Structural and intermediary determinants in sexual health care access in migrant populations: a scoping review.

OBJECTIVES: Addressing migrant population's sexual health needs is essential, given the high vulnerability of this population, especially during migratory trajectories and when accessing health care in destination countries. The aim of this scoping review is to identify and describe the structural and intermediary determinants and their dimensions, which negatively influence sexual healthcare access in migrant population in the world in the last 20 years. STUDY DESIGN: Scoping review. METHODS: The search strategy was carried out in the databases PubMed/MEDLINE, Web of Science, EMBASE, and CINAHL. The inclusion criteria were primary studies published in English or Spanish from 2000 to 2022, describing determinants or barriers to access to sexual health for international migrants, refugees, and asylum seekers. The construction of the results was based on the social determinants of health framework. RESULTS: A total of 44 studies were included. Thirteen categories that negatively affect access to sexual health in migrants were identified-structural determinants: language and communication barriers, religious and cultural values, VIH stigma and discrimination, irregular migration status, financial constraints, racism and discrimination, gender inequalities, and lack of knowledge and awareness about sexuality and sexual health; and intermediary determinants: financial health coverage, privacy and confidentiality, health system navigation; health system and facilities, and psychosocial factors. CONCLUSION: The most relevant dimensions identified as barriers to access to health services were "culture and societal values" and "health system". Identifying the determinants that affect migrants' access to sexual health is relevant for the formulation of public policies with sociocultural relevance and an intersectional and human rights approach.

Physical effectiveness of corn silage fractions stratified with the Penn State Particle Separator for lactating dairy cows.

This study evaluated the physical effectiveness of whole-plant corn silage (CS) particles stratified with the Penn State Particle Separator, composed of 19- and 8-mm-diameter sieves and a pan, for lactating dairy cows. Eight Holstein cows (27.6 ± 2.8 kg/d of milk, 611 ± 74 kg body weight; 152 ± 83 d in milk) were assigned to two 4 × 4 Latin squares (22-d periods, 16-d adaptation), where one square was formed with rumen-cannulated cows. Three CS particle fractions were manually isolated using the 8- and 19-mm diameter sieves and re-ensiled in 200-L drums. The 4 experimental diets were (% dry matter): (1) CON (control): 17% forage neutral detergent fiber (NDF) from CS (basal roughage), 31.5% starch, and 31.9% NDF; (2) PSPan: 17% forage NDF from CS + 9% NDF from CS particles <8 mm, 25.9% starch, and 37.9% NDF; (3) PS8: 17% forage NDF from CS + 9% NDF from CS particles 8 to 19 mm, 25.5% starch, and 38.3% NDF; and (4) PS19: 17% forage NDF from CS + 9% NDF from CS particles >19 mm, 24.9% starch, and 38.8% NDF. Cows fed PS8 had greater dry matter intake and energy-corrected milk yield (22.4 and 26.9 kg/d, respectively) than cows fed CON (20.8 and 24.7 kg/d) and PS19 (21.2 and 24.8 kg/d), but no difference was detected between PSPan (21.6 and 25.8 kg/d) and other treatments. Milk fat concentration was greater for PS8 than CON, with intermediate values for PSPan and PS19. Milk fat yield was greater for cows fed PS8 than CON and PS19, and cows fed PSPan secreted more fat than CON cows but were not different from cows fed the other 2 diets. Cows fed CON had a lower meal frequency than cows fed PSPan, shorter meal and rumination times than PS8, and greater meal size and lower rates of rumination and chewing than the other 3 diets. Total chewing per unit of NDF was higher for PS8 than PSPan, although neither treatment differed from CON or PS19. Cows fed PS19 had higher refusal of feed particles >19 mm than cows fed CON and PSPan. The refusal of dietary NDF and undigested NDF in favor of starch were all greater for PS19 than on the other treatments. Cows fed PS19 had a greater proportion of the swallowed bolus and rumen digesta with particles >19 mm than the other 3 diets. Cows fed CON had the lowest ruminal pH and greatest lactate concentration relative to the other 3 diets. Plasma lipopolysaccharide was higher for cows fed CON and PSPan than for cows fed PS8 and PS19, and serum d-lactate tended to be lower on PSPan than for CON and PS8. In summary, the inclusion of CS fractions in a low-forage fiber diet (CON) reduced signs of ruminal acidosis. Compared with CS NDF <8 and >19 mm, CS NDF with 8- to 19-mm length promoted better rumen health and performance of dairy cows. These results highlight the importance of adjusting CS harvest and formulating dairy diets based on the proportion of particles retained between the 8- and 19-mm sieves.

Inducing a topological transition in graphene nanoribbon superlattices by external strain.

Armchair graphene nanoribbons, when forming a superlattice, can be classified into different topological phases, with or without edge states. By means of tight-binding and classical molecular dynamics (MD) simulations, we studied the electronic and mechanical properties of some of these superlattices. MD shows that fracture in modulated superlattices is brittle, as for unmodulated ribbons, and occurs at the thinner regions, with staggered superlattices achieving a larger fracture strain than inline superlattices. We found a general mechanism to induce a topological transition with strain, related to the electronic properties of each segment of the superlattice, and by studying the sublattice polarization we were able to characterize the transition and the response of these states to the strain. For the cases studied in detail here, the topological transition occurred at ∼3-5% strain, well below the fracture strain. The topological states of the superlattice - if present - are robust to strain even close to fracture. The topological transition was characterized by means of the sublattice polarization of the states.

Effect of sealing strategy on the feeding value of corn silage for growing dairy heifers.

Our objective was to compare the performance of dairy heifers fed diets based on whole-plant corn silage stored in bunker silos sealed with either standard polyethylene film (white-on-black, actual thickness 121 ± 3.1 µm) covering the top surface, held in place with rows of tires every 3 m (PE) or an oxygen barrier system comprised of an ethylene-vinyl alcohol film (actual thickness 46.7 ± 2.5 µm) lining side walls and covering the silage, protected with a woven anti-UV cover and gravel bags placed around the edges and every 3 m across the silo (OB). Whole-plant corn was mechanically harvested at 39% dry matter (DM), packed in bunker silos, and sealed with PE or OB covering methods. After 6 mo of storage, silos were opened and fed to 26 Holstein heifers (260 ± 89.1 kg of shrunk body weight) for 60 d. Heifers were blocked by initial weight (13 blocks with 2 heifers each block) and housed in individual pens. Diets contained (on a DM basis) 80% corn silage (PE or OB), 17.5% soybean meal, and 2.5% mineral mix. Dry matter intake was measured daily, whereas shrunk body weight, hip height, heart girth, and body condition score were measured at the beginning and end of the experiment. Feeding behavior was recorded on d 24 and 46, and total-tract digestibility was measured from d 26 to 30 and 48 to 52. Data of intake, feeding behavior, and digestibility were averaged by animal for the whole feeding period before the statistical analysis. Data of animal performance were analyzed as a randomized complete block design. Initial shrunk body weight was used as a covariate for analyses of intake and body measures. During feed-out, silage quality was also assessed at the top (15 cm depth from upper surface) and bottom layer (135 cm depth from upper surface) and analyzed as a split-plot design. Silage stored under the OB sealing system had less yeast, mold, and NH3-N, and more lactic acid and ethanol-soluble carbohydrates. An interaction between sealing strategy and silo layer showed that OB silage had lower values of temperature, pH, anaerobic spores, acetic acid, and DM loss, and greater in vitro DM digestibility and aerobic stability, especially in the top layer. The proportion of inedible silage was lower in OB than in PE treatment (0.82 vs. 4.00% DM). Total-tract digestibility was similar between treatments, but animals that received the OB diet had higher DM intake by approximately 9% (9.39 vs. 10.20 kg/d) due to a faster eating rate and a greater number of meals per day. Therefore, OB treatment increased the digestible energy intake by 8% (26.3 vs. 28.3 Mcal/d) and average daily gain by 12% (1.08 vs. 1.21 kg/d). Body condition score change was similar between treatments, but heifers fed OB had greater heart girth and tended to have higher hip height. In conclusion, replacing a standard PE film with an OB sealing system improved silage conservation and performance of growing dairy heifers.

[Image-guided brachyablation for hepatocarcinoma. Report of one case]. / Image-Guided BrachyAblation (IGBA) en hepatocarcinoma. Descripción de la técnica y reporte del primer caso en Chile.

Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.

Screening of antifungal activity of 12 essential oils against eight pathogenic fungi of vegetables and mushroom.

