hkb is required for DIP-α expression and target recognition in the Drosophila neuromuscular circuit.

Our nervous system contains billions of neurons that form precise connections with each other through interactions between cell surface proteins. In Drosophila, the Dpr and DIP immunoglobulin protein subfamilies form homophilic or heterophilic interactions to instruct synaptic connectivity, synaptic growth, and cell survival. However, the upstream regulatory mechanisms of Dprs and DIPs are not clear. On the other hand, while transcription factors have been implicated in target recognition, their downstream cell surface proteins remain mostly unknown. We conduct an F1 dominant modifier genetic screen to identify regulators of Dprs and DIPs. We identify huckebein (hkb), a transcription factor previously implicated in target recognition of the dorsal Is motor neuron. We show that hkb genetically interacts with DIP-α and loss of hkb leads to complete removal of DIP-α expression specifically in dorsal Is motor neurons. We then confirm that this specificity is through the dorsal Is motor neuron specific transcription factor, even-skipped (eve), which acts downstream of hkb. Analysis of the genetic interaction between hkb and eve reveals that they act in the same pathway to regulate dorsal Is motor neuron connectivity. Our study provides insight into the transcriptional regulation of DIP-α and suggests that distinct regulatory mechanisms exist for the same CSP in different neurons.

Documento de consenso de la Sociedad Española de Neurología sobre el tratamiento de la esclerosis múltiple y manejo holístico del paciente 2023 / Consensus statement of the Spanish Society of Neurology on the treatment of multiple sclerosis and holistic patient management in 2023

El último documento de consenso del Grupo de Estudio de Enfermedades Desmielinizantes de la Sociedad Española de Neurología sobre el tratamiento de la esclerosis múltiple (EM) data del año 2016. Aunque muchas consideraciones continúan todavía vigentes, desde entonces se han producido cambios significativos en el manejo y tratamiento de esta enfermedad, motivados no solo por la aprobación de nuevos fármacos con diferentes mecanismos de acción, sino también por la evolución de conceptos otrora consolidados. Esto ha permitido abordar situaciones especiales como el embarazo y la vacunación desde otra perspectiva, e incluir nuevas variables en la toma de decisiones en práctica clínica, como plantear tratamiento modificador de la enfermedad (TME) de alta eficacia en fases tempranas, considerar la perspectiva del paciente y utilizar nuevas tecnologías como monitorización remota. Estos cambios han motivado la presente actualización del consenso mediante metodología Delphi, con el objetivo de reflejar el nuevo paradigma de manejo del paciente con EM basándose en la evidencia científica y la experiencia clínica de los participantes. Entre las principales conclusiones destacan como recomendaciones: iniciar TME inmunomodulador en el síndrome radiológico aislado con actividad radiológica persistente, evaluar la perspectiva del paciente y abandonar la terminología «líneas de tratamiento» en la clasificación de los TME (consenso mayor del 90%). Tras el diagnóstico de EM la elección del primer TME debería considerar la presencia/ausencia de factores de mal pronóstico (epidemiológicos, clínicos, radiológicos y biomarcadores) para la aparición de nuevos brotes o progresión de discapacidad, pudiendo plantear desde el inicio TME de alta eficacia. (AU)

The last consensus statement of the Spanish Society of Neurology's Demyelinating Diseases Study Group on the treatment of multiple sclerosis (MS) was issued in 2016. Although many of the positions taken remain valid, there have been significant changes in the management and treatment of MS, both due to the approval of new drugs with different action mechanisms and due to the evolution of previously fixed concepts. This has enabled new approaches to specific situations such as pregnancy and vaccination, and the inclusion of new variables in clinical decision-making, such as the early use of high-efficacy disease-modifying therapies (DMT), consideration of the patient's perspective, and the use of such novel technologies as remote monitoring. In the light of these changes, this updated consensus statement, developed according to the Delphi method, seeks to reflect the new paradigm in the management of patients with MS, based on the available scientific evidence and the clinical expertise of the participants. The most significant recommendations are that immunomodulatory DMT be started in patients with radiologically isolated syndrome with persistent radiological activity, that patient perspectives be considered, and that the term “lines of therapy” no longer be used in the classification of DMTs (> 90% consensus). Following diagnosis of MS, the first DMT should be selected according to the presence/absence of factors of poor prognosis (whether epidemiological, clinical, radiological, or biomarkers) for the occurrence of new relapses or progression of disability; high-efficacy DMTs may be considered from disease onset. (AU)

