Estado actual de las terapias con células madre derivadas de tejido adiposo en elámbito de la Cirugía Plástica / The state of the adipose-derived stem cell therapies in Plastic Surgery

Durante la última década, la terapia celular ha emergido como una estrategia útil en el tratamiento de diversas enfermedades como la isquemia miocárdica y las fístulas en la enfermedad de Crohn; pero últimamente, hay también ya líneas de investigación centradas en su uso en reconstrucción mamaria, cuyos resultados van siendo publicados paulatinamente. Existen varios tipos de células madre adultas que han sido investigadas en estudios preclínicos y clínicos diseñados para este propósito: células de medula ósea, células del sistema circulatorio y mioblastos y, recientemente se está trabajando en una población de células madre en el tejido adiposo ,que presentan una fácil extracción y manipulación. Estas células son capaces de diferenciarse en múltiples líneas celulares, como los adipocitos y las células endoteliales entre otras. En el presente artículo, trataremos de hacer una revisión de los principios básicos de las células madre derivadas del tejido adiposo (tipos, características, procesos de obtención y multiplicación), los primeros estudios experimentales y los ensayos clínicos que están siendo realizados en la actualidad (AU)

Over the past decade, cell therapy has emerged as a new approach to reverse several diseases as myocardialischemia and fistula in Crohn disease; but lately new efforts are centered in breast reconstruction. Several types of adult stem cell have been studied in both preclinical and clinical condition for this purpose: bone marrow cells, circulating cells, and myoblasts. Recently the existence of a population of stem cells located in the adipose tissue has been observed. These cells are able to differentiate into multiple cell lineage including adipocytes and endothelial cells. In this review we discuss the basic principle of adipose-derived stem cell (types, characteristic, harvesting and expansion), the initial experimental studies and the currently on going clinical trials (AU)

Anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: relation with disease aggressiveness.

OBJECTIVES: To analyse the value of the anti-cyclic citrullinated peptide antibody (anti-CCP) in patients with rheumatoid arthritis (RA) as a prognostic factor, as well as its relationship with disease activity. METHODS: A cross-sectional study was made on 89 patients with RA. The following values were assessed: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-CCP, Disease Activity Score 28 (DAS 28), Modified Health Assessment Questionnaire score (M-HAQ) and simplified radiologic score of Sharp/Van der Heijde (SENS: simple erosion narrowing score). RESULTS: Sixty-four percent of the patients were anti-CCP positive, from which 36.8% were negative for RF. Among negative RF patients, 48.3% had anti-CCP antibody. The average value of DAS 28 in anti-CCP positive patients was 4.31 (SD 1.27) compared to 3.30 (SD 1.55) for anti-CCP negative (p 200 U/ml) had higher SENS (p < 0.05). There was no correlation between M-HAQ and anti-CCP. CONCLUSION: Prevalence of anti-CCP was higher among patients with higher activity. Patients with higher levels of anti-CCP antibody had more aggressive disease, with greater activity (elevated values in DAS 28 and CRP) and more severe radiological damage (more erosions and higher radiological damage, SENS).

[Efficacy of clopidogrel as ADP-dependent platelet aggregation inhibitor. Study on individuals with coronary artery disease]. / Eficacia del clopidogrel como inhibidor de la agregación plaquetaria dependiente de ADP. Un estudio en individuos con enfermedad arterial coronaria.

Acetyl-salicylic acid inhibits thromboxane A2 production and reduces the risk of vascular occlusive events by 20 to 25%. Ticlopidine inhibits ADP-dependent platelet aggregation and reduces the same risk by 30 to 35%, but produces some adverse effects. Clopidogrel is a ticlopidin-derived antiplatelet-drug, with the same mechanism of action; reduces the expression of the glycoprotein IIb/IIIa, the fibrinogen receptor on the platelet surface. Clopidogrel has the same clinical efficacy of ticlopidin and lowers the incidence of adverse effects. In this study, we evaluated the effects of one daily dosis of 75 mg of clopidogrel on platelet function in 33 subjects with coronary artery disease. Before treatment and after the 6th and 12th week, the following parameters were evaluated: 5 microM-ADP and 20 micrograms/mL collagen-induced platelet aggregation, bleeding time and fibrinogen concentration. In basal and in the 6th and 12th week samples, ADP-induced platelet aggregation was 90.7% +/- 13.2, 54.6% +/- 23.2 and 49.2% +/- 23.7 respectively, that represents a significant reduction of 38.6% and 44.4%. Reduction of collagen-induced platelet aggregation was not significative. Plasmatic fibrinogen did not suffer variation during treatment. Bleeding time was significant prolonged from 4.1 minutes to 15.4 and 14.6 minutes (3.7-3.5 times compared with the test before treatment). There were no haemorrhagic complications, only digestive discomfort in fewer than 3% of patients. We concluded that clopidogrel is a safe and efficacious drug for patients, it efficiently reduces ADP-induced platelet aggregation and prolongs bleeding time.

[Changes in valvular movements of the velopharyngeal sphincter after speech therapy in children with cleft palate. A videonasopharyngoscopic and videofluoroscopic study of multiple incidence]. / Cambios de los movimientos valvulares del esfínter velofaríngeo después de terapia de lenguaje en niños con paladar hendido. Un estudio videonasofaringoscópico y de videofluoroscopia de incidencia múltiple.

Thirty-one patients with surgically repaired cleft palate who had velopharyngeal deficiency and compensatory articulatory defects in comparison to hyperrhinophony were studied. All patients were submitted to a videonasopharyngescopic and videofluoroscopic study of multiple incidence before and after speech therapy in order to correct the compensatory articulation. The movement proportions of the pharyngeal velum structures increased significantly after the correction of the compensatory articulation. Even moreso, the size of the pharyngeal velum defect decreased significantly. The results of this study support the postulate which recommends that the articulatory abnormalities associated to hyperrhinophony should be corrected before surgery for pharyngeal velum insufficiency secondary to the closure of the cleft palate.