Proximal ulna comminuted fractures: Fixation using a double-plating technique

SummaryIntroductionComminuted fractures of the proximal ulna are severe injuries often associated with bone and ligament injuries of the elbow joint (Monteggia lesion, radial head fractures, dislocation of the elbow). The treatment of these fractures is very demanding and the functional results often fairly mediocre due to associated injuries. Based on a single-center retrospective study, we report the results of the treatment of these fractures fixed using a double-plate technique. The aim was to evaluate the feasibility and reliability of this fixation mode and to compare it with other fractures series using a single plate fixation (in terms of bone union, elbow joint function, and complications stemming from the plates).Patients and methodsEighteen patients sustained a comminuted proximal ulna fracture between 2002 and 2006. The fractures were associated in five cases with a Monteggia type lesion, in two cases with elbow dislocation, and in four cases with a Mason 3 radial head fracture. Four patients had an open fracture. These comminuted ulna fractures included nine Mayo Clinic IIIB fractures. Bone fixation was performed with two third-cylinder tubular plates, one plate on each side of the proximal ulna. This allows more versatile solutions for screw insertion. Functional assessment (according to Broberg and Morrey) and radiological evaluation (bone healing) were provided at 6 months and at the longest follow-up by an independent surgeon.ResultsSixteen of 18 patients achieved bone union. No septic complications occurred and no hardware removal was required on patient request. In 67% of the cases, the Morrey score indicated excellent or good results with a mean score of 82.DiscussionThere are no reports in the literature on the technical point of fixation concerning complex fractures of the ulna. Two plates mean the possibility of twice the number of screw insertions for epiphyseal reconstruction . This fixation remains easy to perform and provides stable anatomic reconstruction of the ulna.Level of evidenceLevel IV. Retrospective study

Tratamiento psicosocial Matrix para la adicción a cocaína: componentes de un tratamiento efectivo

España, uno de los países europeos con mayor prevalencia de consumo de cocaína entre población joven, tiene una necesidad de transferencia de modelos empíricos de tratamiento llegados de otros países. El instituto Norteamericano NIDA recomienda Matrix como un modelo efectivo de tratamiento en adicciones a estimulantes. Los objetivos de este estudio teórico-descriptivo del modelo son describir con detalle: 1) el desarrollo histórico y repercusión del modelo, 2) la fi losofía y base teórica, 3) los constructos centrales; 4) la estructura y organización, y 5) los recursos materiales, humanos e infraestructura necesarios para implementarlo. La metodología incluye una revisión bibliográfi ca exhaustiva, la formación y experiencia clínica directa con el modelo. Los resultados muestran que Matrix está basado en teorías psicológicas consideradas efi caces para el tratamiento de las adicciones y comunes a las utilizadas por los psicólogos a nivel internacional (cognitivo-conductuales, psico-educativas, motivacionales, manejo de contingencias, monitorización del consumo, apoyo social). Consiste en una intervención intensiva inicial de 62 sesiones mínimas repartidas en 4 meses, seguida de un tratamiento de continuación indefi nido. Conclusiones: el modelo en su conjunto cumple los principios de buenas prácticas de NIDA. Su estandarización y materiales lo hacen fácil de implementar a nivel internacional.Evidence-Based Models for the psychosocial treatment drug addiction are in need in Spain, currently one of the European countries with highest prevalence on cocaine use among youth. This article describes in detail the Matrix model, one of the EBM recommended by NIDA as effective treatments for stimulant drugs. The goals are to describe: 1) the history and impact of this model, 2) philosophy and basic psychosocial theories, 3) core constructs, 4) structure of the model and 5) infrastructure and needed resources. Methods include a comprehensive literature review of the model descriptive publications, collaboration with the model authors, on-site training and direct experience utilizing the model sessions. Results showed that Matrix is based on psychological theories known and used by Spanish psychologists (cognitive-behavioral therapy, motivational strategies, relapse prevention, contingency management, monitoring drug-use, social support). It consists on 62 multivariate sessions along 4 months of intensive treatment followed by continuous support group sessions. The model follows the NIDA principles of Drugaddiction Treatment. Its standardization, structure and writing materials make possible to easily transfer this model to multiple communities and countries

Charge-radius change and nuclear moments in the heavy tin isotopes from laser spectroscopy: Charge radius of 132^{132}Sn

NESTER ACCLaser spectroscopy measurements have been carried out on the neutron-rich tin isotopes with the COMPLIS experimental setup. Using the $5s^25p^2$ $^3P_0 \rightarrow 5s^25_p6s$ $^3P_1$ optical transition, hyperfine spectra of $^{126-132}$Sn and $^{125,127,129-131}Sn^m$ were recorded for the first time. The nuclear moments and the mean square charge radius variation ($\delta) were extracted. From the quadrupole moment values, these nuclei appear to be spherical. The magnetic moments measured are thus compared with those predicted by spherical basis approaches. From the measured$\delta, the absolute charge radii of these isotopes were deduced in particular that of the doubly magic $^{132}$Sn nucleus. The comparison of the results with several mean-field-type calculations have shown that dynamical effects play an important role in the tin isotopes

Deformation change in light iridium nuclei from laser spectroscopy

Laser spectroscopy measurements have been performed on neutron-deficient and stable Ir isotopes using the COMPLIS experimental setup installed at ISOLDE-CERN. The radioactive Ir atoms were obtained from successive decays of a mass-separated Hg beam deposited onto a carbon substrate after deceleration to 1kV and subsequently laser desorbed. A three-color, two-step resonant scheme was used to selectively ionize the desorbed Ir atoms. The hyperfine structure (HFS) and isotope shift (IS) of the first transition of the ionization path 5d^{7}6s ^{2}^{4}F_{9/2} \to 5d^{7}6s6p ^{6}F_{11/2} at 351.5nm were measured for $^{182-189}$Ir, $^{186}Ir^{m}$ and the stable $^{191,193}$Ir. The nuclear magnetic moments μI and the spectroscopic quadrupole moments Qs were obtained from the HFS spectra and the change of the mean square charge radii from the IS measurements. The sign of μI was experimentally determined for the first time for the masses 182≤A≤189 and the isomeric state $^{186}Ir^ m$ . The spectroscopic quadrupole moments of $^{182}$Ir and $^{183}$Ir were measured also for the first time. A large mean square charge radius change between $^{187}$Ir and $^{186}Ir^g$ and between $^{186}Ir^m$ and $^{186}Ir ^g$ was observed corresponding to a sudden increase in deformation: from β2 ≃ + 0.16 for the heavier group A = 193, 191, 189, 187 and 186m to β2 ≥ + 0.2 for the lighter group A = 186g, 185, 184, 183 and 182. These results were analyzed in the framework of a microscopic treatment of an axial rotor plus one or two quasiparticle(s). This sudden deformation change is associated with a change in the proton state that describes the odd-nuclei ground state or that participates in the coupling with the neutron in the odd-odd nuclei. This state is identified with the π3/2+[402] orbital for the heavier group and with the π1/2-[541] orbital stemming from the 1h _9/2 spherical subshell for the lighter group. That last state seems to affect strongly the observed values of the nuclear moments

Physical activity guidelines and cardiovascular risk in children: a cross-sectional analysis to determine whether 60 minutes is enough

Background Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects. Methods PA was measured using accelerometry in 182 children (9–11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score ≥1SD indicated ‘higher risk’). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile. Results Active children (92 (53 boys)) undertook more MVPA (38 ± 11 min, P  0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9 ± 0.6, P < 0.05), and the OR was 4.7 times higher. Conclusion Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines

COMPLIS experiments : COllaboration for spectroscopy Measurements using a Pulsed Laser Ion Source

Laser spectroscopy measurements have been carried out on very neutron-deficient isotopes of Au, Pt and Ir, produced as daughter elements from a Hg ISOLDE beam. For these transitional region nuclides, the hyperfine structure (HFS) and isotope shift (IS) were measured by Resonance Ionization Spectroscopy (RIS). Magnetic moments μ, spectroscopic quadrupole moments Qs and changes of the nuclear mean square charge radius δ〈rc 2〉along isotopic series have been extracted. For some results, a detailed comparison with theoretical predictions is presented. (Springer