Tricomicosis palmelina causa poco frecuente de afectación del tallo piloso / Trichomycosis palmelina: rare cause of hair shaft affection

Resumen La tricomicosis o tricobacteriosis palmelina es un motivo de consulta poco frecuente en los servicios de dermatología, es importante reconocerla y diferenciarla de otras patologías ya que puede ser difícil de diagnosticar. La tricomicosis o tricobacteriosis es una condición infecciosa superficial asintomática, rara, causada en la mayoría de los casos por Corynebacterium flavescens (también llamada Corynebacterium tenuis), perteneciente a la familia corinebacteriaceae, las cuales, son bacterias gram positivas, pleomórficas, inmóviles, no encapsuladas, aerobias o anaerobias facultativas. Afecta pelos de la región axilar, zona púbica, escrotal e interglutea; se debe al aumento de la población bacteriana de la microbiota normal, adherida a la cutícula del pelo. Esta afectación es propia de climas húmedos, afectando predominantemente a adultos jóvenes, de sexo masculino, deportistas y homosexuales en un entorno de pobreza y hacinamiento. El objetivo del presente reporte es comunicar un caso de tricomicosis palmelina flava en región púbica en un adulto joven y describir las características clínicas de esta patología relativamente poco conocida.

Abstract Trichomycosis or palmelin trichobacteriosis it is an infrequent reason for consultation in dermatology services, important to recognize and differentiate it from other pathologies since it can be difficult to diagnose. Trichomycosis or trichobacteriosis is a rare, asymptomatic superficial infectious condition, caused in most cases by Corynebacterium flavescens (also called Corynebacterium tenuis), belonging to the Corynebacteriaceae family, which are gram-positive, pleomorphic, immobile, non-encapsulated bacteria, aerobic or facultative anaerobic. It affects hairs in the axillary region, pubic, scrotal and intergluteal area; It is due to the increase in the bacterial population of the normal microbiota, attached to the hair cuticle. This affectation is typical of humid climates, predominantly affecting young adults, males, athletes and homosexuals in an environment of poverty and overcrowding. The objective of this article is to report a case of trichomycosis palmellina flava in the pubic region present in a young adult and to present the clinical characteristics of this relatively unrecognized condition.

Carcinoma basocelular en región plantar / Basal cell carcinoma of the plantar surface of the foot

RESUMEN: El carcinoma basocelular (CBC) es el tumor maligno de piel más frecuente (75% - 80%), localizado generalmente en zonas de exposición solar, aunque en algunos casos se presenta en áreas no fotoexpuestas (1%), lo que puede indicar la participación de otros factores etiológicos diferentes a la radiación ultravioleta. El CBC es decrecimiento lento, bajo potencial metastásico, pero localmente invasivo, por lo que es importante realizar un diagnóstico oportuno, conociendo las características clínicas e histológicas de esta entidad. Se presenta el caso de un paciente de 66 años, con una lesión en región plantar izquierda de dos años de evolución, evaluado por el Departamento de Dermatología, quienes confirman el diagnóstico de CBC nodular, mediante la realización de biopsia incisional y posterior resección con márgenes de seguridad de 4 mm. El CBC delocalizaciónplantar, a pesar de ser poco frecuente, debe sospecharse si se presenta una lesión tumoral, de evolución crónica.

SUMMARY Basal Cell Carcinoma (BCC) is the most frequent malignant tumor (75% - 80%), generally located in sun-exposed areas, although some can occur in areas that are not (1 %). The prior indicates that there are other factors involved in its etiology different from UV radiation. BCC is a slow growing tumor with poor metastatic potential but locally invasive, the reason why a prompt diagnosis is required, by knowing thoroughly its clinical and histopathological features. We present the case of a sixty-six-year-old male patient referred to the dermatology department, with a two-year evolution lesion in the plantar surface of his left foot. Diagnosis of nodular BCC is done through incisional biopsy and posterior resection is performed with a 4 mm safety margin. Although plantar BCC is infrequent, it should always be suspected when finding a chronic tumoral lesion in this area.

A complete chitinolytic system in the atherinopsid pike silverside Chirostoma estor: gene expression and activities.

