Résultats des cupules de grand diamètre dans les reprises d’arthroplastie totale de hanche : suivi minimum de deux ans.

La révision d’arthroplastie de la hanche en cas d’important déficit osseux acétabulaire peut être difficile. Les reconstructions avec cupule de très grand diamètre ou cupule « jumbo » (≥ 62 mm chez la femme et ≥ 66 mm chez l’homme) sont une option thérapeutique. Nous voulions évaluer la préservation et la restauration du centre de rotation de la hanche reconstruite en la comparant au coté controlatéral sain ou selon les critères de Pierchon et al. Nous voulions également évaluer la stabilité du montage à un suivi d’au moins 2 ans. Il s’agissait de 53 cas consécutifs de révision acétabulaire pour descellement non septique avec implantation d’une cupule jumbo sans ciment à l’Hôpital Maisonneuve-Rosemont. Le déficit osseux évalué selon la classification de Paprosky et al. Les cupules implantées avaient un diamètre moyen de 66 mm (62-81) chez les femmes et 68 mm (66-75) chez les hommes. L’allogreffe osseuse morcelée et massive était utilisée dans 34 et dans 14 cas respectivement. La cupule a été positionnée avec un angle d’inclinaison moyen de 41.3° (26.0-53.0). Le centre de rotation de la hanche reconstruite a été jugé satisfaisant dans 78% de cas sur l'axe médiolatéral, 71% sur l'axe craniopodal et amélioré dans 27% dans cet axe. Au recul moyen radiologique de 84.0 mois (24.0-236.4) et clinique de 91.8 mois (24.0 – 241.8): 6 cas étaient décédés, 3 perdus au suivi. On a observé le descellement radiologique dans un 1 cas, la luxation récidivante dans 5 cas et l’infection dans 4 cas. Le retrait de la cupule a été effectué dans 2 cas pour infection. L’ostéointégration des greffons osseux était complète dans tous les cas sauf 3. Les scores cliniques étaient pour le HHS de 82 +/-17, le WOMAC de 86 +/- 14 et le SF-12 physique de 46 +/- 12 et mental 53 +/-13. La cupule jumbo peut être considérée comme un moyen fiable pour gérer le déficit osseux dans les révisions acétabulaires. Elle permet de conserver ou d’améliorer la position du centre de rotation physiologique de la hanche. La fixation sans ciment favorise l’ostéointégration de la cupule et permet une stabilité à moyen terme. Le taux de complications est comparable ou inférieur à d'autres procédures de reconstruction.

Stochastic Modelling Using Markov Chains

Department of Statistics, Cochin University of Science and Technology

Visual Illusions

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Hiperautofluorescencia foveal como factor predictor de recuperación visual en pacientes con desprendimiento regmatógeno de retina

Introducción: una de las causas de pobre ganancia visual luego de un tratamiento exitoso de desprendimiento de retina, sin complicaciones, es el daño de los fotoreceptores, reflejada en una disrupción de la capa de la zona elipsoide y membrana limitante externa (MLE). En otras patologías se ha demostrado que la hiperautofluorescencia foveal se correlaciona con la integridad de la zona elipsoide y MLE y una mejor recuperación visual. Objetivos: evaluar la asociación entre la hiperautofluorescencia foveal, la integridad de la capa de la zona elipsoide y recuperación visual luego de desprendimiento de retina regmatógeno (DRR) exitosamente tratado. Evaluar la concordancia inter-evaluador de estos exámenes. Metodología: estudio de corte transversal de autofluorescencia foveal y tomografía óptica coherente macular de dominio espectral en 65 pacientes con DRR evaluados por 3 evaluadores independientes. La concordancia inter-evaluador se estudio mediante Kappa de Cohen y la asociación entre las diferentes variables mediante la prueba chi cuadrado y pruebas Z para comparación de proporciones. Resultados: La concordancia de la autofluorescencia fue razonable y la de la tomografía óptica coherente macular buena a muy buena. Sujetos que presentaron hiperautofluorescencia foveal asociada a integridad de la capa de la zona elipsoide tuvieron 20% más de posibilidad de recuperar agudeza visual final mejor a 20/50 que los que no cumplieron éstas características. Conclusión: Existe una asociación clínicamente importante entre la hiperautofluorescencia foveal, la integridad de la capa de zona elipsoide y la mejor agudeza visual final, sin embargo ésta no fue estadísticamente significativa (p=0.39)

