Transferable mechanisms of quinolone resistance are more frequent among enterotoxigenic Escherichia coli isolates displaying low-level quinolone resistance.

This study analysed the mechanisms of quinolone resistance among enterotoxigenic Escherichia coli (ETEC) in a periurban area of Lima, Peru. The susceptibility to nalidixic acid and ciprofloxacin, the role of Phe-Arg-b-Naphtylamyde inhibitable-(PAbN) efflux pumps, the presence of mutations in gyrA and parC as well as the presence of aac(6')Ib-cr, qepA, qnrA, qnrB, qnrC, qnrD, qnrVC and oqxAB were determined in 31 ETEC from previous case/control studies of children's diarrhoea. Discordances between disk diffusion, with all isolates showing intermediate or fully resistance to nalidixic acid, and minimal inhibitory concentration (MIC), with 7 isolates being below considered resistance breakpoint, were observed. Twenty-one isolates possessed gyrA mutations (19 S83L, 2 S83A). AAC(6') Ib-cr, QnrS, QnrB and QepA were found in 7, 6, 2 and 1 isolates respectively, with 3 isolates presenting 2 transferable mechanisms of quinolone resistance (TMQR) concomitantly. TMQR were more frequent among isolates with MIC to nalidixic acid ranging from 2 to 16 mg/L (p=0.03), while gyrA mutations were more frequent among isolates with nalidixic acid MIC >= 128 mg/L (p=0.0002). In summary, the mechanisms of quinolone resistance present in ETEC isolates in Peru have been described. Differences in the prevalence of underlying mechanisms associated with final MIC levels were observed. The results suggest two different evolutive strategies to survive in the presence of quinolones related to specific bacterial genetic background.

ICARUS at the Fermilab Short-Baseline Neutrino program: initial operation.

The ICARUS collaboration employed the 760-ton T600 detector in a successful 3-year physics run at the underground LNGS laboratory, performing a sensitive search for LSND-like anomalous νe appearance in the CERN Neutrino to Gran Sasso beam, which contributed to the constraints on the allowed neutrino oscillation parameters to a narrow region around 1 eV2. After a significant overhaul at CERN, the T600 detector has been installed at Fermilab. In 2020 the cryogenic commissioning began with detector cool down, liquid argon filling and recirculation. ICARUS then started its operations collecting the first neutrino events from the booster neutrino beam (BNB) and the Neutrinos at the Main Injector (NuMI) beam off-axis, which were used to test the ICARUS event selection, reconstruction and analysis algorithms. ICARUS successfully completed its commissioning phase in June 2022. The first goal of the ICARUS data taking will be a study to either confirm or refute the claim by Neutrino-4 short-baseline reactor experiment. ICARUS will also perform measurement of neutrino cross sections with the NuMI beam and several Beyond Standard Model searches. After the first year of operations, ICARUS will search for evidence of sterile neutrinos jointly with the Short-Baseline Near Detector, within the Short-Baseline Neutrino program. In this paper, the main activities carried out during the overhauling and installation phases are highlighted. Preliminary technical results from the ICARUS commissioning data with the BNB and NuMI beams are presented both in terms of performance of all ICARUS subsystems and of capability to select and reconstruct neutrino events.

Information needs on nutrition in link to cancer prevention among cancer patients, high-risk individuals and general population - A national cross-sectional study.

BACKGROUND & AIMS: Nutrition is one of the fundamentals of cancer prevention. Knowing what are the patients' needs and beliefs in terms of "nutrition and cancer" information helps tailor future nutritional interventions. The aim of this study was to evaluate specific information needs about "nutrition in relation to cancer prevention", including primary and tertiary prevention, among cancer patients, cancer-free individuals, and genetic high cancer risk individuals. METHODS: This online survey was shared within two large National cancer social networks and proposed to all attendees and carers of a comprehensive cancer center. RESULTS: 2887 individuals answered the survey (of whom 33% were cancer patients, 13% high-risk individuals and 55% participants of the general population). More than 80% of participants were women, had at least a high school degree. Median body mass index was 23.2 kg/m2. Eleven percent (n = 321) were following a diet, mostly low carbohydrate and weight-loss diets. Around 70% of all categories felt they lacked information on nutrition and cancer interplays. Only 12% of cancer patients (n = 108) considered they had received enough information on nutrition during their care pathway. A majority of participants agreed that food can modify cancer risk (93%, n = 2526) and 66% (n = 1781) considered that nutrition should be personalized according to the risk of cancer. Only twenty-nine percent (n = 792) believed that eating 5 fruits and vegetables a day was enough to avoid cancer, but 64% (n = 1720) thought that dietary supplements could help obtain a better health. All proposed nutrition topics were considered important by the participants. CONCLUSIONS: Although cancer patients and cancer-free respondents, whether at high risk of cancer or not, share a common broad interest on the interplay between nutrition and cancer and seek after more information on this topic, some false beliefs are observed. Healthcare providers could successfully propose more evidence-based information to these populations.

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.

An epidemiologic retrospective study of maxillofacial traumatology in the elderly.

INTRODUCTION: The elderly population, which is more active than before, is increasingly suffering from trauma (loss of reflexes and systemic pathologic conditions). Surgical management may be more controversial due to the potential consequences of general anesthesia and the sometimes negligible consequences of functional management. The main objective of this study was to analyze the causes and location of facial fractures in subjects older than 65 years. The secondary objective was to evaluate the management of these fractures (surgical or functional) according to comorbidities. MATERIAL & METHODS: In this retrospective study (over a five-year period), we analyzed the causes and management of facial fractures in patients aged over 65 years, and the medical history of each patient was investigated. RESULTS: One hundred and nineteen patients with 198 facial fractures were included. The main cause of fractures was a fall (50%). The zygomatic region (39.9%) and mandible (27.8%) were the sites of the most frequent fractures. Comorbidities were found in 84.9% of patients, the majority of which were cardiovascular diseases (82.3%). 75.8% of fractures were treated surgically and 4.8% of patients had complications. DISCUSSION: This work is a help to understanding the causes and consequences of facial trauma in the elderly population. The management of these facial fractures requires a multidisciplinary assessment, taking into account the patient's medical history and evaluating the risks and benefits of a surgical procedure with general anesthesia.

Improvement of survival after 10 years with the Durom-type hip resurfacing prosthesis in selected patients: Experience of a public university hospital. / Mejoría de la supervivencia a los 10 años con la prótesis de recubrimiento de cadera tipo Durom en pacientes seleccionados. Experiencia de un hospital público universitario.

INTRODUCTION: Hip resurfacing arthroplastys are a valid alternative for the treatment of degenerative hip disorders in young adults. Poor results and adverse soft tissue effects have been reported with high levels of chromium and cobalt, limiting its indications. Objective is to analyze clinical and functional survival results of the Durom system 10 years after its implementation in a public hospital. The hypothesis is that better results and survival are obtained in patients selected according to FDA criteria. MATERIAL AND METHODS: Retrospective cohort study of 83 patients, 91 hips in 76 men and 7 women operated between 2005 and 2013 with Durom-type prostheses. Demographic study, diagnosis, BMI, radiological study, serum chromium cobalt levels, functional assessment according to MPD and HSS, complications and survival at 10 years of follow-up. A cohort of active men under 65 years of age and heads over 48mm is selected. RESULTS: Follow-up time of 121 months with a range from 84 to 176 months. With a mean age of 52.78 years, with 4 deaths and loss of follow-up of 3 cases. There are 12 complications that require reoperation (14.45%) with 2 chronic infections, 4 femoral neck fractures, 4 acetabular loosening and 2 cases of pseudotumors. With an overall survival of 85.4% (71-91.9) and 87.85% (85.5-91.1) in the absence of infection. No statistical relationship between complications and neck narrowing and the angles of inclination of the components. In selected patients, 69 men and 73 hips, we obtained an overall survival of 91.82% and excluding infection of 93.18% at 10 years. CONCLUSIONS: The indication of the Durom system in the treatment of degenerative processes in selected active young patients presents better results and survival at 10 years, although somewhat lower than other highly indicated veneering models.

