Fracturas de acetábulo tratadas mediante osteosíntesis. Resultados a largo plazo / Surgical treatment of acetabular fractures. Long term outcomes

Resumen: Introducción: las fracturas de acetábulo constituyen entre el 0.3 y 0.6% total de fracturas observadas, siendo estás lesiones relativamente infrecuentes. Objetivo: evaluar los resultados clínico-radiológicos del tratamiento quirúrgico mediante osteosíntesis de fracturas acetabulares con un seguimiento mínimo de 11.5 años. El objetivo secundario fue determinar la tasa de fracaso de la cadera de estos pacientes e identificar los factores de riesgo implicados. Materia y métodos: analizamos retrospectivamente una muestra de 23 pacientes intervenidos de fractura acetabular mediante reducción abierta y fijación interna, con un seguimiento medio de 14 años (11.5-17.5). Clasificamos las fracturas según Judet y Letournel en simples y complejas. Analizamos la evolución clínica y radiológica de estos pacientes mediante la escala de Harris. Resultados: obtuvimos una puntuación media de 81.90/100, objetivamos mejores resultados en fracturas de trazo simple respecto a fracturas complejas (p = 0.027). Evidenciamos mejores resultados clínicos en los pacientes con una reducción anatómica de la fractura (86.9/100), respecto a los que no fue posible (74.38/100) (p = 0.033). Fue necesaria la reintervención con artroplastía por mala evolución clínica en tres pacientes (13%). Como predictores de mal pronóstico para el desarrollo de coxartrosis identificamos las fracturas complejas y la reducción no anatómica de la fractura (p < 0.05). Encontramos relación entre índice de masa corporal (IMC) > 30 con peores resultados funcionales (p = 0.151). Conclusiones: el tratamiento quirúrgico de pacientes tratados con fracturas acetabulares presenta buenos resultados clínicos y radiológicos a largo plazo. Como factores de riesgo para la progresión de coxartrosis con suficiente impronta clínica como para ser necesaria una artroplastía identificamos, las fracturas complejas, la reducción no anatómica y un IMC > 30.

Abstract: Introduction: acetabular fractures constitute between 0.3 and 0.6% of all observed fractures, being these injuries relatively infrequent. Objective: to evaluate clinical and radiological outcomes of surgical treatment of patients with acetabular fracture treated in our hospital with a minimal follow-up of 11.5 years. The secondary objective is to determine the rate of failure in the hip joint of these patients and establish risk factors that are involved. Material and methods: 23 patients with acetabular fractures that were treated by open reduction and internal fixation (ORIF) were retrospectively analysed. They were follow-up during an average of 14 years (range 11.5-17.5). Fractures were classified by Judet y Letournel as simple or complex. Clinical and radiological outcomes were analysed by Harris scale. Results: We obtained an average of 81.90/100 on the Harris scale, aiming at better outcomes on simple fractures compare to those that were complex (p = 0.027). Higher scores were also achieved on those patients with an anatomical reduction (p = 0.033). Three patients required revision and placement of a total arthoplasty (13%). However, patients with body mass index (BMI) > 30 tend to achieve poor clinical results (p = 0.151). Conclusions: ORIF may be suggested for acetabular fractures since good clinical and radiological outcomes were recorded on a long-term follow-up. Complex fractures, non-anatomical reduction and BMI > 30 were identified as risk factors to coxarthrosis progression.

Light-induced sexually active rams prevent the seasonal inhibition of luteinizing-hormone in ovariectomized estradiol-implanted ewes.

