Osteotomía de Weil percutánea en el tratamiento de las metatarsalgias: correlación clínico-radiológica

El objetivo del presente trabajo fue evaluar los resultados de la osteotomía de Weil percutánea para el tratamiento de la metatarsalgia de origen mecánico. Para ello, se revisaron de forma retrospectiva los primeros 28 casos consecutivos intervenidos mediante osteotomía de Weil percutánea en pacientes con metatarsalgia mecánica por sobrecarga de los metatarsianos centrales. Se entrevistó a la totalidad de los pacientes, evaluando los resultados radiológicos, estéticos y funcionales, utilizando para ello la Escala de Valoración funcional AOFAS (American Orthopaedic Foot and Ankle Society) para el antepié. Los resultados fueron considerados como buenos o excelentes desde el punto de vista funcional en 81% de los pies intervenidos y en el 89% desde el punto de vista estético. La puntuación final media en la escala AOFAS fue de 78,3. Tuvimos 3 casos de infección por estafilococo aureus que se resolvieron con tratamiento antibiótico específico. No se observaron pseudoartrosis. Por todo ello, consideramos que la osteotomía de Weil es una técnica adecuada y segura para tratar las metatarsalgias de causa mecánica.The aim of this retrospective study was to evaluate the short-term results after percutaneous Weil osteotomy for the treatment secondary metatarsalgia related to repetitive high-pressure loading under the metatarsal heads. We analyzed retrospectively clinical and radiological outcome of 28 consecutive patients who were treated with percutaneous, subcapital osteotomy for metatarsalgia with overload etiology. Analysis of the esthetic, functional and radiologic results was performed using AOFAS forefoot score. Good to excellent functional results were achieved in 81% of the feet, cosmetic in 89% with average score 78,3 points. Three patients developed a superficial wound infections, which responded to antibiotics. Union occurred in all cases. Percutaneous Weil osteotomy is safe and effective technique for treatment of secondary metatarsalgia with mechanic etiology

Rotura del ligamento deltoideo del tobillo: evaluación clínico-quirúrgica

No existe un criterio uniforme sobre la conduct a a seguir en el tratamient o de la rotur a del ligamento deltoideo del tobillo. Se ha n revisado 36 paciente s diagnosticados y tra - tado s quirúrgicament e de rotur a de dicho ligamento, la mayorí a de la s veces est a lesión iba acompañad a de fractur a del maleolo peroneo. Se ha valorado la etiología, el mecanismo lesional y los resultados siguiendo la clasificación de Cedell, considerándos e estos últimos como buenos en la práctic a totalidad de los casos. En cuatro de los paciente s (11%), se presentó como únic a secuela la limitación de la movilidad en los últimos grados de flexo-extensiónUniform criteria about the actions to be taken in the tearing of the ankle deltoid ligament d o no t exist. Thirt y si x patients diagnose d an d surgicall y treate d becaus e o f th e tearin g o f th e abov e mentione d ligamen t hav e bee n reviewed . Most o f th e times, this lesio n wa s accompanie d b y a fractur e o f th e peronea l maleolus. Etiology , injur y mechanism s an d results followin g Cedell's clasificatio n hav e bee n evaluate d an d th e results hav e bee n considere d goo d i n practicall y all cases. I n fou r patients, th e onl y secuel a wa s a limitatio n o f th e most extrem e grade s o f flexo-extension

Efficacy of a strategy for implementing a guideline for the control of cardiovascular risk in a primary healthcare setting: the SIRVA2 study a controlled, blinded community intervention trial randomised by clusters

This work describes the methodology used to assess a strategy for implementing clinical practice guidelines (CPG) for cardiovascular risk control in a health area of Madrid

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Effect of structural differences of carbon nanotubes and graphene based iridium-NHC materials on the hydrogen transfer catalytic activity

