Green synthesis of gold nanoparticles via Moringa oleifera seed extract: antioxidant, antibacterial and anticarcinogenic activity on lung cancer.

Plant-mediated biosynthesis of nanoparticles is a green method that allows synthesis in one-pot process. Synthesis of gold nanoparticles with plant extracts has gained interest in the field of biomedicine due to its variety of applications. This study presents the synthesis via green chemistry of gold nanoparticles (AuNPs) using the methanol extract of Moringa oleifera seeds. The AuNPs were synthesized at room temperature. UV-Vis spectroscopy confirmed the formation of AuNPs by identifying the surface plasmon resonance located at 546 nm. TEM analysis shows spherical nanoparticles. FTIR analysis demonstrated the presence of specific bioactive molecules responsible for the Au3+ ion reduction process. The antioxidant activity of the nanoparticles was evaluated on the stabilization of the DPPH radical (1,1-diphenyl-2-picrylhydrazyl, 2,2-diphenyl-1-(2,4,6-trinitrophenyl) hydrazyl). The antimicrobial activity analysis was developed by broth microdilution method at different concentrations against Escherichia coli and Staphylococcus aureus. Minimum inhibitory concentration were 400 µg/mL and 200 µg/mL, respectively. A549 lung cancer cell proliferation was measured according to the MTT protocol, indicating a dose-dependent response and a IC50 of 163.9 ± 13.27 µg/mL. The AuNPs synthesized using M. oleifera seeds showed promise as active materials for antimicrobial or anticancer products.

Tratamiento quirúrgico del pie plano valgo adquirido del adulto en estadio IIB: papel de la reparación del «spring ligament» / Surgical treatment at adult acquired flatfoot stage IIB: Spring ligament repair

Antecedentes y objetivos: En el desarrollo del pie plano valgo adquirido del adulto ha cobrado gran importancia el fallo de la columna medial, y no tanto la rotura del tibial posterior, siendo principalmente la lesión del ligamento en hamaca calcaneonavicular (spring ligament) el determinante del desarrollo de esta deformidad. Nuestro objetivo es analizar los resultados clínico-radiológicos de la reparación del ligamento en hamaca y valorar la utilidad e integración de las cuñas de titanio poroso en las osteotomías a las que se asocia la reparación ligamentosa. Material y métodos: Realizamos un estudio retrospectivo de 23 casos con una edad media de 63 años, diagnosticados de pie plano valgo adquirido del adulto estadio IIB de la clasificación RAM tras fallo de tratamiento ortoprotésico, valorando los resultados clínicos mediante la escala de la American Orthopaedic Foot and Ankle Society y los resultados radiológicos pre- y postoperatorios basándose en la variación de los ángulos estudiados (cobertura talonavicular y ángulo talar - 1.° metatarsiano en la proyección dorsoplantar y línea de Meary en la proyección lateral). Resultados: Los puntuación media en escala de la American Orthopaedic Foot and Ankle Society pasó de 52±10 preoperatorio a 88±6 (p<0,05). En cuanto a los resultados radiológicos, se demostró una mejoría estadísticamente significativa (p<0,05) en la variación de los ángulos en el postoperatorio. Conclusiones: La reparación de los estabilizadores mediales, asociada a técnicas óseas ofrece excelentes resultados clínico-radiológicos en el tratamiento del pie plano valgo adquirido del adulto estadio IIB.Además, las cuñas de titanio poroso presentan una adecuada integración, evitando los problemas de pinzamiento de los peroneos asociada al uso de placas y la necesidad posterior de retirada.(AU)

Background and aims: The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies. Material and methods: We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis). Results: The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement. Conclusion: Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.(AU)

[Translated article] Surgical treatment at adult acquired flatfoot stage IIB: Spring ligament repair / Tratamiento quirúrgico del pie plano valgo adquirido del adulto en estadio IIB: papel de la reparación del «spring ligament»

Background and aims: The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies. Material and methods: We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis). Results: The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement. Conclusion: Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.(AU)

