Relationship quality perception of spouses and adult child carers of people with dementia.

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Arthroscopic Anatomical Acromioclavicular Joint Reconstruction using a Button Device and a Semitendinosus Graft

Objective: To report a new technique for anatomical acromioclavicular (AC) joint reconstruction. Methods: In order to minimize such complications, the authors describe a new anatomical and biological AC joint repair. This technique aims to provide greater stability by using two anatomically placed clavicular tunnels and a combined construct with a double endobutton cortical fixation for primary stabilization, and to be biologically advantageous by using an autologous semitendinosus (ST) tendon graft. Additionally, the coracoclavicular ligament reconstruction is complemented with an AC joint cerclage and capsular reinforcement, which will protect the biological construction in its initial stage of healing. Results: This technique provides adequate primary and secondary biomechanical stability by passing both a semitendinosus autogenous graft and a double endobutton device, through anatomically placed and small diameter clavicle holes, without the need for coracoid drilling. Our technique showed encouraging results regarding pain resolution, range of motion, and function. At final follow-up we experienced excellent results with average pain score of 1.6, and average ROM of 159° of forward flexion, 160° of abduction, 68° of external rotation, and internal rotation level at T11. Postoperative function also showed great improvements with average ASES of 85 points, an average Constant Score of 87 and a Subjective Shoulder Value of 89 points. This technique also achieved perfectly acceptable radiographic results, with an average coracoclavicular distance increase of 0.8 mm. Regarding complications, our sample showed one case of AC join subluxation, two cases of internal saphenous nerve injury, and two partial graft tears at the suture-button interface, with none of these requiring surgical revision. Conclusion: This technique is advantageous in treatment of acromioclavicular joint dislocation and can be performed in both the subacute and chronic setting.info:eu-repo/semantics/publishedVersio

p27Kip1 V109G as a biomarker for CDK4/6 inhibitors indication in hormone receptor–positive breast cancer

Biomarker; Hormone receptor-positive; Breast cancerBiomarcador; Cáncer de mama; Receptor hormonal positivoBiomarcador; Càncer de mama; Receptor hormonal positiuCDK4/6 inhibitors benefit a minority of patients who receive them in the breast cancer adjuvant setting. p27Kip1 is a protein that inhibits CDK/Cyclin complexes. We hypothesized that single-nucleotide polymorphisms that impaired p27Kip1 function could render patients refractory to endocrine therapy but responsive to CDK4/6 inhibitors, narrowing the patient subpopulation that requires CDK4/6 inhibitors. We found that the p27Kip1 V109G single-nucleotide polymorphism is homozygous in approximately 15% of hormone-positive breast cancer patients. Polymorphic patients experience rapid failure in response to endocrine monotherapy compared with wild-type or heterozygous patients in the first-line metastatic setting (progression-free survival: 92 vs 485 days, P < .001); when CDK4/6 inhibitors are added, the differences disappear (progression-free survival: 658 vs 761 days, P = .92). As opposed to wild-type p27Kip1, p27Kip1 V109G is unable to suppress the kinase activity of CDK4 in the presence of endocrine inhibitors; however, palbociclib blocks CDK4 kinase activity regardless of the p27Kip1 status. p27Kip1 genotyping could constitute a tool for treatment selection.MM is supported by the Spanish Ministry of Science and Innovation (RTI2018-095582-B-100; PLEC2021-007892 and RED2018-102723-T), AES (DTS21/00132) and Comunidad de Madrid (B2017/BMD-3884 and Y2020/BIO-6519). MQF is a recipient of the following grants: AES—PI 19/00454 funded by the ISCIII and co-funded by the European Regional Development Fund (ERDF), and B2017/BMD3733 (Immunothercan-CM) – Call for Coordinated Research Groups from the Madrid Region—Madrid Regional Government—ERDF funds. This study was also funded by a donation from CRIS Contra El Cancer Foundation

Does HIV infection have an impact upon dental implant osseointegration? A systematic review

Background: A systematic review is made to determine whether human immunodeficiency virus (HIV) infection has an impact upon dental implant osseointegration. Material and Methods: A PubMed (MEDLINE) literature search was made of articles published up until 14 April 2014. The systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The quality of the studies included in the review was assessed using the Methodological Index for Nonrandomized Studies (MINORS) and levels of evidence (based on the University of Oxford's Center for Evidence Based Medicine criteria). Results: The combinations of search terms resulted in a list of 132 titles. Nine studies finally met the inclusion criteria and were selected for inclusion in the systematic review. A total of 173 dental implants were placed in 80 patients (135 implants in 56 HIV-positive subjects and 38 implants in 24 HIV-negative patients), and a single loss of dental implant osseointegration was recorded in an HIV-positive patient. Conclusions: Our results suggest that dental implant placement in HIV-positive patients does not increase the dental implant failure rate. Prophylactic antibiotic treatment, the administration of highly active antiretroviral therapy, and control of the CD4+ T lymphocyte counts appear to be the main influencing factors in this respect. Given the few studies included in our systematic review, further prospective studies involving larger sample sizes and longer durations of follow-up are required in order to confirm the results obtained

