Comparison of Resorbable and Non-Resorbable Osteosynthesis Material in Hallux Surgery: A Systematic Review.

There are various pathologies that involve the hallux, among which hallux valgus is the most common. When conservative treatment fails, it is necessary to resort to a surgical approach. The fixation elements for osteotomies in the hallux are usually composed of metallic materials; however, today, there are numerous resorbable materials that offer numerous advantages over conventional materials. In this article, the objective is to analyze the scientific evidence through the systematic analysis of the existing literature in relation to the effectiveness of resorbable versus non-resorbable osteosynthesis material in the surgical correction of hallux deformities and compare the complications as well as the patient satisfaction and quality of life between both fixation methods. A systematic review of the literature available in the PubMed, EMBASE, Web of Science and Scopus databases and 10 studies were included. The documents were chosen following the eligibility and exclusion criteria, including experimental and observational studies evaluated with the Jadad and Newcastle-Ottawa methodological quality scale, respectively. Data were extracted from valid studies for the review, and the variables functionality, pain, angular corrections, complications, satisfaction and quality of life were observed. In conclusion, there is limited scientific evidence regarding the effectiveness of resorbable versus non-resorbable osteosynthesis material in the surgical correction of hallux deformities. All observed variables are similar regardless of the surgical technique and osteosynthesis material used.

Potential Use of Wearable Inertial Sensors to Assess and Train Deep Cervical Flexors: A Feasibility Study with Real Time Synchronization of Kinematic and Pressure Data during the Craniocervical Flexion Test.

The aim of the study was to develop a novel real-time, computer-based synchronization system to continuously record pressure and craniocervical flexion ROM (range of motion) during the CCFT (craniocervical flexion test) in order to assess its feasibility for measuring and discriminating the values of ROM between different pressure levels. This was a descriptive, observational, cross-sectional, feasibility study. Participants performed a full-range craniocervical flexion and the CCFT. During the CCFT, a pressure sensor and a wireless inertial sensor simultaneously registered data of pressure and ROM. A web application was developed using HTML and NodeJS technologies. Forty-five participants successfully finished the study protocol (20 males, 25 females; 32 (11.48) years). ANOVAs showed large effect significant interactions between pressure levels and the percentage of full craniocervical flexion ROM when considering the 6 pressure reference levels of the CCFT (p < 0.001; η2 = 0.697), 11 pressure levels separated by 1 mmHg (p < 0.001; η2 = 0.683), and 21 pressure levels separated by 0.5 mmHg (p < 0.001; η2 = 0.671). The novel time synchronizing system seems a feasible option to provide real-time monitoring of both pressure and ROM, which could serve as reference targets to further investigate the potential use of inertial sensor technology to assess or train deep cervical flexors.

Clinical utility of urinary gluten immunogenic peptides in the follow-up of patients with coeliac disease.

BACKGROUND: Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD) and its compliance should be monitored to avoid cumulative damage. AIMS: To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on duodenal histology at 12-month follow-up and evaluate the interval of determination of urinary gluten immunogenic peptides (u-GIP) for the monitoring of GFD adherence. METHODS: Ninety-four patients with CD on a GFD for at least 24 months were prospectively included. Symptoms, serology, CDAT questionnaire, and u-GIP (three samples/visit) were analysed at inclusion, 3, 6, and 12 months. Duodenal biopsy was performed at inclusion and 12 months. RESULTS: At inclusion, 25.8% presented duodenal mucosal damage; at 12 months, this percentage reduced by half. This histological improvement was indicated by a reduction in u-GIP but did not correlate with the remaining tools. The determination of u-GIP detected a higher number of transgressions than serology, regardless of histological evolution type. The presence of >4 u-GIP-positive samples out of 12 collected during 12 months predicted histological lesion with a specificity of 93%. Most patients (94%) with negative u-GIP in ≥2 follow-up visits showed the absence of histological lesions (p < 0.05). CONCLUSION: This study suggests that the frequency of recurrent gluten exposures, according to serial determination of u-GIP, could be related to the persistence of villous atrophy and that a more regular follow-up every 6 months, instead of annually, provides more useful data about the adequate adherence to GFD and mucosal healing.

