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1.
Acta ortop. mex ; 35(4): 311-316, jul.-ago. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1374192

ABSTRACT

Resumen: Objetivo: Valoración clínica-funcional de pacientes con lesión de Lisfranc sin causa laboral ni deportiva tratados en nuestro centro. Material y métodos: Se analizaron 13 pacientes con lesión de Lisfranc sin causa laboral ni deportiva, divididos en dos grupos, lesiones de alta energía y de baja energía. Valoración del retorno a la actividad laboral y deportiva previa a la lesión y el uso de calzado y plantillas posteriormente. Se recogen las puntuaciones del test AOFAS y EVA postoperatorio así como la aparición de complicaciones posteriores a la recuperación de la lesión. Resultados: El grupo de alta energía lo formaron siete pacientes que fueron intervenidos en una media de 7.3 días; cuatro presentaron secuelas postquirúrgicas. De estos pacientes, un paciente no pudo reincorporarse a su actividad laboral previa y dos pacientes no pudieron realizar el deporte que practicaban previamente a la lesión. El AOFAS fue de 79.4 y el EVA de 2.8. En el grupo de baja energía encontramos seis pacientes intervenidos en 5.6 días de media. Todos ellos pudieron reincorporarse a su actividad laboral y deportiva previa. El AOFAs fue de 84.8 y el EVA de 1.6. En ninguna de las variables estudiadas se observaron diferencias estadísticamente significativas. Conclusión: Los pacientes con lesión de Lisfranc fuera del ámbito laboral y deportivo presentan buenos resultados clínicos y funcionales.


Abstract: Objective: Clinical and functional evaluation of patients with Lisfranc lesion without work or sport cause and treated in our center. Material and methods: Thirteen patients with Lisfranc lesion without occupational or sports causes were divided into two groups, high-energy and low-energy injuries. Were analyzed the return to work and sports activity prior to the injury and the use of footwear and insoles after the injury. Also were assessed AOFAS and EVA postoperative score and posterior complications after lesion recovery. Results: High-energy group included 7 patients who underwent surgery on an average of 7.3 days. Of the total of patients, 4 presented post-surgical sequelae. Of these patients, one patient was unable to return to their previous work activity and two patients were unable to practice the usual sports activity. The AOFAS was 79.4 and EVA 2.8. In the low energy group, we found six patients operated on 5.6 days on average. All of them were able to return to their previous work and sports activity. The AOFAS were 84.8 and the EVA 1.6. Statistically significant differences were not observed in any of the variables studied. Conclusion: Patients with Lisfranc injury out of laboral or sports background present good clinical and functional results.

2.
Acta Ortop Mex ; 35(4): 311-316, 2021.
Article in Spanish | MEDLINE | ID: mdl-35139588

ABSTRACT

OBJECTIVE: Clinical and functional evaluation of patients with Lisfranc lesion without work or sport cause and treated in our center. MATERIAL AND METHODS: Thirteen patients with Lisfranc lesion without occupational or sports causes were divided into two groups, high-energy and low-energy injuries. Were analyzed the return to work and sports activity prior to the injury and the use of footwear and insoles after the injury. Also were assessed AOFAS and EVA postoperative score and posterior complications after lesion recovery. RESULTS: High-energy group included 7 patients who underwent surgery on an average of 7.3 days. Of the total of patients, 4 presented post-surgical sequelae. Of these patients, one patient was unable to return to their previous work activity and two patients were unable to practice the usual sports activity. The AOFAS was 79.4 and EVA 2.8. In the low energy group, we found six patients operated on 5.6 days on average. All of them were able to return to their previous work and sports activity. The AOFAS were 84.8 and the EVA 1.6. Statistically significant differences were not observed in any of the variables studied. CONCLUSION: Patients with Lisfranc injury out of laboral or sports background present good clinical and functional results.


OBJETIVO: Valoración clínica-funcional de pacientes con lesión de Lisfranc sin causa laboral ni deportiva tratados en nuestro centro. MATERIAL Y MÉTODOS: Se analizaron 13 pacientes con lesión de Lisfranc sin causa laboral ni deportiva, divididos en dos grupos, lesiones de alta energía y de baja energía. Valoración del retorno a la actividad laboral y deportiva previa a la lesión y el uso de calzado y plantillas posteriormente. Se recogen las puntuaciones del test AOFAS y EVA postoperatorio así como la aparición de complicaciones posteriores a la recuperación de la lesión. RESULTADOS: El grupo de alta energía lo formaron siete pacientes que fueron intervenidos en una media de 7.3 días; cuatro presentaron secuelas postquirúrgicas. De estos pacientes, un paciente no pudo reincorporarse a su actividad laboral previa y dos pacientes no pudieron realizar el deporte que practicaban previamente a la lesión. El AOFAS fue de 79.4 y el EVA de 2.8. En el grupo de baja energía encontramos seis pacientes intervenidos en 5.6 días de media. Todos ellos pudieron reincorporarse a su actividad laboral y deportiva previa. El AOFAs fue de 84.8 y el EVA de 1.6. En ninguna de las variables estudiadas se observaron diferencias estadísticamente significativas. CONCLUSIÓN: Los pacientes con lesión de Lisfranc fuera del ámbito laboral y deportivo presentan buenos resultados clínicos y funcionales.


