Considering that osteoarthritis (OA) is the most prevalent joint disease worldwide, multiple pharmacological treatments have been proposed to alter the articular structure with potential benefit in the progression of the disease. The so-called disease-modifying OA drugs have been frequently investigated but conclusive findings are rare. Strontium ranelate (SrRan) is a drug usually prescribed to treat osteoporosis, with proven effects in decreasing the risk of fractures and possible effect in reducing the progression of OA. The objective of this review was to demonstrate the current panorama of knowledge on the use of SrRan in clinical and experimental models, clarifying its mechanisms of action and describing possible anti-nociceptive and anti-inflammatory effects. The systematic review was based on the PRISMA statement and included articles that are indexed in scientific databases. Fifteen studies were included: seven pre-clinical and eight clinical studies. Despite the limited number of studies, the results suggest a positive effect of SrRan in patients with OA, through changes in functional capacity and reduction of progression of morphological parameters and joint degradation, with moderate quality of evidence for those clinical outcomes. Novel studies are necessary to elucidate the molecular targets of SrRan, focusing on anti-inflammatory effects and histological changes promoted by SrRan, which seemed to reduce the progression of OA in the experimental and clinical studies.

Strontium ranelate (SrRan) is a drug usually prescribed to treat osteoporosis, with proven effects of decreasing the risk of fractures and an indication of reducing the progression of osteoarthritis (OA). This study aimed to investigate the effects of SrRan as either a prophylactic or a treatment drug, using an OA rat model to assess pain behavior. A monoiodoacetate (MIA)-induced knee joint OA model in Wistar rats was used. Thirty Wistar rats (both sexes, 60 days old) were distributed in five groups of 6 rats each: the control group, that received no intervention; a prophylactic group, that received oral administration of 25 mg·kg-1·day-1 of SrRan for 28 days before induction of OA; a group treated with 25 mg·kg-1·day-1 of SrRan for 28 days after OA induction; a group treated with 50 mg·kg-1·day-1 during 28 days after OA induction; and a group that received oral saline for 28 days after induction. The assessment of pain behavior was performed considering articular incapacitation (weight-bearing test), mechanical hyperalgesia (Randall Selitto test) and motor activity (rotarod test), on days 0, 7, 14, 21, and 28. This experiment did not yield a significant difference when comparing the group that received SrRan prophylactically with the groups treated with 25 or 50 mg·kg-1·day-1 and the group that received oral saline. Thus, SrRan did not provide analgesia in either treated rats or as a prophylactic drug with the tested doses. Higher doses should be tested further to achieve possible significant results.

Giant hamartoma of the breast is an unusual clinicopathologic entity that tends to be mistaken with other tumours. Its clinical diagnosis is extremely difficult and, despite of the radiologic improvements, most of them are suspected and confirmed only when all specimen is studied. Its differential diagnosis includes fibroadenoma, lipoma, phyllodes tumour and various carcinomas. We report 2 cases of giant hamartoma of the breast in middle age female patients, with surgical approach of the tumor by nipple-areola sparing mastectomy and correction of the resultant breast deformity by prosthetic reconstruction and other with excisional biopsy with mastopexy.

El hamartoma gigante de la mama es una entidad clínico-patológica inusual que tiende a confundirse con otros tumores. A pesar del avance en las técnicas diagnósticas, su diagnóstico clínico es difícil y normalmente solo se confirma cuando se analiza toda la pieza de resección. El diagnóstico diferencial debe incluir entidades como el fibroadenoma, lipoma, tumor phyllodes y diversos tipos de carcinomas. Presentamos 2 casos de hamartoma gigante de mama en mujeres de edad media, de los cuales uno fue tratado mediante mastectomía conservadora de complejo pezónareola y reconstrucción con prótesis y el otro con biopsia escisional y remodelación con patrón de pexia mamaria.

Increasingly, in order to achieve optimum overall outcome, Units breast cancer treatment requires the skills of a reconstructive plastic surgeon. In our Unit, for more than 20 years, is understood as the sum of oncologic competence and reconstructive skill. So, plastic surgeon is incorporated as an integral member of the clinical team, providing aesthetic criteria oncologic surgery using oncoplastic surgical techniques. In this paper we analyze the evolution of oncoplastic surgery in the past 20 years, demonstrating the importance of the plastic surgeon as an integral member of Breast Pathology Unit.

Cada vez más, con el fin de alcanzar un resultado final integral óptimo, las Unidades de tratamiento del cáncer de mama requieren las habilidades de un cirujano plástico reconstructor. En nuestra Unidad, desde hace más de 20 años, se entiende como calidad asistencial la suma de competencia oncológica y habilidad reconstructiva. Por ello se incorpora como miembro integral del equipo clínico la figura del cirujano plástico, aportando criterios estéticos a la cirugía oncológica aplicando las técnicas de cirugía oncoplástica. En este artículo analizamos la evolución de la cirugía oncoplástica en los últimos 20 años, demostrando la importancia del cirujano plástico como miembro integral de Unidad de Patología Mamaria.

The modern reconstructive surgery continuously searches the best coverage option with minimal donor morbidity. Our goal with this prohespective series and revision is to show how versatile sural artery perforator flap can be and the assistance with angioTAC as presurgical planning tool. We describe our experience in 2 years with 11 cases of using of the sural artery perforator flap. We also introduce the using of angioscanner as a presurgical planning tool to identify and design the flap. We conclude that sural artery perforator flap (SAP) is an effective and reliable reconstructive fasciocutaneous option and that angioTAC is a helpful-planning tool that confers suitability to be indicated.

La cirugía reconstructiva moderna busca incesantemente lograr la mejor cobertura bajo la mínima morbilidad de la zona donante. El objetivo de esta revisión y serie prospectiva es mostrar la versatilidad del colgajo de perforantes de la arteria sural medial y lateral para la cobertura de diferentes defectos empleado tanto de forma local como libre. Paralelamente, analizamos el valor del angioTAC en la planificación prequirúrgica de dicho colgajo. Exponemos nuestra experiencia reciente, de 2 años, con 11 casos de utilización del colgajo de perforantes de la arteria sural (SAP). Introducimos el uso del angioscanner como herramienta de planificación quirúrgica para la localización de las perforantes y diseño del colgajo. Concluimos que el colgajo SAP es una opción reconstructiva efectiva y fiable y que el angioTAC prequirúrgico es lo suficientemente útil como para realizarse de forma protocolaria.