Multidomain interventions for sarcopenia and cognitive flexibility in older adults for promoting healthy aging: a systematic review and meta-analysis of randomized controlled trials.

The global population is undergoing rapid aging, making physical activity a crucial element in preventing mortality and lowering the risk of Alzheimer's disease. Age-related declines in muscle mass and cognitive abilities significantly contribute to frailty and dependency. Thus, this study focuses on a meticulous analysis of the protective effects of multidomain interventions, an emerging resource combating age-related declines. It seeks to underscore their profound impact on cognitive flexibility and sarcopenia, highlighting their pivotal role in mitigating the adverse effects of aging. To identify relevant randomized controlled trials up to November 2023, we reviewed eight online academic databases, following PERSiST guidelines, PRISMA reporting system, and PICOs criteria. Meta-analyses on selected functional outcomes utilized a random-effects model, including the Timed Up and Go Test, Sit to Stand Test, Victoria Stroop Test, and Trail Making Test. Out of 2082 scrutinized articles, 17 were included in the systematic review, and 8 in the meta-analysis. Positive effects (p = 0.05, I2 = 57%; 95% CI - 0.63 to - 0.05) were observed in cognitive flexibility for certain interventions. Similarly, interventions addressing muscle strength demonstrated improvements in the Sit to Stand Test for the exercise group compared to the control group (p = 0.02, I2 = 0%; 95% CI - 0.63 to - 0.05). These findings underscore the importance of incorporating physical activity as a primary component of public health interventions for promoting healthy aging and reducing the burden of age-related diseases. Future interventions may explore more homogeneous approaches and evaluate the impact of thrice multidomain weekly sessions.

Distrofia miotónica tipo 1: 13 años de experiencia en un hospital terciario. Estudio clínico y epidemiológico. Correlación genotipo-fenotipo / Myotonic dystrophy type 1: 13 years of experience at a tertiary hospital. Clinical and epidemiological study and genotype-phenotype correlation

Introducción: Se desconoce la incidencia de la distrofia miotónica tipo 1 (DM1), enfermedad con gran variedad fenotípica, en nuestra región. El objetivo de nuestro trabajo es estimar la incidencia de DM1 en nuestro centro (referencia en Aragón) e identificar las características propias de nuestra población (correlación genotipo-fenotipo). Métodos: Estudio descriptivo retrospectivo de 459 pacientes clasificados según número de repeticiones CTG en: normal (5-35), premutado (36-50), protomutado (51-80), pequeñas expansiones (81-150), intermedias (151-1.000) y grandes (> 1.000). Además, según el fenotipo mostrado, se categorizaron como: no afectos (5-50 CTG), forma leve o asintomática (51-150 CTG), clásica (151-1.000 CTG) y severa (> 1.000 CTG). Resultados: La incidencia de DM1 fue de 20,61 (IC 95%: 19,59-21,63) casos por millón de individuos-año. Se evidenció una correlación inversa entre el número de CTG y la edad al diagnóstico genético (ρ = −0,547; IC 95%: −0,610 a −0,375; p < 0,001). El CTG5 fue el alelo polimórfico más frecuente en sanos. Del total de afectos, el 28,3% presentaron la forma leve o asintomática, el 59,1% la forma clásica y el 12,6% la forma severa. El 35,1% presentaron herencia materna, el 59,4% herencia paterna y el 5,5% herencia incierta. En las formas leves la calvicie frontal en varones fue el rasgo fenotípico más prevalente, junto con miotonía y cataratas, mientras que en la clásica predominó la ptosis palpebral, la debilidad facial, las alteraciones en la voz y la pronunciación, la miotonía y la sensación de cansancio/somnolencia. Conclusiones: La incidencia de DM1 es relevante en Aragón. La revisión multidisciplinar del fenotipo de pacientes con DM1 es clave para un diagnóstico precoz y medicina personalizada.(AU)

