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The role of parathyroid hormone (PTH)-related protein (PTHrP) in breast cancer remains controversial, with reports of PTHrP inhibiting or promoting primary tumor growth in preclinical studies. Here, we provide insight into these conflicting findings by assessing the role of specific biological domains of PTHrP in tumor progression through stable expression of PTHrP (-36-139aa) or truncated forms with deletion of the nuclear localization sequence (NLS) alone or in combination with the C-terminus. Although the full-length PTHrP molecule (-36-139aa) did not alter tumorigenesis, PTHrP lacking the NLS alone accelerated primary tumor growth by downregulating p27, while PTHrP lacking the NLS and C-terminus repressed tumor growth through p27 induction driven by the tumor suppressor leukemia inhibitory factor receptor (LIFR). Induction of p27 by PTHrP lacking the NLS and C-terminus persisted in bone disseminated cells, but did not prevent metastatic outgrowth, in contrast to the primary tumor site. These data suggest that the PTHrP NLS functions as a tumor suppressor, while the PTHrP C-terminus may act as an oncogenic switch to promote tumor progression through differential regulation of p27 signaling.

Introducción: Uruguay es el primer país en modificar la legislación sobre el consumo recreativo de cannabis, mediante la Ley 19.172 del 20 de diciembre de 2013, otorgando al Estado la potestad de regular su producción y comercialización. Objetivo: evaluar las prevalencias de la autodeclaración del consumo de marihuana, tabaco, alcohol, cocaína y derivados y su evolución temporal en embarazadas para los años 2013 y 2016. Metodología: estudio descriptivo, transversal y analítico, durante dos períodos de tiempo, en 2013 y 2016. Se incluyeron mujeres que tuvieron su parto y puerperio inmediato en el Centro Hospitalario Pereira Rossell (CHPR) de Montevideo, Uruguay. Se realizó una encuesta protocolizada sobre su nivel sociodemográfico, años de educación formal, datos del embarazo, parto, recién nacido y consumo de sustancias antes y durante la gestación. Resultados: en la investigación participaron 577 mujeres, 319 correspondientes a las entrevistas realizadas en el año 2013 y 258 en 2016. Respecto al alcohol, 76 (23,82%) mujeres declaran su consumo durante el embarazo en 2013, mientras que, en 2016, 91 (35,3%) (p=0,003). En cuanto al tabaco, 59 (43%) dejaron de fumar al enterarse del embarazo en 2013 y 69 (60%) en 2016 (p=0,008). En 2013, 41 mujeres (12,85%) fumaron marihuana hasta saber del embarazo y 79 (30%) en 2016 (p<0,001). Durante la gestación, en 2013 declararon fumar marihuana 5 mujeres (1,57%), mientras que en 2016 fueron 28 (10,85%) (p<0,001). El uso de cocaína y pasta base de cocaína (PBC) no cambió significativamente entre 2013 y 2016. Conclusiones: Entre los años 2013 y 2016 se observó un aumento significativo en la autodeclaración del consumo de marihuana y alcohol antes y durante el embarazo. El consumo de cocaína y pasta base de cocaína se mantuvo estable en ese periodo. El consumo de tabaco disminuyó significativamente en mujeres embarazadas. 

The use of wearable technology is steadily increasing. In orthopedic trauma surgery, where the musculoskeletal system is directly affected, focus has been directed towards assessing aspects of physical functioning, activity behavior, and mobility/disability. This includes sensors and algorithms to monitor real-world walking speed, daily step counts, ground reaction forces, or range of motion. Several specific reviews have focused on this domain. In other medical fields, wearable sensors and algorithms to monitor digital biometrics have been used with a focus on domain-specific health aspects such as heart rate, sleep, blood oxygen saturation, or fall risk. This review explores the most common clinical and research use cases of wearable sensors in other medical domains and, from it, derives suggestions for the meaningful transfer and application in an orthopedic trauma context.