The expression and digestive activity of pike silverside Chirostoma estor endogenous chitinases were analysed in samples from four life stages: whole eggs; larvae; juvenile intestine and hepatopancreas and adult intestine and hepatopancreas. A chitinase cDNA was cloned and partially sequenced (GenBank accession number: FJ785521). It was highly homologous to non-acidic chitinase sequences from other fish species, suggesting that it is a chitotriosidase. Quantitative PCR showed that this chitinase was expressed throughout the life span of C. estor, with maximum expression in the hepatopancreas of juveniles. Chitotriosidase and chitobiosidase activities were found at all life stages, along with a very high level of N-acetyl glucosaminidase (NAGase). The chitotriosidase activity could be encoded by the cloned complementary (c)DNA, although additional chitinase genes may be present. The chitotriosidase activity appeared to be transcriptionally regulated only at the juvenile stage. The expression and activity of chitinases tended to increase from the early to juvenile stages, suggesting that these variables are stimulated by chitin-rich live food. Nevertheless, the feeding of juvenile and adult fish with both live food and a balanced commercial diet seemed to provoke significant reductions in pancreatic NAGase secretion and/or synthesis in the gut. Moreover, all chitinase activities were lower in adults, probably reflecting a higher intake and use of the balanced diet. The observation of chitotriosidase and chitobiosidase activities together with a very high NAGase activity suggest the presence of a complete and compensatory chitinolytic chitinase system that enables this stomachless short-gut fish species to use chitin as an energy substrate. These novel findings suggest that dietary inclusions of chitin-rich ingredients or by-products might reduce the farming costs of C. estor without impairing performance.

Effect of resveratrol and lipoic acid on sirtuin-regulated expression of metabolic genes in bovine liver and muscle slice cultures.

Sirtuins (Sirt) are NAD-dependent deacetylases that are activated by the antioxidants resveratrol (RSV) and lipoic acid (LA). The objective of this study was to determine in bovine liver and muscle slice cultures the effect of RSV and LA treatment on the expresssion of Sirt1, Sirt3, peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A), and the forkhead box O transcription factors FoxO1 and FoxO3 as well as other factors involved in glucose and lipid metabolism and related to Sirt activity. Tissue slices from crossbred bulls were treated during 60 min with 40 or 80 µ RSV and 30, 100, 300, or 1,000 µ LA under restricted conditions (Krebs-Ringer buffer without nutrients) and fed conditions (2.5 m propionate in combination with 1 n glucagon) for liver slices or with 0.01 µ epinephrine for muscle slices. Quantitative real-time PCR was used to analyze the expression of the mRNA for the genes studied and western blot analysis for the expression of the protein for Sirt1. Our results show that the expression of the mRNA for Sirt1 was enhanced by RSV in liver under restriction ( ≤ 0.0112) and by LA in muscle, more under restriction ( ≤ 0.0121) than after epinephrine administration ( < 0.0001). Sirt3 is affected in a dose-dependent manner by both compounds in both tissues and under both metabolic conditions ( ≤ 0.0452). The expression of the protein for Sirt1 was increased by LA in both tissues under restricted conditions ( = 0.0026 and = 0.0201, respectively) but in liver also in fed conditions ( = 0.0016). Genes involved in the antioxidant response were upregulated in both tissues. These results indicate that bovine Sirt respond differently to RSV and LA stimulation than monogastric Sirt do and that gluconeogenesis in ruminants is not related to Sirt to the same degree as in monogastric species. However, these results provide information about the possible role of Sirt in ruminant metabolism.

[Primary care for diabetic patients: a quality improvement cycle]. / Evaluación de la calidad en cuidados médicos prestados a pacientes diabéticos: un ciclo de mejora.

