Plastia sustitutiva del LCA con tendones de la pata de ganso cuadruples

Se han estudiado retrospectivamente 44 casos de pacientes a los que se les realizó por vía artrocóspica una plastia sustitutiva intraticular de reconstrucción del LCA, con tendones de Semitendinoso y Recto Interno antólogos, en 4 fascículos. La edad media de los pacientes fue de 25 años. Los resultados a corto plazo (2 años) obtenidos con KT-1000 a 30 Ib han sido excelente-bueno en 40 casos y aceptable en 4 casos. Cuatro casos referían sensación de inestabilidad. Los test de Lachman y Pívot-Shift fueron positivos en 3 casos. Con el test de Lysholm se obtuvo resultado excelente-bueno en 36 casos, regular en 6 y malo en 2 casos. Este tipo de plastia presenta una baja morbilidad de la zona dadora del injerto, comparativamente con la plastia HTH patelar antóloga, y sin alteración del aparato extensor.A retrospective study of 44 patients, who underwent an arthroscopically assisted ACL (anterior cruciata ligament) reconstruction with quadrupled semitendinosus/gracilis tendon autografts was performed. The mean age was 25 years. Short term outcomes of knee stability (2 years follow-up) with KT-1000 arthrometer at 30 pounds were excellent or good in 40 cases and acceptable in 4. Pain or joint swelling were not found. Instability complaints were found in 4 cases. Lachman and Pivot-shift were found positive in 3 cases. Lysholm questionnaire scores were excellent or good in 36 cases, fair in 6 cases and per in two cases, the donor site morbidity associated with hamstring harvest seems to be minimal compared with bonepatellar tendon-bone autograft without impairment of the extensor mechanism

Lubrication Performance of Sunflower Oil Reinforced with Halloysite Clay Nanotubes (HNT) as Lubricant Additives

This study evaluates the tribological performance of nanolubricants of a vegetable oil (sunflower oil) reinforced with different concentrations of environmentally-friendly nanoparticles of halloysite clay nanotubes (HNTs). Tribological characterization was performed under different conditions to determine its effect on the nanolubricants’ performance and optimal HNT concentration. The tribological performances under low and high contact pressures were analyzed with a block-on-ring tribometer following the ASTM G-077-05 standard procedure. The extreme pressure (EP) properties of the nanolubricants were determined with a T-02 four-ball tribotester according to the ITeE-PIB Polish method for testing lubricants under scuffing conditions. In addition, the lubrication performance of the newly-developed vegetable oil-based nanolubricants was evaluated in an industrial-type application through a tapping torque test. The results indicated that at a low contact pressure 1.5 wt.% HNTs/sunflower oil provided the best tribological behavior by decreasing the coefficient of friction (COF) and wear volume loss by 29 and 70%, respectively. For high contact pressures, 0.05 wt.% HNTs lowered COF and wear by 55% and 56%, respectively. The load-carrying capacity increased by 141% with 0.10 wt.% HNTs compared to the sunflower oil. A high tapping torque efficiency was obtained with HNTs that can prolong tool life in the machining process. Therefore, this study suggests that HNTs/sunflower oil could be used as green lubricants for industrial applications

Theory of Mind in Borderline Personality Disorder A Possible Endophenotypic Factor

The purpose of this study is to examine whether theory of mind (ToM) is an endophenotypic marker of borderline personality disorder (BPD), thus constituting an etiopathogenic factor of the disease. This would suggest familial vulnerability to BPD. This was a case-control study involving 146 individuals with 57 BPD patients, 32 first-degree relatives, and 57 controls (median age of BPD and control = 33.4 years; relatives = 52.9 years; BPD females and controls = 91.2%; female relatives = 62.5%). All the participants completed the Spanish version of the Movie for the Assessment of Social Cognition test to evaluate the ToM subclassification: interpretation of emotions, thoughts and intentions. BPD patients and their healthy first-degree relatives exhibited significant deficits in the correct interpretation of emotions and intentions compared to healthy controls. Both patients with BPD and their healthy first-degree relatives exhibited significant deficits in ToM, which suggests that it may be an etiopathogenic factor of BPD, and ToM (interpretation of emotions, thoughts and intentions) is a possible endophenotypic marker of BPD, suggesting a genetic predisposition to the disorder. Therefore, ToM could be considered as an indicator for the early detection of the disorder of and intervention for BPD

