Exploring the influence of meteorological conditions on the variability of olive pollen intradiurnal patterns: Differences between pre- and post-peak periods.

Olive trees hold a significant economical, ecological and ornamental value, especially in the Mediterranean area. It is a wind-pollinated species emitting huge quantities of pollen with a high degree of allergenic sensitization. Andalusia region (southern Spain), where 15 % of the global olive tree population is cultivated, present a high density of this crop, reaching daily airborne olive pollen concentrations up to 6.000 pollen/m3. Although daily variations during the pollen season have been widely investigated in bibliography, factors influencing the intradiurnal dynamics of olive pollen concentrations remains underexplored in aerobiology. The present paper focuses on it, characterizing main intradiurnal patterns, identifying potential pollen source areas and the influence of wind dynamics on Córdoba city olive pollen data. The results reveal the presence of different pollen peaks at various hours of the day, depending on the stage of the pollen season (pre- and post-peak) and wind dynamics. Nevertheless, the main one is detected at midday during the pre-peak season, with secondary peaks at night, morning and late afternoon. A thorough examination of wind dynamics highlighted the significant influence of distant and local sources on the hourly pollen peaks and hence, on intradiurnal patterns. The analysis of the intradiurnal pattern associated with different air mass patterns demonstrated a considerable variability in the occurrence of peak concentrations and hence, in the contribution of sources. The characterization of surface winds confirms the substantial differences in the dynamics of atmospheric transport processes that influence the primary intradiurnal patterns of olive pollen in this region.

Pollen production in olive cultivars and its interannual variability.

BACKGROUND AND AIMS: Olive (Olea europaea subsp. europaea var. europaea) is the most extensively cultivated fruit crop worldwide. It is considered a wind-pollinated and strictly outcrossing crop. Thus, elevated pollen production is crucial to guarantee optimum fruit set and yield. Despite these facts, the variability of pollen production within the cultivated olive has been scarcely studied. This study aimed to characterize this feature by analysing a representative set of worldwide olive cultivars. METHODS: We evaluated the average number of pollen grains per anther in 57 principal cultivars over three consecutive years. We applied a standard generalized linear model (GLM) approach to study the influence of cultivar, year and the previous year's fruit load on the amount of pollen per anther. Additionally, the K-means method was used for cluster analysis to group cultivars based on their pollen production capacity. KEY RESULTS: Pollen production per anther was highly variable among olive cultivars. The cultivar significantly accounted for 51.3 % of the variance in pollen production and the year for 0.3 %. The interaction between the two factors explained 8.4 % of the variance, indicating that not all cultivars were equally stable in producing pollen across the years. The previous year's fruit load and its interaction with the year were significant, but barely accounted for 1.5 % of the variance. Olive cultivars were classified into four clusters according to their capacity to produce pollen. Interestingly, the fourth cluster was composed of male-sterile cultivars, which presumably share this character by inheritance. CONCLUSIONS: Pollen production per anther varied extensively within the cultivated olive. This variation was mainly driven by the cultivar and its interaction with the year. The differential capacity of olive cultivars to produce pollen should be considered not only for designing new orchards but also gardens where this species is used as an ornamental.

Long-term trends and influence of climate and land-use changes on pollen profiles of a Mediterranean oak forest.

Climate change is disrupting phenology and interaction patterns of natural ecosystems, but also human activities that modify land-uses have a direct impact, especially on species distribution and loss of biodiversity. The objective of this study is to evaluate the impact of climate and land-use changes on phenology and airborne pollen spectrum in a Mediterranean natural area, dominated by Quercus Forest and 'dehesa', in the South of the Iberian Peninsula. 61 different pollen types were identified over a 23-year period (1998-2020), mainly from trees and shrubs, such as Quercus, Olea, Pinus or Pistacia, and from herbaceous plants, such as Poaceae, Plantago, Urticaceae or Rumex. A comparison of pollen data from the first years of the study (1998-2002) up recent years (2016-2020), showed a substantial decrease in the relative abundance of pollen from autochthonous species associated with natural areas, such as Quercus or Plantago. However, the relative abundance of the pollen from cultivated ones such as Olea and Pinus, which is used for reforestation has increased. Regarding flowering phenology trends, our analyses revealed variations between -1.5 and 1.5 days per year. Taxa showing an advance phenology were Olea, Poaceae and Urticaceae, whereas Quercus, Pinus, Plantago, Pistacia or Cyperaceae experienced delayed pollination. Meteorological trends in the area generally resulted in an increase in both minimum and maximum temperatures, along with a decrease in precipitations. Changes in pollen concentration and phenology were correlated with changes in air temperatures and precipitation, although the positive or negative influence varied for each pollen type. The results suggest that climate change together with those motivated by land cover changes lead by human activities are having an impact on the phenology and pollen concentration, with the related consequences on pollination and therefore biodiversity more concerning in threatened areas as the Mediterranean Basin.

Evaluation of patient satisfaction with an ophthalmology video consultation during the COVID-19 pandemic.

BACKGROUND: We introduced a video consultation (VC) during the coronavirus (COVID-19) pandemic in an ophthalmology practice with eight doctors to ensure continuous ophthalmological care, infection prophylaxis and to compensate a decreased number of patient presentations. OBJECTIVE: Evaluation of the most common reasons for patient presentations in the VC, the proportion of re-presentations in the practice despite VC, practical challenges associated with the introduction of VC and patient satisfaction. MATERIAL AND METHODS: Patients with a recent acute visual deterioration and severe eye pain were excluded from the VC. The VC were carried out by a trained specialist in ophthalmology. A questionnaire with eight questions was completed after the VC appointment in order to evaluate the proportion of completed VC and patient satisfaction. RESULTS: We included 29 (13 male, Ø 52.6 years, 16 female, Ø 64.7 years) patients in this analysis. The VC could be performed with 68.97% of the participants who rated their overall experience with an average grade of 1.6 (1 very good to 6 insufficient) and all of them indicated that they would recommend the VC. Of presentations in VC 70% were related to the symptoms of the anterior eye segment. In 70% of the cases no re-presentations took place in the unit. CONCLUSION: Our study represents a significant practical application of VC for the management of non-urgent ocular conditions with maximum infection prophylaxis. The introduction of VC was severely limited by technological or user-related issues by the establishment of video connections. Patient satisfaction with VC was high to very high.

[Impact of a more stringent organization of intravitreal injection treatment on the number of treatments and examinations in routine practice]. / Auswirkungen einer stringenteren IVOM-Behandlungsorganisation auf die Anzahl der Behandlungen und Untersuchungen im Praxisalltag.

BACKGROUND: Results from recent studies show that less intravitreal injections are often performed in everyday practice than in controlled trials, which subsequently leads to worse treatment success. In this study we analyzed the introduction of a more stringent organization of treatment using workflow optimization and new IT systems and analyzed the effect on treatment continuity. MATERIAL AND METHODS: In the second quarter of 2019 a new medical practice management software and a software for automated injection planning were implemented. There was also a change of the treatment regimen from pro re nata (PRN) to treat and extend (T&E ). We analyzed the results of the patients regarding the frequency of injections and treatment controls three quarters before (Q3/2018-Q1/2019) and three quarters after the change (Q2/2019-Q4/2019). Treatment-naive and pretreated patients were analyzed. RESULTS: In group 1 (Q3/2018-Q1/2019) the average number of injections per quarter was 1.74 (SD = 0.4). Eyes of patients from group 2 (Q2/2019-Q4/2019) received on average 2.17 (SD = 0.3) injections. The number of check-ups per quarter was 1.71 (SD = 0.3) before the introduction, and thereafter 2.16 (SD = 0.3). There was a significant increase in the number of OCTs from 1.18 (SD = 0.2) to 1.98 (SD = 0.3). The visual acuity was stable in both groups. CONCLUSION: We were able to show that the introduction of the medical practice management software and the change of the regimen from PRN to T&E can achieve numbers of injections, check-ups and OCT similar to those in studies. A standardized procedure facilitates efficient treatment planning and enables a better patient management.

Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries.

AIMS: Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys. METHODS: The WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women. RESULTS: Each prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2-110.8, interquartile range = 6.0-19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1-2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs. CONCLUSIONS: Survey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.

[Evaluation of patient satisfaction with an ophthalmology video consultation during the COVID-19 pandemic]. / Evaluierung der Patientenzufriedenheit mit einer augenärztlichen Videosprechstunde während der COVID-19-Pandemie.

BACKGROUND: We introduced a video consultation (VC) during the coronavirus (COVID-19) pandemic in an ophthalmology practice with eight doctors to ensure continuous ophthalmological care, infection prophylaxis and to compensate a decreased number of patient presentations. OBJECTIVE: Evaluation of the most common reasons for patient presentations in the VC, the proportion of re-presentations in the practice despite VC, practical challenges associated with the introduction of VC and patient satisfaction. MATERIAL AND METHODS: Patients with a recent acute visual deterioration and severe eye pain were excluded from the VC. The VC were carried out by a trained specialist in ophthalmology. A questionnaire with eight questions was completed after the VC appointment in order to evaluate the proportion of completed VC and patient satisfaction. RESULTS: We included 29 (13 male, Ø 52.6 years, 16 female, Ø 64.7 years) patients in this analysis. The VC could be performed with 68.97% of the participants who rated their overall experience with an average grade of 1.6 (1 very good to 6 insufficient) and all of them indicated that they would recommend the VC. Of presentations in VC 70% were related to the symptoms of the anterior eye segment. In 70% of the cases no re-presentations took place in the unit. CONCLUSION: Our study represents a significant practical application of VC for the management of non-urgent ocular conditions with maximum infection prophylaxis. The introduction of VC was severely limited by technological or user-related issues by the establishment of video connections. Patient satisfaction with VC was high to very high.

[Traumatic Turf-Toe: challenging diagnosis and controversial treatment]. / Turf-Toe traumático: diagnóstico desafiante y tratamiento controvertido.

INTRODUCTION: Turf-Toe includes a wide variety of traumatic injuries of the metatarsophalangeal joint of the first toe (MTF1). It is a potentially severe injury and there is no consensus for surgical management. The objective of this case report was to describe a patient with traumatic Turf-Toe injury grade III with a sesamoid fracture treated surgically. CLINICAL CASE: 24-year-old male with motorcycle fall with hyperflexion of the MTF1 joint, presented pain, edema and functional limitation; the radiographs showed soft tissue edema, lateral displacement of lateral sesamoid with fracture. Traumatic Turf-Toe was established. The ultrasound of the MTF1 joint showed breakage of the plantar plate and collateral ligaments. Patient was surgically managed with sesamoid reduction and plantar plate repair; postoperative evolution was satisfactory. At 8 weeks the patient was assessed with the AOFAS forefoot scale, obtaining 82 points, SF-12 with 87% and VAS of two and returned to his daily activities. CONCLUSION: We describe a patient with traumatic Turf Toe grade III injury, not related to sports practice; first report in the literature of the use of ultrasound in the evaluation of patients with lesion of the metatarso-phalangic joint of the first toe.

INTRODUCCIÓN: Turf-Toe incluye una gran variedad de lesiones traumáticas de la articulación metatarsofalángica del primer dedo del pie (MTF1). Es una lesión potencialmente grave y no existe consenso para el manejo quirúrgico. El objetivo de este reporte fue describir el caso de un paciente con lesión Turf-Toe traumática grado III con fractura sesamoidea tratado quirúrgicamente. CASO CLÍNICO: Masculino de 24 años con caída de motocicleta con hiperflexión de la articulación MTF1 presentó dolor, edema y limitación funcional; las radiografías mostraron edema de tejidos blandos, desplazamiento lateral de sesamoideo lateral con fractura. Se estableció el diagnóstico de Turf-Toe traumático. En el ultrasonido de la articulación MTF1, se demostró rotura de la placa plantar y ligamentos colaterales. Se manejó quirúrgicamente con reducción del sesamoideo y reparación de la placa plantar. La evolución postoperatoria fue satisfactoria; a las ocho semanas el paciente fue valorado con escala AOFAS­ de antepié obteniendo 82 puntos, SF-12 con 87% y EVA de 2 y retornó a sus actividades cotidianas. CONCLUSIÓN: Describimos un paciente con lesión Turf-Toe traumática grado III, no relacionada con la práctica deportiva. Primer reporte en la literatura del uso del ultrasonido en la evaluación de pacientes con lesión de la articulación metatarso-falángica del primer dedo del pie.

Twelve-month mental health service use in six countries of the Americas: A regional report from the World Mental Health Surveys.

AIMS: To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. METHODS: Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001-2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. RESULTS: Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the vast majority (87.1%) of this treatment was minimally adequate, only 35.3% of cases received treatment that met acceptable quality guidelines. Indicators of social-advantage (high education and income) were associated with higher rates of service use and adequacy, but a number of other correlates varied across survey sites. CONCLUSIONS: These results shed light on an enormous public health problem involving under-treatment of common mental disorders, although the problem is most extreme among people with social disadvantage. Promoting services that are more accessible, especially for those with few resources, is urgently needed.

Implantación de condrocitos autólogos versus microfracturas para el tratamiento de lesiones del cartílago en la rodilla / Autologous chondrocytes implantation versus microfracture for the treatment of knee cartilage lesions

Resumen: Objetivo: Comparar la eficacia clínica y la seguridad de la terapia de microfracturas (MF) versus implantación de condrocitos autólogos en membrana (MACI) en el manejo de lesiones condrales de rodilla ≥ 3 cm2 y el seguimiento a 12 meses postratamiento. Material y métodos: Se realizó un estudio de cohorte retrospectiva, de Enero de 2016 a Diciembre de 2017. Se incluyeron pacientes con una o varias lesiones condrales en rodilla ≥ 3 cm2 para comparar la terapia MF versus MACI para la reparación de lesión condral. Se realizaron valoraciones clínicas y funcionales previas al tratamiento quirúrgico y 12 meses posteriores, con medición de los arcos de movimiento, escala EVA, Oxford e índice de Lequesne. Resultados: Se incluyeron 12 pacientes en MF y 12 pacientes en MACI. La lesión más frecuente se localizó en la patela en ocho pacientes (67%). Se demostró incremento en los arcos de movimiento, así como mejoría en la comparación entre el nivel basal y en el seguimiento a 12 meses: en EVA, MF mostró 48.4% y MACI 57.5% (p ≤ 0.05); escala de Oxford: MF 32.65% y MACI 51.04% (p ≤ 0.05); índice de Lequesne: MF 40.12% y MACI 50%. Se presentaron dos casos de derrame articular en MACI, que se resolvieron con la realización de artrotomías. Conclusión: En este estudio se demostró mejoría significativa en MACI con alivio del dolor, funcionalidad y arcos de movimiento en comparación con el tratamiento de MF en lesiones ≥ 3 cm2 del cartílago articular de rodilla después de un año de seguimiento.

