[Stability, function, alignment and associated injuries after surgical intervention and rehabilitation of tibial plate fracture]. / Estabilidad, función, alineación y lesiones asociadas después de una intervención quirúrgica y rehabilitación de fractura de platillos tibiales.

INTRODUCTION: tibial plateau fractures affect functionality of a large load bearing joint such as the knee, due to its multiple compromises, not only articular but also the ones including soft tissues. This study aims to evaluate the stability, function, alignment, associated injuries and complications of the knee after surgery and tibial plateau fractures rehabilitation. MATERIAL AND METHODS: a descriptive prospective observational study was carried out where patients with a tibial plateau fracture who had undergone surgery, that accomplish the inclusion criteria were included, in the period from April 2018 to June 2019. Analysis of variables was performed with t tests for independent samples. RESULTS: from a total of 92 patients with tibial plateau fracture, 66 (71%) were able to achieve the minimum six months follow-up. The most common fracture according to Schatzker classification was type II with 33.3%, and the most common according to Luo classification was the medial, lateral and posterior three column with 39.4%. More than 70% of patients who underwent surgery due to tibial plateau fractures developed soft tissue injury, therefore knee instability, specially with a higher rate of anterior cruciate ligament injuries or anterior instability. CONCLUSION: an important proportion of patients who underwent surgery for tibial plateau fractures have knee ligament injuries.

INTRODUCCIÓN: las fracturas de los platillos tibiales afectan la funcionalidad de una gran articulación de carga como la rodilla debido a sus múltiples compromisos no sólo articulares, sino también de tejidos blandos. Este estudio tiene como objetivo evaluar la estabilidad, función, alineación, lesiones asociadas y complicaciones de la rodilla después de intervención quirúrgica y rehabilitación de fractura de platillos tibiales. MATERIAL Y MÉTODOS: se realizó estudio observacional prospectivo descriptivo, donde se incluyeron los pacientes con fractura de platillos tibiales intervenidos quirúrgicamente que cumplieran los criterios de inclusión en el período comprendido entre Abril de 2018 y Junio de 2019. Se hizo análisis de variables con pruebas t para muestras independientes. RESULTADOS: de un total de 92 pacientes con fractura de platillos tibiales, 66 (71%) lograron completar los seis meses mínimos de seguimiento. La fractura más común según la clasificación de Schatzker fue tipo II con 33.3% y la más común según la clasificación de Luo fue la de tres columnas medial, lateral y posterior con 39.4%. Más de 70% de los pacientes intervenidos por fracturas de platillos tibiales presentaron lesión de tejidos blandos, por ende, una inestabilidad de rodilla, especialmente con mayor índice de lesiones del ligamento cruzado anterior e inestabilidad anterior. CONCLUSIÓN: una proporción importante de los pacientes intervenidos por fractura de platillos tibiales tienen lesión ligamentaria de rodilla.

[No infected union of subtrochanteric fracture of femur, treated with autograft and plate]. / No unión infectada de fractura subtrocantérica de fémur, tratada con autoinjerto y placa.

Hip fractures are considered a public health problem in the world. Among hip fractures we find subtrochanteric fractures that are defined as proximal femur fractures located in the trochanteric region within 5 cm below the lesser trochanter; and they have an approximate incidence of 15 to 20 per 100,000 people. The objective of this case is to report the success of the reconstruction of an infected subtrochanteric fracture, with a non-vascularized fibular segment and a distal femur condylar support plate. Clinical case: 41-year-old male patient suffering from a right subtrochanteric fracture as a result of a traffic accident that required the use of osteosynthesis material. With subsequent rupture of the cephalomedullary nail in its proximal third, non-union of the fracture and infections at the fracture site. He was treated with multiple surgical lavages, antibiotic therapy, and an unconventional orthopedic and surgical procedure, such as the use of a distal femur condylar support plate and an endomedullary bone graft with a 10-cm segment of non-vascularized fibula. Patient with satisfactory and favorable evolution.

