Abordaje transvasto mínimamente invasivo versus abordaje parapatelar medial convencional en la artroplastia total de rodilla en pacientes con gonartrosis: estudio prospectivo comparativo no randomizado

Objetivos: valorar y comparar los resultados a corto plazo de la artroplastia total de rodilla realizada mediante dos vías de abordaje. Material y métodos: estudio prospectivo comparativo que compara abordaje parapatelar medial (24 pacientes) y transvasto mínimamente invasivo (25 pacientes) en artroplastia total de rodilla. Se incluyeron pacientes con gonartrosis grado IV de la clasificación de Kellgren-Lawrence y se excluyeron aquellos menores de 50 años, deformidad en varo (> 15º) o valgo (> 10º), artrosis postraumática, artritis reumatoide, cirugías de revisión, osteotomías correctoras previas, IMC > 40 kg/m2, infección activa local o sistémica y/o deterioro mental. Resultados: se encontraron diferencias estadísticamente significativas en dolor del primer y segundo día postoperatorios a favor del abordaje mínimamente invasivo (1º día: 3,8 ± 2,5 vs. 6,7 ± 2,1; p< 0,001. 2º día: 3 ± 2,1 vs. 6 ± 2; p< 0,001). Conclusiones: no existen diferencias relevantes entre ambos abordajes, por lo que se recomienda la utilización del abordaje con el que el cirujano se encuentre más cómodo y familiarizadoAim: Assess and compare short-term outcomes of total knee arthroplasty performed using two surgical approaches. Material and methods: a prospective study with 49 patients comparing medial parapatellar approach (24 patients) and minimally invasive trans-vastus access (25 patients) in total knee replacement. The patients included suffered knee osteoarthritis grade IV the Kellgren-Lawrence’s classification. Exclusion criteria were age under 50 years, large axial deformity (varus deformity > 15° or valgus > 10°), posttraumatic osteoarthritis, rheumatoid arthritis, revision surgeries, previous osteotomies, BMI> 40 kg/m2 and of course local or systemic active infection and mental impairment. Results: statistically significant differences were found for pain in first and second postoperative days for the minimally invasive approach (1st day: 3.8 ± 2.5 vs. 6.7 ± 2.1; p <0.001. 2nd day: 3 ± 2.1 vs. 6 ± 2; p <0.001). Conclusions: there are not significant differences between mini and standard approaches in knee replacement, so decision about which access to use in knee reconstruction surgery depends on surgeon’s preferences

17. EL APRENDIZAJE INTEGRAL A TRAVÉS DE LA STEM, REFLEXIONES SOBRE SU APLICACIÓN EN LA EDUCACIÓN EN LAS INSTITUCIONES EDUCATIVAS EN MEDELLÍN

Medellín reconocida como la ciudad innovadora del mundo y epicentro de la cuarta revo­lución industrial, tiene un reto y un compromiso con estos dos momentos, modernizar la educación apor­tando al desarrollo de habilidades de pensamiento enfocados a la ciencia y la tecnología, y promover en todos los entornos habilidades para la vida. Uno de los desafíos más importantes en la educación es el desarrollo de una formación integral, lograr que los estudiantes y maestros, apropien disciplinas que necesitan para un desarrollo más sistémico en lo profesional. STEM por sus siglas en ingles Science, Technology, Engineering and Mathematics, es una metodología que posiblemente se ha aplicado en el entorno local, sin darle la connotación que tiene, considerada necesaria para el eficiente desarrollo de los profesionales del futuro. Las disciplinas que se agrupan en esta metodología permiten integrar habilidades duras y blandas en un solo ejercicio, buscando desarrollar competencias necesarias para responder a las actuales necesidades del mercado. El objetivo de esta propuesta de reflexión es realizar una revisión sobre la aplicación de la metodología STEM en la educación en Medellín, aplicando la metodología sistemática para hacer el rastreo y la revisión bibliográfica

Efficacy and safety of HCV-treatment with direct-acting antiviral agents interferon-free, in patients with severe renal impairment in clinical practice

Abstrac

Deep-sequencing reveals broad subtype-specific HCV resistance mutations associated with treatment failure

A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) a-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of “extra-target” RAS suggests the need for RAS screening in all three DAA target regions

Delineating the molecular and phenotypic spectrum of the SETD1B-related syndrome

Purpose: Pathogenic variants in SETD1B have been associated with a syndromic neurodevelopmental disorder including intellectual disability, language delay, and seizures. To date, clinical features have been described for 11 patients with (likely) pathogenic SETD1B sequence variants. This study aims to further delineate the spectrum of the SETD1B-related syndrome based on characterizing an expanded patient cohort. Methods: We perform an in-depth clinical characterization of a cohort of 36 unpublished individuals with SETD1B sequence variants, describing their molecular and phenotypic spectrum. Selected variants were functionally tested using in vitro and genome-wide methylation assays. Results: Our data present evidence for a loss-of-function mechanism of SETD1B variants, resulting in a core clinical phenotype of global developmental delay, language delay including regression, intellectual disability, autism and other behavioral issues, and variable epilepsy phenotypes. Developmental delay appeared to precede seizure onset, suggesting SETD1B dysfunction impacts physiological neurodevelopment even in the absence of epileptic activity. Males are significantly overrepresented and more severely affected, and we speculate that sex-linked traits could affect susceptibility to penetrance and the clinical spectrum of SETD1B variants. Conclusion: Insights from this extensive cohort will facilitate the counseling regarding the molecular and phenotypic landscape of newly diagnosed patients with the SETD1B-related syndrome

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

2010 IEEE ANDESCON Conference Proceedings, ANDESCON 2010

563287

Scientific literature analysis on sustainability with the implication of open innovation

Studies related to sustainability have been performed extensively around the world to evaluate the environmental, economic, and social impact of practices that meet the current and future needs of society. Based on the Scopus database, this study presents a bibliometric analysis for the long, medium, and short term to represent the characteristics of publications related to sustainability, identify research trends and thematic areas with a promising future in research. The analysis covers the following topics: general statistical description, most addressed thematic areas in sustainability, the geographical distribution of sustainability publications, and most influential and cited journals, authors, and articles. The results show sustainability prevails in areas like Engineering, Energy, Environmental Science, and Business, Management, and Accounting, and the publication rate in this field has increased exponentially in the last 10 years. This study also shows that the most productive journals in sustainability research are Sustainability Switzerland and Journal of Cleaner Production, focusing on interdisciplinary and transdisciplinary topics. Likewise, the critical issues of sustainability research are related to sustainable development, humans, environmental sustainability, climate change, decision-making, and environmental impact. As sustainability with open innovation represents a topic with an increasing number of publications, future research can be oriented toward this topic. © 2020 by the authors. Licensee MDPI, Basel, Switzerland