Influence of Mechanical Cycling on Torque Values of Tapped-In and Screw-In Implant-Supported Crowns.

This study investigated the influence of mechanical cycling on screwed-in and tappedin implants restored with screw-retained metallic crowns. Three implant-abutmentcrown systems were evaluated: T1 (multi abutment) and T2 (standard abutment) received tapped-in abutments and S received a screwed-in abutment. The specimens were subjected to two million cycles of 0-150 N load, at 2 Hz, 30° inclination in a dry medium, and torque evaluation. Survival and removal torque were analyzed using chisquare, ANOVA, followed by Tukey's test. Differences between installation and removal torque were determined using a T-test for dependent samples. Analyses were performed in SPSS, considering α = 0.05. All specimens survived mechanical cycling in S, 40% in T1, 80% in T2 (p=0.008). Failures occurred due to loosening of the crown screw. A significant decrease in torque (p=0.000) was found. Group T1 had the lowest removal torque (1.6 ± 0.84 N.Cm²), followed by T2 (3 ± 1.49 N.Cm²) and S (6.3 ± 1.16 N. Cm²), and a statistical difference was found between Groups T1 and S. Both types of implantabutment connections were stable and can be considered for rehabilitative treatment, but failure and removal torque were influenced by the design of prosthetic abutment. Crowns were more susceptible to becoming loose in tapped-in systems.

Prevalence of bovine mastitis-related pathogens, identified by mass spectrometry in flies (Insecta, Diptera) captured in the milking environment.

Diptera (Insecta) are able to transmit approximately 200 pathogenic microorganisms to humans and animals, causing more than 65 diseases, including bovine mastitis, which constitutes a major cause of economic losses in the dairy industry. In this scenario, 217 adult specimens of Diptera were collected from nine farms and identified to the family and/or species level. Of the 11 families recorded, Muscidae was the most prevalent (152 out of 217; 70%). All Diptera specimens were subjected to microbiological culture using conventional and selective media, and isolates were then identified at the species level by mass spectrometry. In total, 275 microorganisms were identified, with a predominance of pathogens related to environmental bovine mastitis (166/275 = 60·4%), that is, Enterococcus species (70/275 = 25·4%) and Escherichia coli (49/275 = 17·8%). Nontraditional agents related to bovine mastitis (called miscellaneous) were detected in 28% (77/275), as well as microorganisms with well-known zoonotic behaviour (e.g. Bacillus cereus). This is study contributes with knowledge of diversity of microorganisms carried by Diptera in the dairy environment, including pathogens associated with environmental and contagious bovine mastitis, and agents with human relevance. To our knowledge, a three-part chromogenic selective medium used to microbial culture of milk on farms was used for the first time to identification of pathogens in Diptera.

Schinus molle essential oil as a potential source of bioactive compounds: antifungal and antibacterial properties.

AIMS: The study was focused on the evaluation of antimicrobial activity in vitro of the essential oil (EO) of leaves from Schinus molle against bacteria and fungi of clinical importance in the search for the discovery of new active compounds. METHODS AND RESULTS: The chemical composition of the S. molle EO was determined by gas chromatography/mass spectrometry and its antimicrobial effect was verified by broth microdilution method. The major compounds found were ß-pinene (25·23%), epi-α-cadinol (21·29%), α-pinene (18·72%), myrcene (11·54%) and sabinene (5·02%). The EO showed significant antifungal activity against Paracoccidioides brasiliensis (39·06 µg ml-1 ), weak action against Cryptococcus neoformans (625 µg ml-1 ) and Trichophyton quinckeanum (625 µg ml-1 ) and was inactive against Candida sp. In the analysis of the antibacterial action, the micro-organisms tested did not show sensitivity. CONCLUSIONS: This study showed a promising result of S. molle volatiles against the fungus P. brasiliensis, which causes paracoccidioidomycosis (PCM), a systemic mycosis of great clinical importance in Latin America. SIGNIFICANCE AND IMPACT OF THE STUDY: The results found here are novel and encourage investigations of the compounds present in this EO, which represents a source of molecules with potential use in the treatment of PCM.

To what extent is climate change adaptation a novel challenge for agricultural modellers?

