Tratamiento de lesiones pélvicas conminutas inestables en niños, con fijadores externos: a propósito de un caso

A propósito de un caso de una fractura pélvica conminuta inestable en una ni- ña de 6 años, se señalan las características peculiares de este tipo de lesiones y se recuerda que pueden presentar las mismas complicaciones potenciales que en los adultos. Nuestra actitud terapéutica en este caso fue la misma que se preconiza para los adultos en cuanto a la estabilización inicial mediante fijación externa.A case of conminute unstable fracture of the pelvis in a 6-year-old girl is presented. The particularities of this type of lesions, including the potential complications like in adults, are commented. This case was treated following the same criteria preconized for adults regarding the initial stabilization using an external device

Utilización de fijadores externos circulares para la corrección de pies gravemente deformados

Se presentan 4 casos de deformidades graves de pie de diferente etiología y diferente combinación de deformidades tratados mediante el fijador externo circular de Ilizarov. Se procedió a la corrección progresiva y simultánea de las deformidades en los 3 planos espaciales. En 2 casos se realizó simultáneamente y con el mismo montaje un alargamiento tibial y en 1 un alargamiento del pie. En todos los casos se lograron pies plantígrados que no necesitaron el uso de ortcsis de contención posteriormente.Four cases with severe deformities of the foot caused by different etiology and treated by using Ilizarov's circular fixators are presented. The deformities were progressively corrected in a triplanar approach. Tibial lengthening was simultaneously performed in two cases using the same device. In one case forefoot lengthening was associated. In all case, the final result achieved was a plantigrade foot. Patients did not need any orthesis after correction

Quiste óseo esencial: Resultados del tratamiento mediante punción intracavitaria con corticoides

Se presenta n los resultado s de l tratamient o de treint a quiste s óseo s esenciales mediante punción intracavitaria con acetato de metil-prednisolona. Se ha obtenido una respuesta favorable en el 93% de los casos con curación completa en el 77% de los casos. Estos resultados apoyan que debe ser el tratamiento inicial de elección en este tipo de lesiones.The results of 30 unicameral bone cyst treated by intracavitary injection of methylprednisolone acetate wer e reviewed. Satisfactory respons e was found in 93% of the cases. Complete restoration of bone architecture was observed in 77% of the cases. These results strongly support the local injection of steroids as the primary elective treatment for unicameral bone cyst

Novel intravesical bacterial immunotherapy induces rejection of BCG-unresponsive established bladder tumors

Background Intravesical BCG is the gold-standard therapy for non-muscle invasive bladder cancer (NMIBC); however, it still fails in a significant proportion of patients, so improved treatment options are urgently needed. Methods Here, we compared BCG antitumoral efficacy with another live attenuated mycobacteria, MTBVAC, in an orthotopic mouse model of bladder cancer (BC). We aimed to identify both bacterial and host immunological factors to understand the antitumoral mechanisms behind effective bacterial immunotherapy for BC. Results We found that the expression of the BCG-absent proteins ESAT6/CFP10 by MTBVAC was determinant in mediating bladder colonization by the bacteria, which correlated with augmented antitumoral efficacy. We further analyzed the mechanism of action of bacterial immunotherapy and found that it critically relied on the adaptive cytotoxic response. MTBVAC enhanced both tumor antigen-specific CD4 + and CD8 + T-cell responses, in a process dependent on stimulation of type 1 conventional dendritic cells. Importantly, improved intravesical bacterial immunotherapy using MBTVAC induced eradication of fully established bladder tumors, both as a monotherapy and specially in combination with the immune checkpoint inhibitor antiprogrammed cell death ligand 1 (anti PD-L1). Conclusion These results contribute to the understanding of the mechanisms behind successful bacterial immunotherapy against BC and characterize a novel therapeutic approach for BCG-unresponsive NMIBC cases. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ

Partially filled stripes in the two dimensional Hubbard model: statics and dynamics

The internal structure of stripes in the two dimensional Hubbard model is studied by going beyond the Hartree-Fock approximation. Partially filled stripes, consistent with experimental observations, are stabilized by quantum fluctuations, included through the Configuration Interaction method. Hopping of short regions of the stripes in the transverse direction is comparable to the bare hopping element. The integrated value of $n_{\bf \vec{k}}$ compares well with experimental results.Comment: 4 page

Utilitat de la metodologia de simulació per adquirir competències en habilitats de comunicació

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524Metodología: Se describen los talleres y seminarios de simulación empleados desde el año académico 2010-11 en la Facultad de Medicina de la Universidad de Barcelona, que se ofrecen a los alumnos a partir de 2 año de grado, con el fin de ofrecer a los alumnos de forma transversal la adquisición y refuerzo continuo de competencias en habilidades de comunicación. Siguiendo las definiciones del Libro Blanco de las Facultades de Medicina y de la Guía de la Facultad de Medicina de la UB, se ofrece formación en los siguientes aspectos de la competencia de comunicación: • Escuchar con atención, obtener y sintetizar información pertinente acerca de los problemas que aquejan al enfermo, y comprender el contenido de esta información. • Comunicación de malas noticias • Obtener un consentimiento Informado • Comunicación entre profesionales Se describen el nivel de aprendizaje, el personal docente requerido, la duración de los seminarios o talleres, los objetivos docentes, el material necesario en cada actividad y el año de la formación de grado en que se aplica. Se describe la utilización de la estrategia de feed-back para la autoevaluación de la actividad práctica, empleando grabaciones de los talleres y simulaciones de los grupos de alumnos. Se describe así mismo, las encuestas empleadas para la evaluación por el docente y los compañeros de clase de las actividades de simulación y la metodología empleada de evaluación de los seminarios y su calificación dentro de la nota final de cada asignatura. Finalmente se describen las asignaturas optativas existentes en la Facultad de Medicina de la UB para reforzar las habilidades de comunicación y los planes futuros de desarrollo de actividades formativas complementarias y de refuerzo y las propuestas evaluativas de la competencia

Diagnosis of cardiac surgery-associated acute kidney injury: State of the art and perspectives

Producción CientíficaDiagnosis of cardiac surgery-associated acute kidney injury (CSA-AKI), a syndrome of sudden renal dysfunction occurring in the immediate post-operative period, is still sub-optimal. Standard CSA-AKI diagnosis is performed according to the international criteria for AKI diagnosis, afflicted with insufficient sensitivity, specificity, and prognostic capacity. In this article, we describe the limitations of current diagnostic procedures and of the so-called injury biomarkers and analyze new strategies under development for a conceptually enhanced diagnosis of CSA-AKI. Specifically, early pathophysiological diagnosis and patient stratification based on the underlying mechanisms of disease are presented as ongoing developments. This new approach should be underpinned by process-specific biomarkers including, but not limited to, glomerular filtration rate (GFR) to other functions of renal excretion causing GFR-independent hydro-electrolytic and acid-based disorders. In addition, biomarker-based strategies for the assessment of AKI evolution and prognosis are also discussed. Finally, special focus is devoted to the novel concept of pre-emptive diagnosis of acquired risk of AKI, a premorbid condition of renal frailty providing interesting prophylactic opportunities to prevent disease through diagnosis-guided personalized patient handling. Indeed, a new strategy of risk assessment complementing the traditional scores based on the computing of risk factors is advanced. The new strategy pinpoints the assessment of the status of the primary mechanisms of renal function regulation on which the impact of risk factors converges, namely renal hemodynamics and tubular competence, to generate a composite and personalized estimation of individual risk.Instituto de Salud Carlos III y Fondo Europeo de Desarrollo Regional (FEDER) - (grant PI18/00996, PI21/01226), Unión Europea, Red de Investigación Renal (Enfermedad Renal) - (grant RICORS2040)Unión Europea–NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR) - (grant RD21/0005/0004)Junta de Castilla y León (Consejería de Educación) y Fondo Europeo de Desarrollo Regional (FEDER) - (grant IES160P20

Synthesis of Porous Clay Heterostructures Modified with SiO2–ZrO2 Nanoparticles for the Valorization of Furfural in One-Pot Process

The layered structure of two smectites (montmorillonite and saponite) are modified by the insertion of SiO2–ZrO2 nanoparticles, with a Si/Zr molar ratio of 5, to form porous clay heterostructures (PCHs). These PCHs exhibit a clear improvement of the textural and acid properties in comparison to the starting clays, due to the formation of a pillared structure and the presence of Zr species, which provide an increase in the amount of Lewis acid sites. These materials are studied in one-pot catalytic processes to transform furfural into valuable products, such as furfuryl alcohol, alkyl furfuryl ethers, alkyl levulinates or γ-valerolactone, depending on the experimental conditions. Thus, the use of milder reaction temperature (110 °C) favors the formation of furfuryl alcohol and alkyl furfuryl ethers, while higher temperatures (170 °C) promote the formation of alkyl levulinate and γ-valerolactone, as well as an increase in nondetected products associated to the formation of humins due to the polymerization of furfural and/or furfuryl alcohol.The authors are grateful for financial support from the Spanish Ministry of Science, Innovation and Universities (RTI2018-94918-B-C44 project), FEDER (European Union) funds (UMA18-FEDERJA-171), and the University of Malaga. C.P.J.-G. and C.G.-S. acknowledge Junta de Andalucía and FEDER funds, respectively, for their postdoctoral contracts. Funding for open access charge: Universidad de Málaga/CBUA

Porous SiO2 Nanospheres Modified with ZrO2 and Their Use in One- Pot Catalytic Processes to Obtain Value-Added Chemicals from Furfural

Porous SiO2 nanospheres have been modified with different proportion of ZrO2 to obtain catalysts with Si/Zr molar ratio between 2.5 and 30. These materials were characterized by X-ray diffraction, transmission electron microscopy, scanning electron microscopy, N2 adsorption-desorption at -196 ºC, X-ray photoelectron spectroscopy and pyridine and 2-6-dimethylpyridine thermoprogrammed desorption. The characterization of these catalysts reveals that the incorporation of a high proportion of Zr favors the formation of Lewis acid sites, which are implied in catalytic transfer hydrogenation processes, whereas the low Brönsted acidity promote dehydration reaction, in such a way that it is possible to obtain a wide range of products from FUR through consecutive reactions, such as furfuryl alcohol, i-propyl furfuryl ether, i-propyl levulinate and γ-valerolactone in a range of temperature of 110-170 ºC between 1-6 h of reaction.Spanish Ministry of Science, Innovation and Universities:RTI2018‐94918‐B‐C44; FEDER (European Union) funds: RTI2018‐94918‐B‐C44 and UMA18-FEDERJA-171; University of Malaga; Junta de Andalucía; Funding for open access charge: Universidad de Málaga/CBU