Encuesta sobre el manejo del nevus displásico por los dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV) / Survey on the Management of Dysplastic Nevus by Dermatologists in the Center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV)

Antecedentes y objetivos No existen guías clínicas para el manejo del nevus displásico (ND). Determinaremos el porcentaje de dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV) que ampliarían márgenes o tendrían actitud conservadora en un ND, y si los antecedentes personales (AP) y/o familiares (AF) de melanoma modificarían la actitud tomada frente a un paciente sin antecedentes de interés. Material y métodos Se difundió la encuesta a 738 dermatólogos y se recogieron datos de forma anónima del 15 de junio de 2022 al 31 de julio de 2022. Las variables de exposición fueron el grado de displasia (bajo/alto), los márgenes (afecto/libre) y los antecedentes de melanoma (sin antecedentes/AF/AP). Las variables dependientes (actitud) incluyeron observación/márgenes de 1-4mm /márgenes 5-10mm. Resultados Se recibieron 86 respuestas. Si el patólogo informase bordes afectos en un ND de bajo grado, el 60,5% ampliarían márgenes de 1 a 4mm, mientras que si los márgenes están libres el 97,7%, tendrían una actitud conservadora. Si el patólogo informara bordes afectos en un ND de alto grado, solo el 1,2% tendrían una actitud conservadora, porcentaje que se incrementa notablemente si los márgenes están libres (68,6%). El AF o el AP de melanoma no influirían en la actitud de la mayoría. Conclusiones El manejo del ND no es uniforme entre los dermatólogos de la sección centro de la AEDV, especialmente en el caso de ND de bajo grado con bordes afectos y ND de alto grado con bordes libres. El AF o el AP de melanoma no modifican en la mayor parte de los casos la actitud clínica (AU)

Background and objectives There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. Material and methods We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). Results We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists’ attitudes. Conclusions Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases (AU)

[Translated article] Survey on the Management of Dysplastic Nevus by Dermatologists in the Center-Spain Section of the Spanish Academy of Dermatology and Venereology (AEDV) / Encuesta sobre el manejo del nevus displásico por los dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV)

Background and objectives There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. Material and methods We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). Results We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists’ attitudes. Conclusions Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases (AU)

Antecedentes y objetivos No existen guías clínicas para el manejo del nevus displásico (ND). Determinaremos el porcentaje de dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV) que ampliarían márgenes o tendrían actitud conservadora en un ND, y si los antecedentes personales (AP) y/o familiares (AF) de melanoma modificarían la actitud tomada frente a un paciente sin antecedentes de interés. Material y métodos Se difundió la encuesta a 738 dermatólogos y se recogieron datos de forma anónima del 15 de junio de 2022 al 31 de julio de 2022. Las variables de exposición fueron el grado de displasia (bajo/alto), los márgenes (afecto/libre) y los antecedentes de melanoma (sin antecedentes/AF/AP). Las variables dependientes (actitud) incluyeron observación/márgenes de 1-4mm /márgenes 5-10mm. Resultados Se recibieron 86 respuestas. Si el patólogo informase bordes afectos en un ND de bajo grado, el 60,5% ampliarían márgenes de 1 a 4mm, mientras que si los márgenes están libres el 97,7%, tendrían una actitud conservadora. Si el patólogo informara bordes afectos en un ND de alto grado, solo el 1,2% tendrían una actitud conservadora, porcentaje que se incrementa notablemente si los márgenes están libres (68,6%). El AF o el AP de melanoma no influirían en la actitud de la mayoría. Conclusiones El manejo del ND no es uniforme entre los dermatólogos de la sección centro de la AEDV, especialmente en el caso de ND de bajo grado con bordes afectos y ND de alto grado con bordes libres. El AF o el AP de melanoma no modifican en la mayor parte de los casos la actitud clínica (AU)

Survey on the Management of Dysplastic Nevus by Dermatologists in the Center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV). / Encuesta sobre el manejo del nevus displásico por los dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV).

BACKGROUND AND OBJECTIVES: There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. MATERIAL AND METHODS: We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). RESULTS: We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists' attitudes. CONCLUSIONS: Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases.

