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PURPOSE: This multicenter, retrospective cohort study aimed to compare the risk of ulnar nerve injury in pediatric supracondylar humeral fractures treated with percutaneous lateral-pins, blinded-crossed-pins, and crossed-pins with a mini-incision. METHODS: Data were collected from 1705 children treated between January 2010 and December 2023 at four orthopedic centers in Colombia. The incidence of postoperative ulnar nerve injury was compared among three fixation techniques: lateral-pin, blinded-crossed-pin, and crossed-pin with a mini-incision. RESULTS: A statistically significant difference in nerve injury rates was observed between the lateral-pin and both blinded-crossed-pin and mini-incision crossed-pin techniques (p < 0.001), with the lateral-pin technique demonstrating a significantly lower risk of injury. No significant difference was found between the blinded-crossed-pin and mini-incision crossed-pin techniques (p = 0.67). CONCLUSION: Crossed-pin fixation was associated with a higher incidence of ulnar nerve injury, regardless of the use of a mini-incision. The lateral-pin technique remains the safest option for minimizing iatrogenic nerve injury. There is insufficient evidence to support the mini-incision as a safer alternative to traditional crossed-pin fixation.
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Hilos Ortopédicos , Fijación Interna de Fracturas , Fracturas del Húmero , Nervio Cubital , Humanos , Fracturas del Húmero/cirugía , Niño , Estudios Retrospectivos , Masculino , Femenino , Fijación Interna de Fracturas/efectos adversos , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas/instrumentación , Nervio Cubital/lesiones , Preescolar , Traumatismos de los Nervios Periféricos/etiología , Traumatismos de los Nervios Periféricos/prevención & control , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/epidemiología , Incidencia , Clavos Ortopédicos/efectos adversos , Colombia/epidemiologíaRESUMEN
Introducción: La promoción de la actividad física en la juventud es fundamental para fomentar un estilo de vida saludable y prevenir enfermedades relacionadas con la inactividad. Objetivos: Analizar los niveles de actividad física que realizan los alumnos de Secundaria de un colegio concertado y observar sí existen diferencias según el curso escolar y el género. Métodos: Se ha utilizado para ello la versión modificada del Assessment of Physical Activity Level Questionnaire (APALQ). La muestra ha constado de 229 participantes (110 chicos y 119 chicas) de edades comprendidas entre los 12 y los 18 años, que cursan desde 1º de ESO a 1º de Bachiller. Resultados: Los resultados indican un nivel de actividad física superior al que se ha encontrado en otros estudios, especialmente para las chicas. Las diferencias en función del género son estadísticamente significativas (media total de 15,8 para los chicos y 13,4 para las chicas) mientras que las diferencias en función del curso escolar indican una disminución de la actividad en función de la edad, pero solo son estadísticamente significativas entre 1º ESO-4º ESO y entre 1º ESO y 1º de Bachiller Conclusiones: Se han obtenido unas cifras superiores de actividad física a las señaladas en otros trabajos sobre adolescentes, especialmente para las chicas, que pueden explicarse por la importancia que se da a la actividad física y al deporte.
Introduction: The promotion of physical activity in youth is essential to encourage a healthy lifestyle and prevent diseases related to inactivity. Objectives: to analyze the levels of physical activity performed by secondary school students in a charter school and to observe whether there are differences according to school year and gender. Methods: We used the modified version of the Assessment of Physical Activity Level Questionnaire (APALQ). The sample consisted of 229 participants (110 boys and 119 girls) aged between 12 and 18 years, from 1st ESO to 1st Bachillerato. Results: The results indicate a higher level of physical activity than has been found in other studies, especially for girls. Differences according to gender are statistically significant (total mean of 15.8 for boys and 13.4 for girls) while differences according to school year indicate a decrease in activity according to age, but are only statistically significant between 1st ESO-4th ESO and between 1st ESO and 1st Bachillerato. Conclusions: Higher physical activity figures have been obtained than those reported in other works on adolescents, especially for girls, which can be explained by the importance given to physical activity and sport.
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El sedimento urinario es una herramienta utilizada hace tantos años para caracterizar manifestaciones renales de enfermedades primarias y secundarias, que es necesario realizar una estandarización y aprender a interpretar el mismo. En los pacientes ingresados a la unidad de cuidados intensivos, muchas veces no se realiza, o hay que tener en cuenta varios factores para su interpretación debido al estado hemodinámico del paciente a la filtración glomerular, la excreción tubular, la reabsorción de agua y los solutos además del equilibrio acido-base, los cuales pueden variar significativamente en pacientes en estado crítico con diferentes condiciones fisiopatológicas. Se presenta una revisión de las condiciones para la interpretación del urianálisis.
