Outcomes in patients managed with endovascular stent for malignant superior vena cava syndrome.

Background: Malignant Superior Vena Cava Syndrome (SVCS) corresponds to the clinical manifestations due to the restriction of venous return to the right atrium secondary to obstruction of the superior vena cava and/or its main tributaries for a tumor. Endovascular management has proven to be safe, effective and cause a fast symptomatic relief in patients with SVCS. There is limited evidence in factors associated with outcomes in malignant setting for this procedure. Materials and methods: An analytical retrospective study was conducted and included patients that underwent endovascular management for malignant SVCS at the National Cancer Institute of Colombia between May 2016 and May 2021. Clinical and technical variables were analyzed to found associations with outcomes in these patients. Results: 54 patients were analyzed. Successful procedure rate was 94.4 %. At 10 months, the OS of the entire cohort of patients was 25 %. Patients with breast or lung cancer (P = 0.031), unsuccessful procedure (P = 0.011), and also with short time of symptoms to the date of the endovascular procedure (P = 0.027) had worse OS. Multivariate analysis showed that lung cancer [HR = 2.55, 95%IC:(1.21-5.36)] and left internal jugular vein or left Innominate vein distal stent attachment [HR = 3.27, 95%IC:(1.31-8.15)] were independent factors for worst OS. Conclusions: Based in the high success rate of the endovascular management and the better outcome in patients with early and successful procedure, this procedure should be considered as part of the multimodal treatment in patients with SVCS independent of the clinical scenario and the oncological diagnosis.

Análisis de supervivencia en pacientes con micosis fungoide foliculotropa de un centro latinoamericano / Folliculotropic Mycosis Fungoides in a Latin American Hospital: Survival Analysis

Introducción La micosis fungoide foliculotropa es una variante de mal pronóstico y presentación clínica variada. Se ha planteado que la estadificación TNMB usada para esta neoplasia no es útil. En una propuesta reciente basada en aspectos clínicos e histológicos, se clasifica en enfermedad temprana y avanzada, encontrando diferencias pronósticas entre las 2categorías. El objetivo de este estudio fue comparar la supervivencia de estos 2 grupos en nuestra población. Materiales y métodos Se realizó un estudio observacional retrospectivo de serie de casos donde se evaluó la evolución clínica de los pacientes con micosis fungoide foliculotropa tratados en el Instituto Nacional de Cancerología entre el 2008 y el 2020, realizando un análisis comparativo de supervivencia entre aquellos que tienen enfermedad temprana y enfermedad avanzada. Resultados Se incluyó a un total de 21 pacientes, 11 de los cuales presentaban enfermedad temprana y 10 enfermedad avanzada. Se identificaron 7 decesos, todos ellos en los pacientes con enfermedad avanzada. La supervivencia global de la población total a 5 años fue del 62%, mientras que para la población con enfermedad avanzada fue del 40%. No hubo diferencias en la supervivencia según la estadificación TNMB. Conclusión La estadificación TNMB no es útil para los pacientes con una micosis fungoide foliculotropa. Por el contrario, la nueva clasificación clínico-patológica parece brindar información pronóstica fiable y permite tomar medidas terapéuticas acordes (AU)

Introduction Folliculotropic mycosis fungoides is a variant that has poor prognosis and a variable clinical presentation. Concerns have been expressed that the current TNMB staging of this tumor may not be useful. A recently developed classification system based on clinical and histologic variables classifies this tumor as early or advanced, a distinction found to correlate with prognosis. The aim of this study was to compare survival in FMF in Colombia between patients with early versus advanced tumors. Material and methods Retrospective, observational study of clinical course and outcomes in patients with FMF treated at the National Cancer Institute of Colombia between 2008 and 2020. Survival was compared between early and advanced disease. Results Twenty-one patients (11 with early FMF and 10 with advanced FMF) were studied. Seven patients, all with advanced disease, died. Survival at 5 years was 62% overall and 40% for patients with advanced FMF. No differences were observed when survival was analyzed according to TNMB stage. Conclusions TNMB staging is not useful in FMF. The new classification system based on clinicopathologic features appears to provide reliable information for assessing prognosis and guiding treatment decisions (AU)

