Osteosíntesis mínimamente invasiva con placa en fracturas de radio distal tipo C

Introducción. La tendencia hacia el uso de técnicas mínimamente invasivas (MIPO) en el tratamiento de fracturas se justifica, por la reducción de la exposición de la fractura y la disección de los planos musculares, lo que facilita la recuperación precoz. Material y Método. Se realizó un estudio en dos fases, la primera descriptiva retrospectiva de una serie de 48 casos, y la segunda, del estudio longitudinal prospectivo de una serie de 23 casos, que se sometieron a MIPO tras una fractura intraarticular de radio distal tipo C de AO. Además de las variables: edad, sexo, lateralidad y mecanismo de lesión, se evaluaron los resultados funcionales, dolor, rango de movimiento y fuerza, a través de Mayo Wrist Score escala y el cuestionario DASH. Las fracturas se clasificaron utilizando las directrices AO, se evaluaron los resultados radiológicos y complicaciones. Resultados. Se realizó la descripción del abordaje quirúrgico de los71 pacientes: 43 mujeres y 28 hombres, con una media de edad de 57 años. El lado más afectado fue el izquierdo con 51 casos. El resultado funcional fue 68,33 en el primer estudio (retrospectivo) y 85,86 en el estudio prospectivo. Observamos una pérdida de fuerza en comparación con el lado contralateral, medida con un dinamómetro, de 5,19 Kg. (retrospectivo) y 2,98 Kg. (prospectivo). Radiográ- ficamente no hubo colapso intraarticular o pérdida de la reducción en el estudio prospectivo, y la consolidación se obtuvo en el 100% de los casos. Se observó, en el segundo estudio, un caso de síndrome de dolor regional complejo y sólo un caso requirió la retirada de material debido a la protrusión dorsal de un tornillo. Conclusiones. Se trata de una técnica segura que permite la reducción y estabilización de las fracturas de la extremidad distal del radio. No solo la estética, sino también, los resultados funcionales son mejores con la técnica MIPO.Introduction. The current trend towards the use of minimally invasive techniques (MIPO) in the treatment of fractures is justified by the reduced exposure of the fracture and dissection of the muscle planes, which facilitates early recovery. Materials and Methods. We performed a double study, a retrospective descriptive study of a series of 48 cases and a prospective longitudinal study of a series of 23 patients that underwent MIPO after intra-articular distal radius fracture. In addition to the variables: age, sex, side and injury mechanism, etc., functional outcomes, pain, range of motion and strength, through Mayo Wrist Score scale and DASH were assessed. Fractures were classified using the AO guidelines, radiological results and complications were assessed. Results. We conducted the description of surgical approach with surgical images. We analyzed a total of 71 patients, 43 women and 28 men with a mean age of 57 years. The most affected side was the left with 51 cases. According to the Mayo Wrist Score, functional outcome was 68,33 in the first study (retrospective) and 85.86 in the prospective study. A mean loss in strength, measured with a dynamometer of 5,19 Kg. (retrospective) and 2,98 Kg. (prospective), was observed when compared to the contralateral side. Radiographically no intraarticular collapse or loss reduction were observed in prospective study, and consolidation was obtained in 100% of the cases. One case of complex regional pain syndrome was observed and only one case required the removal of material because of dorsal protrusion of a screw in this study. Conclusions. It is a safe technique that allows the reduction and stabilization of fractures of the distal radius. Not only the aesthetic but also functional results are better with MIPO technique

Effect of alkali doping on CIGS photovoltaic ceramic tiles

This report studies the influence of alkali elements (Na, K) to morphological, structural and optoelectronic properties of CIGS ceramic tile solar cell. Several ceramic enamels with altered chemical composition in terms of amount of alkali elements have been tested and compared. The influences of alkali type, its quantity and transfer mechanism have been investigated. The solar cell device has been assembled and characterized. The achieved results indicate that alkali elements (Na and K combination) modified the surface roughness and its diffusion from the enamel toward the absorber affect to the structural and final optoelectronic properties of the device. The alkali doping improve the Ga incorporation in the crystal lattice and an increasing in open circuit voltage (Voc) values, fill factor (FF) and the device efficiency. Optimal alkali quantities have been also determined. The best conversion efficiency is achieved for the cell with 4% wt Na2O and 3.2 % wt K2O (Eff. = 3,5 %), which presents an improvement of 30 % in efficiency relative to the standard (STD) solar cell sample chosen for comparative purposes

A practical booklet for ultrasound-guided botulinum toxin injections.

