Comparison of Sodium Selenite and Selenium-Enriched Spirulina Supplementation Effects After Selenium Deficiency on Growth, Tissue Selenium Concentrations, Antioxidant Activities, and Selenoprotein Expression in Rats.

Selenium contributes to physiological functions through its incorporation into selenoproteins. It is involved in oxidative stress defense. A selenium deficiency results in the onset or aggravation of pathologies. Following a deficiency, the repletion of selenium leads to a selenoprotein expression hierarchy misunderstood. Moreover, spirulina, a microalga, exhibits antioxidant properties and can be enriched in selenium.. Our objective was to determine the effects of a sodium selenite or selenium-enriched spirulina supplementation. Thirty-two female Wistar rats were fed for 12 weeks with a selenium-deficient diet. After 8 weeks, rats were divided into 4 groups and were fed with water, sodium selenite (20 µg Se/kg body weight), spirulina (3 g/kg bw), or selenium-enriched spirulina (20 µg Se/kg bw + 3 g spirulina/kg bw). Another group of 8 rats was fed with normal diet during 12 weeks. Selenium concentration and antioxidant enzyme activities were measured in plasma, urine, liver, brain, kidney, heart, and soleus. Expression of GPx (1, 3), Sel (P, S, T, W), SEPHS2, TrxR1, ApoER2, and megalin were quantified in liver, kidney, brain, and heart. We showed that a selenium deficiency leads to a growth delay, reversed by selenium supplementation despite a minor loss of weight in week 12 for SS rats. All tissues displayed a decrease in selenium concentration following deficiency. The brain seemed protected. We demonstrated a hierarchy in selenium distribution and selenoprotein expression. A supplementation of sodium selenite improved GPx activities and selenoprotein expression while a selenium-enriched spirulina was more effective to restore selenium concentration especially in the liver, kidney, and soleus.

Prevalencia de parasitosis intestinal en la población infantil de una zona rural del Ecuador / Prevalence of intestinal parasitosis in the child population of a rural area of Ecuador

En la actualidad las investigaciones entorno a la calidad de vida desde la salud, son de vital importancia a nivel mundial, puesto que la identificación de los factores que desencadenan ciertas patologías prevalentes sirven para actuar y mejorar las condiciones de vida; en específico en este trabajo nos referiremos al grupo infantil y la parasitosis pediátrica, la misma que genera índices de anemia, peso bajo, entre otros. El propósito fue identificar la prevalencia de parásitos intestinales en escolares de 6 a 12 años en poblaciones rurales, de la ciudad de Paute, Ecuador. Se realizó una investigación de tipo cuantitativa, descriptiva y transversal, se trabajó con 608 niños pertenecientes a zonas rurales de Paute, el análisis coprológico fue mediante el método convencional, se reportó número de parásitos por campo. Esta investigación fue desarrollada bajo el permiso de un Comité de Bioética. Se analizaron 608 muestras coproparasitarias, obteniéndose una significancia estadística con respecto al sexo, los varones presentaron una prevalencia de parasitismo (14,63%) sobre las mujeres (8,88%), el parásito con mayor prevalencia es la Entamoeba histolytica. La prevalencia de parasitosis infantil en el sector rural de Paute, Ecuador es de 23,52%, siendo mayor en varones, el parásito más frecuente es la E. histolytica(AU)

Currently, the research about life's quality from a health's point of view has received tremendous attention around the world, because the identification of the facts that start a variety of prevalent pathologies are being used to improve life conditions. In this work we try the child group and its pediatric parasitosis, that produce anemia, low weight, and others. The purpose was to recognize the prevalence of intestinal parasites in scholar children from 6 to 12 years old in marginal populations of the city Paute, Ecuador. A quantity type of investigation was made, descriptive and transversal, using a population of 608 children from the rural population of Paute, the coprological analysis was using conventional methods, number of parasites were reported. This research was developed under the permission of the Bioethics Committee. 608 coproparasites samples were analyzed, getting a significative statistic in reference to sex. Boy's samples show a prevalence of parasitism (14,63%) in girls' samples (8,88%), the more prevalent parasite is Entamoeba Histolytica. The prevalence of children's parasitosis in the rural sector of Paute, Ecuador is 23,52% being more affected boys than girls. The most frequent parasite is E. Histolytica(AU)

Experimental characterization of a biosensor based on a tapered optical fiber for kisspeptin detection.

