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Objective To evaluate the short term and 1-year follow-up functional effects of a physiotherapy programme in patients over 60 years of age with massive and irreparable Rotator Cuff (RC) tear. Methods A total of 96 patients with massive and irreparable RC tear were prospectively recruited. All patients were treated with a 12-week physiotherapy programme. Three evaluations were performed, at the beginning, at the end of the treatment and at one year of follow-up. The Constant–Murley questionnaire was used to assess shoulder function, the DASH questionnaire for upper limb function, and the Visual Analogue Scale (VAS) for pain intensity. Results At the end of the treatment, all the variables showed a clinically and statistically significant difference (p Conclusion In the short term and 1-year follow-up, a physiotherapy programme showed clinically and statistically significant results in all functional variables in patients older than 60 years with massive and irreparable RC tear.

Resumen Objetivo Evaluar los efectos funcionales a corto plazo y al ano de seguimiento de un programa de fisioterapia en pacientes mayores de 60 anos con rotura masiva e irreparable del manguito rotador (MR). Metodo Se reclutaron de forma prospectiva 96 pacientes con rotura masiva e irreparable del MR. Todos los pacientes fueron tratados con un programa de fisioterapia de 12 semanas de duracion. Se realizaron tres evaluaciones, al inicio, al finalizar el tratamiento y al ano de seguimiento. Se utilizo el cuestionario de Constant-Murley para evaluar la funcion del hombro, el cuestionario DASH para la funcion del miembro superior y la escala visual analogica (EVA) para la intensidad del dolor. Resultados Al finalizar el tratamiento, hubo mejoria clinicamente relevante y estadisticamente significativa (p Conclusion A corto plazo y al ano de seguimiento, un programa de fisioterapia consiguio mejoria clinica y estadisticamente significativa en todas las variables funcionales en pacientes mayores de 60 anos con rotura masiva e irreparable del MR.

The aim of this study was to determine the effectiveness of early versus delayed motion on the functional outcomes in patients with distal radius fracture (DRF) treated with a volar locking plate. A systematic review and meta-analysis of randomized clinical trials was performed. An electronic search was performed in the Medline, Central, Embase, PEDro, Lilacs, Cinahl, SPORTDiscus, and Web of Science databases. The eligibility criteria included randomized clinical trials that compared the effect of early versus delayed motion on wrist and/or upper limb function, pain, grip strength, and wrist range of motion in subjects older than 18 years with DRF treated with a volar locking plate. Five clinical trials were included that met the eligibility criteria for the quantitative synthesis. At 6 weeks, the PRWE questionnaire showed a mean difference (MD) of -10.6 points (p 0.001), the MD was -11.1 points for the DASH questionnaire (p 0.001), -0.56 cm for pain on VAS (p = 0.01), 5.0 kg for grip strength (p = 0.01), 12.5 degrees for wrist flexion (p = 0.07), and 12.8 degrees for wrist extension (p = 0.05). All differences favored the early motion treatment. At 3 months of follow-up, only the DASH, pain on VAS, and grip strength showed significant differences in favor of early motion. At 1 year of follow-up, none of the variables studied were different between groups. In the short term, there was moderate to high evidence of clinically and statistically significant differences in the functional outcomes in favor of early versus delayed motion in patients with DRF treated with a volar locking plate. But these differences were not observed at 1 year of follow-up. PROSPERO registration no.: CRD42020158706.

Resumen: Hay muchos atributos que hacen que los proyectos de construcción sean susceptibles de enfrentarse a disputas durante su ejecución, como la naturaleza de las relaciones adversas entre las partes interesadas, los presupuestos ajustados y la falta de incentivos en los contratos que fomenten la colaboración. Además, el impacto de las demandas variará, pero es probable que tenga un efecto negativo en los proyectos. Por consiguiente, las partes interesadas deben gestionar el proceso de resolución de demandas. Un desafío de este proceso es el entendimiento y la claridad de la información utilizada para resolver las demandas de construcción. Una tecnología que ha tenido un crecimiento constante en la industria de la construcción es el Modelado de información para la construcción (del inglés Building Information Modeling, BIM). Los beneficios de la implementación del BIM en los proyectos de construcción son ampliamente reconocidos, tales como la automatización del proceso de estimación del desglose y presupuesto de materiales, la rápida reacción a los cambios de diseño, la mejor visualización de la programación de construcción y la coordinación del diseño. No obstante, estudios limitados han abordado la forma en que los beneficios existentes de la implementación del BIM pueden utilizarse como plataforma para facilitar la resolución de las demandas de construcción. Este estudio explora y analiza la literatura existente para identificar los principales beneficios de la implementación del BIM en la resolución de demandas de construcción. El objetivo es evaluar lo que existe en la rama legal de la implementación del BIM en la construcción para sugerir su uso en este sentido.

