Motivators of physical exercise in older adults from different contexts / Motivos de práctica de ejercicio físico en adultos mayores de diferentes contextos

The aim of the present study was to understand the reasons to join or to continue in a physical exercise programme based on the perceptions of the older adults participating in the study. Four focus groups were selected in various contexts, with a total of 39 older adults. An emergent induction analysis methodology was applied, handling the participants' speeches from the specific to the general through the coding process proposed in the grounded theory. The differences among contexts regarding personal reasons for physical practice were presented, as well as the role of physical and psychological benefits, and body image. The participants of this research engaged in physical exercise to pursue physical health benefits in the first place, followed by psychological well-being, and leaving body image aside (AU)

Este estudio se realizó para tratar de comprender cuáles son los motivos encontrados al unirse a programas o mantener la práctica de ejercicio físico en base a las percepciones de las personas adultas mayores que participan en el estudio. Se realizaron cuatro grupos focales en diferentes contextos con un total de 39 adultos mayores. El análisis metodológico es inductivo, emergente, delimitando los discursos de los participantes del estudio de lo específico a lo general, a través del proceso de codificación de la teoría fundamentada. Se presentaron las diferencias entre contextos sobre los motivos de carácter personal para la práctica física, el papel de los beneficios físicos, psicológicos y la imagen corporal. Los participantes de esta investigación realizan ejercicio físico buscando en primer lugar los beneficios para la salud física, seguido del bienestar psicológico y dejando de lado la mejora de la imagen corporal (AU)

Considerations after lockdown and overcoming Covid-19: A systematic review for returning to safe physical exercise practice.

Objective: This systematic review aims to understand the problems associated with lockdown and the various conditions of Covid-19 infection and to help prepare athletes and exercise enthusiasts for the safe resumption of sport in a manner that promotes wellness, healthy competition, and a sports industry that survives the current situation. This systematic review was carried out, following the recommendations of the currently pre-established reporting elements for systematic reviews and meta-analyses. The following databases were consulted: ISI Web of Science (WOS), Scopus and Google Scholar. This review includes a total of 19 articles. News: The results are presented based on three predominant themes: (1) psychological impact produced by SARS-CoV-2; (2) post-Covid-19 cardiac abnormalities and (3) protocols for an adequate return to physical practice. Prospects and projects: Most of the protocols shown by the various papers are consistent in terms of duration and number of phases. Based on this, the safe return to practice protocol can be divided into four stages of seven days in each phase in order to progress according to the symptoms perceived. In each phase, the physiological demand and efforts necessary to cover the proposed activities are increased until optimal physical condition is recovered.

Objectif: Cette revue systématique vise à comprendre les problèmes associés au confinement et aux diverses conditions d'infection au Covid-19 et à aider à préparer les athlètes et les amateurs d'exercice à la reprise du sport en toute sécurité d'une manière qui favorise le bien-être, une compétition saine et une industrie du sport qui survit à la situation actuelle. Cette revue systématique a été réalisée en suivant les recommandations des éléments de notification actuellement préétablis pour les revues systématiques et les méta-analyses. Les bases de données suivantes ont été consultées : ISI Web of Science (WOS), Scopus et Google Scholar. Cette revue comprend un total de 19 articles. Actualités: Les résultats sont présentés selon trois thèmes prédominants : (1) impact psychologique produit par le SARS-CoV-2 ; (2) anomalies cardiaques post-Covid-19 et (3) protocoles pour un retour adéquat à la pratique physique. Perspectives et projets: La plupart des protocoles présentés par les différents papiers sont cohérents en termes de durée et de nombre de phases. Sur cette base, le protocole de retour à la pratique en toute sécurité peut être divisé en quatre étapes de sept jours chacune afin de progresser selon les symptômes perçus. Dans chaque phase, la demande physiologique et les efforts nécessaires pour couvrir les activités proposées sont augmentés jusqu'à ce que la condition physique optimale soit retrouvée.

