SCC development. Here we show that codeletion of the p53 and αv integrin genes in mouse stratified epithelia induced SCCs in 100% of the mice, more frequently and with much shorter latency than deletion of either gene alone. The SCCs that lacked p53 and αv in the epithelial tumor cells exhibited high Akt activity, lacked multiple types of infiltrating immune cells, contained a defective vasculature and grew slower than tumors that expressed p53 or αv. These results reveal that loss of αv in epithelial cells that lack p53 promotes SCC development, but also prevents remodeling of the tumor microenvironment and delays tumor growth. We observed that Akt inactivation in SCC cells that lack p53 and αv promoted anoikis. Thus, tumors may arise in these mice as a result of the increased cell survival induced by Akt activation triggered by loss of αv and p53, and by the defective recruitment of immune cells to these tumors, which may allow immune evasion. However, the defective vasculature and lack of a supportive stroma create a restrictive microenvironment in these SCCs that slows their growth. These mechanisms may underlie the rapid onset and slow growth of SCCs that lack p53 and αv.

Morphological, chemical and structural characterisation of deciduous enamel: SEM, EDS, XRD, FTIR and XPS analysis.

AIM: The purpose of this study was to characterise the enamel surface of sound deciduous teeth in terms of morphology, chemical composition, structure and crystalline phases. MATERIALS AND METHODS: The enamel of 30 human deciduous teeth was examined by: Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Spectroscopy (EDS), X-ray Powder Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), and X-ray Photoelectron Spectroscopy (XPS). Chemical differences between incisors and canines were statistically evaluated using the Mann-Whitney U test (p ≤ 0.05). RESULTS: Three enamel patterns were observed by SEM: 'mostly smooth with some groves', 'abundant microporosities' and 'exposed prisms'. The average Ca/P molar ratios were 1.37 and 1.03 by EDS and XPS, respectively. The crystallite size determined by XRD was 210.82 ± 16.78 Å. The mean ratio between Ca bonded to phosphate and Ca bonded to hydroxyl was approximately 10:1. CONCLUSION: The enamel of sound deciduous teeth showed two main patterns: 'mostly smooth with some groves' and 'abundant microporosities'. 'Exposed prisms' was a secondary pattern. There were slight variations among the Ca/P molar ratios found by EDS and XPS, suggesting differences in the mineral content from the enamel surface to the interior. The crystalline phases found in enamel were hydroxyapatite and carbonate apatite, with major type B than type A carbonate incorporation.

Generalización e inferencia: un acercamiento a su compresión desde tres enfoques / Generalization and inference: an understanding based on three approaches

Se trata de una reflexión que busca poner en discusión los diferentes significados que pueden adquirir los conceptos de generalización e inferencia, de acuerdo con el enfoque o perspectiva desde el cual se pretendan utilizar. Para este propósito, en primer lugar, se pone en consideración la importancia y el uso que se ha dado a estos conceptos en el campo de la epidemiología clásica-moderna, especialmente para definir asuntos de validez interna y externa y para la formulación de hipótesis. Seguidamente, se presentan las principales argumentaciones que al respecto defiende Clifford Geertz desde su perspectiva epistemológica de la etnografía interpretativista y de acuerdo con su concepción teórica de la cultura. Posteriormente, se presentan las ideas que sustenta Juan Samaja desde su enfoque epistemológico y metodológico para la investigación en salud, abogando principalmente por el razonamiento abductivo, y no sólo el inductivo y el deductivo que han sido privilegiados en los estudios lógicos. Por último se presenta una discusión y unas conclusiones destacando que en estas tres perspectivas la salud pública tiene una oportunidad para enriquecer sus procesos de generación de nuevo conocimiento y para comprender de mejor manera las condiciones de salud y de bienestar colectivo.

This paper is a reflection which seeks to stimulate discussion and debate concerning the different meanings that the concepts of generalization and inference can take on, based on the approach or perspective that is being employed. For this purpose the importance and usage which has been accorded to these concepts within the field of classic-modern epidemiology is taken into consideration, especially in order to define internal and external validity issues and to formulate hypotheses. Next the main arguments are presented and are defended by Clifford Geertz from his epistemological perspective of interpretive ethnography and based on his theoretical conception of culture. Subsequently the ideas maintained by Juan Samaja are presented from his epistemological and methodological approach for research into health, advocating primarily for abductive reasoning, and not simply inductive and deductive, which have until now been privileged in logic studies. Finally a discussion and conclusions are presented, highlighting that from these three perspectives public health has the opportunity to expand its new knowledge generation processes and to better understand the conditions for good collective health and wellbeing.

