Long-term outcome of peripheral T-cell lymphomas: Ten-year follow-up of the International Prospective T-cell Project.

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of haematological cancers with generally poor clinical outcomes. However, a subset of patients experience durable disease control, and little is known regarding long-term outcomes. The International T-cell Lymphoma Project (ITCLP) is the largest prospectively collected cohort of patients with PTCLs, providing insight into clinical outcomes at academic medical centres globally. We performed a long-term outcome analysis on patients from the ITCLP with available 10-year follow-up data (n = 735). The overall response rate to first-line therapy was 68%, while 5- and 10-year overall survival estimates were 49% and 40% respectively. Most deaths occurred prior to 5 years, and for patients alive at 5 years, the chance of surviving to 10 years was 84%. However, lymphoma remained the leading cause of death in the 5- to 10-year period (67%). Low-risk International Prognostic Index and Prognostic Index for T-cell lymphoma scores both identified patients with improved survival, while in multivariate analysis, age >60 years and Eastern Cooperative Oncology Group performance status 2-4 were associated with inferior outcomes. The favourable survival seen in patients achieving durable initial disease control emphasizes the unmet need for optimal front-line therapeutic approaches in PTCLs.

Correction: Inkjet-printed O2 gas sensors in intelligent packaging.

Correction for 'Inkjet-printed O2 gas sensors in intelligent packaging' by M. D. Fernández-Ramos et al., Analyst, 2021, 146, 3177-3184, https://doi.org/10.1039/D1AN00295C.

Intramammary administration of lipopolysaccharides at parturition enhances immunoglobulin concentration in goat colostrum.

In newborn ruminants, transfer of passive immunity is essential to obtain protection against pathogens. This study aimed to increase the permeability of the blood-milk barrier using intramammary lipopolysaccharides (LPS) in goats at parturition to modulate colostrum composition. Twenty multiparous Majorera dairy goats were randomly allocated in one of the two experimental groups. The LPS group (n = 10) received an intramammary administration (IA) of saline (2 mL) containing 50 µg of LPS from Escherichia coli (O55:B5) in each half udder at parturition. The control group (n = 10) received an IA of saline (2 mL). Rectal temperature (RT) was recorded, and a blood sample was collected at parturition (before IA). In addition, RT was measured, and blood and colostrum/milk samples were collected on day (d) 0.125 (3 hours), 0.5 (12 hours), 1, 2, 4, 7, 15 and 30 relative to the IA. Goat plasma immunoglobulin G (IgG) and M (IgM) and serum ß-hydroxybutyrate, glucose, calcium, free fatty acids, lactate dehydrogenase and total protein concentrations were determined. Colostrum and milk yields as well as chemical composition, somatic cell count (SCC), IgG and IgM concentrations were measured. The MIXED procedure (SAS 9.4) was used, and the model included the IA, time, and the interaction between both fixed effects. Statistical significance was set as P < 0.05. Goats from the LPS group showed higher RT on d 0.125, 0.5 and 4 relative to the IA compared to the control group (PIA×Time = 0.007). Goat serum biochemical variables and plasma IgG and IgM concentrations were not affected by the IA. Colostrum and milk yield as well as chemical composition were not affected by the IA, except for milk lactose percentage that was lower in the LPS group compared to the control group (4.3 ± 0.08 and 4.6 ± 0.08%, respectively PIA = 0.026). Colostrum SCC was higher in the LPS group than in the control group (3.5 ± 0.09 and 3.1 ± 0.09 cells × 106/mL, respectively; PIA = 0.011). Similarly, milk SCC increased in the LPS group compared to the control group (PIA = 0.004). The LPS group showed higher IgG (PIA = 0.044) and IgM (PIA = 0.037) concentrations on colostrum than the control group (31.9 ± 4.8 and 19.0 ± 4.8 mg/mL, 0.8 ± 0.08 and 0.5 ± 0.08 mg/mL, respectively). No differences in milk IgG and IgM concentrations between groups were observed. In conclusion, the IA of LPS at parturition increases RT, SCC and IgG and IgM concentrations in colostrum without affecting either yield or chemical composition.

PET/CT in nuclear endocrinology: Results of the survey diffused through different social networks of the SEMNIM in Spain.

AIM: To know the current use of the PET/CT technology applied in the field of endocrinology, the Endocrinology Working Group of SEMNIM proposed conducting a survey. The objective was to obtain a snapshot of the use of PET/CT in nuclear endocrinology, to know if it is being used properly and detect possible needs. MATERIAL AND METHODS: During the first quarter of 2022, we analyzed the data obtained from a survey that was distributed through different social networks throughout the second half of 2021. The survey asked for the use of the different PET/CT techniques available in Spain in different endocrinological pathologies like differentiated thyroid carcinoma, medullary thyroid carcinoma, neuroendocrine tumors and hyperparathyroidism. RESULTS: A total of 15 centers responded to the survey. A percentage of 79 of hospitals used 18F-FDG PET/CT in the diagnosis and/or follow-up of differentiated thyroid carcinoma (mean annual studies: 36.9; range 10-100); 85% used 18F-DOPA PET/CT for the study of biochemical recurrence of medullary thyroid carcinoma (mean annual studies: 7.8; range 2-20); 77% used 18F-DOPA PET/CT for the study of neuroendocrine tumors: 77% used 18F-DOPA PET/CT (mean of 10 scans per year; range 2-30) and 69% used 68Ga-DOTA-SA (mean of 24.7 studies per year; range 2-127); 79% used 18F-choline PET/CT for the study of hyperparathyroidism (mean of 30.1 annual studies; range 10-120). CONCLUSIONS: We detected that the use of the PET/CT technique in endocrinology is not yet widespread, however, we saw that the indications in which it is used are, in general, those reported in the different consensus.

The effect of the acid pretreatment temperature of natural diatomaceous earth on the Si/Al ratio of ZSM-5 zeolite

La tierra de diatomea boliviana es una fuente de silicio potencialmente más económica en comparación a los reactivos de alta pureza comúnmente utilizados para la síntesis de zeolitas. Dada su composición compleja es necesario realizarle un pretratamiento ácido con el fin de reducir las impurezas y regular el contenido de aluminio. En este artículo se realizaron múltiples experimentos durante la etapa de pretratamiento ácido. La temperatura del pretratamiento ácido fue modificada en un rango entre 50 y 155 °C esto con el fin de determinar su efecto en la relación Si/Al final. Los resultados mostraron que la relación Si/Al puede ser modulada en un rango entre 6,2 y 38,1. Posteriormente, se obtuvieron zeolitas a partir de la tierra de diatomea modificada. Las zeolitas obtenidas presentaron una relación Si/Al entre 9,6 y 40,2. Se aplicaron distintas técnicas de caracterización para la determinación de las propiedades. El grado de cristalinidad y el área superficial específica están directamente relacionadas con la relación Si/Al. Los sitios ácidos están conformados por ácidos fuertes de tipo Brönsted y ácidos fuertes y débiles de tipo Lewis. Para la zeolita con menor relación Si/Al se determinó una elevada acidez total (>0,51 molNH3/Kgzeolita), mientras que para la zeolita con mayor relación Si/Al la acidez total se redujo considerablemente (<0,38 molNH3/Kgzeolita).

Bolivian diatomaceous earth is a potentially lower cost silica source than conventional high purity reagents used in zeolite synthesis. Due to its complex composition, it is necessary to pre-treat it with sulfuric acid in order to reduce impurities and regulate the aluminum content. In the present work several experiments were carried out with natural Bolivian diatomaceous earth in the pre-treatment stage. In order to determine the effect on the final Si/Al ratio, the temperature of the acid pre-treatment was varied between 50 to 155 °C. The results show that the Si/Al ratio can be modulated from 6.2 up to 38.1. These treated diatomaceous earth samples were used to synthetise ZSM-5 zeolite. The obtained ZSM-5 zeolites have a Si/Al ratio in the following range: 9.6 to 40.2. XRD, NH3-TPD and Nitrogen Physisorption techniques were used to characterise the properties of the obtained zeolites. The degree of crystallisation and the specific surface area are directly related to the Si/Al ratio, resulting in high values at high Si/Al ratios. The acid sites are composed of strong Brönsted acid sites and, strong and weak Lewis acid sites. For the zeolite with a low Si/Al ratio a high total acidity was found (>0.51 molNH3/Kgzeolite), while at high Si/Al ratios the total acidity is reduced (<0.38 molNH3/Kgzeolite).

A terra diatomácea boliviana é uma fonte potencialmente mais barata de silício em comparação com os reagentes de alta pureza comumente usados para a síntese de zeólitas. Dada a sua composição complexa, é necessário realizar um pré-tratamento ácido para reduzir as impurezas e regular o teor de alumínio. No presente trabalho, vários experimentos foram realizados durante a etapa de pré-tratamento ácido. A temperatura do pré-tratamento ácido foi modificada em uma faixa entre 50 e 155 °C para determinar seu efeito na relação Si/Al final. Os resultados mostram que a razão Si/Al pode ser modulada em uma faixa entre 6,2 e 38,1. Posteriormente, as zeólitas foram obtidas a partir de terra diatomácea modificada. As zeólitas obtidas possuem uma razão Si/Al entre 9,6 e 40,2. Diferentes técnicas de caracterização foram aplicadas para determinar as propriedades. O grau de cristalinidade e a área superficial específica estão diretamente relacionados com a razão Si/Al. Os sítios ácidos são compostos por ácidos fortes do tipo Brönsted e ácidos fortes e fracos do tipo Lewis. Para a zeólita com menor relação Si/Al, foi determinada uma alta acidez total (>0,51 molNH3/Kgzeólita), enquanto para a zeólita com maior relação Si/Al, a acidez total foi consideravelmente reduzida (<0,38 molNH3/Kgzeolita).

Comparison between Accelerated Partial Breast Irradiation with multicatheter interstitial brachytherapy and Whole Breast Irradiation, in clinical practice.

PURPOSE: The aim of this study was to compare accelerated partial breast irradiation (APBI) with multicatheter interstitial brachytherapy (BT) and whole breast irradiation (WBI), in terms of toxicity, aesthetic result, quality of life and survival, in clinical practice. MATERIALS AND METHODS: A comparative study of two prospectively recorded cohorts of 76 breast cancer patients who complied with the recommendations of GEC-ESTRO for APBI was conducted. The main objective was toxicity, quality of life measured through validated questionnaires and the aesthetic results. Secondary objectives were overall survival and disease-free survival. RESULTS: Seventy-six stage I/II breast cancer patients, with a mean age of 66 years entered the study. APBI group showed less acute G1-2 dermatitis (51.4 vs 94.9%, p < 0.001) and late hyperpigmentation (0 vs 17.9%, p = 0.04). There were no differences in aesthetic results, both assessed by the patient herself and by the doctor. Statistically significant differences in measures of quality of life were observed in favour of the APBI, both in EORTC QLQ-BR23 and body image scale questionnaires. With a median follow-up of 72 months (6 years), the estimated overall survival at 5 and 10 years was 96.8 and 77.7%, respectively, and disease-free survival at 5 and 10 years was 91.1 and 69.4%, respectively, without statistically significant differences between groups. DISCUSSION: APBI is an attractive alternative in candidate patients with initial breast cancer, with benefits in acute toxicity and quality of life and fewer visits to the hospital, without compromising tumor control or survival.

Inkjet-printed O2 gas sensors in intelligent packaging.

An inkjet printed membrane is presented as a colorimetric sensor for oxygen for use in smart packaging, in order to quickly inform the consumer about possible degradation reactions in modified atmosphere products (MAP). The colorimetric sensor is based on the redox dye, toluidine blue (TB), a sacrificial electron donor, glycerol, and, hydroxypropyl methylcellulose, as the hydrophilic polymeric matrix. The UVC-wavelength activated TB is photoreduced by SnO2 nanoparticle ink. This colorimetric oxygen indicator stays colourless upon exposure in nitrogen atmosphere to 7 min UVC light (6 W·cm-2). The photoreduced TB to leuco TB recovers its original colour upon exposure to oxygen for 55 min under ambient conditions (∼21 °C, ∼55%RH, 21% O2). The characteristics of the sensor have been evaluated, including its functionality through the colorimetric response to different oxygen concentrations as well as the influence of experimental variables such as humidity and temperature using a digital camera as the detector. The results obtained show that: (1) the colorimetric sensor remains stable in the absence of oxygen; (2) relative humidity greater than 60% significantly affects the reoxidation process; and (3) the temperature has a significant influence on the colour recovery, although the stability increases considerably when the sensor is kept refrigerated at 4 °C. A real application to packaged ham was performed, demonstrating that the printed colorimetric sensor is stable for at least 48 hours once activated and when the container deteriorates upon the entrance of oxygen, the sensor returns to its original blue colour, demonstrating its utility as a UVC-activated colorimetric oxygen sensor.

Isquemia mesentérica: manejo endovascular

La isquemia mesentérica es una condición que puede volverse muy grave y ser letal, más aún en los casos agudos. Un tratamiento precoz es muy importante. Se presentaron cuatro casos consecutivos tratados por nuestro equipo con trombosis, o disección o aneurismas de arterias mesentérica superior y tronco celíaco, se revisaron las indicaciones y se evaluaron los tratamientos llevados a cabo. Se utilizaron procedimientos endovasculares en todos, técnicamente en forma exitosa, evitando que progrese a un desenlace peligroso. Hubo diversidad de técnicas endovasculares adaptándolas a cada caso. En ningún paciente se requirió un acceso quirúrgico abierto para completar el tratamiento realizando las intervenciones prontas. El manejo endovascular de las lesiones mesentéricas es factible y replicable, y en nuestros casos podría haber prevenido una necrosis intestinal así como la necesidad de cirugías resectivas.

SUMMARY Mesenteric ischaemia is a condition that may be very severe and potentially lethal particularly in the acute presentation. Early treatment is crucial. We present four consecutive cases managed by our team with thrombosis or dissection or aneurysm of the superior mesenteric artery and the celiac trunk reviewing indications and treatment implemented. Multiple successful endovascular procedures were used in all cases avoiding progression to lethal consequences. None of the patients required an open surgical procedure. Therefore, endovascular procedures are feasible in these patients avoiding intestinal necrosis as well as the need for open surgeries.

Recomendación Clínica: "Recomendaciones para el manejo de pacientes con COVID-19 con indicación terapéutica de ventilación mecánica que eventualmente son conectados a máquinas de anestesia" / Recommendations for patient management with COVID-19 with therapeutic indication mechanical ventilation that eventually are connected to anesthesia machines

La pandemia de COVID-19 producida por SARS-CoV-2 actualmente en curso anticipa una gran demanda por ventiladores mecánicos (VM), ya que un porcentaje relevante de los contagiados cae rápidamente en insuficiencia respiratoria y requiere de cuidados intensivos. Anticipándose a ese exceso de demanda y considerando que es muy probable que el número actual de ventiladores mecánicos en las unidades de cuidados intensivos (UCI) sean insuficientes, se ha solicitado a la SACH un informe técnico en relación al uso de las máquinas de anestesia como VM.

Recomendaciones para el manejo de pacientes con COVID19 en el perioperatorio / Recommendations for the management of patients with COVID19 in the perioperative period

En diciembre de 2019, una serie de casos de neumonía de causa desconocida surgieron en Wuhan, Hubei, China, con presentaciones clínicas muy parecidas a la neumonía viral. El análisis de secuenciación profunda de muestras del tracto respiratorio inferior indicó un nuevo coronavirus, que se denominó nuevo coronavirus 2019 (2019-nCoV o SARS-CoV2) [15]. La propagación del virus ha sido extremadamente rápida, tanto así que el 11 de marzo de 2020 y luego de más de 118.000 infectados en 114 países con 4.300 fallecidos a esa fecha, la organización mundial de la salud declaró a la enfermedad COVID-19, causada por 2019-nCoV, como una pandemia.

Metástasis inusuales en carcinoma de células renales / Unusual Metastases in Renal Cell Carcinoma

Introducción y Objetivos El carcinoma renal de células claras (CCR), es la neoplasia renal más frecuente. Hasta el 30% de los casos presentan enfermedad sistémica, siendo las más usuales: pulmón, ganglios, hígado y cerebro. El objetivo de este trabajo es informar casos poco frecuentes de metástasis por CCR y establecer posibles factores relacionados con las metástasis. Métodos y Materiales revisión retrospectiva de historias clínicas en el instituto nacional de cancerología de los pacientes con carcinoma de células renales metastásico entre los años 2013 a 2017. Se identificaron 6 casos con sitios de metástasis inusuales en pacientes del servicio de urología oncológica del instituto nacional de cancerología, destacando histopatología e inmunohistoquímica de los especímenes quirúrgicos tanto del primario como de la metástasis, reportando marcadores específicos y clasificaciones según corresponda. Resultados Caso 1 Metástasis a duodeno, Caso 2 metástasis a ovario, caso 3 metástasis a testículo, caso 4 metástasis a piel, caso 5 metástasis a glándula tiroides, caso 6 metástasis a mama y piel. Se evaluaron diferentes variables y se analizaron con base en la literatura. Conclusiones Consideramos que la edad, el tabaquismo, el grado histológico, la invasión de la vena renal, el tamaño tumoral y el estadio pueden ser factores predisponentes para ese comportamiento.

Introduction and Objectives Clear cell renal carcinoma (CRC) is the most frequent renal neoplasm. Up to 30% of cases present systemic disease, being the most common: lung, lymph, liver and brain. The objective of this work is to report rare cases of CRC metastasis and to establish possible factors related to metastasis. Methods and Materials Retrospective review of medical records in the national institute of cancerology of patients with metastatic renal cell carcinoma between the years 2013 to 2017. Six cases with sites of unusual metastases were identified in patients of the oncology urology service of the national institute of cancerology, highlighting histopathology and immunhistochemistry of the surgical specimens of both the primary and metastasis, reporting specific markers and classifications as appropriate. Results Case 1 Metastasis to duodenum, Case 2 metastasis to ovary, case 3 metastasis to testis, case 4 metastasis to skin, case 5 metastasis to thyroid gland, case 6 metastasis to breast and skin. Different variables were evaluated and analyzed based on the literature. Conclusions We consider that age, smoking, histological grade, invasion of the renal vein, tumor size and stage may be predisposing factors to this behavior.

La posición de Trendelenburg no cambia el gasto cardíaco en voluntarios sanos / Trendelenburg position does not change Cardiac output in healthy volunteers

BACKGROUND: The Trendelenburg position (TP) has been empirically used to increase preload and thus cardiac output (CO). Transthoracic echocardiogram (TTE) is a noninvasive technique that estimates CO. We aimed to describe if the TP can improve CO. MATERIALS AND METHODS: We conducted a descriptive study in healthy subjects (ASA I), with TTE measurements of CO and the End-Diastolic Volume of the Left Ventricle (EDVLV) in supine and after 5 minutes in TP. RESULTS: There showed no significant changes in blood pressure, heart rate and pulse oximetry in 0° and after 5 minutes in 45°. The mean CO without inclination was 4.2 l/min ± 0.6, tat is the same results after 5 minutes in PT (p > 0.6). The EDVLV was 95 ± 12 ml at 0° and 101 ± 15 ml after 5 minutes in PT (p > 0.8). CONCLUSION: Trendelenburg position doesn't improve CO or preload in healthy subjects.

INTRODUCCIÓN: Empíricamente se ha utilizado la posición de Trendelenburg (PT) para aumentar la precarga y posteriormente el gasto cardiaco (GC). La ecografía transtorácica (ETT) es una técnica no invasiva que puede estimar el GC. Realizamos un estudio descriptivo para evaluar si la PT afecta el CG. MATERIALES Y MÉTODOS: Examinamos pacientes ASA I, se hicieron mediciones del GC y del volumen de fin de diástole (VDFVI) en posición supina y luego de cinco minutos en PT. RESULTADOS: No se observaron cambios significativos en la presión arterial, frecuencia cardíaca y saturometría en los voluntarios a 0º y a 45º. El GC sin inclinación fue en promedio 4,2 l/min ± 0,6, el mismo resultado tras cinco minutos en PT, sin ser estadísticamente significativo (p > 0,6). El VDFVI a 0º fue en promedio 95 ± 12 ml y tras cinco minutos en PT 101 ± 15 ml, que tampoco alcanzó diferencia estadísticamente significativa (p > 0,8). CONCLUSIÓN: La posición de Trendelenburg no varía el gasto cardiaco ni la precarga en voluntarios sanos.

Fake imported tropical diseases: A retrospective study.

OBJECTIVE: When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay. METHODS: A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain. RESULTS: We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (median, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease. CONCLUSIONS: Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis.

Optimisation of radiation dose and image quality in mobile neonatal chest radiography.

PURPOSE: To optimise the radiation dose and image quality for chest radiography in the neonatal intensive care unit (NICU) by increasing the mean beam energy. METHODS: Two techniques for the acquisition of NICU AP chest X-ray images were compared for image quality and radiation dose. 73 images were acquired using a standard technique (56 kV, 3.2 mAs and no additional filtration) and 90 images with a new technique (62 kV, 2 mAs and 2 mm Al filtration). The entrance surface air kerma (ESAK) was measured using a phantom and compared between the techniques and against established diagnostic reference levels (DRL). Images were evaluated using seven image quality criteria independently by three radiologists. Images quality and radiation dose were compared statistically between the standard and new techniques. RESULTS: The maximum ESAK for the new technique was 40.20 µGy, 43.7% of the ESAK of the standard technique. Statistical evaluation demonstrated no significant differences in image quality between the two acquisition techniques. CONCLUSIONS: Based on the techniques and acquisition factors investigated within this study, it is possible to lower the radiation dose without any significant effects on image quality by adding filtration (2 mm Al) and increasing the tube potential. Such steps are relatively simple to undertake and as such, other departments should consider testing and implementing this dose reduction strategy within clinical practice where appropriate.

Reasons for Noninclusion on the Kidney Transplant Waiting List: Analysis in a Set of Hemodialysis Centers.

INTRODUCTION: End-stage renal disease patients' access to the renal transplant (RT) waiting list (WL) depends on general criteria and their specific application in the different treatment units. METHODS: Study in nonhospital hemodialysis centers (n = 9), dependent on an adult RT center. Cases included 228 patients considered to have nonactive status on the WL due to incomplete immunologic data (no blood group or HLA typing) or temporary contraindication from an incomplete pretransplant study (nonimmunologic) or comorbidity. Each individual situation was studied by reviewing the center's clinical history with the nephrologist in charge. RESULTS: Three situations were classified three groups. (1) Patients in this group had incomplete basic study (65 patients, 28.5%) pending cardiologic evaluation in 34%; urologic evaluation, 26%; both 18%; others, 9%; study not initiated, 12%. (2) Patients in this group had pre-existing or onset comorbidities (117 patients, 51.3%) pending studies or confirmed resolution: obesity, 30%; cancer, 17%; cardiovascular disease, 14%; digestive pathology, 10%; infection, 9%; neuropsychiatric disorders, 7%; multiple, 13%. (3) Patients in this group had other situations contraindicating RT (46 patients, 20.2%): poor therapeutic adherence, 30%; negative will of the patient, 26%; social issues, 9%; excluded by the center (not reported), 35%. CONCLUSIONS: We detected a high incidence of cases pending basic tests for inclusion on the WL. Obesity can be highlighted as the most frequent cause for noninclusion. Further support and coordination is required with referral hospital centers to increase and refine the RT WL.

Litter Type and Number of Flocks Affect Sex Hormones in Broiler Litter.

Broiler litter contains 17ß-estradiol, estrone, and testosterone, which can contaminate surface waters when surface applied to grasslands and no-till fields. The objective of this study was to evaluate the effects of litter type (full or cake cleanout), litter treatment (none or sodium bisulfate), and number of flocks raised on the litter (1-5) on sex hormone concentrations. Our results showed that in untreated broiler litter, cake cleanout had greater concentrations of 17ß-estradiol, estrone, and testosterone than full cleanout, whereas in litter treated with sodium bisulfate, only the concentration of 17ß-estradiol was greater in cake than in full cleanout. The concentrations of 17ß-estradiol and estrone in untreated broiler litter increased as the number of flocks increased from one to three, with the largest increase observed for estrone in cake cleanout. We also sampled three broiler houses in brooding and nonbrooding sections during the growout period. We found no differences in hormone concentrations between sections of each house, but changes in hormone concentrations during growout varied depending on broiler litter water content. Water contents corresponding to ∼60% water-filled porosity favored a decrease in hormone concentrations with time, whereas a water-filled porosity of 44% was associated with increases in hormone concentration, probably due to slow decomposition rates. Our results suggest that cake cleanout of untreated litter, as well as all cleanouts from houses that have raised several flocks on the same bedding, may be good targets for treatments that can reduce hormone concentrations before the litter is surface applied to fields.

Dolor lumbopélvico asociado a discapacidad durante el tercer trimestre de embarazo y su evolución posterior al parto / Lumbopelvic pain associated with disability during the third trimester of pregnancy and its evolution after delivery

RESUMEN El dolor lumbopélvico es una condición muy frecuente, afectando un 50 a 70% de las mujeres durante el embarazo. En la mayoría de los casos ha habido una recuperación al mes o 3 meses postparto. Sin embargo, estudios reportan que la mejoría es incompleta, pudiendo persistir o aumentar años posterior al parto. Esta condición puede causar limitaciones en la vida diaria, provocando algún grado de discapacidad que muchas veces no es abordado con la importancia que se merece. Objetivo Determinar la prevalencia de dolor lumbopélvico y su relación con el grado de discapacidad durante el tercer trimestre de embarazo y 3 meses postparto. Material y método Estudio observacional y cohorte prospectivo; la muestra son 81 mujeres estudiadas en su tercer trimestre de embarazo y 3 meses postparto atendidas durante 2014-2015 en el Departamento de Obstetricia & Ginecología, Clínica Las Condes. Se aplicó un cuestionario y el Índice de discapacidad Oswestry en ambas etapas y autoadministrada. El análisis de datos se realizó con STATA10.0. Resultados El 81,48% de las embarazadas presentaron dolor lumbopélvico, siendo más prevalente y con una asociación significativa en el tercer trimestre (72,84%, p<0,001). El 25,93% de las mujeres lo mantiene después del parto. Existe una asociación significativa entre dolor lumbopélvico y grado de discapacidad (p<0,001), específicamente con actividades de la vida diaria, actividad sexual y actividades domésticas. Conclusiones Existe una alta prevalencia de dolor lumbopélvico en el embarazo, y un porcentaje no menor lo mantiene postparto, y en ambos casos está asociado a un grado de discapacidad.

ABSTRACT Lumbopelvic pain is a very frequent condition that affects between 50 to 70% of pregnant women. In many cases have been a recovery over the month or three months postpartum. However, some studies showed an incomplete improvement, so it could persist or increase through years after childbirth. This condition can cause daily life limitations, it is provoking some disability grade, that many times it didn't understand with the importance that deserve. Aim To identify the lumbopelvic pain prevalence and the relation with disability grade during the third trimester of pregnancy and three months postpartum. Material and Methods Observational and prospective cohort study; the sample was 81 women studied in her third trimester of pregnancy and three months postpartum during 2014-2015 in the "Departamento de Obstetricia & Ginecologia de Clínica Las Condes". It applied a questionnaire and the Oswestry Disability Index in both stages and self-administered. Data analysis was using STATA 10.0 software. Results 81, 48% of pregnant showed lumbopelvic pain, there were being more prevalent and significantly associated with third trimester (72, 84%, p<0,001). 25, 93% of women maintained this condition postpartum. There is a significant association between lumbopelvic pain and disability grade (p<0,001), specifically with daily life, sexual and domestic activities. Conclusions There is a high prevalence of lumbopelvic pain during pregnancy, and not less percentage maintained this condition postpartum, that associated with a high disability grade.

Resultados del tratamiento del cáncer de mama, Programa Nacional de Cáncer del Adulto / Impact of the Chilean Explicit Guaranties Health System (GES) on breast cancer treatment

Background Breast cancer is the most common malignant tumor in women in the world. In 2005, it was incorporated to the Explicit Guaranties Health System (GES) in Chile. Aim To describe the demographic and clinical characteristics of breast cancer patients and to determine the effect of incorporating these women to GES. Material and Methods Medical records of 5,119 women with breast cancer aged 59 ± 14 years, attended at six public hospitals between 2000 and 2010 were reviewed. Median follow up was 87 months (range 1-182). Mortality was assessed using death certificates obtained at the National Identification Registry. Results Sixty six percent of women were in stage I-II, 29% in stage III and 5% in stage IV. Surgery was performed in 4023/5119 cases (79%), adyuvant radiotherapy in 3627/4517 cases (80%), chemotherapy in 3,204/3,424 cases (94%) and hormone therapy in 1,695/2,375 cases (71%). Between 2000 and 2010, there was a significant increase in the proportion of cases in stage I, from 8% to 25%, (p < 0.01). Overall survival (OS) increased 1% per year, since the beginning of GES system (p = 0.024). Five year OS was 75.1%. The figures for Stage I, II, III and IV were 93, 84, 62 and 27% respectively (p < 0.01). Patients without lymph node involvement and who were not triple negative, had a significantly better OS. Conclusions There was a significant increase in stage I cases, and a 1% per year OS improvement after GES system started, compared with the previous period.

Prevalence of metabolic syndrome and its association with lower urinary tract symptoms and sexual function. / Prevalencia del síndrome metabólico y su asociación con síntomas del tracto urinario inferior y función sexual.

OBJECTIVES: To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). MATERIAL AND METHODS: A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. RESULTS: A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6-48.3). The bivariate model showed an association between MetS and LUTS (p<0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14-2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24-7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12-5.8). CONCLUSION: This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it.