Artroplastia total de cadera primaria en pacientes con secuelas de poliomielitis / Primary total hip arthroplasty in patients with sequelae of poliomyelitis

Introducción: La prótesis total de cadera (PTC) en pacientes con secuelas de poliomielitis (SP) supone un reto quirúrgico. La morfología displásica, la osteoporosis y la debilidad glútea dificultan la orientación, incrementan el riesgo de fractura y reducen la estabilidad del implante. El objetivo de este estudio es describir una serie de pacientes con SP tratados mediante PTC. Material y métodos: Estudio descriptivo retrospectivo de pacientes con SP intervenidos mediante PTC entre 1999 y 2021 en un hospital de tercer nivel, con seguimiento clínico y radiológico y evaluación funcional y de las complicaciones hasta el presente o hasta el fallecimiento, con un mínimo de 12meses. Resultados: Se intervinieron 16 pacientes, implantándose 13PTC en el miembro parético, 6 por fractura y 7 por coxartrosis, mientras que las otras 3PTC se implantaron en el miembro contralateral. Se implantaron 4 cotilos de doble movilidad como medida antiluxante. Al año postoperatorio, 11 presentaban un balance articular completo sin aumentar los casos de Trendelenburg. El Harris Hip Score (HHS) mejoró 32,1puntos, la escala visual analógica (EVA), 5,25puntos, y la escala de Merlé-d’Augbiné-Poste, 6puntos. La corrección de la discrepancia de longitud fue de 13,77mm. La mediana del seguimiento fue de 3,5años (1-24). Dos casos se revisaron por usura del polietileno y 2 por inestabilidad, sin registrarse infecciones, fracturas periprotésicas o aflojamiento del cotilo o vástago. Conclusiones: La PTC en pacientes con SP permite mejorar la situación clínico-funcional con una tasa de complicaciones aceptable. El riesgo de luxación podría minimizarse con cotilos de doble movilidad.(AU)

Introduction: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. Material and methods: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. Results: Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d’Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. Conclusions: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.(AU)

[Translated article] Primary total hip arthroplasty in patients with sequelae of poliomyelitis / Artroplastia total de cadera primaria en pacientes con secuelas de poliomielitis

Introducción: La prótesis total de cadera (PTC) en pacientes con secuelas de poliomielitis (SP) supone un reto quirúrgico. La morfología displásica, la osteoporosis y la debilidad glútea dificultan la orientación, incrementan el riesgo de fractura y reducen la estabilidad del implante. El objetivo de este estudio es describir una serie de pacientes con SP tratados mediante PTC. Material y métodos: Estudio descriptivo retrospectivo de pacientes con SP intervenidos mediante PTC entre 1999 y 2021 en un hospital de tercer nivel, con seguimiento clínico y radiológico y evaluación funcional y de las complicaciones hasta el presente o hasta el fallecimiento, con un mínimo de 12meses. Resultados: Se intervinieron 16 pacientes, implantándose 13PTC en el miembro parético, 6 por fractura y 7 por coxartrosis, mientras que las otras 3PTC se implantaron en el miembro contralateral. Se implantaron 4 cotilos de doble movilidad como medida antiluxante. Al año postoperatorio, 11 presentaban un balance articular completo sin aumentar los casos de Trendelenburg. El Harris Hip Score (HHS) mejoró 32,1puntos, la escala visual analógica (EVA), 5,25puntos, y la escala de Merlé-d’Augbiné-Poste, 6puntos. La corrección de la discrepancia de longitud fue de 13,77mm. La mediana del seguimiento fue de 3,5años (1-24). Dos casos se revisaron por usura del polietileno y 2 por inestabilidad, sin registrarse infecciones, fracturas periprotésicas o aflojamiento del cotilo o vástago. Conclusiones: La PTC en pacientes con SP permite mejorar la situación clínico-funcional con una tasa de complicaciones aceptable. El riesgo de luxación podría minimizarse con cotilos de doble movilidad.(AU)

Introduction: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. Material and methods: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. Results: Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d’Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. Conclusions: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.(AU)

[Translated article] Primary total hip arthroplasty in patients with sequelae of poliomyelitis.

