Assessment of microRNA profiles in small extracellular vesicles isolated from bovine colostrum with different immunoglobulin G concentrations.

The consumption of bovine colostrum by newborn calves during the first days of life is essential to ensure the transfer of passive immunity. In addition to critical IgG, colostrum also contains non-IgG biomolecules, including microRNA (miRNA). The present study investigated the profiles of miRNA in small extracellular vesicles (sEV) isolated from bovine colostrum with high (256.5 ± 5.7 mg/mL, mean ± standard deviation, n = 4) and low (62.8 ± 3.6 mg/mL, n = 4) concentrations of IgG. Different combination of sEV extraction methods and bioinformatic pipelines (miRDeep2 and sRNAbench) for miRNA analysis were evaluated. Results showed that miRCURY exosome Cell/Urine/CSF and miRNeasy Mini kits yielded the highest RNA concentration. The miRNA-seq data analysis showed miRDeep2 yielded more comprehensive miRNAome compared with sRNAbench (527 versus 392 unique miRNA), whereas 389 shared miRNA were identified using both approaches. The profiles of top 50 miRNA were the same using both approaches, and their abundance contributed to 91.7% and 94.3% of total abundance of miRNA using miRDeep2 and sRNAbennch, respectively. These core miRNA were predicted to target 2,655 genes, which regulate 78 KEGG (Kyoto Encyclopedia of Genes and Genomes) level-3 pathways including PI3K-Akt and MAPK signaling pathway, axon guidance, and focal adhesion. The expression profiles of sEV-associated miRNA were similar between high- and low-IgG colostrum samples, despite the fact that the abundance of miR-27a-3p was higher in colostrum with high concentrations of IgG. In conclusion, a core miRNAome in bovine colostrum may play a role in regulating health and developmental stages in neonatal calves, independent of IgG concentration.

Delayed-type hypersensitivity skin test against Neospora caninum in heifers with undetectable specific antibodies.

Delayed-type hypersensitivity (DTH) has been used in human and veterinary medicine as a skin testing for evaluating in vivo cell-mediated immune responses (CMIR). Whereas CMIR is a key process to control intracellular pathogens, its value at identifying cattle exposed to the abortigenic intracellular coccidian parasite Neospora caninum is unknown. In this work, we have evaluated a DTH skin testing in cattle exposed to N. caninum and still seronegative. Female calves were experimentally sensitized by subcutaneous (SC) inoculation with live tachyzoites of N. caninum (NC-Argentina LP1) in sterile phosphate-buffered saline (PBS) (group A; n: 8) whereas other calveswere mock-sensitized with PBS (group B; n: 6). Two DTH skin tests were performed by intradermal inoculation with a soluble lysate of N. caninum tachyzoites (NC-Argentina LP1) in the neck region at 60d and 960 d after sensitization. Skinfold thickness at the intradermal inoculation site was measured at 0, 24, 48 h post each DTH skin test and skin biopsies taken for microscopic evaluation. Specific N. caninum antibodies kinetics was evaluated all throughthe experiment. We found that whereas N. caninum specific antibodies remained below the ELISA cut-off, a distinctive skinfold thickness increase was detected in sensitized animals (group A) at the DTH skin test site, showing induration, swelling and inflammatory infiltration. Mock sensitized animals (group B) showed no skinfold thickness growth and lacked specific antibody response. Thus, N. caninum DTH skin testing could be a useful diagnostic tool for the detection of CMIR during N. caninum infection in non-humoral responders.

Cathelicidin bovine myeloid antimicrobial peptide (BMAP) 28 is involved in the inflammatory response against alpha-herpesviruses in the bovine nervous system.

