[Translated article] Comparative clinical and biomechanical study of different types of osteosynthesis in the treatment of distal femur fractures.

INTRODUCTION AND OBJECTIVES: Distal femoral fractures represent a problem due to their high number of complications. The aim was to compare the results, complications and stability achieved with retrograde intramedullary nailing and the angular stable plate in the treatment of distal femoral diaphyseal fractures. MATERIAL AND METHOD: A clinical and experimental biomechanical study was carried out using finite elements. The results of the simulations allowed us to obtain the main results related to the stability of osteosynthesis. For clinical follow-up data, frequencies were used for qualitative variables, and Fisher's exact test and χ2 test were used to evaluate the significance of the different factors, with the condition of P<.05. RESULTS: In the biomechanical study, the retrograde intramedullar nails demonstrated superiority, obtaining lower values in terms of global displacement, maximum tension, torsion resistance, and bending resistance. In the clinical study, the rate of consolidation of the plates was lower than nails (77% vs. 96%, P=.02). The factor that most influenced the healing of fractures treated with plate were the central cortical thickness (P=.019). The factor that most influenced the healing of nail-treated fractures was the difference between the diameter of the medullary canal and the nail. CONCLUSIONS: Our biomechanical study shows that both osteosynthesis provide sufficient stability, but biomechanically behaves differently. Nails provide greater overall stability being preferable the use of long nails adjusted to the diameter of the canal. Plates form less rigid osteosynthesis, with little resistance to bending.

Comparative clinical and biomechanical study of different types of osteosynthesis in the treatment of distal femur fractures. / Estudio comparativo clínico y biomecánico de distintos tipos de osteosíntesis en el tratamiento de fracturas distales de fémur.

INTRODUCTION AND OBJECTIVES: Distal femoral fractures represent a problem due to their high number of complications. The aim was to compare the results, complications and stability achieved with retrograde intramedullary nailing and the angular stable plate in the treatment of distal femoral diaphyseal fractures. MATERIAL AND METHOD: A clinical and experimental biomechanical study was carried out using finite elements. The results of the simulations allowed us to obtain the main results related to the stability of osteosynthesis. For clinical follow-up data, frequencies were used for qualitative variables, and Fisher's exact test and χ2 test were used to evaluate the significance of the different factors, with the condition of P<.05. RESULTS: In the biomechanical study, the retrograde intramedullar nails demonstrated superiority, obtaining lower values in terms of global displacement, maximum tension, torsion resistance, and bending resistance. In the clinical study, the rate of consolidation of the plates was lower than nails (77% vs. 96%, P=.02). The factor that most influenced the healing of fractures treated with plate were the central cortical thickness (P=.019). The factor that most influenced the healing of nail-treated fractures was the difference between the diameter of the medullary canal and the nail. CONCLUSIONS: Our biomechanical study shows that both osteosynthesis provide sufficient stability, but biomechanically behaves differently. Nails provide greater overall stability being preferable the use of long nails adjusted to the diameter of the canal. Plates form less rigid osteosynthesis, with little resistance to bending.

Influence of plate size and screw distribution on the biomechanical behaviour of osteosynthesis by means of lateral plates in femoral fractures.

Distal femoral fractures are fractures associated with high rates of morbidity and mortality, affecting to three different groups of individuals: younger people suffering high-energy trauma, elderly people with fragile bones and people with periprosthetic fractures around previous total knee arthroplasty. They have been classically treated with conventional plates and intramedullary nails and more recently with locked plates that have increased their indications to more types of fractures. The main objective of the present work is the biomechanical study, by means of finite element simulation, of the stability achieved in the osteosynthesis of femoral fractures in zones 4 and 5 of Wiss, by using locked plates with different plate lengths and different screw configurations, and analysing the effect of screw proximity to the fracture site. A three dimensional (3D) finite element model of the femur from 55-year-old male donor was developed, and then a stability analysis was performed for the fixation provided by Osteosynthesis System LOQTEC® Lateral Distal Femur Plate in two different fracture zones corresponding to the zones 4 and 5 according to the Wiss fracture classification. The study was focused on the immediately post-operative stage, without any biological healing process. The obtained results show that more stable osteosyntheses were obtained by using shorter plates. In the cases of longer plates, it results more convenient disposing screws in a way that the upper ones are closer to fracture site. The obtained results can support surgeons to understand the biomechanics of fracture stability, and then to guide them towards the more appropriate osteosynthesis depending on the fracture type and location.

Biomechanical behavior of retrograde intramedullary nails in distal femoral fractures.

Fractures of the distal femur affect three different groups of individuals: younger people suffering high-energy trauma, elderly people with fragile bones and people with periprosthetic fractures around previous total knee arthroplasty. Main indications of intramedullary nailing are for supracondylar fractures type A or type C of the AO classification. The main objective of the present work is to analyze, by means of FE simulation, the influence of retrograde nail length, considering different blocking configurations and fracture gaps, on the biomechanical behavior of supracondylar fractures of A type. A three dimensional (3D) finite element model of the femur from 55-year-old male donor was developed, and then a stability analysis was performed for the fixation provided by the retrograde nail at a distal fracture with different fracture gaps: 0.5 mm, 3 mm y 20 mm, respectively. Besides, for each gap, three nail lengths were studied with a general extent (320 mm, 280 mm and 240 mm), considering two transversal screws (M/L) at the distal part and different screw combinations above the fracture. The study was focused on the immediately post-operative stage, without any biological healing process. In view of the obtained results, it has been demonstrated new possibilities of blocking configuration in addition to the usual ones, which allows establishing recommendations for nail design and clinical practice, avoiding excessive stress concentrations both in screws, with the problem of rupture and loss of blocking, and in the contact of nail tip with cortical bone, with the problem of a new stress fracture.

The Combined Use of Gold Nanoparticles and Infrared Radiation Enables Cytosolic Protein Delivery.

Cytosolic protein delivery remains elusive. The inability of most proteins to cross the cellular membrane is a huge hurdle. Here we explore the unique photothermal properties of gold nanorods (AuNRs) to trigger cytosolic delivery of proteins. Both partners, protein and AuNRs, are modified with a protease-resistant cell-penetrating peptide with nuclear targeting properties to induce internalization. Once internalized, spatiotemporal control of protein release is achieved by near-infrared laser irradiation in the safe second biological window. Importantly, catalytic amounts of AuNRs are sufficient to trigger cytosolic protein delivery. To the best of our knowledge, this is the first time that AuNRs with their maximum of absorption in the second biological window are used to deliver proteins into the intracellular space. This strategy represents a powerful tool for the cytosolic delivery of virtually any class of protein.

A surface acoustic wave bio-electronic nose for detection of volatile odorant molecules.

In this work, a "bio-electronic nose" for vapour phase detection of odorant molecules based on surface acoustic wave (SAW) resonators is presented. The biosensor system is composed of an array of five SAW resonators coated with three types of odorant-binding proteins (OBPs): the wild-type OBP from bovine (wtbOBP), a double-mutant of the OBP from bovine (dmbOBP), and the wild-type OBP from pig (wtpOBP). High resolution deposition of OBPs onto the active area of SAW resonators was implemented through laser-induced forward transfer (LIFT). The resonant frequency shifts of the SAW resonators after the deposition of the biomolecules confirmed the immobilisation of the proteins onto the Al/Au inter-digital transducers (IDTs). In addition, a low increase of insertion losses with a limited degradation of Q-factors is reported. The "bio-electronic nose" fabricated by LIFT is tested in nitrogen upon exposure to separated concentrations of R-(-)-1-octen-3-ol (octenol) and R-(-)-carvone (carvone) vapours. The "bio-electronic nose" showed low detection limits for the tested compounds (i.e. 0.48 ppm for the detection of octenol, and 0.74 ppm for the detection of carvone). In addition, the bio-sensing system was able to discriminate the octenol molecules from the carvone molecules, making it pertinent for the assessment of food contamination by moulds, or for the evaluation of indoor air quality in buildings.

Vacunación en el Ejército del Aire (2005 y 2011) / Vaccinations in the Air Force (2005 y 2011)

La práctica de las vacunaciones es la medida preventiva más eficaz para evitar la aparición y propagación de determinadas enfermedades infecciosas. Esto nos ha motivado a realizar un estudio sobre cómo se ha desarrollado las vacunaciones en el Ejército del Aire durante los últimos cinco años, considerando: calendario vacunal en las FAS, análisis de las dosis de los distintos tipos de vacunas solicitadas por los servicios sanitarios y las dosis que se dan como administradas, registradas en los partes oficiales. Se estudian las causas que motivan el desvío producido entre ambas, coste económico que supone la vacunación al personal militar del Ejército del Aire y evolución en los últimos años, dosis administradas en los distintos servicios sanitarios, los datos de la vacunación de la gripe estacional y de la gripe N1H1. Se determina el porcentaje aproximado de militares del Ejército del Aire que se encuentran vacunados (AU)

Vaccination practices are the most effective preventive measures to prevent the emergence and spread of a number of infectious diseases. This led us to undertake a study about the vaccination activities in the Spanish Air Force during the last five years, taking into account the military immunization schedule. A comparison between data concerning the different types and numbers of vaccines asked for and the number of doses administered in accordance with official reports is made. Deviation between these figures is studied from the point of view of its causes: Cost of vaccination of the Spanish Air Force military personnel and its evolution in recent years; Administered doses in the different medical facilities; Season and N1H1 flu vaccination data are given. The approximate percentage of vaccinated Spanish Air Force personnel is determined (AU)

Condiciones de transporte de medicamentos en misiones internacionales de las Fuerzas Armadas. Diseño de un estudio de estabilidad especifico para operaciones / Conditions of drugs transportation in international missions of the Armed Forces. Design of a specific stability study of operations

Introducción: El abastecimiento de los recursos sanitarios es una parte crítica del apoyo sanitario en las operaciones de nuestras Fuerzas Armadas. El transporte de medicamentos y productos sanitarios se realiza por vía aérea. La regulación del medicamento exige que las condiciones de almacenamiento y transporte se efectúen de modo que su calidad se mantenga íntegra durante el periodo de validez del mismo, por lo que un trasporte de calidad no debe generar riesgos sobre los medicamentos, derivados de exposiciones a elevados grados de calor, frío, humedad, otros factores negativos, microorganismos o plagas. Podremos caracterizar, por tanto, las condiciones ambientales asociadas a un transporte mediante la medición de la Temperatura y la Humedad Relativa. Objetivo: Cualificación del transporte de medicamentos. Diseño de un Estudio de Estabilidad específico para Operaciones (EEO). Material y métodos: Se efectúa una monitorización de los transportes efectuados al ROLE 2 E (Herat) durante un ciclo anual. Se utilizan Data logger: LOG 32 con rango de medición -40 a +70°C y 0 a 100% HR y programa para cálculo de los parámetros de cualificación de los envíos, para la cualificación y evaluación del transporte. Distintos aparatos de laboratorio y sus correspondientes métodos para el ensayo de estabilidad. Paquete estadístico SPSS versión 15 para el tratamiento de resultados Las temperaturas máximas y mínimas registradas en los 18 transportes monitorizados, a lo largo de 13 meses, muestran valores que no rebasan los límites establecidos en el ensayo de estabilidad propuesto. La HR media se mantuvo, de manera habitual, durante el periodo monitorizado, en valores inferiores al 50%. Los resultados analíticos de los medicamentos sometidos al ensayo de estabilidad, basado en la aplicación de oscilaciones térmicas en diferentes ciclos, arrojan valores que se sitúan dentro de las especificaciones del producto terminado, no apreciándose diferencias significativas entre los productos testigo y los sometidos a variaciones térmicas, demostrándose que las oscilaciones de temperatura entre 2ºC y 50ºC establecidas para el ensayo, durante un periodo de 7 días, no afectan a las características de los medicamentos seleccionados en este estudio. Conclusiones: Evaluadas las características ambientales del transporte durante un ciclo anual, no se aprecian diferencias estacionales destacables entre los diferentes envíos. Desde el punto de vista ambiental, el transporte de medicamentos a Role 2E (Herat), resulta cualificado, demostrándose la calidad del mismo. Todos los elaborados fabricados en el Centro Militar de Farmacia de la Defensa, seleccionados en este estudio y que han sido sometidos al nuevo ensayo de estabilidad, se mantienen dentro de las especificaciones, por lo que no se observa alteración en la calidad de los mismos. Para el control del transporte de medicamentos a las Misiones Internacionales, se considerarán condiciones seguras de transporte, oscilaciones térmicas comprendidas entre 2°C y 50°C durante al menos 7 días (AU)

Introduction: The supply of medical materiel and pharmaceuticals is a critical part of medical support in our military operations. The transport of medical materiel and drugs is provided by Air. The drug regulation requires performed storage and transportation conditions so that its quality are maintained during the whole period of drug validity, so a quality transportation should not generate risks to drugs derived from high temperature, cold, humidity or other negative factors, such as microorganisms or pests. We characterize, therefore, the environmental conditions associated to the transport with the measurement of the temperature and relative humidity. Objective: Qualification of drug transport. Design of a specific stability study to Operations (SSO). Materials and Methods: Monitoring is performed for the drugs transport ROLE 2 E (Herat) during an annual cycle. Data logger are used: LOG 32 with measurement range -40 to +70 °C and 0 to 100% RH and program for calculating the parameters of qualified shipments for the qualification and evaluation of transport. Different laboratory equipments and their corresponding methods for stability testing. SPSS version 15 for the treatment of results. Results: The maximum and minimum recorded temperatures in the 18 transports monitored, during 13 months, show values that not exceed the limits in the proposed test stability. Mean relative humidity was maintained on a regular basis during the period monitored, at values below 50%. The analytical results of the drugs tested against stability, based on the of fluctuations temperature application in different cycles, give values that are within the specifications of the finished product, without significant differences between control products and the products subjected to thermal variations, showing that the oscillations of 2 °C and 50 °C set for the trial, during a period of 7 days, do not affect the drugs characteristics selected in this study Conclusions: Have been evaluated environmental characteristics of transportation during an annual cycle, showing there are not remarkable seasonal differences between the various shipments. From the environmental standpoint, drugs transportation to Role 2(Herat) is qualified. All medicines produced by the Military Pharmacy Center of Defense, choosen in this study and which have been subjected on the new stability test, remain within specification, by what alteration is not observed in the quality of the same ones. In order to control the drugs transport to the International Mission, temperature fluctuations between 2 ºC and 50 °C during at least 7 days would be considered safe conditions (AU)

Film-free laser forward printing of transparent and weakly absorbing liquids.

A laser-based technique for printing transparent and weakly absorbing liquids is developed. Its principle of operation relies in the tight focusing of short laser pulses inside the liquid and close to its free surface, in such a way that the laser radiation is absorbed in a tiny volume around the beam waist, with practically no absorption in any other location along the beam path. If the absorbed energy overcomes the optical breakdown threshold, a cavitation bubble is generated, and its expansion results in the propulsion of a small fraction of liquid which can be collected on a substrate, leading to the printing of a microdroplet for each laser pulse. The technique does not require the preparation of the liquid in thin film form, and its forward mode of operation imposes no restriction concerning the optical properties of the substrate. These characteristics make it well suited for printing a wide variety of materials of interest in diverse applications. We demonstrate that the film-free laser forward printing technique is capable of printing microdroplets with good resolution, reproducibility and control, and analyze the influence of the main process parameter, laser pulse energy. The mechanisms of liquid printing are also investigated: time-resolved imaging provides a clear picture of the dynamics of liquid transfer which allows understanding the main features observed in the printed droplets.

Distinct muscle imaging patterns in myofibrillar myopathies.

OBJECTIVE: To compare muscle imaging findings in different subtypes of myofibrillar myopathies (MFM) in order to identify characteristic patterns of muscle alterations that may be helpful to separate these genetic heterogeneous muscular disorders. METHODS: Muscle imaging and clinical findings of 46 patients with MFM were evaluated (19 desminopathy, 12 myotilinopathy, 11 filaminopathy, 1 alphaB-crystallinopathy, and 3 ZASPopathy). The data were collected retrospectively in 43 patients and prospectively in 3 patients. RESULTS: In patients with desminopathy, the semitendinosus was at least equally affected as the biceps femoris, and the peroneal muscles were never less involved than the tibialis anterior (sensitivity of these imaging criteria to detect desminopathy in our cohort 100%, specificity 95%). In most of the patients with myotilinopathy, the adductor magnus showed more alterations than the gracilis muscle, and the sartorius was at least equally affected as the semitendinosus (sensitivity 90%, specificity 93%). In filaminopathy, the biceps femoris and semitendinosus were at least equally affected as the sartorius muscle, and the medial gastrocnemius was more affected than the lateral gastrocnemius. The semimembranosus mostly showed more alterations than the adductor magnus (sensitivity 88%, specificity 96%). Early adult onset and cardiac involvement was most often associated with desminopathy. In patients with filaminopathy, muscle weakness typically beginning in the 5th decade of life was mostly pronounced proximally, while late adult onset (>50 years) with distal weakness was more often present in myotilinopathy. CONCLUSIONS: Muscle imaging in combination with clinical data may be helpful for separation of distinct myofibrillar myopathy subtypes and in scheduling of genetic analysis.

[Frequency and characteristics of letters to the editor published in Farmacia Hospitalaria (1995-2006)]. / Frecuencia y características de las cartas al director publicadas en Farmacia Hospitalaria (1995-2006).

OBJECTIVE: To describe the frequency and bibliographical characteristics of letters to the editor published in the Farmacia Hospitalaria journal (hospital pharmacy) between 1995 and 2006. METHOD: Descriptive and comprehensive study on documents classified as letters to the editor, which were published between 1995 and 2006. Using journal issues as a source, the following variables were identified: number of letters/year, main content, text length (words), language, use of graphs, number of authors and their professional experience, number of participating institutions, origin in terms of autonomous community, number of bibliographical references and their origin. Descriptive statistics were used. RESULTS: A total of 82 letters were identified, with a mean of 7 per year and 1.1 per journal. They were more frequent during the last two years, 43 (52%) of the total, following their practical non-existence between 1998 and 2003. The majority of the letters, 52 (63%), were regarding clinical cases while 23 (28%) were related to publications or were replies to the letters themselves. All letters met the requirements regarding text length, language and use of graphs. The mean number of authors was 3, and in 12 letters (14%) the limit on the number of authors was exceeded. In 56 cases (64%), the letters were written by hospital pharmacists only, however 26 (32%) were written in conjunction with hospital doctors. In 16 of the letters (20%), the authors belonged to one or more institutions. The letters mainly came from Valencia, Catalonia, Madrid and Andalusia. A total of 411 supporting references were gathered. The mean was 5 citations per letter to the editor, between 0 and 15 references, and in 17 cases (21%), the number of references was higher than the accepted limit. Of the total citations, 255 (60%) were from foreign publications. CONCLUSIONS: Letters to the editor in Farmacia Hospitalaria significantly increased during the last two years of the period studied and were practically non-existent before this. It is worth noting that many of the letters were written in collaboration with other health professionals and with the support of a number of institutions. It is compulsory that the letters meet publishing requirements, with the exception of a number of authors and references which were published without being thoroughly checked beforehand.

Frecuencia y características de las cartas al director publicadas en Farmacia Hospitalaria (1995-2006) / No disponible

Objetivo: Describir la frecuencia y las características bibliográficas de las cartas al director publicadas en Farmacia Hospitalaria entre 1995 y 2006. Método: Estudio descriptivo y trasversal sobre documentos clasificados como cartas al director publicados en el periodo interanual 1995-2006. Utilizando como fuentes los ejemplares de las revistas se identificaron las siguientes variables: número de cartas/año, contenido de fondo, extensión del texto en palabras, idioma, utilización de recursos gráficos, número de firmantes y su perfil profesional, número de instituciones participantes, origen por autonomías, número de referencias bibliográficas y origen documental de las mismas. Se empleó estadística descriptiva. Resultados: Se identificaron 82 cartas, con una media de 7 por año y de 1,1 por revista. Fueron más frecuentes en el último bienio, 43 cartas (52%) del total de misivas, tras su práctica ausencia entre 1998 y 2003. La mayoría 52 casos (63%) eran casos clínicos frente a 23 (28%) cartas relacionadas con publicaciones o réplicas. Todas las misivas contemplaron las normas de extensión del texto, idioma o uso de recursos gráficos. El promedio de autores fue de 3, en 12 cartas (14%) su número fue superior al permitido. En 56 casos (64%) firmaron únicamente farmacéuticos hospitalarios pero en 26 ocasiones (32%) lo hicieron junto a médicos de hospital. En el 20% de los documentos, 16 casos, los firmantes pertenecían a dos o más instituciones. Valencia, Cataluña, Madrid y Andalucía fueron los orígenes principales de las cartas. Se recopilaron 411 referencias de apoyo. La media fue de 5 citas por carta al director, entre 0 y 15 referencias, en 17 casos (21%) se superó el tope de referencias aceptables. Del total de citas 255 (60%) correspondían a publicaciones extranjeras. Conclusiones: Las cartas al director en Farmacia Hospitalaria aumentaron de forma importante en el último bienio del periodo estudiado tras su práctica ausencia en años anteriores. Destaca la autoría conjunta con otros profesionales de la salud y el respaldo de varias instituciones a los documentos. La observancia de las normas de publicación es la regla, con excepción del número de autores y de referencias permitidas que no son observadas con suficiente rigor

Objective: To describe the frequency and bibliographical characteristics of letters to the editor published in the Farmacia Hospitalaria journal (hospital pharmacy) between 1995 and 2006. Method: Descriptive and comprehensive study on documents classified as letters to the editor, which were published between 1995 and 2006. Using journal issues as a source, the following variables were identified: number of letters/year, main content, text length (words), language, use of graphs, number of authors and their professional experience, number of participating institutions, origin in terms of autonomous community, number of bibliographical references and their origin. Descriptive statistics were used. Results: A total of 82 letters were identified, with a mean of 7 per year and 1.1 per journal. They were more frequent during the last two years, 43 (52%) of the total, following their practical non-existence between 1998 and 2003. The majority of the letters, 52 (63%), were regarding clinical cases while 23 (28%) were related to publications or were replies to the letters themselves. All letters met the requirements regarding text length, language and use of graphs. The mean number of authors was 3, and in 12 letters (14%) the limit on the number of authors was exceeded. In 56 cases (64%), the letters were written by hospital pharmacists only, however 26 (32%) were written in conjunction with hospital doctors. In 16 of the letters (20%), the authors belonged to one or more institutions. The letters mainly came from Valencia, Catalonia, Madrid and Andalusia. A total of 411 supporting references were gathered. The mean was 5 citations per letter to the editor, between 0 and 15 references, and in 17 cases (21%), the number of references was higher than the accepted limit. Of the total citations, 255 (60%) were from foreign publications. Conclusions: Letters to the editor in Farmacia Hospitalaria significantly increased during the last two years of the period studied and were practically non-existent before this. It is worth noting that many of the letters were written in collaboration with other health professionals and with the support of a number of institutions. It is compulsory that the letters meet publishing requirements, with the exception of a number of authors and references which were published without being thoroughly checked beforehand

[The relationship between lung function and health-related quality of life in patients with generalized myasthenia gravis]. / Relación entre función pulmonar y calidad de vida relacionada con la salud en la miastenia gravis generalizada.

OBJECTIVE: To study lung function abnormalities and health-related quality of life (HRQL) in a group of patients diagnosed with generalized myasthenia gravis, and to analyze the relationship between these 2 sets of variables. PATIENTS AND METHODS: In a prospective study of 20 patients diagnosed with generalized myasthenia gravis, the following parameters were measured: spirometry, static lung volumes, breathing pattern, maximal respiratory pressures, and maximum voluntary ventilation. HRQL was assessed using the 36-item short form general health questionnaire (SF-36). RESULTS: The mean (SD) age of the patients was 64 (11) years. Patients were classified into 2 groups depending on whether they had IIa (12 patients) or IIb (8 patients) type disease. A small decrease in total lung capacity (86%) and slight reductions in maximal inspiratory pressure (88%) and maximum voluntary ventilation (63% in group IIb) were observed. The HRQL domains most affected were those related to physical activity and self-perceived health status in all groups, although women were more affected. The scores relating to vitality and physical activity were found to be significantly associated with forced vital capacity and lung volumes. Tidal volume was associated with maximal inspiratory and expiratory pressures, inspiratory capacity, and maximum voluntary ventilation. The respiratory rate to tidal volume ratio was inversely associated with the first three of these variables. CONCLUSIONS: A very slight restrictive pattern and a reduction in inspiratory muscle strength were observed. The HRQL domains most affected were those related to physical activity and the patients' self-perceived health status. The weakness of the respiratory muscles contributes to the abnormalities observed in lung function and to the deterioration of health-related quality of life.

Relación entre función pulmonar y calidad de vida relacionada con la salud en la miastenia gravis generalizada / The relationship between lung function and health-related quality of life in patients with generalized myasthenia gravis

Objetivo: Estudiar las alteraciones de la función pulmonar y de la calidad de vida relacionada con la salud (CVRS), así como las relaciones entre ambas áreas, en un grupo de pacientes diagnosticados de miastenia gravis generalizada. Pacientes y métodos: Se ha realizado un estudio prospectivo en 20 pacientes diagnosticados de miastenia gravis generalizada. Se evaluaron la espirometría, los volúmenes pulmonares estáticos, el patrón respiratorio, las presiones respiratorias máximas y la ventilación voluntaria máxima. La CVRS se valoró con el cuestionario general de salud SF-36. Resultados: La edad media (± desviación estándar) de los pacientes fue de 64 ± 11 años. Se clasificaron en IIa (12 pacientes) y IIb (8 pacientes). Se observaron una leve disminución de la capacidad pulmonar total (86%) y una ligera reducción de la presión inspiratoria máxima (88%) y de la ventilación voluntaria máxima (un 63% en el grupo IIb). Los dominios más afectados de la CVRS fueron los relacionados con la actividad física y la percepción general de la salud en todos los grupos, pero con mayor intensidad en el sexo femenino. Se observaron relaciones estadísticamente significativas entre las áreas de vitalidad y actividad física, la capacidad vital forzada y los volúmenes pulmonares. También se encontraron relaciones entre la presión inspiratoria máxima, la presión espiratoria máxima, la ventilación voluntaria máxima, la capacidad inspiratoria con volumen circulante y el índice volumen circulante. Conclusiones: Se observaron un patrón restrictivo muy ligero y reducción de la fuerza muscular inspiratoria. Los ámbitos de la CVRS más afectados fueron los relacionados con la actividad física y la percepción general de la salud. La afectación muscular respiratoria contribuye a una alteración en las variables de la función pulmonar y al deterioro de la calidad de vida relacionada con la salud

Objective: To study lung function abnormalities and health-related quality of life (HRQL) in a group of patients diagnosed with generalized myasthenia gravis, and to analyze the relationship between these 2 sets of variables. Patients and methods: In a prospective study of 20 patients diagnosed with generalized myasthenia gravis, the following parameters were measured: spirometry, static lung volumes, breathing pattern, maximal respiratory pressures, and maximum voluntary ventilation. HRQL was assessed using the 36-item short form general health questionnaire (SF-36). Results: The mean (SD) age of the patients was 64 (11) years. Patients were classified into 2 groups depending on whether they had IIa (12 patients) or IIb (8 patients) type disease. A small decrease in total lung capacity (86%) and slight reductions in maximal inspiratory pressure (88%) and maximum voluntary ventilation (63% in group IIb) were observed. The HRQL domains most affected were those related to physical activity and self-perceived health status in all groups, although women were more affected. The scores relating to vitality and physical activity were found to be significantly associated with forced vital capacity and lung volumes. Tidal volume was associated with maximal inspiratory and expiratory pressures, inspiratory capacity, and maximum voluntary ventilation. The respiratory rate to tidal volume ratio was inversely associated with the first three of these variables. Conclusions: A very slight restrictive pattern and a reduction in inspiratory muscle strength were observed. The HRQL domains most affected were those related to physical activity and the patients' self-perceived health status. The weakness of the respiratory muscles contributes to the abnormalities observed in lung function and to the deterioration of health-related quality of life

DNA deposition through laser induced forward transfer.

Laser induced forward transfer (LIFT) is a laser direct write technique that appears to be specially adequate for the production of biosensors, since it permits to deposit patterns of biomolecules with high spatial resolution. In the LIFT technique, a laser pulse is focused on a thin film of the material to be transferred through a transparent support, and under the action of the laser pulse, a small fraction of the film is transferred to a receptor substrate that is placed parallel to the film-support system. In the case of biomolecules transfer, the thin film consists in a liquid solution containing the biomolecules. In this work, microarrays of two different cDNAs have been both spotted by LIFT and pin microspotting onto a poly-L-lysine treated glass slide. Once transferred, all the microarrays have been submitted to hybridization with the complementary strands of the spotted cDNAs, each one tagged with a different fluorochrome. Comparative fluorescence scanner analyses have revealed that the microarrays transferred through LIFT are equivalent to those transferred through pin microspotting in terms of signal intensity and gene discrimination capacity, and that the action of the laser pulse does not result in significant damage of the transferred DNA.

Hemobilia secondary to chronic cholecystitis.

The term hemobilia is used to describe the presence of blood in the biliary tract. We report a case of symptomatic hemobilia associated with chronic cholecystitis in a 57-year-old man with jaundice, gastrointestinal hemorrhage, and epigastric pain. We review the etiology of this condition and highlight the role of abdominal ultrasonography in its diagnosis. In our case, abdominal ultrasonography revealed the presence of clots inside the gallbladder. The clinical condition was resolved by means of a cholecystectomy. The patient had an uneventful recovery.

