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OBJECTIVE: Various systemic inflammation response indexes (SIRI) have repeatedly been described as prognostic factors in ovarian cancer. They have not been validated in prospective trials and published results are sometimes contradictory. We aimed to explore their role in a cohort of patients diagnosed with stage III and IV ovarian cancer treated at our institution. METHODS: We retrospectively examined the prognostic influence of the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the monocyte-to-lymphocyte ratio (MLR), the red cell distribution width (RDW), and the mean platelet volume (MPV). RESULTS: A total of 77 patients were analyzed. NLR > 2.243 at diagnosis, NLR before primary surgery, MLR at diagnosis, PLR > 289.1 at diagnosis, and PLR at diagnosis were significant in univariate Cox regression for progression-free survival, but none of them retained their significance in the multivariate Cox regression analysis. For overall survival, NLR > = 2.53 at diagnosis, MLR > = 0.245 at diagnosis, and PLR > = 198.3 at diagnosis resulted significant in univariate COX regression; only PLR > = 198.3 at diagnosis retained its significance in the multivariate analysis. CONCLUSION: In our cohort, PLR > = 198.3 was an independent prognostic factor for worse OS. The definitive role of SIRI in ovarian cancer has not yet been established. If their value as prognostic factors could finally be established, they would become a simple and economical method to predict prognosis in patients with advanced ovarian cancer. Therefore, it is time to conduct prospective, multicenter studies with larger samples to definitively establish its role in ovarian cancer, if any.
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Viability of a fractional-order proportional-integral-derivative (PID) approximation to regulate voltage in buck-boost converters is investigated. The converter applications range not only to high-power ones but also in micro/nano-scale systems from biomedicine for energy management/harvesting. Using a classic closed-loop control diagram the controller effectiveness is determined. Fractional calculus is considered due to its ability at modeling different types of systems accurately. The non-integer approach is integrated into the control strategy through a Laplacian operator biquadratic approximation to generate a flat phase curve in the system closed-loop frequency response. The controller synthesis considers both robustness and closed-loop performance to ensure a fast and stable regulation characteristic. A simple tuning method provides the appropriate gains to meet design requirements. The superiority of proposed approach, determined by comparing the obtained time constants with those from typical PID controllers, confirms it as alternative to controller non-minimum phases systems. Experimental realization of the resulting controller, implemented through resistor-capacitor (RC) circuits and operational amplifiers (OPAMPs) in adder configuration, confirms its effectiveness and viability.
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The operation of Boost converters in discontinuous conduction mode (DCM) is suitable for many applications due to the, among other advantages, inductor volume reduction, high efficiency, paralleling, and low cost. Uses in biomedicine, nano/microelectromechanical, and higher power systems, where wide ranges of input/output voltage and a constant power load (CPL) can coexist, are well-known examples. Under extremely wide operating ranges, it is not difficult to change to a continuous conduction mode (CCM) operation, and instability, chaos, or bifurcations phenomena can occur regardless of the conduction mode. Unfortunately, existing control strategies consider a single conduction mode or linearized models because only slight resistive/CPL power level or input/output voltage variations (and no conduction mode changes) were expected. In this paper, new mathematical models for the Boost converter (with resistive or CPL) that are conduction mode independent are presented and validated. Since the open-loop dynamics of the proposed CPL model is unstable, a nonlinear control law capable of stabilizing the boost converter regardless of the conduction mode is proposed. A stability analysis based on a common-Lyapunov function is provided, and numerical and experimental tests are presented to show the proposal's effectiveness.
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La trombosis en recién nacidos (RN) es una patología infrecuente que se asocia principalmente a catéter venoso central. Su presentación clínica puede ser la de un RN asintomático o con sintomatología variable, según la ubicación y tamaño de la trombosis. El diagnóstico generalmente se realiza con ecografía doppler y exámenes específicos según sea la presentación clínica. Con respecto al manejo, actualmente no existe mucha evidencia en RN, pero se suele utilizar trombolíticos/fibrinolíticos extrapolando las investigaciones de adultos. En esta revisión se detalla sobre epidemiología, fisiopatología, factores de riesgo, presentaciones clínicas, diagnóstico y tratamiento. Existe falta de estudios sobre epidemiología nacional y tratamiento en RN, se plantea la necesidad de estos.