INTRODUCTION: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. MATERIAL AND METHODS: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12 months. RESULTS: Sixteen patients underwent surgery, with 13 THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1 year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1 points, the visual analogue scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5 years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. CONCLUSIONS: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimised with dual mobility cups.

Primary total hip arthroplasty in patients with sequelae of poliomyelitis. / Artroplastia total de cadera primaria en pacientes con secuelas de poliomielitis.

INTRODUCTION: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. MATERIAL AND METHODS: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. RESULTS: Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. CONCLUSIONS: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.

European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment.

AIMS: To develop quality indicators (QIs) for the evaluation of the prevention and management of cancer therapy-related cardiovascular toxicity. METHODS AND RESULTS: We followed the European Society of Cardiology (ESC) methodology for QI development which comprises (i) identifying the key domains of care for the prevention and management of cancer therapy-related cardiovascular toxicity in patients on cancer treatment, (ii) performing a systematic review of the literature to develop candidate QIs, and (iii) selecting of the final set of QIs using a modified Delphi process. Work was undertaken in parallel with the writing of the 2022 ESC Guidelines on Cardio-Oncology and in collaboration with the European Haematology Association, the European Society for Therapeutic Radiology and Oncology and the International Cardio-Oncology Society. In total, 5 main and 9 secondary QIs were selected across five domains of care: (i) Structural framework, (ii) Baseline cardiovascular risk assessment, (iii) Cancer therapy related cardiovascular toxicity, (iv) Predictors of outcomes, and (v) Monitoring of cardiovascular complications during cancer therapy. CONCLUSION: We present the ESC Cardio-Oncology QIs with their development process and provide an overview of the scientific rationale for their selection. These indicators are aimed at quantifying and improving the adherence to guideline-recommended clinical practice and improving patient outcomes.

Suprapatellar tibial nailing, why have we changed? / Enclavado de tibia suprapatelar, ¿por qué hemos cambiado?

INTRODUCTION: Endomedullary nailing using the infrapatellar approach (IP) is considered the gold standard for the treatment of tibial diaphyseal fractures, however, it has been associated with greater difficulty in reduction and complications such as malalignment in procurvatum and anterior knee pain. The suprapatellar approach (SP) arises as an alternative to solve these aspects, also being associated with a shorter intraoperative time and a lower dose and fluoroscopy time. MATERIAL AND METHODS: Retrospective comparative study between a group of 22 fractures treated by SP approach and another of 30 fractures intervened by IP transtendinous approach. Perioperative variables were analyzed, as well as clinical, radiological, and functional aspects in outpatient visits at 3, 6 and 12 months. RESULTS: No differences were found between groups in terms of intraoperative time, anemization, quality of reduction or complications during follow-up, among others. At 12 months, 12 (54.5%) SP cases and 16 (53.3%) IP presented anterior knee pain, without significant differences. In the evaluation scales, significant differences were recorded in the IKDC (International Knee Documentation Committee) in favor of the SP technique 88.45 (76.44-91.1) vs. IP 69 (49.95-80) (p=.006), with no significant differences in other functional scales analyzed. CONCLUSIONS: According to what has been described so far in the literature, the present study supports the tendency toward SP nailing by improving the functional results (IKDC) in the medium term compared to the traditional IP technique, without increasing complications. Likewise, surgeons perceive greater technical ease for reduction and simplicity in obtaining intraoperative radiological images.

Enclavado de tibia suprapatelar, ¿por qué hemos cambiado? / Suprapatellar tibial nailing, why have we changed?

