Dolor en la fosa iliaca derecha: ¿apendicitis?... No, «Ascaris lumbricoides» / Pain in right lower quadrant: appendicitis? No, Ascaris lumbricoides

El dolor abdominal es un cuadro de consulta muy frecuente en la edad pediátrica, tanto en atención primaria como en atención especializada, e incluye los servicios de urgencias. En los casos en que el dolor se focaliza en la fosa iliaca derecha, el primer diagnóstico que hay que descartar es la apendicitis aguda. Además, destacamos la importancia de la ecografía para el diagnóstico de dolor abdominal. Presentamos un caso de dolor abdominal localizado en la fosa iliaca derecha en el que, tras descartar una apendicitis aguda mediante ecografía, se descubrió una infestación por Ascaris lumbricoides, entidad de dolor abdominal infrecuente en nuestro medio (AU)

Abdominal pain is a usual reason for consultation in pediatric, both in primary care and hospital, including emergency service. When the pain is located in right lower quadrant, the first diagnosis to discard is acute appendicitis. Besides, the relevance of ultrasonography for diagnosis of abdominal pain is emphasized. We report a case of abdominal pain located in right lower quadrant, where, after discarding acute appendicitis with an abdominal ultrasonography, we discover an Ascaris lumbricoides infestation, which is an unusual cause of abdominal pain in our country (AU)

Risk factors associated with self-reported training-related injury before arrival at the US army ordnance school.

OBJECTIVE: This study examined risk factors for self-reported injury incurred before arrival at Ordnance School for advanced individual training (AIT). STUDY DESIGN: During AIT in-processing, soldiers (n=27,289 men and 3856 women) completed a questionnaire that collected demographic and lifestyle information, and asked if the soldier currently had an injury that would affect their AIT performance. METHODS: Potential risk factors for self-reported injury were explored using logistic regression. RESULTS: For men, self-reported injury was associated with older age [odds ratio (OR) >or=30 years/17-19 years=1.9], race (OR Black/Caucasian=1.2), basic combat training (BCT) site (OR Fort Benning/Fort Jackson=1.7; OR Fort Leonard Wood/Fort Jackson=1.6, OR Fort Knox/Fort Jackson=1.3), smoking on 20 or more days in the 30 days prior to BCT (OR smoker/non-smoker=1.2) and current illness (OR ill/not ill=6.2). For women, increased self-reported injury was associated with older age (OR>or=30 years/17-19 years=2.0), BCT site (OR Fort Leonard Wood/Fort Jackson=1.5) and current illness (OR ill/not ill=5.8). CONCLUSIONS: Certain demographic characteristics and lifestyle behaviours may be identified as injury risk factors on arrival at Ordnance AIT.

Canada´s public health association - cpha

The Canadian Public Health Association (CPHA) is a national, independent, not-for-profit, voluntary association representing public health in Canada with links to the international public health community.It present publications, resources, information about conferences, programs, activities and policy.

Ambulatory physical activity during United States Army basic combat training.

Electronic pedometers were used to quantify locomotor physical activity during an entire 9-week United States Army Basic Combat Training (BCT) cycle. Pedometers were worn on the hips of 4 trainees in each of 10 BCT companies during all BCT activities. Investigators obtained pedometer readings (steps) on a daily basis, and estimated travel distances were obtained by multiplying steps by the average individual step length. A short questionnaire was administered daily to assure trainees wore the pedometers and trained with their companies all day. Trainees performed an average +/- SD of 16 311 +/- 5826 steps/day and traveled an estimated 11.7 +/- 4.4 kilometers/day. The highest daily locomotor activity was during the field training exercise in which trainees took an average +/- SD of 22 372 +/- 12 517 steps/day traveling an estimated 16.2 +/- 9.7 kilometers/day. Differences among the 10 companies ranged from 14 720 +/- 6649 steps/day to 18 729 +/- 6328 steps/day. This survey provided the first examination of locomotor physical activity during an entire BCT cycle.

Resultados de las elongaciones de húmero con fijación externa monolateral / Results of humeral lengthening using unilateral external fixation

Objetivo. Estudio clínico retrospectivo sobre 25 pacientes a los que se les realizó un alargamiento de húmero con fijadorexterno monolateral entre 1990 y 2000.Material y método. Los pacientes eran acondroplásicos(18), dos pacientes con condrodisplasia metafisaria, cuatro dismetrías congénitas superiores a los 4 cm y una secuela de artritis séptica. La edad media fue de 15 años y el seguimiento medio de 4 años. La media de elongación fue de9 cm. Resultados y conclusiones. Los resultados obtenidos demuestran que la osteogénesis a distracción en el húmero noes inocua, pero cuando aparecen complicaciones tienen solución y las secuelas no son importantes

Aim. A retrospective clinical study was made of 25 patients who underwent humeral lengthening with a unilateral external fixator between 1990 and 2000.Materials and methods. Eighteen patients had achondroplasia,2 metaphyseal chondrodysplasia, 4 congenital dysmetries over 4 cm and one sequela of septic arthritis. The mean age of patients was 15 years and the mean follow-up was 4years. The mean lengthening achieved was 9 cm. Results and conclusions. Results show that distractive osteogenesisis not innocuous, but the complications that appear can be managed and sequellae are minor

Influence of an injury reduction program on injury and fitness outcomes among soldiers.