Introduction: The incidence of myotonic dystrophy type 1 (DM1), a disease with great phenotypic variety, in our region is unknown. This study aims to estimate the incidence of DM1 at our hospital (a reference centre in Aragon, Spain) and to identify the characteristics of our population (genotype-phenotype correlation). Methods: Retrospective, descriptive study of 459 patients classified according to the number of CTG repeats, as follows: normal (5-35), premutation (36-50), protomutation (51-80), small expansions (81-150), intermediate expansions (151-1000), and large expansions (> 1000). Furthermore, according to clinical phenotype, patients were categorised as unaffected (5-50 CTG repeats), mild form or asymptomatic (51-150), classical form (151-1000), and severe form (> 1000). Results: The incidence of DM1 was 20.61 cases per million person-years (95% CI: 19.59-21.63). An inverse correlation was observed between the number of CTG repeats and the age at genetic diagnosis (ρ = −0.547; 95% CI: −0.610 to −0.375; P < .001). CTG5 was the most frequent polymorphic allele in healthy individuals. Of all patients with DM1, 28.3% presented the mild or asymptomatic form, 59.1% the classical form, and 12.6% the severe form. Inheritance was maternal in 35.1% of cases, paternal in 59.4%, and uncertain in 5.5%. In mild forms, frontal balding in men was the most prevalent phenotypic trait, as well as myotonia and cataracts, while in the classical form, ptosis, facial weakness, voice and pronunciation alterations, myotonia, and fatigue/sleepiness were most frequent. Conclusions: The incidence of DM1 in Aragon is significant. Multidisciplinary study of the phenotype of patients with DM1 is key to early diagnosis and personalised management.(AU)

3D phantom for image quality assessment of mammography systems.

Objective.To present an innovative approach for the design of a 3D mammographic phantom for medical equipment quality assessment, estimation of the glandular tissue percentage in the patient's breast, and emulation of microcalcification (µC) breast lesions.Approach.Contrast-to noise ratio (CNR) measurements, as well as spatial resolution and intensity-to-glandularity calibrations under mammography conditions were performed to assess the effectiveness of the phantom. CNR measurements were applied to different groups of calcium hydroxyapatite (HA) and aluminum oxide (AO)µCs ranging from 200 to 600µm. Spatial resolution was characterized using an aluminum plate contained in the phantom and standard linear figures of merit, such as the line spread function and modulation transfer function (MTF). The intensity-to-glandularity calibration was developed using an x-ray attenuation matrix within the phantom to estimate the glandular tissue percentage in a breast with a compressed thickness of 4 cm.Main results.For the prototype studied, the minimum confidence level for detecting HAµCs is 95.4%, while for AOµCs is above 68.3%. It was also possible to determine that the MTF of the commercial mammography machine used for this study at the Nyquist frequency is 41%. Additionally, a one-to-one intensity-to-glandularity calibration was obtained and verified with Monte-Carlo simulation results.Significance.The phantom provides traditional arrangements presented in accreditation phantoms, which makes it competitive with available devices, but excelling in regarding affordability, modularity, and inlays distribution. Moreover, its design allows to be positioned in close proximity to the patient's breast during a medical screening for a simultaneous x-ray imaging, such that the features of the phantom can be used as reference values to specify characteristics of the real breast tissue, such as proportion of glandular/adipose composition and/orµC type and size lesions.

Myotonic dystrophy type 1: 13 years of experience at a tertiary hospital. Clinical and epidemiological study and genotype-phenotype correlation.

INTRODUCTION: The incidence of myotonic dystrophy type 1 (DM1), a disease with great phenotypic variety, in our region is unknown. This study aims to estimate the incidence of DM1 at our hospital (a reference centre in Aragon, Spain) and to identify the characteristics of our population (genotype-phenotype correlation). METHODS: Retrospective, descriptive study of 459 patients classified according to the number of CTG repeats, as follows: normal (5-35), premutation (36-50), protomutation (51-80), small expansions (81-150), intermediate expansions (151-1000), and large expansions (> 1000). Furthermore, according to clinical phenotype, patients were categorised as unaffected (5-50 CTG repeats), mild form or asymptomatic (51-150), classical form (151-1000), and severe form (> 1000). RESULTS: The incidence of DM1 was 20.61 cases per million person-years (95% CI, 19.59-21.63). An inverse correlation was observed between the number of CTG repeats and the age at genetic diagnosis (ρ = -0.547; 95% CI, -0.610 to -0.375; P < .001). CTG5 was the most frequent polymorphic allele in healthy individuals. Of all patients with DM1, 28.3% presented the mild or asymptomatic form, 59.1% the classical form, and 12.6% the severe form. Inheritance was maternal in 35.1% of cases, paternal in 59.4%, and uncertain in 5.5%. In mild forms, frontal balding in men was the most prevalent phenotypic trait, as well as myotonia and cataracts, while in the classical form, ptosis, facial weakness, voice and pronunciation alterations, myotonia, and fatigue/sleepiness were most frequent. CONCLUSIONS: The incidence of DM1 in Aragon is significant. Multidisciplinary study of the phenotype of patients with DM1 is key to early diagnosis and personalised management.

