Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 211
Filtrar
1.
Sci Total Environ ; 926: 171699, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38508250

RESUMEN

Floodbank realignment is a common practice aimed at restoring salt marsh vegetation on previously embanked land. However, experiences indicate that it may take several years before salt marsh vegetation becomes fully established. Various challenges arising from ecogeomorphic feedback mechanisms could pose significant setbacks to vegetation recolonization. The widespread adoption of transplantation techniques for the restoration and rehabilitation of rewilded landscapes has indeed proven to be a valuable tool for accelerating plant development. In the Ria Formosa coastal lagoon (South of Portugal), a pilot plan was implemented, and two salt marsh pioneer species, Spartina maritima (syn. Sporobolus maritimus) and Sarcocornia perennis (syn. Salicornia perennis), were transplanted from a natural salt marsh to a rewilded marsh. Biodegradable 3D porous structures were installed to mimic transplant clumping, aid sedimentation, and enhance the plant's initial adjustment. Ecological, sediment, and hydrodynamic data were collected during the 12-month pilot restoration plan. The environmental profiles of the donor and restoration sites were compared to substantiate the success of the transplants in the rewilded salt marsh. Results show that although plant shoot density decreased after the transplanting, Spartina maritima acclimated well to the new environmental conditions of the restoration site, showing signs of growth and cover increase, whilst Sarcocornia perennis was not able to acclimatize and survive in the restoration site. The failure behind the Sarcocornia perennis acclimation might be related to the bed properties and topographic properties of the restoration site in the rewilded marsh. Major findings contribute to a more comprehensive understanding of how salt marsh pioneering vegetation successfully colonizes disturbed habitats, facilitated using 3D-biodegradable structures.


Asunto(s)
Chenopodiaceae , Humedales , Sedimentos Geológicos/química , Ecosistema , Poaceae
2.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 68(1): 18-25, Ene-Feb, 2024. tab, graf
Artículo en Español | IBECS | ID: ibc-229665

RESUMEN

Introducción: El proceso diagnóstico de los sarcomas de partes blandas del aparato locomotor (SPBAL) sigue siendo comprometido, con casos de resecciones no planificadas (cirugías «whoops»). Este estudio evalúa la frecuencia de este tipo de procedimientos, tratando de identificar características de los pacientes, tumores, tratamiento quirúrgico y resultados. Material y métodos: Se revisan de forma retrospectiva 131 pacientes tratados de forma quirúrgica en nuestro centro entre octubre de 2018 y diciembre de 2021 de un SPBAL. Se excluyen los pacientes con SPBAL localizados en vísceras, mediastino, corazón, retroperitoneo, peritoneo y aparato genital. Las diferencias entre pacientes con resecciones planificadas y no planificadas fueron evaluadas con pruebas χ2 y un modelo de regresión multivariado de Cox. Resultados: Las resecciones no planificadas de SPBAL han tenido lugar en 18% de los pacientes de nuestra área, principalmente en tumores menos de 5 cm y localizados superficiales a la fascia; 29,2% de estos pacientes no disponían de una prueba de imagen previa. No se ha demostrado que una cirugía «whoops» pueda suponer una disminución de la supervivencia o una mayor tasa de recidivas. Conclusiones: Recomendamos la realización de una prueba de imagen siempre previa a la extirpación de cualquier tipo de tumoración de tejidos blandos, así como la adherencia a las guías de remisión a centros de referencia.(AU)


Introduction: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions (“whoops” surgeries). This study evaluates the frequency of these type of procedures, trying to indentify patient characteristics, tumors, surgical treatment and final results. Material and methods: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with chi2 tests and a Cox multivariate regression model. Results: Unplanned excisions of SPBAL have taken place in 18% of the patients in our área, mainly in tumors of less than 5 cm and located superficial to the fascia. 29,2% of these patients did not have a previous imaging test. It has not been shown that a “whoops” surgery can lead to a decrease in survival or a higher rate of recurrences. Conclusions: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumor, as well as adherence to the referral guidelines to reference centers.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Sarcoma de Células Claras/cirugía , Neoplasias/cirugía , Actividad Motora , Sarcoma/tratamiento farmacológico
3.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 68(1): T18-T25, Ene-Feb, 2024. tab, graf
Artículo en Inglés | IBECS | ID: ibc-229666

