21 results on '"J. Mas-Atance"'
Search Results
2. Ortogeriatría. ¿Caminamos en la dirección adecuada?
- Author
-
M. de Miguel Artal, O. Roca Chacón, M. Serrano Godoy, and J. Mas Atance
- Subjects
Orthopedic surgery ,RD701-811 - Published
- 2022
- Full Text
- View/download PDF
3. [Translated article] Impact of COVID-19 pandemia on spine surgery in 2nd level hospital
- Author
-
P. Solé Florensa, J. González Sanchez, A. Gil Torrano, J. Peroy Garcia, R. Jové Talavera, and J. Mas Atance
- Subjects
Orthopedics and Sports Medicine ,Surgery - Published
- 2023
4. Impacto de la pandemia COVID-19 en la cirugía de columna en un centro de segundo nivel
- Author
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P. Solé Florensa, J. González Sanchez, A. Gil Torrano, J. Peroy Garcia, R. Jové Talavera, and J. Mas Atance
- Subjects
Orthopedics and Sports Medicine ,Surgery - Published
- 2022
5. Orthogeriatrics. Are we walking the right direction?
- Author
-
M, de Miguel Artal, O, Roca Chacón, M, Serrano Godoy, and J, Mas Atance
- Published
- 2021
6. Estudio comparativo aleatorizado de la intervención quirúrgica temprana frente a la demorada en los pacientes con fractura de cadera tratados con antiagregantes plaquetarios. Determinación de la agregabilidad plaquetaria y el sangrado perioperatorio, y la revisión de la mortalidad al año
- Author
-
M. de Miguel-Artal, M. Matute-Crespo, J.J. Trujillano-Cabello, J.J. Fernández-Martínez, N. Català-Tello, J. Mas-Atance, C. Marzo-Alonso, and P. Forcada-Calvet
- Subjects
Orthopedics and Sports Medicine ,Surgery - Abstract
Resumen Objetivo Revisar el tratamiento perioperatorio de los pacientes con fracturas de cadera y tratamiento concomitante con antiagregantes plaquetarios, asi como analizar las diferencias de mortalidad al ano, y el sangrado perioperatorio segun la pauta de cirugia precoz ( 5 dias). Paralelamente, determinar al ingreso y en el preoperatorio inmediato la agregabilidad plaquetaria en todos los pacientes incluidos en el estudio. Pacientes y metodo Sobre 175 pacientes mayores de 65 anos con fractura de cadera de baja energia se aleatorizaron 3 grupos: antiagregados con cirugia precoz, antiagregados con cirugia demorada, y no antiagregados con cirugia precoz; se recogieron prospectivamente los mismos datos clinicos y analiticos para todos ellos. La agregabilidad plaquetaria se determino mediante un sistema informatizado semicuantitativo basado en la agregometria por impedancia en sangre completa. Resultados El sangrado, los requerimientos transfusionales y los resultados analiticos no mostraron diferencias estadisticamente significativas entre los grupos. Un 59,8% de los pacientes que no referian tomar antiagregantes se encontraban analiticamente antiagregados al ingreso, mientras que un 13,5% de los que tomaban antiagregantes no se encontraban correctamente antiagregados. El analisis multivariante mostro mayor mortalidad a 12 meses para las variables del indice de Barthel bajo previo a la fractura (OR: 0,9-0,9) y numero de transfusiones (OR: 1,1-1,5). La estancia media fue de 4,1 dias mayor en el grupo demorado. Conclusion La pauta de cirugia precoz para los pacientes en tratamiento antiagregante tiene resultados clinicos parecidos a la demorada, pero mejora la eficiencia hospitalaria al reducir la estancia media. La antiagregacion farmacologica referida por el paciente resulto poco concordante con la determinacion de la agregabilidad.
- Published
- 2013
7. Randomised comparative study of early versus delayed surgery in hip-fracture patients on concomitant treatment with antiplatelet drugs. Determination of platelet aggregation, perioperative bleeding and a review of annual mortality
- Author
-
J.J. Trujillano-Cabello, M. Matute-Crespo, P. Forcada-Calvet, N. Català-Tello, M. de Miguel-Artal, J.J. Fernández-Martínez, C. Marzo-Alonso, and J. Mas-Atance
- Subjects
Hip fracture ,medicine.medical_specialty ,Antiplatelet drug ,Multivariate analysis ,business.industry ,medicine.medical_treatment ,Concordance ,Perioperative ,medicine.disease ,Surgery ,Anesthesia ,Concomitant ,Concomitant Therapy ,medicine ,Orthopedics and Sports Medicine ,business ,Whole blood - Abstract
Objective A review of the perioperative management of patients with hip fractures and concomitant therapy with antiplatelet agents, and to analyse the differences in mortality and perioperative bleeding in early surgery ( 5 days). Platelet aggregation was measured on admission and immediately before surgery in all patients included in the study Patients and methods A total of 175 patients over 65 years old, with low energy hip fracture were randomised into 3 groups: Patients on antiplatelet therapy undergoing early surgery, patients on antiplatelet therapy undergoing delayed surgery, and patients not on antiplatelet therapy undergoing early surgery. The same clinical and laboratory data were collected prospectively up to 12 months for all the patients. The platelet aggregation was determined by a semi-quantitative computerised system based on impedance aggregometry in whole blood. Results Bleeding, transfusion requirements and analytical results showed no significant differences between groups. More than half (59.8%) of the patients not taking antiplatelet therapy had normal platelet aggregation on admission, while 13.5% of those taking antiplatelet agents did not have that. Multivariate analysis showed increased mortality at 12 months for the variables, low Barthel index before hip fracture (OR: 0.9–0.9) and number of transfusions (OR: 1.1–1.5). The average length of stay was 4.1 days greater in the delayed surgery group. Conclusion Early surgery for patients receiving antiplatelet therapy has similar clinical outcomes to the delayed, but improves hospital efficiency by reducing the average length of stay. The antiplatelet drug reported by the patient showed low concordance with the determination of the platelet aggregation.
- Published
- 2013
8. Migración posterior epidural de fragmento discal
- Author
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R. Jové Talavera, A. Chárlez Marco, E. Curiá Jové, J. Mas Atance, J. Aguas Valiente, and V. Altemir Martínez
- Subjects
Orthopedics and Sports Medicine ,Surgery - Abstract
Resumen Introduccion La migracion posterior epidural de un fragmento de hernia discal lumbar es una presentacion clinica infrecuente. Caso clinico Presentamos el caso de un paciente varon de 76 anos, que acude por dolor lumbar y paraparesia progresiva en extremidades inferiores, con la aparicion a los 4 dias del ingreso de un sindrome de cauda equina. La resonancia magnetica muestra espondilosis lumbar y una masa intrarraquidea bien delimitada en el espacio epidural posterior. Se realiza una exeresis quirurgica de la masa epidural. El estudio anatomopatologico informo de fragmento de disco intervertebral, por lo que se trataba de una migracion completa de una hernia discal lumbar. Tras la intervencion quirurgica y un tratamiento rehabilitador especifico remitio la clinica del paciente. Conclusiones Los pacientes con migracion posterior de un fragmento de disco presentan graves deficits neurologicos como el sindrome de cauda equina. Debido a que las imagenes radiologicas de los fragmentos del disco son similares a los de otras lesiones como metastasis, quiste sinovial, absceso dural o hematoma, el diagnostico definitivo se realiza mediante exeresis y estudio anatomopatologico. El tratamiento quirurgico urgente es necesario para evitar deficits neurologicos severos.
- Published
- 2012
9. Epidural posterior migration of a disc fragment
- Author
-
A. Chárlez Marco, V. Altemir Martínez, R. Jové Talavera, J. Mas Atance, J. Aguas Valiente, and E. Curiá Jové
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Cauda equina syndrome ,Intervertebral disc ,Lumbar vertebrae ,medicine.disease ,Epidural space ,Surgery ,medicine.anatomical_structure ,Back pain ,Medicine ,Orthopedics and Sports Medicine ,Presentation (obstetrics) ,medicine.symptom ,business ,Abscess - Abstract
Introduction The posterior epidural migration of a fragment of lumbar disc herniation is a rare clinical presentation. Case report We report the case of a 76-year-old male patient with back pain and progressive paraparesis in the lower limbs, with the emergence of a cauda equina syndrome 4 days after admission. MRI showed lumbar spondylosis and a well-defined intra-spinal mass in the posterior epidural space. Surgical resection of the epidural mass was performed. The pathological study revealed an intervertebral disc fragment; thus, it was a complete migration of a herniated lumbar disc. The patient was healed after surgery and specific rehabilitation treatment. Conclusions Patients with posterior migration of disc fragment may present with severe neurological deficits, such as cauda equina syndrome. Because the radiological images of disc fragments are similar to those of other lesions, such as metastasis, synovial cyst, dural abscess or haematoma, definitive diagnosis is made by excision and pathological study. Emergency surgery is required to prevent severe neurological deficits.
