[Low-cost reconstructive treatment after resection of distal radius giant cell tumor]. / Tratamiento reconstructivo de bajo costo tras resección de tumor de células gigantes de radio distal.

INTRODUCTION: giant cell tumor (GCT) is a benign intramedullary bone tumor that frequently arises at the ends of long bones. After the distal femur and proximal tibia, the distal radius is the third most affected site with particularly aggressive tumors. Our objective is the presentation of the clinical case of a patient diagnosed with distal radius GCT classified in grade III of Campanacci who received a treatment adjusted to her economic possibilities. CASE REPORT: a 47-year-old female, without economic solvency and with some medical service. Treatment included block resection, reconstruction with distal fibula autograft, and radiocarpal fusion with blocked compression plate. Eighteen months later, the patient had good grip strength (80% on the healthy side) and had fine motor function in the hand. The wrist presented stability with pronation of 85o, supination of 80o, flexion-extension of 0o and a score of 6.7 in the DASH functional outcomes assessment questionnaire. His radiological evaluation five years after his surgery continued with no evidence of local recurrence and pulmonary involvement. CONCLUSION: the result in this patient, together with the published data, indicate that the block tumor resection technique, plus distal fibula autograft and arthrodesis with blocked compression plate provide an optimal result of functionality for the grade III distal radial tumor at low cost.

INTRODUCCIÓN: el tumor de células gigantes (TCG) es un tumor óseo intramedular benigno que surge con frecuencia en los extremos de los huesos largos. Después del fémur distal y la tibia proximal, el radio distal es el tercer sitio más afectado con tumores, particularmente agresivos. Nuestro objetivo es la presentación del caso clínico de una paciente con diagnóstico de TCG de radio distal clasificada en grado III de Campanacci que recibió un tratamiento ajustado a sus posibilidades económicas. REPORTE DE CASO: paciente femenino de 47 años, sin solvencia económica y sin ningún servicio médico. El tratamiento incluyó resección en bloque, reconstrucción con autoinjerto de peroné distal y artrodesis radiocarpiana con placa de compresión bloqueada. Dieciocho meses después, la paciente presentaba una buena fuerza de prensión (80% respecto al lado sano) y tenía una función motora fina en la mano. La muñeca presentó estabilidad con pronación de 85o, supinación de 80o, flexión-extensión de 0o y una puntuación de 6.7 en el cuestionario de evaluación de resultados funcionales DASH. Su evolución radiológica a cinco años después de su cirugía continuó sin datos de recidiva local y afectación pulmonar. CONCLUSIÓN: el resultado en esta paciente, junto con los datos publicados, indican que la técnica de resección tumoral en bloque, más el autoinjerto de peroné distal y la artrodesis con placa de compresión bloqueada proporcionan un resultado óptimo de funcionalidad para el tumor radial distal grado III a bajo costo.

Use of Tithonia diversifolia (hemsl) A. Gray in the diet of growing lambs / [Uso de tithonia diversifolia (hemsl) A. Gray na dieta de cordeiros em crescimento]

Two assays were conducted to study the Tithonia diversifolia (Td) plant: (1) chemical analysis and in vitro dry matter digestibility (IVDMD) of plant parts and (2) productive performance of lambs fed a traditional diet or a Td diet (30% of Td plus 70% of the traditional diet). The plant parts studied were leaves (L), leaves and petioles (LP); and leaves, petioles and stems (LPS). Feed intake, weight gain and feed conversion were registered weekly during five weeks of experimentation. The L showed higher (P<0.05) crude protein content (26.7%) than LP and LPS (25.5 and 19.7%, respectively). Crude fiber (11.2%), neutral detergent fiber (45.4%), cellulose (16.9%) and hemicellulose (33.5%) were lower in L than in LP (12.5, 46.7, 18.0 and 35.7%, respectively) and LPS (22.6, 59.2, 27.0 and 43.5%, respectively). The L and LP showed the highest IVDMD (89.2 and 88.2%, respectively vs. 77.2% of LPS). The Td diet resulted in greater feed intake and weight gain and lower feed conversion than the traditional diet. Therefore, Tithonia diversifolia is a forage plant of good quality for lambs which does not affect the productive performance.(AU)

