RESUMEN
Antecedentes: La gonartrosis es una patología degenerativa que limita de forma importante la funcionalidad de una persona. Se recurre al manejo quirúrgico cuando el paciente presenta una limitación funcional importante así como dolor intenso. La artroplastía de rodilla es una de las cirugías con mejores resultados funcionales en pacientes con esta patología, pero dentro de sus limitaciones está la posibilidad de un sangrado importante y, por consiguiente, la necesidad de hemotransfundir al paciente. El objetivo de este estudio fue evaluar la necesidad de hemotransfundir a los pacientes operados de artroplastía de rodilla que utilizaron recuperador sanguíneo en el postoperatorio y las diferencias entre los costos del recuperador sanguíneo y la transfusión clásica. Métodos: Estudio retrospectivo, transversal y retrolectivo de 300 expedientes de pacientes operados en el Hospital Ángeles de Querétaro de artroplastía de rodilla que utilizaron recuperador sanguíneo que requirieron hemotransfusión alogénica entre Octubre 2001 y Junio 2013. Resultados: De las 246 rodillas operadas, solamente tres requirieron hemotransfusión alogénica. Ninguna complicación/infección con el uso de recuperador sanguíneo. La edad promedio de los pacientes fue de 67.1 ± 9.78 años con un predominio femenino siendo éstos 141 (60.5%) en comparación con 92 (39.5%) masculinos. La sangre recolectada vía recuperador sanguíneo varió de 150 a 1,225 ml con un promedio de 318 ± 100.6 ml, la cual fue retransfundida a cada paciente. Conclusiones: El uso de recapturador sanguíneo en pacientes postoperados de artroplastía de rodilla disminuye de forma importante la necesidad de hemotransfusión alogénica.
Backgound: Gonarthrosis is a degenerative condition that importantly limits an individual's performance. Surgical treatment is used in patients with important functional limitation and severe pain. Knee arthroplasty is one of the surgeries with the best functional results in patients with this condition. However, its limitations include the risk of heavy bleeding and the resulting need for blood transfusion. The objective of this study was to assess the need for blood transfusion in patients undergoing knee arthroplasy in whom the cell saver was used postoperatively and find out the cost differences between the cell saver and standard blood transfusion. Methods: Retrospective, cross-sectional, retrolective trial including 300 records of patients who underwent knee arthroplasty at Hospital Ángeles Querétaro that included the use of the cell saver and allogeneic blood transfusion from October 2001 to June 2013. Results: Only 3 of the 246 operated knees required allogeneic blood transfusion. There were no complications/infections resulting from the use of the cell saver. Mean age of patients was 67.1 ± 9.78 years; females were predominant, as they were 141 (60.5%), compared to 92 (39.5%) males. The blood collected with the cell saver ranged from 150 to 1,225 ml with a mean of 318 ± 100.6 ml and was retransfused to each patient. Conclusions: Cell saver use in patients subjected to knee arthroplasty importantly decreases the need for allogeneic blood transfusion.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Artroplastia de Reemplazo de Rodilla , Recuperación de Sangre Operatoria/instrumentación , Estudios Transversales , Diseño de Equipo , Estudios RetrospectivosRESUMEN
BACKGOUND: Gonarthrosis is a degenerative condition that importantly limits an individua's performance. Surgical treatment is used in patients with important functional limitation and severe pain. Knee arthroplasty is one of the surgeries with the best functional results in patients with this condition. However, its limitations include the risk of heavy bleeding and the resulting need for blood transfusion. The objective of this study was to assess the need for blood transfusion in patients undergoing knee arthroplasy in whom the cell saver was used postoperatively and find out the cost differences between the cell saver and standard blood transfusion. METHODS: Retrospective, cross-sectional, retrolective trial including 300 records of patients who underwent knee arthroplasty at Hospital Angeles Querétaro that included the use of the cell saver and allogeneic blood transfusion from October 2001 to June 2013. RESULTS: Only 3 of the 246 operated knees required allogeneic blood transfusion. There were no complications/infections resulting from the use of the cell saver. Mean age of patients was 67.1 +/- 9.78 years; females were predominant, as they were 141 (60.5%), compared to 92 (39.5%) males. The blood collected with the cell saver ranged from 150 to 1,225 ml with a mean of 318 +/- 100.6 ml and was retransfused to each patient. CONCLUSIONS: Cell saver use in patients subjected to knee arthroplasty importantly decreases the need for allogeneic blood transfusion.