- Published
- 2012
10. [Randomised comparative study of early versus delayed surgery in hip-fracture patients on concomitant treatment with antiplatelet drugs. Determination of platelet aggregation, perioperative bleeding and a review of annual mortality]
- Author
-
J, Mas-Atance, C, Marzo-Alonso, M, Matute-Crespo, J J, Trujillano-Cabello, N, Català-Tello, M, de Miguel-Artal, P, Forcada-Calvet, and J J, Fernández-Martínez
- Subjects
Aged, 80 and over ,Male ,Time Factors ,Platelet Aggregation ,Hip Fractures ,Early Medical Intervention ,Humans ,Female ,Prospective Studies ,Platelet Aggregation Inhibitors - Abstract
A review of the perioperative management of patients with hip fractures and concomitant therapy with antiplatelet agents, and to analyse the differences in mortality and perioperative bleeding in early surgery (48 h) versus delayed surgery (5 days). Platelet aggregation was measured on admission and immediately before surgery in all patients included in the studyA total of 175 patients over 65 years old, with low energy hip fracture were randomised into 3 groups: Patients on antiplatelet therapy undergoing early surgery, patients on antiplatelet therapy undergoing delayed surgery, and patients not on antiplatelet therapy undergoing early surgery. The same clinical and laboratory data were collected prospectively up to 12 months for all the patients. The platelet aggregation was determined by a semi-quantitative computerised system based on impedance aggregometry in whole blood.Bleeding, transfusion requirements and analytical results showed no significant differences between groups. More than half (59.8%) of the patients not taking antiplatelet therapy had normal platelet aggregation on admission, while 13.5% of those taking antiplatelet agents did not. Multivariate analysis showed increased mortality at 12 months for the variables, low Barthel index before hip fracture (OR: 0.9-0.9) and number of transfusions (OR: 1.1-1.5). The average lenth of stay was 4.1 days greater in the delayed surgery group.Early surgery for patients receiving antiplatelet therapy has similar clinical outcomes to the delayed, but improves hospital efficiency by reducing the average length of stay. The antiplatelet drug reported by the patient showed low concordance with the determination of the platelet aggregation.
- Published
- 2011
11. [Epidural posterior migration of disc fragment]
- Author
-
R, Jové Talavera, V, Altemir Martínez, A, Chárlez Marco, J, Mas Atance, E, Curiá Jové, and J, Aguas Valiente
- Subjects
Epidural Space ,Male ,Lumbar Vertebrae ,Humans ,Intervertebral Disc Displacement ,Aged - Abstract
The posterior epidural migration of a fragment of lumbar disc herniation is a rare clinical presentation.We report the case of a 76-year-old with back pain and progressive paraparesis in the lower limbs, with the emergence of a cauda equina syndrome 4 days after admission. MRI showed lumbar spondylosis and a well-defined intra-spinal mass in the posterior epidural space. Surgical resection of the epidural mass was performed. The pathological study revealed an intervertebral disc fragment; thus it was a complete migration of a herniated lumbar disc. The patient was healed after surgery and specific rehabilitation treatment.Patients with posterior migration of disc fragment may present with severe neurological deficits, such as cauda equina syndrome. Because the radiological images of disc fragments are similar to those of other lesions, such as metastasis, synovial cyst, dural abscess or haematoma, definitive diagnosis is made by excision and pathological study. Emergency surgery is required to prevent severe neurological deficits.
