Exploring the interplay of bone lesions: unraveling health implications and daily life challenges in an Iron Age skeleton from Ya'amun, Jordan.

This study analyzed the paleopathological conditions of a 30-year-old male unearthed at the site of Ya'amun in northern Jordan. The skeleton was dated back to Iron age. The paleopathological examinations were performed using macroscopic and radiological analyses. The results revealed multiple significant bone lesions, including periosteal osteosarcoma of the right femur, plagiocephaly, asymmetry of the sacrum, vertebral fractures, anemia, and osteoarthritis. This case represents the first example of neoplasm and plagiocephaly in the Iron Age of the region. Despite enduring severe health conditions, the individual managed to reach the third decade while facing the demands of strenuous daily activities that exemplified the harsh living and subsistence conditions characteristic of the Iron Age.

Diagnostic Utility of Thoracic Radiography and Abdominal Ultrasonography in Canine Immune-Mediated Polyarthritis: 77 Cases.

Thoracic radiography and abdominal ultrasonography are part of standard diagnostic investigations in cases of canine immune-mediated polyarthritis (IMPA). However, the clinical importance of thoracic and abdominal imaging towards the management of canine IMPA currently remains unknown. The primary aim of this study was to describe the findings documented on thoracic radiography and abdominal ultrasonography in dogs diagnosed with IMPA, and to evaluate the diagnostic utility of thoracic radiography and abdominal ultrasonography in the initial approach and management of these cases. Seventy-seven dogs diagnosed with IMPA who underwent thoracic radiography and abdominal ultrasonography at a single referral hospital between 2008 and 2022 were included. The diagnostic imaging studies of these 77 dogs were reviewed by one blinded board-certified diagnostic imaging specialist for quality assurance. The medical records, including the diagnostic imaging reports of these dogs, were then reviewed by three blinded board-certified internal medicine specialists. Using a modified version of a previous question and scoring system, the three internal medicine specialists then generated an answer for the overall diagnostic utility and a diagnostic utility score for thoracic radiography and abdominal ultrasonography for each case. The abnormal findings identified in radiography and ultrasonography were described. In the cases where the findings were considered significant enough to immediately affect the case management, the results of the further investigations that were subsequently performed were also described. No abnormalities were detected in thoracic radiography for 30 cases, and none were detected in abdominal ultrasound for 6. The majority of the internists considered thoracic radiography to be not useful in the overall case management at the time of IMPA diagnosis in 70 cases, and considered abdominal ultrasonography to be not useful in the overall case management in 57 cases. The majority of the internists agreed on the utility of thoracic radiography in 95% of the cases, and in 61% of the cases for abdominal ultrasonography. The most common finding in the thoracic radiography was a mild bronchial pulmonary pattern, and the most common in the abdominal ultrasonography was mild lymphadenomegaly. Therefore, although thoracic radiography and abdominal ultrasonography identified numerous abnormal findings in this population of dogs, in the majority of the cases, the findings were deemed not useful towards the overall case management at the time of the initial diagnosis of IMPA. Thus, the use of thoracic radiography and abdominal ultrasonography should be taken into careful consideration when considering initial diagnostic investigations for canine IMPA.

Retrospective Study of T Cell Leukaemia (Large Granular Lymphocyte Variant) in Dogs Associated with Suspected Immune-Mediated Cytopaenia(s) in the Absence of Peripheral Lymphocytosis.

Canine chronic large granular lymphocyte (LGL) leukaemia is commonly characterised by moderate to marked lymphocytosis but not neutropaenia. In humans, LGL leukaemia is often associated with autoimmune disorders, including immune-mediated cytopaenias (mainly neutropaenia). This presentation is rare in dogs. The aim of this retrospective study was to describe the clinical characteristics, treatments, and outcomes of dogs with chronic LGL leukaemia with suspected immune-mediated cytopaenia. Six dogs with a median age of 4.5 years (range 2-8 years) were included in the study. The most common presenting signs were pyrexia and lethargy. All dogs had severe neutropaenia (median neutrophil count 0.07 × 109/L), three had thrombocytopaenia (median platelet count 66 × 109/L), and one had anaemia (HCT 0.32 L/L). In all dogs, bone marrow cytology revealed infiltration of granular T lymphocytes; PARR analysis confirmed clonality in four, and bone marrow flow cytometry identified CD3+ CD8+ neoplastic cells in two cases. All patients received systemic chemotherapy, and the cytopaenias resolved after 1-19 weeks. Two dogs were euthanised 133 and 322 days after diagnosis, two were lost to follow-up after 224 and 357 days, and two were alive at 546 and 721 days. A subset of LGL leukaemia in dogs is associated with immune-mediated cytopaenia and has a unique clinical presentation.

Results of endovascular treatment of venous anastomotic stenosis in prosthetic arteriovenous for hemodialysis PTFE grafts. Comparative analysis between patent and occluded grafts.

OBJECTIVE: To analyze the results of endovascular treatment of venous anastomotic stenosis (VAS) in humero-axillary arteriovenous grafts (HAG), comparing outcomes between patent and thrombosed HAG. MATERIAL AND METHODS: A retrospective cohort study was made of endovascular treated patients because of a VAS in a HAG between January 2009 and December 2019. Group A: Thrombosed HAG secondary to a VAS. Group B: Patent HAG with a VAS detected during follow-up. Technical success was defined as residual stenosis after treatment <30%, and clinical success as satisfactory immediate dialysis after surgery. After ET a biannual clinical and ultrasound follow-up was performed. STATISTICAL ANALYSIS: Survival analysis was performed for time-to-event data to assess patency. RESULTS: Group A: 55 patients. Group B: 22. There were no significative differences in demographic and anatomical factors between groups. Technical and clinical success were 100% in group B and 94.5% and 91% respectively in group A. Primary patency at 1, 6 and 12 months was: Group A: 81.8%, 22.4% y 15.7% respectively. Group B: 100%, 85.9%, 76,4% (p < 0.001). Secondary patency at 1, 6 and 12 months was: Group A: 85.2%, 45.8% y 31.3% respectively. Group B 100%, 95.3%, 95.2% (p < 0.001). Use of non-covered stents was associated with an increased risk of occlusion (HR 2.669 IC 95% 1.146-6.216, p = 0.010). CONCLUSION: A higher patency of EV performed on a patent HAG is expected. It is therefore advisable to develop surveillance programs that are capable to detect VAS before its occlusion.

Resultados del tratamiento endovascular de la estenosis de la anastomosis venosa en las fístulas arteriovenosas protésicas para hemodiálisis de PTFE. Análisis comparativo entre fístulas permeables y trombosadas / Results of endovascular treatment of venous anastomotic stenosis in prosthetic arteriovenous for hemodialysis PTFE grafts. Comparative analysis between patent and occluded grafts

Objetivo: Analizar los resultados del tratamiento endovascular (TEV) de las estenosis en las anastomosis venosas (EAV) de las fístulas arteriovenosas protésicas (FAVp), comparando su utilidad al realizarse sobre FAVp permeables frente a trombosadas.Material y métodosEstudio retrospectivo de pacientes intervenidos mediante TEV por EAV de fístulas humeroaxilares realizadas entre enero de 2009 y diciembre de 2019 en nuestro centro. Grupo A: FAVp trombosada secundaria a EAV; Grupo B: FAVp permeable con EAV detectada en seguimiento. Se definió éxito técnico como estenosis residual ≤ 30% y éxito clínico como diálisis efectiva inmediata. Tras el TEV se realizó un seguimiento clínico y con eco-Doppler semestral. Estudio estadístico: se realizó un análisis de supervivencia mediante el método Kaplan Meier para el estudio de permeabilidades.ResultadosGrupo A: 55 pacientes. Grupo B: 22 pacientes. No existieron diferencias significativas en las características demográficas ni anatómicas entre grupos.El éxito técnico y clínico fueron del 100% en el grupo B frente a un 94,5% y 91%, respectivamente, en el grupo A.La permeabilidad primaria a 1, 6 y 12 meses en el Grupo A fue: 81,8%, 22,4% y 15,7%, respectivamente, frente al Grupo B: 100%, 85,9%, 76,4% (p<0,001). Permeabilidad secundaria a 1, 6 y 12 meses en el Grupo A fue 85,2%, 45,8% y 31,3%, respectivamente, frente al Grupo B 100%, 95,3%, 95,2% (p<0,001). El uso de stents no cubierto se asoció a un mayor riesgo de oclusión (HR 2,669 IC 95% 1,146-6,216, p=0,010).ConclusiónEs esperable una mayor permeabilidad del TEV realizado sobre una FAVp permeable, por lo que es recomendable elaborar programas de seguimiento que sean capaces de detectar la EAV previo a su trombosis. (AU)

Objective: To analyze the results of endovascular treatment of venous anastomotic stenosis (VAS) in humero-axillary arteriovenous grafts (HAG), comparing outcomes between patent and thrombosed HAG.Material and methodsA retrospective cohort study was made of endovascular treated patients because of a VAS in a HAG between January 2009 and December 2019. Group A: Thrombosed HAG secondary to a VAS. Group B: Patent HAG with a VAS detected during follow-up. Technical success was defined as residual stenosis after treatment <30%, and clinical success as satisfactory immediate dialysis after surgery. After ET a biannual clinical and ultrasound follow-up was performed. Statistical analysis: Survival analysis was performed for time-to-event data to assess patency.ResultsGroup A: 55 patients. Group B: 22. There were no significative differences in demographic and anatomical factors between groups.Technical and clinical success were 100% in Group B and 94.5% and 91% respectively in Group A.Primary patency at 1, 6 and 12 months was: Group A: 81.8%, 22.4% and 15.7% respectively. Group B: 100%, 85.9%, 76.4% (p<0.001). Secondary patency at 1, 6 and 12 months was: Group A: 85.2%, 45.8% and 31.3% respectively. Group B 100%, 95.3%, 95.2% (p<0.001). Use of non-covered stents was associated with an increased risk of occlusion (HR 2.669 95% CI 1.146–6.216, p=0.010).ConclusionA higher patency of EV performed on a patent HAG is expected. It is therefore advisable to develop surveillance programs that are capable to detect VAS before its occlusion. (AU)

