Estudio comparativo radiológico y funcional del abordaje anterior directo versus abordaje posterolateral de cadera / Comparative study of radiological and functional outcomes following a direct anterior approach versus to a posterolateral approach to the hip

Objetivo: Realizar una comparación funcional y radiográfica de los resultados iniciales obtenidos con la utilización de los abordajes anterior directo (AAD) y posterolateral (PL) en la artroplastia total de cadera (ATC). Material y método: Estudio longitudinal prospectivo multicéntrico en 80 pacientes (80ATC). Cuarenta pacientes fueron intervenidos mediante AAD y 40 pacientes mediante abordaje PL. Se recogieron los siguientes parámetros clínicos: anestesia, abordaje, longitud de la incisión cutánea, duración de la cirugía, discrepancia de longitud, dolor, complicaciones, tiempo de ingreso, escala funcional de Harris (HHS) y satisfacción de los pacientes. En cuanto a los parámetros radiográficos, se recogieron ángulo de inclinación acetabular, anteversión acetabular, integración del cotilo, integración y orientación del vástago y longitud del miembro inferior. Resultados: Dolor postoperatorio: AAD 4puntos; PL 4,3puntos. Tamaño incisión: AAD14cm; PL 15cm. Duración media del ingreso hospitalario: AAD 2,8días; PL 3,4días. HHS a las 3semanas: AAD 87,5puntos, PL 84puntos; a los 2meses: AAD 92puntos, PL 91puntos. Se detectó hundimiento del vástago femoral en 4 pacientes AAD y en un paciente PL, y mala alineación en 9 casos del grupo AAD. Conclusiones: Nuestros resultados muestran una leve mejoría inicial del AAD en la recuperación funcional y en el dolor de los pacientes, lo que permite una menor estancia hospitalaria. Esta diferencia se compensa aproximadamente a los 2meses del postoperatorio. Asimismo, se ha detectado un mayor índice de complicaciones en el AAD con el uso de vástagos no cementados estándar

Objective: To compare clinically and radiologically the results obtained using both a direct anterior approach (DAA) and posterolateral (PL) approach in total hip arthroplasty (THA). Material and methods: Multicentric longitudinal prospective study in 80 patients (80 THA). Forty patients underwent total hip arthroplasty through DAA and 40 through a PL approach. The following clinical parameters were collected: anaesthesia, length of surgical incision, duration of the procedure, lower limb discrepancy, pain, complications, hospitalization time, Harris Hip Score (HHS) and subjective patient satisfaction. Radiological measures collected were acetabular tilt angle, acetabular component version, osteointegration and lower limb length. Results: Postoperative pain: DAA 4points; PL 4.3points. Incision length: DAA 14cm, PL 15cm. Mean hospital stay: DAA 2.8days, PL 3.4days. HHS at 3weeks: DAA 87.5points and PL 84points; at 2months: DAA 92points and PL 91points. Femoral stem subsidence was noticed in 4 patients from DAA and 1 from PL. Malalignment was reported in 9 cases from the DAA group. Conclusions: Our results show an initial advantage of the DAA group regarding functional recovery and pain that enabled shorter hospitalization time. This difference equalled out over 2months following the procedure. Likewise, we detected a greater complication rate in the DAA group using standard cementless stems

Comparative study of radiological and functional outcomes following a direct anterior approach versus to a posterolateral approach to the hip. / Estudio comparativo radiológico y funcional del abordaje anterior directo versus abordaje posterolateral de cadera.

OBJECTIVE: To compare clinically and radiologically the results obtained using both a direct anterior approach (DAA) and posterolateral (PL) approach in total hip arthroplasty (THA). MATERIAL AND METHODS: Multicentric longitudinal prospective study in 80 patients (80 THA). Forty patients underwent total hip arthroplasty through DAA and 40 through a PL approach. The following clinical parameters were collected: anaesthesia, length of surgical incision, duration of the procedure, lower limb discrepancy, pain, complications, hospitalization time, Harris Hip Score (HHS) and subjective patient satisfaction. Radiological measures collected were acetabular tilt angle, acetabular component version, osteointegration and lower limb length. RESULTS: Postoperative pain: DAA 4points; PL 4.3points. Incision length: DAA 14cm, PL 15cm. Mean hospital stay: DAA 2.8days, PL 3.4days. HHS at 3weeks: DAA 87.5points and PL 84points; at 2months: DAA 92points and PL 91points. Femoral stem subsidence was noticed in 4 patients from DAA and 1 from PL. Malalignment was reported in 9 cases from the DAA group. CONCLUSIONS: Our results show an initial advantage of the DAA group regarding functional recovery and pain that enabled shorter hospitalization time. This difference equalled out over 2months following the procedure. Likewise, we detected a greater complication rate in the DAA group using standard cementless stems.

