Efficient removal of triclosan from water through activated carbon adsorption and photodegradation processes.

This study investigated the application of adsorption with activated carbons (ACs) and photodegradation to reduce the concentration of triclosan (TCS) in aqueous solutions. Concerning adsorption, ACs (Darco, Norit, and F400) were characterised and batch experiments were performed to elucidate the effect of pH on equilibrium. The results showed that at pH = 7, the maximum adsorption capacity of TCS onto the ACs was 18.5 mg g-1 for Darco, 16.0 mg g-1 for Norit, and 15.5 mg g-1 for F400. The diffusional kinetic model allowed an adequate interpretation of the experimental data. The effective diffusivity varied and increased with the amount of TCS adsorbed, from 1.06 to 1.68 × 10-8 cm2 s-1. In the case of photodegradation, it was possible to ensure that the triclosan molecule was sensitive to UV light of 254 nm because the removal was over 80 % using UV light. The removal of TCS increased in the presence of sulfate radicals. It was possible to identify 2,4-dichlorophenol as one of the photolytic degradation products of triclosan, which does not represent an environmental hazard at low concentrations of triclosan in water. These results confirm that the use of AC Darco, Norit, and F400 and that photodegradation processes with UV light and persulfate radicals are effective in removing TCS from water, reaching concentration levels that do not constitute a risk to human health or environmental hazard. Both methods effectively eliminate pollutants with relatively easy techniques to implement.

Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial.

BACKGROUND AND OBJECTIVE: Primary stability (PS) is remarkable for secondary stability and implant success. Surgical technique modifications seem to improve primary stability, especially in poor quality bone. The aim of this study was to compare the insertion torque (IT) and implant stability quotients (ISQ) of implants placed with underpreparation, expanders, and standard surgical instrumentation in different bone types. MATERIAL AND METHODS: This randomized controlled clinical trial enrolled 108 patients (n=108 implants) distributed in three study groups: group 1 (n=36) underpreparation technique, group 2 (n=36) expander technique, and group 3 (n=36) conventional drilling. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery. RESULTS: ISQ values were associated with the patient's bone quality and were higher in bone quality type II (76.65) and type III (73.60) and lower in bone quality type IV (67.34), with statistically significant differences (p<0.0001). Lower stability results were obtained when conventional drilling (69.31) was used compared to the use of underpreparation (74.29) or expanders (73.99) with a level of significance of p=0.008 and p=0.005, respectively. CONCLUSIONS: The surgical technique influences the PS when there is low-quality bone. In low-quality bones, conventional drilling obtains lower ISQ values. CLINICAL RELEVANCE: Replace the conventional drilling technique for an alternative, underpreparation or expanders, in low-quality bone in order to achieve greater primary stability.

Case Report: Dynamic Interdependencies Between Complementary and Alternative Medicine (CAM) Practice, Urinary Interleukin-6 Levels, and Fatigue in a Breast Cancer Survivor.

Background: This study investigated the influence of complementary and alternative medicine (CAM) techniques (i.e., Jin Shin Jyutsu, music, physiotherapy, Tai Chi, and energy healing) on urinary interleukin-6 (IL-6) levels and fatigue in a 49-year-old breast cancer survivor suffering from cancer-related fatigue and depression. Data were sampled under conditions of "life as it is lived." Methods: For 28 days, a female breast cancer survivor collected her full urine output in 12-h intervals from about 8 a.m. to 8 p.m. and from about 8 p.m. to 8 a.m. These urine samples were used to determine urinary IL-6 levels through ELISA and creatinine concentrations via HPLC. In 12-h intervals (every morning and evening), the patient completed the DIARI, which included fatigue measurement and notes on incidents and activities such as CAM practice. In addition, the patient was interviewed weekly to identify meaningful everyday incidents. In this context, CAM practice was also discussed. Time series analysis consisted of ARIMA modeling and cross-correlational analyses (p < 0.05). Results: When each CAM technique was considered separately in time series analysis, CAM was consistently associated with increases in urinary IL-6 release and decreases in fatigue. Furthermore, when all CAM techniques experienced as positive were included in one time series, a biphasic urinary IL-6 response pattern was found in which CAM practice was first preceded by decreases in IL-6 by 12-0 h and then followed by increases in IL-6 after 108-120 h. Finally, cross-correlations between IL-6 and fatigue showed that increases in IL-6 were followed by decreases in fatigue intensity after 48-60 h and, conversely, that decreases in fatigue intensity were followed by decreases in IL-6 after 24-36 h and 48-60 h. Conclusion: IL-6 increases and fatigue decreases highlight potential health-promoting effects of CAM practice. Moreover, a cyclic IL-6 pattern in response to all CAM activities experienced as positive underscores that CAM was meaningful to the patient. Additionally, a negative feedback circuit between IL-6 and fatigue intensity was detected. Taken together, this study confirms the necessity of integrating subjective meaning and dynamic complexity into biopsychosocial research in order to understand human functioning under real-life conditions.

Real-Life Cause-Effect Relations Between Urinary IL-6 Levels and Specific and Nonspecific Symptoms in a Patient With Mild SLE Disease Activity.

Background: Little is known about the real-time cause-effect relations between IL-6 concentrations and SLE symptoms. Methods: A 52-year-old woman with mild SLE activity collected her entire urine for the determination of IL-6/creatinine and protein/creatinine levels (ELISA, HPLC) for a period of 56 days in 12 h intervals (total: 112 measurements). Additionally, she answered questionnaires (VAS) on oral ulceration, facial rash, joint pain, fatigue and tiredness and measured her temperature orally twice a day. Time-series analyses consisted of ARIMA modeling and cross-correlational analyses (one lag = 12 h, significance level = p < 0.05). Results: Statistical analyses showed that increased urinary IL-6 concentrations preceded increased urinary protein levels by 36-48 h (lag3: r=+.225; p=.017) and that, in the opposite direction of effect, increased urinary protein preceded urinary IL-6 decreases by 12-24 h (lag1: r=-.322; p<.001). Moreover, urinary IL-6 increases co-occurred with increased oral ulceration (lag0: r=+.186; p=.049); after 48-60 h, however, IL-6 increases showed a strong tendency to precede oral ulceration decreases (lag4: r=-.170; p=.072). Increases in facial rash preceded decreases in urinary IL-6 after 84-96 h (lag7: r=-.215; p=.023). As to fatigue, increases in urinary IL-6 co-occurred with decreased fatigue (lag0: r=-.193; p=.042); after 84-96 h, however, IL-6 increases preceded fatigue increases (+lag7: r=+.189; p=.046). Finally, joint pain, tiredness and body temperature did not significantly correlate with urinary IL-6 concentrations in either direction of effect. Conclusions: The results of this evaluation point to real-life feedback mechanisms between immune activity and SLE symptoms. Comparison with a previous evaluation of this patient suggests a counterregulatory mechanism between Th1 activity and IL-6. These findings are preliminary and require replication to draw firm conclusions about the real-time relation between IL-6 and SLE disease activity.

Determination of Exosome Mitochondrial DNA as a Biomarker of Renal Cancer Aggressiveness.

Here, the role of non-invasive biomarkers in liquid biopsy was evaluated, mainly in exosomes and mitochondrial DNA (mtDNA) as promising, novel, and stable biomarkers for renal cell carcinoma (RCC). A total of 140 fractions (named from B to F) obtained by ultracentrifugations of whole blood samples from 28 individuals (13 patients and 15 controls) were included. Nanoparticle Tracking Analysis (NTA) was conducted to characterized exosomal fraction. Subsequently, an analysis of digital PCR (dPCR) using the QuantStudio™ 3D Digital PCR platform was performed and the quantification of mtDNA copy number by QuantStudioTM 12K Flex Real-Time PCR System (qPCR) was developed. Moreover, Next Generation Sequencing (NGS) analyses were included using MiSeq system (Illumina, San Diego, CA, USA). An F fraction, which contains all exosome data and all mitochondrial markers, was identified in dPCR and qPCR with statistically significant power (adjusted p values ≤ 0.03) when comparing cases and controls. Moreover, present analysis in mtDNA showed a relevant significance in RCC aggressiveness. To sum up, this is the first time a relation between exosomal mtDNA markers and clinical management of RCC is analyzed. We suggest a promising strategy for future liquid biopsy RCC analysis, although more analysis should be performed prior to application in routine clinical practice.