Resumen Actualmente existen diversos estudios que explican los eventos de plasticidad neuronal generados en condiciones normales, patologicas, asi como tambien las existentes durante el periodo de neurorrehabilitacion. El aprendizaje motor juega un gran rol durante toda la etapa de rehabilitacion motora, el cual se ha fundamentado mediante diferentes tecnicas de evaluacion, donde la gran mayoria de los resultados se refieren a personas con alteraciones neurologicas y en sujetos asintomaticos. El presente estudio revisa los conceptos y bases del aprendizaje motor en condiciones normales para posteriormente fundamentar la creacion de nuevas estrategias de rehabilitacion motora en alteraciones del dolor cronico musculoesqueletico.

The aim of this study was a comparison between PO4−3-P removal from sewage using zeolite as support medium in subsurface flow treatment wetlands (SSF TWs) operated with different oxidation-reduction potentials (ORPs). In addition, the zeolite’s phosphate adsorption characteristics were evaluated. For this, Two mesocosm SSF TWs were installed and operated during 504 d for the PO4−3-P adsorption from sewage: a) mesocosm SSF TW with natural zeolite (MTW-Z1) and b) mesocosm SSF TW with gravel (MTW-G1). Two ORPs was used in MTW-Z1 and MTW-G1: a) ORP-A, ORP >+50 mV, b) ORP-B, ORP +50 mV) and B (

Osteoblast differentiation is controlled by transcription factor RUNX2 which temporally activates or represses several bone-related genes, including those encoding extracellular matrix proteins or factors that control cell-cell, and cell-matrix interactions. Cell-cell communication in the many skeletal pericellular micro-niches is critical for bone development and involves paracrine secretion of growth factors and morphogens. This paracrine signaling is in part regulated by "A Disintegrin And Metalloproteinase" (ADAM) proteins. These cell membrane-associated metalloproteinases support proteolytic release ("shedding") of protein ectodomains residing at the cell surface. We analyzed microarray and RNA-sequencing data for Adam genes and show that Adam17, Adam10, and Adam9 are stimulated during BMP2 mediated induction of osteogenic differentiation and are robustly expressed in human osteoblastic cells. ADAM17, which was initially identified as a tumor necrosis factor alpha (TNFα) converting enzyme also called (TACE), regulates TNFα-signaling pathway, which inhibits osteoblast differentiation. We demonstrate that Adam17 expression is suppressed by RUNX2 during osteoblast differentiation through the proximal Adam17 promoter region (-0.4 kb) containing two functional RUNX2 binding motifs. Adam17 downregulation during osteoblast differentiation is paralleled by increased RUNX2 expression, cytoplasmic-nuclear translocation and enhanced binding to the Adam17 proximal promoter. Forced expression of Adam17 reduces Runx2 and Alpl expression, indicating that Adam17 may negatively modulate osteoblast differentiation. These findings suggest a novel regulatory mechanism involving a reciprocal Runx2-Adam17 negative feedback loop to regulate progression through osteoblast differentiation. Our results suggest that RUNX2 may control paracrine signaling through regulation of ectodomain shedding at the cell surface of osteoblasts by directly suppressing Adam17 expression.

The aim of this study was to evaluate the performance of ornamental plant species in mesocosm subsurface constructed wetlands (CWs) to treat sewage under different organic loading rates (OLRs). The effect of ornamental plant species was evaluated in four mesocosm CWs with: (a) Iris pseudacorus (MCW-Ip), (b) Eichornia crassipes (MCW-Ec), (c) Tulbaghia violacea (MCW-Tv), and (d) Cyperus papyrus (MCW-Cp). The OLRs were evaluated as follows: (a) 0.47 gCOD/(m2 d) (Phase I), (b) 0.84 gCOD/(m2 d) (Phase II), and (c) 1.94 gCOD/(m2 d) (Phase III). Inside the four mesocosm CWs during the three phases showed oxidation-reduction potential and dissolved oxygen below −50 mV and 0.7 mg/L, respectively, which are characteristic values of anoxic-anaerobic environments. The 5-day biological oxygen demand (BOD5), chemical oxygen demand (COD) and total suspended solids (TSS) removal efficiencies were above 50% for the four mesocosm CWs in the three phases. In the cases of NH4+-N and PO4−3-P, removal efficiency was above 70% only for MCW-Cp during the three phases. When the OLR increased, BOD5, COD, TSS, NH4+-N, PO4−3-P and fecal coliform (FC) effluent concentrations from the four mesocosm CWs were affected in a significant way (α 0.05) effect on COD and BOD5 effluent concentrations for Phase I, II and III. Conversely, Tulbaghia violacea and Cyperus papyrus had a significant influence (α

