Telerrehabilitación en tiempos de COVID: una encuesta de satisfacción a cuidadores y pacientes con daño cerebral / Telerehabilitation in the COVID-19 pandemic: A satisfaction survey of caregivers and stroke patients

Objetivo: Determinar el grado de satisfacción de los cuidadores y de los pacientes con ictus que han recibido fisioterapia en formato de telerrehabilitación (TR) durante la primera oleada de la pandemia de SARS-CoV-2. Material y métodos: Se elaboró un estudio descriptivo mediante un cuestionario. El cuestionario incluía preguntas sobre la experiencia general, los problemas encontrados, los resultados subjetivos obtenidos y las sugerencias para futuras ediciones. Resultados: Se seleccionaron 26 sujetos: 16 pacientes (9 hombres y 7 mujeres) con diagnóstico de ictus y 10 cuidadores (3 hombres y 7 mujeres). El 87,6% de los pacientes y el 90% de los cuidadores consideraron que el sistema de conexión era fácil de usar, aunque el 30% dijeron que elegirían otro sistema de conexión en el futuro. Además, el 87,6% de los pacientes estaban de acuerdo o muy de acuerdo en repetir el tratamiento de TR. Conclusión: Los pacientes con ictus y los cuidadores que participan en el programa TR han mostrado un grado de satisfacción aceptable con su participación. (AU)

Aim: To determine the satisfaction degree of caregivers and stroke patients who received physiotherapy in telerehabilitation (TR) format during the first wave of the SARS-CoV-2 pandemic. Material and methods: A descriptive study was developed using a questionnaire. The questionnaire included questions on general experience, problems encountered, subjective results obtained and suggestions for future editions. Results: Twenty-six subjects were selected: 16 patients (9 men and 7 women) with a diagnosis of stroke and 10 caregivers (3 men and 7 women). 87.6% of the patients and 90% of the caregivers found the connection system easy to use, although 30% said they would choose another connection system in the future. In addition, 87.6% of patients agreed or strongly agreed to repeat the TR treatment. Conclusion: Stroke patients and caregivers participating in the TR program showed an acceptable satisfaction degree with their participation. (AU)

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents. Reply]. / Comentario al original 'Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica.

TITLE: Comentario al original 'Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica.

Validación del dispositivo de monitorización de actividad TomTom Touch Fitness Tracker® para medir la frecuencia cardíaca durante el esfuerzo / Validation of the TomTom Touch Fitness Tracker® activity monitor device for heart rate measuring during exercise (or effort)

Introducción: Las pulseras de actividad son un dispositivo asequible para controlar la salud de las personas. El modelo TomTom Touch Fitness Tracker®, por sus características, podría ser útil en este sentido. Objetivo: El objetivo de este estudio fue evaluar la validez de las pulseras de actividad física TomTom Touch Fitness Tracker® en una población de adultos sanos. Diseño: El diseño del estudio fue descriptivo, longitudinal y prospectivo, y tiene como objetivo evaluar la validez de la pulsera de actividad TomTom Touch Fitness Tracker® en adultos jóvenes sanos en comparación con el modelo POLAR RS800® validado. Métodos: Para el estudio se seleccionaron 38 jóvenes y sanos estudiantes universitarios de la Universidad de Salamanca. La frecuencia cardíaca se registró mediante la pulsera de actividad TomTom Touch Fitness Tracker®, y se comparó con los datos obtenidos por el modelo POLAR RS800®. Resultados: Se encontró una presión arterial promedio de 109 y 68mmHg. La frecuencia cardíaca basal media fue de 61 latidos por minuto (lpm). Después de realizar una prueba de esfuerzo se evidenció una fuerte correlación entre los resultados obtenidos con el dispositivo TomTom® y el modelo Polar®. Si se establece una inferencia mediante regresiones lineales, se revelan relaciones positivas con resultados estadísticamente significativos entre el dispositivo TomTom® y el modelo Polar®. Conclusiones: Los dispositivos TomTom® pueden mejorar la salud de los usuarios proporcionando datos fiables sobre la medición de la frecuencia cardíaca. Los dispositivos TomTom® permiten a los usuarios controlar el nivel de entrenamiento y esfuerzo. (AU)

