Lipoma intraóseo, un tumor óseo benigno infrecuente : presentación de dos casos intervenidos quirúrgicamente y revisión de la literatura

Intraosseous lipomas are rare and benign tumors of unclear etiology. Most of them are asymptomatic, being accidentally diagnosed during imaging tests performed for other reasons and they usually have unspecific clinical presentations. Radiographically, they can be confused with other entities as non-ossifying fibromas or simple cysts. Methods. We report two cases, a 39-year-old and a 25-year-old Caucasian female patients, referred to our hospital with a mass in the proximal third of the right tibia and distal femur respectively with slowly progressive growth. In conventional X-ray images and computed tomography, a well-defined, expansive intraosseous lytic lesion without cortical disruption was observed in both cases. Magnetic resonance imaging demonstrated predominance of lipomatous tissue signal, being compatible with intraosseous lipoma. The patients underwent excision of the tumor, confirming the diagnosis of intraosseous lipoma after pathological study. Results. In the immediate postoperative period, swelling and pain decreased and at the 6th-month postoperative follow-up the patients are asymptomatic and without radiographic signs of recurrence. Discussion. Intraosseous lipomas are tumors that can go easily unnoticed, being difficult to diagnose on conventional X-ray images. Because of that, other imaging tests, such as CT and MRI, are necessary for diagnosis and histopathology for confirmation. Conservative treatment in asymptomatic patients and surgery in symptomatic cases is recommended. Recurrence and malignant transformation of these tumors is rare

Determinación del Potencial de Crecimiento en Lotes de Cebo de Terneros de Raza Retinta

Más del 10 p.100 del censo aproximado de la raza Retinta (200000 a 250000 reproductoras) están inscritas en el libro genealógico de la raza. Representa el 5,3 p.100 del bovino español y el 14,5 p.100 del autóctono. Se ha controlado el cebo de 373 terneros machos retintos puros procedentes de la ganadería del Centro Experimental Agrícola Ganadero de Jerez de la Frontera de la Excma. Diputación de Cádiz. Los animales se controlaron desde el destete hasta que fueron sacrificados, pesándolos con periodicidad mensual, con un total de 1984 pesadas, de las cuales 373 corresponden a entrada en cebadero, 1238 han sido realizadas durante el periodo de cebo y 373 al sacrificio. La duración media del cebo fue 158,5±2,8 días (cv 34,2 p.100). El periodo medio de aclimatación al cebo tuvo una duración media de 32,6±0,9 días, iniciándose el cebo los terneros con una edad media de 226,5±1,5 días y un peso de 271,3±2,6 kg. El peso promedio al sacrificio en todo el periodo analizado (10 años) fue de 518,0±3,9 kg (con un cv de 14,6 p.100). El 70 p.100 de los animales se sacrificaron con un peso comprendido entre los 450 y 600 kg resultando una ganancia media diaria (GMD) global de 1,58±0,012 kg/día (cv del 14,1 p.100) con un valor mínimo de 0,76 kg/día y un máximo de 2,27. Se puede resaltar que el 14 p.100 de los terneros presentaron una GMD superior a los 2 kg/día. Se obtuvo un índice de transformación global (IT) de 5,29 y un consumo medio diario por animal (CMD) de 8,77 kg. Los valores medios de los lotes cebados en los dos últimos años presentaron un peso al sacrificio de 575,2 kg para una duración del cebo de 175,9±4,2 días y una GMD de 1,6 kg/día. La media del IT fue de 5,18 y del CMD de 8,98 kg, con unos c.v. de 5,93 p.100 y de 5,23 p.100 respectivamente.The Retinta breed has approximately 200000 to 250000 reproducers of which more than 10 percent are registered in the genealogic book of the breed. This represents 5.3 percent of Spanish bovines and 14.5 percent of the autochthonous breed. The fattening of 373 pure Retinto male calves from the Centro Experimental Agrícola y Ganadero from Jerez de la Frontera (Cádiz) was controlled. This control lasted from the time of weaning to the slaughter. The animals were monthly weighted. From the 1984 weightings done, 373 correspond to the moment of entering the centre, 1238 weightings were taken during the fattening process and 373 were made at slaughter. The average length of fattening time was 158.5±2.8 days (cv 34.2 percent). The average period for acclimatisation to the fattening process was 32.6±0.9 days, with the process beginning at an average age of 226.5±1.5 days when the weight was 271±2.6 kg. The average weight at slaughter during the period analysed (10 years) was 518.0±3.9 kg (c.v. 14.6 percent). 70 percent of the animals were slaughtered at 450 to 600 kg of live weight, resulting in an average daily gain (GMD) of 1.58±0.012 kg/day (c.v. 14.1) with a minimum value of 0.76 kg/day and a maximum of 2.27. It should be pointed out that 14 percent of the calves had a GMD of more than 2 kg/day. An overall transformation index (IT) on 5.29 was obtained with an average daily consumption per animal (CMD) of 8.77 kg. The average values for the fattened groups during the last two years showed a weight at time of sacrifice of 575.2 kg for a duration of fattening of 179.9 days and an average daily gain of 1.6 kg/ day. The overall IT was 5.18 and the CMD was 8.98 kg with a c.v. of 5.9 percent and 5.2 respectively

