Surface electrical stimulation of the auditory cortex preserves efferent medial olivocochlear neurons and reduces cochlear traits of age-related hearing loss.

The auditory cortex is the source of descending connections providing contextual feedback for auditory signal processing at almost all levels of the lemniscal auditory pathway. Such feedback is essential for cognitive processing. It is likely that corticofugal pathways are degraded with aging, becoming important players in age-related hearing loss and, by extension, in cognitive decline. We are testing the hypothesis that surface, epidural stimulation of the auditory cortex during aging may regulate the activity of corticofugal pathways, resulting in modulation of central and peripheral traits of auditory aging. Increased auditory thresholds during ongoing age-related hearing loss in the rat are attenuated after two weeks of epidural stimulation with direct current applied to the surface of the auditory cortex for two weeks in alternate days (Fernández del Campo et al., 2024). Here we report that the same cortical electrical stimulation protocol induces structural and cytochemical changes in the aging cochlea and auditory brainstem, which may underlie recovery of age-degraded auditory sensitivity. Specifically, we found that in 18 month-old rats after two weeks of cortical electrical stimulation there is, relative to age-matched non-stimulated rats: a) a larger number of choline acetyltransferase immunoreactive neuronal cell body profiles in the ventral nucleus of the trapezoid body, originating the medial olivocochlear system.; b) a reduction of age-related dystrophic changes in the stria vascularis; c) diminished immunoreactivity for the pro-inflammatory cytokine TNFα in the stria vascularis and spiral ligament. d) diminished immunoreactivity for Iba1 and changes in the morphology of Iba1 immunoreactive cells in the lateral wall, suggesting reduced activation of macrophage/microglia; d) Increased immunoreactivity levels for calretinin in spiral ganglion neurons, suggesting excitability modulation by corticofugal stimulation. Altogether, these findings support that non-invasive neuromodulation of the auditory cortex during aging preserves the cochlear efferent system and ameliorates cochlear aging traits, including stria vascularis dystrophy, dysregulated inflammation and altered excitability in primary auditory neurons.

Multisession anodal epidural direct current stimulation of the auditory cortex delays the progression of presbycusis in the Wistar rat.

Presbycusis or age-related hearing loss (ARHL) is one of the most prevalent chronic health problems facing aging populations. Along the auditory pathway, the stations involved in transmission and processing, function as a system of interconnected feedback loops. Regulating hierarchically auditory processing, auditory cortex (AC) neuromodulation can, accordingly, activate both peripheral and central plasticity after hearing loss. However, previous ARHL-prevention interventions have mainly focused on preserving the structural and functional integrity of the inner ear, overlooking the central auditory system. In this study, using an animal model of spontaneous ARHL, we aim at assessing the effects of multisession epidural direct current stimulation of the AC through stereotaxic implantation of a 1-mm silver ball anode in Wistar rats. Consisting of 7 sessions (0.1 mA/10 min), on alternate days, in awake animals, our stimulation protocol was applied at the onset of hearing loss (threshold shift detection at 16 months). Click- and pure-tone auditory brainstem responses (ABRs) were analyzed in two animal groups, namely electrically stimulated (ES) and non-stimulated (NES) sham controls, comparing recordings at 18 months of age. At 18 months, NES animals showed significantly increased threshold shifts, decreased wave amplitudes, and increased wave latencies after click and tonal ABRs, reflecting a significant, spontaneous ARHL evolution. Conversely, in ES animals, no significant differences were detected in any of these parameters when comparing 16 and 18 months ABRs, indicating a delay in ARHL progression. Electrode placement in the auditory cortex was accurate, and the stimulation did not cause significant damage, as shown by the limited presence of superficial reactive microglial cells after IBA1 immunostaining. In conclusion, multisession DC stimulation of the AC has a protective effect on auditory function, delaying the progression of presbycusis.

Clinical course of a complex regional pain syndrome type II in upper limb.

INTRODUCTION: the complex regional pain syndrome type II, also called causalgia, is a rare clinical condition that appears after a traumatic or surgical event with evidence of nervous system involvement. Its clinical presentation is the consequence of a multifactorial pathogenic process that involves peripheral and central mechanisms and has variable clinical manifestations. We present the photographic record of a patient with complex regional syndrome type II. CLINICAL CASE: 43-year-old patient who consulted for neuropathic pain during the last four years, of severe intensity, associated with sensory, vasomotor and trophic changes in the right upper limb, as a consequence of neurectomy of the palmar digital nerves of the third finger. CONCLUSION: achieving the photographic record of the clinical phases of complex regional pain syndrome type II in its entirety is difficult, because not all patients present all clinical phases, a fact that gives relevance to this case.

INTRODUCCIÓN: el síndrome doloroso regional complejo (SDRC) tipo II, también llamado causalgia, es una condición clínica poco frecuente que aparece después de un evento traumático o quirúrgico con evidencia de afectación del sistema nervioso. Su presentación clínica es consecuencia de un proceso patogénico multifactorial que involucra mecanismos periféricos y centrales y tiene manifestaciones clínicas variables. Presentamos el registro fotográfico de un paciente con síndrome regional complejo tipo II. CASO CLÍNICO: paciente de 43 años que consultó por dolor neuropático durante los últimos cuatro años, de intensidad severa, asociado a cambios sensoriales, vasomotores y tróficos en miembro superior derecho, como consecuencia de neurectomía de los nervios digitales palmares propios del tercer dedo. CONCLUSIÓN: lograr el registro fotográfico de las fases clínicas del SDRC tipo II en su totalidad resulta difícil, debido a que no todos los pacientes presentan todas las fases clínicas; hecho que otorga la relevancia a este caso.

Optimizing the Properties of Hybrids Based on Graphene Oxide for Carbon Dioxide Capture.

The reduction of CO2 emissions and its elimination from the atmosphere has become one of the major problems worldwide, since CO2 is the main cause of the greenhouse effect and climate change. In recent years, a great number of carbonaceous materials that can be used as CO2 adsorbents have been synthesized. The strategy is usually to synthesize the materials and determine their adsorption capacity without studying previously the factors that influence this capacity. In this work, different properties of the adsorbents are analyzed to study their influence on the CO2 adsorption capacity. For this purpose, 10 adsorbents have been synthesized using different strategies and characterized with X-ray photoelectron spectroscopy, X-ray diffraction, and micro-Raman spectroscopy. The percentage of sp2 carbons, the position of the D + D' peak of the second-order Raman spectrum, the micropore volume, and the grain size of the C sp2 domains have been related to the amount of CO2 adsorbed by the adsorbents. The results confirm a linear relationship between the volume of the micropores and the CO2 uptake and it proves that CO2 retention is favored in those materials that, in addition to having a high volume of micropores, also have low grain size of C.

Development, characterization and sterilisation of Nanocellulose-alginate-(hyaluronic acid)- bioinks and 3D bioprinted scaffolds for tissue engineering.

3D-bioprinting is an emerging technology of high potential in tissue engineering (TE), since it shows effective control over scaffold fabrication and cell distribution. Biopolymers such as alginate (Alg), nanofibrillated cellulose (NC) and hyaluronic acid (HA) offer excellent characteristics for use as bioinks due to their excellent biocompatibility and rheological properties. Cell incorporation into the bioink requires sterilisation assurance, and autoclave, ß-radiation and γ-radiation are widely used sterilisation techniques in biomedicine; however, their use in 3D-bioprinting for bioinks sterilisation is still in their early stages. In this study, different sterilisation procedures were applied on NC-Alg and NC-Alg-HA bioinks and their effect on several parameters was evaluated. Results demonstrated that NC-Alg and NC-Alg-HA bioinks suffered relevant rheological and physicochemical modifications after sterilisation; yet, it can be concluded that the short cycle autoclave is the best option to sterilise both NC-Alg based cell-free bioinks, and that the incorporation of HA to the NC-Alg bioink improves its characteristics. Additionally, 3D scaffolds were bioprinted and specifically characterized as well as the D1 mesenchymal stromal cells (D1-MSCs) embedded for cell viability analysis. Notably, the addition of HA demonstrates better scaffold properties, together with higher biocompatibility and cell viability in comparison with the NC-Alg scaffolds. Thus, the use of MSCs containing NC-Alg based scaffolds may become a feasible tissue engineering approach for regenerative medicine.

The behavior of graphene oxide trapped at the air water interface.

Graphene oxide is a derivate of graphene obtained by oxidation of graphite and other carbonaceous materials. The more accepted structure consists in carbonyl and carboxyl groups located at the edge of the graphene network and hydroxyl and epoxy groups attached to the basal plane. The percentage of O-groups depends on the synthesis route and the material used as carbon source. In addition, highly oxidized fragments, called oxidative debris, OD, are produced during the oxidation process. These fragments are adsorbed onto the graphene oxide network and can be removed by alkaline washing. The purified material has lower O/C ratio than graphene oxide and its properties are also quite different. Due to its structure, graphene oxide can be adsorbed at the air-water interface of the aqueous solution by diffusion, Gibbs monolayers, or by spreading on a clean water subphase resulting in a Langmuir film. This review is intended to provide information on the importance of controlling the chemical composition, structure, size, and oxidative debris, on the manufacture of graphene oxide films. To this end the review shows the influence of the synthesis route and the starting material on the structure of graphene oxide and analyzes several examples of the behavior and properties of films prepared with different types of graphene oxides. The great variability of behaviors of graphene oxide films caused by the different structure of this material provides a great opportunity to fine-tune the properties of films according to the needs of different applications.

Understanding the Role of Oxidative Debris on the Structure of Graphene Oxide Films at the Air-Water Interface: A Neutron Reflectivity Study.

We address here the role of oxidation impurities on the structure of graphene oxide films at the air-water interface by specular neutron reflectivity (SNR). We study films of purified graphene oxide (PGO) and nonpurified graphene oxide in the close-packed state. Nonpurified graphene oxide is constituted by graphene oxide (GO) layers with oxidation impurities adsorbed on the basal plane, while in PGO sheets, impurities are eliminated. SNR measurements show that GO films are formed by well-defined bilayers constituted by 2-3 layers of GO stacked in contact with air and a second layer of impurities submerged in the aqueous subphase. In contrast, PGO films are formed by a single layer in contact with air. We show for the first time that impurities constitute a layer submerged in the aqueous subphase, decrease the elasticity, and favor the collapse of graphene oxide films. Our results allow designing the surface properties of GO trapped at fluid interfaces.

Cross-modal reaction of auditory and visual cortices after long-term bilateral hearing deprivation in the rat.

Visual cortex (VC) over-activation analysed by evoked responses has been demonstrated in congenital deafness and after long-term acquired hearing loss in humans. However, permanent hearing deprivation has not yet been explored in animal models. Thus, the present study aimed to examine functional and molecular changes underlying the visual and auditory cross-modal reaction. For such purpose, we analysed cortical visual evoked potentials (VEPs) and the gene expression (RT-qPCR) of a set of markers for neuronal activation (c-Fos) and activity-dependent homeostatic compensation (Arc/Arg3.1). To determine the state of excitation and inhibition, we performed RT-qPCR and quantitative immunocytochemistry for excitatory (receptor subunits GluA2/3) and inhibitory (GABAA-α1, GABAB-R2, GAD65/67 and parvalbumin-PV) markers. VC over-activation was demonstrated by a significant increase in VEPs wave N1 and by up-regulation of the activity-dependent early genes c-Fos and Arc/Arg3.1 (thus confirming, by RT-qPCR, our previously published immunocytochemical results). GluA2 gene and protein expression were significantly increased in the auditory cortex (AC), particularly in layers 2/3 pyramidal neurons, but inhibitory markers (GAD65/67 and PV-GABA interneurons) were also significantly upregulated in the AC, indicating a concurrent increase in inhibition. Therefore, after permanent hearing loss in the rat, the VC is not only over-activated but also potentially balanced by homeostatic regulation, while excitatory and inhibitory markers remain imbalanced in the AC, most likely resulting from changes in horizontal intermodal regulation.

Functional Connectivity Changes in Behavioral, Semantic, and Nonfluent Variants of Frontotemporal Dementia.

Frontotemporal dementia (FTD) affects behavior, language, and personality. This study aims to explore functional connectivity changes in three FTD variants: behavioral (bvFTD), semantic (svPPA), and nonfluent variant (nfvPPA). Seventy-six patients diagnosed with FTD by international criteria and thirty-two controls were investigated. Functional connectivity from resting functional magnetic resonance imaging (fMRI) was estimated for the whole brain. Two types of analysis were done: network basic statistic and topological measures by graph theory. Several hubs in the limbic system and basal ganglia were compromised in the behavioral variant apart from frontal networks. Nonfluent variants showed a major disconnection with respect to the behavioral variant in operculum and parietal inferior. The global efficiency had lower coefficients in nonfluent variants than behavioral variants and controls. Our results support an extensive disconnection among frontal, limbic, basal ganglia, and parietal hubs.

c-Fos and Arc/Arg3.1 expression in auditory and visual cortices after hearing loss: Evidence of sensory crossmodal reorganization in adult rats.

Cross-modal reorganization in the auditory and visual cortices has been reported after hearing and visual deficits mostly during the developmental period, possibly underlying sensory compensation mechanisms. However, there are very few data on the existence or nature and timeline of such reorganization events during sensory deficits in adulthood. In this study, we assessed long-term changes in activity-dependent immediate early genes c-Fos and Arc/Arg3.1 in auditory and neighboring visual cortical areas after bilateral deafness in young adult rats. Specifically, we analyzed qualitatively and quantitatively c-Fos and Arc/Arg3.1 immunoreactivity at 15 and 90 days after cochlea removal. We report extensive, global loss of c-Fos and Arc/Arg3.1 immunoreactive neurons in the auditory cortex 15 days after permanent auditory deprivation in adult rats, which is partly reversed 90 days after deafness. Simultaneously, the number and labeling intensity of c-Fos- and Arc/Arg3.1-immunoreactive neurons progressively increase in neighboring visual cortical areas from 2 weeks after deafness and these changes stabilize three months after inducing the cochlear lesion. These findings support plastic, compensatory, long-term changes in activity in the auditory and visual cortices after auditory deprivation in the adult rats. Further studies may clarify whether those changes result in perceptual potentiation of visual drives on auditory regions of the adult cortex.

Resultados sobre la aplicación cráneo-facial del parche de capsaicina 8 % en una serie de 5 casos / Results of the capsaicin 8% patch in craniofacial application in five clinical cases

Los parches de capsaicina al 8 % son una alternativa de segunda línea para el tratamiento del dolor neuropático periférico. Aunque tiene pocos efectos secundarios, no tiene indicación para el tratamiento cráneo-facial debido a la posible irritación de mucosas por la capsaicina. Sólo hemos encontrado tres publicaciones que refieren la aplicación del parche en estas localizaciones, describiendo 7 casos clínicos. Hemos recogido 4 casos en los que se realizan 5 aplicaciones en total, 3 mujeres (repitiendo aplicación en una de ellas) y 1 hombre, entre 58 y 84 años, con los siguientes diagnósticos: necrosis cáustica en labio inferior tras limpieza dental, neuralgia del trigémino y neuropatía postherpética. Tras comprobar ineficacia de otros tratamientos, se propuso el parche de capsaicina al 8 %, con firma previa de los consentimientos informados de la aplicación de parche en régimen de hospital de día y de tratamiento fuera de ficha técnica. Previamente a la aplicación del parche en la zona cutánea dolorosa, se procedió a realizar protección ocular de ambos ojos con parche oftálmico quirúrgico, y de mucosas oral y nasal con mascarilla facial quirúrgica sellada. La protección se mantuvo durante toda la aplicación del parche y se quitó una vez retirado éste y limpiada la zona de aplicación. Únicamente se reportaron 3 efectos secundarios leves del total de las 5 aplicaciones: un paciente presentó piel eritematosa que cedió espontáneamente, otra paciente refirió sensación de quemazón y dolor que cedió con analgesia endovenosa, y otra paciente explicó dolor leve bien tolerado, que cedió de manera espontánea. En ninguno de los casos se apreciaron efectos secundarios a nivel de mucosas. En cuanto a resultados, dos pacientes notaron mejoría durante uno y dos meses, colocando nuevamente el parche en una de ellas, sin lograr esta segunda vez alivio. Las otras dos pacientes no notaron ningún cambio. El tratamiento con parches de capsaicina 8 % en superficies cráneo-faciales parece tener similar eficacia a su aplicación en otras áreas de la piel. Los efectos secundarios en su aplicación en estas superficies son escasos, al igual que en otras aplicaciones corporales. Creemos que con las medidas de precaución adecuadas en las regiones cráneo-faciales, la utilidad clínica observada del parche de capsaicina 8 % lo sitúa como otra opción de tratamiento para dolor neuropático, sin complicaciones añadidas. No obstante, estudios clínicos con mayor número de pacientes deberían llevarse a cabo para confirmar estos hallazgos (AU)

The capsaicin 8 % patch is a secondary line alternative to neuropathic peripheral pain treatment. Although it has few secondary effects, is not indicated in head and facial treatment due to the possibility of the irritation of mucosa. We have only found three publications related with the patch application in those locations, describing 7 clinical cases. We have analyzed 4 cases in which we have applied 5 patches in total. There were 3 women (repeating the application in one of them) and 1 man, between 58 and 84 years old, with the following diagnosis: caustic necrosis in the inferior lip after dental cleaning, trigeminal neuralgia and post-herpetic neuropathy. Inefficacy of other treatments was confirmed, and after that, the capsaicin 8 % patch was proposed. Informed consent of the application of the patch at day clinic and treatment out of technical data sheet were previously signed. Before the patch was applied to the painful cutaneous area, we proceed with ocular protection of both eyes with surgical ophthalmic patch and oral and nasal mucosa protection with surgical mask hermetically seal. That protection was maintained during the whole application of the patch, and was removed once the capsaicin patch was taken off and the application area was cleaned. There were only 3 mild secondary effects of the total 5 applications: one patient showed erythematic skin that was resolved spontaneously, another patient related burn and pain sensation which was solved with endovenous analgesia. Finally, another patient explained mild pain well tolerated, that was resolved also spontaneously. In no cases there were secondary effects in mucosa. Related with the results, 2 patients felt improvement between one and two months, applying again the patch in one of them, not reaching this time relief in the pain. The other 2 patients did not notice any change. The capsaicin 8 % patch treatment in head and facial areas seems to have similar efficacy as the application in other skin areas. Secondary effects in these surfaces are very low, the same as in other corporal locations. We believe that with the adequate preventive measures in head and facial areas, clinical utility observed with capsaicin 8 % patch places it as another treatment option for neuropathic pain, with no complications added. However, clinical studies with a higher number of patients should carry on to confirm these findings (AU)

Cirugía reductora de riesgo en el cáncer de mama / Risk-reducing surgery in breast cancer

Objetivo. Revisión de la bibliografía sobre la mastectomía profiláctica contralateral a nivel de riesgos y costes, así como su probable efecto en la supervivencia. Material y método. Se realizó una estrategia de búsqueda bibliográfica de mastectomía profiláctica con los siguientes descriptores: cirugía reductora de riesgo, cáncer de mama, incidencia, complicaciones, supervivencia libre de enfermedad, supervivencia global, mortalidad por cáncer de mama y costes. Resultados. Existe una tendencia general al aumento de la mastectomía profiláctica como cirugía reductora de riesgo contralateral en el cáncer de mama. Los principales factores que influyen en este proceso son: edad joven, raza blanca, estadio inicial de la enfermedad, expresión de receptores hormonales, uso de la RMN, nivel educacional alto, acceso a la reconstrucción, historia familiar de cáncer de mama y/o susceptibilidad genética para la mutación BRCA 1 y 2. Esta cirugía puede presentar comorbilidades que pueden dar lugar a reintervenciones y/o retraso del tratamiento adyuvante, además de la probabilidad de un impacto psicosocial al influir en variables como la imagen corporal y la sexualidad. La mastectomía profiláctica podría reducir el riesgo de cáncer de mama contralateral favoreciendo la simetría pero sin beneficios evidentes en la supervivencia. Las mejoras en el tratamiento adyuvante han favorecido la supervivencia de este tipo de pacientes con una tendencia a una menor proporción de cánceres de mama contralaterales. En pacientes portadoras de mutación BRCA 1/2 la mastectomía profiláctica contralateral ha resultado coste-efectiva. Conclusiones. La mastectomía profiláctica parece reducir el riesgo de aparición de cáncer de mama contralateral pero no está exenta de complicaciones. Es necesario un proceso de toma de decisiones donde se facilite una información realista de la cirugía, de la enfermedad individual de la paciente y de la posibilidad de un consejo genético (AU)

Objective. To conduct a literature review of contralateral prophylactic mastectomy in unilateral breast cancer as risk reducing surgery and its probable effect on survival. Material and method. We performed a systematic search of the literature on prophylactic mastectomy by using the following keywords risk reducing surgery, breast cancer, incidence, complications, disease-free survival, overall survival, mortality due to breast cancer, and costs. Results. There is a general trend to increased use of contralateral prophylactic mastectomy to reduce the risk of contralateral breast cancer. The main factors influencing this process are young age, Caucasian race, early-stage breast cancer, estrogen receptor positivity, the use of magnetic resonance imaging at diagnosis, high educational level, access to immediate breast reconstruction, and family history of breast cancer and/or genetic testing for the BRCA 1 and BRCA 2 mutations. This surgery may have complications, which can lead to reoperation and/or delay adjuvant therapy and may also have a psychosocial impact, influencing body image and sexuality. Mastectomy may reduce the risk of contralateral breast cancer, favoring symmetry, but with no apparent survival benefit. Improvements in adjuvant treatments have improved survival in these patients with a lower proportion of contralateral breast cancers. Contralateral prophylactic mastectomy is clearly cost-effective in patients carrying the BRCA 1/2 mutation. Conclusion. Prophylactic mastectomy appears to reduce the risk of contralateral breast cancer, although this procedure should be reconsidered because it is not free of complications. Realistic information on the intervention and the disease, as well as genetic counseling, are required for proper decision-making (AU)

Adsorption of quantum dots onto polymer and Gemini surfactant films: a quartz crystal microbalance study.

We used quartz crystal microbalance with dissipation to study the mechanical properties, the kinetics of adsorption, and the amount of CdSe quantum dots (QDs) adsorbed onto a SiO2 sensor, referred as bare sensor, onto the sensor modified with a film of the polymer poly(maleic anhydride-alt-1-octadecene), PMAO, or with a film of the Gemini surfactant ethyl-bis(dimethyl octadecyl ammonium bromide), abbreviated as 18-2-18. Results showed that when the sensor is coated with polymer or surfactant molecules, the coverage increases compared with that obtained for the bare sensor. On the other hand, rheological properties and kinetics of adsorption of QDs are driven by QD nanoparticles. Thus, the QD films present elastic behavior, and the elasticity values are independent of the molecule used as coating and similar to the elasticity value obtained for QDs films on the bare sensor. The QD adsorption is a two-step mechanism in which the fastest process is attributed to the QD adsorption onto the solid substrate and the slowest one is ascribed to rearrangement movements of the nanoparticles adsorbed at the surface.

[Discordant pulmonary thromboembolism]. / Tromboembolismo pulmonar discordante.

The pulmonary thromboembolism (PET) is always a medical emergency. If there is a doubt with the diagnosis, it is important not to delay hospitalisation and treatment. It is a frequently under-diagnosed condition, with high morbidity and mortality. Its real incidence is not well established, due to its clinical variability, as well as the difficulties in diagnosing it. Owing to its high morbidity, this pathology is a major socioeconomic and cost for health care services.

¿Es necesaria la técnica combinada para la detección del ganglio centinela en el cáncer de mama? / No disponible

Objetivos: Determinar si la punción con colorante mejora los resultados de la biopsia del ganglio centinela. Material y métodos: Ciento cincuenta casos de carcinoma invasor de la mama fueron sometidos a biopsia del ganglio centinela mediante técnica combinada, para determinar si la punción con colorante es rentable. Se realizó inyección subareolar indérmica de una dosis de 0,4 mCi de radioisótopico el día previo a la cirugía. Se practicó gammagrafía en todos los casos. La inyección intraparenquimatosa de 4 cc. de colorante se realizó 20 minutos antes de la cirugía, y se siguió de masaje mamario. Resultados: La tasa de migración fue 92,3% para el radioisótopo y 75% para el colorante (p = 0,01). La media de ganglios resecados fue mayor para la técnica con colorante: 2,6 vs. 1,2 (p = 0,02). No se observaron diferencias en la tasa de falsos negativos (0,2 vs. 0,4) ni en el valor predictivo negativo. La precisión diagnóstica fue mayor para el radioisótopo (90,3% vs. 75% (p = 0,001). El mismo resultado se obtuvo para el porcentaje de éxito técnico (92,3 vs. 75% (0,001)). Conclusiones: La punción con colorante no añade información a la realizada con radioisótopo. A pesar de que la técnica se debe adaptar a las necesidades del centro y a las habilidades del cirujano, una vez superada la curva de validación la técnica radioisotópica por sí misma aporta suficiente información, con menor morbilidad y coste(AU)

Objetives: To determine whether blue dye enhances sentinel node biopsy detection. Material and methods: One hundred fifty hundred consecutive cases of breast cancer were submitted to sentinel node biopsy by combined technique in order to analyze if vital blue was cost-efective. Radioisotope dose was 0,4 mCi of Tc, subareolar intradermic inyection, the day before surgery. Gammagraphy was performed in every case. Colorant was methylene blue, 4 cc administered by intraparenchimatous inyection in upper-outer quadrant 20 minutes previous to surgery, followed by breast massagge. Results: Migration rate was 92.3% for radioisotope and 75% for colorant (p = 0.01). Mean number of nodes excised was higher for colorant: 2,6 vs. 1,2 (p = 0.02). False negative rate showed no difference (0.2 vs. 0.4) nor did negative predictive value. Accuracy to staging (True neg+ true pos./total) was higher for technecium (90.3% vs. 75% (p = 0.001) and so happenned with percentage of technical success (total- no migration): 92.3% vs. 75% (0.001). Conclusions: Colorant did no add any information concerning axillary status. More nodes had to be excised, and bigger incisions were made to achieve direct visualization. Accuracy to stage the lesion and percentage of technical success were higher with radioisotope after the learning curve is achieved and blue injection can be spared(AU)

Ketamina en el tratamiento del dolor oncológico: revisión de farmacocinética, farmacodinámica, interacciones medicamentosas y recomendaciones de uso / No disponible

Objetivo: ofrecer una revisión de las características farmacológicas de la ketamina, sus propiedades analgésicas y su aplicación en el manejo del dolor oncológico. Material y métodos: revisión de la literatura hasta octubre de 2009 utilizando las palabras clave: ketamina, dolor, neoplasia, cuidados paliativos. Asimismo, se han utilizado posibles fuentes bibliográficas suministradas en las referencias de los artículos, búsquedas vía on-line a través de Google y el uso de textos reconocidos de anestesia general. Resultados: la ketamina es un anestésico disociativo con efecto analgésico a dosis subanestésicas, teniendo como peculiaridades una acción antagonista sobre la sensibilización central y la disminución de la tolerancia del uso crónico de los opioides. Estas propiedades hacen que sea un fármaco co-analgésico útil en el dolor oncológico refractario, Sin embargo no está libre de efectos secundarios, siendo los psicomiméticos los más frecuentes, También se ha descrito su uso para la sedación del paciente oncológico con buenos resultados. Conclusiones: a pesar las propiedades beneficiosas de la ketamina en el manejo del dolor refractario, aún no existe la suficiente evidencia científica para confirmadas, siendo necesarios más ensayos clínicos randomizados bien diseñados. Tras la revisión realizada se proponen unas recomendaciones para su uso como co-analgésico en el tratamiento del dolor de difícil control en el paciente con cáncer avanzado (AU)

