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1.
Reumatol. clín. (Barc.) ; 14(5): 301-302, sept.-oct. 2018.
Artigo em Espanhol | IBECS | ID: ibc-175993

RESUMO

Describimos un caso de artritis séptica de rodilla por Corynebacterium striatum, bacilo Gram positivo colonizador habitual de la flora de la piel y mucosas, que rara vez ha sido implicado en artritis sépticas de articulaciones nativas. Se trata de un varón de 84 años diagnosticado de artritis séptica de rodilla izquierda por Corynebacterium striatum que evoluciona de forma tórpida con antibioterapia convencional, por lo que se solicita tratamiento compasivo con dalbavancina, con excelente respuesta clínica. Este caso resalta el potencial papel patógeno que las especies del género Corynebacterium pueden tener en artritis sépticas de articulaciones nativas y subraya la importancia de su detección precoz y tratamiento dirigido para obtener resultados clínicos satisfactorios


We describe a case of septic arthritis in a native knee due to Corynebacterium striatum, gram-positive bacilli that are usually commensal organisms of skin and mucosal membranes, but are seldom implicated in native septic arthritis. An 84-year-old man with Corynebacterium striatum septic arthritis of his native left knee and no response to conventional antibiotic therapy. Thus, the patient was allowed to take dalbavancin for compassionate use, with an excellent clinical outcome. This case emphasizes de role of Corynebacterium striatum in native joint infections and highlights the importance of early detection and appropriate treatment in improving the clinical outcome


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Artrite Infecciosa/microbiologia , Corynebacterium/patogenicidade , Infecções por Corynebacterium/complicações , Antibacterianos/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/complicações , Artrocentese
2.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 62(3): 197-203, mayo-jun. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-177323

RESUMO

Objetivo: Comparar dos pares de fricción (metal/polietileno de ultra alto peso molecular [UHMWPE], metal/polietileno de alto entrecruzamiento) mediante análisis cuantitativo y cualitativo de partículas de polietileno en líquido sinovial a los 3 años postintervención en pacientes portadores de prótesis total de rodilla (PTR). Material y métodos: Se llevó a cabo un estudio de cohortes prospectivo, aleatorizado, con evaluación ciega incluyendo 25 pacientes a quienes se intervino de PTR de manera bilateral, con 6 meses de diferencia. A los 3 años postintervención, se realizaron artrocentesis de rodilla a 12 pacientes y se analizaron las partículas de polietileno. Resultados: No se hallaron diferencias significativas en el número de partículas generadas por los diferentes insertos de polietileno a los 3 años tras la implantación de una artroplastia total de rodilla (3.000×: x¯ entrecruzado=849,7; x¯ UHMWPE=796,9; p=0,63; 20.000×: x¯ entrecruzado=66,3; x¯ UHMWPE=73,1; p=0,76). Tampoco existen diferencias significativas entre los 2 tipos de inserto, entre la posibilidad de encontrar partículas de forma elongada (χ2=0,19; p=0,66) ni redonda (χ2=1,44; p=0,23). Sin embargo, la probabilidad de encontrar partículas de forma fibrilar es 3,08 veces mayor en el UHMWPE. Conclusiones: El polietileno altamente entrecruzado no reduce significativamente la generación de partículas de polietileno en aquellos pacientes intervenidos mediante una artroplastia total de rodilla, con muestras a 3 años postintervención


Aim: To compare two different types of inserts: Ultra-high molecular weight polyethylene (UHMWPE) and cross-linked polyethylene with a quantitative and qualitative study of polyethylene wear particles in synovial fluid 3 years after total knee arthroplasty. Material and methods: A prospective, randomized, controlled cohort study with blinded evaluation was carried out on 25 patients undergoing staged bilateral total knee replacement, 6 months apart. Knee arthrocentesis was performed on 12 patients 3 years after surgery, and the polyethylene particles were analyzed. Results: No significant differences were found in the number of particles generated by the two different types of inserts at 3 years from total knee arthroplasty (3,000×: x¯ cross-linked=849.7; x¯ UHMWPE=796.9; P=.63; 20,000×: x¯ cross-linked=66.3; x¯ UHMWPE=73.1; P=.76). Likewise, no differences in the probability of finding elongated (χ2=0.19; P=.66) or rounded (χ2=1.44; P=.23) particles in both types of inserts were observed. However, the probability of finding fibrillar particles is 3.08 times greater in UHMWPE. Conclusions: Cross-linked polyethylene does not significantly reduce the generation of polyethylene particles in patients with total knee arthroplasty, 3 years after the surgical procedure


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia , Prótese do Joelho/normas , Estudos Prospectivos , Materiais Biocompatíveis/análise , Polietileno/análise , Artrocentese/métodos , Falha de Prótese
3.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 62(3): 204-206, mayo-jun. 2018.
Artigo em Espanhol | IBECS | ID: ibc-177324

RESUMO

La artritis séptica tras una artroscopia de rodilla es muy poco frecuente. Se estima una tasa de infección postoperatoria en torno al 0,15-0,84%1, según las series. El procedimiento artroscópico más frecuentemente asociado a infección es la reconstrucción del ligamento cruzado anterior (LCA), cuya frecuencia está en torno al 0,3-1,7%2. El microorganismo más frecuentemente aislado es el estafilococo coagulasa negativo. Describimos un caso de artritis séptica de rodilla tras reconstrucción de ligamento cruzado anterior en la que se aisló el microorganismo Granulicatella adiacens en el cultivo del líquido sinovial. No encontramos ningún caso descrito en la literatura de infección tras artroscopia de rodilla, por dicho microorganismo; tratándose probablemente del primer caso publicado


Septic arthritis after knee arthroscopy is an extremely rare condition. A rate of 0.15-0.84% cases of postoperative infection is estimated in several series. The arthroscopy procedure most frequently related with an infectious complication is anterior cruciate ligament (ACL) reconstruction, with a prevalence of 0.3-1.7% cases. Staphylococcus sp. is the pathogen most commonly cultured. We describe a case of septic arthritis after ACL reconstruction. We found no published case of septic arthritis caused by this microorganism after knee arthroscopy. It is probably the first case published in the literature


Assuntos
Humanos , Masculino , Adulto , Artrite Infecciosa/microbiologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Infecção da Ferida Cirúrgica/complicações , Artroscopia/efeitos adversos , Abiotrophia/isolamento & purificação , Infecções por Bactérias Gram-Positivas/complicações , Artrocentese/métodos , Espectrometria de Massas/métodos
4.
Pediatr. aten. prim ; 20(78): 153-155, abr.-jun. 2018.
Artigo em Espanhol | IBECS | ID: ibc-174694

RESUMO

La vacuna meningocócica del grupo B 4CMenB está indicada para la inmunización activa de individuos a partir de los dos meses de edad frente a la enfermedad meningocócica invasora por Neisseria meningitidis del serogrupo B. Aunque está recomendada, actualmente no se encuentra incluida dentro del calendario de vacunación infantil. En menores de dos años las reacciones locales más frecuentes son dolor y eritema en el sitio de inyección y las sistémicas la aparición de irritabilidad y fiebre, en general de corta duración. En la ficha técnica de la vacuna no se indica como efecto secundario específico la artritis. No obstante, hasta marzo de 2017 se han documentado en la base de datos europea de informes de presuntas reacciones adversas 29 casos de artritis u otra patología similar. A continuación, presentamos las características clínicas y analíticas de dos nuevos casos de artritis en probable relación con la vacuna


Meningococcal group B vaccine is indicated for active immunization of individuals from two months of age against invasive meningococcal disease caused by Neisseria meningitidis serogroup B. Although it is recommended, currently it is not included in the childhood immunization schedule. In children under two years the most common reactions are pain and erythema at the injection site and fever and irritability, generally of short duration. In the technical specifications of the vaccine it is not indicated the arthritis. However, until March 2017 it has been documented 29 cases of arthritis in the European database of suspected adverse reactions reports. Here we report clinical and laboratory characteristics of two new cases of arthritis probably related to the administration of the vaccine


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Artrite Infecciosa/induzido quimicamente , Vacinas Meningocócicas/efeitos adversos , Artrocentese , Articulação do Quadril/microbiologia , Cardiopatias Congênitas/complicações , Fatores de Risco , Antibacterianos/uso terapêutico , Neisseria meningitidis Sorogrupo B/patogenicidade , Proteína C-Reativa/análise
5.
Med. oral patol. oral cir. bucal (Internet) ; 23(3): e351-e358, mayo 2018. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-175888

