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1.
J Clin Med ; 13(12)2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38929939

RESUMO

Background: Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries (RCIs) are notable for their high prevalence. The critical shoulder angle (CSA) is a significant radiological measure for determining the diagnosis and progression of patients with these conditions. Although there are reports in the international literature about this measure, in our country, guideline values considering these two pathologies are unknown. Objective: Our objective was to assess patients diagnosed with GHOA and RCI using an AP X-ray view and the CSA. Methods: To conduct this, we identified differences between sexes and age categories. Fifty-nine adult patients with GHOA and RCI were included. CSA grades varied depending on the age category and type of injury evaluated. Results: Significant differences between the age ranges of 40 and 54 (p = 0.05), 55-69 (p = 0.001), and 70-84 (p = 0.017) were observed. Conclusions: Patients with RCI tended to be younger and have a higher CSA compared to those with GHOA. It is important to have more normative values and to continue monitoring the critical shoulder angle in these patients.

2.
Arthrosc Tech ; 13(2): 102847, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38435258

RESUMO

Traditionally, the management of rotator cuff tears in elderly individuals has involved surgical intervention, specifically biceps tenotomy. However, surgical procedures come with inherent medical risks and significant financial costs. As an alternative, ultrasound-guided biceps tenotomy combined with corticosteroid has emerged as a highly effective, well-tolerated, and cost-efficient option. This article aims to describe the procedural technique of nonsurgical management using ultrasound-guided biceps tenotomy combined with corticosteroid injection.

3.
PhytoKeys ; 237: 201-218, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38317828

RESUMO

Two new species of Haplopappus (Asteraceae) from central Chile are described in this article. Haplopappuscolliguayensissp. nov. is restricted to La Chapa hill, Colliguay, Valparaíso Region, and is most similar to H.undulatus but differs from the latter in its stem indumentum, leaf shape and margin, and synflorescence arrangement. Haplopappusteillierisp. nov. has been recorded from four high-Andean localities in the Choapa, Petorca, Rocín and Aconcagua river basins, and is most similar to H.punctatus but differs from the latter in its leaf length and margin, number of peduncles per twig, width of outer phyllaries, number of ray florets per capitulum, and achene dimensions. Additionally, we propose the reinstatement of H.kingii in agreement with an exhaustive revision of type material and protologues, as well as the study of herbarium specimens. Haplopappuskingii is restricted to mountainous areas in the southern portion of the Atacama Region, and resembles H.parvifolius and H.retinervius but differs from both by its leaf margin and apex, besides additional differences from each. We provide morphological descriptions, field images, distributional maps, conservation assessments, and taxonomic notes for the three species treated, as well as illustrations for the novel taxa.

4.
Investig. desar ; 31(2)dic. 2023.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1534748

RESUMO

Neste artigo objetivamos estudar as imagens de mulheres na publicidade exterior e nas intervenções urbanas, perceber os discursos recorrentes, fenotipos e identificar as ausências e presenças de marcadores sociais da diferença. Observamos as cidades brasileiras de Natal (Rio Grande do Norte) e Recife (Pernambuco), em comparação com a cidade espanhola de Barcelona (Catalunha). Utilizamos a etnografia para o mapeamento e coleta dos dados, cujo período corresponde a abril de 2021 a novembro de 2022. Adotamos parte da metodologia multimodal (análise da emissão) e recorremos à perspectiva interseccional para refletir criticamente sobre as imagens. Concluímos que as intervenções urbanas apresentam temas emergentes do universo das mulheres, como o feminicídio e o racismo, e direcionam à educação feminista, ou seja, elas surgem como contraponto discursivo às imagens de submissão de mulheres propagadas pela publicidade.


En este artículo nos propusimos estudiar las imágenes de las mujeres en la publicidad exterior y las intervenciones urbanas, percibir los discursos recurrentes, los fenotipos e identificar las ausencias y presencias de marcadores sociales de diferencia. Observamos las ciudades brasileñas de Natal (Rio Grande do Norte) y Recife (Pernambuco), en comparación con la ciudad española de Barcelona (Cataluña). Utilizamos la etnografía para el mapeo y la recopilación de datos, cuyo período corresponde a abril de 2021 a noviembre de 2022. Adoptamos parte de la metodología multimodal (análisis de emisiones) y recurrimos a la perspectiva interseccional para reflexionar críticamente sobre las imágenes. Concluimos que las intervenciones urbanas presentan temas emergentes del universo femenino, como el feminicidio y el racismo, y apuntan a la educación feminista, es decir, surgen como contrapunto discursivo a las imágenes de sumisión de la mujer propagadas por la publicidad.

5.
Sci Rep ; 13(1): 17137, 2023 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-37816871

RESUMO

Alzheimer's disease (AD) is the most common neurodegenerative disorder, characterized by protein accumulation in the brain as a main neuropathological hallmark. Among them, Aß42 peptides tend to aggregate and create oligomers and plaques. Macroautophagy, a form of autophagy characterized by a double-membrane vesicle, plays a crucial role in maintaining neuronal homeostasis by degrading protein aggregates and dysfunctional organelles as a quality control process. Recently, DEF8, a relatively uncharacterized protein, has been proposed as a participant in vesicular traffic and autophagy pathways. We have reported increased DEF8 levels in lymphocytes from mild cognitive impairment (MCI) and early-stage AD patients and a neuronal profile in a murine transgenic AD model. Here, we analyzed DEF8 localization and levels in the postmortem frontal cortex of AD patients, finding increased levels compared to healthy controls. To evaluate the potential function of DEF8 in the nervous system, we performed an in silico assessment of its expression and network profiles, followed by an in vivo evaluation of a neuronal Def8 deficient model using a Drosophila melanogaster model of AD based on Aß42 expression. Our findings show that DEF8 is an essential protein for maintaining cellular homeostasis in the nervous system, and it is upregulated under stress conditions generated by Aß42 aggregation. This study suggests DEF8 as a novel actor in the physiopathology of AD, and its exploration may lead to new treatment avenues.


Assuntos
Doença de Alzheimer , Animais , Humanos , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Autofagia/genética , Encéfalo/metabolismo , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Fragmentos de Peptídeos/metabolismo
6.
JAMA Psychiatry ; 80(10): 991-999, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37466983

RESUMO

Importance: A transdiagnostic treatment, the Unified Protocol, is as effective as single diagnostic protocols in comorbid emotional disorders in clinical populations. However, its effects on posttraumatic stress disorder and other emotional disorders in individuals living in war and armed conflict contexts have not been studied. Objective: To evaluate the efficacy of a cultural and contextual adaptation of the Unified Protocol (CXA-UP) on posttraumatic stress disorder, anxiety, and depression compared to waitlist control in individuals exposed to armed conflict in Colombia. Design, Setting, and Participants: From April 2017 to March 2020, 200 participants 18 years and older were randomly assigned to the CXA-UP or to a waitlist condition. CXA-UP consisted of 12 to 14 twice-a-week or weekly individual 90-minute face-to-face sessions. Outcomes were assessed at baseline, posttreatment, and 3 months following treatment. Analyses were performed and compared for all randomly allocated participants (intent-to-treat [ITT]) and for participants who completed all sessions and posttreatment measures (per protocol [PP]). The study took place at an outpatient university center and included individuals who were registered in the Colombian Victims Unit meeting DSM-5 diagnostic criteria for posttraumatic stress disorder, anxiety, or depression or were severely impaired by anxiety or depression. Individuals who were receiving psychological therapy, were dependent on alcohol or drugs, were actively suicidal or had attempted suicide in the previous 2 months, had psychosis or bipolar disorder, or were cognitively impaired were excluded. Intervention: CXA-UP or waitlist. Main Outcomes and Measures: Primary outcomes were changes in anxiety, depression, and somatic scores on the Patient Health Questionnaire and Posttraumatic Stress Disorder Checklist for DSM-5. Results: Among the 200 participants (160 women [80.0%]; 40 men [20.0%]; mean [SD] age, 43.1 [11.9] years), 120 were randomized to treatment and 80 to waitlist. Results for primary outcomes in the ITT analysis showed a significant pretreatment-to-posttreatment reduction when comparing treatment and waitlist on the posttraumatic stress disorder checklist for DSM-5 scores (slope [SE], -31.12 [3.00]; P < .001; Cohen d, 0.90; 90% CI, 0.63-1.19), 9-item Patient Health Questionnaire (PHQ-9) (slope [SE],-11.94 [1.30]; P < .001; Cohen d, 0.77; 90% CI, 0.52-1.06), PHQ-anxiety (slope [SE], -6.52 [0.67]; P < .001; Cohen d, 0.82; 90% CI, 0.49-1.15), and PHQ-somatic (slope [SE], -8.31 [0.92]; P < .001; Cohen d, 0.75; 90% CI, 0.47-1.04). Conclusions and Relevance: In this study, significant reductions and large effect sizes in all measures of different emotional disorders showed efficacy of a single transdiagnostic intervention in individuals exposed to armed conflicts. Trial Registration: ClinicalTrials.gov Identifier: NCT03127982.


