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ACKNOWLEDGEMENTS This publication is part of the project ‘Contribution of the UGR to the PLATO2.0 space mission. Phases C / D-1’, funded by MCNI/AEI/PID2019-107061GB-C64. DPO acknowledges MNRAS for the opportunity to publish his first scientific article, in particular to the assistant editor, Bella Lock, for her comments. He also appreciates the comments of the anonymous reviewer of this article. They have undoubtedly contributed to improving it. He also acknowledges all the co-authors of this work, especially to JCS and AGH, his thesis project directors, because without them, he would not have been able to publish this work. And he also appreciates the patience of his wife, Pilar, and his son, Fernando, for all the time they have allowed him to get to this point. AGH acknowledges funding support from Spanish public funds for research under project PID2019-107061GB-C64 by the Spanish Ministry of Science and Education, and from ‘European Regional Development Fund/Junta de Andalucía-Consejería de Economía y Conocimiento’ under project E-FQM-041-UGR18 by Universidad de Granada. JPG acknowledges funding support from Spanish public funds for research from project PID2019-107061GB-C63 from the ‘Programas Estatales de Generación de Conocimiento y Fortalecimiento Científico y Tecnológico del Sistema de I+D+i y de I+D + i Orientada a los Retos de la Sociedad’, as well as from the State Agency for Research of the Spanish MCIU through the ‘Center of Excellence Severo Ochoa’ award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709). SBF received financial support from the Spanish State Research Agency (AEI) Projects No. PID2019-107061GB-C64. He also thanks the resources received from the PLATO project collaboration with Centro de Astrobiología (PID2019-107061GB-C61). This paper includes data collected with the TESS mission, obtained from the MAST data archive at the Space Telescope Science Institute (STScI). Funding for the TESS mission is provided by the NASA Explorer Program. STScI is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555., DATA AVAILABILITY Tables of the most significant peaks, corresponding to each of the 11 δ Sct stars of our sample, extracted with MM, are available in VizieR DataBase. In them, we can find the values of the frequencies, amplitudes, phases, corresponding errors, and S/N of the extracted peaks., In this work, we aim at constraining the age of the young open cluster Melotte 20, known as α Per, using seismic indices. The method consists of the following steps: (1) Extract the frequency content of a sample of stars in the field of an open cluster. (2) Search for possible regularities in the frequency spectra of δ Sct stars candidates, using different techniques, such as the Fourier transform, the autocorrelation function, the histogram of frequency differences and the échelle diagram. (3) Constrain the age of the selected stars by both the physical parameters and seismic indices by comparing them with a grid of asteroseismic models representative of δ Sct stars. (4) Find possible common ages between these stars to determine the age of the cluster. We performed the pulsation analysis with MultiModes, a rapid, accurate and powerful open-source code, which is presented in this paper. The result is that the age of α Per could be between 96 and 100 Myr. This is an improvement over different techniques in the past. We therefore show that space astroseismology is capable of taking important steps in the dating of young open clusters., Project 'Contribution of the UGR MCNI/AEI/PID2019-107061GB-C64, Spanish public funds for research PID2019-107061GB-C64, Spanish Ministry of Science and Education, European Regional Development Fund/Junta de Andalucia-Consejeria de Economia y Conocimiento' E-FQM-041-UGR18, Universidad de Granada, Spanish public funds for research from project PID2019-107061GB-C63, Programas Estatales de Generacion de Conocimiento y Fortalecimiento Cientifico y Tecnologico del Sistema de I+D+i y de I+D + i Orientada a los Retos de la Sociedad', State Agency for Research of the Spanish MCIU through the `Center of Excellence Severo Ochoa' award SEV-2017-0709, PID2019-107061GB-C64, PID2019-107061GB-C61, National Aeronautics & Space Administration (NASA), Association of Universities for Research in Astronomy, Inc., under NASA NAS 5-26555

OBJECTIVES Cardiopulmonary bypass generates a systemic inflammatory response. This inflammatory response is reduced if patients are ventilated during bypass, as evidenced by lower levels of postoperative circulating inflammatory mediators. However, this does not appear to make much clinical difference in adults, at least not consistently, but, to our knowledge, has never been assessed in paediatric cardiac surgery, which is the objective of this study. METHODS This is a prospective clinical study of 12 consecutive neonates operated for the correction of either transposition of the great arteries ± ventricular septal defect or aortic arch hypoplasia ± ventricular septal defect, who were ventilated during cardiopulmonary bypass. These were compared to 11 neonates with the same malformations, who had undergone the same operations but without being ventilated during bypass (historical control group). RESULTS One patient from the control group died on the 15th postoperative day due to sepsis and multi-organ failure. Bypass times and cross-clamp times were similar in the 2 groups. Ventilation on bypass was associated with significantly lower postoperative serum concentrations of C-reactive protein, shorter mechanical ventilation and lower vasoactive-inotropic score. Duration of stay on intensive care unit (ICU) showed a tendency to be shorter in patients who were ventilated on bypass, but this did not reach statistical significance. There were no differences between the 2 groups with respect to postoperative mixed venous oxygen saturations and serum concentrations of lactate and troponin I. CONCLUSIONS Mechanical ventilation during cardiopulmonary bypass in neonates improves postoperative outcome.

We consider an extension of the Standard Model, where the difference between the baryon number $B$ and the lepton number $L$ is gauged with an Abelian gauge field, in order to explain the exact conservation of $B-L$. To avoid a gauge anomaly, we add a right-handed neutrino $\nu_{\rm R}$ to each fermion generation. Here it is not sterile, so the usual Majorana term is excluded by gauge invariance. We provide a mass term for $\nu_{\rm R}$ by adding a non-standard 1-component Higgs field, thus arriving at a consistent extension of the Standard Model, where the conservation of $B-L$ is natural, with a modest number of additional fields. We study the possible formation of cosmic strings by solving the coupled field equations of the two Higgs fields and the non-standard U(1) gauge field. Numerical methods provide the correspondingstring profiles, depending on the Higgs winding numbers, such that the appropriate boundary conditions in the string center and far from it are fulfilled.

In this paper, we study the pulsation properties of KIC 3440495 using Kepler and TESS data. A Fourier analysis of the light curve reveals 24 pulsation modes as well as 29 frequencies associated with rotation. The rotation frequency is derived to be frot = 2.322909(2) day−1, and the rotational modulation is determined to be caused by starspots. A large frequency separation of Δν = 54.5 μHz is found by using a Fourier transform, the autocorrelation function, a histogram of frequency differences, and an échelle diagram. We use the large separation to estimate the refined stellar parameters of the star to be v = [239, 279] km s−1, M= [1.5, 1.65] Me, Requator = [2.03, 2.30] Re, Rpolar = [1.72, 1.78] Re, and ω = [0.61, 0.77]. The phase modulations of the pulsating frequencies show a long-term trend which may be attributed to an orbital effect of a binary system; hence, the star may be a fast rotating pulsator in a binary system. KIC 3440495 has an amplitude spectrum similar to Altair, and is identified as a potential sister of Altair. Based on studies of Altair, KIC 3330495 is presumably a young star at a similar evolutionary stage., National Natural Science Foundation of China (NSFC) 12003060 U2031209, Natural Science Foundation of Xinjiang Uygur Autonomous Region 2020D01B59, Chinese Academy of Sciences (CAS) "Light of West China" Program 2021-XBQNXZ-029, "FEDER/Junta de Andalucia-Consejeria de Economia y Conocimiento" by Universidad de Granada E-FQM-041-UGR18, "Programas Estatales de Generacion de Conocimiento y Fortalecimiento Cientifico y Tecnologico del Sistema de I+D+i y de I+D+i Orientada a los Retos de la Sociedad" from the Spanish Ministry of Science, Innovation and Universities (MCIU) PID2019-107061GB-C63, State Agency for Research through the "Center of Excellence Severo Ochoa" award from the Spanish Ministry of Science, Innovation and Universities (MCIU) SEV-2017-0709

Stroke is a worldwide leading cause of mortality and disability, and there are substantial economic costs for poststroke care. Disadvantaged populations show increased incidence, severity, and unfavorable outcomes. This study aimed to report the survival, functional outcome, and caregiver satisfaction of low-income patients diagnosed with a large hemispheric infarction (LHI) who underwent decompressive craniectomy (DC).A retrospective analysis was conducted in consecutive adult patients with an LHI who underwent DC at a single center between October 2015 and September 2019. Demographic, clinical, and radiologic data were reviewed. The primary outcomes were 1-year survival and favorable functional outcome.Forty-nine patients were included; those60 years of age showed a higher proportion of favorable functional outcomes (76% vs. 33%; P = 0.031) but similar survival (52% vs. 56%; P = 0.645) than older patients, respectively. Performing the craniectomy in48 hours from stroke onset compared with ≥48 hours showed no statistically significant differences in survival (59% vs. 46%; P = 0.352) and favorable functional outcomes (56% vs. 70%; P = 0.683), respectively. In retrospective thinking, 79% of caregivers would decide to perform the surgery again.Age group and time from stroke onset to craniectomy were not associated with survival; notwithstanding, a higher proportion of patients60 years of age were associated with a favorable functional outcome compared with older patients. Additionally, if given the option, most caregivers would decide to perform the surgery again, independently of the grade of disability of the patient.

La crisis financiera que estalló en el año 2007 y el lento crecimiento económico posterior generaron un elevado volumen de préstamos morosos (non-performing loans –NPLs.) en las entidades europeas. Estos no solo afectan a la rentabilidad individual de las entidades sino también a la estabilidad financiera y al crecimiento económico real. Este artículo recoge las principales medidas adoptadas en la resolución del problema de los NPLs en España y en la Unión Europa. En ambos casos las medidas persiguen tres objetivos fundamentales: la correcta identificación y valoración de los NPLs por las entidades de crédito, la mejora de la eficiencia de los marcos concursales y el desarrollo del mercado secundario de NPLs.

The immediate background of this paper is a research, conducted at the law schools of the Anahuac, Euro Hispano, Xalapa and Veracruz universities, every in the city of Xalapa, Veracruz, Mexico. With the aim of “Analyzing the axiological universe of the subjects of teaching-learning process, to understand the difficulties and shortcomings in order to help establish conditions that enable them to learn, acquire and prioritize their own values”. We have conducted a research design, quasi-experimental mixed descriptive quantitative and qualitative tools to enrich the collection of information; the qualitative part was collected through review of official documents provided by the universities, quantitative by process by Casares (1995) with its Test Exchange. Some features, resulting from the analysis of data obtained as answers for the valuation process that students exert at different stages of their comprehensive training as persons can be described as highly satisfactory results being the categories in each of its factors reported values above 50 percentage points in the degrees of positive satisfaction, which results in a highly significant evaluative process. Reason why we conclude that both education processes implemented by universities studied and the values assumed by students, are significantly to the role of the educational project raised by the institutions in the curriculum, in its mission and vision and the values assumed for them as distinctive notes of their training plan.

We study the theoretical properties of the regular spacings found in the oscillation spectra of δ Scuti stars. A linear relation between the large separation and the mean density is predicted to be found in the low-frequency domain (i.e. radial orders spanning from 1 to 8, approximately) of the main-sequence δ Scuti stars' oscillation spectrum. This implies an independent direct measure of the average density of δ Scuti stars, analogous to that of the Sun, and places tight constraints on the mode identification and hence on the stellar internal structure and dynamics, and allows a determination the radii of planets orbiting around δ Scuti stars with unprecedented precision. This opens the way for studying the evolution of regular patterns in pulsating stars, and its relation to stellar structure and evolution.

