[Surgical procedures involved in claims for alleged defects in praxis]. / Procedimientos quirúrgicos objeto de reclamación por presunto defecto de praxis.

Medical professional liability and adverse events in health care are major concerns worldwide and the analysis of claims for alleged defects in praxis is a potential source of knowledge. High rates of adverse events and complaints have been reported in surgical procedures. This article analyzes the claims registered by the Council of Medical Colleges in Catalonia between 1986 and 2012, and explores surgical procedures claimed (ICD- 9-CM coding), as well as the final outcome of the claim. Among the 5,419 records identified on surgical procedures, the interventions of the musculoskeletal system and skin and integument showed the highest frequencies. Interventions related to "non-curative" medicine should be emphasized because of their higher rates of economical agreement or condemnation outcomes, which were significantly higher for mastopexia. The results underscore the importance of the surgical area in medical professional liability and the high risk of payouts among those procedures belonging to the so-called "non-curative" medicine.

Procedimientos quirúrgicos objeto de reclamación por presunto defecto de praxis / Surgical procedures involved in claims for alleged defects in praxis

La responsabilidad profesional médica y los episodios adversos en la asistencia sanitaria son preocupaciones de primer orden en el ámbito internacional y el análisis de las reclamaciones por presunto defecto de praxis supone una potencial fuente de conocimiento. Se han descrito tasas específicamente elevadas de episodios adversos y reclamaciones en los procedimientos quirúrgicos. El presente artículo analiza las reclamaciones interpuestas ante el Consejo de Colegios de Médicos de Cataluña entre los años 1986 y 2012, mediante la exploración de los procedimientos quirúrgicos reclamados mediante codificación CIE-9-MC, así como el resultado final de la reclamación. Entre los 5.419 expedientes identificados sobre procedimientos quirúrgicos destacaron, por su elevada frecuencia, las intervenciones del sistema musculoesquelético y de piel y tegumentos. Las intervenciones correspondientes a la medicina «no curativa» destacaron por sus elevadas tasas de procedimientos que finalizaron mediante acuerdo transaccional o condena, que resultó significativamente mayor para las mastopexias. Los resultados obtenidos subrayan la importancia del área quirúrgica en responsabilidad profesional médica y el riesgo elevado de condena de los procedimientos pertenecientes a la denominada «medicina satisfactiva o no curativa» (AU)

Medical professional liability and adverse events in health care are major concerns worldwide and the analysis of claims for alleged defects in praxis is a potential source of knowledge. High rates of adverse events and complaints have been reported in surgical procedures. This article analyzes the claims registered by the Council of Medical Colleges in Catalonia between 1986 and 2012, and explores surgical procedures claimed (ICD- 9-CM coding), as well as the final outcome of the claim. Among the 5,419 records identified on surgical procedures, the interventions of the musculoskeletal system and skin and integument showed the highest frequencies. Interventions related to «non-curative» medicine should be emphasized because of their higher rates of economical agreement or condemnation outcomes, which were significantly higher for mastopexia. The results underscore the importance of the surgical area in medical professional liability and the high risk of payouts among those procedures belonging to the so-called «non-curative» medicine (AU)

Elucidation of the structural role of fluorine in potentially bioactive glasses by experimental and computational investigation.

Glasses belonging to the Na(2)O-CaO-P(2)O(5)-SiO(2) system and modified by CaF(2) substitution for CaO and Na(2)O alternatively, were synthesized and characterized experimentally and computationally. The results of molecular dynamics simulations show that fluorine is almost exclusively bonded to modifier cations (Ca and Na) with coordination number close to 4. A similar mean coordination number value is found in the crystal phases obtained by means of thermal treatment at fixed temperature. Addition of fluorine increases the polymerization of silicate tetrahedra by removing modifiers from the siliceous matrix. No appreciable amount of Si-F bonds are detected.

Influence of the displacement out of the center of mass and nonaxiality of the dipole on the thermodynamics of liquids composed of linear dipole molecules.

We present results for organic liquids modeled as linear rods with an embedded point dipole shifted from the geometrical center. Previously, we have obtained results for the vapor-liquid equilibrium (VLE) of similar systems with centered point dipoles. Our results included both models and applications to real systems. Results presented here are based on a previous work ( Phys. Rev. E 2003, 68, 021201) on the structural properties of these systems where relevant results about the appearance of dimers were found. Now, we have also performed systematic simulations on these systems to calculate the VLE of models with different aspect ratios, dipole shifts, and dipole strengths using the Gibbs ensemble Monte Carlo (GEMC) to calculate equilibrium densities and vapor pressure at each temperature. The applications considered here include some important substances such as 1-amines, acetonitrile, and 1-alcohols whose intermolecular parameters were fitted from our model simulations. Furthermore, we have used quantum chemistry calculations to obtain a reliable charge distribution, and we have applied our model to predict the vapor pressure of alpha,omega-diols where experimental results are rather scarce. Our results show a general improvement of the agreement between experiment and models compared to centered dipole models previously used. Results for amines are particularly remarkable.

