Physicochemical and mineral properties of suspended sediments of the Tigris and Euphrates rivers in the Mesopotamian Plain.

Most of the suspended river load from the Tigris and Euphrates rivers is deposited in the Mesopotamian Plain in Iraq. This suspended river load comprises sediments consisting of minerals and organic particles generated from weathering, erosion, transport, and sedimentation. Therefore, it is crucial to analyze, either quantitative or qualitatively, the types of minerals in the sediment particles transported by the suspended river load, in addition to the potential value they may add to the agricultural lands irrigated by the Tigris and Euphrates rivers. Herein, samples of suspended sediments were collected from both rivers for physical, chemical, and mineral assessments. The results revealed the predominance of silt particles, followed by clay, and then sand. The presence of clay particles increased while that of silt and sand decreased with further travel into the rivers. The pH values ranged from 7.39 to 7.70 and the electrical conductivity ranged from 1.39 to 2.16 ds m-1. The values of the total and active calcium carbonate minerals were 352.87-336.12 and 172.64-194.56 g kg-1 for the Tigris and Euphrates rivers, respectively. The mineral analysis identified the presence of non-clay minerals at a rate of 83 %, including calcite, quartz, albite, dolomite, and gypsum. Clay minerals, including chlorite, illite, montmorillonite, palygorskite, vermiculite, and kaolinite, were found at a rate of 17 %. Both rivers exhibited distributions of clay and non-clay minerals that vary as they move along the rivers.

Evaluating temporal sand drift potential trends in the Sistan region, Southeast Iran.

The Sistan region in Southeastern Iran is one of the world's most sensitive areas when it comes to sandstorms and wind erosion. One of the most influential factors in interpreting sandstorms is sand drift potential (DP), which is directly related to wind speed. Accurately, monitoring this phenomenon is still being determined, considering various temporal scales. Therefore, the main aim of this research is to analyze the trend of DP on monthly and annual scales. Our results showed that monthly variations of DP reached the highest and lowest values in July (609 VU) and January (47 VU), respectively. Blowing sand predominantly moved southeast, and the directional index fluctuated from 0.88 to 0.94. The annual DP was measured equal to 2700 VU, signifying a relatively high value when compared to other arid regions worldwide. The trend analysis results obtained from the Mann-Kendall test revealed both positive trends during the period 1987-2001 and negative ones from 2002 to 2016). However, the positive trend was found statistically insignificant. Furthermore, Sen's slope test results demonstrated that a negative trend could be observed with a steeper slope during July, September, and August, while a positive trend could be observed with a steeper pitch during November, December, and June. We recommend that land managers and stakeholders involved in controlling blowing sand using biological and physical methods should consider these trends in the Sistan region. Implementing nature-based solutions or control strategies should focus on these temporal sequences.

Centriolar subdistal appendages promote double-strand break repair through homologous recombination.

The centrosome is a cytoplasmic organelle with roles in microtubule organization that has also been proposed to act as a hub for cellular signaling. Some centrosomal components are required for full activation of the DNA damage response. However, whether the centrosome regulates specific DNA repair pathways is not known. Here, we show that centrosome presence is required to fully activate recombination, specifically to completely license its initial step, the so-called DNA end resection. Furthermore, we identify a centriolar structure, the subdistal appendages, and a specific factor, CEP170, as the critical centrosomal component involved in the regulation of recombination and resection. Cells lacking centrosomes or depleted for CEP170 are, consequently, hypersensitive to DNA damaging agents. Moreover, low levels of CEP170 in multiple cancer types correlate with an increase of the mutation burden associated with specific mutational signatures and a better prognosis, suggesting that changes in CEP170 can act as a mutation driver but could also be targeted to improve current oncological treatments.

Microglia activation and neuronal alterations in retinas from COVID-19 patients: correlation with clinical parameters.

BACKGROUND: Different ocular alterations have been described in patients with coronavirus disease 2019 (COVID-19). Our aim was to determine whether COVID-19 affected retinal cells and establish correlations with clinical parameters. METHODS: Retinal sections and flat-mount retinas from human donors with COVID-19 (n = 16) and controls (n = 15) were immunostained. The location of angiotensin-converting enzyme 2 (ACE2) and the morphology of microglial cells, Müller cells, astrocytes, and photoreceptors were analyzed by confocal microscopy. Microglial quantification and the area occupied by them were measured. Correlations among retinal and clinical parameters were calculated. RESULTS: ACE2 was mainly located in the Müller cells, outer segment of cones and retinal pigment epithelium. Cell bodies of Müller cells in COVID-19 group showed greater staining of ACE2 and cellular retinaldehyde-binding protein (CRALBP). The 81.3% of COVID-19 patients presented disorganization of honeycomb-like pattern formed by Müller cells. Gliosis was detected in 56.3% of COVID-19 patients compared to controls (40%) as well as epiretinal membranes (ERMs) or astrocytes protruding (50%). Activated or ameboid-shape microglia was the main sign in the COVID-19 group (93.8%). Microglial migration towards the vessels was greater in the COVID-19 retinas (P < 0.05) and the area occupied by microglia was also reduced (P < 0.01) compared to control group. Cone degeneration was more severe in the COVID-19 group. Duration of the disease, age and respiratory failure were the most relevant clinical data in relation with retinal degeneration. CONCLUSIONS: The retinas of patients with COVID-19 exhibit glial activation and neuronal alterations, mostly related to the inflammation, hypoxic conditions, and age.

Streptococcus vestibularis atypical infectious keratits after intracorneal ring segment implantation.

PURPOSE: To report the first case of an atypical infectious keratitis caused by Streptococcus vestibularis after ICRS implantation. CASE REPORT: A 65-year-old man underwent intracorneal ring segments (ICRS) implantation for the treatment of a pellucid marginal corneal degeneration (PMCD) in his both eyes (OU). Three weeks after the surgery of the right eye (OD), the patient presented with pain, redness, and vision loss in his OD. BCVA was 20/100 Snellen equivalent in the OD. Slit-lamp examination revealed punctate whitish infiltrates along the ring segment with associated corneal stromal edema in the OD. Corneal scrapings were obtained for gram satins and bacterial and fungal cultures, and topical treatment with hourly ciprofloxacin was started. Two days later, corneal stromal edema worsened with involvement of the ring channel. Thus, the ring segment was removed and sent for cultures, and the ring channel was irrigated with vancomycin. Culture from ring segment came back positive for Streptococcus vestibularis, so topical targeted antiobiotherapy with vancomycin and erythromycin was applied. At 3 weeks of follow-up, BCVA was of 20/40 Snellen equivalent in the OD and a subtle corneal leucoma in the OD was observed in the slit-lamp examination. CONCLUSION: Although infectious keratitis is a rare and serious disorder associated with ICRS implantation, its early recognition and management is essential in order to avoid sight-threatening complications. Thus, a prompt obtainment of corneal curettage samples and removal of ring segment becomes decisive to initiate a targeted antiobiotherapy.

Environmental impacts of corn silage production: influence of wheat residues under contrasting tillage management types.

The intensification of specific land management operations (tillage, herbicide, etc.) is increasing land degradation and contributing to ecosystem pollution. Mulches can be a sustainable tool to counter these processes. This is particularly relevant for rural areas in low-income countries where agriculture is a vital sector. In this research, the environmental impact of different rates of wheat residues (no residues, 25, 50, 75, and 100%) in corn silage cultivation was evaluated using the life cycle assessment (LCA) method under conventional tillage (CT) and no-tillage (NT) systems in a semi-arid region in Karaj, Iran. Results showed that in both tillage systems, marine aquatic ecotoxicity (ME) and global warming potential (GWP) had the highest levels of pollution among the environmental impact indicators. In CT systems, the minimum (17,730.70 kg 1,4-dichlorobenzene (DB) eq.) and maximum (33,683.97 kg 1,4-DB eq.) amounts of ME were related to 0 and 100% wheat residue rates, respectively. Also, in the CT system, 0 and 100% wheat residue rates resulted in minimum (176.72 kg CO2 eq.) and maximum (324.95 kg CO2 eq.) amounts of GWP, respectively. However, in the NT system, the 100% wheat residue rate showed the minimum amounts of ME (11,442.39 kg 1,4-DB eq.) and GWP (120.21 kg CO2 eq.). Also, in the NT system, maximum amounts of ME (17,174 kg 1,4-DB eq.) and GWP (175.60 kg CO2 eq.) were observed with a zero wheat residue rate. On-farm emissions and nitrogen fertilizers were the two factors with the highest contribution to the degradation related to environmental parameters at all rates of wheat residues. Moreover, in the CT system, the number of environmental pollutants increased with the addition of a higher wheat residue rate, while in the NT system, increasing residue rates decreased the amount of environmental pollutants. In conclusion, this LCA demonstrates that the NT system with the full retention of wheat residues (100%) is a more environmentally sustainable practice for corn silage production. Therefore, it may be considered one of the most adequate management strategies in this region and similar semi-arid conditions. Further long-term research and considering more environmental impact categories are required to assess the real potential of crop residues and tillage management for sustainable corn silage production.

