Osteonal Damage Patterns from Ballistic and Blunt Force Trauma in Human Long Bones.

Forensic anthropologists play a key role in skeletal trauma analysis and commonly use macroscopic features to distinguish between trauma types. However, this approach can be challenging, particularly in cases of highly comminuted or incompletely recovered fractures. Histological analysis of microscopic fracture characteristics in fractured bones may thus help provide additional information on trauma type and bone fracture biomechanics in general. This study analysed the extent of microcrack damage to osteons in long bones with blunt force trauma (BFT) and gunshot trauma (GST), from both traumatic death cases and post-mortem experimental fractures. We identified four types of osteonal damage (OD). In traumatic death cases, OD affecting the inside of the osteon and compromising the Haversian canal (type 1) was found to be indicative of BFT. Moreover, OD affecting the cement line (type 3) and interstitial lamellae (type 4) was more common in the GST samples. OD affecting the inside of the osteon without compromising the Haversian canal (type 2) was not found to be indicative of either trauma type. In cases of experimental fractures, our study revealed that post-mortem fractures in dry bone samples featured the highest amount of OD, particularly of type 4. This study also found that the experimentally produced GST featured similar OD patterns to GST death cases. These findings support our hypothesis that there are distinct osteonal damage patterns in human long bones with BFT and GST, which are of relevant value for trauma analysis in forensic anthropology.

Retirada del deporte de élite: Una revisión sistemática de estudios cualitativos / Elite sport retirement: A systematic review of qualitative studies

En este trabajo se ha llevado a cabo una revisión sistemática de estudios cualitativos (RSEC) sobre la retirada del deporte de élite (RDE), con el objetivo de sintetizar los factores de protección propuestos para afrontar con éxito dicha transición. La RSEC se ha realizado utilizando la herramienta CHIP (i.e., Context, How, Issues y Population). Después de leer los títulos y resúmenes, se seleccionaron y examinaron en profundidad 44 publicaciones en inglés, español y portugués obtenidas mediante la búsqueda en bases de datos. Siguiendo el método PRISMA, se registró el proceso de toma de decisiones que nos permitió obtener las publicaciones más relevantes para el análisis en profundidad de esta RSEC. Como resultado, se seleccionaron 30 estudios cualitativos, 27 de ellos en inglés, dos en español y uno en portugués. En general, los resultados de los estudios muestran las experiencias de retirada de ex deportistas olímpicos y de élite, así como la influencia que una carrera dual ejerce en este proceso de transición. La mayoría de los estudios seleccionados coinciden en que la conceptualización de la retirada como un proceso en lugar de como un evento y tener prioridades complementarias como los estudios y/o el trabajo son factores de protección en la RDE (AU)

In this work, we conducted a systematic review of qualitative studies (SRQS) on retirement from elite sport (RES), in order to summarize protective factors to successfully cope with that transition. The SRQS has been developed following the CHIP tool (i.e., Context, How, Issues and Population). The first selection of articles was obtained from the search in databases. After reviewing titles and abstracts, 44 publications in English, Spanish and Portuguese were selected and examined in depth. They were. Following the PRISMA methodology, we registered the decision-making process that allowed us to obtain the most relevant publications for the in-depth analysis for the SRQS. We selected 30 qualitative studies, 27 of them in English, two in Spanish and one in Portuguese. Results of those studies show the retirement experiences of Olympic and elite athletes, as well as the influence of a dual career over this transition process. Most of the selected studies consider retirement as a process instead of as an event. They also concur that having complementary priorities, such as studies or work, are protective factors in RES (AU)

Diagnóstico prenatal en la provincia de Girona en el período 1999-2009 / Prenatal diagnosis in the Girona area in the period 1999-2009

Objetivo. El objetivo de este trabajo es dar una visión global del uso y evolución del diagnóstico citogenético prenatal en la provincia de Girona en el período 1999-2009 y relacionar el diagnóstico citogenético con el cribado prenatal de aneuploidías. A partir de los datos recogidos se obtuvieron diversos indicadores presentados básicamente en forma de gráficos y tablas descriptivas. Resultados. Los resultados obtenidos indican lo siguiente: el uso del diagnóstico citogenético prenatal y posnatal aumentó a través del tiempo. El cribado prenatal de aneuploidías de procedencia pública en el período 1999-2009 mostró una tendencia creciente hasta el año 2005 y decreciente hasta el año 2009, cuando volvió a aumentar ligeramente. En pacientes del PASSIR Gironès-Pla de l’Estany la detección de la trisomía 21 fue del 88,9% en el cribado del primer trimestre y del 45% en el del segundo trimestre. La tasa media de detección de los cariotipos prenatales anómalos fue del 1,4% sin una tendencia temporal clara. Conclusiones. Las conclusiones principales son: - Se constata un aumento del uso del diagnóstico citogenético en el período 1999-2009. - La casuística de anomalías cromosómicas coincide con la bibliografía. - La sustitución del cribado del segundo trimestre por el del primer trimestre ha supuesto un incremento importante en la detección de aneuploidías. -La contribución de las pruebas de cribado prenatal es importante(AU)

Objective. The main goal of this research is to give a broad view of the use and evolution of prenatal cytogenetic diagnosis in Girona province between 1999 and 2009 and linking prenatal cytogenetic diagnosis with aneuploidy prenatal screening. The information collected allowed several indicators to be extracted, primarily presented as descriptive tables and charts. Results. The results show as follows: The use of prenatal and postnatal cytogenetic diagnosis increased in the mentioned period. The evolution of demand for aneuploidy prenatal screening in public health services during 1999-2009 showed an upward trend until 2005. From then on, it varied following a downward path until 2009, when it had a slight increase. Among PASSIR Gironès-Pla de l’Estany patients, detection of trisomy 21 through first-trimester screening was 88.9%, and through second-trimester screening was 45%. The average detection rate of abnormal prenatal karyotyping was 1.4%, with no clear trend in the above mentioned period. Conclusions. The main conclusions of this work are the following: - A rise in the use of cytogenetic diagnosis has been detected in Girona province between 1999 and 2009. - Case studies of chromosome abnormalities match the literature consulted. - Moving from second-trimester to first-trimester screening has meant a significant increase in aneuploidy detections. - Prenatal cytogenetic diagnosis is seen as an interdisciplinary field in which the extent of prenatal screening tests is crucial(AU)

[Five years' experience in a paediatric epilepsy unit]. / Experiencia de cinco años en una unidad de epilepsia pediátrica.

INTRODUCTION AND AIMS: The epilepsy monitoring unit is a space inside a hospital, which objective is to reproduce epileptic seizures in order to better study of an epileptic patient. We have analysed data from all the patients admitted to our pediatric epilepsy unit in the last 5 years. PATIENTS AND METHODS: 191 patients have been admitted in our unit, and we have obtained seizures in 186 admissions (monitoring efficacy, 85.9%). In this report we summarize characteristics of these children, type of seizures and treatment. RESULTS: The most frequent cause of epilepsy in our series is cortical development malformation. Patients are often late in their admission, with a median time of 3 to 4 years from epileptic onset to admission in the epilepsy unit. After the study, 22 patients underwent functional epilepsy surgery, all of them with excellent results, 9 patients underwent vagal nerve stimulator implantation and in 66 patients their previous pharmacological treatment was modified. CONCLUSIONS: The efficacy of our monitoring unit is similar to previously published, 85.9%. After the admission, we have changed diagnose in 57% of the patients and pharmacological treatment in 29%. We recommend the study in a monitoring epilepsy unit of every patient with refractory epilepsy, meaning an epilepsy that does not respond to 2-3 different appropriate treatments.

Scoliosis intensive out-patient rehabilitation based on Schroth method.

Conservative management of idiopathic scoliosis (IS) and other spinal deformities is a real alternative to surgical treatment. Most of adolescent with IS can be managed conservatively with high safety. Many infantile and juvenile cases show also a good immediate response to conservative care, which can be considered a sign of good prognosis. Only patients showing a continue deterioration even treated conservatively with efficient techniques should be considered candidates to surgical correction and stabilization. Rehabilitation (including specific exercises) and bracing are usually involved in conservative care of IS. In this paper we describe our personal approach in conservative scoliosis care regarding rehabilitation. Bracing has been described in a different paper also published in the present book. Specific exercises can change the signs and symptoms in scoliosis patients. Specialists in physiotherapy for spinal deformities teach the patient how to perform a routine of 'curve pattern' specific exercises with the purpose to facilitate the correction of the asymmetric posture and to teach the patient to maintain the corrected posture in daily activities. Principles of correction are based on those developed by the German physiotherapist K. Schroth.

Carcinoide atípico de aritenoides. A propósito de un caso / Atypical carcinoid of the larynx. About a case

Los tumores malignos de laringe más frecuentes son los carcinomas escamosos. Los tumores carcinoides suelen crecer en el intestino, el hígado y bronquios pulmonares. La afectación de la laringe es muy infrecuente. Los tumores neuroendocrinos de laringe fueron descritos por vez primera como entidad clínica por Goldman, et al. en 1969. Desde entonces se han publicado 538 casos en la literatura inglesa. La clínica y pronóstico varía en función del tipo de tumor. Presentamos un nuevo caso de carcinoide atípico de aritenoides. Hemos revisado los métodos diagnósticos, el tratamiento y pronóstico de estos tumores poco frecuentes (AU)