[Frequency of spinopelvic alterations in postoperative total hip arthroplasty patients and their association with functional outcomes]. / Frecuencia de alteraciones espinopélvicas en pacientes postoperados de artroplastía total de cadera y su asociación con resultados funcionales.

INTRODUCTION: the analysis of spinopelvic imbalance in patients undergoing total hip arthroplasty has gained significance in recent years, being recognized as a risk factor for instability. Few reports exist regarding the prevalence of spinopelvic alterations in Latin American literature. The aim of this study is to determine the frequency of spinopelvic imbalance in our patients and to associate them with functional outcomes. MATERIAL AND METHODS: 29 patients who underwent total hip arthroplasty using a lateral approach (32 arthroplasties) were included. All patients completed clinical outcome questionnaires preoperatively. Twelve months after surgery, they underwent anteroposterior pelvic and lateral pelvic X-rays, both standing and sitting, and clinical outcome questionnaires were completed. The radiographic parameters examined were: pelvic incidence, lumbar lordosis, sacral slope, anterior pelvic plane and pelvic femoral angle. Functional outcome was assessed with the Harris Hip Score and WOMAC scales. Patients were classified according to their spinopelvic alteration and statistical analysis was performed to identify significant differences between the groups and the correlation with functional outcomes. RESULTS: there was a high frequency of spinopelvic balance alterations (46.8%); 6.2% (n = 2/32) presented isolated spinal stiffness (group 1B), 37.5% (n = 12/29) spinal deformity without spinal stiffness (group 2A) and 3.1% (n = 1/29) spinal deformity associated with stiffness (group 2B). We found no improvement in HHS and WOMAC scores in the groups with spinal stiffness (1B and 2B) (p = 0.98 y 0.15). There is association between spinal stiffness (SS < 10°) and poor functional outcomes (p = 0.02). CONCLUSIONS: the frequency of spinopelvic balance alterations was high. While there was no observed rise in prosthetic dislocations, the existence of spinal stiffness, defined by a SS of less than 10°, was associated to poor outcomes on functional scales.

INTRODUCCIÓN: el análisis de las alteraciones del balance espinopélvico en pacientes sometidos a artroplastía total de cadera ha adquirido importancia en años recientes, siendo reconocido como un factor de riesgo para inestabilidad. Existen pocos reportes de la prevalencia de alteraciones espinopélvicas en literatura latinoamericana. El objetivo de esta investigación es determinar la frecuencia de alteraciones del balance espinopélvico en nuestros pacientes y su asociación con los resultados funcionales. MATERIAL Y MÉTODOS: se incluyeron 29 pacientes intervenidos de artroplastía total de cadera mediante abordaje lateral (32 artroplastías). Todos los pacientes completaron escalas funcionales preoperatoriamente. A los 12 meses de la intervención, se valoró el balance espinopélvico mediante radiografías anteroposterior de pelvis y laterales de pelvis tanto de pie como en sedestación y completaron escalas funcionales. Los parámetros radiográficos valorados fueron: incidencia pélvica, lordosis lumbar, inclinación del sacro (sacral slope), plano pélvico anterior y ángulo pélvico femoral. El estado funcional se valoró con las escalas Harris Hip Score (HHS) y WOMAC. Se clasificó a los pacientes de acuerdo a su alteración espinopélvica y se realizó análisis estadístico para identificar diferencias significativas entre los grupos y la asociación con resultados funcionales. RESULTADOS: encontramos una elevada frecuencia de alteraciones del balance espinopélvico (46.8%); 6.3% (n = 2/32) presentaron rigidez espinal aislada (grupo 1B), 37.5% (n = 12/29) deformidad espinal sin rigidez espinal (grupo 2A) y 3.1% (n = 1/29) deformidad espinal asociada a rigidez (grupo 2B). En los grupos con rigidez espinal (1B y 2B) no hubo mejoría significativa en HHS y WOMAC (p = 0.98 y 0.15). Encontramos asociación entre la presencia de rigidez espinal (SS < 10°) y resultados funcionales subóptimos con valor de p = 0.02. CONCLUSIONES: la frecuencia de alteraciones en el balance espinopélvico fue elevada. A pesar de no verse reflejado en un aumento en la incidencia de luxaciones protésicas, la presencia de rigidez espinal caracterizada por un SS menor a 10° se asoció con resultados subóptimos en las escalas funcionales.

Mammalian mycophagy: A global review of ecosystem interactions between mammals and fungi.

The consumption of fungi by animals is a significant trophic interaction in most terrestrial ecosystems, yet the role mammals play in these associations has been incompletely studied. In this review, we compile 1 154 references published over the last 146 years and provide the first comprehensive global review of mammal species known to eat fungi (508 species in 15 orders). We review experimental studies that found viable fungal inoculum in the scats of at least 40 mammal species, including spores from at least 58 mycorrhizal fungal species that remained viable after ingestion by mammals. We provide a summary of mammal behaviours relating to the consumption of fungi, the nutritional importance of fungi for mammals, and the role of mammals in fungal spore dispersal. We also provide evidence to suggest that the morphological evolution of sequestrate fungal sporocarps (fruiting bodies) has likely been driven in part by the dispersal advantages provided by mammals. Finally, we demonstrate how these interconnected associations are widespread globally and have far-reaching ecological implications for mammals, fungi and associated plants in most terrestrial ecosystems. Citation: Elliott TF, Truong C, Jackson S, Zúñiga CL, Trappe JM, Vernes K (2022). Mammalian mycophagy: a global review of ecosystem interactions between mammals and fungi. Fungal Systematics and Evolution 9: 99-159. doi: 10.3114/fuse.2022.09.07.

Síndrome de tolosa hunt: presentación de caso clínico / Tolosa Hunt syndrome: case report

El síndrome de Tolosa-Hunt es una entidad poco frecuente cuya etiopatogenia y mecanismos fi- siopatológicos son controversiales, se caracteri- za por cefalea asociada a parálisis de uno o más nervios craneales, diplopía, estrabismo y ptosis palpebral, ocasionados por el compromiso del seno cavernoso o la fisura orbitaria superior. Su diagnóstico es un reto y se aborda dentro de los diagnósticos diferenciales de las oftalmoplejías dolorosas. Con el objetivo de describir y actua- lizar el conocimiento sobre esta enfermedad se presenta el caso de una paciente de 14 años que acudió a consulta por cefalea intensa, dolor ocu- lar y afección de nervios craneales. Los hallazgos clínicos y la resonancia magnética confirmaron el diagnóstico del síndrome de Tolosa Hunt...(AU)

Utilidad del tromboelastograma en pediatría: correlación con pruebas habituales de la coagulación / Usefulness of the thromboelastogram in children: correlation with habitual coagulation tests

INTRODUCCIÓN: Los exámenes habituales de coagulación evalúan distintos elementos de la hemostasia en forma par cial, y no traducen las interacciones celulares, lo que es especialmente sensible en pacientes críticos. Las técnicas viscoelásticas, como el tromboelastograma (TEG) muestran el proceso de coagulación completo, y están siendo evaluadas como exámenes de la coagulación global. OBJETIVO: determinar la correlación de los exámenes habituales de coagulación con los valores del TEG, en niños atendidos en una unidad de cuidados intensivos (UCI). PACIENTES Y MÉTODO: Se revisaron 238 TEG de pacientes <18 años, con evidencia de alteración de coagulación clínica y/o de laboratorio, hospitalizados en UCI. Se correlacionaron los valores de los parámetros del TEG con cada uno de los valores de los exámenes habituales de coagulación. Los exámenes se obtuvieron según protocolo, utilizando una muestra de sangre de 4,5 ml para TEG con equipo TEG® 5000 Thrombelastograph Hemostasis Sys tem, mediante un transductor electromagnético que permite la medición de la resistencia durante la formación y lisis del coágulo. El recuento de plaquetas se obtuvo utilizando método automatizado o microscopía con contraste de fase; el fibrinógeno, tiempo de protrombina y de tromboplastina parcial activada por métodos nefelométricos. RESULTADOS: 201 TEGs correspondientes a 59 pacientes. Se evidenció una correlación moderada a baja en todos los parámetros medidos. No se encontró co rrelación entre porcentaje de lisis del coágulo, ni firmeza del coágulo. CONCLUSIONES: Existe una baja correlación entre la información entregada por TEG y los exámenes de coagulación habituales, esto sugiere que el TEG aporta información diferente acerca del estado de coagulación de los pacientes críticos evaluados.

