RESUMO
PURPOSE: There is a lack of knowledge about whether low vitamin D levels increase the risk of pediatric low-energy fractures among Hispanic population. The objective of this study is to determine whether there is a direct relationship between low vitamin D levels and the incidence of low-energy fractures in Hispanic children. METHOD: Cases included all consecutive patients evaluated with low-energy fractures in the pediatric orthopedic clinic. The control group consisted of all pediatric patients evaluated, without fractures, who had bone and joint pain complaints in the general pediatric clinic. The main focus was to compare cases and controls in relation to their vitamin D levels. Cases and controls were compared using t tests for means of quantitative variables and Chi-square tests. RESULTS: A total of 201 subjects, distributed as cases (n = 107) and controls (n = 94), were included in this study. One hundred twelve (55.7%) of the total study population were males. The mean age for the study population was 8.6 years old ranging from 1 year to 18 years, and standard deviation = 4.0 years. The median age for the study population was 9 years. The mean vitamin D level for the cases was 32.6 ng/dl (SD = 10.9); the mean vitamin D level for controls was 32.3 ng/dl (SD = 13.4). This difference was not statistically significant (t = 0.18, 95% CI - 3.2 to 3.9; p = 0.854). CONCLUSION: A direct relationship between low vitamin D levels and fracture risk in a Hispanic pediatric population was not established. LEVELS OF EVIDENCE: III.
Assuntos
Fraturas Ósseas/sangue , Fraturas Ósseas/etnologia , Vitamina D/análogos & derivados , Adolescente , Fosfatase Alcalina/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Incidência , Lactente , Masculino , Hormônio Paratireóideo/sangue , Porto Rico/epidemiologia , Vitamina D/sangueRESUMO
STUDY DESIGN: A retrospective cohort study with IRB approval. INTRODUCTION: Significant blood loss remains an important concern in terms of the performance of the posterior spinal fusion in adolescent idiopathic scoliosis. Several strategies have been reported to minimize blood loss during surgery. In order to address the need to minimize blood loss without sacrificing the quality of the fusion, in our hospital, we adopted a two-step surgical approach. This surgical approach consist of the exposure and instrumentation of the lumbar region prior to and followed by an extension of the surgical incision to the thoracic region for its subsequent instrumentation. The main purpose of this study was to compare a two-step surgical approach with the one-step (standard) approach. METHODS: This study was a review of all the data on consecutive posterior spinal fusion surgeries performed by a specific two-surgeon team during 2004-2013. Demographics, surgical variables, radiographic findings, and outcomes regarding blood loss, morbidity, and the duration of the procedure were evaluated. RESULTS: Eighty-five patients underwent the standard surgical exposure, and 41 patients underwent the two-step surgical technique. With the exception of BMI, neither group showed any statistically preoperative variable significant differences. None of the postoperative outcome variables were statistically significant between both surgical approaches. CONCLUSIONS: No differences were detected in terms of using a two-step surgical approach versus the one-step standard surgical approach regarding perioperative blood loss, surgical time, or complications. LEVEL OF EVIDENCE: Level of evidence III.
Assuntos
Perda Sanguínea Cirúrgica , Escoliose , Fusão Vertebral , Adolescente , Perda Sanguínea Cirúrgica/prevenção & controle , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Criança , Estudos de Coortes , Pesquisa Comparativa da Efetividade , Feminino , Humanos , Cuidados Intraoperatórios/métodos , Masculino , Radiografia/métodos , Estudos Retrospectivos , Escoliose/diagnóstico , Escoliose/cirurgia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Resultado do TratamentoRESUMO
Se obtuvieron datos de 4,189 expedientes de donaciones de sangre procedentes de dos bancos de sangre en Puerto Rico para determinar si los puertorriqueños tienden a tener niveles en sangre de ALT-SGPT más altos en comparación con donantes de sangre de otros grupos étnicos. El promedio general de ALT-SGPT fue de 36.84 u/l (alcance 1-910, desviación estandard 37.8). El logarítmo de ALT FUE DE 1.47 (alcance 1-2.96, desviación estandard). Analisis de cada banco de sangre en dos períodos de tiempo demostraba promedios de ALT-SGPT consistentemente altos aún cuando excluían donaciones positivas para hepatitis B, H. I. V. y sífilis. Aunque las causas de estos hallazgos no estan claras, factores ambientales como el consumo de alcohol deben considerar-se como posibles explicaciones