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Resumen: Introducción: la saturación venosa central de oxígeno (SvcO2) traduce oxigenación tisular a través de la relación entre el consumo y la disponibilidad de oxígeno. La neumonía grave por SARS-CoV-2 impacta en la morbimortalidad, por lo que identificar pacientes con riesgo de progresión de la enfermedad a través de marcadores séricos como la SvcO2 sería imperativo. Objetivo: identificar si la SvcO2 es un marcador pronóstico en la neumonía grave por SARS-CoV-2. Material y métodos: estudio retrospectivo, longitudinal, descriptivo, analítico. Se clasificó la población de acuerdo al valor de la SvcO2: Grupo 1: SvcO2 < 70%. Grupo 2: SvcO2 70-80%. Grupo 3: SvcO2 > 80%. Se registraron las variables de estudio así como el desenlace clínico durante su estancia en la unidad de cuidados intensivos (UCI): mejoría o defunción. Resultados: se reclutaron 115 pacientes, el grupo 1 incluyó 31 pacientes, el grupo 2 y 3 incluyeron 52 y 32 pacientes respectivamente. El sexo masculino fue el más afectado con 71 pacientes (61.7%). La media de edad fue de 65 años. La mortalidad fue de 51.6, 42.3 y 68.8% en el grupo 1, 2 y 3 respectivamente (p ≥ 0.05). El grupo de SvcO2 de 70-80% presentó una relación inversa con mortalidad con un exponente B -0.185, OR de 0.83 (IC 95% 0.33-2.00) p = 0.69, mientras que el grupo 3 presentó un exponente B de 1 con OR de 2.93 (IC 95% 0.97-8.8) p = 0.05. Conclusión: la SvcO2 > 80% en pacientes con neumonía grave por SARS-CoV-2 puede ser un factor de pronóstico para el desenlace fatal independiente de la PaO2/FiO2.

Abstract: Introduction: central venous oxygen saturation (ScvO2) translates tissue oxygenation through the relationship between oxygen consumption and availability. Severe SARS-CoV-2 pneumonia impacts morbidity and mortality, so identifying patients at risk of disease progression through serum markers such as ScvO2 would be imperative. Objective: to identify whether ScvO2 is a prognostic marker in severe SARS-CoV-2 pneumonia. Material and methods: retrospective, longitudinal, descriptive, analytical study. The population was classified according to the value of ScvO2: Group 1: ScvO2 < 70%. Group 2: ScvO2 70-80%. Group 3: ScvO2 > 80%. The study variables were recorded, as well as the clinical outcome during their stay in the Intensive Care Unit (ICU): improvement or death. Results: 115 patients were recruited, group 1 included 31 patients, group 2 and 3 included 52 and 32 patients respectively. Male sex was the most affected with 71 patients (61.7%). The median age was 65 years. Mortality was 51.6%, 42.3% and 68.8% for group 1, 2 and 3 respectively p ≥ 0.05. The ScvO2 group of 70-80% presented an inverse relationship with mortality with an exponent B -0.185, OR of 0.83 (95% CI 0.33-2.00) p = 0.69 while group 3 presented an exponent B of 1 with OR of 2.93 (95% CI 0.97-8.8) p = 0.05. Conclusion: ScvO2 > 80% in patients with severe SARS-CoV-2 pneumonia may be a prognostic factor for fatal outcome independent of PaO2/FiO2.

Resumo: Introdução: a saturação venosa central de oxigênio (SvcO2) traduz a oxigenação tecidual por meio da relação entre consumo e disponibilidade de oxigênio. A pneumonia grave por SARS-CoV-2 afeta a morbidade e a mortalidade, portanto, seria imperativo identificar pacientes com risco de progressão da doença por meio de marcadores séricos, como SvcO2. Objetivo: identificar se a SvcO2 é um marcador prognóstico na pneumonia grave por SARS-CoV-2. Material e métodos: estudo retrospectivo, longitudinal, descritivo, analítico. A população foi classificada de acordo com o valor de SvcO2: grupo 1: SvcO2 < 70%. Grupo 2: SvcO2 70-80%. Grupo 3: SvcO2 > 80%. As variáveis do estudo foram registradas, assim como o desfecho clínico durante a internação na Unidade de Terapia Intensiva (UTI): melhora ou óbito. Resultados: foram recrutados 115 pacientes, o grupo 1 incluiu 31 pacientes, os grupos 2 e 3 incluíram 52 e 32 pacientes, respectivamente. O sexo masculino foi o mais acometido com 71 pacientes (61.7%). A média de idade foi de 65 anos. A mortalidade foi de 51.6%, 42.3% e 68.8% para os grupos 1, 2 e 3 respectivamente p ≥ 0.05. O grupo SvcO2 de 70-80% apresentou relação inversa com mortalidade com expoente B -0.185 OR de 0.83 (IC 95% 0.33-2.00) p = 0.69 enquanto o grupo 3 apresentou expoente B de 1 com OR de 2.93 (IC 95% 0.97-8.8) p = 0.05. Conclusão: SvcO2 > 80% em pacientes com pneumonia grave por SARS-CoV-2 pode ser um fator prognóstico para desfecho fatal independente de PaO2/FiO2.

