Diseño y comparativa de biomateriales para el tratamiento de defectos óseos. Estudio de su comportamiento in vivo en modelo animal de conejo / Desing and comparison of bone substitutes. Study of in vivo behavior in a rabbit model

Objetivo: Comparar in vivo la capacidad de formación ósea de dos tipos de biomateriales diseñados como sustitutivos óseos respecto a autoinjerto de cresta iliaca, uno basado en carbonatohidroxiapatita y otro en vidrio mesoporoso bioactivo. Material y método: Estudio experimental compuesto por 14 conejos de Nueva Zelanda hembras adultas donde se realizó un defecto crítico en hueso radio. La muestra fue dividida en cuatro grupos: defecto sin material, con autoinjerto de cresta iliaca, con soporte de carbonatohidroxiapatita y con soporte de vidrio mesoporoso bioactivo. Se realizaron estudios seriados de radiología simple a las 2, 4, 6 y 12 semanas y estudio de micro-TC a eutanasia a las 6 y 12 semanas. Resultados: En el estudio de radiología simple, el grupo de autoinjerto mostró las mayores puntuaciones de formación ósea (7,5 puntos). Ambos grupos de biomateriales presentaron formación ósea similar (5,3 y 6 puntos, respectivamente) y mayor al defecto sin material (4 puntos), pero siempre menor que el grupo de autoinjerto. Los resultados del estudio de micro-TC mostraron el mayor volumen de hueso en el área de estudio en el grupo de autoinjerto. Los grupos con sustitutivos óseos presentaron mayor volumen de hueso que el grupo sin material, pero siempre menor que en el grupo de autoinjerto. Conclusiones: Ambos soportes parecen favorecer la formación ósea pero no son capaces de reproducir las características del autoinjerto. Por sus diferentes características macroscópicas cada uno podría ser adecuado para un tipo diferente de defecto.(AU)

Aim: Compare bone formation capacity in vivo of two types of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxyapatites and the other one on bioactive mesoporous glass. Materials and methods: Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite support, and with bioactive mesoporous glass support. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. Results: In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than in the autograft group. Conclusion: Both supports seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.(AU)

[Translated article] Design and comparison of bone substitutes. Study of in vivo behaviour in a rabbit model / Diseño y comparativa de biomateriales para el tratamiento de defectos óseos. Estudio de su comportamiento in vivo en modelo animal de conejo

Objetivo: Comparar in vivo la capacidad de formación ósea de dos tipos de biomateriales diseñados como sustitutivos óseos respecto a autoinjerto de cresta iliaca, uno basado en carbonatohidroxiapatita y otro en vidrio mesoporoso bioactivo. Material y método: Estudio experimental compuesto por 14 conejos de Nueva Zelanda hembras adultas donde se realizó un defecto crítico en hueso radio. La muestra fue dividida en cuatro grupos: defecto sin material, con autoinjerto de cresta iliaca, con soporte de carbonatohidroxiapatita y con soporte de vidrio mesoporoso bioactivo. Se realizaron estudios seriados de radiología simple a las 2, 4, 6 y 12 semanas y estudio de micro-TC a eutanasia a las 6 y 12 semanas. Resultados: En el estudio de radiología simple, el grupo de autoinjerto mostró las mayores puntuaciones de formación ósea (7,5 puntos). Ambos grupos de biomateriales presentaron formación ósea similar (5,3 y 6 puntos, respectivamente) y mayor al defecto sin material (4 puntos), pero siempre menor que el grupo de autoinjerto. Los resultados del estudio de micro-TC mostraron el mayor volumen de hueso en el área de estudio en el grupo de autoinjerto. Los grupos con sustitutivos óseos presentaron mayor volumen de hueso que el grupo sin material, pero siempre menor que en el grupo de autoinjerto. Conclusiones: Ambos soportes parecen favorecer la formación ósea pero no son capaces de reproducir las características del autoinjerto. Por sus diferentes características macroscópicas cada uno podría ser adecuado para un tipo diferente de defecto.(AU)

Aim: Compare bone formation capacity in vivo of two types of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxyapatites and the other one on bioactive mesoporous glass. Materials and methods: Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite support, and with bioactive mesoporous glass support. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. Results: In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than in the autograft group. Conclusion: Both supports seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.(AU)

A novel beam stopper-based approach for scatter correction in digital planar radiography.

X-ray scatter in planar radiography degrades the contrast resolution of the image, thus reducing its diagnostic utility. Antiscatter grids partially block scattered photons at the cost of increasing the dose delivered by two- to four-fold and posing geometrical restrictions that hinder their use for other acquisition settings, such as portable radiography. The few software-based approaches investigated for planar radiography mainly estimate the scatter map from a low-frequency version of the image. We present a novel method for scatter correction in planar imaging based on direct patient measurements. Samples from the shadowed regions of an additional partially obstructed projection acquired with a beam stopper placed between the X-ray source and the patient are used to estimate the scatter map. Evaluation with simulated and real data showed an increase in contrast resolution for both lung and spine and recovery of ground truth values superior to those of three recently proposed methods. Our method avoids the biases of post-processing methods and yields results similar to those for an antiscatter grid while removing geometrical restrictions at around half the radiation dose. It can be used in unconventional imaging techniques, such as portable radiography, where training datasets needed for deep-learning approaches would be very difficult to obtain.

[Translated article] Design and comparison of bone substitutes. Study of in vivo behaviour in a rabbit model.

AIM: To compare the in vivo bone formation capacity of of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxiapatite and the other one on bioactive mesoporous glass. MATERIALS AND METHODS: Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite scaffold, and with bioactive mesoporous glass scaffold. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. RESULTS: In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than the autograft group. CONCLUSION: Both scaffolds seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.

Desing and comparison of bone substitutes. Study of in vivo behavior in a rabbit model. / Diseño y comparativa de biomateriales para el tratamiento de defectos óseos. Estudio de su comportamiento in vivo en modelo animal de conejo.

AIM: Compare bone formation capacity in vivo of two types of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxyapatites and the other one on bioactive mesoporous glass. MATERIALS AND METHODS: Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite support, and with bioactive mesoporous glass support. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. RESULTS: In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than in the autograft group. CONCLUSION: Both supports seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.

Prevalence and types of childhood trauma in first episode psychosis patients. Relation with clinical onset variables.

OBJECTIVE: To study the prevalence and the type of childhood trauma (CT) in a first-episode psychosis (FEP) cohort and in a healthy control (HC) sample. To study which clinical and sociodemographic variables in the onset of the FEP are related to having suffered some traumatic experience in childhood. METHOD: 100 FEP patients and 94 HC participated in the study. The Childhood Traumatic Questionnaire (CTQ) was used to evaluate CT. The Positive and Negative Syndrome Scale (PANSS), the Personal and Social Performance (PSP), the Suicide Risk Scale of Plutchik (SRSP), and the Perceived Stress Scale (PSS) were also administered. RESULTS: 61% of FEP patients and 17% of HC reported having experienced some kind of CT. FEP showed more CT than controls in all subscales, except in sexual abuse. The most frequent CT was emotional abuse. For the FEP group, younger age, more years of education, have a first-degree family history, more positive and negative symptoms, more perceived stress and more personal and social functioning were the variables more influenced by having suffered some kind of CT. CONCLUSIONS: There is a high prevalence of CT in FEP patients. Having a first-degree family history of mental illness, more positive symptoms, and more perception of stress at the time of hospital admission were related to having suffered CT. More research is needed to find out the best way to detect CT and its role in psychosis to be able to implement interventions to improve the evolution of these patients.

Efectividad de intervención de enfermería en conocimientossobre prevención de caídas en ancianos que la experimentaron

