Manejo de la infección protésica de hombro con gran defecto óseo: descripción de un caso complejo

La infección periprotésica de hombro tiene una incidencia de entre el 0.4% al 2.9%; su tratamiento es controvertido y se basa en la experiencia sobre infecciones protésicas de rodilla y cadera. Presentamos el caso de una paciente quien fue tratada mediante recambio en dos tiempos, la cual presentó como complicación añadida un gran defecto óseo metafisodiafisario tratado siguiendo pautas establecidas en la literatura actual, con buen resultado final, valorando aspectos analíticos, radiológicos y clínicosShoulder periprosthetic infection has an incidence of 0.4% to 2.9%; treatment is controversial and is based on the experience of prosthetic hip and knee infections. We report a patient who was treated by two-stage exchange, which added complication presented as a large bone defect treated following guidelines established in the current literature, with good outcome, evaluating blood analysis, radiological and clinical aspects

Myomegalin is a novel protein of the golgi/centrosome that interacts with a cyclic nucleotide phosphodiesterase

Subcellular targeting of the components of the cAMP-dependent pathway is thought to be essential for intracellular signaling. Here we have identified a novel protein, named myomegalin, that interacts with the cyclic nucleotide phosphodiesterase PDE4D, thereby targeting it to particulate structures. Myomegalin is a large 2,324-amino acid protein mostly composed of α-helical and coiled-coil structures, with domains shared with microtubule-associated proteins, and a leucine zipper identical to that found in the Drosophila centrosomin. Transcripts of 7.5-8 kilobases were present in most tissues, whereas a short mRNA of 2.4 kilobases was detected only in rat testis. A third splicing variant was expressed predominantly in rat heart. Antibodies against the deduced sequence recognized particulate myomegalin proteins of 62 kDa in testis and 230-250 kDa in heart and skeletal muscle. Immunocytochemistry and transfection studies demonstrate colocalization of PDE4D and myomegalin in the Golgi/centrosomal area of cultured cells, and in sarcomeric structures of skeletal muscle. Myomegalin expressed in COS-7 cells coimmunoprecipitated with PDE4D3 and sequestered it to particulate structures. These findings indicate that myomegalin is a novel protein that functions as an anchor to localize components of the cAMP-dependent pathway to the Golgi/centrosomal region of the cell

Fracturas periprotésicas postoperatorias de tibia.

Pese a su baja frecuencia las fracturas periprotésicas de tibia son una complicación grave cuya incidencia probablemente aumente en los próximos años. Es fundamental clasificar adecuadamente estas fracturas en función de su localización y presencia de af lojamiento para plantear un correcto tratamiento en cada caso. Se podrá realizar un tratamiento conservador, síntesis o revisión de la prótesis en función del tipo de fractura. En caso de fijación de la fractura, las placas de estabilidad angular, preferiblemente poliaxiales pueden ser una buena opción debido al limitado stock óseo en la metáfisis proximal que aloja un componente protésico. En caso de revisión se produce una importante perdida de hueso que necesita una adecuada reconstrucción. La utilización de sistemas de navegación y la colocación de prótesis unicompartimentales se ha relacionado con esta complicación.The incidence of periprosthetic tibia fractures is expected to increase although still being rare. It is paramount to classify these fractures properly, based on level and loosening in order to plan an adequate treatment in each case. Conservative treatment, fracture fixation and prosthetic revision can be performed depending on the fracture type. In case of fracture fixation, locking plates, preferable polyaxial, can be a good option due to the limited bone stock in the proximal metaphysis hosting a prosthetic component. Revision can result in relevant bone lose that will need of adequate reconstruction. Navigation systems as well as unicompartmental knee arthroplasty have been related to this complication

From social context and resilience to performance through job satisfaction: A multilevel study over time

