Outcomes After Rib Fracture in Elderly Patient Due To Blunt Trauma At Doctors Renaissance Hospital

Background: Blunt trauma remains the most common traumatic reason for presentation at a hospital. Despite their frequency, there remains high morbidity and mortality. This is particularly true amongst the elderly. About 16.5 percent of the American population was 65 years old or over in 2019. This number is projected to reach 22 percent in 2050. Some clinical guidelines requiring admission to an intensive care setting in trauma centers for elderly patients with two or more rib fractures have been adopted by some trauma centers. Usage of these guidelines may lead to significant decreases in hospital stats, ICU stats, and use of mechanical ventilation. However, the effectiveness of these guidelines has not been validated across different institutions. Hence, in our study we sought to determine the mortality rate of elderly patients with ribs fracture compared to patients \u3c 65 years of age at Doctor Renaissance Hospital (Level I trauma center). We also investigated the relationship between the side of injury, the need for mechanical ventilation, ICU length of stay, and overall length of hospital stay. Methods: We performed a retrospective cohort study involving all blunt trauma patients between 18 – 100 years with rib fractures, excluding those with major vascular injuries or those needing emergent surgery due to other injuries. Patients admitted to Doctor renaissance Hospital (Level I trauma) between 2017 – 2020 were divided into two groups. The experimental group consisted of 58 patients aged 65 years or older. The control group was made of 75 patients aged \u3c 65 years old admitted during the same time. (table 1) Outcomes parameters included pulmonary complications (such as pneumonia or respiratory failure), number of ventilator days, intensive care unit length and hospital stay, disposition, and mortality. Results: In the experimental group, 58 patients were identified. These patients were divided into four groups: those with right-sided rib fractures, left-sided rib fractures, and unspecified and bilateral rib fractures. The overall mortality was 1.72 % compared to 4 % in the control group (p \u3c 0.05). Patients with right-sided rib fractures had a median hospital length of stay of 4 days vs. 6 days in the control group (p \u3c 0.05) (figure 2). We found no difference in the number of days spent in ICU between the control and experimental group with right-sided rib fractures. Patients with left-sided rib fractures had a similar median hospital length of stay compared to the control group. We noted no difference between the number of days spent in the ICU or ventilator days between these patients (figure 2). Furthermore, patients with bilateral rib fractures had a median hospital stay of 8 days compared to 13 days in the control group (p \u3c 0.05) (figure 2). Also, patients in the control group with bilateral rib fractures had a median ICU stay of 3 days and median ventilator use of 2 days compared to 0 days (p \u3c 0.05) in the experimental group (table 2). Lastly, patients 65 and older with unspecified multiple rib fractures had a median length of stay of 3.5 days compared to 1.5 days in the control group (p \u3c 0.05). The median length of stay in ICU and ventilator use was 1 day longer in the control group than the experimental group. Conclusion: Elderly patients with more than 2 rib fractures admitted at Doctor hospital renaissance between 2017-2020 had better outcomes than patients younger than 65 admitted during the same period

Comparative analysis of all-terrain vehicles, motorcycle and automobile-related trauma in a rural border community of the USA

Introduction: There is widespread use of all-terrain vehicles (ATVs) in the USA for both work-related and recreational activities. In this study, we aimed to determine the difference in injury severity, Glasgow Coma scales and length of stay between ATV-related injuries and injuries sustained from motorcycles (MOTOs) and automobiles (AUTOs). Methods: We retrospectively analysed ATV, MOTO and AUTO injuries from a Level 2 Trauma Center between 01 January 2015 and 31 August 2020. Proportional odds regression analyses, as well as multivariable regression models, were used to analyse the data. Results: There were significantly more male and paediatric patients that suffered ATV-related injuries compared with MOTO or AUTO injuries. Victims of ATV-related injuries were also more likely to have open fractures. Paediatric patients were less likely to sustain an injury from either AUTO or MOTO accidents compared with ATV accidents. Patients with no drug use during injury and those who used protective equipment such as seat belts and child seats were significantly associated with lower Injury Severity Scores and higher Glasgow Coma Scale scores, indicating less severe injuries. Discussion: Paediatric patients are very likely to suffer sequela and long-term disability due to the severity of ATV-related injuries. Public awareness campaigns to educate our population, especially our youth, about the danger of ATV use are highly needed

Rayas de agua dulce (potamotrygonidae) de la amazonia colombiana: i. composición e información bioecológica

En el marco de un proyecto colaborativo entre Defenders of Wildlife (DoW), la Fundación Omacha (FO) y el Instituto de Investigación de Recursos Biológicos Alexander von Humboldt (IAvH) de Colombia, se realizó una evaluación en campo durante la época transicional de aguas bajas a aguas altas (18 de octubre hasta el 9 de noviembre de 2018), en la Amazonia colombiana (ríos Amazonas, Loretoyacu y Lagos de Tarapoto), Puerto Nariño, departamento del Amazonas, con el objeto de determinar la riqueza de especies e información morfométrica y biológica de las rayas (Potamotrygonidae). Se colectaron 55 individuos pertenecientes a cuatro géneros y ocho especies, un valor muy alto considerando que para toda Colombia se conocían 11 especies: Heliotrygon (H. gomesi), Paratrygon (P. aiereba), Plesiotrygon (P. iwamae y P. nana) y Potamotrygon (P. motoro, P. scobina, Potamotrygon sp.1 y Potamotrygon sp.2). Paratrygon aiereba fue la especie más abundante con el 51% de las capturas, seguida de Plesiotrygon iwamae. Se registró información nueva sobre la biología Heliotrygon gomesi, Plesiotrygon iwamae y Plesiotrygon nana. Por otro lado, las dos especies del género Potamotrygon identificadas solo a nivel genérico, pertenecen al grupo Potamotrygon scobina y requieren de un estudio taxonómico a mayor profundidad, pues podrían ser nuevos reportes para la Amazonia colombiana o incluso para la ciencia. Con esa información se aumentaría la riqueza de rayas de Colombia a de manera tentativa a 13 especies. Se avanzó en el estudio de las rayas de la Amazonia, pero aún quedan muchos vacíos de información biológica, geográfica, así como taxonómica, por lo que es fundamental seguir con los estudios en la región.BogotáCiencias Básicas de la Biodiversida

Autotrasplante de un tercer molar superior al sitio del primer molar superior en paciente de 17 años de edad.

El autotrasplante es el reposicionamiento de dientes erupcionados o embebidos en hueso del mismo individuo, de un sitio a otro; en sitios de extracción o alveolos preparados quirúrgicamente (1). El autotrasplante de dientes se ha convertido en una opción de tratamiento viable para reemplazar los dientes perdidos, ya que los dientes trasplantados con éxito pueden funcionar como dientes totalmente normales (2). Presenta ventajas a comparación de otras opciones de tratamiento, como son: buen pronóstico, económico y relativamente fácil de realizar

Conservación y tráfico de la tortuga matamata, <i>Chelus fimbriata</i> (Schneider, 1783) en Colombia: un ejemplo del trabajo conjunto entre el Sistema Nacional Ambiental, ONG y academia

Se presentan los resultados de una iniciativa interinstitucional (Corpoamazonia, Corporinoquia, Instituto Humboldt, Universidad de Los Andes y Fundación Omacha), donde se verificó, con herramientas moleculares, que varios lotes de tortugas matamata (Chelus fimbriata) decomisadas en la ciudad de Leticia, departamento del Amazonas, Colombia, correspondían a ejemplares capturados en la Orinoquia y cuyo destino final era aparentemente Perú, como parte de una red de tráfico de fauna. Basados en este hallazgo, 2 corporaciones liberaron 400 individuos neonatos en el en el río Bita y la Reserva Natural Privada Bojonawi en el departamento del Vichada, Orinoquia colombiana. Se evidencia el tráfico de esta especie probablemente hacia Perú, donde la comercialización de tortugas es legal. Se recomienda el uso de protocolos de identificación genética para determinar y controlar la procedencia geográfica de tortugas decomisadas a futuro, como paso previo y necesario para su liberación

Conservación y tráfico de la tortuga matamata, Chelus fimbriata (Schneider, 1783) en Colombia: un ejemplo del trabajo conjunto entre el Sistema Nacional Ambiental, ONG y academia

We present the results of an interinstitutional initiative that verified the provenance of several groups of the Matamata Turtle (Chelus fimbriata), confiscated in the city of Leticia, department of Amazonas, Colombia, with molecular tools. The confiscated turtles corresponded to specimens captured in the Orinoquia region, and apparently were destined to Peru as part of a network of illegal trafficking. Based on this finding, two environmental corporations worked together and made possible the release of about 400 individuals in the Vichada department on the Bita River and the Bojonawi Nature Reserve (Orinoco River basin). It is therefore evident that this species is being trafficked towards Peru, where the commercialization of turtles is legal. We recommend the use of genetic identification protocols to identify and control the geographical origin of turtles that may be captured in the future as a necessary step that must precede their liberation.Se presentan los resultados de una iniciativa interinstitucional (Corpoamazonia, Corporinoquia, Instituto Humboldt, Universidad de Los Andes y Fundación Omacha), donde se verificó, con herramientas moleculares, que varios lotes de tortugas matamata (Chelus fimbriata) decomisadas en la ciudad de Leticia, departamento del Amazonas, Colombia, correspondían a ejemplares capturados en la Orinoquia y cuyo destino final era aparentemente Perú, como parte de una red de tráfico de fauna. Basados en este hallazgo, 2 corporaciones liberaron 400 individuos neonatos en el en el río Bita y la Reserva Natural Privada Bojonawi en el departamento del Vichada, Orinoquia colombiana. Se evidencia el tráfico de esta especie probablemente hacia Perú, donde la comercialización de tortugas es legal. Se recomienda el uso de protocolos de identificación genética para determinar y controlar la procedencia geográfica de tortugas decomisadas a futuro, como paso previo y necesario para su liberación

Charge collection and capacitance–voltage analysis in irradiated n-type magnetic Czochralski silicon detectors

Abstract The depletion depth of irradiated n-type silicon microstrip detectors can be inferred from both the reciprocal capacitance and from the amount of collected charge. Capacitance voltage ( C – V ) measurements at different frequencies and temperatures are being compared with the bias voltage dependence of the charge collection on an irradiated n-type magnetic Czochralski silicon detector. Good agreement between the reciprocal capacitance and the median collected charge is found when the frequency of the C – V measurement is selected such that it scales with the temperature dependence of the leakage current. Measuring C – V characteristics at prescribed combinations of temperature and frequency allows then a realistic estimate of the depletion characteristics of irradiated silicon strip detectors based on C – V data alone

Prevalence of Aflatoxin-Associated TP53R249S Mutation in Hepatocellular Carcinoma in Hispanics in South Texas

We aimed to determine whether aflatoxin dietary exposure plays a role in the high incidence of hepatocellular carcinoma (HCC) observed among Hispanics in South Texas. We measured TP53R249S somatic mutation, hallmark of aflatoxin etiology in HCC, using droplet digital PCR and RFLP. TP53R249S mutation was detected in 3 of 41 HCC tumors from Hispanics in South Texas (7.3%). We also measured TP53R249S mutation in plasma cell-free DNA (cfDNA) from 218 HCC patients and 96 Hispanic subjects with advanced fibrosis or cirrhosis, from South Texas. The mutation was detected only in Hispanic and Asian HCC patients, and patients harboring TP53R249S mutation were significantly younger and had a shorter overall survival. The mutation was not detected in any Hispanic subject with advanced fibrosis or cirrhosis. Genes involved in cell-cycle control of chromosomal replication and in BRCA1-dependent DNA damage response were enriched in HCCs with TP53R249S mutation. The E2F1 family members, E2F1 and E2F4, were identified as upstream regulators. TP53R249S mutation was detected in 5.7% to 7.3% of Hispanics with HCC in South Texas. This mutation was associated with a younger age and worse prognosis. TP53R249S was however not detected in Hispanics in South Texas with cirrhosis or advanced fibrosis. Aflatoxin exposure may contribute to a small number of HCCs in Hispanics in South Texas, but the detection of TP53R249S mutation in plasma cfDNA is not a promising biomarker of risk assessment for HCC in subjects with cirrhosis or advanced fibrosis in this population. Cancer Prev Res; 11(2); 103-12. ©2017 AACR