A novel fibrotic disorder associated with increased dermal fibroblast proliferation and downregulation of genes of the microfibrillar network.

Clinical evaluation of a young woman with subcutaneous fibrotic nodules, progressive distal joint contractures and marfanoid stature revealed a previously unrecognized fibrotic disorder characterized by several unique phenotypic features and some features overlapping with known disorders. Mutational analysis of the FBN1 and FBN2 genes excluded Marfan syndrome and congenital contractural arachnodactyly. MMP2 gene sequence analysis excluded multicentric osteolysis, nodulosis and arthropathy. The lack of mutations within the MAGP2 gene also excluded an MAGP2-associated disorder. In order to establish the mechanistic basis for the severe skin pathology noted in this patient, we performed transcriptional profiling of dermal fibroblasts, and candidate gene expression studies in conjunction with immunocytochemistry and cell-based and functional assays. Data from these experiments have further excluded any previously recognized fibrotic disorder and identified a unique pattern of gene expression in this patient consistent with progressive fibrosis. The pathogenic mechanisms included persistent proliferation of dermal fibroblasts in coexistence with a disarray of the microfibrillar network. Collagen accumulation, moreover, could be linked to extensive crosslinking resulting from increased activities of lysyl oxidases (LOX and LOXL), and lack of remodelling due to deficiencies in collagenolytic matrix metalloproteinases. The disorder may represent a novel syndrome in which transforming growth factor-ß1-independent dermal fibrosis, unlike known microfibrillar disorders caused by single gene deficiencies, associates with a disarray of the microfibrillar network.

Hemodiálisis 4 díasa la semana: una alternativa eficaz en el control de la tensión arterial y en alcanzarel peso objetivo posterior a la diálisis / No disponible

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Respuesta clínica al tratamiento con iloprost en paciente con enfermedad por ateroembolismo de colesterol / No disponible

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Identification of genes related to germination in aged maize seed by screening natural variability.

Ageing reduces vigour and viability in maize inbred lines due to non-heritable degenerative changes. Besides non-heritable genetic changes due to chromosome aberrations and damage in the DNA sequence, heritable changes during maize conservation have been reported. Genetic variability among aged seeds of inbred lines could be used for association studies with seed germination. The objective of this study was to identify genes related to germination in aged seeds. The sweet corn inbred line P39 and the field corn inbred line EP44 were used as plant material. Bulks of living and dead seeds after 20 and 22 years of storage were compared by using simple sequence repeats (SSRs) and, when the bulks differed for a marker, the individual grains were genotyped. Differences between dead and living seeds could be explained by residual variability, spontaneous mutation, or ageing. Variability was larger for chromosome 7 than for other chromosomes, and for distal than for proximal markers, suggesting some relationships between position in the genome and viability in aged seed. Polymorphic SSRs between living and dead seeds were found in six known genes, including pathogenesis-related protein 2, superoxide dismutase 4, catalase 3, opaque endosperm 2, and metallothionein1 that were related to germination, along with golden plant 2. In addition, five novel candidate genes have been identified; three of them could be involved in resistance to diseases, one in detoxification of electrophillic compounds, and another in transcription regulation. Therefore, genetic variability among aged seeds of inbreds was useful for preliminary association analysis to identify candidate genes.

Resultados del proyecto de mejora de la calidad de la asistencia en hemodiálisis: estudio multicéntrico de indicadores de calidad de la Sociedad Española de Nefrología (SEN) / No disponible

Introducción: En el año 2002 se creó el grupo de trabajo sobre Calidad en Nefrología de la SEN (CNSEN). Los objetivos de este grupo han sido la identificación, difusión, implantación y consolidación de una herramienta de Gestión de la Calidad en Hemodiálisis, sistemática, objetiva y global, basada en la recopilación de Indicadores de Calidad, las estrategias de retroalimentación (Feedback) y Benchmarking,y el diseño de Planes de Mejora y Evaluación Global. El objetivo de este estudio es presentar los primeros resultados de los indicadores de calidad obtenidos en un grupo de centros españoles, así como evaluar la repercusión de la aplicación de las mencionadas técnicas en los resultados obtenidos. Métodos: Durante 2007 se ha ido incorporando al estudio un total de 28 unidades de hemodiálisis de todo el ámbito nacional. El número total de pacientes evaluados a lo largo del estudio ha sido 2516. Los indicadores han sido recogidos mediante un software informático específico de calidad, que permite calcularlos con facilidad. Los indicadores de cumplimiento se refieren a las siguientes áreas: adecuación de diálisis, anemia, metabolismo mineral y óseo, nutrición, enfermedades víricas, accesos vasculares, mortalidad, morbilidad (ingresos hospitalarios) y trasplante. Cada tres meses los centros reciben sus datos comparados con los del resto del grupo. Resultados: Se detectó una mejora de los resultados a nivel global, excepto en los niveles de hemoglobina. El porcentaje de centros que alcanzaron los estándares definidos por el CNSEN pasó del 65% al 90,9% en el caso del estándar de Kt/V Daugirdas II (> 1,3 en > del 80% de sus pacientes); del 71,4 % al 77,2 % en el caso del estándar de PTH (> 30% de sus pacientes con PTH entre 150 y 300 pg/ml); y del 42,8% al 63,5% en el caso del estándar de fósforo (> 75% de sus pacientes con fósforo < 5,5 mg/dl). Más del 50% de los centros mejoraron sus resultados con respecto al inicio del estudio en todas las áreas analizadas. Los centros que no obtuvieron una mejora en sus resultados partían de porcentajes de cumplimiento de los indicadores significativamente más altos que aquellos que si lograron mejorarlos (80,6 ± 15,4 versus 71,8 ± 16,6 respectivamente; p < 0,001). Conclusiones: Estamos avanzando en lo referente al conocimiento de los resultados de la hemodiálisis, aunque el trabajo pendiente todavía es extenso. La monitorización de indicadores de calidad respecto a un estándar, y su puesta en común con otros centros puede contribuir a la mejora de resultados y a la disminución en la variabilidad entre centros (AU)

Introduction: The Spanish Society of Nephrology «Quality in Nephrology Working Group» (QNWG) was created in 2002. The aims of this group are the identification, diffusion, implementation and consolidation of a systematic, objective and comprehensive set of quality performance measures (QPMs) to help along the improvement of patient care and outcomes on hemodialysis, by means of strategies of feedback and benchmarking, and the design of quality improvement projects. The objective of this study is to present the preliminary results of a set of quality performance measures obtained in a group of Spanish hemodialysis centers, as well as to evaluate the repercussion of the application of the aforementioned thecniques on the observed results. Methods: During 2007 a total of 28 hemodialysis units participated in the study; 2,516 patients were evaluated. A specific software was designed and used to facilitate the calculation of CPMs in each unit. The clinical indicators used refered to dialysis adequacy; anemia; mineral metabolisme; nutrition; viral infections; vascular access; mortality, morbidity (number and days of hospital admissions); and renal transplant. Every three months each center received its own data and its comparison with the rest of the group. Results: Except for hemoglobin levels we observed a global improvement. The percentage of centers reaching the stablished standards defined by the QNWG passed from 65% to 90.9% for Kt/V Daugirdas II (> 1.3 in > that 80% of the patients); from 71.4% to 77.2% for PTH (> 30% of patients with serum PTH between 150 and 300 pg/ml); and from 42.8% to 63.5% for phosphate (> 75% of patients with a serum phsphate < 5.5 mg/dl). More than 50% of centers showed an improvement in their final results as compared with their own initial results in all analyzed CPMs. Those centers that did not obtained an improvement in their results started the study with better percentages of acomplishment than those that showed a significant improvement in QPMs. (80.6 ± 15.4 versus 71.8 ± 16.6 respectively; p < 0.001). Conclusions: We are starting to make progresses in our knowledge of clinical results in our hemodialysis units, although there is still a long way to go over. To monitor and share CPMs results within hemodialysis centers might help to improve their results as well as to reduce intecenters variability (AU)

