Incidencia de tuberculosis osteoarticular en el área sanitaria del Hospital de León. 1997-2001

Introducción y objetivos: Nos proponemos en este trabajo estudiar la incidencia de tuberculosis en su forma osteoarticular en el área sanitaria del Hospital de León durante los años 1997 a 2001, ambos inclusive. Material y método: Dieciséis casos de tuberculosis osteoarticular confirmados por cultivo microbiológico y/o análisis anatomopatológico fueron incluidos. De ellos, cinco afectaron a columna vertebral, cuatro a rodilla y el resto a otras localizaciones más inusuales. Resultados: De las cinco columnas vertebrales afectadas, tres requirieron tratamiento quirúrgico para descomprimir y estabilizar. En una rodilla se realizó sinovectomía abierta y en otra por artroscopia. Se drenaron abscesos fríos en diferentes localizaciones. Todos los casos recibieron tratamiento médico. Se reflejan los diferentes resultados, desde la restitución ad integrum hasta la anquilosis. Discusión y conclusiones: La incidencia de tuberculosis osteoarticular en nuestra área sanitaria en el periodo 1997-2001 fue del 2% al 4% de todos los cascos de tuberculosis. Hubo una alta incidencia de localizaciones inusuales (muñeca, codo, sacroilíaca).Introduction: Current issue is to study the incidence of osteoarticular tuberculosis, within the sanitary area of the Hospital of Leon. Material and Method: Sixteen cases of osteoarticular tuberculosis confirmed by culture and pathological analysis were included. Five of them involved the raquis and knee. Another cases in unusual local sites. Results: Three of five raquis were managed by decompression and stabilization. One knee was treated by open synovectomy and another one by arthroscopy synovectomy. Cold abscesses were drained in different sites. All cases were treated with drugs. Different results are showed since restitutio ad integrum to anquilosis. Discussion: Osteoarticular tuberculosis incidence in our sanitary area between 1997 to 2001 was 2% to 4%. There was a high incidence for unusual localizations (wrist, elbow and sacroiliaca joints)

Nuestra experiencia con el minivástago femoral de disco a compresión y el cotilo Hedrocel (tantalio)

Durante los años 2000 a 2002 intervinimos 18 pacientes de artrosis o necrosis sintomática de cadera, con minivástago de fijación metafisiaria de Disco a Compresión (Sulzer) y cotilo monobloque de tantalio Hedrocel (Zimmer), con par de fricción alúmina-polietileno. La edad media de los pacientes fue de 46,7 años (rango 35-61), y el seguimiento medio de 42 meses. La valoración clínica se realizó con la escala de Merle D'Augbigné Postel obteniendo 38,8% de resultados excelentes, 22,2 de resultados buenos, 11,1% regulares y 27,4% malos (5 casos). Cuatro casos necesitaron reintervención por aflojamiento del tallo femoral. No hubo ningún fracaso del cotilo. La sustitución protésica de la cadera en los pacientes jóvenes requieren soluciones con la menor resección del hueso, pero este modelo de tallo femoral, no da un resultado satisfactorio, por lo que lo hemos abandonado.Between 2000 2002 we treated 18 patients with symptomatic osteoarthritis or osteonechrosis of hip, with uncemneted Thrust Plate Protesis (Sulzer) and tantalium acetabular componente Hedrocel (Zimmer), with ceramic-pol- yethylene pair. The average age of the patients was 46,7 years (range:35-61), and the average follow-up of 42 months. Clinical evaluation was done with Merle D'Augbigné Postel's scale obtaining 38,8 % of excellent results, 22,2 % of good results, 11,1 % fair and 27,4 % poor (5 cases). Four cases needed re-operation for loosening of the femoral stem. There was no failure of the acetabular component. The hip artrhroplasty in the young patients need solutions with the minor resection of bone, but this model of femoral stem does not give a satisfactory result, therefore we have abandoned it

Rotura traumática del tendón del supraespinoso en un niño de seis años

Presentamos un caso de un niño de seis años que sufrió un traumatismo por caída sobre su hombro derecho, con rotura completa del tendón del supraespinoso. Comprobado con Resonancia Magnética. Se operó para efectuar una reinserción transósea del tendón mediante cirugía abierta. Después de un mes de inmovilización se comenzaron los ejercicios activos progresivos con recuperación completa a los tres meses de la intervención.A six year old boy sustained a right shoulder injury after a causal fall. Magnetic Resonance Imaging showed a complete rupture of the supraespinatus tendon. Open surgery was indicated by transosseus reinsertion of the tendon on the humeral head. After one month of shoulder immobilization, the patient physical therapy with progressive active exercises. The patient achivied complete joint motion and function three months after surgery

Optimization of laser-firing processes for silicon-heterojunction solar-cell back contacts

One of the key steps to achieve high efficiencies in amorphous/crystalline silicon photovoltaic structures is to design low-ohmic-resistance backcontacts with good passivation in the rear part of the cell. A well known approach to achieve this goal is to use laser-fired contact (LFC) processes in which a metal layer is fired through the dielectric to define good contacts with the semiconductor. However, and despite the fact that this approach has demonstrated to be extremely successful, there is still enough room for process improvement with an appropriate optimization. In this paper, a study focused on the optimal adjustment of the irradiation parameters to produce laser-fired contacts in a-Si:H/c-Si heterojunctionsolarcells is presented. We used samples consisting of crystalline-silicon (c-Si) wafers together with a passivation layer of intrinsic hydrogenated amorphous silicon (a-Si:H(i)) deposited by plasma-enhanced chemical deposition (PECVD). Then, an aluminum layer was evaporated on both sides, the thickness of this layer varied from 0.2 to 1 μm in order to identify the optimal amount of Al required to create an appropriate contact. A q-switched Nd:YVO4laser source, λ = 532 nm, was used to locally fire the aluminum through the thin a-Si:H(i)-layers to form the LFC. The effects of laser fluences were analyzed using a comprehensive morphological and electrical characterization

Optimization of laser-firing processes for silicon-heterojunction solar-cell back contacts

One of the key steps to achieve high efficiencies in amorphous/crystalline silicon photovoltaic structures is to design low-ohmic-resistance backcontacts with good passivation in the rear part of the cell. A well known approach to achieve this goal is to use laser-fired contact (LFC) processes in which a metal layer is fired through the dielectric to define good contacts with the semiconductor. However, and despite the fact that this approach has demonstrated to be extremely successful, there is still enough room for process improvement with an appropriate optimization. In this paper, a study focused on the optimal adjustment of the irradiation parameters to produce laser-fired contacts in a-Si:H/c-Si heterojunctionsolarcells is presented. We used samples consisting of crystalline-silicon (c-Si) wafers together with a passivation layer of intrinsic hydrogenated amorphous silicon (a-Si:H(i)) deposited by plasma-enhanced chemical deposition (PECVD). Then, an aluminum layer was evaporated on both sides, the thickness of this layer varied from 0.2 to 1 μm in order to identify the optimal amount of Al required to create an appropriate contact. A q-switched Nd:YVO4laser source, λ = 532 nm, was used to locally fire the aluminum through the thin a-Si:H(i)-layers to form the LFC. The effects of laser fluences were analyzed using a comprehensive morphological and electrical characterization

Comment on "Theory and computer simulation for the equation of state of additive hard-disk fluid mixtures"

A flaw in the comparison between two different theoretical equations of state for a binary mixture of additive hard disks and Monte Carlo results, as recently reported in C. Barrio and J. R. Solana, Phys. Rev. E 63, 011201 (2001), is pointed out. It is found that both proposals, which require the equation of state of the single component system as input, lead to comparable accuracy but the one advocated by us [A. Santos, S. B. Yuste, and M. L\'{o}pez de Haro, Mol. Phys. 96, 1 (1999)] is simpler and complies with the exact limit in which the small disks are point particles.Comment: 4 pages, including 1 figur

Neuroimmune response mediated by cytokines in natural scrapie after chronic dexamethasone treatment

