Tratamiento de la luxación congénita de cadera inveterada según la técnica de klisic

En este trabajo se valoran retrospectivamente un grupo de 15 pacientes, con edades superiores a los 6 años, afectos de luxación congenita inveterada y que fueron intervenidos (16 caderas) mediante la técnica de Klisic. El tiempo medio de seguimiento fue de 4 años. En 12 caderas se habían realizado previamente distintas técnicas quirúrgicas sin obtener resultados satisfactorios. Tras efectuar la técnica de Klisic, 11 caderas presentaban un centraje coxofemoral satisfactorio. Se objetivos necrosis epifisaria en 6 casos, aunque en 5 de ellos ya existía antes de la intervención. Valorando los resultados con una escala clínico-radiológica (Trevor y cols. 1975), se obtuvieron resultados excelentes o buenos en el 50% de los casos. En el 3 1% de los pacientes el resultado fue pobre desde el punto de vista radiológico y clínico. En conclusión, la técnica de Klisic supone una alternativa recomendable para el tratamiento de la luxación inveterada de cadera. Su indicación más adecuada sería la luxación alta con acetábulo hipoplásico.A group of 15 patients, over 6 years of age, with neglected congenital hip dislocation (16 hips) were operated on using the Klisic''''s technique. The mean follow-up was 4 years. Prior this surgery, 12 hips had undergone different surgical treatments without satisfactory results. At the end of follow-up 11 hips were satisfactory reduced. In 6 cases necrosis of the femoral head was detected, but necrotic signs were seem in the preoperative radiographs of 5 of these cases. According to a clinico-radiographic score (Trevor et al. 1975), either excellent or good results were obtained in 50% of cases. In 3 1% the outcome was poor from both clinical and radiographic point of view. In conclusion, Klisic''''s technique seems to be a suitable alternative for the treatment of reglected congenital dislocation of the hip. The more proper indication would be a high dislocation of the hip with hypoplasic acetabulum

#HazClick

El presente informe recoge nuestro Trabajo Fin de Grado (TFG) en Pedagogía, bajo la modalidad de Proyecto de Innovación. La temática que aborda se centra en uno de los retos pedagógicos al que se enfrentan las empresas en la actualidad: Como integrar y hacer uso de las tecnologías de la información y la comunicación (TIC) en los procesos de trabajo y potenciar el aprendizaje de los profesionales. En el proceso de incorporación de las TIC en las empresas existen múltiples variables, tales como: la dotación de recursos y la manera de organizarlos, o la política dictada por la Institución para su uso, pero no cabe duda que la predisposición de los profesionales y los recursos TIC con los que dispone la empresa es un factor primordial para llevar a cabo este proyecto. Éste es, precisamente, nuestro interés y por ello que nuestro Proyecto de Innovación se basa en otorgar a los profesionales técnicas y herramientas para la incorporación de los recursos TIC en sus funciones y lograr ampliar sus conocimientos en las TIC, fortaleciendo su liderazgo e influencia para lograr un uso efectico dentro de la Agencia de Colocación. PALABRAS CLAVES Tecnologías de la información y comunicación (TIC), formación de profesionales, conocimientos TIC, usuario/a, gestión y organización.This report contais my Final Year Work(TFG) in Education, under the modality of Innovation Project. The thematic approach is focused on one of the pedagogical challenges facing companies today: How to integrate and make use of information and communication technologies (ICT) in the work processes and enhance the learning of the professionals. In the process of incorporating ICT in companies, there are multiple variables, such as: the allocation of resources and the way to organize them, or the policy dictated by the Institution for its use, but there is no doubt that the predisposition of professionals and The ICT resources available to the company is a key factor in carrying out this project. This is precisely our interest and therefore our Innovation Project is based on giving technical professionals and tools to incorporate ICT resources in their functions and to expand their knowledge in ICT, strengthening their leadership and influence to Achieve effective use within the Placement Agency. KEYWORDS Information techonogy and communication (TIC), training of professionals, knowledge TIC, user, management and organization

The Divided Self: A Puerto Rican Immigrant’s Journey to Biculturalism

Mentor: Ignacio Sanchez Prado From the Washington University Undergraduate Research Digest: WUURD, Volume 6, Issue 2, Spring 2011. Published by the Office of Undergraduate Research, Joy Zalis Kiefer Director of Undergraduate Research and Assistant Dean in the College of Arts & Sciences; Kristin Sobotka, Editor

Increase of leptospirosis in dengue-negative patients after a hurricane in Puerto Rico in 1996 [correction of 1966]

