[Effect of intensive nutritional intervention in patients refractory to weight loss]. / Efecto de una intervención nutricional intensiva en pacientes refractarios a la pérdida de peso.

OBJECTIVE: To assess the effect of an intensive nutritional intervention on the body weight and waist circumference in adults refractory to weight loss, by applying a personalised low-calorie Mediterranean diet. MATERIAL AND METHODS: A prospective study was conducted for 6 months on 100 participants with an age range between 55 and 75 years, a BMI ≥ 27 and < 40 kg/my, and fulfilled 3 or more criteria of metabolic syndrome. The intervention consisted of prescribing a low-calorie Mediterranean diet, exercise recommendations, and motivational talks. Anthropometric variables were recorded 11a month during the entire intervention. An analysis was made of the results using the Chi-squared and Student-t tests. The Odds Ratio of the variables associated with weight loss and their 95% confidence intervals was calculated using a non-conditional logistic regression. RESULTS: After the "rescue" intervention, the patients lost an average of 2.9% of the body weight and 2.1% of waist circumference, the target of the loss ≥ 3% of the weight and 26% of the sample the target of reduction ≥ 3% of waist circumference being achieved 38% of the sample. No statistically significant differences were observed in weight and waist circumference loss in any of the variables analysed. CONCLUSIONS: Intensive intervention, based on a low-calorie Mediterranean diet, with recommendations of physical activity and motivational talks, achieved a moderate weight loss in patients refractory to treatments for obesity.

Predictive factors of COVID-19 in patients with negative RT-qPCR.

OBJECTIVE: To evaluate the factors associated with false negatives in RT-qPCR in patients with mild-moderate symptoms of COVID-19. MATERIALS AND METHODS: This was a cross-sectional study that used a random sample of non-hospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-qPCR-positive cases and 52 RT-qPCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two rapid diagnostic tests - RDTs (Combined - cRDT and Differentiated - dRDT). The association between symptoms and SARS-CoV-2 infection was evaluated by non-conditional logistic regression, with estimation of Odds Ratio. RESULTS: A total of 110 subjects were studied, 52% of whom were women (mean age: 48.2±11.0 years). There were 42.3% of negative RT-qPCRs that were positive in some RDTs. Fever over 38°C (present in 35.5% of cases) and anosmia (present in 41.8%) were the symptoms most associated with SARS-CoV-2 infection, a relationship that remained statistically significant in patients with negative RT-qPCR and some positive RDT (aOR=6.64; 95%CI=1.33-33.13 and aOR=19.38; 95% CI=3.69-101.89, respectively). CONCLUSIONS: RT-qPCR is the technique of choice in the diagnosis of SARS-CoV-2 infection, but it is not exempt from false negatives. Our results show that patients who present mild or moderate symptoms with negative RT-qPCR, but with fever and/or anosmia, should be considered as suspicious cases and should be evaluated with other diagnostic methods.

Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors.

OBJECTIVE: To evaluate the prevalence of and factors associated with SARS-CoV-2 infection in general practitioners and nurses from primary care centers and nursing homes in the Healthcare Area of León (Spain). MATERIALS AND METHODS: Cross-sectional study in a convenience sample of professionals from 30 health centers and 30 nursing homes from the primary care management division of the Healthcare Area of Leon. The work center, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. The true prevalence of SARS-CoV-2 infection was calculated according to two scenarios for RDT (Sensitivity=0.6 and Specificity=0.985; Sensitivity=0.8 and Specificity=1). RESULTS: The true prevalence of SARS-CoV-2 infection was between 4.9% and 11.0%. The observed prevalence was 5.9% and was higher in nursing homes than in primary care centers (9.5% vs. 5.5%). No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures. CONCLUSIONS: The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially for professionals working in nursing homes.

Biogeographical origin and varicella risk in the adult immigration population in Catalonia, Spain (2004-2006).

