The KNee OsteoArthritis Prediction (KNOAP2020) challenge: An image analysis challenge to predict incident symptomatic radiographic knee osteoarthritis from MRI and X-ray images.

OBJECTIVES: The KNee OsteoArthritis Prediction (KNOAP2020) challenge was organized to objectively compare methods for the prediction of incident symptomatic radiographic knee osteoarthritis within 78 months on a test set with blinded ground truth. DESIGN: The challenge participants were free to use any available data sources to train their models. A test set of 423 knees from the Prevention of Knee Osteoarthritis in Overweight Females (PROOF) study consisting of magnetic resonance imaging (MRI) and X-ray image data along with clinical risk factors at baseline was made available to all challenge participants. The ground truth outcomes, i.e., which knees developed incident symptomatic radiographic knee osteoarthritis (according to the combined ACR criteria) within 78 months, were not provided to the participants. To assess the performance of the submitted models, we used the area under the receiver operating characteristic curve (ROCAUC) and balanced accuracy (BACC). RESULTS: Seven teams submitted 23 entries in total. A majority of the algorithms were trained on data from the Osteoarthritis Initiative. The model with the highest ROCAUC (0.64 (95% confidence interval (CI): 0.57-0.70)) used deep learning to extract information from X-ray images combined with clinical variables. The model with the highest BACC (0.59 (95% CI: 0.52-0.65)) ensembled three different models that used automatically extracted X-ray and MRI features along with clinical variables. CONCLUSION: The KNOAP2020 challenge established a benchmark for predicting incident symptomatic radiographic knee osteoarthritis. Accurate prediction of incident symptomatic radiographic knee osteoarthritis is a complex and still unsolved problem requiring additional investigation.

The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units.

OBJECTIVES: Rectal bleeding is very common in the general population. It is produced mainly because of benign disease originating in the anus and the rectum. Our aim was to evaluate the need for colonoscopy in patients presenting with rectal bleeding. PATIENTS AND METHODS: Patients referred from Primary Care Units and complaining of rectal bleeding were included prospectively in a three-month study. All patients underwent a careful medical history along with physical examination, laboratory tests, and colonoscopy. RESULTS: 126 patients with a mean age of 49.2 years (range: 19-80) were studied. Rectal digital examination was abnormal in 75 cases (59.5%). Severe disease was encountered in 22 patients (neoplasm, angiodysplasia, and inflammatory bowel disease); 10 patients had polyps, 6 had colorectal cancer, and 6 had inflammatory bowel disease. Out of 63 patients younger than 50 years, 5 had severe disease, all of them in the form of inflammatory bowel disease. CONCLUSIONS: A neoplasm of the rectum and colon in patients younger than 50 years is a rare event. A colonoscopy must be performed in this group of patients to rule out inflammatory bowel disease.

Determination of volatile compounds in Txakoli wine from Biscay by gas chromatography-mass spectrometry.

An analytical method combining a Soxhlet extraction and gas chromatography with mass spectrometric detection is proposed for the determination of volatile compounds in samples of Txakoli from Biscay (region located in the north of Spain). The use of direct injection was compared with the results obtained from the organic extract. The extraction of the compounds from the matrix was performed with dichloromethane-hexane (1:1, v/v). Both procedures were applied to the study of Txakoli varieties of wine.

Determination of acids and volatile compounds in red Txakoli wine by high-performance liquid chromatography and gas chromatography.

The Txakoli is a wine from the north of Spain with acid characteristics and medium ethanol content. We report the comparative results obtained from red Txakoli elaborated with different grape varieties. We have used chromatographic methods for the characterization of this wine. The volatile compounds were analyzed the means of gas chromatography and the organic acid content was determined by a newly validated liquid chromatographic procedure. The aim of this study is to characterize the red Txakoli and to know the major differences between Hondarrabi Beltza grape variety and the other varieties. Hondarrabi Beltza grape variety is the one which was awarded the Generic Label. The major differences observed in the samples obtained from Hondarrabi Beltza variety are their higher contents in ethanol, propanol, ethyl acetate and tartaric and malic acids.

Squamous cell carcinoma of the oesophagus in a patient with Klippel-Trenaunay syndrome.

The Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by a triad of port-wine stains, varicose veins, and bony or soft tissue hypertrophy of one extremity. Digestive bleeding is the most commonly observed gastrointestinal manifestation. In rare cases, the syndrome is associated with malignancies. We report the case of a 38-year-old woman with KTS and dysphagia caused by an oesophageal squamous cell carcinoma.

[Tolerance to and colon cleansing with 2 preparations. Polyethylene glycol or sodium phosphate]. / Tolerancia y limpieza del colon con dos preparaciones. Polietilenglicol o fosfato sódico.