The effect of the continuous presence of sexually active Rasa Aragonesa rams on the plasma luteinizing-hormone (LH) concentrations of ewes was studied from November to May. Light-treated rams were rendered sexually active (SA rams) by exposure to 2 months of artificially long days (16 h light/8 h dark) in one of two groups from either 1 November (SAR1, n = 3) or 1 December (SAR2, n = 3). Rams (n = 6) in a Control group were kept under the natural photoperiod. Thirty ewes were ovariectomized in September and implanted with a subcutaneous implant (l = 15 mm) that contained estradiol-17ß. One group of ewes (SAR; n = 10) was housed with control rams from 1 October to 15 February before being housed with SAR1 rams from 16 February to 31 March, and with SAR2 rams from 1 April to 31 May. A second group of ewes (C; n = 10) remained with control rams throughout the experiment, and a third group was kept isolated from rams throughout the experiment (ISO; n = 10). Blood samples were collected weekly from November to May, and plasma LH concentrations were measured. In the breeding season (November-February), plasma LH concentrations of ewes did not differ significantly between groups (SAR: 2.00 ±â€¯0.34; C: 1.88 ±â€¯0.16; ISO: 1.67 ±â€¯0.51 ng/ml). From March to May (seasonal anestrus), however, LH plasma concentrations decreased in the C and ISO groups (1.30 ±â€¯0.20 and 0.48 ±â€¯0.04 ng/ml, respectively), but remained at the same level as in the breeding season in the SAR group (2.30 ±â€¯0.17 ng/ml; P < 0.001). Significant differences (P < 0.01) between groups were observed from March onwards: LH concentrations were highest in SAR ewes (P < 0.001) and lowest in the ISO ewes. In conclusion, the continuous presence of sexually active rams prevented the seasonal decrease in plasma LH concentrations, probably by preventing the seasonal negative feedback of estradiol on LH secretion.

Comparación de la conducta alimentaria en niños de diferentes establecimientos educacionales y estado nutricional / Comparison of food behavior among school children by educational establishment and nutritional status

RESUMEN La conducta alimentaria en escolares está dada por grandes cambios, en este periodo adquieren mayor relevancia los hábitos alimentarios que determinarán su alimentación futura. Objetivo: Comparar la conducta alimentaria en escolares de diferentes establecimientos educacionales según estado nutricional. Métodos: Estudio observacional transversal, se aplicó cuestionario de comportamiento de alimentación infantil a 270 madres/tutores de niños entre 6 a 8 años de colegios públicos, subvencionados y privados de Viña del Mar, Chile. Resultados: El 49,6% de los niños presentó mal- nutrición por exceso. Los niños con obesidad presentaron respuestas positivas a la ingesta alimentaria en situaciones de molestia, preocupación y enojo, no fueron exigentes al momento de introducir nuevos sabores y fueron rápidos para comer (p<0,05). Al diferenciar por establecimiento, sólo el colegio particular presenta diferencias entre los niños con distinto estado nutricional, tanto en dimensiones de sobre ingesta como de antiingesta (p <0,05). Conclusiones: Los escolares de 6 a 8 años no presentaron diferencias significativas en su conducta alimentaria, niños con obesidad se asociaron positivamente a conducta de proingesta. Los niños del colegio público mantuvieron la misma conducta alimentaria, independiente de su estado nutricional, evidenciando mayor riesgo a presentar malnutrición por exceso a futuro, a diferencia del colegio particular.

ABSTRACT Eating behavior in schoolchildren is marked by great changes. In this period, eating habits acquire greater relevance as they will determine future behaviors. Objective: To compare feeding behaviors among schoolchildren by school type and nutritional status. Methods: A cross-sectional observational study in which a child eating behavior questionnaire was applied to 270 mothers / guardians of children between 6 and 8 years from public, subsidized and private schools in Viña del Mar, Chile was conducted. Results: Nearly half (49.6%) of children had malnutrition due to excess. Children with obesity had positive responses to food intake in situations of discomfort, worry and anger, were not demanding when introduced to new flavors and were quick to eat (p <0.05). When comparing by establishment, differences between children by nutritional status were observed only in those attending private schools, in terms of excess-intake and anti-eating (p <0.05). Conclusions: Children from 6 to 8 years old did not present significant differences in their eating behavior, children with obesity reported pro-eating behavior. Children attending public schools maintained the same eating behavior, independent of their nutritional status, showing a higher risk of malnutrition due to excess in the future, unlike those attending private school.

