Femoral Neck Preservation and Diaphyseal Invasion Comparing a Calcar-Metaphyseal Short Stem with its Homonymous Standard Femoral Stem. A Radiographic Study.

BACKGROUND: We aim to compare the preoperative planning radiographs of 50 patients in whom both a short stem and its homonymous standard version were programmed, focusing on the preservation of the neck and the invasion of the femoral shaft. The secondary objective was to evaluate the 50 preoperative radiographs with the 50 postoperative radiographs in which the short stem was implanted, measuring the real invasion of the diaphysis and the real preservation of the femoral neck. MATERIAL AND METHODS: We measured cut level at the femoral neck and diaphyseal invasion in 50 preoperative x-rays where an Alteon Neck Preserving Stem (ANPS) was templated and we compared it with 50 preoperative x-rays where an Alteon Taper Wedge Stem (ATWS) was templated. After surgery, we compared both parameters previously measured in the preoperative x-rays with the 50 postoperative radiographs where the short stem was implanted obtaining the real bone preservation at the femoral neck and the real diaphyseal invasion length. RESULTS: For templating comparison, mean bone preservation at the femoral neck was 14.87mm (SD 3.64) for the ANPS group and 9.94mm (SD 8.39) for the ATWS group (p <0.001). The mean diaphyseal bone invasion was 47.21mm (SD 5.89) and 76.77mm (SD 8.39) for ANPS and ATWS respectively (p <0.001). After surgery, the mean postoperative bone preservation at the femoral neck was 15.08mm (SD 3.1) with a mean of 0.17mm (SD 0.51) more preservation in the preoperative group. CONCLUSION: 1. ANPS allow bone preservation with limited diaphyseal invasion when compared with his homonymous ATWS in the preoperative templates. 2. ANPS showed a good correlation between preoperative radiographs and real bone preservation of the femoral neck and invasion of the femoral shaft.

Evaluation of the learning curve and initial outcomes with a short cervicometaphyseal fixation stem: A case series / Evaluación de la curva de aprendizaje y resultados iniciales con un vástago corto de fijación cervicometafisaria: Una serie de casos

Introduction: Total hip arthroplasty in young patients has evolved in recent decades, and the use of short stems in young adult patients has been gaining popularity. The restitution of the biomechanics of the hip is a primary requirement to determine the future success of total hip replacement, and even more so in young adults who present the particularity of having a high functional demand and a long life expectancy. Objective: The aim of this prospective study was to evaluate the learning curve and initial clinical–radiological outcomes of the Alteon Neck Preserving Stem™ (ANPS) (Exactech, Gainesville, FL, USA) with a minimum of 2 years follow up. Material and methods: We conducted a multicenter prospective study that analyzed 90 consecutive total hip replacements during 2014. We performed a clinical–radiological analysis measuring Harris Hip Score (HHS), subjective Rodes and Maudsley satisfaction evaluation, radiolucencies, components position, limb length discrepancy, heterotopic ossification, medical and surgical complications and learning curve. Results: During the first 30 cases, the intraoperative complication rate was 16%, while in the next 60 cases no intraoperative complications were reported. Thigh pain was reported in 3 cases (3.3%), being 2 moderates, and 1 severe. In 2 cases subsidences of 3 mm were detected in the first scheduled X-ray, both related to intraoperative fractures with no progression after 3 months. Mean HHS improved from 42.9 points (range 37–54 points) preoperatively to 93.2 on average (range, 87–96) at the end of the follow up (p < 0.01). Subjective evaluation was excellent in 75 (83.3%) cases and good in 15 patients (16.6%). Conclusions: This short stem has good clinical radiological results in a short and medium term follow-up and in the hands of surgeons specializing in arthroplasty the learning curve is estimated to be less than 30 surgeries.(AU)

Introducción: La artroplastia total de cadera en pacientes jóvenes ha ido evolucionando en las últimas décadas y la utilización de tallos cortos en pacientes adultos jóvenes ha ganado popularidad. La restitución de la biomecánica de la cadera es requisito primordial para determinar el éxito a futuro del reemplazo total de cadera, y aún más en los adultos jóvenes quienes presentan la particularidad de tener una alta demanda funcional y una esperanza de vida prolongada. Objetivo: El objetivo de este estudio prospectivo fue evaluar la curva de aprendizaje y los resultados clínico-radiológicos iniciales del Alteon Neck Preserving Stem™ (ANPS) (Exactech, Gainesville, FL, EE. UU.) con un mínimo de dos años de seguimiento. Material y métodos: Se realizó un estudio prospectivo multicéntrico que analizó 90 reemplazos totales consecutivos de cadera durante 2014. Realizamos un análisis clínico-radiológico utilizando Harris Hip Score (HHS), evaluación de satisfacción subjetiva de Roles y Maudsley, radiolucencias, posición de los componentes, discrepancia en la longitud de las extremidades, osificación heterotópica, complicaciones médicas y quirúrgicas y un análisis de la curva de aprendizaje. Resultados: Durante los primeros 30 casos la tasa de complicaciones intraoperatorias fue del 16% mientras que en los siguientes 60 casos no se reportó ninguna complicación intraquirúrgica. El dolor de muslo se notificó en tres casos (3,3%), siendo dos moderados y uno grave. En dos casos se detectaron hundimientos de 3 mm en la primera radiografía programada, ambas relacionadas con fracturas intraoperatorias sin progresión después de tres meses. La media de HHS mejoró de 42,9 puntos (rango 37 a 54 puntos) preoperatoriamente a 93,2 en promedio (rango, 87-96) al final del seguimiento (p < 0,01). La evaluación subjetiva fue excelente en 75 casos (83,3%) y buena en 15 casos (16,6%).(AU)

Evaluación de la curva de aprendizaje y resultados iniciales con un vástago corto de fijación cervicometafisaria: Una serie de casos / Evaluation of the learning curve and initial outcomes with a short cervicometaphyseal fixation stem: A case series

Introducción: La artroplastia total de cadera en pacientes jóvenes ha ido evolucionando en las últimas décadas y la utilización de tallos cortos en pacientes adultos jóvenes ha ganado popularidad. La restitución de la biomecánica de la cadera es requisito primordial para determinar el éxito a futuro del reemplazo total de cadera, y aún más en los adultos jóvenes quienes presentan la particularidad de tener una alta demanda funcional y una esperanza de vida prolongada. Objetivo: El objetivo de este estudio prospectivo fue evaluar la curva de aprendizaje y los resultados clínico-radiológicos iniciales del Alteon Neck Preserving Stem™ (ANPS) (Exactech, Gainesville, FL, EE. UU.) con un mínimo de dos años de seguimiento. Material y métodos: Se realizó un estudio prospectivo multicéntrico que analizó 90 reemplazos totales consecutivos de cadera durante 2014. Realizamos un análisis clínico-radiológico utilizando Harris Hip Score (HHS), evaluación de satisfacción subjetiva de Roles y Maudsley, radiolucencias, posición de los componentes, discrepancia en la longitud de las extremidades, osificación heterotópica, complicaciones médicas y quirúrgicas y un análisis de la curva de aprendizaje. Resultados: Durante los primeros 30 casos la tasa de complicaciones intraoperatorias fue del 16% mientras que en los siguientes 60 casos no se reportó ninguna complicación intraquirúrgica. El dolor de muslo se notificó en tres casos (3,3%), siendo dos moderados y uno grave. En dos casos se detectaron hundimientos de 3 mm en la primera radiografía programada, ambas relacionadas con fracturas intraoperatorias sin progresión después de tres meses. La media de HHS mejoró de 42,9 puntos (rango 37 a 54 puntos) preoperatoriamente a 93,2 en promedio (rango, 87-96) al final del seguimiento (p < 0,01). La evaluación subjetiva fue excelente en 75 casos (83,3%) y buena en 15 casos (16,6%).(AU)

Introduction: Total hip arthroplasty in young patients has evolved in recent decades, and the use of short stems in young adult patients has been gaining popularity. The restitution of the biomechanics of the hip is a primary requirement to determine the future success of total hip replacement, and even more so in young adults who present the particularity of having a high functional demand and a long life expectancy. Objective: The aim of this prospective study was to evaluate the learning curve and initial clinical–radiological outcomes of the Alteon Neck Preserving Stem™ (ANPS) (Exactech, Gainesville, FL, USA) with a minimum of 2 years follow up. Material and methods: We conducted a multicenter prospective study that analyzed 90 consecutive total hip replacements during 2014. We performed a clinical–radiological analysis measuring Harris Hip Score (HHS), subjective Rodes and Maudsley satisfaction evaluation, radiolucencies, components position, limb length discrepancy, heterotopic ossification, medical and surgical complications and learning curve. Results: During the first 30 cases, the intraoperative complication rate was 16%, while in the next 60 cases no intraoperative complications were reported. Thigh pain was reported in 3 cases (3.3%), being 2 moderates, and 1 severe. In 2 cases subsidences of 3 mm were detected in the first scheduled X-ray, both related to intraoperative fractures with no progression after 3 months. Mean HHS improved from 42.9 points (range 37–54 points) preoperatively to 93.2 on average (range, 87–96) at the end of the follow up (p < 0.01). Subjective evaluation was excellent in 75 (83.3%) cases and good in 15 patients (16.6%). Conclusions: This short stem has good clinical radiological results in a short and medium term follow-up and in the hands of surgeons specializing in arthroplasty the learning curve is estimated to be less than 30 surgeries.(AU)

Evaluation of the learning curve and initial outcomes with a short cervicometaphyseal fixation stem: A case series. / Evaluación de la curva de aprendizaje y resultados iniciales con un vástago corto de fijación cervicometafisaria: Una serie de casos.

INTRODUCTION: Total hip arthroplasty in young patients has evolved in recent decades, and the use of short stems in young adult patients has been gaining popularity. The restitution of the biomechanics of the hip is a primary requirement to determine the future success of total hip replacement, and even more so in young adults who present the particularity of having a high functional demand and a long life expectancy. OBJECTIVE: The aim of this prospective study was to evaluate the learning curve and initial clinical-radiological outcomes of the Alteon Neck Preserving Stem™ (ANPS) (Exactech, Gainesville, FL, USA) with a minimum of 2 years follow up. MATERIAL AND METHODS: We conducted a multicenter prospective study that analyzed 90 consecutive total hip replacements during 2014. We performed a clinical-radiological analysis measuring Harris Hip Score (HHS), subjective Rodes and Maudsley satisfaction evaluation, radiolucencies, components position, limb length discrepancy, heterotopic ossification, medical and surgical complications and learning curve. RESULTS: During the first 30 cases, the intraoperative complication rate was 16%, while in the next 60 cases no intraoperative complications were reported. Thigh pain was reported in 3 cases (3.3%), being 2 moderates, and 1 severe. In 2 cases subsidences of 3 mm were detected in the first scheduled X-ray, both related to intraoperative fractures with no progression after 3 months. Mean HHS improved from 42.9 points (range 37-54 points) preoperatively to 93.2 on average (range, 87-96) at the end of the follow up (p < 0.01). Subjective evaluation was excellent in 75 (83.3%) cases and good in 15 patients (16.6%). CONCLUSIONS: This short stem has good clinical radiological results in a short and medium term follow-up and in the hands of surgeons specializing in arthroplasty the learning curve is estimated to be less than 30 surgeries.

Colangitis aguda como presentación de un hepatocarcinoma con trombosis tumoral de la vía biliar / Hepatocellular carcinoma with bile duct invasion presenting as acute cholangitis

No disponible

Diagnóstico de linfoma folicular de intestino delgado mediante videocápsula endoscópica / Diagnosis of follicular lymphoma of the small bowel by video capsule endoscopy

No disponible

Repression by an auxin/indole acetic acid protein connects auxin signaling with heat shock factor-mediated seed longevity.