Thrombosis in newborns is an infrequent pathology which is mainly associated with a central venous catheter. Its clinical presentation may be that of an asymptomatic newborn or with variable symptoms, depending on the location and size of the thrombosis. The diagnosis is generally made with Doppler ultrasound and specific examinations depending on the clinical presentation. Regarding management, currently there is not much evidence in newborns, but thrombolytics / fibrinolytics are usually used extrapolating from adult investigations. This review details epidemiology, pathophysiology, risk factors, clinical presentations, diagnosis and treatment. There is a lack of studies on national epidemiology and treatment in newborns, the need for these arises.
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Humanos , Recém-Nascido , Trombose/diagnóstico , Trombose/tratamento farmacológico , Trombose/fisiopatologia , Trombose/epidemiologia , Fatores de Risco , Anticoagulantes/uso terapêuticoRESUMO
Abstract: The objective was to analyze whether romantic partners' conflict resolution style and perceived relationship quality are influenced by the dyadic configuration of adult attachment, specifically, by: a) attachment style matching; b) the number of couple members with a secure (vs. insecure) style. A sample of 405 Spanish heterosexual couples of young adults completed an online survey. Results showed no differences between couples with matched versus unmatched attachment styles. However, the presence of one or two members in the couple with a secure style was significantly associated with higher relationship quality and lower use of dysfunctional conflict resolution styles. In conclusion, for insecurely attached young adults, it is more beneficial to be in a relationship with a securely-attached partner than with a similarly-attached partner.
Resumen: El objetivo es analizar si el estilo de resolución de conflictos de los miembros de una pareja y la calidad de la relación percibida se ven influidos por la configuración diádica del apego adulto, específicamente, por: a) la coincidencia del estilo de apego; b) el número de miembros de la pareja con un estilo seguro (vs. inseguro). Una muestra de 405 parejas heterosexuales de adultos jóvenes españoles completó una encuesta en línea. No se encuentran diferencias entre parejas con estilos de apego coincidentes frente a no coincidentes. Sin embargo, la presencia de uno o dos miembros en la pareja con estilo de apego seguro se asoció significativamente con mayor calidad de la relación y menor uso de estilos de resolución de conflictos disfuncionales. En conclusión, para los adultos jóvenes con apego adulto inseguro, es más beneficioso tener una pareja con un estilo seguro que una pareja con un estilo de apego similar.
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Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Qualidade de Vida , Negociação , Relações InterpessoaisRESUMO
ABSTRACT Introduction Since its debut at the 1996 Atlanta Olympics, beach volleyball has grown on the international sports scene. An extensive collection of data from several countries and levels of competition will provide a database that can be used to characterize beach volleyball players and define references for training stages. Objective The purpose of this study was to describe and compare the anthropometric profiles of Spanish male and female beach volleyball players at different levels of competition in relation to sports performance. Methods The sample comprised 150 players participating in the 2011 Spanish Beach Volleyball Championships (Under 19, Under 21, and Senior categories). Using the ranking provided by the Royal Spanish Volleyball Federation, the subjects were distributed by performance level (level 1: players ranked first to fourth; level 2: players ranked fifth to ninth; and level 3: players ranked tenth to seventeenth). The study comprised a group of male players, with 18 level 1 ( M1 ), 39 level 2 ( M2 ), and 22 level 3 players ( M3 ), and a group of female players, with 18 level 1 ( F1 ), 41 level 2 ( F2 ), and 12 level 3 players ( F3 ). Results The top level male sample ( M1 ) had a significantly lower average age (19.33 years) than the men's international elite players (30 years). The top Spanish players of both genders had much lower values for height and body weight than the international elite players. Conclusions Height and fat component are responsible for the differences between top and lower level beach volleyball players, for both men and women. Moreover, as the level of performance increases, players are taller and have a lower fat component. In view of the data observed in this study, the talent selection process in Spanish beach volleyball should aim to select taller individuals than at present. Level of evidence III; Therapeutic studies-Investigating the results of treatment.
