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En este estudio se analiza la influencia, en las propiedades tribológicas, del contenido en carbono para distintas aleaciones férreas con similares contenidos en cromo, así como la influencia del cromo cuando el contenido en carbono es semejante. También, se analizó la influencia de estos elementos en propiedades como la dureza y en la microestructura de las aleaciones. Para el estudio tribológico se llevaron a cabo dos ensayos, el ensayo descrito en la norma ASTM G105: Standard Test Method for Conducting Wet Sand/Rubber Wheel Abrasion Test y ensayos de chorreo.

Objective: To analyze the risk factors associated with hemorrhagic cystitis (HC) severity and the treatment strategies available in HC patients following allogeneic hematopoietic stem cell transplantation (AHSCT)., Materials and Methods: A retrospective study of medical records was carried out. Patients with HC following AHSCT treated from 2017 to 2021 were divided into two groups according to severity -mild and severe. Demographic data, disease-specific characteristics, urological sequelae, and overall mortality were compared between both groups. The hospital's protocol was used for patient management., Results: 33 episodes of HC were collected in 27 patients, 72.7% of whom were male. HC incidence following AHSCT was 23.4% (33/141). 51.5% of HCs were severe (grades III-IV). Severe graft host disease (GHD) (grades III-IV) and thrombopenia at HC onset were associated with severe HC (p= 0.043 and p= 0.039, respectively). This group had longer hematuria times (p< 0.001) and required more platelet transfusions (p= 0.003). In addition, 70.6% required bladder catheterization, but only 1 case needed percutaneous cystostomy. None of the patients with mild HC required catheterization. No differences were found in terms of urological sequelae or overall mortality., Conclusions: Severe HC could be predicted thanks to the presence of severe GHD or thrombopenia at HC onset. Severe HC can be managed with bladder catheterization in most of these patients. A standardized protocol may help reduce the need for invasive procedures in patients with mild HC.

Aim of the Study: To describe perianal Crohn's disease behavior and the role of biological therapy in a sample of pediatric patients., Methods: A retrospective study of pediatric patients with Crohn's disease (CD) treated in our institution from 2017 to 2021, with a minimum follow up period of 6 months, was conducted. Patients were divided whether they had perianal disease (PD) or not. Baseline characteristics, extension of disease, growth failure rate, aggressive pattern rate, use of biological therapy and need for surgery, among other variables, were compared between both groups. Clinical and/or radiological improvement in the last 6 months of follow up was considered good control of PD., Results: Seventy eight pediatric patients with CD were included. Median age at diagnosis was 10.5 years, and median follow up time was 3.8 years. 64.1% patients were male. Of all, 15 (19.2%) had perianal disease, of which 10 had fistulizing findings and 5 had non fistulizing findings. PD was presented at diagnosis in 8 patients, and the rest developed it in a median time of 1 year from diagnosis. PD was associated with growth failure (p = 0.003), use of biological therapies (p = 0.005), and need for second line of biologics (p = 0.005). Most patients (12/15, 80%) had good control of PD with the treatment received., Conclusions: CD patients with PD seem to need a more aggressive treatment, with biological therapies playing a key role for its handling nowadays. These patients require close nutritional evaluation that ensures proper development and growth.

Objective: To study gastroesophageal reflux (GER) in children undergoing gastrostomy in a single pediatric institution., Material and Methods: A retrospective study of patients undergoing gastrostomy from 2000 to 2017 was carried out. Demographic data, clinical data, progression, and complications were recorded. GER was considered positive in patients with clinical signs requiring antisecretory treatment, prokinetic treatment, or anti-reflux surgery to control symptoms., Results: 207 patients with a median age of 2 years [R: 0.25-18] were included. Neurological impairment was the most frequent underlying condition (74%). Swallowing difficulty and undernourishment were the main surgical indications for gastrostomy. Prior to gastrostomy, 96 out of 207 patients (46%) showed GER symptoms. Combined fundoplication and gastrostomy was performed in 41 (43%) patients with preexisting GER, 6 of whom showed GER worsening (4 required redo fundoplication). 5 complications following fundoplication were noted - gastric perforation, sustained Dumping syndrome, and gastroesophageal stenosis. 55 out of 96 (57%) patients with preexisting GER underwent gastrostomy alone. Clinical signs disappeared in 16 of them (29%) and improved or stabilized in 19 (35%). GER worsening occurred in 20 patients (36%), with subsequent fundoplication being required in 10 cases. In patients with no previous clinical signs (111 out of 207), GER symptoms occurred following gastrostomy in just 18 cases (16%), and only 2 patients required fundoplication., Conclusions: In our experience, routine anti-reflux surgery combined with gastrostomy is not justified. Individualized fundoplication should be considered in case of medical treatment failure. Further studies with an adequate design are required to establish which patients could really benefit from this procedure.

Objective: To describe our experience in the diagnostic and therapeutic management of patients with acute abdomen as the main manifestation of SARS-CoV-2 infection., Material and Methods: A descriptive study of patients with clinical signs of acute abdomen diagnosed with COVID-19 and admitted at out healthcare facility from April 1 to May 10, 2020 was carried out. Clinical records were reviewed for data collection purposes., Results: A series of 14 patients (9 male and 5 female) with a median age of 9.5 years was analyzed. All patients had abdominal pain. There were 11 patients with fever, 9 patients with vomit or diarrhea, and 9 patients with clinically suspected surgical pathology (acute appendicitis or peritonitis). Increased acute phase reactants and coagulation disorders were a common characteristic at blood tests. An abdominal ultrasonography was carried out in all patients, and a CT-scan was performed in 4 patients, which demonstrated inflammatory signs in the terminal ileum, the ileocecal valve and the ascending colon, as well as gallbladder edema. Conservative management was decided upon in all patients except one, and eight patients required intensive care admission for support treatment., Conclusions: Gastrointestinal symptoms can be the primary manifestation of the new coronavirus infection, which simulates an acute abdomen with a potentially unfavorable evolution. For an accurate diagnosis to be achieved, a good clinical record and a comprehensive physical exploration, as well as complementary tests in search of characteristic findings of COVID-19, should be carried out.

Aim of Study: To describe our experience in the management of non-tuberculosis mycobacterial lymphadenitits (NTML)., Methods: Retrospective analysis of patients who underwent surgery for NTML in our centre during the period between 2010-2017. Demographic data, diagnostic tests, treatment and follow up information were recovered from medical records., Results: 65 patients (26 male/39 female) with a mean age of 31 months (range 7 months-12 years) were intervened during the period of study. As diagnostic tests, chest X-ray was performed in 92.3% of patients with normal result in all cases, Mantoux test was positive in 20.3%, inconclusive in 12.5% and negative in 67.1%. Preoperative fine needle aspiration was positive for NTML (granulomatous necrotizing lymphadenitis) in 93.7% whereas culture for mycobacteria was only positive in 23.4% of cases, being Mycobacterium lentiflavum the most frequent agent found. Mean preoperative waiting time was 2.5 months with 7.7% of fistulization previous to surgery. Mean hospital stay was 1,1 days and there were no intraoperative complications. Mean follow up time was 5.5 months (range 1-24 months) during which 19 cases of temporal facial paralysis were noted, among which only 2 persisted after one year., Conclusions: NTML is a disease with a growing incidence in our country. It is important to make an early diagnosis and surgical treatment in order to avoid complications, as surgery has demonstrated to be safe and effective, with a low rate of complications. We believe the actual protocols should be revised/checked due to low effectiveness of diagnostic tests.

