Comparison of surgical approaches to radical prostatectomy in our series beyond oncological and functional outcomes.

OBJECTIVES: To evaluate the outcomes of robot-assisted radical prostatectomy (RARP) compared to those of open (ORP) and laparoscopic (LRP) surgery. The interest lies fundamentally in the quality-of-life (QoL) evaluation, postoperative recovery, and personal satisfaction of patients with the intervention (PS) beyond oncological and functional outcomes. METHODS: Six hundred eighty-five RPs were performed in our center between 2011-2018 (17,8% ORP, 22,2% LRP and 60% RARP). Patients were prospectively assessed through follow-up until April 2020 and a multiple questionnaire at 12-months post-RP that included ICIQ-SF, SHIM, IPSS, IQL and questions about pain, postoperative recovery and PS. Also baseline and postoperative patient- and treatment-related data were collected, and binomial logistic regressions were performed for the 1 vs.1 comparisons (ORP vs. RARP and LRP vs. RARP). RESULTS: RARP patients have overall fewer comorbidities, less tumor aggressiveness, more operative time requirements and more positive surgical margins than ORP and LRP patients. Nevertheless, RARP outperforms ORP in: hospital stay (days) (OR 0,86; 95% CI: 0,80-0,94), hemoglobin loss (OR 0,38; 95% CI: 0,30-0,47), transfusion rate (OR 0,18; 95% CI: 0,09-0,34), early complications (p = 0,001), IQL (OR 0,82; 95% CI: 0,69-0,98), erectile function (OR 0,41; 95% CI: 0,21-0,79), pain control (OR 0,82; 95% CI: 0,75-0,89), postoperative recovery (p < 0,001) and choice of a different approach (OR 5,55; 95% CI: 3,14-9,80). RARP is superior to LRP in: urinary continence (OR 0,55; 95% CI: 0,37-0,82), IPSS (OR 0,96; 95% CI: 0,93-0,98), IQL (OR 0,76; 95% CI: 0,66-0,88), erectile function (OR 0,52; 95% CI: 0,29-0,93), postoperative recovery (p = 0,02 and 0,004), PS (p = 0,005; 0,002; and 0,03) and choice of a different approach (OR 7,79; 95% CI: 4,63-13,13). CONCLUSIONS: The findings of our study globally endorse a positive effectiveness of RARP over ORP and/or LRP, both on functional issues, postoperative recovery, QoL and PS. Oncologic results should still be improved.

What is the impact of post-radical prostatectomy urinary incontinence on everyday quality of life? Linking Pad usage and International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) for a COMBined definition (PICOMB definition).

AIMS: To identify the definition for urinary continence (UC) after radical prostatectomy (RP) which reflects best patients' perception of quality of life (QoL). METHODS: Continence was prospectively assessed in 634 patients, 12 months after RP using the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) and the number of pads employed in a 24-hour period (pad usage). We used the one-way ANOVA technique with posthoc pairwise comparisons according to Scheffé's method (homogeneous subsets) for assessing the degree of QoL deficit related to urinary incontinence (UI). RESULTS: The continence prevalence is 64.4%, 74.1%, 88.3%, and 35.8% using "0 pads," "1 safety pad," "1 pad," and "ICIQ score 0" definitions, respectively. Pad usage is moderately strongly associated with ICIQ 1, 2, and 3 (ρ = 0.744, 0.677, and 0.711, respectively; p < 0.001). Concordance between classical UC definitions is acceptable between "0 pads-ICIQ score 0" (K = 0.466), but poor for "1 safety pad" and "1 pad" (K = 0.326 and 0.137, respectively). Patients with "0 pad usage" have better QoL related to urine leakage than patients with "1 safety pad" or "1 pad" (1.41 vs. 2.44 and 3.11, respectively; p < 0.05). There were no significant differences found regarding QoL between patients with ICIQ score 0 and ICIQ score 2 (1.01 vs. 1.63; p = 0.63). CONCLUSIONS: Pad usage and the ICIQ-SF's answers provide useful information. We propose a combined definition (0 pads and ICIQ score ≤2) as it is the definition with the least impact on daily QoL.