RESUMEN

Introducción: El proceso diagnóstico de los sarcomas de partes blandas del aparato locomotor (SPBAL) sigue siendo comprometido, con casos de resecciones no planificadas (cirugías «whoops»). Este estudio evalúa la frecuencia de este tipo de procedimientos, tratando de identificar características de los pacientes, tumores, tratamiento quirúrgico y resultados. Material y métodos: Se revisan de forma retrospectiva 131 pacientes tratados de forma quirúrgica en nuestro centro entre octubre de 2018 y diciembre de 2021 de un SPBAL. Se excluyen los pacientes con SPBAL localizados en vísceras, mediastino, corazón, retroperitoneo, peritoneo y aparato genital. Las diferencias entre pacientes con resecciones planificadas y no planificadas fueron evaluadas con pruebas χ2 y un modelo de regresión multivariado de Cox. Resultados: Las resecciones no planificadas de SPBAL han tenido lugar en 18% de los pacientes de nuestra área, principalmente en tumores menos de 5 cm y localizados superficiales a la fascia; 29,2% de estos pacientes no disponían de una prueba de imagen previa. No se ha demostrado que una cirugía «whoops» pueda suponer una disminución de la supervivencia o una mayor tasa de recidivas. Conclusiones: Recomendamos la realización de una prueba de imagen siempre previa a la extirpación de cualquier tipo de tumoración de tejidos blandos, así como la adherencia a las guías de remisión a centros de referencia.(AU)


Introduction: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions (“whoops” surgeries). This study evaluates the frequency of these type of procedures, trying to indentify patient characteristics, tumors, surgical treatment and final results. Material and methods: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with chi2 tests and a Cox multivariate regression model. Results: Unplanned excisions of SPBAL have taken place in 18% of the patients in our área, mainly in tumors of less than 5 cm and located superficial to the fascia. 29,2% of these patients did not have a previous imaging test. It has not been shown that a “whoops” surgery can lead to a decrease in survival or a higher rate of recurrences. Conclusions: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumor, as well as adherence to the referral guidelines to reference centers.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Sarcoma de Células Claras/cirugía , Neoplasias/cirugía , Actividad Motora , Sarcoma/tratamiento farmacológico
4.
Rev Esp Cir Ortop Traumatol ; 68(1): T18-T25, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37981200

RESUMEN

INTRODUCTION: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions ("whoops" surgeries). This study evaluates the frequency of these type of procedures, trying to identify patient characteristics, tumours, surgical treatment and final results. MATERIAL AND METHODS: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with Chi2 tests and a Cox multivariate regression model. RESULTS: Unplanned excisions of SPBAL have taken place in 18% of the patients in our area, mainly in tumours of less than 5cm and located superficial to the fascia. 29.2% of these patients did not have a previous imaging test. It has not been shown that a "whoops" surgery can lead to a decrease in survival or a higher rate of recurrences. CONCLUSIONS: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumour, as well as adherence to the referral guidelines to reference centres.

5.
Rev Esp Cir Ortop Traumatol ; 68(1): 18-25, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-36841328

RESUMEN

INTRODUCTION: The diagnosis process of soft tissue sarcomas of the musculoskeletal system (SPBAL) continues to be complex, with cases of unplanned excisions ("whoops" surgeries). This study evaluates the frequency of these type of procedures, trying to indentify patient characteristics, tumors, surgical treatment and final results. MATERIAL AND METHODS: 131 patients treated surgically between October 2018 and December 2021 of a SPBAL were retrospectively reviewed. Patients with SPBAL located in the viscera, mediastinum, heart, retroperitoneum, peritoneum and genital tract were excluded. Differences between patients with planned and unplanned excisions were assessed with chi2 tests and a Cox multivariate regression model. RESULTS: Unplanned excisions of SPBAL have taken place in 18% of the patients in our área, mainly in tumors of less than 5 cm and located superficial to the fascia. 29,2% of these patients did not have a previous imaging test. It has not been shown that a "whoops" surgery can lead to a decrease in survival or a higher rate of recurrences. CONCLUSIONS: We recommend carrying out an imaging test always prior to the removal of any type of soft tissue tumor, as well as adherence to the referral guidelines to reference centers.

8.
Methods Cell Biol ; 179: 143-155, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37625872

RESUMEN

Celiac disease (CD) diagnosis in adults and certain cases of children mainly relies on the assessment of histopathological features in duodenal biopsies. However, none of the histological findings that characterize CD are pathognomonic. This, in addition to the clinical heterogeneity of the disease and the presence of seronegative forms, makes the diagnosis of CD still a challenge. A hallmark of the celiac mucosa is the elevated number of TCRγδ intraepithelial lymphocytes (IEL) in the epithelium, which may remain increased even long after gluten withdrawal. Active disease is also characterized by the decreased CD3- IEL subset. The use of flow cytometry enables a precise cell counting and phenotyping, allowing the ascertainment of both TCRγδ+ and CD3- IEL subsets, what is known as the "IEL lymphogram." Although determination of this lymphogram has become a routine evaluation tool in numerous hospitals, standardization of the technical method will guarantee an accurate performance in order to become a pivotal technique for CD diagnosis. Here we describe the protocol to process duodenal biopsies in order to obtain the IELs from the mucosa and to characterize lymphocyte populations by flow cytometry to obtain the IEL lymphogram.


Asunto(s)
Enfermedad Celíaca , Linfocitos Intraepiteliales , Adulto , Niño , Humanos , Enfermedad Celíaca/diagnóstico , Citometría de Flujo , Biopsia , Pruebas Diagnósticas de Rutina
9.
Epilepsy Behav Rep ; 23: 100605, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37332897

RESUMEN

We report a 60-year-old woman who presented to the emergency department after experiencing a witnessed unknown onset bilateral tonic clonic seizure (GTCS) that culminated in cardiac arrest. A neurology consultant uncovered a years-long history of frequent episodic staring followed by confusion and expressive aphasia, which strongly suggested that she suffered from epilepsy. Thus, her cardiac arrest and subsequent resuscitation met criteria for a near-sudden unexpected death in epilepsy (SUDEP) diagnosis. Serial bloodwork demonstrated transient troponin I elevations and leukocytoses, while a brain MRI revealed global cerebral anoxic injury and a small acute right cerebellar ischemic infarction. A review of her medical record uncovered a hospitalization sixteen months earlier for a likely GTCS whose workup showed similar troponin I elevations and leukocytoses, and surprisingly, a different small acute right cerebellar ischemic infarction in the same vascular territory. To our knowledge, this is the first report of subcortical ischemic infarctions occurring concurrently with GTCSs in a near-SUDEP patient. Aside from illustrating the key role of inpatient neurologists in the diagnosis of near-SUDEP, this manuscript discusses the potential significance of postictal ischemic infarctions, transient asymptomatic troponin elevations, and transient non-infectious leukocytoses in epilepsy patients with cardiovascular risk factors.

10.
Sci Rep ; 13(1): 1921, 2023 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-36732596

RESUMEN

One of the key questions about wetlands resilience to sea-level rise is whether sediment supply will be enough to keep them coping with growing inundation levels. To address this question, researchers have put a lot of effort into field data collection and ecogeomorphic modelling, in an attempt to identify the tipping points of marsh survival. This study uses fieldwork data to characterize the sediment fluxes between the tidal flats and salt marshes, in the Ria Formosa lagoon (Portugal). Sediment fluxes were measured from the tidal channel towards the mid-upper marsh, during neap and spring tide conditions. The flow magnitude was measured, and induced transport was determined based on shear velocities. Deposition rates, instantaneous suspended sediment and near-bed velocities were linked through theoretical formulas and used to characterize time-averaged conditions for sediment delivery and deposition to the site. The results showed that suspended sediment concentrations and sediment deposition varied across the transect with no specific relation to elevation. Maximum water depths were recorded in the vegetated tidal flat, and the maximum currents were flood dominated, in the order of 0.20 m/s, in the low marsh due to flow-plant interactions and an increase of turbulence. Deposition rates ranged between 20 to 45 g/m2/hr, after a complete tidal cycle, and were higher in the mid-upper marsh. Hydroperiod was not the main contributor to sediment deposition in the study area. Sediment transport was tidally driven, strongly two-dimension during the cycle, and highly influenced by the vegetation. Measurements of marsh sediment flux obtained in our work are diverse from the ones found in the literature and evidence the importance of considering spatio-temporal variability of vegetated platforms in assessing overall marsh bed level changes.