INTRODUCTION: Usual coagulation tests partially evaluate different elements of hemostasis, and do not translate cell interactions, which is an especially sensitive issue in critically ill patients. Viscoelastic measurement techniques, such as thromboelastogram (TEG) show the complete coagulation pro cess and are being evaluated as global coagulation tests. OBJECTIVE: To determine the correlation of the usual coagulation tests with the TEG values, in children treated in an intensive care unit (ICU). PATIENTS AND METHOD: We reviewed 238 TEGs of patients under 18 years of age, with evidence of clinical and/or laboratory coagulation alterations, who were hospitalized in the ICU. The TEG para meter values were correlated with each of the usual coagulation test values. The tests were obtained according to the protocol, using a 4.5 ml blood sample for TEG with TEG® 5000 Thrombelastograph Hemostasis System, through an electromagnetic transducer that allows the measurement of resis tance during the clot formation and lysis. Platelet count was obtained using an automated method or phase-contrast microscopy, and fibrinogen levels, prothrombin time, and partial thromboplastin time activated by nephelometric methods. RESULTS: 201 TEGs corresponding to 59 patients were re viewed. A moderate to low correlation was observed in all the measured parameters. No correlation was found between the percentages of clot lysis or clot firmness. CONCLUSIONS: There is a low corre lation between the information provided by TEG and the usual coagulation tests. This suggests that the TEG provides different information about the coagulation status of the evaluated critical patients.

Usefulness of the thromboelastogram in children: correlation with habitual coagulation tests. / Utilidad del tromboelastograma en pediatría: Correlación con pruebas habituales de la coagulación.

INTRODUCTION: Usual coagulation tests partially evaluate different elements of hemostasis, and do not translate cell interactions, which is an especially sensitive issue in critically ill patients. Viscoelastic measurement techniques, such as thromboelastogram (TEG) show the complete coagulation pro cess and are being evaluated as global coagulation tests. OBJECTIVE: To determine the correlation of the usual coagulation tests with the TEG values, in children treated in an intensive care unit (ICU). PATIENTS AND METHOD: We reviewed 238 TEGs of patients under 18 years of age, with evidence of clinical and/or laboratory coagulation alterations, who were hospitalized in the ICU. The TEG para meter values were correlated with each of the usual coagulation test values. The tests were obtained according to the protocol, using a 4.5 ml blood sample for TEG with TEG® 5000 Thrombelastograph Hemostasis System, through an electromagnetic transducer that allows the measurement of resis tance during the clot formation and lysis. Platelet count was obtained using an automated method or phase-contrast microscopy, and fibrinogen levels, prothrombin time, and partial thromboplastin time activated by nephelometric methods. RESULTS: 201 TEGs corresponding to 59 patients were re viewed. A moderate to low correlation was observed in all the measured parameters. No correlation was found between the percentages of clot lysis or clot firmness. CONCLUSIONS: There is a low corre lation between the information provided by TEG and the usual coagulation tests. This suggests that the TEG provides different information about the coagulation status of the evaluated critical patients.

[Sickle cell disease: A diagnosis to keep in mind]. / Enfermedad de células falciformes: Un diagnóstico para tener presente.

Sickle cell disease (SCD) is an autosomal recessive genetic disorder. It is the most frequent structural hemoglobinopathy worldwide, and it is produced by an alteration in the globin chain genes. In Chile, there is no data on the prevalence of SCD since it is considered a very rare condition. The incidence of this disease has been increasing due to migration of people from areas with greater presence of SCD. It is important to know and consider this diagnosis in a selected group of patients with anemia, in order to prevent and treat the different complications of this disease. This article reviews the most recent information that shows new concepts in the knowledge of the physiopathology, and especially publications of guidelines and consensus in relation to the diagnosis and management of this con dition.

