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Oil spills, intrinsically related to the petroleum production chain, represent a risk to the marine environment and a potential threat to humans through seafood consumption. We revised the NE Brazil oil spill and other accidents along the Brazilian coast, with a focus on seafood contamination, covering topics such as bioaccumulation, bioaccessibility, and risk analysis. Comprehensive knowledge of the impacts of spills helps in the interpretation of the dynamics of hydrocarbons released into the sea, contributing to actions to control their negative impacts. Currently, no legal limits have been established permanently in Brazil for PAHs in seafood edible tissues.
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Contaminación por Petróleo , Hidrocarburos Policíclicos Aromáticos , Contaminantes Químicos del Agua , Accidentes , Organismos Acuáticos , Monitoreo del Ambiente , Humanos , Contaminación por Petróleo/efectos adversos , Contaminación por Petróleo/análisis , Hidrocarburos Policíclicos Aromáticos/análisis , Hidrocarburos Policíclicos Aromáticos/toxicidad , Medición de Riesgo , Alimentos Marinos/análisis , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidadRESUMEN
A key component of efforts to address the reproducibility crisis in biomedical research is the development of rigorously validated and renewable protein-affinity reagents. As part of the US National Institutes of Health (NIH) Protein Capture Reagents Program (PCRP), we have generated a collection of 1,406 highly validated immunoprecipitation- and/or immunoblotting-grade mouse monoclonal antibodies (mAbs) to 737 human transcription factors, using an integrated production and validation pipeline. We used HuProt human protein microarrays as a primary validation tool to identify mAbs with high specificity for their cognate targets. We further validated PCRP mAbs by means of multiple experimental applications, including immunoprecipitation, immunoblotting, chromatin immunoprecipitation followed by sequencing (ChIP-seq), and immunohistochemistry. We also conducted a meta-analysis that identified critical variables that contribute to the generation of high-quality mAbs. All validation data, protocols, and links to PCRP mAb suppliers are available at http://proteincapture.org.
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Anticuerpos Monoclonales/inmunología , Análisis por Matrices de Proteínas/métodos , Factores de Transcripción/metabolismo , Animales , Clonación Molecular , Bases de Datos Factuales , Femenino , Células HeLa , Humanos , Ratones , Ratones Endogámicos BALB C , Reproducibilidad de los ResultadosRESUMEN
Two experiments were carried out to test better stocking proportion according to animal size for tilapia (Oreochromis niloticus) and tadpole (Lithobates catesbeianus). The experiments were laid out in a completely randomized design with five treatments (in Experiment I) and four treatments (in Experiment II). In Experiment I, the treatments consisted of a tilapia monoculture; a 75% tilapia + 25% tadpole polyculture; a 50% tilapia + 50% tadpole; a 25% tilapia + 75% tadpole; and a tadpole monoculture. In Experiment II, the treatments were represented by a tilapia monoculture; a 12.5% tilapia + 87.5% tadpole polyculture; a 25% tilapia + 75% tadpole; and a tadpole monoculture. In the first trial, mortality rate differed significantly, with the polyculture treatments having almost 100% mortality of tadpoles. In the second experiment, after adjustments in the initial size of the species, there were significant differences between treatments, with the 12.5% tilapia + 87.5% tadpole polyculture and the tadpole monoculture providing the best results. Regardless of the chosen density, for a polyculture of Nile tilapia and bullfrog tadpoles, ideal conditions would be stocking tilapia fry weighing 50% of the weight initial tadpoles and the proportion of one tilapia for seven tadpoles.
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Cíclidos , Tilapia , Animales , Larva , Rana catesbeianaRESUMEN
Four soybean meal-based diets containing increasing levels of an enzyme complex (E50, E100, E150 and E200 at 50, 100, 150 and 200 g ton-1, respectively) and one soybean meal-based diet without the enzyme complex (E0) were fed in triplicate to M. liza juveniles in a semi-static flow system with 20 fish per tank for 75 days. There were no differences between the treatments for animal performance parameters, but fish fed the enzyme complex treatment exhibited significantly (P<0.05) higher values of calcium bone retention compared with control fish. Although there was no relationship between bacterial counts in different sections of the gastrointestinal tract or enzyme levels, filamentous bacteria were increased in E50 compared with E150. All of the treatments resulted in higher bacterial counts in the stomach than in intestinal segments. Histological screening showed serious to moderate infiltration of inflammatory cells, modification in villus morphology and necrosis in some cases in fish fed the E0 diet. In addition, fish from the E0 treatment exhibited significantly (P<0.05) lower lipid deposition in the peritoneal cavity. Therefore, the use of low levels of exogenous enzyme is recommended in diets for M. liza when soybean meal is used as the main source of protein.
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Dieta/veterinaria , Enteritis/veterinaria , Enzimas/administración & dosificación , Enfermedades de los Peces/prevención & control , Glycine max , Smegmamorpha/crecimiento & desarrollo , Análisis de Varianza , Alimentación Animal/análisis , Animales , Carga Bacteriana , Enteritis/microbiología , Enteritis/patología , Enteritis/prevención & control , Tracto Gastrointestinal/microbiología , Tracto Gastrointestinal/patología , Valores de Referencia , Reproducibilidad de los Resultados , Smegmamorpha/microbiología , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
To broaden the range of tools available for proteomic research, we generated a library of 16,368 unique full-length human ORFs that are expressible as N-terminal GST-His(6) fusion proteins. Following expression in yeast, these proteins were then individually purified and used to construct a human proteome microarray. To demonstrate the usefulness of this reagent, we developed a streamlined strategy for the production of monospecific monoclonal antibodies that used immunization with live human cells and microarray-based analysis of antibody specificity as its central components. We showed that microarray-based analysis of antibody specificity can be performed efficiently using a two-dimensional pooling strategy. We also demonstrated that our immunization and selection strategies result in a large fraction of monospecific monoclonal antibodies that are both immunoblot and immunoprecipitation grade. Our data indicate that the pipeline provides a robust platform for the generation of monoclonal antibodies of exceptional specificity.
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Anticuerpos Monoclonales de Origen Murino/inmunología , Especificidad de Anticuerpos , Proteoma/inmunología , Proteínas Recombinantes de Fusión/inmunología , Animales , Antígenos/química , Antígenos/inmunología , Línea Celular Tumoral , Humanos , Hibridomas , Proteínas Inmovilizadas/química , Proteínas Inmovilizadas/inmunología , Ratones , Ratones Endogámicos BALB C , Análisis por Matrices de Proteínas , Proteoma/química , Proteínas Recombinantes de Fusión/químicaRESUMEN
PURPOSE: To evaluate the posterior septum of the knee and determine the presence of a safe zone that could be removed, without significant damage to blood vessels and nerves. METHODS: Nineteen fresh unpaired adult human cadaveric knees, with no macroscopic degenerative or traumatic changes, were used in this study. Microscopic evaluation was performed by analysis of H&E, CD-34, and S-100 staining. RESULTS: The posterior septum of the knee is rich in type II and type IV mechanoreceptors and blood vessels. The superior half has a greater number of blood vessels (21.52 ± 6.36 v 12.05 ± 4.1, P < .001), higher-caliber vessels (2.2 ± 0.89 µm v 1.41 ± 0.45 µm, P < .006), and a greater number of mechanoreceptors per field (type II, 1.8 ± 1.8 v 0.42 ± 1, P = .04; type IV, 22.6 ± 14 v 14.5 ± 9.4, P = .04) than the inferior half of the septum. CONCLUSIONS: This study has shown that the posterior septum of the knee is highly vascularized and has a great number of type II and IV mechanoreceptors. The presence of these structures is significantly higher in the superior half of the septum. CLINICAL RELEVANCE: If debridement of the posterior septum is necessary, it should be done at the inferior aspect so that a greater number of blood vessels and mechanoreceptors can be preserved.