RESUMEN:Introducción: El conocimiento sobre prevención de caídas resulta indispensable en la reducción de su incidencia en ancianos, la intervención de enfermería puede ser la vía para lograrlo.Objetivo: Evaluar la efectividad de una intervención de enfermería sustentada en el modelo de Jean Watson en el nivel de conocimientos sobre prevención decaídas en ancianos que la han experimentado.Métodos: Investigación cuantitativa, preexperimental con pre-test y post-test,contextualizada en 37 consultorios del Policlínico “Dr. Rudesindo Antonio Garcíadel Rijoˮ, provincia Sancti Spíritus, Cuba, del 2018 a 2019. Universo conformado por 42 ancianos que presentaron caídas en el último año. El conocimiento se midió con encuestas validadas por expertos y pilotaje con alfa de Cronbach > 0,5. Para los ejes temáticos y metodológicos de la intervención (sustentada en los 10 factores asistenciales de la teoría de Jean Watson), se revisó bibliografía sobre el tema, se tuvieron en cuenta las necesidades de conocimiento identificadas. Se procesó la información con frecuencias absolutas, porcentajes, media, desviación típica, valor mínimo y máximo. Para contrastar la hipótesis se utilizó la Prueba no paramétrica de rangos con signo de Wilcoxon.Resultados: Previo a la intervención, el nivel cuatro de conocimiento lo presentó el 9,52 Porciento de los ancianos, aplicada la intervención ascendió al 90,47 Porciento , consignificación z = -5,249, p < 0,05.Conclusiones: La intervención de enfermería sustentada en el modelo de Jean Watson resultó efectiva en el incremento del nivel de conocimientos sobre prevención de caídas en ancianos que la han experimentado.[AU]

XAP-Lab: A software tool for designing flexible X-ray acquisition protocols.

BACKGROUND AND OBJECTIVE: The availability of digital X-ray detectors, together with the development of new robotized hardware and reconstruction algorithms, opens the opportunity to provide 3D capabilities with conventional radiology systems. This would be based on the acquisition of a limited number of projections with non-standard geometrical configurations. The versatility of these techniques is enormous, enabling the introduction of tomography in situations where a CT system is hardly available, such as during surgery or in an ICU, or in which a reduction of radiation dose is key, as in pediatrics. Computer simulations are a valuable tool to explore these possibilities before their actual implementation on real systems. Existing software tools generally simulate only standard acquisition protocols, such as cone-beam with circular trajectory, thus not allowing the users to evaluate more sophisticated projection geometries. The goal of this work is to design a simulation tool that enables the design of acquisition protocols with flexible projection geometries. METHODS: We present XAP-Lab, a software tool for the design of X-ray acquisition protocols with flexible trajectories. For a given projection geometry, defined through a graphical user interface, it allows the user to simulate projections using GPU-accelerated kernels, the visualization of the scanned field of view and the estimation of the total radiation dose. The complete acquisition protocol can then be exported with the appropriate format for its use on real systems. We tested the software by optimizing a tomosynthesis protocol and validating the results with real acquisitions using a SEDECAL NOVA FA radiography system and phantoms for quantitative and qualitative evaluation. RESULTS: Quantitative evaluation using a phantom showed a mean error under 4 mm for each position, below the ±5 mm tolerance of the system specified by the manufacturer. Visual evaluation on a thorax acquisition also showed a good geometrical agreement between simulated and real projections. CONCLUSIONS: Results showed an excellent matching with simulations, supporting the usefulness of XAP-Lab for the design of new acquisition protocols with non-standard geometries.

Dual-exposure technique for extending the dynamic range of x-ray flat panel detectors.

This work presents an approach to extend the dynamic range of x-ray flat panel detectors by combining two acquisitions of the same sample taken with two different x-ray photon flux levels and the same beam spectral configuration. In order to combine both datasets, the response of detector pixels was modelled in terms of mean and variance using a linear model. The model was extended to take into account the effect of pixel saturation. We estimated a joint probability density function (j-pdf) of the pixel values by assuming that each dataset follows an independent Gaussian distribution. This j-pdf was used for estimating the final pixel value of the high-dynamic-range dataset using a maximum likelihood method. The suitability of the pixel model for the representation of the detector signal was assessed using experimental data from a small-animal cone-beam micro-CT scanner equipped with a flat panel detector. The potential extension in dynamic range offered by our method was investigated for generic flat panel detectors using analytical expressions and simulations. The performance of the proposed dual-exposure approach in realistic imaging environments was compared with that of a regular single-exposure technique using experimental data from two different phantoms. Image quality was assessed in terms of signal-to-noise ratio, contrast, and analysis of profiles drawn on the images. The dynamic range, measured as the ratio between the exposure for saturation and the exposure equivalent to instrumentation noise, was increased from 76.9 to 166.7 when using our method. Dual-exposure results showed higher contrast-to-noise ratio and contrast resolution than the single-exposure acquisitions for the same x-ray dose. In addition, image artifacts were reduced in the combined dataset. This technique to extend the dynamic range of the detector without increasing the dose is particularly suited to image samples that contain both low and high attenuation regions.