Subject(s)
Fracture Fixation, Internal , Sports , Humans
3.
Acta Otorhinolaryngol Ital ; 38(2): 86-93, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29967555

ABSTRACT

SUMMARY: Elective neck dissection in patients with recurrent head and neck squamous cell carcinoma (HNSCC) without evidence of neck disease (crN0) is poorly defined. A retrospective review was carried out on 165 crN0 patients treated with salvage surgery and elective neck dissection. Multivariate Cox analysis and recursive partitioning analysis were used to evaluate prognostic factors. The frequency of occult neck node metastases in the neck dissection (rpN+) was 16.4%. The risk of occult metastases for glottic rpT1-T2 recurrences was 5.9%, for glottic rpT3-T4 recurrences 13.2%, for non-glottic rpT1-T2 recurrences 16.1% and for locally advanced (rpT3-T4) non-glottic recurrences 31.1%. Patients with occult neck node metastases (rpN+) had a 5-year adjusted survival rate of 38.1%, while patients without nodal disease (rpN0) had a 5-year adjusted survival rate of 71.1% (p = 0.0001). Elective neck dissection can be omitted in crN0 patients with rT1-T2 glottic recurrence. We consider it advisable to perform elective neck dissection in all other situations.


Subject(s)
Neck Dissection , Salvage Therapy , Squamous Cell Carcinoma of Head and Neck/radiotherapy , Squamous Cell Carcinoma of Head and Neck/surgery , Combined Modality Therapy , Elective Surgical Procedures , Female , Humans , Male , Middle Aged , Retrospective Studies
4.
Actas Urol Esp ; 32(1): 59-66, 2008 Jan.
Article in Spanish | MEDLINE | ID: mdl-18411624

ABSTRACT

An aspect of capital importance in the transplant field is the maintainance and preservation of organs during the ischemic phase. Organ susceptibility and injuries secondary to ischemia, organ procurement and transportation are still nowadays one of the main causes for organ failure. Effective artificial organ perfusion has remained a main goal for researchers in this field for more than 100 years. In the second half of the XXth century these techniques have been applied to experimental and clinical organ preservation, with the aim of extending the period of an effective storage (which guarantees an early and good function after the transplant). Primary goal of any organ preservation is to maintain integrity in every cell system in order to minimize those injuries which produces graft dysfunction.


Subject(s)
Organ Preservation/instrumentation , Equipment Design , Humans , Organ Preservation/methods , Perfusion
5.
Actas Urol Esp ; 32(1): 24-6, 2008 Jan.
Article in Spanish | MEDLINE | ID: mdl-18411621

ABSTRACT

Renal graft preservation research is considered complementary but at the same time important activity in high-quality Kidney Transplant Programs. It provides information on limitations of kidneys to be transplanted and to discard those organs with high probability of failure. Unification of criteria in the selection of organs is essential. We think that this activity should be encouraged by Health Institutions although requires investment in staff and technology.


Subject(s)
Kidney Transplantation , Organ Preservation , Humans , Spain
6.
Actas urol. esp ; 32(1): 24-26, ene. 2008.
Article in Es | IBECS | ID: ibc-058830

ABSTRACT

La investigación en preservación del injerto renal es una actividad complementaria aunque a la vez fundamental en los Programas de Trasplante Renal de calidad. Permite conocer las limitaciones de los riñones que se implantan y descartar aquellos órganos con mayor probabilidad de fracasar. La unificación de criterios en la selección de órganos es esencial. Creemos que este tipo de actividad debe ser estimulada por las instituciones sanitarias, aunque precisa de inversión para técnica y personal


Renal graft preservation research is considered complementary but at the same time important activity in high-quality Kidney Transplant Programs. It provides information on limitations of kidneys to be transplanted and to discard those organs with high probability of failure. Unification of criteria in the selection of organs is essential. We think that this activity should be encouraged by Health Institutions although requires investment in staff and technology


Subject(s)
Humans , Kidney Transplantation/methods , Organ Preservation/methods , Tissue Survival , Tissue Donors , Spain
7.
Actas urol. esp ; 32(1): 59-66, ene. 2008. ilus
Article in Es | IBECS | ID: ibc-058833

ABSTRACT

Un aspecto de gran importancia en el campo de los trasplantes es el mantenimiento y preservación del órgano durante la fase isquémica. La sensibilidad del órgano a ésta y la posible lesión inducida durante la extracción, preservación y transporte, siguen siendo una de las principales causas de fracaso del injerto. La perfusión artificial de órganos ha sido objetivo de investigación durante más de 100 años. En la segunda mitad del siglo XX estas técnicas han sido aplicadas a la preservación experimental y clínica, con el fin de alargar el tiempo de almacenamiento efectivo (aquél que permite una función correcta y precoz tras el trasplante del órgano preservado). La meta primaria de la preservación de cualquier órgano es el mantenimiento de la integridad de todos los sistemas celulares, de tal manera que la posibilidad de lesión que lleve a la disfunción del injerto sea mínima


An aspect of capital importance in the transplant field is the maintainance and preservation of organs during the ischemic phase. Organ susceptibility and injuries secondary to ischemia, organ procurement and transportation are still nowadays one of the main causes for organ failure. Effective artificial organ perfusion has remained a main goal for researchers in this field for more than 100 years. In the second half of the XXth century these techniques have been applied to experimental and clinical organ preservation, with the aim of extending the period of an effective storage (which guarantees an early and good function after the transplant). Primary goal of any organ preservation is to maintain integrity in every cell system in order to minimize those injuries which produces graft dysfunction


Subject(s)
Humans , Perfusion/instrumentation , Organ Preservation , Kidney Transplantation/methods , Perfusion/methods , Perfusion/history , Infusion Pumps
8.
Transplant Proc ; 39(1): 258-60, 2007.
Article in English | MEDLINE | ID: mdl-17275517

ABSTRACT

An experimental study in pigs was designed to evaluate the consequences of normothermic ischemia in hypothermic isolated renal perfusion (HP). We perfused 16 kidneys after 45 minutes of vascular occlusion. Another 16 kidneys were perfused without previous warm ischemia. The ureter was catheterized in all procedures and the output collected during HP. Creatinine was added to the perfusion solution initially in order to determine creatinine clearance (CrCl). HP hydrodynamics were recorded in real time through a computerized system. According to the results, renal vascular resistance as well as CrCl were higher in ischemic kidneys. Both facts, along with minimal differences in the microscopic study, suggested an increased vascular tone of the efferent postglomerular arteriole during HP. HP was proven to be an optimal technique to minimize the histological consequences of ischemia. Microvascular and biochemical changes produced during HP may be essentially related to dynamic causes.


Subject(s)
Hypothermia , Ischemia/physiopathology , Kidney/physiopathology , Renal Circulation/physiology , Animals , In Vitro Techniques , Kidney/physiology , Models, Animal , Nephrectomy , Perfusion , Swine , Swine, Miniature , Vascular Resistance
9.
Actas Urol Esp ; 29(8): 739-42, 2005 Sep.
Article in Spanish | MEDLINE | ID: mdl-16304904

ABSTRACT

We report the results obtained in a experimental work designed to evaluate the consequences of warm ischemia in hypothermic isolated renal perfusion. We perfused a number of kidneys after a period of 45 min of vascular occlusion. An alternative group of kidneys were perfused without previous warm ischemia. Ureter was canulated in all the procedures and output collected during the HP. Creatinine was added to the perfusion solution initially in order to determine creatinine clearance. HP hydrodynamics was recorded on real time through a computerised system. According to the results, renal vascular resistance as well as CrCl were higher in ischemic kidneys. Both facts along with minimal differences in pathologic study suggest an increase in vascular tone of efferent-postglomerular arteriole during HP. HP was an adequate technique to minimize histologic consequences of ischemia. Mycrovascular an biochemical changes produced during HP may be produced, essentially, by dynamic causes.


Subject(s)
Ischemia/physiopathology , Microcirculation/physiology , Animals , Guinea Pigs , Ischemia/pathology , Kidney/pathology , Kidney/physiology , Microcirculation/pathology , Perfusion/methods , Renal Circulation/physiology , Temperature
10.
Actas urol. esp ; 29(8): 739-742, sept. 2005. ilus
Article in Es | IBECS | ID: ibc-041391

ABSTRACT

Presentamos los resultados obtenidos en un trabajo experimental en el que evaluamos las consecuencias de la isquemia normotérmica en la perfusión hipotérmica (PH) del riñón aislado. Sometimos a un grupo de riñones a PH tras clampaje del pedículo durante 45 min. A otro grupo equivalente de riñones se les perfundió sin isquemia previa. Añadimos a la solución de preservación una cantidad definida de creatinina y canulamos el uréter para recoger el líquido eliminado durante la perfusión y valorar el posible aclaramiento de creatinina (ClCr). Monitorizamos la hidrodinámica de la PH en tiempo real mediante un sistema informático. En cuanto a los resultados, la resistencia vascular renal (RVR) media de los riñones isquémicos fue mayor, así como el ClCr. Estos dos hechos permitieron inferir, teniendo en cuenta que las diferencias en el estudio histológico fueron mínimas, que los riñones sometidos a isquemia normo térmica experimentan un incremento del tono de la arteriola eferente durante la PH. La PH resultó ser una técnica eficaz para eliminar las consecuencias histológicas de la isquemia. Parece que los cambios microvasculares y bioquímicos producidos durante la PH pueden ser de causa esencialmente dinámica (AU)


We report the results obtained in a experimental work designed to evaluate the consequences of war mischemia in hypothermic isolated renal perfusion. We perfused a number of kidneys after a period of 45 min of vascular occlusion. An alternative group of kidneys were perfused without previous warmischemia. Ureter was canulated in all the procedures and output collected during the HP. Creatinine was added to the perfusion solution initially in order to determine creatinine clearance. HP hydrodynamics was recorded on real time through a computerised system. According to the results, renal vascular resistance as well as CrCl were higher in ischemic kidneys. Both facts along with minimal differences in pathologic study suggest an increase in vascular tone of efferent-postglomerular arteriole during HP. HP was an adequate technique to minimize histologic consequences of ischemia. Mycrovascular an biochemical changes produced during HP may be produced, essentially, by dynamic causes (AU)


Subject(s)
Animals , Ischemia/physiopathology , Microcirculation/physiopathology , Ischemia/pathology , Kidney/pathology , Kidney/physiology , Microcirculation/pathology , Perfusion/methods , Renal Circulation/physiology , Temperature
11.
Actas Urol Esp ; 29(4): 392-400, 2005 Apr.
Article in Spanish | MEDLINE | ID: mdl-15981428

ABSTRACT

Cold ischemia is the best known method to preserve kidneys for transplant. However, it produces several detrimental effects. First, cellular necrosis. Secondarily, during the hypothermic period a mitochondrial injury process develops which makes the cell entering a pre-apoptotic state. This apoptosis occurs definitively in the reperfusion. Preservation solutions currently available are not perfect and are not able to avoid cold-related cell injuries. The addition of certain substances to UW solution (desferrioxamine) has shown experimentally a reduction in mitochondrial cold-related lesions. Isolated hypothermic kidney perfusion reduces initial graft dysfunction about 20% in comparison to hypothermic storage. This fact relates to important either economical as functional consequences.


Subject(s)
Kidney Transplantation/adverse effects , Kidney , Organ Preservation/methods , Adenosine/therapeutic use , Allopurinol/therapeutic use , Cold Temperature , Glutathione/therapeutic use , Graft Survival , Humans , Insulin/therapeutic use , Ischemia , Kidney Transplantation/methods , Organ Preservation Solutions/therapeutic use , Raffinose/therapeutic use , Reperfusion Injury/physiopathology , Reperfusion Injury/prevention & control
12.
Actas urol. esp ; 29(4): 392-400, abr. 2005. ilus, tab
Article in Es | IBECS | ID: ibc-039265

ABSTRACT

La isquemia fría es el mejor método actual para preservar el riñón para trasplante. Sin embargo condiciona, en primer lugar, un proceso de necrosis celular directo. En segundo lugar, durante el período de hipotermia se desarrolla un proceso de lesión mitocondrial que hace que la célula entre en un estado de apoptosis latente. Esta apoptosis se completa definitivamente en esta población celular en el momento de la revascularización. Las soluciones de preservación actualmente disponibles no son perfectas, y no pueden evitar este proceso. La adición de ciertas sustancias en la solución de UW ha demostrado experimentalmente (Desferrioxamina) una reducción de las lesiones mitocondriales producidas durante la fase de hipotermia. La utilización de perfusión de riñón aislado podría, comparativamente con la hipotermia simple, reducir la aparición de disfunción inicial del injerto hasta en un 20%, lo que tendría consecuencias importantes tanto funcionales como económicas (AU)


Cold ischemia is the best known method to preserve kidneys for transplant. However, it produces several detrimental effects. First, cellular necrosis. Secondarily, during the hypothermic period a mithocondrial injury process develops which makes the cell entering a pre-apoptotic state. This apoptosis occurs definitively in the reperfusion. Preservation solutions currently available are not perfect and are not able to avoid cold-related cell injuries. The adition of certain substances to UW solution (desferrioxamine) has shown experimentally a reduction in mitochondrial cold-related lesions. Isolated hypothermic kidney perfusion reduces initial graft dysfunction about 20% in comparison to hypothermic storage. This fact relates to important either economical as functional consequences (AU)


Subject(s)
Humans , Kidney Transplantation/methods , Organ Preservation/methods , Perfusion/methods , Cryopreservation , Organ Preservation Solutions/pharmacokinetics , Ischemia/prevention & control
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