In this paper is presented the evaluation of an algorithm for detection of microcalcifications in breast images, allowing us early breast cancer prevention. The Creme Filter is an algorithm with only one parameter “n” that permits to observe the texture dependence when the parameter is changed. The evaluation is done by a cancer expert medical doctor. This algorithm is a new tool for better detecting microcalcifications characteristic of breast cancer.

espanolRESUMEN Objetivo: Determinar si existe correlacion entre el dolor y el alineamiento aceptable de la fractura de radio distal (FRD) en pacientes mayores de 60 anos. Material y metodo: El presente estudio correlacional fue realizado en el Hospital Clinico San Borja Arriaran. Se reclutaron de forma prospectiva 210 pacientes con FRD extrarticular segun la clasificacion AO. Para evaluar los resultados de la reduccion ortopedica se evaluaron indices radiologicos como la inclinacion radial, la angulacion dorsal residual y la varianza ulnar. Tras la retirada de la inmovilizacion y a los 6 meses de seguimiento se evaluo la intensidad del dolor con la escala visual analogica (EVA), la funcion de la muneca con el cuestionario de evaluacion de la muneca valorada por el paciente (PRWE) y la fuerza de puno con un dinamometro. Resultados: Solo 88 pacientes (42 %) presentaron un alineamiento aceptable de la FRD. Tras la retirada de la inmovilizacion, en el total de pacientes la correlacion con la EVA fue de 0,17 (p = 0,546), la puntuacion PRWE de 0,09 (p = 0,821) y la fuerza de puno de 0,08 (p = 0,631). Al sexto mes de seguimiento la correlacion con la EVA fue de 0,09 (p = 0,668), PRWE de 0,05 (p = 0,882) y la fuerza de puno de 0,04 (p = 0,614). Conclusion: A corto y medio plazo no existe una correlacion significativa entre el alineamiento aceptable basado en indices radiologicos y el dolor y la funcion de pacientes mayores de 60 anos con FRD extrarticular tratados de manera conservadora. EnglishABSTRACT Objective: To determine whether there is a correlation between pain and acceptable distal radius fracture (DRF) alignment in patients older than 60 years of age. Material and method: This correlational study was carried out at the San Borja Arriaran Clinical Hospital. A total of 210 patients diagnosed with extra-articular DRF, according to the AO classification, were recruited prospectively recruited. Radiological parameters, including radial inclination, residual dorsal angulation and ulnar variance, were evaluated to assess the results of the orthopedic reduction. After the removal of the immobilization and after 6 months of follow-up, the pain intensity was assess with the visual analogue scale (VAS), the wrist function with the PRWE questionnaire and the grip strength with a dynamometer. Results: Only 88 patients (42%) showed acceptable DRF alignment. After cast removal, in the total of patients the correlations between alignment were as follows: VAS 0.17 (p = 0.546), PRWE 0.09 (p = 0.821), and grip strength 0.08 (p = 0.631). At the 6th months of follow-up, the correlation with the VAS was 0.09 (p = 0.668), PRWE 0.05 (p = 0.882) and grip strength 0.04 (p = 0.614). Conclusion: In the short and medium term, there was no significant correlation between acceptable alignment according to radiological parameters and pain and function of patients older than 60 years with extra-articular DRF treated conservatively.

The brightly blue shallow water species Terpios fugax Duchassaing and Michelotti, 1864 was originally described from the Caribbean and has been extensively recorded in the Atlantic Ocean, but rarely found in the Indian and Pacific Oceans. In the Pacific Ocean it has been only reported from Sulawesi, Indonesia and from the Caroline and Marshall Islands. Here we report the first record of Terpios in the Eastern Pacific, based on the presence of T. fugax at Caldera, Region de Atacama, northern Chile. Although this species may have been inadvertently introduced to the area by human activity, it should also be considered that the geographically distant populations of this sponge (from the Caribbean to the Eastern Pacific) may represent different species.

The objective was to evaluate the effects of intermittent artificial aeration cycles and natural zeolite as a support medium, in addition to the contribution of plants (Schoenoplectus californicus) on NH4(+)-N removal during sewage treatment by Constructed Wetlands (CW). Two lines of Mesocosm Constructed Wetland (MCW) were installed: (a) gravel line (i.e. G-Line) and (b) zeolite line (i.e. Z-Line). Aeration increased the NH4(+)-N removal efficiency by 20-45% in the G-Line. Natural zeolite increased the NH4(+)-N removal efficiency by up to 60% in the Z-Line. Plants contributed 15-30% of the NH4(+)-N removal efficiency and no difference between the G-Line and the Z-Line. Conversely, the NH4(+)-N removal rate was shown to only increase with the use of natural zeolite. However, the MCW with natural zeolite, the NH4(+)-N removal rate showed a direct relationship only with the NH4(+)-N influent concentration. Additionally, relationship between the oxygen, energy and area regarding the NH4(+)-N removal efficiency was established for 2.5-12.5 gO2/(kWh-m(2)) in the G-Line and 0.1-2.6 gO2/(kWh-m(2)) in the Z-Line. Finally, it was established that a combination of natural zeolite as a support medium and the aeration strategy in a single CW could regenerate the zeolite's adsorption sites and maintain a given NH4(+)-N removal efficiency over time.