Prevalencia del inicio precoz de la lactancia materna / Prevalence of the early onset of maternal breastfeeding

Introducción: el momento en que el recién nacido recibe la primera toma no ha sido estudiado de modo explícito y se necesitan investigaciones para evaluar las medidas de apoyo a la lactancia. Nuestro objetivo fue determinar la prevalencia del inicio precoz de la lactancia materna (IPLM) y analizar su relación con distintos factores maternos y del recién nacido. Métodos: estudio descriptivo transversal realizado durante tres años en un hospital público. La base de datos utilizada para el estudio procedió de un registro clínico electrónico. Se realizó un análisis univariado descriptivo de todas las variables y se analizó la relación existente entre el IPLM con distintos parámetros maternos y del recién nacido mediante el test de Fisher. Resultados: nuestros resultados mostraron que la prevalencia de un IPLM fue de un 88,4%, de un total de 2.683 nacimientos incluidos en el estudio. Además, se encontró asociación significativa entre este IPLM y distintos factores maternos, como la paridad (p = 0,05) y las semanas de gestación (p = 0,047), excepto con la edad (p = 0,522). Igualmente, se encontró una asociación fuerte con todos los factores del niño (p = 0,000), como el peso, el color del líquido amniótico, el test de Apgar al minuto y a los cinco minutos, el tipo de reanimación que precisaba o la necesidad de ingreso en la unidad neonatal. Conclusiones: la tasa de IPLM en nuestro ámbito de estudio es alta y está influenciada por distintos factores maternos y del recién nacido

Introduction: the situation with maternal breastfeeding is difficult to describe with any certainty, given the absence of any data gathered in maternity hospitals, and the timing of its onset has not been explicitly evaluated. Further research is needed to evaluate breastfeeding support measures. The objective of the present study was to determine the prevalence of early onset of maternal breastfeeding (EOMB) and to analyze the relationship with different maternal and newborn factors. Methods: a descriptive study was performed of births in a public hospital over a three-year period. The database used for the study derived from an electronic clinical record system designed by professionals. Descriptive and univariate analyses were performed. The association of early onset of maternal breastfeeding with other parameters from mother and newborn was analyzed by the Fisher's test. Results: the prevalence of EOMB was 88.4%. A total of 2,683 births were included in the study. Significant associations were found between this EOMB and different maternal factors, such as parity (p = 0.05) and weeks of gestation (p = 0.047), but not with age (p = 0.522). A strong association was also found with all the factors of the child (p = 0.000), such as weight, color of the amniotic fluid, the Apgar test at one and five minutes, the type of resuscitation required or the need for admission in the neonatal unit. Conclusions: There has been a high rate of (EOMB) in our setting

[Prevalence of the early onset of maternal breastfeeding]. / Prevalencia del inicio precoz de la lactancia materna.

INTRODUCTION: Introduction: the situation with maternal breastfeeding is difficult to describe with any certainty, given the absence of any data gathered in maternity hospitals, and the timing of its onset has not been explicitly evaluated. Further research is needed to evaluate breastfeeding support measures. The objective of the present study was to determine the prevalence of early onset of maternal breastfeeding (EOMB) and to analyze the relationship with different maternal and newborn factors. Methods: a descriptive study was performed of births in a public hospital over a three-year period. The database used for the study derived from an electronic clinical record system designed by professionals. Descriptive and univariate analyses were performed. The association of early onset of maternal breastfeeding with other parameters from mother and newborn was analyzed by the Fisher's test. Results: the prevalence of EOMB was 88.4%. A total of 2,683 births were included in the study. Significant associations were found between this EOMB and different maternal factors, such as parity (p = 0.05) and weeks of gestation (p = 0.047), but not with age (p = 0.522). A strong association was also found with all the factors of the child (p = 0.000), such as weight, color of the amniotic fluid, the Apgar test at one and five minutes, the type of resuscitation required or the need for admission in the neonatal unit. Conclusions: There has been a high rate of (EOMB) in our setting.

INTRODUCCIÓN: Introducción: el momento en que el recién nacido recibe la primera toma no ha sido estudiado de modo explícito y se necesitan investigaciones para evaluar las medidas de apoyo a la lactancia. Nuestro objetivo fue determinar la prevalencia del inicio precoz de la lactancia materna (IPLM) y analizar su relación con distintos factores maternos y del recién nacido. Métodos: estudio descriptivo transversal realizado durante tres años en un hospital público. La base de datos utilizada para el estudio procedió de un registro clínico electrónico. Se realizó un análisis univariado descriptivo de todas las variables y se analizó la relación existente entre el IPLM con distintos parámetros maternos y del recién nacido mediante el test de Fisher. Resultados: nuestros resultados mostraron que la prevalencia de un IPLM fue de un 88,4%, de un total de 2.683 nacimientos incluidos en el estudio. Además, se encontró asociación significativa entre este IPLM y distintos factores maternos, como la paridad (p = 0,05) y las semanas de gestación (p = 0,047), excepto con la edad (p = 0,522). Igualmente, se encontró una asociación fuerte con todos los factores del niño (p = 0,000), como el peso, el color del líquido amniótico, el test de Apgar al minuto y a los cinco minutos, el tipo de reanimación que precisaba o la necesidad de ingreso en la unidad neonatal. Conclusiones: la tasa de IPLM en nuestro ámbito de estudio es alta y está influenciada por distintos factores maternos y del recién nacido.

Adherence to Mediterranean diet and risk of prostate cancer.

In Europe, countries following the traditional Mediterranean Diet (MeDi), particularly Southern European countries, have lower prostate cancer (PCa) incidence and mortality compared to other European regions. In the present study, we investigated the association between the MeDi and the relative risk of PCa and tumor aggressiveness in a Spanish population. Among individual score components, it has been found that subjects with PCa were less likely to consume olive oil as the main culinary fat, vegetables, fruits and fish than those without. However, these differences were not statistically significative. A high intake of fruit, vegetables and cooked tomato sauce Mediterranean style (sofrito) was related to less PCa aggressiveness. Results showed that there are no differences in the score of adherence to the Mediterranean dietary patterns between cases and controls, with mean values of 8.37 ± 1.80 and 8.25 ± 2.48, respectively. However, MeDi was associated with lower PCa agressiveness according to Gleason score. Hence, relations between Mediterranean dietary patterns and PCa are still inconclusive and merit further investigations. Further large-scale studies are required to clarify the effect of MeDi on prostate health, in order to establish the role of this diet in the prevention of PCa.

The influence of nutritional factors on prostate cancer incidence and aggressiveness.

There is an increasing evidence for a link between nutrition, lifestyle and prostate cancer (PCa) development and/or progression of disease. The objective of this study was to examine the association between dietary factors and PCa incidence and aggressiveness in a case-control study. After the analysis of the anatomic pathology, subjects were classified in patients with PCa (n = 157) and controls (n = 158). Clinical data including Gleason score, PSA values and biopsy results, were compiled. Frequencies of food consumption and sociodemographic data were also obtained. The results showed that physical activity was significantly higher in control (p < .022). It was also found that some nutritional habits offer a protective effect among studied subjects, like high nuts (p = .041) and fish (p = .041) intakes. Moreover, there was a significant reduction in risk (p = .029) in cases with a higher fruits and vegetables intakes. A decreased risk of aggressive PCa was associated with fruits, vegetables, legumes and fish intakes. However, these relationships were not statistically significant when data were adjusted for covariates. In conclusion, this study found an inverse association between PCa risk and the intake of fruits and vegetables, fish and nuts. The results suggested that a diet with higher intakes of these foods as Mediterranean diet may lower the risk of PCa in the studied population. As dietary factors are modifiable, identifying food groups or dietary patterns that modulate the risk of PCa and its aggressiveness can offer effective and practical strategies for its primary prevention.

Risk Assessments of Epidural Analgesia During Labor and Delivery.

Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies. However, women with EA were not and increased risk for perineal laceration or the condition of the membranes at the delivery or with the type of placental expulsion. Thus, the administration of EA should be assessed in each case by the health care professional.

The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section.

INTRODUCTION: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. METHOD: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 ( N = 2,450; EA = 562, non-EA = 1,888). RESULTS: Risk of a cesarean section was significantly increased by EA administration (odds ratio [ OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. CONCLUSION: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.

