Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions.

We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510 GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510 GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02

Folic acid and vitamin B12 as biomarkers of morbidity and mortality in patients with septic shock / El ácido fólico y la vitamina B12 como biomarcadores de morbilidad y mortalidad en pacientes con shock séptico

Introduction and objective: a study was made of the folic acid (Fol) and vitamin B12 (B12) serum concentrations in critical patients with septic shock upon admission and after three days of stay in the Intensive Care Unit (ICU), with an analysis of their association to inflammatory parameters and patient morbidity-mortality. Methods: a prospective analytical study was made of 30 critically ill patients with septic shock. Demographic data, comorbidities, clinical information and severity scores were recorded. Data collected included serum Fol and B12 levels using the DxI® Autoanalyzer (Beckman Coulter) based on a competitive electrochemoluminescence immunoassay. Results: mean serum Fol was within the reference range stipulated by the laboratory on the first day. Nevertheless, a total of 21.4 % of the patients had high Fol levels, with 14.2 % being Fol deficient. An association was observed between Fol (p < 0.012) status and 28-day mortality, and the number of days of mechanical ventilation, fraction of inspired oxygen (FiO2) and fibrinogen increased in patients with higher Fol levels (p < 0.05). In addition, 85.7 % of cases had B12 levels above the reference values, with a correlation being observed between B12 and Fol. Conclusions: this study proposes Fol as a novel morbidity-mortality biomarker in critical septic patients, and reinforces the usefulness of B12 as a morbidity biomarker. It is thus suggested that the measurement of Fol upon admission and over the first 72 hours of hospital stay could provide prognostic information about the clinical course and outcome of septic shock patients (AU)

Introducción y objetivo: se realizó un estudio de las concentraciones séricas de ácido fólico (Fol) y vitamina B12 (B12) en pacientes críticos con shock séptico al ingreso y después de tres días de estancia en la Unidad de Cuidados Intensivos (UCI), con un análisis de su asociación con los parámetros inflamatorios y la morbimortalidad de los pacientes. Método: se realizó un estudio analítico prospectivo de 30 pacientes críticos con shock séptico. Se registraron datos demográficos, comorbilidades, información clínica y puntuaciones de gravedad. Los datos recopilados incluyeron los niveles séricos de Fol y B12 utilizando el autoanalizador DxI® (Beckman Coulter) basado en un inmunoensayo de electroquimioluminiscencia competitivo. Resultados: la media de Fol sérico estuvo dentro del rango de referencia estipulado por el laboratorio el primer día. Sin embargo, el 21,4 % de los pacientes presentaban niveles altos de Fol y el 14,2 % presentaban deficiencia de Fol. Se observó una asociación entre el estado de Fol (p < 0,012) con la mortalidad a los 28 días, con el número de días de ventilación mecánica, con la fracción de oxígeno inspirado (FiO2) y con el fibrinógeno, que aumentaron en los pacientes con niveles de Fol más altos (p < 0,05). Además, el 85,7 % de los casos tenían niveles de B12 por encima de los valores de referencia, observándose una correlación entre B12 y Fol. Conclusiones: este estudio propone al Fol como nuevo biomarcador de morbimortalidad en los pacientes críticos con sepsis y refuerza la utilidad de la B12 como biomarcador de morbilidad. Por tanto, se sugiere que la medición de Fol al ingreso y durante las primeras 72 horas de estancia hospitalaria podría proporcionar información pronóstica sobre el curso clínico y el resultado de los pacientes con shock séptico (AU)

Probing Gluon Spin-Momentum Correlations in Transversely Polarized Protons through Midrapidity Isolated Direct Photons in p

Studying spin-momentum correlations in hadronic collisions offers a glimpse into a three-dimensional picture of proton structure. The transverse single-spin asymmetry for midrapidity isolated direct photons in p^{↑}+p collisions at sqrt[s]=200 GeV is measured with the PHENIX detector at the Relativistic Heavy Ion Collider (RHIC). Because direct photons in particular are produced from the hard scattering and do not interact via the strong force, this measurement is a clean probe of initial-state spin-momentum correlations inside the proton and is in particular sensitive to gluon interference effects within the proton. This is the first time direct photons have been used as a probe of spin-momentum correlations at RHIC. The uncertainties on the results are a 50-fold improvement with respect to those of the one prior measurement for the same observable, from the Fermilab E704 experiment. These results constrain gluon spin-momentum correlations in transversely polarized protons.

