Heterogeneity in the preferential diet of neotropical bats impacts the pancreatic islet mass and α and ß cell distribution.

Whether there is a relationship between bats' dietary patterns and evolutionary endocrine pancreas adaptation is not clearly understood. Aiming to contribute to this topic, we evaluated some metabolic and structural parameters in the following adult bats: the frugivorous Artibeus lituratus, the nectarivorous Anoura caudifer, the hematophagous Desmodus rotundus, and the insectivorous Molossus molossus. A. lituratus and A. caudifer diets consist of high amounts of simple carbohydrates, while D. rotundus and M. molossus diets consist of high amounts of proteins or protein and fat, respectively. In our results, A. lituratus and A. caudifer bats exhibited the highest values of relative islet mass (%), islet density (number of islets per pancreas area), and the lowest values of intestinal length among the four species. When adjusted by the body mass (mg/g of body mass), both D. rotundus and A. caudifer bats exhibited the highest islet mass values among the groups. Blood glucose was similar between A. lituratus, D. rotundus, and M. molossus, with the lowest values for the A. caudifer bats. M. molossus bats had the highest plasma cholesterol values among the studied species but exhibited similar plasma triacylglycerol with D. rotundus and A. caudifer bats. ß- and α-cell distribution within A. lituratus, A. caudifer, and M. molossus islets achieved an approximate average value of âˆ¼ 66% and âˆ¼ 28%, respectively, a pattern inverted in D. rotundus islets (53% of α cells and 40% of ß cells). A. caudifer and D. rotundus exhibited the highest and the lowest ß/α-cells ratio per islet, respectively. We conclude that the macronutrient predominance in each bat-eating niche correlates with the morphophysiological pancreas features being the nectarivorous A. caudifer the species with the highest islet mass per body mass and ß/α-cells ratio, while the hematophagous D. rotundus showed the highest α-cells apparatus.

DM intake by feedlot beef cattle: factors that impact intake patterns.

DM intake (DMI) for individual pens of cattle is recorded daily or averaged across each week by most commercial feedlots as an index of performance. Numerous factors impact DMI by feedlot cattle. Some are available at the start of the feedlot period (initial BW, sex), and others become available early in the feeding period (daily DMI during adaptation) or more continuously (daily DMI from the previous week). To evaluate the relative impact of these factors on daily DMI during individual weeks within the feedlot period, we employed a dataset compiled from 2009 to 2014 from one commercial feedlot, including 4 132 pens (485 458 cattle), which were split into two fractions: 80% were used to calculate DMI regressions on these factors to develop a prediction equation for mean DMI for each week of the feeding period, and 20% were reserved to test the adequacy of these prediction equations. Correlations were used to determine the relationship between all available variables with observed DMI. These variables were then included in the generalized least squares regression models. A veracity test of the model was performed against the reserved data. Daily DMI from previous week was the factor most highly correlated with daily DMI (P < 0.10) during from week 6 to week 31, accounting for approximately 70% of the variation, followed by mean daily DMI during adaptation period (weeks 1-4), including in the prediction model from weeks 5 to 12. Initial shrunk BW (ISBW) was the third most correlated factor, which was included in prediction equations from week 5 to week 20. Sex entered the prediction model only after week 8. Daily DMI for each test week within the feeding period was predicted closely (r2 = 0.98) by these four factors (RMSE = 0.155 kg). In conclusion, the mean daily DMI during each week of the finishing period for a pen of cattle could be predicted closely based on mean daily DMI intake during the previous week plus other variables available early in a feedlot period (daily DMI during adaptation period, ISBW and sex).

Arthroscopic tibiotalocalcaneal arthrodesis. Technique, indications and results. / Panartrodesis artroscópica de tobillo. Indicaciones, técnica y resultados.

BACKGROUND: Arthroscopic tibiotalocalcaneal arthrodesis with a retrograde nail is performed as a minimally invasive technique in patients without improvement in conservative treatment of osteoarthritis. Complications and hospital stay after surgery are less using this technique when they are compared with open ones. MATERIALS AND METHODS: We review retrospectively from 2016 to 2019 seven patients subjected to a posterior arthroscopic tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail. AOFAS scale was used to assess functional results and we collected other data as complications, time required for bony union, time of nonweight-bearing and scale of satisfaction. We also made a description of the technique we performed. RESULTS: The mean hospital stay was 3.43±0.53 days, patients have well functional results and complications were very low. It was noticed tibiotalar bony union in about 86% of patients 10 weeks after surgery and subtalar bony union in about 71% 20 weeks after surgery. Nonweight-bearing was made using a cast for 4 weeks and later, it was changed for Walker allowing patients partial weight-bearing until 10 weeks after surgery. One patient had wound complications and he needed later surgery and another presented tibiotalar pseudoarthrosis, although without symptoms. CONCLUSION: Posterior arthroscopic tibiotalocalcaneal arthrodesis offers very good results with a high rate of bony union, few complications, and minimal nonweight-bearing time. This technique could be used in patients without major deformities, especially in those at high risk of complications from the surgical wound.