Mejoría de arritmias intradialíticas trasaplicación de perfiles combinados deconductividad y ultrafiltración sin expansión de volumen secundaria / No disponible

No disponible

[Preliminary results of the Spanish Society of Nephrology multicenter study of quality performance measures: hemodialysis outcomes can be improved]. / Resultados del proyecto de mejora de la calidad de la asistencia en hemodiálisis: estudio multicéntrico de indicadores de calidad de la Sociedad Española de Nefrología (SEN).

INTRODUCTION: The Spanish Society of Nephrology "Quality in Nephrology Working Group" (QNWG) was created in 2002. The aims of this group are the identification, diffusion, implementation and consolidation of a systematic, objective and comprehensive set of quality performance measures (QPMs) to help along the improvement of patient care and outcomes on hemodialysis, by means of strategies of feedback and benchmarking, and the design of quality improvement projects. The objective of this study is to present the preliminary results of a set of quality performance measures obtained in a group of Spanish hemodialysis centers, as well as to evaluate the repercussion of the application of the aforementioned thecniques on the observed results. METHODS: During 2007 a total of 28 hemodialysis units participated in the study; 2516 patients were evaluated. A specific software was designed and used to facilitate the calculation of CPMs in each unit. The clinical indicators used refered to dialysis adequacy; anemia; mineral metabolisme; nutrition; viral infections; vascular access; mortality, morbidity (number and days of hospital admissions); and renal transplant. Every three months each center received its own data and its comparison with the rest of the group. RESULTS: Except for hemoglobin levels we observed a global improvement. The percentage of centers reaching the stablished standards defined by the QNWG passed from 65% to 90,9% for Kt/V Daugirdas II (> 1,3 in > that 80% of the patients); from 71,4 % to 77,2 % for PTH (> 30 % of patients with serum PTH between 150 and 300 pg/ml); and from 42,8 % to 63,5 % for phosphate (> 75 % of patients with a serum phsphate < 5,5 mg/dl). More than 50% of centers showed an improvement in their final results as compared with their own initial results in all analyzed CPMs. Those centers that did not obtained an improvement in their results started the study with better percentages of acomplishment than those that showed a significant improvement in QPMs. (80,6+/-15,4 versus 71,8+/-16,6 respectively; p<0,001) CONCLUSIONS: We are starting to make progresses in our knowledge of clinical results in our hemodialysis units, although there is still a long way to go over. To monitor and share CPMs results within hemodialysis centers might help to improve their results as well as to reduce intecenters variability.

An 8-year evaluation of antibiotic consumption and antibiotic resistance among Streptococcus pneumoniae from in- and out-patients in Szeged, Hungary.

At the beginning of the 1990s, the prevalence of penicillin resistance of Streptococcus pneumoniae strains in Hungary was found to be extremely high (up to 58% non-susceptible) in some studies, while in other publications the percentage of penicillin highly resistant strains was 0-2%. To see whether this was due to differences in methodology or the composition of the patient population studied, a retrospective evaluation was carried out of the penicillin, amoxicillin, ceftriaxone and macrolide resistance of all S. pneumoniae strains isolated from in- and outpatients in our laboratory between 1998 and 2005. Of the 2670 S. pneumoniae isolates only 5.58% was found to exhibit high-level resistance to penicillin, while resistance to amoxicillin, ceftriaxone and erythromycin was 2.62%, 1.12% and 42.06%, respectively. During this period 6 (3.8%) of 155 S. pneumoniae strains isolated from invasive samples displayed high-level resistance to penicillin. Earlier surveillance data on penicillin resistance of S. pneumoniae may have been biased by the age groups affected by the infection, by whether the strain was isolated from an out-patient or an in-patient, and by whether the isolates were obtained from invasive samples. Our 8-year study using the NCCLS/CLSI methodology consequently revealed a low prevalence of high-level resistance to penicillin in S. pneumoniae strains obtained both from adults and children.

Assessment of in vivo effects of the prestige fuel oil spill on the mediterranean mussel immune system.

A laboratory experiment was carried out to study immune function alteration of the mussel Mytilus galloprovincialis when exposed to the Prestige oil spilled in November 2002 on the northwestern Spanish coast. Mussels were maintained for 4 months in tanks with flowing seawater and with 1, 2, and 0 kg (controls) Prestige fuel oil. Polycyclic aromatic hydrocarbon concentrations, which were determined in gills and digestive glands, were higher in digestive glands. The methylphenantrene and dibenzothiophene profiles confirmed the real exposure of mussels to the fuel oil. Immune data analysis revealed that no differences between fuel-treated and control animals were found in the cellular immune parameters measured (hemocyte viability, phagocytic activity, nitric oxide production, and chemiluminescence emission). In addition, histologic observations did not reveal tissue lesions in any of the samples, probably because of the short time of fuel-oil exposure. In contrast, significant differences were found in serum protein concentration and lysozyme activity between the fuel-treated mussels and controls. However, these humoral immune parameters were dependant on numerous environmental and physiologic factors, so it was difficult to ascertain the real effect of the fuel oil on their variability. Because hemocytes are the primary line of defense of bivalve mollusks, the results obtained in the present study suggest that the mussel immune system was not significantly affected by exposure to the Prestige fuel oil.

Evaluation of popcorn germplasm for resistance to Sesamia nonagrioides attack.

Popcorn adapted to Spanish conditions could be an interesting and profitable alternative to field corn. However, little is known about breeding popcorn germplasm for adaptation to Spain. Sesamia nonagrioides Lefèvbre is the main insect pest affecting popcorn quality and yield under Spanish growing conditions. The objectives of the study were the search for sources of resistance to S. nonagrioides among popcorn germplasm and to study the genetics of the resistance to S. nonagrioides attack. Eight breeding populations along with a five-inbred line diallel and two popcorn commercial checks were evaluated under S. nonagrioides infestation in 2 yr. Significant differences were found among general combining ability (GCA) effects for days to silking, S. nonagrioides tunnel length, general appearance of the ear, kernel moisture, and yield. Specific combining ability (SCA) effects were found to be significant for yield and ear damage. Therefore, heterotic patterns among popcorn materials should be taken into account to generate new popcorn hybrids that are not only more productive but also have higher kernel quality. Breeding popcorn populations BSP4APC0 and PSPW1C1 could be base germplasms in a breeding program for obtaining parental inbreds of healthy kernel popcorn hybrids. New inbred lines could be generated from the cross BP1 x BP2 that would have improved GCA and SCA effects for S. nonagrioides resistance when crossed to South American inbreds.

Molecular changes in the maize composite EPS12 during selection for resistance to pink stem borer.

The pink stem borer (Sesamia nonagrioides Lefèvbre) is the most important pest of maize (Zea mays L.) throughout the Mediterranean area. The maize composite EPS12 has been chosen as the base population for a breeding program based on its resistance to pink stem borer, with the main selection criterion being resistance to stem tunneling. Yield was taken as a secondary selection criterion to avoid any unwanted negatively correlated response on this character. The aims of investigation were: (1) to monitor the effects of selection for resistance to pink stem borer on allele frequency at 70 simple sequence repeat (SSR) markers and their impact on the genetic structure of EPS12 and (2) to identify loci at which allelic frequencies changed significantly due to directional selection. Genetic diversity was reduced during the selection process (as expected since random genetic drift as well as selection could reduce genetic variability), but not significantly so. Although the loss of genetic variation was generally consistent with that expected in a model in which random genetic drift acts alone on neutral alleles, the changes observed in the frequency of five alleles were significantly greater than expected. Further, the linear trend of the departure from the random genetic drift model was significant for some allelic versions of two SSR markers, umc1329 and phi076; directional selection was therefore acting on these loci. The significant effect of directional selection on those markers suggests the presence of quantitative trait loci (QTLs) for tunnel length and/or for yield under artificial infestation with Sesamia nonagrioides on the long arm of chromosome 4.

Performance of crosses among flint maize populations under infestation by Sesamia nonagrioides (Lepidoptera: Noctuidae).

Flint maize, Zea mays L., varieties provide some interesting agronomic characteristics and kernels that possess a better ability than other kernels for developing high-quality flour. The pink stem borer, Sesamia nonagrioides Lefebvre, is an important constraint for the maize crop in Mediterranean regions. The objective of this work was to identify a "flint x flint" heterotic pattern that would perform well under artificial infestation by S. nonagrioides. A 10-population diallel was evaluated under infestation by S. nonagrioides in 2 yr. Variety effects were the only significant effects involved in stem and ear resistance to S. nonagrioides attack. Variety effects and average heterosis effects were the only significant effects for grain yield under artificial infestation conditions. Considering variety effects and cross-performance, the heterotic pattern Basto/Enano levantixo x Longfellow (BA/EL x LO) would be recommended for obtaining flint maize hybrids tolerant to S. nonagrioides attack because BA/EL had the most favorable variety effects for stem resistance, LO exhibited the most positive variety effects for grain yield, and the cross BA/EL x LO yielded significantly more than the remaining crosses.

Resistance of early maturing sweet corn varieties to damage caused by Sesamia nonagrioides (Lepidoptera: Noctuidae).

In Mediterranean countries, the principal pest of maize, Zea mays L., is Sesamia nonagrioides Lefebvre. The objective of this work was to study the resistance of the four early maturing varieties of sweet corn, Baby Orchard, Orchard Baby, Dorinny Sweet, and Golden Early Market, and to check the relationship among resistance to S. nonagrioides and infestation dates. In a previous study, these varieties had showed a confusing behavior, being the most resistant varieties to S. nonagrioides attack in some environments and the most susceptible in others. These varieties were again evaluated along with three medium maturing varieties, used as testers because they were more stable in both environments, by using two infestation dates. Plants were more damaged in the late infestation, but the effect of the infestation depends on the variety studied. Orchard Baby and Baby Orchard were the most resistant varieties under two infestation dates. These two varieties are closely related. Therefore, we can use either one as a source of precocity and resistance for modern sweet corn. Although many studies showed that early maturing inbreds had greater damage caused by S. nonagrioides and European corn borer than late maturing inbreds and hybrids, our results showed that the earliest maturing varieties were the most resistant.

Evaluation of the European Union Maize Landrace Core Collection for resistance to Sesamia nonagrioides (Lepidoptera: Noctuidae) and Ostrinia nubilalis (Lepidoptera: Crambidae).

Two corn borer species are the principal maize insect pests in Europe, the European corn borer, Ostrinia nubilalis (Hübner), and the pink stem borer, Sesamia nonagrioides (Lefebvre). Hence, it would be advisable to evaluate the European maize germplasm for corn borer resistance to generate European varieties resistant to corn borer attack. The creation of the European Union Maize Landrace Core Collection (EUMLCC) allowed the screening of most of the variability for European corn borer resistance present among European maize local populations from France, Germany, Greece, Italy, Portugal, and Spain, testing a representative sample. The objective of this study was the evaluation of stem and ear resistance of the EUMLCC to European corn borer and pink stem borer attack. Trials were made at two Spanish locations that represent two very different maize-growing areas. Populations that performed relatively well under corn borer infestation for stem and ear damage were 'PRT0010008' and'GRC0010085', among very early landraces; 'PRT00100120' and 'PRT00100186', among early landraces; 'GRC0010174', among midseason landraces; and 'ESP0070441', among late landraces. Either the selection that could have happen under high insect pressure or the singular origin of determined maize populations would be possible explanations for the higher corn borer resistance of some landraces. Landraces 'PRT0010008', 'FRA0410090', 'PRT00100186', and 'ESP0090214' would be selected to constitute a composite population resistant to corn borers and adapted to short season, whereas populations 'ESP0090033', 'PRT00100530', 'GRC0010174', and 'ITA0370005' would be used to make a resistant composite adapted to longer season.