Intra-observer reliability for measuring first and second toe and metatarsal protrusion distance using palpation-based tests: a test-retest study

Background: Measurement of first and second metatarsal and toe protrusion is frequently used to explain foot problems using x-rays, osteological measurements or palpation-based tests. Length differences could be related to the appearance of problems in the foot. A test-retest design was conducted in order to establish the intra-rater reliability of three palpation-based tests. Methods: 202 feet of physical therapy students and teachers of the CEU San Pablo University of Madrid, 39 men and 62 women, were measured using three different tests. Data were analysed using SPSS version 15.0. Mean, SD and 95% CI were calculated for each variable. A normal distribution of quantitative data was assessed using the Kolmogorov-Smirnov test. The test-retest intra-rater reliability was assessed using an Intraclass Correlation Coefficient (ICC). The Standard Error Mean (SEM) and the Minimal Detectable Change (MDC) were also obtained. Results: All the ICC values showed a high degree of reliability (Test 1 = 0.97, Test 2 = 0.86 and Test 3 = 0.88) as did the SEM (Test 1 = 0.07, Test 2 = 0.10 and Test 3 = 0.11) and the MDC (Test 1 = 0.21, Test 2 = 0.30 and Test 3 = 0.31). Conclusions: Reliability of measuring first and second metatarsal and toe protrusion using the three palpation-based tests showed a high degree of reliability

Intra-observer reliability for measuring first and second toe and metatarsal protrusion distance using palpation-based tests: a test-retest study

Background: Measurement of first and second metatarsal and toe protrusion is frequently used to explain foot problems using x-rays, osteological measurements or palpation-based tests. Length differences could be related to the appearance of problems in the foot. A test-retest design was conducted in order to establish the intra-rater reliability of three palpation-based tests. Methods: 202 feet of physical therapy students and teachers of the CEU San Pablo University of Madrid, 39 men and 62 women, were measured using three different tests. Data were analysed using SPSS version 15.0. Mean, SD and 95% CI were calculated for each variable. A normal distribution of quantitative data was assessed using the Kolmogorov-Smirnov test. The test-retest intra-rater reliability was assessed using an Intraclass Correlation Coefficient (ICC). The Standard Error Mean (SEM) and the Minimal Detectable Change (MDC) were also obtained. Results: All the ICC values showed a high degree of reliability (Test 1 = 0.97, Test 2 = 0.86 and Test 3 = 0.88) as did the SEM (Test 1 = 0.07, Test 2 = 0.10 and Test 3 = 0.11) and the MDC (Test 1 = 0.21, Test 2 = 0.30 and Test 3 = 0.31). Conclusions: Reliability of measuring first and second metatarsal and toe protrusion using the three palpation-based tests showed a high degree of reliability

Using quantification of the PML-RARα transcript to stratify the risk of relapse in patients with acute promyelocytic leukemia

Background and Objectives The detection of PML-RARα by real-time polymerase chain reaction (RQ-PCR) is becoming an important tool for monitoring minimal residual disease (MRD) in patients with acute promyelocytic leukemia (APL). However, its clinical value remains to be determined. Our aim was to analyze any associations between the risk of relapse and RQ-PCR results in different phases of treatment, comparing these data with those yielded by conventional qualitative reverse transcriptase-PCR.Design and Methods Follow-up samples from 145 APL patients treated with the PETHEMA protocols were evaluated by the RQ-PCR protocol (Europe Against Cancer program) and by the RT-PCR method (BIOMED-1 Concerted Action). Hematologic and molecular relapses and relapse-free survival were recorded. We then looked for associations between relapse risk and RQ-PCR results.Results After induction therapy, no association was found between positive RQ-PCR results and relapse. The PCR result here did not imply any change in the scheduled therapy. After the third consolidation course, two out of three cases with positive RQ-PCR relapsed in contrast to 16 out of 119 (13%) patients with negative RQ-PCR. During maintenance therapy and out-of treatment, all patients with >10 PML-RARα normalized copy number (NCN) (n=19) relapsed while all patients wit