Misalignments calibration in small-animal PET scanners based on rotating planar detectors and parallel-beam geometry.

Technological advances have improved the assembly process of PET detectors, resulting in quite small mechanical tolerances. However, in high-spatial-resolution systems, even submillimetric misalignments of the detectors may lead to a notable degradation of image resolution and artifacts. Therefore, the exact characterization of misalignments is critical for optimum reconstruction quality in such systems. This subject has been widely studied for CT and SPECT scanners based on cone beam geometry, but this is not the case for PET tomographs based on rotating planar detectors. The purpose of this work is to analyze misalignment effects in these systems and to propose a robust and easy-to-implement protocol for geometric characterization. The result of the proposed calibration method, which requires no more than a simple calibration phantom, can then be used to generate a correct 3D-sinogram from the acquired list mode data.

Software architecture for multi-bed FDK-based reconstruction in X-ray CT scanners.

Most small-animal X-ray computed tomography (CT) scanners are based on cone-beam geometry with a flat-panel detector orbiting in a circular trajectory. Image reconstruction in these systems is usually performed by approximate methods based on the algorithm proposed by Feldkamp et al. (FDK). Besides the implementation of the reconstruction algorithm itself, in order to design a real system it is necessary to take into account numerous issues so as to obtain the best quality images from the acquired data. This work presents a comprehensive, novel software architecture for small-animal CT scanners based on cone-beam geometry with circular scanning trajectory. The proposed architecture covers all the steps from the system calibration to the volume reconstruction and conversion into Hounsfield units. It includes an efficient implementation of an FDK-based reconstruction algorithm that takes advantage of system symmetries and allows for parallel reconstruction using a multiprocessor computer. Strategies for calibration and artifact correction are discussed to justify the strategies adopted. New procedures for multi-bed misalignment, beam-hardening, and Housfield units calibration are proposed. Experiments with phantoms and real data showed the suitability of the proposed software architecture for an X-ray small animal CT based on cone-beam geometry.

Roles que desempeñan profesionales de enfermería en instituciones geriátricas de Bogotá / Roles played by nurses in geriatrics institutions of Bogotá

El presente estudio se realizó con el objetivo de describir, mediante un enfoque cualitativo, los roles que desempeñan profesionales de enfermería en instituciones geriátricas de Bogotá, los que fueron expresados por ellas mismas, de acuerdo con sus experiencias en el área. El estudio se realizó con el propósito de aportar nuevos conocimientos que puedan servir como base para mejorar la calidad del cuidado de enfermería al adulto mayor que recibe servicios de instituciones geriátricas. La investigación se llevó a cabo con un abordaje cualitativo utilizando la técnica de entrevistas semiestructuradas profundas y permitió concluir que casi en su totalidad, las instituciones geriátricas carecen de profesionales de enfermería, a pesar de la reglamentación de la Secretaría Distrital de Salud – Resolución 110 de 1995, en la que se establece que “la Profesión de Enfermería debe hacer presencia las 24 horas del día en aquellas instituciones en las cuales es atendido el adulto mayor con limitaciones físicas o psíquicas, con requerimiento de cuidado, con enfermedades crónicas o de alto riesgo y en instituciones de atención a pacientes terminarles, así como en hogares día” (1), puesto que las acciones de promoción y prevención y las actividades de incorporación social, son las de mayor importancia y donde la enfermería tiene un amplio campo de acción. Ante las limitaciones presentadas para el contacto con enfermeras en dichas instituciones, debido a la ausencia de este cargo, fue necesario buscar la participación de dos docentes universitarias expertas en el área, quienes reconocieron que los roles que desempeña el Profesional de Enfermería corresponden a: rol asistencial, administrativo, gerencial y educativo, y dentro de éste, el de proyección social; rol investigativo y finalmente, una de ellas relató sus experiencias en el ejercicio independiente de la profesión, con adultos mayores. Se concluyó que las enfermeras participantes tienen claridad acerca de los roles propios de enfermería en el cuidado al adulto mayor y sus relatos coincidieron con la teoría existente al respecto; pero se requiere abrir espacios para que se desarrollen tales roles en las instituciones geriátricas de Bogotá, ya que se cuenta con profesionales capacitados, puesto que el área del adulto mayor forma parte de las competencias de formación profesional específica, establecidas para los programas de Enfermería en Colombia.

