Fungal Alcohol Dehydrogenases: Physiological Function, Molecular Properties, Regulation of Their Production, and Biotechnological Potential.

Fungal alcohol dehydrogenases (ADHs) participate in growth under aerobic or anaerobic conditions, morphogenetic processes, and pathogenesis of diverse fungal genera. These processes are associated with metabolic operation routes related to alcohol, aldehyde, and acid production. The number of ADH enzymes, their metabolic roles, and their functions vary within fungal species. The most studied ADHs are associated with ethanol metabolism, either as fermentative enzymes involved in the production of this alcohol or as oxidative enzymes necessary for the use of ethanol as a carbon source; other enzymes participate in survival under microaerobic conditions. The fast generation of data using genome sequencing provides an excellent opportunity to determine a correlation between the number of ADHs and fungal lifestyle. Therefore, this review aims to summarize the latest knowledge about the importance of ADH enzymes in the physiology and metabolism of fungal cells, as well as their structure, regulation, evolutionary relationships, and biotechnological potential.

Efectividad de la combinación fija de colágeno nativo tipo II, omega-3 y astaxantina en pacientes con osteoartritis de rodilla / Effectiveness of the fixed combination of type II native collagen, omega-3 and astaxanthin in patients with knee osteoarthritis

Resumen: Introducción: la osteoartritis es una de las enfermedades crónicas con mayor prevalencia en el mundo y se define como la pérdida gradual de cartílago en las articulaciones, principalmente la de rodilla. Es considerada como una causa de discapacidad en adultos mayores y se caracteriza por dolor, rigidez y pérdida de la movilidad. Material y métodos: estudio observacional para evaluar el efecto de la combinación de Sólo debe decir, colágeno nativo tipo II, omega-3 (Om-3) y astaxantina (AX), en una población de 182 pacientes con artrosis de rodilla grado I/II. Se obtuvieron las mediciones de circunferencia del muslo, arcos de movimiento y dolor a través de las escalas internacionales como la escala visual analógica de dolor (EVA), el índice de Lequesne y escala Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). Las revisiones médicas se realizaron cada 30 días durante tres meses. Se utilizó el software Statgraphics (Statgraphics Technologies, Virginia), la evaluación de las variables y la significancia estadística fueron determinadas por la prueba t de Student y los resultados se muestran como media. Resultados: se demostró que el consumo diario incrementa la movilidad, disminuye el dolor y la inflamación de rodilla en los pacientes en un lapso de tres meses. Adicionalmente se registró una reducción en el consumo de antiinflamatorios no esteroideos (AINE) por parte de los sujetos de estudio. Conclusión: la combinación fija colágeno nativo tipo II, omega-3 y astaxantina, genera, en el corto plazo, disminución de la inflamación y la rigidez en pacientes con osteoartritis.

Abstract: Introduction: osteoarthritis is one of the most prevalent chronic diseases in the world and is defined as the gradual loss of cartilage in the joints, mainly that of the knee. It is considered a cause of disability in older adults and is characterized by pain, stiffness and loss of mobility. Material and methods: observational study to evaluate the effect of the combination of non-hydrolyzed type II native collagen (CII-NH), omega-3 (Om-3) and astaxanthin (AX), in a population of 182 patients with knee osteoarthritis grade I/II. Measurements of thigh circumference, arcs of movement and pain were obtained through international scales such as the visual analogue pain scale (VAS), the Lequesne index and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scale. Medical check-ups were performed every 30 days for three months. The Statgraphics software (Statgraphics Technologies, Virginia) was used, the evaluation of the variables and the statistical significance were determined by t Student test and the results are shown as a mean. Results: it was shown that daily consumption increases mobility, decreases knee pain and inflammation in patients within three months. Additionally, there was a reduction in the consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) by the study subjects. Conclusion: the fixed combination of non-hydrolyzed type II collagen, omega-3 and astaxanthin, generates, in the short term, a decrease in inflammation and stiffness in patients with osteoarthritis.

Genotypes and Haplotypes in the AXIN2 and TCF7L2 Genes are Associated With Susceptibility and With Clinicopathological Characteristics in Breast Cancer Patients.