Survival after allogeneic transplantation according to pretransplant minimal residual disease and conditioning intensity in patients with acute myeloid leukemia

BackgroundThe measurement of minimal residual disease (MRD) by multiparametric flow cytometry (MFC) before hematopoietic stem cell transplantation (HSCT) in patients with acute myeloid leukemia (AML) is a powerful prognostic factor. The interaction of pretransplant MRD and the conditioning intensity has not yet been clarified.ObjectiveThe aim of this study is to analyze the transplant outcomes of patients with AML who underwent HSCT in complete remission (CR), comparing patients with positive MRD (MRD+) and negative MRD (MRD−) before HSCT, and the interaction between conditioning intensity and pre-HSCT MRD.Study designWe retrospectively analyzed the transplant outcomes of 118 patients with AML who underwent HSCT in CR in a single institution, comparing patients with MRD+ and MRD− before HSCT using a cutoff of 0.1% on MFC, and the interaction between conditioning intensity and pre-HSCT MRD.ResultsPatients with MRD+ before HSCT had a significantly worse 2-year (2y) event-free survival (EFS) (56.5% vs. 32.0%, p = 0.018) than MRD− patients, due to a higher cumulative incidence of relapse (CIR) at 2 years (49.0% vs. 18.0%, p = 0.002), with no differences in transplant-related mortality (TRM) (2y-TRM, 19.0% and 25.0%, respectively, p = 0.588). In the analysis stratified by conditioning intensity, in patients who received MAC, those with MRD− before HSCT had better EFS (p = 0.009) and overall survival (OS) (p = 0.070) due to lower CIR (p = 0.004) than MRD+ patients. On the other hand, the survival was similar in reduced intensity conditioning (RIC) patients regardless of the MRD status.ConclusionsPatients with MRD+ before HSCT have worse outcomes than MRD− patients. In patients who received MAC, MRD− patients have better EFS and OS due to lower CIR than MRD+ patients, probably because they represent a more chemo-sensitive group. However, among RIC patients, results were similar regardless of the MRD status

Los socios de la RSEHN y el desarrollo de las colecciones científicas del MNCN

Valencia, del 8 al 11 de septiembre de 2021. El tema principal tuvo como lema: “La huella Humana en la Naturaleza”.Las colecciones científicas son una infraestructura de investigación única e irremplazable para numerosas áreas de la ciencia. En la actualidad, se estima que en el Museo Nacional de Ciencias Naturales se conservan 10 millones de especímenes, lo que suponen casi la mitad de todos los conservados en España. Esta infraestructura científica o este tesoro, como puede ser llamado, se ha reunido principalmente a lo largo del último siglo, y se debe al trabajo conjunto de muchos especialistas, estudiosos e interesados en diferentes disciplinas de las ciencias naturales. En esta ponencia se quiere poner en valor la aportación de los socios de la RSEHN en el incremento y desarrollo de las colecciones científicas del MNCN. Se ha realizado un análisis preliminar de los fondos de las diferentes colecciones del MNCN y de los ingresos efectuados por los socios de RSEHN desde su fundación (1871) hasta el momento en que abandona el MNCN (1971). Se realizó en cada una de ellas una consulta de los diferentes colectores y personas que aportaron especímenes y que aparecen en las bases de datos, cruzándola con la base de datos de socios durante dicho periodo. Se ha contabilizado el número de especímenes, número de tipos y taxones correspondientes a éstos. La cifra de socios total supera el centenar. El número de ejemplares ingresados por estos socios, entre esas fechas, se estima que superan el millón y medio, lo que supone al menos un 15% del total actual estimado. Hay que tener en cuenta que las colecciones no se encuentran informatizadas al 100%

Prevalencia y predictores de mal control lipídico en población anciana tratada con intervencionismo coronario.

35 p.INTRODUCCIÓN: Más del 80% de pacientes que fallecen por enfermedad cardiovascular son de edad avanzada y conocer su grado de control lipídico permitirá desarrollar estrategias específicas. OBJETIVOS: Analizar el control lipídico en pacientes mayores de 75 años, identificando factores predictores de mal control. Valorar el efecto del control lipídico sobre la incidencia de eventos cardiovasculares graves (ECVG). MÉTODOS: En este estudio de cohortes retrospectivo, se analizan 213 pacientes consecutivos mayores de 75 años intervenidos por síndrome coronario agudo (SCA) o angina estable. Se han estudiado características clínicas y analíticas al ingreso y a los 6-12 meses. El parámetro de valoración principal fue la prevalencia de mal control lipídico, con cLDL < 70mg/dl a los 6-12 meses. RESULTADOS: Al 94.4% de los pacientes se le prescribieron estatinas. Sin embargo, el 54,5% mantuvo cifras de cLDL > 70mg/dl. Los varones, la edad ≥ 85 años, la polifarmacia y la enfermedad renal crónica no se asocian a un peor control lipídico (p>0,05). Paradójicamente los pacientes no diabéticos mantienen peor control OR 1.96, IC 95% (1.06-3.57), así como los intervenidos por angina OR 1.77; IC95% (1.03-3.17) y los tratados con estatinas de baja potencia OR 2.71; IC95% (1.26- 5.83). Los niveles de cLDL < 70mg/dl no se asocian a ECVG. CONCLUSIÓN: El 54.5% de los pacientes mayores de 75 años intervenidos por SCA o angina estable podría beneficiarse de un tratamiento más intensivo, con especial atención a los no diabéticos y a los pacientes intervenidos por angina, aunque no se asocia a ECVGINTRODUCTION: More than 80% of patients who die from cardiovascular disease are elderly and knowing their degree of lipid control will allow them to develop specific strategies. OBJECTIVES: To analyze the lipid control in patients older than 75 years, identifying predictors of poor control. To assess the effect of lipid control on the incidence of major adverse cardiovascular events (MACE). METHODS: In this retrospective cohort study, we analyzed 213 consecutive patients older than 75 years undergoing surgery for acute coronary syndrome (ACS) or stable angina. Clinical and analytical characteristics have been studied at admission and at 6-12 months. The main parameter of valuation was the prevalence of poor lipid control, with LDL-C < 70mg/dl at 6-12 months. RESULTS: 94.4% of the patients were prescribed statins. However, 54.5% maintained LDL-C levels > 70mg/dL. Males, age ≥ 85 years, polypharmacy and chronic kidney disease are not associated with worse lipid control (p>0.05). Paradoxically, non diabetic patients maintain worse control OR 1.96, 95% CI (1.06-3.57), as well as patients operated on for stable angina OR 1.77; 95% CI (1.03-3.17) and those treated with low intensity statins OR 2.71; 95% CI (1.26-5.83). LDL-C levels < 70mg/dl are not associated with MACE. CONCLUSION: 54.5% of patients older than 75 years undergoing surgery for ACS or stable angina could benefit from more intensive treatment, with special attention to non-diabetics and patients operated on for angina, although it is not associated with higher incidence of MACE.Grado en Medicin

Survival after allogeneic transplantation according to pretransplant minimal residual disease and conditioning intensity in patients with acute myeloid leukemia

