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INTRODUCTION: fractures involving the posterior malleolus (PM) of the ankle can have significant functional and clinical implications if not properly treated. The optimal treatment approach for these fractures remains uncertain. This review aims to compare the use of cannulated screws versus plate with screw fixation in terms of their impact on the development of postoperative ankle osteoarthritis and functional outcomes in patients with PM fractures. MATERIAL AND METHODS: a comprehensive search was conducted in PubMed, EMBASE, and Cochrane Library databases to identify studies directly comparing cannulated screws versus plate with screw fixation for PM fractures and their association with the development of postoperative osteoarthritis and functional outcomes. The quality of the included studies was assessed using appropriate assessment tools. The data on osteoarthritis development and functional outcomes were extracted and analyzed. RESULTS: a total of 691 articles were screened, and several studies were included for analysis. The findings revealed no statistically significant difference in the development of postoperative ankle osteoarthritis between the cannulated screws and plate with screw fixation groups. Similarly, there was no significant difference in functional outcomes between the two treatment approaches. CONCLUSION: based on the available evidence, there is no significant difference in the development of postoperative ankle osteoarthritis or functional outcomes between cannulated screws and plate with screw fixation for PM fractures. However, further research is needed to strengthen these findings and provide more conclusive evidence.
INTRODUCCIÓN: las fracturas que involucran el maléolo posterior (MP) del tobillo pueden tener importantes implicaciones funcionales y clínicas si no se tratan adecuadamente. El enfoque de tratamiento óptimo para estas fracturas sigue siendo incierto. El objetivo de esta revisión es comparar el uso de tornillos canulados versus placa con fijación de tornillos en cuanto a su impacto en el desarrollo de la osteoartrosis de tobillo postoperatoria y los resultados funcionales en pacientes con fracturas del MP. MATERIAL Y MÉTODOS: se realizó una búsqueda exhaustiva en las bases de datos de PubMed, EMBASE y Cochrane Library para identificar estudios que compararan directamente tornillos canulados versus placa con fijación de tornillos para fracturas de MP y su asociación con el desarrollo de osteoartrosis postoperatoria y los resultados funcionales. La calidad de los estudios incluidos se evaluó utilizando herramientas de evaluación adecuadas. Los datos sobre el desarrollo de osteoartrosis y los resultados funcionales se extrajeron y analizaron. RESULTADOS: se revisaron un total de 691 artículos y se incluyeron varios estudios para su análisis. Los hallazgos revelaron que no hay una diferencia estadísticamente significativa en el desarrollo de osteoartrosis de tobillo postoperatoria entre los grupos de tornillos canulados y placa con fijación de tornillos. Del mismo modo, no hubo una diferencia significativa en los resultados funcionales entre los dos enfoques de tratamiento. CONCLUSIÓN: según la evidencia disponible, no hay una diferencia significativa en el desarrollo de osteoartrosis de tobillo postoperatoria o en los resultados funcionales entre los tornillos canulados y la placa con fijación de tornillos para las fracturas del MP. Sin embargo, se necesita más investigación para fortalecer estos hallazgos y proporcionar evidencia más concluyente.
Asunto(s)
Fracturas de Tobillo , Osteoartritis , Humanos , Fijación Interna de Fracturas , Fracturas de Tobillo/cirugía , Placas Óseas , Tornillos Óseos , Osteoartritis/cirugía , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
Abstract: Introduction: fractures involving the posterior malleolus (PM) of the ankle can have significant functional and clinical implications if not properly treated. The optimal treatment approach for these fractures remains uncertain. This review aims to compare the use of cannulated screws versus plate with screw fixation in terms of their impact on the development of postoperative ankle osteoarthritis and functional outcomes in patients with PM fractures. Material and methods: a comprehensive search was conducted in PubMed, EMBASE, and Cochrane Library databases to identify studies directly comparing cannulated screws versus plate with screw fixation for PM fractures and their association with the development of postoperative osteoarthritis and functional outcomes. The quality of the included studies was assessed using appropriate assessment tools. The data on osteoarthritis development and functional outcomes were extracted and analyzed. Results: a total of 691 articles were screened, and several studies were included for analysis. The findings revealed no statistically significant difference in the development of postoperative ankle osteoarthritis between the cannulated screws and plate with screw fixation groups. Similarly, there was no significant difference in functional outcomes between the two treatment approaches. Conclusion: based on the available evidence, there is no significant difference in the development of postoperative ankle osteoarthritis or functional outcomes between cannulated screws and plate with screw fixation for PM fractures. However, further research is needed to strengthen these findings and provide more conclusive evidence.
Resumen. Introducción: las fracturas que involucran el maléolo posterior (MP) del tobillo pueden tener importantes implicaciones funcionales y clínicas si no se tratan adecuadamente. El enfoque de tratamiento óptimo para estas fracturas sigue siendo incierto. El objetivo de esta revisión es comparar el uso de tornillos canulados versus placa con fijación de tornillos en cuanto a su impacto en el desarrollo de la osteoartrosis de tobillo postoperatoria y los resultados funcionales en pacientes con fracturas del MP. Material y métodos: se realizó una búsqueda exhaustiva en las bases de datos de PubMed, EMBASE y Cochrane Library para identificar estudios que compararan directamente tornillos canulados versus placa con fijación de tornillos para fracturas de MP y su asociación con el desarrollo de osteoartrosis postoperatoria y los resultados funcionales. La calidad de los estudios incluidos se evaluó utilizando herramientas de evaluación adecuadas. Los datos sobre el desarrollo de osteoartrosis y los resultados funcionales se extrajeron y analizaron. Resultados: se revisaron un total de 691 artículos y se incluyeron varios estudios para su análisis. Los hallazgos revelaron que no hay una diferencia estadísticamente significativa en el desarrollo de osteoartrosis de tobillo postoperatoria entre los grupos de tornillos canulados y placa con fijación de tornillos. Del mismo modo, no hubo una diferencia significativa en los resultados funcionales entre los dos enfoques de tratamiento. Conclusión: según la evidencia disponible, no hay una diferencia significativa en el desarrollo de osteoartrosis de tobillo postoperatoria o en los resultados funcionales entre los tornillos canulados y la placa con fijación de tornillos para las fracturas del MP. Sin embargo, se necesita más investigación para fortalecer estos hallazgos y proporcionar evidencia más concluyente.
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Resumen Objetivo: Reportar y caracterizar las complicaciones quirúrgicas de las apendicectomías laparoscópicas electivas profilácticas, realizadas a pacientes destinados a dotación antártica, realizadas en Hospital clínico de la Fuerza Aérea de Chile (FACh). Materiales y Método: Análisis retrospectivo descriptivo de fichas clínicas de todos los pacientes sometidos a apendicectomía laparoscópica profiláctica entre los años 2013 y 2017 en Hospital FACh. Se registraron variables demográficas y quirúrgicas de los pacientes. Las complicaciones fueron registradas y clasificadas de acuerdo a Clavien-Dindo. Resultados: Se incluyeron 200 pacientes, 96% hombres y solo 4% mujeres. Se registraron 6 pacientes (3%) con complicaciones quirúrgicas, clasificadas como grado I según Clavien-Dindo. Discusión: No existen reportes de complicaciones en apendicectomías profilácticas. En nuestra serie éstas alcanzan el 3%. Conclusiones: La apendicectomía profiláctica es una cirugía segura, con escasas complicaciones, pero existen y se desarrollan en un paciente que estaba previamente sano.
Aim: To present and characterize surgical complications of elective prophylactic appendectomies, performed in patients for the Antarctic endowment at the Hospital Clínico de la Fuerza Aérea de Chile. Materials and Method: Retrospective descriptive analysis of all patients operated of prophylactic laparoscopic appendectomy between 2013 and 2017. Demographic and surgical variables of the patients were recorded and analysed. Complications were classified according Clavien-Dindo. Results: 200 patients were included, 96% mens. Six patients (3%) had a surgical complication, all classified as Grade I. Discussion: There are no previous reports of surgical complications on prophylactics appendectomies. The complications rate is 3%. Conclusions: The prophylactic appendectomy is a safe surgery with a low rate of complications, although its exists and develops in a previously healthy patient.
Asunto(s)
Humanos , Masculino , Femenino , Apendicectomía/métodos , Procedimientos Quirúrgicos Profilácticos/efectos adversos , Apendicectomía/efectos adversos , Chile , Estudios Retrospectivos , Procedimientos Quirúrgicos Electivos/efectos adversos , Procedimientos Quirúrgicos Profilácticos/métodosRESUMEN
Species of the allocreadiid genus Creptotrema are parasites of freshwater fishes in the Americas. Species in the genus possess one pair of muscular oral lobes on the oral sucker. Currently, the genus contains eight species, six distributed in South America, one in Middle America and one in North America. Genetic data are only available for the North American species, Creptotrema funduli, a parasite of fundulids originally described from Oneida Lake, New York State. In this study, we obtained 28S ribosomal DNA sequences of trematodes morphologically similar to Creptotrema agonostomi from the mountain mullet, Dajaus monticola, across a wide geographical range in Middle America. Our molecular phylogenetic analyses showed that (1) the genus Creptotrema, as currently conceived, is not monophyletic; (2) the allocreadiids in mountain mullets should be re-allocated in the genus Pseudoparacreptotrema; and (3) the allocreadiid trematodes from D. monticola across Middle America represent four morphologically similar species, three of which can be distinguished genetically. These three new species are described herein using an integrative taxonomy approach. We contend that accurate estimates of species diversity and phylogenetic relationships among allocreadiids, and most likely other species of trematodes, necessarily require an integrative taxonomy approach that should consider at least DNA sequences and scanning electron microscopy.
