Osteoporotic vertebral fractures: Natural history and impact. / Fracturas vertebrales osteoporóticas: historia natural e impacto.

Osteoporosis, and the consequences derived from it, such as fragility fractures, constitute a growing public health problem. Suffering from a fracture of this nature is the main risk factor for suffering a new fracture. It is documented that vertebral compression fractures lead to significant morbidity and mortality, in the short and long term, as well as other complications, such as sagittal imbalance and hyperkyphosis of the segment. However, we have not found documentation that analyzes the medium and long-term consequences of these injuries, assessing the type of treatment used, and the economic impact they represent. The purpose of this review is to analyze the main recent literature on the subject and make a breakdown of the consequences of these fractures in various spheres, such as economic, quality of life, sagittal balance and radiographic parameters, pain or mortality; as well as a brief analysis of epidemiology and natural history. CONCLUSION: Osteoporotic fractures constitute an emerging problem, both in the medical and economic fields. The consequences and sequelae on the patient are multiple and although surgical options offer good long-term results, it is necessary to properly select the patient, through multidisciplinary teams, to try to minimize potential complications.

El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales: una revisión narrativa / The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review

Introducción: Las metástasis vertebrales son un problema muy frecuente y asocian un deterioro importante de la calidad de vida en los pacientes oncológicos. El objetivo de esta revisión es determinar el encaje de las técnicas quirúrgicas mínimamente invasivas dentro del manejo de esta entidad. Métodos: Se realizó una revisión bibliográfica en las bases de datos Google Scholar, PubMed, Scopus y Cochrane. Se revisaron los artículos publicados en los últimos 10 años que fueran de una relevancia y calidad adecuadas. Resultados: Tras el cribado de los 2.184 trabajos identificados inicialmente en las distintas bases de datos, se incluyeron un total de 24 artículos en esta revisión. Conclusión: La cirugía mínimamente invasiva de columna es especialmente útil en pacientes oncológicos frágiles con metástasis vertebrales por la reducida comorbilidad que presentan las técnicas que se engloban en ella en comparación con la de la cirugía abierta convencional. Los avances en tecnología aplicada a la cirugía, como la navegación y la robótica, mejoran la precisión y reducen las complicaciones de esta técnica.(AU)

Background: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. Methods: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. Results: After screening the 2184 initially identified registers, a total of 24 articles were included for review. Conclusion: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.(AU)

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales: una revisión narrativa

Introducción: Las metástasis vertebrales son un problema muy frecuente y asocian un deterioro importante de la calidad de vida en los pacientes oncológicos. El objetivo de esta revisión es determinar el encaje de las técnicas quirúrgicas mínimamente invasivas dentro del manejo de esta entidad. Métodos: Se realizó una revisión bibliográfica en las bases de datos Google Scholar, PubMed, Scopus y Cochrane. Se revisaron los artículos publicados en los últimos 10 años que fueran de una relevancia y calidad adecuadas. Resultados: Tras el cribado de los 2.184 trabajos identificados inicialmente en las distintas bases de datos, se incluyeron un total de 24 artículos en esta revisión. Conclusión: La cirugía mínimamente invasiva de columna es especialmente útil en pacientes oncológicos frágiles con metástasis vertebrales por la reducida comorbilidad que presentan las técnicas que se engloban en ella en comparación con la de la cirugía abierta convencional. Los avances en tecnología aplicada a la cirugía, como la navegación y la robótica, mejoran la precisión y reducen las complicaciones de esta técnica.(AU)

Background: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. Methods: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. Results: After screening the 2184 initially identified registers, a total of 24 articles were included for review. Conclusion: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.(AU)

El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales (parte 1): una revisión clínica / The role of minimally invasive spine surgery in the treatment of vertebral metastasis (part 1): A clinical review