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Recuperación de Sangre Operatoria/instrumentación , Anciano , Estudios Transversales , Diseño de Equipo , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
INTRODUCTION: Obesity is an increasing problem of epidemic proportion, and it is associated with various musculoskeletal disorders, including impairment of the spine. However, the relationship between obesity and spino-pelvic parameters remains to date unsupported by an objective measurement of the mechanical behavior of the spino-pelvic parameters depending on body mass index (BMI) and the presence of central obesity. Such analysis may provide a deeper understanding of this relationship. PURPOSE: To assess whether BMI and central obesity are associated with modifications on spino-pelvic parameters and determine if exists any correlation between BMI and obesity with the type of lumbar lordosis (LL). METHODS: A cross-sectional study with 200 participants was conducted. Parameters measured were LL, pelvic tilt, sacral slope, and pelvic incidence (PI), using lumbosacral radiographs in lateral view. Subjects were classified depending on BMI. In a secondary analysis, the subjects were categorized into two groups depending on the presence or not of elevated abdominal circumference. The categorical variables were compared using Chi-square test, and the mean values were compared using ANOVA and student t test. A Spearman correlation test was used to analyze the correlation between BMI categories and LL types. RESULTS: From the total of participants, there were 51 (25.5 %) normal weight subjects, 93 (46.5 %) overweight, and 56 (28 %) obese individuals. The spino-pelvic parameters among these groups are practically equal. The correlation between the different BMI categories and LL types is poor 0.06 (P = 0.34). In a secondary analysis, grouping the participants in obese and non-obese, the results showed that obesity is modestly positively associated with increasing of spino-pelvic parameters values, in particular with PI (P = 0.078). The comparison made between the presence or not of central obesity, interestingly did not show significant differences. CONCLUSIONS: Despite the results did not reach statistically significant differences, the results indicate that the obese spine is slightly different from the non-obese spine. Therefore, this relationship deserves future attention.
Asunto(s)
Índice de Masa Corporal , Lordosis/diagnóstico por imagen , Lordosis/epidemiología , Obesidad Abdominal/complicaciones , Huesos Pélvicos/diagnóstico por imagen , Columna Vertebral/diagnóstico por imagen , Adulto , Análisis de Varianza , Fenómenos Biomecánicos/fisiología , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Humanos , Incidencia , Vértebras Lumbares/diagnóstico por imagen , Masculino , Obesidad Abdominal/fisiopatología , Sobrepeso/complicaciones , Radiografía , Factores de RiesgoRESUMEN
INTRODUCTION: 'Sword stroke' linear scleroderma, which is better known as linear scleroderma en coup de sabre (LSCS), is a rare disease with an uncertain causation that is characterised by progressive craniofacial focal atrophy and is, at least in part, different from Parry-Romberg syndrome (PRS). CASE REPORTS: Here, we report on the cases of 3 patients with LSCS (2 females and 1 male, with a mean age of 40 years). The main neurological symptoms were headache and seizures. Although different alterations were observed in the X-ray images, they were all ipsilateral to the coup de sabre. Histopathological evidence for gliosis and mixed perivascular inflammatory infiltrate was found in the study of a biopsy specimen taken from one female. Cerebrovascular involvement was seen in another patient, as highlighted by the observation of an earlier subclinical cerebellar infarct and occlusion of the superior cerebellar artery in the absence of any other possible causation. CONCLUSIONS: When it affects the central nervous system, the clinical and radiological presentation of LSCS is heterogeneous. Both the imaging studies carried out during the clinical control and the histopathological findings suggest a focal inflammatory process that can be progressive. The arterial involvement is probably due to a non-atherosclerotic, occlusive and chronic inflammatory disease of the peripheral vessels.
Asunto(s)
Esclerodermia Localizada , Adulto , Encéfalo/anatomía & histología , Encéfalo/patología , Femenino , Humanos , Inflamación/patología , Inflamación/fisiopatología , Masculino , Persona de Mediana Edad , Esclerodermia Localizada/diagnóstico , Esclerodermia Localizada/patología , Esclerodermia Localizada/fisiopatologíaRESUMEN
INTRODUCTION: Intracerebral haemorrhage (ICH) has received little attention in studies in Mexico. Isolated reports talk of high frequency, its importance as a disorder among young people, its being mainly located in the lobar regions and a high rate of recurrence. AIMS: The objective of this study was to characterise the clinical, radiological, therapeutic and prognostic spectrum of ICH in a general hospital in the central-western region of Mexico. PATIENTS AND METHODS: The study involved 270 consecutive patients over the age of 15 years with spontaneous ICH who were hospitalised in the Neurology and Neurosurgical Service in the Antiguo Hospital Civil de Guadalajara between the years 2000 and 2002. Their clinical history and progression was known at least on discharge from the hospital. RESULTS: The mean age was 63 years (12% under 40 years old) with no predominance according to gender (53% males). Arterial hypertension was the main risk factor in 69%, followed by obesity in 38%. There were no differences in the Glasgow administered on admission in three pre-established subgroups. The ICH was ganglionic in 64% of cases and lobar in 24%. Arterial hypertension was the principal cause of ICH in 76%. Ventricular aperture was noted in 53%. All the patients were treated in a general ward. Mortality in the acute phase occurred in 49%, although a poor progression was observed in 83%. Overall recurrence was 13%. Outpatient follow-up was poor. CONCLUSIONS: ICH shares most of the features reported in Anglo-Saxon series including aetiology and location. In our population, mortality and recurrence are high with important sequelae. The high frequency of ICH (40%) may represent a bias in the selection of hospitals.