Pseudoaneurismas femorales en fracturas de cadera. ¿Se puede evitar?

Aunque la aparición de un pseudoaneurisma femoral es infrecuente en el contexto del tratamiento de fracturas pertrocantéreas, debido a su extrema gravedad y a su posible implicación en las causas de mortali - dad, es necesario realizar un diagnóstico temprano y un tratamiento adecuado. Presentamos 3 casos en los que se produjo una lesión de la arteria femoral superficial, y 2 de la arteria femoral profunda, tratados los 3 casos con stents recubiertos. Conclusiones . Se debe tomar en consideración, recti fi car la aducción y rotación interna de la extremidad fracturada una vez colocado el implante, el uso de brocas cortas o con un tope para el momento del en - cerrojado distal, longitud adecuada de los tornillos, controlar el desplazamiento del trocánter menor, o una correcta colocación de los cerclajes femorales, para poder disminuir la incidencia de este tipo de lesiones.Although the appearance of a femoral pseudoaneurysm is uncommon in the context of treatment of trochanteric fractures, due to their extreme gravity and its possible involvement in the causes of death, it is ne - cessary for early diagnosis and appropriate treatment. We report 3 cases in which an injury occurred superficial femoral artery, and 2 of the deep femoral artery, 3 cases treated with stents. Conclusions. It should be taken into consideration, correct adduction and internal rotation of the fractured limb once fitted the implant, the use of short bits or a cap on the distal locking time, proper length screws, control the displacement of the lesser trochanter , or the correct placement of the femoral cerclage, to decrease the incidence of these injuries

Glial alterations in human prion diseases

Background: Neuroinflammation has recently been proposed to be a major component of neurodegenerative diseases. The aim of this study was to determine how the interaction between microglia and astroglia, which are the primary immune cell populations in the brain, and pathological prion protein (PrPsc) could influence the development and propagation of this neurodegenerative disease. Because a relevant role for glial response in prion disease has been clearly demonstrated in our previous studies using the natural animal model, a similar approach has been taken here using the natural human model. Methods: A morphological approach has been developed to analyze cerebellar samples from patients with Creutzfeldt-Jakob disease (CJD) in comparison with healthy control cases. Histopathological lesions were assessed, and PrPsc, glial fibrillary acidic protein (GFAP) and reactive microglia were immunolabelled by specific antibodies. Furthermore, co-location studies using confocal microscopy were performed to determine the possible relationships between both types of glial cells in all samples. Results: The results presented in this study support the involvement of both types of glial cells in CJD. Evidence of increased astrocyte and microglia reactivity can be observed in all CJD cases, and a close relationship between the types of glia is demonstrated by co-location studies. Conclusion: Proteinopathies such as Alzheimer, Parkinson, and Huntington diseases, where aberrant proteins spread throughout the brain during disease progression, may share a molecular basis and mechanisms of propagation. Therefore, studies elucidating the interaction between gliosis and prion propagation may be relevant to these other neurodegenerative diseases and may provide new targets for therapeutic intervention

Espondilitis tuberculosa no es una metástasis vertebral: diagnóstico diferencial y tratamiento quirúrgico. A propósito de un caso

Presentamos el caso de una paciente con dorsalgia y clínica neurológica de varios meses de evolución que ante las pruebas de imagen fue erróneamente diagnosticada de metástasis vertebral sin confirmación previa con biopsia. El deterioro progresivo neurológico y las nuevas pruebas de imagen confirmaron el diagnóstico de tuberculosis vertebral. La paciente fue tratada mediante curetaje, desbridamiento, fusión intersomática y osteosíntesis anterior además del tratamiento médico. Hubo una recuperación neurológica de la función sensitiva, motora y esfinteriana prácticamente completa al mes de la intervención. Tras 20 meses de evolución la paciente está asintomática sin evidencia de progresión de la enfermedadWe report a patient with back pain and neurological symptoms several months of evolution to the test image was wrongly diagnosed with spinal metastases without prior confirmation with biopsy. The progressive deterioration of neurological and new imaging confirmed the diagnosis of spinal tuberculosis. The patient was treated by curettage, debridement, anterior interbody fusion and internal fixation in addition to medical treatment. There neurological recovery of sensory function, motor and sphincter almost complete month after the intervention. After 20 months of evolution, the patient is asymptomatic without evidence of disease progressio

Solución numérica del problema inverso de Fraunhofer con técnicas de regularización

En este artículo se estudia un modelo matemático concreto proveniente de laconstrucción de un equipo medidor de diámetros de partículas esféricas medianteel empleo de técnicas láser. Se analiza la dificultad del cálculo de su soluciónnumérica y se describen algunas de la.'>técnicas de regularización más recomendadaspara este tipo de problemas. Se muestran los principales resultados deuna extensa experimentación numérica realizada con datos reales, a partir delos cuales se dan conclusiones sobre el mejor método a utilizar

Solución numérica del problema inverso de Fraunhofer con técnicas de regularización

En este artículo se estudia un modelo matemático concreto proveniente de laconstrucción de un equipo medidor de diámetros de partículas esféricas medianteel empleo de técnicas láser. Se analiza la dificultad del cálculo de su soluciónnumérica y se describen algunas de la.'>técnicas de regularización más recomendadaspara este tipo de problemas. Se muestran los principales resultados deuna extensa experimentación numérica realizada con datos reales, a partir delos cuales se dan conclusiones sobre el mejor método a utilizar

