Open distal ureteroureterostomy for non-refluxing duplicated collecting system in children: Multicentric study and mid-term outcomes.

BACKGROUND: When indicated, ureteroceles and ectopic ureters in duplicated collecting systems can be managed via upper or lower urinary tract surgical approaches, or a combination of both. Open ureteroureterostomy (UU) has been described to address these conditions in the absence of lower pole (LP) vesicoureteral reflux (VUR). We report outcomes from multiple centers worldwide with mid-term follow-up. METHODS: Our study consists of a retrospective review of records and imaging of children who underwent open distal UU via inguinal incision for duplicated collecting system without lower pole VUR in institutions from North America, South America, and the Caribbean. Descriptive statistics and univariate analysis were utilized. RESULTS: The records of 127 patients who underwent open distal UU for double collecting system between 2009 and 2022 were reviewed. Of those, 65% were female (n = 82), with a mean age at operation of 18 months (range 3-180). Main presentation at surgery included prenatal hydronephrosis (64%, n = 81), followed by febrile urinary tract infections (28%, n = 36), and urinary incontinence or other (8%, n = 10). The patients with antenatal or incidental diagnosis of hydronephrosis were classified as preoperative Society for Fetal Urology (SFU) grade 3 (n = 64) and 4 (n = 54) (96%). Those who were classified with SFU grade 0-2 (4%) had symptomatic clinical presentations including febrile urinary tract infections (UTIs) (n = 3), urinary incontinence (n = 3), and a 12-year-old patient with recurrent abdominal pain (n = 1). Mean operative time from skin incision to skin closure was 86 min (range 45-240). Mean hospital stay was estimated at 1.1 days (range 0.5-4). In our cohort of 127 patients, 3 (2%) developed Clavien-Dindo grade I (2 with ureteral stent displacement and 1 with a urine leak/managed conservatively), 6 (5%) with grade II (3 febrile and 3 non-febrile UTIs managed with oral antibiotics), and 2 (2%) with grade IIIb complications (urine leaks requiring surgical management), which were appropriately treated. None presented grade IV or V complications. A double J stent was used in 56 patients (44%), and a Penrose drain was left in 10 (8%). A total of 125 children (98%, n = 125/127) showed sonographic improvement of hydronephrosis, or resolution of symptoms with stable ultrasound findings. Successful outcome was similar for both ureterocele and ectopic ureter subgroups: 49/49 patients with ureterocele showed 100% improvement, 76/78 children with ectopic ureter showed improvement in 97% of the cases. On univariate analysis, outcomes were similar regardless of the use of ureteral stents (p = 0.11). Mean follow-up was 28.2 months (range 12-85). CONCLUSIONS: Open distal UU is a good alternative for the definitive surgical management of ectopic ureters and ureteroceles without LP VUR. This multicentric and mid-term follow-up study demonstrates that open distal UU offers high success rates, low morbidity, short operative times and hospital stays, and satisfactory aesthetic outcomes. Additionally, the surgery is performed extra-peritoneally and may not require the use of stents or drains, depending on surgeon preference. Further investigations are being conducted to determine the role of UU in the settings of double collecting systems associated with ipsilateral LP VUR.

Impact of inclusion of post-spermatic ejaculate fraction in boar seminal doses on sperm metabolism, quality, and interaction with uterine fluid.

Boar ejaculate is composed of sperm cells and seminal plasma (SP) and is emitted in different fractions (pre-sperm fraction; spermatic-rich fraction; intermediate fraction; post-spermatic fraction), with different composition of SP and volume, which could influence the sperm quality during seminal doses preparation, conservation, and interaction with the female reproductive tract. In artificial insemination (AI) centers, seminal doses are usually prepared with the spermatic-rich and intermediate fractions, but the inclusion of other ejaculate fractions, although controversial, is beginning to be applied. The objective was to evaluate the synergic effect of accumulative ejaculated fractions on sperm functionality during seminal doses preparation, throughout storage and after incubation with uterine fluid (UF). For this purpose, a total of 57 ejaculates were collected, and the following experimental groups were prepared (n = 19 per group): (F1) spermatic-rich fraction; (F2) F1 plus intermediate fraction; (F3) F2 plus post-spermatic fraction. Each group was stored for 5 days at ∼16 °C, and the following parameters were evaluated: sperm metabolism of pure and diluted semen (day 1), sperm quality parameters (days 1, 3, 5), thermal-resistance test (TRT) and incubation with uterine fluid (UF) (day 5). Sperm metabolic rates between accumulative ejaculate fractions from pure and diluted semen did not show differences. Also, sperm quality parameters were not affected by the ejaculate fraction during storage. However, sperm subjected to TRT showed similar results except for progressive motility, which was better in F2 and F3 than F1. When sperm were incubated with UF, the quality decreased in each group, but sperm from F2 and F3 were less affected than those from F1. In conclusion, the post-spermatic fraction can be included in seminal doses for their use in AI-centers, with functionality of sperm of different SP origins not being impaired throughout the storage, and responding better to thermal and UF stress. However, further research in AI-centers is necessary to test the sperm behaviour under presented conditions.

Electropolishing Stainless Steel Optimization Using Surface Quality, Dimensional Accuracy, and Electrical Consumption Criteria.

Electropolishing (EP) processes require high electrical consumption that must be optimized to minimize production costs without sacrificing the objectives of surface quality and dimensional accuracy. The aim of the present paper was to analyze the effects of the interelectrode gap, initial surface roughness, electrolyte temperature, current density, and EP time on aspects of the EP process applied to AISI 316L stainless steel, which have not been examined in the literature, such as polishing rate, final surface roughness, dimensional accuracy, and electrical consumption cost. In addition, the paper aimed to obtain optimum individual and multi-objective considering criteria of surface quality, dimensional accuracy, and electrical consumption cost. The results showed that the electrode gap was not significant on the surface finish or current density, and the EP time was the parameter having the greatest effect on all criteria analyzed, with a temperature of 35 °C showing the best electrolyte performance. The initial surface texture with the lowest roughness Ra10 (0.5 ≤ Ra ≤ 0.8 µm) obtained the best results with a maximum polishing rate of ~90% and minimum final roughness (Ra) of ~0.035 µm. The response surface methodology showed the EP parameter effects and the optimum individual objective. The desirability function obtained the best global multi-objective optimum, while the overlapping contour plot provided optimum individual and simultaneous per polishing range.

Are weight or age limits for pediatric laparoscopic pyeloplasty? Results of a multicentric study.

INTRODUCTION: Anderson-Hynes pyeloplasty is the technique of choice for the treatment of pyeloureteral junction obstruction (PUJO) with an excellent success rate. Minimally invasive surgery has become the standard of care for the management of PUJO in children. Although it has been comparable to the open approach at all levels, its diffusion or employment in younger children has not been widely adopted. Our aim is to evaluate laparoscopic pyeloplasty outcomes from international academic centers in children under 1 year of age, focusing on feasibility and outcomes including possible complications. MATERIALS AND METHODS: This is review of consecutive infants under 1 year of age who underwent laparoscopic pyeloplasty between 2009 and 2018 with more than 12 months of follow-up. Seven different training centers with different backgrounds participated in this study. Evaluation was carried out with ultrasound and renogram before and after surgery. Demographic data, perioperative characteristics, complications, and results are described and analyzed. RESULTS: Over 9 years, 124 transperitoneal laparoscopic Anderson-Hynes pyeloplasties were performed on 123 children under 1 year of age; 88 males and 35 females, with 1 case of bilateral PUJO. Of the 124 renal units, 86 were left-sided. Mean age at surgery was 6.6 months (1 week-12 months), with 56% (n = 70) done before 6 months of age. Mean weight at surgery was 6.8 kg (3-12 kg), with 59% (n = 73) weighing less than 8 kg. Mean operative time (skin-to-skin) was 150 min (75-330 min). After a mean follow-up of 46 months (12-84 months), 12 (9%) patients developed complications, with only 1 needing a redo pyeloplasty also done laparoscopically. One child, with deterioration in renal function, underwent nephrectomy. CONCLUSION: Laparoscopic pyeloplasty under 1 year of age and/or less than 12 kilos is feasible with lower complication rate. Furthermore, age younger than 6 months and weight less than 8 kg are no longer limiting factors for a successful pyeloplasty as shown by this multicentre study.

Latitudes and attitudes: A multinational study of laparoscopic pyeloplasty in children.

PURPOSE: The Anderson-Hynes technique has been the treatment of choice for primary ureteropelvic junction obstruction in children. Laparoscopic approach has shown similar outcomes to open, with advantages of shorter hospital stay and less pain. We reviewed the experience of 11 geographically diverse, tertiary pediatric urology institutions focusing on the outcomes and complications of laparoscopic pyeloplasty. MATERIALS AND METHODS: A descriptive, retrospective study was conducted evaluating patients undergoing Anderson-Hynes dismembered laparoscopic pyeloplasty. Centers from four different continents participated. Demographic data, perioperative management, results, and complications are described. RESULTS: Over a 9-year period, 744 laparoscopic pyeloplasties were performed in 743 patients. Mean follow-up was 31 months (6-120m). Mean age at surgery was 82 months (1 w-19 y). Median operative time was 177 min. An internal stent was placed in 648 patients (87%). A catheter was placed for bladder drainage in 702 patients (94%). Conversion to open pyeloplasty was necessary in seven patients. Average length of hospital stay was 2.8 days. Mean time of analgesic requirement was 3.2 days. Complications, according to Clavien-Dindo classification, were observed in 56 patients (7.5%); 10 (1%) were Clavien-Dindo IIIb. Treatment failure occurred in 35 cases with 30 requiring redo pyeloplasty (4%) and 5 cases requiring nephrectomy (0.6%). CONCLUSION: We have described the laparoscopic pyeloplasty experience of institutions with diverse cultural and economic backgrounds. They had very similar outcomes, in agreement with previously published data. Based on these findings, we conclude that laparoscopic pyeloplasty is safe and successful in diverse geographics areas of the world.

Laparoscopic and robot-assisted ureterocalicostomy for treatment of primary and recurrent pelvi-ureteric junction obstruction in children: a multicenter comparative study with laparoscopic and robot-assisted Anderson-Hynes pyeloplasty.

PURPOSE: This multi-institutional study aimed to assess the outcomes of laparoscopic ureterocalicostomy (LUC) and robot-assisted laparoscopic ureterocalicostomy (RALUC) and compare them with laparoscopic pyeloplasty (LP) and robot-assisted laparoscopic pyeloplasty (RALP) in children with pelvi-ureteric junction obstruction (PUJO). METHODS: The data of 130 patients (80 boys), with median age 7.6 years and median weight 33.8 kg, receiving minimally invasive treatment of PUJO over a 6-year period, were retrospectively analyzed. Patients were grouped according to the operative approach: G1 included 15 patients, receiving LUC (n = 9) and RALUC (n = 6), and G2 included 115 patients, receiving LP (n = 30) and RALP (n = 85). Patient characteristics and operative outcomes were compared in both groups. RESULTS: The median patient age and weight were significantly higher in G1 than in G2 [p = 0.001]. The median operative time was similar in both groups (157.6 vs 150.1 min) [p = 0.66] whereas the median anastomotic time was shorter in G1 than in G2 (59.5 vs 83.1 min) [p = 0.03]. The surgical success rate was similar in both groups (100% vs 97.4%) [p = 0.33]. Post-operative complications rate was higher in G1 than in G2 (20% vs 6.1%) but all G1 complications were Clavien 2 and did not require re-intervention. CONCLUSION: LUC/RALUC can be considered safe and effective alternative approaches to LP/RALP for PUJO repair and reported excellent outcomes as primary and salvage procedures. Robot-assisted technique was the preferred option to treat most patients with recurrent PUJO in both groups.

Should All Fractions of the Boar Ejaculate Be Prepared for Insemination Rather Than Using the Sperm Rich Only?

Boar ejaculate is released in several well-characterized fractions, differing in terms of sperm concentration, seminal plasma volume, and composition. However, the inclusion of the last part of the ejaculate for artificial insemination (AI) purposes is still under debate due to its controversial effects. Thus, there is a need to study the potential synergistic impact of the different ejaculate fractions. We aimed to evaluate the effect of accumulative ejaculate fractions on sperm conservation, AI performance, and offspring health. Ejaculates (n = 51) were collected and distributed as follows: F1: sperm-rich fraction; F2: sperm-rich + intermediate fractions; F3: sperm-rich + intermediate + poor fractions. Each group was diluted in a commercial extender, packaged in seminal doses (2000 × 106 sperm/60 mL), and stored at ~16 °C. On day 3 of conservation, sperm were analyzed and used for AI (n = 174). High sperm quality was observed after storage without a significant difference between the groups (p > 0.05). Moreover, no differences were obtained for AI performance (pregnancy and farrowing rates, and litter size; p > 0.05) and offspring health (growth and blood analysis; p > 0.05). Conclusively, the presence of all ejaculate fractions within the seminal doses does not impair the reproductive performance, reporting important economic savings according to the economic model included here.

Relevance of the Ejaculate Fraction and Dilution Method on Boar Sperm Quality during Processing and Conservation of Seminal Doses.

During boar semen processing and distribution, maximizing the work protocols in the laboratories becomes essential for the conservation of seminal doses. One of the recent implementations in the boar studs to improve efficiency has been semi-automatic semen collection systems, which do not allow to discard fractions of the ejaculate. The objective of this work was to evaluate the dilution method and vibrations (simulating delivery transport) effect on sperm quality (motility, viability, morphology, thermo-resistance test) according to the fraction of ejaculate collected. Two different fractions of the ejaculate were obtained [rich fraction (RF); total fractions (TF)] from six boars, and two dilution methods applied [pouring the extender over the semen (control; ES); pouring the semen over the extender (reverse; SE)]. The seminal doses (2000 × 106 sperm/50 mL) were preserved for 5 days. The results showed that the fraction collected affects sperm quality (better total and progressive motility, and faster sperm in TF; p < 0.05) regardless of the dilution method applied. However, these differences diminished after submitting the semen to the thermo-resistance test, with only differences in sperm viability being observed (p < 0.05). When seminal doses were subjected to vibrations, the sperm viability was more affected in the TF than in the RF group (p < 0.05). In conclusion, using the TF ejaculate leads to comparable results to the RF in sperm quality during storage regardless of the dilution method applied. However, the vibrations of seminal doses are more affected in doses prepared with TF than with RF, although more factors should be included to approach the real conditions during transport.

Hydronephrosis Classifications: Has UTD Overtaken APD and SFU? A Worldwide Survey.

Objective: To collect baseline information on the ultrasonographic reporting preferences. Method: A 13-multiple choice questionnaire was designed and distributed worldwide among pediatric urologists, pediatric surgeons, and urologists. The statistical analysis of the survey data consisted of 3 steps: a univariate analysis, a bivariate and a multivariate analysis. Results: Three hundred eighty participants responded from all the continents. The bivariate analysis showed the significant differences in the geographical area, the years of experience and the volume of cases. Most of the physicians prefer the SFU and APD systems because of familiarity and simplicity (37 and 34%, respectively). Respondents noted that their imaging providers most often report findings utilizing the mild-moderate-severe system or the APD measurements (28 and 39%, respectively) except for North America (SFU in 50%). Multivariate analysis did not provide significant differences. Conclusion: Our study evaluates the opinions regarding the various pediatric hydronephrosis classification systems from a large number of specialists and demonstrates that there is no single preferred grading system. The greatest reported shortcoming of all the systems was the lack of universal utilization. The observations taken from this study may serve as basis for the construction of a common worldwide system. As APD and SFU are the preferred systems and the UTD a newer combination of both, it is possible that with time, UTD may become the universal language for reporting hydronephrosis. This time, based on the result of this survey, seems not arrived yet.

[Perception of loneliness, happiness, and health, and quality of diet. The moderator role of weight status]. / Percepción de soledad, felicidad y salud, y calidad de la dieta. El rol moderador del estado ponderal.

INTRODUCTION: Aim: to determine the relationship between perceived loneliness, happiness, and health, and quality of diet, observing the moderator role of weight status in elementary school children during the state of alarm decreed for COVID-19. Methods: a descriptive, cross-sectional study in a sample of 116 Spanish schoolchildren. The perception of loneliness, happiness, and health was assessed using three items of the Health Behavior in School-aged Children questionnaire. The quality of their Mediterranean diet was assessed using the Mediterranean Diet Quality Index quetsionnaire for children and adolescents. Anthropometric variables were collected through a self-reported questionnaire, and for the calculation of body mass index the Quetelet index (kg/m2) was used. Results: the descriptive analysis showed no differences in the perception of loneliness, happiness, or health, quality of diet, or anthropometric variables (p > 0.005), except for weight (p < 0.005), according to sex. The inferential analysis showed that higher values in quality of diet are correlated with higher scores in perceived happiness and health (p < 0.005). In turn, the linear regression test showed an association between quality of diet and perception of happiness after the model was adjusted for normal weight (R2 = 0.382; p < 0.005). Likewise, it showed a significant association between quality of diet and perception of health after the model was adjusted for overweight schoolchildren (R2 = 0.455; p < 0.005). Conclusion: the association between perceived health and happiness with quality of diet seems to be moderated by weight status.

INTRODUCCIÓN: Objetivo: determinar la relación existente entre la percepción de soledad, felicidad y salud, y la calidad de la dieta, observando el rol moderador del estado ponderal en escolares de primaria durante el estado de alarma decretado por la COVID-19. Métodos: estudio descriptivo transversal de una muestra de 116 escolares españoles. Las percepciones de soledad, felicidad y salud se valoraron mediante tres ítems del cuestionario Health Behavior in School-aged Children. La calidad de la dieta mediterránea se valoró a través del cuestionario Índice de calidad de la dieta mediterránea en niños y adolescentes. Las variables antropométricas se recogieron a través de un cuestionario autoinformado y para el cálculo del índice de masa corporal se empleó el índice de Quetelet (kg/m2). Resultados: el análisis descriptivo no mostró diferencias en la percepción de soledad, felicidad y salud, la calidad de la dieta, y las variables antropométricas (p > 0,005), a excepción del peso (p < 0,005), según el sexo. El análisis inferencial mostró que los valores más elevados en la calidad de la dieta se correlacionan con valores más altos en la percepción de felicidad y de salud (p < 0,005). Por su parte, la prueba de la regresión lineal mostró asociación entre la calidad de la dieta y la percepción de felicidad tras ajustarse el modelo al normopeso (R2 = 0,382; p < 0,005). Asimismo, mostró una asociación significativa entre la calidad de la dieta y la percepción de salud tras ajustarse el modelo a los escolares con sobrepeso (R2 = 0,455; p < 0,005). Conclusión: la asociación entre la percepción de salud y de felicidad con la calidad de la dieta parece estar moderada por el estado del peso.