Resultados preliminares en el análisis de elementos finitos de aneurismas de aorta abdominal en rango no quirúrgico / Preliminary results of finite element analysis for small abdominal aortic aneurysms

Introducción: El diagnóstico y manejo del aneurisma de aorta abdominal depende del diámetro máximo de la aorta, cuyo crecimiento es impredecible. Nuestro objetivo fue comparar los resultados de las variables biomecánicas, obtenidas mediante el análisis de elementos finitos, entre 2 grupos con aneurismas pequeños (grupo I 40-49 mm, grupo II 50-54 mm). Métodos: Realizamos un estudio prospectivo y monocéntrico con 23 pacientes con aneurisma de aorta abdominal pequeño (grupo I N = 14; grupo II N = 9), a los que se les realizó una angio-TC toracoabdominopélvica. Se midió y calculó el diámetro máximo, estrés pico de pared (PWR), riesgo de rotura pico de pared (PWRI), diámetro equivalente de riesgo de ruptura (RRED) y volumen del aneurisma y trombo mediante el análisis de elemento finitos, así como la diferencia entre el diámetro máximo y RRED (variabilidad). Resultados: Hemos observado un mayor PWS, PWRR y RRED en el grupo II respecto al grupo I. Además, 5 de los pacientes (21,74%) mostraron una variación positiva (>0,5 mm de diferencia) y 2 de ellos (8,70%) obtuvieron un PWRR>0,5 asociado a un mayor riesgo de rotura del aneurisma. Conclusión: PWS y PWRR son mayores en el grupo II, posiblemente con relación a un mayor tamaño del aneurisma. Son necesarios más estudios con mayor tamaño muestral, antes de utilizar este software para las decisiones clínicas

Introduction: The diagnosis and management of abdominal aortic aneurysms currently relies on the maximal aortic diameter, which grows in an unpredictable manner. The aim of this study was to compare the results of the biomechanical variables using finite elements analysis between the 2 groups of small aneurysms (group I 40-49 mm, group II 50-54 mm). Methods: A total of 23 patients with abdominal aortic aneurysm (group I N=14, group II N=9) who had undergone a thoraco-abdominal angio computed tomography in this hospital were prospectively identified. Abdominal aortic aneurysms diameter, peak wall rupture (PWR), PWR Index, Rupture Risk Equivalent Diameter (RRED) abdominal aortic aneurysms and thrombus volume were measured and calculated using finite element analysis software. The variability between maximum abdominal aortic aneurysms diameter and RRED was also determined. Results: An increased PWS, PWRR, and RRED, was observed in group II. Moreover, 5 (21.74%) patients had a positive variability (>0.5 mm), and 2 of them (8.70%) had a PWRR >0.5, which is associated with a higher aneurysm rupture risk. Conclusion: PWR and PWRR are elevated in group II, perhaps secondary to a larger abdominal aortic aneurysms diameter. Further studies are required before using this software in clinical decisions

Experiencia en nuestro centro con Nellix: EndoVascular Aneurysm Sealing (EVAS) system. Un cambio de paradigma en el tratamiento endovascular del aneurisma aórtico / Experience with Nellix: EndoVascular Aneurysm Sealing (EVAS) system. A paradigm shift in endovascular aortic aneurysm treatment

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Enfermedad de células falciformes: un diagnóstico para tener presente / Sickle cell disease: a diagnosis to keep in mind

La enfermedad de células falciformes (ECF) es un trastorno genético autosómico recesivo. Es la hemoglobinopatía estructural más frecuente en todo el mundo y se produce por alteración en los genes de la cadena de globina. En Chile, no hay datos sobre la prevalencia de la ECF ya que es considerada una condición muy rara. La incidencia de esta enfermedad ha venido aumentando debido a la migra ción de personas de áreas con mayor prevalencia de ECF. Por esta razón resulta importante conocer y considerar este diagnóstico en un grupo seleccionado de pacientes con anemia, para prevenir y tratar las diferentes complicaciones de la enfermedad. En este artículo se revisan los nuevos aportes en el conocimiento de la fisiopatología, con especial énfasis en aquellas publicaciones de consenso y guías relacionadas al diagnóstico y manejo de esta entidad.

Sickle cell disease (SCD) is an autosomal recessive genetic disorder. It is the most frequent structural hemoglobinopathy worldwide, and it is produced by an alteration in the globin chain genes. In Chile, there is no data on the prevalence of SCD since it is considered a very rare condition. The incidence of this disease has been increasing due to migration of people from areas with greater presence of SCD. It is important to know and consider this diagnosis in a selected group of patients with anemia, in order to prevent and treat the different complications of this disease. This article reviews the most recent information that shows new concepts in the knowledge of the physiopathology, and especially publications of guidelines and consensus in relation to the diagnosis and management of this con dition.

