Prevalencia de lesión del ligamento colateral medial de la rodilla valorada por resonancia magnética / Prevalence of injury of the medial collateral ligament of the knee assessed by magnetic resonance

Resumen: Introducción: El ligamento colateral medial (LCM) es uno de los principales estabilizadores de la rodilla, pero su lesión se presenta en conjunto con otras lesiones ligamentarias. Objetivo: Determinar la prevalencia de lesiones del LCM por resonancia magnética, sus grados y lesiones asociadas en nuestra institución. Material y métodos: Estudio retrospectivo de Enero a Abril de 2018, se evaluaron resonancias magnéticas de rodilla donde se presentó lesión del LCM para evaluar grado y tipo de lesiones asociadas. Resultados: Se incluyeron 368 estudios, prevalencia de lesión aislada del LCM de 3.07%, una grado I y una grado II, la prevalencia de lesiones de LCM concomitantes fue de 17.66%, grado I (75%), grado II (15%) y grado III (3%). Las lesiones asociadas fueron lesión del menisco medial (46.15%), lesión del ligamento cruzado anterior (30.7%), contusión ósea aislada (18.46%), lesiones condrales (37.58%), lesión de vasto medial (14.51%), lesión del retináculo medial patelar (14.51%), lesión del vasto lateral (9.23%), lesión del ligamento cruzado posterior (6.15%), lesión del menisco lateral (4.61%), tenosinovitis banda iliotibial (4.61%), fractura de avulsión de la faceta medial (3.07%), tenosinovitis de la Pes Anserinus (3.07%). Conclusión: Prevalencia de 17.66% de lesiones del LCM en nuestro hospital por resonancia magnética, predominan los dos primeros grados con un espectro amplio de lesiones asociadas de la rodilla.

Abstract: Introduction: The medial collateral ligament (MCL) is one of the main stabilizers of the knee, but its injury occurs in conjunction with other ligaments. Objective: To determine the prevalence of MCL lesions by magnetic resonance imaging, their degrees and associated lesions in our institution. Material and Methods: Retrospective study from January to April 2018 where KNEE MRIs were evaluated where the MCL lesion was presented to evaluate the degree and type of associated injuries. Results: We included 368 studies, prevalence of isolated MCL lesion of 3.07%, grade I and grade II, prevalence of concomitant MCL lesions was 17.66% grade I (75%), grade II (15%) and grade III (3%). Associated injuries were medial meniscus injury (46.15%), anterior cruciate ligament injury (30.7%), isolated bone contusion (18.46%), chodral injuries (37.58%), medial vastus injury (14.51%), patellar medial retinacular injury (14.51%), vastus lateral injury (9.23%), posterior cruciate ligament injury (6.15%), lateral meniscus injury (4.61%), iliotibial band tenosynovitis (4.61%), medial facet avulsion fracture (3.07%), Pes Anserine tenosynovitis (3.07%). Conclusion: Prevalence of 17.66% of the MCL injuries in our hospital by magnetic resonance, the first 2 degrees predominate, with a wide spectrum of associated knee injuries.

Renovascular hypertension increases serum TNF and CX3CL1 in experimental Trypanosoma cruzi infection

Trypanosoma cruzi triggers a progressive inflammatory response affecting cardiovascular functions in humans and experimental models. Angiotensin II, a key effector of the renin-angiotensin system, plays roles in mediating hypertension, heart failure, and inflammatory responses. T. cruzi and AngII can induce inflammatory responses by releasing inflammatory mediators. The aim of this study was to evaluate systemic AngII, tumor necrosis factor (TNF), and CX3CL1 mediators in a two-kidney one-clip (2K1C) renovascular hypertension model using Wistar rats infected with T. cruzi. Our data showed an increase in serum AngII in uninfected and T. cruzi-infected rats 1 week after 2K1C surgery compared to non-2K1C (Sham) animals. The baseline systolic blood pressure was higher in both uninfected and infected 2K1C rats. Despite no difference in circulating parasites in the acute phase of infection, elevated serum TNF and CX3CL1 were observed at 8 weeks post-infection in 2K1C rats in association with higher cardiac inflammatory infiltration. In summary, AngII-induced hypertension associated with T. cruzi infection may act synergistically to increase TNF and CX3CL1 in the 2K1C rat model, thereby intensifying cardiac inflammatory infiltration and worsening the underlying inflammation triggered by this protozoan.

