Coupled atomistic spin-lattice simulations of ultrafast demagnetization in 3d ferromagnets.

Despite decades of research, the role of the lattice and its coupling to the magnetisation during ultrafast demagnetisation processes is still not fully understood. Here we report on studies of both explicit and implicit lattice effects on laser induced ultrafast demagnetisation of bcc Fe and fcc Co. We do this using atomistic spin- and lattice dynamics simulations following a heat-conserving three-temperature model. We show that this type of Langevin-based simulation is able to reproduce observed trends of the ultrafast magnetization dynamics of fcc Co and bcc Fe. The parameters used in our models are all obtained from electronic structure theory, with the exception of the lattice dynamics damping term, where a range of parameters were investigated. It was found that while the explicit spin-lattice coupling in the studied systems does not impact the demagnetisation process notably, the lattice damping has a large influence on the details of the magnetization dynamics. The dynamics of Fe and Co following the absorption of a femtosecond laser pulse are compared with previous results for Ni and similarities and differences in the materials' behavior are analysed. For all elements investigated so far with this model, we obtain a linear relationship between the value of the maximally demagnetized state and the fluence of the laser pulse , which is in agreement with experiments. Moreover, we demonstrate that the demagnetization amplitude is largest for Ni and smallest for Co. This holds over a wide range of the reported electron-phonon couplings, and this demagnetization trend is in agreement with recent experiments.

DNA barcoding of herbal supplements on the US commercial market associated with the purported treatment of COVID-19.

INTRODUCTION: The COVID-19 pandemic was associated with an increased global use of traditional medicines, including Ayurvedic herbal preparations. Due to their growing demand, their processed nature, and the complexity of the global supply chain, there is an increased risk of adulteration in these products. OBJECTIVES: The objective of this study was to assess the use of DNA barcoding for species identification in herbal supplements on the US market associated with the Ayurvedic treatment of respiratory symptoms. METHODS: A total of 54 commercial products containing Ayurvedic herbs were tested with four DNA barcoding regions (i.e., rbcL, matK, ITS2, and mini-ITS2) using two composite samples per product. Nine categories of herbs were targeted: amla, ashwagandha, cinnamon, ginger, guduchi, tribulus, tulsi, turmeric, and vacha. RESULTS: At least one species was identified in 64.8% of products and the expected species was detected in 38.9% of products. Undeclared plant species, including other Ayurvedic herbs, rice, and pepper, were detected in 19 products, and fungal species were identified in 12 products. The presence of undeclared plant species may be a result of intentional substitution or contamination during harvest or processing, while fungal DNA was likely associated with the plant material or the growing environment. The greatest sequencing success (42.6-46.3%) was obtained with the matK and rbcL primers. CONCLUSION: The results of this study indicate that a combination of genetic loci should be used for DNA barcoding of herbal supplements. Due to the limitations of DNA barcoding in identification of these products, future research should incorporate chemical characterization techniques.

Assessing the dynamics of CO adsorption on Cu(110) using the vdW-DF2 functional and artificial neural networks.

In this work, we revisit the dynamics of carbon monoxide molecular chemisorption on Cu(110) by using quasi-classical trajectory calculations. The molecule-surface interaction is described through an atomistic neural network approach based on Density Functional Theory calculations using a nonlocal exchange-correlation (XC) functional that includes the effect of long-range dispersion forces: vdW-DF2 [Lee et al. Phys. Rev. B, 82, 081101 (2010)]. With this approach, we significantly improve the agreement with experiments with respect to a similar previous study based on a semi-local XC functional. In particular, we obtain excellent agreement with molecular beam experimental data concerning the dependence of the initial sticking probability on surface temperature and impact energy at normal incidence. For off-normal incidence, our results also reproduce two trends observed experimentally: (i) the preferential sticking for molecules impinging parallel to the [1̄10] direction compared to [001] and (ii) the change from positive to negative scaling as the impact energy increases. Nevertheless, understanding the origin of some remaining quantitative discrepancies with experiments requires further investigations.