Antecedentes y objetivos: En el desarrollo del pie plano valgo adquirido del adulto ha cobrado gran importancia el fallo de la columna medial, y no tanto la rotura del tibial posterior, siendo principalmente la lesión del ligamento en hamaca calcaneonavicular (spring ligament) el determinante del desarrollo de esta deformidad. Nuestro objetivo es analizar los resultados clínico-radiológicos de la reparación del ligamento en hamaca y valorar la utilidad e integración de las cuñas de titanio poroso en las osteotomías a las que se asocia la reparación ligamentosa. Material y métodos: Realizamos un estudio retrospectivo de 23 casos con una edad media de 63 años, diagnosticados de pie plano valgo adquirido del adulto estadio IIB de la clasificación RAM tras fallo de tratamiento ortoprotésico, valorando los resultados clínicos mediante la escala de la American Orthopaedic Foot and Ankle Society y los resultados radiológicos pre- y postoperatorios basándose en la variación de los ángulos estudiados (cobertura talonavicular y ángulo talar - 1.° metatarsiano en la proyección dorsoplantar y línea de Meary en la proyección lateral). Resultados: Los puntuación media en escala de la American Orthopaedic Foot and Ankle Society pasó de 52±10 preoperatorio a 88±6 (p<0,05). En cuanto a los resultados radiológicos, se demostró una mejoría estadísticamente significativa (p<0,05) en la variación de los ángulos en el postoperatorio. Conclusiones: La reparación de los estabilizadores mediales, asociada a técnicas óseas ofrece excelentes resultados clínico-radiológicos en el tratamiento del pie plano valgo adquirido del adulto estadio IIB.Además, las cuñas de titanio poroso presentan una adecuada integración, evitando los problemas de pinzamiento de los peroneos asociada al uso de placas y la necesidad posterior de retirada.(AU)

Surgical treatment at adult acquired flatfoot stage IIB: Spring ligament repair. / Tratamiento quirúrgico del pie plano valgo adquirido del adulto en estadio IIB: papel de la reparación del «spring ligament¼.

BACKGROUND AND AIMS: The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies. MATERIAL AND METHODS: We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis). RESULTS: The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement. CONCLUSION: Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.

[Translated article] Surgical treatment at adult acquired flatfoot stage IIB: Spring ligament repair.

BACKGROUND AND AIMS: The spring ligament has paramount role in supporting the arches and its fail causes the collapse of the medial longitudinal arc, inducing adult acquired flatfoot deformity. Our aim was to analyze the clinical and radiological outcomes of spring ligament repair and titanium wedges integration used in surgical osteotomies. MATERIAL AND METHODS: We performed a retrospective study of 23 cases with middle ages of 63, diagnosed with adult acquired flatfoot deformity stage IIB in RAM classification after ortho-prosthetic treatment failure, assessing the functional outcomes using the American Orthopedic Foot and Ankle Society scale and the radiological outcomes studying angles variation (talonavicular uncoverage, talo-first metatarsal angle and Meary axis). RESULTS: The mean preoperative American Orthopedic Foot and Ankle Society score of the sample was 52±10 and the postoperative 88±6 (p<0.05). The radiological outcomes showed a statistically significant improvement. CONCLUSION: Spring ligament repair associated to bone reconstruction offers large functional and radiological outcomes to adult acquired flatfoot deformity stage IIB treatment. Titanium wedges present an excellent bone integration.

La aplicación informática «SCAE» en el diagnóstico precoz del cáncer musculoesquelético en el área sanitaria del Hospital Universitario 12 de Octubre. Análisis de su efectividad y propuestas de mejora / The computer application «SCAE» in the early diagnosis of musculoskeletal cancer in the healthcare area of the Hospital Universitario 12 de Octubre. Analysis of its effectiveness and proposals for improvement

