RESUMO
Resumen: La artrosis de la muñeca es un proceso degenerativo, postraumático o idiopático que provoca al paciente dolor, pérdida de la movilidad, inflamación y deformidad. Las opciones quirúrgicas incluyen: artrodesis total de muñeca que produce una mejoría del dolor y disminución de la inflamación, otros tratamientos que permiten movilidad relativa son las artrodesis parciales. Otra solución quirúrgica es la carpectomía o la resección de la primera hilera del carpo, de tal manera que constituya una nueva articulación entre el radio y la segunda fila del carpo, obteniendo una congruencia articular adecuada. Material y métodos: Estudio observacional, descriptivo, serie de casos. Se valoraron 15 pacientes con carpectomía proximal durante el período de Enero de 2007 a Agosto de 2009, a quienes se realizó medición de arcos de movilidad y fuerza mediante las escalas de Mayo-DASH. Resultados: En 80% de los pacientes entre 35 y 64 años se encontró predominio del sexo masculino en 67%. La mejoría del dolor fue evidente, pasando de una media 7.7 en el preoperatorio a 2.7 en el postoperatorio, 10% de los casos presentaron dolor residual. Conclusiones: La carpectomía proximal representa una alternativa terapéutica que permite conservar la movilidad con mejora del dolor en la artrosis de muñeca.
Abstract: The arthrosis of the wrist is a degenerative, traumatic or idiopathic process, which cause problem for patient characterized by pain, loss of mobility, swelling and deformity of the affected wrist. A surgical alternative is proximal row carpectomy, which consists of resection of the lunate, scaphoid and triquetrum, forming a new joint between the radius and the distal row carpus. Material and methods: Observational, descriptive, case series. 15 patients were evaluated who underwent proximal row carpectomy during the period January 2007-August 2009, with clinical follow-up until august 2010 through mayo and DASH scores, measuring strength. Range of motion and pain. 80% of patients were between 35 and 64 years. The predominant sex was male in 67%. The result was satisfactory in 73%, according to the scale of Mayo. The DASH scale in the postoperative period also improves. Conclusions: The proximal carpectomy is a surgical alternative, it preserves some joint mobility, reduced pain and improved disability of the limb.
Assuntos
Humanos , Masculino , Osteoartrite/cirurgia , Ossos do Carpo/cirurgia , Punho , Seguimentos , Amplitude de Movimento Articular , Resultado do Tratamento , Força da MãoRESUMO
The arthrosis of the wrist is a degenerative, traumatic or idiopathic process, which cause problem for patient characterized by pain, loss of mobility, swelling and deformity of the affected wrist. A surgical alternative is proximal row carpectomy, which consists of resection of the lunate, scaphoid and triquetrum, forming a new joint between the radius and the distal row carpus. Material and methods: Observational, descriptive, case series. 15 patients were evaluated who underwent proximal row carpectomy during the period January 2007-August 2009, with clinical follow-up until august 2010 through mayo and DASH scores, measuring strength. Range of motion and pain. 80% of patients were between 35 and 64 years. The predominant sex was male in 67%. The result was satisfactory in 73%, according to the scale of Mayo. The DASH scale in the postoperative period also improves. Conclusions: The proximal carpectomy is a surgical alternative, it preserves some joint mobility, reduced pain and improved disability of the limb.