Labeling compliance and online claims for Ayurvedic herbal supplements on the U.S. market associated with the purported treatment of COVID-19.

During the COVID-19 pandemic, many consumers increased their use of supplements that claimed to support immune health, including Ayurvedic preparations. The goal of this study was to analyze labeling compliance and online claims for Ayurvedic herbal supplements associated with the purported treatment of COVID-19. The physical product labels for 51 herbal supplements labeled as ginger, tulsi/holy basil, amla, vacha/calamus root, guduchi/giloy, cinnamon, ashwagandha, tribulus, or turmeric were assessed for U.S. regulatory compliance. Disease claims, structure/function claims, and general well-being claims were also examined. The online listings for products purchased online (n = 42) were examined for claims and for the presence of the required legal disclaimer. Collectively, 61% of products had at least one instance of noncompliance on the physical label. The most common violations included missing/noncompliant disclaimer (33%), noncompliant "Supplement Facts" label (29%), noncompliant statement of identity (27%) and noncompliant domestic mailing address or phone number (25%). Structure/function claims occurred more frequently in the online product listings (average of 5 claims per product) compared to the physical labels (average of 2 claims per product). Disease claims were observed for 38% of online product listings and on 8% of physical labels. The use of disease claims on herbal supplements is a significant concern for public health because it may lead consumers to delay seeking professional treatment for life-threatening diseases. Overall, this study revealed a lack of labeling compliance among Ayurvedic herbal supplements and a need for greater scrutiny and monitoring of online product listings.

Investigating the impact of multiple feeding attempts on mosquito dynamics via mathematical models.

A deterministic differential equation model for the dynamics of terrestrial forms of mosquito populations is studied. The model assesses the impact of multiple probing attempts by mosquitoes that quest for blood within human populations by including a waiting class for mosquitoes that failed a blood feeding attempt. The equations are derived based on the idea that the reproductive cycle of the mosquito can be viewed as a set of alternating egg laying and blood feeding outcomes realised on a directed path called the gonotrophic cycle pathway. There exists a threshold parameter, the basic offspring number for mosquitoes, whose nature is affected by the way we interpret the transitions involving the different classes on the gonotrophic cycle path. The trivial steady state for the system, which always exists, can be globally asymptomatically stable whenever the threshold parameter is less than unity. The non-trivial steady state, when it exists, is stable for a range of values of the threshold parameter but can also be driven to instability via a Hopf bifurcation. The model's output reveals that the waiting class mosquitoes do contribute positively to sustain mosquito populations as well as increase their interactions with humans via increased frequency and initial amplitude of oscillations. We conclude that to understand human-mosquito interactions, it is informative to consider multiple probing attempts; known to occur when mosquitoes quest for blood meals within human populations.

The impact of COVID-19 vaccination campaigns accounting for antibody-dependent enhancement

BackgroundCOVID-19 vaccines are approved, vaccination campaigns are launched, and worldwide return to normality seems within close reach. Nevertheless, concerns about the safety of COVID-19 vaccines arose, due to their fast emergency approval. In fact, the problem of antibody-dependent enhancement was raised in the context of COVID-19 vaccines. Methods and findingsWe introduce a complex extension of the model underlying the pandemic preparedness tool CovidSim 1.1 (http://covidsim.eu/) to optimize vaccination strategies with regard to the onset of campaigns, vaccination coverage, vaccination schedules, vaccination rates, and efficiency of vaccines. Vaccines are not assumed to immunize perfectly. Some individuals fail to immunize, some reach only partial immunity, and - importantly - some develop antibody-dependent enhancement, which increases the likelihood of developing symptomatic and severe episodes (associated with higher case fatality) upon infection. Only a fraction of the population will be vaccinated, reflecting vaccination hesitancy or contraindications. The model is intended to facilitate decision making by exploring ranges of parameters rather than to be fitted by empirical data. We parameterized the model to reflect the situation in Germany and predict increasing incidence (and prevalence) in early 2021 followed by a decline by summer. Assuming contact reductions (curfews, social distancing, etc.) to be lifted in summer, disease incidence will peak again. Fast vaccine deployment contributes to reduce disease incidence in the first quarter of 2021, and delay the epidemic outbreak after the summer season. Higher vaccination coverage results in a delayed and reduced epidemic peak. A coverage of 75% - 80% is necessary to prevent an epidemic peak without further drastic contact reductions. ConclusionsWith the vaccine becoming available, compliance with contact reductions is likely to fade. To prevent further economic damage from COVID-19, high levels of immunization need to be reached before next years flu season, and vaccination strategies and disease management need to be flexibly adjusted. The predictive model can serve as a refined decision support tool for COVID-19 management.

