The impact of gambling advertising and marketing on online gambling behavior: an analysis based on Spanish data.

OBJECTIVES: Online platforms have transformed gambling into a daily activity for many, raising concerns about its potential harm. Notably, marketing strategies play a crucial role in influencing gambling behaviors and normalizing gambling. This study aims to explore the relationship between monthly marketing expenditure by the gambling industry, the online amount of money bet, and the number of online accounts (active and new) in Spain. A secondary goal is to assess the impact of marketing restrictions under the Spanish Royal Decree 958/2020 on the relationship between marketing and online gambling behavior. STUDY DESIGN: Longitudinal study. METHODS: Data covering January 2013 to December 2023. Dependent variables included: new accounts, active accounts, gambler deposits, and the total money bet. Independent variables included: expenditure on advertising, bonuses, affiliate marketing, and sponsorship. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was employed to assess marketing's impact on online gambling behavior. RESULTS: Findings show that investment in advertising (P ≤ 0.025), promotions (P < 0.001), and sponsorships (P ≤ 0.004) significantly increase the number of new and active accounts, deposits, and total money bet. For instance, it has been estimated that, for every €1 invested in bonuses and sponsorship, gamblers deposit €1.6 and €4 into their accounts, respectively. Moreover, the Spanish law regulating gambling advertising has seemingly weakened the link between marketing expenditure and gambling behavior, with the notable exception of bonuses, where the impact has intensified. CONCLUSIONS: These results underline the importance of ongoing monitoring and regulation of gambling behavior in Spain, emphasizing the need for strict adherence to regulations.

Nurses' preferences regarding MenACWY conjugate vaccines attributes: a discrete choice experiment in Spain.

OBJECTIVES: Immunisation against preventable diseases as meningitis is crucial from a public health perspective to face challenges posed by these infections. Nurses hold a great responsibility for these programs, which highlights the importance of understanding their preferences and needs to improve the success of campaigns. This study aimed to investigate nurses' preferences regarding Meningococcus A, C, W, and Y (MenACWY) conjugate vaccines commercialised in Spain. STUDY DESIGN: A national-level discrete choice experiment (DCE) was conducted. METHODS: A literature review and a focus group informed the DCE design. Six attributes were included: pharmaceutical form, coadministration evidence, shelf-life, package contents, single-doses per package, and package volume. Conditional logit models quantified preferences and relative importance (RI). RESULTS: Thirty experienced primary care nurses participated in this study. Evidence of coadministration with other vaccines was the most important attribute (RI = 43.78%), followed by package size (RI = 22.17%), pharmaceutical form (RI = 19.07%), and package content (RI = 11.80%). There was a preference for evidence of coadministration with routine vaccines (odds ratio [OR] = 2.579, 95% confidence interval [95%CI] = 2.210-3.002), smaller volumes (OR = 1.494, 95%CI = 1.264-1.767), liquid formulations (OR = 1.283, 95%CI = 1.108-1.486) and package contents including only vial/s (OR = 1.283, 95%CI = 1.108-1.486). No statistical evidence was found for the remaining attributes. CONCLUSIONS: Evidence of coadministration with routine vaccines, easy-to-store packages, and fully liquid formulations were drivers of nurses' preferences regarding MenACWY conjugate vaccines. These findings provide valuable insights for decision-makers to optimize current campaigns.

Marginalization and tooth loss in older Mexican adults.

OBJECTIVE: To examine the association between the level of marginalization and tooth loss in adults aged ≥50 years in Mexico. METHODS: A retrospective cross­sectional study was conducted on 2098 adults selected from communities presenting both high and medium levels of marginalization, with data obtained from the annual reports of the Epidemiological Surveillance System of Oral Pathologies 2019-2022. Analysis considered sociodemographic characteristics such as sex, age, and years of education. The prevalence of tooth loss was determined using the Decayed, Missing and Filled teeth (DMFT) index. Negative binomial regression was used to estimate rate ratio (RR) and 95% confidence intervals (CIs), using the presence of lost teeth as an outcome. RESULTS: Most (62.4%) participants had lost at least one tooth, of whom 60.3% had a medium level of marginalization, 28.8% a high level, and 10.9% a very high level. More adults who lived in high or very high marginalization communities had lost teeth [RR=1.19 (95% CI 1.08 - 1.30)] than those living in communities with a medium level of marginalization. More males [RR=1.19 (95% CI 1.09 - 1.31)], adults ≥70 years [RR=1.77 (95% CI 1.57 - 1.99)], people who were illiterate [RR=1.60 (95% CI 1.35 - 1.88)] or who had poor oral hygiene [RR=1.26 (95% CI 1.15 - 1.38)] had also lost teeth. CONCLUSION: High and very high marginalization was associated with tooth loss in adults ≥50 years in Mexico. Effective oral health strategies are required to prevent tooth loss, as are interventions to improve access to and quality of dental services for marginalized communities.

Impact of diseases of the hard tissues of teeth on oral health-related quality of life of schoolchildren in area with a high concentration of fluoride in drinking water.

OBJECTIVE: To assess the impact of caries, Molar Incisor Hypomineralization (MIH), and fluorosis on the Oral Health-Related Quality of Life (OHRQoL) of schoolchildren aged 8-10 years living in area with different fluoride levels in the drinking water. SUBJECT AND METHODS: The prevalence of caries and fluorosis were assessed among 663 Mexican schoolchildren using the International Caries Detection and Assessment System (ICDAS II) and the Thylstrup and Fejerskov Index (TFI), respectively. MIH was recorded using the European Academy of Pediatric Dentistry (EAPD) criteria and OHRQoL using the Child Perceptions Questionnaire (CPQ8-10). Poisson regression models were used in data analysis. RESULTS: Schoolchildren presenting two of the three conditions (cavitated lesions and TFI≥4, cavitated lesions and MIH or TFI≥4 and MIH) experienced worse quality of life than children who did not [RR=4.18; (95% CI 3.83, 4.56)]. Children with all three conditions had worse quality of life than children who did not [RR=5.64; (95% CI 5.13, 6.20)]. CONCLUSIONS: Fluorosis, MIH, and caries have a negative impact on the OHRQoL of schoolchildren living in area with a high concentration of fluoride in their drinking water.

Culicoides biting midges and mosquito fauna at three dog and cat shelters in rural and periurban areas in Northern Spain.

The diversity and abundance of Culicoides (Diptera: Ceratopogonidae) and mosquitoes (Diptera: Culicidae) were studied in three animal protection centres (APCs) in Northern Spain between 1 July and 31 October 2018. Four miniature suction CDC light traps (two UV and two standard incandescent bulb traps, both types baited and non-baited with CO2 ) were placed in each APC to compare their efficiency in the collection of these Diptera groups. A total of 1176 biting midges (14 species), 224 mosquitoes (8 species) and 1 black fly were collected and identified by both morphological and molecular approaches. The Culicoides obsoletus complex (C. obsoletus/C. scoticus) accounted for 58.2% of the total collection within the Ceratopogonidae family, whereas Culex pipiens/Cx. torrentium comprised 76.8% of the Culicidae. The input of CO2 in light traps proved largely ineffective in improving the collections of both Diptera groups. UV-light traps were 7.8 and 2.2 times more effective than incandescent light traps in trapping Culicoides and mosquitoes, respectively. Seasonal dynamics differed between both Diptera taxa but captures of both taxa were significantly larger at the beginning of the summer. The epidemiological relevance of the most prevalent species is also discussed.

Access to healthcare services between insured and uninsured adults aged ≥50 years with diabetes in Mexico: the Mexican Health and Aging Study (MHAS-2018).

OBJECTIVES: Analyze the association between health insurance coverage and the use of health care services, dentist visits, and self-medication in a national sample of Mexican adults aged ≥50 years with diabetes. METHODS: Participants with diabetes taken from a subsample of the Mexican Health and Aging Study (MHAS-2018) (n = 3667) were examined, with data pertaining to the frequency of their doctor and dentist visits, residence, years of education, self-medication, and health insurance coverage (insured/uninsured) also collected. A logistic regression model was used to identify the association between independent variables and health insurance coverage, whereas Poisson regression models were also estimated to ascertain whether health insurance coverage was associated with the number of doctor and dentist visits. RESULTS: The prevalence of self-reported diabetes was 24.6%, whereas approximately 93.3% of subjects had visited a doctor, 40.6% had visited a dentist, and 20.3% self-medicated. Individuals with insurance coverage were 75% (Odds ratio [OR] = 1.75 [95% confidence interval {CI}1.32-2.31]; P < 0.001) more likely to have visited a doctor and 57% more likely to have visited a dentist (OR = 1.57 [95% CI 1.35-1.83]; P < 0.001) than uninsured adult subjects, while adults living in rural areas were 77% less likely to be insured than adults living in urban areas. Doctor and dentist visits [rate ratio {RR} = 1.32 (95% CI 1.28-1.35); P < 0.001] and [RR = 1.47 (95% CI 1.37-1.58); P < 0.001, respectively] were found to be positively associated with the insured members of the study population. CONCLUSION: A positive association was found between doctor and dentist visits in the population insured with diabetes. A major public health challenge is the population of diabetics who report being uninsured, wherein this population requires coverage to access the necessary clinical follow-up and control to prevent complications.

An inverse relationship between obesity and dental caries in Mexican schoolchildren: a cross-sectional study.

OBJECTIVE: The aim of the study was to examine the relationship between caries experience and obesity in Mexican schoolchildren aged 8-12 years. STUDY DESIGN: This is a cross-sectional study. METHODS: This study was conducted on 522 schoolchildren selected from public schools. The prevalence of caries was evaluated by applying the decayed, missing and filled teeth (DMFT) index and ascertaining the subjects' dental caries experience from the mean DMFT value. Socio-economic data were collected from the parents, with data on the children's characteristics collected from them via a questionnaire. Their weight and height were then measured and used to calculate their body mass index (BMI)-for-age Z-score, which was then adjusted by age and sex. RESULTS: The prevalence of caries was 79.9% (DMFT≥1) in permanent dentition. Of all children, 47.5% of them brushed their teeth two or more times per day, and the prevalence of overweight and obesity was 20.1% and 17.6%, respectively. The logistic regression model showed that children with obesity (a >2 Z-score on the BMI-for-age growth chart) were less likely to have dental caries (odds ratio [OR] = 0.53 [95% confidence interval {CI}: 0.31-0.89]; P = 0.017) than children without obesity, with schoolchildren who consume more sweets per day (OR = 1.65 [95% CI: 1.03-2.62]; P = 0.035) more likely to present caries than schoolchildren who consume fewer sweets per day. CONCLUSION: Children with obesity are less likely to present dental caries. Comprehensive strategies aimed at risk factors can be useful in controlling nutritional status and improving oral health.

Marginalization and fluorosis its relationship with dental caries in rural children in Mexico: A cross-sectional study.

OBJECTIVE: Examine the association between marginalization and fluorosis with caries experience in Mexican rural children aged 8-12, in Oaxaca, Mexico. METHODS: Cross-sectional study of 283 rural schoolchildren selected from two locations with high and medium levels of marginalization where the water fluoride concentration ranged from 2.0 to 2.5 ppm/F. Caries was evaluated using the DMFT index and dental fluorosis with the Thylstrup-Fejerskov Index (TFI). Socioeconomic data were collected from participants' parents, with data on the children's characteristics collected from them via a questionnaire. RESULTS: The prevalence of caries was 72.4% (DMFT ≥1) in the permanent dentition. The prevalence of fluorosis was 98.0% (TFI ≥4=71.4%). 54.8% of the children brushed their teeth two or more times daily. In logistic regression children living in high levels of marginalization were more likely to present caries (OR=2.11, 95% CI 1.13 - 3.93) than children living in medium levels. Children with severe fluorosis (TFI ≥4) (OR=1.93, 95% CI 1.06 - 3.53) were more likely have caries than those with TFI ⟨3. CONCLUSION: Rural children with a high level of marginalization and fluorosis (TFI ≥4) were more likely to present caries. Poor oral hygiene and low dental service levels were found in both marginalized areas. Populations with medium/high marginalization are more susceptible to caries.

Salivary parameters and oral health status amongst adolescents in Mexico.

BACKGROUND: In the last years an increased interest in the use of salivary parameters in connection with caries experience and caries prediction has been shown. In schoolchildren investigations are known, where the relationship between caries prevalence and salivary parameters has been assessed, but in the adolescent population studies are scarce. The aim of the study was evaluate of the association among salivary parameters, oral health status and caries experience in adolescents in Mexico. METHODS: A cross-sectional study was conducted on 256 (DMFT≥5) and 165 (DMFT< 5) 12-to- 14-year-old adolescents. From all the adolescents, unstimulated mid-morning saliva samples were collected, after which the salivary flow rate was calculated, and the salivary pH and buffer capacity was measured. The caries was evaluated via the application of the DMFT score. Clinical variables such as oral hygiene and dental calculus were examined in the adolescent's oral cavity. The adolescents provided data on their personal characteristics by completing a questionnaire, while socioeconomic data were collected from their parents. Descriptive, bivariate and logistic regression model analyses were performed. RESULTS: The prevalence of caries was 61.1% (DMFT≥5) in permanent dentition, with 72.7% of subjects presenting poor oral hygiene. The mean levels of salivary flow rate, pH, and buffer capacity was significantly lower (p < 0.05) in adolescents with caries score of DMFT≥5 than in those with caries score of DMFT < 5. Salivary flow and buffer capacity were higher in boys than in girls. The logistic regression model applied showed that adolescents with a salivary flow rate < 1 ml per min were more likely to present caries [OR = 1.58 (CI95% 1.04-2.40); p = 0.033] than adolescents with a flow rate ≥ 1 ml per-min, and that, for each unit of increased pH, the probability of presenting caries reduced by 76% [OR = 0.24 (CI95% 0.10-0.55); p = 0.001]. CONCLUSION: Significant association was found in salivary flow rate, pH and buffer capacity in adolescents with caries (DMFT≥5). In addition to differences of these parameters by sex, the results suggest saliva parameters may act as indicators of caries in adolescents.

Environmental sampling coupled with real-time PCR and genotyping to investigate the source of a Q fever outbreak in a work setting.

A Q fever outbreak was declared in February 2016 in a company that manufactures hoists and chains and therefore with no apparent occupational-associated risk. Coxiella burnetii infection was diagnosed by serology in eight of the 29 workers of the company; seven of them had fever or flu-like signs and five had pneumonia, one requiring hospitalisation. A further case of C. burnetii pneumonia was diagnosed in a local resident. Real-time PCR (RTi-PCR) showed a widespread distribution of C. burnetii DNA in dust samples collected from the plant facilities, thus confirming the exposure of workers to the infection inside the factory. Epidemiological investigations identified a goat flock with high C. burnetii seroprevalence and active shedding which was owned and managed by one of the workers of the company as possible source of infection. Genotyping by multispacer sequence typing (MST) and a 10-loci single-nucleotide polymorphism (SNP) discrimination using RTi-PCR identified the same genotype (MST18 and SNP type 8, respectively) in the farm and the factory. These results confirmed the link between the goat farm and the outbreak and allowed the identification of the source of infection. The circumstances and possible vehicles for the bacteria entering the factory are discussed.

Bartonella chomelii is the most frequent species infecting cattle grazing in communal mountain pastures in Spain.

The presence of Bartonella spp. was investigated in domestic ungulates grazing in communal pastures from a mountain area in northern Spain, where 18.3% (17/93) of cattle were found to be positive by PCR combined with a reverse line blot (PCR/RLB), whereas sheep (n = 133) or horses (n = 91) were found not to be infected by this pathogen. Bartonella infection was significantly associated with age, since older animals showed a higher prevalence than heifers and calves. In contrast to other studies, B. chomelii was the most frequent species found in cattle (14/17), while B. bovis was detected in only three animals. Moreover, 18 B. chomelii isolates and one B. bovis isolate were obtained from nine animals. Afterwards, B. chomelii isolates were characterized by a multilocus sequence typing (MLST) method which was adapted in this study. This method presented a high discrimination power, identifying nine different sequence types (STs). This characterization also showed the presence of different STs simultaneously in the same host and that STs had switched over time in one of the animals. In addition, B. chomelii STs seem to group phylogenetically in two different lineages. The only B. bovis isolate was characterized with a previously described MLST method. This isolate corresponded to a new ST which is located in lineage I, where the B. bovis strains infecting Bos taurus subsp. taurus are grouped. Further studies on the dynamics of Bartonella infection in cattle and the potential ectoparasites involved in the transmission of this microorganism should be performed, improving knowledge about the interaction of Bartonella spp. and domestic ungulates.

Changes in the dynamics of Coxiella burnetii infection in dairy cattle: an approach to match field data with the epidemiological cycle of C. burnetii in endemic herds.

This study aimed to evaluate changes in the epidemiological status of Coxiella burnetii in dairy cattle herds to better understand the epidemiology of the infection and to predict its evolution. Bulk-tank milk (BTM) and serum samples were collected from 94 dairy cattle herds and analyzed by ELISA (BTM and sera) and PCR (BTM) in study 1 (S1). Two years later (study 2; S2), the same farms were visited with a similar sampling approach. To estimate seroconversion during this period, blood samples were collected from the maximum possible number of animals surveyed in S1. Environmental samples were collected in S2 to identify active shedding. Farms were allocated into 3 different categories in each study according to PCR and ELISA results: category A, with BTM ELISA and PCR positive herds and at least 1 seropositive animal; category B, with BTM ELISA or PCR positive herds or individual sera positive; and category C, with all negative results among herds. Changes in herd category between S1 and S2 were grouped in 9 classes. Two statistical models, one to search for drives of within-herd changes in C. burnetii infection status and another to look for variables modulating individual changes in C. burnetii antibody level, were built. Several herds in category A in S1 remained in that category 2 yr later, indicating that C. burnetii can remain within a herd for a long time. Most of the herds with seroconversion and detection of the bacterium in the environment belonged to category A, suggesting active and recent infections. Changes in the epidemiological status of herds were driven by local densities of domestic ruminants, showing the implication of neighbor reservoirs; whereas individual changes in antibody levels were modulated by variation in the epidemiological status of herds. Observed changes in epidemiological status allowed depiction of the hypothesized life cycle of C. burnetii within dairy cattle herds, which should be tested by future long-term series studies on C. burnetii infection to help fitting control measures (e.g., vaccination) to within-herd C. burnetii status.

[Changes in mitochondrial function induced by dequalinium precede oxidative stress and apoptosis in the human prostate cancer cell line PC-3].

Mitochondria play central roles in diverse physiological and pathological conditions associated with cell survival and death. Delocalized lipophilic cations, such as dequalinium (DQA), are accumulated in cancer cells attracted by the highly negative mitochondrial transmembrane potential of these cells. DQA showed a potent anticancer activity in cells from different malignancies. Here, we report the effect of DQA on PC-3 prostate cancer cells. Incubation with DQA at concentrations between 1.5 and 100 microM from 24 to 48 h decreases cell viability. The decrease in cell viability together with a loss of mitochondrial transmembrane potential induced an increase in reactive oxygen species production and cell death via caspase-3 dependent apoptotic pathway. QA was shown to cause moderate to strong cell death in a time and concentration dependent manner, causing a most advantageous effect at a concentration of 10 microM applied for a long 48 h time period, which might be a consequence of the kinetics of intracellular DQA accumulation in mitochondria, but also of the mechanisms of DQA-induced cell death. This data shows DQA as a promising agent against the human prostate cancer PC-3 cell line, activating the caspase-3 dependent apoptotic pathway. This fact might be beneficial for possible future applications in cancer therapy.

Intraoperative high flow oxygen therapy for tubeless anaesthesia in thoracoscopic surgery.

Tubeless anaesthesia has become widespread in videothoracoscopic surgery, even in major procedures such as lobectomies. There are several advantages in avoiding general anaesthesia and one-lung mechanical ventilation, such as faster recovery and shorter hospital stays. However, hypoxaemia and hypercapnia are the most reported causes of conversion to general anaesthesia. High Flow Oxygen Therapy (HFOT) generates flow-dependent positive end-expiratory pressure, improves oxygenation and also carbon dioxide washout by flow-dependent dead space flushing. For this reason, intraoperative HFOT may reduce the rate of conversion to general anaesthesia. We report our experience with intraoperative HFOT in a 71-year-old female with lung adenocarcinoma undergoing VATS upper left lobectomy.

[Translated article] Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment.

INTRODUCTION: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations. MATERIAL AND METHOD: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow-up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint). RESULTS: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008). CONCLUSIONS: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

Fluorosis and dental caries in Mexican schoolchildren residing in areas with different water fluoride concentrations and receiving fluoridated salt.

OBJECTIVE: To explore the association between fluoride in drinking water and the prevalence and severity of fluorosis and dental caries in children living in communities receiving fluoridated salt. MATERIAL AND METHODS: Participants were schoolchildren (n = 457) living in two rural areas of the State of Morelos, Mexico, where the water fluoride concentration was 0.70 or 1.50 ppm. Dental caries status was assessed using Pitts' criteria. Lesions that were classified as D3 (decayed) were identified to determine the decayed, missing, and filled teeth index (D3MFT). Fluorosis was assessed using the Thylstrup-Fejerskov Index (TFI). Information regarding drinking water source and oral hygiene practices (tooth brushing frequency, dentifrice use, and oral hygiene index) was obtained. RESULTS: The prevalence of fluorosis (TFI ≥1) in communities with 0.70 and 1.50 ppm water fluoride was 39.4 and 60.5% (p = 0.014), respectively, while the prevalence of more severe forms (TFI ≥4) was 7.9 and 25.5% (p < 0.001), respectively. The mean D3MFT was 0.49 (±1.01) in the 0.70 ppm community and 0.61 (±1.47) in the 1.50 ppm community (p = 0.349). A logistic regression model for caries (D3 >1) showed that higher fluorosis categories (TFI 5-6 OR = 6.81, p = 0.001) were associated with higher caries experience, adjusted by age, number of teeth present, tooth brushing frequency, bottled water use, and natural water fluoride concentration. CONCLUSIONS: The prevalence of fluorosis was associated with the water fluoride concentration. Fluorosis at moderate and severe levels was associated with a higher prevalence of dental caries, compared with lesser degrees of fluorosis. The impact of dental fluorosis should be considered in dental public health programs.

Mapping radon-prone areas using γ-radiation dose rate and geological information.

Identifying radon-prone areas is key to policies on the control of this environmental carcinogen. In the current paper, we present the methodology followed to delineate radon-prone areas in Spain. It combines information from indoor radon measurements with γ-radiation and geological maps. The advantage of the proposed approach is that it lessens the requirement for a high density of measurements by making use of commonly available information. It can be applied for an initial definition of radon-prone areas in countries committed to introducing a national radon policy or to improving existing radon maps in low population regions.

Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment. / Luxación acromioclavicular grado III. Resultados a medio plazo tras tratamiento conservador y quirúrgico.

INTRODUCTION: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations. MATERIAL AND METHOD: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint). RESULTS: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008). CONCLUSIONS: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

A Potent Kalihinol Analogue Disrupts Apicoplast Function and Vesicular Trafficking in P. falciparum Malaria.

Here we report the discovery of MED6-189, a new analogue of the kalihinol family of isocyanoterpene (ICT) natural products. MED6-189 is effective against drug-sensitive and -resistant P. falciparum strains blocking both intraerythrocytic asexual replication and sexual differentiation. This compound was also effective against P. knowlesi and P. cynomolgi. In vivo efficacy studies using a humanized mouse model of malaria confirms strong efficacy of the compound in animals with no apparent hemolytic activity or apparent toxicity. Complementary chemical biology, molecular biology, genomics and cell biological analyses revealed that MED6-189 primarily targets the parasite apicoplast and acts by inhibiting lipid biogenesis and cellular trafficking. Genetic analyses in P. falciparum revealed that a mutation in PfSec13, which encodes a component of the parasite secretory machinery, reduced susceptibility to the drug. The high potency of MED6-189 in vitro and in vivo, its broad range of efficacy, excellent therapeutic profile, and unique mode of action make it an excellent addition to the antimalarial drug pipeline.

Estimation of Coxiella burnetii prevalence in dairy cattle in intensive systems by serological and molecular analyses of bulk-tank milk samples.

A large-scale investigation on Coxiella burnetii was carried out in dairy cattle herds from a Q fever-endemic region to evaluate the degree of exposure to C. burnetii and to estimate prevalences. This study included all of the dairy cattle herds from the province of Bizkaia, Northern Spain (n=178). Herds were visited between September 2009 and February 2010, and 100mL of bulk-tank milk (BTM) per farm was collected to be analyzed by ELISA and PCR. Blood samples were also taken from about 15 animals randomly selected from each herd. One hundred nineteen of the 178 studied herds (66.9±6.9%) were positive for the presence of anti-C. burnetii antibodies in BTM. Serum samples from 1,306 cows, 654 heifers, and 502 calves were analyzed by ELISA, and cows showed a statistically significantly higher seroprevalence (12.3±1.8%) than heifers (1.1±0.8%) and calves (0.0±0.0%). Eighty-nine herds (50.0±7.3%) had at least 1 seropositive animal, but within-herd prevalences higher than 20% were only observed in 24 herds (13.5±5.0%). A significant correlation was observed between BTM ELISA sample-to-positive control ratios and within-herd seroprevalence, being higher when considering only cows (R(2)=0.21). Animals from herds with negative BTM by ELISA showed a mean seroprevalence of 2.5%, whereas animals from herds with positive BTM samples had a statistically significantly higher seroprevalence (8.9%, F=19.7, degrees of freedom=1). The proportion of herds C. burnetii positive by BTM PCR was 51.7±7.3% (92/178). The widespread distribution of C. burnetii in cattle advocates for the implementation of Q fever control strategies.