Tools for Nutrition Assessment of Adults with Cerebral Palsy: Development of a Gold Standard.

PURPOSE OF REVIEW: Cerebral palsy (CP) is a group of disorders caused by non-stabilized cerebral lesions. Individuals with this disorder are at a higher risk of suffering from malnutrition and other related detrimental effects to their quality of life. For this reason, accurate methods of nutritional assessment are vital for people suffering from this condition. While assessment of nutritional status in children with CP has been extensively studied, very few studies have been carried out on adults. These limitations are due to the great anatomical-functional variability characteristic of this syndrome. Difficulties that derive from this variability in adult patients with CP mean that there remains an urgent need for certain standards of nutritional assessment for this population. The objective of this review is to compile the latest trends in nutritional assessment in adults with CP to guide the development of a conceptual framework for future research. RECENT FINDINGS: With this aim, relevant studies have been identified. The most commonly used technique to evaluate nutritional status is the BMI because of its ease-of-use. However, its well-known limitations fail to adequately estimate the nutritional status in this population, with measurements of patients with CP yielding results that are much less accurate than those that already exist in the general population. Although more studies are needed, kinanthropometry is considered one of the most reliable techniques; nevertheless, the anatomical limitation characteristic of CP plays a limiting factor.

Estudio prospectivo aleatorizado sobre la influencia del bloqueo distal del clavo Gamma 3 en el tratamiento de las fracturas pertrocantéreas de fémur / Randomized prospective study on the influence distal block and Gamma 3 nail on the treatment of intertrochanteric fractures of femur

Objetivo. El propósito de este estudio es valorar la necesidad de bloquear distalmente los clavos Gamma 3 (Stryker. Mahwah, New Jersey. USA) en fracturas pertrocantéreas de fémur 31-A1 y 31-A2 de la AO. Material y métodos. Desde junio de 2011 hasta enero de 2013 se recoge una muestra formada por 177 pacientes con fractura pertrocantérea de fémur tratados en nuestro centro mediante osteosíntesis con clavo Gamma 3 estándar. Es un estudio prospectivo y aleatorizado según el año de nacimiento de cada paciente, par con bloqueo o impar sin bloqueo distal del clavo, formando dos grupos de 90 y 87 fracturas respectivamente. Resultados. En los pacientes intervenidos mediante clavo con bloqueo distal se observó una mayor incidencia de complicaciones médicas, una menor incidencia de complicaciones biomecánicas y un aumento en el colapso del foco de fractura en comparación con el grupo control, siendo estas diferencias estadísticamente significativas (p < 0,05). También se observa en el grupo con bloqueo distal un mayor requerimiento transfusional y una mayor tasa de éxitus presentando diferencias estadísticamente significativas (p < 0,05), sin embargo esta significación desaparece al ajustar los resultados por otras características relacionadas con los pacientes. Conclusiones. Basándonos en los resultados hallados en este trabajo, el uso del tornillo de bloqueo distal en los clavos Gamma 3 debe restringirse a fracturas pertrocantéreas inestables tras reducción donde se requiera una estabilidad adicional al clavo intramedular, pudiendo así disminuir el riesgo de complicaciones derivadas de su uso (AU)

Objective. The purpose of this study is to assess the need to lock the Gamma 3 nail (Stryker, Mahwah New Jersey USA) distally for intertrochanteric fractures of femur 31-A1 and 31-A2 of the AO. Material and methods. Details were recorded on a sample of 177 patients with intertrochanteric femoral fractures treated in our hospital by a standard Gamma nail between June 2011 and January 2013. A prospective study was conducted by randomizing patients by year of birth, even numbers with, or odd number without, distal locking, forming two groups of 90 and 87 fractures, respectively. Results. The patients treated with a distal locking nail had an increased incidence of medical complications, a lower incidence of biomechanical complications, and an increase in the fracture collapse compared with the control group, with statistical significance (p < 0 .05). It is also observed in the group with distal locking increased transfusion requirement and a higher death rate, with statistically significant differences (p < 0 .05), but this significance disappears when adjusting for other patient-related characteristics. Conclusions. Based on the results found in this work, the use of distal locking screw in the Gamma 3 nails should be restricted to unstable trochanteric fractures after reduction where additional stability to the intramedullary nail is required, and may decrease the risk of complications from use (AU)

[Randomized prospective study on the influence distal block and Gamma 3 nail on the treatment of intertrochanteric fractures of femur]. / Estudio prospectivo aleatorizado sobre la influencia del bloqueo distal del clavo Gamma 3 en el tratamiento de las fracturas pertrocantéreas de fémur.

OBJECTIVE: The purpose of this study is to assess the need to lock the Gamma 3 nail (Stryker, Mahwah New Jersey USA) distally for intertrochanteric fractures of femur 31-A1 and 31-A2 of the AO. MATERIAL AND METHODS: Details were recorded on a sample of 177 patients with intertrochanteric femoral fractures treated in our hospital by a standard Gamma nail between June 2011 and January 2013. A prospective study was conducted by randomizing patients by year of birth, even numbers with, or odd number without, distal locking, forming two groups of 90 and 87 fractures, respectively. RESULTS: The patients treated with a distal locking nail had an increased incidence of medical complications, a lower incidence of biomechanical complications, and an increase in the fracture collapse compared with the control group, with statistical significance (p < 0.05). It is also observed in the group with distal locking increased transfusion requirement and a higher death rate, with statistically significant differences (p < 0.05), but this significance disappears when adjusting for other patient-related characteristics. CONCLUSIONS: Based on the results found in this work, the use of distal locking screw in the Gamma 3 nails should be restricted to unstable trochanteric fractures after reduction where additional stability to the intramedullary nail is required, and may decrease the risk of complications from use.

Estudio de la presencia de animales domésticos: gatos y perros, y su papel en el asma, la rinitis alérgica y la dermatitis atópica en niños / Study of the presence of domestic animals: cats and dogs and their role in asthma allergic rhinitis and atopic dermatitis in children

No disponible

[Fluoride levels in water for public use in the province of Valencia]. / Niveles de fluor en las aguas de consumo público de la provincia de Valencia.

It has been realized a description study about the fluorine content in the drinking waters from the province of Valencia and it has been looked for the relation with distinct variables in order to prevent possible risks for health. The fluoride level is very low in all the public consumption waters of the province. It has been recommended the fluoridation in order to get prophylaxis of the caries teeth. The structural and geological characteristics of the aquifer don't influence about the fluoride levels in it's water supplies. Fluorine level is lightly industrialized zones and supplies near dumping places of solid and liquid residues situated over vulnerable terrenes to contamination on account of porosity, immediately afterwards fissured zones and finally the mixed terrenes.