The antifungal properties of 12 Eos, that is, Syzygium aromaticum, Pelargonium graveolens, Lavandula angustifolia, Cupresus sempervirens, Mentha piperita, Santolina chamaecyparissus, Citrus sinensis, Pogostemon patchouli, Thymus mastichina, Thymus vulgaris, Eucalyptus globulus and Rosmarinus officinalis, were screened. The influence of five doses of each EOs was tested against Botrytis cinerea, Sclerotinia sclerotiorum, Fusarium oxysporum, Phytophthora parasitica, Pythium aphanidermatum, Alternaria brassicae, Cladobotryum mycophilum and Trichoderma aggressivum f.sp. europaeum using disc-diffusion method. The mycelial growth inhibition and ED50 were calculated. The chemical analysis of the EOs was analysed using gas chromatography-mass spectroscopy. A total of 58 compounds were identified in the 12 EOs. All essential oils (EOs) analysed showed antifungal activity against the test pathogens in the range of 5·32-100%. The inhibitory effect of oils showed dose-dependent activity on the tested fungus. Based on the ED50 values, clove, rose geranium, peppermint and patchouli were the most effective. This study warrants further research into the practical use of EOs for the control of important myco- and phytopathogens in intensive horticulture. SIGNIFICANCE AND IMPACT OF THE STUDY: Due to the serious damage caused by fungal pathogens of vegetables and mushrooms, it is necessary to search for integrated strategies of disease control. This study provides relevant information about the effects of 12 essential oils (EOs) against eight pathogens of agricultural interest, included mycopathogens with emphasis on the possible future application of the EOs as alternative antifungal agents.

Dual effect of serotonin on the dendritic growth of cultured hippocampal neurons: Involvement of 5-HT1A and 5-HT7 receptors.

Serotonin acts through its receptors (5-HTRs) to shape brain networks during development and modulates essential functions in mature brain. The 5-HT1AR is mainly located at soma of hippocampal neurons early during brain development and its expression gradually shifts to dendrites during postnatal development. The 5-HT7R expressed early during hippocampus development, shows a progressive reduction in its expression postnatally. Considering these changes during development, we evaluated in cultured hippocampal neurons whether the 5-HT1AR and 5-HT7R change their expression, modulate dendritic growth, and activate signaling pathways such as ERK1/2, AKT/GSK3ß and LIMK/cofilin, which may sustain dendrite outgrowth by controlling cytoskeleton dynamics. We show that mRNA levels of both receptors increase between 2 and 7 DIV; however only protein levels of 5-HT7R increase significantly at 7 DIV. The 5-HT1AR is preferentially distributed in the soma, while 5-HT7R displays a somato-dendritic localization at 7 DIV. Through stimulation with 5-HT at 7 DIV during 24h and using specific antagonists, we determined that 5-HT1AR decreases the number of primary and secondary dendrites and restricts the growth of primary dendrites. The activation of 5-HT1AR and 5-HT7R promotes the growth of short secondary dendrites and triggers ERK1/2 and AKT phosphorylation through MEK and PI3K activation respectively; without changes in the phosphorylation of LIMK and cofilin. We conclude that 5-HT1AR restricts dendritogenesis and outgrowth of primary dendrites, but that both 5-HT1AR and 5-HT7R promote secondary dendrite outgrowth. These data support the role of 5-HT in neuronal outgrowth during development and provide insight into cellular basis of neurodevelopmental disorders.

Characterization of Colombian serotype 1 avian paramyxoviruses, 2008-2010.

Newcastle disease (ND) still remains one of the most important diseases affecting domestic poultry in Colombia. Here, for the first time, we report on the molecular characterization of 12 virulent and 12 avirulent or lentogenic avian paramyxovirus type 1 (APMV-1) strains that were isolated from commercial, backyard, and game poultry in Colombia from 2008 to 2010. The 12 virulent isolates had a fusion (F) protein cleavage site with basic amino acids at positions 113, 115, and 116 and a phenylalanine at position 117 (112RRQKR*F117), characteristic of virulent strains. The remaining 12 isolates had the F protein cleavage sites 112GKQGR*L117 or 112GRQGR*L117 typical of avirulent or lentogenic APMV-1 strains. Phylogenetic analysis of full-length F genes of all isolates was performed, and based on the recently proposed criteria for classification of APMV-1 strains, the 24 Colombian isolates were found to belong to class II viruses and clustered into four different genotypes. Ten virulent isolates clustered with genotype VII (sub-genotype VIId), seven lentogenic strains within genotype II, five lentogenic strains with genotype I (sub-genotype Ia), and two virulent isolates within genotype XII. Our data provide essential information on the genetic diversity of AMPV-1 isolates circulating in Colombia.