Snowmelt as a determinant factor in the hydrogeological behaviour of high mountain karst aquifers: The Garcés karst system, Central Pyrenees (Spain).

Time series of environmental tracers (groundwater stable isotope composition, electrical conductivity and temperature) and concentration breakthrough curves of artificial tracers (uranine, eosine, amino-G and naphtionate) have been analyzed to characterize fast preferential and slow matrix in-transit recharge flows in the Paleocene-Eocene limestone aquifer of the Ordesa and Monte Perdido National Park, an alpine karst system drained by a water table cave, a rare hydrological feature in high mountain karst systems with similar characteristics. Snowmelt favors the areal recharge of the system. This process is reflected in the large proportion of groundwater flowing through the connected porosity structure of the karst aquifer, which amounts the 75% of the total system water discharge. From the perspective of water resources recovery, the water capacity of the fissured-porous zone (matrix) represents 99% of the total karst system storage. The volume associated to the karst conduits is very small. The estimated mean travel times are 9 days for conduits and 475 days for connected porosity. These short travel times reveal high vulnerability of the karst system to pollutants in broad sense and a great impact of climate change on the associated water resources.

Results of a Pilates exercise program in patients with chronic non-specific low back pain: a randomized controlled trial.

OBJECTIVE: To investigate the effects of a Pilates exercise program on disability, pain, lumbar mobility, flexibility and balance in patients with chronic non-specific low back pain. DESIGN: Randomized controlled trial. SETTING: University laboratory. PARTICIPANTS: A total of 54 patients with chronic non-specific low back pain. INTERVENTION: Patients were randomly allocated to an experimental group ( n=27) included in a Pilates exercise program or to a control group ( n=27) receiving information in a form of a leaflet. MAIN OUTCOME MEASURES: Disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), current, average and pain at it least and at its worst (Visual Analogue Scales), lumbar mobility (modified Shober test), flexibility (finger-to-floor test) and balance (single limb stance test) were measured at baseline and after the intervention. RESULTS: A between-group analysis showed significant differences in the intervention group compared to the control group for both disability scores, the Rolland-Morris questionnaire (mean change±standard deviation of 5.31±3.37 and 2.40±6.78 respectively and between-groups mean difference of 3.2 ± 4.12, p=0.003) and the Oswestry Disability Index ( p<0.001), current pain ( p=0.002) and pain at it least ( p=0.033), flexibility (0.032) and balance (0.043). CONCLUSIONS: An 8-week Pilates exercise program is effective in improving disability, pain, flexibility and balance in patients with chronic non-specific low back pain.

Monoclonal antibody against Saint Louis encephalitis prM viral protein.

Saint Louis encephalitis virus belongs to Flavivirus genus; Flaviviridae family jointly with other medically important flaviviruses including dengue virus and West Nile virus. The biological properties and functions of prM flavivirus protein are under investigation due to its importance in the generation of infectious virion and host interactions. Monoclonal antibodies have become powerful tools in this approach. Also the use of monoclonal antibodies has been successfully applied for antigenic analysis, clinical diagnosis and treatments. Here, using an immunofluorescence assay we describe a monoclonal antibody (mAb 3D2) that uniquely recognizes native prM Saint Louis encephalitis virus protein expressed in either C6/36-HT or Vero cells. In conclusion, mAb3D2 has significant potential for use in (a) the diagnosis of infections caused by this virus and (b) therapeutic use to treat patients infected by this virus and fundamental research to understand the role of the prM in the Saint Louis encephalitis virus infectious process.

