Recovery of the physiological status in professional basketball players using NESA neuromodulation treatment during different types of microcycles in season: A preliminary randomized clinical trial.

The purpose of the study was to describe and compare recovery status after official basketball competition in players who underwent NESA neuromodulation treatment (NNT) in weeks with one or two matches. The recovery parameters of 12 professional male basketball players (mean ± SD, age: 20.6 ± 2.7 yr; height: 197.8 ± 11.7 cm; and body mass: 89.0 ± 21.2 kg) that competed in the LEB Plata (Spanish third division) were monitored 2 days after match-play over 6 weeks, and included: 1) the Hooper Test, which combines four subjective variables (sleep, stress, fatigue and soreness); 2) common biochemical markers (e.g., testosterone, cortisol and ratio T:C); and 3) lowest heart rate [HR], average HR, HR variability, sleep duration, awake time during night and onset latency before asleep). Players that completed NNT presented differences compared to the control group in sleep data. For instance, the lowest HR (p < 0.001), average HR (p < 0.001) and total awake time (p = 0.04) were significantly reduced in the NNT group. On the contrary, the control group presented greater values than the NNT group in the subjective Hooper Test, although only stress presented significant differences (Control 2.5 ± 1.2 vs. NNT cost or 3.2 ± 0.9; p = 0.01). Additionally, there were no significant differences in recovery parameters between weeks with one or two matches. In conclusion, the results suggest that players that underwent NNT tended to improve their sleep quality. Nevertheless, player's values in the biochemical markers and wellness status remained similar in both groups. The fact that no significant differences were found between weeks with one or two matches could help basketball professionals to determine that a congested schedule does not seem to negatively alter recovery status. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04939181?term=NCT04939181, NCT04939181.

Resultados y evolución histórica de las redes sociales en el American College of Surgeons Clinical Congress y el Congreso Nacional de Cirugía. Análisis del #ACSCC20 y #CNCirugia2020 / Trends of social networks in the American College of Surgeons Clinical Congress and the Congreso Nacional de Cirugía. Analysis of the #ACSCC20 and #CNCirugia2020

Objetivo El objetivo de este estudio es analizar el impacto de los congresos del American College of Surgeons Clinical Congress (ACSCC2020) y del Congreso Nacional de Cirugía de la Asociación Española de Cirujanos (CNC2020) en formato virtual por la pandemia SARS-CoV-2 según la huella digital. Material y métodos Se estudiaron los hashtags de Twitter #ACSCC20 y #CNCirugia2020 para determinar tuits, retuits, usuarios e impresiones. Se analizaron los datos sobre las cuentas con mayor influencia y la evolución histórica de los congresos entre 2015 y 2020. Utilizamos el software symplur para la recogida y análisis de los datos. Resultados Entre 2015 y 2017 hubo un incremento consistente en el número de tuits, participantes e impresiones. Entre 2018 y 2020, el ACS mantiene el número de impresiones con menor cantidad de tuits. Sin embargo, el CNC sigue creciendo y logra sus mejores métricas en el presente 2020. Encontramos diferencias estadísticamente significativas entre las cuentas más prolíficas del ACSCC frente al CNC (p<0,002), pero no existen diferencias entre las 10 cuentas más influyentes (p=0,19) o las cuentas con mayor número de impresiones (p=0,450). Conclusiones Los congresos virtuales generan un impacto global a través del uso de Twitter para la diseminación de conocimiento. En el presente 2020 el crecimiento del impacto en redes sociales ha sido proporcionalmente mayor en el CNC que en el ACSCC. No obstante, el congreso virtual del ACS generó mayor impacto en las redes sociales medido por el número de usuarios, tuits e impresiones entre 2015 y 2020 (AU)

Aim The objective of this study is to analyze the impact of the American College of Surgeons Clinical Congress (ACSCC2020) and the National Surgery Congress of the Spanish Association of Surgeons (CNC2020) in virtual format due to the SARS-CoV-2 pandemic according to the fingerprint.Material and methods The Twitter hashtags # ACSCC20 and # CNCirugia2020 were studied to determine tweets, retweets, users and impressions. The data on the accounts with the greatest influence and the historical evolution of the congresses between 2015 and 2020 were analyzed. We used the symplur software to collect and analyze the data. Results Between 2015 and 2017 there was a consistent increase in the number of tweets, participants and impressions. Between 2018 and 2020, the ACS maintains the number of impressions with the fewest number of tweets. However, the CNC continues to grow and achieves its best metrics in 2020. We found statistically significant differences between the most prolific accounts of the ACSCC versus the CNC (P<.002) but there are no differences between the 10 most influential accounts (P=.19) or the accounts with the highest number of impressions (P=.450). Conclusions Virtual congresses generate a global impact through the use of Twitter for the dissemination of knowledge. In the present 2020, the growth of the impact on social networks has been proportionally greater in the CNC than in the ACSCC. However, the ACS virtual congress generated the greatest impact on social networks measured by the number of users, tweets and impressions between 2015 and 2020 (AU)

[Impact of family restrictions during COVID-19 pandemic on the use of physical restraint in an acute hospital: An observational study]. / Impacto de las restricciones de visitas de familiares de pacientes por la pandemia de COVID-19 sobre la utilización de la contención mecánica en un hospital de agudos: estudio observacional.

INTRODUCTION: During the worldwide pandemic of COVID-19 caused by coronavirus SARS-CoV-2, hospitals developed contingency plans that transformed and reorganized the hospital activity. One of the measures was to restrict access to family members of hospitalized patients. The presence of the patient's family is considered an alternative to physical restraint. The aim of this study is to compare the use of physical restraint in hospitalized patients in an acute care hospital during the previous period of the pandemic of COVID-19 with the post-confinement period with hospitals being still closed to family. MATERIAL AND METHODS: We made an observational study that compares the prevalence of physical restraint in an acute care hospital during the previous period to the alarm state (February 2020) with the second period, when visits where restricted (May 2020). From the clinical history of the patients with physical restraint we collected the following variables: sex, diagnostic, hospital admission unit, reason for using physical restraint, localization, length, type of material, registration in the medical record, information given to the family, alternatives to the physical restraint and injuries related to the physical restraint. RESULTS: We evaluated 690 patients: 388 during the previous period and 320 during the second period. From all patients, 29 needed physical restraint. The use of physical restraint went from 8 (2%) to 21 (7%) (p=0.003). In the second period, a not statistically significant increase in continuous physical restraint was identified compared to the first period. CONCLUSIONS: The physical restraint prevalence has been superior during the second period in which families were not present with the hospitalized patients.

Pollutant emissions during the pyrolysis and combustion of starch/poly(vinyl alcohol) biodegradable films.

The massive use of petroleum-based polymers and their improper waste treatment has brought on significant global environmental problems due to their non-biodegradable nature. Starch/poly(vinyl alcohol) (PVA) bioplastics are suitable substitutes for conventional polymers, such as polyethylene, due to their full biodegradability and excellent mechanical properties. Knowledge of the pollutant emissions during pyrolysis and combustion of starch/PVA films is important because they can arrive at landfills mixed with conventional polymers and be thermally degraded in uncontrolled fires. On the other hand, controlled thermal treatments could result in thermal valorization of the waste. Pyrolysis and combustion experiments were carried out at 650, 750, 850 and 950 °C in a laboratory furnace. The analysis of carbon oxides, light hydrocarbons, and semivolatile compounds, including polycyclic aromatic hydrocarbons (PAHs), is shown. Experiments showed lower pollutant emissions than those found with conventional polymers, such as polyethylene and polyester, in the same equipment. Nevertheless, the pyrolysis run at 950 °C showed the highest light hydrocarbon yield (123013 mg kg-1), but this is considerably lower than the values found for polyethylene. The main semivolatile compounds (not PAHs) emitted, with maximum yields ranging from 1351 to 4694 mg kg-1, were benzaldehyde, phenol, indene, and acetophenone. Specifically, the total semivolatile compounds emitted after pyrolysis and combustion of starch/PVA samples represent only 38 and 50%, respectively, of those emitted with polyethylene. Further, the main PAHs were naphthalene, acenaphthylene, and phenanthrene with maximum values of 4694, 2704 and 1496 mg kg-1, respectively. The PAH yield was considerably higher in experiments with low oxygen content.

Adherence to capecitabine in preoperative treatment of stage II and III rectal cancer: do we need to worry?