Introducción: El enclavado endomedular mediante abordaje infrapatelar (IP) se considera el gold estándar del tratamiento de las fracturas diafisarias de tibia, sin embargo, se ha asociado a mayor dificultad para la reducción y complicaciones como la mala alineación en procurvatum y al dolor anterior de rodilla. El abordaje suprapatelar (SP) surge como alternativa para solventar estos aspectos, asociándose también con un menor tiempo intraoperatorio y menor dosis y tiempo de fluoroscopia. Material y métodos: Estudio retrospectivo comparativo entre: un grupo de 22 fracturas intervenidas mediante abordaje SP y otro de 30 fracturas intervenidas por abordaje IP trastendinoso. Se analizaron variables perioperatorias y aspectos clínicos, radiológicos y funcionales en consulta a los 3, 6 y 12 meses. Resultados: No se encontraron diferencias entre grupos en cuanto a tiempo intraoperatorio, anemización, calidad de la reducción, o complicaciones en el seguimiento, entre otros. A los 12 meses, 12 (54,5%) casos SP y 16 (53,3%) IP presentaban dolor anterior de rodilla, sin diferencias significativas. En las escalas de evaluación, se registraron diferencias significativas en la IKDC (International Knee Documentation Committee) a favor de la técnica SP (88,45 [76,44-91,1] vs. IP 69 [49,95-80]) (p=0,006), sin diferencias significativas en otras escalas funcionales analizadas. Conclusiones: En consonancia con lo hasta ahora descrito en la literatura, el presente estudio apoya la tendencia hacia el enclavado SP por mejorar los resultados funcionales (IKDC) a medio plazo respecto a la técnica tradicional IP, sin aumentar las complicaciones. Asimismo se percibe por los cirujanos una mayor facilidad técnica para la reducción y sencillez en la obtención de imágenes radiológicas intraoperatorias.(AU)

Introduction: Endomedullary nailing using the infrapatellar approach (IP) is considered the gold standard for the treatment of tibial diaphyseal fractures, however, it has been associated with greater difficulty in reduction and complications such as malalignment in procurvatum and anterior knee pain. The suprapatellar approach (SP) arises as an alternative to solve these aspects, also being associated with a shorter intraoperative time and a lower dose and fluoroscopy time. Material and methods: Retrospective comparative study between a group of 22 fractures treated by SP approach and another of 30 fractures intervened by IP transtendinous approach. Perioperative variables were analyzed, as well as clinical, radiological, and functional aspects in outpatient visits at 3, 6 and 12 months. Results: No differences were found between groups in terms of intraoperative time, anemization, quality of reduction or complications during follow-up, among others. At 12 months, 12 (54.5%) SP cases and 16 (53.3%) IP presented anterior knee pain, without significant differences. In the evaluation scales, significant differences were recorded in the IKDC (International Knee Documentation Committee) in favor of the SP technique 88.45 (76.44–91.1) vs. IP 69 (49.95–80) (p=.006), with no significant differences in other functional scales analyzed. Conclusions: According to what has been described so far in the literature, the present study supports the tendency toward SP nailing by improving the functional results (IKDC) in the medium term compared to the traditional IP technique, without increasing complications. Likewise, surgeons perceive greater technical ease for reduction and simplicity in obtaining intraoperative radiological images.(AU)

Suprapatellar tibial nailing, why have we changed? / Enclavado de tibia suprapatelar, ¿por qué hemos cambiado?

Introduction: Endomedullary nailing using the infrapatellar approach (IP) is considered the gold standard for the treatment of tibial diaphyseal fractures, however, it has been associated with greater difficulty in reduction and complications such as malalignment in procurvatum and anterior knee pain. The suprapatellar approach (SP) arises as an alternative to solve these aspects, also being associated with a shorter intraoperative time and a lower dose and fluoroscopy time. Material and methods: Retrospective comparative study between a group of 22 fractures treated by SP approach and another of 30 fractures intervened by IP transtendinous approach. Perioperative variables were analyzed, as well as clinical, radiological, and functional aspects in outpatient visits at 3, 6 and 12 months. Results: No differences were found between groups in terms of intraoperative time, anemization, quality of reduction or complications during follow-up, among others. At 12 months, 12 (54.5%) SP cases and 16 (53.3%) IP presented anterior knee pain, without significant differences. In the evaluation scales, significant differences were recorded in the IKDC (International Knee Documentation Committee) in favor of the SP technique 88.45 (76.44–91.1) vs. IP 69 (49.95–80) (p=.006), with no significant differences in other functional scales analyzed. Conclusions: According to what has been described so far in the literature, the present study supports the tendency toward SP nailing by improving the functional results (IKDC) in the medium term compared to the traditional IP technique, without increasing complications. Likewise, surgeons perceive greater technical ease for reduction and simplicity in obtaining intraoperative radiological images.(AU)