Fractura triplanar de tibia distal: Reporte de un caso y revisión de la literatura / Triplanar fracture of proximal tibia: A case report and literature review

Las fracturas triplanares de tibia distal, son fracturas complejas caracterizadas por afectación multiplanar, clasificándose como Salter Harris tipo IV, en el periodo de cierre fisiario. Son poco frecuentes, representando el 5-15% de las fracturas pediátricas. El mecanismo de lesión que ocurre con mayor frecuencia, consiste en supinación y rotación externa. La tomografía computarizada es actualmente el Gold Standard para el diagnóstico de este tipo de fractura, nos permite evaluar todos los planos, siendo la radiografía simple insuficiente para el diagnóstico ya que puede pasar desapercibida. Paciente de 14 años de edad con fractura triplanar en 2 partes de tibia distal, con resolución quirúrgica. Nuestro caso es un ejemplo de una fractura triplanar de tibia distal, la cual es de baja frecuencia, difícil diagnostico e interpretación. Presentamos imágenes preoperatorias, intraoperatorias y postoperatorias del manejo de esta lesión, obteniendo resultados satisfactorios clínicos, funcionales y en estudios de imágenes. Es indispensable lograr una reducción anatómica de la superficie articular para lograr una evolución satisfactoria. Se recomienda una tomografía computarizada para diagnosticar y manejar esta lesión de manera adecuada. El seguimiento postoperatorio es crucial para el manejo de este paciente, ya que se espera una discrepancia en la longitud de las extremidades y/o deformidad(AU)

Triplane fractures of the distal tibia are complex fractures characterized by multiplane effects. They are classified in the Salter-Harris system as type IV in the period of physeal closure. These fractures are rare and represent 5-15% of pediatric fractures. The most common mechanism of injury is supination and external rotation. Computed tomography is currently the Gold Standard for the diagnosis of this type of fracture since it allows us to evaluate all planes, while plain radiography is insufficient because the fracture can go unnoticed. The objective is to report the clinical case of a 14-year-old patient with triplanar fracture in 2 parts of the distal tibia with surgical resolution. This case is an example of a triplanar fracture of the distal tibia, which is of low frequency, and difficult to diagnose and interpret. Preoperative, intraoperative and postoperative images of the management of this lesion are presented, obtaining satisfactory clinical, functional and imaging study results. It is essential to achieve an anatomical reduction of the joint surface to achieve a satisfactory evolution. A CT scan is recommended to properly diagnose and manage this injury. Postoperative follow-up is crucial for the management of this patient, as a limb length discrepancy and/or deformity is expected(AU)

Evolución del síndrome de desgaste profesional, ansiedad y depresión en personal sanitario durante la pandemia de la COVID-19 / Evolution of burnout syndrome, anxiety and depression in healthcare personnel during the COVID-19 pandemic

Introducción. La pandemia de la COVID-19 ha producido un impacto en la esfera psicológica de los trabajadores sanitarios. El objetivo de este estudio es analizar la evolución del síndrome de desgaste profesional, la ansiedad y la depresión en el personal sanitario a lo largo de la pandemia de la COVID-19. Material y métodos. Estudio observacional de los profesionales sanitarios del Servicio de Neumología del Hospital Gregorio Marañón que ha prestado servicio entre diciembre de 2019 y enero de 2021. Se evaluó el síndrome de desgaste profesional mediante el cuestionario Maslach Burnout Inventory (MBI) y la ansiedad y depresión mediante los cuestionarios de Zung referido a diciembre de 2019 (situación basal), marzo de 2020 (primera ola) y enero de 2021 (tercera ola) en diferentes profesiones sanitarias. Resultados. Se incluyeron 62 participantes, de los cuales 15 (24,2%) eran varones. En cuanto a las profesiones sanitarias, 24 (38,7%) eran médicos, 22 eran diplomados universitarios de enfermería (DUE), 12 (19,4%) eran técnicos en cuidados auxiliares de enfermería (TCAE), y 4 (6,5%) eran otros profesionales. Se documentó un cambio significativo al alza del estrés emocional y de despersonalización y a la baja de realización personal tanto de forma global como estratificado por diferentes profesiones sanitarias excepto en otros profesionales. Se objetivó un aumento progresivo de la ansiedad, mientras que el aumento de la depresión no fue estadísticamente significativo. Conclusión. Durante la pandemia de la COVID-19, los profesionales sanitarios sufrieron un aumento progresivo del desgaste profesional y de la ansiedad. Es importante tener en cuenta la salud psicológica de los sanitarios (AU)