The plant hormone auxin regulates growth and development by modulating the stability of auxin/indole acetic acid (Aux/IAA) proteins, which in turn repress auxin response factors (ARFs) transcriptional regulators. In transient assays performed in immature sunflower embryos, we observed that the Aux/IAA protein HaIAA27 represses transcriptional activation by HaHSFA9, a heat shock transcription factor (HSF). We also found that HaIAA27 is stabilized in immature sunflower embryos, where we could show bimolecular fluorescence complementation interaction between native forms of HaIAA27 and HaHSFA9. An auxin-resistant form of HaIAA27 was overexpressed in transgenic tobacco seeds, leading to effects consistent with down-regulation of the ortholog HSFA9 gene, effects not seen with the native HaIAA27 form. Repression of HSFs by HaIAA27 is thus likely alleviated by auxin in maturing seeds. We show that HSFs such as HaHSFA9 are targets of Aux/IAA protein repression. Because HaHSFA9 controls a genetic program involved in seed longevity and embryonic desiccation tolerance, our findings would suggest a mechanism by which these processes can be auxin regulated. Aux/IAA-mediated repression involves transcription factors distinct from ARFs. This finding widens interpretation of auxin responses.

Neurotensin receptor antagonist administered during cocaine withdrawal decreases locomotor sensitization and conditioned place preference.

Chronic use of psychostimulants induces enduringly increased responsiveness to a subsequent psychostimulant injection and sensitivity to drug-associated cues, contributing to drug craving and relapse. Neurotensin (NT), a neuropeptide functionally linked to dopaminergic neurons, was suggested to participate in these phenomena. We and others have reported that SR 48692, an NT receptor antagonist, given in pre- or co-treatments with cocaine or amphetamine, alters some behavioral effects of these drugs in rats. However, its efficacy when applied following repeated cocaine administration remains unknown. We, therefore, evaluated the ability of SR 48692, administered after a cocaine regimen, to interfere with the expression of locomotor sensitization and conditioned place preference (CPP) in rats. We demonstrated that the expression of locomotor sensitization, induced by four cocaine injections (15 mg/kg, i.p.) every other day and a cocaine challenge 1 week later, was attenuated by a subsequent 2-week daily administration of SR 48692 (1 mg/kg, i.p.). Furthermore, the expression of cocaine-induced CPP was suppressed by a 10-day SR 48692 treatment started after the conditioning period (four 15 mg/kg cocaine injections every other day). Taken together, our data show that a chronic SR 48692 treatment given after a cocaine regimen partly reverses the expression of locomotor sensitization and CPP in the rat, suggesting that NT participates in the maintenance of these behaviors. Our results support the hypothesis that targeting neuromodulatory systems, such as the NT systems may offer new strategies in the treatment of drug addiction.

Exposure to AC and DC magnetic fields induces changes in 5-HT1B receptor binding parameters in rat brain membranes.

The binding properties of the G-protein coupled receptor (GPCR) serotonin 5-HT1B receptor were studied under exposure to AC (50 and 400 Hz) and DC magnetic fields (MF) in rat brain membranes. This was an attempt at replicating the positive findings of Massot et al. In saturation experiments using [3H]5-HT, 1-h exposures at 1.1 mT(rms) 50 Hz caused statistically significant increases in both the K(D) and B(max) binding parameters, from 1.74 +/- 0.3 to 4.51 +/- 0.86 nM and from 1428 +/- 205 to 2137 +/- 399 CPM, respectively, in good agreement with previous results. Exposure of the membranes at 400 Hz 0.675 mT(rms) did not elicit a larger increase in K(D) in spite of a much larger induced current density. DC fields (1.1 and 11 mT) had a lesser effect compared to AC fields at low values of K(Dsham), but decreased the affinity at higher values of K(Dsham). Modeling of the receptor-ligand-G protein interactions using the extended ternary complex model yielded good fits for all our data and that of Massot et al., showing that the AC field may act by decreasing the ability of the G-protein to alter the ligand-receptor affinity. The hypothesis is that the bipolar nature of the AC field explains the different nature of the effects observed with AC and DC exposures. These findings constitute one of the few documented pieces of evidence for cell-free effects of DC and extremely low frequency (ELF) AC MFs in the mT range.