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REHABILITATION PROCESS OF MAGNETIC INTRAMEDULLARY LENGTHENING IN OLLIER DISEASE.Marta Ruiz Sanz1, Mu00aa Olga Arroyo Riau00f1o1, Alu00eda Gutiu00e9rrez Mesu00f3n1, u00c1ngel Josu00e9 Villa Garcu00eda2.1Physical Medicine and Rehabilitation Service, General University Hospital Gregorio Marau00f1u00f3n, Madrid, Spain.2Pediatric Orthopaedic Surgery Service, Gregorio Marau00f1u00f3n General University Hospital, Madrid, Spain.Introduction: Ollier disease (multiple enchondromatosis) is a rare nonhereditary sporadic disorder, where enchondromas develop close to growth plate. Prevalence is around 1/100000.The usual orthopedic conditions are severe bone deformities, shortening of the limbs and fractures, that will be managed surgically.The femoral elongation over an intramedullary nail magnetically activated is an innovative alternative to lengthening against external fixation that difficults anchor to enchondromic injuries and presents a higher rate of complications.Despite the promising results, there are short series of cases in the bibliography.Purpose: The objective is to describe the clinical evolution, the rehabilitation process and the results of the lengthening over magnetic PRECICEu00ae (NuVasive) intramedullary femoral nail in Ollier disease.Method: We present a 17 years old woman with Ollier disease with initial dysmetria of 9cm submitted to a first surgery of femoral lengthening over an intramedullary nail and osteotomyon good quality bone in November 2016. The real lengthening of the left lower limb was 72mm. Daily index of distraction was 0.8mm.Secondly was necessary a re-centering of left kneecap (Elmslie-Trillat) in March 2017. In early postoperative she presented sciatic popliteal external nerve neuropraxia, neuropathic pain and anxiety.During the process, she worked in a multidisciplinary program, pediatric orthopedics and rehabilitation, with analgesic and functional objectives, AFO and gabapentin.Results: Six months later she presents hypometria of 1.8cm. Knee ROM 3u00ba-130u00ba, complete ankle-foot. Slight quadricipital atrophy. Deambulation without orthesis neither technical aids, rise of 1,5cm and slight claudication. Integrated in educational environment, without oral medication.Conclusions: The correction of lower limbs discrepancy with PRECICEu00ae (NuVasive) intramedullary femoral nail lengthening has been excellent. Complications have been reversible with surgical techniques and rehabilitation. The intensive early rehabilitation treatment, and psychological adaptation are essential to obtain successful results.

This report describes the current situation of the region of Central America and the Dominican Republic and its outlook for 2019. It also analyzes the recent reduction in the food price pattern and its relationship with the expected increase in international prices and the local production . Finally, it examines the channels through which the reduction of global liquidity could be transferred to the region, including the banking sector, the financial markets, and the foreign direct investment inflows. It is worth noting that to date there have been no substantial effects in the region. However, it is important to continue monitoring the performance of the various transmission channels while strengthening the foundations to be better prepared for global events that increase risk aversion.

We construct the first comprehensive dataset of contingent liability realizations in advanced and emerging markets for the period 1990–2014. We find that contingent liability realizations are a major source of fiscal distress. The average fiscal cost of a contingent liability realization is 6 percent of GDP but costs can be as high as 40 percent for major financial sector bailouts. Contingent liability realizations are correlated among each other and tend to occur during periods of growth reversals and crises, accentuating pressure on the budget during already difficult times. Countries with stronger institutions are able to better control and address the underlying risks so that they are less exposed to contingent liability realizations.

This paper creates the first dataset of bilateral remittance flows for a limited set of developing countries and estimates a gravity model for workers' remittances. We find that most of the variation in bilateral remittance flows can be explained by a few gravity variables. The evidence on the motives to remit is mixed, but altruism may be less of a factor than commonly believed. Most strikingly, remittances do not seem to increase in the wake of a natural disaster and appear aligned with the business cycle in the home country, suggesting that remittances may not play a major role in limiting vulnerability to shocks. To encourage remittances and maximize their economic impact, policies should be directed at reducing transaction costs, promoting financial sector development, and improving the business climate.

Empirical analysis does not suggest that reserves are "too high" in the majority of Asian countries, though China may be a special case. Much of the reserve increase in Asia can be explained by an optimal insurance model under which reserves provide a steady source of liquidity to cushion the impact of a sudden stop in capital inflows on output and consumption. Moreover, the benefits of reserves in terms of reduced spreads on privately held external debt further explains the observed growth in reserves since 1997-98. Using threshold estimation techniques, the paper shows that most of Asia can still benefit from higher reserves in terms of reduced borrowing costs.