Results of endovascular treatment of venous anastomotic stenosis in prosthetic arteriovenous for hemodialysis PTFE grafts. Comparative analysis between patent and occluded grafts. / Resultados del tratamiento endovascular de la estenosis de la anastomosis venosa en las fístulas arteriovenosas protésicas para hemodiálisis de PTFE. Análisis comparativo entre fístulas permeables y trombosadas.

OBJECTIVE: To analyze the results of endovascular treatment of venous anastomotic stenosis (VAS) in humero-axillary arteriovenous grafts (HAG), comparing outcomes between patent and thrombosed HAG. MATERIAL AND METHODS: A retrospective cohort study was made of endovascular treated patients because of a VAS in a HAG between January 2009 and December 2019. Group A: Thrombosed HAG secondary to a VAS. Group B: Patent HAG with a VAS detected during follow-up. Technical success was defined as residual stenosis after treatment <30%, and clinical success as satisfactory immediate dialysis after surgery. After ET a biannual clinical and ultrasound follow-up was performed. STATISTICAL ANALYSIS: Survival analysis was performed for time-to-event data to assess patency. RESULTS: Group A: 55 patients. Group B: 22. There were no significative differences in demographic and anatomical factors between groups. Technical and clinical success were 100% in Group B and 94.5% and 91% respectively in Group A. Primary patency at 1, 6 and 12 months was: Group A: 81.8%, 22.4% and 15.7% respectively. Group B: 100%, 85.9%, 76.4% (p<0.001). Secondary patency at 1, 6 and 12 months was: Group A: 85.2%, 45.8% and 31.3% respectively. Group B 100%, 95.3%, 95.2% (p<0.001). Use of non-covered stents was associated with an increased risk of occlusion (HR 2.669 95% CI 1.146-6.216, p=0.010). CONCLUSION: A higher patency of EV performed on a patent HAG is expected. It is therefore advisable to develop surveillance programs that are capable to detect VAS before its occlusion.

Tratamiento del aneurisma de aorta infrarrenal roto: cirugía abierta versus tratamiento endovascular / Treatment of ruptured abdominal aortic aneurysm: open surgical repair versus endovascular repair

Introducción: el aneurisma de aorta abdominal roto (AAAr) es una patología que asocia una elevada morbimortalidad. El objetivo es analizar los resultados del tratamiento del AAAr en nuestro centro, comparando cirugía abierta (CA) y endovascular (EVAR). Material y métodos:estudio de cohortes retrospectivo de pacientes intervenidos por AAAr con cuello infrarrenal entre enero de 2006 y diciembre de 2017, dividido en grupo CA y grupo EVAR. Análisis comparativo de comorbilidad, características anatómicas, técnica y resultados.Resultados:54 pacientes fueron incluidos, 26 (48,1 %) en el grupo CA y 28 (51,9 %) en el EVAR. Sin diferencias en cuanto a edad (70,7 ± 7,8 años vs. 72,5 ± 9,5, p = 0,45) ni comorbilidades, salvo la dislipemia (26,9 % vs. 67,9 % p = 0,003). Los aneurismas eran mayores en el grupo CA (88,1 ± 17,9 mm vs. 72,4 ± 16 mm, p = 0,02), con un mayor porcentaje de aneurisma iliaco asociado (34,6 % vs. 17,8 %, p = 0,07). Un 65,4 % del grupo CA presentó inestabilidad hemodinámica preoperatoria, frente al 60,7 % del EVAR (p = 0,72). Se empleó anestesia local en el 50 % del grupo EVAR. Las necesidades transfusionales intraoperatorias medianas para el grupo CA y EVAR fueron 11 ± 6 y 4 ± 3 concentrados de hematíes respectivamente (p = 0,001). La mortalidad hospitalaria fue mayor en el grupo CA (46,2 % vs. 28,6 %) (p = 0,18). En dicho grupo hubo 4 éxitus intraoperatorios. Un 54,5 % de pacientes del grupo CA y un 64,3 % del EVAR (p = 0,48) presentaron complicaciones mayores, siendo las más frecuentes la intubación prolongada y el fracaso renal que requirió terapia de reemplazo renal. La tasa de reintervención hospitalaria fue 18,2 % en el grupo CA y 25 % en el EVAR (p = 0,56), siendo en este grupo todas las reintervenciones en el subgrupo de endoprótesis aortouniiliaca. La supervivencia a 2 años fue del 51,7 % en el grupo CA y del 65,2 % en el EVAR (p = 0,28).(AU)

