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Benjamin D Sullivan,1 Marta Palazón de la Torre,2 Ines Yago,2 Raúl Duarte,3 Julie M Schallhorn,4 Lisa M Nijm,5 Darrell E White,6 Michael S Berg,1 Pablo Artal3 1Trukera Medical, Southlake, TX, USA; 2Oftalmología en Murcia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; 3Laboratorio de Optica, Universidad de Murcia, Murcia, Spain; 4Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, CA, USA; 5Department of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, IL, USA; 6SkyVision Centers, Westlake, OH, USACorrespondence: Benjamin D Sullivan, Email bdsulliv@trukera.comPurpose: To study the association between tear film hyperosmolarity and ocular light scatter in a cataract surgery population.Patients and Methods: Contiguous, 20-second objective scatter index (OSI) scans were recorded in hyperosmolar (≥ 320 mOsm/L) and normal subjects (< 308 mOsm/L) with cataract nuclear opacity ≥ 3. OSI was measured at screening, baseline and 90 days following surgery. Along with symptoms of ocular surface disease, slit-lamp examination included corneal staining (0– 3), tear film breakup time (TBUT) and evaluation of meibomian gland disease (MGD). An additional cohort of hyperosmolar subjects were measured for OSI at screening, baseline, and 5, 10, 15 and 30 minutes following instillation of 0.18% sodium hyaluronate (HA).Results: Thirty-one eyes of 31 patients were included. There was a significant difference in post-operative OSI variation when comparing hyperosmolar (0.65± 0.30, N=11) to normal subjects (0.33± 0.11, N=10, p=0.005). Of note, there were no significant differences in OSI variation when subjects were sorted by staining (p=0.9), TBUT (p=0.7), symptoms (p=0.7), or MGD status (p=0.9). Instillation of 0.18% HA (N=10) did not alter OSI at 5 minutes, but significant reductions in OSI of 28.8%, 38.5% and 36.7% (all p < 0.001) were observed at 10, 15 and 30 minutes.Conclusion: Hyperosmolar patients exhibited significantly increased variation in light scatter following cataract surgery that was undifferentiated by staining or TBUT. Elevated osmolarity may be indicative of light scatter equivalent to that of a grade 2– 3 cataract.Keywords: hyperosmolarity, light scatter, tear film, staining, TBUT, cataract

Meniscal injuries represent one of the main causes of intra-articular knee pain, especially in young patients, athletes or those with a high demand for physical activity; representing a challenge for the arthroscopist surgeon due to the great complexity that some of these injuries can present. Currently, the advances that have been implemented in arthroscopy allow us to repair meniscal injuries that in the past were considered irreparable. Although our priority is to preserve as much of the meniscus as possible, there are cases in which the injury reaches such complexity that this is impossible, with partial or total meniscectomy being the only therapeutic option. In the United States, approximately 690,000 partial meniscectomies are performed each year. This situation makes us consider meniscal transplantation as a great therapeutic option for patients considered young enough for joint replacement. The ideal patient is a relatively young patient (between skeletal maturity and 50 years), who has a well-documented history of partial or total meniscectomy, pain well localized to the affected compartment, with failure to conservative treatment and without high-grade chondral defects. in a generalized way. We present case of a 35-year-old male patient with a history of total meniscectomy of the right lateral meniscus seven years ago, who currently presents with a postmeniscectomy syndrome of the lateral compartment. Due to the clinical and demographic characteristics of our patient, as well as the findings in the imaging studies, meniscal transplantation with allograft represents an excellent alternative to alleviate the symptoms and slow down as much as possible the need for joint replacement as a definitive treatment. [ABSTRACT FROM AUTHOR]

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Inappropriate wound healing (WH) management can cause significant comorbidities, especially in patients affected by chronic and metabolic diseases, such as diabetes. WH involves several different, partially overlapping processes, including hemostasis, inflammation, cell proliferation, and remodeling. Oxidative stress in WH contributes to WH impairment because of the overexpression of radical oxygen species (ROS) and nitrogen species (RNS). This study aimed to evaluate the in vitro antioxidative action of a gel containing a Propionibacterium extract (Emorsan® Gel) and assess its skin re-epithelialization properties in a mouse model of WH. The scavenging effects of the bacterial extract were assessed in vitro through the ABTS and DPPH assays and in L-929 murine fibroblasts. The effects of the Emorsan® Gel were studied in vivo in a murine model of WH. After WH induction, mice were treated daily with vehicle or Emorsan® Gel for 6 or 12 days. According to the in vitro tests, the Propionibacterium extract exerted an inhibitory effect on ROS and RNS, consequently leading to the reduction in malondialdehyde (MDA) and nitrite levels. Before proceeding with the in vivo study, the Emorsan® Gel was verified to be unabsorbed. Therefore, the observed effects could be ascribed to a local action. The results obtained in vivo showed that through local reduction of oxidative stress and inflammation (IL-1β, TNF-α), the Emorsan® Gel significantly reduced the infiltration of mast cells into the injured wound, leading to the amelioration of symptoms such as itch and skin irritation. Therefore, the Emorsan® Gel improved the speed and percentage of wound area closure by improving the tissue remodeling process, prompting vascular–endothelial growth factor (VEGF) and transforming growth factor (TGF)- β production and reducing the expression of adhesion molecules. Emorsan® Gel, by its ability to inhibit free radicals, could reduce local inflammation and oxidative stress, thus enhancing the speed of wound healing.

The present article is an international review or state of the art that analyzed more than seventy texts of studies and interventions of information and communication technologies for development and social change with the objective of identifying tendencies, in particular those that had the specific purpose of youth development. In the results of this systematization stands out the discussions around the concept of development, the predominance of works in marginalized communities, and the need to orient this field towards situated users and problems, as is the case of young people, a topic that has been less attended.