Comportamiento de las colinesterasas tras condiciones de fatiga en corredores de fondo / Behaviour of cholinesterases after fatigue conditions in endurance runners

El objetivo del presente estudio fue evaluar el efecto de un entrenamiento intenso en atletas de resistencia sobre el comportamiento de las colinesterasas (ChE) tras condiciones de fatiga y su relación con otros marcadores de carga interna. Participaron 18 atletas de sexo masculino especialistas en pruebas de resistencia. Se evaluó las ChE y dos índices de variabilidad de la frecuencia cardiaca en tres momentos diferentes, previo al protocolo (BASAL), 15 minutos posterior al protocolo (FINAL) y 24 horas después del entrenamiento (24H). Un ANOVA de una vía con post-hoc de Tukey HSD se utilizó para comparar las medias. Se encontraron cambios significativos en las variables analizadas (p < .001) con tamaños de efecto muy grandes (d > 0.9) en los diferentes momentos y correlaciones moderadas entre variables (p < .001). El comportamiento de las ChE muestra un cambio significativo (p < .001) posterior al ejercicio y una relación con otros indicadores de carga interna. Nuestros resultados indican que las ChE tienen relación con la fatiga en el caso de los deportistas estudiados, pudiendo ser una medida para determinar la carga de entrenamiento. (AU)

The objective of the present study was to evaluate the effect of intense training in endurance athletes on the behaviour of cholinesterases (ChE) after fatigue conditions and its relationships with other internal load markers. 18 male athletes specializing in endurance events participated. ChEs and two index of heart rate variability were evaluated at three different moments, before the study protocol (BASAL), 15 minutes after (FINAL) and the day after finishing the training (24H). A one-way ANOVA with post-hoc Tukey HSD was used to compare means. Significant differences were found in the variables analysed (p < .001), with very large effect sizes (d > 0.9) between BASAL, FINAL and 24H and moderate correlations between ChE and LnRMSSD and SS (p < .001). The behaviour of the ChEs showed a significant change (p < .001) after exercise and relationship with other internal training load indicators. Our results indicate that ChEs are related with fatigue in the studied athletes and may be a measure for training load determination. (AU)

Arthroscopic tibiotalocalcaneal arthrodesis. Technique, indications and results / Panartrodesis artroscópica de tobillo. Indicaciones, técnica y resultados

Background: Arthroscopic tibiotalocalcaneal arthrodesis with a retrograde nail is performed as a minimally invasive technique in patients without improvement in conservative treatment of osteoarthritis. Complications and hospital stay after surgery are less using this technique when they are compared with open ones. Materials and methods: We review retrospectively from 2016 to 2019 seven patients subjected to a posterior arthroscopic tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail. AOFAS scale was used to assess functional results and we collected other data as complications, time required for bony union, time of nonweight-bearing and scale of satisfaction. We also made a description of the technique we performed. Results: The mean hospital stay was 3.43±0.53 days, patients have well functional results and complications were very low. It was noticed tibiotalar bony union in about 86% of patients 10 weeks after surgery and subtalar bony union in about 71% 20 weeks after surgery. Nonweight-bearing was made using a cast for 4 weeks and later, it was changed for Walker allowing patients partial weight-bearing until 10 weeks after surgery. One patient had wound complications and he needed later surgery and another presented tibiotalar pseudoarthrosis, although without symptoms. Conclusion: Posterior arthroscopic tibiotalocalcaneal arthrodesis offers very good results with a high rate of bony union, few complications, and minimal nonweight-bearing time. This technique could be used in patients without major deformities, especially in those at high risk of complications from the surgical wound.(AU)

Antecedentes: La artrodesis tibiotalocalcánea artroscópica con clavo retrógrado es una técnica mínimamente invasiva que se realiza en pacientes con artrosis que no mejoran con tratamiento conservador. La ventaja de esta técnica es su menor estancia hospitalaria y su menor tasa de complicaciones respecto a técnicas abiertas. Materiales y métodos: Se realiza un estudio retrospectivo descriptivo de los 7 pacientes intervenidos entre 2016-2019 de artrodesis tibiotalocalcánea artroscópica por vía posterior con clavo retrógrado en nuestro hospital. En él se analizan los datos de funcionalidad con la escala AOFAS, grado de satisfacción, tiempo de consolidación, de descarga y complicaciones. Además, se realiza una descripción de la técnica quirúrgica empleada. Resultados: Se observó una estancia hospitalaria de 3,43±0,53 días de media, buena funcionalidad y baja tasa de complicaciones. Obtuvimos consolidación tibiotalar en el 86% de los casos en aproximadamente 10 semanas y una consolidación subtalar en el 71% en 20 semanas. El tiempo de descarga fue de 4 semanas con férula y posteriormente carga parcial con Walker hasta la décima semana postoperatoria. Uno de los casos tuvo que ser reintervenido por complicaciones en la herida quirúrgica y otro presentó seudoartrosis tibiotalar, aunque sin repercusión clínica. Conclusión: La panartrodesis artroscópica por vía posterior ofrece muy buenos resultados, con elevada tasa de consolidación ósea, pocas complicaciones y tiempo de descarga mínimo. Esta técnica podría ser utilizada en pacientes sin grandes deformidades, sobre todo en aquellos con alto riesgo de complicaciones de la herida quirúrgica, al constatarse un descenso de las mismas.(AU)

Panartrodesis artroscópica de tobillo. Indicaciones, técnica y resultados / Arthroscopic tibiotalocalcaneal arthrodesis. Technique, indications and results

