[GMK rotating hinge prosthesis. A valid option for complex revision knee prosthetic surgery]. / Prótesis bisagra rotatoria GMK. Una opción válida para la cirugía de revisión protésica compleja de rodilla.

INTRODUCTION: revision joint replacement surgery presents a surgical challenge. The use of rotating hinge prostheses is an option in patients with femorotibial bone defects, ligament insufficiency, or significant deformities. The aim of this study was to evaluate the clinical, functional, and radiological outcomes of a series of patients who underwent surgery using the GMK Hinge (Medacta®) rotational hinge model. MATERIAL AND METHODS: a descriptive, retrospective, and analytical study was conducted on a series of 36 patients, with a mean age of 72.5 years (47-85), operated on by the same surgical team between January 2015 and January 2022. The etiology of revision was chronic infection in 38.9% of cases, instability in 33.3%, aseptic loosening in 19.4%, and stiffness in 8.4%. The Knee Society Score (KSS) and the Forgotten Joint Score (FJS) were used to assess functional outcomes. The degree of femorotibial bone defect was evaluated using the Anderson Orthopaedic Research Institute (AORI) classification. Postoperative complications are also recorded. RESULTS: a total of 36 patients, 17 males and 19 females, were included, with a mean follow-up of 30 months (12-66). Twelve patients had type 1 defects, ten had 2A defects, ten had 2B defects, and two had type 3 defects on the femoral side, with the use of wedges required for asymmetrical defects (21 patients). The predominant tibial defect was type 1 without the need for wedges. The majority achieved a satisfactory outcome on the KSS scale (72.2 ± 9.4), with significant differences compared to the previous KSS (54.3 ± 8.9). A score of 31 (12-67) was also obtained on the FJS scale. Postoperative complications were present in 16.7% of patients. CONCLUSIONS: complex prosthetic revision surgery using a rotating hinge prosthesis represents a suitable therapeutic option, yielding appropriate clinical and functional outcomes, albeit not without complications.

INTRODUCCIÓN: la cirugía de revisión protésica constituye un reto quirúrgico. La utilización de prótesis tipo bisagra rotatoria es una opción en pacientes con defectos óseos femorotibiales, insuficiencia ligamentosa o importantes deformidades. El objetivo del presente estudio es evaluar los resultados clínicos, funcionales y radiológicos de una serie de pacientes intervenidos mediante un modelo de bisagra rotacional GMK Hinge (Medacta®). MATERIAL Y MÉTODOS: estudio descriptivo retrospectivo y analítico que incluyó una serie de 36 pacientes, con edad media de 72.5 años (47-85) intervenidos entre Enero de 2015 y Enero de 2022 por el mismo equipo quirúrgico. La etiología de revisión fue infección crónica en 38.9%, inestabilidad en 33.3%, aflojamiento aséptico en 19.4% y rigidez en 8.4%. Para la evaluación de resultados funcionales se utiliza la escala Knee Society Score (KSS), así como la escala Forgotten Joint Score (FJS). El grado de defecto óseo femorotibial se evaluó mediante la clasificación de Anderson Orthopaedic Research Institute (AORI). También se registraron las complicaciones postquirúrgicas. RESULTADOS: se analizó un total de 36 pacientes, 17 varones y 19 mujeres, con seguimiento medio de 30 meses (12-66). Se encontraron doce pacientes con defectos tipo 1, diez con defectos 2A, diez con defectos 2B y dos con defecto tipo 3 en la vertiente femoral, siendo necesario la utilización de cuñas en defectos asimétricos (21 pacientes). El defecto tibial mayoritario fue el tipo 1 sin necesidad de cuñas. La mayoría obtuvo un resultado satisfactorio en la escala KSS (72.2 ± 9.4), con diferencias significativas respecto al KSS previo (54.3 ± 8.9). Se obtuvo también una puntuación de 31 (12-67) en la escala FJS. Presentaron complicaciones postoperatorias 16.7% de los pacientes. CONCLUSIONES: la cirugía de revisión protésica compleja mediante prótesis tipo bisagra rotacional constituye una correcta opción terapéutica, presentando resultados clínicos y funcionales adecuados, no exentos de complicaciones.

Structure-function relationships in the human visual system using DTI, fMRI and visual field testing: pre- and post-operative assessments in patients with anterior visual pathway compression.

The focus of this project is to improve our understanding of the relationships between brain structure and function in patients presenting with anterior visual pathway compression using functional MRI (fMRI), visual field(VF) maps and diffusion tensor imaging (DTI). Significant visual loss can occur when large pituitary lesions compress the optic chiasm. Surgical resection of these lesions decompresses the chiasm and can lead to visual recovery. In this preliminary study, we selected patients presenting with slowly progressive visual loss secondary to a compressive pituitary region mass. Using preoperative DTI data, we reconstructed white matter projections of the optic radiations and demonstrated a structural correlation with functional vision as quantified by formal visual field mapping and fMRI. The structural data generated through a fiber tracking algorithm may represent a potentially powerful tool to better understand functional visual deficits in patients with anterior visual pathway compression. Furthermore, we believe that specific patterns in preoperative DTI data may predict the likelihood of postoperative visual recovery in a select group of patients.

VALIDATION AND COMPARISON OF EQ-5D-3L AND SF-6D INSTRUMENTS IN A SPANISH PARKINSON´S DISEASE POPULATION SAMPLE.

