Risk factors for complications in total hip arthroplasty. / Factores de riesgo para complicaciones en artroplastia total de cadera.

INTRODUCTION AND OBJECTIVE: Hip arthroplasty represents a significant advancement in the treatment of refractory chronic joint pain, improving quality of life and functionality. The objective of this study is to identify the risk factors associated with local and systemic complications in patients treated with total hip arthroplasty. METHODS: Observational, analytical, retrospective cohort study, which included 304 participants treated with total hip replacement. Comparison of variables between two groups was performed; 38 participants in the group with complications and 266 participants in the group without complications. RESULTS: The mean age in the complication group was 66 years (SD 18.7) and in the uncomplicated group it was 67,1 years (SD 15.1) (p 0,686). Female sex was observed in 73.3% of the group with complications and 65% in the group without complications. (p 0.292). Risk factors were: hip fracture as an indication for arthroplasty RR 1.33 [95% CI 1.004;1.775 p 0.047], coronary heart disease RR 1.31 [95% CI 1.067;1.616 p 0.010] and surgical bleeding equal to or greater than 400 cc RR 1.11 [95% CI 1.012;1.218 p 0.028]. CONCLUSIONS: The risk factors for complications in total hip arthroplasty were: hip fracture as the indication for arthroplasty, coronary artery disease, and surgical bleeding equal to or greater than 400 cc.

3D muscle networks based on vibrational mechanomyography.

Objective. Muscle network modeling maps synergistic control during complex motor tasks. Intermuscular coherence (IMC) is key to isolate synchronization underlying coupling in such neuromuscular control. Model inputs, however, rely on electromyography, which can limit the depth of muscle and spatial information acquisition across muscle fibers.Approach. We introduce three-dimensional (3D) muscle networks based on vibrational mechanomyography (vMMG) and IMC analysis to evaluate the functional co-modulation of muscles across frequency bands in concert with the longitudinal, lateral, and transverse directions of muscle fibers. vMMG is collected from twenty subjects using a bespoke armband of accelerometers while participants perform four hand gestures. IMC from four superficial muscles (flexor carpi radialis, brachioradialis, extensor digitorum communis, and flexor carpi ulnaris) is decomposed using matrix factorization into three frequency bands. We further evaluate the practical utility of the proposed technique by analyzing the network responses to various sensor-skin contact force levels, studying changes in quality, and discriminative power of vMMG.Main results. Results show distinct topological differences, with coherent coupling as high as 57% between specific muscle pairs, depending on the frequency band, gesture, and direction. No statistical decrease in signal strength was observed with higher contact force.Significance. Results support the usability vMMG as a tool for muscle connectivity analyses and demonstrate the use of IMC as a new feature space for hand gesture classification. Comparison of spectrotemporal and muscle network properties between levels of force support the robustness of vMMG-based network models to variations in tissue compression. We argue 3D models of vMMG-based muscle networks provide a new foundation for studying synergistic muscle activation, particularly in out-of-clinic scenarios where electrical recording is impractical.

Intermittent parathyroid hormone enhances the healing of medication-related osteonecrosis of the jaw lesions in rice rats.

Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe adverse event in patients treated with antiresorptives. Management of MRONJ is challenging, and no non-antibiotic, established medical treatment exists. Intermittent parathyroid hormone (iPTH) has been used off-label to treat MRONJ with favorable results. However, its medical efficacy has rarely been substantiated in clinical or preclinical experiments. Using a validated rice rat, infection-based model of MRONJ, we evaluated the effects of iPTH on established MRONJ. We hypothesize that iPTH contributes to MRONJ resolution by enhancing alveolar bone turnover and healing oral soft tissues. Eighty-four rice rats began a standard rodent chow diet at age 4 weeks to induce localized periodontitis. Rats were simultaneously randomized to receive saline (vehicle, VEH) or zoledronic acid (ZOL, 80 µg/kg IV) every 4 weeks. Oral exams were conducted bi-weekly to assign a gross quadrant grade (GQG, 0-4) to evaluate any lesion at the lingual aspect of the interdental space between maxillary molar (M2) and M3. 14 of 20 VEH-treated rice rats (70%) developed maxillary localized periodontitis with GQG 2-3 after 30 ± 10 weeks of saline. Additionally, 40 of 64 ZOL-treated rice rats with periodontitis developed MRONJ-like lesions after 30 ± 10 weeks of ZOL treatment. Rice rats with localized periodontitis or MRONJ-like lesions were treated with saline or iPTH (40 µg/kg) subcutaneously (SC) 3 times/week For 6 weeks until euthanasia. We found that iPTH -treated ZOL rats had a lower prevalence of MRONJ (p < 0.001), with lower severity extent of oral lesions (p = 0.003) and percentage of empty osteocyte lacunae (p < 0.001). ZOL rats treated with iPTH displayed a higher osteoblast surface (p < 0.001), more osteoblasts (p < 0.001), higher osteoclast surface (p < 0.001) and more osteoclasts (p = 0.002) at alveolar bone surfaces than ZOL/VEH rats. Greater gingival epithelial thickness and epithelial cell proliferation rate was found in the oral mucosa and gingiva of ZOL/PTH rats than in ZOL/VEH rats (p < 0.001). Our data suggest that iPTH is an efficacious non-operative medicinal therapy that accelerates oral healing and enhances the resolution of MRONJ lesions in ZOL-treated rice rats.

The removal of dissolved organic matter by marine sponges is a function of its composition and concentration: An in situ seasonal study of four Mediterranean species.

Sponges are unique among metazoans in their ability to use dissolved organic matter (DOM), the largest pool of organic matter in the ocean, as a major food source. The effect of variations in DOM abundance and composition on its uptake by sponges has rarely been studied. We examined, in situ, the seasonal uptake of DOM by four sponges [2 species with high microbial abundance (HMA) and 2 with low microbial abundance (LMA)] in the northwestern Mediterranean. Dissolved organic carbon (DOC) showed a strong seasonality with 3-fold higher concentrations in fall-winter (256 ± 16 µmol L-1, mean ± SE) than in spring-summer (88 ± 3 µmol L-1). Dissolved organic nitrogen (DON) showed the opposite trend, with higher summer concentrations (8.9 ± 0.4 µmol L-1) and mean concentrations of 2.5-3.4 µmol L-1 in the other seasons. DOC removal by all sponge species increased linearly with its ambient concentration, but only above a DOC removal threshold that was threefold higher in fall-winter (198 µmol L-1) than in spring-summer (74 µmol L-1). All species showed a concentration-dependent DON removal, but LMA sponges removed more DON than HMA sponges. The DOC removal rate (normalized to sponge volume) was 2-3 times higher in fall-winter, when ambient DOC levels were high, than in spring-summer. Sponges efficiently removed clusters of the fluorescent DOM (FDOM) associated with protein-rich DOM, but not those associated with humic material. The clear threshold for DOC removal and the protein-like FDOM uptake pattern suggest that the quality and quantity of DOM control its removal and transformation by marine sponges. Our results indicate that marine sponges transform the composition of the coastal DOM pool, thereby affecting its fate. It is postulated that the DOM excreted by the sponges is more recalcitrant; consequently, sponge activity enhances carbon sequestration in benthic habitats in a similar fashion to that of the oceanic 'microbial pump'.

Compromiso sensitivo y polineuropatía periférica como manifestación inicial de enfermedad de Creutzfeldt-Jakob. A propósito de un caso

La enfermedad de Creutzfeldt-Jakob (ECJ) es una rara enfermedad neurodegenerativa con una alta incidencia en Chile respecto del resto del mundo. El cuadro se caracteriza principalmente por desarrollo de demencia rápidamente progresiva y diversos signos neurológicos inespecíficos, siendo el más frecuente la mioclonía. El caso que se describirá a continuación destaca por las manifestaciones iniciales atípicas que presentó el paciente, tales como compromiso sensitivo en región cráneo-cérvico-dorsal y polineuropatía periférica de extremidades inferiores (EEII), lo que significó un retraso en el diagnóstico clínico de la ECJ. Es importante conocer los diferentes síntomas y signos que pueden presentarse en el cuadro clínico de ECJ, tanto típicos como aquellos menos frecuentes, para así poder dar con el diagnóstico de la enfermedad en etapas más tempranas. De igual manera, es fundamental contar con herramientas diagnósticas como la detección de proteína 14-3-3 o proteína Tau en los centros de salud de nuestro país. Esto permitiría al equipo de salud, brindar un manejo de soporte adecuado y oportuno a estos pacientes.

Creutzfeldt-Jakob disease is a rare neurodegenerative disease with a high incidence in Chile compared to the rest of the world. The condition is mainly characterized by the development of rapidly progressive dementia and various nonspecific neurological signs, the most common being myoclonus. The case that will be described below stands out for the atypical initial manifestations that the patient presented, such as sensory compromise in the cranio-cervico-dorsal region and peripheral polyneuropathy of the lower extremities, which meant a delay in the clinical diagnosis of the disease. It is important to know the different symptoms and signs that can be present in the clinical picture of CJD, both typical and those less frequent, in order to be able to diagnose the disease in earlier stages. Similarly, it is essential to have diagnostic tools such as the detection of 14-3-3 protein or Tau protein in health centers in our country. This would allow the health team to provide adequate and timely support management to these patients.

Carbon metabolism and bioavailability of dissolved organic carbon (DOC) fluxes in seagrass communities are altered under the presence of the tropical invasive alga Halimeda incrassata.

Seagrass beds act as blue carbon sinks globally as they enhance the trapping of recalcitrant (i.e., low biodegradability) organic carbon in their sediments. Recent studies also show that the recalcitrant fraction of the dissolved organic carbon (DOC) pool in seawater has an important role as long-term carbon sequestration in oceans. Although seagrasses are known for the large amount of DOC they export, little attention has been given to its biodegradability, which ultimately determinates its fate in the coastal carbon cycle. In turn, invasive algae are a major global concern in seagrass ecosystems since they can deeply modify their structure and functions, which may affect carbon metabolism and DOC release. This work assesses how the presence of Halimeda incrassata, an invasive tropical calcareous macroalga, modifies carbon metabolism and DOC fluxes in invaded areas dominated by the seagrass Cymodocea nodosa. Our results show that stands with the presence of this seagrass (i.e., both monospecific and mixed meadow) had the highest production values, acting as high DOC producers in both winter (mainly of labile DOC; DOCL) and summer (mainly as recalcitrant DOC; DOCR). In contrast, monospecific H. incrassata beds exhibited low production values, and the presence of this macroalga (either as monospecific beds or mixed with C. nodosa) triggered the shift from a net DOC-producing-system in summer (mainly DOCL) to a net DOC-consuming-system in winter. This work thus suggests that C. nodosa meadows have the potential to export a significant fraction of both labile and recalcitrant DOC, and that the spread of this invasive alga might decrease the C export capacity of seagrass meadows. Such shift would imply the reduction of a quick and efficient transfer of carbon and energy to higher trophic levels, and might reduce the blue carbon potential of seagrasses as dissolved form in the water column.

COVID-19 lockdown as an opportunity to rethink urban freight distribution: Lessons from the Barcelona metropolitan area.