OBJECTIVE: To compare colon cleansing and tolerance with two preparations: polyethylene glycol 4-liters (PEG) and sodium phosphate (FS). MATERIAL AND METHODS: Prospective randomized study of 100 consecutive patients who underwent endoscopy after taking PEG (Bohm lavage solution) or FS (Fosfosoda). All patients were evaluated for the presence of adverse effects, degree of discomfort of the preparations (1: mild, 2: moderate, 3: severe) and the degree of cleansing with the products (1: poor, 2: fair, 3: good, 4: excellent). RESULTS: Age, sex, depth of insertion and surgical history were similar for both groups. Discomfort in the FS group was mild in 37, moderate in 11 and severe in 2 (mean score 1.30 +/- 0.54); in the PEG group it was mild in 28, moderate in 15 and severe in 7 (mean score 1.58 +/- 0.73). Colon cleansing was poor or fair in 11 (22%) patients in the PEG group and in 8 (16%) patients in the FS group and was good or excellent in 39 (78%) in the PEG group in comparison with 42 (84%) in the FS group. Among the 50 patients who took the FS preparation, 12 had previously taken the PEG preparation and 11 of these preferred the FS preparation. Among the 50 patients who took the PEG preparation, 10 had previously taken preparations: 4 had used enemas (considering the present PEG to be worse) and 6 had taken the same PEG as that used in the present study (p < 0.005). One patient in the FS group and four in the PEG group did not complete the preparation because of vomiting. The adverse effects of both preparations were similar. CONCLUSIONS: The adverse effects and degree of colon cleansing were similar for FS and PEG. Tolerance and patient comfort were greater with FS than with PEG.

[Comparative study of the eradication of Helicobacter pylori: ranitidine bismuth citrate versus omeprazole plus two antibiotics for seven days]. / Estudio comparativo en la erradicación del Helicobacter pylori: ranitidina-citrato bismuto frente omeprazol más dos antibióticos durante 7 días.

AIMS: To compare the efficacy of ranitidine bismuth citrate (RB) combined with two antibiotics during seven days in comparison with OCA-7 for treatment of Helicobacter pylori. METHODS: In a randomized clinical trial 200, consecutive patients infected by Helicobacter pylori were studied prospectively. One of two regimens was given for 7 days; OCA-7 (omeprazole 20 mg b.i.d., amoxycillin 1 gr b.i.d., clarithromycin 500 mg b.i.d.) or RBCA (RB 400 b.i.d., amoxicillin 1 gr b.i.d., clarithromycin 500 mg b.i.d.). Eradication was defined as a negative breath test one month after therapy. RESULTS: 112 male and 88 female with a mean age of 48 years (range 18-82). 100 patients were randomized to OCA-7 and 100 patients to RBCA-7. Overall 186 patients completed the treatment. Intention to-treat eradication was in the group OCA-7 of 72% and 73% in group RBCA-7. Per-protocol eradication was in the group OCA-7 of 78% and 77% in group RBCA-7 (p = 0.3). Five patients in the group OCA-7 and nine in the group RBCA-7, had side effects, three of these patients did not complete therapy by diarrhea. CONCLUSIONS: RB with two antibiotics is as effective and safe as OCA-7 for the eradication of Helicobacter pylori.

[Irritable bowel syndrome in patients under age 55 with dyspeptic syndrome]. / Síndrome de intestino irritable en pacientes con síndrome dispéptico menores de 55 años.

The presence of IBS was studied in 289 patients under 55 years of age with dyspeptic syndrome. The subjects were divided into two groups: group I (240 patients with DS) and group II (49 patients with DS and IBS). The mean duration of follow%shy;up was 10.8 years (130 months). IBS was diagnosed in 49 patients (17%). Females accounted for 64% and 77% of groups I and II, respectively (p < 0.05). There were no differences in mean age or the type of FDS. The patients in group II consulted more often and earlier (92% returned for consultation, and took 27 months in doing so) than those in group I (52% and 40 months)(p < 0.05). The number of diagnostic tests requested was greater in group II. Psychiatric pathology was in turn more common in group II than in group I (20 versus 7%)(p < 0.05).