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Introducción: Los cirujanos informaron esfuerzo y dolor musculoesquelético durante o después de un procedimiento. Modificando que la inserción del trócar localizado en línea media clavicular se coloque en línea media, puede mejorar la postura del cirujano. En el Hospital Universitario de Caracas, la técnica de colecistectomía laparoscópica modificada se realiza con frecuencia por disminuir la sensación de esfuerzo y dolor durante el acto quirúrgico. Se plantea el estudio de los elementos de confort para el cirujano con esta técnica modificada. Métodos: Se realizó un estudio prospectivo, descriptivo, comparativo y de corte transversal en cirujanos de pacientes con litiasis vesicular que se resolvieron con colecistectomía laparoscópica, en el Hospital Universitario de Caracas, período enero-agosto 2022. Resultados: Se realizaron 77 colecistectomías laparoscópicas, conformadas por: técnica americana 32 (41,6%) y la técnica modificada 45 (58,4%). La técnica americana evidenció como zona dolorosa la muñeca izquierda (62,5%), y en la técnica modificada reportan en 91,1% sin zona dolorosa. El 43,8% de los cirujanos no se sienten cómodos con la técnica americana, mientras que en la modificada el 97,8% reportaron la técnica cómoda. Los cirujanos refirieron un esfuerzo difícil en el 56,3% con la técnica americana y con la modificada el 82,2% refieren un esfuerzo leve. El grado de dolor en las extremidades fue mayor en los que realizaron la técnica americana en comparación con la modificada, siendo todos los resultados estadísticamente significativos. Conclusión: La técnica modificada tiene ventajas en cuanto a la comodidad del cirujano y su equipo de trabajo y puede emplearse desde el inicio de la formación de cirujanos(AU)

Surgeons reported exertion and musculoskeletal pain during or after a procedure. Modifying the insertion of the trocar located in the clavicular midline to be placed in the midline, to improve the surgeon's posture. At the Hospital Universitario de Caracas, the modified laparoscopic cholecystectomy technique is frequently performed to reduce the sensation of effort and pain during the surgical act. the study of comfort elements for the surgeon with this modified technique is proposed. Methods: A prospective, descriptive, comparative and cross-sectional study was carried out in patients with gallbladder lithiasis at the Hospital Universitario de Caracas, from January to August 2022. Results: 77 laparoscopic cholecystectomies were performed, consisting of: American technique 32 (41, 6%) and the modified technique 45 (58.4%). The American technique showed the left wrist as a painful area (62.5%), and in the modified technique they reported no painful area in 91.1%. 43.8% of the surgeons did not feel comfortable with the American technique, while in the modified one 97.8% reported the comfortable technique. the surgeons reported a difficult effort in 56.3% with the American technique and with the modified one, 82.2% reported a light effort. the degree of pain in the extremities was greater in those who performed the American technique compared to the modified one, all of the results being statistically significant. Conclusion: the modified technique has advantages in terms of comfort for the surgeon and his team and can be used from the beginning of surgeon training

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This study assessed the effects of Bisphenol A in embryonic stages of zebrafish, applying an IBR multi-biomarker approach that included alterations in growth and oxidative status and relates it with the expression of Nrf1, Nrf2, Wnt3a, Wnt8a, COX-2, Qdpra, and DKK1 genes. For this purpose, we exposed zebrafish embryos to eight environmentally relevant concentrations of BPA (220, 380, 540, 700, 860, 1180, 1340, and 1500 ng L-1) until 96 h post-fertilization. Our results show that BPA induces several malformations in embryos (developmental delay, hypopigmentation, tail malformations, and on), leading to their death. The LC50, EC50 of malformations, and teratogenic index (TI) were 1234.60 ng L-1, 987.77 ng L-1, and 1.25, respectively; thus, this emerging contaminant is teratogenic. Regarding oxidative stress and gene expression, we demonstrated BPA altered oxidative status and the gene expression in embryos of Danio rerio.

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Several studies have reported the presence of phenytoin (PHE) in wastewater treatment plant effluents, hospital effluents, surface water, and even drinking water. However, published studies on the toxic effects of PHE at environmentally relevant concentrations in aquatic organisms are scarce. The present study aimed to determine the effect of three environmentally relevant concentrations of PHE (25, 282, and 1500 ng L-1) on behavioral parameters using the novel tank test. Moreover, we also aimed to determine whether or not these concentrations of PHE may impair acetylcholinesterase (AChE) activity and oxidative status in the brain of Danio rerio adults. Behavioral responses suggested an anxiolytic effect in PHE-exposed organisms, mainly observed in organisms exposed to 1500 ng L-1, with a significant decrease in fish mobility and a significant increase in activity at the top of the tank. Besides the behavioral impairment, PHE-exposed fish also showed a significant increase in the levels of lipid peroxidation, hydroperoxides, and protein carbonyl content compared to the control group. Moreover, a significant increase in brain AChE levels was observed in fish exposed to 282 and 1500 ng L-1. The results obtained in the present study show that PHE triggers a harmful response in the brain of fish, which in turn generates fish have an anxiety-like behavior.

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Fluoxetine (FLX) exerts its therapeutic effect by inhibiting the presynaptic reuptake of the neurotransmitter serotonin. Nonetheless, at high concentrations of this drug, adverse effects occur in the brain of exposed organisms. Bearing this into account, the objective of this study was to evaluate the neurotoxic effects of the fluoxetine through the evaluation of behavior (Novel tank test), determination of oxidative stress, and determination of acetylcholinesterase (AChE) activity in adult zebrafish Danio rerio. For this purpose, Danio rerio adults were exposed to three environmentally relevant concentrations (5, 10, 16 ng L-1) of FLX for 96 h. Our results demonstrate fish presented a significant disruption in their behavior, as they remained long-lasting time frozen at the top of the tank. Since we observed a significant reduction of AChE activity in the brain of fish, we believe the above described anxiety-like state is the result of this enzyme impairment. Moreover, as FLX-exposed fish showed a significant increase in the levels of oxidative damage biomarkers, we suggest this AChE disruption is associated with the oxidative stress response fish exhibited. Based on our findings, we believe the environmentally relevant concentration of FLX alters the redox status of the brain, impairing this way the behavior of fish and making them more vulnerable to predation.

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Selective serotonin reuptake inhibitors (SSRIs) are pharmaceuticals whose consumption has increased significantly. They are prescribed as first-line treatment in mental disorders such as depression, obsessive-compulsive disorder, phobias, and anxiety; also, they are indicated as adjuvants in diseases such as fibromyalgia and bulimia nervosa. In addition to being linked to the illegal market to be consumed as recreational drugs. The relevance of this review lies in the fact that worldwide consumption has increased significantly during the COVID-19 pandemic, due to the depression and anxiety that originated in the population. As a consequence of this increase in consumption, concentrations of SSRIs in the environment have increased, and these have become a relevant issue for toxicologists due to the effects that they could generate in different organisms, both aquatic and terrestrial. For this reason, the objective of this article was to do a critical evaluation of the existing data on the characteristics and physicochemical properties of SSRIs, consumption data during the COVID-19 pandemic, its occurrence in the environment and the reports of toxic effects that have been generated in different organisms; we also conclude with an updated review of different methods that have been used for their removal. With this analysis, it can be concluded that, despite SSRIs are pharmaceutical products widely studied since their launching to the market, still currently under investigation to clarify their mechanisms of action to understand the different effects on the organisms, adverse reactions, as well as possible toxicological effects on non-target organisms. On the other hand, it has been proven that although it is already possible to eliminate a significant percentage of SSRIs in the laboratory, due to their physicochemical characteristics and their behavior in complex mixtures in the environment, they have not yet been eradicated, showing a persistence in the soil, subsoil and surface waters of the entire planet that may represent a future risk.

