The value of magnetic resonance imaging and computed tomography in the study of spinal disorders

Computed tomography (CT) and magnetic resonance imaging (MRI) have replaced conventional radiography in the study of many spinal conditions, it is essential to know when these techniques are indicated instead of or as complementary tests to radiography, which findings can be expected in different clinical settings, and their significance in the diagnosis of different spinal conditions. Proper use of CT and MRI in spinal disorders may facilitate diagnosis and management of spinal conditions. An adequate clinical approach, a good understanding of the pathological manifestations demonstrated by these imaging techniques and a comprehensive report based on a universally accepted nomenclature represent the indispensable tools to improve the diagnostic approach and the decision-making process in patients with spinal pain. Several guidelines are available to assist clinicians in ordering appropriate imaging techniques to achieve an accurate diagnosis and to ensure appropriate medical care that meets the efficacy and safety needs of patients. This article reviews the clinical indications of CT and MRI in different pathologic conditions affecting the spine, including congenital, traumatic, degenerative, inflammatory, infectious and tumor disorders, as well as their main imaging features. It is intended to be a pictorial guide to clinicians involved in the diagnosis and treatment of spinal disorders

The effects of sildenafil citrate on the fetoplacental development and hemodynamics in a rabbit model of intrauterina growth restriction

The present study evaluated the effectiveness of sildenafil citrate (SC) to improve placental and fetal growth in a diet-induced rabbit model of intrauterine growth restriction (IUGR). Pregnant rabbits were fed either ad libitum (Group C) or restricted to 50% of dietary requirements (Group R) or restricted and treated with SC (Group SC). The treatment with SC improved placental development by increasing vascularity and vessel hypertrophy in the decidua. The assessment of feto–placental haemodynamics showed higher resistance and pulsatility indices at the middle cerebral artery (MCA) in fetuses treated with SC when compared with Group R, which had increased systolic peak and time-averaged mean velocities at the MCA. Furthermore, fetuses in the SC group had significantly higher biparietal and thoracic diameters and longer crown–rump lengths than fetuses in Group R. Hence, the SC group had a reduced IUGR rate and a higher kit size at birth compared with Group R. In conclusion, SC may provide potential benefits in pregnancies with placental insufficiency and IUGR, partially counteracting the negative effects of food restriction on placental development and fetal growth. However, the present study also found evidence of a possible blood overflow in the brain that warrants further investigation

Fracturas de Astrágalo: Evaluación Clínico-Quirúrgica

Se han revisado 13 pacientes diagnosticados de fractura de astrágalo recogidos en nuestro Servicio de Urgencias y tratados quirúrgicamente en todos los casos. De ellos se ha realizado un seguimiento clínico y radiológico. En el 46% de los casos se obtuvieron resultados satisfactorios (23% excelentes y 23% buenos). Los restantes se repartieron entre regulares (38%) y malos (16%). La necrosis avascular apareció en 3 de los 13 casos, discutiéndose el origen de esta seria complicación. Siguiendo la clasificación de WEBER, los tipos de fractura más frecuentes fueron el tipo III (38%) y el II (31%). La congruencia articular postquirúrgica del astrágalo fracturado y el tiempo de demora en la cirugía que debe ser de urgencia, se muestran como factores a considerar en la evolución ulterior del "Aviators astragalus". Se discute así mismo el valor del signo de Hawkins.Areview of 13 patients diagnosed of Talus fracture has been colected in our service of trauma emergency. All of them have been managed by surgical methods and clinical and radiologically followed up. Satisfactory results wer e obtained in 46% of the cases (23%, excellents and 23%, good results). The rest wer e regular (38%) and bad (16%). Avascular necrosis was observed in 3 of the 13 cases, discussing the origin of this serious complication. The most frequent types of fracture were type III (38%) ant type II (31%) following Weber's classification. The postsurgical articular congruency of the fractured talus and the delayed time on the surgery which must be an emergency, seem to be factors to conside r in the later evolution of the "aviators astragalus". The value of Hawkins sign is also discussed

A cohort of patients with COVID-19 in a major teaching hospital in Europe

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAMArtículo escrito en nombre del COVID@HULP Working GroupSince the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the region of Madrid. This article describes the first 2226 adult patients with COVID-19, consecutively admitted to La Paz University Hospital in Madrid. Methods: Our cohort included all patients consecutively hospitalized who had a final outcome (death or discharge) in a 1286-bed hospital of Madrid (Spain) from 25 February (first case admitted) to 19 April 2020. The data were manually entered into an electronic case report form, which was monitored prior to the analysis. Results: We consecutively included 2226 adult patients admitted to the hospital who either died (460) or were discharged (1766). The patients’ median age was 61 years, and 51.8% were women. The most common comorbidity was arterial hypertension (41.3%), and the most common symptom on admission was fever (71.2%). The median time from disease onset to hospital admission was 6 days. The overall mortality was 20.7% and was higher in men (26.6% vs. 15.1%). Seventy-five patients with a final outcome were transferred to the intensive care unit (ICU) (3.4%). Most patients admitted to the ICU were men, and the median age was 64 years. Baseline laboratory values on admission were consistent with an impaired immune-inflammatory profile. Conclusions: We provide a description of the first large cohort of hospitalized patients with COVID-19 in Europe. Advanced age, male sex, the presence of comorbidities and abnormal laboratory values were more common among the patients with fatal outcome

Seroprevalence of SARS-CoV-2 Antibodies and Factors Associated with Seropositivity at the University of Salamanca: The DIANCUSAL Study

© 2021 by the authors[Background]: Systematic screening for antibodies against SARS-CoV-2 is a crucial tool for surveillance of the COVID-19 pandemic. The University of Salamanca (USAL) in Spain designed a project called “DIANCUSAL” (Diagnosis of New Coronavirus, COVID-19, in University of Salamanca) to measure antibodies against SARS-CoV-2 among its ~34,000 students and academic staff, as the influence of the university community in the spread of the SARS-CoV-2 pandemic in the city of Salamanca and neighboring towns hosting USAL campuses could be substantial.[Objective]: The aim of this study was to estimate the prevalence of SARS-CoV-2 antibodies among USAL students, professors and staff and to evaluate the demographic, academic, clinical and lifestyle and behavioral factors related to seropositivity.[Methodology]: The DIANCUSAL study is an ongoing university population-based cross-sectional study, with the work described herein conducted from July–October 2020. All USAL students, professors and staff were invited to complete an anonymized questionnaire. Seroprevalence of anti-SARS-CoV-2 antibodies was detected and quantified by using chemiluminescent assays for IgG and IgM. Principal findings: A total of 8197 (24.71%) participants were included. The mean age was 31.4 (14.5 SD) years, and 66.0% of the participants were female. The seroprevalence was 8.25% overall and was highest for students from the education campus (12.5%) and professors from the biomedical campus (12.6%), with significant differences among faculties (p = 0.006). Based on the questionnaire, loss of smell and fever were the symptoms most strongly associated with seropositivity, and 22.6% of seropositive participants were asymptomatic. Social distancing was the most effective hygiene measure (p = 0.0007). There were significant differences in seroprevalence between participants with and without household exposure to SARS-CoV-2 (p = 0.0000), but not between students who lived in private homes and those who lived in dormitories. IgG antibodies decreased over time in the participants with confirmed self-reported COVID-19 diagnoses.[Conclusions]: The analysis revealed an overall 8.25% seroprevalence at the end of October 2020, with a higher seroprevalence in students than in staff. Thus, there is no need for tailored measures for the USAL community as the official average seroprevalence in the area was similar (7.8% at 22 June and 12.4 at 15 November of 2020). Instead, USAL members should comply with public health measures.The DIANCUSAL (Diagnosis of New Coronavirus, COVID-19, in University of Salamanca) study was funded by a grant from the University of Salamanca (USAL)

Demographic and clinical profile of idiopathic pulmonary fibrosis patients in Spain: the SEPAR National Registry

BackgroundLittle is known on the characteristics of patients diagnosed with idiopathic pulmonary fibrosis (IPF) in Spain. We aimed to characterize the demographic and clinical profile of IPF patients included in the IPF National Registry of the Spanish Respiratory Society (SEPAR).MethodsThis is a prospective, observational, multicentre and nationwide study that involved 608 IPF patients included in the SEPAR IPF Registry up to June 27th, 2017, and who received any treatment for their disease. IPF patients were predominantly males, ex-smokers, and aged in their 70s, similar to other registries.ResultsUpon inclusion, meanSD predicted forced vital capacity was 77.6%+/- 19.4, diffusing capacity for carbon monoxide was 48.5%+/- 17.7, and the 6-min walk distance was 423.5m +/- 110.4. The diagnosis was mainly established on results from the high-resolution computed tomography in the proper clinical context (55.0% of patients), while 21.2% of patients required invasive procedures (surgical lung biopsy) for definitive diagnosis. Anti-fibrotic treatment was prescribed in 69.4% of cases, 51.5% pirfenidone and 17.9% nintedanib, overall with a good safety profile.Conclusions The SEPAR IPF Registry should help to further characterize current characteristics and future trends of IPF patients in Spain and compare/pool them with other registries and cohorts

Revelando la geometría en profundidad de las fallas activas que limitan el valle del Guadalentín mediante sísmica de reflexión de alta resolución: resultados preliminares

[EN]: To produce seismic hazard assessments to the current state-of-the-art, it is essential to characterize the active faults in terms of geometry, interrelation and seismotectonic status. The Guadalentin Depression is the main basin within the Eastern Betic Shear Zone, which corresponds to a NE-SW tectonic corridor bounded by the Carrascoy, Alhama de Murcia and Palomares faults, from north to south. Although a number of active tectonics and paleoseismological studies have been carried out in these faults, almost nothing is known about their geometry at depth. To unveil the deep structure, geometry and upper Neogene deformation history of these faults we have carried out a high-resolution seismic reflection survey. The acquired seismic profiles will allow to improve our understanding of the deep geometry of the known active faults (up to 2 km depth), as well as to identify potential buried branches and will help to reduce the uncertainties in seismic hazard assessment.[ES]: Para producir evaluaciones del peligro sísmico actualizadas al estado del arte actual, es esencial caracterizar las fallas activas de una región en términos de geometría, interrelación y estado sismotectónico. La depresión del Guadalentín es la principal cuenca cuaternaria dentro de la Zona de Cizalla de las Béticas Orientales, la cual corresponde a un corredor tectónico con dirección NE-SW delimitado por las fallas de Carrascoy, Alhama de Murcia y Palomares, de norte a sur. Aunque varios estudios de tectónica activa y paleosismología se han centrado en estas fallas, su geometría en profundidad es bastante incierta. Para revelar la estructura profunda, la geometría y el historial de deformación desde el Neógeno superior de estas fallas, hemos llevado a cabo un estudio de sísmica de reflexión de alta resolución. Los perfiles sísmicos adquiridos permitirán mejorar nuestra comprensión de la geometría profunda de las fallas activas conocidas (hasta 2 km de profundidad), así como identificar posibles ramas ciegas, y ayudarán a reducir las incertidumbres en los cálculos de peligrosidad sísmicaHector Perea es un investigador postdoctoral del programa "Atracción de Talento" en la Universidad Complutense de Madrid financiado por la Comunidad de Madrid (2018-T1/AMB-11039). Paula Herrero y Júlia Molins han estado contratadas por el proyecto UNrIDDLE (2018-T1/AMB-11039). Juan Alcalde ha recibido financiación de las ayudas IJC2018-036074-I financiadas por MCIN/AEI/10.13039/501100011033.Peer reviewe

Somos diversidad. Actividades para la formación de profesionales de la educación formal y no formal en diversidad sexual, familiar, corporal y de expresión e identidad de género

Este manual se presenta como una “caja de herramientas” donde acudir en busca de recursos y actividades didácticas para elaborar formaciones en diversidad sexual, familiar, corporal y de expresión e identidad de género, dirigidas a profesionales que trabajan con jóvenes. En este sentido, son materiales que se pueden adaptar a las necesidades de cada formación y a distintos niveles de conocimiento, tanto de los grupos participantes, como de la persona que dinamice las actividades y que son lo suficientemente flexibles para que puedan ser moldeados y utilizados según los recursos temporales y espaciales que presente cada propuestaformativa. “Somos diversidad” ofrece un total de 44 actividades articuladas en 5 módulos temáticos. Abrazar la diversidad como una oportunidad educativa Transformarse para transformar: afectividad, diferencia y diversidad Sexualidades Corporalidades, identidades y expresiones de género Diversidad familiar Cada módulo ofrece un índice inicial, una breve bienvenida donde se reflejan la justificación y objetivos del módulo, una serie de actividades y un apartado de bibliografía citada y consultada. En cada actividad se detalla su duración estimada, los objetivos propuestos, los recursos necesarios, las indicaciones para su desarrollo, y se aportan finalmente los materiales específicos necesarios para realizarlas. Este manual es el resultado de la actividad “Juventud y LGTBI+: abrazar la diversidad en la educación no formal y formal” dentro del Plan de Actividades Transnacionales (TCA) del programa Erasmus+: Juventud en Acción, organizada por el Injuve y el Grupo de Investigación “Antropología, Diversidad y Convivencia” de la Universidad Complutense de Madrid