RESUMO Introdução Desde sua estréia nas Olimpíadas de Atlanta em 1996, o vôlei de praia cresceu internacionalmente. Uma abrangente coleta de dados de diferentes países e níveis de competição fornecerá um banco de dados que pode ser utilizado para caracaterizar os jogadores de volêi de praia e definir referências para as etapas do treinamento. Objetivo O propósito desse estudo consiste em descrever e comparar os perfis antropométricos de jogadores e jogadoras espanhóis de vôlei de praia, de diferentes níveis de competição, em relação ao rendimento esportivo. Métodos A amostra compreendeu 150 jogadores participantes do Campeonato Espanhol de Vôlei de Praia de 2011 (categorias Sub-19, Sub-21 e Sênior). Ao usar o ranking fornecido pela Real Federação Espanhola de Voleibol, os jogadores foram distribuídos através de níveis de rendimento (nível 1: jogadores entre o primeiro e quarto colocado; nível 2: entre o quinto e nono colocado e nível 3: a partir do décimo até o décimo-sétimo colocado). O estudo incluiu um grupo de 18 jogadores do nível 1 (M1), 39 do nível 2 (M2) e 22 do nível 3 (M3) e 18 jogadoras do nível 1 feminino (F1) , 41 do nível 2 (F2) e 12 do nível 3 (F3). Resultados A amostra masculina de alto nível (M1) apresentou uma idade média significativamente menor (19,33 anos) do que os jogadores da elite internacional (30 anos). A estatura e o peso corporal dos jogadores espanhóis de nível mais alto, em ambos os sexos, apresentaram valores inferiores aos apresentados pelos jogadores da elite internacional. Conclusão A altura e o componente de gordura são responsáveis pelas diferenças entre os jogadores de vôlei de praia de alto nível e nível inferior, tanto para homens quanto para mulheres. Além disso, quanto mais alto o nível de rendimento, maior a estatura e menor o componente de gordura. Considerando-se os dados observados no estudo, o processo de seleção de talentos no vôlei de praia espanhol deve priorizar a seleção de indivíduos mais altos do que atualmente. Nível de evidência lll; Estudos terapêuticos-Investigação dos resultados do tratamento.
RESUMEN Introducción Desde su estreno en las Olimpíadas de Atlanta en 1996, el Vóleibol de Playa creció internacionalmente. Una amplia colecta de datos de diferentes países y niveles de competición proveerá un banco de datos que puede ser utilizado para caracterizar a los jugadores de vóleibol de playa y definir referencias para las etapas del entrenamiento. Objetivo El propósito de este estudio consiste en describir y comparar los perfiles antropométricos de jugadores y jugadoras españoles de Vóleibol de Playa, de diferentes niveles de competición, con relación al rendimiento deportivo. Métodos La muestra comprendió a 150 jugadores participantes del Campeonato Español de Vóleibol de Playa de 2011 (categorías Sub-19, Sub-21 y Sénior). Al usar el ranking suministrado por la Real Federación Española de Vóleibol, los jugadores fueron distribuidos a través de niveles de rendimiento (nivel 1: jugadores entre el primero y el cuarto colocado; nivel 2: entre el quinto y el noveno colocado; y nivel 3: a partir del décimo hasta el décimo-séptimo colocado). El estudio incluyó a un grupo de 18 jugadores de nivel 1 (M1), 39 del nivel 2 (M2) y 22 del nivel 3 (M3) y 18 jugadoras del nivel 1 femenino (F1), 41 del nivel 2 (F2), y 12 del nivel 3 (F3). Resultados La muestra masculina de mayor nivel (M1) presentó una edad promedio significativamente menor (19,33 años) que los jugadores de la élite internacional (30 años). La estatura y el peso corporal de los jugadores españoles de nivel más alto, en ambos sexos, presentaron valores inferiores a los presentados por los jugadores de la élite internacional. Conclusión La altura y el componente de grasa son responsables por las diferencias entre los jugadores de vóleibol de playa de alto nivel y nivel inferior, tanto para hombres como para mujeres. Además, cuanto más alto el nivel de rendimiento, mayor la estatura y menor el componente de grasa. Considerándose los datos observados en el estudio, el proceso de selección de talentos en el Vóleibol de Playa español debe priorizar la selección de individuos más altos que los que hay actualmente. Nivel de evidencia III; Estudios terapéuticos-Investigación de los resultados del tratamiento.
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We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 250 Mexicans from the states of Baja California Norte and Baja California Sur living in Mexicali (Nâ¯=â¯100), La Paz (Nâ¯=â¯75), Tijuana (Nâ¯=â¯25) and rural communities (Nâ¯=â¯50) to obtain information regarding allelic and haplotypic frequencies. The most frequent haplotypes for the Baja California region include nine Native American and five European haplotypes. Admixture estimates revealed that the main genetic components are European (50.45⯱â¯1.84% by ML; 42.03% of European haplotypes) and Native American (43.72⯱â¯2.36% by ML; 40.24% of Native American haplotypes), while the African genetic component was less apparent (5.83⯱â¯0.98% by ML; 9.36% of African haplotypes).