[Translated article] Folliculotropic Mycosis Fungoides in a Latin American Hospital: Survival Analysis / Análisis de supervivencia en pacientes con micosis fungoide foliculotropa de un centro latinoamericano

Introduction Folliculotropic mycosis fungoides is a variant that has poor prognosis and a variable clinical presentation. Concerns have been expressed that the current TNMB staging of this tumor may not be useful. A recently developed classification system based on clinical and histologic variables classifies this tumor as early or advanced, a distinction found to correlate with prognosis. The aim of this study was to compare survival in FMF in Colombia between patients with early versus advanced tumors. Material and methods Retrospective, observational study of clinical course and outcomes in patients with FMF treated at the National Cancer Institute of Colombia between 2008 and 2020. Survival was compared between early and advanced disease. Results Twenty-one patients (11 with early FMF and 10 with advanced FMF) were studied. Seven patients, all with advanced disease, died. Survival at 5 years was 62% overall and 40% for patients with advanced FMF. No differences were observed when survival was analyzed according to TNMB stage. Conclusions TNMB staging is not useful in FMF. The new classification system based on clinicopathologic features appears to provide reliable information for assessing prognosis and guiding treatment decisions (AU)

Introducción La micosis fungoide foliculotropa es una variante de mal pronóstico y presentación clínica variada. Se ha planteado que la estadificación TNMB usada para esta neoplasia no es útil. En una propuesta reciente basada en aspectos clínicos e histológicos, se clasifica en enfermedad temprana y avanzada, encontrando diferencias pronósticas entre las 2categorías. El objetivo de este estudio fue comparar la supervivencia de estos 2 grupos en nuestra población. Materiales y métodos Se realizó un estudio observacional retrospectivo de serie de casos donde se evaluó la evolución clínica de los pacientes con micosis fungoide foliculotropa tratados en el Instituto Nacional de Cancerología entre el 2008 y el 2020, realizando un análisis comparativo de supervivencia entre aquellos que tienen enfermedad temprana y enfermedad avanzada. Resultados Se incluyó a un total de 21 pacientes, 11 de los cuales presentaban enfermedad temprana y 10 enfermedad avanzada. Se identificaron 7 decesos, todos ellos en los pacientes con enfermedad avanzada. La supervivencia global de la población total a 5 años fue del 62%, mientras que para la población con enfermedad avanzada fue del 40%. No hubo diferencias en la supervivencia según la estadificación TNMB. Conclusión La estadificación TNMB no es útil para los pacientes con una micosis fungoide foliculotropa. Por el contrario, la nueva clasificación clínico-patológica parece brindar información pronóstica fiable y permite tomar medidas terapéuticas acordes (AU)

Folliculotropic Mycosis Fungoides in a Latin American Hospital: Survival Analysis. / Análisis de supervivencia en pacientes con micosis fungoide foliculotropa de un centro latinoamericano.

INTRODUCTION: Folliculotropic mycosis fungoides is a variant that has poor prognosis and a variable clinical presentation. Concerns have been expressed that the current TNMB staging of this tumor may not be useful. A recently developed classification system based on clinical and histologic variables classifies this tumor as early or advanced, a distinction found to correlate with prognosis. The aim of this study was to compare survival in FMF in Colombia between patients with early versus advanced tumors. MATERIAL AND METHODS: Retrospective, observational study of clinical course and outcomes in patients with FMF treated at the National Cancer Institute of Colombia between 2008 and 2020. Survival was compared between early and advanced disease. RESULTS: Twenty-one patients (11 with early FMF and 10 with advanced FMF) were studied. Seven patients, all with advanced disease, died. Survival at 5 years was 62% overall and 40% for patients with advanced FMF. No differences were observed when survival was analyzed according to TNMB stage. CONCLUSIONS: TNMB staging is not useful in FMF. The new classification system based on clinicopathologic features appears to provide reliable information for assessing prognosis and guiding treatment decisions.