Actualización en medicina de familia: patología periodontal / Update in family medicine: periodontal disease

En España entre el 85-94% de la población mayor de 35 años sufre algún problema de las encías, y entre el 15-30% padece periodontitis, siendo las formas severas un 5-11% de los casos. A diferencia de otras entidades inflamatorias, la enfermedad periodontal rara vez causa molestias, limita la vida o causa alteraciones funcionales hasta que la enfermedad progresa y aparecen signos clínicos (recesión gingival, migración patológica de los dientes, movilidad) en estadios avanzados de la enfermedad. El desconocimiento de la enfermedad, ligado con la falsa creencia de que la pérdida dentaria es una causa inexorable de la edad, repercute en un diagnóstico tardío, requiriendo enfoques del tratamiento más complejos y con un peor pronóstico. En el ámbito de la medicina de atención primaria hay una serie de fármacos asociados con la enfermedad periodontal, con la presencia de agrandamiento gingival (anticonvulsivantes, inmunosupresores y bloqueadores de los canales del calcio) como efectos secundarios, con variabilidad en cuanto a su presencia y severidad en función de la cantidad de placa acumulada. El estrés y la depresión son estados que alteran la respuesta del sistema inmune y aumentan la respuesta inflamatoria, incrementando la susceptibilidad de la periodontitis. Asimismo, se han asociado una serie de enfermedades sistémicas a la periodontitis, entre las que se encuentran la diabetes mellitus, la enfermedad cardiovascular, las enfermedades respiratorias y las complicaciones de la gestación (AU)

About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis (AU)

In vitro inhibitory effects of imatinib mesylate on stromal cells and hematopoietic progenitors from bone marrow

Imatinib mesylate (IM) is used to treat chronic myeloid leukemia (CML) because it selectively inhibits tyrosine kinase, which is a hallmark of CML oncogenesis. Recent studies have shown that IM inhibits the growth of several non-malignant hematopoietic and fibroblast cells from bone marrow (BM). The aim of the present study was to evaluate the effects of IM on stromal and hematopoietic progenitor cells, specifically in the colony-forming units of granulocyte/macrophage (CFU-GM), using BM cultures from 108 1.5- to 2-month-old healthy Swiss mice. The results showed that low concentrations of IM (1.25 µM) reduced the growth of CFU-GM in clonogenic assays. In culture assays with stromal cells, fibroblast proliferation and α-SMA expression by immunocytochemistry analysis were also reduced in a concentration-dependent manner, with a survival rate of approximately 50% with a dose of 2.5 µM. Cell viability and morphology were analyzed using MTT and staining with acrydine orange/ethidium bromide. Most cells were found to be viable after treatment with 5 µM IM, although there was gradual growth inhibition of fibroblastic cells while the number of round cells (macrophage-like cells) increased. At higher concentrations (15 µM), the majority of cells were apoptotic and cell growth ceased completely. Oil red staining revealed the presence of adipocytes only in untreated cells (control). Cell cycle analysis of stromal cells by flow cytometry showed a blockade at the G0/G1 phases in groups treated with 5-15 µM. These results suggest that IM differentially inhibits the survival of different types of BM cells since toxic effects were achieved.

Short-term effects of a spinosyn's family insecticide on energy metabolism and liver morphology in frugivorous bats Artibeus lituratus (Olfers, 1818) / Efeitos em curto prazo de inseticida da família das espinosinas sobre o metabolismo energético e a morfologia hepática em morcegos frugívoros

A new class of insecticide derived from fermentation of Sacharopolyspora spinosa - spinosad, has been indicated as being of low toxicity and a natural alternative to classical pesticides. In order to elucidate several aspects related to the morphophysiological changes induced by spinosad in Artibeus lituratus, the effects of a seven-day administration on plasma glucose, glycogen, protein and lipid concentrations were evaluated, and possible changes in liver cells were examined by histological analysis. Animals were fed with spinosyn-contaminated fruit through immersion in a solution. Data reporting on metabolism revealed a decrease in hind limb muscle lipid concentration in the treated group. Morphological analysis indicated a significant increase in liver cell diameter in treated animals compared to the control group. This study indicates that spinosyn, used at its recommended dose, does not affect general energy metabolism in A. lituratus but may affect some ultrastructural characteristics of liver cells.

