Effects of Exercise Intervention for the Management of Delirium in Hospitalized Older Adults: A Randomized Clinical Trial.

OBJECTIVE: Delirium is a serious neuropsychiatric syndrome frequently occurring in hospitalized older adults, for which pharmacological treatments have shown limited effectiveness. Multicomponent physical exercise programs have demonstrated functional benefits; however, the impact of exercise on the course of delirium remains unexplored. The aim of this study was to investigate the effect of an individualized, multicomponent exercise intervention on the evolution of delirium and patient outcomes. DESIGN: A single-center, single-blind randomized controlled trial. SETTING AND PARTICIPANTS: Medical inpatients with delirium in an acute geriatric unit of a tertiary public hospital. METHODS: Thirty-six patients (mean age 87 years) were recruited and randomized into 2 groups. The control group received usual care and the intervention group received individualized physical exercise (1 daily session) for 3 consecutive days. Primary endpoints were the duration and severity of delirium (4-AT, Memorial Delirium Assessment Scale) and change in functional status [Barthel Index, Short Physical Performance Battery, Hierarchical Assessment of Balance and Mobility (HABAM), and handgrip strength]. Secondary endpoints included length of stay, falls, and health outcomes at 1- and 3-month follow-up. RESULTS: The intervention group showed more functional improvement at discharge (HABAM, P = .015) and follow-up (Barthel, P = .041; Lawton P = .027). Less cognitive decline was observed at 1 and 3 months (Informant Questionnaire on Cognitive Decline in the Elderly, P = .017). Exercise seemed to reduce delirium duration by 1 day and contribute to delirium resolution at discharge, although findings did not reach statistical significance. No exercise-related adverse events occurred. CONCLUSION AND IMPLICATIONS: Findings suggest that individualized exercise in acutely hospitalized older patients with delirium is safe, may improve delirium course and help preserve post-hospitalization function and cognition.

Changes in the expression of genes encoding xanthophyl acyltransferases during the postharvest ripening of avocado (Persea americana) fruit.

BACKGROUND: Avocado fruit is rich in xanthophylls, which have been related to positive effects on human health. Xanthophyl acetyltransferases (XATs) are enzymes catalyzing the esterification of carboxylic acids to the hydroxyl group of the xanthophyll molecule. This esterification is thought to increase the lipophilic nature of the xanthophyll and its stability in a lipophilic environment. Studies on XATs in fruits are very scarce, and no studies had been carried out in avocado fruit during postharvest. The objective of this work was to investigate the changes in the expression of genes encoding XAT, during avocado fruit ripening. RESULTS: Avocado fruits were obtained from a local market and stored at 15 °C for 8 days. The fruit respiration rate, ethylene production, and fruit peel's color space parameters (L*, a*, b*) were measured during storage. Fruit mesocarp samples were taken after 1, 3, 5, and 7 days of storage and frozen with liquid nitrogen. Total RNA was extracted from fruit mesocarp, and the quantification of the two genes designated as COGE_ID: 936743791 and COGE_ID: 936800185 encoding XATs was performed with real-time quantitative reverse transcription polymerase chain reaction using actin as a reference gene. The presence of a climacteric peak and large changes in color were recorded during postharvest. The two genes studied showed a large expression after 3 days of fruit storage. CONCLUSIONS: We conclude that during the last stages of ripening in avocado fruit there was an active esterification of xanthophylls with carboxylic acids, which suggests the presence of esterified xanthophylls in the fruit mesocarp. © 2024 Society of Chemical Industry.

Association of postoperative delirium with serum and cerebrospinal fluid proteomic profiles: a prospective cohort study in older hip fracture patients.

Postoperative delirium (POD) is a common neuropsychiatric complication in geriatric inpatients after hip fracture surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the relationship between preoperative biomarkers in serum and cerebrospinal fluid (CSF) and the development of POD in older hip fracture patients, exploring the possibility of integrating objective methods into future predictive models of delirium. Sixty hip fracture patients were recruited. Blood and CSF samples were collected at the time of spinal anesthesia when none of the subjects had delirium. Patients were assessed daily using the 4AT scale, and based on these results, they were divided into POD and non-POD groups. The Olink® platform was used to analyze 45 cytokines. Twenty-one patients (35%) developed POD. In the subsample of 30 patients on whom proteomic analyses were performed, a proteomic profile was associated with the incidence of POD. Chemokine (C-X-C motif) ligand 9 (CXCL9) had the strongest correlation between serum and CSF samples in patients with POD (rho = 0.663; p < 0.05). Although several cytokines in serum and CSF were associated with POD after hip fracture surgery in older adults, there was a significant association with lower preoperative levels of CXCL9 in CSF and serum. Despite the small sample size, this study provides preliminary evidence of the potential role of molecular biomarkers in POD, which may provide a basis for the development of new delirium predictive models.

