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1.
Med Oral Patol Oral Cir Bucal ; 27(1): e59-e67, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34704978

RESUMEN

BACKGROUND: Alcohol use disorder (AUD) is directly linked to high-risk consumption. Healthcare students have a crucial role to play in its prevention and management. The aim of this study is to analyse alcohol consumption, as well as to consider the knowledge and attitudes regarding morbidity, and the stage of change when providing assistance to quit AUD. MATERIAL AND METHODS: A cross-sectional study was conducted among Dentistry and Medical students using specific and validated questionnaires in an anonymous and voluntary way. Initially, 925 students were invited to participate, of them 500 were reached. RESULTS: Among them 85.9% suffered from AUD of whom 75% were women (p<0.001), and it was considered that the female gender constituted an independent risk factor (OR=2.63, CI 95% 1.55-4.45, p<0.001). The majority of the participants did not achieve the pass mark, nonetheless, the results showed improved levels of knowledge among participants in the latter years of their studies (p<0.001). Dental students demonstrated greater shortcomings in terms of their knowledge of general pathology, whereas the medical students' knowledge of oral pathologies proved worse (p<0.001). Most of students believed that identifying cases of AUD-affected patients falls within their competence, nonetheless, they believed that they do not have the necessary competencies. Among participants 58.2% were in a stage of change regarding AUD attitudes. CONCLUSIONS: The majority of respondents presented AUD. In general, the participants' knowledge about alcohol was low. Reviewing the syllabuses and evaluating the implementation of gender-differentiated training programmes in both degrees would be considered necessary.


Asunto(s)
Consejo , Estudiantes de Medicina , Consumo de Bebidas Alcohólicas , Actitud del Personal de Salud , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Morbilidad , España , Encuestas y Cuestionarios
2.
Med Oral Patol Oral Cir Bucal ; 26(6): e762-e769, 2021 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-34023839

RESUMEN

BACKGROUND: The objective of this study was to analyse the association between oral and general health variables and obesity indicators with the sensation of dry mouth or xerostomia as evaluated on the Xerostomia Inventory (XI). MATERIAL AND METHODS: A total of 354 randomly selected subjects participated in this cross-sectional pilot study and completed an anonymous questionnaire. Anthropometric, clinical, and xerostomic variables were evaluated. Kruskal-Wallis, ANOVA and Bonferroni test were used for multiple comparisons. ROC curves and multinomial logistic regression were used to determine the (OR) risk of xerostomia. RESULTS: A total of 30.7 % of respondents reported xerostomia based on XI. The dry mouth question, the XI taken as a "gold standard", showed a diagnostic sensitivity of 70.37 %, and a specificity of 83.27 % (AUC=0.768, p<0.001). Logistical regression showed the highest xerostomia OR was associated to patients with bad self-perceived health, 6.31 (CI 95% 2.89-13.80, p<0.001). In the model adjusted for tooth mobility, bone or respiratory diseases, and the consumption of anxiolytics and antidepressants, the OR was 3.46 (CI 95% 1.47-8.18, p=0.005). CONCLUSIONS: a high prevalence of xerostomia was found in this cross-sectional pilot study, which was significantly more frequent in women, and increased with age. Xerostomia was associated to several systemic diseases, psychological conditions, and oral functional disorders such as tooth mobility. These preliminary results can serve as the basis for developing guidelines for the application of innovative measures designed to improve the quality of life of individuals with xerostomia.


Asunto(s)
Calidad de Vida , Xerostomía , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Obesidad/complicaciones , Obesidad/epidemiología , Proyectos Piloto , Encuestas y Cuestionarios , Xerostomía/epidemiología , Xerostomía/etiología
3.
Infection ; 47(3): 399-407, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30498902

