Sternal resection and reconstruction: a review.

Sternal resection and reconstruction is a rare but sometimes challenging procedure due to its profound anatomical and functional implications. For these reasons, an adequate preoperative evaluation is crucial in each patient, especially when we are faced with malignant lesions that sometimes require extensive radical resections, thus demanding an integrated reconstructive strategy that allows stabilizing the chest wall, protecting the underlying mediastinum and minimize resulting deformity. The large number of available reconstruction techniques and the lack of quality studies for their analysis mean that sternal reconstruction depends to a great extent on the consensus of experts or, more frequently, on the simple preference of each surgical team. This article aims to provide an overview of sternal resection and reconstruction. Indications for partial versus total or subtotal sternectomy are suggested and their surgical and oncological outcomes are presented. The use of rigid or semi-rigid prostheses is an ongoing debate, although recent functional data advise reserving rigid reconstructions for extensive defects. Sternectomy for primary tumors or local tumor involvement has a good prognosis with an overall survival of 5 and 10 years: 67% and 58%, respectively, provided that a radical resection with free surgical margins is performed. Breast cancer is the most common secondary sternal tumor, and surgery can offer 5-year overall survival ranging from 20% to 50% provided an R0 resection is achieved, although radical surgery does not appear to decrease rates. of recurrence. Metastases of origin other than the breast give the worst results (less than 40% at 36 months and 0% at 5 years) and although the data available on these cases are limited, the radicality of the resection does not seem to modify the survival or recurrence rates, so a conservative approach is probably more appropriate.

Hydrolysis of riboflavins in root exudates under iron deficiency and alkaline stress.

Riboflavins are secreted under iron deficiency as a part of the iron acquisition Strategy I, mainly when the external pH is acidic. In plants growing under Fe-deficiency and alkaline conditions, riboflavins have been reported to accumulate inside the roots, with very low or negligible secretion. However, the fact that riboflavins may undergo hydrolysis under alkaline conditions has been so far disregarded. In this paper, we report the presence of riboflavin derivatives and products of their alkaline hydrolysis (lumichrome, lumiflavin and carboxymethylflavin) in nutrient solutions of Cucumis sativus plants grown under different iron regimes (soluble Fe-EDDHA in the nutrient solution, total absence of iron in the nutrient solution, or two different doses of FeSO4 supplied as a foliar spray), either cultivated in slightly acidic (pH 6) or alkaline (pH 8.8, 10 mM bicarbonate) nutrient solutions. The results show that root synthesis and exudation of riboflavins is controlled by shoot iron status, and that exuded riboflavins undergo hydrolysis, especially at alkaline pH, with lumichrome being the main product of hydrolysis.

Beneficios de incorporar un simbiótico a la dieta de adultos mayores con infecciones recurrentes / Benefits of adding symbiotic food to the diet of elderly people with recurrent infections

El propósito de este trabajo fue estudiar la evolución clínica de un grupo de adultos mayores, proclives a padecer infecciones bacterianas principalmente de las vías respiratorias, al adicionar a su dieta un alimento simbiótico con Lactobacillus casei, Lactobacillus acidophillus y fructanos y, además, correlacionar los resultados obtenidos con modificaciones en los parámetros inmunológicos medidos. Se incluyeron 90 pacientes adultos mayores de 65 años, todos con antecedentes de infecciones bacterianas recurrentes de las vías respiratorias. Cada individuo suplementó su dieta habitual con una dosis diaria del simbiótico SanCor Bio con fructanos. La administración se realizó durante los meses de época invernal. Se realizó un seguimiento clínico, se hizo recuento de Lactobacillus spp en materia fecal, se cuantificaron subpoblaciones linfocitarias CD4 y CD8 y se evaluó la activación de monocitos en sangre periférica. Se observó disminución de los cuadros virales (gripales) y ausencia de infecciones bacterianas de vías respiratorias; además, aumentó el número de Lactobacillus spp en materia fecal y se estimuló la respuesta inmune principalmente inespecífica. Esto sugiere que dicho simbiótico puede ser utilizado como terapia preventiva en grupos vulnerables a infecciones y con depleciones del sistema inmunológico.

The aim of this work was to study the clinical evolution of a group of elderly people who had a tendency to suffer from bacterial infections, mainly of the respiratory tract, after having added food with Lactobacillus casei, Lactobacillus acidophilus and fructans to their diet, and then to correlate the results obtained with alterations in immunological parameters previously set. Ninety patients who were older than 65 and had a background of recurrent bacterial infections in their respiratory tract were included in this study. Their daily diet was supplemented with a dose of Sancor Bio during winter months in 2007. A clinical analysis was carried out, Lactobacillus spp in faeces were counted, CD4 and CD8 lymphocytes were quantified and the activation of monocytes in peripheral blood was evaluated. In conclusion, the administration of this symbiotic food proved to be biochemical and clinically effective, showing to be a good colony of the intestinal mucose, promoting the principally unspecific immune response, everything correlated with clinical information. All this suggests that this food can be used asa preventive therapy in groups of people who are vulnerable to infections and who have immunological system depletions.