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Laser light scattering systems with volume Bragg grating (VBG) filters, which act as spectral/angular filters, have often been used as a point measurement technique, with spatial resolution as low as a few hundred µm, defined by the beam waist. In this work, we demonstrate how VBG filters can be leveraged for spatially resolved measurements with several µm resolution over a few millimeters along the beam propagation axis. The rejection ring, as determined by the angular acceptance criteria of the filter, is derived analytically, and the use of the ring for 1D laser line rejection is explained. For the example cases presented,i.e., for a focused probe beam waist with a diameter of â¼150 µm, the rejection ring can provide resolution up to several millimeter length along the beam propagation axis for a 1D measurement, which is also tunable. Additionally, methods to further extend the measurable region are proposed and demonstrated, using a collimation lens with a different focal length or using multiple VBG filters. The latter case can minimize the scattering signal loss, without the tradeoff of the solid angle. Such use of multiple VBGs is to extend the measurable region along the beam axis, which differs from the commonly known application of multiple filters, to improve the suppression of elastic interferences. 1D rotational Raman and Thomson scattering measurements are carried out on pulsed and DC discharges to verify this method. The system features compactness, simple implementation, high throughput, and flexibility, to accommodate various experimental conditions.
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When a coronal fracture affects the capitellum and the trochlea, the Kocher lateral approach may be inadequate for the correct visualisation, reduction and fixation of the fracture. In such cases an associated medial elbow approach may be required, or a posterior transolecranon approach may be preferred. The anterior limited approach to the elbow (ALAE) could be a valid option when treating these types of fracture, as it does not involve the detachment of any muscle group or ligament, thereby facilitating the recovery process. We can also treat associated injuries such as fractures of the radial head or coronoid process with this approach. We describe the surgical technique and the functional outcome of eight patients with a mean of 66 years of age (range, 53-76) who where treated with open reduction and internal fixation for capitellar and trochlear fractures through the ALAE. Patient outcomes were assessed with physical and radiological evaluation, range-of-motion measurements with a follow-up from 24 to 60 months. Two different quality of life questionnaires were carried out: the EuroQol Five Dimensions Questionnaire (EQ-5D) and the patient-answered questionnnaire of the Liverpool Elbow Score patient (PAQ-LES). Four fractures involved the capitellum, one involved the capitellum with the lateral ridge of the trochlea, and three involved the capitellum and trochlea as separate fragments. The patients presented a favorable clinical evolution at a median of 33 months (range, 24-60), with an average of motion of 10-138°. Four patients presented a fracture of the head of the radius (Mason type 2) and 3 fractures of the coronoid (Bryan-Morrey Type 1) associated. All the patients presented radiological consolidation without signs of osteonecrosis, being the average EQ-5D 0.857 (range, 0.36-1.0) and the PAQ-LES of 35 (range 17 to 36). Patients with isolated capitellar fractures had better results than those with trochlear involvement. The presence of associated fractures does not seem to worsen the results. We believe that the ALAE is a technical option to consider for the open surgical treatment of a capitellar fracture with or without involvement of the trochlea. LEVEL OF EVIDENCEIS: Therapeutic Level III.
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Lesões no Cotovelo , Fixação Interna de Fraturas/métodos , Fraturas do Úmero/cirurgia , Redução Aberta/métodos , Idoso , Articulação do Cotovelo/cirurgia , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Modelos Anatômicos , Radiografia , Amplitude de Movimento Articular , Resultado do TratamentoRESUMO
BACKGROUND: The use of biomaterials has been expanded to improve the characteristics of vaccines. Recently we have identified that the peptide PH(1-110) from polyhedrin self-aggregates and incorporates foreign proteins to form particles. We have proposed that this peptide can be used as an antigen carrying system for vaccines. However, the immune response generated by the antigen fused to the peptide has not been fully characterized. In addition, the adjuvant effect and thermostability of the particles has not been evaluated. RESULTS: In the present study we demonstrate the use of a system developed to generate nano and microparticles carrying as a fusion protein peptides or proteins of interest to be used as vaccines. These particles are purified easily by centrifugation. Immunization of animals with the particles in the absence of adjuvant result in a robust and long-lasting immune response. Proteins contained inside the particles are maintained for over 1 year at ambient temperature, preserving their immunological properties. CONCLUSION: The rapid and efficient production of the particles in addition to the robust immune response they generate position this system as an excellent method for the rapid response against emerging diseases. The thermostability conferred by the particle system facilitates the distribution of the vaccines in developing countries or areas with no electricity.
