Projecte bàsic i d'execució de rehabilitació i ampliació d'edifici plurifamiliar entre mitgeres situat al Carrer Roger de Flor, 105 de Granollers (Barcelona)

L’edifici a rehabilitar està situat en una important avinguda de l’eixample oest de Granollers. En l’actualitat l’edifici es troba a ple rendiment, amb l’ús de magatzem i obrador a la planta baixa i planta primera, i com a habitatge a les plantes segona i tercera. En concret es tracta de la formació d’un total de 6 habitatges i 5 trasters, a més de la reforma general del nucli de comunicació vertical on s’incorpora l’ascensor i la construcció de la paret mitgera que delimitarà l’espai de l’edifici en la seva projecció vertical. La rehabilitació també té com a objectiu reforçar els forjats, en els quals s’ha detectat aluminosi, així com l’enderroc d’envans a la segona i tercera planta per construir una millor distribució que permeti augmentar el nombre d’habitatges per planta

Évaluation de la reconstruction des ligaments croisés post luxation aiguë du genou avec l’utilisation des ligaments synthétiques

La luxation du genou, bien que très rare, demeure une blessure dévastatrice car elle entraîne de multiples complications en raison de la nature complexe du traumatisme associé à cette lésion. La luxation peut résulter d'un traumatisme à haute ou basse énergie. Les blessures sévères aux ligaments et aux structures associées donnent à la luxation du genou un potentiel élevé d'atteinte fonctionnelle. Le traitement conservateur, qui était considéré comme acceptable auparavant, est maintenant réservé à un très faible pourcentage de patients. La reconstruction chirurgicale est maintenant préconisée dans la plupart des cas, mais de nombreuses options existent et le traitement chirurgical optimal à préconiser reste controversé. Certains chirurgiens recommandent la reconstruction complète de tous les ligaments endommagés le plus tôt possible, tandis que d'autres, craignant l’établissement d’arthrofibrose, limitent l'intervention chirurgicale immédiate à la reconstruction du ligament croisé postérieur et de l'angle postéro-externe. En raison des multiples structures endommagées lors d’une luxation du genou, les chirurgiens utilisent couramment la combinaison des autogreffes et des allogreffes pour compléter la reconstruction ligamentaire. Les complications associées au prélèvement de la greffe, l'allongement de la greffe, l’affaiblissement précoce du greffon ainsi que les risques de transmission de maladies ont poussé les chirurgiens à rechercher différentes options d’intervention. L'utilisation de matériaux synthétiques pour le remplacement du ligament lésé a été proposée dans les années ´80. Après une première vague d'enthousiasme, les résultats décevants à long terme et les taux élevés d'échec ont diminué sa popularité. Depuis lors, une nouvelle génération de ligaments artificiels a vu le jour et parmi eux, le Ligament Advanced Reinforced System (LARS) a montré des résultats prometteurs. Il a été utilisé récemment dans les reconstructions isolées du ligament croisé antérieur et du ligament croisé postérieur pour lesquelles il a montré de bons résultats à court et moyen termes. Le but de cette étude rétrospective était d'évaluer la fonction et la stabilité du genou après la luxation aiguë suivant la reconstruction des ligaments croisés avec le ligament artificiel de type LARS. Cette étude a évalué 71 patients présentant une luxation du genou et qui ont subi une chirurgie de reconstruction du ligament croisé antérieur et du ligament croisé postérieur à l'aide du ligament LARS. Suite à la chirurgie le même protocole intensif de réadaptation a été suivi pour tous les patients, où la mise en charge progressive était permise après une période d’environ 6 semaines pendant laquelle la force musculaire et la stabilité dynamique se rétablissaient. Les outils d’évaluation utilisés étaient le score Lysholm, le formulaire de «l’International Knee Documentation Committee», le «Short Form-36», les tests cliniques de stabilité du genou, l'amplitude de mouvement articulaire à l’aide d’un goniomètre et la radiographie en stress Telos à 30° et 90° de flexion du genou. Le même protocole d’évaluation a été appliqué au genou controlatéral pour des fins de comparaison. Les résultats subjectifs et objectifs de cette étude sont satisfaisants et suggèrent que la réparation et la reconstruction combinées avec ligaments LARS est une alternative valable pour le traitement des luxations aiguës du genou. Ces résultats démontrent que ces interventions produisent des effets durables en termes d’amélioration de la fonction et révèlent la durabilité à long terme des ligaments artificiels LARS. Les patients sont à la fois plus autonomes et plus satisfaits avec le temps, même si la luxation du genou est considérée comme une catastrophe au moment où elle se produit. Des études prospectives randomisées sont maintenant nécessaires afin de comparer la sélection de la greffe et le délai de reconstruction chirurgicale.