Introduction: Fitness trackers are affordable devices for monitoring people's health. The TomTom Touch Fitness Tracker® model, due to its characteristics, could be useful in this regard. Objective: The objective of this study was to assess the validity of the TomTom Touch Fitness Tracker® fitness trackers in a population of healthy adults. Design: The study design was descriptive, longitudinal, and prospective and aimed to assess the validity of the TomTom Touch Fitness Tracker® activity tracker in healthy young adults compared to the validated POLAR RS800® model. Methods. In the study, 38 healthy young college students from the University of Salamanca were selected. Heart rate was produced using the TomTom Touch Fitness Tracker® activity bracelet and compared with data obtained by the POLAR RS800® model. Results: An average blood pressure of 109mmHg and 68mm Hg was found. The mean baseline heart rate was 61 beats per minute (bpm). After performing a stress test, a strong connection was evident between the results obtained with the TomTom device and the Polar model. If an inference is performed using linear regressions, positive relationships with statistically significant results are revealed between the TomTom device and the Polar model. Conclusions: TomTom devices can improve users’ health require reliable data on heart rate measurement. TomTom devices allow users to control the level of training and effort. (AU)

Impacto del envejecimiento sobre la incidencia y mortalidad de los cánceres urológicos: proyección a 20 años en España / Impact of aging on the incidence and mortality of urological cancers: 20-year projection in Spain

Introducción En el año 2020, en España, se diagnosticaron 282.421 nuevos casos de cáncer, encontrándose las neoplasias urológicas (NU) entre las más frecuentes. El tratamiento del cáncer en personas mayores es todo un reto, debido a su fragilidad y comorbilidades. Para responder a las necesidades que plantean las NU en las personas mayores, es necesaria una adecuada planificación de la enfermedad, comenzando por analizar los registros de cáncer. El objetivo fue, considerando a la población española de más de 65 años, proporcionar un análisis detallado de incidencia y mortalidad de las NU en el año 2020, así como las estimaciones para el año 2040. Material y métodos Las NU que se incluyeron fueron: testículo, vejiga, pene, riñón y próstata. Las estimaciones de incidencia y mortalidad fueron obtenidas de la base de datos GLOBOCAN. Resultados En el año 2020 se diagnosticaron en España 63.278 NU. Exceptuando la neoplasia de testículo, todas las neoplasias se diagnosticaron con mucha mayor frecuencia en el grupo de mayores de 65 años. Para el año 2040 se estima un aumento del 41,5%, alcanzando los 89.507 nuevos casos por año, de los cuales aproximadamente tres cuartas partes tendrán lugar en mayores de 65. El número de fallecidos mayores de 65 aumentará un 60,15% en 2040. Conclusión En las próximas 2 décadas es esperable que los nuevos casos de NU en mayores de 65 años aumenten por encima del 50%. Mayores recursos económicos y humanos, además de equipos multidisciplinares con experiencia y formación geriátrica, serán necesarios (AU)

Introduction In 2020, 282,421 new cases of cancer were diagnosed in Spain, and urological neoplasms (UN) were among the most frequent ones. Cancer treatment in elderly people is challenging due to frailty and comorbidities. Healthcare resources must be optimized in order to meet the needs of treating UN in the elderly, and deep analysis of cancer registries becomes mandatory. The objective of this work was to provide a detailed analysis of the incidence and mortality of UN in patients over 65 years old in the last year 2020 in Spain, as well as the estimates for the year 2040. Material and methods Incidence and mortality estimates were obtained from the GLOBOCAN database. The UN included were testicle, bladder, penis, kidney, and prostate. Results In 2020, 63,278 cases of UN were diagnosed in Spain. Most UN were much more frequent among patients > 65 years old, except for testicular cancers. For the year 2040, an increased incidence of 41.5% is estimated, reaching 89,507 new cases of UN per year, with approximately 3 out of 4 patients over 65 years of age. Deaths in people over 65 will increase by 60.15% in 2040. Conclusion In the next two decades, it is expected that new cases of UN in people over 65 years will rise above 50%. More financial and human resources, as well as multidisciplinary teams with experience and geriatric training, will be necessary (AU)

Impact of aging on the incidence and mortality of urological cancers: 20-year projection in Spain.

