Composición corporal en mujeres deportistas premenopáusicas y postmenopáusicas / Body composition in premenopausal and postmenopausal well-trained females

Objetivo: El propósito fue analizar la influencia de las hormonas sexuales en la composición corporal de deportistas con diferente estatus hormonal. Metodología: 46mujeres eumenorreicas, 41 usuarias de píldora anticonceptiva monofásica y 16mujeres postmenopáusicas bien entrenadas participaron en el estudio. Las voluntarias realizaron un Dual-energy X-ray Absorptiometry scan (DXA) y una bioimpedancia durante la fase folicular temprana y no hormonal, verificado con una analítica. Resultados: La prueba ANCOVA no mostró diferencias ni en las variables medidas con DXA (peso, masa grasa androide y ginoide, masa grasa total y masa libre de grasa) ni en las de bioimpedancia (peso, masa grasa, masa libre de grasa y agua corporal total). Conclusión: Las hormonas sexuales parecen no influir en la composición corporal de mujeres activas. Las mujeres postmenopáusicas activas presentan una distribución de masa grasa similar a las premenopáusicas, lo que podría explicarse por el efecto positivo de la actividad física. (AU)

Purpose: The aim was to analyse the influence of sex hormones on body composition in well-trained females with different hormonal environments.Methods: Sixty-six eumenorrheic, forty-one low-dose-monophasic oral contraceptive users and sixteen postmenopausal well-trained females participated in this study. Volunteers underwent a Dual-energy X-ray Absorptiometry scan (DXA) and a bioimpedance during the early-follicular and the withdrawal phase, verified with blood samples.Results: ANCOVA test reported no differences neither in DXA measurements (weight, fat free mass, fat mass, android and gynoid fat mass) nor in bioimpedance variables (weight, fat free mass, fat mass and total body water) among study groups.Conclusion: Sex hormones seems not to influence body composition in active women. Curiously, premenopausal and postmenopausal active women present the same fat mass distribution. It could be explained by the positive effect exercise has on body composition, and this in turn on preventing cardiovascular and metabolic diseases in this population. (AU)

Expression and Characterization of Human Vascular Endothelial Growth Factor Produced in SiHa Cells Transduced with Adenoviral Vector.

The vascular endothelial growth factor (VEGF) is an essential factor to pathologic angiogenesis. Disruption of VEGF/VEGF receptor interaction in cancer patients inhibits the development of new and pre-existing tumor blood vessels. Consequently, VEGF becomes an important therapeutic target for handling solid tumors. In this work, human VEGF was produced in the culture supernatant of SiHa cells transduced with a replication-defective adenoviral vector (pAdhVEGF121) encoding this molecule. The 35 kDa VEGF121 homodimer was obtained from clarified culture media as a glycosylated protein. VEGF121 expression levels were strictly dependent on the adenoviral viral load used. VEGF121 was produced with purity over 98% after a single step chromatography by immobilized metal affinity chromatography. Additionally, VEGF121 binds Bevacizumab antibody with a KD of 7 nM. Biological characterization by mitogenic assay in HUVEC and ECV-304 cells showed that VEGF121 stimulates cell proliferation in a dose-dependent manner in both cells. Finally, the neovascularization activity of VEGF121 was demonstrated by vascular permeability assays in matrigel plug-bearing mice, showing significantly increased vasculature leakage after treatment with VEGF121. Consequently, transduction of SiHa cells with adenovirus is a suitable alternative for manufacture heterologous proteins of therapeutic interest.

Recuperación mejorada después de cirugía torácica: ERAS / Enhanced recovery after thoracic surgery

Resumen El concepto de Recuperación Mejorada Después de Cirugía, Enhanced recovery after Surgery (ERAS), engloba una serie de protocolos para el manejo perioperatorio optimizado en diversas patologías quirúrgicas. Los objetivos de estos protocolos son: mejorar los resultados quirúrgicos, disminuir las complicaciones, reducir los días de hospitalización, disminuir los costos asociados a la intervención y, finalmente, favorecer una rehabilitación más rápida. Para una correcta aplicación de estos protocolos, se requiere la interacción y el trabajo de un equipo multidisciplinario. En este artículo, se realizará una puesta al día de las intervenciones más importantes de los procesos perioperatorios de la cirugía torácica.