Background: the ruptured abdominal aortic aneurysm (rAAA) is associated with high morbimortality. The purpose of this study was to compare results of open surgical repair (OSR) and EVAR in our institution in the management of rAAA. Material and methods:retrospective observational cohort study was conducted on rAAA patients with infrarenal neck between January 2006 and December 2017. Sample was divided according to intervention: OSR vs. EVAR. Comorbidities, anatomical features, intervention and results were analyzed by repair method. Results:fifty-four patients were included, 26 (48,1 %) using OSR and 28 (51,9 %) using EVAR. Age (70,7 ± 7,8 years vs. 72,5 ± 9,5; p = 0,45) and comorbidities showed no statistical significance, except for dyslipidemia (26,9 % vs. 67,9 %; p = 0,003). Aneurysms were larger in OSR group (88,1 ± 17,9 mm vs. 72,4 ± 16 mm; p = 0,02), with a higher rate of associated iliac aneurysm (34,6 % vs. 17,8 %, p = 0,07). 65,4 % of patients in OSR group showed preoperative hemodynamic instability, compared to 60,7 % in EVAR group (p = 0,72). 50 % of EVAR procedures were performed under local anesthesia. Median intraoperative transfusion requirements for OSR group and EVAR group were, respectively, 11 ± 6 and 4 ± 3 red blood cell concentrates (p = 0.001). Hospital mortality was higher in OSR group (46.2 % vs. 28.6 %) (p = 0.18). There were four intraoperative deaths in this group. 54.5 % of OSR patients and 64.3 % of EVAR presented major complications. The most common ones were longtime intubation and acute renal failure requiring renal replacement therapy. Reintervention rate was 18.2 % in CA group and 25 % in EVAR group (p = 0.56), all reinterventions in EVAR group performed in rAAAs repaired by an aortouniiliac device. Two-year survival rate was 51.7 % in CA group and 65.2 % in EVAR group (p = 0.28).(AU)

Reparación del arco aórtico mediante prótesis híbrida y su combinación con TEVAR / Aortic arch repair with elephant trunk and TEVAR combination

Introducción y objetivos: la reparación del arco y aorta torácica descendente (ATD) se asocia a una elevada morbi-mortalidad. Las prótesis híbridas del arco y las endoprótesis torácicas (TEVAR) pueden disminuir sus complicaciones.El objetivo es describir resultados a corto y medio plazo del abordaje híbrido de esta patología.Material y métodos: análisis retrospectivo de pacientes intervenidos entre agosto de 2016 y febrero de 2020 porpatología aneurismática del arco aórtico y ATD mediante una prótesis híbrida y TEVAR en dos tiempos.Resultados: trece pacientes intervenidos, todos por aneurisma sin disección. Inicialmente se empleó una prótesishíbrida con diámetro mediano de 30 mm (29-33) y una longitud de 130 mm en 12 de ellos. Se conservaron los3 TSA en todos los pacientes, con pastilla para tronco braquiocefálico y carótida izquierda y bypass a subclaviaizquierda en el 69 % de ellos.El tiempo mediano hasta el TEVAR fue de 13,5 semanas (6-20), con un éxito técnico del 100 %. Se implantó un solomódulo en 9 casos con una sobredimensión media del 10 % respecto a la trompa de elefante. No hubo ningúncaso de paraplejia, ictus o muerte perioperatoria. El tiempo mediano de ingreso hospitalario fue de 4 días (2-6) y elseguimiento mediano tras el TEVAR de 17 meses (9-25), con una supervivencia del 100 % a 24 meses. Se comprobóuna correcta exclusión del aneurisma en el angio-TC de control en todos los casos y sin objetivarse fugas de altofl ujo durante el seguimiento.Conclusiones: en nuestra experiencia, el TEVAR es una opción segura como segundo tiempo, y ofrece unos exce-lentes resultados a medio plazo en tasa de exclusión del aneurisma.(AU)

Introduction and objectives: aortic arch and descending thoracic aorta repair are associated with a high mor-bidity and mortality. The frozen elephant trunk combined with TEVAR could improve outcomes. The objective isto describe short and midterm results of the hybrid approach in this pathology.Material and methods: retrospective analysis of patients who underwent two-staged intervention with hybridprosthesis and TEVAR for aortic arch and thoracic descending aneurysm between August 2009 and February 2020.Results: thirteen patients were included, all of them secondary to non-dissecting aneurysm. First-stage interventionwith frozen elephant trunk (average prosthesis diameter: 30 mm [29-33] average length: 130 mm). Supraaorticvessel reimplantation was performed most frequently (69 %) with an island technique for innominate artery andleft common carotid artery and a left subclavian artery bypass to the aortic graft.The average time to TEVAR implantation was 13.5 weeks (6-20), with technical success of 100 %. A single devicewas implanted in 9 cases, with 10 % oversizing relative to the hybrid prosthesis. No cases of paraplegia, stroke orperioperative death were observed. The average hospital stay length was 4 days (2-6) and the average follow-upafter TEVAR was 17 months (9-25), survival at 24 months was 100 %. Correct aneurysm exclusion was documentedin all CT controls, with no high-flow endoleaks during follow-up.Conclusions: based on our experience, TEVAR is a safe option as a second-stage intervention for complex thoracicaortic aneurysm pathology, offering excellent mid-term results for aneurysm exclusion.(AU)

Aortic Rupture by an Acute Dissection of the Thoracoabdominal Aorta in a 12-Year-Old Boy.

Aortic dissection is exceptional in children. When they are affected, many clinical conditions as Marfan syndrome or Ehlers-Danlos syndrome are usually involved, but up to 22% have no associated background. Its high morbidity and low incidence in this age group require a high level of suspicion in children without predisposing factors when the presentation is atypical, to avoid the severe consequences of the delay of their diagnosis. In this article we describe the dissection and aortic rupture in a 12-year-old child without relevant medical history, and the open repair that was performed as treatment.

Compression stockings attenuate the expression of proteins associated with vascular damage in human varicose veins.

OBJECTIVE: The objective of this study was to analyze whether compression stocking therapy in the human varicose vein wall may change the levels of biomarkers associated with vein insufficiency. METHODS: Dilated collateral varicose vein samples were obtained from patients showing chronic venous disease (class 2 of the Clinical, Etiology, Anatomy, and Pathophysiology classification). Before elective surgery, 12 patients underwent compression stocking therapy (for 1 month) and 9 patients did not (control group). Expression levels of biomarkers associated with endothelial functionality (nitric oxide synthase 3), inflammation (interleukin-6, interleukin-10), oxidative stress (Gp91phox subunit of NADPH oxidase), and coagulation (factor Xa) were determined. P-selectin, an inflammatory and thrombosis-related biomarker, was also measured. RESULTS: Compression stockings increased the content of nitric oxide synthase 3 (control, 16.48 [16.04-17.40] AU; compression, 83.71 [67.70-91.85] AU; P < .001) in the varicose vein wall that was accompanied by reduction of both interleukin-6 levels (control, 38.72 [33.48-48.52] pg/µg protein; compression, 14.49 [11.05-17.41] pg/µg protein; P = .001) and the expression of Gp91phox subunit of NADPH oxidase (control, 63.24 [53.79-77.03] AU; compression, 36.85 [35.66-52.27] AU; P < .010). P-selectin (control, 77.37 [61.86-85.00] AU; compression, 54.31 [49.60-67.50] AU; P = .017) and factor Xa (control, 90.78 [75.02-100.00] AU; compression, 14.50 [13.77-36.20] AU; P < .001) were also reduced in the varicose vein wall of compression stocking-treated patients. However, P-selectin lost its statistical significance after adjustment by dyslipidemia. CONCLUSIONS: In the varicose vein wall, compression stocking therapy improved the content levels of biomarkers associated with endothelial functionality, inflammation, oxidative stress, and coagulation.

Plagio en artículos de investigación en revistas biomédicas cubanas. 2016 / Plagiarism in Cuban biomedical research articles. 2016

Introducción: El plagio junto a la fabricación y falsificación de resultados constituyen las formas más graves de mala conducta científica. Sin embargo, la escasez de estudios concretos sobre esta mala práctica, motivó realizar la presente investigación. Objetivo: Caracterizar los artículos que incurren en plagio publicado en revistas biomédicas cubanas indizadas en SciELO, durante 2016. Material y métodos: Estudio descriptivo, transversal, con una muestra probabilística de 50 artículos originales, obtenida por muestreo aleatorio simple de 786 investigaciones publicadas en 32 revistas biomédicas cubanas indizadas en SciELO. Se realizó un análisis textual a través de Google Scholar, para identificar textos idénticos. Luego se cotejaron los artículos con similitudes, y se seleccionó como original el de fecha de publicación más antigua. Para el análisis se utilizó el Software RStudio 1.0.136. No se revelan títulos de artículos, autores, instituciones ni revistas en que se publicaron. Resultados: Más de la mitad de los artículos (52 por ciento) cumplía el criterio de plagio. Los hallazgos se encontraron en todas las secciones del artículo, fundamentalmente en introducción (52 por ciento), discusión (18 por ciento) y material y métodos (10 por ciento). El patrón de plagio más frecuente fue "en mosaico" (sustitución, adición, sustracción), seguido por "plagio directo" (copia exacta de bloques de texto). Conclusiones: La frecuencia de plagio en los artículos revisados es alta, con predominio hacia las estructuras teóricas del artículo (introducción y discusión), y fundamentalmente a partir del uso de sinónimos, cambios de verbos, adición y/o sustracción de texto, correspondiente al plagio en mosaico(AU)

Introduction: Plagiarism and the fabrication and falsification of results constitute the most serious forms of scientific misconduct. However, there is a lack of solid studies on this malpractice which motivated us to carry out this research work. Objective: To characterize the articles engaged in plagiarism published in Cuban biomedical journals indexed in SciELO in 2016. Material and Methods: A descriptive cross-sectional study was conducted using a probabilistic sample of 50 original articles obtained by simple random sampling of 786 research studies published in 32 Cuban biomedical journals indexed in SciELO. A textual analysis was performed using Google Scholar to identify identical texts. After that, similar articles were compared and the oldest data of publication was taken into account to determine the original article. R Studio Software 1.0.136 was used for the analysis. The titles of the articles, authors, institutions and journals were not shown. Results: More than half of the articles (52 percent) met the criteria of plagiarism. Similarities were found in all sections of the article, mainly in the introduction (52 percent), discussion (18 percent) and material and methods (10 percent). The most frequent pattern of plagiarism was in "mosaic" (substitution, addiction, subtraction), followed by "direct plagiarism" (exact copy of sections of text). Conclusions: The frequency of plagiarism in the articles reviewed is high, predominating in the theoretical structures of the article (introduction and discussion), where synonyms, changes in verbs, addition or omission of parts of the text were identified, corresponding to plagiarism in mosaic.

Prognostic Value of Initial Aneurysmal Sac Regression after EVAR.

BACKGROUND: The objective of the study was to evaluate the impact of initial aneurysmal sac reduction after endovascular aneurysm repair on the evolution of aneurysmal sac over follow-up. METHODS: A retrospective cohort study was made of patients subjected to elective treatment between January 2005 and December 2014, with a minimum follow-up of 18 months. An analysis was made of the evolution of the aneurysmal sac according to its condition one year after surgery, defining of two groups: A (sac reduction) and B (stable sac). Follow-up by computed tomography (CT) angiography was made after one month and then every 6 months or annually, depending on the presence of endoleak. RESULTS: A total of 128 patients were included. Fifty-one patients (39.8%) showed a significant decrease in diameter during the first year (group A), whereas 77 patients (60.2%) showed no initial decrease (group B). Preoperative CT angiography showed the patients in group A to have larger aneurysms (63.5 mm vs. 59.25; P = 0.048), a greater presence of posterior thrombus (68.6% vs. 30.7%; P < 0.001), and fewer patent lumbar vessels (56.9% vs. 83.1%; P = 0.001). The prevalence of endoleak at some point during follow-up was lower in group A (31.4% vs. 74% in group B; P < 0.001), and 100% of all aneurysmal growths were associated to the presence of endoleak. After 5 years, significant differences were observed in the growth-free rate (96.9% in group A vs. 85.2% in group B; hazard ratio [HR] 4.8 [1.1-21.4; P = 0.036]) and in the reintervention-free rate (95,7% vs. 84.6%; HR 6.6 [0.8-52.4; P = 0.07]). No reoperation in group A was due to type II endoleak. CONCLUSIONS: The aneurysmal sac can be expected to take a favorable course in those cases characterized by initial aneurysmal sac reduction. These findings may imply a change in the follow-up protocol, even in cases with type II endoleak.

Relationship among subjective responses, flavor, and chemical composition across more than 800 commercial cannabis varieties.

BACKGROUND: Widespread commercialization of cannabis has led to the introduction of brand names based on users' subjective experience of psychological effects and flavors, but this process has occurred in the absence of agreed standards. The objective of this work was to leverage information extracted from large databases to evaluate the consistency and validity of these subjective reports, and to determine their correlation with the reported cultivars and with estimates of their chemical composition (delta-9-THC, CBD, terpenes). METHODS: We analyzed a large publicly available dataset extracted from Leafly.com where users freely reported their experiences with cannabis cultivars, including different subjective effects and flavour associations. This analysis was complemented with information on the chemical composition of a subset of the cultivars extracted from Psilabs.org . The structure of this dataset was investigated using network analysis applied to the pairwise similarities between reported subjective effects and/or chemical compositions. Random forest classifiers were used to evaluate whether reports of flavours and subjective effects could identify the labelled species cultivar. We applied Natural Language Processing (NLP) tools to free narratives written by the users to validate the subjective effect and flavour tags. Finally, we explored the relationship between terpenoid content, cannabinoid composition and subjective reports in a subset of the cultivars. RESULTS: Machine learning classifiers distinguished between species tags given by "Cannabis sativa" and "Cannabis indica" based on the reported flavours: = 0.828 ± 0.002 (p < 0.001); and effects: = 0.9965 ± 0.0002 (p < 0.001). A significant relationship between terpene and cannabinoid content was suggested by positive correlations between subjective effect and flavour tags (p < 0.05, False-Discovery-rate (FDR)-corrected); these correlations clustered the reported effects into three groups that represented unpleasant, stimulant and soothing effects. The use of predefined tags was validated by applying latent semantic analysis tools to unstructured written reviews, also providing breed-specific topics consistent with their purported subjective effects. Terpene profiles matched the perceptual characterizations made by the users, particularly for the terpene-flavours graph (Q = 0.324). CONCLUSIONS: Our work represents the first data-driven synthesis of self-reported and chemical information in a large number of cannabis cultivars. Since terpene content is robustly inherited and less influenced by environmental factors, flavour perception could represent a reliable marker to indirectly characterize the psychoactive effects of cannabis. Our novel methodology helps meet demands for reliable cultivar characterization in the context of an ever-growing market for medicinal and recreational cannabis.

Free skin micrografts with cyanoacrylate as outpatient treatment for venous leg ulcers.

OBJECTIVE: The present study describes an ambulatory, free skin micrograft technique with cyanoacrylate as a coadjuvant venous leg ulcer (VLU) healing strategy and its outcomes after one month. METHODS: This prospective study involved Comprehensive Classification System for Chronic Venous Disorders (CEAP) stage C6 patients with good granulation tissue and negative culture results, consecutively recruited in January 2017 in the Hospital Clinico San Carlos. A skin micrograft was harvested from the anterior surface of the patient's thigh with a 0.4cm punch (0.12cm2). The graft was adhered to the ulcer bed with cyanoacrylate. Anti-adherent dressing and double-layer bandaging was applied, with weekly replacements. Measurements were obtained of the surface of the VLU and graft progression (in cm2) using a photographic grid. RESULTS: A total of 12 VLUs in 12 patients were included, with a mean treated surface of 20.32±13.9cm2. A total of 18 grafts were placed and all were found to be viable after one week. Average graft growth was not noticeable after one week but was found to be 0.25±0.08cm2 after week two, 0.41±0.98cm2 after week three, and 0.70±0.15cm2 after week four (p<0.001). There were no complications in the donor zone. CONCLUSION: The findings of this study show that free skin micrografting with cyanoacrylate as outpatient treatment for VLUs was simple, rapid and without complication in this study, and may contribute to its wider application in clinical use.

Buccal dental microwear as an indicator of dietary habits and dietary adaptation of the Byzantine people of Jordan.

This study examined buccal microwear from the Byzantine sites of Yajuz and Sa'ad in Jordan (n = 15) to assess different subsistence economies. An Indian Hindu sample (n = 7) was used for comparative purposes. The results show no differences in the pattern of buccal dental microwear between the two Byzantine sites, while a difference was noted when these sites were compared to Hindus. It is probable that cultural variation was the cause of buccal microwear differences between the temporally located sites. Although the economies during the Byzantine period were diversified, technological adaptation spread into region during the Byzantine period , which eased food accession and processing.

Renal function after abdominal aortic aneurysm repair in patients with baseline chronic renal insufficiency: open vs. endovascular repair.

BACKGROUND: The aim of this study is to analyze renal function impairment (RFI) after abdominal aortic aneurysm (AAA) repair in patients with preoperative chronic kidney disease (CKD). METHODS: Retrospective cohort study of patients with CKD undergoing elective AAA repair between 2008-2015, dividing the sample into two groups: open repair (OR) and endovascular repair (EVAR). The primary outcome was RFI defined by the RIFLE scale, studying Risk (1.5-fold increase in Cr or GFR decline >25% compared to baseline) and kidney injury (doubling of Cr or GFR decline >50%). RESULTS: Seventy-five patients (OR=29, EVAR=46). Baseline characteristics for OR and EVAR were similar except for age (70.4 vs. 77.2 years; P<0.001), coronary artery disease (31% vs. 56.5%; P=0.04), neck length (12.3 vs. 22.7 mm; P=0.001) and baseline GFR (40.6 vs. 36.9 mL/min; P=0.03). There were no inter-group differences in postoperative RFI: Risk of RFI 13.8% OR vs. 13% EVAR and kidney Injury 6.9% vs. 0% (P=0.19). There were also no differences in RFI at one year. Comparing GFR and Cr after surgery and at 12 months to baseline values, the OR group presented a significant postoperative decline in GFR compared to EVAR group (-3.8% vs. 11.1%; P=0.03), which had recovered at one-year follow-up (16.6% vs. 9.5%; P=0.43), while EVAR group presented with a tendency toward increased Cr during follow-up (-9.2% vs. 2.2%; P=0.08). Multivariate analysis did not identify independent RFI prognostic factors. CONCLUSIONS: Both techniques can be used safely in patients with CKD and baseline CKD is not a limiting factor for either technique. RFI is rare and transient in both groups.

El problema científico en artículos de resultado de investigación original publicados en revistas biomédicas cubanas / The scientific problem in original articles published in Cuban biomedical journals

Introducción: La formulación del problema científico en un artículo de investigación es un elemento fundamental para su comprensión y reproducibilidad. No definirlo o formularlo de manera incorrecta conduciría inevitablemente a un documento difícil de entender y de replicar. Objetivo: Identificar las líneas de investigación más comunes en revistas biomédicas cubanas indizadas en SciELO, la frecuencia de artículos de investigación con problema científico correctamente definido y los errores más comunes en su formulación. Material y métodos: Se realizó un estudio descriptivo en artículos de investigación publicados en el año 2016 en 32 revistas biomédicas cubanas indizadas en SciELO. A partir de 5 836 palabras clave se obtuvieron las líneas de investigación más frecuentes. Mediante una muestra aleatoria de 50 artículos, se estimó el porcentaje de publicaciones con problema científico correctamente definido. Se calcularon los porcentajes de errores según el tipo en cada artículo. Resultados: Las líneas de investigación más frecuentemente asociadas a las palabras clave fueron educación médica, factores de riesgo y atención secundaria de salud. Solo el 36 por ciento de los trabajos formularon correctamente el problema científico. Ningún artículo realizó una valoración crítica de este y el 58 por ciento incluyó métodos para abordarlo. Conclusiones: Las líneas de investigación identificadas en los artículos estudiados pueden ser de poco interés para la investigación biomédica. Los artículos de investigación con problemas científicos no definidos o formulados de forma incorrecta incrementan las dificultades para el análisis, la discusión y la crítica de los resultados científicos. Los errores más comunes en la formulación del problema científico sugieren que la motivación principal podría no ser la divulgación de un resultado científico, sino la publicación en sí misma(AU)

Introduction: The formulation of the scientific problem in a research article is a key element for its understanding and reproducibility. If it is not defined or if it is incorrectly formulated, it would inevitably lead to the creation of a document which would be very difficult to understand and replicate. Objective: To identify the most common lines of research in Cuban biomedical journals indexed in SciELO, the frequency of research articles with a correctly defined scientific problem, and the most common errors in its formulation. Material and Methods: A descriptive study was carried out in research articles that were published in 2016 in 32 Cuban biomedical journals indexed in SciELO. The most frequent lines of research were obtained from 5 836 keywords. The percentage of publication with a correctly defined scientific problem was estimated by a random selection of a sample of 50 articles, and the percentage of publications with a correctly defined scientific problem was also calculated. Percentages of errors according to type were measured in each article. Results: The most frequent lines of research associated with keywords were: medical education, risk factors, and secondary health care. Only 36 percent of the works formulated the scientific problem correctly. No article made a critical assessment of it, and the 58 percent included methods to address it. Conclusions: The lines of research identified in the articles under study may appear to be of minor interest for biomedical research. The research articles with not defined or incorrectly formulated scientific problems increase the difficulties for their analysis, discussion, and review of scientific results. The most common errors in the formulation of the scientific problem suggest that the main motivation could not be the dissemination of a scientific result, but the publication itself(AU)

Broncholithiasis associated with lower airway inflammation and subsequent pyothorax in a cat.

CASE SUMMARY: A 12-year-old female spayed domestic shorthair cat presented with history of a long-term chronic cough that had worsened during the previous 2 months. Thoracic radiographs revealed numerous mineral opacities throughout the lung fields. Multiple bronchial plugs of pale yellow material were present on bronchoscopy, consistent with broncholithiasis. Bronchoalveolar lavage cytology revealed a mild neutrophilic inflammation and bacterial culture was negative. The cat was diagnosed with chronic inflammatory lower airway disease and broncholithiasis, suspected to be due to mineralisation of secretions in the bronchial lumen. The cat was treated for 6 years with oral prednisolone and responded well to treatment. Six years later, the cat developed severe respiratory distress and died. Post-mortem examination identified chronic multifocal broncholithiasis, pulmonary abscessation and pyothorax. RELEVANCE AND NOVEL INFORMATION: Broncholithiasis is a very rare condition in feline medicine; however, we are reporting a new case and it should be considered as a differential diagnosis for chronic coughing in cats, especially when other common causes have been ruled out and the radiographic findings are suggestive of it. We hypothesise that pathogenesis of the pulmonary abscessation and pyothorax in our patient was, at least partially, due to broncholithiasis. Pleural disease should be considered a complication of broncholithiasis.