Correction to: Fraction of high-grade cervical intraepithelial lesions attributable to genotypes targeted by a nonavalent HPV vaccine in Galicia, Spain.

After publication of the article [1], it was brought to our attention that the author E. López-Díez is missing their second affiliation. The author would also like to indicate an affiliation to "Universidade de Vigo, Pontevedra, Spain".

Fraction of high-grade cervical intraepithelial lesions attributable to genotypes targeted by a nonavalent HPV vaccine in Galicia, Spain.

BACKGROUND: Human papillomavirus (HPV) bivalent and quadrivalent vaccines have been widely implemented in worldwide organized immunization programs. A nonavalent HPV vaccine is now available in several countries. The objective was to describe the fraction of squamous non-invasive high-grade cervical intraepithelial lesions attributable to genotypes targeted by bi-quadrivalent vaccines and by nonavalent vaccine according to age and diagnosis in women living in the city of Vigo (Galicia, Spain). METHODS: Cervical scrapings (2009-2014) of women with histological diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2, n = 145) and grade 3-carcinoma in situ (CIN3-CIS, n = 244) were tested with Linear Array HPV Genotyping test (Roche diagnostics, Mannheim, Germany). Hierarchical estimation of the fraction attributable to HPV 16/18 or HPV 31/33/45/52/58 detected alone or in combination was calculated. Absolute additional fraction attributable to genotypes targeted by nonavalent vaccine compared to genotypes targeted by bi-quadrivalent vaccines was calculated as the increment of attributable cases with respect to all studied cases. Age group 1, 2 and 3 included women 18 to 34, 35-44 and ≥45 years old, respectively. EPIDAT 3.1 was used. RESULTS: Fraction attributable to genotypes targeted by bi-quadrivalent vaccines was 59% CIN2 vs. 69% CIN3-CIS (p < 0.001). It was 63/51/50% of CIN2 and 78/66/45% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by nonavalent vaccine was 86% CIN2 and 86% CIN3-CIS. It was 87/91/75% of CIN2 and 90/86/76% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by these vaccines tended to decrease as age increased (p-trend <0.05). Globally, absolute additional attributable fraction was 16%, 26% and 29% in age group 1, 2 and 3, respectively (p < 0.005). CONCLUSIONS: Absolute additional fraction of CIN2 and CIN3-CIS attributable to genotypes targeted by nonavalent vaccine was observed in women of any age, especially in those over 35 years old.

Impact of serpentinized peridotite mine waste on the composition and quality of sediments in the Ría de Ortigueira (Galicia, NW Spain).

The Ría de Ortigueira is an environmentally well conserved; however, the sediments show high concentrations of toxic elements. In some zones, the concentrations of Ni (60-1080 mg kg-1) and Cr (9-567 mg kg-1) were extremely high, while the concentrations of other toxic elements were within normal ranges. PCA revealed that metal enrichment was due to dumping of waste sludge from a peridotite mine. The study of marine currents showed that the exit of the contaminated waste towards the external zone is restricted by the low energy of the residual currents, and the sludge therefore remains trapped in the internal zones. The potential ecological risk was moderate for all areas of the ría, reaching high values close to the mouth of the river Landoi. Finally, geochemical fractioning showed that most of the metals are associated with Fe oxyhydroxides which can become unstable and release adsorbed or coprecipitated metals, especially Ni.

UV-vis spectroscopic study of Co(II)/Co(III) oxidation in poly[M-protoporphyrins] films and their interaction with axial ligands.

A bathochromic shift for both Soret and Q bands in the polyCo(III)PP were indicative of Co(III) oxidation state in film. The presence of an isosbestic point indicates a chemical equilibrium between polyCo(III)PP (band I) in polyCo(III)PP with water as axial neutral ligand (band II). Concentration levels of iodide of 10(-1) M showed irreversible broadening of Soret band with a maximum shift from 400 nm to 380 nm attributed to film reduction. The thiocyanate anion shows a remarkable effect on polyCo(III)PP spectra. The degree of configuration interaction for Q and B transitions is nearly constant in air and water for Ni(II)PP, Cu(II)PP and Zn(II)PP films. The poly[Co(III)-protoporphyrin IX] showed strong deviation from the pattern. This result indicates that the Co atom does not present a planar conformation in polyCo(III)PP which is consistent with the less packed structure of this film. The apparent diffusion coefficients (D') were calculated for electroactive species using the polyNi(II)PP chemically modified electrode, with an experiment short enough to avoid preconcentration. D' was compared with D (diffusion coefficient), obtained with the bare working electrode. Apparent diffusion coefficients (D') changed regularly with molecular volume indicating certain molecular sieving effect.

Laparoscopy: the preferred method of cholecystectomy in the morbidly obese.

BACKGROUND: Morbid obesity has been considered a contraindication to laparoscopic cholecystectomy (LC). METHODS: To evaluate this we reviewed our first 201 patients undergoing LC and compared the operative procedure and outcome in morbidly obese (greater than or equal to 100 pounds over ideal body weight [IBW]) and nonobese patients. We also compared a group of morbidly obese patients who underwent standard open cholecystectomy (n = 11) with the obese group undergoing LC (n = 21). All groups were comparable in terms of age, sex, and symptoms (acute vs chronic). The obese groups undergoing LC and open cholecystectomy had similar weights (134.0 +/- 9.4 pounds over IBW [range, 100 to 286 pounds] and 133.8 +/- 6.0 pounds over IBW [range, 108 to 170 pounds], respectively) and were significantly different from the nonobese group undergoing LC (28.3 +/- 2.0 pounds over IBW [range, 23 to 98 pounds]). Parameters evaluated included operative time, resumption of normal diet, length of postoperative hospitalization, complications, conversion to open procedure, and ability to perform cholangiography. RESULTS: There were no statistically significant differences between the obese and nonobese groups undergoing LC in any parameters studied (operative time, 151.7 +/- 4.0 minutes vs 160.7 +/- 9.9 minutes; tolerance of diet, 1.2 +/- 0.1 days vs 1.1 +/- 0.1 days; time to discharge, 2.0 +/- 0.1 days vs 1.8 +/- 0.2 days; complications, 7.0% vs 0.0%). Operative time (117.6 +/- 11.6 minutes) was shorter (p = 0.45) in obese patients undergoing open cholecystectomy. However, time to normal diet and length of postoperative hospitalization were significantly longer (3.1 and 4.6 days, respectively; p less than 0.01), and there were more complications (18.2%). CONCLUSIONS: Rather than being contraindicated in the morbidly obese, LC appears to be the preferred method of cholecystectomy.

[The relationship between lipid peroxidation and platelet aggregation in atherosclerotic patients]. / Relación entre la peroxidación lipídica y la agregación plaquetaria en pacientes ateroscleróticos.

We studied 58 patients with arterial esteno-occlusive disease, 32 diabetics and 26 nondiabetics. Some parameters of lipid metabolism and platelet function were evaluated. We show the correlations founded among these parameters and we offer a possible explanation which support this behaviour.

[The effect of vitamin C on the lipolytic activity in type-II diabetics with angiopathy]. / "Efecto de la vitamina C sobre la actividad lipolítica en pacientes diabéticos tipo II con angiopatía".

Effects produced by different doses of Vit C (2, 3 and 4 gr/day) on lipoprotein and hepatic lipase activities were studied between a group of 35 ambulatory patients, men and women, affected by diabetes mellitus type II with macroangiopathy at lower limbs and/or food. The medium age of patients was 62 years, ranging from 44 to 82 years. Patients were aleatory divided into four groups. One from those four groups was treated with placebo, the other three received Vit C. In the group treated with 3 gr./day of Vit C we found a significant reduction and increase (p less than 0.05) of lipoprotein and hepatic lipase activities, respectively, when we compared outcomes before and after eight weeks of treatment with Vit C. By other hand, when we compared the different groups, we found a significant increase in the hepatic lipase activity in the same group, particularly between the patients whose plasmatic Vit C levels before treatment were reduced. We didn't found any significant change in the rest of parameters.

Floating boom performance under waves and currents.

Floating booms constitute a fundamental tool for the protection of marine and coastal ecosystems against accidental oil spills. Their containment performances in exposed areas are often impaired by the action of waves, currents and winds in a manner which is dependent on the boom's response as a floating body, and which is not fully understood at present. In this work the relationship between the design parameters of a floating boom section and its efficiency against the mode of failure by drainage under a variety of wave and current combinations is investigated by means of physical modelling. Seven boom models with different geometries and buoyancy-weight ratios are tested with an experimental setup that allows them to have and rotate freely. The model displacements under waves (both regular and irregular) and currents, as well as those of the free surface adjacent to the model, are measured with a Computer Vision system developed ad hoc. Two efficiency parameters are defined-the significant and minimum effective boom drafts-and applied to the results of an experimental campaign involving 315 laboratory tests. Thus, the manner in which the design parameters influence the boom's efficiency under different wave and current conditions is established.

Results of cholescintigraphy in a VA hospital.

In a review of 200 hepatobiliary imaging studies done in a VA hospital over a 5-year period, a sensitivity of 96% and a specificity of 88% were obtained. In a subgroup of 40 patients with alcoholic liver disease, the specificity dropped to 60% although the sensitivity remained high (100%). These data indicated that in patients with alcoholic liver disease a positive DISIDA scan is not diagnostic of acute cholecystitis and cannot be interpreted as an indication for cholecystectomy. Possible modifications of imaging techniques, including delayed imaging and morphine-augmented cholescintigraphy, may prove to increase the specificity of cholescintigraphy in these patients. A prospective study using these modifications would help in determining the current role of cholescintigraphy in the diagnosis of acute cholecystitis in patients with alcoholic liver disease.

Feeding in the first month of life, by social strata, in Córdoba, Argentina.

A study was made of the feeding history from birth to 1 month of age in a cohort of children born and residing in the city of Córdoba, Argentina, in 1993. The sample was divided into six social strata, in accordance with the occupation of the individual primarily responsible for family support. A total of 620 mothers were surveyed 1 month (mean = 31 days; SD = 1.2 days) following delivery in order to obtain information on the occupational, housing, and demographic characteristics of the family. In addition, information was collected on the first food given to infants following birth as well as on the type of food received at 1 month of age, the latter being based on 24-hour recall. The living conditions and demographic characteristics of the families were associated with their social strata. Families in Stratum I (high) and strata II and III (intermediate) tended to have higher standards of living and to have parents who were older when the children were born than did families in the lowest strata (V and VI), while families in Stratum IV tended to approach the average values found for the entire sample. With regard to feeding practices, it was found that 98% of the children had begun breast-feeding during the first week of life. A statistical association was observed between first food and social strata, with breast-feeding being more prevalent among the very low strata (V and VI) and use of bottle feeding being more prevalent in strata I and III. At 1 month of age, 26% of the sample was receiving complete natural breast-feeding, 60% was receiving partial natural breast-feeding, and 14% was being entirely bottle-fed. A significant association (P < 0.05) was observed between type of breast-feeding and social strata, with a figure of 38% complete natural breast-feeding recorded for Stratum I as compared to 16% for Stratum IV and 17% for Stratum V. Other findings of this study that stood out were that a high percentage of children in all the strata were initially breast-fed; a high percentage of the children were given breast-milk substitutes during the first month of life; and a low prevalence of complete natural breast-feeding was observed at 1 month of age.

An outcome analysis of carotid endarterectomy: the incidence and natural history of recurrent stenosis.

PURPOSE: This report identifies the incidence of recurrent carotid stenosis after carotid endarterectomy (CEA) and records the natural history of the disease process to gain further insight into its proper management. METHODS: A prospective surveillance protocol with duplex imaging and velocity spectral analysis was used to detect recurrent stenosis ( > 50% diameter reduction) and to document the clinical outcomes of patients who underwent CEA. Between 1984 and 1993, 619 consecutive CEAs were performed in 587 patients. RESULTS: Recurrent carotid stenosis developed in 48 CEA sites (7.8%) during a mean follow-up interval of 34 months (range, 2 to 118 months). Normal results on intraoperative assessment correlated with a 5.6% incidence of recurrent stenosis, compared with a 19% incidence when a residual hemodynamic abnormality was present (p < 0.0003). In the first year after surgery, there were no transient ischemic attacks, strokes, or carotid occlusions from recurrent stenosis, compared with a 27% morbidity rate in later follow-up (p < 0.01). Three patients with recurrent stenosis subsequently had occlusion at the CEA site, two of whom had severe ipsilateral strokes. CONCLUSIONS: The incidence of recurrent carotid stenosis is low. Patients are at significant risk for neurologic morbidity when a recurrent stenosis occludes. With a 0.3% incidence of late stroke resulting from carotid bifurcation disease, these data confirm that CEA does provide long-term protection from stroke.

In vivo crushing of an aortic stent enables endovascular repair of a large infrarenal aortic pseudoaneurysm.

PURPOSE: To report an unusual approach to endovascular exclusion of a large aortic pseudoaneurysm. METHODS AND RESULTS: A 63-year-old male had an unsuccessful endovascular repair of an aortic anastomotic pseudoaneurysm that left an expanded, uncovered Palmaz stent lying obliquely within the aorta. After nearly 3 years, the pseudoaneurysm enlarged to 7 cm, and the patient became symptomatic. Repair of the pseudoaneurysm was accomplished by crushing the indwelling stent to allow placement of a stent-graft. CONCLUSIONS: Malpositioned stents that are hindering an endoluminal procedure may be crushed against the arterial wall in vivo to facilitate passage of endovascular instruments or devices.

Using dipyridamole-thallium imaging to reduce cardiac risk in aortic reconstruction.

UNLABELLED: Cardiac morbidity and mortality remain the major operative risk following aortic reconstruction (AR) performed for aneurysmal and occlusive disease. We reviewed the preoperative cardiac evaluation and outcome in 209 patients who had AR between 1987 and 1992. Dipyridamole-thallium stress test (DTST) was performed in 147 (70.3%) patients. Fifty-six of these patients had a normal DTST and only 1 (1.8%) had a perioperative myocardial infarction (MI). Forty-six patients had a fixed defect on their DTST and 3 (6.5%) had perioperative MI. Forty-five patients had reversible defects on their DTST and 2 (4.4%) had perioperative MI with 1 cardiac death. Following DTST, 29 coronary catheterizations were performed. Ten catheterizations were normal or had minimal one-vessel coronary artery disease with an associated postoperative death in 1 patient due to cardiac dysrhythmia. Nineteen patients had abnormal coronary angiography, 1 of whom had a perioperative myocardial infarction and 5 of whom underwent coronary artery revascularization (CABG) (3) or percutaneous transluminal angioplasty (2) prior to AR without subsequent cardiac events. Forty-three (20.6%) had either no cardiac symptoms (40) or prior CABG (3) precluding invasive cardiac evaluation. There was one fatal perioperative myocardial infarction (2.3%), resulting in a cardiac mortality of 2.3% in this group. The remaining 19 patients who did not have a DTST (9.1%) had coronary angiography based on evidence of significant cardiac disease resulting in one CABG and one percutaneous transluminal angioplasty. There was one (5.3%) perioperative myocardial infarction in this group and no cardiac deaths. Thirty-day mortality was 3.8%, perioperative MI rate was 3.8%, and perioperative cardiac mortality was 1.0%. During the follow-up period (median, 18 months; range, 1-89), there were 19 deaths (10%) and the 5-year cumulative survival was 76%. CONCLUSION: Selective use of DTST can direct further evaluation, intervention, and subsequent perioperative care. This algorithm has enabled us to perform AR even in patients with defined perfusion abnormalities with acceptable morbidity. The true sensitivity, specificity, and predictive value of DTST can only be determined by a prospective trial.