Valoración e indicaciones quirúrgicas: cirugía separación / Preoperative assessment and surgical indications: Separation surgery

La compresión neurológica se presenta entre el 10-20% de los pacientes que desarrollan una metástasis vertebral. En la última década, la evolución de las técnicas diagnósticas y médicas oncológicas, el cambio de la radiación convencional externa a la radiocirugía y los nuevos instrumentales quirúrgicos, han hecho que el tratamiento de estos pacientes deba de ser indicado de forma personalizada y en consenso, de forma multidisciplinar, en comisiones específicas.Hoy, el estado biológico del paciente, la presencia de inestabilidad mecánica, la valoración neurológica y el grado de compresión epidural, así como la mejor categorización pronóstica del tumor, se establecen como los factores de decisión previa a la indicación del tratamiento quirúrgico, tratamiento que ha pasado de un concepto «citorreductor» al de «separador» o «preparador» de la médula para asegurar una radiocirugía segura.(AU)

Neurological compression occurs in 10%-20% of patients who develop spinal metastases. In the last decade, the evolution of oncological diagnostic and medical techniques, the change from conventional external radiation to radiosurgery and the new surgical instruments have meant that the treatment of these patients must be indicated in a personalized manner and by consensus, multidisciplinary way, in specific commissions.Today, the biological state of the patient, the presence of mechanical instability, the neurological assessment and degree of epidural compression, as well as the best prognostic categorization of the tumor, are established as decision factors prior to the indication of surgical treatment, treatment that has passed from a cytoreductive concept to that of a spinal cord release from tumor in order to ensure safe radiosurgery.(AU)

[Translated article] Preoperative assessment and surgical indications: Separation surgery / Valoración e indicaciones quirúrgicas: cirugía de separación

La compresión neurológica se presenta entre el 10-20% de los pacientes que desarrollan una metástasis vertebral. En la última década, la evolución de las técnicas diagnósticas y médicas oncológicas, el cambio de la radiación convencional externa a la radiocirugía y los nuevos instrumentales quirúrgicos, han hecho que el tratamiento de estos pacientes deba de ser indicado de forma personalizada y en consenso, de forma multidisciplinar, en comisiones específicas.Hoy, el estado biológico del paciente, la presencia de inestabilidad mecánica, la valoración neurológica y el grado de compresión epidural, así como la mejor categorización pronóstica del tumor, se establecen como los factores de decisión previa a la indicación del tratamiento quirúrgico, tratamiento que ha pasado de un concepto «citorreductor» al de «separador» o «preparador» de la médula para asegurar una radiocirugía segura.(AU)

Neurological compression occurs in 10%-20% of patients who develop spinal metastases. In the last decade, the evolution of oncological diagnostic and medical techniques, the change from conventional external radiation to radiosurgery and the new surgical instruments have meant that the treatment of these patients must be indicated in a personalized manner and by consensus, multidisciplinary way, in specific commissions.Today, the biological state of the patient, the presence of mechanical instability, the neurological assessment and degree of epidural compression, as well as the best prognostic categorization of the tumor, are established as decision factors prior to the indication of surgical treatment, treatment that has passed from a cytoreductive concept to that of a spinal cord release from tumor in order to ensure safe radiosurgery.(AU)

[Translated article] Preoperative assessment and surgical indications: Separation surgery.

Neurological compression occurs in 10%-20% of patients who develop spinal metastases. In the last decade, the evolution of oncological diagnostic and medical techniques, the change from conventional external radiation to radiosurgery and the new surgical instruments have meant that the treatment of these patients must be indicated in a personalized manner and by consensus, multidisciplinary way, in specific commissions. Today, the biological state of the patient, the presence of mechanical instability, the neurological assessment and degree of epidural compression, as well as the best prognostic categorization of the tumor, are established as decision factors prior to the indication of surgical treatment, treatment that has passed from a cytoreductive concept to that of a spinal cord release from tumor in order to ensure safe radiosurgery.

