Incidents control in radiotherapy oncology

Primer pla de l'escut del monarca del s. XVI, conservat i ubicat a la porta de la UB. Mesura 1,60 x 2,20 metre si és de pedra sorrenca

¿Es mayor la mortalidad en los pacientes que han sufrido una fractura de cadera?

Introducción y objetivos El objetivo de este estudio es valorar si los pacientes que han sufrido una fractura de cadera tienen una mortalidad más alta de la esperada. Material y métodos Se realizó un estudio prospectivo, observacional donde se toma como muestra los pacientes con fractura de cadera a lo largo de un año, cuya cifra fue de 284 y el seguimiento mínimo fue de 2 años. La edad media de estos pacientes fue de 84, 26 años, siendo el 21, 48% (61/284) varones y el 78, 5% (223/284) mujeres. La supervivencia y las enfermedades previas que afectan a la mortalidad como factores de riesgo se recogieron y se analizaron mediante el método de Kaplan-Meier y mediante la regresión de Cox. Se comparó la mortalidad real con la esperada según el Índice de Comorbilidad de Charlson, ajustado por la edad. Resultados La patología previa fue el principal factor de mortalidad, siendo la cardiopatía la más significativa (HR: 1, 817; IC95%: 1, 048; 3, 149). La mortalidad real al año de la muestra fue del 22, 5%, mientras que la mortalidad anual estimada según el Índice de Comorbilidad de Charlson era de un 29, 68% (IC95%: 44, 36-15). Conclusiones La fractura de cadera no provoca un aumento de mortalidad según la estimación del Índice de Comorbilidad de Charlson. Background and objective The aim of this study is to value whether patients who have suffered a hip fracture have a higher mortality than expected. Material and methods A prospective, observational study was carried out where patients with hip fracture were collected as a sample over a year. The study included 284 patients and a minimum follow-up was 2 years. The mean age of these patients was 84.26 years, with 21.48% (61/284) males and 78.5% (223/284) females. Survival and previous diseases that affect mortality, as risk factors, were collected and analyzed using the Kaplan-Meier method and the Cox regression model. Actual mortality was compared with that expected according to the Charlson Comorbidity Index, adjusted for age. Results Previous pathology was the main mortality factor, with heart disease being the most significant (OR 1.817, CI95%: 1.048; 3.149). The real mortality at one year of the sample was 22.5%, while the estimated annual mortality according to the Charlson Comorbidity Index was 29.68% (CI95%:44, 36-15). Conclusions Hip fracture does not cause an increase in mortality according to the Charlson Comorbidity Index estimate

Factores de riesgo en fractura periprotésica femoral tras artroplastia sustitutiva primaria de rodilla

Introducción y objetivos Las fracturas periprotésicas tras artroplastia primaria de rodilla cobran gran importancia en nuestro medio debido tanto al aumento de su incidencia, como al reto que suponen para el cirujano. Múltiples factores se han asociado a su producción. El objetivo del estudio fue identificar los factores de riesgo que podían influir en la aparición de estas fracturas, cuáles de todos ellos son modificables y generar un modelo de predicción de probabilidad de las mismas en función de dichos factores. Material y método Estudio analítico, observacional, retrospectivo, no pareado, de 38 casos de fracturas periprotésicas femorales de rodilla y 80 controles con prótesis de rodilla. En total, fueron incluidos en el estudio 118 pacientes, 83 mujeres y 35 hombres con una edad media de 72, 49 años. Se recogieron datos sociodemográficos, antecedentes médicos y consumo de fármacos, así como los relativos a la cirugía. Se realizó un análisis uni- y bivariante de los factores determinantes de fractura, usando un modelo de regresión logística para evitar el sesgo de confusión. Resultados De todos los factores estudiados según el modelo de regresión logística, se obtuvo que el sexo femenino (OR = 7, 6), la demencia (OR = 5), la alteración motora/párkinson (OR = 19, 3) y el sobrecorte femoral anterior (OR = 8, 6) eran factores asociados al incremento de riesgo de este tipo de fracturas. Conclusiones Este trabajo permite concluir que hay factores de riesgo, como son el sexo femenino, la demencia y el párkinson, que aumentan la probabilidad de fractura periprotésica, que son inherentes al paciente y no son modificables. Sin embargo, existe algún otro totalmente modificable que puede evitarse siendo exigente y exhaustivo en la técnica quirúrgica, como es el sobrecorte femoral anterior. Introduction and objectives: Periprosthetic fractures after primary knee arthroplasty has great importance in our environment due to the increase in their incidence and to the challenge they pose to the surgeon. Multiple factors have been associated with its production. The objective of the study was to identify the risk factors that could influence the appearance of these fractures, which of them are all modifiable and generate a probability prediction model based on these factors. Material and methods: Analytical, observational, retrospective, unpaired study of 38 cases of periprosthetic femoral knee fractures and 80 controls with knee prostheses. In total, 118 patients, 83 women and 35 men with a mean age of 72.49 years were included in the study. Sociodemographic data, medical history and drug consumption were collected, as well as those related to surgery. A univariate and bivariate analysis of the fracture determining factors was performed, using a logistic regression model to avoid confusion bias. Results: Of all the factors studied according to the logistic regression model, it was obtained that female sex (OR = 7.6), dementia (OR = 5), motor/parkinson''s alteration (OR = 19.3) and femoral overcut Previous (OR = 8.6) were factors associated with the increased risk of this type of fractures. Conclusions: This work allows us to conclude that there are risk factors such as female sex, dementia and parkinson''s that increase the probability of periprosthetic fracture that are inherent to the patient and are not modifiable. However, there is any other totally modifiable that can be avoided by being demanding and thorough in the surgical technique, such as the anterior femoral overcut

Pure-quartic solitons

Temporal optical solitons have been the subject of intense research due to their intriguing physics and applications in ultrafast optics and supercontinuum generation. Conventional bright optical solitons result from the interaction of anomalous group-velocity dispersion and self-phase modulation. Here we experimentally demonstrate a class of bright soliton arising purely from the interaction of negative fourth-order dispersion and self-phase modulation, which can occur even for normal group-velocity dispersion. We provide experimental and numerical evidence of shape-preserving propagation and flat temporal phase for the fundamental pure-quartic soliton and periodically modulated propagation for the higher-order pure-quartic solitons. We derive the approximate shape of the fundamental pure-quartic soliton and discover that is surprisingly Gaussian, exhibiting excellent agreement with our experimental observations. Our discovery, enabled by precise dispersion engineering, could find applications in communications, frequency combs and ultrafast lasers

Self-similar propagation of optical pulses in fibers with positive quartic dispersion

We study the propagation of ultrashort pulses in optical fiber with gain and positive (or normal) quartic dispersion by self-similarity analysis of the modified nonlinear Schrödinger equation. We find an exact asymptotic solution, corresponding to a triangle-like, T^4/3 intensity profile, with a T^1/3 chirp, which is confirmed by numerical simulations. This solution follows different amplitude and width scaling compared to the conventional case with quadratic dispersion. We also suggest, and numerically investigate, a fiber laser consisting of components with positive quartic dispersion which emits quartic self-similar pulses

Topologically protected localised states in spin chains

We consider spin chain families inspired by the Su, Schrieffer and Hegger (SSH) model. We demonstrate explicitly the topologically induced spatial localisation of quantum states in our systems. We present detailed investigations of the effects of random noise, showing that these topologically protected states are very robust against this type of perturbation. Systems with such topological robustness are clearly good candidates for quantum information tasks and we discuss some potential applications. Thus, we present interesting spin chain models which show promising applications for quantum devices