Infecciones oculares: un estudio de caracterización y perfil de resistencia antibiótica / Ocular infections: characterization and antibiotic resistance profile

Introducción: Las infecciones oculares son patologías frecuentes asociadas a secuelas graves como la ceguera y se convierten en un potencial problema en salud pública. Su perfil epidemiológico, en cuanto a su etiología, es conocido a nivel mundial, pero los perfiles locales son desconocidos, limitando los esfuerzos terapéuticos dirigidos para compartir dicho problema. Objetivo: Caracterizar los principales gérmenes encontrados en los cultivos tomados de la córnea y la secreción conjuntival de pacientes de un centro de referencia oftalmológica de Medellín. Método: Estudio descriptivo, observacional y retrospectivo a partir de los resultados de cultivos, realizando un análisis en función de variables categóricas emitiendo porcentajes y frecuencias. Resultados: Se obtuvieron 176 cultivos en total: el 61.4% fue de córnea y el 34.1% de conjuntiva; los gérmenes más frecuentemente aislados fueron Pseudomonas en un 25%, Staphylococcus aureus con un 20% y Fusarium con un 15%. Conclusión: Los gérmenes más frecuentes que encontramos en este estudio coinciden con los que habitualmente se reportan en la literatura

Background: Eye infections are frequent pathologies associated with serious sequelae such as blindness and they become a potential public health problem. Its epidemiological profile, in terms of its etiology, is known worldwide, but the local profiles are unknown, limiting targeted therapeutic efforts to share this problem. Objective: To characterize the main germs found in cultures taken from the cornea and conjunctival secretion of patients at an ophthalmological reference center in Medellín. Method: Descriptive, observational, and retrospective study based on the results of cultures, carrying out an analysis based on categorical variables, issuing percentages and frequencies. Results: A total of 176 cultures were obtained: 61.4% were from the cornea and 34.1% from the conjunctiva; the most frequently isolated germs were Pseudomonas in 25%, Staphylococcus aureus with 20% and Fusarium with 15%. Conclusion: The most frequent germs that we found in this study coincide with those that are usually reported in the literature

Recurrencia de pterigión operado con autoinjerto conjuntivo-limbar por residentes en la clínica CES / Recurrence of pterygium after conjunctival limbal auto-graft by residents at the CES clinic

Introducción: El pterigión es una lesión fibrovascular, hiperplásica de tejido conjuntival, que crece sobre la córnea por alteración de las células madre que participan en la regeneración del tejido. Su manejo es quirúrgico y el éxito depende del tipo de técnica utilizada. Los reportes más bajos de recurrencia y complicaciones postoperatorias se han encontrado con la técnica de autoinjerto conjuntivo-limbar. Objetivo: Establecer la recurrencia a un año en pacientes sometidos a cirugía pterigión primario con autoinjerto conjuntivo-limbar operados por residentes de oftalmología de primer año en la Clínica CES en el periodo 2015 a 2018. Diseño del estudio: Seguimiento retrospectivo a una cohorte. Método: Se realizó un muestreo probabilístico simple del 10% (110 historias clínicas) de los registros de los pacientes intervenidos entre 2015 y 2018. Resultados: El 55.7% fue mujeres, el promedio de edad fue 45 (33-61) años y se encontró una recurrencia de pterigión del 7.6% a un año. Conclusión: La recurrencia de pterigión primario intervenidos por residentes de primer año con la técnica de autoinjerto conjuntivo-limbar está dentro de lo reportado en estudios realizados con cirujanos de mayor experiencia

Background: Pterygium is a fibrovascular, hyperplastic lesion of conjunctival tissue, which grows on the cornea due to alteration of the stem cells that participate in tissue regeneration. Its management is surgical, and its success depends on the type of technique used. The lowest reports of recurrence and postoperative complications have been found with the conjunctive-limbar autograft technique. Objective: To establish the one-year recurrence in patients undergoing primary pterygium surgery with limbar-conjuntival autograft operated by first-year ophthalmology residents at the CES Clinic in the period 2015 to 2018. Study design: Follow-up to a retrospective cohort. Method: A simple probability sampling of 10% (110 medical records) was carried out of the records of the patients operated between 2015 and 2018. Results: 55.7% were women, the average age was 45 (33-61) years, and it was found a recurrence of pterygium of 7.6% at one year. Conclusion: The recurrence of primary pterygium operated by first-year residents with limbar-conjunctival autograft technique is within that reported in studies carried out with more experienced surgeons

Reliability of a four-column classification for tibial plateau fractures.

PURPOSE: A four-column classification system offers a different way of evaluating tibial plateau fractures. The aim of this study is to compare the intra-observer and inter-observer reliability between four-column and classic classifications. METHODS: This is a reliability study, which included patients presenting with tibial plateau fractures between January 2013 and September 2015 in a level-1 trauma centre. Four orthopaedic surgeons blindly classified each fracture according to four different classifications: AO, Schatzker, Duparc and four-column. Kappa, intra-observer and inter-observer concordance were calculated for the reliability analysis. RESULTS: Forty-nine patients were included. The mean age was 39 ± 14.2 years, with no gender predominance (men: 51%; women: 49%), and 67% of the fractures included at least one of the posterior columns. The intra-observer and inter-observer concordance were calculated for each classification: four-column (84%/79%), Schatzker (60%/71%), AO (50%/59%) and Duparc (48%/58%), with a statistically significant difference among them (p = 0.001/p = 0.003). Kappa coefficient for intr-aobserver and inter-observer evaluations: Schatzker 0.48/0.39, four-column 0.61/0.34, Duparc 0.37/0.23, and AO 0.34/0.11. CONCLUSIONS: The proposed four-column classification showed the highest intra and inter-observer agreement. When taking into account the agreement that occurs by chance, Schatzker classification showed the highest inter-observer kappa, but again the four-column had the highest intra-observer kappa value. The proposed classification is a more inclusive classification for the posteromedial and posterolateral fractures. We suggest, therefore, that it be used in addition to one of the classic classifications in order to better understand the fracture pattern, as it allows more attention to be paid to the posterior columns, it improves the surgical planning and allows the surgical approach to be chosen more accurately.