Introduction. The COVID-19 pandemic has impacted the psychological sphere of healthcare workers. The objective of this study is to analyze the evolution of burnout syndrome, anxiety and depression in healthcare personnel throughout the COVID-19 pandemic Material and methods. Observational study of the healthcare professionals of the Respiratory Department of Gregorio Marañón Hospital that worked between December 2019 and January 2021. Burnout syndrome was evaluated using the Maslach Burnout Inventory (MBI) questionnaire and anxiety and depression using the Zung questionnaires referred to December 2019 (baseline situation), March 2020 (first wave) and January 2021 (third wave) in different healthcare professions. Results. Sixty-two participants were included, of which 15 (24.2%) were male. Regarding the healthcare professions, 24 (38.7%) were doctors, 22 were nurses, 12 (19.4%) were technicians in auxiliary nursing care, and 4 (6, 5%) were other professionals. A significant upward change in emotional stress and depersonalization and a downward personal fulfillment were documented both globally and stratified by different healthcare professions except in other professionals. A progressive increase in anxiety was observed, meanwhile, the increase in depression was not statistically significant. Conclusion. During the COVID-19 pandemic, healthcare professionals suffered a progressive increase in burnout and anxiety. It is important to consider the psychological health of the healthcare personnel (AU)

Energy hormone response to fasting-induced dyslipidemia in obese and non-obese donkeys.

Metabolic and endocrine disorders, such as dyslipidemia, are common in donkeys. Negative energy balance due to fasting, stressful conditions, or disease is a major trigger for fat mobilization often leading to dyslipidemia. The hormonal response to fasting has not been well characterized in donkeys. Therefore, this work aimed to study variations in insulin, glucagon, leptin, total adiponectin, ghrelin, and insulin-like growth factor-1 concentrations, insulin-to-glucagon (IGR) and glucagon-to-insulin (GIR) molar ratios, and lipid and carbohydrate parameters during a 66 h fasting period in 8 adult donkeys, and to determine differences depending on body condition. Obese donkeys developed earlier lipid mobilization (increased plasma total triglyceride and total cholesterol concentrations) compared to non-obese donkeys. Plasma glucose and leptin concentrations decreased in obese animals. After 60 h fasting, obese donkeys showed a significant increase in glucagon and decrease in leptin. GIR significantly increased, while insulin and IGR decreased in both groups. These findings support faster lipid mobilization in response to negative energy status in obese donkeys during fasting, which could be linked to greater glucagonemia and could explain the predisposition of these animals to dyslipidemia.

Effectiveness of early versus delayed motion in patients with distal radius fracture treated with volar locking plate: A systematic review and meta-analysis.

The aim of this study was to determine the effectiveness of early versus delayed motion on the functional outcomes in patients with distal radius fracture (DRF) treated with a volar locking plate. A systematic review and meta-analysis of randomized clinical trials was performed. An electronic search was performed in the Medline, Central, Embase, PEDro, Lilacs, Cinahl, SPORTDiscus, and Web of Science databases. The eligibility criteria included randomized clinical trials that compared the effect of early versus delayed motion on wrist and/or upper limb function, pain, grip strength, and wrist range of motion in subjects older than 18 years with DRF treated with a volar locking plate. Five clinical trials were included that met the eligibility criteria for the quantitative synthesis. At 6 weeks, the PRWE questionnaire showed a mean difference (MD) of -10.6 points (p < 0.001), the MD was -11.1 points for the DASH questionnaire (p < 0.001), -0.56 cm for pain on VAS (p = 0.01), 5.0 kg for grip strength (p = 0.01), 12.5 degrees for wrist flexion (p = 0.07), and 12.8 degrees for wrist extension (p = 0.05). All differences favored the early motion treatment. At 3 months of follow-up, only the DASH, pain on VAS, and grip strength showed significant differences in favor of early motion. At 1 year of follow-up, none of the variables studied were different between groups. In the short term, there was moderate to high evidence of clinically and statistically significant differences in the functional outcomes in favor of early versus delayed motion in patients with DRF treated with a volar locking plate. But these differences were not observed at 1 year of follow-up. PROSPERO registration no.: CRD42020158706.

Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile.

BACKGROUND: Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. MATERIAL AND METHODS: descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. RESULTS: 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation. The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p <0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). CONCLUSIONS: the profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records.