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Peces/parasitología , Lagos/parasitología , Filogenia , Trematodos/clasificación , Infecciones por Trematodos/veterinaria , Américas , Animales , ADN de Helmintos/genética , Enfermedades de los Peces/parasitología , Variación Genética , ARN Ribosómico 28S/genética , Trematodos/anatomía & histología , Trematodos/aislamiento & purificaciónRESUMEN
A túnica vaginal possui características ideais para enxertia e já foi empregada na reparação de diversos tecidos, inclusive do diafragma pélvico. Objetivou-se avaliar a aplicabilidade da túnica vaginal como enxerto autógeno livre, em dupla camada, para a reparação do diafragma pélvico em 14 cães portadores de hérnia perineal, das quais, nove eram unilaterais e cinco, bilaterais. Após a orquiectomia, as túnicas de ambos os testículos foram coletadas, sobrepostas e fixadas entre si por meio de quatro pontos de reparo. Foi realizada abordagem ao saco herniário, inspeção, redução do conteúdo herniário, desbridamento muscular e síntese primária mediante sutura. O enxerto foi fixado à musculatura remanescente por meio de pontos simples separados e, posteriormente, encoberto pela sutura intradérmica e por síntese cutânea. Observações transoperatórias e, posteriormente, avaliações clínicas e ultrassonográficas, por período de um ano, permitiram sugerir que a túnica vaginal possui atributos ideais para a reparação do diafragma pélvico. Conclui-se que o enxerto autógeno livre de túnica vaginal, em dupla camada, é exequível e aplicável para o reparo do diafragma pélvico no tratamento da hérnia perineal em cães.(AU)
The tunica vaginalis has ideal characteristics for grafting and has already been used to repair several tissues, including the pelvic diaphragm. The aim of this study was to evaluate the applicability of the tunica vaginalis as a free double-layer autogenous graft to repair the pelvic diaphragm in 14 dogs with perineal hernia, of which, nine were unilateral and five, bilateral. After orchiectomy, the tunics of both testicles were collected, overlapped and fixed to each other by four repair points. The hernial sac was approached, followed by inspection, reduction of the hernia content, muscle debridement and primary synthesis through suture. The graft was attached to the remaining musculature by simple interrupted stitches and later hidden by intradermal suture and cutaneous synthesis. Intraoperative observations and, later, clinical and sonographic evaluations over a one-year period, allow to suggest that the tunica vaginalis has ideal attributes for the pelvic diaphragm repair. It is concluded that the autogenous graft-free of tunica vaginalis in double layer is feasible and applicable in order to repair the pelvic diaphragm in the perineal hernia treatment in dogs.(AU)
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Animales , Perros , Peritoneo/trasplante , Diafragma Pélvico/cirugía , Hernia/veterinaria , Herniorrafia/veterinariaRESUMEN
A túnica vaginal possui características ideais para enxertia e já foi empregada na reparação de diversos tecidos, inclusive do diafragma pélvico. Objetivou-se avaliar a aplicabilidade da túnica vaginal como enxerto autógeno livre, em dupla camada, para a reparação do diafragma pélvico em 14 cães portadores de hérnia perineal, das quais, nove eram unilaterais e cinco, bilaterais. Após a orquiectomia, as túnicas de ambos os testículos foram coletadas, sobrepostas e fixadas entre si por meio de quatro pontos de reparo. Foi realizada abordagem ao saco herniário, inspeção, redução do conteúdo herniário, desbridamento muscular e síntese primária mediante sutura. O enxerto foi fixado à musculatura remanescente por meio de pontos simples separados e, posteriormente, encoberto pela sutura intradérmica e por síntese cutânea. Observações transoperatórias e, posteriormente, avaliações clínicas e ultrassonográficas, por período de um ano, permitiram sugerir que a túnica vaginal possui atributos ideais para a reparação do diafragma pélvico. Conclui-se que o enxerto autógeno livre de túnica vaginal, em dupla camada, é exequível e aplicável para o reparo do diafragma pélvico no tratamento da hérnia perineal em cães.(AU)
The tunica vaginalis has ideal characteristics for grafting and has already been used to repair several tissues, including the pelvic diaphragm. The aim of this study was to evaluate the applicability of the tunica vaginalis as a free double-layer autogenous graft to repair the pelvic diaphragm in 14 dogs with perineal hernia, of which, nine were unilateral and five, bilateral. After orchiectomy, the tunics of both testicles were collected, overlapped and fixed to each other by four repair points. The hernial sac was approached, followed by inspection, reduction of the hernia content, muscle debridement and primary synthesis through suture. The graft was attached to the remaining musculature by simple interrupted stitches and later hidden by intradermal suture and cutaneous synthesis. Intraoperative observations and, later, clinical and sonographic evaluations over a one-year period, allow to suggest that the tunica vaginalis has ideal attributes for the pelvic diaphragm repair. It is concluded that the autogenous graft-free of tunica vaginalis in double layer is feasible and applicable in order to repair the pelvic diaphragm in the perineal hernia treatment in dogs.(AU)
Asunto(s)
Animales , Perros , Peritoneo/trasplante , Diafragma Pélvico/cirugía , Hernia/veterinaria , Herniorrafia/veterinariaRESUMEN
INTRODUCTION.: Hallux valgus (HV) is a complex forefoot pathology, in which interest has recently been shown in the distal rotational component (CR) of the first metatarsal due to its relationship with postsurgical relapses of the deformity. The selection of surgical technique is controversial with little current literature on the correction of rotation with common osteotomies. The aim of this study is to evaluate preoperative and postoperative radiological characteristics regarding CR of the first metatarsal using long Chevron osteotomy for moderate to severe HV. MATERIAL AND METHODS: An observational, prospective and comparative study was carried out in which the CR of the first metatarsal was evaluated in nine feet belonging to six patients with a mean age of 45 years. The RC was evaluated based on the proximal metaphysis of the first metatarsal in axial fluoroscopies of unloaded metatarsals and standing AP. Measurements were performed by an Orthopedic and Traumatology resident and a Foot and Ankle Surgery subspecialist. RESULTS: Significant differences (p = 0.05) were documented in the preoperative and postoperative pronation angle when using long Chevron osteotomy. The functional result of the evaluated patients was excellent at 11 months of follow-up. CONCLUSIONS: Radiologically, the rotational correction is variable and has not previously been reported in the literature with this osteotomy. We establishes the morphological bases for the performance of subsequent studies in the evaluation of head rotation of the 1st metatarsal with different osteotomies.
INTRODUCCIÓN: Hallux valgus (HV) es una patología compleja del antepié, recientemente se ha mostrado interés en el componente rotacional (CR) distal del primer metatarsiano por su relación con recidivas postquirúrgicas de la deformidad. La selección de la técnica quirúrgica es controversial con escasa literatura acerca de la corrección de rotación con osteotomías comunes. Nuestro objetivo es evaluar características radiológicas prequirúrgicas y postquirúrgicas respecto a CR del primer metatarsiano en la cirugía de corrección de HV moderado a severo usando osteotomía de Chevron largo. MATERIAL Y MÉTODOS: Estudio observacional, prospectivo y comparativo en el que se evaluó el CR del primer metatarsiano en nueve pies pertenecientes a seis pacientes con una edad media de 45 años. El CR fue evaluado con base en la metáfisis proximal del primer metatarsiano en fluoroscopías axiales sin carga y AP de pie. Las mediciones se realizaron por un residente de ortopedia y traumatología y un subespecialista en cirugía de pie y Tobillo. RESULTADOS: Se documentaron diferencias significativas (p = 0.05) en el ángulo de pronación prequirúrgico y postquirúrgico al utilizar osteotomía de Chevron largo. El resultado funcional de los pacientes evaluados fue excelente a 11 meses de seguimiento. CONCLUSIONES: Radiológicamente, la corrección rotacional es variable y previamente no se ha reportado en la literatura con esta osteotomía. Se establecen bases morfológicas para la realización de estudios posteriores en la evaluación de rotación de cabeza del primer metatarsiano con diferentes osteotomías.
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Hallux Valgus , Huesos Metatarsianos , Hallux Valgus/diagnóstico por imagen , Hallux Valgus/cirugía , Humanos , Huesos Metatarsianos/diagnóstico por imagen , Huesos Metatarsianos/cirugía , Persona de Mediana Edad , Osteotomía , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Resumen Introducción: La actinomicosis, es una infección crónica rara producida por bacterias del género Actinomyces sp. La afectación pélvica es una de sus formas más infrecuentes y en gran parte de los casos se relaciona al uso de un dispositivo intrauterino de larga data o a una cirugía previa. Como otras enfermedades raras, la infección es conocida como "la gran imitadora" por su variada forma de presentación y particular comportamiento pudiendo simular una neoplasia. El tratamiento es fundamentalmente médico y de buenos resultados. Caso Clínico: Damos a conocer el caso de una paciente que se presentó con un cuadro compatible con un tumor de recto, pero que resultó ser actinomicosis. El diagnóstico se realizó en base a la tinción de Gram, el cuadro clínico y el antecedente de un dispositivo intrauterino abandonado por más de 25 años. Fue corroborado posteriormente mediante anatomía patológica y tratada en forma exitosa con antibióticos por un periodo extendido. Conclusión: Si bien la actinomicosis es una patología infrecuente, debe ser considerada en el diagnóstico diferencial de los pacientes que se presentan con tumores de la pelvis. Un alto índice de sospecha y una actitud diagnóstica activa son fundamentales para un tratamiento oportuno, seguro y eficaz de esta enfermedad.
Introduction: Actinomycosis is a rare chronic infection caused by bacterias of the genus Actinomyces sp. Pelvic involvement is one of its most infrequent forms and in many cases it is related to the use of a longstanding intrauterine device or a previous surgery. Like other rare diseases, the infection is known as "the great imitator" because of its varied form of presentation and its particular behavior, which can simulate a neoplasm. The treatment is fundamentally medical with good results. Case Report: We present the case of a patient who presented with a rectal tumor but that turned out to be Actinomycosis. The diagnosis was made based on the Gram stain, the clinical presentation and the history of an intrauterine device left for more than 25 years. It was subsequently corroborated by pathological anatomy and successfully treated with antibiotics for an extended period. Conclusion: Although actinomycosis is an infrequent pathology, it should be considered in the differential diagnosis of patients who present with tumors of the pelvis. An active diagnostic attitude and a high index of suspicion are fundamental for the timely, safe and effective treatment of this disease.
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Humanos , Femenino , Persona de Mediana Edad , Actinomyces/aislamiento & purificación , Actinomicosis/etiología , Neoplasias Ováricas/diagnóstico , Actinomicosis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Colonoscopía , Diagnóstico Diferencial , Dispositivos Intrauterinos/efectos adversos , Dispositivos Intrauterinos/microbiologíaRESUMEN
RESUMEN Mujer en cuarta década de la vida, con antecedente de hipotiroidismo, tuberculosis latente y artritis reumatoide, quien no responde a manejo inmunomodulador crónico con distintos esquemas terapéuticos, es valorada por grupo interdisciplinar de endocrinología, medicina interna, medicina del deporte y psicología evidenciando sobrepeso, con alteración de la masa muscular esquelética, masa grasa, grasa visceral y en exámenes complementarios una inadecuada excursión de la glucosa con insulina basal elevada. Se orienta manejo con estrategia nutricional, deportiva y cognitivo conductual logrando resolución de los síntomas y suspensión del tratamiento farmacológico.
ABSTRACT 35 years old woman, with personal history of hypothyroidism, latent tuberculosis and rheumatoid arthritis, who does not respond to chronic immunomodulatory management with different therapeutic schemes, is valued by an interdisciplinary group of endocrinology, internal medicine, sports medicine and psychology, evidencing overweight, with alteration in skeletal muscle mass, fat mass, visceral fat and laboratories with inadequate excursion of glucose with high basal insulin. The management was oriented with nutritional, sports and cognitive behavioral strategy achieving resolution of symptoms and suspension of pharmacological treatment.
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Introducción El trauma de pene tiene una variedad de presentaciones, no siempre de origen sexual con diversas implicaciones anatómicas y funcionales para él. Objetivo Describir los hallazgos en un grupo de pacientes de "Cavernosopatía traumática aguda" (CTA), desde el punto de vista clínico y ecográfico y sus desenlaces. Métodos Se realizó un estudio retrospectivo de un grupo de 38 pacientes que consultaron por CTA en un período de 20 años (1998-2018) en una consulta de medicina sexual en Medellín-Colombia. La condición para ser incluidos, era el antecedente en el tiempo de un trauma agudo y mayor del pene. Se evaluaron el tipo de trauma y variables relacionadas (crack audible, hematoma, fractura albugínea, ruptura del ligamento suspensorio, necesidad de cirugía); hallazgos clínicos (curvaturas, escotaduras, acortamiento); hallazgos ecográficos (Fibrosis peneana, fugas venosas) y otros desenlaces (disfunción eréctil). El estudio contó con la aprobación del comité de ética en investigación del HPTU. Resultados Se estudiaron 38 pacientes con diagnóstico de CTA. Edad de consulta: 42 y edad del trauma 38,7 años, promedio. Trauma sexual (TS): 23 pacientes (60,5%), No sexual (TNS): 15 pacientes (39,4%). Hematomas: 22 (57,8%); fractura albugínea: 16 (42,1%); ruptura del ligamento suspensorio: 2 (5,2%); curvatura secundaria: 14 (36,8%); nódulos palpables: 13 (34,2%); acortamiento: 11 (28,9%); crack audible: 13 (34,2%); algún grado de disfunción eréctil: 26 (68,4%); necesidad de cirugía urgente: 6 (15,78%). En los 31 (81,5%) pacientes que tuvieron una ECO peneana como parte de su estudio tenemos, hallazgo de fibrosis: 25/31 (80,6%); fugas venosas cavernosas: 5/31 (16,1%) e hipervascularización 10/31 (32,2%). Conclusiones La Cavernosopatía traumática aguda (CTA) es una denominación adecuada para el síndrome que desencadena un trauma peneano agudo, que puede incluir secuelas como fibrosis peneana (hasta el 80%), curvaturas secundarias (hasta el 38%), acortamiento, fugas venosas y disfunción eréctil (hasta 70% de los casos). Entre 6/10 de esos traumas, son de índole sexual y el resto son un grupo variopinto de traumas (automovilísticos, deportivos, quemaduras, ataques de animales)
Introduction Penis trauma has a variety of presentations, not always of sexual origin with various anatomical and functional implications for the penis. ObjectiveTo describe the findings in a group of patients of "acute traumatic Cavernosophaty", from the clinical and echographics point of view and their outcomes. Methods A retrospective study of a group of 38 patients who consulted by CTA in a period of 20 years (1998-2018) in a sexual medicine clinic in Medellin, Colombia, was conducted. The condition to be included was the antecedent in time of an acute and major trauma of the penis. The type of trauma and related variables were evaluated (audible crack, hematoma, albuginea fracture, rupture of the suspensory ligament, need for surgery); clinical findings (curvatures, notches, shortening); ultrasound findings (penile fibrosis, venous leaks) and other outcomes (erectile dysfunction). The study was approved by the research ethics committee of the HPTU. Results Thirty-eight patients with diagnosis of CTA were studied. Age of consultation: 42 and age of the trauma 38.7 years, average. Sexual trauma (TS): 23 patients (60.5%), Non-sexual (TNS): 15 patients (39.4%). Haematoma: 22 (57.8%); albugineal fracture: 16 (42.1%); rupture of the suspensory ligament: 2 (5.2%); secondary curvature: 14 (36.8%); palpable nodules: 13 (34.2%); shortening: 11 (28.9%); audible crack: 13 (34.2%); some degree of erectile dysfunction: 26 (68.4%); need for urgent surgery: 6 (15.78%). In the 31 (81.5%) patients who had a penile ECO as part of their study: fibrosis finding: 25/31 (80.6%); venous cavernous leaks: 5/31 (16.1%) and hypervascularization 10/31 (32.2%). Conclusions Acute traumatic cavernosopathy is an appropriate name for the syndrome that triggers a greater and acute penile trauma, which can include sequelae such as penile fibrosis (up to 80%), secondary curvatures (up to 38%), shortening, venous leaks and erectile dysfunction (up to 70% of cases). 6/10 of these traumas are of a sexual nature and the rest are a motley group of traumas (car, sports, burns, animal attacks).
Asunto(s)
Humanos , Masculino , Adulto , Pene , Trauma Sexual , Disfunción Eréctil , Fibrosis , Estudios Retrospectivos , Impotencia Vasculogénica , Comités de Ética en Investigación , Fracturas ÓseasRESUMEN
Neoechinorhynchus is one of the most speciose genera of acanthocephalans, with approximately 116 described species. A recent study, aimed at establishing the genetic diversity of Neoechinorhynchus in Middle American freshwater fishes, validated nine species molecularly and morphologically and revealed the existence of 10 putative candidate species. Neoechinorhynchus golvani, a parasite commonly found in cichlids throughout Middle America with an allegedly large intraspecific morphological variability, was found to represent a species complex; species delimitation methods uncovered three additional genetic lineages. Here, we re-analyse the morphological and molecular data for N. golvani species complex infecting cichlids in that geographical area. A multivariate analysis of variance (MANOVA) was conducted particularly for the length of apical, middle and posterior hooks of the species/lineages of Neoechinorhynchus in cichlids, revealing morphological variation in the length of apical hooks for Lineage 8, although no morphological distinction was observed for Lineages 9 and 10. A new concatenated phylogenetic analysis of one mitochondrial and two ribosomal DNA genes was used to further corroborate the species delimitation among lineages; Neoechinorhynchus Lineage 8 was found to be morphologically and genetically distinct from its sister taxa, N. golvani and other two undescribed genetic lineages, and is formally described as a new species. Neoechinorhynchus costarricense n. sp. is described from the intestines of eight species of cichlids in Costa Rica. The new species is distinguished from the other species/lineages of Neoechinorhynchus in cichlids mainly by the size of the apical hooks of the proboscis.
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Acantocéfalos/crecimiento & desarrollo , Acantocéfalos/genética , Enfermedades de los Peces/parasitología , Helmintiasis Animal/parasitología , Acantocéfalos/clasificación , Acantocéfalos/aislamiento & purificación , Animales , Cíclidos/parasitología , Costa Rica , ADN de Helmintos/genética , ADN Ribosómico/genética , Agua Dulce/parasitología , Intestinos/parasitología , FilogeniaRESUMEN
INTRODUCTION AND AIMS: Double-balloon enteroscopy has been improving the visualization of the entire intestine for more than a decade. It is a complementary method in the study of intestinal diseases that enables biopsies to be taken and treatments to be administered. Our aim was to describe its main indications, insertion routes, diagnostic/therapeutic yield, and complications. MATERIALS AND METHODS: All patients referred to our unit with suspected small bowel pathology were included. The insertion route (oral/anal) was determined through diagnostic suspicion. The variables measured were: insertion route, small bowel examination extent, endoscopic diagnosis/treatment, biopsy/histopathology report, complications, and surgical findings. RESULTS: The study included 28 double-balloon enteroscopies performed on 23 patients, of which 10 were women and 13 were men (mean age of 52.95 years). The oral approach was the most widely used (n=21), the main indication was overt small bowel bleeding (n=16), and the general diagnostic yield was 65.21%. The therapeutic intervention rate was 39.1% and the procedure was effective in all the cases. The most widely used treatment was argon plasma therapy (n=7). The complication rate was 8.6%; one patient presented with low blood pressure due to active bleeding and another had deep mucosal laceration caused by the argon plasma. CONCLUSIONS: Double-balloon enteroscopy is a safe and efficacious method for the study and management of small bowel diseases, with an elevated diagnostic and therapeutic yield.
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Enteroscopía de Doble Balón , Enfermedades Intestinales/diagnóstico por imagen , Enfermedades Intestinales/terapia , Intestino Delgado/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Enteroscopía de Doble Balón/efectos adversos , Enteroscopía de Doble Balón/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Saccocoelioides olmecae n. sp. is described from specimens recovered from the intestine of the fat sleeper Dormitator maculatus (Bloch) (Perciformes: Eleotridae) collected in six localities along the coast of the Gulf of Mexico. The new species is mainly distinguished from the other three described species of Saccocoelioides Szidat, 1954 from North and Middle America (i.e. S. sogandaresi Lumsden, 1963, S. chauhani Lamothe-Argumedo, 1974 and S. lamothei Aguirre-Macedo & Violante-González, 2008) by having an elongated body, a sac-like caecum, a uterus that extends to the first third of body and by having vitelline follicles longitudinally elongated reaching the posterior end of the body. Sequences of the large subunit (LSU) of the ribosomal DNA, including the domain D1-D3, and the internal transcribed spacer 2 (ITS2) were used independently and concatenated to corroborate the morphological distinction among S. olmecae n. sp., S. chauhani and S. lamothei from freshwater and brackish-water fish from Middle America. The genetic divergence estimated among the three species of Saccocoelioides was very low: 1% for LSU and from 1 to 4% for ITS2. Maximum likelihood and Bayesian inference analyses for each dataset and both datasets combined revealed that S. olmecae n. sp. represents an independent clade with moderate bootstrap support and posterior probabilities. This is the third species of Saccocoelioides described in Mexico, and the 17th species from the Americas.
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Enfermedades de los Peces/parasitología , Perciformes , Trematodos/clasificación , Trematodos/aislamiento & purificación , Animales , Análisis por Conglomerados , ADN de Helmintos/química , ADN de Helmintos/genética , ADN Ribosómico/química , ADN Ribosómico/genética , ADN Espaciador Ribosómico/química , ADN Espaciador Ribosómico/genética , Golfo de México , Intestinos/parasitología , Microscopía , Filogenia , ARN Ribosómico/genética , Análisis de Secuencia de ADN , Trematodos/anatomía & histología , Trematodos/genéticaRESUMEN
Femoroacetabular impingement (FAI) syndrome is a frequent cause of pain and in recent years considered to be a precursor of premature hip osteoarthritis. The structural abnormalities which characterize FAI syndrome, such as the cam-type deformity, are associated with morphological alterations that may lead to hip osteoarthritis. The aim of this study was to determine the prevalence and topographic and morphometric features of the cam deformity in a series of 326 femur specimens obtained from a Mexican population, as well as changes in prevalence in relation to age and gender. The specimens were subdivided into groups according to gender and age. A standardized photograph of the proximal femur of each specimen was taken, and the photograph was used to determine the alpha angle using a computer program; the location of the lesion was determined by quadrant and the morphometric characteristics were determined by direct observation. The overall prevalence of cam deformities in the femur specimens was 29.8 % (97/326), with a prevalence by gender of 35.2 % (64/182) in men and 22.9 % (33/144) in women. The mean alpha angle was 54.6° ± 8.5° in all of the osteological specimens and 65.6° ± 7.5° in those specimens exhibiting a cam deformity. Cam deformities were found topographically in the anterior-superior quadrant of the femoral head-neck junction in 86.6 % (84/97) of the femurs. Deformities were found in 28.2 % of the right femurs and 31.3 % of the left femurs. The prevalence of cam deformity was higher in the femur specimens of young men and in those of middle-aged and older women. There were no significant differences in this deformity in relation to the alpha angle according to age and gender.
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Envejecimiento/patología , Pinzamiento Femoroacetabular/diagnóstico por imagen , Pinzamiento Femoroacetabular/patología , Fémur/anomalías , Fémur/diagnóstico por imagen , Caracteres Sexuales , Topografía Médica , Adolescente , Adulto , Femenino , Pinzamiento Femoroacetabular/complicaciones , Pinzamiento Femoroacetabular/epidemiología , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Osteoartritis de la Cadera/etiología , Prevalencia , Adulto JovenRESUMEN
Tylodelphys aztecae n. sp. (Digenea: Diplostomidae) is described from adult specimens obtained from the intestine of the pied-billed grebe (Podilymbus podiceps) and the metacercariae found in the body cavity of freshwater fishes of the families Goodeidae and Cyprinidae in eight localities across central and northern Mexico. The new species is mainly distinguished from the other four described species of Tylodelphys from the Americas (T. adulta, T. americana, T. elongata and T. brevis) by having a forebody slightly concave, a larger ventral sucker, two larger pseudosuckers and by having between 2 and 7 eggs in the uterus. Partial DNA sequences of the mitochondrial gene cytochrome c oxidase subunit I (cox1), and the internal transcribed spacers (ITS1+5.8S+ ITS2) of the ribosomal DNA, were generated for both developmental stages and compared with available sequences in GenBank of other congeners. The genetic divergence estimated among Tylodelphys aztecae n. sp. and other congeneric species varied from 12 to 15% for cox1, and from 3 to 11% for ITS. In contrast, the genetic divergence among metacercariae and adults of the new species was very low, ranging between 0 and 1% for cox1 and between 0 and 0.3% for ITS. Phylogenetic analyses inferred with both molecular markers using maximum likelihood and Bayesian inference placed the adults and their metacercariae in a single clade, confirming that both stages are conspecific. The morphological evidence and the genetic divergence, in combination with the reciprocal monophyly in both phylogenetic trees, support the hypothesis that the diplostomids found in the intestines of the pied-billed grebe bird and the body cavity from goodeid and cyprinid fishes in central and northern Mexico represent a new species.
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Aves/parasitología , Peces/parasitología , Trematodos/clasificación , Trematodos/aislamiento & purificación , Estructuras Animales/anatomía & histología , Animales , Análisis por Conglomerados , ADN de Helmintos/química , ADN de Helmintos/genética , ADN Ribosómico/química , ADN Ribosómico/genética , ADN Espaciador Ribosómico/química , ADN Espaciador Ribosómico/genética , Complejo IV de Transporte de Electrones/genética , México , Microscopía , Filogenia , ARN Ribosómico 5.8S/genética , Análisis de Secuencia de ADN , Trematodos/anatomía & histología , Trematodos/genéticaRESUMEN
The diplostomid genus Austrodiplostomum currently contains two species, i.e. A. mordax and A. ostrowskiae. Adults of these species inhabit the intestine of cormorants of the genus Nannopterum, whereas larval forms (metacercariae) are found in the eyes (vitreous humor) of freshwater fishes. Records of both species have been established across a wide geographic range in the Americas. Diplostomid adults and metacercariae were collected from a wide geographical range that spans from south-eastern Mexico, southwards to Central and South America. Even though the diplostomid has been largely reported in Mexico as Diplostomum (Austrodiplostomum) compactum, our specimens were identified morphologically as A. ostrowskiae. Sequences of the mitochondrial gene cytochrome c oxidase (cox 1) were obtained for 86 individuals, including 15 adults recovered from the intestine of Nannopterum brasilianus, in five localities, and 71 metacercariae from the eyes of ten fish species, in 13 localities. Sequences were used to evaluate the genetic diversity, and to test conspecificity of these specimens with the available sequence of A. ostrowskiae. Sequences were aligned with another 12 taxa representing five genera of Diplostomatidae, forming a dataset of 104 taxa with 478 nucleotides. The genetic divergence estimated among the 86 sequenced individuals, and that of A. ostrowskiae from the double-crested cormorant, Nannopterum auritus, in the USA, was very low, ranging from 0 to 0.8%. The maximum likelihood (ML) and Bayesian consensus trees showed that all sequences nested within a monophyletic lineage, with strong bootstrap and Bayesian posterior probability support values (100/1.0). In conclusion, a link between the metacercariae in fish and the adults in cormorants was established, indicating also that a single species is found in the distribution range comprising southern USA, southwards to Venezuela. Previous records of this species, particularly from Mexico, need to be corrected.
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Enfermedades de las Aves/parasitología , Trematodos/anatomía & histología , Trematodos/genética , Animales , Aves , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Parasitosis Intestinales/veterinaria , México/epidemiologíaRESUMEN
Epstein-Barr virus (EBV) is a persistent virus with oncogenic capacity that has been implicated in the development of aggressive B cell lymphomas, primarily in immunosuppressed individuals, although it can be present in immunocompetent individuals. Changes in the function and clonal diversity of T lymphocytes might be implied by viral persistence and lymphoma development. The aim of the present study was to evaluate the frequency, phenotype, function and clonotypical distribution of EBV-specific T cells after peripheral blood stimulation with a virus lysate in newly diagnosed patients with diffuse large B cell lymphoma (DLBCL) aged more than 50 years without prior histories of clinical immunosuppression compared with healthy controls. Our results showed impaired EBV-specific immune responses among DLBCL patients that were associated primarily with decreased numbers of central and effector memory CD8(+) T lymphocytes. In contrast to healthy controls, only a minority of the patients showed CD4(+)/tumour necrosis factor (TNF)-α(+) T cells expressing T cell receptor (TCR)-Vß17 and CD8(+)/TNF-α(+) T cells with TCR-Vß5·2, Vß9 and Vß18 in response to EBV. Notably, the production of TNF-α was undetectable among TCR-Vß5·3(+), Vß11(+), Vß12(+), Vß16(+) and Vß23(+) CD8(+) T cells. In addition, we observed decreased numbers of CD4(+)/TNF-α(+) and CD8(+)/TNF-α(+), CD8(+)/interleukin (IL)-2(+) and CD8(+)/TNF-α(+)/IL-2(+) T lymphocytes in the absence of T cells capable of producing TNF-α, IL-2 and IFN-γ after EBV stimulation simultaneously. Moreover, DLBCL patients displayed higher IL-10 levels both under baseline conditions and after EBV stimulation. These findings were also observed in patients with positive EBV viral loads. Prospective studies including a large number of patients are needed to confirm these findings.