[A comparative study of recreational screen time in neurodevelopmental disorders]. / Estudio comparativo del tiempo de pantallas recreativas en los trastornos del neurodesarrollo.

INTRODUCTION: Digital screen time has been largely studied in children populations, but few have focused on children with neurodevelopmental disorders. Our main objective was to study the characteristics of use of recreational screens (television (TV) and video games), in children with neurodevelopmental disorders. SUBJECTS AND METHODS: We conducted a case-control study in which children with neurodevelopmental disorders under the age of 6 were compared with controls of the same age range. We analysed TV and video game exposure through a designed questionnaire for parents that included daily time exposure, sociodemographic characteristics, home media environment, sociocultural habits, attitudes and beliefs about TV. RESULTS: Sixty-one individuals with developmental and 153 controls were enrolled. Children with developmental problems spend more time watching TV than controls (124,4 ± 83,4 vs 71,5 ± 47,4 min / day p <0,001), while video game time was similar in both groups (37,6 ± 39, 6 vs 31,7 ± 32,6 min / day p = 0,138). Children with neurodevelopmental disorders began earlier to watch TV than controls. There were no relevant differences between groups in demographics, Sociocultural, environmental and attitudinal and belief variables. CONCLUSIONS: Children with neurodevelopmental disorders start watching TV at an earlier age and consume more screen time than healthy children. Our findings indicate that Children with neurodevelopmental disorders are more vulnerable to screen abuse, and stress the importance to offer anticipatory guidance to their parents.

TITLE: Estudio comparativo del tiempo de pantallas recreativas en los trastornos del neurodesarrollo.Introducción. En poblaciones infantiles, el tiempo de consumo de pantallas recreativas se ha estudiado ampliamente, pero se dispone de menos información en niños con trastornos del neurodesarrollo. Nuestro principal objetivo era estudiar las características de uso de las pantallas recreativas (televisión y videojuegos) en niños con trastornos del neurodesarrollo. Sujetos y métodos. Realizamos un estudio de casos y controles, comparando niños con y sin trastornos del neurodesarrollo menores de 6 años. A través de un cuestionario rellenado por los progenitores, se analizó el tiempo de exposición diaria a pantallas recreativas, las características sociodemográficas y ambientales, los hábitos socioculturales y las actitudes relacionadas con las pantallas recreativas. Resultados. Se analizó a 61 individuos con trastorno del neurodesarrollo y a 153 controles. Los casos pasaron más tiempo mirando la televisión (124,4 ± 83,4 frente a 71,5 ± 47,4 minutos/día; p menor de 0,001), mientras que el tiempo de videojuegos fue similar en ambos grupos (37,6 ± 39, 6 frente a 31,7 ± 32,6 minutos/día; p = 0,138). Los niños con trastorno del neurodesarrollo empezaron a una edad más temprana a ver televisión. No hubo diferencias relevantes entre los dos grupos en características sociodemográficas, socioculturales, ambientales y de actitud relacionadas con las pantallas recreativas. Conclusiones. Los niños con trastorno del neurodesarrollo empiezan a ver la televisión a una edad más temprana y consumen más tiempo que sus coetáneos sanos. Nuestros hallazgos indican que los niños con trastornos del neurodesarrollo son más vulnerables al abuso de la televisión, por lo que consideramos relevante ofrecer una guía anticipada a sus progenitores.

Intraoperative cone beam assessment after reduction of zygomatic fractures helps in taking a decision on associated orbital floor fractures.