Introducción: La aplicación informática SCAE-SM (Solicitud de Cita en Atención Especializada-Sospecha de Malignidad) es una herramienta informática de la que disponen los médicos de Atención Primaria (AP) para la derivación de pacientes que deban ser valorados por el especialista en un plazo máximo de 2 semanas, cuando se sospeche una patología maligna. El objetivo de nuestro trabajo fue analizar la utilidad de esta herramienta y proponer áreas de mejora en la gestión de los pacientes con sospecha de malignidad musculoesquelética. Material y métodos: Se realizó un estudio descriptivo transversal de las 235 derivaciones recibidas en los años 2012-2017. Se analizó su procedencia, la información contenida en las solicitudes y la respuesta proporcionada por evaluadores históricos (facultativos traumatólogos sin formación específica oncológica). Para este estudio, se ha realizado una nueva valoración ciega de todas las solicitudes por 13 traumatólogos con distinto nivel de formación específica en oncología musculoesquelética (reevaluadores). Resultados: De entre todas las SCAE-SM, solo el 8,23% de los pacientes presentaron enfermedad maligna o benigna agresiva. Los reevaluadores más acertados en la adecuación del adelanto de cita fueron aquellos con formación oncológica moderada (5-10 años de experiencia). Durante el periodo de tiempo del estudio, de todos los pacientes tratados en la Unidad de Tumores, solo el 18,81% accedieron por el circuito SCAE-SM, transcurriendo un tiempo medio de espera de 18,11 días desde la derivación de AP. Conclusiones: La aplicación informática SCAE-SM como herramienta de gestión y adelanto de la asistencia a los pacientes con patología tumoral musculoesquelética maligna es útil, si bien el uso del circuito es inadecuado. Es necesario difundirlo y generalizarlo, así como implementar programas de formación oncológica básica tanto en el ámbito de la AP como de la Hospitalaria.(AU)

Introduction: The SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy. Material and methods: A descriptive cross-sectional study of 235 referrals received in the years 2012–2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators). Results: Among all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5–10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral. Conclusions: The SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.(AU)

The computer application “SCAE” in the early diagnosis of musculoskeletal cancer in the healthcare area of the “Hospital Universitario 12 de Octubre”. Analysis of its effectiveness and proposals for improvement / La aplicación informática«SCAE» en el diagnóstico precoz del cáncer musculoesquelético en el área sanitaria del Hospital Universitario 12 de Octubre. Análisis de su efectividad y propuestas de mejora

Introduction: The SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy. Material and methods: A descriptive cross-sectional study of 235 referrals received in the years 2012–2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators). Results: Among all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5–10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral. Conclusions: The SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.(AU)

Introducción: La aplicación informática SCAE-SM (Solicitud de Cita en Atención Especializada-Sospecha de Malignidad) es una herramienta informática de la que disponen los médicos de Atención Primaria (AP) para la derivación de pacientes que deban ser valorados por el especialista en un plazo máximo de 2 semanas, cuando se sospeche una patología maligna. El objetivo de nuestro trabajo fue analizar la utilidad de esta herramienta y proponer áreas de mejora en la gestión de los pacientes con sospecha de malignidad musculoesquelética. Material y métodos: Se realizó un estudio descriptivo transversal de las 235 derivaciones recibidas en los años 2012-2017. Se analizó su procedencia, la información contenida en las solicitudes y la respuesta proporcionada por evaluadores históricos (facultativos traumatólogos sin formación específica oncológica). Para este estudio, se ha realizado una nueva valoración ciega de todas las solicitudes por 13 traumatólogos con distinto nivel de formación específica en oncología musculoesquelética (reevaluadores). Resultados: De entre todas las SCAE-SM, solo el 8,23% de los pacientes presentaron enfermedad maligna o benigna agresiva. Los reevaluadores más acertados en la adecuación del adelanto de cita fueron aquellos con formación oncológica moderada (5-10 años de experiencia). Durante el periodo de tiempo del estudio, de todos los pacientes tratados en la Unidad de Tumores, solo el 18,81% accedieron por el circuito SCAE-SM, transcurriendo un tiempo medio de espera de 18,11 días desde la derivación de AP. Conclusiones: La aplicación informática SCAE-SM como herramienta de gestión y adelanto de la asistencia a los pacientes con patología tumoral musculoesquelética maligna es útil, si bien el uso del circuito es inadecuado. Es necesario difundirlo y generalizarlo, así como implementar programas de formación oncológica básica tanto en el ámbito de la AP como de la Hospitalaria.(AU)

Historical reconstruction of the population dynamics of southern right whales in the southwestern Atlantic Ocean.

