Anti-Anisakis antibodies in colon cancer patients and their relationship with γδ T-cells.

Many pathogens are related to carcinogenesis. Chronic inflammation, as a result of persistent infection, leads to DNA damage, higher expression of oncogenes, decreased apoptosis and immunosuppression, which are some of the reasons for cancer induction. Among parasites, Schistosoma, Opistorchis and Clonorchis are recognised as infectious agents which contribute to cancer. A relationship between Anisakis and cancer was hypothesised because cellular responses to Anisakis products could result in inflammation and DNA damage. Previous research has shown a decrease in CD8+ γδ T-cells and an increase in αß and γδ T-cell apoptosis in colon cancer (CC) samples. Ninety-two CC patients and 60 healthy subjects were recruited. γδ and αß T-cells were analysed, and their apoptosis was evaluated. Anti-Anisakis antibodies were tested in sera from CC patients and controls. Anti-Anisakis IgG, IgM, IgA and IgE antibodies were significantly higher in CC patients. A significant increase in anti-Anisakis IgA levels was observed in patients with angiolymphatic invasion. The number of all γδ T-cells, as well as CD3+ CD4+ αß T-cells, was significantly lower in CC patients. The apoptosis of all T-cells was significantly increased in patients with CC. We observed a significantly higher percentage of anti-Anisakis IgE positive patients having a deficit of CD3+ γδ T-cells. Our results suggest a relationship between Anisakis and CC.

Use of metatarsal hook plates in the treatment of multifragmentary patellar fractures - A case series.

The surgical management of patellar fractures typically yielded satisfactory results; however, in situations involving multifragmented patellar fractures or those affecting the inferior pole, it became imperative to employ alternative osteosynthesis techniques that enhanced stability, enabled early rehabilitation initiation, prevented implant failure, and avoided reduction loss before fracture consolidation. In this context, an unconventional osteosynthesis alternative was presented, utilizing an anatomically designed hook plate originally intended for the fifth metatarsal. This technique was successfully applied in three patients with multifragmentary patellar fractures, allowing stable fixation of small or marginal fragments through the plate's hooks without compromising vascularity. Fracture consolidation was achieved without reduction loss, and owing to its low profile, patient discomfort and irritation were minimized compared to traditional tension band or wiring techniques. This approach suggested the potential to forego early plate removal, thereby contributing to a more effective management of patellar fractures. Level of evidence: IV.

A Low Number of Baselines γδ T Cells Increases the Risk of SARS-CoV-2 Post-Vaccination Infection.

Background: The COVID-19 pandemic is the biggest global health problem in the last hundred years. The efficacy of the vaccine to protect against severe disease is estimated to be 70-95% according to the studies carried out, although there are aspects of the immune response to the vaccine that remain unclear. Methods: Humoral and cellular immunity after the administration of three doses of the Pfizer-BioNTech and Oxford AstraZeneca vaccines against SARS-CoV-2 over one year and the appearance of post-vaccination COVID-19 were studied. SARS-CoV-2 IgG and IgA antibodies, αß and γδ T-cell subsets, and their differentiation stages and apoptosis were analyzed. Results: Anti-SARS-CoV-2 IgG and IgA antibodies showed a progressive increase throughout the duration of the study. This increase was the greatest after the third dose. The highest levels were observed in subjects who had anti-SARS-CoV-2 antibodies prior to vaccination. There was an increase in CD4+ αß, CD8+ γδ and TEM CD8+ γδ T cells, and a decrease in apoptosis in CD4+ CD8+ and CD56+ αß and γδ T cells. Post-vaccination SARS-CoV-2 infection was greater than 60%. The symptoms of COVID-19 were very mild and were related to a γδ T cell deficit, specifically CD8+ TEMRA and CD56+ γδ TEM, as well as lower pre-vaccine apoptosis levels. Conclusions: The results unveil the important role of γδ T cells in SARS-CoV-2-vaccine-mediated protection from the disease.

Evaluation of the humoral and mucosal immune response of a multiepitope vaccine against COVID-19 in pigs.

Introduction: This study evaluated the immune response to a multiepitope recombinant chimeric protein (CHIVAX) containing B- and T-cell epitopes of the SARS-CoV-2 spike's receptor binding domain (RBD) in a translational porcine model for pre-clinical studies. Methods: We generated a multiepitope recombinant protein engineered to include six coding conserved epitopes from the RBD domain of the SARS-CoV-2 S protein. Pigs were divided into groups and immunized with different doses of the protein, with serum samples collected over time to determine antibody responses by indirect ELISA and antibody titration. Peptide recognition was also analyzed by Western blotting. A surrogate neutralization assay with recombinant ACE2 and RBDs was performed. Intranasal doses of the immunogen were also prepared and tested on Vietnamese minipigs. Results: When the immunogen was administered subcutaneously, it induced specific IgG antibodies in pigs, and higher doses correlated with higher antibody levels. Antibodies from immunized pigs recognized individual peptides in the multiepitope vaccine and inhibited RBD-ACE2 binding for five variants of concern (VOC). Comparative antigen delivery methods showed that both, subcutaneous and combined subcutaneous/intranasal approaches, induced specific IgG and IgA antibodies, with the subcutaneous approach having superior neutralizing activity. CHIVAX elicited systemic immunity, evidenced by specific IgG antibodies in the serum, and local mucosal immunity, indicated by IgA antibodies in saliva, nasal, and bronchoalveolar lavage secretions. Importantly, these antibodies demonstrated neutralizing activity against SARS-CoV-2 in vitro. Discussion: The elicited antibodies recognized individual epitopes on the chimeric protein and demonstrated the capacity to block RBD-ACE2 binding of the ancestral SARS-CoV-2 strain and four VOCs. The findings provide proof of concept for using multiepitope recombinant antigens and a combined immunization protocol to induce a neutralizing immune response against SARS-CoV-2 in the pig translational model for preclinical studies.

Reemplazo total primario de rodilla asistido por navegador: serie de casos / Primary knee arthroplasty assisted by a computational navigation system: case series

Introducción: el reemplazo total de rodilla es cada vez más frecuente. El éxito de esta cirugía se basa en el diseño del implante, en la alineación y en la orientación de los componentes. Existe una relación directa entre el fallo temprano y el error de alineación. Actualmente con el uso de la navegación asistida por computador se podrían asegurar mejores resultados al precisar la posición de los componentes. El objetivo de este estudio es determinar la alineación y orientación de los componentes obtenidas luego de reemplazo total de rodilla primario asistido por navegador. Materiales y métodos: se diseñó un estudio prospectivo de 112 pacientes (123 rodillas) con diagnóstico de osteoartrosis tricompartimental. Se realizó reemplazo total de rodilla primario asistido por navegación y se evaluó clínica y radiológicamente la alineación de los componentes. Resultados: la escala funcional KS (Knee Society Score) fue de 26 puntos en el preoperatorio y de 90 en el posquirúrgico. Se encontró un valgo promedio de 2,8 grados. Los resultados radiológicos fueron excelentes en todos los casos. Discusión: el reemplazo de rodilla primario con navegación asistida por computador es eficaz para obtener una alineación y orientación adecuadas de los componentes y reduce el promedio de desviación valgo/varo del eje anatómico del miembro.

Evaluación de la osteólisis periprotésica del componente acetabular cementado mediante resonancia magnética / Evaluation of periprosthetic osteolysis of cemented acetabular component using MRI

Introduccion: La osteólisis periprotésica conduce al aflojamiento de los componentes. El objetivo de este estudio es evaluar la osteólisis periprotésica de cotilos cementados de polietileno mediante resonancia magnética (RM). Materiales y métodos: Se estudiaron 22 caderas (18 pacientes) con artroplastias totales de cadera primaria cementadas realizadas durante el período 1999-2004. En todos los casos se realizó evaluación clínica, radiológica y con RM. Se dividió la muestra según el criterio radiográfico: grupo A (con aflojamiento): radiografía con línea radiotransparente mayor de 2 mm y/o migración del cotilo (4 casos). Tres pacientes fueron sometidos a cirugía de revisión; grupo B (sin aflojamiento): radiografía sin línea radiotransparente o menor de 2 mm y sin migración delcotilo (18 casos). Resultados: La evaluación de la RM mostró: grupo A: 4 casos con osteólisis periprotésica; grupo B: 3 casos con osteólisis periprotésica y 13 sin osteólisis. Dos casos con artefactos magnéticos no pudieron evaluarse. Todo el grupo A presentó manifestaciones clínicas de aflojamiento, mientras que en el grupo B sólo 4 casos, de estos últimos 3, presentaron osteólisis en la resonancia magnética. Conclusiones: La resonancia magnética estaría indicada en la identificación de la osteólisis periprotésica acetabular en los pacientes que presentan una expresión clínica sospechosa y un estudio radiográfico negativo.

Manejo conservador de la ruptura del tendón de Aquiles y coadyuvancia biológica con factores de crecimiento autólogos / Conservative management of ruptured Achilles tendon and biological coadyuvancia with autologous growth factors

La ruptura del tendón de Aquiles es una lesión grave e invalidante, de ahí la importancia de un correcto y rápido tratamiento. Existe controversia en cuanto al tratamiento ideal, ya sea quirúrgico o no quirúrgico. Lo importante es conseguir un resultado funcional satisfactorio. Describimos el caso de un paciente joven con ruptura completa del tendón de Aquiles tratado no quirúrgicamente con inmovilización y aplicación percutánea de factores de crecimiento autólogos como coadyuvancia biológica.

Condroblastoma en acetábulo y reconstrucción con matriz ósea desmineralizada mediante luxación controlada de cadera / Condroblastoma in acetabulum reconstruction and demineralized bone matrix controlled by dislocation of the hip

El condroblastoma es un tumor benigno que puede presentar metástasis pulmonar y provocar destrucción ósea progresiva, de ahi que se recomiende tratamiento quirúrgico oportuno. Describimos el caso de un paciente joven con diagnóstico de condroblastoma de localización inusual a nivel del fondo acetabular, al cual se le realizó una luxación controlada de cadera para manejo intralesional del tumor y reconstrucción y empaquetamiento con matriz ósea desmineralizada alogénica.