Assessing mechanical behavior of ostrich and equine trabecular and cortical bone based on depth sensing indentation measurements.

Guided bone regeneration surgeries are based on grafting a scaffold in the site to be repaired. The main focus of the scaffold is to provide mechanical support to newly formed blood vessels and cells that will colonize the grafted site, achiving bone regenertation. In this regards, the aim of this study was to characterize the anatomy, structular, surface morphologycal, chemical composition, and nanomechanical properties of ostrich and equine trabecular bone. Ostrich and equine specimens were obtained from a local abattoir and bone was obtained by blunt dissection, n = 5. Tissue bone anatomy and trabecular structure were measured using Computerized Axial Tomography (CAT). Atomic Force Microscopy (AFM) and Energy dispersion spectrometry of X-ray (EDS) were used to examine surface morphology and chemical composition of the trabecular ostrich and equine bone. Mechanical behavior was analysted by nanoindentation. Equine specimens were examined as control. CAT results suggest that in terms of anthropometry, ostrich tarsometatarsus bone is more suitable due to its length is 432.56 ± 3.12 mm vs. the highest human bone structures reported, which femur length is 533.66 ± 18.81 mm. Besides, the low radiodensity in the Hounsfield scale exhibits equine trabecular bone more brittle (Av = 1538.4 ± 0.9) than ostrich trabecular bone (Av = 462.1 ± 1.5). EDS showed a slight variation of the element Calcium (Ca2+) ranging from 20% to 25.5% wt in equine bone; the Ca2+ content variation is consistent with the ring-shaped morphology, while in ostrich bone the chemical composition is homogeneous. The elastic modulus, nanohardness (E = 5.3 ± 0.7 GPa, H = 220 ± 10 MPa) and average roughness (Ra = 207 nm) are similar to the human trabecular bone which could reduce the stress shielding, all of these findings suggest that ostrich bone can be promising for native tissue scaffolds for mechanically demanding applications. This research makes innovative contributions to science and provides a framework, which will allow us to address future biomedical tests, and rapidly identify promising organic and sustainable waste for tissue scaffold.

Prospective Study in 355 Patients With Suspected COVID-19 Infection: Value of Cough, Subjective Hyposmia, and Hypogeusia.

OBJECTIVE: To evaluate the incidence of certain symptoms in a population of health workers exposed to coronavirus disease 2019 patients. STUDY DESIGN: Case-control study. METHODS: The study was conducted at a tertiary care hospital from March 1 to April 7, 2020. Health workers with suspected coronavirus disease 2019 (COVID-19) infection were included. The presence of COVID-19 was detected by using real-time polymerase chain reaction (RT-PCR) methods. Positive and negative RT-PCR patients were used as case and control groups, respectively. This study analyzed the incidence of COVID-19 symptoms in both patient groups. Visual analog scales were used for self-assessment of smell and taste disorders, ranging from 0 (no perception) to 10 (excellent perception). RESULTS: There were 215 (60.6%) patients with positive RT-PCR and 140 (39.4%) patients with negative RT-PCR. The presence of symptoms such as hyposmia hypogeusia, dysthermia, and cough were strongly associated with a positive RT-PCR. The association of cough and subjective hyposmia had 5.46 times higher odds of having a positive test. The receiver operating characteristic (ROC) analysis showed that a fever higher than 37.45°C resulted in sensitivity and specificity of 0.65 and 0.61, respectively. A total of 138 cases (64.1%) and 114 cases (53%) had subjective hyposmia and hypogeusia, respectively. The 85.4% of these patients recovered olfactory function within the first 14 days of the onset of the symptoms. CONCLUSION: There is a significant association between positive RT-PCR and subjective hyposmia. The association of subjective hyposmia and cough increase significantly the odds of having a positive RT-PCR. The measurement of fever as the only method for screening of COVID-19 infection resulted in a poor association. LEVEL OF EVIDENCE: 3 Laryngoscope, 130:2674-2679, 2020.

Duración del tratamiento con etanercept y razones de discontinuación en una cohorte de pacientes con patología reumática / Duration of treatment with etanercept and motives for discontinuation in a cohort of patients with rheumatic disease

