RESUMEN
INTRODUCTION: Anterior cruciate ligament injuries are common, however, tibial avulsions in adults are rare. The gold standard continues to be reconstruction. In recent years, primary repairs have been reported in femoral side lesions by bioabsorbable anchorage. CLINICAL CASE: We present the case of a primary repair of the anterior cruciate ligament in tibial avulsion in a patient 19 years old after presenting direct trauma with added injuries of the posterior cruciate ligament and posterolateral corner. Primary repair was performed by transtendon portal with suture of the anterior cruciate ligament with FiberTape and FiberWire and fixed with 4.75 mm SwiveLock anchor in tibial footprint. RESULTS: At 24 months of surgery he is with independent gait, complete range of motion, with clinical assessment scales, Tegner before the injury and after the injury at a level 6, Lysholm scale 91, subjective International Knee Documentation Committee (IKDC) 73.6, objective IKDC in C and EQ-5D 0.79. CONCLUSION: The avulsion of ACL on its tibial side can be repaired in certain conditions with adequate evolution and satisfaction for the patient.
INTRODUCCIÓN: Las lesiones del ligamento cruzado anterior son comunes; sin embargo, las avulsiones tibiales en adultos son raras. El estándar de oro continúa siendo la reconstrucción. En los últimos años se han reportado reparaciones primarias en lesiones de lado femoral mediante anclaje bioabsorbible. CASO CLÍNICO: Presentamos el caso de una reparación primaria de ligamento cruzado anterior en avulsión tibial en paciente masculino de 19 años posterior a sufrir de trauma directo con lesiones agregadas de ligamento cruzado posterior y esquina posterolateral. Se realizó reparación primaria por portal transtendón con sutura del ligamento cruzado anterior en cruz mediante FiberTape y FiberWire con anclaje SwiveLock 4.75 mm en huella tibial. RESULTADOS: A los 24 meses de operado se encuentra con marcha independiente, arcos completos, con escalas de valoración clínica, Tegner antes de la lesión y posterior a la lesión en un nivel 6, escala de Lysholm 91, International Knee Documentation Committee (IKDC) subjetivo 73.6, IKDC objetivo en C y EQ-5D 0.79. CONCLUSIÓN: Se puede reparar la avulsión de LCA en su lado tibial en ciertas condiciones con adecuada evolución y satisfacción para el paciente.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Ligamento Cruzado Anterior , Implantes Absorbibles , Adulto , Ligamento Cruzado Anterior/cirugía , Lesiones del Ligamento Cruzado Anterior/complicaciones , Lesiones del Ligamento Cruzado Anterior/cirugía , Artroscopía , Estudios de Seguimiento , Humanos , Articulación de la Rodilla/cirugía , Masculino , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Anterior cruciate ligament injuries are common, however, tibial avulsions in adults are rare. The gold standard continues to be reconstruction either by allograft or autologous graft. Primary repairs in femoral side lesions have been reported in recent years by bioabsorbable anchors. CASE REPORT: We present the case of a primary repair of anterior cruciate ligament due to tibial avulsion in a patient 19 years after presenting direct trauma with added lesions of posterior cruciate ligament and posterolateral corner. Primary repair was performed by trans-tendon portal with suture of the anterior cruciate ligament crossed by FiberTape and FiberWire with a SwiveLock anchor (4.75 mm) in tibial footprint. RESULTS: Twelve months after surgery is with independent gait, full range of movement, with clinical rating scales, Tegner before injury and post-injury at 6, Lysholm 91, 73.6 subjective IKDC, objective IKDC in C and EQ-5D 0.79. CONCLUSION: Fixation with bioabsorbable anchor is possible in the avulsion of the post-traumatic tibial spine.
INTRODUCCIÓN: Las lesiones del ligamento cruzado anterior son comunes; sin embargo, las avulsiones tibiales en adultos son raras. El estándar de oro continúa siendo la reconstrucción, ya sea por aloinjerto o injerto autólogo. En los últimos años se han reportado reparaciones primarias en lesiones de lado femoral mediante anclaje bioabsorbible. REPORTE DE CASO: Presentamos el caso de una reparación primaria de ligamento cruzado anterior por avulsión tibial en un paciente de 19 años, posterior a presentar trauma directo con lesiones agregadas de ligamento cruzado posterior y esquina posterolateral. Se realizó reparación primaria por portal transtendón con sutura del ligamento cruzado anterior en cruz mediante FiberTape y FiberWire con anclaje SwiveLock 4.75 mm en huella tibial. RESULTADOS: A 12 meses de operado se encuentra con marcha independiente, arcos completos, con escalas de valoración clínica, Tegner antes y posterior a la lesión en 6, escala de Lysholm 91, IKDC subjetivo 73.6, IKDC objetivo en C y EQ-5D 0.79. CONCLUSIÓN: La fijación con ancla bioabsorbible es posible en la avulsión de la espina tibial postraumática.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Ligamento Cruzado Posterior , Adulto , Ligamento Cruzado Anterior , Lesiones del Ligamento Cruzado Anterior/cirugía , Artroscopía , Humanos , Resultado del TratamientoRESUMEN
The predatory mirid bug Dicyphus hesperus Knight (Hemiptera: Miridae) is a native North America species with high potential as biological control agent of the potato psyllid, Bactericera cockerelli Sulcer (Hemiptera: Triozidae), which is a major solanaceous pest. Olfactory responses of D. hesperus to volatiles from plants infested with the potato psyllid and the effect of foraging experience on search efficacy were studied. Using a Y-tube olfactometer, we found that naïve females had no preference in choice tests between either uninfested tomato plants, or Ephestia kuehniella Zeller (Lepidoptera: Pyralidae) eggs-infested plants, and clean air. Naïve females showed an innate positive response to B. cockerelli-infested plants, but no preference when given a choice between uninfested tomato plants and E. kuehniella eggs-infested plants. However, females with experience of foraging on B. cockerelli-infested plants showed a strong preference for B. cockerelli-infested plants (78% response) in choice tests with uninfested tomato plants and E. kuehniella eggs-infested plants. Implications of learning for augmentative biological control are discussed.
Asunto(s)
Conducta Apetitiva , Hemípteros/química , Heterópteros/fisiología , Conducta Predatoria , Compuestos Orgánicos Volátiles/química , Animales , Femenino , Hemípteros/fisiología , Herbivoria , Solanum lycopersicumRESUMEN
Tinturas preparadas com as folhas de Camellia sinensis (chá verde), foram caracterizadas visando a obtenção de extratos enriquecidos em polifenóis. As tinturas foram obtidas por meio de maceração estática da droga pulverizada, com diferentes misturas de 60, 70, 80 e 94,5% de etanol em água. Em seguida foram filtradas e, após 8 dias de extração, realizaram-se as analises: organoléptica, pH, densidade, determinação do resíduo seco, perfil cromatográfico por camada delgada, e teor de polifenóis. Os resultados demonstraram que o solvente (mistura hidroalcoólica a 60 ou 70%) extraiu a maior quantidade de constituintes químicos do chá verde; também foi o mais seletivo ao extrair, especificamente os polifenóis. Estes dados sugerem que a utilização de álcool etílico a 60 ou 70% conduz à obtenção de tinturas mais ricas em polifenóis, a partir das folhas do chá verde (C. sinensis).
In this work, we prepared and characterized Camellia sinensis leaf tinctures aiming to obtain a polyphenol-enriched extract. The tinctures were prepared through the static maceration process of the powdered drug, at different mixtures 60, 70, 80 and 94.5% of ethanol in water. The tinctures were filtered, and after 8 days of extraction, submitted to organoleptic analysis, determination of pH, density analysis, dry residue analysis, thin layer chromatographic profile and polyphenol percentage analysis. The results showed that the 60 or 70% alcohol-water mixture has the best extraction of the constituents of green tea and it was more selective to extract, specifically, the polyphenols of the plant. These data suggest the use of 60 or 70% ethanol to carry out polyphenol-enriched tinctures from green tea leaves (C. sinensis).
Asunto(s)
Té/clasificación , Tintura Madre , Camellia sinensis/metabolismo , Plantas Medicinales/clasificación , Control de Calidad , Extractos Vegetales/administración & dosificación , Polifenoles/análisisRESUMEN
CONTEXT: Contaminated pharmaceutical products can result in substantial morbidity and mortality and should be included in the differential diagnosis of deaths of unknown origin. OBJECTIVE: To investigate an outbreak of deaths among children from acute renal failure in Haiti to determine the etiology and institute control measures. DESIGN: Case-control study, cohort study, and laboratory toxicologic evaluation. SETTING: Pediatric population of Haiti. PARTICIPANTS: Cases were defined as Haitian residents younger than 18 years with idiopathic anuria or severe oliguria for 24 hours or longer. Febrile hospitalized children without renal failure were enrolled as control subjects. MAIN OUTCOME MEASURE: The odds of exposure to suspected etiologic agents among cases and controls. RESULTS: We identified 109 cases of acute renal failure among children. The clinical syndrome included renal failure, hepatitis, pancreatitis, central nervous system impairment, coma, and death. Of 87 patients with follow-up information who remained in Haiti for treatment, 85 (98%) died; 3 (27%) of 11 patients transported to the United States for intensive care unit management died before hospital discharge. A locally manufactured acetaminophen syrup was highly associated with disease (odds ratio, 52.7; 95% confidence interval, 15.2-197.2). Diethylene glycol (DEG) was found in patients' bottles in a median concentration of 14.4%. The median estimated toxic dose of DEG was 1.34 mL/kg (range, 0.22-4.42 mL/kg). Glycerin, a raw material imported to Haiti and used in the acetaminophen formulation, was contaminated with 24% DEG. CONCLUSIONS: An epidemic of severe systemic toxicity and deaths from DEG-contaminated acetaminophen syrup occurred in Haiti. Good manufacturing practice regulations should be used by all pharmaceutical manufacturers to prevent such tragedies.