The concept of ERAS includes a series of optimized perioperative management protocols in various surgical pathologies. The objectives of these protocols are: improve surgical results, reduce complications, reduce length of in-hospital stay, reduce the associated health care costs and finally, favor a more rapid rehabilitation. For the correct application of these protocols, the interaction and work of a multidisciplinary team is required. In this article, an update will be made of the most important interventions in the perioperative processes of thoracic surgery.

Neuroprotective effects of EpoL against oxidative stress induced by soluble oligomers of Aß peptide.

Erythropoietin is a glycoproteic hormone that regulates hematopoiesis by acting on its specific receptor (EpoR). The expression of EpoR in the central nervous system (CNS) suggests a role for this hormone in the brain. Recently, we developed a new Epo variant without hematopoietic activity called EpoL, which showed marked neuroprotective effects against oxidative stress in brain ischemia related models. In this study, we have evaluated the neuroprotective effects of EpoL against oxidative stress induced by chronic treatment with Aß. Our results show that EpoL was neuroprotective against Aß-induced toxicity by a mechanism that implicates EpoR, reduction in reactive oxygen species, and reduction in astrogliosis. Furthermore, EpoL treatment improved calcium handling and SV2 levels. Interestingly, the neuroprotective effect of EpoL against oxidative stress induced by chronic Aß treatment was achieved at a concentration 10 times lower than that of Epo. In conclusion, EpoL, a new variant of Epo without hematopoietic activity, is of potential interest for the treatment of diseases related to oxidative stress in the CNS such as Alzheimer disease.

Erratum: Predicting clinically significant prostate cancer using DCE-MRI habitat descriptors.

[This corrects the article DOI: 10.18632/oncotarget.26437.].

Predicting clinically significant prostate cancer using DCE-MRI habitat descriptors.

Prostate cancer diagnosis and treatment continues to be a major public health challenge. The heterogeneity of the disease is one of the major factors leading to imprecise diagnosis and suboptimal disease management. The improved resolution of functional multi-parametric magnetic resonance imaging (mpMRI) has shown promise to improve detection and characterization of the disease. Regions that subdivide the tumor based on Dynamic Contrast Enhancement (DCE) of mpMRI are referred to as DCE-Habitats in this study. The DCE defined perfusion curve patterns on the identified tumor habitat region are used to assess clinical significance. These perfusion curves were systematically quantified using seven features in association with the patient biopsy outcome and classifier models were built to find the best discriminating characteristics between clinically significant and insignificant prostate lesions defined by Gleason score (GS). Multivariable analysis was performed independently on one institution and validated on the other, using a multi-parametric feature model, based on DCE characteristics and ADC features. The models had an intra institution Area under the Receiver Operating Characteristic (AUC) of 0.82. Trained on Institution I and validated on the cohort from Institution II, the AUC was also 0.82 (sensitivity 0.68, specificity 0.95).

Ex vivo trypanocidal activity of 1-(2-hydroxybenzylidene)thiosemicarbazide against Trypanosoma equiperdum.

Trypanosoma equiperdum is the causative agent of dourine, a venereal disease in horses and donkeys. This parasite has a widely distribution, is found in Africa, Asia, Southern and Eastern Europe, Russia, Mexico and Venezuela. The T. equiperdum is morphologically indistinguishable to other Trypanozoon species, however differs from other mammalian trypanosomes due to the fact that it is primarily a tissue parasite, generating cutaneous plaques, swelling of genitalia and neurological signs. The aim of this study was to evaluate the trypanocidal effectiveness of a set of derivatives of thiosemicarbazones on a T. equiperdum ex vivo culture. All compounds appeared to have trypanocidal activity, however one of them shown better solubility and a dose-dependent effect. The median inhibitory concentration (IC50) was 1.2µM. The selected compound exhibits a greater inhibitory activity than diminazene aceturate, a common drug for animal trypanosomosis treatment.

