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Effective management and control of peri- and postoperative pain in hip surgery is essential in order to minimize the use of opioids and their adverse effects. Effective regional analgesia for hip pain is made particularly challenging by the complex innervation of the hip joint. Standard regional techniques can be associated with complications, including incomplete anesthesia, hypotension, or lower limb weakness. We present the case of a 5-year-old girl with a history of infantile cerebral palsy who underwent bilateral varus derotation osteotomy and adductor tenotomy due to paralytic dislocation. She received bilateral PENG block and femoral cutaneous nerve block - a simple technique that covers all the nerves involved in the sensory innervation of the joint capsule without the need for multiple injections.

Objectives To determine the inter-rater and intra-rater reliability of frontal and sagittal plane landing kinematic measures during drop jump (DVJ) and tuck jump (TJA) tasks in male youth soccer players, to assess the concurrent validity between DVJ and TJA tests, and to evaluate the ability of both tasks to detect differences between players’ stage of maturation. Design Cross-sectional study. Participants 223 male youth soccer players. Main outcome measures Frontal plane knee projection angles (FPPA), and hip (HF), knee (KF) and ankle (AF) flexion angles at initial contact (IC) and peak flexion (PF) (i.e., the deepest landing position) in the sagittal plane were assessed. Results Good-to-excellent inter- and intra-rater reliability (ICC > 0.75; TEMST 10; error 0.6) were only identified for the TJA. Pre-PHV group reported higher FPPA, HF-IC, HF-PF, and KF-IC values, as well as lower AF-IC than post-PHV. Pre-PHV also displayed greater HF-IC and KF-IC than circa-PHV group. Conclusions Although both tests are reliable, the TJA might be viewed as a more informative tool given it shows greater FPPA and can also detect differences by maturity status.

Background Cranial cruciate ligament rupture (CrCLR) is the most common orthopaedic cause of lameness in the hind limb in dogs. Many surgical treatments have been described, but tibial tuberosity advancement (TTA) is one of the most commonly used today. Since it was first described, TTA has evolved to reduce major complications and to arrest the progression of osteoarthrosis. The aim of this study was to assess a surgical technique called Porous TTA with flange prospectively. This study was performed in 61 dogs that underwent 65 Porous TTA with flange procedures, to validate it as an alternative CrCLR treatment. Complications and clinical outcomes (pain, lameness, weight bearing, flexion, extension, crepitation and atrophy) were reported over 3 months, i.e. at 3, 6 and 12 weeks postoperatively. Results The results showed a positive clinical outcome, a minor complication rate of 47.69% at the first review 3 weeks postoperatively, 10.77% at the second one (6 weeks after the surgery) and 4% at the third one (at 12 weeks). Major complications were observed only at the last review, with one case that had an infection requiring implant removal; this represented 1.5% of cases. Variables evaluated for a relationship with complication scores and improvement were body condition score, sex, age, breed, body weight, breed size, side of the affected limb, traumatic anamnesis and time of lameness before surgery. No relationship was detected. Conclusions Clinical outcomes and complications show that Porous TTA with flange is an efficient alternative for surgical treatment of CrCLR in dogs.

To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players.Searches were performed in MEDLINE/PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases. Studies were considered if they reported injury incidence rate in male and female youth (≤19 years old) football players. Two reviewers (FJRP and ALV) extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation approach determined the quality of evidence. Studies were combined using a Poisson random effects regression model.Forty-three studies were included. The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females. Match injury incidence (14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females) was significantly higher than training injury incidence (2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females). The lower extremity had the highest incidence rate in both sexes. The most common type of injury was muscle/tendon for males and joint/ligament for females. Minimal injuries were the most common in both sexes. The incidence rate of injuries increased with advances in chronological age in males. Elite male players presented higher match injury incidence than sub-elite players. In females, there was a paucity of data for comparison across age groups and levels of play.The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.

