Resultados del tratamiento de roturas irreparables de manguito rotador con el uso del balón subacromial / Results of the treatment of irreparable rotator cuff ruptures with the use of the subacromial balloon

Resumen: Introducción: el tratamiento mediante cirugía artroscópica de las lesiones del manguito rotador ha desplazado a la cirugía abierta como primera opción de tratamiento. Existen diferentes técnicas quirúrgicas descritas para tratar las roturas masivas o no reparables. Desde hace unos años se viene utilizando un nuevo dispositivo que consiste en un balón subacromial biodegradable que actúa como espaciador entre la cabeza humeral y el acromion. Este trabajo pretende analizar los resultados de este implante. Material y métodos: realizamos un estudio observacional y retrospectivo de todos los pacientes a los que se les implantó un balón subacromial en nuestro centro entre 2017 y 2019. Se evaluó a los pacientes pre y postoperatoriamente mediante las escalas de Constant, DASH y EVA. Resultados: un total de 43 pacientes cumplieron los criterios de inclusión y el seguimiento mínimo de 24 meses. La puntuación media de la escala DASH pasó de 53.6 en la evaluación preoperatoria a 27.9 en la postoperatoria (p = 0.026). También se obtuvo una mejoría significativa en la escala de Constant, que pasó de una media de 37.9 a 61.8 (p = 0.037). En cuanto a la evaluación del dolor, la EVA media pasó de 7.44 a 3.38 (p = 0.916). En 90% de los pacientes no se objetivaron complicaciones ni necesidad de nuevas intervenciones. Conclusiones: el balón subacromial ha mostrado resultados favorables en nuestra serie de pacientes, por lo que podría suponer una opción válida de tratamiento en pacientes con roturas no reparables del manguito rotador.

Abstract: Introduction: arthroscopic surgical treatment of rotator cuff tendon injuries has replaced open surgery as the first treatment option. Different surgical techniques have been described for massive or irreparable ruptures, and recently, a new device that consists of a biodegradable subacromial spacer between the humeral head and the acromion has been used. The present study aims to analyse the results of this implant in our experience. Material and methods: we conducted an observational and retrospective study of all patients undergoing subacromial spacer implantation at our centre from 2017 to 2019. Patients were assessed pre- and postoperatively using the Constant, DASH and VAS scales. Results: a total of 43 patients met the inclusion criteria and the minimum follow-up of 24 months. The mean DASH scale score went from 53.6 at preoperative assessment to 27.9 at postoperative assessment (p = 0.026). There was also a significant improvement in the Constant scale from a mean of 37.9 to 61.8 (p = 0.037). In terms of pain assessment, the mean VAS went from a mean of 7.44 to 3.38 (p = 0.916). In 90% of patients no complications or need for further interventions were objectified. Conclusions: the subacromial balloon has shown favorable results in our series of patients, so it could be a valid treatment option in patients with non-repairable rotator cuff tears.

Estudio de la composición química y actividad antifouling del extracto de la esponja marina Cliona delitrix / Study of the chemical composition and antifouling activity of the marine sponge Cliona delitrix extract

El extracto crudo y la fracción orgánica de la esponja marina Cliona delitrix, recolectada en San Andrés Islas (Caribe Colombiano), muestra actividad antifouling en ensayos de campo. La fracción orgánica es separada por cromatografía en columna logrando obtener fracciones enriquecidas en glicéridos, glicolípidos, fosfolípidos, ácidos grasos libres, ésteres metílicos y monohidroxiesteroles. Cada una de las fracciones es identificada de manera preliminar por TLC y técnicas de dereplicación (RMN). Los ácidos grasos obtenidos de la hidrólisis de cada una de las fracciones de glicéridos, glicolípidos y fosfolípidos son transformados en sus correspondientes ésteres metílicos, los cuales son analizados por CGAREM; luego se convierten en sus derivados pirrolidínicos y también se analizan por CG-EM. El estudio cuidadoso de los EM, tanto del éster metílico como de las pirrolidina, y los valores de ECL permiten identificar 89 ácidos grasos diferentes. Entre éstos se destacan: el ácido 7,10,12,14-icosatetraenoico, que se reporta por primera vez, y los ácidos 5,9-hexacosadienoico y hexadecanoico, por ser los más abundantes en todas las fracciones. Adicionalmente se identifican, mediante análisis de CG-EM y H-RMN, 19 monohidroxiesteroles. Se destacan el colestanol y el clionasterol, por ser los más abundantes, y también es de notar la presencia de estanoles (cerca del 30%) que no se habían informado antes para este género.

In a field test for antifouling activity the raw extract and the organic fraction obtained from the marine sponge Cliona delitrix, collected at the San Andrés Islas (Colombia, Caribbean Sea), showed activity. The organic fraction was separated by column chromatography to obtain enriched fractions of glycerides, glycolipids, phospholipids, free fatty acids, fatty acids methyl esters (FAMEs) and monohydroxysterols identified by TLC and dereplication techniques (NMR). The glyceride, glycolipid, and phospholipid fractions were hydrolyzed, and the fatty acids methyl esters obtained, together with the initial fatty acids fraction were converted into their methyl esters and analyzed by HRGC-MS. In order to locate unsaturations and alkyl branches in fatty acids, their methyl esters derivates were transformed to the corresponding pyrrolidides and subsequently analyzed by HRGC-MS. The identification of the fatty acids was carried out using their ECL value as methyl esters, and particularly the study of their pyrrolidide spectra was used to locate unsaturations and alkyl branch positions. The analysis allowed the identification of 89 fatty acids. The main acids include the new 7,10,12,14-icosatetraenoic acid, as well as 5,9-hexacosadienoic acid and hexadecanoic acid. Additionally, 19 monohydroxysterols were identified by HRGC-MS and NMR H. Cholestanol and clionasterol were the most abundant compounds and the stanols presence (near to 30%) was not previously reported for this genus.

