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Introduction: The European Working Group on Sarcopenia in Older People (EWGSOP) published a consensus on sarcopenia in 2010 and updated it in 2019 (EWGSOP2) which included the use of specific cut-off points. The aim was to assess how much prevalence of sarcopenia differed between EWGSOP2 and EWGSOP, as well as the use of specific cut-off points to assess differences in presarcopenia versus probable sarcopenia. Methods: Observational, transversal, and comparative study (n = 1,283 older adults; 57% women). Anthropometrics and handgrip strength were measured, and appendicular skeletal muscle mass equation was defined. Conceptual and methodological definitions of EWGSOP and EWGSOP2 consensus were applied to calculate prevalence of presarcopenia, probable sarcopenia, and sarcopenia. Results: Using cut-off points recommended for European population, prevalence of sarcopenia with EWGSOP2 was lower (−6.6%; p < 0.001) than EWGSOP. The prevalence of probable sarcopenia (EWGSOP2) was higher (+7.8%; p < 0.001) than EWGSOP presarcopenia. The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.45; IC = 0.40–0.51). Using specific-population cut-off points for muscle strength and appendicular muscle mass, the prevalence of probable sarcopenia with EWGSOP2 was higher (46.5%; p < 0.001) than EWGSOP (1.8%). The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.48; IC = 0.42–0.52). Conclusion: The new EWGSOP2 consensus underestimates the prevalence of sarcopenia, compared with EWGSOP using conventional cut-off points. The prevalence of presarcopenia with EWGSOP (low muscle mass) was lower than probable sarcopenia (low muscle strength) with the new EWGSOP2. In both cases, agreements between EWGSOP2 and EWGSOP were moderated. Discrepancies between the original and new consensus have implications on the primary health setting for identifying old and new cases for prevention and treatment.

Background and aims Olive oil and components might have a beneficial effect on Metabolic Syndrome (MetS). The aim of this review and meta-analysis was to assess whether those effects are related to hydroxytyrosol or oleic acid contents, or the combination of them as olive oil, and how powerful is this effect. Methods A systematic literature search was performed in MEDLINE via Pubmed, Web of Science (WOS) core collection, and Virtual Health Library (VHL) via LILACS and IBECS (Spain). MeSH terms used were “obesity”, “body weight”, “body mass index”, “adipose tissue”, “lipid metabolism”, “LDL”, “HDL”, “VLDL”, “insulin resistance”, “glucose”, “insulin”, “hypertension”, “arterial pressure”, “olive oil”, “oleic acid”, and other (non-MeSH) terms: “total antioxidant capacity”, “total antioxidant status”, “hydroxytyrosol” (PROSPERO ID: CRD42021247614). Results of the included studies were meta-analyzed with the RevMan 5.3 program, assuming a random effects model. Results 76 articles (67 different trials) were identified. Hydroxytyrosol had no effect on MetS [combined standardized mean differences (SMD) = 0.01 (CI 95%: [-0.23, 0.25], I2 = 83%; p = 0.920)]. Oleic acid had no significant beneficial effect on MetS [SMD = 0.03 (CI 95%: [-0.01, 0.07], I2 = 0%); p = 0.150], but it improved lipid profile [SMD = 0.06 (CI 95%: [-0.00, 0.12], I2 = 0%); p = 0. 050]. Olive oil had no effect on MetS [SMD = −0.01 (CI 95%: [-0.05, 0.03]), I2 = 55%; p = 0.550)]. The supplementation with hydroxytyrosol, oleic acid or olive oil showed a beneficial effect on antioxidant capacity related to components of MetS [SMD = 0.31 (CI 95%: [-0.34, 0.95], I2 = 81%)]; p = 0.35). Conclusion Most articles compared olive oil and oleic acid with other strategies specially designed for MetS management. Our findings suggest that olive oil or oleic acid consumption are as good as the other strategies to manage MetS.