Introduction and objectives The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Methods Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Results Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P

Robles-Palazón, FJ, Ayala, F, Cejudo, A, De Ste Croix, M, Sainz de Baranda, P, and Santonja, F. Effects of age and maturation on lower extremity range of motion in male youth soccer players. J Strength Cond Res 36(5): 1417-1425, 2022-Restricted joint range of motion (ROM) has been considered as a primary risk factor for some sport-related injuries. Consequently, preparticipation assessment of lower extremity joints ROM could help identify youth soccer players at high risk of injury and to aid in the design of tailored age and maturational specific training interventions. The purpose of this study was to analyze and compare the influence of chronological age and maturational stage on several lower extremity ROM measures, as well as to describe the lower extremity ROM profile using a comprehensive approach in youth soccer players. A total of 286 male youth soccer players' ROM were assessed including passive hip (extension [PHE], adduction with hip flexed 90° [PHADHF90°], flexion with knee flexed [PHFKF] and extended [PHFKE], abduction with hip neutral [PHABD] and flexed 90° [PHABDHF90°], external [PHER] and internal [PHIR] rotation), knee (flexion [PKF]) and ankle (dorsiflexion with knee flexed [ADFKF] and extended [ADFKE]) ROMs. Between-group differences were analyzed using a one-way analysis of variance (ANOVA) and magnitude-based decisions. The results only report statistically significant (p0.05; d0.5) and clinically relevant differences (8°) for the PKF ROM between U12 vs. U19, and Pre-PHV vs. Post-PHV groups. Furthermore, approximately 40, 35, and 20% of players displayed restrictions in their PHFKE, PKF, and ADFKF ROM values, respectively. These findings emphasize the necessity of prescribing (across all age groups and periods of growth and maturation) compensatory measures in daily soccer training, and these exercises should be equally applied to both limbs with the aim of improving PHFKE, PKF and ADFKF ROM values.

Limited ranges of motion (ROM) have been considered as a relevant risk factor for team sports injuries. The main purposes of the current study were to describe the lower extremity ROM profile, muscular tightness and asymmetries in elite inline hockey players and to examine sex-related differences. Twenty professional inline hockey players from 2 Spanish National Teams (male and female) were measured of passive hip extension [HE], hip adduction with hip flexed 90&deg, [HAD-HF], hip flexion with the knee flexed [HF-KF] and extended [HF-KE], hip abduction with the hip neutral [HAB] and hip flexed 90&deg, [HAB-HF], hip external [HER] and internal [HIR] rotation, knee flexion [KF], ankle dorsiflexion with the knee flexed [ADF-KF] and extended [ADF-KE] ROMs of the dominant and non-dominant leg ROMs were taken. A paired t-test was carried out to assess asymmetries. ROM values were classified as &ldquo, normal versus tightness&rdquo, and &ldquo, normal versus asymmetry&rdquo, according to the proposed reference values. The effect size for each variable was analyzed. Male team exhibited asymmetry in HF-KF (133.2&deg, dominant vs. 129.8&deg, non-dominant, p = 0.042, d = 0.7243 [moderate effect sizes]) and female team in ADF-KF (38.8&deg, dominant vs. 41.0 non-dominant, p = 0.001, d = 0.6 [moderate effect sizes]) and HAB ROM (41.2&deg, dominant vs. 38.8 non-dominant, p = 0.005, d = 1.1767 [moderate effect sizes]). Male players reported asymmetry in HAD-HF (n = 5), HER (n = 4) and HE (n = 3), whereas female players presented asymmetries in HER (n = 4), HE (n = 3) and KF (n = 2). Overall, 20&ndash, 100% of all participants showed limited KF, HF_KE, HIR, HE, ADF_KF, HAD-HF, HF-KF, ADF_KE, HTR and HER ROM. The results of this study reinforce the requirement of prescribing exercises aimed at improving hip, knee and ankle ROM within everyday inline hockey practices. In addition, as some asymmetries were found, unilateral flexibility training should be considered where appropriate.

The main purpose of this study was to analyse the training effects of the FIFA 11+ and\ud Harmoknee on several parameters of physical performance measures in youth amateur\ud football players. Forty-one adolescent players were randomised within each team into two\ud groups (team 1: control vs. FIFA 11+; team 2: control vs. Harmoknee). The FIFA 11+ and\ud Harmoknee groups performed the program 3 times a week for 4 weeks; the control groups\ud completed their usual warm-up routines. Thirteen physical performance measures (joint range\ud of motion, dynamic postural control, single legged hop limb symmetry, sprint time, jumping\ud height and agility) were assessed. All physical performance parameters were compared via a\ud magnitude-based inference analysis. Significant between-group differences (in favour of the\ud FIFA 11+ players) were found for dynamic postural control (anterior [2.5%] and\ud posteromedial [7.2%] distances), single legged hop limb symmetry (side-to-side symmetry\ud during a triple hop test [8.3%]), 10 (8.4%) and 20 (1.8%) m sprint times and jumping height\ud (9.1%) neuromuscular outcomes. For the Harmoknee, significant differences (in comparison\ud to its paired control group) were found only for 10 (2.7%) and 20 (2.9%) m sprint times and\ud jumping height (9.7%). Therefore, the main findings of this study suggest exchanging\ud traditional warm-up programmes for the FIFA 11+ in male youth soccer players based on its\ud superior effects on some neuromuscular parameters (sprinting, jumping and stability) of\ud physical performance.

[ES] El objetivo principal del presente estudio fue conocer el efecto de la categoría de edad sobre el perfil de flexibilidad en jóvenes taekwondistas usando pruebas angulares. Fueron reclutados un total de 17 taekwondistas jóvenes, que se clasificaron según su categoría federativa de edad en cadetes y junior. El rango de movimiento de los principales movimientos de la extremidad inferior fue valorado mediante el protocolo “ROM SPORT”. Se realizó un análisis descriptivo de cada una de las variables cuantitativas, que incluía la media y su correspondiente desviación típica. Una prueba t‐test fue empleada para determinar la existencia de diferencias entre la extremidad dominante y no dominante. Además, la misma prueba estadística analizó la interacción entre los 11 movimientos seleccionados y las categorías de edad. Por último, se calculó el tamaño del efecto de los resultados. Los resultados mostraron diferencias significativas entre ambas categorías en EC (psoas‐ilíaco), RIC (rotadores externos), REC (rotadores internos) y rotación total de la cadera (suma del RIC y REC). Estos resultados no coinciden con otros estudios que han valorado la flexibilidad en este mismo deporte. Los taekwondistas cadetes presentan valores de flexibilidad superiores a la categoría junior en los músculos rotadores internos y externo de cadera y en el psoas‐iliaco. [EN] The main aim of this study was to analyze the effect of the age category on the flexibility profile in young taekwondo athletes, by using angular tests. A total of 17 young taekwondo athletes were recruited, who were classified according to their federative age category. The range of motion of the main movements of the lower extremity was assessed by using the "ROM SPORT" protocol. A descriptive analysis was made of each of the quantitative variables, which included means and standard deviations. A t‐test was used to determine the existence of differences between the dominant and non‐dominant limbs. In addition, the same statistical test analyzed the interaction between the 11 selected movements and age categories. Finally, the effect size of the results was calculated. The results showed significant differences between cadets and juniors categories in EC (iliopsoas), RIC (external rotators), REC (internal rotators) and total rotation of the hip (sum of RIC and REC). These results are not in tune with other studies that have assessed flexibility in taekwondo. Cadet taekwondo athletes had higher values of flexibility than the junior category in the internal and external rotator muscles and in the psoas‐iliac.

Background Muscle flexibility is a main component of health-related fitness and one of the basic components of fitness for the performance in some sports. Sport and health professionals require the flexibility profile of soccer to define quantitative aims in the training of flexibility. The aim of this study was to identify age-related differences in lower extremity flexibility in youth soccer players. Methods Seventy-two young male soccer players (age: 13.0 ± 3.1 y; body mass: 50.5 ± 15.3 kg; stature 158.2 ± 16.8 cm; BMI: 19.6 ± 2.6 kg/m2) completed this study. Measures of eleven passive hip (hip extension (HE), hip adduction with hip flexed 90°(HAD-HF90°), hip flexion with knee flexed (HF-KF) and extended (HF-KE), hip abduction with hip neutral (HAB) and hip flexed 90°(HAB-HF90°), hip external (HER) and internal (HIR) rotation), knee (knee flexion (KF)) and ankle dorsiflexion (ankle dorsiflexion with knee flexed (ADF-KF) and extended (ADF-KE)) ranges of motion (ROM) were taken. Descriptive statistics were calculated for hip, knee and ankle ROM measured separately by leg (dominant and non-dominant) and age-group (U10, U12, U14, U16 and U19). The data was analysed using a one-way analysis of variance (ANOVA) to examine the interaction of 11 ROM in the different players’ age-group. Results Generally, U10 and/or U12 soccer players obtain the highest mean value in almost all ROM evaluated (U10: HAD-HF [39.6° ± 4.3°], ADF-KE [32.3° ± 4.1°], HER [63.5° ± 5.6°] and HAB-HF90°[64.1° ± 7.5°]; U12: HE [17.7° ± 6.2°], HAB [35.6° ± 3.0], HIR [60.8° ± 4.7°] and KF [133.8° ± 7.1°]). Nonetheless, significant differences between the players’ age-groups are just found in HAD-HF90°(p = .042; ES = .136), HAB (p = .001; ES = .252), HIR (p = .001; ES = .251), HER (p p Conclusion The findings of this study reinforce the necessity of prescribing exercises aimed at improving HAD-HF90° ROM in U16, HAB ROM in U14, HIR ROM in U16 and U19, HER ROM in U12 and U19, and HAB-HF90° ROM in U16 and U19 players within everyday soccer training routines.

