Epidemiological study on supracondylar fractures of distal humerus in pediatric patients. / Estudio epidemiológico sobre fracturas supracondíleas de húmero distal en pacientes pediátricos.

OBJECTIVE: The purpose of this work is to study the epidemiology of patients with distal humerus supracondylar fractures in pediatric age treated in a tertiary hospital. METHOD: A descriptive study was conducted on the epidemiological characteristics of distal humerus supracondylar fractures in pediatric patients treated in a tertiary hospital from January 1, 2014 to June 30, 2018. The following variables were analyzed: age, side of lesion, sex, type of Gartland's classification, date of injury, mechanism, place and moment of trauma, therapeutic attitude, complications and associated fractures. RESULTS: A total of 140 patients were included in the study, with an average age of 5 years and 3 months. According to Gartland's classification, 40% of patients with type I fractures were found, 20.7% with type II and 39.3% with type III. Of the total sample, 76 patients (54.3%) were treated surgically and 9 (6.4%) had neurological complications. Likewise, in 135 cases the place of the fall could be identified, most of them (52.1%) in the park with a significantly higher incidence from May to August (45.8%) and the weekends (70.71%). CONCLUSIONS: The incidence of supracondylar humerus fractures seems to be greater associated with the activity in the parks and, above all, it would be greater during the summer period, in the afternoon and the weekends.

Application of infrared thermography in diagnosing peripherally inserted central venous catheter infections in children with cancer.

APPROACH: Children affected by oncological diseases are often fitted with central venous catheters (CVCs). Catheter infection is a frequent complication, sometimes accompanied by thrombosis. A case/control-type pilot study of children with oncological diseases fitted with a CVC is here designed. OBJECTIVE: The objective of this preliminary study is to use infrared thermography to discern whether there is an infection in patients with a CVC and, if so, to undertake a close follow-up of its evolution, after administering a therapy. Thermal asymmetry by mean and maximum temperatures (temperature affected ROI - temperature contralateral ROI) is measured. MAIN RESULTS: In all cases with catheter infection, thermal asymmetry values were higher than in controls without infection, allowing us to assess improvement after starting the treatment. SIGNIFICANCE: These preliminary results are satisfactory because they reflect the advantages of using infrared thermography on oncological child patients, as it is a harmless, non-contact, accessible and quick technique, allowing us to reduce the use of ionizing radiation and quantify the clinical signs of inflammation, which are otherwise only qualitatively detectable in clinical examination. By doing so, it may be possible to anticipate infection and provide early treatment, and, moreover, to observe whether there is any complication after starting a treatment. More studies need to be undertaken with an extensive paediatric population to establish reference values.

[Quantification of changes in the external morphology of the back by means of surface topography based on structured light in idiopathic scoliosis in adolescents after a year of treatment with orthopedic corse]. / Cuantificación de cambios en la morfología externa de la espalda mediante topografía de superficie basada en luz estructurada en la escoliosis idiopática del adolescente tras un año de tratamiento con corsé ortopédico.

BACKGROUND: To quantify the morphological changes in the surface of the back of adolescents with idiopathic scoliosis as a result of treatment with braces and to correlate them with radiographic changes. MATERIAL AND METHODS: An analytical, cohort, prospective study on a sample of 31 adolescents with idiopathic scoliosis. We divided them into two groups: eleven treated with braces and twenty without them. Quantification of the deformity was performed on two separate occasions with an interval of one year using three systems: 1) angle of trunk rotation (scoliometer); 2) surface topography; 3) full spine X-rays. RESULTS: No statistically significant differences were detected between the initial and final assessment of the topographic and radiographic variables in the group with braces. In the untreated group, only in measures with the scoliometer significant differences were registered. A positive correlation was found between the Cobb angle difference of the main curve with two topographic variables that quantify the asymmetry in the axial and coronal plane, respectively. DISCUSSION: In following patients with scoliosis treated with braces, we should consider and evaluate not only radiographic parameters such as the Cobb angle, but also clinical and topographic parameters that quantify the external deformity of the back, as there is a clinical-radiographic discrepancy amply demonstrated in the literature. The improvement of the external shape of the back is a very important factor for the patient, and can influence a better completion of the orthopedic treatment. In our study, the scoliotic curve and external deformity of the back remained stable during the follow-up period in both treated and untreated patients.