Funding sponsor Funding number Acronym Balearic Islands Health Research Institute, EU-COST 35/2011, CA16112, Fondo de Investigación para la Salud, IDISBA CB12/03, CIBEROBN CB06/03, Margalida Comas DG R+D+I, Ministry of Science, Spain, European Commission 201630.10, EAT2BENICE_H2020_SFS2016, European Research Council 2013–2018, 340918, Generalitat Valenciana PROMETEO/2017/017, Instituto de Salud Carlos III, Funding sponsor Funding number Acronym Balearic Islands Health Research Institute EU-COST 35/2011, CA16112 Fondo de Investigación para la Salud IDISBA CB12/03, CIBEROBN CB06/03 Margalida Comas DG R+D+I Ministry of Science, Spain European Commission See opportunities by EC See opportunities (opens in new window) 201630.10, EAT2BENICE_H2020_SFS2016 EC European Research Council See opportunities by ERC See opportunities (opens in new window) 2013–2018, 340918 ERC Generalitat Valenciana See opportunities by GVA See opportunities (opens in new window) PROMETEO/2017/017 GVA Instituto de Salud Carlos III 2013ACUP00194, PI13/00233, PI13/00272, PI13/00462, PI13/00492, PI13/00673, PI13/00728, PI13/01056, PI13/01090, PI13/01123, PI13/02184, PI14/00618, PI14/00636, PI14/00696, PI14/00728, PI14/00853, PI14/00972, PI14/01206, PI14/01374, PI14/01471, PI14/01722, PI14/01919, PI16/00366, PI16/00381, PI16/00473, PI16/00501, PI16/00533, PI16/00662, PI16/01094, PI16/01120, PI16/01522, PI16/01873, PI17/00215, PI17/00508, PI17/00525, PI17/00532, PI17/00764, PI17/00855, PI17/00926, PI17/01183, PI17/01347, PI17/01441, PI17/01732, PI17/01827, PI19/00017, PI19/00309, PI19/00386, PI19/00576, PI19/00781, PI19/00957, PI19/01032, PI19/01226, PI19/01332, PI19/01560, PI20/00138, PI20/00339, PI20/00456, PI20/00557, PI20/00886, PI20/01158, PI20/01532, PI20/01802, Consejería de Salud y Familias, Junta de Andalucía PI0137/2018, PI0458/2013, PS0358/2016

Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment.To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of COUsing a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary COFood intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically COMore men than women induced higher dietary levels of COThe Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO

The menopausal transition stage brings physiological changes associated with the development of metabolic syndrome (MetS), which can affect bone mineral density (BMD), and may be more evident in the postmenopausal stage. The aim of this study was assessing the association between low BMD and MetS and its components among reproductive/menopausal transition and postmenopausal women in the northeast region of Mexico. A descriptive cross-sectional study was carried out (2015–2016) in 40–60-year-old women (n = 376) who were residents in the metropolitan area of Monterrey, in Nuevo Leon State, Mexico. Anthropometric measurements, blood pressure, a dual-energy X-ray absorptiometry (DXA) evaluation of BMD of two anatomical sites (lumbar spine and dual femur), and a biochemical analysis were obtained. The prevalence of MetS was 57.2%. In participants without MetS, the prevalence of osteopenia was 27.3% in the lumbar spine and 18.6% in the dual femur, while in participants with MetS, the prevalence of osteopenia was 35.8% in the lumbar spine and 14.4% in the dual femur. Osteoporosis in participants without MetS was present in 6.8% in the lumbar spine and in 1.8% in the dual femur, while in women with MetS, its prevalence was 4.7% in the lumbar spine and 0.5% in the dual femur. An association between low BMD at the lumbar spine and dual femur and components of MetS diseases was identified in Mexican women as follows: waist circumference ≥ 88 cm showed an increase risk for low BMD at femoral site in both reproductive/menopausal transition (OR 7.638, 95% CI: 1.607–36.298, p = 0.011) and postmenopausal women (OR 2.600, 95% CI: 1.023–6.609, p = 0.045), HDL &lt, 50 mg/dL was associated with low BMD in both the femur (OR 3.639, 95% CI: 1.039–12.743, p = 0.043) and lumbar spine (OR 2.654, 95% CI: 1.092–6.447, p = 0.031), hypertension in postmenopausal women increased the risk for low BMD in the femur (OR 2.634, 95% CI: 1.150–6.035, p = 0.022). In conclusion, we found that components of the MetS were associated with low BMD, thus indicating that MetS increases the risk for developing osteopenia or osteoporosis. Furthermore, age was found to be an independent risk factor for low BMD.