Consensus statement of the Spanish Society of Neurology on the treatment of multiple sclerosis and holistic patient management in 2023.

The last consensus statement of the Spanish Society of Neurology's Demyelinating Diseases Study Group on the treatment of multiple sclerosis (MS) was issued in 2016. Although many of the positions taken remain valid, there have been significant changes in the management and treatment of MS, both due to the approval of new drugs with different action mechanisms and due to the evolution of previously fixed concepts. This has enabled new approaches to specific situations such as pregnancy and vaccination, and the inclusion of new variables in clinical decision-making, such as the early use of high-efficacy disease-modifying therapies (DMT), consideration of the patient's perspective, and the use of such novel technologies as remote monitoring. In the light of these changes, this updated consensus statement, developed according to the Delphi method, seeks to reflect the new paradigm in the management of patients with MS, based on the available scientific evidence and the clinical expertise of the participants. The most significant recommendations are that immunomodulatory DMT be started in patients with radiologically isolated syndrome with persistent radiological activity, that patient perspectives be considered, and that the term "lines of therapy" no longer be used in the classification of DMTs (> 90% consensus). Following diagnosis of MS, the first DMT should be selected according to the presence/absence of factors of poor prognosis (whether epidemiological, clinical, radiological, or biomarkers) for the occurrence of new relapses or progression of disability; high-efficacy DMTs may be considered from disease onset.

Assessing the Equivalence of Brain-Derived Measures from Two 3D T1-Weighted Acquisitions: One Covering the Brain and One Covering the Brain and Spinal Cord.

BACKGROUND AND PURPOSE: In MS, it is common to acquire brain and spinal cord MR imaging sequences separately to assess the extent of the disease. The goal of this study was to see how replacing the traditional brain T1-weighted images (brain-T1) with an acquisition that included both the brain and the cervical spinal cord (cns-T1) affected brain- and spinal cord-derived measures. MATERIALS AND METHODS: Thirty-six healthy controls (HC) and 42 patients with MS were included. Of those, 18 HC and 35 patients with MS had baseline and follow-up at 1 year acquired on a 3T magnet. Two 3D T1-weighted images (brain-T1 and cns-T1) were acquired at each time point. Regional cortical thickness and volumes were determined with FastSurfer, and the percentage brain volume change per year was obtained with SIENA. The spinal cord area was estimated with the Spinal Cord Toolbox. Intraclass correlation coefficients (ICC) were calculated to check for consistency of measures obtained from brain-T1 and cns-T1. RESULTS: Cortical thickness measures showed an ICC >0.75 in 94% of regions in healthy controls and 80% in patients with MS. Estimated regional volumes had an ICC >0.88, and the percentage brain volume change had an ICC >0.79 for both groups. The spinal cord area measures had an ICC of 0.68 in healthy controls and 0.92 in patients with MS. CONCLUSIONS: Brain measurements obtained from 3D cns-T1 are highly equivalent to those obtained from a brain-T1, suggesting that it could be feasible to replace the brain-T1 with cns-T1.