Distal radius attachments of the radiocarpal ligaments: an anatomical study

Background Understanding the anatomy of the ligaments of the distal radius aids in the surgical repair of ligamentous injuries and the prediction of intraarticular fracture patterns. Purposes (1) to measure the horizontal and vertical distances of the origins of the radiocarpal ligaments from the most ulnar corner of the sigmoid notch and the joint line, respectively; and (2) to express them as a percentile of the total width of the bony distal radius. Methods We dissected 8 cadaveric specimens and identified the dorsal radiocarpal, radioscaphocapitate, and the long and short radiolunate ligaments. Results The dorsal radiocarpal ligament attached from the 16th to the 52nd percentile of the radial width. The radioscaphocapitate ligament attached around the radial styloid from the 86th percentile volarly to the 87th percentile dorsally. The long radiolunate ligament attached from the 59th to the 85th percentile, and the short radiolunate ligament attached from the 14th to the 41st percentile. Discussion There was a positive correlation between the radial width and the horizontal distance of the ligaments from the sigmoid notch. These findings may aid individualized surgical repair or reconstruction adjusted to patient size and enable further standardized research on distal radial fractures and their relationship with radiocarpal ligaments.

Suitability of Common Collagen Scaffolds for Anterior Cruciate Ligament Repair

Introduction: Anterior cruciate ligament (ACL) injuries are very common; in Germany incidence of ACL ruptures is estimated at 32 per 100 000 in the general population and in the sports community this rate more than doubles. Current gold standard for anterior cruciate lig- ament repair is reconstruction using an autograft [1]. However, this approach has shown some limitations. A new method has been her- alded by the Knee Team at the Bern University Hospital (Inselspital) and the Sonnenhof clinic called Dynamic Intraligamentary Stabilization (DIS), which keeps ACL remnants in place in order to promote biologi- cal healing and makes use of a dynamic screw system [2]. The aim of this study was to investigate the cytocompatibility of collagen patches in combination with DIS to support regeneration of the ACL. The spe- cific hypothesis we tested was whether MSCs would differentiate towards TCs in co-culture. Materials and methods: Primary Tenocytes (TCs) and human bone marrow derived mesenchymal stem cells (MSCs) were harvested from ACL removed during knee prothesis or from bone marrow aspirations (Ethical Permit 187/10). Cells were seeded on two types of three dimensional carriers currently approved for cartilage repair, Novocart (NC, B. Brown) and Chondro-Gide (CG, Geistlich). These scaffolds comprise collagen structures with interconnecting pores originally developed for seeding of chondrocytes in the case of CG. ~40k cells were seeded on punched zylindrical cores of 8 mm in Ø and cultured on CG or NC patches for up to 7 days. The cells were either cultured as TC only, MSC only or co-cultured in a 1:1 mix on the scaffolds and on both sides of culture inserts (PET, high density pore Ø 0.4 mm, BD, Fal- con) with cell-cell contact. We monitored DNA content, GAG and HOP-content, tracked the cells using DIL and DIO fluorescent dyes (Molecular Probes, Life technologies) and confocal laser scanning and SEM microscopy as well as RT-PCR of tenocyte specific markers (i.e. col 1 and 3, TNC, TNMD, SCXA&B, and markers of dedifferentiation ACAN, col2, MMP3, MMP13). Finally, H&E stain was interpreted on cryosections and SEM images of cells on the scaffold were taken. Results: ThecLSMimagesshowedcellproliferationoverthe7dayson both matrices, however, on CG there were much fewer MSCs attached than on NC. SEM images showed a roundish chondrocyte-like pheno- type of cells on CG whereas on NC the phenotype was more teno- cyte-like (Fig. 1). Gene expression of both, MSC and TC seem to confirm a more favorable environment in 3D for both patches rather than monolayer control.

