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1.
Anal Methods ; 15(45): 6177-6183, 2023 11 23.
Artículo en Inglés | MEDLINE | ID: mdl-37937436

RESUMEN

Hygrine and cuscohygrine, two coca leaf alkaloids, have been previously proposed as markers to differentiate legal and illegal cocaine consumption. This is a very common problem in some countries of South America, where the consumption of coca leaves has a long tradition. Analytical methods focusing on the assessment of coca leaf alkaloids, such as cuscohygrine, hygrine, tropacocaine and t-cinnamoylcocaine, in oral fluid are virtually non-existent in forensic toxicology laboratories worldwide due to their lack of application. However, the problem of differentiating legal and illegal cocaine use in criminal justice, DUID (drug-impaired driving) and WDT (workplace drug testing) programs is growing. Therefore, researchers are obliged to develop methods to measure coca leaf alkaloids (cuscohygrine, hygrine and t-cinnamoylcocaine) in biological matrices for further validation for routine analyses in forensic toxicology laboratories. This work aims to optimize a previously published separation method by protein precipitation in oral fluid by using solid-phase extraction (SPE) coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) operating in multiple reaction monitoring (MRM) mode. The use of SPE allowed the matrix effect and the background to be reduced in the chromatograms due to the obtained cleaner extracts. Consequently, improved detection and quantification limits were reached. Findings showed that the detection windows for coca leaf alkaloids were longer than three hours in real oral fluid samples from volunteers who drank a cup of coca tea. These detection windows are quite higher than those previously obtained when using the method based on separation by protein precipitation.


Asunto(s)
Alcaloides , Coca , Cocaína , Humanos , Coca/química , Cromatografía Liquida , Espectrometría de Masas en Tándem , Cocaína/análisis , Hojas de la Planta/química , , Extracción en Fase Sólida
2.
Injury ; 52 Suppl 4: S42-S46, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34030863

RESUMEN

INTRODUCTION: Basicervical femoral neck fracture is associated with high rates of failure due instability patterns, mainly collapse and rotational instability. The purpose of this study was to evaluate the clinical-radiological results of a group of patients with a bascervical proximal femoral fractures treated with Percutaneous Compression Plate (PCCP). MATERIAL AND METHODS: Among 5817 patients with a hip fracture who were admitted in our hospital from January 2005 to December 2017, 234 factures (4%) were diagnosed of basicervical femoral fracture. 30 of them were treated with a PCCP, 22 women and 8 men, mean age was 81.2 years (63-94). Demographic and perioperative variables were collected. The patients were followed up at 1, 3 and 6 months clinically and radiologically. RESULTS: There were no intra-operative complications and no conversions to open surgery. There was no early implant failure. No surgical wound infection was diagnosed. Crude mortality was 13% the first year and 87% were able to walk at the 6 months. The last follow-up x-rays revealed 97% fracture healing and the collapse at fracture site occurred in 4 hips. No instances of cut-out were observed. In one case, a fatigue failure of the lag screws of a PCCP plate was observed at 3 months from osteosynthesis. CONCLUSION: PCCP is an appropriated implant for basicervical femoral neck fractures.


Asunto(s)
Fracturas del Cuello Femoral , Fracturas de Cadera , Anciano de 80 o más Años , Placas Óseas , Femenino , Fracturas del Cuello Femoral/diagnóstico por imagen , Fracturas del Cuello Femoral/cirugía , Fijación Interna de Fracturas , Curación de Fractura , Humanos , Masculino
3.
Injury ; 52 Suppl 4: S76-S86, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33642084

RESUMEN

Fractures of the distal femur affect three different groups of individuals: younger people suffering high-energy trauma, elderly people with fragile bones and people with periprosthetic fractures around previous total knee arthroplasty. Main indications of intramedullary nailing are for supracondylar fractures type A or type C of the AO classification. The main objective of the present work is to analyze, by means of FE simulation, the influence of retrograde nail length, considering different blocking configurations and fracture gaps, on the biomechanical behavior of supracondylar fractures of A type. A three dimensional (3D) finite element model of the femur from 55-year-old male donor was developed, and then a stability analysis was performed for the fixation provided by the retrograde nail at a distal fracture with different fracture gaps: 0.5 mm, 3 mm y 20 mm, respectively. Besides, for each gap, three nail lengths were studied with a general extent (320 mm, 280 mm and 240 mm), considering two transversal screws (M/L) at the distal part and different screw combinations above the fracture. The study was focused on the immediately post-operative stage, without any biological healing process. In view of the obtained results, it has been demonstrated new possibilities of blocking configuration in addition to the usual ones, which allows establishing recommendations for nail design and clinical practice, avoiding excessive stress concentrations both in screws, with the problem of rupture and loss of blocking, and in the contact of nail tip with cortical bone, with the problem of a new stress fracture.