INTRODUCTION: In 2020, 282,421 new cases of cancer were diagnosed in Spain, and urological neoplasms (UN) were among the most frequent ones. Cancer treatment in eldery people is challenging due to fragility and comorbidities of these patients. To meet the needs of treating UN in the eldery, it is necessary to optimize healthcare resources, for which a deep analysis of cancer registries becomes mandatory. The objective of this work was to provide a detailed analysis of the incidence and mortality of UN in Spanish people over 65 years old in the last year 2020, as well as the estimates for the year 2040. MATERIAL AND METHODS: Incidence and mortality estimates were obtained from the GLOBOCAN database. The urological neoplasms that were included were: testicle, bladder, penis, kidney and prostate. RESULTS: In 2020, 63,278 cases of UN were diagnosed in Spain. Most UN were much more frequent among patients >65 years old, except for testicular cancers. For the year 2040, an incidence increase of 41.5% is estimated, reaching 89,507 new cases of UN per year, with approximately 3 out of 4 patients being over 65 years old. Deaths in people over 65 will increase by 60.15% in 2040. CONCLUSION: In the next two decades, it is expected that new cases UN in people over 65 years will increase above 50%. For Healthcare systems to face it, greater financial and human resources, as well as multidisciplinary teams with experience and geriatric training will be necessary.

Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares / Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents

Introducción: Los pacientes que han sufrido un accidente cerebrovascular crónico o un ictus necesitan tratamientos de fisioterapia a largo plazo. Sin embargo, la pandemia de COVID-19 ha obligado a detenerlos. Con el objetivo de poder ofrecer una evaluación funcional de forma telemática a estos pacientes, se propuso diseñar una adaptación de la escala de evaluación Fugl Meyer-versión española y comprobar su viabilidad. Pacientes y métodos: Escala telemática adaptada, basada en la escala de evaluación Fugl Meyer. Se mantuvieron los dominios de función motora, equilibrio y dolor, y se eliminaron ítems que requerían ayuda para el paciente. Dicha escala se administró a 14 pacientes con accidente cerebrovascular crónico de la Asociación de Daño Cerebral Adquirido de Salamanca, a través de diferentes plataformas web, siguiendo el mismo procedimiento que la escala original y con una duración de 30 a 45 minutos. Resultados: Todos los pacientes completaron la escala de evaluación Fugl Meyer-versión telemática. La mayor dificultad se encontró para la evaluación de las extremidades inferiores. Los pacientes y los fisioterapeutas destacaron la facilidad de realización de los ítems de la escala. Al comparar las versiones se encontraron correlaciones positivas estadísticamente significativas con la versión original (p < 0,001) y los coeficientes de correlación indicaron una fuerte asociación. La diferencia entre las secciones de la escala equivalentes en cada instrumento no fue mayor que el 5%, excepto en el equilibrio. Conclusión: La escala de evaluación Fugl Meyer-versión telemática, es una escala viable, útil y fácil de aplicar que permite la evaluación del estado funcional de los pacientes con ictus y que puede responder a las necesidades actuales durante la pandemia de COVID-19.(AU)

Introduction: Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability. Patients and methods: The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociación de Daño Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes. Results: All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance. Conclusion: The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.(AU)

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents]. / Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares.

INTRODUCTION: Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability. PATIENTS AND METHODS: The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociacion de Dano Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes. RESULTS: All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance. CONCLUSION: The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.