OBJECTIVE: The aim of this study was to evaluate and improve the quality of medical care provided to diabetic patients following the standards proposed by the American Diabetes Association. MATERIAL AND METHODS: The study was conducted in three phases by analyzing data from the computerized clinical history of a sample of 340 patients. First phase (2010): cross-sectional, descriptive study which assessed the proportion of patients who met the standards related to the screening of diabetes, and goals of control and treatment. Subsequently, health professionals reviewed the results in order to promote the implementation of corrective action. Finally (2012), a new assessment with the same standards was performed. RESULTS: An increase in the number of patients treated with insulin (12.7% in 2010 and 20.2% in 2012) was observed (P < .01). There were also percentage increases in the number of patients who met the screening standards as regards analytical determinations: glycosylated hemoglobin (from 44.4% to 68.2%), lipid profile (47.6%-73.8%), creatinine (32.5% - 73.5%), and albumin-creatinine ratio (9.2%-24.4%) (P < .001). Only 6.4% (CI: 3.2- 9.8) of diabetic patients attained the composite target of glycosylated hemoglobin < 7%, blood pressure < 130/80 mmHg and low-density lipoprotein cholesterol < 100 mg/dl in 2012. CONCLUSIONS: This study shows that medical care has improved the goals related to analytical determinations and the number of insulin-treated diabetic type 2 patients. An optimal level was also maintained in metabolic control of diabetes, but there was still poor control of risk factors for cardiovascular disease.

Evaluación de la calidad en cuidados médicos prestados a pacientes diabéticos: un ciclo de mejora / Primary care for diabetic patients: A quality improvement cycle

Objetivo: Evaluar y mejorar la calidad de los cuidados médicos prestados a pacientes diabéticos a través de los estándares propuestos por la Asociación Americana de Diabetes. Material y métodos: El estudio se realizó en 3 fases, sobre una población diana de 2.795 pacientes diabéticos, analizando los registros en la historia clínica informatizada de una muestra de 340 individuos. Primera fase (año 2010): estudio transversal, descriptivo, donde se evaluó el cumplimiento de estándares relacionados con el cribado, metas de control y tratamiento de la diabetes. En la segunda realizamos una intervención basada en sesiones grupales sobre los profesionales sanitarios. Finalmente evaluamos el cumplimiento de los mismos estándares, durante la asistencia prestada en 2012. Resultados: El porcentaje de diabéticos tipo 2 tratados con insulina se incrementó desde el 12,7% en 2010 al 20,2% en 2012 (p < 0,01). También aumentó el porcentaje de pacientes en los que se cumplió el cribado relacionado con determinaciones analíticas: hemoglobina glucosilada (del 44,4% al 68,2%), perfil lipídico (del 47,6% al 73,8%), creatinina (del 32,5% al 73,5%) y cociente albúmina-creatinina (del 9,2% al 24,4%) (p < 0,001). El 4,2% (IC: 0,9%-7,1%) de los diabéticos alcanzaron, a la vez, las metas recomendadas de hemoglobina glucosilada, tensión arterial y lipoproteínas de baja densidad en 2010, mientras que en el año 2012 fueron el 6,4% (IC: 3,2%-9,8%). Conclusiones: Mejoramos el cribado de parámetros analíticos, insulinizamos más a los pacientes con diabetes tipo 2, pero conseguimos un pobre control de enfermedades, asociadas a la diabetes, que suponen importantes factores de riesgo cardiovascular (AU)

Objective: The aim of this study was to evaluate and improve the quality of medical care provided to diabetic patients following the standards proposed by the American Diabetes Association. Material and methods. The study was conducted in three phases by analyzing data from the computerized clinical history of a sample of 340 patients. First phase (2010): cross-sectional, descriptive study which assessed the proportion of patients who met the standards related to the screening of diabetes, and goals of control and treatment. Subsequently, health professionals reviewed the results in order to promote the implementation of corrective action. Finally (2012), a new assessment with the same standards was performed. Results: An increase in the number of patients treated with insulin (12.7% in 2010 and 20.2% in 2012) was observed (P < .01). There were also percentage increases in the number of patients who met the screening standards as regards analytical determinations: glycosylated hemoglobin (from 44.4% to 68.2%), lipid profile (47.6%-73.8%), creatinine (32.5% - 73.5%), and albumin-creatinine ratio (9.2%-24.4%) (P < .001). Only 6.4% (CI: 3.2- 9.8) of diabetic patients attained the composite target of glycosylated hemoglobin < 7%, blood pressure < 130/80 mm Hg and low-density lipoprotein cholesterol < 100 mg/dl in 2012. Conclusions: This study shows that medical care has improved the goals related to analytical determinations and the number of insulin-treated diabetic type 2 patients. An optimal level was also maintained in metabolic control of diabetes, but there was still poor control of risk factors for cardiovascular disease (AU)

Síndrome de Albrigth-Mccune Sternberg: reporte de un caso y revisión de la literatura / Albright-Mccune Sternberg syndrome: case report and literature review

El síndrome de Albright-McCune Sternberg (SAMS) es un desorden raro que se origina de una mutación del gen GNAS1. Se caracteriza por presentar un fenotipo típico, el cual incluye fibrodisplasia (FD) poliostótica, pubertad precoz (PP), pigmentaciones café au lait (café con leche) junto con otras endocrinopatías. La presente investigación trata de una paciente femenina de 22 años de edad con SAMS la cual presenta algunos signos y síntomas del síndrome tales como: FD poliostótica, pigmentaciones color café con leche en la piel, PP e hipotiroidismo. Acudió por dolor a nivel de las encías inferiores producto de un aumento óseo bimaxilar, inicia su enfermedad actual en mayo de 2013 presentando dolor a nivel de mucosa gingival inferior, localizado, punzante, de intensidad moderada, el cual se agrava ante la masticación y dura hasta el cese del estimulo. La FD fue diagnosticada posterior a la realización de una biopsia de tejido óseo y estudios radiográficos, la paciente presentó metrorragia a los nueve meses de edad el cual se repitió a los cinco años y persistió de manera intermitente hasta los veinte años de edad donde fue diagnosticada con ovarios poliquísticos por lo cual se le prescribió etinilestradiol y acetato de ciproterona. Aunque el SAMS generalmente cursa con una hiperfunción endocrina la paciente tiene un diagnóstico de hipotiroidismo por lo cual está bajo tratamiento con levotiroxina.

The Albright-McCune Sternberg syndrome (AMSS) is a rare disorder that arises from a mutation of the GNAS1 gene. It is characterized by a typical phenotype, which includes polyostotic fibrous dysplasia (FD), precocious puberty (PP), cafe-au-lait pigmentations and other endocrinopathies. The following research is about a 22 year old female patient with SAMS which presents some signs and symptoms of the syndrome such as polyostotic FD, pigmentation of the skin, PP and hypothyroidism. She attended by pain in the lower gum product of increased bimaxillary volume it began in may 2013 having pain in lower gingiva localized, throbbing, of moderate intensity, which is exacerbated by chewing and lasts until the cessation of the stimulus. The FD was diagnosed after performing a bone biopsy and radiographic studies, the patient had metrorrhagia at nine months of age which was repeated at five years and persisted intermittently until twenty years where he was diagnosed with polycystic ovaries so was prescribed ethinylestradiol and cyproterone acetate. Although the AMSS usually occurs with endocrine hyperfunction the patient has a diagnosis of hypothyroidism which is treated with levothyroxine.

Potential role of sirtuins in livestock production.

Sirtuins are NAD(+)-dependent histone and protein deacetylases, which have been studied during the last decade with a focus on their role in lifespan extension and age-related diseases under normal and calorie-restricted or pathological conditions. However, sirtuins also have the ability to regulate energy homeostasis as they can sense the metabolic state of the cell through the NAD(+)/NADH ratio; hence, changes in the diet can modify the expression of these enzymes. Dietary manipulations are a common practice currently being used in livestock production with favorable results, probably due in part to the enhanced activity of sirtuins. Nevertheless, sirtuin expression in livestock species has not been a research target. For these reasons, the goal of this review is to awaken interest in these enzymes for future detailed characterization in livestock species by presenting a general introduction to what sirtuins are, how they work and what is known about their role in livestock.

Effect of 2,4-thiazolidinedione on limousin cattle growth and on muscle and adipose tissue metabolism.

The main adipogenic transcription factor PPARγ possesses high affinity to 2,4-TZD, a member of the Thiazolidinedione family of insulin-sensitizing compounds used as adipogenic agents. We evaluated 2,4-TZD's effect on bovine growth and PPAR tissue expression. Seventeen Limousin bulls (18 month-old; 350 kg body weight (BW)) were assigned into 2 treatments: control and 2,4-TZD (8 mg/70 kg BW) and were fed until bulls reached 500 kg BW. They were weighed and their blood was sampled. DNA, RNA, and protein were determined in liver; skeletal muscle; subcutaneous (SC), omental, perirenal adipose tissues (AT) to determine protein synthesis rate and cellular size. Expression of PPAR mRNA was measured in liver and muscle (PPARα, -δ, and -γ) and SC adipose tissue (γ) by real-time PCR. No significant differences were found (P > 0.1) in weight gain, days on feed, and carcass quality. Muscle synthesis was greater in controls (P < 0.05); cell size was larger with 2,4-TZD (P < 0.05). PPARα, -δ, and -γ expressions with 2,4-TZD in liver were lower (P < 0.01) than in muscle. No differences were found for PPARγ mRNA expression in SCAT. The results suggest the potential use of 2,4-TZD in beef cattle diets, because it improves AT differentiation, liver, and muscle fatty acid oxidation that, therefore, might improve energy efficiency.

Ghrelin stimulates myogenic differentiation in a mouse muscle satellite cell line and in primary cultures of bovine myoblasts.

Ghrelin is an acylated hormone that influences food intake, energy metabolism and reproduction, among others. Ghrelin may also stimulate proliferating myoblast cell differentiation and multinucleated myotube fusion. The aim of this work was to assess the effect of human ghrelin (hGHRL) and human ghrelin fragment 1-18 (hGHRL1-18) on myoblast differentiation by means of mRNA expression and protein level. Two types of cells were tested, the cell line i28 obtained from mouse skeletal muscle and primary cultures of bovine myoblasts. Both ghrelin and its N-terminal fragment hGHRL1-18 were used at concentrations of 0, 0.01, 0.1, 1, 10 and 100 nm. Treatments were applied to pre-confluent cultures and were maintained for 4 days. We determined that between 0.1 and 100 nm, hGHRL and hGRHL1-18 had similar effects on myogenic differentiation of i28 cells (p < 0.01). On the other hand, only the higher concentrations (10 and 100 nm) of hGHRL stimulated bovine myoblast differentiation. These results could be attributed to the presence, in both i28 cells and in bovine myoblasts, of the mRNA for GHS-R1a and CD36 receptors. The use of ghrelin in livestock production is still questionable because of the limited effects shown in this study, and additional research is needed in this field.

New host plant records for Oenomaus ortygnus (Cramer) (Lepidoptera: Lycaenidae) in Mexico.

This is the first record of Oenomaus ortygnus (Cramer) damaging fruits of ilama (Annona diversifolia) and extends the butterfly distribution for three states in Mexico.

Helicobacter pylori: efectividad del tratamiento secuencial vs tratamiento convencional / Helicobacter pylori: effectiveness of conventional treatment versus sequential treatment

Helicobacter pylori (Helicobacter p.) es una bacteria que se aloja a nivel de la mucosa gástrica la cual presenta una prevalencia variable y está asociada al desarrollo de úlceras pépticas, linfomas y cáncer gástrico. Aproximadamente el 40% de los individuos en países desarrollados están afectados y hasta un 85%, en los países subdesarrollados, por ello, se asocia con un bajo nivel socioeconómico. Recientemente se ha propuesto el uso de una terapia secuencial con el objetivo de erradicar la infección por Helicobacter p. El objetivo de este estudio consiste en comparar la efectividad de ambos tratamientos en la consulta del Servicio de Gastroenterología del Hospital “Carlos J. Bello” en el período de febrero 2008 a octubre 2009, en un total de 83 pacientes, 77,1% de sexo femenino, y 22,9% de sexo masculino. El grupo que recibió tratamiento convencional representó el 57,83%, del total de pacientes estudiados, y el grupo que recibió tratamiento secuencial, representó el 42,17%. En cuanto a la efectividad, el tratamiento convencional fue efectivo en un 46,99%, y el secuencial en un 32,53%, dentro de su propio grupo de pacientes. La prueba X2 no representó diferencia significativa entre la efectividad de ambos tratamientos.

