Therapeutic Patient Education with Learning Objects Improves Asthma Control in Mexican Children.

One of the most common chronic diseases that causes missed school days and workdays is pediatric asthma, producing education, health and economic delays in low and middle-income countries. A patient-centered remarkable therapeutic strategy in the prevention and treatment of chronic diseases is the Therapeutic Patient Education (TPE) which denotes an outstanding difference in the outcomes, from the awareness, to the personal treatment adaption to prevent crises. In this paper, an intervention of TPE with learning objects (LOs) of a pediatric asthma course, designed to train the uncontrolled patient and the caregiver as a team on the specific knowledge to self-control the disease, was carried out at a health facility in Mexico. The Asthma Control Test (ACT) was used and the learning performance was evaluated with formative quizzes. A randomized controlled trial was designed, with pairs of children patients and caregivers during 60 days; the control group was trained with the usual approach, receiving general information about the disease. ACT measures showed statistical significance for the TPE group after the use of the LOs, achieving a controlled state, while the control group did not show difference. Also, the intervention group obtained a higher score in learning performance assessment. The users learned how to avoid risks, the personal triggers of the patient, how to correctly use the different treatments and accessories, consequently, they learned how to self-manage the disease. Our study also confirmed that control of asthma is not only a matter of knowledge, but financial issues to afford the treatment.

Osteosarcoma lumbar en edad pediátrica: reporte de casos y revisión de la literatura / Spinal osteosarcoma in the paediatric age group: case series and literature review

Introducción y objetivo: El tumor maligno de raquis más frecuente en la edad pediátrica es el osteosarcoma, su diagnóstico y tratamiento precoces son esenciales. El objetivo del presente trabajo es el presentar los resultados obtenidos en el tratamiento de pacientes pediátricos con osteosarcoma lumbar y realizar una revisión de la literatura. Material y métodos: Se incluyeron aquellos pacientes pediátricos intervenidos de osteosarcoma de columna móvil entre 2012 y 2014 en el mismo centro. Se analizaron datos demográficos, radiológicos (clasificaciones Enneking, WBB y Tomita) y anatomopatológicos (Broders). Todos fueron tratados mediante resección quirúrgica, asociada a distintos protocolos oncológicos (radioterapia y/o quimioterapia) según consenso del comité de tumores. El seguimiento medio fue de 62,53 meses (47-70 meses). Resultados: Se presentan un total de 3 pacientes, dos niñas de 9 y 11 años con osteosarcoma en L5 y un niño de 15 años con osteosarcoma en L4. En dos de los casos se trató inicialmente como un osteoblastoma, ya que las imágenes radiológicas y anatomopatológicas así lo apoyaban. Ninguno de los pacientes presentó recidivas locales ni metástasis tras la cirugía definitiva. Conclusiones: Los casos descritos en la literatura sobre manejo de osteosarcoma vertebral en columna móvil en la infancia son escasos, por lo que el tratamiento óptimo y pronóstico en estos pacientes es incierto. La resección en bloque mejora el control local de la enfermedad, sin demostrar que mejore la supervivencia global. La resección intralesional se asocia a mayor índice de recidivas. Un correcto diagnóstico diferencial del tumor (osteosarcoma vs. osteoblastoma) es vital para su tratamiento