INTRODUCTION: Orbital floor fracture (OFF) are frequently associated with zygomatic fractures (ZF). The reduction of the ZF may modify the features of the associated OFF. Intraoperative cone beam CT (CBCT) has shown diagnostic performance of OFF. The aim of our study was to evaluate how intraoperative CBCT control made after the reduction of ZF may help to take a decision on the associated OFF. MATERIAL AND METHOD: Patients with a unilateral displaced ZF associated with an OFF were consecutively included during a 3-year period. Intraoperative CBCT, systematically performed after reduction of the ZF, allowed to decide if the OFF needed reconstruction. The preoperative estimation made on MDCT and the intraoperative decision regarding the OFF were compared. RESULTS: Fifty-nine consecutive patients could be included in the study. Nineteen OFF were presumed to be surgical indications on the preoperative MDCT but only 16 indications were confirmed on the intraoperative CBCT, meaning that 3 OFF behaved favorably during the ZF reduction. Forty orbital floor fractures were presumed to be non-surgical on the preoperative MDCT but 6 of them worsened during ZF reduction and became surgical indications. Overall, the intraoperative CBCT control had an impact on 9 (15.3%) of the OFF. CONCLUSION: Our study showed that OFF after ZF reduction may evolve favorably or, on the contrary, get worse in 15% of the cases. Surgical indication on an OFF can therefore be confirmed intraoperatively. This allows to avoid under-treatment in the patients where the OFF worsens after ZF reduction and over-treatment in the patient where the OFF reduces after ZF.

Speed-up and slow-down of a quantum particle.

We study non-relativistic propagation of Gaussian wave packets in one-dimensional Eckart potential, a barrier, or a well. In the picture used, the transmitted wave packet results from interference between the copies of the freely propagating state with different spatial shifts (delays), [Formula: see text], induced by the scattering potential. The Uncertainty Principle precludes relating the particle's final position to the delay experienced in the potential, except in the classical limit. Beyond this limit, even defining an effective range of the delay is shown to be an impracticable task, owing to the oscillatory nature of the corresponding amplitude distribution. Our examples include the classically allowed case, semiclassical tunnelling, delays induced in the presence of a virtual state, and scattering by a low barrier. The properties of the amplitude distribution of the delays, and its pole representation are studied in detail.

[Update of the care model in a urogynaecology unit of a tertiary hospital: impact of the COVID-19 pandemic on face-to-face care]. / Cambio del modelo asistencial en una unidad de uroginecología de un hospital de tercer nivel: impacto de la pandemia por COVID-19 en la presencialidad.

The COVID-19 pandemic caused a sudden change in the usual care practice of our urogynaecology unit. Therefore, we designed a new healthcare model to adapt our practice to the epidemiological situation. The central axis of the new model was reduced hospital attendance, offering the same healthcare quality through the introduction of telemedicine.To achieve this aim, we made the following changes: a first telematic medical visit was the first step, telematic monitoring visits for conservative and pharmacological treatments and pack visit. We created the following packs: LUTS, postpartum and post-discharge pack. All packs included visits and diagnostic tests performed on the same day.The LUTS pack is indicated in patients with lower urinary tract symptoms, associated or not with pelvic organ prolapse. It includes two visits (nursing and medical) and two tests (urodynamics and pelvic floor ultrasound).The postpartum pack is indicated in women with symptoms of urinary incontinence, anal incontinence, pelvic organ prolapse and sexual disfunctions after delivery, as well as asymptomatic patients with a history of obstetric perineal trauma. It includes a medical visit, a pelvic floor ultrasound and a visit with the physiotherapist.The post-discharge pack is scheduled a month after the surgery and includes two tests (pelvic floor ultrasound and uroflowmetry) and a medical visit.Some face-to-face visits were maintained, as were physiotherapy treatments and other visits following medical criteria.

[Intraoperative acetabular periprotesic fracture]. / Fractura periprotésica acetabular intraoperatoria.

Intraoperative acetabular fractures (IAF) is a rare complication with an incidence 2% - 5%. We present the review of a series of 13 cases, discussing diagnosis, treatment and results. MATERIAL AND METHODS: Between 2006 and 2018, we performed 4800 primary hip arthroplasties (THA) In our hospital, we identified 13 cases with FIA with a follow-up of 38.3 months. RESULTS: Two cases were stable with conservative management; 11 unstable cases: seven cases we placed trabecular metal, one case we increased acetabular diameter, one case acetabular replacement, one case revision with Ganz type ring and one case do not accept treatment. The use of trabecular metal is an implant that helps effectively and with good results in FIA. CONCLUSION: These fractures are rare, knowing the implant to use is mandatory because if the implants are oversized, with greater rigidity or hemispheric, patients have increased risk of suffering from this complication.

