An evaluation of effectiveness of Ilizarov external fixation in treating infected non-union tibial fractures: a prospective observational study

Background: Infected non-union tibial fractures pose significant challenges in orthopedic care. Ilizarov external fixation has emerged as a promising treatment option for such complex fractures. The purpose of this research is to evaluate the efficacy and safety of Ilizarov fixation in non-union, infected tibial fractures. Methods: A prospective observational study was conducted on 30 patients at Indira Gandhi Institute of Medical Sciences. Inclusion criteria involved patients aged 20-65 with clinical and radiological signs of infection and non-union of the tibia. Data on patient demographics, injury details, treatment history, and outcomes were collected. Ilizarov fixation was performed, and patients were followed up. Results: The study cohort, primarily males (80%), with mean age of 35.75 years, displayed a high incidence of type III compound injuries (63.33%). Monofocal and bifocal osteosynthesis effectively reduced limb shortening, with an overall average residual shortening of 1.8 cm. Bony outcomes were favorable, with 16 cases achieving excellence. Functional outcomes were also promising. Complications included stiffness, infections, and deformities. Conclusions: Ilizarov external fixation demonstrates potential in managing infected non-union tibial fractures, offering favorable bony and functional outcomes. However, post-operative complications require vigilant management. Further research is needed to validate and optimize this approach.

The Relationship of Anatomical Localizations of Hiatal Clamp and Oesophagogastric Junction with Body Mass Index / Relación entre las Localizaciones Anatómicas de la Pinza Hiatal y la Unión Esofagogástrica con el Índice de Masa Corporal

SUMMARY: In our study, we aimed to reveal the relationship between the anatomical localizations measured and the Body Mass Index (BMI) in patients scheduled for upper gastrointestinal endoscopy. In this study, anatomical localizations of the hiatal clamp and oesophagogastric junction in 189 female and 137 male patients who applied to the hospital with different gastrointestinal system complaints and underwent esophagogastroduodenoscopy (EGD) were investigated depending on BMI. In addition, the data were compared with the patients' complaints before EGD and the diagnoses they received after EGD. SPSS Statistics 22 (IBM Corp. Turkey) program was used for statistical analysis and p0.05). On the other hand, it was determined that the hiatal clamp distance and the distance of the oesophagogastric junction increased as the height and weight increased (p38. As a result of the study, it can be said that BMI values, hiatal clamp distance and oesophagogastric junction localizations may change in relation to height and weight.

En este estudio, buscamos revelar la relación entre las localizaciones anatómicas y el Índice de Masa Corporal (IMC) en pacientes programados para endoscopía digestiva alta. Se investigaron las localizaciones anatómicas de la pinza hiatal y la unión esofagogástrica en 189 mujeres y 137 hombres que acudieron al hospital con diferentes problemas del sistema gastrointestinal los cuales fueron sometetidos a una esofagogastro- duodenoscopia (EGD) dependiendo del IMC. Además, los datos se compararon con las quejas de los pacientes antes de la EGD y los diagnósticos que recibieron después de la EGD. Se utilizó el programa SPSS Statistics 22 (IBM Corp. Turquía) para el análisis estadístico y el valor de p0,05). Por otro lado, se determinó que la distancia de la pinza hiatal y la unión esofagogástrica aumentaba con la altura y el peso corporal (p38. Como resultado del estudio, se puede decir que los valores de IMC, la distancia de pinzamiento hiatal y las localizaciones de la unión esofagogástrica pueden cambiar en relación con la altura y el peso.

New development of EU health strategy: Implementation characteristics and policy implications of EU Health / 公共卫生与预防医学

The EU is a joint political and economic community organization of many countries. The formulation and implementation of its health strategy need to take into account the differences in the development level of public health among its member countries. Since 2003, the EU has completed the implementation of the third-generation health strategy and launched the fourth-generation health strategy in June 2021. Compared with previous generations of health strategies, EU4Health not only includes targeted measures to cope with COVID-19, but also analyzes the current health challenges in the EU, pointing out the direction for the future development of health in the EU. By introducing the basic health situation of the EU, sorting out the development process, content, and strategic indicators of the EU health strategy, and analyzing the implementation characteristics of EU4Health in the EU, this article aims to provide inspiration for the implementation and further improvement of the “Healthy China” strategy.

Review on the registration of herbal drugs in north America and Europe / 国际中医中药杂志

International registration of herbal drugs is a necessary prerequisite for the internationalization of Chinese materia medica. North America and European Union occupy an important position in the world herbal drugs market, and their drug administration and quality supervision requirements are relatively complete and progressiveness. By summarizing the definition of herbal drugs in North America and European Union, combing and interpreting the relevant laws, regulations and policy documents, this article constructed the registration path of herbal drugs, and discussed the current status of market registration of herbal drugs in North America and European Union based on the examples of successful marketing of herbal drugs under current application and approval in overseas markets. This article believed that in the future, an internationally matched TCM quality standard evidence system should be built, clinical trials of TCM products in line with international standards should be carried out, standards that are the same or higher than international mainstream GMP should be developed, the registration path of TCM compounds should be explored, and professionals to establish an international registration application team should be recruited to provide theoretical and practical support for China's overseas registration of Chinese TCM products, promote TCM products to enter the world mainstream market, and achieve high-quality development of TCM internationalization.

Thecontinuous practice and exploration of the construction of the public hospital medical union party construction alliance / 现代医院

In the context of comprehensively strengthening party building in public hospitals,multiple medical institu-tions have extended party building to the construction of medical union,explored the establishment of medical union party building alliances,and accumulated rich experience in the integration and development of party building and business.This article takes the Medical Union of the First People's Hospital of Suqian City as an example to deeply summarize and analyze the experience,practices,and existing problems in the process of medical union construction,propose countermeasures and suggestions,and pro-vide beneficial practice and exploration for other medical union party building.