Introduction and objective: Osteosarcoma is the most frequent malignant spinal tumour in the paediatric age group. Diagnosis and early treatment of this pathology is essential for a good prognosis. The aim of this study was to present the results of treatment of paediatric patients with lumbar osteosarcoma and conduct a literature review. Material and methods: All the patients with lumbar osteosarcoma who were operated between 2012 and 2014 in the same centre were included. Demographic and radiological data (Enneking, WBB and Tomita classification), as well as anatomopathological (Broders classification) variables were analysed. All the patients were treated by surgical resection associated with adjuvant therapies (chemotherapy and radiotherapy); according to consensus with the tumour committee. The average follow-up was 62.53 months (47-70 months). Results: A total of 3 patients were studied, two girls of 9 and 11, with L5 osteosarcoma, and a 15-year-old boy with L4 osteosarcoma. Two of the cases were initially treated as an osteoblastoma, supported by radiological and anatomopathological images. None of the patients had local recurrences or metastases during follow-up. Conclusions: Due to a lack of long series of cases of osteosarcoma in the mobile spine during childhood, the optimal treatment and prognosis in these patients is uncertain. Block resection improves local control of the disease, without demonstrating improvement in overall survival. Intralesional resection is associated with a higher rate of local recurrence. Oncological treatment is essential in the treatment of this pathology. A correct differential diagnosis of the tumour (osteosarcoma vs. osteoblastoma) is vital for its correct treatment

Spinal osteosarcoma in the paediatric age group: case series and literature review. / Osteosarcoma lumbar en edad pediátrica: reporte de casos y revisión de la literatura.

INTRODUCTION AND OBJECTIVE: Osteosarcoma is the most frequent malignant spinal tumour in the paediatric age group. Diagnosis and early treatment of this pathology is essential for a good prognosis. The aim of this study was to present the results of treatment of paediatric patients with lumbar osteosarcoma and conduct a literature review. MATERIAL AND METHODS: All the patients with lumbar osteosarcoma who were operated between 2012 and 2014 in the same centre were included. Demographic and radiological data (Enneking, WBB and Tomita classification), as well as anatomopathological (Broders classification) variables were analysed. All the patients were treated by surgical resection associated with adjuvant therapies (chemotherapy and radiotherapy); according to consensus with the tumour committee. The average follow-up was 62.53 months (47-70 months). RESULTS: A total of 3 patients were studied, two girls of 9 and 11, with L5 osteosarcoma, and a 15-year-old boy with L4 osteosarcoma. Two of the cases were initially treated as an osteoblastoma, supported by radiological and anatomopathological images. None of the patients had local recurrences or metastases during follow-up. CONCLUSIONS: Due to a lack of long series of cases of osteosarcoma in the mobile spine during childhood, the optimal treatment and prognosis in these patients is uncertain. Block resection improves local control of the disease, without demonstrating improvement in overall survival. Intralesional resection is associated with a higher rate of local recurrence. Oncological treatment is essential in the treatment of this pathology. A correct differential diagnosis of the tumour (osteosarcoma vs. osteoblastoma) is vital for its correct treatment.

El síndrome dismorfofóbico, entre otros, y la piel / Skin, Body Dysmorphic Disorder, and Other Syndromes

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Gestación por sustitución: reflexiones desde la perspectiva pediátrica / No disponible

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Recomendaciones sobre el diagnóstico y manejo de la enfermedad pleural y pulmonar por asbesto / Recommendations for the diagnosis and management of asbestos-related pleural and pulmonary disease

Asbesto, también conocido en España como amianto, es el término utilizado para nombrar a un conjunto de silicatos minerales que suelen romperse en fibras. Su uso ha comportado la aparición de numerosas enfermedades, especialmente pleuropulmonares, todas ellas caracterizadas por su prolongada latencia. El asbesto es, además, un carcinógeno del grupo IA reconocido por la OMS desde 1987. En España está prohibido desde 2002. La publicación en 2013 de la 3.ª edición del protocolo de vigilancia sanitaria específica del amianto junto con la aparición de nuevas técnicas diagnósticas han motivado al grupo EROM de SEPAR a promover la elaboración de esta normativa que revisa aspectos clínicos, radiológicos y funcionales de las diferentes enfermedades relacionadas. También establece recomendaciones para el diagnóstico y seguimiento de los pacientes expuestos. Dichas recomendaciones han sido establecidas mediante sistema GRADE.(AU)

