Background/Objective: The aim of this study was to describe the evolution of total and regional fat mass according to gender, and to establish age and gender-related differences in a largely non-obese sedentary Spanish sample population using dualenergy X-ray absorptiometry (DXA). Subject/Methods: A total of 1113 healthy subjects (397 male and 716 female) from the city of Alcalá de Henares (Madrid), Spain, were used in the study. Fat mass measures were obtained from DXA scans of all subjects. Total body fat and body fat in three subregions (trunk, arms and legs) were evaluated. Results: As opposed to males, females showed from early infancy a smaller rate of muscular mass and a larger percentage of body fat (from 10 years of age), with fat deposits being basically gynoid or peripheral. With age, females showed a greater increase in fat mass together with an accelerated loss of muscular mass. Both rates tended to level out between 51 and 65 years of age. Between the ages of 40 and 60, females exhibited significant morphological evidence of larger fat depots in their legs. Conclusions: Gender differences in the patterns of proportion and distribution of body fat, as well as in the pattern of body fat evolution, were found from early infancy. Further research is required, including assessing fat mass variables in order to unravel the dynamic of body composition and to understand the complex relationship between trunk fat mass deposits and the health risks associated with obesity.

The purpose of this article was to describe and explain our experience with Anatomage table in the process of teaching and learning anatomy to medicine students who are preparing as military physicians. Anatomage combines stereoscopic images of the whole body with software in order to build a 3-dimensional (3-D) reconstruction of the different human body parts. These images were taken from two cadavers, male and female, who were frozen and cut into sections to allow for virtual dissection and reconstruction of the human body. Users can visualize anatomy exactly as they would on a fresh cadaver. The table allows for exploration and learning of human anatomy beyond the experience with a cadaver. It is possible to cut away from the body surface to the inner body using a scalpel, as well as to watch images of 3-D sections in the three spatial planes.We described the importance of dissection in practical anatomy teaching, and the large number of body donations needed. Thus, many authors have proposed different solutions, such as software with reconstructions of the human body. Anatomage allows for anatomy teaching and learning in an interactive way. Students can practice actively and take the images watched in a practical session with them in a storage device, in order to study and discuss them later in a lecture. Anatomage is also used for practical anatomy exams to students. Despite being rather costly, it stimulates the learning of anatomy by being directly used by students in various ways.

We have determined an evolutionary normal pattern of bone mineral content in urban Spanish people.

Aim The short-term results of the use of seprafilm® as a reinforcement of the peritoneum are presented. Material and Methods Seprafilm® was used in 5 patients with large midline and lateral incisional hernia in which Transversus Abdominis Release Technique was performed in which it was necessary to explant mesh previously. This weakness of the peritoneum was reinforced with the seprafilm® plates, to isolate the intra-abdominal contents from the mesh. Results The patients treated had an average stay of 6.6 days. All of them carried drains. There were no infectious complications in surgical site. There were no prolonged pain. All of them began tolerance the day after the surgery. At one month of the surgical intervention, there were no signs of infection, seroma or higher pain than 3 on the EVA scale. Discussion Post-operative adhesions to mesh are related to intestinal fistulas. The use of preperitoneal space to place the mesh is a good option, although sometimes it can have continuity problems, especially when there are explants of previous materials. The use of barrier materials is appropriate in these cases. Conclusion The use of Seprafilm® can be a good option as a barrier between viscera and prostheses for the prevention of adhesions.

Objective: To identify factors associated with the higher proportion of fatty tissue and overweight/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4–15 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 > 4.2 for oligoarticular JIA or >8.5 for polyarticular disease) had higher values for BMI (p = 0.006); total fat mass (p = 0.003); FMI (p = 0.001); and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02–1.04]; p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07–0.68]; p = 0.010), while the factors associated with FMI were age (β [95% CI] = 0.30 [0.17–1.41]; p = 0.014), JADAS27 (β [95% CI] = 0.45 [0.16–1.08]; p = 0.009), and physical activity (β [95% CI] = −0.22 [−5.76 to 0.29]; p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.

Two heat treatments were carried out at below (Ti6Al4V800) and above (Ti6Al4V1050) the beta-phase transformation temperature (TTRANSUS = 980 °C), to study the effect of microstructural changes on osseointegration. The alloys were implanted in the femurs of hind legs of Wistar rats for 15, 30, and 60 days. Histology of the femur sections obtained for the first 15 days showed inflammatory tissue surrounding the implants and tissue contraction, which prevented osseointegration in early stages. After 30 days, trabecular bone, reduction of inflammatory tissue around the implants, and osseointegration were observed in Ti6Al4V as received and Ti6Al4V1050 alloys, while osseointegration was detected for the three alloys after 60 days. These results were supported through morphometric studies based on the analysis of Bone Implant Contact (BIC), where there was a larger bone contact after 60 days for the Ti6Al4V1050 alloy; indicating that microstructural features of the Ti6Al4V alloys influence their osseointegration, with the lamellar microstructure (Ti6Al4V1050), being the most responsive.