The role of the local innate immune response in the neuropathogenesis of bovine herpesvirus (BoHV) type 1 and 5 remains largely unknown. This study determined the gene transcriptional expression of relevant bovine cathelicidins, TNFα and IFNß in the nervous system of experimentally-infected cattle during the different stages of BoHV-1 and BoHV-5 infectious cycle. We studied the modulation of bovine myeloid antimicrobial peptide (BMAP) 27 and 28 by alpha-herpesviruses during acute infection of the central nervous system (CNS). However, BMAP28 was the main cathelicidin modulated. BoHV-5 supressed BMAP28 expression mainly in frontal cortex and cervical medulla whereas BoHV-1 slightly induced the expression of cathelicidins in the olfactory and posterior cortex. The differences in the regulation of the innate response are likely related to distinct replication rates of both alpha-herpesviruses in the CNS. During latency and reactivation, BoHV-1 and -5 decreased BMAP28 and BMAP27 expression, accompanied by high levels of TNFα and IFNß transcripts in the posterior brain region and medulla during BoHV reactivation. In terms of cytokines, a remarkably overexpression of IFNß was induced by BoHV-5 (133.8-fold). In trigeminal ganglion (TG) both alpha-herpesviruses induced cathelidicins gene expression at all stages of the infection cycle, while only acute BoHV-5 infection increased TNFα (129-fold) mRNA levels. This study suggests that the pronounced downregulation of BMAP28 in BoHV-5-acutely-infected CNS is due to a decreased immune stimulation during viral infection, favouring its establishment in the CNS with a low replication rate until latency. Thus, cathelicidins, together with IFNß and TNFα, are differentially regulated by BoHV-5 and BoHV-1 infections and this regulation is dependent on the stage of virus infection in the bovine nervous system.

Dietary methionine deficiency reduces laying performances of female common ducks and impacts traits of interest of their mule ducklings.

The effects of maternal nutrition on offspring phenotypes have been mainly documented over the past years in mammals, and are now studied in poultry as well. In the present study, we investigated the effects of a reduced level of dietary Methionine (Met) on laying performances of common laying ducks and their impacts on the phenotype of their mule ducklings. A total of 60 female laying ducks were divided into 2 dietary treatments at 10 wk of age. The restricted group received Met-restricted diets (R group) containing 0.25% of Met whereas the control group received control diets (C group) containing 0.40% of Met that meets Met requirements. The restriction was applied during the growing and laying periods, from 10 to 51 wk of age and a particular focus was put on female breeder traits that might be affected by the Met restriction. Plasma parameters of hepatic and lipid metabolisms were recorded in ducklings. Total weight (P < 0.001), albumen weight (P < 0.001) and albumen percentage of dry matter (P < 0.01) were decreased for eggs laid by female breeders from the R group. Both male and female ducklings from the R group of female breeders showed a reduced BW at hatching (P < 0.001) and a tendency to an increased proportional liver weight (P = 0.07). Finally, the maternal low dietary Met level modified plasma parameters in newborn ducklings regardless of sex: alkaline phosphatase (ALP) and alanine transaminase (ALT) activities were reduced (P = 0.07 and P = 0.002, respectively), levels of glucose (P = 0.03) and triglycerides (P = 0.01) were higher whereas level of free fatty acids decreased (P = 0.01). It was concluded that feeding female laying ducks with a restricted dietary Met content during the growing and laying periods has a negative effect on egg weight and composition. The ducklings that were restricted in nutrients during their early development, have a reduced BW, and altered lipid and hepatic metabolisms.

Modulation of cathelicidins, IFNß and TNFα by bovine alpha-herpesviruses is dependent on the stage of the infectious cycle.

Production of antimicrobial peptides cathelicidins, interferons and cytokines is an important feature in airway epithelial host defense. The innate immune response to alpha-herpesvirus infection at the sites of primary replication has not been fully studied. Thus, the aim of this study was to determine the expression of innate immune components, cathelicidins, IFNß, TNFα and TNF receptors (TNFRI and TNFRII) during acute infection and reactivation of bovine herpesvirus type 1 (BoHV-1) and 5 (BoHV-5) in the respiratory tract and lymphoid tissue of their natural host. We found that BoHV infection modulates mainly the expression of BMAP28, a key cathelicidin in cattle. It was downregulated by both viruses in retropharyngeal lymph nodes of acutely infected-calves, and it was accompanied by a lower expression of IFNß, TNFα and TNFRI. BoHV-5 showed a pronounced role in the downregulation of BMAP28, even in nasal mucosa and lung. However, during reactivation, BoHV-5 upregulated both BMAP28 and IFNß in retropharyngeal lymph nodes. Acute replication induced also TNFα mRNA and protein synthesis, and expression of TNFRI and II was positively regulated during both acute infection and reactivation, particularly in the trachea. Moreover, BMAP27 was detected during BoHV-1 reactivation suggesting a potential role at this stage. Thus, cathelicidins are implicated in alpha-herpesvirus infections of the bovine respiratory system and the response is distinct during BoHV-1 and BoHV-5 acute infection and reactivation. This demonstrates that these viruses modulate differentially the components of innate immune response, possibly influencing their pathogenesis. This study provides an initial pilot analysis of factors that might be implicated in alpha-herpesvirus infection of the bovine respiratory system.

