Fracturas proximales de fémur. Osteosíntesis con tornillo-placa deslizante versus clavo gamma

Presentamos un estudio retrospectivo de noventa fracturas del fémur proximal tratados con clavo GAMMA o tornillo-placa dinámico de cadera (DHS). No encontramos diferencias en la duración de la intervención, pérdida hemática, ni estancia hospitalaria. Sin embargo, la serie con clavo GAMMA inició el apoyo más temprano, aunque en la revisión al final del seguimiento no había diferencias significativas en cuanto a la función de la cadera. El fracaso de la síntesis ocurrió en cuatro casos con el DHS, pero las complicaciones intraoperatorias fueron más frecuentes con el clavo GAMMA, principalmente elevada incidencia de fracturas de la diáfisis femoral, asociado en parte al diseño del implante. Recomendamos el empleo del clavo GAMMA sólo para las fracturas inestables del fémur proximal.We report a prospective study of ninety fractures of proximal femur treated by either the GAMMA nail or the dynamic hip screw (DHS). We found no difference in operating time, blood loss or stay in the hospital. However, the GAMMA nail group had a earlier full weight-bearing, but there was no significant difference in hip function at final review. There was failure of proximal fixation in four cases with the DHS. More intra-operative complications were recorded in the GAMMA nail group, mainly a high incidence of femoral shaft fracture which we relate in part to the design of the implant. We only recommend the use of the GAMMA nail for unstable intertrochanteric fractures of the proximal femur

EL COMPORTAMIENTO ELECTORAL EN LAS ELECCIONES LOCALES DE 2015 EN EL ÁREA METROPOLITANA DE VALENCIA

Las elecciones locales de 2015 pueden ser consideradas unas elecciones de crisis en las que el comportamiento electoral de los valencianos, en lo que se refiere cuanto menos al área metropolitana de Valencia, ha experimentado grandes cambios: por un lado, los dos partidos que tradicionalmente se repartían casi el 80% de los votos en el área, el PP y el PSPV-PSOE (71,94% en las elecciones de 2011), han descendido drásticamente en votos hasta el punto de quedarse por debajo del 50% de los mismos (46, 94% de los votos en las elecciones de 2015), descenso que incluso ha afectado al tercer partido tradicionalmente en discordia que era, aun con un menor porcentaje de votos, EU (en torno al 5-7% de los votos); mientras que, por otro lado, han surgido nuevas fuerzas políticas ?Compromís, Ciudadanos y Podemos? con el suficiente empuje para disputar los primeros puestos del escalafón electoral a los dos grandes partidos: Compromís, 19,46%; Ciudadanos, 10,70%; y Podemos, sumando ?con las reservas obvias para el caso? las candidaturas que se inspiran de una u otra forma en sus planteamientos, 8,10%. Con estos resultados se abre una nueva etapa en la historia electoral del área metropolitana de Valencia en la que el PP pierde su posición dominante y reaparece el antiguo cinturón rojo del área metropolitana de Valencia ahora con otros matices. En esta comunicación, por ello, queremos analizar, en primer lugar, la evolución del voto en el área desde las primeras elecciones locales de 1979 y el rendimiento institucional alcanzado; en segundo lugar, el comportamiento electoral en relación a cada uno de los partidos; para, en tercer lugar, desagregar el estudio de ese comportamiento por distintas variables como el tamaño del municipio, el comportamiento comarcal y, en concreto, el del cinturón rojo de Valencia; para, en cuarto lugar, extraer las oportunas conclusiones del análisis realizad

Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression

New treatment options offering enhanced activity in elderly, newly diagnosed patients with multiple myeloma are required. One strategy is to combine melphalan and prednisone with novel agents. We previously reported an 89% response rate, including 32% complete responses and 11% near complete responses, in our phase 1/2 study of bortezomib plus melphalan and prednisone (VMP) in 60 newly diagnosed multiple myeloma patients with a median age of 75 years. Here, we report updated time-to-events data and the impact of poor prognosis factors on outcome

Age-associated distribution of normal B-cell and plasma cell subsets in peripheral blood

Background: Humoral immunocompetence develops stepwise throughout life and contributes to individual susceptibility to infection, immunodeficiency, autoimmunity, and neoplasia. Immunoglobulin heavy chain (IgH) isotype serum levels can partly explain such age-related differences, but their relationship with the IgH isotype distribution within memory B-cell (MBC) and plasma cell (PCs) compartments remains to be investigated. Objective: We studied the age-related distribution of MBCs and PCs expressing different IgH isotypes in addition to the immature/transitional and naive B-cell compartments. Methods: B-cell and PC subsets and plasma IgH isotype levels were studied in cord blood (n = 19) and peripheral blood (n = 215) from healthy donors aged 0 to 90 years by using flow cytometry and nephelometry, respectively. Results: IgH-switched MBCs expressing IgG1, IgG2, IgG3, IgA1, and IgA2 were already detected in cord blood and newborns at very low counts, whereas CD27+IgM++IgD+ MBCs only became detectable at 1 to 5 months and remained stable until 2 to 4 years, and IgD MBCs peaked at 2 to 4 years, with both populations decreasing thereafter. MBCs expressing IgH isotypes of the second immunoglobulin heavy chain constant region (IGHC) gene block (IgG1, IgG3, and IgA1) peaked later during childhood (2-4 years), whereas MBCs expressing third IGHC gene block immunoglobulin isotypes (IgG2, IgG4, and IgA2) reached maximum values during adulthood. PCs were already detected in newborns, increasing in number until 6 to 11 months for IgM, IgG1, IgG2, IgG3, IgA1, and IgA2; until 2 to 4 years for IgD; and until 5 to 9 years for IgG4 and decreasing thereafter. For most IgH isotypes (except IgD and IgG4), maximum plasma levels were reached after PC and MBC counts peaked. Conclusions: PC counts reach maximum values early in life, followed by MBC counts and plasma IgH isotypes. Importantly, IgH isotypes from different IGHC gene blocks show different patterns, probably reflecting consecutive cycles of IgH isotype switch recombination through life