Myotonic dystrophy type1: 13years of experience at a tertiary hospital. Clinical and epidemiological study and genotype-phenotype correlation. / Distrofia miotónica tipo1: 13años de experiencia en un hospital terciario. Estudio clínico y epidemiológico. Correlación genotipo-fenotipo.

INTRODUCTION: The incidence of myotonic dystrophy type1 (DM1), a disease with great phenotypic variety, in our region is unknown. This study aims to estimate the incidence of DM1 at our hospital (a reference centre in Aragon, Spain) and to identify the characteristics of our population (genotype-phenotype correlation). METHODS: Retrospective, descriptive study of 459 patients classified according to the number of CTG repeats, as follows: normal (5-35), premutation (36-50), protomutation (51-80), small expansions (81-150), intermediate expansions (151-1000), and large expansions (>1000). Furthermore, according to clinical phenotype, patients were categorised as unaffected (5-50 CTG repeats), mild form or asymptomatic (51-150), classical form (151-1000), and severe form (>1000). RESULTS: The incidence of DM1 was 20.61 cases per million person-years (95%CI: 19.59-21.63). An inverse correlation was observed between the number of CTG repeats and the age at genetic diagnosis (ρ=-0.547; 95%CI: -0.610 to -0.375; P<.001). CTG5 was the most frequent polymorphic allele in healthy individuals. Of all patients with DM1, 28.3% presented the mild or asymptomatic form, 59.1% the classical form, and 12.6% the severe form. Inheritance was maternal in 35.1% of cases, paternal in 59.4%, and uncertain in 5.5%. In mild forms, frontal balding in men was the most prevalent phenotypic trait, as well as myotonia and cataracts, while in the classical form, ptosis, facial weakness, voice and pronunciation alterations, myotonia, and fatigue/sleepiness were most frequent. CONCLUSIONS: The incidence of DM1 in Aragon is significant. Multidisciplinary study of the phenotype of patients with DM1 is key to early diagnosis and personalised management.

[Uncommon case of Mycobacterium bovis brain abscess complicated by suppurative fistula]. / Caso insólito de absceso cerebral por Mycobacterium bovis complicado con fístula supurativa.

TITLE: Caso insólito de absceso cerebral por Mycobacterium bovis complicado con fístula supurativa.

Gut bacterial composition in a mouse model of Parkinson's disease.

The mechanism of neurodegeneration in Parkinson's disease (PD) remains unknown but it has been hypothesised that the intestinal tract could be an initiating and contributing factor to the neurodegenerative processes. In PD patients as well as in animal models for PD, alpha-synuclein-positive enteric neurons in the colon and evidence of colonic inflammation have been demonstrated. Moreover, several studies reported pro-inflammatory bacterial dysbiosis in PD patients. Here, we report for the first time significant changes in the composition of caecum mucosal associated and luminal microbiota and the associated metabolic pathways in a rotenone-induced mouse model for PD. The mouse model for PD, induced by the pesticide rotenone, is associated with an imbalance in the gut microbiota, characterised by a significant decrease in the relative abundance of the beneficial commensal bacteria genus Bifidobacterium. Overall, intestinal bacterial dysbiosis might play an important role in both the disruption of intestinal epithelial integrity and intestinal inflammation, which could lead or contribute to the observed alpha-synuclein aggregation and PD pathology in the intestine and central nervous system in the oral rotenone mouse model of PD.

Open-label randomised phase III trial of vinflunine versus an alkylating agent in patients with heavily pretreated metastatic breast cancer.