Las fracturas de cadera se consideran un problema de salud pública en el mundo, entre las fracturas de cadera encontramos las subtrocantéricas, que se definen como fracturas proximales de fémur situadas en la región trocantérea dentro de los 5 cm debajo del trocánter menor; tienen una incidencia aproximada de 15 a 20 por cada 100,000 personas. El objetivo de este de caso es reportar el éxito de la reconstrucción de una fractura subtrocantérica infectada, con un segmento del peroné no vascularizado y una placa de soporte condíleo de fémur distal. Caso clínico: masculino de 41 años de edad que sufre fractura subtrocantérica derecha producto de un accidente de tránsito que requirió manejo de osteosíntesis. Con posterior ruptura del clavo cefalomedular en su tercio proximal, no unión de la fractura e infecciones en sitio de la fractura. Fue tratado con múltiples lavados quirúrgicos, antibioticoterapia y un procedimiento ortopédico y quirúrgico poco convencional como el uso de una placa de soporte condíleo de fémur distal y un injerto óseo endomedular con un segmento de 10 cm de peroné no vascularizado. Paciente con evolución satisfactoria y favorable.

[Quality of life in noninstitutionalized persons older than 65 years in two health care districts in Madrid]. / Calidad de vida en mayores de 65 años no institucionalizados de dos áreas sanitarias de Madrid.

AIM: To describe self-perceived health status and quality of life in noninstitutionalized persons older than 65 years in two health care districts in Madrid (central Spain). DESIGN: Descriptive study based on home interviews by investigators trained in the administration of the questionnaires. SETTING: Health care districts 2 and 4 in Madrid; community level. PARTICIPANTS: Of a sample of 2002 persons older than 65 years residing in private homes, we obtained 911 valid questionnaires. MAIN MEASURES: Description and stratification by age group and sex, for sociodemographic variables, economic resources, social and familial support, physical and mental health, functional capacity and results on the EuroQol and Nottingham Health Profile (NHP) questionnaires. RESULTS: Mean age, 74.7 years (95% CI, 74.3%75.1%); women, 59.7% (95% CI, 56.4%-62.9%); no formal education, 41% (95% CI, 37.7%-44.2%); social classes I and II, 38.3% (95% CI, 35.1%-41.6%). Self-perceived health status good or very good, 52.1% (95% CI, 48.8%-55.4%), 57.5% (95% CI, 52.2%-62.6%) in men and 48.4% (95% CI, 44.2%-52.7%) in women. Mean scores on the NHP were: energy, 21.1 (95% CI, 18.9%23.2%); pain, 25.6 (95% CI, 23.6%27.6%); physical mobility, 28 (95% CI, 26.4%29.7%); sleep, 31.8 (95% CI, 29.4%34.1%); emotional reaction, 24.5 (95% CI, 22.8%26.3%); social isolation, 10.9 (95% CI, 9.6%12.1%). The percentages of persons with problems according to the EuroQol instrument were: mobility, 21.3% (95% CI, 18.7%-24.1%); self-care, 7.7% (95% CI, 6.1%-9.7%); usual activities, 19.9% (95% CI, 17.4%-22.7%); pain/discomfort, 38.2% (95% CI, 35%-41.4%); anxiety/depression, 27% (95% CI, 24.1%-30%). Both the NHP and the EuroQol instrument identified more problems in women than in men, and in persons older than 80 years compared to persons younger than 80 years. CONCLUSIONS: Women had a worse perceived health status and quality of life than men. Persons older than 80 years scored worse on the NHP and the EuroQol, but did not perceive their health status to be worse.

Ultrastructural study of spermatogenesis and the spermatozoon in Postorchigenes gymnesicus (Trematoda, Lecithodendriidae).

An ultrastructural study of spermatogenesis, spermiogenesis, and spermatozoa in Postorchigenes gymnesicus is presented. Cytoplasmic projections originating in nurse cells surround the spermatogonia, which are located at the periphery of the testes. Primary spermatocytes attached to a cytophore show synaptonemal complexes and a pair of centrioles. Spermiogenesis begins with the appearance of a cytoskeletal structure formed by an intercentriolar body and two perpendicular centrioles. An axoneme and a striated rootlet emerge from each centriole. The progressive rotation and fusion of both flagella with the median process occurs simultaneously with the migration of nucleus to the distal tip of the forming spermatozoon. The mature spermatozoon consists of three regions: (1) the nuclear region, containing the nucleus, one mitochondrion, two 9+1 axonemes, and cortical microtubules; (2) the intermitochondrial region, containing two axonemes; and (3) the mitochondrial region with another mitochondrion, two axonemes, cortical microtubules, and external ornamentation symmetrically and asymmetrically arranged coincidental with the cortical microtubules. Glycogen particles, absent in testicular cells, are abundant in the spermatozoon. Ultrastructural features of the non-nuclear region of the spermatozoon are specific for P. gymnesicus and are proposed to characterize the spermatozoon of digenean species. J. Morphol. 234:223-232, 1997. © 1997 Wiley-Liss, Inc.

[Usefulness of the guide of standards for the duration of processes of transient work disability published by Insalud for the attending physician]. / Utilidad de la guía de estándares de duración de procesos de incapacidad laboral transitoria publicada por el Insalud para el médico de cabecera.

OBJECTIVE: To compare the duration average of the ten most frequent causes of unfitness for work (ILT) observed in a services company's staff, with the duration standards registered in the guide published by the Insalud. Besides, some of the factors that could influence these ten diseases duration will be analyzed. DESIGN: An observational, retrospective, population-based study. SETTING: Sanitary district in Madrid area. POPULATION: Hospital Universitario de la Princesa's staff. From 1-1-93 to 31-12-94, a total of 1835 ILTs have been registered among the 2147 workers. MEASURES AND RESULTS: Among the ten most frequent causes of ILT analysed, influenza, acute gastroenteritis, lumbalgia, anide sprain, lumbociatica, contusions, tonsillitis and bronchitis have a duration median included within the Insalud's references. Acute respiratory infection duration is situated out of the intervals. Depressive syndrome does not appear in the guide. It has been proved that all the previous causes have a greater incidence on women except for contusions, tonsillitis and bronchitis. Ankle sprain has a longer duration in workers over fifty years old. CONCLUSIONS: We consider that Insalud's standards guide should be promoted and improved in order to be used as a reference handbook by general practitioners.

Ultrastructural observations of the tegument of Postorchigenes gymnesicus (Digenea: Lecithodendriidae).

The tegument of Postorchigenes gymnesicus has been studied by scanning and transmission electron microscopy. The general body tegument is spinous and contains mitochondria, biconcave disc-shaped vesicles bounded by an unitary membrane and displaying a protein content, and scarce spherical bodies. The tegument covering specialized body regions is aspinous. Few vesicles were evident in the tegument covering the suckers and oesophagus, being more abundant in the metraterm and cirrus where the tegument is thicker. Laurer's canal has a thick tegument with sparse vesicles, mostly arranged close to the apical membrane. A direct association was evident between the basal lamina underlying the spines and the muscular subtegumental fibres, suggesting a motile character for the spine.

[The study of occupational satisfaction and its determining factors among health professionals working in one of the areas in Madrid]. / Estudio de la satisfacción laboral y sus determinantes en los trabajadores sanitarios de un área de Madrid.

BACKGROUND: It is well known that job satisfaction influences health care services quality. The aim of this study is to evaluate sanitary workers' job satisfaction and to determine its components, in a sanitary district institutions: primary health care centres, speciality centres and district hospital. METHODS: A cross-sectional study was designed. The sample is proportional, stratified and randomized. It is composed of 947 workers, 460 of which are speciality care workers (SCW) (from a total study population of 1579 people), and 486 are primary care workers (PCW) (the whole population of PCW) from the tenth sanitary area of Madrid. We have used two questionnaires: the first one is Font-Roja's questionnaire which consists of 27 items that are evaluated through a Likert 1-5 scale. The second questionnaire consists of independent variables: socio-demographic and job variables. We have made an exploratory factorial analysis of various satisfaction components. We have evaluated the relationship between each dimension and the independent variables. RESULTS: 255 professionals of SCW (55.4% of the whole) and 357 of PCW (73.9% of the whole) answered the questionnaire. The dimensions that reached the lowest score were these factors: stress related with job and professional promotion (this factor was lowest in nurses and administrative worker). There are significant differences with respect to studied factors, professional level, and kind of job. CONCLUSIONS: We have found a half way satisfaction level in this sanitary district health care workers. Our results suggest that modifications in management and working conditions are needed, according to satisfaction dimension scores.

[Importance of Tarebia granifera in the control of a population of Biomphalaria peregrina introduced in Cuba]. / Importancia de Tarebia granifera en el control de una población introducida de biomphalaria peregrina en Cuba.

It was observed that the Tarebia granifera plays a significant role in the control of a Biomphalaria peregrina population introduced in a permanent water body. The densities of this planorbid, which had reached high levels, were notably reduced by two important events: an increase of the water level due to heavy rains, and the introduction of the competitor, whose effectiveness had been tested in a different habitat. Knowledge on the ecology and biology of the competitor and the host in permanent water bodies helped to elaborate the measures of control which led to the reduction of the host densities while those of the competitor increased.

Influence of the nontarget mollusc Marisa cornuarietis on the hourly cercarial production of Schistosoma mansoni from Biomphalaria glabrata.

A comparative study of hourly cercarial productivities of Schistosoma mansoni from infected Biomphalaria glabrata was carried out in the presence of either healthy B. glabrata (control) or healthy Marisa cornuarietis (experimental). The results showed that, with M. cornuarietis, almost all the hourly cercarial productivities increased by a factor varying from 1.3 to 2.5 without modification of the shedding period.

Nicotine administration to rats: methodological considerations.

The effects of nicotine on normal physiological function are of increasing concern. Preliminary to studies on the effects of prenatal exposure to nicotine, we examined methods of administering nicotine to rats. Drinking water containing nicotine was not palatable to rats and was an unsatisfactory method in our hands, producing weight loss and large decreases in fluid intake. Administration of nicotine in a complete liquid diet produced better results but the data suggest that oral administration of nicotine may interfere with absorption of some nutrients. Osmotic mini-pumps were found to be the best mechanism of nicotine delivery of those tried. There were no significant effects on food or water intake nor on weight gain, particularly when using a short term anesthetic for pump implantation. Plasma nicotine and cotinine levels were directly correlated to dose of nicotine delivered. Plasma nicotine levels similar to levels reported in humans were obtained.

Ontogeny of dopamine, serotonin and spirodecanone receptors in rat forebrain--an autoradiographic study.

Sections from freshly frozen neonatal rat brain, ages 0-21 days, were incubated with [3H]spiperone (SP). Initial studies characterized the binding sites for SP in terms of association and dissociation rates, saturability and pharmacology. The binding sites were found to be predominantly dopamine D2 receptors in sections centered in the striatum and these receptors were similar to receptors in adult brain. Autoradiographic studies using in vitro techniques examined the anatomic distribution of [3H]SP binding sites. Using domperidone, ketanserin and (+)butaclamol it was possible to differentiate dopamine D2, serotonin S2 and spirodecanone receptors. Dopamine receptors were found at birth in striatum and nucleus accumbens and increased in density with age. In the first two weeks postnatally there was an apparent dorsolateral to ventromedial gradient in the striatum. Serotonin S2 receptors were found in the cortex, lateral olfactory tubercles and nucleus accumbens and claustrum. These receptors increased in density with age but to a much lesser extent than dopamine receptors. Spirodecanone receptors were first apparent in the piriform cortex by day 5. They became very dense with age in particular regions, i.e., layer II of cortex, piriform cortex, medial olfactory tubercles, lateral septum and in patches in the nucleus accumbens. These studies delineate with a high resolution at an anatomical level the major receptor sites for neuroleptic drugs in the developing rat forebrain. They describe the developmental pattern of these receptors and provide a basis for further studies on their control and function during development.

Ontogeny of the rat striatum: correspondence of dopamine terminals, opiate receptors and acetylcholinesterase.

The ontogeny of dopamine terminals, mu opiate receptors and acetylcholinesterase (AChE) in rat striatum were examined during the first two weeks postnatally using fluorescence histochemistry, autoradiography and AChE stain, respectively. The most dense regions of all three markers were superimposable, particularly in the dorsal third of the striatum, as long as the dense regions could be clearly visualized. This anatomic overlapping of markers for three neuronal systems suggests an important and distinct relationship between these neuronal systems during development in addition to that already seen in adult tissue.