Deformidad vertebral y mielomeningocele: actitud terapéutica y resultados

Presentamos nuestra experiencia en el tratamiento quirúrgico de la deformidad vertebral relacionada con el mielomeningocele entre los años 1972 y 1995. En ese período un total de 48 pacientes fueron intervenidos. Se han evaluado las condiciones generales previas, el estado prequirúrgico, las diversas modalidades de instrumentación y el resultado de las mismas, así como el tipo y número de complicaciones. Durante el período posquirúrgico inmediato hemos encontrado un porcentaje de infecciones del 68%. Sin embargo, el resultado final, tanto del equilibrio pélvico como del vertebral conseguido, no estuvo influenciado significativamente por esta complicación. El tipo de patología, las complicaciones generales derivadas de la misma, el tiempo quirúrgico empleado y las pérdidas sanguíneas, son condiciones estrechamente relacionadas con el número de infecciones encontradas.We present our experience on the surgical treatment of myelomeningocelelinked vertebral deformity between 1972 and 1995. We evaluated the previous general condition, the presurgical status, the instrument modalities and their outcome, as well as the type and number of complications in a series of 48 patients. During the immediate postoperative period, we found a 68% infection rate. However, the end result for pelvic as well as vertebral balance was not influenced significantly by this complication. The number of infections found is closely linked to the specific pathology, the complications, duration of operation, and blood loss

Complicaciones sépticas de la osteosíntesis lumbosacra: Análisis de 23 casos

Entre 1987 y 1995 hemos intervenido 295 pacientes afectos de patología lumbosacra realizando en todos ellos una artrodesis instrumentada. Veintitrés pacientes tuvieron como complicación una infección profunda, lo que equivale a un 7,8%. El germen más frecuentemente aislado como responsable de la infección fue el Staphylococcus aureus resistente a la meticilina. La antibioterapia más veces utilizada fue una cefalosporina de 2.a generación. La infección se resolvió en 4 ocasiones bajo tratamiento médico; sin embargo, en 19 se procedió a limpieza quirúrgica de los tejidos dañados no siendo necesaria la retirada del material de osteosíntesis. En 9 ocasiones se practicó una 2.a reintervención, y en otros 4 una tercera. En nuestra serie, fue necesario reintervenir quirúrgicamente el 50% de los pacientes a los que se practicó una limpieza quirúrgica. Dado que la profilaxis antibiótica debe de cubrir los gérmenes prevalentes en cada unidad hospitalaria, de acuerdo con su patrón de resistencia, hubiera sido más adecuado el empleo de antibióticos glucopeptídicos.Between 1987 and 1995 we performed an instrumented arthrodesis on 295 patients with lumbosacral pathology and 23 patients (7.8%) had a serious infection. Methicillin-resistent Staphylococcus aureus was the most frequently isolated causal germs. Second generation Cephalosporin was the antibiotic administered the most. The infection was cured in 4 cases with medical treatment. However, in 19 patients surgical cleaning of the damaged tissue was required, although it was not necessary to remove the osteosynthesis material. In 9 cases a second operation was performed and a third in 4 others. In our series, 50% of the patients who required surgical cleaning underwent another operation. Due to the fact that prophylactic antibiotics should cover the germs prevalent in each hospital ward, according to the resistence patterns, the use of Glycopeptid antibiotics would have been more appropriate

Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer’s disease: additional results from the AMBAR study

Albumin; Intravenous immunoglobulin; PlasmapheresisAlbúmina; Inmunoglobulina intravenosa; PlasmaféresisAlbúmina; Immunoglobulina intravenosa; PlasmafèresiPurpose This study was designed to detect structural and functional brain changes in Alzheimer’s disease (AD) patients treated with therapeutic plasma exchange (PE) with albumin replacement, as part of the recent AMBAR phase 2b/3 clinical trial. Methods Mild-to-moderate AD patients were randomized into four arms: three arms receiving PE with albumin (one with low-dose albumin, and two with low/high doses of albumin alternated with IVIG), and a placebo (sham PE) arm. All arms underwent 6 weeks of weekly conventional PE followed by 12 months of monthly low-volume PE. Magnetic resonance imaging (MRI) volumetric analyses and regional and statistical parametric mapping (SPM) analysis on 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) were performed. Results MRI analyses (n = 198 patients) of selected subcortical structures showed fewer volume changes from baseline to final visit in the high albumin + IVIG treatment group (p < 0.05 in 3 structures vs. 4 to 9 in other groups). The high albumin + IVIG group showed no statistically significant reduction of right hippocampus. SPM 18FDG-PET analyses (n = 213 patients) showed a worsening of metabolic activity in the specific areas affected in AD (posterior cingulate, precuneus, and parieto-temporal regions). The high-albumin + IVIG treatment group showed the greatest metabolic stability over the course of the study, i.e., the smallest percent decline in metabolism (MaskAD), and least progression of defect compared to placebo. Conclusions PE with albumin replacement was associated with fewer deleterious changes in subcortical structures and less metabolic decline compared to the typical of the progression of AD. This effect was more marked in the group treated with high albumin + IVIG.The AMBAR study is sponsored by Grifols, a manufacturer of therapeutic human serum albumin and intravenous immune globulin. GC-B, IR, JC-C, DP, MBo, and OLL received direct or indirect funding from Grifols to carry out the study and the preparation of the manuscript

On the use ofSb to improve the performance of GaInP subcells of multijunction solar cells

GaInP is a material commonly employed for the top subcells of different multijunction solar cells architectures. In this study, the performance of GaInP top cells has been improved by increasing the energy band gap with the use of Sb as a surfactant during the MOVPE growth of the structures. The optimization of the appropriate Sb molar flow was done by Reflectance Anisotropy Spectroscopy. Different characterization techniques have been employed to assess the effect of Sb on the morphology, microstructure and optoelectronic properties of the resulting GaInP grown with different Sb/P ratios. Finally, the performance of several GaInP subcells with different order parameters has been assessed

Multiple strain-induced phase transitions in LaNiO3 thin films

Strain effects on epitaxial thin films of LaNiO3 grown on different single crystalline substrates are studied by Raman scattering and first-principles simulation. New Raman modes, not present in bulk or fully-relaxed films, appear under both compressive and tensile strains, indicating symmetry reductions. Interestingly, the Raman spectra and the underlying crystal symmetry for tensile and compressively strained films are different. Extensive mapping of LaNiO3 phase stability is addressed by simulations, showing that a variety of crystalline phases are indeed stabilized under strain which may impact the electronic orbital hierarchy. The calculated Raman frequencies reproduce the principal features of the experimental spectra, supporting the validity of the multiple strain-driven structural transitions predicted by the simulations.Comment: 18 pages, 7 figure

Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease : additional results from the AMBAR study

This study was designed to detect structural and functional brain changes in Alzheimer's disease (AD) patients treated with therapeutic plasma exchange (PE) with albumin replacement, as part of the recent AMBAR phase 2b/3 clinical trial. Mild-to-moderate AD patients were randomized into four arms: three arms receiving PE with albumin (one with low-dose albumin, and two with low/high doses of albumin alternated with IVIG), and a placebo (sham PE) arm. All arms underwent 6 weeks of weekly conventional PE followed by 12 months of monthly low-volume PE. Magnetic resonance imaging (MRI) volumetric analyses and regional and statistical parametric mapping (SPM) analysis on 18 F-fluorodeoxyglucose positron emission tomography (18 FDG-PET) were performed. MRI analyses (n = 198 patients) of selected subcortical structures showed fewer volume changes from baseline to final visit in the high albumin + IVIG treatment group (p < 0.05 in 3 structures vs. 4 to 9 in other groups). The high albumin + IVIG group showed no statistically significant reduction of right hippocampus. SPM 18 FDG-PET analyses (n = 213 patients) showed a worsening of metabolic activity in the specific areas affected in AD (posterior cingulate, precuneus, and parieto-temporal regions). The high-albumin + IVIG treatment group showed the greatest metabolic stability over the course of the study, i.e., the smallest percent decline in metabolism (MaskAD), and least progression of defect compared to placebo. PE with albumin replacement was associated with fewer deleterious changes in subcortical structures and less metabolic decline compared to the typical of the progression of AD. This effect was more marked in the group treated with high albumin + IVIG. (AMBAR trial registration: EudraCT#: 2011-001,598-25; ClinicalTrials.gov ID: NCT01561053). The online version contains supplementary material available at 10.1007/s00259-022-05915-

Methodology of the Virtual Reconstruction of Arquitectonic Heritage: Ambassador Vich's Palace in Valencia

The 19th century was disastrous as far as the conservation of architectonic heritage is concerned. The awareness of the importance of preserving monuments that has prevailed since the end of the last century was dazzlingly absent in the previous, leading both to the disappearance of representative heritage works and the plundering of many others. The present study establishes the methodological basis to proceed with the virtual reconstruction of many disappeared architectures, representative of emblematic architectonic typologies. A method based on the combination of deduction and induction allows benchmarks to be created that signify a starting point to which the key and specific elements of each building are later incorporated, from the data extracted from the conserved parts and the graphic, literary and archive documents. The result is the virtual recovery of the general outlines of the architecture: morphology of the plot, volumetry, exterior and interior facades, and the functional layout. The good results obtained in the study of the disappeared Ambassador Vich's Palace, allow the methodology to be extended to the analysis of other similar examples, serving investigators as a tool to carry out an arduous task of deciphering a trail that is increasingly fading with the passing of time.Galiana Agullo, M.; Mas Tomas, MDLA.; Lerma Elvira, C.; Peñalver Martínez, MJ.; Conesa Tejada, S. (2014). Methodology of the Virtual Reconstruction of Arquitectonic Heritage: Ambassador Vich's Palace in Valencia. International Journal of Architectural Heritage. 8(1):94-123. doi:10.1080/15583058.2012.672623S9412381Boix, V. 1979.Historical and topographic Valencia[in Spanish]. Vol. I261 S. A. Printing J. Rius.Estaban Chapapría, J. (2001). Impostación del patio del Embajador Vich en el ex-convento del Carmen (Valencia). Loggia, Arquitectura & Restauración, (12), 26. doi:10.4995/loggia.2001.3605Morrish, S. W., & Laefer, D. F. (2010). Web-Enabling of Architectural Heritage Inventories. International Journal of Architectural Heritage, 4(1), 16-37. doi:10.1080/15583050902731056Lotz, W. 1995.Architecture in Italy 1500–1600 [in Italian]35–37. ed. RizzoliYale University Press.Lourenço, P. B., Peña, F., & Amado, M. (2010). A Document Management System for the Conservation of Cultural Heritage Buildings. International Journal of Architectural Heritage, 5(1), 101-121. doi:10.1080/15583050903318382Vila Ferrer, S. (2001). La recuperación del patio del palacio del Embajador Vich (Valencia). Loggia, Arquitectura & Restauración, (12), 44. doi:10.4995/loggia.2001.3606Zonta, D., Pozzi, M., & Zanon, P. (2008). Managing the Historical Heritage Using Distributed Technologies. International Journal of Architectural Heritage, 2(3), 200-225. doi:10.1080/1558305080206369

Origin of the large dispersion of magnetic properties in nanostructured oxides: FexO/Fe3O4 nanoparticles as a case study

The intimate relationship in transition-metal oxides between stoichiometry and physiochemical properties makes them appealing as tunable materials. These features become exacerbated when dealing with nanostructures. However, due to the complexity of nanoscale materials, establishing a distinct relationship between structure-morphology and functionalities is often complicated. In this regard, in the FexO/Fe3O4 system a largely unexplained broad dispersion of magnetic properties has been observed. Here we show, thanks to a comprehensive multi-technique approach, a clear correlation between magneto-structural properties in large (45 nm) and small (9 nm) FexO/Fe3O4 core/shell nanoparticles that can explain the spread of magnetic behaviors. The results reveal that while the FexO core in the large nanoparticles is antiferromagnetic and has bulk-like stoichiometry and unit-cell parameters, the FexO core in the small particles is highly non-stoichiometric and strained, displaying no significant antiferromagnetism. These results highlight the importance of ample characterization to fully understand the properties of nanostructured metal oxide