TITLE: Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares.Introducción. Los pacientes que han sufrido un accidente cerebrovascular crónico o un ictus necesitan tratamientos de fisioterapia a largo plazo. Sin embargo, la pandemia de COVID-19 ha obligado a detenerlos. Con el objetivo de poder ofrecer una evaluación funcional de forma telemática a estos pacientes, se propuso diseñar una adaptación de la escala de evaluación Fugl Meyer-versión española y comprobar su viabilidad. Pacientes y métodos. Escala telemática adaptada, basada en la escala de evaluación Fugl Meyer. Se mantuvieron los dominios de función motora, equilibrio y dolor, y se eliminaron ítems que requerían ayuda para el paciente. Dicha escala se administró a 14 pacientes con accidente cerebrovascular crónico de la Asociación de Daño Cerebral Adquirido de Salamanca, a través de diferentes plataformas web, siguiendo el mismo procedimiento que la escala original y con una duración de 30 a 45 minutos. Resultados. Todos los pacientes completaron la escala de evaluación Fugl Meyer-versión telemática. La mayor dificultad se encontró para la evaluación de las extremidades inferiores. Los pacientes y los fisioterapeutas destacaron la facilidad de realización de los ítems de la escala. Al comparar las versiones se encontraron correlaciones positivas estadísticamente significativas con la versión original (p menor de 0,001) y los coeficientes de correlación indicaron una fuerte asociación. La diferencia entre las secciones de la escala equivalentes en cada instrumento no fue mayor que el 5%, excepto en el equilibrio. Conclusión. La escala de evaluación Fugl Meyer-versión telemática, es una escala viable, útil y fácil de aplicar que permite la evaluación del estado funcional de los pacientes con ictus y que puede responder a las necesidades actuales durante la pandemia de COVID-19.

Small bowel obstruction caused by pericaecal hernia resolved with a laparoscopic approach.

Small bowel obstruction from internal hernias is a familiar pathology for the surgeon, with an incidence of 0.5-5.8%. However, pericaecal hernia is a very uncommon type of internal hernia. Diagnosis and early treatment are essential to avoid strangulation and necrosis of the incarcerated small bowel. We report a case of an 84-year-old woman with no previous history of abdominal surgery who came to our hospital having endured 6 hours of abdominal pain and vomiting. Following physical examination and computed tomography, a diagnosis of small bowel obstruction caused by pericaecal hernia was made and emergency surgery was performed. The hernia was successfully reduced with a laparoscopic approach. Although pericaecal hernia is a rare disease, surgeons should bear it in mind as a differential diagnosis in small bowel obstruction.

Single and Combined Release of Trichopria drosophilae (Hymenoptera: Diapriidae) to Control Drosophila suzukii (Diptera: Drosophilidae).

To further the use of local parasitoids to control the spotted wing drosophila suzukii (Matsumura) in Mexico, three treatments were implemented by sextuplicate in commercial berry fields of Colima and Jalisco from June 2017 to May 2018: single release of Trichopria drosophilae Perkins (pupal parasitoid), combined release of T. drosophilae + Leptopilina boulardi Barbotin, Carton & Kelner-Pillault (larval parasitoid), and a no release control. Compared with the no release sites, parasitism by T. drosophilae increased 4 and 4.1-fold at the single and combined release sites, respectively, and parasitism of L. boulardi increased 2.8-fold at the sites where it was evaluated. Additionally, it was registered a 50 and 55% reduction of D. suzukii at the sites with single and combined releases, respectively; in other words, supplementing T. drosophilae with L. boulardi provided little benefit compared with the release of T. drosophilae alone. These results indicate that single release of local T. drosophilae is a more cost-effective option to reduce D. suzukii populations, and that such activity can contribute significantly to the phytosanitary management of this invasive pest.

Applying Data Science methods and tools to unveil healthcare use of lung cancer patients in a teaching hospital in Spain.

PURPOSE: Our primary goal was to study the use of outpatient attendances by lung cancer patients in Hospital Universitario Puerta de Hierro Majadahonda (HUPHM), Spain, by leveraging our Electronic Patient Record (EPR) and structured clinical registry of lung cancer cases as well as assessing current Data Science methods and tools. METHODS/PATIENTS: We applied the Cross-Industry Standard Process for Data Mining (CRISP-DM) to integrate and analyze activity data extracted from the EPR (9.3 million records) and clinical data of lung cancer patients from a previous registry that was curated into a new, structured database based on REDCap. We have described and quantified factors with an influence in outpatient care use from univariate and multivariate points of view (through Poisson and negative binomial regression). RESULTS: Three cycles of CRISP-DM were performed resulting in a curated database of 522 lung cancer patients with 133 variables which generated 43,197 outpatient visits and tests, 1538 ER visits and 753 inpatient admissions. Stage and ECOG-PS at diagnosis and Charlson Comorbidity Index were major contributors to healthcare use. We also found that the patients' pattern of healthcare use (even before diagnosis), the existence of a history of cancer in first-grade relatives, smoking habits, or even age at diagnosis, could play a relevant role. CONCLUSIONS: Integrating activity data from EPR and clinical structured data from lung cancer patients and applying CRISP-DM has allowed us to describe healthcare use in connection with clinical variables that could be used to plan resources and improve quality of care.

Valoración mediante Dixon modificado de las lesiones suprarrenales incidentales en RM 3T / Using the modified Dixon technique to evaluate incidental adrenal lesions on 3T MRI

Objetivo: Cuantificar mediante secuencia mDIXON-Quant la fracción grasa (FG) de las lesiones suprarrenales encontradas incidentalmente en estudios de TC. Analizar la relación de la caída de señal entre las secuencias potenciadas en T1 en fase y fase opuesta con la FG en mDIXON-Quant. Comparar la sensibilidad y especificidad de ambos métodos para caracterizar las lesiones suprarrenales. Material y métodos: Se realizó un estudio prospectivo descriptivo que incluyó a 31 pacientes con lesiones suprarrenales incidentales evaluados mediante RM 3T con las secuencias T1 en fase y fase opuesta y mDIXON-Quant. Se midió la FG de las lesiones suprarrenales mediante mDIXON-Quant y la intensidad de señal en secuencias T1 en fase y fase opuesta, calculando su porcentaje de pérdida de señal (PPS). Resultados: El PPS medio fue significativamente mayor en el grupo adenoma (61,3% ± 20,4%) que en el no adenoma (5,1% ± 5,8%) (p < 0,005). La FG media de los adenomas también fue significativamente mayor (26,9% ± 10,8% vs. 3,4% ± 3,0%) (p < 0,005). El área bajo la curva ROC fue 0,99 (0,96-1,00) para el PPS y 0,98 (0,94-1,00) para la FG. El punto de corte obtenido fue de 24,42% para el PPS y de 9,2% para la FG. Los valores diagnósticos fueron iguales para los dos métodos: sensibilidad del 96% (79,6-99,9), especificidad del 100% (39,8-100,0), valor predictivo positivo del 100% (85,8-100,0) y valor predictivo negativo del 80% (28,4-99,5). Conclusión: La FG obtenida mediante técnica Dixon modificada es capaz de diferenciar adenomas de no adenomas con la misma sensibilidad y especificidad que la PPS

Objectives: To use the mDIXON-Quant sequence to quantify the fat fraction of adrenal lesions discovered incidentally on CT studies. To analyze the relation between the signal loss between in-phase and out-of-phase T1-weighted sequences and the fat fraction in mDIXON-Quant. To compare the sensitivity and specificity of the two methods for characterizing adrenal lesions. Material and methods: This prospective descriptive study included 31 patients with incidentally discovered adrenal lesions evaluated with 3T MRI using in-phase and out-of-phase T1-weighted sequences and mDIXON-Quant; the fat fraction of the adrenal lesions was measured by mDIXON-Quant and by calculating the percentage of signal loss between in-phase and out-of-phase T1-weighted sequences. Results: The percentage of signal loss was significantly higher in the group of patients with adenoma (61.3% ± 20.4% vs. 5.1% ± 5.8% in the group without adenoma, p<0.005). The mean fat fraction measured by mDIXON-Quant was also higher for the adenomas (26.9% ±10.8% vs. 3.4% ± 3.0%, p<0.005).The area under the ROC curve was 0.99 (0.96 - 1.00) for the percentage of signal loss and 0.98 (0.94 - 1.00) for the fat fraction measured by mDIXON-Quant. The cutoffs obtained were 24.42% for the percentage of signal loss and 9.2% for the fat fraction measured by mDIXON-Quant. The two techniques had the same values for diagnostic accuracy: sensitivity 96% (79.6 - 99.9), specificity 100% (39.8 - 100.0), positive predictive value 100% (85.8 - 100.0), and negative predictive value 80% (28.4 - 99.5). Conclusion: The fat fraction measured by the modified Dixon technique can differentiate between adenomas and other adrenal lesions with the same sensitivity and specificity as the percentage of signal loss between in-phase and out-of-phase T1-weighted sequences

Using the modified Dixon technique to evaluate incidental adrenal lesions on 3T MRI. / Valoración mediante Dixon modificado de las lesiones suprarrenales incidentales en RM 3T.

OBJECTIVES: To use the mDIXON-Quant sequence to quantify the fat fraction of adrenal lesions discovered incidentally on CT studies. To analyze the relation between the signal loss between in-phase and out-of-phase T1-weighted sequences and the fat fraction in mDIXON-Quant. To compare the sensitivity and specificity of the two methods for characterizing adrenal lesions. MATERIAL AND METHODS: This prospective descriptive study included 31 patients with incidentally discovered adrenal lesions evaluated with 3T MRI using in-phase and out-of-phase T1-weighted sequences and mDIXON-Quant; the fat fraction of the adrenal lesions was measured by mDIXON-Quant and by calculating the percentage of signal loss between in-phase and out-of-phase T1-weighted sequences. RESULTS: The percentage of signal loss was significantly higher in the group of patients with adenoma (61.3% ± 20.4% vs. 5.1% ± 5.8% in the group without adenoma, p<0.005). The mean fat fraction measured by mDIXON-Quant was also higher for the adenomas (26.9% ±10.8% vs. 3.4% ± 3.0%, p<0.005).The area under the ROC curve was 0.99 (0.96 - 1.00) for the percentage of signal loss and 0.98 (0.94 - 1.00) for the fat fraction measured by mDIXON-Quant. The cutoffs obtained were 24.42% for the percentage of signal loss and 9.2% for the fat fraction measured by mDIXON-Quant. The two techniques had the same values for diagnostic accuracy: sensitivity 96% (79.6 - 99.9), specificity 100% (39.8 - 100.0), positive predictive value 100% (85.8 - 100.0), and negative predictive value 80% (28.4 - 99.5). CONCLUSION: The fat fraction measured by the modified Dixon technique can differentiate between adenomas and other adrenal lesions with the same sensitivity and specificity as the percentage of signal loss between in-phase and out-of-phase T1-weighted sequences.

Efecto de la segmentación por tejidos en los mapas de atenuación sobre la cuantificación PET con especial hincapié en grandes arterias / The effect of tissue-segmented attenuation maps on PET quantification with a special focus on large arteries

Objetivos. La precisión cuantitativa en PET requiere una adecuada aplicación de la corrección de atenuación, lo cual representa uno de los mayores retos que aún están por resolver en la técnica PET/RM. El propósito de este estudio es evaluar el efecto de utilizar mapas de atenuación basados en RM y el uso de antenas flexibles sobre la precisión cuantitativa en PET con especial hincapié en grandes arterias. Materiales y métodos. Se utilizaron datos PET/TC de 8 pacientes oncológicos. Los datos PET fueron reconstruidos utilizando mapas de atenuación con diferente nivel de detalle emulando las distintas aproximaciones utilizadas actualmente por lo equipos PET/RM. Las imágenes PET obtenidas con mapas de atenuación basados en TC y RM fueron comparadas para evaluar las desviaciones cuantitativas obtenidas. El efecto producido por las antenas flexibles fue también estudiado. Resultados. El uso de mapas de atenuación más simplificados da lugar a un incremento en las desviaciones cuantitativas en grasa, tejido blando y hueso. Las desviaciones en pulmón son altas debido a su heterogeneidad y a la variabilidad entre pacientes. La cuantificación en grandes arterias muestra pequeñas desviaciones excepto en el caso de utilizar antenas flexibles. La cuantificación mediante TBR proporciona menores desviaciones al cancelarse las desviaciones medidas en arterias y las venas utilizadas como referencia. Conclusiones. Los mapas de atenuación simplificados que se utilizan en PET/RM producen un incremento significativo de variabilidad cuantitativa especialmente en pulmones y huesos. La cuantificación aplicada al estudio de la aterosclerosis produce pequeñas desviaciones, especialmente cuando se utiliza el TBR (AU)