Analysis of the employee’s labor agreement suspension in Colombia and some legislation references

Considering that the employment contract suspension responds to labor stability,one of the most important principles of labor law is important to study it because itsprincipal purpose is to maintain the link between de employer and the employeedespite the presence of adversity or other situations that would break up the relationshipin other fields. However, at the occurrence of any of the grounds of suspensionmay be presented some questions or voids that it will try to be answer in this paper.Consequently we shall refer first to the definition, purpose and characteristics of thesuspension. Subsequently, will be analyzed in detail every single ground of contractsuspension in Colombia. Then, will be studied the effects of the suspension andwe will refer to the resumption of work, and conclude with the comparative analysisof the figure in some Hispanic countries (Mexico, Paraguay and Spain).

Habiendo roto el freno de la obediencia: participación indígena en la insurgencia de Quito, 1809-1812 (Estudios)

El artículo analiza un ámbito de la participación de los indígenas en la coyuntura de quiebre del régimen monárquico producida en Quito ante las noticias de la invasión napoleónica y la abdicación del trono español en favor de José Bonaparte. El trabajo investiga si los indígenas de Quito fueron fundamentalmente indiferentes ante la proclamación de autonomía de la primera junta quiteña en 1809 o si tuvieron alguna propuesta específica durante el período de mayor convulsión y movilización entre 1810 y 1812. De otro lado, explora las actitudes de la élite y la plebe en el período. El trabajo pone atención en el ambiente de temor que la movilización popular suscitó luego de los abusos y la cruenta represión cometidas por las tropas limeñas acantonadas en Quito, en 1810.

Tras las ruinas del poema: el agotamiento lírico como clave interpretativa en Mordiendo el frío de Edwin Madrid (Crítica)

El autor interpreta el poemario Mordiendo el frío, del ecuatoriano Edwin Madrid. Lo hace a la luz de una afirmación del filósofo Alain Badiou: que el poema actual tiene solo una responsabilidad estética, ya no filosófica. Barreto afirma que Madrid muestra el deslinde entre filosofía y el poema moderno, para ello, se vale del lenguaje coloquial, el humor y la gozosa levedad sexual de Valerio, el personaje poético del libro. Según Barreto, el lenguaje poético, vacío, ya no cataliza la experiencia del sujeto: deviene en pura información. Añade que tal desconfianza en la poesía y el lenguaje líricos constituye una velada crítica a la institucionalización del género. Así, esta obra mostraría el agotamiento lírico de cierta poesía moderna. Barreto sugiere que dicho agotamiento se inserta en las condiciones globalizadas de las sociedades actuales, y que participa de la muerte de la experiencia en el sujeto moderno. Concluye que Madrid no lamenta la ruptura entre filosofía y poesía, por el contrario, busca trazar nuevas sensibilidades, signadas por la cotidianidad posmoderna.

Sensitivity of Southern Hemisphere climate to zonal asymmetry in ozone

Climate model simulations of past and future climate invariably contain prescribed zonal mean stratospheric ozone. While the effects of zonal asymmetry in ozone have been examined in the Northern Hemisphere, much greater zonal asymmetry occurs in the Southern Hemisphere during the break up of the Antarctic ozone hole. We prescribe a realistic three-dimensional distribution of ozone in a high vertical resolution atmospheric model and compare results with a simulation containing zonal mean ozone. Prescribing the three dimensional ozone distribution results in a cooling of the stratosphere and upper troposphere comparable to that caused by ozone depletion itself. Our results suggest that changes in the zonal asymmetry of ozone have had important impacts on Southern Hemisphere climate, and will continue to do so in the future.

