Institutional arthroplasty registry: what is the minimum acceptable dataset to be included in your hospital? Recommendations from a single-country national consensus using the Delphi method.

PURPOSE: Institutional arthroplasty registries are very popular nowadays; however, very few efforts have been made in order to standardize the information to be collected, thus limiting the possibility of inter-institutional data interpretation. This manuscript reports the results of a single-country consensus designed to define the minimum standardized dataset to be recorded within an institutional arthroplasty registry. METHODS: A national consensus was carried out among all members of the Colombian Society of Hip and Knee Surgeons using the Delphi method. Eleven questions and answers comprising every potential domain of an institutional registry of hip and knee arthroplasty were defined. According to the methodology, anonymous voting and multiple discussion rounds were performed. Three levels of agreement were defined: Strong consensus: equal to or greater than 80%, weak consensus between 70 and 79.9%, and no consensus below 70%. RESULTS: All of the questions reached consensus level. The minimum dataset was defined to include demographic and clinical information, intraoperative and implant details, follow-up and early complications, implant survival, and functional outcome scores, as well as the validation model to assess information quality within the database. Currently, this dataset is being implemented voluntarily by the members of our national society. DISCUSSION: A national consensus is a feasible method to build homogeneous arthroplasty registries. We recommend such an exercise since it establishes the basis to compare and add data between institutions and the joint analysis of said information in a national registry.

La psicología de emergencias ante la COVID-19: enfoque desde la prevención, detección y gestión operativa del riesgo / No disponible

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Symptomatology and quality of life between two populations of climacteric women.

PURPOSE: The aim of this study is to compare climacteric symptomatology and sociodemographic conditions and their effect on quality of life in two populations: Monterrey (Mexico) and Madrid (Spain). METHODS: 469 women from Monterrey (mean age 50.5 + 4.3 years) and 452 (mean age 51.7 + 3.7 years) from Madrid participated in the study. Descriptive analyses of sociodemographic and clinics characteristics of the sample were performed. A cross-sectional design and a regression analysis were performed to establish the sociodemographic and clinical variables that would be used as predictors of quality of life. Data was collected using the Menopause-Specific Quality of Life, MENQOL, the Menopause Rating Scale (MRS), the Hospital Anxiety and Depression Scale (HADS), the Quality of Life Scale for Women Aged From 45 to 64 (QLS), and a sociodemographic and clinical interview designed ad hoc. RESULTS: Approximately 60% of both Spanish and Mexican women present symptoms during climacteric that impairs their quality of life. Spanish women suffer more intense symptoms and for a longer period of time than Mexican women, with the exception of anxiety. Mexican women report better quality of life than Spanish women and it is moderated by educational, socioeconomical, and marital status. Women's knowledge about menopause is also related to a better quality of life. CONCLUSIONS: Our study confirms the differences in climacteric symptomatology between populations and the impact of educational level and knowledge about menopause as predictors of a better quality of life in climacteric women.

Intention-to-treat survival analysis of hepatitis C virus/human immunodeficiency virus coinfected liver transplant: Is it the waiting list?

In human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients, the accelerated severity of liver disease, associated comorbidities, and mortality on the waiting list could change the possibility and results of liver transplantation (LT). Intention-to-treat survival analysis (ITTA) can accurately estimate the applicability and efficacy of LT. The primary objective of this study was to compare the survival of patients with HCV with and without HIV infection. We analyzed a cohort of 199 patients with HCV infection enrolled for LT between 1998 and 2015; 17 were also infected with HIV. The patients with HCV/HIV coinfection had higher mortality on the waiting list than those with HCV monoinfection (35.3% versus 4.6%; P < 0.001). ITTA at 1, 3, and 4 years was 75%, 64%, and 57% for HCV monoinfection and 52%, 47%, and 39% for HCV/HIV coinfection, respectively (Wilcoxon test P < 0.05). The ITTA at 1, 3, 6, and 12 months was 96%, 91%, 87%, and 75% for HCV monoinfection and 76%, 70%, 64%, and 52% for HCV/HIV coinfection, respectively (log-rank P < 0.05; Wilcoxon test P < 0.01). A Cox regression analysis was carried out including all variables with predictive value in the univariate analysis, showing that only donor age > 70 years (hazard ratio [HR] = 3.12; P < 0.05), United Network for Organ Sharing status 1 (HR = 10.1; P < 0.01), Model for End-Stage Liver Disease (HR = 1.13; P < 0.001), and HIV coinfection (HR = 2.65; P < 0.05) had independent negative predictive value for survival. In conclusion, our study indicates that HIV coinfection is a factor in mortality prior to transplantation and associated with higher mortality on the waiting list. Liver Transplantation 22 1186-1196 2016 AASLD.

First synthesis and biological evaluation of 4-amino-2-aryl-6,9-dichlorobenzo[g]pteridines as inhibitors of TNF-α and IL-6.

A direct new synthetic method on the chemistry of benzo[g]pteridines is reported. Reactions between 5,8-dichloro-2,3-dicyanoquinoxaline and benzamidines gave 4-amino-2-aryl-6,9-dichlorobenzo[g]pteridines in high to quantitative yields. The molecular structure of an N-acetyl derivative of a member of this family of compounds, 4-acetamido-6,9-dichloro-2-phenylbenzo[g]pteridine, was determined by X-ray crystallography. The synthesized compounds were evaluated for their potential anti-inflammatory activity as inhibitors of the pro-inflammatory cytokines TNF-α and IL-6. Compounds 5b, 5d and 5i showed the highest level of inhibition of both cytokines. The rest of the compounds into the series (5a, 5f, 5g and 5h), with the only exceptions of compounds 5c and 5e, which were unable to inhibit TNF-α and were the two compounds with the lower effect upon IL-6, were also able to reach good levels of inhibition of TNF-α and even higher levels of inhibition of IL-6.

Synthesis and biological evaluation of 4-alkoxy-6,9-dichloro[1,2,4]triazolo[4,3-a]quinoxalines as inhibitors of TNF-α and IL-6.

An efficient synthetic method for previously unattainable 4-alkoxy-6,9-dichloro[1,2,4]triazolo[4,3-a]quinoxalines has been established. Reactions between 5,8-dichloro-2,3-dicyanoquinoxaline and alcohols in the presence of triethylamine led to 3-alkoxy-5,8-dichloro-2-cyanoquinoxalines in high to quantitative yields. These compounds were treated with hydrazine giving 3-alkoxy-5,8-dichloro-2-hydrazinoquinoxalines in near quantitative yields, that reacted with triethyl orthoformate to provide the title compounds in high yields. The molecular structure of a member of this family of compounds: 6,9-dichloro-4-ethoxy[1,2,4]triazolo[4,3-a]quinoxaline, was determined by X-ray crystallography. The series of compounds synthesized were evaluated for their potential anti-inflammatory activity as inhibitors of the pro-inflammatory cytokines TNF-α and IL-6. Compounds 8e, 8a, 8b and 8g presented simultaneously good levels of inhibition of both cytokines being compound 8e the most concomitantly potent one. Compounds 8d, 8f and 8h specifically inhibited IL-6 with no significant inhibition of TNF-α. Compound 8c was not significantly active upon TNF-α, and showed no activity upon IL-6.