Dois ensaios foram realizados para estudar a planta de Tithonia diversifolia (Td): (1) análise química e digestibilidade in vitro da matéria seca (DIVMS) de partes de plantas e (2) desempenho produtivo de cordeiros alimentados com dieta tradicional ou dieta Td (30% de Td mais 70% da dieta tradicional). As partes vegetais estudadas foram folhas (L), folhas e pecíolos (LP); folhas, pecíolos e caules (LPS). O consumo de ração, o ganho de peso e a conversão alimentar foram registrados semanalmente, durante cinco semanas de experimentação. O L apresentou maior (P<0,05) conteúdo de proteína bruta (26,7%) que o LP e o LPS (25,5 e 19,7%, respectivamente). Fibra bruta (11,2%), fibra em detergente neutro (45,4%), celulose (16,9%) e hemicelulose (33,5%) foram menores em L do que em LP (12,5, 46,7, 18,0 e 35,7%, respectivamente) e LPS (22,6, 59,2, 27,0 e 43,5%, respectivamente). O L e o LP apresentaram o maior DIVMS (89,2 e 88,2%, respectivamente vs. 77,2% do LPS). A dieta Td resultou em maior consumo de ração e maior ganho de peso e menor conversão alimentar que a dieta tradicional. Portanto, Tithonia diversifolia é uma planta forrageira de boa qualidade para cordeiros que não afeta o desempenho produtivo.(AU)

Spectroscopic, photochromic and kinetic behavior of photo conversion of Aberchrome 540™ in an ionic liquid media.

The photo-bleaching reaction of the chemical actinometer, Aberchrome 540™, is reported for the first time in a series of ionic liquids (ILs). This fulgide in its C-form undergoes an opening reaction to yield its E-form, when it is irradiated with UV light at wavelengths >400 nm. The magnitude of bleaching was monitored spectrophotometrically and their kinetics evaluated, obtaining first-order rate constants (kobs). The results obtained in different ILs suggest that changes in the rate constants (kobs) of the opening reaction of Aberchrome 540™ are mainly governed by weaker interactions such as coulombic (π* parameter) and Van der Waals interactions (δH2, parameter). In addition, the photochemical fatigue resistance was also studied in ILs media and compared with conventional solvents (benzene, toluene, etc.). In particular, we found that three different tendencies dependent on the ILs used exist. The first group of ILs where the reversibility of the fulgide is favored (for example, [Bmim][BF4], [Bmim][PF6] and [Bmim][OTf]), behaviour similar to conventional solvents. The second group corresponds to ILs where photo reversibility is partial; and finally, other group of ILs that prevented photo reversibility. It is proposed that depending on the ILs used, the stabilization of different forms of the fulgide can be controlled, thus resulting important in terms of choosing the appropriate ILs for a specific photochemical reaction.

Intestinal anti-inflammatory effects of RGD-functionalized silk fibroin nanoparticles in trinitrobenzenesulfonic acid-induced experimental colitis in rats.

BACKGROUND: Current treatment of inflammatory bowel disease is based on the use of immunosuppressants or anti-inflammatory drugs, which are characterized by important side effects that can limit their use. Previous research has been performed by administering these drugs as nanoparticles that target the ulcerated intestinal regions and increase their bioavailability. It has been reported that silk fibroin can act as a drug carrier and shows anti-inflammatory properties. PURPOSE: This study was designed to enhance the interaction of the silk fibroin nanoparticles (SFNs) with the injured intestinal tissue by functionalizing them with the peptide motif RGD (arginine-glycine-aspartic acid) and to evaluate the intestinal anti-inflammatory properties of these RGD-functionalized silk fibroin nanoparticles (RGD-SFNs) in the trinitrobenzenesulfonic acid (TNBS) model of rat colitis. MATERIALS AND METHODS: SFNs were prepared by nanoprecipitation in methanol, and the linear RGD peptide was linked to SFNs using glutaraldehyde as the crosslinker. The SFNs (1 mg/rat) and RGD-SFNs (1 mg/rat) were administered intrarectally to TNBS-induced colitic rats for 7 days. RESULTS: The SFN treatments ameliorated the colonic damage, reduced neutrophil infiltration, and improved the compromised oxidative status of the colon. However, only the rats treated with RGD-SFNs showed a significant reduction in the expression of different pro-inflammatory cytokines (interleukin [IL]-1ß, IL-6, and IL-12) and inducible nitric oxide synthase in comparison with the TNBS control group. Moreover, the expression of both cytokine-induced neutrophil chemoattractant-1 and monocyte chemotactic protein-1 was significantly diminished by the RGD-SFN treatment. However, both treatments improved the intestinal wall integrity by increasing the gene expression of some of its markers (trefoil factor-3 and mucins). CONCLUSION: SFNs displayed intestinal anti-inflammatory properties in the TNBS model of colitis in rats, which were improved by functionalization with the RGD peptide.

Expanded criteria donors, histological scoring, and prolonged cold ischemia: impact on renal graft survival.

The use of expanded donors or kidneys with preexistent chronic damage remains controversial, but they offer the opportunity to expand the donor pool. We investigated the impact of these conditions as predictors of graft survival among a cohort of recipients with prolonged cold ischemia times and a high incidence of delayed graft function. We included 70 consecutive cadaveric kidney allografts implanted between 2001 and 2005, which had undergone an early graft biopsy. Delayed graft function was present in 84% of cases with moderate or severe preexistent chronic damage in 63% and 27% of biopsies, respectively, and acute rejection was diagnosed in 14.3% of overall cases. The graft survival was 73.3% at 48 months. Primary nonfunctioning kidneys were more frequent using kidneys from expanded compared with standard donors (20.0% vs 0.0%, P < .002). Multivariate analysis showed that only the donor condition (standard vs expanded) was independently associated with graft survival (hazard ratio: 0.12; 95% confidence interval: 0.01-0.87; P < .03). Our results suggested that the donor characteristics prevail over other variables to predict graft outcomes.

[Clinical usefulness of the reticulocyte hemoglobin equivalent in chronic hemodialysis patients]. / Utilidad clínica de la hemoglobina reticulocitaria equivalente en pacientes en hemodialisis crónica.

BACKGROUND: Iron deficiency is the main cause of failure to respond to erythropoietin (EPO) in haemodialysis patients. Several laboratory tests to detect the deficiency, ferritin and transferrin saturation (TSat) are the most commonly used but its limitations in this patient population are necessary to find other parameters to improve the identification of iron-deficient state. OBJECTIVE: To evaluate the ability of Reticulocyte Hemoglobin Equivalent (RET-He) to predict iron deficiency, taking as a reference standard to the increase of hemoglobin in response to iron intake. MATERIALS AND METHODS: 44 patients on chronic hemodialysis and fixed-dose EPO received 400 mg of intravenous iron. Were measured Hb, Ret-He, IRF, and ferritin prior to iron administration. After 20 to 30 days of completion of loading the patients were classified as responders if hemoglobin increased by at least 0.8 g / L and non-responders if this increase did not occur. RESULT: 25 patients were responders, the ROC curves analysis showed the Ret-He with the largest AUC of 0.862 similar to the AUC of 0.833 that showed the IST, but the first is more sensitive (72% CI 95%: 51-88% vs 52% 95% CI 31-72%) and similar specificity (94.7% CI 95%: 74-100% vs 100% 95% CI 82-100%). Ferritin AUC was 0.772 and finally the IRF AUC was 0.7. The Ret-He, to a cutoff of 29.5 pg was the best combination of sensitivity and specificity (72 and 94.7 respectively), and the sensitivity of the combination Ret-He/IST rose to 80% specificity 94.7%. CONCLUSIONS: According to these results it could consider to Ret-He and the Ret-He/IST combination of clinical utility for the identification of the iron deficit in patients in chronic haemodialysis.

Pandemic influenza A/H1N1 and organ donation.

One of the concerns regarding the pandemic of novel influenza A/H1N1 virus is its potential to hamper transplant programs if the decision is made that organs from donors with influenza A/H1N1 should not be used. Evidence of transmissibility through organ transplantation is speculative at best. We report the outcome of 2 kidney transplant recipients who received kidneys from the same deceased donor, in whom the diagnosis of infection by the novel virus became available only after engraftment. The donor also had received a complete course of antiviral treatment before donation. The recipients were transplanted at 2 different facilities and were managed differently. Neither recipient developed flu syndrome, and both had an uneventful outcome. It is possible to speculate that kidneys from donors who have had confirmed influenza A/H1N1 and who have received antiviral treatment can be safely used in transplantation.

Thrombophilic mutations: no association with thrombotic events in renal transplant recipients.

Factor V Leiden and mutation of prothrombin gene G20210A have been associated with poor results in the early post-kidney transplantation period. Its long-term importance in stable patients has yet to be evaluated. We studied the prevalence of these inherited mutations and their relationship to thrombotic events in 82 Argentine renal transplant recipients with adequate long-term kidney function. In aggregate, 7.2% of patients were carriers of these mutations; however, their presence did not show any association with thrombotic events or renal function alterations. The routine evaluation for these mutations does not seem to be cost-effective in renal transplant patients.

Propagation of a Brazilian isolate of Anaplasma marginale with appendage in a tick cell line (BME26) derived from Rhipicephalus (Boophilus) microplus.

