Congenital knee dislocation. Therapeutic protocol and long-term functional results. / Luxación congénita de rodilla. Protocolo terapéutico y resultados funcionales a largo plazo.

BACKGROUND AND OBJECTIVE: Congenital knee dislocation is a very rare entity, characterised by deformity in knee recurvatum present at birth, and there is currently no consensus on the optimal treatment. The aim of the present study is to analyse the functional results and long-term complications after the application of a protocol of therapeutic action for the management of congenital knee dislocation (CKD) created in a reference centre for child orthopaedics. MATERIALS AND METHODS: Retrospective descriptive study of patients with congenital dislocation of the knee who followed CRPL between January 1997 and December 2010. Demographic variables, type of treatment, functional outcomes at the end of the follow-up, complications and relapses were studied. The conservative treatment consisted of serial casts, leaving the surgical treatment for cases in which passive flexion was not achieved above 30° or the conservative treatment failed. RESULTS: 9 patients (11 knees) met the inclusion criteria. The 66.7% were girls and the average follow-up was 15 years (9-22). In all cases, conservative treatment was initiated. Of the 11 knees treated, less than half (36%) required surgery. The average Lysholm questionnaire was 90.3 points, the WOMAC pain 0.4 (0-1), WOMAC stiffness 1.8 (0-6) and WOMAC function 3.8 (1-12). CONCLUSIONS: The existence and application of the PLCR protocol in a pathology as rare as congenital knee dislocation suggests good long-term functional results with few complications and no recurrences.

Menisco discoideo medial bilateral sintomático tratado con remodelación meniscal artroscópica: caso clínico / Symptomatic bilateral medial discoid meniscus treated with arthroscopic meniscal remodeling: clinical case

El menisco discoideo medial es una entidad muy poco frecuente, con una incidencia reportada del 0,12 al 0,3%, aunque la incidencia real puede ser mayor ya que no siempre se manifiesta clínicamente. Al igual que el menisco discoideo lateral, el menisco discoideo medial es susceptible de degeneración meniscal, lo que puede derivar en síntomas mecánicos en edades tempranas. Se presenta el caso de un paciente varón de 14 años con dolor de ambas rodillas de inicio insidioso sin relación con traumatismo definido que tras estudio de resonancia es diagnosticado de menisco discoideo medial bilateral con degeneración intrasustancia. Debido a la presencia de síntomas mecánicos limitantes para actividades de la vida diaria y deportivas, se realiza remodelación meniscal primero de la rodilla derecha y, a los 3 meses, de la izquierda, con buenos resultados en el tiempo de seguimiento - 6 y 3 meses, respectivamente -, que permiten al paciente el retorno a las actividades deportivas sin restricciones

Medial discoid meniscus is a rare entity with a reported incidence of 0.12 to 0.3%, although the real incidence may be greater because not all the patients are symptomatic. Like lateral discoid menisci, medial discoid menisci are prone to degeneration that may prompt the presence of mechanical symptoms at early age. We present the case of a 14 year old male patient with bilateral knee symptoms of insidious onset without a traumatic event. Magnetic resonance revealed bilateral medial discoid menisci. Arthroscopic medial meniscus remodelling was performed in the right knee and, three months later, in the left knee, due to limitating mechanical symptoms. At the latest follow up - 6 months for the right knee, 3 months for the left knee -, the patient resumed his sports activities

Symptomatic bilateral medial discoid meniscus treated with arthroscopic meniscal remodeling: clinical case. / Menisco discoideo medial bilateral sintomático tratado con remodelación meniscal artroscópica: caso clínico.

Medial discoid meniscus is a rare entity with a reported incidence of 0.12 to 0.3%, although the real incidence may be greater because not all the patients are symptomatic. Like lateral discoid menisci, medial discoid menisci are prone to degeneration that may prompt the presence of mechanical symptoms at early age. We present the case of a 14 year old male patient with bilateral knee symptoms of insidious onset without a traumatic event. Magnetic resonance revealed bilateral medial discoid menisci. Arthroscopic medial meniscus remodelling was performed in the right knee and, three months later, in the left knee, due to limitating mechanical symptoms. At the latest follow up -6 months for the right knee, 3 months for the left knee-, the patient resumed his sports activities.

Detection of obstructive sleep apnea in ECG recordings using time-frequency distributions and dynamic features.

Detection of obstructive sleep apnea can be performed through heart rate variability analysis, since fluctuations of oxygen saturation in blood cause variations in the heart rate. Such variations in heart rate can be assessed by means of time-frequency analysis implemented with time-frequency distributions belonging to Cohen's class. In this work, dynamic features are extracted from time frequency distributions in order to detect obstructive sleep apnea from ECG signals recorded during sleep. Furthermore, it is applied a methodology to measure the relevance of each dynamic feature, before the implementation of k-nn classifier used to recognize the normal and pathologic signals. As a result, the proposed method can be applied as a simple diagnostic tool for OSA with a high accuracy (up to 92.67%) in one-minute intervals.

Tratamiento del quiste óseo simple en la población infantil / Treatment of simple bone cyst in children

Objetivo. Comparar los resultados del tratamiento del quiste óseo simple mediante aspiración e infiltración con corticoides frente al curetaje y relleno con injerto. Analizar la existencia de factores pronósticos que se relacionen con la respuesta al tratamiento. Material y método. Estudio retrospectivo de 29 niños con diagnóstico clínico-radiológico y/o anatomopatológico de quiste óseo simple que hayan sido tratados mediante alguno de los dos métodos. Se han comparado los resultados en función de la clasificación de Neer modificada. Resultados. La frecuencia de curaciones (completas o incompletas) fue del 85 por ciento para los tratados mediante curetaje e injerto y del 88 por ciento para los tratados mediante infiltración con corticoides. No se han encontrado diferencias significativas entre los dos grupos de tratamiento. La respuesta al tratamiento no se relacionó en nuestra serie con ninguno de los posibles factores pronósticos estudiados: edad, localización, actividad, tamaño y aspecto radiológico. No se observaron complicaciones entre los niños tratados con infiltraciones. Conclusiones. El tratamiento con infiltración con corticoides debe ser considerado de elección en el quiste óseo simple, por su menor morbilidad y coste (AU)

[Alcohol consumption and adolescence: a descriptive epidemiological study]. / Consumo de alcohol y adolescencia: estudio epidemiológico descriptivo.

OBJECTIVES: To determine the consumption of alcoholic drinks among adolescents in Tres Cantos and its defining characteristics. DESIGN: A descriptive, cross-sectional study. SETTING: State schools in Tres Cantos. PARTICIPANTS: All the students present (994) who had registered for the 1994-95 year. MEASUREMENTS AND RESULTS: A self-filled anonymous questionnaire was answered in the class-rooms of the schools in Tres Cantos during May 1995. The relationship between the variables was worked out using the computer programme EPI-INFO (version 5.01). 73.1% of those polled consumed alcoholic drinks. There were no significant differences for gender. Most consumption was at the weekend. The commonest drink was wine and its combinations, followed by beer, rum or gin and coke, spirits and fizzy drinks. The CAGE test was positive in 14.1% of cases. 59.6% had got drunk on some occasion, 89.3% consumed alcohol for the first time before they were 16, which most did outside the home. There was a significant association between participating in religious activities and less alcohol consumption. CONCLUSIONS: The percentage of alcohol consumers among students is high. It is characterised by being similar in both sexes, starting at an early age and clear predominance of consumption at weekends and outside the home. Wine and its combinations is the commonest drink.