Inestabilidad anterior de hombro con defecto óseo no crítico: ¿Bankart-Remplissage o Latarjet? / Anterior shoulder instability with non critical bone loss: Bankart-Remplissage or Latarjet?

Resumen: Introducción: Los defectos óseos se asocian a inestabilidad de hombro recidivante. Bankart-Remplissage (B+R) y Latarjet (L) son alternativas de tratamiento. Pocos estudios comparan ambas técnicas. Objetivo: Comparar evolución funcional, complicaciones y tasa de recidiva, entre B+R y L en pacientes con inestabilidad glenohumeral anterior con defecto óseo no crítico. Material y métodos: Estudio retrospectivo de cohortes, en pacientes operados entre 2010 y 2018. Ciento siete pacientes fueron reclutados, de éstos, se obtuvo información desde su ficha clínica. Se midió tamaño de Hill-Sachs (HS) y defecto glenoideo en tomografía axial computarizada (TAC). Se envió encuesta remota evaluando funcionalidad con SSV, WOSI, EVA y qDASH. Cuarenta y ocho pacientes completaron el seguimiento remoto (26 B+R y 22 L). Media de seguimiento de 3.8 años. Resultados: Al comparar ambos grupos no hubo diferencias significativas en WOSI, EVA, qDASH ni SSV. No hubo diferencia en el número de complicaciones (B+R: 13 [18.8%], L: 5 [13.2%], p = 0.16), reoperaciones (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41) ni reluxación (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41). En pacientes que realizan deporte de contacto o colisión, L tuvo mejor SSV (92.5 vs 72.5 p = 0.048) y WOSI total (98.3 vs 67.3 p = 0.043). B+R en extremidad dominante presentó mayor tasa de complicaciones (50 vs 9.1% p = 0.038). No se encontró asociación para complicaciones y reluxación según defecto glenoideo o número de luxaciones previo a cirugía. Conclusión: Bankart-Remplissage y Latarjet tienen similar resultado funcional y tasa de reluxación en nuestros grupos estudiados. Latarjet muestra mejor resultado funcional subjetivo en deportistas de contacto y menores complicaciones en extremidad dominante.

Abstract: Introduction: Significant Hill-Sachs lesions are associated with recurrent shoulder instability. Bankart-Remplissage (B+R) and Latarjet (L) are valid treatments for these injuries. Few studies compare both techniques. Objective: To compare functional outcome, complications and recurrent instability rate between B+R and L in patients operated for anterior shoulder instability (ASI) with significant Hill-Sachs (HS) lesions and non critical glenoid bone loss (NC-GBL). Material and methods: Retrospective cohort study with patients operated between 2010 and 2018 for ASI. 107 met inclusion criteria. Demographic data, complications, recurrence rate and subsequent procedures were obtained from their medical records. CT scan imaging was used to assess humeral and glenoid bone loss. Online questionnaires were sent for assesing functional outcomes with SSV, WOSI, VAS and qDASH. 48 patients completed the online assessment (26 B+R, 22 L). The mean follow-up was 3.8 years. Results: Comparing both groups, there were no differences in WOSI, SSV, EVA and qDASH. There was no difference in complication rate (B+R: 13 [18.8%], L: 5 [13.2%], p = 0.16), revisions (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41) and recurrent instability (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41). L in subgroup who practiced collision sports had better SSV (92.5 vs 72.5 p = 0.048) and WOSI (98.3 vs 67.3 p = 0.043). B+R in dominant extremity had worst complication rate (50 vs 9.1% p = 0.038). Association was not found between complications and recurrent instabillity according to glenoid bone defect or previous dislocation episodes. Conclusion: Significant Hill-Sachs lesions with NC-GBL, both Bankart-Remplissage and Latarjet achieve satisfactory results, with similar recurrent instability and functional outcomes. Latarjet has better subjetive funtional results in collision sports and less complication in dominant extremity compared to Bankart-Remplissage.

[Anterior shoulder instability with non critical bone loss: Bankart-Remplissage or Latarjet?] / Inestabilidad anterior de hombro con defecto óseo no crítico: ¿Bankart-Remplissage o Latarjet?