Building a Teleost Fish Traceability Program Based on Genetic Data from Pacific Panama Fish Markets.

Fish tissue samples from 203 adult individuals were collected in the main ports and markets of the Pacific coast of Panama. Molecular identification based on a cytochrome oxidase I gene segment of all species was verified by GENBANK reference sequences. A total of 34 species from 14 families (Ariidae, Caranjidae, Centropomidae, Gerreidae, Haemulidae, Lobotidae, Lutjanidae, Malacanthidae, Mugilidae, Scianidae, Scombridae, Serranidae, Sphyraenidae, Stromateidae) were identified at the species level from 164 sequences. Additionally, three Caribbean species were molecularly identified among the analyzed samples (Mycteroperca xenarcha, Paralonchurus brasilensis and Lobotes surinamensis). Species diversity was slightly higher in the Gulf of Panama than in the Gulf of Chiriquí. For species with five or more individual sequences, genetic diversity and genetic connectivity parameters such as total number of haplotypes (H), haplotype diversity (Hd), and nucleotide diversity (π) were calculated. Overall, pelagic-migratory species showed higher values of genetic diversity than coastal and estuarine species with some exceptions. Connectivity between Gulf areas was compared using values of genetic distances and genetic differentiation (Fst). The high level of connectivity observed between the Gulf of Chiriqui and the Gulf of Montijo indicates the existence of a single stock in that area for the following species: Scomberomorus sierra, Caranx caninus and Lutjanus guttatus. The demographic history of the most common species was examined using Tajima's D values, suggesting population expansion for two snapper species, L. peru and L. argentiventris, having significant and higher values. Another important contribution from this research was the production of primers and dual-labeled probes for environmental DNA detection using qPCR for the five most abundant species (spotted rose snapper, yellow snapper, green jack, Pacific crevalle jack and the Pacific sierra fish). These markers represent a new set of tools for environmental DNA (eDNA) detection and molecular traceability of three commercially important fish species along the supply chain including landing sites and markets of the main fishery areas.

Biomarkers of delirium risk in older adults: a systematic review and meta-analysis.

Delirium is a neuropsychiatric syndrome associated with increased morbidity and mortality in older patients. The aim of this study was to review predictive biomarkers of delirium in older patients to gain insights into the pathophysiology of this syndrome and provide guidance for future studies. Two authors independently and systematically searched MEDLINE, Embase, Cochrane Library, Web of Science and Scopus databases up to August 2021. A total of 32 studies were included. Only 6 studies were eligible for the meta-analysis, pooled results showed a significant increase in some serum biomarkers (C-reactive protein [CRP], tumour necrosis factor alpha [TNF-α] and interleukin-6 [IL-6]) among patients with delirium (odds ratio = 1.88, 95% CI 1.01 to 1.637; I2 = 76.75%). Although current evidence does not favour the use of any particular biomarker, serum CRP, TNF-α, and IL-6 were the most consistent biomarkers of delirium in older patients.

Early language outcomes in Argentinean toddlers: Associations with home literacy, screen exposure and joint media engagement.

This study aimed to analyse the contribution of mothers' home literacy beliefs and practices and the quantity and quality of screen media exposure on Argentinean toddler's language. In addition, we considered parent-child joint engagement, as well as adult scaffolding behaviours during the use of electronic devices. A total of 465 mothers of 18-36 months old children completed an online survey including: the MacArthur Bates CDI, home literacy, screen exposure, joint engagement and scaffolding questionnaires. We observed positive effects of literacy beliefs, PC times and verbal scaffolding on language outcomes. TV exposure contributed negatively to vocabulary and, along with educational content, to sentence use. Shared reading and screen media experiences can be an opportunity for language stimulation, provided there is dialogue and joint engagement. Passive screen exposure and inadequate content may be detrimental for toddlers' language outcomes, probably by displacement of socially significant interactions.

Proporción sexual y hermafroditismo del molusco, Anadara tuberculosa (Bivalvia: Arcidae) en Panamá / Sexual proportion and hermaphroditism of the mollusc, Anadara tuberculosa (Bivalvia: Arcidae) in Panama

Introducción: El bivalvo Anadara tuberculosa es un recurso pesquero y económico importante en el Pacífico Este Tropical. La proporción sexual varia a lo largo de su área de distribución, con casos de aparición de hermafroditismo, ocasional para algunas poblaciones, normal en otras. Estas características podrían ser una respuesta a presiones antropogénicas y ambientales. Objetivo: Evaluar la proporción sexual y el hermafroditismo en la especie en el Pacífico de Panamá. Métodos: Se analizó información reproductiva de A. tuberculosa generada entre 1994 y 2020 para el Golfo de Montijo, así como datos de 2017 para el manglar de David. Se aplicaron procedimientos macroscópicos, contrastados con histológicos y se generó un factor de corrección para ajustar la proporción sexual macroscópica, debido al efecto, sobre la proporción sexual, que ocasiona los organismos indeterminados. Resultados: Para el Golfo de Montijo, la histología indicó una proporción sexual hembra a macho de 1:1 hasta 3.2:1, entre 1994 y 2017, mientras que la macroscopía varió de 1.9:1 a 5.1:1 entre 2004 y 2020. Para el manglar de David, la histología indicó una proporción sexual de 3.7:1, y de 7.9:1 por macroscopía en el 2017. En ambas localidades, especímenes más grandes mostraron mayor variación en la proporción sexual, pese a la técnica implementada, así como hermafroditismo protándrico no casual en el 2017. Conclusiones: La aparición del hermafroditismo protándrico y los cambios en la proporción sexual indican que la población de A. tuberculosa, en ambas localidades, está respondiendo a presiones antropogénicas y ambientales.

Introduction: The bivalve Anadara tuberculosa is an important fishery in the Eastern Tropical Pacific. The sex ratio varies along its geographic range and there are cases of hermaphroditism, occasional in some populations, normal in others. These characteristics may be a response to anthropogenic and environmental pressure. Objective: To evaluate sex ratio and hermaphroditism of the species in the Panamanian Pacific. Methods: Data on reproductive features of A. tuberculosa generated between 1994 and 2020 for Gulf of Montijo, as well as 2017 data from mangroves of David was analyzed. Macroscopic diagnosis of individual sex is sensitive to the problem of indeterminate individuals, which in turn can skew the sex ratio analysis; therefore, the macroscopic method was compared with histological sections to generate a correction factor to adjust the macroscopically determined sex ratio. Results: For Montijo, histology indicated that the female to male sex ratio ranged from 1:1 to 3.2:1 between 1994 and 2017, while macroscopy indicated 1.9:1 to 5.1:1 between 2004 and 2020. For David, histology indicated a ratio of 3.7:1, and macroscopy 7.9:1. At both localities, larger specimens had more sex ratio variation, independently of the technique, and there was non-casual protandric hermaphroditism in 2017. Conclusion: The occurrence of protandric hermaphroditism and sex ratio changes suggest anthropogenic and environmental pressure in all populations.

Coping and Resilience Strategies among Ukraine War Refugees.

(1) Background: The war in Ukraine has triggered a huge humanitarian crisis: millions of refugees have escaped from their homes looking for shelter beyond Ukraine's borders. This emergency offers a unique opportunity to investigate and to document those characteristics of the human condition that emerge in exceptional circumstances provoked by war. Based on considerations derived from recent studies on resilience, the research at the base of this paper was conducted to better understand the circumstances, states of mind, and coping mechanisms of the refugees leaving their homes looking for security. (2) Methods: A qualitative approach was applied, resorting to semi-structured interviews (n = 94) to closely explore the traumatic experiences lived by refugees and to identify their coping strategies. (3) Results: The data obtained pointed to a plurality of coping and resilience strategies. Maintaining communication with separated loved ones as well as experiencing accompaniment by helpers and hosts emerged as principal elements for coping and resilience. It was found that a prior development of interior life or practice of prayer served as psychological "capital" that increased their resilience. (4) Conclusion: The results point to the need to care for social networking, attention by hosts, and cultivating interior life as keys for resilience.

Moynihan's Lump as an unusual variant of right hepatic artery during a laparoscopic cholecystectomy approach. A case report.

INTRODUCTION AND IMPORTANCE: One of the most important measures during the cholecystectomy procedure is based on a "Culture for Safe Cholecystectomy (CSC)". Vascular injury reports an open surgery conversion rate of 0 to 1.9% and a mortality of less than 0.02%. The caterpillar or Moynihan's hump configuration is characterized by a tortuous right hepatic artery (RHA) running proximal and/or parallel to the cystic duct and predisposes to a small and/or short cystic artery (CA). CASE PRESENTATION: A 65-year-old woman with no relevant clinical history underwent a laparoscopic cholecystectomy (LC) for cholelithiasis; during the procedure a caterpillar or Moynihan's hump was identified. CLINICAL DISCUSSION: Anatomical variations represent 20-50% of all cases; therefore, CVS is required. The incidence of caterpillar or Moynihan's hump varies between 1% and 13% of all cases. To date, the scientific literature on this topic is limited. The most accepted etiology is related to embryological formation. CONCLUSION: Biliary and arterial variations are more frequent than we think, so an anatomical knowledge, CSC and CVS represent a fundamental rule, increasing the safety of the surgical procedure.

Estructura de tallas, distribución y abundancia de Anadara tuberculosa (Bivalvia: Arcidae) en dos sistemas de manglar del Pacífico de Panamá / Size structure, distribution, and abundance of Anadara tuberculosa (Bivalvia: Arcidae) in two mangrove systems from the Pacific Coast of Panama

Resumen Introducción: Anadara tuberculosa es un recurso pesquero y económico importante, propio de los ecosistemas de manglar en el Pacífico Orienta Tropical. Objetivo: El objetivo del estudio fue analizar la estructura de tallas, distribución y densidad de A. tuberculosa, en el Golfo de Montijo y Manglares de David, para evaluar el estado del recurso en los dos sistemas de manglar del Pacífico de Panamá. Métodos: Los datos corresponden a información histórica de tallas y densidad levantada entre el 2004 y 2020 para el Golfo de Montijo (GM), así como datos de tallas, densidades y distribución levantados en el 2016 de manera simultánea en 51 cuadrantes en GM y 56 cuadrantes en Manglares de David (MD), muestreados en temporada seca, transición, lluviosa y transición, donde además se registró la temperatura, la salinidad y el pH del agua del canal y del agua retenida en el manglar. En el 2016 se instalaron y muestrearon cuadrantes fijos para seguimiento de densidades, muestreo que se repitió en el 2019. En el 2019 se establecen transectos desde el borde del manglar con el canal principal, hasta límite con tierra firme y en cada transecto se instalaron tres cuadrantes, en los estratos inicial, medio y final. Resultados: Los ejemplares del Golfo de Montijo resultaron más grandes, pero la densidad resultó superior en Manglares de David. La comparación de tallas por periodo de muestreo en el 2016, dentro de cada localidad, resultó significativa solo para el Golfo de Montijo, donde las mayores tallas se presentaron en marzo y junio y las menores en octubre-diciembre. No se encontró asociación entre la temperatura, salinidad y pH, y la distribución del molusco. Para el Golfo de Montijo se encontró un descenso sostenido de las densidades desde 1.82 conchas/m2 en el 2004 hasta 0.6 conchas/m2 en el 2019, contrario a lo observado en la estructura de tallas, donde se observó predominio de las tallas superiores a los 50 mm de longitud total y un aumento de la talla promedio de captura de 52.62 mm en el 2004 a 59.28 mm en el 2020. Atendiendo a la distancia del canal principal, se determinó la presencia del molusco hasta poco más de dos kilómetros dentro del manglar y hasta más de 500 m del canal secundario más cercano, así como una disminución de la densidad y un aumento de la talla conforme nos acercamos a tierra firme. Conclusiones: Para A. tuberculosa, la combinación de una estructura de tallas sobre los 50 mm y de bajas densidades, indican que la población de concha negra en el Golfo de Montijo presenta un grado de deterioro, asociado a estresores pesqueros y ambientales.

Abstract Introduction: Anadara tuberculosa is an economically important fishery resource of mangrove ecosystems in the tropical Eastern Pacific. Objective: The objective of this study was to analyze the size structure, distribution, and density of A. tuberculosa, in the Gulf of Montijo (GM) and Mangroves of David (MD) in the Panamanian Pacific, to assess the state of the resource in Panama's two Pacific mangrove systems. Methods: We analyzed Gulf of Montijo historical clam size records and densities from 2004 and 2020. Hundred and seven 30 m2 permanent plots (51 from GOM and 56 from MOD) were set and sampled in 2016 at four time intervals (dry season, transition into rainy, rainy season and transition into dry season) to obtain clams sizes, densities and distributions. The plots were sampled again in 2019. Physical variables such as temperature (°C), salinity (PSU) and pH from the water retained in the mangrove channels were also recorded. Nine transects were installed and sampled in 2019. Three at the seaward edge of the mangrove fringe, three at the inshore edge, and three half-way between the first two. Three quadrats were sampled at the beginning, middle and end of each transect. Results: Gulf of Montijo A. tuberculosa were found to larger but at lower densities than those from Mangroves of David. At each site, size comparison by sampling period, were statistically significant only for GOM, where larger sizes were found in March and July and smaller sizes in October-December. There was no correlation between the distributions of A. tuberculosa and temperature, salinity and pH. A sustained decrease in A. tuberculosa densities was found for GOM (1.82 ind/m2 in 2004 to 0.6 ind/m2 in 2019). This contrast with the predominantly larger clam sizes above 50 mm in total length and an increase in mean size of collected individuals (52.62 mm in 2004 to 59.28 mm in 2020). Specimens of A. tuberculosa were found up to slightly more than 2 km inshore from the main channel and within slightly more than 500 m from a secondary channel. Clam densities decreased and sizes increased in a seaward-inshore direction. Conclusions: For A. tuberculosa, the combination of size classes larger than 50 mm and low densities of individuals is evidence of population deterioration associated to fishery and environmental stressors.

Comparative Numerical Analysis between Two Types of Orthodontic Wire for the Lingual Technique, Using the Finite Element Method.

In the lingual orthodontic technique, there are two paradigms regarding the type of wire used. Regardless of the material or gauge, some orthodontists choose to use the straight wire and resin and bond it to the surface of the tooth; they call it compensations. Other orthodontists prefer to bend the wire, giving it a mushroom shape. There is no specific indication for the use of each type of wire, so orthodontists use them according to their criteria. The present study establishes the bases so that it is possible to find the indications for each type of wire. A clinical trial of a lingual orthodontic patient was used. To carry out the comparative study, a straight arch was placed in his right arch and a mushroom arch in the left arch. Using 3D imaging, a high-biofidelity biomodel of the patient's mandible was generated, with which the FEM analysis was performed, which allowed comparing the reactions of the mandibular bone and appliances with the different arches. It was found that, on the side with the straight arch, there were greater deformations, and in the mushroom arch, there were greater stresses. With this, it is possible to find which clinical cases in each type of wire are indicated.

Regression-Based Normative Data for Children From Latin America: Phonological Verbal Fluency Letters M, R, and P.

This study is part of a larger project to generate norms for letter verbal fluency test (VFT) in 3,284 children from nine Latin American countries. The letter VFT (letters M, R, and P) was administered and multiple linear regressions, including age, age2, MPE (mean parental education), MPE2, sex, and interactions were used as predictors. Results showed significant differences across countries for all scores. Age affected scores linearly except for Ecuador (P-letter), in which a quadratic effect was found. Scores increased linearly as a function of MPE, with the exception of Mexico (R-letter), in which a quadratic effect was found. Age by MPE (M- and P-letters), and age by MPE2 (R-letter) interactions were found in Mexico. Sex had an impact on letter R in Cuba, and letter P in Ecuador and Paraguay. Age2 by sex interaction was found in Ecuador (P-letter). These norms will be useful for clinical neuropsychologists in these countries to evaluate their patients' verbal fluency.

Multivariate Base Rates of Low Scores on Tests of Executive Functions in a Multi-Country Latin American Sample.