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Antígenos/imunologia , Imunoglobulinas/metabolismo , Proteínas de Matriz de Corpos de Inclusão/química , Peptídeos/química , Vacinas/imunologia , Animais , Antígenos/química , Estabilidade de Medicamentos , Feminino , Proteínas de Fluorescência Verde/química , Proteínas de Fluorescência Verde/imunologia , Imunização , Camundongos , Nanopartículas , Tamanho da Partícula , Agregados Proteicos , Proteínas Recombinantes de Fusão/imunologia , Termodinâmica , Vacinas/químicaRESUMO
A 3-month-old baby presented with a whitish lesion over the right cornea since birth. Due to the clinical and ultrasonic characteristics of the lesion, a manual anterior lamellar keratoplasty was performed. Histopathological examination showed it to be a simple grade II epibulbar choristoma. Although dermoid tumours are usually considered as benign, some of them, depending on their location, can seriously affect the vision of a paediatric patient. Due to the high probability of amblyopia in these cases, a surgical procedure is mandatory. Anterior lamellar keratoplasty is recommended when the visual axis is compromised without intraocular implications.
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Coristoma/cirurgia , Tecido Conjuntivo , Doenças da Córnea/cirurgia , Transplante de Córnea/métodos , Ambliopia/prevenção & controle , Coristoma/diagnóstico , Coristoma/diagnóstico por imagem , Doenças da Córnea/diagnóstico , Doenças da Córnea/diagnóstico por imagem , Humanos , Lactente , Microscopia AcústicaRESUMO
OBJECTIVE: The management of MasonII fracture pattern assisted by arthroscopy is a valid technique that provides good results. The objective of this study was to draw attention to the usefulness of the location of the fracture in the head of the radius in defined quadrants with respect to the bicipital tuberosity through CT. This would help to plan the optimal forearm position to access each quadrant and foresee the specific difficulties of each one. MATERIAL AND METHOD: We dissected 4 specimens of cryopreserved cadaver. We divided the radial head into 4 quadrants with regard to the bicipital tuberosity, objectifying the change of position in pronation and maximum supination with respect to the sigmoid cavity and neurovascular structures. RESULTS: The head of the radio moves with pronosupination, so there are areas of convergence between the different quadrants. Quadrant1 is approached in supination via an anteromedial portal. Quadrant2 is approached in maximum pronation through a lateral portal. Quadrant3 can be approached through lateral portals, with the forearm in neutral position and in pronation. Quadrant4 is accessible with the forearm in a neutral position and in supination through a lateral portal. CONCLUSIONS: Depending on the location of the fracture in the head of the radius with respect to the bicipital tuberosity, we will need access through a specific arthroscopic portal, with the medial quadrants (anteromedial and posteromedial) being the most technically demanding.
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Artroscopia , Lesões no Cotovelo , Fixação Interna de Fraturas , Fraturas do Rádio/classificação , Rádio (Anatomia)/lesões , Artroscopia/métodos , Articulação do Cotovelo/anatomia & histologia , Articulação do Cotovelo/cirurgia , Fixação Interna de Fraturas/métodos , Humanos , Rádio (Anatomia)/anatomia & histologia , Rádio (Anatomia)/cirurgia , Fraturas do Rádio/diagnóstico , Fraturas do Rádio/patologia , Fraturas do Rádio/cirurgiaRESUMO
An 11 year-old girl presented with a recent growth pigmented conjuntival lesion in the bulbar conjunctiva of left eye. Due to the the biomicroscopic and ultrasound findings, an excisional biopsy was performed on the lesion using the «no touch¼ technique, as well as cryo-coagulation of surgical margins. Histopathological examination revealed an inflammatory compound nevus. Melanotic conjunctival tumours are mostly benign. However, the recent growth of a lesion, its vascularisation, irregularities of the margins, and colour change must suggest it has turned malignant. In such case, excision of the lesion is mandatory. Despite all the clinical changes, especially in young patients, it can still be an inflammatory compound nevus.
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Neoplasias da Túnica Conjuntiva/diagnóstico , Melanoma/diagnóstico , Nevo Pigmentado/diagnóstico , Biópsia/métodos , Criança , Neoplasias da Túnica Conjuntiva/irrigação sanguínea , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/cirurgia , Diagnóstico Diferencial , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Nevo Pigmentado/irrigação sanguínea , Nevo Pigmentado/patologia , Nevo Pigmentado/cirurgiaRESUMO
The study of Biomechanics of the lumbar spine with clinical approach allows the physician related to locomotive sciences, to have a better interpretation of the clinical and radiological findings in order to carry out a treatment or a prediction of a medical problem with greater scientific foundation. The lumbar vertebral segment is studied from a biomechanical point of view in an integrated way, correlating with other body regions. The structures analyzed are the vertebrae, the intervertebral disks, the ligament and muscular system. The method of study goes from the static of the column to the dynamic, which includes the kinetic and kinematic aspects. The contradiction in the study of the lumbar spine is that the disorders of this body region are of the most frequent in the general and specialized medical consultation and, however, is not enough provided to the financial funds to carry out research.
El estudio de la biomecánica de la columna lumbar con enfoque clínico permite al médico especialista, relacionado con ciencias del aparato locomotor, tener una mejor interpretación de los hallazgos clínicos y radiológicos, para así poder realizar un tratamiento o una predicción de un problema médico con mayor fundamento científico. El segmento vertebral lumbar se estudia desde el punto de vista biomecánico de manera integrada, correlacionándolo con las demás estructuras corporales. Las estructuras analizadas son las vértebras, los discos intervertebrales, el sistema ligamentario y muscular. El método de estudio va desde la estática de la columna hasta la dinámica, que incluye los aspectos cinéticos y cinemáticos. La contradicción del estudio de la columna lumbar estriba en que los trastornos de esta región corporal son de los más frecuentes en la consulta médica general y especializada y, sin embargo, no está proporcionada con los fondos financieros para realizar investigación.
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Disco Intervertebral , Vértebras Lombares , Fenômenos Biomecânicos , HumanosRESUMO
Porcine reproductive and respiratory syndrome (PRRS) is caused by a genetically diverse RNA virus and is an economically significant disease in the swine industry. In this study, a total of 8,126 serum samples were obtained from 275 technified and semi-technified farms belonging to 30 of the 32 states of Mexico and representative of the eight regions of the country. Anti-PRRSv antibodies against the PRRS vaccine and an isolated wild Mexican virus were tested by ELISA. Antibodies were found in 15%-49% of the tested sera, with 2.4%-9.8% against the vaccine and 7.7%-26% against the wild virus. The PRRSv virus was detected by RT-PCR in 77 of the 1,630 pooled samples tested, representing seven of the eight geographic regions into which the Mexican Republic is divided. The complete sequences of open reading frames 5 and 7 from 20 PRRSv-positive samples were determined. The analysis of the sequences together with the previously published sequences of historic strains revealed that all the strains belonged to the one, five and eight lineages of the PRRSV2. Striking differences, particularly in ORF5 and ORF7, were found between sequences of the strains and the reference virus, due to insertions and substitutions in positions that play key roles in the recognition, structure and function of the virus. Overall, these results established the magnitude of PRRS virus genetic diversity, and the most frequent virus strain that predominates in Mexico. The PRRSV2 is presented in the porcine population of Mexico; the circulating strains have important changes in ORF5 and ORF7, which probably explain the results obtained in the serological analysis of the wild virus and vaccine strains.