Resumen La alergia al latex es una respuesta alterada de nuestro organismo al contactar con las proteinas que se encuentran en el latex de caucho natural. Los sintomas de la hipersensibilidad alergica al latex son bastante parecidos a los de la alergia a los alimentos, siendo menos frecuentes los sintomas digestivos y mas tipicos los cutaneos tras el uso de guantes de latex, y los nasales y/o el asma tras la inhalacion del polvo de los guantes de latex o de los globos. En caso de pacientes muy sensibles puede provocar reacciones alergicas graves si entra en contacto con mucosas o cavidades internas. Se da la paradoja de que el medio hospitalario, es el lugar de mas riesgo dada la cantidad existente de latex, tanto directo como indirecto. Las personas alergicas al latex presentan a menudo reacciones alergicas cruzadas, a veces graves, tras ingerir determinadas frutas y vegetales. Las reacciones cruzadas se deben a los alergenos comunes presentes en el latex y en los diferentes alimentos. Es importante utilizar el analisis molecular de alergenos para detectar falsos diagnosticos a latex por problemas de reactividad cruzada con proteinas de frutas. Indicamos como estas nuevas pruebas han sustituido a analisis menos precisos y eficientes, logrando un considerable ahorro de recursos.

Background: Antioxidant supplementation has become a common practice among athletes to theoretically achieve a reduction in oxidative stress, promote recovery and improve performance. Objective: To assess the effect of antioxidant supplements on exercise. Methods: A systematic literature search was performed up to January 2019 in MEDLINE via EBSCO and Pubmed, and in Web of Sciences based on the following terms: “antioxidants” [Major] AND “exercise” AND “adaptation”; “antioxidant supplement” AND “(exercise or physical activity)” AND “(adaptation or adjustment)” [MesH]. Thirty-six articles were finally included. Results: Exhaustive exercise induces an antioxidant response in neutrophils through an increase in antioxidant enzymes, and antioxidant low-level supplementation does not block this adaptive cellular response. Supplementation with antioxidants appears to decrease oxidative damage blocking cell-signaling pathways associated with muscle hypertrophy. However, upregulation of endogenous antioxidant enzymes after resistance training is blocked by exogenous antioxidant supplementation. Supplementation with antioxidants does not affect the performance improvement induced by resistance exercise. The effects of antioxidant supplementation on physical performance and redox status may vary depending on baseline levels. Conclusion: The antioxidant response to exercise has two components: At the time of stress and adaptation through genetic modulation processes in front of persistent pro-oxidant situation. Acute administration of antioxidants immediately before or during an exercise session can have beneficial effects, such as a delay in the onset of fatigue and a reduction in the recovery period. Chronic administration of antioxidant supplements may impair exercise adaptations, and is only beneficial in subjects with low basal levels of antioxidants.

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

Background: The use of health services is a complex behavioral phenomenon affected by multiple factors (availability, distance, cost, quality, attitudes, cultural beliefs, socioeconomic characteristics, and individuals’ self-perception of health). Mexico has a segmented health system, and the access to it depends on the labor insertion and the population’s ability to pay. Objective: To assess association between use of health services and cardiovascular and metabolic syndrome risk factors among Mexican adults. Methods: Analytical cross-sectional nationally representative study carried out on Mexican adults (≥20-year-old adults of both sexes, n = 4595). Socioeconomic factors, geographic area, health care coverage, information about the use of health services, previous medical diagnoses of diabetes and hypertension, and smoking were assessed. Anthropometrics, triglyceride, total cholesterol, HDL-cholesterol, and glucose plasma levels were measured. Metabolic syndrome (MetS) and cardiovascular risk factors were assessed. Prevalences were expressed in terms of percentages, and significant differences were calculated using χ2 test. Univariate and multivariate analysis was performed to evaluate the association between the use of health services and cardiovascular risk factors and sociodemographic variables. Results: The probability of using health services is higher and more significant in subjects with obesity, diabetes (OR (95% CI): 1.73 (1.49–2.00, p &lt, 0.001), hypertension (OR (95% CI): 1.29 (1.14–1.45, 0.001), hypertriglyceridemia (OR (95% CI): 1.30 (1.15–1.46, 0.001), and in those with hypercholesterolemia (OR (95% CI): 1.23 (1.03–1.39, p = 0.001). Conclusions: Among health service users, there is a positive significant association between the use of health services and the presence of metabolic syndrome, obesity, diabetes, hypertension, hypertriglyceridemia, and hypercholesterolemia.