Mathematical assessment of the impact of human-antibodies on sporogony during the within-mosquito dynamics of Plasmodium falciparum parasites.

We develop and analyze a deterministic ordinary differential equation mathematical model for the within-mosquito dynamics of the Plasmodium falciparum malaria parasite. Our model takes into account the action and effect of blood resident human-antibodies, ingested by the mosquito during a blood meal from humans, in inhibiting gamete fertilization. The model also captures subsequent developmental processes that lead to the different forms of the parasite within the mosquito. Continuous functions are used to model the switching transition from oocyst to sporozoites as well as human antibody density variations within the mosquito gut are proposed and used. In sum, our model integrates the developmental stages of the parasite within the mosquito such as gametogenesis, fertilization and sporogenesis culminating in the formation of sporozoites. Quantitative and qualitative analyses including a sensitivity analysis for influential parameters are performed. We quantify the average sporozoite load produced at the end of the within-mosquito malaria parasite's developmental stages. Our analysis shows that an increase in the efficiency of the ingested human antibodies in inhibiting fertilization within the mosquito's gut results in lowering the density of oocysts and hence sporozoites that are eventually produced by each mosquito vector. So, it is possible to control and limit oocysts development and hence sporozoites development within a mosquito by boosting the efficiency of antibodies as a pathway to the development of transmission-blocking vaccines which could potentially reduce oocysts prevalence among mosquitoes and hence reduce the transmission potential from mosquitoes to human.

Fracturas transversales del cuerpo del semilunar con retraso en la consolidación. Experiencia en el tratamiento artroscópico / Transverse fractures through the body of the lunate with delay in consolidation. Experience with arthroscopic treatment

ANTECEDENTES Y OBJETIVO: Las fracturas traumáticas del semilunar representan entre el 0,5% y el 1% de todas las fracturas del carpo. Las fracturas transversales del cuerpo del semilunar (tipo V) son las menos frecuentes y quirúrgicas si están desplazadas, porque tienen alto riesgo de necrosis o pseudoartrosis. El objetivo de este trabajo es presentar nuestra experiencia con el tratamiento artroscópico en pacientes con un retraso en la consolidación tras una fractura transversal del cuerpo del semilunar. MATERIAL Y MÉTODO: Presentamos dos casos clínicos de retardos de consolidación tras fracturas transversales del cuerpo del semilunar. RESULTADOS: En ambos casos no se diagnosticó la fractura con radiografía simple inicial y se determinaron mediante tomografía computarizada. En ambos casos se produjo un retraso en la consolidación. Se trataron mediante cruentación, aporte de injerto y osteosíntesis bajo control artroscópico obteniendo una correcta consolidación radiográfica. CONCLUSIONES: El tratamiento artroscópico es una técnica válida, eficaz y segura para el tratamiento de los retardos de consolidación de las fracturas transversales del hueso semilunar, y evita las complicaciones y lesión de las partes blandas de las técnicas por cirugía abierta