Asbestos is the term used for a set of mineral silicates that tend to break up into fibers. Its use has been associated with numerous diseases affecting the lung and pleura in particular, all of which are characterized by their long period of latency. Asbestos, moreover, has been recognized by the WHO as a Group IA carcinogen since 1987 and its use was banned in Spain in 2002. The publication in 2013 of the 3rd edition of the specific asbestos health monitoring protocol, together with the development of new diagnostic techniques, prompted the SEPAR EROM group to sponsor publication of guidelines, which review the clinical, radiological and functional aspects of the different asbestos-related diseases. Recommendations have also been made for the diagnosis and follow-up of exposed patients. These recommendations were drawn up in accordance with the GRADE classification system.(AU)

Resección de radios de la mano en pacientes pediátricos / Ray resection in paediatric population

Objetivo. Valoración de los resultados clínicos y funcionales de la resección completa de los radios de la mano en población pediátrica y descripción de los aspectos técnicos más relevantes de la cirugía. Material y método. Estudio retrospectivo observacional de pacientes intervenidos en el periodo comprendido entre 2010-2015. Criterios de inclusión: resección de uno o más radios de la mano y seguimiento mínimo de un año. Evaluación de las características clínicas, resultados funcionales y estéticos, complicaciones, necesidad de apoyo psicológico y grado de satisfacción. Resultados. Cuatro pacientes cumplieron criterios de inclusión. La edad media fue de 5 años (rango 1-14 años). Las causas fueron: hamartoma lipofibromatoso, amputación traumática, deficiencia radial y sindactilia compleja. El segundo radio fue resecado en tres pacientes y el tercer y cuarto radio en un paciente. No se realizó transferencia de radios adyacentes. No existieron complicaciones postoperatorias ni durante el seguimiento. Ningún paciente precisó ayuda psicológica. Todos presentaron excelentes resultados estéticos, funcionales y con un alto grado de satisfacción. Discusión. La resección completa de uno o más radios de la mano se utiliza como técnica de rescate en pacientes con lesiones vasculares, tumores, traumatismos, infecciones o malformaciones congénitas. Las publicaciones existentes son pequeñas series en pacientes adultos o casos clínicos aislados, no existiendo apenas referencias en población pediátrica. Conclusión. La resección de radios de la mano es una técnica útil y segura en la población pediátrica que proporciona excelentes resultados estéticos y funcionales en aquellos casos en los que es imposible la preservación de uno o varios dedos (AU)

Aim. Evaluation of clinical and functional outcome of ray resection in paediatric population and description of key aspects of surgical technique. Material and methods. We performed a retrospective review of all patients undergoing surgery between 2010-2015. Inclusion criteria: one or more ray resections of the hand and a minimum of one year follow-up. Evaluation of clinical characteristics, functional and cosmetic results, complications, need for psychological support and patient or family satisfaction. Results. Four patients met the inclusion criteria. The mean age at surgery was 5 years (range, 1-14 years). Aetiology was: fibrolipomatous hamartoma, traumatic amputation, radial deficiency and complex syndactyly. Second ray was resected in three patients and third and fourth ray in one. No finger transfer was performed. No immediate post-operative complications were found at the final evaluation. None of them needed psychological support. All the patients showed excellent clinical and functional results with a high grade of satisfaction. Discussion. Ray resection of the hand has been used as salvage procedure in patients with vascular lesions, tumours, trauma, infections or congenital malformations. There are only a few published studies including small samples in adults or case reports, with no references in the paediatric population. Conclusion. Ray resection of the hand is a useful and safe technique in paediatric population, obtaining excellent cosmetic and functional results in those cases in which it is impossible to preserve one or more fingers (AU)

Ray resection in paediatric population. / Resección de radios de la mano en pacientes pediátricos.