Molecular dating and biogeography of fig-pollinating wasps

Figs and fig-pollinating wasps are obligate mutualists that have coevolved for over 60 million years. But when and where did pollinating fig wasps (Agaonidae) originate? Some studies suggest that agaonids arose in the Late Cretaceous and the current distribution of fig-wasp faunas can be explained by the break-up of the Gondwanan landmass. However, recent molecular-dating studies suggest divergence time estimates that are inconsistent with the Gondwanan vicariance hypothesis and imply that long distance oceanic dispersal could have been an important process for explaining the current distribution of both figs and fig wasps. Here, we use a combination of phylogenetic and biogeographical data to infer the age, the major period of diversification, and the geographic origin of pollinating fig wasps. Age estimates ranged widely depending on the molecular-dating method used and even when using the same method but with slightly different constraints, making it difficult to assess with certainty a Gondwanan origin of agaonids. The reconstruction of ancestral areas suggests that the most recent common ancestor of all extant fig-pollinating wasps was most likely Asian, although a southern Gondwana origin cannot be rejected. Our analysis also suggests that dispersal has played a more important role in the development of the fig-wasp biota than previously assumed. (C) 2009 Elsevier Inc. All rights reserved.

Reproducibility of a short semi-quantitative food group questionnaire and its performance in estimating nutrient intake compared with a 7-day diet diary in the Million Women Study

Objectives: To assess the short- and long-term reproducibility of a short food group questionnaire, and to compare its performance for estimating nutrient intakes in comparison with a 7-day diet diary. Design: Participants for the reproducibility study completed the food group questionnaire at two time points, up to 2 years apart. Participants for the performance study completed both the food group questionnaire and a 7-day diet diary a few months apart. Reproducibility was assessed by kappa statistics and percentage change between the two questionnaires; performance was assessed by kappa statistics, rank correlations and percentages of participants classified into the same and opposite thirds of intake. Setting: A random sample of participants in the Million Women Study, a population-based prospective study in the UK. Subjects: In total, 12 221 women aged 50-64 years. Results: in the reproducibility study, 75% of the food group items showed at least moderate agreement for all four time-point comparisons. Items showing fair agreement or worse tended to be those where few respondents reported eating them more than once a week, those consumed in small amounts and those relating to types of fat consumed. Compared with the diet diary, the food group questionnaire showed consistently reasonable performance for the nutrients carbohydrate, saturated fat, cholesterol, total sugars, alcohol, fibre, calcium, riboflavin, folate and vitamin C. Conclusions: The short food group questionnaire used in this study has been shown to be reproducible over time and to perform reasonably well for the assessment of a number of dietary nutrients.

Heterogenisation of Os species on MCM-41 structure for epoxidation of trans-stilbene

Metal organic chemical vapour deposition technique (MOCVD) has been used to immobilise Os species onto the internal porous structure of MCM-41. Evidence suggests that volatile Os-3(CO)(12) cluster reacts with surface silanol groups of the MCM-41 via an oxidative addition reaction to yield a trinuclear HOs3(CO)(10)(OSi-) surface species. After heat treatment in air or at their very low surface coverage, these triangular sites break up to partially oxidised mononuclear surface species. In the presence of tert-butyl hydroperoxide (TBHP) as an oxidant, we demonstrate that the mononuclear species form extremely active species that catalyse the oxidation of trans-stilbene selectively to the corresponding epoxide. By carefully controlling the parameters of the MOCVD method (loading and calcination temperature), we report a new class of optimised MCM-41 porous heterogeneous catalysts carrying isolated but active Os sites for the selective oxidation of trans-stilbene in liquid phase. The reaction selectivity of the solid supported Os is apparently higher than the soluble homogeneous Os-3(CO)(12) cluster. It is envisaged that our solid supported catalysts not only facilitate separation from products but also offer an excellent utilisation of Os for catalysis. (C) 2003 Elsevier Science B.V. All rights reserved.