Corrección quirúrgica de infartode intestino delgado en un equinomediante yeyunocecostomíacon grapadora quirúrgica mecánica / Surgical management of small intestine infarction by stapled jejunocecostomy in a horse

Un equino macho, entero, criollo colombiano de siete años de edad, fue remitido a la clínica de grandes animales del centro de veterinaria y zootecnia CES debido a síndrome abdominal agudo. Al ser evaluado clínicamente presentó depresión, ruidos abdominales disminuidos, deshidratación (6%), frecuencia cardiaca y respiratoria en 40 lpm y 28 rpm, respectivamente, temperatura en 37.1 °C y distensión marcada de intestino delgado evidente mediante palpación rectal y ultrasonografía transabdominal. No hubo respuesta a los analgésicos por parte del equino; los parámetros en líquido peritoneal estuvieron alterados. Se sospechó lesión estrangulante en intestino delgado. La laparotomía exploratoria reveló infarto idiopático de siete metros de yeyuno y la porción proximal del íleon. Fue practicada una yeyunocecostomía latero lateral con grapadora quirúrgica mecánica (GIA 80). El animal permaneció hospitalizado 10 días y la recuperación postquirúrgica fue exitosa. Este caso es el primer reporte en el país de esta cirugía.

A 7- years-old criollo colombiano stallion was referred to the Large Animal Hospital Centro de Veterinaria y Zootecnia CES (Envigado, Colombia) because of an acute abdominal syndrome that had persisted for seven hours despite medical treatment. On physical examination the stallion was depressed, dehydrated (6%), borborygmi were diminished, rectal temperature was � 37.1 °C,hearth and respiration rates were 40 beats/min and 28 breaths/min, respectively. On rectal examination and abdominal ultrasonography small intestine was distended. Peritoneal fluid analysis was altered. Signs of pain were nonresponsive to analgesics. The diagnosis by exploratory � laparotomywas infarctionof small intestine (seven meters of the jejunum and proximal portion of the ileum) of unknown etiology. A jejunocecostomy was done using a GIA 80 surgical stapler (United Surgical). Postsurgical recuperation was successful. This case becomes the first report of a jejunocecostomy in a horse in Colombia.

Enfoque clínico y diagnóstico del absceso hepático / A diagnostic approach to hepatic abscess

Background: The non invasive diagnosis of amebic liver abscess allows the use of empirical therapy without the requirement of invasive diagnostic procedures. Aim: To determine the discriminatory capacity of clinical, laboratory and ultrasound studies for the etiological diagnosis of liver abscess. Patients and methods: Sixty one patients were initially included in this prospective study, but 12 did not comply with the inclusion criteria. Of the rest, 29 (59%) had an amebic liver abscess, 16 (33%) had a pyogenic liver abscess and four (8%) had an abscess of mixed etiology. Blood cultures were done in 42 patients. Ultrasound guided needle aspiration was done in 7 patients with amebic liver abscess and 13 patients with non amebic liver abscess. Results: The clinical picture and ultrasound fndings were similar in all types of amebic abscess. ELISA test for IgG anti-Entamoeba histolytica antibodies were positive in 100% of patients with amebic liver abscess. Antibodies measured by gel diffusion were positive in 93%. All patients with mixed liver abscess had positive antibodies and some of them positive culture. Blood cultures were positive for anaerobic bacteria in five patients. Cultures of aspirated material were positive in 7 patients (obligate anaerobic bacteria in 3 and facultative anaerobic bacteria in the rest). The most common complications, whatever the etiology, were right pleural effusion and systemic inflammatory response. Conclusions: A final model of binomial regression analysis revealed that age under 40 years, an hematocrit greater than 35% and an elevation in prothrombin time of less than 1.5 seconds had enough discriminatory capacity for the diagnosis of amoebic liver abscess (Rev Méd Chile 2003; 131: 1411-20).

Effect of the intracerebroventricular administration of GR 113808, a selective 5-HT4 antagonist, on water intake during hyperosmolarity and hypovolemia

We demonstrate here that acute third ventricle injections of GR 113808, a highly selective 5-HT4 antagonist, decrease water intake induced by a previous salt load while potentiating drinking elicited by hypovolemia induced by previous subcutaneous administration of polyethylene glycol in male Wistar rats (200 + or - 20 g). At the dose of 160 nmol/rat, third ventricle injections of GR 113808 induced a significant reduction of water intake in salt-loaded animals after 120 min as compared to salt-loaded animals receiving third ventricle injections of saline (salt load + GR = 3.44 + or - 0.41 ml, N = 12; salt load + saline = 5.74 + or - 0.40 ml, N = 9). At the dose of 80 nmol/rat, GR 113808 significantly enhanced water intake in hypovolemic animals after 120 min as compared to hypovolemic animals receiving third ventricle injections of saline (hypovol + GR = 4.01 + or - 0.27 ml, N = 8; hypovol + saline = 2.41 + or - 0.23 ml, N = 12). We suggest that central 5-HT4 receptors may exert a positive drive on water intake due to hyperosmolarity and a negative input on drinking provoked by hypovolemia.

Distrofia muscular progressiva: estudo histopatologico e epidemiologico. / Progressive muscular dystrophy: histopatological and epidemiological study

Os autores estudaram uma serie de 56 casos com diagnostico histopatologico de distrofia muscular progressiva. Notaram que predominaram os casos do sexo masculino, na faixa etaria de 5 a 19 anos, nao havendo preponderancia de cor. O achado histopatologico mais constante foi a variabilidade de diametro das fibras, seguido por perda de fibras e infiltracao adiposa do endomisio e perimisio