Leptospirosis has rarely been reported in Puerto Rico, although in the period from 1948 to 1952, 208 cases of leptospirosis and an island-wide seroprevalence of antibody to Leptospira of 14% were documented. In Puerto Rico in October 1996, following rainfall and a period of flooding generated by Hurricane Hortense, serum specimens of 4 patients with suspected dengue fever that were negative for dengue tested positive for Leptospira-specific IgM antibodies in a dipstick assay. Subsequently, we used an island-wide dengue laboratory-based surveillance system to determine the increase in leptospirosis after hurricane-generated floods. All anti-dengue IgM-negative patients (n = 142) with disease onset from August 8 to October 6, 1996 from prehurricane and posthurricane groups were investigated for leptospirosis. Laboratory-confirmed leptospirosis cases were defined as microscopic agglutination test titers > or = 1 :400 to 1 or more serovars, or positive immunohistochemistry in autopsy tissues. Four (6%) of 72 prehurricane and 17 (24%) of 70 posthurricane patients had laboratory-confirmed cases of leptospirosis (relative risk [RR] = 4.4, 95% confidence interval [CI] = 1.6-12.4). The mean age of case-patients was 34 years (range = 13-64). Eighteen (86%) of 21 confirmed case-patients were males, including one patient who died (31 years old). Patients were located in 18 (38%) of 48 municipalities that submitted serum samples. Clinical features significantly associated with leptospirosis were eye pain (RR = 1.5, 95% CI = 1.3-1.9), joint pain (RR = 1.4, 95% CI = 1.1-1.6), diarrhea (RR = 1.7, 95% CI = 1.2-2.5), and jaundice (RR = 3.3, 95% CI = 1.5-7.2). This study demonstrates the utility of a dengue laboratory-based surveillance system for the detection of an increase of leptospirosis, which most likely would have gone unrecognized. Leptospirosis is treatable with antibacterial agents; knowledge of this diagnosis may significantly reduce morbidity and mortality

03. Immunogenicity and Safety of a Quadrivalent Meningococcal Conjugate Vaccine (MenACYW-TT) Administered as a Booster Dose in Adults and Adolescents Vaccinated Against Meningococcal Disease 3 - 6 Years Earlier

BACKGROUND: Booster doses of meningococcal conjugate vaccines may induce long-term protection against invasive meningococcal disease. MenACYW-TT [MenQuadfi®] is a quadrivalent meningococcal conjugate vaccine, licensed for use in ages 2 years and older in USA. The vaccine is also licensed in ages 12 months and older in EU and other countries. METHODS: A phase IIIb study (NCT04084769) was conducted to evaluate the persistence of immune response in adults and adolescents primed 3-6 years earlier with either MenACYW-TT or MCV4-CRM (Menveo®) and, safety and immunogenicity of MenACYW-TT when administered as a booster dose with or without concomitant administration with MenB vaccines (Bexsero® and Trumenba®). Serum bactericidal assays with human complement (hSBA) and baby rabbit complement (rSBA) were used to measure antibodies against vaccine serogroups at baseline (Day 0 [D0]), D06 (in a subset) and 30 days post-vaccination (D30). Safety data were collected up to 6 months post-vaccination. RESULTS: At D0, the GMTs were higher in subjects primed with MenACYW-TT vs MCV4-CRM for serogroups C, Y and W, and were comparable for serogroup A. At D0, all hSBA GMTs were higher than those observed pre-priming dose, suggesting persistence of immunity. Sufficiency of hSBA seroresponse ( >75%) was demonstrated following administration of MenACYW-TT booster dose regardless of the priming vaccine administered 3-6 years earlier. Vaccine seroresponse in a subset of participants at D06 ranged from 77.8% (95%CI 62.9%; 88.8%) for serogroup A to 97.8% (88.5%; 99.9%) for serogroup W suggesting a quick onset of immune response post-booster. Post-vaccination (D30) hSBA GMTs were comparable for serogroups A, Y and W regardless of the nature of the priming vaccine and were higher for serogroup C in subjects primed with MenACYW-TT vaccine. The MenACYW-TT booster dose was well-tolerated and had similar safety profiles regardless of the priming vaccine. The safety profiles were comparable regardless of the MenB vaccine co-administered with MenACYW-TT vaccine. CONCLUSION: MenACYW-TT used as priming vaccine was able to demonstrate persistence of immune response 3-6 years later. MenACYW-TT elicits robust booster responses in adults and adolescents primed with MenACYW-TT or MCV4-CRM DISCLOSURES: Betzana Zambrano, MD, Sanofi Pasteur (Employee) Germán Áñez, MD, Sanofi Pasteur (Other Financial or Material Support, Former employee) Sue Jiayuan, MSc, Sanofi Pasteur (Independent Contractor) Judy Pan, PhD, Sanofi Pasteur (Employee) Habiba Arroum, MD, Sanofi Pasteur (Employee) Kucku Varghese, PhD, Sanofi Pasteur (Employee) Emilia Jordanov, MD, Sanofi Pasteur (Employee, Shareholder) Mandeep S. Dhingra, MD, Sanofi Pasteur (Employee, Shareholder

Leptospirosis among patients presenting with dengue-like illness in Puerto Rico.

Leptospirosis is difficult to distinguish from dengue fever without laboratory confirmation. Sporadic cases/clusters of leptospirosis occur in Puerto Rico, but surveillance is passive and laboratory confirmation is rare. We tested for leptospirosis using an IgM ELISA on sera testing negative for dengue virus IgM antibody and conducted a case-control study assessing risk factors for leptospirosis, comparing clinical/laboratory findings between leptospirosis (case-patients) and dengue patients (controls). Among 730 dengue-negative sera, 36 (5%) were positive for leptospirosis. We performed post mortem testing for leptospirosis on 12 available specimens from suspected dengue-related fatalities; 10 (83%) tested positive. Among these 10 fatal cases, pulmonary hemorrhage and renal failure were the most common causes of death. We enrolled 42 case-patients and 84 controls. Jaundice, elevated BUN, hyperbilirubinemia, anemia, and leukocytosis were associated with leptospirosis (p < .01 for all). Male sex, walking in puddles, rural habitation, and owning horses were independently associated with leptospirosis. Epidemiological, clinical, and laboratory criteria may help distinguish leptospirosis from dengue and identify patients who would benefit from early antibiotic treatment