Using kinematic reduction for studying grasping postures. An application to power and precision grasp of cylinders.

The kinematic analysis of human grasping is challenging because of the high number of degrees of freedom involved. The use of principal component and factorial analyses is proposed in the present study to reduce the hand kinematics dimensionality in the analysis of posture for ergonomic purposes, allowing for a comprehensive study without losing accuracy while also enabling velocity and acceleration analyses to be performed. A laboratory study was designed to analyse the effect of weight and diameter in the grasping posture for cylinders. This study measured the hand posture from six subjects when transporting cylinders of different weights and diameters with precision and power grasps. The hand posture was measured using a Vicon(®) motion-tracking system, and the principal component analysis was applied to reduce the kinematics dimensionality. Different ANOVAs were performed on the reduced kinematic variables to check the effect of weight and diameter of the cylinders, as well as that of the subject. The results show that the original twenty-three degrees of freedom of the hand were reduced to five, which were identified as digit arching, closeness, palmar arching, finger adduction and thumb opposition. Both cylinder diameter and weight significantly affected the precision grasping posture: diameter affects closeness, palmar arching and opposition, while weight affects digit arching, palmar arching and closeness. The power-grasping posture was mainly affected by the cylinder diameter, through digit arching, closeness and opposition. The grasping posture was largely affected by the subject factor and this effect couldn't be attributed only to hand size. In conclusion, this kinematic reduction allowed identifying the effect of the diameter and weight of the cylinders in a comprehensive way, being diameter more important than weight.

Aglepristone decreases proliferation in progesterone receptor-positive canine mammary carcinomas.

BACKGROUND: Progesterone receptor (PR) antagonist aglepristone (RU534) has been used successfully for pregnancy termination and therapy of pyometra, vaginal tumors, and mammary hyperplasia in bitches and queens. All of these conditions share with canine mammary carcinomas the expression of PR. OBJECTIVES: To study the effect of RU534 on proliferation and apoptosis in canine mammary carcinomas in relation to PR expression. ANIMALS: Twenty-seven nonspayed bitches with mammary carcinomas were treated with either 2 doses of 20 mg/kg RU534 (n = 22, RU534-treated group) or oil placebo (n = 5, control group) on days 1 and 8. METHODS: Tumor samples were collected before (day 1) and after (day 15) treatment for immunohistochemistry. PR expression, proliferation index (PI), and apoptotic index (AI) were determined using antibodies against PR, Ki67, and cleaved lamin A/C antigens, respectively. The effect of treatment on these parameters was analyzed. RESULTS: Differential expression of PR between day 1 (59.1% PR-positive tumors) and day 15 (36.4% PR-positive tumors) was observed in RU534-treated tumors exclusively. After RU534 treatment, mean PI was significantly decreased in PR-positive but unchanged in PR-negative RU534-treated tumors. A reduction of ≥20% in PI was found in 61.5% of RU534-treated tumors with PR expression. Conversely, no effect on AI was observed after RU534 treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Neoadjuvant RU534 treatment had PR expression-related inhibiting effects on proliferation of canine mammary carcinoma cells.

Enfermedad de injerto contra huésped. Presentación atípica / Graft versus host disease, a typical presentation

La enfermedad de injerto contra huésped(EICH) es la complicación más grave del trasplante de precursores hematopoyéticos alogénico y se puede presentar de forma aguda o crónica. La EICH aguda ocurre en el 40-70% de los pacientes y es causa de muerte en más del 20 %. La forma crónica aparece en un 20-50 % de los supervivientes a largo plazo.Presentamos el caso de un paciente con antecedente personal de leucemia mieloblástica aguda que había requerido trasplante de precursores hematopoyéticos alogénico de un hermano HLA compatible y presentó una EICH de presentación atípica como sinovitis de flexores de carpo y síndrome doloroso regional complejo asociado

Graft versus host disease (GVHD), which can occur in acute or chronic form, is the most serious complication of allogeneic hematopoietic stem cell transplantation(HSCT). The acute GVHD occurs in 40 % to 70 % of the patients and is the first cause of death in about 20 %. The chronic type occurs in 20 % to 50 % of long-term survivors.We present the case of a patient with acute myeloblasticleukemia who received allogeneic HSCT from his HLA-identical brother, and presented atypical GVHD with carpal flexor synovitis associated with complex regional pain syndrome

ECT anesthesia: the lighter the better?

BACKGROUND: Electroconvulsive therapy (ECT) is a most effective treatment for patients with major affective disorders. The influence of anesthetic drugs on seizure "adequacy" or on treatment success has not been systematically investigated. METHODS: A bispectral EEG index score (BIS) was used to identify the depth of anesthesia during ECT. Our study included 22 major depressive episode (MDE) patients expanding to 219 ECTs (05/05-01/06) with no limitations of concurrent medication. RESULTS: Fourteen out of the 22 patients showed full remission. Individual number of ECT sessions needed to reach full remission correlated negatively with mean pre-ECT BIS values (p=0.001). Additionally, using a repeated measurement regression analysis significant correlations were found for pre-ECT BIS versus motor response time, seizure concordance, ictal coherence and peak heart rate. CONCLUSION: The results of our study suggest BIS-levels as a predictor of faster ECT response. Controlling BIS-levels before stimulation may have an additional effect on treatment success.