Valoración del dolor crónico de hombro en población mayor: un enfoque biopsicosocial / Assessment of chronic shoulder pain in the elderly population: A biopsychosocial approach

Introducción. La prevalencia de dolor crónico de hombro entre la población mayor es muy alta. Los objetivos de este estudio fueron establecer el perfil clínico del paciente con dolor crónico de hombro incorporando un enfoque biopsicosocial a la valoración del paciente y examinar la interacción entre discapacidad y variables físicas y psicológicas. Material y métodos. Estudio descriptivo en el que se incluyeron 70 personas mayores de 60 años que acudieron al Servicio de Rehabilitación del Hospital por presentar dolor crónico inespecífico de hombro con duración de los síntomas superior a 3 meses, sin comorbilidades motoras asociadas a la extremidad superior. Un fisioterapeuta valoró las variables físicas referentes al rango de movimiento, la dinamometría, la algometría y la intensidad del dolor. Los participantes completaron un cuestionario de creencias de evitación por temor, kinesiofobia y de percepción de discapacidad. La interacción entre estas variables se estableció mediante un análisis correlacional. Resultados. Se encontró una correlación negativa significativa (p < 0,05) entre las variables físicas y en los aspectos psicológicos relativos al cuestionario de evitación por temor y la escala de kinesiofobia. Una correlación significativa (p < 0,001) se encontró entre discapacidad y las variables físicas y psicológicas. Conclusión. Nuestros resultados apoyan la existencia de una relación entre discapacidad y variables físicas y psicológicas en el dolor crónico de hombro. Estos hallazgos refuerzan la idea de que una aproximación biopsicosocial es necesaria para adecuar la terapéutica al paciente (AU)

Introduction. The prevalence of chronic shoulder pain within the elderly population is very high. This study has aimed to establish the clinical profile of patients with chronic shoulder pain, incorporating a biopsychosocial approach for the assessment and to study the relationship between disability and physical and psychological variables. Material and methods. A descriptive survey in which 76 participants aged over 60 years old who came to rehabilitation in the hospital with non-specific chronic shoulder pain without motor comorbidities associated to the upper limbs and with a duration of more than 3 months was performed. A physical therapist assessed the physical variables regarding range of motion, dynamometry, algometry, and pain intensity. The participants also filled out a questionnaire on fear-avoidance beliefs, kinesiophobia, and perception of disability. A correlation analysis was conducted to determine the interaction between these variables. Results. A significant negative significant (P < .05) correlation was found between the physical variables and psychological aspects regarding the fear avoidance questionnaire and the Kinesiophobia scale. There was a significant correlation (P < .001) between disability and physical and psychological variables. Conclusion. Our results support the existence of a strong association between disability and psychological and physical variables in chronic shoulder pain. These findings reinforce the idea that a biopsychosocial approach is necessary to adapt the therapy to the patient (AU)

Effectiveness of different exercises and stretching physiotherapy on pain and movement in patellofemoral pain syndrome: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of proprioceptive neuromuscular facilitation combined with exercise, classic stretching physiotherapy intervention, and educational intervention at improving patient function and pain in patients with patellofemoral pain syndrome. DESIGN: Randomized, controlled, blind trial over four months. SETTING: Urban population, Spain. PARTICIPANTS: Patients undergoing primary care for retropatellar pain. INTERVENTION: Subjects were allocated on three different treatment options: a proprioceptive neuromuscular facilitation and aerobic exercise group, a classic stretching group, and a control treatment were applied over four months under the supervision of a physiotherapist. MAIN OUTCOME: Knee Society Score, pain reported (Visual analogue scale) and knee range of motion. Assessments were completed at baseline and after four months. RESULTS: 74 patients were enrolled in the study and distributed between groups. Both the proprioceptive neuromuscular facilitation and classic stretching group showed significant changes in all variables after four months intervention (p < 0.001). The difference in mean Kujala knee score changes between groups (classic stretching group vs. proprioceptive neuromuscular facilitation group vs. control group) at four months was -24.05 (95% confidence interval (CI) -30.19, -17.90), p ≤ 0.001; vs. -39.03 (95% confidence interval (CI) -42.5, -35.5), p ≤ 0.001; vs. -0.238 (95% confidence interval (CI) -1.2, 0.726), p = 0.621, respectively. CONCLUSIONS: A proprioceptive neuromuscular facilitation intervention protocol combined with aerobic exercise showed a better outcome than a classic stretching protocol after four months.

