Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis

OBJECTIVE

A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it.

MATERIAL AND METHOD

Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA- standards, and the inclusion criteria following the PICO strategy. Data from included studies were analyzed using Review Manager 5.4 software.

RESULTS

A total of 7 retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group vs. 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99).

CONCLUSION

Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.

[Translated article] Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis

OBJECTIVE

A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it.

MATERIAL AND METHOD

Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA- standards, and the inclusion criteria following the PICO strategy. Data from included studies were analysed using Review Manager 5.4 software.

RESULTS

A total of seven retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group versus 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99).

CONCLUSION

Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.

Immune thrombotic thrombocytopenic purpura in older patients: Results from the Spanish TTP Registry (REPTT)

Immune thrombotic thrombocytopenic purpura (iTTP) is an ultra-rare disease that seldom occurs in the elderly. Few reports have studied the clinical course of iTTP in older patients. In this study, we have analysed the clinical characteristics at presentation and response to therapy in a series of 44 patients with iTTP ≥60 years at diagnosis from the Spanish TTP Registry and compared them with 209 patients with <60 years at diagnosis from the same Registry. Similar symptoms and laboratory results were described in both groups, except for a higher incidence of renal dysfunction among older patients (23% vs. 43.1%; p = 0.008). Front-line treatment in patients ≥60 years was like that administered in younger patients. Also, no evidence of a difference in clinical response and overall survival was seen in both groups. Of note, 14 and 25 patients ≥60 years received treatment with caplacizumab and rituximab, respectively, showing a favourable safety and efficacy profile, like that observed in patients <60 years.

Neuropsychiatric phenotypes of anti-NMDAR encephalitis: a prospective study

BACKGROUND

Patients with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (ANMDARE) show a wide range of behavioral abnormalities and are often mistaken for primary psychiatric presentations. We aimed to determine the behavioral hallmarks of ANMDARE with the use of systematic neuropsychiatric and cognitive assessments.

METHODS

A prospective study was conducted, with 160 patients admitted to the National Institute of Neurology and Neurosurgery of Mexico, who fulfilled criteria for possible autoimmune encephalitis and/or red flags along a time window of seven years. Cerebrospinal fluid (CSF) antibodies against the NR1 subunit of the NMDAR were processed with rat brain immunohistochemistry and cell-based assays with NMDA expressing cells. Systematic cognitive, neuropsychiatric, and functional assessments were conducted before knowing NMDAR antibodies results. A multivariate analysis was used to compare patients with and without definite ANMDARE according to antibodies in CSF.

RESULTS

After obtaining the CSF antibodies results in 160 consecutive cases, 100 patients were positive and classified as having definite ANMDARE. The most frequent neuropsychiatric patterns were psychosis (81%), delirium (75%), catatonia (69%), anxiety-depression (65%), and mania (27%). Cognition was significantly impaired. A total of 34% of the patients had a predominantly neuropsychiatric presentation without seizures. After multivariate analysis, the clinical hallmarks of ANMDARE consisted of a catatonia-delirium comorbidity, tonic-clonic seizures, and orolingual dyskinesia.

CONCLUSIONS

Our study supports the notion of a neurobehavioral phenotype of ANMDARE characterized by a fluctuating course with psychotic and affective symptoms, catatonic signs, and global cognitive dysfunction, often accompanied by seizures and dyskinesia. The catatonia-delirium comorbidity could be a distinctive neurobehavioral phenotype of ANMDARE.

[Clinical results in hip replacement surgery with mild acetabular defects: a retrospective comparative study of cups with dual mobility and monopolar cups]

INTRODUCTION

hip revision arthroplasty surgery is a surgical procedure that has been growing in recent years. Revision total hip arthroplasty (THA) is a notable surgical challenge due to the technical difficulty of the surgery itself. Complications of revision surgery includes dislocation, aseptic loosening, and infection.

OBJECTIVE

to compare the clinical-radiological results, as well as the incidence of complications, of two independent samples of patients who underwent revision total hip arthroplasty (rTHA) with mild-moderate acetabular defects using dual mobility implants compared to monopolar implants.

MATERIAL AND METHODS

retrospective comparative study of two cohorts of 30 patients who underwent acetabular revision surgery using large 36 mm monopolar heads or dual mobility respectively. All patients had Paprosky type I or II acetabular defects. The results on the VAS scale, WOMAC, and Harry hip score (HHS) were evaluated pre and postoperatively in both cohorts. Likewise, the incidence of postoperative complications and the survival rate between both groups were analyzed.

RESULTS

mean follow-up was 5.8 years (1-10.3 years). The difference between the pre and postoperative results in each cohort was significant for the VAS, WOMAC and HHS scale. The differences obtained in these scales between the different study groups did not find significant differences. The incidence of postoperative complications between both cohorts was similar, without finding significant differences.

