RESUMEN
KEY MESSAGE: Rice breeding programs based on pedigree schemes can use a genomic model trained with data from their working collection to predict performances of progenies produced through rapid generation advancement. So far, most potential applications of genomic prediction in plant improvement have been explored using cross validation approaches. This is the first empirical study to evaluate the accuracy of genomic prediction of the performances of progenies in a typical rice breeding program. Using a cross validation approach, we first analyzed the effects of marker selection and statistical methods on the accuracy of prediction of three different heritability traits in a reference population (RP) of 284 inbred accessions. Next, we investigated the size and the degree of relatedness with the progeny population (PP) of sub-sets of the RP that maximize the accuracy of prediction of phenotype across generations, i.e., for 97 F5-F7 lines derived from biparental crosses between 31 accessions of the RP. The extent of linkage disequilibrium was high (r 2 = 0.2 at 0.80 Mb in RP and at 1.1 Mb in PP). Consequently, average marker density above one per 22 kb did not improve the accuracy of predictions in the RP. The accuracy of progeny prediction varied greatly depending on the composition of the training set, the trait, LD and minor allele frequency. The highest accuracy achieved for each trait exceeded 0.50 and was only slightly below the accuracy achieved by cross validation in the RP. Our results thus show that relatively high accuracy (0.41-0.54) can be achieved using only a rather small share of the RP, most related to the PP, as the training set. The practical implications of these results for rice breeding programs are discussed.
Asunto(s)
Genoma de Planta , Oryza/genética , Fitomejoramiento , Enfermedades del Desarrollo Óseo , Anomalías Craneofaciales , Frecuencia de los Genes , Genotipo , Hiperostosis , Hipertelorismo , Desequilibrio de Ligamiento , Modelos Genéticos , FenotipoRESUMEN
Rupture of the quadriceps tendon is an uncommon injury observed predominantly in subjects over 40 years old. Multiple surgical techniques have been employed to repair fresh and neglected ruptures; methods that make use of allograft and augmentation with tissues harvested from around the knee have been reported. We describe a case of surgical repair of a tendon-bone junction rupture in a 64-year-old patient by use of suture anchors to attach the tendon to bone and improve fixation of the soft tissue elements. Clinical diagnosis of rupture was confirmed radiographically and echographically. Surgical repair was performed within 24 hours of injury. Active movement of the knee started after 3 weeks and the patient was permitted to walk without weight-bearing with a knee cage. Three weeks later, he was permitted to walk with full weight-bearing unassisted by crutches; the knee cage was removed 6 weeks after surgery. At his most recent follow-up 24 months postoperative, quadriceps strength was equal to that of the controlateral knee and the patient has returned to sports and daily activities. The surgical method presented here provides a suture of the tendon ends without putting excess stress on the suture line during the period of early knee mobilization. Advantages over other techniques include reduced operative time, easy access to the implantation site, and better resistance of the suture material: the patient is thus able to initiate physical therapy earlier and more aggressively.
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Procedimientos Ortopédicos/métodos , Traumatismos de los Tendones/cirugía , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Rotura/diagnóstico por imagen , Rotura/cirugía , Traumatismos de los Tendones/diagnóstico por imagenRESUMEN
BACKGROUND: The worldwide increased incidence in fractures of the proximal end of the femur is increasing with the parallel increase in the average age of the population. The advanced age and poor physical condition of these patients render surgery necessary. METHODS: In 1999, at the Orthopaedic Clinic of the University of Siena, 56 patients were treated with the compression hip nail-plate system, a new synthesis device for the treatment of peritrochanteric fractures. The system consists of a new dynamic cephalic screw that could be combined with a plate or a femoral nail. The dynamic cephalic screw of the BCM system has a limited sliding method, impeding excursions greater than 10 mm and preventing excessive collapse of the fracture fragments that can evolve into a shortening of the limb. The canulated nail has a diameter of only 9 mm, which permits insertion into the shaft canal without reaming. RESULTS: Four patients with a follow-up of less than 3 months, 2 patients lost to control, and 1 patient who died were excluded from the study. All 49 remaining patients healed clinically and radiographically within 3 months. CONCLUSIONS: The possibility of the double combination of the screw with a plate or with an intramedullary nail permits the surgeon to have a double solution with a single instrument at hand, and offers the opportunity of changing the choice of synthesis method to implant even during surgery.
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Fijación Intramedular de Fracturas/instrumentación , Fracturas de Cadera/cirugía , Anciano , Anciano de 80 o más Años , Clavos Ortopédicos , Placas Óseas , Tornillos Óseos , Femenino , Fracturas de Cadera/diagnóstico por imagen , Humanos , Masculino , RadiografíaRESUMEN
Septic arthritis due to Streptococcus Pneumoniae appears to be relatively uncommon. Single- or clustered-case histories constitute the majority of reports on pneumococcal septic arthritis. A 70-year-old man presented with a 7-day history of pain, erythema and swelling of the left shoulder. Physical examination of the left shoulder revealed a warm, swollen, erythematous, and markedly tender to light palpation. The patient was unable to elevate his arm more than 30 degrees without pain. Arthrocentesis performed on admission produced 30 cc of grossly purulent fluid whose culture demonstrated S. Pneumoniae. The septic arthritis was treated with intravenous vancomycin and imipenem. The antibiotics were substituted when the sensitivities were known with oral ciprofloxacin and rifampycin to complete 8 weeks' total treatment. On follow-up examination 1 year later, the patient has remained afebrile and asymptomatic without evidence of increasing joint effusion or acute joint inflammation. Pneumococcal arthritis is classically described as a painful monoarticular arthritis complicating an active pneumococcal infection, generally a primary pulmonary infection. Pneumococcal arthritis appears to be predominantly a disease affecting the elderly. Clinical presentation ranges from septicemia to indolent infection with few systemic symptoms. With adequate antibiotic therapy and aspiration or drainage of the joint, the prognosis for return of normal joint function appears to be excellent. Although pneumococcal organisms are not likely causes, this bacteria should certainly be considered as a possible cause of arthritis or prosthetic infection.
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Artritis Infecciosa/etiología , Infecciones Neumocócicas/etiología , Anciano , Antibacterianos , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/tratamiento farmacológico , Ciprofloxacina/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Humanos , Masculino , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/tratamiento farmacológico , Rifampin/uso terapéutico , Articulación del HombroRESUMEN
Standard heparin is still considered as a reference point for anticoagulation in CEC, although its use is not totally devoid of long-term and short term side effects, considering the risk of hemorrhage that patients undergo during dialysis. Numerous attempts have been made in the search for an alternative anticoagulating method. The recent discovery that low molecular weight fractions (LMWH) of standard heparin (UFH) assure the same antithrombotic effect but with a minor anticoagulating action, points to such a drug as an interesting alternative to the traditional use of heparin during dialysis. Our present task is to evaluate the purifying efficiency of different cuprophan and synthetic membranes with two LMWH and UFH, measuring the instantaneous ureic clearance of different dialysers at the start and end of each dialysis. N. 43 chronic patients were examined whilst undergoing different methods of treatment; using 12 different kinds of membrane, for a total of 22 filters. Every patient underwent a dialysis using each kind of heparin at least once, for a total of 189 dialysis. Neither the initial nor the final ureic clearances, nor the percentage of decreasing had changed by using different types of heparin and membranes with diverse thrombogenicity and ultrafiltration capacities. We may conclude from the results of the tests that the purifying efficiency of small molecules, judging from the istantaneous clearances, do not significant results compared to UFH.
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Heparina/farmacocinética , Diálisis Renal , Heparina de Bajo-Peso-Molecular/farmacocinética , Humanos , Tasa de Depuración MetabólicaRESUMEN
Having analysed the results of a large series of patients, the Authors propose endocervical examination as a vital step to be performed at the same time as colposcopy or, in certain well identified cases, following cytohistological results. Endocervical examination either before or after colposcopy is then described in a protocol taking into account the various parameters. The most important are: the assessment of the squamocolumnar line, the type of colposcopic lesion, and cytohistological findings. Following a brief discussion of traditional diagnostic tests (endocervical curettage, endocervical observation using Kagan forceps), the Authors underline the importance of the endocervicoscope which allows a closer, noninvasive and precise evaluation to be made.
