Fracturas supracondíleas de fémur tratadas con clavo retrógrado versus tornillo condilar dinámico

Objetivo: valorar los resultados mediante tratamiento con clavo intramedular retrógrado (CIR). Material y Métodos: se revisaron 54 pacientes con fracturas supracondíleas de fémur tipos AO A y C1, con edad media de 68 años, de los que 23 fueron tratados con CIR y 31 con tornillo condilar dinámico (TCD). Seguimiento medio de 5 años (rango, 2 a 9). Se valoraron clínicamente con las escalas Knee Society y cuestionario Womac y radiográficamente. Resultados: no hubo diferencias significativas respecto a los datos perioperatorios, resultados funcionales, movilidad de rodilla, calidad de vida o tiempo medio de consolidación. En el grupo CIR no hubo pseudoartrosis y 2 pacientes tuvieron acortamiento mayor de 2 cm. En el grupo TCD hubo 2 pseudoartrosis que precisaron reintervención y otros 4 casos tuvieron consolidación con desviación angular de al menos 5º, 2 de ellos además con acortamiento mayor de 2 cm. Discusión: los resultados fueron similares en ambos grupos pero, aunque no significativamente, con el CIR hubo menor número de complicaciones de alineación y de consolidación. Conclusiones: el CIR es un método satisfactorio para las fracturas supracondíleas sin o poca afectación articular, tanto en jóvenes como en ancianos.Objective: To evaluate functional and radiographic results after retrograde intramedullary nail (RIN). Material and Methods: We reviewed 54 supracondylar femoral fractures, AO-types A and C1, in patients with mean aged of 68 years, of which 23 were treated with RIN and 31 with dynamic condylar screw (DCS). Mean follow-up of 5 years (range, 2 to 9). They were evaluated clinically by means Knee Society scores and Womac self-form, and radiographically. Results: There were no significant differences with reagard to perioperative data, functional results, knee mobility, quality of life, or mean healed time. In the RIN group, there was no nonunion, and 2 patients had shortening greater than 2cm. In the DCS group, there were 2 nonunion which required revision, and other 4 healed with angular malunion greater than 5º, 2 of which had also shortening greater than 2cm. Discussion: Outcomes were similar in both groups. Although no significantly, the RIN group had lower malunion and nonunion rates. Conclusion: RIN is a satisfactory method for supracondylar fractures with little or no joint involvement, for both young and elderly patients

Dendro-anthracological tools applied to Scots type pine forests exploitation as fuel during the Mesolithic-Neolithic transition in the southern central pre-Pyrenees (Spain)

This work focuses on the reconstruction of fuelwood procurement during the Mesolithic-Neolithic transition in the southern central Pre-Pyrenees (Spain). The study combines wood charcoal identification with the application of dendro-anthracological approaches in the archaeological sequence of Esplugón (9.4–6.8 kyr cal BP) (Sabiñanigo, Huesca). Scots type pine (Pinus sylvestris tp.) reaches in this record around 90% of exploited firewood in line with its abundance in the inner Iberia mountainous areas during the onset of the Holocene. The classification of pine wood fragments in anthraco-groups is based on the combination of different dendro-anthracological tools: i) pith location tool and wood diameter estimation based on the trigonomethric method tool (ADmodel), ii) the study of growth rate based on the annual tree-ring width measurements, and iii) a modern dendrological dataset. There are hardly any differences observed in firewood procurement between the last hunter-gatherers and the first farmers in the long sequences from rock-shelters with recurrent human occupations. First results from this site point to the exploitation of whole trees but a high use of small pine branches probably from the gathering of branch shedding

Understanding illnesses through a film festival: an observational study

Audio-visual materials play a fundamental role in the context of education, care and clinical treatment, as they seem to have a high impact on public awareness. This study aims to describe what messages are perceived by the society at an International Festival of Short Films and Art on Diseases that may help to understand difficult topics, such as illness, dying and suffering. Through an observational, descriptive, cross-sectional study, using full participant observation and an open, self-administered questionnaire, 32 short films were analysed during a healthcare art festival. Categories were developed using inductive content analysis. The message perceived by the participants, after the viewing of the shorts and reflection of the debates among the attendees, were considered in four categories: i) creative and positive education is possible; ii) awareness of preconception and practical duties; iii) meaning of life changes the experience of illness; iv) family and caregivers also experienced suffering. The short films are considered as an excellent tool to generate social dialogue and debate. Public events can be understood as an opportunity to ac- quire, in an emotional and critical manner, other competencies for public awareness. Together, they are capable of communicating difficult messages through a fast, positive, and creative way

Identidad de género y cuidados intensivos: influencia de la masculinidad y la feminidad en la percepción de los cuidados enfermeros