Antecedentes: La artrodesis tibiotalocalcánea artroscópica con clavo retrógrado es una técnica mínimamente invasiva que se realiza en pacientes con artrosis que no mejoran con tratamiento conservador. La ventaja de esta técnica es su menor estancia hospitalaria y su menor tasa de complicaciones respecto a técnicas abiertas. Materiales y métodos: Se realiza un estudio retrospectivo descriptivo de los 7 pacientes intervenidos entre 2016-2019 de artrodesis tibiotalocalcánea artroscópica por vía posterior con clavo retrógrado en nuestro hospital. En él se analizan los datos de funcionalidad con la escala AOFAS, grado de satisfacción, tiempo de consolidación, de descarga y complicaciones. Además, se realiza una descripción de la técnica quirúrgica empleada. Resultados: Se observó una estancia hospitalaria de 3,43±0,53 días de media, buena funcionalidad y baja tasa de complicaciones. Obtuvimos consolidación tibiotalar en el 86% de los casos en aproximadamente 10 semanas y una consolidación subtalar en el 71% en 20 semanas. El tiempo de descarga fue de 4 semanas con férula y posteriormente carga parcial con Walker hasta la décima semana postoperatoria. Uno de los casos tuvo que ser reintervenido por complicaciones en la herida quirúrgica y otro presentó seudoartrosis tibiotalar, aunque sin repercusión clínica. Conclusión: La panartrodesis artroscópica por vía posterior ofrece muy buenos resultados, con elevada tasa de consolidación ósea, pocas complicaciones y tiempo de descarga mínimo. Esta técnica podría ser utilizada en pacientes sin grandes deformidades, sobre todo en aquellos con alto riesgo de complicaciones de la herida quirúrgica, al constatarse un descenso de las mismas.(AU)

Background: Arthroscopic tibiotalocalcaneal arthrodesis with a retrograde nail is performed as a minimally invasive technique in patients without improvement in conservative treatment of osteoarthritis. Complications and hospital stay after surgery are less using this technique when they are compared with open ones. Materials and methods: We review retrospectively from 2016 to 2019 seven patients subjected to a posterior arthroscopic tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail. AOFAS scale was used to assess functional results and we collected other data as complications, time required for bony union, time of nonweight-bearing and scale of satisfaction. We also made a description of the technique we performed. Results: The mean hospital stay was 3.43±0.53 days, patients have well functional results and complications were very low. It was noticed tibiotalar bony union in about 86% of patients 10 weeks after surgery and subtalar bony union in about 71% 20 weeks after surgery. Nonweight-bearing was made using a cast for 4 weeks and later, it was changed for Walker allowing patients partial weight-bearing until 10 weeks after surgery. One patient had wound complications and he needed later surgery and another presented tibiotalar pseudoarthrosis, although without symptoms. Conclusion: Posterior arthroscopic tibiotalocalcaneal arthrodesis offers very good results with a high rate of bony union, few complications, and minimal nonweight-bearing time. This technique could be used in patients without major deformities, especially in those at high risk of complications from the surgical wound.(AU)

Use of healthcare REsources and associated COsts in controlled versus uncontrolled carcinoid SYndrome in patients with neuroendocrine tumours: the RECOSY study

Purpose To report healthcare resource use and associated costs in controlled versus uncontrolled carcinoid syndrome (CS) in patients with neuroendocrine tumours. Methods A cross-sectional, non-interventional multicentre study was conducted with retrospective data analysis. Resource use was compared between two patient groups: those with controlled CS (> 12 months with no uncontrolled CS episodes) and uncontrolled CS (< 12 months since last uncontrolled episode). Patients were matched for age, sex, and origin and grade of tumour. When no matching patients were available, data from deceased patients were used. Information on healthcare resource use came from review of medical records, patient history and physician reports. Working capacity was assessed using the Work Productivity and Activity Impairment General Health questionnaire. Results Twenty-six university hospitals in Spain participated, between July 2017 and April 2018. 137 patients were enrolled; 104 were analysed (2 groups of 52). Patients with uncontrolled CS had 10 times more emergency department (ED) visits (mean 1.0 vs 0.10 visits; P = 0.0167), were more likely to have a hospital admission (40.4% vs 19.2%; P = 0.0116) and had longer hospital stays (mean 7.87 vs 2.10 days; P = 0.0178) than those with controlled CS. This corresponded to higher annual hospitalisation costs (mean €5511.59 vs €1457.22; P = 0.028) and ED costs (€161.25 vs €14.85; P = 0.0236). The mean annual total healthcare costs were 60.0% higher in patients with uncontrolled than controlled CS (P = NS). Conclusion This study quantifies higher health resource use, and higher hospitalisation and ED costs in patients with uncontrolled CS. Better control of CS may result 3in lower medical costs (AU)

Use of healthcare REsources and associated COsts in controlled versus uncontrolled carcinoid SYndrome in patients with neuroendocrine tumours: the RECOSY study.

