Resultados de la Neumonectomía en el Cáncer de Pulmón no Microcítico: Estudio Unicéntrico de Morbi-Mortalidad / Results of Pneumonectomy in Non-Small Cell Lung Cancer: Single Center Study of Morbi-Mortality

Resumen abreviado: Estudio de la morbi-mortalidad de la neumonectomía por Cáncer de pulmón en nuestro centro durante 2012-2017. La morbilidad <90días y mortalidad <90días global fue 38,4% y 17%. La morbilidad y mortalidad son mayores en lado derecho. Durante último trienio disminuyó la morbi-mortalidad y el número de neumonectomías por año (5,3%).Introducción: Presentamos este trabajo para analizar la morbi-mortalidad de la neumonectomía en nuestro centro, así como los factores que influyen en la misma, mostrando nuestros resultados en el tiempo en dos períodos: 2012-2014 y 2015-2017.Material y métodos: Se trata de un estudio analítico y observacional retrospectivo de todas las neumonectomías por Cáncer de pulmón no células pequeñas (CPNCP) intervenidas durante 2012-2017. Se ha analizado la morbi-mortalidad de toda la muestra según lateralidad, FEV1, estadio, edad y sistema de sutura. También se ha estudiado la morbi-mortalidad durante: 2012-2014 y 2015-2017. El análisis estadístico se realizó con el software SPSS versión 26.Resultados: Se realizaron 65 neumonectomías (izquierdas: 39 y derechas: 26) en pacientes con el diagnóstico de CPNCP. La morbilidad <90días fue del 38,4% (25/65). El porcentaje de complicaciones en el lado derecho y en los pacientes con FEV1 <80% fue 46%, en estadio avanzado 50%, pacientes >75años 77% y neumonectomías con sistema de sutura TA-roticulator 50%. La mortalidad <90días global fue un 17% (11/65). La mortalidad de las neumonectomías en los pacientes con FEV1 <80% fue 18%, el lado derecho 30,7%, en estadio avanzado 22,2%, pacientes >75años 22% y neumonectomías con sistema de sutura TA-roticulator 28%. El análisis por períodos reveló una morbilidad (27,5%) y mortalidad (6,8%) más baja en último trienio y menor número de neumonectomías por año (5,3%). (AU)

Resumen abreviado: Study of the morbidity and mortality of pneumonectomy for lung cancer in our center during 2012-2017. Overall morbidity <90 days and mortality <90 days were 38.4% and 17%. Morbidity and mortality are higher on the right side. During the last triennium, morbidity and mortality and the number of pneumonectomies per year decreased (5.3%).Introduction: We present this work to analyze the morbidity and mortality of pneumonectomy in our center, as well as the factors that influence it, showing our results over time in two periods: 2012-2014 and 2015-2017.Material and methods: This is a retrospective analytical and observational study of all pneumonectomies for non-small cell lung cancer (NSCLC) operated during 2012-2017. The morbi-mortality of the entire sample was analyzed according to laterality, FEV1, stage, age and suture system. Morbi-mortality has also been studied during: 2012-2014 and 2015-2017. Statistical analysis was performed with SPSS version 26 software.Results: 65 pneumonectomies were performed (left: 39 and right: 26) in patients diagnosed with NSCLC. Morbidity <90 days was 38.4% (25/65). The percentage of complications on the right side and in patients with FEV1 <80% was 46%, in advanced stage 50%, patients >75 years old 77% and pneumonectomies with TA-roticulator suture system 50%. Overall <90-day mortality was 17% (11/65). Mortality of pneumonectomies in patients with FEV1 <80% was 18%, right side 30.7%, advanced stage 22.2%, patients >75 years old 22%, and pneumonectomies with TA-roticulator suture system 28%. The analysis by periods revealed a lower morbidity (27.5%) and mortality (6.8%) in the last triennium and a lower number of pneumonectomies per year (5.3%). (AU)

Síndrome paraneoplásico atípico sin anticuerpos onconeuronales detectables: a propósito de un caso / Atypical paraneoplastic syndrome with no onconeuronal antibodies: A case report

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Drosophila melanogaster Models of Friedreich's Ataxia.

Friedreich's ataxia (FRDA) is a rare inherited recessive disorder affecting the central and peripheral nervous systems and other extraneural organs such as the heart and pancreas. This incapacitating condition usually manifests in childhood or adolescence, exhibits an irreversible progression that confines the patient to a wheelchair, and leads to early death. FRDA is caused by a reduced level of the nuclear-encoded mitochondrial protein frataxin due to an abnormal GAA triplet repeat expansion in the first intron of the human FXN gene. FXN is evolutionarily conserved, with orthologs in essentially all eukaryotes and some prokaryotes, leading to the development of experimental models of this disease in different organisms. These FRDA models have contributed substantially to our current knowledge of frataxin function and the pathogenesis of the disease, as well as to explorations of suitable treatments. Drosophila melanogaster, an organism that is easy to manipulate genetically, has also become important in FRDA research. This review describes the substantial contribution of Drosophila to FRDA research since the characterization of the fly frataxin ortholog more than 15 years ago. Fly models have provided a comprehensive characterization of the defects associated with frataxin deficiency and have revealed genetic modifiers of disease phenotypes. In addition, these models are now being used in the search for potential therapeutic compounds for the treatment of this severe and still incurable disease.

Mielitis transversa longitudinal extensa parainfecciosa asociada a virus varicela zóster / Parainfectious longitudinally extensive transverse myelitis associated with varicella-zoster virus

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Allergenicity of vertebrate tropomyosins: challenging an immunological dogma

With the exception of tilapia tropomyosin, other anecdotic reports of tropomyosin recognition of vertebrate origin are generally not accompanied by clinical significance and a dogmatic idea is generally accepted about the inexistence of allergenicity of vertebrate tropomyosins, based mainly on sequence similarity evaluations with human tropomyosins. Recently, a specific work-up of a tropomyosin sensitised patient with seafood allergy, demonstrated that the IgE-recognition of tropomyosin from different fish species can be clinically relevant. We hypothesise that some vertebrate tropomyosins could be relevant allergens. The hypothesis is based on the molecular evolution of the proteins and it was tested by in silico methods. Fish, which are primitive vertebrates, could have tropomyosins similar to those of invertebrates. If the hypothesis is confirmed, tropomyosin should be included in different allergy diagnosis tools to improve the medical protocols and management of patients with digestive or cutaneous symptoms after fish intake

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Allergenicity of vertebrate tropomyosins: Challenging an immunological dogma.

With the exception of tilapia tropomyosin, other anecdotic reports of tropomyosin recognition of vertebrate origin are generally not accompanied by clinical significance and a dogmatic idea is generally accepted about the inexistence of allergenicity of vertebrate tropomyosins, based mainly on sequence similarity evaluations with human tropomyosins. Recently, a specific work-up of a tropomyosin sensitised patient with seafood allergy, demonstrated that the IgE-recognition of tropomyosin from different fish species can be clinically relevant. We hypothesise that some vertebrate tropomyosins could be relevant allergens. The hypothesis is based on the molecular evolution of the proteins and it was tested by in silico methods. Fish, which are primitive vertebrates, could have tropomyosins similar to those of invertebrates. If the hypothesis is confirmed, tropomyosin should be included in different allergy diagnosis tools to improve the medical protocols and management of patients with digestive or cutaneous symptoms after fish intake.

Diamine oxidase levels in different chronic urticaria phenotypes

BACKGROUND: Diamine oxidase (DAO) is a polyamine-degrading enzyme also implicated in histamine metabolism. Chronic urticaria (CU) has a wide spectrum of clinical presentations and causes. Anisakis sensitisation associated chronic urticaria (CU+) has been characterised as a phenotype with different clinical and immunological characteristics and possibly associated with previous acute parasitism. We aimed to analyse serum DAO levels in different CU phenotypes. We further analysed the possible association of DAO with fish eating habits. METHODS: We studied 35 CU+ patients and 39 non-sensitised CU patients (CU−) as well as 19 controls. We analysed fish-eating frequency as well as fish intake associated exacerbation of CU (FIAE) or gastro-intestinal complaints (GI). DAO levels were further analysed with respect to lymphoproliferative responses, cytokine and specific IgE production. RESULTS: DAO levels were not different between CU and controls, but were significantly higher in CU+ than in CU−. CU+ patients with FIAE had lower DAO levels, but no differences were detected in patients with GI. DAO levels correlated positively with oily and canned fish consumption in CU−. In CU+, DAO levels correlated positively with specific Anisakis IgE, percentages of proliferation in Anisakis stimulated peripheral blood lymphocytes, serum IL-2 and IL-6, but correlated negatively with mitogen stimulated TGF-β in supernatants. CONCLUSIONS: DAO levels in CU depend on fish-eating habits and in CU+ on the amount of specific IgE production. In the CU+ phenotype, lower levels of DAO predispose to urticaria exacerbation after fish intake, probably due to a relative insufficient enteric availability of this enzyme

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Diamine oxidase levels in different chronic urticaria phenotypes.