Asunto(s)
Fracturas del Fémur , Fijación Intramedular de Fracturas , Fracturas Periprotésicas , Anciano , Fenómenos Biomecánicos , Clavos Ortopédicos , Tornillos Óseos , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/cirugía , Humanos , Masculino , Persona de Mediana Edad , Fracturas Periprotésicas/cirugía
4.
Injury ; 52 Suppl 4: S37-S41, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33612250

RESUMEN

INTRODUCTION: Excellent results have been published in the treatment of the trochanteric fractures in the elderly with cephalomedullary nails or compression hip screws but not free of complications. The perforation of the lag screw through the superior cortex of femoral neck or head followed by rotation and varus collapse of the head-neck fragment, also known as cut-out, is one of them. Probably total hip arthroplasty is the most common solution, but there is no systematic technique for treatment. The objective of this study is to evaluate the results obtained in the treatment of this complication using a variable angle femoral plate. MATERIAL AND METHODS: This retrospective study concerns patients over 65 years with peritrochanteric fractures treated with cephalomedullary nail with cut-out failure solved by re-osteosyntesis with variable angle femoral plate between 1st January 2000 and 31 st December 2017. The series includes 29 patients, 26 women and 3 men with average age 87,3. Patients were followed up clinically and radiologically at regular intervals until fracture consolidation at least 9 months. RESULTS: No patients died at the first 9 months after surgery. Fracture mean consolidation has occurred in all patients in 14th weeks (6-20). Operative time was 93,2 minutes (62-129) including removal of nail. No intraoperative complications were observed. Five patients experienced medical complications and two had a superficial wound infection. The mean tip-apex distance (TAD) was 5mm (2-7mm). The neck-shaft angle was 127 degrees. The mean valgization achieved was 32 degrees (15-40). Only one patient needed a second revision surgery due to aseptic hip joint subluxation after 8 weeks of the surgery solved with total hip arthroplasty. CONCLUSIONS: The use of variable angle femoral plate in the cut-out treatment is an attractive option which allows the valgization of the fracture to virtually physiological limits and the placement of the cephalic screw in the most sutiable position with good outcomes and few complications.


Asunto(s)
Fijación Intramedular de Fracturas , Fracturas de Cadera , Anciano , Anciano de 80 o más Años , Clavos Ortopédicos , Femenino , Fracturas de Cadera/diagnóstico por imagen , Fracturas de Cadera/cirugía , Humanos , Masculino , Uñas , Estudios Retrospectivos , Resultado del Tratamiento
5.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33516655

RESUMEN

BACKGROUND AND OBJECTIVE: The aim of this study is to value whether patients who have suffered a hip fracture have a higher mortality than expected. MATERIAL AND METHODS: A prospective, observational study was carried out where patients with hip fracture were collected as a sample over a year. The study included 284 patients and a minimum follow-up was 2 years. The mean age of these patients was 84.26 years, with 21.48% (61/284) males and 78.5% (223/284) females. Survival and previous diseases that affect mortality, as risk factors, were collected and analyzed using the Kaplan-Meier method and the Cox regression model. Actual mortality was compared with that expected according to the Charlson Comorbidity Index, adjusted for age. RESULTS: Previous pathology was the main mortality factor, with heart disease being the most significant (OR 1.817, CI95%: 1.048; 3.149). The real mortality at one year of the sample was 22.5%, while the estimated annual mortality according to the Charlson Comorbidity Index was 29.68% (CI95%:44,36-15). CONCLUSIONS: Hip fracture does not cause an increase in mortality according to the Charlson Comorbidity Index estimate.

6.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32381394

RESUMEN

INTRODUCTION AND OBJECTIVES: Periprosthetic fractures after primary knee arthroplasty has great importance in our environment due to the increase in their incidence and to the challenge they pose to the surgeon. Multiple factors have been associated with its production. The objective of the study was to identify the risk factors that could influence the appearance of these fractures, which of them are all modifiable and generate a probability prediction model based on these factors. MATERIAL AND METHODS: Analytical, observational, retrospective, unpaired study of 38 cases of periprosthetic femoral knee fractures and 80 controls with knee prostheses. In total, 118 patients, 83 women and 35 men with a mean age of 72.49 years were included in the study. Sociodemographic data, medical history and drug consumption were collected, as well as those related to surgery. A univariate and bivariate analysis of the fracture determining factors was performed, using a logistic regression model to avoid confusion bias. RESULTS: Of all the factors studied according to the logistic regression model, it was obtained that female sex (OR = 7.6), dementia (OR = 5), motor/parkinson's alteration (OR = 19.3) and femoral overcut Previous (OR = 8.6) were factors associated with the increased risk of this type of fractures. CONCLUSIONS: This work allows us to conclude that there are risk factors such as female sex, dementia and parkinson's that increase the probability of periprosthetic fracture that are inherent to the patient and are not modifiable. However, there is any other totally modifiable that can be avoided by being demanding and thorough in the surgical technique, such as the anterior femoral overcut.