PURPOSE: To report healthcare resource use and associated costs in controlled versus uncontrolled carcinoid syndrome (CS) in patients with neuroendocrine tumours. METHODS: A cross-sectional, non-interventional multicentre study was conducted with retrospective data analysis. Resource use was compared between two patient groups: those with controlled CS (> 12 months with no uncontrolled CS episodes) and uncontrolled CS (< 12 months since last uncontrolled episode). Patients were matched for age, sex, and origin and grade of tumour. When no matching patients were available, data from deceased patients were used. Information on healthcare resource use came from review of medical records, patient history and physician reports. Working capacity was assessed using the Work Productivity and Activity Impairment General Health questionnaire. RESULTS: Twenty-six university hospitals in Spain participated, between July 2017 and April 2018. 137 patients were enrolled; 104 were analysed (2 groups of 52). Patients with uncontrolled CS had 10 times more emergency department (ED) visits (mean 1.0 vs 0.10 visits; P = 0.0167), were more likely to have a hospital admission (40.4% vs 19.2%; P = 0.0116) and had longer hospital stays (mean 7.87 vs 2.10 days; P = 0.0178) than those with controlled CS. This corresponded to higher annual hospitalisation costs (mean €5511.59 vs €1457.22; P = 0.028) and ED costs (€161.25 vs €14.85; P = 0.0236). The mean annual total healthcare costs were 60.0% higher in patients with uncontrolled than controlled CS (P = NS). CONCLUSION: This study quantifies higher health resource use, and higher hospitalisation and ED costs in patients with uncontrolled CS. Better control of CS may result 3in lower medical costs.

Virus-related neurological lower urinary tract dysfunction: Lessons learned during 4-year follow-up of patients with Congenital Zika Syndrome.

INTRODUCTION: We have previously reported on neurogenic bladder dysfunction among Congenital Zika Vírus Syndrome (CZS) patients, but it is unknown how they will respond to treatment. OBJECTIVE: To assess whether children with neurological lower urinary tract dysfunction and CZS will respond to Standard therapies. METHODOLOGY: A prospective observational cohort study of children with CZS referred for urological assessment between 2016 and 2020 to our quaternary center in Brazil. Urological protocol included clinical history, urinalysis and culture, renal and bladder ultrasonography and urodynamic study. Patients were treated based on findings from the first evaluation, with oxybutynin chloride for overactive bladder and low bladder compliance, clean intermittent catheterization for ineffective bladder emptying, or dual therapy when both were observed. Urological outcomes were evaluated between the first and second visits considering patient's adherence. Outcomes measured included clinical, imaging, and urodynamic variables. Data was analyzed using the IBM SPSS 22 software. RESULTS: From the cohort of 90 patients, 56 completed the second urodynamic assessment and were included. One presented underactive bladder and 55 overactive bladder. Among these 55, 39 were adherent and 16 non-adherents to the prescribed treatment. Among the 39 adherents, 8 adhered regularly to oxybutynin and clean intermittent catheterization (CIC), 29 to oxybutynin alone, and two to catheterization alone. During follow-up, the number of patients with urinary tract infection and postvoid residual increased, but all other parameters had improved. Renal and bladder ultrasonography improved in 10, maximum bladder pressure decreased in 22 and maximum cystometric capacity and compliance increased in 14 patients. Sixteen patients did not adhere regularly to the prescribed treatment and although the number of patients with urinary tract infection reduced with antibiotic therapy, their bladder capacity and compliance did not improve during follow-up. DISCUSSION: Ultrasonographic and urodynamic improvements were observed after 10.8 ± 7.5 months of treatment, including one patient with ureterohydronephrosis that resolved. Adherence to CIC remains a challenge and reflected in the number of patients presenting urinary tract infection and postvoid residual. The immediate clinical relevance is the major study strength, given the previously uncharacterized therapy options for this patient population. The number of patients remains one of the study limitations, reducing our ability to perform more advanced statistical analyses. CONCLUSION: Patients with Zika-related neurological lower urinary tract dysfunction may benefit from conventional therapies. Results confirmed ultrasonographic and urodynamic improvements after treatment, although not statically significant. Adherence to treatment, specifically to CIC, remains a challenge.

Evaluation of the Freezability of the Bovine Epididymis Tail Sperm with the Addition of Antioxidants.

BACKGROUND: The cryopreservation and recovery of epididymis tail sperm is an important biotechnology dependent on the composition of the freezing medium. OBJETIVE: To evaluate the effect of melatonin, added to commercial freezing medium extender, on the kinetics and viability of bovine epididymis tail sperm. MATERIAL AND METHODS: Five routines were performed, each consisting of eight epididymis and the structures were sliced onto a glass plate containing a commercial diluting medium for Botubov. The samples were divided into four groups, with 80 x 106 spermatozoa per mL. Group 1: samples diluted in Botubov. Group 2: samples centrifuged (600 g, 10 min), and the pellet re-suspended in Botubov. Group 3, samples diluted in Botubov containing 100 pM melatonin. Group 4: samples centrifuged (600 g, 10 min) and the pellet resuspended in Botubov with 100 pM melatonin. The samples were transferred to 0.5 mL straws at 40 x 106 viable spermatozoa, stabilized at 5º C for 4 h, transferred to liquid nitrogen vapour for 20 min, dipped in liquid nitrogen and stored in a cryogenic cylinder. After thawing (46ºC, 15s), sperm kinetics and viability parameters were evaluated. RESULTS: There was no difference in the parameters of total motility (MT, %), progressive motility (MP, %), progressive linear velocity (VSL, µm/s), curvilinear velocity (VCL, µm/s), linearity (LIN, %), spermatozoa with rapid movement (RAP, %) and level of intact plasma membranes and acrosome (IPMA, %) among the groups studied. However, a difference was observed between the routines performed. CONCLUSION: The protocol for freezing bovine epididymis tail sperm is applicable; however, there is an influence of the epididymis used, for the best efficacy of this biotechnology.