ABPSE: Alineador de ADN Basado en Paralelismo a Nivel de Bit y la Estrategia Siembra y Extiende / ABPSE: DNA Aligner Based on Bit-level Parallelism and the Seed and Extend Strategy

Resumen La alineación de ADN es un proceso clave para la reconstrucción de genomas, a partir de los millones de lecturas cortas producidas por las máquinas de secuenciación paralela masiva. Tal proceso suele realizarse mediante algoritmos con elevada complejidad espacial y temporal, requiriendo varias horas para entregar los resultados, así como decenas de GB de RAM. Esto ha motivado la búsqueda de nuevos algoritmos y/o estrategias que permitan disminuir los tiempos de ejecución, mientras se utilizan recursos mínimos de memoria. En este artículo se presenta ABPSE, un nuevo alineador de ADN que combina el algoritmo de Ferragina y Manzini (o índices de FM) y el algoritmo de Myers, mediante la estrategia siembra y extiende. En la siembra, los índices de FM permiten calcular de manera rápida regiones con alta probabilidad de alineación; mientras que en la extensión, el algoritmo de Myers refina la alineación utilizando operaciones basadas en vectores de bits, calculando simultáneamente varias celdas de la matriz de programación dinámica. Los resultados muestran un 96.1% de lecturas alineadas correctamente, un factor de aceleración de 2.45x en relación a BWA-SW y un uso de memoria de apenas 7.6 GB, cuando se alinea el genoma humano completo.

Abstract DNA alignment is a key process in the assembly of genomes from the millions of short reads that are produced by massive parallel sequencing machines. Such a process is usually done by means of high spatial and temporal complexity algorithms, which takes hours to deliver the results as well as tens of GB of RAM. This has prompted the search for new algorithms and/or strategies that allow shorter runtimes, while using minimal memory footprint. In this article, we present ABPSE, a new DNA aligner that combines the Ferragina and Manzini algorithm (or FM indexes) and the Myers algorithm, by means of the seed and extend strategy. In the seeding, the FM indices allow a rapid calculation of the regions with high probability of alignment. In the extension, the Myers algorithm refines the alignment using operations based on bit vectors. It simultaneously calculates several cells of the dynamic programming matrix. The results show 96.1% of correctly aligned reads, an acceleration factor of 2.45x in relation to BWA-SW and a memory footprint of only 7.6 GB when aligning the entire human genome.

Effect of intravenous glucose and combined glucose-insulin challenges on energy-regulating hormones concentrations in donkeys.

Metabolic disorders are highly prevalent in donkeys. Differences in energy regulatory hormones and glucose dynamic testing, including the intravenous glucose tolerance test (IVGTT) and combined glucose-insulin test (CGIT), have been documented between donkeys and horses. The aims of this study were to characterise the insulin:glucagon (IGR) and glucagon:insulin (GIR) molar ratios, at baseline and in response to the IVGTT and CGIT in healthy donkeys, and to determine their correlation with endocrine (leptin, ghrelin and adiponectin) and morphometric variables. Median values and interquartile ranges (IQRs) for IGR and GIR in 49 healthy adult donkeys were 1.5 (IQR, 1.0-1.8) and 0.7 (IQR 0.5-0.9), respectively. IVGTT and CGIT were each performed on eight donkeys, while dynamic testing was performed on six donkeys due to loss of two donkeys from the study. IVGTT induced an increase in IGR (and a decrease in GIR) from 15 to 180min after the onset of the test, but had no effect on leptin, adiponectin or ghrelin concentrations. CGIT resulted in a significant elevation in IGR (and a decrease in GIR) from 15 to 120min after the onset of the test. Plasma leptin concentrations increased significantly at 240min. No correlations were found between ratios, hormones and morphometric measurements. The findings support differences between donkeys and horses, which are likely to be related to proportionally higher glucagon compared to insulin concentrations in donkeys, and may be relevant to disorders related to energy dysregulation in donkeys, including metabolic syndrome and dyslipidaemias.

Cryopreservation of donkey sperm using non-permeable cryoprotectants.