Nanofiltration separation of polyvalent and monovalent anions in desalination brines

This work, as part of a global membrane process for the recovery of alkali and acids from reverse osmosis (RO) desalination brines, focuses on the nanofiltration (NF) separation of polyvalent and monovalent anions, more specifically sulfate and chloride. This pretreatment stage plays a key role in the whole recovery process. Working with model brines simulating the concentration of RO concentrates, 0.2–1.2 M chloride concentration and 0.1 M sulfate concentration, the experimental performance and modeling of the NF separation is reported. The study has been carried out with the NF270 (Dow Filmtec) membrane. The effect of operating pressure (500–2000 kPa), ionic strength (0.4–1.3 M) and chloride initial concentration (0.2–1.2 M) on the membrane separation capacity has been investigated. Finally, the Donnan Steric Pore Model (DSPM) together with experimentally determined parameters, effective pore radius (rp), thickness of the membrane effective layer (d) and effective membrane charge density (Xd), was proved accurate enough to satisfactorily describe the experimental results. In this work we provide for the first time the analysis of partitioning effects and transport mechanism in the NF separation of sulfate and chloride anions in concentrations that simulate those found in RO desalination brines.This work has been financially supported by projects CTQ2008-0690, ENE2010-15585 and CTM2011-23912 (co-financed by ERDF Funds).The authors would like to acknowledge SADYT, S.A. for providing assistance for this work

InBO3 and ScBO3 at high pressures: an ab initio study of elastic and thermodynamic properties

We have theoretically investigated the elastic properties of calcite-type orthoborates ABO(3) (A= Sc and In) at high pressure by means of ab initio total-energy calculations. From the elastic stiffness coefficients, we have obtained the elastic moduli (B, G and E), Poisson's ratio (nu), B/G ratio, universal elastic anisotropy index (A(U)), Vickers hardness, and sound wave velocities for both orthoborates. Our simulations show that both borates are more resistive to volume compression than to shear deformation (B > G). Both compounds are ductile and become more ductile, with an increasing elastic anisotropy, as pressure increases. We have also calculated some thermodynamic properties, like Debye temperature and minimum thermal conductivity. Finally, we have evaluated the theoretical mechanical stability of both borates at high hydrostatic pressures. It has been found that the calcite-type structure of InBO3 and ScBO3 becomes mechanically unstable at pressures beyond 56.2 and 57.7 GPa, respectively. (C) 2016 Elsevier Ltd. All rights reserved.This study is supported by the Spanish MICINN projects MAT2013-46649-C4-2-P/3-P and MAT2015-71070-REDC. H.M.O., A.M., and P.R-H. acknowledge computing time provided by Red Espanola de Supercomputacion (RES) and MALTA-Cluster. J.A.S. acknowledges Juan de la Cierva fellowship program for financial support.Gomis, O.; Ortiz, HM.; Sans Tresserras, JÁ.; Manjón Herrera, FJ.; Santamaría-Pérez, D.; Rodríguez-Hernández, P.; Muñoz, A. (2016). InBO3 and ScBO3 at high pressures: an ab initio study of elastic and thermodynamic properties. Journal of Physics and Chemistry of Solids. 98:198-208. https://doi.org/10.1016/j.jpcs.2016.07.002S1982089

