Concept, design and fabrication of smart orthopedic implants.

Extensive clinical experience has been built up using orthopaedic implants instrumented with strain gauges connected to a Wheatstone bridge by means of percutaneous leads. This research showed the medical relevance of the monitoring of the deformation of implants as a powerful tool to evaluate nursing and rehabilitation exercises, for tracing dangerous overloads and anticipating implant failure and also to observe the healing process. The IMPACT 3500 project focuses on the instrumentation of femoral implants with on board sensors: regular Benoist-Girard implants have been modified, to contain a 'sensing cell', and thoroughly tested in vitro and in vivo. The implant deformations are measured with resistive strain gauges, and the signal is transferred to a personal computer for processing and display, via a hard wired connection, or via a telemetry system. Two fully implantable wireless designs, called Linkstrain and Sealstrain, are powered from the outside by magnetic induction. As Sealstrain contains the whole telemetric system in its cavity, the highest miniaturization was required; this seriously deteriorates the efficiency of the inductive power link.

[Cutaneous metastases. Clinical pathological review]. / Metastasis cutánea. Revisión clínico patológica.

Cutaneous metastases may be the first clinical manifestation of a visceral carcinoma, its incidence fluctuates between 0.7 and 9% of the carcinomas and normally indicate a dismal prognosis. The most frequent morphologies of cutaneous metastases are metastatic nodules, sclerotic forms that appear as infiltrated and stiff plates, the inflammatory variety that resembles an erysipelatous plate, mammary and extra-mammary Paget's disease that appear as erythematous erosive and crusty plates resembling dermatitis.