7.
Radiologia (Engl Ed) ; 62(4): 266-279, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32273126

RESUMEN

Breast implants are associated with well-known common complications that have been widely studied, such as rupture and capsular contraction. However, the increasingly growing number of patients with breast implants has led to the increased likelihood of coming across less common complications; these include seromas or late infection; adenopathies in the internal mammary chain; granulomas in the capsule of the implant, which in some cases can extend beyond the fibrous capsule; desmoid tumors associated with the implants; and breast implant-associated large cell anaplastic lymphoma. This article aims to review the main uncommon complications associated with breast implants and to describe and illustrate their findings in different imaging techniques. Proper management of these complications is important; this is especially true of late seroma and the diagnosis of breast implant-associated large cell anaplastic lymphoma for their repercussions.


Asunto(s)
Implantes de Mama/efectos adversos , Complicaciones Posoperatorias/etiología , Neoplasias de la Mama/etiología , Femenino , Fibroma/etiología , Granuloma de Cuerpo Extraño/etiología , Humanos , Linfoma Anaplásico de Células Grandes/etiología , Complicaciones Posoperatorias/diagnóstico por imagen , Geles de Silicona
8.
Lett Appl Microbiol ; 70(5): 380-387, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32048328

RESUMEN

Chitosan with higher molecular weight exhibited higher antimicrobial efficacy against foodborne pathogens. However, the poor water solubility of higher or medium molecular weight chitosan limits its applications. To overcome the challenge, our research team searched for simple preparation procedure for fast-dissolving medium molecular weight chitosan in water. Throughout the process, we were able to obtain a higher concentration of medium molecular weight water-soluble (MMWWS) chitosan (400 kDa). The MMWWS chitosan showed physicochemical properties that are suitable for edible coating. Antibacterial activities of 400-kDa chitosan coating prepared in acetic acid (1% v/v) or aspartic acid (1% or 3% w/v) were examined. The surface of catfish cubes was inoculated with six foodborne pathogens and then coated with chitosan solutions. The survival of each pathogen was evaluated during shelf life storage. Compared with the control, 3% w/v chitosan coating in aspartic acid solution exhibited the most effective antibacterial activities among other coating treatments, completely inhibiting Vibrio parahaemolyticus on the surface of catfish. The study suggested that chitosan dissolved in aspartic acid has the potential for use as an alternative antimicrobial coating for catfish fillet.


Asunto(s)
Antiinfecciosos/farmacología , Quitosano/farmacología , Conservación de Alimentos/métodos , Ictaluridae/microbiología , Animales , Antiinfecciosos/química , Ácido Aspártico/química , Quitosano/química , Películas Comestibles , Microbiología de Alimentos , Peso Molecular , Alimentos Marinos/microbiología
9.
Forensic Sci Int ; 297: 171-176, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30798102

RESUMEN

BACKGROUND: Hair analysis is a suitable way to discriminate between coca chewers and consumers of manufactured cocaine using the coca alkaloids hygrine (HYG) and cuscohygrine (CUS) as markers. In the present preliminary study it was examined whether CUS and HYG can be detected in hair of occasional and moderate coca chewers or coca tea drinkers, whether CUS and HYG appear in hair of PACO consumers (smoking coca paste waste), and whether anhydroecgonine methyl ester (AEME) is a useful cocaine smoking marker in this context. METHOD: Three groups were included: 10 volunteers from Buenos Aires with occasional or moderate chewing of coca leaves or drinking coca tea, 20 Argentinean PACO smokers and 8 German cocaine users. The hair samples (1-4 segments) were analyzed by a validated LC-MS/MS method for cocaine (COC), norcocaine (NC), benzoylecgonine (BE), ecgonine methyl ester (EME), cocaethylene (CE), cinnamoylcocaine (CIN), tropacocaine (TRO), AEME, CUS and HYG. For comparison, eight samples of coca leaves or coca tea were analyzed. RESULTS: Only low concentrations of COC were found in hair of seven occasional users of coca leaves or coca tea (0.010-0.051 ng/mg). For three moderate chewers of coca leaves all compounds were detected including AEME but except TRO. The hair samples of PACO smokers contained much higher concentrations of COC (0.027-341 ng/mg, mean 37.4 ng/mg) and its metabolites. CUS was not found in these samples but traces of HYG were seen in 8 of 37 hair segments. AEME as a marker for coca smoking was detected in hair of 15 smokers. In comparison to COC, the concentrations of EME and CIN were higher for PACO smokers than for German cocaine consumers. AEME (56 ± 20 µg/g) was detected in all coca leave and coca tea samples which explains the detection of this substance in hair of coca chewers. Therefore, its use for differentiation between coca chewers and PACO smokers is limited. CONCLUSION: CUS remains to be the most suitable marker in hair for chewing coca leaves or drinking coca tea more frequently than two times per month since it does not appear in hair of Argentinean PACO smokers and German cocaine users. Contrary to a previous proposal, the ratios CIN/COC and EME/COC appeared not to be applicable as criteria for this purpose because of the higher concentration of these alkaloids in hair of PACO smokers. More research is needed to assess the value of AEME in hair of South American coca leave or cocaine users.


Asunto(s)
Coca , Trastornos Relacionados con Cocaína/diagnóstico , Cabello/química , Detección de Abuso de Sustancias/métodos , Acetona/análogos & derivados , Acetona/análisis , Adolescente , Adulto , Biomarcadores/análisis , Cocaína/análogos & derivados , Cocaína/análisis , Femenino , Humanos , Masculino , Masticación , Persona de Mediana Edad , Hojas de la Planta , Pirrolidinas/análisis , Fumar , , Adulto Joven
10.
Semergen ; 45(2): 93-100, 2019 Mar.
Artículo en Español | MEDLINE | ID: mdl-30584031

RESUMEN

OBJECTIVE: To determine if the introduction of some referral criteria in the dermatology emergency department has changed the number of patients referred from the emergency department, as well as the type of diseases, and the profile of the patient who uses this service. MATERIAL AND METHODS: A cross-sectional study was conducted on all consecutive patients attended in the emergency department of the Hospital Príncipe de Asturias during a 31-day period from March 2015 to May 2015 and in the same period in 2016. Variables collected were: gender, age, days from the onset, day of the week, complementary diagnostic tests, referral, reason for consultation, diagnosis and group, whether or not they met the criteria, destination, and whether or not they had a previous appointment. RESULTS: A total of 525 patients were seen in dermatology emergency department in 2015, and 371 in 2016 (P<.001). Of the 896 patients seen 55.7% were women and 44.3% men (14.45 patients per day). A total of 121 diagnoses were made, with the most common being: other dermatitis, drug reactions, and atopic dermatitis. Only 32 pathologies made up 70% of the diagnoses. More than half (51.6%) did not meet the referral criteria. CONCLUSIONS: The introduction of referral criteria has led to a reduction of 30% in the number of patients in 2016. The main diagnoses in both groups were other dermatitis and drug reactions. The profile of the patient is in accordance with the description in the literature.


Asunto(s)
Enfermedades de la Piel/diagnóstico , Adolescente , Adulto , Anciano , Niño , Estudios Transversales , Urgencias Médicas , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Derivación y Consulta , Adulto Joven
11.
Artículo en Inglés, Español | MEDLINE | ID: mdl-29776890

RESUMEN

INTRODUCTION AND OBJECTIVES: Acetabular revision surgery is a challenge due to the appearance of bone defects that make primary fixation of implants difficult when extracting loosened components. Reinforcement rings, such as Burch-Schneider (BS), have been shown to be allies in moderate or severe bone defects. The objective of the study is to evaluate the results and survival of these types of implants in acetabular revision surgery in the medium follow-up. MATERIAL AND METHODS: Retrospective study on a cohort of 64 patients (67 replacements) with BS rings associated with morselized bone allografts in a 2 years minimum follow-up. Data were collected regarding clinical outcomes, graft incorporation, implant mobilization, survival and complications. RESULTS: The mean follow-up was 5.06 years (R=2.2-12). The Merle scale improved from 8 points to 15 points at the end of follow-up (P<.0001) with 76.11% of good or excellent results. Reproduction of the anatomical centre of rotation was associated with a better result (P<.05). There was total or subtotal incorporation of the bone allograft in 97% of the patients, although this did not prevent a significant migration of the ring according to Gill criteria in 6 cases. We observed an overall survival of the implant for any cause of 93.4% at 5 years, and 84.6% at 10 years. CONCLUSIONS: The BS reinforcement ring shows good results in the medium and long term enabling anatomical reconstruction in revision surgery as well as replacement of the bone stock. These results are also comparable and are a vast improvement on other rings.