Los Determinantes Sociales de la Salud: base teórica de la salud pública / Social Determinants of Health: public health´s theoretical basis

Este artículo presenta una mirada histórica al concepto de los determinantes sociales de la salud, en la perspectiva de las distintas aportaciones conceptuales y teóricas de algunos académicos de la disciplina de la salud pública. Para su cometido, en primer lugar se reconocen algunos de los conceptos germinales de la salud pública y su relación con los determinantes sociales de la salud y del bienestar colectivo. Luego se indaga por el concepto de los determinantes sociales en las declaraciones de las Conferencias Internacionales sobre Promoción de la Salud a partir de Alma Ata. Seguidamente se presentan de manera sintética los más recientes aportes conceptuales desde el punto de vista del Movimiento Latinoamericano de Medicina Social, así como los conceptos y categorías más relevantes desarrolladas desde el enfoque de la Comisión de los Determinantes Sociales de la Salud de la Organización Mundial de la Salud. Por último, se aborda una breve discusión y se hacen algunas conclusiones.

This article presents a historical overview of the concept of social determinants of health, in the perspective of the different theoretical and conceptual contributions provided by some academics of health public discipline. For its purpose, first are recognized some of the public health germ concepts and its relationship with social determinants of health and social welfare. Then, it´s looks for the concepts of social determinants into the statements of International Conferences on Health Promotion since Alma Ata. After, synthetically are presented the most recent conceptual contributions since the point of view of the Latin American Movement of Social Medicine, and the more relevant concepts and categories developed from the approach of the Commission on Social Determinants of Health of the World Health Organization. Finally, are addressed a brief discussion and some conclusions.

[Characterization socio-occupational and health insurance of two groups of unemployed workers from Medellin-Colombia 2004 and 2007]. / Caracterización socio-laboral y de aseguramiento en salud de dos grupos de trabajadores cesantes de Medellín-Colombia 2004 y 2007.

OBJECTIVE: Analyzing the socio-occupational and health insurance for two groups of workers who lost their job in the city of Medellin, Colombia in two periods (2004 and 2007), in order to help design alternative public policies that effectively confront the problem of vulnerability in health of unemployed workers and their families. METHODOLOGY: Based on primary information, collected through the same instrument applied to two independent samples of workers who lost their job in the city of Medellin in 2004 (n = 267) and 2007 (n = 198), a descriptive cross-sectional study was made using quantitative research techniques of univariate and bivariate analysis. RESULTS: In both 2004 and 2007 studies the possibility that unemployed workers remain without health insurance was largely associated to variables of sex, age, education, socioeconomic status, occupational status, salary level and duration of unemployment. Their willingness to access to micro credit resources or a micro insurance, proposed to the municipal government as public policies to maintain their membership as contributors to the contributory regime, was highly favorable in both groups. CONCLUSIONS: The socio-occupational profile of unemployed workers keeps correspondence in both groups, although there are significant differences in the conditions of health insurance. We conclude that the vulnerability of unemployed workers excluded from the health insurance demands of society and State alternative public policies for their protection.

Perfil socio-laboral de los profesionales en Administración en Salud de la Universidad de Antioquia 1999-2008 / Social and work profile of the Health Administration professionals from Universidad de Antioquia, 1999–2008

Objetivo: caracterizar el perfil socio-laboral de los profesionales egresados del programa Administración en Salud de la Universidad de Antioquia. Metodología: estudio descriptivo de corte transversal basado en información primaria mediante encuesta a 356 profesionales egresados del programa entre 1999 y 2008. Se aplicaron técnicas de análisis estadístico descriptivo e inferencial. Según la naturaleza de las variables, se reportan valores absolutos, proporciones, medidas de resumen y tendencia central. Resultados: se trata de un grupo de profesionales jóvenes con edad promedio de 32,5 años, principalmente mujeres, en su mayoría con experiencia laboral profesional después de haberse graduado y con vínculo laboral al momento de la encuesta. El 12,1% reportó estar desempleado. El principal sector de la economía donde laboran es el de servicios, seguido de la construcción. El cargo desempeñado durante su historia laboral más frecuente es el administrativo seguido del operativo. Para la mayoría, sus ingresos salariales no superan los 4 Salarios Mínimos Legales Vigentes (SMLV). Discusión: algunos hallazgos se corresponden con estudios previos de 2001 y 2004. Otras variables contrastan con esos estudios y con otros referentes nacionales. Se concluye que las condiciones de precariedad laboral no son inherentes a la profesión en sí misma sino a las características del mercado laboral del mundo capitalista actual.

OBJECTIVE: To characterize the social and work profiles of the professionals from Universidad de Antioquia (University of Antioquia) who hold a degree in Health Administration.METODHOLOGY: A cross–sectional study based on primary data obtained by surveying 356 graduate professionals between 1999 and 2008. Descriptive and inferential statistical analysis techniques were applied. Depending on the nature of the variables, absolute values, ratios, and summary measures of central tendency were reported. RESULTS: It was a group of young professionals with an average age of 32.5 years. They were mainly women with professional work experience after graduation. They were employed at the time of the survey, but 12.1% of them reported being unemployed. The main sector of the economy where they work is services, followed by construction. Their most common position is that of administrator, followed by operational positions. In most cases, their income doesn't exceed 4 legal minimum wages.DISCUSSION: some findings are consistent with previous studies conducted in 2001 and 2004. Other variables contrast with these studies and with other national references. We conclude that the conditions of job insecurity are not inherent to the profession itself but to the labor market characteristics of the current capitalist world.