11.
Rev. esp. anestesiol. reanim ; 69(9): 567-577, Nov. 2022. ilus
Artículo en Español, Portugués, Francés | IBECS | ID: ibc-211679

RESUMEN

Las complicaciones cardiorrespiratorias son las principales causas de morbimortalidad en las unidades de cuidados críticos (UCC). Las técnicas de imagen son una pieza fundamental tanto en el diagnóstico diferencial como en el tratamiento. En la última década la ecografía ha demostrado gran potencial para el diagnóstico a pie de cama de patología respiratoria, así como para la valoración hemodinámica de los pacientes críticos. La ecografía ha demostrado ser una guía útil para la identificación del tipo de shock, la estimación del gasto cardiaco, guiar la fluidoterapia y los fármacos vasoactivos, aportar seguridad en la realización de las técnicas percutáneas (toracocentesis, pericardiocentesis, evacuación de abscesos/hematomas), objetivar de forma dinámica y en tiempo real la atelectasia pulmonar y su respuesta a las maniobras de reclutamiento alveolar, y predecir el fracaso en el destete de la ventilación mecánica. Por su carácter dinámico, sencilla curva de aprendizaje y ausencia de radiación ionizante, se ha incorporado como una herramienta imprescindible en la práctica clínica diaria en las UCC. El objetivo de la presente revisión es ofrecer una visión global del papel de la ecografía y sus aplicaciones en el paciente crítico.(AU)


Hemodynamic and respiratory complications are the main causes of morbidity and mortality in in critical care units (CCU). Imaging techniques are a key tool in differential diagnosis and treatment. In the last decade, ultrasound has shown great potential for bedside diagnosis of respiratory disease, as well as for the hemodynamic assessment of critically ill patients. Ultrasound has proven to be a useful guide for identifying the type of shock, estimating cardiac output, guiding fluid therapy and vasoactive drugs, providing security in the performance of percutaneous techniques (thoracentesis, pericardiocentesis, evacuation of abscesses/hematomas), detecting dynamically in real time pulmonary atelectasis and its response to alveolar recruitment maneuvers, and predicting weaning failure from mechanical ventilation. Due to its dynamic nature, simple learning curve and absence of ionizing radiation, it has been incorporated as an essential tool in daily clinical practice in CCUs. The objective of this review is to offer a global vision of the role of ultrasound and its applications in the critically ill patient.(AU)


Asunto(s)
Humanos , Ultrasonografía , Diagnóstico , Monitoreo Fisiológico , Unidades de Cuidados Intensivos , Enfermedades Respiratorias/complicaciones , Cuidados Críticos , Reanimación Cardiopulmonar , Anestesiología , España
12.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(9): 567-577, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36253286

RESUMEN

Hemodynamic and respiratory complications are the main causes of morbidity and mortality in in critical care units (CCU). Imaging techniques are a key tool in differential diagnosis and treatment. In the last decade, ultrasound has shown great potential for bedside diagnosis of respiratory disease, as well as for the hemodynamic assessment of critically ill patients. Ultrasound has proven to be a useful guide for identifying the type of shock, estimating cardiac output, guiding fluid therapy and vasoactive drugs, providing security in the performance of percutaneous techniques (thoracentesis, pericardiocentesis, evacuation of abscesses/hematomas), detecting dynamically in real time pulmonary atelectasis and its response to alveolar recruitment maneuvers, and predicting weaning failure from mechanical ventilation. Due to its dynamic nature, simple learning curve and absence of ionizing radiation, it has been incorporated as an essential tool in daily clinical practice in CCUs. The objective of this review is to offer a global vision of the role of ultrasound and its applications in the critically ill patient.


Asunto(s)
Cuidados Críticos , Enfermedad Crítica , Humanos , Cuidados Críticos/métodos , Ultrasonografía/métodos , Unidades de Cuidados Intensivos , Respiración Artificial
13.
Rev Med Chil ; 150(2): 216-221, 2022 Feb.
Artículo en Español | MEDLINE | ID: mdl-36156648

RESUMEN

Procedural skills are essential in the nursing profession and should be acquired during undergraduate training according to new regulations. Clinical simulation is a good alternative to teach such skills. During COVID pandemic, face-to-face learning activities were reduced to a minimum amount, thus hampering the use of clinical simulations. Since simulations should adapt to the new scenario, their virtual implementation appears as an alternative. The latter should become an important teaching tool while restrictions in mobility last. We herein review the evolution of clinical simulation as a teaching tool and to determine its future challenges.


