RESUMEN
ABSTRACT Objective: To assess the adequacy to the Brazilian population of orthopedic implants used for treatment of proximal femoral fractures. Methods: The neck-shaft angle of the femur of 101 patients was measured in anteroposterior pelvis radiographs and these measurements were correlated to gender, age, height, weight and ethnicity. In addition, we compared the values of the neck -shaft angle with the angulation of the main implants available in the Brazilian market for the treatment of transtrochanteric fractures. Results: Of the 101 measurements, an average of 130.9±6.7° was obtained, ranging from 112° to 150°. Correlating these measurements with epidemiological variables, only age was statistically significant. Conclusion: Most of the analyzed population presented anatomical characteristics that allow the proper use of these implants to treat transtrochanteric fractures, as indicated from the analysis of neck-shaft angles. Nonetheless, 4% of individuals did not fit this pattern and would have required alternative implants. Level of Evidence III, Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.
RESUMEN
Our team was the firstly to perform an EUS biliary and pancreatic drainage in Latin america. When distal biliary obstruction (pancreatic and papillary lesions) occurs, EUS-guided fistulization between the common bile duct and duodenal bulb is an efficient and feasible strategy on achieving resolution of jaundice with low morbidity and mortality rates under experienced hands. EUS-guided hepaticogastrostomy and coledochoduodenostomy are advanced procedures on biliary and pancreatic endoscopy and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is coledochoduodenostomy in distal lesions. Both procedures must be done only after unsucessfull ERCP. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. This study was conducted from june 2007 until march 2010.
Nossa equipe foi a primeira a realizar drenagem pancreáticobiliar na América Latina. Na ocasião de obstrução distal (massas em cabeça de pâncreas e papila duodenal maior), a fistulização eco-guiada entre o colédoco médio e o bulbo duodenal é uma estratégia factível no alívio da icterícia e com baixa morbimortalidade em equipes experientes. A hepaticogastrostomia e coledocoduodenostomia ecoguiadas são procedimentos avançados na endoscopia bilio-pancreática e compõe em conjunto a drenagem biliar eco-guiada. A hepaticogastrostomia é indicada nos casos de obstrução hilar, enquanto a coledocoduodenostomia é procedimento de escolha nas lesões distais. Convém lembrar que a drenagem biliar eco-guiada deve ser a segunda opção depois da falha da colangiografia endoscópica retrógrada. A indicação destes procedimentos deve ter alcance multidisciplinar e compartilhar a informação com o paciente ou responsável legal. Este estudo foi realizado entre junho de 2007 até março de 2010.