RESUMO
INTRODUCTION: The rotator cuff tears are a very frequent condition. The rotator cuff repair is a procedure often perform by the orthopedic surgeon. There are multiple techniques and suture configurations for this type of repairs. The double row configuration is one of the most used and consider very effective for mid-size and large size rotator cuff tears. The parachute configuration for this repair is a novel technique that may be useful for mid-size and large size tears, for this repair two medial double row anchors are used and one knotless lateral anchor. Our porpoise was to compare biomechanical performance and footprint coverage of a conventional suture-bridge double-row rotator cuff repair configuration versus a double-row-parachute. METHODS: This paper shows the biomechanical behavior on a cadaver model of the parachute configuration, and also compares this conformation with a double row in a suture-bridge fashion. Our hipothesis was that the Parachute configurations biomechanical performance is equivalent to the suture-bridging double-row technique. RESULTS: The parachute configuration advantages show the advantage of using less anchors, which will decrease the surgical time and also the risks of using multiple hardware in the humeral head.
INTRODUCCIÓN: La lesión del manguito rotador es una patología común cuya reparación es un procedimiento realizado por los cirujanos ortopedistas. Existen muchas técnicas de reparación, así como múltiples configuraciones de anclas y suturas para realizar estos procedimientos. La técnica de doble fila es una de las más usadas para rupturas de tamaño mediano y grande con buenos resultados. La configuración en «paracaídas¼ para la reparación del manguito rotador puede llegar a ser útil para éstas, en este tipo de configuración se utilizan dos anclas mediales y un ancla sin nudos lateral. Nuestro objetivo fue la comparación de la eficiencia biomecánica y cobertura de la huella de una configuración convencional de doble fila «suture bridge¼ frente a una configuración en «paracaídas¼. MÉTODOS: Este trabajo revisó el comportamiento biomecánico, en piezas cadavéricas, de la configuración de paracaídas y se comparó con la configuración de doble fila tipo «suture-bridge¼. Nuestra hipótesis era que el rendimiento biomecánico de la configuración de Parachute es equivalente a la técnica de doble fila «suture bridge¼. RESULTADOS: Las posibles ventajas de la configuración de paracaídas son el uso de menos anclas, disminuyendo el tiempo quirúrgico y los riesgos de tener múltiples implantes en la cabeza humeral.
Assuntos
Lesões do Manguito Rotador , Fenômenos Biomecânicos , Humanos , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Técnicas de Sutura , SuturasRESUMO
In the present study, the decolourization efficiencies of LP-Hg lamp, XeCl and KrCl excilamps at the same power density were compared for the decolourization of dyes in water by UV and UV/H2O2 processes in a batch reactor. Laboratory prototypes of XeCl and KrCl excilamps and a commercial LP-Hg lamp were studied as UV sources. Methylene Blue and Eliamine Blue dyes were used as model pollutants. The effect of the initial concentrations of dye and H2O2 in the TOC removal and kinetic parameters were also studied. The ratio of dye decolourization to the electric power consumption of the KrCl excilamp and LP-Hg lamp for the decolourization of Methylene Blue and Eliamine Blue were evaluated. As a result, the KrCl excilamp showed significantly higher decolourization efficiencies than LP-Hg lamp and XeCl excilamp, but the dye removal rate was significantly slower for Methylene Blue than for Eliamine Blue with this lamp. The KrCl lamp can be an alternative to conventional LP-Hg lamp for the decolourization of dyes by photodegradation, but it depends on the type of dye treated. The addition of H2O2 in a concentration between 0.05 and 0.09%v/v increases significantly the efficiency of the decolourization of Methylene Blue, and further increase does not lead to a higher increase in conversion. The experimental data were fitted to the one phase decay kinetic model with good agreement and the kinetic parameters were reported.
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Mercúrio , Poluentes Químicos da Água , Corantes , Peróxido de Hidrogênio , Raios Ultravioleta , ÁguaRESUMO
No Abstract available.
Assuntos
COVID-19 , Ortopedia , Hospitais , Humanos , Salas Cirúrgicas , Pandemias , SARS-CoV-2RESUMO
BACKGROUND: Hepatocellular carcinoma (HCC) is the most frequent primary malignant liver tumor, with the Milan criteria considered to be the gold standard for patient selection for liver transplantation (LT). MATERIALS AND METHODS: We performed a descriptive observational study, reviewing 20 years of experience of LT in patients with HCC in the Fundacion Valle del Lilí in Cali, Colombia. Subgroup analysis was undertaken for periods 1999 to 2007 and 2008 to 2015. RESULTS: Fifty-seven cases with a pretransplant HCC diagnosis were reviewed. In the first period patients within the Milan criteria had a recurrence-free survival at 5 years of 66.6%, and in those who exceeded the Milan criteria, recurrence-free survival was 75%. In the second period, patients within the Milan criteria, recurrence-free survival at 5 years was 93.5%, and in those who exceeded the Milan criteria, recurrence-free survival was 75.7%. No statistically significant difference was found in either period. For patients with mild and moderate tumor differentiation, the relapse survival rate at 5 years was 69.4% (95% confidence interval [CI] 35.8-87.8) and 74.7% (95% CI 44.5-90), respectively. All patients with poor tumor differentiation relapsed and died within 3 years. CONCLUSION: Global and recurrence-free survival among patients who met and patients who exceeded the Milan criteria was not significantly different, suggesting an expansion of the Milan criteria to include potential recipients who were previously excluded. Obtaining histologic differentiation and identifying vascular invasion will provide a more worthwhile contribution to LT decision making.
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Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/mortalidade , Adulto , Idoso , Colômbia/epidemiologia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologia , Seleção de PacientesRESUMO
BACKGROUND: Around 2.4% of the world's population is infected with hepatitis C virus (HCV), and it is the most common cause of liver transplantation (LT) in the world. Latin America (LA), with nearly 9% of the world population, has had a continuous increase in the number of LTs per year. Yet, due to the lack of mandatory data collection and a well-developed health-care system, access to transplantation is limited in most LA countries. We report the first LA experience of HCV-infected LT patients. METHODS: We performed a retrospective cohort study by reviewing the medical histories of all HCV-infected LT patients between 1996 and 2016 who acquired HCV before their LT, at the Fundación Valle del Lilí, Cali, Colombia. RESULTS: Between January 1996 and December 2015, a total of 770 LTs were performed, of which 75 had a cirrhotic liver due to HCV infection. With a median follow-up time of 24.4 months (interquartile range [IQR] 4.7-61.2 months), patient survival was 44.9% and 66.9% for the time periods 1996-2006 and 2007-2015, respectively. Hepatocellular carcinoma (HCC) was present in 30.6% of the patients, and overall postoperative complications had an incidence of 80%. CONCLUSIONS: This is the first report of LT in HCV-infected patients in Colombia and in LA. Our results are comparable to those of other transplant centers worldwide with regard to postoperative complications and patient survival. Patients with LT in the 1996-2006 time frame had higher morbidity and mortality. Studies including larger numbers of patients are needed to determine the reason for this finding.
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Hepatite C/cirurgia , Transplante de Fígado , Adulto , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/epidemiologia , Estudos de Coortes , Colômbia , Feminino , Hepacivirus , Hepatite C/complicações , Humanos , Incidência , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/epidemiologia , Transplante de Fígado/mortalidade , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos RetrospectivosRESUMO
BACKGROUND: Renal transplantation is the most effective treatment for children with end-stage renal disease. Recent work suggests that induction with alemtuzumab in the pediatric population permits the use of lower doses of maintenance immunosuppressive therapy. In addition, it has a low cost compared with other induction therapies. OBJECTIVE: To conduct a clinical description of pediatric renal transplant patients comparing induction protocols to evaluate graft and patient survival, infections complications, and lymphoproliferative diseases. MATERIALS AND METHODS: This descriptive and retrospective study, of evaluated pediatric renal transplant patients between 2006 and 2010. RESULTS: The agents for induction therapy were: alemtuzumab (61.5%), daclizumab (19.25%), and thymoglobulin (19.25%). Graft survival was better among the alemtuzumab group (87.5%) compared with the other two induction therapies (80%). The frequency of acute rejection episodes during the first year posttransplantation as well as chronic rejection was lower among the alemtuzumab group. Cytomegalovirus infection was noted in 30% of patients with greater frequency among those induced with alemtuzumab. CONCLUSION: Induction therapy with alemtuzumab was safe in a pediatric population not predisposing to a greater risk of acute or chronic rejection. Except for a greater incidence of Cytomegalovirus, there was no difference in other complications.
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Anticorpos Monoclonais Humanizados/uso terapêutico , Transplante de Rim/métodos , Insuficiência Renal/terapia , Adolescente , Alemtuzumab , Anticorpos Monoclonais Humanizados/farmacologia , Soro Antilinfocitário/farmacologia , Antineoplásicos/farmacologia , Criança , Pré-Escolar , Infecções por Citomegalovirus/complicações , Daclizumabe , Feminino , Sobrevivência de Enxerto , Humanos , Imunoglobulina G/farmacologia , Imunossupressores/uso terapêutico , Transtornos Linfoproliferativos/etiologia , Masculino , Pediatria/métodos , Insuficiência Renal/mortalidade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Induction therapies in kidney transplantation have led to prescriptions of lower doses of maintenance immunosuppression and fewer acute rejection episodes. We sought to assess the use of an affordable monoclonal antibody in terms of the incidences of rejection episodes as well as graft and patient survivals and cytomegalovirus (CMV) and opportunistic infections among our kidney transplant recipients between August 2005 and December 2010. Data were obtained for patients who had more than 20 months' follow-up. MATERIALS AND METHODS: We retrospectively analyzed data from kidney recipients between August 2005 and December 2010, using descriptive statistics and Kaplan-Meier survival analysis. We performed a multivariate analysis with logistic regression for the dependent variables of rejection episodes and death. RESULTS: Among 425 transplant patients graft survival was 89.2% and patient survival was 94.1% after 76.2% of patients received alemtuzumab, 10.7% daclizumab, 3.6% basiliximab, 2.4% thymoglobulin, and 7%, no induction therapy. Rejection incidence in general in the first year was 10.8% and CMV incidence 10%. There was an increased risk of rejection among subjects without any us with alemtuzumab induction therapy. CONCLUSION: Induction therapies show an important reduction in kidney transplant rejection incidence during the first year, allowing low doses of maintenance immunosuppressants, thereby diminishing long-term adverse effects. Alemtuzumab seemed to be a safe alternative with similar results to those obtained with standard immunosuppression.
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Transplante de Rim/métodos , Insuficiência Renal/terapia , Adulto , Alemtuzumab , Anticorpos Monoclonais/química , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Soro Antilinfocitário/uso terapêutico , Basiliximab , Colômbia , Infecções por Citomegalovirus , Daclizumabe , Feminino , Rejeição de Enxerto , Sobrevivência de Enxerto , Hospitais , Humanos , Imunoglobulina G/uso terapêutico , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Proteínas Recombinantes de Fusão/uso terapêutico , Análise de Regressão , Insuficiência Renal/mortalidade , Estudos Retrospectivos , Risco , Resultado do TratamentoRESUMO
El carcinoma de células renales es responsable del 80 al 85 por cien de todas las neoplasias renales y su diagnóstico trae consigo la necesidad de intervención oportuna por las altas tasas de morbimortalidad relacionadas con esta patología. Es conocida la posibilidad de curación con el tratamiento quirúrgico cuando la enfermedad está organoconfinada, sin embargo, en un porcentaje no despreciable de pacientes aún con este tipo de intervención pueden desarrollar metástasis o recaídas posteriores a la cirugía. El desarrollo de nuevas estrategias terapéuticas enfocadas al manejo fisiopatológico de esta enfermedad comienza a demostrar en medianos plazos respuestas que son alentadoras y que se han constituido en la herramienta terapéutica más adecuada posterior al manejo quirúrgico citorreductor. Está por definirse el papel de las terapias blanco como alternativas neoadyuvantes.
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Humanos , Receptor 1 de Fatores de Crescimento do Endotélio Vascular , Carcinoma de Células Renais/terapia , Inibidores da Angiogênese/uso terapêutico , Neoplasias Renais/terapia , Neovascularização Patológica/terapiaRESUMO
El manejo del Cáncer de Próstata con intención curativa ya sea mediante prostatectomía radical retropúbica, prostatectomía radical perineal, braquiterapia de baja o de alta tasa o radioterapia tiene consecuencias para el paciente en cuanto a calidad de vida se refiere. Realizamos una revisión de la literatura para evaluar los reportes de complicaciones de cada uno de estos manejos para determinar el estado actual de los efectos secundarios de estas terapias.