Prótesis total de rodilla primaria en un paciente con ruptura no reciente del tendón rotuliano, tratado en 2 tiempos quirúrgicos / Total primary knee prosthesis in a patient with non-recent rupture of the patellar tendon, treated in 2 surgical times

Resumen: Introducción: La ruptura de tendón rotuliano en pacientes mayores se relaciona con enfermedades sistémicas como la artritis reumatoide, el lupus eritematoso y aquéllos con tratamiento prolongado con corticoides o antibioticoterapia. Es ocasionado por traumatismo con la rodilla en flexión acompañado de una contracción del cuádriceps o fuerza excéntrica, su diagnóstico puede omitirse hasta en 38% de los casos. El tratamiento en las rupturas no recientes es más complejo ya que después de 45 días de la lesión ocurre retracción del cuádriceps, fibrosis, formación de adherencias e hipotrofia muscular. Las opciones de tratamiento son variadas utilizando desde autoinjertos hasta injertos sintéticos con túneles óseos y anclas de fijación. Reporte de caso: Hombre de 71 años con ruptura del tendón rotuliano de 18 años de evolución tratado en dos tiempos, comenzando por la reparación del aparato extensor con tendones de la pata de ganso preservando la inserción de los mismos y realizando después prótesis total de rodilla en un segundo tiempo quirúrgico y mostramos su evolución.

Abstract: Introduction: Patellar tendon rupture has a higher prevalence in older patients related to systemic diseases such as rheumatoid arthritis, lupus erythematosus and those with prolonged treatment with corticosteroids or antibiotic therapy. It is caused by trauma with the knee in flexion accompanied by a contraction of the quadriceps or eccentric force, the diagnosis can be omitted in up to 38% of cases. Treatment of non-recent tendon ruptures is more difficult with end-to-end techniques are complicated and difficult to perform 45 days after injury due to quadriceps retraction, fibrosis, adhesion formation, and muscle hypotrophy. Treatment options are varied, ranging from autografts to synthetic grafts using bone tunnels and fixation anchors. Case report: Our case is a 71-year-old patient with an 18-year-old patellar tendon rupture treated in two stages, starting with repairing the extensor apparatus with pes anserinus tendons, preserving their insertion and subsequently performing total knee replacement in a second surgical time and we show its evolution.

[Total primary knee prosthesis in a patient with non-recent rupture of the patellar tendon, treated in 2 surgical times]. / Prótesis total de rodilla primaria en un paciente con ruptura no reciente del tendón rotuliano, tratado en 2 tiempos quirúrgicos.

INTRODUCTION: Patellar tendon rupture has a higher prevalence in older patients related to systemic diseases such as rheumatoid arthritis, lupus erythematosus and those with prolonged treatment with corticosteroids or antibiotic therapy. It is caused by trauma with the knee in flexion accompanied by a contraction of the quadriceps or eccentric force, the diagnosis can be omitted in up to 38% of cases. Treatment of non-recent tendon ruptures is more difficult with end-to-end techniques are complicated and difficult to perform 45 days after injury due to quadriceps retraction, fibrosis, adhesion formation, and muscle hypotrophy. Treatment options are varied, ranging from autografts to synthetic grafts using bone tunnels and fixation anchors. CASE REPORT: Our case is a 71-year-old patient with an 18-year-old patellar tendon rupture treated in two stages, starting with repairing the extensor apparatus with pes anserinus tendons, preserving their insertion and subsequently performing total knee replacement in a second surgical time and we show its evolution.

INTRODUCCIÓN: La ruptura de tendón rotuliano en pacientes mayores se relaciona con enfermedades sistémicas como la artritis reumatoide, el lupus eritematoso y aquéllos con tratamiento prolongado con corticoides o antibioticoterapia. Es ocasionado por traumatismo con la rodilla en flexión acompañado de una contracción del cuádriceps o fuerza excéntrica, su diagnóstico puede omitirse hasta en 38% de los casos. El tratamiento en las rupturas no recientes es más complejo ya que después de 45 días de la lesión ocurre retracción del cuádriceps, fibrosis, formación de adherencias e hipotrofia muscular. Las opciones de tratamiento son variadas utilizando desde autoinjertos hasta injertos sintéticos con túneles óseos y anclas de fijación. REPORTE DE CASO: Hombre de 71 años con ruptura del tendón rotuliano de 18 años de evolución tratado en dos tiempos, comenzando por la reparación del aparato extensor con tendones de la pata de ganso preservando la inserción de los mismos y realizando después prótesis total de rodilla en un segundo tiempo quirúrgico y mostramos su evolución.

Testicular thermoregulation, scrotal surface temperature patterns and semen quality of water buffalo bulls reared in a tropical climate.

This study evaluated the capacity of thermoregulation and its consequences on the scrotal surface temperature patterns and semen quality of buffalo bulls raised in a wet tropical climate. Eleven water buffaloes were evaluated in the rainiest, in the transitional and in the less rainy season. Air temperature and humidity were consistently high, but the animals did not show thermal stress in any season. The scrotal temperature gradient of buffalo bulls using infrared thermography was described, and three parallel and decreasing thermal bands were characterised. Sperm quality (n = 176 ejaculates) was maintained in normal parameters over the periods. Pearson's coefficients showed that sperm volume and progressive motility were negatively correlated with ocular globe, epididymal tail and minimum scrotal temperatures (p < .01). Sperm membrane integrity was negatively influenced by increases in epididymal tail and minimum scrotal temperatures (p < .01). Ocular globe temperature also showed positive correlation with rectal, spermatic cord, and epididymal tail temperatures (p < .01). Therefore, even under high temperature and humidity, the thermoregulatory system was effective in preventing heat stress and the normality of scrotal surface temperatures, spermatogenesis and sperm maturation were maintained.

Índice de inmunidad-inflamación sistémica en sepsis / Systemic immune inflammatory index in sepsis

Resumen ANTECEDENTES: se han estudiado índices de pronóstico de inflamación basados en células periféricas como predictores de disfunción endotelial, riesgo cardiovascular y mortalidad. En 2014 se desarrolló el índice de inmunidad-inflamación sistémica (IIS) que se ha propuesto como factor de pronóstico y de seguimiento en cáncer. OBJETIVO: determinar si existe modificación del índice de inmunidad-inflamación sistémica (IIS) en pacientes con sepsis. MATERIAL Y MÉTODO: estudio retrospectivo que incluyó aleatoriamente a pacientes hospitalizados de 2013 a 2015. Se verificó la homogeneidad de poblaciones demostrando que no existía diferencia estadística entre la edad y comorbilidades (distribución Kolmogorov-Smirnov), frecuencia de comorbilidades (χ2). Se calculó el IIS con la citometría hemática de ingreso. Se compararon las medias del IIS de pacientes con sepsis y sin sepsis (Wilcoxon) y se determinó si había correlación entre el IIS y sepsis (coeficiente de correlación biserial puntual). RESULTADOS: se incluyeron 242 pacientes (128 con sepsis, edad promedio de 70.1 años y 114 sin sepsis, edad promedio de 69.7 años). La media del índice de inmunidad-inflamación sistémica (IIS) en pacientes con sepsis fue 4444.06x109, en pacientes sin sepsis fue de 3013.94x109. Se demostró que existe correlación estadísticamente significativa entre el IIS y sepsis (rbp= 0.150253625, p=0.05), se demostró que la media del IIS fue significativamente más elevada en pacientes con sepsis (W=5,097, p=0.00001). CONCLUSIONES: el índice de inmunidad-inflamación sistémica (IIS), un índice innovador que ha mostrado mejor efectividad para describir el desequilibrio de inmunidad e inflamación, se propone como una herramienta que puede ser útil en pacientes con sepsis; sin embargo, se requieren estudios futuros para comprobar su potencial pronóstico y de seguimiento.

Abstract BACKGROUND: In the past several indices based on peripheral blood cells have been studied to prove their utility as prognostic factors in endothelial dysfunction, cardiovascular risk and mortality. In 2014 the systemic immune inflammatory index (SII) was developed and it has been proposed as a prognostic factor in the follow-up of patients with cancer. OBJECTIVE: To determine if there is a modification of the SII in patients with sepsis. MATERIAL AND METHOD: A retrospective study included randomized patients hospitalized from 2013 to 2015; homogeneity of populations was verified by demonstrating that there was no statistical difference between age and comorbidities (Kolmogorov-Smirnov distribution), frequency of comorbidities (χ2). IIS was calculated with the blood cell count on hospital admission. IIS was compared in sepsis and without sepsis patients (Wilcoxon), and we determined whether there was correlation between IIS and sepsis (correlation coefficient biserial point). RESULTS: There were included 242 patients (128 with sepsis, mean age 70.1 years and 114 without sepsis, mean age 69.7 years). The mean IIS in patients with sepsis was 4444.06x109 and without sepsis 301 3.94x109. We showed that there was statistically significant cor relation between IIS and sepsis (rbp=0.150253625, p=0.05), we also detailed that the mean IIS was significantly higher in patients with sepsis (W=5,097, p=0.00001). CONCLUSIONS: The IIS, an innovative index that has shown accuracy describing the imbalance of immunity and inflammation, is proposed as a tool that can be useful in patients with sepsis; however, further studies are required to prove its potential in prognosis and monitoring.

Pharmacological inhibition of DNA methyltransferase 1 promotes neuronal differentiation from rodent and human nasal olfactory stem/progenitor cell cultures.

Nasal olfactory stem and neural progenitor cells (NOS/PCs) are considered possible tools for regenerative stem cell therapies in neurodegenerative diseases. Neurogenesis is a complex process regulated by extrinsic and intrinsic signals that include DNA-methylation and other chromatin modifications that could be experimentally manipulated in order to increase neuronal differentiation. The aim of the present study was the characterization of primary cultures and consecutive passages (P2-P10) of NOS/PCs isolated from male Swiss-Webster (mNOS/PCs) or healthy humans (hNOS/PCs). We evaluated and compared cellular morphology, proliferation rates and the expression pattern of pluripotency-associated markers and DNA methylation-associated gene expression in these cultures. Neuronal differentiation was induced by exposure to all-trans retinoic acid and forskolin for 7 days and evaluated by morphological analysis and immunofluorescence against neuronal markers MAP2, NSE and MAP1B. In response to the inductive cues mNOS/PCs expressed NSE (75.67%) and MAP2 (35.34%); whereas the majority of the hNOS/PCs were immunopositive to MAP1B. Treatment with procainamide, a specific inhibitor of DNA methyltransferase 1 (DNMT1), increases in the number of forskolin'/retinoic acid-induced mature neuronal marker-expressing mNOS/PCs cells and enhances neurite development in hNOS/PCs. Our results indicate that mice and human nasal olfactory stem/progenitors cells share pluripotency-related gene expression suggesting that their application for stem cell therapy is worth pursuing and that DNA methylation inhibitors could be efficient tools to enhance neuronal differentiation from these cells.

Fractura de Toddler. Reporte de un caso y revisión de la literatura / Toddler's fracture, case report and review of literature

Resumen: Introducción: La sospecha del diagnóstico de una fractura de Toddler a menudo es complicada debido a una historia poco clara, a la falta de hallazgos específicos en la clínica y a la ausencia de cambios evidentes en las radiografías iniciales. Presentamos el caso de una infante de tres años y siete meses de edad con el antecedente de caída desde su propia altura con mecanismo de rotación del miembro pélvico izquierdo. La finalidad de este escrito es describir la etiología, patología, diagnóstico y el manejo terapéutico en este tipo de fracturas. Discusión: La historia clínica, la exploración física y el uso de estudios de imagenología ayudan a identificar las fracturas de Toddler, patología que debe ser conocida por médicos especialistas para su manejo ideal.

Abstract: Introduction: The suspected diagnosis of a Toddler's fracture can often be complicated by an unclear history, the lack of specific clinical findings and the absence of obvious changes in the initial radiographs. We present the case of an infant of 3 years and 7 months old with a history of falling from her own height with a rotation mechanism of the left pelvic limb. The purpose of this paper is to describe the etiopathology, diagnosis and therapeutic management of these fractures. Discussion: The clinical history, physical examination and the use of imaging studies help identify Toddler's fractures, pathology that must be known to medical specialists for an ideal treatment.

Assessment of surface temperatures of buffalo bulls (Bubalus bubalis) raised under tropical conditions using infrared thermography / Avaliação de temperaturas superficiais de touros bubalinos (Bubalus bubalis) criados em ambiente tropical com uso da termografia infravermelha

This paper aimed to evaluate the surface temperatures of buffalo bulls using infrared thermography, considering four distinct anatomical parts over time, and to correlate surface temperatures and thermal comfort indexes. The humid tropical climate (Kõppen's Afi) was predominant in the research station where the experiment was performed and the trial lasted from April to August. Ten bulls (n=10) were evaluated every 25 days (morning: 6:00-9:00; afternoon: 12:00-15:00) and the parameters assessed were respiratory rate (RR), rectal temperature (RT), and the thermograms of surface temperature for orbital area (ORB), right flank (RF), left flank (LF) and scrotum (SCR). Climatological data was continuously monitored and the Temperature and Humidity Index (THI) and the Index of Comfort of Benezra (ICB) were calculated. The average values of THI were ≥78, and significant differences between shifts were observed (P<0.05). The ICB ranged from 1.96 to 2.25 and significant differences were observed for shifts and throughout the months (P<0.05). The averages of surface temperatures were RT=38.2±0.5°C, ORB=36.1±0.8°C, LF=33.5±2.5°C, RF=35.4±1.7ºC and SCR=33.3±1.1°C, which exhibited significant differences for shifts and throughout the months (P<0.05). Positive correlations were obtained between THI and ORB (0.72), RF (0.77), LF (0.75) and SCR (0.41) (P<0.0001). The maximum temperature of ORB showed the highest correlation with RT (0.58, P<0.0001). Therefore, the surface temperatures are subject to climatic variations and increase throughout the day, due to the variation in thermal comfort indexes, and the maximum ORB temperature was the parameter most related to rectal temperature. Lastly, the results indicate that IRT may be a useful non-invasive and accurate tool to detect the variations in ORB, LF, RF and SCR temperature in buffalo bulls.(AU)

O presente trabalho visou avaliar as temperaturas superficiais de diferentes regiões anatômicas de búfalos ao longo do tempo, por meio da termografia infravermelha, e correlacioná-las a índices bioclimatológicos de conforto térmico. O ensaio foi realizado em região de clima tropical úmido (Afi de Kõppen), de abril a agosto. Dez touros (n=10) foram avaliados a cada 25 dias (manhã: seis-nove horas; tarde: 12-15h), quanto à frequência respiratória (FR), temperatura retal (TR) e imagens termográficas da órbita ocular (ORB), flanco direito (FLd), flanco esquerdo (FLe) e escroto (ESC). Os dados climatológicos foram ininterruptamente monitorados, e calculados o índice de temperatura e umidade (ITU) e o índice de conforto de Benezra (ICB). O ITU foi ≥78, com diferença entre turnos (P<0,05). Já o ICB variou de 1,96 a 2,25 e apresentou diferenças ao longo dos meses e entre turnos (P<0,05). As temperaturas observadas foram de TR=38,2±0,5ºC, ORB=36,1±0,8ºC, FLd=33,5±2,5ºC, FLe=35,4±1,7ºC e ESC=33,3±1,1ºC, as quais variaram significativamente ao longo dos meses e entre turnos (P<0,05). O ITU apresentou correlações positivas com ORB (0,72), FLd (0,77), FLe (0,75) e ESC (0,41) (P<0,0001). A temperatura máxima de ORB apresentou a maior correlação com a TR (0,58; P<0,0001). Portanto, as temperaturas superficiais dos animais sofrem interferências das variações climáticas e se elevam ao longo do dia, devido à variação nos índices de conforto térmico; a temperatura máxima de ORB foi o parâmetro mais condicionado à temperatura retal. Também, as oscilações de temperatura de superfície de ORB, FLd, FLe e ESC podem ser aferidas em bubalinos com o uso da termografia infravermelha, de modo preciso e não invasivo.(AU)

Assessment of surface temperatures of buffalo bulls (Bubalus bubalis) raised under tropical conditions using infrared thermography / Avaliação de temperaturas superficiais de touros bubalinos (Bubalus bubalis) criados em ambiente tropical com uso da termografia infravermelha

This paper aimed to evaluate the surface temperatures of buffalo bulls using infrared thermography, considering four distinct anatomical parts over time, and to correlate surface temperatures and thermal comfort indexes. The humid tropical climate (Kõppen's Afi) was predominant in the research station where the experiment was performed and the trial lasted from April to August. Ten bulls (n=10) were evaluated every 25 days (morning: 6:00-9:00; afternoon: 12:00-15:00) and the parameters assessed were respiratory rate (RR), rectal temperature (RT), and the thermograms of surface temperature for orbital area (ORB), right flank (RF), left flank (LF) and scrotum (SCR). Climatological data was continuously monitored and the Temperature and Humidity Index (THI) and the Index of Comfort of Benezra (ICB) were calculated. The average values of THI were ≥78, and significant differences between shifts were observed (P<0.05). The ICB ranged from 1.96 to 2.25 and significant differences were observed for shifts and throughout the months (P<0.05). The averages of surface temperatures were RT=38.2±0.5°C, ORB=36.1±0.8°C, LF=33.5±2.5°C, RF=35.4±1.7ºC and SCR=33.3±1.1°C, which exhibited significant differences for shifts and throughout the months (P<0.05). Positive correlations were obtained between THI and ORB (0.72), RF (0.77), LF (0.75) and SCR (0.41) (P<0.0001). The maximum temperature of ORB showed the highest correlation with RT (0.58, P<0.0001). Therefore, the surface temperatures are subject to climatic variations and increase throughout the day, due to the variation in thermal comfort indexes, and the maximum ORB temperature was the parameter most related to rectal temperature. Lastly, the results indicate that IRT may be a useful non-invasive and accurate tool to detect the variations in ORB, LF, RF and SCR temperature in buffalo bulls.

O presente trabalho visou avaliar as temperaturas superficiais de diferentes regiões anatômicas de búfalos ao longo do tempo, por meio da termografia infravermelha, e correlacioná-las a índices bioclimatológicos de conforto térmico. O ensaio foi realizado em região de clima tropical úmido (Afi de Kõppen), de abril a agosto. Dez touros (n=10) foram avaliados a cada 25 dias (manhã: seis-nove horas; tarde: 12-15h), quanto à frequência respiratória (FR), temperatura retal (TR) e imagens termográficas da órbita ocular (ORB), flanco direito (FLd), flanco esquerdo (FLe) e escroto (ESC). Os dados climatológicos foram ininterruptamente monitorados, e calculados o índice de temperatura e umidade (ITU) e o índice de conforto de Benezra (ICB). O ITU foi ≥78, com diferença entre turnos (P<0,05). Já o ICB variou de 1,96 a 2,25 e apresentou diferenças ao longo dos meses e entre turnos (P<0,05). As temperaturas observadas foram de TR=38,2±0,5ºC, ORB=36,1±0,8ºC, FLd=33,5±2,5ºC, FLe=35,4±1,7ºC e ESC=33,3±1,1ºC, as quais variaram significativamente ao longo dos meses e entre turnos (P<0,05). O ITU apresentou correlações positivas com ORB (0,72), FLd (0,77), FLe (0,75) e ESC (0,41) (P<0,0001). A temperatura máxima de ORB apresentou a maior correlação com a TR (0,58; P<0,0001). Portanto, as temperaturas superficiais dos animais sofrem interferências das variações climáticas e se elevam ao longo do dia, devido à variação nos índices de conforto térmico; a temperatura máxima de ORB foi o parâmetro mais condicionado à temperatura retal. Também, as oscilações de temperatura de superfície de ORB, FLd, FLe e ESC podem ser aferidas em bubalinos com o uso da termografia infravermelha, de modo preciso e não invasivo.

The Importance of Wild Canids in the Epidemiology of Rabies in Northeast Brazil: A Retrospective Study.

Rabies is an endemic disease in Brazil, where it is considered a serious public health problem. Although the number of human and dog-transmitted cases has declined in recent decades, rabies in wildlife has emerged considerably. Among the sylvatic animals, wild canids have been considered important hosts of the rabies virus. We performed a retrospective study of reported cases of rabies in wild canids and human victims in Ceará state (Northeast Brazil) during 2003 to 2013. Information was provided by governmental laboratories involved in rabies detection and by the Ministry of Health. From January 2003 to December 2013, a total of 11 931 animal samples were examined for rabies. Positivity were detected in 438 samples (3.67%), of which 229 (52.28%) were domestic animals, 105 (23.97%) wild canids and 104 (23.74%) other wild animals (bats, marmosets and raccoons). Approximately 33% of wild canids surveyed (n = 317) were positive for rabies. During the studied period, a total of 1923 attacks on humans by wild canids were registered. Males (n = 1405) were more affected than females (n = 520; 72.98% versus 27.01%), and the median age of all cases was 36.5 years. Injuries to individuals up to 19 years old corresponded to approximately 30% (n = 565) of all cases. Most of the victims lived in rural areas (72.46%; n = 1395), and the majority showed bites (81.13%; n = 1677) or scratches (12.23%; n = 253). Injuries were considered profound (52.1%; n = 1003), superficial (40.91; n = 788) or multiple with severe laceration (6.98%; n = 134). Only 1300 (67.53%) victims were enrolled for the complete rabies post-exposure prophylaxis scheme. Data from the present study confirm that wild canids are important hosts of rabies virus in northeastern Brazil and jeopardize rabies control in this area. Local authorities should focus their efforts in education of health professionals. In addition, strategies should be formulated to preserve wildlife.

[Toddler's fracture, case report and review of literature]. / Fractura de Toddler. Reporte de un caso y revisión de la literatura.

INTRODUCTION: The suspected diagnosis of a Toddler's fracture can often be complicated by an unclear history, the lack of specific clinical findings and the absence of obvious changes in the initial radiographs. We present the case of an infant of 3 years and 7 months old with a history of falling from her own height with a rotation mechanism of the left pelvic limb. The purpose of this paper is to describe the etiopathology, diagnosis and therapeutic management of these fractures. DISCUSSION: The clinical history, physical examination and the use of imaging studies help identify Toddler's fractures, pathology that must be known to medical specialists for an ideal treatment.

INTRODUCCIÓN: La sospecha del diagnóstico de una fractura de Toddler a menudo es complicada debido a una historia poco clara, a la falta de hallazgos específicos en la clínica y a la ausencia de cambios evidentes en las radiografías iniciales. Presentamos el caso de una infante de tres años y siete meses de edad con el antecedente de caída desde su propia altura con mecanismo de rotación del miembro pélvico izquierdo. La finalidad de este escrito es describir la etiología, patología, diagnóstico y el manejo terapéutico en este tipo de fracturas. DISCUSIÓN: La historia clínica, la exploración física y el uso de estudios de imagenología ayudan a identificar las fracturas de Toddler, patología que debe ser conocida por médicos especialistas para su manejo ideal.

[Classification of pediatric supracondylar fractures: Gartland, AO and Holmberg: Which has the best interobserver agreement?]. / Clasificación de las fracturas supracondíleas en niños: Gartland, AO y Holmberg. ¿Cuál tiene el mayor acuerdo interobservador?

METHODS: Several classifications have been proposed for supracondylar fractures of the humerus. The purpose of this study was to assess the reproducibility and interobserver agreement of the Holmbert, Gartland and AO classifications. Retrospective study consisting of concurrent, blind and independent assessments of a consecutive sample of 42 elbow X-rays (AP and lateral) of pediatric patients with supracondylar fractures. Three observers, with similar degree of training, evaluated the X-rays independently and scored each one of them using the 3 scales compared herein. The interobserver agreement was assessed using Kendalls Tau-b ratio; the arithmetic mean was calculated and the ratios were compared with Fishers transformation. The interpretation was made using the standards proposed by Landis Koch. RESULTS: The Holmberg and Gartland classifications had a mean correlation coefficient of 0.654 and 0.706, respectively (p 0.001). Holmbergs classification provides a better anatomical description. The mean correlation coefficient of the AO classification was 0.491 (p = 0.001).The difference between the correlation coefficients was 0.052 for Holmbert/Gartland; 0.163 for Holmberg/AO, and 0.215 for Gartland/AO. There were no statistically significant differences among these values, but there were epistemological differences. According to Landis and Koch, the Holmberg and Gartland classifications show a substantial agreement, while the AO classification showed a moder ate agreement. CONCLUSION: Holmbergs classification is the most recommendable one.

MÉTODOS: Existen diversas clasificaciones para las fracturas supracondíleas de húmero. El objetivo de este estudio fue evaluar la reproducibilidad y acuerdo interobservador de las clasificaciones Holmberg, Gartland y AO. Estudio retrospectivo, de evaluaciones concurrentes, ciegas e independientes realizado en una muestra consecutiva de 42 placas radiográficas de codo (AP y lateral) de pacientes pediátricos con fracturas supracondíleas. Tres observadores, con grados similares de entrenamiento, las evaluaron de manera independiente y asignaron los puntajes a cada una de acuerdo con las tres escalas mencionadas. Valoramos el acuerdo interobservador con el coeficiente Tau-b de Kendall; se calculó la media aritmética y los coeficientes se compararon con una transformación de Fisher. La interpretación se hizo de acuerdo con los estándares propuestos por Landis y Koch. RESULTADOS: Las clasificaciones de Holmberg y Gartland tuvieron una media de coeficiente de correlación de 0.654 y 0.706, respectivamente (p 0.001). La clasificación de Holmberg ofrece mejor descripción anatómica. La clasificación AO tuvo una media de coeficiente de correlación de 0.491 (p = 0.001). La diferencia entre los coeficientes de correlación Holmberg/Gartland fue de 0.052; Holmberg/AO de 0.163 y Gartland/AO = 0.215. No hubo diferencias estadísticamente significativas entre estos valores, pero sí epistemológicas. De acuerdo con Landis y Koch, las clasificaciones de Holmberg y Gartland tienen un acuerdo substancial; la clasificación de AO, moderado. CONCLUSIÓN: La clasificación de Holmberg es la más recomendable.

Influência do tabagismo sobre as análises laboratoriais de rotina: um estudo piloto em adultos jovens / Influence of tobacco smoking on standard clinical blood tests: a pilot study in young adults

Várias doenças estão relacionadas ao tabagismo, mas não se sabe ao certo o momento em que os malefícios superamos mecanismos de defesa do organismo. O objetivo deste trabalho foi verificar as alterações bioquímicas, hematológicas e imunológicas, em adultos jovens fumantes, comparando com adultos jovens, não fumantes. Vinte e quatro não-fumantes e 14 fumantes (fumam há 8 mais ou menos 1 ano, e uma quantidade média de cigarros/dia = 10 mais ou menos 4,9), alunos da UNISO dos cursos da saúde (Farmácia, Nutrição e Terapia Ocupacional), com idade média de 23 mais ou menos 3,6 anos, participaram do estudo. As amostras de sangue foram coletadas de acordo com as exigências para as seguintes análises: colesterol total, HDL-colesterol, LDL-colesterol, VLDL-colesterol, triacilgliceróis, glicose, uréia, ácido úrico e creatinina sérica. Os grupos demonstraram ser normolipidêmicos, euglicêmicos, com valores séricos de uréia, creatinina, ácido úrico, proteína C reativa (PCR), imunoglobulinas G (IgG) e M (IgM), complemento C3 e contagem global de glóbulos brancos e vermelhos, dentro dos valores de referência. A maior concentração sérica da uréia foi observada no grupo de fumantes e nenhuma outra diferença significativa foi observada entre os grupos, indicando talvez que a duração do tabagismo não foi ainda suficiente para alterar algum parâmetro laboratorial

[Risk factors for the health of adolescent students]. / Factores de riesgo para la salud en estudiantes adolescentes.

OBJECTIVE: To profile COU and 5th-year FP students for the theoretical importance they give to health and their self-perception of the same. To measure their level of knowledge, activities and conduct regarding health risk factors. DESIGN: Descriptive crossover study. SETTING: Primary Care district of the Alpujarra, Granada. PARTICIPANTS: 190 COU and 5th-year FP students from schools in the Alpujarra (95% of the total). MEASUREMENTS AND MAIN RESULTS: The majority of these young people cites health as among the three most important elements in their life, yet lived alongside important risk factors. Although 69% defined their health as good or very good, 64% got drunk at least once a year. Although they all accepted the harmfulness of tobacco, 54.1% (with no difference between the sexes) smoked to some degree. Only 2.6% identified the days of greatest risk of pregnancy in a supposed cycle, although 19% stated that they had heterosexual relations. AIDS was considered the illness most to be feared. 13% had had a motor-bike accident in recent years. CONCLUSIONS: There is a contradiction between the high theoretical importance given to health, the self-definition of good health and cohabitation with important risk factors. The inefficacy of the Primary Care and Education systems in the primary prevention of important risk factors affecting adolescents' health was also demonstrated.