Utilidad de la reconstrucción tridimensional con tomografía computarizada en Traumatología y Ortopedia

La reconstrucción tridimensional es una nuev a técnica diagnóstica introducida en cirugía ortopédica y traumatología. Está indicada en algunas fracturas de acetábulo, columna y pelvis porque facilita una visión desde diferente s ángulos y en determinadas lesiones congénitas donde es imprescindible una correcta evaluación preoperatoria. Presentamo s dos paciente s con fracturas acetabulares, otro con lesión me - tastásica en columna lumbar y otro con hipoplasia del arco neural de cuarta vértebra lumbar. La reconstrucción tridimensional fue útil para el definitivo diagnóstico en los cuatro pacientes.Three dimensional images is a new technique introduced in orthopaedic surgery and traumatology. It's indicated for some fractures of the acetabulum, spine or pelvic girdle becaus e supply a vision from differents angles and in determinated congenital damage s who is indispensable an accurate evaluation before the surgery. We presented two patients with acetabular fractures, other with a metastasi c tumour in lumbar spine and anothe r with a hipoplasti c neural arch in a lumbar vertebra. The thre e dimensional reconstruction was useful for the definitive diagnostic in the four patients

Fracturas epifisiolisis graves de la extremidad proximal del radio: resultado tras tratamiento quirúrgico

La fractura-epifisiolisis del cuello radial es una lesión grave que puede originar alteracione s en e l crecimiento epifisario. Presentamo s una seri e de 22 casos revisados con una antigüedad mínima de dos años. Fueron intervenidos 14 pacientes, de los que 10 estaban incluidos en el grupo III o en lesione s de Jeffery. Once enfermos fueron tratado s con cirugí a abierta. Cuando l a intervenció n consisti ó en reducció n abierta y osteosíntesis, los resultados clínicos fueron buenos en el 50%, pero cuando só- lo se practicó reducción cruenta sin asociar sistema estabilizador metálico, éstos llegaron al 100%. En cinco de los ocho paciente s del primer grupo se presentaron calcificacione s articulares y en dos, epifisiodesis. En el segundo grupo no aparecieron ninguna de éstas alteraciones. Creemos que en los casos de fracturas epifisiolisis del cuello radial en niños con gran desplazamiento, el tratamiento ideal es la cuidadosa reducción cruenta evitando fijación con aguja.The fracture epiphysiolysis of radial neck is a grave lesion which may induc e epiphysea l grown disturbances. A review of 22 case s suffering such fracture s was carried out with a mean follow-up of 2 years. Of the total, 14 cases wer e treated by surgery, 10 of thes e showing either type III or Jeffery's fractures. Eleven patients reequired open reduction. In 50% of the cases treated by open reduction and internal fixation, the clinical results wer e satisfactory. When internal fixation was not used, the satisfactory results reached 100%. Five of the 8 cases of the firt groups developed periarticular ossifications and 2 othe r showed epiphyseal closening. Thes e type of complications wer e not seen in the second group. For epiphysiolysis of the radial neck with sever e displacement. The ideal treatment seems to be a careful open reduction avoiding internal fixation

Evolution of Research into the Management of Family Businesses that are Part of the Instituto de la Empresa Familiar Network of Chairs (1992-2016)

ABSTRACT: The family business field of study has grown considerably in recent years in Spain. In fact, it is no exaggeration to say that twenty years ago there was barely any research in this field. In 1992, exactly 25 years ago, a group of family entrepreneurs founded the Instituto de la Empresa Familiar (IEF). IEF created the Chair in Family Business at Spanish universities to foster its inclusion in Business Administration syllabuses and promote its research by Spanish academics. This paper analyses the evolution of research into family businesses carried out by academics who are part of the IEF Network of Chairs, both at international and management level. To do this, the ISI Web of Knowledge database and Scopus were used as sources of information

Clavo gamma en el tratamiento de las fracturas del macizo trocantérico: estudio comparativo entre el Clavo Gamma Trocantérico y el Gamma 3

El clavo Gamma es una técnica bien establecida en el tratamiento de las fracturas del macizo trocantéreo. Hemos realizado un estudio prospectivo en 40 pacientes para comparar dos tipos de clavos. En 20 se utilizó el clavo gamma trocantérico y en 20 un nuevo dispositivo llamado Gamma3 fabricado en titanio y con modificaciones en el diseño para permitir una menor incisión y mayor faciliad en su implante. De todos los parámetros estudiados tanto intra como postoperatorios sólo hemos encontrado diferencias en cuanto al tiempo del acto quirúrgico y al tamaño de la incisión, encontrando menor tiempo y menor tamaño de la incisión en el clavo gamma 3. No encontramos diferencias en cuanto a las complicaciones técnicas, ni en cuanto al dolor, tiempo transcurrido hasta la consolidación o grado de independencia obtenido. Consideramos el clavo Gamma3 como una técnica valiosa que disminuye el tiempo de cirugía y el traumatismo de las partes blandas.The nail Gamma is a well-established technique in the treatment of the trochanteric fractures. We have made a prospective study in 40 patients for compare two Gamma nail types. In 20 we use the Trochanteric Gamma Nail and in 20 a new device called Gamma 3 manufactured in titanium and with modifications in the design to permit a less incision and most facilities in his implantation. Of all of the parameters studied both intra and postoperative we have found differences in the time of surgical act and in the size of the incision, finding less time and less size of the approach in the gamma 3 nail. We do not find differences about technical complications, neither as to the pain, time to the consolidation or independence grade obtained. We regard to the nail Gamma 3 as a valuable technique that decreases the time of surgery and the traumatism of the soft tissues

Osteopoiquilia: A propósito de 2 casos

La osteopoiquilosis es una rara displasia ósea esclerosante. Su diagnóstico es normalmente hecho de forma accidental de radiografías que muestran múltiples áreas escleróticas en diversos huesos del esqueleto. Su diagnóstico diferencial se realiza con la melorreostosis, osteopatía estriada y metástasis osteobásticas, en base a la clínica, radiología y gammagrafía. Histológicamente aparecen condensaciones focales de hueso lamelar compacto dentro de la esponjosa. Nosotros recogemos 2 casos de osteopoiquilosis y se hace a su vez un recuerdo.Osteopoikilosis, is a rare sclerosing bone dysplasia. The diagnosis is usually made incidentally from radiographs with show multiple sclerotic areas in several bones of the body. The differential diagnosis from melorheostosis, osteophatia striata and specially from osteoblastic bone metastases, on the basis of the clinical, radiological and radionuclide scanning characteristics. Histologically, there are focal condensations of compact lamellar bone within the spongiosa. We report two case osteopoikilosis

Muerte de un lince ibérico. Establecimiento de la causa y la autoría

Las ciencias forenses se aplican desde hace poco tiempo como herramientas en las investigaciones de delitos contra el medio ambiente. En este trabajo se expone un caso pionero en cuanto a la utilización de estas técnicas en un caso de un delit o contra la fauna silvestre. La investigación se inicia tras la apari ción de un lince ibérico muerto en el interior de una finca, donde se encontraron también varios pollos supuestamente utilizados como cebos envenenados y otro cadáver, el de un zorro. El lince ib érico es uno de los mamíferos más amenazados del planeta. Se llevaron a cabo distintos análisis a partir de la necropsia de los cadáveres en el Centro de Análisis y Diagnóstico de la Fauna Silvestre (CAD), el laboratorio de referencia para la fauna silvestre pertene ciente a la Junta de Andalucía. Los resultados fuer on concluyentes, ambas muertes se produjeron como consecuencia de la ingestión de cebos envenenados con un plaguicida extremadamente tóxico, el aldicarb. También se encontró esta sustancia en los pollos recogidos en el interior de la finca. Con el fin de e stablecer la culpabilidad de los propietarios de la finca, que negaron tener nada que ver con las muertes y la colocación de los cebos, se utilizó una herramienta novedosa en este tipo de investigaciones, la genética forens e. En base a los resultados se co nsiguió establecer una relación de parentesco entre los pollos utilizados como cebos envenenados y los pollos propiedad reconocida de los sospechosos, que permitió demostrar que todos tenían el mismo origen. Gracias al trabajo conjunto y coordinado durante toda la investigación y el informe pericial elaborado por el laboratorio del CAD, la Consejería de Medio Ambiente y Organización del Territorio de la Junta de Andalucía consiguió una sentencia ejemplar contra los envenenador es.The application of forensic science as a research tool to resolve crimes against the environment is relatively rec ent. To our knowledge this is the first instance in which the forensic genetic have been used as a definitive evidence to find out guilty in crimes against the wildlife. Our research starts when an Iberian lynx was found dead into a farm; very close to sev eral chickens used as poisoned baits and a fox carcass. Iberian lynx is one of the most endangered mammals in the planet. A comprehensive investigation from the carcasses was performed in the Analysis and Diagnostic Center for Wildlife in Andalucia (CAD), the reference laboratory for wildlife of the Andalusian Government (Spain). The results determined that the deaths occurred as a result of ingestion o f baits poisoned with an extremely toxic pesticide, aldicarb. This substance was also found in chickens ga thered inside the farm. In order to establish the guilt of the owners of the farm, who refused to be related to the deaths and the placement of the b aits, an innovative tool was used in this kind of research, the forensic genetic. Based on the results we got, we established a relationship between the chickens used as poisoned baits and the chickens from the farmer, all of them had the same origin. Thanks to the coordinated actuation during the complete investigation and the official report by the CAD labor atory used in the trial, the Ministry of Environmental and Territorial Organization got an exemplary sentence against the poisoners

Testosterone Replacement Therapy

Male hypogonadism (HG) can be defined according to its etiology as primary (pHG) when caused by any diseases affecting the testes, or as secondary (sHG) when due to a pituitary or hypothalamic dysfunction. Both fertility and testosterone (T) can be theoretically restored in sHG by removing the precipitating cause and/or by appropriate endocrine therapy. Conversely, only T treatment can be offered to patients with pHG. Symptoms and signs are quite similar independent of the underlying causes. Conversely, the phenotype of the hypogonadal patient is more often affected by the age of hypogonadism onset. Late-onset hypogonadism (LOH) that occurs in adulthood is probably the most common form of HG. In this chapter, the criteria defining LOH and the available T formulations along with their outcomes and main important side effects are analyzed in detail

Diversity of HLA Class I and Class II blocks and conserved extended haplotypes in Lacandon Mayans.