In vitro bioactivity of laser ablation pseudowollastonite coating.

Pseudowollastonite (psW) coatings on titanium alloys substrates were prepared by laser ablation and immersed in simulated body fluid (SBF) for different periods in order to investigate the nucleation and growth of hydroxyapatite (HA)-like formation on their surface. The structure of the coatings before soaking was analysed by X-ray diffraction (XRD) and scanning electron microscopy (SEM). The interfacial reactions product was examined by thin-film XRD, SEM and transmission electron microscopy at low and high resolution level, both fitted with energy-dispersive X-ray spectroscopy. Additional changes in ionic concentration, using inductively couple plasma atomic emission spectroscopy, were determined as well as pH right at the psW-coatings/SBF interface using an ion-sensitive field effect transistor. The solution composition changes, increasing the Ca(2+) and Si(4+) concentration and pH as a function of the soaking time while HPO(4)(2-) decreased. The results obtained showed that the coating surfaces were covered by HA-like, which indicated that the psW-coating possesses good bioactivity and also suggested that the mechanism of HA-like layer formation in SBF was similar to that showed in in vitro test by other silica-based materials.

Stimulated single-fiber EMG of the frontalis and orbicularis oculi muscles in ocular myasthenia gravis.

We performed single-fiber electromyography by axonal stimulation (stimulated SFEMG) of the frontalis and orbicularis oculi muscles of 20 patients with ocular myasthenia gravis (OM) and 46 controls. In controls, mean consecutive differences (MCD) ranged from 5 to 55 micros (average, 14.7 +/- 2.8 micros) in the frontalis and from 4 to 56 micros (average, 12.56 +/- 2.19 micros) in orbicularis oculi. The mean MCD of individual muscle potentials (MPs) was 14.6 +/- 6.8 micros in frontalis and 12.68 +/- 6.10 micros in orbicularis oculi. In the OM patients, the mean MCD was 43.85 +/- 25.18 micros in the frontalis and 69.85 +/- 29.55 micros in orbicularis oculi (P < 0.0001), and the number of MPs with altered MCD was 7.15 +/- 4.66 (range, 1-18) and 12.65 +/- 4.90 (range, 6-21), respectively (P < 0.0001). We conclude that stimulated SFEMG of the orbicularis oculi muscle is more sensitive for the diagnosis of OM than of the frontalis muscle.

Characterization of calcium phosphate coatings deposited by Nd:YAG laser ablation at 355 nm: influence of thickness.

Calcium phosphate coatings were deposited by pulsed laser ablation with a radiation of 355 nm from a Nd:YAG laser. All the coatings were obtained at the same conditions, but deposition was stopped after different number of pulses to get coatings with different thickness. The influence of thickness in the structural and mechanical properties of the coatings was investigated. Coatings structure was characterised by scanning electron microscopy, grazing incidence X-ray diffractometry and Raman spectroscopy. The mechanical properties were evaluated by scratch test. The morphology of the coatings is dominated by the presence of droplets. The coatings are composed mainly of hydroxyapatite, alpha tricalcium phosphate and amorphous calcium phosphate. Thinner coatings withstand higher loads of failure in the scratch test.

Pulsed laser deposition of pseudowollastonite coatings.

Pseudowollastonite (alpha-CaSiO3) is a bioactive ceramic material that induces direct bone growth. A process to obtain pseudowollastonite coatings that may be applied to implants is described and evaluated in this work. The coatings were first deposited on titanium alloy by laser ablation with a pulsed Nd:YAG laser tripled in frequency. After deposition, they were submitted to a soft laser treatment with a continuous wave Nd:YAG infrared laser. Coatings were characterised by X-ray diffractometry, Raman spectroscopy, scanning electron microscopy and energy dispersive spectroscopy before and after the laser treatment. As-deposited coatings are composed of pseudowollastonite and amorphous material. They have a porous structure of gathered grains and poor cohesion. After the laser treatment the coatings crystallinity and cohesion are improved. The laser treatment also makes the coatings dense and well adhered to the substrate. Therefore, this two-step process has been demonstrated as a valuable method to coat titanium implants with pseudowollastonite.