Evaluación de resultados en el tratamiento quirúrgico de las fracturas aisladas de cabeza de radio en el adulto

Presentamos una serie de 35 pacientes intervenidos en nuestro servicio por fractura aislada de cabeza de radio. El objetivo ha sido evaluar el resultado funcional del tratamiento quirúrgico de estas fracturas en el adulto, la correlación de los diferentes sistemas de evaluación de resultados y determinar los factores pronóstico. Las fracturas se clasificaron según Mason evaluando los resultados utilizando la escala de valoración del hospital par cirugía especial (HSSA) de Inglis y Pellici, el índice de clasificación funcional de Broberg y Morrey y la escala de evaluación funcional del codo de la Clínica Mayo. En más del 80% de los casos se obtuvieron resultados buenos ó excelentes, con una flexión media de 139% y un déficit de extensión de 10º. Los tres métodos de valoración mostraron un índice de concordancia estadísticamente significativo resultado por tanto ser equiparables. El retraso en la cirugía resultó ser un factor pronóstico en el resultado final (p<0.05) mientras que el tipo de fractura y de cirugía muestran tendencia a influir en el resultado final.Functional outcome after surgery for isolated radial head fractures in adults was assessed using three different outcome assessment approaches and favourable prognostic factors were determined. Thirty-five patients with radial head fractures were operated. Fractures were grouped according to the Mason classification, and the results obtained were assessed by means of the hospital for special surgery assessment (HSSA) system. Broberg and Morrey functional classification index and the Mayor Clinic elbow functional in over 80% of cases, with an average flexion of 139 degrees and an extension defect of 10 degrees. All three assessment system yielded statistically significant concordant scores, and was thus considered to be equivalent. Surgical delay proved to be a significant prognostic factor of the end result (p<0.05), while the type of fracture and surgery employed tended to influence outcome

Necrosis avascular de cabeza femoral en pacientes con enfermedad de Gaucher tipo I : tratamiento mediante artroplastia total de cadera no cementada

El 80% de los pacientes con enfermedad de Gaucher presentan manifestaciones óseas, siendo la necrosis avascular de la cabeza femoral una de las que mayor limitación produce y la primera causa de intervención quirúrgica osteoarticular. La artroplastia total de cadera cementada ha sido el tratamiento de elección en los casos con mayor deterioro de la articulación, pero sus resultados a medio y largo plazo se han visto ensombrecidos por la elevada tasa de aflojamiento. La terapia enzimática sustitutiva ha disminuido las complicaciones postoperatorias, además de permitir el uso de componentes no cementados con resultados similares a las prótesis implantadas por otros motivos. Presentamos una serie de 5 artroplastias de cadera no cementadas, con un seguimiento medio de 12.4 años (3.4-30), en 4 pacientes con enfermedad de Gaucher tipo I y osteonecrosis de la cabeza femoral. Solo se observó un caso de aflojamiento aséptico a los 18 años de la intervención

Osificación Heterotópica Coxofemoral secundaria a Encefalitis Herpética : a propósito de un caso y revisión de la literatura

Heterotopic ossification is the abnormal formation of bone in soft tissues outside the skeleton. It is associated with nervous system injuries or after a hip replacement. It is therefore a relevant pathology against which there is a controversial diagnostic and therapeutic attitude. We report a case of a patient of 36 year who developed heterotopic ossification after herpetic encephalitis. We also review the published studies collecting the current recommendations for diagnosis, prevention and treatment

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Search for the standard model Higgs boson in the H to ZZ to 2l 2nu channel in pp collisions at sqrt(s) = 7 TeV

A search for the standard model Higgs boson in the H to ZZ to 2l 2nu decay channel, where l = e or mu, in pp collisions at a center-of-mass energy of 7 TeV is presented. The data were collected at the LHC, with the CMS detector, and correspond to an integrated luminosity of 4.6 inverse femtobarns. No significant excess is observed above the background expectation, and upper limits are set on the Higgs boson production cross section. The presence of the standard model Higgs boson with a mass in the 270-440 GeV range is excluded at 95% confidence level.Comment: Submitted to JHE

Combined search for the quarks of a sequential fourth generation

Results are presented from a search for a fourth generation of quarks produced singly or in pairs in a data set corresponding to an integrated luminosity of 5 inverse femtobarns recorded by the CMS experiment at the LHC in 2011. A novel strategy has been developed for a combined search for quarks of the up and down type in decay channels with at least one isolated muon or electron. Limits on the mass of the fourth-generation quarks and the relevant Cabibbo-Kobayashi-Maskawa matrix elements are derived in the context of a simple extension of the standard model with a sequential fourth generation of fermions. The existence of mass-degenerate fourth-generation quarks with masses below 685 GeV is excluded at 95% confidence level for minimal off-diagonal mixing between the third- and the fourth-generation quarks. With a mass difference of 25 GeV between the quark masses, the obtained limit on the masses of the fourth-generation quarks shifts by about +/- 20 GeV. These results significantly reduce the allowed parameter space for a fourth generation of fermions.Comment: Replaced with published version. Added journal reference and DO