Caracterización de la Lámpara Flash-LED: EBNeuro Usada para Adquirir Potenciales Evocados Visuales en Ratas / Characterization of the Flash-LED Lamp: EBNeuro Used to Acquired Visual Evoked Potentials in Rats

Resumen: La señal de la amplitud en análisis de Potenciales Evocados Visuales (PEVs) es una variable que depende del tipo y posición de los electrodos, de la fuente, del estímulo y por consecuente, de la intensidad luminosa por lo que es fundamental reportarla para cada diseño experimental y así, garantizar su reproducibilidad. El objetivo de este trabajo es caracterizar una lámpara con 96 LEDs para la adquisición de PEVs en ratas. Se midió la iluminancia y la intensidad luminosa promedio en un sistema espacial XYZ de 8 cm3 aplicable a un sistema estereotáxico para la fijación de ratas. Se realizaron desplazamientos cada 2 cm en cada plano. Se observó que debido a la distribución geométrica de los LEDs la distribución de la iluminancia no sigue la ley del inverso cuadrado, ya que aumenta conforme la lámpara se aleja. Finalmente, se seleccionó una coordenada para la colocación del ojo de la rata empleando una intensidad luminosa promedio para la adquisición del PEV de 1.043 cd e iluminancia de 128.77 luxes a una distancia ojo-lámpara de 9 cm. Una vez caracterizada la intensidad luminosa y de acuerdo con los PEVs obtenidos, esta lámpara puede utilizarse para estudios PEV en ratas en investigaciones posteriores.

Abstract: Signal amplitude for recordings of Visual Evoked Potentials (VEPs) is a variable dependent on the type and position of the electrodes, the source, the stimulus and consequently the luminous intensity; therefore, it is relevant to report it to assure experimental reproducibility. The objective of this work is to characterize flash lamp with 96 LEDs in order to perform the acquisition of VEPs in rats. We measure the illuminance and mean light intensity on space system XYZ of 8 cm3 corresponding to a stereotaxic frame for rodents. Displacements were performed every 2 cm in each plane. Because of the geometric distribution of the LEDs in the EBNeuro lamp the spatial distribution of illuminance does not follow the law of the inverse square, because the illuminance increases as the lamp goes away. Finally a spatial coordinate was selected for the rat eye positioning were the mean luminous intensity was 1.043 cd and 128.77 luxes of illuminance at an eye-lamp distance of 9 cm. According to the obtained VEPs and spatial characterization this lamp can be used for acquire of recordings PEV in rats for further investigations.

Effectiveness of a three-dimensional anorectal ultrasound in perianal Crohn's disease: incompatibility with clinical and surgical examinations.

PURPOSE: We have correlated the 3D anorectal ultrasound (3D ARU) findings with clinical examination and the surgical findings and examined its capacity to provide ancillary information, which potentially alters patient management. PATIENTS AND METHODS: This is a prospective analysis conducted at a tertiary academic hospital. A total of 95 patients were included. We screened for sphincter defects and the presence of perianal Crohn's disease (PACD)-related lesions. RESULTS: We performed 150 3D ARUs. Exploratory ultrasound coincided with the rationale for diagnosis in 67.7% of cases, and fistulae were detected in 79% of cases where there was clinical suspicion. Fistulae were associated with abscesses in 29 cases, and isolated abscesses were identified in 19 cases (17.7%), only 12 of which (63.2%) were clinically suspected. Sphincter defects were observed in 15 cases with 7 cases (77.8%) presenting with clinical fecal incontinence. The operative findings coincided with ultrasonographic findings in 81.3% of the analyzed cases. The inter-observer variability of endosonographic classification resulted in a kappa score of 0.86. Ultrasonographic data altered the therapeutic plan of management in 73 cases (48.6%). CONCLUSIONS: Three-dimensional ARU is accurate in the diagnosis of fistula type in PACD and in the delineation of ancillary suspected and unsuspected abscess collections. Its use impacts therapeutic management in about half the cases examined. A new ultrasonographic-based PACD classification system is presented which has high inter-observer agreement but which requires future prospective validation in clinical PACD patients.

