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OBJECTIVE: Our aim was to add to the small but growing body of evidence on the effectiveness of ultrasound-guided Achilles intratendinous hyperosmolar dextrose prolotherapy and introduce a novel, preceding step of paratenon hydrodissection with lidocaine in patients with chronic Achilles tendinosis resistant to rehabilitation therapy. METHODS: We conducted a longitudinal, observational study on 27 consecutive patients diagnosed with Achilles tendinosis, in whom conservative treatment, ie, physiotherapy or shock wave therapy, had failed. A 2% lidocaine paratenon anesthesia and hydrodissection was followed by ultrasound-guided, intratendinous injections of 25% glucose every 5 weeks. Visual analogue scales (VAS) were used for pain assessment at rest, for activities of daily living, and after moderate exercise at the begining and at the end of the treatment. Moreover, tendon thickness and vascularisation were recorded at baseline and final treatment consultation. Effectiveness was estimated from scoring and relative pain reduction using a 95% CI. The non-parametric Wilcoxon test and a general linear model for repeated measures were applied. Statistical significance was established as p < 0.05. RESULTS: A median of 5 (1-11) injection consultations per patient were required. Pain scores decreased significantly in all three conditions (p < 0.001). Relative reductions were 75% in pain at rest (95% CI;61-93%), 69% in pain with daily living activities (95% CI; 55-83%), and 70% in pain after moderate exercise (95% CI; 57-84%). Tendon neo-vascularisation was significantly reduced (p < 0.001). We did not observe significant changes in tendon thickness (p = 0.083). CONCLUSIONS: Achilles tendinosis treatment with paratenon lidocaine hydrodissection and subsequent prolotherapy with hyperosmolar glucose solution is safe, effective, inexpensive, and virtually painless with results maintained over time.
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Tendón Calcáneo , Tendinopatía , Humanos , Tendón Calcáneo/diagnóstico por imagen , Actividades Cotidianas , Glucosa , Lidocaína/uso terapéutico , Dolor , Tendinopatía/diagnóstico por imagen , Tendinopatía/tratamiento farmacológico , Resultado del Tratamiento , Estudios LongitudinalesRESUMEN
Antecedentes y objetivo: Las fracturas de falange proximal (FP) son las fracturas más frecuentes de la mano. En los últimos años, se ha descrito el uso de tornillos endomedulares sin cabeza (TESC) para las fracturas inestables transversas u oblicuas de la FP. A pesar de que tanto la técnica anterógrada como retrógrada con TESC han mostrado buenos resultados, no se ha publicado ningún estudio comparativo de su uso en fracturas de FP. Nuestro objetivo es determinar la estabilidad que se obtiene con el uso de TESC retrógrados y anterógrados en un modelo en cadáver de fractura transversa proximal de FP, a dos niveles diferentes. Material y métodos: Realizamos un estudio biomecánico en 30 modelos de fractura de FP de cadáver fresco-congelado. La osteotomía se realizó a los 9 mm desde la articulación metacarpofalángica (MCF) en 15 especímenes, y a una distancia de 15 mm en los otros 15. A su vez, en cada grupo, cinco osteotomías se estabilizaron con un TESC anterógrado intraarticular, cinco mediante un TESC anterógrado transarticular y cinco con un TESC retrógrado. Resultados: La fijación con TESC anterógrado en osteotomías realizadas a los 9 mm (tanto con la técnica transarticular como intraarticular, 62,74 N y 70,86 N, respectivamente) fue más estable que la fijación con TESC retrógrado (32,72 N) (p 0,022). Por otra parte, la fijación con TESC retrógrado fue más estable en el modelo de fractura más distal (90,52 N retrógrado vs. 57,64 N transarticular vs. 42,92 N intraarticular (p = 0,20). Conclusiones: La fijación con TESC retrógrado ofrece más estabilidad en fracturas más distales, mientras que las técnicas anterógradas son más estables en fracturas proximales.(AU)