Helicobacter pylori (Helicobacter p. ) Its a bacteria that lives in the gastric mucosa and its prevalence is variable and it is associated to the development of peptic ulcer, lymphoma, and gastric cancer. Approximately 40% of individuals in developed countries are affected and 85% in undeveloped countries in which are related to low socioeconomics level. Recently its been proposed the use of a sequential therapy to eradicate the infection by Helicobacter p. The objective of this study consist in to compare the effectiveness between both treatments (Sequential and conventional) in the consult from the Gastroenterology Service of the Carlos J. Bello Hospital in a period of time between February 2008 to October 2009 in a total of 83 patients, 77,1% feminine, 22,9% masculine. The group that received conventional treatment represented 57,83% and sequential 42,17%. In regard to the effectiveness the conventional group presented 46, 99% and sequential group 32, 53%. The X2 test it didn’t present significative difference of effectiveness between both treatments.

New host plant records for Oenomaus ortygnus (Cramer) (Lepidoptera: Lycaenidae) in Mexico

This is the first record of Oenomaus ortygnus (Cramer) damaging fruits of ilama (Annona diversifolia) and extends the butterfly distribution for three states in Mexico.

Bovine sirtuins: initial characterization and expression of sirtuins 1 and 3 in liver, muscle, and adipose tissue.

Sirtuins, the mammalian homologs of the silent information regulator 2 gene of Saccharomyces cerevisiae, are members of the NAD(+)-dependent family of histone deacetylases. In vertebrates, 7 sirtuins have been described, with different cellular localizations and target proteins. Glucose and lipid metabolism are among the processes regulated by these enzymes. In ruminants, gluconeogenesis is the main biochemical pathway by which glucose is obtained. Because sirtuins in bovines have not been studied, the aim of this work was to obtain sequences coding for the 7 sirtuins and determine the expression patterns of sirtuin1 (Sirt1) and sirtuin3 (Sirt3) in the liver, muscle, and adipose tissue of calves and bulls. Using PCR amplification, we obtained sirtuin gene sequences and reported them to the National Center for Biotechnology Information GenBank. Characteristic sequence motifs corresponding to the sirtuin catalytic core domain were found, including the active and zinc-binding sites. Relative expression patterns of Sirt1 and Sirt3 in liver, muscle, and adipose tissue were quantified by real-time PCR, normalizing to the geometric mean of the housekeeping genes cyclophilin A and ß-actin. Expression of Sirt1 was less in liver and muscle, whereas it was greater in adipose tissue of adult animals, with statistical differences (P=0.0071) only in the latter. In the case of Sirt3, expression was greater in all 3 adult tissues, but statistical differences were found only in liver (P=0.0141) and muscle (P=0.0017). The greatest expression was observed in liver for Sirt1 and in muscle for Sirt3, whereas the least expression was in muscle for Sirt1 and in adipose tissue for Sirt3. In other species, sirtuin expression (both Sirt1 and Sirt3) in liver is reported to be the greatest among these 3 tissues, a pattern different from what we measured. These differences in expression can be associated with metabolic differences between nonruminant and ruminant species. However, further research on the relationship between bovine sirtuins and ruminant metabolism is required for a better understanding of these fields.

Patrón sexualidad inefectivo en valoración inicial de pacientes urológicos / No disponible

Tras un primer estudio de 52 valoraciones de enfermería realizadas al ingreso de pacientes urológicos, acogidos al modelo de M. Gordon,se observó que el 70% de las valoraciones omitían el patrón sexualidad. A continuación se llevó a cabo estudio descriptivo sobre la función eréctil en pacientes que iban a ser intervenidos de alguna patología prostática, el estudio indicó que el 90% de los pacientes sometidosa estudio tienen una disfunción eréctil severa. Con estos estudios nos damos cuenta de la importancia de la valoración del patrón sexualidad en especial en los pacientes urológicos, para poder planificar intervenciones futuras con el paciente (AU)

After a first study of 52 realised valuations of infirmary to the entrance of urologic patients, refugees to the model of M. Gordon, wereobserved that 70% of the valuations omitted the landlord sexuality. Next descriptive study was carried out on the erectil function in patients who were going to be taken part of some prostate pathology, the study indicated that 90% of the patients put under study have a severe erectil dysfunction. With these studies we occur to account of the importance of the valuation of landlord sexuality is special in the urologic patients, to be able to plan future interventions with the patient (AU)

Cuidados de enfermería en un paciente intervenido de prostatectomía radical asistida por robot / No disponible