Anaplasma marginale is a tick-borne pathogen of cattle responsible for the disease anaplasmosis. Data suggest that Rhipicephalus (Boophilus) microplus and R. annulatus may be the major tick vectors of A. marginale in tropical and subtropical regions of the world. In this work we demonstrated the first infection and propagation of a Brazilian isolate of A. marginale (UFMG1) in the BME26 cell line derived originally from embryos of R. (Boophilus) microplus. The establishment of A. marginale infection in a cell line derived from R. (Boophilus) microplus is relevant for studying the A. marginale/tick interface.

Renal transplantation in diabetic patients.

OBJECTIVE: Diabetes is one of the main causes of end-stage renal disease (ESRD) and admission to hemodialysis, and the demand for kidney transplantation in this population has increased. Our aim was to evaluate the clinical aspects and survival of diabetic patients with kidney transplants by comparing them with the nondiabetic population. MATERIALS AND METHODS: Patients transplanted during the period from 1994 to 2003 were evaluated for this study. The transplant and demographic characteristics were analyzed by the chi-square test and Student t test according to the type of variable. Kaplan-Meier curves and the log-rank test were used to evaluate the graft and patient survival. RESULTS: From a total of 523 consecutive renal transplants, 35 (6.6%) were diabetics who were older than nondiabetics (47 +/- 11 years vs 37 +/- 16, P < .002). Patients received immunosuppression with cyclosporine (84.3%), tacrolimus (11.2%), azathioprine (46.6%), mycophenolate mofetil (43.5%), and steroids (all patients). The diabetic patients had a higher percentage of living donors (33.5% vs 17.2%; P = .04). Graft survival rates at 1, 3, and 5 years were 82.7%, 70.9%, and 63.0% in the diabetic patients and 87.6%, 79.0%, and 72.5% (P = .6) in the nondiabetic patients. Patient survival at 5 years was 90.5% in diabetic patients vs 89.0% in nondiabetic patients (P = .9). CONCLUSIONS: No differences were found in our series in transplant complications or survival in the diabetic patients compared with the nondiabetic patients. Kidney transplants, even with living donors, must be offered to well-selected diabetic patients without reservations.

Effect of sewage sludge or compost on the sorption and distribution of copper and cadmium in soil.

The application of biosolids such as sewage sludge is a concern, because of the potential release of toxic metals after decomposition of the organic matter. The effect of application of sewage sludge (Sw) and compost (C) to the soil (S) on the Cu and Cd sorption, distribution and the quality of the dissolved organic matter (DOM) in the soil, was investigated under controlled conditions. Visible spectrophotometry, infrared spectroscopy, sorption isotherms (simple and competitive sorption systems), and sequential extraction methods were used. The E4/E6 (lambda at 465 and 665 nm) ratio and the infrared spectra (IR) of DOM showed an aromatic behaviour in compost-soil (C-S); in contrast sewage sludge-soil (Sw-S) showed an aliphatic behaviour. Application of either Sw or C increased the Cu sorption capacity of soil. The Cd sorption decreased only in soil with a competitive metal system. The availability of Cu was low due to its occurrence in the acid soluble fraction (F3). The Cu concentration varied in accordance with the amounts of Cu added. The highest Cd concentration was found in the exchangeable fraction (F2). The Sw and C applications did not increase the Cd availability in the soil.

Fatty acid composition of meat from typical lamb production systems of Spain, United Kingdom, Germany and Uruguay.

The fatty acid composition of commercial lambs from different production systems of Spain, Germany, United Kingdom and of two types of Uruguayan lambs (heavy and light) was studied. Concentrate fed lambs, as Spanish lambs, displayed the highest proportions of linoleic acid (C18:2), while Uruguayan lambs, reared under extensive grazing conditions, showed the highest proportions of linolenic acid (C18:3), due to the great concentration of this fatty acid in grass. German and British lambs, which were fed grass and concentrate, displayed intermediate proportions of linolenic acid (C18:3). Heavy Uruguayan lambs had higher intramuscular fat content (5.92%) than German (4.25%) and British (4.32%) lambs, and this content was twofold higher than light lambs (Spanish (2.41%) and light Uruguayan (3.05%)). Heavy Uruguayan, German and British lambs had a low polyunsaturated/saturated (P/S) ratio due to their high saturated fatty acid (SFA) content and proportion. Principal component analysis was performed to study the relationship between fatty acids. Spanish lambs were clearly separated from the other types and were situated close to the proportions of short chain and n-6 fatty acids and n-6/n-3 ratio in the data plot for fatty acid proportions. Light Uruguayan lambs were located close to long chain fatty acids, and heavy Uruguayan and British lambs were placed near the antithrombotic potential (ATT), stearic acid (C18:0), SFA and conjugated linoleic acid (CLA) proportions. German lambs were located between Spanish lambs and the other types.

