Protetización en paciente pediátrico amputado con plastia de rotación tipo Van Nes (Cali, Colombia) / Prosthetic rehabilitation in pediatric patient amputated with Van Nes rotation plasty (Cali, Colombia)

La plastia de rotación tipo Van Nes es una opción reconstructiva para pacientes con pérdida ósea de miembros inferiores congénita o adquirida. Se describe la rehabilitación protésica en un paciente pediátrico oncológico con osteosarcoma de fémur distal izquierdo que requirió realización de plastia de rotación tipo Van Nes y posterior rehabilitación por equipo multidisciplinario. Se logró marcha independiente altamente funcional. La plastia de rotación con preservación del mecanismo del control activo de la pseudo-rodilla es una técnica válida que ofrece un resultado óptimo para la adaptación de prótesis y que permite marcha funcional e independiente. Por su condición anatómica, oncológica y los cambios biomecánicos derivados, estos pacientes requieren un plan de rehabilitación protésica riguroso dirigido por un equipo multidisciplinario que incluya especialistas en rehabilitación, trabajo social, psicología y demás profesiones requeridas con el fin de brindar una atención oportuna, óptima y con resultados satisfactorios

The Van Nes rotational plasty is a reconstructive option for patients with congenital or acquired lower limb bone loss. We describe the prosthetic rehabilitation of a pediatric oncologic patient with osteosarcoma of the left distal femur who required a Van Nes rotational plasty and subsequent rehabilitation by a multidisciplinary team. Highly functional independent gait was achieved. Rotational plasty with preservation of the mechanism of active control of the pseudo-knee is a valid technique that offers an optimal result for prosthesis adaptation and allows functional and independent gait. Due to their anatomical and oncological condition and the biomechanical changes derived, these patients require a rigorous prosthetic rehabilitation plan directed by a multidisciplinary team that includes specialists in rehabilitation, social work, psychology and other required professions,psychology and other professions required in order to provide timely, optimal care with satisfactory results.

Síndrome de disfunción de la articulación sacroiliaca. Análisis clínico de los resultados a corto y mediano plazo de una serie de 115 pacientes tratados con bloqueo selectivo percutáneo / Sacroiliac Joint Dysfunction Syndrome. Results of Clinical Analysis in the Short and Medium Term, in a series of 115 Patients Treated with Percutaneous Blockage

Objetivo: el síndrome de disfunción de la articulación sacroiliaca es una de las principales causas de dolor lumbar. Este artículo muestra cómo se evaluó el curso clínico de personas sometidas a bloqueos selectivos percutáneos para el tratamiento del dolor sacroiliaco. Materiales y métodos: se trataron 115 pacientes que asistieron a consulta entre noviembre de 2006 y mayo de 2013. Fueron diagnosticados con síndrome de disfunción de la articulación sacroiliaca. Se realizaron 131 bloqueos de esta articulación, llevados a cabo por uno de los autores (JCA) con técnica percutánea bajo visión fluoroscópica. El análisis se realizó a partir de la información de la historia clínica con un seguimiento de hasta un año. Resultados: se evaluó la intensidad del dolor con la escala visual análoga y se encontró que el 67 % de los pacientes presentó mejoría superior al 50% del dolor. El 35% presentó mejoría superior al 75% del dolor. Conclusiones: el tratamiento del dolor lumbar secundario a una alteración en la articulación sacroiliaca puede ser tratado con la realización percutánea de bloqueo selectivo con esteroides y anestésicos.

Sacroiliac joint ¿ysfunction syndrome is a major cause of lower back pain. Aim: To discuss the usefulness of selective percutaneous blockages as a potential treatment. Materials and methods: The population of this study were 115 patients who consultad hrom November 2006 until May 2013, and were diagnosed with sacroiliac joint syndrome. 131 blockages of the sacroiliac joint were performed in the last 6 years by observen (JCA) with a technique under fluoroscopic víew. The analysis was performed with data from the clinical history followed for up to one vean Results: It was found that 67% of patients showed an ¿mprovement of over 50% of pain using analog pain scale of these, 35% had greater improvement than 75% of the pain. Conclusions: One of the high-cost diseases un the system is lower back pain, and it ineludes Sacroiliac joint dysfunction Syndrome which must be diagnosed by history physical examination and radiological aids. The percutaneous blockage ¿s a treatment under fluoroscopic visión which can reach verv favorable results.

Serum 25-hydroxyvitamin D concentrations and treatment outcomes of women undergoing assisted reproduction.

BACKGROUND: Vitamin D deficiency impairs fertility in animal models, but the role of vitamin D in human fertility or treatment of infertility is less clear. OBJECTIVE: We examined the association between circulating 25-hydroxyvitamin D [25(OH)D] concentrations and the outcome in women undergoing assisted reproduction technologies (ARTs). DESIGN: We randomly selected 100 women undergoing infertility treatment with ART enrolled in an ongoing prospective cohort study who underwent 168 treatment cycles. Serum 25(OH)D concentrations were measured in samples collected from women between days 3 and 9 of gonadotropin treatment. Generalized linear mixed models were used to evaluate the association of 25(OH)D concentrations with ART outcomes while adjusting for potential confounders and accounting for repeated treatment cycles per woman. RESULTS: Median (range) serum 25(OH)D concentrations were 86.5 (33.5-155.5) nmol/L. Ninety-one percent of participants consumed multivitamins. Serum 25(OH)D concentrations were positively related to fertilization rate. The adjusted fertilization rate for women in increasing quartiles of serum 25(OH)D were 0.62 (95% CI: 0.51, 0.72), 0.53 (95% CI: 0.43, 0.63), 0.67 (95% CI: 0.56, 0.76), and 0.73 (95% CI: 0.63, 0.80), respectively (P-trend = 0.03). This association persisted when analyses were restricted to women with serum 25(OH)D between 50 and 125 nmol/L when models were further adjusted for season of blood draw and when analyses were restricted to the first treatment cycle. However, 25(OH)D concentrations were unrelated to probability of pregnancy (P-trend = 0.83) or live birth after ART (P-trend = 0.47). CONCLUSION: Vitamin D may be associated with higher fertilization rates, but this apparent benefit does not translate into higher probability of pregnancy or live birth. This trial was registered at www.clinicaltrials.gov as NCT00011713.