Uma nova classe de inseticida derivado da fermentação de Sacharopolyspora spinosa - espinosade - tem sido indicada como uma alternativa natural de baixa toxicidade aos agrotóxicos clássicos. A fim de elucidar diversos aspectos relacionados às mudanças morfofisiológicas induzidas por espinosade Artibeus lituratus, os efeitos da administração durante sete dias sobre a glicose plasmática, proteína de glicogênio, e as concentrações de lipídios foram avaliados, assim como possíveis alterações nas células do fígado foram examinadas por análise histológica. Os animais foram alimentados com frutas contaminadas com espinosade por meio de imersão em uma solução. Os dados sobre o metabolismo revelaram um decréscimo na concentração de lipídios dos músculos das patas posteriores dos animais do grupo tratado. A análise morfológica indicou um aumento significativo no diâmetro das células do fígado dos animais tratados em relação ao controle. Este estudo indica que o espinosade, utilizado na dose recomendada, não afeta o metabolismo energético em geral de A. lituratus, mas pode afetar algumas características ultraestruturais das células hepáticas.

Paraplejía aguda secundaria a la disección indolora de la aorta / Acute paraplegia secondary to painless aortic dissection

La disección aguda de aorta (DAA) es una patología grave y poco común, y su presentación clínicaincluye dolor torácico y dorsal. La disección indolora de la aorta es una enfermedad muy rara y la paraplejía aguda constituye una de las complicaciones secundarias a la DAA. Aunque la paraplejía dolorosa se observa entre un 2 y un 3% de todos los casos de DAA, la paraplejía indolora es extremadamente rara. Caso clínico. Varón de 51 años, con un largo historial de hipertensión,que presentaba paraplejía aguda, sin dolor torácico o dorsal. Conclusión. Ante la presencia de episodios neurológicos agudos, siempre debe investigarse una causa vascular, y dentro de ese grupo de enfermedades hay que tener en cuenta la disección de la aorta, aunque no haya dolor en el momento de realizar el diagnóstico

Acute aortic dissection (AAD) is a serious and uncommon event. The clinical presentation generallyincludes thoracic or back pain. Painless aortic dissection is an extremely rare occurrence. Acute paraplegia is one of the neurological complications secondary to AAD. Although painful paraplegia is seen in 2% to 3% of AAD cases, painless paraplegia is a very rare event. Case report. A 51-year-old man with a long term history of hypertension, presented with acuteparalysis of the lower extremities, with no chest or back pain. Conclusion. In presence of acute neurologic events, must always be investigated a vascular cause and, in these group of disease, the aortic dissection may be researched, although the pain wasn’t present on occasion of the diagnosis

Esclerosis lateral amiotrófica. Evaluación de la función tiroidea y del metabolismo fosfocálcico / Amyotrophic lateral sclerosis. Its relationship with thyroid function and phosphate-calcium metabolism

Introducción. La esclerosis lateral amiotrófica (ELA) es una enfermedad degenerativa progresiva que afecta motoneuronas de la médula espinal, tronco encefálico y corteza motora cerebral. Se ha comunicado la coexistencia de enfermedad de motoneurona y patología tiroidea, al igual que la asociación de hiperparatiroidismo primario y afectación de las neuronas motoras espinales, hechos que condu jeron a la discusión de una eventual relación patogénica entre las alteraciones metabólicas enunciadas y el cuadro neurológico señalado. Objetivo. Tratar de identificar alteraciones de la función tiroidea y del metabolismo fosfocálcico en pacientes con ELA. Pacientes y métodos. Se analizaron retrospectivamente los datos de laboratorio de 41 pacientes internados desde junio de 1998 hasta junio de 2001 con el diagnóstico de ELA esporádica. Se consideraron los valores de tirotrofina (TSH), tiroxina (T4), tiroxina libre, calcemia, fosfatemia, hormona paratiroidea (PTH) intacta y calcio iónico. Resultados. Ningún paciente presentó hipertiroidismo; dos pacientes exhibieron TSH aumentada con T4 normal, lo que sugería la posibilidad de un hipotiroidismo subclínico. Un paciente mostró PTH aumentada. Un paciente presentó hiperparatiroidismo primario. Tres enfermos exhibieron calcemia baja y otros cuatro fosfatemia alta. Conclusiones. Los hallazgos hechos en esta serie de pacientes no permiten aseverar la existencia de asociación patogénica entre alteraciones de la función tiroidea o del metabolismo fosfocálcico y la ELA (AU)