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Etnicidade/genética , Variação Genética , Genética Populacional , Antígenos HLA/genética , Alelos , Frequência do Gene , Genótipo , Geografia Médica , Haplótipos , Humanos , Desequilíbrio de Ligação , México , Tipagem de Sequências MultilocusRESUMO
The interest of the scientific community for ultrasound techniques has increased in recent years due to its wide range of applications. A continuous effort of researchers and industries has been made in order to improve and increase the applicability of non-destructive evaluations (NDE). In this context, the monitoring of manufacturing processes, such as the grinding process, arises. This work proposes a novel technique of ultrasound monitoring (chirp-through-transmission) through low-cost piezoelectric diaphragms and digital signal processing. The proposed technique was applied to the monitoring of material removal during the grinding process. The technique is based on changes in ultrasonic waves when propagated through the material under study, with the difference that this technique does not use traditional parameters of ultrasonic techniques but digital signal processing (RMS and Counts). Furthermore, the novelty of the proposed technique is also the use of low-cost piezoelectric diaphragms in the emission and reception of ultrasonic waves, enabling the implementation of a low-cost monitoring system. The results show that the monitoring technique proposed in this work, when used in conjunction with the frequency band selection, is sensitive to the material removal in the grinding process and therefore presents an advance for monitoring the grinding processes.
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Extensive European and African admixture coupled with loss of Amerindian lineages makes the reconstruction of pre-Columbian history of Native Americans based on present-day genomes extremely challenging. Still open questions remain about the dispersals that occurred throughout the continent after the initial peopling from the Beringia, especially concerning the number and dynamics of diffusions into South America. Indeed, if environmental and historical factors contributed to shape distinct gene pools in the Andes and Amazonia, the origins of this East-West genetic structure and the extension of further interactions between populations residing along this divide are still not well understood. To this end, we generated new high-resolution genome-wide data for 229 individuals representative of one Central and ten South Amerindian ethnic groups from Mexico, Peru, Bolivia, and Argentina. Low levels of European and African admixture in the sampled individuals allowed the application of fine-scale haplotype-based methods and demographic modeling approaches. These analyses revealed highly specific Native American genetic ancestries and great intragroup homogeneity, along with limited traces of gene flow mainly from the Andes into Peruvian Amazonians. Substantial amount of genetic drift differentially experienced by the considered populations underlined distinct patterns of recent inbreeding or prolonged isolation. Overall, our results support the hypothesis that all non-Andean South Americans are compatible with descending from a common lineage, while we found low support for common Mesoamerican ancestors of both Andeans and other South American groups. These findings suggest extensive back-migrations into Central America from non-Andean sources or conceal distinct peopling events into the Southern Continent.
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Genoma Humano , Migração Humana , Indígenas Sul-Americanos/genética , Fluxo Gênico , Variação Genética , Haplótipos , Humanos , Modelos Genéticos , Filogeografia , Polimorfismo de Nucleotídeo Único , Análise de Componente Principal , América do SulRESUMO
PURPOSE: Germline mutations in BRCA1 and/or BRCA2 genes (gBRCA1/2m) are associated with an increased risk of breast cancer (BC) and ovarian cancer (OC). The aim of this study was to estimate the efficiency of providing germline BRCA1/2 testing to high-grade epithelial ovarian cancer (HGEOC) patients without family history of OC or BC and the subsequent testing and management of their relatives with gBRCA1/2m in Spain. METHODS/PATIENTS: Incident HGEOC patients without family history of OC or BC who were gBRCA1/2m carriers and their relatives were simulated in a 50-year time horizon. The study compared two scenarios: BRCA1/2 testing vs no testing, using the perspective of the Spanish National Health Service. Cancer risk among gBRCA1/2m carriers was estimated based on their age and whether they had undergone risk-reducing surgeries. Direct healthcare costs and utilities of patients who developed EOC and BC were also included. A probabilistic sensitivity analysis (PSA) with 5 thousand simulations was developed considering ± 25% of the base-case value. RESULTS: The BRCA1/2-testing scenario amounted to 13,437,897.43 while the no-testing scenario amounted to 12,053,291.17. It was estimated that the screening test improved the quality of life among the patients' relatives by 43.8 quality-adjusted life years (QALYs). The incremental cost-utility ratio (ICUR) was 31,621.33/QALY in the base case. The PSA showed that 89.12% of the simulations were below the 50,000/QALY threshold. CONCLUSION: Providing this screening test to HGEOC patients and their relatives is cost-effective and it allows one to identify a target population with high risk of cancer to provide effective prevention strategies.
