[On the Ten Commandments of the Finochietto Surgical School]. / Sobre los Diez Mandamientos de la Escuela Quirúrgica Finochietto.

No Abstract available.

COL1A1, CCDC170, and ESR1 single nucleotide polymorphisms associated with distal radius fracture in postmenopausal Mexican women.

Objective: The aim of this study was to analyze the genetic association of five ESR1 single nucleotide polymorphisms (SNPs) (rs3020331, rs851982, rs1999805, rs2234693, rs3020404), four COL1A1 SNPs (rs1800012, rs2075555, rs2412298, rs1107946), and two SNPs on the CCDC170 gene (rs9479055, rs4870044) with distal radius fracture (DRF) in a group of postmenopausal Mexican women.Methods: A case-control study was conducted. Cases (n = 182) were women above the age of 38 years with low-energy DRF, and controls (n = 201) were women without. Analysis was done through real-time polymerase chain reaction. Frequencies and Hardy-Weinberg equilibrium were calculated. A multivariate analysis including bone mass index, age, menarche, and menopause as covariables was carried out. Finally, haplotype and linkage disequilibrium (LD) analyses were performed.Results:COL1A1 rs1107946 was strongly associated with DRF. Both CCDC170 SNPs showed strong association with DRF. For the ESR1 gene, four SNPs (rs2234693, 3020404, rs3020331, and rs851982) showed very strong association with DRF. Additionally, the region between the latter two showed strong LD.Conclusions: A strong association of DRF with variants in these genes was found, including haplotypes and a region with strong LD on ESR1. The results suggest that these SNPs could be useful to detect the population at risk of presenting DRF among Mexican perimenopausal women.

Ulnar shortening: results for treatment of distal radioulnar joint pathology and conversion to DRUJ replacement arthroplasty / Acortamiento cubital: resultados del tratamiento de la patología de la articulación radiocubital distal y su conversión a una artroplastia

Abstract: Background: Ulnar shortening (US) is used for treatment of ulnar abutment, early osteoarthrosis (OA) and distal radioulnar joint (DRUJ) instability. However, it has never been strongly advocated as a mid-stage procedure to slow OA progression and reduce requirement of secondary DRUJ procedures. The study aim was to determine if a specific sigmoid notch type is likely to lead to DRUJ replacement after US. Methods: A retrospective study of 119 patients (124 wrists) with DRUJ painful early osteoarthritis, ulnar abutment and DRUJ instability that underwent US was performed. The goals of osteotomy were to decrease pain and slow the initiation or progression of OA. Sigmoid notch type, previous trauma, bone healing time, pain relief, ulnar variance and conversion to DRUJ arthroplasty were analyzed. Results: Of the 124 wrists studied, bone healing took 3.33 months of average (union rate 98.3%). Sigmoid notch type distribution was 55.6% for type 1, 25.8% for type 2, and 18.5% for type 3. Of the patients with pain after US, 37 had hardware removal and 13 required a DRUJ semi-constrained arthroplasty. Even though analysis did not show any statistically significant correlation, a slight trend towards association of sigmoid notch type 3 with conversion to DRUJ arthroplasty was found. Conclusion: US has a role in treatment of DRUJ pathology, and its use may delay the need for DRUJ secondary procedures, protecting the native joint. A specific sigmoid notch type does not present risk for OA and does not appear to be related to conversion to DRUJ arthroplasty. Type of study: Therapeutic

Resumen: Antecedentes: El acortamiento cubital es utilizado para el tratamiento del síndrome de impactación, osteoartrosis (OA) temprana y la inestabilidad de la articulación radiocubital distal (ARCD). Sin embargo, no se ha recomendado como procedimiento intermedio para detener la progresión de la OA y reducir la necesidad de procedimientos secundarios. El objetivo es determinar si un tipo específico de la escotadura sigmoidea predispone a una artroplastia de la ARCD después del acortamiento cubital. Métodos: Estudio retrospectivo de 119 pacientes (124 muñecas) a las que se les realizó acortamiento cubital. El objetivo de la osteotomía fue disminuir el dolor y retardar el progreso de la OA. Se analizó el tipo de escotadura sigmoidea, trauma previo, tiempo de consolidación ósea, alivio del dolor, varianza cubital y conversión a artroplastia. Resultados: De las 124 muñecas estudiadas, la consolidación ocurrió en 3.33 meses en promedio (98.3% de consolidación). El tipo de escotadura sigmoidea fue 55.6% tipo 1; 25.8% tipo 2 y 18.5% tipo 3, 37 pacientes ameritaron retiro de material y 13 una artroplastia de la ARCD semiconstriñida. Aunque el análisis no mostró ninguna correlación estadísticamente significativa, una tendencia leve hacia la Asociación del tipo 3 de la escotadura sigmoidea con la conversión a la artroplastia de ARCD fue encontrada. Conclusiones: El acortamiento cubital juega un papel en el tratamiento de la patología de la ARCD, su uso puede retrasar la necesidad de procedimientos secundarios. Un tipo de escotadura sigmoidea específica no presenta riesgo para la OA y no parece estar relacionado con la conversión a la artroplastia de la ARCD.

Ulnar shortening: results for treatment of distal radioulnar joint pathology and conversion to DRUJ replacement arthroplasty.

BACKGROUND: Ulnar shortening (US) is used for treatment of ulnar abutment, early osteoarthrosis (OA) and distal radioulnar joint (DRUJ) instability. However, it has never been strongly advocated as a mid-stage procedure to slow OA progression and reduce requirement of secondary DRUJ procedures. The study aim was to determine if a specific sigmoid notch type is likely to lead to DRUJ replacement after US. METHODS: A retrospective study of 119 patients (124 wrists) with DRUJ painful early osteoarthritis, ulnar abutment and DRUJ instability that underwent US was performed. The goals of osteotomy were to decrease pain and slow the initiation or progression of OA. Sigmoid notch type, previous trauma, bone healing time, pain relief, ulnar variance and conversion to DRUJ arthroplasty were analyzed. RESULTS: Of the 124 wrists studied, bone healing took 3.33 months of average (union rate 98.3%). Sigmoid notch type distribution was 55.6% for type 1, 25.8% for type 2, and 18.5% for type 3. Of the patients with pain after US, 37 had hardware removal and 13 required a DRUJ semi-constrained arthroplasty. Even though analysis did not show any statistically significant correlation, a slight trend towards association of sigmoid notch type 3 with conversion to DRUJ arthroplasty was found. CONCLUSION: US has a role in treatment of DRUJ pathology, and its use may delay the need for DRUJ secondary procedures, protecting the native joint. A specific sigmoid notch type does not present risk for OA and does not appear to be related to conversion to DRUJ arthroplasty. Type of study: Therapeutic.

ANTECEDENTES: El acortamiento cubital es utilizado para el tratamiento del síndrome de impactación, osteoartrosis (OA) temprana y la inestabilidad de la articulación radiocubital distal (ARCD). Sin embargo, no se ha recomendado como procedimiento intermedio para detener la progresión de la OA y reducir la necesidad de procedimientos secundarios. El objetivo es determinar si un tipo específico de la escotadura sigmoidea predispone a una artroplastia de la ARCD después del acortamiento cubital. MÉTODOS: Estudio retrospectivo de 119 pacientes (124 muñecas) a las que se les realizó acortamiento cubital. El objetivo de la osteotomía fue disminuir el dolor y retardar el progreso de la OA. Se analizó el tipo de escotadura sigmoidea, trauma previo, tiempo de consolidación ósea, alivio del dolor, varianza cubital y conversión a artroplastia. RESULTADOS: De las 124 muñecas estudiadas, la consolidación ocurrió en 3.33 meses en promedio (98.3% de consolidación). El tipo de escotadura sigmoidea fue 55.6% tipo 1; 25.8% tipo 2 y 18.5% tipo 3, 37 pacientes ameritaron retiro de material y 13 una artroplastia de la ARCD semiconstriñida. Aunque el análisis no mostró ninguna correlación estadísticamente significativa, una tendencia leve hacia la Asociación del tipo 3 de la escotadura sigmoidea con la conversión a la artroplastia de ARCD fue encontrada. CONCLUSIONES: El acortamiento cubital juega un papel en el tratamiento de la patología de la ARCD, su uso puede retrasar la necesidad de procedimientos secundarios. Un tipo de escotadura sigmoidea específica no presenta riesgo para la OA y no parece estar relacionado con la conversión a la artroplastia de la ARCD.

Protocolo clínico para inducción del trabajo de parto: propuesta de consenso / Clinical protocol for labor induction: consensus proposal

Resumen: ANTECEDENTES: la inducción del trabajo de parto es un procedimiento que se indica cuando existe riesgo de continuar el embarazo, en lugar de interrumpirlo. Esta maniobra enfrenta nuevas presiones, por lo que es necesario mantener actualizado el conocimiento sobre su indicación. En los últimos años se han desarrollado protocolos clínicos de mayor eficacia y seguridad, que han hecho más accesible este procedimiento. OBJETIVO: emitir un consenso actualizado y analizar los diferentes aspectos de la práctica cotidiana relacionada con la inducción del trabajo de parto. MATERIALES Y MÉTODOS: se integró un grupo de especialistas de trece instituciones nacionales para analizar diferentes aspectos de la práctica cotidiana de la inducción del trabajo de parto. Se siguió una metodología tipo Delphi de cuatro etapas, con bibliografía de normas clínicas internacionales de apoyo. CONCLUSIONES: la inducción del trabajo de parto considera los siguientes criterios: establecer con certeza que el procedimiento ofrece el mejor desenlace para la madre y el feto, confirmar la edad gestacional, realizar la evaluación obstétrica completa y contar con infraestructura para enfrentar las posibles complicaciones. Existen diferentes opciones para la inducción del trabajo de parto; sin embargo, en los últimos años se ha generalizado la prescripción de análogos de prostaglandinas (misoprostol) en todo el mundo. El especialista debe efectuar la evaluación individualizada de la paciente y el feto, con la finalidad de descartar situaciones que comprometan la salud de ambos. La complicación más común de la inducción del trabajo de parto es la taquisistolia, que puede asociarse con desprendimiento prematuro de placenta, rotura uterina y sufrimiento fetal agudo. Los óvulos vaginales de liberación controlada representan la única opción para retirar el estímulo con dinoprostona o misoprostol ante efectos adversos.

Abstract: BACKGROUND: Induction of labor is a maneuver indicated when there is a greater risk of continuing the pregnancy, than interrupting it. The induction of labor faces new pressures that make it necessary for the doctor to be permanently updated. In recent years, clinical protocols of greater efficiency and safety have been developed, which have made this procedure more accessible. OBJECTIVE: To present an updated consensus and to analyze the different aspects related to the labor induction. MATERIAL AND METHODS: A Delphi-type of consensus was conducted with participation of active obstetricians and gynecologists specialists from thirteen national institutions. Major clinical-oriented topics of induction of labor were addressed. CONCLUSIONS: To induce labor, it is necessary that at least the following situations coexist: to establish with certainty that the procedure offers the best outcome for the mother and her child, to confirm the gestational age, to make a complete obstetric evaluation and to have the infrastructure Necessary to deal with possible complications. There are several options to induce labor, although in recent years the indication of prostaglandin analogues (misoprostol) has become the most common option worldwide. The specialist must make an individualized evaluation of the patient and the fetus, in order to rule out situations that may endanger the health of any of them. The most common complication of labor induction is tachysystole, which can be complicated by premature placental abruption, uterine rupture and acute fetal distress, requiring urgent attention. Controlled-release vaginal ovules are the only option available to withdraw the stimulus with dinoprostone or misoprostol in the presence of adverse effects.

[Severe strongyloidiasis with pseudotumor pancreatic involvement. Clinical case]. / Strongyloidiasis severa con compromiso pancreático seudotumoral. Caso clínico.

We report the first clinical case of a patient with a severe hyper infestation due to Strongyloides stercoralis who developed a pancreatic pseudotumoral complication. Its clinical aspects, auxiliary exams, therapeutic schedule, evolution and the roentgenographic, ultrasound and TAC images are shown in this paper.

Muerte fetal temprana en una paciente con leucemia aguda. / Early fetal death in a patient with acute leukemia

Se informa un caso de muerte fetal temprana en una paciente con leucemia aguda monoblastica. El embarazo precedio al desarrollo clinico de la leucemia y sus manifestaciones clinicas se asociaron con la muerte del feto, la cual precedio al inicio de la quimioterapia. El estudio de la placenta mostro placas amarillentas por su lado materno, asi como infiltracion blastica de los espacios intervellosos y ausencia casi total de celulas trofoblasticas. Se comenta la asociacion entre el desarrollo clinico de la enfermedad y la muerte fetal, asi como la posibilidad de que la infiltracion blastica de la placenta pueda ocasionar muerte fetal

[Prevalence of anemia in women attending family planning clinic in Durango (author's transl)]. / La prevalencia de anemia en mujeres asistentes a servicios de planificación familiar en la Ciudad de Durango.

PIP: This study investigates the prevalence of anemia in a group of 500 women requesting contraception for the first time at the Health Center in Durango, Mexico. 92% of women were between 15-34, with the majority in the age group 20-24; most had parity 1-4. The average hemoglobin level was 13.04 g/dl, with SE of 0.08. There were 70 anemic women with hemoglobin level below 12 g/dl, which gave a percentage of 14%. 90% of anemic women presented iron deficiency. 16.8% of the total number of women were within the 1st 6 weeks postpartum or postabortion; of these 32% were anemic. Of the 82.4% of women beyond this period of time only 10.4% were anemic. There was no increase in the prevalence of anemia in women with higher parity; among the 174 obese women the percentage of anemia was 86%. The relatively high prevalence of anemia in women seeking contraception compels the doctor to consider very seriously the type of contraception to be prescribed. In Mexico there is an important difference in the geographic distribution of anemia, which seems to be most common in the province of Yucatan, and which is probably caused by alimentary iron deficiency.^ieng