Background: Breast cancer is a multifactorial disease whose genetic susceptibility is related to polymorphic variants of cell proliferation and migration pathways. Variants in AXIN2 and TCF7L2 in the Wnt-ß catenin pathway have been associated with different types of cancer; however, little is known about its role in breast cancer. This study tests the hypothesis of links between AXIN2 rs1133683 and rs2240308, and TCF7L2 rs7903146 and rs12255372 variants in breast cancer. Methods: Peripheral blood samples were obtained from 404 women (202 patients and 202 control females). The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology was used to identify the gene variants. Results: The AXIN2 rs2240308 (C > T), and TCF7L2 rs7903146 (C > T) and rs12255372 (G > T) variants were associated with breast cancer and with age, TNM stage, and histologic-molecular subtype (p = 0.001). Likewise, the haplotype T-T in the TCF7L2 gene (rs7903146-rs12253372) was significantly related with breast cancer (OR = 2.66, 95%, CI = 1.64-4.30, p = 0.001). Conclusion: Our data show a link between AXIN2 rs2240308 and TCF7L2 rs7903146 and rs12255372 variants in breast cancer, and speculate this may be important in pathogenesis.

Evaluación radiográfica de la posición del túnel femoral y tibial en reconstrucción de ligamento cruzado anterior con técnica anatómica / Radiographic evaluation of femoral and tibial tunnel position in anterior cruciate ligament reconstruction with anatomic technique

Resumen: Introducción: En la reconstrucción de ligamento cruzado anterior se intenta reproducir ligamento nativo, realizar túneles independientes, optimizar los puntos de entrada y la efectividad de la anatomía; hacer mediciones radiográficas de rodilla, identificar la posición del túnel femoral y tibial en pacientes operados de reconstrucción de ligamento cruzado anterior con técnica anatómica. Material y métodos: Se identificaron pacientes en el período de Enero de 2018 a Diciembre de 2019. Se evaluaron de manera retrospectiva 98 pacientes. Mediciones radiográficas en fémur: se determinó el ángulo de inclinación del túnel, el sitio de inserción con respecto a la línea de Blumensaat y la distancia transósea. En tibia: la ubicación en porcentaje de la localización de platillo tibial en proyección anteroposterior y lateral, ángulo de túnel tibial. Resultados: Los pacientes postoperados fueron 98, masculinos (75.5%) y femeninos (24.5%). Postoperados en el año 2018 (57.15%) y en 2019 (42.85%). Rango de edad: el grupo afectado fue de 21-25 años, lado afectado: derecho en 57.15%. Mediciones radiográficas en fémur: el ángulo de inclinación del túnel fue de 45o, el porcentaje en la línea de Blumensaat fue de 20% y la distancia transósea fue 3.43 cm. En tibia la distancia porcentual en proyección anteroposterior fue de 44% y lateral de 28%. El ángulo en túnel tibial en proyección anteroposterior fue de 73º y lateral de 114º. Conclusión: La técnica anatómica es una buena opción para efectuar túneles con posición anatómica óptima. Realizar túneles independientes permite mejorar la cobertura de la huella anatómica normal, aumenta los grados y la inclinación de túneles y provoca lesiones agregadas.

Abstract: Introduction: Reconstruction of the anterior cruciate ligament attempts to reproduce the native ligament; make independent tunnels optimize the entry points and effectiveness the anatomy. Perform radiographic measurements of the knee, identify position of femoral and tibial tunnels in patients operated for reconstruction of anterior cruciate ligament with anatomical technique. Material and methods: Patients were identified in the period January 2018 to December 2019. 98 patients were retrospectively evaluated. Radiographic measurements in the femur, the inclination angle of the tunnel, the insertion site with respect to the Blumensaat line and the transosseous distance were determined. In tibia, the location in percentage of the tibial plateau location in anteroposterior and lateral view, tibial tunnel angle. Results: Postoperative patients were 98. (75.5%) male, female (24.5%). Postoperative in 2018 (57.15%) and 2019 (42.85%) Age range: affected group was 21-25 years, right side affected in 57.15%; Radiographic measurements in femur, the angle of inclination of the tunnel was 45o, percentage in the Blumensaat line was 20%, and the transosseous distance was 3.43 cm. In tibia the percentage distance in anteroposterior projection was 44%, and lateral 28%, The angle in tibial tunnel anteroposterior projection of 73 degrees, and lateral 114. Conclusion: The anatomical technique is a good option to perform tunnels with an optimal anatomical position. By making independent tunnels it allows to improve coverage of normal antomic footprint. Increases degrees and inclination of tunnels, causes added injuries.

Modelo de atención para el tratamiento de pacientes con osteoartritis del primer al tercer nivel / Model of care for the treatment of patients with osteoarthritis from the first to the third level

Resumen: Introducción: La osteoartritis en México es una de las 10 causas más frecuentes de discapacidad. El diagnóstico temprano y la detección de factores de riesgo son determinantes para el tratamiento. La organización institucional establece las pautas terapéuticas de acuerdo con cada nivel de atención, pero no se logra un manejo efectivo. Material y métodos: Se realizó un estudio prospectivo, piloto, de intervención, clínico conformado por pacientes diagnosticados con diferentes grados de osteoartritis de rodilla en el primer, segundo y tercer nivel de atención, con un modelo integrador que incluyó un grupo de profesionales para la intervención de la evaluación nutricional, fisioterapéutica, social y sicológica desde el primer nivel. Resultados: La intervención de un grupo de atención multidisciplinaria permite una correcta evaluación y asignación del nivel de atención optimizando los recursos humanos y materiales. La participación de diferentes disciplinas en nutrición, sicología, trabajo social, fisioterapia y rehabilitación modifica el estilo de vida global al involucrar a los propios pacientes en su tratamiento. El grupo de intervención tuvo mejoras en la escala de dolor análogo visual, arcos de movilidad, bajo índice de masa corporal y mejoría en el aspecto sicológico. Conclusiones: El modelo de atención propuesto demuestra que la implementación en la institución y en cada unidad clínica de atención debe considerarse para mejorar los resultados.

Abstract: Introduction: Osteoarthritis in Mexico is one of the ten most frequent causes of disability. Early diagnosis and detection of risk factors are determinant for treatment. The institutional organization establishes therapeutic guidelines according to each level of care, but effective management is not achieved. Material and methods: A prospective, pilot, interventional, clinical study was conducted, which included patients diagnosed with different degrees of knee osteoarthritis in the first, second and third level of care, with an integrative model that includes a group of professionals for the intervention of nutritional, physiotherapeutic, social and psychological evaluation from the first level. Results: The intervention of a multidisciplinary care group allows a correct evaluation and assignment of the level of care, optimizing human and material resources. The participation of different disciplines in nutrition, psychology, social work, physiotherapy and rehabilitation modifies the global lifestyle by involving the patients themselves in their treatment. The intervention group had improvements in the visual analog pain scale, mobility arcs, low body mass index and improvement in the psychological aspect. Conclusions: The proposed model of care demonstrates that implementation in the institution and in each clinical care unit should be considered to improve outcomes.

Noncoding RNAs as potential biomarkers for DIPG diagnosis and prognosis: XIST and XIST-210 involvement.

PURPOSE: Diffuse intrinsic pontine gliomas (DIPGs) are the most fatal primary brainstem tumors in pediatric patients. The identification of new molecular features, mediating their formation and progression, as non-coding RNAs (ncRNAs), would be of great importance for the development of effective treatments. METHODS: We analyzed the DIPGs transcriptome with the HTA2.0 array and it was compared with pediatric non-brainstem astrocytoma expression profiles (GSE72269). RESULTS: More than 50% of the differentially expressed transcripts were ncRNAs and based on this, we proposed a DIPGs ncRNA signature. LncRNAs XIST and XIST-210, and the HBII-52 and HBII-85 snoRNA clusters were markedly downregulated in DIPGs. qPCR assays demonstrated XIST downregulation in all non-brainstem astrocytomas, in a gender, age, and brain location-independent manner, as well as in DIPGs affecting boys; however, DIPGs affecting girls showed both downregulation and upregulation of XIST. Girls' with longer survival positively correlated with XIST expression. CONCLUSIONS: The involvement of ncRNAs in DIPGs is imminent and their expression profile is useful to differentiate them from non-neoplastic tissues and non-brain stem astrocytomas, which suggests their potential use as DIPG biomarkers. In fact, XIST and XIST-210 are potential DIPG prognostic biomarkers.

Eficacia del ácido tranexámico para la disminución de la transfusión de sangre alogénica en la artroplastía total de cadera / Effectiveness of tranexamic acid for decreased allogenic blood transfusion in total hip arthroplasty

Resumen: Introducción: La artroplastía total de cadera (ATC) puede causar una pérdida considerable de sangre. Para reducir la necesidad de transfusión de sangre se utilizan diversas técnicas preoperatorias como la administración de ácido tranexámico (ATX). Objetivo: Demostrar que el uso de ATX disminuye la necesidad de transfusión de sangre alogénica en pacientes operados de ATC. Material y métodos: estudio prospectivo, observacional, descriptivo, utilizado para observar la tasa de transfusión de sangre alogénica en pacientes a quienes se les practicó ATC primaria unilateral de Mayo de 2016 a Diciembre de 2017. A los pacientes incluidos en el estudio se les aplicó ATX preoperatoriamente, a las 24 horas se tomó una biometría hemática y se valoró la necesidad de transfusión sanguínea. Resultados: Se incluyó un total de 70 pacientes en el estudio. La Hb promedio postquirúrgica 11.7 mg/dl con un rango de 9.2 a 14.9 mg/dl y un Hto promedio de 37.1% con un rango de 30.2 a 44.2%. Ninguno de los pacientes requirió de transfusión de sangre alogénica. Conclusiones: En este estudio se demuestra cómo el ATX es una estrategia transoperatoria para reducir la necesidad de transfusión de sangre alogénica en pacientes a quienes se realiza una ATC primaria.