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Cápsula Articular/anatomía & histología , Articulación de la Rodilla/anatomía & histología , Ligamento Cruzado Posterior/anatomía & histología , Adulto , Cadáver , Disección , Humanos , Cápsula Articular/irrigación sanguínea , Masculino , Mecanorreceptores , Persona de Mediana Edad , Ligamento Cruzado Posterior/irrigación sanguíneaRESUMEN
AIM: The aim of this study was to compare the peak extensor torque (primary outcome), sensory-motor capacity and Lysholm questionnaire score up to the fourth postoperative month post-primary anterior cruciate ligament reconstruction (ACLR) with bone-patellar-tendon-bone (BPTB) graft using either ipsilateral or contralateral technique in young sportsmen. METHODS: We performed a randomized controlled trial from 2018 to 2019. The same preoperative protocol, surgical technique and postoperative protocol were used in both groups. Eighty-eight young adult male patients were randomized, and 44 of each group completed the trial. RESULTS: After the follow up analysis, the contralateral receptor and donor limb demonstrated a statistically significant increase in peak extension torque compared with the ipsilateral operated limb (effect size (ES) = 0.99, power = 0.99, P < 0.0001; ES = 0.46, power = 0.56, P < 0.04). The symmetry between limbs was compared between groups. In the contralateral group, there was a significant decrease in the recipient limb (after surgery), compared with the donor limb (before surgery) (ES = 0.87, power = 0.99, P < 0.0001). In the ipsilateral group, the operated limb demonstrated a significant decrease in peak extension torque compared with the non-operated limb after surgery (ES = 1.88, power = 0.99, P < 0.0001). The comparison between groups in sensory-motor capacity and Lysholm score demonstrated a non-significant group effect postoperatively. CONCLUSION: The use of contralateral BPTB is more effective in increasing peak extension torque when compared with ipsilateral technique in young sportsmen. Furthermore, patients achieved greater symmetry (side to side) in quadriceps muscle performance after the 4-month follow up with a contralateral graft.
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Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Ligamento Rotuliano , Ligamento Cruzado Anterior/cirugía , Lesiones del Ligamento Cruzado Anterior/cirugía , Reconstrucción del Ligamento Cruzado Anterior/métodos , Plastía con Hueso-Tendón Rotuliano-Hueso , Humanos , Masculino , Ligamento Rotuliano/trasplante , Músculo Cuádriceps/cirugía , Torque , Adulto JovenRESUMEN
Injury to the medial compartment of the knee is the most common ligament injury to this joint. The medial approach must consider the presence of associated anteromedial instability. Untreated injury of these instabilities can result in failure of the other reconstructed ligaments. As treatment is usually associated with other ligaments, it is relevant that the technique could save grafts and synthetic material. This article aims to describe a technique for the treatment of anteromedial instabilities through semimembranosus tendon tenodesis in a more anterior and distal position, promoting the tensioning of the posteromedial structures.
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BACKGROUND: Despite the increasing international popularity of CrossFit, there is a paucity of scientific evidence on the risk of CrossFit-related musculoskeletal injuries (CRMIs). PURPOSE: To investigate the incidence (cumulative incidence proportion [IP] and incidence density [ID]) of CRMIs and the association of CRMIs with personal and training characteristics. STUDY DESIGN: Descriptive epidemiology study. METHODS: A prospective, 12-week descriptive epidemiology cohort study was conducted in a convenience sample of CrossFit facilities in a single Brazilian city. Printed baseline questionnaires were distributed to 13 CrossFit boxes. All participants who filled out the questionnaire and consented to participate in the study were invited to respond to an online follow-up questionnaire every 2 weeks to collect data on CrossFit training characteristics and CRMIs. A CRMI was defined as any self-reported musculoskeletal injury or pain that prevented an athlete from exercising for at least 1 day. The IP was defined as the number of new cases divided by the entire population at risk, while the ID was defined as new events divided by the total person-time exposure in hours. Logistic mixed models were developed to investigate the association of CRMIs with personal and training characteristics. RESULTS: A total of 515 CrossFit participants filled out the baseline questionnaire and provided informed consent, and 406 (78.8%) completed at least 1 follow-up measure. There were 133 participants who reported at least 1 CRMI during the study, and a total of 247 unique and new CRMIs were reported over a total estimated person-time exposure to CrossFit of 13,041 hours. The IP was 32.8% (95% CI, 28.4%-37.5%). The ID was 18.9 (95% CI, 16.6-21.3) per 1000 hours of CrossFit exposure. The shoulders (19.0%; n = 47) and lumbar spine (15.0%; n = 37) were most affected. Muscle injuries (45.3%; n = 112) and joint pain (24.7%; n = 61) were the most common CRMI types reported. Switching between prescribed and scaled down training loads (odds ratio [OR], 3.5 [95% CI, 1.7-7.3]) and previous injuries (OR, 3.2 [95% CI, 1.4-7.7]) were risk factors for a CRMI, while CrossFit experience was identified as a protective factor (OR, 0.7 [95% CI, 0.5-1.0]). CONCLUSION: In this 12-week prospective study, the ID was 18.9 CRMIs per 1000 hours of exposure; switching between training loads and previous injuries was associated with 3.5- and 3.2-fold higher odds, respectively, of sustaining CRMIs.
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BACKGROUND: Injuries to the lateral collateral ligament (LCL) are most commonly associated with anterior cruciate ligament (ACL) injury than with posterior cruciate ligament (PCL) injury. There is currently a paucity in the literature in regards to treatment and outcomes of such lesions. METHODS: 30 patients underwent surgical treatment of concomitant LCL and ACL injury or concomitant LCL and PCL injury with follow-up postoperative period of two years. The Lysholm score and varus stress radiographs was calculated and analysed before and at 6, 12, and 24 months postoperatively. RESULTS: There was a significant increase in scores between two timepoints over the follow-up period for both groups: before surgery and after 6 months, and between 6 and 12 months (pâ¯<â¯0.05). The lateral joint opening measured on the varus stress radiographs was greater in group 2 than in group 1 before surgery (pâ¯=â¯0.04). When assessing each group separately, the lateral joint opening decreased at each timepoint in the first year for both groups (pâ¯<â¯0.05). CONCLUSION: Patients diagnosed with combined LCL and PCL injuries were shown to have a higher degree of lateral opening at the time of injury when compared to patients with combined LCL and ACL injuries. However, there was no difference in lateral joint opening on stress radiography after 12 months postoperatively in either group. Finally Lysholm scores for both groups significantly increased between the preoperative period and 6 months postoperatively, as well as between 6 months and 12 months postoperatively. LEVEL OF EVIDENCE: III.
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BACKGROUND: Infections caused by extended-spectrum beta-lactamases enterobacteria (ESBL-EP) have implications for neonatal morbidity and mortality. AIM: To describe the prevalence of ESBL-EP in neonatal sepsis and associated factors. METHODS: A prospective cohort study was conducted from August 2016 to August 2017; newborn babies (NB) hospitalized in the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" were included. The ESBL-EP were investigated by double-disk synergy test and its association with clinical and demographic characteristics of the NB. RESULTS: A total of 1,501 hospitalized NB were studied, with an average gestational age of 36.3 weeks. They were diagnosed 196 neonatal sepsis events, the most frequent etiologies were enterobacteria (45.5%). Resistance to ampicilin was found in 88.8% and to broad spectrum cephalosporins in more than 42% of the strains; 22.9% of them were ESBL phenotype. Apgar ≤ 7 at five minutes of life (OR 4.6; 95% CI 1.47-14.6) and gestational age < 37 weeks (OR 5.4; 95% CI 1.04-27.) increase the risk. CONCLUSION: In enterobacteria that cause neonatal sepsis, 22.9% were EP-ESBL; infection was more likely in patients with Apgar ≤ 7 at five minutes of age and in preterm infants.
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Antibacterianos/farmacología , Infección Hospitalaria/microbiología , Infecciones por Enterobacteriaceae/microbiología , Enterobacteriaceae/efectos de los fármacos , Sepsis Neonatal/microbiología , beta-Lactamasas/biosíntesis , Adolescente , Adulto , Niño , Enterobacteriaceae/clasificación , Femenino , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Adulto JovenRESUMEN
PURPOSE: The aim of this anatomic study on cadavers was to determine the anatomic relation between the posterior cruciate ligament (PCL) and the posterior joint capsule attachment. METHODS: Thirty knees were dissected by means of a posterior approach to the knee. The presence of the posterior popliteal ligament and Wrisberg meniscofemoral ligament was observed and a U-shaped capsulotomy was performed while preserving the distal insertion of the ligament. After detaching the PCL and determining its area on the tibia, we determined its geometric center and posterior margin and measured the distances between the tibial insertion of the capsule and these points. RESULTS: The distance between the center of the PCL and the posterior capsule was 10.3 mm, and the distance between the posterior margin of the PCL and the capsule was 1.7 mm. The posterior popliteal ligament was easy to see in all the specimens, measuring around 42 mm in length. The Wrisberg meniscofemoral ligament was seen in 12 specimens. CONCLUSIONS: We can conclude that the distances from the center of the tibial insertion and the margin of the PCL to the joint capsule were 10.3 mm and 1.7 mm, respectively, thus enabling greater knowledge of the anatomy of the posterior compartment of the knee. CLINICAL RELEVANCE: Our findings provide anatomic data that increase the safety and knowledge regarding the surgical procedures related to the PCL, because we have supplied information that can contribute to obtaining the best arthroscopic view of this area, thus decreasing the risk of vascular and nerve damage.
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Cápsula Articular/anatomía & histología , Ligamento Cruzado Posterior/anatomía & histología , Adulto , Anciano , Estatura , Cadáver , Disección/métodos , Humanos , Rodilla/anatomía & histología , Masculino , Persona de Mediana Edad , Tibia/anatomía & histologíaRESUMEN
INTRODUCTION: The increasing survival rate of preterm infants has altered the epidemiology of neonatal diseases; however, neonatal mortality is still the main component of child mortality. The objective of this study was to evaluate neonatal mortality and associated factors in newborn infants admitted to a neonatal care unit. MATERIAL AND METHODS: Prospective cohort study conducted between January 2016 and January 2017 at Hospital Civil de Guadalajara "Dr. Juan I. Menchaca." The incidence of deaths and associated conditions was evaluated using a multivariate logistic regression analysis. RESULTS: A total of 9366 live births were registered; 15% (n: 1410) of these were admitted to the neonatal care unit. The mortality rate was 125.5 per 1000 hospitalized newborn infants (95% confidence interval [CI]: 109-144); the main reasons for admission were congenital malformations or genetic disorders (28.2%), infections (24.9%), and respiratory distress (20.9%). The conditions associated with death were gestational age < 37 weeks (OR: 2.41, 95% CI: 1.49-3.93), birth weight < 1500 grams (OR: 6.30, 95% CI: 4.15-9.55), moderate/severe respiratory distress at 10 minutes (OR: 1.89, 95% CI: 1.24-2.86), Apgar score < 7 at 5 minutes (OR: 9.40, 95% CI: 5.76-15.31), congenital malformations (OR: 5.52, 95% CI: 3.12-9.78), and less than 5 antenatal care visits (OR: 1.51, 95% CI: 1.09-2.08). CONCLUSIONS: Preterm birth, low birth weight, respiratory distress, Apgar score < 7, congenital malformations, and a history of < 5 antenatal care visits were associated with a higher risk for death.
INTRODUCCIÓN: La mayor supervivencia de pacientes prematuros ha modificado la epidemiología de las enfermedades del recién nacido, pero la mortalidad neonatal aún es el principal componente de la mortalidad infantil. El objetivo del estudio fue cuantificar la mortalidad neonatal y los factores asociados en recién nacidos internados en una Unidad de Cuidados Neonatales. MATERIAL Y MÉTODOS: Estudio de cohorte prospectivo realizado de enero de 2016 a enero de 2017 en el Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Se cuantificó la incidencia de muertes y las condiciones asociadas mediante un análisis multivariado con regresión logística. RESULTADOS: Se registraron 9366 nacidos vivos; fueron internados en la Unidad de Cuidados Neonatales el 15% (n: 1410). La mortalidad fue de 125,5 por 1000 recién nacidos internados (IC 95%: 109-144); las principales causas fueron malformaciones o enfermedades genéticas (28,2%), infecciones (24,9%) y síndrome de dificultad respiratoria (20,9%). Las condiciones asociadas a muerte fueron edad gestacional < 37 semanas (OR 2,41; IC 95%: 1,49-3,93), peso al nacer < 1500 gramos (OR 6,30; IC 95%: 4,159,55), dificultad respiratoria moderada/grave a los 10 minutos de vida (OR 1,89; IC 95%: 1,242,86), Apgar < 7 a los 5 minutos de vida (OR 9,40; IC 95%: 5,76-15,31), malformaciones congénitas (OR 5,52; IC 95%: 3,12-9,78) y menos de cinco consultas de control prenatal (OR 1,51; IC 95%: 1,09-2,08). CONCLUSIONES: El nacimiento prematuro, bajo peso al nacer, dificultad respiratoria, Apgar < 7, malformaciones congénitas y antecedente de < 5 consultas de control prenatal se asociaron con mayor riesgo de muerte.