Objectives: To estimate the recurrence rate of intussusception after successful enema reduction and to analyze the costs of hospital admission with the current management of this pathology., Material and Methods: A retrospective study over 5 years of 97 patients with confirmed diagnosis of intussusception was undertaken. Medical records were evaluated for patient demographic, clinical and radiological data. Patients with enema-reduced intussusception were selected and data respecting to timing and outcome of recurrences, and length of stay were analyzed. Recurrence was defined as a new episode of intussusception within 72 hours of the initial presentation. Costs were calculated using hospital-specific data., Results: During the study period there were 81/97 children with successful enema reduction. Mean length of stay was 35 hours in the conservative treatment group. There were 8 episodes of recurrence, 5 of them within the first 24 hours (6.17%), for an overall recurrence rate of 9.88%. 7 children were treated by repeated enema and only one patient needed surgery for persistent illness. Assuming the overall recurrence rate of 9.88%, it would require hospitalizing 16 patients to identify a single recurrence with a cost of 1,723.75 € per patient., Conclusions: Given the low recurrence rate for enema-reduced intussusception and the possibility of repeated enema for their treatment in most of recurrences, we strongly advocated for the outpatient management as a safe and cost-effective alternative.

Objective: Show that the infection rate in scheduled orthopedic surgery is less than 2% provided the principles of asepsis, antisepsis and surgical would care are applied, without the administration of prophylactic antibiotics., Material and Methods: A prospective, observational, longitudinal study was conducted in a secondary care hospital of the IMSS system and at Angeles Metropolitano hospital, from January 2, 2006 to April 30, 2008. All male and female patients aged > 1 year undergoing scheduled orthopedic surgery with a complete preoperative protocol were included. Patients admitted for an infectious process were excluded. The wounds were kept dry and covered, and all wound care was omitted during the first five days. Then dry wound care was provided at the doctor's office at postoperative days 5, 10 and 15, when the sutures were removed in the case of soft tissue surgery, and at postoperative days 20 and 25, when the sutures of the surgery involving bone tissue were removed. Patients whose surgery involved nailing were asked to come at postoperative day 30 for nail removal and at postoperative day 60 for final discharge. The observations were made by 3 orthopedic surgeons from the medical units of the study hospitals, 2 of whom performed the surgeries., Results: A total of 382 scheduled surgeries were performed with infection observed in 3 of them (0.79%). The result of the binomial statistical test was p < .0001., Conclusion: We have shown that by following a surveillance protocol and applying appropriate asepsis and antisepsis we may omit the use of prophylactic antibiotics in patients scheduled for orthopedic surgery.

Background: Disorders of the musculoskeletal system, whether due to congenital or acquired alterations of the body, have important repercussions in the work, economic, psychosocial and family setting of adult individuals. In developed countries, these conditions are considered as a public health problem together with the socioeconomic repercussions they entail., Objective: To determine the incidence of orthopedic disorders in adult patients seen from January 1st 2001 to December 31st 2005 at a private Hospital., Material and Methods: We selected the male and female patients over 18 years of age who presented for their first visit with the orthopedic surgeon for an orthopedic non-traumatic condition., Results: A total of 18,780 patients were seen; 11,343 (60.4%) females and 7437 (39.6%) males. The predominant orthopedic conditions were: low back problems in 53% of males and 47% of females, and gonarthrosis in 77% of females and 23% of males., Conclusion: The reported prevalence of orthopedic conditions ranges from 7.2% to 36.2%. Our study is consistent with such reports. Spine and knee conditions accounted for 13.4% and 12.7% among females, and 13.6% and 4.8% among males.

Thirty-eight patients (31 children and 7 adults) with meningococcal infection (sepsis and/or meningitis) were studied. The strain most frequently isolated was B (44.7%), followed by C (31.6%). Of the strains isolated, 52.6% were moderately resistant to penicillin (91.6% if only strain C was considered). No resistance to cephotaxime or chloramphenicol was found. Even though patients with moderately resistant strains treated with penicillin G evolved satisfactorily (minimum inhibitory concentrations 0.12-0.50 microgram/ml), the possible appearance of more resistant strains and/or of strains that produce beta-lactamase leads us to the conclusion that cephotaxime is the treatment of choice until an antibiogram is available.