Introducción: El enclavado endomedular mediante abordaje infrapatelar (IP) se considera el gold estándar del tratamiento de las fracturas diafisarias de tibia, sin embargo, se ha asociado a mayor dificultad para la reducción y complicaciones como la mala alineación en procurvatum y al dolor anterior de rodilla. El abordaje suprapatelar (SP) surge como alternativa para solventar estos aspectos, asociándose también con un menor tiempo intraoperatorio y menor dosis y tiempo de fluoroscopia. Material y métodos: Estudio retrospectivo comparativo entre: un grupo de 22 fracturas intervenidas mediante abordaje SP y otro de 30 fracturas intervenidas por abordaje IP trastendinoso. Se analizaron variables perioperatorias y aspectos clínicos, radiológicos y funcionales en consulta a los 3, 6 y 12 meses. Resultados: No se encontraron diferencias entre grupos en cuanto a tiempo intraoperatorio, anemización, calidad de la reducción, o complicaciones en el seguimiento, entre otros. A los 12 meses, 12 (54,5%) casos SP y 16 (53,3%) IP presentaban dolor anterior de rodilla, sin diferencias significativas. En las escalas de evaluación, se registraron diferencias significativas en la IKDC (International Knee Documentation Committee) a favor de la técnica SP (88,45 [76,44-91,1] vs. IP 69 [49,95-80]) (p=0,006), sin diferencias significativas en otras escalas funcionales analizadas. Conclusiones: En consonancia con lo hasta ahora descrito en la literatura, el presente estudio apoya la tendencia hacia el enclavado SP por mejorar los resultados funcionales (IKDC) a medio plazo respecto a la técnica tradicional IP, sin aumentar las complicaciones. Asimismo se percibe por los cirujanos una mayor facilidad técnica para la reducción y sencillez en la obtención de imágenes radiológicas intraoperatorias.(AU)

FMD empty capsids combined with the Immunostant Particle Adjuvant -ISPA or ISA206 induce protective immunity against foot and mouth disease virus.

Foot and Mouth Disease Virus (FMDV) causes economy losses and is controlled by vaccination in many countries. Vaccine formulations based on empty capsids or Virus-Like Particles (VLPs) have the advantage of avoiding the biological hazard of using infectious FMDV, albeit are poorly immunogenic. Recently, we have described that ISPA a new Immune Stimulating Complex adjuvant, is useful to improve the response against FMD of vaccines that use inactivated virus. Now, the adjuvant effects of ISPA and ISA 206 (water/oil/water) on a VLPs-based FMD vaccine were evaluated. VLPs (strain A/Argentina/2001) were obtained in mammalian cell cultures and their elicitation of an immune response against FMDV with and without ISPA or ISA 206 was evaluated in mice as a first approach. Notably, VLPs-ISPA and VLPs-ISA 206 vaccines induced protection against viral challenge in 100 % of mice, while protection induced by VLPs alone was of 40 %. Total and neutralizing FMDV antibodies were higher in the VLPs-ISPA and VLPs-ISA 206 groups compared to the VLPs group. VLPs-ISPA induced significantly higher (p < 0.001) IgG1, IgG2a, IgG2b and IgG3 titers than the VLPs vaccine. Moreover, in comparison with non-adjuvanted VLPs, VLPs-ISPA and VLPs-ISA 206 elicited an increased virus-specific T response, including higher IFNγ+/CD8 + lymphocyte production in mice. When these vaccines were tested in calves, antibody titers reached an Expected Percentage of Protection (EPP) above 90 % in the case of the VLPs-ISPA and VLPs-ISA 206 vaccines, while, in the VLPs group, EPP reached 25 %. IFNγ levels secreted by mononuclear cells of VLP-ISPA-vaccinated cattle were significantly higher than in the VLPs group. Overall, the results demonstrate that VLPs-ISPA or VLPs-ISA 206 are promising formulations for the development of a novel FMD vaccine.

Cambios en el modelo de atención de personas con multimorbilidad crónica: una revisión narrativa / Changes in the care model of people with chronic multimorbidity: a narrative review

Introducción: Muchos países deben enfrentarse al rápido aumento de personas viviendo con alguna condición crónica de salud. En Chile, según datos entregados por la última encuesta nacional de salud, se ha estimado que la población con alguna condición crónica es de 11 millones de personas, de las cuales un 81% presenta multimorbilidad. Este grupo tiene una menor calidad de vida, una mayor mortalidad ajustada por edad, mayor utilización de recursos del sistema de salud, así como un mayor riesgo de hospitalización y una estadía hospitalaria más prolongada. Metodología: revisión narrativa de la literatura para lograr identificar como se ha organizado el cuidado de los pacientes con multimorbilidad a lo largo del tiempo y como se han ido desarrollando estrategias que buscan un abor-daje distinto. Resultados: los sistemas de salud se han organizado con un enfoque centrado en la enfermedad, lo que genera que los pacientes reciban un cuidado fragmentado, ineficiente e inefectivo, sin lograr dimensionar la complejidad de la persona y su contexto biopsicosocial. Los sistemas de salud, principalmente en Europa han desarrollado diversas iniciativas que buscan cambiar la perspectiva desde el cuidado centrado en la enfermedad al cuidado centrado en la persona Conclusiones: se puede concluir que la multimorbilidad es un problema que afecta a millones de personas en el mundo y que los servicios y sistemas de salud necesitan hacer un cambio hacia un modelo centrado en la persona de forma de dar respuestas a las necesidades de este grupo de pacientes.

Estudio transversal sobre la repercusión de la información educativa en los hábitos de fotoprotección tópica en estudiantes de medicina / A cross-sectional study of the impact of educational information on topical photoprotection habits in medical students

Objetivos: El cáncer cutáneo (melanoma y no melanoma) es el tumor más frecuente del ser humano, siendo el melanoma el más agresivo. Dado que la exposición a la radiación ultravioleta (UV) es el único factor etiológico modificable, la fotoprotección es una medida preventiva primordial. Con estos fundamentos, se realizó una investigación cuyo objetivo principal fue comparar tres grupos poblacionales con distintos niveles de conocimiento sobre fotoprotección para conocer si existen diferencias en hábitos de exposición solar y grado de concienciación de los efectos perjudiciales del sol sobre la piel. Material y métodos: Estudio observacional transversal realizado mediante una encuesta entre octubre y diciembre de 2015 a 317 universitarios españoles con edades entre 18 y 25años. Se emplearon medidas estadísticas descriptivas y el test de chi-cuadrado. Resultados: Se realizaron seis preguntas para evaluar los hábitos de exposición solar. Se detectaron diferencias significativas en dos de ellas: autoexamen periódico de lunares (p<0,001) y empleo de factor de protección adecuado (p=0,025). Respecto al nivel de conocimientos, se realizaron cinco preguntas, encontrándose diferencias en todos los casos (p<0,001). Conclusiones: Tener más conocimientos sobre los riesgos de la exposición solar solo mejoró dos de los seis hábitos cuestionados sobre exposición solar. Probablemente existen otros factores que influyen en esta conducta, como los factores estéticos o socioculturales. La prevención temprana del cáncer de piel es fundamental, y es necesario establecer programas de promoción de la salud que tengan en cuenta estos otros condicionantes

Objectives: Skin cancer (melanoma and non-melanoma) is the most common cancer in humans, with melanoma being the most aggressive. Due to the fact that ultraviolet (UV) radiation exposure is the only adjustable aetiological factor, UV protection is the essential preventive measure. Based on these grounds, a study was conducted in order to compare three population groups with different levels of knowledge about UV protection, as well as to determine any differences in sun exposure habits, and the level of awareness of the damaging effects of the sun on the skin. Materials and methods: An observational, cross-sectional study was conducted using a questionnaire survey of 317 Spanish university students aged 18-25years old, between October and December 2015. Descriptive statistics methods and Pearson's Chi-squared were used. Results: Six questions were used to evaluate the sun exposure habits. Significant differences were detected in two of them: mole self-assessment (P<.001) and the use of an appropriate sun protection factor (P=.025). Five questions were asked concerning the level of knowledge about UV protection, with differences (P<.001) being found in all cases. Conclusions: Despite having more knowledge about the risks of sun exposure in the medical dermatology students group, only two of the six habits questioned were improved. Other factors that could be involved are the aesthetic or sociocultural factors. The early prevention of skin cancer is essential, with health promotion programs needing to be established that take into account all these conditions

Immune Response and Partial Protection against Heterologous Foot-and-Mouth Disease Virus Induced by Dendrimer Peptides in Cattle.

Synthetic peptides mimicking protective B- and T-cell epitopes are good candidates for safer, more effective FMD vaccines. Nevertheless, previous studies of immunization with linear peptides showed that they failed to induce solid protection in cattle. Dendrimeric peptides displaying two or four copies of a peptide corresponding to the B-cell epitope VP1 [136-154] of type O FMDV (O/UKG/11/2001) linked through thioether bonds to a single copy of the T-cell epitope 3A [21-35] (termed B2T and B4T, resp.) afforded protection in vaccinated pigs. In this work, we show that dendrimeric peptides B2T and B4T can elicit specific humoral responses in cattle and confer partial protection against the challenge with a heterologous type O virus (O1/Campos/Bra/58). This protective response correlated with the induction of specific T-cells as well as with an anamnestic antibody response upon virus challenge, as shown by the detection of virus-specific antibody-secreting cells (ASC) in lymphoid tissues distal from the inoculation point.

[A cross-sectional study of the impact of educational information on topical photoprotection habits in medical students]. / Estudio transversal sobre la repercusión de la información educativa en los hábitos de fotoprotección tópica en estudiantes de medicina.

OBJECTIVES: Skin cancer (melanoma and non-melanoma) is the most common cancer in humans, with melanoma being the most aggressive. Due to the fact that ultraviolet (UV) radiation exposure is the only adjustable aetiological factor, UV protection is the essential preventive measure. Based on these grounds, a study was conducted in order to compare three population groups with different levels of knowledge about UV protection, as well as to determine any differences in sun exposure habits, and the level of awareness of the damaging effects of the sun on the skin. MATERIALS AND METHODS: An observational, cross-sectional study was conducted using a questionnaire survey of 317 Spanish university students aged 18-25years old, between October and December 2015. Descriptive statistics methods and Pearson's Chi-squared were used. RESULTS: Six questions were used to evaluate the sun exposure habits. Significant differences were detected in two of them: mole self-assessment (P<.001) and the use of an appropriate sun protection factor (P=.025). Five questions were asked concerning the level of knowledge about UV protection, with differences (P<.001) being found in all cases. CONCLUSIONS: Despite having more knowledge about the risks of sun exposure in the medical dermatology students group, only two of the six habits questioned were improved. Other factors that could be involved are the aesthetic or sociocultural factors. The early prevention of skin cancer is essential, with health promotion programs needing to be established that take into account all these conditions.

The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients: Euro-CCAD study.

AIMS: In this retrospective study we assessed the predictive value of the coronary calcium score for significant (>50%) stenosis relative to conventional risk factors. METHODS AND RESULTS: We investigated 5515 symptomatic patients from Denmark, France, Germany, Italy, Spain and the USA. All had risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9%) patients had significant stenosis, 5.5% of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50% stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score and the combination for prediction of >50% stenosis when measured by conventional angiogram was considerably higher than when assessed by CTCA but the specificity was considerably higher when assessed by CTCA. The accuracy of CTCA for predicting >50% stenosis using the CAC score alone was higher (AUC=0.85) than using a combination of the CAC score and risk factors with conventional angiography (AUC=0.81). CONCLUSION: In symptomatic patients, the CAC score is a more accurate predictor of significant coronary stenosis than conventional risk factors.

Early protection against foot-and-mouth disease virus in cattle using an inactivated vaccine formulated with Montanide ESSAI IMS D 12802 VG PR adjuvant.

Foot and mouth disease is an acute disease of cattle with a broad distribution around the world. Due to the fast spread of FMDV infections, control measures must be applied immediately after an outbreak, such as the use of vaccines that induce fast protection. Previously, it was shown that mice vaccinated with FMD inactivated virus (iFMDV) formulated with Montanide™ ESSAI IMS D 12802 VG PR adjuvant (802-iFMDV) were protected when they were challenged 4 and 7 days post-vaccination (dpv) with homologous virus. In this work, we describe the successful use of this formulation in cattle. In addition, adjuvant Montanide™ IMS 1313 VG NPR was also tested. 802-iFMDV vaccine was able to confer 100% protection against viral challenge at 4 and 7 dpv, while eliciting low antibody levels, at 7 dpv. 1313-iFMDV vaccine induced protection in 60% of cattle. At 4 dpv, 1313-iFMDV vaccinated animals presented increased levels of IFNγ but not of macrophages. At 4 and 7 dpv, macrophages, IFNγ, nasal IgA and IgG1 antibodies against FMDV, and opsonophagocytosis were increased in animals vaccinated with 802-iFMDV indicating that these phenomena could be involved in protection.It is the first time that total protection against FMDV at early stages post-vaccination is reported using a single dose of the formulation iFMDV plus Montanide™ ESSAI D IMS 12802 VG PR adjuvant.

Eficacia de cápsulas radiales en la promoción de alimentación saludable / Efficacy of radio capsules in promoting healthy eating

The high prevalence of obesity in children supports the need to implement preventive actions such as the development of programs to promote healthy food intake. Objective: To evaluate the effectiveness of radio capsules in developing a positive attitude towards healthy eating in children. Method: Under an experimental design with control group, were assessed using a scale attitudinal differences bifactorial pre and post intervention in two groups. The average age of each group was 10 years. In the experimental group 28 children participated in the pre-intervention assessment and 22 in the post intervention; in the control group 36 students participated in the pre-intervention assessment and 32 in post evaluation. Results: The factor attitude toward healthy eating, and healthy behaviors decreased in the control group, while in the experimental group there was a slight increase in the average factor both in attitude and behavior factor. The only statistically significant differences between the averages of the measurements before and after the intervention in the control group, were in both attitude factor (t (66) = -3.108, p = .003) compared to the behavior factor (t (65) = -3.350, P = .001). Conclusions: Students exposed to radio capsules had increased awareness of healthy eating, while the control group decreased significantly positive attitude towards healthy eating in both factors studied.

La alta prevalencia de obesidad en escolares de 10 años en promedio de edad, fundamenta la necesidad de implementar acciones preventivas como el desarrollo de programas de promoción de ingesta de alimentos saludables. Objetivo: Evaluar la eficacia de las cápsulas radiales en el desarrollo de una actitud favorable hacia la alimentación saludable en menores escolarizados, mensajes transmitidos en la radio del establecimiento educacional. Método: Bajo un diseño experimental con grupo control, se evaluaron mediante una escala actitudinal bi factorial las diferencias pre y post intervención en dos grupos similares, uno de ellos sometidos a cápsulas radiales. El promedio de edad de cada grupo fue de 10 años. En el grupo experimental, participaron en la evaluación pre intervención 28 menores y en la evaluación pos intervención 22; en tanto en el grupo control participaron en la evaluación pre intervención 36 estudiantes, y en la evaluación post 32. Resultados: tanto el factor actitud frente a la alimentación sana, como conductas saludables, disminuyeron en el grupo control, en tanto en el grupo experimental se observó un leve aumento en la media tanto en el factor actitud y en el factor conducta; sólo son estadísticamente significativas las diferencias entre las medias de las mediciones pre y post intervención en el grupo control, tanto para el factor actitud (t(66)=-3,108; p=.003) como para el factor conducta (t(65)=-3,350; p=.001). Conclusiones: Los estudiantes expuestos a las cápsulas radiales tuvieron mayor conciencia acerca de la alimentación saludable, en tanto los del grupo control disminuyeron significativamente la actitud positiva frente a la alimentación sana en ambos factores estudiados.

Immune response and protection provided by live tachyzoites and native antigens from the NC-6 Argentina strain of Neospora caninum in pregnant heifers.