Evaluation of phytochemical composition, toxicity in Drosophila melanogaster and effects on antibiotics modulation of Plathymenia reticulata Benth extract.

Bacterial resistance is interfering with the action of antibiotics for clinical use in treating pathologies. The search for new substances capable of combating this resistance is necessary. An alternative to the search for these substances is in the extract of medicinal plants. Plathymenia reticulata, plant of the Fabaceae family, is a common tree species from the Brazilian cerrado, and is commonly used in areas of environmental degradation. This species is rich in phenolic compounds, such as flavonoids and tannins, compounds that are associated with various biological effects. A hydroethanolic extract from the bark of Plathymenia reticulata (HEPrB) was produced and then tests were carried out to verify the direct antibacterial activity, the modulatory effect of antibiotics for clinical use and their toxicity in Drosophila melanogaster flies. Through the analysis with UPLC, a wide variety of flavonoids contained in the HEPrB was observed. Direct antibacterial activity was observed for the standard strain of Staphylococcus aureus, however, the extract showed antagonistic activity or no significance in relation to the antibiotics tested in this study. As for toxicity, the HEPrB did not show significant damage in the proposed model. The results emphasize care when associating the consumption of teas with treatments with antibiotics for clinical use.

Isoperistaltic gastric tube: a surgical alternative in a pharyngoesophageal burn - a clinical case. / Tubo gástrico isoperistáltico, alternativa quirúrgica en quemadura faringoesofágica. Caso clínico.

INTRODUCTION: Caustic burns still cause complex esophageal lesions in the pediatric population. However, therapeutic possibilities in severe cases are limited. A surgical approach allowing for a longer neoesophagus, an isoperistaltic esophagus, and a better vascularization, with a lower risk of complications such as necrosis, stenosis, or perforation, is proposed. CLINICAL CASE: 16-month-old patient who accidentally ingested caustic soda. This caused a IIIb degree burn compromising the pharynx down to the stomach. Esophageal replacement with an isoperistaltic gastric tube was carried out, which allowed for a neoesophagus of appropriate length, an optimal vascularization for the graft, and physiological peristalsis. COMMENTS: The surgical approach proposed allows the esophagus to be irrigated from the right gastro-omental artery, thus preserving irrigation of the greater curvature. It also allows for a longer esophagus, and thanks to anatomical positioning, for physiological peristalsis.

INTRODUCCION: Las quemaduras por ingesta de cáusticos en la población pediátrica continúan siendo causa de lesiones esofágicas complejas. Sin embargo, las posibilidades terapéuticas en casos severos son limitadas. Se propone un abordaje quirúrgico en el cual se obtiene mayor longitud del neoesófago, esófago isoperistáltico y mejor vascularización con el subsecuente menor riesgo de complicaciones (necrosis, estenosis, perforación). CASO CLINICO: Paciente de 16 meses de edad, quien presenta ingesta accidental de sosa cáustica que ocasiona quemadura grado IIIb que compromete desde la faringe hasta el estómago. Se realizó reemplazo esofágico con tubo gástrico isoperistáltico, con lo cual se obtuvo un neoesófago de longitud apropiada, vascularización óptima para el injerto y peristaltismo fisiológico. COMENTARIOS: El abordaje quirúrgico propuesto permite obtener un esófago con irrigación proveniente de la arteria gastroepiploica derecha, preservando irrigación de la curvatura mayor, una longitud mayor y por el posicionamiento anatómico del esófago con un peristaltismo fisiológico.

Tubo gástrico isoperistáltico, alternativa quirúrgica en quemadura faringoesofágica. Caso clínico / Isoperistaltic gastric tube: a surgical alternative in a pharyngoesophageal burn - a clinical case

INTRODUCCIÓN: Las quemaduras por ingesta de cáusticos en la población pediátrica continúan siendo causa de lesiones esofágicas complejas. Sin embargo, las posibilidades terapéuticas en casos severos son limitadas. Se propone un abordaje quirúrgico en el cual se obtiene mayor longitud del neoesófago, esófago isoperistáltico y mejor vascularización con el subsecuente menor riesgo de complicaciones (necrosis, estenosis, perforación). CASO CLÍNICO: Paciente de 16 meses de edad, quien presenta ingesta accidental de sosa cáustica que ocasiona quemadura grado IIIb que compromete desde la faringe hasta el estómago. Se realizó reemplazo esofágico con tubo gástrico isoperistáltico, con lo cual se obtuvo un neoesófago de longitud apropiada, vascularización óptima para el injerto y peristaltismo fisiológico. COMENTARIOS: El abordaje quirúrgico propuesto permite obtener un esófago con irrigación proveniente de la arteria gastroepiploica derecha, preservando irrigación de la curvatura mayor, una longitud mayor y por el posicionamiento anatómico del esófago con un peristaltismo fisiológico

INTRODUCTION: Caustic burns still cause complex esophageal lesions in the pediatric population. However, therapeutic possibilities in severe cases are limited. A surgical approach allowing for a longer neoesophagus, an isoperistaltic esophagus, and a better vascularization, with a lower risk of complications such as necrosis, stenosis, or perforation, is proposed. CLINICAL CASE: 16-month-old patient who accidentally ingested caustic soda. This caused a IIIb degree burn compromising the pharynx down to the stomach. Esophageal replacement with an isoperistaltic gastric tube was carried out, which allowed for a neoesophagus of appropriate length, an optimal vascularization for the graft, and physiological peristalsis. COMMENTS: The surgical approach proposed allows the esophagus to be irrigated from the right gastro-omental artery, thus preserving irrigation of the greater curvature. It also allows for a longer esophagus, and thanks to anatomical positioning, for physiological peristalsis

[Hip fracture in the elderly: epidemiology and costs of care]. / Fractura de cadera en el adulto mayor: epidemiología y costos de la atención.

INTRODUCTION: The aim of this study was to describe the epidemiology and to estimate the direct medical costs of hip fracture among elderly patients in Mexico. MATERIAL AND METHODS: An observational, cross sectional and retrospective study was undertaken. Hospital discharge and surgical procedures for the period 2013-2018 were the databases used for the analysis, and obtained from General Directorate of Health Information. Variables included were sex, federal entity, age, year of discharge, and fracture type according to the CIE-10; and also, the supplies needed for the surgical procedures. RESULTS: A total of 16,829 patients with hip fracture were discharge, 69% were women, and the mean for age was 79 years old and for the hospital stay length was nine days. The most frequent fracture type was the femur neck with 77% and the average medical costs was USD$45,122,228.00. CONCLUSION: Falling risks increase with age, especially in patients among 80-89 years of age, hence, is expected that this type of pathology increases in the following years. The medical costs for treatment of hip fracture represents an economic impact on health services. For that reason, the implementation of prevention strategies, risk of falling for example, is the one of most efficient approach.

INTRODUCCIÓN: El objetivo general de la investigación fue describir la epidemiología y estimar los costos médicos directos de la fractura de cadera en el adulto mayor en México. MATERIAL Y MÉTODOS: Se realizó un estudio observacional y transversal retrospectivo. Se utilizaron dos bases de datos obtenidas de la Dirección General de Información en Salud del período 2013-2018: egresos hospitalarios y procedimientos quirúrgicos. Las variables incluidas fueron: sexo, entidad federativa, edad, año de registro y tipo de fractura de acorde a la CIE-10; de igual forma, todos los insumos necesarios para la realización del procedimiento quirúrgico. RESULTADOS: Se registraron 16,829 ingresos de pacientes con fractura de cadera. Las mujeres representaron 69% del total de pacientes, la edad en promedio fue de 79 años y la estancia hospitalaria fue de nueve días, 77% de las fracturas fueron de cuello de fémur y el promedio de los costos médicos directos de los procedimientos ascendieron a USD $45,122,228.00 para el período estudiado. CONCLUSIÓN: El riesgo de caídas aumenta con la edad, especialmente en el grupo etario de 80-89 años, por lo que se espera que este tipo de patologías se incremente en los próximos años. De igual forma, los costos para la atención de estas fracturas representan un impacto económico para los sistemas de salud. De manera que la implementación de estrategias de prevención, por ejemplo, en caídas es el método más eficiente para contribuir al envejecimiento saludable.

Perfil del estilo de vida y actividad inflamatoria en personas con artritis reumatoide / Lifestyle and inflammation profiles among persons with rheumatoid arthritis / Perfil do estilo de vida e atividade inflamatória em pessoas com artrite

Resumen Introducción: La artritis reumatoide es una enfermedad autoinmune, crónica, degenerativa. Su control está relacionado con la medicación y los factores ambientales, especialmente los estilos de vida, que son potencialmente modificables. Objetivo: Determinar el perfil del estilo de vida de las personas con artritis reumatoide y su relación con el grado de actividad de la enfermedad. Metodología: Estudio descriptivo, transversal y correlacional en adultos con artritis reumatoide. Con previo consentimiento informado, se aplicó clinimetría basada en el nivel de actividad de la enfermedad (DAS28) y el Perfil de Estilos de Vida (PEPS-II) de Nola J. Pender. Para el análisis se recurrió a la estadística descriptiva, correlación de Spearman. Se utilizó el paquete estadístico SPSS versión 22. Resultados: Se valoraron 110 personas, el promedio global del estilo de vida se ubica en un perfil saludable, la dimensión actividad física se clasificó como la más afectada (85.5%). No se encontró correlación entre la actividad de la enfermedad y estilo de vida. Discusión: Existen pocos estudios análogos, los resultados primordiales de estos coinciden con los encontrados. Se hace evidente la necesidad de seguir trabajando en los estilos de vida para lograr disminuir la presencia de actividad inflamatoria en las personas con artritis reumatoide. Conclusiones: No existe una correlación entre las dos variables, es decir, a medida que el perfil de estilo de vida es saludable, la actividad inflamatoria de la enfermedad está activa.

Abstract Introduction: Rheumatoid arthritis is a chronic-degenerative autoimmune illness whose control depends on medications and environmental factors, in particular the lifestyles. Objective: To determine the profiles of lifestyles among persons suffering from rheumatoid arthritis and their related illness severity. Methodology: This is a descriptive, transversal, and correlational study on adults with rheumatoid arthritis. After obtaining their corresponding informed consents, the Disease Activity Score of 28 joints test, and Nola J. Pender's Lifestyles Profile Questionnaire were given. SPSS version 22 was used to determine descriptive statistics with Spearman correlations. Results: 110 individuals were assessed, the global average of lifestyle scores was suggesting a healthy general profile, physical activity was found to be the most affected (85.5%). No correlation between the illness activity and the lifestyle was found. Discussion: There are few analogous studies and their results have been diverse. Therefore, it is important to continue analyzing the characteristics of lifestyles that can help reduce rheumatoid arthritis related inflammation in these patients. Conclusions: No correlation was found between the two studied variables; therefore, a lifestyle change does not necessarily imply a reduction in the level of inflammation.

Resumo Introdução: A artrite reumatoide é uma doença autoimune, crônica, degenerativa. Seu controle está relacionado com a medicação e os fatores ambientais, especialmente os estilos de vida, que são potencialmente modificáveis. Objetivo: Determinar o perfil do estilo de vida das pessoas com artrite reumatoide e sua relação com o grau de atividade da doença. Metodologia: Estudo descritivo, transversal e correlacional em adultos com artrite reumatoide. Com prévio consentimento informado, aplicou-se Clinimetria baseada no nível de atividade da doença (DAS28) e o Perfil de Estilos de Vida (PEPS-II) de Nola J. Pender. Para a análise recorreu-se à estatística descritiva, correlação de Spearman. Utilizou-se o pacote estatístico SPSS versão 22. Resultados: Foram avaliadas 110 pessoas, a média global do estilo de vida localizou-o em um perfil saudável, a dimensão atividade física classificou-se como a mais afetada (85.5%). Não se encontrou correlação entre a atividade da doença e o estilo de vida. Discussão: Existem poucos estudos análogos, os resultados primordiais destes coincidem com os encontrados. Fica evidente a necessidade de seguir trabalhando nos estilos de vida para atingir diminuir a presença de atividade inflamatória nas pessoas com artrite reumatoide. Conclusões: Não existe uma correlação entre as duas variáveis, quer dizer, à medida que o perfil de estilo de vida for saudável, a atividade inflamatória da doença estará ativa.

Stress Score y LnrRMSSD como parámetros de carga interna durante una competición / Stress Score and LnrMSSD as Internal Load Parameters During Competition

El objetivo del estudio fue analizar el comportamiento del stress score (SS) y el logaritmo neperiano de la media de la raíz cuadrada de las diferencias de los intervalos sucesivos R-R (LnrMSSD) de la variabilidad de la frecuencia cardíaca (VFC) como indicadores de la carga interna mediante la modulación simpática y parasimpática, apoyado con parámetros bioquímicos de carga interna. Se evaluaron 14 atletas universitarios de balonmano (edad 22.30 ± 1.83 años). Se monitoreó la VFC y marcadores bioquímicos en seis momentos. Se analizaron las diferencias entre las tomas de cada variable mediante estadística descriptiva convencional y el tamaño del efecto con la d de Cohen y la magnitud de Hopkins. Se examinaron las correlaciones de Pearson entre variables. El LnrMSSD, SS y cortisol presentaron cambios significativos (p < .05). Se encontraron correlaciones entre los parámetros de la VFC (SS y LnrMSSD) con creatin kinasa (CK) respectivamente. Los resultados del estudio muestran que el SS puede ser una metodología fiable para la evaluación de la carga interna durante una competición

The aim of this study was to analyse the behaviour of the stress score (SS) and the Neperian logarithmof the Root Mean Square of Successive R-R Interval differences (LnrMSSD) of heart rate variability (HRV) as indicators of internal load throughout sympathetic and parasympathetic modulation, supported by biochemical parameters of internal load. 14 handball university athletes (age 22.30 ± 1.83 years) were evaluated. Six times of HRV and biochemical markers were collected. Each variable were analyzed by conventional statistics and using the Cohen´s d, and Hopkins magnitude for the sample size effect. It was analyzed the Pearson correlations between variables. The LnrMSSD, SS and cortisol presented significant changes (p< .05). Correlations were found between HRV (SS and LnrMSSD) and CK respectively. Results of this study shows that SS can be a reliable method for the evaluation of internal load during competition

Relación entre VFC post-ejercicio y la carga interna de entrenamiento en triatletas / Relationship Between Post-Exercise hrv and Internal Training Load in Triathletes

El objetivo del estudio fue relacionar valores de VFC post-ejercicio con componentes de carga interna de entrenamiento medida por tres métodos de Estímulo de Entrenamiento (Training Impulse, TRIMP) en triatletas juveniles. Los métodos de TRIMP estuvieron relacionados entre ellos (r = 0,970 a 0,983, R2 = 0.940 a 0.967), sin embargo, mostraron diferencias significativas en sus valores promedio (p < 0.01). El entrenamiento redujo significativamente la VFC (p < 0.01) y existe un efecto significativo del tiempo en la recuperación de la VFC (p < 0.01). La reducción de la VFC en Post5 está negativamente relacionada con la intensidad del ejercicio, volumen en >90% FCres y valores de TRIMP (r = -0.302 a -0.495, p < 0.01) y positivamente relacionada con el volumen en <50% FCres (r = 0.488, p < 0.01). La reducción post-ejercicio de la VFC puede proporcionar información valiosa para evaluar efectos fisiológicos del entrenamiento interválico o continuo en triatletas juveniles

