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1.
PLoS One ; 19(6): e0303979, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38843271

RESUMEN

The aim of this present clinical trial is to evaluate the effectiveness of a multicomponent prehabilitation programme administered through educational videos versus another programme based on written exercise recommendations, in patients scheduled for lumbar radiculopathy surgery. This study will be a multicentre, controlled, randomised, parallel clinical trial. One hundred participants undergoing lumbar radiculopathy surgery who meet the established inclusion criteria will be recruited at different Spanish hospitals. The experimental group will follow a 4-week prehabilitation programme combining therapeutic exercise, back care education, and pain neuroscience education delivered through videos designed for consumption at home. The control group will be provided with written instructions to perform therapeutic exercises during the same prehabilitation time period. The primary outcome of the study will be disability, assessed using the Spanish version of the Oswestry Disability Index. The secondary outcomes will be pain perception, health-related quality of life, fear avoidance, kinesiophobia, catastrophising, anxiety, depression, physical activity, and the treatment satisfaction of the patients. This study will provide evidence for the effectiveness of a home-based multicomponent prehabilitation programme that addresses some already identified barriers to patient attendance in face-to-face programmes. Understanding the medium and long-term effects of pre-surgery lumbar muscle training and pain neuroscience education administered via instructional videos watched by patients at home, will help improve the design of prehabilitation programmes in this population while also improving the cost-effectiveness of such interventions.


Asunto(s)
Educación del Paciente como Asunto , Radiculopatía , Humanos , Radiculopatía/cirugía , Radiculopatía/terapia , Radiculopatía/rehabilitación , Educación del Paciente como Asunto/métodos , Terapia por Ejercicio/métodos , Ejercicio Preoperatorio , Femenino , Masculino , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Dolor de la Región Lumbar/terapia , Dolor de la Región Lumbar/cirugía , Adulto , Persona de Mediana Edad , Resultado del Tratamiento , Neurociencias , Manejo del Dolor/métodos
2.
Bone Joint Res ; 13(4): 169-183, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38618868

RESUMEN

Aims: Rotator cuff (RC) injuries are characterized by tendon rupture, muscle atrophy, retraction, and fatty infiltration, which increase injury severity and jeopardize adequate tendon repair. Epigenetic drugs, such as histone deacetylase inhibitors (HDACis), possess the capacity to redefine the molecular signature of cells, and they may have the potential to inhibit the transformation of the fibro-adipogenic progenitors (FAPs) within the skeletal muscle into adipocyte-like cells, concurrently enhancing the myogenic potential of the satellite cells. Methods: HDACis were added to FAPs and satellite cell cultures isolated from mice. The HDACi vorinostat was additionally administered into a RC injury animal model. Histological analysis was carried out on the isolated supra- and infraspinatus muscles to assess vorinostat anti-muscle degeneration potential. Results: Vorinostat, a HDACi compound, blocked the adipogenic transformation of muscle-associated FAPs in culture, promoting myogenic progression of the satellite cells. Furthermore, it protected muscle from degeneration after acute RC in mice in the earlier muscle degenerative stage after tenotomy. Conclusion: The HDACi vorinostat may be a candidate to prevent early muscular degeneration after RC injury.

3.
Sci Rep ; 14(1): 2694, 2024 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-38302695

RESUMEN

Current statistical models to simulate pandemics miss the most relevant information about the close atomic interactions between individuals which is the key aspect of virus spread. Thus, they lack a proper visualization of such interactions and their impact on virus spread. In the field of computer graphics, and more specifically in computer animation, there have been many crowd simulation models to populate virtual environments. However, the focus has typically been to simulate reasonable paths between random or semi-random locations in a map, without any possibility of analyzing specific individual behavior. We propose a crowd simulation framework to accurately simulate the interactions in a city environment at the individual level, with the purpose of recording and analyzing the spread of human diseases. By simulating the whereabouts of agents throughout the day by mimicking the actual activities of a population in their daily routines, we can accurately predict the location and duration of interactions between individuals, thus having a model that can reproduce the spread of the virus due to human-to-human contact. Our results show the potential of our framework to closely simulate the virus spread based on real agent-to-agent contacts. We believe that this could become a powerful tool for policymakers to make informed decisions in future pandemics and to better communicate the impact of such decisions to the general public.


