ABSTRACT
INTRODUCTION: Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure. MATERIAL AND METHODS: We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computarized tomography (CT) scan. The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker®) that matched the characteristics of the fracture and the approach to be used. RESULTS: Printing the moulds took a mean of 385minutes (322-539), and 238grams of plastic were used to print the model (180-410). In all cases, anatomic reduction was obtained and intra-operative changes were not required in the initial contouring of the plates. The time needed to perform the full osteosynthesis, once the fracture had been reduced was 16.9minutes (10-24). In one case fixed with two plates, a postoperative CT scan showed partial contact of the implant with the surface of the quadrilateral plate. In the remaining cases, the contact was complete. CONCLUSIONS: In conclusion, our results suggest that the use of preoperative planning, by printing 3D mirror imaging models of the opposite hemipelvis and pre-contouring plates over the mould, might effectively achieve a predefined surgical objective and reduce the inherent risks in these difficult procedures.
ABSTRACT
En España, la osteoporosis la padecen tres millones de personas. Para su diagnóstico se utiliza la absorciometría dual por Rayos-X (DEXA), que permite obtener medidas estándares de densidad mineral ósea (DMO), las cuales se utilizan como marcadores predictivos de la pérdida de masa ósea. La aplicación de este tipo de tecnologías sobre poblaciones especiales ha experimentado un notable auge durante los últimos años, ya que la actividad física y la práctica deportiva suponen un área de estudio esencial de cara a comprender en mayor medida todos aquellos procesos de adaptación ósea a los cuales se somete a la estructura esquelética. Con esta revisión se pretende aclarar en qué medida diferentes prácticas deportivas, realizadas en diferentes medios y con diferentes implementos, inciden sobre el sistema esquelético de deportistas bien entrenados. De esta forma, podremos constatar qué tipo de actividad física, en qué medio y bajo qué circunstancias, son las más propensas a generar aumentos en el contenido mineral óseo (CMO) y la DMO en diferentes lugares específicos de la estructura ósea
In Spain, osteoporosis is suffered by three million people. For its diagnostic the Dual X-Ray Absorciometry (DEXA) is used, that allows to obtain the standard measures of bone mineral density (BMD) which are used like predictors markers of bone mass lost. The application of this type of technology on a special population has experimented an increase during the last years. Physical activity and sports suppose an area of essential study to understand better all the bone adaptations process which the skeletal structure suffers. The following review pretends to elucidate to which extend the practice of different sports, done at different mediums and with different implements, affect the skeletal system of the well sportsmen. So, we trained what type of physical activity, at what medium and below what circumstances generate an increase of the bone mineral content (BMC) and the BMD at different specific sites of the bone structure
Subject(s)
Male , Female , Humans , Sports/physiology , Bone and Bones/physiology , Bone Density/physiology , Exercise/physiology , Absorptiometry, Photon , Osteoporosis/prevention & controlSubject(s)
Death, Sudden , Syncope , Child , Humans , Long QT Syndrome/complications , Male , Syncope/etiologyABSTRACT
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Subject(s)
Male , Child , Humans , Death, Sudden , Syncope/ethnology , Long QT Syndrome/complicationsABSTRACT
This prospective, controlled, but not formally randomized study investigates the feasibility and efficiency of an alternative to standard hospitalization for patients with exacerbated chronic obstructive pulmonary disease (COPD), based upon supported discharge with nurse supervision at home. Over a 12-month period, emergency physicians, not directly involved in the study, admitted 205 patients with exacerbated COPD to the authors' respiratory unit. Patients were included in the supported discharge group (n=105) if they voluntarily chose to participate in the programme and lived in the city of Palma de Mallorca (where adequate home support could be provided). Patients not fulfilling these criteria (mainly residents outside the city) served as controls (n=100). Inpatient treatment was standardized in all patients and included oxygen therapy, bronchodilators, antibiotics and steroids. Both groups were comparable in terms of age (mean +/- SD: 70 +/- 10 versus 65 +/- 11 yr for supported discharge and control group, respectively), severity of airflow obstruction (forced expiratory volume in one second 45 +/- 18% reference versus 46 +/- 19% ref.), comorbidity and socioeconomic status. Length of hospital stay (LOS) in the supported discharge group was shorter (5.9 +/- 2.8 versus 8.0 +/- 5.1 days, p < 0.001). After discharge, a respiratory nurse visited supported discharge patients at home during 7.3 +/- 3.8 days. Only one patient (1%) required hospital readmission during this period of time. The reduced LOS resulted in a lower utilization of hospital beds at any given point in time throughout the study period. Within the framework and potential limitations of this study, the results indicate that the supported discharge programme in Spain: 1) allows a significant reduction in the length of hospital stay of patients hospitalized because of an exacerbation of chronic obstructive pulmonary disease; 2) does not result in an inappropriately increased rate of hospital readmissions; and 3) reduces the utilization of hospital resources.