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Colposcopía/métodos , Enfermedades Uterinas/diagnóstico , Neoplasias Uterinas/diagnóstico , Cuello del Útero , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades Uterinas/patología , Neoplasias Uterinas/patologíaRESUMEN
We performed an open study on 37 patients (average age 35 years), with CIN III or VAIN III and Viral Cytopatic Effects (VCE), who underwent a new standardized bifasic therapy by means of intralesional beta-interferon, topic beta-interferon and subcutaneous timopentine injection. Each therapeutic and checking step was made by colposcopic and microcolpohysteroscopic inspection, which showed spreading necrotic zones in the dysplastic places and peripheral typical epithelium replacement. Microcolpohysteroscopy allowed us to obtain correct diagnosis of the lesion and its location, to discriminate each pathologic aspects (CIN, VAIN, VCE), to perform an adeguated biopsy and intralesional therapy and to follow-up lesion course without repeated biopsies. After two months of therapy as maximum safety limit, we performed conization (in CIN case) in order to confirm the effects of therapy by hystology and especially to evaluate the deep lesional border. The istologic examination underlined the previous microcolpohysteroscopic report of dysplastic regression until its disapperance, with lasting VCE in all the cases.
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Interferón Tipo I/administración & dosificación , Fragmentos de Péptidos/uso terapéutico , Timopoyetinas/uso terapéutico , Hormonas del Timo/uso terapéutico , Infecciones Tumorales por Virus/tratamiento farmacológico , Displasia del Cuello del Útero/tratamiento farmacológico , Enfermedades Vaginales/tratamiento farmacológico , Adyuvantes Inmunológicos/uso terapéutico , Administración Tópica , Efecto Citopatogénico Viral , Sondas de ADN de HPV , Evaluación de Medicamentos , Femenino , Humanos , Interferón Tipo I/uso terapéutico , Papillomaviridae/efectos de los fármacos , Papillomaviridae/inmunología , Fragmentos de Péptidos/administración & dosificación , Timopentina , Timopoyetinas/administración & dosificación , Infecciones Tumorales por Virus/inmunología , Infecciones Tumorales por Virus/patología , Displasia del Cuello del Útero/inmunología , Displasia del Cuello del Útero/patología , Enfermedades Vaginales/inmunología , Enfermedades Vaginales/patologíaRESUMEN
PURPOSE: To compare the development of the visual pathway in healthy preterm and full-term newborns using flash and patterned (both transient and steady-state) visual-evoked potentials (fVEP, pVEP-t, pVEP-ss). PATIENTS AND METHODS: Twenty-nine preterm newborns (28-35 weeks gestational age) were evaluated at four different times: at 3 months postnatal and corrected age, at 8 months postnatal and corrected age. They were matched with 92 term newborns tested at 3 and 8 months of life. RESULTS: The maximal perceived spatial frequencies in the groups were: 2 C/d at 3 months postnatal age, >2 C/d at 3 months corrected age and at 3 months at term, between 3 and 5C/d, >=5C/d at 8 months corrected age and at 8 months of life, respectively. The latencies of the P1 and P100 waves for the flash and the transient stimulation were, respectively, 192 ms and 207.9 ms at 3 months postnatal age, 144 ms and 137.7 ms at 3 months corrected age, 126.3 ms and 124.1 ms at 8 months postnatal age, 112.7 ms and 112.5 ms at 8 months corrected age, 137.3 and 110.1 ms at 3 months of life; and 122.3 and 100.5 ms at 8 months of life. DISCUSSION: In the preterm infants of 3 gestational months, the latencies of the fVEP are comparable to those of the 3-month-old full-term infants, although the pVEP-t latencies are still delayed at 8 months. In the fVEP; however, we noted a shorter latency in the preterm infants at 8 months corrected age compared to those of the full-term infants. This tendency inversion was also evidenced at the steady-state stimulation. CONCLUSIONS: As evidenced by our results, at 8 months of corrected age the preterm infants recovered the fVEP and pVEP-ss, but not the pVEP-t. Different results obtained with different visual-evoked stimulations suggest that similar neural pools are developed in not completely equal amounts of time.
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Potenciales Evocados Visuales , Recien Nacido Prematuro , Vías Visuales/crecimiento & desarrollo , Vías Visuales/fisiopatología , Factores de Edad , Humanos , Recién NacidoRESUMEN
With the growing problem of elder abuse, it is imperative that physicians become aware of the warning signs of elder abuse. In addition, physicians must be knowledgeable in the diagnosis and treatment of elder abuse. Educated physicians can help to alleviate this problem.
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Abuso de Ancianos/diagnóstico , Evaluación Geriátrica , Rol del Médico , Anciano , Cuidadores/psicología , Abuso de Ancianos/prevención & control , Humanos , Relaciones Médico-Paciente , Derivación y ConsultaRESUMEN
BACKGROUND: Missed or chronic subscapularis tendon ruptures may have muscle atrophy and tendon retraction resulting in a large defect with high risk of re-tear after a surgical repair. To improve the clinical results of this challenging surgery, the repaired tendon could be augmented with endogenous or exogenous materials. The purpose of this study was to evaluate the structural tendon integrity and clinical outcomes after an open subscapularis tendon repair with a synthetic soft tissue reinforcement. MATERIALS AND METHODS: Ten patients were managed with an open repair of the subscapularis tendon with augmentation by means of SportMesh, a readily available synthetic degradable poly(urethaneurea) scaffold. Clinical findings were assessed for all patients preoperatively and postoperatively with use of the visual analog scale for pain and the DASH scoring system. All patients had an ultrasonographic study at the latest follow-up. RESULTS: The visual analog scale for pain (mean ± standard deviation) improved significantly (P < 0.01) from 7.9 ± 1.1 preoperatively to 1.95 ± 1.85 at the latest clinical follow-up evaluation. The mean DASH score at the latest clinical follow-up was 12.63 %. Ultrasound imaging revealed a structural intact repair at follow-up in 9 shoulders (90 %) with average 5.4 mm in thickness (4.3 mm in the contralateral healthy side). CONCLUSIONS: At a median follow-up of 23 months, 80 % (8 of 10) of patients had a good or excellent result after an open subscapularis tendon repair with a soft tissue reinforcement. As a synthetic material, SportMesh Soft Tissue Reinforcement eliminates the risk of collagen reactions, which may result from collagen or dermis patches. Although the follow-up is relatively short, our series shows a promising durable repair with a 10 % re-tear rate at an average of 23 postoperative months. Level of evidence Case Series, Treatment Study, Level IV.
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Prótesis e Implantes , Lesiones del Manguito de los Rotadores , Manguito de los Rotadores/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Ortopédicos/métodos , RoturaRESUMEN
OBJECTIVE: In order to improve our understanding of high-density lipoprotein cholesterol (HDL-C) cardiovascular (CV) impact in obesity, the association of HDL-C plasma level with circulating early endothelial progenitor cell (early-EPC) number and endothelium-dependent vasodilatation (EDV) in obese women with normal or high low-density lipoprotein cholesterol (LDL-C) plasma levels was evaluated. DESIGN AND METHODS: One hundred thirteen obese female subjects and a control group of 78 healthy female subjects were recruited. Circulating early-EPC were assessed by single- and two-color flow cytometric analyses with a fluorescence activated cell sorting (FACScan) flow cytometer. EDV was evaluated as response to ischemia by strain gauge plethysmography. RESULTS: Both early-EPC number and EDV were significantly decreased in obese women compared with the control group. Obese women with low HDL-C showed a further decrease of early-EPC and EDV in the presence of both high or normal LDL-C plasmatic levels. In the normal HDL-C level subgroup, hypercholesterolemic and nonhypercholesterolemic subjects showed no difference in early-EPC number, whereas slight EDV impairment was present in hypercholesterolemic subjects. CONCLUSION: In obese women, low HDL-C is associated to decreased early-EPC number and impaired EDV, suggesting the need to assess whether evaluation of early-EPC and EDV may increase HDL-C prognostic value in the stratification of CV risk.