Immigrants to the European Union may have a higher susceptibility to varicella-zoster virus primo-infection than the indigenous population. There is no evidence as yet that this is caused by genetic or social factors. Therefore, susceptibility could be due to a lesser transmission of the virus in their ecosystems of origin. A multicentre observational study was performed from July 2004 to June 2006 in four primary healthcare centres in Catalonia, Spain, monitoring varicella incidences and comparing standardised incidence rates and standardised rate ratios among different populations classified according to their biogeographical origin (holarctic, Asian paleotropical, African paleotropical or neotropical). Overall, 516 varicella cases were recorded. The standardised incidence rates per 1,000 inhabitants per year were: holarctic: 2.17 (95% confidence interval (CI): 1.95-2.39); autochthonous 2.26 (95% CI: 2.03-2.49); immigrants 3.59 (95% CI: 2.92-4.26); neotropical 4.50 (95% CI: 3.28-5.71); non-holarctic 5.38 (95% CI: 4.27-6.14); Asian paleotropical 7.03 (95% CI: 4.77-9.28); and African paleotropical 7.05 (95% CI: 1.12-23.58). The difference to the autochthonous population was greatest in immigrants of neotropical origin (standardised rate ratio = 2.07 (95% CI: 1.61-2.64) or 4.5 excess cases per 1,000 inhabitants per year) and Asian paleotropical origin (standardised rate ratio = 3.24 (95% CI: 2.47-4.11) or 9.6 excess cases per 1,000 inhabitants per year). Biogeographical origin may therefore account for the vulnerability of certain immigrant populations to varicella, in particular those from Asian paleotropical (Indostan and Southeast Asia) and neotropical (South America and the Caribbean) ecosystems. Vaccination of immigrants at high risk (fertile women, healthcare workers) could be recommendable.

[Dislocation of the extensor tendons of the hand at the metacarpo-phalangeal level (zone V of Verdan)]. / Luxación de tendones extensores de la mano a nivel metacarpofalángico (zona V de Verdan).

MATERIAL AND METHODS: Traumatic dislocation of the extensor tendon over the metacarpophalangeal (MCP) joint is a rare lesion that is caused by the dysfunction or rupture of the sagittal band, which is an important stabilizing structure of the extensor tendon. This mechanical alteration presents itself as instability that affects function and may cause pain or snapping during finger motion. The diagnosis is made when ulnar dislocation of the extensor tendon is observed over the MCP joint. Nonsurgical treatment is successful and should be attempted when injuries are diagnosed within the first three weeks. Several surgical repairs have been described. We searched medical databases (Ovid, Medline) for papers on extensor tendon dislocation. We also revised our own cases of this injury. RESULTS: Our search resulted in 10 articles and four books. We found 18 patients with 21 injuries, 10 men and eight women. The most frequently affected finger was the middle one (in thirteen cases), followed by the index (in five cases), the fourth finger (in two cases) and the third one (in one case). Eight of our patients were treated conservatively and thirteen required surgical treatment. The surgical procedures performed were Wheeldons in seven cases; primary repair of the sagittal band and Wheeldon in four cases; primary repair alone in one case; and Carrolls in one case. The follow-up was between one and 34 years (average: 17.5 years). DISCUSSION: Extensor tendon dislocation in zone V is rare. When the diagnosis is made after three weeks of the lesion, the surgical treatment is recommended.

La luxación de los tendones extensores a nivel metacarpofalángico (MCF) de los dedos es una alteración mecánica poco frecuente que se caracteriza por incompetencia o ruptura de la banda sagital (BS), estructura que estabiliza dichos tendones. Se manifiesta por desplazamiento cubital del tendón extensor (en raras ocasiones, la luxación es radial o divergente), que limita su función y puede causar dolor o chasquido. El diagnóstico se hace al observar el tendón extensor del lado cubital de la articulación MCF en flexión del dedo. El tratamiento debe ser conservador cuando el diagnóstico se efectúa en las primeras tres semanas. Se recomienda tratamiento quirúrgico cuando el diagnóstico es tardío. Existen varias técnicas de reparación quirúrgica. Se revisaron bases de datos electrónicas (Ovid y Medline) en busca de artículos relacionados con esta patología. Se examinaron los casos de luxación de tendones extensores en zona V en nuestros pacientes.

DMFT, dmft and treatment requirements of schoolchildren in Asturias, Spain.

An epidemiological survey was carried out in 1992 to study the dental health status of schoolchildren aged 6, 9 and 12 in Asturias, Spain. It focused on the caries prevalence, dmtf, DMFT, restoration indices and dental treatment needs of this population. A representative sample of 1839 subjects, randomly selected and proportionally assigned by age group (6, 9 and 12) with the classroom as the sample unit, was examined. Analysis of the data showed that in 6-year-old children the caries prevalence in primary teeth was 45.8%. The mean caries indices were 2.10 dmft and 0.25 DMFT. At 9 years old the prevalence of caries in primary teeth was 62.8% and in the permanent teeth 49.1%. The mean level of caries was 2.38 dmft and 1.50 DMFT. At 12 years old the caries prevalence in permanent teeth was 71% and in first molars 64.2%. The mean caries experienced was 3.30 DMFT. In all groups the D-component constituted the major part of the caries index. The results for girls were higher than for boys in almost all age groups. Surface fillings were the treatment most required in all age groups.

DMFT and treatment needs in adult population of Oviedo, Spain.