A criação da Fundação Brasileira para a Conservação da Natureza / The creation of the Fundação Brasileira para a Conservação da Natureza

Abstract This study within the field of environmental history explores the scenario amid which the Fundação Brasileira para a Conservação da Natureza (Brazilian Foundation for Nature Conservation) was founded between 1958 and 1966; this important Brazilian non-governmental organization headquartered in Rio de Janeiro worked at the local, national, and international levels. Primary documentary sources were utilized, along with research of the related literature. The conclusions demonstrate the importance of non-governmental organizations predating this foundation, and the influence of conservationists on its establishment and current work.

Resumo Este estudo se insere no campo da história ambiental e tem o objetivo de compreender o cenário de criação, entre 1958 e 1966, da Fundação Brasileira para a Conservação da Natureza, importante organização não governamental ambientalista brasileira, com sede no Rio de Janeiro e atuação local, nacional e internacional. Para isso, utiliza fontes documentais primárias e pesquisa bibliográfica relacionada. As conclusões demonstraram a importância da existência de organizações não governamentais mais antigas que a fundação e a influência de conservacionistas sobre sua criação e sua atuação inicial.

Vitamin D-associated genetic variants in the Brazilian population: Investigating potential instruments for Mendelian randomization / Variantes genéticas asociadas con la vitamina D en la población brasileña: investigación de potenciales instrumentos para aleatorización mendeliana

Introduction. Vitamin D is required for bone and mineral metabolism and participates in the regulation of the immune response. It is also linked to several chronic diseases and conditions, usually in populations of European descent. Brazil presents a high prevalence of vitamin D deficiency and insufficiency despite the widespread availability of sunlight in the country. Thus, it is important to investigate the role of vitamin D as a risk factor for disease and to establish causal relationships between vitamin D levels and health-related outcomes in the Brazilian population. Objective. To examine genetic variants identified as determinants of serum vitamin D in genome-wide association studies of European populations and check whether the same associations are present in Brazil. If so, these single nucleotide polymorphisms (SNPs) could be developed locally as proxies to use in genetically informed causal inference methods, such as Mendelian randomization. Materials and methods. We extracted SNPs associated with vitamin D from the genome-wide association studies catalog. We did a literature search to select papers ascertaining these variants and vitamin D concentrations in Brazil. Results. GC was the gene with the strongest association with vitamin D levels, in agreement with existing findings in European populations. However, VDR was the most investigated gene, regardless of its non-existing association with vitamin D in the genomewide association studies. Conclusions. More research is needed to validate sound proxies for vitamin D levels in Brazil, for example, prioritizing GC rather than VDR.

Introducción. La vitamina D es necesaria para el metabolismo óseo y mineral, y participa en la regulación de la respuesta inmunitaria. También está relacionada con enfermedades crónicas en poblaciones europeas. En Brasil, existe una prevalencia elevada de deficiencia e insuficiencia de vitamina D, a pesar de la amplia disponibilidad de luz solar. Por lo tanto, es importante investigar el papel de la vitamina D como factor de riesgo de diversas enfermedades y establecer relaciones causales entre los niveles de vitamina D y los problemas de salud en la población brasileña. Objetivo. Examinar variantes genéticas relacionadas con la vitamina D sérica en estudios de asociación genómica de poblaciones europeas y comprobar si estas mismas están presentes en Brasil. De ser así, estos SNPs podrían utilizarse como proxies en métodos de inferencia causal, tales como la aleatorización mendeliana. Materiales y métodos. A partir del catálogo de estudios de asociación de genoma completo se extrajeron SNPs relacionados con los niveles de vitamina D. Luego se hizo una búsqueda bibliográfica para identificar los artículos que evaluaran estos SNPs y la concentración de vitamina D en Brasil. Resultados. GC fue el gen más fuertemente asociado con los niveles de vitamina D, en concordancia con los resultados existentes en poblaciones europeas. Sin embargo, el gen VDR fue el más investigado, aunque no esté vinculado con la vitamina D en los estudios de asociación de genoma completo. Conclusiones. Se necesita más investigación para validar proxies genéticos de los niveles de vitamina D en Brasil y se recomienda priorizar el gen GC en lugar de VDR.

Evaluación de la fuerza de unión de sistemas adhesivos universales previa aplicación de clorhexidina al 2 % / Evaluation of the Bond Strength of Universal Adhesive Systems after Application of 2% Chlorhexidine

Introducción: La influencia de la clorhexidina sobre la fuerza de unión de los sistemas adhesivos es aún muy controversial. Objetivo: Determinar la fuerza de unión de dos adhesivos universales en dentina previa aplicación de la clorhexidina al 2 por ciento en tiempos de aplicación diferentes. Métodos: Se empleó treinta incisivos y se desgastó la superficie vestibular para exponer la dentina. Posteriormente, se dividió aleatoriamente en seis grupos (n = 5). Se emplearon los adhesivos Single Bond Universal (SBU) y All-Bond Universal (ABU) con/sin clorhexidina. Grupo SBU-0: Single Bond Universal; Grupo SBU-30: clorhexidina por 30 segundos + Single Bond Universal; Grupo SBU-60: clorhexidina por 60 segundos + Single Bond Universal; Grupo ABU-0: All-Bond Universal; Grupo ABU-30: clorhexidina por 30 segundos + All-Bond Universal y Grupo ABU-60: clorhexidina por 60 segundos + All-Bond Universal. La resistencia adhesiva se analizó mediante ANOVA mixto de dos factores y post hoc de Tukey (p < 0,05). Resultados: La fuerza de unión para el grupo SBU-60 aumentó significativamente respecto al grupo control (p = 0,032). Igualmente, para los grupos ABU-30 y ABU-60, la fuerza de unión aumentó significativamente respecto al grupo control (p = 0,001) y (p = 0,000), respectivamente. Conclusión: La aplicación previa de clorhexidina al 2 por ciento durante 60 segundos aumenta la fuerza de unión de los sistemas adhesivos Single Bond Universal y All-Bond Universal(AU)

