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Resumen Objetivo Evaluar la utilidad del aporte de concentrado de medula osea rico en celulas troncales mesenquimales (MSC) como tratamiento de la necrosis avascular de cabeza femoral (NAV) para evitar o retrasar la artroplastia total de cadera (ATC). Material y metodos Estudio clinico unicentrico, prospectivo, no controlado, de pacientes con diagnostico de NAV. Evaluacion de parametros demograficos, Harris Hip Score (HHS), pruebas de imagen (radiografia y RMN); estadificacion mediante escala de Arlet-Ficat. Seguimiento a 1, 6, 12 y 24 meses. Aspirado de medula osea de cresta iliaca, concentrado con sistema Harvest SmartPReP 2, e infusion en zona de necrosis mediante forages. Resultados Veintidos caderas en 17 pacientes fueron reclutados entre los anos 2006-2012, seguimiento minimo 2 anos. Extraccion media de 119,5 ml de aspirado, implantandose 15,25 ml de concentrado de MSC. Durante los primeros 2 anos de la infusion 5 caderas (24,7%) precisaron ATC, sin diferencias en estadio de Ficat basal, y 4 (80%) de ellas presentaban afectacion de cabeza femoral igual o superior al 30%. En las 17 caderas restantes, se observo a los 2 anos de la infusion un aumento significativo del HHS (14,27) (p = 0,026) y disminucion del dolor (0,98) en la EVA (p = 0,089). Nuestros resultados sugieren que la infusion de concentrado de medula osea rico en MSC asociado a descompresion quirurgica del nucleo mejora significativamente la funcionalidad de la cadera (HHS) y evita la ATC en el 75,3% de los pacientes con NAV tratados durante los primeros 2 anos.

Objective To assess the efficacy of implanting concentrated bone marrow rich in mesenchymal stem cells (MSC) for the treatment of femoral head avascular necrosis (AVN) to prevent or delay total hip replacement (THR). Material and methods A single-centre, prospective, non-controlled clinical study was conducted on patients with a diagnosis of AVN. The parameters assessed were, patient demographics, Harris Hip Score (HHS), imaging test (X-ray and NMR), and staging using the Arlet–Ficat scale. The patients were followed up for 1, 6, 12 and 24 months. The bone marrow was aspirated from the iliac crest, concentrated with the Harvest SmartPReP 2 system, and infused into the necrotic area by means of core decompression. Results A total of 22 hips in 17 patients were recruited between the years 2006 and 2012, with a minimum follow-up of 2 years. A mean of 119.5 ml of aspirate was extracted, with 15.25 ml of MSC being implanted. During the first 2 years of the infusion, 5 hips (24.7%) required THR, with no differences in the baseline Arlet–Ficat stage, and 4 of these (80%) had femoral head involvement equal to or higher than 30%. A significant increase of 14.27 ( P = .026) in the HHS and a 0.98 ( P = .089) decrease in the VAS was observed two years after the infusion in the remaining 17 hips. The results suggest that the infusion of concentrated bone marrow rich in MSC, combined with surgical decompression of the nucleus, improves hip function (HHS), and avoids THR in 75.3% of patients with AVN treated during the first 2 years.

Size-exclusion chromatography with coupled multiangle light scattering and differential refractometry detectors has been used to obtain molecular mass and radius of gyration distributions of polydisperse polymer samples. From these data the scaling law between dimensions and the absolute molecular mass is obtained with just one sample of each polymer. Three different kinds of polymers are presented: polystyrene which serves as reference polymer, polyphosphazenes which behave abnormally in solution and poly(ethylene oxide) which is soluble in water. Since the relationship between dimensions and molecular mass depends on the extent of interactions between chain segments and solvent molecules, the scaling law provides information about the solution properties of the polymer.

Resumen Con motivo de la presentacion de un enfermo afecto de fibrosis pulmonar, enfermedad de Hashimoto, y que habia sido criador de canarios, se realiza el comentario de que existe un grupo de procesos, tales como las neumonias descamativas en sus distintos grupos, las alveolitis extrinsecas alergicas y criptogenicas, las neumonias eosinofilas cronicas, la neumonia intersticial cronica, que tienen un inicio anatomopatologico comun en su localizacion y conformacion, con capacidades en un principio de evolucion de un tipo hacia otro, regresion o evolucion comun, hacia la fibrosis. Se expone la tesis de que este grupo forma un sindrome comun reactivo de orden disimunitario, tan solo diferenciado por las distintas fases en el que se realiza el estudio o modificados por la naturaleza de la noxa.