Abstract: Introduction: ATC can cause considerable blood loss. To reduce the need for blood transfusion, various preoperative techniques such as administration of tranexamic acid (ATX) are used. Objective: to demonstrate that the use of ATX decreases the need for allogeneic blood transfusion in patients operated on ATC. Material and methods: Prospective, observational, descriptive study, used to observe the allogeneic blood transfusion rate in patients who underwent unilateral primary ATC from May 2016 to December 2017. ATX was applied preoperatively and after 24 hours a blood count was taken and the need for blood transfusion was assessed. Results: A total of 70 patients were included in the study. The average postoperative Hb 11.7 mg/dl with a range of 9.2 to 14.9 mg/dl and an average Ht of 37.1% with a range of 30.2 to 44.2%. None of the patients required allogeneic blood transfusión. Conclusions: This study demonstrates how ATX is a transoperative strategy to reduce the need for allogeneic blood transfusion in patients undergoing primary ATC.

Hidden Costs in the Physiology of Argia anceps (Zigoptera: Coenagrionidae) due to Pollution.

Before a population becomes extinct, there are hidden costs in the physiology at the individual level that provide valuable insights into their condition. Here, we study two dams with one species in common (Argia anceps Garrison, 1996) to evaluate whether their physiological condition differed (total protein quantity, prophenoloxidase (proPO) and phenoloxidase (PO) activity, and protein carbonylation) during two consecutive years. The first dam, "El Gallinero" (contaminated, C), contains organic input from mines and agricultural activity, whereas the second, "Paso de Vaqueros" (non-contaminated, NC), is part of a biosphere reserve. Although at a phenological level, some physiological differences were observed (2012 vs 2013), individuals from the contaminated population had less total protein (2012, median = 1.815 µg/µL; 2013, 0.081 µg/µL) and more carbonylations in their proteins (2012, median = 19.00 nmol/mg; 2013, median = 121.69 nmol/mg) compared with the non-contaminated population (protein quantity in 2012, median = 3.716 µg/µL; 2013, median = 0.054 µg/µL; protein carbonylations in 2012, median = 0.00 nmol/mg; 2013, median = 99.44 nmol/mg). However, no significant differences were found in prophenoloxidase (C, median = 0.002 Vmax; NC, median = 0.002 Vmax) and phenoloxidase activity (C, median = 0.002 Vmax; NC, median = 0.001 Vmax). In addition, the biological oxygen demand (BOD) and Zn were more elevated in the C than NC population (C, BOD = 11.7, Zn = 0.17; NC, BOD = 8, Zn = 0.14). The results show that the impact of human activity can be observed not only through the extinction of species, but also at the physiological level of the individuals composing the populations through the evaluation of biomolecular damage, which can be observed at a much shorter scale compared with species extinction.

Prognostic factors in neoadjuvant treatment followed by surgery in stage IIIA-N2 non-small cell lung cancer: a multi-institutional study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

PURPOSE: To evaluate the prognostic factors associated with survival in patients treated with neoadjuvant treatment [chemoradiotherapy (CRT) or chemotherapy] followed by surgery (CRTS) in patients with stage IIIA-N2 non-small cell lung cancer (NSCLC). METHODS: A retrospective study was conducted of 118 patients diagnosed with stage T1-T3N2M0 NSCLC and treated with CRTS at 14 hospitals in Spain between January 2005 and December 2014. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was performed. RESULTS: Surgery consisted of lobectomy (74.5% of cases), pneumectomy (17.8%), or bilobectomy (7.6%). Neoadjuvant treatment was CRT in 62 patients (52.5%) and chemotherapy alone in 56 patients (47.5%). Median follow-up was 42.5 months (5-128 months). 5-year OS and PFS were 51.1% and 49.4%, respectively. The following variables were independently associated with worse OS and PFS: pneumonectomy (vs. lobectomy); advanced pathologic T stage (pT3 vs. pT0-pT2); and presence of persistent N2 disease (vs. ypN0-1) in the surgical specimen. CONCLUSIONS: In this sample of patients with stage IIIA-N2 NSCLC treated with CRTS, 5-year survival (both OS and PFS) was approximately 50%. After CRTS, the patients with the best prognosis were those whose primary tumour and/or mediastinal nodal metastases were downstaged after induction therapy and those who underwent lobectomy. These findings provide further support for neoadjuvant therapy followed by surgery in selected patients.

