781 research outputs found

    Resultados de la reparaciĂłn quirĂşrgica Del ligamento deltoideo en las fracturas equivalentes bimaleolares

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    ObjetivoEl objetivo de este estudio es evaluar los resultados de la reparación quirúrgica del ligamento deltoideo en fracturas equivalente bimaleolares.Material y métodoEntre 2002 y 2009 fueron intervenidos 49 pacientes con fractura del maléolo peroneo y signos clásicos de lesión del ligamento deltoideo; finalmente se recuperaron para la revisión 44 pacientes. Se dividieron en 2 grupos: grupo A con 33 casos, en los que se reparó el ligamento deltoideo, y grupo B con 11 casos, donde el deltoideo fue tratado conservadoramente. Las fracturas fueron clasificadas según Lauge-Hansen y la AO/OTA. Para la valoración clínico-funcional se usó la escala de la American Orthopaedic Foot and Ankle Society (AOFAS) para el tobillo. Se registraron las complicaciones y reintervenciones.ResultadosTras un seguimiento medio de 12 meses, se obtuvo un resultado satisfactorio en ambos grupos, con una puntuación media final de 95 puntos en el grupo A y una de 94 en el grupo B, según la escala AOFAS. Hubo 2 infecciones, 1 intolerancia de la sutura medial, 1 algodistrofia y 4 casos precisaron retirada de material.ConclusionesNuestros resultados sugieren que la lesión del ligamento deltoideo puede ser reparada con buenos resultados funcionales. Y entendemos que, aunque los signos clásicos nos ayudan a sospechar la lesión, no son predictores fiables de la necesidad de reparación del lado medial.PurposeThe purpose of this study is to evaluate the result of surgical repair of deltoid ligament in fracture of the distal fibula upper or at the syndesmotic level.Materials and methodsBetween 2002 and 2009, 49 patients with distal fibula fractures and classical signs of deltoid ligament incompetence were operated, 44 were available for follow-up. Two groups: group A included 33 cases in whom deltoid ligament was treated by surgical repair, and group B, 11 cases who were treated conservatively. All fractures were classified according to Lauge-Hansen and AO/OTA. The AOFAS ankle score was used for clinical and functional evaluation. Complications and reinterventions were recorded.ResultsAt a mean follow-up of 12 months, a satisfactory functional result was obtained in both groups, with a mean final score of 95 points in group A and 94 in group B on the AOFAS scale. There were 2 infection, a medial suture intolerance, an algodystrophy and 4 hardware removed.ConclusionsOur findings suggest that a ruptured deltoid ligament can be repair with goods functional result. And we understand that although the classical signs help us to suspect a torn ligament, are not reliable predictors for surgical revision of the medial side

    Detection system of magnetic nanoparticles in biological tissues by Magnetoencephalography

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    Magnetic nanoparticles are useful for a wide range of applications from data storage to medical imaging. Their unique features (controllable size in the nanoscale range, possibility to be coated with biological molecules, response to the application of a magnetic field...) make the development of a variety of medical applications possible, both for diagnosis and therapy [1-3]. On the other hand, Magnetoencephalography (MEG) is a non-invasive functional imaging technique that enables the description of the temporal and spatial patterns of brain activity in resting conditions or related to different basic cognitive processes, by detecting the weak magnetic fields generated by currents in the neurons [4,5]. The detection of the weak magnetic fields depends on gradiometer detection coils coupled to a superconducting quantum interference device (SQUID). However, MEG systems are not currently being used for the detection of MNPs in biological tissues. A system to newly detect Magnetic Nanoparticles (MNPs) in the brain and in biological tissues will be described. The method uses a commercial Magnetoencephalograph (MEG) and opens new possibilities to extend the use of MEG systems to new applications for both diagnosis and therapy of medical diseases, different from its common use in neurological diagnosis. To test the validity of the system, in this work, we will show its ability to detect MNPs in biological tissues and their possible use in diagnosis of cerebral brain microinjurie

    High prognostic value of measurable residual disease detection by flow cytometry in chronic lymphocytic leukemia patients treated with front-line fludarabine, cyclophosphamide, and rituximab, followed by three years of rituximab maintenance

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    It has been postulated that monitoring measurable residual disease (MRD) could be used as a surrogate marker of progression-free survival (PFS) in chronic lymphocytic leukemia (CLL) patients after treatment with immunochemotherapy regimens. In this study, we analyzed the outcome of 84 patients at 3 years of follow-up after first-line treatment with fludarabine, cyclophosphamide and rituximab (FCR) induction followed by 36 months of rituximab maintenance thearpy. MRD was assessed by a quantitative four-color flow cytometry panel with a sensitivity level of 10-4. Eighty out of 84 evaluable patients (95.2%) achieved at least a partial response or better at the end of induction. After clinical evaluation, 74 patients went into rituximab maintenance and the primary endpoint was assessed in the final analysis at 3 years of follow-up. Bone marrow (BM) MRD analysis was performed after the last planned induction course and every 6 months in cases with detectable residual disease during the 36 months of maintenance therapy. Thirty-seven patients (44%) did not have detectable residual disease in the BM prior to maintenance therapy. Interestingly, 29 patients with detectable residual disease in the BM after induction no longer had detectable disease in the BM following maintenance therapy. After a median followup of 6.30 years, the median overall survival (OS) and PFS had not been reached in patients with either undetectable or detectable residual disease in the BM, who had achieved a complete response at the time of starting maintenance therapy. Interestingly, univariate analysis showed that after rituximab maintenance OS was not affected by IGHV status (mutated vs. unmutated OS: 85.7% alive at 7.2 years vs. 79.6% alive at 7.3 years, respectively). As per protocol, 15 patients (17.8%), who achieved a complete response and undetectable peripheral blood and BM residual disease after four courses of induction, were allowed to stop fludarabine and cyclophosphamide and complete two additional courses of rituximab and continue with maintenance therapy for 18 cycles. Surprisingly, the outcome in this population was similar to that observed in patients who received the full six cycles of the induction regimen. These data show that, compared to historic controls, patients treated with FCR followed by rituximab maintenance have high-quality responses with fewer relapses and improved OS. The tolerability of this regime is favorable. Furthermore, attaining an early undetectable residual disease status could shorten the duration of chemoimmunotherapy, reducing toxicities and preventing long-term side effects. The analysis of BM MRD after fludarabine-based induction could be a powerful predictor of post-maintenance outcomes in patients with CLL undergoing rituximab maintenance and could be a valuable tool to identify patients at high risk of relapse, influencing further treatment strategies

    Influence of Vancomycin Minimum Inhibitory Concentration on the Outcome of Methicillin-Susceptible Staphylococcus aureus Left-Sided Infective Endocarditis Treated with Anti-staphylococcal Beta-Lactam Antibiotics; a Prospective Cohort Study by the International Collaboration on Endocarditis

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    Objectives: Left-sided methicillin-susceptible Staphylococcus aureus (MSSA) endocarditis treated with cloxacillin has a poorer prognosis when the vancomycin minimum inhibitory concentration (MIC) is ≥1.5 mg/L. We aimed to validate this using the International Collaboration on Endocarditis cohort and to analyse whether specific genetic characteristics were associated with a high vancomycin MIC (≥1.5 mg/L) phenotype. Methods: All patients with left-sided MSSA infective endocarditis treated with antistaphylococcal β-lactam antibiotics between 2000 and 2006 with available isolates were included. Vancomycin MIC was determined by Etest as either high (≥1.5 mg/L) or low (<1.5 mg/L). Isolates underwent spa typing to infer clonal complexes and multiplex PCR for identifying virulence genes. Univariate analysis was performed to evaluate the association between in-hospital and 1-year mortality, and vancomycin MIC phenotype. Results: Sixty-two cases met the inclusion criteria. Vancomycin MIC was low in 28 cases (45%) and high in 34 cases (55%). No significant differences in patient demographic data or characteristics of infection were observed between patients with infective endocarditis due to high and low vancomycin MIC isolates. Isolates with high and low vancomycin MIC had similar distributions of virulence genes and clonal lineages. In-hospital and 1-year mortality did not differ significantly between the two groups (32% (9/28) vs. 27% (9/34), p 0.780; and 43% (12/28) vs. 29% (10/34), p 0.298, for low and high vancomycin MIC respectively). Conclusions: In this international cohort of patients with left-sided MSSA endocarditis treated with antistaphylococcal β-lactams, vancomycin MIC phenotype was not associated with patient demographics, clinical outcome or virulence gene repertoire

    New measurement of the 242Pu(n,Îł) cross section at n-TOF-EAR1 for MOX fuels : Preliminary results in the RRR

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    The spent fuel of current nuclear reactors contains fissile plutonium isotopes that can be combined with 238U to make mixed oxide (MOX) fuel. In this way the Pu from spent fuel is used in a new reactor cycle, contributing to the long-term sustainability of nuclear energy. The use of MOX fuels in thermal and fast reactors requires accurate capture and fission cross sections. For the particular case of 242Pu, the previous neutron capture cross section measurements were made in the 70's, providing an uncertainty of about 35% in the keV region. In this context, the Nuclear Energy Agency recommends in its "High Priority Request List" and its report WPEC-26 that the capture cross section of 242Pu should be measured with an accuracy of at least 7-12% in the neutron energy range between 500 eV and 500 keV. This work presents a brief description of the measurement performed at n-TOF-EAR1, the data reduction process and the first ToF capture measurement on this isotope in the last 40 years, providing preliminary individual resonance parameters beyond the current energy limits in the evaluations, as well as a preliminary set of average resonance parameters

    Time-of-flight and activation experiments on 147Pm and 171Tm for astrophysics

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    The neutron capture cross section of several key unstable isotopes acting as branching points in the s-process are crucial for stellar nucleosynthesis studies, but they are very challenging to measure due to the difficult production of sufficient sample material, the high activity of the resulting samples, and the actual (n,Îł) measurement, for which high neutron fluxes and effective background rejection capabilities are required. As part of a new program to measure some of these important branching points, radioactive targets of 147Pm and 171Tm have been produced by irradiation of stable isotopes at the ILL high flux reactor. Neutron capture on 146Nd and 170Er at the reactor was followed by beta decay and the resulting matrix was purified via radiochemical separation at PSI. The radioactive targets have been used for time-of-flight measurements at the CERN n-TOF facility using the 19 and 185 m beam lines during 2014 and 2015. The capture cascades were detected using a set of four C6D6 scintillators, allowing to observe the associated neutron capture resonances. The results presented in this work are the first ever determination of the resonance capture cross section of 147Pm and 171Tm. Activation experiments on the same 147Pm and 171Tm targets with a high-intensity 30 keV quasi-Maxwellian flux of neutrons will be performed using the SARAF accelerator and the Liquid-Lithium Target (LiLiT) in order to extract the corresponding Maxwellian Average Cross Section (MACS). The status of these experiments and preliminary results will be presented and discussed as well

    Characterization of the n-TOF EAR-2 neutron beam

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    The experimental area 2 (EAR-2) at CERNs neutron time-of-flight facility (n-TOF), which is operational since 2014, is designed and built as a short-distance complement to the experimental area 1 (EAR-1). The Parallel Plate Avalanche Counter (PPAC) monitor experiment was performed to characterize the beam prole and the shape of the neutron 'ux at EAR-2. The prompt Îł-flash which is used for calibrating the time-of-flight at EAR-1 is not seen by PPAC at EAR-2, shedding light on the physical origin of this Îł-flash

    Measurement of the 240Pu(n,f) cross-section at the CERN n-TOF facility : First results from experimental area II (EAR-2)

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    The accurate knowledge of the neutron-induced fission cross-sections of actinides and other isotopes involved in the nuclear fuel cycle is essential for the design of advanced nuclear systems, such as Generation-IV nuclear reactors. Such experimental data can also provide the necessary feedback for the adjustment of nuclear model parameters used in the evaluation process, resulting in the further development of nuclear fission models. In the present work, the 240Pu(n,f) cross-section was measured at CERN's n-TOF facility relative to the well-known 235U(n,f) cross section, over a wide range of neutron energies, from meV to almost MeV, using the time-of-flight technique and a set-up based on Micromegas detectors. This measurement was the first experiment to be performed at n-TOF's new experimental area (EAR-2), which offers a significantly higher neutron flux compared to the already existing experimental area (EAR-1). Preliminary results as well as the experimental procedure, including a description of the facility and the data handling and analysis, are presented

    The measurement programme at the neutron time-of-flight facility n-TOF at CERN

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    Neutron-induced reaction cross sections are important for a wide variety of research fields ranging from the study of nuclear level densities, nucleosynthesis to applications of nuclear technology like design, and criticality and safety assessment of existing and future nuclear reactors, radiation dosimetry, medical applications, nuclear waste transmutation, accelerator-driven systems and fuel cycle investigations. Simulations and calculations of nuclear technology applications largely rely on evaluated nuclear data libraries. The evaluations in these libraries are based both on experimental data and theoretical models. CERN's neutron time-of-flight facility n-TOF has produced a considerable amount of experimental data since it has become fully operational with the start of its scientific measurement programme in 2001. While for a long period a single measurement station (EAR1) located at 185 m from the neutron production target was available, the construction of a second beam line at 20 m (EAR2) in 2014 has substantially increased the measurement capabilities of the facility. An outline of the experimental nuclear data activities at n-TOF will be presented
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