Estudio longitudinal del estado nutricional y de la condición física de estudiantes de enseñanza media de un liceo municipal de Talca, Chile / Longitudinal study of the nutritional status and physical condition of high school students of a municipal high school of Talca, Chile

El objetivo de esta investigación es analizar las variables de estado nutricional y condición física de estudiantes de dos niveles de enseñanza media (primero y cuarto) durante los años 2016, 2017 y 2018, para saber cómo ingresan y cómo egresan del establecimiento. Se evaluaron parámetros de peso, talla y perímetro de cintura para el estado nutricional, mientras que para la condición física se contemplaron pruebas físicas de salto horizontal y flexo-extensión de codos. Las variables peso y salto horizontal sufrieron cambios. La primera tuvo un aumento constante durante los años de estudio en Primer Año Medio (p<0,068), lo cual conllevó a un aumento del IMC (p<0,054) mientras el salto horizontal tuvo una disminución significativa en Cuarto Año Medio (p<0,004). Con esto se determina que los parámetros de estado nutricional y condición física de los estudiantes evaluados sufren efectos negativos durante los años de investigación.

The objective of this research is to analyze the variables or nutritional status and physical condition of students from two high school grades (first and fourth year) during the years 2016, 2017 and 2018, to know their measurements upon entering and when leaving the establishment. For this, parameters of weight, height and waist circumference were evaluated in terms of nutritional status, while for physical condition; physical tests such as horizontal jump and elbow flexionextension were contemplated. The variables of weight and horizontal jumps underwent changes. The first had a constant increase during the years of study in first year (p<0,068), which led to an increase in BMI (p<0,054) while the horizontal jump had a significant decrease in fourth year (p<0,004). This determines that the parameters of nutritional status and physical condition of the students evaluated suffered negative effects during this research.

Mechano-optical effects in multiwall carbon nanotubes ethanol based nanofluids.

A highly sensitive technique for analyzing surface tension and dynamic viscosity of nanofluids was reported. Multiwall carbon nanotubes suspended in ethanol were evaluated. The assistance of a Fabry-Perot interferometer integrated by a small sample volume fluid allowed us to explore the stability and mechanical properties exhibited by the nanostructures. The surface tension and dynamic viscosity of the colloid was examined by using interferometric optical signals reflected from a remnant drop pending at the end of an optical fiber. Nanosecond pulses provided by a Nd:YAG laser source with 9.5 MW/mm2 at 532 nm wavelength were used to induce mechano-optical effects in the liquid drop. The mechanical parameters were approximated, taking into account single optical pulses interacting with an inelastic mass-spring-damper system.

Alternativa quirúrgica para el linfedema obstructivo de los miembros mediante el implante de drenajes de silicona hidrófobos / Alternative surgical treatment for chronic lower limb lymphoedema by implantation of hydrophobic silicone drainage tubes

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Tratamiento quirúrgico y endovascular en pacientes con arteritis de Takayasu / Surgical and endovascular treatment in patients with Takayasu arteritis

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Resultados preliminares sobre cambios en la rigidez arterial tras reparación endovascular de aneurismas de aorta con endoprótesis bifurcadas, ramificadas y con sistema de sellado / Preliminary report on arterial stiffness changes after endovascular aneurysm repair with a bifurcated, branched, and a sealed system endoprosthesis

Introducción: Los pacientes portadores de aneurisma de aorta abdominal (AAA) tienen un mayor riesgo cardiovascular. La cirugía abierta ha sido el tratamiento tradicional; sin embargo, el abordaje endovascular ha crecido exponencialmente en los últimos años debido al menor riesgo perioperatorio. La rigidez arterial parece elevarse tras el implante de endoprótesis aórtica. Material y métodos: Presentamos un subestudio del estudio registrado en la web del National Institutes of Health (ClinicalTrials.gov) como NCT02642952. Describimos 3 grupos que han recibido diferentes endoprótesis aórticas como tratamiento de un AAA. El grupo A fue tratado mediante el implante de una endoprótesis aórtica bifurcada estándar, el grupo B mediante una endoprótesis ramificada (4 ramas) y el grupo C con una endoprótesis de sellado del saco. Cada grupo incluye 2 pacientes. Hemos analizado los cambios individuales en la rigidez arterial mediante el análisis de la onda de pulso carótido-radial (AOP) y el índice de aumento (IA). Resultados: Todos los pacientes estudiados fueron varones, mayores de 70 años, con AAA en rango quirúrgico y alto riesgo quirúrgico (ASA III). Hemos observado cambios variables del AOP carótido-radial y del IA(a)75 en el postoperatorio en los pacientes incluidos. Conclusiones: Nuestro estudio muestra que los dispositivos endovasculares en el tratamiento de los AAA están implicados en el cambio de los Diferentes parámetros de rigidez arterial. Nuevos estudios aleatorizados y con mayor tamaño muestral son necesarios para comparar los diferentes tipos de endoprótesis aórticas. El impacto cardiovascular a largo plazo de estos dispositivos requiere más estudios (AU)

Introduction: Patients with diagnosis of abdominal aortic aneurysm (AAA) are known to have an increased cardiovascular risk. Open surgery has been the traditional approach however, endovascular repair has widely expanded due to the lower peri-operative risk. Arterial stiffness has been suggested to change and elevate after aortic stent-graft implantation. Material and methods: As part of a study registered in National Institutes of Health website (ClinicalTrials.gov) with NCT02642952, a description is presented of 3 groups with endovascular treatment of AAA with different endografts and mechanisms. Group A with standard bifurcated endograft, group B with a branched (4 branches) device, and group C with a sac sealing device. Each group included 2 patients. A report is presented on the individual changes of arterial stiffness measured by carotid-radial pulse wave velocity (PWV) and Augmentation Index (AIx). Results: All the patients included were men, older than 70 years, with AAA greater than 55 mm, and high-risk (ASAIII) patients. We observed a variable change in carotid-radial PWV and IA(a)75 in the postoperative period in all patients studied. Conclusions: It seems that endovascular devices in the treatment of AAAs are implicated in the change of arterial stiffness measurements. More randomised studies, with larger samples comparing the different types of endografts are required. The long-term impact on cardiovascular outcomes needs further investigation (AU)

Disección aislada de la arteria mesentérica superior: tratamiento endovascular mediante stent y embolización / Isolated dissecting aneurysm of the superior mesenteric artery: Endovascular treatment using stent-assisted coil embolisation

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Trombosis de rama en reparación endovascular de aneurisma de aorta abdominal. A propósito de 2 casos y revisión de la literatura / Thrombosis in endovascular repair of abdominal aortic aneurysm. Two case reports and review of the literature

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Tratamiento híbrido de los aneurismas del arco aórtico. Nuestra experiencia / Hybrid approach to aortic arch aneurysm. Experience in a single centre

Introducción: El tratamiento de la disfunción del arco aórtico sigue siendo un reto. El reemplazo quirúrgico del arco aórtico se asocia a una elevada morbimortalidad. Se propone el tratamiento híbrido como una alternativa menos invasiva. Objetivos: Presentamos la experiencia de nuestro centro en el tratamiento híbrido de aneurismas del cayado aórtico. Se describe la morbimortalidad a 30 días y a medio plazo; endofugas, reintervenciones y permeabilidad de los bypasses. Material y métodos: Realizamos un estudio descriptivo y retrospectivo de los aneurismas de aorta con afectación del arco que se sometieron a un procedimiento híbrido entre enero del 2009 y diciembre del 2014. Incluimos pacientes tratados tanto de forma urgente como electiva. Resultados: De un total de 38 pacientes tratados por disfunción aneurismática del cayado aórtico en dicho periodo, 12 (31,5%) recibieron tratamiento híbrido. Se realizaron 2 bypasses aortotronco branquiocefálico-carotídeo izquierdo y carótido-subclavio izquierdo, 5 bypasses carótido-carótido-subclavio izquierdo, un bypass carótido-carotídeo y 5 bypasses carótido-subclavio izquierdo, seguidos de la colocación de una endoprótesis torácica mediante técnica habitual. Se consiguió éxito técnico del 92%. La mortalidad a 30 días fue del 16% (n = 2). El seguimiento medio fue de 29,3 meses (±15 meses). Dos pacientes (16%) cursaron con endofuga en el seguimiento, ambas de tipo Ia, por lo cual precisaron de reintervenciones mediante bypass proximal y nueva endoprótesis. La mortalidad global fue del 25% (n = 3). La permeabilidad de los bypasses fue del 92%. No apareció ningún caso de isquemia medular ni ictus en el postoperatorio ni durante el seguimiento. Conclusión: Los resultados obtenidos en nuestro centro son similares a los publicados en grandes series en la literatura. El debranching del cayado aórtico es una alternativa válida en la cirugía electiva y una gran herramienta en el caso urgente, con una aceptable morbimortalidad en el medio plazo (AU)