The transformation process for palliative care professionals: The metamorphosis, a qualitative research study.

BACKGROUND: Palliative care professionals are exposed daily to high levels of suffering. This makes them particularly vulnerable to suffering from stress, which can lead to burnout and/or compassion fatigue. AIMS: To analyse the professional trajectory of palliative care workers over time and the factors which influence this trajectory. DESIGN: A qualitative study was designed based on the Grounded Theory approach, using semi-structured individual interviews. Interviews were recorded audio-visually and transcribed verbatim for subsequent analysis using the procedure described by Miles and Huberman. This process was supported using ATLAS.ti 6 software. SETTING/PARTICIPANTS: A total of 10 palliative care professionals from Extremadura (Spain) took part in the study. RESULTS: The analysis revealed a common trajectory followed by participants in their working lives: pre-palliative care/honeymoon/frustration/maturation. In addition, factors which influence this trajectory were identified. Details of the self-care strategies that these professionals have developed are described. The result of this process, which we have metaphorically termed 'metamorphosis', is the formation of a professional who can work satisfactorily within a palliative care context. CONCLUSION: During their professional activity, palliative care professionals go through a series of phases, depending on the relationship between the cost of caring and the satisfaction of caring, which can influence both the care provided to patients and families and their own personal circumstances. Being aware of this risk, and implementing self-care strategies, can protect professionals and enable them to conduct their work in an optimal manner. Reflecting on the experiences of these professionals could be useful for other health professionals.

Synthesis and physicochemical characterization of alkanedyil-α-ω-bis(dimethyldodecylammonium) bromide, 12-s-12,2Br-, surfactants with s=7, 9, 11 in aqueous medium.

In this work, three didodecyl dicationic dibromide dimeric surfactants 12-s-12,2Br(-), with different methylene spacer lengths (s=7, 9, and 11) were prepared and characterized and their properties compared to those of 12-s-12,2Br(-) surfactants with s=2, 3, 4, 5, 6, 8, 10, and 12. Information about the critical micelle concentration, the micellar ionization degree, the average aggregation number and the polarity of the interfacial region, and microviscosity of the micellar interior was obtained by using different techniques. Their surface activity was investigated by means of surface tension measurements. Micellization was also studied by using (1)H NMR and diffusion NMR (DOSY) spectroscopy as well as isothermal titration calorimetry. The values of the thermodynamic parameters show that the dimeric surfactants micellization is exothermic and driven by entropy. The occurrence of morphological transitions upon increasing surfactant concentration was studied, and the results indicate that the spacer length, s, plays a key role in the micellar growth of 12-s-12,2Br(-) aggregates. The value of s not only control the magnitude of C(*), the surfactant concentration above which the morphological transition from spherical micelles into elongated ones occurs, but also the sign of the enthalpy change accompanying the sphere-to-rod transition.

Pregnancy outcome after preimplantation genetic diagnosis in an affected couple with X-linked adrenoleukodystrophy.

OBJECTIVE: To achieve a pregnancy free of X-linked adrenoleukodystrophy (X-ALD) by intracytoplasmic sperm injection (ICSI) and preimplantation genetic diagnosis (PGD). DESIGN: Case report. SETTING: Clínica FIV Recoletos, a private IVF center. PATIENT(S): A couple in which the man had X-ALD. INTERVENTION(S): The ICSI protocol and PGD of the obtained embryos. MAIN OUTCOME MEASURE(S): Blastomeres were analyzed by fluorescence in situ hybridization using sex selection techniques. Embryos were transferred and pregnancy was diagnosed by hCG analysis and ultrasonographic examination. RESULT(S): Ten embryos were obtained by ICSI. A biopsy was taken from eight embryos to perform PGD and two male embryos were transferred resulting in a twin pregnancy. CONCLUSION(S): This is the first registered gestation in which PGD has been used to prevent X-ALD transmission.

Tránsito hepatopleural del quiste hidático: contribución de la ecografía al diagnóstico

Una paciente de 6 años presentó una complicación rara de la hidatidosis hepática: la invasión pleural. Se llegó al diagnóstico positivo en base a la ecografía y a la inmunoelectroforesis, y se lo confirmó en el acto operatorio