La función pulmonar, factores físicos que la determinan y su importancia para el fisioterapeuta / Pulmonary function. the physical factors that determine it and its importance for the physiotherapist

Introducción. El fisioterapeuta emplea, dentro de sus herramientas de valoración, aquellas destinadas a la medición de la función pulmonar. Todos los factores que afectan la función pulmonar deben ser conocidos de manera exhaustiva por el fisioterapeuta. Este trabajo pretende esclarecer aquellos factores, de carácter físico, que condicionan la función pulmonar. Objetivo. Revisar la bibliografía disponible que relacione los factores físicos que influyen en la función pulmonar. Estrategia de búsqueda. Revisión bibliográfica sistemática en las bases de datos: CINAHL, ScienceDirect, Ovid, Scopus y PubMed. Con antigüedad inferior a 25 años. Síntesis de resultados. Se obtuvo un número total de 90 artículos. Los autores han reconocido que entre los factores físicos de la función pulmonar se encuentran la edad, el sexo, la talla, el peso y el grupo étnico. A estos factores se han sumado en los últimos años, gracias a numerosos autores, los musculoesqueléticos, como la morfología de la caja torácica y el desarrollo muscular. Conclusiones. Los diferentes estudios asocian la edad, el sexo, la raza, el peso y la altura, y los factores musculoesqueléticos torácicos a la función pulmonar. Sin embargo, son necesarios más estudios que expliquen esta influencia (AU)

Introduction: Within their assessment tools, the physical therapist uses those designated for the measurement of lung function. Having extensive knowledge about the physical factors affecting normal lung function is important for the physical therapist. This paper aims to clarify those physical factors that condition pulmonary function. Aims: To review the bibliography available that relate the physical factors having an influence on pulmonary function. Search strategy: The search was made with the following databases: CINAHL, Ovid, Scopus, ScienceDirect and PubMed, with time antiquity limited to the last 25 years. Synthesis of results: A total of 90 articles were obtained from the search. The authors have stated that physical factors of pulmonary function include age, sex, height, weight and ethnic group. In recent year, many authors have also added musculoskeletal factors, morphology of the thoracic cavity and muscle development. Conclusions: The different studies associate age, sex, race, height and weight and thoracic musculoskeletal factors to pulmonary function. However, more studies are needed to explain this influence (AU)

Linfangiomatosis pulmonar difusa con afectación mediastínica / Diffuse pulmonary lymphangiomatosis with mediastinal affectation

No disponible

Monoclonal antibody to dengue capsid protein: its application in dengue studies.

Dengue fever (DF) and dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) are considered the most important arthropod-borne viral diseases in terms of morbidity and mortality. The emergency and severity of dengue (Den) infections increase the necessity of an early, quick and effective dengue laboratory diagnostic. Viral isolation is considered a gold standard for diagnosis of dengue infection using monoclonal antibodies (mAbs) as a tool for determining serotype specificity. Alternatives have been used to improve sensitivity and time to dengue diagnosis. Based on the early expression of dengue C protein in the life cycle, we focused our study on the application of an anti-dengue 2 virus capsid protein mAb in dengue diagnosis. The kinetic expression of dengue-2 capsid in mosquito cells and its immuno-localization in experimentally infected suckling albin Swiss (OF-1) mice brain tissues was established. The results demonstrate the possible utility of this mAb in early dengue diagnosis versus traditional isolation. In addition, a preliminary study of an enzyme immunoassay method using 8H8 mAb for specific detection of dengue C protein antigen was performed, making possible recombinant C protein quantification. The results suggest that detection of dengue capsid protein could be useful in the diagnosis of early dengue infection.

