Application of Deformable Models in Orthopaedic Surgery Planning

Total knee replacement (TKR) is a surgical procedure used by orthopaedic surgeons. It requires an adequate preoperative planning. Several parameters involved in this planning are usually obtained by manually measuring on radiographic images (91.44 cm cassette for alignment film in weight bearing stance). We have devised a system which makes it possible to automate the measurements. It automatically finds the cortical bone internal and external contours from full femur and tibia. Detection of bone boundaries is achieved using active contours. The snake is initialized with the interactive definition of a poligonal contour on the radiographic image. From the obtained contours, the parameters can be easily derived. The system speeds up the measuring processes and eliminates subjectivity

Impact analysis of accidents on the traffic flow based on massive floating car data

The wide usage of GPS-equipped devices enables the mass recording of vehicle movement trajectories describing the movement behavior of the traffic participants. An important aspect of the road traffic is the impact of anomalies, like accidents, on traffic flow. Accidents are especially important as they contribute to the the aspects of safety and also influence travel time estimations. In this paper, the impact of accidents is determined based on a massive GPS trajectory and accident dataset. Due to the missing precise date of the accidents in the data set used, first, the date of the accident is estimated based on the speed profile at the accident time. Further, the temporal impact of the accident is estimated using the speed profile of the whole day. The approach is applied in an experiment on a one month subset of the datasets. The results show that more than 72% of the accident dates are identified and the impact on the temporal dimension is approximated. Moreover, it can be seen that accidents during the rush hours and on high frequency road types (e.g. motorways, trunks or primaries) have an increasing effect on the impact duration on the traffic flow

Effectiveness of rotavirus vaccination in Spain

With the aim of determining rotavirus vaccine effectiveness (RVVE) in Spain, from Oct-2008/Jun-2009, 467 consecutive children below 2 years old with acute gastroenteritis (AGE) were recruited using a pediatric research network (ReGALIP-www.regalip.org) that includes primary, emergency and hospital care settings. Of 467 enrolled children, 32.3% were rotavirus positive and 35.0% had received at least one dose of any rotavirus vaccine. RRVE to prevent any episode of rotavirus AGE was 91.5% (95% CI: 83.7%-95.6%). RVVE to prevent hospitalization by rotavirus AGE was 95.6% (85.6-98.6%). No differences in RVVE were found regarding the vaccine used. Rotavirus vaccines have showed an outstanding effectiveness in Spain

HTLV-1 infection in solid organ transplant donors and recipients in Spain

Background: HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. Methods: All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. Results: A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. Conclusion: The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopath

Responsible self-medication: review of the process of pharmaceutical attendance

This article presents a review, based on a qualitative study, of pharmaceutical orientation in the management of minor illness. Action research methodology was used by a group of faculty members responsible for the community pharmacy internship and by postgraduates in clinical pharmacy, to carry out the study with the objective to present a standard service for this kind of procedure. The interaction with the individual starts with a welcoming reception, at which point the pharmacist should be receptive and show empathy. Subsequently, data from the history of the patient are collected to obtain relevant information. Based on this information, the pharmacist must develop a line of clinical reasoning and make a decision, taking the context of the patient into account. After this analysis, the most appropriate intervention is performed. This intervention could indicate the need for referral to another health professional, the use of a non-pharmacological therapy or the provision of sound advice on medicines available without prescription. The next step is monitoring the patient in order to identify the effectiveness and safety of treatment. The standardization process of pharmaceutical attendance in the management of minor disorders contributes to the rational use of medicines.A reflexão apresentada neste artigo representa um estudo de abordagem qualitativa baseada na pesquisa-ação da prática do atendimento farmacêutico no manejo de transtornos menores, realizada pelo grupo de professores do Estágio em Farmácia Comunitária e por farmacêuticos pós-graduados em Farmácia Clínica, com o objetivo de realizar uma proposta de atendimento padrão para este tipo de procedimento. A interação com o indivíduo é iniciada pelo acolhimento, momento no qual o farmacêutico deve ser receptivo e empático. A seguir, se executa a coleta de dados sobre a história do paciente, para obtenção de informações relevantes. Com base nas informações, o farmacêutico deve desenvolver um raciocínio clínico e tomar uma decisão, levando em consideração o contexto do paciente. Após esta análise é realizada a intervenção mais adequada ou o conjunto dessas que podem ser: procurar outro profissional de saúde, utilizar uma terapia não-farmacológica ou auxiliar na escolha de um medicamento de venda livre. O próximo passo é o acompanhamento do paciente com vistas a identificar a efetividade e segurança do tratamento. A padronização do processo de atendimento farmacêutico no manejo de transtornos menores, contribui para o uso racional de medicamentos

Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals

Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor-recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain

LRRK2 Biology from structure to dysfunction: research progresses, but the themes remain the same

Since the discovery of leucine-rich repeat kinase 2 (LRRK2) as a protein that is likely central to the aetiology of Parkinson's disease, a considerable amount of work has gone into uncovering its basic cellular function. This effort has led to the implication of LRRK2 in a bewildering range of cell biological processes and pathways, and probable roles in a number of seemingly unrelated medical conditions. In this review we summarise current knowledge of the basic biochemistry and cellular function of LRRK2. Topics covered include the identification of phosphorylation substrates of LRRK2 kinase activity, in particular Rab proteins, and advances in understanding the activation of LRRK2 kinase activity via dimerisation and association with membranes, especially via interaction with Rab29. We also discuss biochemical studies that shed light on the complex LRRK2 GTPase activity, evidence of roles for LRRK2 in a range of cell signalling pathways that are likely cell type specific, and studies linking LRRK2 to the cell biology of organelles. The latter includes the involvement of LRRK2 in autophagy, endocytosis, and processes at the trans-Golgi network, the endoplasmic reticulum and also key microtubule-based cellular structures. We further propose a mechanism linking LRRK2 dimerisation, GTPase function and membrane recruitment with LRRK2 kinase activation by Rab29. Together these data paint a picture of a research field that in many ways is moving forward with great momentum, but in other ways has not changed fundamentally. Many key advances have been made, but very often they seem to lead back to the same places