In the last 15 years, the use of ultrasound to guide botulinum neurotoxin type A injections has been advocated by many authors, with growing evidence showing the benefits of using ultrasound guidance to improve the efficacy of injections. Patients with spasticity may show severely altered postures, atrophy and fibrotic modifications of target muscles, leading to significant challenges in recognising and differentiating between the muscles to be injected or not. At present time, there are no available books with images that clarify how to identify and inject muscles in patients showing these problems. Another problem we considered is the accessibility, from an economic standpoint, of medical books for clinicians in low-income countries. We have created a practical booklet to help clinicians acquire the confidence and expertise needed to administer US-guided injections in patients with severe spasticity, combining the experience of more than 10 years in training clinicians in ultrasound-guided injections. We utilised our experience to create a method that offers a consistent way to recognise muscles, even in challenging conditions. The aim of our booklet is to offer a reliable technique for identify and target muscles in patients with altered muscular structure and pathological postures due to spasticity, relying on easily identifiable anatomical structures such as bones, vessels or nerves, or "iconic" patterns that can easily be learned and remembered. We have provided images and anatomical schemes, as well as ergonomic clinical pearls, to help clinicians providing reliable ultrasound-guided injections. To reduce barriers to education, this booklet is be distributed for free without any royalties

Biomimetic rehabilitation engineering: the importance of somatosensory feedback for brain-machine interfaces.

Brain-machine interfaces (BMIs) re-establish communication channels between the nervous system and an external device. The use of BMI technology has generated significant developments in rehabilitative medicine, promising new ways to restore lost sensory-motor functions. However and despite high-caliber basic research, only a few prototypes have successfully left the laboratory and are currently home-deployed. The failure of this laboratory-to-user transfer likely relates to the absence of BMI solutions for providing naturalistic feedback about the consequences of the BMI's actions. To overcome this limitation, nowadays cutting-edge BMI advances are guided by the principle of biomimicry; i.e. the artificial reproduction of normal neural mechanisms. Here, we focus on the importance of somatosensory feedback in BMIs devoted to reproducing movements with the goal of serving as a reference framework for future research on innovative rehabilitation procedures. First, we address the correspondence between users' needs and BMI solutions. Then, we describe the main features of invasive and non-invasive BMIs, including their degree of biomimicry and respective advantages and drawbacks. Furthermore, we explore the prevalent approaches for providing quasi-natural sensory feedback in BMI settings. Finally, we cover special situations that can promote biomimicry and we present the future directions in basic research and clinical applications. The continued incorporation of biomimetic features into the design of BMIs will surely serve to further ameliorate the realism of BMIs, as well as tremendously improve their actuation, acceptance, and use

“We Don’t Wanna Birth It Here”: A Qualitative Study of Southern Jail Personnel Approaches to Pregnancy

Each year, approximately 55,000 pregnant people are incarcerated in US jails. To learn about pregnancy and postpartum care in jails, we analyzed 34 qualitative interviews with jail personnel from facilities in five Southeastern US states. Themes included jail processes unique to pregnancy and burden on jails produced by liability and limited resources. Societal attitudes such as stigma, distrust of pregnant people, and a focus on fetal well-being were also important themes. Jail-community partnerships may mitigate the effects of scarce resources and improve jail perinatal care. Better community safety nets that decrease contact with jails are needed to improve pregnancy outcomes

Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1:A multicentre cohort follow-up study

Objective: High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1). Methods: 117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records. Follow up was for a mean of 23 months. Results: Fifty five females and 62 males (mean age 47.7 years) were included. Complete data were available for ECG in 107, echocardiography in 53. Muscle Impairment Rating Scale score was recorded for all patients. A highly significant excess (p = 0.0007) of DM1 patients presented with cTnI levels greater than the 99th centile of the range usually observed in the general population (9 patients; 7.6%). Three patients with elevated troponin were found to have left ventricular systolic dysfunction (LVSD), compared with four of those with normal range cTnI (33.3% versus 3.7%; p = 0.001). Sixty two patients had a cTnI level < 5ng/L, of whom only one had documented evidence of LVSD. Elevated cTnI was not predictive of severe conduction abnormalities on ECG, or presence of a cardiac device, nor did cTnI level correlate with muscle strength expressed by Muscle Impairment Rating Scale score. Conclusions: Plasma cTnI is highly elevated in some ambulatory patients with DM1 and shows promise as a tool to aid cardiac risk stratification, possibly by detecting myocardial involvement. Further studies with larger patient numbers are warranted to assess its utility in this setting