CONCLUSIONS

we consider that dual mobility does not provide superiority in terms of clinical-functional results and incidence of postoperative complications with respect to monopolar assemblies in acetabular revision surgery with mild-moderate defects.

Multigene germline testing usefulness instead of BRCA1/2 single screening in triple negative breast cancer cases

Triple negative breast cancer is considered as the worst aggressive subtype with poor prognosis. Recent studies suggest a hereditary component is involved in TNBC development, especially in young patients. However, genetic spectrum remains unclear. Our purpose was to evaluate the usefulness of multigene panel testing in triple negative patients compared to overall breast cancer cases as well as contributing to elucidate which genes are most implicated in triple negative subtype development. Two breast cancer cohorts, comprising 100 triple negative breast cancer patients and 100 patients with other breast cancer subtypes, were analyzed by Next-Generation Sequencing using an On-Demand panel which included 35 predisposition cancer genes associated with inherited cancer susceptibility. The percentage of germline pathogenic variant carriers was higher in the triple negative cohort. ATM, PALB2, BRIP1 and TP53 were the most non-BRCA mutated genes. Moreover, triple negative breast cancer patients without family history related who were identified as carriers were diagnosed at significantly earlier age. As conclusion, our study reinforces the usefulness of multigene panel testing in breast cancer cases but specifically in those with triple negative subtype regardless family history.

[First case series of femoral lengthening using a Precice® intramedullary nail in our center]

INTRODUCTION

femoral lengthening using an intramedullary nail is one of the surgical options in the treatment of severe lower limb dysmetria in routine clinical practice.

MATERIAL AND METHODS

a retrospective descriptive study was carried out on a series of five patients with a mean age of 15.4 years, who underwent femoral lengthening surgery using a Precice® intramedullary nail. The etiology in all cases was idiopathic. Preoperative and definitive postoperative theoretical lengthening or dysmetry was measured, as well as lengthening accuracy, distraction rate and index (mm/day and days/cm, respectively) and consolidation index (days/cm). Intraoperative and postoperative complications were identified in all cases.

RESULTS

mean follow-up was 21 months (12-42), with no loss to follow-up. The mean duration of the surgical procedure was 126 minutes (105-160). The preoperative theoretical dysmetry was 38 ± 2.7 mm. The final mean lengthening was 41 ± 7.5 mm. The mean accuracy was 108% (91-125) and the distraction rate was 0.9 ± 0.4 mm/day. The distraction rate was 13.9 ± 5.1 days/cm and the consolidation rate was 26.6 ± 9.1 days/cm. Bone consolidation was observed in all patients with a mean of 113 ± 58 days. Regarding complications, a total of four minor muscular complications were found.

CONCLUSION

the Precice® intramedullary nail is a good treatment option for cases of severe femoral shortening, providing good clinical and radiological results with a low rate of complications and implant failure.

Limosilactobacillus reuteri ATCC PTA 5289 and DSM 17938 as adjuvants to improve evolution of pharyngitis/tonsillitis in children: randomised controlled trial

Pharyngitis and tonsillitis are the most common acute respiratory infections (ARIs) in children aged ≤5 years. The analysis of published data showed that some probiotics could decrease the frequency and number of days with ARIs. This study evaluated the safety and efficacy of Limosilactobacillus reuteri ATCC PTA 5289 and DSM 17938 to reduce the duration and severity of ARI symptoms. This randomised controlled trial included children aged from 6 months to 5 years, with pharyngitis or tonsillitis, who were randomised to receive a probiotic product containing L. reuteri ATCC PTA 5289 and L. reuteri DSM 17938 or placebo, as drops, ingested orally for 10 days as adjuvants to the use of non-steroidal anti-inflammatory drugs. The main outcomes were the duration and severity of ARI symptoms. The secondary outcomes were changes in salivary immunoglobulin A and inflammatory biomarkers. There was no fever on day 2 and subsequent days in the L. reuteri group (37.3 ±0.5 °C vs 38.6±0.3 °C, P<0.05). Beginning on day 3, the severity of sore throat (5±0.9 vs 8±1.2, P<0.05) was lower in the L. reuteri group. Significant differences in the days with runny nose, nasal congestion, days of non-programmed visits to the medical office or emergency department, levels in tumoral necrosis factor-alpha (TNF-alpha) and related costs of treatment were observed in the L. reuteri group. The frequency of adverse events was similar between the groups. Therefore, L. reuteri ATCC PTA 5289 combined with L. reuteri DSM 17938 is a safe and effective adjunct to reduce the symptoms of pharyngitis or tonsillitis in children.