Aprendizaje cooperativo, necesidades psicológicas básicas e intencionalidad de mantenerse físicamente activo / Cooperative learning, basic psychological needs and intention to be physically active

El objetivo de este estudio fue evaluarlos efectos de un programa de larga duración de Aprendizaje Cooperativo en las necesidades psicológicas básicas de los estudiantes y su intención de ser físicamente activos. Un total de 109 estudiantes (12-14 años) de cuatro clases diferentes de primer curso de Educación Secundaria Obligatoria aceptaron participar. Los estudiantes fueron organizados en un grupo experimental (n=56),que desarrolló un programa de intervención de Aprendizaje Cooperativo en Educación Física durante cinco meses (cinco unidades didácticas, 40 sesiones),y un grupo de control (n=53) que experimentó, durante el mismo periodo, las mismas unidades didácticas bajo un enfoque de Instrucción Directa. Se siguió un diseño cuasi-experimental de medidas repetidas, empleando una comparación de grupos pretest-postest. Los resultados evidenciaron mejoras estadísticamente significativas en la intención de ser físicamente activo y las necesidades psicológicas básicas de autonomía y relación solo en el grupo de alumnos que experimentaron el Aprendizaje Cooperativo. (AU)

The goal of this study was to assess the effects of a long-term Cooperative Learning programme in students’ basic psychological needs and their intention to be physically active. A total of 109 students (12-14 years old) enrolled in four different Year 8 classes of Secondary Education agreed to participate. Students were organised into an experimental group (n=56), who experienced a Cooperative Learning intervention programme in Physical Education for five months (five learning units, 40 sessions) and a control group (n=53) who experimented, during the same period, the same learning units under a Direct Instruction approach. A quasi-experimental repeated measure applying a pre-test, post-test comparison group design was followed. The results evidenced statistically significant improvements in the intention to be physically active and the basic psychological needs for autonomy and relatedness only in the group of students who experienced Cooperative Learning. (AU)

Dpr10 and Nocte are required for Drosophila motor axon pathfinding.

The paths axons travel to reach their targets and the subsequent synaptic connections they form are highly stereotyped. How cell surface proteins (CSPs) mediate these processes is not completely understood. The Drosophila neuromuscular junction (NMJ) is an ideal system to study how pathfinding and target specificity are accomplished, as the axon trajectories and innervation patterns are known and easily visualized. Dpr10 is a CSP required for synaptic partner choice in the neuromuscular and visual circuits and for axon pathfinding in olfactory neuron organization. In this study, we show that Dpr10 is also required for motor axon pathfinding. To uncover how Dpr10 mediates this process, we used immunoprecipitation followed by mass spectrometry to identify Dpr10 associated proteins. One of these, Nocte, is an unstructured, intracellular protein implicated in circadian rhythm entrainment. We mapped nocte expression in larvae and found it widely expressed in neurons, muscles, and glia. Cell-specific knockdown suggests nocte is required presynaptically to mediate motor axon pathfinding. Additionally, we found that nocte and dpr10 genetically interact to control NMJ assembly, suggesting that they function in the same molecular pathway. Overall, these data reveal novel roles for Dpr10 and its newly identified interactor, Nocte, in motor axon pathfinding and provide insight into how CSPs regulate circuit assembly.

Processing and mechanical properties of novel biodegradable poly-lactic acid/Zn 3D printed scaffolds for application in tissue regeneration.

The feasibility to manufacture scaffolds of poly-lactic acid reinforced with Zn particles by fused filament fabrication is demonstrated for the first time. Filaments of 2.85 mm in diameter of PLA reinforced with different weight fractions of µm-sized Zn - 1 wt.% Mg alloy particles (in the range 3.5 to 17.5 wt.%) were manufactured by a double extrusion method in which standard extrusion is followed by precision extrusion in a filament-maker machine. Filaments with constant diameter, negligible porosity and a homogeneous reinforcement distribution were obtained for Zn weight fractions of up to 10.5%. It was found that the presence of Zn particles led to limited changes in the physico-chemical properties of the PLA that did not affect the window temperature for 3D printing nor the melt flow index. Thus, porous scaffolds could be manufactured by fused filament fabrication at 190 °C with poly-lactic acid/Zn composites containing 3.5 and 7 wt.% of Zn and at 170 °C when the Zn content was 10.5 wt.% with excellent dimensional accuracy and mechanical properties.

