Factores favorecedores del colapso en las fracturas trocantéricas tratadas con el tornillo dinámico de cadera (DHS)

Presentamos una serie de 164 fracturas trocantéreas tratadas con el tornillo dinámico de cadera evaluando el tipo de fractura según la clasificación AO, el grao de osteoporosis, la colocación del tornillo cefálico y la calidad de reducción para relacionarlos con el deslizamiento del tornillo cefálico y la aparición de complicaciones. El tipo de fractura más frecuente ha correspondido al tipo a.1.1. a 2.1. con un 42.6%. Un 72.6% de los pacientes presentaban un grado 4, 5 ó 6 de osteoporosis, en un 91.4% la posición del tornillo fue la adecuada y en un 64% la calidad del montaje fue anatómica. El mayor deslizamiento del tornillo cefálico y la mayor incidencia de complicaciones se han producido en las fracturas inestables, en los grados 4 a 6 de osteoporosis, en aquellos casos en los que el tornillo se localizaba de forma no satisfactoria y cuando la calidad de reducción era inadecuada.We present a series of 164 trochanteric fractures treated with the dynamic hip screw, evaluating fracture type according to the AO classificationl, osteoporosis index, cephalic screw placement and quality of reduction, to relate them with the sliding of the cephalic screw and the appearance of complications. The more frequent fracture types were A.1.1. and A.2.1. with a 42.6%. 72.6% of patients were a 4,5 or 6 osteoporosis index, in 91.4% of cases the screw position was sintable and in 64% of cases de quality of assembly was anatomical. The greatest cephalic screw sliding and the highest rate of complications happened in unstable fractures, in the 4 and 6 osteoporosis index, in cases of unsintable screw placement and when the reduction quality was inadequate

Lesiones en el hombro causadas por electrocución

Las lesiones en el hombro tras sufrir una descarga eléctrica son raras. Presentamos siete pacientes con luxaciones y fracturas en el hombro debidas a una electrocución. Un alto porcentaje de estas lesiones se diagnostican tarde, empeorando de esta manera el pronóstico. Por ello, ante una electrocución, debemos pensar en una lesión de hombro.Shoulder injuries after an electrical shock are rare. We report seven cases with dislocation and fractures of the shoulder due to electrocution. A high percentage of these lesions are diagnosed late, worsening thus the prognosis. This is why, after an electrocution, a shoulder injury should be considered

Quiste subcondral de comportamiento agresivo

Los quistes subcondrales son lesiones poco frecuentes que se desarollan generalmente en torno grandes articulaciones en pacientes adultos. Su aspecto radiológico y su escasa clínica permiten generalmente el diagnóstico directo y en su mayoría no precisan tratamiento. En aquellos casos cuyo diámetro sea mayor de 2 cm y tengan tendencia a la recidiva deben descartarse otros procesos paratumorales o tumoralesSubchondral bone cysts are rare lesions generally found next to major joints in adult patients. The clinical and radiological appearances are usually enough to allow the diagnosis, and most of them do not need any treatment. In unusual large lesions and in those cases of aggressive behaviour another diagnosis must be ruled-out

Resultados de un programa de ahorro de sangre en prótesis de rodilla unilateral

La implantación de una prótesis de rodilla es un procedimiento que frecuentemente requiere reposición hemática en el postoperatorio inmediato. Entre las alternativas a la sangre alogénica, se ha propuesto la autodonación como una opción segura y efectiva; sin embargo, este procedimiento no está exento de controversia dada la anemia preoperatorio que supone para el paciente y el elevado coste de las unidades no utilizadas y, por tanto, desechadas. Se presentan los resultados obtenidos a lo largo de los últimos tres años con el uso no restrictivo de un programa de autotransfusión en pacientes en quienes se implantó una prótesis de rodilla unilateral. Las cifras obtenidas muestran una ligera reducción en la tasa de transfusión alogénica, pero con una eficiencia baja. Se plantean otras alternativas de reposición hemática y el perfil de pacientes que sería candidatos a seguir en un programa de autodonación.Total knee replacement is a procedure that frequently need postoperative blood transfusion. Instead of allogeneic blood, predeposit autologous transfusion has been proposed as a safe and efficient choice; nevertheless, this procedure is not free of debate due to the anaemia caused to the patients and the high number of no-used, and lost, units. We report the results of a no restrictive program of blood autologous transfusion in patients having a knee replace- ment, in the period between 2001 to 2003. The numbers show a slight decrease in the rate of allogeneic blood transfusion; nonetheless, with a short efectivenuess. We analyse other alternatives for blood transfusion and in what patients this procedure should be done

Transcriptome, Genetic Transformation and Micropropagation: Some Biotechnology Strategies to Diminish Water Stress Caused by Climate Change in Sugarcane