Introduction: The influence of chlorhexidine on the bond strength of adhesive systems is still very controversial. Objective: To determine the bond strength of two universal adhesives on dentin after application of 2 percent chlorhexidine at different application times. Methods: Thirty incisors were used and the vestibular surface was abraded to expose the dentin. Subsequently, they were randomly divided into six groups (n = 5). Single Bond Universal (SBU) and All-Bond Universal (ABU) adhesives with/without chlorhexidine were used. Group SBU-0: Single Bond Universal; Group SBU-30: chlorhexidine for 30 seconds + Single Bond Universal; Group SBU-60: chlorhexidine for 60 seconds + Single Bond Universal; Group ABU-0: All-Bond Universal; Group ABU-30: chlorhexidine for 30 seconds + All-Bond Universal and Group ABU-60: chlorhexidine for 60 seconds + All-Bond Universal. Adhesive strength was analyzed by two-factor mixed ANOVA and Tukey's post hoc (p < 0.05). Results: The bond strength for the SBU-60 group increased significantly with respect to the control group (p = 0.032). Similarly, for the ABU-30 and ABU-60 groups, the bond strength increased significantly with respect to the control group (p = 0.001) and (p = 0.000), respectively. Conclusion: Pre-application of 2 percent chlorhexidine for 60 seconds increases the bond strength of Single Bond Universal and All-Bond Universal adhesive systems(AU)

Analysis of Environmental and Energy Policies in Turkey, the European Union and the United States

Energy consumption plays a pivotal role in the development of societies. Sustainable Energy Resources are vital inputs for daily life, and energy and industrial products are essential for economic growth (Ministry of Energy and Natural Resources, 2022). Consequently, those responsible for managing a country's energy sector must ensure the uninterrupted, reliable, timely, clean, and affordable supply of energy, as well as diversify energy sources to enhance energy security.The concept of "sustainable development" has emerged in response to the need to prevent irreversible environmental damage caused by conventional energy sources and outdated technologies while ensuring access to energy as a fundamental human right under optimal conditions (Pamir, N 2005). Developed societies have transitioned from planning based solely on energy source acquisition and production to a planning approach that carefully considers the energy-economy-ecology balance (3E) while taking into account resource diversity and geopolitical realities (Energy Policies and Global Developments, emo.org.tr).Turkey remains heavily dependent on energy imports, accounting for approximately 74% of its energy needs (Ministry of Energy and Natural Resources, 2023). The multifaceted nature of Turkey's energy strategy and its energy dependence emphasize the importance of international relations in this field.U.S. energy policies have global ramifications, particularly in areas such as energy resource utilization, energy trade, and energy independence (Ministry of Energy and Natural Resources, 2022). U.S. energy policies play a significant role in international relations, impacting relationships with other countries, especially in matters related to energy exports and imports.In Europe, there is uneven progress towards clean electricity, with both successes and challenges in transitioning to a low-carbon energy system. While the European energy sector has taken significant steps towards decarbonization, there has been limited progress in some countries, and much more progress is needed. Achieving a fully decarbonized energy system in Europe requires united efforts and coordination to address the challenges posed by fossil fuel dependence and climate change.

Microtensile bond strength of resin cements to 3-D printed and milled temporary restorative resins / Resistencia de unión en microtracción de cementos resinosos a resinas para provisionales impresas y fresadas

Abstract To evaluate the microtensile bond strength (µTBS) of two resin cements to 3D printed and milled CAD/CAM resins used for provisional fixed partial dentures. Blocks (5 x 5 x 5 mm) of three 3D-printed resins (Cosmos3DTemp / Yller; Resilab3D Temp / Wilcos and SmartPrint BioTemp, / MMTech) were printed (Photon, Anycubic Technology Co.). A milled material (VitaCAD-Temp, VITA) was used as control. Half the specimens were sandblasted and the rest were untreated. Two blocks were bonded with the corresponding resin cement: PanaviaV5 (Kuraray Noritake) and RelyX Ultimate (3M Oral Care). After 24 hours, the bonded blocks were sectioned into 1 x 1 mm side sticks. Half the beams were tested for µTBS and the other half was thermocycled (5000 cycles, 30s dwell-time, 5s transfer time) before µTBS testing. A four way Generalized Linear Model (material*sandblasting*cement*aging) analysis was applied. VITA exhibited the lowest µTBS, regardless of the cement, sandblasting and thermocycling. Sandblasting significantly improved the µTBS of VIT, especially after aging, but did not improve the µTBS of 3D printed resins. Sandblasting was not beneficial for 3D printed resins, although is crucial for adhesive cementation of milled temporary resins. Airborne particle abrasion affects the integrity of 3D-printed resins, without producing a benefit on the microtensile bond strength of these materials. However, sandblasting is crucial to achieve a high bond strength on milled temporary resins.

Resumen Evaluar la resistencia adhesiva en microtracción (µTBS) de dos cementos resinosos a resinas CAD/CAM impresas y fresadas indicadas para restauraciones provisionales. Bloques (5 x 5 x 5mm) de tres resinas impresas (Cosmos3DTemp / Yller; Resilab3D Temp / Wilcos and SmartPrint BioTemp, / MMTech) y una resina fresada (VitaCAD-Temp, VITA) fueron fabricados. La mitad de los especímenes fueron arenados y el resto no recibió tratamiento mecánico. Dos bloques con condiciones de tratamiento iguales fueron cementados con cemento resinoso (PanaviaV5 / Kuraray Noritake y RelyX Ultimate / 3M Oral Care). Después de 24 horas los bloques fueron seccionados en palitos de 1 mm² de área. En la mitad de los especímenes se midió la TBS inmediatamente y el resto fue termociclado (5000 ciclos, 30s remojo, 5s transferencia) antes de la prueba de TBS. Se aplica un análisis estadístico por Modelo Linear General con 4 factores (material*arenado*cemento*termociclado). La resina VITA presentó la menor µTBS, independientemente del cemento usado, el arenado y el termociclado. Sin embargo, el arenado aumentó la µTBS de VIT, especialmente después del termociclado. Por otro lado, el arenado no resultó en un aumento significativo de la µTBS de las resinas impresas. El arenado no fue beneficiosos para las resinas impresas, aunque es un paso crucial para la cementación adhesive de las resinas fresadas. El arenado afecta la integridad de las capas de las resinas impresas, sin generar un beneficio en la TBS.

Desigualdad de género y paternidad adolescente en dos comunidades indígenas de Chiapas, México / Gender inequality, and adolescent fatherhood in two indigenous communities in Chiapas, Mexico

Resumen Introducción: La paternidad adolescente ha sido considerada un importante problema social que recientemente ha empezado a estudiarse desde la construcción sociocultural de las masculinidades y la desigualdad de género. Este trabajo contribuye a documentar la experiencia de la paternidad adolescente en las comunidades rurales indígenas Ch'oles y Tseltales del estado de Chiapas, México. Metodología: El estudio fue realizado a través de un enfoque cualitativo, la técnica de acopio de información consistió en entrevistas semiestructuradas y la selección de las personas participantes fue mediante la técnica de bola de nieve lineal. Se completó un total de 25 entrevistas. En específico, se entrevistó a 16 personas menores de 20 años que fueron padres o madres en la adolescencia; a cinco varones de 24 a 40 años; y a cuatro varones de 50 años o más. Resultados: La paternidad adolescente se asocia con la construcción de las masculinidades soportada en normas socioculturales tradicionales, como el pago por la novia, la poliginia y el intercambio de mujeres. El embarazo adolescente se asocia con la importancia de la paternidad para los hombres, pese a la resistencia de las mujeres a unirse y embarazarse tempranamente. Conclusiones: Diversas condiciones facilitan la ocurrencia de la paternidad adolescente no como un fenómeno individual, aislado, sino en el contexto de la producción económica de las estructuras familiares y de la subordinación de las mujeres, el cual se ha mantenido más allá de algunos cambios generacionales.

Abstract Introduction: Teenage paternity has been considered an important social problem that has been recently studied from the sociocultural construction of masculinities and gender inequality. This work contributes to documenting the experience of adolescent fatherhood in two Ch'ol and Tseltal indigenous rural communities in the state of Chiapas, Mexico. Methodology: The study was conducted through a qualitative approach, the data collection technique consisted of semi structured interviews and the selection of participants was through the linear snowball technique. Twenty-five complete interviews were carried out in two stages, 13 in each locality, of which 16 were with children under 20 years of age who were fathers and mothers in adolescence, five with men between 24 and 40 years old, and four with men aged 50 and over. Results: Adolescent fatherhood is associated with the construction of masculinities, supported by traditional sociocultural norms such as payment for the bride, polygyny, and the traffic of women. Teenage pregnancy is associated with the importance of fatherhood for men despite the resistance of women to unite and get pregnant early. Conclusions: There are some conditions that facilitate the occurrence of adolescent fatherhood, but not as an individual, isolated phenomenon, but rather in the context of economic production, family structures and the subordination of women, which have remained despite some generational social changes.

Esophagogastric Junction Contractile Integral (EGJ-CI) in Various Phenotypes of Gastroesophageal Reflux Disease (GERD)

Introduction: Two parameters of high-resolution esophageal manometry are used to observe the function of the esophagogastric junction (EGJ): the anatomical morphology of the EGJ and contractile vigor, which is evaluated with the esophagogastric junction contractile integral (EGJ-CI). To date, how these parameters behave in different gastroesophageal reflux disease (GERD) phenotypes has not been evaluated. Materials and methods: An analytical observational study evaluated patients with GERD confirmed by pH-impedance testing and endoscopy undergoing high-resolution esophageal manometry. The anatomical morphology of the EGJ and EGJ-CI was assessed and compared between reflux phenotypes: acid, non-acid, erosive, and non-erosive. Results: 72 patients were included (63% women, mean age: 54.9 years), 81.9% with acid reflux and 25% with erosive esophagitis. In the latter, a decrease in EGJ-CI (median: 15.1 vs. 23, p = 0.04) and a more significant proportion of patients with type IIIa and IIIb EGJ (83.3% vs 37.1%, p < 0.01) were found. No significant differences existed in the manometric parameters of patients with and without acid and non-acid reflux. Conclusion: In our population, EGJ-CI significantly decreased in patients with erosive GERD, suggesting that it could be used to predict this condition in patients with GERD. This finding is also related to a higher proportion of type III EGJ and lower pressure at end-inspiration of the lower esophageal sphincter in this reflux type.