Design and experimental validation of a magnetic device for stem cell culture

Cell culture of bone and tendon tissues requires mechanical stimulation of the cells in order to mimic their physiological state. In the present work, a device has been conceived and developed to generate a controlled magnetic field with a homogeneous gradient in the working space. The design requirement was to maximize the magnetic flux gradient, assuring a minimum magnetizing value in a 15 mm × 15 mm working area, which highly increases the normal operating range of this sort of devices. The objective is to use the machine for two types of biological tests: magnetic irradiation of biological samples and force generation on paramagnetic particles embedded in scaffolds for cell culture. The device has been manufactured and experimentally validated by evaluating the force exerted on magnetic particles in a viscous fluid. Apart from the magnetic validation, the device has been tested for irradiating biological samples. In this case, viability of human dental pulp stem cells has been studied in vitro after electromagnetic field exposition using the designed device. After three days of irradiation treatment, cellular microtissues showed a 59% increase in the viable cell number. Irradiated cells did not show morphological differences when compared with control cells

(1R,4R,5R)-1,3,4-Triphenyl-7-[(R)-1-phenyl­ethyl]-2-oxa-3,7-diaza­spiro­[4.5]decan-10-one

In the title compound, C33H32N2O2, the polysubstituted piperidine ring adopts a chair conformation. The isoxazolidine ring is in an envelope conformation. In the crystal structure, intra- and inter­molecular C—H⋯π inter­actions involving the phenyl rings are observed

Synthesis and in-vitro evaluation of s-allyl cysteine ester-caffeic acid amide hybrids as potential anticancer agents

We have synthesized a series of S-allyl cysteine ester-caffeic acid amide hybrids and evaluated them in order to determine their possible anticancer activity and selectivity in colorectal cancer, which is still one of the leading causes of morbidity and mortality worldwide. All compounds were tested against SW480 human colon adenocarcinoma cells and the non-malignant CHO-K1 cell line. Among the tested compounds, hybrids 6e, 9a, 9b, 9c and 9e exhibited the highest effect on viability (IC50 SW480-48h= 0.18, 0.12, 0.12, 0.11 and 0.12 mM, respectively) and selectivity (SI= 10.3, 1.5, >83.33, >90.91 and >83.33, respectively) in a time- and concentration-dependent manner. Besides, our results were even better as regards lead compounds (S-allyl cysteine and caffeic acid) and the standard drug (5-FU). Additionally, these five compounds induced mitochondrial depolarization that could be related with an apoptotic process. Moreover, hybrids 6e, 9a and 9e induced cell cycle arrest in G2/M phase, and compound 9c in S- phase, which suggests that these hybrid compounds could have also a cytostatic effect in SW480 cell line. The SAR analysis showed that hydroxyl groups increased the activity, besides, there was not a clear relationship between the antitumor properties and the length of the alkyl chain. Since hybrid compounds were much more selective than the conventional drug (5-FU), this make them promising candidates for further studies against colorectal cancer

Synthesis and Antiproliferative Activity of 3 and 7-Styrylcoumarins

A series of styrylcoumarins were obtained via Mizoroki-Heck reactions between 3-bromo-4-methyl7-(octyloxy)-2H-chromen-2-one or 2-oxo-2H-chromen-7-yl trifluoromethanesulfonate and functionalized styrenes. The structures of the products were elucidated by spectroscopic analysis. All compounds were evaluated against SW480 and CHO-K1 cell lines. A number of hybrids showed good antiproliferative activity. Among the tested compounds, hybrids 6e, 10c and 10d, exhibited the highest activity (IC50- SW480/48h = 6,92; 1,01 and 5,33 µM, respectively) and selectivity (IS48h = >400; 67,8 and 7,2, respectively). In addition, these compounds were able to preserve their activities over time. The results achieved by these hybrids were even better than the lead compounds (coumarin and resveratrol) and the standard drug (5-FU). As regards structure-activity relationship it seems that the location of the styryl group on the coumarin structure and the presence of the hydroxyl group on the phenyl ring were determinant for the activity