Multimodal postoperative analgesia with transdermal buprenorphine is a safe option in arthroscopic rotator cuff repair.

BACKGROUND: Arthroscopic rotator cuff repairs are associated with moderate-to-severe pain. Opioids are not the first line for postsurgical pain control due to their potential misuse and side effects. Transdermal buprenorphine represents an alternative for multimodal postoperative pain control. METHODS: This was a single-centre, prospective longitudinal exploratory study of patients undergoing arthroscopic rotator cuff repairs managed with multimodal analgesia with transdermal buprenorphine. Patients were followed-up by telephone at eight time points, assessing pain levels, rescue analgesics requirement and side effects. FINDINGS: Twenty-five patients with an average age of 63.4 ± 8.2 were included. Fourteen patients were ⩾65 years. Pain levels were similar among age groups at all time points, with no pain or mild pain (visual analogue scale 1-4) in most patients. The most frequent side effects were dizziness and somnolence. CONCLUSION: Transdermal buprenorphine provided a sustained analgesic effect after an arthroscopic rotator cuff repair during the acute postsurgical period. It showed a similar safety profile among younger and older patients.

Long-Term Results of Slipped Capital Femoral Epiphysis Treated with the Modified Dunn Procedure in a Colombian Cohort.

BACKGROUD: Slipped capital femoral epiphysis (SCFE) is a severe and catastrophic disorder that affects the hips of adolescents. Many reports about surgical procedures to treat this condition have been published, but to our knowledge, there are no published results of treatment in Latin American patients. This study describes the clinical and radiological results of the modified Dunn procedure with the surgical approach described by Ganz to treat mild to severe SCFE in a cohort of Colombian pediatric patients. METHODS: We retrospectively analyzed 21 patients (22 hips) with SCFE treated with surgical dislocation of the hip from 2005 to 2017. The same pediatric orthopedic surgeon performed all operations. Clinical outcome was assessed using the range of movement and Merle d'Aubigné score, while radiological measurements and assessment included the slip angle and Tönnis score. RESULTS: The average duration of follow-up was 29 months (range, 12-72 months). Of all cases, 17 presented with acute-on-chronic symptoms. Preoperatively, all 22 hips were classified as poor according to the Merle d'Aubigné score. Preoperative radiological classification showed compromise grade II or III in 20 hips. Last follow-up Merle d'Aubigné score rated 17 cases as good or excellent (p < 0.05). The postoperative radiological classification was grade I or II in all 22 cases, and the Tönnis score was stage II in 3 cases and stage III in 4 cases. CONCLUSIONS: Our results suggest that the modified Dunn osteotomy performed through the Ganz technique could be safely and effectively used to treat patients with mild to severe SCFE.

Utilidad de la técnica genotypemtbdrplus para el diagnóstico de tuberculosis pulmonar / Utility of the genotype mtbdrplus technique for pulmonary tuberculosis diagnosis

Introducción: es necesario identificar de forma simple y rápida el bacilo Mycobacterium tuberculosis (MTB) para la instauración temprana de tratamiento efectivo y de medidas decontrol que prevengan la transmisión de la enfermedad.Objetivos: evaluar la utilidad de la prueba Genotype MTBDRplus para la identificación de M. tuberculosisen muestras respiratorias de pacientes atendidos en el Hospital Universitario San Vicentede Paúl Fundación entre junio y agosto de 2010.Materiales y métodos: las muestras respiratorias fueron colectadas de 100 pacientes atendidosen el Hospital, a las cuales se les realizó baciloscopia, cultivo en medio Ogawa Kudoh y PCR por la prueba comercial Genotype MTBDRplus. La sensibilidady especificidad de la PCR fue determinada tomandocomo referencia el cultivo en Ogawa Kudoh.Resultados: la sensibilidad, especificidad, valor predictivopositivo y valor predictivo negativo fueron 86,7 %, 93,7 %, 72,2 % y 97,4 % respectivamente. La sensibilidaden muestras con baciloscopia positiva fue 100 % y de 60 % en muestras con baciloscopia negativa. La medianadel tiempo para el reporte por PCR fue 14 días, comparadocon los 60 días requeridos por el cultivo (p=0,000).Conclusiones: La prueba de PCR Genotype MTBDRpluses una buena opción para la detección rápida de M. tuberculosisen muestras respiratorias con baciloscopia positiva.

Introduction: For the early establishment ofeffective treatment and control measures to prevent disease transmission it´s necessary tohave simple and fast diagnostic tools to identify M. tuberculosis (MTB) bacilli.Objetives: In this study, the usefulness of the Genotype MTBDRplus assay for identifying M. tuberculosisin respiratory specimens from patientsat Hospital Universitario San Vicente de Paúl (HUSVP) was evaluated.Materials and methods: Respiratory specimens were collected from 100 patients treated atthe HUSVP to which smear, culture in Ogawa Kudoh medium and commercial Polymerase ChainReaction (PCR) Genotype MTBDRplus assay were performed. The sensitivity and specificity of PCRwere determined in reference to the culture in Ogawa Kudoh.Results: The sensitivity, specificity, positive predictivevalue and negative predictive value were 86.7 %, 93.7 %, 72.2 % and 97.4 % respectively. Sensitivity in smear-positive samples was 100 %,and 60 % in smear-negative samples. The median time for results reporting using PCR was 14 days compared with the 60 days required by the culture (p=0.000).Conclusions: Genotype MTBDRplus is a good choice for rapid detection of M. tuberculosis in smear positive respiratory specimens.

Principios Básicos y simples de la tecnología transgénica y Knock-Out / Basic and simple concepts on the transgenic and knock-out technologies

El desarrollo de los animales knock-out ha permitido grandes avances en la investigación médica moderna y en la creación de nuevas alternativas terapéuticas para diferentes enfermedades. Hasta la fecha, la habilidad humana para manipular el genoma murino ha tranformado dramáticamente la investigación científica a nivel mundial. Durante la última década, las tecnologías transgénetica convencional y de Knock-out genético se han convertido en herramientas de incalculable valor para la modelacion de desordenes genéticos, para la asignacion de diferentes funciones a diferentes genes, para la evaluación de drogas y tóxinas, y para la resolución de importantes preguntas en la investigación básica y aplicada. Actualmente, el uso de ambos, animales transgénicos y knock-out, se ha convertido en una práctica estándar global en la investigación biomédica