RESUMO

Background: This clinical study aimed to radiologically and clinically compare the effect of intra-articular injection of methylprednisolone, sodium hyaluronate or tenoxicam following arthrocentesis with that of arthrocentesis alone in patients with non-reducing disc displacement. Material and Methods: A total of 44 patients radiographically diagnosed with non-reducing disc displacement of the temporomandibular joint (TMJ) were randomly divided into four treatment groups, as follows: Group 1, arthrocentesis alone; Group 2, arthrocentesis plus methylprednisolone acetate; Group 3, arthrocentesis plus sodium hyaluronate; Group 4, arthrocentesis plus tenoxicam. Maximum mouth opening (MMO), lateral movement, pain severity and tenderness of TMJ and muscles of mastication on palpation were measured before treatment and at 1 week and 1, 3 and 6 months after treatment. Disc position, presence or absence of disc reduction, level of effusion, joint movement and joint space were also evaluated using magnetic resonance imaging (MRI) before treatment and 6 months after treatment. Results: No significant differences in treatment success were found among the four groups. MRI findings did not vary significantly among the groups, but pre- and post-operative MRI findings varied significantly within all four groups (p<0.001). Conclusions: According to the data from this study, it may be concluded that either arthrocentesis alone or arthrocentesis with methylprednisolone acetate or sodium hyaluronate or tenoxicam intra-articular injections are similarly effective and promising methods in the treatment of TMJ with non-reducing disc displacement


No disponible


Assuntos
Humanos , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Artrocentese , Viscossuplementos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Metilprednisolona/administração & dosagem , Piroxicam/análogos & derivados , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/cirurgia , Terapia Combinada , Injeções Intra-Articulares , Piroxicam/administração & dosagem , Estudos Prospectivos , Método Simples-Cego
6.
Med. oral patol. oral cir. bucal (Internet) ; 23(3): e367-e375, mayo 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-175890

RESUMO

Background: Temporomandibular disorders (TMDs) are musculoskeletal conditions that can inhibit the normal function of temporomandibular joints (TMJs) and affect the patient’s quality of life, negatively. Arthrocentesis (AC) is a minimally invasive surgical procedure used for treating TMDs. The aim of present paper is to evaluate the advantages of administrating corticosteroid (CS) during AC by reviewing high quality released articles. Material and Methods: Searching on Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, and Scopus databases were performed with focusing on proper key words. Related titles and abstracts, up to December 2017, were screened and selected based on inclusion criteria. The full text of all randomized controlled trials (RCTs) was extensively read and subjected to quality assessments. Results: After initial search, a total of 2067 articles were included into the study. Finally, 7 studies were reliable enough in methodology and randomization to be included into the study. All of the observed studies showed improvements in jaw functions and pain relief with no statistical differences in both AC and control groups. One study reported painless maximum incisal opening in CS group than the control group. Conclusions: Based on available RCTs, the AC of TMJ with CS seems to result in similar findings to other therapeutic drugs, with no significant differences


No disponible


Assuntos
Humanos , Artrocentese , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/cirurgia , Glucocorticoides/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia Combinada
7.
Rev. esp. cir. oral maxilofac ; 39(4): 213-220, oct.-dic. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-166796

RESUMO

Los trastornos temporomandibulares comprenden un conjunto de alteraciones relacionadas con factores biológicos, psicológicos y sociales. La cirugía mínimamente invasiva de la articulación temporomandibular constituye un tratamiento efectivo que junto con el uso del ácido hialurónico es usado para disminuir los signos y síntomas de los pacientes con trastornos temporomandibulares. Objetivo. Evaluar el beneficio clínico adicional de la infiltración del ácido hialurónico como único tratamiento o como coadyuvante a la cirugía mínimamente invasiva de la articulación temporomandibular. Material y método. Se ha realizado una búsqueda electrónica en las bases de datos Medline (PubMed) y Cochrane Central Register of Controlled Trials (CENTRAL) utilizando los términos: temporomandibular joint, temporomandibular disorders, hyaluronic acid y sodium hyaluronate. El criterio de selección fue: ensayos clínicos aleatorizados controlados o cuasi-aleatorizados que evalúan la infiltración de ácido hialurónico como único procedimiento o junto con cirugía mínimamente invasiva de la articulación temporomandibular. Resultados. Se incluyeron 8 estudios en la revisión. Cuatro estudios compararon la infiltración de ácido hialurónico con placebo. Dos estudios compararon la artroscopia más ácido hialurónico con artroscopia sin ácido hialurónico. Dos estudios compararon la artrocentesis con la artrocentesis más ácido hialurónico. Los resultados en las variables clínicas favorecen al ácido hialurónico frente al placebo a corto plazo. Conclusiones. Debido al riesgo de sesgo elevado son necesarios estudios con un mejor diseño metodológico que aporten datos más fiables para la cirugía mínimamente invasiva de la articulación temporomandibular más ácido hialurónico (AU)