Abstract: Objective: To compare the clinical efficacy and safety of microfracture therapy (MF) versus implantation of autologous chondrocytes (MACI) in the management of chondral lesions of the knee ≥ 3 cm2 and follow up to 12 months post treatment. Material and methods: A retrospective cohort study was conducted from January 2016 to December 2017. Patients with one or more chondral lesions in knee ≥ 3 cm2 were included to compare MF versus MACI therapy for the repair of chondral lesion. Clinical and functional evaluations were carried out prior to the surgical treatment and 12 months later, with measurement of the range of motion, EVA, Oxford scale and Lequesne index. Results: Twelve patients were included in MF and 12 patients in MACI. The most frequent lesion was located in the Patella in eight patients (67%). It showed an increase in the arcs of motion, as well as improvement in the comparison between baseline and follow-up at 12 months: in EVA, MF demonstrated 48.4% and MACI 57.5% (p ≤ 0.05); Oxford scale: MF 32.65% and MACI 51.04% (p ≤ 0.05); index of Lequesne: MF 40.12% and MACI 50%. Two cases of joint effusion were presented in MACI, which were resolved with the realization of arthrotomies. Conclusion: In this study, significant improvement was demonstrated in MACI with pain relief, functionality, and range of motion compared to the treatment of MF in lesions ≥ 3 cm2 of the articular cartilage of the knee after one year of follow-up.

Trasplante de menisco: experiencia con seguimiento clínico y funcional a un año / Meniscal transplant: clinical and functional experience at one year follow-up

Resumen: Introducción: En México se realizó el primer trasplante de menisco en 2002. El objetivo fue describir la evolución clínica de pacientes con dolor asociado al síndrome postmeniscectomía que fueron sometidos a trasplante de menisco alogénico (MAT), con bloques óseos vía artroscópica con seguimiento a un año. Material y métodos: Se realizó un estudio de cohorte retrospectiva con seguimiento a un año; se incluyeron pacientes con dolor en interlínea articular secundario a meniscectomía parcial o total, entre 15 y 55 años de edad, de ambos sexos, que fueron sometidos a MAT. La evolución clínica se evaluó con EVA, SF-36 y escala de Lysholm; los resultados se describen en frecuencias, porcentajes y valor de p significativa < 0.05. Resultados: Se incluyeron nueve pacientes; ocho hombres y una mujer con edad de 31.3 años (16-52), el seguimiento fue de 16.6 meses (12-23). La EVA prequirúrgica fue de 8.5 (6-10) y al año de seguimiento el promedio de esta escala fue de 1.25 (0-5) (p < 0.001). En el seguimiento a un año posterior al MAT, la escala de Lysholm fue en promedio de 91 (68-100) y la SF-36 fue en promedio de 79.17 (65-92.92); tres pacientes regresaron a su práctica deportiva previa a la lesión. Conclusión: Éste es el primer reporte en México del seguimiento a un año del MAT; se demostró mejoría clínica significativa (p < 0.001) con remisión del dolor en la rodilla con meniscectomía previa y en algunos casos el retorno a la práctica deportiva.

Abstract: Introduction: In Mexico, the first meniscus transplant was performed in 2002. The objective was to describe the clinical evolution of patients with pain associated with postmenisectomy syndrome, who underwent meniscal allograft transplantation (MAT), with bony blocks via arthroscopy, with follow-up to one year. Material and methods: A retrospective cohort study with a one-year follow-up was conducted. We included patients with joint interlining pain secondary to partial or total menisectomy, between 15 and 55 years of age, of both sexes, who underwent MAT. The clinical evolution was evaluated with visual analogue scale (VAS), SF-36 and Lysholm scale; the results are described in frequencies, percentages and p value was significant at < 0.05. Results: We included nine patients; eight men and one woman with an age of 31.3 years (16-52), the follow-up was 16.6 months (12-23). The preoperative VAS was 8.5 (6-10) and, at one year of follow-up, the average of this scale was 1.25 (0-5) (p < 0.001). In the follow-up one year after the MAT, the Lysholm scale was on average 91 (68-100) and the SF-36 was on average 79.17 (65-92.92); three patients returned to their sports practice prior to the injury. Conclusion: This is the first report in Mexico that describes the one year follow-up of the MAT; significant clinical improvement was demonstrated (p < 0.001) with remission of pain in the knee with previous menisectomy and in some cases the return to sports practice.