In vivo measurement of pH and CO2 levels in the uterus of sows through the estrous cycle and after insemination.

The pH-CO2-HCO3- system is a ubiquitous biological regulator with important functional implications for reproduction. Knowledge of the physiological values of its components is relevant for reproductive biology and the optimization of Assisted Reproductive Technologies (ARTs). However, in situ measurements of these parameters in the uterus are scarce or null. This study describes a non-invasive method for in situ time-lapse recording of pH and CO2 within the uterus of non-anesthetized sows. Animals were at three different reproductive conditions, estrous with no insemination and two hours after insemination, and diestrous. From pH and CO2 data, HCO3- concentration was estimated. The non-invasive approach to the porcine uterus with novel optical probes allowed the obtaining of in situ physiological values of pH, CO2, and HCO3-. Variable oscillatory patterns of pH, CO2 and HCO3- were found independently of the estrous condition. Insemination did not immediately change the levels of uterine pH, CO2 (%) and HCO3- concentration, but all the values were affected by the estrous cycle decreasing significantly at diestrous condition. This study contributes to a better understanding of the in vivo regulation of the pH-CO2-HCO3- system in the uterus and may help to optimize the protocols of sperm treatment for in vitro fertilization.

Nivel de ansiedad según el tipo de desayuno en escolares durante el estado de alarma por la COVID-19 en España / Anxiety level and breakfast type in schoolchildren during the COVID-19 state of alarm in Spain

Introducción: El desayuno suscita un considerable interés científico como posible parámetro relacionado con el estilo de vida. Objetivo: Analizar los niveles de ansiedad según el tipo de desayuno en escolares de Educación Primaria durante el estado de alarma decretado en España a causa de la COVID-19. Métodos: Estudio transversal compuesto por 116 escolares de la Isla de Fuerteventura. Se valoró la ansiedad a través del cuestionario Spence Children Anxiety Scale (SCAS). Los ítems referidos al desayuno fueron extraídos del test de Adhesión a la Dieta Mediterránea KIDMED. Las pruebas estadísticas utilizadas fueron el análisis de varianza simple (one way ANOVA) y la prueba de regresión logística multivariante. Resultados: La ingesta de un cereal se asocia con una menor probabilidad de desarrollar ataques de pánico y agorafobia (OR = 1,14, p < 0,01), fobia social (OR = 0,71, p < 0,05), trastorno obsesivo-compulsivo (OR = 1,22, p < 0,05) e índice ansiedad global (OR = 1,05, p < 0,05). Asimismo, no desayunar bollería habitualmente se asoció con una menor probabilidad de desarrollar un trastorno obsesivo-compulsivo (OR = 1,13; p < 0,05). Conclusiones: Una calidad del desayuno óptima, como consumir cereales saludables y no consumir bollería industrial, se asocia con menores niveles de ansiedad en escolares de Educación Primaria durante el estado de alarma decretado en España a causa de la COVID-19(AU)

Introduction: Breakfast arouses considerable scientific interest as a potential lifestyle parameter. Objective: Analyze the relationship between anxiety levels and breakfast type in schoolchildren. Methods: A cross-sectional study was conducted of 116 schoolchildren from the Isle of Fuerteventura. Anxiety was evaluated with the Spence Children Anxiety Scale (SCAS) questionnaire. Items about breakfast were taken from the KIDMED Test of Adherence to the Mediterranean Diet. Statistical processing was based on one way ANOVA and the multivariate logistic regression test. Results: Intake of a cereal is associated to a lesser probability of developing agoraphobia and panic attacks (OR = 1.14, p < 0.01), social phobia (OR = 0.71, p < 0.05), obsessive-compulsive disorder (OR = 1.22, p < 0.05) and overall anxiety index (OR = 1.05, p < 0.05). On the other hand, not having pastry for breakfast habitually was associated to a lesser probability of developing obsessive-compulsive disorder (OR = 1.13; p < 0.05). Conclusions: Optimum breakfast quality, such as eating healthy cereals and not eating industrial pastries, is associated to lower levels of anxiety in schoolchildren during the state of alarm decreed in Spain due to the COVID-19 pandemic(AU)

Imagen corporal, variables antropométricas y ansiedad en escolares de primaria / Body image, anthropometric variables and anxiety in primary school students

La imposición de un modelo estético en las sociedades actuales genera insatisfacción con el propio cuerpo. Esta situación puede agravarse durante la pandemia y en edades tempranas. Objetivo: determinar la relación existente entre el grado de satisfacción con la imagen corporal, variables antropométricas e índice de ansiedad en escolares de primaria durante el estado de alarma decretado a causa de la COVID-19. Material y métodos: estudio descriptivo transversal realizado el 23 de marzo de 2020 el cual está compuesto con una mues¬tra de 116 escolares españoles de Educación Primaria con un rango de edad comprendido entre los 8 y 12 años. El índice de ansiedad se valoró mediante el cuestionario Spence Children Anxiety Scale (SCAS). El grado de satisfacción con la imagen corporal se valoró mediante un ítem del cuestionario Health Behavior in School-aged Children (2009). Resultados: el análisis descriptivo mostró que las mujeres presentan un mayor porcentaje de satisfacción con la imagen corporal menor (p < 0.005), una mayor ansiedad (p < 0.005) y un menor peso (p < 0.005) respecto a los varones. La prueba de regresión lineal mostró una asociación entre el grado de satisfacción con la imagen corporal con la edad, el peso, el IMC y el índice de ansiedad con un valor de R2 = 0,293. Conclusión: el grado de satisfacción con la imagen corporal se asocia con variables antropométricas y ansiedad en las mujeres pero no en varones escolares de Primaria(AU)

The imposition of an aesthetic model in current societies generates dissatisfaction with the body itself. This situation can be aggravated during the pandemic and at an early age. Objective: to determine the relationship between the degrees of satisfaction with body image, anthropometric variables and anxiety index in primary school children during the state of alarm decreed due to COVID-19. Material and methods: This cross-sectional descriptive study was carried out on 23 March 2020 and consisted of a sample of 116 Spanish primary schoolchildren aged between 8 and 12 years. The anxiety index was assessed using the Spence Children Anxiety Scale (SCAS) questionnaire. The degree of satisfaction with body image was assessed using an item from the Health Behavior in School-aged Children questionnaire (2009). Results: the descriptive analysis showed that women have a lower percentage of satisfaction with body image (p <0.005), higher anxiety (p <0.005) and lower weight (p <0.005) compared to men. Likewise, the linear regression test showed an association between the degree of satisfaction with body image with age, weight, BMI and the anxiety index with a value of R2 = 0.293. Conclusion: the degree of satisfaction with body image is associated with anthropometric variables and anxiety in women but not in primary school boys(AU)

Clinical impact of Ga68-DOTATOC PET/CT on neuroendocrine tumors. A preliminary experience. / Impacto clínico del PET/TC Ga68-DOTATOC en tumores de origen neuroendocrino. Experiencia preliminar.

Ga-68-DOTATOC PET/CT is a recently introduced imaging technique for the diagnosis and follow-up of neuroendocrine tumors. A prospective observational study was conducted in seven patients who underwent a Ga-68-DOTATOC PET/CT study. They were suspected of active neuroendocrine tumor lesions, either on initial diagnosis or as a possible recurrence and/or progression of already known tumors. The results of prior imaging studies (MRI, thoracoabdominal CT scan, octreotide...), had been negative or inconclusive. All positive Ga-68-DOTATOC PETs were true positives, confirmed by pathological examination. There were no false positive results. Only one false negative result was found. Ga-68-DOTATOC PET/CC is more sensitive and specific for the detection of primary neuroendocrine tumor lesions, allows for a more complete extension study, and detects recurrences in earlier stages, conditioning changes in staging and surgical treatment. It provides additional information on somatostatin receptor overexpression, which is essential for the indication of PRRT (peptide receptor radionuclide therapy) with Lu177 dotatate.

Analysis of physical fitness according to sex, age, body mass index and level of physical activity in Spanish elementary school students / Análisis de la condición física según sexo, edad, índice de masa corporal y nivel de actividad física en estudiantes de primaria en España

Abstract Introduction: Scientific evidence suggests that schoolchildren's quality of life is directly related to their physical fitness (PF). Objective: To analyze the physical fitness of elementary school students according to age, sex, body mass index (BMI) and level of physical activity (PA). Materials and methods: Cross-sectional and descriptive study conducted in 103 schoolchildren (aged 8-12 years) from Spain. PF and PA were measured using the ALPHA-fitness test battery and the Physician-based Assessment and Counseling for Exercise instrument, respectively. Participants were classified according to their level of PA (physically inactive vs. physically active) and their BMI (normal weight vs. overweight-obese). Parametric statistics were used for data analysis. Results: Male participants had a better level of PF. In addition, it was found that PF slightly increases as age increases, regardless of the sex. Normal weight or physically active schoolchildren had better aerobic capacity and a healthier body composition. Conclusion: Keeping optimal PF levels at any stage of life requires adopting a healthy lifestyle since childhood; therefore, it is necessary to encourage schoolchildren to do physical activity on their own.

Resumen Introducción. La evidencia científica sugiere que la calidad de vida de los escolares se relaciona de forma directa con el estado de su condición física (CF). Objetivo. Analizar la CF según edad, sexo, índice de masa corporal (IMC) y nivel de actividad física en estudiantes de primaria. Materiales y métodos. Se realizó un estudio descriptivo transversal con 103 escolares entre 8 y 12 años de España. La CF se midió mediante la batería ALPHA-Fitness y la actividad física, con el cuestionario Physician-based Assessment and Counseling for Exercise. Los participantes se categorizaron según su nivel de actividad física (no activos versus activos) y su IMC (normo-peso versus sobrepeso-obesidad). Para el análisis se aplicó estadística paramétrica. Resultados. Los varones tuvieron un mejor nivel de CF, pero en ambos sexos se observó un leve incremento de esta a medida que aumentaba la edad. Los escolares con normopeso o activos físicamente tuvieron una mejor capacidad aeróbica y una composición corporal más saludable. Conclusión. Mantener niveles óptimos de CF a lo largo de la vida requiere de la adopción de un estilo de vida saludable desde la infancia, por tanto, es necesario promover la práctica autónoma de actividad física en los escolares.

Incidencia del sexo, el índice de masa corporal y el número de hermanos en la competencia motriz autopercibida / Influence of sex, body mass index and number of siblings on self-perceived motor competence

Introducción: La infancia se caracteriza por ser un periodo trascendental en el ciclo vital de la persona, es donde se inicia la formación de la personalidad y la adquisición de hábitos de vida saludables. Objetivo: Analizar la autopercepción de competencia motriz en relación al género, el estado de peso y el número de hermanos. Métodos: Participaron en el estudio 310 escolares de sexto curso (M ± DE; 10,87 ± 0,54) ubicados en la comunidad Autónoma de Castilla La Mancha. El instrumento utilizado para medir este constructo es la percepción de la competencia motriz en Educación Física. Resultados: La percepción de competencia motriz es un factor más a desarrollar en la adquisición de estilos de vida saludables, especialmente en las chicas. El contexto educativo en colaboración con los padres debe favorecer la formación de una personalidad completa y equilibrada del escolar junto con la adquisición de hábitos de vida saludables. Conclusiones: El análisis estadístico efectuado pone de manifiesto una mayor percepción de competencia motriz a favor de los varones, los escolares normopeso y los escolares sin hermanos en los factores de experiencia personal y compañeros (p < 0,05)(AU)

Introduction: Childhood is a crucial period in a person's life cycle. It is the time when the personality begins to take definitive shape and healthy daily habits are acquired. Objective: Analyze the self-perception of motor competence in relation to gender, body weight and number of siblings. Methods: The study population was 310 sixth-grade students (M ± SD; 10.87 ± 0.54) from the Autonomous Community of Castile-La Mancha. The tool used to measure this construct was motor competence perception in physical education. Results: Motor competence perception is yet another factor to be developed as part of the acquisition of a healthy lifestyle, particularly by girls. The educational setting in joint coordination with the parents should contribute to the formation of the students' full, well-balanced personality alongside the acquisition of healthy daily habits. Conclusions: The statistical analysis performed revealed greater motor competence perception among male, normal weight, only child students in terms of their own experience and that of their schoolmates (p < 0.05)(AU)

Relación entre la actividad física y el índice de masa corporal en escolares de Murcia / Relationship between physical activity and body mass index in schoolchildren in Murcia

La obesidad infantil es una epidemia mundial, en donde, la Organización mundial para la salud prevé que casi dos de cada tres europeos adultos tendrá sobrepeso en 2030. El objetivo de este estudio fue analizar la relación entre la actividad física y el índice de masa corporal (IMC) según la etapa educativa y el sexo. Diseño descriptivo de corte transversal con una muestra de 635 participantes (266 varones (41,9%) y 369 mujeres (58,1%); 13,1 ± 2,8 años) procedentes de un área urbana de Murcia. La prueba T de student reflejó que los varones de Secundaria realizan más AF que las chicas (p < 0,004). Por su parte, la prueba Ji cuadrado mostró diferencias significativas en el estado de peso en normopeso a favor de las mujeres (72,4% vs. 63,2%; p < 0,001) y en sobrepeso a favor de los varones (31,2% vs. 20,1%; p < 0,003). Al analizar la relación entre el IMC y la actividad física mediante la correlación de Pearson, se obtuvo una correlación inversa en las mujeres de bachillerato (p = 0,002; r = - 0,223), en los varones de bachillerato (p = 0,001; r = - 0,212 y en el total de los escolares de bachillerato (p = 0,002; r = - 0,218). La relación entre el IMC y la actividad física en escolares de Primaria, Secundaria y Bachillerato es nula o débil. En futuros estudios se sugiere tener en cuenta valoraciones más objetivas del nivel de actividad física y variables antropométricas que puedan aportar luz a la relación entre estas variables(AU)

