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El presente ensayo es una reflexión teórica sobre los modos en los que se construye el dato en un estudio de la grafía en el campo de la Documentología. Se toma como referencia las principales propuestas de autores de la región hispanohablante, principalmente la empleada en Argentina. Se realiza un abordaje de estas obras desde una mirada historicista, donde el énfasis está puesto sobre los procesos inferenciales implicados en el análisis del manuscrito, y en diálogo sobre los patrones consolidados. La reconstrucción del gesto gráfico –aspecto individualizante de la escritura– implica una instancia dialéctica entre diversos procesos inferenciales. En este contexto, la abducción cumple un rol fundamental, pues habilita a decodificar los rasgos únicos de la grafía, y con ello, la construcción de un dato inserto en un sistema de matrices de datos. El estudio del documento atraviesa diferentes niveles de integración en la construcción de sus categorías de análisis, y en ese proceso descubre pautas y las valida; innova y aplica; transita desde una hermenéutica a un dato objetivo, tanto explora como describe y explica.

Se presenta el caso de un hombre de 57 años que consulta por parálisis alta del nervio radial, con dolor y prueba de Tinel positiva en la cara lateral del brazo dominante, de inicio súbito, luego de grandes esfuerzos musculares repetitivos, sin mejoría clínica al tercer mes de evolución. Se realizó un tratamiento quirúrgico descompresivo. El paciente tuvo una rápida recuperación a partir del séptimo día, y remisión completa a los 25 días de la cirugía. Conclusión: El atrapamiento del nervio radial en el brazo es un cuadro poco frecuente. Según los estudios publicados, la evolución clínica es variada, pero si no hay remisión o la evolución de la parálisis no es favorable en 3 meses, creemos que la cirugía es el tratamiento de elección.

Objetivo: Presentar una nueva técnica quirúrgica y los resultados clínicos comparativos de pacientes con roturas de tenorrafia primaria o lesiones crónicas del flexor profundo en las zonas I y II de Verdan, tratados con avance tendinoso no convencional. Materiales y Métodos: Se incluyó a pacientes >18 años, con antecedente de lesiones en las zonas I y II de Verdan y un seguimiento mínimo de 36 meses. La serie estaba formada por 13 pacientes (edad promedio 29 años) que fueron divididos en dos grupos según el tipo de lesión (7 con roturas de tenorrafia primaria y 6 con lesiones crónicas del flexor profundo) y la técnica quirúrgica utilizada (alargamiento en Z más sutura término-terminal y sutura lateral del tendón alargado a un flexor vecino indemne en la zona V, respectivamente). Se empleó la Clasificación de Strickland para la evaluación. Resultados: El seguimiento promedio fue de 51 meses. El intervalo promedio entre la lesión y la cirugía fue de 11.7 semanas. Según la Clasificación de Strickland, 8 pacientes tuvieron resultados excelentes; 4, buenos y uno, pobre. El avance tendinoso promedio fue de 20,5 mm en ambos grupos. Conclusiones: El avance tendinoso no convencional para lesiones en las zonas I y II de Verdan, sea en roturas de tenorrafia primaria o lesiones crónicas del flexor profundo, resultó un tratamiento reproducible y eficaz. Palabras clave: Tendón flexor; alargamiento; zetaplastia.Nivel de Evidencia: III

Objective: To report functional and radiologic outcomes of reverse shoulder arthroplasty (RSA) in patients with complex proximal humeral fractures. A second objective was to assess the relation between the greater tuberosity healing and the range of motion (ROM) and the American Shoulder and Elbow Surgeons (ASES) score. Materials and Methods: Sixteen patients treated between 2013 and 2017, older than 65 years old, operated before 4 weeks after the trauma, and with a minimum of 2-year follow-up were included. ASES scores and active ROMs were recorded. Greater tuberosity and the prosthesis position and healing were radiologically evaluated, and the complications and treatment were recorded. Results: The median age was of 74.5 years (IQR 66-78.5), 11 patients were females (69%). According to Neer classification, 11 cases were four-part fractures and 5 were four-part fracture-dislocations. The average time between trauma and surgery was 9.4 days, and the average follow-up was of 29.5 months. The greater tuberosity was healed in 9 cases (56%). Internal rotation: 5 patients (31.25%) were able to reach up with their thumbs to gluteal level, 4 (25%) to T12, 3 (18.75%) to T7, and 4 (25%) to L3. The medians for external rotation and forward flexion were 30° (IQR 17.5°-40°) and 100° (IQR 87.5°-160°). The average ASES score was of 78.3 (IQR 63.3-87.4). There was no significant statistical relation between greater tuberosity healing and forward flexion or ASES score (P=0.24 and P=0.52, respectively). Conclusion: The use of reverse prostheses for complex fractures with greater tuberosity reattachment could lead to good functional outcomes, low complication rates and reoperations. There was no significant statistical relation between ASES score and greater tuberosity healing or failure to heal.