Assuntos
Transtornos de Ansiedade , Transtornos de Estresse Pós-Traumáticos , Masculino , Humanos , Feminino , Adulto , Colômbia , Transtornos de Ansiedade/terapia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ansiedade/diagnóstico , Ansiedade/terapia , Conflitos Armados , Resultado do Tratamento
7.
Front Med (Lausanne) ; 10: 1070499, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37305126

RESUMO

Background: The supraspinatus muscle fatty infiltration (SMFI) is a crucial MRI shoulder finding to determine the patient's prognosis. Clinicians have used the Goutallier classification to diagnose it. Deep learning algorithms have been demonstrated to have higher accuracy than traditional methods. Aim: To train convolutional neural network models to categorize the SMFI as a binary diagnosis based on Goutallier's classification using shoulder MRIs. Methods: A retrospective study was performed. MRI and medical records from patients with SMFI diagnosis from January 1st, 2019, to September 20th, 2020, were selected. 900 T2-weighted, Y-view shoulder MRIs were evaluated. The supraspinatus fossa was automatically cropped using segmentation masks. A balancing technique was implemented. Five binary classification classes were developed into two as follows, A: 0, 1 v/s 3, 4; B: 0, 1 v/s 2, 3, 4; C: 0, 1 v/s 2; D: 0, 1, 2, v/s 3, 4; E: 2 v/s 3, 4. The VGG-19, ResNet-50, and Inception-v3 architectures were trained as backbone classifiers. An average of three 10-fold cross-validation processes were developed to evaluate model performance. AU-ROC, sensitivity, and specificity with 95% confidence intervals were used. Results: Overall, 606 shoulders MRIs were analyzed. The Goutallier distribution was presented as follows: 0 = 403; 1 = 114; 2 = 51; 3 = 24; 4 = 14. Case A, VGG-19 model demonstrated an AU-ROC of 0.991 ± 0.003 (accuracy, 0.973 ± 0.006; sensitivity, 0.947 ± 0.039; specificity, 0.975 ± 0.006). B, VGG-19, 0.961 ± 0.013 (0.925 ± 0.010; 0.847 ± 0.041; 0.939 ± 0.011). C, VGG-19, 0.935 ± 0.022 (0.900 ± 0.015; 0.750 ± 0.078; 0.914 ± 0.014). D, VGG-19, 0.977 ± 0.007 (0.942 ± 0.012; 0.925 ± 0.056; 0.942 ± 0.013). E, VGG-19, 0.861 ± 0.050 (0.779 ± 0.054; 0.706 ± 0.088; 0.831 ± 0.061). Conclusion: Convolutional neural network models demonstrated high accuracy in MRIs SMFI diagnosis.