INTRODUCTION: Significant Hill-Sachs lesions are associated with recurrent shoulder instability. Bankart-Remplissage (B+R) and Latarjet (L) are valid treatments for these injuries. Few studies compare both techniques. OBJECTIVE: To compare functional outcome, complications and recurrent instability rate between B+R and L in patients operated for anterior shoulder instability (ASI) with significant Hill-Sachs (HS) lesions and non critical glenoid bone loss (NC-GBL). MATERIAL AND METHODS: Retrospective cohort study with patients operated between 2010 and 2018 for ASI. 107 met inclusion criteria. Demographic data, complications, recurrence rate and subsequent procedures were obtained from their medical records. CT scan imaging was used to assess humeral and glenoid bone loss. Online questionnaires were sent for assesing functional outcomes with SSV, WOSI, VAS and qDASH. 48 patients completed the online assessment (26 B+R, 22 L). The mean follow-up was 3.8 years. RESULTS: Comparing both groups, there were no differences in WOSI, SSV, EVA and qDASH. There was no difference in complication rate (B+R: 13 [18.8%], L: 5 [13.2%], p = 0.16), revisions (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41) and recurrent instability (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41). L in subgroup who practiced collision sports had better SSV (92.5 vs 72.5 p = 0.048) and WOSI (98.3 vs 67.3 p = 0.043). B+R in dominant extremity had worst complication rate (50 vs 9.1% p = 0.038). Association was not found between complications and recurrent instabillity according to glenoid bone defect or previous dislocation episodes. CONCLUSION: Significant Hill-Sachs lesions with NC-GBL, both Bankart-Remplissage and Latarjet achieve satisfactory results, with similar recurrent instability and functional outcomes. Latarjet has better subjetive funtional results in collision sports and less complication in dominant extremity compared to Bankart-Remplissage.

INTRODUCCIÓN: Los defectos óseos se asocian a inestabilidad de hombro recidivante. Bankart-Remplissage (B+R) y Latarjet (L) son alternativas de tratamiento. Pocos estudios comparan ambas técnicas. OBJETIVO: Comparar evolución funcional, complicaciones y tasa de recidiva, entre B+R y L en pacientes con inestabilidad glenohumeral anterior con defecto óseo no crítico. MATERIAL Y MÉTODOS: Estudio retrospectivo de cohortes, en pacientes operados entre 2010 y 2018. Ciento siete pacientes fueron reclutados, de éstos, se obtuvo información desde su ficha clínica. Se midió tamaño de Hill-Sachs (HS) y defecto glenoideo en tomografía axial computarizada (TAC). Se envió encuesta remota evaluando funcionalidad con SSV, WOSI, EVA y qDASH. Cuarenta y ocho pacientes completaron el seguimiento remoto (26 B+R y 22 L). Media de seguimiento de 3.8 años. RESULTADOS: Al comparar ambos grupos no hubo diferencias significativas en WOSI, EVA, qDASH ni SSV. No hubo diferencia en el número de complicaciones (B+R: 13 [18.8%], L: 5 [13.2%], p = 0.16), reoperaciones (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41) ni reluxación (B+R: 4 [5.7%], L: 1 [2.6%], p = 0.41). En pacientes que realizan deporte de contacto o colisión, L tuvo mejor SSV (92.5 vs 72.5 p = 0.048) y WOSI total (98.3 vs 67.3 p = 0.043). B+R en extremidad dominante presentó mayor tasa de complicaciones (50 vs 9.1% p = 0.038). No se encontró asociación para complicaciones y reluxación según defecto glenoideo o número de luxaciones previo a cirugía. CONCLUSIÓN: Bankart-Remplissage y Latarjet tienen similar resultado funcional y tasa de reluxación en nuestros grupos estudiados. Latarjet muestra mejor resultado funcional subjetivo en deportistas de contacto y menores complicaciones en extremidad dominante.

Melanoma maligno gastrointestinal de origen primario desconocido: reporte de caso / A case report of malignant gastrointestinal melanoma of unknown primary origin

Resumen Una de las características inusuales del melanoma cutáneo es la capacidad de metastatizar en el intestino delgado. A menudo se diagnostica durante la autopsia, en la cual se ha encontrado depósitos metastásicos en el 50%-60% de los casos, pero menos del 2% al 4% de los pacientes con diagnóstico de melanoma tiene metástasis gastrointestinal (GI) durante el curso de la enfermedad y entre el 4%-9% de casos de melanoma GI tiene un primario desconocido. La rápida identificación y resección del melanoma en el tracto digestivo podría mejorar la tasa de supervivencia en aquellos pacientes en los que se presentan complicaciones, como obstrucción intestinal. Se presenta un caso clínico de melanoma gastrointestinal de origen primario desconocido. El porcentaje de este tipo de casos es poco frecuente. La paciente presentó cuadro clínico de náuseas, hiporexia, epigastralgia, fatiga, parestesias en región dorsal derecha y disminución de 9 kilogramos en 3 semanas. Le realizaron tomografía computarizada (TAC) de abdomen contrastado, que reportó 3 lesiones en hígado de predominio isodenso en el parénquima, con algunas áreas de menor densidad al interior, localizadas en los segmentos 2, 5, 7 y 8 del hígado al que se le realizó la biopsia. Se llevó a cabo endoscopia de vías digestivas altas con biopsia de 2 lesiones hiperpigmentadas en la segunda porción de duodeno. El examen histopatológico de las biopsias evidenció melanoma maligno. Se excluyeron todas las localizaciones típicas de melanoma primario durante el procedimiento diagnóstico.

Abstract One of the unusual characteristics of cutaneous melanoma is its ability to metastasize in the small intestine. It is often diagnosed during autopsies of cutaneous melanoma patients. Metastatic deposits have been found in 50% to 60% of these autopsies, but less than 2% to 4% of patients diagnosed with melanoma have gastrointestinal metastasis during the course of the disease. Between 4% and 9% of gastrointestinal melanoma cases have unknown primary tumors. Rapid identification and resection of melanoma in the digestive tract could improve the patient survival rate and prevent complications such as intestinal obstructions from occurring. We present a rare clinical case of gastrointestinal melanoma of unknown primary origin. The patient had a clinical picture of nausea, hyporexia, epigastralgia, fatigue, paresthesias in the right dorsal region and had lost nine kilograms in three weeks. An abdominal CT scan showed three predominantly isodense liver lesions in the parenchyma, with some areas of lower density located in segments 2,5,7 and 8 of the liver. These were biopsied. Upper digestive tract endoscopy took biopsy samples of two hyperpigmented lesions in the second portion of the duodenum. Histopathological examination showed malignant melanoma. All typical locations of primary melanoma were excluded during the diagnostic procedure.

Thermal diffusivity measurement in thin metallic filaments using the mirage method with multiple probe beams and a digital camera.

Photothermal beam deflection is a well-established technique for measuring thermal diffusivity. In this technique, a pump laser beam generates temperature variations on the surface of the sample to be studied. These variations transfer heat to the surrounding medium, which may be air or any other fluid. The medium in turn experiences a change in the refractive index, which will be proportional to the temperature field on the sample surface when the distance to this surface is small. A probe laser beam will suffer a deflection due to the refractive index periodical changes, which is usually monitored by means of a quadrant photodetector or a similar device aided by lock-in amplification. A linear relationship that arises in this technique is that given by the phase lag of the thermal wave as a function of the distance to a punctual heat source when unidimensional heat diffusion can be guaranteed. This relationship is useful in the calculation of the sample's thermal diffusivity, which can be obtained straightforwardly by the so-called slope method, if the pump beam modulation frequency is well-known. The measurement procedure requires the experimenter to displace the probe beam at a given distance from the heat source, measure the phase lag at that offset, and repeat this for as many points as desired. This process can be quite lengthy in dependence of the number points. In this paper, we propose a detection scheme, which overcomes this limitation and simplifies the experimental setup using a digital camera that substitutes all detection hardware utilizing motion detection techniques and software digital signal lock-in post-processing. In this work, the method is demonstrated using thin metallic filaments as samples.

Biogeographical patterns of bacterial and archaeal communities from distant hypersaline environments.

Microorganisms are globally distributed but new evidence shows that the microbial structure of their communities can vary due to geographical location and environmental parameters. In this study, 50 samples including brines and sediments from Europe, Spanish-Atlantic and South America were analysed by applying the operational phylogenetic unit (OPU) approach in order to understand whether microbial community structures in hypersaline environments exhibited biogeographical patterns. The fine-tuned identification of approximately 1000 OPUs (almost equivalent to "species") using multivariate analysis revealed regionally distinct taxa compositions. This segregation was more diffuse at the genus level and pointed to a phylogenetic and metabolic redundancy at the higher taxa level, where their different species acquired distinct advantages related to the regional physicochemical idiosyncrasies. The presence of previously undescribed groups was also shown in these environments, such as Parcubacteria, or members of Nanohaloarchaeota in anaerobic hypersaline sediments. Finally, an important OPU overlap was observed between anoxic sediments and their overlaying brines, indicating versatile metabolism for the pelagic organisms.

Effects of an Educational Intervention on Breast Self-Examination, Breast Cancer Prevention-Related Knowledge, and Healthy Lifestyles in Scholars from a Low-Income Area in Bogota, Colombia.

The aim of this study was to evaluate the effects of an educational intervention on breast self-examination, cancer prevention-related knowledge, practices, and behavior change in scholars from a low-income area in Bogota, Colombia. Uncontrolled trial was conducted in 155 scholars. Two educational sessions, 90 min each, were carried out in March 2015 according to the Colombian guidelines for educational communication in the framework of cancer control. All participants completed a self-reported questionnaire at pre- and post-intervention, as well as 1, 3, and 6 months after the intervention. Breast self-examination was practiced by 78.1% of the scholars, and the overall knowledge of breast cancer risk factors was poor. The educational intervention resulted in significant improvements on breast self-examination practice, the knowledge of the technique, and the knowledge of the main risk factors for breast cancer as well as the practice of physical activity and vegetable intake at 6 months follow-up. An educational intervention according to the Colombian guidelines for educational communication in the framework of cancer control improved the practice of breast self-examination, cancer prevention-related knowledge, as well as the practice of physical activity and vegetable consumption in scholars from a low-income area in Bogota, Colombia. Further randomized controlled studies are warranted.

Pressurized liquid extraction of Neochloris oleoabundans for the recovery of bioactive carotenoids with anti-proliferative activity against human colon cancer cells.

In recent years, the green microalgae Neochloris oleoabundans have demonstrated to be an interesting natural source of carotenoids that could be used as potential food additive. In this work, different N. oleoabundans extracts obtained by pressurized liquid extraction (PLE) have been analyzed in depth to evaluate the influence of different culture conditions (effect of nitrogen, light intensity or carbon supplied) not only on the total carotenoid content but also on the carotenoid composition produced by these microalgae. Regardless of the cultivation conditions, lutein and carotenoid monoesters were the most abundant carotenoids representing more than 60% of the total content in all extracts. Afterwards, the effect of the different N. oleoabundans extracts and the dose-effect of the most potent algae extracts (namely, N9, PS and CO2 (-)) on the proliferation of human colon cancer cells lines (HT-29 and SW480) and a cell line established from a primary colon cancer cell culture (HGUE-C-1) were evaluated by an MTT assay whereas a stepwise multiple regression analysis was performed to get additional evidences on the relationship between carotenoid content and the antiproliferative activity. Results revealed that, as a general trend, those extracts with high total carotenoid content showed comparably antiproliferative activity being possible to establish a high correlation between the cell proliferation values and the carotenoid constituents. Monoesters showed the highest contribution to cell proliferation inhibition whereas lutein and violaxanthin showed negative correlation and diesters and zeaxanthin showed a positive significant contribution to cell proliferation.

Infección por adenovirus en el Hospital de niños Roberto del Río 2016 / Adenovirus infection at the Roberto del Río children's Hospital 2016

En los meses de invierno, las enfermedades respiratorias representan la primera causa de hospitalización en hospitales pediátricos. La mayoría de estas enfermedades son causadas por virus, dentro de los cuales se encuentra el adenovirus (AdV), el cual puede generar infecciones diseminadas graves, secuelantes e incluso letales y se caracteriza por tener una rápida transmisión entre pacientes, generando brotes intrahospitalarios. Se identificó a 54 pacientes hospitalizados con infección por adenovirus en el periodo de marzo-julio del 2016 con una edad promedio de 18,3 meses, de los cuales 23 casos fueron infecciones asociadas a la atención de salud (IIAS) y 2 tuvieron desenlace fatal. Los casos de IIAS, se asociaron a una mayor tasa de hospitalización prolongada (p= <0.01), ingreso a UPC (p= <0.01) y uso de ventilación mecánica (p= <0.01). No se encontró asociación entre la presencia de antecedentes mórbidos con el desarrollo de IIAS. Las IIAS por adenovirus se asocia a una hospitalización prolongada, ingreso de unidades de alta complejidad y necesidad de uso de ventilación mecánica. Dado que el adenovirus se transmite a través de contactos directo, aerosoles y fómites, las medidas básicas de precaución de contacto y de aislamiento permiten reducir los contagios nosocomiales, recayendo la responsabilidad en todo el equipo de salud a cargo.