Design and performance evaluation of a coplanar multimodality scanner for rodent imaging.

This work reports on the development and performance evaluation of the VrPET/CT, a new multimodality scanner with coplanar geometry for in vivo rodent imaging. The scanner design is based on a partial-ring PET system and a small-animal CT assembled on a rotatory gantry without axial displacement between the geometric centers of both fields of view (FOV). We report on the PET system performance based on the NEMA NU-4 protocol; the performance characteristics of the CT component are not included herein. The accuracy of inter-modality alignment and the imaging capability of the whole system are also evaluated on phantom and animal studies. Tangential spatial resolution of PET images ranged between 1.56 mm at the center of the FOV and 2.46 at a radial offset of 3.5 cm. The radial resolution varies from 1.48 mm to 1.88 mm, and the axial resolution from 2.34 mm to 3.38 mm for the same positions. The energy resolution was 16.5% on average for the entire system. The absolute coincidence sensitivity is 2.2% for a 100-700 keV energy window with a 3.8 ns coincident window. The scatter fraction values for the same settings were 11.45% for a mouse-sized phantom and 23.26% for a rat-sized phantom. The peak noise equivalent count rates were also evaluated for those phantoms obtaining 70.8 kcps at 0.66 MBq/cc and 31.5 kcps at 0.11 MBq/cc, respectively. The accuracy of inter-modality alignment is below half the PET resolution, and the image quality of biological specimens agrees with measured performance parameters. The assessment presented in this study shows that the VrPET/CT system is a good performance small-animal imager, while the cost derived from a partial ring detection system is substantially reduced as compared with a full-ring PET tomograph.

Sinogram bow-tie filtering in FBP PET reconstruction.

Low-pass filtering of sinograms in the radial direction is the most common practice to limit noise amplification in filtered back projection (FBP) reconstruction of positron emission tomography studies. Other filtering strategies have been proposed to prevent the loss in resolution due to low-pass radial filters, although results have been diverse. Using the well-known properties of the Fourier transform of a sinogram, the authors defined a binary mask that matches the expected shape of the support region in the Fourier domain of the sinogram ("bow tie"). This mask was smoothed by a convolution with a ten-point Gaussian kernel which not only avoids ringing but also introduces a pre-emphasis at low frequencies. A new filtering scheme for FBP is proposed, comprising this smoothed bow-tie filter combined with a standard radial filter and an axial filter. The authors compared the performance of the bow-tie filtering scheme with that of other previously reported methods: Standard radial filtering, angular filtering, and stackgram-domain filtering. All the quantitative data in the comparisons refer to a baseline reconstruction using a ramp filter only. When using the smallest size of the Gaussian kernel in the stackgram domain, the authors achieved a noise reduction of 33% at the cost of degrading radial and tangential resolutions (14.5% and 16%, respectively, for cubic interpolation). To reduce the noise by 30%, the angular filter produced a larger degradation of contrast (3%) and tangential resolution (46% at 10 mm from the center of the field of view) and showed noticeable artifacts in the form of circular blurring dependent on the distance to the center of the field of view. For a similar noise reduction (33%), the proposed bow-tie filtering scheme yielded optimum results in resolution (gain in radial resolution of 10%) and contrast (1% increase) when compared with any of the other filters alone. Experiments with rodent images showed noticeable image quality enhancement when using the proposed bow-tie filtering scheme.

Formulation, characterization, and efficacy of an adenosine-containing dissolvable film for a localized anti-wrinkle effect.

A water-dissolvable film was developed to topically deliver adenosine for a localized anti-wrinkle effect. The polymers used to produce the film were cellulose derivatives. An aqueous mixture of the film components was made, coated on a liner, and then dried to form a solid film. No preservatives were added and the film was shown to be stable over time. The film quickly dissolves in water to form a uniform layer at the surface of the skin, as shown by scanning electron microscopy. The film layer can still be visualized on the wrinkle six hours after being applied on the skin. A randomized, placebo-controlled, investigator-blind study was conducted in female volunteers to assess the efficacy of the 1% adenosine-containing dissolvable film. After three weeks and eight weeks, a twice daily application led to a significant decrease in the skin roughness parameters as observed using fast optical in vivo topometry (FOITS). These results demonstrate that water-dissolvable films may be used as novel, preservative-free, cosmetic delivery systems.

Increased cholesterol intake in women with gestational diabetes mellitus.

AIM: Cholesterol intake is associated with the risk for type 2 diabetes mellitus, but no previous studies have evaluated its role regarding the risk of gestational diabetes mellitus (GDM). We investigate the relation between cholesterol intake and GDM. METHODS: At screening for GDM, 335 pregnant women were evaluated for dietary intake (including cholesterol) during the previous year (validated food-frequency questionnaire). RESULTS: Forty-one women were diagnosed with GDM and 294 did not meet the GDM criteria. Women with GDM were older (32.8+/-0.7 vs. 30.2+/-0.3 years; P=0.01) and had a higher body mass index (27.3+/-0.7 vs. 24.3+/-0.3 kg/m2; P=0.01) than women without GDM. They also had more frequently a family history of type 2 diabetes mellitus (51.2% vs. 40.0%; P=0.02) and history of previous GDM (14.6% vs. 1.7%; P=0.01), and were evaluated earlier in pregnancy (22.1+/-1.2 vs. 24.9+/-0.5 weeks; P=0.03). There were no significant differences between groups in smoking habit, and alcohol, total energy, protein, carbohydrate, fats and fiber intake. Women with GDM had a higher cholesterol intake than women without GDM (145.3+/-4.5 mg/1000 kcal vs. 134.5+/-1.6 mg/1000 kcal; P=0.03). In a multiple logistic regression model, previous GDM, BMI, age and cholesterol intake (OR=1.88; 95% CI: 1.09-3.23 for each increase of 50 mg/1000 kcal) were independently and positively associated with GDM. CONCLUSION: We conclude that cholesterol intake is independently associated with GDM and that it could be involved in the pathogenesis of GDM.

A simple experimental method to study depigmenting agents.

The first objective of the study was to verify that a controlled UV exposure of four areas of the forearms together with randomized product application enabled to compare treatment efficacy and then to compare the depigmenting efficacy of different products with a simple experimental method. Sixteen volunteers received 0.7 minimal erythermal dose for four consecutive days. Products tested were ellagic acid (0.5%), vitamin C (5%) and C8-LHA (2%). Product application started 72 h post last exposure, was repeated for 42 days, the control zone being exposed, non-treated. Colour measurements included Chromameter, Chromasphere, Spectro-colorimeter and visual assessment. Comparison of colour values at day 1 and at day 7 showed that all zones were comparably tanned, allowing a rigorous comparison of the treatments. We report a new simple experimental model, which enables the rapid comparison of different depigmenting products. The efficacy and good tolerance of C8-LHA make it an excellent candidate for the treatment of hyperpigmentory disorders.

Evaluation of anti-wrinkle efficacy of adenosine-containing products using the FOITS technique.

The objective of this study was to evaluate formulations containing adenosine to reduce periorbital lines and glabellar frowns in a blind, randomised, placebo-controlled study. One hundred twenty-six female volunteers between 45 and 65 years of age fulfilled inclusion criteria for periorbital lines. They were provided with two of three products (cream with adenosine, dissolvable film with adenosine or placebo), to be applied to the periorbital area on each side of the face (84 subjects per product). Eighty-four of these subjects also fulfilled the inclusion criteria for glabellar frowns, and received placebo or cream with adenosine to be applied to the glabellar area. Products were applied twice daily for 2 months, and evaluation was performed under dermatological supervision at 0, 3 and 8 weeks using Fast Optical in vivo Topometry of human Skin (FOITS) analysis to describe skin profile. Both adenosine-containing products led to significant improvements in skin smoothness in the periorbital area. Improvements were evidenced after 3 weeks of product application as measured by Ra and Rz parameters using the FOITS technique, and were steadily confirmed after 2 months, despite severe climatic conditions and independently of the analysis technique that was used with the FOITS data. Adenosine-containing cream also significantly improved glabellar frowns. This study demonstrates the potential beneficial effects of adenosine-containing products on crow's feet and glabellar facial wrinkles.