Infección en prótesis total de rodilla: factores de riesgo, relación con el recambio patelar

La artrosis es una dolencia degenerativa y de instauración lenta producida por el creciente daño y desgaste del cartílago articular y hueso subcondral, que provoca dolor, incapacidad funcional y empeoramiento de la calidad de vida de las personas que lo padecen. La rodilla es la localización principal de esta afección, denominándose gonartrosis, la cual genera una elevada tasa de discapacidad a nivel mundial. A pesar de las intervenciones no farmacológicas y farmacológicas, en muchas ocasiones el tratamiento de elección es el quirúrgico mediante Artroplastia Total de Rodilla (ATR). Sin embargo, el recambio patelar durante la cirugía es un procedimiento que genera debate entre los autores por sus ventajas, como la reducción del dolor e inconvenientes, como el aumento de riesgo de infección. Esta investigación se enmarca en el objetivo principal de explorar los factores de riesgo de la infección periprotésica tras una ATR y su relación con el recambio patelar. Para ello, se realizó un metaanálisis con la última evidencia disponible destinado a determinar la conveniencia o inconveniencia del recambio patelar en base a sus consecuencias; así como un estudio retrospectivo y descriptivo sobre las ATR practicadas en el periodo 2014-2018 en el Servicio de Traumatología y Cirugía Ortopédica del Hospital Universitario de Burgos (HUBU), con la intención de analizar los predisponentes dependientes del paciente y del sistema sanitario, con respecto al desarrollo de infección periprotésica. Como beneficios del recambio patelar, se observaron la disminución del dolor anterior de rodilla y la tasa de revisión, sin mostrar, en el metaanálisis realizado, efectos adversos significativos. No obstante, en el estudio llevado a cabo, se ha hallado por primera vez una relación significativa entre el recambio patelar y el desarrollo de infecciones periprotésicas [p=0,049], las cuales, se producen con tasas significativamente mayores en hombres, con cirugías de larga duración, estancia hospitalaria prolongada, y cirujanos de mayor experiencia. Estos hallazgos suponen un punto de partida para este ámbito del conocimiento, dado que es necesario aumentar la investigación para corroborar estos datos y poder desarrollar métodos preventivos y quirúrgicos que permitan el tratamiento de esta patología con el mínimo riesgo posible, para poder así aumentar la calidad de vida de las personas que lo padecen.Osteoarthritis is a degenerative and slow-onset disease caused by the increasing damage and wear of the articular cartilage and subchondral bone, which causes pain, functional disability and worsening of the quality of life of people who suffer from it. The knee is the main location of this condition, called gonarthrosis, which generates a high rate of disability worldwide. Despite non-pharmacological and pharmacological interventions, on many occasions the treatment of choice is surgery through Total Knee Arthroplasty (TKA). However, patellar replacement during surgery is a procedure that generates debate among authors due to its advantages, such as pain reduction, and drawbacks, such as increased risk of infection. This research is part of the main objective of exploring the risk factors for periprosthetic infection after TKA and its relationship with patellar replacement. For this, a meta-analysis was carried out with the latest available evidence aimed at determining the convenience or inconvenience of patellar replacement based on its consequences; as well as a retrospective and descriptive study on the TKAs performed in the period 2014- 2018 in the Traumatology and Orthopedic Surgery Service of the University Hospital of Burgos (HUBU), with the intention of analyzing the predisposing factors dependent on the patient and the health system, with regarding the development of periprosthetic infection. As benefits of patellar replacement, the decrease in anterior knee pain and revision rate were observed, without showing, in the meta-analysis carried out, significant adverse effects. However, in the study carried out, a significant relationship was found for the first time between patellar replacement and the development of periprosthetic infections [p=0.049], which occur at significantly higher rates in men, with patellar surgeries. long duration, prolonged hospital stay, and more experienced surgeons. These findings represent a starting point for this field of knowledge, since it is necessary to increase research to corroborate these data and to be able to develop preventive and surgical methods that allow the treatment of this pathology with the minimum possible risk, in order to thus increase the quality life of the people who suffer from it

Disfunción sexual eréctil en pacientes diabéticos atendidos en la consulta multidisciplinaria de Terapia y Orientación Sexual. Manzanillo