Background: Adoption of a certain dietary pattern is determined by different factors such as taste, cost, convenience, and nutritional value of food. Objective: To assess the association between the daily cost of a diet and its overall quality in a cohort of 6–12-year-old Spanish schoolchildren. Methods: A cross-sectional survey was conducted on a cohort (n = 130, 47% female) of 6–12-year-old children schooled in primary education in the central region of Spain. Three-day 24 h records were administered, and the nutritional quality of the diet was also determined by means of Mediterranean Adequacy Index (MAI). A questionnaire on sociodemographic data, frequency of eating in fast-food restaurants, and supplement intake were also recorded. The person responsible for the child’s diet and the schooler himself completed the questionnaires, and homemade measures were used to estimate the size of the portions. Food prices were obtained from the Household Consumption Database of the Spanish Ministry of Agriculture, Fisheries and Food. The economic cost of the diet was calculated by multiplying the amount in grams of the food consumed by each child by the corresponding price in grams and adding up the total amount for each participant. The total economic cost of the diet was calculated in €/day and in €/1000 kcal/day. Results: The area under the curve (AUC) for €/day and €/1000 kcal/day represent 62.6% and 65.6%, respectively. According to AUC values, adherence to Mediterranean diet (MD) is a moderate predictor of the monetary cost of the diet. A direct relationship between the cost of the diet and the adherence to MD was observed [OR (€/1000 kcal/day) = 3.012, CI (95%): 1.291, 7.026, p = 0.011]. Conclusions: In a cohort of Spanish schoolchildren with low adherence to the MD, a higher cost of the diet standardized to 1000 kcal was associated with above-average MAI values.

Vasomotor symptoms (VMS) are the most common symptoms among menopausal women; these include hot flashes and night sweats, and palpitations often occur along with hot flashes. Some studies in Mexico reported that around 50% of women presented with VMS mainly in the menopausal transition. It has been proven that VMS are not only triggered by an estrogen deficiency, but also by nutritional risk factors. Evidence of an association between nutritional risk factors and VMS is limited in Mexican women. The aim of this study is to identify nutritional risk factors associated with VMS in women aged 40–65 years. This is a comparative cross-sectional study, undertaken in a retrospective way. A sample group (n = 406 women) was divided into four stages according to STRAW+10 (Stages of Reproductive Aging Workshop): late reproductive, menopausal transition, early postmenopause, and late postmenopause. Hot flashes were present mainly in the early postmenopause stage (38.1%, p ≤ 0.001). Two or more VMS were reported in 23.2% of women in the menopausal transition stage and 29.3% in the early postmenopause stage (p < 0.001). The presence of VMS was associated with different nutritional risk factors (weight, fasting glucose levels, cardiorespiratory fitness, and tobacco use) in women living in the northeast of Mexico.

Background: Health-related quality of life (HRQoL) allows knowing the subject’s feelings in distress and well-being, as well as perception of current and future health. Objective: To assess associations between health-related quality of life, fitness status, and adherence to the Mediterranean diet in Spanish children and adolescents. Methods: A cross-sectional study was carried out in a sample of 305 (47.2% women) children and adolescents aged between 8 and 16 years, in the primary and secondary schools of the province of Ávila (central Spain) (NCT05380674). Subjects were classified according to their quality of life: group 1 (highest quality of life) > group 2 (medium quality of life) > group 3 (lowest quality of life). Results: More participants in group 1 showed higher adherence to Mediterranean diet (70.8%) than other groups (group 2: 55.0%; group 3: 43.4%). It was less likely to find optimal levels of muscle strength as quality of life decreased (OR; 95% CI: group 2: 0.535; 0.303–0.955; and group 3: 0.424; 0.234–0.768). Similar trends were found for speed and agility, but only group 3 showed significant results (OR; 95% CI: group 3: 0.297; 0.162–0.545). Flexibility was also the worst in groups 2 and 3 (OR; 95% CI: G2: 0.403; 0.213–0.762; and group 3: 0.520; 0.282–0.958). Conclusion: High fitness status and adherence to the Mediterranean diet were associated with improved health-related quality of life in schoolchildren of central Spain.

Resumen Las infecciones por Candida spp. son una de las principales causas de morbimortalidad en neonatos prematuros, especialmente en neonatos pretermino de muy bajo peso al nacer (peso inferior a 1.500 g). Se realiza una revision de las infecciones por Candida en neonatologia, unidades de cuidados intensivos neonatales en neonatos pretermino de muy bajo peso al nacer, y la conveniencia o no de la utilizacion de profilaxis, principalmente con fluconazol, y de los factores de riesgo asociados a estos neonatos. La utilizacion de profilaxis no es una practica utilizada de forma sistematica en todos los hospitales ni en todas las unidades de intensivos neonatales, dependiendo su implantacion de la incidencia de infeccion por Candida, de la mortalidad asociada y de las caracteristicas particulares del centro hospitalario. Con base en la evidencia cientifica, no se sugiere el uso de profilaxis antifungica de forma rutinaria en todos los neonatos pretermino (grado 2B). Esta se reserva para los neonatos de peso inferior a 1.000 g en centros con alta incidencia de infeccion fungica. Y en estos casos se sugiere la utilizacion de fluconazol frente a otros antifungicos debido a la mayor y mas robusta evidencia.

Background Nutrition is a key factor in determining exercise response. The aim of this review is to assess the response to exercise in older adults who take supplements of antioxidants and/or omega-3 polyunsaturated fatty acids. Methods A systematic literature search was performed (June 2009- September 2019) in MEDLINE via Pubmed. The following search strategy was used with Boolean markers: (“omega-3 fatty acids” [Major] OR “antioxidants” [Major]) AND “exercise” AND “aged” [MesH]. Fourteen articles were finally included. Results Exercise-induced free radical and inflammatory marker blood levels, but not changed the plasma total antioxidant capacity (TAC), after administration of antioxidant supplement. The oral administration of antioxidants produced null or negative effect on endothelial function, but the infusion into the brachial artery during rhythmic handgrip exercise produced a significant improvement in muscle blood flow, due to an on increase in the availability of nitric acid derived from the nitric oxide synthase. Aerobic exercise and antioxidant supplementation improved submaximal and maximal aerobic parameters, as well as mitochondrial density and mitochondria-regulated apoptotic signaling. Antioxidant supplementation, but not omega-3 PUFA, decreased pro-inflammatory marker levels and fat oxidation induced by exercise. Strength training decreased serum B12 concentration but combined with omega-3 PUFA or antioxidant supplementation, B12 levels were maintained. Antioxidant supplementation has protective effect after fatigue in isometric exercise but improved appendicular fat-free mass just combined with resistance exercise. Omega-3 fatty acid supplement combined with exercise increased lean mass in women, but not in men. Muscle damage induced by exercise is protected by antioxidant supplementation. Conclusions Older people who take antioxidant and/or omega-3 PUFA supplements showed improved exercise response, as well as lower muscle damage.

Objetivos: Analizar los principales patrones de consumo de alimentos de los estudiantes universitarios de Zamora y su asociación con los diferentes grupos de alimentos.Métodos: Estudio transversal, descriptivo y observacional sobre una muestra representativa de los estudiantes universitarios de la provincia de Zamora (n=213; 18-29 años). El consumo de alimentos se determinó mediante un cuestionario validado semicuantitativo de frecuencia de consumo, que incluía 64 alimentos, reunidos en 13 grupos. Los patrones de consumo se determinaron por análisis factorial.Resultados: Los estudiantes universitarios de Zamora muestran dos patrones de consumo: “Mediterráneo”, que explica un 19.4% de la varianza total y se caracteriza por un consumo de lácteos, pescado y mariscos, carnes y legumbres, embutidos, cereales y tubérculos, fruta y verduras y aceite de oliva, y “Occidental”, que explica un 22.2% de la varianza total y se caracteriza por un consumo de lácteos, huevos, carnes y legumbres, embutidos, frutos secos, otras grasas distintas del aceite de oliva, bollería y dulces, alimentos preparados y bebidas azucaradas, con bajo consumo de fruta y verduras. El análisis factorial presenta una medida de adecuación de la muestra (KMO) de 0.615. Conclusiones: Los estudiantes universitarios de Zamora se encuentran en de transición nutricional, con una dieta que se aleja de las recomendaciones de la Dieta Mediterránea.