Modelling is key to adapting agriculture to climate change (CC), facilitating evaluation of the impacts and efficacy of adaptation measures, and the design of optimal strategies. Although there are many challenges to modelling agricultural CC adaptation, it is unclear whether these are novel or, whether adaptation merely adds new motivations to old challenges. Here, qualitative analysis of modellers' views revealed three categories of challenge: Content, Use, and Capacity. Triangulation of findings with reviews of agricultural modelling and Climate Change Risk Assessment was then used to highlight challenges specific to modelling adaptation. These were refined through literature review, focussing attention on how the progressive nature of CC affects the role and impact of modelling. Specific challenges identified were: Scope of adaptations modelled, Information on future adaptation, Collaboration to tackle novel challenges, Optimisation under progressive change with thresholds, and Responsibility given the sensitivity of future outcomes to initial choices under progressive change.

Effect of a single injection of cabergoline at dry off on udder characteristics in high-yielding dairy cows.

In recent years, relationships between high milk yield at dry off, higher prevalence for new intramammary infections, and stress were evaluated. Considering increasing milk yield, dry off methods need to be refined to ensure udder health and animal welfare, especially in high-yielding dairy cows. The present work evaluated the effect of a single cabergoline injection (Velactis, Ceva Santé Animale, Libourne, France) at dry off on udder pressure, milk leakage, and signs of udder pain after dry off. A total of 234 high-yielding (≥16 kg of milk/d) dairy cows was enrolled 7 d before and followed up until 14 d after dry off. Cows were dried off without preparation (i.e., no feed change or intermittent milking before dry off) and treated with a single i.m. injection of 5.6 mg of cabergoline (n = 115) or placebo (n = 119) after last milking. Udder characteristics were measured 4 d before (i.e., before and after milking) and 1, 2, 3, 7, 10, and 14 d after dry off. Udder pressure was evaluated utilizing a hand-held dynamometer. Milk leakage and signs of udder pain were noted as binary variables. Whereas udder pressure baseline values after last milking did not differ between treatment groups (0.541 ± 0.15 kg), cabergoline significantly reduced udder pressure in primiparous but not in multiparous cows after dry off. Differences between cabergoline- and placebo-treated primiparous cows could be evaluated until 3 d after dry off. The first day after dry off, udder pressure in placebo- and cabergoline-treated cows increased by 115% and 42.3%, respectively. Whereas pressure values in placebo cows were highest on the first day after dry off (1.16 ± 0.61 kg) and slowly decreased afterward, udder pressure in cows treated with cabergoline had a slower increase and peak only 2 d after dry off (0.94 ± 0.44 kg). Furthermore, cabergoline caused a reduction of milk leakage, a known factor for new intramammary infections. Only 11.3% of cows treated with cabergoline showed milk leakage compared with 21.0% placebo-treated cows. Additionally, cows with placebo treatment were 2.8 times as likely to show signs of udder pain compared with cows treated with cabergoline. An effect of cabergoline on udder pressure, milk leakage, and udder pain was limited to the first week after dry off. Our data provide evidence that a single injection of cabergoline reduces risk factors for udder health and animal welfare problems around dry off in high-yielding dairy cows with more than 16 kg of milk/d. Further research is warranted, however, to investigate if cabergoline at dry off can also be used to reduce new intramammary infection rates and improve animal welfare after dry off.

An ultra-high performance liquid chromatography method to determine the skin penetration of an octyl methoxycinnamate-loaded liquid crystalline system.