INTRODUÇÃO: A sedação profunda em pacientes gravemente enfermos se associa a uma maior duração da ventilação mecânica e à permanência mais longa na unidade de terapia intensiva. Diversos protocolos foram utilizados para melhorar esses desfechos. Implantamos e avaliamos um protocolo de sedação baseado em analgesia, direcionado por objetivos e cuidado por enfermeiros, em pacientes gravemente enfermos submetidos à ventilação mecânica. MÉTODOS: Realizamos um estudo multicêntrico prospectivo em duas fases (antes e depois), que envolveu 13 unidades de terapia intensiva localizadas no Chile. Após uma fase observacional (grupo observacional, N=155), delineamos, implantamos e avaliamos um protocolo de sedação cuidado por enfermeiros, direcionado por objetivos (grupo de intervenção, N=132) para tratar pacientes que necessitaram de ventilação mecânica por mais do que 48 horas. O parâmetro primário de avaliação foi a obtenção de dias livres de ventilador até o dia 28. RESULTADOS: No grupo de intervenção, a proporção de pacientes com sedação profunda ou coma diminuiu de 55,2 para 44,0%. A incidência de agitação não se alterou entre os períodos, permanecendo em cerca de 7%. Dias livres de ventilador até o dia 28, permanência na unidade de terapia intensiva e mortalidade foram similares em ambos os grupos. Após 1 ano, a presença de sintomas de desordem de estresse pós-traumático nos sobreviventes foi similar entre os grupos. CONCLUSÕES: Delineamos e implantamos no Chile um protocolo de sedação baseado em analgesia, direcionado por objetivos e cuidado por enfermeiros. Embora não se tenha observado melhora nos principais desfechos, observamos que o presente protocolo foi seguro e factível, e que resultou em períodos mais curtos de sedação profunda, sem aumento da agitação. INTRODUCTION: Deep sedation in critically ill patients is associated with a longer duration of mechanical ventilation and a prolonged length of stay in the intensive care unit. Several protocols have been used to improve these outcomes. We implement and evaluate an analgesia-based, goal-directed, nurse-driven sedation protocol used to treat critically ill patients who receive mechanical ventilation. METHODS: We performed a prospective, two-phase (before-after), non-randomized multicenter study that involved 13 intensive care units in Chile. After an observational phase (observational group, n=155), we designed, implemented and evaluated an analgesia-based, goal-directed, nurse-driven sedation protocol (intervention group, n=132) to treat patients who required mechanical ventilation for more than 48 hours. The primary outcome was to achieve ventilator-free days by day 28. RESULTS: The proportion of patients in deep sedation or in a coma decreased from 55.2% to 44.0% in the interventional group. Agitation did not change between the periods and remained approximately 7%. Ventilator-free days to day 28, length of stay in the intensive care unit and mortality were similar in both groups. At one year, post-traumatic stress disorder symptoms in survivors were similar in both groups. CONCLUSIONS: We designed and implemented an analgesia-based, goal-directed, nurse-driven sedation protocol in Chile. Although there was no improvement in major outcomes, we observed that the present protocol was safe and feasible and that it resulted in decreased periods of deep sedation without increasing agitation.

The medial septum inhibits the appearance of interictal spikes and seizures through theta rhythm generation. We have determined that medial septal neurons increase their firing rates during chronic epilepsy and that the GABAergic neurons from both medial and lateral septal regions are highly and selectively vulnerable to the epilepsy process. Since the lateral septal region receives a strong projection from the hippocampus and its neurons are vulnerable to epilepsy, their functional properties are probably altered by this disorder. Using the pilocarpine model of temporal lobe epilepsy we examined the pilocarpine-induced functional alterations of lateral septal neurons and provided additional observations on the pilocarpine-induced functional alterations of medial septal neurons. Simultaneous extracellular recordings of septal neurons and hippocampal field potentials were obtained from chronic epileptic rats under urethane anesthesia. Our results show that: (1) the firing rates of lateral septal neurons were chronically decreased by epilepsy, (2) a subset of lateral septal neurons increased their firing rates before and during hippocampal interictal spikes, (3) the discharges of those lateral septal neurons were well correlated to the hippocampal interictal spikes, (4) in contrast, the discharges of medial septal neurons were not correlated with the hippocampal interictal spikes. We conclude that epilepsy creates dysfunctional and uncoupled septo-hippocampal networks. The elucidation of the roles of altered septo-hippocampal neuronal populations and networks during temporal lobe epilepsy will help design new and effective interventions dedicated to reduce or suppress epileptic activity.

Degeneration of septal neurons in Alzheimer's disease (AD) results in abnormal information processing at cortical circuits and consequent brain dysfunction. The septum modulates the activity of hippocampal and cortical circuits and is crucial to the initiation and occurrence of oscillatory activities such as the hippocampal theta rhythm. Previous studies suggest that amyloid beta peptide (Abeta) accumulation may trigger degeneration in AD. This study evaluates the effects of single injections of Abeta 1-40 into the medial septum. Immunohistochemistry revealed a decrease in septal cholinergic (57%) and glutamatergic (53%) neurons in Abeta 1-40 treated tissue. Additionally, glutamatergic terminals were significantly less in Abeta treated tissue. In contrast, septal GABAergic neurons were spared. Unitary recordings from septal neurons and hippocampal field potentials revealed an approximately 50% increase in firing rates of slow firing septal neurons during theta rhythm and large irregular amplitude (LIA) hippocampal activities and a significantly reduced hippocampal theta rhythm power (49%) in Abeta 1-40 treated tissue. Abeta also markedly reduced the proportion of slow firing septal neurons correlated to the hippocampal theta rhythm by 96%. These results confirm that Abeta alters the anatomy and physiology of the medial septum contributing to septo-hippocampal dysfunction. The Abeta induced injury of septal cholinergic and glutamatergic networks may contribute to an altered hippocampal theta rhythm which may underlie the memory loss typically observed in AD patients.

KIC~8262223 is an eclipsing binary with a short orbital period ($P=1.61$ d). The {\it Kepler} light curves are of Algol-type and display deep and partial eclipses, ellipsoidal variations, and pulsations of Delta Scuti type. We analyzed the {\it Kepler} photometric data, complemented by phase-resolved spectra from the R-C Spectrograph on the 4-meter Mayall telescope at Kitt Peak National Observatory and determined the fundamental parameters of this system. The low mass and oversized secondary ($M_2=0.20M_{\odot}$, $R_2=1.31R_{\odot}$) is the remnant of the donor star that transferred most of its mass to the gainer, and now the primary star. The current primary star is thus not a normal $\delta$ Scuti star but the result of mass accretion from a lower mass progenitor. We discuss the possible evolutionary history and demonstrate with the MESA evolution code that the system can be understood as the result of non-conservative binary evolution similar to that for the formation of EL CVn type binaries. The pulsations of the primary star can be explained as radial and non-radial pressure modes. The equilibrium models from single star evolutionary tracks can match the observed mass and radius ($M_1=1.94M_{\odot}$, $R_1=1.67R_{\odot}$) but the predicted unstable modes associated with these models differ somewhat from those observed. This work presents a preliminary asteroseismic analysis of the abnormal Delta Scuti pulsators, and we discuss the need for better theoretical understanding of such pulsating mass gaining stars., Comment: ApJ accepted

A series of experiments was carried out testing the hypothesis that the septal region decreases the hippocampal susceptibility to hyperexcitability states through theta rhythm generation. Medial septal neurons were simultaneously recorded with hippocampal field potentials to investigate the septo-hippocampal function in the pilocarpine model of chronic epilepsy. The theta rhythm from chronically epileptic rats had lower amplitude (20% less) and higher frequency than controls (from 3.38 to 4.25 Hz), suggesting that both generator and pacemaker structures are affected during the epileptic process. At the cellular level, the group of rhythmically bursting firing medial septal neurons, in the epileptic animals, significantly and chronically increased their firing rates in relation to controls (from 13.86 to 29.14 spikes/s). Peristimulus histograms performed around hippocampal sharp waves showed that all high-frequency firing neurons, including rhythmically bursting neurons and most slow firing neurons, decreased firing rates immediately after hippocampal epileptic discharges. Thus inhibitory hippocampo-septal influences prevail during hippocampal epileptic discharges. The occurrence of epileptic discharges was reduced 86–97% of the number observed during spontaneous theta and theta induced by sensory (tail pinch) or chemical stimulation (carbachol), suggesting that the presence of the theta state regardless of how it was produced was responsible for the reduction in epileptic discharge frequency. The understanding of the theta rhythm “anti-epileptic” effect at the cellular and molecular levels may result in novel therapeutic approaches dedicated to protect the brain against abnormal excitability states.

La distincion de Sen entre medios y fines al abordar la medicion de los niveles de vida es el punto de partida del presente trabajo. En el se propone la construccion del Indice Fisico de Calidad de Vida (IFCV) para los 17 municipios del estado de Tabasco a partir de variables demograficas y educativas, con una variante: la utilizacion del metodo de componentes principales. Los resultados del ejercicio sugieren la necesidad de tener una vision mas cautelosa de la relacion entre crecimiento economico, bienestar y distribucion de la renta en terminos espaciales y confirma la virtualidad de un enfoque del desarrollo economico de caracter normativo.

The increase in hip fractures among the elderly and the presence of intercurrent diseases makes it necessary to institute treatments that help patients resume their activities as soon as possible.Analyze the clinical course of patients with a cemented femoral endoprosthesis with calcar replacement and determine the time to resuming walking.18 patients were seen from January 2003 to December 2006, all of them with a diagnosis of Tronzo T IV and V intertrochanteric hip fractures, over 70 years of age and treated primarily with a cemented femoral endoprosthesis with calcar replacement.The total number of patients was 18, 14 females (77.77%) and 4 males (22.22%). The fracture types were: Tronzo grade IV in 11 patients and grade V in 7 patients; mean age was 78 years and their functional capacity in the immediate postoperative period was: onset of walking with full weightbearing at 48 hours in 100% of patients. Return to usual activities occurred at 4 weeks in 17 patients (94.44%).Due to the complexity of these fractures and the patients' bone quality, there are limited chances to treat them with osteosynthesis, as the latter would increase patients' morbidity and mortality. Patients could undergo early rehabilitation.

For distant stars, as observed by the NASA Kepler satellite, parallax information is currently of fairly low quality and is not complete. This limits the precision with which the absolute sizes of the stars and their potential transiting planets can be determined by traditional methods. Asteroseismology will be used to aid the radius determination of stars observed during NASA's Kepler mission. We report on the recent asteroFLAG hare-and-hounds Exercise#2, where a group of `hares' simulated data of F-K main-sequence stars that a group of `hounds' sought to analyze, aimed at determining the stellar radii. Based on the asteroseismic large frequency spacing, obtained from simulations of 4-year time series data from the Kepler mission, we demonstrate that the stellar radii can be correctly and precisely determined, when combined with traditional stellar parameters from the Kepler Input Catalogue. The radii found by the various methods used by each independent hound generally agree with the true values of the artificial stars to within 3%, when the large frequency spacing is used. This is 5--10 times better than the results where seismology is not applied. These results give strong confidence that radius estimation can be performed to better than 3% for solar-like stars using automatic pipeline reduction. Even when the stellar distance and luminosity are unknown we can obtain the same level of agreement., 14 pages, 10 figures, accepted by ApJ

Recently, the surgical approach for total hip replacement has been refined and has been reduced in size. Controversies exist between advantages and complications it can present.To show the complications of total hip arthroplasty by means of minimal access approach.Thirty six patients, 24 women and 12 men (mean age 48 years), grade IV hip arthrosis. Twenty four patients underwent cementless hip arthroplasty and 12 patients hybrid arthroplasty. The preoperative evaluation was done with Harris score. An initial lateral approach of 6 cm (100%) was performed. Complications were grouped on acetabular, femoral and soft tissue complications.Necrosis at the comissure of the wound was seen in 12 patients (33.33%), necrosis at the surface border of the wound in 10 patients (27.77%), mal positioning of the acetabular cup in 3 patients (8.33%), mal positioning of acetabular cup screws in 2 patients (5.55%), eccentric reaming of the acetabulum in one patient (2.77%), and femoral stem malalignment in one patients (2.77%).There are many reports on the advantages of minimal invasion total hip replacement but few on complications which include mal positioning of the acetabular cup, eccentric reaming of the acetabulum and femoral stem malalignment. Nevertheless, advantages include a decreased healing time and postoperative recovery with less pain and reduced blood loss. We recommend that this technique should remain in the hands of experienced orthopaedic surgeons.

A study of the scuptural decoration of the Main Doorway of Seville Cathedral, dealing with the phases of execution and positioning, together with the iconography and an examination of the documentation: firstly the contract and receipt for the relief work on the tympanum, and secondly the documents detailing the expenses involved in the whole process of execution and positioning of the central medallion and the rest of the sculptures.