- Published
- 2011
12. [Total prosthetic knee and hip joint infection. Descriptive epidemiology, therapeutics and evolution in a secondary hospital during ten years]
- Author
-
A, Jover Sáenz, F, Barcenilla Gaite, J, Torres Puig Gros, J, Mas Atance, S, Garrido Calvo, and J M, Porcel Pérez
- Subjects
Male ,Reoperation ,Prosthesis-Related Infections ,Treatment Outcome ,Humans ,Female ,Hip Prosthesis ,Arthroplasty, Replacement ,Knee Prosthesis ,Aged ,Anti-Bacterial Agents ,Retrospective Studies - Abstract
Epidemiological description, retrospective in its classification, evolution and therapeutics of total prosthesis knee and hip infected among the arthoplasties made between 1st of January 1994 and 31st of December 2003 in our hospital.The global infection rate was 2.4% (confidence interval of 95% [CI 95%], 1.6%-3.2%) over 40 cases in 1,666 joint implants. The average age +/- standard deviation (SD) was 69.5 years old +/- 5.1 years, mainly in women (67.5%). The most common location was the knee, 31 cases (77.5%). In 90.0% of the patients the aetiology was identified: 64,0% were gram-positive cocci (plasmacoagulase-negative staphylococci, and Staphylococcus aureus); 14.0% were gram-negative bacilli and mixed flora (11.0%). Acute infections were found in most of the cases (45,0%). The joint replacement had a healing rate of 66.7% in the first replacement and of 83.3% in the second replacement.The gram-positive cocci are the main microorganisms in these infections. More extensive studies about multiple aspects are necessary to evaluate the effectiveness of the different surgical techniques, the new antibiotics and the combined antibiotic therapies.
- Published
- 2007
13. Infección de prótesis total de rodilla y cadera. Epidemiología descriptiva, terapéutica y evolución en un hospital de segundo nivel durante 10 años
- Author
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A Jover Sáenz, J.M. Porcel Pérez, J. Torres Puig Gros, J. Mas Atance, S. Garrido Calvo, and F. Barcenilla Gaite
- Subjects
medicine.medical_specialty ,medicine.drug_class ,business.industry ,Joint replacement ,medicine.medical_treatment ,Antibiotics ,Confidence interval ,Surgery ,MIXED FLORA ,Healing rate ,Epidemiology ,Internal Medicine ,medicine ,Etiology ,Infección ,Prótesis articulares ,Epidemiología ,Prosthesis knee ,business - Abstract
Objetivo: Descripción epidemiológica retrospectiva en su clasificación, evolución y terapéuticas de las prótesis totales de cadera y rodilla infectadas entre las artroplastias realizadas desde el 1 de enero de 1994 al 31 de diciembre del 2003 en nuestro hospital. Resultados: La tasa de infección global de artroplastias fue 2,4% (intervalo de confianza del 95% [IC 95%], 1,6% -3,2%) sobre 40 casos de 1666 implantes articulares. La media de edad ± desviación estándar (DE) fue de 69,5 ± 5,1 años, en su mayoría mujeres (67,5%). La localización más frecuente fue rodilla, 31 casos (77,5%). En un 90,0% de los enfermos se filió la etiología, siendo un 64,0% cocos grampositivos (Staphylococcus plasmocoagulasa negativos y S. aureus), un 13,0% bacilos gramnegativos y flora mixta (11,0%). Predominaron las infecciones agudas (45,0%). El recambio articular en un tiempo tuvo una curación del 66,7% frente a un 83,3% en recambio en 2 tiempos. Conclusiones: Los cocos gram positivos son los principales microrganismos en estas infecciones. Son necesarios estudios amplios multicéntricos para valorar la eficacia de las distintas técnicas quirúrgicas, los nuevos antibióticos y las terapias antibióticas combinadas.
