RESUMEN
The total hip arthroplasty with short stems to preserve bone is a good choice in young patients that expected future revision surgery, it is also a good choice when we use approaches for minimal invasive surgeries. In this study, we have evaluated, clinically and radiologically, our experience in total hip arthroplasty with the use of short stems and metaphyseal anchorage. In total we have involved 23 patients with a mean age of 50.2 years (range 45 to 69 y/o) at the time of surgery. The median follow-up was greater than five years. There was a slight Varus femoral stem in three cases, one of them in severe varus. The latter presented continuous pain in the lateral aspect of the thigh that increased with time, with a diaphyseal reaction and an increase in radiolucencies around the stem that required revision surgery 12 months postoperative. A longer follow-up is required to analyze the results and confirm the durability of the observed clinical findings. Patients were evaluated radiological and clinically using the scale of Merle dAubigné (MD).
La artroplastía total de cadera con los vástagos cortos encaminada a preservar el hueso es una buena opción en pacientes jóvenes a quienes se les prevé futuras cirugías de revisión. También es una buena elección cuando se utilizan cirugías con abordajes miniinvasivos. En este estudio clínico y radiológico hemos evaluado nuestra experiencia en el uso de artroplastía total de cadera con vástagos cortos de anclaje metafisario tipo DePuy Próxima. En total se han intervenido 23 pacientes con una edad media de 50.2 años (rango de 45 a 69 años) en el momento de la cirugía. El seguimiento medio fue de más de cinco años. Hubo un ligero varo del tallo femoral en tres casos, uno de ellos en varo severo. Este último caso presentó dolor continuo en las caras laterales del muslo que aumentó con el tiempo junto con una reacción diafisaria y un aumento en el tallo que requirió cirugía de revisión a los 12 meses postoperatorios. Se requiere un seguimiento más prolongado para analizar los resultados y confirmar la durabilidad de los resultados clínicos observados. Los pacientes fueron evaluados radiológica y clínicamente utilizando el baremo de Merle dAubigné (MD).
Asunto(s)
Artroplastia de Reemplazo de Cadera , Prótesis de Cadera , Anciano , Artroplastia de Reemplazo de Cadera/métodos , Fémur/cirugía , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Diseño de Prótesis , Reoperación , Resultado del TratamientoRESUMEN
Resumen: La artroplastía total de cadera con los vástagos cortos encaminada a preservar el hueso es una buena opción en pacientes jóvenes a quienes se les prevé futuras cirugías de revisión. También es una buena elección cuando se utilizan cirugías con abordajes miniinvasivos. En este estudio clínico y radiológico hemos evaluado nuestra experiencia en el uso de artroplastía total de cadera con vástagos cortos de anclaje metafisario tipo DePuy Próxima. En total se han intervenido 23 pacientes con una edad media de 50.2 años (rango de 45 a 69 años) en el momento de la cirugía. El seguimiento medio fue de más de cinco años. Hubo un ligero varo del tallo femoral en tres casos, uno de ellos en varo severo. Este último caso presentó dolor continuo en las caras laterales del muslo que aumentó con el tiempo junto con una reacción diafisaria y un aumento en el tallo que requirió cirugía de revisión a los 12 meses postoperatorios. Se requiere un seguimiento más prolongado para analizar los resultados y confirmar la durabilidad de los resultados clínicos observados. Los pacientes fueron evaluados radiológica y clínicamente utilizando el baremo de Merle d'Aubigné (MD).
Abstract: The total hip arthroplasty with short stems to preserve bone is a good choice in young patients that expected future revision surgery, it is also a good choice when we use approaches for minimal invasive surgeries. In this study, we have evaluated, clinically and radiologically, our experience in total hip arthroplasty with the use of short stems and metaphyseal anchorage. In total we have involved 23 patients with a mean age of 50.2 years (range 45 to 69 y/o) at the time of surgery. The median follow-up was greater than five years. There was a slight Varus femoral stem in three cases, one of them in severe varus. The latter presented continuous pain in the lateral aspect of the thigh that increased with time, with a diaphyseal reaction and an increase in radiolucencies around the stem that required revision surgery 12 months postoperative. A longer follow-up is required to analyze the results and confirm the durability of the observed clinical findings. Patients were evaluated radiological and clinically using the scale of Merle d'Aubigné (MD).