Objective: To analyse the training effects of the FIFA 11+ Kids on several parameters of physical performance in male youth football players. Material and Methods: Twenty-three youth players were randomised within each team into two groups (control vs. intervention). The intervention group performed the FIFA 11+ Kids programme 2 times a week for 4 weeks; the control groups completed their normal warm-up routines. Thirteen physical performance measures (range of motion [hip, knee and ankle joints], dynamic postural control [measured throughout the Y-balance test], 20 m sprint time, slalom dribble with a ball, agility, vertical jumping height [counter movement jump and drop jump], horizontal jump distance, accuracy when volleying a ball [measured throughout the Wall Volley test]) were assessed. All physical performance parameters were compared via magnitude-based inference analysis. Results: Significant between-group differences in favour of the FIFA 11+ players were found for dynamic postural control (anterior [mean and 90% confidence intervals [CI] = 1 cm, from -1.6 to 3.5 cm] and posteromedial [mean and 90% CI = 5.1 cm, from -1.8 to 12 cm] and posterolateral [mean and 90% CI = 4.8 cm, from 0.6 to 9.0 cm] distances), agility run (mean and 90% CI = 0.5 s, from -0,9 to 0 s), vertical jump height (counter movement jump [mean and 90% CI = 3.1 cm, from 0.2 to 6.1 cm] and drop jump [mean and 90% CI = 1.7 cm, from -0.5 to 3.9 cm]), and horizontal jump distance (mean and 90% CI = 2.5 cm, from -8 to 15 cm). The control groups showed better performance in 20 m sprint time (mean and 90% CI = -0.05 s, from -0.11 to 0.07) and wall volley tests (mean and 90% CI = 0.2, from -0.2 to 0.6) compared to the intervention group. Conclusions: The main findings of this study suggest that just 4 weeks of implementation of the FIFA 11+ Kids produces improved physical performance compared with traditional warm up routines in youth soccer players.

[ES] El objetivo principal del presente estudio fue determinar el perfil de flexibilidad de la extremidad inferior en atletas jóvenes de taewwondo, así como identificar los deportistas con cortedad muscular. Para ello, un total de 17 taekwondistas jóvenes participaron en el presente estudio; siete deportistas pertenecían a la selección española y diez a la selección Murciana. El rango de movimiento de los principales movimientos de la extremidad inferior fue valorado mediante el protocolo “ROM SPORT” y se realizó un análisis descriptivo de cada una de las variables cuantitativas. Se aplicó la prueba t­test de Student o Wilcoxon dependiendo de la normalidad de los datos. Los valores de ROM de cada movimiento se clasificaron como “normal” o “cortedad” de acuerdo con valores de referencia previamente justificados. Los resultados definen como perfil de flexibilidad en 23º para psoas‐iliaco, 28º para piramidal, 37º para gemelos, 42º para sóleo, 46º para aductores, 46º para rotadores externos, 56º para rotadores internos, 77º para aductores monoarticulares, 80º para isquiosurales, 140º para cuádriceps y 145º para glúteo mayor. La medición individual del ROM identificó cortedad muscular en 11 deportistas en piramidal (64,7%), 13 deportistas en sóleo (76,4%), 8 deportistas en rotadores externos (47%), 14 deportistas en aductores monoarticulares (82,3%), 13 deportistas en isquiosural (76,4%), 4 deportistas en cuádriceps (23,5%) y 12 en glúteo mayor (70,5%). Este perfil de flexibilidad puede ayudar a los profesionales del deporte a marcar objetivos cuantificables en el entrenamiento de la flexibilidad en este deporte. La inclusión de estiramientos o el aumento de la dosis deben de aplicarse sobre las cortedades identificadas en piramidal, sóleo, rotadores externos de cadera, aductores monoarticulares, isquiosural, cuádriceps y glúteo mayor. [EN] The main aim of this study was to determine the flexibility profile of the lower extremity in young taekwondo athletes, as well as identifying athletes with muscle shortness. For this purpose, a total of 17 young taekwondo athletes were assessed; seven from the Spanish team and ten from the Murcia team. The range of motion of the main movements of the lower extremity was evaluated by the "ROM SPORT" protocol and a descriptive analysis of each of the quantitative variables was performed. A Student t‐test or arWilcoxon test was applied depending on the normality distribution of the data. The ROM values of each movement were classified as “normal” or “shortness” according to previously determined reference values. The results define the following flexibility profile: 23º for iliopsoas, 28º for piriformis, 37º for gastrocnemius, 42º for soleus, 46º for adductors, 46º for external rotators, 56º for internal rotators, 77º for monoarticular adductors, 80º for hamstrings, 140º for quadriceps and 145º for gluteus maximus. Individual evaluations identified muscle shortness in pyramidal (11 athletes, 64.7%), soleus (13 athletes, 76.4%), external rotators (8 athletes, 47%), monoarticular adductors (14 athletes, 82.3%), hamstrings (13 athletes, 76.4%), quadriceps (4 athletes, 23.5%) and gluteus maximus (12 athletes, 70.5%). This flexibility profile can help sports professionals to set quantifiable goals for thetraining of flexibility in this sport. The inclusion of stretching exercises or the increase of their doses should be applied for the improvement of the identified shortness in piriformis, soleus, external hip rotators, monoarticular, hamstring, quadriceps and gluteus maximus adductors.