OBJECTIVE: This study evaluated the influence of a multiple injury control intervention on injury and physical fitness outcomes among soldiers attending United States Army Ordnance School Advanced Individual Training. METHODS: The study design was quasiexperimental involving a historical control group (n = 2559) that was compared to a multiple intervention group (n = 1283). Interventions in the multiple intervention group included modified physical training, injury education, and a unit based injury surveillance system (UBISS). The management responsible for training independently formed an Injury Control Advisory Committee that examined surveillance reports from the UBISS and recommended changes to training. On arrival at school, individual soldiers completed a demographics and lifestyle questionnaire and took an army physical fitness test (APFT: push-ups, sit-ups, and two mile run). Injuries among soldiers were tracked by a clinic based injury surveillance system that was separate from the UBISS. Soldiers completed a final APFT eight weeks after arrival at school. RESULTS: Cox regression (survival analysis) was used to examine differences in time to the first injury while controlling for group differences in demographics, lifestyle characteristics, and physical fitness. The adjusted relative risk of a time loss injury was 1.5 (95% confidence interval 1.2 to 1.8) times higher in the historical control men and 1.8 (95% confidence interval 1.1 to 2.8) times higher in the historical control women compared with the multiple intervention men and women, respectively. After correcting for the lower initial fitness of the multiple intervention group, there were no significant differences between the multiple intervention and historical control groups in terms of improvements in push-ups, sit-ups, or two mile run performance. CONCLUSIONS: This multiple intervention program contributed to a reduction in injuries while improvements in physical fitness were similar to a traditional physical training program previously used at the school.

Fracturas articulares del tercio proximal de la tibia. Factores pronósticos / Articular fractures of the proximal tibia. Prognostic factors

Objetivo. Describir los resultados obtenidos en el tratamiento quirúrgico de las fracturas articulares de la tibia proximal y los factores preoperatorios y postoperatorios que condicionan su pronóstico. Material y método. Se revisaron de forma retrospectiva 111 casos de fracturas articulares de la tibia proximal, intervenidas entre los años 1988 y 2000, clasificadas según el sistema AO (asociación de osteosíntesis) en 12 casos del tipo B1, 33 del B2, 42 del B3, 7 del C1, 1 del C2 y 16 casos del tipo C3. Pertenecientes a 74 hombres (66,7 por ciento) y 37 mujeres (33,3 por ciento) de edad media 42,7 años. El método de tratamiento utilizado fue artroscópico en 6,3 por ciento, atornillamiento con o sin injerto en el 54 por ciento, placas de sostén en el 28,8 por ciento y fijación híbrida en el 8,1 por ciento; en el 2,7 por ciento sólo se usó injerto sin material de osteosíntesis. Resultados. Para la valoración postoperatoria se usó el protocolo de Honkonen, modificación del creado por Rasmussen. Se obtuvo un 89,2 por ciento de resultados excelentes o buenos (99 casos) y un 10,8 por ciento de resultados regulares o malos (12 casos). La técnica quirúrgica utilizada no influyó en el resultado final. Sí influyó el tipo de fractura, obteniendo peores resultados en las tipo C (p = 0,005). También condicionaron un mal resultado los hallazgos postoperatorios de alineación femorotibial en varo (p = 0,004), escalón articular mayor de 6 mm (p = 0,02) y sobre todo la inestabilidad residual (p < 0,0001) (AU)

Polymorphic Chromosomes Bearing the Tox2 Locus in Cochliobolus carbonum Behave as Homologs during Meiosis.

The HTS1 gene in the Tox2 locus of the fungal pathogen Cochliobolus carbonum race 1 is required for synthesis of a host-selective phytotoxin and for increased virulence on susceptible genotypes of maize. The locus is present in race 1 isolates but absent from isolates of the other races, which do not produce the toxin. By pulsed-field gel electrophoresis and Southern analysis with HTS1 sequences and chromosome-specific markers, the HTS1 gene was detected on a 4-Mb chromosome in one group of isolates and on a 2.3-Mb chromosome in another group, which lacked the 4-Mb chromosome. A chromosome-specific marker from C. heterostrophus hybridized to a 2.3-Mb chromosome in non-toxin-producing isolates and in toxin-producing isolates, including those with a 4-Mb chromosome. A marker from C. carbonum hybridized to the 4-Mb chromosome, but in isolates lacking the 4-Mb chromosome, this marker hybridized to a smaller, 2.0-Mb chromosome. Thus, the Tox2 locus is on different chromosomes in different groups of race 1 isolates. Single ascospore progeny from crosses between isolates having HTS1 on different chromosomes were analyzed for toxin-producing ability, virulence, and the presence and chromosomal location of HTS1. All progeny produced HC toxin in culture, incited race 1-type lesions on susceptible maize genotypes, and contained HTS1 sequences, as determined by PCR amplification with gene-specific primers. Analysis of the chromosomal complements of several progeny indicated that they all had only one Tox2-containing chromosome. Thus, despite their differences in size, these chromosomes behave as homologs during meiosis and may have arisen by a translocation.

NASA spinoffs to bioengineering and medicine.

Through the active transfer of technology, the National Aeronautics and Space Administration (NASA) Technology Utilization (TU) Program assists private companies, associations, and government agencies to make effective use of NASA's technological resources to improve U.S. economic competitiveness and to provide societal benefit. Aerospace technology from areas such as digital image processing, space medicine and biology, microelectronics, optics and electrooptics, and ultrasonic imaging have found many secondary applications in medicine. Examples of technology spinoffs are briefly discussed to illustrate the benefits realized through adaptation of aerospace technology to solve health care problems. Successful implementation of new technologies increasingly requires the collaboration of industry, universities, and government, and the TU Program serves as the liaison to establish such collaborations with NASA. NASA technology is an important resource to support the development of new medical products and techniques that will further advance the quality of health care available in the U.S. and worldwide.