Characteristic pro-inflammatory cytokines and host defence cathelicidin peptide produced by human monocyte-derived macrophages infected with Neospora caninum.

Neospora caninum is a coccidian intracellular protozoan capable of infecting a wide range of mammals, although severe disease is mostly reported in dogs and cattle. Innate defences triggered by monocytes/macrophages are key in the pathogenesis of neosporosis, as these cells are first-line defenders against intracellular infections. The aim of this study was to characterize infection and innate responses in macrophages infected with N. caninum using a well-known cell model to study macrophage functions (human monocyte THP-1 cells). Intracellular invasion of live tachyzoites occurred as fast as 4 h (confirmed with immunofluorescence microscopy using N. caninum-specific antibodies). Macrophages infected by N. caninum had increased expression of pro-inflammatory cytokines (TNFα, IL-1ß, IL-8, IFNγ). Interestingly, N. caninum induced expression of host-defence peptides (cathelicidins), a mechanism of defence never reported for N. caninum infection in macrophages. The expression of cytokines and cathelicidins in macrophages invaded by N. caninum was mediated by mitogen-activated protein kinase (MEK 1/2). Secretion of such innate factors from N. caninum-infected macrophages reduced parasite internalization and promoted the secretion of pro-inflammatory cytokines in naïve macrophages. We concluded that rapid invasion of macrophages by N. caninum triggered protective innate defence mechanisms against intracellular pathogens.

Immunization with inactivated antigens of Neospora caninum induces toll-like receptors 3, 7, 8 and 9 in maternal-fetal interface of infected pregnant heifers.

Neospora caninum is an obligate parasite and a major cause of abortion in cattle. Pregnancy failures appear to be associated with weak innate defences on the maternal-fetal interface during infection with N. caninum. Herein, we studied the gene expression of Toll-like receptors (TLRs) in pregnant heifers immunized with different vaccine formulations against N. caninum before mating and then challenged the heifers with live N. caninum on day 70 of gestation. TLR7 and TLR8 expression was upregulated in the placental caruncle of infected-pregnant heifers previously exposed to live N. caninum as immunogen. However, TLR7 and 8 expression in both placenta and caruncle as well as, TLR3 and 9 expression in caruncle were upregulated when heifers were previously immunized with inactivated soluble whole antigens and recombinant NcSAG1, NcHSP20 and NcGRA7 proteins. All dams were carrying viable fetuses when they were culled at day 104 of gestation. Upregulation of TLR7 and IFNγ expression was detected in fetal spleen when their mothers where previously vaccinated with soluble antigens and recombinant NcSAG1, NcHSP20 and NcGRA7 proteins. These studies demonstrate that soluble or recombinant NcSAG1, NcHSP20 and NcGRA7 antigens induce key TLRs expression at the maternal-fetal interface, probably triggering damaging inflammatory cellular immune responses associated with abortion. Previous infection with N. caninum seems to attenuate the innate immune response at the maternal-fetal interface, which could favour pregnancy maintenance and perpetuation of the disease. This finding represents novel information on how N. caninum vaccination and infection modulate TLRs expression at the placenta and fetal spleen, the possible role in the pregnancy outcomes and transplacental transmission of the protozoa.

Toll-like receptors 3, 7 and 8 are upregulated in the placental caruncle and fetal spleen of Neospora caninum experimentally infected cattle.

Innate immune responses at the maternal-fetal interface are key in the pathogenesis of Neospora caninum, an obligate parasite that causes abortion in cattle. Herein, we determined the gene expression of endosomal Toll-like receptors (TLRs) in the placenta and fetuses from both non-infected pregnant heifers and pregnant heifers intravenously challenged with live tachyzoites of N. caninum on day 70 of gestation. On day 104 of pregnancy, mRNA expression of TLRs 3 and 8, as well as that of TLRs 7 and 9, was high in the spleen of fetuses from N. caninum-infected heifers. Gene expression levels of endosomal TLRs were also detectable in the placenta and the maternal caruncle from infected heifers, being TLRs 3, 7 and 8 particularly upregulated, mostly in the caruncle. Basal TLR levels were higher in fetal spleen than in placental tissues. This study provides novel information on how innate TLR responses are induced at the maternal-fetal interface of cattle in response to intracellular N. caninum.

Revisión de la amputación Gritti-Stokes, a propósito de un caso / Reviewing Gritti-Stokes amputation: a case report

La amputación Gritti-Stokes (AGS) es una modificación de la amputación supracondílea (ASC) tradicional, que consigue una distribución mejor de las cargas distales. Presentamos el caso de una mujer de 85 años que sufrió un infarto isquémico y desarrolló una isquemia aguda en el miembro inferior izquierdo. Se le realizó la AGS, teniendo en consideración su edad y comorbilidades. Nuestra paciente se recuperó satisfactoriamente y adquirió una marcha para cortos recorridos con andador (grado de movilidad: deambulante por interiores), sin complicaciones. La mayoría de los pacientes en los que se efectúa una ASC podrían beneficiarse de una AGS, por las múltiples ventajas que presenta. Nuestro objetivo es la descripción de un caso de AGS, hacer una revisión de la literatura sobre esta técnica y resaltar sus ventajas y la importancia de su consideración a la hora de programar una amputación (AU)

Gritti-Stokes amputation (GSA) is a modification of the traditional above-knee amputation (AKA) that achieves a better distal load distribution. We present the case of an 85-year-old woman who developed acute ischaemia of the left lower limb after an ischaemic stroke. The patient underwent GSA, taking into account her age and comorbidities. Recovery was satisfactory and the patient achieved short ambulation with a walker (mobility grade: Indoor walker), with no complications. Most of the patients who undergo AKA might benefit from a GSA because of its many advantages. This article describes a case of GSA and provides a review of the literature on this technique, stressing its advantages and the importance of its consideration when planning an amputation (AU)

Calidad y transparencia de FISIOTERAPIA mediante guías de publicación / Quality and transparency of FISIOTERAPIA by means of publication guidelines

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Colonic MUC2 mucin regulates the expression and antimicrobial activity of ß-defensin 2.

In this study we identified mechanisms at the colonic mucosa by which MUC2 mucin regulated the production of ß-defensin in a proinflammatory milieu but functionally protected susceptible bacteria from its antimicrobial effects. The regulator role of MUC2 on production of ß-defensin 2 in combination with the proinflammatory cytokine interleukin-1ß (IL-1ß) was confirmed using purified human colonic MUC2 mucin and colonic goblet cells short hairpin RNA (shRNA) silenced for MUC2. In vivo, Muc2(-/-) mice showed impaired ß-defensin mRNA expression and peptide localization in the colon as compared with Muc2(+/-) and Muc2(+/+) littermates. Importantly, purified MUC2 mucin abrogated the antimicrobial activity of ß-defensin 2 against nonpathogenic and enteropathogenic Escherichia coli. Sodium metaperiodate oxidation of MUC2 removed the capacity of MUC2 to stimulate ß-defensin production and MUC2's inhibition of defensin antimicrobial activity. This study highlights that a defective MUC2 mucin barrier, typical in inflammatory bowel diseases, may lead to deficient stimulation of ß-defensin 2 and an unbalanced microbiota that favor the growth of ß-defensin-resistant microbes such as Clostridium difficile.

Utilidad de la ecografía para el diagnóstico y tratamiento del neuroma ciático en un amputado femoral / Usefulness of ultrasonography for the diagnosis and treatment of sciatic nerve neuroma in femoral amputation

La ecografía es una técnica de imagen que permite el diagnóstico y la realización de procedimientos intervencionistas. Entre sus ventajas, ofrece una imagen dinámica, sin radiación ionizante, que permite el control continuo de la aguja en tiempo real. Se presenta un caso clínico de un varón amputado femoral traumático con dolor en muñón secundario a un neuroma del nervio ciático, que fue tratado mediante infiltración ecodirigida con bloqueo anestésico de lidocaína y posterior infiltración perilesional de corticosteroides. El paciente presentó mejoría del dolor valorado con la escala numérica del dolor tras 2 infiltraciones. El objetivo del trabajo es presentar la ecografía como una herramienta segura y eficaz para realizar procedimientos diagnósticos y terapéuticos en patologías del aparato locomotor en la consulta de rehabilitación (AU)

Ultrasound is an imaging technique that allows diagnostic and interventional procedures. One of the advantages of this technique is to provide dynamic imaging, without ionizingradiation, and to allow the continuous monitoring of the needle in real time. We present the case of a man with traumatic femoral amputation and stump pain due to a sciatic nerve neuroma. He was treated using ultrasound-guided injection with lidocaine anesthetic blockade and perilesional steroid injection. The patient reported pain improvement, assessed using a numerical pain scale, after two injections. The aim of this article is to present ultrasonography as a safe and effective technique for the diagnosis and treatment of musculoskeletal disorders in rehabilitation (AU)

Utilidad clínica de la procalcitonina en gastroenteritis aguda / Use of procalcitonin as diagnostic marker in acute gastroenteritis

Introducción: No hay ningún marcador hematológico que diferencie con seguridad entre gastroenteritis aguda (GEA) bacteriana y no bacteriana. Nuestro objetivo fue evaluar la procalcitonina (PCT) como marcador de GEA de origen bacteriano y analizar su correlación con el ingreso hospitalario. Pacientes y Método: Estudio prospectivo de niños diagnosticados de GEA en el departamento de Urgencias durante un período de 7 meses que requirieron de analítica sanguínea y muestras de heces. Se analizaron variables epidemiológicas, clínicas y analíticas. Se excluyeron pacientes con enfermedad digestiva crónica, diarrea prolongada, inmunodeficiencia o tratamiento antibiótico previo. El estudio fue aprobado por el Comité de Ética y se solicitó consentimiento informado. Resultados: Se analizaron 45 pacientes. Los niños con GEA bacteriana tenían mayor edad (p = 0,027), mayor mediana de PCT y proteína C reactiva (PCR) (p = 0,001). Los valores de PCT y PCR que mejor discriminaron la etiología bacteriana fueron PCT > 0,5 mg/L (sensibilidad: 64,3 por ciento, especificidad: 83,9 por ciento, cociente de probabilidad positivo (CPP): 4) y PCR > 3 mg/dL (sensibilidad: 78,6 por ciento, especificidad: 90,3 por ciento, CPP: 8). No se encontró asociación entre la elevación de dichos marcadores y una mayor probabilidad de hospitalización. Conclusión: La procalcitonina, al igual que la PCR, se eleva en gastroenteritis bacterianas (p = 0,001), no siendo estos marcadores predictores de hospitalización.

Introduction: There is no hematological marker that reliably differentiates between bacterial and nonbacterial acute gastroenteritis (AGE). The objective of this study is to evaluate procalcitonin (PCT) as a marker for bacterial AGE and analyze its relationship with hospital admission. Patients and Method: A prospective study of children diagnosed with AGE was conducted at the emergency room during a period of seven months, which required blood and stool samples. Epidemiological, clinical and analytical variables were analyzed. Patients with chronic digestive disease, prolonged diarrhea, immunodeficiency or prior antibiotic treatment were excluded. The study was approved by the Ethics Committee and an informed consent was requested. Results: 45 patients were analyzed. Children with bacterial GEA were older (p = 0.027) and presented higher median PCT and C-reactive protein concentrations (CRP) (p = 0.001). The PCT and CRP values that best discriminated bacterial infection were PCT > 0.05 mg/L (sensibility 64.3 percent specificity 83.9 percent, positive probability coefficient (PPC): 4), and CRP > 3mg/dL (sensibility 78.6 percent, specificity 90.3 percent, PPC: 8). No association between the elevation of these markers and higher hospitalization probability was found. Conclusion: Procalcitonin, like CRP, is elevated in bacterial gastroenteritis (p = 0.001), but these markers are not a predictor of hospitalization.

[Use of procalcitonin as diagnostic marker in acute gastroenteritis]. / Utilidad clínica de la procalcitonina en gastroenteritis aguda.

INTRODUCTION: There is no hematological marker that reliably differentiates between bacterial and nonbacterial acute gastroenteritis (AGE). The objective of this study is to evaluate procalcitonin (PCT) as a marker for bacterial AGE and analyze its relationship with hospital admission. PATIENTS AND METHOD: A prospective study of children diagnosed with AGE was conducted at the emergency room during a period of seven months, which required blood and stool samples. Epidemiological, clinical and analytical variables were analyzed. Patients with chronic digestive disease, prolonged diarrhea, immunodeficiency or prior antibiotic treatment were excluded. The study was approved by the Ethics Committee and an informed consent was requested. RESULTS: 45 patients were analyzed. Children with bacterial GEA were older (p=0.027) and presented higher median PCT and C-reactive protein concentrations (CRP) (p=0.001). The PCT and CRP values that best discriminated bacterial infection were PCT≥0.05 mg/L (sensibility 64.3%, specificity 83.9%, positive probability coefficient (PPC): 4), and CRP≥3 mg/dL (sensibility 78.6%, specificity 90.3%, PPC: 8). No association between the elevation of these markers and higher hospitalization probability was found. CONCLUSION: Procalcitonin, like CRP, is elevated in bacterial gastroenteritis (p=0.001), but these markers are not a predictor of hospitalization.

Resultados funcionales tras artroplastia total de muñeca. A propósito de un caso / Functional outcomes after total wrist arthtroplasty. A case report

Las articulaciones de la mano y la muñeca son unas de las más frecuentemente afectadas en la artritis reumatoide. Las principales indicaciones de la cirugía de la muñeca son el dolor, la deformidad y la pérdida de función global de la extremidad superior secundaria al proceso patológico de base. La artrodesis de muñeca ha demostrado suficientemente su éxito para proporcionar estabilidad y eliminar el dolor en la muñeca reumática, pero a expensas de sacrificar su movilidad. La artroplastia de muñeca se propone como alternativa a la artrodesis de muñeca para, además de proporcionar un alivio del dolor, incrementar la movilidad y mejorar así la funcionalidad (AU)

The hand and wrist joints are among the most commonly affected by rheumatoid arthritis. The main indications for wrist surgery are pain, deformity and loss of overall function of the upper limb secondary to the baseline disease. Wrist arthrodesis has sufficiently demonstrated its success to provide stability and eliminate pain in the rheumatic wrist but at the expense of sacrificing its mobility. Wrist arthroplasty is proposed as an alternative to wrist arthrodesis in order to also provide pain relief, increased mobility and improved functionality (AU)

Effect of using reporting guidelines during peer review on quality of final manuscripts submitted to a biomedical journal: masked randomised trial.

OBJECTIVE: To investigate the effect of an additional review based on reporting guidelines such as STROBE and CONSORT on quality of manuscripts. DESIGN: Masked randomised trial. Population Original research manuscripts submitted to the Medicina Clínica journal from May 2008 to April 2009 and considered suitable for publication. CONTROL GROUP: conventional peer reviews alone. Intervention group: conventional review plus an additional review looking for missing items from reporting guidelines. Outcomes Manuscript quality, assessed with a 5 point Likert scale (primary: overall quality; secondary: average quality of specific items in paper). Main analysis compared groups as allocated, after adjustment for baseline factors (analysis of covariance); sensitivity analysis compared groups as reviewed. Adherence to reviewer suggestions assessed with Likert scale. RESULTS: Of 126 consecutive papers receiving conventional review, 34 were not suitable for publication. The remaining 92 papers were allocated to receive conventional reviews alone (n=41) or additional reviews (n=51). Four papers assigned to the conventional review group deviated from protocol; they received an additional review based on reporting guidelines. We saw an improvement in manuscript quality in favour of the additional review group (comparison as allocated, 0.25, 95% confidence interval -0.05 to 0.54; as reviewed, 0.33, 0.03 to 0.63). More papers with additional reviews than with conventional reviews alone improved from baseline (22 (43%) v eight (20%), difference 23.6% (3.2% to 44.0%), number needed to treat 4.2 (from 2.3 to 31.2), relative risk 2.21 (1.10 to 4.44)). Authors in the additional review group adhered more to suggestions from conventional reviews than to those from additional reviews (average increase 0.43 Likert points (0.19 to 0.67)). CONCLUSIONS: Additional reviews based on reporting guidelines improve manuscript quality, although the observed effect was smaller than hypothesised and not definitively demonstrated. Authors adhere more to suggestions from conventional reviews than to those from additional reviews, showing difficulties in adhering to high methodological standards at the latest research phases. To boost paper quality and impact, authors should be aware of future requirements of reporting guidelines at the very beginning of their study. Trial registration and protocol Although registries do not include trials of peer review, the protocol design was submitted to sponsored research projects (Instituto de Salud Carlos III, PI081903).

