Mesh excision secondary to spondylodiscitis after colposacropexy graft rejection: a step by step video.

INTRODUCTION: Spondylodiscitis secondary to colposacropexy is an extremely rare entity. Infection and mesh rejection are the main causes. Removal of the mesh is essential for patient's recovery and it can be a very challenging surgical procedure. CASE: A 72-year-old woman presented with severe low back pain in the context of a recent colposacropexy. Magnetic resonance imaging was performed and spondylodiscitis secondary to prolapse correction surgery with mesh was suspected. In order to ensure an adequate recovery, removal of the mesh was required. CONCLUSIONS: Spondylodiscitis secondary to colposacropexy should be suspected when the patient starts with moderate lumbar pain and is not correctly controlled with first-level analgesia. Infection or mesh rejection should be considered. Mesh rejection should be suspected when the patient does not improve after antibiotics. Complete removal of the mesh is needed in order to ensure the patient's recovery.

Coastal current convergence structures in the Bay of Biscay from optimized high-frequency radar and satellite data.

The southeastern Bay of Biscay has been described as a "dead end" for floating marine litter, often accumulating along small-scale linear streaks. Coastal Current Convergence Structures (CCS), often associated with vertical motions at river plume edges, estuarine fronts, or other physical processes, can be at the origin of the accumulation. Understanding the formation of CCS and their role in the transport of marine litter is essential to better quantify and to help mitigate marine litter pollution. The Lagrangian framework, used to estimate the absolute dispersion, and the finite-size Lyapunov exponents (FSLE), have proved very effective for identifying CCS in the current velocity field. However, the quality of CCS identification depends strongly on the Eulerian fields. Two surface current velocity data sets were used in the analysis: the remotely sensed velocities from the EuskOOS High-Frequency Radar (HFR) network and velocities from three-dimensional model outputs. They were complemented by drifting buoy velocity measurements. An optimization method, involving the fusion of drifting buoys and HFR velocities is proposed to better reconstruct the fine-scale structure of the current velocity field. Merging these two sources of velocity data reduced the mean Lagrangian error and the Root Mean Square Error (RMSE) by 50 % and 30 % respectively, significantly improving velocity reconstruction. FSLE ridgelines obtained from the Lagrangian analysis of optimized velocities were compared with remotely sensed concentrations of Chlorophyll-a. It was shown that ridgelines control the spatial distribution of phytoplankton. They fundamentally represent the CCS which can potentially affect marine litter aggregation. Analysis of the absolute dispersion revealed large stirring in the alongshore direction which was also confirmed by spatial distribution of FSLE ridgelines. The alignment between FSLE ridgelines and patterns of high Chlorophyll-a concentration was observed, often determining the limits of river plume expansion in the study area.

Comparison between pollutants found in breast milk and infant formula in the last decade: A review.

Since ancient times, breastfeeding has been the fundamental way of nurturing the newborn. The benefits of breast milk are widely known, as it is a source of essential nutrients and provides immunological protection, as well as developmental benefits, among others. However, when breastfeeding is not possible, infant formula is the most appropriate alternative. Its composition meets the nutritional requirements of the infant, and its quality is subject to strict control by the authorities. Nonetheless, the presence of different pollutants has been detected in both matrices. Thus, the aim of the present review is to make a comparison between the findings in both breast milk and infant formula in terms of contaminants in the last decade, in order to choose the most convenient option depending on the environmental conditions. For that, the emerging pollutants including metals, chemical compounds derived from heat treatment, pharmaceutical drugs, mycotoxins, pesticides, packaging materials, and other contaminants were described. While in breast milk the most concerning contaminants found were metals and pesticides, in infant formula pollutants such as metals, mycotoxins, and packaging materials were the most outstanding. In conclusion, the convenience of using a feeding diet based on breast milk or either infant formula depends on the maternal environmental circumstances. However, it is important to take into account the immunological benefits of the breast milk compared to the infant formula, and the possibility of using breast milk in combination with infant formula when the nutritional requirements are not fulfilled only with the intake of breast milk. Therefore, more attention should be paid in terms of analyzing these conditions in each case to be able to make a proper decision, as it will vary depending on the maternal and newborn environment.

Quantitative assessment of the interplay between DNA elasticity and cooperative binding of ligands.

Binding of ligands to DNA can be studied by measuring the change of the persistence length of the complex formed, in single-molecule assays. We propose a methodology for persistence length data analysis based on a quenched disorder statistical model and describing the binding isotherm by a Hill-type equation. We obtain an expression for the effective persistence length as a function of the total ligand concentration, which we apply to our data of the DNA-cationic ß-cyclodextrin and to the DNA-HU protein data available in the literature, determining the values of the local persistence lengths, the dissociation constant, and the degree of cooperativity for each set of data. In both cases the persistence length behaves nonmonotonically as a function of ligand concentration and based on the results obtained we discuss some physical aspects of the interplay between DNA elasticity and cooperative binding of ligands.

Geometry dependence in linear interface growth.

The effect of geometry in the statistics of nonlinear universality classes for interface growth has been widely investigated in recent years, and it is well known to yield a split of them into subclasses. In this work, we investigate this for the linear classes of Edwards-Wilkinson and of Mullins-Herring in one and two dimensions. From comparison of analytical results with extensive numerical simulations of several discrete models belonging to these classes, as well as numerical integrations of the growth equations on substrates of fixed size (flat geometry) or expanding linearly in time (radial geometry), we verify that the height distributions (HDs) and the spatial and the temporal covariances are universal but geometry-dependent. In fact, the HDs are always Gaussian, and, when defined in terms of the so-called "KPZ ansatz" [h≃v_{∞}t+(Γt)^{ß}χ], their probability density functions P(χ) have mean null, so that all their cumulants are null, except by their variances, which assume different values in the flat and radial cases. The shape of the (rescaled) covariance curves is analyzed in detail and compared with some existing analytical results for them. Overall, these results demonstrate that the splitting of such university classes is quite general, being not restricted to the nonlinear ones.

Circular Kardar-Parisi-Zhang interfaces evolving out of the plane.

Circular KPZ interfaces spreading radially in the plane have Gaussian unitary ensemble (GUE) Tracy-Widom (TW) height distribution (HD) and Airy_{2} spatial covariance, but what are their statistics if they evolve on the surface of a different background space, such as a bowl, a mountain, or any surface of revolution? To give an answer to this, we report here extensive numerical analyses of several one-dimensional KPZ models on substrates whose size enlarges as 〈L(t)〉=L_{0}+ωt^{γ}, while their mean height 〈h〉 increases as usual [〈h〉∼t]. We show that the competition between the L enlargement and the correlation length (ξ≃ct^{1/z}) plays a key role in the asymptotic statistics of the interfaces. While systems with γ>1/z have HDs given by GUE and the interface width increasing as w∼t^{ß}, for γ<1/z the HDs are Gaussian, in a correlated regime where w∼t^{αγ}. For the special case γ=1/z, a continuous class of distributions exists, which interpolate between Gaussian (for small ω/c) and GUE (for ω/c≫1). Interestingly, the HD seems to agree with the Gaussian symplectic ensemble (GSE) TW distribution for ω/c≈10. Despite the GUE HDs for γ>1/z, the spatial covariances present a strong dependence on the parameters ω and γ, agreeing with Airy_{2} only for ω≫1, for a given γ, or when γ=1, for a fixed ω. These results considerably generalize our knowledge on 1D KPZ systems, unveiling the importance of the background space on their statistics.

Ultrasound in the study and monitoring of osteoarthritis.

This review addresses the use of ultrasound (US) as an imaging technique for the evaluation and monitoring of the osteoarthritic joint. US complements both the clinical examination and radiological imaging by allowing the rheumatologist to recognize not only the bony profile but also to visualize the soft tissues. Systematic US scanning following established guidelines can demonstrate even minimal abnormalities of articular cartilage, bony cortex and synovial tissue. US is also extremely sensitive in the detection of soft tissue changes in the involved joints including the proliferation of the synovium and changes in the amount of fluid present within the joint. Monitoring the amount of fluid in the hip and knee joint with osteoarthritis may be a potentially useful finding in the selection of patients for clinical investigation and for assessing their response to therapeutic interventions.

Kardar-Parisi-Zhang growth on one-dimensional decreasing substrates.

Recent experimental works on one-dimensional (1D) circular Kardar-Parisi-Zhang (KPZ) systems whose radii decrease in time have reported controversial conclusions about the statistics of their interfaces. Motivated by this, here we investigate several one-dimensional KPZ models on substrates whose size changes in time as L(t)=L_{0}+ωt, focusing on the case ω<0. From extensive numerical simulations, we show that for L_{0}≫1 there exists a transient regime in which the statistics is consistent with that of flat KPZ systems (the ω=0 case), for both ω<0 and ω>0. Actually, for a given model, L_{0} and |ω|, we observe that a difference between ingrowing (ω<0) and outgrowing (ω>0) systems arises only at long times (t∼t_{c}=L_{0}/|ω|), when the expanding surfaces cross over to the statistics of curved KPZ systems, whereas the shrinking ones become completely correlated. A generalization of the Family-Vicsek scaling for the roughness of ingrowing interfaces is presented. Our results demonstrate that a transient flat statistics is a general feature of systems starting with large initial sizes, regardless of their curvature. This is consistent with their recent observation in ingrowing turbulent liquid crystal interfaces, but it is in contrast with the apparent observation of curved statistics in colloidal deposition at the edge of evaporating drops. A possible explanation for this last result, as a consequence of the very small number of monolayers analyzed in this experiment, is given. This is illustrated in a competitive growth model presenting a few-monolayer transient and an asymptotic behavior consistent, respectively, with the curved and flat statistics.

Width and extremal height distributions of fluctuating interfaces with window boundary conditions.

We present a detailed study of squared local roughness (SLRDs) and local extremal height distributions (LEHDs), calculated in windows of lateral size l, for interfaces in several universality classes, in substrate dimensions d_{s}=1 and 2. We show that their cumulants follow a Family-Vicsek-type scaling, and, at early times, when ξ≪l (ξ is the correlation length), the rescaled SLRDs are given by log-normal distributions, with their nth cumulant scaling as (ξ/l)^{(n-1)d_{s}}. This gives rise to an interesting temporal scaling for such cumulants as 〈w_{n}〉_{c}∼t^{γ_{n}}, with γ_{n}=2nß+(n-1)d_{s}/z=[2n+(n-1)d_{s}/α]ß. This scaling is analytically proved for the Edwards-Wilkinson (EW) and random deposition interfaces and numerically confirmed for other classes. In general, it is featured by small corrections, and, thus, it yields exponents γ_{n} (and, consequently, α,ß and z) in good agreement with their respective universality class. Thus, it is a useful framework for numerical and experimental investigations, where it is usually hard to estimate the dynamic z and mainly the (global) roughness α exponents. The stationary (for ξ≫l) SLRDs and LEHDs of the Kardar-Parisi-Zhang (KPZ) class are also investigated, and, for some models, strong finite-size corrections are found. However, we demonstrate that good evidence of their universality can be obtained through successive extrapolations of their cumulant ratios for long times and large l. We also show that SLRDs and LEHDs are the same for flat and curved KPZ interfaces.

Universality and dependence on initial conditions in the class of the nonlinear molecular beam epitaxy equation.

We report extensive numerical simulations of growth models belonging to the nonlinear molecular beam epitaxy (nMBE) class, on flat (fixed-size) and expanding substrates (ES). In both d=1+1 and 2+1, we find that growth regime height distributions (HDs), and spatial and temporal covariances are universal, but are dependent on the initial conditions, while the critical exponents are the same for flat and ES systems. Thus, the nMBE class does split into subclasses, as does the Kardar-Parisi-Zhang (KPZ) class. Applying the "KPZ ansatz" to nMBE models, we estimate the cumulants of the 1+1 HDs. Spatial covariance for the flat subclass is hallmarked by a minimum, which is not present in the ES one. Temporal correlations are shown to decay following well-known conjectures.

Functional luteolysis in response to hydrogen peroxide in human luteal cells.

To evaluate the effect of reactive oxygen species in human corpus luteum function, we investigated whether hydrogen peroxide (H2O2) affects the in vitro luteal cell production of steroids. H2O2 treatment (1.0-100 microM) of mid and late luteal cell cultures elicited a dose-dependent decrease in basal progesterone production. However, treatment of mid luteal cells with a low concentration of H2O2 (0.01 microM) significantly stimulated progesterone secretion (P < 0.05). In addition, H2O2 (100 microM) markedly inhibited human chorionic gonadotropin (hCG)-stimulated progesterone and estradiol secretion. cAMP production was enhanced (2.4-fold, P < 0.05) by hCG treatment of luteal cells. The addition of H2O2 (0.1-100 microM) to hCG-stimulated luteal cell cultures elicited a decrease in cAMP concentration (P < 0.05) and in the specific binding of radiolabeled hCG by luteal cells. Progesterone and estradiol production stimulated by dibutyryl cAMP were significantly inhibited by H2O2 (P < 0.05). These findings suggest that H2O2 interferes with basal steroid production and, in hCG-stimulated conditions, it may inactivate the gonadotropin-receptor complex. The anti-steroidogenic action of H2O2 therefore raises the possibility of a modulatory role of H2O2 in human luteal steroidogenesis.

Hydrosalpinx fluid affects murine embryonic development in a coculture system with epithelial endometrial cells.

OBJECTIVE: The aim of the present investigation was to assess whether a coculture system protects from the effect of hydrosalpinx fluid (HF) on murine embryo development, evaluated through blastocyst cell number. DESIGN: Controlled prospective study. SETTING: Academic research center. PATIENT(S): Endometrium and HF from six patients and endometrium from six normal patients. INTERVENTION(S): Murine embryos were exposed to the absence or presence of different concentrations of human HF: 0% HF (control), 50% HF, 70% HF in human tubal fluid, and 100% HF, in a simple culture system (SCS), epithelial coculture system (ECS), and hydrosalpinx epithelial coculture system (HECS). MAIN OUTCOME MEASURE(S): Embryonic development at 72 hours and blastocyst cell number determined by the Tarcowsky method. RESULT(S): In SCS, 91.9% of the embryos reached the blastocyst stage, and no significant differences were shown in the presence of HF. However, significant differences were observed in the blastocyst cell number. Of the embryos cultured in ECS, 97.1% reached the blastocyst stage, and high concentrations of HF caused a decrease in embryonic development. A significant difference was observed between ECS and HECS in embryo development without HF. When HF was added, a significant decrease in blastocyst cell number was seen in embryos exposed to HECS compared with ECS. CONCLUSION(S): Our data suggest that normal and hydrosalpinx endometria do not protect from the deleterious effect of HF on embryo development at the concentrations evaluated. This effect is dose dependent and was determined through the blastocyst cell number.

Procedure for radiolabeling gizzerosine and basis for a radioimmunoassay.

A method for the labeling of gizzerosine (GZ), a biogenic amine found in fish meal, is described. The labeling procedure with (125)I using a water-soluble Bolton-Hunter reagent and a mild water-insoluble oxidant (Iodogen) reagent is rapid and reproducible. The (125)I-GZ hapten was demonstrated to be immunologically active in a radioimmunoassay developed with polyclonal antibodies to GZ absorbed with a histamine-Sepharose column. The curves were linear in the range of 0.0001 and 0.1 microgram/mL. Samples of fish meal previously extracted of histamine with methanol and submitted to acid hydrolysis were contaminated with known amounts of GZ and submitted to the assay. The fish meal samples contaminated with GZ show a dose-response effect similar to the standard curve, and apparently the other component present in the sample did not interfere with the binding of the antibodies to (125)I-GZ. These data indicate the suitability of the radioimmunoassay to determine specifically GZ in fish meal.

Development of monoclonal antibodies to gizzerosine, a toxic component present in fish meal.

This study is the first report of the development of monoclonal antibodies (MAbs) against gizzerosine (GZ), one of the causative agents of black vomit, a serious poultry disease. Balb/c mice were immunized with different GZ conjugates; the most immunogenic conjugate in experimental animals was determined by enzyme-linked immunoadsorbent assays (ELISA). Somatic fusions were carried out using splenic lymphocytes from GZ-immune mice and the NSO/2 myeloid cell line. Primary selection of hybridomas secreting antibodies to GZ was done using a direct ELISA, with GZ bound to bovine serum albumin (BSA), GZ directly bound to maleinimide preactivated plates and histamine bound to BSA, a GZ related biogenic amine present in fish meal. Four MAbs--3H4, 3H10, and 5B1 of the IgG1 isotype, and 8G7 of the Ig2a isotype-were specific to GZ and did not cross-react with histamine. Only monoclonals 3H4 and 8G7 bound GZ in solution by means of a competitive ELISA. Finally, to determine the performance of the competitive ELISA developed with the MAbs, experiments were conducted with GZ in solution (0 to 10 microg/ml) and with GZ labeled with horseradish peroxidase (HRP) as the tracer; the antibody complex was captured by using rabbit anti-mouse IgG preactivated ELISA plates. These experiments showed that monoclonal anti-GZ-3H4 generates a more sensitive assay close to linearity in the range about of 0.1 to 10 microg/ml of GZ. No cross-reaction was observed with histamine, histidine, or lysine at all concentrations tested.

[Minimal intervention in smoking in Spain]. / Intervención mínima en tabaquismo en España.

OBJECTIVE: To determine the percentage of smokers who have been counseled by a physician to quit, among patients who visit a variety od specialist clinica; to identify the characteristics associated with a history of minimal intervention. PATIENTS AND METHODS: An anonymous survey of 501 patients over 14 years of age (230 men, 271 women; mean age of 51.4 yr) who were out patients in cardiology (61), neurology (68), digestive medicine (124), endocrinology (22), internal medicine (14), otorhinolaryngology (53) and dermatology (159) over a period of one week. The questionnaire asked if the patient smoked currently and if so, if a physician had ever recommended quitting. The association between a history or minimal intervention and other variables was evaluated using Spearman a correlation coefficient. RESULTS: 1) One hundred fifteen (22.9%) were smokers. 2) Only 49 (42.6%) of the smokers reported that a physician had advised quitting and 66 (57.4%) reported that none had done so. 3) We found an association between a history of minimal intervention and older age (rs = -0.246; p = 0.008) and male sex (rs = 0.244; p = 0.009). CONCLUSIONS: The infrequency with which physicians counsel patients to quit in our setting suggests an urgent need for the Spanish health authorities to develop programs aimed at minimal intervention.

[Patient with tricuspid atresia undergoing orthopedic surgery: anesthetic considerations]. / Paciente con atresia tricúspide para cirugía ortopédica: cuidados anestésicos.

We describe a 52-year-old patient with rheumatoid arthritis, interventricular communication and pulmonary stenosis. After an accidental fall she was scheduled for total hip replacement. The main objective of anesthetic management was to preserve pulmonary blood circulation at arterial pressures that would assure adequate tissue perfusion. Other objectives were to maintain hydration to prevent decreases in hematocrit levels, avoid systemic embolization and allow for antibiotic prophylaxis.

[The current situation of adolescents with cancer in pediatric hematology-oncology units in Spain. Results of a national survey]. / Situación actual de los adolescentes con cáncer en las unidades de hemato-oncología pediátrica españolas.

Little attention was paid to adolescents with Cancer in Spain up to 2010. In 2011 an "Adolescents with Cancer Committee" was established by the Spanish Society of Pediatric Hemato-Oncology (SEHOP) to care for the needs of these patients. The aim of this national survey was to outline the present situation of adolescents with cancer in Spanish Pediatric Hemato-Oncology units. A web based survey assessed institutional management of adolescents with cancer. The survey was personally sent to one member of the staff of each Pediatric Hemato-Oncology unit in Spain. It included questions about epidemiology, management, psycho-social coverage, specific facilities, and follow up of these patients. A total of 40 institutions out of 41 responded to the survey (overall response rate 98%). Fifty-six percent of the institutions had patients over 14, but only 36% of the institutions treated patients up to 18 years old. Only 25.6% of the units have more than 40 new pediatric cases every year. The percentage of patients between 14 and 18 years of age is below 10% in most of the units (77%). In 30.8% and 48.7% of the institutions, pediatric hemato-oncologists treat adolescents with hematological and solid tumors, respectively. The rest of the patients are seen by adult oncologists. There is only one institution that has a physician specifically dedicated to adolescent patients, and only two units have a "teenager's room". Only 2 units have a psychologist specifically trained to treat adolescents with cancer. The survey shows that most adolescents with cancer in Spain between 14 and 18 years of age are treated by adult oncologists. Most pediatric institutions still do not have specific facilities and psychosocial support for adolescents. The SEHOP is working hard in order to improve the quality of cancer care, and the quality of survival of this population.

Atomic Force Microscopy of spermidine-induced DNA condensates on silicon surfaces.

In the present work, we show that oxidized silicon may be successfully used to image multivalent cation-induced DNA condensates under the Atomic Force Microscope (AFM). The images thus obtained are good enough, allowing us to distinguish between different condensate forms and to perform nanometer-sized measurements. Qualitative results previously obtained using mica as a substrate are recovered here. We additionally show that the interactions between the cation spermidine (the condensing agent) and the DNA molecules are not significantly disturbed by the silicon surface, since the phase behavior of an ensemble of DNA molecules deposited on the silicon substrate as a function of the cation concentration is very similar to that found in solution.