Ultrasound evaluation of the femoral trochlea in newborns: incidence of trochlear dysplasia and associated risk factors.

This study aimed to describe the femoral groove morphology using ultrasound in children under 6 months, estimate the incidence of trochlear dysplasia, and evaluate associated risk factors. A prospective study included 298 patients who underwent universal ultrasound screening for hip dysplasia [developmental dysplasia of the hip (DDH)] and knee ultrasound. Measurements of sulcus angle (SA), trochlear depth (TD), and trochlear facet asymmetry (TFA) were analyzed. Trochlear dysplasia was considered present if the ASO was ≥159°. Reproducibility was assessed using the intraclass correlation coefficient (ICC) in 60 knees. Logistic regression adjusted for confounders, presenting odds ratios (OR) and 95% confidence intervals (CI). Significance was set at P < 0.05. Analysis included 596 knees (298 patients). Females accounted for 51% of patients, with 7% having breech presentation, 4.4% DDH, 6.4% family history of DDH, and 5% family history of patellofemoral instability. ICC showed excellent agreement for SA and TD, but poor for TFA. Trochlear dysplasia incidence was 3% (9/298; 67% bilateral). Median (IQR) values were 147.5 (144.0-150.5) for SA, 2.4 (2.2-2.8) for TD, and 1.1 (1.0, 1.1) for TFA. Breech presentation (OR, 9.68; 95% CI 1.92-48.71, P = 0.006) and concomitant DDH (OR 6.29, 95% CI 1.04-37.78, P = 0.044) were associated with trochlear dysplasia. Ultrasound effectively evaluates femoral groove morphology and diagnoses trochlear dysplasia in newborns. Trochlear dysplasia incidence was 3%, with a 10-fold higher risk in breech presentation and 6-fold higher risk in concomitant DDH. Standardized screening and timely treatment protocols should be further investigated. Level of evidence: Diagnostic Level II.

Relación de los niveles plasmáticos de homocisteína y apolipoproteína b-100 con el riesgo cardiovascular / Relationship of plasma levels of homocysteine and apolipoprotein b-100 with cardiovascular risk

INTRODUCCION: las enfermedades cardiovasculares son responsables del 31% de la mortalidad mundial, existen parámetros como la homocisteína y la Apolipoproteína B-100 que podrían tener utilidad en la predicción del riesgo. OBJETIVO: relacionar los niveles plasmáticos de Homocisteína y Apolipoproteína B-100 con el riesgo cardiovascular en pacientes que acuden a consulta externa del Hospital Univalle, durante julio-agosto del 2018 METODOLOGIA: el presente estudio es no experimental observacional, tipo prospectivo, transversal, con un enfoque de análisis positivista cuantitativo, con un universo de (N=133) que se redujo a una unidad de análisis de 81, que cumplieron con los criterios de inclusión y exclusión con un 6.83% de error máximo aceptable. RESULTADOS: el 52% de los pacientes fueron mujeres. La edad media de fue de 49,8 (Rango 25 a 83), el grupo etario predominante fueron los adultos mayores. Según el IMC los sujetos de estudio presentan sobre peso (n=31) y grado de obesidad 1 (n=24) más frecuentemente. Los niveles plasmáticos elevados de Apolipoproteína B en ambos sexos no muestran una diferencia significativa, mientras en que los de homocisteína la diferencia fue de 8:1. Se constato que los niveles séricos de la Apolipoproteína B-100 tienen una sensibilidad y especificidad bajas del 19.40% y 28.42%, mientas los de la homocisteína fueron del 14.29% y 27.27% respectivamente en comparación con la técnica convencional. CONCLUSIONES: los niveles plasmáticos de homocisteína y Apolipoproteína B-100 no son parámetros predictores de padecer riesgo cardiovascular

INTRODUCTION: cardiovascular diseases are responsible for 31% of world mortality, there are parameters such as homocysteine and Apolipoprotein B-100 that could be useful in predicting risk. OBJECTIVE: to relate the plasma levels of Homocysteine and Apolipoprotein B-100 with cardiovascular risk in patients who attend the outpatient clinic of the Univalle Hospital, during July-August 2018. METHODOLOGY: this study is non-experimental, observational, prospective, cross-sectional, with a quantitative positivist analysis approach, with a universe of (N=133) that was reduced to an analysis unit of 81, who met the inclusion criteria. and exclusion with a 6.83% maximum acceptable error. RESULTS: 52% of the patients were women. The mean age was 49.8 (range 25 to 83), the predominant age group was the elderly. According to the BMI, the study subjects are overweight (n=31) and obesity grade 1 (n=24) more frequently. The elevated plasmatic levels of Apolipoprotein B in both sexes do not show a significant difference, while in those of homocysteine the difference was 8:1. It was found that the serum levels of Apolipoprotein B-100 have a low sensitivity and specificity of 19.40% and 28.42%, while those of homocysteine were 14.29% and 27.27% respectively compared to the conventional technique. CONCLUSIONS: plasma levels of homocysteine and Apolipoprotein B-100 are not predictors of cardiovascular risk.