The objective of the study was to determine the prevalence of low scores in a diverse Latin American population for two neuropsychological commonly used tests to evaluate executive functions and to compare the number of low scores obtained using normative data from a Spanish-speaking population from Latin America versus an English-speaking population from U.S.A. Healthy adults (N = 5402) were administered the Modified Wisconsin Card Sorting Test and Stroop Color-Word. Low scores on measures of executive functioning are common. Clinicians working with Spanish-speaking adults should take into account the higher probability of low scores on these measures to reduce false-positive diagnoses of cognitive deficits in an individual.

Análisis de homologías y heterogeneidad entre congresos de Reumatología: mexicanos, ACR y EULAR / Homologies and heterogeneity between Rheumatology Congresses: Mexican, American College of Rheumatology and European League Against Rheumatism

INTRODUCCIÓN: Los congresos médicos representan una herramienta que favorece la actualización permanente del médico; su calidad es obligación de los colegios e instituciones. OBJETIVO: Evaluar el contenido académico de 4 congresos internacionales de Reumatología. MATERIALES Y MÉTODOS: Se utilizó como fuente de información los resúmenes publicados en los suplementos de la revista Reumatología Clínica, SE1 Vol. 12 del mes de febrero de 2016, el suplemento SE 1 Vol. 13 del mes de febrero de 2017, la aplicación para medios electrónicos del ACR/ARHP 2016 del Congreso Americano de Reumatología 2016 dedicado a los trabajos presentados en el XLIV Congreso Mexicano de Reumatología (CMR 44), XLV Congreso Mexicano de Reumatología (CMR 45) y del 2016 ACR/ARHP Annual Meeting (ACR 2016), y la página electrónica de archivos y resúmenes de EULAR 2017, respectivamente; de cada trabajo se obtuvo información referente a la principal patología referida, el tipo de información contenida y el tipo de trabajo. Cabe resaltar que algunos eran patologías o diseños combinados de los cuales se seleccionó el que a nuestro juicio era el más importante. RESULTADOS: Se presentaron 275, 340, 3275 y 4129 estudios en el CMR 44, CMR 45, ACR 2016, EULAR 2017, respectivamente. La artritis reumatoide fue la patología con mayor número de trabajos con 23, 26, 21 y 27% en el CMR 44, CMR 45 y ACR 2016 y EULAR 2017 respectivamente, seguida por informes sobre lupus eritematoso sistémico; en tercer lugar, en los congresos mexicanos destacan reportes sobre vasculitis, mientras en los congresos internacionales lo ocupan las espondiloartropatías. De resaltar que en el caso de artritis reumatoide los tópicos sobre clínica representan alrededor del 30% en los congresos mexicanos y ACR, y casi el 20% en EULAR. Los estudios observacionales representaron el 40% en los congresos mexicanos vs. 33% en el ACR 2016 y 55% en EULAR 2017, por otro lado, los estudios sobre ciencia básica fueron mínimos en los congresos mexicanos mientras que en ACR 2016 representan el 21% y en EULAR 12%. CONCLUSIONES: Los congresos de Reumatología constituyen fuente adecuada para la obtención de conocimientos basados en evidencia. Para estudios mexicanos requerimos de fomentar el esfuerzo de colaboración entre instituciones, que reditúen en mayor número de estudios controlados, ensayos clínicos y estudios básicos que apuntalen la calidad del congreso. Se debe hacer conciencia que hace falta mayor difusión del resto de enfermedades del aparato locomotor, y no solo las patologías autoinmunes, ya que las primeras constituyen un porcentaje importante de la práctica diaria

BACKGROUND: Medical meetings are a tool to help physicians advance and update their medical knowledge. Their quality is the responsibility of colleges and institutions. OBJECTIVE: To assess and compare the academic level of four different annual rheumatology meetings. MATERIAL AND METHODS: As a source of information, we used the abstracts published in the supplements of the journal Reumatología Clínica, SE1 Vol. 12, issued in February 2016, SE 1 Vol. 13 issued in February 2017, the electronic application of the 2016 ACR/ARHP of the 2016 American Congress of Rheumatology, devoted to the works presented at the 44th Mexican Congress of Rheumatology (CMR 44), the 45th Mexican Congress of Rheumatology (CMR 45), and the 2016 ACR/ARHP Annual Meeting (ACR 2016), as well as the Web page on the files and abstracts of EULAR 2017, respectively; from each work we compiled information on the major disease being referred to, the type of information provided and the type of report. We should point out that some were combined conditions or designs, from which we selected that which we considered to be the most important. RESULTS: In all, 275, 340, 3275 and 4129 studies were submitted to the XLIV Mexican Congress of Rheumatology, XLV Mexican Congress of Rheumatology, the 2016 ACR/ARHP Annual Meeting and EULAR 2017, respectively. Rheumatoid arthritis was the most common disorder, dealt with in 23%, 26%, 21% and 27% in CMR 44, CMR 45, 2016 ACR and EULAR 2017, respectively, followed by systemic lupus erythematosus; in third place, Mexican congresses reported trials related to systemic vasculitis, whereas spondylitis was the main subject of international congresses. In the case of rheumatoid arthritis, clinical topics accounted for 30% in the Mexican congresses and ACR, and nearly 20% in EULAR. Observational studies accounted for 40% in the Mexican congresses vs. 33% in 2016 ACR and 55% in EULAR 2017. Studies on basic science were minimal in the Mexican congress, whereas in 2016 ACR, they represented 21% and 12% in EULAR 2017. CONCLUSION: Rheumatology meetings constitute a tool to obtain adequate evidence-based medical knowledge in this important branch of medicine. For our Mexican Congress, we should encourage collaborative efforts between institutions, which will result in a greater number of controlled studies, clinical trials and basic studies that support the quality of the congress. We wish to emphasize that a greater diffusion of other musculoskeletal diseases is needed, not only autoimmune diseases, since the former represent an important percentage of the daily practice

Homologies and heterogeneity between Rheumatology Congresses: Mexican, American College of Rheumatology and European League Against Rheumatism. / Análisis de homologías y heterogeneidad entre congresos de Reumatología: mexicanos, ACR y EULAR.

BACKGROUND: Medical meetings are a tool to help physicians advance and update their medical knowledge. Their quality is the responsibility of colleges and institutions. OBJECTIVE: To assess and compare the academic level of four different annual rheumatology meetings. MATERIAL AND METHODS: As a source of information, we used the abstracts published in the supplements of the journal Reumatología Clínica, SE1 Vol. 12, issued in February 2016, SE 1 Vol. 13 issued in February 2017, the electronic application of the 2016 ACR/ARHP of the 2016 American Congress of Rheumatology, devoted to the works presented at the 44th Mexican Congress of Rheumatology (CMR 44), the 45th Mexican Congress of Rheumatology (CMR 45), and the 2016 ACR/ARHP Annual Meeting (ACR 2016), as well as the Web page on the files and abstracts of EULAR 2017, respectively; from each work we compiled information on the major disease being referred to, the type of information provided and the type of report. We should point out that some were combined conditions or designs, from which we selected that which we considered to be the most important. RESULTS: In all, 275, 340, 3275 and 4129 studies were submitted to the XLIV Mexican Congress of Rheumatology, XLV Mexican Congress of Rheumatology, the 2016 ACR/ARHP Annual Meeting and EULAR 2017, respectively. Rheumatoid arthritis was the most common disorder, dealt with in 23%, 26%, 21% and 27% in CMR 44, CMR 45, 2016 ACR and EULAR 2017, respectively, followed by systemic lupus erythematosus; in third place, Mexican congresses reported trials related to systemic vasculitis, whereas spondylitis was the main subject of international congresses. In the case of rheumatoid arthritis, clinical topics accounted for 30% in the Mexican congresses and ACR, and nearly 20% in EULAR. Observational studies accounted for 40% in the Mexican congresses vs. 33% in 2016 ACR and 55% in EULAR 2017. Studies on basic science were minimal in the Mexican congress, whereas in 2016 ACR, they represented 21% and 12% in EULAR 2017. CONCLUSION: Rheumatology meetings constitute a tool to obtain adequate evidence-based medical knowledge in this important branch of medicine. For our Mexican Congress, we should encourage collaborative efforts between institutions, which will result in a greater number of controlled studies, clinical trials and basic studies that support the quality of the congress. We wish to emphasize that a greater diffusion of other musculoskeletal diseases is needed, not only autoimmune diseases, since the former represent an important percentage of the daily practice.