The aim of the present study was to compare the immunogenicity and protective efficacy of live tachyzoites and native antigen extract obtained from the NC-6 Argentina strain against vertical transmission of Neospora caninum, following experimental challenge in pregnant heifers with the NC-1 strain. Sixteen pregnant heifers were divided in 4 groups of 4 animals, each receiving different inoculation before mating: group A animals were intravenously (iv) inoculated with 6.25×10(7) live tachyzoites of the NC-6 strain, group B heifers were inoculated twice subcutaneously (sc) with N. caninum native antigen extract formulated with ISCOMs, group C heifers were sc injected with sterile phosphate-buffered saline (PBS) and group D heifers received sc ISCOM-matrix (ISCOMs without antigen). All groups were iv challenged with the NC-1 strain at 70 days of gestation. Serum and heparinized blood samples were collected eight times on weeks 0, 2, 3, 5, 9, 13, 16 and 17 post-inoculation. Dams were slaughtered at the 17th week of experiment (104 days of pregnancy) and placental and fetal tissue samples were collected. Specific antibody responses in heifers were tested by indirect enzyme linked immunosorbent assay (iELISA). The cellular immune response in dams was assessed by quantifying IFN-γ production and the percentages of T-cells (CD4(+), CD8(+) and γδ(+)) and monocytes in peripheral blood mononuclear cells (PBMC). Fetal fluids and tissue samples were tested using the indirect fluorescence antibody test, western blot, histopathology, immunohistochemistry and nested-PCR. A significant increase in N. caninum antibody response was detected in heifers of groups A and B from week 3 after inoculation (P<0.001). IFN-γ production was similar in groups A and B at week 13 (P>0.05). All fetuses were viable at necropsy. Specific IgG against N. caninum was detected in 1/4 fetal fluids recovered from groups A, C and D heifers and 3/4 fetal fluids from group B. Transplacental transmission could be determined in one fetus from group A and three fetuses from group B by nPCR. All fetuses from groups C and D were positive by nPCR. It is noteworthy that dams with higher CD4(+)/CD8(+) ratios in PBMC, regardless of the experimental group, had lower pathology scores. The results of this study confirm that inoculation with live parasites pre-mating may provide at least partial protection against vertical transmission of N. caninum following challenge in heifers at early gestation.

Co-inoculation of baculovirus and FMDV vaccine in mice, elicits very early protection against foot and mouth disease virus without interfering with long lasting immunity.

Baculoviruses (Bvs) potentiate the immune response against soluble antigens. We investigated whether Bv could be used as immunoactivator in foot-and-mouth disease (FMD) vaccines using the BALB/c mouse model. Mice were vaccinated with a single dose of inactivated FMDV (iFMDV), iFMDV+Bv, Bv, or culture medium. Humoral and cellular immune responses were higher in animals immunized with iFMDV+Bv than in mice vaccinated with iFMDV alone. Animals receiving iFMDV+Bv had significantly lower viremia at 2, 4 and 7dpv, than those immunized with iFMDV alone. In order to prolong the immune response, iFMDV oil vaccine was co-inoculated with Bv. Animals receiving iFMDV oil vaccine+Bv were protected two days earlier than those receiving the iFMDV oil vaccine alone. Both formulations protected until 14dpv, the last day of the experiment. This is the first report in which Bv is used as an adjuvant in a FMDV vaccine.

Effect of soil slope on the appearance of Mycobacterium avium subsp. paratuberculosis in water running off grassland soil after application of contaminated slurry.

The study assessed the effect of soil slope on Mycobacterium avium subsp. paratuberculosis transport into rainwater runoff from agricultural soil after application of M. avium subsp. paratuberculosis-contaminated slurry. Under field conditions, 24 plots of undisturbed loamy soil 1 by 2 m(2) were placed on platforms. Twelve plots were used for water runoff: 6 plots at a 3% slope and 6 plots at a 15% slope. Half of the plots of each slope were treated with M. avium subsp. paratuberculosis-contaminated slurry, and half were not treated. Using the same experimental design, 12 plots were established for soil sampling on a monthly basis using the same spiked slurry application and soil slopes. Runoff following natural rainfall was collected and analyzed for M. avium subsp. paratuberculosis, coliforms, and turbidity. M. avium subsp. paratuberculosis was detected in runoff from all plots treated with contaminated slurry and one control plot. A higher slope (15%) increased the likelihood of M. avium subsp. paratuberculosis detection but did not affect the likelihood of finding coliforms. Daily rainfall increased the likelihood that runoff would have coliforms and the coliform concentration, but it decreased the M. avium subsp. paratuberculosis concentration in the runoff. When there was no runoff, rain was associated with increased M. avium subsp. paratuberculosis concentrations. Coliform counts in runoff were related to runoff turbidity. M. avium subsp. paratuberculosis presence/absence, however, was related to turbidity. Study duration decreased bacterial detection and concentration. These findings demonstrate the high likelihood that M. avium subsp. paratuberculosis in slurry spread on pastures will contaminate water runoff, particularly during seasons with high rainfall. M. avium subsp. paratuberculosis contamination of water has potential consequences for both animal and human health.