Desde septiembre de 2007 hasta junio de 2009 se ha realizado en nuestra Unidad de Gestión Clínica un total de 72 intervenciones de prostatectomía radical robótica (PRR). Los resultados han sido muy satisfactorios: disminución del sangrado posquirúrgico; bajada significativa de la estancia media hospitalaria (2,5 días); una más rápida recuperación del paciente y mejores tasas de función eréctil. La técnica quirúrgica se ejecuta con un robot Da Vinci, serie S, de cuatro brazos. Partiendo de un caso clínico, un paciente diagnosticado en nuestro Servicio de cáncer de próstata, se exponen los cuidados que presta el personal de enfermería en un caso de PRR una vez que llega a la planta hasta su alta hospitalaria, así como la evolución seguida por el paciente.El modelo de cuidados que se sigue se basa en los once patrones funcionales de Majori Gordon. Por último, se resalta el papel que juega en este tipo de cirugía tanto enfermería domiciliaria como de Atención Primaria (AU)

Since September 2007 until June 2009 a total of 72 interventions of Robotic Radical Prostatectomy Radical Robótica (RRP) have been carried out in our Unit of Clinical Management. The results have been very satisfactory: decrease of the postsurgical bleeding; significant descent of the hospital average stay (2,5 days); a faster recovery of the patient and better rates of erectile function. The surgical technique is executed witha robot Da Vinci, series S, of four arms.Starting from a clinical case, a patient diagnosed in our Service of cancer of prostate, the cares that the staff of nursery in a case ofRRP are exposed once he arrives to the medical ward up to his hospital discharge, as well as the evolution followed by the patient.The model of cares that is followed is based on the eleven functional patterns of Majori Gordon. Finally, domiciliary nursing and Primary Care are highlighted for roles that they play (AU)

Induction of peroxisomal proliferator-activated receptor gamma and peroxisomal proliferator-activated receptor gamma coactivator 1 by unsaturated fatty acids, retinoic acid, and carotenoids in preadipocytes obtained from bovine white adipose tissue1,2.

The importance of dietary fat components, such as fatty acids, in the expression of multiple genes is clear. In the case of beef cattle, fat in the form of fatty acids (saturated or unsaturated), vitamin A (mainly retinoic acid), or carotenoids (beta-carotene and lutein) is obtained from dietary feed or pasture. The aim of this work was to study the effect of fatty acids (phytanic and pristanic acids), vitamin A (all-trans and 9-cis retinoic acid), and carotenoids (beta-carotene and lutein) on the expression of PPARgamma and its coactivator PGC-1alpha during differentiation of bovine white adipose tissue. Samples were collected at slaughter from subcutaneous adipose tissue and processed in a solution containing type II collagenase for 2 h at 37 degrees C. Cells were resuspended in basal medium, Dulbecco's modified Eagle's medium containing 5% fetal bovine serum, plated on 24-well culture plates at a density of 1 x 10(4) cells/cm(2), and incubated at 37 degrees C in a 5% CO(2) atmosphere. Preadipocyte differentiation after reaching confluence was induced by various treatments: rosiglitazone (20 microM); unsaturated fatty acids: phytanic acid (25, 50, 100 microM) and pristanic acid (25, 50, 100 microM); retinoids: 9-cis retinoic acid (0.5, 0.75, 1 microM) and all-trans retinoic acid (0.5, 0.75, 1 microM); and carotenoids: beta-carotene (10, 20, 30 microM) and lutein (10, 20, 30 microM). Expression of PPARgamma and PGC-1alpha was measured in differentiated cells. Phytanic acid, all-trans retinoic acid, and 9-cis retinoic acid were the best activators of PPARgamma expression, and the combination of 9-cis and all-trans retinoic acid was the best activator of PGC-1alpha expression (P < 0.05). Therefore, these are powerful agents for the promotion of bovine adipogenesis and constitute promising compounds to be used in bovine fattening.

Beta-carotene is incorporated or mobilized along with triglycerides in bovine adipose tissue in response to insulin or epinephrine.