Introducción: Para observar la función de la unión esofagogástrica (UEG) se utilizan dos parámetros de la manometría esofágica de alta resolución: la morfología anatómica de la UEG y el vigor contráctil, el cual se evalúa con la integral de contractilidad distal de la unión esofagogástrica (IC-UEG). Hasta el momento, no se ha evaluado cómo se comportan estos parámetros en los diferentes fenotipos de enfermedad por reflujo gastroesofágico (ERGE). Metodología: Estudio observacional analítico en el que se evaluaron pacientes con ERGE confirmado por pH-impedanciometría y endoscopia, llevados a manometría esofágica de alta resolución. Se evaluó la morfología anatómica de la UEG y la IC-UEG, y se comparó entre los diferentes fenotipos de reflujo: ácido, no ácido, erosivo y no erosivo. Resultados: Se incluyó a 72 pacientes (63% mujeres, edad media: 54,9 años), 81,9% con reflujo ácido y 25% con esofagitis erosiva. En este último grupo se encontró una disminución de la IC-UEG (mediana: 15,1 frente a 23, p = 0,04) y una mayor proporción de pacientes con UEG tipo IIIa y IIIb (83,3% frente a 37,1%, p < 0,01). No se encontraron diferencias significativas en los parámetros manométricos de los pacientes con y sin reflujo ácido y no ácido. Conclusión: En nuestra población, la IC-UEG estuvo significativamente disminuida en los pacientes con ERGE erosivo, lo que sugiere que podría ser utilizada como un predictor de esta condición en pacientes con ERGE. Este hallazgo también se relaciona con mayor proporción de UGE tipo III y menor presión al final de la inspiración del esfínter esofágico inferior en este tipo de reflujo.

Effect of Different Rootstocks and Scions Compatibility Study on Rosa sp

An investigation entitled, “Effect of different rootstocks and scion compatibility study on Rosa sp.’’ was conducted to study the graft compatability and growth performance of grafted rose plants and the experiment was conducted in Vegetable Research Station, Tamil Nadu Agricultural University, Palur, Cuddalore district, Tamil Nadu during the year 2022. It was carried out using completely randomized design (CRD) with fifteen treatments (T1- Andhra red rose + Dog rose, T2-Andhra red rose + Button rose, T3-Andhra red rose + Ebb tide rose, T4- Andhra red rose +Fairy rose, T5- Andhra red rose + Edward rose, T6- Edward rose+ Dog rose, T7-Edward rose + Button rose, T8-Edward rose+ Ebb tide rose, T9-Edward rose + Fairy rose, T10-Edward rose+ Edward rose, T11-Damask rose + Dog rose, T12-Damask rose + Button rose, T13-Damask rose + Ebb tide rose, T14-Damask rose+ Fairy rose, T15-Damask rose+ Edward rose) and two replications. The results indicated a significant difference between the different treatment combination for graft union, success percentage, survival percentage, plant height (cm), leaf length (cm), leaf width (cm), days taken for leaf initiation. The experiment data revealed that the maximum graft success (90) and graft survival percentage (80), length of leaves (3.9 cm) and plant height (67.6) was recorded in the treatments T7 (Edward rose + Button rose). It can be concluded that the combination of rootstock as Edward rose and scion as Button rose is said to be most compatible and can be recommended for commercial cultivation.

Evaluation of Ethanolic leaf extract of Cucumis melo var. agrestis in Acetic Acid-Induced Ulcerative Colitis on Rats

The crux of the present research work was to evaluate the therapeutic potential of Ethanolic leaf extract of Cucumis melo var. agrestis (ELECM)on Ulcerative Colitis in rats. The successful induction of Ulcerative Colitis was done by intra-rectal administration of 500 ?l of acetic acid (4% v/v), rats were euthanized on day 8 by cervical dislocation under anesthesia. The pathological parameters such as colon weight, colon antioxidant enzymes (SOD, CAT), lipid peroxidase enzymes (MDA, MPO), inflammatory markers (TNF- ? and IL-6), and histopathological aspects were estimated to evaluate the ELECM against the disease control. Sulfasalazine was used as positive control to compare the protective effect of the ELECM. The GC-MS analysis of ELECM confirms the presence of about 12 specific phytochemicals. Induction of ulcerative colitis was evidenced in the control group due to increased colon weight, lipid peroxidase enzymes, and immune markers also by alleviated levels of antioxidant enzymes in the rat colon. However, ELECM treated group almost reversed the effect of the disease control group, above all the histopathological response of the ELECM-treated group against the acetic acid-induced ulcerative colitis was almost the same as that of the control group, indicating the significant protective effect. Our present study suggests that ELECM extract has significant protective activity against acetic acid-induced ulcerative colitis, due to its higher antioxidant, moderate anti-inflammatory, and mild immune-suppressive effects, and the protective action might be due to the presence of active constituents such as flavonoids and total phenols as presented on the GC-MS analysis report.