AIM: Evaluation of clinical and functional outcome of ray resection in paediatric population and description of key aspects of surgical technique. MATERIAL AND METHODS: We performed a retrospective review of all patients undergoing surgery between 2010-2015. INCLUSION CRITERIA: one or more ray resections of the hand and a minimum of one year follow-up. Evaluation of clinical characteristics, functional and cosmetic results, complications, need for psychological support and patient or family satisfaction. RESULTS: Four patients met the inclusion criteria. The mean age at surgery was 5 years (range, 1-14 years). Aetiology was: fibrolipomatous hamartoma, traumatic amputation, radial deficiency and complex syndactyly. Second ray was resected in three patients and third and fourth ray in one. No finger transfer was performed. No immediate post-operative complications were found at the final evaluation. None of them needed psychological support. All the patients showed excellent clinical and functional results with a high grade of satisfaction. DISCUSSION: Ray resection of the hand has been used as salvage procedure in patients with vascular lesions, tumours, trauma, infections or congenital malformations. There are only a few published studies including small samples in adults or case reports, with no references in the paediatric population. CONCLUSION: Ray resection of the hand is a useful and safe technique in paediatric population, obtaining excellent cosmetic and functional results in those cases in which it is impossible to preserve one or more fingers.

Magneto-conductivity and magnetically-controlled nonlinear optical transmittance in multi-wall carbon nanotubes.

The impact of vectorial magnetic field effects on electrical conductivity and nonlinear optical transmittance exhibited by multi-wall carbon nanotubes was studied. The samples were synthetized by an aerosol pyrolysis processing route in a thin film form. Optical signals in a two-wave mixing configuration allowed us to identify two orthogonal directions of propagation for a magnetic field travelling through the nanomaterials studied. A selective modification in optical absorption was considered to be induced by magnetic perturbations in the sample. Standard optical Kerr gate measurements were carried out for exploring the third order nonlinear optical behavior of the film. A capacitive effect influenced by optical and magnetic excitations was distinguished to be characteristic of the sample. Magneto-quantum conductivity sensitive to the direction of an external magnetic field interacting with the tubes was analyzed. Magnetically-induced changes in electronic band parameters seem to be the main responsible for the optical and electrical modulation observed in the nanostructures. Immediate applications for developing magneto-optical and magneto-electrical functions can be contemplated.

Prescripción off-label inducida. Responsabilidad ¿compartida? / Induced off-label drug prescribing. Shared responsability?

La prescripción off-label es una práctica tan frecuente como incorrectamente manejada por los pediatras. Solo dos de cada diez pediatras completan todos los pasos necesarios para el registro correcto del uso off-label de medicamentos para niños. Es necesario conocer conceptos básicos relacionados con esta práctica, especialmente cuando se trata de una prescripción inducida, por sus connotaciones éticas y legales (AU)

Although off-label prescribing is common practice among pediatricians, it is surprising how rarely it is carried out properly. Only two out of ten pediatricians complete all the steps necessary for the correct registration of off-label drug use in pediatric patients. It is necessary to know the basic concepts related to this practice, especially when it comes to induced prescribing, due to its ethical and legal connotations (AU)

¿Denunciar o no denunciar? / Denounce or not denounce?

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Prevención cuaternaria. La contención como imperativo ético / Quaternary prevention: Containment as an ethical necessity

La creciente capacidad de la medicina para producir más iatrogenia que nunca y el riesgo de insostenibilidad de los sistemas sanitarios han generado en los países desarrollados un nuevo concepto de prevención: la prevención cuaternaria, cuyo objetivo es contener la medicalización. La prevención cuaternaria es imprescindible en el fenómeno llamado disease mongering, que podría traducirse por mercantilización de las enfermedades. Potenciar este tipo de prevención y frenar las consecuencias del disease mongering requiere desarrollar todo el potencial institucional de la prevención y toda la voluntad personal de la contención; implica separarnos de la tutela innecesaria de la industria, ser críticos con nuestro trabajo, no ser maleficentes, respetar el principio de justicia sabiéndonos gestores de los limitados recursos públicos, y sentirnos responsables del coste social de oportunidad de las decisiones médicas En este trabajo analizamos desde este punto de vista los cribados en los recién nacidos, los avances en el área de la neonatología y la atención primaria de salud