Test de condición física: Modelo tradicional versus modelo de educación deportiva / Fitness Testing: Traditional Model Versus Sport Education Model

El objetivo fue comparar el uso de dos planteamientos metodológicos, el modelo tradicional (MT) y el Modelo de Educación Deportiva (MED), en la valoración de las capacidades físicas básicas con 118 estudiantes de 13 años (M = 12,81, DE = 0,74). Los resultados indicaron que el uso del MED produjo mayores puntuaciones en las variables autonomía, competencia, relación, y motivación intrínseca. Los varones se aburrieron más y las mujeres sintieron menor presión-tensión con el MED. Los resultados registrados por el profesor en todos los test mediante el MT se correspondían con los resultados registrados por los alumnos con el MED con una fiabilidad que oscilaba entre buena y excelente. Con base en la teoría de la autodeterminación, se sugiere que el uso del MED en la enseñanza y aplicación de los test de condición física puede producir beneficios sin perder fiabilidad en la valoración de la condición física. (AU)

The aim was to compare the use of two methodological approaches, the traditional model (TM) and the Sport Education Model (SEM) on the assessment of physical fitness with 118 students of 13 years old (M = 12.81, SD = 0.74). The results indicated that the use of the MED in physical fitness test administration produced higher scores on the variables autonomy, competence, relationship, and intrinsic motivation. Males became more bored and females felt less pressure-tension with the SEM. Fitness assessment from both methodological approaches were similar, indicating good reliability in data collection. Based on the self-determination theory, the results of this study suggest that the use of the SEM in fitness testing can produce benefits in the students without losing reliability in fitness testing. (AU)

Seguimiento de resultados de Test de Antígenos en trabajadores del ámbito sanitario con infección activa por SARS-CoV-2 / Monitoring of Antigen Test results in healthcare workers with active SARS-CoV-2 infection

Introducción: La introducción del Test de Antígenos como prueba válida para valorar el alta de un trabajador del ámbito sanitario afectado por SARS-CoV-2, supone un cambio importante para los Servicios de Prevención de centros sanitarios, por lo que se decide el estudio de los resultados obtenidos de dichas pruebas, en un hospital de la Comunidad de Madrid durante un tiempo determinado en un periodo de alta transmisibilidad, valorando el tiempo que tarda un trabajador con infección activa por SARS-CoV-2 en negativizar un Test de Antígenos. Método: Estudio observacional, descriptivo, retrospectivo realizado en el Hospital Universitario Infanta Cristina en Parla (Madrid) desde el 11 de enero del 2.022 hasta el 21 de febrero 2.022, en el que se estudian variables como sexo, edad, vacunación, categoría profesional e infección previa por SARS-CoV-2 y su influencia en el tiempo de negativización de un Test de Antígenos. Resultados: Un total de 164 trabajadores del ámbito sanitario se vieron afectados por Covid-19 durante el periodo estudiado, de los cuales 74 (45,1%) dieron positivo en Test de Antígenos a los 7 días del inicio de la infección, llegando hasta el 13º día 4 trabajadores (2,4 %). Conclusiones: Se pone de manifiesto que el haber tenido una infección previa por Covid-19, influye en el tiempo que tarda en negativizar un Test de Antígenos; disminuyéndolo, en trabajadores con infección activa por SARS-CoV-2 (AU)

Introduction: The introduction of the Antigen Test as a valid test to assess the discharge of a healthcare worker affected by SARS-CoV-2, represents an important change for the Prevention Services of health centers, for which it is decided to study the results obtained from these tests, in a hospital in the Community of Madrid for a certain time in a period of high transmissibility, assessing the time it takes for a worker with active SARS-CoV-2 infection to make an Antigen Test negative. Method: Observational, descriptive, retrospective study carried out at the Infanta Cristina University Hospital in Parla (Madrid) from January 11, 2022 to February 21, 2022, in which variables such as sex, age, vaccination, category professional and previous SARS-CoV-2 infection and its influence on the negative time of an Antigen Test. Results: A total of 164 healthcare workers were affected by Covid-19 during the period studied, of which 74 (45,1%) tested positive for Antigen Test 7 days after the start of the infection, reaching up to the 13th day 4 workers (2.4%). Conclusions: It is shown that having had a previous Covid-19 infection influences the time it takes for an Antigen Test to become negative; decreasing it, in health workers with active SARS-CoV-2 infection (AU)

Analysis of co-isogenic prion protein deficient mice reveals behavioral deficits, learning impairment, and enhanced hippocampal excitability.

BACKGROUND: Cellular prion protein (PrPC) is a cell surface GPI-anchored protein, usually known for its role in the pathogenesis of human and animal prionopathies. However, increasing knowledge about the participation of PrPC in prion pathogenesis contrasts with puzzling data regarding its natural physiological role. PrPC is expressed in a number of tissues, including at high levels in the nervous system, especially in neurons and glial cells, and while previous studies have established a neuroprotective role, conflicting evidence for a synaptic function has revealed both reduced and enhanced long-term potentiation, and variable observations on memory, learning, and behavior. Such evidence has been confounded by the absence of an appropriate knock-out mouse model to dissect the biological relevance of PrPC, with some functions recently shown to be misattributed to PrPC due to the presence of genetic artifacts in mouse models. Here we elucidate the role of PrPC in the hippocampal circuitry and its related functions, such as learning and memory, using a recently available strictly co-isogenic Prnp0/0 mouse model (PrnpZH3/ZH3). RESULTS: We performed behavioral and operant conditioning tests to evaluate memory and learning capabilities, with results showing decreased motility, impaired operant conditioning learning, and anxiety-related behavior in PrnpZH3/ZH3 animals. We also carried in vivo electrophysiological recordings on CA3-CA1 synapses in living behaving mice and monitored spontaneous neuronal firing and network formation in primary neuronal cultures of PrnpZH3/ZH3 vs wildtype mice. PrPC absence enhanced susceptibility to high-intensity stimulations and kainate-induced seizures. However, long-term potentiation (LTP) was not enhanced in the PrnpZH3/ZH3 hippocampus. In addition, we observed a delay in neuronal maturation and network formation in PrnpZH3/ZH3 cultures. CONCLUSION: Our results demonstrate that PrPC promotes neuronal network formation and connectivity. PrPC mediates synaptic function and protects the synapse from excitotoxic insults. Its deletion may underlie an epileptogenic-susceptible brain that fails to perform highly cognitive-demanding tasks such as associative learning and anxiety-like behaviors.

The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2021 Update on Echocardiography.

The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) is the world's premier clinical outcomes registry for adult cardiac surgery and a driving force for quality improvement in cardiac surgery. Echocardiographic data provide a wealth of hemodynamic, structural, and functional data and have been part of STS ACSD data collection since its inception. An increasing body of evidence suggests that the use of echocardiography in patients undergoing cardiac surgery has a positive impact on postoperative outcomes. In this report, we describe and summarize the type and rate of reporting of echocardiography-related variables in the STS ACSD, including the Adult Cardiac Anesthesiology Module, from July 2017 to December 2019 for the most frequently performed cardiac surgical procedures. With this review, we aim to increase awareness of the importance of collecting accurate and consistent echocardiography data in the STS ACSD and to highlight opportunities for growth and improvement.

Miocarditis y trombosis in situ en ventrículo derecho en paciente COVID-19 / Myocarditis and in situ thrombosis in the right ventricle in a COVID-19 patient

A pesar de que el SARS-CoV-2 afecta principalmente al aparato respiratorio, se está evidenciando cada vez más la afectación de otros sistemas. Uno de los que más relevancia ha tomado es el cardiovascular tanto por daño miocárdico agudo (DMA) como por complicaciones tromboembólicas debidas al estado de hipercoagulabilidad que produce la infección. Este caso clínico presenta la coexistencia de complicaciones cardiovasculares en un paciente joven, sin enfermedades previas e infección reciente por COVID-19. Así mismo, plantea la necesidad de realizar cribado de complicaciones cardiovasculares mediante técnicas de imagen por el aumento en su incidencia. (AU)

Although SARS-CoV-2 mainly affects the respiratory system, its impact on other systems is becoming increasingly evident. Cardiovascular involvement is highly significant in the form of acute myocardial damage (AMD) and thromboembolic complications due to the hypercoagulable state produced by this infection. This clinical case presents the coexistence of several cardiovascular complications in a young patient, with no previous disease and recent COVID-19 infection. It also highlights the need for screening for cardiovascular complications by imaging techniques due to the increase in their incidence. (AU)

Optical and thermal properties of edible coatings for application in solar drying.

Solar drying is a sustainable process that may impact the quality of dried food. This is because, pigments contained in food are sensitive to sunlight, and exposure to ultraviolet radiation can affect them. We applied biopolymer-based coatings on strawberry, from hydro-colloidal solutions of Opuntia ficus indica-mucilage, fenugreek, xanthan gum, gum Arabic, and guar gum to evaluate their potential use as UV filters for solar drying of food. Thermal properties and the optical transmittance, absorbance and reflectance of the coatings were measured to assess their influence on food-sunlight interaction. During the drying experiments, the moisture content, total anthocyanins (TA), and total phenolic compounds (TPC) were measured. Optical and thermal properties are influenced by the biopolymer-based coatings. Also, the optical properties are influenced by the coating thickness. The differences in optical and thermal properties influence the drying process. Differences exist in the drying rate for strawberry slices with coating, compared with those without the coatings. In general, the TA and TPC content in the product are better preserved under solar drying than in control experiments done in a drying oven. A partial transmittance of solar UV radiation is recommended to obtain increased TA and TPC contents in the dried product.

Optical and thermal performance of a toroidal compound parabolic concentrator.

The design, construction, and ray simulation of a new compound parabolic concentrator based on a toroidal shape (toroidal compound parabolic concentrator, TCPC) are addressed. Such analysis indicates that the amount of concentrated radiation is independent of the Sun trajectory. Thus, the TCPC has the advantage of concentrating Sun rays in a spot, and if positioned with an inclination corresponding to the latitude, a solar tracker would not be needed. Experimental measurements with a prototype model are shown to be in good agreement with the simulation results. The possibility of a variety of applications, as natural illumination for this TCPC device, is also pointed out. The simple design, fabrication, and implementation of the TCPC make it an excellent alternative for low concentration in a spot. We present the analysis of the TCPC in natural illumination as one of these applications.

[Myocarditis and in situ thrombosis in the right ventricle in a COVID-19 patient]. / Miocarditis y trombosis in situ en ventrículo derecho en paciente COVID-19.

Although SARS-CoV-2 mainly affects the respiratory system, its impact on other systems is becoming increasingly evident. Cardiovascular involvement is highly significant in the form of acute myocardial damage (AMD) and thromboembolic complications due to the hypercoagulable state produced by this infection. This clinical case presents the coexistence of several cardiovascular complications in a young patient, with no previous disease and recent COVID-19 infection. It also highlights the need for screening for cardiovascular complications by imaging techniques due to the increase in their incidence.

Bowel ultrasonography in acute abdomen: beyond acute appendicitis. / Ecografía intestinal y abdomen agudo: más allá de la apendicitis aguda.