Introducción: La enfermería ha sido fundamentalmente un trabajo de mujeres. El incremento en la incorporación de hombres a la enfermería nos hace reflexionar en torno a la cuestión de si existen diferentes formas de expresar y practicar una profesión en relación al género. Objetivo: Describir si existen diferentes maneras de percibir y valorar el trabajo en la UCI desde una perspectiva de género. Metodología: Estudio cualitativo fenomenológico. Muestra: 6 enfermeros y 6 enfermeras de la UCI del HUB Recogida de datos: Entrevista semi-estructurada en profundidad. Análisis de contenido. Resultados: Los enfermeros describen el trabajo en la UCI en términos de autonomía en las decisiones y competencia profesional; reivindican su identidad como enfermeros y destacan el bajo reconocimiento social que se hace de la profesión; priorizan más la responsabilidad en la toma de decisiones que el resultado final y valoran la satisfacción familiar en términos de prestigio y competencia. Son más prácticos. Las enfermeras califican el trabajo en términos de control y seguimiento en la evolución del enfermo; destacan más el resultado final del cuidado y valoran la satisfacción en términos de relación de confianza y calidez asistencial. Son más detallistas. Conclusiones: Existen diferencias en la manera de calificar el trabajo en la UCI, en la valoración de la identidad profesional, el comportamiento en el desarrollo de los cuidados de enfermería y en la percepción de la satisfacción familiar. No se observan diferencias en relación al abordaje en la resolución de problemas con la tecnología

Urbanismo neoliberal y fragmentación urbana: El caso de Zaragoza (España) en los primeros quince años del siglo XXI

El crecimiento del espacio urbano de Zaragoza durante los primeros quince años del siglo xxi se caracteriza por su fragmentación socioespacial a varias escalas, un rasgo significativo del urbanismo neoliberal. En esta ciudad se ha seguido un modelo que se compone por grandes fragmentos monofuncionales, no separados unos de otros, sino soldados al espacio urbano preexistente por las principales arterias de circulación; estas vías y otros obstáculos físicos o percibidos interrumpen la continuidad con el espacio consolidado, sobre todo para el movimiento de personas. No obstante este patrón permite la conexión de los nuevos espacios con el entorno urbano local, al mismo tiempo fomenta la segregación social e impulsa un modelo policéntrico basado en desplazamientos en automóvil privado. The growth of urban space of Zaragoza during the first fifteen years of the 21st century is characterized by its socio-spatial fragmentation at several scales, a significant feature of the neoliberal urbanism. The growth model of the city is composed of large monofunctional urban fragments attached to the existing urban space by the main traffic routes. These ways and other physical or perceived obstacles interrupt the continuity with the consolidated urban space, especially for the movement of people. Nevertheless, this pattern allows the connection of the new spaces with the local urban environment but, at the same time, promotes the social segregation and fosters a polycentric functional model based on travel by private car

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Melatonin counteracts inducible mitochondrial nitric oxide synthase‐dependent mitochondrial dysfunction in skeletal muscle of septic mice

Producción CientíficaMitochondrial nitric oxide synthase (mtNOS) produces nitric oxide (NO) to modulate mitochondrial respiration. Besides a constitutive mtNOS isoform it was recently suggested that mitochondria express an inducible isoform of the enzyme during sepsis. Thus, the mitochondrial respiratory inhibition and energy failure underlying skeletal muscle contractility failure observed in sepsis may reflect the high levels of NO produced by inducible mtNOS. The fact that mtNOS is induced during sepsis suggests its relation to inducible nitric oxide synthase (iNOS). Thus, we examined the changes in mtNOS activity and mitochondrial function in skeletal muscle of wild-type (iNOS(+/+)) and iNOS knockout (iNOS(-/-)) mice after sepsis. We also studied the effects of melatonin administration on mitochondrial damage in this experimental paradigm. After sepsis, iNOS(+/+) but no iNOS(-/-) mice showed an increase in mtNOS activity and NO production and a reduction in electron transport chain activity. These changes were accompanied by a pronounced oxidative stress reflected in changes in lipid peroxidation levels, oxidized glutathione/reduced glutathione ratio, and glutathione peroxidase and reductase activities. Melatonin treatment counteracted both the changes in mtNOS activity and rises in oxidative stress; the indole also restored mitochondrial respiratory chain in septic iNOS(+/+) mice. Mitochondria from iNOS(-/-) mice were unaffected by either sepsis or melatonin treatment. The data suggest that inducible mtNOS, which is coded by the same gene as that for iNOS, is responsible for mitochondrial dysfunction during sepsis. The results also suggest the use of melatonin for the protection against mtNOS-mediated mitochondrial failure

Productive Performance of Growing Cattle Grazing a Silvopastoral System with \u3cem\u3eLeucaena leucocephala\u3c/em\u3e

In tropical regions, the feeding of cattle is usually based on the grazing of medium to low quality grasses. Low fertility of soils, changing climatic conditions and the poor management of pastures, have further reduced the quality and forage yield of pastures. The low availability and quality of grasses gives modest weight gains for grazing cattle and this in-turn causes low economical efficiency of cattle production systems (Campos et al. 2011). Silvopastoral systems represent a sustainable option for meat and milk production in the tropics. The association of grasses with legumes such as Leucaena leucocephala (leucaena) supply forage with high concentration of crude protein (Barros et al. 2012). There are reports in the scientific literature which show that intake of leucaena can result in good rates of growth in cattle (e.g. Shelton and Dalzell 2007); however the presence of the free amino acid mimosine and its metabolites (3,4-DHP and 2,3-DHP) in leucaena when the anaerobic bacteria Synergistes jonesii (Allison et al. 1992) is absent from the rumen, may induce subclinical toxicity in grazing ruminants (Graham 2007; Dalzell et al. 2012; Phaikaew et al. 2012). There are no reports in Mexico regarding the rate of growth of cattle grazing silvopastoral systems with leucaena. The aim of the present work was to evaluate the rate of growth of cattle grazing an association of Panicum maximum and leucaena compared to that of cattle fed a high grain ration (feedlot)