Resultado de suturas meniscales por técnica artroscópica "todo adentro", revisión a mediano plazo / Results of all-inside arthroscopic meniscal sutures, mid-term review

Resumen: Introducción: los dispositivos de suturas meniscal todo adentro han evolucionado y simplificado la reparación meniscal. En este estudio formulamos las siguientes preguntas de investigación: ¿cuál es la tasa de supervivencia y falla?, ¿cuáles son los factores de riesgo asociado a falla? y ¿cuáles son los resultados funcionales posterior a la cirugía de reparación meniscal? Material y métodos: estudio ambispectivo desde el 2001 al 2021 de pacientes con lesión meniscal reparable con dispositivos meniscales de sutura todo adentro. La razón de supervivencia y falla se obtuvo con el test de Kaplan-Meier, los factores de riesgo asociado con falla de la sutura meniscal se valoraron con el test de regresión logística y los resultados funcionales pre y postquirúrgicos fueron estimados con la prueba t-Student. Resultados: en 20 años de seguimiento de 316 menisco reparados con suturas meniscal todo adentro se obtuvo que la razón de supervivencia de 95.9%. La ausencia de lesión del cuerno anterior del menisco se mostró como un factor protector [OR = 0.12], junto a la no práctica de deportes de impacto [OR = 0.2]. Se mostraron resultados del IKDC y Tegner-Lysholm posterior a la cirugía de muy buenos a excelentes (p < 0.0001). Conclusión: los dispositivos de sutura de meniscal todo adentro son y seguirán siendo armas de primera línea en la reparación de las roturas meniscales. En 20 años de seguimiento se evidenció una menor tasa de falla, asociados con excelentes resultados funcionales.

Abstract: Introduction: all-in meniscal suture devices have evolved and simplified meniscal repair. In this study we will formulate the following research questions: what is the rate of survival and failure? What are the risk factors associated with failure? And what are the functional results after meniscal repair surgery? Material and methods: ambispective study from 2001 to 2021 of patients with repairable meniscal injury with all-in meniscal suture devices. The survival and failure ratio were obtained with the Kaplan-Meier test, the risk factors associated with meniscal suture failure were assessed with the logistic regression test, and the pre- and post-surgical functional results were estimated with the test. t-Student. Results: in 20 years of follow-up of 316 menisci repaired with all-in meniscal sutures, a survival rate of 95.9% was obtained. The absence of injury to the anterior horn of the meniscus was shown to be a protective factor [OR = 0.12], together with not practicing impact sports [OR = 0.2]. Post-surgery IKDC and Tegner-Lysholm results were shown to be very good to excellent (p < 0.0001). Conclusion: all-in meniscal suture devices are and will continue to be front-line weapons in the repair of meniscal tears. In 20 years of follow-up, a lower failure rate was evidenced, associated with excellent functional results.

Agresores sexuales seriales en Colombia: dos estudios de casos de las ciudades de Bogotá y Cali / Serial sex offenders in Colombia: two case studies from the citiesof Bogotá and Cali

El presente artículo, luego de ilustrar al lector sobre la naturaleza de los agresores sexuales seriales, desarrolla puntualmente dos casos de estudio documentados por la Procuraduría Delegada para el Ministerio Público en Asuntos Penales y la Policía Nacional, extraídos de las líneas investigativas que implementan estas instituciones desde años atrás. Este ejercicio investigativo conforma un estudio de caso múltiple que busca ampliar el conocimiento disponible sobre la materia, haciendo los respectivos análisis frente a la naturaleza de los individuos que cometen esta clase de transgresiones y a sus dinámicas delincuenciales. Se encuentran los resultados de diferentes entrevistas, revisión de expediente judicial, aplicación de pruebas psicométricas en dos sujetos capturados y condenados por la comisión de agresiones sexuales de similares características. En ambos casos, el delito sexual es el objetivo de la actividad, en el que predomina amenaza con arma cortopunzante. En los dos casos estos comportamientos se presentan después de los 18 años, el sujeto (1) presenta 23 víctimas registradas en el sistema judicial, y el sujeto (2), 15 víctimas reconocidas; en cuanto a las características psicológicas, los dos tuvieron problemas en el acatamiento de normas, con baja tolerancia a la frustración y actitudes machistas durante su infancia y adolescencia.

Descubriendo el pseudoxantoma elástico / Discovering the elasticum pseudoxanthoma

Enfermedad hereditaria rara, el pseudoxantoma elástico es un trastorno genético del tejido conectivo, que se caracteriza por fragmentación de las fibras elásticas y posterior calcificación de éstas afectando dermis, vasos sanguíneos y la membrana de Bruch de retina. El patrón de herencia es muy variable, lo que hace posible que esta enfermedad pueda estar subdiagnosticada. La escasa incidencia de esta patología justifica la presentación de dos casos que tuvieron solamente manifestaciones cutáneas.

Hereditary disease does not frequent pseudoxanthoma elastic; is a genetic upheaval of the conective weave, that characterizes by fragmentation of elastic fibers and later calcification of these, affecting dermis, blood vessels and membrane of Bruch of retina. The inheritance pattern is very variable which causes that disease; can be subdiagnosed. The litlle incidence of this pathology, causes that in our professional experience we have been able to diagnose two cases in which the manifestations were cutaneous.

Antitumor activity of locally-isolated actinomycins

The actinomycins were isolated from two locally-grown Streptomyces cultures S-67-3 and S-62-30. Acute and short-term toxicity studies on S-67-3 using mice, rats, rabbits and monkeys showed much less toxicity than S-62-30. The LD50 of S-62-30 in mice was 1.78 mg/kg by subcutaneous route. In rats, the LD50 by intraperitoneal route were 0.095 mg/kg and 0.1 mg/kg for S-62-30 and S-67-3, respectively. Toxicities of the two fractions, however differ significantly below and above the LD50. While a dose of 1 ug/kg of the S-62-30 fraction proved very toxic to monkeys. S-67-3 showed hardly any toxicity at the same dose level. A dose of 5 ug/kg of S-62-30 was lethal to the two monkeys tested. S-67-3 showed barely any marked acute toxicity on the rabbits up to 1.0 mg /kgPreliminary studies in vitro showed significant activity against ascitic tumors, TB bacillus and Gram-positive bacteria. In vivo studies on three types of experimental tumors showed inhibition of Ehrlich Ascites Carcinomas (EAT) in Swiss albino and Leukemia L-1210 in DBA/2 and BDF, mice but not Sarcoma (S-180) in either C57 or the local strain of white mice. The Sarcoma regressed in both control and experimental groups with necrosis and alopecia at the site inoculation. Such apparent "immunity" was not observed with EAT or L-1210. Marked inhibition of L-1210 was observed with S-67-3 when grown in DBA/2 or BDF, mice, at a dose of level of 20 ug/kg and higher. Dose-response curves on S-67-3 reveal a higher antitumor activity and a lower toxicity as compared with S-62-30 which is rather unusual for cytotoxic agents. Implications in therapy are discussedSignificant alteration in tumor membrane phospholipoprotein was observed at the higher dose levels (20 ug/kg and 40 ug/kg) as assessed by thin-layer-chromatography. Such effects are extrapolated to have produced changes in membrane permeabilityThe role of cyclic-adenyl cyclase system in membranes in relation to "contact inhibition" is also discussed with projections into wound healing, embryogenesis, differentiation, aging and cancerSo far, pharcogenetic studies on mice, rats, rabbits and monkeys now in progress (except on monkeys which was temporarily suspended) have not shown significant results for meaningful evaluation. Studies on the possible immunosuppressive activity are now underway.(Summary)

Assessment of nephrolithiasis risk factors among assembly line workers exposed to heat stress

This study involved the assessment of nephrolithiasis risk factors among thirty one (n=31) assembly line workers exposed to heat stress. Assembly line workers working in normal temperature were used as a comparison group. Subjects were matched according to age, body mass index, length of employment and diet. Workplace temperatures were determined using a room thermometer for both groups. Urinary parameters measured include pH, specific gravity, volume, calcium, sodium, phosphorus, uric acid and creatinine. Results showed that the mean levels of urine volume (345.52 +/- 294.88 mL, p0.005483), sodium (121.97 +/- 64.23 mmol/L, p0.006441), calcium (3.39 +/- 2.90 mmol/L, p0.03173), uric acid (3.24 +/- 2.83 mmol/L, p0.046342) and creatinine (11698.93+9091.19 umol/L, p0.035313) were significantly higher in the test group compared to the comparison group. However, there was no significant difference noted in the mean levels of urine pH, specific gravity and phosphorus. The increased risk of nephrolithiasis as assessed in the study was mainly attributed to dehydration during the workshift. Likewise, metabolic acidosis can also provide a possible explanation for the findings