The first objective was to investigate the behavioural activity in the systems of Gray's theory; these are the Behavioural Inhibition System (BIS) and Behavioural Approach System (BAS), in fibromyalgia (FM) patients. The second aim was to assess in FM patients whether there is an association between BIS or BAS with self-reported somatic symptoms. Twenty FM patients and 20 healthy controls completed questionnaire measures of BIS and BAS activity (Sensitivity to Punishment and Sensitivity to Reward Questionnaire), self-reported somatic symptoms (Somatic Symptoms Scale Revised), positive and negative affect (Positive and Negative Affect Schedule) and health status (EuroQoL Visual Analogue Scale). The results showed that FM patients had lower Sensitivity to Reward (SR) scores than controls. The SR score correlated with different somatic symptoms groups. The partial correlation (controlling for other variables measured) showed that the SR score correlated specifically with musculoskeletal symptoms. Furthermore, in regression analysis, SR score significantly predicted musculoskeletal symptoms, after controlling for other variables measured in this study. Our findings suggest that FM patients show BAS hypoactivity. This BAS activity in FM is similar to patients with depression, where a lower BAS functioning has also been found. The BAS activity predicts the musculoskeletal self-reported symptoms in FM better than other measures included in this study. Although this is a preliminary study, it suggests the importance of BAS activity in FM.

Los objetivos de esta revisión son: (1) describir los principales programas de prevención de lesiones de la extremidad inferior en jóvenes deportistas que cuentan con una eficacia demostrada, cuya prevención ha estado dirigida a deportes colectivos de balón, no requieren de material adicional para su aplicación y la duración permite su implementación como calentamiento previo a la práctica deportiva; y (2) analizar las ventajas e inconvenientes de las medidas preventivas de acuerdo a su posibilidad de implantación de manera regular en el deporte. Para ello, un total de 5 pro- gramas neuromusculares para la prevención de lesiones fueron selecciona- dos. Aunque todos los programas han demostrado efectos positivos sobre la reducción de la incidencia lesional, el análisis pormenorizado de las carac- terísticas de las 5 medidas preventivas recomienda el uso de los programas FIFA 11+ y el Knäkontroll por su mayor adaptabilidad al contexto de apli- cación y la facilidad de su implementación de manera regular en el deporte. ABSTRACT: The aims of this review are: (1) describing the principal lower extremity injury prevention programs in young athletes that have a demon- strated efficacy, whose prevention have been destined for ball team sports, do not require any additional material for their application and the dura- tion allows for their implementation as previous warm-up programs; and (2) analyzing the advantages and disadvantages of the prevention strategies according to their possibility of implantation in the regular sport practice. For this purpose, a total of 5 neuromuscular injury prevention programs were selected. Although all the programs have shown positive effects in terms of the reduction of sport injury incidence, the detailed analysis of the characteristics of the prevention strategies recommend the utilization of the FIFA 11+ and Knäkontroll programs for their greater adaptability to the application context and their facility for the implementation in the regular sport practice.