Las fracturas intraoperatorias acetabulares (FIA) son una complicación rara con incidencia de 2 a 5%. Presentamos la revisión de una serie de 13 casos, que aborda diagnóstico, tratamiento y resultados. Material y métodos: entre 2006 y 2018 realizamos 4,800 artroplastías primarias de cadera (ATC). En nuestro hospital identificamos 13 casos con FIA con un seguimiento de 38.3 meses. Resultados: Dos casos fueron estables con manejo conservador; 11 casos inestables: en siete casos colocamos trabecular metal, en un caso aumentamos diámetro acetabular, en un caso recambio de cotilo, en un caso revisión con anillo tipo Ganz y un caso no aceptó tratamiento. El uso de trabecular metal es un implante que ayuda eficazmente y con buenos resultados en FIA. Conclusión: Estas fracturas son raras, conocer el implante a utilizar es imperativo, ya que si los implantes están sobredimensionados, con mayor rigidez o hemisféricos, los pacientes tienen mayor riesgo de sufrir esta complicación.

Fractura periprotésica acetabular intraoperatoria / Intraoperative acetabular periprotesic fracture

Resumen: Las fracturas intraoperatorias acetabulares (FIA) son una complicación rara con incidencia de 2 a 5%. Presentamos la revisión de una serie de 13 casos, que aborda diagnóstico, tratamiento y resultados. Material y métodos: entre 2006 y 2018 realizamos 4,800 artroplastías primarias de cadera (ATC). En nuestro hospital identificamos 13 casos con FIA con un seguimiento de 38.3 meses. Resultados: Dos casos fueron estables con manejo conservador; 11 casos inestables: en siete casos colocamos trabecular metal, en un caso aumentamos diámetro acetabular, en un caso recambio de cotilo, en un caso revisión con anillo tipo Ganz y un caso no aceptó tratamiento. El uso de trabecular metal es un implante que ayuda eficazmente y con buenos resultados en FIA. Conclusión: Estas fracturas son raras, conocer el implante a utilizar es imperativo, ya que si los implantes están sobredimensionados, con mayor rigidez o hemisféricos, los pacientes tienen mayor riesgo de sufrir esta complicación.

Abstract: Intraoperative acetabular fractures (IAF) is a rare complication with an incidence 2% - 5%. We present the review of a series of 13 cases, discussing diagnosis, treatment and results. Material and methods: Between 2006 and 2018, we performed 4800 primary hip arthroplasties (THA) In our hospital, we identified 13 cases with FIA with a follow-up of 38.3 months. Results: Two cases were stable with conservative management; 11 unstable cases: seven cases we placed trabecular metal, one case we increased acetabular diameter, one case acetabular replacement, one case revision with Ganz type ring and one case do not accept treatment. The use of trabecular metal is an implant that helps effectively and with good results in FIA. Conclusion: These fractures are rare, knowing the implant to use is mandatory because if the implants are oversized, with greater rigidity or hemispheric, patients have increased risk of suffering from this complication.

Heat rectification with a minimal model of two harmonic oscillators.

We study heat rectification in a minimalistic model composed of two unequal atoms subjected to linear forces and in contact with effective Langevin baths induced by Doppler lasers. Analytic expressions of the heat currents in the steady state are spelled out. Asymmetric heat transport is found in this linear system if both the bath temperatures and the temperature-dependent bath-system couplings are exchanged. The model can be realized with two ions in either common or individual traps. This physical setting allows for a natural temperature dependence of the coupling to the baths. We also explore the parameter space of the model to optimize asymmetric heat current and find conditions for maximal rectification. High rectification corresponds to a good match of the power spectra of the ions for forward temperature bias and mismatch for reverse bias, which may be understood by the behavior of dissipative normal modes.

Diagnostic performance of mobile cone beam computed tomography versus conventional multi-detector computed tomography in orbital floor fractures: a study on human specimens.