The impotence associated with diabetes can appear at any age. A descriptive investigation was carried out to describe the morbidity of erectile sexual dysfunction in diabetic patients. The universe of work was made up of all the diabetic patients seen in the multidisciplinary municipal consultation of Sexual Orientation and Therapy (n = 18, 100 %) in the period of February 2016-February 2017. The variables age, type of diabetes mellitus, were explored, time of evolution of diabetes, cause of dysfunction (psychogenic or organic), intensity of erectile dysfunction and levels of anxiety as a state and as a trait, several instruments were applied for the collection of data as psychological clinical interview, questionnaire for the Male Sexual Health (IIFE) and Trait-State Anxiety Inventory (IDARE). The data were expressed in absolute numbers and percentages. We found predominance of type II diabetic patients over 50 years of age and more than 10 years of suffering from the disease and included in the stage of life of middle and older adult, the cause of the dysfunction is mostly organic, the intensity of erectile sexual dysfunction in the patients was severe and moderate, mostly with the diagnosis of type II diabetes and when anxiety type was assessed, anxiety at medium and high levels prevailed. It is concluded that high morbidity of maintenance erectile dysfunction was found in diabetic patients attended in the specialized consultation of orientation and sexual therapy.La impotencia asociada a la diabetes puede aparecer a cualquier edad. Se realizó una investigación descriptiva para describir la morbilidad de disfunción sexual eréctil en pacientes diabéticos. El universo de trabajo lo conformaron todos los pacientes diabéticos atendidos en la consulta multidisciplinaria municipal de Orientación y Terapia Sexual (n=18; 100 %) en el periodo de febrero 2016-febrero 2017. Se exploraron las variables edad, tipo de diabetes mellitus, tiempo de evolución de la diabetes, causa de la disfunción (psicógena u orgánica), intensidad de la disfunción eréctil y niveles de ansiedad como estado y como rasgo, se aplicaron varios instrumentos para la recolección de los datos como entrevista clínica psicológica, cuestionario para la salud sexual masculina (IIFE) y el inventario de ansiedad rasgo-estado (IDARE). Los datos se expresaron en números absolutos y porcentajes. Se encontró predominio de pacientes diabéticos tipo II con más de 50 años de edad y más de 10 años de padecer la enfermedad e incluidos en la etapa de la vida de adulto medio y mayor, la causa de la disfunción es mayormente de tipo orgánica, la intensidad de la disfunción sexual eréctil en los pacientes fue grave y moderada, en su mayoría con el diagnóstico de diabetes tipo II y al evaluar el tipo de ansiedad predominó la ansiedad a niveles medio y alto. Se concluye que se encontró alta morbilidad de disfunción eréctil de mantenimiento en los pacientes diabéticos atendidos en la consulta especializada de orientación y terapia sexual

Low cost indoor ultrasonic positioning implemented in FPGA

Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works. A. Sánchez, S. Elvira, Á. de Castro, G. Gonzalez-de-Rivera, R. Ribalda, J. Garrido, "Low cost indoor ultrasonic positioning implemented in FPGA", 35th Annual Conference of IEEEIndustrial Electronics, 2009. IECON '09, Porto (Portugal), 2009, pp. 2709 - 2714This paper presents a low cost indoor ultrasonic-based positioning system. This system allows the mobile nodes of a Wireless Sensor Network to know their location using radiofrequency and ultrasonics. To achieve this goal, a matrix of transmitting anchor points is installed whereas the mobile nodes receive these transmitted signals and estimate the time-of-flight of the ultrasonic signals. Using two time-of-flight measurements and trilateration equations, the location of the mobile nodes can be inferred in a 2-D space.This work has been partially supported by the CCG08-UAM/TIC-4258 project of the Comunidad de Madrid and UAM

Short-term effects of impurities in the CO2 stream injected into fractured carbonates.

After the Paris Agreement in which 195 countries are involved, the Carbon Capture and Storage (CCS) is now an accepted technology in the United Nations Framework Convention on Climate Change (UNFCCC). In Spain, Fundación Ciudad de la Energía (CIUDEN) has successfully completed the full CCS chain, being CO2 captured in the Technology Development Centre in Cubillos del Sil (León, Spain) whereas that it is geologically stored in a deep saline aquifer, formed by fractured carbonates with poor matrix porosity, located in the Technology Development Plant (TDP) at Hontomín (Burgos, Spain). The results of the field tests, in which up to 150 tons of CO2 and synthetic air (5 %v of N2 and O2) were co-injected on site, are analyzed in this paper comparing the operational parameters gained during the injection of impure CO2 (pressures, temperatures and flow ranges) with its corresponding baseline previously determined (i.e. 1,500 tons of pure CO2 were injected during the reservoir hydraulic characterization). Besides that, the geochemical reactivity analysis of impure CO2 injected in this saline aquifer and its correlation with the results from laboratory tests were assessed. As main conclusions from laboratory scale results, a porosity diminution was measured after the injection of CO2 with 5 %v of SO2; apart from that, without SO2, the effluent pH was in the range of 7-8 whereas in case of CO2 and SO2, a pH of 1-2 was obtained. Otherwise and focused on field scale tests, a density decrease was detected comparing the base case (pure CO2) with the CO2 injection containing 5.1 %v of synthetic air. On the other hand, Ca2+, SO42-, Mg2+ and K+ migration effects in the rock were also detected and analyzed

Printable Graphene Oxide Nanocomposites as Versatile Platforms for Immobilization of Functional Biomolecules

A series of novel nanocomposites containing graphene oxide (GO) suitable for stereolithography is presented. Different loads of GO are tested, identifying that these materials can be printed with concentrations up to 2.5 wt% GO, presenting improved mechanical properties for concentrations below 1.0 wt% GO. In this range, the nanocomposites exhibit higher strength and toughness when compared to the pristine resin. Microscopic analyses of the material demonstrate that this can be correlated with the good compatibility of GO with the resin, which favors its homogeneous dispersion in the form of flexible nanoplates. After manufacturing, the availability of GO to participate in surface modification reactions with chitosan (CHI) and an alkaline phosphatase (ALP) is evaluated. CHI and ALP are well-known to act as biological cues in biorecognition processes, evidencing that these nanocomposites are suitable as platforms for selective immobilization of functional biomolecules.This work was funded by the Ministry of Science, Innovation and Universities (TEC2017-86102-C2-2-R), the 2014-2020 ERDF Operational Programme and the Department of Economy, Knowledge, Business and University of the Regional Government of Andalusia (FEDER-UCA18-106586). Co-funding from UE and the research group INNANOMAT (ref. TEP-946) is also acknowledged. A.S.d.L. and M.d.l.M. acknowledge Ministry of Science, Innovation and Universities for their Juan de la Cierva Incorporacion postdoctoral fellowships (IJC2019-041128-I, IJCI-2017-31507). SEM and TEM measurements were carried out at the DME-SC-ICyT-ELECMI-UCA

A comparison of transformer HF models and their application to PQ analysis

This research work is devoted to the comparison of some proposed high-frequency (HF) models of transformers and their application to power quality (PQ) studies. The models are classified according their structure, physical description and experimental methodology and set-up facilities needed to obtain the parameters

Peloids prepared with three mineral-medicinal waters from spas in Granada. Their suitability for use in pelotherapy

Three peloids were studied, prepared with three mineral-medicinal water (MMW) from the spas at Alicún (sulphate, rich in magnesium and calcium, highly mineralized), Zújar (sulphate, rich in sodium chloride, highly mineralized) and Graena (sulphate, rich in magnesium and calcium, highly mineralized) (province of Granada, Spain) and matured for three months, in order to determine their properties and suitability for use in pelotherapy. Their solid phase was prepared by mixing kaolin and bentonite (9:1, w:w). In the peloids the following was studied: composition of interstitial liquid, granulometry, physicochemical properties (specific surface area -SSA-, cation exchange capacity -CEC- and exchangable bases), crystallinity index of the minerals, thermal behavior and ultramicroscopic fabric using scanning electron microscopy (SEM) and image analysis (IA). A modification of the ionic concentration of the interstitial liquid was observed with regard to the initial MMW, namely, an increase in the concentration of Na+ and K+, and a decrease in Ca2+ and Mg2+, due to exchange between the exchangable cations of the solid phase and the ions of the MMW. Increases in the proportion of fraction <2 μm, SSA and CEC were also observed. The crystallinity index of the kaolinite decreased after three months' maturation, as compared to the initial mineral sample. The fabric developed during maturation was porous and reticulated and the fabric parameters were related to the thermal properties of the peloid. The properties of the three peloids studied make them potentially suitable for use in pelotherapy

Basalt Fiber Composites with Reduced Thermal Expansion for Additive Manufacturing

Fused filament fabrication (FFF) is gaining attention as an efficient way to create parts and replacements on demand using thermoplastics. This technology requires the development of new materials with a reliable printability that satisfies the requirement of final parts. In this context, a series of composites based on acrylonitrile styrene acrylate (ASA) reinforced with basalt fiber (BF) are reported in this work. First, several surface modification treatments are applied onto the BF to increase their compatibility with the ASA matrix. Then, once the best treatment is identified, the mechanical properties, coefficient of thermal expansion (CTE) and warping distortion of the different specimens designed and prepared by FFF are studied. It was found that the silanized BF is appropriate for an adequate printing, obtaining composites with higher stiffness, tensile strength, low CTE and a significant reduction in part distortion. These composites are of potential interest in the design and manufacturing of final products by FFF, as they show much lower CTE values than pure ASA, which is essential to successfully fabricate large objects using this technique

Relaciones entre modelos gerenciales y pensamiento estratégico empresarial en las empresas agroindustriales del departamento del Tolima

 Algunos de los factores clave del éxito de la empresa moderna están dados tanto por su modelo gerencial y el pensamiento estratégico, como por la orientación administrativa (tareas, personas y estructura) y el proceso gerencial (formulación, ejecución y evaluación estratégicas) adoptados. La presente investigación es de carácter descriptivo y tuvo como objeto estudiar las empresas agroindustriales del departamento del Tolima, de acuerdo con la caracterización presentada en la “Visión Tolima 2025” y con la Clasi cación Industrial Internacional Uniforme - Ciiu, referentes en los cuales aparecen relacionadas las actividades vinculadas con las cadenas pro- ductivas con mayor potencial de desarrollo y crecimiento (frutas, cárnicos y lácteos y piscícola). Los hallazgos dan cuenta del estado en que se encuen- tran las empresas y actividades económicas agroindustriales mencionadas, sus potencialidades hacia el futuro y del modelo teórico gerencial que las puede guiar