The effects of interactions between proline and carbon nanostructures on organocatalysis in the Hajos-Parrish-Eder-Sauer-Wiechert reaction

The non-covalent interactions of S-(-)-proline with the surfaces of carbon nanostructures (fullerene, nanotubes and graphite) change the nucleophilic-electrophilic and acid-base properties of the amino acid, thus tuning its activity and selectivity in the organocatalytic Hajos-Parrish-Eder-Sauer-Wiechert (HPESW) reaction. Whilst our spectroscopy and microscopy measurements show no permanent covalent bonding between S-(-)-proline and carbon nanostructures, a systematic investigation of the catalytic activity and selectivity of the organocatalyst in the HPESW reaction demonstrates a clear correlation between the pyramidalisation angle of carbon nanostructures and the catalytic properties of S-(-)-proline. Carbon nanostructures with larger pyramidalisation angles have a stronger interaction with the nitrogen atom lone pair of electrons of the organocatalyst, thereby simultaneously decreasing the nucleophilicity and increasing the acidity of the organocatalyst. These translate into lower conversion rates but higher selectivities towards the dehydrated product of Aldol addition

Contribution of JAK2 mutations to T-cell lymphoblastic lymphoma development

Financial support to JFP: grants from Spanish Ministry of Economy and Competitiveness (SAF2012-36566), Madrid Regional Government (Oncocycle S2011/BMD-2470), Instituto de Salud Carlos III (ACCI-CIBERER-16); financial support to MAP: RTICC SAF2008-03871 (MINECO). Spanish Association Against Cancer (AECC)

Primary alpha-tertiary amine synthesis via alpha-C-H functionalization

A quinone-mediated general synthetic platform for the construction of primary a-tertiary amines from abundant primary a-branched amine starting materials is described. This procedure pivots on the efficient in situ generation of reactive ketimine intermediates and subsequent reaction with carboncentered nucleophiles such as organomagnesium and organolithium reagents, and TMSCN, creating quaternary centers. Furthermore, extension to reverse polarity photoredox catalysis enables reactivity with electrophiles, via a nucleophilic a-amino radical intermediate. This efficient, broadly applicable and scalable amine-to-amine synthetic platform was successfully applied to library and API synthesis and in the functionalization of drug molecules

Impact of adherence on growth response during the first 2 years of growth hormone treatment

Purpose Adherence to growth hormone (GH) treatment impacts clinical outcomes. The aim of this study is to assess the impact of adherence to rhGH treatment (2 years) on auxological outcomes. Methods Multicentric, retrospective observational study in rhGH-naive GHD/SGA children treated with Saizen (R) during >= 2 years. Growth response was assessed by evaluating the change in height standard deviation score (Delta H SDS) and the index of responsiveness (IoR). Adherence was monitored using EasyPod (TM) Connect device. Results A total of 110 patients (3 Spanish centers) were evaluable (GHD n = 76, SGA n = 34). Adherence was 95.6 and 93.9% (year 1, 2). SGA and GHD children showed an increase of 0.6 cm/year and 1.1 cm/year for each 10% adherence modification. Lower adherence was observed in patients with lower pretreatment height velocity (HV) and in patients whose parents had a lower level of education. A positive correlation between index of responsiveness (IoR) during the first and second years with HV SDS during the second year and between IoR2 and adherence (year 1, 2) was observed. The frequency of patients with HV > 1 SD was higher (p = 0.025) among patients with adherence >90%. The best model to predict the height gain(cm) reaching an adjusted R squared of 0.489 involved percentage of adherence, Tanner stage, pretreatment HV, dose of rhGH, and whether the treatment was initiated before or after puberty. Conclusions Adherence during the first 2 years of response was very high >90% and showed a negative association with age, pretreatment HV and treatment duration and a positive correlation with the level of parent education

Boletín de la Sociedad de Pediatría de Aragón, La Rioja y Soria

[No abstract available

Detection of financial opportunities in micro-blogging data with a stacked classification system

Micro-blogging sources such as the Twitter social network provide valuable real-time data for market prediction models. Investors' opinions in this network follow the fluctuations of the stock markets and often include educated speculations on market opportunities that may have impact on the actions of other investors. In view of this, we propose a novel system to detect positive predictions in tweets, a type of financial emotions which we term "opportunities" that are akin to "anticipation" in Plutchik's theory. Specifically, we seek a high detection precision to present a financial operator a substantial amount of such tweets while differentiating them from the rest of financial emotions in our system. We achieve it with a three-layer stacked Machine Learning classification system with sophisticated features that result from applying Natural Language Processing techniques to extract valuable linguistic information. Experimental results on a dataset that has been manually annotated with financial emotion and ticker occurrence tags demonstrate that our system yields satisfactory and competitive performance in financial opportunity detection, with precision values up to 83%. This promising outcome endorses the usability of our system to support investors' decision making