Understanding the recovery of whale populations is critical for developing population-management and conservation strategies. The southern right whale (SRW) Eubalena australis was one of the baleen whale species that has experienced centuries of exploitation. We assess here for the first time the population dynamics of the SRW from the southwestern Atlantic Ocean at the regional level to measure numerically the effect of whaling and estimate the population trend and recovery level after depletion. We reconstructed the catch history of whaling for the period 1670-1973 by an extensive review of different literature sources and developed a Bayesian state-space model to estimate the demographic parameters. The population trajectory indicated that the pre-exploitation abundance was close to 58,000 individuals (median = 58,212; 95% CI = 33,329-100,920). The abundance dropped to its lowest abundance levels in the 1830s when fewer than 2,000 individuals remained. The current median population abundance was estimated at 4,742 whales (95% CI = 3,853-6,013), suggesting that the SRW population remains small relative to its pre-exploitation abundance (median depletion P2021 8.7%). We estimated that close to 36% of the SRW population visits the waters of the Península Valdés, the main breeding ground, every year. Our results provide insights into the severity of the whaling operation in the southwestern Atlantic along with the population´s response at low densities, thus contributing to understand the observed differences in population trends over the distributional range of the species worldwide.

La presencia de las enfermeras en las residencias de mayores en Cantabria / The presence of nurses in Cantabria old people's home

Objetivos: Caracterizar la situación de la asistencia sociosanitaria y de dependencia en la comunidad autónoma de Cantabria y analizar la aplicación de cuidados por parte del personal de enfermería tanto del centro de salud como de los propios de los centros sociosanitarios y de dependencia. Metodología:Estudio descriptivo transversal y multicéntrico en el cual se diseñó una encuesta ad-hoc anónima enviada a todos los centros sociosanitarios de la comunidad autónoma de Cantabria para su cumplimentación. Resultados: Se obtuvieron 54 de las 60 encuestas enviadas, el total de residentes en centros sociosanitarios de Cantabria es de 5.335 personas con una media del 86,4% de pacientes dependientes y un total de 169 profesionales de enfermería que trabajan en estos centros. La ratio enfermera/paciente es de 32 pacientes por enfermera y la media de estos profesionales es de 4,12. La enfermera del centro de salud acude a los centros sociosanitarios 51,66 min/semana. Conclusiones: La situación actual es deficitaria en enfermeras por centro y en ratio por residente, cifras que no posibilitan la atención de enfermería adecuada. La ausencia de profesionales de enfermería no garantiza la continuidad de cuidados, la prevención ni el seguimiento de patologías crónicas. La presencia de enfermeras propias supone una mayor implicación, mejoras en la calidad de vida, calidad asistencial, mayor satisfacción general, minimización de errores y un descenso del intrusismo profesional (AU)

Objectives: Characterize the situation of the socio-sanitary assistance and dependency situation in the autonomous community (region) of Cantabria and to analyze the application of care by the nurses of the health center and the nurses of the sociosanitary and dependency centers. Methodology: Cross-sectional and multicenter descriptive study in which an anonymous ad-hoc survey was designed and sent to all the socio-sanitary centers of the autonomous community of Cantabria to be filled out. Results: A total of 54 of the 60 surveys sent were returned; the total number of residents in socio-sanitary centers in Cantabria is 5,335 people, with an average of 86.4% of dependent patients and a total of 169 nursing professionals who work in these centers. The nurse/patient ratio is 32 patients per nurse and the average of these professionals is 4.12. The health center nurse goes to the socio-sanitary centers 51.66 min/week. Conclusions: The current situation is deficient in nurses per center and in ratio per resident, figures that do not allow for adequate nursing care. The absence of nursing professionals does not guarantee the continuous care, prevention or monitoring of chronic pathologies. The presence of own nurses implies greater involvement, improvements in quality of life, quality of care, greater general satisfaction, minimization of errors and a decrease in professional intrusion (AU)

The computer application «SCAE¼ in the early diagnosis of musculoskeletal cancer in the healthcare area of the Hospital Universitario 12 de Octubre. Analysis of its effectiveness and proposals for improvement. / La aplicación informática «SCAE¼ en el diagnóstico precoz del cáncer musculoesquelético en el área sanitaria del Hospital Universitario 12 de Octubre. Análisis de su efectividad y propuestas de mejora.