Muertes por suicidio en la Región de Tarapacá, años 1990-2013 / Suicides death in the Region of Tarapacá, years 1990-2013

Introduction: It presents the update of an epidemiologic descriptive study of deaths by suicide that took place in the Tarapacá region, Chile. The study encompasses almost a quarter of a century, between the years 1990 and 2013, and brings interesting information with respect to the tendencies of the phenomenon along an extensive period of time. Method: A retrospective epidemiologic descriptive study of type transvensal of deaths classified as violent in the autopsy protocols of the Servicio Médico Legal of the city of Iquique and the medical death certificate. Results: In a total of 565 cases, a general rate of suicide for this period of 9,18 for 100.000 hab has been noted, with variations of the annual rates between 4, 95 in the year 1995 and 13, 97 in the year 1999. It was observed that suicide was more frequent between the ages 20 and 44 years, with a relation men-women of 5,3:1. Conclusions: The previous study (2010) confirmes a tendency to the stabilization of the increasing rates observed in the past decade. In figures this rate was somehow inferior to the general rate of suicide of the country in the year 2011 (13,3 for 100.00 hab.), but it doubled the registered rates in the 90’s.

Introducción: Se presenta la actualización de un estudio epidemiológico descriptivo de las muertes por suicidio ocurridas en la región de Tarapacá, Chile, abarcando casi un cuarto de siglo, entre los años 1990 y 2013, lo que aporta una interesante información respecto del movimiento tendencial del fenómeno a lo largo de un período extenso de tiempo. Método: Estudio epidemiológico descriptivo de tipo retrospectivo transversal a partir de las muertes clasificadas como violentas en los protocolos de autopsias del Servicio Médico Legal de Iquique y del certificado médico de defunción. Resultados: En un total de 565 casos, constatamos una tasa general de suicidio para el período de 9,18 por 100.000 hab., con variaciones de tasas anuales que van entre 4,95 el año 1995 y 13,97 el año 1999; se observó que el suicidio fue más frecuente entre los 20 y los 44 años, con una relación hombre-mujer de 5,3:1. Conclusiones: Respecto del estudio anterior (2010) se confirma una tendencia a la estabilización del alza de tasas observada en la década anterior, en cifras algo inferiores a la tasa general de suicidio del país en el año 2011 (13,3 por 100.000 hab.), pero el doble respecto a las tasas registradas en los años noventa.

Prevalencia del suicidio en la Región de Tarapacá, años 1990-2008 / Prevalence of suicide in the Region of Tarapacá, years 1990-2008

Hemos llevado a cabo un estudio epidemiológico descriptivo de las muertes de tipo suicida en Tarapacá, Chile, entre los años 1990 y 2008, obteniéndose interesantes datos acerca del comportamiento de este fenómeno en una zona extrema, con indicios de una compleja adaptación social y dificultades en la integración individual. En un total de 432 casos, por ejemplo, la tasa de suicidio varió de un 6,11 por 100.000 hab. en 1990 a 13,32 por 100.000 hab. en 2008; se observó que el suicidio fue más frecuente entre los 20 a 44 años, especialmente en hombres, con una proporción cercana a 6:1, siendo el mecanismo más utilizado el ahorcamiento, tanto entre hombres como mujeres. Otro punto interesante lo constituye el hecho de que la tasa de suicidio a partir de 1996 se duplica respecto a los años precedentes, excediendo las tasas de otras regiones del país, la tasa nacional de suicidio y la de muchos países de la región y de Europa, constituyéndose en la segunda causa de muerte violenta en la provincia, lo cual nos retrotrae al complejo fenómeno biopsicosocial involucrado en la génesis del suicidio.

We carried out an epidemiological descriptive study of suicidal type deaths in Tarapacá, Chile, between 1990 and 2008, collecting interesting information about the behavior of this phenomenon in an extreme zone, with indicators of a complex social adjustment and difficulties in individual integration. In a whole of 432 cases, for example, the rate of suicide changed from 6.11 for 100.000 hab. in 1990 to 13.32 for 100.000 hab. in 2008; we observe that the suicide was more frequent in ages between 20 to 44 years, especially in men with a nearby proportion of 6:1, being the mechanism most used in both sexes, the hanging. Another interesting point constitutes the fact that the rate of suicide from 1996 doubled in relation to previous years, exceeding the rates of other regions of the country, the national rate and the rate of many American countries and even some European countries, being constituted in the second cause of violent death in our province, which makes us think about the complex phenomenon biopsicosocial involved in the genesis of the suicide.

Utilidad de la colonoscopia en pacientes derivados desde Atención Primaria por rectorragia / The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units

Objetivos: la rectorragia es frecuente en la población general. En la mayoría de las ocasiones está producida por patología anorrectal benigna. Nuestro objetivo era determinar la necesidad de realizar pruebas endoscópicas en pacientes con rectorragia. Pacientes y métodos: se incluyeron de forma prospectiva durante tres meses todos los pacientes que eran derivados desde la Atención Primaria por rectorragia. En todos los pacientes se realizó historia clínica y exploración física que incluía tacto rectal, analítica básica y una colonoscopia.Resultados: se incluyeron 126 pacientes con una edad mediade 49,2 años (19-80). El tacto rectal fue anormal en 75 (59,5%). En 22 pacientes se encontró patología severa o positiva (lesiones neoplásicas, angiodisplasias y enfermedad inflamatoria intestinal); 10 pacientes pólipos, en 6 cáncer colorrectal y en 6 enfermedadinflamatoria intestinal. De los 63 pacientes menores de 50 años, 5 presentaron patología severa todos ellos con enfermedad inflamatoria intestinal. Conclusiones: la patología neoplásica en menores de 50 años con rectorragia es rara. Se debe realizar una rectoscopia eneste grupo de edad para descartar una enfermedad inflamatoria intestinal

Objectives: rectal bleeding is very common in the general population. It is produced mainly because of benign disease originating in the anus and the rectum. Our aim was to evaluate the need for colonoscopy in patients presenting with rectal bleeding. Patients and methods: patients referred from Primary Care Units and complaining of rectal bleeding were included prospectively in a three-month study. All patients underwent a careful medical history along with physical examination, laboratory tests, and colonoscopy. Results: 126 patients with a mean age of 49.2 years (range: 19-80) were studied. Rectal digital examination was abnormal in 75 cases (59.5%). Severe disease was encountered in 22 patients (neoplasm, angiodysplasia, and inflammatory bowel disease); 10 patients had polyps, 6 had colorectal cancer, and 6 had inflammatory bowel disease. Out of 63 patients younger than 50 years, 5 had severe disease, all of them in the form of inflammatory bowel disease. Conclusions: a neoplasm of the rectum and colon in patients younger than 50 years is a rare event. A colonoscopy must be performed in this group of patients to rule out inflammatory bowel disease

Estudio comparativo en la erradicación del Helicobacter pylori: ranidinacitrato bismuto frente omeprazol más dos antibióticos durante 7 días / Ranitidine bismuth citrate versus omeprazole plus two antibiotics for Helicobacter pylori eradication during one week

Objetivos: Comparar la eficacia en la erradicación del Helicobacter pylori con ranitidina-citrato bismuto (RB) frente al tratamiento clásico con omeprazol. Material y métodos: Se estudiaron de forma prospectiva y randomizada la eficacia de erradicación en 200 pacientes consecutivos con dos pautas de tratamiento; OCA-7 (omeprazol 20 mg/12 horas, amoxicilina 1g/12 horas, claritromicina 500 mg/12 horas durante 7 días) y RBCA-7 (RB 400 mg/12 horas, amoxicilina 1g/12 horas, claritromicina 500 mg/12 horas durante 7 días). La erradicación se valoró con el test del aliento al menos 4 semanas de finalizar el tratamiento.Resultados: 112 hombres y 88 mujeres con una media de edad de 48 años (18-82 años). 100 pacientes eran randomizados a OCA-7 y 100 pacientes a RBCA-7. En total 186 pacientes completaban todo el estudio. La tasa de erradicación por intención a tratar en el grupo OCA-7 fue del 72 por ciento y del grupo RBCA-7 del 73 por ciento. La tasa de erradicación por protocolo en el grupo OCA-7 fue del 78 por ciento y del grupo RBCA-7 del 77 por ciento (p=0,3). Cinco pacientes del grupo OCA-7 y 9 pacientes del grupo RBCA-7 relataron efectos secundarios, 3 de estos últimos suspendieron el tratamiento por diarrea. Conclusiones: Ranitidina citrato bismuto más dos antibióticos es tan eficaz y segura como el tratamiento clásico con omeprazol en la erradicación del Helicobacter pylori. (AU)

Síndrome de intestino irritable en pacientes con síndrome dispéptico menores de 55 años / Irritable bowel syndrome in patients under age 55 with dyspeptic syndrome

Se estudió la presencia de síndrome intestino irritable (SII) en 289 pacientes menores de 55 años con síndrome dispéptico (SD). El número de pacientes diagnosticados de SII fue 49 (17 por ciento).El grupo I se consideró a los pacientes con SD (240 pacientes), mientras que el grupo II eran los pacientes con SD y SII (49 pacientes). El grupo II acudió con más frecuencia a las consultas y antes (92 por ciento volvio a las consultas y tardaron 27 meses en volver) que los pacientes del grupo I (52 por ciento y 40 meses) (p<0,05). El número de pruebas diagnósticas solicitadas fue superior en los pacientes del grupo II. La patología psiquiátrica fue más frecuente en el grupo II que en el grupo I (20 por ciento frente al 7 por ciento) (p<0,05). Los pacientes con SD que son diagnosticados de SII, acuden con más frecuencia y antes a la consulta. El número de pruebas diagnósticas solicitadas por paciente es mayor en los pacientes con SII y SD (AU)