The sewage snail Physa acuta, native to North America, is an effective invasive species around the world. In Chile, it was first reported in 2014 in the north central area of the country. So far, the species has not been recorded in southern Chile. Sampling performed in 2015 in three localities from Llanquihue Lake, Chilean Patagonia, only provided native freshwater snails. However, new collections performed in February 2018 in the same three sites were successful for physid specimens suggesting a biological invasion entailing a large southward range expansion of these snails. Here we performed morphological, microstructural and phylogenetic analyses to investigate whether the new samples belong to Physa acuta. The shell morphology, male copulatory complex and radula microstructure of the new material agree with those of the sewage snail. The molecular phylogenetic analyses using the cytochrome c oxidase subunit 1 (COI) gene confirmed morphological identification. We suggest to take prompt measures to prevent the expansion of Physa acuta in Llanquihue Lake or nearby aquatic ecosystems.

African animal trypanosomosis is arguably the most important animal disease impairing livestock agricultural development in sub-Saharan Africa. In addition to vector control, the use oftrypanocidal drugs is important in controlling the impact of the disease on animal health and production in most sub-Saharan countries. However, there are no internationally agreed standards (pharmacopoeia-type monographs or documented product specifications) for the quality control of these compounds. This means that it is impossible to establish independent quality control and quality assurance standards for these agents. An international alliance between the Food and Agriculture Organization of the United Nations, the International Federation for Animal Health, the Global Alliance for Livestock Veterinary Medicines, the University of Strathclyde and the International Atomic Energy Agency (with critical support from the World Organisation for Animal Health) was established to develop quality control and quality assurance standards for trypanocidal drugs, with the aim of transferring these methodologies to two control laboratories in sub-Saharan Africa that will serve as reference institutions for their respective regions. The work of the international alliance will allow development of control measures against sub-standard or counterfeit trypanocidal drugs for treatment of trypanosome infection. Monographs on diminazene aceturate (synonym: diminazene diaceturate), isometamidium chloride hydrochloride, homidium chloride and bromide salts and their relevant veterinary formulations for these agents are given in the annex to this paper. However, the authors do not recommend use of homidium bromide and chloride, because of their proven mutagenic properties in some animal test models and their suspected carcinogenic properties.

Alzheimer disease (AD) is a neurodegenerative disease characterised by progressive dementia associated with global cognitive dysfunction.We conducted a systematic review and meta-analysis of clinical trials evaluating omega-3 supplementation in patients with AD.To determine if there is scientific evidence of the effectiveness of omega-3 supplementation in improving cognitive function in patients with AD.We included only randomised controlled trials (RCTs) from the following databases: Medline, Cochrane Central, Cinahl, and LILACS. An electronic search was also conducted using Google Scholar.Six articles met the eligibility criteria. The risk of bias was assessed following the Cochrane method.There is no consistent evidence to support the effectiveness of omega-3 supplementation in improving cognitive function in AD patients in the short and medium term.

Osteosarcoma is the most common malignant bone tumor in children and adolescents. Metastasis and poor responsiveness to chemotherapy in osteosarcoma correlates with over-expression of the runt-related transcription factor RUNX2, which normally plays a key role in osteogenic lineage commitment, osteoblast differentiation, and bone formation. Furthermore, WNT/β-catenin signaling is over-activated in osteosarcoma and promotes tumor progression. Importantly, the WNT/β-catenin pathway normally activates RUNX2 gene expression during osteogenic lineage commitment. Therefore, we examined whether the WNT/β-catenin pathway controls the tumor-related elevation of RUNX2 expression in osteosarcoma. We analyzed protein levels and nuclear localization of β-catenin and RUNX2 in a panel of human osteosarcoma cell lines (SAOS, MG63, U2OS, HOS, G292, and 143B). In all six cell lines, β-catenin and RUNX2 are expressed to different degrees and localized in the nucleus and/or cytoplasm. SAOS cells have the highest levels of RUNX2 protein that is localized in the nucleus, while MG63 cells have the lowest RUNX2 levels which is mostly localized in the cytoplasm. Levels of β-catenin and RUNX2 protein are enhanced in HOS, G292, and 143B cells after treatment with the GSK3β inhibitor SB216763. Furthermore, small interfering RNA (siRNA)-mediated depletion of β-catenin inhibits RUNX2 expression in G292 cells. Thus, WNT/β-catenin activation is required for RUNX2 expression in at least some osteosarcoma cell types, where RUNX2 is known to promote expression of metastasis related genes. J. Cell. Biochem. 118: 3662-3674, 2017. © 2017 Wiley Periodicals, Inc.