Introducción: Estudios previos han relacionado la vía Wnt con la alteración del metabolismo óseo y la patología cardiovascular. Así mismo, el control de la inflamación con terapia biológica tiene un efecto positivo sobre la densidad mineral ósea (DMO) y el riesgo cardiovascular. El objetivo de este estudio fue, por tanto, evaluar el efecto de la terapia biológica en pacientes con artritis reumatoide (AR) que no habían recibido previamente terapia biológica sobre la carga inflamatoria, y su relación con el riesgo cardiovascular y el metabolismo óseo. Pacientes y métodos: Estudio de cohortes prospectivo en pacientes con diagnóstico de AR activa que iniciaban terapia biológica. Los pacientes fueron seleccionados de forma consecutiva no seleccionada. Se recogieron: las concentraciones séricas de proteína Dickkopf-1 (DKK1) y esclerostina, ambas mediante el método ELISA (Biomedica Medizinprodukte GmbH and Co. KG, Viena, Austria); características sociodemográficas y clínicas; marcadores de remodelado óseo; la DMO en columna lumbar y en cadera mediante absorciometría de rayos X de energía dual (DXA); el grosor íntima-media carotídea (c-IMT); y la evaluación de riesgo cardiovascular mediante el modelo Systematic Coronary Risk Evaluation (SCORE). Resultados: El 46,7% de los pacientes presentaron respuesta EULAR al tratamiento a los 12 meses. Sólo en este subgrupo de pacientes encontramos un aumento en las concentraciones de DKK1 tras el inicio de la terapia biológica (basal: 20,55±8,13 pg/ml vs. 12 meses: 31,20±4,88 pg/ml, p=0,03). En cuanto a los marcadores de remodelado óseo, se detectó un aumento en los niveles de osteocalcina (basal: 11,25±3,28 ng/ml vs. 12 meses: 15,78,±4,11 ng/ml, p=0,01). No se encontraron cambios estadísticamente significativos en el c-IMT ni en el SCORE tras 12 meses de tratamiento. Conclusiones: En pacientes con AR tratados con terapia biológica y con respuesta al tratamiento hemos observado un aumento significativo de las concentraciones séricas de DKK1 a los 12 meses de tratamiento, no asociado a cambios en el metabolismo óseo o al riesgo cardiovascular.

Andrea Mingoli,1,2 Marco La Torre,1,2 Emanuele Migliori,1,2 Bruno Cirillo,1,2 Martina Zambon,1,2 Paolo Sapienza,1,2 Gioia Brachini1,2 1Emergency Department, 2Department of Surgery P Valdoni, Policlinico Umberto I, Sapienza University, Rome, Italy Introduction: Preservation of kidney and renal function is the goal of nonoperative management (NOM) of renal trauma (RT). The advantages of NOM for minor blunt RT have already been clearly described, but its value for major blunt and penetrating RT is still under debate. We present a systematic review and meta-analysis on NOM for RT, which was compared with the operative management (OM) with respect to mortality, morbidity, and length of hospital stay (LOS). Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed for this study. A systematic search was performed on Embase, Medline, Cochrane, and PubMed for studies published up to December 2015, without language restrictions, which compared NOM versus OM for renal injuries. Results: Twenty nonrandomized retrospective cohort studies comprising 13,824 patients with blunt (2,998) or penetrating (10,826) RT were identified. When all RT were considered (American Association for the Surgery of Trauma grades 1–5), NOM was associated with lower mortality and morbidity rates compared to OM (8.3% vs 17.1%, odds ratio [OR] 0.471; 95% confidence interval [CI] 0.404–0.548; P

Andrea Mingoli,1,2 Marco La Torre,1,2 Gioia Brachini,1,2 Gianluca Costa,3 Genoveffa Balducci,3 Barbara Frezza,3 Giovanna Sgarzini,4 Bruno Cirillo1,2 1Emergency Department, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy; 2Department of Surgery P Valdoni, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy; 3Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy; 4Department of Surgery, S Giovanni Addolorata Hospital, Rome, Italy Introduction: Hollow viscus injuries (HVIs) are uncommon but potentially catastrophic condi­tions with high mortality and morbidity rates. The aim of this study was to analyze our 16-year experience with patients undergoing surgery for blunt or penetrating bowel trauma to identify prognostic factors with particular attention to the influence of diagnostic delay on outcome. Methods: From our multicenter trauma registry, we selected 169 consecutive patients with an HVI, enrolled from 2000 to 2016. Preoperative, intraoperative, and postoperative data were analyzed to assess determinants of mortality, morbidity, and length of stay by univariate and multivariate analysis models. Results: Overall mortality and morbidity rates were 15.9% and 36.1%, respectively. The mean length of hospital stay was 23±7 days. Morbidity was independently related to an increase of white blood cells (P=0.01), and to delay of treatment >6 hours (P=0.033), while Injury Severity Score (ISS) (P=0.01), presence of shock (P=0.01), and a low diastolic arterial pressure registered at emergency room admission (P=0.02) significantly affected postoperative mortality. Conclusion: There is evidence that patients with clinical signs of shock, low diastolic pressure at admission, and high ISS are at increased risk of postoperative mortality. Leukocytosis and delayed treatment (>6 hours) were independent predictors of postoperative morbidity. More effort should be made to increase the preoperative detection rate of HVI and reduce the delay of treatment. Keywords: bowel injuries, hollow viscus injuries, abdominal blunt trauma, trauma, traumatic bowel perforation, BIPS