A proper design of heterogeneous molecular catalysts supported on carbon materials requires a systematic study of >metal-carbon support interactions> and their influence on catalytic activity. In this study, hybrid materials containing covalently anchored iridium N-heterocyclic carbene (NHC) organometallic complexes have been successfully prepared from oxidized and partially reduced carbon nanotubes (CNTs). The preparation method for these supported materials relies on the selective functionalization of the superficial hydroxylic groups using the imidazolium salt, 1-(3-hydroxypropyl)-3-methyl-1H-imidazol-3-ium chloride. The hydrogen transfer catalysis activity of these nanotube-based hybrid catalysts was tested by the reduction of cyclohexanone to cyclohexanol with 2-propanol, and the results of the tests were compared with those obtained using similar hybrid graphene-based catalysts. While EXAFS analysis revealed a common first coordination shell of the iridium atom for all the hybrid materials examined, independently of whether they were either supported on carbon nanotubes or graphene materials, catalytic activity in all the reduced materials was significantly superior. Moreover, catalytic systems based on reduced CNTs exhibited a better performance than those based on reduced graphene materials. Both these facts suggest there is a positive correlation between hydrogen transfer catalytic activity, reconstruction of the aromatic carbon structure and the smaller amount of oxygen functional groups.The authors thank the Spanish Ministry of Economy and Competitiveness (MINECO/FEDER) (Projects Consolider Ingenio 2010 CSD2009-00050 and CTQ2013-42532-P), and the Diputación General de Aragón (DGA) (FSE-E07 and FSE-E69) for their financial support. Dr. P. A. thanks MICINN for a Ramón y Cajal contract. J. F-T. and M. B. acknowledge their fellowships from MINECO and MECD (AP2010-0025).Peer Reviewe

The local structure of Rh in new catalysts based on Rhodium N-heterocycled carbenes located on graphene surfaces

Resumen del trabajo presentado a la 17th International Conference on X-Ray Absorption Fine Structure (XAFS), celebrada en Kraków (Polonia) del 22 al 27 de julio de 2018.We here report an x-ray absorption spectroscopic (XAS) study of a set of hybrid catalysts with Rh. This task focuses on the development and characterization of new effective heterogeneous catalysts, easily recoverable, of great interest for industrial processes. In particular, the hydrosilylation of multiple C-C bonds what is one of the most direct and efficient ways of preparing functionalized alkyl/alkenylsilanes. These silanes are quite versatile intermediate compounds in organic synthesis and represent a more sustainable alternative to stannanos or boranes due to its non-toxic nature. Rh(I) complexes based on N-heterocyclic carbenes showed a high efficiency in the hydrosilylation of terminal alkynes. However, this was a homogeneous system with a consequent difficulty in separating the catalyst for later uses. Therefore, the development of heterogeneous catalysts with similar activity would be a breakthrough in these processes. Our strategy to achieve this goal was to anchor Rh-NHC carbenes in functionalized graphene oxides (GO) through a three steps procedure. First, the azolium salts were linked to the GO walls directly through a C-N bond obtained by reaction of the carbon material with azide groups, and secondly, the azolium salts formed by reaction with alkynes were the precursors of these mesoinic NHC-carbenes bonded to the rhodium by a posterior third reaction. Different salts were tested in order to modify the complex solubility in water. Room temperature x-ray absorption measurements at the Rh K-edge were carried at the Claess beam line of the Alba synchrotron facility (Barcelona, Spain). The energy resolution ΔE/E was estimated to be about 8 × 10−5 at the Rh K-edge, and a foil of Rh metal was simultaneously measured for energy calibration. Different homogeneous and heterogeneous catalysts were measured to determine changes in the local structure around Rh atoms. The extended X-ray absorption fine structure (EXAFS) spectra were analyzed using the ARTEMIS program. The fits were carried out in R space using a Hanning window for filtering purposes. Our XAS results confirms an oxidation state of Rh(I) in both, homogeneous and heterogeneous materials. We were successful in refining the local structure from EXAFS spectra and we have related the catalytic activity to the changes of the ligands surrounding the Rh atoms. One surprising result was the fragility of the catalysts made using azolium salts. In spite of the high activity of those hetereogeneous catalysts based on 1,2,3-triazole ligands supported on graphene oxides in hydrosilylation of unsaturated compounds, our measurements revealed a continuous diminution of the supported Rh after each catalytic cycle.Peer Reviewe

Mortality rates in chronic thromboembolic pulmonary hypertension patients: Medical versus surgical treatment

Sin financiación20.212 JCR (2016) Q1, 1/126 Cardiovascular System & CardiologyUE