INTRODUCTION: generic, preference-based Health- Related Quality of Life instruments are receiving growing attention in health-care decision-making process. In spite of this, to our knowledge, EQ-5D and SF-6D have never been compared in a Parkinson´s disease population sample. OBJECTIVE: the aim of this paper was to assess the psychometric properties of both instruments in a Spanish PD population sample. METHODS: a total sample of 133 patients were interviewed using EQ-5D-3L and SF-6D. The validity, level of agreement and sensitivity of both instruments were computed and then compared. The Spanish tariff has been used in both instruments. RESULTS: utilities of EQ-5D-3L and SF-6D have shown a strong correlation (r >0.50 and p<0.001) with the summary score of the PDQ-8 and the EQ-VAS score. Significant differences were observed in the stages III-IV of the Hoehn & Yahr stage. SF-6D had 51% higher efficiency than EQ-5D at detecting differences in symptoms severity. DISCUSSION: both EQ-5D-3L and SF-6D seem to be adequate generic Health-Related Quality of Life measures in terms of validity and sensitivity. CONCLUSION: EQ-5D-3L presents greater ceiling and floor effects than the SF-6D instrument in this sample. Besides, the instrument SF-6D was better at detecting changes in symptoms severity compared with EQ-5D-3L.

Introducción: el uso de cuestionarios de calidad de vida basados en preferencias poblacionales están recibiendo cada vez más atención en el proceso de toma de decisiones en el ámbito sanitario. Sin embargo, a nuestro entender, EQ-5D y SF-6D nunca han sido comparados en una muestra de población con la enfermedad de Parkinson. Objetivo: el objetivo de este trabajo fue evaluar las propiedades psicométricas de ambos instrumentos en una muestra de población española con enfermos de Parkinson. Métodos: un total de 133 pacientes fueron entrevistados utilizando EQ-5D y SF-6D. La validez, el grado de acuerdo y la sensibilidad de ambos instrumentos fueron calculados para su posterior comparación. Las preferencias de la población española fueron utilizadas en ambos instrumentos. Resultados: las utilidades de EQ-5D y SF-6D han mostrado una fuerte correlación (r> 0,50 y p.

[Complete clinical remission over 50 months of a patient with acute monocytic leukaemia (author's transl)]. / Remisión clínica completa de 50 meses de evolución en un paciente afecto de leucemia aguda monocítica.

A case of Schilling type pure acute monocytic leukaemia (M5 variety of the FAB classification) in a 38-year-old man is presented. The initial predominant clinical manifestation was an increase hypertrophic gingivitis. The cytological type was established according to the morphologic and cytochemical criteria currently in use. The patient was treated with daunomycin (60 mg/m2 one day) and ARA-C (100 mg/m2/12 hours for 7 days) in a 2-week interval cycles. Total remission was achieved after the fifth series. The series have been repeated over 4 years with intervals of up to 6 or 8 weeks. Complete haematologic remission has been constant, with normalization of the serum muramidase levels. A gingival biopsy taken at the same time has shown no evidence of leukaemic infiltration. The high incidence of malignancy in this cytological variety of acute leukaemia is pointed out; it is normally less sensitive to chemotherapy than the myeloid types. Remission has been total over a long period of time, which is exceptional in this type of leukaemia. The mean survival rate as recorded in the literature is only a little over 3 months.

Modeling the point-spread function in helium-ion lithography.

We present here a hybrid approach to modeling helium-ion lithography that combines the power and ease-of-use of the Stopping and Range of Ions in Matter (SRIM) software with the results of recent work simulating secondary electron (SE) yield in helium-ion microscopy. This approach traces along SRIM-produced helium-ion trajectories, generating and simulating trajectories for SEs using a Monte Carlo method. We found, both through simulation and experiment, that the spatial distribution of energy deposition in a resist as a function of radial distance from beam incidence, i.e. the point spread function, is not simply a sum of Gauss functions.

[The degree of participation in a family planning survey performed by personal interview]. / Grado de participación en una encuesta sobre planificación familiar mediante entrevista personal.

OBJECTIVE: To analyse participation levels in a family planning survey. DESIGN: Descriptive and sectorial survey by means of personal interviews. SITE. Primary Care. Rural Context. Basic Health Area of Sanlúcar la Mayor (Sevilla). PARTICIPANTS: 271 women of child-bearing age (15 to 49) chosen at random from the Municipal Census, who were invited by letter to the place of work of those doing the survey. INTERVENTIONS: Those who did not attend were invited on two further occasions. MAIN MEASUREMENTS AND RESULTS: The level of reply was 24.8% of those invited by the first letter, 25.12% by the second and 28.9% by the third. 40% of the total number did not attend on any of the three occasions: in 29.9% of cases because of work or study; in 22.9% because they hadn't received the letter; in 18.1% because of another commitment; in 26.5% due to lack of interest; 6% due to absence; and 3.6% owing to other reasons. 72.3% had no School Graduation Certificate. Only 10.3% were working. Differences of age, level of studies achieved and work activity between those attending and those not attending were considered significant but of no overall relevance. CONCLUSIONS: A survey based on personal interviews is a useful and valid way of collecting information in a rural community. Poor participation is thought to be due to both the low social and cultural levels and to the survey's subjects-matter. We consider that sending follow-up letters of invitation is a sound method of reducing as much as possible the number of home interviews which would otherwise have to be administered to those who did not attend.