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Proteína BRCA1/genética , Proteína BRCA2/genética , Carcinoma Epitelial do Ovário/economia , Análise Custo-Benefício , Testes Genéticos/economia , Mutação em Linhagem Germinativa , Custos de Cuidados de Saúde/estatística & dados numéricos , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/economia , Neoplasias da Mama/genética , Carcinoma Epitelial do Ovário/diagnóstico , Carcinoma Epitelial do Ovário/genética , Feminino , Seguimentos , Predisposição Genética para Doença , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Prognóstico , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , EspanhaRESUMO
Propósito: Determinar cuáles son las causa y montos del vencimiento y avería de los medicamentos e insumos médicos aptos para su disposición final, en el primer nivel de atención de la Región de Salud Central. Material y Métodos: Tipo de Estudio: observacional, descriptivo y retrospectivo; área de estudio: Región de Salud Central; universo y muestra fue el 100% de la información existente y proveniente de los 108 establecimientos de salud del Primer Nivel de Atención de la Región de Salud Central. Resultados: La principal causa que provoca el vencimiento de medicamentos es el no lograr su transferencia. La avería de medicamentos e insumos médicos, y el vencimiento de insumos médicos tienen como principal causa el incumplimiento de las buenas prácticas de almacenamiento. El mayor costo lo tiene la causa denominada No lograr su transferencia. Conclusiones: Los montos y las causas del vencimiento y avería, se encuentran principalmente, en el SIBASI La Libertad y Almacén Regional, respectivamente. El vencimiento de medicamentos e insumos médicos es menor al estándar internacional. Recomendaciones: Fortalecer, como parte de la gestión de medicamentos e insumos, el Sistema de Transferencia Regional a fin de evitar el vencimiento de todo medicamento que le es notificado. Crear un nuevo Instrumento Técnico Jurídico sobre Buenas Prácticas de Almacenamiento que considere el escenario nacional, regional y local; evitando las asignaciones por encima de la política de cobertura
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Insumos Farmacêuticos , Saúde PúblicaAssuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Aneurisma Coronário/diagnóstico por imagem , Anomalias dos Vasos Coronários/diagnóstico por imagem , Dilatação Patológica/diagnóstico por imagem , Aneurisma Coronário/complicações , Radiografia Torácica , Angiografia Coronária , Anomalias dos Vasos Coronários/patologia , Vasos Coronários/patologia , Vasos Coronários/diagnóstico por imagemRESUMO
Este artigo visa refletir sobre as mudanças da imagem corporal na mulher durante a gravidez, colocando em foco alguns dos paradoxos desse aspecto da gestação. A gravidez é um dos grandes momentos de transformação na vida de uma mulher. Essa realidade profundamente mobilizadora traz em si uma contradição tamanha: o corpo da gestante, ao passo que se torna o receptáculo de uma nova vida, sofre transformações marcantes. As mudanças na imagem corporal envolvidas nesse processo são intensas para qualquer mulher, mas podem ser extremamente perturbadoras para aquelas que possuem feridas narcísicas refletidas na formação de sua imagem corporal; principalmente pelo papel que o corpo ocupa na atualidade. Com isso, a gestação deixa de se sustentar como um processo integrativo e se torna um campo de oposições simbólicas de natureza conflituosa (AU)
This article reflects on the body image changes of women during pregnancy focusing on some paradoxes of this aspect of gestation. Pregnancy is one of the most important transformational moments in a woman's life. This profoundly mobilizing period brings in itself the contradiction of turning the body into a vessel for a new life and lead it to experience astonishing transformations. Changes in the body image associated to pregnancy are intense for all women, but they can be extremely disturbing for those who have narcissistic wounds reflected in the formation of their body image, mainly by the role of the body in the present society. In these cases, gestation ceases to be an integrative process and becomes a field of symbolic oppositions of a conflicting nature (AU)
Este artículo tiene como objetivo reflexionar sobre los cambios en la imagen corporal en las mujeres durante el embarazo, y poner de relieve algunas de las paradojas de este aspecto de la gestación. El embarazo es uno de los grandes puntos de transformación en la vida de una mujer. Esta realidad profundamente movilizadora trae consigo una contradicción: el cuerpo de la madre, mientras se convierte en el receptáculo de una nueva vida, sufre una transformación notable. Los cambios en la imagen corporal involucrados en este proceso son intensos para cualquier mujer, pero puede ser muy perturbador para aquellas con heridas narcisistas reflejadas en la formación de su imagen corporal; especialmente por el papel que el cuerpo ocupa en la actualidad. Con ello, el embarazo deja de sostenerse a sí mismo como un proceso integrador y se convierte en un carácter simbólico, campo de la oposición de confrontación (AU)
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Complicações na Gravidez , Imagem Corporal/psicologia , MulheresRESUMO
Este artigo visa refletir sobre as mudanças da imagem corporal na mulher durante a gravidez, colocando em foco alguns dos paradoxos desse aspecto da gestação. A gravidez é um dos grandes momentos de transformação na vida de uma mulher. Essa realidade profundamente mobilizadora traz em si uma contradição tamanha: o corpo da gestante, ao passo que se torna o receptáculo de uma nova vida, sofre transformações marcantes. As mudanças na imagem corporal envolvidas nesse processo são intensas para qualquer mulher, mas podem ser extremamente perturbadoras para aquelas que possuem feridas narcísicas refletidas na formação de sua imagem corporal; principalmente pelo papel que o corpo ocupa na atualidade. Com isso, a gestação deixa de se sustentar como um processo integrativo e se torna um campo de oposições simbólicas de natureza conflituosa.
This article reflects on the body image changes of women during pregnancy focusing on some paradoxes of this aspect of gestation. Pregnancy is one of the most important transformational moments in a woman's life. This profoundly mobilizing period brings in itself the contradiction of turning the body into a vessel for a new life and leading it to experience astonishing transformations. Changes in the body image associated to pregnancy are intense for all women, but they can be extremely disturbing for those who have narcissistic wounds reflected in the formation of their body image, mainly by the role of the body in the present society. In these cases, gestation ceases to be an integrative process and becomes a field of symbolic oppositions of a conflicting nature.
Este artículo tiene como objetivo reflexionar sobre los cambios en la imagen corporal en las mujeres durante el embarazo, y poner de relieve algunas de las paradojas de este aspecto de la gestación. El embarazo es uno de los grandes puntos de transformación en la vida de una mujer. Esta realidad profundamente movilizadora trae consigo una contradicción: el cuerpo de la madre, mientras se convierte en el receptáculo de una nueva vida, sufre una transformación notable. Los cambios en la imagen corporal involucrados en este proceso son intensos para cualquier mujer, pero puede ser muy perturbador para aquellas con heridas narcisistas reflejadas en la formación de su imagen corporal; especialmente por el papel que el cuerpo ocupa en la actualidad. Con ello, el embarazo deja de sostenerse a sí mismo como un proceso integrador y se convierte en un carácter simbólico, campo de la oposición de confrontación.
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Introducción: la reconstrucción del Ligamento Cruzado Anterior (LCA) con isquiotibiales resistiría 1216 N, con una pérdida extensora de sólo un 3%. Nuestro objetivo es revisar nuestra experiencia con este procedimiento con el sistema Aperfix®. Material y métodos: Estudio observacional, descriptivo y retrospectivo. Tamaño muestral de 224 casos, seguimiento mínimo de 12 meses. Analizamos entre otros: filiación, movilidad, R.N.M., tiempo quirúrgico y escala Lysholm. Analizamos diferencias estadísticas entre el abordaje femoral desde el portal anteromedial o desde el túnel tibial, mediante los test t de Student, U de Mann Whitney y Chi Cuadrado, con S.P.S.S. 20.0. Resultados: Edad media de 36.5 ± 8.7 años, Lachmann previo en el 96.8% y Pívot Shift previo positivo en el 51.4%, lesiones meniscales asociadas en el 73.8%. Tiempo quirúrgico: 87.1± 18.9 minutos, Lachmann postquirúrgico en el 17.4% y Pívot Shift negativo en el 98.9%. Flexión final de 128.1 ± 5.2°, 95.8 ± 7 puntos de escala final de Lysholm. Complicaciones en el 11%. Altas por mejoría en el 98.9%. No hallamos diferencias significativas entre ambas formas de realización del túnel femoral. Sólo con respecto al tiempo quirúrgico, p=0.004, siendo éste algo mayor cuando se realizada desde el portal anteromedial. Conclusiones: En nuestra experiencia, la ligamentoplastia con el sistema Aperfix® mejora la escala Lysholm, con escasas complicaciones y buen resultado funcional. No hallamos grandes diferencias en cuanto a la realización del túnel femoral, sólo un mayor tiempo quirúrgico cuando se realiza desde el portal anteromedical.