Purpose: The main objective was to evaluate the usefulness of early ultrasonography for determining prognosis Ultrasonography schemic colitis of patients with ischemic colitis. Materials and methods: We reviewed the histories of patients with diagnosis of ischemic colitis over a period of 11 years. Two hundred twenty nine patients with ischemic colitis were included. Demographic, clinical, laboratory and sonographic findings were retrospectively analyzed. Patients were divided into two groups according to the outcome: mild (those who improved with conservative treatment) or severe (those who died or required surgery), and the findings of each group were compared. In addition, we developed a predictive model of multivariate logistic regression analysis, and then it was validated in a different population of 58 consecutive patients with ischemic colitis. Results: The mild ischemic colitis group consisted of 184 patients (age 74,7 +/- 8,8 years), and the severe group of 45 patients (age 78,6 7,7 years). More pancolitis (p = 0.005), altered pericolic fat (p = 0.032) and free fluid (p = 0.013) was observed in the severe ischemic colitis group compared with the mild group. Severe ischemic group had lower wall thickness (p = 0.020) and higher resistive index than mild group (p = 0.025). Multivariate analysis identified as protective factors to severe ischemic colitis: pain (p = 0.026), diarrhea (p = 0.034), rectal bleeding (p = 0.000), and hypertension (p = 0.001). Altered pericolic fat (p = 0.008) and pancolitis (p = 0.017) were sonographic findings significantly related to severe ischemic colitis. Our model correctly classified 88.4% of the study patients and 89.6% of the population of 58 patients used in validation. Conclusions: Sonographic features with clinical findings can predict the outcome of ischemic colitis. Our predictive model could differentiate properly between patients with mild or severe ischemic colitis.

Aim Our aim was to analyse the feasibility of integrating an MRI acquired in a non-radiotherapy set-up into the prostate cancer radiotherapy workflow. Material and methods The MRIs of 15 prostate cancer patients, acquired with a flat table-top (MRI-flat), and with a curved tabletop (MRI-curve) were analysed. MRIs were rigidly (RIR) and non-rigidly registered (DIR) with CT images. The prostate and rectum were contoured in each image set and translated to the CT, and IMRT plans were computed taking into account structural changes after RIR and DIR (P-flat RIR , P-curve RIR and P-curve DIR ). In addition the P-curve DIR was overlaid with RIR structures. Spatial overlap parameters and dose-volume histogram metrics were generated. Results No significant differences were observed among P-flat RIR and P-curve RIR or P-flat RIR and P-curve DIR . Median gamma-values: P-curve RIR , 95.3%; P-curve DIR , 96%, translated-P-curve DIR , 95%. DVH metrics for translated-P-curve DIR were: D min , 64.5Gy; D mean , 70.06Gy; V95%, 100%. No statistically significant differences were found in the dosimetric MRI-flat DIR values. Conclusions The dosimetric reproduction of treatment position image following image registration of non-radiotherapy set-up images suggests that it is feasible to integrate these images into the radiotherapy workflow.

The purpose of this study was to describe the sonographic findings of 58 patients with proven ischemic colitis and to evaluate whether any of the findings are related to the presence or development of transmural necrosis.We reviewed the histories of patients diagnosed with ischemic colitis over a period of 5.5 years. Sixty-two patients had undergone sonographic examinations. The spectrum of sonographic findings in ischemic colitis was based on the original imaging report, with an analysis of the presence of colonic abnormalities and their associated alterations. In the second part of the study, we divided the patients into two groups according to the presence or absence of transmural necrosis, and the sonographic findings of each group were compared. Ten patients had sonographic follow-up studies during their hospital stay.The prospective sensitivity of sonography for the characterization of colonic abnormalities was 93.5% (58/62 patients). Segmental involvement was detected in 57 of the 58 patients, with left-sided colitis in 47 (81%). The mean length of bowel involved was 19 cm, with a mean wall thickness of 7.6 mm. Colon wall stratification was preserved in 38 patients (66%). Altered pericolic fat was observed in 16 patients (28%). Absence of or barely visible color Doppler flow in the thickened bowel wall was recorded in 80% of patients. Altered pericolic fat was the only sonographic variable significantly associated with the presence of transmural necrosis (p = 0.004). Improvement as assessed on sonography was observed in all patients with a good clinical course. In patients with transmural necrosis, sonography did not show improvement.Sonography is a valuable technique for the detection of colonic abnormalities resulting from ischemic colitis. In this study, altered pericolic fat or the absence of improvement in sonographic follow-up studies were factors associated with transmural necrosis.