Cinética del lactato para el pronóstico en el shock cardiogénico asistido con oxigenador extracorpóreo de membrana venoarterial / Lactate levels as a prognostic predict in cardiogenic shock under venoarterial extracorporeal membrane oxygenation support

Introducción y objetivos: El lactato y su evolución se asocian con el pronóstico de los pacientes en shock, si bien es escasa la evidencia en aquellos asistidos con oxigenador extracorpóreo de membrana venoarterial (ECMO-VA). Nuestro objetivo es evaluar su valor pronóstico en shock cardiogénico asistido con ECMO-VA. Métodos: Estudio de pacientes tratados con ECMO-VA por shock cardiogénico de indicación médica entre julio de 2013 y abril de 2021. Se calculó el aclaramiento de lactato: (lactato inicial − lactato 6 h) / lactato inicial × tiempo exacto entre ambas determinaciones. Resultados: De 121 pacientes, 44 (36,4%) tenían infarto agudo de miocardio; 42 (34,7%), implante intraparada; 14 (11,6%), tromboembolia pulmonar, 14 (11,6%), tormenta arrítmica y 6 (5,0%), miocarditis fulminante. A los 30 días habían fallecido 60 pacientes (49,6%); la mortalidad fue mayor con el implante intraparada que con el implante en circulación espontánea (30 [71,4%] de 42 frente a 30 [38,0%] de 79; p=0,030). Se asociaron de manera independiente con la mortalidad a 30 días la alanina aminotransferasa (ALT) antes del implante y el lactato (tanto basal como a las 6 h y el aclaramiento). Los modelos de regresión que incluían el lactato presentaron mejor capacidad predictiva de la supervivencia que las puntuaciones ENCOURAGE y ECMO-ACCEPTS, con mayor área bajo la curva ROC en el modelo con lactato a las 6 h.Conclusiones: El lactato (basal y a las 6 h y el aclaramiento) es un predictor independiente para el pronóstico de los pacientes en shock cardiogénico asistidos con ECMO-VA que facilita una mejor estratificación del riesgo y tiene una capacidad predictiva superior (AU)

Introduction and objectives: Lactate and its evolution are associated with the prognosis of patients in shock, although there is little evidence in those assisted with an extracorporeal venoarterial oxygenation membrane (VA-ECMO). Our objective was to evaluate its prognostic value in cardiogenic shock assisted with VA-ECMO. Methods: Study of patients with cardiogenic shock treated with VA-ECMO for medical indication between July 2013 and April 2021. Lactate clearance was calculated: [(initial lactate − 6 h lactate) / initial lactate × exact time between both determinations]. Results: From 121 patients, 44 had acute myocardial infarction (36.4%), 42 implant during cardiopulmonary resuscitation (34.7%), 14 pulmonary embolism (11.6%), 14 arrhythmic storm (11.6%), and 6 fulminant myocarditis (5.0%). After 30 days, 60 patients (49.6%) died, mortality was higher for implant during cardiopulmonary resuscitation than for implant in spontaneous circulation (30 of 42 [71.4%] vs 30 of 79 [38.0%], P=.030). Preimplantation GPT and lactate (both baseline, at 6hours, and clearance) were independently associated with 30-day mortality. The regression models that included lactate clearance had a better predictive capacity for survival than the ENCOURAGE and ECMO-ACCEPTS scores, with the area under the ROC curve being greater in the model with lactate at 6 h. Conclusions: Lactate (at baseline, 6h, and clearance) is an independent predictor of prognosis in patients in cardiogenic shock supported by VA-ECMO, allowing better risk stratification and predictive capacity (AU)

Telephone consultation service in orthopedics during COVID-19 pandemic.