VALIDACIÓN NUMÉRICA Y EXPERIMENTAL DE UN ARO DE FIJACIÓN EXTERNA ILIZAROV PARA FRACTURAS

La validación numérica de sistemas biomecánicos sigue siendo un tema de interés. Por lo anterior, este trabajo tiene como objetivo determinar y analizar el comportamiento mecánico del sistema de fijación externa circular Ilizarov (F.E.C) y su validación numérica por M.E.F con resultados de pruebas experimentales por extensometria basadas en ASTM F-1541-02 A.3 (Standard Specification and Test Methods for External Skeletal Fixation Device) [1], en donde previamente se fabricaron probetas en base a ASTM-E8M [3]. A través de este trabajo se obtuvieron el diagrama fuerza-deformación de la prueba experimental, por medio de un  sistema adquisitor, utilizando extensometria con strain-gages [2], y se compararon los resultados contra un análisis numérico del tipo multi-lineal isotrópico, Los resultados presentan una comparación entre los resultados por simulación numérica y experimental, se muestran  la rigidez, curvas de fuerza versus desplazamiento,  esfuerzo y fuerza versus deformación unitaria, en donde se obtuvo  el diagrama fuerza- desplazamiento, con una fuerza al punto de fluencia de 1800 N, con su respectivo desplazamiento de 3.4 mm, de lo que se calcula la rigidez del fijador y se obtiene el valor de 530 N/mm, con lo cual , se excede el criterio interno T.D.I, el cual define parámetros de rigidez y fuerza para la aceptación de dispositivos médicos, la simulación del aro y su validación son parte de las pruebas requeridas por la COFEPRIS, para la regulación sanitaria correspondiente a pruebas biomecánicas en dispositivos médicos.Este trabajo permitió observar los efectos estructurales del aro de fijación externa de manera experimental y la validación de su modelo numérico. Adicionalmente se lograron simular las no-linealidades por contacto en la región de unión del aro, obteniendo buenos resultados no solo cualitativos, si no también cuantitativos. Finalmente, los resultados obtenidos en este trabajo permitirán simular de manera confiable, el sistema completo de fijación externa circular Ilizarov y con ello tener un modelo numérico completo de este sistema para estudios e investigación posteriores.Palabra(s) Clave(s): F.E.C. Ilizarov, Aro, Strain-gage, Traumatología por osteosíntesis, Prueba de compresión, Elemento finito

Compassion Fatigue, Compassion Satisfaction, and Burnout in Oncology Nurses: A Systematic Review and Meta-Analysis

Professionals working in cancer care are exposed to strong sources of stress. Due to the special characteristics of this unit, the appearance of burnout, compassion fatigue, and low compassion satisfaction is more likely. The principal aim was to analyze the levels and prevalence of burnout, compassion fatigue, and low compassion satisfaction in oncology nurses and interventions for its treatment. The search for the systematic review was done in Medline, ProQuest, Lilacs, CINAHL, Scopus, Scielo, and PsycINFO databases, with the search equation “burnout AND nurs* AND oncology AND compassion fatigue”. The results obtained from the 15 studies confirmed that there are levels of risk of suffering burnout and compassion fatigue among nursing professionals, affecting more women and nurses with more years of experience, with nurses from oncology units having one of the highest levels of burnout and compassion fatigue. The oncology nurse sample was n = 900. The meta-analytic estimations were 19% for low compassion satisfaction, 56% for medium and high burnout, BO, and 60% for medium and high compassion fatigue. The increase in cases of burnout and compassion fatigue in nursing staff can be prevented and minimized with a correct evaluation and development of intervention programs, considering that there are more women than men and that they seem to be more vulnerable

Consenso mexicano para el diagnóstico y tratamiento de la dermatitis atópica en adolescentes y adultos

Abstract Background: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. Objective: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care. Methods: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from intense electronic communication, several issues of disagreement were discussed in two face-to-face meetings. Results: The clinical experts reached consensus on 46 statements related to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to general care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes —low level evidence—) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimination diet, if there is an IgE-mediated respiratory or food allergy, respectively. Conclusion: The panel of experts reached consensus on relevant aspects of AD with a focus on the transcultural adaptation of recent evidence. Keywords: Atopic dermatitis; Atopic dermatitis treatment; Consensus; Cyclosporin A; Biological treatment; Dupilumab; Omalizumab. Resumen Antecedentes: Los abordajes diagnósticos y las estrategias terapéuticas de la dermatitis atópica generalmente son inconsistentes entre los médicos y entre las instituciones de salud. Objetivo: Consensar las opiniones de expertos para reducir las variaciones en la práctica respecto al diagnóstico y tratamiento de pacientes ≥ 12 años con dermatitis atópica para mejorar su cuidado. Métodos: Búsqueda sistemática de la literatura en PubMed y GREAT. Con apoyo metodológico y utilizando el método Delphi se desarrolló un consenso formal entre 16 expertos en dermatología y alergología, basándose en la evidencia actual y su aplicabilidad en el contexto mexicano. A parte de una comunicación electrónica intensa, se discutieron los puntos en desacuerdo en dos reuniones presenciales. Resultados: Los expertos clínicos alcanzaron consenso en 46 declaraciones relacionadas con la definición, clasificación, estrategias de diagnóstico y tratamiento de la dermatitis atópica. Para el diagnóstico sugerimos se usan los criterios de Williams y el SCORAD (por parte del médico) y POEM (por parte del paciente) para definir la gravedad. Aunado a cuidados generales y educación terapéutica, sugerimos cuatro pasos para tratamiento, según gravedad: 1. Manejo tópico con antiinflamatorio (y sistémico: antihistamínico/ antileucotrieno —evidencia reducida—) 2. Fototerapia, 3. Ciclosporina A y 4. Dupilumab, con la posibilidad de manejarlo antes si se necesita efecto rápido. En la dermatitis atópica extrínseca sugerimos agregar inmunoterapia con alérgenos o una dieta de eliminación si existe una alergia IgE-mediada, inhalatoria o alimentaria, respectivamente. Conclusión: El panel de expertos realizó consenso en aspectos relevantes de la dermatitis atópica con enfoque en la adaptación transcultural de evidencia reciente. Palabras clave: Dermatitis atópica; Ciclosporina A; Tratamiento biológico; Dupilumab; Omalizumab; Posición de consenso

SELNET clinical practice guidelines for bone sarcoma

Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context