Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis. / Retorno a la actividad completa tras cirugía de reconstrucción de ligamento cruzado anterior en personal militar: metaanálisis.

OBJECTIVE: A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it. MATERIAL AND METHOD: Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA- standards, and the inclusion criteria following the PICO strategy. Data from included studies were analyzed using Review Manager 5.4 software. RESULTS: A total of 7 retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group vs. 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99). CONCLUSION: Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.

[Translated article] Return to full duty after anterior cruciate ligament reconstruction surgery in military personnel: A meta-analysis.

OBJECTIVE: A meta-analysis was carried out to evaluate the clinical-functional results of anterior cruciate ligament surgery in military population, as well as the complications associated with it. MATERIAL AND METHOD: Three major database sources up to December 2022 (PubMed, Google Scholar, and ScienceDirect) were searched for outcomes after anterior cruciate ligament surgery in military personnel. The systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA- standards, and the inclusion criteria following the PICO strategy. Data from included studies were analysed using Review Manager 5.4 software. RESULTS: A total of seven retrospective studies were selected. The general rate of return to full duty in military personnel was 62.3% (61.5% for the non-officer group versus 68.3% for the officer group) without this difference being significant (p=0.92). The general rate of meniscal injury in the military was 58.8%, without this difference being significant (p=0.88). The homogeneity in both cases was good (I2=0%, p=0.99). CONCLUSION: Return to full military duty can be used in the military population as a marker of success after anterior cruciate ligament reconstruction. It should be noted that a large number of military personnel experience permanent activity limitations that prevent full return to service.

Investigación del consumo de alcohol y diagnóstico de los pacientes alcohólicos en atención primaria / Research on alcohol consumption and diagnosis of alcoholism in a primary health care setting

Objetivos: conocer la frecuencia con que se investiga la presencia de problemas relacionados con el consumo de alcohol y la tasa de identificación de los pacientes alcohólicos en atención primaria. Material y métodos: se investigó en 219 pacientes la existencia de un diagnóstico de alcoholismo basado en el cumplimiento de los criterios diagnósticos del DSM-III y/o en la presencia de un consumo de alcohol mayor a igual a 60 gramos al día para los hombres o 30 gramos al día para las mujeres, y se revisó la historia clínica de cada paciente para investigar si figuraba su consumo habitual de alcohol, así como se había registrado la existencia de un diagnóstico de alcoholismo. El análisis estadístico se realizó por medio del test de X2, y la comparación de medias por el test de Student en el caso de la edad. Resultados: fueron diagnosticados de alcoholismo 54 pacientes. En la historia clínica de 167 pacientes (76,2 por ciento) constaba la investigación previa del consumo de alcohol. Se encontró un diagnóstico de alcoholismo registrado en la historia de 19 de los 54 pacientes que cumplían los criterios diagnósticos fijados en nuestro estudio (35,2 por ciento), así como en 3 pacientes que no los cumplían. Conclusiones: a pesar de que existía un buen registro de los hábitos de consumo de alcohol, el 64,8 por ciento de los pacientes diagnosticados de alcoholismo en nuestro estudio no eran conocidos previamente, lo que hace que debamos cuestionarnos la eficacia de los métodos diagnósticos que utilizamos habitualmente

Problems related to alcohol consumption in primary health care: prevalence and clinical profile.

The objective of this study was to discover the medical prevalence of alcoholism in our primary care centres, the sociodemographic and clinical profile of these patients and their use of medical resources at our level of health care. The study was an observational one of a cross-sectional descriptive nature, and was set in an urban health centre. Six-hundred and ninety-eight patients aged over 15 years were selected randomly from doctors surgeries. The prevalence of alcoholism among the patients participating in our study estimated from the answers to the CAGE questionnaire, was 17.18%. Of the alcoholic patients, 90.7% were male, with a significantly lower average age than the non-alcoholics; diagnosis was more frequent in production workers than in other occupational groups. The alcoholic patients generally drank daily and consumed drinks with a high percentage of alcohol; 74.1% were smokers. The alcoholic patients were more likely to present a history of neoplasms and injuries or adverse effects than the non-alcoholics. There was a higher attendance rate among alcoholic patients who presented more severe symptoms. It was concluded that alcoholism is a highly prevalent health problem at our level of health care, and fundamentally affects young males.

Determinación de volumen corpuscular medio, gamma-glutamil transpeptidasa y creatinfosfokinasa en la valoración de la abstinencia alcohólica / Mean corpuscular volume, gamma-glutamyl transpeptidase and creatine phosphokinase determination in the evaluation of alcoholic with drawal

Se han determinado VCM, GGT y CPK en 220 pacientes alcohólicos ingresados en la Unidad de Alcoholismo del Hospital Psiquiátrico, a fin de estudiar su interés en el seguimiento de la abstinencia alcohólica. Los resultados fueron comparados con los de un grupo de 48 voluntarios sanos procedentes del personal sanitario de este hospital. Se establecieron dos grupos clínicos en función de la severidad de la hepatopatía: grupo A, formado por 144 pacientes con índice de Orrego inferior a 5. Grupo B: 76 pacientes con índice igual o superior a 5 o bien filiados de hepatitis/cirrosis mediante biopsia. Se llega a la conclusión de que la alta sensibilidad diagnóstica y su precoz normalización, hacen de la CPK el marcador más útil para dar por terminada una cura de desintoxicación. Por otro lado, la de GGT no puede ser utilizada como índice de cese de ingesta de alcohol en todos los pacientes, al menos para valorar precozmente la abstinencia, pues su normalización se ve influenciada de forma apreciable por la severidad de la enfermedad hepática

Correlation of cardiovascular and neuroendocrine tests of autonomic function in diabetes.

Six normal subjects and 16 insulin-dependent diabetics with varying degrees of autonomic damage each had blood sampled for norepinephrine and pancreatic polypeptide for fifteen minutes after a mixed meal and intravenous (IV) edrophonium (Tensilon). The normal subjects showed a brisk but short-lived rise in norepinephrine after edrophonium (average maximum increase 70% between 2 and 6 minutes), as did most diabetics. However, diabetics with cardiovascular reflex evidence of sympathetic damage showed no rise in norepinephrine. Pancreatic polypeptide concentrations increased up to 400% above baseline after a mixed meal in both the normal and the diabetic group with normal cardiovascular reflexes. There was no significant rise in pancreatic polypeptide either in the diabetics with parasympathetic damage alone or in those with additional sympathetic damage. These results provide further evidence for the diffuse nature of the damage in diabetic autonomic neuropathy.