Asunto(s)
Modelos Estadísticos , Pandemias , Humanos , Simulación por Computador
4.
Minerva Anestesiol ; 90(1-2): 87-97, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38197590

RESUMEN

The outcome of fascial plane blocks (FPBs) has a certain variability that may depend on many factors, which can be divided into three main categories: operator-related, patient-related and drug-related. Operator-related factors include personal skills, choice of needle and injection modalities. Patient variables include anthropometric features, the type of targeted fascia, anatomical variants, patient positioning, muscle tone and breathing. Ultimately, efficacy, onset, and duration of fascial blocks may be affected by characteristics of the injected solution, including the type of local anesthetic, volume, concentration, pH, temperature and the use of adjuvants. In this article, we investigated all the factors that may influence the outcome of FPBs from a generic perspective, without focusing on any specific technique. Also, we provided suggestions to optimize techniques for everyday practitioners and insights to researchers for future studies.


Asunto(s)
Bloqueo Nervioso , Humanos , Bloqueo Nervioso/métodos , Manejo del Dolor , Anestesia Local/métodos , Anestésicos Locales/uso terapéutico , Fascia
5.
Reg Anesth Pain Med ; 2023 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-38050174

RESUMEN

BACKGROUND: Inconsistent nomenclature and anatomical descriptions of regional anesthetic techniques hinder scientific communication and engender confusion; this in turn has implications for research, education and clinical implementation of regional anesthesia. Having produced standardized nomenclature for abdominal wall, paraspinal and chest wall regional anesthetic techniques, we aimed to similarly do so for upper and lower limb peripheral nerve blocks. METHODS: We performed a three-round Delphi international consensus study to generate standardized names and anatomical descriptions of upper and lower limb regional anesthetic techniques. A long list of names and anatomical description of blocks of upper and lower extremities was produced by the members of the steering committee. Subsequently, two rounds of anonymized voting and commenting were followed by a third virtual round table to secure consensus for items that remained outstanding after the first and second rounds. As with previous methodology, strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. RESULTS: A total of 94, 91 and 65 collaborators participated in the first, second and third rounds, respectively. We achieved strong consensus for 38 names and 33 anatomical descriptions, and weak consensus for five anatomical descriptions. We agreed on a template for naming peripheral nerve blocks based on the name of the nerve and the anatomical location of the blockade and identified several areas for future research. CONCLUSIONS: We achieved consensus on nomenclature and anatomical descriptions of regional anesthetic techniques for upper and lower limb nerve blocks, and recommend using this framework in clinical and academic practice. This should improve research, teaching and learning of regional anesthesia to eventually improve patient care.

6.
Reg Anesth Pain Med ; 2023 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-37597856

RESUMEN

INTRODUCTION: Serratus anterior plane block has been proposed to reduce opioid requirements after minimally invasive cardiac surgery, but high-quality evidence is lacking. METHODS: This prospective, double-blinded, randomized controlled trial recruited patients undergoing totally endoscopic aortic valve replacement. Patients in the intervention arm received a single-injection serratus anterior plane block on arrival to the intensive care unit added to standard of care. Patients in the control group received routine standard of care, including patient-controlled intravenous analgesia. Primary outcome was piritramide consumption within the first 24 hours after serratus anterior plane block placement. We hypothesized that compared with no block, patients in the intervention arm would consume 25% less opioids. RESULTS: Seventy-five patients were analyzed (n=38 in intervention arm, n=37 in control arm). When comparing the serratus anterior plane group with the control group, median 24-hour cumulative opioid use was 9 (IQR 6-19.5) vs 15 (IQR 11.3-23.3) morphine milligram equivalents, respectively (p<0.01). Also, pain scores at 4, 8 and 24 hours were lower in the intervention arm at 4, 8 and 24 hours, respectively. CONCLUSION: Combined deep and superficial single-injection serratus anterior plane block is superior to standard of care in reducing opioid requirements and postoperative pain intensity up to 24 hours after totally endoscopic aortic valve replacement. TRIAL REGISTRATION NUMBER: NCT04699422.

