¿Qué pasa durante y después del síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2? / What happens during and after multisystem inflammatory syndrome in children associated with SARS-CoV-2?

Objetivo. Analizar las características clínicas y analíticas de los pacientes diagnosticados de síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2 (SIM-PedS) en la Comunidad Autónoma del Principado de Asturias, durante su ingreso y en los seis meses posteriores. Material y métodos. Estudio descriptivo, observacional, prospectivo (diciembre 2020 - junio 2022). Se incluyeron los pacientes menores de 18 años diagnosticados de SIM-PedS en la Comunidad Autónoma del Principado de Asturias. Se recogieron datos demográficos, clínicos y analíticos durante el ingreso y en los seis meses posteriores. Resultados. Durante el periodo de estudio, se incluyeron 16 pacientes (11 varones, edad mediana 10,6 años). Todos los pacientes tuvieron fiebre, 12 clínica gastrointestinal y 12 exantema. Todos los pacientes presentaron elevación de reactantes de fase aguda, 13 elevación de la porción N-terminal del pro-péptido natriurético tipo B, 10 linfopenia y 6 trombopenia. En la evaluación cardiológica durante el ingreso se encontraron alteraciones en seis pacientes. Todos los pacientes recibieron inmunoglobulinas, 14 corticoides y 6 inotrópicos. Nueve pacientes precisaron ingreso en la Unidad de Cuidados Intensivos Pediátricos (UCIP), con una estancia mediana de cuatro días. Un paciente falleció. No se han observado alteraciones reseñables ni en la clínica ni en la analítica ni en la evaluación cardiaca durante los seis meses posteriores al alta. Conclusiones. Los casos recogidos han mostrado las características clínicas y analíticas descritas en la literatura sobre el SIM-PedS, requiriendo más de la mitad ingreso en UCIP y recibiendo en todos los casos tratamiento con inmunoglobulinas. Presentaron frecuentemente afectación cardiológica, falleciendo un paciente. A los seis meses del episodio, ningún paciente ha mostrado afectación clínica, analítica ni de la función cardiaca (AU)

Aim. To analyze the clinical and analytical characteristics of patients diagnosed with Multisystem Inflammatory Syndrome in Children associated with SARS-CoV-2 (MIS-C) in the autonomous community of the Principality of Asturias, during their admission and in the subsequent six months. Material and methods. Descriptive, observational, prospective study (December 2020 - June 2022). Patients under 18 years of age diagnosed with MIS-C in the autonomous community of the Principality of Asturias were included. Demographic, clinical and analytical data were collected during admission and in the following six months. Results. During the study period, 16 patients were included (11 males, median age 10.6 years). All patients had fever, 12 had gastrointestinal symptoms and 12 had rash. All patients presented elevation of acute phase reactants, 13 elevation of the N-terminal portion of B-type natriuretic pro-peptide, 10 lymphopenia and 6 thrombopenia. In the cardiological evaluation during admission, alterations were found in six patients. All patients received immunoglobulins, 14 corticosteroids and 6 inotropes. Nine patients required admission to the Pediatric Intensive Care Unit (PICU), with a median stay of four days. One patient died. No notable alterations have been observed either in clinical symptoms, laboratory tests or cardiac evaluation during the six months after discharge. Conclusions. The cases collected have shown the clinical and analytical characteristics described in the literature on MIS-C, with more than half requiring admission to the PICU and receiving treatment with immunoglobulins in all cases. They frequently presented cardiological involvement, with one patient dying. Six months after the episode, no patient has shown clinical, analytical or cardiac function impairment (AU)

La aplicación informática «SCAE» en el diagnóstico precoz del cáncer musculoesquelético en el área sanitaria del Hospital Universitario 12 de Octubre. Análisis de su efectividad y propuestas de mejora / The computer application «SCAE» in the early diagnosis of musculoskeletal cancer in the healthcare area of the Hospital Universitario 12 de Octubre. Analysis of its effectiveness and proposals for improvement

Introducción: La aplicación informática SCAE-SM (Solicitud de Cita en Atención Especializada-Sospecha de Malignidad) es una herramienta informática de la que disponen los médicos de Atención Primaria (AP) para la derivación de pacientes que deban ser valorados por el especialista en un plazo máximo de 2 semanas, cuando se sospeche una patología maligna. El objetivo de nuestro trabajo fue analizar la utilidad de esta herramienta y proponer áreas de mejora en la gestión de los pacientes con sospecha de malignidad musculoesquelética. Material y métodos: Se realizó un estudio descriptivo transversal de las 235 derivaciones recibidas en los años 2012-2017. Se analizó su procedencia, la información contenida en las solicitudes y la respuesta proporcionada por evaluadores históricos (facultativos traumatólogos sin formación específica oncológica). Para este estudio, se ha realizado una nueva valoración ciega de todas las solicitudes por 13 traumatólogos con distinto nivel de formación específica en oncología musculoesquelética (reevaluadores). Resultados: De entre todas las SCAE-SM, solo el 8,23% de los pacientes presentaron enfermedad maligna o benigna agresiva. Los reevaluadores más acertados en la adecuación del adelanto de cita fueron aquellos con formación oncológica moderada (5-10 años de experiencia). Durante el periodo de tiempo del estudio, de todos los pacientes tratados en la Unidad de Tumores, solo el 18,81% accedieron por el circuito SCAE-SM, transcurriendo un tiempo medio de espera de 18,11 días desde la derivación de AP. Conclusiones: La aplicación informática SCAE-SM como herramienta de gestión y adelanto de la asistencia a los pacientes con patología tumoral musculoesquelética maligna es útil, si bien el uso del circuito es inadecuado. Es necesario difundirlo y generalizarlo, así como implementar programas de formación oncológica básica tanto en el ámbito de la AP como de la Hospitalaria.(AU)

Introduction: The SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy. Material and methods: A descriptive cross-sectional study of 235 referrals received in the years 2012–2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators). Results: Among all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5–10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral. Conclusions: The SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.(AU)

The computer application “SCAE” in the early diagnosis of musculoskeletal cancer in the healthcare area of the “Hospital Universitario 12 de Octubre”. Analysis of its effectiveness and proposals for improvement / La aplicación informática«SCAE» en el diagnóstico precoz del cáncer musculoesquelético en el área sanitaria del Hospital Universitario 12 de Octubre. Análisis de su efectividad y propuestas de mejora

Introduction: The SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy. Material and methods: A descriptive cross-sectional study of 235 referrals received in the years 2012–2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators). Results: Among all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5–10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral. Conclusions: The SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.(AU)

Introducción: La aplicación informática SCAE-SM (Solicitud de Cita en Atención Especializada-Sospecha de Malignidad) es una herramienta informática de la que disponen los médicos de Atención Primaria (AP) para la derivación de pacientes que deban ser valorados por el especialista en un plazo máximo de 2 semanas, cuando se sospeche una patología maligna. El objetivo de nuestro trabajo fue analizar la utilidad de esta herramienta y proponer áreas de mejora en la gestión de los pacientes con sospecha de malignidad musculoesquelética. Material y métodos: Se realizó un estudio descriptivo transversal de las 235 derivaciones recibidas en los años 2012-2017. Se analizó su procedencia, la información contenida en las solicitudes y la respuesta proporcionada por evaluadores históricos (facultativos traumatólogos sin formación específica oncológica). Para este estudio, se ha realizado una nueva valoración ciega de todas las solicitudes por 13 traumatólogos con distinto nivel de formación específica en oncología musculoesquelética (reevaluadores). Resultados: De entre todas las SCAE-SM, solo el 8,23% de los pacientes presentaron enfermedad maligna o benigna agresiva. Los reevaluadores más acertados en la adecuación del adelanto de cita fueron aquellos con formación oncológica moderada (5-10 años de experiencia). Durante el periodo de tiempo del estudio, de todos los pacientes tratados en la Unidad de Tumores, solo el 18,81% accedieron por el circuito SCAE-SM, transcurriendo un tiempo medio de espera de 18,11 días desde la derivación de AP. Conclusiones: La aplicación informática SCAE-SM como herramienta de gestión y adelanto de la asistencia a los pacientes con patología tumoral musculoesquelética maligna es útil, si bien el uso del circuito es inadecuado. Es necesario difundirlo y generalizarlo, así como implementar programas de formación oncológica básica tanto en el ámbito de la AP como de la Hospitalaria.(AU)

The computer application «SCAE¼ in the early diagnosis of musculoskeletal cancer in the healthcare area of the Hospital Universitario 12 de Octubre. Analysis of its effectiveness and proposals for improvement. / La aplicación informática «SCAE¼ en el diagnóstico precoz del cáncer musculoesquelético en el área sanitaria del Hospital Universitario 12 de Octubre. Análisis de su efectividad y propuestas de mejora.

INTRODUCTION: The SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy. MATERIAL AND METHODS: A descriptive cross-sectional study of 235 referrals received in the years 2012-2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators). RESULTS: Among all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5-10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral. CONCLUSIONS: The SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.

Abnormal pulmonary function tests predict the development of radiation-induced pneumonitis in advanced non-small cell lung Cancer.

BACKGROUND: Radiation pneumonitis (RP) is a frequent complication of concurrent chemoradiotherapy (CCRT) and is associated with severe symptoms that decrease quality of life and might result in pulmonary fibrosis or death. The aim of this study is to identify whether pulmonary function test (PFT) abnormalities may predict RP in non-small cell lung cancer (NSCLC) patients. METHODS: A prospective multi-institutional study was conducted with locally advanced and oligometastatic NSCLC patients. All participants were evaluated at baseline, end of CCRT, week 6, 12, 24, and 48 post-CCRT. They completed forced spirometry with a bronchodilator, body plethysmography, impulse oscillometry, carbon monoxide diffusing capacity (DLCO), molar mass of CO2, six-minute walk test and exhaled fraction of nitric oxide (FeNO). Radiation pneumonitis was assessed with RTOG and CTCAE. The protocol was registered in www.clinicaltrials.gov (NCT01580579), registered April 19, 2012. RESULTS: Fifty-two patients were enrolled; 37 completed one-year follow-up. RP ≥ Grade 2 was present in 11/37 (29%) for RTOG and 15/37 (40%) for CTCAE. Factors associated with RP were age over 60 years and hypofractionated dose. PFT abnormalities at baseline that correlated with the development of RP included lower forced expiratory volume in one second after bronchodilator (p = 0.02), DLCO (p = 0.02) and FeNO (p = 0.04). All PFT results decreased after CCRT and did not return to basal values at follow-up. CONCLUSIONS: FEV1, DLCO and FeNO prior to CCRT predict the development of RP in NSCLC. This study suggests that all patients under CCRT should be assessed by PFT to identify high-risk patients for close follow-up and early treatment.

Tratamiento de las fracturas diafisarias extraarticulares de húmero distal por abordaje posterior modificado y placa extraarticular / Surgical treatment of extra-articular distal-third diaphyseal fractures of the humerus using a modified posterior approach and an extra-articular plate

Objetivo. Evaluar los resultados clínicos y radiológicos del tratamiento quirúrgico de las fracturas diafisarias extraarticulares de húmero distal tratadas mediante un abordaje posterior modificado con una placa extraarticular preconformada de húmero distal. Material y métodos. Realizamos un estudio retrospectivo entre los años 2013 y 2015 de 23 pacientes mayores de 18 años, 45 años de media, con diagnóstico de fractura extraarticular de húmero distal que fueron intervenidos quirúrgicamente en nuestro centro mediante abordaje posterior modificado de Gerwin y placa extraarticular de húmero distal con seguimiento mínimo de un año y seguimiento medio de 18 meses. Se excluyeron las fracturas patológicas. Se recogieron los datos demográficos, el tipo de fractura, la lateralidad, el mecanismo de producción y la presencia de parálisis radial. Se evaluó el resultado clínico-funcional con las escalas Quick-Dash (QD), MEPS y EVA, el resultado radiológico y el tiempo hasta la consolidación. Se recogieron la satisfacción (sí o no) y las complicaciones. Resultados. Seis pacientes presentaban fractura tipo 12-A, 7 tipo 12-B y 10 tipo 12-C. Todos los pacientes presentaron consolidación al año de la intervención (media 12 semanas). Nueve pacientes presentaron parálisis radial prequirúrgica y uno posquirúrgica. No hubo complicaciones relacionadas con fracasos de material y se observaron 2 infecciones de herida quirúrgica. La puntuación media de las escalas fue la siguiente: QD 6,43, EVA 0,66, MEPS 88,88; 12 resultados fueron considerados como excelentes, 3 como buenos y 3 como suficientes. Conclusión. La osteosíntesis de este tipo de fracturas con placa extraarticular empleando el abordaje de Gerwin presenta una tasa de complicaciones muy baja, permite la exploración del nervio radial con una buena exposición proximal del húmero, permite reducción anatómica con montaje rígido y estabilización absoluta de la fractura, dejando libre las articulaciones, obtiene altas tasas de consolidación con excelentes resultados funcionales y una rápida vuelta a la actividad de los pacientes (AU)