espanolIntroduccion: El desgarro masivo del maguito rotador (DMMR) es una condicion clinica degenerativa que corresponde a una ruptura de 5 cm, o una que compromete a dos o mas tendones del manguito rotador (MR), generando perdida de funcionalidad y dolor incapacitante. Objetivo: Describir los cambios en el dolor y funcion de hombro posterior a un programa de 6 semanas de terapia de juicio de lateralidad e imagineria de movimiento y ejercicios de activacion selectiva glenohumerales en sujetos con rotura masiva del manguito rotador. Metodos: Este estudio es una investigacion descriptiva y diseno serie de casos, con una muestra de 50 participantes con diagnostico de ruptura masiva de manguito rotador. Los pacientes realizaron un programa de ejercicios selectivos glenohumerales mas terapia de juicio de lateralidad e imagineria de movimiento durante 6 semanas. Se midieron las variables de funcion, dolor, ROM de abduccion y flexion de hombro, a la sexta semana y al sexto mes de evolucion. Resultados: Existen diferencias significativas en la intensidad del dolor, funcion de hombro, AROM de flexion y AROM de abduccion de hombro, posterior a la intervencion (p EnglishIntroduction: Massive tear of the rotator cuff (DMMR) is a degenerative clinical condition, which corresponds to a 5 cm rupture, or one that compromises two or more tendons of the rotator cuff (MR), generating loss of functionality and disabling pain. Objective: To describe changes in pain and shoulder function following a 6-week program of lateral-imaging and motion imaging therapy and selective glenohumeral activation exercises in subjects with massive rotator cuff tears. Methods: This study is a descriptive research and design of a series of cases, with a sample of 50 participants with diagnosis of rotator cuff mastication. Patients underwent a glenohumeral selective exercise program plus laterality and motion imaging therapy for 6 weeks. The variables of function, pain, abduction ROM and shoulder flexion were measured at sixth week and sixth month of evolution. Results: There were significant differences in pain intensity, shoulder function, AROM flexion and shoulder abduction AROM, after the intervention (p > 0.05). Statistically significant differences were found for all outcome measures between the intervention and the sixth follow-up month (p

El pinzamiento sub-acromial (SPS) es el trastorno músculo-esquelético más frecuente de las patologías de hombro. El taping se ha transformado en una indicación relativamente nueva y bastante común en los últimos años. Se realizará una síntesis de la evidencia a través de una revisión sistemática (RS) de ensayos clínicos aleatorizados que hayan comparado el uso del taping para el manejo de estos pacientes. El objetivo de esta revisión es determinar el efecto del taping sobre el dolor en sujetos con pellizcamiento sub-acromial. La estrategia de búsqueda incluyó ensayos clínicos aleatorizados (ECA); las bases de datos usadas fueron: Medline, Cinahl, PEDro, Central, LILACS. Además, se realizó una búsqueda en revistas electrónicas, actas de congresos, Registro de Estudios Clínicos Aleatorizados y se contactó con expertos en el tema. Los resultados obtenidos fueron de dos artículos que cumplían con nuestros criterios de elegibilidad. Se concluye que existe evidencia de baja calidad que sugiere que la aplicación de taping sería efectiva para mejorar la funcionalidad, reducir el dolor en reposo y durante los movimientos hasta en una semana posterior a su aplicación, en sujetos que presentan pellizcamiento sub-acromial en comparación a un programa de terapia física.

Phosphorus (P) contained in sewage maybe removed by mesocosm-scale constructed wetlands (MCW), although removal efficiency is only between 20% and 60%. P removal can be enhanced by increasing wetland adsorption capacity using special media, like natural zeolite, operating under aerobic conditions (oxidation-reduction potential (ORP) above +300 mV). The objective of this study was to evaluate P removal in sewage treated by MCW with artificial aeration and natural zeolite as support medium for the plants. The study compared two parallel lines of MCW: gravel and zeolite. Each line consisted in two MCW in series, where the first MCW of each line has artificial aeration. Additionally, four aeration strategies were evaluated. During the operation, the following parameters were measured in each MCW: pH, temperature, dissolved oxygen and ORP. Phosphate (PO4(-3) - P) and chemical oxygen demand (COD), five-day biological oxygen demand (BOD5), total suspended solids (TSS) and ammonium. (NH4(+) - N) were evaluated in influents and effluents. Plant growth (biomass) and proximate analysis for P content into Schoenoplectus californicus were also performed. The results showed that PO4(-3) - P removal efficiency was 70% in the zeolite medium, presenting significant differences (p.05) with the results obtained by the gravel medium. Additionally, aeration was found to have a significant effect (p.05) only in the gravel medium with an increase in up to 30% for PO43 - P removal. Thus, S. californicus contributed to 10-20% of P removal efficiency.

Epilepsy is a brain disorder that affects both children and adults. From the 1920s the ketogenic diet has gained prestige as another treatment option for patients with refractory epilepsy.A summary of the evidence will be made through a systematic review of randomized clinical trials that have compared a single ketogenic diet with other diet for the management of these patients.To determine the effectiveness of the ketogenic diet in reducing episodes of seizures in patients with refractory epilepsy. The search strategy included randomized controlled trials and controlled clinical trials. Databases used were Medline, LILACS, Central and CINAHL.Six articles that met our elegibility criteria.There is limited evidence that the ketogenic diet compared to the medium-chain triglyceride diet is more effective in reducing the frequency of seizures. There is also moderate evidence that classical ketogenic diet compared to the gradual diet (2.5:1 and 3:1) is more effective in reducing seizures. There is moderate evidence that classical ketogenic diet compared to Atkins diet is more effective in reducing the frequency of seizure. The decision to apply this type of diet should also be based on costs, preferences and safety of treatment. It should also take into account the likelihood that studies have indexing problems have been left out of the review.Efectividad de la dieta cetogenica en niños con epilepsia refractaria: revision sistematica.Introduccion. La epilepsia es una patologia cerebral que afecta tanto a niños como a adultos. Desde los años veinte, la dieta cetogenica ha ganado prestigio como otra opcion de tratamiento en pacientes con epilepsia refractaria. Sujetos y metodos. Se realiza una sintesis de la evidencia a traves de una revision sistematica de ensayos clinicos aleatorizados que hayan comparado una dieta cetogenica sola con otros tipos de dieta para el tratamiento de estos pacientes. Objetivo. Determinar la efectividad de la dieta cetogenica en la disminucion de los episodios de convulsiones en pacientes con epilepsia refractaria. La estrategia de busqueda incluyo ensayos clinicos aleatorizados y ensayos clinicos controlados. Las bases de datos usadas fueron: Medline, LILACS, Central y CINAHL. Resultados. Se obtuvieron seis articulos que cumplian con los criterios de elegibilidad. Conclusiones. Existe evidencia limitada de que la dieta cetogenica en comparacion con la dieta de trigliceridos de cadena media es mas efectiva en disminuir la frecuencia de las convulsiones. Existe evidencia moderada de que la dieta cetogenica clasica en comparacion con la dieta gradual (2,5:1 y 3:1) es mas efectiva para disminuir las crisis epilepticas. Existe evidencia moderada de que la dieta cetogenica clasica en comparacion con la dieta Atkins es mas efectiva para disminuir la frecuencia de convulsiones en tres meses. La decision de aplicar este tipo de dietas tambien debe basarse en costes, preferencias y seguridad del tratamiento. Ademas, debe considerarse la probabilidad de que algunos estudios, por problemas de indizacion, hayan quedado fuera de la revision.

The purpose of the study was to compare the acute hepatic response to diet modification and exercise-induced endotoxemia, and to determine if associations exist between liver damage markers, body core temperature, and IL-6 responses to a laboratory-based duathlon. Eleven moderately-trained healthy males followed a low-carbohydrate (CHO) and a high CHO diet to change their glycogen stores two-days before completing a duathlon. Blood samples were obtained at rest, immediately after and 1- and 2-h following the duathlon for determination of endotoxin-lipopolysaccharide binding protein (LPS-LBP) complex, IL-6, and liver integrity markers AST, ALT, and AST/ALT ratio. Hydration status and body core temperature were assessed at rest, during, and after the duathlon. Athletes were more dehydrated and had higher AST/ALT ratios in the low- compared to the high-CHO diet trial regardless of the measurement time (p

Aim: To find out whether there is an association between parity and obesity, evaluated through body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in Chilean women after controlling for sociodemographic characteristics, health risk and gynaeco-obstetric factors. Design: Cross-sectional study, using baseline data of the San Francisco Project. Setting: San Francisco de Mostazal, located in the central region of Chile, 6512 Chilean-Hispanic women (Spanish heritage with a variable indigenous component). Methods: A weighted random sample of 508 women who had their first pregnancy inside the primary child-bearing ages. Data were collected between 1997 and 1999. Statistical associations between parity and different anthropometric measurements of adiposity in multiple linear (MLnR) and logistic regression models (MLtR) were evaluated. Results: In MLnR a modest parity-related increment in BMI and practically null increment in WC, WHR and WHtR was observed. Covariates that showed a statistically significant association with anthropometric measures of adiposity were age, low education, marital status, employment, smoking, smoking cessation, hypertension, diabetes, dyslipidaemia, parent’s obesity, menarche and fetal macrosomia. Crude odds ratio (OR) showed a strong association between parity and anthropometric markers of obesity. Nevertheless, after adjustments in MLtR models, the association remained only for BMI. All the measures of abdominal obesity related to parous women showed OR smaller than 1 (95% confidence intervals 0.57 to 0.96). Conclusions: Parity modestly influences BMI, but does not seem to be related to WC, WHR and WHtR after controlling by confounders. Parity can increase adiposity but not necessarily following an abdominal pattern.