Dynamic contrast-enhanced MRI for automatic detection of foci of residual or recurrent disease after prostatectomy.

PURPOSE: This study aimed to develop an automated procedure for identifying suspicious foci of residual/recurrent disease in the prostate bed using dynamic contrast-enhanced-MRI (DCE-MRI) in prostate cancer patients after prostatectomy. MATERIALS AND METHODS: Data of 22 patients presenting for salvage radiotherapy (RT) with an identified gross tumor volume (GTV) in the prostate bed were analyzed retrospectively. An unsupervised pattern recognition method was used to analyze DCE-MRI curves from the prostate bed. Data were represented as a product of a number of signal-vs.-time patterns and their weights. The temporal pattern, characterized by fast wash-in and gradual wash-out, was considered the "tumor" pattern. The corresponding weights were thresholded based on the number (1, 1.5, 2, 2.5) of standard deviations away from the mean, denoted as DCE1.0, …, DCE2.5, and displayed on the T2-weighted MRI. The resultant four volumes were compared with the GTV and maximum pre-RT prostate-specific antigen (PSA) level. Pharmacokinetic modeling was also carried out. RESULTS: Principal component analysis determined 2-4 significant patterns in patients' DCE-MRI. Analysis and display of the identified suspicious foci was performed in commercial software (MIM Corporation, Cleveland, OH, USA). In general, DCE1.0/DCE1.5 highlighted larger areas than GTV. DCE2.0 and GTV were significantly correlated (r = 0.60, p < 0.05). DCE2.0/DCA2.5 were also significantly correlated with PSA (r = 0.52, 0.67, p < 0.05). Ktrans for DCE2.5 was statistically higher than the GTV's Ktrans (p < 0.05), indicating that the automatic volume better captures areas of malignancy. CONCLUSION: A software tool was developed for identification and visualization of the suspicious foci in DCE-MRI from post-prostatectomy patients and was integrated into the treatment planning system.

Neumonías necrosantes graves con empiema asociado / Severe necrotizing pneumonias with secondary empyemas

Introducción: Las neumonías necrosantes (NN) con empiema son una enfermedad grave y un desafío multidisciplinario. El objetivo de este estudio es realizar una caracterización epidemiológica y, en forma secundaria, analizar su tratamiento y evolución. Presentación de casos: Se realizó un estudio retrospectivo de una serie de casos consecutivos con NN con empiema que se presentaron en el Hospital Padre Hurtado. Siete (77,8%) eran de sexo masculino. La mediana de edad fue de 53 (rango 21-73) años. El 44% presentaban comorbilidades (diabetes, HTA o enfermedades neurológicas). El 44% presentaban abuso de drogas y 3 estaban en un estado de desnutrición severa. Manejo y evolución: La mediana de tiempo de hospitalización fue de 41 (rango 16-129) días. En 4 pacientes el germen aislado fue un Enterococcus faecalis. Complicaciones torácicas ocurrieron en el 33,3% de los pacientes. Un paciente requirió una lobectomía, un paciente una fenestración y otro paciente falleció. Discusión: Las NN con empiemas son raras. Sin embargo, frente a la asociación de diabetes, desnutrición y abuso de drogas continuaremos viendo estos casos de difícil manejo con elevada morbimortalidad.

Introduction: Necrotizing pneumonia complicated with empyema is a life-threatening condition that challenges multidisciplinary teams. The aim of this study is to perform an epidemiological characterization of these patients, and secondly, analyse their treatment and outcomes. Case presentation: A retrospective analysis of a series of consecutive patients experiencing necrotizing pneumonia with empyema who presented at Hospital Padre Hurtado. Seven (77.8%) were male. The median age was 53 (range 21-73) years. 44% presented with comorbidities (diabetes, high blood pressure, and neurological diseases). 44% presented drug abuse consumption and three (33.3%) were in a state of severe malnutrition. Management and outcome: The median time of hospitalization was 41 (range 16-129) days. Thoracotomies were performed in eight (83.2%) of the patients. In four patients, the isolated bacteria's were Enterococcus faecalis. Thoracic complications occurred in three (33.3%) patients. One patient required a lobectomy, one patient a fenestration and one (11.1%) patient died. Discussion: Necrotizing pneumonias complicated with empyema are rare, however, if there is an association with drug abuse, diabetes and malnutrition, we will continue to see such challenging cases with high morbidity and mortality.

