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INTRODUCTION: It has been hypothesized that cognitive and memory-related brain function in transgender during cross-sex hormonal treatment might be activated towards that of the subjective gender. However, research on this topic has produced inconsistent results, and to the best of our knowledge no studies have investigated neurocognitive changes in androgen-treated female-to-male (FM) transgender adolescents. SUBJECTS AND METHODS: A total of 15 FM transgender adolescents (14-17 years) underwent neuropsychological testing in order to examine the effects of androgen on visuo-spacial abilities, verbal memory language, processing speed and executive functions. We used a longitudinal design in which 10 participants were tested twice, before and after receiving 12 months of testosterone treatment. This group was also compared with 5 FM transgender adolescents off-androgen treatment. RESULTS: Participants tested before and after 12 months of androgen treatment improved significantly on processing speed in a visuo-spatial (Rey-Osterrieth complex figure test) and in a visuo-oral task (Stroop), their performance on a verbal memory task (TAVEC) and on interference (Stroop) and they exhibited lower impulsivity control (CARAS-R). On-androgen treatment adolescents exhibited worse cognitive impulsivity control than off-androgen treatment adolescents. CONCLUSIONS: The results indicate that androgen has an influence on immediate verbal memory, cognitive interference, impulsivity control and processing speed.
TITLE: Efectos del tratamiento con andrógenos sobre la neurocognición en adolescentes transgénero de mujer a hombre.Introducción. Se ha planteado la hipótesis de que la neurocognición en personas transgénero durante el tratamiento hormonal cruzado podría aproximarse a la del género subjetivo. Sin embargo, la investigación sobre este tema ha producido resultados inconsistentes y, hasta donde sabemos, ningún estudio ha investigado los cambios neurocognitivos en adolescentes transgénero de mujer a hombre (FM) tratados con andrógenos. Sujetos y métodos. Quince adolescentes transgénero FM (14-17 años) se sometieron a pruebas neuropsicológicas para examinar los efectos de los andrógenos en sus habilidades visuoespaciales, memoria verbal, velocidad de procesamiento y funciones ejecutivas. Utilizamos un diseño longitudinal en el que se evaluó a 10 participantes dos veces, antes y después de recibir, durante 12 meses, tratamiento con testosterona. Este grupo también se comparó con cinco adolescentes transgénero FM sin tratamiento con andrógenos. Resultados. Los participantes evaluados antes y después de 12 meses de tratamiento con andrógenos mejoraron significativamente en velocidad de procesamiento en una tarea visuoespacial (prueba de la figura compleja de Rey-Osterrieth) y en una tarea visual (Stroop), en una tarea de memoria verbal (test de aprendizaje verbal España-Complutense) y en interferencia (Stroop), y exhibieron un menor control de la impulsividad (test de percepción de diferencias revisado). Los adolescentes que recibieron tratamiento con andrógenos mostraron un peor control de la impulsividad cognitiva que los adolescentes que no recibieron tratamiento con andrógenos. Conclusiones. Los resultados indican que los andrógenos influyen en la memoria verbal, la interferencia cognitiva, el control de la impulsividad y la velocidad de procesamiento.
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Personas Transgénero , Adolescente , Femenino , Masculino , Humanos , Andrógenos/uso terapéutico , Encéfalo , Función Ejecutiva , Conducta ImpulsivaRESUMEN
La disponibilidad en España de indicadores y estándares de calidad asistencial para Psicología Clínica en el Sistema Nacional de Salud es limitada. En este trabajo analizamos indicadores y estándares asistenciales ambulatorios informados por 107 Facultativos de Psicología Clínica en Centros de Salud Mental del Servicio Madrileño de Salud, a través de una encuesta online completada en 2021. El tiempo medio para la primera consulta normal en adultos fue de 4 meses y 5 en infanto-juvenil. El tiempo medio entre sesiones en ambos fueron 7 semanas. El número medio de pacientes nuevos semanales es de 8 y 6 en adultos e infanto-juvenil y de pacientes diarios fue de 9 y 8 respectivamente. La carga media total es 328 pacientes en adultos y 280 en infanto-juvenil. Sin embargo, los encuestados creen que la carga de pacientes activos debería ser 74, sin superar los 150 y un máximo de 6 al día. La mayoría de los psicólogos/as clínicos/as propone aumentar el número de plazas PIR y apoya la creación de Servicios de Psicología Clínica. La carga asistencial supera las recomendaciones de otros expertos. Se concluye que es imprescindible aumentar la ratio de psicólogos/as clínicos/as para alcanzar los estándares recomendados (AU)
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Humanos , Encuestas de Atención de la Salud , Calidad de la Atención de Salud , Servicios de Salud Mental/normas , Carga de Trabajo , Satisfacción en el Trabajo , Personal de Salud , EspañaRESUMEN
BACKGROUND: To investigate the true accuracy of the surgical guide in the planning of orthognathic surgeries, which are performed worldwide. MATERIAL AND METHODS: A systematic search was conducted in the PubMed database, Web of science, Scopus and Embase, covering August 2020 to January 2021. Studies that included patients with dentofacial deformity including anteroposterior, vertical and asymmetry problems who were undergoing an orthognathic surgery procedure were included; QUADAS-2 was used to determine the risk of bias by analyzing the quality of the studies. A PRISMA (flowchart) was created to show the study selection, keywords, nomination processes, and inclusion and exclusion criteria. RESULTS: Eleven studies were selected for qualitative and quantitative synthesis. All studies evaluated described high precision of the surgical guide, where the lowest error values were represented by the CAD/CAM technique. CONCLUSIONS: The planning and printing errors related to the guide were all less than 2 mm, and the absolute averages of the errors related to virtual planning in the analysis of the different plans were less than 1 mm. Finally, the measurement of the ANB angle obtained equivalent results between the virtual planning and the traditional.