Las metástasis espinales representan una importante carga sobre la calidad de vida en los pacientes afectados por una enfermedad oncológica activa, debido a la alta incidencia de síndromes dolorosos, deformidad espinal y deterioro neurológico. La cirugía juega un papel determinante a la hora de mejorar la calidad de vida mediante el control del dolor, el restablecimiento de la función neurológica y el mantenimiento de la estabilidad espinal, además de contribuir a la respuesta de la terapia médica. La cirugía mínimamente invasiva (MIS) es una opción de tratamiento en determinados pacientes con alto riesgo quirúrgico, ya que tiene una baja tasa de complicaciones, de sangrado intraoperatorio, de estancia hospitalaria y ofrece resultados similares a la cirugía abierta. Presentamos en esta revisión el papel de la MIS en esta enfermedad, y algunos casos tratados en nuestro centro hospitalario.(AU)

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.(AU)

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis (Part 1): A clinical review / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales (parte 1): una revisión clínica

Las metástasis espinales representan una importante carga sobre la calidad de vida en los pacientes afectados por una enfermedad oncológica activa, debido a la alta incidencia de síndromes dolorosos, deformidad espinal y deterioro neurológico. La cirugía juega un papel determinante a la hora de mejorar la calidad de vida mediante el control del dolor, el restablecimiento de la función neurológica y el mantenimiento de la estabilidad espinal, además de contribuir a la respuesta de la terapia médica. La cirugía mínimamente invasiva (MIS) es una opción de tratamiento en determinados pacientes con alto riesgo quirúrgico, ya que tiene una baja tasa de complicaciones, de sangrado intraoperatorio, de estancia hospitalaria y ofrece resultados similares a la cirugía abierta. Presentamos en esta revisión el papel de la MIS en esta enfermedad, y algunos casos tratados en nuestro centro hospitalario.(AU)

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.(AU)

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis (Part 1): A clinical review.

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.

[Translated article] The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review.

BACKGROUND: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. METHODS: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. RESULTS: After screening the 2184 initially identified registers, a total of 24 articles were included for review. CONCLUSION: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.

The role of minimally invasive spine surgery in the treatment of vertebral metastasis (part 1): A clinical review. / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales (parte 1): una revisión clínica.

Spinal metastases represent a significant burden on the quality of life in patients affected by active oncological disease due to the high incidence of pain syndromes, spinal deformity, and neurological impairment. Surgery plays a decisive role in improving quality of life by controlling pain, restoring neurological function and maintaining spinal stability, as well as contributing to the response to medical therapy. Minimally invasive surgery (MIS) is a treatment option in certain patients with high surgical risk since it has a low rate of complications, intraoperative bleeding, hospital stay, and offers similar results to open surgery. In this review, we present the role of MIS in this pathology and some cases treated in our hospital.

The role of minimally invasive spine surgery in the treatment of vertebral metastasis: A narrative review. / El papel de la cirugía mínimamente invasiva de columna en el tratamiento de las metástasis vertebrales: una revisión narrativa.

BACKGROUND: Spinal metastases are a very common problem which dramatically affects the quality of life of cancer patients. The objective of this review is to address the issue of how minimally invasive surgery can play an important role in treating this pathology. METHODS: A literature review was performed, searching in the Google Scholar, PubMed, Scopus and Cochrane databases. Relevant and quality papers published within the last 10 years were included in the review. RESULTS: After screening the 2184 initially identified registers, a total of 24 articles were included for review. CONCLUSION: Minimally invasive spine surgery is specially convenient for fragile cancer patients with spinal metastases, because of its reduced comorbidity compared to conventional open surgery. Technological advances in surgery, such as navigation and robotics, improve accuracy and safety in this technique.

Convolutional Neural Networks for Chagas' Parasite Detection in Histopathological Images.

Chagas disease is a widely spreaded illness caused by the parasite Trypanosoma cruzi (T. cruzi). Most cases go unnoticed until the accumulated myocardial damage affect the patient. The endomyocardium biopsy is a tool to evaluate sustained myocardial damage, but analyzing histopathological images takes a lot of time and its prone to human error, given its subjective nature. The following work presents a deep learning method to detect T. cruzi amastigotes on histopathological images taken from a endomyocardium biopsy during an experimental murine model. A U-Net convolutional neural network architecture was implemented and trained from the ground up. An accuracy of 99.19% and Jaccard index of 49.43% were achieved. The obtained results suggest that the proposed approach can be useful for amastigotes detection in histopathological images.Clinical relevance- The proposed method can be incorporated as automatic detection tool of amastigotes nests, it can be useful for the Chagas disease analysis and diagnosis.

Machine Learning based Classification of Local Robotic Surgical Skills in a Training Tasks Set.

During surgical training, it is important for the surgeon develops good motor skills throughout his training. For this reason, various surgical training systems have been developed to enhance these skills. However, one of the great challenges in these training systems is being able to objectively measure the ability and performance of the main surgical tasks, where currently only a global measurement is obtained once the task is completed. In this work, a temporal evaluation scheme is proposed, that is, an evaluation of local surgical performance at different time intervals during the training of typical tasks (knot-tying, needle-passing and suturing). The goal is to automatically classify expert (experience >100 hrs) and non-expert (experience <10 hrs) surgeons according to their performance during training, based on three classifiers: K-Nearest Neighborhood, Random Forest, and Support Vector Machine Unlike other previously reported methods, this work proposes a new evaluation scheme based on segments or time intervals, which can be an indicator of the surgeon's local performance during a robotic surgical task, without the need for direct labeling of the data at the segment level. The classification performance from obtained results was in accuracy 83% to 100%, 88% to 100% of AUC-ROC, and 88% to 100% of F1-Score in the final test between experts and non-experts surgeons, where the Support Vector Machine classifier presented the best performance. These results suggest that this proposed method by time intervals could be used in various surgical trainers to evaluate the local performance of a surgeon during trainingand thus be able to provide a tool for the quantitative visualization of opportunities to improve surgical skills.Clinical relevance- We consider that the proposed method to carry out a local performance evaluation during surgical training can provide useful information in the learning and improvement of surgical skills.

[Emotional facial recognition difficulties as primary deficit in children with attention deficit hyperactivity disorder: a systematic review]. / Dificultades de reconocimiento emocional facial como deficit primario en niños con trastorno por deficit de atencion/hiperactividad: revision sistematica.

INTRODUCTION: It has recently been warned that children with attention deficit hyperactivity disorder (ADHD) show a deficit in emotional competence and emotional intelligence, specifically in their ability to emotional recognition. PATIENTS AND METHODS: A systematic review of the scientific literature in reference to the emotional recognition of facial expressions in children with ADHD is presented in order to establish or rule the existence of emotional deficits as primary dysfunction in this disorder and, where appropriate, the effect size of the differences against normal development or neurotypical children. RESULTS: The results reveal the recent interest in the issue and the lack of information. Although there is no complete agreement, most of the studies show that emotional recognition of facial expressions is affected in children with ADHD, showing them significantly less accurate than children from control groups in recognizing emotions communicated through facial expressions. A part of these studies make comparisons on the recognition of different discrete emotions; having observed that children with ADHD tend to a greater difficulty recognizing negative emotions, especially anger, fear, and disgust. CONCLUSIONS: These results have direct implications for the educational and clinical diagnosis of ADHD; and for the educational intervention for children with ADHD, emotional education might entail an advantageous aid.

TITLE: Dificultades de reconocimiento emocional facial como deficit primario en niños con trastorno por deficit de atencion/hiperactividad: revision sistematica.Introduccion. Recientemente se ha advertido que los niños con trastorno por deficit de atencion/hiperactividad (TDAH) muestran algun deficit en su competencia o inteligencia emocional, en concreto, en su capacidad de reconocimiento emocional. Pacientes y metodos. Se presenta una revision sistematica de la literatura cientifica referente al reconocimiento emocional de expresiones faciales en niños con TDAH con el objeto de establecer o descartar la existencia de deficits emocionales como disfunciones primarias en dicho trastorno y, en su caso, el tamaño del efecto de las diferencias con niños de desarrollo normal o neurotipico. Resultados. Los resultados desvelan lo reciente del interes sobre el asunto y la limitada informacion al respecto. A pesar de que no hay acuerdo total, la mayor parte de los estudios evidencia que el reconocimiento emocional de expresiones faciales esta afectado en los niños con TDAH, y estos se muestran significativamente menos precisos que niños pertenecientes a grupos control en el reconocimiento de emociones comunicadas a traves de expresiones faciales. Una parte de estos estudios realiza comparaciones en el reconocimiento de diferentes emociones discretas, y se observa en los niños con TDAH una tendencia a la mayor dificultad para el reconocimiento de emociones negativas, principalmente ira, miedo y asco. Conclusiones. Estos resultados tienen implicaciones directas para el diagnostico educativo y clinico del TDAH, y para la intervencion educativa con niños con TDAH, a quienes la educacion emocional podria suponerles una ventajosa ayuda.

Extrusion and characterization of thermoplastic starch sheets from "macho" banana.

UNLABELLED: Starch isolated from macho banana was oxidized by using 2.5% and 3.5% (w/w) of sodium hypochlorite. Native and oxidized starches with glycerol were processed using a conical twin screw extruder to obtain thermoplastic laminates or sheets, which were partially characterized. Oxidized banana starches presented higher moisture and total starch but lower ash, protein, lipids, and apparent amylose content than the native starch. Micrographs of sheets from oxidized starches showed wrinkles and cavities presumably caused by the plasticizer, but with less free glycerol and unplasticized starch granules than those from native starch. Sheets from oxidized starch showed a notorious increase in all thermal parameters (To, Tp, and ΔH), mechanical properties (tensile strength, elongation at break, and elasticity), and solubility. Banana starch X-ray diffraction patterns corresponded to a mixture of the A- and B-type polymorphs, with apparently slightly higher crystallinity in oxidized specimens than in native starch. A similar trend was observed in the corresponding sheets. PRACTICAL APPLICATION: Due to the pollution problem caused by the conventional plastics, there has been a renewed interest in biodegradable sheets, because they may have the potential to replace conventional packaging materials. Banana starch might be an interesting raw material to be used as edible sheet, coating or in food packaging, and preservation, because it is biodegradable, cheap, innocuous, and abundant.

Female-biased dispersal under conditions of low male mating competition in a polygynous mammal.

Sex-biased dispersal is a common phenomenon in birds and mammals. Competition for mates has been argued to be an important selective pressure favouring dispersal. Sexual differences in the level of intrasexual competition may produce asymmetries in the costs-benefits balance of dispersal and philopatry for males and females, which may favour male-biased dispersal in polygynous species such as most mammals. This being the case, condition-dependent dispersal predicts that male-bias should decrease if mating competition relaxes. We test this expectation for red deer, where male-biased dispersal is the norm. In southwestern Spain, red deer populations located in nonfenced hunting estates presented altered structures with sex ratio strongly biased to females and high proportion of young males. As a consequence, mate competition in these populations was lower than in other, most typical red deer populations. We found that, under such conditions of altered population structure, dispersal was female-biased rather than male-biased. Additionally, mate competition positively related to male dispersal but negatively to female dispersal. Other factors such as resource competition, age of individuals and sex ratio were not related to male or female dispersal. Males may not disperse if intrasexual competition is low and then females may disperse as a response to male philopatry. We propose hypotheses related to female mate choice to explain female dispersal under male philopatry. The shift of the sex-biased dispersal pattern along the gradient of mate competition highlights its condition-dependence as well as the interaction between male and female dispersal in the evolution of sex-biased dispersal.

Parents' genetic dissimilarity and offspring sex in a polygynous mammal.

Offspring quality may benefit from genetic dissimilarity between parents. However, genetic dissimilarity may trade-off with additive genetic benefits. We hypothesized that when sexual selection produces sex-specific selective scenarios, the relative benefits of additive genetic vs. dissimilarity may differ for sons and daughters. Here we study a sample of 666 red deer (Cervus elaphus) microsatellite genotypes, including males, females and their foetuses, from 20 wild populations in Spain (the main analyses are based on 241 different foetuses and 190 mother-foetus pairs). We found that parental lineages were more dissimilar in daughters than in sons. On average, every mother was less related to her mate than to the sample of fathers in the population when producing daughters not sons. Male foetuses conceived early in the rutting season were much more inbred than any other foetuses. These differences maintained through gestation length, ruling out intrauterine mortality as a cause for the results, and indicating that the potential mechanism producing the association between parents' dissimilarity and offspring sex should operate close to mating or conception time. Our findings highlight the relevance of considering the sex of offspring when studying genetic similarity between parents.

Flúter auricular en un recién nacido pretérmino / Atrial flutter in preterm newborn

Se comunica un caso de flúter auricular en un recién nacido pretérmino con insuficiencia cardiaca, mala respuesta farmacológica y recuperación del ritmo normal tras una cardioversión eléctrica (AU)

We describe an atrial flutter in preterm newborn with heart failure, resistant to pharmacological treatment and recovery of the normal heart rhythm after electrical cardioversion (AU)

Polygyny can increase rather than decrease genetic diversity contributed by males relative to females: evidence from red deer.

Polygyny is expected to erode genetic variability by reducing the diversity of genetic contribution of males to the next generation, although empirical evidence shows that genetic variability in polygynous populations is not lost as rapidly as expected. We used microsatellite markers to study the genetic variability transmitted by mothers and fathers to offspring during a reproductive season in wild populations of a polygynous mammal, the red deer. Contrary to expectations, we found that males contributed more genetic diversity than females. Also, we compared study populations with different degrees of polygyny to find that polygyny was not related to a decrease in genetic diversity contributed by males. On the contrary, when population genetic diversity was relatively low, polygyny associated with higher genetic diversity of paternal lineage. Our results show that sexual selection, by favouring heterozygote individuals, may compensate the potential reduction of effective population size caused by polygyny, thus contributing to explain why genetic diversity is not depleted in polygynous systems.

Zinc supplementation in infants with asymmetric intra uterine growth retardation; effect on growth, nutritional status and leptin secretion.

OBJECTIVES: To analyse the effect of zinc supplementation in growth and nutritional status of a homogeneous group of newborns with intra uterine growth retardation and asymmetric growth. The effect of changes of zinc status on growth and leptin serum concentrations was also analysed. POPULATION AND METHODS: A double blind, randomised clinical trial was designed in order to detect differences in growth between zinc and placebo groups during the first 6 months of life. 31 infants were included either to the zinc group (n = 14) (38.8+/-1.4 weeks GA, 2,171+/-253 g body weight) or the placebo group (n = 17) (38.9+/-1.1 weeks GA, 2,249+/-220 g body weight). The zinc group received a supplement of 3 mg elemental zinc per day (as zinc sulphate). RESULTS: There were not significant differences between groups for anthropometric measurements through the study period. We found a significant effect of the study group, in hair zinc concentrations, but not in serum zinc concentrations; post-hoc comparisons for hair zinc revealed that there were significant differences between groups at 1, 2, and 6 months of age. Changes in serum and hair zinc concentrations from baseline to 6 months, showed significant correlations with changes in weight/age and length/age z-scores, in the supplement group. Changes in leptin serum concentrations during follow-up, showed significant correlations with changes in sum of 4 skinfolds and weight/age z-score, in the placebo group. Changes in hair zinc concentration through the study period showed significant correlations with changes in leptin serum concentrations from baseline to 6 months of follow-up. CONCLUSIONS: In a homogeneous group of intra uterine growth retardation infants with asymmetric growth, 3 mg/day zinc supplementation do not show significant improvements in weight and length growth. Changes in zinc status were related with changes in weight and length during the first 6 months of life. Changes in leptin serum concentrations were related with changes in the anthropometric indices of body fat accretion.

Plan de Cuidados Urológicos al paciente lesionado medular espinal con vejiga neurógena / No disponible

No disponible

Skinfold measurements at birth: sex and anthropometric influence.

Weight, length, and skinfold thicknesses were measured in 4634 term and preterm neonates. Sex and weight/length ratio were important determinants of the amount and distribution of the subcutaneous fat store at birth. Gestational age, weight, length, and other ponderal indices did not explain subcutaneous fat variability.