BACKGROUND AND AIM: The current COVID-19 pandemic scenario has driven surgical departments to a transformation.The worldwide spread of the disease has led to a public health quarantine where health care professionals are at high risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. This study aims to demonstrate that a combined framework based on telematics and in-person clinical encounter not only ensures medical care but the safety of healthcare professionals and patients. MATERIAL AND METHOD: Descriptive observational study on the follow-up of patients during the COVID19 Pandemic, combining telephone and traditional. RESULTS: A total of 5031 telephone calls were made, differentiating between medical referrals, specialised primary care visits, and outpatient consultation.They were classified as successful, required an in-person visit, or no successful telephone contact. Furthermore, we divided them into 2 groups: resolved and unresolved.53% of all telematic visits were successful. CONCLUSIONS: Telematic medical systems are a feasible option in a orthopedics department and an interesting resource to preserve once the pandemic is resolved. Future lines of research should be opened to improve system success, analyze its cost-effectiveness ratio, and correct any legal conflicts that may exist.

ANTECEDENTES Y OBJETIVO: Durante la pandemia COVID-19 la actividad de los servicios quirúrgicos se ha visto obligada a adaptarse y transformarse. La telemedicina se está implantando como nunca antes en esta nueva situación en la que los pacientes están confinados y los profesionales sanitarios presentan riesgo de infectarseEl objetivo es mostrar que una reestructuración combinada telemática y presencial de las visitas permite asegurar la asistencia médica, garantizando la protección del personal sanitario y de los pacientes. MATERIAL Y MÉTODO: Estudio descriptivo observacional sobre el seguimiento de pacientes durante la Pandemia COVID combinando la consulta telefónica con la presencial. RESULTADOS: Se realizaron un total de 5031 llamadas telefónicas diferenciando entre Derivaciones, Visitas de atención primaria especializada y Consulta externa hospitalaria.Se registraron como efectivas, tributarias de visita presencial y no se logra contacto telefónico. Y las dividimos en 2 grupos resueltas y no resueltas.Del total de visitas no presenciales telefónicas fueron efectivas un 53%. CONCLUSIONES: La medicina telemática es una opción factible en un servicio de traumatología y de manera adecuada será una opción interesante de mantener tras la pandemia.Futuras líneas de investigación deberían ser abiertas para mejorar la capacidad de resolución de este sistema, analizar su relación coste-efectividad y subsanar los conflictos legales que pudieran existir.

Telephone consultation service in orthopedics during COVID-19 pandemic. / Consultoría telefónica en COT durante la pandemia por COVID-19. ¿Ha venido para quedarse?

BACKGROUND AND AIM: The current COVID-19 pandemic scenario has driven surgical departments to a transformation. The worldwide spread of the disease has led to a public health quarantine where health care professionals are at high risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. This study aims to demonstrate that a combined framework based on telematics and in-person clinical encounter not only ensures medical care but the safety of healthcare professionals and patients. MATERIAL AND METHOD: Descriptive observational study on the follow-up of patients during the COVID19 Pandemic, combining telephone and traditional. RESULTS: A total of 5031 telephone calls were made, differentiating between medical referrals, specialized primary care visits, and outpatient consultation. They were classified as successful, required an in-person visit, or no successful telephone contact. Furthermore, we divided them into 2 groups: resolved and unresolved. 53% of all telematic visits were successful. CONCLUSIONS: Telematic medical systems are a feasible option in a orthopedics department and an interesting resource to preserve once the pandemic is resolved. Future lines of research should be opened to improve system success, analyze its cost-effectiveness ratio, and correct any legal conflicts that may exist.