Seismic Risk Scenarios in Puerto Principe (Haiti). A Tool for Reconstruction and Emergency Planning

The 12 January 2010, an earthquake hit the city of Port-au-Prince, capital of Haiti. The earthquake reached a magnitude Mw 7.0 and the epicenter was located near the town of Léogâne, approximately 25 km west of the capital. The earthquake occurred in the boundary region separating the Caribbean plate and the North American plate. This plate boundary is dominated by left-lateral strike slip motion and compression, and accommodates about 20 mm/y slip, with the Caribbean plate moving eastward with respect to the North American plate (DeMets et al., 2000). Initially the location and focal mechanism of the earthquake seemed to involve straightforward accommodation of oblique relative motion between the Caribbean and North American plates along the Enriquillo-Plantain Garden fault system (EPGFZ), however Hayes et al., (2010) combined seismological observations, geologic field data and space geodetic measurements to show that, instead, the rupture process involved slip on multiple faults. Besides, the authors showed that remaining shallow shear strain will be released in future surface-rupturing earthquakes on the EPGFZ. In December 2010, a Spanish cooperation project financed by the Politechnical University of Madrid started with a clear objective: Evaluation of seismic hazard and risk in Haiti and its application to the seismic design, urban planning, emergency and resource management. One of the tasks of the project was devoted to vulnerability assessment of the current building stock and the estimation of seismic risk scenarios. The study was carried out by following the capacity spectrum method as implemented in the software SELENA (Molina et al., 2010). The method requires a detailed classification of the building stock in predominant building typologies (according to the materials in the structure and walls, number of stories and age of construction) and the use of the building (residential, commercial, etc.). Later, the knowledge of the soil characteristics of the city and the simulation of a scenario earthquake will provide the seismic risk scenarios (damaged buildings). The initial results of the study show that one of the highest sources of uncertainties comes from the difficulty of achieving a precise building typologies classification due to the craft construction without any regulations. Also it is observed that although the occurrence of big earthquakes usually helps to decrease the vulnerability of the cities due to the collapse of low quality buildings and the reconstruction of seismically designed buildings, in the case of Port-au-Prince the seismic risk in most of the districts remains high, showing very vulnerable areas. Therefore the local authorities have to drive their efforts towards the quality control of the new buildings, the reinforcement of the existing building stock, the establishment of seismic normatives and the development of emergency planning also through the education of the population.

Buildings Sustainability: The HVAC Contribution

A very important part of the globally produced energy is consumed in buildings, being an important share frequently used in the HVAC systems. These ones are increasing both in performance and in complexity, taking advantage from the use of the recent advances in mechanical and power electronic devices, particularly in the speed variation field. However the improved efficiency only occurs while the HVAC unit is working in the conditions specified by the manufacturer, otherwise the energy consumption raises to values considerably higher than the nominal ones. The adequate maintenance enforces the system to run on its nominal performance and the contrary has undesirable impact both in the performance and in the system expected life time. Therefore, HVAC field maintenance assumes a very important role in the global building sustainability concept. This work presents some results of an incorrect use of HVAC and the associated electric energy overconsumption that can assume values 50% higher than those that occur when the installation is operated according to the adequate maintenance plan.

Influence of curing conditions in lime-metakaolin blended mortars – A mineralogical and mechanical study

3rd Historic Mortars Conference, 11-14 September 2013, Glasgow, Scotland

Analysis and selection of indicators for a sustainability assessment method for school buildings based on SBTool ‐ PT

Nowadays, the sustainability of buildings has an extreme importance. This concept goes towards the European aims of the Program Horizon 2020, which concerns about the reduction of the environmental impacts through such aspects as the energy efficiency and renewable technologies, among others. Sustainability is an extremely broad concept but, in this work, it is intended to include the concept of sustainability in buildings. Within the concept that aims the integration of environmental, social and economic levels towards the preservation of the planet and the integrity of the users, there are, currently, several types of tools of environmental certification that are applicable to the construction industry (LEED, BREEAM, DGNB, SBTool, among others). Within this context, it is highlighted the tool SBTool (Sustainable Building Tool) that is employed in several countries and can be subject to review in institutions of basic education, which are the base for the formation of the critical masses and for the development of a country. The main aim of this research is to select indicators that can be used in a methodology for sustainability assessment (SBTool) of school buildings in Portugal and in Brazil. In order to achieve it, it will also be analyzed other methodologies that already incorporate parameters directly related with the schools environment, such as BREEAM or LEED.