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Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Cirugía Asistida por Computador , Diseño Asistido por Computadora , Humanos , Imagenología Tridimensional , Procedimientos Quirúrgicos Ortognáticos/métodos , Impresión Tridimensional , Cirugía Asistida por Computador/métodosRESUMEN
Combining standard drugs with low doses of histone deacetylase inhibitors (HDACIs) is a promising strategy to increase the efficacy of chemotherapy. The ability of well-tolerated doses of HDACIs that act as chemosensitizers for platinum-based chemotherapeutics has recently been proven in many types and stages of cancer in vitro and in vivo. Detection of changes in HDAC activity/expression may provide important prognostic and predictive information and influence treatment decision-making. Use of [18F] FAHA, a HDAC IIa-specific radionuclide, for molecular imaging may enable longitudinal, noninvasive assessment of HDAC activity/expression in metastatic cancer. We evaluated the synergistic anticancer effects of cisplatin and the histone deacetylase inhibitor suberoylanilide hydroxamic acid (SAHA) in xenograft models of nonsmall cell lung cancer (NSCLC) using [18F] FAHA and [18F] FDG PET/CT imaging. Cisplatin alone significantly increased [18F] FAHA accumulation and reduced [18F] FDG accumulation in H441 and PC14 xenografts; coadministration of cisplatin and SAHA resulted in the opposite effects. Immunochemical staining for acetyl-histone H3 confirmed the PET/CT imaging findings. Moreover, SAHA had a more significant effect on the acetylome in PC14 (EGFR exon 19 deletion mutation) xenografts than H441 (wild-type EGFR and KRAS codon 12 mutant) xenografts. In conclusion, [18F] FAHA enables quantitative visualization of HDAC activity/expression in vivo, thus, may represent a clinically useful, noninvasive tool for the management of patients who may benefit from synergistic anticancer therapy.
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Carcinoma de Pulmón de Células no Pequeñas , Carcinoma , Neoplasias Pulmonares , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Línea Celular Tumoral , Cisplatino/farmacología , Fluorodesoxiglucosa F18 , Humanos , Ácidos Hidroxámicos , Pulmón , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Tomografía Computarizada por Tomografía de Emisión de Positrones , Vorinostat/farmacologíaRESUMEN
BACKGROUND: The aim of this research was to assess the expression of aldehyde dehydrogenase 1 (ALDH1) and epithelial-mesenchymal transition (EMT) markers in head and neck squamous cell carcinoma (HNSCC), and to correlate them with the clinical and histopathological parameters of a patient cohort with follow-up over an 8-year period. MATERIAL AND METHODS: For this, seventeen HNSCC and non-neoplastic adjacent epithelium (AE) samples were subjected to laser microdissection and real-time PCR to evaluate the mRNA expression of ALDH1, E-cadherin (E-CAD), N-cadherin (N-CAD), and vimentin (VIM). Also, immunohistochemistry was performed for ALDH1, E-CAD, N-CAD, and VIM in the tumor center (TC), invasion front (IF), and AE of the seventeen samples. Mann-Whitney, Kruskal-Wallis and Chi-square tests were used to correlate the mRNA and immunohistochemical expression with different variables, considering p<0.05. Kaplan-Meier curves were produced for local recurrence, regional metastasis and treatment. RESULTS: A mRNA overexpression of ALDH1 in primary tumors was associated with regional metastasis and a high ALDH1 immunostaining was related to metastasis and a worse patient outcome. Additionally, a favorable outcome was associated with the transition phase and an unfavorable outcome was associated with EMT event. An overall 26.9 months was observed with longer survival associated with surgery and radiotherapy. CONCLUSIONS: However, due to the intense variability inherent to the indicator proteins in the EMT process, the complete profile markers related to this biological process should be continuous investigated.