Valoración funcional en las lesiones del ligamento cruzado anterior operado: utilidad del test de Bosco / Functional assessment in operated anterior crossed ligament lesions: utility of the Bosco test

Objetivo: Estudiar, a los seis meses de la intervención mediante plastia de LCA, la correlación entre la escala de valoración funcional de Lysholm y Gillquist, el salto vertical monopodal en tapiz de Bosco y la fuerza isocinética concéntrica (60, 90 y 180º/s).Material y métodos: Estudiamos 32 pacientes (12 mujeres y 20 hombres), con una edad media de 24,1 años (DE 7,1; rango 16-39), intervenidos mediante plastia de tendón rotuliano. Las valoraciones se llevaron a cabo a las 29,7 semanas de media (DE 6,3; rango 26,4-32,1) de la intervención quirúrgica. Se estimó el coeficiente de correlación de Pearson entre cada par de variables. Resultados: El 84,4 por ciento obtuvieron una puntuación muy buena-normal en la escala de Lysholm, frente a tan sólo el 53,1 por ciento para el salto monopodal y el 43,7 por ciento para la fuerza isocinética de extensión. Se observó una buena correlación, estadísticamente significativa, entre el salto vertical monopodal y la fuerza isocinética de extensión a las tres velocidades (r=0,75, 0,7, 0,63). En cambio, la escala de Lysholm, mostraba una correlación moderada-baja con el salto monopodal (r=0,45) y con la fuerza isocinética de extensión (r=0,54, 0,54) y de flexión (r=0,54, 0,55) a 60º y 90º/s. Conclusiones: El salto vertical monopodal en tapiz de Bosco se correlaciona bien con la fuerza isocinética de extensión de la rodilla en nuestra muestra de pacientes. El uso aislado de la escala de Lysholm puede dar una falsa buena imagen del estado de la rodilla, ya que no detecta los déficit importantes de fuerza (AU)

Evaluation of patterns of urinary proteins by SDS-PAGE in rats of different ages.

The patterns of urinary proteins in rats of different ages were examined on SDS gradient polyacrylamide gel electrophoresis coupled with silver staining. Proteins were fractionated into at least 26 bands. Densitometric measurements were used to characterize protein excretion patterns. The results showed that proteinuria in newborn, young and adult rats is predominantly tubular, consisting of low molecular-weight species. Conversely, late adults and old rats had a mixed glomerular pattern, with a steadily increasing excretion of albumin, IgG and transferrin, as was the case of other high molecular-weight proteins. Fragments of both immunoglobulins and albumin were found in all urine samples assayed. In 1 month old rats the percentage of Tamm-Hörsfall (T-H) protein was higher (P < 0.01) than in the remaining groups studied. In newborns, relatively high albumin, IgG and transferrin percentages were detected, as well as an alpha 1-acid glycoprotein and carbonic anhydrase excretion (P < 0.05 and P < 0.01 respectively) higher than that observed in the other age groups studied.

Clindamycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis: a prospective double-blind clinical trial.

Bacterial vaginosis is common among patients seen by gynecologists. Several types of therapy have been proposed. The purpose of this prospective, randomized, double-blind clinical trial was to examine the efficacy of clindamycin vaginal cream for the treatment of bacterial vaginosis. Sixty patients with symptoms of bacterial vaginosis were randomized into the study, and 46 completed the protocol. Twenty-three patients received 2% clindamycin vaginal cream (5 g applied intravaginally at bedtime for 7 days), with placebo oral tablets twice daily for 7 days. The other 23 patients received oral metronidazole tablets (500 mg twice a day for 7 days) and placebo vaginal cream (5 g intravaginally for 7 days). The cure rates for the two regimens were comparable. Twenty-two (97%) of the patients treated with clindamycin vaginal cream had improvement or cure at the first follow-up visit versus 19 (83%) of those taking metronidazole. There was no statistically significant difference between the two results. Side effects for both regimens were comparable. We conclude that 2% clindamycin vaginal cream offers similar efficacy and safety to standard oral metronidazole therapy for bacterial vaginosis.

Calcium excretion in preeclampsia.

Recent studies have suggested that preeclampsia is associated with hypocalciuria. We compared 24-hour urine data from 143 obstetric patients: 33 with preeclampsia, 58 normotensives, and 52 patients with gestational hypertension. The mean maternal age, race, and parity of these three groups did not differ significantly. The patients with preeclampsia had significantly less excretion of total calcium (129.7 +/- 18.7 mg/24 hours) (mean +/- SEM) than normotensives (283.9 +/- 12.3) or those with gestational hypertension (233.2 +/- 22.3) (P = .0001). The mean arterial pressure and excretion of total protein were significantly increased in the preeclampsia group (P = .0001). Using the receiver operator curve, a urine calcium threshold of 12 mg/dL was chosen as predictive for the development of preeclampsia, with a sensitivity of 85%, specificity of 91%, and positive and negative predictive values of 85 and 91%, respectively. Urinary calcium levels below 12 mg/dL may help distinguish preeclampsia from other hypertensive disorders of pregnancy.

[The place of intra- and postoperative autotransfusion in the exchange of a hip endoprosthesis]. / Stellenwert der intra- und postoperativen Autotransfusion beim Austausch einer Hüftgelenkendoprothese.

Intraoperative autologous transfusion with a cell separator is being employed to an increasing extent in orthopedic procedures associated with high blood loss, including surgery for exchange total hip arthroplasty. Postoperative loss of blood via drains after exchange total hip replacement is also considerable. To our knowledge, there are only unpublished reports on postoperative autotransfusion in this type of surgery. In this study the role of intra- and postoperative autotransfusion is investigated.