The growing capacity of medicine to generate more iatrogenic events than ever, and the risk of unsustainability of health systems have led to new prevention concept: quaternary prevention aimed at restraining medicalization. Quaternary prevention is essential in the phenomenon called disease mongering, which could be translated as commercialization of disease. Encouraging this sort of prevention and halting the consequences of disease mongering requires the development of all the institutional potential for prevention, as well as all the personal willingness for restraint; it involves separating us from the unnecessary auspices of industry, being critical of our work, not being maleficent, respecting the principle of justice as managers of the limited public resources and making ourselves feel responsible for the social cost resulting from medical decisions. From this point of view, this work analyses neonatal screening, developments in the area of neonatology and primary health care

[Quaternary prevention: containment as an ethical necessity]. / Prevención cuaternaria. La contención como imperativo ético.

The growing capacity of medicine to generate more iatrogenic events than ever, and the risk of unsustainability of health systems have led to new prevention concept: quaternary prevention aimed at restraining medicalization. Quaternary prevention is essential in the phenomenon called disease mongering, which could be translated as commercialization of disease. Encouraging this sort of prevention and halting the consequences of disease mongering requires the development of all the institutional potential for prevention, as well as all the personal willingness for restraint; it involves separating us from the unnecessary auspices of industry, being critical of our work, not being maleficent, respecting the principle of justice as managers of the limited public resources and making ourselves feel responsible for the social cost resulting from medical decisions. From this point of view, this work analyses neonatal screening, developments in the area of neonatology and primary health care.

Embarazo y parto en el cine (I): emociones y reflexiones / Pregnancy and childbirth in the movies (I): emotions and reflections

En la mayoría de los lugares del planeta Tierra el embarazo no es una elección, sino una obligación. Cada día nacen en el mundo más de 350 000 niños. No es difícil imaginar que la gran mayoría de nacimientos ocurren en países del Tercer y del Segundo Mundo. Y estos embarazos y partos no ocurren con las condiciones sanitarias y sociales que conocemos en los países desarrollados del Primer Mundo. El embarazo como leitmotiv en el cine ha oscilado entre el tono de tragedia y, principalmente, el tono de comedia. La mayoría de estas últimas producciones se convierten en un fast food cinematográfico bastante llevadero que funciona perfectamente como entretenimiento de bajo nivel. Pero también hay películas que tratan el tema del embarazo y el parto no para entretener, sino para concienciar. Hoy destacamos cuatro películas en este aspecto, las cuatro con carácter de película documental: 1) una película que nos acerca al problema del embarazo en el mundo: la estadounidense No llores mujer (Christy Turlington, 2010); 2) una película que nos acerca al problema del parto en el mundo, la colombiana Nacer-Diario de maternidad (Jorge Caballero, 2012); 3) una película que nos acerca al problema del parto respetado, principalmente en el Primer Mundo, la española Néixer (Ana Victoria Pérez, 2012), y 4) una película que nos acerca al problema de la maternidad como reto, como experiencia transformadora de la mujer y de la familia, la francesa Un feliz acontecimiento (Rémi Bezançon, 2011). De nuevo, el cine como una oportunidad para hablar con arte, ciencia y conciencia de un tema social y sanitario de tal importancia. Y una oportunidad para mejorar la relación profesional-paciente, para mejorar la humanización y para abrir el debate bioético (AU)

Teenage pregnancies are described as early pregnancies, because these women haven’t reached the legal age and are in a situation of dependence on family of origin. Pregnancy in adolescent girls is a serious and prevalent socio-medical problem. For all these reasons and more, the teen pregnancy becomes a “sacred” medical consultation: that is, a medical advice that deserves a friendly, warm, dignified, empathetic, respectful and serene communication with the patient and involve a style of practice that makes fluid the present and future doctor-patient relationship. In this article we invite you to live the emotions and thoughts of motherhood and pregnancy in 16 pregnant adolescents, 16 stories between cinema and reality. Because in “sacred” medical consultation about pregnancy in adolescents, we also believe that it is useful to prescribe movies, at least for the professionals. It helps us to better understand the complexity of this hard situation in this complex stage of life. We dare to advise our “top five” films (in chronological order): A Taste of Honey, Palindromos, Juno, Precious and Blog (AU)

Embarazo y parto en el cine (II): historias de embarazos en adolescentes / Pregnancy and labor in the movies (II): history of pregnancy in adolescents

Los embarazos en adolescentes se describen como embarazos precoces, porque normalmente estas mujeres no han alcanzado la mayoría de edad jurídica y están en situación de dependencia de la familia de origen. El embarazo suele implicar un riesgo en la trayectoria vital de las jóvenes adolescentes, y un serio y prevalente problema médico-social. Por todo ello y por más, el embarazo de la adolescente se convierte en una consulta “sagrada” y que debemos conocer; es decir, una consulta que merece una comunicación amable, cálida, digna, empática, respetuosa y serena con el paciente, y que conlleva un estilo de práctica que hace fluidas las relaciones médico-paciente presentes y futuras. En este artículo os invitamos a vivir las emociones y reflexiones de la maternidad y el embarazo en 16 adolescentes, historias entre el cine y la realidad. Porque en las consultas “sagradas” alrededor de los adolescentes que se enfrentan a un embarazo, también creemos que es útil prescribir películas, al menos para los propios profesionales. Nos sirve para entender mejor la complejidad de este momento en esta, ya de por sí, compleja etapa de la vida. Nos atrevemos a aconsejar nuestro "top five" de películas (por orden cronológico): Un sabor a miel, Palíndromos, Juno, Precious y Blog (AU)

Teenage pregnancies are described as early pregnancy, before these women have reached the legal age and are in a situation of dependence on family of origin. Pregnancy in adolescent girls is a serious and prevalent socio-medical problem. For all these reasons and more, the teen pregnancy becomes a "sacred" medical consultation: that is, a medical advice that deserves a friendly, warm, dignified, empathetic, respectful and serene communication with the patient and involve a style of practice that makes fluid the present and future doctor-patient relationship. In this article we invite you to live the emotions and thoughts of motherhood and pregnancy in 16 pregnant adolescents, 16 stories between cinema and reality. Because in "sacred" medical consultation about pregnancy in adolescent, we also believe that it is useful to prescribe movies, at least for the professionals. It helps us better understand the complexity of this hard situation in this complex stage of life. We dare to advise our "top five" films (in chronological order): A Taste of Honey, Palindromos, Juno, Precious and Blog (AU)

Recomendaciones para la toma de decisiones ante la negativa de los padres a la vacunación de sus hijos: análisis ético / Recommendations for making decisions when parents refuse to vaccinate their children: ethical analysis

Vacunar a los niños es la actividad de prevención primaria más efectiva que se conoce y gracias a las vacunas se han salvado muchas vidas. Los movimientos antivacunas siembran dudas acerca de la seguridad y la efectividad de las vacunas infantiles provocando la negativa de algunos padres a vacunar a sus hijos. Dicha negativa plantea un conflicto de valores entre el derecho de los padres a la crianza de sus hijos según sus creencias y el de justicia, al poner en riesgo la inmunidad del grupo. En España, la ley protege esta capacidad de decisión de los padres al no obligar al cumplimiento del calendario oficial. Los pediatras tenemos un papel esencial en la decisión de los padres y debemos informar con rigor y claridad. Es necesario explorar los valores de los padres y sus preocupaciones, desde la empatía, buscando acuerdos. El respeto a la autonomía no nos exime de argumentar e intentar persuadir para conseguir actitudes y decisiones saludables para los niños. Nuestro compromiso desde el fomento de la responsabilidad es esencial para lograr mantener altos niveles de vacunación que protejan la salud infantil (AU)