Determinación de la calidad de imágenes clínicas de proyecciones postero anterior y lateral de tórax / Determination of clinical image quality of posteroanterior and lateral chest images

RESUMEN Los estudios radiológicos son fundamentales en el diagnóstico y tratamiento de diversas patologías. Su calidad depende de múltiples variables, entre las que destacan, los parámetros de adquisición, interpretación, entre otros. Se propone una metodología estandarizada, sencilla, de fácil interpretación, permitiendo la evaluación regular de la calidad de las imágenes, dando indicios de la propiedad del trabajo en el centro de salud y poder realizar comparaciones entre centros y autores, a partir de los criterios anatómicos establecidos por la Unión Europea, definiendo el parámetro de calidad de la imagen (CI), representadas en una escala de Likert para el análisis de frecuencia, demostrando que puede ser una herramienta de utilidad para la evaluación reiterada de los centros de radiología. Evaluando 140 proyecciones postero anterior y 85 laterales de tórax, con una muestra de 225 estudios, realizados en un centro de salud, ubicado en la ciudad de Mérida, República Bolivariana de Venezuela, escogiendo estas proyecciones, ya que, representan el 32% de los estudios de radiología convencional. Permitiendo la comparación entre proyecciones y autores, obteniéndose para la proyección postero anterior un CI de 5,07 ± 1,53 criterios de los ocho establecidos, normalizado un CI de 0,62 ± 0,19; las imágenes excelentes solo representan el 22,78%. Comparado con un CI de 4,91 ± 1,17 criterios de los seis establecidos, normalizado un CI de 0,82 ± 0,19, e imágenes excelentes en un 64,71% para la proyección lateral. Se observa las notorias diferencias entre la calidad de las imágenes clínicas en hombres y mujeres para ambas proyecciones

ABSTRACT Radiological studies are essential in the diagnosis and treatment of various pathologies. Their quality depends on multiple variables, among which the acquisition and interpretation parameters, among others, stand out. A standardized methodology is proposed, simple, of easy interpretation, allowing the regular evaluation of the quality of the images, giving indications of the property of the work in the health center and being able to make comparisons between centers and authors, from the anatomical criteria established by the European Union, defining the parameter of image quality (IQ), represented on a Likert scale for frequency analysis, demonstrating that it can be a useful tool for the repeated evaluation of radiology centers. Evaluating 140 postero anterior and 85 lateral projections of the thorax, with a sample of 225 studies, performed in a health center, located in the city of Merida, Bolivarian Republic of Venezuela, taking these projections, since they represent 32% of the conventional radiology studies. Allowing the comparison between projections and authors, obtaining for the postero anterior projection an IQ of 5.07 ± 1.53 criteria of the eight established, normalized an IQ of 0.62 ± 0.19; the excellent images only represent 22.78%. Compared with an IQ of 4.91 ± 1.17 criteria of the six established, normalized IQ of 0.82 ± 0.19, and excellent images in 64.71% for the lateral projection. It is observed the notorious differences between the quality of clinical images in men and women for both projections

Comportamiento del tiempo de conducción retrógrada al momento de la inducción de las taquicardias supraventriculares y su rol en el diagnóstico diferencial / Behavior of Retrograde Conduction Time at Supraventricular Tachycardia Induction and its Role in Differential Diagnosis

RESUMEN Antecedentes : El diagnóstico diferencial entre la taquicardia reentrante ortodrómica (TRO) y la taquicardia por reentrada nodal atípica (TRNa) puede ser dificultoso. Nuestra hipótesis es que las TRNa tienen más variabilidad en el tiempo de con ducción retrógrada al comienzo de la taquicardia que las TRO. Nuestros objetivos fueron evaluar la variabilidad en el tiempo de conducción retrógrada al inicio de la taquicardia en TRNa y TRO, y proponer una nueva herramienta diagnóstica para diferenciar estas dos arritmias. Métodos : Se midió el intervalo ventrículo-auricular (VA) de los primeros latidos tras la inducción de la taquicardia, hasta su estabilización. La diferencia entre el intervalo VA máximo y el mínimo se definió como delta VA (ΔVA). También contamos el número de latidos necesarios para que se estabilice el intervalo VA. Se excluyeron las taquicardias auriculares. Resultados : Se incluyeron 101 pacientes. Se diagnosticó TRO en 64 pacientes y TRNa en 37. El ΔVA fue 0 (rango intercuartílico, RIC, 0-5) milisegundos (ms) en la TRO frente a 40 (21-55) ms en la TRNa (p < 0,001). El intervalo VA se estabilizó significativamente antes en la TRO (1,5 [1-3] latidos) que en la TRNa (5 [4-7] latidos; p < 0,001). Un ΔVA < 10 ms diagnosticó TRO con 100% de sensibilidad, especificidad y valores predictivos positivo y negativo. La estabilización del intervalo VA en menos de 3 latidos predijo TRO con buena precisión diagnóstica. Los resultados fueron similares considerando sólo vías accesorias septales. Las TRN típicas tuvieron una variación intermedia. Conclusión : Un ΔVA < 10 ms es un criterio simple, que distingue con precisión la TRO de la TRNa, independientemente de la localización de la vía accesoria.

ABSTRACT Background : Differential diagnosis between orthodromic reentrant tachycardia (ORT) and atypical nodal reentrant tachy cardia (ANRT) can be challenging. Our hypothesis was that ANRT presents more variability in retrograde conduction time at tachycardia onset than ORT. Objectives : The objectives of this study were to assess retrograde conduction time variability at the start of tachycardia in ANRT and ORT, and postulate a new diagnostic tool to differentiate these two types of arrhythmias. Methods : The ventriculoatrial (VA) interval of the first beats after tachycardia induction was measured until stabilization. The difference between the maximum and minimum VA interval was defined as delta VA (ΔVA), and the number of beats needed for VA interval stabilization was also assessed. Atrial tachycardias were excluded. Results : In a total of 101 patients included in the study, ORT was diagnosed in 64 patients and ANRT in 37. ΔVA interval was 0 (interquartile range [IQR] 0-5) milliseconds (ms) in ORT vs. 40 (21-55) ms in ANRT (p <0.001). The VA interval significantly stabilized earlier in ORT (1.5 [1-3] beats) than in ANRT (5 [4-7] beats) (p<0.001). A ΔVA <10 ms diagnosed ORT with 100% sensitivity, specificity, and positive and negative predictive values. Ventriculoatrial interval stabilization in less than 3 beats predicted ORT with good diagnostic accuracy. The results were similar considering only accessory septal pathways. Typical NRTs presented an intermediate variation. Conclusion : Presence of DVA <10 ms is a simple criterion that accurately differentiates ORT from ANRT, independently of the accessory pathway localization.