The aim of this study was to evaluate the effect of different concentrations of sucrose combined with bovine serum albumin (BSA), as non-permeable cryoprotectants, on donkey sperm parameters after cryopreservation, in comparison to a control extender containing glycerol. Semen from five Andalusian donkeys (n = 12) were centrifuged and resuspended with a commercial extender for equine sperm (Gent A, Minitube) adding 1% BSA and different concentrations (M, mol/l) of water-diluted sucrose: 0.05, 0.1, 0.25, 0.35 and 0.45. Thereafter, semen (n = 24) were diluted in the same base extender containing 0.25 M sucrose (S25) or glycerol (GLY, Gent B). Sperm were slowly cooled, filled in 0.5 ml straws and frozen in nitrogen vapours. Post-thaw samples were assessed for sperm motility, plasma membrane and DNA integrity and results were compared by ANOVA. In Experiment 1, sperm motility was significantly higher (P < 0.001) for S25 than the remaining treatments, and no differences were found for plasma membrane or DNA integrity. In Experiment 2, no differences were found between S25 or GLY for sperm motility and DNA integrity but plasma membrane integrity was significantly higher (P < 0.05) for S25. In conclusion, the extender with sucrose 0.25 M combined with BSA can be considered as an alternative to conventional extenders with glycerol for donkey sperm cryopreservation.

Characterization of the intravenous glucose tolerance test and the combined glucose-insulin test in donkeys.

Glucose-insulin dynamic challenges such as the intravenous glucose tolerance test (IVGTT) and combined glucose-insulin test (CGIT) have not been described in donkeys. The objectives of this study were (1) to characterize the IVGTT and CGIT in healthy adult donkeys, and (2) to establish normal glucose-insulin proxies. Sixteen donkeys were used and body morphometric variables obtained each. For the IVGTT, glucose (300 mg/kg) was given IV. For the CGIT, glucose (150 mg/kg) followed by recombinant insulin (0.1 IU/kg) were administered IV. Blood samples for glucose and insulin determinations were collected over 300 min. In the IVGTT the positive phase lasted 160.9 ± 13.3 min, glucose concentration peaked at 323.1 ± 9.2 mg/dL and declined at a rate of 1.28 ± 0.15 mg/dL/min. The glucose area under the curve (AUC) was 21.4 ± 1.9 × 10(3) mg/dL/min and the insulin AUC was 7.2 ± 0.9 × 10(3) µIU/mL/min. The positive phase of the CGIT curve lasted 44 ± 3 min, with a glucose clearance rate of 2.01 ± 0.18 mg/dL/min. The negative phase lasted 255.9 ± 3 min, decreasing glucose concentration at rate of -0.63 ± 0.06 mg/dL/min, and reaching a nadir (33.1 ± 3.6 mg/dL) at 118.3 ± 6.3 min. The glucose and insulin AUC values were 15.2 ± 0.9 × 10(3) mg/dL/min and 13.2 ± 0.9 × 10(3) µIU/mL/min. This is the first study characterizing CGIT and IVGTT, and glucose-insulin proxies in healthy adult donkeys. Distinct glucose dynamics, when compared with horses, support the use of species-specific protocols to assess endocrine function.

Energy-related parameters and their association with age, gender, and morphometric measurements in healthy donkeys.

Donkeys are commonly afflicted by endocrine and metabolic disturbances but few studies have investigated endocrine variables involved in energy regulation and their association with morphometric indices, age or gender in this species. Hemostatic and clinical differences have been demonstrated between horses and donkeys, so to consider both species as metabolically and endocrinologically similar could lead to misdiagnosis. In this study, plasma concentrations of glucose, triglycerides and endocrine factors involved in energy homeostasis (insulin, glucagon, leptin, adiponectin, ghrelin and insulin-like growth factor [IGF]-1) were measured and their association with morphometric variables (body condition score, neck scoring and body mass index), gender and age was determined in 62 healthy donkeys. In addition, a neck scoring system specific for donkeys was developed. Insulin, glucagon, leptin and IGF-1 concentrations were found to be similar between donkeys and other species, but adiponectin and active ghrelin were lower in donkeys than horses. Donkeys with larger neck scores and body mass indices had higher triglyceride, leptin and IGF-1 concentrations. A sexual dimorphism was observed on all morphometric measurements and plasma glucose concentrations independent of adiposity. Younger animals had lower morphometric measurements and triglyceride and leptin concentrations.

Atomic switch networks-nanoarchitectonic design of a complex system for natural computing.