Introduction: Aortic arch aneurysm treatment is still considered a challenge for surgeons. Total aortic arch replacement is associated with high morbidity and mortality. Hybrid treatment is considered an alternative and a less invasive treatment. Objective: To present our results for the treatment of aortic arch aneurysms with hybrid procedures. An analysis was made of the 30-day and mid-term morbidity and mortality, endoleak rate, re-intervention rate, and bypass patency. Material and methods: An extensive review was carried out on all patients treated by hybrid procedures, from January 2009 to December 2014. Elective and urgent cases were included. Results: A total of 38 patients with aortic arch and thoracic aneurysm were reviewed. Of these, 12 (31.5%) required hybrid treatment. Two complete revascularisations of supra-aortic vessels were performed, as well as 5 carotid-carotid bypass plus left subclavian artery bypass, one carotid-carotid bypass alone, and 4 left carotid-to-left subclavian artery bypass, all followed by endovascular aortic aneurysm exclusion. Technical success was 92%. The 30-day mortality rate was 16% (n = 2). Mean follow-up was 29.3 months (±15 months). Two patients (16%) developed a type Ia endoleak in the follow-up that required further proximal revascularisation plus proximal endograft extension. Overall mortality was 25%. Patency of supra-aortic vessels revascularisation was 92% during follow-up. No neurological complications were found. Conclusion: These findings support the assumption that the hybrid approach in the management of aortic arch aneurysm is a reliable alternative to open surgery in elective surgery. This technique is also valid for patients in the urgent setting. Our results are comparable to other published series. There is low morbidity and mortality in the mid-term (AU)

Significant and variable linear polarization during the prompt optical flash of GRB 160625B.

Newly formed black holes of stellar mass launch collimated outflows (jets) of ionized matter that approach the speed of light. These outflows power prompt, brief and intense flashes of γ-rays known as γ-ray bursts (GRBs), followed by longer-lived afterglow radiation that is detected across the electromagnetic spectrum. Measuring the polarization of the observed GRB radiation provides a direct probe of the magnetic fields in the collimated jets. Rapid-response polarimetric observations of newly discovered bursts have probed the initial afterglow phase, and show that, minutes after the prompt emission has ended, the degree of linear polarization can be as high as 30 per cent-consistent with the idea that a stable, globally ordered magnetic field permeates the jet at large distances from the central source. By contrast, optical and γ-ray observations during the prompt phase have led to discordant and often controversial results, and no definitive conclusions have been reached regarding the origin of the prompt radiation or the configuration of the magnetic field. Here we report the detection of substantial (8.3 ± 0.8 per cent from our most conservative simulation), variable linear polarization of a prompt optical flash that accompanied the extremely energetic and long-lived prompt γ-ray emission from GRB 160625B. Our measurements probe the structure of the magnetic field at an early stage of the jet, closer to its central black hole, and show that the prompt phase is produced via fast-cooling synchrotron radiation in a large-scale magnetic field that is advected from the black hole and distorted by dissipation processes within the jet.

Conversión a cirugía abierta, mediante explante endoprotésico, tras intento fallido de tratamiento endovascular, y persistencia de fuga Ia, en aneurisma de aorta abdominal roto / Open conversion with endograft explantation after failed attempt of endovascular repair and persistent type Ia endoleak in a ruptured abdominal aortic aneurysm

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Behçet vascular: seguimiento a 3 años de paciente con presentación poli-aneurismática arterial complicada por múltiples roturas / Vascular Behcet's disease: a 3 year follow-up of a patient with multiple arterial aneurysms complicated by ruptures

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