Background and objective: Phalangeal fractures are the most common hand fractures. In the last years, intramedullary compression screw (IMHCS) for instable transverse or short oblique proximal P1 fractures have been described. Although both anterograde (intraarticular or trans-articular) and retrograde IMHCS techniques have shown good results, no comparison between anterograde and retrograde screw in P1 fractures has been published. We sought to determine stability with retrograde IMHCS and anterograde IMHCS, both trans-articular and intra-articular technique, in a cadaveric transverse proximal P1 fracture model, at two different levels. Material and methods: We performed a biomechanical study in 30 fresh-frozen human cadaveric P1 fracture model. Fracture was performed at 9-mm from the metacarpo-phalangeal (MCP) joint in 15 specimens, whereas it was done at 15 mm in the other 15. In turn, in each group, five fractures were stabilized with an anterograde intra-articular IMHCS, five with anterograde trans-articular IMHCS and other five with retrograde IMHCS. Results: Anterograde IMHCS fixation in 9-mm P1 fractures (both trans- and intra-articular technique, 62.74 N and 70.86 N, respectively) was found to be more stable than retrograde IMHCS one (32.72 N) (p = 0.022). Otherwise, retrograde IMHCS fixation was found to be more stable in more distal P1 fractures (90.52 N retrograde vs. 57.64 N trans-articular vs. 42.92 N intra-articular; p = 0.20). Conclusions: Anterograde IMHCS fixation in proximal transverse P1 bone cut in a cadaveric model provides more stability than retrograde IMHCS, while retrograde screw provides more stability when the bone cut is located more distal.(AU)
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Humanos , Masculino , Femenino , Anciano de 80 o más Años , Falanges de los Dedos de la Mano/cirugía , Fracturas Óseas , Cadáver , Articulación Metacarpofalángica , Ortopedia , Procedimientos OrtopédicosRESUMEN
Los pacientes con COVID-19 grave pueden desarrollar restricciones dolorosas del rango de movimiento de las grandes articulaciones debido a osificaciones heterotópicas. Presentamos el caso de un paciente que desarrolló dolor en las caderas después de un ingreso prolongado por neumonía COVID-19 severa. La radiografía convencional, la tomografía computarizada y la gammagrafía ósea mostraron extensas osificaciones heterotópicas en caderas. Es probable que tanto factores locales como sistémicos contribuyan al desarrollo de osificaciones heterotópicas, y es necesario descartar esta entidad cuando estos pacientes refieran dolor articular. El diagnóstico precoz es importante para proporcionar intervenciones no farmacológicas como la movilización pasiva suave y medicación antiinflamatoria y en casos refractarios considerar la resección quirúrgica del hueso ectópico.(AU)
Patients with severe COVID-19 can develop painful range-of-motion restrictions of large joints due to heterotopic ossification. We present the case of a patient who developed hip pain after prolonged admission for severe COVID-19 pneumonia. Conventional radiography, computed tomography and bone scan showed extensive heterotopic ossification in the hips. It is probable that both local and systemic factors contribute to the development of heterotopic ossifications and it is necessary to rule out this entity when these patients reported joint pain. Early diagnosis is important to provide non-pharmacological interventions such as mild passive mobilization and anti-inflammatory medication and in refractory cases surgical resection of the ectopic bone is consider.(AU)
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Humanos , Masculino , Anciano , Osificación Heterotópica , Cintigrafía , Radiografía , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Infecciones por Coronavirus , Betacoronavirus , Lesiones de la Cadera , Cadera , Dolor , Articulaciones , Pacientes Internos , Rehabilitación , Examen FísicoRESUMEN
Patients with severe COVID-19 can develop painful range-of-motion restrictions of large joints due to heterotopic ossification. We present the case of a patient who developed hip pain after prolonged admission for severe COVID-19 pneumonia. Conventional radiography, computed tomography and bone scan showed extensive heterotopic ossification in the hips. It is probable that both local and systemic factors contribute to the development of heterotopic ossifications and it is necessary to rule out this entity when these patients reported joint pain. Early diagnosis is important to provide non-pharmacological interventions such as mild passive mobilization and anti-inflammatory medication and in refractory cases surgical resection of the ectopic bone is consider.