Temporomandibular disorders are a set of related biological, psychological and social factors. Minimally invasive surgery of the temporomandibular joint is an effective treatment, and together with the use of hyaluronic acid this may reduce the signs and symptoms of patients with temporomandibular disorders. Objective. To evaluate the additional clinical benefit of an injection of hyaluronic acid as single treatment or as an adjunct to minimally invasive surgery of the temporomandibular joint. Material and methods. An electronic search of databases Medline (PubMed) and the Cochrane Central Register of Controlled Trials (CENTRAL) was made using the terms "temporomandibular joint", "temporomandibular disorders", "hyaluronic acid" and "sodium hyaluronate". The selection criteria were: randomised controlled or quasi-randomised clinical trials evaluating the injecting of hyaluronic acid as a single procedure or with minimally invasive surgery of the temporomandibular joint. Results. A total of 8 studies were included in this review. Four of them compared the injection of hyaluronic acid with placebo. Two studies compared arthroscopy with hyaluronic acid versus arthroscopy without hyaluronic acid. Two studies compared arthrocentesis versus arthrocentesis with hyaluronic acid. The results using the clinical variables showed hyaluronic acid to be superior to placebo in the short term. Conclusions. Due to the high risk of bias, more studies with better methodological design are needed in order to provide more reliable data for minimally invasive surgery of the temporomandibular joint with hyaluronic acid (AU)


Assuntos
Humanos , Transtornos da Articulação Temporomandibular/terapia , Ácido Hialurônico/uso terapêutico , Viscossuplementação/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Artrocentese/métodos , Bibliometria , Artroscopia/métodos
10.
Rev. esp. patol ; 50(3): 192-195, jul.-sept. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-163531

RESUMO

La lipomatosis sinovial es una entidad, rara y benigna, de la membrana sinovial, que fue descrita por Albert Hoffa en 1904, y afecta con mayor frecuencia a la articulación de la rodilla, pudiendo presentarse en otras articulaciones. Ocurre en varones de mediana edad y, raramente, en niños. Siendo normalmente monoarticular, en algunos casos aparece en más de una articulación. Su etiología es desconocida y se habla de un proceso reactivo más que neoplásico. Esta enfermedad tiene una morfología radiológica, macroscópica y microscópica característicamente arborescente, por infiltración adiposa del tejido subsinovial, que es clave para su diagnóstico. Presentamos el caso de una niña de 12 años de edad, realizándose revisión de los hallazgos radiológicos y patológicos, así como su diagnóstico diferencial con otras entidades y su tratamiento (AU)


Synovial lipomatosis, described by Albert Hoffa in 1904, is a rare and benign entity of the synovial membrane. The knee joint is the most frequent site, although it can occur in other joints. Middle-aged men are most often affected; it is rarely found in children. It is normally monoarticular, although in some cases it appears in more than one joint. Of unknown etiology, it is thought to be a reactive, rather than a neoplastic, process. The pathology shows characteristic arborescent radiological, macroscopic and microscopic morphology due to adipose infiltration of sub-synovial tissue, which is essential for diagnosis. We report a case of synovial lipomatosis in a 12 year old girl and discuss the radiological and pathological findings, differential diagnosis and treatment (AU)


Assuntos
Humanos , Feminino , Criança , Lipomatose/etiologia , Lipomatose/patologia , Lipomatose , Traumatismos do Joelho/patologia , Traumatismos do Joelho , Substância Branca/patologia , Diagnóstico Diferencial , Joelho/patologia , Joelho , Artrocentese/métodos , Hiperplasia/patologia
11.
Rehabilitación (Madr., Ed. impr.) ; 51(3): 195-198, jul.-sept. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-163686

RESUMO

La atrofia muscular espinal, es la segunda enfermedad neuromuscular más frecuente en la infancia. Se transmite con carácter autosómico recesivo. Se conocen tres formas clínicas, según la edad de inicio de los síntomas y la capacidad de marcha, con una gran variabilidad en el pronóstico vital y funcional. Durante su evolución aparecen distintas complicaciones del aparato locomotor, entre las que destaca la luxación de caderas, en la cual, según la mayoría de los autores no se recomienda actualmente la cirugía, debido a la alta frecuencia de recidivas. Por otro lado, se cree que la existencia de dolor asociada a la misma es poco frecuente, y tanto su aparición como el manejo del mismo, están muy poco reportados. Presentamos dos pacientes con atrofia muscular espinal III, con luxación de caderas asociada a dolor, a las que se practicó una artrocentesis más infiltración con anestésico y corticoides, consiguiéndose de esta forma el control del dolor. Creemos que es una opción terapéutica a tener en cuenta, cuando la luxación de cadera se acompaña de dolor, se objetiva derrame intraarticular y el cuadro no remite con el tratamiento farmacológico habitual (AU)