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Neoplasias de Cabeza y Cuello , Carcinoma de Células Escamosas de Cabeza y Cuello , Familia de Aldehído Deshidrogenasa 1 , Biomarcadores de Tumor , Transición Epitelial-Mesenquimal , Humanos , Recurrencia Local de NeoplasiaRESUMEN
BACKGROUND: Despite the widespread use of organophosphate (OP) pesticides, information on predictors of children's exposure to such pesticides is scarce. OBJECTIVE: To assess exposure to OP pesticides in children 3-11 year-old living in agricultural communities and urban areas from Andalusia (Southern Spain), and to identify the main determinants of exposure. METHODS: A longitudinal study was conducted in children 3-11-year-old children living in agricultural communities and urban areas from the provinces of Almeria, Granada and Huelva (Andalusia, Spain) between 2010 and 2011. Urinary levels of six dialkylphosphate (DAP) metabolites were measured by UHPLC-QqQ-MS/MS at the periods of low and high pesticide use in the agriculture (LPU and HPU, respectively). Information on sociodemographic characteristics, parental occupation, residential history, lifestyle and diet, among other relevant factors, was obtained from questionnaires administered to the mothers. RESULTS: A total of 559 and 597 children participated in LPU and HPU periods, respectively. The proportion of urine samples below LOD was 67.4% for ΣDMs (sum of dimethyl metabolites), 77% for ΣDEs (sum of diethyl metabolites) and 58.5% for ΣDAPs (sum of total dialkylphosphate metabolites) in LPU period, and 50.4% for ΣDMs, 65.3% for ΣDEs and 43.9% for ΣDAPs in HPU period. Significantly greater urinary ΣDAP, ΣDM and ΣDE levels were observed in HPU relative to LPU period. Maternal schooling years, proximity of the house to crops or greenhouses, use of insecticides at home, spraying the garden with pesticides, storage of pesticides at home, house cleaning frequency, as well as child's frequency of bath/shower, were found to be the major predictors of urinary levels of ΣDAP. Likewise, not washing fruit and vegetables before consumption and banana consumption were also identified as determinants of the exposure levels. CONCLUSIONS: Urinary levels of metabolites of OP pesticides found in this study were relatively lower compared to similar studies. DAP levels were significantly increased in HPU period. Maternal schooling years and variables related to residential environment and home exposures were identified as the most relevant determinants of DAP metabolites. Regarding diet, banana consumption and not washing fruit before consumption were also identified as determinants of the exposure levels. This study contributes to improve our knowledge on the main sources and determinants of children exposure to OPS, and given that children are more vulnerable than adults this information is essential to reduce children exposure and protect their health.
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Insecticidas , Plaguicidas , Adulto , Agricultura , Niño , Preescolar , Exposición a Riesgos Ambientales/análisis , Humanos , Insecticidas/análisis , Estudios Longitudinales , Organofosfatos , Compuestos Organofosforados , España , Espectrometría de Masas en TándemRESUMEN
Heavy metals and other toxic elements are frequently detected in humans. Rare earth elements (REE) have arisen as a novel group of substances considered as emerging pollutants due to its dependence for high tech industry. We designed a study aimed to conduct the biomonitoring a total of 45 inorganic elements in the population of Andalusia (Spain). A total of 419 participants were recruited and their plasma samples analyzed. Concentration of elements, including elements in the ATSDR's priority pollutant list and REE were measured by ICP-MS in the blood plasma of participants. Arsenic, copper, lead, selenium, antimony, strontium, and bismuth were detected in Ë98% of subjects. Median values of arsenic, mercury and lead were 1.49, 1.46, and 5.86â¯ng/mL, respectively. These concentrations did not exceed reference values published by international agencies. We observed a positive correlation between age and plasma concentrations of arsenic, mercury, antimony and strontium. Sum of elements was lower in the group of subjects younger than 45â¯years old (Pâ¯=â¯0.002). Positive correlations were observed between body mass index (BMI) and plasma concentrations of barium, cerium, osmium, tin, and ytterbium. 7 out of 26 REEs showed a percentage of detectionâ¯≥â¯90%. Bismuth, yttrium, and cerium were quantified at the highest concentrations (median valueâ¯=â¯7.7, 0.19, and 0.16â¯ng/mL, respectively). We found that plasma levels of 6 REEs were higher among males, and a positive correlation between REEs and age was detected. The present results suggest a potential interaction with the human physiology that deserves additional research. Given the high persistence of these elements in the environment, and the significant technological dependence on them, future studies are needed to elucidate the potential sources of exposure and possible adverse effects on health, especially in the most vulnerable populations.
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Monitoreo Biológico , Estudios Transversales , Humanos , Masculino , Metales Pesados , Metales de Tierras Raras , Persona de Mediana Edad , EspañaRESUMEN
INTRODUCTION AND AIM: Abdominal pain in children is a frequent cause of emergency room consultation. An important group of those patients presents with chronic constipation and fecal impaction. Plain abdominal x-ray is widely used for making a diagnosis and ruling out the need for surgical treatment. The present study examined the association between pain intensity and fecal impaction grade. MATERIALS AND METHODS: An analytic cross-sectional study was conducted that compared 2 radiographic scales to determine the association between the grade of fecal impaction observed and abdominal pain intensity in patients that sought medical attention at an emergency service within a 7-month period. The analysis was carried out by 2 different observers, utilizing 2 different radiographic scales to confirm their reproducibility. The degree of interobserver agreement was measured using the Kappa coefficient and the association between abdominal pain and fecal impaction grade was measured through the Spearman correlation coefficient. RESULTS: There was a significant association between pain intensity and the radiographic grade of fecal impaction (P<.05) for the radiographic scale by segments and its interobserver agreement was high, compared with the scale by percentage. CONCLUSIONS: Radiographic scales may be useful in the evaluation and treatment of patients with abdominal pain and constipation. The segmental scale showed less interobserver variability, suggesting its proposal as an alternative in the evaluation and follow-up of patients with chronic constipation.
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Dolor Abdominal/etiología , Estreñimiento/complicaciones , Impactación Fecal/complicaciones , Impactación Fecal/diagnóstico por imagen , Adolescente , Niño , Preescolar , Estudios Transversales , Servicios Médicos de Urgencia , Femenino , Humanos , Lactante , Masculino , RadiografíaRESUMEN
Objetivo: Validar a nivel extrahospitalario la capacidad diagnóstica de seis escalas de predicción para hemorragia masiva. Diseño: Cohorte retrospectiva. Ámbito: Atención extrahospitalaria del paciente con enfermedad traumática grave. Participantes: Pacientes mayores de 15 años, que han sufrido un trauma grave (definido por los criterios de código 15), atendidos en el medio extrahospitalario por un servicio de atención sanitaria de emergencias desde enero de 2010 hasta diciembre de 2015 y trasladados a un centro hospitalario de alta complejidad en Madrid. Variables de interés principales: Se validaron las siguientes escalas: 1. Trauma Associated Severe Haemorrhage score. 2. Assessment of Blood Consumption Score. 3. Emergency Transfusion Score. 4. Índice de Shock. 5. Prince of Wales Hospital/Rainer Score. 6. Larson Score. Resultados: Se estudiaron 548 pacientes, el 76,8% (420) fueron hombres, una edad mediana de 38 (rango intercuartil [RIC]: 27-50). Injury Severity Score de 18 (RIC: 9-29). El trauma cerrado fue el 82,5% (452). La frecuencia global de HM fue de 9,2% (48), días de estancia en UCI de 2,1 (RIC: 0,8 - 6,2) y una mortalidad hospitalaria del 11,2% (59). La escala con mayor precisión fue la Emergency Transfusion Score (AUC 0,85), en segundo lugar se encuentran Trauma Associated Severe Haemorrhage y Prince of Wales Hospital/Rainer (AUC 0,82); la escala con menor precisión Assessment of Blood Consumption (AUC 0,68). Conclusiones: A nivel extrahospitalario la aplicación de cualquiera de las seis escalas predice la presencia de hemorragia masiva y permite la activación de los protocolos de transfusión masiva mientras el paciente es trasladado a un centro hospitalario
Objective: To validate the diagnostic ability of six different scores to predict massive bleeding in a prehospital setting. Design: Retrospective cohort. Setting: Prehospital attention of patients with severe trauma. Subjects: Subjects with more than 15 years, a history of severe trauma (defined by code 15 criteria), that were initially assisted in a prehospital setting by the emergency services between January 2010 and December 2015 and were then transferred to a level one trauma center in Madrid. Variables: To validate: 1. Trauma Associated Severe Haemorrhage Score. 2. Assessment of Blood Consumption Score. 3. Emergency Transfusión Score. 4. Índice de Shock. 5. Prince of Wales Hospital/Rainer Score. 