La falta de pérdida de peso o la re-ganancia de peso postoperatoria, en el by pass gastrico, es un fenomeno que ocurre en un porcentaje significativo de los pacientes, que puede indicar el desarrollo de una dilatación en la anastomosis gastro-yeyunal, que no restringe adecuadamente la ingesta de alimentos. Hay evidencia que muestra que el diametro de la anastomosis gastro-yeyunal se correlaciona positivamente con la reganancia de peso.La recalibración endoscópica de la gastro-yeyuno anastomosis es un procedimiento efectivo que constituye una alternativa a la cirugía de revisión.

En este escrito se presentarán reflexiones preliminares de una investigación etnográfica del proceso judicial llamado "La Causa de Los Jueces" (9002/03 y 300029/12), incluida en la Megacausa III, a cargo del Tribunal Oral en lo Criminal Federal de Santiago del Estero, Argentina. Dicho proceso, que tuvo catorce años de instrucción, llegó a juicio en 2016/17 con la imputación, por primera vez en la provincia, de dos funcionarios judiciales por delitos de lesa humanidad cometidos durante la última dictadura en el país (1976/1983)2. Con este objeto indagamos en torno al concepto de ?impunidad técnica? de Wlasic (2010), es decir, la instrumentación de medidas y acciones tendientes a demorar, limitar o impedir el juzgamiento de los responsables de las practicas genocidas. Tomamos como corpus de análisis los documentos del proceso de esta causa: denuncias iniciales, indagatorias, resoluciones, recursos interpuestos en las diferentes instancias. De modo que en este escrito nos abocamos a reconstruir la batería de prácticas que instrumentaron la decisión política de (no)juzgar a algunos de los responsables de la última dictadura argentina en la Causa de los Jueces y el contexto, o esa trama político-policial-judicial provincial en el que se inserta esta causa y que actúa como limitante de la posibilidad de una contra-justicia: de poder ejercer, respecto de un justiciable que generalmente escapa a la justicia, un acto de tipo judicial (Foucault, 1979: 73). This paper will present preliminary reflections of an ethnographic investigation of the judicial process called “The Cause of the Judges” (9002/03 and 300029/12), included in “Megacausa III”, by the Oral Federal Criminal Court of Santiago del Estero, Argentina. This process, which took fourteen years to complete, reached trial in 2016/17 with the indictment, for the first time in the province, of two judicial officials for crimes against humanity committed during the last dictatorship in the country (1976/1983). For this purpose we explore the concept of "technical impunity" from Wlasic (2010), that means, the implementation of measures and actions aimed at delaying, limiting or preventing the prosecution of those responsible for genocidal practices. We take as a corpus of analysis the documents of the process of this case: initial complaints, investigations, resolutions, appeals filed at various levels. In this paper, we therefore attempt to reconstruct the battery of practices that implemented the political decision to (non)judge some of the leaders of the last Argentine dictatorship in “The Cause of the Judges” and the context, or that provincial political-politico-judicial plot into which this case is inserted and which acts as a limitation on the possibility of counter-justice: of being able to exercise a judicial type of act with respect to a defendant who generally escapes justice (Foucault, 1979: 73). Fil: de Marco, Florencia Iris. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Estudios para el Desarrollo Social. - Universidad Nacional de Santiago del Estero. Facultad de Humanidades Ciencias Sociales y de la Salud. Instituto de Estudios para el Desarrollo Social; Argentina Fil: Garay, Luis Guillermo. Universidad Nacional de Santiago del Estero. Facultad de Humanidades, Ciencias Sociales y de la Salud. Instituto de Estudios para el Desarrollo Social; Argentina

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Introduction: Denervation is a simple alternative for the treatment of chronic pain syndromes of the wrist joint. It is a palliative resource with the limited objective of removing or relieving pain when other treatments attempted have failed to ensure an effective solution. The success of this procedure is based on a specific neurotomy of the articular branches of the nerves that go to the affected joint, without affecting the superficial and deep sensitivity. We present this work to evaluate the indications and outcomes over time of denervation of the wrist in arthritis stage 4. Methods: We performed a retrospective study of 26 patients with complete denervation of one of the wrists and of 36 patients with selective denervation, with a minimum follow-up of 24 months in both groups. Patients in whom denervation was accompanied by another procedure, such as partial fusion, internal fixation, or arthroplasty, were not included in this study. All patients underwent a preoperative test with local injection of lidocaine at 1%. As regards the surgical technique, we used 5 incisions for complete denervation, as was first advanced by Wilhelm and further modified by Foucher. The indications for this procedure were joint degenerative changes, stage 4, caused by navicular pseudarthrosis, Kienböck disease, scapholunate dissociation, and others. Results: The evaluation was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the test for assessing mobility and grip strength as measured by dynamometer comparison. Of 26 patients with complete denervation, 20 (76.92%) showed significant improvement in pain, 16 of whom were discharged without pain (61.53%). In 4 patients (15.38%), the result was moderate, with pain during heavy work. The remaining 2 patients did not show any improvement with the procedure. The 36 patients with selective denervation reported no pain or only mild pain during heavy work. All patients, considering both groups, retained at least the previous mobility and strength of grip, which was increased in many cases, whereas 2 patients had paresthesias in the back of the thumb that disappeared after 12 months. Conclusions: Denervation of the wrist is a simple and palliative treatment, which ensures good results in patients with painful restriction of mobility caused by degenerative changes. To achieve a good result, it is essential to have both an accurate knowledge of the anatomy of the articular branches of the peripheral nerves innervating the wrist and an adequate selection of patients by clinical, radiological, and lidocaine tests.

Objective: Two techniques for reconstruction of tendon flexor injuries in zones 1 and 2 of Verdan in which primary suture cannot take place are presented. These techniques consists in carrying out a zetaplasty of the injured tendon in zone 5 to slide the proximal stump of the original rupture toward the distal stump of the tendon, suture both stump, and then perform the suture of the zetaplasty with the required tension. Another option, in case the end to end suture is unable, is to suture the lengthened tendon to an uninjured superficial flexor tendon. Methods: Thirteen patients with an average of 29 years of age were operated on with these two techniques. Diagnoses included 3 failures in primary suture of profundus flexor tendon, 7 tendon injuries treated 4 weeks after the trauma, and 3 injuries with shortening of the distal stump greater than 3 cm. In 7 cases, zetaplasty was performed with an end to end suture of the same flexor tendon, and in the remaining 6 zetaplasty was carried out with a suture of the proximal stump to an uninjured flexor tendon. Results: Average follow-up was 17.23 months. Assessment with the Strickand’s evaluation system yielded the following results: 8 excellent, 4 good, and 1 poor. Conclusions: The encouraging results in the short term with these techniques of shorter operating time and less surgical requirement motivate further development. A larger number of cases are necessary to obtain more reliable conclusions about their advantages and side effects.

Benzodiazepine use is associated to a risk of abuse of dependency. In Chile benzodiazepine abuse is a public health issue. In an attempt to overcome this problem, several restrictions in their prescription were implemented by the health authority. Despite these measures, inadequate use of benzodiazepines in primary care continues to be frequent.To study the frequency of benzodiazepine use among primary care patients.Cross sectional survey done during two days, with seven physicians working in public primary care clinics. They applied a structured questionnaire about psychotropic medication use.One hundred eighty eight subjects aged 46.8 +/- 17.5 years, 66% women, were interviewed. Thirty two percent were consuming a psychotropic drug and 82% of these corresponded to benzodiazepines. General practitioners and psychiatrists prescribed the drug to 75% and 13% of subjects, respectively. A higher frequency of benzodiazepine use was observed in women and in urban areas.Benzodiazepine use continues to be highly prevalent in primary care patients, in spite of the nationwide implementation of controlled prescriptions.

Background: Benzodiazepine use is associated to a risk of abuse of dependency. In Chile benzodiazepine abuse is a public health issue. In an attempt to overcome this problem, several restrictions in their prescription were implemented by the health authority. Despite these measures, inadequate use of benzodiazepines in primary care continues to be frequent. Aim: To study the frequency of benzodiazepine use among primary care patients. Material and methods: Cross sectional survey done during two days, with seven physicians working in public primary care clinics. They applied a structured questionnaire about psychotropic medication use. Results: One hundred eighty eight subjects aged 46.8±17.5 years, 66% women, were interviewed. Thirty two percent were consuming a psychotropic drug and 82% of these corresponded to benzodiazepines. General practitioners and psychiatrists prescribed the drug to 75% and 13% of subjects, respectively. A higher frequency of benzodiazepine use was observed in women and in urban areas. Conclusions: Benzodiazepine use continues to be highly prevalent in primary care patients, in spite of the nationwide implementation of controlled prescriptions (Rev Med Chile 2003; 131: 535-40).