Consultoría telefónica en COT durante la pandemia por COVID-19. ¿Ha venido para quedarse? / Telephone consultation service in orthopedics during COVID-19 pandemic

ANTECEDENTES Y OBJETIVO: Durante la pandemia COVID-19, la actividad de los servicios quirúrgicos se ha visto obligada a adaptarse y transformarse. La telemedicina se está implantando como nunca antes en esta nueva situación, en la que los pacientes están confinados y los profesionales sanitarios presentan riesgo de infectarse. El objetivo es mostrar que una reestructuración combinada telemática y presencial de las visitas, permite asegurar la asistencia médica, garantizando la protección del personal sanitario y de los pacientes. MATERIAL Y MÉTODO: Estudio descriptivo observacional sobre el seguimiento de pacientes durante la pandemia por COVID-19, combinando la consulta telefónica con la presencial. RESULTADOS: Se realizaron un total de 5.031 llamadas telefónicas, diferenciando entre derivaciones, visitas de atención primaria especializada y consulta externa hospitalaria. Se registraron como: efectivas, tributarias de visita presencial y no se logra contacto telefónico. Y las dividimos en dos grupos: resueltas y no resueltas. Del total de visitas no presenciales telefónicas fueron efectivas un 53%. CONCLUSIONES: La medicina telemática es una opción factible en un servicio de traumatología, y de manera adecuada será una opción interesante de mantener tras la pandemia. Futuras líneas de investigación deberían ser abiertas para mejorar la capacidad de resolución de este sistema, analizar su relación coste-efectividad y subsanar los conflictos legales que pudieran existir

BACKGROUND AND AIM: The current COVID-19 pandemic scenario has driven surgical departments to a transformation. The worldwide spread of the disease has led to a public health quarantine where health care professionals are at high risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. This study aims to demonstrate that a combined framework based on telematics and in-person clinical encounter not only ensures medical care but the safety of healthcare professionals and patients. MATERIAL AND METHOD: Descriptive observational study on the follow-up of patients during the COVID19 Pandemic, combining telephone and traditional. RESULTS: A total of 5031 telephone calls were made, differentiating between medical referrals, specialized primary care visits, and outpatient consultation. They were classified as successful, required an in-person visit, or no successful telephone contact. Furthermore, we divided them into 2 groups: resolved and unresolved. 53% of all telematic visits were successful. CONCLUSIONS: Telematic medical systems are a feasible option in a orthopedics department and an interesting resource to preserve once the pandemic is resolved. Future lines of research should be opened to improve system success, analyze its cost-effectiveness ratio, and correct any legal conflicts that may exist

Three-dimensional photographic analysis of the face in European adults from southern Spain with normal occlusion: reference anthropometric measurements.

BACKGROUND: Recent non-invasive 3D photography method has been applied to facial analysis, offering numerous advantages in orthodontic. The purpose of this study was to analyze the faces of a sample of healthy European adults from southern Spain with normal occlusion in order to establish reference facial soft tissue anthropometric parameters in this specific geographic-ethnic population, as well as to analyze sexual dimorphism. METHODS: A sample of 100 healthy adult volunteers consisting of 50 women (mean age, 22.92 ± 1.56 years) and 50 men (mean age, 22.37 ± 2.12 years) were enrolled in this study. All participants had normal occlusion, skeletal Class I, mesofacial pattern, and healthy body mass index. Three-dimensional photographs of the faces were captured non-invasively using Planmeca ProMax 3D ProFace®. Thirty landmarks related to the face, eyes, nose, and orolabial and chin areas were identified. RESULTS: Male displayed higher values in all vertical and transversal dimensions, with the exception of the lower lip height. Larger differences between sexes were observed in face, mandible, and nose. Male also had higher values in the angular measurements which referred to the nose. No sex differences were found in transverse upper lip prominence or transverse mandibular prominence. No differences were found in the ratio measurements, with the exception of intercantal width/nasal width, which was higher in women than in men. CONCLUSIONS: Reference anthropometric measurements of facial soft tissues have been established in European adults from southern Spain with normal occlusion. Significant sexual dimorphism was found, with remarkable differences in size between sexes.

Quasichiral Interactions between Quantum Emitters at the Nanoscale.

We present a combined classical and quantum electrodynamics description of the coupling between two circularly polarized quantum emitters held above a metal surface supporting surface plasmons. Depending on their position and their natural frequency, the emitter-emitter interactions evolve from being reciprocal to nonreciprocal, which makes the system a highly tunable platform for chiral coupling at the nanoscale. By relaxing the stringent material and geometrical constraints for chirality, we explore the interplay between coherent and dissipative coupling mechanisms in the system. Thus, we reveal a quasichiral regime in which its quantum optical properties are governed by its subradiant state, giving rise to extremely sharp spectral features and strong photon correlations.

WITHDROWN: Effect of smoking habit on crestal bone height in maxillary sinus augmentation with bone grafts.

In relation to the article with reference "Carreño-Carreño J, Gómez-Moreno G, Aguilar-Salvatierra A, Menéndez-López-Mateos C, Piattelli A, Menéndez-Núñez M. Effect of smoking habit on crestal bone height in maxillary sinus augmentation with bone grafts. Med Oral Patol Oral Cir Bucal. (2018), doi:10.4317/medoral.22439", published in Oral Medicine Oral Pathology and Oral Surgery in the modality "AHEAD OF PRINT - article in press", the authors mention that "The study was conducted according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) Statement". However, and based on the opinion of several expert reviewers who have re-evaluated the article, it is considered that although "there has not been plagiarism", these STROBE criteria are not adequately met. In addition, the mentioned article is very similar to two articles that have already been published by the same authors in Clinical Oral Implants Research. The sample is the same; many data are repeated; and the only difference is the inclusion of a variable (smoking), which does not exert a significant effect. This outcome therefore would not justify publication of the paper in the journal. Retraction of the article is therefore decided.

Exciting Polaritons with Quantum Light.

We discuss the excitation of polaritons-strongly coupled states of light and matter-by quantum light, instead of the usual laser or thermal excitation. As one illustration of the new horizons thus opened, we introduce "Mollow spectroscopy"-a theoretical concept for a spectroscopic technique that consists of scanning the output of resonance fluorescence onto an optical target-from which weak nonlinearities can be read with high precision even in strongly dissipative environments.

Ultrafast Control and Rabi Oscillations of Polaritons.

We report the experimental observation and control of space and time-resolved light-matter Rabi oscillations in a microcavity. Our setup precision and the system coherence are so high that coherent control can be implemented with amplification or switching off of the oscillations and even erasing of the polariton density by optical pulses. The data are reproduced by a quantum optical model with excellent accuracy, providing new insights on the key components that rule the polariton dynamics.

Urinary exosomes as a source of kidney dysfunction biomarker in renal transplantation.

End-stage renal disease (ESRD) requires for its treatment permanent dialysis or kidney transplantation (KT). KT is the best clinical treatment, however, the early function of the allograft varies depending on multiple factors associated with cold ischemia time (CIT) and the allograft rejection process. It is known that serum creatinine is an insensitive and late marker for predicting graft recovery after KT, mainly in patients with delayed graft function (DGF). Neutrophil gelatinase-associated lipocalin (NGAL) is produced in the distal nephron and it is one of the most promising novel biomarkers for acute kidney injury (AKI) and chronic kidney disease (CKD). NGAL has been proposed to be a predictor of organ recovery from DGF after KT from donors after cardiac death. Because nonrenal diseases can also induce NGAL, more information is necessary to validate the sensitivity and specificity of urine and plasma NGAL in clinical samples. The exosomes are vesicles released into the urine from the kidney epithelium and they have been proposed as better source to explore as biomarker of renal dysfunction. The molecular composition of the urinary exosomes could be representative of the physiological or physiopathologic condition of the urinary system. We propose that determination of NGAL in urinary exosomes is a better predictor of kidney dysfunction after KT than other urinary fractions. We analyzed 15 kidney allograft recipients, with a mean age of 36 years (range, 16-60 years) and 75% were male: 11 living donors (LD) and 4 deceased donors (DD). The average length of CIT was 14 hours in DD and less than 1 hour in LD. Three patient developed DGF. Using Western blot analysis, NGAL was detectable in the cellular and exosomal fraction of the urine. The exosomes expressed higher levels of NGAL than the cellular fraction. The expression of NGAL was observed from the first day after transplantation. In the cellular fraction of the urine, no significant differences of NGAL were observed between the patients. However, the median of NGAL expression in the exosomes fraction was significantly higher in DD patient, from the first day after KT (P < .05). Moreover, we noticed that NGAL expression in exosomes remained elevated in the patients with DGF compared with non-DGF patients (P < .05). Considering the highest abundance of NGAL in the urinary exosomes and its correlation with DGF patients, we suggest the exosomal fraction as a more sensitive substrate to evaluate early biomarkers of DGF after KT.

Osteoporosis and multiple fractures in an antiretroviral-naive, HIV-positive child.

As a result of the increased incidence of osteopenia and osteoporosis in HIV-infected patients, numerous publications have suggested that there may be a link between bone metabolism alterations and HIV infection. The early bone loss seen in these patients was initially attributed to the use of highly active antiretroviral treatment (HAART) that included protease inhibitors. Recent studies, however, have suggested that it may be a direct consequence of the viral infection on bone metabolism, persistent activation of pro-inflammatory cytokines (TNFa), or altered vitamin D metabolism secondary to the virus, combined with subsequent factors (e.g., antiretroviral treatment) that aggravate the bone demineralization. We present an antiretroviral-naive 6-year-old girl with vertically transmitted HIV infection who presented with severe osteoporosis and multiple pathological fractures of the vertebrae, ribs, and upper and lower limbs. The child was treated with HAART, appropriate nutritional support for her age, physiotherapy and rehabilitation, calcium and vitamin D supplements, and alendronate therapy. After 6 weeks of treatment, the intense pain and muscle atrophy had disappeared and she was able to walk unassisted. At 6 months, bone mass had increased by 72%. The interest of this case lies in the presence of severe osteoporosis and multiple pathological fractures in an HIVinfected naive child. To date, this condition has only been described in patients treated with antiretrovirals. Moreover, this is the first reported HIV-positive pediatric patient treated with bisphosphonates, which proved to be highly successful.

Organochlorine pesticides in placentas from Southern Spain and some related factors.

During pregnancy, lipophilic xenobiotics stored in maternal adipose tissue can be mobilized and enter her blood circulation and reach the placenta. This study measured residues of oestrogen-mimicking organochlorine pesticides (OCs) in 150 placenta samples from women in Southern Spain. OCs were extracted from placenta by solid-liquid technique and purified by preparative liquid chromatography. Gas chromatography/electron-capture detection and mass spectrometry were used to identify and quantify p,p'-DDT and congeners/metabolites, endosulphan and congeners/metabolites, lindane, aldrin/dieldrin/endrin, hexachlorobenzene, methoxychlor and mirex. A mean of eight pesticides per placenta were detected (range, 3-15 pesticides). Endosulphan-ether, endosulphan-diol, endosulphan-I, p,p'-DDE, o,p'-DDD, p,p'-DDT, o,p'-DDT and lindane were detected in >or=50% of samples; p,p'-DDE was the most frequent (96.03%), followed by endosulphan-diol (76.86%) and lindane (74.17%). Presence of more pesticides was significantly associated with lower birth weight. Mean concentration of p,p'-DDE was 2.37+/-2.80 ng/g of placenta or 76.62+/-104.85 ng/g of lipid. Higher maternal body mass index was significantly associated with higher endosulphan concentrations in placenta, and greater maternal weight gain was significantly associated with higher p,p'-DDE concentrations. Prenatal exposure to OC xenoestrogens may be a causative factor in adverse reproductive health trends, and further studies are required to identify and describe pathways of this exposure to enhance preventive measures.

The relation among the diameter of the great saphenous vein, clinical state and haemodynamic pattern of the saphenofemoral junction in chronic superficial venous insufficiency.

OBJECTIVE: To find out if there is a relation among the diameter of the great saphenous vein (GSV) when it is incompetent, the clinical gravity of the varicose syndrome and the type of insufficiency of the saphenofemoral junction (SFJ) in patients with chronic venous insufficiency (CVI) by means of duplex exploration. METHODS: The sample included 145 extremities, 38 normal as a control group and 107 with incompetence of the GSV. According to the results of the Valsalva and Parana manoeuvres in the SFJ, they were distributed into four groups. The diameter of the GSV and the clinical state according to the clinical, aetiological, anatomical and pathological element classification were recorded for each group. RESULTS: Statistically significant differences were obtained for the diameter and the clinical state in patients with positive manoeuvres with regard to other groups. The diameter was greater and the clinical state more severe (C4, C5 and C6) when two manoeuvres were positive. CONCLUSIONS: The presence of both positive manoeuvres in the SFJ is related to severe clinical states and greater diameters of the GSV, allowing the establishment of a prognosis of the CVI and the most suitable surgical approach.

A health promotion programme in Adventist and non-Adventist women based on Pender's model: a pilot study.

OBJECTIVE: In the last decades, the epidemiological and demographic transition in Chile has resulted in a considerable increase in diet-related non-communicable chronic diseases. The aim of this study was to determine the impact of a health promotion programme (HPP) on behaviour in terms of the dimensions of the health-promoting lifestyle profile (HPLP) based on Pender's model. Pender based his research on the development of a model that explains, predicts and modifies forms of behaviour that promote health; an HPP based on this model may achieve positive changes that promote a healthy lifestyle. STUDY DESIGN: This was a comparative study and the participants were Seventh-Day Adventist Church women (SDAW) and non-Seventh-Day Adventist Church women (NSDAW) aged 20-45 years from the urban area of Villarrica, Ninth Region of Chile. From a population of 300 women (150 SDAW and 150 NSDAW), a random sample of 18 SDAW and 18 NSDAW was chosen. Both groups were comparable in age and socio-economic status. An HPP was undertaken for both groups between April and September 2002. The response rate was 100%. METHODS: The overall score and the scores for the six dimensions of the HPLP (self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management) were measured in the pre- and post-test periods. Statistical analysis was performed using the Sign test and Wilcoxon's test. Data were processed using the statistical analysis system. RESULTS: In both groups, the median scores increased significantly between the pre- and post-test periods for the overall HPLP score and the scores of the six dimensions. When comparing the median scores in SDAW with NSDAW, only the score for nutrition was significantly higher in SDAW than NSDAW in both the pre-test (P<0.0001) and post-test (P<0.0005) periods. CONCLUSIONS: These findings demonstrate that an HPP based on Pender's model improves behaviour related to a health-promoting lifestyle in both groups, but more so for the NASDW.

A genetic analysis of seed and berry weight in grapevine.

Fruit size and seedlessness are highly relevant traits in many fruit crop species, and both are primary targets of breeding programs for table grapes. In this work we performed a quantitative genetic analysis of size and seedlessness in an F1 segregating population derived from the cross between a classical seeded (Vitis vinifera L. 'Dominga') and a newly bred seedless ('Autumn Seedless') cultivar. Fruit size was scored as berry weight (BW), and for seedlessness we considered both seed fresh weight (SFW) and the number of seeds and seed traces (SN) per berry. Quantitative trait loci (QTL) analysis of BW detected 3 QTLs affecting this trait and accounting for up to 67% of the total phenotypic variance. QTL analysis for seedlessness detected 3 QTLs affecting SN (explaining up to 35% of total variance) and 6 affecting SFW (explaining up to 90% of total variance). Among them, a major effect QTL explained almost half of the phenotypic variation for SFW. Comparative analysis of QTLs for these traits reduced the number of grapevine genomic regions involved, one of them being a major effect QTL for seedlessness. Association analyses showed that microsatellite locus VMC7F2, closely linked to this QTL, is a useful marker for selection of seedlessnes.