Introduction: reconstruction of the anterior cruciate ligament (A.C.L.) with hamstring grafts would resist 1216 N, with an extensor loss of only 3%. Our goal is to review our experience with this procedure with the Aper x® system. Material and methods: Observational, descriptive and retrospective study. Sample size of 224 cases, minimum followup of 12 months. We analyzed among others: liation, mobility, M.R.I., surgical time and Lysholms scale. We analyzed statistical differences between femoral approach from anteromedial portal or from tibial tunnel, using the Student t, Mann Whitney U and Chi Square tests, with S.P.S.S. 20.0. Results: Mean age was 36.5 ± 8.7 years, Lachmanns test previous surgery was positive in 96.8% and Pivot Shift in 51.4%. There were associated meniscal injuries in 73.8%. Surgical time was 87.1 ± 18.9 minutes. Post-surgical Lachmanns test was positive at 17.4% and post-surgical Pivot Shift was negative at 98.9%. Final exion was 128.1 ± 5.2°, with 95.8 ± 7 points at Lysholms scale. There were complications in 11%. 98.9% of patients returned to their previous jobs. We did not nd signi cant differences between both forms of femoral tunneling. Only with respect to surgical time, p = 0.004, it was longer for cases operated by means of anteromedial portal. Conclusions: In our experience, ligamentoplasty with the Aper x® system improves Lysholms scale, with a few complications and good functional outcome. We do not nd great differences in performance of femoral tunnel, only a longer surgical time when it was performed from the anteromedial portal.
Assuntos
Humanos , Adulto , Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirurgia , Artroscopia/métodos , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Seguimentos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To analyze the origin, structure, relationships, and recent admixture in Mexican Native groups based on 15 STRs commonly used in human identification. METHODS: We analyzed 39 Mexican Native population samples using STR databases based on the AmpFlSTR® Identifiler kit (n = 3,135), including Mexican-Mestizos (admixed), European and African populations, as reference. RESULTS: Based upon effective population size (Ne) differences, Native groups were clustered into three regions: i) Center-Southeast groups, characterized by larger Ne, migration rate (Nm), genetic diversity (He), and relative homogeneity principally in the Yucatan Peninsula; ii) Isolated southern groups from Chiapas and Oaxaca, characterized by lower Ne, Nm, and He (i.e. higher isolation and genetic differentiation); iii) North-Northwest groups, which are similar to the previous group but are characterized by generating the widest gene flow barrier in the Pre-Hispanic Mexican territory, and currently by elevated admixture in some northern Native groups. Despite the relative congruence between genetic relationships with cultural, linguistic, geographic criteria, these factors do not explain the present-day population structure of Native groups, excepting in those linguistically related to the Mayan that show higher homogeneity. The Isolation by distance model was demonstrated at long distances (>1,500 km), whereas geographic isolation stands as a determining factor to avoid both non-indigenous admixture and bottleneck processes. CONCLUSIONS: Different dynamics of gene flow and drift were observed among Mexican Native groups, highlighting the geographic barriers (mountains, canyons and jungle regions) as the main factor differentiating Pre-Hispanic populations, and eventually helping to avoid Post-European contact admixture and population bottleneck. Am J Phys Anthropol 160:298-316, 2016. © 2016 Wiley Periodicals, Inc.
Assuntos
Fluxo Gênico/genética , Deriva Genética , Indígenas Norte-Americanos/genética , Repetições de Microssatélites/genética , Variação Genética , Genética Populacional , Humanos , Indígenas Norte-Americanos/classificação , México , FilogeniaRESUMO
The genetic characterization of Native American groups provides insights into their history and demographic events. We sequenced the mitochondrial D-loop region (control region) of 520 samples from eight Mexican indigenous groups. In addition to an analysis of the genetic diversity, structure and genetic relationship between 28 Native American populations, we applied Bayesian skyline methodology for a deeper insight into the history of Mesoamerica. AMOVA tests applying cultural, linguistic and geographic criteria were performed. MDS plots showed a central cluster of Oaxaca and Maya populations, whereas those from the North and West were located on the periphery. Demographic reconstruction indicates higher values of the effective number of breeding females (Nef) in Central Mesoamerica during the Preclassic period, whereas this pattern moves toward the Classic period for groups in the North and West. Conversely, Nef minimum values are distributed either in the Lithic period (i.e. founder effects) or in recent periods (i.e. population declines). The Mesomerican regions showed differences in population fluctuation as indicated by the maximum Inter-Generational Rate (IGRmax): i) Center-South from the lithic period until the Preclassic; ii) West from the beginning of the Preclassic period until early Classic; iii) North characterized by a wide range of temporal variation from the Lithic to the Preclassic. Our findings are consistent with the genetic variations observed between central, South and Southeast Mesoamerica and the North-West region that are related to differences in genetic drift, structure, and temporal survival strategies (agriculture versus hunter-gathering, respectively). Interestingly, although the European contact had a major negative demographic impact, we detect a previous decline in Mesoamerica that had begun a few hundred years before.
Assuntos
DNA Mitocondrial/genética , Variação Genética/genética , Teorema de Bayes , Etnicidade/genética , Feminino , Efeito Fundador , Genética Populacional/métodos , Humanos , Indígenas Norte-Americanos/genética , México , Mitocôndrias/genéticaRESUMO
El objetivo fue realizar una evaluación antropométrica de ambos hemisferios corporales en nadadores adolescentes. La muestra estuvo formada por 83 nadadores (52 hombres y 31 mujeres) con una edad media de 15,21±1,90 años. Sus valores antropométricos fueron analizados en función de las siguientes variables: edad, género, años de entrenamiento, estilo de nado (simultáneo o alternativo), lado dominante, lado no dominante, lado de respiración, peso y estatura, con el fin de determinar la existencia o no de diferencias en la composición de cada lado del cuerpo del nadador. Para evaluar la composición corporal se utilizaron: pliegues (tricipital, subescapular, bicipital, cresta iliaca, supraespinal, abdominal, anterior del muslo y pierna), longitudes (brazo, antebrazo, mano, muslo, pie y pierna), perímetros (brazo relajado, brazo flexionado, antebrazo, muñeca, muslo, pierna y tobillo) y diámetros (muñeca, mano, pie, bimaleolar, húmero y fémur). También fueron determinados otros valores como: la masa grasa, muscular, residual, ósea y sus porcentajes, así como el sumatorio de pliegues y el cálculo del somatotipo. Los datos obtenidos mostraron que no existen diferencias estadísticamente significativas entre las medidas tomadas a cada lado corporal de los nadadores, incluso cuando éstas fueron analizadas desde las variables, años de entrenamiento y estilo de nado. La práctica continua e intensa de la natación durante las etapas de crecimiento, no provoca asimetrías corporales entre ambos lados de los nadadores, incluso con técnica de nado alternativo, corroborando que la natación es un deporte de trabajo muscular completo y de composición corporal equilibrada.
The purpose of this study was to conduct an anthropometric assessment of both sides of the body in adolescent swimmers. The sample comprised 83 swimmers (52 males and 31 females) with an average age of 15.21±1.90 years. Their anthropometric values were studied in relation to the variables of age, sex, years of training, swimming stroke (simultaneous or alternating), dominant side, non-dominant side, breathing side, weight and height to determine whether any differences existed in the composition of each side of the swimmers bodies. Body composition was assessed using skinfolds (tricipital, subscapular, bicipital, iliac crest, supraspinal, abdominal, anterior thigh and anterior lower leg), lengths (upper arm, forearm, hand, thigh, lower leg and foot), perimeters (relaxed arm, flexed arm, forearm, wrist, thigh, lower leg and ankle) and diameters (wrist, hand, foot, malleolus, humerus and femur). Other values determined were fat mass, muscle mass, residual mass and bone mass (including percentages), sum of skinfolds and calculation of somatotype. The data obtained showed no statistically significant differences between the measures taken on each side of the swimmers bodies, even when they were analysed using the variables of years of training and swimming stroke. Continuous, intensive swimming during the growth stages does not cause body asymmetry in swimmers, even when the swimming stroke is alternating, thus supporting the thesis that swimming is a sport that works all muscles and provides a balanced body composition.