Adhesion to brown trout skin mucus, antagonism against cyst adhesion and pathogenicity to rainbow trout of some inhibitory bacteria against Saprolegnia parasitica .

Biological control of saprolegniosis with bacteria might be an alternative to the use of chemical compounds. Among criteria for the selection of such bacteria are their absence of pathogenicity to fish and their ability to prevent adhesion of the pathogen to the skin mucus. The pathogenicity to rainbow trout of 21 bacterial isolates with in vitro inhibitory activity against Saprolegnia parasitica was studied. Fifteen of the isolates, identified as Aeromonas sobria, Pantoea agglomerans, Pseudomonas fluorescens, Serratia fonticola, Xanthomonas retroflexus and Yersinia kristensenii, were non-pathogenic when injected into rainbow trout. Their capacity to adhere to the skin mucus of male and female brown trout and to reduce the adhesion of S. parasitica cysts under exclusion, competition and displacement conditions was tested. The 15 bacterial isolates showed a low adhesion rate, ranging between 1.7% (for an A. sobria isolate) and 15.3% (a P. fluorescens isolate). This adhesion was greater in the case of mucus from male brown trout than from females. Similarities in the adhesion to male mucus and other substrates and correlation to that observed to polystyrene suggest that adhesion to skin mucus does not depend on the substrate. A high percentage (88.9%) of the S. parasitica cysts adhered to the skin mucus of male brown trout. Almost all of the bacteria reduced this adhesion ratio significantly under exclusion and competition conditions. However, only half of the isolates displaced cysts from skin mucus, and more bacterial cells were necessary for this effect. A novel method to study the adhesion of S. parasitica cysts to skin mucus of trout and their interactions with inhibitory bacteria is described.

Factores que influyen en la prevalencia de patologías bucales de tejidos blandos y duros de niños y adolescentes: revisión de la literatura / Factors affecting the prevalence of oral soft tissue pathology and hard of children and teens: literature review

El objetivo de este trabajo es hacer una revisión bibliográfica del tema, con el fin de actualizar los conocimientos relativos al mismo, considerando las variables involucradas y presentar una propuesta de línea de investigación, ya que como señalan algunos autores la edad pediátrica es una etapa de crecimiento rápido, desarrollo, de múltiples aptitudes en los campos de las áreas motoras, de la inteligencia, del lenguaje, de la personalidad y de la emocionalidad, por lo que constituye una edad crucial que requiere ser atendida eficazmente en la prevención de sus múltiples aspectos. La Organización Mundial de la Salud, (OMS), ha incrementado las recomendaciones epidemiológicas en los últimos años a este grupo poblacional, además los signos y síntomas de la mucosa bucal de los infantes pueden cambiar con la edad y son a menudo diferentes a las del adulto. Metodología: Se revisaron 34 publicaciones en revistas especializadas, todas referidas a escolares con edades comprendidas entre 6 y 14 años, aunque algunos se refieren a edades puntuales. Resultados: las patologías de los adolescentes difieren de la de los adultos, aunque existen pocas referencias; no hay acción definida en los planes y proyectos nacionales ni regionales para esta población; la mayoría de las patologías que ocurren en la cavidad bucal de esta población, son relativamente inocuas, no necesitan tratamiento, presentándose de forma asintomática y limitándose al desarrollo cronológico del niño. Conclusión: definir una línea de investigación, e incorporar la población de niños, niñas y adolescentes, por cuanto en Venezuela y América Latina, la investigación en esta área es limitada