Asunto(s)
Humanos , Anciano , Artroplastia de Reemplazo de Cadera/métodos , Prótesis de Cadera , Diseño de Prótesis , Reoperación , Estudios de Seguimiento , Resultado del Tratamiento , Fémur/cirugía , Persona de Mediana EdadRESUMEN
During dental caries, the dental biofilm modifies the composition of the hundreds of involved bacterial species. Changing environmental conditions influence competition. A pertinent model to exemplify the complex interplay of the microorganisms in the human dental biofilm is the competition between Streptococcus sanguinis and Streptococcus mutans. It has been reported that children and adults harbor greater numbers of S. sanguinis in the oral cavity, associated with caries-free teeth. Conversely, S. mutans is predominant in individuals with a high number of carious lesions. Competition between both microorganisms stems from the production of H2 O2 by S. sanguinis and mutacins, a type of bacteriocins, by S. mutans. There is limited evidence on how S. sanguinis survives its own H2 O2 levels, or if it has other mechanisms that might aid in the competition against S. mutans, nonetheless. We performed a genomic and metabolic pathway comparison, coupled with a comprehensive literature review, to better understand the competition between these two species. Results indicated that S. sanguinis can outcompete S. mutans by the production of an enzyme capable of metabolizing H2 O2 . S. mutans, however, lacks the enzyme and is susceptible to the peroxide from S. sanguinis. In addition, S. sanguinis can generate energy through gluconeogenesis and seems to have evolved different communication mechanisms, indicating that novel proteins may be responsible for intra-species communication.
Asunto(s)
Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Biopelículas , Placa Dental/microbiología , Streptococcus mutans/genética , Streptococcus mutans/metabolismo , Streptococcus sanguis/genética , Streptococcus sanguis/metabolismo , Bacteriocinas/metabolismo , Simulación por Computador , Bases de Datos Genéticas , Caries Dental/microbiología , Genes Bacterianos/genética , Gluconeogénesis , Humanos , Peróxido de Hidrógeno/metabolismo , Redes y Vías Metabólicas , Boca/microbiologíaRESUMEN
BACKGROUND: Basal cell carcinoma (BCC) recurrences, especially in the facial region, represent a complex cosmetic problem. To date the possibility of predicting recurrence is supported solely by the histologic subtype. OBJECTIVE: To evaluate the relationship between BCC histologic subtypes linked to high and low risk of recurrence and the presence of hyperechoic spots on sonography. METHODS: Retrospective analysis of the pre-surgical ultrasound examinations of primary BCC tumours with visualization and counting of intra-tumoural hyperechoic spots. The data were then correlated with the corresponding histologic subtype. RESULTS: Thirty one patients with histologically proven BCC were included in the study. Hyperechoic spots were detected in all cases and there was a positive, statistically significant association between hyperechoic spots count and high recurrence risk histologic subtypes. Higher hyperechoic spots count was found in the recurrence-prone micronodular, sclerosing variant and morpheiform BCC subtypes. Low risk and high risk of recurrence showed a significant difference on the mean hyperechoic spots count of 5.5 (range: 3-25) and 8 (4-81). A cut-off point ≥7 hyperechoic spots presented a sensitivity of 79% and specificity of 53% for predicting the high risk of recurrence subtypes. CONCLUSION: The presence and count of hyperechoic spots within BCC lesions may help predicting the high risk of recurrence histologic subtypes.
Asunto(s)
Carcinoma Basocelular/diagnóstico por imagen , Neoplasias Faciales/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Recurrencia Local de Neoplasia , Cuero Cabelludo , Neoplasias Cutáneas/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/patología , Neoplasias Faciales/patología , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Cutáneas/patología , UltrasonografíaRESUMEN
A retrospective, comparative cohort study was performed of metacarpophalangeal or proximal interphalangeal joint arthrodesis with either tension band (n = 28) or compression (Acutrak Mini) screw (n = 29) methods. We compared rate of union, healing time, complications, and re-operation rate. Union was achieved in 26/28 (92.8%) of the tension band group (9.4 weeks) and 24/28 (85.7%) of the compression screw group (9.8 weeks). Only 28 patients in the screw group were assessed for union as one patient in the screw group sustained a fracture at the time of insertion and was converted to tension band fixation. The complication rate was 8/28 (28.6%) in the tension band group and 8/29 (27.6%) in the compression screw group. Re-operation rate was 9/28 (32.1%) in the tension band group and 1/29 (3.6%) in the compression screw group. Our findings indicate that bone healing, healing time, and complications are similar in both groups. The tension band technique had a significantly higher re-operation rate (hardware removal), but was the technique for salvage following failure of the screw technique.
Asunto(s)
Artrodesis/instrumentación , Articulaciones de los Dedos/cirugía , Articulación Metacarpofalángica/cirugía , Adulto , Tornillos Óseos , Hilos Ortopédicos , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
Introducción: La hipoacusia sensorioneural súbita (HSNS), es una causa poco frecuente de hipoacusia. La mayoría son consideradas idiopáticas y sólo en el 10 por ciento-15 por ciento puede descubrirse un factor etiológico. Se han propuesto 4 teorías fisiopatológicas: viral, vascular, inmunológica y por ruptura de membranas. La etiología viral es controversial. Objetivo: Investigar la etiología viral como posible causa de HSNS y evaluar su presencia en relación con el pronóstico de recuperación auditiva. Material y método: Estudio descriptivo observacional de 24 meses, de pacientes con cuadro clínico de HSNS y exámenes compatibles. Previo al tratamiento se tomó hisopado y aspirado nasofaríngeo analizados mediante Microarray. Resultados: Se reclutaron 15 pacientes. En 9 se detectó virus respiratorio sincicial (VRS) y simultáneamente cuatro de ellos además otros virus (bocavirus, herpes VI y VII). No se detectaron casos de virus herpes I y II. No se han evidenciado diferencias en la evolución auditiva en el grupo con muestras positivas para virus. Conclusiones: La etiología viral de HSNS permanece en controversia. El 60 por ciento de los pacientes evaluados resultaron positivos, sin embargo, no hubo ningún virus herpes I ó II en las muestras. El VRS aparece como nuevo agente involucrado, aun cuando se encuentra fuera de temporada habitual.
Introduction: Sudden sensorineural hearing loss (SSHL) is a rare cause of hearing loss. Most are considered idiopathic and only 10-15 percent can discover an etiologic factor. Four pathophysiological theories have been proposed: viral, vascular, immunological and rupture of membranes. The viral etiology is controversial and there are reports with varying results. Aim: To investigate the viral etiology as a cause of HSNS and evaluate their presence in relation to the prognosis of hearing recovery. Material and method: descriptive, observational study of 24 months, patients with symptoms and exams compatible SSHL. Before treatment, nasopharyngeal aspirate was taken and then analyzed using Microarray. Results: Were enrolled 15 patients. In 9 was detected a respiratory syncytial virus (RSV) and four of them simultaneously also other viruses (Bocavirus, Herpes VI and VII). There were no cases of Herpes Virus I and II. There were no evidence differences in auditory development in the group with samples positive for virus. Conclusions: The viral etiology of SSHL remains controversial. 60 percent of patients tested were positive, however, there was no Herpes virus I or II in the samples. RSV appears as a new agent involved, even when was out of regular season.
Asunto(s)
Humanos , Masculino , Adolescente , Adulto , Femenino , Persona de Mediana Edad , Pérdida Auditiva Sensorineural/virología , Pérdida Auditiva Súbita/virología , Antivirales/uso terapéutico , Bocavirus/aislamiento & purificación , /aislamiento & purificación , /aislamiento & purificación , Pronóstico , Pérdida Auditiva Sensorineural/etiología , Pérdida Auditiva Sensorineural/tratamiento farmacológico , Pérdida Auditiva Súbita/tratamiento farmacológico , Virus Sincitial Respiratorio Humano/aislamiento & purificación , Índice de Severidad de la EnfermedadRESUMEN
La enfermedad tromboembólica constituye un gran problema clínico debido a su alta incidencia y a su importante morbilidad. Desde el punto de vista patogénico, esta es una enfermedad multifactorial que resulta de la interrelación entre factores ambientales y genéticos. Durante los últimos años se han identificado varios factores genéticos que predisponen a la trombosis, sin embargo sólo dos de ellos has sido ampliamente estudiados: el factor V Leiden y la protombina 20210A. Además de estos factores existen otros que quizás no se han desarrollado ampliamente como los anteriores, pero al parecer diversas investigaciones indican que la presencia de mutaciones como de la Metiltetrahidrofolato Reductasa (MTHFR) y polimorfismos del gen del Inhibidor del Activador del Plasminógeno 1 (PAI-1) y de la Enzima Convertidora de Angiotensina (ECA) pudiesen participar en la alteración de la hemostasia, especialmente durante el proceso de gestación donde su efecto es más evidente. Cabe destacar que nuestro laboratorio ha sido pionero en el análisis del polimorfismo para PAI-1 y ECA en conjunto con la detección de dos mutaciones para MTHFR. El estudio de estas mutaciones es a través del análisis del ADN del paciente. Este exámen se realiza a partir de leucocitos periféricos, siendo necesaria sólo una muestra de sangre-EDTA.
Asunto(s)
Femenino , Embarazo , Humanos , Biología Molecular , Trombofilia/genética , Riesgos Ambientales , Hemostasis , Mutación , Factores de RiesgoRESUMEN
Doasypsyllus (Neomipsyllus) aedon n. sp. is described from specimens obtained from Passeriform's nests (Troglodytidae and Furnariidae).
Asunto(s)
Enfermedades de las Aves/parasitología , Infestaciones Ectoparasitarias/veterinaria , Passeriformes/parasitología , Filogenia , Siphonaptera/clasificación , Animales , Enfermedades de las Aves/epidemiología , Chile/epidemiología , Infestaciones Ectoparasitarias/epidemiología , Infestaciones Ectoparasitarias/parasitología , Femenino , Masculino , Siphonaptera/anatomía & histologíaRESUMEN
Monosodium l-glutamate (MSG) was administered subcutaneously to male neonatal rats, and the effect on developmental profile of tyrosine hydroxylase (TH), D1, D2 receptors, and dopamine (DA) transporter expression in the striatum was examined using Western blot. In addition, TH-immunopositive neurons at substantia nigra (SN) were also examined. MSG treatment (4mg/g of body weight, administered on postnatal days 1, 3, 5, and 7) resulted in a reduction of D1 and D2 receptor expression from 30 days of age and persisted to adulthood (120 days of age), while DA transporter expression was significantly reduced from 14 days of age to adulthood. TH immunopositive neurons at SN showed a significant reduction, as well as TH expression on postnatal days 10, 30, 60, and 120 at striatum was reduced. No changes of TH were observed at 14 days of age. Results indicate that an over-stimulation of the glutamatergic system by neonatal exposure to a high glutamate concentration induces a partial loss in TH-positive neurons in the SN and an important reduction in dopaminergic markers expression in the striatum, suggesting that early excitotoxicity could contribute to developmental alterations in the nigrostriatal pathway, which may be associated with various disorders of the basal ganglia.
Asunto(s)
Envejecimiento/metabolismo , Cuerpo Estriado/metabolismo , Ácido Glutámico/administración & dosificación , Glicoproteínas de Membrana/metabolismo , Proteínas de Transporte de Membrana/metabolismo , Proteínas del Tejido Nervioso/metabolismo , Receptores de Dopamina D1/metabolismo , Receptores de Dopamina D2/metabolismo , Tirosina 3-Monooxigenasa/metabolismo , Envejecimiento/efectos de los fármacos , Animales , Animales Recién Nacidos , Biomarcadores/metabolismo , Cuerpo Estriado/efectos de los fármacos , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática , Femenino , Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Regulación del Desarrollo de la Expresión Génica/fisiología , Inyecciones Subcutáneas , Masculino , Ratas , Ratas Wistar , Distribución Tisular/efectos de los fármacosRESUMEN
The effect of aging on prism adaptation, a motor learning paradigm, was evaluated. Different measures were obtained from a task consisting of throwing clay balls to a target in front of the subjects before, during, and after wearing prisms that deviate the visual field by several degrees. When performing the task without wearing the prisms, the aged subjects showed a larger hit variance, whereas the young subjects hit closer to the target. When donning the prisms, the aged group adapted more slowly than the controls, although after throwing all the balls both groups showed the same adaptation levels. After removing the prisms, the aged group showed a larger aftereffect. These findings suggest that the aftereffect requires the involvement of non-cognitive and cognitive processes and indicate that both adaptation and aftereffect are influenced by aging.
Asunto(s)
Adaptación Fisiológica/fisiología , Envejecimiento/fisiología , Efecto Tardío Figurativo/fisiología , Campos Visuales/fisiología , Adolescente , Adulto , Anciano , Anteojos , Femenino , Humanos , Aprendizaje/fisiología , Masculino , Persona de Mediana Edad , Destreza Motora/fisiología , Desempeño Psicomotor/fisiologíaRESUMEN
Evidence in support for the concept of the so-called 'siesta culture' is not well developed and has, to date, relied largely on qualitative anthropological data. Presumably such cultures are characterized by a strong tendency for daytime naps and daytime sleepiness, phenomena which may partially represent the effects of geographic, climatic or light conditions and/or cultural influences. In this study we surveyed the nocturnal sleep habits and daytime sleep tendencies of 577 Mexican college students residing in Mexico City (19 degrees N latitude). Results indicated a number of parallels between the reported sleep habits of these students and those reported from other cultures at latitudes far to the north (North America, Europe), such as longer sleep at the weekends, an association between snoring and daytime sleepiness and a lack of relationship between nocturnal sleep duration and the reported tendency to nap. There was some suggestion that these Mexican students may actually nap less when compared to other college student populations. Taken together, these results call into question what is meant by the concept of a 'siesta culture', at least in this urban, educated, upper social economic scale (SES) population, and suggest that future studies in equatorial regions be undertaken to further appreciate the role of climate, photoperiod and/or culture in the tendency for humans to nap during the day.
Asunto(s)
Cultura , Sueño/fisiología , Estudiantes/psicología , Población Urbana , Adolescente , Adulto , Factores de Edad , Estudios de Cohortes , Trastornos de Somnolencia Excesiva/diagnóstico , Femenino , Humanos , Masculino , México , Sueño/efectos de los fármacos , Ronquido/diagnóstico , Encuestas y Cuestionarios , Factores de Tiempo , VigiliaRESUMEN
The purpose of this study was to describe the factor structure of the Sleep-Wake Activity Inventory (SWAI) in a Mexican population. In a sample of 722 Mexican college students, we replicated five of the six factors originally described in the SWAI. Retained factors included: excessive daytime sleepiness (similarity coefficient of 0.735), psychic distress (0.609), social desirability (0.638), individual's ability to relax (0.864), and nocturnal sleep (0.660). These results confirm the factor structure and extend the possible utility of the SWAI in a siesta culture.
Asunto(s)
Sueño , Vigilia , Adolescente , Adulto , Trastornos de Somnolencia Excesiva/diagnóstico , Hispánicos o Latinos , Humanos , Deseabilidad Social , Estrés Psicológico/psicología , Estados Unidos/etnologíaRESUMEN
The economic and social strategy developed by the democratic governments in Chile since 1990 has been based on the premise that free-market policies promoting growth and economic stability must continue, but should be combined with social policies designed to promote greater equality. This new set of policies produced quick and positive results in the context of strong economic growth. The reduction of poverty was its crowning achievement. However, not all the Concertación's redistributive efforts have enjoyed the same level of success. Inequalities in income distribution are again increasing. Significant segments of society, such as subsistence farmers, rural migrants to cities, women and youth who lack vocational training--as well as an important segment of the middle class that had been impoverished during the military regime--are being systematically marginalized from the benefits of economic growth and social policy. The fundamental problems of current Chilean social policy are rooted in the privatization of social sectors under the military government and the resulting dual model of social welfare.