A urinary sediment is a tool used for years to characterize renal manifestations of primary and secondary diseases, which requires standardization and learning to interpret it. In patients admitted to the intensive care unit, it is often not performed, or several factors must be taken into account for its interpretation due to the patient's hemodynamic status, glomerular filtration, tubular excretion, water reabsorption, and solutes. In addition to the acid-base balance, which can vary significantly in critically ill patients with different pathophysiological conditions? A review of the conditions for the interpretation of urinalysis is presented.
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El sedimento urinario es una herramienta utilizada hace tantos años para caracterizar manifestaciones renales de enfermedades primarias y secundarias, que es necesario realizar una estandarización y aprender a interpretar el mismo. En los pacientes ingresados a la unidad de cuidados intensivos, muchas veces no se realiza, o hay que tener en cuenta varios factores para su interpretación debido al estado hemodinámico del paciente a la filtración glomerular, la excreción tubular, la reabsorción de agua y los solutos además del equilibrio acido-base, los cuales pueden variar significativamente en pacientes en estado crítico con diferentes condiciones fisiopatológicas. Se presenta una revisión de las condiciones para la interpretación del urianálisis.
A urinary sediment is a tool used for years to characterize renal manifestations of primary and secondary diseases, which requires standardization and learning to interpret it. In patients admitted to the intensive care unit, it is often not performed, or several factors must be taken into account for its interpretation due to the patient's hemodynamic status, glomerular filtration, tubular excretion, water reabsorption, and solutes. In addition to the acid-base balance, which can vary significantly in critically ill patients with different pathophysiological conditions? A review of the conditions for the interpretation of urinalysis is presented.
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The slow-growing, nontuberculous mycobacterium Mycobacterium kumamotonense possesses two rRNA operons, rrnA and rrnB, located downstream from the murA and tyrS genes, respectively. Here, we report the sequence and organization of the promoter regions of these two rrn operons. In the rrnA operon, transcription can be initiated from the two promoters, named P1 rrnA and PCL1, while in rrnB, transcription can only start from one, called P1 rrnB. Both rrn operons show a similar organization to the one described in Mycobacterium celatum and Mycobacterium smegmatis. Furthermore, by qRT-PCR analyses of the products generated from each promoter, we report that stress conditions such as starvation, hypoxia, and cellular infection affect the contribution of each operon to the synthesis of pre-rRNA. It was found that the products from the PCL1 promoter of rrnA play a pivotal role in rRNA synthesis during all stress conditions. Interestingly, the main participation of the products of transcription from the P1 promoter of rrnB was found during hypoxic conditions at the NRP1 phase. These results provide novel insights into pre-rRNA synthesis in mycobacteria, as well as the potential ability of M. kumamotonense to produce latent infections.
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Precursores del ARN , Operón de ARNr , Operón de ARNr/genética , Secuencia de Bases , Regiones Promotoras Genéticas , ARN Ribosómico/genéticaRESUMEN
PURPOSE: We carried out a randomized, clinical trial in adults of both sexes with metabolic syndrome (MS) to assess the efficacy of high-intensity, low-volume interval training (HIIT) compared to moderate-intensity continuous training (MICT) on insulin resistance (IR), muscle mass, muscle activation, and serum musclin. METHODS: Fasting glycemia, insulinemia, and glycated haemoglobin were determined by conventional methods, IR by Homeostatic model assessment (HOMA), lean mass by Dual-Energy X-ray Absorptiometry, muscle activation through carnosine by Proton Magnetic Resonance Spectroscopy, and musclin by Enzyme-Linked ImmunoSorbent Assay before and after a supervised, three-times/week, 12-week treadmill programme. HIIT (n = 29) consisted of six intervals with one-minute, high-intensity phases at 90% of peak oxygen consumption (VO2peak). MICT (n = 31) trained at 60% of VO2peak for 30 min. RESULTS: Patients had a mean age of 50.8 ± 6.0 years, body mass index of 30.6 ± 4.0 kg/m2, and VO2peak of 29.0 ± 6.3 mL.kg-1.min-1. Compared to MICT, HIIT was not superior at reducing Ln HOMA-IR (adjusted mean difference: 0.083 [95%CI - 0.092 to 0.257]), carnosine or musclin or at increasing thigh lean mass. HIIT increased carnosine by 0.66 mmol/kg.ww (95% CI 0.08-1.24) after intervention. Both interventions reduced IR, body fat percentage and increased total lean mass/height2 and VO2peak. Musclin showed a non-significant reduction with a small effect size after both interventions. CONCLUSION: Compared to MICT, HIIT is not superior at reducing IR, carnosine or musclin or at increasing skeletal muscle mass in adults with MS. Both training types improved IR, muscle mass and body composition. NCT03087721, March 22nd, 2017. TRIAL REGISTRATION NUMBER: NCT03087721. Registered March 22nd, 2017.
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Entrenamiento de Intervalos de Alta Intensidad , Resistencia a la Insulina/fisiología , Síndrome Metabólico/prevención & control , Síndrome Metabólico/fisiopatología , Adulto , Biomarcadores/sangre , Carnosina/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas Musculares/sangre , Factores de Transcripción/sangreRESUMEN
More effective methods to detect bovine tuberculosis, caused by Mycobacterium bovis, in wildlife, is of paramount importance for preventing disease spread to other wild animals, livestock, and human beings. In this study, we analyzed the volatile organic compounds emitted by fecal samples collected from free-ranging wild boar captured in Doñana National Park, Spain, with an electronic nose system based on organically-functionalized gold nanoparticles. The animals were separated by the age group for performing the analysis. Adult (>24 months) and sub-adult (12-24 months) animals were anesthetized before sample collection, whereas the juvenile (<12 months) animals were manually restrained while collecting the sample. Good accuracy was obtained for the adult and sub-adult classification models: 100% during the training phase and 88.9% during the testing phase for the adult animals, and 100% during both the training and testing phase for the sub-adult animals, respectively. The results obtained could be important for the further development of a non-invasive and less expensive detection method of bovine tuberculosis in wildlife populations.
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Nariz Electrónica , Nanopartículas del Metal , Mycobacterium tuberculosis , Tuberculosis , Compuestos Orgánicos Volátiles , Animales , Animales Salvajes , Bovinos , Heces , Femenino , Oro , Humanos , Masculino , España , Sus scrofa , Porcinos , Tuberculosis/diagnóstico , Tuberculosis/veterinariaRESUMEN
Introducción La transfusión posoperatoria es una complicación frecuente de la artroplastia de rodilla. El ácido tranexámico (AT) ha demostrado eficacia en disminuir la probabilidad de sangrado, sin embargo, son pocos los estudios en cuanto al tema. Los objetivos del estudio son: 1) Comparar el efecto de dosis única de 1g de ácido tranexámico preoperatoria en la tasa de transfusión en pacientes a quienes se realizó artroplastia de rodilla entre enero de 2010 y diciembre de 2016. 2) Caracterizar población de pacientes a quienes se realizó artroplastia de rodilla. 3) Determinar tasa de transfusión sanguínea en grupos de estudio. 4) Determinar factores de riesgo para transfusión sanguínea en pacientes con artroplastia de rodilla. Materiales y Metodos Estudio observacional descriptivo de tipo corte transversal analítico retrospectivo. Resultados Tasa de transfusión en grupo sin AT=15,2%; en grupo con AT=1,2%. La sangre perdida y el tiempo quirúrgico no presentaron diferencias estadísticamente significativas entre los grupos (p>0,05). Se consideran factores de riesgo: anticoagulación (OR 3,52; IC95% 1,28-9,65), insuficiencia renal crónica (OR 5,91; IC95% 1,11-31,27) y artritis reumatoidea (OR 55,83; IC95% 18,34-169,91). Discusión Según regresión logística, la cantidad de sangre perdida y administración del AT pueden predecir con un 97.5% de acierto la probabilidad de transfusión ante presencia de artritis reumatoide. La pérdida sanguínea mayor a 400 cc aumenta significativamente la probabilidad de transfusión cuando no se administra AT. El uso de AT preoperatorio es efectivo en reducir la tasa de transfusión sanguínea en pacientes a quienes se realiza ATR. Nivel de Evidencia: III
Background Postoperative transfusion is a common complication of knee arthroplasty. Tranexamic acid has shown efficacy in reducing the probability of bleeding, however, there are few studies on the subject. The aims of the study are: 1) To compare the effect of a single dose of 1g of preoperative tranexamic acid on the transfusion rate in patients who underwent knee arthroplasty between January 2010 and December 2016. 2) Characterize the population of patients who underwent knee arthroplasty. 3) Determine blood transfusion rate in study groups. 4) Determine risk factors for blood transfusion in patients with knee arthroplasty. Methods A descriptive observational study of a retrospective analytical cross section type was performed. Results Group transfusion rate without TA=15.2%, group transfusion rate with TA=1.2%. The blood loss and the surgical time did not show statistically significant differences between the groups (p>0.05). The following are considered risk factors: anticoagulation (OR: 3.52; 95%CI 1.28-9.65), chronic renal failure (OR: 5.91; 95%CI 1.11-31.27) and rheumatoid arthritis (OR: 55.83; 95%CI 18.34-169.91). Discussion According to logistic regression, the amount of blood lost and administration of the TA can predict with a 97.5% accuracy the probability of transfusion in the presence of rheumatoid arthritis. Blood loss greater than 400 cc significantly increases the probability of transfusion when TA is not administered. The use of preoperative TA is effective in reducing the rate of blood transfusion in patients who undergo ATR Evidence Level: III