Menstrual health and period poverty among young people who menstruate in the Barcelona metropolitan area (Spain): protocol of a mixed-methods study

INTRODUCTION

The importance of menstrual health has been historically neglected, mostly due to taboos and misconceptions around menstruation and androcentrism within health knowledge and health systems around the world. There has also been a lack of attention on 'period poverty', which refers to the financial, social, cultural and political barriers to access menstrual products and education. The main aim of this research is to explore menstrual health and experiences of period poverty among young people who menstruate (YPM).

METHODS AND ANALYSIS

This is a convergent mixed-methods study, which will combine a quantitative transversal study to identify the prevalence of period poverty among YPM (11-16 years old), and a qualitative study that will focus on exploring menstruation-related experiences of YPM and other groups (young people who do not menstruate (YNM); primary healthcare professionals; educators and policy-makers). The study will be conducted in the Barcelona metropolitan area between 2020 and 2021. Eighteen schools and 871 YPM will be recruited for the quantitative study. Sixty-five YPM will participate in the qualitative study. Forty-five YNM and 12 professionals will also be recruited to take part in the qualitative study. Socioeconomic and cultural diversity will be main vectors for recruitment, to ensure the findings are representative to the social and cultural context. Descriptive statistics will be performed for each variable to identify asymmetric distributions and differences among groups will be evaluated. Thematic analysis will be used for qualitative data analyses ETHICS AND DISSEMINATION: Several ethical issues have been considered, especially as this study includes the participation of underage participants. The study has received ethical approval by the IDIAPJGol Research Ethics Committee (19/178 P). Research findings will be disseminated to key audiences, such as YPM, YNM, parents/legal tutors, health professionals, educators, youth (and other relevant) organisations, general community members, stakeholders and policy-makers, and academia.

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air® App

BACKGROUND

In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently.

METHODS

All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated.

RESULTS

A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures.

CONCLUSIONS

VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.

Assessing forest availability for wood supply in Europe

The quantification of forests available for wood supply (FAWS) is essential for decision-making with regard to the maintenance and enhancement of forest resources and their contribution to the global carbon cycle. The provision of harmonized forest statistics is necessary for the development of forest associated policies and to support decision-making. Based on the National Forest Inventory (NFI) data from 13 European countries, we quantify and compare the areas and aboveground dry biomass (AGB) of FAWS and forest not available for wood supply (FNAWS) according to national and reference definitions by determining the restrictions and associated thresholds considered at country level to classify forests as FAWS or FNAWS. FAWS represent between 75 and 95 % of forest area and AGB for most of the countries in this study. Economic restrictions are the main factor limiting the availability of forests for wood supply, accounting for 67 % of the total FNAWS area and 56 % of the total FNAWS AGB, followed by environmental restrictions. Profitability, slope and accessibility as economic restrictions, and protected areas as environmental restrictions are the factors most frequently considered to distinguish between FAWS and FNAWS. With respect to the area of FNAWS associated with each type of restriction, an overlap among the restrictions of 13.7 % was identified. For most countries, the differences in the FNAWS areas and AGB estimates between national and reference definitions ranged from 0 to 5 %. These results highlight the applicability and reliability of a FAWS reference definition for most of the European countries studied, thereby facilitating a consistent approach to assess forests available for supply for the purpose of international reporting.

Biología del transporte axonal y síndrome de doble compresión

Después de más de 40 años desde la descripción del Síndrome de Doble Compresión por Upton y McComas en el Lancet, sigue siendo un tema debatido que ha llevado a algunos cirujanos de mano a dudar de su existencia. La evidencia científica demuestra que la alteración del transporte axonal es el mecanismo más plausible en la fisiopatología de ese síndrome de compresión nerviosa. Se ha demostrado que una cuidadosa exploración clínica junto a un buen estudio neurofisiológico bien dirigido incrementa la eficiencia diagnóstica en términos de pacientes correctamente diagnosticados en el SDC. La liberación del Ligamento Transverso del Carpo está indicada en determinados pacientes que cumplen unos criterios de inclusión y exclusión específicos. Los resultados demuestran que la liberación del canal carpiano en esa población diana específica, es capaz de mejorar la gravedad de los síntomas de manera similar a la población afecta de Síndrome del Túnel Carpiano y de manera casi similar, a nivel de la Discapacidad de MMSS. Sólo instrumentos genéricos, como el SF-36, han sido capaces de detectar la diferencia a nivel de ciertas dimensiones de la Salud en relación a la Calidad de Vida entre los resultados del tratamiento en SDC y STC.

Field Performance of Cryopreserved Seed-derived Maize Plants

BACKGROUND

Cryo-preservation of plant materials in liquid nitrogen (LN) has been described as a suitable technology to conserve genetic resources of several species. However, the potential effects of LN in the subsequent plant growth in the field should be studied before large-scale implementation of cryopreserved germplasm banks.

OBJECTIVE

To describe the field performance of cryopreserved seed-derived maize adult plants.