Purpose. To evaluate the clinical and radiological outcomes of these fractures treated through a modified posterior approach with a distal humerus plate. Material and methods. Between 2013 and 2015 we performed a retrospective study of these fractures surgically treated in our centre. Inclusion criteria: older than 18 years old, no pathological fractures, follow up 1 year at least. 23 patients underwent surgery, mean age 45 years old, with an average follow-up of 18 months. Patient characteristics, aetiology and type of fractures were recorded. The surgery was performed using Gerwin modified posterior approach with a posterolateral distal humerus plate. Clinical results were evaluated using Quick DASH, MEPS, VAS. Radiological results were also evaluated. Complications associated with treatment and radial nerve palsy incidence were recorded as well. Results. Type of fracture according AO/OTA: six 12-A, seven 12-B, ten 12-C. 23 patients progressed to union. After one year: QD 6.43, VAS 0.66, MEPS 88.88. No failure of internal fixation. Two superficial infections. 15 excellent results, 5 good, and 3 fair, with no poor results. Conclusion. Surgical fixation of these fractures through a modified posterior approach with a posterolateral plate minimises iatrogenic nerve injury, provides better visualisation of the proximal humerus, provides stable fixation of these injuries and results in high union rates and overall excellent functional results (AU)

Surgical treatment of extra-articular distal-third diaphyseal fractures of the humerus using a modified posterior approach and an extra-articular plate. / Tratamiento de las fracturas diafisarias extraarticulares de húmero distal por abordaje posterior modificado y placa extraarticular.

PURPOSE: To evaluate the clinical and radiological outcomes of these fractures treated through a modified posterior approach with a distal humerus plate. MATERIAL AND METHODS: Between 2013 and 2015 we performed a retrospective study of these fractures surgically treated in our centre. INCLUSION CRITERIA: older than 18 years old, no pathological fractures, follow up 1 year at least. 23 patients underwent surgery, mean age 45 years old, with an average follow-up of 18 months. Patient characteristics, aetiology and type of fractures were recorded. The surgery was performed using Gerwin modified posterior approach with a posterolateral distal humerus plate. Clinical results were evaluated using Quick DASH, MEPS, VAS. Radiological results were also evaluated. Complications associated with treatment and radial nerve palsy incidence were recorded as well. RESULTS: Type of fracture according AO/OTA: six 12-A, seven 12-B, ten 12-C. 23 patients progressed to union. After one year: QD 6.43, VAS 0.66, MEPS 88.88. No failure of internal fixation. Two superficial infections. 15 excellent results, 5 good, and 3 fair, with no poor results. CONCLUSION: Surgical fixation of these fractures through a modified posterior approach with a posterolateral plate minimises iatrogenic nerve injury, provides better visualisation of the proximal humerus, provides stable fixation of these injuries and results in high union rates and overall excellent functional results.

Inestabilidad crónica de tobillo: reparación anatómica artroscópica / Chronic ankle instability: arthroscopic anatomical repair

Introducción. Los esguinces de tobillo son una de las patologías traumatológicas más frecuentes. A pesar de un tratamiento conservador adecuado, este fracasa en el 20-40% de los casos. Estos pacientes suelen desarrollar una inestabilidad crónica de tobillo. En el 75-80% de las ocasiones existe una rotura aislada del ligamento talofibular anterior. Material y método. Estudio retrospectivo observacional de 21 pacientes intervenidos quirúrgicamente mediante técnica de reparación anatómica artroscópica, por inestabilidad lateral crónica de tobillo, entre mayo de 2012 y enero de 2013. Se realizó un seguimiento medio de 29 meses (rango de 25-33). La distribución por sexos fue de 15 hombres y 6 mujeres; la edad media fue de 30,43 años (rango de 18-48). En 4 pacientes (19%), se diagnosticó una deformidad en varo del retropié asociada. En 15 pacientes (71,4%), se diagnosticaron lesiones intraarticulares: 6 pacientes presentaron lesiones osteocondrales (LOC) talares, 3 presentaban un pinzamiento posterior de tobillo y 6 pacientes presentaban distintas patologías de los tendones peroneos. Todas estas lesiones fueron abordadas quirúrgicamente en el mismo acto quirúrgico. Resultados. Se llevó a cabo una revisión clínico-funcional, utilizando la escala American Orthopaedic Foot and Ankle Society (AOFAS). La media preoperatoria fue de 66,12 puntos (rango de 60-71) y la postoperatoria se incrementó hasta una media de 96,95 puntos (rango de 90-100). Todos los pacientes pudieron retomar sus actividades deportivas previas en una media de 21,5 semanas (rango de 17-28). Encontramos complicaciones en 3 pacientes (14%). Conclusiones. La reparación anatómica del ligamento talofibular anterior mediante esta técnica presenta unos resultados clínico-funcionales excelentes, con una temprana reincorporación del paciente a sus actividades deportivas y un bajo índice de reintervenciones y complicaciones (AU)

Introduction. Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. Material and method. A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. Results. A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. Conclusions. Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time (AU)

Chronic ankle instability: Arthroscopic anatomical repair. / Inestabilidad crónica de tobillo: reparación anatómica artroscópica.

INTRODUCTION: Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. MATERIAL AND METHOD: A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. RESULTS: A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. CONCLUSIONS: Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time.

Valores de referencia de la proteína S100beta en población pediátrica / Serum S100Beta protein reference values in a paediatric population

INTRODUCCIÓN: La proteína S100β se ha propuesto como posible biomarcador en patología neurológica, tanto crónica como aguda. Los valores normales de esta proteína están bien definidos en adultos, no así en niños, en los que los valores séricos parecen variar con la edad. Nuestro objetivo es describir valores de referencia de S100β sérica en niños de 0 a 14 años. MATERIAL Y MÉTODOS: Estudio prospectivo en 257 niños sanos. Se establecieron 3 grupos por edad (menores de 12 meses, de 12 a 24 meses y mayores de 24 meses). RESULTADOS: Se incluyó a 179 niños y 78 niñas. La edad media ± DE fue de 5,5 ± 3,75 años. La concentración sérica media de la proteína S100β en todo el grupo fue 0,156 (0,140-0,172) μg/l. En los menores de 12 meses, la concentración sérica de S100β fue de 0,350 (0,280-0,421) μg/l; 0,165 (0,139-0,190) μg/l en el grupo entre 12 y 24 meses y 0,121 (0,109-0,133) μg/l en el grupo de niños mayores de 24 meses. Se observó una relación inversa entre la edad y la concentración sérica de S100β, que desciende conforme se incrementa la edad. No se observaron diferencias en cuanto al sexo. CONCLUSIONES: La concentración de S100β permanece estable a partir de los 2 años de edad, siendo posible establecer unos valores de referencia de S100β para mayores de 2 años. En los 2 primeros años de vida, la concentración de S100β sérica es más elevada cuanto menor es la edad del niño. No se observan diferencias en el valor de S100β sérica entre ambos sexos

INTRODUCTION: S100β protein has been proposed as a potential biomarker for both chronic and acute neurological disorders. Reference values of this protein are well defined in adults but not in children, in whom serum levels appear to vary with age. Reference values for serum S100β in children from 0 to 14 years are presented. MATERIALS AND METHODS: A prospective study was conducted on 257 healthy children, who were divided into three age groups (under 12 months, 12 to 24 months and over 24 months). RESULTS: The study included179 boys and 78 girls, with a mean age of 5.5 (3.75) years. The mean serum concentration of protein S100β was 0.156 (0.140-0.172) μg/l. In children under 12 months, serum S100β concentration was 0.350 (0.280-0.421) μg/l; 0.165 (0.139-0.190) μg/l in the group between 12 and 24 months and 0.121 (0.109-0.133) μg/l in children older than 24 months. An inverse relationship was observed between age and serum S100β, which declines as age increases. No differences were observed between sexes. CONCLUSIONS: The concentration of S100β remains stable after two years of age, being possible to establish a baseline of S100β for over two years. During the first two years of life, S100β serum concentration is higher, the lower the age of the child. No differences in serum S100β levels between sexes are observed

[Serum S100ß protein reference values in a paediatric population]. / Valores de referencia de la proteína S100ß en población pediátrica.

INTRODUCTION: S100ß protein has been proposed as a potential biomarker for both chronic and acute neurological disorders. Reference values of this protein are well defined in adults but not in children, in whom serum levels appear to vary with age. Reference values for serum S100ß in children from 0 to 14 years are presented. MATERIALS AND METHODS: A prospective study was conducted on 257 healthy children, who were divided into three age groups (under 12 months, 12 to 24 months and over 24 months). RESULTS: The study included179 boys and 78 girls, with a mean age of 5.5 (3.75) years. The mean serum concentration of protein S100ß was 0.156 (0.140-0.172) µg/l. In children under 12 months, serum S100ß concentration was 0.350 (0.280-0.421) µg/l; 0.165 (0.139-0.190) µg/l in the group between 12 and 24 months and 0.121 (0.109-0.133) µg/l in children older than 24 months. An inverse relationship was observed between age and serum S100ß, which declines as age increases. No differences were observed between sexes. CONCLUSIONS: The concentration of S100ß remains stable after two years of age, being possible to establish a baseline of S100ß for over two years. During the first two years of life, S100ß serum concentration is higher, the lower the age of the child. No differences in serum S100ß levels between sexes are observed.

Estudio comparativo de la reparación de la rotura de espesor completo del supraespinoso mediante técnica "hilera simple" o "suture bridge" / Comparative study of the repair of full thickness tear of the supraspinatus by means of "single row" or "suture bridge" techniques

Resumen: Objetivo: Analizar si existen diferencias clínicas entre las técnicas "hilera simple" versus "suture bridge" en la reparación artroscópica de roturas de espesor completo del supraespinoso. Material y métodos: Estudio retrospectivo de 123 pacientes con rotura de espesor completo del supraespinoso, intervenidos entre Enero de 2009 y Enero de 2013 (60 hilera simple y 63 suture bridge). La edad media en el grupo suture bridge fue 63.3 años y en el grupo hilera simple, 62.9. Predominio de mujeres (67%) en ambos grupos. En todos los casos, se reparó la hilera medial con anclajes Bio-Corkscrew y la hilera lateral con implantes Bio-PushLock (Arthrex, Naples, FL). Resultados: El valor del test de Constant medio en individuos intervenidos mediante suture bridge fue 76.7 (ponderado 96.5). En hilera simple, fue 72.4 (ponderado 92.8). Se realizó también un análisis estadístico comparativo de cada ítem del test de Constant por separado. La fuerza es el único parámetro del test de Constant estadísticamente significativo y es mayor en el grupo suture bridge. Conclusiones: La reparación de las roturas de espesor completo del supraespinoso mediante suture bridge proporciona resultados clínicos superiores a la reparación en hilera simple, sin existir diferencias estadísticamente significativas (p = 0.298).

Abstract: Purpose: The purpose of this study is to analyze if there is any difference between the arthroscopic reparation of full-thickness supraspinatus tears with simple row technique versus suture bridge technique. Material and methods: We accomplished a retrospective study of 123 patients with full-thickness supraspinatus tears between January 2009 and January 2013 in our hospital. There were 60 simple row reparations, and 63 suture bridge ones. Results: The mean age in the simple row group was 62.9, and in the suture bridge group was 63.3 years old. There were more women than men in both groups (67%). All patients were studied using the Constant test. The mean Constant test in the suture bridge group was 76.7, and in the simple row group was 72.4. We have also accomplished a statistical analysis of each Constant item. Strength was higher in the suture bridge group, with a significant statistical difference (p < 0.04). The range of movement was also greater in the suture bridge group, but was not statistically significant. Conclusions: Suture bridge technique has better clinical results than single row reparations, but the difference is not statistically significant (p = 0.298).

[Comparative study of the repair of full thickness tear of the supraspinatus by means of "single row" or "suture bridge" techniques]. / Estudio comparativo de la reparación de la rotura de espesor completo del supraespinoso mediante técnica "hilera simple" o "suture bridge".

PURPOSE: The purpose of this study is to analyze if there is any difference between the arthroscopic reparation of full-thickness supraspinatus tears with simple row technique versus suture bridge technique. MATERIAL AND METHODS: We accomplished a retrospective study of 123 patients with full-thickness supraspinatus tears between January 2009 and January 2013 in our hospital. There were 60 simple row reparations, and 63 suture bridge ones. RESULTS: The mean age in the simple row group was 62.9, and in the suture bridge group was 63.3 years old. There were more women than men in both groups (67%). All patients were studied using the Constant test. The mean Constant test in the suture bridge group was 76.7, and in the simple row group was 72.4. We have also accomplished a statistical analysis of each Constant item. Strength was higher in the suture bridge group, with a significant statistical difference (p 0.04). The range of movement was also greater in the suture bridge group, but was not statistically significant. CONCLUSIONS: Suture bridge technique has better clinical results than single row reparations, but the difference is not statistically significant (p = 0.298).

OBJETIVO: Analizar si existen diferencias clínicas entre las técnicas «hilera simple¼; versus «. MATERIAL Y MÉTODOS: suture bridge¼; en la reparación artroscópica de roturas de espesor completo del supraespinoso. Estudio retrospectivo de 123 pacientes con rotura de espesor completo del supraespinoso, intervenidos entre Enero de 2009 y Enero de 2013 (60 hilera simple y 63. RESULTADOS: suture bridge). La edad media en el grupo suture bridge fue 63.3 años y en el grupo hilera simple, 62.9. Predominio de mujeres (67%) en ambos grupos. En todos los casos, se reparó la hilera medial con anclajes Bio-Corkscrew y la hilera lateral con implantes Bio-PushLock (Arthrex, Naples, FL). El valor del test de Constant medio en individuos intervenidos mediante. CONCLUSIONES: suture bridge fue 76.7 (ponderado 96.5). En hilera simple, fue 72.4 (ponderado 92.8). Se realizó también un análisis estadístico comparativo de cada ítem del test de Constant por separado. La fuerza es el único parámetro del test de Constant estadísticamente significativo y es mayor en el grupo suture bridge. La reparación de las roturas de espesor completo del supraespinoso mediante.

Stress and DNA assembly differences on cantilevers gold coated by resistive and e-beam evaporation techniques.

Changes in the sign of differential surface stress of gold-coated cantilevers produced by thiol-derivatized single-stranded DNA immobilization are observed, depending on the method used to deposit the gold. While the DNA immobilization on e-beam gold-coated cantilevers produces a compressive differential surface stress in the metallic layer, the opposite is observed for resistively coated cantilevers under the same immobilization conditions. The gold films exhibit quite a similar morphology, and the immobilization differences seem to be related to the charge state of the metallic layer surface. This in turn produces a different distribution of the orientation of the DNA strands on the gold layer. A tentative explanation for the observed effect is proposed.

Hybrid titania-aminosilane platforms evaluated with human mesenchymal stem cells.

The properties of hybrid aminopropyltriethoxysilane-tetraisopropylorthotitanate (APTS-TIPT) platforms prepared by a sol-gel route have been explored, and their biocompatibility was assayed after culture of human mesenchymal stem cells (hMSCs). The organic content of this material was observed to be preferably surface-oriented as indicated by microanalytical techniques. Furthermore, the surface showed characteristic amino-silane bands when explored by Raman spectroscopy as well as indications of silane and titanate condensation. Surface activity of the amino groups was probed by ultraviolet-visible spectroscopy imine derivatization and chemical force spectroscopy, showing a pH-dependent surface charge-induced potential. hMSCs cultured onto these surfaces showed relevant differences with respect to their behavior on gelatin-coated glass plates. Even if with a lower proliferative rate than controls, the cells develop long cytosolic prolongations in osteogenic differentiation medium, thus, supporting the idea of an APTS-TIPT stimulated process.

One step processing of aminofunctionalized gate oxides.

A plasma discharge process has been developed that allows the growth of biosensor gate oxides with adapted surface properties for the direct application of biomolecular immobilization cascades. The process involves an accurate selection of processing conditions, mainly, low temperature evaporation of (3-aminopropyl)triethoxysilane (APTS) and dynamic power and flow conditions. Room temperature evaporation of APTS was achieved by designing a vessel with an internal capillary network. The initial high power (100 W) plasma conditions were replaced by milder molecular fragmentation (50 W, 25 W) in a pure Ar discharge. Under these conditions the thin SiO(2) layers presented graded properties with a denser layer at the Si (100) interface and a hybrid organic-inorganic structure at the surface. The chemistry of the films was analysed by Fourier transformed infrared spectroscopy (FTIR) and Rutherford backscattering spectroscopy combined with elastic recoil detection analysis (RBS, ERDA), which confirmed the presence of the SiO(2) and organic phases. Contact angle measurements indicate the higher contribution of the basic polar component to the surface free energy. Furthermore, the higher affinity of the surface towards biomolecular immobilization was confirmed by fluorescence microscopy. Finally, penetration of nitrobenzaldehyde was obtained by application of a molecular permeation method evaluated by UV-vis spectroscopy onto fused silica substrates.