Online audio-visual information on oral cancer for Spanish-speaking laypersons. A cross-sectional study.

BACKGROUND: Lack of knowledge and awareness of oral cancer seem to be the main causes of diagnostic delay. Online resources are often used by patients to obtain health/medical information. However, there are no reports on the quality and usefulness of oral cancer audio-visual resources in Spanish. The aims of this investigation were to disclose the type of information about oral cancer available, and whether it may be useful to shorten the patients' oral cancer appraisal time-interval. MATERIAL AND METHODS: Cross-sectional study undertaken at three video-sharing sites on October, 13th 2019. KEYWORDS: "Cáncer oral"; "cáncer de boca". The first 100 results in each viewing list were retrieved by three reviewers. Demographical data was recorded, and interaction indexes, viewing rates, comprehensiveness, and usefulness were calculated for each video. The presence of non-scientifically supported information was also assessed. A descriptive analysis was undertaken, and relationships between variables were explored using the Spearman correlation test. RESULTS: A total of 127 videos were selected. They were produced mainly by mass-media (46.5%; n=59) and their length ranged from 0.28 to 105.38 minutes (median 4.15 minutes; IQR: 2.34-9.67). The most viewed video (10,599,765 views; visualization rate 726,508.9) scored 0 both in usefulness and comprehensiveness. The most useful video gathered 44,119 views (visualization rate 2.033.13). A highly significant positive correlation (0.643; p<0.001) could be observed between usefulness and comprehensiveness of the videos, together with negative correlations between the visualization rate and usefulness (-0.186; p<0.05), and visualization rate and comprehensiveness (-0.183; p<0.05). CONCLUSIONS: Online audio-visual material about oral cancer in Spanish is incomplete, of limited usefulness, and often includes non-scientifically supported information. Most of these resources are produced by mass media and healthcare professionals, with minor contributions from educational and healthcare institutions. Visualization rates negatively correlated with the usefulness and comprehensiveness of the contents in these digital objects.

Oral cancer awareness in North-Western Spain: a population-based study.

BACKGROUND: An early diagnosis depends greatly on patient awareness. Thus, the aim of this study was to investigate general awareness of oral cancer and knowledge about its risk factors, signs and symptoms. MATERIAL AND METHODS: Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016. RESULTS: A total of 5,727 people entered the survey (response rate: 53%). When asked what cancers participants had heard about, 20.3% mentioned oral cancer. Regarding risk factors, tobacco was mentioned by 55.3% of the sample (n=3,169), followed by alcohol (12.5%; n=708), poor oral hygiene (10.8%; n=618), diet (6.5%; n=377), and genetics (4.5%; n=248). CONCLUSIONS: General population has low awareness of oral cancer with poor knowledge of risk factors and main alarm signs. In addition, individuals in the risk group scored lower values in the main variables analysed; even those highly educated showed insufficient awareness and knowledge of oral cancer. In these circumstances, there is clear need for educational interventions tailored to the target audience and aimed at increasing knowledge and awareness of oral cancer to promote primary prevention of oral cancer and minimising the time interval of patients with symptomatic oral cancer in their path to treatment.

People would rather see a physician than a dentist when experiencing a long-standing oral ulceration. A population-based study in Spain.

BACKGROUND: Primary care physicians have been reported to be the first choice for patients with oral ulcerations. This study investigates the health-seeking behaviour of lay public in Galicia (North-western Spain) if experiencing a long-standing oral ulceration. MATERIAL AND METHODS: Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016. RESULTS: A total of 5,727 pedestrians entered the study (response rate: 53%), mostly in the 45-64 age group (30.2%; n=1,728), 47.7% of them (n=2,729) were males. Most participants (42.1%; n=2,411) reported to visit their dentist once a year and had secondary or compulsory education as their highest educational achievement (28.18%, n=1,614; 28%, n=1,600 respectively). When questioned what they would do if they had a wound/ulceration lasting longer than 3 weeks, most participants answered they would go to see their primary care physician (62.8%; n=3,597) and less than one quarter of the sample (23.8%; n=1,371) would seek consultation with their dentist. CONCLUSIONS: General Galician population would seek professional consultation about a long-standing oral ulceration, relying mostly on primary care physicians. Those neglecting these lesions are elderly, less-schooled people and unaware of oral cancer.

La adherencia a los medicamentos en pacientes hipertensos y en muestra de la población general / Characterization of medication adherence in a sample of the general population and another of hypertensive patients in Panama

OBJETIVO: Caracterizar la adherencia al tratamiento farmacológico en la población adulta, y en pacientes hipertensos atendidos en dos centros de atención primaria de la Caja de Seguro Social en Panamá. MÉTODOS: Aplicación de encuesta poblacional sobre la adherencia medicamentosa a 1.200 personas en las 4 ciudades de mayor población y crecimiento económico en Panamá y otra encuesta a pacientes hipertensos atendidos en centros de atención primaria de la Seguridad Social, durante los meses de septiembre a octubre del 2016. RESULTADOS: De 1.200 personas que participaron en la encuesta, 671 tomaban medicamentos, 54% eran mujeres y 54% con estudios universitarios. El 91% manifestaron padecer algún tipo de enfermedad y uso de diversos medicamentos. El 55% contestó que alguna vez había olvidado tomar el medicamento. Fueron 176 pacientes encuestados en los centros de atención primaria, 67% mujeres, 42% con grado universitario. El 97% eran hipertensos, 48% diabéticos. El 80% de los hipertensos tomaban diversos medicamentos. Al aplicarse el test de Morisky-Green a los pacientes, el 40% indicó haber dejado de tomar los medicamentos por lo tanto no cumplían con la farmacoterapia ordenada. De acuerdo al test de Batalla, los pacientes mostraron tener un gran conocimiento sobre su enfermedad. CONCLUSIONES: La mayoría de la población encuestada sufría HTA y habían olvidado tomar los medicamentos. Los pacientes reconocieron padecer y conocer la hipertensión, sin embargo, no fueron adherentes al tratamiento medicamentoso. Se hace necesario una toma de conciencia y participación en el control de su enfermedad e impulsar campañas nacionales sobre la adherencia medicamentosa

OBJECTIVE: To characterize adherence to pharmacological treatment in the adult population, and in hypertensive patients treated in two primary care centers of the Social Security in Panama. METHODS: A survey on drug adherence was applied to 1,200 study participants in 4 major cities in Panama. The survey for hypertensive patients was applied in primary health care centers. RESULTS: Of 1,200 study participants, 671 were taking medications, 54% were women and 54% university degrees. 91% reported suffering from some type of illness and use of various medications. 55% replied that they had once forgotten to take the medication whereas 80% of the participants said they forget medication intake frequently. There were 176 hypertensive patients survey in primary care centers, 67% women, and 42% with university degree. 97% were hypertensive and 48% diabetic. 80% of patients with hypertension took various medications. When the Morisky-Green test was applied to patients, 40% indicated that they stopped taking the medications; therefore, they did not comply with the ordered pharmacotherapy. According to the Batalla test, patients showed great knowledge about their disease. CONCLUSIONS: The majority of the population surveyed suffered from hypertension and had forgotten to take the medications. The patients recognized suffering and knowing the hypertension, however, they were not adherent to the drug treatment. Awareness and participation in the control of your disease is necessary and to promote national campaigns on drug adherence

Anti-Vel alloimmunization and severe hemolytic disease of the fetus and newborn.

Only rare cases of anti-Vel-associated mild-to-moderate hemolytic disease of the fetus and newborn have been previously reported. No case of fetal anemia requiring prenatal therapy has been noted to date. We report such a case recently encountered at our Fetal Center. Strategies are discussed for managing pregnancy complicated with alloimmunization to an antibody to a high-prevalence antigen, including sources of red blood cells for intrauterine transfusions.Only rare cases of anti-Vel­associated mild-to-moderate hemolytic disease of the fetus and newborn have been previously reported. No case of fetal anemia requiring prenatal therapy has been noted to date. We report such a case recently encountered at our Fetal Center. Strategies are discussed for managing pregnancy complicated with alloimmunization to an antibody to a high-prevalence antigen, including sources of red blood cells for intrauterine transfusions.

[Results of revision after failed surgical treatment for traumatic anterior shoulder instability]. / Cirugía de revisión de la inestabilidad anterior de hombro.

INTRODUCTION AND OBJECTIVES: Persistent or recurrent glenohumeral instability after a previous operative stabilization can be a complex problem. Our aim is to establish the incidence of recurrence and its revision surgery, and to analyse the functional results of the revision instability surgery, as well as to determine surgical protocols to perform it. MATERIALS AND METHODS: A retrospective analysis was conducted on 16 patients with recurrent instability out of 164 patients operated on between 1999 and 2011. The mean follow-up was 57 months and the mean age was 29 years. To evaluate functional outcome we employed Constant, Rowe, UCLA scores and the visual analogue scale. RESULTS: Of the 12 patients who failed the initial arthroscopic surgery, 6 patients underwent an arthroscopic antero-inferior labrum repair technique, 4 using open labrum repair techniques, and 2 coracoid transfer. The two cases of open surgery with recurrences underwent surgery for coracoid transfer. Results of the Constant score were excellent or good in 64% of patients. CONCLUSIONS: Surgical revision of instability is a complex surgery essentially for two reasons: the difficulty in recognising the problem, and the technical demand (greater variety and the increasingly complex techniques).

Cirugía de revisión de la inestabilidad anterior de hombro / Results of revision after failed surgical treatment for traumatic anterior shoulder instability

Introducción y objetivos. Aunque las tasa de recidiva tras la cirugía primaria de la inestabilidad no son despreciables, son pocos los estudios que encontramos sobre su cirugía de revisión. Los objetivos de esta serie son establecer la frecuencia de recidiva de la inestabilidad en la misma y de su cirugía de revisión; analizar los resultados funcionales obtenidos, y determinar un protocolo quirúrgico de actuación ante la necesidad de realizar una cirugía de revisión. Material y métodos. Análisis retrospectivo: 16 pacientes con recidiva de inestabilidad tras cirugía previa en 164 pacientes intervenidos entre 1999-2011. Seguimiento medio de 57 meses y edad promedio 29 años. Evaluación de resultados mediante las escalas Constant, Rowe y UCLA. Resultados. De los 12 casos de cirugía artroscópica que recidivaron, en 6 se reparó el labrum mediante artroscopia, en 4 mediante reparación abierta y plicatura capsular, y en 2 mediante trasferencia de coracoides. En los 2 casos de cirugía abierta se realizó una cirugía de trasferencia de coracoides. Las puntuaciones obtenidas en la escala de Constant en el hombro intervenido fueron excelente/buena en el 64% de los pacientes. Conclusiones. Aunque las técnicas de estabilización primaria abierta y/o artroscópica se han perfeccionado mucho, el porcentaje de recurrencia no resulta nada despreciable. De ahí la importancia de establecer un protocolo quirúrgico de actuación como existe para la indicación quirúrgica de una estabilización primaria. Podemos afirmar que los resultados funcionales obtenidos tras la cirugía de revisión resultan satisfactorios para las elevadas demandas funcionales que presentan este tipo de pacientes (AU)

Introduction and objectives. Persistent or recurrent glenohumeral instability after a previous operative stabilization can be a complex problem. Our aim is to establish the incidence of recurrence and its revision surgery, and to analyse the functional results of the revision instability surgery, as well as to determine surgical protocols to perform it. Materials and methods. A retrospective analysis was conducted on 16 patients with recurrent instability out of 164 patients operated on between 1999 and 2011. The mean follow-up was 57 months and the mean age was 29 years. To evaluate functional outcome we employed Constant, Rowe, UCLA scores and the visual analogue scale. Results. Of the 12 patients who failed the initial arthroscopic surgery, 6 patients underwent an arthroscopic antero-inferior labrum repair technique, 4 using open labrum repair techniques, and 2 coracoid transfer. The two cases of open surgery with recurrences underwent surgery for coracoid transfer. Results of the Constant score were excellent or good in 64% of patients. Conclusions. Surgical revision of instability is a complex surgery essentially for two reasons: the difficulty in recognising the problem, and the technical demand (greater variety and the increasingly complex techniques) (AU)

[Fractures of the mid third of the clavicle. Results after osteosynthesis]. / Fracturas de tercio medio de clavícula. Resultados tras osteosíntesis.

BACKGROUND: The traditional idea that most fractures of the mid third of the clavicle heal with a good functional outcome after orthopedic treatment is increasingly controversial due to the publication of studies reporting high pseudoarthrosis rates and functional limitations in certain subpopulations. Our objective is to analyze the results obtained with open reduction and internal fixation with low profile plates for the treatment of these fractures. METHODS: We conducted an observational, retrospective, cohort study of the patients who underwent surgery for displaced fracture of the mid third between January 2006 and December 2009. They all were radiologically and functionally assessed using the Constant and disabilities of the arm, shoulder and hand scales. RESULTS: Surgical treatment of displaced fractures of the mid third of the clavicle with low profile plates using a meticulous technique results in low intra- and postoperative complication rates, with a mean healing rate of 4 months. The Constant score in the affected arm compared with the healthy one was 93.41% in the subjective assessment and 96% in the objective one. CONCLUSIONS: The good functional results obtained lead us to recommend this type of treatment, mainly in certain subpopulations (young and active patients).

Ascitis fetal transitoria: alerta al ultrasonografista / Prenatal diagnosis of isolated fetal ascites

We review our experience with the management and perinatal outcome in three cases of isolated fetal ascites detected prenatally at the San Camilo Hospital, San Felipe, Chile, in a period of seven years. Two cases were confirmed as being the result of meconium peritonitis and the remaining to a Klippel-Feil syndrome. We conclude that the detection of transient isolated fetal ascites warrants a close surveillance of the neonate looking for signs associated with intestinal rupture and non-chromosomal genetic syndromes.

Se presenta nuestra experiencia con el manejo y resultados perinatales de 3 casos de ascitis fetal aislados diagnosticados prenatalmente en el Hospital “San Camilo”, San Felipe, durante un período de 7 años. Dos casos correspondieron a peritonitis meconial y uno a un síndrome de Klippel-Feil. Se concluye que la detección de ascitis fetal aislada, aunque sea transitoria, obliga a realizar una observación acuciosa de la evolución neonatal, ya que puede ser el único indicio prenatal de una perforación intestinal o algún síndrome genético no cromosómico.

Espondilolistesis degenerativas: fusión a un nivel vertebral / Degenerative spondylolistheses: single-level fusion

Introducción. Se realiza un estudio retrospectivo de una serie de espondilolistesis degenerativas de grado I y II, intervenidas quirúrgicamente llevando a cabo una fusión vertebral en un nivel, comparando la fusión circunferencial con la fusión posterolateral.Material y método. La serie consta de 33 pacientes (22 mujeres y 11 varones) que fueron intervenidos entre 1999 y 2002. En todos los casos se hizo un abordaje posterior y una artrodesis vertebral en un único nivel: en 15 pacientes se efectuó una artrodesis posterolateral (grupo 1) y en 18, una artrodesis circunferencial (grupo 2). La media de edad en el grupo 1 fue de 54,2 años (rango: 34-78 años) y el seguimiento mínimo, de 3 años (rango: 3-5,6 años). La media de edad en el grupo 2 fue de 50,8 años (rango: 25-76 años) y el seguimiento mínimo, de 3,2 años (rango: 3,2-5,5 años). Nohubo diferencias significativas en la edad entre ambos grupos. Analizamos los resultados clínicos con el cuestionario funcional SF-36 y con una valoración subjetiva del dolor por parte del paciente. Analizamos radiológicamente la fusión del espacio vertebral.Resultados. Las artrodesis circunferenciales obtienen unapuntuación media de 47,7 puntos en el SF-36, superior a los 38,4 puntos de las artrodesis posterolaterales. Los resultados radiológicos en cuanto a la obtención de la artrodesis son muy similares.Conclusiones. En nuestra experiencia, se obtienen mejoresresultados clínicos y radiológicos en el tratamiento quirúrgico de las espondilolistesis degenerativas cuando se realiza una artrodesis circunferencial

Introduction. A retrospective study was carried out of a series of grade I and II degenerative spondylolistheses subjected to a single-level fusion, comparing circumferential to posterolateral fusion.Materials and methods. Our series comprises 33 patients (22 females and 11 males) operated between 1999 and 2002. In all cases a single-level fusion was performed through a posterior approach: a posterolateral fusion was conducted in 15 patients (group 1), and a circumferential fusion in 18 (group 2). Mean age in group 1 was 54.2 years (range: 34-78), andfollow-up at least 3 years (range: 3-5.6 years). Mean age in group 2 was 50.8 years (range: 25-76 years) and follow-up at least 3.2 years (range: 3.2-5.5 years). There were no significant age-related differences between both groups. Clinical results were analyzed with the SF-36 functional scale and with a subjective pain assessment by the patient. We radiologicallyanalyzed fusion of the vertebral space.Results. Circumferential fusion obtained a mean score of47.7 points on the SF-36 scale vs 38.4 points for posterolateral fusion. X-ray results as to the success of the fusion procedure are very similar in both groups.Conclusions. In our experience, surgical treatment of degenerative spondylolistheses achieves better clinical and radiological results when a circumferential fusion is performed

Artrodesis mediocarpiana con placa Spider® / Midcarpal Spider® plate arthrodesis

Objetivo. Con este estudio pretendemos valorar la efectividad de la placa Spider® en la artrodesis mediocarpiana. Material y método. Hemos estudiado 11 pacientes intervenidos de artrodesis mediocarpiana con placa Spider® que presentaban un proceso degenerativo avanzado del carpo estadio II o III. El seguimiento medio ha sido de 15 meses (7 a 25 meses). Resultados. Se observa una importante disminución del dolor en todos los casos, manteniéndose una flexión postquirúrgica de 33° (12° a 37°); una extensión de 29° (12° a 33°); una desviación radial postoperatoria de 12° (0° y 16°) y una desviación cubital de 17° (0° a 20°). Se apreció un aumento de la fuerza de prensión después de la cirugía. Se observó la consolidación de la artrodesis en todos los casos, con una pequeña disminución del índice de la altura del carpo. Conclusiones. Esta técnica quirúrgica nos ha permitido obtener buenos resultados clínico-radiológicos y una movilización precoz tras la cirugía

Purpose. The aim of this study was to assess the effectiveness of SpiderTM plates in midcarpal arthrodesis. Materials and methods. We studied 11 patients with advanced stage II and III degenerative process of the carpus treated by midcarpal arthrodesis with SpiderTM plates. Mean followup was 15 months (7-25 months). Results. A significant decrease in pain was seen in all cases. Postoperative flexion was 33° (12º-37º); extension 29° (12°-33°); there was one postoperative radius deviation of 12° (0°­16°) and one ulnar deviation of 17° (0°-20°). After surgery an increase in grasping strength was seen. Arthrodesis healing was seen in all cases, with a small decrease in the carpal height index. Conclusions. This surgical technique has allowed us to obtain good clinical and radiological results and early postoperative mobilization (AU)

Myelin oligodendrocyte glycoprotein antibodies in pathologically proven multiple sclerosis: frequency, stability and clinicopathologic correlations.