To describe the clinical and X-ray outcomes of the use of structured bone autograft and uncemented extended-configuration acetabular cup in hip revision surgery.Eighteen patients, 12 females (66.66%) and 6 males (33.33%), with a diagnosis of uncemented, aseptic acetabular loosening were assessed during the preoperative period, radiologically with the Paprowsky classification and clini cally with the Harris scale. They were considered for revision surgery and exchange of the acetabular component with a structured autograft and an extended-configuration, uncemented acetabular cup. They were reviewed during the period from January 2000 to June 2005.Mean followup was 48 months; according to the Paprowsky scale the acetabular deficiency was: grade I in 11 patients (61.11%), grade II in 5 patients (27.77%), and grade III in 2 patients (11.11%). The following uncemented cups were used: the Healy Flanged in 4 patients (22.22%), and the extended diameter cup in 14 patients (77.77%). The mean time to the assessment of radiological grafting was 14 weeks; the time to assisted weight bearing with a walker was 8 weeks, the time to full weight bearing with a walker was 10 weeks.The use of a structured autograft assures the integration and reinforcement of the acetabular bottom with a considerable length of time to healing of 8 to 12 weeks. The use of revision extended-configuration implants and their three-point fixation assures primary and secondary stability and helps the patient resume his activities.

Non-union is most frequent in the tibia. It may occur with bone loss and is most often seen in the mid-third, mainly as a result of high-energy trauma. Our purpose is to present a treatment alternative.Prospective, longitudinal, experimental trial conducted between 1999 and 2004. Five patients classified according to Judet and Paley were included. A half-tubular fibular graft plus an autologous and/or heterologous iliac crest graft were used with a UTN nail for stabilization purposes; mean follow-up was 24 months.All patients were male. High energy trauma was the cause in 100%; 5 were Gustilo III fractures; Paley B1 type was present in 60%; the mean bone defect was 7.8 cm. Grade III Montoya bone healing was observed on average at 13.6 months. There were two complications; one infection that required removal of the synthesis without disrupting the healing, and one re-fracture which was managed at a different service.An autologous half-tubular fibular graft, plus autologous and/or heterologous graft, stabilized with a UTN nail, restores the loss caused by the bone defect and allows achieving an appropriate bone healing.

A new approach has been developed recently that considerable decreases the size of the skin incision and that has led to controversy around the advantages it offers.To analyze the immediate postoperative course of patients considering the following parameters: operative time, blood loss, postoperative pain. To report the complications that occurred.Thirty six patients, with a mean age of 48 years, with a diagnosis of grade IV coxarthrosis. Twenty-four patients underwent uncemented total hip arthroplasty, and 12 total hybrid hip arthroplasty. The preoperative Harris clinical assessment was applied and a lateral approach was used in all cases. The initial incision was 6 cm long (100%).The final incision was 6.5 cm in 26 patients (72.22%), 7 cm in 10 patients. Necrosis of wound commissures occurred in 12 patients, superficial necrosis of wound margins in 10 patients; no wound infections were reported. The mean operative time was 65 minutes for uncemented hips and 80 minutes for hybrid hips. Mean intraoperative bleeding was 150 ml. Mean postoperative pain was 3 in the VAS. Complications included performing a neo-acetabulum in one case, and a false passage of the femur component in one case.The minimally invasive approach for total hip replacement is indicated for patients with special characteristics. It is less invasive, safe, involves minimal bleeding, shorter operative time, and is reproducible. Moreover, it offers significant benefits during the immediate postoperative period when compared with the standard incision, since it involves ess pain and mobility is resumed sooner.

The description of the first laparoscopic nephrectomy made a revolution in the managing of the benign and malignant renal diseases. Hand-assisted laparoscopy (HAL) was developed with the aim of offering advantages to both patients and surgeons. The aim of the present work is to compare, in our experience, the results offered in the radical nephrectomy by HAL and open surgery, by analysis of surgical time, estimated blood loss during surgery and hospital stay.Eleven Hand-assisted laparoscopic (HAL) radical nephrectomies and eight open radical nephrectomies were carried out at our institution during the same period (June 2001 to December 2002). All patients underwent computed tomography and were found to have a clinically localised functioning renal mass in all cases. The size of this renal mass was 4-7 cm (average 5.5 cm) in the HAL group and 4.5-15 cm (average 7.8 cm) in the open group. Patient age, body mass index, and American Society of Anaesthesiologists' score showed no significant difference between groups.The average surgical time in the HAL group was 156.72 minutes, the average blood loss during surgery was of 83.6 ml and the average hospital stay was of 3.09 days. Conversion to open surgery was not necessary in any patient. Average surgical time in the open surgery group was 178.25 minutes, the estimated blood loss during surgery was of 337.75 ml (p0.05) and the hospital stay was of 5.37 days (p0.05). The comparison of the means by two-tailed student's t test revealed significant differences in estimated blood loss and hospital stay, favoring HAL, and no significant differences in surgical time.HAL nephrectomy is feasible in almost all nephrectomies and is a safe, reproducible, and minimally invasive technique to perform extirpable renal surgery. HAL offer clear advantages over traditional open surgery, including decreased blood loss and hospital stay.