Dinámica del anillo mitral en pacientes con insuficiencia mitral isquemica

OBJETIVOS: Describir y comparar los cambios dinámicos de la geometría del anillo mitral durante todo el ciclo cardiaco en pacientes con insuficiencia mitral isquémica y pacientes con válvula mitral normal. MATERIALES Y MÉTODOS: Los estudios ecocardiográficos analizados fueron 37, 23 con insuficiencia mitral isquémica y 14 con válvula mitral normal. La reconstrucción del anillo se realizó en la estación de trabajo Xcelera (Philips Medial Systems) mediante la herramienta de análisis mitral (MVQ), en 5 momentos del ciclo cardiaco: Comienzo de Sístole, Mitad de Sístole, Final de Sístole, Mitad de Diástole y Final de Diástole. RESULTADOS: El anillo del grupo control, fue más dinámico, con sus menores dimensiones al final de la diástole, presentando incremento progresivo durante la sístole. Los cambios en el perímetro y el área, fueron significativos entre el comienzo y mitad de la sístole (p:0.087 y p: 0.055). En el grupo con insuficiencia mitral isquémica, el anillo fue más estático. Todas las dimensiones en este grupo, fueron mayores en los cinco momentos del ciclo cardiaco. (p < 0.1). El anillo también fue más plano, con un índice morfológico anular menor al del grupo control (p:0.087). DISCUSIÓN Y CONCLUSIONES: En pacientes sin insuficiencia mitral, el anillo es una estructura dinámica. Durante la sístole, las menores dimensiones se produjeron al comienzo de este periodo y la conformación en silla de montar se mantuvo, protegiendo contra la insuficiencia mitral. El anillo del grupo con insuficiencia mitral fue más estático y plano, perdiendo los mecanismos protectores.

Beyond the technical: a snapshot of energy and buildings research

The past decade has witnessed a sharp increase in published research on energy and buildings. This paper takes stock of work in this area, with a particular focus on construction research and the analysis of non-technical dimensions. While there is widespread recognition as to the importance of non-technical dimensions, research tends to be limited to individualistic studies of occupants and occupant behavior. In contrast, publications in the mainstream social science literature display a broader range of interests, including policy developments, structural constraints on the diffusion and use of new technologies and the construction process itself. The growing interest of more generalist scholars in energy and buildings provides an opportunity for construction research to engage a wider audience. This would enrich the current research agenda, helping to address unanswered problems concerning the relatively weak impact of policy mechanisms and new technologies and the seeming recalcitrance of occupants. It would also help to promote the academic status of construction research as a field. This, in turn, depends on greater engagement with interpretivist types of analysis and theory building, thereby challenging deeply ingrained views on the nature and role of academic research in construction.

IFSSH Flexor Tendon Committee report 2014: from the IFSSH Flexor Tendon Committee (Chairman: Jin Bo Tang)

Hand surgeons continue to search for the best surgical flexor tendon repair and treatment of the tendon sheaths and pulleys, and they are attempting to establish postoperative regimens that fit diverse clinical needs. It is the purpose of this report to present the current views, methods, and suggestions of six senior hand surgeons from six different countries - all experienced in tendon repair and reconstruction. Although certainly there is common ground, the report presents provocative views and approaches. The report reflects an update in the views of the committee. We hope that it is helpful to surgeons and therapists in treating flexor tendon injuries.

Dynamic intraligamentary stabilization and primary repair: A new concept for the treatment of knee dislocation.

BACKGROUND Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL. METHODS Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000). RESULTS Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed. CONCLUSIONS Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.

Instabilidade crónica da tíbio-társica

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Two-Dimensional Failure Modeling with Minimal Repair

In this paper, we discuss two-dimensional failure modeling for a system where degradation is due to age and usage. We extend the concept of minimal repair for the one-dimensional case to the two-dimensional case and characterize the failures over a two-dimensional region under minimal repair. An application of this important result to a rnanufacturer's servicing costs for a two-dimensional warranty policy is given and we compare the minimal repair strategy with the strategy of replacement of failure. (C) 2003 Wiley Periodicals, Inc.

Robust gap repair in the contractile ring ensures timely completion of cytokinesis

Cytokinesis in animal cells requires the constriction of an actomyosin contractile ring, whose architecture and mechanism remain poorly understood. We use laser microsurgery to explore the biophysical properties of constricting rings in Caenorhabditis elegans embryos. Laser cutting causes rings to snap open. However, instead of disintegrating, ring topology recovers and constriction proceeds. In response to severing, a finite gap forms and is repaired by recruitment of new material in an actin polymerization-dependent manner. An open ring is able to constrict, and rings repair from successive cuts. After gap repair, an increase in constriction velocity allows cytokinesis to complete at the same time as controls. Our analysis demonstrates that tension in the ring increases while net cortical tension at the site of ingression decreases throughout constriction and suggests that cytokinesis is accomplished by contractile modules that assemble and contract autonomously, enabling local repair of the actomyosin network. Consequently, cytokinesis is a highly robust process impervious to discontinuities in contractile ring structure.