6. Larson Score. Results: 548 subjects were studied, 76,8% (420) were male, median age was 38 (interquartile range [IQR]: 27-50). Injury Severity Score was 18 (IQR: 9-29). Blunt trauma represented 82,5% (452) of the cases. Overall, frequency of MB was 9,2% (48), median intensive care unit admission days was 2,1 (IQR: 0,8 - 6,2) and hospital mortality rate was 11,2% (59). Emergency Transfusión Score had the highest precisions (AUC 0,85), followed by Trauma Associated Severe Haemorrhage score and Prince of Wales Hospital/Rainer Score (AUC 0,82); Assessment of Blood Consumption Score was the less precise (AUC 0,68). Conclusion: In the prehospital setting the application of any the six scoring systems predicts the presence of massive hemorrhage and allows the activation of massive transfusion protocols while the patient is transferred to a hospital
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Humanos , Masculino , Adulto , Persona de Mediana Edad , Hemorragia/diagnóstico , Índices de Gravedad del Trauma , Heridas y Lesiones/diagnóstico , Servicios Médicos de Urgencia/métodos , Índice de Severidad de la Enfermedad , Hemorragia/etiología , Heridas y Lesiones/complicaciones , Estudios de Cohortes , Estudios Retrospectivos , Transfusión Sanguínea/métodosRESUMEN
BACKGROUND: Many studies demonstrate the relationship between the high intrapatient variability of calcineurin inhibitor (CNI) levels and poor long-term renal graft outcome. Our objective is to analyze the intrapatient variability observed in the mammalian target of rapamycin inhibitors (mTOR-i) blood levels, to compare the variability of sirolimus (SRL) with that of everolimus (EVL) in kidney transplant patients converted to an mTOR-i, and to analyze whether the coefficient of variation (CV) was correlated with long-term graft survival. METHODS: We analyzed 279 adult renal transplant patients converted to an mTOR-i. CV was calculated using at least 3 blood trough levels between 3 and 18 months postconversion. RESULTS: The mean and median CV of the entire group was 25.54% and 23.7%, respectively. SRL and EVL mean CV was 23.8% and 27.1% (P = .03), respectively. The group of patients into the last tertile with CV> 28.52% presented a lower death-censored graft survival (75.26% vs. 93.01%, P < .0001) with a mean follow-up of 66.5 months. CONCLUSION: The CV of mTOR-i is correlated with long-term renal graft survival, so it should be considered a prognostic factor. SRL has a lower CV than EVL in renal transplant patients converted to mTOR-i in the stable posttransplant phase.
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Everolimus/uso terapéutico , Supervivencia de Injerto/efectos de los fármacos , Inmunosupresores/uso terapéutico , Sirolimus/uso terapéutico , Adulto , Inhibidores de la Calcineurina/sangre , Inhibidores de la Calcineurina/uso terapéutico , Everolimus/sangre , Femenino , Humanos , Inmunosupresores/sangre , Trasplante de Riñón , Masculino , Persona de Mediana Edad , Sirolimus/sangreRESUMEN
No disponible
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Humanos , Niño , Adolescente , Atropina/uso terapéutico , Relación Dosis-Respuesta a Droga , Resultado del Tratamiento , MidriáticosRESUMEN
OBJECTIVE: To validate the diagnostic ability of six different scores to predict massive bleeding in a prehospital setting. DESIGN: Retrospective cohort. SETTING: Prehospital attention of patients with severe trauma. SUBJECTS: Subjects with more than 15 years, a history of severe trauma (defined by code 15 criteria), that were initially assisted in a prehospital setting by the emergency services between January 2010 and December 2015 and were then transferred to a level one trauma center in Madrid. VARIABLES: To validate: 1. Trauma Associated Severe Haemorrhage Score. 2. Assessment of Blood Consumption Score. 3. Emergency Transfusión Score. 4. Índice de Shock. 5. Prince of Wales Hospital/Rainer Score. 6. Larson Score. RESULTS: 548 subjects were studied, 76,8% (420) were male, median age was 38 (interquartile range [IQR]: 27-50). Injury Severity Score was 18 (IQR: 9-29). Blunt trauma represented 82,5% (452) of the cases. Overall, frequency of MB was 9,2% (48), median intensive care unit admission days was 2,1 (IQR: 0,8 - 6,2) and hospital mortality rate was 11,2% (59). Emergency Transfusión Score had the highest precisions (AUC 0,85), followed by Trauma Associated Severe Haemorrhage score and Prince of Wales Hospital/Rainer Score (AUC 0,82); Assessment of Blood Consumption Score was the less precise (AUC 0,68). CONCLUSION: In the prehospital setting the application of any the six scoring systems predicts the presence of massive hemorrhage and allows the activation of massive transfusion protocols while the patient is transferred to a hospital.
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Hemorragia/diagnóstico , Heridas y Lesiones/complicaciones , Adulto , Área Bajo la Curva , Transfusión Sanguínea/estadística & datos numéricos , Servicios Médicos de Urgencia , Femenino , Hemorragia/etiología , Hemorragia/terapia , Mortalidad Hospitalaria , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Choque Hemorrágico/etiología , España/epidemiología , Heridas y Lesiones/epidemiología , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/epidemiologíaRESUMEN
El tubérculo lateral del proceso posterior del talo se fusiona generalmente con el cuerpo de este hueso, sin embargo, debido al estrés (flexión plantar forzada) aplicado durante los años de la adolescencia o cuando un centro osificado parcialmente e incluso totalmente osificado se fractura, se provoca una falta de unión, dando lugar a un hueso accesorio denominado Os trigonum (OT). En algunos casos puede producirse el síndrome os trigonum o síndrome de pinzamiento posterior, el cual se caracteriza por un dolor agudo o crónico de la región posterior del tobillo. Basado en lo anterior, se realizó un estudio retrospectivo entre el período de Agosto de 2017 a Mayo de 2018, en el cual se analizaron radiografías bilaterales de 205 pacientes concurrentes al Hospital Hernán Henríquez Aravena de Temuco, Chile. De la población estudiada, 154 fueron de sexo femenino y 51 de sexo masculino cuyas edades fluctuaron entre los 15 y 85 años, Las proyecciones radiológicas utilizadas fueron de pie lateral, tobillo lateral o calcáneo lateral, para así para determinar la prevalencia de OT y contribuir acerca de su distribución en pie derecho e izquierdo y aparición según sexo y edad. Del total de la muestra, se encontraron 24 individuos que presentaban OT (11,7 %) de los cuales 18 (75 %) correspondían al sexo femenino y 6 (25 %) al sexo masculino. Además se realizaron mediciones del largo y ancho del OT. Los datos obtenidos son una contribución al conocimiento de los huesos accesorios del pie en la población chilena.
The lateral tubercle of the posterior process of the talus is generally fused with the body of this bone, however, due to stress (forced plantar flexion) applied during the adolescent years. Also, when a partially ossified and even fully ossified center fractures, it causes a lack of union, giving rise to an accessory bone called Os trigonum (OT). In some cases Os trigonum syndrome or posterior impingement syndrome may occur, which is characterized by acute or chronic pain in the posterior region of the ankle. Based on the above, a retrospective study was conducted between August 2017 and May 2018, in which bilateral radiographs of 205 patients attending the Hernán Henríquez Aravena Hospital of Temuco were analyzed. Of the population studied, 154 were female and 51 were male, whose ages fluctuated between 15 and 85 years. The radiological projections used were lateral foot, lateral ankle and calcaneus lateral, to determine the prevalence of OT and provide information about its distribution in right and left foot and appearance according to sex and age. From the total sample, 24 individuals were found who had OT (11.7 %) of which 18 (75 %) corresponded to the female sex and 6 (25 %) to the male sex. In addition, measurements of the length and width of the OT were made. The data obtained is a contribution to the knowledge of the accessory bones of the foot in the Chilean population.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Astrágalo/patología , Astrágalo/diagnóstico por imagen , Chile , Prevalencia , Estudios Retrospectivos , Distribución por Edad y SexoRESUMEN
BACKGROUND: Dopamine physiological functions make dopaminergic genes suitable candidates for association studies in eating disorders (ED). A Val158Met polymorphism in the catechol-O-methyltransferase (COMT) gene, which is involved in dopamine degradation, has been studied in relation to ED. OBJECTIVE: We aimed to analyze the association between this polymorphism and general psychopathological symptoms that are often coupled to these disorders. METHOD: A total of 303 ED patients, diagnosed according to DSM-5 criteria, completed the SCL-90R questionnaire and were genotyped for the Val158Met polymorphism. RESULTS: There were significant differences in the global indices of the SCL-90R inventory between the three ED groups (Anorexia Nervosa (AN), Bulimia Nervosa (BN) and binge-eating disorder; ANOVA-p < 0.05). Females with BN showed the highest scores (worse symptomatology) of all participants. In this group, a gene-dose effect was observed on the psychometric evaluation of the patients, as Val/Val carriers displayed the highest scores for all the SCL-90R scales, followed by Val/Met and then Met/Met carriers. Significant differences between genotypes were observed in the Obsessive- Compulsive (p = 0.018), Paranoid Ideation (p = 0.0005) and Psychoticism (p = 0.039) scales, as well as in the PSDI (p = 0.014) general index. CONCLUSION: The results taken together suggest that COMT genetic variability may contribute to general psychopathological symptoms in patients with BN.
