A modified chemical protocol of decellularization of rat sciatic nerve and its recellularization with mesenchymal differentiated schwann-like cells: morphological and functional assessments.

The functional reconstruction of large neural defects usually requires the use of peripheral nerve autografts, though these have certain limitations. As a result, interest in new alternatives for autograft development has risen. The acellular peripheral nerve graft is an alternative for peripheral nerve injury repair, but to date there is not a standardized chemical decellularization method widely accepted. The objective of this study was to propose a modified chemical protocol of decellularization of rat sciatic nerve and its recellularization in vitro with mesenchimal differentiated Schwann-like cells. After the transplantation, an evaluation of its regeneration was performed using morphological and functional tests. The study consisted of two phases; in phase 1, different concentrations and times of exposure of rat sciatic nerves to detergents were tested, to establish a modified chemical protocol for nerve decellularization. The chemical treatment with 3% triton X-100 and 4% sodium deoxycholate for 15 days allowed a complete decellularization whilst conserving the extracellular matrix of the harvested nerve. In phase 2, the decellularized and recellularized alografts were compared against autografts. The morphological analysis showed a higher positivity to specific myelin antibodies in the recellularized group compared to the autograft. There were no differences in this parameter between the control limb and the experimental limb (recellularized group). The functional analysis showed no statistical differences at week 15 in the Sciatic Function Index in the autograft group vs the other groups. This study sets the morphological and functional bases for posterior studies about nerve defects regeneration in humans.

Toxins and virulence factors of enterotoxigenic Escherichia coli associated with strains isolated from indigenous children and international visitors to a rural community in Guatemala.

Diarrhoea remains a common cause of illness in Guatemala, with children suffering most frequently from the disease. This study directly compared the frequency, enterotoxin, and colonization factor (CF) profiles of enterotoxigenic Escherichia coli (ETEC) strains isolated from children living in a rural community in Guatemala and from Western visitors to the same location during the same seasons, using similar detection methodologies. We found that ETEC accounted for 26% of severe cases of diarrhoea in children requiring hospitalization, 15% of diarrhoea in the community, and 29% of travellers' diarrhoea in visitors staying ⩾2 weeks. The toxin and CF patterns of the ETEC strains isolated from both groups differed significantly (P < 0·0005) as determined by χ 2 = 60·39 for CFs and χ 2 = 35 for toxins, while ETEC phenotypes found in Guatemalan children were comparable to those found in children from other areas of the world.

Luxación antero-inferior de cadera en una presentación poco común. Estudio de un caso y revisión de literatura / Anteroinferior hip dislocation in an unusual presentation. Case report and literature review

Las luxaciones anteriores de cadera son raras y se suelen presentar en varones, en la tercera década de la vida, asociados con accidentes de alta energía. Presentamos el caso de una mujer con este tipo de luxación con la cabeza encajada en el agujero obturador, irreductible por maniobras externas (AU)

Anterior hip dislocation are rare events, most commonly presented in males, in the third decade of life, usually associated with high-energy accidents. We present the case of a female patient with anterior dislocation of the hip, anchored in the obturator foramen, irreductible by closed reduction (AU)

[Proximal femoral intramedullary nail versus DHS plate for the treatment of intertrochanteric fractures. A prospective analysis]. / Comparación del clavo intramedular femoral proximal (PFN) versus placa DHS para el tratamiento de fracturas intertrocantéricas. Análisis prospectivo.

OBJECTIVE: To show that patients with intertrochanteric fractures treated with a proximal femoral nail have a better postoperative course than those treated with a DHS plate (dynamic hip screw). METHODS: Patients with a Boyd & Griffin type II intertrochanteric fracture were randomly divided into two groups: a group of patients treated with a PFN and another one treated with a DHS plate. All patients were assessed at 2, 4, 8 and 16 weeks using the Harris scale and the visual analog scale pre- and postoperatively, as well as the operative time, incision size, intraoperative bleeding, onset of partial and/or total weight bearing, healing time, time to attain prior physical activity level, and radiographic result. RESULTS: 32 patients met our criteria. The variables that had a significant reduction were: incision, operative time, postoperative pain according to the visual analog scale, onset of mobility, partial weight bearing and pain at 2 weeks. CONCLUSIONS: The proximal femoral nail has better short-term outcomes than the DHS plate; however, in the medium term both implants have the same outcomes.

[Septic knee arthritis caused by Pseudomonas aeruginosa after anterior cruciate ligament reconstruction in an adolescent athlete]. / Artritis de rodilla por Pseudomonas aeruginosa posterior a reconstrucción de ligamento cruzado anterior en un adolescente deportista.

Anterior cruciate ligament reconstruction is a very frequent procedure. Postoperative infection after this procedure is a catastrophic, although infrequent, complication. According to the literature, it occurs in less than 1% of all reconstructions done in the United States. We present herein a case report of septic arthritis of the posterior knee associated with anterior cruciate ligament reconstruction.

Lesiones condrales de rodilla tratadas con trasplante de condrocitos autólogos en una matriz tridimensional: Evaluación clínica a un año de evolución / Chondral knee lesions treated with autologous chondrocyte transplant in a three-dimensionematrix: Clinical assessment at one year of evolution

Objetivos: evaluar la evolución clínica de pacientes tratados con Implante de Condrocitos Autólogos (ICA) en una matriz tridimensional, creada en nuestro Banco de Hueso y Tejidos. Pacientes y metodología: 22 pacientes, 15 fueron evaluados a un año de la cirugía, 6 hombres y 9 mujeres, con una media de edad de 42 años. Siete fueron rodillas izquierdas y ocho derechas y la localización fue en nueve casos en el cóndilo lateral, cuatro en el cóndilo medial, uno en la rótula y otro en ambos cóndilos. Se obtuvieron artroscópicamente condrocitos autólogos que, una vez procesados, se colocaron en la matriz (Condrograft®). Resultados: con el WOMAC antes de la cirugía se obtuvo un promedio de 56,4, y de 16,2 después de la cirugía (<0,002) y con el de Oxford el promedio fue de 18,8. El promedio de la valoración con el KOOS fue de 83,6. Los hombres presentaron una media de 88,1 mientras que las mujeres de 80,5. Los pacientes con lesión en el cóndilo lateral presentaron una media de 86,7 puntos, y los afectados del cóndilo medial 88,2. Conclusión: el ICA en una matriz tridimensional es efectiva para el tratamiento de pacientes con lesiones osteocondrales, al menos, a corto plazo (AU)

Objective: To establish clinical outcome in patients treated with an autologous chondrocyte implant (ACI) in a three-dimension matrix created at our Bone and Tissue Bank. Patients and methods: Twenty-two patients were operated, 15 of whom were evaluated at one year of surgery. The patients included 6 men and 9 women with a mean age of 42 years. Seven were left knees and eight right and in nine cases the location was the lateral acetabulum, in four the medial acetabulum, in one the patella, and the other in both acetabula. Autologous chondrocytes were obtained by arthroscopy that, once processed, were placed in the matrix (Condrograft®). Results: With the WOMAC prior to surgery, an average of 56.4 and 16.2 was obtained after surgery (<0.002). With Oxford, the average was 18.8. The average assessment with KOOS was 83.6. Men had a mean of 88.1, while women had 80.5. Patients with lesion in the lateral acetabulum had a mean of 86.7 points and those with the medial acetabulum affected 88.2. Conclusion: The ACI in a three-dimension matrix is effective for treating patients with osteochondral lesions, at least in the short term (AU)