Urgencia odontológica ambulatoria en la población de la red pública de salud en Chile, 2017-2020 / Outpatient dental emergency in the population of the public health network in Chile, 2017-2020

OBJETIVO Describir la tendencia de las consultas de urgencia odontológica ambulatoria registrada en la población atendida en la red pública de salud en Chile entre los años 2017 y 2020. MATERIALES Y METODOS Diseño de estudio ecológico. Se evaluaron las consultas de urgencia odontológica ambulatoria obtenidas del Registro Estadístico Mensual (REM) del Ministerio de Salud de Chile entre los años 2017 y 2020. Se calculó la tasa de consulta por urgencia odontológica ambulatoria (UOA) considerando el total de consultas de urgencias con Garantía explícitas en salud en el numerador y la población beneficiaria registrada por el Fondo Nacional de salud en el denominador, amplificado por 1000 para cada año de estudio. Las tasas se especificaron por sexo, grupo etario (<20 años; 20 a 64 años y 65 y más años), y zona geográfica de Chile (zona norte, centro y sur). RESULTADOS Se registraron un total de 27.639.889 consultas odontológicas en la red pública de atención de salud en el país, de estas, 1.345.390 corresponden a consultas por UOA. Se observó una disminución de la tasa de consulta por urgencia odontológica ambulatoria hacia el año 2020 (variación porcentual de -17,93%). La tasa de consultas es levemente mayor en mujeres, en edades entre 20 a 64 años y en la zona norte y sur del país. CONCLUSION Se observa una disminución sostenida en la tasa de consultas por UOA en la red pública de salud del país, lo que podría reflejar la existencia de un mayor acceso de la población a resolver los problemas de salud bucal en el nivel primario de atención asociado al desarrollo de diferentes programas de alud bucal. Sin embargo hay que ser cautelosos con la interpretación considerando que durante el periodo Chile vivió un estallido social e hizo frente a la pandemia por COVID-19

AIM To describe the trend of outpatient dental emergency registered in the population attended in the public health system in Chile between 2017 and 2020. MATERIALS AND METODOS Ecological study design. Outpatient dental emergency obtained from the Statistical Registry (REM) of the Ministry of Health of Chile between 2017 and 2020 were evaluated. The consultation rate for outpatient dental emergency (OUA) was calculated considering the total number of emergency consultations with Explicit health guarantees in the numerator and the beneficiary population registered by the National Health Fund in the denominator, amplified by 1,000 for each year of study. The rates were specified by sex, age group (<20 years; 20 to 64 years and 65 years and over), and geographical area of Chile (north, center and south). RESULTS A total of 27,639,889 dental consultations were registered in the public health care network in the country, of these, 1,345,390 correspond to consultations by UOA. A decrease in the outpatient dental emergency consultation rate was observed towards the year 2020 (percentage variation of -17.93%). The consultation rate is slightly higher in omen, between the ages of 20 and 64, and in the north and south of the ountry.CONCLUSION A sustained decrease in the consultation rate for UOA in the country's public health system is observed, which could reflect the existence of a greater access of the population to solve oral health problems at the primary level of care associated to the development of different oral health programs. However, one must be cautious with the interpretation considering that during the period Chile experienced a social explosion and faced the COVID-19 pandemic

Bioinspired gelatin/bioceramic composites loaded with bone morphogenetic protein-2 (BMP-2) promote osteoporotic bone repair.

There are currently several commercialized products approved by the Food and Drug Administration and the European Medicines Agency based on the use of recombinant human BMP-2 for the treatment of non-unions long fractures and spinal fusion. However, the adverse effects recorded with the use of BMPs suggest the need for drug delivery carriers that allow reducing the required doses and improve their cost-effectiveness. Herein, we have developed a new osteoconductive scaffold that reduces the required doses of BMP-2 for promoting bone regeneration in an osteoporotic defect model. The composite is, in brief, a gelatin-based 3D scaffold reinforced with either calcium sulfate or hydroxyapatite as an inorganic osteoconductive biomaterial. To this end, the organic/inorganic composite systems showed high hydration capacity and good in vitro degradability. The incorporation of 7.5% (m/v) ceramic compounds resulted in scaffolds with stiffer Young modulus (179 and 75 kPa for CaSO4_7 and HA_7, respectively) than bare gelatin hydrogels (48 kPa). Studies with human bone-marrow derived mesenchymal stem cells (hBM-MSCs) revealed that the 3D scaffolds promote cell adhesion and proliferation along with osteogenic differentiation capabilities. Specifically, downregulation of stemness (Nanog, Oct4) genes and upregulation of osteogenic markers (ALP, Col1a1, Fmod) by two fold were observed over 10 days under basal culture conditions. Promisingly, the sustained in vitro release of BMP-2 observed from the porous reinforced scaffolds allowed us to address the critical-sized osteoporotic mice calvarial defects with a relatively low growth factor doses (600 ng BMP-2/scaffold) compared to conventional doses at 2-15 micrograms. Overall, this study demonstrates the promising potential of osteoconductive gelatin/calcium bioceramics composites as osteogenic growth factors delivery carriers for bone-regeneration via ultra-low growth factor doses.