La artrosis de la muñeca es un proceso degenerativo, postraumático o idiopático que provoca al paciente dolor, pérdida de la movilidad, inflamación y deformidad. Las opciones quirúrgicas incluyen: artrodesis total de muñeca que produce una mejoría del dolor y disminución de la inflamación, otros tratamientos que permiten movilidad relativa son las artrodesis parciales. Otra solución quirúrgica es la carpectomía o la resección de la primera hilera del carpo, de tal manera que constituya una nueva articulación entre el radio y la segunda fila del carpo, obteniendo una congruencia articular adecuada. Material y métodos: Estudio observacional, descriptivo, serie de casos. Se valoraron 15 pacientes con carpectomía proximal durante el período de Enero de 2007 a Agosto de 2009, a quienes se realizó medición de arcos de movilidad y fuerza mediante las escalas de Mayo-DASH. Resultados: En 80% de los pacientes entre 35 y 64 años se encontró predominio del sexo masculino en 67%. La mejoría del dolor fue evidente, pasando de una media 7.7 en el preoperatorio a 2.7 en el postoperatorio, 10% de los casos presentaron dolor residual. Conclusiones: La carpectomía proximal representa una alternativa terapéutica que permite conservar la movilidad con mejora del dolor en la artrosis de muñeca.
Assuntos
Ossos do Carpo , Osteoartrite , Ossos do Carpo/cirurgia , Seguimentos , Força da Mão , Humanos , Masculino , Osteoartrite/cirurgia , Amplitude de Movimento Articular , Resultado do Tratamento , PunhoRESUMO
Allele distribution and forensic parameters were estimated for 15 STR loci (AmpFlSTR Identifiler kit) in 251 Mexican-Mestizos from the state of Guerrero (South, Mexico). Genotype distribution was in agreement with Hardy-Weinberg expectations for all 15 STRs. Similarly, linkage disequilibrium test demonstrated no association between pair of loci. The power of exclusion and power of discrimination values were 99.999634444% and >99.99999999%, respectively. Genetic relationship analysis regarding Mestizo populations from the main geographic regions of Mexico suggests that the Center and the present South regions conform one population cluster, separated from the Southeast and Northwest regions.
Assuntos
Genética Populacional , Indígenas Norte-Americanos/genética , Repetições de Microssatélites , Impressões Digitais de DNA , Etnicidade/genética , Frequência do Gene , Técnicas de Genotipagem , Humanos , México , Reação em Cadeia da PolimeraseRESUMO
We report two Colombian siblings affected by overgrowth, intellectual disability and facial dysmorphism. Exome (via NGS) and Sanger sequencing revealed that biallelic sequence variants in a novel gene (HERC1) might be related to the disease pathogenesis. These results provide useful data for future genotype-phenotype correlations and for a molecular diagnosis of overgrowth.
Assuntos
Transtornos do Crescimento/genética , Fatores de Troca do Nucleotídeo Guanina/genética , Deficiência Intelectual/genética , Mutação , Análise Mutacional de DNA , Feminino , Estudos de Associação Genética , Genoma Humano , Transtornos do Crescimento/patologia , Humanos , Deficiência Intelectual/patologia , Masculino , Síndrome , Ubiquitina-Proteína LigasesRESUMO
Migrant and seasonal farmworkers are at high risk for musculoskeletal and other occupational injuries. Although persons aged 40-80 years account for 40 % of all US farmworkers and as many as 50 % in certain regions, little is known about their occupational health issues. The current study examined work-related persistent musculoskeletal injuries (PMIs) and their association with clinical and functional indicators of disability and health-related quality of life (HRQOL) in 177 middle-aged and elderly US-Mexico border farmworkers. At interview, 68 % reported current PMI pain; 51 % had pain at multiple sites. PMI pain was associated with increased shoulder, knee, and lower extremity dysfunction and reduced HRQOL scores. However, fewer than 25 % of injured participants received any conventional medical treatment. The study results indicated that work-related PMIs, especially multiple PMIs, caused significant functional impairment, disability, and poorer HRQOL, adversely affecting the ability of the aging farmworkers to perform work, self-care, and other daily activities.