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Variação Genética , Síndrome Respiratória e Reprodutiva Suína/epidemiologia , Síndrome Respiratória e Reprodutiva Suína/virologia , Vírus da Síndrome Respiratória e Reprodutiva Suína/classificação , Vírus da Síndrome Respiratória e Reprodutiva Suína/genética , Proteínas do Envelope Viral/genética , Proteínas Virais/análise , Sequência de Aminoácidos , Criação de Animais Domésticos/métodos , Animais , Ensaio de Imunoadsorção Enzimática/veterinária , México/epidemiologia , Dados de Sequência Molecular , Filogenia , Síndrome Respiratória e Reprodutiva Suína/prevenção & controle , Vírus da Síndrome Respiratória e Reprodutiva Suína/isolamento & purificação , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Estudos Soroepidemiológicos , Suínos , Proteínas Virais/classificação , Proteínas Virais/genéticaRESUMO
AIM: To describe mortality and complications of patients seen in the emergency room, diagnosed with necrotizing soft tissue infection (NSTI) and the correlation of such complications with the Laboratory Risk Indicator for Necrotizing fasciitis scale (LRINEC). METHODS: Retrospective observational study including patients with a diagnosis of NSTI in the emergency room of a tertiary hospital over 7 years. The results are shown as median, interquartile range and absolute range for quantitative variables. In the case of qualitative variables, the results are shown as absolute and relative frequency. The comparison between the categories of the LRINEC scale was performed through a post-hoc comparison from a non-parametric ANOVA analysis. Comparisons between LRINEC groups in the qualitative variables were performed using Fisher's Exact test. RESULTS: 24 patients with a mean age of 51.9 years were identified. The LRINEC scale was used on 21 patients: in 10, the value indicated low risk (<6), in 4 it indicated intermediate risk (6 or 7) and in 7 it indicated high risk (≥8). The amputation rate in patients with low, intermediate and high risk was 10%, 25% and 66% respectively with a mortality of 4.2%. There was an increase in hospital stay between the low and high level of the scale (p=0,007). CONCLUSIONS: In general, a change in the prognosis between the medium and high levels of the LRINEC scale could not be recorded, but was recorded in hospital stay between the low and the high level, practically tripling the median of days of hospital stay.
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Serviço Hospitalar de Emergência , Fasciite Necrosante/diagnóstico , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Fasciite Necrosante/complicações , Fasciite Necrosante/mortalidade , Fasciite Necrosante/terapia , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto JovemRESUMO
This is a first report in Mexico of the presence of antibodies against respiratory syncytial virus (RSV) and parainfluenza-3 virus in Mexican sheep in different productive stages. We determine the association of serological positivity with age and production system, and obtain molecular evidence of infection by both virus. RSV prevalence in adult sheep was 47% (49/105) at the tropic and 64% (63/99) at the uplands. A significant difference in RSV seropositivity between animals from the tropic and the uplands was observed (P < 0.05). Seropositivity correlated with production system (P = 0.003, OR = 2.042), with a risk of showing antibodies was 2.042 times higher in sheep under an extensive production system. A significant difference in PI3V seropositivity between animals from either provenance (P = 0.017, OR = 0.475) were also found, with a risk of showing antibodies 0.475 times higher in sheep under an extensive production system. Genetic material from RSV and PI3V was identified by RT-PCR in nasal swab samples from clinically healthy lambs and confirmed by sequencing and phylogenetic analysis. Serological results show that sheep are susceptible to infection by both viruses, and molecular results suggest that the identified antibodies are result of natural infections and reinfections.
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OBJECTIVE: Fractures involving the capitellum can be treated surgically by excision of the fragment, or by reduction and internal fixation with screws, with or without heads. The lateral Kocher approach is the most common approach for open reduction. We believe that the limited anterior approach of the elbow, could be a valid technique for treating these fractures, as it does not involve the detachment of any muscle group or ligament, facilitating the recovery process. MATERIAL AND METHOD: A description is presented of the surgical technique, as well as of 2cases with a Bryan-Morrey type 1 fracture (Dubberley type 1A). Two different final quality of life evaluation questionnaires were completed by telephone: the EuroQol Five Dimensions Questionnaire (EQ-5D), and the patient part of the Liverpool Elbow Score (PAQ-LES) questionnaire. RESULTS: The 2patients showed favourable clinical progress at 36 and 24 months, respectively, with an extension/flexion movement arc of -5°/145° and -10°/145°, as well as a pronosupination of 85°/80° and 90°/90°. The 2patients showed radiological consolidation with no signs of osteonecrosis. The EQ-5D score was 0.857 and 0.910 (range: 0.36-1), and a PAQ-SLE of 35 and 35 (range: 17-36), respectively. CONCLUSIONS: We believe that the limited anterior approach of the elbow is a technical option to consider for the open surgical treatment of a capitellum fracture, although further studies are needed to demonstrate its superiority and clinical safety compared to the classical lateral Kocher approach.
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Lesões no Cotovelo , Fixação Interna de Fraturas/métodos , Fraturas do Úmero/cirurgia , Fraturas Intra-Articulares/cirurgia , Redução Aberta/métodos , Idoso , Articulação do Cotovelo/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The aim of this study was to perform the complete genome sequence of a swine influenza A H1N2 virus strain isolated from a pig in Guanajuato, México (A/swine/Mexico/GtoDMZC01/2014) and to report its seroprevalence in 86 counties at the Central Bajio zone. To understand the evolutionary dynamics of the isolate, we undertook a phylogenetic analysis of the eight gene segments. These data revealed that the isolated virus is a reassortant H1N2 subtype, as its genes are derived from human (HA, NP, PA) and swine (M, NA, PB1, PB2 and NS) influenza viruses. Pig serum samples were analysed by the hemagglutination inhibition test, using wild H1N2 and H3N2 strains (A/swine/México/Mex51/2010 [H3N2]) as antigen sources. Positive samples to the H1N2 subtype were processed using the field-isolated H1N1 subtype (A/swine/México/Ver37/2010 [H1N1]). Seroprevalence to the H1N2 subtype was 26.74% in the sampled counties, being Jalisco the state with highest seroprevalence to this subtype (35.30%). The results herein reported demonstrate that this new, previously unregistered influenza virus subtype in México that shows internal genes from other swine viral subtypes isolated in the past 5 years, along with human virus-originated genes, is widely distributed in this area of the country.
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Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N2/genética , Vírus da Influenza A Subtipo H3N2/genética , Infecções por Orthomyxoviridae/veterinária , Vírus Reordenados , Animais , Testes de Inibição da Hemaglutinação/veterinária , Humanos , Vírus da Influenza A Subtipo H1N2/classificação , Vírus da Influenza A Subtipo H1N2/imunologia , México/epidemiologia , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/virologia , Filogenia , Estudos Soroepidemiológicos , SuínosRESUMO
A traumatic and/or degenerative meniscus lesion is thought to be a clinical manifestation of early-onset osteoarthritis (OA), which is a chronic progressive condition that can cause substantial pain and disability. Platelet-rich plasma (PRP) is an emerging treatment option that has been reported to improve healing. Here, we present a case of a 29-year-old woman, with left anterior and medial knee pain, without history of trauma or injury. The patient was managed with leukocyte-poor PRP injections derived from her peripheral blood with high concentrations of platelets, platelet-derived growth factors, and bioactive proteins, with a total follow-up of 30 months. Post-treatment patient was evaluated at every follow-up for improvement using three independent measures, VAS, GROC, and KOOS. There was considerable improvement in the pain symptoms from baseline (VAS: 70 mm; GROC: n/a; and KOOS: 39) to 30 months (VAS: 40 mm; GROC: 5; and KOOS: 63.1) indicating that PRP injections can serve as therapeutic intervention for treatment of pain associated with early onset of OA. To further validate these results, more longitudinal and evidence-based studies are recommended, which may further guide the clinicians to manage early-onset OA with PRP.