This paper presents the development of a biosensor based on optical fiber, using a polyclonal antibody kisspeptin receptor as a biological recognition element that is connected to puberty onset and may also help to suppress metastasis in melanoma breast cancer. The fiber surface was chemically prepared to immobilize the antibody. The structural homogeneity of the biosensor, at each stage of the self-assembly, was characterized by Fourier transform infrared spectroscopy and by measurements of the transmission at the output of the biosensor. The morphological homogeneity analysis was performed by optical microscopy and scanning electron microscopy. The biosensor developed was checked to detect kisspeptin in brain tissues by spectral transmission using a superluminescent diode. The data were analyzed using principal component analysis. The interaction of the kisspeptin with its counterpart by means of the evolution of the transmission spectrum as a function of time was observed.

Prevalence of eosinophilic esophagitis: A multicenter study on a pediatric population evaluated at thirty-six Latin American gastroenterology centers. / Prevalencia de esofagitis eosinofílica: estudio multicéntrico en población pediátrica evaluada en 36 centros de gastroenterología de América Latina.

INTRODUCTION AND OBJECTIVE: Eosinophilic esophagitis is a chronic, immune-mediated disease described in case series and publications worldwide. Over the past twenty years, the authors of different studies have attempted to evaluate its incidence and prevalence. The objetive of the present study was to estimate the prevalence of eosinophilic esophagitis in a group of children seen at 36 pediatric gastroenterology centers in ten Latin American countries. MATERIALS AND METHODS: A multicenter, observational, and cross-sectional study was conducted that estimated the period prevalence of eosinophilic esophagitis in children seen at outpatient consultation and that underwent diagnostic upper gastrointestinal endoscopy for any indication at 36 centers in 10 Latin American countries, within a 3-month time frame. RESULTS: Between April and June 2016, 108 cases of eosinophilic esophagitis were evaluated. Likewise, an average of 29,253 outpatient consultations and 4,152 diagnostic upper gastrointestinal endoscopies were carried out at the 36 participating centers. The period prevalence of eosinophilic esophagitis in the population studied (n=29,253) was 3.69 cases×1,000 (95% CI: 3.04 to 4.44), and among the children that underwent routine upper gastrointestinal endoscopy (n=4,152), it was 26x1,000 (95% CI: 22.6 to 29.4). CONCLUSIONS: The general period prevalence of eosinophilic esophagitis in a group of children evaluated at 36 Latin American pediatric gastroenterology centers was 3.69×1,000, and in the children that underwent endoscopy, it was 26×1,000. There was important prevalence variability between the participating countries and centers. The present analysis is the first study conducted on the prevalence of pediatric eosinophilic esophagitis in Latin America.

Fiabilidad de dos pruebas de velocidad de marcha de diferentes fases cronometradas e iguales fases no cronometradas en personas mayores que viven en la comunidad / Reliability of two gait speed tests of different timed phases and equal non-timed phases in community-dwelling older persons

ANTECEDENTES La velocidad de la marcha es una medida rápida, económica y precisa para evaluar la capacidad funcional de las personas mayores, tanto saludables como con diferentes comorbilidades. Estudios previos han evaluado la velocidad de la marcha medida a lo largo de cursos de diferentes distancias, pero las fases no cronometradas no se miden de manera uniforme y se desconoce si esto afecta los resultados de la prueba. OBJETIVO El objetivo de este estudio fue evaluar la confiabilidad de la prueba de velocidad de marcha de diferentes fases cronometradas e iguales fases no cronometradas. MÉTODOS Estudio de confiabilidad descriptivo, con diseño observacional analítico y de corte transversal. Se incluyeron 136 personas mayores. Se realizaron pruebas de 4 y 10 metros, con 2 metros para la fase de aceleración/desaceleración de ambas. El promedio de dos intentos se obtuvo como la medida final de cada prueba. Los resultados se obtuvieron mediante el coeficiente de correlación intraclase (CCI) con un modelo de efectos fijos y el método Bland y Altman (con un intervalo de confianza del 95%). Se complementaron con los valores de error estándar de la media y del cambio mínimo detectable (CMD95). RESULTADOS Los resultados indican un excelente nivel de acuerdo entre los intentos de las pruebas de 4 y 10 metros (CCI = 0,959 y 0,976, respectivamente), así como entre el promedio de las dos pruebas (CCI = 0,867). Destaca un nivel de acuerdo ligeramente mejor entre los dos intentos de la prueba de 10 metros. Por lo tanto, el número de intentos no es capaz de afectar los resultados de la velocidad de la marcha; sin embargo, se requieren análisis adicionales para concluir lo mismo con respecto a la distancia de la prueba. La diferencia del análisis Bland Altman para el promedio de las pruebas de 4 y 10 metros fue 1,5945 m/s (intervalo de confianza 95%: 0,9759 a 2,2130 m/s), siendo demasiado grande y más alto que el valor CMD95. CONCLUSIONES El CCI fue excelente en todos los casos, pero se requiere un análisis adicional para concluir lo mismo con respecto a la distancia de la prueba. Existe un acuerdo insuficiente entre las dos pruebas para permitir que se utilicen indistintamente en poblaciones con las características de este estudio.

BACKGROUND Gait speed is a fast, low cost and accurate measurement for evaluating older persons' functional ability, both health and with comorbidities. Previous studies have evaluated gait speed measured over courses of varying distances, but the non-timed phases are not measured uniformly. It is unknown if this affects the results of the test. OBJECTIVE This study aims to evaluate the reliability of the running speed test of two different timed phases compared to the same nontimed phases. METHODS We conducted a descriptive reliability study, with an observational and cross-sectional analytical design. One hundred thirty-six older persons were included. Two gait speed tests were taken, one of 4 and 10 meters, and 2 meters for the acceleration/deceleration phase for both tests. The average of two attempts was obtained as a final measure of each test. The intraclass correlation coefficient was used to express the results (ICC) with a fixed effects model and the Bland and Altman method (confidence interval of 95%), complemented with the standard error of the mean and minimal detectable change with 95% confidence values (MDC95). RESULTS The results indicate an excellent level of agreement between the attempts of the tests of 4- and 10-m (ICC = 0.959 and 0.976, respectively), as well as between the average of the two tests (ICC = 0.867). The agreement was slightly better between the two attempts in the 10-meter test. The number of attempts does not affect the results of gait speed. Further analysis is required to conclude the same regarding the distance of the test (4 and 10 meters). The difference in the results of the Bland Altman analysis for the average of the 4 and 10-meter tests was 1.5945 m/s (95% confidence interval: 0.9759 to 2.2130 m/s), which is too wide and higher than the MDC95 value. CONCLUSIONS The ICC value was excellent in all cases, and the number of attempts does not affect the results of gait speed. However, further analysis is required to conclude the same regarding the distance of the test. There is an insufficient agreement between the two tests to allow them to be used interchangeably in populations with the characteristics of this study.

Impact of hydrologic boundaries on microbial planktonic and biofilm communities in shallow terrestrial subsurface environments.

Subsurface environments contain a large proportion of planetary microbial biomass and harbor diverse communities responsible for mediating biogeochemical cycles important to groundwater used by human society for consumption, irrigation, agriculture and industry. Within the saturated zone, capillary fringe and vadose zones, microorganisms can reside in two distinct phases (planktonic or biofilm), and significant differences in community composition, structure and activity between free-living and attached communities are commonly accepted. However, largely due to sampling constraints and the challenges of working with solid substrata, the contribution of each phase to subsurface processes is largely unresolved. Here, we synthesize current information on the diversity and activity of shallow freshwater subsurface habitats, discuss the challenges associated with sampling planktonic and biofilm communities across spatial, temporal and geological gradients, and discuss how biofilms may be constrained within shallow terrestrial subsurface aquifers. We suggest that merging traditional activity measurements and sequencing/-omics technologies with hydrological parameters important to sediment biofilm assembly and stability will help delineate key system parameters. Ultimately, integration will enhance our understanding of shallow subsurface ecophysiology in terms of bulk-flow through porous media and distinguish the respective activities of sessile microbial communities from more transient planktonic communities to ecosystem service and maintenance.

Whitewater Rafting and Kayaking Deaths in Colorado: Increasing Preventative Measures by Understanding Risk Factors.