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Anorexia Nerviosa , Trastorno por Atracón , Bulimia Nerviosa , Catecol O-Metiltransferasa/genética , Predisposición Genética a la Enfermedad , Polimorfismo Genético , Adolescente , Adulto , Sustitución de Aminoácidos , Anorexia Nerviosa/genética , Anorexia Nerviosa/psicología , Trastorno por Atracón/genética , Trastorno por Atracón/psicología , Bulimia Nerviosa/genética , Bulimia Nerviosa/psicología , Niño , Femenino , Humanos , Mutación Missense , PsicometríaRESUMEN
One of the main goals of the Spanish and Portuguese-Speaking Group of the International Society for Forensic Genetics (GHEP-ISFG) is to promote and contribute to the development and dissemination of scientific knowledge in the field of forensic genetics. Due to this fact, GHEP-ISFG holds different working commissions that are set up to develop activities in scientific aspects of general interest. One of them, the Mixture Commission of GHEP-ISFG, has organized annually, since 2009, a collaborative exercise on analysis and interpretation of autosomal short tandem repeat (STR) mixture profiles. Until now, six exercises have been organized. At the present edition (GHEP-MIX06), with 25 participant laboratories, the exercise main aim was to assess mixture profiles results by issuing a report, from the proposal of a complex mock case. One of the conclusions obtained from this exercise is the increasing tendency of participating laboratories to validate DNA mixture profiles analysis following international recommendations. However, the results have shown some differences among them regarding the edition and also the interpretation of mixture profiles. Besides, although the last revision of ISO/IEC 17025:2017 gives indications of how results should be reported, not all laboratories strictly follow their recommendations. Regarding the statistical aspect, all those laboratories that have performed statistical evaluation of the data have employed the likelihood ratio (LR) as a parameter to evaluate the statistical compatibility. However, LR values obtained show a wide range of variation. This fact could not be attributed to the software employed, since the vast majority of laboratories that performed LR calculation employed the same software (LRmixStudio). Thus, the final allelic composition of the edited mixture profile and the parameters employed in the software could explain this data dispersion. This highlights the need, for each laboratory, to define through internal validations its criteria for editing and interpreting mixtures, and to continuous train in software handling.
Asunto(s)
Dermatoglifia del ADN/normas , Genética Forense/normas , Laboratorios/estadística & datos numéricos , Repeticiones de Microsatélite , Sociedades Científicas , Humanos , Funciones de Verosimilitud , Informe de Investigación/normas , Programas InformáticosRESUMEN
OBJETIVO: Evaluar la incidencia y evolución de la diplopía como complicación de las fracturas orbitarias en adultos. PACIENTES Y MÉTODOS: Estudio retrospectivo de los adultos con fractura orbitaria remitidos entre enero de 2014 y diciembre de 2015. Analizamos la incidencia de diplopía secundaria a la fractura en la fase aguda y su evolución. Realizamos un estudio descriptivo de las variables relativas a los pacientes, las fracturas, y el tratamiento de la fractura y de la diplopía. RESULTADOS: Se estudiaron un total de 39 pacientes con edad media de 48años (17-85). Del total, 17 pacientes (43,6%) presentaron diplopía en la fase aguda. Se encontraron diferencias entre los grupos con y sin diplopía para el atrapamiento muscular diagnosticado mediante TC orbitario, la limitación en las ducciones y la cirugía de la fractura ≤ 1semana (p = 0,02; p = 0,00; p = 0,04, respectivamente). De los 17 pacientes con diplopía, 12 tuvieron seguimiento medio de 18 semanas (1-72) y de ellos en 10 (83,3%) la diplopía se resolvió en un tiempo medio de 10semanas (1-72). Se produjo resolución espontánea en 4 pacientes (33,3%), y resolución tras cirugía de la fractura en 4 (57%) de los 7 que fueron intervenidos. En 4c asos (33,3%) se prescribieron prismas, y 2 (16,6%) precisaron cirugía de estrabismo. CONCLUSIONES: La diplopía secundaria a fractura orbitaria en adultos es frecuente pero se resuelve en la mayoría de los casos espontáneamente o tras cirugía de la fractura; una minoría de pacientes precisarán prismas y/o cirugía de estrabismo
OBJECTIVE: To evaluate the incidence and evolution of diplopia as a complication of orbital fractures in adults. PATIENTS AND METHODS: A review was conducted on medical records of all consecutive adults with orbital fracture referred between January 2014 and December 2015. An analysis was made of the incidence of diplopia secondary to fracture in the acute phase and its evolution. A descriptive study was performed on the variables related to patients, fractures, and fracture and diplopia treatment. RESULTS: The study included 39 patients with a mean age of 48 years (17-85). Of all the patients, 17 (43.6%) presented with diplopia in the acute phase. Differences were found between the groups with and without diplopia in relation to muscle entrapment diagnosed by orbital computed tomography, duction limitation, and fracture surgery ≤ 1week (P = .02, P = .00, P = .04, respectively). Out of the 17 patients with diplopia, 12 had a mean follow-up of 18 weeks (1-72), and in 10 (83.3%) diplopia was resolved in a mean time of 10 weeks (1-72). There were spontaneous resolution in 4 (33.3%) patients, and resolution after fracture surgery in 4 (57%) of the 7 that underwent surgery. In 4 cases (33.3%) prisms were prescribed, and 2 (16.6%) required strabismus surgery. CONCLUSIONS: Diplopia secondary to orbital fracture in adults is frequent, but it is resolved in most cases spontaneously or after fracture surgery. A few patients will require prisms and/or strabismus surgery
Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Diplopía/epidemiología , Diplopía/cirugía , Fracturas Orbitales/complicaciones , Estrabismo/cirugía , Órbita/lesiones , Fracturas Orbitales/terapia , Diplopía/diagnóstico por imagen , Tomografía Computarizada de Emisión/métodos , Estudios Retrospectivos , Órbita/diagnóstico por imagen , Órbita/cirugíaRESUMEN
OBJECTIVE: To evaluate the incidence and evolution of diplopia as a complication of orbital fractures in adults. PATIENTS AND METHODS: A review was conducted on medical records of all consecutive adults with orbital fracture referred between January 2014 and December 2015. An analysis was made of the incidence of diplopia secondary to fracture in the acute phase and its evolution. A descriptive study was performed on the variables related to patients, fractures, and fracture and diplopia treatment. RESULTS: The study included 39patients with a mean age of 48years (17-85). Of all the patients, 17 (43.6%) presented with diplopia in the acute phase. Differences were found between the groups with and without diplopia in relation to muscle entrapment diagnosed by orbital computed tomography, duction limitation, and fracture surgery ≤1week (P=.02, P=.00, P=.04, respectively). Out of the 17patients with diplopia, 12 had a mean follow-up of 18weeks (1-72), and in 10 (83.3%) diplopia was resolved in a mean time of 10weeks (1-72). There were spontaneous resolution in 4 (33.3%) patients, and resolution after fracture surgery in 4 (57%) of the 7 that underwent surgery. In 4cases (33.3%) prisms were prescribed, and 2 (16.6%) required strabismus surgery. CONCLUSIONS: Diplopia secondary to orbital fracture in adults is frequent, but it is resolved in most cases spontaneously or after fracture surgery. A few patients will require prisms and/or strabismus surgery.
Asunto(s)
Diplopía/etiología , Fracturas Orbitales/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diplopía/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Information on exposure levels to organochlorine compounds (OCs) in child population is limited, despite their greater vulnerability to the adverse health effects of these chemicals. OBJECTIVE: To determine serum concentrations of 10 OCs (including organochlorine pesticides and polychlorinated biphenyls -PCBs-) in children living in agricultural communities from Almería (South-Eastern Spain), and to identify the main predictors of exposure related to socio-economic characteristics, diet and lifestyle. METHODS: A cross-sectional study was conducted on 133 children aged 6-11 years selected from public schools of the study area. OCs compounds were determined in serum samples by GC/ECD. Anthropometric measures were obtained during sample collection. Information on sociodemographic characteristics, parental occupation, residential history, lifestyle and frequency of food consumption, among other relevant factors, was obtained by questionnaires administered to the mothers. RESULTS: Geometric means of serum concentrations (ng/ml) were 0.11 for ß-hexachloro-cyclohexane (ß-HCH), 0.09 for endosulfan, 0.20 for endosulfan-ether, 0.51 for hexachorobenzene (HCB), 0.08 for mirex, 0.06 for oxychlordane, 0.36 for p,p'-DDE, 0.20 for PCB 138, 0.36 for PCB 153, and 0.45 for PCB 180. Percentage of samples above the limit of detection (0.05 ppb) ranged from 32 (ß-HCH) to 100 (HCB). A high variability in OC levels depending on the compound was observed between our results and others found in similar studies carried out in children. Variables related to fish consumption were found to be the major dietary determinant of PCB 138, p,p´-DDE, endosulfan-α, ß-HCH, mirex and oxychlordane levels. CONCLUSIONS: Children participating in this study showed detectable levels of many OC, despite these compounds are no longer used. Their presence in children serum can be explained by their high lipophilicity and environmental persistence, leading to contamination of fatty food. In this line, fish consumption seemed to be the most relevant determinant of OC levels found in our study.
Asunto(s)
Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/sangre , Hidrocarburos Clorados/sangre , Plaguicidas/sangre , Adolescente , Agricultura/estadística & datos numéricos , Animales , Niño , Clordano/análogos & derivados , Clordano/sangre , Estudios Transversales , Diclorodifenil Dicloroetileno/sangre , Dieta/estadística & datos numéricos , Endosulfano/análogos & derivados , Endosulfano/sangre , Femenino , Peces , Humanos , Masculino , Bifenilos Policlorados/sangre , EspañaRESUMEN
BACKGROUND: Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects. MATERIAL AND METHODS: A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized. RESULTS: Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC. CONCLUSIONS: The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws.