[Use of metaphyseal stems «Proxima¼ DePuy: our experience to more than five years]. / Utilización de los vástagos metafisarios «Próxima¼ DePuy: nuestra experiencia a más de cinco años.

The total hip arthroplasty with short stems to preserve bone is a good choice in young patients that expected future revision surgery, it is also a good choice when we use approaches for minimal invasive surgeries. In this study, we have evaluated, clinically and radiologically, our experience in total hip arthroplasty with the use of short stems and metaphyseal anchorage. In total we have involved 23 patients with a mean age of 50.2 years (range 45 to 69 y/o) at the time of surgery. The median follow-up was greater than five years. There was a slight Varus femoral stem in three cases, one of them in severe varus. The latter presented continuous pain in the lateral aspect of the thigh that increased with time, with a diaphyseal reaction and an increase in radiolucencies around the stem that required revision surgery 12 months postoperative. A longer follow-up is required to analyze the results and confirm the durability of the observed clinical findings. Patients were evaluated radiological and clinically using the scale of Merle dAubigné (MD).

La artroplastía total de cadera con los vástagos cortos encaminada a preservar el hueso es una buena opción en pacientes jóvenes a quienes se les prevé futuras cirugías de revisión. También es una buena elección cuando se utilizan cirugías con abordajes miniinvasivos. En este estudio clínico y radiológico hemos evaluado nuestra experiencia en el uso de artroplastía total de cadera con vástagos cortos de anclaje metafisario tipo DePuy Próxima. En total se han intervenido 23 pacientes con una edad media de 50.2 años (rango de 45 a 69 años) en el momento de la cirugía. El seguimiento medio fue de más de cinco años. Hubo un ligero varo del tallo femoral en tres casos, uno de ellos en varo severo. Este último caso presentó dolor continuo en las caras laterales del muslo que aumentó con el tiempo junto con una reacción diafisaria y un aumento en el tallo que requirió cirugía de revisión a los 12 meses postoperatorios. Se requiere un seguimiento más prolongado para analizar los resultados y confirmar la durabilidad de los resultados clínicos observados. Los pacientes fueron evaluados radiológica y clínicamente utilizando el baremo de Merle dAubigné (MD).

Utilización de los vástagos metafisarios «Próxima¼ DePuy: nuestra experiencia a más de cinco años / Use of metaphyseal stems «Proxima¼ DePuy: our experience to more than five years

Resumen: La artroplastía total de cadera con los vástagos cortos encaminada a preservar el hueso es una buena opción en pacientes jóvenes a quienes se les prevé futuras cirugías de revisión. También es una buena elección cuando se utilizan cirugías con abordajes miniinvasivos. En este estudio clínico y radiológico hemos evaluado nuestra experiencia en el uso de artroplastía total de cadera con vástagos cortos de anclaje metafisario tipo DePuy Próxima. En total se han intervenido 23 pacientes con una edad media de 50.2 años (rango de 45 a 69 años) en el momento de la cirugía. El seguimiento medio fue de más de cinco años. Hubo un ligero varo del tallo femoral en tres casos, uno de ellos en varo severo. Este último caso presentó dolor continuo en las caras laterales del muslo que aumentó con el tiempo junto con una reacción diafisaria y un aumento en el tallo que requirió cirugía de revisión a los 12 meses postoperatorios. Se requiere un seguimiento más prolongado para analizar los resultados y confirmar la durabilidad de los resultados clínicos observados. Los pacientes fueron evaluados radiológica y clínicamente utilizando el baremo de Merle d'Aubigné (MD).

Abstract: The total hip arthroplasty with short stems to preserve bone is a good choice in young patients that expected future revision surgery, it is also a good choice when we use approaches for minimal invasive surgeries. In this study, we have evaluated, clinically and radiologically, our experience in total hip arthroplasty with the use of short stems and metaphyseal anchorage. In total we have involved 23 patients with a mean age of 50.2 years (range 45 to 69 y/o) at the time of surgery. The median follow-up was greater than five years. There was a slight Varus femoral stem in three cases, one of them in severe varus. The latter presented continuous pain in the lateral aspect of the thigh that increased with time, with a diaphyseal reaction and an increase in radiolucencies around the stem that required revision surgery 12 months postoperative. A longer follow-up is required to analyze the results and confirm the durability of the observed clinical findings. Patients were evaluated radiological and clinically using the scale of Merle d'Aubigné (MD).

[The evolution of AIDS mortality and survival in Barcelona (1981-1997)]. / Evolución de la mortalidad y supervivencia del SIDA en Barcelona (1981-1997).

BACKGROUND: To analyze the evolution of AIDS mortality and survival in Barcelona, Spain. PATIENTS AND METHODS: AIDS-cases registered in Barcelona (Spain) between 1981-1997. Study of mortality and survival probability. RESULTS: Mortality decreased by 55% between 1996-1997. Survival probability at 547 days was of 80.3% in 1997 compared with 48.6% before 1988. Being older than 36 years old, IVDU, having other AIDS-defining disease than tuberculosis, and year of diagnostic before 1997 were associated with poor survival. CONCLUSIONS: AIDS mortality in Barcelona has enormously decreased. The best survival in 1997 is probably attributable to the new antiretroviral therapies.

The biological tests used in acute-phase of inflammation in bone infection : Clinical study.

We present a comparative study of different biological tests in the acute phase of inflammation. The study was performed in 80 patients after surgical procedures in septic cases. We have compared the levels of C-Reactive Protein (CRP), C3, C3a, C4, T(o), sedimentation rate, and the leucocyte count. The analysis was made before surgery and every week until the ninth week after surgery. The variations in CRP which ocurred very early were extensive. The increase ranged between 200 and 600% after the surgical procedure. In cases without complications the CRP level returned to normal within 20 days. The study showed the CRP as the most specific and sensitive biological test of the acute phase of inflammation. However this biological test cannot differentiate between an acute infective and a severe inflammatory process.

[Pancreatic ascites and pleural effusion]. / Ascitis pancreática y derrame pleural.

UNLABELLED: Pancreatic ascites consists in the presence of pancreatic juice into the peritoneal cavity, coming from pseudocysts or pancreatic ducts breaches, that produce the accumulation of an exudate rich in proteins and amylase; these findings certify the diagnosis. We report a case of pancreatic ascites with pleural effusion: alcoholic patient, without previous episodes of acute pancreatitis, with ascites, weight loss, abdominal pain, right pleural effusion, insidious onset, blood level of amylase: more than 1024 UD; CT: ascites, right pleural effusion, pseudocyst in the head (24 mm) and in the tail (77 mm) of the pancreas. TREATMENT: a transgastric cystogastrostomy in the cyst of 8 cm and a transduodenal punction in the cyst of 3 cm were performed, with an excellent postoperative result.

Ascitis pancreática y derrame pleural. / [Pancreatic ascites and pleural effusion]

Pancreatic ascites consists in the presence of pancreatic juice into the peritoneal cavity, coming from pseudocysts or pancreatic ducts breaches, that produce the accumulation of an exudate rich in proteins and amylase; these findings certify the diagnosis. We report a case of pancreatic ascites with pleural effusion: alcoholic patient, without previous episodes of acute pancreatitis, with ascites, weight loss, abdominal pain, right pleural effusion, insidious onset, blood level of amylase: more than 1024 UD; CT: ascites, right pleural effusion, pseudocyst in the head (24 mm) and in the tail (77 mm) of the pancreas. Treatment: a transgastric cystogastrostomy in the cyst of 8 cm and a transduodenal punction in the cyst of 3 cm were performed, with an excellent postoperative result.

Ascitis pancreática y derrame pleural. / [Pancreatic ascites and pleural effusion]

Pancreatic ascites consists in the presence of pancreatic juice into the peritoneal cavity, coming from pseudocysts or pancreatic ducts breaches, that produce the accumulation of an exudate rich in proteins and amylase; these findings certify the diagnosis. We report a case of pancreatic ascites with pleural effusion: alcoholic patient, without previous episodes of acute pancreatitis, with ascites, weight loss, abdominal pain, right pleural effusion, insidious onset, blood level of amylase: more than 1024 UD; CT: ascites, right pleural effusion, pseudocyst in the head (24 mm) and in the tail (77 mm) of the pancreas. Treatment: a transgastric cystogastrostomy in the cyst of 8 cm and a transduodenal punction in the cyst of 3 cm were performed, with an excellent postoperative result.