RESUMEN

BACKGROUND: There are few data on the epidemiology of infections caused by Streptococcus bovis (Sb). Some studies suggest that both residence in rural areas and contact with livestock could be potential risk factors. METHODS: We performed a retrospective study for the period 2005-2016 of all cases of bacteremia caused by Sb in Galicia (a region in the northwest of Spain). The association between the incidence rate of Sb bacteremia and the number of cattle by province and district was analyzed. RESULTS: 677 cases were included with a median age of 76 years, 69.3% males. The most frequent infections were endocarditis (234 cases, 34.5%), primary bacteremia (213 cases, 31.5%) and biliary infection (119 cases, 17.5%). In 252 patients, colon neoplasms were detected (37.2%). S. gallolyticus subsp. gallolyticus was the predominant species (52.3%). Mortality was 15.5% (105 cases). The annual incidence rate was 20.2 cases/106 inhabitants and was correlated with the density of cattle (p < 0.001), but not with rurality. When comparing the two provinces with a strong predominance of rural population, but with important differences in the number of cattle, such as Orense and Lugo, with 6% and 47.7% of Galician cattle, respectively, the rates were very different: 15.8 and 43.6 cases/106, respectively, with an RR of 2.7 (95% CI, 2.08-3.71). Some districts of the province of Lugo had rates higher than 100 cases/106 inhabitants. CONCLUSIONS: Our study shows a significant correlation between the rates of Sb bacteremia and cattle density, suggesting a possible transmission of Sb from cows to people.


Asunto(s)
Bacteriemia/epidemiología , Infecciones Estreptocócicas/epidemiología , Streptococcus bovis/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Bacteriemia/microbiología , Bovinos , Niño , Preescolar , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Densidad de Población , Estudios Retrospectivos , España/epidemiología , Infecciones Estreptocócicas/microbiología , Adulto Joven
4.
Clin Exp Obstet Gynecol ; 43(1): 37-42, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27048015

RESUMEN

OBJECTIVE: The objective of this study was to determine whether puncturing the uterine wall and the amnion causes uterine contractions that result in fetal abnormalities. MATERIALS AND METHODS: An experimental study was performed using four groups of three female rabbits. Group A received a puncture of the amniotic membranes of one of the uteri on day 15 of gestation followed by group B on day 16, group C on day 17, and group D on day 18. The duration and force of contractions and fetal abnormalities were determined. RESULTS: There were immediate contractions after the puncture, which lasted 20 to 132 seconds with forces that ranged from 309 to 4,411 mg. All of the experimental fetuses exhibited anomalies of the head and extremities, exencephaly, cleft palates, and an absence of eye-lids. CONCLUSION: Injury to the uterine wall and the aniion can immediately cause uterine contractions, which are associated with different types of fetal abnormalities.


Asunto(s)
Síndrome de Bandas Amnióticas/etiología , Preñez , Contracción Uterina/fisiología , Útero/fisiopatología , Síndrome de Bandas Amnióticas/fisiopatología , Animales , Modelos Animales de Enfermedad , Femenino , Embarazo , Conejos
5.
J Hand Ther ; 27(3): 225-33; quiz 234, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24878351

RESUMEN

This paper presents the results of a descriptive survey on human grasps. Sixty-four videos were selected to represent tasks performed in the main areas of activities of daily living (ADL) (personal care, meal preparation, eating, housekeeping, etc.). All the participants were right-handed. Elementary grasps were identified for each hand, and the grasp type (from a 9-type classification), the hands involved, and the duration were registered for each case. The results show that the most commonly used grasps are: pinch, non-prehensile, cylindrical, lateral pinch and lumbrical. The presence of these grasps in the areas of ADL is, however, very different (e.g., pinch is widely used in food preparation and very little in driving). Some grasps were used more frequently with one hand or when both hands were used simultaneously (e.g., special pinch was hardly used by the left hand). Knowing the grasp types most frequently used in ADL is essential to be able to assess grasp rehabilitation processes or hand prostheses development.


Asunto(s)
Actividades Cotidianas , Fuerza de la Mano , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Actividad Motora , Valores de Referencia , Análisis y Desempeño de Tareas , Adulto Joven
6.
Rev Esp Anestesiol Reanim (Engl Ed) ; 71(5): 368-378, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38387503

