Relationship between median nerve vascularization before tourniquet release and the Boston Carpal Tunnel Questionnaire: a cohort study.

The results of this study suggest that a decreased vascularization of the median nerve after releasing the carpal tunnel predicts an inferior clinical improvement assessed by the Boston Carpal Tunnel Questionnaire.

Lysophosphatidylinositol Promotes Chemotaxis and Cytokine Synthesis in Mast Cells with Differential Participation of GPR55 and CB2 Receptors.

Mast cells (MCs) are the main participants in the control of immune reactions associated with inflammation, allergies, defense against pathogens, and tumor growth. Bioactive lipids are lipophilic compounds able to modulate MC activation. Here, we explored some of the effects of the bioactive lipid lysophosphatidylinositol (LPI) on MCs. Utilizing murine bone marrow-derived mast cells (BMMCs), we found that LPI did not cause degranulation, but slightly increased FcεRI-dependent ß-hexosaminidase release. However, LPI induced strong chemotaxis together with changes in LIM kinase (LIMK) and cofilin phosphorylation. LPI also promoted modifications to actin cytoskeleton dynamics that were detected by an increase in cell size and interruptions in the continuity of the cortical actin ring. The chemotaxis and cortical actin ring changes were dependent on GPR55 receptor activation, since the specific agonist O1602 mimicked the effects of LPI and the selective antagonist ML193 prevented them. The LPI and O1602-dependent stimulation of BMMC also led to VEGF, TNF, IL-1α, and IL-1ß mRNA accumulation, but, in contrast with chemotaxis-related processes, the effects on cytokine transcription were dependent on GPR55 and cannabinoid (CB) 2 receptors, since they were sensitive to ML193 and to the specific CB2 receptor antagonist AM630. Remarkably, GPR55-dependent BMMC chemotaxis was observed towards conditioned media from distinct mouse and human cancer cells. Our data suggest that LPI induces the chemotaxis of MCs and leads to cytokine production in MC in vitro with the differential participation of GPR55 and CB2 receptors. These effects could play a significant role in the recruitment of MCs to tumors and the production of MC-derived pro-angiogenic factors in the tumor microenvironment.

Caracterización de adolescentes trasplantados de riñón y en protocolo pretasplante en Cali, Colombia / Characterisation of adolescent kidney transplant recipients and in pre-transplant protocol in Cali, Colombia

Introducción: El paso del adolescente con trasplante renal del servicio de pediatría al de adulto se relaciona con aumento en el rechazo y pérdida del injerto renal. Identificar las características de esta población podría ayudar a la hora de poder implementar un proceso de transición adecuado.Objetivo: Identificar las principales características sociodemográficas de los adolescentes con trasplante renal o en protocolo pre-trasplante renal previo a la implementación del programa de transición (STARx).Material y Método: Estudio cuantitativo, descriptivo de corte transversal. Se incluyeron los pacientes entre 11-19 años del servicio de nefrología pediátrica de la Fundación Valle del Lili, obteniendo 31 participantes con trasplante renal y 4 en protocolo pre-trasplante. Una prueba piloto de la encuesta sociodemográfica se aplicó a otro grupo con salud similar. La encuesta fue diseñada específicamente para este estudio. Tras la obtención del consentimiento informado la encuesta fue ajustada y aplicada a la población objeto del estudio.Resultados: El 54% de los adolescentes eran de sexo masculino, el promedio de edad fue 14,3±2,3 años, 23% afrodescendientes, el 65% provenían del Valle del Cauca y el 35% de otros departamentos del suroccidente colombiano. El 65% pertenecían a un nivel socioeconómico. El 44% cursó primaria, 47% secundaria y 9% cursaba educación superior. La madre fue el cuidador principal en el 85% y el 63% de los cuidadores cursó algún grado de secundaria. La enfermedad renal de base fueron las malformaciones congénitas 57%, y el 89% calificó su estado de salud como bueno.Conclusiones: El conocimiento de las características de esta población resulta de gran utilidad para poder llevar a cabo un proceso de transición al pasar del seguimiento en consulta pediátrica a la de adulto. (AU)

Introduction: The transference of the adolescent with a renal transplant from pediatric healthcare to adult healthcare has been related to an increased risk of graft rejection and graft loss. The evidence supports that an adequate transition program reduces the risk of graft rejection and improves clinical outcomes.Objective: Sociodemographic characterization of adolescents with a renal transplant or in pre-transplantation protocol previous to the implementation of a transition program (STARx).Material and Method: Quantitative, descriptive, and cross-sectional study. Patients aged 11 to 19 and registered in the service of pediatric nephrology were enrolled, obtaining 31 participants with a renal transplant and 4 participants in a pre-transplantation protocol. A pilot test of the sociodemographic survey was applied to a different group with a similar health condition. The survey was designed specifically for the study. Then, consent form was acquired and the survey was adjusted and applied to the target population.Results: 54% were male, the average age was 14.3 ±2.3 years, 23% were Afro-descendants, 65% came from the department of Valle del Cauca and 35% from other departments in the southwest of Colombia. The socioeconomic level was low in 65%. Regarding to schooling, 44% attended primary, 47% secondary and 9% attended higher education. The mother was the main caregiver in 85% and 63% of the caregivers attended some grade of secondary education. The underlying kidney disease was congenital anomalies of the kidney and urinary tract (CAKUT) in 57% and 89% rated their health as good.Conclusions: This study generated an appropriation of knowledge and compliance with treatment in adolescents, leading to the second phase of evaluation of the program in an oncoming study. (AU)

Mast Cell-Tumor Interactions: Molecular Mechanisms of Recruitment, Intratumoral Communication and Potential Therapeutic Targets for Tumor Growth.

Mast cells (MCs) are tissue-resident immune cells that are important players in diseases associated with chronic inflammation such as cancer. Since MCs can infiltrate solid tumors and promote or limit tumor growth, a possible polarization of MCs to pro-tumoral or anti-tumoral phenotypes has been proposed and remains as a challenging research field. Here, we review the recent evidence regarding the complex relationship between MCs and tumor cells. In particular, we consider: (1) the multifaceted role of MCs on tumor growth suggested by histological analysis of tumor biopsies and studies performed in MC-deficient animal models; (2) the signaling pathways triggered by tumor-derived chemotactic mediators and bioactive lipids that promote MC migration and modulate their function inside tumors; (3) the possible phenotypic changes on MCs triggered by prevalent conditions in the tumor microenvironment (TME) such as hypoxia; (4) the signaling pathways that specifically lead to the production of angiogenic factors, mainly VEGF; and (5) the possible role of MCs on tumor fibrosis and metastasis. Finally, we discuss the novel literature on the molecular mechanisms potentially related to phenotypic changes that MCs undergo into the TME and some therapeutic strategies targeting MC activation to limit tumor growth.

Síndrome compartimental del brazo tras cirugía por fractura supracondilea de húmero / Compartment syndrome of the arm after surgery for supracondylar fracture of the humerus

Presentamos un síndrome compartimental en el brazo que es una localización muy poco frecuente y de la que apenas existe bibliografía. El caso se presentó 48 h después de una cirugía de humero a través de abordaje posterior, aunque afecto al compartimento anterior. Queremos con este caso resaltar la importancia del diagnóstico diferencial al no tratarse de una localización habitual.

We present a compartment syndrome in the arm that is a very rare location and for which there is hardly any literature. The case presented 48 hours after humerus surgery through a posterior approach, although it affected the anterior compartment. With this case we want to highlight the importance of differential diagnosis as it is not a common location.

Actualización sobre aspectos científico-técnicos y regulatorios de los edulcorantes bajos en o sin calorías / Update for scientific-technical and regulatory data about low and non-calorie sweeteners

FUNDAMENTOS: El término edulcorante ha tenido desde hace más de 40 años una gran presencia en la información científico-técnica, en la legislación alimentaria, así como en la información dirigida a los profesionales de la salud, alimentación, nutrición y dietética y, en los medios de comunicación. MÉTODOS: Se ha realizado un trabajo de análisis bibliográfico en las bases de datos PubMed, Science Direct, Bucea (Biblioteca Complutense de Madrid) y Google Académico. Se han consultado las bases de datos oficiales, la legislación y regulación vigente, tanto a nivel de la Unión Europea como de España. Además, se han analizado los datos en las encuestas de ingesta dietética de ámbito nacional. RESULTADOS: Existe legislación específica en la Unión Europea que regula la autorización de edulcorantes bajos en o sin calorías, no hay encuestas dietéticas en España que reflejen a nivel cuantitativo la presencia de edulcorantes bajos en o sin calorías en los productos alimenticios, a excepción del estudio ANIBES. CONCLUSIONES: Las autoridades de seguridad alimentaria y nutrición, en España y Unión Europea, deben seguir velando por la aprobación, regulación y monitorización de los edulcorantes bajos en o sin calorías

BACKGROUND: For more than 40 years, the term sweetener has had a great presence in scientific and technical information, in food legislation, as well as the information aimed at health, food, nutrition and dietetic professionals and in the media. METHODS: The analysis has been carried out in the databases PubMed, Science Direct, Bucea (Biblioteca Complutense de Madrid) and Google Académico. The official databases, legislation and regulations in force have been consulted, both at the level of the European Union and Spain. In addition, for the national dietary intake surveys have been analyzed the data. RESULTS: There is specific legislation in the European Union that regulates the authorisation of low and non-calorie sweeteners. There are no dietary surveys in Spain that quantitatively reflect the presence of low and non-calorie sweeteners in food products, with the exception of the ANIBES study. CONCLUSIONS: Food safety and nutrition authorities, European and Spanish level, must continue to ensure the approval, regulation and monitoring of low and non-calorie sweeteners

Tratamiento urgente y diferido de la luxación radiocarpiana: dos casos con desviación dorsal y afectación transestiloidea / Early and delayed treatment of radiocarpal dislocation: two cases with dorsal and transstyloid instability

Objetivo:La luxación radiocarpiana es una entidad poco frecuente que suele estar asociada a daño articular complejo. El manejo definitivo no está bien establecido así como la reducción cerrada o el tratamiento conservador por sí solos no aseguran una buena evolución. Se presentan dos pacientes además de una revisión de la literatura con énfasis en el entendimiento de la patogenia de la lesión.Material y métodos: Se describen dos casos de fractura-luxación radiocarpiana dorsal. En el caso 1 se sintetizó la estiloides radial únicamente, y en el caso 2 además se reinsertaron las estructuras capsuloligamentosas.Resultados: Con una media de seguimiento de 18 meses, la puntuación fue media para un paciente y buena para el otro. Se constató traslación ulnar en el caso 1, el más sintomático. En ambos el balance articular era bueno. Los dos pacientes han vuelto a su actividad laboral habitual. Discusión: De acuerdo a las propuestas de tratamiento de Dumontier y Moneim, hay que considerar todos los aspectos del daño articular de cara a lograr una adecuada estabilidad que limite el riesgo de artrosis y traslación ulnar. La fijación de ambas estiloides o la reparación de los ligamentos radio-carpianos son puntos críticos para una reducción anatómica

Objetives: Radiocarpal dislocation is an uncommon and severe injury which involve soft-tissue and osseus trauma. No consensus on optimal treatment for this wrist disorder. Closed reduction or non-operative treatment may not optimize outcome. This paper is a report of two patients and we also reviewed the literature with emphasis on understanding the pathogenesis of the lesion. Material and methods: Two cases of posterior radiocarpal fracture- dislocation are described. Case 1 was just treatedby styloradial osteosynthesis and case 2 the same reduction was done in addition to capsuloligamentous suture with anchors. Results: At last follow-up (mean 17 months), the score was higher in case 2 (85/100 - 65/100). Ulnar translation appeared in the first case. Both ranges of motion were good. The two patients returned to their original jobs. Discussion: According to Dumontier and Moneim's treatment proposal, all aspects of joint injury must be considered in order to limit the risk of future arthritis and ulnar translocation. The restoration of the radial and ulnar styloids, and radiocarpal ligamens, are critical to achieve anatomic reduction

Compresión nervio cubital en el canal de Guyón: estudio retrospectivo de 12 casos / Compression of the ulnar nerve in Guyon’s canal: retrospective study of 12 cases

Objetivo: valorar causas y zonas de compresión del nervio cubital en el canal de Guyon. Material y método: se realizó un estudio retrospectivo de 12 pacientes intervenidos de síndrome del túnel cubital con un seguimiento medio de 9 meses. A todos se les practicó un estudio electrofisiológico y se observó si existe relación con la presencia de síndrome de túnel del carpo. Resultados: En solo 3 casos encontramos una etiología clara de la compresión nerviosa. Existe mayor presencia de síndrome de túnel del carpo en aquellos con compresión cubital idiopática pero sin significación estadística. Conclusiones: La mayoría de las compresiones cubitales en la muñeca, bajo nuestra experiencia, son de origen idiopático. Con la cirugía existe mejoría clínica de la sintomatología

Objective: To assess causes and areas of ulnar nerve compression in Guyon's canal Methods: A retrospective study of 12 patients undergoing cubital tunnel syndrome with a mean of 9 months was performed. All we performed an electrophysiological study and found the correlation with the presence of carpal tunnel syndrome. Results: In only 3 cases we found a clear etiology of nerve compression. There is an increased presence of carpal tunnel syndrome in those with idiopathic ulnar compression but without statistical significance. Conclusions: Most of the ulnar compression at the wrist, in our experience, are idiopathic. With surgery there is clinical improvement of symptoms

Hemoperitoneo espontáneo por hemangiosarcoma de bazo / Spontaneous hemoperitoneum due to hemangiosarcoma of the spleen

No disponible

Mortality and antibody responses of mice to three successive episodes of experimental scorpion (Centruroides limpidus limpidus) envenomation and immunological rescue.

Mortality rates of mice and their levels of anti-venom and anti-F(ab')2 antibodies were assessed after three episodes of subcutaneous envenomations with or without treatment with horse F(ab')2. Soluble venom from the Mexican scorpion Centruroides limpidus limpidus was used for these experiments. Repetition of episodes did not induce different mortality rates in untreated mice. F(ab')2 rescued about 85% of the mice in the first two episodes and 66% in the third, without distinction of gender or ostensible side-effects: a suggestion of selection of the most resistant mice. Surviving mice produced in vitro neutralizing antibodies to the scorpion venom and also antibodies to F(ab')2, when injected alone but more so if combined: a possible immunological adjuvant or alarm effect of the venom or of the cascading physiopathology of envenomation. In the few surviving mice, both anti-venom and anti-F(ab')2 antibodies increased significantly after the first envenomation but not thereafter, showing no correlation with mortality rates: a suggestion of their clinical irrelevance, the few hard-to kill mice appeared to resist envenomation by mechanisms other than antibody response. Injection of F(ab')2 alone induced production of detectable anti-venom antibodies in a few mice and injection of venom alone induced that of anti-F(ab')2 antibodies, perhaps due to trace amounts of venom in the high affinity fraction of F(ab')2 and to anti-idiotypic antibodies or polyclonal activity in the envenomation episode, respectively.

The quality in the radiology department.

In the last three years, the Spanish juridical ordinance has regulated (mostly the radiologic protection area) the essential quality that every radiodiagnostic and dentistry unit should comply with. This quality, as in every service, rests on the competence of the professional's who perform it. This means that in advanced countries much time and effort is dedicated to forming these people and therefore the academic charge for teaching dentistry radiology in Venezuela results 15 times higher than what is dedicated in our environment. Also, the supply of graduates or specialized radiologists is very poor; for example, it does not exist in Barcelona while in Merida the radiology service staff has 4 licentiates exclusively dedicated to oral radiology assistance and teaching (apart from two other people who work as technicians). This wealth influences positively in the quality of the service. Among other things, it allows the readjustment of the incoming petitions and also to justify them better and makes possible that all the explorations go out with the corresponding judgment. The academic quality in this discipline is also high due to the fact that it is a university teaching service. Our goal, through this work, is to show the situation of the problem comparing 2 different university services of oral radiology and reveal the lacks found with its solutions.

La calidad en el servicio de radiología / The quality in the radiology department

En los últimos 3 años el ordenamiento jurídico español ha regulado (sobre todo en el ámbito de la protección radiológica) la calidad imprescindible que debe cumplir toda unidad de radiodiagnóstico, también odontológico. Pero esta calidad, como en todo servicio, descansa en la competencia de los profesionales que lo desempeñan, de modo que en países avanzados se dedica mucho tiempo y esfuerzo a la formación de estas personas. Así, la carga lectiva para la enseñanza pregrado de radiología odontológica en Venezuela resulta 15 veces superior a la que se dedica en nuestro entorno y la dotación de profesionales licenciados o especialistas radiólogos orales en estos servicios resulta muy pobre, por ejemplo inexistente en Barcelona, mientras que en Mérida el staff del servicio de radiología es de 4 licenciados con dedicación completa y exclusiva a la asistencia y docencia de la radiología oral (además de contar con otras 2 personas que hacen la función de técnicos). Esta riqueza influye positivamente en la calidad del servicio. Entre otras cosas permite reajustar las peticiones que le llegan, justificándolas mejor; logra que todas las exploraciones salgan con el dictamen correspondiente y dado que el servicio es docente y universitario, hace posible una enseñanza de calidad en esta disciplina. Con este trabajo pretendemos divulgar el "estado de la cuestión" comparando 2 diferentes servicios universitarios de radiología oral. Su objetivo es poner de manifiesto las carencias halladas y promover su solución (AU)

Experimental envenoming of mice with venom from the scorpion Centruroides limpidus limpidus: differences in mortality and symptoms with and without antibody therapy relating to differences in age, sex and strain of mouse.

C57Bl/6J and BALB/cAnN inbred strains of mice differed significantly in mortality and symptoms when intoxicated subcutaneously with one LD(50) of venom from Centruroides limpidus limpidus. Higher mortality was observed in C57Bl/6J than in BALB/cAnN. Also, C57Bl/6J mice more quickly developed muscular and respiratory collapse whilst BALB/cAnN mice were hyperactive before dying. Also, the symptoms in the survivors lasted for 24 h in C57Bl/6J and for 2 h in BALB/cAnN. The age and sex of mice were also related to mortality: younger mice were more resistant than older mice and females were more susceptible than males, especially in the younger groups. Antivenom (horse F(ab')(2)) administration 5-10 min after envenoming of mice with one LD(50) rescued 60% of BALB/cAnN and 52% of C57Bl/6J mice, respectively. Results indicate that genetic background, gender and age differences are of consequence in the pathogenesis of C. limpidus scorpion envenomation in mice, and that timely treatment with active antivenom F(ab')(2) saves a significant fraction of intoxicated mice without statistically significant distinction of strains.

An atypical protein disulfide isomerase from the protozoan parasite Leishmania containing a single thioredoxin-like domain.

In higher eukaryotes, secretory proteins are under the quality control of the endoplasmic reticulum for their proper folding and release into the secretory pathway. One of the proteins involved in the quality control is protein disulfide isomerase, which catalyzes the formation of protein disulfide bonds. As a first step toward understanding the endoplasmic reticulum quality control of secretory proteins in lower eukaryotes, we have isolated a protein disulfide isomerase gene from the protozoan parasite Leishmania donovani. The parasite enzyme shows high sequence homology with homologs from other organisms. However, unlike the four thioredoxin-like domains found in most protein disulfide isomerases, of which two contain an active site, the leishmanial enzyme possesses only one active site present in a single thioredoxin-like domain. When expressed in Escherichia coli, the recombinant parasite enzyme shows both oxidase and isomerase activities. Replacement of the two cysteins with alanines in its active site results in loss of both enzymatic activities. Further, overexpression of the mutated/inactive form of the parasite enzyme in L. donovani significantly reduced their release of secretory acid phosphatases, suggesting that this single thioredoxin-like domain protein disulfide isomerase could play a critical role in the Leishmania secretory pathway.

Heridas del duodeno: ¿Qué hacer? / Duodenal wounds: What to do?

Con el objetivo primordial de documentar nuestra experiencia con las "heridas duodenales" en el Hospital Escuela de Tegucigalpa, Honduras, C.A.-en primer lugar- y de hacer una revisión bibliográfica, con el respectivo análisis crítico de ella, para así detectar cual es la experiencia foránea con éste tipo de lesiones traumáticas -en segundo lugar-, se hizo una "investigación clínica" orientada esencialmente a determinar cual procedimiento quirúrgico debe ser utilizado en cada caso, de acuerdo al grado de "lesión duodenal", para así disminuir la alta tasa de mortalidad postoperatoria de estas heridas. La investigación retrospectiva hecha en el Hospital Escuela entre 1987 y 1992 reveló que la mortalidad global fue de aproximadamente 17 por ciento y que la operación más usada fue la "duodenorrafía", también con una mortalidad postoperatoria de aproximadamente 17 por ciento, es decir 6 en 35 casos. Por otro lado, al revisar también retrospectivamente los casos personales de uno de los autores, encontramos que entre 1991 y 1999 operó 12 casos y en todos ellos practicó "solo duodenorrafia" con sonda nasogástrica-duodenal y drenajes periduodenales obteniendo similares resultados, es decir: una mortalidad de aproximadamente 17 por ciento (2 en 12 casos). La otra operación utilizada en la primera parte de nuestra investigación fue la "exclusión pilórica", la cual también resultó tener idéntico porcentaje de mortalidad operatoria, aproximadamente 17 por ciento, pero sólo en 6 casos. En base a nuestra experiencia y a los resultados encontrados en la revisión y análisis de bibliografía que se hizo, creemos que ambas operaciones pueden ser utilizadas en "heridas duodenales" que son correctamente clasificadas como "grado III", durante la parte inicial del acto quirúrgico; pero así mismo recomendamos muy enfáticamente que en aquellas otras heridas que igualmente son clasificadas por el cirujano como "grado II", sólo debe hacerse una o más duodenorrafias, toda vez que técnicamente sea posible, para evitar hacer algún otro procedimiento más difícil y más largo, que podría aumentar la morbimortalidad postoperatoria...