Preoperative assessment and surgical indications: Separation surgery. / Valoración e indicaciones quirúrgicas: cirugía separación.

Neurological compression occurs in 10%-20% of patients who develop spinal metastases. In the last decade, the evolution of oncological diagnostic and medical techniques, the change from conventional external radiation to radiosurgery and the new surgical instruments have meant that the treatment of these patients must be indicated in a personalized manner and by consensus, multidisciplinary way, in specific commissions. Today, the biological state of the patient, the presence of mechanical instability, the neurological assessment and degree of epidural compression, as well as the best prognostic categorization of the tumor, are established as decision factors prior to the indication of surgical treatment, treatment that has passed from a cytoreductive concept to that of a spinal cord release from tumor in order to ensure safe radiosurgery.

Middle eastern genetic legacy in the paternal and maternal gene pools of Chuetas.

Chuetas are a group of descendants of Majorcan Crypto-Jews (Balearic Islands, Spain) who were socially stigmatized and segregated by their Majorcan neighbours until recently; generating a community that, although after the seventeenth century no longer contained Judaic religious elements, maintained strong group cohesion, Jewishness consciousness, and endogamy. Collective memory fixed 15 surnames as a most important defining element of Chueta families. Previous studies demonstrated Chuetas were a differentiated population, with a considerable proportion of their original genetic make-up. Genetic data of Y-chromosome polymorphism and mtDNA control region showed, in Chuetas' paternal lineages, high prevalence of haplogroups J2-M172 (33%) and J1-M267 (18%). In maternal lineages, the Chuetas hallmark is the presence of a new sub-branching of the rare haplogroup R0a2m as their modal haplogroup (21%). Genetic diversity in both Y-chromosome and mtDNA indicates the Chueta community has managed to avoid the expected heterogeneity decrease in their gene pool after centuries of isolation and inbreeding. Moreover, the composition of their uniparentally transmitted lineages demonstrates a remarkable signature of Middle Eastern ancestry-despite some degree of host admixture-confirming Chuetas have retained over the centuries a considerable degree of ancestral genetic signature along with the cultural memory of their Jewish origin.

Interpretation of the LHCb P_{c}(4312)

We study the nature of the new signal reported by LHCb in the J/ψp spectrum. Based on the S-matrix principles, we perform a minimum-bias analysis of the underlying reaction amplitude, focusing on the analytic properties that can be related to the microscopic origin of the P_{c}(4312)^{+} peak. By exploring several amplitude parametrizations, we find evidence for the attractive effect of the Σ_{c}^{+}D[over ¯]^{0} channel, which is not strong enough, however, to form a bound state.

Analysis of 21 X-chromosome polymorphisms in urban and rural populations in Salta province (north-western Argentina).

Population genetic data for 21 X-chromosome markers (Alu insertions and STRs) are reported for two populations (rural and urban) in Salta province (north-western Argentina). New variants are described, confirming the complexity and variability of some markers in this set. Results reveal Salta populations harbor a high Native American component, despite their self-recognized European ancestry. Notwithstanding the high genetic similarity of both populations, the rural sample seems to have maintained a larger Amerindian legacy. Data further show these X-linked markers, especially STRs, are highly informative in Salta populations and, therefore, can contribute to the development of a local database for forensic purposes in north-western Argentina.

Direct Li+ incorporation during the anodic formation of compact TiO2 layers.

In this work, compact titanium oxide layers are formed by anodization in 1 M H3PO4 aqueous electrolyte containing LiClO4. Elastic Recoil Detection Analysis (ERDA) measurements demonstrate that incorporation of lithium ions occurs during anodization, and cell-voltage transient measurements evidence the different electronic properties of Li-doped TiO2 layers. The mechanism of direct incorporation of Li during the fabrication of TiO2 layers is discussed.

Accuracy of octa-polar bioelectrical impedance analysis for the assessment of total and appendicular body composition in children and adolescents with HIV: comparison with dual energy X-ray absorptiometry and air displacement plethysmography.

