176 research outputs found

    Luxación Posterior de Hombro

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    Se presentan cuatro casos de luxación posterior de hombro , de etiología trau - mática aguda . Se realiza una reseña de las características anatomopatológicas, del estudio clínico y radiográfico así como del tratamiento que fué conservador en todos los casos, utilizándose sólo en dos casos de reducción inestable fijación con agujas de Kirschner. La valoración de los resultados fué uniformemente buenaTh e author s repor t fou r case s o f posterio r shoulde r dislocatio n o f traumati c etiology , emphasizin g th e followin g aspects: Clinica l an d X-ra y traits, the - rapeuti c procedure s an d follow-u p results. Tw o case s wer e treate d withou t surger y a n d anothe r tw o stabilizatio n wit h Kirschne r wire s wa s used . En d results wer e uniformel y good

    Luxación Acromioclavicular en los Niños

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    Se presentan cuatro pacientes con diagnóstico de pseudoluxación acromioclavicular tratados en nuestro Hospital. Se describen los tratamientos realizados y se discute la conveniencia de realizar tratamiento quirúrgico de los casos con mayor desplazamiento en pacientes menores de quince años a fin de evitar la aparición de una clavicula en "Y". Mantienen la misma indicación en pacientes de más edad en los que la anatomía patológica presenta similitud y en los que , aunque el periostio no tiene ya esa capacidad de neoformación, el proceder quirúrgico logra un buen a reducción estable.Th e author s presen t fou r case s o f patients wit h a diagnosis o f acro - mioclavicula r pseudodislocatio n treate d i n thei r hospital . The y describ e th e treatments carrie d ou t an d discuss th e suitabilit y o f surger y i n case s o f majo r displace - men t in patients younge r tha n 1 5 year s o f age , s o a s t o avoi d th e occurrenc e o f a "Y" clavicle . The y suppor t th e sam e suggestio n i n th e cas e o f olde r patients whe n the y sho w a simila r pathologica l anatom y an d surger y is expecte d t o achiev e a goo d an d stabl e reduction , althoug t thei r periostiu m keep s a neoformin g capabilit y an y more

    Hemangioendotelioma de Humero

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    Se describe un caso de hemangioendotelioma grado I, que afectaba a la epífisis humeral superior en una paciente de cincuenta y siete años, presentándose clínicamente como una periartritis escapulo humeral. Se comenta el diagnóstico diferencial y el tratamiento que fué de resección local y sustitución del tercio superior del húmero por una prótesis isoelástica, más radioterapia complementaria. Después de ocho meses no hay evidencia de recidiva local o sistémica, ha desaparecido el dolor y la funcionalidad de la extremidad es aceptable. Se destaca la importancia del estudio anatomopatológico como guía casi única para el diagnóstico y la necesidad de realizar la gradación histológica de la malignidad como base para emitir un pronóstico e indicar la terapéutica, así como el rastreo del resto del esqueleto, tanto ante la lesión primaria como en las sucesivas revisiones.This is a report on a case of Hemangioendothelioma grade I located over the uppe r humeral epiphysis, in a woman aged 57, and mimicing scapulohume - ral periarthitis. The authors detail differential diagnosis and treatment consisting of partial ablation and us e a humeral isoelastic prosthesis as well as complementary radioterapy. After 8 months there is no evidence of local recidives or systemic, no pain, and the function of the limb is acceptable. They emphazise the importance of the pathologic as a true valid guidanc e concerning the diagnosis, and the necessity of a histologic typing to set both pronosti c and terapeutic planing. General skeletic X-Ray examination in the benning and also during the follow-up is also of paramount importance

    Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics

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    Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single appointment. We aimed to evaluate the clinical outcomes at HR-TNCs. Design and Methods: A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain. We evaluated fine-needle aspiration (FNA) indications and the association between clinical and ultrasound characteristics with cytological and histopathological outcomes. Results: A total of 2809 thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications, significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid component were independently associated with increased odds of malignancy. Thyroid nodules <20 mm and ≥20–<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively in comparison with those ≥40 mm. Conclusion: In this large multicenter study, we found that the presence of a solid component and irregular margins are factors independently related to malignancy in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy, this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with a low rate of nondiagnostic FNA

    Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis : Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model

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    Accurate prognostic tools are crucial to assess the risk/benefit ratio of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with myelofibrosis (MF). We aimed to evaluate the performance of the Myelofibrosis Transplant Scoring System (MTSS) and identify risk factors for survival in a multicenter series of 197 patients with MF undergoing allo-HCT. After a median follow-up of 3.1 years, 47% of patients had died, and the estimated 5-year survival rate was 51%. Projected 5-year risk of nonrelapse mortality and relapse incidence was 30% and 20%, respectively. Factors independently associated with increased mortality were a hematopoietic cell transplantation-specific comorbidity index (HCT-CI) ≥3 and receiving a graft from an HLA-mismatched unrelated donor or cord blood, whereas post-transplant cyclophosphamide (PT-Cy) was associated with improved survival. Donor type was the only parameter included in the MTSS model with independent prognostic value for survival. According to the MTSS, 3-year survival was 62%, 66%, 37%, and 17% for low-, intermediate-, high-, and very high-risk groups, respectively. By pooling together the low- and intermediate-risk groups, as well as the high- and very high-risk groups, we pinpointed 2 categories: standard risk and high risk (25% of the series). Three-year survival was 62% in standard-risk and 25% in high-risk categories (P <.001). We derived a risk score based on the 3 independent risk factors for survival in our series (donor type, HCT-CI, and PT-Cy). The corresponding 5-year survival for the low-, intermediate-, and high-risk categories was 79%, 55%, and 32%, respectively (P <.001). In conclusion, the MTSS model failed to clearly delineate 4 prognostic groups in our series but may still be useful to identify a subset of patients with poor outcome. We provide a simple prognostic scoring system for risk/benefit considerations before transplantation in patients with MF

    Shrinking a large dataset to identify variables associated with increased risk of Plasmodium falciparum infection in Western Kenya

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    Large datasets are often not amenable to analysis using traditional single-step approaches. Here, our general objective was to apply imputation techniques, principal component analysis (PCA), elastic net and generalized linear models to a large dataset in a systematic approach to extract the most meaningful predictors for a health outcome. We extracted predictors for Plasmodium falciparum infection, from a large covariate dataset while facing limited numbers of observations, using data from the People, Animals, and their Zoonoses (PAZ) project to demonstrate these techniques: data collected from 415 homesteads in western Kenya, contained over 1500 variables that describe the health, environment, and social factors of the humans, livestock, and the homesteads in which they reside. The wide, sparse dataset was simplified to 42 predictors of P. falciparum malaria infection and wealth rankings were produced for all homesteads. The 42 predictors make biological sense and are supported by previous studies. This systematic data-mining approach we used would make many large datasets more manageable and informative for decision-making processes and health policy prioritization

    Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

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    This paper presents measurements of the W+μ+νW^+ \rightarrow \mu^+\nu and WμνW^- \rightarrow \mu^-\nu cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

    Milagro limits and HAWC sensitivity for the rate-density of evaporating Primordial Black Holes

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    RICORS2040 : The need for collaborative research in chronic kidney disease

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    Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

    New insights into the genetic etiology of Alzheimer's disease and related dementias.

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    Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele
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