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Topological insulators are very interesting from a fundamental point of view, and their unique properties may be useful for electronic and spintronic device applications. From the point of view of applications it is important to understand the decay behavior of carriers injected in the band gap of the topological insulator, which is determined by its complex band structure (CBS). Using first-principles calculations, we investigate the dispersion and symmetry of the complex bands of Bi2Se3 family of three-dimensional topological insulators. We compare the CBS of a band insulator and a topological insulator and follow the CBS evolution in both when the spin-orbit interaction is turned on. We find significant differences in the CBS linked to the topological band structure. In particular, our results demonstrate that the evanescent states in Bi2Se3 are non-trivially complex, i.e. contain both the real and imaginary contributions. This explains quantitatively the oscillatory behavior of the band gap obtained from Bi2Se3 (0 0 0 1) slab calculations.
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INTRODUCTION: Preeclampsia is associated with abnormalities in the umbilical cord in several ways: morphological, biochemical and functional. Alteration in blood vessels of the placenta, decidua and circulatory system of the fetus might be related to factors that cause preeclampsia and may be associated with alterations of the umbilical cord. OBJECTIVES: This study aimed to analyze the relationship between each type of umbilical cord abnormality and the different subtypes of hypertensive gestational disorders. METHODS: We conducted a prospective study on consecutive autopsies and its placentas, looking for abnormalities in the umbilical cord's features and their clinical associations. RESULTS: Umbilical cord abnormalities including length, diameter, insertion, entanglements, knots and coils were associated with maternal gestational hypertension. CONCLUSION: In women with gestational hypertension, umbilical cord abnormalities are associated with fetal and neonatal consequences.
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Pré-Eclâmpsia/patologia , Cordão Umbilical/anormalidades , Adulto , Autopsia , Colômbia , Dilatação Patológica/patologia , Feminino , Retardo do Crescimento Fetal/etiologia , Retardo do Crescimento Fetal/patologia , Humanos , Recém-Nascido , Masculino , Troca Materno-Fetal , Placenta/irrigação sanguínea , Placenta/patologia , Gravidez , Estudos Prospectivos , Cordão Umbilical/patologiaRESUMO
Tissue engineering with the use of biodegradable and biocompatible scaffolds is an interesting option for ear repair. Chitosan-Polyvinyl alcohol-Epichlorohydrine hydrogel (CS-PVA-ECH) is biocompatible and displays appropriate mechanical properties to be used as a scaffold. The present work, studies the potential of CS-PVA-ECH scaffolds seeded with chondrocytes to develop elastic cartilage engineered-neotissues. Chondrocytes isolated from rabbit and swine elastic cartilage were independently cultured onto CS-PVA-ECH scaffolds for 20 days to form the appropriate constructs. Then, in vitro cell viability and morphology were evaluated by calcein AM and EthD-1 assays and Scanning Electron Microscopy (SEM) respectively, and the constructs were implanted in nu/nu mice for four months, in order to evaluate the neotissue formation. Histological analysis of the formed neotissues was performed by Safranin O, Toluidine blue (GAG's), Verhoeff-Van Gieson (elastic fibers), Masson's trichrome (collagen) and Von Kossa (Calcium salts) stains and SEM. Results indicate appropriate cell viability, seeded with rabbit or swine chondrocyte constructs; nevertheless, upon implantation the constructs developed neotissues with different characteristics depending on the animal species from which the seeded chondrocytes came from. Neotissues developed from swine chondrocytes were similar to auricular cartilage, while neotissues from rabbit chondrocytes were similar to hyaline cartilage and eventually they differentiate to bone. This result suggests that neotissue characteristics may be influenced by the animal species source of the chondrocytes isolated.