7.
Global Spine J ; 13(1): 156-163, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33601909

RESUMEN

STUDY DESIGN: Animal experimental model. OBJECTIVE: To study the clinical behavior and histological changes in the spinal cord, nerve roots and perivertebral muscles of the spine after induced leakage of polymethylmethacrylate (PMMA) loaded with antiblastic drugs during vertebroplasty in an animal model of pigs. METHODS: We performed vertebroplasty on 25 pigs. The animals were divided into 3 groups: vertebroplasty with PMMA alone (control group), vertebroplasty with PMMA loaded with methotrexate (MTX) and vertebroplasty with PMMA loaded with cisplatin (CYS). At 2 vertebral levels, epidural and prevertebral, massive cement leaks were induced. Animals were evaluated daily. Two weeks later, the pigs were sacrificed, and the tissues that came in contact with the cement were analyzed. RESULTS: The clinical results for each of the groups were reported. The control group had no clinical alterations. In the MTX group, 2 pigs died before 1 week due to pneumonitis. In the CYS group, 4 animals had motor impairment, and 3 of the 4 had paraplegia. The histological results were as follows: the control and MTX groups showed synovial metaplasia, inflammatory reaction, crystal deposits, and giant cell reaction in the dura mater and muscle and all the animals in the CYS group had spinal cord and muscular necrosis. CONCLUSIONS: Massive cement leak after vertebroplasty with PMMA loaded with cisplatin is extremely toxic to the spinal cord and muscles around the spine. Therefore, its use cannot be recommended for the treatment of vertebral metastases. Using PMMA loaded with methotrexate seems to be a safe procedure, but further research is needed.

8.
Geriatrics (Basel) ; 7(6)2022 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-36547278

RESUMEN

Changes in vertebral body height depend on various factors which were analyzed in isolation and not as a whole. The aim of this study is to analyze what factors might influence the restoration of the vertebral body height after vertebral augmentation. We analyzed 48 patients (108 vertebrae) with osteoporotic vertebral fractures who underwent vertebral augmentation when a conservative treatment proved to be unsatisfactory. The analyses were carried out at the time of the fracture, during surgery (pre-cementation and post-cementation), at the first medical check-up (6 weeks post-surgery) and at the last medical check-up. The average vertebral height was measured, and the differences from the preoperative values were calculated at each timepoint. A Pearson correlation coefficient and a linear multivariable regression were carried out at different timepoints. The time since the vertebral fracture was 60.4 ± 41.7 days. The patients' average age was 73.8 ± 7 years. The total follow-up period was 1.43 ± 1 year. After vertebral cementation, there was an increase in the vertebral body height of +0.3 cm (13.6%). During the post-operative follow-up, there was a progressive collapse of the vertebral body, and the pre-surgical height was reached. The factors that most influenced the vertebral height restoration were: a grade III collapse, an intervertebral-vacuum-cleft (IVVC) and the use of a flexible trocar before cement augmentation. The factor that negatively influenced the vertebral body height restoration was the location of the thoracolumbar spine.

9.
Molecules ; 27(19)2022 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-36235044

RESUMEN

Most physicochemical and sensory properties of edible vegetable oils are not stable over time. One of the main causes of quality depletion of vegetable oils is oxidation, which influences sensory acceptability and nutritional value, and could even lead to toxic compounds. That negative influence affects international refined oil prices and the variety of its culinary applications. Modelling quality depletion of vegetable oils and establishing the shelf life, generally accepted as the time until rancidity becomes evident, already remains a challenge for the industry. Hence, this paper will show a promising chemofoodmetric methodology, as an easy and straightforward tool to estimate the current shelf-life of refined vegetable oils, based on a comprehensive characterisation of quality depletion-related changes over storage time under real market conditions. The methodology for building a multivariate kinetic ageing-based model is described, taking into account all time-related physicochemical parameters and chemometric processing tools. From a particular ageing state, multiparametric models are able to reliably infer the expected storage time for each vegetable oil so that it remains consistent with acceptability requirements. The results of the study pointed out the accuracy of multivariate shelf-life modelling with regard to univariate modelling. Discrepancies were found in the oxidation rates of oils extracted from different plant seeds.


Asunto(s)
Aceites de Plantas , Semillas , Oxidación-Reducción , Aceites de Plantas/química , Semillas/química , Verduras
10.
IEEE Trans Vis Comput Graph ; 28(9): 3277-3291, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35015642

RESUMEN

We present a case study on a journey about a personal data collection of carnivorous plant species habitats, and the resulting scientific exploration of location data biases, data errors, location hiding, and data plausibility. While initially driven by personal interest, our work led to the analysis and development of various means for visualizing threats to insight from geo-tagged social media data. In the course of this endeavor we analyzed local and global geographic distributions and their inaccuracies. We also contribute Motion Plausibility Profiles-a new means for visualizing how believable a specific contributor's location data is or if it was likely manipulated. We then compared our own repurposed social media dataset with data from a dedicated citizen science project. Compared to biases and errors in the literature on traditional citizen science data, with our visualizations we could also identify some new types or show new aspects for known ones. Moreover, we demonstrate several types of errors and biases for repurposed social media data. Please note that people with color impairments may consider our alternative paper version.


Asunto(s)
Medios de Comunicación Sociales , Sesgo , Gráficos por Computador , Humanos
11.
Reg Anesth Pain Med ; 46(7): 571-580, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34145070

RESUMEN

BACKGROUND: There is heterogeneity in the names and anatomical descriptions of regional anesthetic techniques. This may have adverse consequences on education, research, and implementation into clinical practice. We aimed to produce standardized nomenclature for abdominal wall, paraspinal, and chest wall regional anesthetic techniques. METHODS: We conducted an international consensus study involving experts using a three-round Delphi method to produce a list of names and corresponding descriptions of anatomical targets. After long-list formulation by a Steering Committee, the first and second rounds involved anonymous electronic voting and commenting, with the third round involving a virtual round table discussion aiming to achieve consensus on items that had yet to achieve it. Novel names were presented where required for anatomical clarity and harmonization. Strong consensus was defined as ≥75% agreement and weak consensus as 50% to 74% agreement. RESULTS: Sixty expert Collaborators participated in this study. After three rounds and clarification, harmonization, and introduction of novel nomenclature, strong consensus was achieved for the names of 16 block names and weak consensus for four names. For anatomical descriptions, strong consensus was achieved for 19 blocks and weak consensus was achieved for one approach. Several areas requiring further research were identified. CONCLUSIONS: Harmonization and standardization of nomenclature may improve education, research, and ultimately patient care. We present the first international consensus on nomenclature and anatomical descriptions of blocks of the abdominal wall, chest wall, and paraspinal blocks. We recommend using the consensus results in academic and clinical practice.


Asunto(s)
Pared Abdominal , Anestesia de Conducción , Pared Torácica , Consenso , Técnica Delphi , Humanos
13.
Foot Ankle Surg ; 27(2): 143-149, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32370948

RESUMEN

BACKGROUND: The literature published about osteoid osteoma (OO) in the ankle-foot consists mainly on case reports. METHODS: We performed a retrospective study in which we analyzed demographic parameters, pain characteristics, treatment options and functional outcomes measured using the AOFAS and the SEFAS scales. RESULTS: We treated 17 patients with OO around the ankle-foot. Eighty-eight percent of patients had night pain that was relieved with NSAIDs. The bones most often affected were the talus and calcaneus. OO was diagnosed 21 months after the onset of symptoms. Mean follow-up was 17.3 years. The surgical techniques most used were curettage and curettage and bone grafting. There was a significant increase in AOFAS and SEFAS scores after surgery. CONCLUSIONS: Suspicion is the base of a prompt and a correct diagnosis of OO. The OO should be especially suspected in patients who present night pain that can be relieved with NSAIDs.


Asunto(s)
Neoplasias Óseas/cirugía , Peroné , Osteoma Osteoide/cirugía , Dolor/etiología , Huesos Tarsianos , Tibia , Adolescente , Adulto , Articulación del Tobillo , Neoplasias Óseas/diagnóstico por imagen , Trasplante Óseo , Niño , Legrado , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoma Osteoide/complicaciones , Osteoma Osteoide/diagnóstico por imagen , Dolor/cirugía , Estudios Retrospectivos , Adulto Joven
15.
Braz J Anesthesiol ; 70(4): 443-447, 2020.
Artículo en Portugués | MEDLINE | ID: mdl-32739200