Background: There is no standard treatment after progression on second-line chemotherapy for metastatic breast cancer (MBC). We compared vinflunine with physician's choice of alkylating agent (AA) for patients with heavily pretreated MBC. Patients and methods: In this open-label phase III trial, patients with MBC were included if they had received at least two prior chemotherapy regimens for MBC and had received anthracycline, taxane, antimetabolite and vinca alkaloid therapy. Patients were no longer candidates for these chemotherapies because of resistance and/or intolerance. Patients were randomised to either vinflunine 280 mg/m2 intravenously every 3 weeks (q3w) or AA monotherapy q3w. Stratification factors were performance status, number of prior chemotherapy lines for MBC, disease measurability and study site. The primary end point was overall survival (OS). Results: A total of 594 patients were randomised (298 to vinflunine, 296 to AA). There was no difference between treatment arms in OS (hazard ratio 1.04, P = 0.67; median 9.1 months for vinflunine versus 9.3 months for AA), progression-free survival (hazard ratio 0.94, P = 0.49; median 2.5 versus 1.9 months, respectively) or overall response rate (6% versus 4%, respectively). However, the disease control rate was significantly higher with vinflunine than AA (44% versus 35%, respectively; P = 0.04). The most common adverse events (any grade) were haematological and gastrointestinal disorders and asthenia in both arms. The most common grade 3/4 adverse events were neutropenia (19% versus 11% with vinflunine versus AA, respectively) and asthenia (10% versus 4%). Conclusions: Vinflunine 280 mg/m2 q3w did not improve OS compared with the physician's choice of AA as third- or later-line therapy for MBC. Vinflunine demonstrated an acceptable safety profile, suggesting that vinflunine 320 mg/m2 merits evaluation. ClinicalTrials.gov: NCT01091168.

Seguimiento de los resultados de Microbiología y del tratamiento antibiótico empírico prescrito en un Servicio de Urgencias / Follow-up of the results of Microbiology Laboratory and the empiric treatment prescribed in an Emergency Department

Introducción: la gestión deficiente de los resultados del Laboratorio de Microbiología tiene un efecto negativo en la seguridad del paciente y en el manejo adecuado de los antibióticos. El objetivo de este estudio es analizar el seguimiento de los resultados microbiológicos en un Servicio de Urgencias de Pediatría y su impacto en la toma de decisiones terapéuticas. Material y métodos: estudio descriptivo retrospectivo realizado mediante revisión de resultados microbiológicos e historias clínicas electrónicas de los niños de 0 a 15 años atendidos en el periodo de un año. Resultados: se solicitaron 921 pruebas correspondientes a 837 pacientes, mayoritariamente urocultivos (416), hemocultivos (175) y coprocultivos (136). El laboratorio informó 246 microorganismos, fundamentalmente bacterias (91%). Se prescribieron antimicrobianos a 333 pacientes. Tras la revisión de los resultados microbiológicos, se modificó el tratamiento en 109 pacientes (13%): 96 interrupciones del antimicrobiano prescrito, tres cambios y diez prescripciones nuevas. Se notificaron los resultados a 381 pacientes, 218 del grupo de los resultados positivos y 163 en el de los negativos. El urocultivo fue la muestra implicada en el 63% de las modificaciones terapéuticas. Conclusiones: el seguimiento de las pruebas microbiológicas de los pacientes que acuden a Urgencias y la modificación de los tratamientos antimicrobianos prescritos pueden ser herramientas útiles en la mejora del uso de antimicrobianos en los Servicios de Urgencias Pediátricas (AU)

Introduction: the poor management of the results of microbiological cultures has a negative impact on patient safety due to the misuse of antibiotics. The aim of this study is to analyze the follow-up of the results of the microbiological results in an Emergency Department of Pediatrics and its impact on treatment decisions. Patients and methods: a retrospective descriptive study was conducted by reviewing microbiological results and medical records of children from 0 to 15 years assisted in the Emergency Department in the period of one year. Results: 921 tests were requested corresponding to 837 patients, mostly urine cultures (45.2%), blood cultures (19%) and stool cultures (14.6%). Laboratory reported 246 microorganisms, mainly bacteria (91%). Antimicrobials were prescribed to 333 patients. After the reviewing of the microbiological results, treatment was modified in 109 (13%) patients: 96 interruptions, 3 changes and 10 new prescriptions. The results were reported to 381 patients, 218 in the positive results group and 163 in the negative results group. The urine culture was the sample involved in 63% of therapeutic modifications. Conclusions: monitoring of microbiological tests on patients attending emergency department and modification of antimicrobial treatments prescribed may improve the use of antimicrobials in the Emergency Departments (AU)

Defining the optimal sequence for the systemic treatment of metastatic breast cancer.

Metastatic breast cancer is a heterogeneous disease that presents in varying forms, and a growing number of therapeutic options makes it difficult to determine the best choice in each particular situation. When selecting a systemic treatment, it is important to consider the medication administered in the previous stages, such as acquired resistance, type of progression, time to relapse, tumor aggressiveness, age, comorbidities, pre- and post-menopausal status, and patient preferences. Moreover, tumor genomic signatures can identify different subtypes, which can be used to create patient profiles and design specific therapies. However, there is no consensus regarding the best treatment sequence for each subgroup of patients. During the SABCC Congress of 2014, specialized breast cancer oncologists from referral hospitals in Europe met to define patient profiles and to determine specific treatment sequences for each one. Conclusions were then debated in a final meeting in which a relative degree of consensus for each treatment sequence was established. Four patient profiles were defined according to established breast cancer phenotypes: pre-menopausal patients with luminal subtype, post-menopausal patients with luminal subtype, patients with triple-negative subtype, and patients with HER2-positive subtype. A treatment sequence was then defined, consisting of hormonal therapy with tamoxifen, aromatase inhibitors, fulvestrant, and mTOR inhibitors for pre- and post-menopausal patien ts; a chemotherapy sequence for the first, second, and further lines for luminal and triple-negative patients; and an optimal sequence for treatment with new antiHER2 therapies. Finally, a document detailing all treatment sequences, that had the agreement of all the oncologists, was drawn up as a guideline and advocacy tool for professionals treating patients with this disease.

Coat genetic markers of the domestic cat Felis catus (Felidae) from southwestern Colombia / Marcadores genéticos del pelaje del gato doméstico Felis catus (Felidae) del suroccidente colombiano

ABSTRACT Objectives. Establish the genetic profiles of cats from 12 neighboring municipalities in southwestern Colombia, in a town course from Pereira-Popayán. Estimate the degree of diversity, genetic structure, and quantify gene flow. Materials and methods. Were inventoried the phenotypic markers present in the pigmentation and structure of the coat of 1482 cats of the municipalities surveyed. Based on these phenotypic frequencies, allele frequencies, heterozygosity, Hardy-Weinberg equilibrium, F statistics and Nei genetic distances were calculated. A comparison was also made between genetic and geographic distance matrices to determine if there was a significant association between the two. Results. With the genetic profiles of the populations we estimated the degree of diversity. We found the populations in equilibrium for the S autosomal locus and for the O sex-linked locus. We found a low level genetic structure, and it was determined that there was no significant correlation between the genetic and geographic distance matrices among populations. Conclusions: These findings can be explained on the basis of the processes of human displacement for this region, due to the fact that the establishment of feline populations in these municipalities originated during the same historical period. Identical genetic profiles are shared as a result of colonization events, and due to possible continued migration among these populations.

RESUMEN Objetivos. Determinar los perfiles genéticos de los gatos de 12 municipios contiguos del suroccidente colombiano en un trayecto Pereira-Popayán; estimar el grado de diversidad, estructura genética y cuantificar el flujo de genes. Materiales y métodos. Se inventariaron los marcadores fenotípicos presentes en la pigmentación y estructura del pelaje de 1482 gatos de los municipios estudiados, con base en estas frecuencias fenotípicas se calcularon frecuencias alélicas, heterocigosidad, equilibrio Hardy-Weinberg, el estadístico FST y distancias genéticas de Nei. También se realizó una comparación entre matrices de distancia genética y geográfica para determinar si existía asociación significativa entre las dos. Resultados. Con los perfiles genéticos de las poblaciones se estimó el grado de diversidad, se halló en equilibrio Hardy-Weinberg a las poblaciones para el locus autosómico S y el locus ligado al sexo O. Se encontró bajo nivel de estructura genética y se determinó que no existe correlación significativa entre las matrices de distancia genética y geográfica entre poblaciones. Conclusiones. Estos hallazgos se pueden explicar con base en los procesos de desplazamiento humano para esta región, debido a que el establecimiento de poblaciones felinas en estos municipios se originó en el mismo período histórico. Se comparten perfiles genéticos idénticos como resultado, posiblemente, de eventos de colonización y migración continua entre estas poblaciones.

Ribociclib plus letrozole in early breast cancer: A presurgical, window-of-opportunity study.

OBJECTIVES: Cyclin D-cyclin-dependent kinase (CDK) 4/6-inhibitor of CDK4/6-retinoblastoma (Rb) pathway hyperactivation is associated with hormone receptor-positive (HR+) breast cancer (BC). This study assessed the biological activity of ribociclib (LEE011; CDK4/6 inhibitor) plus letrozole compared with single-agent letrozole in the presurgical setting. MATERIALS AND METHODS: Postmenopausal women (N = 14) with resectable, HR+, human epidermal growth factor receptor 2-negative (HER2-) early BC were randomized 1:1:1 to receive 2.5 mg/day letrozole alone (Arm 1), or with 400 or 600 mg/day ribociclib (Arm 2 or 3). Circulating tumor DNA and tumor biopsies were collected at baseline and, following 14 days of treatment, prior to or during surgery. The primary objective was to assess antiproliferative response per Ki67 levels in Arms 2 and 3 compared with Arm 1. Additional assessments included safety, pharmacokinetics, and genetic profiling. RESULTS: Mean decreases in the Ki67-positive cell fraction from baseline were: Arm 1 69% (range 38-100%; n = 2), Arm 2 96% (range 78-100%; n = 6), Arm 3 92% (range 75-100%; n = 3). Decreased phosphorylated Rb levels and CDK4, CDK6, CCND2, CCND3, and CCNE1 gene expression were observed following ribociclib treatment. Ribociclib and letrozole pharmacokinetic parameters were consistent with single-agent data. The ribociclib plus letrozole combination was well tolerated, with no Grade 3/4 adverse events over the treatment. CONCLUSION: The results suggest absence of a drug-drug interaction between ribociclib and letrozole and indicate ribociclib plus letrozole may reduce Ki67 expression in HR+, HER2- BC (NCT01919229).

Mielopatía cervical como forma de presentación de un os odontoideo / Cervical myelopathy as the initial manifestation of os odontoideum

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Lesiones no intencionadas en el centro escolar: ¿de qué estamos hablando? / Unintentional injuries at school: what are we talking about?

Introducción: se han realizado estudios sobre el impacto de las lesiones no intencionadas en el hogar y la vía pública, pero existe escasa literatura médica acerca de aquellas que se originan en los centros escolares. Objetivo: conocer las características de los accidentes escolares atendidos en nuestra área de influencia en el periodo de un año. Material y métodos: estudio descriptivo retrospectivo realizado mediante revisión de historias clínicas de los niños de 1 a 15 años que acudieron al Servicio de Urgencias de una clínica privada en el año 2014 por lesiones ocasionadas en centros escolares concertados de Vizcaya. Resultados: se atendieron un total de 20 420 casos, de los que 958 correspondieron a accidentes escolares (4,6%). Predominó el sexo masculino y la edad media fue de nueve años. El 70% de las lesiones se produjo en el exterior de las aulas, el mecanismo de lesión más frecuente fue el traumatismo directo (56,5%) y la localización predominante fueron las extremidades superiores, donde las lesiones presentaron, además, mayor gravedad. Se realizaron numerosas pruebas complementarias, fundamentalmente radiografía ósea (56%), y el 69% de los pacientes precisó tratamiento en el área de Urgencias. Conclusiones: las lesiones no intencionadas que suceden en el entorno escolar son un gran desconocido para el pediatra. En general, se trata de traumatismos de gravedad leve-moderada, que precisan pruebas complementarias y tratamiento en un alto porcentaje de casos. El conocimiento de las circunstancias que rodean a estos accidentes y sus factores de riesgo permitirían establecer estrategias preventivas adecuadas (AU)

Introduction: Studies on the impact of the unintentional injuries resulting from accidents at home and outdoors have been carried out, but there is scarce literature about those originating at schools. Objective: To know the characteristics of school accidents treated in our area of influence in the period of one year. Material and methods: Retrospective and descriptive study conducted by review of medical records of children aged 1 to 15 who came to the Emergency Department of a private clinic in the year 2014, for assessment of injuries originated at schools of Vizcaya. Results: 20,420 cases of which 958 were school accidents (4.6%) were attended. Male were more prominent and the average age was 9 years old. Seventy percent of injuries occurred outside the classroom, the most frequent injury mechanism was direct trauma (56.5%) and the predominant location were the upper extremities where the injuries were also more serious. Complementary tests were carried out, mainly bone x-ray in 56%, and 69% of patients required treatment in the Emergency Department. Conclusions: Unintentional injuries that happen in school are a great unknown for the pediatrician. In general, they are injuries of mild to moderate severity, requiring additional tests and treatment in a high percentage of cases. The knowledge of the circumstances surrounding these accidents and their risk factors would establish appropriate preventive strategies (AU)

Genetic diversity detection of the domestic horse (Equus caballus) by genes associated with coat color / Detección de la diversidad genética del caballo doméstico (Equus caballus) mediante genes asociados al color del pelaje

Objective. To assess the population structure and genetic diversity in populations of domestic horse (Equus caballus) in the municipality Cienaga de Oro-Córdoba (Colombia). Materials and methods. Random sampling were conducted between August and October 2013, in adult animals on farms seven districts, which was carried out phenotypic characterization of each animal, based on autosomal markers encoding morphological Extension (E) , Agouti (A), Cream (C), White (W), Gray (G), Tobiano (TO), Overo (O) and Roan (RN). Population genetic parameters: allele frequency, genetic diversity, gene flow, Hardy-Weinberg equilibrium and genetic distance were calculated through the program POPGENE 1.31; the genetic structure was assessed using the program FSTAT v. 2.9.3.2. Results. 341 individuals were analyzed in the seven populations studied, where the Extension gene Was the MOST faq frequently as the Overo and Tobiano genes showed the lowest values. Insignificant values of genetic variability and population recorded a global level, likewise, low genetic differentiation among populations, accompanied by a high gene flow was obtained; an excess of heterozygotes at population and global level was observed; to this is added the presence of Hardy-Weinberg equilibrium in all populations relative to the markers studied and low genetic distance values ​​were reported. Conclusions. The populations are highly genetically related, a situation that may result from the existing geographical proximity between them, favoring genetic exchange and the establishment of a metapopulation.

Objetivo. Evaluar la estructura poblacional y la diversidad genética en poblaciones de caballo doméstico (Equus caballus), en el municipio Ciénaga de Oro, Córdoba (Colombia). Materiales y métodos. Se realizaron muestreos aleatorios entre los meses de Agosto y Octubre del año 2013, en animales adultos presentes en las fincas de siete corregimientos, donde se llevó a cabo la caracterización fenotípica a cada animal, atendiendo a los marcadores autosómicos de codificación morfológica Extension (E), Agouti (A), Cream (C), White (W), Gris (G), Tobiano (TO), Overo (O) y Roan (RN). Los parámetros genéticos poblacionales: frecuencia alélica, diversidad genética, flujo génico, equilibrio Hardy-Weinberg y distancia génica, fueron calculados a través del programa PopGene 1.31; la estructura genética se evaluó mediante el programa FSTAT v. 2.9.3.2. Resultados. Se analizaron 341 individuos en las siete poblaciones estudiadas, donde El marcador Extensión fue el de mayor frecuencia mientras los genes Overo y Tobiano presentaron los menores valores. Se registraron cifras poco significativas de variabilidad genética a nivel global y poblacional, así mismo, se obtuvo una escasa diferenciación genética entre las poblaciones, acompañado de un elevado flujo génico; se observó un exceso de heterocigotos a nivel poblacional y a nivel total, a esto se le suma la presencia de equilibrio Hardy-Weinberg en todas las poblaciones con relación a los marcadores estudiados y se reportaron valores bajos de distancia genética. Conclusiones. Las poblaciones se encuentran muy relacionadas genéticamente, situación que puede obedecer a la cercanía geográfica existente entre ellas, favoreciendo el intercambio genético y la constitución de una metapoblación.

Retina y vítreo / No disponible

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Concordancia entre la tonometría de Goldmann, Icare Pro y Corvis ST / Comparison between Goldmann, Icare Pro and Corvis ST tonometry

OBJETIVO: Comparar los valores de presión intraocular (PIO) del nuevo tonómetro de no contacto Corvis ST (CST) con la tonometría de aplanación de Goldmann (GAT) y la tonometría de rebote Icare Pro (PRO). MATERIAL Y MÉTODOS: Se seleccionaron 178 ojos de 178 voluntarios sanos a los que se les midió la PIO de manera aleatorizada con CST, PRO y GAT. Se midió el espesor corneal central (GCC) con paquimetría ultrasónica. Para cada variable, se tomaron 3 medidas y la media de las 3 fue introducida en el análisis estadístico. La concordancia entre los tonómetros se determinó mediante las gráficas de Bland-Altmann. RESULTADOS: La PIO medias obtenidas con los 3 tonómetros fueron de 15,5 ± 2,8 mmHg para GAT, 14,6 ± 2,3 mmHg para PRO y 15,4 ± 2,8 mmHg para CST. La diferencia media entre pares de tonómetros fue: GAT-PRO = 0,9 ± 1,7 mmHg (p < 0,001); GAT-CST: 0,1 ± 2,2 (p = 0,398) y PRO-CST: −0,8 ± −0,7 mmHg, p < 0,001. En los 3 casos se encontró una correlación significativa con el GCC: GAT: r = 0,325, p < 0,001; PRO: r = 0,385, p < 0,001 y CST: r = 0,428; p < 0,001. CONCLUSIONES: Las diferencias encontradas entre el PRO y el GAT son significativamente mayores que entre el CST y el GAT, sin diferencias significativas entre las medidas de estos 2. Las medidas de los 3 tonómetros se ven afectadas por el GCC

PURPOSE: To compare intraocular pressure (IOP) between the new non-contact tonometer Corvis ST (CST), the Goldmann applanation tonometry (GAT) and Icare Pro rebound tonometer (PRO). METHODS: A total of 178 eyes of 178 healthy subjects were selected for the study. Measurements of IOP were made in a random order with GAT, PRO and CST. Central corneal thickness (CCT) was determined by ultrasound pachymetry. The mean of three valid measurements of each variable was used in the statistical analysis. The relationship between the tonometers was established using Bland-Altman plots. RESULTS: Mean IOP was 15.5±2.8 mmHg for GAT, 15.4±2.8 mmHg for CST, and 14.6±2.3 mmHg for PRO. The mean differences between pairs of tonometers were: GATPRO= 0.9±1.7 mmHg (P<0.001), GAT-CST: 0.1±2.2 (P=0.398), and PRO-CST: −0.8±−0.7 mmHg,p < 0.001. A positive relationship was detected between CCT and the three tonometers: GAT:r = 0.325, P<0.001; PRO: r = 0.385, P<0.001, and CST: r = 0.428; P<0.001. CONCLUSIONS: The differences found between PRO and GAT were significantly higher than those found between CST and GAT, which showed non-significant differences. The measurements of the three tonometers were affected by the CCT

[Comparison between Goldmann, Icare Pro and Corvis ST tonometry]. / Concordancia entre la tonometría de Goldmann, Icare Pro y Corvis ST.

PURPOSE: To compare intraocular pressure (IOP) between the new non-contact tonometer Corvis ST (CST), the Goldmann applanation tonometry (GAT) and Icare Pro rebound tonometer (PRO). METHODS: A total of 178 eyes of 178 healthy subjects were selected for the study. Measurements of IOP were made in a random order with GAT, PRO and CST. Central corneal thickness (CCT) was determined by ultrasound pachymetry. The mean of three valid measurements of each variable was used in the statistical analysis. The relationship between the tonometers was established using Bland-Altman plots. RESULTS: Mean IOP was 15.5 ± 2.8 mmHg for GAT, 15.4 ± 2.8 mmHg for CST, and 14.6 ± 2.3 mmHg for PRO. The mean differences between pairs of tonometers were: GAT-PRO=0.9 ± 1.7 mmHg (P<.001), GAT-CST: 0.1 ± 2.2 (P=.398), and PRO-CST: -0.8 ±-0.7 mmHg, p<0.001. A positive relationship was detected between CCT and the three tonometers: GAT: r=0.325, P<.001; PRO: r = 0.385, P<.001, and CST: r = 0.428; P<.001. CONCLUSIONS: The differences found between PRO and GAT were significantly higher than those found between CST and GAT, which showed non-significant differences. The measurements of the three tonometers were affected by the CCT.