Respiratorio deseases are frequent in winter times. being the main cause of hospital admissions. Viral infecciones are the main etiology, and adenovirus infección clould lead to severe disease, with cross infections. We identified 54 patients admitted to the Roberto del Río Childrens hospital in 2016, with a mean age of 18,3 months old; 23 cases where nosocomial infection, and 2 were fatal. Hospital acquired adenovirus infection were associated to long hospital stay (p= <0.01), intensive care admission (p= <0.01) and ventilatory support (p= <0.01). We did not find previous illness conditions. Adenovirus hospital acquired infection is associated with longer hospital stay and dead. Adenovirus is transmitted with direct contact, aerosols and fomites, therefore basic contact precautions are important.

Non-invasive metabolomics for improved determination of embryonic sex markers in chemically defined culture medium.

Metabolic differences between early male and female embryos can be reflected in culture medium (CM). We used a single bovine embryo culture step (24h) supporting improved birth rates under chemically defined conditions (CDC) to investigate biomarker detection of embryonic sex in contrast to classical BSA-containing medium. In vitro matured slaughterhouse oocytes were fertilized in vitro with a single bull. Embryos were initially cultured in synthetic oviduct fluid with BSA. On day-6, morulae were cultured individually in droplets with (BSA) or without protein (CDC). On day-7, expanded blastocysts were sexed (amelogenin gene amplification) and CM was stored at -145°C until metabolomic analysis by UHPLC-TOF MS. N=10 embryos per group (i.e. male-protein; female-protein; male-non-protein; female-non-protein) were produced. Statistical analysis revealed N=6 metabolites with different concentrations in CM, N=5 in male embryos (methionine, tryptophan, N-stearoyl-valine, biotin and pipecolic acid), N=1 in female embryos (threonine) (P<0.05 in BSA; P<10-7 in CDC). Only the clear threshold between males and females in CDC allowed correct classification of 100% males and 91% females within 5 out of 6 biomarkers (one female outlier showing the male biomarker profile). The use of CDC represents a critical aspect in the efficient detection of embryonic sex biomarkers by metabolomics.

Technical note: Comparison of automated ribosomal intergenic spacer analysis and denaturing gradient gel electrophoresis to assess bacterial diversity in the rumen of sheep.

The aim of this study was to compare automated ribosomal intergenic spacer analysis (ARISA) and denaturing gradient gel electrophoresis (DGGE) techniques to assess bacterial diversity in the rumen of sheep. Sheep were fed 2 diets with 70% of either alfalfa hay or grass hay, and the solid (SOL) and liquid (LIQ) phases of the rumen were sampled immediately before feeding (0 h) and at 4 and 8 h postfeeding. Both techniques detected similar differences between forages, with alfalfa hay promoting greater (P < 0.05) bacterial diversity than grass hay. In contrast, whereas ARISA analysis showed a decrease (P < 0.05) of bacterial diversity in SOL at 4 h postfeeding compared with 0 and 8 h samplings, no variations (P > 0.05) over the postfeeding period were detected by DGGE. The ARISA technique showed lower (P < 0.05) bacterial diversity in SOL than in LIQ samples at 4 h postfeeding, but no differences (P > 0.05) in bacterial diversity between both rumen phases were detected by DGGE. Under the conditions of this study, the DGGE was not sensitive enough to detect some changes in ruminal bacterial communities, and therefore ARISA was considered more accurate for assessing bacterial diversity of ruminal samples. The results highlight the influence of the fingerprinting technique used to draw conclusions on factors affecting ruminal bacterial diversity.

The angiogenesis promoter, proadrenomedullin N-terminal 20 peptide (PAMP), improves healing in both normoxic and ischemic wounds either alone or in combination with autologous stem/progenitor cells.

A combination of vascular pathologies and other complicating factors results in chronic wounds which constitute a serious burden for both patients and national health systems, due to prolonged hospital stays, high costs, and prolonged nursing staff dedication. Here we investigate whether proadrenomedullin N-terminal 20 peptide (PAMP), a naturally occurring peptide of the skin with antimicrobial and proangiogenic properties, either alone or in combination with autologous skeletal muscle stem/progenitor cells, acts as a wound healing factor. The rabbit ear was chosen as a test system, since it offers a reliable model for normoxic and ischemic wounds. Topical treatments with PAMP, stem/progenitor cells, or a combination of both, resulted in significant improvements of healing, when compared to untreated wounds. PAMP was very effective in promoting reepithelialization and angiogenesis, whereas treatment with stem/progenitor cells alone resulted in less wound contraction. Interestingly, the combination of PAMP and stem/progenitor cells, while maintaining angiogenic potency, reverted to the contraction levels observed in the untreated controls. Under ischemic conditions, generalized necrosis of the dermis and the underlying cartilage was observed in untreated wounds. Treatments of these wounds with PAMP or stem/progenitor cells allowed a timely recovery. In conclusion, PAMP either alone or in combination with autologous stem/progenitor cells may provide a useful tool for improving wound healing both in normoxic and ischemic conditions.

Immune response to the long-term grafting of cryopreserved small-diameter arterial allografts.

INTRODUCTION: The viability and immunological response induced by cryopreserved arterial allografts remain unclear. This study examines the post-graft behaviour of this type of vessel substitute. MATERIALS AND METHODS: Both iliac arteries were extracted from Lewis rats (donors) and used to establish groups of allogeneic fresh (group I) or cryopreserved (group II) grafts in Fisher-344 rats (recipients). Cryopreserved segments for grafting were prepared by automated controlled freezing at a cooling rate of 1°C/min followed by storage in liquid nitrogen vapour at -145°C for 30 days. Before grafting, the vessels were slowly thawed. Animals were sacrificed at 14, 30, 90 and 180 days post-surgery when graft specimens were obtained for light and electron microscopy and immunohistochemical detection of inflammatory cells (CD45, ED1, CD4, CD8). RESULTS: After surgery, 85.71% of the grafts in group I and 82.14% in group II were patent. Following long-term implant, both the fresh and cryopreserved allografts showed complete loss of the muscle compartment of the media. Inflammatory or CD45-positive cells (mainly macrophages and CD8 T-lymphocytes) were detected at earlier time points in suture zones and adventitia. In the fresh allografts, the number of immunolabelled cells steadily increased until they were seen to occupy the entire adventitia at 90 days, with high numbers persisting at 6 months. In the cryopreserved allografts, this adventitial inflammatory infiltrate was significantly reduced. CONCLUSIONS: The cryopreservation/slow thawing protocol used diminished the immune response induced by fresh arterial allografts improving their behaviour after grafting.

Advanced analysis of nutraceuticals.

In this article, we present a review work on different nutraceuticals found in natural matrices together with the analytical techniques used to identify and/or quantify them with special emphasis in the period January 2005-May 2010. The work is distributed according to the different families of nutraceuticals (lipids, vitamins, proteins, glycosides, phenolic compounds, etc.) discussing the analytical techniques employed for their determination (separation, spectroscopic, hyphenated techniques, etc.). Information about the claimed health promoting effects of the different families of nutraceuticals is also provided together with data on the natural matrices in which they can be found (e.g., fruits, vegetables, plants, microalgae, cereals, milk, etc.).

Role of lysyl oxidases in neointima development in vascular allografts.

BACKGROUND: Extracellular matrix deposition is the main factor inducing stenotic lesions in arterial grafts. Lysyl oxidases (LOX) play a key role in stabilizing collagen and elastin. OBJECTIVE: To examine the repair response to arterial allografts in terms of LOX expression and collagen/elastin deposition using LOX inhibitors. METHODS: Lewis/Fisher-344 rats were used as donors/recipients. Donor segments were grafted to the right iliac artery of recipients and retrieved 14/30 (short-term) or 90/180 days (long-term) after surgery. One group of animals was injected with a potent irreversible LOX inhibitor daily for 30 days. RESULTS: Intimal hyperplasia increased in thickness until 90/180 days postsurgery. Elastin showed great expression in the neointima at 14/30 days and in the media at 90/180 days. LOX/LOXL1 were similarly expressed in the arterial wall during the first month. In the long term, their overexpression was confined to neointimal layers. At 14 days, collagen types I/III were identified in the grafts. The neointima acquired collagen I over time. In the group of animal treated with the LOX inhibitor, intimal hyperplasia was significantly inhibited. CONCLUSION: LOX were overexpressed in late stages of intimal hyperplasia in the allografts. LOX inhibitors prevented the development of the neointimal layer, such that their modulation could reduce the excessive extracellular matrix deposition that leads to stenosis.

Componentes ocupacionales a evaluar en el proceso de tratamiento y rehabilitación del consumo problemático de drogas / Assessment of occupational components in the treatment and rehabilitation process of problematic drug abuse

La recolección de datos se llevó a cabo a través de la revisión de la literatura existente sobre el tema y una entrevista semiestructurada a siete Terapeutas Ocupacionales, con experiencia en el área de estudio. La entrevista se centró en los siguientes temas: Componentes Ocupacionales evaluados por terapeutasocupacionales durante el proceso de Tratamiento y Rehabilitación, modelos y evaluaciones utilizadas por terapeutas ocupacionales y Componentes Ocupacionales que muestran mayor déficit. Los resultados de esta investigación revelaron que la mayoría de los terapeutas ocupacionales evalúan los componentes ocupacionales de rutina/hábitos, roles, volición, tiempo libre e historia laboral en la etapa de ingreso a Centros de Tratamiento y Rehabilitación. Los resultados también revelaron una carencia de modelos y evaluaciones adecuadas y específicas desde la Terapia Ocupacional en el tema de estudio. Este estudio concluye en que existe una carencia de homogeneidad en el lenguaje, instrumentos de evaluación y los modelos utilizados entre Terapeutas Ocupacionales en los distintos Centros de Tratamiento y Rehabilitación.

This research topic is framed within the field of occupational therapy and problematic drug abuse. The purpose of this qualitative study is to explore what occupational components occupational therapists assess in the process of treatment and rehabilitation of problematic drug abuse. The study also explores the models and assessments used during this process. The participants were selected out of the list of Treatment and Rehabilitation Centers, that provides Occupational Therapy intervention in an Intensive Outpatient Program. This list was obtained from thedatabase of the National Council for Narcotics Control (CONACE). Data was collected through literature review on the topic and semi-structured interviews with seven Occupational Therapists with experience in the field of Drug Addiction Treatment and Rehabilitation. Theinterviews focused on the following topics: occupational components that are assessed for occupational therapists during the process of Treatment and Rehabilitation, models or theoretical frameworks and assessments used during this process and occupational components most affected. The results revealed that the majority of occupational therapists evaluate the occupational components of routine / habits, roles, volition, leisure and work history at the stage of admission to Treatment and Rehabilitation Centers. In addition, the results reveal a lack of appropriate and specific models andassessments from the occupational therapy perspective within the field of drug abuse. This study concludes that there is a lack of homogeneity in language, assessment tools and models used between the Occupational Therapists working in the Treatment and Rehabilitation Centers.

[Clinical use of diagnostic tests (Part 1): Analysis of the properties of a diagnostic test]. / Uso de tests diagnósticos en la práctica clínica (Parte 1): Análisis de las propiedades de un test diagnóstico.

Diagnostic tests are widely used in clinical practice. Qualitative analysis of diagnostic test properties (validity, reproducibility and safety) has been systematized using clinical epidemiology tools that have introduced a series of concepts such as sensitivity, specificity and predictive values. Based on data reported by a clinical investigation, the present article illustrates the theoretical background underlying these concepts, explains the methodology for their calculation, and analyzes their main strengths and limitations. A second article (Part 2: Clinical application and usefulness of a diagnostic test), describes the manner in which information provided by a test should be applied in order to correctly resolve a clinical dilemma.

Uso de tests diagnósticos en la práctica clínica (Parte 2): Aplicación clínica y utilidad de un test diagnóstico / Clinical use of diagnostic tests (Part 2): Clinical application and usefulness of a diagnostic test

La utilidad clínica de un test diagnóstico se califica de acuerdo a la magnitud en la que éste contribuye a modificar la probabilidad pre test de ocurrencia de un determinado diagnóstico. Para tales efectos, el cálculo y aplicación de razones de verosimilitud (likelihood ratios, LR) constituye una herramienta de gran utilidad. Cada resultado posible de un test posee un LR, a partir del cual es posible estimar cuánto aumenta o disminuye la probabilidad pre test, permitiendo al clínico descartar un diagnóstico, confirmarlo o bien continuar su investigación mediante la solicitud de nuevos exámenes. En la primera parte del presente artículo se analizaron las propiedades de un test diagnóstico (validez, reproducibilidad y seguridad). En esta segunda parte se ilustra el sustrato teórico subyacente al concepto de LR, se explica su metodología de cálculo y se describe su aplicación clínica.

The clinical usefulness of a diagnostic test is determined by the extent to which it helps to modify the pretest probability of occurrence of a certain diagnosis. For this purpose, the calculation and application of likelihood ratios (LR) is a very useful tool. Every possible result of a test has a LR, which allows for an estimation of the magnitude by which the pretest probability increases or decreases, thereby helping the physician rule out, confirm, or continue investigating a diagnosis with new tests. In the first part of this article the properties of a diagnostic test (validity, reproducibility and safety) were analyzed. This second part illustrates the theoretical background underlying the concept of LR, explains the methodology for calculating them and describes their clinical application.

Uso de tests diagnósticos en la práctica clínica (Parte 1): análisis de las propiedades de un test diagnóstico / Clinical use of diagnostic tests (Part 1): analysis of the properties of a diagnostic test

Diagnostic tests are widely used in clinical practice. Qualitative analysis of diagnostic test properties (validity, reproducibility and safety) has been systematized using clinical epidemiology tools that have introduced a series of concepts such as sensitivity, specificity and predictive values. Based on data reported by a clinical investigation, the present article illustrates the theoretical background underlying these concepts, explains the methodology for their calculation, and analyzes their main strengths and limitations. A second article (Part 2: Clinical application and usefulness of a diagnostic test), describes the manner in which information provided by a test should be applied in order to correctly resolve a clinical dilemma.

Los tests diagnósticos constituyen herramientas complementarias ampliamente utilizadas en la práctica clínica. La Epidemiología Clínica ha sistematizado el análisis cualitativo de sus propiedades (validez, repro-ducibilidady seguridad) mediante la introducción de una serie de conceptos tales como sensibilidad, especificidad y valores predictores. En base a los datos aportados por una investigación clínica, el presente artículo ilustra el sustrato teórico subyacente a los conceptos anteriormente mencionados, detalla su forma de cálculo y analiza sus principales fortalezas y limitaciones. En un segundo artículo (Parte 2: Aplicación clínica y utilidad de un test diagnóstico) se describe la forma en que la información aportada por una prueba debe ser aplicada correctamente en la resolución de un dilema clínico.

Green processes for the extraction of bioactives from Rosemary: Chemical and functional characterization via ultra-performance liquid chromatography-tandem mass spectrometry and in-vitro assays.

In this contribution, the performance of three different extraction procedures towards the extraction of antioxidants from rosemary (Rosmarinus officinalis) is presented. Namely, pressurized liquid extraction (PLE), using water and ethanol as solvents, supercritical fluid extraction (SFE), using neat CO(2) and supercritical CO(2) modified with ethanol, as well as a novel extraction process called Water Extraction and Particle formation On-line (WEPO) are directly compared. Different extraction conditions including temperatures, times and pressures have been studied. The produced extracts have been characterized in terms of extraction yield, antioxidant activity (using the DPPH radical scavenging method) and total phenols (using the Folin method). Besides, all the extracts have been chemically characterized using a new quantitative UPLC-MS/MS method. This method allowed the determination of the main antioxidants present in rosemary, including, among others, rosmarinic acid, carnosic acid and carnosol, attaining detection limits as low as 2ng/mL. The results obtained in this study show that PLE using ethanol at high temperatures (200 degrees C) was able to produce extracts with high antioxidant activity (EC(50) 8.8microg/mL) and high yield (ca. 40%) while efficiently extracting antioxidants of diverse polarity, among them, carnosic and rosmarinic acids, regarded as the most important antioxidants present in rosemary. Nevertheless, in this work, the ability of the three studied environmentally friendly extraction techniques to obtain bioactives from natural sources is demonstrated.