Factores predictivos de nivel funcional tras artroplastia total primaria de rodilla / Predictive factors of the functional level after total knee arthroplasty

Introducción. El objetivo de este estudio fue determinar la existencia de factores predictivos de resultado funcional tras la intervención de artroplastia total primaria de rodilla (ATPR). Material y métodos. Estudio prospectivo con 25 pacientes, pendientes de ATPR, con fecha prevista de cirugía, candidatos a seguir el proceso rehabilitador en el servicio de medicina física y rehabilitación de nuestro hospital. Se valoró a los pacientes una semana antes de la cirugía, al mes, a los 3 meses y al año. Las variables recogidas fueron: sexo, edad, dolor, balance articular y balance muscular de ambas rodillas, índice de Lequesne y cuestionario de WOMAC. En la primera visita, se calculó el índice de masa corporal (IMC) de cada paciente. En cada valoración, se evaluó la capacidad funcional de los pacientes mediante los tests: prueba de la marcha de los 6min (PM6), Timed Up and Go test (TUG) y Stair Climbing Test (SCT). Resultados. Tras la ATPR existe una mejora en los parámetros analizados. En la valoración previa a la cirugía, el IMC y la valoración muscular de cuádriceps y glúteo medio de la rodilla afecta pueden considerarse como factores predictivos del resultado de las pruebas de capacidad funcional al año de la intervención. Conclusiones. La ATPR es una intervención eficaz en el tratamiento de la gonartrosis. El IMC, el balance muscular y la capacidad funcional previos a la cirugía pueden considerarse como factores predictivos de resultados funcionales al año de la intervención (AU)

Introduction. The aim of this study was determine the existence of predictive factors of the functional level after primary total knee arthroplasty (PTKA). Material and methods A prospective study of 25 patients on the waiting list of PTKA, with foreseen date of surgery and candidates to follow the rehabilitating process in the department physical medicine and rehabilitation of our hospital was performed. The patients were evaluated one week before the arthroplasty, and at one month, three months and one year after surgery. The variables registered in each evaluation were sex, age, pain, range of movement and muscular balance of the surgical and nonsurgical knees and the results of Lequesne index and WOMAC questionnaire. In the first evaluation, body mass index (BMI) was calculated. In each visit, functional ability was evaluated by the 6-Minute Walking Test (6M-WT), Time Up and Go test (TUG) and a timed Stair Climbing Test (SCT). Results. After PTKA, there is an improvement in the analyzed parameters. In the evaluation before surgery, the BMI and the muscular balance of quadriceps femoris and gluteus medius of surgical knee can be considered as predictors of the results of functional capacity tests at one year of the arthroplasty. Conclusions. PTKA is a good treatment for the knee osteoarthritis. The BMI, muscular balance and functional ability in the preoperative evaluation can be considered as predictors of the functional level one year after PTKA (AU)

[Study of the nutritional status of elders in Cantabria]. / Estudio del estado nutricional de los ancianos de Cantabria.

INTRODUCTION: Population ageing is a main concern under the biosanitary point of view. AIM: To assess the nutritional status of people 65 year-old and older in Cantabria (Spain) METHOD: A total of 1605 persons were studied by means of the MNA (Mini Nutritional Assessment); a) by primary care (59.9% in the unit, and 4.7% at home) and, b) in nursing homes (35.4%). RESULTS: Nutritional score (NS) was 23.4 ± 4.1 for women and 24.4 ± 4 in males (p < 0.001). We emphasize the fact that 22.3% of people studied in the nursing homes were malnourished or at risk of malnutrition, compared with 14.2% of those studied at the unit, and only 3.3% of the home visited elders. The correlation between the value of the NS and the subjective estimation of nutrition status showed a high value (0.65). We emphasize the negative correlation (-0.53) between BNI value and the incidence of skin lesions. CONCLUSION: Our results highlight the importance of identifying malnutrition or its risk in elders in order to prevent the negative consequences of this deficiency.