Self-organized complex systems are ubiquitous in nature, and the structural complexity of these natural systems can be used as a model to design new classes of functional nanotechnology based on highly interconnected networks of interacting units. Conventional fabrication methods for electronic computing devices are subject to known scaling limits, confining the diversity of possible architectures. This work explores methods of fabricating a self-organized complex device known as an atomic switch network and discusses its potential utility in computing. Through a merger of top-down and bottom-up techniques guided by mathematical and nanoarchitectonic design principles, we have produced functional devices comprising nanoscale elements whose intrinsic nonlinear dynamics and memorization capabilities produce robust patterns of distributed activity and a capacity for nonlinear transformation of input signals when configured in the appropriate network architecture. Their operational characteristics represent a unique potential for hardware implementation of natural computation, specifically in the area of reservoir computing-a burgeoning field that investigates the computational aptitude of complex biologically inspired systems.

New clostebol metabolites in human urine by liquid chromatography time-of-flight tandem mass spectrometry and their application for doping control.

In this study, clostebol metabolic profiles were investigated carefully. Clostebol was administered to one healthy male volunteer. Urinary extracts were analyzed by liquid chromatography quadrupole time-of-flight mass spectrometry (MS) using full scan and targeted MS/MS techniques with accurate mass measurement for the first time. Liquid-liquid extraction and direct injection were applied to processing urine samples. Chromatographic peaks for potential metabolites were found by using the theoretical [M-H](-) as target ion in full scan experiment, and their actual deprotonated ions were analyzed in targeted MS/MS mode. Fourteen metabolites were found for clostebol, and nine unreported metabolites (two free ones and seven sulfate conjugates) were identified by MS, and their potential structures were proposed based on fragmentation and metabolism pathways. Four glucuronide conjugates were also first reported. All the metabolites were evaluated in terms of how long they could be detected and S1 (4ξ-chloro-5ξ-androst-3ξ-ol-17-one-3ξ-sulfate) was considered to be the long-term metabolite for clostebol misuse detected up to 25 days by liquid-liquid extraction and 14 days by direct injection analysis after oral administration. Five conjugated metabolites (M2, M5, S2, S6 and S7) could also be the alternative biomarkers for clostebol misuse.

Programa de incentivo de la actividad física apoyado con contadores de pasos en la enfermedad pulmonar obstructiva crónica / A program of physical activity enhancement using pedometers in chronic obstructive pulmonary disease

Introducción: La actividad física diaria está reducida en la EPOC lo que se asocia a una mayor morbimortalidad. La indicación médica de caminar más se ha demostrado poco eficaz y, en nuestro medio, se desconoce el beneficio del uso de los contadores de pasos en la EPOC. Objetivo: Determinar el efecto de los contadores de pasos para incentivar la actividadfísica en la EPOC. Método: 55 Pacientes con EPOC fueron incorporados a un programa de tres meses destinado a aumentar su actividad física y fueron asignados aleatoriamente a dos grupos: en uno el paciente autocontroló su actividad con un contador de pasos (grupo experimental) y en el otro se siguió el manejo habitual (grupo control). Al comienzo y al final del estudio se realizaron las siguientes mediciones: promedio de pasos caminados por día medidos en una semana, espirometría, caminata de seis minutos (C6M), disnea con escala de la Medical Research Council Modificada (mMRC) y calidad de vida mediante cuestionario de Saint George (SGRQ) y COPD Assessment Test (CAT). Resultados: 69 por ciento de los pacientes eran hombres, edad promedio 68 años, VEF1ICVF = 55 por ciento, VEF(1)63 por ciento predicho. El grupo experimental (n = 29) y el control (n = 26) presentaron características basales comparables. El grupo experimental presentó una diferencia significativa en el incremento de los pasos por día en comparación con el grupo control (mediana de 2073,5 versus -68, p < 0,001). También hubo diferencia en la reducción del componente síntomas del SGRQ (promedio de -9,65 versus 0,05 puntos, grupo experimental versus control, p = 0,048). Conclusión: Un programa de incentivo de la actividad física apoyado con contadores de pasos es útil para incentivar la actividad física en la EPOC.