- Published
- 2007
14. Impact of COVID-19 pandemia on spine surgery in 2nd level hospital.
- Author
-
Solé Florensa P, González Sanchez J, Gil Torrano A, Peroy Garcia J, Jové Talavera R, and Mas Atance J
- Abstract
Introduction: The consequences of COVID-19 pandemic, like in any other field of medicine, had such a massive effect in the activity of spine surgeons., Objectives: The main purpose of the study is quantifying the number of interventions done between 2016 and 2021 and analyze the time between the indication and the intervention as an indirect measurement of the waiting list. As secondary objectives we focused on variations of the length of stay and duration of the surgeries during this specific period., Methods: We performed a descriptive retrospective study including all the interventions and diagnosis made during a period including pre-pandemic data (starting on 2016) until 2021, when we considered the normalization of surgical activity was achieved. A total of 1039 registers were compiled. The data collected included age, gender, days in waiting list before the intervention, diagnosis, time of hospitalization and surgery duration., Results: We found that the total number of interventions during the pandemic has significantly decreased compared to 2019 (32.15% less in 2020 and 23.5% less in 2021). After data analysis, we found an increase of data dispersion, average waiting list time and for diagnosis after 2020. No differences were found regarding hospitalization time or surgical time., Conclusion: The number of surgeries decreased during pandemic due to the redistribution of human and material resources to face the raising of critical COVID-19 patients. The increase of data dispersion and median of waiting time, is the consequence of a growing waiting list for non-urgent surgeries during the pandemic as the urgent interventions also raised, those with a shorter waiting time., (Copyright © 2022 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
15. [Translated article] Impact of COVID-19 pandemia on spine surgery in 2nd level hospital.
- Author
-
Solé Florensa P, González Sanchez J, Gil Torrano A, Peroy Garcia J, Jové Talavera R, and Mas Atance J
- Abstract
Introduction: The consequences of COVID-19 pandemic, like in any other field of medicine, had such a massive effect in the activity of spine surgeons., Objectives: The main purpose of the study is quantifying the number of interventions done between 2016 and 2021 and analyze the time between the indication and the intervention as an indirect measurement of the waiting list. As secondary objectives we focused on variations of the length of stay and duration of the surgeries during this specific period., Methods: We performed a descriptive retrospective study including all the interventions and diagnosis made during a period including pre-pandemic data (starting on 2016) until 2021, when we considered the normalization of surgical activity was achieved. A total of 1039 registers were compiled. The data collected included age, gender, days in waiting list before the intervention, diagnosis, time of hospitalization and surgery duration., Results: We found that the total number of interventions during the pandemic has significantly decreased compared to 2019 (32.15% less in 2020 and 23.5% less in 2021). After data analysis, we found an increase of data dispersion, average waiting list time and for diagnosis after 2020. No differences were found regarding hospitalization time or surgical time., Conclusion: The number of surgeries decreased during pandemic due to the redistribution of human and material resources to face the raising of critical COVID-19 patients. The increase of data dispersion and median of waiting time, is the consequence of a growing waiting list for non-urgent surgeries during the pandemic as the urgent interventions also raised, those with a shorter waiting time., (Copyright © 2022 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
16. Orthogeriatrics. Are we walking the right direction?
- Author
-
de Miguel Artal M, Roca Chacón O, Serrano Godoy M, and Mas Atance J
- Published
- 2022
- Full Text
- View/download PDF
17. [Hip fracture in the elderly patient: Prognostic factors for mortality and functional recovery at one year].
- Author
-
de Miguel Artal M, Roca Chacón O, Martínez-Alonso M, Serrano Godoy M, Mas Atance J, and García Gutiérrez R
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Longitudinal Studies, Male, Prognosis, Prospective Studies, Time Factors, Hip Fractures mortality, Hip Fractures therapy, Recovery of Function
- Abstract
Objective: The aim of this study is to identify the risks factors for mortality and functional recovery in elderly patients admitted to hospital with a hip fracture., Materials and Methods: Longitudinal prospective study in patients 80 years old or more and patients between 75 and 79 in residential home care with a hip fracture and with a past medical history of dementia or followed-up by the Geriatric Unit. A total of 359 patients were included, and the demographic data, previous functional status, comorbidity, type of fracture, and dementia were recorded. The data collected during admission included time to surgery, delirium, functional recovery, length of stay, placement at discharge, and mortality. Patients were followed-up for one year and details were collected on placement at the end of follow-up, functional recovery, medical complications, and mortality., Results: The baseline characteristics of the patients with a strong association with mortality after a hip fracture were old age (> 92 years), medical complications delaying surgery (HR 2.17; 95% CI; 1.27-3.73), diagnosis of dementia (HR 1.78; 95% CI; 1.15-2.75), or heart failure (HR 1.75; 95% CI; 1.12-2.75). The fitted multivariable regression models showed that functional impairment before the hip fracture or lack of functional recovery are associated with higher mortality, and patients with increased age, delirium, dementia, and previous functional impairment showed worse functional recovery., Conclusion: In the elderly patients with a hip fracture, increased age, comorbidity and previous functional status is associated with mortality. Functional recovery prognosis will depend on age, previous functional status, past medical history of dementia, and the presence of delirium during admission., (Publicado por Elsevier España, S.L.U.)
- Published
- 2018
- Full Text
- View/download PDF
18. [Randomised comparative study of early versus delayed surgery in hip-fracture patients on concomitant treatment with antiplatelet drugs. Determination of platelet aggregation, perioperative bleeding and a review of annual mortality].
- Author
-
Mas-Atance J, Marzo-Alonso C, Matute-Crespo M, Trujillano-Cabello JJ, Català-Tello N, de Miguel-Artal M, Forcada-Calvet P, and Fernández-Martínez JJ
- Subjects
- Aged, 80 and over, Early Medical Intervention, Female, Hip Fractures blood, Hip Fractures mortality, Humans, Male, Platelet Aggregation, Prospective Studies, Time Factors, Hip Fractures surgery, Platelet Aggregation Inhibitors therapeutic use
- Abstract
Objective: A review of the perioperative management of patients with hip fractures and concomitant therapy with antiplatelet agents, and to analyse the differences in mortality and perioperative bleeding in early surgery (<48 h) versus delayed surgery (>5 days). Platelet aggregation was measured on admission and immediately before surgery in all patients included in the study, Patients and Methods: A total of 175 patients over 65 years old, with low energy hip fracture were randomised into 3 groups: Patients on antiplatelet therapy undergoing early surgery, patients on antiplatelet therapy undergoing delayed surgery, and patients not on antiplatelet therapy undergoing early surgery. The same clinical and laboratory data were collected prospectively up to 12 months for all the patients. The platelet aggregation was determined by a semi-quantitative computerised system based on impedance aggregometry in whole blood., Results: Bleeding, transfusion requirements and analytical results showed no significant differences between groups. More than half (59.8%) of the patients not taking antiplatelet therapy had normal platelet aggregation on admission, while 13.5% of those taking antiplatelet agents did not. Multivariate analysis showed increased mortality at 12 months for the variables, low Barthel index before hip fracture (OR: 0.9-0.9) and number of transfusions (OR: 1.1-1.5). The average lenth of stay was 4.1 days greater in the delayed surgery group., Conclusion: Early surgery for patients receiving antiplatelet therapy has similar clinical outcomes to the delayed, but improves hospital efficiency by reducing the average length of stay. The antiplatelet drug reported by the patient showed low concordance with the determination of the platelet aggregation., (Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
19. [Epidural posterior migration of disc fragment].
- Author
-
Jové Talavera R, Altemir Martínez V, Chárlez Marco A, Mas Atance J, Curiá Jové E, and Aguas Valiente J
- Subjects
- Aged, Epidural Space, Humans, Male, Intervertebral Disc Displacement diagnosis, Lumbar Vertebrae
- Abstract
Introduction: The posterior epidural migration of a fragment of lumbar disc herniation is a rare clinical presentation., Case Report: We report the case of a 76-year-old with back pain and progressive paraparesis in the lower limbs, with the emergence of a cauda equina syndrome 4 days after admission. MRI showed lumbar spondylosis and a well-defined intra-spinal mass in the posterior epidural space. Surgical resection of the epidural mass was performed. The pathological study revealed an intervertebral disc fragment; thus it was a complete migration of a herniated lumbar disc. The patient was healed after surgery and specific rehabilitation treatment., Conclusions: Patients with posterior migration of disc fragment may present with severe neurological deficits, such as cauda equina syndrome. Because the radiological images of disc fragments are similar to those of other lesions, such as metastasis, synovial cyst, dural abscess or haematoma, definitive diagnosis is made by excision and pathological study. Emergency surgery is required to prevent severe neurological deficits., (Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