Prevención de riesgos y responsabilidad profesional en Anestesiología / Prevention of risks and professional liability in anesthesiology

No disponible

No disponible

Hepatitis aguda grave tras anestesia con sevoflurano / Severe acute hepatitis after anesthesia with sevoflurane

No disponible

Cerámicas para prótesis parcial fija en el sector posterior. Revisión bibliográfica / No disponible

No disponible

Lava System ®. Un nuevo tipo de prótesis mecanizada libre de metal. Procedimientos de laboratorio / No disponible

Los recientes avances en los materiales dentales totalmente cerámicos permiten tanto al técnico de laboratorio (..) (AU)

Relatively recent advances in all-ceramic dental (..) (AU)

Sitema lava. Procedimiento clínico / No disponible

Cada día se buscan sistemas que puedan proporcionar una mejor estética (..) (AU)

Everyday we are searching for a better system that can give a better (..) (AU)

Restauración del diente endodonciado. ¿Debemos colocar siempre un poste? / No disponible

La patología pulpar y su tratamiento endodóntico tiene una elevada prevalencia y siempre han existido dudas (..) (AU)

The pulpar pathology and endodontic treatment has a high prevalence (..) (AU)

Prótesis completa: técnica Cortada. A propósito de un caso / No disponible

Una parte importante de los pacientes que acude a las consultas (..) (AU)

A big percentage of patients that goes to a dental officel (..) (AU)

Pilar Sub-Tec Universal. Resistencia experimental a la torsión / No disponible

Semados ha desarrollado un nuevo pilar protésico que consiste en una pieza mecanizada de titanio (..) (AU)

Semados has feveloped a new abutment which consistes of a mechanized titanium (..) (AU)

Un paciente con hipertransaminasemia prolongada

El hallazgo, en muchas ocasiones casual, de unos valores elevados de transaminasas es uno de los problemas que con más frecuencia se plantean en la práctica clínica diaria. Dicha elevación responde, salvo excepciones, a una inflamación aguda o crónica del hígado. Las causas de inflamación hepática son diversas, por lo que es fundamental establecer el diagnóstico etiológico del cual depende habitualmente el tratamiento. Una historia clínica detallada y una exploración física meticulosa, junto a determinaciones que incluyan pruebas hepáticas, serología vírica y un estudio inmunológico básico, nos permitirán diagnosticar la enfermedad causal en la mayoría de los casos, siendo necesario realizar otro tipo de pruebas en situaciones más excepcionales (AU)

Vacunación en el personal sanitario

El personal que trabaja en el medio sanitario, por la naturaleza de su actividad, tiene un riesgo superior al de la población general de contraer determinadas infecciones provenientes de enfermos, pero a su vez puede también ser la fuente de transmisión a sus propios pacientes. Algunas de estas enfermedades infecciosas pueden ser prevenidas de una forma efectiva mediante vacunas. El personal sanitario, además de recibir las vacunas que están indicadas por su condición de ciudadano adulto, debería recibir otras de acuerdo con las condiciones y características de su actividad laboral (AU)

Galvanic corrosion behavior of titanium implants coupled to dental alloys.

The corrosion of five materials for implant suprastructures (cast-titanium, machined-titanium, gold alloy, silver-palladium alloy and chromium-nickel alloy), was investigated in vitro, the materials being galvanically coupled to a titanium implant. Various electrochemical parameters E(CORR), i(CORR) Evans diagrams, polarization resistance and Tafel slopes) were analyzed. The microstructure of the different dental materials was observed before and after corrosion processes by optical and electron microscopy. Besides, the metallic ions released in the saliva environment were quantified during the corrosion process by means of inductively coupled plasma-mass spectrometry technique (ICP-MS). The cast and machined titanium had the most passive current density at a given potential and chromium-nickel alloy had the most active critical current density values. The high gold content alloys have excellent resistance corrosion, although this decreases when the gold content is lower in the alloy. The palladium alloy had a low critical current density due to the presence of gallium in this composition but a selective dissolution of copper-rich phases was observed through energy dispersive X-ray analysis.

Metallic ion release in artificial saliva of titanium oral implants coupled with different metal superstructures.

In this work the metallic ion release in oral implants with superstructures of different metals and alloys used in clinical dentistry has been determined. This study has been realized in a saliva environment at 37 degrees C. The measurements of the ion release were carried out by means of the Inductively Coupled Plasma Mass Spectrometry technique. The titanium oral implant coupled with a chromium-nickel alloy releases a high quantity of ions and the implant coupled with the titanium superstructure presents a low value of ion release.