Detección de ARN del SARS-CoV-2 por PCR en una serie de cadáveres remitidos para autopsia / Detection of SARS-CoV-2 RNA by PCR in a series of corpses sent for autopsy

A partir de la emergencia del SARS-CoV-2 en el mundo se desató la pandemia por COVID-19 que afectó a 185 países; aparecieron numerosas publicaciones científicas presentando datos epidemiológicos, clínicos, estadísticos y microbiológicos. La elevada mortalidad ha implicado la necesidad de contar con datos cada vez más precisos con relación al virus y a su comportamiento en el medio y, por otro lado, enfrentó a los equipos de salud con un grave problema con relación al manejo seguro de cadáveres y a los riesgos de transmisión que ello implica. El objetivo del presente estudio ha sido detectar la presencia de ARN del SARS-CoV-2 en cadáveres remitidos a la Morgue Judicial de la Nación que no estuvieran comprendidos en la definición de caso sospechoso propuesta por el Ministerio de Salud de la Nación de la República Argentina. Se realizaron hisopados nasofaríngeos a 101 cadáveres elegidos aleatoriamente y basándose en criterios de inclusión para la detección de ARN viral mediante técnica RT-PCR. Se detectó ARN viral en el 16,8% de los cadáveres incluidos en el estudio. (AU)

Following the emergence of SARS-CoV-2 in the world, the COVID-19 pandemic broke out, affecting 185 countries. There have been numerous scientific publications presenting epidemiological, clinical, statistical, and microbiological data. The high mortality has implied the need for increasingly accurate data regarding the virus and its behaviour in the environment and, on the other hand, faced health teams with a serious problem in relation to the safe handling of corpses and the risks of transmission that this implies. The objective of this study was to detect the presence of SARS-CoV-2 RNA in corpses sent to the National Judicial Morgue that were not included in the definition of a suspected case submitted by the Argentine Ministry of Health. Nasopharyngeal and oropharyngeal swabs were taken from 101 cadavers chosen randomly and based on inclusion criteria for detection of viral RNA using the RT-PCR technique. Of the cadavers included in the study, 16.8%, not classified as suspected cases of COVID-19, were tested for the presence of viral RNA in the samples collected. (AU)

Distal radius fractures - Treatment with volar locking plates - Functional results according to fracture type.

BACKGROUND: The aim of this study is to determine if there are differences in functional results in patients presenting fractures of the distal radius treated with volar locking plates and, secondarily, to compare these results according to fracture type (AO). METHODS: 39 patients treated between January 2013 and December 2015 were evaluated. They were 19 women and 20 men, with an average of 60 years old and a range between 18 and 86 years old. The average follow up was of 46 months. We made radiographic postoperative measurements of the ulnar tilt angle of the radius, the volar tilt angle of the radius and styloid height. We evaluated residual pain with VAS (Analogue Visual Scale). The objective and subjective function were evaluated with the DASH inquiry (Disabilities of the Arm, Shoulder, and Hand) and Mayo wrist score. RESULTS: The mean flexion was of 51º, the extension was 55º, pronation was 80º, and supination was 75º. The mean ulnar tilt angle was 19, 66°, the mean volar tilt angle was  2.07°, and the mean styloid height was 8.97 mm. The average DASH was 14.38  and the average Mayo was of 78.58. There was no significant statistical correlation between the fracture complexity and the analyzed variables. CONCLUSIONS: In this series, volar locking plates were a valid option for the resolution of unstable distal radius fractures in its different patterns and in a wide age range.

Introducción: el objetivo de este estudio es determinar si existen diferencias en los resultados funcionales en pacientes con fracturas del radio distal tratados con placas de bloqueo volar y, en segundo lugar, comparar estos resultados según el tipo de fractura (AO). Métodos: se evaluaron 39 pacientes tratados entre enero de 2013 y diciembre de 2015. Fueron 19 mujeres y 20 hombres, con un promedio de 60 años y un rango entre 18 y 86 años. El seguimiento promedio fue de 46 meses. Se realizaron mediciones radiográficas postoperatorias del ángulo de inclinación cubital del radio, el ángulo de inclinación volar del radio y la altura de la estiloides. Evaluamos el dolor residual con VAS (Escala visual analógica). La función objetiva y subjetiva se evaluó con el cuestionario DASH (Discapacidades del brazo, hombro y mano) y el score de Mayo. Resultados: La flexión media fue de 51º, la extensión fue de 55º, la pronación fue de 80º y la supinación fue de 75º. El ángulo medio de inclinación cubital fue de 19,66 °, el ángulo medio de inclinación volar fue de 2,07 ° y la altura media de la estiloides fue de 8,97 mm. El DASH promedio fue de 14.38 y el promedio de Mayo fue de 78.58. No hubo correlación estadística significativa entre la complejidad de la fractura y las variables analizadas. Conclusiones: las placas de bloqueo volar son una opción válida para la resolución de fracturas inestables de radio distal en sus diferentes patrones y en un amplio rango de edad

Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications.

PURPOSE: To report radiologic, functional outcomes, and complications with a long-term follow-up in acute olecranon fractures treated with osteosynthesis and, secondly, to determine the predisposing factors to arthritis. METHODS: Forty-two patients treated with osteosynthesis for acute olecranon fractures were reviewed, with a minimum follow-up of 24 months. Radiological and clinical evaluations including DASH, MEPS, active range of motion, pain, arthritis, associated lesions, and complications were recorded. Arthritis was classified according to Broberg-Morrey scale. A logistic regression model was estimated to determine risk factors to develop ulnohumeral arthritis. The association between the types of fractures according to Mayo classification and MEPS, and the association between the type of fracture and the presence of pain were analyzed. RESULTS: The average follow-up was of 43.64 months. The flexion-extension average range was 135.6°, and the mean MEPS was 89.45; the DASH was 25.26. Eighteen cases (42.86%) were fixed with pre-contoured locking plates, 21 with tension band wiring (50%), and 3 with cannulated screws of 7 mm (7.14%). Six cases (14.29%) needed hardware removal. All fractures healed. Ulnohumeral osteoarthritis was observed in 14 cases (33.3%). We did not find a significant association among the MEPS, pain, and the fracture type, according to Mayo (p > 0.1 for both values). A significant association was found (p < 0.05) between fracture type and the osteoarthritis. CONCLUSIONS: In olecranon fractures, good functional and radiological results with low complications are predictable. The osteoarthritis is possible in more complex fractures and with other associated fractures.

Precontoured Locking Plate Treatment in Mid-Shaft Clavicle Fractures: Outcomes and Complications with a Minimun of 2- ears Follow up.

BACKGROUND: The aim of this study was to evaluate functional outcome and complications with a long term follow up (minimum of 2 years post-operative) in patients with mid-shaft clavicle fractures treated with precontoured locking plates. METHODS: We included 41 patients. Goniometric measurement of shoulder range of motion (ROM) was performed, as well as functional evaluation using the rating scale shoulder of the University of California (UCLA), the Constant scale, score of disability of the arm, shoulder and hand (DASH) and visual analog scale (VAS). Postoperative complications, implants removal rates and new x-rays were analized. RESULTS: The mean postoperative follow-up was 41.5 (24; 69. SD 13.4) months. Mean shoulder anterior elevation was 168.5º (120; 180. SD 22.9). The average value obtained for abduction was 175.2° (150; 180. SD 27.8), as to internal and external rotations, these were not affected. DASH 1.27% (0%; 25%. SD 4.3), UCLA 33.6 points (20; 35. SD 3.5), Constant 90.5 points (50; 100. SD 11.2) and VAS was 0 in 34 patients (83%). Complications: mild residual pain (3), hypoesthesia of the infraclavicular area (2), and rupture (1) and loosening (1) of the implant. hardware removal due to intolerance (2 cases) and new osteosynthesis due to acute implant rupture (1 case). CONCLUSION: Our experience after a mean follow-up of 41.5 months with precontoured locking plates for the treatment of displaced mid-shaft clavicle fractures has shown good functional results, with low complication and reoperation rate.

Heridas por proyectiles de arma de fuego en la columna vertebral / Gunshot injuries of the spine

Se evaluaron 26 pacientes con heridas por proyectiles de arma de fuego en la columna vertebral. La mayor parte presento lesiones asociadas y un alto porcentaje fallecio como consecuencia de ellas. Se propone una clasificacion que plantea conjuntamente las principales variables que afectan la evolucion, el pronostico y el tratamiento de este tipo de lesiones. Las lesiones neurologicas y menos frecuentemente la inestabilidad inciden en la indicacion quirurgica. Las lesiones asociadas influyen en la morbimortalidad

Heridas por proyectiles de arma de fuego en la columna vertebral / Gunshot injuries of the spine

Se evaluaron 26 pacientes con heridas por proyectiles de arma de fuego en la columna vertebral. La mayor parte presento lesiones asociadas y un alto porcentaje fallecio como consecuencia de ellas. Se propone una clasificacion que plantea conjuntamente las principales variables que afectan la evolucion, el pronostico y el tratamiento de este tipo de lesiones. Las lesiones neurologicas y menos frecuentemente la inestabilidad inciden en la indicacion quirurgica. Las lesiones asociadas influyen en la morbimortalidad