Escoliosis desarrollo temprano. Curso de instrucción / Early onset scoliosis. Instructional course

Introducción Escoliosis de desarrollo temprano, es aquella escoliosis que se presenta antes de los 10 años de edad secundaria a anomalías estructurales congénitas de la columna, enfermedades neuromusculares, síndromes, o idiopáticamente. Materiales & Métodos Revisión literaria narrativa de todo lo publicado sobre escoliosis de desarrollo temprano durante 2003 al 2018. Resultados Esta deformidad de la columna a temprana edad limitara el crecimiento pulmonar e incapacitara la función respiratoria apropiada, provocando el síndrome de insuficiencia torácica. Históricamente, la historia natural de esta condición puede ser letal y el daño ocasionado por la escoliosis de desarrollo temprano suele ser permanente a pesar de su restauración. Actualmente, la escoliosis de desarrollo temprano se clasifica utilizando la combinación de las variables: edad, etiología, magnitud de la escoliosis y cifosis. Los métodos de tratamiento más utilizados son: enyesado en serie, implantes de distracción costal longitudinal en aleación de titanio, barras de crecimiento dobles, técnica de Shilla™, y barras de crecimiento electromagnéticas. Discusión Indudablemente, es imperativo conocer sus manifestaciones y peculiaridades para poder clasificar, monitorear la severidad, personalizar el tratamiento, detener el deterioro de la columna lo más pronto posible, y prevenir la insuficiencia respiratoria Nivel de evidencia IV

Background Early onset scoliosis presents before the age of 10 years old due to congenital structural anomalies of the thorax, neuromuscular diseases, and syndromes, or is idiopathic. Methods A review of the literature from 2003 to 2018 on the early onset scoliosis. Result A deformity of the spine at an early age limits lung development and proper respiratory function, thereby provoking the onset of a thoracic insufficiency syndrome. Historically, the natural path of this condition can be lethal, and the damage caused by the early onset scoliosis tends to be permanent, regardless of its restoration after the age of 10. The early onset scoliosis classification is currently based on the age, aetiology, and the extent of the deformity. The treatment modalities most often used are: serial casts, vertical expandable prosthetic titanium ribs, double traditional growing rods, Shilla™ growing rods, and magnetically controlled growing rods. Discussion Undoubtedly, it is imperative to know its manifestations and peculiarities in order to classify the disease, as well as to monitor the disease. Treatment should be personalised, and the deterioration of the spine halted as soon as possible, as well as to prevent respiratory insufficiency Level of evidence IV

Prevalencia de factores de riesgo cardiovascular en indígenas embera-chamí de Cristianía (Jardín), Antioquia / Prevalence of cardiovascular risk factors in the embera-chami indigenous population of Cristianía (Jardín) Antioquia, Colombia / Prevalência de fatores de risco cardiovascular em indígenas embera-chamí de Cristianía (Jardim), Antioquia

Estudiamos la prevalencia de los factores de riesgo cardiovascular en 488 individuos mayores de 14 años, en el resguardo indígena Karmata Rúa de Cristianía. Se encontraron las siguientes frecuencias: hipertensión arterial (HTA) 18,1%; antecedente personal de diabetes mellitus 3,3%; glucemia mayor de 126 mg/dL 0,7%; hábito de fumar 15%; sobrepeso 40,2%; obesidad 8,0%; hipercolesterolemia 21,4%; hipertrigliceridemia 33,3% y dislipidemia 56,2%. El índice de masa corporal y los valores de colesterol total, glucemia, perímetro de la cintura, índice cintura/ cadera y presión arterial sistólica y diastólica presentaron correlación positiva y significativa con la edad. El grado de escolaridad mostró correlación negativa con el perímetro de la cintura, el índice cintura/cadera, la glucemia y la presión arterial. Al comparar con poblaciones indígenas y no indígenas de Colombia y de otros países, se encontró una prevalencia entre tres y cuatro veces menor de diabetes mellitus; en la población estudiada hay menos HTA aunque existe tendencia al sobrepeso. No se encontraron diferencias significativas en otros factores de riesgo; todos ellos fueron más frecuentes en mujeres, en personas de escolaridad baja y en individuos mayores. Los factores que contribuyen a estas diferencias son genéticos (homogeneidad étnica) y ambientales, como la mayor actividad física de los hombres, la dieta y la estructura demográfica.

Prevalence of cardiovascular risk factors was studied in 488 individuals over the age of 14 years in the Karmata Rua indigenous population of Cristianía, Colombia. The following rates were found: arterial hypertension 18.1%, family history of diabetes mellitus 3.3%, serum glucose over 126 mg/dL 0.7%, smoking habit 15%, overweight 40.2%, obesity 8.0%, hypercholesterolemia 21.4%, hypertriglyceridemia 33.3% and dyslipidemia 56.2%. Values of body mass index, total cholesterol, glucose, waist circumference, waist/hip index, systolic and diastolic blood pressure showed a positive and significant correlation with age. Higher level of education showed negative correlation with waist circumference, the waist/hip index, blood sugar and blood pressure. In comparison with other indigenous and non-indigenous communities of Colombia and other countries, prevalence of diabetes mellitus was between three and four times lower in the studied population; prevalence or high blood pressure was also lower despite a tendency to overweight. For other risk factors no significant differences were found, but they were more common in women, in people with low level of schooling and in elder individuals. Probably this difference is caused by genetic and environmental factors, such as increased physical activity in men, diet, and population structure.

Estudamos a prevalência dos fatores de risco cardiovascular em 488 indivíduos maiores de 14 anos, no resguardo indígena Karmata Rúa de Cristianía. Encontraram- se as seguintes frequências: hipertensão arterial (HTA) 18,1%; antecedente pessoal de diabete mellitus 3,3%; glicemia maior de 126 mg/DL 0,7%; hábito de fumar 15%; sobrepeso 40,2%; obesidade 8,0%; hipercolesterolemia 21,4%; hipertrigliceridemia 33,3% e dislipidemia 56,2%. O índice de massa corporal e os valores de colesterol total, glicemia, perímetro da cintura, índice cintura/quadril e pressão arterial sistólica e diastólica apresentaram correlação positiva e significativa com a idade. O grau de escolaridade mostrou correlação negativa com o perímetro da cintura, o índice cintura/quadril, a glicemia e a pressão arterial. Ao comparar com populações indígenas e não indígenas da Colômbia e de outros países, encontrou-se uma prevalência entre três e quatro vezes menor de diabetes mellitus; na população estudada há menos HTA ainda que existe tendência ao sobrepeso. Não se encontraram diferenças significativas em outros FR; todos eles foram mais frequentes em mulheres, em pessoas de escolaridade baixa e em indivíduos maiores. Os fatores que contribuem a estas diferenças são genéticos (homogeneidade étnica) e ambientais, como a maior atividade física dos homens, a dieta e a estrutura demográfica.

Slipped capital femoral epiphysis in a hispanic population from 1980-1989

Between 1980 to 1989 all the records of patients with slipped capital femoral epiphysis (SCFE) from the University Children Hospital in San Juan, Puerto Rico were Reviewed. This was done in an effort to assess the outcome of patients affected with SCFE admitted to University Pediatric Hospital. Comparison with other populations already studied showed no significant differences regarding patients age, weight, side effected, bilaterality and response to current standard surgical methods of treatment.