Pathological hoarding is characterized by excessive collection of objects and inability to discard. This behaviour causes personal distress, familial or social disruption and public health problems. Different disorders include pathological hoarding, one of these disorders is a hoarding disorder (HD). This disorder has been conceptualized as a symptom or subtype of obsessive compulsive disorder (OCD), but recent studies conceptualize HD as a possible distinct clinical syndrome and propose this disorder as a new diagnostic category. We present a possible clinical case of HD and describe the clinical characteristics of hoarding and the consequences of its behaviour in personal and social functioning. The principal characteristics of HD are in the patient's behaviour, in accordance with recent studies in this area that distinguish this disorder of the OCD's symptoms and Diogenes syndrome. The characteristics of HD can have a negative influence on the treatment of these patients and on their relatives. Future studies must be conducted to improve knowledge of the characteristics of this disorder.

Molecular imaging receives increased attention for selecting patients who will benefit from targeted anticancer therapies. Neo-ALTTO (Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) enrolled 455 women with invasive human epidermal growth factor receptor 2 (HER2)-positive breast cancer and compared rates of pathologic complete response (pCR) to neoadjuvant lapatinib, trastuzumab, and their combination. Each anti-HER2 therapy was given alone for 6 wk, followed by 12 wk of the same therapy plus weekly paclitaxel. The early metabolic effects of the anti-HER2 therapies on the primary tumors and their predictive values for pCR were assessed in a subset of patients. Methods: eighty-six patients underwent (18)F-FDG PET/CT at baseline and weeks 2 and 6 of anti-HER2 treatment. An imaging core laboratory provided central validation, and 2 independent reviewers, masked to assigned treatment arm and clinical outcomes, performed consensus (18)F-FDG PET/CT readings. Maximum standardized uptake value (SUVmax) reductions from baseline were used to measure metabolic response. Results: seventy-seven of the 86 enrolled patients presented an evaluable baseline (18)F-FDG PET/CT scan; of these, 68 and 66 were evaluable at weeks 2 and 6, respectively. Metabolic responses in the primary tumors were evident after 2 wk of targeted therapy and correlated highly with metabolic responses at week 6 (R(2) = 0.81). pCRs were associated with greater SUVmax reductions at both time points. Mean SUVmax reductions for pCR and non-pCR, respectively, were 54.3% versus 32.8% at week 2 (P = 0.02) and 61.5% versus 34.1% at week 6 (P = 0.02). (18)F-FDG PET/CT metabolic response rates at weeks 2 and 6 were 71.6% and 60%, respectively using European Organization for Research and Treatment of Cancer criteria; pCR rates were twice as high for (18)F-FDG PET/CT responders than nonresponders (week 2: 42% vs. 21%, P = 0.12; week 6: 44% vs. 19%, P = 0.05). Conclusion: early metabolic assessment using (18)F-FDG PET/CT can identify patients with an increased likelihood of pCR after neoadjuvant trastuzumab, lapatinib, or their combination when given with chemotherapy.

Gerodermia osteodysplastica hereditaria was diagnosed in three Mexican brothers 6, 7, and 8 years old, respectively, who had the distinct facial appearance with sagging cheeks, premature wrinkling of the skin of face, abdomen, and dorsum of hands and feet; malocclusion, span greater than height; hyperextensibility; winging of the scapulae; stooped posture with kyphoscoliosis; protuberant abdomen; and pes planus. Radiologically they had generalized osteoplorosis, platyspondily due to multiple compression fractures, pseudoepiphyses of second metacarpals, and dislocated hips. Three other families with a total of 14 affected individuals have been reported. Inter- and intrafamilial variability can be recognized, particularly regarding the tendency to fractures, upper:lower segment ratio abnormalities, and results of skin biopsies, which have shown fragmentation of the elastic fibers in some cases (including the present family) and not in others. Although inheritance was considered to be X-linked recessive in the first reported family, an analysis of that pedigree together with those of the other reported families, including the present one, suggests that gerodermia osteodrysplastica is inherited in an autosomal recessive manner.

Sixty patients submitted to mitral commissurotomy were studied. Fourteen of them were treated with cortisone before as well as after surgery in order to evaluate (a) the incidence of asymptomatic but active cardiac rheumatic lesions; (b) the effects of cortisone on these lesions as well as upon the inflammatory reactions secondary to the surgical trauma, and (c) whether or not the post-operative follow-up in the treated patients is more favorable than in the untreated group.