An epidemiological survey was carried out in 1992 researching dental caries and treatment needs in an adult population in Oviedo, Spain. A representative sample of 261 subjects, randomly obtained and stratified by age, was examined. Results show a dental decay prevalence of 99.6%; 12.5 DMFT index with 2.9, 7.5 and 2.1 mean values for D, M and F components. Women and the lower social class showed the highest DMFT index. Treatment needs reach a mean value of 12.1 teeth per person. Pontics are the most needed treatment, the mean value increases with age while the differences among age groups and social classes are statistically significant. The next most needed dental treatment is filling of one surface which decreases with age, is the same for men and women and higher among the middle social class; the differences are statistically significant among the social classes.

Fabrication of an implant radiologic-surgical stent for the partially edentulous patient.

This article describes a technique for fabrication of an implant radiologic-surgical stent, made of thermocurable clear resin, for the partially edentulous patient. Dual-curing composite resin is mixed with colored chalk powder and incorporated into the stent to provide contrast during computerized tomographic bone evaluation and to serve as an easily visible guide during fixture placement.

Determination of the horizontal movement of the working-side condyle during lateral movements of the mandible using computed tomography.

The purpose of this study was to evaluate the horizontal movement of the working-side condyle during lateral movements of the mandible using computed tomography. The results showed that the working-side condyle moves in an outward and forward direction from the position of maximum intercuspation. The average movement is less than 1 mm.

[Inclusion bone cyst in the distal phalanx. Report of three cases]. / Quiste oseo de inclusión en la falange distal. Informe de tres casos.

UNLABELLED: Inclusion bone cysts are cysts of an epidermal lineage containing keratin. They are commonly found in the subcutaneous tissue, occasionally in intratendinous, subungueal or intraosseous tissue. The diagnosis is usually clinical. The most frequent symptom is pain, which may be associated with ungueal deformity. Plain X-rays in two views allow identifying the bone location. The treatment recommended for all cases of epidermoid cyst of the distal phalanx is curettage of the lesion. MATERIAL AND METHODS: The clinical charts of patients with inclusion cysts of the distal phalanx from 1983 to 2010 were reviewed. RESULTS: Three cases were found; 2 males and one female, ages 23, 28 and 47 years. The most frequent symptom was pain with ungueal deformity in 2 cases. In 2 cases the X-rays show the characteristics of the epidermoid cyst. Curettage was performed in the 3 cases; a bone graft was used in 2 cases. The follow-up ranged between 120 and 324 months (mean of 222 months). No relapses or complications were reported. DISCUSSION: Inclusion bone cysts are infrequent tumors of the distal phalanx and have particular characteristics that the orthopedist surgeon should be familiar with.

[Glomus tumor of the hand]. / Tumor glomus en la mano.

BACKGROUND: Glomus type of tumors are benign tumors of the hand phalanges. Their most frequent location is the nail bed. The diagnosis requires a certain index of suspicion and is usually a clinical one. The recommended approach is surgery. MATERIAL AND METHODS: The clinical files of patients with glomus of the hand were reviewed from June 1978 to May 2010, analyzing the characteristics of their management. RESULTS: Twelve patients with a glomus type of tumor were found; 4 females and 8 males, ages 31-55 years. The distal phalanx and the little finger were the most frequent sites. The diagnosis was mostly clinical and treatment in all cases was surgical. Mean follow-up was 8 years. CONCLUSIONS: The glomus type of tumor is a lesion often involving the distal phalanx, with unique clinical and pathologic characteristics that the orthopedic surgeon should know to determine management.

[Enchondroma of the distal phalanx]. / Encondroma de la falange distal.

Enchondroma is the most frequent benign tumor in hand bones. It occasionally occurs in the distal phalanx of the fingers; it is usually an asymptomatic lesion, but pain may occur when it is associated with a fracture. The most recommended treatment is lesion curettage and application of a bone graft, besides fixation as needed. Five cases with location in the distal phalanx are reported, as well as treatment results from January 1978 to May 2010. Of the 5 patients, 4 were females and one was male. The most frequently affected digit was the middle finger followed by the little finger. The most frequent symptom at the time of diagnosis was pain. Lesion curettage was performed in all cases, with the use of an autologous distal radius bone graft in 4 and coralline graft in one. Mean follow-up was 193 months (2-384 months). No complications or relapses were reported.

Shell structure of the near-dripline nucleus 23O.

Breakup reactions were used to study the ground-state configuration of the neutron-rich isotope 23O. The 22O fragments produced in one-nucleon removal from 23O at 938 MeV/nucleon in a carbon target were detected in coincidence with deexciting gamma rays. The widths of the longitudinal momentum distributions of the 22O fragments and the one-neutron removal cross sections were interpreted in the framework of a simple theoretical model which favors the assignment of Ipi = 1/2+ to the 23O ground state.