Objectives. Accuracy on quantitative PET image analysis relies on the correct application of attenuation correction which is one of the major challenges for PET/MRI that remains to be solved. The purpose of this study is to evaluate the effect of MRI-based attenuation maps and the use of flexible coils on the quantitative accuracy of PET images with a special focus on large arteries. Materials and methods. PET/CT data from eight oncologic patients was used. PET data was reconstructed using attenuation maps with different level of detail emulating several approaches available on current PET/MRI scanners. PET images obtained with CT-based and MRI-based attenuation maps were compared to evaluate the quantitative biases obtained. The quantitative effect produced by flexible MRI receiver coils on the attenuation maps was also studied. Results. The use of simpler attenuation maps produced increased biases between PET data reconstructed with CT-based and MRI-based attenuation maps for fat, non-fat soft-tissues and bone. Biases in lung were very high due to the large heterogeneity and inter-patient variability of the lung. The quantification on large arteries had small deviations except for the case when flexible coils were used. The TBR provided smaller biases in all cases as it cancelled out the similar deviations obtained for arteries and reference veins. Conclusions. Simplified attenuation maps used on PET/MRI significantly increase the quantitative variability of PET images especially on lungs and bones. The quantification of PET images acquired with PET/MRI scanners applied to studies of atherosclerosis has small deviations, especially when the TBR is considered (AU)

[The effects of moderate physical exercise on cognition in adults over 60 years of age]. / Efectos del ejercicio fisico moderado sobre la cognicion en adultos mayores de 60 años.

INTRODUCTION: Clinical evidence gathered in recent years indicates that elderly individuals more frequently display cognitive changes. These age-related changes refer, above all, to memory functions and to the speed of thinking and reasoning. A number of studies have shown that physical activity can be used as an important mechanism for protecting the cognitive functions. AIM: To test the hypothesis that physical exercise is able to bring about changes in the cognitive functions of healthy elderly adults without cognitive impairment, thereby improving their quality of life. SUBJECTS AND METHODS: The study population included participants in the University of Salamanca geriatric revitalisation programme. The sample initially consisted of a total of 44 subjects of both sexes, with a mean age of 74.93 years. The neuropsychological evaluation of the subjects included a series of validated neuropsychological tests: Mini-Mental State Examination, Benton Visual Retention Test, Rey Auditory Verbal Learning Test, Stroop Test and Trail Making Test. RESULTS: The results show that more physical activity is related to better performance in the cognitive functions of the subjects included in this study, after applying the geriatric revitalisation programme. CONCLUSIONS: The geriatric revitalisation programme can be a valuable tool for improving cognition in adults over 60 years of age, resulting in enhanced well-being in their quality of life.

TITLE: Efectos del ejercicio fisico moderado sobre la cognicion en adultos mayores de 60 años.Introduccion. La evidencia clinica a lo largo de estos años indica que los individuos ancianos muestran con mayor frecuencia diversos cambios cognitivos. Estos cambios asociados a la edad se refieren sobre todo a las funciones mnesicas y a la rapidez de pensamiento y razonamiento. Numerosos estudios han demostrado que la actividad fisica puede establecerse como un mecanismo importante para la proteccion de las funciones cognitivas. Objetivo. Contrastar la hipotesis de que el ejercicio fisico es capaz de producir cambios en las funciones cognitivas de adultos mayores sanos sin deterioro cognitivo, mejorando su calidad de vida. Sujetos y metodos. La poblacion de estudio fue tomada de los participantes en el programa de revitalizacion geriatrica de la Universidad de Salamanca. La muestra estaba formada en un principio por un total de 44 sujetos de ambos sexos, con una edad media de 74,93 años. Para la valoracion neuropsicologica de los sujetos se incluyo una serie de pruebas neuropsicologicas validadas: examen cognitivo minimental, test de retencion visual de Benton, aprendizaje audioverbal de Rey, test de Stroop y test del trazo. Resultados. Los resultados indican que una mayor actividad fisica se relaciona con un mejor rendimiento en las funciones cognitivas de los sujetos incluidos en este estudio, tras la aplicacion del programa de revitalizacion geriatrica. Conclusiones. El programa de revitalizacion geriatrica puede ser una herramienta util de cara a la mejoria sobre la cognicion en adultos mayores de 60 años, logrando un mejor bienestar en su calidad de vida.

The effect of tissue-segmented attenuation maps on PET quantification with a special focus on large arteries. / Efecto de la segmentación por tejidos en los mapas de atenuación sobre la cuantificación PET con especial hincapié en grandes arterias.

OBJECTIVES: Accuracy on quantitative PET image analysis relies on the correct application of attenuation correction which is one of the major challenges for PET/MRI that remains to be solved. The purpose of this study is to evaluate the effect of MRI-based attenuation maps and the use of flexible coils on the quantitative accuracy of PET images with a special focus on large arteries. MATERIALS AND METHODS: PET/CT data from eight oncologic patients was used. PET data was reconstructed using attenuation maps with different level of detail emulating several approaches available on current PET/MRI scanners. PET images obtained with CT-based and MRI-based attenuation maps were compared to evaluate the quantitative biases obtained. The quantitative effect produced by flexible MRI receiver coils on the attenuation maps was also studied. RESULTS: The use of simpler attenuation maps produced increased biases between PET data reconstructed with CT-based and MRI-based attenuation maps for fat, non-fat soft-tissues and bone. Biases in lung were very high due to the large heterogeneity and inter-patient variability of the lung. The quantification on large arteries had small deviations except for the case when flexible coils were used. The TBR provided smaller biases in all cases as it cancelled out the similar deviations obtained for arteries and reference veins. CONCLUSIONS: Simplified attenuation maps used on PET/MRI significantly increase the quantitative variability of PET images especially on lungs and bones. The quantification of PET images acquired with PET/MRI scanners applied to studies of atherosclerosis has small deviations, especially when the TBR is considered.

Protocol of toothbrushing based on bioavailability of fluoride in toothpaste: a systematic review / Protocolo de cepillado basado en la biodisponibilidad del flúor en dentífricos: una revisión sistemática

The objective of the study is to propose a protocol for the appropriate use of fluorides in dentifrices (Dt), based on its bioavailability in saliva (Bs) and / or plaque (Bp) through a systematic review (SR). SR of the literature from 2005 to 2015 in PubMed, Cochrane and SciELO. Inclusion criteria: clinical studies in vivo, Spanish and English, made only with Dt that measured Bs and Bp. The results were evaluated in relation to: 1) Concentration of fluoride in Dt, 2) Brushing time with Dt, 3) Frequency of brushing, 4) Rinse post-brushing and 5) Amount of Dt on the brush. Twelve (12) studies were selected. 1) Bs increases 241 % when using a 5000 ppm of Dt compared to 1450 ppm. 2) Bs is increased by 55 % by increasing the duration of brushing 40 s to 120 s 3) Bp increases by 68 % when brushing 3 times a day compared to 2 times. 4) Not rinsing or rinsing with <10 ml for <10 s increases Bs to 270 % compared to rinses higher volume / time. 5) By increasing the amount of Dt of 0.5 g to 1.5 g, Bs increases up to 266 %. The use of 1.5 g of Dt 1450 ppm of fluoride for 120 s, 3 times a day is recommended and once brushing is complete avoiding oral rinse with water or non fluoride mouthwash.

El objetivo de este studio es proponer un protocolo para el uso adecuado de fluoruros en dentífricos (Dt), basado en su biodisponibilidad en saliva (Bs) y/o placa (Bp) mediante una revisión sistemática (RS). RS de la literatura 2005- 2015 en PubMed, Cochrane y SciELO. Criterios de inclusión: estudios clínicos in vivo, español e inglés, realizados únicamente con Dt que midieran Bs y Bp. Los resultados fueron evaluados en relación a: 1) Concentración de flúor en el Dt, 2) Tiempo de cepillado con Dt, 3) Frecuencia de cepillado, 4) Enjuague post-cepillado y 5) Cantidad de Dt en el cepillo. Fueron seleccionados 12 estudios. 1) La Bs aumenta en un 241 % al utilizar un Dt de 5000 ppm en comparación con un 1450 ppm. 2) Bs aumenta en un 55 % al aumentar la duración del cepillado de 40 s a 120 s, 3) La Bp aumenta en un 68 % al cepillarse 3 veces al día en comparación a 2 veces. 4) No enjuagarse o enjuagues de <10 ml por <10 s puede aumentar la Bs hasta en un 270 % en comparación a enjuagues con mayor volumen/tiempo. 5) Al aumentar la cantidad de Dt de 0,5 g a 1,5 g, la Bs aumenta hasta en un 266 %. Se recomienda utilizar 1,5 g de Dt 1450 ppm de flúor por 120 s, 3 veces al día, y evitar enjuague oral con agua o colutorios sin flúor una vez finalizado el cepillado.