The goal is to make a literature review of the subject, in order to update the knowledge relating to the subject, considering the variables involved and submit a proposal for a line of research, as some authors point out the Pediatric is rapid growth, development of multiple skills in the fields of motor areas, intelligence, language, personality and emotionality, for what constitutes a crucial age requiring to be dealt with effectively in the prevention of its multiple aspects. The World Health Organization, (who), the epidemiological recommendations has increased in recent years to this population group, also the signs and symptoms of the buccal mucosa of infants can change with age and are often different from the adult. Methodology: We reviewed 34 publications in specialized magazines, all relating to school children aged between 6 and 14 years old, although some refer to specific ages. Results: pathologies of adolescents differ from that of adults, although there are few references; There is no action defined in the plans and national and regional projects for this population; the majority of diseases that occur in the oral cavity of this population, are relatively harmless, do not need treatment, presenting of asymptomatic form and limited to the chronological development of the child. Conclusion: define a line of research, and to incorporate the population of children and adolescents, as in Venezuela and Latin America, research in this area is limited

Variación en expresión de marcadores moleculares entre componentes intraductal e infiltrante del carcinoma de mama / Variation in the molecular markets expressem between intraductal and infiltrant breast carcinoma

Valorar variación de expresión de marcadores moleculares entre componente intraductal y ductal infiltrante. Evaluamos expresión de biomarcadores moleculares RE, RP, p53, Her-2, Bcl2 en pacientes concarcinoma de mama, durante el período 1999-2006. La muestra conformada por 243 casos se seleccionó con criterios de inclusión: sexo femenino, diagnóstico histológico de carcinoma ductal infiltrante con componente intraductal. Promedio de edad 42,13 años, 48,14% menores de 50 años. Marcadores moleculares RE,RP, p53, Bcl2, Her-2, expresaron en ambos componentes del tumor en más del 70%, presentando expresión de cada uno diferencias, según tipo histológico. Bcl2, RE, RP y p53 fueron más positivos en el componente infiltrante que en intraductal, siendo significativa para RP (P=0,04) y proteína p53 (P=0,00001), Her-2/neu se observó más positivo en componente intraductal que en invasor (P=0,02). La intensidad del inmunomarcaje RP y p53 se expresaron con comportamiento de más ganancia que pérdida en tinción en componente infiltrante, contrario a lo observado para Her-2/neu. Correlación de expresión de marcadores moleculares entre ambos componentes histológicos y edad de paciente, el RE, RP, Bcl2 y proteína p53 se comportaron con ganancia en inmunomarcaje en componente infiltrante en mayores de 50 años, resultando significativa la asociación para RE (P=0,04). El análisis de variables del estudio no demostró asociación estadísticamente significativa. La variación de expresión de marcadores moleculares entre componente intraductal e infiltrante en carcinoma de mama se asocia al grado de malignidad de la lesión

To assess variation in expression of molecular markers between intraductal and infiltrating ductal. Evaluated expression of molecular biomarkers ER, PR, p53, Her-2, Bcl-2 in patients with breast cancer, during the period 1999 to 2006. 243 cases were selected according inclusion criteria: female gender, histological diagnosis of infiltrating ductal carcinoma with intraductal component. The average it was 42.13 years 48.14% of them were younger than 50 years. Molecular markers ER, PR, p53, Bcl2, Her-2 were expressed in both components in more than 70% cases, presenting the expression of individual differences, according to the histological type. The Bcl2, ER, PR, p53 were more positive in infiltrating intraductal component, difference being significant for RP (P = 0.04) and p53 (P = 0.00001), Her-2/neu more positive was observed in intraductal component than in invasive (P = 0.02). Considering intensity of PR and p53 immunostaining were expressed as a behavior more gain than loss of staining in invasive component, contrary to observed for Her-2/neu. Correlation of expression of molecular markers between the two histological components and age, ER, PR, Bcl2 and p53 protein behaved gain in immunostaining in invasive component in over 50 years, resulting significantly association to ER (P =0.04). Analysis of other variables showed no statistically significant association between them. The variation of the expression of molecular markers between the intraductal and infiltrating breast carcinoma is associated with the degree of malignancy of the lesion

Control of FLIP(L) expression and TRAIL resistance by the extracellular signal-regulated kinase1/2 pathway in breast epithelial cells.

Increased activation of the epidermal growth factor receptor (EGFR) is frequently observed in tumors, and inhibition of the signaling pathways originated in the EGFR normally renders tumor cells more sensitive to apoptotic stimuli. However, we show that inhibition of EGFR signaling in non-transformed breast epithelial cells by EGF deprivation or gefitinib, an inhibitor of EGFR tyrosine kinase, causes the upregulation of the long isoform of caspase-8 inhibitor FLICE-inhibitory protein (FLIP(L)) and makes these cells more resistant to the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). We demonstrate that the extracellular signal-regulated kinase (ERK)1/2 pathway plays a pivotal role in the regulation of FLIP(L) levels and sensitivity to TRAIL-induced apoptosis by EGF. Upregulation of FLIP(L) upon EGF deprivation correlates with a decrease in c-Myc levels and c-Myc knockdown by siRNA induces FLIP(L) expression. FLIP(L) upregulation and resistance to TRAIL in EGF-deprived cells are reversed following activation of an estrogen activatable form of c-Myc (c-Myc-ER). Finally, constitutive activation of the ERK1/2 pathway in HER2/ERBB2-transformed cells prevents EGF deprivation-induced FLIP(L) upregulation and TRAIL resistance. Collectively, our results suggest that a regulated ERK1/2 pathway is crucial to control FLIP(L) levels and sensitivity to TRAIL in non-transformed cells, and this mechanism may explain the increased sensitivity of tumor cells to TRAIL, in which the ERK1/2 pathway is frequently deregulated.

The therapeutic potential of TRAIL receptor signalling in cancer cells.

In tumour cells, activation of the apoptotic machinery by death receptor ligands of the tumour necrosis factor (TNF) receptor superfamily of cytokines represents a novel therapeutic strategy. However, systemic treatment of tumours with TNF-α and CD95 ligand may produce severe toxic effects. The tumour necrosis-related apoptosisinducing ligand (TRAIL) is a member of the TNF family capable of inducing apoptosis in a wide variety of cancer cells upon binding to pro-apoptotic receptors, while having no effect on the majority of normal human cells tested. Interestingly, preclinical studies in mice and nonhuman primates showed no systemic cytotoxicity upon injection of either recombinant TRAIL or agonistic TRAIL-receptor antibodies. Furthermore, these treatments have been shown to effectively suppress the growth of a range of tumour xenografts. Although unwanted effects of some TRAIL preparations have been reported in normal cells, the use of TRAIL receptor agonists could represent a suitable approach in cancer therapy. Here, we shall review our current understanding of apoptotic and non-apoptotic TRAIL signalling, the therapeutic potential of TRAIL-based approaches in cancer treatment, and the results of phase 1 and 2 clinical trials with recombinant TRAIL or agonistic TRAIL receptor antibodies, either as monotherapy or in combination with other chemotherapeutic agents.

The rabbit as an animal model for proctology research: anatomical and histological description.

PURPOSE: This study was designed to describe the surgical anatomy and histology of the rabbit anorectum comparing it to that of humans, in order to decide whether it can be a good experimental model for research in proctology. MATERIAL AND METHODS: This study of the anorectal region was performed on six female New Zealand white rabbits, weighting between 2.5-2.9 kg. An autopsy was performed immediately after sacrificing the animal and an anatomical and histological description was performed. RESULTS: The mean rectum and anal canal lengths were of 7.2 cm and 0.9 cm, respectively. The macroscopic study showed that the musculature of the anal canal is formed by the coccygeus muscle, which serves as puborectalis in humans. It also defined an external anal sphincter with a deep and superficial portion. The histological evaluation showed similarity to that of humans, with mucosa of simple columnar type, muscularis mucosae, a small submucosa, with a muscular wall divided into internal and external layers, separated by the myenteric plexus. CONCLUSION: The great similarity to both the anatomy and the histology of humans, appropriate size and easy-handling and care, make the rabbit an attractive animal for the use as experimental and research model in proctology.