ANTECEDENTES: Cuantificar los cambios morfológicos producidos en la superficie de la espalda de adolescentes con escoliosis idiopática como resultado del tratamiento mediante corsé y correlacionarlos con las variaciones radiográficas. MATERIAL Y MÉTODOS: Estudio analítico, de cohortes, prospectivo, sobre una muestra de 31 adolescentes con escoliosis idiopática divididos en dos grupos: 11 con tratamiento mediante corsé y 20 sin corsé. Se realizó una cuantificación de la deformidad en dos ocasiones separadas entre sí por un intervalo de un año mediante tres sistemas: 1) ángulo de rotación del tronco (escoliómetro); 2) topografía de superficie; 3) radiografía simple de raquis completo. RESULTADOS: No se detectaron diferencias estadísticamente significativas entre la valoración inicial y final de las variables topográficas y radiográficas en el grupo con corsé. En el grupo no tratado, sólo hubo diferencias significativas para las medidas del escoliómetro. Se encontró una correlación positiva entre la diferencia del ángulo de Cobb de la curva principal con la de dos variables topográficas que cuantifican la asimetría en el plano axial y en el coronal, respectivamente. DISCUSIÓN: En el seguimiento de pacientes con escoliosis tratados con corsé, se deben tener en cuenta y valorar no sólo parámetros radiográficos como el ángulo de Cobb, sino también parámetros clínicos y topográficos que cuantifiquen la deformidad externa de la espalda, ya que existe una discrepancia clínico-radiográfica demostrada de manera amplia en la literatura. La mejoría de la forma externa de la espalda es un factor muy importante para el paciente y es lo que va a percibir fundamentalmente, lo que puede influir en una mejor cumplimentación del tratamiento ortopédico. En nuestro estudio, la curva escoliótica, así como la deformidad externa de la espalda, se mantuvo estable en el período de seguimiento tanto en los pacientes tratados con corsé como en los no tratados.

Effects of graduated compression stockings on skin temperature after running.

High skin temperatures reduce the thermal gradient between the core and the skin and they can lead to a reduction in performance and increased risk of injury. Graduated compression stockings have become popular among runners in the last years and their use may influence the athlete's thermoregulation. The aim of this study was to investigate the effects of graduated compression stockings on skin temperature during running in a moderate indoor environment. Forty-four runners performed two running tests lasting 30min (10min of warm-up and 20min at 75% of their maximal aerobic speed) with and without graduated compressive stockings. Skin temperature was measured in 12 regions of interest on the lower limb by infrared thermography before and after running. Heart rate and perception of fatigue were assessed during the last minute of the running test. Compression stockings resulted in greater increase of temperature (p=0.002 and ES=2.2, 95% CI [0.11-0.45°C]) not only in the body regions in contact (tibialis anterior, ankle anterior and gastrocnemius) but also in the body regions that were not in contact with the garment (vastus lateralis, abductor and semitendinosus). No differences were observed between conditions in heart rate and perception of fatigue (p>0.05 and ES<0.8). In conclusion, running with graduated compression stockings produces a greater increase of skin temperature without modifying the athlete's heart rate and perception of fatigue.

Estudio comparativo de la fiabilidad y reproducibilidad de los tamaños MEDIODISTA LES y las medidas de la arcada dentaria, entre la tomografía Computarizada de haz cónico (CBCT ) y un método digital / No disponible

Introducción: La introducción de herramientas diagnósticas como Tomografía Computarizada de Haz Cónico (CBCT) y su aplicación clínica a la imagen dentofacial en 3D, es una de las materias más interesantes y más novedosas actualmente en Ortodoncia permitiendo obtener imágenes tridimensionales de los dientes y por lo tanto, realizar mediciones sobre las mismas. Objetivos: Valorar la fiabilidad y reproducibilidad de los tamaños mesiodistales y las medidas de la arcada dentaría, entre un Método Tridimensional (CBCT) y un Método Digital. Material y método: La muestra estaba compuesta de 50 pacientes a los que se les realizó un CBCT como parte de su diagnóstico ortodóncico. El CBCT utilizado fue el Dental Picasso (..) (AU)

Introduction: The introduction of diagnostic tools such as Cone Beam Computed Tomography (CBCT) and its clinical application to dentofacial 3D image, is one of the most interesting materials and latest in Orthodontics currently possible to obtain three-dimensional images of the teeth and therefore measurements on them. Objectives: To assess the reliability and reproducibility of tooth size and dental arch measurements between a Three Dimensional Method (CBCT) and a digital one. Material and Methods: The sample consisted of 50 patients who underwent a CBCT as part of orthodontic diagnosis. The CBCT used was Picasso Master 3D ®. The images were sent in DICOM format to secure the company’s Web In Vivo Dental (Anatomage, San Jose, California) to obtain three-dimensional images of the models. To make comparative studies were made of plaster study models these (..) (AU)

Valoración de los métodos de predicción de tamaños dentarios en dentición mixta / Assessment of the mixed dentition methods to predict unerupted teeth

Desde siempre, conocer el tamaño de los dientes no erupcionados, caninos y premolares, en dentición mixta, ha sido un claro reto en ortodoncia. El objetivo del presente trabajo es mostrar todos los métodos existentes en la bibliografía para realizar la predicción del tamaño de estos dientes, así como sus ventajas e inconvenientes. Estos métodos pueden clasificarse en 4 grandes grupos: los basados en ecuaciones de regresión; los basados en mediciones directas en radiografías; los que combinan elementos de los 2 anteriores, y otro método no clasificable en ninguno de los anteriores. Los métodos basados en ecuaciones de regresión son rápidos de realizar pero presentan coeficientes de correlación bajos y de poca fiabilidad; los que usan mediciones directas sobre radiografías periapicales presentan el problema de obtener imágenes distorsionadas en ocasiones, lo cual limita la exactitud de estas técnicas; los métodos combinados son los más fiables, aunque son los que más tiempo consumen y son más complejos de realizar. Por último, se presenta un método digital de gran fiabilidad y sencillo y rápido de realizar, no clasificable en ninguno de los grupos anteriores. Se trata de un método basado en la interpolación de tamaños de los dientes utilizando listas de tamaños dentarios y dientes de referencia ya erupcionados

The estimation of the size of unerupted permanent teeth, canines and premolars, in mixed dentition has always been considered an essential aspect in orthodontics. The aim of the present study is to show all the methods that have been developed to make these predictions and their advantages and disadvantages. Four main methods have been used to estimate the mesiodistal crown widths of unerupted canines and premolars: calculations from prediction equations and tables, direct measurements on radiographs, combination of radiographic measurements and prediction tables and other independent method. Methods with a regression equation that relate the widths of unerupted teeth to the widths of erupted teeth are easy and fast to use but not very reliable, methods of measuring unerupted teeth on radiographs depend on the quality of the x-ray films available for use and methods that combine regression equations and radiographs present great accuracy but are time consuming and difficult to use. Finally, we present a new digital computerized-aid method to predict the size of unerupted teeth in mixed dentition using several reference teeth already erupted and mesiodistal teeth tables

Método de medición del índice de Bolton mediante digitalización de la arcada dentaria / Bolton tooth-size analyses measurement by a digital and computerized new method

El presente trabajo consiste en la puesta a punto de un método de medida que a través de una imagen digitalizada de la arcada dentaria y el correspondiente programa informático desarrollado por nosotros, permite de una forma rápida, sencilla y exacta, la medición de los tamaños mesiodistales de los dientes, así como el posterior cálculo del índice de Bolton.Este procedimiento, al que denominamos método digital, resulta igualmente sensible y más rápido de realizar que el método de medición tradicional. (AU)