Replacing chemical fertilizers with organic and biological ones in transition to organic farming systems in saffron (Crocus sativus) cultivation.

To evaluate the response of saffron to animal manure, and biological and chemical fertilizer in an arid climate, an experiment was performed as split plots based on a randomized complete blocks design with three replications during three consecutive crop growth seasons (2015-2018) at the Research Farm of University of Gonabad, Iran. The experimental treatments included application (60 t ha-1) and non-application (control) of manure as the main plot and the use of biosulfur (5 kg ha-1), biophosphate (3 L ha-1), nitroxin (3 L ha-1), chemical fertilizer (150, 100, and 100 kg ha-1 of urea, triple superphosphate, and potassium sulfate, respectively), and no fertilizer application (control) as the sub-plot. The results showed a highly significant response of the quantitative traits of saffron to the application of manure, which increased the leaf, flower, and corm indices of saffron by a mean of 15.1-35.7% than control. The interaction effect of manure with biological and chemical fertilizers for leaf, flower, and weeds indices of saffron was significant. There was no significant difference between the interaction treatments of manure and chemical fertilizer with nitroxin and biophosphorus fertilizers in most of the mentioned traits in the three experiment years. The simultaneous application of these fertilizers increased the average by about 60, 105, 135, 110, 165, and 55% of the leaf dry weight, the number of flowers, fresh flower yield, dry flower yield, dry stigma yield, and weed dry weight of saffron, respectively as compared to control. There was no significant difference between the chemical fertilizer with nitroxin or biophosphate in terms of the effect on the traits related to saffron corm so the use of these fertilizers, as compared to control, increased replacement corm weight, replacement corm size, and bud number per corm by, respectively, about 35, 60, and 40% on average. The chemical and biological fertilizers improved the content of crocin, picrocrocin, and safranal of saffron stigma. The best results were obtained from the use of chemical fertilizers, although no significant difference was observed between this treatment and the nitroxin and biophosphate treatments. Overall, the results of this three-year experiment show a very high response of the saffron plant to the simultaneous use of manure and biological fertilizers and, therefore, it is possible to replace chemical fertilizers with organic and biological fertilizers in saffron cultivation to implement organic agriculture and achieve acceptable quantitative and qualitative yields in areas similar to the experiment location.

Arthroscopic-assisted latissimus dorsi transfer for irreparable posterosuperior cuff tears: Clinical outcome of 15 patients.

OBJECTIVE: We analyzed the clinical and functional results of patients with irreparable posterosuperior rotator cuff tears treated with arthroscopic-assisted latissimus dorsi transfer and the clinical relevance of the addition of partial repair of the remaining cuff to the transfer. METHODS: This was a prospective cohort study that included patients diagnosed with irreparable massive rotator cuff tears treated by arthroscopic-assisted latissimus dorsi transfer between 2015 and 2018. Demographic characteristics, clinical and functional outcomes (Constant-Murley (CS) score and subjective shoulder value (SSV)), and the incidence of complications were evaluated. Clinical outcomes were compared between patients treated with transfer alone and transfer with partial cuff repair. RESULTS: Fifteen patients were included, with an average follow-up of 37 ± 16 months. The median duration of symptoms before surgery was 66 weeks (24-208). A significant increase in forward elevation of 52° (p < 0.003) and abduction of 48° (p < 0.001) was obtained. The CS score increased by 48 points (p < 0.001), and the SSV changed from 29% preoperatively to 70% postoperatively (p < 0.001), with a significant decrease in the visual analog pain score from 7 to 1 (p < 0.001). In 10 patients, partial repair of the rotator cuff was also performed. No statistically significant differences were found in these patients compared with patients treated with transfer alone. Two patients presented complications, including transient sensitive neuropraxia of the axillary nerve and seroma, which were managed conservatively and did not affect the outcomes. CONCLUSION: Arthroscopic-assisted latissimus dorsi transfer is a safe technique that significantly improves clinical and functional outcomes in selected patients. Longer follow-up and comparison with other treatment options are needed to confirm these excellent results in this group of difficult-to-treat patients. LEVEL OF EVIDENCE IV: Nil.

TRIM37: a critical orchestrator of centrosome function.

Loss of function mutations in the E3 ubiquitin ligase TRIM37 result in MULIBREY nanism, a disease characterized by impaired organ growth and a high propensity to develop different tumor types. Additionally, increased copy number of TRIM37 is a feature of some breast cancers and neuroblastomas. The molecular role played by TRIM37 in such loss and gain of function conditions has been a focus of research in the last decade, which led notably to the identification of critical roles of TRIM37 in centrosome biology. Specifically, deletion of TRIM37 results in the formation of aberrant centrosomal proteins assemblies, including Centrobin-PLK4 assemblies, which can act as extra MTOCs, thus resulting in defective chromosome segregation. Additionally, TRIM37 overexpression targets the centrosomal protein CEP192 for degradation, thereby preventing centrosome maturation and increasing the frequency of mitotic errors. Interestingly, increased TRIM37 protein levels sensitize cells to the PLK4 inhibitor centrinone. In this review, we cover the emerging roles of TRIM37 in centrosome biology and discuss how this knowledge may lead to new therapeutic strategies to target specific cancer cells.

Results of standardized treatment of elbow fracture dislocations as per their injury pattern: a retrospective cohort of 89 patients.

BACKGROUND: Elbow fracture dislocations represent difficult injuries to treat, with a high percentage of complications. Classically, they are divided into posterolateral, posteromedial and transulnar pattern. It is essential to distinguish them to guide intraoperative treatment to achieve an anatomic and stable reduction that allows early mobility. METHODS: A retrospective study of 89 adult patients diagnosed with elbow fracture dislocations who underwent a standardized surgery between 2013 and 2018 with a minimum follow-up of 12 months. Demographic data, characteristics of the injury, and associated procedures were collected. Patients were evaluated with functional scores (Mayo elbow performance score/Broberg and Morrey score) and ranges of movement at the end of the follow-up. RESULTS: The mean age was 41 ± 12 years, mostly men (82%), with an average follow-up of 29 months. We present 42 patients with posterolateral fracture dislocation (47%), 21 posteromedial (24%) and 26 transulnar (29%). The average range of motion at the end of follow-up was -12 ± 11° extension, 124 ± 20° flexion, 76 ± 16° pronation, and 73 ± 20° supination, with a Mayo elbow performance score of 88.7 ± 12 points and 87.2 ± 12 points in the Broberg and Morrey scale. Reoperation rate was 23%, with no infection or heterotopic ossification cases. Transulnar fracture dislocations have significantly worse extension and supination. As per the functional result (Mayo elbow performance score/Broberg and Morrey scale), there are no significant differences between the different patterns. CONCLUSION: Proper injury pattern recognition and a standardized surgical management lead to a stable joint and good results in range of motion. Functional results are encouraging at least at short term, despite the high reoperations rate.

Arthroscopy-Assisted Latissimus Dorsi Transfer for Irreparable Subscapularis Tears.

Irreparable tears of the subscapularis (SS) tendon are difficult to manage and represent a challenge for the surgeon, especially in young and active patients. They are associated with a horizontal imbalance of the shoulder, causing pain and limitation of active internal rotation. Historically, the alternative for these patients has been transfer of the pectoralis major, with all its variations, total or partial, up or under the conjoint tendon. However, this transfer has mechanical disadvantages, especially related to the vector of traction, because it originates in the anterior region of the chest. In 2013, Elhassan and colleagues demonstrated in cadavers the technical feasibility and neurological safety of performing transfers of the latissimus dorsi (LD) to the lesser tuberosity to reconstruct irreparable lesions of the subscapularis. This option, compared with alternatives, has superior biomechanical advantages such as a similar vector of traction, originating from lower and posterior to the thorax, in addition to involving a synergistic muscle in action. In early 2016, Kany and colleagues first published a study of 5 patients undergoing arthroscopic assisted LD to SS transfer, with promising results. Our purpose is to present an arthroscopically assisted latissimus dorsi transfer technique in patients with irreparable subscapularis rupture.

Tomografía de coherencia óptica de segmento anterior en la distrofia corneal de Reis-Bücklers / Anterior segment optical coherence tomography in Reis-Bücklers corneal dystrophy

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TRIM37 prevents formation of centriolar protein assemblies by regulating Centrobin.

TRIM37 is an E3 ubiquitin ligase mutated in Mulibrey nanism, a disease with impaired organ growth and increased tumor formation. TRIM37 depletion from tissue culture cells results in supernumerary foci bearing the centriolar protein Centrin. Here, we characterize these centriolar protein assemblies (Cenpas) to uncover the mechanism of action of TRIM37. We find that an atypical de novo assembly pathway can generate Cenpas that act as microtubule-organizing centers (MTOCs), including in Mulibrey patient cells. Correlative light electron microscopy reveals that Cenpas are centriole-related or electron-dense structures with stripes. TRIM37 regulates the stability and solubility of Centrobin, which accumulates in elongated entities resembling the striped electron dense structures upon TRIM37 depletion. Furthermore, Cenpas formation upon TRIM37 depletion requires PLK4, as well as two parallel pathways relying respectively on Centrobin and PLK1. Overall, our work uncovers how TRIM37 prevents Cenpas formation, which would otherwise threaten genome integrity.

Reparación del tendón del supraespinoso con técnica transósea equivalente en población sujeta a compensación laboral. ¿Cuál es el porcentaje de cicatrización? / Supraspinatus tendon repair using an equivalent transosseous technique to workers compensation. What is the percentage of cicatrization?

Introducción: El objetivo de este trabajo es evaluar el porcentaje de cicatrización y los resultados funcionales de una cohorte de pacientes sometidos a reparación artroscópica del tendón del supraespinoso mediante una técnica de doble fila transósea equivalente. Materiales y métodos: durante el período de enero de 2015 a diciembre de 2017, se realizó una reparación artroscópica del supraespinoso a cuarenta y ocho pacientes utilizando una técnica transósea equivalente, todas por el mismo cirujano; al cuarto mes de evolución, se evaluó la tasa de cicatrización del tendón mediante ecografía. Los resultados funcionales se analizaron mediante la escala de Constant-Murley (CS), valoración subjetiva del hombro (SSV) y la escala visual análoga (EVA) para objetivar el dolor. Para el análisis estadístico se utilizó t test para muestras pareadas. Población sometida a compensación laboral.Resultados: el seguimiento ecográfico objetivó una tasa de re-ruptura del 6%. El promedio de incremento en la escala de Constant-Murley fue de 55 puntos, del SSV de 55%, de flexión anterior 32° y de rotación externa de 13°. La escala visual análoga tuvo un descenso de 6 puntos. Todos estos cambios fueron estadísticamente significativos (p < 0.05). Conclusión: la reparación del tendón del supraespinoso, mediante una técnica transósea equivalente mejora los resultados clínicos y funcionales de los pacientes, objetivados con los índices de Constant-Murley y SSV. En nuestra serie obtuvimos una tasa de cicatrización en el 94% de los pacientes. Tipo de estudio: Serie de casos. Nivel de Evidencia: IV

Introduction: the objective of this work was to evaluate the healing rate and functional results in a retrospective cohort of patients undergoing arthroscopic repair of the supraspinatus tendon, using a double row transosseous equivalent technique. Materials and methods: during the period from January 2015 to December 2017, an arthroscopic repair of the supraspinatus was performed on forty-eight patients, using a transosseous technique, by the same surgeon. We evaluated the healing rate by an ultrasound exam at the fourth month of evolution. Functional results were evaluated using the Constant-Murley scale (CS), subjective shoulder assessment (SSV) and the visual analog scale (VAS) to objectify the pain. For the statistical analysis, t-tests were used for paired samples. This cohort of patients is subject to workers compensation. Results: the ultrasound follow-up showed a 6% re-rupture rate. The average increase in the Constant scale was 55 points, the SSV had a mean increase of 55% and the VAS score decrease 6 points. All these changes were statistically significant (p < 0.05).Conclusions: the supraspinatus tendon repair, using an equivalent transosseous technique, improves the clinical and functional results of patients, objectified with the Constant-Murley and SSV scores. In our series we obtained a healing rate on 94% of the patients. Type study: Case Series. Level of Evidence: IV

Transferencia artroscópica del trapecio inferior en pacientes con rotura irreparable del manguito rotador posterosuperior. Resultados preliminares de ocho pacientes / Arthroscopically assisted lower trapezius transfer in patients with irreparable posterosuperior rotator cuff tears. Preliminary outcomes in eight patients

Introducción: El objetivo de este trabajo es evaluar resultados clínicos y funcionales de pacientes con una rotura irreparable del manguito rotador posterosuperior, sometidos a una transferencia artroscópica del trapecio inferior. Materiales y métodos: estudio de una cohorte retrospectiva de pacientes con roturas irreparables del manguito rotador, en quienes se realizó una transferencia del trapecio inferior asistida por artroscopía. Se evaluó la evolución clínica mediante la ganancia del rango de movilidad del hombro y la disminución del dolor. Del mismo modo, se evaluó la evolución funcional usando el índice de Constant-Murley y la valoración subjetiva del hombro (SSV, por sus siglas en inglés). Resultados: se incluyeron ocho pacientes, con un seguimiento promedio de veintidós meses. Obtuvimos una ganancia estadísticamente significativa de rotación externa de 32°, disminución de 5 puntos en la escala del dolor, aumento de 31 puntos en el score de Constant y un aumento de 38% del SSV. Se registró un aumento de 12° de elevación, sin embargo, este no fue estadísticamente significativo. Dos pacientes presentaron un seroma en el sitio de la cosecha del trapecio, que se resolvió con manejo conservador. Conclusión: la transferencia del trapecio inferior con asistencia artroscópica, en pacientes con rotura irreparable del manguito rotador posterosuperior, es una técnica segura que mejora significativamente la rotación externa y los índices funcionales en este grupo de pacientes. Tipo de estudio: Serie de casos IV

Introduction: The purpose of this study is to compare clinical and functional outcomes of patients with irreparable posterosuperior rotator cuff tears treated by arthroscopic assisted lower trapezius transfer. Materials and methods: retrospective cohort design of patients with irreparable rotator cuff tear, treated by arthroscopy-assisted lower trapezius transfer. The clinical evolution was evaluated according to the gain in the range of shoulder movement and the decrease of pain. Functional outcomes were evaluated using the Constant-Murley score and the subjective shoulder value (SSV). Results: eight patients were included, with average follow-up of twenty-two months. We obtained a statistically significant gain in active external rotation of 32°, 5-point decrease in the pain scale (VAS), a 31-point increase in the Constant score, and a 38% increase in SSV. There was a 12° increase in active forward elevation, however this was not statistically significant. Two patients had a seroma at the trapezius harvest site, which resolved with conservative treatment. Conclusion: arthroscopically assisted lower trapezius transfer in patients with irreparable posterosuperior rotator cuff tears were a safe technique that significantly improves external rotation and functional scores in patients. Type of study: Case series IV

Case Report: Tapioca Iris Melanoma: An Uncommon Presentation of an Uncommon Tumor.

SIGNIFICANCE: Iris tumors are rare conditions, and there is a relative paucity of recent published data on its broad clinical spectrum. Tapioca iris melanoma is a rarer yet devastating form with wide and challenging differential diagnoses because of its amelanotic nodular appearance. PURPOSE: This study aimed to report the challenging presentation of an uncommon iris melanoma, describing the clinical and histological findings and comparing them with the existing published data. CASE REPORT: An uncommon clinicopathological report on the tumor unusual localization, patient age, absence of elevated IOP and heterochromia, and negative S-100 stain that caused diagnostic uncertainty is presented. The patient remains free of metastatic disease 7 years after a complete tumor full-thickness excision. CONCLUSIONS: Tapioca iris melanomas are uncommon tumors with a presentation/surgical management that differs from other malignant tumors. Ophthalmologists should consider it among the vast differential diagnoses when observing amelanotic lesions, even without the hallmark signs being evident.

Development and Psychometric Validation of a Screening Questionnaire to Detect Excessive Menstrual Blood Loss That Interferes in Quality of Life: The SAMANTA Questionnaire.

Background: Heavy menstrual bleeding (HMB) affects up to 35% of women at some point in their lives, and has an important impact on their quality of life (QoL). Current techniques to assess and quantify menstrual blood loss are inconvenient and the correlation between actual and perceived blood loss is poor. This study aimed to develop and validate a screening questionnaire in Spanish to identify HMB in women of reproductive age. Methods: The study consisted of two phases: the conceptual development of a set of items to discriminate between women with and without HMB and the assessment of the sensitivity and specificity of these items. Correlation of the screening tool with women's perception of the intensity of bleeding and the interference in their daily life activities was also assessed. Results: An initial set of 46 items were identified, from which 21 items were selected following the cognitive interviews. For the psychometric validation phase, 389 patients were enrolled, of whom 364 were assessable: 211 cases with Pictorial Blood loss Assessment Chart-confirmed excessive menstrual loss (EML) and 153 controls. Six items met entry criteria in the model and together yielded a sensitivity of 86.7% and specificity of 89.5% to identify cases and controls. These items were weighted according to their contribution to the final model to yield a tool that can be scored from 0 to 10 being 3 the cutoff point to diagnose EML that interferes in QoL. Conclusions: The 6-item SAMANTA questionnaire represents a valid screening tool to easily identify women with EML that interfere with QoL.

Diagnostic Performance of First Trimester Screening of Preeclampsia Based on Uterine Artery Pulsatility Index and Maternal Risk Factors in Routine Clinical Use.

Preeclampsia is a pregnancy-specific disorder defined by new onset of hypertension and proteinuria after 20 weeks of gestation. The early detection of patients at risk of developing preeclampsia is crucial, however, predictive models are still controversial. We aim to evaluate the diagnostic performance of a predictive algorithm in the first trimester of pregnancy, in order to identify patients that will subsequently develop preeclampsia, and to study the effect of aspirin on reducing the rate of this complication in patients classified as high risk by this algorithm. A retrospective cohort including 1132 patients attending prenatal care at Clínica Dávila in Santiago, Chile, was conceived. The risk of developing preeclampsia (early and late onset) was calculated using algorithms previously described by Plasencia et al. Patients classified as high risk, in the first trimester of pregnancy, by these algorithms, were candidates to receive 100 mg/daily aspirin as prophylaxis at the discretion of the attending physician. The overall incidence of preeclampsia in this cohort was 3.5% (40/1132), and the model for early onset preeclampsia prediction detected 33% of patients with early onset preeclampsia. Among the 105 patients considered at high risk of developing preeclampsia, 56 received aspirin and 49 patients did not. Among those who received aspirin, 12% (7/56) developed preeclampsia, which is equal to the rate of preeclampsia (12% (6/49)) of those who did not receive this medication. Therefore, the diagnostic performance of an algorithm combining uterine artery Doppler and maternal factors in the first trimester predicted only one third of patients that developed preeclampsia. Among those considered at high risk for developing the disease using this algorithm, aspirin did not change the incidence of preeclampsia, however, this could be due either to the small study sample size or the type of the study, a retrospective, non-interventional cohort study.

Síndrome de Lemierre o tromboflebitis séptica de vena yugular interna tras extracción dentaria / Lemierre syndrome or septic thromboflebitis of internal yugular vein after dental extraction

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