[Clinical and functional results of the Broström-Gould technique for lateral ankle instability: evaluation with three scales]. / Resultados clínicos y funcionales de la plastía Broström-Gould para inestabilidad lateral de tobillo: evaluación con tres escalas.

BACKGROUND: The most frequent sequel to the ankle sprain is the instability of the lateral ligament complex; the results of surgical treatment have not been evaluated with multiple scales simultaneously. The objective of the study was to assess the clinical and functional results with three scales in patients with lateral instability of ankle undergoing Broström-Gould technique, using for fixation, anchors with suture to distal fibula. MATERIAL AND METHODS: The design of the study was cross-sectional and descriptive; we included patients with lateral instability of ankle and partial or complete rupture of the APA or CP ligament subject to repair with Broström-Gould technique. Magnetic resonance imaging was performed to confirm the diagnosis; clinical and functional outcomes were determined with three scales: EVA, SF-36 and AOFAS. Patients were evaluated at six months, or more, after the surgical procedure. RESULTS: We included 13 patients; quality of life (SF-36 questionnaire) showed a good result with average score of 90; 10 (77%) patients showed excellent results in function, absence of pain and alignment of the ankle (AOFAS 90-100). Also found significant improvement in pain (presurgical EVA: 6, compared with 1 in the postoperative period). CONCLUSIONS: The surgical procedure showed excellent results, in the short term with resolution of pain and ankle stability.

ANTECEDENTES: La secuela más frecuente del esguince de tobillo es la inestabilidad del complejo ligamentario lateral; los resultados del tratamiento quirúrgico no han sido evaluados con varias escalas simultáneamente. El objetivo del estudio fue evaluar los resultados clínicos y funcionales con tres escalas en pacientes con inestabilidad lateral de tobillo sometidos a plastía de Broström-Gould, utilizando para su fijación anclas con sutura al peroné distal. MATERIAL Y MÉTODOS: El diseño del estudio fue transversal y descriptivo; se incluyeron pacientes con inestabilidad lateral de tobillo y ruptura parcial o completa del ligamento PAA y/o PC, sometidos a reparación con plastía de Broström-Gould. Se realizó resonancia magnética nuclear para confirmar el diagnóstico; los resultados clínicos y funcionales se determinaron con tres escalas: EVA, SF-36 y AOFAS. Los pacientes fueron evaluados a los seis meses o más posteriores al procedimiento quirúrgico. RESULTADOS: Se incluyeron 13 pacientes; la calidad de vida (cuestionario SF-36) arrojó un resultado bueno con promedio de 90; 10 (77%) pacientes mostraron resultados excelentes en la función, ausencia de dolor y alineación del tobillo (AOFAS 90-100). Asimismo, se observó mejoría importante en el dolor (EVA prequirúrgico: 6, comparado con 1 en el período postquirúrgico). CONCLUSIONES: El procedimiento quirúrgico demostró excelentes resultados en el corto plazo con resolución del dolor y estabilidad del tobillo.

Cervical vaporization in LSIL and persistent HPV infection.

OBJECTIVE: To assess rates of negative cytology and high-risk HPV testing after CO2 laser treatment for low-grade lesions and persistent infection with high-risk HPV as well as factors that can influence these rates. MATERIAL AND METHODS: Between February 2011 and January 2015, 124 cervical vaporizations were performed with a CO2 laser in patients presenting persistent infection with high-risk HPV or LSIL of CIN I that had persisted for more than 2 years. Data on parity, condom use, oral contraceptive use, smoking, vaccination against HPV, and immune status were collected and the relationship with rates of negative cytology and high-risk HPV testing was studied. RESULTS: We performed cytology, colposcopic and high-risk HPV detection 6 months after treatment in 116 patients (93%). Seventy-nine percent of patients had benign cytology in this control and 60% had negative results for HPV. Both parameters were normalized in 54% of patients. Mean follow-up was 22.35 months. Rates of negative cytology testing showed no significant relationship with any of the variables studied. Regarding rates of negative high-risk HPV testing, there is a statistically significant relationship with age younger than 45 years; type of high-risk HPV other than 16 and 18; and nulliparity and condom use. Among patients with persistent HPV infection and abnormal cytology at 6 months of vaporization, 55% had normalized cytology results but only 14.7% had negative results for high-risk HPV at the end of follow-up. CONCLUSIONS: CO2 laser vaporization is a simple, safe, and successful outpatient treatment that can be performed without anesthesia.

Resultados clínicos y funcionales de la plastía Broström-Gould para inestabilidad lateral de tobillo: evaluación con tres escalas / Clinical and functional results of the Broström-Gould technique for lateral ankle instability: evaluation with three scales

Resumen: Antecedentes: La secuela más frecuente del esguince de tobillo es la inestabilidad del complejo ligamentario lateral; los resultados del tratamiento quirúrgico no han sido evaluados con varias escalas simultáneamente. El objetivo del estudio fue evaluar los resultados clínicos y funcionales con tres escalas en pacientes con inestabilidad lateral de tobillo sometidos a plastía de Broström-Gould, utilizando para su fijación anclas con sutura al peroné distal. Material y métodos: El diseño del estudio fue transversal y descriptivo; se incluyeron pacientes con inestabilidad lateral de tobillo y ruptura parcial o completa del ligamento PAA y/o PC, sometidos a reparación con plastía de Broström-Gould. Se realizó resonancia magnética nuclear para confirmar el diagnóstico; los resultados clínicos y funcionales se determinaron con tres escalas: EVA, SF-36 y AOFAS. Los pacientes fueron evaluados a los seis meses o más posteriores al procedimiento quirúrgico. Resultados: Se incluyeron 13 pacientes; la calidad de vida (cuestionario SF-36) arrojó un resultado bueno con promedio de 90; 10 (77%) pacientes mostraron resultados excelentes en la función, ausencia de dolor y alineación del tobillo (AOFAS 90-100). Asimismo, se observó mejoría importante en el dolor (EVA prequirúrgico: 6, comparado con 1 en el período postquirúrgico). Conclusiones: El procedimiento quirúrgico demostró excelentes resultados en el corto plazo con resolución del dolor y estabilidad del tobillo.

Abstract: Background: The most frequent sequel to the ankle sprain is the instability of the lateral ligament complex; the results of surgical treatment have not been evaluated with multiple scales simultaneously. The objective of the study was to assess the clinical and functional results with three scales in patients with lateral instability of ankle undergoing Broström-Gould technique, using for fixation, anchors with suture to distal fibula. Material and methods: The design of the study was cross-sectional and descriptive; we included patients with lateral instability of ankle and partial or complete rupture of the APA or CP ligament subject to repair with Broström-Gould technique. Magnetic resonance imaging was performed to confirm the diagnosis; clinical and functional outcomes were determined with three scales: EVA, SF-36 and AOFAS. Patients were evaluated at six months, or more, after the surgical procedure. Results: We included 13 patients; quality of life (SF-36 questionnaire) showed a good result with average score of 90; 10 (77%) patients showed excellent results in function, absence of pain and alignment of the ankle (AOFAS 90-100). Also found significant improvement in pain (presurgical EVA: 6, compared with 1 in the postoperative period). Conclusions: The surgical procedure showed excellent results, in the short term with resolution of pain and ankle stability.

[Autologous chondrocytes implantation versus microfracture for the treatment of knee cartilage lesions]. / Implantación de condrocitos autólogos versus microfracturas para el tratamiento de lesiones del cartílago en la rodilla.

OBJECTIVE: To compare the clinical efficacy and safety of microfracture therapy (MF) versus implantation of autologous chondrocytes (MACI) in the management of chondral lesions of the knee 3 cm2 and follow up to 12 months post treatment. MATERIAL AND METHODS: A retrospective cohort study was conducted from January 2016 to December 2017. Patients with one or more chondral lesions in knee 3 cm2 were included to compare MF versus MACI therapy for the repair of chondral lesion. Clinical and functional evaluations were carried out prior to the surgical treatment and 12 months later, with measurement of the range of motion, EVA, Oxford scale and Lequesne index. RESULTS: Twelve patients were included in MF and 12 patients in MACI. The most frequent lesion was located in the Patella in eight patients (67%). It showed an increase in the arcs of motion, as well as improvement in the comparison between baseline and follow-up at 12 months: in EVA, MF demonstrated 48.4% and MACI 57.5% (p 0.05); Oxford scale: MF 32.65% and MACI 51.04% (p 0.05); index of Lequesne: MF 40.12% and MACI 50%. Two cases of joint effusion were presented in MACI, which were resolved with the realization of arthrotomies. CONCLUSION: In this study, significant improvement was demonstrated in MACI with pain relief, functionality, and range of motion compared to the treatment of MF in lesions 3 cm2 of the articular cartilage of the knee after one year of follow-up.

OBJETIVO: Comparar la eficacia clínica y la seguridad de la terapia de microfracturas (MF) versus implantación de condrocitos autólogos en membrana (MACI) en el manejo de lesiones condrales de rodilla 3 cm2 y el seguimiento a 12 meses postratamiento. MATERIAL Y MÉTODOS: Se realizó un estudio de cohorte retrospectiva, de Enero de 2016 a Diciembre de 2017. Se incluyeron pacientes con una o varias lesiones condrales en rodilla 3 cm2 para comparar la terapia MF versus MACI para la reparación de lesión condral. Se realizaron valoraciones clínicas y funcionales previas al tratamiento quirúrgico y 12 meses posteriores, con medición de los arcos de movimiento, escala EVA, Oxford e índice de Lequesne. RESULTADOS: Se incluyeron 12 pacientes en MF y 12 pacientes en MACI. La lesión más frecuente se localizó en la patela en ocho pacientes (67%). Se demostró incremento en los arcos de movimiento, así como mejoría en la comparación entre el nivel basal y en el seguimiento a 12 meses: en EVA, MF mostró 48.4% y MACI 57.5% (p 0.05); escala de Oxford: MF 32.65% y MACI 51.04% (p 0.05); índice de Lequesne: MF 40.12% y MACI 50%. Se presentaron dos casos de derrame articular en MACI, que se resolvieron con la realización de artrotomías. CONCLUSIÓN: En este estudio se demostró mejoría significativa en MACI con alivio del dolor, funcionalidad y arcos de movimiento en comparación con el tratamiento de MF en lesiones 3 cm2 del cartílago articular de rodilla después de un año de seguimiento.

[Meniscal transplant: clinical and functional experience at one year follow-up]. / Trasplante de menisco: experiencia con seguimiento clínico y funcional a un año.

INTRODUCTION: In Mexico, the first meniscus transplant was performed in 2002. The objective was to describe the clinical evolution of patients with pain associated with postmenisectomy syndrome, who underwent meniscal allograft transplantation (MAT), with bony blocks via arthroscopy, with follow-up to one year. MATERIAL AND METHODS: A retrospective cohort study with a one-year follow-up was conducted. We included patients with joint interlining pain secondary to partial or total menisectomy, between 15 and 55 years of age, of both sexes, who underwent MAT. The clinical evolution was evaluated with visual analogue scale (VAS), SF-36 and Lysholm scale; the results are described in frequencies, percentages and p value was significant at 0.05. RESULTS: We included nine patients; eight men and one woman with an age of 31.3 years (16-52), the follow-up was 16.6 months (12-23). The preoperative VAS was 8.5 (6-10) and, at one year of follow-up, the average of this scale was 1.25 (0-5) (p 0.001). In the follow-up one year after the MAT, the Lysholm scale was on average 91 (68-100) and the SF-36 was on average 79.17 (65-92.92); three patients returned to their sports practice prior to the injury. CONCLUSION: This is the first report in Mexico that describes the one year follow-up of the MAT; significant clinical improvement was demonstrated (p 0.001) with remission of pain in the knee with previous menisectomy and in some cases the return to sports practice.

INTRODUCCIÓN: En México se realizó el primer trasplante de menisco en 2002. El objetivo fue describir la evolución clínica de pacientes con dolor asociado al síndrome postmeniscectomía que fueron sometidos a trasplante de menisco alogénico (MAT), con bloques óseos vía artroscópica con seguimiento a un año. MATERIAL Y MÉTODOS: Se realizó un estudio de cohorte retrospectiva con seguimiento a un año; se incluyeron pacientes con dolor en interlínea articular secundario a meniscectomía parcial o total, entre 15 y 55 años de edad, de ambos sexos, que fueron sometidos a MAT. La evolución clínica se evaluó con EVA, SF-36 y escala de Lysholm; los resultados se describen en frecuencias, porcentajes y valor de p significativa 0.05. RESULTADOS: Se incluyeron nueve pacientes; ocho hombres y una mujer con edad de 31.3 años (16-52), el seguimiento fue de 16.6 meses (12-23). La EVA prequirúrgica fue de 8.5 (6-10) y al año de seguimiento el promedio de esta escala fue de 1.25 (0-5) (p 0.001). En el seguimiento a un año posterior al MAT, la escala de Lysholm fue en promedio de 91 (68-100) y la SF-36 fue en promedio de 79.17 (65-92.92); tres pacientes regresaron a su práctica deportiva previa a la lesión. CONCLUSIÓN: Éste es el primer reporte en México del seguimiento a un año del MAT; se demostró mejoría clínica significativa (p 0.001) con remisión del dolor en la rodilla con meniscectomía previa y en algunos casos el retorno a la práctica deportiva.

Sintomatología depresiva en el post parto y factores psicosociales asociados / Postpartum depressive symptomatology and its associated psychosocial factors

Introducción: La sintomatología depresiva en el postparto impacta negativamente en el sistema familiar. En México existe poca investigación al respecto por ello es primordial su estudio. Objetivo: Conocer la frecuencia de sintomatología depresiva postparto y los factores psicosociales que se le asocian. Material y métodos. Se entrevistaron 154 mujeres con 0 a 12 meses de postparto que acudieron a dos hospitales públicos de un estado del noreste México. Se aplicó el Cuestionario de Depresión Postparto de Edimburgo (EPDS) para medir la sintomatología depresiva y un Cuestionario de Factores Psicosociales diseñado por los investigadores. Resultados. El 16% de la muestra presentó sintomatología depresiva. Los factores que se le asociaron fueron estado civil de unión libre, familiar con depresión, tristeza en embarazo, acontecimiento vital estresante en embarazo, consumo de alcohol en embarazo, ansiedad, consumo de alcohol actual, insatisfacción con los cambios corporales, percibir mayor atención de la familia al bebé y haber experimentado tristeza en embarazos anteriores. Conclusiones. Existen factores psicosociales que se asocian a sintomatología depresiva en el postparto que es de relevancia conocer en la atención primaria con el fin de crear estrategias preventivas en las instituciones de salud.

Background. Postpartum depressive symptomatology has a negative impact on the nuclear family. Research on this topic is scarce in Mexico, therefore conducting more studies in this field is of upmost importance. Objective. Finding out the frequency of postpartum depressive symptomatology and its associated psychosocial factors. Material and methods. 154 women at 0-12 months postpartum that attended two public hospitals in a northeast state of the Mexico were interviewed. They answered the Edinburgh Postpartum Depression Scale (EPDS), measuring depressive symptomatology, and a Psychosocial Factors questionnaire designed by the researchers. Results. 16% of women in the cohort presented depressive symptomatology. The factors associated were out-of-wedlock cohabitation, having relatives that suffer from depression, feelings of sadness during pregnancy, stressful life event during pregnancy, alcohol consumption during pregnancy, anxiety, current alcohol consumption, dissatisfaction regarding body changes caused by pregnancy, feeling that family attention is focused on the baby and having feelings of sadness during previous pregnancies. Conclusions. There are psychosocial factors that are associated to postpartum depressive symptomatology, which should be taken into consideration to create preventive strategies in health institutes.

A meta-analysis of acute use of alcohol and the risk of suicide attempt.

BACKGROUND: No review has used a meta-analytic approach to estimate common odds ratios (ORs) for the effect of acute use of alcohol (AUA) on suicide attempts. We aim to report the results of the first meta-analysis of controlled epidemiological studies on AUA and suicide attempt. METHOD: The English-language literature on Medline, PsycINFO and Google Scholar was searched for original articles and critical review on AUA and suicide attempt (period 1996-2015). Studies had to report an OR estimate for this association. Common ORs and 95% confidence intervals (CIs) from random effects in meta-analyses for any AUA and two levels of alcohol use on suicide attempt were calculated. RESULTS: In all, seven studies provided OR estimates for the likelihood of suicide attempt by AUA, compared with those who did not drink alcohol. Studies used case-control (n 3) and case-crossover designs (n 4). Meta-analysis revealed a common OR of 6.97 (95% CI 4.77-10.17) for any AUA. Using four studies, 'low levels of acute drinking' resulted in an OR of 2.71 (95% CI 1.56-4.71) and 'high levels' had an OR of 37.18 (95% CI 17.38-79.53). CONCLUSIONS: AUA is associated with increased likelihood of a suicide attempt, particularly at high doses. Such data should be incorporated into estimates of the burden of disease associated with alcohol use, which are currently limited by a consideration of only alcohol's chronic effects. Future research should focus on the mechanisms through which AUA confers risk for attempt.

The growth of suicide ideation, plan and attempt among young adults in the Mexico City metropolitan area.

AIMS: Low and middle income countries share a heavy burden of suicide with about three in every four suicides occurring in these countries. Mexico has witnessed a growing trend in suicide deaths; if this trend is not simply a reflection of better reporting of suicide on death certificates, then this increase should logically be accompanied by an increasing trend in suicide ideation, plan and attempts, but we lack information on the trends for suicide ideation, plan and attempt for this period. We therefore aim to report changes for suicidal behaviour for the period 2001-2013 in the Mexico City Metropolitan Area. METHOD: Using two cross-sectional surveys conducted in Mexico in 2001 and 2013, we report the lifetime and 12-month prevalence of suicide ideation, plan and attempt and changes in treatment for these problems among respondents aged 19-26 living in the Mexico City Metropolitan Area 12 years apart. To estimate the changes in prevalence for each outcome, we used generalised linear models to calculate prevalence ratios (PR; the prevalence rate in the exposed (year 2013) divided by the prevalence rate in the unexposed (year 2001-2002), adjusting for sociodemographic variables. RESULTS: While increases in the prevalence are noted everywhere, statistical comparisons only found differences for lifetime ideation (PR = 3.1; 95% CI = 1.7-5.8) and a borderline difference for suicide attempt (PR = 2.2; 95% CI = 1.0-4.9). No attempt within the last 12-months was reported in 2001, but the prevalence in 2013 reached 1.5% (18 cases). While PRs for 12-month prevalence were all above the null, none reached statistically significant differences. During this 12-year period, the distribution of mental disorders and the use of services for mental disorders among suicide ideators, planners and attempters did not change in any noticeable way. CONCLUSIONS: The limitations of our data are the small number of participants in the 2001 survey, the low follow-up rate for the survey in 2013 and that while representative from one city it does not represent the whole country. These findings suggest that suicide ideation and attempt may have increased during this 12-year period in the Mexico City metropolitan area, but this increase did not lead to more use of mental health care services. This information, coupled with the long-term trend of increasing suicide death rates in the country, draw a worrisome and neglected scenario for our youth in this region. Urgent measures, following the recent WHO guidelines for suicide prevention, must not be postponed.