MATERIALS AND METHODS

Germination percentage and numbers of leaves and ears per plant, internodes in stems, middle - aged leaf length, plant height, ear traits and weight of 100 seeds were recorded.

RESULTS

Statistically significant differences between adult plants derived from cryopreserved seeds and the control treatment were not observed (t-test, p=0.05).

CONCLUSION

The results presented confirm at the phenotype level the effectiveness of maize seed cryostorage to preserve and regenerate true-to-type plants.

Effect of heat stress on the endogenous intestinal loss of amino acids in growing pigs

Heat stress (HS) increases the death of intestinal cells in pigs, which, in turn, may elevate the endogenous intestinal loss (EIL) of proteins and AA. An experiment was conducted to analyze the effect of HS on the AA composition of intestinal endogenous proteins and the EIL of AA in pigs. Eight pigs (25.2 ± 1.2 kg initial BW) were surgically implanted with T-type cannulas at the end of the small intestine. After surgery recovery, during the subsequent 7 d, all pigs were adapted to a protein- and AA-free diet and trained to consume the same amount of feed twice a day. All pigs were housed under thermoneutral (TN) conditions (22 ± 2°C) during this time. The following day, all pigs were still under TN conditions and ileal content was collected during 12 consecutive hours, at the end of which and for the following 8 d the pigs were exposed to natural HS conditions (31 to 37°C). Ileal content was collected again on d 2 (HS at d 2 [HSd2]) and 8 (HS at d 8 [HSd8]). Body temperature (BT) was measured in another group of 8 pigs every 15 min during the whole study. The average BT at HSd2 (39.6°C) was higher ( < 0.05) compared with both TN conditions (38.6°C) and HSd8 (38.8°C), but it did not differ between TN conditions and HSd8. The AA composition of endogenous intestinal protein was not affected by HS. The EIL of Arg and His were greater ( < 0.05) and the EIL of Thr and Phe tended to be greater ( ≤ 0.10) at HSd2 than in TN conditions; the EIL of Pro was greater ( = 0.01) at HSd8. The EIL of the remaining AA was not affected by HS. Although HS increased the EIL of Arg and His within the first 2 d, it appeared that normal EIL was shortly reestablished. These data show that acute HS does not affect the AA composition of intestinal endogenous proteins in growing pigs and that the EIL of AA may not be critical in growing pigs acclimated to high ambient temperature. Nevertheless, the increased EIL of Arg and Thr at HSd2 indicate that HS might affect the integrity of the intestinal epithelium of pigs during the first day of their exposure to high ambient temperature.

Detection and identification of orthopoxviruses using a generic nested PCR followed by sequencing

Some orthopoxviruses are considered to be potential biological weapons. After the smallpox eradication campaign ended, routine vaccination was stopped around the world. Consequently, a significant portion of the population is now completely unprotected from infection by variola virus and related orthopoxviruses. Some of the symptoms associated with non-variola infections can be similar to smallpox, causing alert and panic situations. These infections should be considered as real public health concerns, so suitable tools for their differential diagnosis are needed. This study aims to devise a simple and easy-to-perform method that is able to detect and identify any orthopoxvirus that might cause infection in humans. In addition, the similarity of the different genes in the genomes of several species of orthopoxviruses is investigated, and orthopoxvirus-universal primer pairs in the tumour necrosis factor receptor II homologue gene are designed, taking full account of nucleotide similarity. A strategy is devised for their sensitive, rapid and cost-effective detection and identification, based on a nested PCR followed by sequencing. The efficacy of the method is tested with samples sent by the European Network of Imported Viral Diseases as part of two external quality control assays. All human orthopoxviruses assayed were detected and identified.

A multicentric study regarding the use of hormone therapy during female mid-age (REDLINC VI)

BACKGROUND

Menopausal hormone therapy (HT) has shown benefits for women; however, associated drawbacks (i.e. risks, costs, fears) have currently determined its low use.

OBJECTIVE

To determine the prevalence of current HT use among mid-aged women and describe the characteristics of those who have never used, have abandoned or are currently using HT. In addition, reasons for not using HT were analyzed.

METHOD

This was a cross-sectional study that analyzed a total of 6731 otherwise healthy women (45-59 years old) of 15 cities in 11 Latin American countries. Participants were requested to fill out the Menopause Rating Scale (MRS) and a questionnaire containing sociodemographic data and items regarding the menopause and HT use.

RESULTS

The prevalence of current HT use was 12.5%. Oral HT (43.7%) was the most frequently used type of HT, followed by transdermal types (17.7%). The main factors related to the current use of HT included: positive perceptions regarding HT (odds ratio (OR) 11.53, 95% confidence interval (CI) 9.41-14.13), being postmenopausal (OR 3.47, 95% CI 2.75-4.36) and having a better socioeconomic level. A total of 48.8% of surveyed women had used HT in the past, but abandoned it due to symptom improvement or being unconcerned; fear of cancer or any other secondary effects were also reported but in less than 10%. Among women who had never used HT, 28% reported the lack of medical prescription as the main reason, followed by the absence of symptoms (27.8%). Among those reporting lack of prescription as the main reason for not using HT, 30.6% currently had severe menopausal symptoms (total MRS score > 16); 19.5% of women were using alternative 'natural' therapies, with 35.1% of them displaying severe menopausal symptoms as compared to a 22.5% observed among current HT users.