Asunto(s)
COVID-19 , Entrenamiento Simulado , Estudiantes de Enfermería , Competencia Clínica , Humanos , Aprendizaje
14.
Cir. Esp. (Ed. impr.) ; 100(9): 555-561, sept. 2022. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-208256

RESUMEN

Introducción El cáncer de colon y recto presenta una incidencia creciente en nuestra sociedad. Sin embargo, la realización de intervenciones por laparoscopia en este subcampo sigue sin incluirse de forma protocolizada en el Programa Nacional de Formación. Ante la falta de referencias, nuestro objetivo fue analizar la participación del residente en cirugía colorrectal laparoscópica y su posible efecto sobre la morbimortalidad y el pronóstico oncológico. Métodos Estudio retrospectivo longitudinal unicéntrico que incluyó todas las intervenciones de cirugía colorrectal realizadas por residentes (grupo R) y adjuntos (grupo A) por laparoscopia entre el 01 de enero de 2009 y el 31 de diciembre de 2017, manteniendo el seguimiento hasta el 31 de diciembre de 2018. Se analizó la morbimortalidad postoperatoria, la supervivencia global (SVG) y libre de enfermedad (SLE), y su relación con la participación del residente como primer cirujano. Resultados Se analizaron 408 pacientes, de los cuáles 138 (33,8%) fueron intervenidos por parte de residentes bajo supervisión y 270 (66,2%) por parte de adjuntos. No se detectaron diferencias en la tasa de complicaciones postoperatorias entre ambos grupos (OR: 1,536; IC 95%: 0,947-2,409; p = 0,081). Asimismo, la participación del residente no tuvo influencia sobre la recidiva tumoral (grupo R:14,2% vs. grupo A: 16,9%; p = 0,588) ni sobre la SVG (p = 0,562) ni SLE (p = 0,305). Conclusiones La realización de cirugía laparoscópica colorrectal por parte del residente no tuvo influencia sobre la morbimortalidad ni el pronóstico oncológico en nuestro centro. La realización de estudios prospectivos y de mayor evidencia proporcionará un mayor conocimiento, posibilitando una mejora progresiva de la metodología docente (AU)


Introduction Colorectal cancer has a growing incidence in our society. However, the performance of laparoscopic interventions in this field is still not included in the National Training Program. Given the lack of references, our objective was to analyze the resident's participation in laparoscopic colorectal surgery and its possible effect on morbidity and mortality and oncological prognosis. Methods A retrospective longitudinal single-center study that included all laparoscopic colorectal surgical procedures performed by residents (R group) and by attending surgeons (A group) between 01/01/2009 and 12/31/2017, maintaining follow-up until 12/31/2018. Postoperative morbidity and mortality, overall survival (OS) and disease-free survival (DFS), as well as their relationship with the resident involvement as first surgeon were analyzed. Results 408 patients were analyzed, of which 138 (33.8%) were operated by a supervised resident and 270 (66.2%) by the attending surgeon. No differences were detected in the rate of postoperative complications between both groups (OR: 1.536; 95% CI: 0.947-2.409; p=0.081). Furthermore, resident participation had no influence on tumor recurrence rate (R Group: 14.2% vs. A Group: 16.9%; p=0.588) or on overall (p = 0.562) or disease-free survival (p = 0.305). Conclusion Resident involvement in laparoscopic colorectal surgery had no influence on morbidity and mortality or oncological prognosis in our center. Conducting prospective studies in this regard will provide greater knowledge, enabling a progressive improvement of the training program (AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/cirugía , Internado y Residencia , Laparoscopía , Estudios Retrospectivos , Estudios Longitudinales , Análisis de Supervivencia
15.
Int J Biol Markers ; 37(2): 113-122, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35473449

RESUMEN

Skin tumours are among the cancer types most sensitive to immunotherapy, due to their unique immunogenic features including skin-associated lymphoid tissue, high mutational load, overexpression of tumour antigens, and high frequency of viral antigens. Despite this high immunotherapy response rate, however, ultimately most skin tumours develop similar treatment resistance to most other malignant tumours, which highlights the need for in-depth study of mechanisms of response and resistance to immunotherapy. A bibliographic review of the most recent publications regarding currently in use and emerging biomarkers on skin tumors has been done. Predictive biomarkers of treatment response, biomarkers that warn of possible resistance, and emerging markers, the majority of a systemic nature, are described. Including factors affecting not only genomics, but also the immune system, nervous system, microbiota, tumour microenvironment, metabolism and stress. For accurate diagnosis of tumour type, knowledge of its functional mechanisms and selection of a comprehensive therapeutic protocol, this inclusive view of biology, health and disease is fundamental. This field of study could also become a valuable source of practical information applicable to other areas of oncology and immunotherapy.


