(P2-13) Pitfalls for Upper Limb Injuries in Emergency

Sternoclavicular dislocation usually requires a Computed Tomography (CT) scan and surgery. This injury is rare because costoclavicular ligaments are strong. They appear in motorcycle accidents and sports collisions. Compression of the neurovascular structures or trachea involving the vital prognosis is not rare. Practitioners must be aware of symptoms such as dysphagia, dyspnea, hoarseness, or neurologic disorders. On the printing of thoracic standards, the medial clavicle appears misplaced superiorly in previous dislocations and posterior inferior dislocations. Fracture of the scapula (less than 1% of all fractures) rarely requires surgery, but should not be ignored because they signal a very high-energy trauma. The posterior shoulder dislocation is 2-4% of all delayed dislocations. Diagnosis is most often attributed to inadequate x-ray photographs. The main causes of this dislocation are epilepsy and electrocution. Radiography in front and profile observed a duplication of the humeral head. Joint space is not completely in view, and the CT scan can confirm the diagnostic if there is any doubt. Fracture of the clavicle is common in young patients. Fractures with lesions of the clavicular vessels and nerves are common. Practitioners also must be wary of intermediate fragments, which can puncture skin. Pneumothorax should always be excluded by a complete chest auscultation. The stump of the shoulder must be minimized in young patients, or an active patient operative indication can have negative functional and aesthetic consequences. Neurovascular examination must be complete, and circonflex nerve damage should not be confused with injury of the rotator cuff. These two injuries reduce abduction. The elbow is complex and a number of lesions could be missed, including: (1) the tip of the coronoid process; (2) epitrochlea and epicondyle; (3) radial head fractures; or (4) pullout capitelu

Articular nodular fasciitis in the glenohumeral joint

We describe a case of multiple intra-articular masses in the glenohumeral joint of a 15-year-old patient. The patient was treated with arthroscopic excision of the masses and synovectomy. Histological and immunohistochemical studies were consistent with those of a nodular fasciitis. Follow-up examination did not reveal recurrence at 6months. In this article we report the first case of articular nodular fasciitis in the glenohumeral joint with unusual imaging finding

Risk factors for treatment failure in orthopedic device-related methicillin-resistant Staphylococcus aureus infection

The purpose of this study was to determine the clinical and microbiological risk factors for treatment failure of methicillin-resistant Staphylococcus aureus (MRSA) orthopedic device-related infection (ODRI). A retrospective cohort study of patients with MRSA ODRI who were treated at Geneva University Hospitals between 2000 and 2008 was undertaken. Stored MRSA isolates were retrieved for genetic characterization and determination of the vancomycin minimum inhibitory concentration (MIC). Fifty-two patients were included, of whom 23 (44%) had joint arthroplasty and 29 (56%) had osteosynthesis. All 41 of the retrieved MRSA isolates were susceptible to vancomycin (MIC ≤ 2mg/L) and 35 (85%) shared genetic characteristics of the South German clone (ST228). During a median follow-up of 391days (range, 4-2,922days), 18 patients (35%) experienced treatment failure involving MRSA persistence or recurrence. Microbiological factors such as infection with the predominant clone and a vancomycin MIC of 2mg/L were not associated with treatment failure. Using a Cox proportional hazards model, implant retention (hazard ratio [HR], 4.9; 95% confidence interval [CI], 1.3-18.2; P = 0.017) and single-agent antimicrobial therapy (HR, 4.4; 95% CI, 1.2-16.3; P = 0.025) were independent predictors of treatment failure after debridement. Therapy using a combination of antimicrobials should be considered for patients with MRSA ODRI, especially when implant removal is not feasibl

Laser modulated optical reflectance of thin semiconductor films on glass

Semiconductor films, deposited by reactive magnetron sputtering on glass substrates have been analyzed with the help of laser-modulated optical reflectance. The results are discussed with respect to the thermal and charge carrier transport properties. Semiconductor properties have been identified both for micro-crystalline and amorphous film

Hidrografía de la columna de agua en Puerto Cuatreros

Se analizó la variación de las condiciones hidrográficas en la columna de agua en relación al ciclo de mareas en Puerto Cuatreros. Durante el período comprendido entre diciembre de 2004 y diciembre de 2005 se midieron perfiles verticales de temperatura y salinidad y se obtuvieron muestras de agua en dos profundidades para determinar la concentración de sedimentos en suspensión. Los parámetros meteorológicos y la marea se obtuvieron en forma continua. La temperatura del agua presentó un suave gradiente vertical en bajamar, en tanto que en pleamar el sistema se homogeneizó producto de la mezcla turbulenta de la marea. La temperatura superficial del agua presentó una variación a lo largo del ciclo de marea con mayor amplitud en los meses cálidos. La salinidad presentó un notorio gradiente vertical en bajamar. En creciente y pleamar la salinidad fue similar a la de la plataforma continental interior, mientras que en bajante y bajamar disminuyó por influencia de la descarga de agua dulce de arroyos próximos a la zona. En meses con altas precipitaciones la salinidad decreció significativamente y en días con altas temperaturas aumentó por efecto de la evaporación. Las mayores concentraciones de sedimento en suspensión se registraron con precipitaciones máximas y en marea bajante. Si bien la marea es el principal agente que influye sobre las características de la columna de agua, el factor meteorológico contribuye a generar variabilidad sobre las características hidrográficas en Puerto Cuatreros.The variation ofthe hydrographic conditions in the water column in relation to the tidal cycle in Cuatreros Port wás analyzed. Vertical profiles of temperature and salinity were measured between December 2004 and December 2005. Water samples were also obtained to determine the suspended sediment concentration. Meteorological parameters and tides were registered continuously. Water temperature showed a smooth vertical gradient during low tide, while in high tide the system became homogenous as a consequence of tidal mixing. The surface water temperature showed a variation throughout the tidal cycle with the greatest amplitude in the warm months. The salinity showed a significant vertical gradient in low tide. During flood and high tide salinity was similar to the typical values ofthe inner continental shelf, while in ebb and low tide it diminished because ofthe influence offreshwater discharges ofnearby streams. In months with high precipitations, salinity decreased significantly and in days with high temperatures it increased by effect ofevaporation. The highest concentrations ofsuspended sediment were registered with maximum precipitations and during ebb tide. Although the tide is the main agent that influences the characteristics ofthe water column, the meteorological factor contributes to generate variability on the hydrographic conditions in Cuatreros Port.Material digitalizado en SEDICI gracias a la colaboración de la Facultad de Ciencias Astronómicas y Geofísicas (UNLP).Asociación Argentina de Geofísicos y Geodesta