In the terrace Te, of Constitucion, many fractures and associated deformations of its platform appeared in the street pavements after the earthquake of 02.27.2010. On this basis, this work deals with the co-seismic deformation in this terrace, observed by means of survey of fractures and associated superficial deformations. The principal undulated and irregular surface of the terrace shows no difference between the profiles surveyed before and after the 2010 seism, with exception of those that represent a minor part in the northward sector. In exchange, the flagstones or slabs of pavement show brittle micro-deformations or pop up like array structures associated to micro fractures produced during the seism. There is great dissimilarity of size order between principal irregularities of the terrace surface (undulations) and micro-deformations. The principal irregularities of the terrace Te indicate that its undulated form is inherited and older than the seism of 02.27.2010. Only a minor part represents a 2010 co-seismic deformation with gentle warping of the inherited undulation during the seism. In exchange, the flagstone dislocations or brittle deformations shown as pop ups like array are co-seismic microforms. They appear only as small tectonic deformations in the epidermis of the inherited undulated surface. Their apparent random distribution is possibly the result of a complex interaction between the seismic waves and the inherited topography, producing strain structures.

African animal trypanosomosis is arguably the most important animal disease impairing livestock agricultural development in sub-Saharan Africa. In addition to vector control, the use oftrypanocidal drugs is important in controlling the impact of the disease on animal health and production in most sub-Saharan countries. However, there are no internationally agreed standards (pharmacopoeia-type monographs or documented product specifications) for the quality control of these compounds. This means that it is impossible to establish independent quality control and quality assurance standards for these agents. An international alliance between the Food and Agriculture Organization of the United Nations, the International Federation for Animal Health, the Global Alliance for Livestock Veterinary Medicines, the University of Strathclyde and the International Atomic Energy Agency (with critical support from the World Organisation for Animal Health) was established to develop quality control and quality assurance standards for trypanocidal drugs, with the aim of transferring these methodologies to two control laboratories in sub-Saharan Africa that will serve as reference institutions for their respective regions. The work of the international alliance will allow development of control measures against sub-standard or counterfeit trypanocidal drugs for treatment of trypanosome infection. Monographs on diminazene aceturate (synonym: diminazene diaceturate), isometamidium chloride hydrochloride, homidium chloride and bromide salts and their relevant veterinary formulations for these agents are given in the annex to this paper. However, the authors do not recommend use of homidium bromide and chloride, because of their proven mutagenic properties in some animal test models and their suspected carcinogenic properties.

espanolLa epicondilalgia lateral es una de las lesiones mas comunes del brazo, siendo el musculo extensor radial corto del carpo (ERCB) la estructura mas afectada, por movimientos repetitivos, rapidos y monotonos, principalmente afecta entre 1-3% de la poblacion general, siendo mas comun en mujeres. El ejercicio terapeutico, es uno de los elementos claves en los programas disenados para el manejo de esta condicion. Se realizara una busqueda de la evidencia a traves de una revision sistematica de ensayos clinicos aleatorizados que hayan determinado la efectividad del ejercicio terapeutico para el manejo de estos pacientes. El objetivo de esta Revision es determinar si existe evidencia cientifica que avale la efectividad clinica del ejercicio terapeutico solo o dentro de un programa de tratamiento en pacientes adultos con epicondilalgia lateral. La estrategia de bus-queda incluyo ensayos clinicos aleatorizados (ECA) y ensayos clinicos controlados (ECC); las bases de datos usadas fueron: Medline, Cinahl, PEDro, Central, Lilacs. Los resultados obtenidos fueron de treinta y seis articulos que cumplian con nuestros criterios de elegibilidad. Se concluye que existe evidencia moderada que el ejercicio terapeutico comparado con una intervencion unica, disminuye el dolor, mejora la funcionalidad y aumenta la fuerza libre de dolor en corto, medio y largo plazo. Existe evidencia de que el ejercicio terapeutico disminuye el dolor, y aumenta la fuerza sin dolor a corto plazo. Existe evidencia fuerte de que el ejercicio terapeutico disminuye el dolor, aumenta la fuerza y mejora la funcionalidad a corto, medio y largo plazo. EnglishThe lateral epicondylalgia is one of the most common injuries of the arm; with the muscle extensor carpi radialis brevis (ERCB) affected the structure, repetitive motion, rapids and monotonous, mainly affects between 1-3% of the general population, being more common in women. Therapeutic exercise is one of the key elements in programs designed for the management of this condition. There will be a synthesis of evidence through a systematic review of randomized clinical trials that established the effectiveness of exercise therapy in the management of these patients. The aim of this review is to determine whether there is scientific evidence to support the clinical effectiveness of exercise therapy alone or in a treatment program for adult patients with LE. The search strategy included randomized clinical trials (RCTs) and controlled clinical trials (CCTs) databases were used: Medline, CINAHL, PEDro, Central, Lilacs. The results obtained were thirty-six articles that met our eligibility criteria. We conclude that there is moderate evidence shows that therapeutic exercise alone compared with a single intervention, decreases pain, improves function and increases strength pain free in short, medium and long term. There is strong evidence that exercise therapy reduces pain, increases strength and free from short-term pain. There is strong evidence that exercise therapy reduces pain, increases strength and improves functionality in the short, medium and long term.