The COVID-19 health crisis has had a strong impact on societies around the world, affecting both the health of populations and countries' economies. While lockdowns imposed to stop the spread of infection reduced urban mobility and had a positive impact on air quality, lowering the emission of polluting particles and greenhouse gases, they had the opposite effect on urban freight distribution (UFD). With the population remaining at home, ecommerce-driven shipments surged, and total freight traffic increased. In order to have a better understanding of this phenomenon, the aim of this study was to identify the impact of COVID-19 lockdowns on the daily operation of the region's main logistics agents. Lessons learned from this cyclical scenario could be used to define more sustainable public policies regarding UFD in the post-COVID era. To meet the above objectives, semi-structured interviews were conducted with public administrations and private operators, before being transcribed and encoded for later analysis. The results of our study show that common problems in UFD, such as traffic congestion or problems finding parking in the loading and unloading (L/U) zones, temporarily disappeared during the lockdown phase. Delivery times were consequently reduced, despite an increase in operations due to ecommerce. In addition, the public administrations took advantage of this situation to adapt the urban space and force a transition towards new delivery systems, such as cargo-bikes, to guarantee sustainable last-mile operations in specific zones.

Synergistic Upper-Limb Functional Muscle Connectivity Using Acoustic Mechanomyography.

Functional muscle network is a critical concept in describing functional synergistic muscle synchronization and functional connectivity needed for the execution of complex motor tasks. Muscle network is typically derived from decomposition of intermuscular coherence (IMC) at different frequency bands of multichannel electromyography (EMG) measurements, which potentially limits out-of-clinic applications. In this investigation, we introduce muscle network analysis to assess the functional coordination and functional connectivity of muscles based on mechanomyography (MMG). We focus on a targeted group of muscles vital for activities of daily living (ADLs) in the upper-limb. Functional muscle networks are evaluated for ten able-bodied participants and three upper-limb amputees. Muscle activity was acquired from a custom-made wearable armband of MMG sensors placed over four superficial muscles around the forearm (flexor carpi radialis (FCR), brachioradialis (BR), extensor digitorum communis (EDC), and flexor carpi ulnaris (FCU)) while participants performed four different hand gestures. Muscle connectivity analysis at multiple frequency bands shows significant topographical differences across gestures for low (i.e., 5 Hz) and high (i.e., 12 Hz) activation frequencies as well as observable network differences between amputee and non-amputee subjects. Results demonstrate MMG can be used for the analysis of functional muscle connectivity and mapping of synergistic functional synchronization of upper-limb muscles in complex movement tasks. The new physiological modality provides key insights into neural circuitry of motor coordination. Findings further offer the concomitant outcomes of demonstrating feasibility of MMG to map muscle coherence from a neurophysiological perspective and providing a mechanistic basis for its translation in human-robot interface.

Assessing the effects of common topical exposures on skin bacteria associated with atopic dermatitis.

BACKGROUND: While patients and families struggling with atopic dermatitis (AD) have documented concerns for a contributory role of skin care products in AD pathology, nearly all the skin microbiome studies to date have asked participants to avoid topical products (such as soaps or select medications) for the preceding days to weeks prior to sample collection. Thus, given the established role of the microbiome in AD, the interactions between topical exposures, dysbiosis and AD remains underrepresented in the academic literature. OBJECTIVES: To address this knowledge gap, we expanded our previous evaluations to test the toxicological effects of a broader range of common chemicals, AD treatment lotions, creams and ointments using both health- and AD-associated strains of Roseomonas mucosa and Staphylococcus spp. METHODS: Use of in vitro culture techniques and mouse models were deployed to identify chemicals with dysbiotic or pre-biotic potential. A proof-of-concept study was subsequently performed in healthy volunteers to assess global microbiome shifts after exposure to select chemicals using dermatologic patch testing. RESULTS: Numerous chemicals possessed antibiotic properties, including many not marketed as anti-microbials. Through targeted combination of potentially beneficial chemicals, we identified combinations which promoted the growth of health-associated isolates over disease-associated strains in bacterial culture and enhanced microbe-specific outcomes in an established mouse model of AD; the most promising of which was the combination of citral and colophonium (often sold as lemon myrtle oil and pine tar). Additional studies would likely further optimize the combination of ingredients use. Similar results were seen in the proof-of-concept human studies. CONCLUSIONS: Our results could offer a systematic, multiplex approach to identify which products carry dysbiotic potential and thus may guide formulation of new topicals to benefit patients with AD.

