Treatment of large bone defects with the Ilizarov technique.

Between 1985 and 1990 we treated 11 large segmental bone defects (average 6.7 cm) in ten patients with the Ilizarov technique. Open fractures, type III according to Gustilo, represented the largest group (8 of 11 cases). The average delay before the Ilizarov technique was initiated was 8.9 months. The external fixator was usually maintained for 1 year. Bone regeneration was obtained in every case. Consolidation was not fulfilled with this technique in three cases. The complications observed were one refracture, four leg-length discrepancies (average 1.5 cm), and five axial deformities exceeding 5 degrees. No pin-track infection was observed. In our limited series of four type IIIC open fractures treated by the Ilizarov technique, no patients required amputation. The Ilizarov technique is particularly useful in the treatment of large bone defects, without major complications, especially if there is an adequate initial debridement.

Incidence of second sarcomas: a cancer registry-based study.

BACKGROUND: In high-quality cancer registration systems, about one in eight incident cancers are second primary cancers. This is due to a combination of careful diagnostic ascertainment, shared genetic determinants, shared exposure to environmental factors and consequences of treatment for first cancer. METHODS: We used data derived from the Swiss population-based cancer Registries of Vaud and Neuchâtel, including 885,000 inhabitants. RESULTS: Among 107,238 (52% males) first cancers occurring between 1976 and 2010, a total of 126 second sarcomas were observed through active and passive follow-up versus 68.2 expected, corresponding to a standardized incidence ratio (SIR) of 1.85 (95 % CI 1.5-2.2). Significant excess sarcoma risks were observed after skin melanoma (SIR = 3.0), breast cancer (2.2), corpus uteri (2.7), testicular (7.5), thyroid cancer (4.2), Hodgkin lymphoma (5.7) and leukemias (4.0). For breast cancer, the SIR was 3.4 ≥5 years after sarcoma diagnosis. CONCLUSIONS: The common denominator of these neoplasms is the utilization of radiotherapy in their management. Some sarcomas following breast cancer may be due to shared genetic components (i.e., in the Li-Fraumeni syndrome), as well as possibly to shared environmental factors, with sarcomas, including overweight, selected dietary and reproductive factors which are, however, too little defined for any quantitative risk assessment.

Bioaccumulation of 210Pb and 210Po in fish tissues in a radioactive naturally enhanced area: the Peníscola marsh (Castelló, Spain)

210Pb and 210Po concentration in fish tissues from Peníscola marsh were analyzed, being this area a radioactive naturally enhanced marsh located in the East coast of Spain. Results showed that 210Po accumulation in tissues could reach values ranging from 28±8 Bq kg-1 in muscle of Cyprinus carpio, to 8558±6378 Bq kg-1 in gut content of Chelon labrosus. On the other hand, 210Pb concentrations ranged from 8±4 Bq kg-1 in muscle of Cyprinus carpio, to 475±481 Bq kg-1 in gut content of Chelon labrosus. Bioaccumulation pattern is generally 210Po&210Pb, except in spine, where more 210Pb than 210Po is accumulated. When comparing our samples to those collected as blanks, individuals from Peníscola marsh showed an enrichment in 210Po and 210Pb in their tissues compared to the blanks. Bioaccumulation factors showed that feeding is the major input route of 210Pb and 210Po into the fish body. Highest values of 210Pb and 210Po concentration in tissues were found on Chelon labrosus and Carassius auratus, being Cyprinus carpio the species with the lowest average values of 210Pb and 210Po accumulation.

Seguiment de l'evolució de la recuperació del bosc de ribera en la zona afectada per l'incendi del riu Canaletes del 20/07/2009. Proposta de campanya de voluntariat ambiental en rius per la custòdia i recuperació fluvial

El riu Canaletes va resultar afectat per l’ incendi que es va produir a Horta de Sant Joan el juliol de l’any 2009. El foc va malmetre bona part de la flora i fauna de la zona, però un dels ecosistemes que en va sortir més perjudicat va ser el del bosc de ribera, ecosistema molt fràgil en front de pertorbacions d’aquest tipus, ja que la seva capacitat de regeneració no és tant senzilla ni ràpida com en altres ecosistemes mediterranis com podrien ser els boscos de pi blanc. No obstant, si que existeixen algunes espècies de ribera que presenten una ràpida resposta als incendis com és el cas dels salzes o alguns pollancres o àlbers, que en aquest cas, poc temps després del foc ja presentaven rebrots, segons observacions realitzades al camp. Per comprovar l’evolució de la recuperació del bosc de ribera en la zona afectada per l’incendi, es van realitzar diverses sortides de camp. D’aquestes observacions, es va poder deduir que actualment el bosc de ribera de la zona estudiada, evoluciona segons les previsions realitzades en estudis immediatament posteriors al foc, de manera que hi estan proliferant de manera ràpida bardisses amb esbarzer, gavarrera, roldor i sanguinyol, en aquells llocs que abans de l’incendi eren ocupats per arbres caducifolis.

Age-specific incidence of all neoplasms after colorectal cancer.

PURPOSE: Patients diagnosed with a specific neoplasm tend to have a subsequent excess risk of the same neoplasm. The age incidence of a second neoplasm at the same site is approximately constant with age, and consequently the relative risk is greater at younger age. It is unclear whether such a line of reasoning can be extended from a specific neoplasm to the incidence of all neoplasms in subjects diagnosed with a defined neoplasm. METHODS: We considered the age-specific incidence of all non-hormone-related epithelial neoplasms after a first primary colorectal cancer (n = 9542) in the Vaud Cancer Registry data set. RESULTS: In subjects with a previous colorectal cancer, the incidence rate of all other epithelial non-hormone-related cancers was stable around 800 per 100,000 between age 30 and 60 years, and rose only about twofold to reach 1685 at age 70 to 79 years and 1826 per 100,000 at age 80 years or older. After excluding synchronous cancers, the rise was only about 1.5-fold, that is, from about 700 to 1000. In the general population, the incidence rate of all epithelial non-hormone-related cancers was 29 per 100,000 at age 30 to 39 years, and rose 30-fold to 883 per 100,000 at age 70 to 79 years. Excluding colorectal cancers, the rise of all non-hormone-related cancers was from 360 per 100,000 at age 40 to 49 years to 940 at age 70 to 79 years after colorectal cancer, and from 90 to 636 per 100,000 in the general population (i.e., 2.6- vs. 7.1-fold). CONCLUSIONS: The rise of incidence with age of all epithelial non-hormone-related second cancers after colorectal cancer is much smaller than in the general population. This can possibly be related to the occurrence of a single mutational event in a population of susceptible individuals, although alternative models are plausible within the complexity of the process of carcinogenesis.

Efecte de l'estrès estructual sobre l'emissió estimulada (laseig) en capes epitaxials de KY0.8Yb0.2(WO4)2 i KLu0.8Yb0.2(WO4)2 crescudes sobre substractes de KY(WO4)2 i KLu(WO4)2

Projecte de recerca elaborat a partir d’una estada a la State University of New York a Stony Brook, EEUU, a l’agost i setembre del 2008. S’ha demostrat com està relacionada la diferència en el rendiment de lasejat de dos mostres altament dopades amb iterbi (20 at. %) de capes epitaxials de KY(WO4)2 (KYW) dopat amb Yb crescut sobre un substrat de KYW i de KLu(WO4)2 (KLuW) dopat amb Yb crescut sobre un substrat de KLuW, respectivament, amb la presència de estrès estructural en les capes epitaxials, investigat per Topografia de Feix Blanc de Raig X de Sincrotró. A partir dels resultats obtinguts, queda clar que les mostres que mostren una quantitat d'estrés estructural més gran, les epitaxies de KYW dopat amb Yb crescudes sobre substrats de KYW, duen a una eficiència més petita durant el lasejat, permetent establir una correlació directa entre l'existència i la magnitud d'aquest estrès estructural i la pèrdua del rendiment làser en aquestes capes epitaxial, que per altra banda, des del punt de vista espectroscòpic són equivalents.

Cleusonite, (Pb,Sr)(U4+,U6+)(Fe2+ Zn)2(Ti,Fe2+ Fe3+)18(O,OH)38, a new mineral species of the crichtonite group from the western Swiss Alps

Cleusonite, (Pb,Sr)(U4+,U6+) (Fe2+,Zn)(2) (Ti,Fe2+,Fe3+)(18) (O,OH)(38), is a new member of the crichtonite group. It was found at two occurrences in greenschist facies metamorphosed gneissic series of the Mont Fort and Siviez-Mischabel Nappes in Valais, Switzerland (Cleuson and Bella Tolla summit), and named after the type locality. It occurs as black opaque cm-sized tabular crystals with a bright sub-metallic lustre. The crystals consist of multiple rhombohedra and hexagonal prisms that are generally twinned. Measured density is 4.74(4) g/cm(3) and can be corrected to 4.93(12) g/cm(3) for macroscopic swelling due to radiation damage; the calculated density varies from 5.02(6) (untreated) to 5.27(5) (heat-treated crystals); the difference is related to the cell swelling due to the metamictisation. The empirical formula for cleusonite from Cleuson is (Pb0.89Sr0.12)(Sigma=1.01) (U0.79+4U0.30+6)(Sigma=1.09) (Fe1.91+2Zn0.09)(Sigma=2.00) (Ti11.80Fe3.44+2Fe2.33+3V0.19+5Mn0.08Al0.07)(Sigma=17.90) [O-35.37(OH)(2.63)](Sigma=38). Cations were measured by electron microprobe, the presence of structural (OH) was confirmed by infrared spectroscopy and the U6+/U4+ and Fe2+/Fe3+ ratios were determined by X-ray photoelectron spectroscopy. Cleusonite is partly metamict, and untreated crystals only show three major X-ray diffraction peaks. Because of this radiation-damaged state, the mineral appears optically isotropic and shows a light-grey to white colour in reflected polarized light. Cleusonite is trigonal, space group R $(3) over bar $, and unit-cell parameters are varying from a = 10.576(3), c = 21.325(5) angstrom (untreated crystal) to a = 10.4188(6), c = 20.942(1) angstrom (800 degrees C treatment) and to a = 10.385(2), c = 20.900(7) angstrom (1000 degrees C treatment). The three cells give a common axial ratio 2.01 (1), which is identical to the measured morphological one 2.04(6). ne name cleusonite also applies to the previously described ``uranium-rich senaite'' from Alinci (Macedonia) and the ``plumbodavidite'' from Huanglongpu (China).

High proportion of wrongly identified methicillin-resistant Staphylococcus aureus carriers by use of a rapid commercial PCR assay due to presence of staphylococcal cassette chromosome element lacking the mecA gene.

During a 9-month period, 217 patients were newly diagnosed as methicillin-resistant Staphylococcus aureus (MRSA) carriers by using a commercial rapid PCR-based test (GeneXpert). However, no MRSA was recovered by culturing the second swab in 61 of these patients. Further analyses showed that 28 (12.9%) of the patients harbored S. aureus isolates with a staphylococcal cassette chromosome element lacking the mecA gene and were thus incorrectly determined to be MRSA carriers.

Universal screening and decolonization for control of MRSA in nursing homes : a cluster randomized controlled study

OBJECTIVE The risk of carrying methicillin-resistant Staphylococcus aureus (MRSA) is higher among nursing home (NH) residents than in the general population. However, control strategies are not clearly defined in this setting. In this study, we compared the impact of standard precautions either alone (control) or combined with screening of residents and decolonization of carriers (intervention) to control MRSA in NHs. DESIGN Cluster randomized controlled trial SETTING NHs of the state of Vaud, Switzerland PARTICIPANTS Of 157 total NHs in Vaud, 104 (67%) participated in the study. INTERVENTION Standard precautions were enforced in all participating NHs, and residents underwent MRSA screening at baseline and 12 months thereafter. All carriers identified in intervention NHs, either at study entry or among newly admitted residents, underwent topical decolonization combined with environmental disinfection, except in cases of MRSA infection, MRSA bacteriuria, or deep skin ulcers. RESULTS NHs were randomly allocated to a control group (51 NHs, 2,412 residents) or an intervention group (53 NHs, 2,338 residents). Characteristics of NHs and residents were similar in both groups. The mean screening rates were 86% (range, 27%-100%) in control NHs and 87% (20%-100%) in intervention NHs. Prevalence of MRSA carriage averaged 8.9% in both control NHs (range, 0%-43%) and intervention NHs (range, 0%-38%) at baseline, and this rate significantly declined to 6.6% in control NHs and to 5.8% in intervention NHs after 12 months. However, the decline did not differ between groups (P=.66). CONCLUSION Universal screening followed by decolonization of carriers did not significantly reduce the prevalence of the MRSA carriage rate at 1 year compared with standard precautions