Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 26
Filtrar
1.
J Insect Sci ; 20(3)2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32417920

RESUMEN

After its initial discovery in California in 2008, Drosophila suzukii Matsumura has become one of the most important invasive agricultural pest insects across climate zones in much of Asia, Europe, North America, and South America. Populations of D. suzukii have demonstrated notable behavioral and physiological plasticity, adapting to diverse environmental and climatic conditions, interspecific competition, novel food sources, and potential predators. This adaptability and plasticity have enabled rapid range expansion and diversified niche use by D. suzukii, making it a species particularly suited to changing habitats and conditions. This article reviews factors and evidence that influence plasticity in D. suzukii and promotes this species' invasiveness.


Asunto(s)
Adaptación Fisiológica , Drosophila/fisiología , Especies Introducidas , Animales , Clima , Ambiente , Cadena Alimentaria
2.
J Insect Sci ; 19(4)2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31313814

RESUMEN

The past 100 yr have seen dramatic philosophical shifts in our approach to controlling or managing pest species. The introduction of integrated pest management in the 1970s resulted in the incorporation of biological and behavioral approaches to preserve ecosystems and reduce reliance on synthetic chemical pesticides. Increased understanding of the local ecosystem, including its structure and the biology of its species, can improve efficacy of integrated pest management strategies. Pest management strategies incorporating insect learning paradigms to control insect pests or to use insects to control other pests can mediate risk to nontarget insects, including pollinators. Although our understanding of insect learning is in its early stages, efforts to integrate insect learning into pest management strategies have been promising. Due to considerable differences in cognitive abilities among insect species, a case-by-case assessment is needed for each potential application of insect learning within a pest management strategy.


Asunto(s)
Control de Insectos , Insectos , Aprendizaje , Animales
3.
Ann Plast Surg ; 80(3): 272-276, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28984656

RESUMEN

The peroneus brevis flap was first described as proximally based by Mathes et al (Surg Clin North Am. 1974;54:1337-1354) and later by Jackson and Scheker (Injury. 1982;13:324-330). A distally based version of this flap by Mathes and Nahai (Reconstructive Surgery: Principles, Anatomy and Technique. 1997:1437e46) was subsequently described in 1997. The first case series of distally based flaps was published by Eren et al (Plast Reconstr Surg. 2001;107:1443-1448). In our experience, the distally based flap is a useful muscle flap to reconstruct small defects in the lateral distal third of the leg. Initial interest and confidence in the use of this flap in our unit were hindered by lack of direct experience and descriptive detail in the literature. We have now developed a systematic approach to harvest the distally pedicled peroneus brevis muscle flap in 5 reproducible, safe steps. This has allowed the flap to become adopted as a standard technique of limb reconstruction in our unit with no cases of flap loss.


Asunto(s)
Traumatismos de la Pierna/cirugía , Músculo Esquelético/trasplante , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos/trasplante , Humanos , Músculo Esquelético/irrigación sanguínea , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos/irrigación sanguínea
4.
J Econ Entomol ; 114(2): 652-675, 2021 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-33704447

RESUMEN

Monitoring is critical to control efforts for Drosophila suzukii Matsumura, an invasive polyphagous fly that has the potential to cause significant losses in commercial soft fruit and berry production worldwide. We used an iterative process to identify trap colors, trap designs, and volatile mixtures to improve monitoring efforts in commercial blueberry, raspberry, and blackberry crops. Our results suggest that the selection of trap color and design and attractant lures should be customized to the crop in which they are deployed. In raspberries grown in high tunnel systems, DrosaLure paired with Drosal traps painted green and purple were highly specific to D. suzukii although actual capture counts were low. However, in field grown raspberries, BioLure and Multilure traps were most effective, but with significant nontarget bycatch. In blueberries, we had greatest success with a 5 µg:50 ng mixture of ethyl acetate-acetoin in a green/purple-colored jar-style trap with large (5 cm) mesh covered openings.