The aim of the study was to stablish relationships between post-exercise heart rate variability (HRV) values and internal training load (TL) components measured by three Training Impulse (TRIMP) methods in youth triathletes. TRIMP methods were related with each other (r = 0,970 to 0,983, R2 = 0,940 to 0,967) but showed significant differences in mean values (p < 0,01). Training significantly reduced HRV (p < 0,01) with a significant time effect on HRV recovery (p < 0,01). Post5 HRV reduction has a negative relationship to exercise intensity, volume at >90% HRres, and TRIMP values (r = -0,302 to -0,495, p < 0,01) and a positive relationship with volume at <50% HRres (r = 0.488, p < 0,01). Immediate post-exercise HRV reduction can provide valuable information for evaluation of physiological effects at intervallic or continuous training in youth triathletes

Free-running cardiac magnetic resonance fingerprinting: Joint T1/T2 map and Cine imaging.

PURPOSE: To develop and evaluate a novel non-ECG triggered 2D magnetic resonance fingerprinting (MRF) sequence allowing for simultaneous myocardial T1 and T2 mapping and cardiac Cine imaging. METHODS: Cardiac MRF (cMRF) has been recently proposed to provide joint T1/T2 myocardial mapping by triggering the acquisition to mid-diastole and relying on a subject-dependent dictionary of MR signal evolutions to generate the maps. In this work, we propose a novel "free-running" (non-ECG triggered) cMRF framework for simultaneous myocardial T1 and T2 mapping and cardiac Cine imaging in a single scan. Free-running cMRF is based on a transient state bSSFP acquisition with tiny golden angle radial readouts, varying flip angle and multiple adiabatic inversion pulses. The acquired data is retrospectively gated into several cardiac phases, which are reconstructed with an approach that combines parallel imaging, low rank modelling and patch-based high-order tensor regularization. Free-running cMRF was evaluated in a standardized phantom and ten healthy subjects. Comparison with reference spin-echo, MOLLI, SASHA, T2-GRASE and Cine was performed. RESULTS: T1 and T2 values obtained with the proposed approach were in good agreement with reference phantom values (ICC(A,1) > 0.99). Reported values for myocardium septum T1 were 1043 ± 48 ms, 1150 ± 100 ms and 1160 ± 79 ms for MOLLI, SASHA and free-running cMRF respectively and for T2 of 51.7 ± 4.1 ms and 44.6 ± 4.1 ms for T2-GRASE and free-running cMRF respectively. Good agreement was observed between free-running cMRF and conventional Cine 2D ejection fraction (bias = -0.83%). CONCLUSION: The proposed free-running cardiac MRF approach allows for simultaneous assessment of myocardial T1 and T2 and Cine imaging in a single scan.

Photoluminescence emission from nanostructured porous preparations of CdS-ZnTiO3 assembled nanoparticles.

This study reports the structural and optical properties of CdS/ZnTiO3 nanocomposites prepared using a chemical bath and different titanate concentrations. Commercial ZnTiO3 nanoparticles were introduced into a chemical bath that had been used to produce CdS semiconductor nanoparticles (NPs). Here, the growing CdS crystallites precipitated onto the suspended zinc titanate NPs. X-ray diffraction patterns revealed that samples of CdS/ZnTiO3 nanopowders were made of cubic ZnTiO3 and hexagonal CdS wurtzite. The morphology of the particles was studied using transmission electron microscopy and scanning electron microscopy images. These images demonstrated the different characteristics of the CdS/ZnTiO3 nanocomposites and their dependence on titanate concentration when placed into the CdS-growing solution. Photoluminescence spectra showed three main emission bands for the electron transitions in the CdS/ZnTiO3 composite. This composite produced three photoluminescence bands, the intensities of which depended on composite shape, which in turn depended on the relative concentrations of CdS and ZnTiO3 .

Blocking substance P signaling reduces musculotendinous and dermal fibrosis and sensorimotor declines in a rat model of overuse injury.

Purpose/Aim: Substance P-NK-1R signaling has been implicated in fibrotic tendinopathies and myositis. Blocking this signaling with a neurokinin 1 receptor antagonist (NK1RA) has been proposed as a therapeutic target for their treatment.Materials and Methods: Using a rodent model of overuse injury, we pharmacologically blocked Substance P using a specific NK1RA with the hopes of reducing forelimb tendon, muscle and dermal fibrogenic changes and associated pain-related behaviors. Young adult rats learned to pull at high force levels across a 5-week period, before performing a high repetition high force (HRHF) task for 3 weeks (2 h/day, 3 days/week). HRHF rats were untreated or treated in task weeks 2 and 3 with the NK1RA, i.p. Control rats received vehicle or NK1RA treatments.Results: Grip strength declined in untreated HRHF rats, and mechanical sensitivity and temperature aversion increased compared to controls; these changes were improved by NK1RA treatment (L-732,138). NK1RA treatment also reduced HRHF-induced thickening in flexor digitorum epitendons, and HRHF-induced increases of TGFbeta1, CCN2/CTGF, and collagen type 1 in flexor digitorum muscles. In the forepaw upper dermis, task-induced increases in collagen deposition were reduced by NK1RA treatment.Conclusions: Our findings indicate that Substance P plays a role in the development of fibrogenic responses and subsequent discomfort in forelimb tissues involved in performing a high demand repetitive forceful task.