Acute elbow dislocation: a critical appraisal of the literature.

Background: The purpose of this study was to perform a narrative review of acute elbow dislocation (AED). There are certain aspects of the management of AED that are controversial, including type and length of immobilization, indications for surgery, type of surgery, and new evidence available. Material and methods: A literature search was performed using MEDLINE and Embase databases for studies regarding AED. Preference was given to studies according to their level of evidence. Studies regarding the outcome of conservative and surgical treatment, including patient-reported outcomes, complications, and conversion to stabilization or revision surgery were included. Results: We found only 1 level I study and 3 level II randomized clinical trials. The rest consisted of level III-V evidence. Conservative care continues to be the standard of care for stable AEDs. Shorter immobilization periods are favored when possible. A consensus definition of an unstable elbow still needs to be improved. Unstable simple elbow dislocation may benefit from surgical intervention with different techniques showing similar outcomes. Advances in surgical procedures and suture designs, including tapes, and ligament augmentation, need to prove their role in managing acute elbow instability. Conclusion: There is a need for higher quality studies after the reduction of an AED, including discerning the outcome of specific patterns of injury and particular groups of patients like high-level athletes or people with preoperative laxity. Comparison between different surgical techniques is warranted, including arthroscopic techniques and types of ligament augmentation to promote early motion and reduce postoperative stiffness.

Afrontamiento, apoyo social y resiliencia asociados a la calidad de vida de mujeres con cáncer de mama / Coping, social support and resilience associated with quality of life in women with breast cancer

Objetivo Ante el cáncer de mama (CM) se emplean recursos intra e interpersonales que favorecen el mantenimiento de la calidad de vida. El presente estudio buscó analizar la relación que tiene el afrontamiento, el apoyo social y la resiliencia con la calidad de vida de mujeres mexicanas con CM. Método Es un estudio transversal que contempló 150 participantes con edades comprendidas entre los 25 a 60 años, en población abierta con tal diagnóstico y sin antecedentes psiquiátricos. Se les aplicó la Escala de ajuste mental al cáncer, la Escala de resiliencia, el Cuestionario MOS de apoyo social percibido y la European Organization for Research and Treatment of Cancer. Resultados Las variables estudiadas se relacionaron con la calidad de vida. Las estrategias de afrontamiento, como desesperanza, tuvieron relación con la salud global y funcionamiento (físico, de rol y social); y la evitación cognitiva con el funcionamiento de rol y dolor. Por su parte, el apoyo social y la resiliencia con la salud global, el funcionamiento (de rol, físico y social) y las naúseas. Conclusiones Se presentaron relaciones de las estrategias de afrontamiento (desesperanza y evitación cognitiva), apoyo social (tangible, emocional y social) y resiliencia (factores externos) con la calidad de vida, donde el uso de recursos brindados por los miembros de su entorno facilitan la superación del riesgo a pesar de la condición de enfermedad. Se sugiere analizar el efecto de estas variables sobre la calidad de vida en diferentes etapas y tipos de tratamientos del CM. (AU)

Objective In women with breast cancer (BC), intra- and interpersonal resources are used that help to maintain quality of life. This study aimed to analyse the relationship between coping, social support and resilience with quality of life in Mexican women with BC. Method We conducted a cross-sectional study that included 150 participants aged between 25 and 60 years in an open population with BC and no psychiatric history. The women were assessed with the Mental Adjustment to Cancer Scale (MAC-M), the Resilience Scale, the Medical Outcomes Study (MOS) Perceived Social Support Survey, and the European Organisation for Research and Treatment of Cancer (EORCT-QLQ-C30). Results The variables studied were associated with quality of life. Coping strategies such as hopelessness were related to global health and functioning (physical, role, and social), cognitive avoidance with role functioning and pain. Social support and resilience were associated with global health, functioning (role, physical and social) and nausea. Conclusions This study describes the associations between coping strategies (hopelessness and cognitive avoidance), social support (tangible, emotional and social) and resilience (external factors) and quality of life. Resources provided by people in the environment help to overcome risk of vulnerability, despite the illness. We suggest that the effect of these variables on quality of life be analysed in distinct stages and types of treatment in BC. (AU)

Psycho-sociocultural influences on psychopathological symptoms in the open community: ecosystemic inequalities / Influencias psicosocioculturales sobre los síntomas psicopatológicos en comunidad abierta: desigualdades ecosistémicas

Abstract Mental health problems in the general population tend to be related to social determinants which also influence health inequity. However, these determinants are usually taken into account only for clinical populations and often go unnoticed at the community level. The purpose of the present study was to identify the psycho-socio-cultural factors that influence the presence of psychopathological symptoms in the open population. In this study, 229 women and men, Mexican adults, participated. Two self-report instruments were used: the SCL 90-R to evaluate psychopathological symptoms, and the Questionnaire of Factors Associated with Health. The results show differences between men and women, both in the symptoms and in the factors evaluated, where women are more disadvantaged. Predictive models indicate that in women the factors predicting the symptomatology are: conflicting thoughts, domestic violence, lack of confidence in their abilities and gender discrimination; while in men they were: family violence, poverty and lower well-being. It is concluded that psychosocial and ecosystemic models enable to understand that psycho-socio-cultural factors influence the presence of incipient symptoms in the community population, following different paths for women and men, showing that the context has a differential impact on mental health.

Resumen Los problemas de salud mental en la población general tienden a estar relacionados con determinantes sociales que también influyen en la inequidad sanitaria. Sin embargo, estos determinantes suelen tenerse en cuenta solo en la población clínica y pasan inadvertidos en el ámbito comunitario. Teniendo esto en cuenta, el propósito del presente estudio fue identificar los factores psicosocioculturales que influyen en la presencia de los síntomas psicopatológicos en población abierta. Para esto, participaron 229 mujeres y hombres, adultos, mexicanos, a quienes se les aplicaron dos instrumentos de autorreporte para evaluar sus síntomas psicopatológicos, el SCL 90-R y el Cuestionario de Factores Asociados a la Salud. Los resultados muestran diferencias entre hombres y mujeres tanto en los síntomas como en los factores evaluados, en donde las mujeres resultaron ser las más desfavorecidas. Los modelos predictivos señalan que en las mujeres los factores que predicen la sintomatología son los pensamientos conflictivos, la violencia intrafamiliar, la falta de confianza en sus capacidades y la discriminación de género; mientras que en los hombres fueron la violencia intrafamiliar, la pobreza y un menor bienestar. Se concluye que los modelos psicosociales y ecosistémicos permiten comprender que los factores psicosocioculturales influyen sobre los síntomas incipientes de población comunitaria, con vías diferentes tanto para las mujeres como para los hombres. Con esto se demuestra que el contexto imprime un impacto diferencial en la salud mental.

Construcción y Análisis Estadístico del Inventario Multidimensional de Celos Románticos: estudio Preliminar

Con el objetivo de construir y validar una prueba para medir propiedades de los celos románticos, se desarrolló el Inventario Multidimensional de Celos Románticos (IMCR) desde tres ejes: 1) su conceptualización, 2) circunstancias que lo generan y 3) respuestas cognitivas, afectivas y conductuales involucradas. El IMCR está constituido por cinco escalas tipo Likert con sus respectivas opciones de respuesta. Se acudió a juicio de expertos para la validez de contenido y por análisis factoriales exploratorios para la validez de constructo de cada escala, presentando coeficientes de confiabilidad superiores a (α > .873). Por esto, el IMCR tiene una estructura relativamente clara con dimensiones en parte independientes y que miden con razonable precisión los tres ejes; concluyendo que los celos románticos son un constructo multidimensional con respuestas afectivas, cognitivas y conductuales desencadenadas a partir de una situación que representa la posible pérdida de la pareja.

Aiming to construct and validate a test to measure jealousy, the Multidimensional Inventory of Romantic Jealousy (MIRJ) was developed from three axes: 1) conceptualization, 2) conditions that generate romantic jealousy and 3) cognitive, affective and behavioral responses involved. The MIRJ consists of five Likert scales with five response options each. The inventory was validated by expert judgment on the content validity and exploratory factor analysis to construct the validity of each scale, showing higher reliability coefficients (α> 0.85). MIRJ has a fairly clear structure with independent dimensions that measure with reasonable accuracy the three axes. In Conclusion, romantic jealousy is a multidimensional construct with affective, cognitive and behavioral responses, triggered from a situation that represents the possible loss of a partner.