Asunto(s)
Arándanos Azules (Planta) , Drosophila , Animales , Electrofisiología , Frutas , Control de Insectos , Laboratorios
5.
Plast Reconstr Surg Glob Open ; 8(9): e3108, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33133957

RESUMEN

Lower limb reconstruction of the distal third following tumor extirpation or trauma is a complex procedure. The use of free flaps to cover lower limb defects is a common practice in our department. Vascular kinking or compression resulting in thrombosis is the leading cause of venous congestion and free flap failure in lower limb reconstruction. We describe a simple and inexpensive technique to avoid venous kinking during microvascular anastomosis in free flap reconstructions in the lower leg, which has proved safe in a cohort of patients.

6.
Injury ; 51(4): 1077-1085, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32192717

RESUMEN

BACKGROUND: The medial sural artery perforator (MSAP) flap provides a thin, pliable and durable soft tissue reconstruction with adequate pedicle length and low donor morbidity. It is an ideal choice for small-to-moderate defects of the lower extremity, although it does have limitations. We report our experience of the flap in a three-pronged anatomical, clinical and patient reported outcome-based study. METHODS: Cadaveric fresh frozen lower limbs (n = 10) were used for anatomical dissections to assess pertinent and clinically relevant findings. Data relating to MSAP flaps was collected from a prospectively maintained database over a 2-year period. Both clinical data and modified Enneking scores were analysed. RESULTS: Anatomical study: A mean of 2.1 ± 0.99 perforators arose from the medial sural artery, located 11.9 cm ± 2.07 along the line between the popliteal fossa and medial malleolus. The largest perforator was located 13.58 cm ± 2.01 from the popliteal artery. The distance from the dominant perforator to the first branching point within the gastrocnemius was 7.39 ± 1.50 (range 5-9.2 cm). The short saphenous vein was located on average 3.08 cm ± 0.77 from the dominant perforator. Clinical study: Twenty free and nine pedicled MSAPs were included (n = 29). Open lower limb fractures (n = 18, 62%) and infection (n = 10, 35%) were the most common aetiologies. Defects sites included: foot-and-ankle (n = 12, 55%), knee (n = 9, 31%) and anterior leg (n = 4, 14%). Four patients (14%) required SSG to for donor site coverage. Venous congestion was responsible for partial flap necrosis in 6.9%(n = 2) of patients. All wounds were healed at discharge. At 14 months, the mean Enneking score was 72.5%. All patients were ambulant, 96% returned to work and 87% were using pre-operative footwear. CONCLUSIONS: The MSAP provides robust foot-and-ankle reconstruction, whilst permitting glide when over the knee. Patient satisfaction and functional outcomes are excellent with careful patient selection. Care should be taken to avoid compression or kinking of the large, thin walled veins as the most commonly observed complication was venous congestion. We advocate MSAP as a first choice flap for small-to-moderate foot, ankle or knee defects.


Asunto(s)
Colgajos Tisulares Libres/irrigación sanguínea , Extremidad Inferior/lesiones , Extremidad Inferior/cirugía , Colgajo Perforante/irrigación sanguínea , Procedimientos de Cirugía Plástica/efectos adversos , Adulto , Anciano , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Dehiscencia de la Herida Operatoria/etiología , Adulto Joven
7.
Injury ; 50(7): 1376-1381, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31128908

RESUMEN

INTRODUCTION: Open lower limb fractures can be devastating with outcomes determined by tissue damage and adherence to strictly defined care pathways. Managing such injuries in paediatric and elderly populations presents logistical and technical challenges to achieve best outcomes. Orthoplastic principles were developed mainly in the young adult population whereas requirements for paediatric and elderly patients need further understanding. METHODS: A retrospective analysis was performed on two groups of patients at the extremes of age, with type IIIb (severe) open lower limb fractures, presenting to a Major Trauma Centre (MTC) with orthoplastic services over a six-year period - the first group being under 16 years; the second group being over 65. The timelines of combined surgery to both fix the fracture and flap the soft-tissue defect were strictly observed. Each group were followed-up for a minimum of nine months. Data were analysed according to patient demographics, mechanism of trauma, time to wound excision, time to definitive surgery, fixation technique, soft-tissue reconstruction type, deep infection rate, flap survival, bony union, secondary amputation and functional outcome (Enneking score). RESULTS: 33 paediatric patients and 99 elderly patients were identified. Paediatric: The median age was 12 years. All the children were ASA Grade I. Open tibial fractures were most common (76%) followed by ankle fracture dislocation (12%). The majority were high-energy injuries and were commonly managed with external fixators (or frames) and free flap coverage. Median hospital stay was 12 days, and time to union 114 days, with median Enneking scores of 85%. There was one flap failure and no deep infections. Elderly: The median age was 76 years. ASA grades varied and reflected multiple comorbidities. High-energy injuries required free flaps, while more common, low-energy fragility fractures were covered with loco-regional flaps. Internal fixation with intramedullary nails was most commonly used. Median hospital stay was 13 days, and time to union was 150 days, with median Enneking scores of 70%. There was one flap failure, one deep infection, and one delayed amputation. DISCUSSION: These results reflect both similarities and important differences in managing open fractures in the extremes of age. The specific challenges of each group of patients are discussed, including surgical aspects, but also the importance of orthoplastics infrastructure within the MTC and input from allied professionals to facilitate patient pathways.


Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas Abiertas/terapia , Extremidad Inferior/lesiones , Procedimientos de Cirugía Plástica/métodos , Traumatismos de los Tejidos Blandos/terapia , Infección de la Herida Quirúrgica/terapia , Centros Traumatológicos , Adolescente , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Desbridamiento , Femenino , Fracturas Abiertas/fisiopatología , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Estudios Retrospectivos , Traumatismos de los Tejidos Blandos/fisiopatología , Infección de la Herida Quirúrgica/prevención & control , Resultado del Tratamiento
8.
BMC Biol ; 5: 3, 2007 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-17257412

RESUMEN

BACKGROUND: Insects that feed on plants contribute greatly to the generation of biodiversity. Hypotheses explaining rate increases in phytophagous insect diversification and mechanisms driving speciation in such specialists remain vexing despite considerable attention. The proliferation of plant-feeding insects and their hosts are expected to broadly parallel one another where climate change over geological timescales imposes consequences for the diversification of flora and fauna via habitat modification. This work uses a phylogenetic approach to investigate the premise that the aridification of Australia, and subsequent expansion and modification of arid-adapted host flora, has implications for the diversification of insects that specialise on them. RESULTS: Likelihood ratio tests indicated the possibility of hard molecular polytomies within two co-radiating gall-inducing species complexes specialising on the same set of host species. Significant tree asymmetry is indicated at a branch adjacent to an inferred transition to a Plurinerves ancestral host species. Lineage by time diversification plots indicate gall-thrips that specialise on Plurinerves hosts differentially experienced an explosive period of speciation contemporaneous with climatic cycling during the Quaternary period. Chronological analyses indicated that the approximate age of origin of gall-inducing thrips on Acacia might be as recent as 10 million years ago during the Miocene, as truly arid landscapes first developed in Australia. CONCLUSION: Host-plant diversification and spatial heterogeneity of hosts have increased the potential for specialisation, resource partitioning, and unoccupied ecological niche availability for gall-thrips on Australian Acacia.


Asunto(s)
Acacia/genética , Biodiversidad , Insectos/genética , Acacia/parasitología , Animales , Australia , Clima Desértico , Evolución Molecular , Interacciones Huésped-Parásitos , Filogenia
9.
Environ Entomol ; 47(5): 1242-1251, 2018 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-30010732

RESUMEN

Drosophila suzukii Matsumara (Diptera: Drosophilidae) has become a serious pest in soft-skin fruits and berries, infesting both ripe and ripening fruits. Crop damage in highbush blueberry has been particularly severe. During blueberry fruit development, fruits of various degrees of ripeness are present simultaneously. In addition, foliage color changes as the season progresses. We investigated the influence of blueberry fruit and leaf color on host-finding behavior in D. suzukii. Opposing shifts between reflectance spectra of ripening fruits and senescing leaves increased contrast between ripe fruit and senesced foliage. Developmental changes in contrast between fruit color and leaf color may act as a visual contextual cue in finding suitable host fruits. Opposing shifts in reflectance spectra of ripening fruits and senescing leaves increased the contrast between ripe fruit and senesced foliage. These opposing changes in color may contribute to the attractiveness of blueberry fruit as a late season host for D. suzukii.


Asunto(s)
Arándanos Azules (Planta) , Drosophila , Conducta de Búsqueda de Hospedador , Animales , Color , Señales (Psicología) , Femenino , Masculino , Odorantes
10.
J Hazard Mater ; 147(1-2): 588-93, 2007 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-17314007

RESUMEN

Recent studies have shown that the light-absorption and photocatalytic efficiencies of TiO2 can be improved by coupling TiO2 nano-particles with nonmetallic dopants, such as carbon. In this paper, we describe the electrophoretic preparation of a novel TiO2-carbon nano-composite photocatalyst on a glass indium thin oxide (ITO) substrate. The objective is to take better advantage of the (e-/h+) pair generated by photoexcitation of semiconducting TiO2 particles. The transfer of electrons (e-) into adjacent carbon nano-particles promotes reduction of oxygen to produce hydrogen peroxide (H2O2) which, in the presence of iron ions, can subsequently form hydroxyl radicals (*OH) via the Fenton reaction. At the same time, *OH is formed from water by the (h+) holes in the TiO2. Thus, the *OH oxidant is produced by two routes. The efficiency of this photolytic-Fenton process was tested with a model organic compound, Orange-II (OG-II) azo dye, which is employed in the textile industry.


Asunto(s)
Carbono/química , Nanoestructuras/química , Fotoquímica/métodos , Titanio/química , Compuestos Azo/química , Bencenosulfonatos/química , Catálisis , Electroforesis , Peróxido de Hidrógeno , Hierro , Oxidación-Reducción , Adherencias Tisulares
11.
Pest Manag Sci ; 73(1): 160-166, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27447732

RESUMEN

BACKGROUND: Drosophila suzukii Matsumara has recently emerged as a major invasive pest species in soft-skinned fruits in berries throughout North America and Europe. Its distribution has spread so rapidly that little is known of the extent of fruit susceptibility, particularly in boreal regions. Populations of D. suzukii increase dramatically in late summer in boreal regions, concurrent with fruiting seasons for commercially and culturally significant fruits and berries. We tested fruit preference and susceptibility of lingonberry, blueberry, chokecherry, sea buckthorn and raspberry fruits to D. suzukii. RESULTS: Female D. suzukii attempted to oviposit on all fruit types tested. Fruits with lower brix and lower pH levels were preferred in choice tests. Undamaged lingonberries were relatively safe from infestation; however, bruised or frost-damaged fruits were easily penetrated. Sea buckthorn and raspberry fruits were highly preferred. CONCLUSION: Although blueberry growers have experienced severe economic crop losses due to D. suzukii, we have found that blueberries were the least preferred of the fruits tested. This suggests that D. suzukii are largely opportunistic and highlights the importance of fruit phenology in fruit susceptibility. © 2016 Society of Chemical Industry.


Asunto(s)
Drosophila/fisiología , Frutas/fisiología , Especies Introducidas , Animales , Conducta Animal , Herbivoria , Especificidad del Huésped , Concentración de Iones de Hidrógeno , Oviposición , Taiga
12.
J Med Entomol ; 54(3): 712-718, 2017 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-28069630

RESUMEN

Arthropod-borne diseases negatively affect humans worldwide. Understanding the biology of the arthropod vectors and the pathogens they harbor, the arthropods are moving targets as a result of climate change, ecosystem degradation, species introductions, and increased human travel. Viruses within the California serogroup of the genus Orthobunyavirus (family Bunyaviridae) are among the mosquito-borne viruses of concern owing to their zoonotic potential. Two of these, snowshoe hare virus (SSHV) and Jamestown Canyon virus, were shown, using a combination of serology and virus isolations, to circulate on the Island of Newfoundland, Canada, in the 1980s. More recently, serological analysis demonstrated that these two viruses continue to circulate on the Island in several domesticated and wild animals. Here, we detected the seroconversion to SSHV in wild snowshoe hares and in a single sentinel rabbit. The seroconversion in the sentinel rabbit occurred in early August (2011), which corresponded to the weeks of peak mosquito collections and the timing of the detection of SSHV in suspected mosquito vectors. A portion of the SSHV S segment sequence was generated from mosquito pools collected at sites near the sentinel rabbits and phylogenetically analyzed using the neighbor-joining method with other available California serogroup virus sequences. This analysis validated the SSHV identification but showed that the Newfoundland sequence fell outside the other SSHV sequences available, which originated from the United States between 1959 and 2005.


Asunto(s)
Culicidae/virología , Virus de la Encefalitis de California/fisiología , Encefalitis de California/transmisión , Liebres , Insectos Vectores/virología , Animales , Encefalitis de California/virología , Terranova y Labrador , Estaciones del Año
13.
Water Res ; 40(9): 1754-62, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16626778

RESUMEN

In this work, the design and construction of an annular tube reactor for the electrochemical and photo-electrochemical in situ generation of H2O2 are described. By cathodic reduction of dissolved oxygen and the coupled oxidation of water at a UV-illuminated nanocrystalline-TiO2 semiconductor anode, it was found that the electrochemically generated H2O2 can be employed to readily oxidize the model compound Direct Yellow-52 in dilute acidic solution at high rates in the presence of small quantities of dissolved iron(II). Although, the model organic compound is chemically stable under UV radiation, its electrochemical oxidation rate increases substantially when the semiconductor anode is illuminated as compared to the same processes carried out in the dark.


Asunto(s)
Peróxido de Hidrógeno/química , Hierro/química , Titanio/química , Purificación del Agua/métodos , Abastecimiento de Agua , Carbono/análisis , Electroquímica , Oxidación-Reducción/efectos de la radiación , Fotoquímica , Rayos Ultravioleta , Contaminantes Químicos del Agua/análisis
14.
J Med Entomol ; 53(6): 1364-1369, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27592550

RESUMEN

Culex pipiens L., the northern house mosquito, is the primary vector of West Nile virus to humans along the east coast of North America and thus the focus of much study. This species is an urban container-breeding mosquito whose close contact with humans and flexibility in host choice has led to its classification as a "bridge vector"; that is, it is thought to move zoonotic diseases to humans from vertebrate reservoirs. While this invasive species is now well documented in its established range, which expanded in 2001 to include Canada, the existence of populations of this species along the fringes of its range are less well known. Here we report, using morphological and genetic techniques, the existence of two locations where Cx. pipiens exists in Newfoundland in both expected and unexpected sites based on projected habitat suitability on the island.


Asunto(s)
Distribución Animal , Culex/fisiología , Insectos Vectores/fisiología , Animales , Culex/anatomía & histología , Culex/genética , Complejo IV de Transporte de Electrones/genética , Proteínas de Insectos/genética , Especies Introducidas , Terranova y Labrador , Fiebre del Nilo Occidental/transmisión
15.
Knee ; 23(4): 736-9, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27225442

RESUMEN

INTRODUCTION: An exposed knee prosthesis is a limb threatening condition. Our unit manages such cases according to a multidisciplinary orthoplastic protocol. Whilst early prosthetic joint infection with dehiscence may be managed by Debridement, Antibiotics and Implant Retention (DAIR) and soft tissue coverage, the majority of these cases are chronic and in our unit are managed by Debridement, Explantation, Antibiotics (spacer and systemic) and Flap (DEAF). PATIENTS AND METHODS: We report our experience of managing 17 of these challenging cases, 16 DEAFs and one DAIR and flap. Outcomes were assessed clinically and using the 36-item Short Form Health Survey (SF-36). RESULTS: The mean time from arthroplasty to presentation in our unit was 19months (range: 0.5-80). Whilst an open knee replacement is by definition 'infected', significant microbiological growth from deep tissue/fluid samples was only detected in 14 patients (82%). Five patients (29.4%) subsequently underwent an amputation. Of these five, three patients were extensor deficient at presentation. At follow-up, health-related quality of life scoring using the Short Form-36 demonstrated poor physical function and highlighted differences in emotional function and pain levels between patients whose limbs were salvaged and patients who underwent amputation. CONCLUSION: An exposed total knee prosthesis is a devastating complication, which despite our multidisciplinary salvage approach, has a high rate (5/17=29%) of amputation in this series. Quality of life in this patient group is poor irrespective of limb salvage. Salvage surgery was associated with worse pain, but better emotional profile than patients with an above knee amputation.


