Trombosis venosa extensa de la extremidad inferior izquierda en sujetos jóvenes: ¿debemos realizar estudio de extensión? / Extensive left-leg venous thrombosis in young patients: Should we perform extended tests?

Se presentan 3 casos de trombosis de la vena ilíaca izquierda que como causa subyacente presentaban una compresión por parte de la arteria ilíaca derecha, lo cual es conocido como síndrome de May-Thurner. Se procedió en 2 de ellos a tratamiento endovascular con corrección anatómica mediante colocación de un stent, manteniendo la anticoagulación por presentar trombofilia asociada. Es importante conocer esta entidad, para además de aplicar la anticoagulación, intentar realizar una corrección anatómica que mejore el pronóstico del enfermo (AU)

We report 3 cases of left iliac vein thrombosis whose underlying cause was right iliac artery compression syndrome, also known as May-Thurner syndrome. Endovascular treatment with anatomical correction (stent placement) was applied in 2 of the cases; anticoagulant therapy was maintained given the presence of associated hypercoagulability. A thorough understanding of this diagnosis is important so that an attempt at anatomical correction can be proposed to complement anticoagulant therapy in the interest of improving prognosis (AU)

[Extensive left-leg venous thrombosis in young patients: Should we perform extended tests?] / Trombosis venosa extensa de la extremidad inferior izquierda en sujetos jóvenes: ¿debemos realizar estudio de extensión?

EN: We report 3 cases of left iliac vein thrombosis whose underlying cause was right iliac artery compression syndrome, also known as May-Thurner syndrome. Endovascular treatment with anatomical correction (stent placement) was applied in 2 of the cases; anticoagulant therapy was maintained given the presence of associated hypercoagulability. A thorough understanding of this diagnosis is important so that an attempt at anatomical correction can be proposed to complement anticoagulant therapy in the interest of improving prognosis.

ES: Se presentan 3 casos de trombosis de la vena ilíaca izquierda que como causa subyacente presentaban una compresión por parte de la arteria ilíaca derecha, lo cual es conocido como síndrome de May-Thurner. Se procedió en 2 de ellos a tratamiento endovascular con corrección anatómica mediante colocación de un stent, manteniendo la anticoagulación por presentar trombofilia asociada. Es importante conocer esta entidad, para además de aplicar la anticoagulación, intentar realizar una corrección anatómica que mejore el pronóstico del enfermo.

Masa tumoral en el miembro superior derecho / Tumor mass in the right upper limb

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Antioxidized LDL antibodies are associated with different metabolic pathways in patients with atherosclerotic plaque and type 2 diabetes.

OBJECTIVE: Oxidized lipoproteins and antioxidized LDL antibodies (antioxLDL abs) have been detected in human plasma and atherosclerotic lesions. The principle aim of this study was to analyze the possible relationship between IgG and IgM antioxLDL abs and factors involved in different metabolic pathways (inflammation, lipid metabolism, apoptosis, and cell cycle arrest profile) in the occluded popliteal artery (OPA) compared with the femoral vein (FV). RESEARCH DESIGN AND METHODS: Fifteen patients with advanced atherosclerosis and type 2 diabetes undergoing lower limb amputation participated in this study. Each patient had OPA and FV biopsy specimens and peripheral arterial occlusive disease. By real-time PCR, gene expression was analyzed from the OPA and FV specimens, and antioxLDL ab levels were measured by specific enzyme-linked immunosorbent assay. RESULTS: The OPA and FV showed a positive correlation between only IgM antioxLDL ab levels and the expression of genes involved in different metabolic pathways, including inflammation (TFPI), apoptosis (BAX, caspase 3, AKT1), plaque disruption (MMP2 and MMP10), lipid metabolism (SCARB1, PPARg), and cell turnover (CDKN1A), and genes for transcription and growth factors (NFkB and VEGFA, respectively). CONCLUSIONS: The results show that gene expression in the metabolic pathways (apoptosis, lipid metabolism, and inflammation) in the OPA and FV are directly related to the levels of IgM antioxLDL abs.

Técnica quirúrgica para abordaje intraoral de quiste dermoide cervical de gran tamaño: a propósito de un caso clínico / Surgical technique for intraoral approach to a large cervical dermoid cyst: case report

Lesiones benignas de extensión submilohioidea pueden abordarse por vía intraoral, eludiendo una cicatriz cutánea y garantizando la preservación de las ramas del nervio facial. Se aborda el suelo de boca, consiguiendo una buena exposición del campo quirúrgico extirpando la glándula sublingual. Se diseca el conducto submaxilar para evitar su morbilidad. Se diseca la lesión en todos sus polos. Una vez que se encuentra completamente despegada, se vacía parcialmente de contenido para que pueda caber por la incisión que se ha realizado(AU)

Submilohyoid benign lesions can be approached intraorally, thus avoiding skin scars and ensuring the preservation of facial nerve branches. The floor of the mouth is opened and better exposure of the surgical field is achieved by removing the sublingual gland. The submandibular duct is identified and probed to prevent damage. The lesion is totally dissected and its contents removed so it could fit through the incision made(AU)

Apicectomía quirúrgica: propuesta de un protocolo basado en la evidencia / Surgical apicoectomy: proposed evidence-based protocol

Diversos refinamientos de la técnica quirúrgica de apicectomía han propiciado que su tasa de éxito haya aumentado de modo considerable. Se revisa la bibliografía científica para determinar cuáles de estos procedimientos son superiores. Se realiza un protocolo que aúna racionalmente esas técnicas, con lo que así se optimiza el resultado final de la intervención(AU)

Diverse refinements of the apicoectomy surgical technique have considerably increased the success rate of the procedure. The scientific literature was reviewed to identify the most relevant procedures for the final outcome of surgery. A protocol was prepared to facilitate the rational selection of technique, thus optimizing the surgical outcome(AU)