Estado actual del estudio del síndrome de burnout en el deporte / Status atual da síndrome de burnout estudo no esporte / Current status of the study of burnout syndrome in sport

El estudio del síndrome de burnout en el deporte comenzó en los años 80. Estos deportistas presentaban síntomas caracterizados por agotamiento emocional, despersonalización y baja realización personal. Como consecuencia llevaba a una disminución progresiva de sus niveles de rendimiento deportivo, hasta ocasionar, en algunos casos, la retirada prematura de la práctica deportiva. Se hace una revisión de los estudios publicados desde el inicio del estudio de burnout en el deporte. El número de estudios en esta área ha aumentado estos últimos años, no obstante, quedan cuestiones apenas tratadas como programas de prevención e intervención, nuevos modelos teóricos y la importancia que puede tener las variables de personalidad en el origen y mantenimiento del síndrome (AU)

Burnout in sport has been studied since the 80´s. The symptons were emotional exhaustion, depersonalization and low personal fulfillment. As a consequence their performance get worse, it can also cause the departure from the sport at a young age. A revision about the burnout since the beginning is made in this paper. The amount of papers about burnout is increasing since the last few years, however, some aspects haven´t been studied yet for example intervention and prevention programs, new theoretical models and the relevance of personality traits at the beginning and development of the síndrome (AU)

O estudo da síndrome do burnout no desporto começou nos anos 80. Estes desportistas apresentavam sintomas caracterizados pelo esgotamento emocional, despersonalização e baixa realização pessoal. Como consequência levava a uma diminuição progressiva dos seus níveis de rendimento desportivo, até originar, em alguns casos, o abandono prematuro da prática desportiva. Elabora-se uma revisão dos estudos publicados desde o início do estudo do burnout no desporto. O número de estudos nesta área tem aumentado nos últimos anos, não obstante, faltam programas de prevenção e intervenção, novos modelos teóricos e esclarecer a importância que podem ter as variáveis de personalidade na origem e persistência da síndrome (AU)

Absceso mediastínico con extensión espontánea a través de la pared torácica / Mediastinal abscess with spontaneous across chest wall extension

Introduction: Mediastinal abscess (MA) is a rare disease in the adult population. Generally presents as a systemic inflammatory response syndrome (SIRS) with high morbidity and mortality. The prognosis improves with an early diagnosis associated with an aggressive surgical drainage. Clinical case: We report a clinical case with a MA with an unusual spontaneous extension across the chest wall.

Introducción: Los abscesos mediastínicos (AM) son una patología poco frecuente en la población adulta. Su presentación clínica más habitual es la de un síndrome de respuesta inflamatoria sistémica (SIRS) con una elevada morbimortalidad. Su pronóstico mejora con un diagnóstico temprano asociado a un drenaje quirúrgico agresivo y precoz. Caso clínico: Presentamos un caso clínico de un AM con una inusual extensión espontánea a través de la pared torácica.

Effectiveness of the E2-classical swine fever virus recombinant vaccine produced and formulated within whey from genetically transformed goats.

Subunit recombinant vaccines against classical swine fever virus (CSFV) are a promising alternative to overcome practical and biosafety issues with inactivated vaccines. One of the strategies in evaluation under field conditions is the use of a new marker E2-based vaccine produced in the milk of adenovirally transduced goats. Previously we had demonstrated the efficacy of this antigen, which conferred early protection and long-lasting immunity in swine against CSFV infection. Here, we have used a simpler downstream process to obtain and formulate the recombinant E2 glycoprotein expressed in the mammary gland. The expression levels reached approximately 1.7 mg/ml, and instead of chromatographic separation of the antigen, we utilized a clarification process that eliminates the fat content, retains a minor amount of caseins, and includes an adenoviral inactivation step that improves the biosafety of the final formulation. In a vaccination and challenge experiment in swine, different doses of the E2 antigen contained within the clarified whey generated an effective immune response of neutralizing antibodies that protected all of the animals against a lethal challenge with CSFV. During the immunization and after challenge, the swine were monitored for adverse reactions related to the vaccine or symptoms of CSF, respectively. No adverse reactions or clinical signs of disease were observed in vaccinated animals, in which no replication of CSFV could be detected after challenge. Overall, we consider that the simplicity of the procedures proposed here is a further step toward the introduction and implementation of a commercial subunit vaccine against CSF.

Análisis comprensivo de los traumatismos torácios penetrantes atendidos en Hospital Padre Hurtado de Santiago / Penetrating chest trauma

Objectives: Penetrating chest trauma (PCT) is a life threatening condition that challenges emergency surgeons daily. The aim of this study is to make an epidemiological characterization of these patients, and secondarily analyze their treatment and outcome. Methods: A retrospective analysis of a series of consecutive patients experiencing PCT who presented at our hospital, was performed from 1st May 2009 to 30th April 2013. Results: Of 274 consecutive patients who presented to the emergency department (ED) with PCT, 257 (94 percent) were male and 17 (6 percent) were female. The median age was 26 (range 15-66) years. Stab wounds (SW) accounted for 185 (68 percent) of the injuries, and 80 (29 percent) suffered from gunshot wounds (GSW). As first treatment, chest tube drainage was performed in 229 (84 percent) patients, emergent thoracotomy in 21 (8 percent) and observation, in 13 (5 percent). 26 (9 percent) patients died: 21 (81 percent) from GSW and 4 (15 percent) with SW P<0.0001; 20 (77 percent) had heart or thoracic great vessels involvement. Thoracic complications occurred in 30 (12 percent) patients. There was no mortality associated with thoracic complications. The median hospital stay was 4 days. Conclusions: PCT is frequent in our hospital compared with historical series. The majority of the patients who died had cardiac or thoracic great vessels involvement due to GSW. Therefore, healthcare improvements are needed to reduce mortality in this group of patients.

Objetivos: Los traumatismos torácicos penetrantes (TTP) son graves y desafían diariamente a los cirujanos de urgencia. El objetivo de este estudio es realizar una caracterización epidemiológica de los pacientes con TTP, y como objetivo secundario analizar el tratamiento efectuado y su evolución. Métodos: Se realizó un estudio retrospectivo de los pacientes atendidos en el Hospital Padre Hurtado de Santiago que presentaron un TTP desde el 1 de mayo de 2009 hasta el 30 de abril de 2013. Resultados: 274 pacientes que se consultaron al servicio de urgencia con un TTP, 257 (94 por ciento) eran hombres y 17 (6 por ciento) eran mujeres. La mediana de edad fue 26 (15-66) años. Lesiones por arma blanca 185 (68 por ciento), y 80 (29 por ciento) fueron por arma de fuego. Como primer tratamiento la pleurostomía fue realizada en 229 (84 por ciento) pacientes. La toracotomía de emergencia fue realizada en 21 (8 por ciento) pacientes. No se realizó tratamiento y solo observación en 13 (5 por ciento) de los casos. 26 (9 por ciento) de los pacientes murieron, 21 (81 por ciento) fueron consecuencia de lesiones por arma de fuego y 4 (15 por ciento) por arma blanca P<0,0001, 20 (77 por ciento) tenían lesiones cardíacas o de grandes vasos torácicos. 30 (12 por ciento) pacientes presentaron complicaciones torácicas. No hubo mortalidad asociada a complicaciones torácicas. La mediana de días de hospitalización fue 4. Conclusiones: El TTP es frecuente en nuestro hospital comparado con series históricas. La mayoría de los pacientes fallecidos presentaban TTP por arma de fuego con lesiones cardíacas o de grandes vasos torácicos. Se precisan mejoras asistenciales en este grupo para disminuir su mortalidad.

Volumetric spectroscopic imaging of glioblastoma multiforme radiation treatment volumes.