Association study of the serotonin transporter gene polymorphism in obsessive-compulsive disorder.

The hypothesis implicating the serotonergic system in the pathophysiology of obsessive-compulsive disorder (OCD) is supported by the therapeutic efficacy of selective serotonin reuptake inhibitors (SSRIs). Since SSRIs act on the serotonin transporter (5-HTT), it has been suggested that the 5-HTT gene (SCL6A4) could be a good candidate for OCD. The SCL6A4 gene has a 44-bp insertion/deletion polymorphism in its promoter region (5-HTTLPR). Previous studies have revealed an association between OCD and the l allele. We analysed the 5-HTTLPR polymorphic system in 115 Mexican OCD patients and 136 controls. No significant association was found between l allele and OCD (chi2 = 1.54, d.f. = 1, p = 0.21). Furthermore, we assessed alternative methods that employ family-based designs in a sample of 43 trios. Haplotype-based haplotype relative risk and transmission disequilibrium analysis did not show a preferential transmission of l allele to OCD probands. Our results indicate the need to analyse larger samples using family-based methods.

Withanolides from Salpichroa origanifolia.

Five new withanolides, 5 alpha,6 alpha:22,26:24,25-triepoxy-16 alpha,26-dihydroxy-18(13-->17)-abeo-ergosta-2,13-dien-1-one (salpichrolide N, 1), 5 alpha,6 alpha:22,26:24,25-triepoxi-15 alpha,26-dihydroxyergosta-2,16-dien-1-one (salpichrolide L, 2), 5 alpha,6 alpha:22,26-diepoxi-24,25,26-trihydroxy-17(13-->18)-abeo-ergosta-2,13,15,17-tetraen-1-one (salpichrolide M, 3a), 5 alpha,6 alpha:22,25:22,26-triepoxy-24-hydroxy-17(13-->18)-abeo-ergosta-2,13,15,17-tetraen-1-one (salpichrolide J, 4), and 5 alpha,6 alpha:22,26-diepoxy-22,24,25-trihydroxy-17(13-->18)-abeo-ergosta-2,13,15,17-tetraen-1-one (salpichrolide K, 5), were isolated from the leaves of Salpichroa origanifolia and characterized by a combination of spectroscopic (1D and 2D NMR, MS) and chemical methods.

The evaluation of yeast derivatives as adjuvants for the immune response to the Bm86 antigen in cattle.

BACKGROUND: The Gavac vaccine against the cattle tick Boophilus microplus has proven its efficacy in a large number of controlled and field experiments. However, this vaccine could be further improved by searching for new alternative adjuvants that would induce a stronger long-lasting immune response. We conducted several experiments to assay the adjuvant effect of fractions of the recombinant yeast Pichia pastoris in mouse and cattle models. In previous experiments, the combination of the yeast membrane with saponin was the most effective formulation in stimulating the humoral immune response in mice, eliciting a response higher than Montanide 888. The response was predominantly of the IgG1 isotype. Here, we evaluated the response in cattle and compared the results with that obtained in mice. RESULTS: Bm86 on the membrane of P. pastoris plus saponin produced high antibody titers in cattle, though the protection level against tick infestations was lower when compared to Gavac, probably due to a decrease in the IgG1/IgG2 ratio. The predictive value of the mouse model was studied through correlation analysis between the isotype levels in mice and the efficacy of formulations in cattle. Good correlation was established between the level of antibodies in mice and cattle, and between the amount of anti -Bm86 IgG1 in mice and the degree of protection in cattle. CONCLUSION: Mouse model have the potential to predict immunogenicity and efficacy of formulations in cattle. These results also support the use of the yeast expression system for recombinant vaccine formulations, enabling the prediction of more cost--effective formulations.

[Medicine and history. Concerning of the case of a man with a tumour on his forehead]. / Medicina e historia. A propósito del caso de un hombre con un tumor en la frente.

This case report is about the sickness of a 59 year old priest, politician and war veteran who died in 1844. The case history is based on the detailed report of his doctor, gathered in a diary and later published. The collected clinical data relied exclusively on touch and observation. The patient's illness started with a painful lump on his forehead that was in part excised. Surgical exploration revealed a soft tissue mass that bled easily and involved the frontal bone. In the following months, the lesion, which had been treated with complex topical medications, became ulcerated and extended to the orbit and the chin. The patient died postrated and in severe undernutrition one year after the onset of the symptoms. The case discussion, presented in the format of a clinicopathological conference, concluded that a metastasis of a renal cell carcinoma or an osseous lymphoma were the more likely diagnoses.