Epidemiología de las fracturas de la extremidad superior del fémur: a propósito de 322 casos

Se realiza un estudio epidemiológico retrospectivo en una serie de 322 pacientes ancianos con fractura de la extremidad superior del fémur (FEPF), vistos y tratados entre los años 1985-1988, en el Servicio de Traumatología del Hospital del Insalud de Logroño, siendo comparados los resultados con los de otras series. Las caídas casuales por mínimo traumatismo fueron la principal causa de la lesión, con mayor incidencia en la mujer de 78 años y con predominio de las fracturas trocantereas sobre las cervicales. En nuestra serie el 48% de estos pacientes están afectados por más de una enfermedad previa a la fractura y a la intervención. Complicaciones locales postoperatorios (migración de los clavos, infección local, luxación de la prótesis, hematomas), los hemos encontrado en un 12% y entre los generales (Infecciones urinarias, Tromboflebitis, Embolia Pulmonar, escaras, etc.) en un 19%. En la valoración funcional, siguiendo a Nickens, hemos obtenido que un 71% caminaban después de la intervención. Los resultados obtenidos son, en esta Comunidad, análogos a los encontrados por otros autores.A retrospective epydemiologic study was undertaken in a serie of 322 aged patients with fracture of the upper extremity of the femur treated at the traumatology unit of the «Hospital del Insalud» in Logroño beetween 1985 and 1988. Accidental falls with a minimum traumatism were the main cause of the injury, with major incidence on 78 years old women, the trochanteric fractures being more frequent than femoral week fractures. In our serie, 48% of patients were affected by more than one previous disease to the fracture. Local post-operatire complications (nail migration, local infection, haematoma) were found in 12%, and general complications (urinary infection, pulmonary embolism, crust) in 19%. According to Nickens' functional evaluation we found that 71% of patients were able to walk after surgery. The results obtained in this community have been found similar to those reported by other authors

Bursitis del psoas-ilíaco

La bolsa serosa del psoas-ilíaco es una estructura anatómica bien definida, habitualmente presente en el adulto. La comunicación entre dicha bolsa y la articulación de la cadera se asocia frecuentemente a la coxartria. Presentamos un caso de agrandamiento de la bolsa serosa del psoas ilíaco en una paciente de 69 años. El diagnóstico de sospecha se estableció por la presencia de una masa inguinal y dolor de cadera. La ecografía y la T.A.C. confirmaron el diagnóstico. Tras la punción de la bolsa y la instilación de corticoides hemos obtenido la remisión de los síntomas.The iliopsoas bursa is a well-defined anatomic structure rarely absent in adults. Communication existing between the iliopsoas bursa and the hip joint is frequently associated with preexisting hip arthrosis. We present a case of iliopsoas bursa enlargement in a 69-yearold woman. The diagnosis was suspected by the presence of inguinal mass and hip pain. Echography, and later computed tomography confirmed it. The patient was successfully treated with aspiration of cyst content and steroid instillation

Osteoma osteoide sobre callo de fractura

Se comunica un caso de osteoma osteoide de localización tibial en un hombre de 23 años, cuya particularidad ha sido su manifestación clínica después de un largo intervalo libre y de haberse desarrollado sobre el lugar mismo del foco de una fractura cerrada tibial sucedida hacía 4 años. El diagnóstico se realizó por la clínica dolorosa de ritmo nocturno, por el estudio radiológico convencional, por tomografía axial computarizada (TAC) y Resonancia Nuclear Magnética (IRM). Su confirmación se hizo por estudio anatomopatológico. El tratamiento consistió en exéresis quirúrgica de la tumoración tras la cual desapareció el dolor no existiendo residuos después de un año. Aunque numerosas publicaciones han sido consagradas al osteoma osteoide, nos ha parecido interesante publicar esta observación particular de esta tumoración en razón de la rareza de su asiento sobre el lugar mismo del callo de una fractura.We report a case of osteoid osteoma in the tibial region in a 23 year old male, whose interest resides in its clinical appearance following a long period without pain and having developed in the same location of a closed tibial fracture that occured some 4 years ago. The diagnosis was performed in addition to the night-time pain experienced, by means of conventional Radiographic study, and Nuclear Magnetic Resonance Diagnostic. Its confirmation was carried out by pathological study. Treatment consisted in surgical exeresis of the tumour. Pain disappeared, after exeresis, not existing tumour ral tissue after one year follow-up. Although numerous publications have been made concerning the osteoide osteoma, it seems interesting to publish this particular case, because of the rarity of its occurrence in the same location of the callus of a fracture

Characterization of a temperature-sensitive DNA ligase from Escherichia coli

DNA ligases are essential enzymes in cells due to their ability to join DNA strand breaks formed during DNA replication. Several temperature-sensitive mutant strains of Escherichia coli, including strain GR501, have been described which can be complemented by functional DNA ligases. Here, it is shown that the ligA251 mutation in E. coli GR501 strain is a cytosine to thymine transition at base 43, which results in a substitution of leucine by phenylalanine at residue 15. The protein product of this gene (LigA251) is accumulated to a similar level at permissive and non-permissive temperatures. Compared to wild-type LigA, at 20 °C purified LigA251 has 20-fold lower ligation activity in vitro, and its activity is reduced further at 42 °C, resulting in 60-fold lower ligation activity than wild-type LigA. It is proposed that the mutation in LigA251 affects the structure of the N-terminal region of LigA. The resulting decrease in DNA ligase activity at the non-permissive temperature is likely to occur as the result of a conformational change that reduces the rate of adenylation of the ligase

Novetats per a la flora del massís del Port

En aquest article es presenten tota una sèrie de notes corològiques sobre el massís del Port (nord-est de la península Ibèrica). Agrostis nebulosa Boiss. & Reut. i Rhamnus × colmeiroi Rivera, Obón & Selma constitueixen una novetat per a la flora de Catalunya.A series of chorological notes are presented on the massís del Port (northeast of the Iberian peninsula). Agrostis nebulosa Boiss. & Reut and Rhamnus × colmeiroi Rivera, Obón & Selma are new records for the Catalan flora

Alteraciones anatómicas y funcionales en la muñeca después de la fractura de la extremidad distal del radio

Se revisaron retrospectivamente 75 casos de fracturas de la extremidad distal del radio tratadas ortopédicamente. Los resultados se valoraron desde el punto de vista anatómico y funcional. En el 49% de los casos existió trazo articular y en el 23% se asoció la lesión de la apó- fisis estiloides del cúbito. Asimismo obtuvimos un 60% de excelentes y buenos resultados a pesar de existir en el 37% de los casos complicaciones evolutivas.A series of 75 cases with fracture of the distal radius treated by conservative methods were retrospectively reciewed. Results were evaluated from anatomical and functional standpoints. In 49% of cases there was an articular extension of the fracture, and 23% had an associated fracture of the ulnar styloid process. Satisfactory outcome was achieved in 60% of cases, although there way 37% of cases showing complications during follow-up

Tratamiento de las fracturas de tobillo con polaina funcional conformada

Se realiza un estudio retrospectivo sobre 35 fracturas de tobillo tratadas con yeso funcional conformado en período de seguimiento de 1 año, algunas no desplazadas y otras desplazadas, pero en las que fue posible conseguir ortopédicamente o con osteosíntesis «a mínima» una correcta reducción. Para la confección del enyesado funcional conformado (YFC), se siguió el método preconizado por F. Esteve valorando clínicamente movilidad, dolor, marcha y estabilidad y radiográficamente reducción, articulación en carga y consolidación. La edad media fue de 53 años, predominando etiología casual (86% de los casos) y el tipo de fractura las de supinación. La duración del período agudo fue de 3,5 a 4 semanas, la del período funcional de 4 semanas y la del período de readaptación de 2 a 3 semanas. Los resultados, en base a los criterios clínicos y radiológicos, fueron excelentes en el 21 % de los casos, buenos en el 62%, regulares en el 10% y malos en el 7%.A total of 35 ankle fractures treated with a functional below-the-knee brace were retrospectively studied. The follow-up period was one year. There were displaced and non displaced fractures, but in all of them was possible to achieved a satisfactory reduction either orthopaedically or with a minimal osteosynthesis. Functional bellow-the-knee bracings was performed according to Esteve. Different parameters such as motion, pain, walking ability and fracture stability were clinically assesed. Fracture reduction and joint consolidation were radiographically evaluated with weight-bearig in the affected leg. The age average was 53 years. Among fractures predominated casual fall etiology (86%) and supination type. The duration of the no loading immovilization period way 3-4 weeks. The functional casting period was 4 weeks and the readaptative period was 2-3 weeks. Based on the clinical and radiological assessments, the results were excellent in a 2 1 % of cases, good in 67%, fair in 10% and poor in 7%

Analysis of ligation and DNA binding by Escherichia coli DNA ligase (LigA).

NAD+-dependent DNA ligases are essential enzymes in bacteria, with the most widely studied of this class of enzymes being LigA from Escherichia coli. NAD+-dependent DNA ligases comprise several discrete structural domains, including a BRCT domain at the C-terminus that is highly-conserved in this group of proteins. The over-expression and purification of various fragments of E. coli LigA allowed the investigation of the different domains in DNA-binding and ligation by this enzyme. Compared to the full-length protein, the deletion of the BRCT domain from LigA reduced in vitro ligation activity by 3-fold and also reduced DNA binding. Using an E. coli strain harbouring a temperature-sensitive mutation of ligA, the over-expression of protein with its BRCT domain deleted enabled growth at the non-permissive temperature. In gel-mobility shift experiments, the isolated BRCT domain bound DNA in a stable manner and to a wider range of DNA molecules compared to full LigA. Thus, the BRCT domain of E. coli LigA can bind DNA, but it is not essential for DNA nick-joining activity in vitro or in vivo

Factores pronósticos del resultado de la quimionucleosis

Los resultados exitosos de la quimionucleosis dependen íntimamente de una estricta selección de los pacientes. En el presente trabajo se revisa la influencia de diferentes factores preoperatorios, clínicos y radiológicos, sobre el resultado de la quimionucleosis a los dos años de evolución, a través de un estudio estadístico de los casos. Los autores destacan como factores de mal pronóstico, en su casuística, las lumbalgias aisladas o prolongadas y el régimen laboral autónomo. Ni el tamaño ni la localizatción, central o lateral, de la imagen herniaria influyeron de manera estadística significativa en el resultado de la discolisis. Tampoco el número de discos explorados o inyectados, ni la presencia de signos radiológicos o tomodensitométricos asociados a la hernia discal sintomática.Successful results of chemonucleolysis depend specially on a strict patient selection. In this paper the influence of different preoperative, clinical and radiologic factors on the results two years after chemonucleolysis, is reviewed through the statistical analysis of the cases. The author s hav e observed the isolated or persistent low back pain (rather than sciatica), and being an autonomous worke r as poor prognosis factors in their environment. Size and site, either midline or lateral, of the disc herniation did not influence the results of chemonucleolysis with statistical significance; nor did the number of discs explored or injected, neither the presence of radiologic or tomodensitometric findings associated with symptomatic disc herniation

Genetic structure of Micromeria (Lamiaceae) in Tenerife, the imprint of geological history and hybridization on within-island diversification

Geological history of oceanic islands can have a profound effect on the evolutionary history of insular flora, especially in complex islands such as Tenerife in the Canary Islands. Tenerife results from the secondary connection of three paleo-islands by a central volcano, and other geological events that further shaped it. This geological history has been shown to influence the phylogenetic history of several taxa, including genus Micromeria (Lamiaceae). Screening 15 microsatellite markers in 289 individuals representing the eight species of Micromeria present in Tenerife, this study aims to assess the genetic diversity and structure of these species and its relation with the geological events on the island. In addition, we evaluate the extent of hybridization among species and discuss its influence on the speciation process. We found that the species restricted to the paleo-islands present lower levels of genetic diversity but the highest levels of genetic differentiation suggesting that their ranges might have contracted over time. The two most widespread species in the island, M. hyssopifolia and M. varia, present the highest genetic diversity levels and a genetic structure that seems correlated with the geological composition of the island. Samples from M. hyssopifolia from the oldest paleo-island, Adeje, appear as distinct while samples from M. varia segregate into two main clusters corresponding to the paleo-islands of Anaga and Teno. Evidence of hybridization and intraspecific migration between species was found. We argue that species boundaries would be retained despite hybridization in response to the habitat\u27s specific conditions causing postzygotic isolation and preserving morphological differentiation