Role of long non-coding RNAs in the determination of ß-cell identity.

Pancreatic ß-cells are highly specialized cells committed to secrete insulin in response to changes in the level of nutrients, hormones and neurotransmitters. Chronic exposure to elevated concentrations of glucose, fatty acids or inflammatory mediators can result in modifications in ß-cell gene expression that alter their functional properties. This can lead to the release of insufficient amount of insulin to cover the organism's needs, and thus to the development of diabetes mellitus. Although most of the studies carried out in the last decades to elucidate the causes of ß-cell dysfunction under disease conditions have focused on protein-coding genes, we now know that insulin-secreting cells also contain thousands of molecules of RNA that do not encode polypeptides but play key roles in the acquisition and maintenance of a highly differentiated state. In this review, we will highlight the involvement of long non-coding RNAs (lncRNAs), a particular class of non-coding transcripts, in the differentiation of ß-cells and in the regulation of their specialized tasks. We will also discuss the crosstalk between the activities of lncRNAs and microRNAs and present the emerging evidence of a potential contribution of particular lncRNAs to the development of both type 1 and type 2 diabetes.

Continuous tissue glucose monitoring correlates with measurement of intermittent capillary glucose in patients with distributive shock.

BACKGROUND: Intermittent glycemic measurements in patients admitted to the intensive care unit (ICU) can result in episodes of severe hypoglycemia or in a poor control of glycemia range. We designed a study to assess accuracy and reliability of continuous monitoring of tissue glucose for patients with distributive shock. METHODS: Consecutive patients admitted to the ICU with a diagnosis of distributive shock and the need of insulin infusion for glycemic control were included in the study. These patients were implanted a Continuous Glucose Control Monitoring System (CGMS) with the sensor inserted subcutaneously into the abdominal wall. CGMS values were recorded every 5min. Capillary glucose (CG) was monitored for adjusting insulin perfusion according to the ICU protocol. Correlation between both methods was assessed. RESULTS: A total of 11,673 CGMS and 348 CG values were recorded. In five patients, CGMS failed to detect tissue glucose. A glucose value <3.33mmol/l (<60mg/dl) was observed in 3.6% of CGMS and in 0.29% CG values. 295 pairs of measurements were included in the statistical analysis for correlation assessment. The intraclass correlation coefficient was 0.706. The Pearson correlation coefficient was 0.71 (p<0.0001, 95% CI 0.65-0.76). The mean of differences between both measurement methods was 0.22mmol/l (3.98mg/dl) (95% CI 0.66-7.31). CONCLUSIONS: When the Continuous Glucose Control Monitoring System (CGMS) is able to obtain data (75% of the patients), there is correlation between the values obtained by this method and capillary blood glucose in patients with distributive shock. CGMS can detect more episodes of glycemic excursions outside the normal range than intermittent capillary glucose monitoring. Variables that may impair glucose metabolism and peripheral soft tissues perfusion could impair CGMS measurements.

Diagnostic validity of the Alzheimer's disease functional assessment and change scale in mild cognitive impairment and mild to moderate Alzheimer's disease.

BACKGROUND: The Alzheimer's Disease Functional Assessment and Change Scale (ADFACS) is a functional assessment instrument widely used in clinical research. AIMS: To test the diagnostic and concurrent validity of the Spanish version of this scale and to describe the functional deficit pattern for mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia. METHODS: The ADFACS, the Interview for Deterioration in Daily Living Activities in Dementia (IDDD), and the Mini Mental State Examination (MMSE) were administered to 146 control subjects (CS) and 165 patients (67 MCI and 98 AD). Nonparametric tests were used to compare the diagnostic groups. Cronbach's α and correlations with the MMSE and the IDDD were calculated. Sensitivity, specificity and predictive values were studied. RESULTS: The ADFACS had a high internal consistency (α = 0.95). Three cutoff points of 1, 4, and 17 were provided to separate CS and MCI patients, MCI and mild AD patients, and mild AD and moderate AD patients, respectively. The ADFACS strongly correlated with functional (IDDD, 0.927) and cognitive (MMSE, 0.747) measures. A similar pattern of dysfunction, but in different grades, was found for the MCI and AD groups. CONCLUSION: The ADFACS is a reliable, valid, and sensitive instrument to assess functional abilities; it is useful in dementia assessment for elderly populations.

Organic matter removal during pilot-scale soil aquifer treatment for domestic wastewater in the tropics.

The potential of enhancing water uses using soil aquifer treatment (SAT) is an interesting alternative for tropical regions, limited only by lack of knowledge on its performance in local conditions and the feasibility of adapting this technology. A SAT pilot study was conducted to analyze the phenomena associated with the transformation of organic matter (OM) from domestic wastewater. Chemically enhanced primary effluent collected at the Cañaveralejo wastewater treatment plant (Cali, Colombia) was used to feed pilot-scale SAT units at a rate of 1.25 m.d⁻¹. Dissolved organic carbon (DOC) removal in a 5.0 m length and 0.1 m diameter column packed with sand was 64.4%, while a similar column packed with a Mollisol soil from Valle del Cauca region yielded 56.2%. Oxygen availability was an important factor in OM degradation, given that the sand column degraded OM aerobically and the soil column degraded OM under oxic as well as anoxic conditions. SAT acted as a reliable barrier for DOC in tropical conditions. Nevertheless, operational problems such as clogging indicated that probably Mollisol soil may not be the suitable for SAT or that this particular effluent requires further pre-treatment before SAT.

Study of nsLTPs in Lotus japonicus genome reveal a specific epidermal cell member (LjLTP10) regulated by drought stress in aerial organs with a putative role in cutin formation.

The cuticle is the first defense against pathogens and the second way water is lost in plants. Hydrophobic layers covering aerial plant organs from primary stages of development form cuticle, including major classes of aliphatic wax components and cutin. Extensive research has been conducted to understand cuticle formation mechanisms in plants. However, many questions remain unresolved in the transport of lipid components to form cuticle. Database studies of the Lotus japonicus genome have revealed the presence of 24 sequences classified as putative non-specific lipid transfer proteins (nsLTPs), which were classified in seven groups; four groups were selected because of their expression in aerial organs. LjLTP8 forms a cluster with DIR1 in Arabidopsis thaliana while LjLTP6, LjLTP9, and LjLTP10 were grouped as type I LTPs. In silico studies showed a high level of structural conservation, and substrate affinity studies revealed palmitoyl-CoA as the most likely ligand for these LTPs, although the Lyso-Myristoyl Phosphatidyl Choline, Lyso-myristoyl phosphatidyl glycerol, and Lyso-stearyl phosphatidyl choline ligands also showed a high affinity with the proteins. The LjLTP6 and LjLTP10 genes were expressed in both the stems and the leaves under normal conditions and were highly induced during drought stress. LjLTP10 was the most induced gene in shoots during drought. The gene was only expressed in the epidermal cells of stems, primordial leaves, and young leaflets. LjLTP10 was positively regulated by MeJA but repressed by abscisic acid (ABA), ethylene, and H2O2, while LjLTP6 was weakly induced by MeJA, repressed by H2O2, and not affected by ABA and ethylene. We suggest that LjLTP10 is involved in plant development of stem and leaf cuticle, but also in acclimation to tolerate drought stress in L. japonicus.

Biomedical doctoral students' research practices when facing dilemmas: two vignette-based randomized control trials.

Our aim was to describe the research practices of doctoral students facing a dilemma to research integrity and to assess the impact of inappropriate research environments, i.e. exposure to (a) a post-doctoral researcher who committed a Detrimental Research Practice (DRP) in a similar situation and (b) a supervisor who did not oppose the DRP. We conducted two 2-arm, parallel-group randomized controlled trials. We created 10 vignettes describing a realistic dilemma with two alternative courses of action (good practice versus DRP). 630 PhD students were randomized through an online system to a vignette (a) with (n = 151) or without (n = 164) exposure to a post-doctoral researcher; (b) with (n = 155) or without (n = 160) exposure to a supervisor. The primary outcome was a score from - 5 to + 5, where positive scores indicated the choice of DRP and negative scores indicated good practice. Overall, 37% of unexposed participants chose to commit DRP with important variation across vignettes (minimum 10%; maximum 66%). The mean difference [95%CI] was 0.17 [- 0.65 to 0.99;], p = 0.65 when exposed to the post-doctoral researcher, and 0.79 [- 0.38; 1.94], p = 0.16, when exposed to the supervisor. In conclusion, we did not find evidence of an impact of postdoctoral researchers and supervisors on student research practices.Trial registration: NCT04263805, NCT04263506 (registration date 11 February 2020).

Past and projected temporal trends in arthroscopic hip surgery in Spain between 1998 and 2018. / Tendencias temporales pasadas y proyectadas en la cirugía artroscópica de cadera en España entre 1998 y 2018.

OBJECTIVE: Describe the population incidence of hip arthroscopy from 1998 to 2018 and to project the trends for the year 2030, as well as to describe the variations in the population incidence between the autonomous communities. MATERIAL AND METHOD: A retrospective review of the minimum basic data set from 1998 to 2018 was carried out. Temporal evolution was analyzed and the variables associated with the indication (age, sex, regions) were identified. For each region, the crude rate per 100,000 inhabitants was calculated. The 2019-2030 projection was made using linear regression. RESULTS: In Spain between 1998 and 2018 a total of 10,663 arthroscopic hip surgeries were carried out. The population incidence in 1998 was 0.14 CAC per 100,000 inhabitants, while in 2018 it was 4.09. For the year 2030 an increase of 156.9% in the number of arthroscopic hip surgeries is expected (P<.001). On average, 57.7% of all procedures (95% CI 55.2-60.2) were done in men and the highest incidence was found in ages ≤44 years. The geographical variation was 81%, being up to 15.4 times the difference in incidence per 100,000 inhabitants between some regions. CONCLUSIONS: The number of hip arthroscopies in Spain has been increasing in the 1998-2018 period and this growing trend is expected to continue until 2030. In Spain, hip arthroscopic procedures are performed more frequently in male patients and in under 45 years old. The variability of the population incidence between the autonomous communities is high.

[Translated article] Past and projected temporal trends in arthroscopic hip surgery in Spain between 1998 and 2018.

OBJECTIVE: Describe the population incidence of hip arthroscopy from 1998 to 2018 and to project the trends for the year 2030, as well as to describe the variations in the population incidence between the autonomous communities. MATERIAL AND METHOD: A retrospective review of the minimum basic data set from 1998 to 2018 was carried out. Temporal evolution was analysed and the variables associated with the indication (age, sex, regions) were identified. For each region, the crude rate per 100,000 inhabitants was calculated. The 2019-2030 projection was made using linear regression. RESULTS: In Spain between 1998 and 2018 a total of 10,663 arthroscopic hip surgeries were carried out. The population incidence in 1998 was 0.14 CAC per 100,000 inhabitants, while in 2018 it was 4.09. For the year 2030 an increase of 156.9% in the number of arthroscopic hip surgeries is expected (p<.001). On average, 57.7% of all procedures (95% CI 55.2-60.2) were done in men and the highest incidence was found in ages≤44 years. The geographical variation was 81%, being up to 15.4 times the difference in incidence per 100,000 inhabitants between some regions. CONCLUSIONS: The number of hip arthroscopies in Spain has been increasing in the 1998-2018 period and this growing trend is expected to continue until 2030. In Spain, hip arthroscopic procedures are performed more frequently in male patients and in under 45 years old. The variability of the population incidence between the autonomous communities is high.

Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures.

PURPOSE: To assess the usefulness of magnetic resonance imaging (MRI) with spin-echo echo-planar diffusion-weighted imaging (SE-EPI-DWI) in differentiation between vertebral osteoporotic fractures and pathological neoplastic fractures. MATERIALS AND METHODS: Thirty-three patients with both osteoporotic or neoplastic vertebral fractures diagnosed with X-ray or TC were studied with MRI exam, (1.5 T unit) with DWI sequences. DWI sequences were qualitatively analyzed. Apparent diffusion coefficient (ADC) values were also determined and compared to the definitive histologic diagnosis. RESULTS: DWI of neoplastic lesions showed hyperintensity signal in 22 out of 23 cases. Mean ADC value of neoplastic fractures was 1.241 ± 0.4 × 10(-3) mm(2)/s; mean ADC value of osteoporotic fractures was 0.646 ± 0.368 × 10(-3) mm(2)/s. Neoplastic fractures showed ADC values significantly higher than osteoporotic ones (p < 0.001). DWI imaging and histology showed a significant correlation. CONCLUSION: DWI provides reliable information to support MRI diagnosis of neoplastic versus osteoporotic fractures. ADC value appears as a useful adjunctive parameter.

[Translated article] Results of cementless total knee arthroplasty in patients over 70 years of age.

OBJECTIVE: To analyse the clinical and radiologic results, the survival and complications obtained in 70 year or older patients who underwent cementless total knee arthroplasty (TKA). MATERIAL AND METHOD: An observational study of patients operated between January 2014 and December 2016 was carried out according to the Natural Knee model (Zimmer®, USA). The main variables were the Oxford Knee Score, the visual analogue scale, the presence of radiolucencies, complications, survival and reasons for revision. RESULTS: Of 104 TKA, 86 were available for revision. The median age was 76 years. The mean follow-up was 5.4 years (range 3.7-6.9). The Oxford Knee Score punctuation showed a median of 17 presurgical (range 0-40) and 37 post surgical (range 5-48), P<.001. The 87.2% of the patients obtained a clinically significant improvement. The median visual analogue scale punctuation was 8 for presurgical (range 4-10) and 2 for post surgical (range 1-9), P<.001. The 88.3% of the patients obtained a clinically significant decrease. Three months after the surgery, the 55.81% of the TKAs presented radiolucencies around the tibial plateau. At the end of the follow-up, radiolucencies were present in 30.23% of the TKAs. Survival from all causes was 91.86% at 77.2 months and 96.5% due to aseptic loosening. CONCLUSION: Cementless knee prostheses are a valid option in patients aged 70 or older, presenting good clinical, radiological and survival results.

Results of cementless total knee arthroplasty in patients over 70 years of age. / Resultados de la artroplastia total de rodilla no cementada en pacientes mayores de 70 años.

OBJECTIVE: To analyze the clinical and radiologic results, the survival and complications obtained in 70 year or older patients who underwent cementless total knee arthroplasty (TKA). MATERIAL AND METHOD: An observational study of patients operated between January 2014 and December 2016 was carried out according to the Natural Knee model (Zimmer®, USA). The main variables were the Oxford Knee Score, the visual analog scale, the presence of radiolucencies, complications, survival and reasons for revision. RESULTS: Of 104 TKA, 86 were available for revision. The median age was 76 years. The mean follow-up was 5.4 years (range 3.7-6.9). The Oxford Knee Score punctuation showed a median of 17 presurgical (range 0-40) and 37 post surgical (range 5-48), P<.001. The 87.2% of the patients obtained a clinically significant improvement. The median visual analog scale punctuation was 8 for presurgical (range 4-10) and 2 for post surgical (range 1-9), P<.001. The 88.3% of the patients obtained a clinically significant decrease. Three months after the surgery, the 55.81% of the TKAs presented radiolucencies around the tibial plateau. At the end of the follow-up, radiolucencies were present in 30.23% of the TKAs. Survival from all causes was 91.86% at 77.2 months and 96.5% due to aseptic loosening. CONCLUSION: Cementless knee prostheses are a valid option in patients aged 70 or older, presenting good clinical, radiological and survival results.

Evaluation of the convenience of changing the rivastigmine administration route in patients with Alzheimer disease.

INTRODUCTION: Rivastigmine transdermal patches for the treatment of Alzheimer's disease (AD) have potential benefits compared to capsules because of their sustained absorption through the skin, good local tolerability and reduction of gastrointestinal problems. PURPOSE: To assess gastrointestinal and skin tolerability and the need for optimal dose titration of rivastigmine transdermal patches in Alzheimer's disease patients previously treated with oral rivastigmine. PATIENTS AND METHODS: A multicenter, randomized, open-label study including patients with mild to moderate AD (DSM-IV) previously treated with rivastigmine capsules (6-12 mg/day) was conducted. Patients were randomized to: continue with capsules for 3 months (n=49) or switch to rivastigmine patch without titration (9.5mg/day for 3 months; n=48), or switch to rivastigmine patch with titration (4.6 mg/day for 1 month followed by 9.5mg/day for 2 months, n=43). RESULTS: Incidence of gastrointestinal adverse events was 6.1% in the group treated orally and 4.2% in the group treated with non-titrated patches (P=.908). Skin tolerability was good (n=15, 16.7%) without any serious adverse events registered. Patch treatment was considered very easy to use by 72% of patients compared with 30% in the group with oral treatment (P=.0005). 60% of patients were satisfied with the patch, while only 14% were satisfied with capsules (P<.0001). CONCLUSIONS: Rivastigmine patches have a tolerability profile similar to that shown by capsules, but are associated with greater patient satisfaction.