Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip

To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and crosssectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve

Prevention of diet-induced obesity by apple polyphenols in Wistar rats through regulation of adipocyte gene expression and DNA methylation patterns

This study was conducted to determine the mechanisms implicated in the beneficial effects of apple polyphenols (APs) against diet-induced obesity in Wistar rats, described in a previous study from our group. Supplementation of high-fat sucrose diet with AP prevented adiposity increase by inhibition of adipocyte hypertrophy. Rats supplemented with AP exhibited improved glucose tolerance while adipocytes isolated from these rats showed an enhanced lipolytic response to isoproterenol. AP intake led to reduced Lep, Plin, and sterol regulatory element binding transcription factor 1 (Srebf1) mRNA levels and increased aquaporin 7 (Aqp7), adipocyte enhancer binding protein 1 (Aebp1), and peroxisome proliferator-activated receptor gamma co-activator 1 alpha (Ppargc1a) mRNA levels in epididymal adipocytes. In addition, we found different methylation patterns of Aqp7, Lep, Ppargc1a, and Srebf1 promoters in adipocytes from apple-supplemented rats compared to high-fat sucrose fed rats. The administration of AP protects against body weight gain and fat deposition and improves glucose tolerance in rats. We propose that AP exerts the antiobesity effects through the regulation of genes involved in adipogenesis, lipolysis, and fatty acid oxidation, in a process that could be mediated in part by epigenetic mechanisms

A comprehensive study on the effect of cavitation on injection velocity in diesel nozzles

Results when testing cavitating injection nozzles show a strong reduction in mass flow rate when cavitation appears (the flow is choked), while the momentum flux is reduced to a lesser extent, resulting in an increase in effective injection velocity. So as to better understand the origin of this increase in effective injection velocity, the basic equations for mass and momentum conservation were applied to an injection nozzle in simplified conditions. The study demonstrated that the increase in injection velocity provoked by cavitation is not a direct effect of the latter, but an indirect effect. In fact, the vapor appearance inside the injection hole produces a decrease in the viscosity of the fluid near the wall. This leads to lower momentum flux losses and to a change in the velocity profile, transforming it into a more "top hat" profile type. This change in the profile shape allows explaining why the momentum flux reduction is not so important compared to that of the mass flow rate, thus explaining why the effective injection velocity increases. © 2012 Elsevier Ltd. All rights reserved.The authors thank different members of the CMT-Motores Termicos team of the Universitat Politecnica de Valencia for their contribution to this work: to Jaime Gimeno, for his fruitful comments, and to Xandra Margot, Stavroula Patouna and Gabriela Bra-cho for their help in the CFD calculations. Also they thank the FPU program of the Ministerio de Educacion of Spain for granting the Ph.D. studies of Oscar A. de la Garza (grant AP2008-01913). Open-FOAM and Star-CD are registered trademarks of OpenCFD Ltd. and CD-Adapco, respectively.López, JJ.; Salvador Rubio, FJ.; De La Garza De Leon, O.; Arregle, JJP. (2012). A comprehensive study on the effect of cavitation on injection velocity in diesel nozzles. Energy Conversion and Management. 64:415-423. https://doi.org/10.1016/j.enconman.2012.03.032S4154236

Morphometric characteristics of lumbar vertebral pedicles in Mexican population. Implications for transpedicular lumbar fusion surgery

Introduction. Spinal fusion surgery using transpedicular fixation is the most common technique for surgical treatment of spinal pathologies of any etiology. The morphometric characteristics of the vertebral pedicle determine the size and shape of pedicle implants. The objective of this study is to determine the morphometric characteristics of the lumbar vertebral pedicle in Mexican population by direct measurement of bone parts. Materials and Methods. We analyzed 65 L1–L5 cadaver lumbar spines from a collection of bone specimens from the Department of Human Anatomy. Pedicle width, height, and length were determined bilaterally in each sample studied. We obtained measures of central tendency, and parametric correlation tests were performed with a 95% confidence interval to determine if significant differences exist between the lumbar vertebral levels. Results. Pedicle width increased from L1 to L5. We obtained a minimum mean value of 7.40 ± 1.84 mm at L1 and a maximum mean value of 14.74 ± 3.77 mm at L5. Pedicle height decreased from L1 to L4 with a subsequent increase at L5. We obtained a maximum mean value of 18.32 ± 4.15 mm at L5 and minimum mean value of 14.09 mm ± 2.75 at L4. Significant differences were observed (P < 0.05) when groups were compared. Conclusions. This study accurately describes the morphometric characteristics of the lumbar vertebral pedicle. These data will be useful for correct selection and positioning of transpedicular screws

Long-term survival in patients with non-small cell lung cancer and synchronous brain metastasis treated with whole-brain radiotherapy and thoracic chemoradiation

<p>Abstract</p> <p>Background</p> <p>Brain metastases occur in 30-50% of Non-small cell lung cancer (NSCLC) patients and confer a worse prognosis and quality of life. These patients are usually treated with Whole-brain radiotherapy (WBRT) followed by systemic therapy. Few studies have evaluated the role of chemoradiotherapy to the primary tumor after WBRT as definitive treatment in the management of these patients.</p> <p>Methods</p> <p>We reviewed the outcome of 30 patients with primary NSCLC and brain metastasis at diagnosis without evidence of other metastatic sites. Patients were treated with WBRT and after induction chemotherapy with paclitaxel and cisplatin for two cycles. In the absence of progression, concurrent chemoradiotherapy for the primary tumor with weekly paclitaxel and carboplatin was indicated, with a total effective dose of 60 Gy. If disease progression was ruled out, four chemotherapy cycles followed.</p> <p>Results</p> <p>Median Progression-free survival (PFS) and Overall survival (OS) were 8.43 ± 1.5 and 31.8 ± 15.8 months, respectively. PFS was 39.5% at 1 year and 24.7% at 2 years. The 1- and 2-year OS rates were 71.1 and 60.2%, respectively. Three-year OS was significantly superior for patients with N0-N1 stage disease vs. N2-N3 (60 vs. 24%, respectively; Response rate [RR], 0.03; <it>p</it>= 0.038).</p> <p>Conclusions</p> <p>Patients with NSCLC and brain metastasis might benefit from treatment with WBRT and concurrent thoracic chemoradiotherapy. The subgroup of N0-N1 patients appears to achieve the greatest benefit. The result of this study warrants a prospective trial to confirm the benefit of this treatment.</p

Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis

<p>Abstract</p> <p>Background</p> <p>Central nervous system is a common site of metastasis in NSCLC and confers worse prognosis and quality of life. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), serum CEA levels, and EGFR and HER2 tissue-expression in brain metastasis (BM) and overall survival (OS) in patients with advanced NSCLC.</p> <p>Methods</p> <p>In a prospective manner, we studied 293 patients with NSCLC in IIIB-IV clinical stage. They received standard chemotherapy. CEA was measured prior to treatment; EGFR and HER2 were evaluated by immunohistochemistry. BM development was confirmed by MRI in symptomatic patients.</p> <p>Results</p> <p>BM developed in 27, and 32% of patients at 1 and 2 years of diagnosis with adenocarcinoma (RR 5.2; 95% CI, 1.002–29; p = 0.05) and CEA ≥ 40 ng/mL (RR 11.4; 95% CI, 1.7–74; <it>p </it>< 0.01) as independent associated factors. EGFR and HER2 were not statistically significant. Masculine gender (RR 1.4; 95% CI, 1.002–1.9; <it>p </it>= 0.048), poor performance status (RR 1.8; 95% CI, 1.5–2.3; <it>p </it>= 0.002), advanced clinical stage (RR 1.44; 95% CI, 1.02–2; <it>p </it>= 0.04), CEA ≥ 40 ng/mL (RR 1.5; 95% CI, 1.09–2.2; <it>p </it>= 0.014) and EGFR expression (RR 1.6; 95% CI, 1.4–1.9; <it>p </it>= 0.012) were independent associated factors to worse OS.</p> <p>Conclusion</p> <p>High CEA serum level is a risk factor for BM development and is associated with poor prognosis in patients with advanced NSCLC. Surface expression of CEA in tumor cells could be the physiopathological mechanism for invasion to CNS.</p

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Hydraulic Interactions between Injection Events Using Multiple Injection Strategies and a Solenoid Diesel Injector

An experimental study was performed to explore the influence of dwell time on the hydraulic interactions between injection events using pilot injection strategy, split injection strategy, post injection strategy and a solenoid diesel injector. To do so, a sweep of dwell time from 0.55 up to 2 ms using all multiple injection strategies and levels of rail pressure, of 80, 100 and 120 MPa, and single level of back pressure, of 5 MPa, was performed. The hydraulic interactions between injection events were characterized through the second injection hydraulic delay and second injection mass in an injection discharge curve indicator equipped with all the components required for its operation and control. In order to define the operating conditions of the multiple injection strategies, to ensure the same injected fuel mass in all cases, the characteristic curves of injection rate for the solenoid diesel injector studied were obtained. The second injection hydraulic delay increases with dwell time values in the range of 0.55–0.9 ms for all multiple injection strategies and levels of rail pressure tested. Conversely, the second injection hydraulic delay decreases with dwell time values higher than 0.9 ms. Moreover, the second hydraulic delay depends mainly on the dwell time and not on the injected fuel mass during the first injection event. The second injection mass increases with dwell values less than 0.6 ms. By contrast, the second injection mass is not significantly affected by that of the first injection at a dwell time higher than 0.6 ms

Floristic Composition, Diversity, and Biomass of a Protected Tropical Evergreen Forest Belize

A challenge in community ecology is the development of ecosystem baselines, allowing the assessment of the variation in the ecological dynamics through different temporal and spatial scales. To our best knowledge, no studies have been carried out in seasonal evergreen forests of Belize to establish a baseline for future monitoring. Hence, a floristic study of the woody plant species diversity and composition was carried out at the Billy Barquedier National Park (BBNP) to develop an ecosystemic baseline for the assessment of the originally implemented conservation strategies. A thorough floristic survey was performed from May to August 2015 in 42 rectangular plots (500 m2) randomly allocated along the 100 to 500 m elevation gradient of the BBNP. Species richness, diversity, composition, and aboveground biomass were assessed. Likewise, information of a series of indicators on protection and risk situation (e.g., IUCN Red List of threatened species, CITES categories), and restoration for each relevant species are also provided. The BBNP is an important forest with 67 woody species distributed in 30 plant families. Terminalia amazona and Corozo palm Attalea cohune are the most important species in the reserve, in terms of abundance, frequency, and biomass. A clear trend between biodiversity metrics, elevation, and aboveground biomass was noted. This study contributes to understand relevant ecological topics as well as provides key elements for the management and conservation of the BBNP area and Belize