BACKGROUND: Preoperative oral capecitabine plus radiotherapy has been progressively adopted in oncology units to provide more convenient care to patients with rectal cancer, but little is known about adherence to this therapy. PATIENTS AND METHODS: Prospective, multicentre observational study in six hospitals in metropolitan Barcelona (Spain), in patients with stage II and III rectal cancer. Assessment of adherence was based on the medical report in the clinical history, a patient questionnaire and a pill count in the pharmacy service upon finalization of treatment. Patients were considered adherent if they had taken 80%-110% of the prescribed treatment. We evaluated clinical variables, adverse effects, anxiety and depression (using the hospital anxiety depression scale [HADS]), and quality of life (EORTC QLQ-30). We analysed adherence-associated variables using a logistic regression model and concordance between adherence measures by means of the modified Kappa index. RESULTS: We included 119 participants. Adherence measures showed little concordance between the assessment methods used: adherence was 100% according to the clinical history, 83.2% according to self-report and 67.9% according to the pill count. In the multivariable analysis, the most relevant variable associated with non-adherence was anxiety prior to treatment (adjusted odds ratio [ORa] 6.96, 95% confidence interval [CI] 1.48-32.7). We did not observe any relevant association between adherence and clinical variables and baseline quality of life parameters. CONCLUSIONS: Adherence to short-term oral neoadjuvant treatment in rectal cancer may be a clinical problem, and it should be acknowledged and systematically evaluated by clinicians during treatment. The limited concordance between different measures of adherence highlights the challenges in monitoring it and the need to use different approaches to assess its impact in clinical practice.

[MALLEOLAR ULCERS ASSOCIATED TO HYDROXYUREA TREATMENT]. / Úlceras maleolares asociadas al tratamiento con hidroxiurea.

INTRODUCTION: Hydroxyurea (HU) is an antineoplastic drug used in chronic myeloproliferative disorders. In this article we will go into detail about the rare but serious appearance of lower limb ulcers in relation to HU treatment. METHODOLOGY: Two simultaneous cases are presented, both from patients with lower limb torpid lesions unresponsive to conventional treatments. After dismissing other aetiologies, HU was found to be the causal agent in both cases. DISCUSSION: In spite of HU's known correlation to lower limb ulcers, pathogenesis isn't clearly defined. In this article we add two more cases to the existing bibliography, with the goal of both insisting on the importance of integral valuation of patients with ulcers and contemplating dermatologic screening on patients treated with HU. CONCLUSION: HU laden ulcers are usually underdiagnosed. Integral valuation and dermatologic screening on patients are critical.

La rehabilitación con implantes en el paciente edéntulo maxilar mediante cirugía guiada y carga inmediata / Implant rehabilitation of maxillary edentulous patient by guided surgery and immediate loading

INTRODUCCIÓN: La cirugía guiada y la carga inmediata de los implantes constituye un nuevo enfoque integral de la rehabilitación de los pacientes edéntulos. El objetivo del presente trabajo era presentar el protocolo diagnóstico, quirúrgico y protésico del tratamiento con implantes mediante la técnica de cirugía guiada y carga inmediata en el tratamiento del maxilar edéntulo. CASO CLÍNICO: Paciente varón de 70 años que acude a consulta para tratamiento con implantes del maxilar edéntulo. La tomografía computarizada de haz cónico (TCHC) muestra que el paciente presenta un adecuado volumen óseo para la inserción de implantes. La información obtenida por la TCHC es utilizada para la evaluación y el plan de tratamiento. Se planificaron diez implantes. Los datos digitales de imagen tomográfica fueron enviados a un centro especializado (Galimplant 3.D(R)) para la realización de la férula quirúrgica y la prótesis provisional. De acuerdo a la férula guiada se insertaron los implantes sin colgajo con un fresado preciso. La prótesis fija inmediata provisional fue realizada y ajustada sobre los pilares, evaluando su oclusión. La prótesis fija definitiva se realizó después de un periodo de 6 meses. CONCLUSIONES: Este caso clínico indica que la implantología oral guiada puede constituir una terapéutica exitosa en el tratamiento del paciente edéntulo maxilar

INTRODUCTION: Guided surgery and immediate functional loading of dental implants constitute a new comprehensive approach for rehabilitation of edentulous patients. The aim of this paper was to present the diagnosis, surgical and prosthetic protocol of implants by guided technique and immediate loading in the treatment of edentulous maxilla. CASE REPORT: A 70-year-old-man, requested an evaluation regarding implant treatment for the edentulous maxilla. The cone beam computarized tomography (CBCT) showed that the patient have an adequate bone volume for maxillary implant placement. The data from CBCT were used for evaluation and treatment planning. Ten implants were treatment planned. Digital data were sent to a software manufacturer (Galimplant.3D(R)) and surgical template and fixed provisional prosthesis according clinical examination were received. According surgical template implants were inserted for a flapless surgical technique with an accuraced drilling. Immediate transitional fixed prosthesis were realized and adjusted with the abutment and finally, occlusion is evaluated. Definitive fixed prosthesis was realized after a 6 month-period of time. CONCLUSIONS: This paper indicated that guided implant dentistry may constitute a successful treatment of edentulous maxillary patients

The effectiveness of a program of physical activity and diet to modify cardiovascular risk factors in patients with severe mental illness after 3-month follow-up: CAPiCOR randomized clinical trial.

BACKGROUND: The aim of this randomized clinical trial follow-up at three months was to evaluate the effectiveness of an educational intervention with a focus on diet and physical activity (PA) to change the amount of PA, body mass index (BMI) and the waist circumference (WC) in patients with severe mental illness. METHODS: We recruited 332 outpatients with severe mental disorders undergoing treatment with antipsychotic medication from Mental Healthcare Centers of Barcelona. They were randomly assigned to an intervention or a control group. The patients in the intervention group participated in a group PA and diet educational program. The blinded measurements at 0 and 3 months were: the level of PA (IPAQ questionnaire), BMI, WC, blood pressure, dietary habits (PREDIMED questionnaire), quality of life (SF-36 questionnaire) and laboratory parameters (cholesterol, triglycerides, glucose). RESULTS: The average age was 46.7 years and 55% were males. Schizophrenia had been diagnosed in 67.1% of them. At 3 months, the average weekly walking METs rose significantly in the IG 266.05 METs (95%CI: 16.86 to 515.25; P=0.036). The total MET average also rose although not significantly: 191.38 METs (95%CI: 1.38 to 381.38; P=0.086). However, the BMI decreased significantly more in the CG, by 0.26kg/m(2) (95%CI: 0.02 to 0.51; P=0.038), than in the IG. There were no significant differences in the WC. CONCLUSIONS: The short-term results suggest that the intervention increases the level of PA, but does not improve physical or laboratory parameters. TRIAL REGISTRATION: Clinicaltrials.gov NCT01729650 (effectiveness of a physical activity and diet program in patients with psychotic disorder [CAPiCOR]).

Chemical characterization of emissions from a municipal solid waste treatment plant.

Gaseous emissions are an important problem in municipal solid waste (MSW) treatment plants. The sources points of emissions considered in the present work are: fresh compost, mature compost, landfill leaks and leachate ponds. Hydrogen sulphide, ammonia and volatile organic compounds (VOCs) were analysed in the emissions from these sources. Hydrogen sulphide and ammonia were important contributors to the total emission volume. Landfill leaks are significant source points of emissions of H2S; the average concentration of H2S in biogas from the landfill leaks is around 1700 ppmv. The fresh composting site was also an important contributor of H2S to the total emission volume; its concentration varied between 3.2 and 1.7 ppmv and a decrease with time was observed. The mature composting site showed a reduction of H2S concentration (<0.1 ppmv). Leachate pond showed a low concentration of H2S (in order of ppbv). Regarding NH3, composting sites and landfill leaks are notable source points of emissions (composting sites varied around 30-600 ppmv; biogas from landfill leaks varied from 160 to 640 ppmv). Regarding VOCs, the main compounds were: limonene, p-cymene, pinene, cyclohexane, reaching concentrations around 0.2-4.3 ppmv. H2S/NH3, limonene/p-cymene, limonene/cyclohexane ratios can be useful for analysing and identifying the emission sources.

PCDD/F emissions from light-duty diesel vehicles operated under highway conditions and a diesel-engine based power generator.