Impact of Cr(VI) on the oxidation of polyunsaturated fatty acids in Helianthus annuus roots studied by metabolomic tools.

The impact of Cr(VI) in sunflower roots has been studied, focusing on the oxidation of polyunsaturated fatty acids. Plants were grown hydroponically in the presence of 0, 1.0, 5.0 and 25 mgCr L-1. Methanolic root extracts were analyzed by capillary liquid chromatography coupled through negative electrospray ionization to a quadrupole-time of flight mass spectrometry (capHPLC-ESI-QTOF-MS). Using partial least squares algorithm, eighteen features strongly affected by Cr(VI) were detected and annotated as linoleic acid (LA), alpha-linolenic acid (ALA) and sixteen oxidation products containing hydroperoxy-, epoxy-, keto-, epoxyketo- or hydroxy-functionalities, all of them classified as oxylipins. Inspection of the MS/MS spectra acquired for features eluting at different retention times but assigned as a sole compound, confirmed isomers formation: three hydroperoxy-octadecadienoic acids (HpODE), two oxo-octadecadienoic acids (OxoODE) and four epoxyketo-octadecenoic acids (EKODE). Around 70% of metabolites in sunflower LA metabolic pathway were affected by Cr(VI) stress and additionally, four EKODE isomers not included in this pathway were found in the exposed roots. Among ALA-derived oxylipins, 13-epi-12-oxo-phytodienoic acid (OPDA) is of relevance, because of its participation in the activation of secondary metabolism. The abundances of all oxylipins were directly dependent on the Cr(VI) concentration in medium; furthermore, autooxidation of LA to HpODE isomers was observed after incubation with Cr(VI). These results point to the direct involvement of Cr(VI) in non-enzymatic oxidation of fatty acids; since oxylipins are signaling molecules important in plant defensive response, their synthesis under Cr(VI) exposure sustains the ability of sunflower to grow in Cr(VI)-contaminated environments.

[Review of femoral component with proximal metaphyseal reconstruction using allograft cortical struts in a multioperated patient. Case report]. / Revisión de componente femoral con reconstrucción metafisaria proximal con aloinjerto óseo en lajas en paciente multioperado. Reporte de caso.

INTRODUCTION: Periprosthetic hip fractures are those that occur at the femoral and acetabular level. These fractures are associated with a wide variety of problems such as comminution, loose of bone stock and loosening of the femoral stem. Treatment of these fractures has historically been associated with high rates of treatment failures, complications and unsatisfactory outcomes. OBJECTIVE: To present the clinical-radiographic case of the treatment of a periprosthetic hip fracture, with a femoral revision and metaphyseal reconstruction with cortical strut allograft and cerclage cables, in a multioperated patient. MATERIAL AND METHODS: We present the case of a patient with a dislocation of a revision total hip prosthesis with a periprosthetic fracture type B3 of the Vancouver classification, who underwent a revision of the femoral component and a proximal metaphyseal reconstruction of the femur with cortical strut allograft and cerclage cables. RESULTS: The patient had an adequate evolution at the postoperative year, walking with a cane, radiographic control with adequate congruence of the prosthetic components and data of consolidation of the fracture. DISCUSSION: In the treatment of periprosthetic fractures, reconstruction can be done with use of cortical strut allograft and cerclage cables, with good functional and radiological results.

INTRODUCCIÓN: Las fracturas periprotésicas de cadera son aquéllas que ocurren a nivel femoral y acetabular. A estas fracturas se asocia una amplia variedad de problemas como la conminución, la pérdida ósea y con frecuencia el aflojamiento del vástago femoral. El tratamiento de estas fracturas ha estado históricamente asociado a altas tasas de fracasos del tratamiento, de complicaciones y de resultados insatisfactorios. OBJETIVO: Presentar el caso clínico-radiográfico del tratamiento de una fractura periprotésica con revisión femoral y reconstrucción metafisaria con lajas de cortical y cables de acero en un paciente multioperado. MATERIAL Y MÉTODOS: Se presenta el caso de un paciente con luxación de prótesis total de cadera izquierda de revisión + fractura periprotésica Vancouver B3, a quien se le realiza revisión de componente femoral y reconstrucción metafisaria proximal de fémur con aloinjerto óseo en lajas y fijación con cables de acero. RESULTADOS: El paciente cursa con adecuada evolución al año de postoperado, deambulando con apoyo de bastón, control radiográfico y adecuada congruencia de los componentes protésicos y datos de consolidación de la fractura. DISCUSIÓN: En el tratamiento de las fracturas periprotésicas es posible recurrir a la reconstrucción mediante el uso de aloinjertos en laja de cortical, cerclados con cables de acero, con buenos resultados funcionales y radiológicos.