Introduction. Amyotrophic lateral sclerosis (ALS) is a progressive degenerative disease involving motor neurons of the spinal cord, brain stem, and motor cortex. Previous studies reported the coexistence of motor neuron disease with thyroid dysfunction and primary hyperparathyroidism. These findings suggested an eventual role of the previously mentioned endocrine disorders and the development of ALS. Objective. Identify thyroid dysfunction and changes in mineral metabolism in patients affected by sporadic ALS. Patients and methods. We retrospectively analyzed data from 41 in-ward patients from June 1998, to June 2001. All of them were diagnosed with sporadic ALS. The following laboratory test were performed: thyrotropin (TSH), thyroxine (T4), serum calcium, serum phosphate, parathyroid hormone (PTH) and ionic calcium concentrations. Results. None of the studied patients was found to be hyperthyroid. Two patients had elevated TSH and normal T4, these findings suggested subclinical hypothyroidism. Elevated PTH was found in one patient; another had primary hyperparathyroidism. Low serum calcium was found in three patients and elevated phosphate was found in another four. Conclusions. All these findings do not allow us to assert a pathogenic association between thyroid dysfunction or alteration of phosphatecalcium metabolism and ALS (AU)

Latex Fractionation by Sedimentation and Colloidal Crystallization: The Case of Poly(styrene-co-acrylamide).

Poly(styrene-co-acrylamide) (PS-AAM) latex was prepared, fractionated by sedimentation under gravity, and characterized by PCS, infrared spectra, secondary and backscattered electron imaging in the scanning electron microscope, and electron spectroscopy imaging in an analytical transmission electron microscope. Three latex fractions were obtained. The lower fraction was opalescent and its particles were the more uniform, concerning size, chemical composition, and topochemical features. This lower fraction was still further fractionated by zonal centrifugation in a density gradient, yielding two fractions with similar macrocrystal-forming abilities but different sizes and chemical compositions. These results confirm those previously obtained for the PS-HEMA latex. Copyright 2000 Academic Press.

Flexible foraging strategy of Cory's shearwater, Calonectris diomedea, during the chick-rearing period.

Procellariiformes are well known for their low rates of food provisioning to their slow-growing chicks. In some species, the patterns of food delivery to chicks have been deduced from changes in their weight, obtained from periodic weighings. However, the behaviour of individual parents cannot be resolved using this method. In this study, we used a periodic weighing protocol with Cory's shearwater chicks on Selvagem Grande island, in the northeast Atlantic. In addition, we used an automatic logging system to examine the attendance of individual parents. In 1997, the chicks were fed infrequently, and were in significantly poorer condition, than in other years and at other colonies. This suggests that the adults were experiencing some difficulties in finding an adequate food supply close to the colony. Under these conditions, individual parents adopted a dual provisioning strategy, making both short and long foraging trips, a previously undescribed behaviour in any northern hemisphere petrel species. Although meals delivered to chicks were larger after long trips than after short trips, the average amount of food provisioned per day spent at sea decreased with increasing trip length, and so chicks did not benefit from longer trips. This finding suggests that long trips can be used to restore the adult's body condition, presumably depleted during short trips as shown previously for some petrels and albatrosses. The adoption of this flexible foraging strategy, which differs from the uniform intervals observed in Cory's shearwaters experiencing situations of 'normal' food abundance, may represent a mechanism through which breeding birds compromise between the needs of their chicks and the maintenance of their own body condition. Copyright 1998 The Association for the Study of Animal Behaviour.