BACKGROUND: Body composition analysis has been used to investigate fat mass (FM) and bone mineral content (BMC) in children and adolescents diagnosed with HIV. Investigating the validity of bioelectrical impedance analysis (BIA) is interesting with respect to testing useful techniques for monitoring body composition in children and adolescents in clinical practice. The present study aimed to determine the validity of body composition analysis by BIA compared to dual-energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP) in children and adolescents an HIV diagnosis. METHODS: Sixty-four children and adolescents (35 females and 29 males) with a mean (SD) age of 12.22 (2.13) years and with an HIV diagnosis participated in the study. Fat-free mass (FFM), FM and body fat percentage (%BF) were obtained by BIA for comparison with DXA and ADP. Segmented FM (trunk, legs and arms), lean soft tissue mass (LSTM) (total and segmented) and BMC were obtained by BIA for comparison with DXA. RESULTS: BIA presented a clinically acceptable correlation with DXA and ADP for FFM. Values found by BIA were underestimated compared to ADP, and overestimated compared to DXA. BIA presented a clinically acceptable correlation with DXA for LSTM estimates (total and segmented parameters) in both sexes (underestimating FM and overestimating LSTM). For other components (%BF, FM and BMC), BIA had a clinically unacceptable correlation with the reference methods in both sexes. CONCLUSIONS: BIA was suitable for evaluating FFM and LSTM in children and adolescents with an HIV diagnosis. For FM, %BF and BMC, BIA was not suitable for performing an evaluation in both sexes.

Biocerâmica de fosfato de cálcio nanoestruturada micro-macroporosa em grânulos de absorção rápida no preenchimento de defeito crítico em rádio de coelhos (Oryctolagus cuniculus) / Bioceramics of calcium phosphate nano-structured micro-macro porous granules rapidly absorbed in filling critical radial defect in rabbits (Oryctolagus cuniculus)

O objetivo do presente trabalho foi avaliar, por radiografia, histologia e densitometria óssea, o efeito da HA/ßTCP em grânulos de absorção rápida em defeito ósseo crítico em rádio de coelhos. Foram utilizados 35 coelhos machos, da raça Nova Zelândia, e realizou-se um defeito crítico nos rádios direito e esquerdo. Os animais foram distribuídos em GI, enxerto autólogo e GII, HA/ßTCP em grânulos de absorção rápida. Avaliações radiográficas foram feitas antes da cirurgia, após, aos oito, 15, 30, 45 e 60 dias e avaliações histológicas e de densitometria. Verificou-se diferença significativa ao se comparar a densidade mineral óssea obtida ao longo do tempo de estudo. Observou-se formação de rede vascular entre os poros da biocerâmica desde o primeiro tempo de avaliação, (oito dias). Foram observados tecido ósseo primário e trabéculas em tecido ósseo preexistente a partir de 30 dias da implantação. Aos 60 dias, constatou-se presença de matriz óssea em segmentos ósseos preexistentes, caracterizando a formação óssea centrípeta. A biocerâmica HA/ßTCP nanoestruturada micro-macroporosa em grânulos de absorção rápida não causa alterações microscópicas indicativas de rejeição, permite a invasão e a multiplicação celular, bem como propicia a regeneração óssea, constituindo um implante apropriado para preenchimento de falhas ósseas críticas.(AU)

The objective of this study was to evaluate the effect of HA/ ßTCP on rapid absorption granules in rabbit radiography, histology, and bone densitometry. Thirty - five male rabbits of the New Zealand breed were used and a critical defect was performed on the right and left radios. The animals were distributed in GI, autologous graft and GII HA / ßTCP in rapidly absorbed granules. Radiographic, histological, and densitometry evaluations were performed before surgery, then after eight, 15, 30, 45 and 60 days. A significant difference was found when comparing the bone mineral density obtained over the study time. Formation of vascular network between the bioceramic pores was observed by the first evaluation time, (eight days). Primary bone tissue and trabeculae were observed from preexisting bone tissue after 30 days of implantation. At 60 days, the presence of bone matrix was observed from the preexisting bone segments, characterizing the centripetal bone formation. The micro-macroporous nanocomposite HA / ßTCP of rapidly absorbing granules do not cause microscopic changes indicative of rejection, allows invasion, cell multiplication, and promotes bone regeneration, constituting an appropriate implant for filling of critical bone failures.(AU)