Asunto(s)
Artritis/cirugía , Artroplastia de Reemplazo de Rodilla/efectos adversos , Prótesis de la Rodilla/efectos adversos , Infecciones Relacionadas con Prótesis/cirugía , Dehiscencia de la Herida Operatoria/cirugía , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica , Antibacterianos , Artroplastia de Reemplazo de Rodilla/instrumentación , Enfermedad Crónica , Desbridamiento , Remoción de Dispositivos , Femenino , Humanos , Articulación de la Rodilla/cirugía , Recuperación del Miembro/métodos , Masculino , Persona de Mediana Edad , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Calidad de Vida , Reoperación , Estudios Retrospectivos , Colgajos Quirúrgicos , Dehiscencia de la Herida Operatoria/tratamiento farmacológico , Dehiscencia de la Herida Operatoria/etiología
16.
Injury ; 46(6): 1112-5, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25601085

RESUMEN

INTRODUCTION: We reviewed the functional outcome of 68 patients with open ankle fractures managed in an orthoplastic specialist centre. MATERIALS AND METHODS: Patients managed at Frenchay Hospital over a 6 year period were divided into 3 groups: group P were patients initially seen and managed at Frenchay Hospital (an orthoplastic specialist centre), group S were patients stabilised at a different unit and referred for definitive management, while group R were patients managed in a different unit and referred following complications. Injuries were graded using the AO score and outcome was measured using the Enneking score (both validated). RESULTS: 19 patients (group P, mean age: 43 years), 26 patients (group S, mean age: 41 years) and 23 patients (group R, mean age: 41.9 years) made the cohort. 82.4% patients required free tissue transfer. Mean AO scores of groups P, S and R were 11.5, 12.3 and 9.7 (p+0.03). Mean number of procedures for P, S and R were 2.6, 3.5 and 4.2 (p = 0.0006). Mean follow up time was 55.5, 61.0 and 57.0 weeks respectively (p = 0.72). Mean Enneking scores for groups P, S and R were 63.3, 74.8 and 73.5 (p = 0.16). CONCLUSION: Patients from groups S and R underwent more procedures. However, a similar outcome can be achieved, highlighting the importance of managing such injuries in an orthoplastic specialist centre.


Asunto(s)
Traumatismos del Tobillo/cirugía , Fijación Interna de Fracturas/métodos , Fracturas Abiertas/cirugía , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Adulto , Traumatismos del Tobillo/complicaciones , Traumatismos del Tobillo/patología , Femenino , Curación de Fractura , Fracturas Abiertas/complicaciones , Fracturas Abiertas/patología , Humanos , Masculino , Recuperación de la Función , Traumatismos de los Tejidos Blandos/complicaciones , Traumatismos de los Tejidos Blandos/patología , Resultado del Tratamiento
18.
J Health Adm Educ ; 20(2): 123-34, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12625648

RESUMEN

Little is known about their learning preferences of the health care industry's most senior executives, particularly CEOs. This paper focuses on the "powerful mechanisms for CEO learning" made available to health care managers through "exclusive learning groups." By meeting ad hoc or regularly under the auspices of such organizations as The Aspen Institute, the American College of Health Care Executives, Healthcare Research and Development, Inc., and other professional and commercial organizations, CEOs come together to discuss the challenges and dilemmas of their jobs. This paper reports on a two-part research effort to determine why CEO exclusive learning groups are so effective. A survey of 70 CEOs in health care-related organizations and in-depth interviews with 8 CEOs reveals that CEOs use exclusive learning group sessions as social learning vehicles, as opportunities to create secondary-level executive networks, as mechanisms for achieving a competitive advantage, and as safe, confidential environments to try out new ideas, seek information, and build relationships.


Asunto(s)
Directores de Hospitales/educación , Educación Continua/métodos , Procesos de Grupo , Administración Hospitalaria/educación , Aprendizaje Basado en Problemas/métodos , Desarrollo de Personal/métodos , Comportamiento del Consumidor , Humanos , Cambio Social , Estados Unidos
19.
Injury ; 45(11): 1776-81, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25082348

RESUMEN

INTRODUCTION: Soft tissue defects around the knee joint resulting from trauma or because of wound breakdown after total knee arthroplasty present a challenge in a group of patients that often suffer from other co-morbidities. A pedicled gastrocnemius muscle flap remains a workhorse for this kind of wound. However, where the defect lies in the supero-lateral aspect of the proximal knee area, an alternative solution is required. The distally based pedicled gracilis flap has been described as an option for these cases where free-tissue transfer may not be an option and the pedicled gastrocnemius is not sufficient or has already been used. The purpose of this review is to evaluate the usefulness of this flap in the nine cases in which we have utilized it in our unit. METHODS: Nine patients underwent reconstruction of complex proximal knee wound defects with a distally based pedicled gracilis muscle flap. The mean age was 62 years (range 23-83). Five patients had wound breakdown following total-knee arthroplasty (TKR) and four patients had wound complications after road traffic accidents (RTA). Three of the nine flaps were delayed. RESULTS: Eight of the nine patients had successful salvage of the knee with the use of the distally based gracilis flap. Although four of the flaps suffered partial loss, this did not compromise the joint salvage. The patients were moderately satisfied with the reconstruction and achieved a mean range of movement of 75° (±12°). CONCLUSION: The distally based pedicled gracilis flap can be a salvage solution for complex soft tissue defects with exposed knee joint, patella or proximal part of knee or exposed knee prosthesis in cases where a pedicled gastrocnemius muscle is inadequate or the patient is not suitable for a free flap. Evidence Level IV.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/efectos adversos , Articulación de la Rodilla/cirugía , Recuperación del Miembro , Músculo Esquelético/trasplante , Procedimientos de Cirugía Plástica , Colgajos Quirúrgicos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Rango del Movimiento Articular , Resultado del Tratamiento
20.
J Plast Reconstr Aesthet Surg ; 66(7): e201-4, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23587679

RESUMEN

The proximally pedicled medial plantar flap is well described for coverage of wounds around the ankle and heel. This flap is usually based on the deep venae comitantes for venous drainage, with the superficial veins divided during dissection. Usually any disruption of the deep venous system of the flap would result in abandoning this choice of flap. Venous congestion is a recognised complication of medial plantar flaps. The patient described in this case report had a medial ankle defect with exposed bone, for which a proximally pedicled medial plantar flap was used. As we raised the flap, both venae comitantes of the medial planter artery were found to be disrupted. The flap was raised based on the superficial veins draining into the great saphenous, as the only system for venous drainage, with no evidence of venous congestion. The flap was successfully transposed into the defect and healed with no complications. The proximally pedicled medial plantar flap can safely rely on the superficial venous system alone for drainage. In addition, preserving the superficial veins minimise the risk of venous congestion in this flap. We recommend preservation of superficial venous system when possible.


Asunto(s)
Calcáneo/lesiones , Fijación Interna de Fracturas/efectos adversos , Fracturas Abiertas/cirugía , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos/irrigación sanguínea , Infección de la Herida Quirúrgica/cirugía , Adulto , Traumatismos del Tobillo/diagnóstico por imagen , Traumatismos del Tobillo/cirugía , Calcáneo/cirugía , Desbridamiento/métodos , Estudios de Seguimiento , Fijación Interna de Fracturas/métodos , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fracturas Abiertas/diagnóstico por imagen , Humanos , Hiperemia/etiología , Hiperemia/cirugía , Masculino , Radiografía , Reoperación/métodos , Medición de Riesgo , Infección de la Herida Quirúrgica/diagnóstico , Resultado del Tratamiento , Cicatrización de Heridas/fisiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA