Uncommon gastric hernia in parastomal defect.

An 84-year-old woman with a Barthel Index of 40 and a history of rectal adenocarcinoma treated with total mesorectal excision and colostomy presented with a 24-hour history of abdominal pain, vomiting, and a defunctioning ileostomy. Examination revealed hemodynamic instability, a distended abdomen, and diffuse tenderness around the parastomal hernia. CT scan revealed significant gastric dilation extending through the parastomal hernia with obstructive changes at the gastroduodenal junction. Parastomal hernias are relatively common, with an incidence of 0-48.1%.

The impact of time from ILD diagnosis to referral to the transplant center on the probability of inclusion in the transplant waiting list.

BACKGROUND: Lung transplant is a therapeutic option for patients with progressive interstitial lung disease (ILD). OBJECTIVES: The objective of this study was to determine whether time from ILD diagnosis to referral to a transplant center influences the probability of being included in the transplant waiting list. METHODS: We performed a retrospective cohort study including all ILD patients evaluated as lung transplantation (LT) candidates at a lung transplant center between 01/01/2017 and 31/12/2022. The primary endpoint was the probability of being included in the lung transplant waiting list according to the time elapsed from diagnosis to referral to the transplant center. RESULTS: A total of 843 lung transplant requests were received, of which 367 (43.5%) were associated with ILD. Thirteen patients were excluded because they did not attend the first visit, whereas another 11 were excluded because some information was missing. As a result, our final sample was composed of 343 patients. The median time from diagnosis to referral was 29.4 (10.9 - 61.1) months. The overall probability of inclusion in the waiting list was 29.7%. By time from diagnosis to referral, the probability of inclusion in the waiting list was 48.1% for the patients referred 〈 6 months from diagnosis; 27.5% for patients referred 6 to 24 months from diagnosis; and 25.8% for patients referred 〉 24 months from diagnosis (p = 0.007). CONCLUSIONS: Early referral to a lung transplant center seemed to increase the probability of being included in the lung transplant waiting list. Further research is needed in this topic.

Is the fracture pattern in periprosthetic fractures around the knee related with the anterior femoral notch?

INTRODUCTION: Periprosthetic fractures around the knee (PPF) are a devastating complication of total knee arthroplasty (TKA). Anterior femoral notching during TKA is considered a risk factor for PPF. The aim of this paper is to determine if an anterior femoral notch after total knee arthroplasty may affect the fracture pattern when a PPF appears postoperatively. MATERIAL AND METHODS: 50 patients diagnosed in our centre of a PPF from January 2010 to December 2013 were retrospectively enrolled. 100 patients who underwent a total knee arthroplasty without fracture were randomly obtained as a control group. Evidence of the notch was searched in both groups in postoperative X-rays. In the PPF group, distance from the shield of the femoral component to the most distal (d) and proximal (D) point of the fracture were measured. RESULTS: Two different groups were obtained: 1) d = 0 (33 out of 50 patients); the fracture is supposed to be related with the notch as it's a theoretically weaker area. 2) d > 0 (17 out of 50 patients); the fracture pattern has no relationship with the notch. Prevalence of patients suffering a fracture in the shield of the prosthesis (d = 0), was similar in both patients with notch (66,7%) and without it (68%). CONCLUSIONS: In conclusion, fracture pattern is not related with the existence of a femoral notch in the clinical setting.

Inestabilidad multidireccional atraumática del hombro / Multidirectional atraumatic shoulder instability

Se ha realizado un estudio prospectivo de una serie de casos consecutivos de pacientes con una inestabilidad atraumática de hombro tratados mediante una plicatura capsular artroscópica anterior y posterior. El objetivo de este trabajo es evaluar los resultados de esta técnica. Para ello, se analizó el balance articular, el test de Constant y la reincorporación laboral y deportiva. A los seis meses, se obtuvieron unos resultados satisfactorios en la evaluación clínica de los pacientes, sin encontrar ninguna complicación. Creemos que es por tanto una técnica quirúrgica apropiada para el tratamiento de esta patología

A prospective study of a series of cases of patients with atraumatic shoulder instability undergoing an anterior and posterior arthroscopic capsular plication was carried out. The aim of this report is to assess the outcome of this procedure. To that view, the range of motion, the Constant score and reintegration into working and sport life were analysed. Satisfactory results were achieved following the clinical re-evaluation of the patients at 6 months. Serious complications did not arise during this period of time. The authors therefore believe that this surgical technique is most suited to address the disorder outlined above

Lesiones de la porción larga del bíceps / Long biceps tendon injuries

Se ha realizado una revisión de las lesiones que ocurren en el tendón de la porción larga del bíceps, desde su inserción proximal, hasta las lesiones más distales del mismo, incluyendo aquellas que se dan a lo largo de la polea bicipital. Partiendo del análisis de la anatomía de dicha región, profundizaremos en las lesiones, su diagnóstico y tratamiento más actuales; para concluir, en la importancia que posee el conocimiento de las variantes anatómicas, el estudio de imagen y el manejo terapéutico, fundamentalmente artroscópico, para obtener un adecuado manejo de estas lesiones

A review of the long bíceps tendon has been mad, from it insertion until the more distal lesions, including the pulley biceps injuries. Describing the anatomy, injuries, diagnoses and treatment, concluding in the importance of knowing anatomical variations, imaging studies and the arthroscopic treatment, for a proper management of these injuries

Soluciones tecnológicas e ingenieriles en la producción de radiofármacos / Technological and engineering solutions in the radiopharmaceuticals production

En el trabajo se examinan la concepción y el diseño original de las instalaciones del Centro de Isótopos y las modificaciones a que fueron sometidas durante 15 años de operación a los efectos de cumplir las regulaciones de Buenas Prácticas de Fabricación no existentes en el momento de su puesta en operación. Se presta particular énfasis a los cambios realizados a celdas calientes y cajas de guantes, también a algunos aspectos de los procesos tecnológicos. El trabajo realizado permitió que las producciones del Centro de Isótopos cumplan estándares internacionales y que sus instalaciones se hayan podido validar en correspondencia con las regulaciones nacionales. Se indican pasos encaminados no solo a cumplir los requisitos exigidos por las normas ISO 9000 y las BPF, sino a asegurar la optimización y flexibilización en la utilización de las instalaciones.

The paper discusses the conception and original design of the Isotope Centre’s facilities, and structural changes made to the centre over 15 years of operation with the aim of meeting the Good Manufacturing Practices Regulations nonexistent at the time of its commissioning. Particular emphasis is given to the changes made to hot cells, glove boxes, and also some aspects related to technological processes. As a result, the CENTIS productions fulfil international standards and its facilities have been validated in correspondence with the national regulations. Steps are directed not only to meet the requirements of ISO 9000 and GMP, but to ensure optimization and flexibility in the use of the facilities.