CONCLUSION

The use of HT has not regained the rates observed a decade ago. Positive perceptions regarding HT were related to a higher use. Lack of medical prescription was the main reason for not using HT among non-users, many of whom were currently displaying severe menopausal symptoms.

ALBIRA: a small animal PET∕SPECT∕CT imaging system

PURPOSE

The authors have developed a trimodal PET∕SPECT∕CT scanner for small animal imaging. The gamma ray subsystems are based on monolithic crystals coupled to multianode photomultiplier tubes (MA-PMTs), while computed tomography (CT) comprises a commercially available microfocus x-ray tube and a CsI scintillator 2D pixelated flat panel x-ray detector. In this study the authors will report on the design and performance evaluation of the multimodal system.

METHODS

X-ray transmission measurements are performed based on cone-beam geometry. Individual projections were acquired by rotating the x-ray tube and the 2D flat panel detector, thus making possible a transaxial field of view (FOV) of roughly 80 mm in diameter and an axial FOV of 65 mm for the CT system. The single photon emission computed tomography (SPECT) component has a dual head detector geometry mounted on a rotating gantry. The distance between the SPECT module detectors can be varied in order to optimize specific user requirements, including variable FOV. The positron emission tomography (PET) system is made up of eight compact modules forming an octagon with an axial FOV of 40 mm and a transaxial FOV of 80 mm in diameter. The main CT image quality parameters (spatial resolution and uniformity) have been determined. In the case of the SPECT, the tomographic spatial resolution and system sensitivity have been evaluated with a (99m)Tc solution using single-pinhole and multi-pinhole collimators. PET and SPECT images were reconstructed using three-dimensional (3D) maximum likelihood and ordered subset expectation maximization (MLEM and OSEM) algorithms developed by the authors, whereas the CT images were obtained using a 3D based FBP algorithm.

RESULTS

CT spatial resolution was 85 μm while a uniformity of 2.7% was obtained for a water filled phantom at 45 kV. The SPECT spatial resolution was better than 0.8 mm measured with a Derenzo-like phantom for a FOV of 20 mm using a 1-mm pinhole aperture collimator. The full width at half-maximum PET radial spatial resolution at the center of the field of view was 1.55 mm. The SPECT system sensitivity for a FOV of 20 mm and 15% energy window was 700 cps∕MBq (7.8 × 10(-2)%) using a multi-pinhole equipped with five apertures 1 mm in diameter, whereas the PET absolute sensitivity was 2% for a 350-650 keV energy window and a 5 ns timing window. Several animal images are also presented.

CONCLUSIONS

The new small animal PET∕SPECT∕CT proposed here exhibits high performance, producing high-quality images suitable for studies with small animals. Monolithic design for PET and SPECT scintillator crystals reduces cost and complexity without significant performance degradation.

Expectation maximization (EM) algorithms using polar symmetries for computed tomography (CT) image reconstruction

We suggest a symmetric-polar pixellation scheme which makes possible a reduction of the computational cost for expectation maximization (EM) iterative algorithms. The proposed symmetric-polar pixellation allows us to deal with 3D images as a whole problem without dividing the 3D problem into 2D slices approach. Performance evaluation of each approach in terms of stability and image quality is presented. Exhaustive comparisons between all approaches were conducted in a 2D based image reconstruction model. From these 2D approaches, that showing the best performances were finally implemented and evaluated in a 3D based image reconstruction model. Comparison to 3D images reconstructed with FBP is also presented. Although the algorithm is presented in the context of computed tomography (CT) image reconstruction, it can be applied to any other tomographic technique as well, due to the fact that the only requirement is a scanning geometry involving measurements of an object under different projection angles. Real data have been acquired with a small animal (CT) scanner to verify the proposed mathematical description of the CT system.

Automatic intraductal breast carcinoma classification using a neural network-based recognition system

A contour-based automatic recognition system was applied to classify intraductal breast carcinoma into high nuclear grade and low nuclear grade in a digitized histologic image. The image discriminating characteristics were selected by their invariability condition to rotation and translation. They were acquired from cellular contours information. The totally interconnected multilayer perceptron network architecture was selected, and it was trained with the error back propagation algorithm. Forty cases were analyzed by the system and the diagnoses were compared with that of pathologist consensus, obtaining agreement in 97.5% (p < .00001 of cases). The system may become a very useful tool for the pathologist in the definitive classification of intraductal carcinoma.