Asunto(s)
Neoplasias , Neoplasias Cutáneas , Antígenos de Neoplasias , Biomarcadores de Tumor/metabolismo , Humanos , Inmunoterapia , Neoplasias/terapia , Neoplasias Cutáneas/terapia , Microambiente Tumoral
16.
Rev. méd. Chile ; 150(2): 216-221, feb. 2022.
Artículo en Español | LILACS | ID: biblio-1389626

RESUMEN

Procedural skills are essential in the nursing profession and should be acquired during undergraduate training according to new regulations. Clinical simulation is a good alternative to teach such skills. During COVID pandemic, face-to-face learning activities were reduced to a minimum amount, thus hampering the use of clinical simulations. Since simulations should adapt to the new scenario, their virtual implementation appears as an alternative. The latter should become an important teaching tool while restrictions in mobility last. We herein review the evolution of clinical simulation as a teaching tool and to determine its future challenges.


Asunto(s)
Humanos , Estudiantes de Enfermería , Entrenamiento Simulado , COVID-19 , Competencia Clínica , Aprendizaje
19.
Acta Ortop Mex ; 34(2): 71-76, 2020.
Artículo en Español | MEDLINE | ID: mdl-33244904

RESUMEN

INTRODUCTION: Glenohumeral osteoarthritis leads to a functional loss and a decrease in the quality of life of many patients that suffers it. Currently there is no agreement on the use of hemiarthroplasty or total arthroplasty as definitive treatment. The objective is to show the results of the treatment of primary glenohumeral osteoarthritis through hemiarthroplasty in our service. MATERIAL AND METHODS: We reviewed 14 patients (19 hemiarthroplasties) performed between 2004 and 2013 in patients diagnosed with primary glenohumeral osteoarthritis without glenoid morphological anomaly. We managed to collect data from eight patients (11 hemiarthroplasties), assessing functional status, pain, and performing activities of daily living using the Constant, ASES and DASH scores preoperatively and at five years of minimum follow-up (range 5-11 years), as well as related complications. The preoperative status was compared to the end of the follow-up. RESULTS: A significant improvement was found in all the parameters analyzed in the study (p. CONCLUSION: < 0.05). The average pain in EVA score decreased from 8.89 to 2.67. The ASES improved from 13.51 to 63. 51 half point. The Constant increase of 20.11 points to 65.11 points. The mean preoperative score in the DASH score was 73.68 and 28.30 postoperatively. The average survival of the implant was 81.82% in the seven years of average follow-up. Shoulder hemiarthroplasty obtains good functional results in the treatment of primary glenohumeral osteoarthritis with few complications. The cause of the failure were glenoid erosion in all the cases.


INTRODUCCIÓN: La artrosis glenohumeral conlleva a una pérdida funcional y a una disminución de la calidad de vida de muchos pacientes. Actualmente, no existe consenso en cuanto al uso de la hemiartroplastía o la artroplastía total como tratamiento definitivo para este padecimiento. El objetivo es mostrar los resultados del tratamiento de la artrosis glenohumeral primaria mediante hemiartroplastía en nuestro servicio. MATERIAL Y MÉTODOS: Revisamos 19 hemiartroplastías (14 pacientes) realizadas entre 2004 y 2013 en pacientes con artrosis glenohumeral primaria sin alteración morfológica glenoidea. Se recabaron los datos de ocho pacientes (11 hemiartroplastías), valorándose el estado funcional, el dolor y la realización de actividades de la vida diaria mediante las escalas Constant, ASES y DASH preoperatorias, a los cinco años de seguimiento mínimo (rango 5-11 años), así como las complicaciones presentadas. Se comparó el estado preoperatorio y al final del seguimiento. RESULTADOS: Se encontró una mejoría estadísticamente significativa (p. CONCLUSIÓN: < 0.05) en todos los parámetros analizados en el estudio. La media del dolor en la escala EVA disminuyó de 8.89 a 2.67. La escala ASES mejoró de 13.51 a 63.51 puntos de media. El Constant aumentó de 20.11 a 65.11 puntos. La puntuación media preoperatoria en la escala DASH fue de 73.68 y la postoperatoria de 28.30 puntos. La supervivencia media del implante fue de 81.82% a los siete años de seguimiento medio. Obtuvimos buenos resultados funcionales con la artrosis glenohumeral primaria, presentándose pocas complicaciones. La causa del fracaso fue la erosión glenoidea.


