How common is extra-articular knee deformity? How to achieve a ''safe zone'' alignment total knee arthroplasty in patients with extra-articular deformity.

The need for total knee arthroplasty is increasing considerably and one of the goals is to achieve post-surgical coronal alignment. Robotic surgical assistance achieves a functional alignment, which is a hip-knee-ankle angle of 0°. However, it is not possible to provide robotic assisted surgery to all our patients so we must include the full-length hip-to-ankle AP weight-bearing radiograph in preoperative planning to obtain a "safe zone" alignment, which is a post-surgical hip-knee-ankle Angle of 0 ± 3°. How can we achieve a "safe zone" alignment total knee arthroplasty in patients with extra-articular deformity?

La necesidad de artroplastia total de rodilla está aumentando considerablemente y uno de los objetivos es lograr la alineación coronal postquirúrgica. La asistencia quirúrgica robótica consigue una alineación funcional, que es un ángulo cadera-rodilla-tobillo de 0°. Sin embargo, no es posible ofrecer cirugía asistida por robot a todos nuestros pacientes, por lo que debemos incluir la radiografía AP de soporte de peso de cadera a tobillo de cuerpo entero en la planificación preoperatoria para obtener una alineación de "zona segura", que es un ángulo postquirúrgico cadera-rodilla-tobillo de 0 ± 3°. ¿Cómo podemos conseguir una artroplastia total de rodilla con alineación de "zona segura" en pacientes con deformidad extraarticular?

TP53 pathogenic variants related to cancer / Variantes patogénicas de TP53 relacionadas con cáncer

TP53 or P53 is a tumor suppressor gene known as the "genome guardian", responsible for inducing cell response to DNA damage, by stopping the cell cycle in case of mutation, activating DNA repair enzymes, initiating senescence and activation of apoptosis. Mutations in the gene sequence can cause non-synonymous mutations or errors in the reading frame by insertion, deletion or displacement of nucleotides: e.g., c.358A>G mutation in exon 4 and variants located in exons 9 and 10 of the TD domain. Therefore, in this review, we will see that changes in the reading frame, including the loss of one or two base pairs could prevent accurate transcription or changes in the structure and function of the protein, and could completely impair reparation function. These changes promote self-sufficiency in growth signaling, insensitivity to anti-growth signals, and evasion of apoptosis, resulting in limitless replication and induction of metastatic angiogenesis, generating as a consequence the proliferation of tumor, neoplastic, and lymphoid cells. Taking into account the importance of TP53 in the regulation of the cell cycle, the objective of this review is to update information related to the role of this gene in the development of cancer and the description of genetic variations.

TP53 o P53 es un gen supresor de tumores conocido como el "guardián del genoma", encargado de inducir la respuesta de la célula ante el daño del ADN, deteniendo el ciclo celular en caso de mutación, activando enzimas de reparación del ADN, iniciando el proceso de senescencia celular y activación de la apoptosis. Las mutaciones en la secuencia del gen pueden originar mutaciones no sinónimas o errores en el marco de lectura por la inserción, deleción o desplazamiento de nucleótidos: ejemplo, mutación c.358A>G en el exón 4 y variantes que se albergan en los exones 9 y 10 del dominio TD. Por lo tanto en esta revisión examinaremos cambios en el marco de lectura, incluyendo la pérdida de una o dos pares de bases, que podrían impedir la exacta transcripción o cambiar la estructura y función de la proteína o perjudicar completamente la función de reparación. Tales cambios promueven la auto-suficiencia en la señal de crecimiento, la insensibilidad a señales anticrecimiento y la evasión de la apoptosis, lo que resulta en la replicación ilimitada y la inducción de angiogénesis metastásica, generando como consecuencia la proliferación de células tumorales, neoplásicas y linfoides. Teniendo en cuenta la importancia del TP53 en la regulación del ciclo celular, el objetivo de la presente revisión es actualizar la información relacionada con el papel de este gen en el desarrollo de cáncer y la descripción de las variaciones genéticas.

ANÁLISIS DE LA DIVERSIDAD GENÉTICA DE GANADO BOVINO LECHERO DEL TRÓPICO ALTO DE NARIÑO MEDIANTE MARCADORES MOLECULARES HETERÓLOGOS DE TIPO MICROSATÉLITE / ANALYS IS OF GENETIC DIVERSITY OF DAIRY CATTLE IN THE HIGH TROPIC OF NARIÑO BY MOLECULAR HETEROLOGOUS MICROSATELLITE MARKERS

Cinco razas de ganado bovino (Bos taurus) del trópico alto de Nariño fueron caracterizadas usando once loci microsatélites. Se incluyeron las razas Holstein, Jersey, Normando, Pardo suizo y el ganado Criollo. Las frecuencias alélicas fUeron calculadas y usadas para la caracterización de las razas y el estudio de sus relaciones genéticas. La diversidad genética reflejada en el número de alelos por locus (NPA = 10) y la heterocigosidad observada (Ho = 0,7) fue alta, siendo mayor para la raza Criolla. El AMOVA, evidenció una baja diferenciación genética (FST = 0,0663) para la población total, con una pequeña diferenciación entre Criollo y Holstein (0,006), resultado que fue correspondiente con el análisis de agrupamiento bayesiano, que permitió determinar un grado de absorción del núcleo Criollo del 56% por la raza Holstein. La alta diversidad, supone procesos de adaptación a diferentes ambientes y mezcla de razas, facilitando un continuo flujo genético. Esto puede explicarse por la realización de cruces dirigidos al incremento del volumen de producción teniendo como base la raza Holstein, donde la selección intensiva puede conllevar al detrimento de la pureza del ganado criollo e incidir en su capacidad adaptativa.

Five populations of cattle (Bos taurus) from tropical high of Narino were characterized with 11 loci microsatellites. The breeds included were Holstein, Jersey, Normande, Brown Swiss and Creole. The molecular characterization of breeds and study genetic relationships were made with Alleles frequencies. Genetic diversity as the number of alleles per locus (NPA = 10) and observed heterozygosity (Ho = 0.7) were high, being higher for the Creole breed. Analysis of molecular variance (AMOVA), showed low genetic differentiation (FST = 0.0663) for the total population, with a small difference between Creole and Holstein (0.006). This result was similar to the Bayesian clustering analysis, which identified a percentage of absorption of 56% to Creole by the Holstein breed. The high diversity assumes processes of adaptation to different environments and miscegenation, showing a continuous gene flow. The above can be explain by cross-breeding to increase the production volume on the basis of the Holstein breed. Detrimental impacts, due to the intensive selection, might this have on the creole cattle and has influence in their adaptive capacity.

Human papillomavirus: a highly prevalent sexually transmitted disease agent among female sex workers from Mexico City.

BACKGROUND: Cervical cancer, a human papillomavirus (HPV)-caused neoplasia, is highly prevalent in Mexico. GOAL: To determine the prevalence of HPV infection in female sex workers (FSW) from Mexico City and to assess the association between HPV infection and the characteristics of these women. STUDY DESIGN: A questionnaire was applied to 495 FSW. Cervical cell specimens were obtained for DNA amplification and hybridization to detect 27 HPV types. A risk factor analysis was performed. RESULTS: The overall prevalence of HPV infection was 48.9%. The prevalence of high-risk HPV types was 43%, whereas that of low-risk types was 24.6%. A total of 18.8% of study participants was infected with both high-risk and low-risk HPV types, and 28.5% were infected with two or more HPV types. Younger age and failure to use a condom were independently associated HPV risks (odds ratio, 7.3 and 2.3; 95% CI, 3.5-15.0 and 1.2-4.4, respectively). CONCLUSIONS: Infection with high-risk and multiple HPV types is high among Mexican FSW. This study corroborated a higher infection rate in younger women. A higher risk of HPV infection is also observed in women who have been involved with sex work for less than 1 year. However, condom use showed a protective effect against HPV infection.