Background:In recent years, several studies show contradictory results regarding body composition in juvenile idiopathic arthritis. Adiposity in Rheumatoid Arthritis and Psoriasic Arthritis has been associated to inflammatory activity, but it is not clear what happens in JIA.Objectives:To describe the body composition and anthropometric parameters of patients with JIA compared with healthy controls and analyze associated risk factors in JIA patients.Methods:Observational cross-sectional study in spanish children aged 4-15 years with JIA compared with healthy controls matched for age and sex. We recorded epidemiological variablesanthropometric parameters, clinical data and validated physical activity questionnaires. Body composition was measured using dual-energy x-ray absorptiometry (DXA), and included total mass (kg), fat mass (g), lean mass (g), and lean mass and android and gynoid fat mass. The fat mass index (FMI) was defined as fat mass (kg)/height squared (m2) and fat-free mass index (FFMI) as fat-free mass (kg)/height squared (m2). Descriptive, bivariete and two multivariate models were constructed to identify factors associated with obesity and fat mass in JIA patients.Results:We analyze 160 subjects: 80 patients with JIA and 80 healthy controls.The baseline characteristics of both groups are shown in Table 1. No differences were found between both groups in BMI (p=0.936), fat mass (p = 0.449), lean mass (p = 0.793) and in fat and lean mass of legs, arms and trunk, or in physical activity questionnaire (p = 0.582). The factors associated with obesity in patients with JIA were: time with biological drug (OR [95% CI] = 1.12 [1.01-1.04]; p = 0.042) and sedentary lifestyle (OR [95% CI] = 3.50 [1.18-7.35]; p = 0.023); while the factors associated with the fat mass index were: age (ß [95% CI] = 0.30 [0.16-1.41]; p= 0.014), inflammatory activity (JDAS) (ß [95% CI] = 0.44 [0.16-1.08]; p= 0.009) and physical activity (ß [95% CI] = -0.22 [-0.10,-0.28]; p = 0.031).Table 1.Baseline characteristics of patients with JIA and controlsVariableJIA (n=80)Controls (n=80)P-value Sex, girls n (%)56 (70.0)57 (71.3)0.862 Age, mean (SD)10.7 (3.2)10.2 (3.2)0.893Disease duration (years) JIA, mean (SD)6.5 (3.7)JIA subtype Systemic, n (%)9 (11.3) Oligoarticular persistent, n (%)38 (47.5) Oligoarticular extended, n (%)13 (16.3) Rheumatoid Factor-positive polyarticular, n (%)1 (1.3) Rheumatoid Factor-negative polyarticular, n (%)19(23.8)CRP (mg/l), mean (SD)4,8 (9,5)ESR (mm/h), mean (SD)8.8 (7,3)JADAS27, mean (SD)2 (4.0)CHAQ, mean (SD)0.17 (0.4)Treatment DMARDs (synthetic), n (%)42 (52.5) DMARDs (biological), n (%)24 (30.0) Anti IL-1, n (%)4 (16.7) Anti IL-6, n (%)2 (8.3) Anti TNF-α, n (%)18 (75.0)Treatment duration DMARDs synthetic, (months), mean (±SD)51 (37.5) DMARDs biological, (months), mean (±SD)19.7 (28.4) DMARDs total (months), mean (±SD)55.8 (38.0)Cumulative corticoisteroids dose, median (range)11.3 (0.12-870)Abreviaturas; JIA: juvenile idhipathic arthritis; SD: standart deviation; CRP: C-reactive protein; VSG:erytrocyte sedimentation rate; JADAS27: Juvenile Arthritis Disease Activity Score; CHAQ: Childhood Health Assessment; DMARD: disease-modifyng anti-rheumatic drug.Conclusion:Children with JIA have adiposity similar to healthy controls. Inflammatory activity measured by JDAS is associated with fat mass but not to anthropometric measurements such as body mass index (BMI).References:[1]Grönlund et al Juvenile idiopathic arthritis patients with low inflammatory activity have increased adiposity. Scand J Rheumatol 2014.[2]Giani et al. The Influence of Overweight and Obesity on Treatment Response in Juvenile Idiopathic Arthritis. Front Pharmacol 2019[3]Wiech et al. Body composition and phase angle as an indicator of nutritional status in children with juvenile idiopathic arthritis. Pediatric Rheumatology 2018[4]Alvarez-Nemegyei et al. Association between Overweight/Obesity and Clinical Activity in rheumatoid arthritis. Reumatol Clin 2020Disclosure of Interests:None declared

A B S T R A C TMeckel's diverticulum it is the most common malformation of the gastrointestinal tract. Femoral hernia is the second most common inguinal hernia, and is characterized by incarceration and strangulation. We present a case of 90-year-old woman wiht strangulation of Meckel's diverticulum in a left-sided femoral hernia. The diverticulum was resected and hernia was repared wihtout complications. A Littre's hernia is a complication of Meckel's diverticulum and it is a result of its protrusion through a herniary orifice. Surgical resection is recommended for this type of hernia due to possible vascular complications, intestinal obstruction and herniation. Although usually Littre's hernia appears in the early ages of the life, we must not ignore their possible appearance in people who are aged. We present in this case a Littre's hernia in a very old woman.