Childhood obesity is a global epidemic, with the World Health Organization predicting that almost two out of every three adult Europeans will be overweight by 2030. The objective of this study was to analyze the relationship between physical activity and body mass index (BMI) according to educational stage and sex. Descriptive cross-sectional design with a sample of 635 participants (266 men (41.9%) and 369 women (58.1%); 13.1 ± 2.8 years) from an urban area of Murcia. Student's T-test showed that Secondary males perform more physical activity than girls (p <0.004). In turn, the Chi-square test showed significant differences in weight status in normal weight in favor of women (72.4% vs. 63.2%, p <0.001) and overweight in favor of men (31.2% vs. 20.1% p <0.003). When analyzing the relationship between BMI and physical activity through the Pearson correlation, an inverse correlation was obtained in high school girls (p = 0.002, r = - 0.223), in high school boys (p = 0.001, r = - 0.212 and in the total number of baccalaureate students (p = 0.002, r = - 0.218). The relationship between BMI and physical activity in primary, secondary and high school students is null or weak. In future studies, it is suggested to take into account more objective assessments of the level of physical activity and nutritional status that may shed light on the relationship between these variables(AU)

Urology mythbusters: do we need to surgically correct vesicoureteral reflux in older girls to prevent problems in future pregnancy? (revision 1).

In this edition of Mythbusters we critically examine the premise that, because women with history of vesicoureteric reflux (VUR) are at higher risk of urinary tract infection (UTI) and other morbidity during pregnancy, persistent VUR in older girls should be considered an indication for surgical correction. The literature is very limited in that there are essentially no methodologically robust comparisons of pregnancy outcomes among women whose childhood VUR was or was not surgically repaired. Most of the case series and cohorts find relatively high incidence of UTI and pyelonephritis among pregnant women with a history of VUR, but there is very little to suggest that persistent VUR is itself a risk factor for infection during pregnancy. Indeed, some studies suggest that UTI risk is actually higher among women who previously underwent anti-reflux surgery compared to those who did not, although these data are compromised by significant selection bias. In contrast, there is relatively strong evidence that maternal and fetal morbidity is higher when the mother is known to have renal scarring; such women probably merit close surveillance during pregnancy for infection, hypertension and pre-eclampsia, and other problems. Overall, current evidence is insufficient to support routine anti-reflux surgery in girls with the sole purpose of decreasing complications during future pregnancy, particularly for girls with lower-grades of VUR and no renal scarring. The verdict for this urolegend: it contains a a "teeny, tiny nugget of truth."

Analysis of PLA Geometric Properties Processed by FFF Additive Manufacturing: Effects of Process Parameters and Plate-Extruder Precision Motion.

The evolution of fused filament fabrication (FFF) technology, initially restricted to the manufacturing of prototypes, has led to its application in the manufacture of finished functional products with excellent mechanical properties. However, FFF technology entails drawbacks in aspects, such as dimensional and geometric precision, and surface finish. These aspects are crucial for the assembly and service life of functional parts, with geometric qualities lagging far behind the optimum levels obtained by conventional manufacturing processes. A further shortcoming is the proliferation of low cost FFF 3D printers with low quality mechanical components, and malfunctions that have a critical impact on the quality of finished products. FFF product quality is directly influenced by printer settings, material properties in terms of cured layers, and the functional mechanical efficiency of the 3D printer. This paper analyzes the effect of the build orientation (Bo), layer thickness (Lt), feed rate (Fr) parameters, and plate-extruder movements on the dimensional accuracy, flatness error, and surface texture of polylactic acid (PLA) using a low cost open-source FFF 3D printer. The mathematical modelling of geometric properties was performed using artificial neural networks (ANN). The results showed that thinner layer thickness generated lower dimensional deviations, and feed rate had a minor influence on dimensional accuracy. The flatness error and surface texture showed a quasi-linear behavior correlated to layer thickness and feed rate, with alterations produced by 3D printer malfunctions. The mathematical models provide a comprehensive analysis of the geometric behavior of PLA processing by FFF, in order to identify optimum print settings for the processing of functional components.