Neoadjuvant treatment followed by surgery versus definitive chemoradiation in stage IIIA-N2 non-small-cell lung cancer: A multi-institutional study by the oncologic group for the study of lung cancer (Spanish Radiation Oncology Society).

OBJECTIVES: The role of surgery in stage IIIA-N2 non-small cell lung cancer (NSCLC) is an actively debated in oncology. To evaluate the value of surgery in this patient population, we conducted a multi-institutional retrospective study comparing neoadjuvant chemoradiotherapy or chemotherapy plus surgery (CRTS) to definitive chemoradiotherapy (dCRT). MATERIAL AND METHODS: A total of 247 patients with potentially resectable stage T1-T3N2M0 NSCLC treated with either CRTS or dCRT between January 2005 and December 2014 at 15 hospitals in Spain were identified. A centralized review was performed to ensure resectability. A propensity score matched analysis was carried out to balance patient and tumor characteristics (n = 78 per group). RESULTS: Of the 247 patients, 118 were treated with CRTS and 129 with dCRT. In the CRTS group, 62 patients (52.5%) received neoadjuvant CRT and 56 (47.4%) neoadjuvant chemotherapy. Surgery consisted of either lobectomy (97 patients; 82.2%) or pneumonectomy (21 patients; 17.8%). In the matched samples, median overall survival (OS; 56 vs 29 months, log-rank p = .002) and progression-free survival (PFS; 46 vs 15 months, log-rank p < 0.001) were significantly higher in the CRTS group. This survival advantage for CRTS was maintained in the subset comparison between the lobectomy subgroup versus dCRT (OS: 57 vs 29 months, p < 0.001; PFS: 46 vs 15 months, p < 0.001), but not in the comparison between the pneumonectomy subgroup and dCRT. CONCLUSION: The findings reported here indicate that neoadjuvant chemotherapy or chemoradiotherapy followed by surgery (preferably lobectomy) yields better OS and PFS than definitive chemoradiotherapy in patients with resectable stage IIIA-N2 NSCLC.

Revisión de componente femoral con reconstrucción metafisaria proximal con aloinjerto óseo en lajas en paciente multioperado. Reporte de caso / Review of femoral component with proximal metaphyseal reconstruction using allograft cortical struts in a multioperated patient. Case report

Resumen: Introducción: Las fracturas periprotésicas de cadera son aquéllas que ocurren a nivel femoral y acetabular. A estas fracturas se asocia una amplia variedad de problemas como la conminución, la pérdida ósea y con frecuencia el aflojamiento del vástago femoral. El tratamiento de estas fracturas ha estado históricamente asociado a altas tasas de fracasos del tratamiento, de complicaciones y de resultados insatisfactorios. Objetivo: Presentar el caso clínico-radiográfico del tratamiento de una fractura periprotésica con revisión femoral y reconstrucción metafisaria con lajas de cortical y cables de acero en un paciente multioperado. Material y métodos: Se presenta el caso de un paciente con luxación de prótesis total de cadera izquierda de revisión + fractura periprotésica Vancouver B3, a quien se le realiza revisión de componente femoral y reconstrucción metafisaria proximal de fémur con aloinjerto óseo en lajas y fijación con cables de acero. Resultados: El paciente cursa con adecuada evolución al año de postoperado, deambulando con apoyo de bastón, control radiográfico y adecuada congruencia de los componentes protésicos y datos de consolidación de la fractura. Discusión: En el tratamiento de las fracturas periprotésicas es posible recurrir a la reconstrucción mediante el uso de aloinjertos en laja de cortical, cerclados con cables de acero, con buenos resultados funcionales y radiológicos.

Abstract: Introduction: Periprosthetic hip fractures are those that occur at the femoral and acetabular level. These fractures are associated with a wide variety of problems such as comminution, loose of bone stock and loosening of the femoral stem. Treatment of these fractures has historically been associated with high rates of treatment failures, complications and unsatisfactory outcomes. Objective: To present the clinical-radiographic case of the treatment of a periprosthetic hip fracture, with a femoral revision and metaphyseal reconstruction with cortical strut allograft and cerclage cables, in a multioperated patient. Material and methods: We present the case of a patient with a dislocation of a revision total hip prosthesis with a periprosthetic fracture type B3 of the Vancouver classification, who underwent a revision of the femoral component and a proximal metaphyseal reconstruction of the femur with cortical strut allograft and cerclage cables. Results: The patient had an adequate evolution at the postoperative year, walking with a cane, radiographic control with adequate congruence of the prosthetic components and data of consolidation of the fracture. Discussion: In the treatment of periprosthetic fractures, reconstruction can be done with use of cortical strut allograft and cerclage cables, with good functional and radiological results.

Reemplazo bilateral de rodilla / Bilateral total knee replacement

Resumen: La patología degenerativa bilateral en las rodillas es muy frecuente e incapacitante; el manejo que se ofrece en los casos avanzados es el reemplazo articular por medio de una prótesis. La afección bilateral y el dolor severo de la rodilla son comunes y su tratamiento definitivo puede ser de forma bilateral. Material y métodos: Se revisaron los expedientes de los primeros pacientes operados de reemplazos bilaterales de rodilla por nuestro grupo quirúrgico, entre los años 1993 y 1998. Resultados: El procedimiento fue realizado en 56 pacientes (112 rodillas) con rango de edad de 60 a 82 años, con enfermedad articular degenerativa (EAD). Los reemplazos se llevaron a cabo de tres formas: simultánea, consecutiva y en dos tiempos. Se analizan los resultados de cada método, sus ventajas y desventajas. Discusión: En nuestra serie, practicar los reemplazos totales de rodilla en forma consecutiva es el método que mejores resultados mostró y fue el más balanceado en sus ventajas y desventajas.

Abstract: Bilateral osteoarthrosis of the knee is very frequent and disabling; the treatment in severe cases is joint replacement. Bilateral condition and severe knee pain are common and the definitive treatment can be performed on both. Material and methods: We reviewed the records of the first patients undergoing bilateral total knee replacement by our surgical group, between 1993-1998. Results: The procedure was performed on 56 patients (112 knees) with degenerative joint disease; their age range was 60 to 82 years. The knee replacements were done either simultaneously, consecutively, or via two unique surgeries. The outcomes of each method were analyzed to assess its advantages and disadvantages. Discussion: Based upon the results of the study, we find that total knee replacements done consecutively provide the best results for patients suffering from articular degeneration.

Contribution of polymorphisms in the LEP, LEPR and RETN genes on serum leptin and resistin levels in young adults from Mexico.

Polymorphisms in the LEP (G-2548A and A19G), LEPR (A326G, A668G and G3057A) and RETN (C-420G and G+62A) genes were documented according to their association with alterations in biochemical parameters such as glucose, insulin and lipid profiles, along with serum leptin and resistin concentrations. The aim of the study was to establish any contribution of the G-2548A and A19G polymorphisms of the LEP gene, the A326G, A668G and G3057A polymorphisms of the LEPR gene, and the C-420G and G+62A polymorphisms of the RETN gene to serum leptin and resistin levels in Mexican young adults. Clinical and biochemical variables, serum leptin and resistin levels, and genotype profiles were analysed in 66 Mexican young adults. Seven polymorphisms in the LEP, LEPR and RETN genes were genotyped using polymerase chain reaction-restriction fragment length polymorphisms analysis. Individuals carrying allele 3057A of the G3057A polymorphism in the LEPR gene showed significantly higher leptin concentrations than those bearing the genotype G/G (43.78 ± 39.11 vs 28.20 ± 14.12 ng/mL; p = 0.021). There were no associations of serum leptin or resistin levels according to the genotype of the other six analysed polymorphisms. Our results suggest that the allele 3057A of the LEPR G3057A polymorphism contributes to increased serum leptin levels in Mexican young adults.

Protective role of +294 T/C (rs2016520) polymorphism of PPARD in Mexican patients with colorectal cancer.