Vaccinating children is the most effective primary prevention activity and many lives have been saved due to vaccines. Anti-vaccine movements have spread doubts about the safety and effectiveness of childhood vaccines, leading to some parents refusing to vaccinate their children. This refusal raises a conflict of values between the right of parents to the upbringing of their children according to their beliefs and justice, putting the immunity of the group at risk. In Spain, the law protects this ability for parents to decide not to comply with the official vaccine program. Pediatricians play an essential role in a parent's decision, and must provide accurate information about vaccination. It is necessary to explore The values of the parents, their concerns need to be empathetically examined, in order to reach an agreement. Respect for freedom does not exempt us from using discussion and persuasion to achieve attitudes and healthy choices for children. Our commitment to responsability promotion is essential for maintaining high vaccination levels that protect the health of children (AU)

[Recommendations for making decisions when parents refuse to vaccinate their children: ethical analysis]. / Recomendaciones para la toma de decisiones ante la negativa de los padres a la vacunación de sus hijos: análisis ético.

Vaccinating children is the most effective primary prevention activity and many lives have been saved due to vaccines. Anti-vaccine movements have spread doubts about the safety and effectiveness of childhood vaccines, leading to some parents refusing to vaccinate their children. This refusal raises a conflict of values between the right of parents to the upbringing of their children according to their beliefs and justice, putting the immunity of the group at risk. In Spain, the law protects this ability for parents to decide not to comply with the official vaccine program. Pediatricians play an essential role in a parent's decision, and must provide accurate information about vaccination. It is necessary to explore The values of the parents, their concerns need to be empathetically examined, in order to reach an agreement. Respect for freedom does not exempt us from using discussion and persuasion to achieve attitudes and healthy choices for children. Our commitment to responsability promotion is essential for maintaining high vaccination levels that protect the health of children.

Random walk in chemical space of Cantor dust as a paradigm of superdiffusion.

We point out that the chemical space of a totally disconnected Cantor dust K(n) [Symbol: see text E(n) is a compact metric space C(n) with the spectral dimension d(s) = d(ℓ) = n > D, where D and d(ℓ) = n are the fractal and chemical dimensions of K(n), respectively. Hence, we can define a random walk in the chemical space as a Markovian Gaussian process. The mapping of a random walk in C(n) into K(n) [Symbol: see text] E(n) defines the quenched Lévy flight on the Cantor dust with a single step duration independent of the step length. The equations, describing the superdiffusion and diffusion-reaction front propagation ruled by the local quenched Lévy flight on K(n) [Symbol: see text] E(n), are derived. The use of these equations to model superdiffusive phenomena, observed in some physical systems in which propagators decay faster than algebraically, is discussed.

Epifisiolisis de la cabeza femoral / Slipped capital femoral epiphysis

La epifisiolisis de la cabeza femoral (ECF) se describe como el desplazamiento de la epífisis (cabeza femoral) respecto a la metáfisis (cuello) a través de la fisis. El término es confuso ya que es la metáfisis la que se desplaza en dirección anterosuperior mientras que la epífisis no se mueve y mantiene su posición respecto al acetábulo. La ECF se considera estable cuando el paciente es capaz de caminar e inestable cuando no puede hacerlo ni siquiera con ayuda de bastones. Los pacientes con ECF son adolescentes que presentan dolor en la región inguinal y/o en la rodilla asociado a cojera. El tratamiento de elección en las estables es la fijación in situ con un tornillo (AU)

Slipped capital femoral epiphysis (SCFE) is characterized by displacement of the capital femoral epiphysis from the metaphysis through the physis. The term is confusing, because the metaphysis moves upward and outward while the epiphysis remains in the acetabulum. The SCFE is considered stable when the child is able to walk with or without crutches, and it is considered unstable when the child cannot walk with or without crutches. Patients with SCFE present with pain in the groin, knee and limp. The current treatment of stable SCFE is in situ stabilization with a single screw (AU)