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Several studies have indicated that hospital effluents can produce genotoxic and mutagenic effects, cytotoxicity, hematological and histological alterations, embryotoxicity, and oxidative stress in diverse water organisms, but research on the neurotoxic effects hospital wastewater materials can generate in fish is still scarce. To fill the above-described knowledge gap, this study aimed to determine whether the exposure of adult zebrafish (Danio rerio) to several proportions (0.1%, 2.5%, 3.5%) of a hospital effluent can disrupt behavior or impair redox status and acetylcholinesterase content in the brain. After 96 h of exposure to the effluent, we observed a decrease in total distance traveled and an increase in frozen time compared to the control group. Moreover, we also observed a significant increase in the levels of reactive oxygen species in the brains of the fish, especially in hydroperoxide and protein carbonyl content, relative to the control group. Our results also demonstrated that hospital effluents significantly inhibited the activity of the AChE enzyme in the brains of the fish. Our Pearson correlation demonstrated that the response to acetylcholinesterase at the lowest proportions (0.1% and 2.5%) is positively related to the oxidative stress response and the behavioral changes observed. The cohort of our studies demonstrated that the exposure of adult zebrafish to a hospital effluent induced oxidative stress and decreased acetylcholinesterase activity in the brain of these freshwater organisms, which can lead to alterations in their behavior.

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Phenytoin (PHE) is an antiepileptic drug that has been widely used in clinical practice for about 80 years. It is mainly used in the treatment of tonic-clonic and partial seizures. The widespread consumption of this drug around the world has led to PHE being introduced into water bodies through municipal, hospital, and industrial effluent discharges. Since the toxic effects of this drug on aquatic species has been scarcely explored, the aim of this work was to investigate the influence of low (25-400 ngL-1) and high (500-1500 ngL-1) environmentally relevant concentrations of PHE on the development and oxidative status of zebrafish (Danio rerio) embryos. The toxicity of PHE was evaluated from 12 to 96 h after fertilization in D. rerio at concentrations between 25 and 1500 ngL-1. In both the control group and the 0.05% DMSO system, no malformations were observed, all embryos developed normally after 96 h. The severity and frequency of malformations increased with increasing PHE concentration compared to embryos in the control group. Malformations observed included developmental delay, hypopigmentation, miscellaneous (more than one malformation in the same embryo), modified chorda structure, tail malformation, and yolk deformation. Concerning the biomarkers of oxidative stress, an increase in the degree of lipid peroxidation, protein carbonylation, and hydroperoxide content was observed (p < 0.05) concerning the control. In addition, a significant increase (p < 0.05) in antioxidant enzymes (SOD, CAT, and GPx) was observed at low exposure concentrations (25-400 ngL-1), with a decrease in enzyme activity at high concentrations (500-1500 ngL-1). Our IBR analysis demonstrated that oxidative damage biomarkers got more influence at 500ngL-1 of PHE. The results demonstrated that PHE may affect the embryonic development of zebrafish and that oxidative stress may be involved in the generation of this embryotoxic process.

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Fluoxetine (FLX) is a psychoactive drug that acts as an antidepressant. FLX is one of the world's best-selling prescription antidepressants. FLX is widely used for the treatment of various psychiatric disorders. For these reasons, this drug may eventually end up in the aquatic environment via municipal, industrial, and hospital discharges. Even though the occurrence of FLX in aquatic environments has been reported as ubiquitous, the toxic effects that this drug may induce, especially at environmentally relevant concentrations, on essential biological processes of aquatic organisms require more attention. In the light of this information, this work aimed to investigate the influence that fluoxetine oxidative stress-induced got over the embryonic development of Danio rerio. For this purpose, D. rerio embryos (4 h post fertilization) were exposed to environmentally relevant concentrations (5, 10, 15, 20, 25, 30, 35, and 40 ng L-1) of fluoxetine, until 96 h post fecundation. Along the exposure, survival, alterations to embryonic development, and teratogenic effects were evaluated using a stereomicroscope. Furthermore, oxidative stress biomarkers (superoxide dismutase, catalase, glutathione peroxidase, lipid peroxidation, hydroperoxide, and carbonyl content) were evaluated at 72 and 96 h post fecundation. LC50, EC50m, and teratogenic index were 30 ng L-1, 16 ng L-1, and 1.9, respectively. The main teratogenic effects induced by fluoxetine were pericardial edema, hatching retardation, spine alterations and craniofacial malformations. Concerning oxidative stress, our integrated biomarkers (IBR) analysis demonstrated that as the concentration increased, oxidative damage biomarkers got more influence over the embryos than antioxidant enzymes. Thus, fluoxetine induces an important oxidative stress response on the embryos of D. rerio. Collectively, our results allow us to concluded that FLX is a dangerous drug in the early life stages of D. rerio due to its high teratogenic potential and that FLX-oxidative stress induced may be involved in this toxic process.

