Abordaje transvasto mínimamente invasivo versus abordaje parapatelar medial convencional en la artroplastia total de rodilla en pacientes con gonartrosis: estudio prospectivo comparativo no randomizado

Objetivos: valorar y comparar los resultados a corto plazo de la artroplastia total de rodilla realizada mediante dos vías de abordaje. Material y métodos: estudio prospectivo comparativo que compara abordaje parapatelar medial (24 pacientes) y transvasto mínimamente invasivo (25 pacientes) en artroplastia total de rodilla. Se incluyeron pacientes con gonartrosis grado IV de la clasificación de Kellgren-Lawrence y se excluyeron aquellos menores de 50 años, deformidad en varo (> 15º) o valgo (> 10º), artrosis postraumática, artritis reumatoide, cirugías de revisión, osteotomías correctoras previas, IMC > 40 kg/m2, infección activa local o sistémica y/o deterioro mental. Resultados: se encontraron diferencias estadísticamente significativas en dolor del primer y segundo día postoperatorios a favor del abordaje mínimamente invasivo (1º día: 3,8 ± 2,5 vs. 6,7 ± 2,1; p< 0,001. 2º día: 3 ± 2,1 vs. 6 ± 2; p< 0,001). Conclusiones: no existen diferencias relevantes entre ambos abordajes, por lo que se recomienda la utilización del abordaje con el que el cirujano se encuentre más cómodo y familiarizadoAim: Assess and compare short-term outcomes of total knee arthroplasty performed using two surgical approaches. Material and methods: a prospective study with 49 patients comparing medial parapatellar approach (24 patients) and minimally invasive trans-vastus access (25 patients) in total knee replacement. The patients included suffered knee osteoarthritis grade IV the Kellgren-Lawrence’s classification. Exclusion criteria were age under 50 years, large axial deformity (varus deformity > 15° or valgus > 10°), posttraumatic osteoarthritis, rheumatoid arthritis, revision surgeries, previous osteotomies, BMI> 40 kg/m2 and of course local or systemic active infection and mental impairment. Results: statistically significant differences were found for pain in first and second postoperative days for the minimally invasive approach (1st day: 3.8 ± 2.5 vs. 6.7 ± 2.1; p <0.001. 2nd day: 3 ± 2.1 vs. 6 ± 2; p <0.001). Conclusions: there are not significant differences between mini and standard approaches in knee replacement, so decision about which access to use in knee reconstruction surgery depends on surgeon’s preferences

Fractura de Maisonneuve abierta: una entidad infrecuente: a propósito de un caso y revisión de la literatura

Introducción. La fractura de Maisonneuve representa aproximadamente el 5% de todas las fracturas de tobillo tratadas quirúrgicamente. Debido a que suelen ser fracturas cerradas, presentamos el caso de una fractura de Maisonneuve abierta por su infrecuencia. Caso Clínico. Varón de 63 años que acudió a urgencias tras traumatismo de miembro inferior derecho. En la exploración se evidenció una solución de continuidad de la piel en cara medial de tobillo con exposición de maléolo tibial. La radiografía mostró una apertura de la mortaja tibio-peronea y una fractura espiroidea en el tercio proximal del peroné. Se realizó osteosíntesis con dos tornillos canulados. Tras 12 meses de seguimiento, el paciente presenta una puntuación media de 86,8 puntos en la escala AOFAS. Conclusión. Ante una luxación abierta de tobillo, debe sospecharse una fractura de Maisonneuve aunque sea poco frecuente, siendo la osteosíntesis una opción terapéutica eficaz en este tipo de fracturas.Introduction. Maisonneuve fracture represents approximately 5% of all surgically treated ankle fractures. Because these fractures are usually closed, we present the case of a Maisonneuve open fracture owing to its rarity. Case report. A 63-year-old man presented to his emergency department after a right leg trauma. Physical examination revealed a skin solution of continuity above the ankle joint, with a medial tibial malleolus exposure. The radiography showed an opening of the tibiofibular mortise and a spiral fracture of the proximal third of the fibula. Fixation with two cannulated screws was performed. After 12 months of follow up, the patient has an average score of 86.8 points on the AOFAS scale. Conclusion. In the face of an open ankle dislocation, a Maisonneuve open fracture should be suspected in spite of its infrequency, being the osteosynthesis an effective therapeutic option in this type of fracture

Hybrid control architecture for navigation of unmanned underwater vehicles

In the present paper, a hybrid architecture based on multi-agent systems is proposed based on a layered system. This architecture presents qualities of modularity and scalability. It is also developed a methodology for trajectory tracking based on the generation of a reliable virtual space, on which the navigation takes place under operative conditions (safety and e ectiveness). Time processing operations reduction is expected during the inspection

Overview of recent TJ-II stellarator results

The main results obtained in the TJ-II stellarator in the last two years are reported. The most important topics investigated have been modelling and validation of impurity transport, validation of gyrokinetic simulations, turbulence characterisation, effect of magnetic configuration on transport, fuelling with pellet injection, fast particles and liquid metal plasma facing components. As regards impurity transport research, a number of working lines exploring several recently discovered effects have been developed: the effect of tangential drifts on stellarator neoclassical transport, the impurity flux driven by electric fields tangent to magnetic surfaces and attempts of experimental validation with Doppler reflectometry of the variation of the radial electric field on the flux surface. Concerning gyrokinetic simulations, two validation activities have been performed, the comparison with measurements of zonal flow relaxation in pellet-induced fast transients and the comparison with experimental poloidal variation of fluctuations amplitude. The impact of radial electric fields on turbulence spreading in the edge and scrape-off layer has been also experimentally characterized using a 2D Langmuir probe array. Another remarkable piece of work has been the investigation of the radial propagation of small temperature perturbations using transfer entropy. Research on the physics and modelling of plasma core fuelling with pellet and tracer-encapsulated solid-pellet injection has produced also relevant results. Neutral beam injection driven Alfvénic activity and its possible control by electron cyclotron current drive has been examined as well in TJ-II. Finally, recent results on alternative plasma facing components based on liquid metals are also presented. ISSN:0029-5515 ISSN:1741-432

Ibero-American Consensus on Low- and No-Calorie Sweeteners : Safety, Nutritional Aspects and Benefits in Food and Beverages

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2\u207b4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable

Measurement of the azimuthal anisotropy of Y(1S) and Y(2S) mesons in PbPb collisions at √S^{S}NN = 5.02 TeV

The second-order Fourier coefficients (υ$_{2}$) characterizing the azimuthal distributions of Υ(1S) and Υ(2S) mesons produced in PbPb collisions at $\sqrt{s_{NN}}$ = 5.02 TeV are studied. The Υmesons are reconstructed in their dimuon decay channel, as measured by the CMS detector. The collected data set corresponds to an integrated luminosity of 1.7 nb$^{-1}$. The scalar product method is used to extract the υ$_{2}$ coefficients of the azimuthal distributions. Results are reported for the rapidity range |y| < 2.4, in the transverse momentum interval 0 < p$_{T}$ < 50 GeV/c, and in three centrality ranges of 10–30%, 30–50% and 50–90%. In contrast to the J/ψ mesons, the measured υ$_{2}$ values for the Υ mesons are found to be consistent with zero

Measurement of the Y(1S) pair production cross section and search for resonances decaying to Y(1S)μ⁺μ⁻ in proton-proton collisions at √s = 13 TeV

The fiducial cross section for Y(1S)pair production in proton-proton collisions at a center-of-mass energy of 13TeVin the region where both Y(1S)mesons have an absolute rapidity below 2.0 is measured to be 79 ± 11 (stat) ±6 (syst) ±3 (B)pbassuming the mesons are produced unpolarized. The last uncertainty corresponds to the uncertainty in the Y(1S)meson dimuon branching fraction. The measurement is performed in the final state with four muons using proton-proton collision data collected in 2016 by the CMS experiment at the LHC, corresponding to an integrated luminosity of 35.9fb$^{-1}$. This process serves as a standard model reference in a search for narrow resonances decaying to Y(1S)μ$^{+}$μ$^{-}$ in the same final state. Such a resonance could indicate the existence of a tetraquark that is a bound state of two bquarks and two b̅ antiquarks. The tetraquark search is performed for masses in the vicinity of four times the bottom quark mass, between 17.5 and 19.5GeV, while a generic search for other resonances is performed for masses between 16.5 and 27GeV. No significant excess of events compatible with a narrow resonance is observed in the data. Limits on the production cross section times branching fraction to four muons via an intermediate Y(1S)resonance are set as a function of the resonance mass