PCDD/F emissions from three light-duty diesel vehicles--two vans and a passenger car--have been measured in on-road conditions. We propose a new methodology for small vehicles: a sample of exhaust gas is collected by means of equipment based on United States Environmental Protection Agency (U.S. EPA) method 23 A for stationary stack emissions. The concentrations of O2, CO, CO2, NO, NO2 and SO2 have also been measured. Six tests were carried out at 90-100 km/h on a route 100 km long. Two additional tests were done during the first 10 min and the following 60 min of the run to assess the effect of the engine temperature on PCDD/F emissions. The emission factors obtained for the vans varied from 1800 to 8400 pg I-TEQ/Nm(3) for a 2004 model year van and 490-580 pg I-TEQ/Nm(3) for a 2006 model year van. Regarding the passenger car, one run was done in the presence of a catalyst and another without, obtaining emission factors (330-880 pg I-TEQ/Nm(3)) comparable to those of the modern van. Two other tests were carried out on a power generator leading to emission factors ranging from 31 to 78 pg I-TEQ/Nm(3). All the results are discussed and compared with literature.

PCDD/F formation from chlorophenols by lignin and manganese peroxidases.

Polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/F) formation was studied, in vitro, with two different chlorophenol mixtures (group "di+tri" 2,4-dichlorophenol; 2,3,4-, 2,3,5-, and 3,4,5-trichlorophenols and group "tri+tetra+penta" with 2,4,5-trichlorophenol, 2,3,4,6-tetrachlorophenol and pentachlorophenol) and two different lignolytic enzymes, lignin and manganese peroxidase (LiP and MnP respectively), which can be found during the composting process of sewage sludge. The concentrations of PCDD/F in final samples are compared to the PCDD/F content of the control samples containing the chlorophenols. High increases were observed for experiments with MnP and phosphate buffer. Experiments that contained tri-, tetra- and pentachlorophenol with MnP resulted in more than 8·10(8)ng of OCDD kg(-1) chlorophenol which was much higher than the initial amount (1·10(7)ng OCDD kg(-1) chlorophenol). In relation to LiP experiments, only those at 37°C showed a moderate increase (from 1.3·10(7) to 2.6·10(7)ng of OCDD kg(-1) chlorophenol). The results agree with the literature in which high amounts of HpCDD and OCDD were found after a composting process and could explain the biogenic formation suggested by others, but the incidence on the total toxicity is less than that expected.

PCDD/F and dioxin-like PCB concentrations during municipal solid waste biomethanation and subsequent composting.

PCDD/F and dioxin-like PCB concentrations were compared in different samples of a municipal solid waste (MSW) treatment plant: the initial MSW fraction that enters the biomethanation from the digester, the semi-solid digestate obtained after biomethanation of MSW, and the solids after composting the digestate since the final product is destined for land application and special attention must be paid to these compounds for environmental considerations. The initial MSW sample showed low concentrations of PCDD/Fs, although in the biomethanation output sample the concentration was more than ten times higher. The difference was even more significant for PCBs. In compost samples concentrations for both PCDD/Fs and PCBs were in the same range as in biomethanation or lower. Nevertheless, concentrations found for all samples were low and these treatments do not pose a major problem for the environment in the working conditions used.

Estudio clínico de los implantes dentales Naturactis en postextracción dental / Clinical study of naturactis dental implants postextraction dental procedures

Introducción: Los implantes inmediatos postextracción tienen un éxito variable según diferentes autores entre un 92,7% y 98,0%. Su principal indicación es la sustitución de dientes susceptibles de extracción. Su ventaja principal es la de acortar el tiempo de tratamiento rehabilitador y evitar una segunda cirugía. Como inconveniente destaca el requerir, generalmente, técnicas de regeneración tisular guiada. Material y método: 60 implantes Naturactis de Euroteknika (Euroteknika Groupe, Sallanches - Francia) fueron colocados de forma inmediata postextracción siguiendo un protocolo clínico de actuación. 33 pacientes fueron incluidos en este estudio en base a unos criterios de inclusión. Se analizaron variables clínicas (edad, sexo y hábitos tóxicos), quirúrgicos (torque de inserción, evaluación periodontal, estabilidad con Ostell) radiológicos (pérdida ósea crestal). Todos ellos fueron analizados 10 meses vista. Se evitaron las descargas mucoperiósticas en todos los casos. Resultados: Los implantes colocados obtuvieron un torque de inserción >35 Nm tras su colocación así como unos valores >63 ISQ de Ostell. El protocolo quirúrgico fue satisfactorio por los operadores. 4 implantes del total fracasaron de forma temprana (<1 mes). Se constató ausencia de pérdida ósea crestal en los primeros 6 meses de su colocación. La cicatrización y postoperatorio fue satisfactoria con ausencia de complicaciones (AU)

Introduction: Dental implants places in dental fresh sockets, have a variable success according to different authors, between 92,7% and 98%. Its principle indication is to substitute teeth admitting dental extraction. Its principle advantage is a shorter time of treatment up to loading of the prosthesis, also it avoids a second surgery and improves the healing process. As an inconvenient we remark, the need for guided tissue regeneration. Material and method: 60 dental implants (Naturactis from Euroteknika Groupe, Sallanches - Francia) were placed immediate after dental extraction with a clinical protocol. 33 patients were included in this study, based on some inclusion criterias. We analyzed clinical aspects like (age, gender, toxic habits), surgical aspects (insertion torque, periodontal evaluation, ostell stability measure), radiology (crestal alveolar resorption). All these cases were analyzed during 10 months. Mucoperiostical flaps were avioded in all cases. Results: All dental implants placed, achieved at least 35 NM after placed, as well a >63 ISQ measured with Ostell. The surgical protocol was approved by surgeons. 4 of all the implants placed failed in the early stages (<1 month). We verify no crestal bone loss in the first 6 months after the implants were placed. Healing and post surgical procedures were correct without any complication described (AU)

Actualización en los protocolos de extracción dental en pacientes anticoagulados / Update in dental procedures in patients receiving oral anticoagulated therapy

Las intervenciones de cirugía oral y las simples extracciones dentales pueden ser objeto de complicaciones inmediatas y mediatas desde un punto de vista hemorrágico para el profesional que interviene sobre pacientes en tratamiento con anticoagulantes orales. Los protocolos clínicos publicados en relación al enfoque terapéutico a seguir en estos casos se basa en dos vertientes: la que postula una disminución de la ingesta farmacológica del anticoagulantes y sustitución por heparina o bien aquella que preconiza su mantenimiento y el control del INR junto con unas medidas hemostáticas específicas del proceso. Nuestro propósito es evaluar los protocolos descritos en la literatura y por las sociedades médicas con el fin de iniciar unas pautas aclaratorias actualizadas (AU)

Oral surgery and easy dental extractions could be potential mediate or immediate clinical haemorrhagic complications that dental clinicians may encounter when treating patients on anticoagulant oral medication. The clinical protocols published regarding which therapeutic procedure to follow when dealing with these patients are based on two approaches: One that postulates a decrease of the pharmacological ingestion of the anticoagulants and their substitution with heparin; another which recommends their maintenance and the control of INR (international normalized ratio) together with a few haemostatic specific procedures. Our aim is, therefore, to evaluate the protocols described in the literature in order to establish a few explanatory updated guidelines for the medical associations (AU)

[Patellar osteochondral injury as onset of patellar instability]. / Lesión osteocondral patelar como debut de una inestabilidad rotuliana.

Patellar osteochondral fractures with no dislocation are uncommon and usually affect the centromedial facet of the patella. We present the case of a 10 year-old, overweight, female patient. She was seen in the emergency room after suffering an accidental fall, assessed as an osteochondral fracture-dislocation of the right patella with upper-outer displaced free fragments. By patient interview, she referred to no previous episodes of patellar dislocation. To complete the study, we performed an MRI which showed a medial facet patellar fracture, with two osteochondral fragments located in the sub-quadricipital recess, associated with other lesions suggesting patellar subluxation. We considered that the best treatment was surgery, so the following was performed: an open reduction and internal fixation with absorbable bars, lateral patellar release (Ficat technique), patellar coverage by medial portion of quadriceps (Insall technique) and internal moving of the lateral half of the patellar tendon (Goldwaith technique). The injury was checked one year later using arthroscopy. It confirmed a good reconstruction of the articular surface, and right patellar centering. At follow-up, during the physiotherapy period, the patient began to have repeated episodes of instability in the contralateral patella. The CT scan confirmed the patellar lateralisation (TAGT 17). Centering surgery was indicated due to the occurrence of multiple dislocation episodes. The patient currently carries out normal physical activity and she has a complete range of movement. Patellar osteochondral fracture is an injury frequently associated with patellar instability, which may onset in the first episode. The medial location of the lesions and the involvement of the system of medial knee stability is a fundamental finding. This fact reinforces the diagnosis of pre-fracture patellar dislocation. This is not a fracture-dislocation, but a dislocation-fracture. We may, therefore, treat the injury and its cause.

Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain.

AIMS: To compare different methods in order to assess adherence and persistence with oral endocrine therapy in women diagnosed with breast cancer (BC) in Catalonia. MATERIALS AND METHODS: This study covered all women newly diagnosed with stage I, II or IIIa BC and positive hormone receptors at six hospitals in Catalonia (Spain) in 2004. Adherence was assessed on the basis of physician report and patient self-report using a telephone questionnaire. Persistence was measured by refill prescriptions. We used the Kappa index to compare adherence measures and logistic regression to evaluate adherence-related risk factors. RESULTS: The study covered a total of 692 women. Adherence ranged from 92% (self-report) to 94.7% (physician report), depending on the measure used; persistence was 74.7% at 5 years of follow-up. Low concordance between measures was observed (Kappa range: 0.018-0.267). Patients aged 50-74 years showed higher adherence than those aged <50 years. Adherence was also associated with: adjuvant chemotherapy and sequential hormonal therapy. CONCLUSIONS: Concordance between the different measures was remarkably low, indicating the need for further research. Adherence is an issue in the management of BC patients taking oral drugs, and should be assessed in clinical practice.

Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review).

Multifocal epithelial hyperplasia (MEH), also known as Heck's disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported.

Potential of Spanish sour-sweet pomegranates (cultivar C25) for the juice industry.

Commercial juices of sweet pomegranates and fresh juices of sour-sweet pomegranates were analysed for organic acids, sugars, antioxidant activity, volatile composition, sensory profile and consumer liking. Organic acids and sugars were analysed by high-performance liquid chromatography, while volatiles were extracted using hydrodistillation and analysed by gas chromatography-mass spectrometry and gas chromatography-flame ionisation detector. Malic acid was predominant in sweet juices while citric acid in sour-sweet samples. Fructose and glucose were found as the predominant sugars in all juices. A total of 18 compounds were found in pomegranate aroma profile, including monoterpenes, aldehydes, alcohols, monoterpenoids and linear hydrocarbons; the most abundant compounds were 3-carene, α-terpinene and α-terpineol. The total concentration of volatiles ranged from 2.0 up to 5.1 mg/L, with commercial samples presenting higher total concentrations due to the presence of peel volatiles. The high potential of sour-sweet pomegranate fruits for the juice industry was supported by (a) the high values of positive attributes, such as colour and fresh pomegranate flavour and (b) the high overall liking of consumers.

In vivo biological activity of rocket extracts (Eruca vesicaria subsp. sativa (Miller) Thell) and sulforaphane.

Eruca is thought to be an excellent source of antioxidants like phenolic compounds, carotenoids, glucosinolates and their degradation products, such as isothiocyanates. Sulforaphane is one of the most potent indirect antioxidants of Eruca isolated until the date. In this work we investigate: (i) the safety and DNA protective activity of Eruca extracts and sulforaphane (under and without oxidative stress) in Drosophila melanogaster; and (ii) the influence on D. melanogaster life span treated with Eruca extracts and sulforaphane. Our results showed that among the four concentrations of Eruca extracts tested (from 0.625 to 5mg/ml), intermediate concentrations of the Es2 accession (1.25 and 2.5mg/ml) exhibited no genotoxic activity, as well as antigenotoxic activity (inhibition rate of 0.2-0.6) and the lowest concentration of Es2 and Es4 accessions (0.625 mg/ml) also enhanced the health span portion of the live span curves. Sulforaphane presented a high antigenotoxic activity in the SMART test of D. melanogaster and intermediate concentrations of this compound (3.75 µM) enhanced average healthspan. The results of this study indicate the presence of potent antigenotoxic factors in rocket, which are being explored further for their mechanism of action.