122 research outputs found
All-Arthroscopic Triangular Fibrocartilage Complex Ligamentoplasty: Technique and Results
Objective The aim of the study is to describe the modified all-arthroscopic technique
for triangular fibrocartilage complex (TFCC) ligamentoplasty in chronic injuries of the
TFCC with distal radioulnar joint (DRUJ) instability, and to present the results obtained.
Methods A prospective study was conducted including 11 consecutive patients with
chronic TFCC injury with DRUJ instability who underwent an all-arthroscopic TFCC
ligamentoplasty. During follow-up, the range of joint motion, grip strength, pain
according to the visual analog scale (VAS), functional outcomes according to the Mayo
Wrist Score (MWS), and the QuickDASH Score were measured, and any complications
and necessary reinterventions were recorded
Results We analyzed 11 patients with distal radioulnar ligament injury treated using
the all-arthroscopic ligamentoplasty technique. Mean follow-up was 31.5 4.4 (range
12–58) months. The technique presented achieved DRUJ stability in 100% of cases at
12 months. Grip strength and pain, showed a statistically significant improvement
between the preoperative score and the two postoperative assessments. Functional
assessment using the QuickDASH score and the MWS also improved significantly.
Conclusion The all-arthroscopic technique for the reconstruction of irreparable
peripheral TFCC tears is a reliable technique, intended not only to minimize the
surgical trauma to reduce postoperative pain and to facilitate rehabilitation, but also to
improve both the quality of the reconstruction and the functional outcome.Medicin
Arthroscopic Scapholunate Capsuloligamentous Repair: Suture With Dorsal Capsular Reinforcement for Scapholunate Ligament Lesion
Scapholunate ligament (SLL) injury is the most frequent injury of the intrinsic carpal ligaments. The dorsal part
of the SLL is the most important part for the stability of the scapholunate joint, and tears of this part and at least one of its
secondary capsular attachments cause scapholunate dissociation. The arthroscopic technique most frequently used for
acute injuries is reduction and fixation with Kirschner wires, and techniques that involve a primary repair of the injured
ligament are performed by open surgery with efficient results. However, they lead to significant stiffness of the wrist due to
injury to the soft tissue caused by damage to the secondary dorsal stabilizers; the dorsal blood supply; and in many cases,
the proprioceptive innervation of the posterior interosseous nerve. We present an all-arthroscopic technique for the direct
repair of acute injuries of the dorsal part of the SLL using bone anchors, complemented by a dorsal arthroscopic plication
that reconstructs the dorsal capsulo-scapholunate septum of the scapholunate complex.Medicin
Characterizing diagnostic inertia in arterial hypertension with a gender perspective in primary care
Background and Objectives: Substantial evidence shows that diagnostic inertia leads to failure to achieve screening and diagnosis objectives for arterial hypertension (AHT). In addition, different studies suggest that the results may differ between men and women. This study aimed to evaluate the differences in diagnostic inertia in women and men attending public primary care centers, to identify potential gender biases in the clinical management of AHT. Study Design/Materials and methods: Cross-sectional descriptive and analytical estimates were obtained nested on an epidemiological ambispective cohort study of patients aged ≥30 years who attended public primary care centers in a Spanish region in the period 2008-2012, belonging to the ESCARVAL-RISK cohort. We applied a consistent operational definition of diagnostic inertia to a registry- reflected population group of 44,221 patients with diagnosed hypertension or meeting the criteria for diagnosis (51.2% women), with a mean age of 63.4 years (62.4 years in men and 64.4 years in women). Results: Of the total population, 95.5% had a diagnosis of hypertension registered in their electronic health record. Another 1,968 patients met the inclusion criteria for diagnostic inertia of hypertension, representing 4.5% of the total population (5% of men and 3.9% of women). The factors significantly associated with inertia were younger age, normal body mass index, elevated total cholesterol, coexistence of diabetes and dyslipidemia, and treatment with oral antidiabetic drugs. Lower inertia was associated with age over 50 years, higher body mass index, normal total cholesterol, no diabetes or dyslipidemia, and treatment with lipid-lowering, antiplatelet, and anticoagulant drugs. The only gender difference in the association of factors with diagnostic inertia was found in waist circumference. Conclusion: In the ESCARVAL-RISK study population presenting registered AHT or meeting the functional dia
Tratamiento artroscópico de las roturas masivas del manguito rotador
La reparación artroscópica de las roturas masivas del manguito rotador (RMMR) es un procedimiento
técnicamente exigente, que requiere de una indicación correcta, una buena técnica artroscópica y un
adecuado tratamiento rehabilitador. El estudio clínico del paciente y las características de la lesión del manguito
son fundamentales para establecer el plan estratégico y terapéutico, que debe incluir desde el tratamiento no
quirúrgico hasta la reparación artroscópica, transferencias tendinosas artroscópicas, espaciadores subacromiales
o artroplastias de hombro. La reparación artroscópica se establece en pacientes con roturas masivas reparables
y sin degeneración grasa del manguito, las transferencias tendinosas se indican en pacientes jóvenes con importantes
exigencias funcionales que presentan roturas masivas irreparables y los espaciadores subacromiales y las
artroplastias de hombro para roturas irreparables en pacientes con baja demanda funcionalThe arthroscopic repair of a massive rotator cuff tear, is a technically demanding procedure. It
requires correct indications, good arthroscopic skills and a proper rehabilitation program. The clinical study of
the patient and the instances of the rotator cuff injury, are fundamental to determine a correct therapeutic strategy.
This strategy should consider every option from non-surgical to arthroscopic repair, tendon transfers, subacromial
spreaders or shoulder arthroplasties. The arthroscopic repair is the standard treatment in patients with
massive repairable tears and with no fatty degeneration of the affected muscle. Meanwhile, the tendon transfers
are indicated in young patients with highly functional demands that comprehend irreparable massive tears. The
spreaders or subacromial balloons and the shoulder prosthesis are performed in irreparable tears in low functional
demand patients
Anthropometrical profile of elite Spanish judoka: comparative analysis among ages
P. 240-245El objetivo del estudio fue comparar las variables antropométricas en judoka masculino y femenino de los equipos nacionales españoles.
Material y métodos: Participaron en este estudio ochenta y siete judokas españoles de todas las categorías de peso: mujeres (n = 46) - cadete (n = 16), junior (n = 12) y senior (n = 18); varones (n = 44) - cadete (n = 18), junior (n = 15) y senior (n = 8). Se realizaron mediciones antropométricas de masa corporal, altura, grosor del pliegue cutáneo, circunferencias y amplitud. También se estimaron los componentes del somatotipo, el índice de masa corporal, la grasa corporal y la masa muscular. Se utilizaron un análisis de varianza de dos vías (género y edad) y la prueba de Tukey para comparar los grupos.
Resultados: (1) los hombres eran más pesados, más altos, tenían menor grasa corporal y mayor masa muscular absoluta y valores relativos, circunferencias y diámetros óseos, endomorfos inferiores y componentes mesomorfos superiores que las mujeres; (2) para el grosor del pliegue cutáneo, los hombres presentaron valores más bajos en las extremidades que las mujeres, pero no se encontraron diferencias en el grosor del pliegue cutáneo del tronco; (3) se encontraron pocas diferencias entre las categorías de edad, con cadetes que presentaban menor circunferencia del brazo flexionado y amplitud ósea del húmero epicondilo en comparación con los juveniles junior y senior, y menor masa muscular absoluta en comparación con los seniors; (4) Se observó una tendencia a reducir el dimorfismo sexual en algunas dimensiones antropológicas y en los componentes endomórficos y mesomórficos en todas las categorías de edad.
Conclusiones: los atletas de judo de cadetes de nivel morfológicamente alto son muy similares a los atletas de mayor edad y los entrenadores pueden seleccionarlos a partir de estas edades. Estos datos pueden utilizarse como referencia para entrenadores y profesionales del acondicionamiento físicoS
Potential of MMP-9 based nanoparticles at optimizing the cow dry period: pulling apart the effects of MMP-9 and nanoparticles
The cow dry period is a non-milking interval where the mammary gland involutes and regenerates
to guarantee an optimal milk production in the subsequent lactation. Important bottlenecks such
as the high risk of intramammary infections complicate the process. Antibiotics have been routinely
used as a preventive treatment but the concerns about potential antibiotic resistance open a new
scenario in which alternative strategies have to be developed. Matrix metalloproteinase-9 (MMP-9) is
an enzyme able to degrade the extracellular matrix, triggering the involution and immune function of
cow mammary gland. We have studied the infusion into the mammary gland of MMP-9 inclusion bodies
as protein-based nanoparticles, demonstrating that 1.2 mg of MMP-9 enhanced the involution and
immune function of the cow mammary gland. However, the comparison of the efects triggered by the
administration of an active and an inactive form of MMP-9 led to conclude that the response observed
in the bovine mammary gland was mainly due to the protein format but not to the biological activity of
the MMP-9 embedded in the inclusion body. This study provides relevant information on the future use
of protein inclusion bodies in cow mammary gland and the role of MMP-9 at dry-of.info:eu-repo/semantics/publishedVersio
Active interventions in hypercholeteroloemia patiens with high cardiovascular risk in primary care
Introduction: Hypercholesterolemia is a major modifiable risk factors for cardiovascular disease (CVD). Its reduction reduces morbidity and mortality from ischemic heart disease and CVD in general, primary prevention and secondary prevention especially. Objective: To determine whether a notarized and intensive clinical practice can overcome inertia and achieve the therapeutic goal (OT) LDL-C <100 mg <dL in high-risk patients attended in Primary Care (PC) in our country. Methodology: epidemiological, prospective, multicenter study conducted in centers of different ACs By AP consecutive sampling 310 patients at high cardiovascular risk (diabetic or established CVD) previously treated with statins, which did not reach the OT included c-LDL. Results: The study subjects had a mean age of 65.2 years, of which 60.32% were male. The 41.64% had a previous EVC, acute myocardial infarction (20.33%), angina (16.07%), stroke /TIA (9.19%), arthropathy (5.25%), diabetes (70 , 87%), hypertension (71.01%), and abdominal obesity (69.62%). The 43.57% (95% CI: 37,21; 50,08) of patients who performed the 2nd visit (241) got the OT. 62.50% (95% CI: 55.68, 68.98) of those who took the 3rd (216) got the OT. Finally, 77.56% (95% CI: 72.13, 83.08) patients who performed the last visit (205) got the OT. Throughout the study there was a reduction in LDL-C levels from 135.6 mg /dL at baseline, 107.4 mg /dL in the 2nd visit, 97.3 mg /dL in the 3rd visit, up to 90.7 mg /dL at the final visit (p <0.0001) The increase in HDL-C from baseline (50.9 mg /dL) and final (53.6 mg /dL) was also significant (p = 0.013). Conclusions: The reassessment and intensification of treatment in patients at high cardiovascular risk treated in primary care, applying the indications of the guides, achieves the OT in more than three quarters of the previously uncontrolled within half a year. These results should encourage us to overcome the therapeutic inertia in the control of CVD by early and energetic performance against hypercholesterolemia.Introducción: La hipercolesterolemia es uno de los
principales factores de riesgo modificables de la enfermedad
cardiovascular (ECV). Su reducción disminuye
la morbimortalidad por cardiopatía isquémica y ECV en
general, en prevención primaria y en prevención secundaria
especialmente.
Objetivo: Comprobar si una práctica clínica protocolizada
e intensiva permite vencer la inercia y alcanzar el
objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes
de alto riesgo asistidos en Atención Primaria (AP)
de nuestro país.
Metodología: Estudio epidemiológico, prospectivo,
multicentrico, realizado en Centros de AP de diferentes
CC.AA. Mediante muestreo consecutivo se incluyeron
310 pacientes de alto riesgo cardiovascular (diabéticos o
con ECV establecida), tratados previamente con estatinas,
que no alcanzaban el OT de c-LDL.
Resultados: Los sujetos del estudio tenían una edad
media de 65,2 años, de los que el 60,32% eran varones.
El 41,64% presentaba un EVC previo, infarto agudo
de miocardio (20,33%), angina (16,07%), ictus/AIT
(9,19%), artropatía (5,25%), diabetes (70,87%), hipertensión
(71,01%), y obesidad abdominal (69,62%). El
43,57% (IC95%: 37,21; 50,08) de los pacientes que realizaron
la 2a visita (241) consiguieron el OT. El 62,50%
(IC95%: 55,68; 68,98) de los que realizaron la 3a (216)
consiguieron el OT. Finalmente, el 77,56% (IC95%:
72,13; 83,08) de los pacientes que realizaron la última visita
(205) consiguieron el OT. A lo largo del estudio hubo
una reducción de los niveles de c-LDL desde los 135,6 mg/
dL en la visita basal, 107,4 mg/dL en la 2a visita, 97,3 mg/
dL en la 3a visita, hasta los 90,7 mg/dL en la visita final
(p < 0,0001) El incremento de c-HDL entre la visita basal
(50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo
(p = 0,013). Conclusiones: La reevaluación e intensificación del tratamiento
en pacientes de alto riesgo cardiovascular atendidos
en Atención Primaria, aplicando las indicaciones de
las guías, permite alcanzar el OT en más de las tres cuartas
partes de los previamente no controlados en el plazo de medio
año. Estos resultados nos deben estimular a superar la
inercia terapéutica en el control de la ECV mediante una
actuación precoz y enérgica ante la hipercolesterolemi
Audiencias críticas en Twitter frente a coberturas tránsfobas: la identidad de género como nuevo derecho y su tratamiento periodístico
Estrés oxidativo en judocas de élite sometidos al test de Sterkowicz
P. 380Se presenta una evaluación de los marcadores de estrés oxidativo para poder corregirlos mediante una intervención dietética específica.S
Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study
A corrigendum on
Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple
Sessions in Chronic Stroke Patients: A Feasibility Study
by Ibáñez, J., Monge-Pereira, E., Molina-Rueda, F., Serrano, J. I., del Castillo, M. D., Cuesta-Gómez,
A., et al. (2017). Front. Neurosci. 11:126. doi: 10.3389/fnins.2017.00126. In the recently published article, there were incorrect and missing contents in the
Acknowledgments section
- …