Evaluación del componente patelar en artroplastía total de rodilla / Evaluation of patellar resurfacing in total knee arhtroplasty

Ever since the first Total Knee Arthroplasty was made to our present times, a point that still generates controversy is, if the accomplishment of patellar resurfacing will take to a higher global rate of complications. It was the final objective of our work to analyze clinically and radiologically, in addition to satisfaction degree and quality of life surveys, the patellar resurfacing in a sample of total knee arthroplasty made in our center. We can conclude that in our experience, the patellar resurfacing has a low incidence of complications, which do not affect in a significant way the quality of life of the patients carrying on a total knee arthroplasty, which justifies this procedure absolutely.

Desde que se realizan las Artroplastías Totales de Rodilla hasta la fecha, un punto que genera controversia, es, si la realización de un componente protésico patelar llevará a una mayor tasa global de complicaciones. Es por eso que el objetivo de nuestro trabajo fue analizar clínica y radiológicamente, además de encuestas del grado de satisfacción, el componente de recubrimiento patelar en una muestra de las artroplastías totales de rodilla realizadas en nuestro centro. Se concluye que en nuestra experiencia, el uso de recubrimiento patelar tiene una baja incidencia de complicaciones, las cuales no afectan de manera significativa la calidad de vida de los pacientes con artroplastía total de rodilla, lo que justifica plenamente su utilización.

The prevalence of multiple sclerosis in the District of Santarém, Portugal.

The prevalence of multiple sclerosis (MS) in Portugal is still unknown. Recent studies conducted in southern European countries showed higher than expected rates of MS prevalence. In an attempt to evaluate the MS prevalence in Santarém--a district with 62621 inhabitants (1991 census) located in the centre of Portugal--we have conducted a population survey in this district for five years. The crude prevalence rate found was 46.3/100,000. This figure is not different from findings recently reported in studies conducted at similar latitudes in neighbour southern European countries. This was the first population survey conducted in Portugal, and it is the first accurate contribution to the knowledge of the MS prevalence in this country.

Síndrome de edema de la médula ósea de cadera / Bone marrow edema syndrome of the hip

Background: Bone marrow edema syndrome (BMES) is a rare clinical condition. Its etiology is unknown and it can be seen in different locations. In the case of the hip, avascular necrosis is the main differential diagnosis. Aim: To present our experience of BMES of the hip and a review of the literature. Patients and methods: Retrospective analysis of clinical records of patients with hip pain that met clinical, radiological, and magnetic resonance imaging criteria for BMES. Clinical outcome and clinical and radiological follow up are presented. Results: Two men and two women (one of them pregnant) aged 42, 48, 36 and 26 years old, fulfilled criteria. Treatment included limited weight bearing, non steroidal antiinflammatory drugs, intranasal calcitonin and physical therapy. Complete remission of symptoms was observed within five to seven months. At an average follow up of 36 months, all patients presented complete function of the hip, returning to their previous activity levels, with no new episodes of BMES. Conclusions: It is important to be aware of this condition as part of the differential diagnosis of hip pain to avoid aggressive and unnecessary diagnostic and therapeutic procedures (Rev Méd Chile 2004; 132: 947-54).

Artroplastia total de rodilla en pacientes con artritis reumatoide / Total knee arthroplasty in patients with rheumatoid arthritis

Background: Approximately 90 percent of patients with rheumatoid arthritis (RA) will have one or both knees involved during the course of the disease. Total knee arthroplasty (TKA) allows restoring function and relieving pain satisfactorily, but these patients perform in a different way than those with primary knee osteoarthritis. Aim: To evaluate the clinical and radiographic results of TKA in patients with RA. Patients and methods: We analyzed retrospectively the data of 25 posterior stabilized total knee prostheses in 19 patients, available to an average follow-up of 6 years. The scores of Hospital for Special Surgery and of the Knee Society were used for clinical assessment. Results: The mean Hospital for Special Surgery score increased from 44 points (range 27-58) preoperatively to 80 points (range 58-91) at the final follow-up examination. Two prostheses required revision and removal of the implants because of deep infection, and two had clinical failure as defined by the Knee Society score. There were no cases of implant loosening. Discussion: Even though it is not free of complications, TKA is a good choice in patients with RA in the medium term follow up, with 80 percent of excellent and good results in our series (Rev MÚd Chile 2004; 132: 337-45).