First Report of Colletotrichum acutatum and C. fragariae Causing Bitter Rot of Apple in Uruguay

Almost 50% of deciduous fruit produced in Uruguay are apples and bitter rot is ubiquitous in the apple-production regions in Uruguay. In rainy and hot seasons (25 to 32°C by day), severe outbreaks of bitter rot occur. In summer 2010, when apple rot incidence reached 70% in some orchards, fruit with typical symptoms of bitter rot were collected from orchards in the south-central region, the main apple-production area. Symptoms included 0.5 to 6.0 cm in diameter, circular, sunken, light brown-to-brown lesions on the fruit surface that contained black, pinhead-sized fruiting structures that produced orange-to-brown conidial masses under high relative humidity. Each lesion progressed to the core of the fruit in a V-shaped pattern. Single-conidial isolates from lesions were examined morphologically (3), and based on sequences of the internal transcribed spacer (ITS) rDNA determined using ITS1/ITS4 primers (4), three species were identified: Colletotrichum acutatum with white-to-pale orange colonies and one-celled, hyaline, fusiform to cylindrical conidia that averaged 14.5 (9.3 to 17.8) × 5.0 (6.9 to 4.0) μm (isolates C11 and C18, GenBank Nos. JN413081 and JN413082, respectively); C. fragariae with white-to-pale gray and/or dark gray colonies and one-celled, hyaline, cylindrical to fusiform conidia that averaged 20.5 (14.3 to 22.9) × 6.0 (4.6 to 7.6) μm (isolate C15 and C37, GenBank Nos. JN413083 and JN413084, respectively); and C. gloeosporioides with white-to-pale gray or gray colonies and one-celled, hyaline, cylindrical to fusiform conidia that averaged 16.5 (13.1 to 20.3) × 6.5 (3.7 to 7.6) μm (isolates C5 and C29, GenBank Nos. JN413079 and JN413080) when grown on potato dextrose agar (PDA) at 25°C. To confirm pathogenicity, two isolates of each Colletotrichum spp. were inoculated onto mature, asymptomatic fruit of cv. Pink Lady (eight fruit per isolate). Each fruit was surface disinfested with 70% ethanol, wounded with a sterile needle, and inoculated with 10 μl of a spore suspension (5 × 10⁵ conidia/ml) of the appropriate isolate. Eight control fruit were each inoculated with 10 μl of sterile water. Inoculated fruit and the control fruit were placed in plastic bags (eight fruit per bag) and incubated at 25°C. Symptoms (sunken, brown lesions each with a V-shaped pattern extending to the core) developed on all inoculated fruit 2 to 4 days after inoculation. No lesions were observed on control fruit. When fungi were reisolated from lesions of inoculated fruit onto PDA and incubated at 25°C, colony and conidial morphology were identical to those of the original isolates, confirming Koch's postulates. This study confirms a previous report of C. gloeosporioides causing bitter rot on apple in Uruguay (1). C. acutaum and C. gloeosporioides are known to cause bitter rot on apple. C. fragariae has traditionally been associated with strawberry and recently with other host plants (2), but not with bitter rot of apple. To our knowledge, this is the first report of bitter rot of apple caused by C. fragariae, and the first report of this disease caused by C. acutatum and C. fragariae in Uruguay. References: (1) S. García. Page 49 in: Guía Para el Manejo Integrado de Plagas y Enfermedades en Frutales. INIA Las Brujas, Canelones, 1998. (2) S. J. MacKenzie et al. Plant Dis. 92:1432, 2008. (3) B. C. Sutton. The Coelomycetes. CAB International Publishing, New York, 1980. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

High power rapidly tunable system for laser cooling

We present a laser configuration capable of fast frequency changes with a high power output and a large tuning range. The system integrates frequency tuning with an acousto-optic modulator with a double pass tapered amplifier. A compensation circuit keeps the seed power constant and prevents damage to the amplifier. A single mode fiber decouples the modulation and amplification sections and keeps the alignment fixed. The small power required to saturate the amplifier makes the system very reliable. We use the system to obtain a dipole trap that we image using a beam derived from the same configuration.

[Musculoskeletal chronic pain: Latin-American expert panel review based on scientific evidence]

Based on the continual medical education, in the first trimester of 2010 an expert in pain meeting has being made at Mexico City. The priority of the research was on educate residents of medical school or at their post graduate years, and the priority was on investigate of how our residents use adequate pain medication. In that first meeting at Mexico City, from different countries, the agreement was on inadequate use of pain treatment caused from inadequate education of the proper indication of drugs and other therapies for muscle skeletal pain. We decided to make a Latin American expert recommendation in chronic muscle pain where we include: epidemiological and socioeconomic pain data, actual classification of NSAIDs, pharmacological and other treatment in pain, and side effects of most popular drugs with actual recommendations. We include Medline guides, reviews, randomized studies and meta-analysis from 2001 to 2010.

