Luxación aislada del piramidal

ResumenAunque las luxaciones carpianas son lesiones relativamente frecuentes, la luxación aislada del piramidal es excepcional. Presentamos un caso aislado de luxación volar del hueso piramidal, revisando los casos similares publicados en la literatura y analizando los aspectos más importantes en relación con su diagnóstico y tratamiento.Varón de 38 años de edad, con caída sobre su mano derecha en hiperextensión. Inicialmente el diagnóstico pasó desapercibido. Al mes se realizó reducción abierta y estabilización con agujas de Kirchner.A los 4 años de la cirugía el paciente se encuentra asintomático y con la misma fuerza de agarre que la mano contralateral. Las radiografías postoperatorias muestran una buena reducción del carpo sin signos de inestabilidad.La falta de un diagnóstico inicial y en consecuencia un retraso en el tratamiento hacen más difícil el manejo de las lesiones, pero es una reducción inadecuada del carpo el factor pronóstico más negativo.AbstractAlthough carpal dislocations are a relatively common injury, isolated dislocation of the triquetrum is exceptional. The report of a new case is presented of isolated volar dislocation of the triquetrum, as well as an analysis of similar cases published in the literature. The main factors related to their diagnosis and treatment are also reviewed.A 38-year-old man fell and landed on his right hand in hyper-extension. Diagnosis was initially unnoticed. An open reduction and Kirchner wires stabilisation was performed one month later.Four years after surgery the patient was asymptomatic and with the same grip strength as contralateral hand. Post-operative X-rays were favourable with good carpal reduction and alignment and without carpal instability signs.The lack of an initial diagnosis and consequently a delayed treatment, make more difficult the injury management more difficult, but an inadequate carpal reduction the most negative prognostic factor

Evaluación de la accidentalidad en los pasos a nivel en La Habana, Cuba

El presente trabajo constituye una profundización de una investigaciónprevia realizada en Cuba en el año 2007 por los mismos autores, sobreel comportamiento de la accidentalidad en los pasos a nivel a escalanacional, en la cual fue identificada La Habana (capital de Cuba) comola provincia de mayor incidencia en estos hechos, lo cual será analizadodetalladamente.El análisis se centra en el aspecto estadístico con la recogida deinformación sobre los accidentes del tránsito con el objetivo dedeterminar los municipios de mayor concentración de los mismos, laslíneas donde ocurren, horas del día y tipos de vehículos automotores conlos que más colisionan los trenes, para luego, identificar por frecuenciade accidentes, los pasos a niveles más peligrosos en el territorio, a loscuales se le determinarán los factores que están incidiendo en estaaccidentalidad en la siguiente fase de la investigación

Performance evaluation for 68Ga and 18F of the ARGUS small-animal PET scanner based on the NEMA NU-4 standard

Proceeding of: 2010 IEEE Nuclear Science Symposium, Medical Imaging Conference and 17th Room Temperature Semiconductor Detector Workshop (IEEE), Knoxville, Tennessee, USA, October 30 - November 6, 201068Ga is one of the non-conventional nuclides that are being used in preclinical imaging. One disadvantage of 68Ga versus 18F is its larger positron range, which deteriorates the effective spatial resolution and the overall image quality. In this work we present a performance evaluation of the ARGUS smallanimal positron emission tomography (PET) scanner for two positron emitters, 68Ga and 18F. These experiments followed the procedure based on the National Electrical Manufacturers Association (NEMA) NU 4-2008 standard. We show how the use of 68Ga may affect the NEMA performance of the system in terms of image quality and spatial resolution. The recovery coefficients (RC) measured in the image-quality phantom ranged from 0.17 to 0.72 for 68Ga and from 0.28 to 0.92 for 18F, using iterative image reconstruction methods and applying all corrections. Under the same conditions the image noise (%STD) in a uniform region was 17.0% for 68Ga and 15.1% for 18F. The respective spillover ratios (SOR) were 0.13 and 0.09 in air, and 0.21 and 0.12 in water. Attenuation correction yielded an improvement of the SOR close to 50% for both radionuclides in the air-filled region. This work evaluates the image reconstruction methods and corrections available in the ARGUS PET for 68Ga and 18F to assess the influence of their physical properties on the NEMA parameters.Publicad

Survey of selected pathogens in free-ranging pinnipeds in Uruguay

Marine mammals, regarded as sentinels of aquatic ecosystem health, are exposed to different pathogens and parasites under natural conditions. We surveyed live South American fur seals Arctocephalus australis and South American sea lions Otaria flavescens in Uruguay for Leptospira spp., canine distemper virus (CDV), Mycobacterium spp., Toxoplasma gondii, and Neospora caninum. Samples were collected from 2007 to 2013. The seroprevalence of Leptospira spp. was 37.6% positive, 50.9% negative, and 11.5% suspect for A. australis (n = 61) while for O. flavescens (n = 12) it was 67% positive, 25% negative, and 8% suspect. CDV RNA was not detected in any of the analyzed samples. Most animals tested seropositive to tuberculosis antigens by WiZo ELISA (A. australis: 29/30; O. flavescens: 20/20); reactivity varied with a novel ELISA test (antigens MPB70, MPB83, ESAT6 and MPB59). Seroprevalence against N. caninum and T. gondii was 6.7 and 13.3% positive for O. flavescens and 0 and 2.2% positive for A. australis respectively. To evaluate possible sources of infection for pinnipeds, wild rats Rattus rattus and semi-feral cats Felis catus were also tested for Leptospira spp. and T. gondii respectively. Water samples tested for Leptospira revealed saprofitic L. bioflexa. Pathogenic Leptospira were detected in the kidneys of 2 rats, and cats tested positive for T. gondii (100%). These results represent a substantial contribution to the study of the health status of wild pinnipeds in Uruguay.CSIC (Council for Scientific Research) of the Universidad de la Republica.Peer reviewe

Cosmic evolution of submillimeter galaxies and their contribution to stellar mass assembly

The nature of galaxies selected at submillimeter wavelengths (SMGs, S_850 > 3 mJy), some of the bolometrically most luminous objects at high redshifts, is still elusive. In particular their star formation histories and source of emission are not accurately constrained. In this paper we introduce a new approach to analyse the SMG data. Namely, we present the first self-consistent UV-to-radio spectral energy distribution fits of 76 SMGs with spectroscopic redshifts using all photometric datapoints from ultraviolet to radio simultaneously. We find that they are highly star-forming (median star formation rate 713 MSun yr^-1 for SMGs at z>0.5), moderately dust-obscured (median A_V~2 mag), hosting significant stellar populations (median stellar mass 3.7x10^11 MSun) of which only a minor part has been formed in the ongoing starburst episode. This implies that in the past, SMGs experienced either another starburst episode or merger with several galaxies. The properties of SMGs suggest that they are progenitors of present-day elliptical galaxies. We find that these bright SMGs contribute significantly to the cosmic star formation rate density (~20%) and stellar mass density (~30-50%) at redshifts 2-4. Using number counts at low fluxes we find that as much as 80% of the cosmic star formation at these redshifts took place in SMGs brighter than 0.1 mJy. We find evidence that a linear infrared-radio correlation holds for SMGs in an unchanged form up to redshift of 3.6, though its normalization is offset from the local relation by a factor of ~2.1 towards higher radio luminosities. We present a compilation of photometry data of SMGs and determinations of cosmic SFR and stellar mass densities.Comment: Accepted to A&A. 14 pages (+23 pages as appendix), 7 figures, 6 tables. Table A1-A5 can be found in the source file in the machine-readable form. For SED templates, see http://archive.dark-cosmology.dk/ or the source file. v3: major improvements: 1) the incompleteness correction applied; 2) the (higher) local q-value correctly assigned; 3) estimates of A_V adde

Factors associated with therapeutic response in acromegaly diagnosed in the elderly in Spain

ContextSome reports suggest that acromegaly in elderly patients has a more benign clinical behavior and could have a better response to first-generation long-acting somatostatin receptor ligands (SRL). However, there is no specific therapeutic protocol for this special subgroup of patients. ObjectiveThis study aimed at identifying predictors of response to SRL in elderly patients. DesignMulticentric retrospective nationwide study of patients diagnosed with acromegaly at or over the age of 65 years. ResultsOne-hundred and eighteen patients (34 men, 84 women, mean age at diagnosis 71.7 +/- 5.4 years old) were included. Basal insulin-like growth factor type 1 (IGF-1) above the upper limit of normal (ULN) and growth hormone (GH) levels (mean +/- SD) were 2.7 +/- 1.4 and 11.0 +/- 11.9 ng/ml, respectively. The mean maximal tumor diameter was 12.3 +/- 6.4 mm, and up to 68.6% were macroadenoma. Seventy-two out of 118 patients (61.0%) underwent surgery as primary treatment. One-third of patients required first-line medical treatment due to a rejection of surgical treatment or non-suitability because of high surgical risk. After first-line surgery, 45/72 (63.9%) were in disease remission, and 16/34 (46.7%) of those treated with SRL had controlled disease. Patients with basal GH at diagnosis <= 6 ng/ml had lower IGF-1 levels and had smaller tumors, and more patients in this group reached control with SRL (72.7% vs. 33.3%; p < 0.04) [OR: 21.3, IC: 95% (2.4-91.1)], while male patients had a worse response [OR: 0.09, IC 95% (0.01-0.75)]. The predictive model curve obtained for SRL response showed an AUC of 0.82 CI (0.71-0.94). ConclusionsThe most frequent phenotype in newly diagnosed acromegaly in the elderly includes small adenomas and moderately high IGF-1 levels. GH at diagnosis <= 6 ng/ml and female gender, but not age per se, were associated with a greater chance of response to SRL

ESTILOS DE VIDA DE ESTUDIANTES UNIVERSITARIOS DE CIENCIAS DE LA SALUD

Objetivos: El objetivo de este artículo es realizar una revisión de las publicaciones que revelen el impacto de los estilos de vida en la salud integral de estudiantes universitarios del área ciencias de la salud. Métodos : La revisión fue efectuada mediante búsqueda electrónica de artículos relacionados con estilos de vida en estudiantes universitarios pertenecientes a las escuelas de ciencias de la salud. Las fuentes de búsqueda fueron ISI, SCIELO, MEDLINE, BVS y PUBMED. Los términos de búsqueda fueron: estilo de vida, estudiantes universitarios y ciencias de la salud. Para esta revisión se seleccionaron los artículos publicados que tuvieron experiencias investigativas desde el 2010 a la actualidad y los que incluyeron aspectos teórico-conceptuales se consideró los publicados desde el año 2000. Resultados: De los 83 artículos revisados, se descartaron 38 por no cumplir con el criterio de haber realizado la investigación en el área de ciencias de la salud, y 12 fueron retirados por ser publicados antes del 2010, quedando solo 33 artículos para esta revisión bibliográfica. De los 33 artículos seleccionados, 18 estudios cumplieron con los criterios de investigación, 15 fueron considerados para incluir aspectos teórico – conceptuales. Respecto a la actividad física, un estudio evidenció que el 40% de los jóvenes universitarios no realiza ningún ejercicio físico; otra investigación demostró que solo el 44% de los estudiantes de ciencias de la salud practicaban los recomendados 30 minutos de ejercicio 5 días por semana. Además los patrones alimentarios de los estudiantes fueron inadecuados, haciéndose necesario un cambio en el 90% de la población, siendo la “comida chatarra” la que más consumieron los participantes. Por otro lado, los datos de un estudio revelaron que 1 de cada 5 de los estudiantes universitarios presentan alteraciones en su salud mental y el consumo de tabaco y/o drogas, aparece como factor de riesgo. Conclusión: La mayoría de los estudiantes universitarios de ciencias de la salud no aplican sus conocimientos en sus propios estilos de vida (alimentación, actividad física y demás prácticas). Esto revela la urgencia de crear programas universitarios que modifiquen y promuevan estilos de vida saludable. DOI:https://doi.org/10.25176/RFMH.v16.n2.67

SINDROME DE BURNOUT EN ESTUDIANTES UNIVERSITARIOS: TENDENCIAS ACTUALES

Objetivo: Realizar una actualización del Síndrome de Burnout en estudiantes universitarios. Métodos: Revisión sistemática de artículos científicos relacionados con el tema. Los artículos científicos se obtuvieron a través de las siguientes bases de datos: PubMed, Lillacs, Cochrane. Los criterios de inclusión utilizados para seleccionar los artículos base para esta revisión fueron: 1) que tengan título con las palabras clave de la investigación, 2) con población de estudio en estudiantes universitarios, 3) publicados desde el año 2010 que estén relacionados al tema de investigación. Resultados: De 34 artículos revisados en total 12 cumplieron con los criterios de investigación. La prevalencia del Síndrome de Burnout universitario varía entre el 8% y el56,9% de acuerdo a la población estudiada. Conclusión: La prevalencia del síndrome de burnout en estudiantes universitarios es significativa, afectando los tres dominios: agotamiento emocional, cinismo y rendimiento académico, por lo que su evaluación amerita futuras investigaciones. &nbsp; DOI:https://doi.org/10.25176/RFMH.v16.n1.33

Long-term adherence to IFN beta-1a treatment when using rebismart1device in patients with relapsing-remitting multiple sclerosis

The effectiveness of disease-modifying drugs in the treatment of multiple sclerosis is associated with adherence. RebiSmart® electronic device provides useful information about adherence to the treatment with subcutaneous (sc) interferon (IFN) ß-1a (Rebif®). The aim of the study was to determine long-term adherence to this treatment in patients with relapsing- remitting multiple sclerosis (RRMS). This retrospective multicentre observational study analysed 258 patients with RRMS who were receiving sc IFN ß-1a (Rebif®) treatment by using RebiSmart® until replacement (36 months maximum lifetime) or treatment discontinuation. Adherence was calculated with data (injection dosage, time, and date) automatically recorded by RebiSmart®. Patients in the study had a mean age of 41 years with a female proportion of 68%. Mean EDSS score at start of treatment was 1.8 (95% CI, 1.6-1.9). Overall adherence was 92.6%(95% CI, 90.6-94.5%). A total of 30.2% of patients achieved an adherence rate of 100%, 80.6% at least 90%, and only 13.2% of patients showed a suboptimal adherence (<80%). A total of 59.9% of subjects were relapse-free after treatment initiation. Among 106 subjects (41.1%) who experienced, on average, 1.4 relapses, the majority were mild (40.6%) or moderate (47.2%). Having experienced relapses from the beginning of the treatment was the only variable significantly related to achieving an adherence of at least 80% (OR = 3.06, 1.28-7.31). Results of this study indicate that sc IFN ß-1a administration facilitated by RebiSmart® could lead to high rates of adherence to a prescribed dose regimen over 36 months