Síndrome uña-rótula

Presentamos el estudio de 3 casos afectos de un síndrome "uña-rótula", con historia familiar positiva en uno de ellos. Este síndrome es un transtorno hereditario de transmisión autosómica dominante, caracterizado por displasia ungueal y de articulacione s y formación de una s excrecencia s óseas características a nive l del ilíaco (cuernos ilíacos). El síndrome completo se define por los cambios esqueléticos asociados a una nefropatía. Describimos las anomalías clínico-radiográficas de tres paciente s y realizamos una revisión de la literatura sobre esta displasia poco frecuente.The author s showed thre e patients affected by "nail patella" syndrome with positive familiar history in one case. The "nail patella" syndrome is an autosomal dominant condition, characterized by nail and joint dysplasia and extra bone formation at the os ilium. The complet e syndrome is characterized by a serie s of skeletal disorders and specific nephropathy. This article reports the clinical and roentgenographi c findings of three patients and the results of the study of their families. A review of the literature is done

Fracturas supracondíleas sobre prótesis total de rodilla

Presentamos 7 casos de fractura del extreme distal del fémur en pacientes con sustitución total de rodilla. El propósito del estudio consiste en valorar las distintas opciones terapéuticas y los resultados obtenidos a medio plazo. Los enfermos fueron tratados quirúrgicamente mediante un clavo intramedular u ortopédicamente con un sistema de tracción de Neufeld de una férula de tipo Q.T.B. El método de tratamiento se decidió en función del grado de desplazamiento de la fractura, tiempo transcurrido desde la misma y estado general del paciente. Todos alcanzaron un nivel de actividad similar al que poseían previo a la fractura.We present 7 cases of supracondylar fracture of the femur in patients with total knee arthroplaty. The purpose of this study was to asses the different options of treatment and their results at mid-term. Fractures were treated with an intramedular nail or with a Neufeld traction system followed by a Q.T.B. cast. The method of treatment depends on the grade of fracture displacement, period of time since the fracture and patient health. All o them reached similar level of activity like before the fracture

Estudios culturales : prácticas diversas, enfoques pluralistas

Desde el ámbito de los estudios culturales plantea un acercamiento teórico y metodológico multidisciplinar en el que a partir de la reflexión y el estudio de casos se analizan problemáticas reales de la historia de la cultura mexicana. Ciencia y humanismo, empirismo y reflexión son las caras de la moneda de una tendencia epistemológica que en las últimas décadas se ha planteado en el ámbito de la investigación sociológica y antropológica bajo el marbete de estudios culturales, con el objetivo de aprehender el complejo funcionamiento de los procesos culturales en las sociedades modernas

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology