ABSTRACT
Introduccion La tendencia creciente de uso de implantes no cementados y el desarrollo de tecnologías que buscan restablecer la anatomía y función articular con una mayor preservación ósea, ha incrementado el uso de vástagos cortos en el remplazo total de cadera (RTC). El objetivo de este estudio es describir resultados funcionales, restauración radiológica de la anatomía, tasa de complicaciones y reintervención de pacientes sometidos a RTC usando vástagos femorales cortos de fijación cervico metafisiaria con apoyo en cortical lateral. Materiales y Métodos Estudio descriptivo prospectivo, donde se incluyeron 45 caderas en pacientes con artrosis de cadera de cualquier etiología. El seguimiento fue de 18 meses. Las variables de desenlace evaluadas fueron: 1. Integración del implante, 2. Complicaciones dependientes del implante femoral, 3. Subsidencia y 4. Reintervención. Se evaluó adicionalmente el resultado funcional con escala WOMAC. Resultados Durante el periodo comprendido entre diciembre de 2011 a julio 2017, encontramos una mejoría en estado funcional en el 97% (n:44) de los pacientes, no hubo reintervenciones. Discusión En el 100% de los casos se encontró osteointegración del implante y los resultados son comparables con los reportes de la literatura. Consideramos que el uso de vástagos cortos en el Reemplazo total de Cadera es un procedimiento seguro, con buenos resultados, teniendo la ventaja de una adecuada integración ósea del implante y garantizar un mejor stock óseo en una próxima cirugía.
Background The growing trend in the use of non-cemented implants and the development of technologies that attempt to restore the anatomy and joint function with greater bone preservation has increased the use of short stems in the total hip replacement (THR). The objective of this study is to describe functional results, radiological restoration of the anatomy, complication and revision rate of patients undergoing THR using short femoral stems with metaphyseal cervical fixation with lateral cortical support. Materials and Methods A prospective descriptive study was performed that included 45 hips of patients with hip osteoarthritis of any origin. The follow-up was 18 months. The outcome variables evaluated were: 1. Integration of the implant, 2. Complications dependent on the femoral implant, 3. Subsidence, and 4. Re-intervention. The functional result was additionally evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results During the period from December 2011 to July 2017, an improvement was observed in functional status in 97% (n: 44) of patients, with no reoperations. Discussion Bone integration of the implant was observed in 100% of the cases, making the results comparable with the reports in the literature. It is believed that the use of short stems in total hip replacement is a safe procedure, with good outcomes. It also has the advantage of an adequate bone integration of the implant, and guaranteeing a better bone stock in the next surgery.
Subject(s)
Humans , Arthroplasty, Replacement, Hip , Prostheses and Implants , Femur NeckABSTRACT
Background Globally, snake envenomation is a well-known cause of death and morbidity. In many cases of snakebite, myonecrosis, dermonecrosis, hemorrhage and neurotoxicity are present. Some of these symptoms may be provoked by the envenomation itself, but others are secondary effects of the produced oxidative stress that enhances the damage produced by the venom toxins. The only oxidative stress effect known in blood is the change in oxidation number of Fe (from ferrous to ferric) in hemoglobin, generating methemoglobin but not in other macromolecules. Currently, the effects of the overproduction of methemoglobin derived from snake venom are not extensively recorded. Therefore, the present study aims to describe the oxidative stress induced by Crotalus molossus nigrescens venom using erythrocytes. Methods Human erythrocytes were washed and incubated with different Crotalus molossus nigrescens venom concentrations (0-640 μg/mL). After 24 h, the hemolytic activity was measured followed by attenuated total reflectance-Fourier transform infrared spectroscopy, non-denaturing PAGE, conjugated diene and thiobarbituric acid reactive substances determination. Results Low concentrations of venom (<10 μg/mL) generates oxyhemoglobin release by hemolysis, whereas higher concentrations produced a hemoglobin shift of valence, producing methemoglobin (>40 μg/mL). This substance is not degraded by proteases present in the venom. By infrared spectroscopy, starting in 80 μg/mL, we observed changes in bands that are associated with protein damage (1660 and 1540 cm−1) and lipid peroxidation (2960, 2920 and 1740 cm−1). Lipid peroxidation was confirmed by conjugated diene and thiobarbituric acid reactive substance determination, in which differences were observed between the control and erythrocytes treated with venom. Conclusions Crotalus molossus nigrescens venom provokes hemolysis and oxidative stress, which induces methemoglobin formation, loss of protein structure and lipid peroxidation.(AU)
Subject(s)
Animals , Snake Venoms , Spectrum Analysis , Methemoglobin , Oxyhemoglobins , Crotalus , Oxidative Stress , Erythrocytes , Spectroscopy, Fourier Transform InfraredABSTRACT
Abstract Background Globally, snake envenomation is a well-known cause of death and morbidity. In many cases of snakebite, myonecrosis, dermonecrosis, hemorrhage and neurotoxicity are present. Some of these symptoms may be provoked by the envenomation itself, but others are secondary effects of the produced oxidative stress that enhances the damage produced by the venom toxins. The only oxidative stress effect known in blood is the change in oxidation number of Fe (from ferrous to ferric) in hemoglobin, generating methemoglobin but not in other macromolecules. Currently, the effects of the overproduction of methemoglobin derived from snake venom are not extensively recorded. Therefore, the present study aims to describe the oxidative stress induced by Crotalus molossus nigrescens venom using erythrocytes. Methods Human erythrocytes were washed and incubated with different Crotalus molossus nigrescens venom concentrations (0640 g/mL). After 24 h, the hemolytic activity was measured followed by attenuated total reflectance-Fourier transform infrared spectroscopy, non-denaturing PAGE, conjugated diene and thiobarbituric acid reactive substances determination. Results Low concentrations of venom ( 10 g/mL) generates oxyhemoglobin release by hemolysis, whereas higher concentrations produced a hemoglobin shift of valence, producing methemoglobin (>40 g/mL). This substance is not degraded by proteases present in the venom. By infrared spectroscopy, starting in 80 g/mL, we observed changes in bands that are associated with protein damage (1660 and 1540 cm1) and lipid peroxidation (2960, 2920 and 1740 cm1). Lipid peroxidation was confirmed by conjugated diene and thiobarbituric acid reactive substance determination, in which differences were observed between the control and erythrocytes treated with venom. Conclusions Crotalus molossus nigrescens venom provokes hemolysis and oxidative stress, which induces methemoglobin formation, loss of protein structure and lipid peroxidation.
ABSTRACT
Este documento fue preparado por un grupo multidisciplinario de expertos seleccionados por la Asociación Colombiana de Infectología (ACIN) para poner al día las recomendaciones previas dadas por nuestro grupo en cuanto a la inmunización del adolescente, de la población adulta y de aquellos mayores de 60 años de edad. Para este último grupo, hemos decidido, como lo han hecho en otros países, el inmunizar a esta edad (y no después), debido a la carga de enfermedad incrementada por afecciones respiratorias y otros factores propios para América Latina y las condiciones socioeconómicas de nuestro país. Esta edición reescribe ciertos párrafos y actualiza en parte las recomendaciones hechas anteriormente y publicadas en Infectio en mayo de 2012. Las guías están orientadas al uso por aquellos que cuidan de estos pacientes y hacemos énfasis en el anciano, el inmunocomprometido y en aquellos que sufren de varias comorbilidades. Aunque en un momento dado el documento pudiera parecer incompleto, la intención deseada fue la de abarcar los recientes cambios en la administración de nuevas vacunas y otros regímenes en dosificación. Se incluye por primera vez el uso de las vacunas de 4 valencias contra la influenza. El uso de la vacuna contra el herpes zóster se discute, y se toma un cuidado especial en cuanto a la redacción del "cuándo y por qué" de la vacunación contra Streptococcus pneumoniae. En la administración de esta vacuna, el tiempo de aplicación y la secuencia asociada con la aplicación de la administración de la vacuna polisacárida de 23 valencias puede variar de acuerdo con la edad del paciente,las comorbilidades y en aquellos previamente vacunados con dicha vacuna. Finalmente, exponemos las nuevas recomendaciones de vacunación contra fiebre amarilla y dengue y le damos la bienvenida a la vacuna nonavalente contra el virus humano del papiloma.
This document was prepared by a multi-disciplinary panel of experts who have been selected by the Asociación Colombiana de Infectologia (ACIN) to revise and update previous recommendations (by our group) for the immunization of adolescents and adult population and those older than 60 years of age. For the latter group, we have chosen to move forward, like many others, and immunize them at that age because of the particular burden of disease due to respiratory conditions, and other factors strictly related to Latin America and Colombian socio-economic conditions. This edition replaces in part, updates or ads to previous recommendations published in Infectio, May 2012. The guidelines are intended to assist those caring for these patients, and emphasizes on the elderly, the immunocompromissed and on those who suffer from several co-morbidities.The contents of the guidelines could seem in complete at some point; nevertheless, they were purposefully thought as such to embrace on major changes in new vaccines or new dosin gregimens. It is included for the first time the use of cuadri-valent vaccines against influenza. The use of herpes zoster vaccine is discussed and special care is placed in the phrasing for the reader so he (she) understands the "when and why" of vaccine administration against Streptococcus pneumoniae. With pneumococcal vaccines, timing of administration may vary according to age, co-morbidities and in those previously vaccinated with the 23-polyvalent polysaccharide vaccine. There are new recommendations for the vaccination against yellow fever and dengue and we welcome the new nona-valent vaccine against the human papillomavirus.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Viruses , Mass Vaccination , Resource Guide , Pneumococcal Vaccines , Infectious Disease Medicine , Papilloma , Polysaccharides , Association , Social Class , Streptococcus pneumoniae , Cost of Illness , Vaccines, Combined , Colombia , Alphapapillomavirus , Herpes Zoster VaccineABSTRACT
Con el notable aumento en los últimos años a nivel mundial de la prevalencia de la obesidad, se ha generado un vasto número de alternativas para su tratamiento. Las intervenciones quirúrgicas han mostrado ser muy efectivas para lograr una disminución importante y sostenida de peso. Se han descrito complicaciones secundarias a la realización de los procedimientos quirúrgicos entre los que se incluyen los que derivan directamente del acto quirúrgico, alteraciones nutricionales como desnutrición y carencias de micro y macronutrientes, alteraciones metabólicas como anomalías en el metabolismo del calcio, formación de cálculos biliares e inclusive entidades más raras como la nesidioblastosis, son frecuentes los efectos secundarios que alteran la calidad de vida como el vómito y el síndrome de Dumping y los trastornos adaptativos relacionados con la necesidad de modificar hábitos alimentarios. La mortalidad se relaciona directamente con la experiencia del grupo quirúrgico y ha mostrado ser muy baja en sitios de gran experiencia y con un equipo interdisciplinario. En esta publicación se revisan los efectos adversos metabólicos de la cirugía bariátrica en particular del bypass gástrico así como su diagnóstico y manejo médico o quirúrgico, para lo cual se realizó una búsqueda sistemática en www.pubmed.com de los artículos publicados en los últimos siete años, en inglés, español y portugués, que estuvieran incluidos en las bases de datos Hinari, Ovid y Cochrane, seleccionando 28 artículos que cumplieron con los criterios de inclusión.
With the notable increases at a global scale of the prevalence of obesity, a huge number of alternatives for its treatment have been developed. The surgical interventions have demonstrated to be effective in obtaining a significant and sustained weight loss. Complications have been described after the surgical procedures, which include those derived directly from surgery, nutritional abnormalities like malnutrition and deficiencies in micro and macro nutrients, metabolic abnormalities such as modifications in the calcium metabolism, formation of gallbladder stones and also some rare entities like nesidioblastosis; these adverse effects frequently affect the quality of life including vomit and Dumping syndrome, and the adaptive upheaval related to the need of modifying eating habits. Mortality is directly related to the surgeons expertise, and it has shown to be very low at places with important experience and an interdisciplinary group. In this publication we will review the adverse effects of the bariatric surgery, particularly the gastric bypass, and so their diagnosis and treatment, after a systematic search in www.pubmed.com of the articles published on the lost seven years, in english, spanish or portuguese language and who where included in the following data bases: Hinary, Ovid and Cochrane. There were selected 28 papers which met the inclusion criteria.