Artroplastia total bilateral de cadera / Bilateral Total Hip Arthroplasty

Introducción: La artroplastia total de cadera es uno de los procedimientos más exitosos del siglo veinte. Cuando se realizan de manera simultánea, presentan varios beneficios como son: menor costo, menor estadía hospitalaria, uso de una sola dosis de anestésico y retorno precoz a las actividades diarias. Objetivo: Presentar el primer caso de artroplastia total bilateral simultánea, realizado satisfactoriamente en el Hospital Universitario Manuel Ascunce Domenech en la provincia de Camagüey. Presentación del caso: Paciente femenina de 78 años de edad, color de piel blanca, con antecedentes de coxartrosis bilateral de cinco años de evolución con dolor moderado y crisis de dolor intenso a predominio de la cadera izquierda. Presentó además escoliosis antálgica. A la exploración física se constató limitación a la abducción de ambas caderas con predominio de la izquierda, con las maniobras de Patrick, Thomas y Trendelemburg positivas bilaterales. En la radiografía simple de pelvis ósea anteroposterior se observaron: disminución marcada del espacio articular, osteofitos marginales bilaterales y esclerosis subcondral marcada. Se decidió realizar una artrolplastia total bilateral en un tiempo quirúrgico, una vez evaluadas las condiciones clínicas de la paciente y su consentimiento. Se utilizó el sistema Surgival no cementado. Conclusiones: La artoplastia total de cadera se presenta como un procedimiento factible, que proporciona numerosas ventajas, y aunque no está exento de complicaciones, estas no representan un riesgo sobreañadido, siempre y cuando se seleccionen los pacientes de manera adecuada. El caso presentado, evolucionó de manera satisfactoria tras dos años de realizada la cirugía(AU)

Introduction: Total hip replacement is one of the most successful procedures of the twentieth century. When performed simultaneously, it poses several benefits such as lower cost, shorter hospital stay, use of a single dose of anesthetic and early return to daily activities. Objective: To report the first case of simultaneous bilateral total arthroplasty, successfully performed at Manuel Ascunce Domenech University Hospital in Camagüey province. Case report: This is a case of a 78-year-old female patient, white skin color, with a five-year history of bilateral coxarthrosis, moderate pain and crisis of intense pain mainly in the left hip. She also had antalgic scoliosis. The physical examination revealed abduction limitation of both hips mainly on the left, with positive bilateral Patrick, Thomas and Trendelenburg maneuvers. In the plain anteroposterior bone pelvis radiograph marked decrease in joint space, bilateral marginal osteophytes, and marked subchondral sclerosis were observed. It was decided to perform a bilateral total arthroplasty in a surgical time, once the clinical conditions of the patient and her consent had been evaluated. The uncemented Surgival system was used. Conclusions: Total hip replacement represents a feasible procedure, which provides numerous advantages, and although it is not exempt from complications, these do not signify added risks, as long as the patients are properly selected. The case reported here evolved satisfactorily after two years of surgery(AU)

Esquema de cuidados de enfermería ante posibles afecciones psicológicas en pacientes con enfermedad renal crónica / Nursing care scheme for possible psychological conditions in patients with chronic kidney disease

La enfermedad renal crónica afecta progresivamente la función de los correspondientes órganos, provocando una pérdida de la capacidad de eliminar toxinas y control del volumen de líquido del organismo; lo que repercute en el estado general del paciente en sus dimensiones bio-psico-so-ciales. Se realizó una búsqueda de fuentes acerca de la satisfacción de las necesidades del usua-rio en relación con los cuidados de salud en el ámbito psicológico, para plantear actividades de enfermería utilizando la taxonomía NIC desde los fundamentos de la teoría de las relaciones interpersonales de Hildegard Peplau. El estudio abarcó la revisión del contenido de 57 artículos recopilados de las bases de datos: Google Académico, Biblioteca Virtual en Salud, SciELO, Redalyc, Elsiever, MedLine, Scopus, Proquest, Pubmed, Enfermería Global, entre otras. La información fue procesada empleando la técnica de triangulación de fuentes.

Chronic kidney disease progressively affects the function of the corresponding organs, causing a loss of the ability to eliminate toxins and control the volume of fluid in the body, which affects the general state of the patient in its bio-psycho-social dimensions. An academic source about the satisfaction of the user's needs in relation to health care in the psychological field was carried out to propose nursing activities using the NIC taxonomy from the foundations of Hildegard Peplau's theory of interpersonal relationships. The study included a review of the content of 57 articles collected from the databases: Google Scholar, Virtual Health Library, SciELO, Redalyc, Elsiever, MedLine, Scopus, Proquest, Pubmed, Global Nursing, among others. The information was processed using the source triangulation technique.

Inhibitory effect of compound NS5806 on cardiac transient outward potassium channel dependents on interaction between auxiliary subunits / 中国药理学与毒理学杂志

OBJECTIVE Transient outward potassium current (Ito) plays a crucial role in cardiac phase 1 repolarization and the channels are assembled by pore-forming α-subunits (Kv4.2 or Kv4.3) and auxiliary subunits (KChIP2 and DPP6). Previous studies have found that the compound NS5806 increases Ito in canine ventricular cardiomyocytes through slowing current decay. Here, we reported that NS5806 produced an acute inhibitory action on Ito in mouse ventricular cardiomyocytes and human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM). METHODS Whole-cell patch-clamp was used to record Ito in native myocytes and in HEK cells expressing cloned Kv4.x/KChIP2/DPP6 channels; Western-blot detected the channel protein expression. RESULTS In isolated mouse ventricular cardiomyocytes, NS5806 (0.1-30 μmol·L-1) inhibited Ito in a concentration-dependent manner with IC50 of 6.6±1.9 μmol·L-1. The current decay was significantly accelerated with a time constant from 53.8±5.5 to 41.8±3.0 ms at +60 mV (P<0.01). Similarly, NS5806 concentration-dependently reduced the Ito peak current amplitude with an acceleration of current decay. In addition, NS5806 increased IKv4.2/KChIP2 and delayed current decay, but decreased IKv4.2/KChIP2/DPP6 with the acceleration of current decay. The inhibitory action on the current was more potent if DPP6 expression level was increased from Kv4.2/KChIP2/DPP61:1:1 to 1:1:3. Western-blot showed a higher expression of DPP6 protein in mouse heart and in hiPS- CM compared to canine heart. Moreover, specific knock- down DPP6 expression by siRNA antagonized the inhibitory action of NS5806 in hiPS-CM. Our results pointed to an important role of DPP6 subunit in the regulation of NS5806 on the channel. By using molecular docking simulation, five interaction sites with high possibility between KChIP2 and DPP6 were identified. Mutations of those sites changed the inhibitory action of NS58056 into excitatory effect on the current with the delay of current decay. CONCLUSION NS5806 significantly inhibits Ito by accelerating current decay in mouse cardiomyocytes and hiPS-CM. The effect depends on the interaction between DPP6 and KChIP2 subunits.

Caracterización de la densidad mineral ósea en columna lumbar y caderas según factores de riesgo aterogénico en fallecidos / Characterization of bone mineral density in the lumbar spine and hips according to atherogenic risk factors in dead patients

Objetivo: caracterizar la densidad mineral ósea en columna lumbar y caderas según factores de riesgo aterogénico. Métodos: se estudiaron 79 fallecidos sin osteoporosis secundaria. Se realizó densitometría posmorten de columna lumbar y caderas. Se clasificaron los niveles de densidad mineral ósea según T score en normal, osteopenia y osteoporosis. De la historia clínica se extrajeron los factores de riesgo aterogénico: edad mayor de 60 años, hipertensión arterial, tabaquismo, dislipidemia, obesidad y diabetes mellitus tipo 2. Resultados: los ancianos, fumadores y dislipidémicos presentaron los T score más bajos, con un riesgo para osteoporosis de 8,7; 35,4 y 5,6 respectivamente. La hipertensión, obesidad y diabetes no mostraron discrepancias significativas con respecto a la densidad mineral ósea, pero los hipertensos tuvieron 3,1 veces más riesgo significativo para osteoporosis. Conclusiones: los factores de riesgo aterogénico: envejecimiento, tabaquismo, dislipidemia e hipertensión se asociaron a masa ósea disminuida en columna lumbar y caderas, así como a un mayor riesgo de osteoporosis.