The actual role of prion protein-induced glial activation and subsequent cytokine secretion during prion diseases is still incompletely understood. The overall aim of this study is to assess the effect of an anti-inflammatory treatment with dexamethasone on different cytokines released by neuroglial cells that are potentially related to neuroinflammation in natural scrapie. This study emphasizes the complex interactions existent among several pleiotropic neuromodulator peptides and provides a global approach to clarify neuroinflammatory processes in prion diseases. Addition-ally, an impairment of communication between microglial and astroglial populations mediated by cytokines, mainly IL-1, is suggested. The main novelty of this study is that it is the first one assessing in situ neuroinflammatory activity in relation to chronic anti-inflammatory therapy, gaining relevance because it is based on a natural model. The cytokine profile data would suggest the activation of some neurotoxicity-associated route. Consequently, targeting such a pathway might be a new approach to modify the damaging effects of neuroinflammation

Validation of metabolic syndrome using medical records in the SUN cohort

The objective of this study was to evaluate the validity of self reported criteria of Metabolic Syndrome (MS) in the SUN (Seguimiento Universidad de Navarra) cohort using their medical records as the gold standard. METHODS: We selected 336 participants and we obtained MS related data according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF). Then we compared information on the self reported diagnosis of MS and MS diagnosed in their medical records. We calculated the proportion of confirmed MS, the proportion of confirmed non-MS and the intraclass correlation coefficients for each component of the MS. RESULTS: From those 336 selected participants, we obtained sufficient data in 172 participants to confirm or reject MS using ATP III criteria. The proportion of confirmed MS was 91.2% (95% CI: 80.7- 97.1) and the proportion of confirmed non-MS was 92.2% (95% CI: 85.7-96.4) using ATP III criteria. The proportion of confirmed MS using IDF criteria was 100% (95% CI: 87.2-100) and the proportion of confirmed non-MS was 97.1% (95% CI: 85.1-99.9). Kappa Index was 0.82 in the group diagnosed by ATP III criteria and 0.97 in the group diagnosed by IDF criteria. Intraclass correlation coefficients for the different component of MS were: 0.93 (IC 95%:0.91- 0.95) for BMI; 0.96 (IC 95%: 0.93-0.98) for waist circumference; 0.75 (IC 95%: 0.66-0.82) for fasting glucose; 0.50 (IC 95%:0.35-0.639) for HDL cholesterol; 0.78 (IC 95%: 0.70-0.84) for triglycerides; 0.49 (IC 95%:0.34-0.61) for systolic blood pressure and 0.55 (IC 95%: 0.41-0.65) for diastolic blood pressure. CONCLUSIONS: Self-reported MS based on self reported components of the SM in a Spanish cohort of university graduates was sufficiently valid as to be used in epidemiological studies

Prospective study of changes in sugar-sweetened beverages consumption and incidence of metabolic syndrome and its components

The incidence of the metabolic syndrome (MetS) is increasing and lifestyle behaviours may play a role. The aim of the present study was to prospectively assess the association between changes in the consumption of sugar-sweetened beverages (SSB) and the incidence of the MetS and its components in a Spanish cohort of university graduates. We included 8157 participants initially free of the MetS and followed up during at least 6 years. SSB consumption was collected by a FFQ previously validated in Spain. The change in SSB consumption was calculated as the difference between SSB consumption at a 6-year follow-up and baseline consumption. The MetS was defined according to the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute's new definition of the MetS that had harmonised previous definitions. The associations between changes in SSB intake and the MetS were examined using multiple logistic regression. We observed 361 incident cases of the MetS. Participants who increased their consumption of SSB (upper v. lower quintile) had a significantly higher risk of developing the MetS (adjusted OR 2·2, 95 % CI 1·4, 3·5; P for trend = 0·003). Similarly, they presented a significantly higher risk of developing high blood pressure (adjusted OR 1·6, 95 % CI 1·3, 2·1), central obesity (adjusted OR 2·3, 95 % CI 1·9, 2·7), hypertriacylglycerolaemia (adjusted OR 1·7, 95 % CI 1·1, 2·6) or impaired fasting glucose (adjusted OR 1·6, 95 % CI 1·1, 2·2). In conclusion, an increase in SSB consumption was associated with a higher risk of developing the MetS and other metabolic disorders after 6 years of follow-up in a Mediterranean cohort of university graduates