BACKGROUND AND AIM: Lunate traumatic fractures represent between 0.5% and 1% of carpal bone fractures. Transverse fracture through the body of the lunate (type V) are the least frequent and need surgical treatment if displaced, because it has a high risk of necrosis or pseudoarthrosis. The objective of this paper is to present our experience with arthroscopic treatment in patients with a delay in consolidation after a transverse fracture through the body of the lunate. METHODS: Two clinical cases of delay in consolidation in transverse fracture through the body of the lunate are presented. Both cases have delay in consolidation. RESULTS: Both fractures were misdiagnosed in initial simple radiographic exploration and were diagnosed with computerised tomography. Both patients were treated by debridement, bone grafting and osteosynthesis under arthroscopic control, obtaining a correct radiographic consolidation. CONCLUSION: Arthroscopic treatment is a valid, effective and safe technique for the treatment of delay in consolidation of transverse fractures through the body of the lunate and avoids complications and soft tissues injury of the open surgery techniques

Atrial matrix remodeling in atrial fibrillation patients with aortic stenosis.

BACKGROUND: This study aimed to evaluate atrium extracellular matrix remodeling in atrial fibrillation (AF) patients with severe aortic stenosis, through histological fibrosis quantification and extracellular matrix gene expression analysis, as well as serum quantification of selected protein targets. METHODS: A posthoc analysis of a prospective study was performed in a cohort of aortic stenosis patients. Between 2014 and 2019, 56 patients with severe aortic stenosis submitted to aortic valve replacement surgery in a tertiary hospital were selected. RESULTS: Fibrosis was significantly increased in the AF group when compared to sinus rhythm (SR) patients (p = 0.024). Moreover, cardiomyocyte area was significantly higher in AF patients versus SR patients (p = 0.008). Conversely, collagen III gene expression was increased in AF patients (p = 0.038). TIMP1 was less expressed in the atria of AF patients. MMP16/TIMP4 ratio was significantly decreased in AF patients (p = 0.006). TIMP1 (p = 0.004) and TIMP2 (p = 0.012) were significantly increased in the serum of AF patients. Aortic valve maximum (p = 0.0159) and mean (p = 0.031) gradients demonstrated a negative association with serum TIMP1. CONCLUSIONS: Atrial fibrillation patients with severe aortic stenosis present increased atrial fibrosis and collagen type III synthesis, with extracellular matrix remodelling demonstrated by a decrease in the MMP16/TIMP4 ratio, along with an increased serum TIMP1 and TIMP2 proteins.

Sarcomas de partes blandas en la región del codo e influencia de sus particularidades anatómicas en su tratamiento. Experiencia en una Unidad de Tumores musculoesqueléticos / Soft tissue sarcomas in the elbow region and influence of their anatomical features in their treatment. Experience in the Unit of Musculoskeletal Tumours

ANTECEDENTES Y OBJETIVO: Los sarcomas de partes blandas se localizan excepcionalmente en la región del codo. El objetivo de este trabajo fue estudiar los sarcomas de partes blandas de la región del codo, sus características epidemiológicas e histopatológicas, particularidades anatómicas, tratamiento realizado y resultados obtenidos, en una Unidad de Tumores Musculoesqueléticos. MATERIALES Y MÉTODOS: Revisión retrospectiva de 10 pacientes con un seguimiento de 65,0 ± 11,9 (rango 21-132) meses con sarcoma de partes blandas situado en la región del codo, intervenidos en nuestro centro entre los años 2008 y 2016. RESULTADOS: La edad media fue de 60,8 ± 6,7 años. La histología más frecuente fue sarcoma pleomórfico indiferenciado. El 90% de los pacientes fueron sometidos a cirugía de preservación de extremidad. Tres pacientes fueron previamente intervenidos sin criterios oncológicos en otro centro, y esto se relacionó de forma estadísticamente significativa con requerir más de una cirugía para el control de la enfermedad. En cinco pacientes se obtuvo un margen R1 y en cinco R0. La radioterapia adyuvante se utilizó en siete casos. En cuatro pacientes se realizó cirugía posterior para control local o sistémico de la enfermedad. En tres casos se produjo recidiva local y en cinco se presentó enfermedad a distancia. CONCLUSIONES: La región del codo presenta dificultad para lograr márgenes amplios por la proximidad de estructuras neurovasculares, por lo que las terapias adyuvantes, neoadyuvantes (o ambas) podrían tener un papel importante para poder realizar una cirugía de preservación de la extremidad. Sería recomendable remitir estos tumores a unidades especializadas con equipos multidisciplinarios