INTRODUCTION: Whitewater rafting and kayaking are popular, adventurous excursions that are provided along various rivers throughout the United States. We expect that certain individuals' comorbid medical conditions may increase the risk of mortality by preventing them from being physically able to avoid inadvertently entering the water and subsequently rescue themselves. METHODS: Retrospective data were collected from 11 El Paso County, Colorado coroner cases from 2014-2017 in which the individual was whitewater rafting or kayaking and drowning was determined to be the primary cause of death. RESULTS: Health characteristics and autopsy findings of several of these individuals revealed that a significant number of these individuals were overweight or obese (90.9%), with 70% of these individuals also demonstrating cardiomegaly on examination. Of the cases studied, 81.8% of individuals had little to no experience with whitewater rafting or kayaking and 45% were under the influence of marijuana or alcohol based on toxicology studies. DISCUSSION: While a major selling point for whitewater excursions are the perceived risks they offer, our review suggests that certain individuals demonstrate increased health risks, have little to no experience with whitewater rafting or kayaking, or practice unsafe behaviors that may increase chance of injury and death. Efforts have been made to reduce risks associated with whitewater rafting and kayaking; however, further risk can be mitigated by excluding those who may be under the influence of alcohol or drugs, implementing more stringent health requirements, and setting an upper limit of difficulty of rapids based on an individual's previous experience.

Urinary tract infection and kidney transplantation: a review of diagnosis, causes, and current clinical approach.

Urinary tract infection (UTI), including bacteriuria, cystitis, and pyelonephritis, is the most common infectious complication after kidney transplantation (KTx). Over the past few years, many medical groups assumed this pathological process to be a "benign" disease in kidney transplant recipients (KTxR). However, increased medical and scientific advances in knowledge and management of KTx complications have raised questions about UTI as a pathological process that decreases and worsens kidney allograft function and survival. This review sought to clarify diagnostic criteria, as well as to describe factors associated with UTI in KTxR that expose its effects on the allograft. We sought to show the uncertainty of important topics within the field of UTI among kidney allograft recipients and to propose a practical clinical approach to KTxRs with UTI.

Concomitant combination of active immunotherapy and carboplatin- or paclitaxel-based chemotherapy improves anti-tumor response.

Recent preclinical evidence substantially supports the successful combination of chemotherapies and active immunotherapy for cancer treatment. These data sustain the effect of sequential combination schemes (vaccine plus chemotherapy or vice versa), which could be difficult to implement in clinical practice. Since chemotherapy is the standard treatment for most cancers, ethical issues forbid its delay and make difficult the evaluation of other treatments such as using an immunotherapeutic agent. Besides, vaccines must be applied as soon as possible to advanced cancer patients, in order to give them time to develop an effective immune response. Thus, a clinically attractive scenario is the concomitant application of treatments. However, little is known about the specific effect of different chemotherapeutic agents when combined with a cancer vaccine in such concomitant treatment. In this work, we analyze the influence of high-dose carboplatin or paclitaxel in the generation of a specific immune response when administered concomitantly with an OVA vaccine. Interestingly, neither carboplatin nor paclitaxel affects the humoral and CTL in vivo response generated by the vaccine. Moreover, an enhancement of the overall anti-tumor effect was observed in animals treated with OVA/CF vaccine combined with cytotoxic drugs. Moreover, the effect of the concomitant treatment was tested using a tumor-related antigen, the epidermal growth factor (EGF). Animals administered with EGF-P64k/Montanide and cytotoxic agents showed an antibody response similar to that from control animals. Therefore, our study suggests that carboplatin and paclitaxel can be concomitantly combined with active immunotherapies in the clinical practice of advanced cancer patients.

Surfers' myelopathy: a case series of 19 novice surfers with nontraumatic myelopathy.

OBJECTIVE: We report the clinical characteristics of the largest series of nontraumatic spinal cord injury in novice surfers (surfers' myelopathy). METHODS: A retrospective review of the electronic medical record was performed in patients with nontraumatic spinal cord injury associated with surfing identified upon admission to the largest tertiary referral hospital in Hawaii from June 2002 to November 2011. Classification by the American Spinal Injury Association Impairment Scale (AIS) was performed upon admission and at follow-up. Clinical management, including blood pressure measurements and optimization, use of corticosteroids, and diagnostic evaluations, were reviewed. Follow-up information was obtained by clinic visits, telephone interviews, and electronic mail up to 3 years after injury. RESULTS: In 19 patients (14 male) aged 15-46 years, all patients complained of sudden onset of low back pain while surfing, followed by bilateral leg numbness and paralysis progressing over 10-60 minutes. All patients were novice surfers; 17 of 19 were surfing for the first time. On T2-weighted MRI, all patients had hyperintensity from the lower thoracic spinal cord to the conus medullaris. Six of 10 patients who underwent spinal diffusion-weighted MRI showed restricted diffusion in this region. Patients presenting with worse AIS scores had minimal improvement at follow-up. Blood pressure, corticosteroids, and imaging results were not associated with severity of neurologic deficits at follow-up. CONCLUSIONS: Although the cause of surfers' myelopathy is unclear, the rapid onset and presence of restricted diffusion suggest ischemic injury. Admission severity appears to be most predictive of neurologic outcome.

Genome-wide analysis of hepatic gene silencing in hepatoma cell variants.

Genome-wide gene expression profiling was carried out on rat hepatoma cells and compared to profiles of hepatoma "variant" cell lines derived via a stringent selection protocol that enriches for rare cells (<1 in 100,000 cells) that fail to drive liver function. Results show 132 genes that are strongly (>5-fold) repressed in each of the four variant cell lines tested. An additional 68 genes were repressed in 3 of 4 variant cell lines. Importantly, several of the repressed genes are members of transcriptional activation pathways, suggesting that they may contribute to maintaining the hepatic phenotype. Ectopic expression of the HNF1A gene in a variant cell line resulted in activation of 56 genes, 37 of which were included in the repressed data set. These data suggest that a high level of reprogramming occurs when hepatoma cells convert to a non-differentiated phenotype, a process that can be partially reversed by the introduction of transcription factors.

Fatal Burkholderia gladioli infection misidentified as Empedobacter brevis in a lung transplant recipient with cystic fibrosis.

Data describing the risk of lung transplantation (LT), clinical features, and outcomes of patients with cystic fibrosis (CF) infected with Burkholderia gladioli are limited. Herein, we report a case of disseminated B. gladioli infection characterized by bacteremia, necrotizing pneumonia, lung abscess, and empyema in a lung transplant recipient with CF, highlight the importance of accurate microbiological identification, and review published outcomes of LT in CF patients infected with B. gladioli, which include cases of pneumonia, tracheobronchitis, bacteremia, and abscesses, and demonstrate an all-cause 1-year mortality of approximately 23%, often after combined medical and surgical treatment.

T-2 toxin inhibits the differentiation of human monocytes into dendritic cells and macrophages.

The aim of this work was to study the in vitro effect of T-2 toxin on human monocyte differentiation into macrophages and dendritic cells. Cytotoxicity of T-2 toxin on monocytes, on monocytes in differentiation process into macrophages or dendritic cells, and on immature dendritic cells and macrophages was evaluated to determine IC50. Monocytes are more sensitive to T-2 toxin than to differentiate cells. IC50 were equal to 0.11 nM for monocyte, to 45 and 30 nM for monocyte during differentiation process for 24 and 48 h of incubation, respectively, to 38 and 20 nM for immature dendritic cells after 24 and 48 h of incubation, and to 22 and 20 nM for macrophages after 24 and 48 h of incubation. T-2 toxin effects on monocyte differentiation process into macrophages have been explored: according to phenotypic expressions (CD71, CD14, CD11a, CD80, CD86, HLA-DR and CD64), endocytic capacity, phagocytosis, burst respiratory activity and TNF-alpha secretion. In the presence of 10 nM of T-2 toxin (no cytotoxic concentration), CD71 expression is downregulated compared to control. Endocytosis and phagocytosis capacities are less effective as burst respiratory activity and TNF-alpha secretion. Monocyte differentiation process into dendritic cells in the presence of 10 nM T-2 toxin is also markedly disturbed. Expression of CD1a (specific dendritic cells marker) is downregulated while that of CD14 (specific monocyte marker) is upregulated. CD11a, CD80, CD86, HLA-DR and CD64 expressions did not change. These results show that T-2 toxin disturbs human monocytes differentiation process into macrophages and dendritic cells. These results could significantly contribute to immunosuppressive properties of this alimentary toxin.

Morphometric changes associated with the reproductive cycle and behaviour of the intertidal-nesting, male plainfin midshipman Porichthys notatus.

Morphometric changes in body condition, liver, sonic muscle and gonadal development associated with the annual reproductive cycle and behaviour of the intertidal-nesting male plainfin midshipman Porichthys notatus were investigated. Body condition of type I males rapidly increased during the pre-nesting (PN) period, peaked at the beginning of the summer nesting cycle and then gradually declined to lowest levels during the non-reproductive (NR) period. The gonado-somatic index of type I males peaked during PN and then declined during the summer nesting cycle to lowest levels at the end of the nest cycle and during NR. Indices of sonic muscle and liver of type I males were lowest during NR, gradually increased during PN and then peaked during the summer nesting cycle. Results indicate that body condition and fecundity of type I males were positively correlated with body mass at the end of the nest cycle. These findings as they relate to the annual reproductive cycle and behaviour of the type I male P. notatus are discussed.

The effect of frontal plane position on first ray motion: forefoot locking mechanism.

BACKGROUND: Several joints in the foot have a locking mechanism that allows the foot to function as a rigid lever. The transverse tarsal joint (talonavicular and calcaneocuboid joints) has a locking mechanism that is well understood. The purpose of the study is to determine if the first ray also has such a locking mechanism. METHOD: Five cadaver limbs were loaded onto a custom frame. The first metatarsal was attached to a jig that placed a force of 50 N in plantarflexion and dorsiflexion. The motion of the jig was measured with the first ray in three positions: maximally everted, neutral, and maximally inverted. No tendons were loaded to ensure that any change in motion was solely due to osseous position. RESULTS: The average motion of the first ray for the three testing position was as follows: 7 mm in the everted position, 14 mm in the neutral position, and 18 mm in the inverted position. There was a statistically significant increase in range of motion from an everted position to a neutral position (p=0.003). This increase in range of motion continued when the first ray was inverted compared to neutral, but not statistically significance (p=0.07). CONCLUSION: This study demonstrates that the frontal plane position of the first ray affects the sagittal plane motion. An everted position has the least mobility, and we hypothesize that this represents a closed-packed or locked position.

Bronchiolitis obliterans syndrome and survival following lung transplantation for patients with sarcoidosis.

BACKGROUND: End-stage sarcoidosis is characterized by severe pulmonary fibrosis and is often poorly responsive to medical therapy. Lung transplantation, therefore, may be the only treatment option. Currently, there are few studies evaluating long-term outcomes following transplantation for these patients. Our aim was to evaluate post-transplant morbidity and survival of patients with sarcoid compared to recipients transplanted for idiopathic pulmonary fibrosis (IPF). METHODS: We retrospectively examined 300 lung transplant recipients using a dedicated database. Over a 10-year period, 15 (5.0%) patients with sarcoidosis and 48 (16%) patients with IPF were identified. Primary outcome measures included rate and time to onset of bronchiolitis obliterans syndrome (BOS) and survival. RESULTS: Recipients in the sarcoid group were younger and predominantly female compared to recipients in the IPF group. Five of 15 (33%) sarcoid patients developed BOS versus 15 of 48 (31%) IPF patients (p=1.0). There was no significant difference in the time to BOS onset. Median survival was 1,365 days for the sarcoid group and 1,593 days for the IPF group (Hazard Ratio 0.94 by Kaplan-Meier analysis; [95% CI] 0.33-2.67; p = 0.90). CONCLUSIONS: We observe similar long term outcomes following lung transplantation for sarcoid and IPF recipients. Transplantation remains a treatment option for end-stage sarcoidosis, as BOS and survival rates are comparable to IPF.

The role of passive plantar flexion in floating toes following Weil osteotomy.

Floating toes are a common complication following Weil osteotomy. The toes are passively plantarflexed via the windlass mechanism, which may play a role in floating toe. Five cadaver lower limb specimens were loaded on a custom frame and 3 different interventions were tested, including control group, Weil osteotomy group, and Weil osteotomy plus plantar plate-shortening group. The extensor tendon to the second toe was loaded with 20 Newtons of tension during the trials, and non-weight-bearing and simulated weight-bearing radiographs were taken to measure the metatarsophalangeal joint extension angle. The extension angle passively plantarflexed 11.20 degrees +/- 3.43 degrees in the control group, 0.40 degrees +/- 0.89 degrees in the Weil osteotomy group, and 8.00 degrees +/- 1.41 degrees in the Weil osteotomy plus plantar plate-shortening group. Comparison of the amount of passive plantarflexion between the groups revealed statistically significant changes between the control and Weil osteotomy groups (P = .0001), and the Weil osteotomy compared with the Weil osteotomy plus plantar plate-shortening (P < .0001); whereas no statistically significant difference was observed between the control and Weil osteotomy plus plantar plate-shortening groups (P = .0893). These results support the idea that the toes undergo passive plantar flexion due to the windlass mechanism, which is dampened by the Weil osteotomy. Dampening of the windlass mechanism may be responsible for floating toe following a Weil osteotomy.