Asunto(s)
Hemiartroplastia , Osteoartritis , Articulación del Hombro , Actividades Cotidianas , Estudios de Seguimiento , Humanos , Osteoartritis/cirugía , Calidad de Vida , Rango del Movimiento Articular , Estudios Retrospectivos , Articulación del Hombro/cirugía , Resultado del Tratamiento
20.
Acta ortop. mex ; 34(2): 71-76, mar.-abr. 2020. tab, graf
Artículo en Español | LILACS | ID: biblio-1345090

RESUMEN

Resumen: Introducción: La artrosis glenohumeral conlleva a una pérdida funcional y a una disminución de la calidad de vida de muchos pacientes. Actualmente, no existe consenso en cuanto al uso de la hemiartroplastía o la artroplastía total como tratamiento definitivo para este padecimiento. El objetivo es mostrar los resultados del tratamiento de la artrosis glenohumeral primaria mediante hemiartroplastía en nuestro servicio. Material y métodos: Revisamos 19 hemiartroplastías (14 pacientes) realizadas entre 2004 y 2013 en pacientes con artrosis glenohumeral primaria sin alteración morfológica glenoidea. Se recabaron los datos de ocho pacientes (11 hemiartroplastías), valorándose el estado funcional, el dolor y la realización de actividades de la vida diaria mediante las escalas Constant, ASES y DASH preoperatorias, a los cinco años de seguimiento mínimo (rango 5-11 años), así como las complicaciones presentadas. Se comparó el estado preoperatorio y al final del seguimiento. Resultados: Se encontró una mejoría estadísticamente significativa (p < 0.05) en todos los parámetros analizados en el estudio. La media del dolor en la escala EVA disminuyó de 8.89 a 2.67. La escala ASES mejoró de 13.51 a 63.51 puntos de media. El Constant aumentó de 20.11 a 65.11 puntos. La puntuación media preoperatoria en la escala DASH fue de 73.68 y la postoperatoria de 28.30 puntos. La supervivencia media del implante fue de 81.82% a los siete años de seguimiento medio. Conclusión: Obtuvimos buenos resultados funcionales con la artrosis glenohumeral primaria, presentándose pocas complicaciones. La causa del fracaso fue la erosión glenoidea.


Abstract: Introduction: Glenohumeral osteoarthritis leads to a functional loss and a decrease in the quality of life of many patients that suffers it. Currently there is no agreement on the use of hemiarthroplasty or total arthroplasty as definitive treatment. The objective is to show the results of the treatment of primary glenohumeral osteoarthritis through hemiarthroplasty in our service. Material and methods: We reviewed 14 patients (19 hemiarthroplasties) performed between 2004 and 2013 in patients diagnosed with primary glenohumeral osteoarthritis without glenoid morphological anomaly. We managed to collect data from eight patients (11 hemiarthroplasties), assessing functional status, pain, and performing activities of daily living using the Constant, ASES and DASH scores preoperatively and at five years of minimum follow-up (range 5-11 years), as well as related complications. The preoperative status was compared to the end of the follow-up. Results: A significant improvement was found in all the parameters analyzed in the study (p < 0.05). The average pain in EVA score decreased from 8.89 to 2.67. The ASES improved from 13.51 to 63. 51 half point. The Constant increase of 20.11 points to 65.11 points. The mean preoperative score in the DASH score was 73.68 and 28.30 postoperatively. The average survival of the implant was 81.82% in the seven years of average follow-up. Conclusion: Shoulder hemiarthroplasty obtains good functional results in the treatment of primary glenohumeral osteoarthritis with few complications. The cause of the failure were glenoid erosion in all the cases.


Asunto(s)
Humanos , Osteoartritis/cirugía , Articulación del Hombro/cirugía , Hemiartroplastia , Calidad de Vida , Actividades Cotidianas , Estudios Retrospectivos , Estudios de Seguimiento , Rango del Movimiento Articular , Resultado del Tratamiento
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA