Placa escalonada de calcáneo en insuficiencias del tibial posterior grado II. Serie de casos. Resultados radiológicos / Stained plate of calcaneo in insufficiencies of the tibial grade II. Number of cases. Radiological results

Como resultado de la insuficiencia del tendón tibial posterior (TTP), el arco longitudinal medial se derrumba en forma progresiva. Los intentos de restaurar la función del TTP mediante reparación directa no han sido satisfactorios. Por lo tanto, se ha recomendado la sustitución del TTP por medio de la transferencia de tendones aunque eso no corrige la deformidad. Debido a esto es necesario agregar una osteotomía. La osteotomía por preferencia es la medialización de la tuberosidad posterior del calcáneo. Respecto al método de fijación de la osteotomía existen diferentes alternativas de fijación. El objetivo del trabajo es presentar los resultados radiográficos y clínicos del tratamiento de la insuficiencia del TTP Grado II y sus deformidades resultantes mediante osteotomía de desplazamiento medial del calcáneo fijada con placa escalonada y otros procedimientos. (AU)

As a result of posterior tibial tendon insufficiency (PTT), the medial longitudinal arch collapses progressively. Attempts to restore the TTP function through direct repair have not been satisfactory.2 Therefore, TTP replacement has been recommended by means of tendon transfer although this does not correct the deformity. Because of this it is necessary to add an osteotomy. The osteotomy by preference is the medialization of the posterior tuberosity of the calcaneus. Regarding the fixation method of the osteotomy, there are different fixation alternatives. The objective of this study was to present the radiographic and clinical results of the treatment of TTP grade II insufficiency and its resulting deformities by osteotomy of the medial displacement of the calcaneus fixed with stepped plaque and other procedures. (AU)

Tratamiento de fracturas diafisarias de antebrazo en niños con técnica de enclavado endomedular elástico / Treatment of diaphyseal forearm fractures in children with elastic endomedullary nailing technique

INTRODUCCIÓN: Las fracturas diafisarias de antebrazo son lesiones frecuentes en los niños. Las alternativas de tratamientos quirúrgicos para dichas fracturas son la reducción abierta y fijación interna, y el enclavado endomedular elástico. OBJETIVO: Analizar la evolución de los pacientes con diagnóstico de fracturas de antebrazo tratados quirúrgicamente con la técnica del enclavado endomedular elástico. MATERIAL Y MÉTHODO: Estudio observacional, retrospectivo y descriptivo. Análisis de historias clínicas de niños de ambos sexos, de 4 a 16 años con diagnóstico de fracturas de antebrazo tratados quirúrgicamente con la técnica del enclavado endomedular elástico en el Departamento de Ortopedia Infantil del Servicio de Ortopedia y Traumatología de la Clinica Universitaria Reina Fabiola, entre abril de 2013 a diciembre de 2015. Las fracturas se clasificaron de acuerdo a Clasificación AO de Müller de las fracturas de los huesos largos . La evolución se evaluó de acuerdo alMayo Elbow Performance Score. Se realizó un Análisis descriptivo de los datos. Análisis descriptivo de los datos. RESULTADOS: Se incluyeron 19 pacientes con media + DE de edad de 10,68±3,5 años al momento de la fractura. Diecisiete (89,47%) niños fueron de sexo masculino. El lado derecho estuvo afectado en 10 (53%) niños con respecto a la clasificación AO: 1 (5,26%) niño tuvo fractura 22A1, 2 (10,53%) niños tuvieron fractura 22A2, 14 (73,68%) niños tuvieron fractura 22A3 y Dos (10,53%) niños tuvieron fractura 22B3.2(10,53%) pacientes tuvieron fracturas abiertas. En ningún caso se observaron complicaciones. Se observo un resultado bueno según Mayo Elbow Performance Score en 3 (15,79%) niños y resultado excelente en 16 (84,21%) niños. (Figura 1) CONCLUSIONES: La mayoría de los pacientes presentaron fracturas tipo 22A3.No se observaron complicaciones. Según el Mayo Elbow Performance Score todos los pacientes presentaron resultados buenos y excelentes. (AU)

INTRODUCTION: Diaphyseal forearm fractures are frequent injuries in children. The alternatives of surgical treatments for these fractures are the open reduction and internal fixation, and the elastic endomedullary nailing. OBJECTIVE: Analyze the evolution of patients with a diagnosis of forearm fractures treated surgically with the elastic endomedullary nailing technique. MATERIAL AND METHOD: Observational, retrospective and descriptive study. Analysis of clinical histories of children of both sex, from 4 to 16 years old with diagnosis of forearm fractures surgically treated with the elastic endomedullary nailing technique in the Pediatric Ortopaedics and Traumatology Department of Clinica Universitaria Reina Fabiola, between April 2013 to December 2015. Fractures were classified according to Müller's AO classification of long bone fractures. Evolution was assessed according to the Mayo Elbow Performance Score. A descriptive analysis of the data was performed. RESULTADOS: We included 19 patients with mean ± SD aged 10.68 ± 3.5 years at the time of fracture. Seventeen (89.47%) were male. The right side was affected in 10 (53%) children. Regarding the AO classification: 1 (5.26%) child had a 22A1 fracture, 2 (10.53%) children had a 22A2 fracture, 14 (73.68%) Children had fracture 22A3 and two (10.53%) children had fractures 22B3. Only 2 (10.53%) patients had open fractures. In no case were complications observed. A good result was observed according to the Mayo Elbow Performance Score in 3 (15.79%) children and excellent result in 16 (84.21%) children. (Figure 1) CONCLUSIONS: The majority of patients had type 22A3 fractures. No complications were observed. According to the Mayo Elbow Performance Score all patients presented good and excellent results.(AU)

Effect of bisacodyl and cascara on growth of aberrant crypt foci and malignant tumors in the rat colon.

Laxatives abuse has been associated with an increased risk for colon cancer. However, little is known about laxatives long-term carcinogenic potential in experimental studies. The present study was designed to investigate the effects of bisacodyl (4.3 and 43 mg/kg) and cascara (140 and 420 mg/kg) on azoxymethane (AOM)-induced aberrant crypt foci (ACF) and tumors. Animals, divided in 10 groups were treated with AOM and laxatives (alone or in combination) for 13 weeks. At the end of treatment animals were killed and the colon removed and analysed for the determination of ACF and tumors. Bisacodyl (4.3 and 43 mg/kg), given alone, did not induce the development of colonic ACF and tumors. Bisacodyl (4.3 mg/kg) coupled with AOM increased the number of crypt per focus, but not the number of tumors. Bisacodyl (43 mg/kg) significantly increased the number of crypt per focus and tumors. Cascara (140 and 420 mg/kg) did not induce the development of colonic ACF and tumors and did not modify the number of AOM-induced ACF and tumors. The results of the present study indicate a possible promoting effect of bisacodyl on rat colon carcinogenesis (especially at higher doses) and absence of any promoting or initiating activity of a laxative and diarrhoeal dose of cascara.

N-acetyl-cysteine reduces neointimal thickening and procoagulant activity after balloon-induced injury in abdominal aortae of New Zealand white rabbits.

BACKGROUND: Procoagulant activity and oxidative stress generated by balloon injury to normal vessels promote the migration of medial smooth muscle cells and their proliferation in the intima. We hypothesised that administering levo N-acetyl-cysteine (NAC) i.v. at the time of injury, and s.c. before and after injury would reduce neointimal formation 4 weeks later and would regulate procoagulant activity in vessels with neointima undergoing ballooning a second time. METHODS AND RESULTS: at the time of injury rabbits received: NAC, unfractionated heparin (HEP) or both (NAC + HEP). Neointimal thickening at 28 days, calculated as the ratio between the intimal and medial area, was attenuated after NAC, HEP and NAC+HEP by 39%, 30% and 47% respectively when compared to untreated injured animals (CONTROLS) (p <0.05). At 28 days, bound thrombin activity and platelet adhesion 1 h after a repeated balloon injury decreased in animals receiving NAC, HEP and NAC+HEP bv 54%, 63% and 64% for thrombin activity (p <0.05 vs CONTROLS), and by 56%, 66% and 75% respectively for 111Indium-platelet deposition (p <0.05 vs CONTROLS). CONCLUSIONS: NAC in-vivo was effective in reducing neointimal thickening and procoagulant response after balloon injury.

Does senna extract promote growth of aberrant crypt foci and malignant tumors in rat colon?

Current evidence suggests that aberrant crypt foci (ACF) can be used to evaluate agents for their potential colon carcinogenic activity. The aim of the present study was to determine whether senna pod extract (SE) itself induces ACF and tumors in the rat colon or increases the development of ACF and tumors induced by azoxymethane (AOM). A daily administration of SE 10 mg/kg by mouth for 13-28 weeks produced a weak laxative effect but did not itself cause the appearance of ACF or tumors. The numbers of ACF and tumors induced by AOM were, however, increased by a dose of SE (100 mg/kg) able to induce chronic diarrhea over three months. These results suggest that SE does not cause the appearance of ACF or tumors in the rat colon nor does it have a promoting effect when given to rats at a dose that produces laxation (10 mg/kg), whereas a diarrhogenic dose (100 mg/kg) increases the appearance of tumors induced by AOM.

Evaluation of omeprazole genotoxicity in a battery of in vitro and in vivo assays.

Omeprazole, a proton pump inhibitor of wide use in the treatment of gastric acid-related disorders, was evaluated for its genotoxic effects in both rat and human cultured cells and in the intact rat. DNA repair synthesis, as revealed by autoradiography, was detected in primary cultures of metabolically competent rat hepatocytes exposed to concentrations ranging from 10 to 100 mg/l, but the responses cannot be considered as clearly positive. Under the same experimental conditions any significant evidence of DNA repair was absent in primary hepatocytes from two human donors. At the same concentrations a modest but dose-related increase of micronucleated cells, that reached the level of statistical significance at 33 mg/l, was present in primary rat hepatocytes and in one of two human donors. In human lymphocytes exposed to subtoxic concentrations ranging from 0.78 to 12.5 mg/l a reproducible concentration dependent clastogenic effect was absent. In partially hepatectomized female rats treated with a single p.o. dose of 1000 mg/kg, the frequency of micronucleated cells was 5.2-fold higher than in controls in the liver, but only 2.0-fold higher in polychromatic erythrocytes of the bone marrow. In rats of the same sex given azoxymethane as initiator of colon carcinogenesis the oral administration for 8 successive weeks of 10 mg/kg omeprazole on alternate days increased the response to azoxymethane, as indicated by the occurrence in colon mucosa of a modest but statistically significant increase in both the average number and size of aberrant crypt foci. Taken as a whole, our results suggest that omeprazole behaves as a weak genotoxic agent for the rat liver. Reliable information about the potential genotoxic risk to humans requires further studies on primary cells from a wide number of donors.