Here we studied HLA blocks and haplotypes in a group of 218 Lacandon Maya Native American using a high-resolution next generation sequencing (NGS) method. We assessed the genetic diversity of HLA class I and class II in this population, and determined the most probable ancestry of Lacandon Maya HLA class I and class II haplotypes. Importantly, this Native American group showed a high degree of both HLA homozygosity and linkage disequilibrium across the HLA region and also lower class II HLA allelic diversity than most previously reported populations (including other Native American groups). Distinctive alleles present in the Lacandon population include HLA-A*24:14 and HLA-B*40:08. Furthermore, in Lacandons we observed a high frequency of haplotypes containing the allele HLA-DRB1*04:11, a relatively frequent allele in comparison with other neighboring indigenous groups. The specific demographic history of the Lacandon population including inbreeding, as well as pathogen selection, may have elevated the frequencies of a small number of HLA class II alleles and DNA blocks. To assess the possible role of different selective pressures in determining Native American HLA diversity, we evaluated the relationship between genetic diversity at HLA-A, HLA-B and HLA-DRB1 and pathogen richness for a global dataset and for Native American populations alone. In keeping with previous studies of such relationships we included distance from Africa as a covariate. After correction for multiple comparisons we did not find any significant relationship between pathogen diversity and HLA genetic diversity (as measured by polymorphism information content) in either our global dataset or the Native American subset of the dataset. We found the expected negative relationship between genetic diversity and distance from Africa in the global dataset, but no relationship between HLA genetic diversity and distance from Africa when Native American populations were considered alone

Eight Become One: the EURECA-PRO University Network

[EN] The United Nations Sustainable Development Goal 12 is the foundation of the European University on Responsible Consumption and Production consortium (EURECA-PRO). This article introduces the eight EURECAPRO partner universities: Montanuniversität Leoben (Austria), Technische Universität Bergakademie Freiberg (Germany), Technical University of Crete (Greece), University of León (Spain), Silesian University of Technology (Poland), Mittweida University of Applied Sciences (Germany), University of Petro¸sani (Romania), and Hasselt University (Belgium). In addition, each university’s role within the alliance and unique research and study programmes are outlined. The synergy created by EURECA-PRO enables the pursuit of an ambitious research agenda with five research “Lighthouse Missions” as well as the implementation of joint study programmes.SIMontanuniversität Leoben (Austria

Gram-negative prosthetic joint infection: outcome of a debridement, antibiotics and implant retention approach. A large multicentre study

AbstractWe aim to evaluate the epidemiology and outcome of gram-negative prosthetic joint infection (GN-PJI) treated with debridement, antibiotics and implant retention (DAIR), identify factors predictive of failure, and determine the impact of ciprofloxacin use on prognosis. We performed a retrospective, multicentre, observational study of GN-PJI diagnosed from 2003 through to 2010 in 16 Spanish hospitals. We define failure as persistence or reappearance of the inflammatory joint signs during follow-up, leading to unplanned surgery or repeat debridement >30 days from the index surgery related death, or suppressive antimicrobial therapy. Parameters predicting failure were analysed with a Cox regression model. A total of 242 patients (33% men; median age 76 years, interquartile range (IQR) 68–81) with 242 episodes of GN-PJI were studied. The implants included 150 (62%) hip, 85 (35%) knee, five (2%) shoulder and two (1%) elbow prostheses. There were 189 (78%) acute infections. Causative microorganisms were Enterobacteriaceae in 78%, Pseudomonas spp. in 20%, and other gram-negative bacilli in 2%. Overall, 19% of isolates were ciprofloxacin resistant. DAIR was used in 174 (72%) cases, with an overall success rate of 68%, which increased to 79% after a median of 25 months' follow-up in ciprofloxacin-susceptible GN-PJIs treated with ciprofloxacin. Ciprofloxacin treatment exhibited an independent protective effect (adjusted hazard ratio (aHR) 0.23; 95% CI, 0.13–0.40; p <0.001), whereas chronic renal impairment predicted failure (aHR, 2.56; 95% CI, 1.14–5.77; p 0.0232). Our results confirm a 79% success rate in ciprofloxacin-susceptible GN-PJI treated with debridement, ciprofloxacin and implant retention. New therapeutic strategies are needed for ciprofloxacin-resistant PJI