Giving the crucial role of organizational context in shaping individual attitudes and behaviors at work, in this research we studied the effects of collective work-unit Perceptions of Social Context (PoSC) on individual work resilience and two key individual outcomes: job satisfaction and job performance as rated by the supervisor. We theorized that collective PoSC act as antecedents of individual variables, and that individual job satisfaction mediates the relationship between collective PoSC and job performance, and between work resilience and job performance over time. A sample of 305 white-collar employees, clustered in 67 work-units, participated in the study. Hierarchical linear modeling highlighted that collective PoSC are significant related to individual work resilience. Moreover, results showed that individual job satisfaction fully mediates the relationship between collective PoSC and individual job performance and the relationship between individual work resilience and individual job performance. At a practical level, results suggest that interventions on collective PoSC may increase work resilience, job satisfaction and job performance over time at the individual level

How to enhance service quality through organizational facilitators, collective work engagement, and relational service competence

This study aims to test how collective work engagement and relational service competence, as affective and cognitive-competent collective states, mediate the relationship between organizational facilitators and customers' perceptions of service quality. In all, 107 service-oriented units were aggregated from 615 service workers and 2165 customers. Structural equation modelling confirmed that organizational facilitators are related to collective work engagement andrelational service competence, which play a mediating role between organizational facilitators and service quality. Whereas collective work engagement plays a partially mediating role between organizational facilitators and relational service competence, relational service competence plays a fully mediating role between collective work engagement and service quality. A discussion and limitations are also provided

The dark side of technologies: Technostress among users of information and communication technologies

This paper tests the structure and the predictors of two psychological experiences of technostress associated with the use of information and communication technologies (ICT), i.e., technostrain (users report feelings of anxiety, fatigue, scepticism and inefficacy beliefs related to the use of technologies) and technoaddiction (users feel bad due to an excessive and compulsive use of these technologies). The study included a sample of 1072 ICT users (N = 675 nonintensive ICT users and N = 397 intensive ICT users). Results from multigroup confirmatory factor analyses among non-intensive and intensive ICT users showed, as expected, the four-factor structure of technostrain in both samples. Secondly, and also as expected, confirmatory factorial analyses revealed that technostress experiences are characterized not only by technostrain but also by an excessive and compulsive use of ICT. Moreover, multiple analyses of variance showed significant differences between non-intensive and intensive ICT users (1) in the dimensions of technostress and (2) in specific job demands and job/personal resources. Finally, linear multiple regression analyses revealed that technostrain is positively predicted by work overload, role ambiguity, emotional overload, mobbing and obstacles hindering ICT use, as well as by lack of autonomy, transformational leadership, social support, ICT use facilitators and mental competences. Work overload, role ambiguity and mobbing, as well as the lack of emotional competences, positively predict technoaddiction. Theoretical and practical implications, in addition to future research, are discussed

A newer and broader definition of burnout: Validation of the "Burnout Clinical Subtype Questionnaire (BCSQ-36)"

<p>Abstract</p> <p>Background</p> <p>Burnout syndrome has been clinically characterised by a series of three subtypes: frenetic, underchallenged and worn-out, with reference to coping strategies for stress and frustration at work with different degrees of dedication. The aims of the study are to present an operating definition of these subtypes in order to assess their reliability and convergent validity with respect to a standard burnout criterion and to examine differences with regard to sex and the temporary nature of work contracts.</p> <p>Method</p> <p>An exploratory factor analysis was performed by the main component method on a range of items devised by experts. The sample was composed of 409 employees of the University of Zaragoza, Spain. The reliability of the scales was assessed with Cronbach's α, convergent validity in relation to the Maslach Burnout Inventory with Pearson's <it>r</it>, and differences with Student's t-test and the Mann-Whitney U test.</p> <p>Results</p> <p>The factorial validity and reliability of the scales were good. The subtypes presented relations of differing degrees with the criterion dimensions, which were greater when dedication to work was lower. The frenetic profile presented fewer relations with the criterion dimensions while the worn-out profile presented relations of the greatest magnitude. Sex was not influential in establishing differences. However, the temporary nature of work contracts was found to have an effect: temporary employees exhibited higher scores in the frenetic profile (<it>p </it>< 0.001), while permanent employees did so in the underchallenged (<it>p </it>= 0.018) and worn-out (<it>p </it>< 0.001) profiles.</p> <p>Conclusions</p> <p>The classical Maslach description of burnout does not include the frenetic profile; therefore, these patients are not recognised. The developed questionnaire may be a useful tool for the design and appraisal of specific preventive and treatment approaches based on the type of burnout experienced.</p