Objetivos. Evaluar la supervivencia del tratamiento con etanercept (ETN) y las causas de discontinuación en una cohorte local de pacientes en tratamiento biológico (TB). Comparar con la supervivencia general del resto de TB. Pacientes y métodos. Estudio observacional prospectivo de cohortes. Se han analizado los datos de diagnóstico, fecha de inicio y fin de tratamiento, así como la causa de interrupción de nuestro registro de TB. Mediante el método de Kaplan-Meier se ha estimado la supervivencia de ETN al año, a los 2 años y a los 5 años. Resultados. De un total de 205 pacientes que recibieron TB, 92 (45%) iniciaron tratamiento con ETN. En el 48% el diagnóstico fue artritis reumatoide, 33% espondilitis anquilosante, 11% artritis psoriásica y 8% otros diagnósticos (artritis idiopática juvenil, espondiloartritis asociada a enfermedad inflamatoria intestinal y síndrome SAPHO). Continúan con ETN 48 pacientes (52%). Las causas de discontinuación fueron: ineficacia (65%), acontecimiento adverso (33%), pérdida de seguimiento (2%). En 2 pacientes el tratamiento se retiró por remisión clínica. Los acontecimientos adversos fueron: infección (4 pacientes), reacción cutánea post-inyección (3), uveítis (3), neoplasia (2) y otros (3). La supervivencia estimada de ETN al año de tratamiento fue del 64% (IC del 95%, 54-74), a los dos años del 59% (48-69) y a los 5 años del 43% (30-52), y la del resto de TB fue del 61% (51-68), el 47,5% (40-55) y el 23% (10,5-32), respectivamente. Los tests estadísticos revelaron diferencias significativas (log-rank: p=0,024; Breslow: p=0,068; Tarone-Ware: p=0,040). Conclusiones. En nuestra cohorte de pacientes la supervivencia estimada de ETN en el primero, segundo y quinto de año de tratamiento es superior a la obtenida con el resto de TB, siendo la diferencia significativa a los 5 años (AU)

Objective. To evaluate the duration of etanercept (ETN) treatment and motives for discontinuation in our local cohort of patients with rheumatic pathology and compare them to the group with other biological treatments. Patients and methods. Prospective observational cohort study. Disease diagnosis, start and end date and motive for discontinuation were recorded. Survival estimation was explored using Kaplan-Meier analysis with remaining patients censored at 1-year, 2-years and 5-years follow-up. Results. Ninety-two (45%) out of 205 patients started ETN treatment. Disease diagnoses recorded were: 48% rheumatoid arthritis, 33% ankylosing spondylitis, 11% psoriatic arthritis, 8% others (juvenile idiopathic arthritis, inflammatory bowel disease related spondylitis, SAPHO syndrome). 52% of patients are still on the drug. The motives for discontinuation were: inefficacy (65%), adverse events (33%) and lack of compliance (2%). Two patients discontinued ETN due to prolonged disease control. Adverse events were: infection (4 patients), post-injection skin reaction (3), uveitis (3), neoplasia (2) and others (3). Using a Kaplan–Meier analysis, at 1-year 64% (CI95% 54-74) of patients with ETN treatment had not experienced treatment failure, at 2-years, 59% (48-69) and at 5-years, 43% (30-52). With the rest of biologicals estimated survival was 61% (51-68), 47,5% (40-55) and 23% (10,5-32) respectively. Statistical analysis revealed significant differences (log-rank: P=.024; Breslow: P=.068; Tarone-Ware: P=.040). Conclusions. In our cohort of patients treated with ETN the estimated survival was better than patients treated with other biological drugs at 1-year, 2-years and 5-years (AU)

[Duration of treatment with etanercept and motives for discontinuation in a cohort of patients with rheumatic disease]. / Duración del tratamiento con etanercept y razones de discontinuación en una cohorte de pacientes con patología reumática.

OBJECTIVE: To evaluate the duration of etanercept (ETN) treatment and motives for discontinuation in our local cohort of patients with rheumatic pathology and compare them to the group with other biological treatments. PATIENTS AND METHODS: Prospective observational cohort study. Disease diagnosis, start and end date and motive for discontinuation were recorded. Survival estimation was explored using Kaplan-Meier analysis with remaining patients censored at 1-year, 2-years and 5-years follow-up. RESULTS: Ninety-two (45%) out of 205 patients started ETN treatment. Disease diagnoses recorded were: 48% rheumatoid arthritis, 33% ankylosing spondylitis, 11% psoriatic arthritis, 8% others (juvenile idiopathic arthritis, inflammatory bowel disease related spondylitis, SAPHO syndrome). 52% of patients are still on the drug. The motives for discontinuation were: inefficacy (65%), adverse events (33%) and lack of compliance (2%). Two patients discontinued ETN due to prolonged disease control. Adverse events were: infection (4 patients), post-injection skin reaction (3), uveitis (3), neoplasia (2) and others (3). Using a Kaplan-Meier analysis, at 1-year 64% (CI(95%) 54-74) of patients with ETN treatment had not experienced treatment failure, at 2-years, 59% (48-69) and at 5-years, 43% (30-52). With the rest of biologicals estimated survival was 61% (51-68), 47,5% (40-55) and 23% (10,5-32) respectively. Statistical analysis revealed significant differences (log-rank: P=.024; Breslow: P=.068; Tarone-Ware: P=.040). CONCLUSIONS: In our cohort of patients treated with ETN the estimated survival was better than patients treated with other biological drugs at 1-year, 2-years and 5-years.