PURPOSE: Magnetic resonance (MR) imaging and computed tomography (CT) are used almost exclusively in radiation therapy planning of glioblastoma multiforme (GBM), despite their well-recognized limitations. MR spectroscopic imaging (MRSI) can identify biochemical patterns associated with normal brain and tumor, predominantly by observation of choline (Cho) and N-acetylaspartate (NAA) distributions. In this study, volumetric 3-dimensional MRSI was used to map these compounds over a wide region of the brain and to evaluate metabolite-defined treatment targets (metabolic tumor volumes [MTV]). METHODS AND MATERIALS: Volumetric MRSI with effective voxel size of ∼1.0 mL and standard clinical MR images were obtained from 19 GBM patients. Gross tumor volumes and edema were manually outlined, and clinical target volumes (CTVs) receiving 46 and 60 Gy were defined (CTV46 and CTV60, respectively). MTVCho and MTVNAA were constructed based on volumes with high Cho and low NAA relative to values estimated from normal-appearing tissue. RESULTS: The MRSI coverage of the brain was between 70% and 76%. The MTVNAA were almost entirely contained within the edema, and the correlation between the 2 volumes was significant (r=0.68, P=.001). In contrast, a considerable fraction of MTVCho was outside of the edema (median, 33%) and for some patients it was also outside of the CTV46 and CTV60. These untreated volumes were greater than 10% for 7 patients (37%) in the study, and on average more than one-third (34.3%) of the MTVCho for these patients were outside of CTV60. CONCLUSIONS: This study demonstrates the potential usefulness of whole-brain MRSI for radiation therapy planning of GBM and revealed that areas of metabolically active tumor are not covered by standard RT volumes. The described integration of MTV into the RT system will pave the way to future clinical trials investigating outcomes in patients treated based on metabolic information.

Mapping of glycine distributions in gliomas.

BACKGROUND AND PURPOSE: Increased glycine concentration in the brain is associated with altered metabolism in cancer and can be detected by using in vivo MR spectroscopy. This has been proposed as a marker for grade IV gliomas; however, little is known about the potential significance and frequency of in vivo glycine observation. The purpose of this study was to examine the rate of occurrence and spatial distribution of glycine observation with respect to other MR imaging parameters. MATERIALS AND METHODS: Data from volumetric whole-brain MR spectroscopic imaging of 59 subjects with glioma were analyzed with glycine included in the spectral model. The associations of the signal amplitude and spatial distributions of glycine with findings from contrast-enhanced T1, perfusion, and diffusion MR imaging were then examined. RESULTS: Glycine was detected in 24% of all studies, though with a wide range of signal amplitude and extent of the spatial distributions. While more commonly seen in grade IV tumors (42% of studies), relatively large concentrations were also detected in grade II and III gliomas. Coanalysis with other metabolites indicated a strong association with choline and that glycine was frequently seen to be overlapping with, and adjacent to, areas of high lactate concentration. Increased glycine was always associated with contrast enhancement and areas of increased cerebral blood flow, but without any clear association with other image parameters. CONCLUSIONS: Detection of increased glycine in gliomas appears to identify a subgroup of tumors and areas of increased proliferation.

Resección traqueal y anastomosis primaria en traumatismo traqueo esofágico por arma de fuego / Tracheal resection and primary anastomosis in tracheoesophagueal gunshot trauma

Introduction: even though tracheoesophagueal lesions due to cervicothoracic gunshot wound are infrecuent, they should always be considered in a lesion of this kind, based on the proximity of the structures in this area, as well as the rapid compromise and deterioration that can develop these patients if the air way or vascular structures are damaged. Clinical case: we present a patient with a tracheoesophageal gunshot trauma and the surgical repair.

Introducción: las lesiones traqueo esofágicas secundarias a heridas de bala en cuello, a pesar de ser infrecuentes, siempre deben descartarse frente a un mecanismo de este tipo, no sólo por la proximidad de las estructuras sino también por el importante compromiso y rápido deterioro que pudieran presentar estos pacientes si la vía aérea o estructuras vasculares se vieran comprometidas. Caso clínico: se presenta en este trabajo un paciente con lesión traqueo esofágica secundaria a herida de bala, además de la técnica de reparación utilizada.