Ge-Sb-S-Se-Te amorphous chalcogenide thin films towards on-chip nonlinear photonic devices.

Thanks to their unique optical properties Ge-Sb-S-Se-Te amorphous chalcogenide materials and compounds offer tremendous opportunities of applications, in particular in near and mid-infrared range. This spectral range is for instance of high interest for photonics or optical sensors. Using co-sputtering technique of chalcogenide compound targets in a 200 mm industrial deposition tool, we show how by modifying the amorphous structure of GeSbwSxSeyTez chalcogenide thin films one can significantly tailor their linear and nonlinear optical properties. Modelling of spectroscopic ellipsometry data collected on the as-deposited chalcogenide thin films is used to evaluate their linear and nonlinear properties. Moreover, Raman and Fourier-transform infrared spectroscopies permitted to get a description of their amorphous structure. For the purpose of applications, their thermal stability upon annealing is also evaluated. We demonstrate that depending on the GeSbwSxSeyTez film composition a trade-off between a high transparency in near- or mid-infrared ranges, strong nonlinearity and good thermal stability can be found in order to use such materials for applications compatible with the standard CMOS integration processes of microelectronics and photonics.

Resultados en el tratamiento quirúrgico de hernia discal lumbar, reporte a siete años de seguimiento / Results in the surgical treatment of lumbar disc hernia, report of seven years follow up

Resumen: Introducción: La lumbalgia por hernia discal es provocada por el movimiento anormal intersomático, considerándose éste como factor etiológico de hernia discal, que en ocasiones es la indicación quirúrgica. Material y métodos: Con un diseño de estudio prospectivo, descriptivo, observacional y longitudinal en un período de Enero de 2000 a Diciembre de 2006. Muestra inicial de 195 pacientes, con 20 pacientes con criterios de inclusión a los siete años de seguimiento. Se tomaron en cuenta variables demográficas, dependientes e independientes. Se realizó análisis estadístico descriptivo comparando preoperatorio con la evolución a siete años. Resultados: Se englobaron los resultados en dos procedimientos: estabilización dinámica interespinosa y artroplastía, con 10 pacientes por cada procedimiento. Mediante la prueba de T y χ2 se observó significancia estadística al comparar los resultados de dolor y escala de Oswestry con parámetros de imagenología según Pfirrmann prequirúrgicos contra seguimiento final en los pacientes sometidos a estabilización dinámica. Para el grupo de artroplastía fue estadísticamente significativa la comparación de resultados de dolor con EVA (escala visual análoga) y función con escala de Oswestry, con una p < 0.05. Conclusión: Con este trabajo comprobamos que hubo significancia estadística al comparar los resultados clínicos de ambos procedimientos, observamos un porcentaje mínimo de complicaciones en los pacientes a quienes se les realizó estabilización dinámica en comparación con la artroplastía; por lo tanto, sugerimos realizar esta última sólo en casos en los que se reúnan adecuadamente todos los criterios para que los resultados clínicos y funcionales sean iguales a los esperados.

Abstract: Introduction: Low back pain by herniated disc is caused by abnormal intersomatic movement, considering this as an etiological factor of disc herniation and the surgical indication. Material and methods: A prospective, descriptive, observational, longitudinal study design, in a period from January 2000 to December 2006. Initial sample of 195 patients, with inclusion criteria in 20 patients at seven years follow up. Demographic, dependent and independent variables were taken into account. Descriptive statistical analysis was conducted comparing preoperative with evolution to seven years. Results: Two groups were compared: dynamic interspinous stabilization and lumbar arthroplasty, with 10 patients for each procedure. Using T and χ2 test, statistical significance was observed when comparing the results of pain and Oswestry scale with parameters of imaging according to Pfirrmann pre surgical against final follow-up in patients undergoing dynamic stabilization. And for Arthroplasty was statistically meaningful comparison of results of pain with VAS (visual analogue scale) and function with Oswestry scale, with a p < 0.05. Conclusion: With this work we can see that there was statistical significance to compare clinical outcomes of both procedures, observing a minimum percentage of complications in patients who underwent dynamic stabilization compared with arthroplasty; therefore we suggest to perform the latter only in cases in all criteria, to meet adequately to be equal to the anticipated clinical and functional outcomes.

Prevalence and Factors Associated With Fatigue in Patients With Inflammatory Bowel Disease: A Multicentre Study.

BACKGROUND AND AIMS: The aims of this study were to determine the prevalence of fatigue in patients with inflammatory bowel disease [IBD], to identify the factors associated with fatigue and its severity, to assess the impact of fatigue on quality of life [QoL], and to evaluate the relationship between fatigue and sleep disorders. METHODS: This was a prospective multicentre study conducted at 22 Spanish centres. Consecutive patients followed at IBD Units were included. Fatigue was evaluated with the Fatigue Severity Scale [FSS] and the Fatigue Impact Scale [FIS]. Quality of life and sleep quality were assessed using the IBD Questionnaire-Short Form [IBDQ-9] and the Pittsburgh Sleep Quality Index [PSQI], respectively. RESULTS: A total of 544 consecutive adult IBD patients were included [50% women, mean age 44 years, 61% Crohn's disease]. The prevalence of fatigue was 41% (95% confidence interval [CI] = 37-45%). The variables associated with an increased risk of fatigue were: anxiety [OR = 2.5, 95% CI = 1.6-3.7], depression [OR = 2.4, 95% CI = 1.4-3.8], presence of extraintestinal manifestations [EIMs] [OR = 1.7, 95% CI = 1.1-2.6], and treatment with systemic steroids [OR = 2.8, 95% CI = 1.4-5.7]. The presence of EIMs [regression coefficient, RC = 8.2, 95% CI = 2.3-14.2], anxiety [RC = 25.8, 95% CI = 20.0-31.5], depression [RC = 30.6, 95% CI = 24.3-37.0], and sleep disturbances [RC = 15.0, 95% CI = 9.3-20.8] were associated with severity of fatigue. Patients with fatigue had a significantly decreased IBDQ-9 score [p < 0.001]. CONCLUSIONS: The prevalence of fatigue in IBD patients is remarkably high and has a negative impact on QoL. Therapy with systemic steroids is associated with an increased risk of fatigue. The severity of fatigue is associated with anxiety, depression, sleep disorders, and the presence of EIMs. Fatigue was not associated with anaemia, disease activity or anti-TNF therapy.

[Results in the surgical treatment of lumbar disc hernia, report of seven years follow up]. / Resultados en el tratamiento quirúrgico de hernia discal lumbar, reporte a siete años de seguimiento.

INTRODUCTION: Low back pain by herniated disc is caused by abnormal intersomatic movement, considering this as an etiological factor of disc herniation and the surgical indication. MATERIAL AND METHODS: A prospective, descriptive, observational, longitudinal study design, in a period from January 2000 to December 2006. Initial sample of 195 patients, with inclusion criteria in 20 patients at seven years follow up. Demographic, dependent and independent variables were taken into account. Descriptive statistical analysis was conducted comparing preoperative with evolution to seven years. RESULTS: Two groups were compared: dynamic interspinous stabilization and lumbar arthroplasty, with 10 patients for each procedure. Using T and 2 test, statistical significance was observed when comparing the results of pain and Oswestry scale with parameters of imaging according to Pfirrmann pre surgical against final follow-up in patients undergoing dynamic stabilization. And for Arthroplasty was statistically meaningful comparison of results of pain with VAS (visual analogue scale) and function with Oswestry scale, with a p 0.05. CONCLUSION: With this work we can see that there was statistical significance to compare clinical outcomes of both procedures, observing a minimum percentage of complications in patients who underwent dynamic stabilization compared with arthroplasty; therefore we suggest to perform the latter only in cases in all criteria, to meet adequately to be equal to the anticipated clinical and functional outcomes.

INTRODUCCIÓN: La lumbalgia por hernia discal es provocada por el movimiento anormal intersomático, considerándose éste como factor etiológico de hernia discal, que en ocasiones es la indicación quirúrgica. MATERIAL Y MÉTODOS: Con un diseño de estudio prospectivo, descriptivo, observacional y longitudinal en un período de Enero de 2000 a Diciembre de 2006. Muestra inicial de 195 pacientes, con 20 pacientes con criterios de inclusión a los siete años de seguimiento. Se tomaron en cuenta variables demográficas, dependientes e independientes. Se realizó análisis estadístico descriptivo comparando preoperatorio con la evolución a siete años. RESULTADOS: Se englobaron los resultados en dos procedimientos: estabilización dinámica interespinosa y artroplastía, con 10 pacientes por cada procedimiento. Mediante la prueba de T y 2 se observó significancia estadística al comparar los resultados de dolor y escala de Oswestry con parámetros de imagenología según Pfirrmann prequirúrgicos contra seguimiento final en los pacientes sometidos a estabilización dinámica. Para el grupo de artroplastía fue estadísticamente significativa la comparación de resultados de dolor con EVA (escala visual análoga) y función con escala de Oswestry, con una p 0.05. CONCLUSIÓN: Con este trabajo comprobamos que hubo significancia estadística al comparar los resultados clínicos de ambos procedimientos, observamos un porcentaje mínimo de complicaciones en los pacientes a quienes se les realizó estabilización dinámica en comparación con la artroplastía; por lo tanto, sugerimos realizar esta última sólo en casos en los que se reúnan adecuadamente todos los criterios para que los resultados clínicos y funcionales sean iguales a los esperados.

Epidemiological and radiological profile of patients with degenerative scoliosis: 20 year experience at a referral institute.

BACKGROUND: Adult degenerative scoliosis is a complex three-dimensional rotational deformity, in a previously straight spine, resulting in sagittal and axial disbalance. MATERIAL AND METHODS: This retrospective study presents the casuistry of patients 40 to 80 years old with adult degenerative scoliosis who underwent surgery in a referral institute from January 1994 to December 2013. RESULTS: The prevalence was 0.087% (CI 95% 67.8-111), with a median age of 64.9 ± 9.4 years old, increased frequency in women and older adults. The prevalence of spondylolisthesis associated with degenerative scoliosis was 21%. The estimated risk for scoliosis in women was OR = 2.37 (CI 95% 1.35-4.15), while men showed OR = 0.4 (CI95% 0.24-0.73). The risk for spondylolisthesis associated to degenerative scoliosis was in men OR = 1.87. CONCLUSIONS: The prevalence in our experience is low and the sample age was higher; while gender, severity of the curve and presence of spondylolisthesis and olistesis were similar to the reviewed literature.

ANTECEDENTES: La escoliosis degenerativa del adulto es una deformidad rotacional tridimensional compleja, en una columna recta previamente, dando por resultado desequilibrio sagital y axial. MATERIAL Y MÉTODOS: Este estudio retrospectivo presenta la casuística de los pacientes de 40 a 80 años de edad con escoliosis degenerativa del adulto que experimentaron la cirugía en un instituto de referencia desde enero de 1994 a diciembre de 2013. RESULTADOS: La prevalencia fue de 0.087% (IC 95% 67.8-111), con una edad media de 64.9 ± 9.4 años, mayor frecuencia en mujeres y adultos mayores. La prevalencia de la espondilolistesis asociada a escoliosis degenerativa fue de 21%. El riesgo estimado para la escoliosis en las mujeres fue = 2.37 (IC 95% 1.35-4.15), mientras que los hombres mostraron OR = 0.4 (IC95% 0.24-0.73). El riesgo de espondilolistesis asociada a escoliosis degenerativa fue en hombres OR = 1.87. CONCLUSIONES: La prevalencia en nuestra experiencia es baja y la edad de la muestra fue mayor; mientras que el género, la gravedad de la curva y la presencia de espondilolistesis y olistesis eran similares a la literatura consultada.

[Degenerative adult scoliosis]. / Escoliosis degenerativa del adulto.

Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.

[Use of ischemia in total knee arthroplasty. Is there a difference?]. / Uso de isquemia en la artroplastía total de rodilla. ¿Existe diferencia?

In Mexico, aging has become the daily routine of millions. Total Knee Arthroplasty is a procedure that is doing more and more with satisfactory results and survival of the implant up to 20 years in 90%. The tourniquet is a useful tool to the orthopedic surgeons to minimize blood loss and make the placement of implants easier, because it enhances the vision of the surgical field. We report the results of 75 total knee arthroplasties performed in January 2007 to January 2010, in terms of bleeding, duration of procedure and Haemoglobin levels with and without tourniquet, the patients were distributed in 3 different groups, In group 1 the tourniquet was kept inflated until the placement of the femoral and tibial components, in group 2 the tourniquet was kept inflated until the wound dressing and finally in group 3 we did not use tourniquet. We performed hematic biometry 24 hours after surgery and if the patient's hemoglobin was less than 9.0 g/dl or the patient had low cardiac output symptoms, regardless of hemoglobin level, blood transfusion was indicated. The results demonstrate that there significant differences between the amount of blood loss among the 3 groups (1:1.157 ml, 2:709 ml, 3:1.493 ml) and surgical time (1:100, 2:110, 3:135). So that demonstrates that tourniquet use has a direct relation to blood loss and surgical time.

[Surgical treatment of carpal tunnel syndrome and its correlation with preoperative nerve conduction tests]. / El tratamiento quirúrgico del síndrome del túnel del carpo y su correlación con estudios prequirúrgicos de conducción nerviosa.

INTRODUCTION: Carpal tunnel syndrome is the most prevalent compressive neuropathy and its medical costs in the United States exceed one billion dollars per year. Occurrence increases with age; prevalence is 0.6% in males and as much as 5.8% in females, in ages between 45 and 54 years. Besides a thorough case history, there are other more reliable diagnostic methods such as electrophysiological tests that include electromyography and conduction velocity tests. MATERIAL AND METHODS: A prospective, longitudinal analysis was conducted of patients with a diagnosis of Carpal tunnel syndrome confirmed with electromyography and evoked potentials. They were treated at Hospital Español de México in 2008-2009. RESULTS: Forty-seven patients were detected, representing 60 cases of carpal tunnel syndrome; 36 females, 11 males. In forty-seven percent of patients the right hand was involved; in 15% the left hand; 38% of patients had bilateral involvement. They underwent medical treatment and the results of the electrodiagnostic tests were good (61%), moderate (33%), and poor (6%). DISCUSSION: Isolated electromyography does not measure the true magnitude of the damage; however, motor conduction velocity becomes a relevant diagnostic method as it detects almost 50% of the patients at the time diagnosis. Patients with motor abnormalities had very favorable postoperative results compared to those with sensory abnormalities.

[Infection prevention during the perioperative period of primary hip and knee arthroplasty]. / Prevención de infecciones en el perioperatorio de la artroplastía primaria de cadera y rodilla.

All surgical wounds are at risk of contamination by pathogens that may get in through the incision. The pre-surgical bath with a skin antiseptic agent 24 hours prior to the surgery, the timing of administration of prophylactic antibiotics, the choice and postoperative duration of the latter, the number of individuals within the OR and the movement inside it, the choice of chlorhexidine gluconate for its long duration against gram-positive and gram-negative organisms, and the use of a hair remover or an electric razor, all of the former concepts, some new and others not so new, led to performing an extensive bibliographic review with the idea of starting a standardization process that could change the way in which institutions operate when performing primary joint replacement, trying to reduce the annual infection rate and upgrade the quality of life of patients.

[Periprosthetic femur fractures. Experience at hospital Español de México with a 2-year follow-up]. / Fracturas periprotésicas del fémur. Experiencia en el hospital Español de México a 2 años de seguimiento.

UNLABELLED: Periprosthetic fractures have had an increasing incidence in the past decades; their resolution is a difficult challenge even for the most experienced orthopedist surgeons. The Vancouver classification has contributed to a great extent to their better characterization and therapeutic guidance. The purpose of this paper is to make a review of the most recent advances on the topic and present our experience in the treatment of these fractures. MATERIAL AND METHODS: We describe the characteristics of a sample of 20 patients with periprosthetic femur fractures treated at our hospital from March 2008 to March 2010 and typed according to the Vancouver classification. RESULTS: Mean age was 74.5 years with a range of 65-87 years. Females were predominant (70%). Five cases were type A in the classification, 10 cases type B, and 5 cases type C. Nineteen underwent surgical treatment. The mean total length of stay was 7 days, with a range of 5-12. The mean healing time for types B and C was 4 months (range 3-6 months). Four patients had complications. The resolution was assessed as excellent in 5 cases (25%), good in 11 cases (55%), and poor in 4 cases (20%). CONCLUSIONS: A thorough individual assessment based on the Vancouver classification, age and the patient's functional requirements are the major parameters for treatment success.

Painful tongue lesions associated with a food allergy.

Transient lingual papillitis is an inflammatory disease of the tongue that can be very symptomatic in children. This case report describes the clinical features of transient lingual papillitis in a 7-year-old boy that was associated with a food allergy. The potential causes of this condition are reviewed and a differential diagnosis is provided.

[Prevalence of anemia in women attending family planning clinic in Durango (author's transl)]. / La prevalencia de anemia en mujeres asistentes a servicios de planificación familiar en la Ciudad de Durango.

PIP: This study investigates the prevalence of anemia in a group of 500 women requesting contraception for the first time at the Health Center in Durango, Mexico. 92% of women were between 15-34, with the majority in the age group 20-24; most had parity 1-4. The average hemoglobin level was 13.04 g/dl, with SE of 0.08. There were 70 anemic women with hemoglobin level below 12 g/dl, which gave a percentage of 14%. 90% of anemic women presented iron deficiency. 16.8% of the total number of women were within the 1st 6 weeks postpartum or postabortion; of these 32% were anemic. Of the 82.4% of women beyond this period of time only 10.4% were anemic. There was no increase in the prevalence of anemia in women with higher parity; among the 174 obese women the percentage of anemia was 86%. The relatively high prevalence of anemia in women seeking contraception compels the doctor to consider very seriously the type of contraception to be prescribed. In Mexico there is an important difference in the geographic distribution of anemia, which seems to be most common in the province of Yucatan, and which is probably caused by alimentary iron deficiency.^ieng

45,X/46,X,dic(Yq) mosaicism and mixed gonadal dysgenesis. Case report and review of the literature.

A 4 year 7 month-old boy with ambiguous genitalia, histological evidence of mixed gonadal dysgenesis, and 45,X/46,X,dic(Yq) mosaicism is reported. The identity of the dicentric Y chromosome was stablished by its typical fluorescent banding patterns and the presence of two centromeres demonstrated by C-band technique. A review of the literature yielded nine additional cases of mosaic 45,X/46,X,dic(Yq). Phenotypical and histological findings among these cases were compared, and the possible localization of the genes responsible for testicle induction and maturation is discussed.

[Teratoma of the thyroid gland in children]. / Teratoma del tiroides en el nino

Two cases of teratoma of the thyroid gland occurring in children are presented. Both tumors were discovered shortly after birth and were not associated with clinical hypothyroidism. One of the patients was thoroughly studied from the endocrinological point of view utilizing several techniques. There was some iodine uptake by the gland, formation of tirosine and thyroid hormones as well as their release into the blood serum. The clinical and pathological features of teratoma of the thyroid are discussed.