[Anteromedialization in the treatment of high-riding and lateralized patella in adults]. / Anteromedialización en el tratamiento de la rótula alta y lateralizada en el adulto.

INTRODUCTION: A study conducted at our hospital showed that patellofemoral instability associated with a high-riding and lateralized patella occurred in 34 out of 4,954 admitted patients (6.86% rate). In order to treat these alterations we studied a series of patients in whom an anteromedialization technique was used. MATERIAL AND METHODS: This is a prospective, cross-sectional, descriptive cohort study, with probabilistic sampling, conducted between March 1st, 2009 and September 1st, 2011. Twenty patients who met the inclusion criteria were selected. The same technique was used in all patients, performed by the same surgeon, with the same postoperative and rehabilitation protocol. The modified Lyshom scale was applied and the results were assessed by two blinded observers whose concordance was assessed with the Kappa index. RESULTS: Twenty patients were treated, 12 females and 8 males; mean age was 20 years. In 14 patients the dislocating event occurred in one of the knees and in 6 patients it was bilateral; the right side predominated. Dislocation was recurrent in 7 patients and relapsing in 13; 12 of the latter had undergone soft tissue realignment and lateral retinaculum release, and one patellar advancement. The mean clinical Q angle was 18 degrees preoperatively and 7 degrees postoperatively. The preoperative and postoperative radio- graphic assessment was equivalent to a Kappa of 88%. Mean healing time of the osteotomy was 8 weeks; 2 hemarthroses occurred in the immediate postoperative period, which were resolved with puncture; no fractures and no graft collapses were reported. The mean Lysholm scale was 90.9 at 6 months (interobserver kappa of 90%). All patients had quadriceps atrophy of 1-2 cm, one patient had residual pain and by the end of the study none of the patients had had relapsing dislocation. CONCLUSIONS: This technique corrects the dislocation resulting from a high-riding and lateralized patella by modifying the Q angle. It involves minimal complications, uses a small 5 cm approach and does not require special guides. This study remains open to long-term follow-up to detect the presence or absence of patellofemoral arthrosis.

Automated sample preparation and gas chromatographic-mass spectrometric analysis of urinary androgenic anabolic steroids.

This paper presents an automated method for extracting anabolic agents from urine samples for their GC-MS analysis by selected-ion monitoring. The sample preparation was carried out in a Hewlett-Packard 7686 SPE PrepStation system. Each 0.6-ml aliquot was hydrolyzed, extracted, dried and trimethylsilyl (TMS) derivatized in a 2-ml vial without any hands-on labor. When sample preparation was finished 2 microl of the extract was injected into the gas chromatograph by split (1:10) mode. Due to the small amount of free space in the 2-ml vials for handling the sample, parameters like time of hydrolysis, type of shaking, number of extractions and some TMS derivatization parameters had to be adjusted to achieve the best recovery for all of the compounds in the screening. Manual and automated sample preparation schemes were compared in terms of linearity, precision, accuracy, limit of detection and recovery data. When large concentrations were analyzed using the automated method no carry-over effect was observed.

[Comparation of the antero-lateral and posterior approaches in primary total hip arthroplasty]. / Comparación de abordajes antero lateral y posterior en artroplastia total primaria de cadera.

Comparison between the antero-lateral and posterior approaches in primary total hip arthroplasty. In this retrospective study, 184 patients were enrolled, 95 submitted to the anterolateral (Watson jones) and 89 to the posterior approach (Moore) from June 1993 to June 1997. The outcomes assessed were perioperative data (operative time, hospital stay, time from surgery until hospital discharge, surgical bleeding and the need for blood transfusion), as well as late complications (deep venous thrombosis DVP, pulmonary embolism, periopheral nerve injury, prothesis instability and others). Both groups did not differ in terms of preoperative parameters. Those submitted to the posterior approach had shorter operative times (p < 0.001), as well as reduced bleeding (p < 0.05) and need for blood transfusion (p < 0.001) during surgery. The outcomes, such as late complications, had similar reduced frequency in both groups. The posterior approach has been successfully applied in our service and proves to be an excellent alternative surgical access to the total hip arthroplasty.

Brevetoxin-3 (PbTx-3) inhibits oxygen consumption and increases Na+ content in mouse liver slices through a tetrodotoxin-sensitive pathway.

To have insights into possible non-neural effects of PbTx-3 (0.07 microgram/ml), its effects on various parameters of hepatic metabolism were evaluated. PbTx-3 inhibits oxygen consumption (QO2) in liver slices by 25 +/- 1%, and increases hepatocyte Na+/K+ ratio by 72 +/- 4%. Ouabain, a Na(+)-K(+)-pump inhibitor, also reduced QO2 by 19 +/- 2% and raised the Na+/K+ ratio by 77 +/- 4%. The effects of PbTx-3 and ouabain on QO2 and Na+/K+ ratio were not additive, suggesting a role for the Na(+)-K(+)-pump in these actions of PbTx-3. However, Na(+)-K(+)-pump activity determinations, using 86Rb as a K+ tracer, did not reveal inhibitory effects of this toxin on the transport system. This indicates that the pump is not a target of PbTx-3. The effect of PbTx-3 on liver slices Na+ content was abolished by the sodium channel blocker tetrodotoxin (0.1 microM). Tetrodotoxin also antagonized the inhibition of oxygen consumption by PbTx-3. These results suggest that in the liver PbTx-3 can induce effects that appear to be similar to those observed in excitable tissue.

Septicemia y pancreatitis. / Septicemia and pacreatitis

Se estudia la relacion de inflamacion pancreatica y estados septicemicos en ninos lactantes, encontrandose un 15% de pancreatitis en las autopsias de ninos fallecios con septcemia. Asi mismo en el 10% de lactantes septicos se encontraron valores elevados de amilasemia, observandose una posible relacion entre la hiperamilasemia y el pronostico de estos pacientes