Fijación con tornillos iliosacros en las fracturas de la parte posterior del anillo pélvico

Los objetivos principales del presente trabajo es la actualización y revisión bibliográfica sobre el tratamiento de las fracturas inestables de la parte posterior del anillo pélvico. Revisión de la casuística mediante un estudio observacional, descriptivo, tipo serie de casos retrospectivo-prospectivo, en el Servicio de Cirugía Ortopédica y Traumatología-COT de nuestro centro; con una serie de 6 pacientes (3 hombres y 3 mujeres) tratados por fracturas inestables de pelvis que comprometieron la estabilidad de la articulación sacro-ilíaca. El promedio de edad era de 43 años con un rango de 37 a 55 años. Cuatro de los paciente (66,6%) presentaron fracturas tipo B2 de Tile (compresión lateral ipsilateral) y los dos restantes (33,3%) presentaron fracturas tipo C1 de Tile (disrupción completa posterior unilateral)

Hedgerow Olive Orchards versus Traditional Olive Orchards: Impact on Selected Soil Chemical Properties

Olive orchards cover over 10 million hectares worldwide, with production techniques undergoing significant changes in the past three decades. The traditional rainfed approach, involving minimal inputs, has given way to irrigated super-intensive systems with higher planting density, increased productivity, a greater use of fertilizers and phytopharmaceuticals, and total mechanization. Its impact on soil chemical properties remains a topic of great debate, and no definitive consensus has been reached. Our main objective was to examine the different effects of traditional olive orchards and super-intensive orchards on soil chemistry over a decade. We collected and analyzed 1500 soil samples from an irrigation perimeter in southern Portugal in 2003 and 2013. Our findings indicate that, compared to traditional olive orchards, super-intensive ones show, in a decade, a significant decrease in soil organic matter (less 22.8%—p p < 0.001) highlighting the importance of monitoring this factor for soil fertility. In comparison to other irrigated crops in the region, super-intensive olive orchards promote a significant soil acidification (from 7.12 to 6.58), whereas the pH values of the other crops increase significantly (3.3%, 13.5%, and 3.0% more in corn, tomato, and cereals, respectively). Mainly because of the decrease in organic matter levels with soil acidification and soil sodization, we can underline that hedgerow olive orchards can affect soil characteristics negatively when compared with traditional ones, and it is necessary to adopt urgent measures to counter this fact, namely sustainable agriculture practices

Acercamiento antropológico de la alimentación y salud en México Anthropological approach to nutrition and health in Mexico

En este artículo presento un panorama de la alimentación en México, particularmente sobre la ciudad de México desde una perspectiva antropológica considerando aspectos socioculturales y económicos. Inicia con una breve revisión de los estudios antropológicos sobre alimentación en México, para reconocer tanto los aportes metodológicos como los principales problemas de estudio. Posteriormente, se presentan algunos datos de contextualización del país y de la ciudad que enmarcan los datos nutricios y alimentarios característicos. En las siguientes secciones se proponen algunas explicaciones sobre algunos de los fenómenos alimentarios contemporáneos, donde la obesidad es la característica principal en una sociedad de reciente acceso al consumo masivo, al mismo tiempo que se enfrenta al ideal cultural de delgadez. Los datos sobre la alimentación en México y los fenómenos sociales relacionados dan cuenta de la complejidad del fenómeno alimentario y de cómo los procesos macrosociales afectan las decisiones cotidianas de la gente. El análisis antropológico de la alimentación en la población mexicana ha permitido mostrar la relación entre estos procesos históricamente y en fechas recientes. Son la muestra de la utilidad de la metodología antropológica para estudiar la alimentación contemporánea, llena de contradicciones, que tienen que ver con el desarrollo del capitalismo y la sociedad de consumo, la promoción al consumo, y el acceso inmediato a él, la medicalización de la vida cotidiana, las ideas sobre el control corporal, y la imagen como un elemento de estatus.<br>This paper presents an overview of food in Mexico, particularly in Mexico City, from an anthropological perspective considering sociocultural and economic aspects. It begins with a brief review of anthropological studies on food in Mexico to recognize both the methodological contributions as the major problems of study. Subsequently, are presented some facts of contextualization of the country and city that frame the distinctive food and nutritional data. The following sections propose some explanations of some of the phenomena of contemporary food, where obesity is the main feature in a society of recent consumer access, while facing the cultural ideal of thinness. The data on food in Mexico and related social phenomena account for the complex nature of food and how macro-processes affect people's everyday decisions. The anthropological analysis of food in the Mexican population has been allowed to show the relationship between these processes historically and recently. They are the sign of the usefulness of anthropological methodology to study contemporary food, full of contradictions that have to do with the development of capitalism and consumer society, consumer promotion, and immediate access to it, the medicalization everyday life, ideas about body control, and image as an element of status

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p&lt;0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients