Approach and management of patients injured by bullfighting trauma. / Abordaje y manejo médico-quirúrgico del paciente herido por traumatismo taurino.

INTRODUCTION: Bullfighting festivals are attributed to the cultural idiosyncrasies of the Ibero-American people, posing an extreme risk to the physical integrity of the participants. Spain is considered the country with the highest number of bull-related celebrations worldwide and, therefore, with the highest number of patients injured by bullfighting trauma treated, thus justifying a public health problem. The generalities associated with this type of trauma define the people injured as polytraumatised patients. In addition, it is important to know the kinematics of the injuries and their specific characteristics, in order to implement quality medical-surgical care. METHODS: scientific review of the literature to promote a comprehensive guide for the medical-surgical management of patients injured by bullfighting trauma. RESULTS: We described the guidelines to standardise protocols for in-hospital approach of patients injured by bullfighting trauma. CONCLUSIONS: Bullfighting trauma is considered a real health problem in the emergency departments of the ibero-Americans countries, especially in Spain, where bullfighting is part of the national culture. The inherent characteristics of these animals cause injuries with special aspects, so it is important to know the generalities of bullfighting trauma. Because of the multidisciplinary approach, this guidelines are adressed to all healthcare providers involved in the management of these patients. It is essential to establish particular initial care for this type of injury, specific therapeutic action and follow-up based on the medical-surgical management of the trauma patient in order to reduce the associated morbidity and mortality.

Anal trauma caused by bull-horn injury.

BACKGROUND: Bullfighting festivals are commonly performed at Spain. Perineal trauma due to bull-horn injury is associated with high morbidity due to sphincteric associated lesions METHODS: We report a case of 37-year-old male patient with anal trauma due to a bull-horn injury involving the sphincter complex, treated in our Emergency department RESULTS: Urgent surgery was performed with primary sphincteroplasty, without performing a colostomy. The associated complication was a partial dehiscence of the surgical wound (Clavien-Dindo I). No transfusions, re-interventions or readmissions were registered. The degree of incontinence at discharge and after 12 month follow-up, according to the Wexner scale was 8 points and 2 points, respectively. CONCLUSIONS: The main treatment of bull-horn injuries is extensive surgical debridement, antibiotic therapy, and lavage of the area. In cases involving the anal sphincter, primary sphincteroplasty is recommended. The modern trend does not include the systematic performance of a colostomy however, it has been described in cases with catastrophic wounds and urological lesions associated.

Manejo de fractura de cuello femoral en paciente con amputación supracondílea femoral bilateral y revisión de la literatura / Femoral neck fracture management in patient with bilateral femoral supracondylar amputation and literature review

Resumen: El tratamiento de un paciente con amputación supracondílea femoral bilateral, y que ha sufrido una fractura de cuello femoral, es un evento poco común tanto para el cirujano ortopédico como para el equipo de rehabilitación. Presentamos un caso, en el cual se discuten diferentes dificultades en su tratamiento, elección de implante y regreso a sus actividades diarias. Se trata de un joven con diagnóstico de amputación traumática bilateral supracondílea, con fractura de cuello femoral, tratado mediante artroplastía total de cadera primaria no cementada. La evaluación de la funcionalidad de la prótesis total de cadera con escala de Houghton fue al cabo de 12 meses, se obtuvo una puntuación final de 9 puntos, los cuales son el resultado de una rehabilitación satisfactoria.

Abstract: The treatment of a patient with amputation above the knee who has suffered a femoral neck fracture is a challenge for both the orthopedic surgeon and the rehabilitation team. We present a case, in which different difficulties are discussed in their treatment, choice of implant and return to their daily activities. The clinical case of a young man diagnosed with supracondylar bilateral traumatic amputation, with fracture of the femoral neck, treated by total non-cemented hip arthroplasty is presented. The functionality of the total hip prosthesis with Houghton scale after 12 months, obtaining a final score of 9 points which are the result of a satisfactory rehabilitation.

Farmacología en atención estomatológica en menores de 19 años / Presence of Pharmacology in stomatologic care in children aged under 19

Se presenta una revisión bibliográfica actualizada basada en evidencias científicas del uso de antimicrobianos, antiinflamatorios, analgésicos, antisépticos bucales y medicina natural y tradicional en estomatología, realizada por Medline, Doyma y otras fuentes bibliográficas. Se reporta que más de la mitad de la población mundial consume en un momento de su vida algunos de estos fármacos, indicados por diferentes patologías de orígenes infecciosos, inflamatorios, incluso como tratamiento prevenivos y preoperatorios. La edad pediátrica constituye un grupo de difícil manejo terapéutico dada la inmadurez física, fisiológica (sistema pulmonar, cardiovascular, inmunológico y metabólico) y emocional, lo que exige que el uso de estas drogas requieren un conocimiento actualizado por parte del personal médico. En tal sentido, presentamos una revisión con el objetivo de exponer lo más actual sobre el uso de antibióticos, antiinflamatorios, analgésicos y antisépticos bucales en cuanto a farmacología para estomatólogos generales que brindan atención a menores de 19 años con afecciones estomatológicas(AU)

A updated bibliographic review is presented based on scientific evidences on use of antimicrobials, anti-inflammatory, analgesics agents, oral antiseptics and natural and folk medicine in Stomatology, performed by Medline Doyma, and other bibliographic sources. Authors reports that more than half of world population, in any moment of its life, has been a consumer of these drugs, prescribed from different pathologies of infectious, inflammatory nature, even as a preventive preoperative treatment. Pediatric age is a difficult therapeutic management group due to physical, physiological ( pulmonary, cardiovascular, immunologic, and metabolic system) and emotional immaturity, requiring that medical staff must to have a updated knowledge on use of these drugs. In this context, we presented a revision to expose the more updated features on use of antibiotics, anti-inflammatory, and oral antiseptics, as for a Pharmacology for general stomatologists giving care to children ages under 19 presenting with stomatologic affections(AU)