BACKGROUND AND AIM: Soft tissue sarcomas are exceptionally located in the elbow region. The aim of this work was to study the soft tissue sarcomas of the elbow region, their epidemiological and histopathological characteristics, anatomical features, the treatment performed, and the results obtained, in a unit of musculoskeletal tumours. METHODS: Retrospective review of ten patients with a mean follow-up of 65.0 ± 11.9 (range 21-132) months with soft tissue sarcomas located in the elbow region operated in our centre between 2008 and 2016. RESULTS: Mean age was 60.8 ± 6.7 years. Undifferentiated pleomorphic sarcoma was the most frequent histological diagnosis. Limb preservation surgery was performed in 90% of patients. Three patients were previously operated without following surgical oncology guidelines in another hospital, and this was statistically related to the need for more than one surgery to control the disease. R1 margin was obtained in 5 patients and R0 in another 5. Adjuvant radiotherapy was used in 7 cases. In 4 patients, subsequent surgery was performed for local or systemic control of the disease. Local recurrence occurred in 3 cases and in 5 there was distant disease. CONCLUSION: The elbow region presents difficulty in achieving wide margins due to the proximity of neurovascular structures, adjuvant and / or neoadjuvant therapies could play an important role in performing limb preservation surgery. It would be advisable to refer these tumours to specialized units with multidisciplinary teams

Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?

BackgroundGovernments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adapted draconic measures, which have been perceived controversial others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper control measure, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection. Methods and findingsWe extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to multi infections, either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the East Coast of the USA. We assume a phase of general contact reduction ( lockdown) at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi infections and different susceptibility to multi infectious in different disease phases. It is demonstrated that multi infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths. ConclusionsEnhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity.

Soft tissue sarcomas in the elbow region and influence of their anatomical features in their treatment. Experience in the Unit of Musculoskeletal Tumours. / Sarcomas de partes blandas en la región del codo e influencia de sus particularidades anatómicas en su tratamiento. Experiencia en una Unidad de Tumores musculoesqueléticos.

BACKGROUND AND AIM: Soft tissue sarcomas are exceptionally located in the elbow region. The aim of this work was to study the soft tissue sarcomas of the elbow region, their epidemiological and histopathological characteristics, anatomical features, the treatment performed, and the results obtained, in a unit of musculoskeletal tumours. METHODS: Retrospective review of ten patients with a mean follow-up of 65.0 ± 11.9 (range 21-132) months with soft tissue sarcomas located in the elbow region operated in our centre between 2008 and 2016. RESULTS: Mean age was 60.8 ± 6.7 years. Undifferentiated pleomorphic sarcoma was the most frequent histological diagnosis. Limb preservation surgery was performed in 90% of patients. Three patients were previously operated without following surgical oncology guidelines in another hospital, and this was statistically related to the need for more than one surgery to control the disease. R1 margin was obtained in 5 patients and R0 in another 5. Adjuvant radiotherapy was used in 7 cases. In 4 patients, subsequent surgery was performed for local or systemic control of the disease. Local recurrence occurred in 3 cases and in 5 there was distant disease. CONCLUSION: The elbow region presents difficulty in achieving wide margins due to the proximity of neurovascular structures, adjuvant and / or neoadjuvant therapies could play an important role in performing limb preservation surgery. It would be advisable to refer these tumours to specialized units with multidisciplinary teams.

Transverse fractures through the body of the lunate with delay in consolidation. Experience with arthroscopic treatment. / Fracturas transversales del cuerpo del semilunar con retraso en la consolidación. Experiencia en el tratamiento artroscópico.

BACKGROUND AND AIM: Lunate traumatic fractures represent between 0.5% and 1% of carpal bone fractures. Transverse fracture through the body of the lunate (type V) are the least frequent and need surgical treatment if displaced, because it has a high risk of necrosis or pseudoarthrosis. The objective of this paper is to present our experience with arthroscopic treatment in patients with a delay in consolidation after a transverse fracture through the body of the lunate. METHODS: Two clinical cases of delay in consolidation in transverse fracture through the body of the lunate are presented. Both cases have delay in consolidation. RESULTS: Both fractures were misdiagnosed in initial simple radiographic exploration and were diagnosed with computerised tomography. Both patients were treated by debridement, bone grafting and osteosynthesis under arthroscopic control, obtaining a correct radiographic consolidation. CONCLUSION: Arthroscopic treatment is a valid, effective and safe technique for the treatment of delay in consolidation of transverse fractures through the body of the lunate and avoids complications and soft tissues injury of the open surgery techniques.

Evaluación funcional de los pacientes con rotura del ligamento cruzado anterior. Estudio analítico transversal / Functional evaluation of patients with anterior cruciate ligament injury. A transversal analytical study

OBJETIVO: Evaluar, mediante un análisis biomecánico, la alteración funcional de la marcha y del equilibrio de pacientes con rotura del ligamento cruzado anterior (LCA). MATERIAL Y MÉTODO: Estudio analítico transversal en 64 sujetos, 27 sujetos sanos y 37 pacientes con lesión de LCA. A todos los sujetos se les realizó un análisis biomecánico de la marcha mediante 4 pruebas: 1) prueba cinemática de la marcha, para caracterizar el patrón de marcha; 2) prueba de análisis cinético de la marcha, para analizar las características de las fuerzas ejercidas contra el suelo, la duración de las pisadas, la simetría entre ambas extremidades y la repetitividad del gesto analizado; 3) prueba de la marcha con pívot, para valorar la estabilidad rotacional de la rodilla alrededor del eje sagital; y 4) prueba de equilibrio. RESULTADOS: Se han encontrado alteraciones en el análisis cinemático y cinético tanto en la rodilla lesionada como en la sana respecto al grupo control. En la prueba de la marcha con pívot hay una tendencia al aumento de las fuerzas en los 3 ejes, tanto en la pierna de apoyo como en la pierna de salida en los pacientes con rotura de LCA, en comparación con los sujetos sanos. CONCLUSIÓN: La rotura del LCA produjo alteración del patrón de marcha, alteración de las fuerzas ejercidas contra el suelo, de la duración de las pisadas, de la simetría entre ambas extremidades y de la repetitividad del gesto durante la marcha y alteración de la estabilidad rotacional de la rodilla en el eje sagital

OBJECTIVE: To evaluate, by means of biomechanical analysis, functional alterations of gait and balance of patients with anterior cruciate ligament (ACL) injury. MATERIAL AND METHODS: Transversal analytical study on 64 people, 27 health subjects and 37 patients with ACL injury. Biomechanical analysis of gait in all individuals was performed by means of four tests: 1) kinematic test, to characterize gait pattern; 2) kinetic test, to characterize forces against the floor, duration of treads, symmetry of both legs, and the reproducibility of the gait; 3) pivot-shift test, to analyze the rotational stability of the knee on the sagittal axis; and 4) equilibrium test. RESULTS: Alterations in kinematic and kinetic analysis were found in both the injured knee and the healthy knee compared to the control group. In the pivot-shift gait test there is a tendency to increase the forces on the three axes, both in the support leg and in the exit leg in patients with ACL injury, in comparison with healthy subjects. CONCLUSION: ACL injury-induced changes in gait pattern, changes in forces against the floor, duration of treads, symmetry of both legs, and the reproducibility of gait and changes in rotational stability of the knee on the sagittal axis

Utilización del ácido tranexámico tópico en la artroplastia total primaria de cadera. Eficacia y seguridad. Nuestra experiencia / Use of topical tranexamic acid in primary total hip arthroplasty. Efficiency and safety. Our experience

ANTECEDENTES Y OBJETIVO: El ácido tranexámico por vía intravenosa ha demostrado que disminuye el sangrado y la necesidad de transfusiones en la artroplastia total de cadera, aunque tiene un riesgo teórico de producir fenómenos tromboembólicos. Recientemente, se han publicado algunos trabajos con la aplicación del ácido tranexámico tópico, sin haberse definido todavía cuál es el protocolo de administración ideal. El objetivo de este trabajo fue demostrar que nuestro protocolo de administración tópica de ácido tranexámico es eficaz y seguro. MATERIALES Y MÉTODOS: Recogida de datos de una serie prospectiva de 80 artroplastias primarias de cadera, en las que se utilizó un protocolo de ácido tranexámico tópico: se prepararon 1,5 g diluidos en un volumen total de 60ml, administrando 20ml tras fresar el cotilo, 20ml en el canal femoral y 20ml a través del redón, manteniéndolo cerrado durante 20 min. RESULTADOS: Se intervino a 80 pacientes. Hemoglobina preoperatoria 14,26g/dl; hematocrito preoperatorio 42,39%. Se observó una pérdida media de 2,74g/dl de hemoglobina y del 8% de hematocrito. Precisaron transfusión el 11% de los pacientes, de los cuales el 67% tenía una anemia previa conocida; solo 3 pacientes sin anemia previa precisaron transfusión (4%). No hubo ninguna complicación tromboembólica en nuestra serie. CONCLUSIONES: La utilización de ácido tranexámico tópico fue eficaz y segura en la artroplastia total primaria de cadera, reduciendo la necesidad de transfusión sanguínea respecto a lo descrito en la literatura en pacientes no tratados

BACKGROUND AND AIM: Intravenous tranexamic acid has been shown to reduce bleeding and the need for transfusions in total hip arthroplasty, although it has a theoretical risk of producing thromboembolic phenomena. Recently some papers have been published using the topical application of tranexamic acid, but the ideal administration protocol has not yet been clearly defined. The aim of this paper was to demonstrate that our protocol of topical tranexamic acid is effective and safe. MATERIALS AND METHODS: Prospective data collection from a case series of 80 primary hip arthroplasties, in which the following topical tranexamic acid protocol is used: 1.5 grams diluted to a total volume of 60ml were administered, applying 20ml in the acetabular bed, 20ml in the femoral canal and 20ml through the Redon drain, keeping it closed for 20minutes. RESULTS: Eighty patients were operated. Preoperative haemoglobin 14.26g / dL; preoperative haematocrit 42.39%. An average loss of 2.74g / dL of haemoglobin and 8% of haematocrit was obtained. Eleven percent of the patients required transfusion, of whom 67% had known previous anaemia; only 3 patients without prior anaemia required transfusion (4%). There were no thromboembolic complications in our series. CONCLUSIONS: The use of topical tranexamic acid was safe and effective in primary total hip arthroplasty, reducing the need for blood transfusion compared to that described in the literature in untreated patients

Tendinitis calcificante de hombro con extensión intraósea: experiencia con el tratamiento artroscópico y revisión de la literatura / Calcific tendinopathy of the shoulder with intraosseous extension: experience with arthroscopic treatment and review of the literature

ANTECEDENTES Y OBJETIVO: La tendinitis calcificante del manguito de los rotadores es una de las causas frecuentes de dolor en el hombro. El objetivo fue dar a conocer una presentación poco habitual de la tendinitis calcificante de hombro, la expansión intraósea, que en muchos casos puede ser confundida con una lesión tumoral o infecciosa, y de esta manera evitar biopsias o tratamientos innecesarios, y presentar nuestra experiencia con el tratamiento artroscópico. MATERIAL Y MÉTODOS: Se presentan 2 casos clínicos de tendinitis calcificante de hombro con extensión intraósea y una revisión de las series publicadas. RESULTADOS: En ambos casos se observó erosión de la cortical, una lesión osteolítica en la tuberosidad mayor y un edema perilesional. Se obtuvieron buenos resultados con el tratamiento mediante artroscopia de hombro con desbridamiento de la lesión y reinserción del supraespinoso en la tuberosidad mayor mediante un arpón. CONCLUSIONES: Ante una lesión osteolítica con edema perilesional en la tuberosidad mayor, hay que valorar, dentro del diagnóstico diferencial, la expansión intraósea de una tendinitis calcificante. En nuestros casos el tratamiento artroscópico fue eficaz

BACKGROUND AND AIM: Calcific tendinitis of the rotator cuff is a common cause of shoulder pain. The aim of the present study was to show a rare presentation of calcific tendinopathy of the shoulder, the intraosseous extension, which can be mistaken for a bone tumour or an infectious disease. MATERIAL AND METHODS: Two clinical cases of calcific tendinopathy of the shoulder with intraosseous extension and a review of the literature are presented. RESULTS: Cortical erosion, osteolytic lesion in the greater tuberosity and perilesional oedema were observed in both cases. Good results were achieved with shoulder arthroscopy including lesion debridement and reinsertion of the tendon in the greater tuberosity with an anchor. CONCLUSIONS: In the presence of an osteolytic lesion with perilesional oedema in the greater tuberosity, the intraosseous expansion of a calcifying tendinopathy should be included in the differential diagnosis. In our cases the arthroscopic treatment was successful

Functional evaluation of patients with anterior cruciate ligament injury. A transversal analytical study. / Evaluación funcional de los pacientes con rotura del ligamento cruzado anterior. Estudio analítico transversal.

OBJECTIVE: To evaluate, by means of biomechanical analysis, functional alterations of gait and balance of patients with anterior cruciate ligament (ACL) injury. MATERIAL AND METHODS: Transversal analytical study on 64 people, 27 health subjects and 37 patients with ACL injury. Biomechanical analysis of gait in all individuals was performed by means of four tests: 1) kinematic test, to characterize gait pattern; 2) kinetic test, to characterize forces against the floor, duration of treads, symmetry of both legs, and the reproducibility of the gait; 3) pivot-shift test, to analyze the rotational stability of the knee on the sagittal axis; and 4) equilibrium test. RESULTS: alterations in kinematic and kinetic analysis were found in both the injured knee and the healthy knee compared to the control group. In the pivot-shift gait test there is a tendency to increase the forces on the three axes, both in the support leg and in the exit leg in patients with ACL injury, in comparison with healthy subjects. CONCLUSION: ACL injury-induced changes in gait pattern, changes in forces against the floor, duration of treads, symmetry of both legs, and the reproducibility of gait and changes in rotational stability of the knee on the sagittal axis.

Use of topical tranexamic acid in primary total hip arthroplasty. Efficiency and safety. Our experience. / Utilización del ácido tranexámico tópico en la artroplastia total primaria de cadera. Eficacia y seguridad. Nuestra experiencia.

BACKGROUND AND AIM: Intravenous tranexamic acid has been shown to reduce bleeding and the need for transfusions in total hip arthroplasty, although it has a theoretical risk of producing thromboembolic phenomena. Recently some papers have been published using the topical application of tranexamic acid, but the ideal administration protocol has not yet been clearly defined. The aim of this paper was to demonstrate that our protocol of topical tranexamic acid is effective and safe. MATERIALS AND METHODS: Prospective data collection from a case series of 80 primary hip arthroplasties, in which the following topical tranexamic acid protocol is used: 1.5 grams diluted to a total volume of 60ml were administered, applying 20ml in the acetabular bed, 20ml in the femoral canal and 20ml through the Redon drain, keeping it closed for 20minutes. RESULTS: Eighty patients were operated. Preoperative haemoglobin 14.26g / dL; preoperative haematocrit 42.39%. An average loss of 2.74g / dL of haemoglobin and 8% of haematocrit was obtained. Eleven percent of the patients required transfusion, of whom 67% had known previous anaemia; only 3 patients without prior anaemia required transfusion (4%). There were no thromboembolic complications in our series. CONCLUSIONS: The use of topical tranexamic acid was safe and effective in primary total hip arthroplasty, reducing the need for blood transfusion compared to that described in the literature in untreated patients.