Impact of COVID-19 pandemic on cardiometabolic patients without SARS CoV-2 infection in Latin America

A cross-sectional survey including 38 questions about demography, clinical condition, changes in health habits, and medical treatments for cardiometabolic patients in outpatient follow-up was conducted. From June 15 to July 15, 2020, a total of 13 Latin-American countries participated in enrolling patients. These countries were divided into 3 geographic regions: Region 1 including North, Central, and Caribbean Regions (NCCR), Region 2 including the Andean Region (AR), and Region 3 including the Southern Cone Region (SCR). 4.216 patients were analyzed, resulting in a coefficient of 33.82%, 32.23%, and 33.94% for NCCR, AR, and SCR, respectively. Significant differences were found between the AR, SCR, and NCCR regions. The analysis of habitual medication usage showed that discontinued use of medication was more present in AR, reaching almost 30% (p < 0.001). The main finding of this study was the negative impact that restrictive measures have on adherence to medications and physical activity: Rs = 0.84 (p = 0.0003) and Rs = 0.61 (p = 0.0032), respectively. AR was the most vulnerable region. Restrictive quarantine measures imposed by the different countries showed a positive correlation with medication discontinuation and a negative correlation with physical activity levels in patients analyzed. These findings characterize the impact of the consequences left by this pandemic. Undoubtedly, restrictive measures have been and will continue to have reverberating negative effects in most Latin-American countries.Fil: Camiletti, Jorge. Hospital Italiano de La Plata; ArgentinaFil: Renna, Nicolas Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Cátedra de Fisiología Patológica; Argentina. Hospital Español de Mendoza; ArgentinaFil: López Santi, Ricardo. Hospital Italiano de La Plata; ArgentinaFil: Erriest, Juan. Hospital Italiano de La Plata; ArgentinaFil: García-Bello, Eliomar. Centro de Diagnóstico Medicina Avanzada y Telemedicina; República DominicanaFil: Araujo, John. Centro Cardiovascular Somer Incare; ColombiaFil: Varleta-Olivares, Paola. Hospital Dipreca; ChileFil: Gómez-Díaz, Eduardo. Hospital Metropolitano del Norte; VenezuelaFil: Ramírez, Gisselle. Medicina Cardiovascular Asociada; República DominicanaFil: Berni Betancourt, Ana. Sociedad interamericana de Cardiología; México. Consejo Interamericano de Electrocardiográfica y Arritmias; México. Hospital Ángeles Pedregal; MéxicoFil: Escalada Lesme, Gustavo. Centro Médico Nacional-Hospital Nacional Itaguá; ParaguayFil: Campos Alcántara, Lourdes V.. Consultorio de Lourdes Victoria Campos Alcántara; PerúFil: Moya Loor, Leonardo. Hospital Santa Margarita; EcuadorFil: Rey Benavente, Claudio. Hospital Arroyabe Pichanal; ArgentinaFil: Almonte, Claudia. Medicina Cardiovascular Asociada; República DominicanaFil: Cortez Sandoval, Maicol. Hospital Nacional Edgardo Rebagliti Martins; PerúFil: Alvarado Cuadros, María. Department of Cardiology, Institution; EcuadorFil: Rosario, Monica I.. Centro de Diagnóstico Medicina Avanzada y Telemedicina; República DominicanaFil: Gupta, Shyla. Queen’s University; CanadáFil: Ibarrola, Martin. Cardiovascular Center BV; ArgentinaFil: Baranchuk, Adrián. Kingston Health Sciences Centre; Canad