Background: The measurement of minimal residual disease (MRD) by multiparametric flow cytometry (MFC) before hematopoietic stem cell transplantation (HSCT) in patients with acute myeloid leukemia (AML) is a powerful prognostic factor. The interaction of pretransplant MRD and the conditioning intensity has not yet been clarified. Objective: The aim of this study is to analyze the transplant outcomes of patients with AML who underwent HSCT in complete remission (CR), comparing patients with positive MRD (MRD+) and negative MRD (MRD−) before HSCT, and the interaction between conditioning intensity and pre-HSCT MRD. Study design: We retrospectively analyzed the transplant outcomes of 118 patients with AML who underwent HSCT in CR in a single institution, comparing patients with MRD+ and MRD− before HSCT using a cutoff of 0.1% on MFC, and the interaction between conditioning intensity and pre-HSCT MRD. Results: Patients with MRD+ before HSCT had a significantly worse 2-year (2y) event-free survival (EFS) (56.5% vs. 32.0%, p = 0.018) than MRD− patients, due to a higher cumulative incidence of relapse (CIR) at 2 years (49.0% vs. 18.0%, p = 0.002), with no differences in transplant-related mortality (TRM) (2y-TRM, 19.0% and 25.0%, respectively, p = 0.588). In the analysis stratified by conditioning intensity, in patients who received MAC, those with MRD− before HSCT had better EFS (p = 0.009) and overall survival (OS) (p = 0.070) due to lower CIR (p = 0.004) than MRD+ patients. On the other hand, the survival was similar in reduced intensity conditioning (RIC) patients regardless of the MRD status. Conclusions: Patients with MRD+ before HSCT have worse outcomes than MRD− patients. In patients who received MAC, MRD− patients have better EFS and OS due to lower CIR than MRD+ patients, probably because they represent a more chemo-sensitive group. However, among RIC patients, results were similar regardless of the MRD status.Grant for help with the preparation of the manuscript - financed by Jazz Pharmaceuticals as part of the “Publibecas” grant program of the GETH3.5 Q2 JCR 20231.066 Q2 SJR 2023No data IDR 2023UE

Sedentary behaviours and socio-economic status in Spanish adolescents: The AVENA study

Background: This study aimed to describe the influence of socio-economic status (SES) on the prevalence sedentary behaviours among Spanish adolescents. Methods: Cross-sectional data from Spanish adolescents from the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) Study (2002). A national representative sample of 1776 adolescents aged 13-18.5 years provided information about time spent watching television (TV), playing with computer or videogames and studying. Parental education and occupation were assessed as SES. Participants were categorized by gender, age, parental education and occupation. Logistic regression models were used. Results: No gender differences were found for TV viewing. For computer and videogames use (weekdays), more boys played >3 h/day (P 3 h/day (P < 0.001). Among boys, parental education and occupation were inversely associated with TV viewing, parental occupation directly associated with study and maternal education inversely with computer and videogames use during weekdays (all P < 0.05). For girls, parental occupation was inversely associated with TV viewing. Conclusion: Spanish adolescents presented different sedentary patterns according to age, gender and SES. Boys reported more time engaged in electronic games, whereas girls reported more time studying. Parental occupation had more influence than parental education on the time spent in sedentary behaviours. © The Author 2010.Peer Reviewe

Liquid biopsy for molecular characterization of diffuse large B‐cell lymphoma and early assessment of minimal residual disease

Circulating tumour DNA (ctDNA) allows genotyping and minimal residual disease (MRD) detection in lymphomas. Using a next‐generation sequencing (NGS) approach (EuroClonality‐NDC), we evaluated the clinical and prognostic value of ctDNA in a series of R‐CHOP‐treated diffuse large B‐cell lymphoma (DLBCL) patients at baseline (n = 68) and after two cycles (n = 59), monitored by metabolic imaging (positron emission tomography combined with computed tomography [PET/CT]). A molecular marker was identified in 61/68 (90%) ctDNA samples at diagnosis. Pretreatment high ctDNA levels significantly correlated with elevated lactate dehydrogenase, advanced stage, high‐risk International Prognostic Index and a trend to shorter 2‐year progression‐free survival (PFS). Valuable NGS data after two cycles of treatment were obtained in 44 cases, and 38 achieved major molecular response (MMR; 2.5‐log drop in ctDNA). PFS curves displayed statistically significant differences among those achieving MMR versus those not achieving MMR (2‐year PFS of 76% vs. 0%, p &lt; 0.001). Similarly, more than 66% reduction in ΔSUVmax by PET/CT identified two subgroups with different prognosis (2‐year PFS of 83% vs. 38%; p &lt; 0.001). Combining both approaches MMR and ΔSUVmax reduction, a better stratification was observed (2‐year PFS of 84% vs. 17% vs. 0%, p &lt; 0.001). EuroClonality‐NDC panel allows the detection of a molecular marker in the ctDNA in 90% of DLBCL. ctDNA reduction at two cycles and its combination with interim PET results improve patient prognosis stratification