RESUMEN

BACKGROUND AND OBJECTIVE: The diagnosis of infection, to diagnose septic shock, has been qualified by leukocyte counts and protein biomarkers. Septic shock mortality is persistently high (20%-50%), and rising in the long term. The definition of sepsis does not include leukocyte count, and lymphopenia has been associated with its mortality in the short term. Immunosuppression and increased mortality in the long term due to sepsis have not been demonstrated. The aim is to relate the occurrence of lymphopenia and its lack of recovery during septic shock with mortality at 2 years. PATIENTS AND METHODS: Cohort of 332 elderly patients diagnosed with septic shock. Mortality at 28 days and 2 years was analysed according to leukocyte, neutrophil, and lymphocyte counts, and the ability to recover from lymphopenia (LRec). RESULTS: A total of 74.1% of patients showed lymphopenia, and 73.5% did not improve during ICU stay. Mortality was 31.0% and 50.3% at 28 days and 2 years, respectively. Lymphopenia was a predictor of early mortality (OR 2.96) and LRec of late mortality (OR 3.98). Long-term mortality was associated with LRec (HR 1.69). CONCLUSIONS: In elderly patients with septic shock, 28-day mortality is associated with lymphopenia and neutrophilia, and LRec with 2-year mortality; this may represent 2 distinct phenotypes of behaviour after septic shock.


Asunto(s)
Linfopenia , Choque Séptico , Humanos , Linfopenia/sangre , Linfopenia/mortalidad , Choque Séptico/mortalidad , Choque Séptico/sangre , Masculino , Estudios Retrospectivos , Femenino , Anciano , Anciano de 80 o más Años , Recuento de Leucocitos , Neutrófilos , Factores de Tiempo , Recuento de Linfocitos
7.
Rev Esp Cir Ortop Traumatol ; 67(5): T401-T410, 2023.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37328055

RESUMEN

INTRODUCTION: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. MATERIAL AND METHODS: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12 months. RESULTS: Sixteen patients underwent surgery, with 13 THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1 year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1 points, the visual analogue scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5 years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. CONCLUSIONS: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimised with dual mobility cups.

8.
Rev Esp Cir Ortop Traumatol ; 67(5): 401-410, 2023.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37011859

RESUMEN

INTRODUCTION: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. MATERIAL AND METHODS: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. RESULTS: Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. CONCLUSIONS: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.

9.
J Oral Rehabil ; 39(3): 188-97, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21913956

RESUMEN

The aim of this study was to analyse the strength and failure mode of teeth restored with fibre posts under retention and flexural-compressive loads at different stages of the restoration and to analyse whether including a simulated ligament in the experimental setup has any effect on the strength or the failure mode. Thirty human maxillary central incisors were distributed in three different groups to be restored with simulation of different restoration stages (1: only post, 2: post and core, 3: post-core and crown), using Rebilda fibre posts. The specimens were inserted in resin blocks and loaded by means of a universal testing machine until failure under tension (stage 1) and 50º flexion (stages 2-3). Half the specimens in each group were restored using a simulated ligament between root dentine and resin block and the other half did not use this element. Failure in stage 1 always occurred at the post-dentine interface, with a mean failure load of 191·2 N. Failure in stage 2 was located mainly in the core or coronal dentine (mean failure load of 505·9 N). Failure in stage 3 was observed in the coronal dentine (mean failure load 397·4 N). Failure loads registered were greater than expected masticatory loads. Fracture modes were mostly reparable, thus indicating that this post is clinically valid at the different stages of restoration studied. The inclusion of the simulated ligament in the experimental system did not show a statistically significant effect on the failure load or the failure mode.


Asunto(s)
Diseño de Prótesis Dental/normas , Fracaso de la Restauración Dental/estadística & datos numéricos , Restauración Dental Permanente/normas , Análisis del Estrés Dental , Restauración Dental Permanente/métodos , Humanos , Incisivo , Ensayo de Materiales , Maxilar , Técnica de Perno Muñón/normas
10.
J Obstet Gynaecol ; 32(6): 560-5, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22779962

RESUMEN

Female genital mutilation (FGM) is still performed throughout Africa and in a few countries of Asia and the Middle East, affecting over 100 million females worldwide. It includes procedures that intentionally injure female external genital organs for non-medical reasons, and can have deleterious consequences for the physical, psychological and sexual lives of its victims. This paper presents three case studies illustrating the psychological and sexual consequences of FGM. Data were gathered about child and family history, employment, medical and psychiatric history, and the genital mutilation experienced. Self-report measures of self-esteem, mental health status and sexual life were also administered. The results obtained highlight the need for European professionals to develop greater knowledge about FGM and its serious consequences, especially as regards sexuality. This is particularly important given the large numbers of immigrant women now residing within EU countries.


Asunto(s)
Circuncisión Femenina/psicología , Adulto , Circuncisión Femenina/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Sexual , Disfunciones Sexuales Fisiológicas/etiología
11.
Pulmonology ; 2022 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-36280590

RESUMEN

INTRODUCTION: Silicosis is an irreversible and incurable disease. Preventive measures to eliminate exposure are the only effective way to reduce morbidity and mortality. In such situations, having a biomarker for early diagnosis or to predict evolution would be very useful in order to improve control of the disease. The elevation of serum angiotensin-converting enzyme (sACE) in silicosis has been described in previous studies, although its relationship with severity and prognosis is not clear. AIMS: To determine the levels of sACE in a cohort of patients with exposure to silica dust with and without silicosis, and to assess their impact on the prognosis of the aforementioned patients. METHOD: Prospective observational study on patients treated in a silicosis clinic from 2009 to 2018. sACE levels and pulmonary function tests were performed. Radiological progression was assessed in patients who had already had 2 X-rays of the thorax and / or two CT scans with at least a 1-year interval, from the time of inclusion in the study. RESULTS: A total of 413 cases of silicosis were confirmed, as well as 73 with exposure to silica dust but without silicosis. The mean sACE level for healthy subjects was 27.5±7.3U/L, for exposed patients without silicosis it was 49.6±24.2U/L, for simple silicosis it was 57.8±31,3U/L and for complicated silicosis it was 74.5±38.6U/L. Patients with a higher sACE generally progressed radiologically during follow-up (73.3±38.0 vs. 60.4±33.7; p<.001) and so the category of silicosis changed (73,9±38.1 vs. 62.5±34.6; p<.021). CONCLUSIONS: sACE was elevated in patients with silicosis, and the greater its severity, the higher it was, which is associated with disease progression measured radiologically or as a category change of silicosis.

12.
Science ; 269(5225): 830-2, 1995 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-7638599

RESUMEN

A paleomagnetic investigation at the Gran Dolina site excavation (Atapuerca, Spain) shows that the sediments containing the recently discovered human occupation were deposited more than 780,000 years ago, near the time of the Matuyama-Brunhes boundary. Forty-one oriented samples were obtained from 22 sites along an 18-meter section of the Gran Dolina karst filling. The lower 16 sites displayed reversed-polarity magnetizations whereas the upper six sites were normal. The reversal spans the hominid finds at stratigraphic level TD6 (the Aurora stratum), and these hominid fossils are therefore the oldest in southern Europe.


Asunto(s)
Fósiles , Hominidae , Animales , Historia Antigua , Humanos , Magnetismo , España
13.
J Oral Rehabil ; 36(10): 737-47, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19702682

RESUMEN

Numerous research works have studied the effect of post-design parameters on the mechanical behaviour of restored teeth without reaching any clear conclusions. Previous works by the authors ascertained the effect of material and post-dimensions for non-crowned restored teeth. The aim of this work was to study the effect of post-material and diameter for crowned teeth. First, an experimental fracture strength test was performed on eighteen extracted human maxillary central incisors. Teeth were decoronated, treated endodontically and restored (nine with glass fibre posts and nine with stainless steel posts). Several post-diameters were used. The final crown restoration was carried out using a reinforced glass-ceramic material. Failure loads were recorded and results were compared using the one-way anova. Secondly, the finite element technique was used to model the restored teeth and to compare the estimated stress distributions. The addition of the crown did not affect the strength of the restoration to any significant extent and post-diameter did not influence the biomechanical performance of either of the post-systems. The crown acts as a protector, thus eliminating the influence of the post-diameter that was found previously when using stainless steel posts, but it does not completely rule out the possibility of a root fracture. Significantly, lower failure loads were found experimentally for teeth restored with stainless steel posts. The stress distributions predicted by the model corroborated these findings and allowed the authors to propose the use of glass fibre posts as a more robust restorative technique.


Asunto(s)
Materiales Dentales/química , Diseño de Prótesis Dental/instrumentación , Restauración Dental Permanente/instrumentación , Técnica de Perno Muñón/instrumentación , Análisis del Estrés Dental , Análisis de Elementos Finitos , Vidrio , Humanos , Incisivo , Ensayo de Materiales , Maxilar
14.
Med Intensiva (Engl Ed) ; 43(8): 464-473, 2019 Nov.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30025749

RESUMEN

PURPOSE: To determine the differences in short- and long-term mortality in elderly septic patients with multiorgan dysfunction syndrome and establish the factors related to non-survival. MATERIALS AND METHODS: A retrospective cohort study was made of 206 patients over 65 years of age with septic and septic shock criteria admitted to the ICU of Rio Hortega Hospital between January 2011 and February 2017. Study variables were obtained from electronic database records. RESULTS: A total of 206 patients were included, divided into three groups of age (65-74, 75-85, >85 years). There were no significant differences in mortality according to age group after 28 days, 90 days or one year (28.6%, 32.1% and 45.2% in the 65-74 years age group; 32.5%, 38.6% and 45.8% in the 75-85 years age group, 41%, 48.7% and 56.4% in the >85 years age group). The factors related to mortality were: chronic heart failure, non-haematological cancer, liver dysfunction and central nervous system dysfunction. CONCLUSIONS: The results indicate that there is no significant difference in mortality among the different age groups. About 50% of the elderly patients survive a septic process. There is a close relationship between the number of affected organs and days of dysfunction, the use of interventional techniques and long-term mortality.


Asunto(s)
Insuficiencia Multiorgánica/mortalidad , Complicaciones Posoperatorias/mortalidad , Sepsis/mortalidad , APACHE , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Estudios de Cohortes , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Estimación de Kaplan-Meier , Puntuaciones en la Disfunción de Órganos , Estudios Retrospectivos , Choque Séptico/mortalidad , Factores de Tiempo
15.
Sci Rep ; 8(1): 3082, 2018 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-29449566

RESUMEN

We describe a European Acheulean site characterised by an extensive accumulation of large cutting tools (LCT). This type of Lower Paleolithic assemblage, with dense LCT accumulations, has only been found on the African continent and in the Near East until now. The identification of a site with large accumulations of LCTs favours the hypothesis of an African origin for the Acheulean of Southwest Europe. The lithic tool-bearing deposits date back to 293-205 thousand years ago. Our chronological findings confirm temporal overlap between sites with clear "African" Acheulean affinities and Early Middle Paleolithic sites found elsewhere in the region. These complex technological patterns could be consistent with the potential coexistence of different human species in south-western Europe during the Middle Pleistocene.


Asunto(s)
Arqueología/métodos , Tecnología/instrumentación , Comportamiento del Uso de la Herramienta/clasificación , Animales , Europa (Continente) , Fósiles , Historia Antigua , Hominidae , Humanos , España , Tecnología/métodos
16.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(5): 401-410, Sept-Oct, 2023. ilus, tab
Artículo en Español | IBECS (España) | ID: ibc-224970

RESUMEN

Introducción: La prótesis total de cadera (PTC) en pacientes con secuelas de poliomielitis (SP) supone un reto quirúrgico. La morfología displásica, la osteoporosis y la debilidad glútea dificultan la orientación, incrementan el riesgo de fractura y reducen la estabilidad del implante. El objetivo de este estudio es describir una serie de pacientes con SP tratados mediante PTC. Material y métodos: Estudio descriptivo retrospectivo de pacientes con SP intervenidos mediante PTC entre 1999 y 2021 en un hospital de tercer nivel, con seguimiento clínico y radiológico y evaluación funcional y de las complicaciones hasta el presente o hasta el fallecimiento, con un mínimo de 12meses. Resultados: Se intervinieron 16 pacientes, implantándose 13PTC en el miembro parético, 6 por fractura y 7 por coxartrosis, mientras que las otras 3PTC se implantaron en el miembro contralateral. Se implantaron 4 cotilos de doble movilidad como medida antiluxante. Al año postoperatorio, 11 presentaban un balance articular completo sin aumentar los casos de Trendelenburg. El Harris Hip Score (HHS) mejoró 32,1puntos, la escala visual analógica (EVA), 5,25puntos, y la escala de Merlé-d’Augbiné-Poste, 6puntos. La corrección de la discrepancia de longitud fue de 13,77mm. La mediana del seguimiento fue de 3,5años (1-24). Dos casos se revisaron por usura del polietileno y 2 por inestabilidad, sin registrarse infecciones, fracturas periprotésicas o aflojamiento del cotilo o vástago. Conclusiones: La PTC en pacientes con SP permite mejorar la situación clínico-funcional con una tasa de complicaciones aceptable. El riesgo de luxación podría minimizarse con cotilos de doble movilidad.(AU)


Introduction: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. Material and methods: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. Results: Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d’Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. Conclusions: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.(AU)


Asunto(s)
Humanos , Artroplastia de Reemplazo de Cadera , Poliomielitis , Osteoartritis de la Cadera , Luxación de la Cadera , Fracturas de Cadera/cirugía , Lesiones de la Cadera , Epidemiología Descriptiva , Estudios Retrospectivos , Traumatología , Ortopedia , Procedimientos Ortopédicos , España , Fracturas Óseas/cirugía , Implantación de Prótesis
17.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(5): T401-T410, Sept-Oct, 2023. ilus, tab
Artículo en Inglés | IBECS (España) | ID: ibc-224971

RESUMEN

Introducción: La prótesis total de cadera (PTC) en pacientes con secuelas de poliomielitis (SP) supone un reto quirúrgico. La morfología displásica, la osteoporosis y la debilidad glútea dificultan la orientación, incrementan el riesgo de fractura y reducen la estabilidad del implante. El objetivo de este estudio es describir una serie de pacientes con SP tratados mediante PTC. Material y métodos: Estudio descriptivo retrospectivo de pacientes con SP intervenidos mediante PTC entre 1999 y 2021 en un hospital de tercer nivel, con seguimiento clínico y radiológico y evaluación funcional y de las complicaciones hasta el presente o hasta el fallecimiento, con un mínimo de 12meses. Resultados: Se intervinieron 16 pacientes, implantándose 13PTC en el miembro parético, 6 por fractura y 7 por coxartrosis, mientras que las otras 3PTC se implantaron en el miembro contralateral. Se implantaron 4 cotilos de doble movilidad como medida antiluxante. Al año postoperatorio, 11 presentaban un balance articular completo sin aumentar los casos de Trendelenburg. El Harris Hip Score (HHS) mejoró 32,1puntos, la escala visual analógica (EVA), 5,25puntos, y la escala de Merlé-d’Augbiné-Poste, 6puntos. La corrección de la discrepancia de longitud fue de 13,77mm. La mediana del seguimiento fue de 3,5años (1-24). Dos casos se revisaron por usura del polietileno y 2 por inestabilidad, sin registrarse infecciones, fracturas periprotésicas o aflojamiento del cotilo o vástago. Conclusiones: La PTC en pacientes con SP permite mejorar la situación clínico-funcional con una tasa de complicaciones aceptable. El riesgo de luxación podría minimizarse con cotilos de doble movilidad.(AU)


Introduction: Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. Material and methods: Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. Results: Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d’Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. Conclusions: THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Artroplastia de Reemplazo de Cadera , Poliomielitis , Osteoartritis de la Cadera , Luxación de la Cadera , Fracturas de Cadera/cirugía , Lesiones de la Cadera , Epidemiología Descriptiva , Estudios Retrospectivos , Traumatología , Ortopedia , Procedimientos Ortopédicos , España , Fracturas Óseas/cirugía , Implantación de Prótesis
18.
Oper Dent ; 31(1): 47-54, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16536193

RESUMEN

AIMS: This work studied how prefabricated intraradicular post material affects the mechanical performance of restored teeth. The effect of using two different materials (glass fiber and stainless steel) with significantly different elastic moduli was studied. METHODS: A combined theoretical and experimental method was used: first, an experimental fracture strength test was performed on 60 extracted human maxillary central incisors. The teeth were decoronated, treated endodontically and restored, 30 with glass fiber posts and 30 with stainless steel posts. The data were recorded and the results compared using an ANOVA test. Then, the finite element technique was used to develop a model of the restored tooth. For both post systems, the model allowed for the study of stress distribution patterns on the restored tooth under external loads. RESULTS: For teeth restored with stainless steel posts, a significantly lower failure load was found, as compared with those teeth restored with glass fiber posts (520 N versus 803 N). The estimated distributions confirmed a worse mechanical performance on teeth restored using stainless steel posts, with a high stress concentration due to the significant difference between the elastic moduli of the steel and the surrounding materials. CONCLUSION: Within the limitations of this study, post systems, where the elastic modulus of the post is similar to that of dentin and core, have a better biomechanical performance.


Asunto(s)
Materiales Dentales/química , Técnica de Perno Muñón/instrumentación , Fracturas de los Dientes/fisiopatología , Diente/fisiopatología , Simulación por Computador , Aleaciones Dentales/química , Diseño de Prótesis Dental , Análisis del Estrés Dental/instrumentación , Elasticidad , Análisis de Elementos Finitos , Vidrio/química , Humanos , Ensayo de Materiales , Modelos Biológicos , Tratamiento del Conducto Radicular , Acero Inoxidable/química , Estrés Mecánico , Diente no Vital/fisiopatología
19.
Appl Ergon ; 56: 52-61, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27184310

RESUMEN

The kinematic analysis of human grasping is challenging because of the high number of degrees of freedom involved. The use of principal component and factorial analyses is proposed in the present study to reduce the hand kinematics dimensionality in the analysis of posture for ergonomic purposes, allowing for a comprehensive study without losing accuracy while also enabling velocity and acceleration analyses to be performed. A laboratory study was designed to analyse the effect of weight and diameter in the grasping posture for cylinders. This study measured the hand posture from six subjects when transporting cylinders of different weights and diameters with precision and power grasps. The hand posture was measured using a Vicon(®) motion-tracking system, and the principal component analysis was applied to reduce the kinematics dimensionality. Different ANOVAs were performed on the reduced kinematic variables to check the effect of weight and diameter of the cylinders, as well as that of the subject. The results show that the original twenty-three degrees of freedom of the hand were reduced to five, which were identified as digit arching, closeness, palmar arching, finger adduction and thumb opposition. Both cylinder diameter and weight significantly affected the precision grasping posture: diameter affects closeness, palmar arching and opposition, while weight affects digit arching, palmar arching and closeness. The power-grasping posture was mainly affected by the cylinder diameter, through digit arching, closeness and opposition. The grasping posture was largely affected by the subject factor and this effect couldn't be attributed only to hand size. In conclusion, this kinematic reduction allowed identifying the effect of the diameter and weight of the cylinders in a comprehensive way, being diameter more important than weight.


Asunto(s)
Mano/fisiología , Postura , Aceleración , Adulto , Fenómenos Biomecánicos , Ergonomía , Femenino , Mano/anatomía & histología , Fuerza de la Mano , Humanos , Masculino , Persona de Mediana Edad , Análisis de Componente Principal , Soporte de Peso/fisiología , Adulto Joven
20.
Sci Rep ; 6: 34799, 2016 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-27713562

RESUMEN

Gran Dolina is a cavity infilled by at least 25 m of Pleistocene sediments. This sequence contains the TD6 stratigraphic unit, whose records include around 170 hominin bones that have allowed the definition of a new species, Homo antecessor. This fossil accumulation was studied as a single assemblage and interpreted as a succession of several human home bases. We propose a complete stratigraphic context and sedimentological interpretation for TD6, analyzing the relationships between the sedimentary facies, the clasts and archaeo-palaeontological remains. The TD6 unit has been divided into three sub-units and 13 layers. Nine sedimentary facies have been defined. Hominin remains appear related to three different sedimentary facies: debris flow facies, channel facies and floodplain facies. They show three kinds of distribution: first a group of scattered fossils, then a group with layers of fossils in fluvial facies, and third a group with a layer of fossils in mixed fluvial and gravity flow facies. The results of this work suggest that some of these hominin remains accumulated in the cave by geological processes, coming from the adjacent slope above the cave or the cave entry, as the palaeogeography and sedimentary characteristics of these allochthonous facies suggest.


Asunto(s)
Fósiles , Sedimentos Geológicos , Hominidae , Animales , Sedimentos Geológicos/análisis , Humanos , Paleontología/métodos , Tamaño de la Partícula , España
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