Report a new case of renal angiosarcoma treated by surgery and adjuvant chemotherapy with bad results.72-year-old male undergoing right nephrectomy for renal tumor. Pathology reports renal angiosarcoma.Three months after surgery patient refers lumbar pain and hemoptysis and CT scan reveals the existence of multiple bone and lung metastasis; a regimen of systemic chemotherapy with Doxorrubicine+ Ifosfamide was started without response; he died two months later.Primary renal angiosarcoma is very rare, with less than 10 cases in the literature before 1998, and it is always associated with bad prognosis. Diagnosis is based on immunohistochemical studies (antibodies against CD31, CD34 and factor VIII related antigen) to define the endothelial differentiation of the tumor. There is no experience to define the best therapeutic strategy against this entity.

Intravenous urography (IVU) has been classically considered as an essential examination in the great majority of urologic diseases due to the great amount of information that supplies both functional and morphological, mainly for ureteral abnormalities where other exams do not reach enough definition. Nevertheless, there are cases in which it is not possible to perform an intravenous urography due to allergy to iodine contrasts or renal failure with impossibility of contrast excretion.We report three cases which represent the example of the indications of MRI urography as an alternative to IVU in cases in which this latter cannot or should not be performed.MRI urography is completely accepted as a diagnostic technique for urologic diseases as an alternative to IVU. It has advantages, such as obtaining images in multiple planes, avoiding the use of ionizing radiation, that there is no evidence of it causing cell damage, that it does not require glomerular elimination of any substance so it can be used in patients with renal failure and allergy to iodine contrasts.The use of MRI urography results in an advantage for patients with renal failure, iodine contrasts allergy, or greater risk of contrast nephrotoxicity as it is the case of renal transplant patients.

Aneurysmatic processes of the renal artery after transplant are rare entities, generally secondary to technical defects or infectious pictures. Among other presentations, dissecting aneurysm are exceptional, having a particularly difficult diagnosis due to the lack of specific clinical data which could differentiate them from other processes such as graft rejection or acute tubular necrosis, as well as the absence of characteristic representative images.We report one case of dissecting aneurysm after a kidney transplant resulting in graft loss.We analyze the presentation form, diagnostic procedures, pathologic studies, and possible therapeutic options.Dissecting aneurysm of the renal artery is a rare entity of difficult diagnosis due to the poorness of presenting symptoms and the difficulty of finding it in routine tests, being necessary to think of it and to perform angiography as the only diagnostic test. Treatment is carried out by hilar reconstruction or transplant nephrectomy when the former is not possible.

Asymptomatic microhematuria continues to be a problem. It has a prevalence of 16% and numerous conditions can present this clinical manifestation.A prospective study was carried out on all patients that consulted at the urological services during 2000 for asymptomatic hematuria. Patients presenting with irritative symptoms, urethral secretion, perineal or suprapubic pain, urinary tract infections, renal lithiasis or history of trauma were not included in the study.None of the patients presented tumors. Two patients presented renal lithiasis, 5 simple renal cysts, 8 hypercalciuria and 3 hyperuricosuria. None of the 11 patients with hypercalciuria or hyperuricosuria had a history of lithiasis.Although the size of the study is small, the incidence of tumors in patients with asymptomatic microhematuria appears to be far from the 12.5% incidence reported by some authors and might probably be closer to the 0.5% incidence reported by others. Furthermore, the significant pathology (renal lithiasis), which requires treatment, is also infrequent.

https://www.upo.es/revistas/index.php/atrio/article/view/3155, Universidad Pablo de Olavide

URL del artículo en la web de la Revista: https://www.upo.es/revistas/index.php/atrio/article/view/3280, Universidad Pablo de Olavide

URL del artículo en la web de la Revista: https://www.upo.es/revistas/index.php/atrio/article/view/3415, Universidad Pablo de Olavide