RESUMO
Resumen: Introducción: la lesión del manguito de los rotadores es una de las lesiones más comunes del hombro. El tratamiento por elección es la reparación artroscópica con uso de anclas. La técnica Mason-Allen modificada, que integra los beneficios de las suturas puente y colchonero, ha demostrado resultados satisfactorios. El propósito de este estudio es reportar y analizar los resultados clínicos del uso de dicha sutura en rupturas del manguito de los rotadores. Resultados: flexión activa media 126o inicial, 169o a tres meses, 175o a 12 meses (p < 0.0001), abducción activa 98o, tres meses 159o y 167o a 12 meses (p < 0.0001), rotación interna valor prequirúrgico 4.4 ± 3, a los tres meses 7.1 ± 1.7 (p < 0.05) y 12 meses 7.6 ± 1.1 (p < 0.001). Constant Score 45.76 ± 16.35 con un valor de p < 0.0001, a tres meses 87.27 ± 10.94 y 12 meses 91.30 ± 6.00. SSV 41.30 ± 20.89, tres meses 81.43 ± 18.31 y 12 meses 94.37 ± 6.90 (p = 0.0001). EVA media inicial 6.6 ± 1.6 y 12 meses 0.63 ± 1.02 (p < 0.0001). Conclusión: en rupturas del manguito de los rotadores, el uso de hilera simple con técnica Mason-Allen modificada es una opción recomendada y replicable con resultados satisfactorios y mejoría clínica estadísticamente significativa a los tres y 12 meses postquirúrgicos.
Abstract: Introduction: rotator cuff tears are one of the most common shoulder injuries. The treatment of choice is arthroscopic repair with the use of anchors. The modified Mason-Allen technique, which combines the benefits of suture bridge and mattress sutures, has shown satisfactory results. This study aims to report and analyze the clinical results using these suture techniques in rotator cuff tears. Results: preoperative mean active flexion 126o, 169o at three months, 175o at 12 months (p < 0.0001), active abduction 98o, 159o at three months and 167o at 12 months (p < 0.0001), internal rotation preoperative value 4.4 ± 3, at three months 7.1 ± 1.7 (p < 0.05) and 12 months 7.6 ± 1.1 (p < 0.001). Constant score 45.76 ± 16.35 (p < 0.0001) at three months 87.27 ± 10.94 and 12 months 91.30 ± 6.00. SSV 41.30 ± 20.89, three months 81.43 ± 18.31 and 12 months 94.37 ± 6.90 (p = 0.0001). Initial mean VAS 6.6 ± 1.6 and 12 months 0.63 ± 1.02 (p < 0.0001). Conclusion: in rotator cuff tears, using a single row with the modified Mason-Allen technique is a recommended and replicable option with satisfactory results and statistically significant clinical improvement at three and 12 months post-surgery.
RESUMO
INTRODUCTION: rotator cuff tears are one of the most common shoulder injuries. The treatment of choice is arthroscopic repair with the use of anchors. The modified Mason-Allen technique, which combines the benefits of suture bridge and mattress sutures, has shown satisfactory results. This study aims to report and analyze the clinical results using these suture techniques in rotator cuff tears. RESULTS: preoperative mean active flexion 126o, 169o at three months, 175o at 12 months (p < 0.0001), active abduction 98o, 159o at three months and 167o at 12 months (p < 0.0001), internal rotation preoperative value 4.4 ± 3, at three months 7.1 ± 1.7 (p < 0.05) and 12 months 7.6 ± 1.1 (p < 0.001). Constant score 45.76 ± 16.35 (p < 0.0001) at three months 87.27 ± 10.94 and 12 months 91.30 ± 6.00. SSV 41.30 ± 20.89, three months 81.43 ± 18.31 and 12 months 94.37 ± 6.90 (p = 0.0001). Initial mean VAS 6.6 ± 1.6 and 12 months 0.63 ± 1.02 (p < 0.0001). CONCLUSION: in rotator cuff tears, using a single row with the modified Mason-Allen technique is a recommended and replicable option with satisfactory results and statistically significant clinical improvement at three and 12 months post-surgery.
INTRODUCCIÓN: la lesión del manguito de los rotadores es una de las lesiones más comunes del hombro. El tratamiento por elección es la reparación artroscópica con uso de anclas. La técnica Mason-Allen modificada, que integra los beneficios de las suturas puente y colchonero, ha demostrado resultados satisfactorios. El propósito de este estudio es reportar y analizar los resultados clínicos del uso de dicha sutura en rupturas del manguito de los rotadores. RESULTADOS: flexión activa media 126o inicial, 169o a tres meses, 175o a 12 meses (p < 0.0001), abducción activa 98o, tres meses 159o y 167o a 12 meses (p < 0.0001), rotación interna valor prequirúrgico 4.4 ± 3, a los tres meses 7.1 ± 1.7 (p < 0.05) y 12 meses 7.6 ± 1.1 (p < 0.001). Constant Score 45.76 ± 16.35 con un valor de p < 0.0001, a tres meses 87.27 ± 10.94 y 12 meses 91.30 ± 6.00. SSV 41.30 ± 20.89, tres meses 81.43 ± 18.31 y 12 meses 94.37 ± 6.90 (p = 0.0001). EVA media inicial 6.6 ± 1.6 y 12 meses 0.63 ± 1.02 (p < 0.0001). CONCLUSIÓN: en rupturas del manguito de los rotadores, el uso de hilera simple con técnica Mason-Allen modificada es una opción recomendada y replicable con resultados satisfactorios y mejoría clínica estadísticamente significativa a los tres y 12 meses postquirúrgicos.
Assuntos
Lesões do Manguito Rotador , Lesões do Ombro , Humanos , Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Artroscopia , Técnicas de Sutura , Resultado do TratamentoRESUMO
Antecedentes: La incidencia de heridas por proyectil de arma de fuego en mano de pacientes civiles se ha incrementado en los últimos años, lo cual es causa de incapacidades prolongadas o definitivas con un impacto personal, social y económico. Las lesiones severas de mano incluyen: afección del arco palmar mayor, fractura de dos o más huesos del carpo, luxaciones palmares irreductibles, fracturas articulares de radio distal y lesiones neurovasculares, los cuales requieren de múltiples procedimientos quirúrgicos para el manejo de tejidos blandos y musculoesqueléticos. Métodos: Se describe el reporte de un paciente con fractura de los huesos del carpo derecho, expuestos grados IIIB de Gustillo y Anderson por proyectil de arma de fuego, el cual fue tratado con artrodesis del carpo mediante injerto sintético, fijación externa y rotación de colgajo fasciocutáneo. Resultados: Paciente que fue sometido a tratamiento quirúrgico de la lesión del carpo consistente en fractura de todos los huesos del carpo, expuestos grados IIIB de Gustillo y Anderson por proyectil de arma de fuego quien fue sometido a tratamiento quirúrgico mediante artrodesis del carpo con injerto sintético, estabilización con fijador externo y cobertura con colgajo fasciocutáneo, obteniendo una evolución clínica mediante la escala de DASH con un score de 14.2 y Michigan Hand score de 70 puntos con un seguimiento de 12 meses. Conclusiones: El tratamiento con fijación externa más artrodesis del carpo con injerto sintético y cobertura cutánea con colgajo proporcionó un resultado funcional bueno para un paciente con lesión por proyectil de arma de fuego.
Background: The incidence of hand gunshot wounds in civil patients has increased in recent years; it causes long-term or permanent disability and has a personal, social and economic impact. Severe hand injuries include: involvement of the greater palmar arch, fracture of two or more carpal bones, irreducible palmar dislocations, articular fractures of the distal radius, and neurovascular injuries. All of these injuries require multiple surgical procedures for the management of soft and musculoskeletal tissues. Methods: We report the case of a patient with a Gustilo and Anderson grade IIIB open fracture of the right carpal bones caused by a gunshot projectile. He was treated with arthrodesis of the carpus using a synthetic graft, external fixation and rotation of a fasciocutaneous flap. Results: The patient underwent surgical treatment of the carpal injury that consisted of Gustilo and Anderson grade IIIB open fracture of all carpal bones caused by a gunshot projectile. Surgery included arthrodesis of the carpus with a synthetic graft, stabilization with an external fixator, and a fasciocutaneous graft as skin cover. The clinical course according to the DASH scale had a score of 14.2 and the Michigan Hand score was 70, with a 12-month follow-up. Conclusions: Treatment with external fixation plus arthrodesis of the carpus with a synthetic graft and skin cover using a flap provided a good functional result in a patient who sustained a gunshot wound.
Assuntos
Adolescente , Humanos , Masculino , Artrodese , Articulações do Carpo/cirurgia , Fixadores Externos , Traumatismos da Mão/cirurgia , Próteses e Implantes , Ferimentos por Arma de Fogo/cirurgia , Terapia Combinada , Escala de Gravidade do FerimentoRESUMO
BACKGROUND: The incidence of hand gunshot wounds in civil patients has increased in recent years; it causes long-term or permanent disability and has a personal, social and economic impact. Severe hand injuries include: involvement of the greater palmar arch, fracture of two or more carpal bones, irreducible palmar dislocations, articular fractures of the distal radius, and neurovascular injuries. All of these injuries require multiple surgical procedures for the management of soft and musculoskeletal tissues. METHODS: We report the case of a patient with a Gustilo and Anderson grade IIIB open fracture of the right carpal bones caused by a gunshot projectile. He was treated with arthrodesis of the carpus using a synthetic graft, external fixation and rotation of a fasciocutaneous flap. RESULTS: The patient underwent surgical treatment of the carpal injury that consisted of Gustilo and Anderson grade IIIB open fracture of all carpal bones caused by a gunshot projectile. Surgery included arthrodesis of the carpus with a synthetic graft, stabilization with an external fixator, and a fasciocutaneous graft as skin cover. The clinical course according to the DASH scale had a score of 14.2 and the Michigan Hand score was 70, with a 12-month follow-up. CONCLUSIONS: Treatment with external fixation plus arthrodesis of the carpus with a synthetic graft and skin cover using a flap provided a good functional result in a patient who sustained a gunshot wound.
Assuntos
Artrodese , Articulações do Carpo/cirurgia , Fixadores Externos , Traumatismos da Mão/cirurgia , Próteses e Implantes , Ferimentos por Arma de Fogo/cirurgia , Adolescente , Terapia Combinada , Humanos , Escala de Gravidade do Ferimento , MasculinoRESUMO
The centromere appears as a single constriction at mitotic metaphase in most eukaryotic chromosomes. Holokinetic chromosomes are the exception to this rule because they do not show any centromeric constrictions. Holokinetic chromosomes are usually forgotten in most reviews about centromeres, despite their presence in a number of animal and plant species. They are generally linked to very intriguing and unusual mechanisms of mitosis and meiosis. Holokinetic chromosomes differ from monocentric chromosomes not only in the extension of the kinetochore plate, but also in many other peculiar karyological features, which could be understood as the 'holokinetic syndrome' that is reviewed in detail. Together with holokinetic chromosomes we review neocentromeric activity, a similarly intriguing case of regions able to pull chromosomes towards the poles without showing the main components reported to be essential to centromeric function. A neocentromere is a chromosomal region different from the true centromere in structure, DNA sequence and location, but is able to lead chromosomes to the cell poles in special circumstances. Neocentromeres have been reported in plants and animals showing different features. Both in humans and Drosophila, neocentric activity appears in somatic cells with defective chromosomes lacking a functional centromere. In most cases in plants, neocentromeres appear in chromosomes which have normal centromeres, but are active only during meiosis. Because of examples such as spontaneous or induced neocentromeres and holokinetic chromosomes, it is becoming less surprising that different structures and DNA sequences of centromeres appear in evolution.
Assuntos
Centrômero/genética , Centrômero/fisiologia , Cromossomos de Plantas/genética , Cromossomos de Plantas/fisiologia , Animais , Segregação de Cromossomos/genética , Segregação de Cromossomos/fisiologia , Cromossomos/genética , Cromossomos/fisiologia , Cyperaceae/genética , Humanos , Meiose/genética , Meiose/fisiologia , Mitose/genética , Mitose/fisiologia , Secale/genética , Zea mays/genéticaRESUMO
In previous work, genotypes for high and low B chromosome transmission rate were selected from a native race of maize. It was demonstrated that the B transmission is genetically controlled. The present work reports the fourth and fifth generations of selection and the F1 hybrids between the lines. The native B is characterized by a constant behaviour, with normal meiosis and nondisjunction in 100% of postmeiotic mitosis. It is concluded that genetic variation for B transmission between the selected lines is due to the preferential fertilization process. The F1 hybrids show intermediate B transmission rate between the lines. They are uniform, the variance of the selected character being one order of magnitude lower than that of the native population. In addition, 0B x 2B and 2B x 2B crosses were made to study the effect of the presence of B chromosomes in the female parent, resulting in non-significant differences. Several crosses were made both in Buenos Aires and in Madrid to compare the possible environmental effect, but significant differences were not found. Our results are consistent with the hypothesis of a single major gene controlling B transmission rate in maize, which acts in the egg cell at the haploid level during fertilization. It is also hypothesized that maize Bs use the normal maize fertilization process to promote their own transmission.
Assuntos
Cromossomos/genética , Fertilização/genética , Genes de Plantas/genética , Zea mays/genética , Argentina , Cruzamentos Genéticos , Meio Ambiente , Variação Genética/genética , Genótipo , Meiose/genética , Não Disjunção Genética , Seleção Genética , EspanhaRESUMO
We report 173 patients with venous thrombosis (or post-thrombotic syndrome) demonstrated by phlebography. We show up the importance of blood groups as risk factor, being very significant the A group. Female sex is associated with a high incidence of this pathology. A frequent location is the left lower limb.
Assuntos
Antígenos de Grupos Sanguíneos , Tromboflebite/sangue , Doença Aguda , Distribuição de Qui-Quadrado , Cuba/epidemiologia , Feminino , Humanos , Masculino , Síndrome Pós-Flebítica/sangue , Síndrome Pós-Flebítica/epidemiologia , Fatores de Risco , Fatores Sexuais , Tromboflebite/epidemiologiaRESUMO
PIP: Intelligence quotients (IQs) were measured in 15 children hospitalized in their 1st 2 years with 3rd degree malnutrition and in their siblings of closest age who had no history of hospitalization for malnutrition. Clinical records were reviewed of 459 malnourished infants admitted to the Dr. Robert Reid Cabral Hospital in Santo Domingo between January 1976-January 1977. 230 of the children had died, and 15 of the 57 survivors who returned to the hospital for a preliminary interview were selected as subjects. Their closely aged siblings served as controls. Both groups were given Bender's visual-motor test and Weschler's intelligence scale for children. The ages of the subjects were 7-0 years and of siblings 6-13 years. Children who had spent a greater number of days in the hospital appeared to have a greater degree of mental impairment. 2 of the children with marasmus presented moderate mental retardation, 1 slight retardation, and another borderline retardation. The controls for these 5 cases included 1 moderately retarded, 2 slightly retarded, and 1 borderline case. 1 child with marasmus who was removed from his home showed a normal intelligence while his control who had remained in the home had a slight retardation. There was no consistent relationship between the cephalic perimeter and the IQ score, although 40% of the malnourished children and 30% of controls had perimeters below the normal range. 20% of cases and no controls required more than 18 months to learn to walk. Cases were also slower than controls to begin speaking and to be toilet trained. The tests showed that the control group members had somewhat higher intelligence quotients than the malnourished group. 53.2% of the malnourished children had IQs far below normal at 60-69, compared to 39.9% of controls. 93% of the study group and 87% of controls had IQs below normal values of 80-89. But there was no statistically significant difference in average IQs: 72.2 + or - 17.5 in the study group and 75.3 + or - 11.2 in the control group. Because both groups had low IQ scores, it was concluded that environmental factors played a strong role in development of intelligence. Low income, parental education, and large family sizes were all believed to be important.^ieng