Clinical presentation and outcome of venous thromboembolism in COPD

Chronic obstructive pulmonary disease (COPD) is a moderate risk factor for venous thromboembolism (VTE), but neither the clinical presentation nor the outcome of VTE in COPD patients is well known. The clinical presentation of VTE, namely pulmonary embolism (PE) or deep venous thrombosis (DVT), and the outcome at 3 months (death, recurrent VTE or bleeding) were compared between 2,984 COPD patients and 25,936 non-COPD patients included in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry. This ongoing international, multi-centre registry includes patients with proven symptomatic PE or DVT. PE was the more frequent VTE presentation in COPD patients (n = 1,761, 59%). PE presentation was more significantly associated with COPD patients than non-COPD patients (OR 1.64, 95% CI 1.49-1.80). During the 3-month follow-up, mortality (10.8% versus 7.6%), minor bleeding (4.5% versus 2.3%) or first VTE recurrences as PE (1.5% versus 1.1%) were significantly higher in COPD patients than in non-COPD patients. PE was the most common cause of death. COPD patients presented more frequently with PE than DVT. It may explain the worse prognosis of COPD patients, with a higher risk of death, bleeding or VTE recurrences as PE compared with non-COPD patients. Further therapeutic options are needed.

Note: fast, small, and low vibration mechanical laser shutters

We present three novel mechanical laser shutter designs based, respectively, on a stepper motor, a relay, and a piezoelectric actuator. Each shutter type is ideally suited to a specific shuttering application. The stepper motor is well suited for applications requiring low vibrations, the relay is compact and capable of rapid bursts, and the piezoelectric is 2 orders of magnitude faster than other available mechanical shutters.

A selective spectrofluorimetric method for carbendazim determination in oranges involving inclusion-complex formation with cucurbit[7]uril

The increase in fluorescence intensity with respect to carbendazim that occurs as a result of supramolecular-complex formation between carbendazim and cucurbit[7]uril has been studied. This host-guest interaction has been employed to develop a sensitive and selective method for benzoimidazole-type pesticide determination in fruit samples. The association constant and stoichiometry of the complex formed are reported herein, and the influence of experimental variables, such as the pH or ionic strength of the solution, on complex formation and the presence of interfering substances is also discussed. Under the optimal conditions found, the developed method allows the detection of carbendazim at a 5.0x10(-9)M level. To test the method, matrix solid phase dispersion was employed as a sample preparation method for carbendazim determination in orange samples with an RSD (%) (n=3) value of 5%. The LOD and LOQ values calculated for real samples were 0.10 and 0.52mg/kg, respectively, thus showing that the proposed method is sensitive enough to meet legal requirements.

[The extent of knowledge about strokes among the population of a rural area in the province of Lleida]

INTRODUCTION

Although stroke continues to be a significant cause of morbidity and mortality, the knowledge of warning signs and risk factors among general population is still insufficient.

AIM

To assess the current knowledge of stroke (terminology, signs and symptoms, risk factors and attitude) among rural population of Baix Segria in Lleida in order to the best target and message, prior to educational campaigns.

SUBJECTS AND METHODS

A structured interview using closeended questions was conducted among 153 users of Primary Health Centers.

RESULTS

In our cohort, 6.5% ignored the disease, while 48 (31,4%) had good knowledge of risk factors (more than three risk factors) and 62 (40,5%) identified more than three warnings signs correctly. Only 31,1% would correctly act if stroke occurred. Transient ischemic attack was not considered as emergency. Most participants, 78,5%, would contact to primary care. Surprisingly, knowledge of stroke symptoms and risk factors was not associated with an increased chance of calling 061 or going to the hospital. Older respondents were less likely to recognize symptoms and to consider stroke as an emergency, while the university education was associated with good knowledge and actuation.

CONCLUSION

The level of knowledge of established stroke risk factors, warning signs, and treatment in rural population of Lleida is low. Our data suggested not only that a community-based education program to increase public knowledge of stroke among rural population is necessary, but also we need to inform the people stroke is treatable.

Luxación recidivante postraumática del tendón extensor carpi ulnaris (ECU) en la muñeca: a propósito de un caso

La luxación o subluxación del tendón del extensor carpi ulnaris es uno de los diagnósticos diferenciales, a tener en cuenta, ante la existencia de dolor en el lado cubital de la muñeca, siendo rara su lesión aislada, por lo que su diagnóstico, puede pasar, con frecuencia, desapercibido.

