Tratamiento conservador de las fracturas diafisarias de tibia en adultos

Se ha revisado la evolución y los resultados finales de 148 fracturas diafisarias de tibia cerradas (94 casos) y abiertas (54 casos) tratadas de forma conservadora. Las etiologías más frecuentes fueron los accidentes de tráfico (58%) y las caídas casuales (33%). Se constató un predominio de las fracturas espiroideas (26%), seguidas de las transversas (22%) y oblicuas cortas (22%), siendo la loralización más frecuente a nivel del tercio distal de la diálisis (48%). El período de consolidación medio fue de 15 semanas; la consolidación fue precoz en 36 casos (24%), normal en 88 (59%) y retardada en 24 (16%), observándose la presencia de pseudoartrosis en 10 pacientes (7%). Los resultados clínicos fueron satisfactorios en el 84% de los casos y los radiológicos en el 88%.The follow-up and final results of 148 diaphyseal tibial fractures (54 open and 94 closed) treated conservatively were reviewed. The most frequent causes were road traffic accident (58%) and casual falls (33%). We found predominantly spiroid fractures (26%), transverse fractures (22%) and oblicues fractures (22%). The most frequent location was the distal third of the diaphysis (48%). The average period of consolidation was 15 weeks. This was shorter in 6 cases (24%), normal in 88 (59%) and prolonged in 24 (16%). Pseudoarthrosis was present in 10 patients (7%). The results were satisfactory clinically in 84% of cases and radiologically in 88% of patients

Tratamiento quirúrgico de las fracturas de meseta tibial: Estudio de 53 casos

Se han revisado 53 fracturas de meseta tibial tratadas quirúrgicamente con reducción abierta y síntesis según el método AO. El seguimiento medio de los pacientes fue de 14 meses (mínimo, 12 meses). Según la clasificación de Schatzker y colaboradores las fracturas se distribuyeron en cinco casos tipo I, tres tipo II, veinticuatro tipo III, seis tipo IV, ocho tipo V y siete tipo VI. En función de la valoración clínica se obtuvo un 76% de resultados satisfactorios. No se encontró relación entre resultado y tipo de fractura, tipo de osteosíntesis o periodo de inmovilización; pero sí con el grado de reducción conseguido. Los peores resultados se obtuvieron en pacientes con fractura de platillo tibial externo o de ambos platillos con inclinación tardía mayor de 4 mm.A review of 53 fractures of the tibial plateau treated with open reduction and internal fixation is presented. The average follow-up was 14 months. Attending to Schatzker's classification, we found 5 fractures type I, 3 type II, 24 type III, 6 type IV, 8 type V and 7 type VI. The results were excellent or good in 76%. In our study, results do not correlate with type of fracture, type of internal fixation or period of immobilization, but do with the articular step-off. The results deteriorated when the step-off was more than 3 mm

Técnica de Ender y tornillo-placa deslizante a compresión en el tratamiento de las fracturas trocantéreas

Se realizó un estudio comparativo de 195 fracturas troncantéreas del fémur tratadas quirúrgicamente de las que 112 lo fueron mediante enclavado endomedular de Ender y 83 mediante tornillo-placa deslizante a compresión (TPDC). No encontramos diferencias significativas de las pérdidas sanguíneas entre las dos técnicas. El TPDC presentó mejores resultados funcionales salvo en pacientes mayores de 80 años en que son similares ambas técnicas. El enclavado Ender presentó mayor número de complicaciones mecánicas y reintervenciones.A comparative study on 195 throchanttric hip fractures treated Esther by Ender's mailing (112 cases) and slidding screw-plate (83 cases) were performed. There were no statistically significant differences between the two techniques regarding blood loosening. The slidding screw-plate showed better functional results, except in cases over 80 years old where both techniques were found to be similar. Ender's nailing disclosed a higher number of mechanical and reoperations

The missing light of the Hubble Ultra Deep Field

Context. The Hubble Ultra Deep field (HUDF) is the deepest region ever observed with the Hubble Space Telescope. With the main objective of unveiling the nature of galaxies up to z ∼ 7−8, the observing and reduction strategy have focused on the properties of small and unresolved objects, rather than the outskirts of the largest objects, which are usually over-subtracted. Aims. We aim to create a new set of WFC3 IR mosaics of the HUDF using novel techniques to preserve the properties of the low surface brightness regions. Methods. We created ABYSS: a pipeline that optimises the estimate and modelling of low-level systematic effects to obtain a robust background subtraction. We have improved four key points in the reduction: 1) creation of new absolute sky flat fields, 2) extended persistence models, 3) dedicated sky background subtraction and 4) robust co-adding. Results. The new mosaics successfully recover the low surface brightness structure removed on the previous HUDF published reductions. The amount of light recovered with a mean surface brightness dimmer than µ = 26 mag arcsec^(−2) is equivalent to a m = 19 mag source when compared to the XDF and a m = 20 mag compared to the HUDF12. Conclusions. We present a set of techniques to reduce ultra-deep images ( µ > 32.5 mag arcsec^(−2) , 3σ in 10 × 10 arcsec boxes), that successfully allow us to detect the low surface brightness structure of extended sources on ultra deep surveys. The developed procedures are applicable to HST, JWST, EUCLID and many other space and ground-based observatories

Usos del e‐learning en las Universidades Andaluzas: estado de la situación y análisis de buenas prácticas. (Resumen ejecutivo).

Secretaría General de Universidades, Investigación y Tecnología P07-SE-J.0267

Usos del e-learning en las Universidades Andaluzas: Estado de la situación y análisis de buenas prácticas. (Versión completa)

Secretaría General de Universidades, Investigación y Tecnología P07-SE-J.0267

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

re-habitar El Carmen : Un proyecto sobre patrimonio contemporáneo

El proyecto _re-HABITAR suponía para el propio proceder de la institución un avance más allá del reconocimiento, registro, inventario o protección patrimonial de la arquitectura del siglo XX y del Movimiento Moderno para posicionarse en la acción preventiva y conservativa de ese legado contemporáneo. Para ello, la praxis patrimonial se aferraba a un modelo: el de la vivienda social en España en la segunda mitad del siglo XX; a un caso concreto: el de la barriada de Nuestra Señora del Carmen (Recasens Méndez-Queipo de Llano, 1958); y a un requisito fundamental: analizar un objeto vivo y en uso, aún con la presencia de quienes lo vivieron y usaron desde su origen

Indirect Scapholunate Ligament Repair: All Arthroscopic

The arthroscopic technique most frequently used in acute scapholunate instability is reduction and fixation with Kirschner wires. To repair the injured ligament, open surgery and dorsal capsular plication are recommended, but this procedure has the risk of damaging secondary dorsal stabilizers, the dorsal blood supply, and the proprioceptive innervation of the posterior interosseous nerve. In this report, we present an all-arthroscopic technique of a dorsal reconstruction of the scapholunate interosseous ligament for scapholunate instability using a tape by tethering the scaphoid to the lunate