Nutrition and health: guidelines for dental practitioners.

Good nutrition is vital to overall health, and poor diet and a sedentary lifestyle are major causes of morbidity and mortality worldwide. Nutritional factors are implicated in many oral and systemic diseases and conditions, including obesity, hypertension, dyslipidemia, type II diabetes, cardiovascular disease, osteoporosis, dental caries and some cancers including oral cancers. This review focuses on the evidence for the relations between key nutritional factors and health. Energy intake is related to body weight and obesity, highlighting the importance of lower-energy diets and regular physical activity for body weight maintenance and for preventing obesity. Evidence is presented for the health benefits of high quality carbohydrates, such as whole grain products, and fruits and vegetables, in reducing the risk of cardiovascular disease and cancer. The adverse effects of sugar, sweetened beverages, and trans and saturated fats on several diseases including caries, diabetes and cardiovascular disease are described. The health benefits of unsaturated fats, antioxidants, B vitamins and vitamin D in cardiovascular disease, periodontitis, cancer, and other conditions are documented. Both benefits and harmful effects of dairy product intake on health are discussed. Based on the evidence, nutritional guidelines are provided, as well as key recommendations for preventing obesity. Dentists can play a critical role in motivating and enabling healthy food choices.

[Intermediate-term outcome of glaucoma drainage devices]. / Resultados a medio plazo de los dispositivos de drenaje para glaucoma.

OBJECTIVE: To study the intermediate-term results of glaucoma drainage devices (DDG) with respect to control of intraocular pressure (IOP), control of glaucoma, and maintenance of pre-operative visual acuity. METHODS: This was a retrospective cohort study of 86 eyes in 77 patients in whom a DDG was implanted, using descriptive statistics and survival analysis. RESULTS: Success was achieved in 53 eyes (61.6%), complete (without treatment) in 34 eyes (39.5%) and qualified (needing treatment) in 19 eyes (22.1%). In the 33 eyes where the DDG treatment was unsuccessful, poor IOP control occurred in 13 eyes - (15.1%), and complications occurred in 20 eyes (23.2%) resulting in a severe reduction or loss of visual acuity (plate exposure, suprachoroidal hemorrhage, retinal detachment). IOP control was obtained in 66 eyes (76.7%), 47 of them without treatment (54.6%), although on 13 occasions the overall treatment failed due to complications occurring. Despite IOP control, glaucoma progression occurred in 7 eyes (8.1%). Preoperative vision was maintained in 46 eyes (53.5%), but decreased by 3 or more lines in 20 eyes (46.5%); bullous kerathopathy was the most frequent cause of the worsening. Loss of light perception occurred in 21 eyes (24.4%) and 4 eyes (4.6%) were eviscerated. CONCLUSIONS: DDG are an effective surgical option for control of IOP when conventional surgery has a poor prognosis, but they are associated with an increased risk of serious complications and loss of visual acuity in a significant proportion of cases.

Impact of calcium intake on body mass index in Venezuelan adolescents

The prevalence of overweight and obesity is increasing worldwide, affecting approximately 15% of adolescents in Venezuela, 17% in United States, and more than 30% in Mexico and Puerto Rico. Recent studies have shown that dietary calcium and dairy intake are associated with body fat. These studies show that a high calcium intake results in low body mass index (BMI). Therefore, the objective of the present study is to relate calcium intake from foods rich in calcium-rich foods to body weight and BMI in a random sample of 100 adolescents, aged 13-18 years. Anthropometric measurements (weight and height) were obtained for each participant, who also completed a food frequency questionnaire (FFQ), modified with calcium-rich foods. Dietary calcium consumption was 1076+/-534 mg/d among the adolescents, which represented an adequacy of 90%. A negative and significant association was found between calcium intake and BMI in the boys aged 13-15 years (r=-0.39, p<0.05). This population subgroup exhibited the widest range of BMI values among all groups evaluated. This correlation was not found among the older boys (aged 16-18 years) or girls, in which BMI was in the normal range and with relatively high calcium intake. In conclusion, we found that high calcium intake in younger boys was related to a lower BMI. A high calcium intake, not only helps to maintain a healthy body weight, but also is essential for acquiring peak bone mass in this crucial stage of life.

Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t(8;21) and inv(16)].

Most patients with acute myeloid leukemia (AML) and t(8;21) or inv(16) have a good prognosis with current anthracycline- and cytarabine-based protocols. Tandem analysis with flow cytometry (FC) and real-time RT-PCR (RQ-PCR) was applied to 55 patients, 28 harboring a t(8;21) and 27 an inv(16), including one case with a novel CBFbeta/MYH11 transcript. A total of 31% (n=17) of CR patients relapsed: seven with t(8;21) and 10 with inv(16). The mean amount of minimal residual disease (MRD) detected by FC in relapsed and nonrelapsed patients was markedly different: 0.3 vs 0.08% (P=0.002) at the end of treatment. The mean number of fusion transcript copies/ ABL x 10(4) also differed between relapsed and non-relapsed patients: 2385 vs 122 (P=0.001) after induction, 56 vs 7.6 after intensification (P=0.0001) and 75 vs 3.3 (P=0.0001) at the end of chemotherapy. Relapses were more common in patients with FC MRD level >0.1% at the end of treatment than in patients with < or = 0.1%: cumulative incidence of relapse (CIR) was 67 and 21% (P=0.03), respectively. Likewise, using RQ-PCR, a cutoff level of >10 copies at the end of treatment correlated with a high risk of relapse: CIR was 75% for patients with RQ-PCR >10 compared to 21% for patients with RQ-PCR levels < or = 10 (P=0.04). Combined use of FC and RQ-PCR may improve MRD detection, and provide useful clinical information on relapse kinetics in AML patients.

Adverse prognostic impact of CD36 and CD2 expression in adult de novo acute myeloid leukemia patients.

BACKGROUND AND OBJECTIVES: A consecutive series of acute myeloid leukemias (AML) patients was analyzed in conditions which reduce the inter-assay variations (the same flow cytometer, the same observers and the same panel of monoclonal antibodies) in order to investigate the prognostic information provided by flow cytometry. DESIGN AND METHODS: Two hundred and sixty-six bone marrow (BM) samples from 326 patients enrolled in the LMA-99 protocol from the CETLAM group were studied by multiparametric flow cytometry. Immunophenotyping studies were performed on erythrocyte-lysed BM samples. Antigen expression of leukemic cells was analyzed using triple stainings with fluorochrome-conjugated combinations of monoclonal antibodies. RESULTS: CD2 was positive in 21 cases (8%); an associated inv(16) was detected in eight CD2+ cases (38%). Two-year overall survival (OS) rate for CD2+/inv(16)+ patients was 75%, whereas it was 0% for CD2+/inv(16)- patients and 47% for CD2- patients (p=0.0001). CD36 was expressed in 37% of patients (n=98). Two-year leukemia-free survival (LFS) rate was 34% for CD36+ patients and 55% for CD36- patients (p=0.001). In the multivariate analysis, CD2+ (RR=8.4; p=0.0001) and adverse karyotype (RR=10.2; p=0.0001) were associated with a lower CR rate, CD36+ (RR=1.5; p=0.03), CD2+ (RR=2; p=0.04) and adverse karyotype (RR=4; p=0.0001) were associated with a lower OS and CD36+ (RR=2; p=0.002) and adverse karyotype (RR=3.5; p=0.005) predicted a lower LFS. CONCLUSIONS: CD2+ patients had a very poor OS when CD2/inv(16)+ cases were excluded. CD36 and CD2 expression at diagnosis can provide prognostically important information in adult de novo AML.