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Enfermedades del Recién Nacido/mortalidad , Femenino , Unidades Hospitalarias , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Masculino , Neonatología , Estudios Prospectivos , Factores de RiesgoRESUMEN
Abstract Objective: To determine the prevalence of HIV in individuals by analyzing the influence of social determinants and sexual risk behaviors, in order to estimate the crude and adjusted risks of being HIV positive in the municipality of Solidaridad, state of Quintana Roo, Mexico. Method and Materials: A cross-sectional study was conducted in the municipality of Solidaridad, Quintana Roo, Mexico. Third and fourth generation HIV rapid tests were performed. Descriptive statistics, measures of association (OR and 95 % CI) and p value were calculated for each stratum. Logistic regression models were performed to determine the risk factors associated with being HIV positive in the tests. Results: The sample consisted of 4,800 people, of whom 3,030 were men (63.12%); the mean age was 32.6 years (SD 14.96). The variables included in the multivariate model for being HIV positive are: men who have sex with men with OR=61.20, age 30-39 years OR=1.72, having anal sex OR=2.21, and as a protective factor having health service OR =0.42. Conclusions: This study confirms already known social determinants such as being male and being in economically active age and sexual practices such as: having anal sex and men with men. Being entitled to health services was shown to be the only protective factor.
Resumen Objetivo: Determinar la prevalencia de VIH en personas analizando la influencia de los determinantes sociales y las conductas sexuales de riesgo, para estimar los riesgos crudos y ajustados para ser VIH positivo en el municipio Solidaridad, estado de Quintana Roo, México. Método y Materiales: Se realizó un estudio transversal en el municipio de Solidaridad, Quintana Roo, México. Se realizaron pruebas rápidas de VIH de tercera y cuarta generación. Se calcularon las estadísticas descriptivas, las medidas de asociación (OR e IC del 95 %) y el valor de p para cada estrato. Se realizaron modelos de regresión logística para determinar los factores de riesgo asociados con ser VIH positivo en las pruebas. Resultados: La muestra estuvo compuesta por 4,800 personas de las cuales; 3,030 hombres (63.12%); la edad promedio fue de 32.6 años (D.E. 14.96). Las variables incluidas en el modelo multivariado para ser VIH positivo son: hombres que tienen sexo con hombres con OR=61.20, edad 30-39 años OR=1.72, tener sexo anal OR=2.21, y como factor protector contar con servicio de salud OR =0.42. Conclusiones: Este estudio confirma determinantes sociales ya conocidos como el ser hombre y estar en edad económicamente activa y prácticas sexuales como: el tener sexo anal y hombres con hombres. Contar con derechohabiencia se muestra como único factor protector.
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Com a chegada da cirurgia robótica na cirurgia do joelho no Brasil em 2021, novos questionamentos são feitos para que possamos compreender como essa nova tecnologia pode ser assimilada no contexto da saúde e da realidade do país. As novas tendências no financiamento da saúde relacionadas ao setor privado fazem questionar de que maneira novos procedimentos podem ser incorporados, buscando o equilíbrio entre o avanço tecnológico e a acessibilidade baseada em custos e desfechos relacionados à qualidade de vida dos pacientes.
With the arrival of robotic surgery in knee surgery in Brazil in 2021, new questions are asked so that we can understand how this new technology can be assimilated in the context of health and the reality of the country. The new trends in health financing related to the private sector raises the question of how new procedures can be incorporated seeking a balance between technological advancement and accessibility based on costs and outcomes related to the quality of life of patients.
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Análisis Costo-Beneficio , Artroplastia de Reemplazo de Rodilla , Procedimientos Quirúrgicos RobotizadosRESUMEN
Objective: To evaluate the micro-costing of viscosupplementation procedures compared to different infiltration regimens. Methods: This study compared, through the Time-Driven ActivityBased Costing method, the micro-costing of these different application regimens using national cost averages as a basis for calculation in a medium-sized outpatient service. Results: The results demonstrated that the difference in costs with the single application is 31.47% less for three and 119.13% for five applications. Conclusions: No study showed a superiority of the five-application regimen over the three-application regimen, which leads one to believe that there is no justification for this procedure from an economic or quality-of-life point of view.
Objective: Avaliar o microcusteio dos procedimentos de viscossuplementação do joelho em diferentes regimes de aplicação. Métodos: Este estudo comparou, por meio do método Time-Driven Activity-Based Costing, o microcusteio desses diferentes regimes de aplicação, usando com base de cálculo médias nacionais de custo em um serviço ambulatorial de porte médio. Resultados: Os resultados encontrados demonstraram que a diferença nos custos com a aplicação única é 31,47% menor para três aplicações e 119,13% para cinco aplicações. Conclusão: Em nenhum estudo houve superioridade do regime de cinco aplicações ao regime de três, fato que leva a acreditar que não há nenhuma justificativa para esse procedimento do ponto de vista econômico ou de qualidade de vida do paciente.
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Osteoartritis , Asignación de Costos , ViscosuplementaciónRESUMEN
RESUMEN La toxocariasis humana es una importante zoonosis parasitaria causada por formas larvarias del toxocara, un parásito nematodo de perros y gatos. La migración de la larva por los diferentes tejidos blandos en el ser humano genera una serie de entidades clínicas, tales como: toxocariasis encubierta, el síndrome de larva migrans visceral, la toxocariasis ocular y la neurotoxocariasis. Se presenta un caso clínico de un paciente de seis años de edad, hospitalizado a consecuencia de un síndrome febril agudo asociado a dolor abdominal; cuyo examen físico, reveló signos meníngeos, fotofobia, alteraciones en el fondo de ojo y eosinofilia moderada. Teniendo en cuenta la epidemiología, el cuadro clínico y los resultados de estudios serológicos, se concluyó el diagnóstico de larva migrans ocular, para lo cual se utilizó tratamiento específico con una evolución satisfactoria. Esta entidad nosológica requiere de una adecuada valoración socio-epidemiológica de los pacientes, así como de un minucioso examen físico que, unido a las pruebas específicas permitirán el diagnóstico precoz y el tratamiento oportuno.
ABSTRACT Human toxocariasis is an important parasitic zoonosis caused by larval forms of toxocara, a nematode parasite of dogs and cats. The migration of the larva through the different soft tissues in humans generates a series of clinical entities, such as: covert toxocariasis, visceral larva migrans syndrome, ocular toxocariasis and neurotoxocariasis. The clinical case of a six-year-old patient is presented, hospitalized as a result of an acute febrile syndrome associated with abdominal pain; whose physical examination revealed meningeal signs, photophobia, fundus alterations and moderate eosinophilia. Taking into account the epidemiology, the clinical picture and the results of serological studies, the diagnosis of ocular larva migrans was concluded, for which specific treatment was used with a satisfactory evolution. This nosological entity requires an adequate socio-epidemiological assessment of the patients, as well as a thorough physical examination that, together with the specific tests, will allow early diagnosis and timely treatment.
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BACKGROUND: The middle genicular artery (MGA) is responsible for the blood supply to the cruciate ligaments and synovial tissue. Traumatic sports injuries and surgical procedures (open and arthroscopic) can cause vascular damage. Little attention has been devoted to establish safe parameters for the MGA. PURPOSE: To investigate the anatomy of the MGA and its relation to the posterior structures of the knees, mainly the posterior capsule and femoral condyles, and to establish safe parameters to avoid harming the MGA. STUDY DESIGN: Descriptive laboratory study. METHODS: Dissection of the MGA was performed in 16 fresh, unpaired adult human cadaveric knees with no macroscopic degenerative or traumatic changes and no previous surgeries. The specimens were meticulously evaluated with emphasis on preservation of the MGA. The distances from the MGA to the medial and lateral femoral condyles were measured. The Mann-Whitney test was used for statistical analysis. RESULTS: In all specimens, the MGA emerged from the anterior aspect of the popliteal artery, distal to the superior genicular arteries, and had a short distal trajectory toward the posterior capsule where it entered proximal to the oblique popliteal ligament. The artery lay in the midportion between the condyles. The distance between the posterior aspect of the tibia and the point of entry of the MGA into the posterior joint capsule was 23.8 ± 7.3 mm (range, 14.72-35.68 mm). There was no correlation between an individual's height and the distance of the entrance point of the MGA into the posterior joint capsule to the posterior superior corner of the tibia. CONCLUSION: The middle genicular artery lies in the midportion between the medial and lateral femoral condyles. CLINICAL RELEVANCE: This knowledge is important for the preservation of the blood supply during posterior knee surgical procedures and to settle a secure distance between the posterior aspect of the tibia and the MGA input. This could decrease and prevent iatrogenic vascular injury risk to the MGA.
RESUMEN
Muscle injury causes functional impairment. The healing process takes time and fibrotic tissue can result. Recurrence and delayed recovery remain as unsolved problems. Surgical intervention can be a feasible alternative to avoid early and late complications associated with complete muscle tear in attempt to improve functional results. This article hopes to provide an update about surgical treatments for muscle tears in different scenarios.