8.
Repert. med. cir ; 32(1): 38-47, 2023. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1526554

RESUMO

Introducción: la osteoartritis de rodilla (OR) se define como una enfermedad crónica, inflamatoria, degenerativa y progresiva, caracterizada por el deterioro del cartílago articular. Tiene manifestaciones clínicas y etiológicas diferentes según el grupo etario y se encuentra asociada con múltiples factores que intervienen en la fisiopatología, entre los que están: edad, raza, sexo, sobrepeso, obesidad y síndrome metabólico. Objetivo: determinar los factores de riesgo que influyen en el proceso degenerativo de la OR en la adultez temprana y tardía. Materiales y métodos: revisión sistemática de la literatura científica en diferentes bases de datos que incluyeron estudios de cohorte, transversales, casos y controles, evaluando los factores de riesgo predisponentes. Resultados: se seleccionaron 50 artículos que cumplieron con los criterios, identificando diferentes factores que afectan el desarrollo o progresión de la OR como las alteraciones metabólicas, sistémicas y estilo de vida que influyen en esta patología, además de factores modificables y no modificables. Conclusión: la OR es una afección de carácter multifactorial, donde la obesidad, la hipertensión arterial (HTA), el índice de masa corporal (IMC) elevado, los niveles altos de LDL, la debilidad muscular e incluso la profesión del paciente, son los principales factores predisponentes para desarrollar o aumentar su progresión.


Introduction: knee osteoarthritis (OA) is defined as a chronic, inflammatory, degenerative, and progressive disease, characterized by articular cartilage deterioration. It has different clinical and etiological manifestations according to age group and multiple contributing pathophysiological factors, among which are: age, race, gender, overweight, obesity and metabolic syndrome. Objective: to determine the risk factors leading to knee OA degenerative process in early and late adulthood. Materials and methods: a systematic review of the scientific literature which included cohort cross-sectional case-control studies evaluating knee OA predisposing risk factors, in different databases. Results: fifty articles which met the criteria and identified the various predisposing factors for developing knee OA such as metabolic, systemic and lifestyle alterations, in addition to modifiable and non-modifiable factors, were selected. Conclusion: knee OA is a multifactorial condition, where obesity, hypertension, high body mass index (BMI), high LDL levels, poor muscular strength and even the patient ́s occupation are the main predisposing factors for developing or increasing knee OA progression.


Assuntos
Humanos , Adulto , Idoso
9.
Rev Sci Instrum ; 93(10): 105101, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319312

RESUMO

Here, we build and characterize a single-stage gas-gun microparticle accelerator, where a pressurized gas expands and launches particles on a target. The microparticles in the range of 60-250 µm are accelerated by the expansion of pressurized nitrogen. By using a high-speed camera, we study how the velocity distribution of accelerated particles is modified by particle size, pressure in the gas reservoir, valve's opening time, and diaphragm's thickness and composition. We employ this microparticle accelerator to study the impact of glass particles with diameters of (69 ± 6) µm accelerated at moderate velocities ∼ (10-25) m/s, using films of poly-dimethylsiloxane as targets.

10.
Front Med (Lausanne) ; 9: 945698, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36213676

RESUMO

Background: Ultrasound (US) is a valuable technique to detect degenerative findings and intrasubstance tears in lateral elbow tendinopathy (LET). Machine learning methods allow supporting this radiological diagnosis. Aim: To assess multilabel classification models using machine learning models to detect degenerative findings and intrasubstance tears in US images with LET diagnosis. Materials and methods: A retrospective study was performed. US images and medical records from patients with LET diagnosis from January 1st, 2017, to December 30th, 2018, were selected. Datasets were built for training and testing models. For image analysis, features extraction, texture characteristics, intensity distribution, pixel-pixel co-occurrence patterns, and scales granularity were implemented. Six different supervised learning models were implemented for binary and multilabel classification. All models were trained to classify four tendon findings (hypoechogenicity, neovascularity, enthesopathy, and intrasubstance tear). Accuracy indicators and their confidence intervals (CI) were obtained for all models following a K-fold-repeated-cross-validation method. To measure multilabel prediction, multilabel accuracy, sensitivity, specificity, and receiver operating characteristic (ROC) with 95% CI were used. Results: A total of 30,007 US images (4,324 exams, 2,917 patients) were included in the analysis. The RF model presented the highest mean values in the area under the curve (AUC), sensitivity, and also specificity by each degenerative finding in the binary classification. The AUC and sensitivity showed the best performance in intrasubstance tear with 0.991 [95% CI, 099, 0.99], and 0.775 [95% CI, 0.77, 0.77], respectively. Instead, specificity showed upper values in hypoechogenicity with 0.821 [95% CI, 0.82, -0.82]. In the multilabel classifier, RF also presented the highest performance. The accuracy was 0.772 [95% CI, 0.771, 0.773], a great macro of 0.948 [95% CI, 0.94, 0.94], and a micro of 0.962 [95% CI, 0.96, 0.96] AUC scores were detected. Diagnostic accuracy, sensitivity, and specificity with 95% CI were calculated. Conclusion: Machine learning algorithms based on US images with LET presented high diagnosis accuracy. Mainly the random forest model shows the best performance in binary and multilabel classifiers, particularly for intrasubstance tears.

11.
Rev. argent. salud publica ; 14(supl.1): 55-55, feb. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1407218

RESUMO

RESUMEN INTRODUCCIÓN: Uno de los desafíos más relevantes al comienzo de la pandemia consistió en implementar estrategias dirigidas a prevenir la transmisión del virus SARS-CoV-2 y mitigar el impacto de la COVID-19. El propósito de este estudio fue contribuir a reducir la transmisión comunitaria a través de una iniciativa interinstitucional, cuyos objetivos fueron validar un método de detección de ARN del SARS-CoV-2 e implementar y evaluar la vigilancia en trabajadores de salud asintomáticos de instituciones de salud pública de Bahía Blanca. MÉTODOS: Se validó una prueba de detección del gen E del coronavirus mediante RT-PCR a partir de ARN aislado de hisopados nasofaríngeos. Para aumentar la capacidad de testeo se validó la detección del ARN viral en muestras agrupadas (pooles). Se realizó un estudio de cohorte prospectiva entre el 15/09/20 y el 15/09/21. RESULTADOS: La sensibilidad y especificidad de la prueba en muestras individuales fue del 95% (IC 95%: 85%-100%). La sensibilidad de la detección en pooles fue del 73% (IC 95%: 46%-99%) y la especificidad, del 100%. A lo largo de la vigilancia se incluyeron 855 trabajadores y 1764 hisopados, con una incidencia acumulada anual de 2,3% (IC 95%: 1,2%-3,4%). Se detectaron 20 casos asintomáticos positivos. DISCUSIÓN: El tamizaje de trabajadores de salud asintomáticos en la pandemia contribuyó a reducir el riesgo de brotes hospitalarios. Asimismo, se generó un marco de trabajo interdisciplinario aplicable a otros problemas de salud.


ABSTRACT INTRODUCTION: One of the most important challenges at the beginning of the pandemic was to implement strategies to prevent SARS-CoV-2 virus transmission and reduce the impact of COVID-19. The purpose of this study was to contribute to the reduction of community transmission through an interinstitutional initiative, aimed at validating a SARS-CoV-2 RNA detection method, and at implementing and assessing the surveillance of asymptomatic infected healthcare workers (HCWs) at public health institutions in the city of Bahía Blanca. METHODS: To validate a coronavirus RNA detection method, RNA was extracted from nasopharyngeal swabs and identification of the viral E gene was done by RT-PCR. Validation of sample pooling was performed to increase the testing capacity. A prospective cohort study was conducted from 15 September 2020 to 15 September 2021. RESULTS: The sensitivity and specificity of the test in individual samples was 95% (CI 95%: 85%-100%). The sensitivity of the pooling strategy was 73% (CI 95%: 46%-99%) and the specificity was 100%. A total of the 855 HCWs were included in the surveillance and 1764 swabs were performed, with an annual cumulative incidence of 2.3% (CI 95%: 1,2%-3,4%), and 20 positive asymptomatic cases were detected. DISCUSSION: The screening of asymptomatic HCWs during the pandemic contributed to reduce the risk of outbreaks in hospital settings. Moreover, an interdisciplinary team framework applicable to other health problems was generated.