Cutaneous penetration is a critical factor in the use of sunscreen, as the compounds should not reach systemic circulation in order to avoid the induction of toxicity. The evaluation of the skin penetration and permeation of the UVB filter octyl methoxycinnamate (OMC) is essential for the development of a successful sunscreen formulation. Liquid-crystalline systems are innovative and potential carriers of OMC, which possess several advantages, including controlled release and protection of the filter from degradation. In this study, a new and effective method was developed using ultra-high performance liquid chromatography (UPLC) with ultraviolet detection (UV) for the quantitative analysis of penetration of OMC-loaded liquid crystalline systems into the skin. The following parameters were assessed in the method: selectivity, linearity, precision, accuracy, robustness, limit of detection (LOD), and limit of quantification (LOQ). The analytical curve was linear in the range from 0.25 to 250 µg.m-1, precise, with a standard deviation of 0.05-1.24%, with an accuracy in the range from 96.72 to 105.52%, and robust, with adequate values for the LOD and LOQ of 0.1 and 0.25 µg.mL -1, respectively. The method was successfully used to determine the in vitro skin permeation of OMC-loaded liquid crystalline systems. The results of the in vitro tests on Franz cells showed low cutaneous permeation and high retention of the OMC, particularly in the stratum corneum, owing to its high lipophilicity, which is desirable for a sunscreen formulation.

A first look into the influence of triathlon wetsuit on resting blood pressure and heart rate variability.

The purpose of this study was to investigate the effects of wearing a wetsuit on resting cardiovascular measures (blood pressure (BP), heart rate variability (HRV)). The influence of position (upright, prone) and wetsuit size were also explored. Participants (n=12 males, 33.3±12.1 years) had BP and HRV measured during six resting conditions: standing or prone while not wearing a wetsuit (NWS), wearing the smallest (SWS), or largest (LWS) wetsuit (based upon manufacturer guidelines). Heart rate was recorded continuously over 5-mins; BP was measured three times per condition. HRV was represented by the ratio of low (LF) and high (HF) frequency (LF/HF ratio); mean arterial pressure (MAP) was calculated. Each dependent variable was analyzed using a 2 (position) x 3 (wetsuit) repeated measures ANOVA (α=0.05). Neither HRV parameter was influenced by position x wetsuit condition interaction (p>0.05) and MAP was not influenced by position (p=0.717). MAP and LF/HF ratio were both influenced by wetsuit condition (p<0.05) with higher during SWS than NWS (p=0.026) while LF/HF ratio was lower during SWS compared to NWS (p=0.032). LF/HF ratio was influenced by position being greater during standing vs. prone (p=0.001). It was concluded that during resting while on land (i.e., not submerged in water), wearing a small, tight-fitting wetsuit subtlety altered cardiovascular parameters for healthy, normotensive subjects.

Short communication: The effects of cabergoline administration at dry-off of lactating cows on udder engorgement, milk leakages, and lying behavior.

Cabergoline is an ergot derivative with high affinity for the D2 dopamine receptors whose dopaminergic effects cause inhibition of prolactin (PRL) secretion; thus, it could be considered a molecule that acts as a potential dry-off facilitator. One hundred ninety-nine Holstein cows (102 primiparous; 97 multiparous) producing ≥ 18 kg/d at dry-off were split in 2 treatments to evaluate the effects of diminishing PRL secretion at dry-off (between 70 and 50 d from the expecting calving date) on udder engorgement, milk leakage, and cow well-being after dry-off. Treatments consisted of a single i.m. injection of 5 mL of a solution containing 5.6 mg of cabergoline (CAB; Velactis, Ceva Santé Animal, Libourne, France) or 5 mL of saline solution as a placebo (CTRL). Each animal was evaluated for presence or absence of milk leakages during the 4 d following dry-off and udder engorgement was determined using a digital algometer. Lying behavior was recorded during 10 d after dry-off. Twenty-five cows from each treatment were randomly chosen and blood sampled at 3 and 15 d after dry-off, and again at 5 and 3 d before the expected calving date to determine serum PRL concentrations. Cows on CAB had lower serum PRL concentrations than cows on CTRL at 3 and 15 d after dry-off. Average udder engorgement was lower for cows on CAB than for cows on CTRL following dry-off, and it decreased as days after dry-off increased. The overall incidence of milk leakage in cows on CAB (3.1 ± 0.88%) was 73.5% of that obtained in cows on CTRL (11.7 ± 1.64%); cows on CAB had 0.2 lower odds of incurring milk leakage than cows on CTRL. The day following dry-off, CAB cows lied about 1.5h/d more than cows on CTRL. We conclude that i.m. administration of 5.6 mg of cabergoline at dry-off effectively reduces PRL secretion, udder engorgement, and milk leakages, and improves lying time the day following dry-off.

Intraspecific differentiation of Hancornia speciosa revealed by simple sequence repeat and random amplified polymorphic DNA markers.

Hancornia speciosa, popularly known as mangabeira, is a fruit tree native to the Brazilian Cerrado that shows great economic potential, due to its multiple uses. Intraspecific classification of this species is difficult because it shows high morphological diversity. An early study of the species reported that there are six botanic varieties that differ morphologically mainly in the shapes of their leaves and flowers. Except to note the wide morphological variation and economic potential of this species, few studies have been published about the genetic diversity of mangabeira. Knowledge of the genetic variability of this species among populations would be useful for genetic conservation and breeding programs. Therefore, we tested the transferability of 12 simple sequence repeats from expressed sequence tags (EST-SSRs) from Catharanthus roseus to H. speciosa and used 10 random amplified polymorphic DNA markers to evaluate the genetic variability among botanical varieties of H. speciosa. We obtained a high transferability frequency of EST-SSR markers from C. roseus to H. speciosa (75%). However, EST-SSR markers showed low heterozygosity and locus variability (two or three alleles by locus), which suggest low genetic diversity in the mangabeira samples. The Jaccard dissimilarity index and an examination of geographic distances indicated a non-spatial structuring of the genetic variability. Our markers were unable to distinguish H. speciosa botanical varieties.

Tangential velocity constraint for orbital maneuvers with Theory of Functional Connections.

Maneuvering a spacecraft in the cislunar space is a complex problem, since it is highly perturbed by the gravitational influence of both the Earth and the Moon, and possibly also the Sun. Trajectories minimizing the needed fuel are generally preferred in order to decrease the mass of the payload. A classical method to constrain maneuvers is mathematically modeling them using the Two Point Boundary Value Problem (TPBVP), defining spacecraft positions at the start and end of the trajectory. Solutions to this problem can then be obtained with optimization techniques like the nonlinear least squares conjugated with the Theory of Functional Connections (TFC) to embed the constraints, which recently became an effective method for deducing orbit transfers. In this paper, we propose a tangential velocity (TV) type of constraints to design orbital maneuvers. We show that the technique presented in this paper can be used to transfer a spacecraft (e.g. from the Earth to the Moon) and perform gravity assist maneuvers (e.g. a swing-by with the Moon). In comparison with the TPBVP, solving the TV constraints via TFC offers several advantages, leading to a significant reduction in computational time. Hence, it proves to be an efficient technique to design these maneuvers.

Citric Acid Conditioning as an Alternative to EDTA for Growth Factors Release and Stem Cell Response in Regenerative Endodontics: A Systematic Review of In Vitro Studies.

INTRODUCTION: Citric acid (CA) conditioning may be a promising alternative to ethylenediaminetetraacetic acid (EDTA) in regenerative endodontic procedures, as reported to improve growth factors' release from dentin. This review systematically investigated the effect of CA conditioning on the growth factors release from dentin and cell behavior compared to EDTA conditioning. METHODS: Searches were conducted (PubMed/MEDLINE, Scopus, Web of Science, Embase, SciELO, Cochrane Library, and grey literature) until May-2023. Only in vitro studies that evaluated the effects of CA on growth factors' release from dentin and cell behavior outcomes compared to EDTA were included. The studies were critically appraised using a modified Joanna Briggs Institute's checklist. Meta-analysis was unfeasible. RESULTS: Out of the 335 articles screened, nine were included. Among these, three studies used dentin discs/roots from permanent human teeth; the rest combined them with stem cells. 10% CA for 5 or 10 minute was the most used protocol. Meanwhile, EDTA concentrations ranged from 10% to 17%. In eight studies examining the release of growth factors, five reported a significant release of transforming growth factor-ß after dentin conditioning with 10% CA compared to 17% EDTA. Regarding cell behavior (6 studies), three studies assessed cell viability. The findings revealed that 10% CA conditioning showed cell viability similar to those of 17% EDTA. Additionally, in two out of three studies, it was observed that 10% CA conditioning did not affect cell morphology. The studies had a low risk of bias. CONCLUSIONS: The use of 10% CA to condition dentin for 5-10 minutes resulted in a notable transforming growth factor -ß1 release, but its cell responses were similar to those of EDTA.

Salivary biomarkers, vital signs and behaviour of pre-school children during their first dental visit.

AIM: Anxiety may influence dental treatment unfavourably, thus evaluation of the psychophysiological reactions of the child may reduce its negative effects. This study aimed to evaluate and correlate the levels of cortisol and alpha-amylase, vital signs and behaviour of children during their first dental visit. METHODS: Study sample consisted of 32 children (11 male and 21 female patients) aged between 4 and 6 years, who would go to the dentist for the first time, with no pain or chronic illness, and without the use of medication. Three saliva samples were collected: before, immediately after and 20 minutes after the dental procedure (dental prophylaxis). STATISTICS: Data were analysed using Student's t test and Pearson's correlation test (p = 0.05). RESULTS: In the comparison of the levels of alpha-amylase, the heart rate and blood pressure were higher after the dental visit and the levels of salivary cortisol were significantly higher before. There was no statistically significant difference in the correlation between the Frankl Behaviour Rating Scale and the levels of cortisol and alpha-amylase, but the results showed that the levels of these two salivary biomarkers increased gradually as the child had a less cooperative behaviour. CONCLUSION The sample revealed that the first dental visit generated anxiety, which was manifested through physiological and behavioural alterations.

[The two-staged intervention for complicated colonic cancer].

The methods of colonic resection and a two-barrel colostomy closure, after performance of modified Mikulicz operation for complicated colonic cancer with formation of a two-staged extraperitoneal invagination duplicature anastomosis, were proposed. Postoperative complicationshave had occurred in 10 (10.9%) patients, including the anastomotic sutures insufficiency--in 2 (2.2%).

Animal board invited review: Opportunities and challenges in using GWP* to report the impact of ruminant livestock on global temperature change.

Ruminant livestock is a large contributor of CH4 emissions globally. Assessing how this CH4 and other greenhouse gases (GHG) from livestock contribute to anthropogenic climate change is key to understanding their role in achieving any temperature targets. The climate impacts of livestock, as well as other sectors or products/services, are generally expressed as CO2-equivalents using 100-year Global Warming Potentials (GWP100). However, the GWP100 cannot be used to translate emission pathways of short-lived climate pollutants (SLCPs) emissions to their temperature outcomes. A key limitation of handling long- and short-lived gases in the same manner is revealed in the context of any potential temperature stabilisation goals: to achieve this outcome, emissions of long-lived gases must decline to net-zero, but this is not the case for SLCPs. A recent alternative metric, GWP* (so-called 'GWP-star'), has been proposed to overcome these concerns. GWP* allows for simple appraisals of warming over time for emission series of different GHGs that may not be obvious if using pulse-emission metrics (i.e. GWP100). In this article, we explore some of the strengths and limitations of GWP* for reporting the contribution of ruminant livestock systems to global temperature change. A number of case studies are used to illustrate the potential use of the GWP* metric to, for example, understand the current contribution of different ruminant livestock production systems to global warming, appraise how different production systems or mitigations compare (having a temporal element), and seeing how possible emission pathways driven by changes in production, emissions intensity and gas composition show different impacts over time. We suggest that for some contexts, particularly if trying to directly infer contributions to additional warming, GWP* or similar approaches can provide important insight that would not be gained from conventional GWP100 reporting.

ABCB1 gene variants as risk factors and modulators of age of onset of demyelinating disease in Mexican patients.

INTRODUCTION: The C1236T, G2677T/A, and C3435T variants of the ABCB1 gene alter the functioning of P-glycoprotein and the transport of endogenous and exogenous substances across the blood-brain barrier, and act as risk factors for some neurodegenerative diseases. This study aimed to determine the association between demyelinating disease and the C1236T, G2677T/A, and C3435T variants of ABCB1 and its haplotypes and combinations of genotypes. METHODS: Polymerase chain reaction with restriction fragment length polymorphism analysis (PCR-RFLP) and Sanger sequencing were used to genotype 199 patients with demyelinating disease and 200 controls, all Mexicans of mixed race; frequencies of alleles, genotypes, haplotypes, and genotype combinations were compared between patients and controls. We conducted a logistic regression analysis and calculated chi-square values and 95% confidence intervals (CI); odds ratios (OR) were calculated to evaluate the association with demyelinating disease. RESULTS: The TTT and CGC haplotypes were most frequent in both patients and controls. The G2677 allele was associated with demyelinating disease (OR: 1.79; 95% CI, 1.12-2.86; P =  .015), as were the genotypes GG2677 (OR: 2.72; 95% CI, 1.11-6.68; P =  .025) and CC3435 (OR: 1.82; 95% CI, 1.15-2.90; P =  .010), the combination GG2677/CC3435 (OR: 2.02; 95% CI, 1.17-3.48; P =  .010), and the CAT haplotype (OR: 0.21; 95% CI, 0.05-0.66; P =  .001). TTTTTT carriers presented the earliest age of onset (23.0 ±â€¯7.7 years, vs 31.6 ±â€¯10.7; P =  .0001). CONCLUSIONS: The GG2677/CC3435 genotype combination is associated with demyelinating disease in this sample, particularly among men, who may present toxic accumulation of P-glycoprotein substrates. In our study, the G2677 allele of ABCB1 may differentially modulate age of onset of demyelinating disease in men and women.

Effectiveness of Twitter Threads to Improve Medical Student Electrocardiogram (ECG) Reading-Skills. The TwittUVa-ECG Non-Randomized Pre-Post Study.

Introduction: social media is increasingly used in medical education, but its real educational effectiveness is unclear. In this study we assess the effectiveness of Twitter threads (TTS) in improving electrocardiogram (ECG) basic reading skills (ECGBRS). Materials and Methods: Seven TTS describing ECGBRS were published from October 28, 2021, to November 24, 2021. Tests were used to assess medical students ECGBRS pre and post intervention. All third and sixth-year medical students were invited to participate. Sixty-three students were enrolled (33 third year and 30 sixth year). Nine (14.3%) participants dropped out. Results: Sixth year medical students had higher ECGBRS at baseline. The number of correct items increased after the Twitter intervention; median correct pre-test items were 20 out of 56, (interquartile range (IQR) 14-23), and median post-test were 29 out of 56, (IQR 21-36) (p < 0.001). The improvement in sixth year students was greater than for third year students; 10 more correct items (IQR 4-14) vs. 7 (IQR 1-14) items (p = 0.045). The more TTS followed, the greater the improvement in ECGBRS (p = 0.004). The QRS axis calculation was the ECG reading skill with the lowest scores. Most medical students were definitely (35%) or very probably (46%) interested in repeating another on-line learning experience and found the TTS extremely (39%) or very (46%) interesting. Conclusions: The use of specifically designed TTS was associated with improvement in medical students' interpretation of ECGs. The effectiveness of the threads was higher in the final years of medical school when basic skills had already been acquired. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01885-x.

Gravitational perturbations correlated with the asteroid kinetic impact deflection technique.

This paper presents the use of the kinetic impact technique to deflect asteroids that may present some risk of collision with Earth. Within the work to be developed here, we intend to evaluate in more detail the possibility to deflect the orbit of the asteroid 101955 Bennu by applying variations in its velocity ([Formula: see text]v) at different positions along its orbital period and measuring effects of close encounters with planet Earth. We will see that, in a relatively long period of time, the asteroid has several close encounters with the planet, thus suffering a natural gravitational perturbation. With the application of the impulses, the relative distances change, causing variations in the energy of the asteroid and a large variation in the relative distance between the asteroid and Earth over a long period after the impulse. We present results related to the magnitude of the impulse applied, which is important because its defines the mass and velocity of the impactor to be considered. Then, we mapped the positions of the impulses along a period of the orbit of the asteroid. We finish by explaining what happens to the orbit of the asteroid during the periods of gravitational perturbation, since the close encounters amount to "Swing Bys" that intensify the variations of the relative distances between the bodies after the impulse is applied.

[Biomechanics of the bone-screw interface in transpedicular spinal instrumentation]. / Biomecánica de la interfaz hueso-tornillo en instrumentación transpedicular de columna.

Implant loosening, catastrophic failure of the bone-screw interface, material migration, and loss of stability of the fixation component assembly constitute a serious complication in adult spinal surgery. The contribution of biomechanics is based on experimental measurement and simulation of transpedicular spinal fixations. The cortical insertion trajectory showed an increase in the resistance of the screw-bone interface with respect to the pedicle insertion trajectory, both for axial traction forces to the screw and for stress distribution in the vertebra. The double-threaded screws and standard pedicle screws had similar strength. Partially threaded screws with four-thread showed better resistance to fatigue in terms of a higher failure load and number of cycles to fail. Cement or hydroxyapatite augmented screws with also showed a better fatigue resistance in osteoporotic vertebrae. Rigid segment simulations confirmed the presence of higher stresses on the intervertebral discs causing damage to adjacent segments. The posterior body of the vertebra may be subjected to high stresses, in the bone-screw interface, being this bone region more susceptible to failure.

El aflojamiento de los implantes, la falla catastrófica de la interfaz hueso-tornillo, la migración de material y la pérdida de estabilidad de los componentes del ensamble de la fijación constituyen una seria complicación en la cirugía de columna de adultos. La contribución de la biomecánica se basa en la medición experimental y la simulación de las fijaciones transpediculares de columna. La trayectoria de inserción cortical mostró un incremento en la resistencia de la interfase tornillo-hueso respecto a la inserción pedicular tanto para fuerzas de tracción axiales al tornillo como en distribución de esfuerzos en la vértebra. Los tornillos de doble rosca tuvieron una resistencia similar a los pediculares estándar. Los tornillos de rosca parcial de cuatro filetes mostraron mejor resistencia a la fatiga en cuanto a mayor carga de rotura y número de ciclos para la falla. Los tornillos aumentados, ya sea con cemento o hidroxiapatita mejoraron también la resistencia a la fatiga en vértebras osteoporóticas. Las simulaciones de segmentos rígidos confirmaron la presencia de esfuerzos superiores en los discos intervertebrales que provocan el daño de los segmentos adyacentes. La parte posterior de las vértebras puede estar sometida a mayores esfuerzos, fundamentalmente en la superficie de la interfaz hueso-tornillo, por lo que son más susceptibles a la falla en esta región.

Low-dose radiation therapy for hand osteoarthritis: shaking hands again?

BACKGROUND: Hand osteoarthritis (HOA) is one of the most common causes of pain and functional disability in western countries and there is still no definitive cure. Low-dose radiation therapy (LDRT) has anti-inflammatory properties that have shown to be effective in the symptomatic relief of various degenerative musculoskeletal disorders. We designed a clinical protocol using LDRT for symptomatic HOA and present results and tolerance in the first 100 patients included. MATERIALS AND METHODS: Between April 2015 and March 2021, 100 patients with a median age of 60 were treated. Fifty-seven patients suffering from proximal/distal interphalangeal joint pain, 40 patients with thumb arthritis, 2 patients with radiocarpal joint affection and 1 patient with metacarpophalangeal joint pain were enrolled. LDRT comprised of 6 fractions of 0.5-1 Gy on every other day up to a total dose of 3-6 Gy. Clinical response was evaluated according to the visual analog scale (VAS) for pain level and the von Pannewitz score (VPS) for joint functionality. Any patients not achieving subjective adequate pain relief after 8 weeks of treatment were offered a second identical LDRT course. RESULTS: With a median follow-up of 10.5 months (range 7.55-12.45), 94% reported an improvement in the pain, with a significant reduction in the VAS level after 3, 6 and 12 months (p < 0.001). Sixty-three patients needed a second course of treatment at a median time interval of 12 weeks (range 9-14). The mean VAS score before treatment was 8 (range 3-10). After treatment, it was 5 (range 1-10). After 3, 6 and 12 months, the mean VAS scores were 4 (range 0-9), 3 (range 0-9) and 3.5 (range 0-9), respectively. Seventy patients reported functionality improvements after LDRT according to the von Pannewitz score. No acute or late complications were observed. CONCLUSION: LDRT appears to be safe and useful for HOA and is associated with good rates of pain relief and functionality improvements. However, further studies are necessary to confirm these promising results.