Subjective Positive and Negative Sleep Variables Differentially Affect Cellular Immune Activity in a Breast Cancer Survivor: A Time-series Analysis Approach.

This study on a breast cancer survivor suffering from cancer-related fatigue (CaRF) and depression investigated the bidirectional relationship between cellular immune activity and subjective sleep. The 49-year-old patient (breast cancer diagnosis 5 years before the study, currently in remission) collected her full urine output for 28 days in 12-h intervals (8:00 p.m. to 8:00 a.m. and 8:00 a.m. to 8:00 p.m.). These urine samples were used to determine urinary neopterin (cellular immune activation marker) and creatinine concentrations via high-pressure liquid chromatography (HPLC). Each morning, the patient answered questions on five sleep variables: sleep quality (SQ), sleep recreational value (SRV), total sleep time (TST), total wake time (TWT), and awakenings during sleep period (ADS). For the purpose of this study, the time series of the nighttime urinary neopterin levels and the five sleep variables were determined. Using centered moving average (CMA) smoothing and cross-correlational analysis, this study showed that increases in the positive sleep variables SQ and SRV were followed by urinary neopterin concentration decreases after 96-120 h (SQ, lag 4: r = -0.411; p = 0.044; SRV: lag 4: r = -0.472; p = 0.021) and 120-144 h (SRV, lag 5: r = -0.464; p = 0.026). Increases in the negative sleep variable TWT, by contrast, were followed by increases in urinary neopterin concentrations 72-96 h later (lag 3: r = 0.522; p = 0.009). No systematic effects in the other direction, i.e., from urinary neopterin levels to sleep, were observed in this study. Although preliminary, the findings of this study highlight the benefit of carefully investigating temporal delays and directions of effects when studying the dynamic relationship between sleep and immune variables in the natural context of everyday life.

Association of cardiovascular emerging risk factors with acute coronary syndrome and stroke: A case-control study.

In this study, we estimated the risk of acute coronary syndrome and stroke associated with several emerging cardiovascular risk factors. This was a case-control study, where an age - and sex-matched acute coronary syndrome group and stroke group were compared with controls. Demographic and clinical data were collected through patient interviews, and blood samples were taken for analysis. In the bivariate analysis, all cardiovascular risk factors analyzed showed as predictors of acute coronary syndrome and stroke, except total cholesterol and smoking. In the multivariate logistic regression model for acute coronary syndrome, hypertension and body mass index, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent predictors. For stroke, the predictors were hypertension, diabetes mellitus, body mass index, and N-terminal section brain natriuretic peptide. Controlling for age, sex, and classical cardiovascular risk factors, N-terminal section brain natriuretic peptide and pregnancy-associated plasma protein-A were independent emerging cardiovascular risk factors for acute coronary syndrome, but pregnancy-associated plasma protein-A was not for stroke. High levels of cardiovascular risk factors in individuals with no episodes of cardiovascular disease requires the implementation of prevention programs, given that at least half of them are modifiable.

Effectiveness of a flamenco and sevillanas program to enhance mobility, balance, physical activity, blood pressure, body mass, and quality of life in postmenopausal women living in the community in Spain: a randomized clinical trial.

OBJECTIVE: This study aimed to test the effectiveness of a dance therapy program in improving mobility, balance, physical activity, blood pressure (BP), body mass, and quality of life in postmenopausal women in Spain. METHODS: Fifty-two sedentary postmenopausal women (mean age 69.27 ±â€Š3.85 y) were randomly assigned to receive either dance therapy (n = 27) or self-care treatment advice (n = 25). The intervention group participated in 2 months of dance therapy, three sessions weekly, based on Spanish folk dance (flamenco and sevillanas). The control group was provided a booklet containing physical activity recommendations. Mobility, balance, physical activity, BP, body mass, and quality of life were assessed at baseline and posttreatment in both groups. Statistical analysis was performed using a 2 × 2 analysis of variance (ANOVA). RESULTS: Women in the intervention group showed significant improvements in mobility and balance (timed up-and-go test [P = 0.022], cognitive timed up-and-go [P = 0.029], and one-leg stance test results [P = 0.001]), physical activity (total time index [P = 0.045], energy expenditure [P = 0.007], vigorous physical activity [P = 0.001], leisure activity [P = 0.001], moving [P < 0.001], and activity dimension summary [P = 0.001]), and fitness (overall fitness [P = 0.039], cardiorespiratory fitness [P < 0.001], speed-agility [P = 0.001], and flexibility [P = 0.007]) compared with those in the control group. No differences were observed in BP, body mass, or quality of life. CONCLUSIONS: Spanish dance therapy may be effective to improve mobility, balance, and levels of physical activity and fitness in sedentary postmenopausal women.

Cause-effect relations between 55 kD soluble TNF receptor concentrations and specific and unspecific symptoms in a patient with mild SLE disease activity: an exploratory time series analysis study.

BACKGROUND: This integrative single-case study investigated the 12 h-to-12 h cause-effect relations between 55 kD soluble tumor necrosis factor receptor type 1 (sTNF-R55) and specific and unspecific symptoms in a 52-year-old Caucasian woman with mild systemic lupus erythematosus (SLE) disease activity. METHODS: The patient collected her entire urine for 56 days in 12 h-intervals to determine sTNF-R55/creatinine and protein/creatinine levels (ELISA, HPLC). Additionally, twice a day, she took notes on oral ulceration and facial rash; answered questionnaires (VAS) on fatigue, weakness, and joint pain; and measured body temperature orally. Time series analysis consisted of ARIMA modeling and cross-correlational analyses (significance level = p < 0.05). RESULTS: Time series analysis revealed both a circadian and a circasemiseptan rhythm in the urinary sTNF-R55 data. Moreover, several significant lagged correlations between urinary sTNF-R55 concentrations and SLE symptoms in both directions of effect were identified. Specifically, increased urinary sTNF-R55 concentrations preceded decreased urinary protein levels by 36-48 h (r = -0.213) and, in the opposite direction of effect, increased protein levels preceded increased sTNF-R55 concentrations by 24-36 h (r = +0.202). In addition, increased urinary sTNF-R55 levels preceded increased oral ulcers by 36-48 h (r = +0.277) and, conversely, increased oral ulceration preceded decreased sTNF-R55 levels by 36-48 h (r = -0.313). Moreover, increased urinary sTNF-R55 levels preceded decreased facial rash by 36-48 h (r = -0.223) and followed increased body temperature after 36-48 h (r = +0.209). Weakness, fatigue and joint pain were not significantly correlated with urinary sTNF-R55 levels. CONCLUSIONS: This study gathered first evidence of real-life, long-term feedback loops between cytokines and SLE symptoms in mild SLE disease activity. Such insights into the potential role of sTNF-R55 in SLE would not have been possible had we applied a pre-post design group study. These findings require replication before firm conclusions can be drawn.

Bacterial contamination levels of autogenous bone particles collected by 3 different techniques for harvesting intraoral bone grafts.

PURPOSE: The aim of this study was to compare levels of bacterial contamination of autogenous bone collected when using low-speed drilling, a back-action chisel, and a bone filter. MATERIALS AND METHODS: Bone tissue samples were taken from 31 patients who underwent surgical extraction of their third lower molars. Before surgical removal of the molar, bone particles were collected by a low-speed drill or a back-action chisel. Then, a stringent aspiration protocol was applied during the ostectomy to collect particulate bone by a bone filter. Processing of samples commenced immediately by incubation in an anaerobic or a CO2-rich atmosphere. The number of colony-forming units (CFUs) was determined at 48 hours of culture. RESULTS: No significant difference in the number of CFUs per milliliter was observed between the low-speed drilling group and the back-action chisel group in the anaerobic or CO2-rich condition (P = .34). However, significantly more micro-organisms were found in the bone filter group than in the low-speed drilling group or the back-action chisel group in the anaerobic and CO2-rich conditions (P < .001). CONCLUSIONS: Particulate bone harvested with low-speed drilling or a back-action chisel is safer for use as an autograft than are bone particles collected with a bone filter. These results suggest that bone obtained from low-speed drilling is safe and straightforward to harvest and could be the method of choice for collecting particulate bone. Further research is needed to lower the bacterial contamination levels of autogenous bone particles used as graft material.

Efecto del Phlebodium decumanum y de la coenzima q10 sobre el rendimiento deportivo en jugadores profesionales de voleibol / Effect of Phlebodium decumanun y de la coenzima q10 on sports performance in profesional volleyball players

Introducción: Los programas de entrenamiento físico, se basan en provocar estados de fatiga transitoria para inducir supercompensaciones de los sistemas biológicos implicados en la actividad, con el objeto mejorar el rendimiento del deportista a medio-largo plazo. La administración de suplementos nutricionales con propiedades antioxidantes e inmunomoduladoras, como Phlebodium decumanum y Coenzima Q10, constituyen medidas muy ventajosas para la recuperación de la inflamación y el daño tisular originados por el estrés del ejercicio intenso y mantenido. Metodología: Se llevó a cabo un diseño experimental, longitudinal, a doble ciego, con tres grupos randomizados a partir de una muestra de 30 jugadores varones de voleibol (22-32 años) de la Universidad de Granada, con un nivel de entrenamiento alto (17 horas por semana en los 6 meses previos a la investigación). Se evaluaron los efectos de un programa de entrenamiento físico de un mes de duración, común a todos los grupos de estudio, asociado a la administración simultánea de suplementos nutricionales a base de Phlebodium decumanum (4 cápsulas de 400 mg/ cáp. al día) el Grupo Experimental 1, Phlebodium decumanum(la misma dosis y posología que el grupo 1) más Coenzima Q10 (4 cápsulas de 30 mg/cáp al día) el Grupo Experimental 2, y sustancia placebo, el Grupo Control. Las variables dependientes sanguíneas para valorar los efectos de dicha intervención sobre el perfil endocrinometabólico e inmunológico basales fueron: cortisol e interleuquina 6 relacionados ambos con el eje del estrés inducido por el ejercicio, y ácido láctico y amonio, vinculados esencialmente, al metabolismo energético anaeróbio. Resultados: Todos los grupos del estudio manifestaron cambios adaptativos favorables sobre el perfil endocrihormonano- metabólico e inmunológico, que se objetivaron a través de un descenso significativo basal postest de las concentraciones de cortisol, interleuquina 6, ácido láctico y amoniaco, respecto a los valores previos a la intervención actividad física ± suplemención nutricional protocolizada. Los grupos que mostraron un perfil más favorable, fueron los que recibieron suplementación nutricional frente a placebo, y de entre los primeros, los sujetos que tomaron doble suplementación con Phlebodium decumanum más Coenzima Q10. Conclusiones: La ingesta de Phlebodium decumanum y de Coenzima Q10 durante 4 semanas, mostró efectos protectores sobre el perfil endocrino-metabólico e inmunológico basales, que atribuimos a las propiedades inmunomoduladoras y antioxidantes de ambas sustancias, lo que no sólo resulta altamente beneficioso para retrasar la fatiga y mejorar el rendimiento deportivo, sino también, para disminuir el riesgo de lesiones asociadas al ejercicio físico de alta intensidad (AU)

Introduction: Physical training programmes are based on provoking transitory states of fatigue in order to induce super compensation by the biological systems involved in the activity, in order to improve the athlete’s medium-long term performance. The administration of nutritional supplements with antioxidant and immunomodulatory properties, such as Phlebodium decumanum and coenzyme Q10, can be a very advantageous means of achieving recovery from the inflammation and tissue damage caused by the stress of prolonged, intense exercise. Methodology: An experimental, longitudinal, double- blind experiment was conducted, with three randomized groups obtained from a sample of 30 male volleyball players (aged 22-32 years) at the University of Granada, with a high level of training (17 hours a week during the 6 months preceding the study). The effects were then evaluated of a month-long physical training programme, common to all the study groups, associated with the simultaneous administration of the following nutritional supplements: Phlebodium decumanum (4 capsules of 400 mg/capsule, daily), Experimental Group 1; Phlebodium decumanum (same dose and schedule as Group 1) plus coenzyme Q10 (4 capsules of 30 mg/ capsule, daily), Experimental Group 2; a placebo substance, Control Group. The following dependent blood variables were examined to assess the effects of the intervention on the basal immune and endocrine-metabolic profile: cortisol and interleukin-6, both related to the axis of exercise-induced stress; and lactic acid and ammonium, related essentially to the anaerobic metabolism of energy. Results: All the study groups presented favourable adaptive changes with respect to the endocrine-metabolic and immune profile, as reflected by a significant decrease in the post-test concentrations of cortisol, interleukin 6, lactic acid and ammonium, compared to the values recorded before the physical activity with/without nutritional supplement, per protocol. The groups that achieved the most favourable profile were those which had received nutritional supplementation, rather than the placebo, and among the former, those which had received the double- strength supplement with Phlebodium decumanum plus coenzyme Q10. Conclusions: The intake of Phlebodium decumanum plus coenzyme Q10 for 4 weeks produced protective effects on the endocrine-metabolic and immune profile, which we attribute to the immunomodulatory and antioxidant properties of these substances, which are highly beneficial not only in terms of delaying fatigue and improving athletic performance, but also in reducing the risk of injuries associated with high intensity exercise (AU)

Should arm span or height be used in calculating the BMI for the older people? Preliminary results.

AIMS AND OBJECTIVES: To consider using arm span rather than height for calculating the body mass index, as a parameter that offers greater long-term stability, for the nutritional assessment of persons aged over 65 years. BACKGROUND: The body mass index presents certain drawbacks for the nutritional screening of older people suffering malnutrition or at risk of malnutrition, due to the anthropometric changes that occur with increasing age, especially the progressive loss of height. DESIGN: Observational, cross-sectional study, using nonprobabilistic convenience sampling, with anthropometric measurements and nutritional screening in older men and women, divided into two groups: (1) aged 65-75 years and (2) aged over 75 years. METHODOLOGY: Height and arm span were measured to calculate two separate indices of body mass: body mass index (weight/height) and body mass index.1 (weight/arm span). Nutritional screening was conducted using the Mini Nutritional Assessment Short-Form, which includes the body mass index as an anthropometric measure. RESULTS: Our results reveal statistically significant differences between the two indices, for the sample analysed. Body mass index.1 classifies a larger number of older people as suffering malnutrition and fewer as being at nutritional risk. When this new index is used, there is a displacement of the subjects at risk, thus increasing the number considered at risk of malnutrition and in need of appropriate therapeutic intervention. Therefore, the use of body mass index.1 would enable more people suffering malnutrition, who would otherwise remain untreated, to be attended. CONCLUSIONS: As arm span, as an anthropometric measure, remains unchanged over time, it could be used instead of height, as an alternative index (body mass index.1) to the conventional body mass index. Further research is needed to determine the association between body mass index.1 and clinical status parameters to determine optimum cut-off points. RELEVANCE TO CLINICAL PRACTICE: This study describes the greater stability of body mass index.1 with respect to body mass index for nutritional screening, and the resulting benefits for nutritional monitoring and intervention for older people.

Effectiveness of platelet-rich plasma and hyaluronic acid for the treatment and care of pressure ulcers.

Platelet-rich growth factor (PRGF) is a natural source of growth factors (GF), while hyaluronic acid (HA) is a biopolymer present in the extracellular matrix of skin, cartilage, bone, and brain, among other tissues. Both are involved in the pathophysiological mechanisms underlying wound healing. The objective of this study was to evaluate the clinical efficacy (as measured by ulcer area) and safety (as measured by signs of infection) of PRGF and PRGF plus HA in the treatment of pressure ulcers (PUs). Patients (N = 100) with 124 Stage II-III PUs were randomized to a control group (n = 25 PUs) for standard care or to case groups for treatment with one (n = 34 PUs) or two (n = 25 PUs) doses of PRGF from their own peripheral blood, or two doses of PRGF plus HA (n = 40 PUs). All ulcers were followed up every 3 days for a 36-day period. At 36 days, a significant reduction in ulcer area (p ≤ .001) was observed in all treatment groups, with a mean reduction of more than 48.0% versus baseline. The greatest mean reduction (80.4% vs. baseline) was obtained with the PRGF plus HA regimen. Complete wound healing was observed in 32.0% of PUs treated with two doses of PRGF (p ≤ .002) and in 37.5% of those treated with two doses of PRGF plus HA (p ≤ .004). There were no signs of infection in any PUs during the 36-day follow-up period. The degree of wound healing was inversely correlated with the consumption of drugs such as statins and with the peripheral blood platelet levels of patients at baseline.