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Sanpera Jr. I.,Hospital Universitari Son Espases | Raluy-Collado D.,Hospital Universitari Son Espases | Tejada-Gavela S.,Hospital Universitari Son Espases | Ramos-Asensio R.,Fundacio Hospital Son Llatzer
Journal of Pediatric Orthopaedics | Year: 2012

Background: During the last few years, the use of the 8-plate as a technique for hemiepiphysiodesis has gained wide acceptance, as it has been shown that it works in a more physiological way than other methods such as staples or transphyseal screws. It has mechanically been compared with a tension band plate, and for this reason, only a single plate is needed. The following study was undertaken to test the 8-plate against the staples and assess factors that can influence the difference in results. Methods: A prospective experimental study was designed to compare the ability of 2 hemiepiphysiodesis methods, the 8-plate and the double staple, to produce angular deformity in the rabbit's tibia (group I). The variable studied was the variations in the articular line-diaphysis angle at 6 weeks. As the results showed that the 8-plate produced a bigger deformity, a second group was designed (group II) comparing single against double staple, under the hypothesis that the differences observed in the first group could be related to the number of anchors put across the physis and consequently depend on the volume of physis involved by the staples. Results: In group I, the 8-plate produced a bigger angulation at 6 weeks' time than the 2 staples (a difference of 6.5 degrees, P=0.03). Similarly, in group II, the single staple produced a greater angulation than the 2 staples (difference 6 degrees, P=0.08). When both groups were compared, no differences in the angulation produced by the 8-plate and the single staple with respect to the 2 staples were found. Conclusions: These results suggest that one of the reasons why the 8-plate may act in a more "physiological way" (vs. the traditional 2-staple or 3-staple hemiepiphysiodesis) could be the fact that the growth plate is tethered only at a single point. Therefore, the physis retains a major potential for growth and deformity. Clinical relevance: The 8-plate is superior in producing/correcting angular deformity when compared with the traditionally used staples (2 or more) but not when compared with a single staple. Copyright © 2012 by Lippincott Williams & Wilkins.


Menzies S.W.,Royal Prince Alfred Hospital | Menzies S.W.,University of Sydney | Moloney F.J.,Materials Misericordiae University Hospital | Byth K.,Clinical Trials Center | And 45 more authors.
JAMA Dermatology | Year: 2013

Importance: Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical. Objective: To determine the dermoscopy features of NM. Design: Eighty-three cases of NM, 134 of invasive non- NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/ hypomelanotic or pigmented to assess outcomes. Setting: Predominantly hospital-based clinics from 5 continents. Main Outcome Measures: Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma. Results: Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, bluewhite veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/ hypomelanoticNM(84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM. Conclusions and Relevance: When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded. © 2013 American Medical Association.


Bujanda L.,University of the Basque Country | Bujanda L.,Hospital Donosti | Bujanda L.,Hospital San Eloy | Sarasqueta C.,Donostia Hospital | And 120 more authors.
World Journal of Gastroenterology | Year: 2010

AIM: To evaluate changes in colorectal cancer (CRC) survival over the last 20 years. METHODS: We compared two groups of consecutive CRC patients that were prospectively recruited: Group I included 1990 patients diagnosed between 1980 and 1994. Group II included 871 patients diagnosed in 2001. RESULTS: The average follow up time was 21 mo (1-229) for Group I and 50 mo (1-73.4) for Group II. Overall median survival was significantly longer in Group II than in Group I (73 mo vs 25 mo, P < 0.001) and the difference was significant for all tumor stages. Post surgical mortality was 8% for Group I and 2% for Group II (P < 0.001). Only 17% of Group I patients received chemotherapy compared with 50% of Group II patients (P < 0.001). CONCLUSION: Survival in colorectal cancer patients has doubled over the past 20 years. This increase seems to be partly due to the generalization in the administration of chemotherapy and to the decrease of post surgical mortality. © 2010 Baishideng. All rights reserved.


Renom F.,Hospital Joan March | Yanez A.,Program of Epidemiology and Clinical Research | Garau M.,Fundacio Hospital Son Llatzer | Rubi M.,Hospital Joan March | And 8 more authors.
Respiratory Medicine | Year: 2010

Rationale: A subgroup of patients with chronic obstructive pulmonary disease require frequent hospitalization because of exacerbations of the disease. We hypothesized that airway infection by non-usual pathogens is a major factor driving hospitalization needs in these patients. Objectives: 1) To describe the clinical and functional characteristics of a cohort of COPD patients requiring ≥2 hospitalizations per year; 2) to determine prospectively their microbiological pattern during exacerbations; and, 3) to analyze the prognostic value of several clinical, functional and microbiological variables with respect to hospitalizations and mortality. Methods: Open cohort study of 116 COPD patients who had been hospitalized at least twice during the last 12 months. Patients were followed for an average of 21 months. Measurements and main results: Clinical data, forced spirometry and 6 min walking distance were determined, and the BODE index was calculated, at the time of inclusion in the study. During follow-up, sputum culture was obtained during exacerbations, and hospitalization and mortality were collected every two months. Mean age was 71 yrs, and 94% of patients were male. Main findings show that: 1) not all patients had severe disease according to either the degree of airflow limitation or the BODE index; 2) non-usual pathogens, mainly Pseudomonas aeruginosa, other gram-negative non-fermentative rods and Enterobacteriaceae, were isolated among 71.1% of the sputum obtained during exacerbations; and, 3) these pathogens were associated with poor prognosis and frequent hospitalization. Conclusions: Airway infection by non-usual pathogens appears to be a key driver of frequent hospitalizations and mortality in COPD. © 2009 Elsevier Ltd. All rights reserved.


Scotta C.,University of the Balearic Islands | Bennasar A.,University of the Balearic Islands | Bennasar A.,Institute Universitari vestigacio En Ciencies Of La Salut Iunics Uib | Moore E.R.B.,Sahlgrenska University Hospital | And 4 more authors.
Systematic and Applied Microbiology | Year: 2011

Three ceftazidime-resistant strains isolated from the sewage water of a municipal hospital in Palma de Mallorca, Spain, were analysed phenotypically and genotypically to clarify their taxonomic positions. Sequence determinations and phylogenetic analyses of the 16S rRNA genes indicated that strains CS20.3 T, CS39 and CS41 were affiliated with the species of the alphaproteobacterial genus Brevundimonas, most closely related to B. bullata, B. diminuta, B. naejangsanensis and B. terrae. Additional sequences analyses of the ITS1 region of the rRNA operon and the genes for the housekeeping enzymes DNA gyrase β-subunit and RNA polymerase β-subunit, genomic DNA-DNA hybridisation similarities, cell fatty acid profiles and physiological and biochemical characterizations supported the recognition of CS20.3 T (CCUG 58127 T=CECT 7729 T) as a distinct and novel species, for which the name Brevundimonas faecalis sp. nov. is proposed. Strains CS39 and CS41 were ascribed to the species B. diminuta. © 2011 Elsevier GmbH.

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