La columna cervical degenerativa / The degenerative cervical spine

Las técnicas de imagen proporcionan una imagen anatómica excelente de la columna cervical. La elección de cada una de ellas dependerá del escenario clínico y de las alternativas terapéuticas. La radiografía simple sigue siendo fundamental, ya que permite valorar la alineación, las alteraciones óseas y el seguimiento tras el tratamiento. La mayor resolución de contraste de la resonancia magnética permite la valoración de las partes blandas, incluyendo los discos intervertebrales, los ligamentos, la médula ósea y la médula espinal. El papel de la tomografía computarizada en el estudio de la patología degenerativa ha cambiado en los últimos tiempos debido a la gran resolución espacial y su capacidad para visualizar el componente óseo. En este artículo revisaremos la anatomía y las características biomecánicas de la columna cervical, y después profundizaremos en su patología degenerativa y manejo clínico (AU)

Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management (AU)

The degenerative cervical spine. / La columna cervical degenerativa.

Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management.

[Mortality following cardiac surgery in the National Health Service Hospitals of the Community of Valencia in 2007: a descriptive analysis]. / Análisis descriptivo de mortalidad en cirugía cardiaca en los hospitales públicos de la Comunidad Valenciana en el año 2007.

OBJECTIVE: To analyze clinical records of cardiac surgery patients in an attempt to identify factors associated with mortality in the postoperative critical care units of the public health service hospitals in the Community of Valencia, Spain, in 2007. METHODS: Retrospective study of cases from January 1, 2007 to December 31, 2007. The charts of all patients who underwent cardiac surgery with or without extracorporeal circulation were reviewed. A data collection protocol was followed to obtain information on age, sex, body mass index (BMI), presurgical risk factors, type of surgery, duration of extracorporeal circulation, duration of ischemia, cause of death, and length of stay in the postoperative critical care unit. RESULTS: The study population consisted of 2113 patients at 5 public hospitals; 124 patients (70 men, 54 women) died. The mean (SD) age was 70 (9.43) years (range, 36-91 years). The mean BMI was 28.19 kg/m2 (maximum, 42 kg/m2). The mean Euroscore was 21.92 (maximum, 94.29). Hypertension was present as a preoperative risk factor in most patients (74.2%); dyslipidemia was present in 51.6%, diabetes mellitus in 38.7%, stroke in 73%, and renal failure in 2.4%. It was noteworthy was that the group who underwent coronary revascularization had the highest mortality rate (nearly 35% of the 124 patients). The next highest mortality rate (19.4%) was in patients who had combined procedures (valve repair or substitution plus coronary revascularization). Mortality was 18.5% in the group undergoing aortic valve surgery and 11.3% in those undergoing mitral valve surgery. The mean duration of extracorporeal circulation was 148.63 minutes. The mean duration of myocardial ischemia was 94.91 minutes. The most frequent cause of death was cardiogenic shock (54.8%). This was followed by distributive shock (29.8%) and hemorrhagic shock (8.9%). The mean length of stay in the postoperative critical care unit was 13.6 days. Overall mortality was 5.87%. CONCLUSIONS: The highest mortality rate among cardiac surgery patients in postoperative critical care units in hospitals in the Community of Valencia in 2007 was in patients who underwent coronary revascularization. The most prevalent preoperative risk factor was hypertension. Cardiogenic shock and distributive shock were the most frequent causes of death in these patients. A system for classifying risk is needed in order to predict mortality in critical care units and improve perioperative care.

Análisis descriptivo de mortalidad en cirugía cardiaca en los hospitales públicos de la Comunidad Valenciana en el año 2007 / Mortality following cardiac surgery in the national health service hospitals of the Community of Valencia in 2007: a descriptive analysis

OBJETIVO: Analizar los datos clínicos y tratar de identificarlos factores asociados que pudieran haber influidoen la mortalidad postoperatoria de los pacientes decirugía cardiaca durante su permanencia en la Unidadde Cuidados Críticos de los hospitales de la sanidadpública de la Comunidad Valenciana durante el 2007.MÉTODO: Estudio retrospectivo desde 1 enero de 2007hasta 31 diciembre del 2007. Se revisaron todas las historiasclínicas de los pacientes operados de cirugía cardiacacon y sin circulación extracorpórea y se aplicó unformulario de recogida de datos que permitió obtener lainformación necesaria para determinar edad, sexo, índicede masa corporal, factores de riesgo prequirúrgicos,tipo de intervención quirúrgica realizada, tiempo de circulaciónextracorpórea, tiempo de isquemia, causa demortalidad y tiempo de estancia en la Unidad de CuidadosCríticos.RESULTADOS: En los 5 centros públicos donde se realizacirugía cardiaca la población estudiada fue de 2.113pacientes. El número de pacientes fallecidos fue de 124,de ellos 70 fueron hombres y 54 mujeres. La media deedad fue 70 años (DE 9,43) oscilando entre 36 y 91 años.El valor medio del índice de masa corporal fue de 28,19kg/m2 con un máximo de 42 kg/m2. El valor medio delEuroscore fue de 21,92 con un máximo de 94,29. Entrelos factores de riesgo estudiados la hipertensión arterialestaba presente en la mayoría de los pacientes (74,2%),dislipemia en el 51,6% de los casos, diabetes mellitus enel 38,7%, accidentes cerebrovasculares previos en el7,3% e insuficiencia renal previa a la cirugía en el 2,4%...(AU)

OBJETIVE: To analyze clinical records of cardiacsurgery patients in an attempt to identify factorsassociated with mortality in the postoperative criticalcare units of the public health service hospitals in theCommunity of Valencia, Spain, in 2007.METHODS: Retrospective study of cases from January1, 2007 to December 31, 2007. The charts of all patientswho underwent cardiac surgery with or without miocárdiextracorporealcirculation were reviewed. A datacollection protocol was followed to obtain informationon age, sex, body mass index (BMI), presurgical riskfactors, type of surgery, duration of extracorporealcirculation, duration of ischemia, cause of death, andlength of stay in the postoperative critical care unit.RESULTS: The study population consisted of 2113patients at 5 public hospitals; 124 patients (70 men, 54women) died. The mean (SD) age was 70 (9.43) years(range, 36-91 years). The mean BMI was 28.19 kg/m2(maximum, 42 kg/m2). The mean Euroscore was 21.92(maximum, 94.29). Hypertension was present as apreoperative risk factor in most patients (74.2%);dyslipidemia was present in 51.6%, diabetes mellitus in38.7%, stroke in 7.3%, and renal failure in 2.4%. It wasnoteworthy was that the group who underwent coronaryrevascularization had the highest mortality rate (nearly35% of the 124 patients). The next highest mortality rate(19.4%) was in patients who had combined procedures(valve repair or substitution plus coronaryrevascularization). Mortality was 18.5% in the groupundergoing aortic valve surgery and 11.3% in thoseundergoing mitral valve surgery. The mean duration ofextracorporeal circulation was 148.63 minutes...(AU)

[MR arthrography of the hip with emphasis on femoroacetabular impingement]. / Resonancia magnética artrografía de cadera con énfasis en el atrapamiento femoroacetabular.

Hip pain is a common complaint in patients of all ages. Recent advances in imaging and treatment are changing the approach to the evaluation and management of hip pain. Abnormal femoral and acetabular morphology and lesions of the acetabular labrum and cartilage are increasingly recognized as crucial in the development of degenerative changes. In addition, femoroacetabular impingement is increasingly recognized as an etiologic factor in hip pain. This article discusses techniques for MR arthrography of the hip, normal anatomy at hip MR arthrography, common intra-articular pathologies in patients with hip pain, and imaging findings of femoroacetabular impingement.

Resonancia magnética artrografía de cadera con énfasisen el atrapamiento femoroacetabular / MR arthrography of the hip with emphasis on femoroacetabular impingement

El dolor de cadera es un problema frecuente en todas las edades. Los avances recientes en el diagnóstico por imagen y en el tratamiento están cambiando la forma de evaluación y manejo del dolor de cadera. Las alteraciones morfológicas del fémur y del acetábulo, el atrapamiento femoroacetabular, las lesiones del labrum y condrales pueden ser causa de dolor de cadera y hoy en día está aceptado su papel en el desarrollo de cambios degenerativos. Este artículo revisa la técnica de la RM artrografía de cadera, la anatomía normal de la cadera en RM artrografía, las patologías intraarticulares frecuentes en pacientes con dolor de cadera y los hallazgos de imagen en el atrapamiento femoroacetabular (AU)

Hip pain is a common complaint in patients of all ages. Recent advances in imaging and treatment are changing the approach to the evaluation and management of hip pain. Abnormal femoral and acetabular morphology and lesions of the acetabular labrum and cartilage are increasingly recognized as crucial in the development of degenerative changes. In addition, femoroacetabular impingement is increasingly recognized as an etiologic factor in hip pain. This article discusses techniques for MR arthrography of the hip, normal anatomy at hip MR arthrography, common intra-articular pathologies in patients with hip pain, and imaging findings of femoroacetabular impingement (AU)

Reduction of tris(benzene-1,2-dithiolate)molybdenum(VI) by hydroxide ions in dry tetrahydrofuran solution.

Tris(benzene-1,2-dithiolate)molybdenum(VI) reacts rapidly and quantitatively with tetrabutylammonium hydroxide to yield the corresponding Mo(V) and Mo(IV) complexes and hydrogen peroxide; the reaction has been executed in dry tetrahydrofuran where the reaction rate shows a fair dependence on complex and OH- concentrations.