Evaluación, marginalidad y desarrollo

En los últimos años se ha desarrollado una tendencia a culpar a la evaluación de la deserción escolar y por consiguiente de propiciar el desarrollo de marginalidad en aquellos jóvenes que abandonan las aulas por no poder aprobar determinadas materias. Aunque también existen algunas situaciones, que quizá por falta de motivación hacia los estudiantes, también propician su deserción y que abandonen por consiguiente sus estudios

Pure cervical radiculopathy due to spontaneous spinal epidural haematoma (SSEH): report of a case solved conservatively

Abstract Introduction: Spontaneous spinal epidural haematoma (SSEH) is widely recognised throughout the literature as a cause of myelopathy, radicular compression being very rarely reported. Surgical management is almost always recommended, especially in the cases of spinal cord compression. Conservative treatment is reported as a curiosity and only in the case of spontaneous improvement. This report presents the particular case of a 64-year-old patient undergoing anticoagulant therapy that had a cervical radiculopathy due to a SSEH confirmed by MRI. The patient improved spontaneously and symptoms were solved with unconventional conservative treatment and without stopping the anticoagulant therapy. Conclusions: Spontaneous epidural haematoma must be kept in mind when patients undergoing anticoagulant therapy have a sudden onset of cervicobrachialgia. Even though most spinal surgeons advocate surgical treatment, a conservative approach may lead to a complete recovery and may be considered as a good option in the case of radicular involvement. Discontinuation of the anticoagulant therapy may not always be needed, especially when the clinical syndrome improves spontaneously

El deber de informar del ISP frente al “usuario cazurro”

En el presente artículo planteamos el problema de la falta de información eficaz de las empresas proveedoras de servicio de internet en la República Argentina, para con aquellos usuarios que no tienen los conocimientos básicos y se encuentran en una situación de vulnerabilidad frente a los avances de las diversas tecnologías. Encontrándose, frente al ISP, en una posición frágil y de indefensión, personas a las cuales denominamos “usuarios cazurros”, que fueron y son olvidados a la hora de legislar e impartir justicia. Asimismo atento el avance que ha adquirido a nivel mundial la declaración del sistema de internet como un derecho humano, lo que conlleva a una mayor protección de los derechos de los usuarios en su conjunto, proponemos su declaración, en nuestro país, como servicio público esencial, con un mayor celo de cuidado al usuario cazurro. Por eso entendemos necesario, un rol más activo del Estado, en conjunto con una normativa capaz de paliar estos conflictos.Sociedad Argentina de Informática e Investigación Operativ

Afrontamiento y etnia: Estrategias en niños y niñas aymara

Menores aymara han experimentado un proceso migratorio importante durante las últimas décadas, sin embargo, se han desarrollado escasos estudios en población infantil perteneciente a esta etnia. El objetivo de esta investigación es evaluar y comparar las estrategias de afrontamiento utilizado por niños y niñas Aymara y no Aymara. La muestra estuvo compuesta por 685 niños/as entre 9 y 15 años de escuelas municipales y colegios particular subvencionados de la ciudad de Arica. Los resultados muestran la inexistencia de diferencias poblacionales entre niños/as aymara y no aymara en relación a los problemas experimentados (pχ2> .05), el uso de estrategias de afrontamiento utilizadas (pt> .05) y la eficacia de estas últimas (pt> .05). Se concluye que los niños/as pertenecientes a la etnia estarían logrando adecuados mecanismos de afrontamiento en contextos urbanos

Symptomatic Medial Exostosis of the Great Toe Distal Phalanx: A Complication Due to Over-correction Following Akin Osteotomy for Hallux Valgus Repair

The authors present the case of a 54-year-old female who developed a painful compression lesion localized to the medial aspect of the base of the distal phalanx of the great toe as a complication of hallux valgus surgery. Preoperative radiographic evaluation of the patient's foot revealed the first ray to be longer than the second, a 12 degrees first intermetatarsal angle, a 33 degrees hallux abductus angle, and an exostosis at the medial aspect of the base of the hallux that was not considered by the surgeon to be important. Correction of the hallux valgus deformity was performed with a combination of scarf and Akin osteotomies, and the intermetatarsal and hallux abductus angles reduced to 2 degrees and 8 degrees , respectively. By 2 months postoperative, the patient was complaining of pain at the medial aspect of the distal phalanx of the hallux associated with shoe pressure. The pain correlated both clinically and radiologically with the exostosis at the base of the distal phalanx, and had become symptomatic only after the hallux had been operatively realigned. At 6 months postoperative, percutaneous exostectomy was undertaken to remove the exostosis. Pain relief was complete, thereafter, and after 2 years of postoperative follow-up the patient remained pain free. The clinical importance of a medial exostosis localized to the base of the distal phalanx of the hallux must be taken into consideration whenever hallux valgus correction is undertaken, and this is particularly important whenever an Akin osteotomy is being considered. Level of Clinical Evidence: 4

Precision and safety of Multilevel Cervical Transpedicular Screw Fixation with 3D Patient-Specific Guides; A Cadaveric Study

The aim is to design a patient-specific instrument (PSI) for multilevel cervical pedicle screw placement from C2 to C7, as well as verifying reliability and reproducibility. Computed tomography (CT) scans were obtained from 7 cadaveric cervical spines. Using Mimics software, semiautomatic segmentation was performed for each cervical spine, designing a 3D cervical spine bone model in order to plan transpedicular screw fixation. A PSI was designed according to the previously cited with two cannulated chimneys to guide the drill. The guides were 3D printed and surgeries performed at the laboratory. Postoperative scans were obtained to study screw placement. Sixty-eight transpedicular screws were available for study. 61.8% of all screws were within the pedicle or partially breached <4 mm. No differences were observed between cervical levels. None of these screws had neurovascular injury. Of the 27 screws with a grade 3 (screw outside the pedicle; 39.7%), only 2 had perforation of the transverse foramen and none of them would have caused a neural injury. In conclusion, multilevel PSI for cervical pedicle screw is a promising technology that despite showing improvements regarding free-hand technique requires further studies to improve the positioning of the PSI and their accuracy

Infected Vertebroplasty Due to Uncommon Bacteria Solved Surgically: A Rare and Threatening Life Complication of a Common Procedure

Case report. OBJECTIVE: The aim of this work is to describe a case of infected vertebroplasty due to uncommon bacteria solved surgically with 2 years of follow-up and to discuss 6 other cases found in literature. SUMMARY OF BACKGROUND DATA: Vertebroplasty is a well-known and useful technique for the treatment of painful osteoporotic vertebral fractures. Complications, such as cord or root compression or pulmonary embolisms, are infrequent and are mainly related with the frequent escape of cement throughout the vertebral veins. Infection is even more rare, but when it occurs is difficult to manage and can be a life-threatening complication. METHODS: A 63-year-old-man had a spondylitis of L2 after vertebroplasty. The patient was initially managed with antibiotics without clinical improvement. Surgical treatment by anterior debridement and anterior and posterior stabilization was done. The bacteria isolated from the intraoperative cultures were Serratia marcescens, Stenotrophomonas maltophilia, and Burkholderia cepacia. After surgery, the patient was treated with antibiotics for 3 month. RESULTS: After 2 years of follow-up, the patient was free of pain, without signs of infection, and a correct fusion was achieved. CONCLUSION: When facing an infected vertebroplasty, initial conservative treatment with needle biopsy culture and antibiotic administration are a rational option to start. If this treatment fails, surgical debridement is then indicated in order to remove the infected tissue and the acrylic cement and to stabilize the spine. Although this can be an effective treatment, it could be a difficult and hazardous surgical procedure

An asymmetrical bulk-modified composite MOS transistor with enhanced linearity

In this work, an asymmetrical bulk-linearized composite MOSFET is presented, with an enhanced linear range and an equivalent saturation voltage of up to several hundred mV even in weak inversion, allowing to implement large MOS resistors. Some preliminary measurements are presented, as well as 150MΩ and 200MΩ equivalent resistors simulations, with a linear range up to 1.5V. A low frequency, 40dB gain, fully integrated cardiac sensing channel filter/amplifier is also shown. Taking advantage of the proposed technique, the circuit consumes only 25nA of supply current.Agencia Nacional de Investigación e Innovació