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COVID-19 , Osificación Heterotópica , Artralgia , COVID-19/complicaciones , Humanos , Osificación Heterotópica/diagnóstico por imagen , Osificación Heterotópica/etiología , Dolor , Radiografía , Rango del Movimiento Articular , SARS-CoV-2RESUMEN
Abstract Osteoarthritis (OA) is the most common type of arthritis, is a growing disease in the industrialized world. OA is an incapacitate disease that affects more than 1 in 10 adults over 60 years old. X-ray medical imaging is a primary diagnose technique used on staging OA that the expert reads and quantify the stage of the disease. Some Computer-Aided Diagnosis (CADx) efforts to automate the OA detection have been made to aid the radiologist in the detection and control, nevertheless, the pain inherits to the disease progression is left behind. In this research, it's proposed a CADx system that quantify the bilateral similarity of the patient's knees to correlate the degree of asymmetry with the pain development. Firstly, the knee images were aligned using a B-spline image registration algorithm, then, a set of similarity measures were quantified, lastly, using this measures it's proposed a multivariate model to predict the pain development up to 48 months. The methodology was validated on a cohort of 131 patients from the Osteoarthritis Initiative (OAI) database. Results suggest that mutual information can be associated with K&L OAI scores, and Multivariate models predicted knee chronic pain with: AUC 0.756, 0.704, 0.713 at baseline, one year, and two years' follow-up.
Resumen La osteoartritis (OA) es el tipo de artritis más común. OA es una enfermedad limitante que afecta a 1 de 10 adultos con 60 años o más. Las imágenes de rayos-x son una técnica de diagnóstico primario que permite conocer el estado de OA, las cuales el experto lee y cuantifica así la etapa de la enfermedad. El Diagnóstico Asistido por Computadora (CADx, por sus siglas en inglés) ha buscado automatizar el diagnóstico de OA para ayudar al radiólogo en la detección y control; sin embargo, el dolor provocado por la progresión de la enfermedad es dejado atrás. En este trabajo se propone un sistema de CADx que cuantifica la similitud bilateral de las rodillas de los pacientes, con el fin de correlacionar el grado de asimetría con el dolor. Inicialmente, las imágenes de las rodillas fueron alineadas usando el algoritmo B-spline para su registro, después, un conjunto de métricas estándar fue cuantificado; finalmente, con estas métricas se propone un modelo multivariado para predecir el dolor de rodilla desarrollado en 48 meses. La metodología fue validada con 131 pacientes obtenidos de la base de datos de la Osteoarthritis Initiative (OAI). Los resultados sugieren que las métricas pueden ser asociadas con los puntajes de KellgrenLawrence; además, los modelos predicen significativamente el dolor crónico de rodilla con: AUC 0.756, 0.704 y 0.7113, al inicio, un año y dos años después, respectivamente.
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BACKGROUND: Accurate identification of patients at risk of major adverse cardiac events (MACE) places a substantial burden on emergency physicians (EPs). Bayesian nomogram for risk stratification in low- to intermediate-risk cardiovascular patients has not been investigated previously. OBJECTIVE: The objective of this study was to develop a comparative diagnostic model using Bayesian statistics for exercise treadmill test (ETT) and stress echocardiogram (ECHO) to calculate post-test diagnostic risk of MACE using HEART (history, electrocardiogram, age, risk factors, and troponin) risk score as predictor of pretest probability. METHODS: Stratification was made by applying HEART scores for the prediction of MACE. Likelihood ratios (LR) were calculated using pooled sensitivity and specificity of ETT and ECHO from the American College of Cardiology Foundation/American Heart Association systematic review. Post-test probabilities were obtained after inserting HEART score and LR into Bayesian nomogram. Analysis of variance was used to assess statistical association. RESULTS: Positive LR (LR+) for ETT was 4.56 and negative LR (LR-) was 0.27; for ECHO, LR+ 5.65 and LR- 0.15. Bayesian statistical modeling post-test probabilities for LR+ and low HEART risk yielded a post-test probability for ETT of 7.75% and 9.09% for ECHO; intermediate risk gave 47.62% and 52.63%, respectively. For LR-, low HEART risk post-test probability for ETT was 0.46% and for ECHO 0.26%; intermediate risk probabilities were 4.48% and 2.49%, respectively. LR- was statistically significant in ruling out MACE with ECHO (p < 0.001), but no significant differences were seen for LR+ (p = 0.64). CONCLUSIONS: This Bayesian analysis demonstrated slight superiority of stress ECHO over ETT in low- and intermediate-risk patients in ruling out MACE.
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Síndrome Coronario Agudo/clasificación , Síndrome Coronario Agudo/diagnóstico , Toma de Decisiones , Prueba de Esfuerzo/métodos , Teorema de Bayes , Ecocardiografía de Estrés/métodos , Electrocardiografía/métodos , Servicio de Urgencia en Hospital/organización & administración , Prueba de Esfuerzo/estadística & datos numéricos , Humanos , Factores de RiesgoRESUMEN
Objetivo: Evaluar la influencia de la contaminación con sangre en una capa de adhesivo formada sobre esmalte humano y su posterior descontaminación con NaOCl (2.5 por ciento) y etanol (70°) en la resistencia microtraccional. Métodos: La superficie vestibular de 80 premolares humanos fue fresada para obtener superficies planas sobre las que se aplicó un adhesivo de grabado y lavado siguiendo las indicaciones del fabricante (Adper Single Bond 2, 3M ESPE). Los premolares fueron distribuidos aleatoriamente en cuatro grupos: Grupo 1 (control), Grupo 2 (contaminación con sangre), Grupo 3 (descontaminación con NaOCl 2.5 por ciento) y Grupo 4 (descontaminación con etanol 70°). Luego, sobre cada premolar se confeccionó una corona de resina compuesta (Filtek Z350, 3M ESPE) y fueron cortados para obtener cuerpos de prueba de 1mm2 de sección transversal, los cuales fueron termociclados (5500 ciclos, 5-55°C) y traccionados hasta su límite de ruptura (Micro Tensile Tester, Bisco). Los resultados fueron analizados estadísticamente (ANOVA, Scheffe, p<0.05). Resultados: La resistencia microtraccional del Grupo 1 (24.8 MPa) fue significativamente superior al resto de los grupos (p<0.05). Las diferencias entre los grupos 2, 3 y 4 no fueron estadísticamente significativas (p>0.05). Conclusión: La contaminación con sangre de la capa de adhesivo interfiere significativamente en la resistencia microtraccional. La descontaminación con NaOCl o etanol no logró una recuperación de la resistencia microtraccional.
Aim: To evaluate the influence of blood contamination of the adhesive layer and posterior decontamination with NaOCl (2.5 percent and ethanol (70º) on microtensile bond strength on human enamel. Methods: Vestibular surfaces of eighty human premolars were grounded to obtain flat surfaces. An etch-and-rinse adhesive was applied according to the manufacturers instructions (Adper Single bond 2, 3M ESPE). Teeth were randomly assigned into 4 groups: Group 1 (control), Group 2 (blood contamination), Group 3 (decontamination with NaOCl 2.5 percent) and Group 4 (decontamination with ethanol 70º). Then, a 4mm composite crown (Filtek Z350) was made and the teeth were vertically sectioned to obtain 1mm cross-section stick shape specimens. Specimens were thermocycled (5500 cycles, 5-55ºC) and pulled under tension until failure (Micro Tensile Tester, Bisco). Results were statistically analyzed (ANOVA, Scheffes test, p<0.05). Results: Microtensile bond strength in group 1 (24.8 MPa) was significantly higher than groups 2, 3 and 4 (p<0.05). The differences between groups 2, 3 and 4 were not significant (p>0.05). Conclusion: Blood contamination significantly interferes in microtensile bond strength. Decontaminating the blood residues with NaOCl or ethanol did not show a recovery of bond strength.
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Humanos , Masculino , Adulto , Femenino , Sangre , Cementos Dentales/química , Recubrimiento Dental Adhesivo , Contaminación de Equipos , Resistencia a la Tracción , Análisis de Varianza , Descontaminación , Propiedades de SuperficieRESUMEN
La abdominoplastia es una de las intervenciones quirúrgicas de mayor solicitud por parte de los pacientes dentro de la Cirugía Plástica. Uno de los inconvenientes que pueden presentarse después de su realización es la disminución o pérdida de sensibilidad cutánea de la pared abdominal como consecuencia de la disección de los nervios tóraco-abdominales al elevar el colgajo cutáneo, que se presenta hasta en un 57-72 % de los pacientes. Nuestro objetivo es determinar los trastornos de la sensibilidad cutánea superficial que se producen en el abdomen tras una abdominoplastia y el tiempo necesario para recuperar esa sensibilidad. Realizamos un estudio observacional, prospectivo, de cohorte, en el cual se incluyen 50 pacientes de sexo femenino, en dos grupos: un grupo control, al cual no se le realizó abdominoplastia, constituido por 20 mujeres con edades entre 24-40 años (promedio de 29.6 años) y sin cirugías abdominales previas, comorbilidades cutáneas ni sistémicas, y un grupo de estudio compuesto por 30 pacientes de edades comprendidas entre los 22-57 años (promedio de 36.2 años), con características similares a las del grupo control, a las cuales se les realizó abdominoplastia. La evaluación de la pared abdominal se realizó para los diferentes parámetros de la sensibilidad cutánea superficial usando un sistema de división del abdomen en 12 áreas; se examinó el tacto, el dolor, la temperatura (calor y frío) y la discriminación de dos puntos antes de la cirugía, a los 3 y a los 6 meses después de la abdominoplastia. Todas nuestras pacientes sometidas a abdominoplastia presentaron alguna alteración de la sensibilidad en comparación con las pacientes del grupo control. Las modalidades de la sensibilidad evaluadas a los 3 y 6 meses en el área 8 presentaron ausencia de respuesta al estímulo excepto para el tacto superficial, que estuvo presente en un 33.3 % a los 6 meses; el área 5 presentó mejoría ante los estímulos en la evaluación a los 6 meses, aunque no mejoró para la sensibilidad al calor. Concluimos que después de la realización de una abdominoplastia se presentan alteraciones de la sensibilidad de la pared abdominal que tienen un grado de severidad variable dependiendo de la región del abdomen considerada, siendo la más afectada la región del hipogastrio o suprapúbica, seguida del mesogastrio o umbilical, en las cuales están afectadas todas las modalidades de la sensibilidad excepto la táctil que es la primera en recuperarse pero no totalmente, por lo que se le debe explicar a los pacientes acerca de este inconveniente, frecuente en este procedimiento quirúrgico
Abdominoplasty is one of the most common cosmetic procedures performed in Plastic Surgery. One of the drawbacks that may arise after conclusion of the surgery is the reduction or loss of skin sensation in the abdominal wall as a result of skin flap dissection occurring in 57-72 % of patients. Our objective is to determine the sensory disturbances that occur on superficial skin in the abdomen after abdominoplasty and the time needed to recover sensitivity after surgery. We conducted an observational, prospective cohort study which included 50 female patients, which were divided into two groups: a control group which did not go through abdominoplasty consists of 20 women aged 24-40 years (mean of 29.6 years) without previous abdominal surgery, comorbidities of the skin or systemic illness, and a study group with 30 patients aged 22-57 years (mean 36.2 years) who underwent abdominoplasty. The evaluation of the abdominal wall was performed for different parameters of the superficial skin sensitivity. We used a system of division of the abdomen in 12 areas, we examined touch, pain, temperature (hot and cold) and discrimination of two points before surgery, 3 months and 6 months after abdominoplasty. All our patients had some impairment of sensitivity compared with the control group. All modalities of sensation assessed at 3 and 6 months in the area 8 had no response to the stimulus except for the superficial touch that was present in 33.3 % at 6 months; the area 5 presented an improvement to stimuli in evaluation at 6 months but did not recover the sensitivity to heat. We conclude that after an abdominoplasty there are some alterations in the sensitivity and severity of these are variable depending on the region of the abdomen being the most affected hypogastric area followed by mesogastric area, where all modalities of sensation were affected except touch, which is the first to recover but not entirely. So we should explain to patients about this inconvenience, which occurs consistently with this procedure
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Humanos , Abdominoplastia/efectos adversos , Pared Abdominal/fisiopatología , Estudios Prospectivos , Estudios de Casos y ControlesRESUMEN
Objetivo: Evaluar la capacidad de sellado de una resina fluida autoadhesiva (Fusio Liquid Dentin, Pentron Clinical) utilizada como sellante de fosas y fisuras con distintos acondicionamientos de la superficie de esmalte. Materiales y Métodos: Se seleccionaron 140 terceros molares recientemente extraídos, los que fueron distribuidos aleatoriamente en cuatro grupos (n=35) y recibieron una técnica de acondicionamiento del esmalte y aplicación de un sellante. Se establecieron los siguientes grupos: Grupo 1, grabado ácido y aplicación de sellante (Clinpro, 3M ESPE); Grupo 2, grabado ácido y aplicación de resina autoadhesiva (Fusio Liquid Dentin, Pentron Clinical); Grupo 3, aplicación de resina autoadhesiva; Grupo 4, microarenado del esmalte y aplicación de resina autoadhesiva. Los dientes sellados fueron termociclados (500 ciclos, 5-55°C), y posteriormente sumergidos en solución de nitrato de plata amoniacal por 24 h (pH=14) y luego en revelador radiográfico (GBX, Kodak) por 8h. Posteriormente, los dientes fueron cortados para obtener 2 láminas por diente que fueron observadas bajo magnificación (4x) y analizadas digitalmente para evaluar la microinfiltración y la penetración en la fisura. Los resultados fueron analizados estadísticamente (ANOVA, Dunnett, p<0.05). Resultados: La microinfiltración del Grupo 1 (13.18 +/- 9.25 por ciento) fue significativamente menor que la de los grupos 2, 3 y 4 (p<0.05). La penetración en la fisura en el Grupo 1 (98.92 +/- 2.77 por ciento) fue mayor que en los otros grupos, siendo esta diferencia significativa sólo con el Grupo 4. Conclusión: Fusio Liquid Dentin tiene una capacidad de sellado inferior a la del sellante convencional Clinpro, independiente del acondicionamiento del esmalte que se utilice.
Aim: To evaluate the sealing ability of a self-adhesive flowable composite-resin (Fusio Liquid Dentin, Pentron Clinical) with different conditioning treatments of the enamel surface used as a fissure sealant. Materials and Method: 140 recently extracted human third molars were selected and randomly divided into four groups (n=35). Each group received an enamel conditioning treatment and a sealant application. The following groups were established: Group 1, acid etching and sealant application (Clinpro, 3M ESPE); Group 2, acid etching and self-adhesive flowable composite-resin (Fusio Liquid Dentin, Pentron Clinical); Group 3, self-adhesive flowable composite-resin; Group 4, sandblasting and self-adhesive flowable composite-resin. Sealed teeth were thermocycled (500 cycles, 5-55ºC) and immersed in ammoniacal silver nitrate solution for 24 h (ph=14). After that, the teeth were immersed in radiographic developer solution (GBX, Kodak) for 8 h. Then, the teeth were vertically sectioned to obtain two slides each that were observed under magnification (4x) and digitally analyzed to assess microleakage and sealant penetration. Results were statistically analyzed (ANOVA, Dunnett, p<0.05). Results: Microleakage of Group 1 (13.18 +/- 9.25 percent) was significantly lower than groups 2, 3 and 4 (p<0.05). Group 1 had the highest sealant penetration mean (98.92 +/- 2.77 percent). Conclusion: Fusio Liquid Dentin had a worse sealing ability than Clinpro irrespective of their enamel conditioning treatment when used as a fissure sealant. Among Fusios groups, acid etching was the best enamel surface conditioning treatment.
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Humanos , Resinas Compuestas , Filtración Dental , Selladores de Fosas y Fisuras , Ensayo de Materiales , Cementos de Resina , Propiedades de SuperficieRESUMEN
An adequate response of the innate immune system after allo-SCT is crucial for the clinical outcome of patients submitted to this procedure. EP300 is one of the key genes of the innate immune system (IIS). We evaluated the influence of gene variant A>G rs20551 in EP300 in donor and/or recipient on clinical results after HLA-identical sibling allo-SCT. Patients with AA gene variant had a lower relapse incidence (31 vs 48%, P=0.025; odds ratio (OR)=1.6, P=0.05), attained better disease-free survival (AA: 53% vs AG+GG: 24%, P=0.001; OR=1.8, P=0.01), and better OS (AA: 53% vs AG+GG: 34%, P=0.001; OR=1.9, P=0.007). This beneficial association was more evident when AA gene variant was present in both donor and patient. In healthy individuals, AA gene variant was associated with lower IL2 production after a mitogenic stimuli, higher CD4+ cell response after CMV infection, and higher expression of innate immune genes (IRF-3 and MIF), cell cycle genes (AURKB, CCNA2 and CCNB1), lymphocyte survival genes (NFAT5 and SLC38A2), and with a lower expression of P53 compared with recessive GG gene variant. These findings suggest a beneficial effect of the AA gene variant in rs20551 on clinical outcome after allo-SCT.
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Proteína p300 Asociada a E1A/genética , Neoplasias Hematológicas/genética , Neoplasias Hematológicas/cirugía , Trasplante de Células Madre Hematopoyéticas/métodos , Adolescente , Adulto , Anciano , Supervivencia sin Enfermedad , Proteína p300 Asociada a E1A/inmunología , Antígenos HLA/inmunología , Neoplasias Hematológicas/inmunología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Estudios Retrospectivos , Factores de Riesgo , Donantes de Tejidos , Resultado del Tratamiento , Adulto JovenAsunto(s)
Hemorragia Subaracnoidea , Adulto , Muerte Encefálica , Resultado Fatal , Humanos , Hipoxia-Isquemia Encefálica/diagnóstico , Hipoxia-Isquemia Encefálica/diagnóstico por imagen , Masculino , Radiografía , Hemorragia Subaracnoidea/diagnóstico , Hemorragia Subaracnoidea/diagnóstico por imagenRESUMEN
El quiste óseo aneurismático es una lesión ósea benigna de etiopatogenia incierta. Se ha postulado que pudiera tratarse de una lesión reactiva a un traumatismo o a un tumor óseo primario benigno (tumor de células gigantes, condroblastoma, etc.) o maligno (osteosarcoma) que acaba produciendo cambios hemodinámicos locales. Existe controversia sobre su posible malignización. Presentamos un caso de evolución radiológica de osteosarcoma de bajo grado indistinguible de quiste óseo aneurismático (AU)
Aneurysmatic bone cysts are benign lesions of unknown origin. It has been postulated that they might occur in reaction to trauma or to a primary benign (giant cell tumor, chondroblastoma, etc.) or malignant (osteosarcoma) bone tumor that results in local hemodynamic changes. Their malignant transformation is controversial. We present a case of low grade osteosarcoma with a radiologic progression that was indistinguishable from that of an aneurysmatic bone cyst (AU)
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Humanos , Femenino , Niño , Quistes Óseos Aneurismáticos , Osteosarcoma , Neoplasias de Tejido Óseo , Tumores de Células Gigantes , Quistes Óseos Aneurismáticos/diagnóstico , Quistes Óseos Aneurismáticos/patología , Condroblastoma , Hombro/patología , HombroRESUMEN
Aneurysmatic bone cysts are benign lesions of unknown origin. It has been postulated that they might occur in reaction to trauma or to a primary benign (giant cell tumor, chondroblastoma, etc.) or malignant (osteosarcoma) bone tumor that results in local hemodynamic changes. Their malignant transformation is controversial. We present a case of low grade osteosarcoma with a radiologic progression that was indistinguishable from that of an aneurysmatic bone cyst.
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Quistes Óseos Aneurismáticos/diagnóstico por imagen , Húmero , Osteosarcoma/diagnóstico por imagen , Quistes Óseos Aneurismáticos/complicaciones , Niño , Femenino , Humanos , Osteosarcoma/complicaciones , RadiografíaRESUMEN
INTRODUCTION: Two separate molecular pathways have been proposed for the early carcinogenic events observed in the oral cavity and pharynx: one is associated with chemical etiological factors such as smoking and drinking, and the other one is associated with HPV insertion. OBJECTIVE: A proof-of-principle study was performed to ascertain if global DNA methylation could be used to distinguish between the early molecular changes in premalignant oral lesions. METHODS: Personal histories of tobacco and alcohol use were obtained by questionnaire. HPV insertion in tumor tissue was detected by polymerase chain reaction (PCR). Global DNA methylation levels were obtained using HPLC for fraction separation and mass spectrometry for quantification. Predictive simulations were performed to explore potential associations between different etiological factors and the global DNA methylation index. Significance of results was ascertained using Pearson's Chi-squared test. RESULTS: The global methylation index was found to be 4.28 (95% CI, 4.1, 4.4) in an oral cancer case series. Pearson's chi squared test showed no statistically significant difference between cases that had smoking (p = 0.21), drinking (p = 0.31) or HPV insertion (p = 0.34) as etiologic risk factors, when compared to cases that did not. An inverse significant association between smoking and DNA methylation was observed. As the smoking effect increases, the global methylation index decreases, In addition, no associations between the probability of DNA methylation and drinking, or DNA methylation and HPV insertion were observed in simulations. CONCLUSIONS: The global DNA methylation index was shown to vary for oral cancer cases with different etiologies. Smoking was inversely correlated with DNA methylation levels when generalized linear model simulations were performed. Future studies should look at global DNA methylation alterations associated to the progression from normal to premalignant oral epithelium tissue in a cohort of smokers and nonsmokers.
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Carcinoma de Células Escamosas/genética , Metilación de ADN , Neoplasias de la Boca/genética , Consumo de Bebidas Alcohólicas/efectos adversos , Carcinoma de Células Escamosas/etiología , Humanos , Modelos Genéticos , Neoplasias de la Boca/etiología , Infecciones por Papillomavirus/complicaciones , Fumar/efectos adversosRESUMEN
The parasite Trypanosoma cruzi is the causative agent of Chagas disease. T. cruzi invasion and replication in cardiomyocytes induce cellular injuries and cytotoxic reactions, with the production of inflammatory cytokines and nitric oxide, both source of reactive oxygen species. The myocyte response to oxidative stress involves the progression of cellular changes primarily targeting mitochondria. We studied the cardiac mitochondrial structure and the enzymatic activity of citrate synthase and respiratory chain CI-CIV complexes, in Albino Swiss mice infected with T. cruzi, Tulahuen strain and SGO Z12 isolate, in two periods of the acute infection. Changes in the mitochondrial structure were detected in both infected groups, reaching values of 71% for Tulahuen and 88% for SGO Z12 infected mice, 30 days post infection. The citrate synthase activity was different according to the evolution of the infection and the parasite strain, but the respiratory chain alterations were similar with either strain.