The use of anthropometrical variables for detection of homeostatic measurement assessment-insulin resistance (HOMA-IR) in female participants of a physical exercise program.

BACKGROUND: The Homeostatic Measurement Assessment-Insulin Resistance (HOMA-IR) is a recognized and validated method which uses the levels of fasting glucose in blood and insulin of patients to evaluate the insulin resistance. AIMS: The purpose of the present study was to assess the cut-off values for anthropological variables to identify the (HOMA-IR) index in female participants of a physical exercise program. In addition, the association and prediction of insulin resistance by anthropological variables was studied. METHODS: A total of 143 participants (45.64 ± 13.17 years) volunteered for this study. Clinical data were collected by means of a self-reported questionnaire. Body weight and BMI were assessed by bioelectrical impedance analysis and skinfold thickness was taken using a caliper. Girths were assessed with a flexible metallic tape measures and finally, the HOMA-IR was calculated by the formula as follows: fasting plasma insulin ((µU/ml) x fasting plasma glucose (mmol/L). RESULTS: The outcomes of the study indicated that the AUC of anthropometrical variables for identifying HOMA-IR are reflected primarily in weight, waist-to-hip ratio, waist-to-thigh ratio, subscapular skinfold thickness, abdominal skinfold thickness, hip circumference, chest circumference, upper arm muscular girths (tensed and relaxed) (all, p ≤ 0.001), triceps skinfold thickness (p 109 cm (specificity: 99.2  waist circumference > 116 cm (specificity: 99.2 %) and abdomen skinfold < 8.8 (specificity: 97.6 %), predict the HOMA-IR in 35.29 %, 29.41 %, 23.53 % and 23.53 %, respectively. CONCLUSION: The present empirical study demonstrates that hip, chest and waist circumference on the one hand, and abdomen skinfold on the other hand are markers that are relevant to the identification of HOMA-IR index in females (Tab. 3, Ref. 33). Text in PDF www.elis.sk Keywords: insulin resistance, anthropometry, cut-off value, women, HOMA-IR.

Papel del índice neutrófilo/linfocito en pacientes con cáncer de próstata resistente a castración metastásicos tratados en primera línea con abiraterona / Role of the neutrophil/lymphocyte ratio in patients with metastatic castration-resistant prostate cancer treated first-line with abiraterone

INTRODUCCIÓN: En pacientes con cáncer de próstata un NLR elevado parece asociarse a una peor supervivencia. Abiraterona es un tratamiento hormonal de nueva generación que ha aumentado SLP y SG en CPRCm. MATERIAL Y MÉTODOS: Análisis retrospectivo de pacientes tratados con AA en nuestro centro (diciembre del 2012-septiembre del 2018). Analizamos la asociación del NLR (< o ≥ 3) previo y a los 6 meses de tratamiento con la respuesta del PSA, SLP y SG, y hormonosensibilidad previa a AA (< o > 12 meses). RESULTADOS: Hemos tratado a 56 pacientes con una mediana de edad de 82 (62-94), de los cuales 22 pacientes (39%) presentan NLR ≥ 3 previo al tratamiento. Existe una asociación estadísticamente significativa entre el NLR previo al tratamiento < 3 y la respuesta del PSA, OR = 9,444, p =0,001, no existiendo esa asociación con el NLR a los 6 meses de tratamiento. Se encontraron diferencias estadísticamente significativas entre los grupos de NLR < y > 3 previo al tratamiento con abiraterona en SLP con 15 meses de mediana vs.9 y una p = 0,008 y en SG con 20 meses vs.9 con una p = 0,014. Con respecto a la determinación de NLR, a los 6 meses no existen diferencias en las curvas de supervivencia entre ambos grupos. Existen diferencias significativas entre el NLR previo al tratamiento según la duración del tiempo hasta la resistencia a castración (p = 0,026). CONCLUSIONES: Nuestros resultados indican que el NLR podría aportarnos información trascendente y ser constituido un marcador pronóstico temprano y accesible en los pacientes con CPRCm en tratamiento en primera línea con abiraterona

INTRODUCTION: In patients with prostate cancer, high NLR seems to be associated with worse survival. Abiraterone acetate (AA) is a new generation hormonal treatment that has shown to increase PFS and OS in mCRPC. MATERIAL AND METHODS: Retrospective analysis of patients treated with AA in our center (December 2012-September 2018). We analyzed the association of the NLR (< or ≥ 3) before and after 6 months of treatment with PSA response, PFS, OS, and hormone sensitivity prior to AA (< or > 12 months). RESULTS: We have treated 56 patients with a median age of 82 (62-94), of which 22 (39%) had NLR ≥ 3 before treatment. There is a statistically significant association between the NLR prior to treatment < 3 and PSA response, OR = 9,444, P = .001, and there was no association with the NLR at 6 months of treatment. Statistically significant differences were found between the groups of NLR < and > 3 prior to treatment with abiraterone in PFS with 15 months of median vs.9 and P=.008, and in OS with 20 months vs.9 with P = .014. With respect to the determination of NLR at 6 months, there are no differences in the survival curves between both groups. There are significant differences between the NLR prior to treatment according to the length of hormone sensitivity (P = .026). CONCLUSIONS: Our results suggest that NLR could provide relevant information and could act as an early and accessible prognostic marker in patients with mCRPC in first line treatment with Abiraterone

Role of the neutrophil/lymphocyte ratio in patients with metastatic castration-resistant prostate cancer treated first-line with abiraterone. / Papel del índice neutrófilo/linfocito en pacientes con cáncer de próstata resistente a castración metastásicos tratados en primera línea con abiraterona.

INTRODUCTION: In patients with prostate cancer, high NLR seems to be associated with worse survival. Abiraterone acetate (AA) is a new generation hormonal treatment that has shown to increase PFS and OS in mCRPC. MATERIAL AND METHODS: Retrospective analysis of patients treated with AA in our center (December 2012-September 2018). We analyzed the association of the NLR (< or ≥ 3) before and after 6 months of treatment with PSA response, PFS, OS, and hormone sensitivity prior to AA (< or> 12 months). RESULTS: We have treated 56 patients with a median age of 82 (62-94), of which 22 (39%) had NLR ≥ 3 before treatment. There is a statistically significant association between the NLR prior to treatment<3 and PSA response, OR=9,444, P=.001, and there was no association with the NLR at 6 months of treatment. Statistically significant differences were found between the groups of NLR 3 prior to treatment with abiraterone in PFS with 15 months of median vs. 9 and P=.008, and in OS with 20 months vs. 9 with P=.014. With respect to the determination of NLR at 6 months, there are no differences in the survival curves between both groups. There are significant differences between the NLR prior to treatment according to the length of hormone sensitivity (P=.026). CONCLUSIONS: Our results suggest that NLR could provide relevant information and could act as an early and accessible prognostic marker in patients with mCRPC in first line treatment with Abiraterone.

Molecular Diagnosis in House Dust Mite-Allergic Patients Suggests That Der p 23 Is Clinically Relevant in Asthmatic Children.

BACKGROUND: Patterns of sensitization to house dust mites depend on geographic area and are important in clinical practice. However, the role of molecular diagnosis is not currently defined. We sought to characterize a pediatric population by focusing on sensitization to different mite species and major mite components in order to assess the clinical relevance of sensitization to allergenic components in our practice. METHODS: Consecutive children with respiratory allergy sensitized to house dust mites (determined by skin prick test [SPT]) were recruited. We determined specific IgE to nDer p 1, rDer p 2, and rDer p 23 using ImmunoCAP and sIgE using ImmunoCAP-ISAC microarray. Patients were followed up for 3 years. RESULTS: A total of 276 children were recruited. The frequency of sensitization was 86.6% for nDer p 1, 79.3% for rDer p 2, and 75.8% for rDer p 23. Lepidoglyphus species was the most common storage mite detected by SPT. Twenty-six patients (9.4%) were not sensitized to Der p 1 or Der p 2. It is noteworthy that IgE binding to Der p 23 was positive in 14 (53.8%). Asthmatic patients, especially those with a persistent moderate-severe phenotype, more frequently recognized the 3 major allergens. CONCLUSIONS: Most patients with mite allergy were sensitized to the major allergens Der p 1, Der p 2, and Der p 23. Of the allergens evaluated, 5% were sensitized to Der p 23 but not to Der p 1 or Der p 2. Sensitization to Der p 23 should be considered in the diagnosis and treatment of mite allergy, especially in patients with moderate-severe asthma, because it may worsen the clinical phenotype.

Molecular diagnosis in house dust mite-allergic patients suggests that Der p 23 is clinically relevant in asthmatic children

BACKGROUND: Patterns of sensitization to house dust mites depend on geographic area and are important in clinical practice. However, the role of molecular diagnosis is not currently defined. We sought to characterize a pediatric population by focusing on sensitization to different mite species and major mite components in order to assess the clinical relevance of sensitization to allergenic components in our practice. METHODS: Consecutive children with respiratory allergy sensitized to house dust mites (determined by skin prick test [SPT]) were recruited. We determined specific IgE to nDer p 1, rDer p 2, and rDer p 23 using ImmunoCAP and sIgE using ImmunoCAP-ISAC microarray. Patients were followed up for 3 years. RESULTS: A total of 276 children were recruited. The frequency of sensitization was 86.6% for nDer p 1, 79.3% for rDer p 2, and 75.8% for rDer p 23. Lepidoglyphus species was the most common storage mite detected by SPT. Twenty-six patients (9.4%) were not sensitized to Der p 1 or Der p 2. It is noteworthy that IgE binding to Der p 23 was positive in 14 (53.8%). Asthmatic patients, especially those with a persistent moderate-severe phenotype, more frequently recognized the 3 major allergens. CONCLUSIONS: Most patients with mite allergy were sensitized to the major allergens Der p 1, Der p 2, and Der p 23. Of the allergens evaluated, 5% were sensitized to Der p 23 but not to Der p 1 or Der p 2. Sensitization to Der p 23 should be considered in the diagnosis and treatment of mite allergy, especially in patients with moderate-severe asthma, because it may worsen the clinical phenotype

ANTECEDENTES: El perfil de sensibilización a los ácaros del polvo depende del área geográfica y es importante en la práctica clínica. Sin embargo, el papel del diagnóstico molecular no ha sido del todo definido. Nuestro objetivo fue la caracterización del perfil de sensibilización de una población pediátrica a diferentes especies de ácaros; y evaluar la sensibilización a componentes alergénicos y su relevancia en nuestra práctica clínica. MÉTODOS: Se reclutaron de forma consecutiva pacientes con alergia respiratoria y sensibilización a ácaros del polvo doméstico mediante pruebas cutáneas. Se determinó la IgE específica por ImmunoCAP a nDer p 1, rDer p 2, rDer p 23 y la sIgE mediante el microarray de ImmunoCAP ISAC. Los pacientes fueron evaluados durante tres años según práctica cínica habitual. RESULTADOS: Se reclutaron un total de 276 niños. La sensibilización fue de 86,6% a nDer p 1, 79,3% a rDer p 2 y 75,8% a rDer p 23. Lepidoglyphus fue el ácaro de almacén más común según prueba cutánea. Un total de veintiséis pacientes (9,4%) no estaban sensibilizados a Der p 1 ni Der p 2; cabe destacar que 14 de ellos (53,8%) presentaban IgE positiva a Der p 23. Los pacientes con asma, y en especial los de fenotipo persistente moderado y grave, reconocieron con mayor frecuencia los tres alérgenos mayores. CONCLUSIONES: La mayoría de nuestra población pediátrica con alergia a ácaros está sensibilizada a los alérgenos mayores Der p 1, Der p 2 y Der p 23. Un 5% estaba sensibilizado a Der p 23, pero no a Der p 1 ni a Der p 2. La sensibilización a Der p 23 debe considerarse en el diagnóstico y tratamiento de la alergia a ácaros, especialmente en pacientes con asma persistente moderada y grave

[Simulation in medical education from the perspective of patients’ safety]. / Efectividad de la simulación en la educación médica desde la perspectiva de seguridad de pacientes.

We herein review the association between patients’ safety and simulation methods for medical education. This evidence should help to change the present paradigm in medical education, where there is still reticence towards this education method. A total of 20 papers on the subject were reviewed. Ninety percent of these articles conclude that simulation contributes to patient safety, 5% conclude that the evidence is uncertain and 5% conclude that the effects will be seen in the next decade. Thus, the majority of papers support the use of simulation in medical education as a method that improves patients’ safety.

Efectividad de la simulación en la educación médica desde la perspectiva de seguridad de pacientes / Simulation in medical education from the perspective of patients safety

We herein review the association between patients’ safety and simulation methods for medical education. This evidence should help to change the present paradigm in medical education, where there is still reticence towards this education method. A total of 20 papers on the subject were reviewed. Ninety percent of these articles conclude that simulation contributes to patient safety, 5% conclude that the evidence is uncertain and 5% conclude that the effects will be seen in the next decade. Thus, the majority of papers support the use of simulation in medical education as a method that improves patients’ safety.

Relevance of Allergenic Sensitization to Cynodon dactylon and Phragmites communis: Cross-reactivity With Pooideae Grasses.

BACKGROUND AND OBJECTIVES: The homologous group of sweet grasses belongs to the Pooideae subfamily, but grass pollen species from other subfamilies can also cause allergy, such as Cynodon dactylon (Chloridoideae) and Phragmites communis (Arundinoideae). C dactylon and P communis have not been included in the sweet grasses homologous group because of their low cross-reactivity with other grasses. The aims of this study were to investigate the profile of sensitization to C dactylon and P communis in patients sensitized to grasses and to analyze cross-reactivity between these 2 species and temperate grasses. METHODS: Patients were skin prick tested with a grass mixture (GM). Specific IgE to GM, C dactylon, P communis, Cyn d 1, and Phl p 1 was measured by ImmunoCAP. A pool of sera was used for the immunoblot assays. Cross-reactivity was studied by ELISA and immunoblot inhibition. RESULTS: Thirty patients had sIgE to GM. Twenty-four (80%) had positive results for C dactylon, 27 (90%) for P communis, 22 (73.3%) for nCyn d 1, and 92.9% for rPhl p 1. Bands were detected in the 3 extracts by immunoblot. Inhibition of GM was not observed with C dactylon or P communis by immunoblot or ELISA inhibition. When C dactylon or P communis were used in the solid phase, GM produced almost complete inhibition. CONCLUSIONS: Eighty percent of patients sensitized to grasses were also sensitized to C dactylon and 90% were sensitized to P communis. Sensitization to these species seems to be induced by allergens different to those in sweet grasses.

Relevance of allergenic sensitization to cynodon dactylon and Phragmites communis: cross-reactivity with pooideae grasses

Background and Objectives: The homologous group of sweet grasses belongs to the Pooideae subfamily, but grass pollen species from other subfamilies can also cause allergy, such as Cynodon dactylon (Chloridoideae) and Phragmites communi (Arundinoideae). C dactylon and P communis have not been included in the sweet grasses homologous group because of their low cross-reactivity with other grasses. The aims of this study were to investigate the profile of sensitization to C dactylon and P communis in patients sensitized to grasses and to analyze cross-reactivity between these 2 species and temperate grasses. Methods: Patients were skin prick tested with a grass mixture (GM). Specific IgE to GM, C dactylon, P communis, Cyn d 1, and Phl p 1 was measured by ImmunoCAP. A pool of sera was used for the immunoblot assays. Cross-reactivity was studied by ELISA and immunoblot inhibition. Results: Thirty patients had sIgE to GM. Twenty-four (80%) had positive results for C dactylon, 27 (90%) for P communis, 22 (73.3%) or nCyn d 1, and 92.9% for rPhl p 1. Bands were detected in the 3 extracts by immunoblot. Inhibition of GM was not observed with C dactylon or P communis by immunoblot or ELISA inhibition. When C dactylon or P communis were used in the solid phase, GM produced almost complete inhibition. Conclusions: Eighty percent of patients sensitized to grasses were also sensitized to C dactylon and 90% were sensitized to P communis. Sensitization to these species seems to be induced by allergens different to those in sweet grasses (AU)

Antecedentes y Objetivos: Desde un punto de vista taxonómico, el grupo homólogo de las gramíneas pertenece a la sub-familia Pooideae. Sin embargo, existen también otras especies de gramíneas alergénicas que pertenecen a sub-familias diferentes como son Cynodon dactylon (Chloridoideae) o Phragmites communis (Arundinoideae). C. dactylon y P. communis no están incluidas en este grupo homólogo debido a que la reactividad cruzada con otras gramíneas es limitada. Los objetivos del estudio fueron investigar el perfil de sensibilización a C. dactylon y P. communis en pacientes sensibilizados a gramíneas y analizar la reactividad cruzada entre estas dos especies y las gramíneas más comunes. Métodos: A los pacientes se les realizó una prueba cutánea con una mezcla de gramíneas (MG). Mediante ImmunoCAP se midió la IgE específica para MG, C. dactylon P. communis , Cyn d 1 y Phl p 1. Un pool de sueros se utilizó para ensayos de inmunoblot. La reactividad cruzada se estudió mediante ELISA e inmunoblot inhibición Resultados: Treinta pacientes tuvieron IgE específica para MG. Veinticuatro (80%) fueron positivos a C. dactylon, 27 (90%) a P. communis, 22 (73,3%) a nCyn d 1 y 92,9% fueron positivos a rPhl p 1. Se detectaron bandas en los tres extractos mediante inmunoblot. No se observó inhibición de MG con las otras dos especies mediante inmunoblot o ELISA inhibición. Cuando C. dactylon o P. communis se usaron en fase sólida, MG produjo una inhibición casi completa. Conclusiones: El 80% de los pacientes sensibilizados a gramíneas estaban también sensibilizados a C. dactylon y el 90% a P. communis. La sensibilización a estas especies parece estar inducida por diferentes alérgenos que en el caso de gramíneas (AU)

The incidence of unexplained visual loss following removal of silicone oil.

PURPOSE: To assess the incidence and clinical features of unexpected visual loss after removal of silicone oil (ROSO). PATIENTS AND METHODS: A retrospective cross-sectional observational study of 421 consecutive eyes, which underwent silicone oil removal at one institution over a 2-year period. RESULTS: Fourteen (3.3%) patients, (12 male, mean age of 53.1 years) suffered unexplained visual loss. In these eyes, the mean duration of silicone oil fill was 141 days (range 76-218). The mean loss of visual acuity was 3.7 (range 2-6) Snellen lines (SL) at 1 month, 3.5 (2-6) SL at 3 months and 2.91 (0-6) SL at 6 months. The change from preoperative visual acuity was statistically significant at all visits (P=0.02). Subgroup analysis of 20 fovea-sparing giant retinal tear (GRT) detachments, observed 10 (50%) cases of visual loss after ROSO. Electrodiagnostic testing suggested predominantly macular dysfunction, with optic nerve involvement in one case. Five of the 14 cases had variable recovery of vision. CONCLUSION: There is a 3.3% overall incidence of visual loss following ROSO with a high rate (50%) observed in maculae on GRT detachments. Although recovery of visual acuity is seen in a minority of cases, visual loss after ROSO remains a serious and unexplained concern for vitreoretinal surgeons.

Tomato nsLTP as an "In Vivo" Diagnostic Tool: Sensitization in a Mediterranean Population.

BACKGROUND: Tomato allergies have been extensively studied but component-resolved in vivo diagnosis with purified allergens has yet to be performed. OBJECTIVES: To evaluate the prevalence of sensitization to Sola l 3 in a Mediterranean population, and to compare the resulting sensitization profile with that of individuals sensitized to tomato, peach, and/or purified lipid transfer protein (LTP). METHODS: Sola l 3 was purified, characterized, and used to prepare skin prick tests (SPTs). Two groups of patients were selected. Group 1 consisted of patients with at least 1 positive SPT to tomato, peach, or LTP mixture (marker extracts) who were subsequently tested with Sola l 3 (n = 280). Group 2 (prevalence study) consisted of patients who underwent simultaneous SPT with the 3 marker extracts and Sola l 3 (n = 658). Patients from either group who were positive to any of the 4 extracts were studied in detail (study group, n = 1 23). ELISA and immunoblot assays were performed in individuals with a positive SPT to Sola l 3 to detect the presence of specific IgE antibodies to this allergen. RESULTS: Prevalence of sensitization to Sola l 3 was 3.2% overall and 54.7% in tomato-positive patients. Most tomato-sensitized patients were asymptomatic. Symptoms were more common in Sola l 3-positive individuals. Sensitization to peach and the LTP mixture did not discriminate between Sola l 3-positive and Sola l 3-negative patients. CONCLUSIONS: This study confirms that LTP, not only from peach but also from other fruit and vegetables, including tomato, is an important allergen in the Mediterranean area. Sensitization to Sola l 3 is associated with more symptoms in tomato-sensitized patients.

Tomato nsLTP as an 'In Vivo' diagnostic tool: sensitization in a mediterranean population

Antecedentes: La alergia a tomate ha sido ampliamente estudiada; sin embargo, todavía no se ha realizado diagnóstico basado en componentes in vivo con alérgenos purificados. Objetivos: Evaluar la prevalencia de sensibilización a Sola l3 en una población mediterránea y comparar su perfil de sensibilización con el de individuos sensibilizados a piel de tomate, piel de melocotón y/o nsLTP (proteínas de transferencia de lípidos) purificadas. Métodos: Se purificó Sola l3, se caracterizó y se utilizó para preparar pruebas cutáneas (SPT). Se seleccionaron dos grupos de pacientes. Grupo 1: a estos pacientes se les realizaron pruebas cutáneas con tomate, melocotón y una mezcla de LTPs (extractos marcadores); a los pacientes que fueron positivos al menos a uno ellos se les realizó una prueba cutánea con Sola l3 (n=280). Grupo 2 (estudio de prevalencia): a los pacientes se les realizó una prueba cutánea simultáneamente con los tres extractos marcadores y Sola l3 (n=658). Los pacientes de los dos grupos que fueron positivos a cualquiera de los cuatros extractos se analizaron con más detalle (grupo de estudio, n=123). Se realizaron ensayos de ELISA e inmunoblot con los individuos positivos a Sola l3 para detectar la presencia de anticuerpos IgE específicos para este alérgeno. Resultados: La prevalencia de sensibilización a Sola l3 fue del 3,2%, pero incrementó hasta un 54,7% en pacientes positivos a tomate. La mayoría de los pacientes sensibilizados a tomate fueron asintomáticos. El número de pacientes sintomáticos aumentó en los individuos positivos a Sola l3. La sensibilización a melocotón y mezcla de LTP no discriminó entre pacientes positivos y negativos a Sola l3. Conclusiones: Este estudio confirma que las nsLTP son alérgenos importantes en el área mediterránea, no solo relacionados con melocotón, sino también con otros vegetales, como el tomate. La sensibilización a Sola l3 está relacionada con más síntomas en pacientes sensibilizados a tomate (AU)

Background: Tomato allergies have been extensively studied but component-resolved in vivo diagnosis with purified allergens has yet to be performed. Objectives: To evaluate the prevalence of sensitization to Sola l3 in a Mediterranean population, and to compare the resulting sensitization profile with that of individuals sensitized to tomato, peach, and/or purified lipid transfer protein (LTP). Methods: Sola l3 was purified, characterized, and used to prepare skin prick tests (SPTs). Two groups of patients were selected. Group 1 consisted of patients with at least 1 positive SPT to tomato, peach, or LTP mixture (marker extracts) who were subsequently tested with Sola l3 (n=280). Group 2 (prevalence study) consisted of patients who underwent simultaneous SPT with the 3 marker extracts and Sola l3 (n=658). Patients from either group who were positive to any of the 4 extracts were studied in detail (study group, n=123). ELISA and immunoblot assays were performed in individuals with a positive SPT to Sola l3 to detect the presence of specific IgE antibodies to this allergen. Results: Prevalence of sensitization to Sola l3 was 3.2% overall and 54.7% in tomato-positive patients. Most tomato-sensitized patients were asymptomatic. Symptoms were more common in Sola l3–positive individuals. Sensitization to peach and the LTP mixture did not discriminate between Sola l3–positive and Sola l3–negative patients. Conclusions: This study confirms that LTP, not only from peach but also from other fruit and vegetables, including tomato, is an important allergen in the Mediterranean area. Sensitization to Sola l3 is associated with more symptoms in tomato-sensitized patients (AU)

Hyperthyroidism as a clinical manifestation of a embryonal carcinoma of the testis.

This case report describes a case of hyperthyroidism as manifestation of an embryonal carcinoma, and illustrates the causes that led to it. The case describes a 33-year-old male patient who complained of chest pain, palpitations, mild dyspnoea, and weight loss. Blood analysis reveals high levels of human chorionic gonadotropin (833818 mlU/ml), T3 (16.90 pg/ml), and T4 (7.77 ng/dl), as well as a fall of TSH (0.01 ulU/ml). Physical examination and imaging procedures confirm the occurrence of a left testicular tumour associated with numerous lung, hepatic and retroperitoneal metastases. Treatment with carbimazol and propanolol is established to manage hyperthyroidism, and an urgent orchiectomy is performed; the histologic diagnosis confirms an embryonal carcinoma (organoid type), but the patient died unexpectedly 24 hours later after having suffered sudden dyspnoea, tachypnoea, and tachyarrhythmia. Hyperthyroidism is a rare manifestation of a testicular tumour that should be borne in mind with regard to the patient's symptomatology and HCG levels.

Oral health status and inequalities among ambulant older adults living in central Chile.

OBJECTIVE: To assess the oral health status and treatment needs of older adults, living in the Valparaiso Region of Chile. BASIC RESEARCH DESIGN: A random sample of 354 older adults, aged 60 years or older, living independently in the community were examined orally by calibrated examiners and underwent a structured oral health interview. Data collection extended from October 2006 to June 2007. RESULTS: This was a largely dentate population (80%) with a mean DMFT score of 21.6 (s.d. 5.7). While about 28% of the dentate sample had all their restorative needs unmet, 30.8% had all of their restorative needs met. Regarding periodontal health, 3.3% had sound periodontum; complex periodontal therapy (CPI 3-4) was needed by 43.1% of the sample. CONCLUSION: This study represents one of the largest data collections in oral health among older adults living in Chile. Participants seemed to have better oral health status than previously reported. Of particular relevance is the reduction of the decayed component and the increased number of sound teeth in the present sample. Participants also presented lower need for advance periodontal treatment. Yet, inequalities were apparent in the proportion of unmet restorative needs. Strategies to develop oral health care programmes focused on improving access to and use of preventive services for older adults are critical. Further research is indicated to get a more complete picture of the factors that shape the oral health of Chilean older adults.