Assuntos
Agricultura/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Traumatismos Ocupacionais/etnologia , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Pessoas com Deficiência/psicologia , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/etnologia , Traumatismos Ocupacionais/epidemiologia , Qualidade de Vida/psicologia , Texas/epidemiologiaRESUMO
Trapeziometacarpal arthrosis is a degenerative condition described by Fostier in 1937. Osteoarthrosis of the trapeziometacarpal joint is a common condition among postmenopausal women; mean age of individuals affected by this disease is 64 years. The male:female ratio is 1:10; 33% of patients have a bilateral component. This study was conducted at Lomas Verdes Traumatology and Orthopedics UMAE hospital, hand surgery module, between March and December 2006. Descriptive, cross-sectional, retrospective study including a total of 18 patients, 12 females (66.6%) and 6 males (33.3%). Mean age is 49.3 years. Patients were clinically and radiographically diagnosed and classified by stages according to the Eaton classification. Surgery was performed more frequently in right hands, which were a total of 10 (55.6%), than left hands, which were 8 (44.4%). Surgery of the dominant hand was performed in 8 patients, 7 of them right handed, and one left handed. Arthrodesis with nails was performed in 12 patients (66.7%) and with a 2.0 condylar plate in 6 (33.3%). Mean operative time was 52.8 minutes. Eleven patients were found to have primary arthrosis, and 7 had posttraumatic arthrosis: 2 due to untreated Benett fractures, one due to a healed trapezius fracture and 4 patients had recurrent dislocation. As regards their occupation, 12 were employees, 5 were housewives and one was unemployed. The concomitant conditions found included: 9 without disease, 7 with hypertension, 7 diabetes mellitus, and one had rheumatoid arthritis. Two patients were reoperated (11.1%) due to pseudoarthrosis. In one of them a new arthrodesis was performed 18 months later, which failed and 8 months later triscaphoid arthrodesis was performed with a 10-week healing time. Trapeziometacarpal arthrodesis is a procedure involving a certain difficulty due to the anatomic conformation of the joint, which results in the various complications that have already been described. It provides pain relief; it is a good option for people who need to resume a type of work requiring the use of force; a longer follow-up is required to determine the course of these patients.
Assuntos
Artrodese , Articulações Carpometacarpais/cirurgia , Adulto , Idoso , Estudos Transversais , Feminino , Mãos/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
Objetivo: describir el manejo intraoperatorio de la hipertensión pulmonar severa mediante la utilización de Oxido Nítrico inhalado. Diseño: Reporte de un caso. Paciente: Paciente con politraumatismo quien requirió tratamiento quirúrgico. Medidas y Resultados: Medición del gasto cardíaco, resistencias vasculares y oxigenación pre y post administración de oxido nítrico. Después de la administración inhalada de NO 10 ppm, el IRVP disminuyó de 889 a 314; el IC de 2.8 a 3.1 y la presión venosa mixta de oxígeno de 21 a 43.3. Conclusión: la utilización de óxido nítrico debe ser considerada cuando la hipertensión pulmonar severa ha sido refractaria y afecte el gasto cardíaco y la perfusión tisular
Assuntos
Hipertensão Pulmonar/cirurgia , Cuidados IntraoperatóriosRESUMO
La cirugía conservadora de tumores óseos localizados en pelvis, representa un desafío para el equipo médico quirúrgico, del cual exige una incuestionable experiencia. La resección innominada tipo II, II-A y la IIA + III presenta serios problemas de reconstrucción, debido a que el remanente óseo es un hueso plano delgado, con una anatomía irregular, que impide efectuar una osteosíntesis estable y suficiente. El objetivo del presente trabajo es dar a conocer una nueva técnica de reconstrucción para la hemipelvectomía parcial interna, mediante el uso de un clavo en "y", bloqueado con pernos a fémur y con cerclajes de alambre al iliaco. Se presenta el reporte preliminar en dos pacientes. Se pretende asegurar la artrodesis femoroiliaca o cuando menos una pseudoartrosis no dolorosa. No hubo acortamiento significativo de la extremidad y la reincorporación a la actividad fue rápida.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Artroplastia de Quadril , Articulação do Quadril/cirurgia , Articulação do Quadril/patologia , Pinos Ortopédicos , Neoplasias PélvicasRESUMO
En el servicio de Biología de la Reproducción Humana del Centro Médico Nacional "20 de Noviembre" del I.S.S.S.T.E. de enero de 1994 a agosto de 1998 en la primera visita fueron tomadas en forma rutinaria muestras para detectar anticuerpos anti-VIH en la pareja. De 672 muestras 3 (0.44 por ciento) fueron positivas para anticuerpos anti-VIH con ELISA y dos de ellas confirmadas con el análisis de Western Blot
Assuntos
Humanos , Feminino , Adulto , Anticorpos Anti-HIV/imunologia , Soropositividade para HIV/diagnóstico , Programas de Rastreamento , México/epidemiologiaRESUMO
An enzyme-linked immunosorbent assay (ELISA) using Mycobacterium tuberculosis antigen 5 has been evaluated as a serodiagnostic test for active tuberculosis in children. Forty children of either sex, ages 1 to 14 yr, were studied, including 21 bacteriologically confirmed tuberculous patients and 19 control subjects who were evaluated for tuberculosis and found to be free of disease. At a 1:20 dilution, the test showed a sensitivity of 0.857 and a specificity of 1.000, with an accuracy value of 0.925, a positive predictive value of 1.000, and a negative predictive value of 0.864. The prevalence of disease calculated directly from the data of the study was found to be of 0.525. The geometric mean ELISA titer of the tuberculosis group was 1:58, and the difference in antibody titers between patient and control groups was found to be statistically significant (p less than 0.001). From our results, we conclude that ELISA using M. tuberculosis antigen 5 may be useful in those situations of high prevalence of disease when children suspected of tuberculosis are being evaluated.
Assuntos
Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina G/imunologia , Mycobacterium tuberculosis/imunologia , Tuberculose/diagnóstico , Adolescente , Vacina BCG , Criança , Pré-Escolar , Estudos de Avaliação como Assunto , Feminino , Humanos , Lactente , Masculino , Testes Cutâneos , Tuberculose/prevenção & controleRESUMO
Se revisaron 629 expedientes clínicos de pacientes con diagnóstico de carcinoma broncogénico, vistos en el Instituto Nacional de Cancerología durante 12 años, de 1975 a 1986. El sexo con mayor frecuencia fue el masculino con el 70% (440 pacientes) y la edad de la 5a. a la 7a. década de la vida. El hábido tabáquico se detectó en el 80% de los enfermos (503). El tiempo de evolución del padecimiento antes de llegar al Instituto fué un promedio de 45 días. El 80% de los pacientes estaban en estado clínico III (503 pacientes). A diferencia de lo reportado en la literatura al respecto, el adenocarcinoma fue el tipo histológico más frecuente
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Carcinoma Broncogênico , Neoplasias PulmonaresAssuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Pacientes Desistentes do Tratamento , Educação em Saúde , Fatores Socioeconômicos , TuberculoseAssuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Pacientes Desistentes do Tratamento , Educação em Saúde , Fatores Socioeconômicos , TuberculoseRESUMO
Se estudiaron 225 enfermos con diferentes formas de tuberculosis pulmonar y extrapulmonar, desde el 1o. de junio de 1979 hasta el 31 de diciembre de 1980, todos ellos virgenes de tratamiento y con enfermedad confirmada por baciloscopia, cultivo o biopsia con estudio histopatologico
Assuntos
Isoniazida , Rifampina , Estreptomicina , Tuberculose , Esquema de MedicaçãoAssuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Doenças Profissionais , Pneumopatias , NeutrófilosRESUMO
Se estudiaron 225 enfermos con diferentes formas de tuberculosis pulmonar y extrapulmonar, desde el 1o. de junio de 1979 hasta el 31 de diciembre de 1980, todos ellos virgenes de tratamiento y con enfermedad confirmada por baciloscopia, cultivo o biopsia con estudio histopatologico