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The gasometric analysis offers a formal evaluation in the process of weaning for the mechanical ventilation (MV). Gasometry and clinical symptoms allow the identificaron of patients who are candidates for a spontaneous breathing test (SBT). The decrease in SvcO2 > 5.4% and the increase in APv-aCO2 > 40%, after 30 minutes of SBT, predict with very good precision failure to remove MV. The oxygenation indices (IsOx) show changes and also change at the end of the SBT and could predict extubation failure, but cut-off points need to be established in pulmonary and non-pulmonary problems.

El análisis gasométrico ofrece una evaluación formal en el proceso de weaning y para retiro de la ventilación mecánica (VM). La gasometría y la clínica permiten identificar a los pacientes candidatos a una prueba de respiración espontánea (PRE). La disminución de la SvcO2 > 5,4% y el incremento del APv-aCO2 > 40%, posterior a 30 minutos de PRE predicen con muy buena precisión fracaso en el retiro de la VM. Los índices de oxigenación (IsOx) presentan cambios también se modifican al final de la PRE y podría predecir fracaso en la extubación, pero se necesita establecer puntos de corte en problemas pulmonares y no pulmonares.

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Antiepileptic drugs (AEDs) are the main treatment for people with epilepsy. However, in recent years, more and more people are using them for other indications such as: migraine, chronic neuropathic pain, and mood disorders. Consequently, the prescriptions and consumption of these drugs are increasing worldwide. In WWTPs, AEDs can resist degradation processes, such as photodegradation, chemical degradation and/or biodegradation. Until now, only constructed wetlands and photocatalysis have shown good removal rates of AEDs from wastewater. However, their effectiveness depends on the specific conditions used during the treatment. Since the consumption of AEDs has increased in the last decade and their degradation in WWTPs is poor, these drugs have been largely introduced into the environment through the discharge of municipal and/or hospital effluents. Once in the environment, AEDs are distributed in the water phase, as suspended particles or in the sediments, suggesting that these drugs have a high potential for groundwater contamination. In this first part of the AEDs review is designed to fill out the current knowledge gap about the occurrence, fate and removal of these drugs in the aquatic environment. This is a review that emphasizes the characteristics of AEDs as emerging contaminants.

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PURPOSE: This study investigated the acute effect of maximal cycling sprint against difference resistances on intraocular pressure (IOP) depending on participants' fitness level. METHODS: In total, 26 physically active collegiate men performed 5 maximal cycling sprints against different resistances in a randomized order, and IOP was measured immediately before and after each sprint. Participants were divided in 2 subgroups (low fit and high fit) according to their maximum power output relative to body weight to assess the influence of fitness level. Two identical testing sessions were performed to assess the repeatability of IOP values. RESULTS: We found that IOP decreases with the lightest resistance (P<0.01), whereas IOP increases with heavier resistances (P<0.01), and it showed a positive linear tendency (r=0.99). Our results suggest that participants' fitness level seems to influence IOP responses, with a more stable response in the high-fit group. A strong intersession repeatability of IOP values was observed (intraclass correlation coefficient range, 0.82 to 0.98; coefficients of variations range, 1.76% to 6.23%). CONCLUSIONS: We conclude that (1) IOP is sensitive to cycling resistance in all-out sprints, with a lowering effect on the lightest resistance and an increasing effect with medium and heavy resistances, (2) high fitness level is beneficial to avoid IOP fluctuations during sprints, and (3) these changes are comparable when measured on 2 different days under the same experimental conditions. A progressive involvement in physical activity may be desirable to avoid IOP peaks during highly demanding physical effort. Future studies are needed to clarify the consequences of exercise in glaucoma patients.

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Water is an increasingly deteriorated, limited natural resource due to population increase and industrialization. Also, the widespread use of pharmaceuticals in modern society leads to their presence in domestic, hospital and industrial effluents. Due to their analgesic properties, some of the most commonly used pharmaceuticals are nonsteroidal anti-inflammatory drugs (NSAIDs). High concentrations of one these products, diclofenac (DCF), have been detected in effluents and water bodies of different countries, including Mexico. Diverse studies show that trace amounts (ngL-1 to µgL-1) of this compound induce toxicity on aquatic organisms such as algae, microcrustaceans and fish. However, studies on its potential toxicity during development in species of commercial interest such as the American bullfrog Lithobates catesbeianus are scarce. The present study aimed to evaluate DCF-induced teratogenesis and embryotoxicity in Xenopus laevis and L. catesbeianus, a species marketed as a nutritional meat source in Mexico, using the frog embryo teratogenesis assay: Xenopus (FETAX). Oocytes in mid-blastula transition were exposed for 96h to 1, 4, 8, 16, 32 and 62.5mgDCFL-1. The criteria evaluated were mortality, malformation and growth inhibition. The teratogenic index was 4.2 in L. catesbeianus, three-fold higher than the reference limit (1.5), and 3.9 in X. laevis. Diclofenac induced diverse malformations in both species, the most frequent of these being axial malformations in the tail and notochord, edema and stunted growth. Results indicate that DCF is a potentially teratogenic compound and is toxic during development in X. laevis and L. catesbeianus, a species which, due to its sensitivity, can be used to evaluate the toxicity of pharmaceutical products, using FETAX.

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El presente documento expone los resultados de una investigación enfocada en la búsqueda de teorías que den sustento a lo que deberá ser un modelo para evaluar la participación institucional en el desarrollo de las competencias informacionales del estudiantado. La investigación se basa principalmente en revisión de la literatura y en las reflexiones que las lecturas inspiraron. Los resultados llevan a las personas autoras a concluir que un modelo de evaluación puede enmarcarse en la Teoría General de Sistemas en cuanto a la transformación que se espera lograr en estudiantes durante su paso por la universidad, pero que para lograr una visión más completa se requiere identificar una teoría del aprendizaje; se encuentra que la que puede brindar mayores explicaciones es la recientemente desarrollada Teoría del Conectivismo, como una forma de expansión de las teorías constructivistas del aprendizaje.

This document presents the results of a study focused on the search for theories to support what should be an evaluation model of university efforts aimed to develop student's information competencies. The research is mainly based on literature review and on the reflections that the readings inspired. The results lead the authors to conclude that an evaluation model can be framed in the General Systems Theory as to the transformation to be achieved by students during their pass by the university; nevertheless, for a more complete picture, it is necessary to identify a learning theory: we observe that one that may provide further explanations is the recently developed theory of Connectivism, as a way of expanding constructivist theories of learning.

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The pharmaceutical industry generates wastewater discharges of varying characteristics and contaminant concentrations depending on the nature of the production process. The main chemicals present in these effluents are solvents, detergents, disinfectants - such as sodium hypochlorite (NaClO) - and pharmaceutical products, all of which are potentially ecotoxic. Therefore, this study aimed to evaluate the geno- and cytotoxicity induced in the common carp Cyprinus carpio by the effluent emanating from a nonsteroidal anti-inflammatory drug (NSAID)-manufacturing plant. Carp were exposed to the lowest observed adverse effect level (LOAEL, 0.1173%) for 12, 24, 48, 72 and 96 h, and biomarkers of genotoxicity (comet assay and micronucleus test) and cytotoxicity (caspase-3 activity and TUNEL assay) were evaluated. A significant increase with respect to the control group (p<0.05) occurred with all biomarkers from 24h on. Significant positive correlations were found between NSAID concentrations and biomarkers of geno- and cytotoxicity, as well as among geno- and cytotoxicity biomarkers. In conclusion, exposure to this industrial effluent induces geno- and cytotoxicity in blood of C. carpio.

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Se revisaron 62 pacientes en edad pediátrica con fractura supracondílea humeral, que fueron tratados mediante reducción cerrada y enclavamiento percutáneo con dos alambres de Kirschner cruzados de 1.2 mm. Todos los pacientes presentaron consolidación primaria en un periodo de cinco a seis semanas. Las complicaciones de las fracturas tratadas fueron las siguientes: hubo lesión neurológica en 12 casos por irritación producida por los clavos de Kirschner, de los cuales fueron 10 casos de neuropraxia del nervio cubital y dos del radial; en un caso la extremidad desarrolló cúbito varo de 10 grados sin alteraciónes funcionales

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