Distribution of fractured bones among children: Experience with the Comprehensive Pediatric AO classification in a children's orthopedic hospital in Bogotá-Colombia.

INTRODUCTION: Fractures in children and adolescents are a public health issue. However, reliable epidemiological descriptions of the South American population must be improved. This study aims to present epidemiological data on fractures from a children's orthopedic hospital in one of the five largest cities in Latin America. PATIENTS AND METHODS: Descriptive epidemiological data from 2015 to 2019 were used to characterize children's fractures. Demographic variables, the number of fractured bones, high-energy trauma findings, fracture characteristics, fingertip injuries, and associated complications discriminated by the type of treatment are presented. Long bone fractures were classified according to the AO classification. All children less than 18 years of age were included. RESULTS: In a population of 3,616 children, 4,596 fractures were identified. More boys than girls sustain a fractured bone, with ratios as high as 6:1 around 15 years old. Distal forearm fractures were the most common (31.9%), followed by distal humerus (20.2%). Most of the complications were related to these two sites of fractures. The OR of complications between surgical and conservative management was 2.86. CONCLUSION: Epidemiological data of fractures from the authors' institution display the usual trending reported in most populations. Gender-related and age-related differences were relevant. Most fractures and complications are related to upper limb low-energy trauma. The most frequent are loss of ROM and loss of reduction. LEVEL OF EVIDENCE: Level III - retrospective cohort study.

A systematic review and meta-analysis of risk factors associated with acquisition of waterborne healthcare-associated infection or colonization in high-risk units.

In this meta-analysis, central venous catheter exposure (pooled odds ratio, 8.02; 95% confidence interval [CI], 2.19-29.31; P < .01) in neonates and length of stay (standardized mean difference, 0.65; 95% CI, 0.26-1.05; P = .01) in an adult population were associated with acquisition of waterborne healthcare-associated infections or colonization in ICUs. The quality of evidence was low.

Age, education and gender effects on Wisconsin card sorting test: standardization, reliability and validity in healthy Argentinian adults.

The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological assessment of executive functioning. The aim of this study was to provide norm values and analyze the psychometric properties of WCST in healthy Argentinian adults aged from 18 to 89 years old (N = 235). Descriptive statistics are reported as means, standard deviations and percentiles, with the effects of age, education and gender being investigated by ANOVA, and with the effect sizes being calculated. The psychometrics were studied using the WCST structure, reliability, convergent validity, and discriminant validity, and WCST norms adjusted for age and educational level are proposed. This instrument is a reliable and valid tool for the assessment of executive functions. However, as the age- and educational-related effects were demonstrated, these characteristics need to be considered before interpreting WCST scores. Regarding gender, no differences were found. Our results expand the geographical and sociocultural applicability of WCST.

Comparación de la efectividad del fentanilo versus morfina, en dolor severo postoperatorio. Ensayo clínico aleatorizado, doble ciego / Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial

Introduction: Intravenous rescue analgesia in the postoperative anesthesia care unit (PACU) is the most effective method for reducing postoperative pain (POP) when perioperative multimodal analgesia fails to control it. Appropriate analgesia during these first postoperative hours may prevent morbidity associated with pain. Objective: To compare the effectiveness of intravenous morphine versus fentanyl in the PACU for reducing severe POP. Methods: Randomized, prospective, double blind trial that included patients with severe POP using VAS in the PACU. Rescue was performed on one group with 01 mg/kg morphine and with another with 1 mcg/kg of fentanyl every 5 min intravenously until pain was reduced from severe to mild (VAS<4). 30 patients were included in both groups. Results: There were no significant differences in the percentage of patients with reduction of severe POP to mild 5 min after the injection of morphine or fentanyl, or in the subsequent rescue analgesia intervals (p > 0.05). Similarly, there were no significant differences in mean VAS (95% CI) in morphine or fentanyl groups beginning 5 min after the first analgesic dose (p > 0.05) between the groups. There were no significant differences in side effects such as respiratory depression, nausea, vomiting or pruritus (p = 1.0). There was a high satisfaction in both groups (p > 0.05). Conclusions: Morphine and fentanyl were equally effective in treating severe POP after 5 min and following intervals after rescue analgesia was initiated, during 25 min at PACU, with no differences in efficacy or adverse effects between groups Register # NCT02145975 clinical-trials.gov, prospective.

Introducción: La analgesia intravenosa de rescate en la unidad de cuidados postanestesicos (UCPA), es la forma más efectiva de reducir el dolor POP, cuando la analgesia mutimodal perioperatoria falla en controlarlo. Una adecuada analgesia en las primeras horas previene la morbilidad asociada al dolor. Objetivo: Compararla efectividad para reducir el dolor POP severo de fentanilo versus morfina en recuperación postanestésica. Metodología: Estudio aleatorizado, prospectivo, doble ciego, en pacientes con dolor severo POP medido con la escala EVA. El rescate se hizo con un grupo morfina a 0,1 mg/kg versus fentanilo a 1 mcg/kg, cada 5 minutos, vía intravenosa, hasta reducir el dolor de severo a leve (EVA <4). Se incluyeron 30 pacientes en el grupo morfina y 30 en el grupo fentanilo. Resultados: No se observaron diferencias en porcentaje de pacientes con reducción del dolor severo a leve desde los 5 minutos luego del rescate entre morfina o fentanilo, ó en los intervalos restantes (p>0,05). Similarmente, no se encontraron diferencias significativas en la media de EVA (IC 95%) desde los 5 minutos luego del rescate (p > 0.05) entre los grupos. No hubo diferencias en efectos adversos como depresión respiratoria, náuseas, vómitos o prurito entre grupos (p = 1,0). La satisfacción fue comparable en ambos grupos (p >0,05). Conclusiones: La morfina y el fentanilo fueron igualmente efectivos para el rescate en dolor severo desde los primeros 5 minutos, sin diferencias en los efectos adversos en ambos grupos. Registro # NCT02145975 (clinicaltrials.gov, prospectivo).

Influencia de la religión en la toma de decisiones sobre sexualidad en estudiantes católicos practicantes / Influence of religion in decision making about sexuality in practicing catholic students

Esta investigación cualitativa de diseño fenomenológico tuvo como objetivo comprender la influencia de la religión en la toma de decisiones sobre sexualidad en estudiantes católicos practicantes. La muestra, seleccionada intencionalmente, estuvo conformada por cuatro hombres y cuatro mujeres, de los cuales dos de cada sexo habían iniciado su vida sexual y dos no. Las entrevistas en profundidad se analizaron con el apoyo del programa Atlas.ti. Las motivaciones para no iniciar su vida sexual se relacionaron con el amor hacia Dios y no convertir sus relaciones en un acto sexual, mientras que para iniciarla se asociaron con la exploración y la madurez espiritual. Los participantes que no habían iniciado su vida sexual estuvieron en contra de los métodos anticonceptivos artificiales al percibirlos como un elemento que solo promueve la satisfacción sexual. Se identificó que la religión influyó en las motivaciones que tuvieron los estudiantes para iniciar o no su vida sexual.

This qualitative phenomenological research aimed to understand the influence of religion in decision making about sexuality in practicing Catholic students. The selected sample consisted of eight men and women, four men who had already started their sexual life and four that had not. In-depth interviews were analyzed using Atlas.ti. Motivations for not starting having sex were associated with love for God and not converting their relations into a sexual act, while those who had started their sexual life had motivations associated with exploration and spiritual maturity. Participants who had not started their sex lives were against artificial contraception and perceived them as elements that promoted only sexual satisfaction. Religion seemed to influence the motivations of students to start having sex.