Asunto(s)
Acetábulo/cirugía , Artroplastia de Reemplazo de Cadera/métodos , Trasplante Óseo/métodos , Reoperación/métodos , Acetábulo/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Trasplante Homólogo , Resultado del Tratamiento
12.
Acta ortop. mex ; 31(5): 222-227, sep.-oct. 2017. tab, graf
Artículo en Español | LILACS | ID: biblio-886571

RESUMEN

Resumen: Introducción: La reproducción de la correcta línea articular podría ser un buen índice para la obtención de resultados satisfactorios en la cirugía protésica de rodilla, aunque en la cirugía de revisión no se ha estudiado ampliamente. Es necesaria la búsqueda de un método sencillo y reproducible para evaluar esos resultados. Material y métodos: Se realizó un estudio retrospectivo entre Enero del 2000 y Diciembre del 2013. Se implantaron 97 artroplastías totales de revisión de rodilla. El grupo de estudio lo conformaron 67 pacientes. Para la realización de nuestro trabajo se evaluó la línea articular según el método descrito por Hofmann A. La evaluación de los resultados clínicos incluyó las siguientes variables primarias: flexión, extensión, rango de movimiento, WOMAC, SF-36, KSS (Knee Society Score) y KSS funcional. Se estudió la supervivencia de las artroplastías. Resultados: Las variables de flexión, extensión y rango de movimiento postoperatorio se correlacionaron estadísticamente con esta medición. El KSS se relacionó estadísticamente en su vertiente articular con la restauración de la línea articular. Para el resto de escalas, SF-36 y WOMAC, las puntuaciones fueron más altas pero no se correlacionó con la significación aceptada. Conclusión: Ante estos resultados podemos afirmar que la restauración de la correcta línea articular mejora los resultados clínicos de la cirugía de revisión de rodilla.


Abstract: Introduction: The reproduction of the anatomical joint line could be a good index to obtain good results in knee prosthesis surgery, although in revision surgery has not been enough studied. A search for a simple and reproducible method is needed to review these results. Material and methods: A retrospective study was conducted between January 2000 and December 2013. A total of 97 total revision knee arthroplasties were implanted. Finally, the study group consisted of 67 patients. To perform our study, the joint line was evaluated according to the method described by Hofmann A. The evaluation of the clinical results included the following main variables: Flexion, extension, range of motion, WOMAC, SF-36, KSS (Knee Society Score) and functional KSS. The survival of the arthroplasties was studied. (p = 0.05). Results: The variables of flexion, extension and range of postoperative movement are statistically correlated with this measure. The KSS was statistically related in its joint aspect with the restoration of the joint line. For the other scales, SF-36 and WOMAC, the figures were higher but did not correlate with the accepted p. Conclusion: In view of these results, we can say that the restoration of the anatomical joint line improves the clinical results of revision total knee arthroplasty.


Asunto(s)
Humanos , Calidad de Vida , Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Reoperación , Estudios Retrospectivos , Rango del Movimiento Articular , Articulación de la Rodilla
13.
Thorax ; 72(5): 415-423, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28137918

RESUMEN

RATIONALE: Reduced physical activity (PA) in patients with COPD is associated with a poor prognosis. Increasing PA is a key therapeutic target, but thus far few strategies have been found effective in this patient group. OBJECTIVES: To investigate the effectiveness of a 12-week semiautomated telecoaching intervention on PA in patients with COPD in a multicentre European randomised controlled trial. METHODS: 343 patients from six centres, encompassing a wide spectrum of disease severity, were randomly allocated to either a usual care group (UCG) or a telecoaching intervention group (IG) between June and December 2014. This 12-week intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualised daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. PA was measured using accelerometry during 1 week preceding randomisation and during week 12. Secondary outcomes included exercise capacity and health status. Analyses were based on modified intention to treat. MAIN RESULTS: Both groups were comparable at baseline in terms of factors influencing PA. At 12 weeks, the intervention yielded a between-group difference of mean, 95% CI (lower limit - upper limit; ll-ul) +1469, 95% CI (971 to 1965) steps/day and +10.4, 95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all p≤0.001). The change in 6-min walk distance was significantly different (13.4, 95% CI (3.40 to 23.5) m, p<0.01), favouring the IG. In IG patients, an improvement could be observed in the functional state domain of the clinical COPD questionnaire (p=0.03) compared with UCG. Other health status outcomes did not differ. CONCLUSIONS: The amount and intensity of PA can be significantly increased in patients with COPD using a 12-week semiautomated telecoaching intervention including a step counter and an application installed on a smartphone. TRIAL REGISTRATION NUMBER: NCT02158065.


