Effective production of multifunctional magnetic-sensitive biomaterial by an extrusion-based additive manufacturing technique.

A calcium phosphate (CaP)-based scaffold used as synthetic bone grafts, which smartly combines precise dimensions, controlled porosity and therapeutic functions, presents benefits beyond those offered by conventional practices, although its fabrication is still a challenge. The sintering step normally required to improve the strength of the ceramic scaffolds precludes the addition of any biomolecules or functional particles before this stage. This study presents a proof of concept of multifunctional CaP-based scaffolds, fabricated by additive manufacturing from an innovative ink composition, with potential for bone regeneration, cancer treatment by local magnetic hyperthermia and drug delivery platforms. Highly loaded inks comprising iron-doped hydroxyapatite and ß-tricalcium phosphate powders suspended in a chitosan-based solution, in the presence of levofloxacin (LEV) as model drug and magnetic nanoparticles (MNP), were developed. The sintering step was removed from the production process, and the integrity of the printed scaffolds was assured by the polymerization capacity of the ink composite, using genipin as a crosslinking agent. The effects of MNP and LEV on the inks' rheological properties, as well as on the mechanical and structural behaviour of non-doped and iron-doped scaffolds, were evaluated. Magnetic and magneto-thermal response, drug delivery and biological performance, such as cell proliferation in the absence and presence of an applied magnetic field, were also assessed. The addition of a constant amount of MNP in the iron-doped and non-doped CaP-based inks enhances their magnetic response and induction heating, with these effects more pronounced for the iron-doped CaP-based ink. These results suggest a synergistic effect between the iron-doped CaP-based powders and the MNP due to ferro/ferrimagnetic interactions. Furthermore, the iron presence enhances human mesenchymal stem cell metabolic activity and proliferation.

Evaluación de la columna lumbar posquirúrgica / Evaluation of the postoperative lumbar spine

Dada la gran prevalencia del dolor lumbar, la cirugía de columna es una intervención cada vez más frecuente. Existen múltiples procedimientos quirúrgicos disponibles, de los que la laminectomía y discectomía son las intervenciones más frecuentes. En un 10-40% de los pacientes intervenidos, el dolor lumbar que ocasionó la intervención puede recurrir o no solucionarse completamente, lo que se incluye dentro del síndrome de cirugía fallida de columna. Hay múltiples causas que pueden ocasionar este síndrome, aunque frecuentemente es de etiología multifactorial y no deben confundirse con los hallazgos normales en columnas postoperadas. La decisión de la técnica de imagen a realizar dependerá del tipo de cirugía, la utilización de material ortopédico metálico y la sospecha clínica. El conocimiento de las ventajas y limitaciones de las distintas técnicas de imagen disponibles es esencial para la óptima valoración de estos pacientes, especialmente tras cirugía con instrumentación donde serán necesarios ajustes técnicos para minimizar el artefacto producido por estos materiales (AU)

Given the prevalence of low back pain, surgical interventions on the lumbar spine are becoming more common. Among the many surgical procedures available for these interventions, the most common are laminectomy and discectomy. In 10 to 40% of patients who undergo surgical interventions on the lumbar spine, low back pain is not completely alleviated or it recurs, and these cases fall into the category of «failed back surgery syndrome». This syndrome can have many different causes and multiple factors are often involved. It is important not to confuse the normal postoperative findings with those specific to failed back surgery syndrome. Deciding which imaging technique to use will depend on the type of surgical intervention, whether metallic orthopedic material was used, and the clinical suspicion. It is essential to know the advantages and limitations of the available imaging techniques to ensure the optimal evaluation of these patients, especially after interventions carried out with instrumentation to minimize the artifacts due to these materia (AU)

Evaluation of the postoperative lumbar spine.

Given the prevalence of low back pain, surgical interventions on the lumbar spine are becoming more common. Among the many surgical procedures available for these interventions, the most common are laminectomy and discectomy. In 10 to 40% of patients who undergo surgical interventions on the lumbar spine, low back pain is not completely alleviated or it recurs, and these cases fall into the category of « failed back surgery syndrome ¼. This syndrome can have many different causes and multiple factors are often involved. It is important not to confuse the normal postoperative findings with those specific to failed back surgery syndrome. Deciding which imaging technique to use will depend on the type of surgical intervention, whether metallic orthopedic material was used, and the clinical suspicion. It is essential to know the advantages and limitations of the available imaging techniques to ensure the optimal evaluation of these patients, especially after interventions carried out with instrumentation to minimize the artifacts due to these materials.

Factores que inciden en la infección de una herida quirúrgica: estudio de 423 casos / Incidence factors in surgical wound infection: study of 423 cases

Se realiza un estudio descriptivo de la frecuencia de infección de la herida quirúrgica en 423 operados en un servicio de cirugía general, en el período de un año, para un porcentaje de infección del 10,2 porciento. Las tiroidectomías presentaron los más bajos índices de infección entre las operaciones limpias, y las gastrectomías entre las limpias-contaminadas. Entre las intervenciones quirúrgicas codificadas como sucias, las apendicitis superadas presentaron más elevados porcentajes que las úlceras perforadas. La incidencia de infección fue mayor mientras más prolongado fue el tiempo operatorio. El 62,8 por ciento de las infecciones se detectó antes del 7mo día posoperatorio. Los gérmenes gramnegativos fueron más frecuentes en los cultivos bacterianos de las heridas, que el S. aureus (AU)

[Phantom tumor (author's transl)]. / Tumor fantasma.

Phantom tumors are accumulations of pleural effusion in the interlobular spaces of the lungs. They appear in patients with heart failure simulating a lung tumor but disappearing with medical treatment. The encystment of the fluid is apparently due to congenital defects in the pleura, which tends to store up the transudate produced by heart failure. Another pathogenetic possibility is the existence of pleural adherences. The most common localization is in the minor cissure, perhaps because it is more easily identified in the posterior view of the chest X-ray. In most of these cases the pleural effusion is due to left heart failure, though pleural effusion in normally associated with right congestive heart failure. On the posterior chest X-ray the fluid is observed as a round or fusiform mass. Differential diagnosis should be established for measotheliomas, pulmonary infarctions, pulmonary or metastatic tumoral nodules, hydatic cysts, and tuberculomas. Sixteen cases of phantom tumors are reported; nine of them were localized on the minor cissure, five on the right major cissure, one on the left major cissure, and one case of double localization on the left major cissure and minor cissure. All of them were due to left congestive heart failure.

Plan de prevención para accidentes intrahospitalarios

Todo hospital debe prepararse adecuadamente para afrontar los accidentes que por su actividad pudieran presentarse, en bien de su personal, pacientes y visitantes. Este trabajo presenta un plan de prevención para cumplir con esta premisa. Un comite multidisciplinario de seguridad se ocupará de diseñar un Plan de Prevención General de Accidentes, plan que integrará el Plan Hospitalario para Casos de Desastre e incluirá uno de Educación Continua del Personal y otro de Supervivencia

Bases para la preparación de un plan hospitalario

Todo hospital debe estar en todo momento preparado para aceptar y desempeñar su rol en los desastres comunitarios. Es imprescindible disponer de un plan preestablecido, realizable y actualizado. Los objetivos del plan deben apuntar a preparar al personal y los recursos institucionales para un rendimiento óptimo, informar a la comunidad sobre la importancia del plan, ejecución y beneficios que aporta y lograr medidas de seguridad para el caso de accidente interno de la institución