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Materiais Biocompatíveis , Diferenciação Celular/fisiologia , Quitosana , Condrócitos/fisiologia , Cartilagem da Orelha/citologia , Cartilagem da Orelha/crescimento & desenvolvimento , Hidrogéis , Alicerces Teciduais , Animais , Etídio/análogos & derivados , Cartilagem Hialina/citologia , Cartilagem Hialina/crescimento & desenvolvimento , Camundongos , Osteogênese/fisiologia , Álcool de Polivinil , Coelhos , Sus scrofa , SuínosRESUMO
In HPTN 061, a study of Black men who have sex with men (MSM), we evaluated the association of healthcare-specific racial discrimination with healthcare utilization and HIV testing among 1167 HIV-negative participants. Median age was 38 years, 41 % were uninsured, and 38 % had an annual household income <$10,000. Overall, 19 % reported healthcare-specific racial discrimination directed toward family, friend, or self; 61 % saw a healthcare provider in the previous 6 months and 81 % HIV tested within the past year. Healthcare-specific racial discrimination was positively associated with seeing a provider [adjusted odds ratio (AOR) = 1.4 (1.0, 2.0)] and HIV testing [AOR = 1.6 (1.1, 2.4)] suggesting that barriers other than racial discrimination may be driving health disparities related to access to medical care and HIV testing among Black MSM. These results contrast with previous studies, possibly due to measurement or cohort differences, strategies to overcome discrimination, or because of greater exposure to healthcare.
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Negro ou Afro-Americano , Infecções por HIV/prevenção & controle , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde , Homossexualidade Masculina , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Racismo/estatística & dados numéricos , Adolescente , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Racismo/psicologia , Comportamento Sexual , Percepção Social , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
AIM: Retrospective review of long term biphosphonates treated patients who sustained a subtrochanteric or diaphyseal femoral fracture with an atypical pattern. A literature review is presented as an update of the topic. MATERIAL AND METHODS: A retrospective study was conducted on 13 subtrochanteric or diaphyseal fractures in female patients treated with biphosphonates at our institution from September 2007 to March 2011. RESULTS: Four cases of subtrochanteric fractures and 13 diaphyseal fractures were detected. Four patients had bilateral fractures. All cases but one (that affected only the lateral cortex) were complete fractures. Surgically, these kinds of fractures are demanding due to the hardness of the bones. DISCUSSION: It is difficult to know if there is any relationship between bisphosphonates treatment and atypical femoral fractures. Nevertheless, current literature supports a greater benefit of their use in preventing vertebral and non-vertebral fractures. For this reason, biphosphonates continue being considered as a first choice in the prevention of osteoporotic fractures. CONCLUSIONS: Patients on long-term treatment with bisphosphonates may present atypical femoral fractures as a complication. It is considered that the maximum period for biphosphonates treatment should not exceed 5 years.
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Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Fraturas do Fêmur/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Warming experiments are increasingly relied on to estimate plant responses to global climate change. For experiments to provide meaningful predictions of future responses, they should reflect the empirical record of responses to temperature variability and recent warming, including advances in the timing of flowering and leafing. We compared phenology (the timing of recurring life history events) in observational studies and warming experiments spanning four continents and 1,634 plant species using a common measure of temperature sensitivity (change in days per degree Celsius). We show that warming experiments underpredict advances in the timing of flowering and leafing by 8.5-fold and 4.0-fold, respectively, compared with long-term observations. For species that were common to both study types, the experimental results did not match the observational data in sign or magnitude. The observational data also showed that species that flower earliest in the spring have the highest temperature sensitivities, but this trend was not reflected in the experimental data. These significant mismatches seem to be unrelated to the study length or to the degree of manipulated warming in experiments. The discrepancy between experiments and observations, however, could arise from complex interactions among multiple drivers in the observational data, or it could arise from remediable artefacts in the experiments that result in lower irradiance and drier soils, thus dampening the phenological responses to manipulated warming. Our results introduce uncertainty into ecosystem models that are informed solely by experiments and suggest that responses to climate change that are predicted using such models should be re-evaluated.