Acute abdomen is a common reason for consultation in the emergency department. A broad spectrum of entities, including diverse diseases of the gastrointestinal tract, can cause acute abdomen. Although computed tomography is the technique most widely used to evaluate acute abdomen in the emergency department, abdominal ultrasound is often performed first and allows bowel disease to be suspected. This article describes the ultrasound features of diverse bowel diseases that can cause acute abdomen, such as acute diverticulitis, bowel obstruction, gastrointestinal perforation, bowel ischemia, intraabdominal fat necrosis, and miscellaneous processes such as endometriosis, foreign bodies, or vasculitis. Radiologists must be familiar with the different features of abnormal bowel that can be detected incidentally in patients without clinical suspicion of bowel disease. This article focuses on ultrasonographic signs of bowel disease; other articles in this series cover the ultrasonographic signs of acute appendicitis, inflammatory bowel disease, and infectious diseases.

Delayed lower extremity paresis following iliosacral screws: Atypical complication and treatment.

Percutaneous iliosacral screw placement has become the technique of choice for treating injuries to the posterior pelvis. However, the technique requires an understanding of the anatomy surrounding the bone corridors to avoid complications and detect them early if they occur. We present the clinical case of a patient with a U-shaped fracture of the sacrum that evolves with gluteal pain and left foot equine paresis after percutaneous fixation with iliosacral screws. Angio-CT of the pelvis shows active arterial bleeding from the superior gluteal artery associated to extensive hematoma in the thickness of the gluteus medius muscle. Emergency embolization is performed by installing coil and gelatin. Successful control of bleeding is achieved. To avoid this complication, a complete imaging study is recommended in planning the surgery and to avoid multiple repositioning of the guide or screw. Arterial injury should be suspected in case of increasing pain despite analgesia, functional impairment or neurological deficit and the angiographic study and resolution by selective embolization of the bleeding vessels must be performed.

The Adult Cardiac Anesthesiology Section of STS Adult Cardiac Surgery Database: 2020 Update on Quality and Outcomes.

The Society of Cardiovascular Anesthesiologists, in partnership with The Society of Thoracic Surgeons, has developed the Adult Cardiac Anesthesiology Section of the Adult Cardiac Surgery Database. The goal of this landmark collaboration is to advance clinical care, quality, and knowledge, and to demonstrate the value of cardiac anesthesiology in the perioperative care of cardiac surgical patients. Participation in the Adult Cardiac Anesthesiology Section has been optional since its inception in 2014 but has progressively increased. Opportunities for further growth and improvement remain. In this first update report on quality and outcomes of the Adult Cardiac Anesthesiology Section, we present an overview of the clinically significant anesthesia and surgical variables submitted between 2015 and 2018. Our review provides a summary of quality measures and outcomes related to the current practice of cardiothoracic anesthesiology. We also emphasize the potential for addressing high-impact research questions as data accumulate, with the overall goal of elucidating the influence of cardiac anesthesiology contributions to patient outcomes within the framework of the cardiac surgical team.

Infiltrating endometriosis: diagnostic keys in abdominal ultrasonography. / Endometriosis infiltrante: claves diagnósticas en la ecografía abdominal.

OBJECTIVE: Endometriosis is the presence of endometrial tissue outside the uterus. Endometriosis of the bowel and urinary tract are types of extragenital endometriosis that manifest with nonspecific symptoms, but their detection involves specific therapeutic strategies. Although the characteristics of the disease on transvaginal ultrasonography and on magnetic resonance imaging have been described in many publications, few references describe its characteristics on abdominal ultrasonography. This paper illustrates the findings for infiltrating endometriosis involving the bowel and urinary tract on abdominal ultrasonography and shows the usefulness of this technique for identifying signs of the disease that have been described with other techniques. Knowledge of infiltrating endometriosis and its ultrasonographic features will enable radiologists to suggest its diagnosis and to include it in the differential diagnosis of pelvic pain in women of child-bearing age. CONCLUSION: Abdominal ultrasonography is a useful tool in the diagnosis of extragenital endometriosis. Familiarity with the ultrasonographic appearance of this entity facilitates the diagnostic orientation and management of patients with pelvic pain.