Introduction: The level of daily physical activity is reduced in COPD and has a negative effect on the morbidity and mortality of this condition. Usual advice is not sufficient to reverse the sedentary condition. Pedometers are widely used but their effects in COPD have not been tested in our country. Aim: To determine the effect of pedometers on physical activity in COPD patients. Method: 55 COPD patients were recruited for a 3 months individual program promoting daily physical activity enhancement and were randomly assigned either to a pedometer-based program (experimental group) or to usual care (control group). At the beginning and at the end of the intervention period we measured the average daily steps over one week, exercise capacity using the six-minute walking test (6MWT), the MMRC dyspnoea score, the Saint George Respiratory Questionnaire (SGRQ) and the COPD assessment Test (CAT) to estimate quality of life. Results: 69% of the subjects were male, mean age 68 years, mean FEV1IFVC 55%, mean FEV163% of predicted value. Experimental (n = 29) and control group (n = 26) had comparable baseline characteristics. There was a significant difference in the increase of steps/day in the experimental group in comparison with the control group (median value = 2073.5 versus -68, p < 0.001). Also, a significant difference was observed in the symptoms subscale score of the SGRQ (reduction of 9.65 versus 0.05points, experimental versus control group, p = 0.048). Conclusions: Pedometers are a useful tool to increase physical activity level in COPD.

Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia.

BACKGROUND: Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). METHODS: A case-control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. RESULTS: Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47-11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20-0.91). CONCLUSION: Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.

GSK3 is a regulator of RAR-mediated differentiation.

Acute myeloid leukemia (AML) is the most common form of leukemia in adults. Unfortunately, the standard therapeutic agents used for this disease have high toxicities and poor efficacy. The one exception to these poor outcomes is the use of the retinoid, all-trans retinoic acid (ATRA), for a rare subtype of AML (APL). The use of the differentiation agent, ATRA, in combination with low-dose chemotherapy leads to the long-term survival and presumed cure of 75-85% of patients. Unfortunately ATRA has not been clinically useful for other subtypes of AML. Though many non-APL leukemic cells respond to ATRA, they require significantly higher concentrations of ATRA for effective differentiation. Here we show that the combination of ATRA with glycogen synthase kinase 3 (GSK3) inhibition significantly enhances ATRA-mediated AML differentiation and growth inhibition. These studies have revealed that ATRA's receptor, the retinoic acid receptor (RAR), is a novel target of GSK3 phosphorylation and that GSK3 can impact the expression and transcriptional activity of the RAR. Overall, our studies suggest the clinical potential of ATRA and GSK3 inhibition for AML and provide a mechanistic framework to explain the promising activity of this combination regimen.

Use of morphometric variables for differentiating spanish hound breeds / Uso de variables morfométricas para la diferenciación de razas de sabueso español

The term Podencos refers to a group of dog breeds from Spain and classification in Group 5 of dog breeds by the Fédération Cynologique Internationale (FCI). The aim of this study was to compare traits morphometric breeds of Podencos; Canario, Ibecenco, Andaluz (small, medium and large) and Orito. Ten morphometric variables were measured in 385 animals (245 females and 140 males), head length, muzzle length, height at withers, rump height, body length, head width, rump width, chest depth, chest girth and the shin circumference. Morphostructural variables were more homogeneous in the Podenco Ibicenco and the Podengo Canario, because for many years there were gradually distinctive trait standards for each breed. The discriminate analysis indicated morphostructural differences between all breeds, as reflected in the significant Mahalanobis distance, and confirmed that the hound Orito may be accepted as a different dog population.

El término Podencos se refiere a un grupo de razas de perros originarios de España y clasificados en el grupo 5 de razas caninas por la Federación Cinológica Internacional (FCI). El objetivo del presente trabajo fue comparar caracteristicas morfométricas de las razas caninas de Podencos; Canario, Ibecenco, Andaluz (pequeño, medio y grande) y Orito. Se midieron diez variables morfométricas en 385 animales (245 hembras y 140 machos); longitud de la cabeza, la longitud hocico, altura a la cruz, alzada a la grupa, la longitud del cuerpo, ancho de la cabeza, ancho de la grupa, la profundidad del pecho, la circunferencia del pecho y la circunferencia de la caña. Las variables morfoestructurales fueron más homogéneas en el Podenco Ibicenco y el Podenco Canario, porque por muchos años fueron fijados gradualmente los rasgos distintivos para los estandares de cada raza. El análisis discriminante manifestó diferencias morfoestructurales entre todas las razas, lo que se refleja en la significativa distancia de Mahalanobis, y confirmó que el podenco Orito puede ser aceptado como una población de perros diferentes.

Utilidad de la reconstrucción 3D mediante tomografía computarizada con detectores múltiples en un cuerpo extraño intranasal / Use of 3D reconstruction with multidetector computed tomography in a nasal foreign body

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