Controversy exists regarding the pathogenic or predictive role of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in patients with multiple sclerosis (MS). Four immunopathological patterns (IP) have been recognized in early active MS lesions, suggesting heterogeneous pathogenic mechanisms. Whether MOG antibodies contribute to this pathological heterogeneity and potentially serve as biomarkers to identify specific pathological patterns is unknown. Here we report the frequencies of antibodies to human recombinant MOG (identified by Western blot and enzyme-linked immunoabsorbent assay (ELISA)) in patients with pathologically proven demyelinating disease, and investigate whether antibody status is associated with clinical course, HLA-DR2-genotype, IP or treatment response to plasmapheresis. The biopsy cohort consisted of 72 patients: 12 pattern I, 43 pattern II and 17 pattern III. No association was found between MOG antibody status and conversion to clinically definite MS, DR-2 status, IP or response to plasmapheresis. There was poor agreement between Western blot and ELISA (kappa = 0.07 for MOG IgM). Fluctuations in antibody seropositivity were seen for 3/4 patients tested serially by Western blot. This study does not support a pathologic pattern-specific role for MOG-antibodies. Variable MOG-antibody status on serial measurements, coupled with the lack of Western blot and ELISA correlations, raises concern regarding the use of MOG-antibody as an MS biomarker and underscores the need for methodological consensus.

Fractura de estrés en región supracondílea de fémur / Supracondylar stress fractures of the femur

Se describe un caso clínico de una fractura de estrés en la región supracondílea del fémur, una localización extremadamente rara. Pretendemos llamar la atención sobre la importancia del diagnóstico precoz de estas fracturas para evitar el desarrollo de complicaciones, debiendo tenerlas presentes ante un dolor persistente en la región anterior de la rodilla, no sólo en atletas y militares, sino en cualquier persona que realice una actividad física importante. El diagnóstico diferencial principal se hace con el síndrome femoropatelar. En personas jóvenes nos inclinamos por el tratamiento quirúrgico de estas fracturas frente al conservador, ya que permite una rápida reincorporación a la actividad laboral previa y evita las complicaciones derivadas de su desplazamiento

Description of a clinical case report of a stress fracture in the supracondylar femur an extremely rare fracture site. We wish to highlight the importance of early diagnosis of these fractures to prevent complications. Their existence must be considered when there is persistent pain in the anterior knee, not only in the case of athletes or military personnel, but in any person who does a lot of physical activity. The main differential diagnosis must be a femoropatellar syndrome. We consider surgical, and not conservative, treatment advisable in young persons, since it allows a rapid return to work and prevents complications due to displacement

[Treatment with topical interferon alone in severe conjunctivo-corneal neoplasia]. / Interferón tópico como tratamiento único en un caso de neoplasia córneo-conjuntival severa.

CASE REPORT: A 78-year-old man was referred for evaluation of a limbic lesion in his left eye. This had a gelatinous appearance and an extension of 240 degrees . The lesion was clinically diagnosed to be a conjunctival and corneal intraepithelial neoplasia (CIN). Topical treatment with interferon alpha2b (INFalpha2b) four times daily was started and continued until the lesion had completely resolved at 4 months. DISCUSSION: Topical INFalpha2b alone may be a safe and effective treatment of CIN instead of the other classic alternatives such as surgical excision with cryotherapy, which could induce the development of severe limbic deficiency in cases with extensive disease.

Interferón óptico como tratamiento único en un caso de neoplasia córneo-conjuntival severa / Treatment with topical interferon alone in severe conjunctivo-corneal neoplasia

Caso clínico: Varón de 78 años remitido por una lesión límbica en ojo izquierdo (OI) de aspecto gelatinoso con una extensión de 240º, que fue diagnosticada clínicamente como una probable neoplasia intraepitelial conjuntivo-corneal (CIN). Se inició tratamiento tópico con interferon alfa2b (INFalfa2b) 4 veces al día hasta conseguir su desaparición completa a los 4 meses de tratamiento.Discusión: El uso aislado del INFalfa2b tópico podría ser una alternativa eficaz y segura en el tratamiento del CIN, frente a otras opciones terapéuticas clásicas como la escisión quirúrgica asociada a crioterapia que podrían condicionar el desarrollo de insuficiencias límbicas severas en casos extensos

Case report: A 78-year-old man was referred for evaluation of a limbic lesion in his left eye. This had a gelatinous appearance and an extension of 240º. The lesion was clinically diagnosed to be a conjunctival and corneal intraepithelial neoplasia (CIN). Topical treatment with interferon alpha2b (INFalpha2b) four times daily was started and continued until the lesion had completely resolved at 4 months. Discussion: Topical INFalpha2b alone may be a safe and effective treatment of CIN instead of the other classic alternatives such as surgical excision with cryotherapy, which could induce the development of severe limbic deficiency in cases with extensive disease

Simulación en 3D de las variaciones de comportamiento en un segmento de columna al incorporar un fijador transpedicular / Three-dimensional simulation of variations in the behavior of a spinal segment with transpedicular fixation

Objetivo. Analizar las variaciones del comportamiento biomecánico mediante el análisis de elementos finitos de un segmento vertebral con un fijador transpedicular. Material y método. Se realizó un modelo matemático de elementos finitos (lineal, anisótropo y tridimensional) de un segmento vertebral lumbar (L1-L3) que fue sometido a cargas de compresión sucesivas de 1.177, 3.923 y 9.806 N. Posteriormente se incorporó al modelo un sistema de instrumentación transpedicular con las mismas cargas. Se estudió el desarrollo tensional del sistema, la redistribución de las cargas debidas al implante y las tensiones y deformaciones en el segmento instrumentado y del implante. Resultados. Los cambios en las distribuciones de las tensiones en el hueso, fueron de 502 MPa sin fijador y 460 MPa con fijador. El fijador produjo un aumento de la rigidez del 11,2%. Conclusiones. Este modelo de simulación 3D nos ha permitido estudiar el comportamiento de un segmento del raquis en diferentes situaciones y obtener datos que no son accesibles mediante los estudios experimentales, como la distribución de las concentraciones de tensiones

Aim. The aim of this study is to analyze variations in biomechanical behavior by finite-element analysis of a vertebral segment with transpedicular fixation. Materials and method. A finite-element mathematical model (linear, anisotropic, and three-dimensional) of a lumbar vertebral segment (L1-L3) that was subjected to successive compression loads of 1,177, 3,923, and 9,806 N. A transpedicular instrumentation system with the same loads was then added. The development of forces in the system, load redistribution due to the implant, and the forces and deformations in the instrumented segment and implant were studied. Results. The distribution of forces in the bone changed by 502 MPa without fixation and 460 MPa with fixation. Fixation increased resistance by 11.2%. Conclusions. This three-dimensional simulation model made it possible to study the behavior of a spinal segment in different situations and to obtain data not available from experimental studies, such as the distribution of force concentrations. Keywords: biomechanics, finite elements, spine, transpedicular fixation.En las últimas décadas se ha producido un aumento del uso instrumentaciones posteriores en las intervenciones del raquis que no se ha correlacionado con un conocimiento paralelo de las modificaciones que se producen1 . El estudio con modelos experimentales en el laboratorio es una forma directa de analizar el comportamiento del implante ante las cargas y, sin embargo, presenta una serie de limitaciones. Resulta muy difícil evaluar el desarrollo tensional y la redistribución de las cargas del sistema. Además, existe el problema de la dispersión de datos por la utilización de tejidos orgánicos. La metodología matemática de los elementos finitos nos permite superar estos problemas2 .En este estudio se analizan las variaciones del comportamiento biomecánico mediante el análisis de elementos finitos de un segmento vertebral al añadir un fijador transpedicular