Ecological Drawbacks of Nanomaterials Produced on an Industrial Scale: Collateral Effect on Human and Environmental Health.

Currently, hundreds of different nanomaterials with a broad application in products that make daily lives a little bit easier, in every aspect, are being produced on an industrial scale at thousands of tons per year. However, several scientists, researchers, politics, and ordinary citizens have stated their concern regarding the life cycle, collateral effects, and final disposal of these cutting-edge materials. This review summarizes, describes, and discusses all manuscripts published in the Journal Citation Reports during the last 10 years, which studied the toxicity or the effects of nanomaterials on human and environmental health. It was observed that 23.62% of the manuscripts analyzed found no ecological or human risks; 54.39% showed that several nanomaterials have toxicological effects on the ecosystems, human, or environmental health. In comparison, only 21.97% stated the nanomaterials had a beneficial impact on those. Although only 54.39% of the manuscripts reported unfavorable effects of nanomaterials on ecosystems, human, or environmental health, it is relevant because the potential damage is invaluable. Therefore, it is imperative to make toxicological studies of nanomaterials with holistic focus under strictly controlled real conditions before their commercialization, to deliver to the market only innocuous and environmentally friendly products.

"ST-elevation myocardial infarction associated with air pollution levels in Mexico City".

Background Coronary heart disease has multiple risk factors, including air pollution. Numerous pathophysiological mechanisms have been identified with increasing levels of air pollution, mainly with ozone (O3), nitrogen dioxide (NO2), sulphur dioxide (SO2), particulate matter (PM10), fine particulate matter (PM2.5) and carbon monoxide (CO). In Mexico, the pollution level is reported using an air quality index called IMECA. Methods All patients with STEMI admitted at Hospital Español were collected between 2012 and 2019 (N = 348). We conducted a retrospective analysis using the air pollution exposure at the time of each event (lag0), the previous 24 h (lag1), 48 h (lag2), 72 h (lag3) and 5-day cumulative lag. The level of air pollution was analyzed independently using IMECA and particle concentrations. The data was divided in two groups: days with one of more STEMI's (MI group) and days free of events (Control group), using ANCOVA to evaluate the difference between means of both groups taking into account confounders. Results: For days with one or more cardiovascular event, a significant increase in SO2 was observed at lag1; similar increase was found in CO, PM2.5, SO2 at lag2. For the 5-day cumulative lag, SO2 and PM2.5 showed a significant increase. No differences were found using the IMECA levels in both groups. Conclusions: The elevated concentrations levels of CO, SO2 and PM2.5 showed significant association with STEMI at different time points before the event. Ozone, PM10 and NO2 showed no difference between groups. IMECA levels showed no association with STEMI in our study.

Cervical Spinal Cord Degeneration in Spinocerebellar Ataxia Type 7.

BACKGROUND AND PURPOSE: Spinocerebellar ataxia type 7 is an autosomal dominant neurodegenerative disease caused by a cytosine-adenine-guanine (CAG) repeat expansion. Clinically, spinocerebellar ataxia type 7 is characterized by progressive cerebellar ataxia, pyramidal signs, and macular degeneration. In vivo MR imaging studies have shown extensive gray matter degeneration in the cerebellum and, to a lesser extent, in a range of cortical cerebral areas. The purpose of this study was to evaluate the impact of the disease in the spinal cord and its relationship with the patient's impairment. MATERIALS AND METHODS: Using a semiautomated procedure applied to MR imaging data, we analyzed spinal cord area and eccentricity in a cohort of 48 patients with spinocerebellar ataxia type 7 and compared them with matched healthy controls. The motor impairment in the patient group was evaluated using the Scale for Assessment and Rating of Ataxia. RESULTS: Our analysis showed a significantly smaller cord area (t = 9.04, P < .001, d = 1.31) and greater eccentricity (t = -2.25, P =. 02, d = 0.32) in the patient group. Similarly, smaller cord area was significantly correlated with a greater Scale for Assessment and Rating of Ataxia score (r = -0.44, P = .001). A multiple regression model showed that the spinal cord area was strongly associated with longer CAG repetition expansions (P = .002) and greater disease duration (P = .020). CONCLUSIONS: Our findings indicate that cervical spinal cord changes are progressive and clinically relevant features of spinocerebellar ataxia type 7, and future investigation of these measures as candidate biomarkers is warranted.

Influence of Klebsiella pneumoniae and quinolone treatment on prognosis in patients with pancreatic cancer.

BACKGROUND: An increasing body of evidence suggests that microbiota may promote progression of pancreatic ductal adenocarcinoma (PDAC). It was hypothesized that gammaproteobacteria (such as Klebsiella pneumoniae) influence survival in PDAC, and that quinolone treatment may attenuate this effect. METHODS: This was a retrospective study of patients from the Massachusetts General Hospital (USA) and Ludwig-Maximilians-University (Germany) who underwent preoperative treatment and pancreatoduodenectomy for locally advanced or borderline resectable PDAC between January 2007 and December 2017, and for whom a bile culture was available. Associations between tumour characteristics, survival data, antibiotic use and results of intraoperative bile cultures were investigated. Survival was analysed using Kaplan-Meier curves and Cox regression analysis. RESULTS: Analysis of a total of 211 patients revealed that an increasing number of pathogen species found in intraoperative bile cultures was associated with a decrease in progression-free survival (PFS) (-1·9 (95 per cent c.i. -3·3 to -0·5) months per species; P = 0·009). Adjuvant treatment with gemcitabine improved PFS in patients who were negative for K. pneumoniae (26·2 versus 15·3 months; P = 0·039), but not in those who tested positive (19·5 versus 13·2 months; P = 0·137). Quinolone treatment was associated with improved median overall survival (OS) independent of K. pneumoniae status (48·8 versus 26·2 months; P = 0·006) and among those who tested positive for K. pneumoniae (median not reached versus 18·8 months; P = 0·028). Patients with quinolone-resistant K. pneumoniae had shorter PFS than those with quinolone-sensitive K. pneumoniae (9·1 versus 18·8 months; P = 0·001). CONCLUSION: K. pneumoniae may promote chemoresistance to adjuvant gemcitabine, and quinolone treatment is associated with improved survival.

Linkages between greenhouse gases (CO2, CH4, and N2O) and dissolved organic matter composition in a shallow estuary.

Estuarine systems receive large amounts of organic matter that enhance the production of greenhouse gases (GHGs), such as carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O). Despite considerable research on GHGs and dissolved organic matter (DOM) distribution in estuaries, little is known about the linkage between these gases and DOM composition. Here we evaluated the relationship between three GHGs (CO2, CH4, and N2O) and DOM composition, determined through optical properties, in Guadalete estuary (Bay of Cadiz, Spain). The partial pressure of CO2, and CH4 and N2O concentrations ranged between 332.8 and 6807.1 µatm, 19.9-6440.1 nM, and 6.8-283.9 nM, respectively. Thus, the Guadalete estuary was a source of CO2, CH4 and N2O to the atmosphere. We validated three PARAFAC components related to humic-like fluorescence from terrestrial, microbial and effluent sources, and one with protein-like material. Humic-like components accounted for 86% ± 6% of the total FDOM pool, indicating a predominantly allochthonous DOM origin. The three GHGs were significantly linked to DOC concentration and DOM composition, exhibiting different patterns in these linkages. Terrestrial and microbial humic-like substances with increasing aromaticity might enhance pCO2 in Guadalete estuary. Dissolved CH4 concentrations showed the strongest relationship with DOM composition, indicating that humic and protein-like material are linked with their distribution. In contrast, dissolved N2O was only related with the protein-like fraction and with humic-like material derived from anthropogenic activities (sewage and agriculture). Our results further indicate that a possible coupling between benthic fluxes of GHGs and DOM might be occurring in this shallow estuary. We conclude that it is important to account for DOM composition when studying GHGs distribution in estuarine systems to understand their roles and potential responses associated with climate change.

Decoupling of biotic and abiotic patterns in a coastal area affected by chronic metal micronutrients disturbances.

Coastal systems are highly productive areas for primary productivity and ecosystem services and host a large number of human activities. Since industrialization, metal micronutrients in these regions have increased. Phytoplankton use metals as micronutrients in metabolic processes, but in excess, had deleterious effects. In coastal systems, picoeukaryotes represent a diverse and abundant group with widespread distribution and fundamental roles in biogeochemical cycling. We combined different approaches to explore picoeukaryotes seasonal variability in a chronically metal polluted coastal area at the south-eastern Pacific Ocean. Through remote and field measurements to monitor environmental conditions and 18S rRNA gene sequencing for taxonomic profiling, we determined metal chronic effect on picoeukaryote community's structure. Our results revealed a stable richness and a variable distribution of the relative abundance, despite the physicochemical seasonal variations. These results suggest that chronic metal contamination influences temporal heterogeneity of picoeukaryote communities, with a decoupling between abiotic and biotic patterns.

Clinical assessment of acid-base balance in Netherland Dwarf rabbit.

Pet rabbits have increased their popularity in a lot of countries. However, most of the laboratory profiles in rabbit medicine come from the observations made in rabbit as biomodels or meat production. So that further researches are necessary to obtain reference values for hematology and biochemical profiles in pet rabbits and the different breeds, especially, in relation to acid-base balance. The aim of this report was to offer the mean values of the main parameters connected with acid-base profile in Netherland Dwarf breed. Thirty-five healthy rabbits (15 males and 20 females) were studied. Venous blood sample from lateral saphenous vein was analyzed to measure: haematocrit, haemoglobin, blood urea nitrogen, glucose, blood pH, partial pressure of CO2 (pCO2), total CO2, ions bicarbonate, chloride, sodium, potassium, base excess and anion Gap. Results showed a shorter range that those reported by different researchers. Moreover, differences between genders were showed in pCO2, its values were higher in males. It may be associated with a greater cellular metabolism. Values obtained in this research should be taken into account by veterinary clinicians for this breed in their clinical assessments. Besides, these values provide new results in parameters with few reference values.

Rhabdomyolysis in a patient with McArdle's disease. / Rabdomiólisis en un paciente con enfermedad de McArdle.

INTRODUCTION: McArdle's disease or glycogenosis type V is a rare disease due to deficiency of muscle myophosphorylase leading to inability to degrade glycogen at this level. Patients have fatigue, pain, and cramps on a regular basis. In addition, after intense exercise or stressful situation, they are exposed to cellular lysis. This can occur in the form of rhabdomyolysis and myoglobinuria, a potentially serious clinical syndrome if not treated quickly. CASE EVALUATION: We present the care plan of a 38-year-old man with McArdle's disease and secondary rhabdomyolysis on physical exercise, which required attention in the Emergency Department for 24 hours, as well as his subsequent admission to the ward. A nursing evaluation was performed following the care model of Virginia Henderson. DIAGNOSIS: Priority was given to nurse diagnoses: (00016) deterioration of urinary elimination, (00092) activity intolerance, (00093) fatigue and (00132) acute pain; and potential complication: risk of acute renal failure. PLANNING: The Care Plan is developed following the NANDA-NIC-NOC methodology, with special attention to alterations in the elimination and musculoskeletal system. The diuresis is monitored. Fluid replenishment is performed, and analgesic medication is given. DISCUSSION: There is little literature on the nursing care of patients with McArdle's disease, which has limited the comparison of our results with those of other authors. However, given the good response of the subject through fluid replacement, optimal pain control and rest, they made a rapid recovery.

Preoperative cholangitis is an independent risk factor for mortality in patients after pancreatoduodenectomy for pancreatic cancer.

OBJECTIVES: Preoperative biliary stenting is required for patients with obstructive jaundice from pancreatic adenocarcinoma who are receiving neoadjuvant chemotherapy. While in most patients this approach results in durable biliary drainage, some patients develop cholangitis during neoadjuvant treatment. Further, several studies have shown that preoperative cholangitis in patients with hepatobiliary malignancies can result in substantially unfavorable outcomes. The aim of this study was to evaluate the impact of preoperative cholangitis in patients who underwent pancreaticoduodenectomy after completing neoadjuvant chemotherapy. METHODS: Participants: all adult patients (n = 449) diagnosed with pancreatic adenocarcinoma from January 1st, 2013 to March 31st, 2018 who pursued treatment at the Massachusetts General Hospital were screened. Of these 449 patients, 97 met final inclusion criteria of receiving neoadjuvant chemotherapy with intent to pursue curative surgery. Data were collected via retrospective chart review including baseline characteristics, survival, episodes of preoperative cholangitis, and surgical complications. RESULTS: In patients completing successful pancreaticoduodenectomy surgery, preoperative cholangitis is associated with increased mortality (HR 2.67, 95% CI:1.16-6.13). This finding is independent of postoperative outcomes or tumor recurrence rate. The presence of cholangitis did not impact completion of neoadjuvant chemotherapy (92% vs 85%, p = 0.5) or ability to proceed to surgery (76% vs 75%, p = 1.0). Preoperative cholangitis was not associated with postoperative morbidity (42.1% vs 45.1%, p = 1.0). CONCLUSIONS: One episode of cholangitis during neoadjuvant chemotherapy is associated with increased mortality following successful pancreaticoduodenectomy, independent of immediate postoperative outcomes or tumor recurrence. Preoperative cholangitis does not affect ability to pursue neoadjuvant chemotherapy or complete successful surgery. Patients who develop cholangitis during the neoadjuvant chemotherapy treatment phase may reflect a distinct phenotype of patients with PDAC with a complex and more challenging clinical course.

Wearable MMG-Plus-One Armband: Evaluation of Normal Force on Mechanomyography (MMG) to Enhance Human-Machine Interfacing.

In this paper, we introduce a new mode of mechanomyography (MMG) signal capture for enhancing the performance of human-machine interfaces (HMIs) through modulation of normal pressure at the sensor location. Utilizing this novel approach, increased MMG signal resolution is enabled by a tunable degree of freedom normal to the sensor-skin contact area. We detail the mechatronic design, experimental validation, and user study of an armband with embedded acoustic sensors demonstrating this capacity. The design is motivated by the nonlinear viscoelasticity of the tissue, which increases with the normal surface pressure. This, in theory, results in higher conductivity of mechanical waves and hypothetically allows to interface with deeper muscle; thus, enhancing the discriminative information context of the signal space. Ten subjects (seven able-bodied and three trans-radial amputees) participated in a study consisting of the classification of hand gestures through MMG while increasing levels of contact force were administered. Four MMG channels were positioned around the forearm and placed over the flexor carpi radialis, brachioradialis, extensor digitorum communis, and flexor carpi ulnaris muscles. A total of 852 spectrotemporal features were extracted (213 features per each channel) and passed through a Neighborhood Component Analysis (NCA) technique to select the most informative neurophysiological subspace of the features for classification. A linear support vector machine (SVM) then classified the intended motion of the user. The results indicate that increasing the normal force level between the MMG sensor and the skin can improve the discriminative power of the classifier, and the corresponding pattern can be user-specific. These results have significant implications enabling embedding MMG sensors in sockets for prosthetic limb control and HMI.