Histological Techniques for the Study of the Dentogingival Junction: A Scoping Review Using the Anatomical Quality Assurance Checklist (AQUA) / Técnicas Histológicas para el Estudio de la Unión Dentogingival: Una Revisión de Alcance Utilizando el Anatomical Quality Assurance Checklist (AQUA)

SUMMARY: The dentogingival junction (DGJ) is an adaptation of the oral mucosa composed of epithelial and connective tissues intimately related with the mineralised tissues of the tooth. The histological evidence available is mainly based on studies in animals, separate evaluations of hard and soft tissues, and studies using conventional histological techniques that eliminate the enamel from preparations. The aim of this study was to carry out a review of the existing evidence on histological techniques available for study of the tooth and periodontium in conjunction in humans. A scoping review was carried out of the available literature referring to study of the tooth and the periodontium in conjunction in humans, in the Web of Science (WoS), EMBASE, Scopus and SciELO databases, using the terms "Histological Techniques"[Mesh]) and "Epithelial Attachment"[Mesh]. One hundred and fifty-nine articles were found, of which 54 were selected for full- text reading. Ten were finally included in the qualitative synthesis, and we applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the selected articles. The results showed that the only articles with a low risk of bias in all five domains according to the AQUA criteria corresponded to Silva et al. (2011) and Agustín-Panadero et al. (2020). Finally, we conclude that the quality of the histological sections to observe tissues that simultaneously contain the tooth and the periodontium, is conditioned by the selected technique and by the care required in certain specific tasks during the histological processing of the samples.

La unión dentogingival (DGJ) es una adaptación de la mucosa oral compuesta por tejidos epitelial y conectivo íntimamente relacionados con los tejidos mineralizados del diente. La evidencia histológica disponible se basa principalmente en estudios en animales, evaluaciones separadas de tejidos duros y blandos y estudios utilizando técnicas histológicas convencionales que eliminan el esmalte de las preparaciones. El objetivo de este estudio fue realizar una revisión de la evidencia existente sobre las técnicas histológicas disponibles para el estudio del diente y el periodonto en conjunto en humanos. Se realizó un scoping review de la literatura disponible referente al estudio del diente y el periodonto en conjunto en humanos, en las bases de datos Web of Science (WoS), EMBASE, Scopus y SciELO, utilizando los términos "Histological Techniques"[Mesh]) y "Epithelial Attachment"[Mesh]. Se encontraron 159 artículos, de los cuales 54 fueron seleccionados para lectura de texto completo. Diez fueron finalmente incluidos en la síntesis cualitativa, y se aplicó la lista de verificación Anatómica Quality Assurance (AQUA) para el análisis de la calidad metodológica de los artículos seleccionados. Los resultados mostraron que los únicos artículos con bajo riesgo de sesgo en los cinco dominios según los criterios AQUA correspondían a Silva et al. (2011) y Agustín-Panadero et al. (2020). Finalmente, concluimos que la calidad de los cortes histológicos para observar los tejidos que contienen simultáneamente el diente y el periodonto, está condicionada por la técnica seleccionada y por el cuidado requerido en ciertas tareas específicas durante el procesamiento histológico de las muestras.

Diagnóstico y tratamiento de los tumores de la unión esofagogástrica. Experiencia en el Instituto Nacional de Cancerología / Diagnosis and treatment of esophagogastric junction tumors. Experience at the National Cancer Institute

Introducción. El diagnóstico adecuado de los tumores de la unión esofagogástrica es esencial para el tratamiento de estos pacientes. La clasificación propuesta por Siewert-Stein define las características propias, factores de riesgo y estrategias quirúrgicas según la localización. El objetivo de este estudio fue describir las características de los pacientes con adenocarcinoma de la unión esofagogástrica tratados en nuestra institución. Métodos. Estudio retrospectivo, descriptivo, de corte longitudinal, que incluyó los pacientes con diagnóstico de adenocarcinoma de la unión esofagogástrica intervenidos quirúrgicamente en el Instituto Nacional de Cancerología, Bogotá, D.C., Colombia, entre enero de 2012 y mayo de 2017. Resultados. Se operaron 59 pacientes (84,7 % hombres), con una edad media de 62,5 años. En su orden de frecuencia los tumores fueron tipo II (57,6 %), tipo III (30,7 %) y tipo I (11,9 %). El 74,6 % recibieron neoadyuvancia y se realizó gastrectomía total en el 73 % de los pacientes. La concordancia diagnóstica moderada con índice Kappa fue de 0,56, difiriendo con la endoscópica en 33,9 %. El 10,2 % de los pacientes presentó algún tipo de complicación intraoperatoria. La supervivencia a tres años en los tumores tipo II fue del 89,6 % y del 100 % en aquellos con respuesta patológica completa. Conclusión. Es necesario el uso de diferentes estrategias para un proceso diagnóstico adecuado en los tumores de la unión esofagogástrica. En esta serie, los pacientes Siewert II, aquellos que recibieron neoadyuvancia y los que obtuvieron una respuesta patológica completa, tuvieron una mejor supervivencia a tres años

