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1.
Musculoskelet Surg ; 106(2): 133-143, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32845424

RESUMO

BACKGROUND: We analyzed the clinical and radiographic evolution of patients with knee unicompartmental osteoarthritis and axis alteration and osteochondral lesions in the femoral condyle, treated with tibial plateau and meniscus allograft and cultured autologous chondrocyte implantation in the femur in two steps. PURPOSE: To analyze the clinical results with the first patients treated with this two-stage technique to avoid knee prosthesis in patients with unicompartmental osteoarthritis. MATERIAL AND METHODOLOGY: Sixteen patients, average age 56 years, were included in a cohort study. We performed an osteotomy with tibia plateau allograft, including the meniscus. In a second surgery, the chondrocyte fibrin scaffold was placed in the femur. Clinical symptoms and function were measured using KSSR and KOOS scores. Wilcoxon's test was performed to compare the results over the 2-year follow-up period. RESULTS: Mean KSSR before surgery was 35.69 (SD: 3.75) points, rising to 67 (SD: 15.42) at 3 months, 95.88 at 12 months (SD: 2.68) and 96.31 at 24 months (SD: 2.24). The KOOS before surgery was 65.14 (SD: 16.34), rising to 72.68 after 3 months (SD: 19.15), 76.68 at 12 months (SD: 18.92) and 64.28 at 24 months (SD: 11.79). Four of 5 patients returned to engaging in the activity that they had stopped practicing. Three patients experienced collapse of the tibia allograft, and they needed later a prosthesis. CONCLUSIONS: Simultaneous tibia plateau allograft and autologous chondrocyte implantation in the femur, after correction of the angular deformity, were performed, restoring the anatomy of the medial compartment and knee function in 82% of the patients 2 years after the operation. LEVEL OF EVIDENCE: IV.


Assuntos
Menisco , Osteoartrite do Joelho , Aloenxertos , Condrócitos , Estudos de Coortes , Fêmur/cirurgia , Seguimentos , Humanos , Articulação do Joelho/cirurgia , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Próteses e Implantes
2.
Med. infant ; 28(2): 81-95, Julio - Diciembre 2021. ilus, Tab
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1355111

RESUMO

Introducción: Debido a la emergencia provocada por la pandemia por el virus SARS-CoV-2 se ha producido una crisis sanitaria global. Una vez disponibles las vacunas, se espera que jueguen un rol decisivo para el control de la enfermedad. Dichas vacunas fueron desarrolladas en tiempo récord por lo que es esencial monitorear su seguridad. Durante la Campaña de Vacunación contra COVID-19, todos los Eventos supuestamente atribuibles a vacunación e inmunización (ESAVI) debieron ser notificados al Ministerio de Salud de la Nación a través del Sistema Integrado de Información Sanitaria de Argentina (SIISA). Materiales y métodos: Se realizó un estudio observacional prospectivo desde el 04/01/2021 al 05/05/2021 en el personal del Hospital Garrahan. Se utilizaron dos métodos de vigilancia de ESAVI. La vigilancia pasiva incluyó las notificaciones voluntarias recibidas de forma telefónica y a través de un cuestionario publicado en intranet. La vigilancia activa se realizó sobre los primeros 947 trabajadores inmunizados, enviando el mismo cuestionario por WhatsApp. Resultados: Hasta el día 05/05/2021 fueron inmunizados 5056 agentes, 4865 con las dos dosis. Se notificaron 473 ESAVI. De ellos, 304 correspondían a la primera dosis y 169 a la segunda. La cantidad de notificaciones según su origen fue de 136 para la vigilancia pasiva, y 333 para la vigilancia activa. Se registraron 5 ESAVI graves; tres anafilaxias, un escotoma secundario a la hipertermia generada por la vacuna y una reacción alérgica grave. Los síntomas locales más frecuentes fueron: dolor, enrojecimiento, hinchazón e induración. Los síntomas sistémicos más frecuentes fueron: fiebre, febrícula, astenia, cefalea, mialgia, artralgia y síntomas gastrointestinales. Como tratamiento en la mayoría de los casos se utilizó paracetamol. Discusión: El presente trabajo logró recolectar un número significativo de notificaciones, brindando información útil al tratarse de una vacuna recientemente aprobada en nuestro país y el mundo. (AU)


Introduction: Due to the SARS-CoV-2 pandemic emergency, a global health crisis has occurred. Once vaccines become available, they are expected to play a decisive role in controlling the disease. These vaccines were developed in record time, and therefore it is essential to monitor their safety. During the COVID-19 Vaccination Campaign, all Events Suspected to be Attributable to Vaccination and Immunization (ESAVI) had to be notified to the National Ministry of Health through the Integrated Health Information System of Argentina (SIISA). Material and methods: A prospective observational study was conducted from 04/01/2021 to 05/05/2021 in the staff of Garrahan Hospital. Two methods of ESAVI surveillance were used. Passive surveillance included voluntary notifications received by telephone and through a questionnaire posted on intranet. Active surveillance was conducted on the first 947 immunized workers, sending the same questionnaire by WhatsApp. Results: Up to 05/05/2021, 5056 workers were immunized, of whom 4865 with two doses. A total of 473 ESAVI were reported. Of these, 304 corresponded to the first dose and 169 to the second. The number of notifications was 136 for passive surveillance and 333 for active surveillance. Five severe ESAVIs were recorded; three anaphylaxis, one scotoma secondary to vaccine-generated hyperthermia, and one severe allergic reaction. The most frequent local symptoms were: pain, redness, swelling, and induration. The most frequent systemic symptoms were: mild fever or fever, asthenia, headache, myalgia, arthralgia, and gastrointestinal symptoms. Paracetamol was used as treatment in most cases. Discussion: In the present study a significant number of notifications was collected, providing useful information on a vaccine recently approved in our country and in the world (AU)


Assuntos
Humanos , Imunização/efeitos adversos , Vacinação/efeitos adversos , Pessoal de Saúde , Farmacovigilância , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Estudos Prospectivos
3.
Acta ortop. mex ; 29(1): 13-20, ene.-feb. 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-755659

RESUMO

Antecedentes: Las fracturas de la extremidad inferior ocurren más frecuentemente en los pacientes de edad avanzada con osteopenia después de una caída de baja energía y/o en los pacientes más jóvenes involucrados en traumatismos de alta energía. En la Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia "Lomas Verdes" se desconoce la prevalencia de fracturas de cadera, fémur y rodilla. Material y métodos: Diseño transversal, descriptivo y retrospectivo. Se revisaron los casos con fracturas de la extremidad inferior tratados durante el 01 de enero del 2012 al 31 de diciembre de 2013 en el Servicio de Cirugía de Cadera, Fémur y Rodilla de la Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia "Lomas Verdes". Resultados: La mayoría de los pacientes (52.2%) fueron del sexo femenino, siendo 64.1% de los pacientes mayor de 60 años de edad. La distribución de las fracturas de acuerdo al segmento afectado: 73.4% (n = 1,327) correspondieron a fracturas de fémur, 13.5% (n = 244) a fracturas de la meseta tibial y 13.2% (n = 238) fracturas de patela. En 66.8% (n = 1,209) de los pacientes tuvieron una estancia intrahospitalaria prolongada (mayor a 10 días). De acuerdo con la localización anatómica ósea más frecuente, las fracturas transtrocantéricas (49.1%) fueron las más frecuentes, seguidas por las fracturas de patela (13.2%) y las diafisarias del fémur (12.7%). Conclusiones: La prevalencia de las fracturas de la extremidad inferior en nuestro hospital corresponde con lo reportado a nivel internacional.


Background: Lower limb fractures are more frequent among older patients with osteopenia after a low energy fall and/or among young patients who sustain a high energy trauma. The prevalence of hip, femur and knee fractures at the High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes" is unknown. Material and methods: Cross-sectional study, descriptive and retrospective design. Cases with low extremity fractures treated from January 1st, 2012 to December 31st, 2013 at the Hip, Femur and Knee Service, High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes", were reviewed. Results: Most patients (52.2%) were females; 64.1% of patients were over 60 years of age. Fracture distribution according to the segment involved was as follows: 73.4% (n = 1,327) were femur fractures, 13.5% (n = 244) tibial plateau fractures, and 13.2% (n = 238) patellar fractures. 66.8% (n = 1,209) of patients had a long hospital stay (more than 10 days). According to the anatomical location of fractures, transtrochanteric fractures (49.1%) were the most frequent ones, followed by patellar fractures (13.2%), and femur shaft fractures (12.7%). Conclusions: The prevalence of lower limb fractures at our hospital corresponds to what has been reported internationally.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Fraturas do Fêmur/epidemiologia , Fraturas Ósseas/epidemiologia , Fraturas do Quadril/epidemiologia , Traumatismos do Joelho/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Estudos Transversais , Hospitalização/estatística & dados numéricos , Tempo de Internação , México/epidemiologia , Prevalência , Patela/lesões , Estudos Retrospectivos , Fraturas da Tíbia/epidemiologia
4.
Acta Ortop Mex ; 29(1): 13-20, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26999921

RESUMO

BACKGROUND: Lower limb fractures are more frequent among older patients with osteopenia after a low energy fall and/or among young patients who sustain a high energy trauma. The prevalence of hip, femur and knee fractures at the High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes" is unknown. MATERIAL AND METHODS: Cross-sectional study, descriptive and retrospective design. Cases with low extremity fractures treated from January 1st, 2012 to December 31st, 2013 at the Hip, Femur and Knee Service, High Specialty Medical Unit, Hospital de Traumatología y Ortopedia "Lomas Verdes", were reviewed. RESULTS: Most patients (52.2%) were females; 64.1% of patients were over 60 years of age. Fracture distribution according to the segment involved was as follows: 73.4% (n = 1,327) were femur fractures, 13.5% (n = 244) tibial plateau fractures, and 13.2% (n = 238) patellar fractures. 66.8% (n = 1,209) of patients had a long hospital stay (more than 10 days). According to the anatomical location of fractures, transtrochanteric fractures (49.1%) were the most frequent ones, followed by patellar fractures (13.2%), and femur shaft fractures (12.7%). CONCLUSIONS: The prevalence of lower limb fractures at our hospital corresponds to what has been reported internationally.


Assuntos
Fraturas do Fêmur/epidemiologia , Fraturas Ósseas/epidemiologia , Fraturas do Quadril/epidemiologia , Traumatismos do Joelho/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Patela/lesões , Prevalência , Estudos Retrospectivos , Fraturas da Tíbia/epidemiologia , Adulto Jovem
5.
Haemophilia ; 17(2): 296-9, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21070486

RESUMO

Synoviorthesis is already widely used in the treatment of chronic haemophilic synovitis. The aim of this study was evaluate the effectiveness of oxytetracicline synoviorthesis on the frequency of haemarthrosis in haemophilic children with chronic synovitis and its impact on joint function. Between January 2001 and October 2006, we performed 34 synoviorthesis in 28 paediatric patients (6-16 years old) with diagnosis of haemophilic arthropathy stage I-II. At each joint were administered five doses of oxytetracycline for five consecutive weeks at doses of 100 mg in elbow and ankle and 250 mg in the knee. The frequency of haemarthrosis and range of joint mobility were evaluated before and after of treatment. The results were analysed with Student t-test and descriptive statistics. Thirty-four joints were treated, including 20 knees (58.8%), eight elbows (23.5%) and six ankles (17.6%). Median follow-up was 46.3 months (range 12-71 months). The frequency of haemarthrosis was recorded before treatment 47.3 year(-1) (range 12-96, P < 0.0001) and decreased to 3.5 year(-1) (range 0-15, P = 0.0119) after treatment. The range of joint motion in flexion-extension before treatment was 84.9°, while after this was 97.5° (P = 0.0119). The synoviorthesis with oxytetracycline has shown a favourable effect in the treatment of chronic haemophilic synovitis in reducing the frequency of haemarthrosis and improvement was observed consistently in the range of motion.


Assuntos
Antibacterianos/uso terapêutico , Hemartrose/tratamento farmacológico , Hemofilia A/complicações , Oxitetraciclina/uso terapêutico , Sinovite/tratamento farmacológico , Adolescente , Adulto , Articulação do Tornozelo , Criança , Doença Crônica , Articulação do Cotovelo , Seguimentos , Hemartrose/etiologia , Humanos , Injeções Intra-Articulares , Articulação do Joelho , Amplitude de Movimento Articular/efeitos dos fármacos , Sinovite/etiologia , Adulto Jovem
6.
Acta Ortop Mex ; 25(3): 167-70, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-22512112

RESUMO

OBJECTIVE: To report the patellar dislocation recurrence in patients ages 9 to 16 years treated surgically with the Green technique or an arthroscopic approach. MATERIAL AND METHODS: A prospective, longitudinal study was conducted with patients ages 9 to 16 years who presented at the pediatric orthopedics and arthroscopy service at IMSS "Lomas Verdes" UMAE Orthopedics and Traumatology Hospital with a diagnosis of patellar dislocation from January 1st 2003 to December 31st 2006. The patellar dislocation recurrences were recorded. RESULTS: Twenty patients and 24 knees were included; 13 females and 7 males; mean age was 14.3 years +/- 1.75. The dislocations prior to surgical treatment occurred at a mean of 5.5 +/- 2.57 dislocation events, with a range of 2 to 10 events. As regards the side involved, 40% had involvement of the left side, 40% of the right side, with 8 patients each, and 20% were bilateral dislocations. No significant differences were found in the clinical course of the patients treated with the Green technique compared with the arthroscopic surgery group (p = 0.371). CONCLUSIONS: The number of dislocation recurrences after the surgical procedure was not related with the age, gender, number of prior dislocations or surgical technique. No significant difference was found between both groups.


Assuntos
Artroscopia , Luxação Patelar/cirurgia , Adolescente , Criança , Feminino , Humanos , Masculino , Procedimentos Ortopédicos/métodos , Estudos Prospectivos , Recidiva
7.
Acta Ortop Mex ; 24(6): 400-3, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-21400763

RESUMO

INTRODUCTION: The injury of the cruciate ligaments secondary to knee dislocation is caused by high energy trauma; its incidence rate is less than 0.02%; there are multiple treatments, with surgery being the most common one. OBJECTIVE: To determine the functional characteristics of patients who underwent cruciate ligament plasty and sustained knee dislocation. MATERIAL AND METHODS: An observational, prospective, cross-sectional study was conducted including all adult patients with a diagnosis of cruciate ligament injury resulting from knee dislocation who were surgically treated from January 2006 to December 2007. Two knee functional assessment scales were used. RESULTS: A total of 16 patients were included, 12 males and 4 females; mean age was 32.1 years. The Knee Society Clinical Rating Scale had a positive correlation with the Lysholm Knee Scoring Scale (r = 0.836) with p = 0.001. DISCUSSION: The functional results of patients treated surgically are diverse. This study was not conducted as a controlled clinical trial due to the absence of randomization, which was not possible due to the infrequency of the condition. CONCLUSIONS: It will be necessary to confirm the results after a longer follow-up and in a comparative, double-blind study of patients undergoing surgery.


Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/cirurgia , Luxação do Joelho/complicações , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos , Estudos Prospectivos , Recuperação de Função Fisiológica , Adulto Jovem
8.
Rev. Fac. Odontol. Univ. Chile ; 15(1): 43-51, ene.-jun. 1997. tab
Artigo em Espanhol | LILACS | ID: lil-216511

RESUMO

The aim of this study was to establish the principal cause of teeth lossing in the adult community aged between 35-44 and 65-74 in Santiago, Metropolitana Región. The clinical histories of the patients included in an investigation carried out in 8 communities of the Metropolitan Región, and in a private medical-dental center in the Tabancura and Ñuñoa communities were cheeked. The sample was of 1.096 individuals, with a total of 5.207 lossed teeth. Results: the 77,17 por ciento of the total extracted teeth were lost because of dental decay (p

Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Causalidade , Perda de Dente/epidemiologia , Distribuição por Idade , Cárie Dentária , Escolaridade , Extração Dentária/estatística & dados numéricos , Doenças Periodontais , Distribuição por Sexo , Classe Social
9.
Bol Med Hosp Infant Mex ; 48(10): 699-709, 1991 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-1764192

RESUMO

Diarrheal diseases are the main cause of infant mortality in children under five year of age in the Third World. In order to diminish the mortality and morbidity rate, the World Health Organization developed the Diarrhoeal Diseases Control Programme (DDCP). The DDCP recommends two actions: to prevent diarrheal diseases and treatment of dehydration, the main cause of death in diarrheal diseases. Plan A is devoted to prevent dehydration; Plan B to treat orally dehydration; and Plan C to treat severe dehydration by means of rapid intravenous therapy. These plans were devised by health workers skill in the management of adults presenting Asiatic Cholerae. Thereafter the same method was used in non cholerae diarrhea, and finally in infants and children of all ages. The method has proven to be useful for treating all dehydration complications. The pediatric textbooks recommend the use of oral rehydration therapy (ORT) but do not support it very strongly. Plan C is not known by these authors, who recommend the old fashioned method used in the 70's. Here in I present the most advanced rehydration methods.


Assuntos
Diarreia/terapia , Doença Aguda , Criança , Desidratação/complicações , Desidratação/prevenção & controle , Diarreia/diagnóstico , Diarreia/etiologia , Diarreia/prevenção & controle , Hidratação/métodos , Humanos , Distúrbios Nutricionais/complicações , Distúrbios Nutricionais/prevenção & controle , Organização Mundial da Saúde
10.
N Engl J Med ; 324(8): 517-21, 1991 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-1992304

RESUMO

BACKGROUND: In infants the treatment of acute diarrhea with glucose-based solutions results in rehydration but does not reduce the severity of diarrhea. Oral rehydration with solutions based on rice powder may reduce stool output as well as restore fluid volume. METHODS: We designed a prospective, randomized, double-blind study to evaluate the efficacy of two rice-based rehydration solutions and a conventional glucose-based solution. Solution A contained only rice-syrup solids, solution B contained rice-syrup solids and casein hydrolysate, and solution C, the glucose-based solution, served as control. The study subjects were 86 mildly to moderately dehydrated infant boys, 3 to 18 months old, who were admitted to a children's hospital with acute diarrhea. We measured fluid intake, fecal and urine output, and absorption and retention of fluid, sodium, and potassium at intervals for 48 hours in all 86 infants. RESULTS: The mean (+/- SE) fecal output was significantly lower in the infants given solution A (group A infants) than in the infants given solution C (group C) (29 +/- 4 vs. 46 +/- 7 ml per kilogram of body weight, P less than 0.05) during the first six hours of therapy. The infants in group A also had greater fluid absorption (221 +/- 16 vs. 167 +/- 9 ml per kilogram, P less than 0.05) over the entire 48 hours of therapy and greater potassium absorption (1.6 +/- 0.2 vs. 0.6 +/- 0.1 mmol per kilogram, P less than 0.05) during the first six hours than the infants in group C. Solution B offered no advantages over solution A. CONCLUSIONS: Solutions containing rice-syrup solids were effective in the rehydration of infants with acute diarrhea. They decreased stool output and promoted greater absorption and retention of fluid and electrolytes than did a glucose-based solution.


Assuntos
Diarreia Infantil/terapia , Oryza , Soluções para Reidratação/uso terapêutico , Doença Aguda , Método Duplo-Cego , Fezes , Hidratação/métodos , Humanos , Lactente , Masculino , Potássio/metabolismo , Estudos Prospectivos , Sódio/metabolismo , Equilíbrio Hidroeletrolítico
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