Asunto(s)
Terapia por Ejercicio/métodos , Ejercicio Físico/fisiología , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Telemedicina , Anciano , Femenino , Grecia , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Pronóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Espirometría , Suiza , Resultado del Tratamiento , Reino Unido
14.
Acta Ortop Mex ; 31(5): 222-227, 2017.
Artículo en Español | MEDLINE | ID: mdl-29518296

RESUMEN

INTRODUCTION: The reproduction of the anatomical joint line could be a good index to obtain good results in knee prosthesis surgery, although in revision surgery has not been enough studied. A search for a simple and reproducible method is needed to review these results. MATERIAL AND METHODS: A retrospective study was conducted between January 2000 and December 2013. A total of 97 total revision knee arthroplasties were implanted. Finally, the study group consisted of 67 patients. To perform our study, the joint line was evaluated according to the method described by Hofmann A. The evaluation of the clinical results included the following main variables: Flexion, extension, range of motion, WOMAC, SF-36, KSS (Knee Society Score) and functional KSS. The survival of the arthroplasties was studied. (p = 0.05). RESULTS: The variables of flexion, extension and range of postoperative movement are statistically correlated with this measure. The KSS was statistically related in its joint aspect with the restoration of the joint line. For the other scales, SF-36 and WOMAC, the figures were higher but did not correlate with the accepted p. CONCLUSION: In view of these results, we can say that the restoration of the anatomical joint line improves the clinical results of revision total knee arthroplasty.


INTRODUCCIÓN: La reproducción de la correcta línea articular podría ser un buen índice para la obtención de resultados satisfactorios en la cirugía protésica de rodilla, aunque en la cirugía de revisión no se ha estudiado ampliamente. Es necesaria la búsqueda de un método sencillo y reproducible para evaluar esos resultados. MATERIAL Y MÉTODOS: Se realizó un estudio retrospectivo entre Enero del 2000 y Diciembre del 2013. Se implantaron 97 artroplastías totales de revisión de rodilla. El grupo de estudio lo conformaron 67 pacientes. Para la realización de nuestro trabajo se evaluó la línea articular según el método descrito por Hofmann A. La evaluación de los resultados clínicos incluyó las siguientes variables primarias: flexión, extensión, rango de movimiento, WOMAC, SF-36, KSS (Knee Society Score) y KSS funcional. Se estudió la supervivencia de las artroplastías. RESULTADOS: Las variables de flexión, extensión y rango de movimiento postoperatorio se correlacionaron estadísticamente con esta medición. El KSS se relacionó estadísticamente en su vertiente articular con la restauración de la línea articular. Para el resto de escalas, SF-36 y WOMAC, las puntuaciones fueron más altas pero no se correlacionó con la significación aceptada. CONCLUSIÓN: Ante estos resultados podemos afirmar que la restauración de la correcta línea articular mejora los resultados clínicos de la cirugía de revisión de rodilla.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Calidad de Vida , Humanos , Articulación de la Rodilla , Rango del Movimiento Articular , Reoperación , Estudios Retrospectivos
15.
Chem Commun (Camb) ; 51(45): 9366-9, 2015 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-25959229

RESUMEN

The intrinsic nonlinear photoluminescence (PL) property of chemically functionalized multi-walled nanotubes MWNTs (f-MWNTs) is reported in this study. f-MWNTs are imaged in fixed lung epithelial cancer cells (A549) and Kupffer cells in vitro, and in subcutaneously implanted solid tumors in vivo, for the first time, using multiphoton PL and fluorescence lifetime imaging (FLIM). Multiphoton imaging in the near-infrared excitation region (∼750-950 nm), employed in this study in a label-free manner, provides sensitivity and resolution optimal to track f-MWNTs within intra-cellular compartments and facilitates tumour imaging and sentinel lymph node tracking in vivo. Wider applications include employing this technique in live imaging of f-MWNTs in biological milieu to facilitate image-guided drug delivery.


Asunto(s)
Diagnóstico por Imagen , Sistemas de Liberación de Medicamentos , Nanotubos de Carbono/química , Animales , Línea Celular Tumoral , Neoplasias del Colon/diagnóstico , Humanos , Luminiscencia , Ratones
16.
J Appl Microbiol ; 117(2): 451-64, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24844932

RESUMEN

AIMS: The purpose of this study was to select autochthonous yeasts with metabolic ability to degrade L-malic acid for its potential use in young wine deacidification. METHODS AND RESULTS: Fifty seven Patagonian nonSaccharomyces yeast of oenological origin were identified by conventional molecular methods and tested in their capability to grow at the expense of L-malic acid. Only four isolates belonging to Pichia kudriavzevii species showed this property, and one of them was selected to continue with the study. This isolate, named as P. kudriavzevii ÑNI15, was able to degrade L-malic acid in microvinifications, increasing the pH 0·2-0·3 units with a minimal effect on the acid structure of wine. Additionally, this isolate produced low levels of ethanol, important levels of glycerol (10·41 ± 0·48 g l(-1) ) and acceptable amounts of acetic acid (0·86 ± 0·13 g l(-1) ). In addition, it improved the sensorial attributes of wine increasing its fruity aroma. CONCLUSIONS: The selection of yeasts for oenological use among nonSaccharomyces species led to the finding of a yeast strain with novel and interesting oenological characteristics which could have significant implications in the production of well-balanced and more physicochemical and microbiological stable young wines. SIGNIFICANCE AND IMPACT OF THE STUDY: The use of P. kudriavzevii ÑNI15 as mixed starter with S. cerevisiae would eliminate the cultural and cellar operations undertaken to adjust the musts acidity, therefore improving wine quality and reducing production costs.


Asunto(s)
Malatos/metabolismo , Pichia/metabolismo , Vino/microbiología , Fermentación , Concentración de Iones de Hidrógeno , Saccharomyces cerevisiae/metabolismo , Levaduras/aislamiento & purificación , Levaduras/metabolismo
17.
Forensic Sci Int ; 243: 30-4, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24656326

RESUMEN

The objectives of present work are twofold. First, we want to verify that hygrine and cuscohygrine are good markers to distinguish between chewing coca leaves and cocaine abuse. Secondly, we try to develop a quick and easy qualitative method to determine the two mentioned markers. We analyzed two kinds of urine samples: the first group consisted of twenty-four (24) subjects: urine samples were obtained from various types of workers (e.g. doctors, chemists, nurses, technicians, painters, contractors, employees and some retired persons) who admitted chewing coca leaves. Frequency of the habit of chewing coca leaves was variable. They practiced "coqueo" between two (2) and forty-four (44) years. Sixteen (16) of them used alkaline substances to enhance the extraction of cocaine from the leaves The second group of urine samples consisted on thirty-eight (38) cocaine abusers, from forensic cases from Spain and Argentina. A GC/MS qualitative method, performed after liquid-liquid extraction, was developed and validated (the parameters studied were selectivity/specificity, LOD and stability), and then applied to the urine samples. Hygrine and cuscohygrine are good markers to distinguish between chewing coca leaves and cocaine abuse, and the qualitative method presented can be used successfully in workplace drug testing and forensic cases.


Asunto(s)
Acetona/análogos & derivados , Coca/química , Trastornos Relacionados con Cocaína/diagnóstico , Hojas de la Planta/química , Pirrolidinas/análisis , Detección de Abuso de Sustancias/métodos , Acetona/análisis , Adolescente , Adulto , Anciano , Biomarcadores/orina , Trastornos Relacionados con Cocaína/orina , Femenino , Toxicología Forense , Cromatografía de Gases y Espectrometría de Masas , Humanos , Límite de Detección , Masculino , Masticación , Persona de Mediana Edad , Adulto Joven
18.
Neuroscience ; 247: 309-18, 2013 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-23742846

RESUMEN

Theiler's murine encephalomyelitis virus (TMEV) induces demyelination in susceptible strains of mice through a CD4(+) Th1 T cell-mediated immunopathological process. TMEV infection produces a syndrome in mice that resembles multiple sclerosis. In this work, we focused on the increased expression of the genes encoding voltage-gated Ca(2+) channel subunits in SJL/J mouse astrocytes infected in culture with a BeAn strain of TMEV. Affymetrix DNA murine genome U74v2 DNA microarray hybridized with cRNA from mock- and TMEV-infected astrocytes revealed the upregulation of four sequences encoding Ca(2+)-binding and Ca(2+) channel subunit proteins. The DNA hybridization results were further validated using conventional RT-PCR and quantitative RT-PCR, demonstrating the increased expression of mRNA encoding channel subunit proteins. Western blotting also showed the increased synthesis of L- and N-type channel subunit specific proteins after infection. The reduced expression and the functional upregulation of functional voltage-gated Ca(2+) channels in mock- and TMEV-infected cells, respectively, was demonstrated using voltage clamp experiments. TMEV infection in mouse astrocytes induced a Ca(2+) current with a density proportional to the amount of viral particles used for infection. The use of Ca(2+) channel blockers, nimodipine and ω-conotoxin-GVIA, showed that both functional L- and N-type Ca(2+) channels were upregulated in infected astrocytes. The upregulation of Ca(2+) channels in astrocytes after TMEV infection provides insight into the molecular processes and potential role of astrocyte Ca(2+) dysregulation in the pathophysiology of encephalomyelitis and is important for the development of novel therapeutic strategies leading to prevention of neurodegeneration.


Asunto(s)
Astrocitos/metabolismo , Astrocitos/virología , Canales de Calcio/biosíntesis , Poliomielitis/metabolismo , Theilovirus/patogenicidad , Regulación hacia Arriba/fisiología , Animales , Línea Celular , Células Cultivadas , Cricetinae , Ratones , Poliomielitis/fisiopatología , Poliomielitis/veterinaria
19.
Rev Esp Cir Ortop Traumatol ; 57(1): 38-44, 2013.
Artículo en Español | MEDLINE | ID: mdl-23594981

RESUMEN

INTRODUCTION: The development of one-day surgery units has shown to be a better use of health resources without reducing quality. The objective of this study was to evaluate the effectiveness and quality criteria of ambulatory surgery program in the Hallux valgus process. MATERIAL AND METHODS: A retrospective study was conducted on a sample of 753 patients who underwent a Hallux valgus process at our institution between 2002 and 2012 (292 in ambulatory surgery cohort and 461 in hospitalization group). The cost-process was evaluated using the Weighted Care Unitas a measuring unit. Secondary data were collected as regards discharge criteria and patient satisfaction. RESULTS: A significant difference was found between Weighted Care Unit spending on in-patient surgery and out-patient surgery. Both samples were comparable and no differences were found between diagnosis and intervention. The admission rate after ambulatory surgery was 2.39%, and the substitution index increased to 56.04%. The ambulatory surgery program was given a satisfaction rating of 84.6 out of 100. CONCLUSIONS: The results of our study indicate that it is possible to maximize the substitution index of the Hallux valgus process leading to a better use of resources and a high degree of patient satisfaction.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios/economía , Hallux Valgus/cirugía , Costos de la Atención en Salud/estadística & datos numéricos , Procedimientos Ortopédicos/economía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos Ambulatorios/normas , Niño , Análisis Costo-Beneficio , Estudios Transversales , Femenino , Hallux Valgus/economía , Hospitalización/economía , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Ortopédicos/normas , Satisfacción del Paciente/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Garantía de la Calidad de Atención de Salud , Estudios Retrospectivos , España , Resultado del Tratamiento , Adulto Joven
20.
Oncogene ; 32(6): 724-35, 2013 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-22430214

RESUMEN

Little is known about metastatic pathways that are specific to the lung rather than other organs. We previously showed that antioxidant proteins such as peroxiredoxins were specifically upregulated in lung metastatic breast cancer cells. We hypothesize that cancer cells that live under aerobic conditions, as might be the case in lungs, protect themselves against the damage caused by reactive oxygen species (ROS). To examine this hypothesis, we studied the role of peroxiredoxin-2 (PRDX2) in lung vs bone metastasis formation. A metastatic variant of MDA-MB-435 breast cancer cells that specifically metastasize to lungs (435-L3) was transduced with short hairpin RNAs to specifically silence PRDX2. Conversely, a bone metastatic variant of MDA-MB-231 cells (BO2) was stably transfected to overexpress PRDX2. The 435-L3 cells silenced for PRDX2 were significantly more sensitive to H(2)O(2)-induced oxidative stress than the parental and scrambled transfected cells. BO2/PRDX2 cells produced less ROS than BO2/green fluorescent protein control cells under oxidative stress. Moreover, PRDX2 knockdown inhibited the growth of 435-L3 cells in the lungs, whereas lymph node metastasis remained unaffected. In contrast, PRDX2 overexpression in bone metastatic BO2 breast cancer cells led to drastic inhibition of the skeletal tumor burden and reduction of bone destruction. Furthermore, PRDX2 expression in breast cancer cells was associated with a glucose-dependent phenotype, different from bone metastatic cells. Overall, our results strongly suggest that PRDX2 is a targetable 'metabolic adaptor' driver protein implicated in the selective growth of metastatic cells in the lungs by protecting them against oxidative stress.


Asunto(s)
Neoplasias de la Mama/patología , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/secundario , Estrés Oxidativo/genética , Peroxirredoxinas/fisiología , Estrés Fisiológico/genética , Neoplasias Óseas/secundario , Neoplasias de la Mama/genética , Línea Celular Tumoral , Femenino , Humanos , Peróxido de Hidrógeno/metabolismo , Neoplasias Pulmonares/genética , Metástasis Linfática , Transfección
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