ABSTRACT
Resumen: Objetivo: Analizar los resultados clínicos de las metatarsalgias tratadas con osteotomías metafisarias metatarsales distales (DMMO) por vía percutánea. Material y métodos: Estudio prospectivo y continuo de 29 pacientes afectados de metatarsalgia mecánica aislada unilateral, intervenidas con una DMMO, con un seguimiento medio de 38 meses. La edad media de los pacientes fue 58 (rango: 50-67) años y sólo dos hombres. Utilizamos la escala AOFAS, anotamos la fórmula digital y metatarsiana sobre la radiografía. Registramos la valoración subjetiva del cirujano y del paciente al final del tratamiento. Resultados: La mejoría de la puntuación final superó los 80 puntos en todos los metatarsianos (p = 0.000), con una mejoría significativa del dolor (p = 0.000) y de las callosidades (p = 0.000), mejorando la estabilidad articular metatarso-falángica e interfalángica y la alineación de los metatarsianos. El tipo del calzado no cambió después de la cirugía, no encontramos variación de la movilidad, ni en las articulaciones metatarso-falángicas (p = 0.382), ni en las interfalángicas (p = 0.672). Después de la cirugía aumentaron los pies cuadrados (p = 0.027). La fórmula metatarsiana sufrió pocas modificaciones, 96% de los pacientes y de los cirujanos se mostraron «muy satisfechos¼ o «satisfechos¼. Conclusión: La DMMO consigue un alto grado de satisfacción en pacientes y también en el cirujano, elimina el dolor y la hiperqueratosis bajo la cabeza de los metatarsianos dolorosos que mejora significativamente la capacidad funcional de los pacientes.
Abstract: Objective: To analyze the clinical results of metatarsalgia treated with percutaneous distal metatarsal metaphyseal osteotomies (DMMO). Material and methods: Prospective and continuous study of 29 patients with isolated unilateral mechanical metatarsalgia, operated on with DMMO, with a mean follow-up of 38 months. The mean age of the patients was 58 (range: 50-67) years and only two men. We use the AOFAS score, we obtained the digital and metatarsal formulas on the X-rays. We record the subjective assessment of the surgeon and the patient at the end of the treatment. Results: The improvement in the final score exceeded 80 points in all cases (p = 0.000), with a significant improvement in pain (p = 0.000) and calluses (p = 0.000), improving metatarsal-phalangeal joint stability and interphalangeal and metatarsal alignment. The type of footwear did not change after surgery, we found no variation in mobility, neither in the metatarsophalangeal joints (p = 0.382), nor in the interphalangeal joints (p = 0.672). After surgery increased the square foot morphology (p = 0.027) but the metatarsal formula underwent few modifications. Patients and surgeons were in 96% of the cases «very satisfied¼ or «satisfied¼. Conclusion: DMMO achieves a high degree of satisfaction in patients and in the surgeon, pain and hyperkeratosis under the head of the painful metatarsals disappear and that significantly improves the functional capacity of patients.
ABSTRACT
OBJECTIVE: To analyze the clinical results of metatarsalgia treated with percutaneous distal metatarsal metaphyseal osteotomies (DMMO). MATERIAL AND METHODS: Prospective and continuous study of 29 patients with isolated unilateral mechanical metatarsalgia, operated on with DMMO, with a mean follow-up of 38 months. The mean age of the patients was 58 (range: 50-67) years and only two men. We use the AOFAS score, we obtained the digital and metatarsal formulas on the X-rays. We record the subjective assessment of the surgeon and the patient at the end of the treatment. RESULTS: The improvement in the final score exceeded 80 points in all cases (p = 0.000), with a significant improvement in pain (p = 0.000) and calluses (p = 0.000), improving metatarsal-phalangeal joint stability and interphalangeal and metatarsal alignment. The type of footwear did not change after surgery, we found no variation in mobility, neither in the metatarsophalangeal joints (p = 0.382), nor in the interphalangeal joints (p = 0.672). After surgery increased the square foot morphology (p = 0.027) but the metatarsal formula underwent few modifications. Patients and surgeons were in 96% of the cases "very satisfied" or "satisfied". CONCLUSION: DMMO achieves a high degree of satisfaction in patients and in the surgeon, pain and hyperkeratosis under the head of the painful metatarsals disappear and that significantly improves the functional capacity of patients.
OBJETIVO: Analizar los resultados clínicos de las metatarsalgias tratadas con osteotomías metafisarias metatarsales distales (DMMO) por vía percutánea. MATERIAL Y MÉTODOS: Estudio prospectivo y continuo de 29 pacientes afectados de metatarsalgia mecánica aislada unilateral, intervenidas con una DMMO, con un seguimiento medio de 38 meses. La edad media de los pacientes fue 58 (rango: 50-67) años y sólo dos hombres. Utilizamos la escala AOFAS, anotamos la fórmula digital y metatarsiana sobre la radiografía. Registramos la valoración subjetiva del cirujano y del paciente al final del tratamiento. RESULTADOS: La mejoría de la puntuación final superó los 80 puntos en todos los metatarsianos (p = 0.000), con una mejoría significativa del dolor (p = 0.000) y de las callosidades (p = 0.000), mejorando la estabilidad articular metatarso-falángica e interfalángica y la alineación de los metatarsianos. El tipo del calzado no cambió después de la cirugía, no encontramos variación de la movilidad, ni en las articulaciones metatarso-falángicas (p = 0.382), ni en las interfalángicas (p = 0.672). Después de la cirugía aumentaron los pies cuadrados (p = 0.027). La fórmula metatarsiana sufrió pocas modificaciones, 96% de los pacientes y de los cirujanos se mostraron "muy satisfechos" o "satisfechos". CONCLUSIÓN: La DMMO consigue un alto grado de satisfacción en pacientes y también en el cirujano, elimina el dolor y la hiperqueratosis bajo la cabeza de los metatarsianos dolorosos que mejora significativamente la capacidad funcional de los pacientes.
Subject(s)
Metatarsal Bones , Metatarsalgia , Metatarsophalangeal Joint , Aged , Humans , Male , Metatarsal Bones/surgery , Metatarsalgia/etiology , Metatarsalgia/surgery , Metatarsophalangeal Joint/surgery , Middle Aged , Minimally Invasive Surgical Procedures/methods , Prospective Studies , Treatment OutcomeSubject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Aged, 80 and over , Asymptomatic Infections , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/etiology , Coronavirus Infections/therapy , Female , Humans , Pandemics , Pneumonia, Viral/etiology , Pneumonia, Viral/therapy , Protective Factors , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Vulnerable PopulationsABSTRACT
Nocturia is the interruption of the main sleep, one or more times, due to the need for urination. It is associated with a decrease in the quality of life and an increase in mortality. It is a complex and multifactorial symptom in which two pathophysiological mechanisms are mainly involved. These occur alone or in combination as nocturnal polyuria or decreased bladder capacity. Nocturnal polyuria is the most frequent. The preparation of a bladder diary is the key to diagnosis. Treatment usually combines lifestyle changes and drug therapy. Desmopressin has proven to be an effective and well-tolerated treatment in patients with nocturnal polyuria. The risk of hyponatraemia should be controlled in patients treated with desmopressin.
Subject(s)
Nocturia , Humans , Polyuria , Primary Health Care , Quality of Life , SleepABSTRACT
Portus Ilicitanus (Picola, Alicante) was the main sea harbour of the Roman Colonia Iulia Ilici Augusta and as such played a crucial role in the supply of fundamental commodities to the Iberian Peninsula. Excavations yielded large quantities of glass in fourth- and early fifth-century contexts. Elemental analysis of 60 samples by laser ablation - inductively coupled plasma - mass spectrometry (LA-ICP-MS) confirmed that the glasses were imported from the Eastern Mediterranean. A majority of the glasses correspond to the HIMTa primary production group, which originates from Egypt. The statistical evaluation of published data of 589 HIMT glasses further revealed differential distribution patterns of the HIMTa and HIMTb subtypes between the Eastern and Western Mediterranean, suggesting chronological trends that are linked to wider geopolitical changes. This demonstrates the need for systematic large-scale approaches to identify supply patterns and possible factors underlying geographical differences and/or chronological developments.
ABSTRACT
No disponible
Subject(s)
Humans , Actigraphy/methods , Deprescriptions , Hypnotics and Sedatives/administration & dosage , Sleep Initiation and Maintenance Disorders/drug therapy , Chronic DiseaseABSTRACT
OBJECTIVE: The aim of this study was to know the incidence of serious bacterial infections (SBI) in children without sepsis or intracranial infection in which spinal puncture (LP) was performed in an Emergency Department. PATIENTS AND METHODS: A retrospective study of all 471 previously healthy children between 1 month and 14 years of age in which a lumbar puncture was performed between July 1995 and March 1997 in the Emergency Department of our hospital was performed. RESULTS: Two hundred and three children (43%) had sepsis, meningitis or encephalitis (aseptic meningitis 149, 31.6%; sepsis-bacterial meningitis 26, 5.5%; nonspecific meningitis 26, 5.5%; encephalitis 2, 0.4%) and 14 (5.2%) had pneumonia. Of the other 254 children, 36 (14.1%) had a SBI: 19 urinary tract infections (E. coli), 11 bacteremia (Streptococcus pneumoniae 8, Salmonella enteritidis 1, Proteus mirabilis 1, E. coli 1, the latter two also having a positive urine culture) and 6 bacterial gastroenteritis (salmonella 5, Campylobacter jejuni 1). The incidence of SBI was significantly higher in the group of children younger than 5 years old (32/175, 18.2%) than in the older group (4/79, 5.0%, p = 0.009). Two patients died (one with pneumococcal meningitis and one with meningococcal sepsis). CONCLUSIONS: Children with fever and a normal result in the LP must be carefully examined and, especially in younger patients, urine, blood and stool (if stool abnormalities) cultures should be collected. These children must be closely observed in the hospital or at home and must be re-evaluated by their pediatrician in the following 24 hours.
Subject(s)
Bacterial Infections/diagnosis , Spinal Puncture , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Emergencies , Emergency Service, Hospital , Female , Humans , Infant , Male , Pediatrics , Retrospective Studies , Spain , Spinal Puncture/statistics & numerical dataABSTRACT
A microparticle-enhanced nephelometric immunoassay, based on polystyrene beads coated with antihuman lysozyme antibody, has been developed for lysozyme quantification in sera and pleural effusions. The standard curve extends from 0.58 mg/l to 18.75 mg/l and no antigen effect was observed. The results showed a good serial precision. The intra-assay precision (n = 20) expressed as CV was between 2.2 and 4.2 in three different concentrations. The inter-assay precision, with different calibration curves (n = 12) was between 6.4 and 7.1. The analytical assay showed a sufficient linearity (r > 0.999). There were no interferences either with haemoglobin (up to 4 g/l), lipids (up to 0.5%, expressed as 1% Lipofundina content), or bilirubin (up to 5 mg/dl). The analytical sensitivity was lower than 0.6 mg/l. The correlation with a Micrococcus lysodeikticus turbidimetric assay showed a correlation coefficient of 0.915. We have studied 92 patients with pleural effusion. In each case, pleural fluid adenosine deaminase activity and pleural fluid to plasma lysozyme ratio were determined. The lysozyme ratio showed similar clinical sensitivity and specificity as to adenosine deaminase.
Subject(s)
Muramidase/analysis , Nephelometry and Turbidimetry/methods , Pleural Effusion/enzymology , Adenosine Deaminase/metabolism , Humans , Immunoassay/methods , Muramidase/blood , Polystyrenes , Sensitivity and SpecificityABSTRACT
Gastroesophageal reflux (GER) can be found in a high number of patients with respiratory tract disease (RTD). In the present study a 24 hours esophageal pH monitoring was performed in 55 children. 15 of them were normal controls, 16 patients with GER but normal score, 14 patients with GER and RTD and 9 patients with GER and only digestive symptoms. The number of reflux episodes of more than 5 minutes, the duration of the longest single reflux episode, the percentage of time the esophageal pH was less than 4, the reflux/hour index and the clearance index were measured. Comparing the results of the different groups we found that normal controls and normal vomiting patients were significatively different. Refluxers and refluxers with RTD also were different of asymptomatic controls. The main significative differences founded comparing refluxers and refluxers with RTD were the duration of the longest single reflux, the percentage of time the esophageal pH was less than 4 and the clearance index. All these parameters were longer in the refluxers with RTD. Our conclusion is that esophageal clearance is slower in the group of refluxers with RTD and that this index is helpful to distinguish them from the single refluxers.