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Humanos , Transfusión Sanguínea , Artroplastia , Ácido Tranexámico , RodillaRESUMEN
We present here the first study that directly correlates gastric cancer (GC) with specific biomarkers in the exhaled breath composition on a South American population, which registers one of the highest global incidence rates of gastric affections. Moreover, we demonstrate a novel solid state sensor that predicts correct GC diagnosis with 97% accuracy. Alveolar breath samples of 30 volunteers (patients diagnosed with gastric cancer and a controls group formed of patients diagnosed with other gastric diseases) were collected and analyzed by gas-chromatography/mass-spectrometry (GC-MS) and with an innovative chemical gas sensor based on gold nanoparticles (AuNP) functionalized with octadecylamine ligands. Our GC-MS analyses identified 6 volatile organic compounds that showed statistically significant differences between the cancer patients and the controls group. These compounds were different from those identified in previous studied performed on other populations with high incidence rates of this malady, such as China (representative for Eastern Asia region) and Latvia (representative for Baltic States), attributable to lifestyle, alimentation and genetics differences. A classification model based on principal component analysis of our sensor data responses to the breath samples yielded 97% accuracy, 100% sensitivity and 93% specificity. Our results suggest a new and non-intrusive methodology for early diagnosis of gastric cancer that may be deployed in regions lacking well-developed health care systems as a prediagnosis test for selecting the patients that should undergo deeper investigations (e.g., endoscopy and biopsy).
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Erupción dentaria es el movimiento del diente desde su alveolo hasta hacer su aparición en la cavidad bucal; toda pieza dentaria tiene su orden de aparición en la cavidad bucal lo cual llamamos secuencia de erupción, también tienen una edad de erupción lo que se conoce como cronología de erupción dentaria. Este estudio fue enfocado principalmente a Caninos permanentes y premolares, y permitió reflejar una tabla de resultados, los cuales determinaron que existe una variación respecto a datos sobre secuencia y rangos cronológicos de erupción realizados por diversos autores en poblaciones diferentes a la nuestra. El presente trabajo de investigación aportó los resultados del estudio de 140 radiografías panorámicas de pacientes que asistieron a las clínicas de la Facultad de Odontología de la Universidad de El Salvador en los años 2006-2008, 77 del sexo femenino y 63 del sexo masculino, sobre la secuencia y rangos cronológicos de erupción dentaria en esta población. Los resultados reflejaron que la secuencia de erupción predominante para el arco superior fue la siguiente: Primer premolar, Segundo premolar y Canino permanente con un 85.71%, que coincide con la que determinan los diversos autores. En el arco inferior fue: Primer premolar, Segundo premolar y Canino permanente con un 45%, la cual difiere de la establecida por la mayoría de autores. Concluimos que existen características en cada población que determinan la secuencia y los rangos cronológicos de erupción dentaria, las cuales difieren a la nuestra y se reflejan en este trabajo de investigación
Dental eruption is the movement of the tooth from its socket until it appears in the oral cavity; Every tooth has its order of appearance in the oral cavity, which we call an eruption sequence. They also have an eruption age, which is known as a dental eruption chronology. This study was mainly focused on permanent canines and premolars, and allowed to reflect a table of results, which determined that there is a variation with respect to data on sequence and chronological ranges of eruption carried out by various authors in populations other than ours. The present research work provided the results of the study of 140 panoramic radiographs of patients who attended the clinics of the Faculty of Dentistry of the University of El Salvador in the years 2006-2008, 77 of the female gender and 63 of the male gender, on the sequence and chronological ranges of tooth eruption in this population. The results reflected that the predominant eruption sequence for the upper arch was the following: First premolar, Second premolar and Permanent canine with 85.71%, which coincides with that determined by the various authors. In the lower arch it was: First premolar, Second premolar and Permanent canine with 45%, which differs from that established by most authors. We conclude that there are characteristics in each population that determine the sequence and chronological ranges of tooth eruption, which differ from ours and are reflected in this research work.
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Erupción Dental , Facultades de Odontología , Odontología Pediátrica , Diente Canino , El SalvadorRESUMEN
En el Hospital Universitario Clínica San Rafael fueron reportadas setenta y ocho artroplastias infectadas, entre los años 1999 y 2004; 27 (34,6%) corresponden a infecciones en reemplazos totales de cadera primarios cumpliendo criterios de inclusión: infección protésica confirmada con cultivo positivo y con un seguimiento mínimo de un año después del tratamiento definitivo de la infección. Para su tratamiento existen seis procedimientos básicos: supresión antibiótica, desbridamiento quirúrgico, artroplastia de resección, artrodesis, reimplante de otra prótesis y amputación; la elección de cualquiera de estas estrategias depende de variables como el tiempo de infección, la condición del paciente, los estudios bacteriológicos, y el estado local de los tejidos blandos y del hueso, variables que están en la clasificación de Coventry, la cual fue utilizada como guía para la elección terapéutica. Once pacientes (37%) necesitaron desbridamiento quirúrgico como único tratamiento para el control de la infección; catorce pacientes necesitaron dos procedimientos: lavado quirúrgico y reimplante de otra prótesis, y a dos pacientes se les practicó artroplastia de resección. Todos los pacientes recibieron terapia antibiótica de acuerdo con la sensibilidad del antibiograma. El germen más frecuente en los cultivos fue el estafilococo aureus en un 48%. La infección fue erradicada en el 70,4% de los casos, y se relacionó con resultados buenos y excelentes, según la escala funcional de Harris.
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Artroplastia de Reemplazo de Cadera , Infecciones Bacterianas , Infección de la Herida Quirúrgica , Infecciones Estafilocócicas , Staphylococcus aureus , ColombiaRESUMEN
Introducción. Las conductas disruptivas son frecuentes en más de la mitad de los pacientes pediátricos con epilepsia, impactan sobre su funcionamiento psicosocial global y provocan el rechazo de la sociedad. El presente estudio plantea la posibilidad de coadyuvar en el tratamiento integral de los niños con epilepsia mediante el empleo de risperidona. Material y métodos. Se seleccionaron pacientes pediátricos epilépticos (con epilepsia parcial o generalizada) que presentaban conductas disruptivas asociadas, hombres y mujeres con edades comprendidas entre los 5 y 14 años, captados en la consulta externa de Neurología del Hospital Infantil de México Federico Gómez. Se realizó un estudio clínico abierto, prospectivo, con seguimiento durante 4 semanas. Se les administró risperidona, cuya eficacia se evaluó mediante las escalas de mejoría clínica global, la de Peers y la de ADHD-RS. Se midieron el número de crisis y los efectos secundarios con la escala de Yale. Resultados. Se estudiaron 23 pacientes, 7 femeninos y 16 masculinos con una relación M:F de 1.5:1 ,todos con diagnóstico de epilepsia (parcial 19 y generalizada 4). La dosis promedio de risperidona fue de 0.75 mg/día, se hizo un seguimiento de 4 semanas, con respuesta favorable al final del mes en 91% de los pacientes. Los efectos indeseables observados fueron: incremento ponderal en 12 niños, además de síntomas extrapiramidales (discinesias de cabeza y cuello), sialorrea, sed y somnolencia. Conclusión. En el manejo agudo de conductas disruptivas en pacientes pediátricos con epilepsia, la risperidona mostró ser efectiva y segura.
Introduction. Disruptive behavior (DB) is frequent in pediatric patients with epilepsy.This conducts impacts on the functioning of the children, and often leads to their social rejection. The objectives of this study were to observe the efficacy and safety of risperidone in the treatment of acute disruptive behavior in pediatric patients with epilepsy. Material and methods. A clinical open label, prospective study with a month follow up was carried out. Pediatric patients with epilepsy (partial or generalized) and disruptive behavior, both gender, between 5 and 14 years of age seen in the neurology department, Hospital Infantil de Mexico, were enrolled.The efficacy was evaluated with CGI, Peers scale and ADHD RS. Number of seizures and secondary effects was evaluated with the same methods. Results. A total of 23 patients, 7 females and 16 males enter the study with a relation M:F of 1.5:1. All the patients had epilepsy, either partial or generalized.The average doses of risperidone was 0.75 mg/kg/d, with and efficacy of 91 % at the final of the 4 weeks follow up.The more frequent side effects were increase in weight in 12 patients, extrapiramidal symptoms (head and neck discinesias) sialorrhea, thirst and somnolence. Conclusions. With these results, we support in this clinic open label study, the efficacy and safety of the use of risperidone in the management of acute disruptive behaviors in pediatric patients with epilepsy.