RESUMEN

BACKGROUND: There are various approaches to perform an ultrasound guided Quadratus Lumborum Block (QLB). The lateral, posterior, anterior or trans muscular and subcostal paramedian are the various approaches described for performing a QLB. Each of these blocks are aimed to achieve a maximum spread with high volume and low concentration of local anesthetics. CASE REPORT: In this novel approach a curvilinear ultrasound probe was used with the patient lying in supine position. The probe was placed longitudinally in the mid axillary line to visualize Quadratus Lumborum Muscle (QLM) in the coronal plane. The needle was then introduced from cranial to caudal direction and catheters were inserted in the Anterior Thoracolumbar Fascia (ATLF) up to a distance of 4-5 cm in 24 patients for an anterior approach to acetabulum fractures. The needle tip and the Local Anesthetic (LA) spread was visible in all patients. All patients except 4 had excellent perioperative pain relief considering stable hemodynamics and VAS 2-3/10 for the first 48 hours. All patients received 1g intravenous paracetamol each 8hours. VAS in postoperative period was 2-3/10, in 20/24 patients. In the postoperative period, 4 patients complained of persistent pain, requiring intravenous fentanyl boluses and multimodal analgesia. Mean VAS score was 2.87 from 0-12 hours, 3.14 from 12-24 hours, and 3.35 from 24-48 hours. There were no block-related complications in any patient. CONCLUSION: The supine midaxillary coronal approach to anterior QLB is an effective and feasible approach to QLB which can be performed in supine position.


Asunto(s)
Anestésicos Locales/administración & dosificación , Bloqueo Nervioso/métodos , Dolor Postoperatorio/prevención & control , Músculos Abdominales , Acetábulo/lesiones , Acetábulo/cirugía , Acetaminofén/administración & dosificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/efectos adversos , Posición Supina , Factores de Tiempo , Ultrasonografía Intervencional
16.
Rev. bras. anestesiol ; 70(4): 443-447, July-Aug. 2020. graf
Artículo en Inglés, Portugués | LILACS | ID: biblio-1137201

RESUMEN

Abstract Background: There are various approaches to perform an ultrasound guided Quadratus Lumborum Block (QLB). The lateral, posterior, anterior or trans muscular and subcostal paramedian are the various approaches described for performing a QLB. Each of these blocks are aimed to achieve a maximum spread with high volume and low concentration of local anesthetics. Case report: In this novel approach a curvilinear ultrasound probe was used with the patient lying in supine position. The probe was placed longitudinally in the mid axillary line to visualize Quadratus Lumborum Muscle (QLM) in the coronal plane. The needle was then introduced from cranial to caudal direction and catheters were inserted in the Anterior Thoracolumbar Fascia (ATLF) up to a distance of 4-5 cm in 24 patients for an anterior approach to acetabulum fractures. The needle tip and the Local Anesthetic (LA) spread was visible in all patients. All patients except 4 had excellent perioperative pain relief considering stable hemodynamics and VAS 2-3/10 for the first 48 hours. All patients received 1 g intravenous paracetamol each 8 hours. VAS in postoperative period was 2-3/10, in 20/24 patients. In the postoperative period, 4 patients complained of persistent pain, requiring intravenous fentanyl boluses and multimodal analgesia. Mean VAS score was 2.87 from 0-12 hours, 3.14 from 12-24 hours and 3.35 from 24-48 hours. There were no block-related complications in any patient. Conclusion: The supine midaxillary coronal approach to anterior QLB is an effective and feasible approach to QLB which can be performed in supine position.


Resumo Justificativa: Existem várias abordagens para a realização do Bloqueio do Quadrado Lombar (BQL) guiado por ultrassom. Diversas abordagens são descritas para a realização do BQL: paramediana lateral, posterior, anterior ou transmuscular e subcostal, todas com o objetivo de obter a máxima dispersão da solução injetada, usando-se alto volume e baixa concentração de anestésico local. Relato de caso: Nesta nova abordagem, a sonda de ultrassom curvilínea foi usada com o paciente em decúbito dorsal. A sonda foi posicionada longitudinalmente na linha axilar média para visualizar o Músculo Quadrado Lombar (MQL) no plano coronal. A agulha foi introduzida na direção cranial-caudal, e foram inseridos cateteres na Fáscia Toracolombar Anterior (FTLA) até uma distância de 4-5 cm, em 24 pacientes a serem submetidos à correção de fratura do acetábulo pela via anterior. O bisel da agulha e a dispersão do Anestésico Local (AL) eram visíveis em todos os pacientes. Os 24 pacientes, com exceção de quatro, apresentaram excelente analgesia perioperatória, baseando-se na estabilidade hemodinâmica e nos escores EVA de 2-3/10 nas primeiras 48 horas. Todos os pacientes receberam 1 g de paracetamol intravenoso a cada 8 horas. O escore EVA no período pós-operatório foi de 2-3/10, em 20 dos 24 pacientes. No período pós-operatório, quatro pacientes apresentaram queixa de dor persistente, necessitando de bolus de fentanil por via intravenosa e analgesia multimodal. O escore médio da EVA no pós-operatório foi 2,87 entre 0-12 horas; 3,14 entre 12-24 horas e 3,35 entre 24-48 horas pós-operatórias. Não houve complicações relacionadas ao bloqueio em nenhum paciente. Conclusão: A abordagem supina axilar média coronal para BQL anterior é eficaz e viável para BQL, e pode ser realizada com os pacientes em decúbito dorsal.


Asunto(s)
Humanos , Masculino , Femenino , Dolor Postoperatorio/prevención & control , Anestésicos Locales/administración & dosificación , Bloqueo Nervioso/métodos , Factores de Tiempo , Posición Supina , Músculos Abdominales , Ultrasonografía Intervencional , Acetábulo/cirugía , Acetábulo/lesiones , Acetaminofén/administración & dosificación , Persona de Mediana Edad , Bloqueo Nervioso/efectos adversos
17.
Reprod Sci ; 27(10): 1857-1862, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32533457

RESUMEN

The aim of this study was to assess the association between IRF6 single nucleotide polymorphisms and nonsyndromic cleft lip, with or without cleft palate (NSCL/P), in a Chilean population, based on a case-control sample and confirmed in a case-parent trio population. In a sample of 150 Chilean case-parent trios and 164 controls (cohort 1), we evaluated the association between three common IRF6 variants (rs764093, rs2236909, rs2235375) and NSCL/P using odds ratio (OR) for case-control and case-parent trios and in a combined OR of both designs. To confirm associations from the cohort 1, we increased the sample size to 215 triads and 320 controls (cohort 1 + cohort 2). The combined OR for the cohort 1 reveals that the rs2235375 C allele is associated with NSCL/P in Chile (OR 1.34; p = 0.013), which was supported by the results for the two cohorts (OR 1.29; p = 0.006). Bioinformatic prediction showed that this variant, located 27 bp downstream from IRF6 exon 6, potentially alters the splicing process and based on functional annotations is associated with a decrease of gene expression. We propose that the C allele of rs2235375 from IRF6 gene seems to be a risk factor for NSCL/P in a Chilean population. However, we cannot discard a population stratification bias in our findings. On the other hand, further studies are necessary to confirm the biological role of rs2235375 in IRF6 function at craniofacial development level.


Asunto(s)
Labio Leporino/genética , Fisura del Paladar/genética , Predisposición Genética a la Enfermedad , Factores Reguladores del Interferón/genética , Polimorfismo de Nucleótido Simple , Alelos , Estudios de Casos y Controles , Chile , Femenino , Frecuencia de los Genes , Estudios de Asociación Genética , Genotipo , Humanos , Masculino
18.
Asian J Anesthesiol ; 57(2): 28-36, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-31382323

RESUMEN

Since the original description in 2011, the array of pectoral nerve blocks has evolved. The pectoral nerve (PECS) block in conjunction with general anesthesia can decrease an additional analgesic in perioperative period for breast cancer surgeries. Current literature on the PECS block has reported 3 several types (PECS I, PECS II, and serratus plane blocks). The PECS I block is the same as to the fi rst injection in the PECS II block. The second injection in the PECS II block and the serratus plane block blocks intercostal nerves (Th2­6) and provides an analgesic for the breast cancer surgery. However, the PECS I block (or fi rst injection in the PECS II block) has no analgesic, because both lateral and medial pectralis nerve blocks are motor nerves. PECS block in previous reports, when added to opioid-based general anesthesia, may improve analgesia and decrease narcotic use for breast cancer surgery. Moreover, PECS block compares favorably with other regional techniques for selected types of surgery. A major limitation of the PECS block is that it cannot block the internal mammary region. Therefore, some studies have reported its ability to block the anterior branches of the intercostal nerve. PECS block is an effective analgesic tool for the anterolateral chest. In particular, the PECS block can provide more effective analgesia for breast cancer surgery.


Asunto(s)
Neoplasias de la Mama/cirugía , Bloqueo Nervioso/métodos , Femenino , Humanos , Músculos Pectorales/anatomía & histología , Nervios Torácicos
19.
Arch Orthop Trauma Surg ; 139(12): 1681-1690, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31098688

RESUMEN

INTRODUCTION: A multitude of procedures has been described in the literature for the treatment of lesser toe deformities and there is currently no general consensus on the optimal method of fixation. The aim of this study is to assess the clinical and radiological outcomes of an intramedullary nitinol implant for the correction of lesser toe deformities, and to determine if the distal interphalangeal (DIP) joint and metatarsophalangeal (MTP) joint are modified during patient follow-up after correction of the PIP joint. MATERIALS AND METHODS: A prospective analysis of 36 patients with claw toe or hammertoe who were treated with an intramedullary nitinol implant. Clinical manifestations and angulation of the metatarsophalangeal, proximal and distal interphalangeal (MTP, PIP, DIP) joints were evaluated in radiographic studies preoperatively, at first medical revision post-surgery, and after a minimum of 1 year of follow-up. Complications such as non-union rate, implant rupture, and implant infection were also evaluated during follow-up. RESULTS: All patients were women with an average age of 65.5 (range 47-82) years. The average follow-up time was 2.4 (range 1-5.7) years. Fifty intramedullary nitinol implants were used. The MTP joint extension and PIP joint flexion decreased by 15.9° (95% CI - 19.11 to - 12.63) and 49.4° (95% CI - 55.29 to - 43.52), respectively, at the end of follow-up. Moreover, the DIP joint flexion increased progressively during follow-up (13.7° pre-surgery versus 35.6 in last medical check-up, 95% CI 13.24-30.57). There were four (8%) asymptomatic implant ruptures. The rate of fusion was 98%. CONCLUSION: The reduction of the PIP joint using an intramedullary nitinol implant is a good option in lesser toe deformities, with few complications and a high rate of arthrodesis. Moreover, the PIP joint reduction affects both the MTP and DIP joints.


Asunto(s)
Aleaciones/uso terapéutico , Artrodesis/métodos , Síndrome del Dedo del Pie en Martillo/cirugía , Procedimientos de Cirugía Plástica/métodos , Prótesis e Implantes , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Examen Físico , Complicaciones Posoperatorias/cirugía , Estudios Prospectivos , Rango del Movimiento Articular
20.
Rev. latinoam. cienc. soc. niñez juv ; 16(2): 839-852, jul.-dic. 2018.
Artículo en Español | LILACS | ID: biblio-978575

RESUMEN

Resumen (descriptivo): Este artículo analiza dos características principales del activismo juvenil que tuvo lugar en los partidos políticos y en la universidad pública en la década de 1980 en la Argentina. En primer lugar, indicamos como una particularidad del período la coexistencia de dos generaciones políticas en las organizaciones juveniles. En segundo lugar, señalamos la conformación de un emergente ethos ligado a la democracia como causa militante que estructura los lenguajes y repertorios de acción en ambos espacios. A partir de un trabajo de entrevistas en profundidad, se recupera aquí la dimensión cotidiana del activismo en un período de participación y movilización juvenil singular, en el que se produjeron cambios y rupturas respecto de la militancia de los años setenta.


Abstract (descriptive): This article analyzes two main characteristics of youth activism that occurred in political parties and public universities in the 1980s in Argentina. Firstly, the authors highlight the coexistence of two political generations in youth organizations during this period. Secondly, the authors highlight the emergence of an ethos linked to democracy as a militant cause that structures the languages and repertoires of action in both spaces. From a set of in-depth interviews, the study recovers the daily dimensions of activism in a period with high levels of youth participation and mobilization in which there are changes and ruptures following the militancy of the seventies.


Resumo (descritivo): O artigo analisa duas características principais do ativismo juvenil na década de 1980 em Argentina que tiveram lugar nos partidos políticos e nas universidades públicas. Primeiro, a singularidade da coexistência de duas gerações políticas nas organizações de jovens. Em segundo lugar, observamos a formação de um ethos emergente ligado à democracia, que estrutura as causas militantes, as linguagens e os repertórios de ação em ambos espaços. A partir de entrevistas em profundidade, o artigo recupera aqui a dimensão cotidiana do ativismo, em um período de participação e mobilização da juventude singular, em que foram produzidas mudanças e rupturas com relação ao ativismo dos anos setenta.


Asunto(s)
Humanos , Democracia , Universidades , Adolescente
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