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Background: "Convex Pedicle Screw Technique" reduces the theoretical risk of neurovascular injury. Our aim is to evaluate the efficacy of this technique in patients with neuromuscular scoliosis (NMS). Methods: Retrospective study of 12 patients who underwent a Convex Pedicle Screw Technique and were diagnosed with NMS. Patients who had undergone previous spinal surgery were excluded. The minimum follow-up required was 24 months. Demographic data, intraoperative data, neurovascular complications and neurophysiological events requiring implant repositioning, as well as pre- and postoperative radiological variables were collected. Results: Twelve patients diagnosed with NMS underwent surgery. The median operative time was 217 minutes. Mean blood loss was 3.8±1.1 g/dL hemoglobin (Hb). The median postoperative stay was 8.8±4 days. A reduction of the Cobb angle in primary curve of 49.1% (from 52.8°±18° to 26.5°±12.6°; P<0.001) and in secondary curve of 25.2% (from 27.8°±18.9° to 18.3°±13.3°; P=0.10) was achieved. Coronal balance improved by 69.4% (7.5±46.2 vs. 2.3±20.9 mm; P=0.72) and sagittal balance by 75% (from -14.1±71.8 vs. -3.5±48.6 mm; P=0.50). There were no neurovascular complications. There were no intraoperative neurophysiological events requiring implant repositioning, nor during reduction maneuvers. No infections were reported. Conclusions: The correction of the deformity from convexity in NMS achieves similar results to other techniques, and a very low complication rate.
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Scheuermann´s kyphosis (SK) is the most common cause of painful and progressive structural hyperkyphosis in adolescents. Surgical treatment should be considered in cases of refractory pain or progressive deformities. We present the clinical and radiological results obtained using a bipolar, hybrid posterior instrumentation tecnique. We analysed 12 males and 6 females, with mean age of 15.8 years. Minimum follow-up was 2 years. We used transverse process hooks at the cranial level and polyaxial screws for the remaining levels. We did not instrument the periapical segment. We used the sagittal stable vertebra (SSV) as the lower instrumented vertebra (LIV) in most cases, the "barely touched SSV" if the above disc space is lordotic. The mean preoperative kyphosis was 73.6º, mean postoperative kyphosis 44.7º, and mean correction of 28.9º (p = 0.0002). The mean reduction in lumbar lordosis (LL) was 8.9º (p = 0.0018). There were no significant differences in the spinopelvic parameters or sagittal balance. The mean number of instrumented levels was 8.9. Type II osteotomies were necessary in only three patients. Three patients had a cranial sagittal angle greater than 10°, all of them asymptomatic. Postoperatively, all patients had VAS scores less than 2 and SRS-22 scores greater than 4. Hybrid bipolar posterior instrumentation offers adequate curve correction, less operative time, implant density, bleeding, material protrusion and risk of spinal cord injury, leaving a large periapical bed for graft supply. We propose to measure the flexibility of the curve in MRI. In flexible curves (those that correct at least 20% in the supine decubitus position), wide facetectomies offer adequate correction of the deformity.
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Background: Cylindrical fully-coated cobalt-chromium stems (CCS) have been widely used in femoral revisions. However, monoblock fluted conical tapered stems (FCTS) are growing in popularity. The present study seeks to determine whether there are any long-term differences between the two designs. Material and methods: A retrospective study of 38 CCS versus 40 FCTS was carried out. Demographic data, clinical variables and radiographic parameters were recorded. Results: Demographic data were comparable. A greater proportion of septic revisions, periprosthetic fractures and previous osteosynthesis failures was observed with FCTS versus CCS (p = 0.012). A greater use of FCTS was recorded in cases with bone defects of type IIIA and higher (p = 0.025). There were no significant differences in terms of in-hospital complications (p = 0.815), postoperative surgical complications or need for reoperation (p = 0.156). The CCS group presented a higher percentage of clinical thigh pain at the end of follow-up (p = 0.006). Additionally, a greater presence of radiolucencies was observed with CCS, especially in proximal zones (1, 7, 10 and 14). More subsidence, tip cortical hypertrophy and stress shielding were recorded in the CCS group. The overall survival at 120 months was 84.2% in the CCS group and 85% in the FCTS group (p = 0.520). When analyzing isolated aseptic loosening as the cause of failure, the survival rate was 94.7% in the CCS group and 95% in the FCTS group (p = 0.506). Conclusions: Both FCTS and CCS with diaphyseal anchorage afford excellent long-term survival rates, with no differences between the two designs. However, a higher incidence of stress shielding, radiolucencies and thigh pain with CCS seems to favor the use of FCTS.
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Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the presence of autoantibodies against factor VIII (FVIII). As with other autoimmune diseases, its etiology is complex and its genetic basis is unknown. The aim of this study was to identify the immunogenetic background that predisposes individuals to AHA. HLA and KIR gene clusters, as well as KLRK1, were sequenced using next-generation sequencing in 49 AHA patients. Associations between candidate genes involved in innate and adaptive immune responses and AHA were addressed by comparing the alleles, genotypes, haplotypes, and gene frequencies in the AHA cohort with those in the donors' samples or Spanish population cohort. Two genes of the HLA cluster, as well as rs1049174 in KLRK1, which tags the natural killer (NK) cytotoxic activity haplotype, were found to be linked to AHA. Specifically, A*03:01 (p = 0.024; odds ratio (OR) = 0.26[0.06-0.85]) and DRB1*13:03 (p = 6.8 × 103, OR = 7.56[1.64-51.40]), as well as rs1049174 (p = 0.012), were significantly associated with AHA. In addition, two AHA patients were found to carry one copy each of the low-frequency allele DQB1*03:09 (nallele = 2, 2.04%), which was completely absent in the donors. To the best of our knowledge, this is the first time that the involvement of these specific alleles in the predisposition to AHA has been proposed. Further molecular and functional studies will be needed to unravel their specific contributions. We believe our findings expand the current knowledge on the genetic factors involved in susceptibility to AHA, which will contribute to improving the diagnosis and prognosis of AHA patients.
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Hemofilia A , Humanos , Hemofilia A/genética , Genotipo , Haplotipos/genética , Alelos , Frecuencia de los Genes , Secuenciación de Nucleótidos de Alto Rendimiento , Sistema Inmunológico , Predisposición Genética a la EnfermedadRESUMEN
The performance of first-year students in electromagnetism (E&M) courses of different engineering degrees at a Spanish public university was measured using the Brief Electricity and Magnetism Assessment (BEMA), a standard research-based instrument to assess students' understanding after attending introductory courses in electricity and magnetism. In all cases, Flipped classroom (FC) built on information and communications technology was used. The objective of this paper is to analyse if the gain in the BEMA pre and post-test results is influenced by several factors such as the degree, the students' academic grade, and gender. Moreover, as some studies have shown that the students' retention of the concepts was significantly stronger in active learning than in traditional approaches, a third BEMA test was performed by the students to analyse the long-term retention gain dependence on the same factors. Students from different engineering degree programs were asked to complete two BEMA tests during the course and a third one after a few months. ANOVA tests were used to analyse the existence of significant differences in gain between student degree programs, student academic level and student gender. Results have shown no differences in the BEMA performance by degree program, but significant differences were found by academic level and gender. Retention did not depend on the degree course but on the academic level. Mean gain value by academic level, and gender was obtained and concluded that the best students presented the best gain results and that gain depends on the students' gender: males outperformed females in the BEMA tests, although there were no significant differences in the course grades. It is thus necessary to understand these differences and to implement measures in daily teaching work to improve women's performance.
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The ability to manage the myriad of musculoskeletal conditions successfully requires multiple years of training. Access to and completion of orthopaedic surgical training entails an often grueling, highly regulated path to certification to practice. Although the world is more connected than ever, the question is whether the local certification criteria for medical specialists leads to a generic residency program and a similar training in all countries. This report from eight nations on five continents details the distinctive features of that training, including the number of positions available, the examinations required, the gender distribution of residents, and available possibilities once the residence period is complete. This analysis shows a wide variation in the orthopaedic trauma training program worldwide, with emphasis on different skills per country.
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Internado y Residencia , Ortopedia , Humanos , Ortopedia/educación , Educación de Postgrado en Medicina , Curriculum , Competencia ClínicaRESUMEN
Necrotizing fasciitis is a rare soft tissue infection that requires immediate medical attention to prevent its fulminant development that can lead to amputation or death of the patient. In most of reported cases of multifocal necrotizing fasciitis, injuries appear synchronously within hours from the initial diagnosis. It is the only third reported case with metachronous lesions, and the first that involves both S. pyogenes and S. aureus. Early diagnosis and multidisciplinary treatment is mandatory to prevent fatal outcomes. We present the case of a 58-year-old Caucasian man who developed necrotizing fasciitis of both lower limbs with four days between each one. After initial clinical suspicion, he was treated with intravenous antibiotics and we performed an urgent fasciotomy of the right leg and diagnosis was confirmed. Streptococcus pyogenes and Methicillin-Resistant Staphylococcus aureus were isolated from intraoperative cultures. Four days later, due to rising signs on the left limb, another fasciotomy had to be performed and the same microorganisms were isolated. Our patient was discharged home one month after his admission and had no complications during the follow-up. In order to prevent the development of metachronous lesions, early multidisciplinary treatment with aggressive and repeated debridement is necessary. We managed to keep our patient alive, without amputation or intervention by Plastic Surgery, and he recovered fully which is an excellent outcome from a very aggressive disease.
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Fascitis Necrotizante , Staphylococcus aureus Resistente a Meticilina , Masculino , Humanos , Persona de Mediana Edad , Staphylococcus aureus , Extremidad Inferior , PiernaRESUMEN
Drinking wine is a processed beverage that offers high nutritional and health benefits. It is produced from grape must, which undergoes fermentation by yeasts (and sometimes lactic acid bacteria) to create a product that is highly appreciated by consumers worldwide. However, if only one type of yeast, specifically Saccharomyces cerevisiae, was used in the fermentation process, the resulting wine would lack aroma and flavor and may be rejected by consumers. To produce wine with a desirable taste and aroma, non-Saccharomyces yeasts are necessary. These yeasts contribute volatile aromatic compounds that significantly impact the wine's final taste. They promote the release of primary aromatic compounds through a sequential hydrolysis mechanism involving several glycosidases unique to these yeasts. This review will discuss the unique characteristics of these yeasts (Schizosaccharomyces pombe, Pichia kluyveri, Torulaspora delbrueckii, Wickerhamomyces anomalus, Metschnikowia pulcherrima, Hanseniaspora vineae, Lachancea thermotolerans, Candida stellata, and others) and their impact on wine fermentations and co-fermentations. Their existence and the metabolites they produce enhance the complexity of wine flavor, resulting in a more enjoyable drinking experience.
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BACKGROUND: We hypothesized that, as posterior malleolar ankle fractures usually present one or two main fragments, the buttress plating principle can be successfully achieved either with conventional nonlocking or anatomic locking posterior tibia plates, and no clinical differences should be found. The aim of this study was to evaluate the outcomes of posterior malleolar ankle (PM) fractures treated with conventional nonlocking (CNP) or anatomic locking plates (ALP), and also to compare both constructs in terms of crude costs. METHODS: A retrospective cohort study was designed. CNP was used in 22 patients and ALP was used in 11 patients. American Orthopedic Foot and Ankle Society (AOFAS) score was registered at four weeks, 3-6 months, 12 and 24 months to assess all patients' functional status. The primary outcome was ankle and hindfoot AOFAS score at 12 months follow-up visit. All complications, radiographic evaluation and implant construct costs were also registered and compared. The average follow-up was 25.4 (range, 12-42) months. RESULTS: No significant difference was observed between both cohorts, in terms of AOFAS score and complication rate (P > .05). We found that ALP construct is 17 times more expensive than CNP construct in our institution (P < .001). CONCLUSION: Anatomic locking posterior tibial plates may be an interesting device when poor bone quality is present or when a true multifragmentary pilon fracture is faced. Anatomic locking posterior tibia plate should not become a regular implant for any PM fracture since equivalent clinical and radiological results were obtained in our study using CNP with a significant reduced cost.
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Background: Cerebrospinal fluid leakage can cause abducens nerve palsy (ANP) secondary to downward brain traction, caused by intracranial hypotension. We present the first case after cervical fixation and fusion with spinal cord decompression. Case Description: We present a 65-year-old male, who undergone C5-C6 decompression by laminectomy and C3-T2 fixation and fusion, without intraoperative complications. Two months later, the patient referred a 2-week history of diplopia, with no other accompanying symptom. Clinical examination revealed a lack of lateral gaze of the left eye. Cervical MRI disclosed findings compatible with pseudomeningocele. Given the time of evolution, the subacute clinical findings and the absence of image or clinical data of infection or intracranial hypotension, we decided to perform conservative treatment. We submitted the patient to periodic clinical examinations and we confirmed progressive clinical improvement of diplopia, in association with neurologic and ophthalmologic specialists. At this time, six months after surgery, the patient is asymptomatic. The swelling has significantly decreased in size. Control MRI revealed no growth of the pseudomeningocele. Conclusions: ANP secondary to intracranial hypotension after cervical spine surgery requires immediate imaging tests and clinical evaluation from neurology and ophthalmology specialists. Management can be conservative, as long as diplopia is the only clinical and radiological finding and wound does not show signs of infection.
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Electroactive composite materials are very promising for musculoskeletal tissue engineering because they can be applied in combination with electrostimulation. In this context, novel graphene-based poly(3-hydroxybutyrate-co-3-hydroxyvalerate)/polyvinyl alcohol (PHBV/PVA) semi-interpenetrated networks (semi-IPN) hydrogels were engineered with low amounts of graphene (G) nanosheets dispersed within the polymer matrix to endow them with electroactive properties. The nanohybrid hydrogels, obtained by applying a hybrid solvent casting-freeze-drying method, show an interconnected porous structure and a high water-absorption capacity (swelling degree > 1200%). The thermal characterization indicates that the structure presents microphase separation, with PHBV microdomains located between the PVA network. The PHBV chains located in the microdomains are able to crystallize; even more after the addition of G nanosheets, which act as a nucleating agent. Thermogravimetric analysis indicates that the degradation profile of the semi-IPN is located between those of the neat components, with an improved thermal stability at high temperatures (>450 °C) after the addition of G nanosheets. The mechanical (complex modulus) and electrical properties (surface conductivity) significantly increase in the nanohybrid hydrogels with 0.2% of G nanosheets. Nevertheless, when the amount of G nanoparticles increases fourfold (0.8%), the mechanical properties diminish and the electrical conductivity does not increase proportionally, suggesting the presence of G aggregates. The biological assessment (C2C12 murine myoblasts) indicates a good biocompatibility and proliferative behavior. These results reveal a new conductive and biocompatible semi-IPN with remarkable values of electrical conductivity and ability to induce myoblast proliferation, indicating its great potential for musculoskeletal tissue engineering.
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A broad variety of microorganisms with useful characteristics in the field of biotechnology live on the surface of grapes; one of these microorganisms is Metschnikowia pulcherrima. This yeast secretes a ß-glucosidase that can be used in fermentative processes to liberate aromatic compounds. In this work, the synthesis of an exocellular ß-glucosidase has been demonstrated and the optimal conditions to maximize the enzyme's effectiveness were determined. There was a maximum enzymatic activity at 28 °C and pH 4.5. Furthermore, the enzyme presents a great glucose and fructose tolerance, and to a lesser extent, ethanol tolerance. In addition, its activity was stimulated by calcium ions and low concentrations of ethanol and methanol. The impact of terpene content in wine was also determined. Because of these characteristics, ß-glucosidase is a good candidate for use in enology.
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A new strategy based on the combination of electrically conductive polymer nanocomposites and extracellular Zn2+ ions as a myogenic factor was developed to assess its ability to synergically stimulate myogenic cell response. The conductive nanocomposite was prepared with a polymeric matrix and a small amount of graphene (G) nanosheets (0.7% wt/wt) as conductive filler to produce an electrically conductive surface. The nanocomposites' surface electrical conductivity presented values in the range of human skeletal muscle tissue. The biological evaluation of the cell environment created by the combination of the conductive surface and extracellular Zn2+ ions showed no cytotoxicity and good cell adhesion (murine C2C12 myoblasts). Amazingly, the combined strategy, cell-material interface with conductive properties and Zn bioactive ions, was found to have a pronounced synergistic effect on myoblast proliferation and the early stages of differentiation. The ratio of differentiated myoblasts cultured on the conductive nanocomposites with extracellular Zn2+ ions added in the differentiation medium (serum-deprived medium) was enhanced by more than 170% over that of non-conductive surfaces (only the polymeric matrix), and more than 120% over both conductive substrates (without extracellular Zn2+ ions) and non-conductive substrates with extracellular Zn2+. This synergistic effect was also found to increase myotube density, myotube area and diameter, and multinucleated myotube formation. MyoD-1 gene expression was also enhanced, indicating the positive effect in the early stages of myogenic differentiation. These results demonstrate the great potential of this combined strategy, which stands outs for its simplicity and robustness, for skeletal muscle tissue engineering applications.
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The Feldenkrais Method (FM) is based on the learning of alternative movement patterns, carried out in an active and conscious way, which may have therapeutic effects. The objective of this systematic review is to identify the populations and conditions for which the FM can be used in physiotherapy and to determine the intervention modalities. Research in PubMed, Cochrane and PEDro databases was performed. The PEDro scale was employed to assess the methodological quality. Meta-analyses (MA) were performed whenever populations and outcome measures were comparable in at least two studies. Sixteen studies were included. In elderly people, in three of the four selected trials, the FM group significantly improved gait, balance, mobility and quality of life. The MA showed significant differences between interventions in the Timed-Up-and-Go test [Cohen's d = -1.14, 95% CI (-1.78, -0.49), p = 0.0006]. FM significantly improved pain, functional balance, and perceived exertion in three trials performed on subjects with cervical, dorsal, or shoulder pain. FM demonstrated improvements in pain, disability, quality of life and interoceptive awareness in the three trials performed in subjects with chronic low back pain. In multiple sclerosis, an improvement in functional capacity was observed in the two selected studies. The MA showed no significant differences between groups in the Function (p = 0.97) and Control (p = 0.82) dimensions of the Multiple Sclerosis Self-Efficacy Scale. In Parkinson's disease, two studies showed significant effects on quality of life and functional tests. In conclusion, evidence shows that FM has therapeutic effects comparable to other physiotherapy techniques in patients with spine pain. In addition, improvements in mobility and balance were seen in the elderly and people with neurodegenerative diseases.
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Dolor de la Región Lumbar , Esclerosis Múltiple , Humanos , Anciano , Equilibrio Postural , Calidad de Vida , Estudios de Tiempo y Movimiento , Ensayos Clínicos Controlados Aleatorios como Asunto , Modalidades de FisioterapiaRESUMEN
BACKGROUND: Haemophilia A (HA) has been associated with poor health-related quality of life and a large economic burden, accentuated by severity, arthropathy, and inhibitors. To meet global standards of care, the management of HA should align with the principles of care outlined by the World Federation of Haemophilia. The aims of the present study were to establish a set of proposals to improve HA management within the Spanish National Health System (SNHS) and to estimate the impact its hypothetical implementation would generate from a clinical, healthcare, economic, and social perspective. METHODS: A multidisciplinary group of experts agreed on a set of 15 proposals to improve HA management within the SNHS. Thereafter, a forecast-type Social Return on Investment analysis was carried out to estimate the impact of implementing this set of proposals within the SNHS over a one-year timeframe, in relation to the required investment. RESULTS: This study estimated that the implementation of the complete set of 15 proposals would require a total investment of 2.34 M and have a total impact of 14.60 M. Accordingly, every euro invested in the complete set of 15 proposals would yield a social return of 6.23 (3.37 in the worst-case scenario and 9.69 in the best-case scenario) of both tangible and intangible nature in similar proportions (45.71 and 54.29%, respectively). CONCLUSIONS: These results can be used to inform policy and practice such that interventions that may potentially improve current public health challenges associated with the management of HA may be implemented.
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Hemofilia A , Atención a la Salud , Hemofilia A/tratamiento farmacológico , Hemofilia A/epidemiología , Humanos , Inversiones en Salud , Calidad de VidaRESUMEN
INTRODUCTION: Type 2N von Willebrand disease (VWD) is characterized by a decreased affinity of von Willebrand factor (VWF) for factor VIII (FVIII). Abnormal binding of FVIII to VWF (VWF:FVIIIB), results in low FVIII plasma levels, which can lead to a misdiagnosis of mild haemophilia A. Accurate diagnosis of type 2N VWD is essential for appropriate genetic counselling and therapy. This disease can be distinguished from haemophilia A by in vitro assays (measurement VWF:FVIIIB activity) and/or genetic analysis. AIM: To identify the current challenges in the diagnosis and treatment of this type of VWD and provide an in-depth description of the phenotypes and mutations identified. RESULTS: Twenty-eight patients had at least one type 2N mutation, and 13 of these had a type 2N mutation combined with other variations. Three type 2N mutations were detected: p.Arg816Trp, p.Arg854Gln, and p.Arg763Ser. Two of these are the most frequently described mutations worldwide. This mutational spectrum differs from the broad spectrum seen in neighbouring France, where at least eight distinct 2N mutations have been found. In the PCM-EVW-ES cohort, 11 asymptomatic type 2N carriers with borderline FVIII plasma levels would probably have been excluded if the evaluation had been based on clinical and laboratory data only. Likewise, three patients with a severe phenotype would have been classified as homozygous for a 2N mutation if only the phenotype study had been performed. CONCLUSION: The high detection yield and affordability of next-generation sequencing support the use of this technology as a first-line diagnostic tool in this setting.
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Hemofilia A , Enfermedad de von Willebrand Tipo 2 , Enfermedades de von Willebrand , Factor de von Willebrand/genética , Factor VIII/genética , Heterocigoto , Homocigoto , Humanos , Enfermedad de von Willebrand Tipo 2/diagnóstico , Enfermedad de von Willebrand Tipo 2/genéticaRESUMEN
Skeletal deformities reduce fish viability, growth, wellbeing, and feed efficiency but also degrade the consumer's perception of aquaculture products. Herein, the skeletal development and the incidence of skeletal deformities in tench (Tinca tinca) reared in semi-extensive conditions has been described in detail for the first time. Larval skeletons were assessed through an acid-free double-staining procedure in 157 individuals, while 274 specimens at the juvenile stage were evaluated through X-ray analysis. The first skeletal structures to be formed were those related with breathing and feeding activities (e.g., Meckel's cartilage and opercula) and were visible in larvae of 4 mm of standard length (SL). The axial skeleton was fully ossified in larvae of 12-17 mm of SL, and the caudal fin complex in larvae with 17-26 mm of SL. At the larval stage, no upper-jaw or opercula deformities were observed, while a low incidence (1-9%) of other severe deformities in the heads of the fish (e.g., lower-jaw deformities) were reported. The incidence of vertebral deformities in tench reared in natural ponds was considerable in larvae (54%) and juveniles (52%). Vertebral deformities (fusion and compression) were the most common deformities found in tench larvae (approximately 30%) and vertebral shape deformity in juveniles (around 10%), being mainly located in the caudal region. Thus, a regular monitoring of the skeletal deformities in tench might help to identify better rearing protocols and improve product quality sold at markets. Characterizing the skeletal development not only in semi-extensive systems such as artificial and natural ponds but also under intensive rearing conditions, seems vital for a sustainable and profitable European tench aquaculture.
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Hemostasis is crucial for reducing bleeding during surgical procedures. The points-of-care based on the platelet function test could be useful to minimize the complications related to chronic antiplatelet therapy during surgery. The present study is aimed at comparing two point-of-care platelet function devices-Platelet Function Analyzer PFA-100® (Siemens Canada, Mississauga, ON, Canada) and Plateletworks®(Helena Laboratories, Beaumont, TX, USA). Our objective is to evaluate if they provide comparable and useful information to manage anti-aggregate patients before surgery. We included patients with a femoral fracture receiving chronic antiplatelet therapy and a median age of 89 years (range from 70 to 98). A platelet function evaluation was performed on all patients before surgery using both devices-Plateletworks® and PFA-100®. The correlation between Plateletworks® and PFA-100® was performed using Cohen's Kappa coefficient. Twenty consecutive patients participated in the trial; 16 patients were under treatment with 75 mg/day of clopidogrel, three with >300 mg/day of acetylsalicylic acid (ASA), and only one was in treatment with both antiplatelet agents. Cohen's Kappa coefficient was 0.327 comparing PFA-100®-ADP (adenosine diphosphate) and Plateletworks® and, 0.200 comparing PFA-100®-EPI (epinephrine) and Plateletworks®. In conclusion, we found a weak concordance comparing PFA-100® and Plateletworks®. This could partially be due to the advanced age of the included patients. However, given the limited sample size, more studies are necessary to confirm these results.
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The aim of the study was to determine whether platelet hyperaggregability correlates with short closure times (PFA-100) and if hyperaggregability is associated with the risk of venous thrombosis in a Spanish population. Case--control study (RETROVE project) involving 400 patients with venous thrombosis and 400 healthy controls. We determined platelet aggregation in platelet-rich plasma (PRP) by light transmission aggregometry. Various concentrations of two aggregation agonists [ADP and epinephrine (EPI)] were tested to determine the percentage of maximal aggregation and the percentage area under the curve (AUC). Venous thrombosis risk associated with platelet hyperaggregability was calculated by logistic regression. We estimated the crude and adjusted (by sex and age) odds ratios (OR) for venous thrombosis risk. An agonist concentration of 0.5âµmol/l differentiated between hypo-responders and hyper-responders at the following AUC cut-off values: EPI: the 50th percentile for aggregation with 0.5âµmol/l of EPI (EPI_AUC) was 22.53% (>22.53%â=âhyper-EPI); the crude risk for venous thrombosis was statistically significant (ORâ=â1.37; 95% CI 1.03-1.82); ADP: the 75th percentile for aggregation with 0.5âµmol/l of ADP (ADP_AUC) was 29.6% (>29.6%â=âhyper-ADP), with a significant crude risk for venous thrombosis (ORâ=â1.44; 95% CI 1.05-1.98). However, after adjustment for confounders (age), the ORs for EPI or ADP aggregation were no longer significant. EPI_AUC and PFA-100 values with the EPI agonist were significantly correlated (Râ=â-0.342, Pâ<â0.01). Only 12% of the PFA-100 values were explained by platelet aggregation. In this case--control study, platelet hyperaggregability was not associated with the risk of developing venous thrombosis.