PPARD encodes for peroxisome proliferator-activated receptor delta, which plays a significant role in controlling lipid metabolism, atherosclerosis, inflammation, cancer growth, progression, and apoptosis. Accumulated evidence suggests that the polymorphism rs2016520 in PPARD is associated with lipid metabolism, obesity, metabolic syndrome, and type 2 diabetes mellitus. The aim of this study was to determine whether the single nucleotide polymorphism +294T/C (rs2016520) in PPARD is associated with colorectal cancer (CRC) in the Mexican population. Genomic DNA from 178 CRC patients and 97 healthy blood donors was analyzed. The polymorphism was identified by the polymerase chain reaction-restriction fragment length polymorphism method. Results demonstrated that patients with the T/C genotype for the +294T/C (rs2016520) polymorphism present a protective role against CRC [odds ratio (OR) = 0.39; 95% confidence interval (CI) = 0.22-0.69; P = 0.0008]. This association was also evident for the T/C genotype in the stratified analysis by tumor-node-metastasis stages I+II (OR = 0.26, P = 0.0332) and III+IV (OR = 0.44, P = 0.0067). However, in the stratified analysis by tumor location, we observed an increased risk of rectal cancer (OR = 7.57, P = 0.0403) vs colon cancer (OR = 4.87, P = 0.234) in patients carrying the C/C genotype and under the dominant and recessive models of inheritance. In conclusion, for the first time, the association between the +294T/C (rs2016520) polymorphism and colorectal cancer has been studied in Mexican patients. Our results reveal that variations in PPARD may play a significant role in genetic susceptibility to colorectal cancer.

[Bilateral total knee replacement]. / Reemplazo bilateral de rodilla.

Bilateral osteoarthrosis of the knee is very frequent and disabling; the treatment in severe cases is joint replacement. Bilateral condition and severe knee pain are common and the definitive treatment can be performed on both. MATERIAL AND METHODS: We reviewed the records of the first patients undergoing bilateral total knee replacement by our surgical group, between 1993-1998. RESULTS: The procedure was performed on 56 patients (112 knees) with degenerative joint disease; their age range was 60 to 82 years. The knee replacements were done either simultaneously, consecutively, or via two unique surgeries. The outcomes of each method were analyzed to assess its advantages and disadvantages. DISCUSSION: Based upon the results of the study, we find that total knee replacements done consecutively provide the best results for patients suffering from articular degeneration.

La patología degenerativa bilateral en las rodillas es muy frecuente e incapacitante; el manejo que se ofrece en los casos avanzados es el reemplazo articular por medio de una prótesis. La afección bilateral y el dolor severo de la rodilla son comunes y su tratamiento definitivo puede ser de forma bilateral. Material y métodos: Se revisaron los expedientes de los primeros pacientes operados de reemplazos bilaterales de rodilla por nuestro grupo quirúrgico, entre los años 1993 y 1998. Resultados: El procedimiento fue realizado en 56 pacientes (112 rodillas) con rango de edad de 60 a 82 años, con enfermedad articular degenerativa (EAD). Los reemplazos se llevaron a cabo de tres formas: simultánea, consecutiva y en dos tiempos. Se analizan los resultados de cada método, sus ventajas y desventajas. Discusión: En nuestra serie, practicar los reemplazos totales de rodilla en forma consecutiva es el método que mejores resultados mostró y fue el más balanceado en sus ventajas y desventajas.

TCF7L2 and CCND1 polymorphisms and its association with colorectal cancer in Mexican patients.

Accumulative evidence suggests that alterations due to mutations or genetic polymorphisms in the TCF7L2 and CCND1 genes, which are components of the Wnt signaling pathway, contributes to carcinogenesis. The present study was designated to clarify whether common single nucleotide polymorphisms (SNPs) of the transcription factor 7- like 2 (TCF7L2) and cyclin D1 (CCND1) genes are associated with colorectal cancer risk in Mexican patients. A case-control study including 197 colorectal cancer patients and 100 healthy subjects was conducted in a Mexican population. Identification of polymorphisms was made by the polymerase chain reaction-restriction fragment length polymorphism methodology. The association was calculated by the odds ratio (OR) test. The results demonstrate that patients with the T/T genotype for the rs12255372 polymorphism of the TCF7L2 gene present an increased colorectal cancer risk (OR=2.64, P=0.0236). Also, the risk analysis for Tumor-Nodule-Metastasis (TNM) stage and tumor location showed association with this polymorphism under the over-dominant model of inheritance (OR=1.75, P=0.0440). A similar relation was observed for the genotype T/T of the rs7903146 polymorphism and the rectal location of cancer (OR=7.57, P=0.0403). For the rs603965 polymorphism of the CCND1 gene, we observed a protection effect for the colon cancer location under the dominant model (OR=0.49, P=0.0477). These results reveal a significant role of the analyzed polymorphisms in the TCF7L2 and CCND1 genes on the susceptibility or protection for developing colorectal cancer in the Mexican population.