The diagnosis and treatment of non-unions still represents an interdisciplinary challenge. Therefore, prevention, early detection and specific treatment are of great importance. Non-unions of the upper extremities, although less common than that of the lower extremities, requires special attention for successful treatment due to the central role of the shoulder girdle and arm in day to day activities. Successful treatment of non-unions requires a comprehensive evaluation of the patient's medical history, a thorough clinical examination and in particular radiological imaging. In order to effectively treat the pseudarthrosis it is crucial to distinguish between pseudarthroses that are suspected to be due to infections and those that are not. This article presents a treatment algorithm for managing both pseudarthrosis due to infection and pseudarthrosis without infection in the upper extremities.

Background/Objectives: Using a patient’s own wearable sensor to obtain objective outcome data is a growing field in trauma allowing for the assessment of the recovery trajectory back toward the pre-injury performance. The aim of this study was to analyze recruitment characteristics and reasons for declined study participation in an orthopedic trauma study that measures postoperative recovery using wearables. Methods: Data from 225 patients screened for participation in a wearable-sensor-based outcome study were assessed. The influence of age, sex and injury location on study participation was analyzed. Reasons for patients declining to participate were investigated from the screening log. Availability and type of sensor system in patients agreeing to participate were analyzed. Results: Overall, 48% of patients agreed to participate. Age was the only significantly different factor between agreeing and declining patients (p < 0.05). The main reasons to decline study participation were technical difficulties with or inability to use the wearable device, lack of availability of a wearable, and general disinterest to participate in a study. Notably, 7% declined due to data safety concerns. Conclusions: The results show that age, availability of the wearable, and technical ability to use a wearable are the main obstacles impacting objective outcome measurement using a personal wearable device. In studies including geriatric patients, a dedicated device requiring no patient handling can be a valid option to improve enrollment. Understanding the reasons for declining to participate will facilitate the development of future sensor-based studies to address concerns of technical handling through alternative means of data harvesting and increase the inclusion rate. These outcomes will guide future study designs to optimize patient inclusion.

Uruguay passed Law 19.172 on December 20, 2013, thus enabling the State to regulate the production, distribution, sale, and consumption of cannabis. to determine the change in maternal self-report of marijuana, tobacco, alcohol, and cocaine use during pregnancy between 2013 and 2016. cross-sectional, descriptive, analytical study between 2013 and 2016. The sample consists of pregnant woman who delivered and received immediate postpartum care at the Centro Hospitalario Pereira Rossell in Montevideo, Uruguay. The instrument was a protocolized survey that assessed outcomes such as sociodemographic level, years of formal education, data on pregnancy, childbirth, newborn, and substance use before and during pregnancy. the sample consisted of 577 pregnant women, 319 corresponding to interviews conducted in 2013 and 258 in 2016. Regarding alcohol intake, 76 (23.82%) women reported drinking while pregnant in 2013, whereas in 2016, 91 (35.3%) (p=.003) did so. As for tobacco, 59 (43%) quit smoking when they found out about their pregnancy in 2013, and 69 (60%) quit in 2016 (p=.008). In 2013, 41 women (12.85%) smoked marijuana until they discovered their pregnancy, and 79 (30%) did so in 2016 (p < .001). The use of cocaine and its derivatives did not change significantly between 2013 and 2016. between 2013 and 2016, there was a significant increase in the self-report of marijuana and alcohol consumption before and during pregnancy. The consumption of cocaine and cocaine base paste remained stable during this period. Tobacco use decreased significantly in pregnant women.

Zusammenfassung Die Diagnose und Behandlung von Pseudarthrosen stellt nach wie vor eine interdisziplinäre Herausforderung dar. Prävention, Früherkennung und gezielte Behandlung sind daher von großer Bedeutung. Pseudarthrosen der oberen Extremität sind insgesamt seltener als solche der unteren Extremität, bedürfen aber aufgrund der zentralen Rolle von Schultergürtel und Arm in der Alltagsbewältigung besonderer Aufmerksamkeit für den Behandlungserfolg. Die ausführliche Anamnese, die klinische Untersuchung und insbesondere die radiologische Bildgebung sind die Grundpfeiler einer erfolgreichen Therapie. Dabei ist die Unterscheidung zwischen infektverdächtigen und nichtinfektverdächtigen Pseudarthrosen von entscheidender Bedeutung für eine zielführende Therapie.

Introducción: Uruguay es el primer país en modificar la legislación sobre el consumo recreativo de cannabis, mediante la Ley 19.172 del 20 de diciembre de 2013, otorgando al Estado la potestad de regular su producción y comercialización. Objetivo: evaluar las prevalencias de la autodeclaración del consumo de marihuana, tabaco, alcohol, cocaína y derivados y su evolución temporal en embarazadas para los años 2013 y 2016. Metodología: estudio descriptivo, transversal y analítico, durante dos períodos de tiempo, en 2013 y 2016. Se incluyeron mujeres que tuvieron su parto y puerperio inmediato en el Centro Hospitalario Pereira Rossell (CHPR) de Montevideo, Uruguay. Se realizó una encuesta protocolizada sobre su nivel sociodemográfico, años de educación formal, datos del embarazo, parto, recién nacido y consumo de sustancias antes y durante la gestación. Resultados: en la investigación participaron 577 mujeres, 319 correspondientes a las entrevistas realizadas en el año 2013 y 258 en 2016. Respecto al alcohol, 76 (23,82%) mujeres declaran su consumo durante el embarazo en 2013, mientras que, en 2016, 91 (35,3%) (p=0,003). En cuanto al tabaco, 59 (43%) dejaron de fumar al enterarse del embarazo en 2013 y 69 (60%) en 2016 (p=0,008). En 2013, 41 mujeres (12,85%) fumaron marihuana hasta saber del embarazo y 79 (30%) en 2016 (p<0,001). Durante la gestación, en 2013 declararon fumar marihuana 5 mujeres (1,57%), mientras que en 2016 fueron 28 (10,85%) (p<0,001). El uso de cocaína y pasta base de cocaína (PBC) no cambió significativamente entre 2013 y 2016. Conclusiones: Entre los años 2013 y 2016 se observó un aumento significativo en la autodeclaración del consumo de marihuana y alcohol antes y durante el embarazo. El consumo de cocaína y pasta base de cocaína se mantuvo estable en ese periodo. El consumo de tabaco disminuyó significativamente en mujeres embarazadas. Palabras clave: Cannabis; Tabaco; Alcohol; Embarazo; Autodeclaración. Background: Uruguay passed Law 19.172 on December 20, 2013, thus enabling the State to regulate the production, distribution, sale, and consumption of cannabis. Objectives: to determine the change in maternal self-report of marijuana, tobacco, alcohol, and cocaine use during pregnancy between 2013 and 2016. Methods: cross-sectional, descriptive, analytical study between 2013 and 2016. The sample consists of pregnant woman who delivered and received immediate postpartum care at the Centro Hospitalario Pereira Rossell in Montevideo, Uruguay. The instrument was a protocolized survey that assessed outcomes such as sociodemographic level, years of formal education, data on pregnancy, childbirth, newborn, and substance use before and during pregnancy. Results: the sample consisted of 577 pregnant women, 319 corresponding to interviews conducted in 2013 and 258 in 2016. Regarding alcohol intake, 76 (23.82%) women reported drinking while pregnant in 2013, whereas in 2016, 91 (35,3%) (p=.003) did so. As for tobacco, 59 (43%) quit smoking when they found out about their pregnancy in 2013, and 69 (60%) quit in 2016 (p=0,008). In 2013, 41 women (12.85%) smoked marijuana until they discovered their pregnancy, and 79 (30%) did so in 2016 (p < .001). The use of cocaine and its derivatives did not change significantly between 2013 and 2016. Conclusions: between 2013 and 2016, there was a significant increase in the self-report of marijuana and alcohol consumption before and during pregnancy. The consumption of cocaine and cocaine base paste remained stable during this period. Tobacco use decreased significantly in pregnant women. Key Words: Cannabis; Tobacco; Alcohol; Pregnancy; Self-report.