Pasture fed cattle ingest substantial amounts of beta-carotene (beta-C). Not all of the carotenoid compound is transformed into vitamin A, but the surplus is deposited in adipose tissue (AT). The mechanisms of beta-C incorporation and mobilization are unknown. Two experiments were conducted using explants from bovine AT cultured in vitro. First, beta-C incorporation by explants from three animals was examined with different beta-C concentrations (0, 1, 5 and 20 microm) and different times of incubation (every 5 h up to 25 h). The data showed a significant increase of beta-C concentration in explants only for 20 microm beta-C. Secondly, effects of insulin and epinephrine on beta-C and triglyceride (TG) contents of explants were studied. Explants from six animals were incubated with either hormone and 0 or 20 microm beta-C for 20 h. Both TG and beta-C contents were affected positively by insulin and negatively by epinephrine. Interestingly, changes in ratios of beta-C/TG (hormone vs. control) were similar (1.7 x 10(-3) and 1.8 x 10(-3)), respectively, for insulin and epinephrine, indicating that beta-C level is directly related to TG content. We also report the presence of mRNA for beta-C 15, 15' oxygenase in bovine AT. The in vitro culture system using explants from bovine AT is a promising model to investigate factors that might affect the accumulation and metabolism of beta-C.

Ulcera de Majorlin en cicatriz de quemadura: manejo quirúrgico / Majorlin's ulcer arising in burn scar: surgical management

We discuss the case of a 63-years-old woman presenting with Majorlin's ulcer over the popliteal area. This localization is the most frequent for this lesion. We review the diagnosis, epidemiology, and aggressive surgical treatment with wide excision of the ulcer and repair with fasciocutaneous flap.

Se presenta un caso de úlcera de Majorlin en la región poplítea de una paciente de 63 años de edad. Esta localización es la más frecuente de esta lesión. Se discute su diagnóstico, epidemiología, etiología y tratamiento agresivo con resección amplia de la ulcera y reparación con un colgajo fasciocutáneo.

Un caso infrecuente de aneurisma ateroesclerótico de la arteria temporal superficial / Atherosclerotic aneurysm of the superficial temporal artery: report of one case

Introducción: Los aneurismas de la arteria temporal superficial (AATS) constituyen una rara condición infrecuentemente reportada, ya que se han publicado sólo 14 casos de AATS ateroescleróticos en la literatura mundial. Este hecho contrasta con los aproximadamente 400 casos de pseudoaneurismas traumáticos de arteria temporal superficial reportados tanto en publicaciones nacionales, como internacionales. Reporte de Caso: Paciente femenino de 66 años de edad con antecedente de hipertensión arterial en tratamiento hace 17 años. El motivo de consulta fue la presencia de una masa pulsátil indolora en la región temporal derecha de 14 meses de evolución. Se estudió con ecografía Doppler vascular, la cual describe un aneurisma fusiforme de 2 cm de diámetro y 3 cm de longitud de la arteria temporal superficial. La cirugía consiste en la disección simple del aneurisma y la resección completa de la lesión con ligadura de los extremos proximales y distales de la arteria comprometida. El estudio histopatológico informa compromiso de las tres capas de la pared vascular en el área del aneurisma; también se observa la presencia de vasos adventiciales ateroescleróticos y engrasamiento ateroesclerótico de la íntima. La tinción de Van Gieson para fibras elásticas demuestra la integridad de la lámina elástica interna arterial. Conclusiones: Aún cuando los aneurismas verdaderos de la arteria temporal superficial son muy raros, su diagnóstico, estudio y tratamiento son relativamente simples y se encuentran actualmente bien establecidos.

Superficial temporal artery aneurysms (STAA) are an uncommon condition. Only 14 atherosclerotic STAA had been reported. This contrasts with almost 400 cases of superficial temporal artery traumatic pseudoaneurysms reported. We report a 66 years old female with hypertension treated for 17 years. She consulted for a painless pulsatile mass on the right temporal region lasting 14 months. A Doppler vascular ultrasound, described a superficial temporal artery fusiform aneurysm of 2 cm diameter and 3 cm length. The surgical exploration revealed the presence of the aneurysm compromising the superficial temporal artery. Simple dissection and resection of the lesion, ligating all the involved vascular branches was performed. The histopathological study reported involvement of all three layers of the vascular wall over the aneurysmatic area, also reported the presence of atherosclerotic adventitial vessels and atherosclerotic thickening of the intima. The Van Gieson stain for elastic fibers demonstrated integrity of the internal elastic layer.