Randomized clinical trial on the usefulness of 3D printing in intra-articular fractures of the distal radius. / Ensayo clínico aleatorizado sobre la utilidad de la impresión 3D en las fracturas intraarticulares de radio distal.

OBJECTIVES: We evaluated the utility of 3D printing technology for preoperative planning in the treatment of intra-articular fractures of the distal radius in relation to the improvement of surgical technique, radiological and clinical results. MATERIAL AND METHODS: A total of 30 patients with 2B and C fractures of the AO classification were operated on by a single surgeon with a volar plate, randomly divided into two groups, 15 of them with conventional planning (Rx and CT) and 15 adding a 3D model of the fracture and the previous simulation of the intervention. Simulation time, surgical time in minutes, radioscopy time in minutes, loss of material expressed in lost screws were recorded. Clinical evaluation based PRWE questionnaire and full radiographic analysis was done for all patients with a mean follow-up of 6 months by an independent, blinded observed. RESULTS: No statistically significant differences were observed in the PRWE questionnaire (p=0.22), nor were we observed differences in the radiological values, except in relation to the articular step (p=0.028), which represents statistical significance, but in both groups the median was of 0.0 (0.0-0.0). We also did not see statistically significant differences in surgical times (p=0.745), radioscopy (p=0.819) or in the loss of synthesis material (p=0.779). CONCLUSIONS: 3D printing has not improved the parameters studied in relation to routinely operated patients.

Neumatosis portal tras accidente de buceo / Portal pneumatosis after diving accident

No disponible

Ecotoxicidad aguda en Physa cubensis P. y Artemia salina L. de 8 antibacterianos con riesgo ambiental / Acute toxicity in Physa cubensis P. and Artemia salina L. of 8 antibiotics with environmental risk

Los productos farmacéuticos son ampliamente utilizados en todo el planeta. Existe una creciente preocupación por los efectos que los medicamentos consumidos y los desechos de estos producen en el ambiente. A pesar del gran uso de los antibacterianos no son muy investigados como contaminantes, prestándose mayor atención a la antibioresistencia por lo que el objetivo de la investigación fue evaluar la ecotoxicidad aguda de antibacterianos. Teniendo en cuenta el consumo de los antibacterianos y la predicción de sus concentraciones ambientales así como su ecoxicidad en Lactuca sativa L ya previamente determinados en anteriores investigaciones se determinó el riesgo ecotoxicológico en Artemia salina L. y Physa cubensis P. En el ensayo de Artemia salina la Ceftazidima se clasifica como muy tóxico con valor de CL50 de 0,060773 g/L, la Cefepima con valor de 0,993731 g/L como moderadamente tóxica y el resto de los antibacterianos evaluados se clasifican como no tóxicos. En los bioensayos en Physa cubensis Cefepima y Cefazolina ocasionaron la mayor mortalidad con CL50 de 0,000270 y 0,025684 g/L respectivamente y los que indujeron menor mortalidad fueron Vancomicina y Amoxicilina/Sulbactam con CL50 de 1,528440 y 1,055492 g/L. El vertimiento de residuos de antibacterianos puede ser causa de contaminación ambiental perjudicial para algunas especies (AU)

Pharmaceuticals are widely used all over the planet. There is growing concern about the effects that drugs and its residues produce in the environment. Despite the wide use of antibacterial, they are not very investigated as pollutants, paying greater attention to the antibiotic resistance, so the objective of this research was to evaluate the antibacterial acute ecotoxicity. Taking into account the antibacterial consumption and the prediction of their environmental concentrations as well as their ecotoxicity in Lactuca sativa L already determined in previous research, the ecotoxicological risk was determined in Artemia salina L. and Physa cubensis P. In the Artemia salina trial Ceftazidime is classified as very toxic with LC50 value of 0.060773g/L, Cefepime with value of 0.993731g/L is classified as moderately toxic and the rest of antibacterial evaluated are classified as non-toxic. In bio trials of Physa cubensis, Cefepime and Cefazolin caused the greatest mortality with LC50 0.000270 and 0.025684g/L respectively, and the ones that led lower mortality were Vancomycin and Amoxicillin/Sulbactam with LC50 of 1.528440 and 1.055492 g/L. The dumping of antibiotics residues can be the cause of environmental pollution, detrimental to some species (AU)

Influence of Traditional Management and Environmental Variables on Mediterranean Saproxylic Beetle Assemblages.

Mediterranean oak forests of the Iberian Peninsula host a great diversity of saproxylic beetles. For centuries, humans have carried out traditional management practices in this area, at both habitat and tree level, causing changes in forest structure. The aim of this study was to evaluate the anthropic effect of these traditional practices on saproxylic beetle diversity by measuring a set of environmental variables related to forest structure at both plot and tree level. Fauna was collected using window traps over a period of 12 mo. Multiple regression procedures showed which variables significantly affected the diversity of the studied assemblage. Our results demonstrated that the different metrics used to assess the diversity of assemblages responded variably depending on the management strategies applied and the level at which they were carried out. Certain management practices that disrupted the landscape from its natural state, such as the introduction of livestock or the local removal of particular trees, maximized species richness but, nevertheless, had a negative effect on the rest of diversity metrics analyzed. However, other practices such as pollarding, which involves the suppression of the main branch of the tree, had a positive effect on all diversity metrics evaluated as it promoted the formation of potential microhabitats for saproxylic fauna. We concluded that not all types and degrees of traditional forest management favor saproxylic beetle diversity and that different diversity metrics should be taken into consideration in future strategies for the protection and conservation of this fauna.

Saproxylic Beetle Assemblage Selection as Determining Factor of Species Distributional Patterns: Implications for Conservation.

The knowledge of the distributional patterns of saproxylic beetles is essential for conservation biology due to the relevance of this fauna in the maintenance of ecological processes and the endangerment of species. The complex community of saproxylic beetles is shaped by different assemblages that are composed of species linked by the microhabitats they use. We evaluate how different the species distribution patterns that are obtained can be, depending on the analyzed assemblage and to what extent these can affect conservation decisions. Beetles were sampled using hollow emergence and window traps in three protected areas of the Iberian Peninsula. Species richness, composition, and diversity turnover were analyzed for each sampling method and showed high variation depending on the analyzed assemblage. Beta diversity was clearly higher among forests for the assemblage captured using window traps. This method collects flying insects from different tree microhabitats and its captures are influenced by the forest structuring. Within forests, the assemblages captured by hollow emergence traps, which collect the fauna linked to tree hollows, showed the largest turnover of species, as they are influenced by the characteristics of each cavity. Moreover, the selection of the forest showing the highest species richness strongly depended on the studied assemblage. This study demonstrates that differences in the studied assemblages (group of species co-occurring in the same habitat) can also lead to significant differences in the identified patterns of species distribution and diversity turnover. This fact will be necessary to take into consideration when making decisions about conservation and management.

Biofeedback animado para el tratamiento de la micción disfuncional / Animated biofeedback for the dysfunctional voiding syndrome

Objetivos. Se pretende analizar resultado clínico y electromiográfico del tratamiento de la micción disfuncional (MD) con Biofeedback (Bfb) animado. Además, se estudia si existen variables clínicas o electromiográficas asociadas a mayor tasa de éxito. Pacientes y métodos. Se realizó corte transversal de pacientes con MD, que en 2010- 2015 siguieron programa de Bfb animado. El control post-tratamiento se realizó con Uroflujometría más Electromiografía y cuestionario validado. Se excluyeron los pacientes con mielodisplasia, malformaciones anatómicas, y a los que recibieron menos de 3 sesiones. Las variables clínicas estudiadas fueron: edad, número de sesiones, fugas diurnas, enuresis nocturna, estreñimiento, ITU, RVU. Las flujométricas fueron: morfología de curvas, electromiograma, flujos, y residuo postmiccional (RPM) elevado. Resultados. De 37 pacientes que recibieron Bfb, se seleccionaron 27 niñas que cumplieron criterios de inclusión. Edad media: 7,8 años (DE: 2,5). Doce (44%) presentaron hiperactividad del detrusor asociado a la MD. De manera global, todos los parámetros clínicos y flujométricos mejoraron. Clínicamente 33,5% presentó resolución completa de síntomas y el 37% mejoraron (desaparecieron más del 50% de los síntomas según criterios ICCS). El 29% no presentó mejoría. Electromiográficamente el 74% logró flujometrías normales. El estreñimiento al inicio del estudio se asocia a tasas menores de éxito (curación: 13 vs. 58%, p= 0,019; curación + mejoría: 60% vs. 83% p > 0,05). La ausencia de RPM al final del estudio se relacionó con la mejoría clínica (curación: 66,7% vs. 0%, p= 0,012; curación + mejoría: 89% vs. 60%, p > 0,05). Conclusiones. El Bfb en la micción disfuncional proporciona tasas de curación/mejoría clínica y de resolución electromiográfica del 69 y 74%, respectivamente. La ausencia de estreñimiento se asocia a mayores tasas de éxito. La persistencia de clínica se relaciona con RPM elevado post-tratamiento

Objectives. To analyze clinical and electromyographic treatment outcome of dysfunctional voiding (DV) with animated Biofeedback (Bfb). Clinical or electromyographic variables associated with higher success rate were checked. Patients and Methods. Cross-sectional study of patients with DV, that in 2010- 2015 followed animated Bfb program. Efficacy was measured with Uroflowmetry, Electromyography (EMG) and validated clinical questionnaire. Inclusion criteria: no myelodysplasia, no anatomical malformations and a minumin of 3 Bfb sessions. Clinical variables: age, number of sessions, daytime leaks, nocturnal enuresis, constipation, UTI, VUR. Flow measurement variables: morphology of curves, electromyogram, flows, and elevated post void residual (PVR). Results. Of 37 patients who received Bfb, 27 girls who met inclusion criteria were selected. Mean age: 7.8 years (2.5). Twelve (44%) had detrusor overactivity on urodynamics concomitantly. Globally, all clinical and flowmetry parameters improved. Clinically 33.5% had complete resolution of symptoms, 37% improved (> 50% of symptoms according to criteria ICCS) and 29% had no improvement. In EMG, 74% achieved normal perineal relaxation. Constipation at baseline is associated with lower rates of success (cure: 13 vs. 58%, p = 0.019; cure + improvement: 60% vs. 83% p> 0.05). The absence of RPM at the end of the study was associated with clinical improvement (cure: 66.7% vs. 0%, p = 0.012; cure + improvement: 89% vs. 60%, p> 0.05). Conclusions. Bfb in DV provides cure or improvement and electromyographic resolution are 69 and 74% respectively. The absence of constipation is associated with higher success rates. The High RPM correlates with persistence of clinics

[Animated biofeedback for the dysfunctional voiding syndrome]. / Biofeedback animado para el tratamiento de la micción disfuncional.

OBJECTIVES: To analyze clinical and electromyographic treatment outcome of dysfunctional voiding (DV) with animated Biofeedback (Bfb). Clinical or electromyographic variables associated with higher success rate were checked. PATIENTS AND METHODS: Cross-sectional study of patients with DV, that in 2010- 2015 followed animated Bfb program. Efficacy was measured with Uroflowmetry, Electromyography (EMG) and validated clinical questionnaire. Inclusion criteria: no myelodysplasia, no anatomical malformations and a minumin of 3 Bfb sessions. Clinical variables: age, number of sessions, daytime leaks, nocturnal enuresis, constipation, UTI, VUR. Flow measurement variables: morphology of curves, electromyogram, flows, and elevated post void residual (PVR). RESULTS: Of 37 patients who received Bfb, 27 girls who met inclusion criteria were selected. Mean age: 7.8 years (2.5). Twelve (44%) had detrusor overactivity on urodynamics concomitantly. Globally, all clinical and flowmetry parameters improved. Clinically 33.5% had complete resolution of symptoms, 37% improved (> 50% of symptoms according to criteria ICCS) and 29% had no improvement. In EMG, 74% achieved normal perineal relaxation. Constipation at baseline is associated with lower rates of success (cure: 13 vs. 58%, p = 0.019; cure + improvement: 60% vs. 83% p> 0.05). The absence of RPM at the end of the study was associated with clinical improvement (cure: 66.7% vs. 0%, p = 0.012; cure + improvement: 89% vs. 60%, p> 0.05). CONCLUSIONS: Bfb in DV provides cure or improvement and electromyographic resolution are 69 and 74% respectively. The absence of constipation is associated with higher success rates. The High RPM correlates with persistence of clinics.

OBJETTIVOS: Se pretende analizar resultado clínico y electromiográfico del tratamiento de la micción disfuncional (MD) con Biofeedback (Bfb) animado. Además, se estudia si existen variables clínicas o electromiográficas asociadas a mayor tasa de éxito. PACIENTES Y METODOS: Se realizó corte transversal de pacientes con MD, que en 2010- 2015 siguieron programa de Bfb animado. El control post-tratamiento se realizó con Uroflujometría más Electromiografía y cuestionario validado. Se excluyeron los pacientes con mielodisplasia, malformaciones anatómicas, y a los que recibieron menos de 3 sesiones. Las variables clínicas estudiadas fueron: edad, número de sesiones, fugas diurnas, enuresis nocturna, estreñimiento, ITU, RVU. Las flujométricas fueron: morfología de curvas, electromiograma, flujos, y residuo postmiccional (RPM) elevado. RESULTADOS: De 37 pacientes que recibieron Bfb, se seleccionaron 27 niñas que cumplieron criterios de inclusión. Edad media: 7,8 años (DE: 2,5). Doce (44%) presentaron hiperactividad del detrusor asociado a la MD. De manera global, todos los parámetros clínicos y flujométricos mejoraron. Clínicamente 33,5% presentó resolución completa de síntomas y el 37% mejoraron (desaparecieron más del 50% de los síntomas según criterios ICCS). El 29% no presentó mejoría. Electromiográficamente el 74% logró flujometrías normales. El estreñimiento al inicio del estudio se asocia a tasas menores de éxito (curación: 13 vs. 58%, p= 0,019; curación + mejoría: 60% vs. 83% p > 0,05). La ausencia de RPM al final del estudio se relacionó con la mejoría clínica (curación: 66,7% vs. 0%, p= 0,012; curación + mejoría: 89% vs. 60%, p > 0,05). CONCLUSIONES: El Bfb en la micción disfuncional proporciona tasas de curación/mejoría clínica y de resolución electromiográfica del 69 y 74%, respectivamente. La ausencia de estreñimiento se asocia a mayores tasas de éxito. La persistencia de clínica se relaciona con RPM elevado post-tratamiento.

Molecular identification of Fusarium species isolated from transgenic insect-resistant cotton plants in Mexicali valley, Baja California.

Cotton production in the Mexicali valley is adversely affected by wilt and root rot disease associated with Fusarium species. In the present study, we sought to isolate and identify the Fusarium species in the rhizosphere of transgenic insect-resistant cotton plants grown in the Mexicali valley. Our analyses isolated four native fungi from the rhizosphere of cotton plants, namely, T-ICA01, T-ICA03, T-ICA04, and T-ICA08. These fungal isolates were categorized as belonging to Fusarium solani using their phenotypic characteristics and ITS region sequence data. Examination of the infection index showed that T-ICA03 and T-ICA04 caused systemic colonization (90%) of seeds followed by the occurrence of radicle and coleoptile decay. In contrast, T-ICA08 strain was less pathogenic against seed tissues (40%) in comparison to the other strains isolated. Our study showed that in transgenic insect-resistant cotton the disease "Fusarium wilt" is caused by the fungus, F. solani. Future studies are necessary to characterize the F. solani populations to determine whether phenological stages might influence the genetic diversity of the fungal populations present.

A modified device to facilitate flow measurements during voiding cystometry studies in infants.

INTRODUCTION: Urodynamic studies (UDS) in infants are traditionally hampered by technique and flow collection; both are difficult and have not yet been standardized. METHODS: A very simple device has been developed to collect urine during the voiding phase in UDS. It is based on a urine-collection adhesive bag, which is connected to a tube that conducts the urine to a flowmeter. RESULTS: Eleven infants (4-23 months) were selected and a complete UDS was performed on all of them. A diagnosis was obtained for all of the infants. DISCUSSION: This device is easily available in every pediatric clinic; it is also disposable and inexpensive. It enables UDS in infants to be complete and achievable.

Síndrome de Sjögren-Larsson: tomografía de coherencia óptica y una nueva mutación / Sjögren-Larsson syndrome: Optical coherence tomography and a novel mutation

CASO CLÍNICO: Varón de 30 años con ictiosis, retraso intelectual, epilepsia y espasticidad. La exploración oftalmológica presenta agudeza visual corregida de 0,5 y maculopatía cristalina bilateral. La tomografía de coherencia óptica (OCT) muestra depósitos hiperrefringentes y pequeños quistes intrarretinianos foveales. Se diagnostica de síndrome de Sjögren-Larsson (SSL) y se confirma con el análisis genético. DISCUSIÓN: El SSL ocurre por mutaciones en el gen ALDH3A2. Se identifica una nueva mutación, la c.681-14T>G, no descrita previamente. La OCT permite analizar la mácula y detectar cambios, incluso no visibles oftalmoscópicamente. Su empleo es importante, porque ofrece imágenes específicas del SSL y ayuda al diagnóstico de esta rara enfermedad sistémica

CASE REPORT: A case is presented of a thirty year-old male with ichthyosis, mental retardation, epilepsy and spasticity. Ocular examination showed a best-corrected visual acuity of 0.5 and bilateral crystalline maculopathy. Optical coherence tomography (OCT) revealed focal hyperreflective spots and intrafoveal microcystoid spaces. The diagnosis of Sjögren-Larsson syndrome (SLS) was made, and confirmed by genetic analysis. DISCUSSION: SLS is caused by mutations in the ALDH3A2 gene. A previously unreported novel mutation was identified, c.681-14T>G. Macular OCT makes it possible to find even funduscopy invisible changes. Its use is important because the OCT features of SLS are specific and, therefore, it can help to diagnose this rare systemic disease

Paciente con notalgia parestésica y siringomielia: ¿relación o coincidencia? / A patient with notalgia paresthetica and syringomyelia: association or coincidence?

La notalgia parestésica (NP) es una neuropatía sensitiva comúnmente manifestada con prurito y aparición de una mácula hiperpigmentada a nivel del raquis dorsal en la mayoría de los casos. La fisiopatología de la NP es aún desconocida, aunque se considera su origen, por distintas causas, en una lesión producida en los nervios espinales. No existe un tratamiento definitivo para este desorden aunque son muchas las alternativas terapéuticas descritas. Presentamos el caso clínico de una paciente diagnosticada de NP y tratada satisfactoriamente con capsaicina, en quien encontramos una posible asociación etiológica con una siringomielia subclínica evidenciada en el estudio por resonancia magnética. Aunque teóricamente posible, no hemos encontrado otros artículos que asocien dichos cuadros (AU)

Notalgia paresthetica (NP) is a sensory neuropathy commonly manifested by pruritus and the appearance of a hyperpigmented macula, usually in the thoracic spine. The physiopathology of NP is unknown, although, for different reasons, its origin is considered to be an injury to the spinal nerves. There is no definitive treatment for this disorder, although many therapeutic alternatives have been used. We report the case of a patient diagnosed with notalgia paresthetica and successfully treated with capsaicin. In this patient, we found a possible etiological association with subclinical syringomyelia revealed by magnetic resonance imaging. Although this association is theoretically possible, we have found no other reports of an association between these two disorders (AU)

Consummation of the legislative map of transplantation in Latin America: Law on Donation and Transplantation Nicaragua--the last piece of the puzzle.

Latin America started its transplant activity early-as soon as the first transplants in the world took place. Its member states have created their laws of donation and transplantation also. The first laws for transplants in the region were created in Brazil in 1963. Subsequently, all states approved its regulatory framework for transplants. Until 2012, Nicaragua was the only country in the region that did not have a transplants law. In October 2013, Nicaragua adopted the "Law on Donation and Transplantation of Organs, Tissues and Cells for Human Beings," which consummates the process that creates the legal framework for donation and transplantation in Latin America, a journey of 50 years' duration, from Brazil's law to Nicaragua's law. This achievement is the fundament for searching an exercise of transplantation in a ground of accessibility, equity, ethics, and transparency as part of comprehensive health care services in the region.

Membrana neovascular subretiniana asociada a estrías angioides tratada con bevacizumab intravítreo / Subretinal neovascular membrane in angioid streaks treated with intravitreal bevacizumab

INTRODUCCIÓN: Las estrías angioides son roturas en la membrana de Bruch que pueden asociarse, entre otras, a pseudoxantoma elástico. Su complicación más frecuente es el desarrollo de membranas neovasculares subretinianas (MNVSR) con la disminución de visión que conlleva. CASO CLÍNICO: Mujer de 28 años con estrías angioides y MNVSR en ojo izquierdo, que recibió tres inyecciones de bevacizumab intravítreo, con rápida mejoría de la visión y estabilidad durante 11 meses de seguimiento. El hallazgo de estrías angioides permitió el diagnóstico de pseudoxantoma elástico. CONCLUSIÓN: El bevacizumab intravítreo debe ser considerado como una opción terapéutica eficaz para la neovascularización coroidea asociada a estrías angioides

INTRODUCTION: Angioid streaks are breaks in Bruch's membrane that may be associated, among others, with pseudoxanthoma elasticum. Its most common complication is the development of subretinal neovascular membranes (SRNVM) and the decreased vision this entails. CASE REPORT: A 28 year old woman with angioid streaks and SRNVM in the left eye, who received 3 injections of intravitreal bevacizumab, with rapid improvement in vision and stability during 11 months follow up. The finding of angioid streaks led to the diagnosis of pseudoxanthoma elasticum. CONCLUSION: Intravitreal bevacizumab should be considered as an effective treatment option for choroidal neovascularization associated with angioid streaks

Tratamiento de la sinostosis radiocubital proximal mediante la interposición de colgajo interóseo posterior de flujo anterógrado / Treatment of proximal radioulnar synostosis using a posterior interosseous antegrade flow pedicled flap

Nuestro objetivo es estudiar las diferentes opciones terapéuticas descritas para el tratamiento de la sinostosis radiocubital y, aportar nuestra experiencia con las modificaciones técnicas introducidas con posterioridad. Hemos revisado 2 pacientes con más de un año de evolución, que fueron operados con el colgajo reseñado; describimos las novedades técnicas, el resultado final y las complicaciones. En los 2 casos descritos existe ausencia de recidiva de sinostosis, complicación más frecuente descrita en esta enfermedad, con ausencia de complicaciones postoperatorias. En la literatura se han empleado numerosos materiales interpuestos en el espacio radiocubital tras la exéresis de la sinostosis, desde artificiales hasta biológicos libres o vascularizados; siendo la técnica de interposición de colgajos musculares o adipofascial vascularizados, la que ofrece los mejores resultados. El colgajo interóseo posterior pediculado de flujo anterógrado es una alternativa fiable, de poca morbilidad y, efectiva para el tratamiento de la sinostosis radiocubital proximal (AU)

The aim of this study is to determine the different therapeutic options described for the treatment of radioulnar synostosis, and report our experience with posterior interosseous antegrade flow pedicled flap with technical amendments. Two patients, who were treated with the designed flap, and with more than one year of follow-up, were reviewed. The technical innovations, end result and complications are described. In the two cases described, there was no recurrence of synostosis, which is the most frequent complication described in this condition, and no postoperative complications were observed. In the literature, many filler materials, from artificial to biological, free or vascularized, have been used the radioulnar space after excision of synostosis. The technique that provides the best results is the interposition of muscle or vascularized adipofascial flaps. The interosseous posterior antegrade flow pedicled flap is reliable, with a low morbidity, and is an effective alternative for the treatment of proximal radioulnar synostosis (AU)

Sjögren-Larsson syndrome: optical coherence tomography and a novel mutation.

CASE REPORT: A case is presented of a thirty year-old male with ichthyosis, mental retardation, epilepsy and spasticity. Ocular examination showed a best-corrected visual acuity of 0.5 and bilateral crystalline maculopathy. Optical coherence tomography (OCT) revealed focal hyperreflective spots and intrafoveal microcystoid spaces. The diagnosis of Sjögren-Larsson syndrome (SLS) was made, and confirmed by genetic analysis. DISCUSSION: SLS is caused by mutations in the ALDH3A2 gene. A previously unreported novel mutation was identified, c.681-14T>G. Macular OCT makes it possible to find even funduscopy invisible changes. Its use is important because the OCT features of SLS are specific and, therefore, it can help to diagnose this rare systemic disease.

[Treatment of proximal radioulnar synostosis using a posterior interosseous antegrade flow pedicled flap]. / Tratamiento de la sinostosis radiocubital proximal mediante la interposición de colgajo interóseo posterior de flujo anterógrado.

The aim of this study is to determine the different therapeutic options described for the treatment of radioulnar synostosis, and report our experience with posterior interosseous antegrade flow pedicled flap with technical amendments. Two patients, who were treated with the designed flap, and with more than one year of follow-up, were reviewed. The technical innovations, end result and complications are described. In the two cases described, there was no recurrence of synostosis, which is the most frequent complication described in this condition, and no postoperative complications were observed. In the literature, many filler materials, from artificial to biological free or vascularized, have been used the radioulnar space after excision of synostosis. The technique that provides the best results is the interposition of muscle or vascularized adipofascial flaps. The Interosseous posterior antegrade flow pedicled flap is reliable, with a low morbidity, and is an effective alternative for the treatment of proximal radioulnar synostosis.

[Subretinal neovascular membrane in angioid streaks treated with intravitreal bevacizumab]. / Membrana neovascular subretiniana asociada a estrías angioides tratada con bevacizumab intravítreo.

INTRODUCTION: Angioid streaks are breaks in Bruch's membrane that may be associated, among others, with pseudoxanthoma elasticum. Its most common complication is the development of subretinal neovascular membranes (SRNVM) and the decreased vision this entails. CASE REPORT: A 28 year old woman with angioid streaks and SRNVM in the left eye, who received 3 injections of intravitreal bevacizumab, with rapid improvement in vision and stability during 11 months follow up. The finding of angioid streaks led to the diagnosis of pseudoxanthoma elasticum. CONCLUSION: Intravitreal bevacizumab should be considered as an effective treatment option for choroidal neovascularization associated with angioid streaks.

Importance of tuberculosis screening before inhibiting tumour necrosis factor-alpha therapy.

INTRODUCTION: There has been an increase in the incidence of tuberculosis infection in recent years, due to the increasing use of drugs inhibiting tumour necrosis factor-alpha (anti-TNFα) in the treatment of inflammatory diseases. CASE REPORT: We report the case of a male patient being treated with infliximab (anti-TNFα) who developed disseminated tuberculosis with ocular involvement. CONCLUSION: It is very important to conduct a proper screening to detect patients at risk for tuberculosis before starting treatment with these drugs. For this purpose, the QuantiFERON®-TB Gold in Tube (Interferon Gamma Release Assay, IGRA) is presented as an alternative screening test with high sensitivity and specificity.