Anxiety is the cause of the worse outcomes of allergic patients after total knee arthroplasty.

PURPOSE: The presence of allergies has been proposed as a risk factor for worse outcomes in total knee arthroplasty surgery. The aim of this study is to evaluate if the presence of some psychiatric disorders is more frequent in patients who report allergies and if they could be the main cause for the worse outcomes. METHODS: A prospective study, including patients undergoing a primary total knee arthroplasty, was designed. In the preoperative visit, all the patients completed a questionnaire about the presence of allergies and also psychiatric tests for anxiety (State-Trait Anxiety Inventory-STAI-), depression (Remission from Depression Questionnaire-RDQ-), somatization disorder (Patient Health Questionnaire-15-PHQ-15-), pain catastrophizing syndrome (Pain Catastrophizing Scale-PCS), and personality disorder (Reduced NEO-Inventory of Five Factors-NEO-FFI-). In the preoperative and at 6 months of follow up, the functional results of the surgery were assessed by the WOMAC, the SF-12, and the KSS scores. RESULTS: A total of 209 patients was included: 136 (65%) did not have reported allergies and 73 (35%) did report some allergies. The psychiatric questionnaires showed that the presence of anxiety was more prevalent in the group of patients with reported allergies (STAI-T: no allergies 24.08 points vs. allergies 19.18 points, p = 0.039). When comparing the functional outcomes at 6 months of follow up, most of the analyzed scores improved less in the group of patients with reported allergies than in the no allergy-referred group: WOMAC-total score (34.37 vs. 40.10 points, p = 0.023), WOMAC-pain score (6.03 vs. 7.50 points, p = 0.018), WOMAC-function score (22.97 vs. 27.24 points, p = 0.023), KSS-knee score (25.37 vs. 33.79 points, p = 0.002), and SF-12 physical score (7.89 vs. 11.15 points, p = 0.046). The significance of the difference in the outcomes scores in this group was lost after adjusting for anxiety (p > 0.05). CONCLUSION: Allergies reported by patients are confirmed as a risk factor for worse results after TKA surgery. The relationship with anxiety disorder seems to explain the association between self-reported allergies and sub-optimal outcomes. LEVEL OF EVIDENCE: II.

Interrelationships between meat quality traits, texture measurements and physicochemical characteristics of M. rectus abdominis from Charolais heifers.

Ninety-nine Charolais heifers were used to study the variability of meat quality traits in relation to the physicochemical characteristics of M. rectus abdominis. The heifers of the same trade class were slaughtered at 33months of age (±4months) and 381kg carcass weight (±31kg). Muscle and bone development scores were evaluated before slaughter. Carcass weight, slaughter age and life average daily gain were recorded. Shear force measurements and meat quality traits were evaluated after 14days of aging. Some physicochemical characteristics were measured 24h post-slaughter. Tenderness was correlated with slaughter age (r=-0.31), bone development (r=-0.22) and life average daily gain (r=+0.37). Tenderness was significantly related to total collagen content (r=-0.24), lipid content (r=+0.27) and I myosin heavy chain proportion (r=+0.24). Juiciness was positively correlated with lipid content (r=+0.31) and I myosin heavy chain proportion (r=+0.20). Flavor intensity was correlated with lipid content (r=+0.26) and mean fiber area (r=+0.24). Shear force was correlated with total collagen, lipid and 27K proteasome sub-unit contents. Taking animal characteristics and muscle properties together in a multiple regression analysis increased the explained tenderness variability to 33%. The independent variables listed in order of importance were life average daily gain, total collagen content, bone development, lipid content, I myosin heavy chain isoform proportion, shear force of broiled meat and slaughter age.

Pressure algometry is a useful tool to quantify pain in the medial part of the knee: an intra- and inter-reliability study in healthy subjects.

PURPOSE: Pain quantification is essential for diagnostic and pain monitoring purposes in disorders around the knee. Pressure algometry is a method described to determine pressure pain threshold (PPT) by applying controlled pressure to a given body point. The purpose of this study was to determine the reliability of this method when it was applied to the medial part of the proximal tibia metaphysis and to evaluate the PPT levels between genders. METHODS: Fifty healthy (mean age; 46.9) volunteers were recruited, 25 men and 25 women. Pressure algometry was applied to a 1 cm(2)-probe area on the medial part of the knee by 2 raters. Intra- and interclass correlation (ICC) was obtained and differences between genders were evaluated. Bland-Altman plots were performed to evaluate the variability of the measures. RESULTS: The mean values of PPT obtained by rater 1 and 2 were 497.5 Kpa and 489 Kpa respectively. The intrarater reliability values (95% IC) for rater 1 and 2 were 0.97 (0.95-0.98) and 0.84 (0.73-0.90) respectively. With regard to interrater reliability, the ICC (95% IC) for the first measurement was 0.92 (0.87-0.95) and 0.86 (0.78-0.92) for the second one. Women showed significant lower values of PPT than men. The Bland-Altmand plots showed excellent agreement. CONCLUSIONS: Pressure algometry has excellent reliability when it is applied to the medial part of the proximal metaphysis of the tibia. Women have lower values of PTT than men. The high reliability of the PA in an individual volunteer makes it a more valuable tool for longitudinal assessment of a given patient than for comparison between them. LEVEL OF EVIDENCE: Level III. Prospective study.

A new approach to examine the relationships between sensory and gas chromatography-olfactometry data using Generalized Procrustes analysis applied to six French Chardonnay wines.

Six French Chardonnay wines were submitted to both sensory and combined headspace/gas chromatography-olfactometry analyses. The detection frequencies allowed five hierarchical levels to be distinguished: P25, the odorant areas (OAs) having a detection frequency > or =25% (the complete olfactogram without the odor noise); P40, > or =40%; P55, > or =55%; P70, > or =70%; and P85, > or =85%. Moreover, the detection frequencies were analyzed to distinguish 21 discriminative OAs. Wines tested by sensory analysis and the headspace samples analyzed by gas chromatography-olfactometry (GC-O) were described by a heterogeneous vocabulary distributed into nine overall classes of descriptors. The new statistical treatment to examine hierarchical or discriminative OA categories with respect to sensory data used Generalized Procrustes analysis (GPA) from coordinate tables provided by correspondence analysis (CA). The successive data sets supplied by CA were subjected to GPA to yield consensus method maps. The more selective levels of detection frequency (P70 and P85) were responsible for incomplete or distorted information with respect to sensory data. The most appropriate segmentation of the OA distribution (olfactogram) to represent the sensory profile of the six samples would correspond to the intermediate pattern (P40 and P55). The other interest was to study the reasons of distortion due to the dynamic headspace extraction. The highest proportions of the variance were at all times related to the same classes: spicy, herbaceous, and, to a lesser degree, microbiological. This would indicate that the dynamic headspace analysis induces a distortion with respect to sensory data, which systematically affected the perception of both spicy and herbaceous characters of wines.

[Delayed healing in long bone fracture: radiologic course and treatment]. / Retraso de consolidación en fractura de hueso grande: evolución radiológica y tratamiento.

Isolated long bone fractures are unusual and may be missed in the initial X-rays, especially when they are minimally displaced. The delayed treatment of these fractures may cause various complications, such as delayed bone healing or seudoarthrosis, which are difficult to manage. Our clinical case shows delayed healing in a long bone fracture and how the radiologic course may assist in the therapeutic management of this complication.

Endometrial progesterone and estradiol receptors in patients with recurrent early pregnancy loss of unknown etiology--preliminary report.

INTRODUCTION: It is not possible to identify the cause of the recurrent early pregnancy loss in approximately half of the cases, and different results have been reported according to estrogen (ER) and progesterone receptors (PR). The objective of this work was to evaluate the PR and ER levels in the endometrium of patients with recurrent early pregnancy loss, and to compare them with those of patients with proven fertility. MATERIAL AND METHODS: Endometrial receptors (R) for estrogen and progesterone as well as estradiol (E2) and progesterone (P) levels were determined in patients with recurrent early pregnancy loss, and compared with patients with proven fertility. RESULTS: The E2 and P levels, and the E2/P ratio did not show significant differences among the groups. Estrogen receptor in the cytoplasm and nucleus was lower in those with miscarriages, but without significant differences between the groups. However, the cytoplasmic PR was lower in those with pregnancy loss (p < 0.04), while nuclear PR was lower in the control group (p < 0.04). CONCLUSION: Maybe low PR levels can be the cause of early pregnancy loss of unknown etiology, but this deserves further investigation.