Global climate change caused by natural processes results in major environmental issues that affect the world. Climate variability results in changes that cause water stress in plants. Sugarcane is a tropical grass C4, perennial and a multi-purpose industrial cash crop which serves as the main source of raw material for the production of sugar and biofuel. Farmers face the challenge to provide biotech alternatives with potential benefits and minimize potential adverse impacts on sugarcane’s production. In order to find biotechnology strategies to diminish the impact of climate change, our laboratory teamworks with micropropagation, transcriptome and genetic transformation of sugarcane using the var. MEX69290. In the transcriptome of sugarcane, a total of 536 and 750 genes were differentially regulated under normal and water stress treatment respectively, of which key genes were selected to be inserted into sugarcane for tolerance to abiotic stress. Regarding results of micropropagation, it was concluded that the continuous immersion propagation system was the best culture strategy. This may be as result of the elimination of gelling agent, which additionally helps reduce production costs

Coral Reef Resilience Index for Novel Ecosystems: A Spatial Planning Tool for Managers and Decision Makers - A Case Study from Puerto Rico

Timely information is critical for coral reef managers and decision-makers to implement sustainable management measures. A Coral Reef Resilience Index (CRRI) was developed with a GIS-coupled decision-making tool applicable for Caribbean coral reef ecosystems. The CRRI is based on a five-point scale parameterized from the quantitative characterization of benthic assemblages. Separate subindices such as the Coral Index, the Threatened Species Index, and the Algal Index also provide specific information regarding targeted benthic components. This case study was based on assessments conducted in 2014 on 11 reef sites located across 3 geographic zones and 3 depth zones along the southwestern shelf of the island of Puerto Rico, Caribbean Sea. There was a significant spatial and bathymetric gradient (p < 0.05) in the distribution of CRRI values indicating higher degradation of inshore reefs. Mean global CRRI ranged from 2.78 to 3.17 across the shelf, ranking them as “fair.” The Coral Index ranged from 2.60 to 3.76, ranking reefs from “poor” to “good,” showing a general cross-shelf trend of improving conditions with increasing distance from pollution sources. Turbidity and ammonia were significantly correlated to CRRI scores. Multiple recommendations are provided based on coral reef conditions according to observed CRRI rankings

Ageing and Long-Term Care Planning Perceptions of Hispanics in the USA: Evidence from a Case Study in New London, Connecticut

This paper explores the ageing attitudes and long-term care planning behavior of adult Hispanics in New London, Connecticut, a town with 30 thousand inhabitants that is rapidly ageing. We conducted six focus groups and had 37 participants share their ageing perceptions and long-term care needs. Our main findings suggest that informal care arrangements are vulnerable and unsustainable especially since women have historically and disproportionately provided most family eldercare even at their own personal and financial expense. Though male participants expected their female relatives to care for them when they age and need personal assistance, female participants did not necessarily expect the same from their relatives including their daughters. Also, both formal and government long-term care systems lack cultural competence and can be prohibitively costly. Therefore, Hispanics plan for ageing within their circles of family care and their resilience in a context of cultural exclusion and socio-economic disadvantage epitomizes strong intergenerational values. These support networks may help explain why may outlive whites (the Hispanic paradox ) who, on average, have higher wealth and education levels. Long-term care planning is a complex process that cannot be relayed to families only. Adequate training for family members from other relatives, and from private and government entities to appropriately convey this type of planning is vital to ensure that Hispanic families understand their options

Dr. Ahmed Ouali, 1948–2020

International audienceAhmed Ouali was born on October 4, 1948 in Tigzirt, Tizi-Ouzou, Algeria. In 1952, he moved with his parents to Montluçon, France. In 1974, he was trained and graduated with a bachelor's degree in Biochemistry at the University of Lyon. He then, in 1976, earned a joint Ph.D. in Animal Science at the University of Blaise Pascal (Clermont-Ferrand) where he studied at the National Institute of Agricultural Research (INRA, Theix). The title of his doctorate thesis was “The role of muscle proteases on meat tenderization”. Subsequently, he was employed in a private laboratory for medical analysis from 1976 to 1978 and thereafter at the Meat Research Laboratory group at INRA, Theix as a permanent researcher. In 1990, he was appointed as a research director and led the “Biochemistry and Functions of Muscle Proteins” unit for 8 years. The Meat Research Station focused their research on many topics including colour and protein oxidation; enzymology and tenderness; and muscle protein functionalities. During his entire scientific career at INRA, but before his retirement on October 2013, Ahmed was living in Clermont-Ferrand, the city of the famous volcanic chain of the Puy-de-Dôme, with his wife Anne-Marie with whom he had two lovely children: Armelle (41 years) and Gäel (38 years). In 2019, they moved to their new house in Montpellier in the South of France

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London