20. Septic arthritis of a posterior lumbar facet joint in an infant: a case report.
- Author
-
Mas-Atance J, Gil-García MI, Jover-Sáenz A, Curià-Jové E, Jové-Talavera R, Charlez-Marco A, Ibars-Valverde Z, and Fernández-Martínez JJ
- Subjects
- Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Arthritis, Infectious drug therapy, Arthritis, Infectious microbiology, Female, Humans, Infant, Staphylococcal Infections diagnosis, Streptococcal Infections diagnosis, Streptococcal Infections drug therapy, Treatment Outcome, Arthritis, Infectious diagnosis, Lumbar Vertebrae, Zygapophyseal Joint pathology
- Abstract
Study Design: : Case report., Objective: : To describe a case of septic arthritis of the facet joint in an infant., Summary of Background Data: : To our knowledge, no more than 50 cases of septic arthritis of a facet joint are reported in literature, including only 4 cases in children and none in infants., Methods: : A girl of age 18 months presented with a fever pattern of 4 days evolution, right lumbar paravertebral tumefaction with local inflammatory signs and limping related to pain with weight-bearing on the right lower extremity. The mother reported a pharyngeal infection 2 weeks earlier.Conventional radiology showed no alterations. MR and scintigraphy with radioactivity-marked leukocytes showed affectation only of the posterior facet joint of right L4-L5, without associated collections. Blood and urine cultures were negative. The diagnosis was established as right L4-L5 septic arthritis of a lumbar facet joint, probably of hematogenous origin., Results: : The fever pattern and the limp disappeared in 24 hours with wide-spectrum empirical intravenous antibiotherapy. Although no microorganism was isolated, the good response to the empirical treatment and the background of pharyngeal infection point to a hematogenous dissemination by Staphylococcus aureus or Streptococcus spp., Conclusion: : Septic arthritis of a facet joint does not differ clinically from other spinal infections and its incidence is possibly underestimated in favor of other more common entities. Only imaging techniques can differentiate the affected structures and establish the exact diagnosis.MR allows the detection in initial stages, delimits the affectation and extension through the soft tissues, and rules out other more common entities such as discitis. Scintigraphy and SPECT can detect other active foci and be useful in the follow-up.The result achieved with antibiotic treatment in early stages is usually satisfactory. Surgical debridement is only necessary when associated purulent collections appear. From the pediatric point of view, spinal infections should also be taken into consideration within the differential diagnostic of limp in children.
- Published
- 2009
- Full Text
- View/download PDF
21. [Total prosthetic knee and hip joint infection. Descriptive epidemiology, therapeutics and evolution in a secondary hospital during ten years].
- Author
-
Jover Sáenz A, Barcenilla Gaite F, Torres Puig Gros J, Mas Atance J, Garrido Calvo S, and Porcel Pérez JM
- Subjects
- Aged, Anti-Bacterial Agents therapeutic use, Arthroplasty, Replacement methods, Female, Humans, Male, Prosthesis-Related Infections diagnosis, Prosthesis-Related Infections surgery, Reoperation, Retrospective Studies, Treatment Outcome, Hip Prosthesis adverse effects, Knee Prosthesis adverse effects, Prosthesis-Related Infections epidemiology
- Abstract
Objective: Epidemiological description, retrospective in its classification, evolution and therapeutics of total prosthesis knee and hip infected among the arthoplasties made between 1st of January 1994 and 31st of December 2003 in our hospital., Results: The global infection rate was 2.4% (confidence interval of 95% [CI 95%], 1.6%-3.2%) over 40 cases in 1,666 joint implants. The average age +/- standard deviation (SD) was 69.5 years old +/- 5.1 years, mainly in women (67.5%). The most common location was the knee, 31 cases (77.5%). In 90.0% of the patients the aetiology was identified: 64,0% were gram-positive cocci (plasmacoagulase-negative staphylococci, and Staphylococcus aureus); 14.0% were gram-negative bacilli and mixed flora (11.0%). Acute infections were found in most of the cases (45,0%). The joint replacement had a healing rate of 66.7% in the first replacement and of 83.3% in the second replacement., Conclusions: The gram-positive cocci are the main microorganisms in these infections. More extensive studies about multiple aspects are necessary to evaluate the effectiveness of the different surgical techniques, the new antibiotics and the combined antibiotic therapies.
- Published
- 2007
- Full Text
- View/download PDF
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