Optimal maintenance policies under different operational schedules

In the reliability literature, maintenance time is usually ignored during the optimization of maintenance policies. In some scenarios, costs due to system failures may vary with time, and the ignorance of maintenance time will lead to unrealistic results. This paper develops maintenance policies for such situations where the system under study operates iteratively at two successive states: up or down. The costs due to system failure at the up state consist of both business losses & maintenance costs, whereas those at the down state only include maintenance costs. We consider three models: Model A, B, and C: Model A makes only corrective maintenance (CM). Model B performs imperfect preventive maintenance (PM) sequentially, and CM. Model C executes PM periodically, and CM; this PM can restore the system as good as the state just after the latest CM. The CM in this paper is imperfect repair. Finally, the impact of these maintenance policies is illustrated through numerical examples.

The effect of intensive case management on the relatives of patients with severe mental illness

Objective: Relatives play a vital role in caring for patients with severe mental illness but receive inadequate support from psychiatric services. Evidence suggests that although intensive case management is directed primarily at patients, relatives may benefit a's well. This study examined whether relatives of patients who were receiving intensive case management had more contact with mental health professionals than relatives of patients who were receiving standard case management. It also examined whether relatives of patients receiving intensive case management appraised caregiving less negatively and experienced less psychological distress than relatives of patients receiving standard case management. Methods: The sample was drawn from the pool of patients participating in the UK700 randomized controlled trial of intensive case management. Prospective data on contact between case managers and the relatives of 146 patients were collected over a two-year period. At a two-year follow-up assessment, relatives of 116 patients were. interviewed with the Experience of Caregiving Inventory and the 12-item General Health Questionnaire. Results: Considerably more relatives of patients receiving intensive case management had contact with a case manager during the study period than relatives of patients receiving standard case management (70 percent compared with 45 percent). However, relatives of patients receiving intensive case management did not-appraise caregiving less negatively or experience less psychological distress than relatives of patients who were receiving. standard case management. Conclusions: Reducing case managers' caseloads alone. will not guarantee adequate support for relatives.. Instead, providing more support will need to be an explicit aim, and staff will require specific additional training to achieve it.

PEGylated amyloid peptide nanocontainer delivery and release system

A micellar nanocontainer delivery and release system is designed on the basis of a peptide-polymer conjugate. The hybrid molecules self-assemble into micelles comprising a modified amyloid peptide core surrounded by a PEG corona. The modified amyloid peptide previously studied in our group forms helical ribbons based on a beta-sheet motif and contains beta-amino acids that are excluded from the beta-sheet structure, thus being potentially useful as fibrillization inhibitors. In the model peptide-PEG hybrid system studied, enzymatic degradation using alpha-chymotrypsin leads to selective cleavage close to the PEG-peptide linkage, break up of the micelles, and release of peptides in unassociated form. The release of monomeric peptide is useful because aggregation of the released peptide into beta-sheet amyloid fibrils is not observed. This concept has considerable potential in the targeted delivery of peptides for therapeutic applications.

An RCT study to evaluate a targeted, theory driven healthy eating leaflet

A theory based healthy eating leaflet was evaluated against an existing publicly available standard leaflet. The intervention leaflet was designed to encourage healthy eating in 18-30 year olds and was developed by modifying an existing British Nutrition Foundation leaflet. The intervention leaflet targeted attitudes and self-efficacy. Participants (n=104) were randomly assigned either to the intervention, Foundation or a local food leaflet control condition. Cognitions were measured pre-intervention, immediately after reading the corresponding leaflet, and once again at two weeks follow-up. Critically, intentions to eat healthily were significantly greater at follow-up in the Intervention group compared to the other two groups, with the former leaflet also being perceived as more persuasive. The Intervention group also showed evidence of healthier eating at two weeks compared to the other two groups. Collectively the results illustrate the utility of a targeted theory-based approach.