Requirement of RIZ1 for cancer prevention by methyl-balanced diet

The typical Western diet is not balanced in methyl nutrients that regulate the level of the methyl donor S-adenosylmethionine (SAM) and its derivative metabolite S-adenosylhomocysteine (SAH), which in turn may control the activity of certain methyltransferases. Feeding rodents with amino acid defined and methyl-imbalanced diet decreases hepatic SAM and causes liver cancers. RIZ1 (PRDM2 or KMT8) is a tumor suppressor and functions in transcriptional repression by methylating histone H3 lysine 9. Here we show that a methyl-balanced diet conferred additional survival benefits compared to a tumor-inducing methyl-imbalanced diet only in mice with wild type RIZ1 but not in mice deficient in RIZ1. While absence of RIZ1 was tumorigenic in mice fed the balanced diet, its presence did not prevent tumor formation in mice fed the imbalanced diet. Unlike most of its related enzymes, RIZ1 was upregulated by methyl-balanced diet. Methyl-balanced diet did not fully repress oncogenes such as c-Jun in the absence of RIZ1. The data identify RIZ1 as a critical target of methyl-balanced diet in cancer prevention. The molecular understanding of dietary carcinogenesis may help people make informed choices on diet, which may greatly reduce the incidence of cancer

VARIABILIDAD EN EL REGISTRO DE ALERGIAS POR PROFESIONALES SANITARIOS EN UN HOSPITAL DE TERCER NIVEL.

Introducción: El objetivo del estudio es cuantificar el grado de coincidencia en las alergias registradas en las distintas aplicaciones informáticas disponibles para cada profesional sanitario (médicos, personal de enfermería y farmacéuticos). Métodos: Estudio observacional descriptivo retrospectivo de 3 meses de duración en el que participaron todas las Unidades Clínicas con Sistema de Distribución de Medicamentos en Dosis Unitarias. Se incluyeron a todos los pacientes ingresados con al menos una alergia registrada en cualquiera de las tres aplicaciones informáticas utilizadas por los distintos profesionales sanitarios. Se cuantificaron el porcentaje de alergias registradas en una, dos o tres aplicaciones disponibles. Resultados: Se incluyeron 767 pacientes en los que se registraron 1257 alergias. La mediana de edad fue 59 años y el 60,76% eran mujeres. El 70,09% de las alergias registradas fueron farmacológicas. El registro de alergias únicamente a través de la aplicación de enfermería fue el más frecuente (36,67%). El porcentaje de alergias registradas por los tres profesionales sanitarios fue el 7,88%. Haciendo distinción en el tipo de alergia, solamente el 0,80% de las alergias no farmacológicas fueron registradas simultáneamente por los tres profesionales sanitarios frente al 10,90% de las farmacológicas. El personal médico contribuyó al registro del 59,29% de las alergias farmacológicas y del 10,65% de las no farmacológicas. Discusión: Existe una gran variabilidad en el registro de alergias por parte del personal sanitario y escasa concordancia en las registradas por cada  tipo de profesionales. El personal médico únicamente registró una décima parte de las alergias no farmacológicas

Antigen Incorporation on Cryptosporidium parvum Oocyst Walls

Cryptosporidium parvum oocysts are the infective stages responsible for transmission and survival of the organism in the environment. In the present work we show that the oocyst wall, far from being a static structure, is able to incorporate antigens by a mechanism involving vesicle fusion with the wall, and the incorporation of the antigen to the outer oocyst wall. Using immunoelectron microscopy we show that the antigen recognized by a monoclonal antibody used for diagnosis of cryptosporidiosis (MerifluorÒ, Meridian Diagnostic Inc.) could be found associated with vesicles in the space between the sporozoites and the oocysts wall, and incorporated to the outer oocyst wall by an unknown mechanism

VARIABILIDAD EN EL REGISTRO DE ALERGIAS POR PROFESIONALES SANITARIOS EN UN HOSPITAL DE TERCER NIVEL.

Introducción: El objetivo del estudio es cuantificar el grado de coincidencia en las alergias registradas en las distintas aplicaciones informáticas disponibles para cada profesional sanitario (médicos, personal de enfermería y farmacéuticos). Métodos: Estudio observacional descriptivo retrospectivo de 3 meses de duración en el que participaron todas las Unidades Clínicas con Sistema de Distribución de Medicamentos en Dosis Unitarias. Se incluyeron a todos los pacientes ingresados con al menos una alergia registrada en cualquiera de las tres aplicaciones informáticas utilizadas por los distintos profesionales sanitarios. Se cuantificaron el porcentaje de alergias registradas en una, dos o tres aplicaciones disponibles. Resultados: Se incluyeron 767 pacientes en los que se registraron 1257 alergias. La mediana de edad fue 59 años y el 60,76% eran mujeres. El 70,09% de las alergias registradas fueron farmacológicas. El registro de alergias únicamente a través de la aplicación de enfermería fue el más frecuente (36,67%). El porcentaje de alergias registradas por los tres profesionales sanitarios fue el 7,88%. Haciendo distinción en el tipo de alergia, solamente el 0,80% de las alergias no farmacológicas fueron registradas simultáneamente por los tres profesionales sanitarios frente al 10,90% de las farmacológicas. El personal médico contribuyó al registro del 59,29% de las alergias farmacológicas y del 10,65% de las no farmacológicas. Discusión: Existe una gran variabilidad en el registro de alergias por parte del personal sanitario y escasa concordancia en las registradas por cada  tipo de profesionales. El personal médico únicamente registró una décima parte de las alergias no farmacológicas