This paper presents a power control strategy for the doubly fed induction machine. Calculated from the active and reactive power references in the stator, the rotor current references are then controlled through a predictive control algorithm, which calculates rotor voltages required for high-bandwidth current tracking. Using a two-voltage level three-phase inverter, pulse width modulation is used to generate voltage pulses within one period of a constant frequency carrier signal. The use of predictive control in conjunction with PWM allows for high-bandwidth current control at fixed switching frequency.

Twin pregnancy carries higher foetal and neonatal complications. This situation is worse in Sub-Saharan Africa due to lack of well-equipped facilities. Studies on twin pregnancy and its perinatal complications are limited in Ethiopia. Thus, this study aimed to fill this gap. A hospital-based cohort study was conducted in Jimma University Specialized Hospital on 144 twin deliveries and 288 singleton deliveries from December 2012 to November 2013 in obstetrics ward of Jimma university specialized hospital. Data were collected through face-to- face interview by using structured-questionnaire and analyzed by SPSS V.20.0. The relative risks of twin deliveries were higher for the occurrence of low birth weight, need for neonatal intensive care unit admissions, early neonatal deaths and preterm births as compared with singleton deliveries. Unique foetal complications like both twin deaths, co-twin deaths, discordant twin and gross congenital malformation were common in twin deliveries. In conclusion, women with twin pregnancy were at a higher risk of ante-partum and intrapartum foetal and neonatal complications. Therefore, care providers should give special attention for the mother during pregnancy, labour and delivery, and both for the mother and her new born during postpartum period.

Este trabalho apresenta resultados do uso da sísmica de reflexão sísmica em ambientes deposicionais glaciomarinhos da costa de fiordes norte e central do Chile. As geoformas são identificadas de acordo com as distintas respostas dos refletores acústicos, através do perfilador de subfundo 3.5 kHz. Facies sísmicas e movimentos de massa distribuídos ao longo dos fiordes de irregular morfologia submarina são classificados e interpretados em conjunto com modelos 3D da topografia submarina e subaérea, além de mapas de pendentes. Apesar de ser um importante instrumento para a reconstrução de paleoambientes glaciomarinhos, a sísmica de reflexão apresenta limitações quando não dispõe de amostras sedimentológicas in situ.

Human T-cell lymphotropic virus type I (HTLV-I) is the cause of endemic tropical spastic paraparesis (TSP) or HTLV-I-associated myelopathy (HAM). Because TSP/HAM is not a fatal disease, the neuropathology of this disease, albeit relatively well understood, is based on the examination of just a few incidental cases. We summarise our experience with the neuropathology of tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM). We studied three cases of TSP/HAM from different parts of the world. We demonstrated peculiar lamellated structures, called "multilamellar bodies" (MLB). It is tempting to suggest that MLB may represent specific ultrastructural markers of TSP/HAM. The pathology of the anteriorand posterior horns was similar and comprised axonal degeneration, accompanied by extensive astrocytic gliosis. Lymphocytic infiltration, particularly observed as "cuffs" around blood vessels, was scattered among other cellular elements. Ultrastructurally, myelin sheaths were relatively well preserved, and some demyelinated but not remyelinated fibres were observed. Moreover, axons with abnormal accumulations of neurofilaments, suggestive of axonal degeneration, were detected. Several axons contained Hirano bodies. In many samples glial processes replaced most of the remaining neuropil.

An approach on the regional coastal geomorphology of Chile is presented here. The used taxonomy is based partly on the H. Valentin,s ideas. A determinate regional unit is defined by her uniform character, configuration and similiar dynamics (genetic aspect), using the notion of common coasts. Each unit integrates regional individuals and regional types, based on coastal key individuals.