La lesión ocurre durante una hipersupinación del antebrazo, desviación cubital y flexión palmar de la muñeca. Manifestando el paciente la sintomatología dolorosa tras la reducción del tendón con la pronación, dolor que puede llegar a ser muy incapacitante, con disminución del movimiento de pronosupinación de la muñeca, y disminución de fuerza. Debido a su mecanismo de producción y aparición de los síntomas, el diagnóstico es clínico, pues las pruebas complementarias pueden ser normales. La luxación del tendón, sólo ocurre, ante la ruptura o desinserción de su vaina osteofibrosa propia, o capa profunda del sexto compartimento extensor, a pesar de que el ligamento anular dorsal, o capa superficial del retináculo extensor, permanezca intacto. El tratamiento ha de ser quirúrgico, para reconstruir la vaina o corredera osteofibrosa, obteniéndose resultados satisfactorios.

Injectable acrylic bone cements for vertebroplasty based on a radiopaque hydroxyapatite. Formulation and rheological behaviour

The utilization of injectable acrylic bone cement is crucial to the outcome of vertebroplasty and kyphoplasty. However, only a few cements that are in clinical use today are formulated specifically for use in these procedures and even these formulations are not regarded as "ideal" injectable bone cements. The aim of this work is to prepare bioactive bone cements by adding strontium hydroxyapatite (SrHA) to a cement formulation based on polymethylmethacrylate. Thus, the cement combines the immediate mechanical support given by the setting of the acrylic matrix with optimum radiopacity and bioactivity due to the incorporation of the SrHA. Formulations of bioactive cement were prepared with 10 and 20 wt% of SrHA as synthesised and after a surface treatment with the monomer. Cements loaded with treated particles showed an enhancement of their handling properties, and hence, an improvement on their rheological behaviour, injectabilities and compressive parameters. Further experiments were also carried out to determine their bioactivity and biocompatibility and results appear in other publication.

Diffraction by a circular aperture: an application of the vectorial theory of Huygens's principle in the near field

A vectorial theory that brings new insight into the nature of diffraction is used to obtain mathematical expressions that evaluate diffraction patterns in the near field. The equations allow us to discriminate between the contributions of the vectorial and the scalar approaches. In the near field we studied the pattern of light diffracted through a circular aperture, and it was proved that the vectorial approach is significant in a region very near the circular aperture. In spite of the obvious differences between the circular aperture and other obstacles, the present theory may also be used with other geometries.

Phenotypic diversity of Triatoma infestans at the microgeographic level in the Gran Chaco of Argentina and the Andean valleys of Bolivia

Triatoma infestans (Klug) is the main vector of Trypanosoma cruzi, etiologic agent of Chagas disease. The phenotype of the species varies at different geographic scales. The objective of this study was to compare the antennal phenotype of spatially close T. infestans populations and to evaluate its usefulness as a marker of exchange of individuals between populations. The antennal phenotype of 190 T. infestans from Argentina and Bolivia was analyzed using uni- and multivariate techniques. This study shows heterogeneity of the antennal phenotypes of closely related T. infestans populations living in different habitats. Specimens collected in a goat corral and a rabbit cage in La Rioja (Argentina) were dissimilar to the specimens collected in the nearby intradomestic environment. Similarly, specimens from peridomestic corrals in Cochabamba (Bolivia) were different from the intradomestic and sylvatic specimens, indicating some degree of isolation between these populations. In contrast, T. infestans collected in chicken coops and the intradomestic environment were similar, in all studied regions, suggesting a frequent exchange of individuals between the two habitats and/or because of the similarity of the habitat due to the presence of chickens in the intradomestic environment. We propose that each habitat affects in a particular mode the insect morphology and these changes could be used to identify recolonizing T. infestans. These results support the hypothesis of different degrees of isolation between intradomestic and peridomestic habitats. Within this context, special attention should be given to chicken coops and other close peridomestic structures in relation to the recolonization process of domestic habitats by T. infestans.

SodERF3, a novel sugarcane ethylene responsive factor (ERF), enhances salt and drought tolerance when overexpressed in tobacco plants

The molecular signals and pathways that govern biotic and abiotic stress responses in sugarcane are poorly understood. Here we describe SodERF3, a sugarcane (Saccharum officinarum L. cv Ja60-5) cDNA that encodes a 201-amino acid DNA-binding protein that acts as a transcriptional regulator of the ethylene responsive factor (ERF) superfamily. Like other ERF transcription factors, the SodERF3 protein binds to the GCC box, and its deduced amino acid sequence contains an N-terminal putative nuclear localization signal (NLS). In addition, a C-terminal short hydrophobic region that is highly homologous to an ERF-associated amphiphilic repression-like motif, typical for class II ERFs, was found. Northern and Western blot analysis showed that SodERF3 is induced by ethylene. In addition, SodERF3 is induced by ABA, salt stress and wounding. Greenhouse-grown transgenic tobacco plants (Nicotiana tabacum L. cv. SR1) expressing SodERF3 were found to display increased tolerance to drought and osmotic stress.