Tendones peroneos: una revisión contemporánea / Peroneal tendons. Contemporary update

La patología de peroneos es compleja y frecuentemente subdiagnosticada. El conocimiento detallado de la anatomía, biomecánica y fisiopatología es fundamental para realizar un correcto diagnóstico y tratamiento. El objetivo de este artículo es revisar la información más actualizada sobre la patología de los tendones peroneos (tendinopatía, inestabilidad y rotura).

Pathology of the peroneal tendons is complex and often underdiagnosed. Knowledge of anatomy, biomechanics, and physiopathology is necessary for diagnosing and treating this condition. The objective of this article is to review the most updated information regarding peroneal tendon pathology (tendinopathy, dislocation/subluxation, and tears), which may help managing patients with lateral pain of the foot and ankle.

Neumoperitoneo progresivo preoperatorio para el tratamiento de la hernia inguinoescrotal gigante: reporte de caso / Progressive Preoperative Pneumoperitoneum for Giant Inguinoscrotal Hernia: a Case Report

Resumen Introducción: El procedimiento de neumoperitoneo progresivo preoperatorio para el manejo de hernias gigantes con "Pérdida de dominio" o Pérdida de derecho a domicilio" fue introducido en 1940 por Goñi Moreno en Argentina. Autores como Herszage, Berlemont, Koontz, Gravez y Martínez Munive presentaron variaciones interesantes del método original. Su uso se recomienda para preparación previa de pacientes con hernias gigantes y grandes contenidos de vísceras en el saco herniario, en los cuales no sería posible su re-introducción y efectuar la hernioplástia, o en los que su reducción de manera forzada pudiera llevar al paciente al desarrollo de un síndrome compartimental abdominal en el postoperatorio inmediato. Caso clínico: Paciente de sexo masculino de 65 años de edad, que presenta cuadro clínico de un mes de evolución caracterizado por dolor a nivel de la región inguinal izquierda, en el cual se evidencia presencia de hernia inguino escrotal gigante izquierda, no reductible, con aproximadamente un 40% de contenido abdominal. Resultados: La mayoría de los estudios describen el uso del neumoperitoneo progresivo para la reparación de las eventraciones gigantes, sin embargo, en nuestra experiencia y en la de otros autores, esta técnica también puede utilizarse para resolver las hernias inguinales y umbilicales gigantes, con buenos resultados. En todos los casos se aconseja utilizar material protésico. Conclusión: El uso del neumoperitoneo preoperatorio progresivo, se trata de una técnica segura y fácil de realizar que puede complementar las técnicas de eventroplastía complejas, aportando ventajas en la preparación de los pacientes con grandes defectos de pared abdominal y obteniendo buenos resultados.

Abstract Introduction: The procedure of progressive preoperative pneumoperitoneum for the management of giant hernias with "Loss of domain" or "Loss of the right of domain" was introduced in 1940 by Goñi Moreno in Argentina, followed in later years by authors such as Herszage, Berlemont, Koontz, Gravez and Martínez Munive, all with some interesting variations of the original method. Its use is recommended for previous preparation of patients with giant hernias and large contents of viscera in the hernial sac, in which it would not be possible to re-introduce and perform hernioplasty, or in which its forced reduction could lead to the patient to the development of an abdominal compartment syndrome in the immediate postoperative period. Clinical case: A 65-year-old male patient with a clinical picture of one month of evolution characterized by pain in the left inguinal region. There was evidence of a giant left inguinal scrotum, not reducible, with approximately 40% abdominal contents. Results: Most studies describe the use of progressive pneumoperitoneum for the repair of giant hernias, however, in our experience and in that of other authors, this technique can also be used to resolve hernias giant inguinal and umbilical, with good results. In all cases it is recommended use prosthetic material. Conclusion: The use of progressive preoperative pneumoperitoneum is a safe and easy-to-perform technique that can complement complex eventroplasty's techniques, providing advantages in the preparation of patients with large abdominal wall defects and obtaining good results.

Diseño y validación de una escala de actitudes hacia la Policía Nacional, para muestras colombianas / Desenho e validação de uma escala de atitudes em relação à Polícia Nacional, para amostras colombianas / Designing and Validating a Scale of Attitudes towards the National Police, for Colombian Samples

El diseño de esta investigación es de corte empírico y cuantitativo, además, es de tipo psicométrico, bajo el criterio de estudio instrumental. Su objetivo principal fue diseñar y validar una escala de actitudes hacia la Policía Nacional para una muestra colombiana. Para ello, se realizó una revisión teórica y se diseñó una tabla de especificaciones que permitió identificar la cantidad de ítems que se requerían para abarcar las seis funciones principales de dicha entidad. Posteriormente, los ítems fueron sometidos a la validación por parte de jueces, se realizaron algunos ajustes sugeridos a la escala y se aplicó la encuesta a 566 ciudadanos colombianos con edades entre los 18 y 82 años, cuya media fue de 26 años. Se tuvo acceso a la población a través de un muestreo no probabilístico por bola de nieve. Así mismo, se llevó a cabo un análisis factorial exploratorio, que agrupó los reactivos en cuatro factores: pensamientos y creencias hacia la Policía Nacional, emociones y sentimientos hacia la Policía Nacional, accionar propio de la Policía y accionar de la Policía ante riñas y peleas. Además, se realizó un análisis factorial confirmatorio que refiere adecuados índices de bondad de ajuste. Los resultados de los análisis estadísticos demostraron que este instrumento tiene una alta consistencia interna y confiabilidad, lo cual se ve reflejado en el alfa de Cronbach general de 0,875 y una adecuada validez, ya que los ítems tienen apropiados índices de extracción y los cuatro factores en los que se agruparon explican el 47,140% de la varianza total.

This study's design was empirical and quantitative. In addition, it was psychometric, under instrumental study criteria. Its main objective was to design and validate a scale of attitudes towards the National Police for a Colombian sample. To do so, a theoretical review was performed and a table of specifications was created, which allowed identifying the amount of items required to cover the six main functions of said entity. Subsequently, the ítems were submitted to validation by judges. Some suggested adjustment were made to the scale, and the survey was given to 566 Colombian citizens between the ages of 18 to 82. The average age was 26. The population was accessed by means of non-probability, snowball sampling. Moreover, an exploratory factor analysis was performed, which regrouped the reactive items into four factors: thoughts and beliefs regarding the National Police, feelings and emotions towards the National Police, the Police's own actions, and the Police's actions in light of brawls and fights. In addition, a confirmatory factor analysis that refers to proper goodness of fit indices was performed. The results of the statistical analyses demonstrated that this instrument has high internal consistency and reliability, which is reflected in the general Cronbach's alpha of 0,875 and proper validity, since the items have appropriate extraction indices and the four factors in which they were grouped explain 47,140% of total variance.

O desenho desta pesquisa é empírico e quantitativo, além disso, é psicométrico, sob o critério de estudo instrumental. Seu principal objetivo foi desenhar e validar uma escala de atitudes em relação à Polícia Nacional para uma amostra colombiana. Para isso, foi realizada uma revisão teórica e foi elaborado um quadro de especificações para identificar o número de itens necessários para cobrir as seis funções principais da referida entidade. Posteriormente, os itens foram submetidos à validação de juízes, alguns ajustes sugeridos foram feitos na escala e a pesquisa foi aplicada a 566 cidadãos colombianos com idade entre 18 e 82 anos, cuja média foi de 26 anos. A população foi acessada por amostragem não probabilística em bola de neve. Da mesma forma, foi realizada uma análise fatorial exploratória, que agrupou os itens em quatro fatores: pensamentos e crenças em relação à Polícia Nacional, emoções e sentimentos em relação à Polícia Nacional, atuação característica da Polícia e atuação da Polícia frente a rixas e brigas. Além disso, foi realizada uma análise fatorial confirmatória que se refere a índices adequados de bondade de ajuste. Os resultados das análises estatísticas demonstraram que este instrumento possui alta consistência interna e confiabilidade, o que se reflete no alfa de Cronbach geral de 0,875 e validade adequada, uma vez que os itens apresentam taxas de extração adequadas e os quatro fatores nos quais foram agrupados explicam 47,140% da variância total.

Clinical and epidemiological characteristics of patients diagnosed with covid-19 in a tertiary care center in Mexico City: a prospective cohort study

ABSTRACT Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.

Caso de reunión clínica: trastorno delirante / Case of clinical meeting: delirious disorder

Hombre, 76 años, Jubilado, Soltero sin hijos, Estudios técnicos incompletos. Domicilio: Comuna de Providencia. Diagnóstico: Trastorno Delirante. Ideas delirantes persecutorias relacionadas con personas que viven en su edificio. Amenaza a sus vecinos de piso. Refiere que hablan de él en la televisión. Sospecha que su madrastra y hermanos quieren quedarse con herencia de su padre, quien falleció el año 2006. Antecedente de delirio de persecución aproximadamente a los 30 años. Se logra un control parcial de la sintomatología psiquiátrica y se mantiene trabajando en industria de muebles del padre. Paciente actualmente vive solo, sin pareja ni hijos. No sale de su departamento desde hace dos años. Efectúa compras por teléfono. Visitas de Parientes: Escasa, mayor contacto telefónico.

Case report: Man, Ricardo M. A., 76 years old, Retired, Single without children, Technical studies incomplete. Domicile: Commune of Providence. Diagnosis: Delusional disorder Persecutory delirious ideas related to people living in your building. Threatens his neighbors to the floor. He says they talk about him on TV. She suspects that her stepmother and siblings want to inherit their father, who passed away in 2006. Antecedent of delirium of persecution at approximately 30 years. A partial control of the psychiatric symptomatology is obtained and it is kept working in the father's furniture industry. Patient currently lives alone, without a partner or children. He has not left his apartment for two years. Make purchases by phone. Visits of Relatives: Scarce, greater telephone contact.

Genu valgo en niño: aproximación diagnóstica y tratamiento / Genu valgus in children: diagnosis approach and treatment

El objetivo de este trabajo es revisar las consideraciones que debe tener en cuenta el pediatra para poder distinguir entre el genu valvo fisiológico y en genu valgo patológico a través de los datos de la historia clínica, los antecedentes y el examen físico y además revisar el diagnóstico diferencial básico de esta patología así como su manejo