Introduction: Proper diagnosis of gastroesophageal junction tumors is essential for the treatment of these patients. The classification proposed by Siewert-Stein defines its own characteristics, risk factors and surgical strategies according to the location. This study describes the characteristics of patients with adenocarcinoma of the esophagogastric junction treated at our institution. Methods. Retrospective, descriptive, longitudinal study, which includes patients diagnosed with adenocarcinoma of the esophagogastric junction who underwent surgery at the National Cancer Institute in Bogotá, Colombia, between January 2012 and May 2017. Results. Fifty-nine patients (84.7% men) were operated on, with a mean age of 62.5 years. In their order of frequency, the tumors were type II (57.6%), type III (30.7%) and type I (11.9%). 74.6% received neoadjuvant therapy and total gastrectomy was performed in 73% of the cases. The moderate diagnostic concordance with the Kappa index was 0.56, differing from the endoscopic one in 33.9%. 10.2% of the patients presented some type of intraoperative complication. Three-year survival in type II tumors was 89.6% and 100% in those with complete pathologic response. Conclusion. The use of different strategies is necessary for an adequate diagnostic process in tumors of the esophagogastric junction. In this series, Siewert II patients, those who received neoadjuvant therapy, and those who obtained a complete pathological response had a better three-year survival

No-consolidación diafisaria de húmero en pacientes adultos con osteoporosis. Tratamiento quirúrgico y resultados a largo plazo / Diaphyseal osteoporotic nonunion of the humerus in elderly patients. Surgical treatment and long-term results

Resumen: Introducción: evaluar los resultados radiográficos y funcionales obtenidos a largo plazo en pacientes adultos que presentaron no-consolidaciones atróficas diafisarias de húmero asociadas a osteoporosis; tratadas quirúrgicamente mediante reducción abierta y fijación interna con placas e injerto óseo. Material y métodos: evaluamos retrospectivamente 22 pacientes, con edad promedio de 72 años, el tiempo desde el trauma inicial hasta la cirugía definitiva promedió, 18 meses. Once pacientes eran fumadores y cuatro presentaban infección activa. El score de Constant y el DASH preoperatorios promediaron 23.13 y 81.04, respectivamente. El valor de la escala analógica del dolor preoperatorio promedió 7.45 puntos. Resultados: el seguimiento promedió 69 meses. Se obtuvo la consolidación en todos los casos, luego de un promedio de 4.68 meses. Al último seguimiento, los valores del DASH promediaron 20.27 puntos y el score de Constant promedió 79.31 puntos. La escala analógica del dolor promedió 0.77 puntos. La estabilización se realizó utilizando clavos placa bloqueados en 12 no-consolidaciones, placas bloqueadas de compresión en seis y doble placa en cuatro. Los pacientes con infección activa fueron tratados en dos etapas utilizando la técnica descripta por Masquelet. Se asoció injerto óseo en todas las reconstrucciones (autoinjerto esponjoso de cresta ilíaca en 17, aloinjerto en tres y se combinó aloinjerto estructural con autoinjerto esponjoso en dos). Dos gramos de vancomicina en polvo fueron asociados localmente al injerto óseo. Conclusión: la combinación de reducción abierta y fijación interna con placas e injerto óseo permitió obtener la consolidación y resultados funcionales objetivos y subjetivos buenos y predecibles a largo plazo en todos los casos, sin complicaciones mayores ni la necesidad de intervenciones quirúrgicas sucesivas.

Abstract: Introduction: to evaluate the long term radiographic and functional results achieved in adult patients with osteoporotic, atrophic, non-unions of the diaphyseal humerus, treated surgically by open reduction and internal fixation with plates and bone graft. Material and methods: we retrospectively evaluated 22 patients. Patient's age averaged 72 years. Time from initial trauma to definitive surgery averaged 18 months. Eleven patients were smokers, and four had active infection. Pre-operative Constant score and DASH score averaged 23.13 and 81.04, respectively. Pre-operative pain scale averaged 7.45 points. Results: follow-up averaged 69 months. Union was achieved in all cases after an average of 4.68 months. DASH score at last follow-up averaged 20.27 points and Constant score 79.31 points. Analog pain scale averaged 0.77 points. Stabilization was performed using locking blade plates in 12 non-unions, locking compression plates in six cases, and double plating in four non-unions. Patients with active infection were treated in two stages using Masquelet's technique. Bone graft was associated in all cases (cancellous iliac crest autograft in 17, allograft in three, and combined structural allograft and cancellous autograft in two). Two grams of vancomycin powder were associated to the bone graft in all cases. Conclusion: the use of open reduction and internal fixation with plates associated to bone graft with local antibiotics, aloud achieving bony union and good predictable long-term objective and subjective functional results in all cases, without major complications or the need of further surgical intervention.

Late consolidation of the scaphoid. Case report and literature review / Consolidación tardía del escafoides. Reporte de un caso y revisión de la literatura

Abstract: Scaphoid fractures are a common wrist injury accounting for 2-7% of all adult fractures. Nonunion is described in 5-12% of cases leading to osteoarthritis. Several classifications have been developed focused on this pathology and its complication. We present a case of a 28 years old male patient with a scaphoid fracture and nonunion who spontaneously consolidates without treatment. We performed a literature review to recognize this pathology, its common evolution and possible treatment options.

Resumen: Las fracturas de escafoides son una lesión frecuente de la muñeca y representan de 2-7% de todas las fracturas en adultos. La no unión se describe en 5-12% de los casos y conduce a la osteoartritis. Se han desarrollado varias clasificaciones centradas en esta patología y su complicación. Presentamos el caso de un paciente varón de 28 años con fractura y no unión de escafoides que consolida espontáneamente sin tratamiento. Realizamos una revisión bibliográfica para reconocer esta patología, su evolución habitual y las posibles opciones de tratamiento.