INTRODUCTION: The SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy. MATERIAL AND METHODS: A descriptive cross-sectional study of 235 referrals received in the years 2012-2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators). RESULTS: Among all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5-10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral. CONCLUSIONS: The SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.

Hemodynamic resuscitation with fluids bolus and norepinephrine increases severity of lung damage in an experimental model of septic shock / La resucitación hemodinámica con bolos de fluidos y noradrenalina incrementa la severidad del daño pulmonar en un modelo experimental de shock séptico

Objective Hemodynamic resuscitation is considered a cornerstone of the initial treatment of septic shock. However, there is growing concern about its side effects. Our objective was to assess the relationship between fluid administration and norepinephrine infusion and the development of lung injury. Design Randomized in vivo study in rabbits. Setting University animal research laboratory. Patients Eighteen New Zealand rabbits. Control group (SHAM, n=6), Sepsis group with or without hemodynamic resuscitation (ETX-R, n=6; ETX-NR, n=6). Interventions Sepsis was induced by intravenous lipopolysaccharide administration and animals were followed-up for 4h. Hemodynamic resuscitation with Ringer lactate (20mL·kg−1) was administered and later norepinephrine was initiated 3h after sepsis induction. At the end, the left lung was excised. Main variables of interestAn indwelling arterial catheter and an esophageal Doppler were placed. Lung mechanics were monitored with side stream spirometry. Lung damage was analyzed by histopathological examination. Results The SHAM group did not show hemodynamic or respiratory changes. Lipopolysaccharide administration aimed an increase in cardiac output and arterial hypotension. In the ETX-NR group, animals remained hypotensive until the end of the experiment. Resuscitation with fluids and norepinephrine reversed arterial hypotension. Compared to the ETX-NR group, the remaining lung of the ETX-R group showed greater accumulation of neutrophils and reactive type-II pneumocytes, thicker alveolar wall, alveolar hemorrhage and non-aerated pulmonary areas. Lung injury score was larger in the ETX-R group. Conclusions In our experimental study, following a strategy with bolus fluids and late norepinephrine used in the early phase of endotoxic septic shock has a negative influence on the development of lung injury. (AU)

Objetivo La resucitación hemodinámica es considerada piedra angular en el tratamiento inicial del shock séptico. Sin embargo, existe creciente preocupación sobre sus efectos indeseables. Nuestro objetivo fue evaluar la relación entre la administración de fluidos e infusión de noradrenalina y el desarrollo de lesión pulmonar. Diseño Estudio aleatorizado en animales vivos. Ámbito Laboratorio universitario de investigación. Participantes Dieciocho conejos de raza New Zealand White. Grupo control (SHAM, n=6), grupo séptico con o sin resucitación hemodinámica (ETX-R, n=6; ETX-NR, n=6). Intervención La sepsis fue inducida tras administración intravenosa de lipopolisacárido, y los animales fueron seguidos durante 4h. La resucitación hemodinámica mediante suero Ringer lactato (20ml·kg-1) y posterior noradrenalina fue iniciada a las 3h de ser inducida la sepsis. Al final del estudio, el pulmón izquierdo fue extraído. Principales variables de interés Fueron empleados catéter arterial y doppler esofágico. La mecánica pulmonar fue monitorizada con sensor de flujo. El daño pulmonar fue analizado mediante examen histopatológico. Resultados El grupo control no mostró cambios hemodinámicos ni respiratorios. La administración del lipopolisacárido produjo un incremento del gasto cardíaco e hipotensión arterial. En el grupo ETX-NR, los animales permanecieron hipotensos hasta el final del estudio. La resucitación con fluidos y noradrenalina revirtió la hipotensión arterial. Comparados con el grupo ETX-NR, en el grupo ETX-R el estudio histopatológico mostró mayor acumulación de neutrófilos, así como mayor presencia de neumocitos activados tipo II, engrosamiento de la pared alveolar, hemorragia alveolar y zonas pulmonares no aireadas. La escala final de daño pulmonar fue mayor en el grupo ETX-R. Conclusiones En nuestro estudio experimental ... (AU)

Hemodynamic resuscitation with fluids bolus and norepinephrine increases severity of lung damage in an experimental model of septic shock.

OBJECTIVE: Hemodynamic resuscitation is considered a cornerstone of the initial treatment of septic shock. However, there is growing concern about its side effects. Our objective was to assess the relationship between fluid administration and norepinephrine infusion and the development of lung injury. DESIGN: Randomized in vivo study in rabbits. SETTING: University animal research laboratory. PATIENTS: Eighteen New Zealand rabbits. Control group (SHAM, n=6), Sepsis group with or without hemodynamic resuscitation (ETX-R, n=6; ETX-NR, n=6). INTERVENTIONS: Sepsis was induced by intravenous lipopolysaccharide administration and animals were followed-up for 4h. Hemodynamic resuscitation with Ringer lactate (20mL·kg-1) was administered and later norepinephrine was initiated 3h after sepsis induction. At the end, the left lung was excised. MAIN VARIABLES OF INTEREST: An indwelling arterial catheter and an esophageal Doppler were placed. Lung mechanics were monitored with side stream spirometry. Lung damage was analyzed by histopathological examination. RESULTS: The SHAM group did not show hemodynamic or respiratory changes. Lipopolysaccharide administration aimed an increase in cardiac output and arterial hypotension. In the ETX-NR group, animals remained hypotensive until the end of the experiment. Resuscitation with fluids and norepinephrine reversed arterial hypotension. Compared to the ETX-NR group, the remaining lung of the ETX-R group showed greater accumulation of neutrophils and reactive type-II pneumocytes, thicker alveolar wall, alveolar hemorrhage and non-aerated pulmonary areas. Lung injury score was larger in the ETX-R group. CONCLUSIONS: In our experimental study, following a strategy with bolus fluids and late norepinephrine used in the early phase of endotoxic septic shock has a negative influence on the development of lung injury.

New and rapid strategies for the diagnosis of bovine paratuberculosis "in situ" using latex particles.

The chemical coupling of a protoplasmatic antigen from Mycobacterium avium subsp. paratubeculosis onto core-shell carboxylated particles was investigated with the aim of producing latex-protein complexes to be used in immunoagglutination assays capable of detecting bovine paratuberculosis disease. For this purpose, sensitizations were carried out using both colored and not colored carboxylated latexes as well as the protoplasmatic antigen at pH close to its isoelectric point to favor the antigenic protein to approach the particle surface. In all cases, higher fractions of proteins were chemically-bound to carboxyl groups on the surface of the particles. The assessment of the performance of the visual immunoagglutination assays consisted of evaluating 111 sera from healthy and infected bovines with Mycobacterium avium subsp. paratuberculosis. Complexes obtained from the colored latex allowed an acceptable visual discrimination between the studied positive and negative sera. Most of the positive samples showed strong to very strong agglutination and only a few samples reacted weakly, i.e. a sensitivity of 70%. The specificity of the assay, on the other hand, was 86%. Therefore, this rapid detection technique allows an easy and inexpensive identification of animals possibly infected with paratuberculosis "in situ" in the herds.

Study of the functional results of the percutaneous surgical treatment of subtle injuries of the tarso-metatarsian complex. / Resultados funcionales del tratamiento quirúrgico percutáneo de las lesiones sutiles del complejo tarso-metatarsiano.

INTRODUCTION AND OBJECTIVES: The concept subtle Lisfranc defines low energy lesions of the tarsometatarsal joint complex (TMC) that involve joint instability. Often unnoticed, with long-term sequelae. The objective is to evaluate the clinical-functional results of patients with MTC ligament damage grade II-III (Nunley and Vertullo classification) treated with percutaneous surgery. MATERIAL AND METHODS: Retrospective study of 16 patients who underwent percutaneous surgery for MLC ligament damage. Demographic data, days of delay in diagnosis, surgical technique, joint reduction in load (adequate if C1-M2 space is less than 2 mm) and Manchester-Oxford scale (MOXFQ) score were collected. The sample consisted of nine males and seven females, mean age 43.6 years (17-71) and mean follow-up of 22 months (12-28). RESULTS: Diagnosis was delayed for more than 24 hours in four patients (3-6 days). In 11 patients the treatment consisted of closed reduction and percutaneous synthesis with cannulated screws from M2 to C1 and from C1 to C2. In three patients it was supplemented with Kirschner wires in the lateral radii. Two patients were treated with only M2 to C1 screws. An anatomical reduction was not achieved in six patients, with a mean of 2.6 mm between C1-M2 (2.1-3 mm); the mean functional MOXFQ score of these patients was 41.1% (IC 95% 23.1-59.1%), worse results compared to the anatomical reduction: 17.2% (IC 95% 5.7-28.7); statistically significant difference (p < 0.01). CONCLUSION: Subtle injuries from MTC are rare and can go unnoticed. Surgical treatment with percutaneous synthesis offers good clinical-functional results in the medium term. The anatomical reduction is a determining factor for the good functional result of our patients.

Hemodynamic resuscitation with fluids bolus and norepinephrine increases severity of lung damage in an experimental model of septic shock.

OBJECTIVE: Hemodynamic resuscitation is considered a cornerstone of the initial treatment of septic shock. However, there is growing concern about its side effects. Our objective was to assess the relationship between fluid administration and norepinephrine infusion and the development of lung injury. DESIGN: Randomized in vivo study in rabbits. SETTING: University animal research laboratory. PATIENTS: Eighteen New Zealand rabbits. Control group (SHAM, n=6), Sepsis group with or without hemodynamic resuscitation (ETX-R, n=6; ETX-NR, n=6). INTERVENTIONS: Sepsis was induced by intravenous lipopolysaccharide administration and animals were followed-up for 4h. Hemodynamic resuscitation with Ringer lactate (20mL·kg-1) was administered and later norepinephrine was initiated 3h after sepsis induction. At the end, the left lung was excised. MAIN VARIABLES OF INTEREST: An indwelling arterial catheter and an esophageal Doppler were placed. Lung mechanics were monitored with side stream spirometry. Lung damage was analyzed by histopathological examination. RESULTS: The SHAM group did not show hemodynamic or respiratory changes. Lipopolysaccharide administration aimed an increase in cardiac output and arterial hypotension. In the ETX-NR group, animals remained hypotensive until the end of the experiment. Resuscitation with fluids and norepinephrine reversed arterial hypotension. Compared to the ETX-NR group, the remaining lung of the ETX-R group showed greater accumulation of neutrophils and reactive type-II pneumocytes, thicker alveolar wall, alveolar hemorrhage and non-aerated pulmonary areas. Lung injury score was larger in the ETX-R group. CONCLUSIONS: In our experimental study, following a strategy with bolus fluids and late norepinephrine used in the early phase of endotoxic septic shock has a negative influence on the development of lung injury.

Diagnosis and treatment of hindfoot osteoid osteoma: A therapeutic method for each case. / Diagnóstico y tratamiento de los osteomas osteoides del retropié: un método terapéutico para cada caso.