Luxación qirúrgica de cadera en condromatosis sinovial. A propósito de un caso / Surgical dislocation of the hip in synovial chondromatosis. Case report

La condromatosis sonovial es un proceso beningo infrecuente que afecta las articulacione y otras estructuras que contienen tejido sinovial. Se presenta el caso de una mujer de 46 años con condromatosis sinovial sintomática de cadera derecha, en etapa inicial, localizada en la fosa acetabular. El tratamiento fue la resección abierta de la lesión mediante luxación quirúrgica de la cadera. No hubo complicaciones intra o postoperatorias y la osteotomía consolidó adecuadamente. Al último seguimiento, la paciente no tiene dolor y realiza una vida normal.

Non-random distribution of the pericentromeric heterochromatin in meiotic prophase nuclei of mammalian spermatocytes.

The central or peripheral distribution of condensed chromatin (CC) was studied in pachytene spermatocyte nuclei in Mus domesticus, 2n = 40; Pudu puda, 2n = 70; Ctenomys opimus, 2n = 26 and Octodon degus, 2n = 58. Species were chosen according to the morphological characteristics of their chromosomal complements and in particular, the terminal or medial chromosomal localisation of the pericentromeric constitutive heterochromatin. Counts were made by defining the areas corresponding to peripheral and central location in each nuclear section from a series. The null hypothesis (i.e. random distribution of CC) was rejected. In the nuclear sections of Mus domesticus and Pudu puda, 69% and 74% of CC, respectively, was found in the peripheral nuclear space, while in those of Octodon degus and Ctenomys opimus, 69% and 65% of CC, respectively, was found in the central nuclear space. We estimate that if the CC measured in spermatocyte nuclei corresponds mainly to pericentromeric constitutive heterochromatin, the distribution found is consistent with that expected in accordance with the nuclear architecture model for meiocytes (Fernández-Donoso, 1982; Fernández-Donoso & Berrios, 1985). This model proposes a peripheral nuclear localisation for pericentromeric heterochromatin of telocentric bivalents and a relatively central nuclear localisation for pericentromeric heterochromatin of metacentric bivalents. We also discuss some of the biological consequences that could arise from the conservation of such distributions.

[Colostomy closure: is it an intervention without risk?]. / Cierre de colostomía: es una intervención sin riesgo?

OBJECTIVE: To examine whether colostomy closure is an operation with a high risk of complications. DESIGN: Retrospective study of colostomy closures in a 14-year period. PARTICIPANTS: 60 patients, averaging 54 years, males in 63%. The main indication for colostomy was colorectal neoplasm (47%), followed by trauma (23%). RESULTS: There were 15 Hartman's procedure reconstructions, 4 reconstructions of colostomy and mucous fistula, and 41 "simple" colostomy closures. The closure was extraperitoneal in 40%, suturing only the anterior colonic wall in 42%. We had 27 postoperative complications in 33% of the patients, without mortality. The average hospital stay was 8 days longer in the group with complications. The complication rate was 29% in the "simple" closure versus 42% in the reconstruction group (this difference was not statistically significant). The statistic analysis (chi-square and Mann-Whitney tests) showed no influence on morbidity of factors such as age, sex, previous disease, age of colostomy, and type and closure technique of colostomy. CONCLUSIONS: Colostomy closure has a high rate of postoperative complications (33%). These are minor in almost all cases, without mortality.

Fluoxetina en el tratamiento de obesos no depresivos / Fluoxetine in the treatment of non-depressive obese patients

La fluoxetina es un antidepresivo que actúa inhibiendo la reaceptación de serotoninas a nivel presináptico. Por este efecto, no solo se aplica en cuadros depresivos sino que tiene, también, efecto sobre la inducción de la sensación de saciedad y promueve una mejor utilización de la insulina a nivel periférico en pacientes diabéticos no insulino dependientes. Este estudio, realizado con el método doble ciego, muestra resultados alentadores de la fluoxetina en el tratamiento de la obesidad. Su administración en dosis única diaria de 40mg ha permitido obtener resultados estadísticamente significativos, tanto en la disminución del peso, como en los cambios en la conducta alimentaria, disminuyendo la ingesta principalmente en lo que respecta a los carbohidratos

Acute abdomen caused by torsion of the pedicle in a wandering spleen.

A case of acute abdomen caused by acute torsion of a wandering spleen in a 20-year-old female patient is presented. It underscores the efficiency of the ultrasonic examination in the diagnosis of this type of pathology.