Infecciones graves de prótesis total de cadera tratadas con artroplastia - resección e irrigación contínua

Han sido tratados mediante resección-artroplástica, al modo de Girdlestone, nueve casos de importante infección de prótesis total de cadera, con una clínica de flemón articular grave o de infección crónica. El método operatorio ha sido completado con la irrigación continua, la tracción esquelética y la descarga con férula de apoyo isquiático. El análisis de los resultados recae sobre los hallazgos operatorios, el control de la irrigación con fistulografías, la evolución bacteriana, la repercusión hemática, el control de la VSG y el balance funcional. Estos resultados han sido satisfactorios en todos los casos por la cicatrización y el secamiento de la infección y en siete casos por la indolencia y la excelente movilidad; la deambulación es inestable y requiere muleta

Tratamiento de las osteitis diafisarias de tibia mediante sinostosis tibioperonea y resección ósea

El tratamiento de las osteítis crónicas de la diáfisis tibial obliga a menudo a practicar una amplia resección para alcanzar el tejido óseo sano y esta exigencia operatoria debilita la diáfisis. Para obviar la fractura operatoria o posterior por fatiga y para facilitar la resección sin temor se ha utilizado una táctica quirúrgica consistente en una solidarización tibioperonea que construye un residente eje en la pierna ya sea mediante injerto intertibioperoneo ya con peroné protibia de Zanoli. Bajo la protección ósea de este bloque, la resección puede llevarse tan lejos como sea necesario, tánica garantía de evitar la recidiva. Ha sido aplicado a ocho casos con éxito. El plazo de sinostosis es de tres a cuatro meses y la resección en forma de «salserización» va seguida de la cobertura cutánea. Este tiempo no es previsible y su dificultad y duración son función de la técnica que se elija para cada caso. Hemos precisado entre dos y cuatro meses para obtener la cobertura de piel

Beliefs in conspiracy theories about COVID-19 vaccines in the Andean Community of Nations

Los estudios sobre aceptación y rechazo hacia las vacunas, así como la creencia en teorías conspirativas, y la falta de confianza en los gobiernos y la ciencia, han sido importantes para analizar el proceso de vacunación contra el COVID-19 a nivel mundial, pero han sido bastante limitados, hasta el momento, para el caso de América Latina. En este sentido, el objetivo de este trabajo consiste en describir el grado de aceptación o no a ciertas creencias de conspiración sobre las vacunas contra la COVID-19 en una muestra de países miembros de la Comunidad Andina de Naciones (CAN): Bolivia, Colombia, Ecuador y Perú. Se diseñó un estudio transversal descriptivo en el que participaron 1835 personas de Bolivia, Colombia, Ecuador y Perú. Para la evaluación de estas creencias se utilizó la Escala de Creencias de Conspiración de Vacunas COVID-19 (ECCV-COVID, Caycho-Rodríguez et al., 2022a). Los resultados indican que, el Perú presenta el mayor puntaje promedio de creencias de conspiración sobre las vacunas contra la COVID19. Además, en los 4 países el menor grado de aceptación es con la creencia sobre “Vacunar a los niños contra la COVID-19 es perjudicial y este hecho está ocultado”. En Colombia, Ecuador y Perú el mayor grado de aceptación está referida a la creencia conspirativa referida a que “La información sobre la seguridad de las vacunas contra la COVID-19 a menudo se inventan”. Finalmente, en Bolivia, el mayor grado de aceptación es con la creencia de que “Las empresas farmacéuticas ocultan los peligros de las vacunas contra la COVID-19”. Los resultados presentados en este estudio son los primeros que se conoce de forma genérica en población latinoamericana, y particularmente, en la población Andina.Studies on the acceptance and rejection of vaccines, as well as the belief in conspiracy theories, and the lack of trust in governments and science, have been important to analyze the vaccination process against COVID-19 worldwide, but they have been quite limited, so far, in the case of Latin America. In this sense, the objective of this work is to describe the degree of acceptance or not of certain conspiracy beliefs about vaccines against COVID-19 in a sample of countries members in the Andean Community of Nations (CAN): Bolivia, Colombia, Ecuador and Peru. A descriptive cross-sectional study was designed in which 1835 people from Bolivia, Colombia, Ecuador and Peru participated. To evaluate these beliefs, the COVID-19 Vaccine Conspiracy Belief Scale (ECCV-COVID, Caycho-Rodríguez et al., 2022a) was used. The results indicate that Peru has the highest average score of conspiracy beliefs about vaccines against COVID-19. In addition, in the 4 countries, the lowest degree of acceptance is with the belief that "Vaccinating children against COVID-19 is harmful and this fact is hidden". In Colombia, Ecuador and Peru, the highest degree of acceptance is related to the conspiratorial belief that "Information on the safety of vaccines against COVID-19 is often invented." Finally, in Bolivia, the highest degree of acceptance is with the belief that "Pharmaceutical companies hide the dangers of vaccines against COVID-19". The results presented in this study are the first known generically in the Latin American population, and particularly in the Andean population.Fil: Caycho Rodríguez, Tomás. Universidad Privada del Norte; PerúFil: Gallegos de San Vicente, Miguel Omar. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Pontifícia Universidade Católica de Minas Gerais; BrasilFil: Valencia, Pablo D.. Facultad de Estudios Superiores Iztacala; MéxicoFil: Vilca, Lindsey W.. Universidad Norbert Wiener; PerúFil: Moreta Herrera, Rodrigo. Pontificia Universidad Católica del Ecuador; EcuadorFil: Puerta Cortés, Diana Ximena. Universidad de Ibagué; ColombiaFil: Tapia, Bismarck Pinto. Universidad Catolica Boliviana; Bolivi