OBJECTIVES: 1) to set a reminder of the diagnostic approach to osteoid osteomas (OOs) of the foot; 2) to define the indications of treatment for hindfoot OOs. MATERIAL AND METHOD: 5 OOs were checked (3 cases located in the talus and two cases in calcaneus). The diagnosis was established by clinical and imaging data. In all cases, a calcified nidus was identified on CT, perilesional bone oedema on MRI and focal scintigraphic uptake. Two cases were treated with radiofrequency ablation (RFA) and 3 cases with surgical resections: two open surgeries and one arthroscopic surgery. Clinical and oncological outcomes were evaluated at the end of the follow-up. RESULTS: No complications were reported. The clinical outcome was excellent in all cases. One patient was initially treated with open surgery and then subsequently with RFA due to failure of the procedure. There were no recurrences after an average follow-up time of 4 years and 8 months (range, 1-12 years). DISCUSSION: Hindfoot OOs are uncommon and their diagnosis is based on clinical data in conjunction with characteristic imaging findings. Their treatment choices depend on the location of the nidus and relationships with nearby anatomical structures. CONCLUSIONS: The diagnosis of an OO of the hindfoot can be ensured when the epidemiological, clinical and imaging data are compatible with this pathological entity. RFA is indicated for intracortical or cancellous cases in which the nidus is more than 1cm off the skin and significant neurovascular structures. For all other cases an open surgical resection or arthroscopic resection would be the first choice.

Regulation of signaling pathways by tanshinones in different cancers.

Past several years have witnessed dramatic leaps in our understanding of rewiring of gene expression at the translation level during cancer developmentthat provides linchpin support to the transformed phenotype. Most recent and ground-breaking developments in the field of molecular oncology aredriven by an explosion in technological advancements and have started to reveal previously unimagined regulatory mechanisms and how they intricately co-ordinate to modulate cancer progression, loss of apoptosis and development of resistance against different therapeutics. However, the insights gained from work in this natural product research have far-reaching impact because of rapidly increasing repertoire of medicinally and biologically efficient phytochemicals. How Tanshinones mediate targeting of JAK-STAT, ER stress associated signaling cascade,PI3K/AKT/mTOR pathway,autophagy, TRAIL pathway and microRNAs are being discovered and will prove to be helpful in getting a step closer to personalized medicine.

Analysing the natural population growth of a large marine mammal after a depletive harvest.

An understanding of the underlying processes and comprehensive history of population growth after a harvest-driven depletion is necessary when assessing the long-term effectiveness of management and conservation strategies. The South American sea lion (SASL), Otaria flavescens, is the most conspicuous marine mammal along the South American coasts, where it has been heavily exploited. As a consequence of this exploitation, many of its populations were decimated during the early 20th century but currently show a clear recovery. The aim of this study was to assess SASL population recovery by applying a Bayesian state-space modelling framework. We were particularly interested in understanding how the population responds at low densities, how human-induced mortality interplays with natural mechanisms, and how density-dependence may regulate population growth. The observed population trajectory of SASL shows a non-linear relationship with density, recovering with a maximum increase rate of 0.055. However, 50 years after hunting cessation, the population still represents only 40% of its pre-exploitation abundance. Considering that the SASL population in this region represents approximately 72% of the species abundance within the Atlantic Ocean, the present analysis provides insights into the potential mechanisms regulating the dynamics of SASL populations across the global distributional range of the species.

Signaling networks in TMPRSS2-ERG positive prostate cancers: Do we need a Pied Piper or sharpshooter to deal with "at large" fused oncoprotein.

Overwhelmingly increasing scientific evidence has provided near complete resolution of prostate cancer landscape and it is now more understandable that wide ranging factors underlies its development and progression. Increasingly it is being realized that genetic/epigenetic factors, Intra-tumoral and inter-tumoral heterogeneity, loss of apoptosis, dysregulations of spatio-temporally controlled signaling cascades, Darwinian evolution in response to therapeutic pressures play instrumental role in prostate carcinogenesis. Moreover, multi-directional patterns of spread between primary tumors and metastatic sites have also been studied extensively in prostate cancer. Research over the years has gradually and systematically revealed closer association between tumor phenotype and type of gene fusion. Latest developments in deep sequencing technologies have shown that gene fusions originate in a non-random, cell type dependent manner and are much more frequent than previously surmised. These findings enabled sub-classification and categorization of seemingly identical diseases. Furthermore, research methodologies have shown that many gene fusions inform us about risk stratification and many chimeric proteins encoded by the fused genes are being studied as drug target/s. We partition this multi-component review into the molecular basis of formation of fusion transcripts, how protein network is regulated in fusion positive prostate cancer cells and therapeutic strategies which are currently being investigated to efficiently target fusion transcript and its protein product.