Evolución de la Cirugía Plástica en España (1953/2030) / Evolution of Plastic Surgery in Spain (1953/2030)

La Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) ha experimentado cambios desde su inicio en 1953 y sus integrantes han participado en la creación de diferentes sociedades profesionales que han mostrado su eficacia en el desarrollo de la especialidad. La creación de la Fundación Docente SECPRE contribuye a mejorar la formación de los futuros especialistas, a los que hay que mantener motivados después de un exigente examen de ingreso en el sistema de formación nacional de médicos internos y residentes español. En la especialidad de Cirugía Plástica no existe desempleo, pero hay interinidad en muchos puestos de trabajo. Es una especialidad que ha sabido adaptarse al progreso de la ciencia médica y ha contribuido a su desarrollo. Mantener motivadas a las nuevas generaciones de especialistas, adaptarse a las necesidades de los cambios sociales y seguir contribuyendo a los avances biomédicos, son el camino de una especialidad que repara los "tejidos histológicos"

The Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE) has undergone changes since its inception in 1953 and its members have participated in the creation of different professional societies, which have shown their effectiveness in the development of the specialty. The creation of the SECPRE Educational Foundation helps to improve the training of future specialists, who must keep motivated after a demanding examination to enter into the spanish national residents training system. In the specialty of Plastic Surgery there is no unemployment, but temporariness is too common. The specialty has adapted to the progress of medical science and has contributed to its development. Keeping the new generations of specialists motivated, adapting to the needs of social changes and continuing to contribute to biomedical advances are the path of a specialty that repairs the "histological tissues"

Artroplastia de interposición-suspensión con aloinjertos para el tratamiento de la rizartrosis: evolución y resultados a largo plazo / Interposition-suspension arthroplasty with allografts for trapezio-metacarpal joint osteoarthritis treatment: evolution and long term results

Antecedentes y Objetivos. La articulación trapecio-metacarpiana (TMC) presenta una especial anatomía que se altera en la rizartrosis. De entre todas las técnicas quirúrgicas que existen para tratar esta patología, proponemos una artroplastia de interposición suspensión con tejidos criopreservados que creemos que reproduce bastante fielmente el movimiento de la articulación. Material y Método. Presentamos un estudio prospectivo en 103 pacientes con rizartrosis tratados entre los años 1995 y 2008 a los que se realizó la técnica que presentamos. Valoramos el dolor, la capacidad para hacer su trabajo o las actividades de la vida diaria para evaluar la técnica y la permanencia de ésta en el tiempo. Resultados. Objetivamos en los pacientes del grupo de estudio una mejoría del dolor y de la capacidad para hacer su trabajo y sus actividades diarias tras la realización de la artroplastia, mantenidas en el tiempo, incluso en los pacientes con seguimiento superior a 9 años. Las complicaciones aparecidas fueron resueltas en todos los casos sin secuelas. Comparamos la movilidad de la articulación con la que presentan dos anillos entrelazados, lo que permite los grados de libertad de la articulación TMC. Conclusiones. La técnica elegida refleja el movimiento de una sección de espiral que permite a la articulación recuperar todos los movimientos. Además, esta técnica se puede utilizar en cualquier estadio de la enfermedad y mantiene sus resultados en el tiempo (AU)

Background and Objectives. The trapezium-metacarpal (TMC) joint has a special anatomy that is modified when the osteoarthritis come in. Of all the techniques, we propose an interposition-suspension arthroplasty with criopreserved allografts that we think that reproduces truly the joint movement. Methods. We submit a prospective study with 103 patients that suffered osteoarthritis of de TMC joint and were treated with this technique of arthroplasty. Pain, ability for work or daily live activities were valued to evaluate this technique and its remaining in time. Results. An improvement in pain and in their daily activities was obtained following arthroplasty, and these results were kept on time even in patients with as a long follow up as 9 years. Complications were solved in all cases without sequelae. Joint movement is similar to the movement of two rings interlocked, which allows the same grades of movement than the TMC joint. Conclusions. The submitted technique evidence the movement of a coil section allows recover all the movement to the joint. This technique could be used in any stage of the disease and retain its results along the time (AU)

In vivo interleukin-6 protects neutrophils from apoptosis in osteomyelitis.

Polymorphonuclear neutrophils are critical for resolution of bacterial infections. In tissues, most of the neutrophils quickly die through apoptosis. Using propidium iodide DNA staining and DNA gel electrophoresis, we found that spontaneous apoptosis of neutrophils from patients suffering osteomyelitis (n = 52) was significantly decreased in relation to control neutrophils (n = 20) (40.2% +/- 25.2% versus 54.5% +/- 23.5%; P < 0.03). Incubation of neutrophils from normal volunteers with sera from patients with osteomyelitis reduced apoptosis from 79.1% +/- 14.8% in control sera to 62.2% +/- 18.7% in osteomyelitis sera. A significant increase of serum interleukin-6 (IL-6) and IL-1alpha was found in osteomyelitis (IL-6, 8.8 +/- 11.9 pg/ml versus 1.8 +/- 1.2 pg/ml in controls [P < 0.004]; IL-1alpha, 3.8 +/- 6.4 pg/ml versus 1.0 +/- 2.2 pg/ml in controls [P < 0.02]). No differences in the levels of other cytokines, such as tumor necrosis factor alpha, were found. There was an inverse correlation between IL-6 levels and neutrophil apoptosis (r = -0.855; P < 0.007), but this was not the case for other cytokines. The antiapoptotic effect of the osteomyelitis sera was reversed with anti-IL-6 antibodies (P < 0.03) and was reproduced with recombinant human IL-6 (P < 0.001). The longer life span of neutrophils in osteomyelitis induced by IL-6 could contribute to the tissue damage that occurs in these chronic bone infections.

IL-1 alpha (-889) promoter polymorphism is a risk factor for osteomyelitis.

As osteomyelitis (OM) induces the synthesis of inflammatory cytokines and IL-1 mediates bone resorption by osteoclasts we determined if there is an association between certain common polymorphisms of the genes encoding proinflammatory cytokines (IL-1 alpha and beta, IL-6, TNF-alpha) and OM in adults. The IL-1 alpha (-889) TT genotype was significantly more frequent among 52 OM patients than in 109 healthy controls (13/52, [25.0%] vs. 9/109, [8.3%], P = 0.0081, chi(2) = 7.01, OR = 3.7, 95% CI, 1.35-10.34). Patients who were homozygous for the T allele were younger than the rest of the OM patients (mean age 35.7 +/- 11.5 vs. 58.1 +/- 18.6 years, P = 0.001). IL-1 beta TT (+3953) polymorphism was also more frequent in OM patients (P = 0.014, chi(2) = 5.12, OR = 5.1, 95% CI, 1.21-52.14), but IL-1 beta is in linkage disequilibrium with the IL-1 alpha *T (P < 0.001). Route of infection, chronicity of the infection, type of microorganism isolated, and frequency of relapses were similar in patients with and without the IL-1 alpha TT genotype. There were no associations between OM and polymorphisms of other cytokines genes. IL-1 alpha serum levels were significantly increased in all the OM patients independently of their IL-1 genotype compared to the controls (P = 0.021). Although IL-1 alpha serum levels were not significantly higher in patients with the IL-1 alpha (-889) polymorphism, this does not exclude a difference in production of IL-1 alpha by osteoclasts or other inflammatory cells at the site of infection.