[Medical coverage of the disease that causes death and place of death in the sixth region of Chile from 1990 to 2003]. / Cobertura de la atención de la enfermedad que causa la muerte y lugar de ocurrencia del deceso, en Chile y la sexta región, 1990--2003.

BACKGROUND: The place of death has changed and coverage of medical attention at death varies according to the development level of countries. AIM: To assess the evolution of coverage of medical attention of the last disease and place of death as indicators of health care quality and development level, in the sixth region of Chile. MATERIAL AND METHODS: We analyzed the Chilean death certificate data bases for the period 1990--2003. We performed linear regression analysis of death year with place of death and medical attention at death, comparing the sixth region and the rest of Chile. RESULTS: The population under study corresponds to 1,102,896 death records, from 1990 to 2003. Proportion of deaths at home decreased in sixth region and increased in the rest of our country. Deaths at home for individuals under 15 years of age, decreased. Deaths in places different from home or hospital increased progressively in elderly people. The same happened among adolescents, probably related to the high proportion of deaths due to trauma. CONCLUSIONS: Coverage of attention of diseases that cause death improved. Place of death varies according to age. There is a remarkable increase in the access of children to hospitals, for the treatment of severe diseases. These results indicate that Chilean healthcare system quality has improved.

Cobertura de la atención de la enfermedad que causa la muerte y lugar de ocurrencia del deceso, en Chile y la sexta región, 1990-2003 / Medical coverage of the disease that causes death and place of death in the sixth region of Chile from 1990 to 2003

Background: The place of death has changed and coverage of medical attention at death varies according to the development level of countries. Aim: To assess the evolution of coverage of medical attention of the last disease and place of death as indicators of health care quality and development level, in the sixth region of Chile. Material and methods: We analyzed the Chilean death certificate data bases for the period 1990-2003. We performed linear regression analysis of death year with place of death and medical attention at death, comparing the sixth region and the rest of Chile. Results: The population under study corresponds to 1,102,896 death records, from 1990 to 2003. Proportion of deaths at home decreased in sixth region and increased in the rest of our country. Deaths at home for individuals under 15 years of age, decreased. Deaths in places different from home or hospital increased progressively in elderly people. The same happened among adolescents, probably related to the high proportion of deaths due to trauma. Conclusions: Coverage of attention of diseases that cause death improved. Place of death varies according to age. There is a remarkable increase in the access of children to hospitals, for the treatment of severe diseases. These results indicate that Chilean healthcare system quality has improved.

Effects on the metatarsophalangeal joint after simulated first tarsometatarsal joint arthrodesis.

A first tarsometatarsal (TMT) arthrodesis is a common procedure; however; the biomechanical effects on the first metatarsophalangeal (MTP) joint are not well understood. Instant centers of rotation range of motion have been used as biomechanical parameters to determine function of the first MTP joint. The effects that a simulated first TMT joint arthrodesis has on the distribution of instant centers of rotation and resistance to dorsiflexion the first MTP joint were investigated. Five lower extremity limbs were mounted onto a custom-loading frame. A 3-dimensional tracking system was placed along the first ray. A tilting platform that simulates propulsion was used to calculate the instant centers of rotation. A hinged platform was used to determine the motion of the first MTP joint at 40 N of force. Both parameters were measured before and after simulated first TMT joint arthrodesis. Instant centers of rotation were mathematically calculated with a modified Reuleaux method. The standard deviation between instant centers of rotation was found to be significantly reduced (P = .05) after the simulated first TMT arthrodesis. There was an average of a 25% (P = .01) increase in dorsiflexion of the MTP joint after a simulated first TMT arthrodesis. The findings of this study suggest that first TMT arthrodesis does not have a negative effect on the first MTP joint. There was no reduction of the intrametatarsal angle and plantar flexion or shortening of the metatarsal. Thus, the change in biomechanics of the first MTP joint can only be attributed to elimination of the first TMT joint motion.