Avaliação histológica e por microscopia eletrônica de varredura da biocerâmica de fosfato de cálcio nano-estruturada micromacro porosa em grânulos em defeito crítico de rádio de coelhos / Histological and nano-structured calcium phosphate bioceramic micro-macro porous granules in critical defect rabbits radius scanning electron microscopy evaluation

Objetivou-se avaliar, histologicamente e por microscopia eletrônica de varredura (MEV), a evolução de defeitos críticos experimentais em rádio de coelhos preenchidos ou não com biocerâmica fosfocálcica nanoestruturada micromacro porosa em grânulos. Utilizaram-se 70 coelhos, Nova Zelândia, adultos jovens, machos, e realizou-se um defeito crítico nos rádios. Os membros constituíram os grupos: GI, biocerâmica lenta, GII, biocerâmica moderada e GIII, controle negativo. Após cada período experimental, os animais foram sacrificados, e os rádios coletados. As avaliações histológicas foram realizadas aos oito, 15, 30, 45, 60, 90 e 120 dias, e as análises de MEV aos 60, 90 e 120 dias. Histologicamente, observou-se processo de reparação óssea mais adiantado nos grupos GI e GII comparando-se ao GIII. Na MEV, constatou-se maior proporção de osso maduro e presença de ósteons secundários nos GI e GII, sendo mais evidente no GII, confirmando os achados histológicos. As cerâmicas promoveram preenchimento completo do defeito, enquanto no grupo controle houve preenchimento no centro do defeito, permanecendo espaços vazios nas laterais. Conclui-se que o emprego das biocerâmicas de absorção lenta e moderada favorece a regeneração óssea completa em defeitos críticos sendo indicadas como substituto ósseo. A maturação óssea ocorre mais precocemente quando se emprega a cerâmica de absorção moderada.(AU)

The objective was to evaluate, through histologic exam and by scanning electron microscopy (SEM), the evolution of experimental critical defects in radio or not filled with nano-structured calcium phosphate micro-macro porous bioceramic granules rabbits. We used 70 rabbits, New Zealand, young adults, males, there was a critical defect in radio. The members were the groups: GI, slow bioceramic, GII, GIII and bioceramic moderate, negative control. After each experimental period, the animals were sacrificed and the radios harvested. Histological evaluations were performed at eight, 15, 30, 45, 60, 90 and 120 days and SEM analyzes at 60, 90 and 120 days. Histologically there was bone healing process earlier in GI and GII compared to GIII. In SEM we observed a higher proportion of mature bone and presence of secondary osteons in GI and GII, being more evident in the GII, confirming the histological findings. Ceramic promoted complete filling of the defect, while the control group was filling in the center of the defect, with empty spaces remaining on the sides. In conclusion, the use of bioceramics, slow and moderate absorption favor complete bone regeneration in critical defects being indicated as a bone substitute. The maturation occurs earlier when employing the ceramic moderate absorption.(AU)

Genetic portrait of Jewish populations based on three sets of X-chromosome markers: Indels, Alu insertions and STRs.

Population genetic data for 53 X-chromosome markers (32 X-indels, 9 X-Alu insertions and 12 X-STRs) are reported for five populations with Jewish ancestry (Sephardim, North African Jews, Middle Eastern Jews, Ashkenazim, and Chuetas) and Majorca, as the host population of Chuetas. Genetic distances between these populations demonstrated significant differences, except between Sephardic and North African Jews, with the Chuetas as the most differentiated group, in accordance with the particular demographic history of this population. X-chromosome analysis and a comparison with autosomal data suggest a generally sex-biased demographic history in Jewish populations. Asymmetry was found between female and male effective population sizes both in the admixture processes between Jewish communities, and between them and their respective non-Jewish host populations. Results further show that these X-linked markers are highly informative for forensic purposes, and highlight the need for specific databases for differentiated Jewish populations.

Evolutionary history of Podarcis tiliguerta on Corsica and Sardinia.

BACKGROUND: Podarcis tiliguerta is a wall lizard endemic to the Mediterranean islands of Corsica and Sardinia. Previous findings of high mtDNA and morphological diversity have led to the suggestion that it may represent a species complex. Here, we analysed mitochondrial and nuclear markers (mtDNA, 3110 bp; 6 nDNA loci, 3961 bp) in P. tiliguerta sampled from thirty-two localities across Corsica and Sardinia. RESULTS: We find much greater intraspecific genetic divergence than between sister species of other Mediterranean island Podarcis, i.e., between P. lilfordi and P. pityusensis. We detected three mtDNA clusters in Corsica (North, South-East and South-West) and either two or three in Sardinia (North vs. South) depending on the clustering method. Only one or two nDNA groups were identified within each main island (again, depending on the method). A Bayesian time-calibrated multispecies coalescent tree was obtained from mtDNA and provided statistical support for a Miocene origin of the species (13.87 Ma, 95% HPD: 18.30-10.77 Ma). The posterior mean divergence time for the Corsican and Sardinian lineages was 12.75 Ma ago (95% HPD: 16.94-9.04 Ma). CONCLUSION: The results support the evolutionary distinctiveness of Corsican and Sardinian populations and also indicate a lack of post-divergence migration despite periods of contact being possible. Further to this, species delimitation analyses of Corsican and Sardinian lineages provided statistical support for their recognition as distinct (sister) taxa. Our results provide new insights into the biogeography of the Mediterranean biodiversity hotspot, and contribute important findings relevant to the systematics and evolution of this speciose lizard genus.

Genetic diversity of 38 insertion-deletion polymorphisms in Jewish populations.

Population genetic data of 38 non-coding biallelic autosomal indels are reported for 466 individuals, representing six populations with Jewish ancestry (Ashkenazim, Mizrahim, Sephardim, North African, Chuetas and Bragança crypto-Jews). Intra-population diversity and forensic parameters values showed that this set of indels was highly informative for forensic applications in the Jewish populations studied. Genetic distance analysis demonstrated that this set of markers efficiently separates populations from different continents, but does not seem effective for molecular anthropology studies in Mediterranean region. Finally, it is important to highlight that although the genetic distances between Jewish populations were small, significant differences were observed for Chuetas and Bragança Jews, and therefore, specific databases must be used for these populations.

Genetic analysis of 12 X-chromosome STRs in Western Mediterranean populations.

Haplotype and allele frequencies of 12 X-STRs included in the Investigator Argus X-12 kit are reported for 255 individuals, representing four Western Mediterranean populations: Valencia (eastern mainland Spain) and the Balearic Islands (Majorca, Minorca, and Ibiza). Ibiza shows the lowest intra-population variability and the highest level of linkage disequilibrium together with an important genetic distance with regard to the geographically close populations, which is consistent with the historical evidence for long-term demographic isolation and its different matrilineal background.

Risk factors for proximal neck complications after endovascular aneurysm repair using the endurant stentgraft.

OBJECTIVE: To assess the incidence and risk factors for proximal aneurysm neck related complications with a late generation device for endovascular abdominal aneurysm repair (EVAR). METHODS: Data were retrieved from a prospective registry (Endurant Stent Graft Natural Selection Global Postmarket Registry) involving 79 institutions worldwide. The risk factors tested were age, gender, surgical risk profile, proximal neck length (<10 mm), diameter (>30 mm), supra- and infrarenal angulation (>60° and 75°), mural thrombus/calcification (>50%) and taper (>10%), and AAA diameter (>65 mm). Two neck related composite endpoints were used, for intra-operative (type-1a endoleak, conversion, deployment/retrieval complication or unintentional renal coverage) and post-operative (type-1a endoleak or migration) adverse events. Independent risk factors were identified using multivariable backwards modeling. RESULTS: The study included 1263 patients (mean age 73, 10.3% female) from March 2009 to May 2011. Twenty three (1.8%) intra-operative adverse events occurred. Neck length <10 mm (OR 4.9, 95% CI 1.1-22.6) and neck thrombus/calcification >50% (OR 4.8, 95% CI 1.7-13.5) were risk factors for intra-operative events. The planned 1 year follow up visit was reached for the entire cohort, and the 2 year visit for 431 patients. During this time, 99 (7.8%) events occurred. Female gender (HR 1.9, 95% CI 1.1-3.2), aneurysm diameter >65 mm (HR 2.8, 95% CI 1.9-4.2), and neck length <10 mm (HR 2.8, 95% CI 1.1-6.9) were significant post-operative risk factors. Neck angulation, neck taper, large diameter neck, and presence of thrombus/calcification were not predictors of adverse outcome in this study. CONCLUSION: These results support the adequacy of this device in the face of adverse neck anatomy, and confirm neck length as the most relevant anatomical limitation for EVAR. Additionally, the study confirms the decline in early to mid-term intervention rates with a newer generation device in a large patient sample. Lastly, it suggests that neck related risk factors affect outcome and impact on prognosis in varying degrees.

New data on Perkinsus mediterraneus in the Balearic Archipelago: locations and affected species.

Perkinsus mediterraneus, a protozoan parasite that can cause perkinsosis (marine mollusc disease), was first detected in oysters Ostrea edulis from Mahon (Minorca, Balearic Islands, Spain) in 2004. Several years later it was also found in Andratx Harbour (Majorca, Balearic Islands) and in the Gulf of Manfredonia (Adriatic coast of Italy) in oyster populations. Since 2007, Perkinsus surveys have been conducted in different localities and shellfish species in the Balearic Archipelago. In the present work, we found P. mediterraneus in the Balearic Islands infecting oyster and other shellfish species. We describe infection with P. mediterraneus for the first time in Arca noae and Mimachlamys varia. The detection was carried out using Ray's fluid thioglycolate medium (RFTM), histology and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodologies. The internal transcribed spacer (ITS) region (including ITS1, 5.8S and ITS2) of P. mediterraneus ribosomal DNA was sequenced from infected bivalve gills (or from the body in Chamelea gallina) from Balearic Archipelago localities. Twelve haplotypes with a strong genetic similarity between them (97-100%) were observed in our samples. These data were completed with 12 more haplotypes from GenBank sequences. The phylogenetic relationship between Balearic P. mediterraneus haplotypes found in this study, those previously obtained in Mahon Harbour, and the Perkinsus spp. sequences available in GenBank clearly grouped the different Perkinsus spp. in distinct clades supported by strong bootstrap values. Moreover, these analyses detected different P. mediterraneus groups in O. edulis from Minorca Island. No abnormal mortalities or decline in populations were detected during the survey, except for C. gallina, which is also affected by Marteilia refringens.

Improving sodium dodecyl sulfate polyacrylamide gel electrophoresis detection of low-abundance protein samples by rapid freeze centrifugation.

This work presents a rapid and simple freeze centrifugation method to concentrate dilute protein solutions for detection by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) Coomassie blue staining. Moreover, a simple way to assemble a cryoconcentration device is presented, and its use is discussed. Commercial purified protein standard and an enzyme with high fructosyltransferase (FTase) activity, coming from target fractions obtained by chromatographic separation, were used as an example. FTase, coming directly from the chromatographic fractions, was difficult to view through SDS-PAGE analysis; however, it was easily visualized, and its activity was enhanced, after the application of the freeze centrifugation protocol presented here.