The aim of this study was to evaluate the diagnostic accuracy of mobile cone beam computed tomography (MCBCT) versus multi-detector computed tomography (MDCT) in orbital floor fractures. Twenty-four fresh cadaver heads were used, and one orbital floor was fractured for each head by transconjunctival approach. MDCT and MCBCT were performed on each of the heads. The images obtained were then analysed independently by eight evaluators. The radiological characteristics of the orbital floor fractures were visualized with good interpretation agreement between the two images. The location of the fracture and enophthalmos were identified in a comparable manner with strong agreement (κ=0.93 and κ=0.85, respectively). Measurements of fatty hernias and bone defects showed a strong correlation between the two imaging modalities (Pearson coefficient between 0.64 and 0.71 and between 0.67 and 0.71, respectively). The fracture limits and the presence of bone fragments, an intrasinus fatty hernia, and a fracture of the associated medial orbital wall were visualized in both examinations with good agreement (κ=0.68, κ=0.51, κ=0.57, and κ=0.46, respectively). The soft tissue study showed superiority for MDCT, with a κ<0.0009. MCBCT showed good diagnostic performance in the study of orbital floor fracture characteristics.

Use of barbed suture in total hip prosthesis. Prospective randomized study. / Utilización de sutura barbada en prótesis total de cadera. Estudio prospectivo aleatorizado.

INTRODUCTION: The correct closure of the surgical wound is an important step in the procedure of a total hip prosthesis implantation (total hip arthroplasty, THA), which aims to a correct healing of the wound and minimize the risk of complications. The objective of our study is to determine if the use of a bidirectional barbed suture decreases the closing time after THA, in the fascial and subcutaneous plane, when compared to the conventional suture polyglactin 910. The hypothesis is that there is no difference in closing time when comparing both sutures. MATERIAL AND METHOD: Prospective single blind randomized study comparing two groups: study group with the use of bidirectional continuous barbed suture (Quill™) (Gr. Q) and a control group (Gr. V) using discontinuous polyglactin 91 suture (Vicryl™). Closure was performed in two planes (fascial and subcutaneous) simultaneously by two surgeons. The exclusion criteria were: previous surgeries on the same hip, revision surgeries, major deformities and allergies to suture components. The variables under study were: 1) fascia closure time, subcutaneous and global; 2) surgical wound infection; and 3) dehiscence. RESULTS: 82 patients (39 Gr. Q, 43 Gr. V) were included. The global closing time was shorter in Gr. Q (5 min 59 sec) compared to Gr. V (7.01 min), (p < 0.04). They showed differences in subcutaneous closure: Gr. Q shorter time with a 37 seconds difference (p = 0.048). Differences in fascial plane were not observed. Superficial infection was observed in one Gr. Q patient and another in Gr. V; one case of deep infection in Gr. Q (p = 0.29). One patient presented dehiscence of the wound in Gr. Q (p = 0.3). However, these differences did not show statistical significance. CONCLUSIONS: The use of a barbed suture allows a shorter closing time compared to the conventional one. However, despite this decrease in time, no differences were found in terms of the appearance of infection or wound dehiscence.

Post-void residual and voiding dysfunction symptoms in women with pelvic organ prolapse before and after vaginal surgery. A multicenter cohort study. / Residuo posmiccional y síntomas de disfunción de vaciado en mujeres con prolapso de órganos pélvicos antes y después de la cirugía vaginal. Estudio de cohortes multicéntrico.

OBJECTIVES: The present study evaluates the impact of vaginal surgery for pelvic organ prolapse (POP) on voiding dysfunction (VD) symptoms and post-void residual (PVR) one year after the intervention. MATERIAL AND METHODS: Epidemiological, longitudinal, prospective study. Thirty-nine gynecology units included women with symptomatic POP grade 2 or higher according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who would undergo surgery for vaginal prolapse (CIRPOP-IUE study). Sociodemographic and clinical variables were collected before and after the intervention. At both visits, patients completed the 'Epidemiology of Prolapse and Incontinence Questionnaire' (EPIQ) and 'Pelvic Floor Distress Inventory' (PFDI-20) questionnaire. PVR volume was measured by bladder catheterization immediately after spontaneous urination. RESULTS: VD symptoms were present in 50% cases before the intervention. PVR was measured in 277 women of which 116 (41.87%) were >50ml and 42/277 (15.2%) were >100ml. Objective and subjective reduction in VD symptoms was observed one year after the intervention. Mean PVR volume was reduced with statistical significance, from a mean (SD) of 66.4 (68.9)ml to 48.3 (51.3)ml. The number of patients who reported difficulty in emptying and sensation of incomplete emptying on the EPIQ and PFDI-20 questionnaires also decreased. CONCLUSIONS: In general, improved voiding functions were observed in the CIRPOP-IUE study through a decrease in specific VD symptoms and a reduction in mean PVR volume.

Klein paradox for bosons, wave packets and negative tunnelling times.

We analyse a little known aspect of the Klein paradox. A Klein-Gordon boson appears to be able to cross a supercritical rectangular barrier without being reflected, while spending there a negative amount of time. The transmission mechanism is demonstrably acausal, yet an attempt to construct the corresponding causal solution of the Klein-Gordon equation fails. We relate the causal solution to a divergent multiple-reflections series, and show that the problem is remedied for a smooth barrier, where pair production at the energy equal to a half of the barrier's height is enhanced yet remains finite.

De novo assembly of the Brown trout (Salmo trutta m. fario) brain and muscle transcriptome: transcript annotation, tissue differential expression profile and SNP discovery.

OBJECTIVES: The Brown trout is a salmonid species with a high commercial value in Europe. Life history and spawning behaviour include resident (Salmo trutta m. fario) and migratory (Salmo trutta m. trutta) ecotypes. The main objective is to apply RNA-seq technology in order to obtain a reference transcriptome of two key tissues, brain and muscle, of the riverine trout Salmo trutta m. fario. Having a reference transcriptome of the resident form will complement genomic resources of salmonid species. DATA DESCRIPTION: We generate two cDNA libraries from pooled RNA samples, isolated from muscle and brain tissues of adult individuals of Salmo trutta m. fario, which were sequenced by Illumina technology. Raw reads were subjected to de-novo transcriptome assembly using Trinity, and coding regions were predicted by TransDecoder. A final set of 35,049 non-redundant ORF unigenes were annotated. Tissue differential expression analysis was evaluated by Cuffdiff. A False Discovery Rate (FDR) ≤ 0.01 was considered for significant differential expression, allowing to identify key differentially expressed unigenes. Finally, we have identified SNP variants that will be useful tools for population genomic studies.

Modular diaphyseal anchor stems with locking screws in the hip revision with massive femoral defects. / Vástagos modulares de anclaje diafisario con tornillos de bloqueo en la revisión de cadera con defectos femorales masivos.

INTRODUCTION: Complex femoral defects with insufficient isthmus (Paprosky III and IV) and Vancouver B3 periprosthetic fractures determines the fixation of the revision stems. The objective is to evaluate the results of the modular revision stems with diaphyseal anchor and distal block (Revitan Zimmer Biomet GmbH, Winterthur, Switzerland). Our hypothesis is that this procedure offers a stable primary fixation in cases of alteration of the femoral isthmus. MATERIAL AND METHODS: Retrospective cohort study of 38 patients, minimum follow-up of 12 months (12-94) with severe femoral defects treated with Revitan stems distally blocked. An endofemoral or transfemoral approach was used. The subsidence was assessed according to Callahan's method and bone neoformation according to Nordin. Merle d'Aubigné-Postel was used and complications and reoperations were collected. A statistical analysis was performed with SPSS and a significance level p < 0.05 was considered. RESULTS: Between 2009 and 2017, 147 revisions were carried out with Revitan stem, 38 locked, 23 men and 15 women, with an average age of 74 years and an average follow-up of 64 months. The cause of the review was: 15 septic loosenings, 14 aseptic, two fractures and seven stable fibrous unions. Right fixation was obtained in 27 cases, there were four loosenings, three screw breakages, three infections, one of dislocation and one of femoral nerve injury. The MDP increased significantly from 11.26 to 14.98. CONCLUSIONS: Distally locked conical modular stems are a good alternative in femoral defects with isthmus involvement if proper canal filling and bicortical screw fixation are achieved.