Objectives: to review the pharmacologic characters of ketamine, its analgesic properties and its application on cancer pain. Matherial and methods: a review till October 2009 using the key words: ketamine, pain, neoplasm, palliative care. Potencial sources provided by bibliographic references in reviewed articles were used, as well as searches on line in Google and recognized texts of Anaesthesia. Results: ketamine is a dissociative anaesthetic with analgesic effect at sub-anaesthetic doses, where it has an antagonism effect to central sensibilitation and anti-tolerance effect to opioids. These properties make ketamine a useful treatment for refractory cancer pain. Nevertheless, it is not free of side effects being the psychotomimetic the most frequent ones. It has also been described its use as a sedative in oncologic patients with good results. Conclusions: although the beneficial ketamina's properties in the management of refractory pain, there is not yet enough evidence to confirm those characteristics. Thus, more randomized clinical trials are needed. After the review done, some recommendations are given for the use of ketamine as a co-analgesic in the treatment of difficult pain control in advanced cancer patients (AU)

Investigation of the oviductal glycoprotein 1 (OVGP1) gene associated with embryo survival and development in the rabbit.

An association study was performed in rabbits between early embryo survival and development, and the nonconservative SNP 12944C>G located in exon 11 and the triallellic microsatellite [(GT)(15)T(G)(5), (GT)(14)T(G)(5), and (GT)(11)T(G)(7))] located in the promoter region of the oviductal glycoprotein 1 (OVGP1) gene. We analyzed an F(2) cross of 2 lines of rabbits divergently selected for uterine capacity. A total of 172 and 159 females were slaughtered at 48 and 72 h of gestation, respectively, to determine whether OVGP1 influences ovulation rate, fertilization rate, early embryo survival, and embryonic stage of development. The results of the SNP indicated that all genotypes showed similar early embryo survival and a similar embryonic stage of development at 48 h of gestation. However, at 72 h of gestation, the GG genotype showed greater early embryo survival than the CC genotype (0.56 embryos) and their embryos presented less embryonic development. Analysis of the microsatellite was performed to ascertain the presence or absence of the allele (GT)(14)T(G)(5). At both stages of gestation, the (GT)(14)T(G)(5)/(GT)(14)T(G)(5) genotype showed greater early embryo survival (0.94 and 1.54 embryos at 48 and 72 h of gestation, respectively) and less embryonic development than the homozygous genotypes without the allele (GT)(14)T(G)(5).

Candidate gene analysis for reproductive traits in two lines of rabbits divergently selected for uterine capacity.

The objective of this work was to analyze 3 functional candidate genes for reproduction in 2 lines of rabbits divergently selected by uterine capacity. Both lines were selected for 10 generations. The selection was then relaxed until the 17th generation, when it was compounded by 61 and 63 does of the High and Low lines, respectively. We sequenced the SCGB1A1 gene, which encodes the main protein secreted by the rabbit in the uterus and seems to play an important role in implantation. We found 6 SNP in the promoter region cosegregating in 2 haplotypes in both lines with similar frequency. We also analyzed IGF1 mRNA because of its effects on embryo development, but we did not find any polymorphism between individuals of the 2 lines. The third gene analyzed was the TIMP1, which encodes a protein involved in many biological processes related to reproduction. We determined the sequence of its promoter region and found 1 SNP (g.1423A>G) segregating with different frequencies in both lines (0.60 for allele A in the High line and 0.82 for allele G in the Low line). The association study performed in an F(2) population (n = 598) generated by the cross of the 2 lines of rabbits revealed that the AA genotype had 0.88 embryos more than the GG genotype at 72 h of gestation. The difference increased to 2.23 embryos at implantation, but no difference was found between genotypes at birth. These results suggest that TIMP1 could be a candidate gene for embryo implantation and embryo survival.