Spinal muscular atrophy is the second most frequent hereditary neuromuscular disease during childhood. Transmission is autosomal recessive. There are three clinical forms, classified according to age of symptom onset and ability to walk, with a wide range of severity. As the disorder progresses, several complications related to the locomotor apparatus may appear. Hip dislocation is a frequent manifestation associated with spinal muscular atrophy. Currently, most authors believe that surgery of the hip joint in these patients is not justified because of the high incidence of redislocations. Moreover, it is believed that hip dislocation is rarely associated with pain, with very few reports of its presence or the need for pain management. We report two patients with spinal muscular atrophy type III and hip dislocation with associated pain. The patients underwent arthrocentesis and infiltration with anaesthetic and corticoids, which achieved pain control. We believe that this is a good therapeutic option to consider when hip dislocation is associated with pain that cannot be controlled with conventional drug treatment (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Luxação do Quadril/complicações , Luxação do Quadril/reabilitação , Luxação do Quadril , Atrofia Muscular/reabilitação , Atrofia Muscular , Artrocentese , Atrofia Muscular/complicações , Atrofia Muscular/tratamento farmacológico , Doenças Neuromusculares/reabilitação , Doenças Neuromusculares , Manejo da Dor/tendências , Corticosteroides/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Aparelhos Ortopédicos
13.
Rev. esp. quimioter ; 30(2): 118-122, abr. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-161006

RESUMO

Introducción. Se revisan los casos de artritis séptica en población pediátrica por Streptococcus pneumoniae en el Área Sanitaria de Santiago de Compostela. Material y métodos. Se realizó una revisión retrospectiva de los aislamientos de S. pneumoniae en líquidos articulares en niños el período de enero de 2005 a marzo de 2014. Resultados. De los 7.416 líquidos articulares recibidos en el Servicio de Microbiología, 77 pertenecían a pacientes pediátricos, y de ellos, solamente 8 tuvieron cultivo positivo. En total fueron tres casos positivos para S. pneumoniae, dos con cultivo positivo y un tercero con detección antigénica positiva en el líquido articular. En los tres pacientes (dos de ellos menores de 15 meses) la articulación afectada fue la cadera, se combinó el tratamiento antibiótico con el drenaje quirúrgico y la evolución fue favorable. Conclusiones. La artritis neumocócica es una entidad que debe ser tenida en cuenta ya que la mayoría de los cuadros de artritis en población pediátrica aparecen como complicación de una bacteriemia posterior a un cuadro catarral o una otitis. El mayor riesgo de secuelas se asocia a retrasos en el diagnóstico, por ello es imprescindible un diagnóstico precoz clínico y microbiológico (AU)


Introduction. Cases of septic arthritis in paediatric population by Streptococcus pneumoniae in the Health Area of Santiago de Compostela (Spain) were reviewed. Material and methods. A retrospective study from January 2005 to March 2014 was conducted for all S. pneumoniae isolates obtained from joint fluids in children. Results. From the 7,416 joint fluids received in the Microbiology Department, 77 belonged to paediatric patients, and of these, only 8 had positive culture. In total, there were three positive cases for S. pneumoniae, two with positive culture and a third with positive antigen detection. In the three patients (two of them under 15 months) the affected joint was hip, antibiotic treatment was combined with surgical drainage and evolution was favourable. Conclusions. We conclude that pneumococcal arthritis is an entity that must be taken into account since most cases of arthritis in paediatric population appear as a complication of bacteraemia after a common cold or an ear infection. The greatest risk of sequel is associated with delays in diagnosis, so it is essential clinical and microbiological early diagnosis (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Criança , Infecções Pneumocócicas/complicações , Infecções Pneumocócicas/tratamento farmacológico , Artrite Infecciosa/complicações , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/microbiologia , Artrocentese/métodos , Streptococcus pneumoniae , Streptococcus pneumoniae/isolamento & purificação , Estudos Retrospectivos , Infecções Pneumocócicas/imunologia , Ceftriaxona/uso terapêutico , Vancomicina/uso terapêutico
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