Solución numérica del problema inverso de Fraunhofer con técnicas de regularización

En este artículo se estudia un modelo matemático concreto proveniente de laconstrucción de un equipo medidor de diámetros de partículas esféricas medianteel empleo de técnicas láser. Se analiza la dificultad del cálculo de su soluciónnumérica y se describen algunas de la.'>técnicas de regularización más recomendadaspara este tipo de problemas. Se muestran los principales resultados deuna extensa experimentación numérica realizada con datos reales, a partir delos cuales se dan conclusiones sobre el mejor método a utilizar

Formation and evolution of back-barrier perched lakes in rocky coasts: an example of a Holocene system in NW Spain

Coastal back-barrier perched lakes are freshwater bodies that are elevated over sea-level and are not directly subjected to the inflow of sea-water. This study provides a detailed reconstruction of the Doniños back-barrier perched lake that developed at the end of a small river valley in the rocky coast of the northwest Iberian Peninsula during the Holocene transgression. Its sequence stratigraphy was reconstructed based on a core transect across the system, the analyses of its lithofacies and microfossil assemblages, and a high-resolution radiocarbon-based chronology. The Doniños perched lake was formed ca. 4.5 ka BP. The setting of the perched lake was favoured by Late Holocene sea-level stabilization and the formation of a barrier and back-barrier basin, which was contemporaneous with the high systems tract period. This basin developed over marine and lagoonal sediments deposited between 10.2 and 8.0 ka BP, during rapidly rising sea-level characteristic of the transgressive systems track period. At 1.1 ka BP, the barrier was breached and the perched lake was partially emptied, causing the erosion of the back-barrier basin sediments and a significant sedimentary hiatus. Both enhanced storminess and human intervention were likely responsible for this event. After 1 ka BP, the barrier reclosed and the present-day lake was reformed, with the water level reaching as high as 5 m amsl. The depositional evolution of the Doniños system serves as a model of coastal back-barrier perched lakes in coastal clastic systems that have developed over gently seaward-dipping rugged substrates at small distances from the shoreline and under conditions of rising sea-level and high sediment supply. A review of estuaries, back-barrier lagoons, pocket beaches and back-barrier perched lakes in the rocky coast of the northwest Spain shows that the elevation of the bedrock is the main factor controlling the origin and evolution of these systems

Influenza vaccination among multiple sclerosis patients during the COVID-19 pandemic

In the context of the COVID-19 pandemic, the co-circulation of influenza and SARS-CoV-2 viruses may have severe complications for vulnerable populations. For this reason, the World Health Organization pointed to the 2020–2021 anti-influenza campaign as being of special relevance. Our aim was to assess the 2020–2021 influenza vaccination coverage, and its associated factors, among patients in a Spanish multiple sclerosis (MS) unit. A cross–sectional study was conducted. People attending the MS unit of the Clinical Hospital of Zaragoza during 2020 were included. Variables were obtained by reviewing records. Associations with 2020–2021 influenza vaccination were analyzed using bivariate analysis and a multiple logistic regression model. A total of 302 patients were studied; 62.6% were women, whose mean age (standard deviation) was 47.3 (11.5) years. The 2020–2021 influenza vaccination coverage was 55.3% (59.8% in women and 47.8% in men). A total of 89.7% had at least one other indication for vaccination (e.g., immunosuppressive treatment in 225 patients). The variables associated with getting vaccinated were being female (adjusted odds ratio (95% confidence interval) (aOR (95%CI) = 2.12 (1.12–3.99)), having received the 2019–2020 influenza vaccine (aOR (95%CI) = 31.82 (14.71–68.86)) and being born in Spain (aOR (95%CI) = 12.91 (1.07–156.28)). Coverage is moderate compared to other countries. It is necessary to develop strategies to improve it, especially in men and those born outside Spain

Influenza vaccination coverage among multiple sclerosis patients: evolution over time and associated factors

Our objective was to determine the influenza vaccination rate in a Spanish cohort of multiple sclerosis (MS) patients. A retrospective cohort study was carried out. Patients who attended the MS unit of the Lozano Blesa Hospital of Zaragoza between January 2015 and 2020 were included. The variables were obtained by reviewing the specialized and primary care records. Associations between receiving the vaccine in each flu season and the other variables were analyzed using bivariate analysis and multiple logistic regression models. A total of 260 patients were studied, with a median age of 31 years at the time of diagnosis. A total of 62.3% (162/260) were women. Vaccination coverage ranged from 20.4% in the 2015–2016 and 2016–2017 seasons to 41.5% in the 2019–2020 season (p = 0.000). Having been vaccinated in the previous season (ORa: 16.47–390.22; p = 0.000) and receiving a vaccination recommendation from the hospital vaccination unit (ORa: 2.44–3.96; p < 0.009) were associated with being vaccinated. The coverage is in an intermediate position compared to other countries. It is necessary to improve the referral system of these patients to the hospital vaccination unit because the information obtained by this service contributed to higher vaccination rates