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

IV consenso mexicano sobre Helicobacter pylori

Desde el último consenso mexicano para el diagnóstico y tratamiento de la infección por Helicobacter pylori (H. pylori) en el 2007, han existido avances importantes al respecto. Por tal motivo, la Asociación Mexicana de Gastroenterología convocó a 20 expertos para la realización del «IV consenso mexicano sobre H. pylori». Durante febrero y junio del 2017 se organizaron 4 mesas de trabajo, una revisión de la literatura y 3 rondas de votaciones donde se establecieron 32 enunciados para discusión y consenso. Dentro de las recomendaciones se destaca el reconocer a México como un país con riesgo de cáncer gástrico bajo a intermedio a pesar de la alta prevalencia de infección por H. pylori. Se corrobora que enfermedad ulcerosa péptica, presencia de lesiones premalignas, antecedentes de cáncer gástrico y linfoma asociado a la mucosa deben considerarse indicaciones claras para erradicación. La relación del H. pylori con los síntomas dispépticos sigue siendo controversial. La triple terapia de erradicación con amoxicilina, claritromicina y un inhibidor de la bomba de protones ya no debe ser considerada la primera línea de tratamiento. En su lugar, se proponen 2 opciones: la terapia cuádruple con bismuto (inhibidor de la bomba de protones, subcitrato de bismuto, tetraciclina y metronidazol) y la terapia cuádruple sin bismuto (inhibidor de la bomba de protones, amoxicilina, claritromicina y metronidazol). Se establece la necesidad de la realización de sensibilidad antimicrobiana ante la falla a 2 tratamientos de erradicación. Finalmente, se proponen campañas de educación respecto al diagnóstico y tratamiento del H. pylori para médicos de primer contacto y población general. Abstract Important advances have been made since the last Mexican consensus on the diagnosis and treatment of Helicobacter pylori (H. pylori) infection was published in 2007. Therefore, the Asociación Mexicana de Gastroenterología summoned 20 experts to produce ‘‘The Fourth Mexican Consensus on Helicobacter pylori’’. From February to June 2017, 4 working groups were organized, a literature review was performed, and 3 voting rounds were carried out, resulting in the formulation of 32 statements for discussion and consensus. From the ensuing recommendations, it was striking that Mexico is a country with an intermediate-to-low risk for gastric cancer, despite having a high prevalence of H. pylori infection. It was also corroborated that peptic ulcer disease, premalignant lesions, and histories of gastric cancer and mucosaassociated lymphoid tissue lymphoma should be considered clear indications for eradication. The relation of H. pylori to dyspeptic symptoms continues to be controversial. Eradication triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor should no longer be considered first-line treatment, with the following 2 options proposed to take its place: quadruple therapy with bismuth (proton pump inhibitor, bismuth subcitrate, tetracycline, and metronidazole) and quadruple therapy without bismuth (proton pump inhibitor, amoxicillin, clarithromycin, and metronidazole). The need for antimicrobial sensitivity testing when 2 eradication treatments have failed was also established. Finally, the promotion of educational campaigns on the diagnosis and treatment of H. pylori for both primary care physicians and the general population were proposed

Retrieval of optical and microphysical properties of transported Saharan dust over Athens and Granada based on multi-wavelength Raman lidar measurements: Study of the mixing processes

In this paper we extract the aerosol microphysical properties for a collection of mineral dust cases measured by multi-wavelength depolarization Raman lidar systems located at the National Technical University of Athens (NTUA, Athens, Greece) and the Andalusian Institute for Earth System Research (IISTA-CEAMA, Granada, Spain). The lidar-based retrievals were carried out with the Spheroidal Inversion eXperiments software tool (SphInX) developed at the University of Potsdam (Germany). The software uses regularized inversion of a two-dimensional enhancement of the Mie model based on the spheroid-particle approximation with the aspect ratio determining the particle shape. The selection of the cases was based on the transport time from the source regions to the measuring sites. The aerosol optical depth as measured by AERONET ranged from 0.27 to 0.54 (at 500 nm) depending on the intensity of each event. Our analysis showed the hourly mean particle linear depolarization ratio and particle lidar ratio values at 532 nm ranging from 11 to 34% and from 42 to 79 sr respectively, depending on the mixing status, the corresponding air mass pathways and their transport time. Cases with shorter transport time showed good agreement in terms of the optical and SphInX-retrieved microphysical properties between Athens and Granada providing a complex refractive index value equal to 1.4 + 0.004i. On the other hand, the results for cases with higher transport time deviated from the aforementioned ones as well as from each other, providing, in particular, an imaginary part of the refractive index ranging from 0.002 to 0.005. Reconstructions of two-dimensional shape-size distributions for each selected layer showed that the dominant effective particle shape was prolate with diverse spherical contributions. The retrieved volume concentrations reflect overall the intensity of the episodes.Spanish Ministry of Sciences, Innovation and Universities through project CGL2016-81092,Spanish Ministry of Education, Culture and Sports through grant FPU14/0368

Effectiveness of an mHealth intervention combining a smartphone app and smart band on body composition in an overweight and obese population: Randomized controlled trial (EVIDENT 3 study)

Background: Mobile health (mHealth) is currently among the supporting elements that may contribute to an improvement in health markers by helping people adopt healthier lifestyles. mHealth interventions have been widely reported to achieve greater weight loss than other approaches, but their effect on body composition remains unclear. Objective: This study aimed to assess the short-term (3 months) effectiveness of a mobile app and a smart band for losing weight and changing body composition in sedentary Spanish adults who are overweight or obese. Methods: A randomized controlled, multicenter clinical trial was conducted involving the participation of 440 subjects from primary care centers, with 231 subjects in the intervention group (IG; counselling with smartphone app and smart band) and 209 in the control group (CG; counselling only). Both groups were counselled about healthy diet and physical activity. For the 3-month intervention period, the IG was trained to use a smartphone app that involved self-monitoring and tailored feedback, as well as a smart band that recorded daily physical activity (Mi Band 2, Xiaomi). Body composition was measured using the InBody 230 bioimpedance device (InBody Co., Ltd), and physical activity was measured using the International Physical Activity Questionnaire. Results: The mHealth intervention produced a greater loss of body weight (–1.97 kg, 95% CI –2.39 to –1.54) relative to standard counselling at 3 months (–1.13 kg, 95% CI –1.56 to –0.69). Comparing groups, the IG achieved a weight loss of 0.84 kg more than the CG at 3 months. The IG showed a decrease in body fat mass (BFM; –1.84 kg, 95% CI –2.48 to –1.20), percentage of body fat (PBF; –1.22%, 95% CI –1.82% to 0.62%), and BMI (–0.77 kg/m2, 95% CI –0.96 to 0.57). No significant changes were observed in any of these parameters in men; among women, there was a significant decrease in BMI in the IG compared with the CG. When subjects were grouped according to baseline BMI, the overweight group experienced a change in BFM of –1.18 kg (95% CI –2.30 to –0.06) and BMI of –0.47 kg/m2 (95% CI –0.80 to –0.13), whereas the obese group only experienced a change in BMI of –0.53 kg/m2 (95% CI –0.86 to –0.19). When the data were analyzed according to physical activity, the moderate-vigorous physical activity group showed significant changes in BFM of –1.03 kg (95% CI –1.74 to –0.33), PBF of –0.76% (95% CI –1.32% to –0.20%), and BMI of –0.5 kg/m2 (95% CI –0.83 to –0.19). Conclusions: The results from this multicenter, randomized controlled clinical trial study show that compared with standard counselling alone, adding a self-reported app and a smart band obtained beneficial results in terms of weight loss and a reduction in BFM and PBF in female subjects with a BMI less than 30 kg/m2 and a moderate-vigorous physical activity level. Nevertheless, further studies are needed to ensure that this profile benefits more than others from this intervention and to investigate modifications of this intervention to achieve a global effect

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true