Una mirada al examen profesional por áreas de conocimiento en la licenciatura en Enfermería / A look into the baccalaureate of nursing professional exam by areas of knowledge

El Examen General por Áreas de Conocimiento (EPAC) es una opción de titulación que ofrece la Escuela Nacional de Enfermería y Obstetricia de la UNAM a estudiantes de los sistemas escolarizado; abierto e incorporado; para obtener el grado de licenciatura o profesional técnico en Enfermería. El propósito del artículo es socializar y evidenciar el trabajo realizado con el EPAC de nivel licenciatura a partir de la creación de la Unidad de Apoyo para la Evaluación de los Aprendizajes. Ello ha permitido; con el trabajo de un equipo multidisciplinar; mejorar el proceso del examen; hacer innovaciones informáticas y administrativas; mantener un apoyo educativo directo y confiable tanto a instituciones participantes como a sustentantes. Los resultados que se muestran fueron extraídos de las cuatro aplicaciones realizadas hasta el año 2006; las que se juzgaron a partir de estudios de tipo descriptivo y transversal; con muestra censal. Es innegable que el trabajo permanente con este proceso reorientará las acciones para una mejora continua; que posibiliten altos estándares de confiabilidad lo que garantizará la obtención de resultados más objetivos y oportunos.

The General Test by Knowledge Areas (EPAC) is an option for obtaining the nurse licentiate or technician degree that the National Nursery and Obstetrics School (ENEO, UNAM) offers to the students of the traditional, open and incorporated systems. The purpose of this article is to share what has been done regarding the licentiate level EPAC since the Support Unit for Knowledge Evaluation was created. This has allowed, with the work of a multidisciplinary team, to improve the general exam process, to attain computer and administrative innovations and to give a direct, realiable educative support to both institutions and individual participants. The results shown in this article proceed from the four exams presented until the year 2006, which were judged based on descriptive, transversal studies with census sample. It is undeniable that the permanent work with this process will redirect the actions for a continuous improvement, that will allow high reliability standards that guarantee the attainment of more objective, convenient results.

[Epidermoid carcinoma of the larynx: anatomo-pathological results of 58 cases]. / Carcinoma epidermoide de laringe: resultados anatomopatológicos en 58 casos.

In this study was considered 58 patients diagnosed of squamous cell carcinoma of larynx and operated between 1991 and 1996 at the Ear Nose and Throat Service of the University Hospital Complex of Santiago de Compostela. They are all men but one female and the biggest percentage were T2 (39.7%) and T3 (37.9%) tumours. The macroscopic characters such as the average diameter of the pieces was 6.91 cm and 2.66 cm of the tumour. The most usual tumoral shape encounter was exofitic and ulcerous. And between the microscopic characters we valued the histologic grade of differentiation and the most usual were the well (44.8%) and moderated (41.4%) differentiated. The average of mitosis was 20.6 and 31 tumours presented necrosis.

Quantitative ELISA for mouse monoclonal antibody determination in culture supernatants and in human serum.

An ELISA has been set up for quantifying mouse monoclonal antibodies in culture supernatant. The assay includes rabbit anti-mouse IgG antibodies chromatographycally purified. This preparation was used as coating and as conjugated antibodies in the ELISA. The assay can detect IgG1 with sensitivity of 0.2 ng/mL, IgG2a (0.85 ng/mL), IgG2b (0.13 ng/mL), and IgG3 (3.19 ng/mL) in culture supernatants. The effective working range was from subnanogram per mL quantities to 30 ng/mL by using a computer statistical program. Variation coefficient of ELISA was below 7%. Correlation estimates with a similar ELISA using commercial reagents were performed for each mouse antibody subclass. The assay was able to detect the four mouse monoclonal antibody subclasses in pure human serum as compared with the same ELISA using commercial antibodies. A 24-h pharmacokinetic profile of 1 patient treated with an IgG2a monoclonal antibody is presented.