12.
Rev. argent. salud pública ; 14 (Suplemento COVID-19), 2022;14: 1-9, 02 Febrero 2022.
Artigo em Espanhol | LILACS, ARGMSAL, BINACIS | ID: biblio-1392755

RESUMO

INTRODUCCIÓN: Uno de los desafíos más relevantes al comienzo de la pandemia consistió en implementar estrategias dirigidas a prevenir la transmisión del virus SARS-CoV-2 y mitigar el impacto de la COVID-19. El propósito de este estudio fue contribuir a reducir la transmisión comunitaria a través de una iniciativa interinstitucional, cuyos objetivos fueron validar un método de detección de ARN del SARS-CoV-2 e implementar y evaluar la vigilancia en trabajadores de salud asintomáticos de instituciones de salud pública de Bahía Blanca. MÉTODOS: Se validó una prueba de detección del gen E del coronavirus mediante RT-PCR a partir de ARN aislado de hisopados nasofaríngeos. Para aumentar la capacidad de testeo se validó la detección del ARN viral en muestras agrupadas (pooles). Se realizó un estudio de cohorte prospectiva entre el 15/09/20 y el 15/09/21. RESULTADOS: La sensibilidad y especificidad de la prueba en muestras individuales fue del 95% (IC 95%: 85%-100%). La sensibilidad de la detección en pooles fue del 73% (IC 95%: 46%-99%) y la especificidad, del 100%. A lo largo de la vigilancia se incluyeron 855 trabajadores y 1764 hisopados, con una incidencia acumulada anual de 2,3% (IC 95%: 1,2%-3,4%). Se detectaron 20 casos asintomáticos positivos. DISCUSIÓN: El tamizaje de trabajadores de salud asintomáticos en la pandemia contribuyó a reducir el riesgo de brotes hospitalarios. Asimismo, se generó un marco de trabajo interdisciplinario aplicable a otros problemas de salud.


Assuntos
Programas de Rastreamento , Reação em Cadeia da Polimerase , Pessoal de Saúde , SARS-CoV-2
13.
ACS Appl Mater Interfaces ; 14(4): 5843-5855, 2022 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-35048694

RESUMO

Near-infrared (NIR) radiation plays an important role in guided external stimulus therapies; its application in bone-related treatments is becoming more and more frequent. Therefore, metallic biomaterials that exhibit properties activated by NIR are promising for further orthopedic procedures. In this work, we present an adapted electroforming approach to attain a biomorphic nano-holed TiO2 coating on Ti6Al4V alloy. Through a precise control of the anodization conditions, structures revealed the formation of localized nano-pores arranged in a periodic assembly. This specific organization provoked higher stability against thermal oxidation and precise hydrophobic wettability behavior according to Cassie-Baxter's model; both characteristics are a prerequisite to ensure a favorable biological response in an implantable structure for guided bone regeneration. In addition, the periodically arranged sub-wavelength-sized unit cell on the metallic-dielectric structure exhibits a peculiar optical response, which results in higher NIR reflectivity. Accordingly, we have proved that this effect enhances the efficiency of the scattering processes and provokes a significant improvement of light confinement producing a spontaneous NIR fluorescence emission. The combination of the already favorable mechanical and biocompatibility properties of Ti6Al4V, along with suitable thermal stability, wetting, and electro-optical behavior, opens a promising path toward strategic bone therapeutic procedures.


Assuntos
Ligas/química , Materiais Biomiméticos/química , Materiais Revestidos Biocompatíveis/química , Ligas/efeitos da radiação , Materiais Biomiméticos/efeitos da radiação , Materiais Revestidos Biocompatíveis/efeitos da radiação , Interações Hidrofóbicas e Hidrofílicas , Raios Infravermelhos , Porosidade , Titânio/química , Titânio/efeitos da radiação , Molhabilidade
14.
Orthop Res Rev ; 14: 495-503, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36606066

RESUMO

Background: Lateral elbow tendinopathy (LET) is one of the most common causes of musculoskeletal pain. The diagnosis is based on the clinical history and different physical maneuvers. Ultrasound (US) is a complementary diagnostic method to detect degenerative tendon changes and intrasubstance tears (IST). To date, there is no available physical maneuver to identify an IST in patients with LET. Aim: To evaluate the diagnostic accuracy of an index test to detect an IST confirmed by ultrasound in patients with LET. Methods: A diagnostic retrospective study was performed. Patients who presented medical records with LET were recruited. Two orthopaedic surgeons developed the physical maneuver. The index test was considered positive when the position failed to resist the wrist extension maximum effort. Clinical findings were associated with confirmation of IST by US. Data were calculated using diagnostic accuracy, sensitivity, and specificity with 95% confidence intervals. Results: Thirty-nine patients (39 elbows) were analyzed, 25 (64%) women and 14 (36%) men, with an average age of 47.7 years. The index test's sensitivity was 0.86 (95% CI, 0.67-0.96). Accuracy was 0.79 (95% CI, 0.64-0.91), and the specificity was 0.64 (95% CI, 0.31-0.89). Conclusion: The index test presented very good sensitivity and good accuracy in patients with LET with US diagnostic confirmation of IST. Level of Evidence: Diagnostic study, Level III.

15.
Neumol. pediátr. (En línea) ; 17(4): 113-116, 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1427361

RESUMO

Las alteraciones de la relación entre la ventilación y el flujo sanguíneo (V/Q) en diversas regiones del pulmón alteran el aporte de oxígeno (O2) y remoción del dióxido de carbono (CO2) al organismo. Fisiológicamente existen diferencias regionales en la relación V/Q. Determinadas patologías pueden alterar esta relación, produciendo tres escenarios distintos: Cortocircuito (Shunt), Alteración V/Q y aumento del espacio muerto. Para evaluar estos escenarios y realizar una aproximación diagnostica son de utilidad el estudio de los gases arteriales y venosos, la diferencia alveolo arterial y la respuesta al suministrar O2


Alterations in the ventilation perfusion relationship (V/Q) in various lung regions alter the supply of oxygen (O2) and the removal of carbon dioxide (CO2) in the body. Physiologically, there are regional differences in the V/Q ratio. Certain pathologies can alter this relationship, producing three different scenarios: Shunt, V/Q mismach and dead space increased. To evaluate these scenarios and carry out a diagnostic approach, it is useful to study arterial and venous gasometry, the alveolar arterial difference and the response to oxygen supplying.


Assuntos
Humanos , Fenômenos Fisiológicos Respiratórios , Relação Ventilação-Perfusão/fisiologia , Gasometria
17.
Rev. argent. cir. plást ; 26(2): 88-91, apr-jun 2020. fig, tab
Artigo em Espanhol | LILACS | ID: biblio-1147144

RESUMO

El lindefema masivo localizado es una condición rara pero su incidencia se encuentra en aumento. El linfedema puede ser primario o secundario a infecciones, radioterapia, cirugías, cáncer, enfermedades del sistema inmune o a compresión. Algunos autores han sugerido un incremento en su incidencia debido a la epidemia de obesidad. El linfedema escrotal produce una morbilidad importante debido a mala higiene, infecciones, incontinencia urinaria, disfunción sexual, pérdida de la libido e inclusive limitación en la deambulación. Las opciones de tratamiento no quirúrgico de la linfedema incluyen el drenaje linfático manual, prendas de compresión, terapia física y ejercicio. Usualmente, el tratamiento conservador falla debido a la dificultad anatómica que presenta la región genital para la aplicación de dichas terapias. El tratamiento quirúrgico puede ser efectivo en casos graves y moderados. Existen diferentes variantes a la técnica quirúrgica, pero la resección del tejido afectado y la reconstrucción con tejido sano es primordial. El pronóstico de esta patología tiende a ser bueno; sin embargo, se reporta una alta tasa de recidiva.


Massive localized lymphedema is a rare but rising condition that could be primary in nature or secondary to infections, radiation, surgery, malignancies, autoimmune or compression. Some authors have suggested and increased incidence due to the raising epidemic of obesity. Scrotal lymphedema causes significant morbidity such as poor hygiene, infections, urinary incontinence, sexual dysfunction, loss of libido and a limited ambulation. Although non operative treatment options for lymphedema include manual lymph drainage, compression garments, exercises, sequential gradient pump. Usually, non-operative techniques fail due to the difficult in the anatomic area. Surgical treatment can be effective in moderate to severe cases of giant scrotal lymphedema. There are many variations of the surgical technique, however, resection of the affected tissue and reconstruction with healthy skin is primordial. The prognosis tends to be good, although there is reported a significant amount of relapse, mostly dependent on the weight lost and diet of the patients


Assuntos
Humanos , Masculino , Adulto , Escroto/cirurgia , Linfedema/patologia , Elefantíase , Neoplasias , Obesidade
18.
J Ultrasound Med ; 39(1): 165-168, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31268176

RESUMO

The aim of this study was to describe a perineural ultrasound-guided infiltration technique for management of radial tunnel syndrome and to report its preliminary results in 54 patients. A mixture of a saline solution, a local anesthetic, and a corticosteroid solution was infiltrated in the perineural region at the arcade of Frohse. Pain was reported in 100% of patients before the procedure versus 1.9% after the procedure. Scratch collapse and Cozen test results were positive in 98.1% and 66.7% of patients before infiltration, respectively, versus 5.6% and 9.2% after infiltration. All variables had statistically significant differences between preprocedure and postprocedure evaluations (P < .01).


Assuntos
Corticosteroides/uso terapêutico , Anestésicos Locais/uso terapêutico , Neuropatia Radial/tratamento farmacológico , Solução Salina/uso terapêutico , Ultrassonografia de Intervenção/métodos , Corticosteroides/administração & dosagem , Anestésicos Locais/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Radial/diagnóstico por imagem , Neuropatia Radial/diagnóstico por imagem , Estudos Retrospectivos , Solução Salina/administração & dosagem , Síndrome , Resultado do Tratamento
19.
Rev. chil. anest ; 49(6): 911-914, 2020. ilus
Artigo em Inglês | LILACS | ID: biblio-1512358

RESUMO

Intraabdominal fluid extravasation (IAFE) is a rare complication of hip arthroscopy which has a wide range of clinical presentations, from mild abdominal distention to abdominal compartment syndrome and cardiorespiratory arrest. There are few detailed reports of cases in literature, therefore, considering risk factors, high pathological suspicion and training in ultrasound are key points to prevent complications and health costs. In this report, the case of a 29 year old male patient with severe abdominal pain during the immediate postoperative period of an arthroscopic hip surgery is presented, which led to a review of the literature on the subject.


La extravasación intraabdominal de líquido es una complicación poco frecuente de la artroscopia de cadera que presenta un amplio rango de manifestaciones clínicas, desde leve distensión abdominal hasta síndrome compartimental y paro cardiorrespiratorio. Hay escasos reportes de casos en la literatura, por lo que la alta sospecha considerando factores de riesgo y el ultrasonido son claves para prevenir sus complicaciones y costos asociados. En este reporte, se presenta el caso de un paciente masculino de 29 años con dolor abdominal intenso durante el postoperatorio inmediato de una artroscopia de cadera, lo que llevó a una revisión de la literatura sobre el tema.


Assuntos
Humanos , Masculino , Adulto , Artroscopia/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Articulação do Quadril/cirurgia , Dor Pós-Operatória/etiologia , Tomografia Computadorizada por Raios X , Fatores de Risco , Cavidade Abdominal/diagnóstico por imagem , Extravasamento de Materiais Terapêuticos e Diagnósticos/diagnóstico por imagem
20.
Revista Divulgación Científica ; 4: 82-85, 2020. Ilus
Artigo em Espanhol, Inglês | COLNAL | ID: biblio-1282932

RESUMO

Las protestas de las comunidades afrodescendientes e indígenas emberas a favor de la construcción de la hidroeléctrica en la Ensenada de Utría, Chocó, fueron uno de los hallazgos durante la investigación realizada por Nicolás Acosta García y Katharine N. Farrell. De ella, se derivó el artículo Elaborando la electricidad a través de la protesta social. En él, los investigadores muestran la importancia de escuchar la voz de comunidades sin preconcepciones ni paternalismos.


The protests of the Afro-descendant and indigenous Emberas communities in favor of the construction of the hydroelectric plant in Ensenada de Utría, Chocó, were one of the findings during the investigation carried out by Nicolás Acosta García and Katharine N. Farrell. From it, the article Making electricity through social protest was derived. In it, the researchers show the importance of listening to the voice of communities without preconceptions or paternalisms.


Assuntos
Humanos , Povos Indígenas , Pesquisa , Indústria da Construção , Eletricidade , Luz
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