L'artroplàstia-ressecció com a tractament de pròtesis totals d'anca infectades

La pròtesi total d'anca ha estat la solució funcional que ha permès molts malalts de conservar una mobilitat indolora i estalviar-se el greu preu que representava l'artròdesi o la inestabilitat d'una ressecció artroplàstica tipus operació de Girdlestone. Però la cirurgia dels empelts protèsics exigeix una tècnica molt acurada per tal de no caure en la infecció postoperatòria, que és el gran risc immediat i llunyà. Algunes infeccions es presenten en el postoperatori immediat però d'altres evolucionen lentament i es manifesten passat un any. La innovació de les sales operatòries amb aire laminar ha fet descendir notablement el percentatge d'infeccions però en alguns llocs quirúrgics amb utillatge deficient encara es produeixen en xifres excessivament altes

La amputación del pie según técnica de Pirogoff-Maurer

El planteo de las dificultades técnicas que presentan las amputaciones del pie en su aspecto anatómico y funcional nos lleva a escoger como electiva la técnica de Pirogoff. Maurer, aplicada de modo satisfactorio en tres pacientes. Exponemos los detalles técnicos de la intervención y las bases de la prótesis de pierna con apoyo patelar y pie de tipo Sachs. El análisis de los métodos de amputación de Syme, de Boyd, de Vasconcelos, de Chopart y de Ricard pone de relieve los inconvenientes de cada uno de ellos habida cuenta de las posibilidades protésicas actuales. Así se confirma la prioridad que en la elección recae sobre el método utilizado por nosotros con un resultado plenamente bueno tanto en el aspecto formal como funciona

Espondilitis piógenas del adulto. Análisis de 15 casos

La espondilitis piógena es una entidad clínica poco frecuente que últimamente ha experimentado un considerable aumento, relacionado con la adicción a drogas por vía parenteral. Se presentan 15 casos tratados en el período entre 1981-1988. La etiología más frecuente fue el estafilococo dorado (53%), seguida de gérmenes gramnegativos (47%). Es de destacar la presencia de factores predisponentes en un 47% de pacientes. El cuadro clínico consistió en una raquialgia acompañada de fiebre en el 73% de los casos. La radiología era normal en las etapas iniciales, pero no la gammagrafía con Ga y Te. El tratamiento fue inicialmente conservador, estando indicada la cirugía cuando se presentaron alteraciones neurológicas, abscesos paravertabrales o imposibilidad diagnóstica. En la serie presentada, 4 de los J5 pacientes fueron sometidos a tratamiento quirúrgic

COVID-19 anxiety, psychological well-being and preventive behaviors during the COVID-19 pandemic in Latin America and the Caribbean: relationships and explanatory model

This study assesses the relationship between COVID-19 anxiety and subjective well-being in terms of the mediating role of COVID-19 preventive behaviors. Additionally, the contribution of sociodemographic factors (sex and age) and risk perception on COVID-19 anxiety and its potential measurement invariance was tested in 5655 participants from 12 countries in Latin America and the Caribbean. A mixture of both latent and observable variables were analyzed using a system of structural equations. The Coronavirus Anxiety Scale (CAS), Preventive COVID-19 Infection Behaviors Scale (PCIBS) and single-item measures were used to assess the perceived probability of death, perceived severity and concern about transmitting COVID-19. The results indicated that there is a significant and relevant direct effect of COVID-19 anxiety on participants' well-being. Furthermore, COVID-19 anxiety significantly predicted both preventive behavior (β = .29, p < .01) and well-being (β = –.32, p < .01). The effects of COVID anxiety and preventive behavior explained 9.8% of the variance in well-being (R-square = .098); whereas, 8.4% of the variance in preventive behavior was associated with COVID anxiety (R-square = .084). Likewise, perceived likelihood of death from COVID, perceived severity of COVID, and concerns about COVID transmission were positively related to anxiety. Age was negatively related to anxiety, with men being less anxious than women. The results are invariant by country, i.e., the broad relationships found in the combined sample are also present in each individual country. The findings indicate that, although the exact relationships between variables may vary between countries, there are enough similarities to provide useful information about the impact of the COVID-19 pandemic in each of the countries included in the study

Is the meaning of subjective well-being similar in Latin American countries? A cross-cultural measurement invariance study of the WHO-5 well-being index during the COVID-19 pandemic

"Background: There is an urgent need to assess changes in well-being on a multinational scale during the COVID-19 pandemic, thus culturally valid scales must be available. Methods: With this in mind, this study examined the invariance of the WHO well-being index (WHO-5) among a sample of 5183 people from 12 Latin Americans countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, and Uruguay). Results: The results of the present study indicate that the WHO-5 is strictly invariant across samples from different Latin American countries. Furthermore, the results of the IRT analysis indicate that all items of the WHO-5 were highly discriminative and that the difficulty required to respond to each of the five items is ascending. Additionally, the results indicated the presence of moderate and small size differences in subjective well-being among most countries. Conclusion: The WHO-5 is useful for assessing subjective well-being in 12 Latin American countries during the COVID-19 pandemic, since the differences between scores can be attributed to differences in well-being and not in other characteristics of the scale.

What Is the Support for Conspiracy Beliefs About COVID-19 Vaccines in Latin America? A Prospective Exploratory Study in 13 Countries

Conspiracy theories about COVID-19 began to emerge immediately after the first news about the disease and threaten to prolong the negative impact of the COVID-19 pandemic by limiting people’s willingness of receiving a life-saving vaccine. In this context, this study aimed to explore the variation of conspiracy beliefs regarding COVID-19 and the vaccine against it in 5779 people living in 13 Latin American countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela) according to sociodemographic variables such as gender, age, educational level and source of information about COVID-19. The study was conducted during the COVID-19 pandemic between September 15 and October 25, 2021. The Spanish-language COVID-19 Vaccine Conspiracy Beliefs Scale (ECCV-COVID) and a sociodemographic survey were used. The results indicate that, in most countries, women, people with a lower educational level and those who receive information about the vaccine and COVID-19 from family/friends are more supportive of conspiracy ideas regarding the COVID-19 vaccine. In the case of age, the results vary by country. The analysis of the responses to each of the questions of the ECCV-COVID reveals that, in general, the countries evaluated are mostly in some degree of disagreement or indecision regarding conspiratorial beliefs about COVID-19 vaccines. The findings could help open further study which could support prevention and treatment efforts during the COVID-19 pandemic

Design and Cross-Cultural Invariance of the COVID-19 Vaccine Conspiracy Beliefs Scale (COVID-VCBS) in 13 Latin American Countries

"Aims: Over the past 2 years, the vaccine conspiracy beliefs construct has been used in a number of different studies. These publications have assessed the determinants and outcomes of vaccine conspiracy beliefs using, in some cases, pooled data from different countries, and compared the results across these contexts. However, studies often do not consider measurement invariance as a necessary requirement for comparative analyses. Therefore, the aim of this study was to develop and evaluate the crosscultural MI of the COVID-19 Vaccine Conspiracy Beliefs Scale (COVID-VCBS) in 12 Latin American countries. Methods: Confirmatory factor analysis, item response theory analysis and alignment method were applied to test measurement invariance in a large number of groups. Results: The COVID-VCBS showed robust psychometric properties and measurement invariance for both factor loadings and crosstabs. Also, a higher level of acceptance of conspiracy beliefs about vaccines is necessary to respond to higher response categories. Similarly, greater acceptance of conspiracy beliefs about COVID-19 vaccines was related to a lower intention to be vaccinated. Conclusion: The results allow for improved understanding of conspiracy beliefs about COVID-19 vaccines in the countries assessed; furthermore, they provide researchers and practitioners with an invariant measure that they can use in cross-cultural studies in Latin America. However, further studies are needed to test invariance in other countries, with the goal of developing a truly international measure of conspiracy beliefs about COVID-19 vaccines.