Objective: to characterize bone mineral density in the lumbar spine and hips according to atherogenic risk factors. Methods: 79 dead patients without secondary osteoporosis were studied. Postmortem densitometry of the lumbar spine and hips was performed. The levels of bone mineral density were classified according to T score in normal, osteopenia and osteoporosis. Atherogenic risk factors were taken from clinical histories which reported: people over 60 years of age, high blood pressure, smoking habit, dyslipidemia, obesity and Type 2 diabetes. Results: the elderly, the smokers and the dyslipidemic patients presented the lowest T scores and a risk of suffering from osteoporosis of 8.7; 35.4 y 5.6 respectively. High blood pressure, obesity and diabetes did not show significant differences regarding bone mineral density, but the hypertensive ones presented a 3, 1 higher risk of suffering from osteoprosis. Conclusions: atherogenic risk factors such as aging, smoking, dyslipidemia and high blood pressure were associated to a diminished bone mass the in lumbar spine and hips as well as a higher risk of suffering from osteoporosis.

Clinical observation on treating severe neonatal diaper rash with hip bath and oxygen blowing / 中国实用护理杂志

Objective This research is to observe the treatment effects of hip bath and oxygen blowing on severe neonatal diaper rash.Methods 289 neonates with severe diaper rash were randomly divided into three groups.91 cases in the flat tube group,102 cases in the round tube group and 96 cases in the control group.Three groups of neonates were cleaned on the hips and perineuma after poops and then dried with wet tissues and Mupirocin Ointment.The control group was treated with the above-mentioned method.The oxygen blowing groups were treated with hip bath of 1:5000 chameleon solution twice a day.Blowing the hips with oxygen five minutes every time after hip bath.The method of blowing oxygen was that oxygen humidifying containers as normal oxygen aspiration facilities was not filled with water,whose oxygen flowing volume standed at 10 L/min and whose tube blew at the afflicted parts until being dry.The oxygen blower held the oxygen exit and blowed at the afflicted parts in the round tube group and the oxygen blower flattened the oxygen exit and blew at the afflicted parts in the fiat tube group.The treatment effects will be compared among the three groups four days later.Results The cure period of the round tube group was obviously shorter than that of the control group,and the cure period of the fiat tube group was remarkably shorter than that of the round tube group.The total effective rate in the round tube group was obviously higher than that of the control group and the total effective rate in the fiat tube group was obviously higher than that in the round tube group.The difference had a statistical significance.Conclusions The treatment effects for the severe neonatal diaper rash with hip bath and oxygen blowing are remarkable and the oxygen blowing effects with fiat tubes are better than those with round tubes.

Purification and some properties of rose (Fructus cynosbati) hips invertase.

Invertase was purified from rose (Fructus cynosbati) hips by ammonium sulfate fractionation and hydroxyapatite column chromatography. The enzyme was obtained with a yield of 4.25% and about 10.48-fold purification and had a specific activity of 8.59 U/mg protein. The molecular mass of invertase was estimated to be 66.51 kDa by PAGE and 34 kDa by SDS-PAGE, indicating that the native enzyme was a homodimer. The enzyme was a glycoprotein and contained 5.86% carbohydrate. The Km for sucrose was 14.55 mM and the optimum pH and temperature of the enzyme were 4.5 and 40°C, respectively. Sucrose was the most preferred substrate of the enzyme. The enzyme also hydrolyzed D(+) raffinose, D(+) trehalose and inulin (activity 39.88, 8.12 and 4.94%, respectively of that of sucrose), while D(+) lactose, cellobiose and D(+) maltose showed no effect on the enzyme. The substrate specificity was consistent with that for a β-fructofuranoside, which is the most popular type in the higher plants. The enzyme was completely inhibited by HgCl2, MnCl2, MnSO4, FeCl3, Pb(NO3)2, ammonium heptamolybdate, iodoacetamide and pyridoxine hydrochloride. It was also inhibited by Ba(NO3)2 (86.32%), NH4Cl (84.91%), MgCl2 (74.45%), urea (71.63%), I2 (69.64%), LiCl (64.99%), BaCl2 (50.30%), Mg(NO3)2 (49.90%), CrCl3 (31.90%) and CuSO4 (21.45%) and but was activated by Tris (73.99%) and methionine (12.47%).

Levels of serum retinol-binding protein 4 and related factors in type 2 diabetic patients / 中国医师进修杂志

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4 )and related factors in type 2 diabetic patients. Methods Eighty type 2 diabetic and patients 30 non-diabetic subjects were recruited into obese-diabetic group [body mass index (BMI) 1525 kg/m~2],normal-weighted diabetic group(BMI < 25 kg/m~2)and control group(BMI < 25 kg/m~2). Serum adiponectin(APN), RBP4 and hemoglobin A_1c (HbA_1c)triacylglycerol (TG),total cholesterol (TC).high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)and were measured on fasting samples. BMI, waist/hips girth ratio (WHR) and insulin resistance index (HOMA-IR) were calculated. The correlation between RBP4 and other factors was analyzed. Results The concentration of RBP4 was significantly increased in obese-diabetic group and normal-weighted diabetic group compared with that in control group [ (30.02 ± 5.32), (20.10 ± 5.45), (12.02 ± 3.45) mg/L] (P < 0.01). The concentration of RBP4 was higher in obese-diabetic group than that in normalweighted diabetic group (P < 0.01). Univariate analysis showed serum RBP4 was positively associated with TG,BMI,FBG, WHR,FINS,HOMA-IR and negatively associated with APN (r = 0.225, 0.697, 0.323,0.557, 0.272, 0.461, -0.398). Conclusions The concentration of RBP4 is significantly higher in type 2 diabetic patients compared with that in normal subjects. RBP4 possibly plays an important role in the insulin resistance and the occurrence and development of type 2 diabetes.

The Relationship Dyslipidemia with Body Mass Index and Waist Hip Ratio in the Population in Shanghai Free Trade / 中国慢性病预防与控制

Objective To explore the relationship between Body Mass Index (BMI), Waist-Hips-Ratio (WHR) and Blood lipids.Methods Body measurements including BMI, WHR and body fat percentage (FAT%), and blood lipid profile assessment and liver ultrasonography were conducted on 350 employees from Shanghai Waigaoqiao Free Trade Zone from January 2006 to August 2007. All subjects were classified into a group of overweight/obesity and a group of normal body weight based on their BMI. BMI, WHR, FAT%, blood lipid profile, the prevalence of fatty liver and dyslipidemia were compared between the two groups. Results WHR, FAT%, the level of TG and TC in overweight/obesity group were significantly higher than that in normal body weight group(P=0.000), but the level of HDL-C was significantly lower than that in normal body weight group (P=0.000). The prevalence of central obesity (88.70%), fatty liver (72.32%), and hypertriglyceridemia (49.7%),hypercholesterolemia (33.89%), low HDL-C (40.68%) in overweight/obesity group were significantly higher than those in normal body weight group (P=0.000). Concludes BMI, WHR were associated with blood lipids. Early identification and intervention on these people with high risk of cardiovascular diseases are possible by body measurement, which are significant for predicting and reducing the occurrence of cardiovascular diseases.

X-ray Photographic and Magnetic Resonance Imaging Features of Hip Pigmented Villonodular Synovitis / 广州中医药大学学报

Objective To investigate the X-ray photographic and magnetic resonance imaging (MRI) features of hip pigmented villonodular synovitis (PVNS). Methods A retrospective analysis was carried out in 19 patients with hip PVNS confirmed by operation and pathological examination.The X-ray plain photography in 10 patients and MRI features in 19 patients (of which 9 received enhanced scan) were analyzed.Results (1)The results of X-ray photography were as follows:Of 10 patients,6 showed swollen joint capsule,2 had higher-density masses around the joint;joint space narrowing was found in all of the 10 patients;except 2 patients,8 showed various degrees of bone erosion in the margin area of the joint,in the intertrochanteric area and around neck ,and showed capsule-like clear focus area with sclerotic margin in the joint surface of the bone;bonespur was found in the edge of the joints of 4 patients,of which 3 were complicated with osteoporosis.(2)The manifestations of MRI features:of 19 patients with hip PVNS,17 were differentiated as the diffused and 2 as the focalized.All of 17 diffused hip PVNS showed different degrees of diffuse hyperplasia of synovium,5 of them had intra-articular effusion,13 showed multiple-diffused nodular synovial changes with low signals of T1WI and T2WI,14 showed different degrees of bony erosion and depression in acetabulum,in the head of the femur and around the neck,which signals were similar to those with synovial hyperplasia.Of the 14 patients,8 foci presented circular low signals,capsule-like clear images under the bony joint surface with medium to low signals of T1WI and T2WI,and diffused swelling close to medullar cavities with sheet-like high signals of T2WI/STIR.The results of contrast-enhanced scanning for 8 of the 14 patients showed enhanced signals in the joint synovium and focus area of joint bones.Two focalized PVNS patients showed single mass on the outer flank of the femoral neck with medium to low T1WI signal and with medium to high T2WI signal,and also presented multiple dot-like and nodule-like foci with low T1WI and T2WI signals.One of the 2 focalized PVNS patients showed arc-shaped bone erosion at the outer margin of the femur.Conclusion MRI features of hip pigmented villonodular synovitis exert specific characteristics,which are valuable for the diagosis of PVNS;X-ray plain photography has indicative value for the diagnosis,but it has limitation.

The range of motion of normal hips in Thais.

The normal range of hip motion that used in medical therapy, are based on the data from western countries. The purpose of this study is to find out the normal angles of active range of motion of hip joints in Thais. Five hundred subjects were divided into three age groups : 25 – 39 years, 40 – 59 years and 60 – 69 years. The study was perfowed in the volunteers who had normal joint and had no symptom of hip pain for a period of six months prior to the study. The universal goniometer was used in measuring all directions of hip movement. The average degrees values of hip movements were : flexion = 111.91o, extension = 18.01o, abduction = 38.16o, adduction = 24.88o, medial rotation = 34.73o and lateral rotation = 34.94o. There was no significant differences of range of motions for hip extension, hip adduction and hip abduction between right and left hips (p > 0.05). Range of hip flexion and hip rotation were found significantly different between right and left hips (p < 0.05).

Combined Procedure of Open Reduction and Shortening of the Femur in Treatment of Congenital Dislocation of the Hips in Older Children / 대한정형외과학회잡지

Combined procedue of open reduction and shortening of femur for treatment of congenital hip dislocation in the older child is known to minmize the incidence of avascular necrosis, redislocation and stiffness. Thirty six hips in thirty three children were operated upon in the past six years with combined procedue of open reduction and shortening of femur. And twenty eight hips in twenty five children who were followed up more than one year were analysed. By the results, we obtained excellent in twenty nine percent, good in fifty three percent, fair in fourteen percent and poor in four percent.

Total Hip Replacement in Painful Stiff and Deformed Hips / 대한정형외과학회잡지

Total hip replacement is an available rnethod of treatment for various causes of disabled hips in adults, especially in painful stiff hips. In many cases, malposition has led to degenrative changes in the opposite hip, the lumbar spine or knee, often with severe loss of function due to pain. Between March, 1979 and February, 1983, twenty hips in sixteen patients with painful and deformed hips were operated at Kosin Medical College, and we obtained relif of pain and increase of range of motion of the hip joints. Furthermore we found relife of adjacent joint pain in several cases, and in addition correction of inequality of leg lenght.