BACKGROUND: Diamine oxidase (DAO) is a polyamine-degrading enzyme also implicated in histamine metabolism. Chronic urticaria (CU) has a wide spectrum of clinical presentations and causes. Anisakis sensitisation associated chronic urticaria (CU+) has been characterised as a phenotype with different clinical and immunological characteristics and possibly associated with previous acute parasitism. We aimed to analyse serum DAO levels in different CU phenotypes. We further analysed the possible association of DAO with fish eating habits. METHODS: We studied 35 CU+ patients and 39 non-sensitised CU patients (CU-) as well as 19 controls. We analysed fish-eating frequency as well as fish intake associated exacerbation of CU (FIAE) or gastro-intestinal complaints (GI). DAO levels were further analysed with respect to lymphoproliferative responses, cytokine and specific IgE production. RESULTS: DAO levels were not different between CU and controls, but were significantly higher in CU+ than in CU-. CU+ patients with FIAE had lower DAO levels, but no differences were detected in patients with GI. DAO levels correlated positively with oily and canned fish consumption in CU-. In CU+, DAO levels correlated positively with specific Anisakis IgE, percentages of proliferation in Anisakis stimulated peripheral blood lymphocytes, serum IL-2 and IL-6, but correlated negatively with mitogen stimulated TGF-ß in supernatants. CONCLUSIONS: DAO levels in CU depend on fish-eating habits and in CU+ on the amount of specific IgE production. In the CU+ phenotype, lower levels of DAO predispose to urticaria exacerbation after fish intake, probably due to a relative insufficient enteric availability of this enzyme.

Evaluation of composition and performance of composts derived from guacamole production residues.

The utilization of organic wastes to improve soils or for growth media components in local farms and nurseries can reduce the environmental pollution linked to waste disposal while increasing the sustainability of crop production. This approach could be applied to waste products generated from the production of guacamole (an emerging activity in the avocado production areas in mainland Spain), where appropriate treatment of this oily and doughy waste product has not been previously reported. The aim of this work is to study the feasibility of co-composting guacamole production residues (GR) with garden pruning waste (PW) as bulking agent, and the possible use of the compost produced depending on its quality. A windrow composting trial using three GR:PW ratios, 2:1, 1:2, and 1:7 was carried out. Temperature, moisture, organic matter, and C/N ratio were used to follow the evolution of the composting process during 7 months. After an additional 3-month curing period, composts were sieved to less than 10 mm and a set of European quality criteria was used to assess compost quality and intended use. In general, the 3 composting mixtures followed the classical process evolution, with minor differences among them. The 1:2 GR:PW ratio appeared most adequate for combining better process evolution and maximum GR ratio. Except for their high pH that limits their use as growing media component in some particular cases, the obtained composts fulfilled the more stringent European standards for commercial composts. Self-heating tests confirmed the high stability of the composts produced. The germination of cress by the direct contact method was satisfactory for composts GR:PW 1:2 and 1:7, showing no signs of toxicity. Avocado seedlings planted in substrates containing 67% of the GR:PW composts exhibited greater plant growth than those in the control treatment, and with no signs of phytotoxicity. The results open an interesting opportunity for the sustainable treatment of avocado fruit by-products derived from guacamole and avocado oil processing.

H1N1 virus infection: chest radiographic findings.

OBJECTIVE: To show the plain chest film findings in patients with confirmed infection with the new variant of the influenza A (H1N1) virus and to correlate these findings with the clinical history and evolution. MATERIAL AND METHODS: We reviewed the clinical histories and radiological studies in 99 patients infected with the new variant of H1N1 influenza who were admitted in two Hospitals in Cantabria, Spain. Plain chest film findings were classified according to their parenchymal pattern and the distribution of the lesions. RESULTS: Of the 99 patients evaluated, 28 had changes on the plain chest film acquired at admission. In these 28 patients, the findings were: condensation in 19, condensation and ground-glass opacities in 7, and ground-glass opacities in 2; the distribution of the lesions was diffuse in 17 patients and bilateral in 17, with the lower and middle lobes being the most frequently affected. The lesions progressed in 13 patients, and the 7 patients who required mechanical ventilation had a higher frequency of diffuse lesion distribution and more lung fields affected on the plain chest field acquired at admission. Pathological findings on plain chest films were more common in males, in smokers, and in patients who presented with shortness of breath, pleuritic pain, and diarrhea (P<0.05). CONCLUSION: Most patients infected with the new variant of the H1N1 virus had no alterations on the plain chest film acquired on admission; when findings were present, the predominant pattern was diffuse, bilateral condensation mainly involving the bases of the lungs. Pleural effusion and hilar or mediastinal lymph node enlargement were uncommon.

Posible origen en la arteria carótida de un infarto vertebrobasilar / No disponible

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Hemorragia de núcleo caudado por anestesia dental / Caudal nucleus haemorrhage due to dental anaesthesia

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[Digestive disorders in Parkinson's disease: dysphagia and sialorrhea]. / Trastornos digestivos en la enfermedad de Parkinson: disfagia y sialorrea.

INTRODUCTION: The non-motor symptoms of Parkinson's disease are a frequent and often under-diagnosed disorder. Two of the most significant non-motor symptoms are perhaps dysphagia and sialorrhea (which are relatively common in advanced stages of the disease) owing to their important functional repercussions and to the associated comorbidity. DEVELOPMENT AND CONCLUSIONS: In recent years, different evaluation scales have been developed for clinical use and in screening the aforementioned symptoms. Of the different therapeutic options available, botulinum toxin represents the preferred treatment for sialorrhea. In contrast, speech therapy and an optimisation of the antiparkinsonian therapy are generally useful measures to treat dysphagia, percutaneous endoscopic gastrostomy being reserved for patients suffering from Parkinson who have severe dysphagia.

[Locomotion and gait disorders]. / Locomoción y trastornos de la marcha.

INTRODUCTION: Human beings are characterised by the specialisation of certain functions, such as language or the ability to walk. We have achieved this capacity thanks to the development of multiple connections among different areas of the central and peripheral nervous system, together with adaptation of the musculoskeletal system. These are all essential to be able to walk correctly and to keep our balance. DEVELOPMENT: Gait disorders are currently receiving a great deal of attention in neurology departments, and this fact is directly related to the phenomenon of the ageing of the population, since it is a pathology that is particularly prevalent among the elderly. One of the fundamental mainstays in the study of these disorders is being able to distinguish between the different clinical gait patterns and their classification according to the neural system that has been damaged. Observation, the use of different manoeuvres in the examination and the search for other associated clinical signs all enable us reach a good diagnostic approximation, which will later be confirmed with more specific complementary techniques. CONCLUSIONS: From the therapeutic point of view, an early multidisciplinary intervention by the neurologist, primary care, specialists in rehabilitation and physiotherapists improves patients' quality of life and lowers the rate of associated comorbidity and mortality, which also results in a reduction in spending on community health resources.

Locomoción y trastornos de la marcha / Locomotion and gait disorders

Resumen. Introducción. El ser humano se caracteriza por la especialización de determinadas funciones, como son el lenguaje o la marcha. Esta capacidad la hemos llevado a cabo gracias al desarrollo de múltiples interconexiones entre diferentes áreas del sistema nervioso central y periférico, así como a la adaptación musculoesquelética. Todas ellas son fundamentales para una correcta realización de la deambulación y el mantenimiento del equilibrio. Desarrollo. Los trastornos de la marcha, en la actualidad, están cobrando especial importancia en las consultas de neurología, hecho que está directamente relacionado con el fenómeno de envejecimiento de la población, dado que es una patología especialmente prevalente en la población anciana. Uno de los pilares básicos en el estudio de estos trastornos es la diferenciación de los distintos patrones clínicos de marcha y la clasificación según el sistema neuronal dañado. La observación, el empleo de diferentes maniobras en la exploración y la búsqueda de otros signos clínicos asociados nos permiten una buena aproximación diagnóstica, que posteriormente podremos confirmar con técnicas complementarias más específicas. Conclusiones. Desde el punto de vista terapéutico, una intervención multidisciplinar precoz por parte de neurólogo, atención primaria, rehabilitadores y fisioterapeutas mejora la calidad de vida de los pacientes y disminuye la comorbilidad y mortalidad asociada, lo que permite, además, la reducción de los recursos sociosanitarios (AU)

Summary. Introduction. Human beings are characterised by the specialisation of certain functions, such as language or the ability to walk. We have achieved this capacity thanks to the development of multiple connections among different areas of the central and peripheral nervous system, together with adaptation of the musculoskeletal system. These are all essential to be able to walk correctly and to keep our balance. Development. Gait disorders are currently receiving a great deal of attention in neurology departments, and this fact is directly related to the phenomenon of the ageing of the population, since it is a pathology that is particularly prevalent among the elderly. One of the fundamental mainstays in the study of these disorders is being able to distinguish between the different clinical gait patterns and their classification according to the neural system that has been damaged. Observation, the use of different manoeuvres in the examination and the search for other associated clinical signs all enable us reach a good diagnostic approximation, which will later be confirmed with more specific complementary techniques. Conclusions. From the therapeutic point of view, an early multidisciplinary intervention y the neurologist, primary care, specialists in rehabilitation and physiotherapists improves patients’ quality of life and lowers the rate of associated comorbidity and mortality, which also results in a reduction in spending on community health resources (AU)

Outside-the-ribcage thoracic migration of a spigelian hernia.

Lung and spigelian hernia are both extremely rare diseases, and their combined and simultaneous appearance in the same patient, causing the small bowel to shift from the abdomen towards the thorax external to the ribcage is even more unusual. Here, we report such a case, supported by comprehensive iconography and a detailed discussion of the hypothetical pathogenesis.