ABSTRACT
BACKGROUND: Cardiovascular support (CVS) treatment failure (TF) is associated with a poor prognosis in preterm infants. METHODS: Medical charts of infants with a birth weight <1500 g who received either dopamine (Dp) or dobutamine (Db), were reviewed. Treatment response (TR) occurred if blood pressure increased >3rd centile for gestational age or superior vena cava flow was maintained >55 ml/kg/min, with decreased lactate or less negative base excess, without additional CVS. A predictive model of Dp and Db on TR was designed and the impact of TR on survival was analyzed. RESULTS: Sixty-six infants (median gestational age 27.3 weeks, median birth weight 864 g) received Dp (n = 44) or Db (n = 22). TR occurred in 59% of the cases treated with Dp and 31% with Db, p = 0.04. Machine learning identified a model that correctly labeled Db response in 90% of the cases and Dp response in 61.4%. Sixteen infants died (9% of the TR group, 39% of the TF group; p = 0.004). Brain or gut morbidity-free survival was observed in 52% vs 30% in the TR and TF groups, respectively (p = 0.08). CONCLUSIONS: New predictive models can anticipate Db but not Dp effectiveness in preterm infants. These algorithms may help the clinicians in the decision-making process. IMPACT: Failure of cardiovascular support treatment increases the risk of mortality in very low birth weight infants. A predictive model built with machine learning techniques can help anticipate treatment response to dobutamine with high accuracy. Predictive models based on artificial intelligence may guide the clinicians in the decision-making process.
Subject(s)
Cardiovascular Diseases , Infant, Premature , Infant , Infant, Newborn , Humans , Infant, Premature/physiology , Dobutamine/therapeutic use , Birth Weight , Vena Cava, Superior/physiology , Artificial Intelligence , Dopamine/therapeutic use , Infant, Very Low Birth WeightABSTRACT
INTRODUCTION: Stroke is a significant worldwide cause of death and a prevalent contributor to long-term disability among adults. Survivors commonly encounter a wide array of motor, sensory and cognitive impairments. Rehabilitation interventions, mainly targeting the upper extremities, include a wide array of components, although the evidence indicates that the intensity of practice and task-specific training play crucial roles in facilitating effective results. Assisted therapy with electronic devices designed for the affected upper extremity could be employed to enable partial or total control of this limb, while simultaneously incorporating the aforementioned characteristics in the rehabilitation process. METHODS AND ANALYSIS: 32 adults who had a subacute or chronic stroke, aged over 18 years old, will be included for this randomised controlled trial aiming to determine the non-inferiority effect of the inclusion of a robotic device (ALBA) to regular treatment against only regular rehabilitation. Participants will be assessed before and after 4 weeks of intervention and at 3 months of follow-up. The primary outcome will be the Fugl-Meyer assessment for upper extremities; secondary outcomes will include the questionnaires Functional Independence Measure, Medical Outcomes Study 36-item Short-Form Health Survey as well as the System Usability Scale. ETHICS AND DISSEMINATION: Full ethical approval was obtained for this study from the scientific and ethical review board Servicio de Salud Metropolitano Oriente of Santiago (approval number: SSMOriente030522), and the recommendations of the Chilean law no 20120 of 7 September 2006, concerning scientific research in the human being, its genome and human cloning, will be followed. Ahead of inclusion, potential participants will read and sign a written informed consent form. Future findings will be presented and published in conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER: International ClinicalTrials.gov Registry (NCT05824416; https://clinicaltrials.gov/ct2/show/NCT05824416?term=uMOV&draw=2&rank=1).
Subject(s)
Brain Injuries , Stroke Rehabilitation , Stroke , Adult , Humans , Brain Injuries/complications , Chile , Randomized Controlled Trials as Topic , Recovery of Function , Stroke/complications , Stroke Rehabilitation/methods , Treatment Outcome , Upper ExtremityABSTRACT
Adaptive learning is necessary for nonstationary environments where the learning machine needs to forget past data distribution. Efficient algorithms require a compact model update to not grow in computational burden with the incoming data and with the lowest possible computational cost for online parameter updating. Existing solutions only partially cover these needs. Here, we propose the first adaptive sparse Gaussian process (GP) able to address all these issues. We first reformulate a variational sparse GP (VSGP) algorithm to make it adaptive through a forgetting factor. Next, to make the model inference as simple as possible, we propose updating a single inducing point of the SGP model together with the remaining model parameters every time a new sample arrives. As a result, the algorithm presents a fast convergence of the inference process, which allows an efficient model update (with a single inference iteration) even in highly nonstationary environments. Experimental results demonstrate the capabilities of the proposed algorithm and its good performance in modeling the predictive posterior in mean and confidence interval estimation compared to state-of-the-art approaches.
ABSTRACT
The fruit fly Anastrepha obliqua is an economically important pest. The sterile insect technique to control it involves mass production and release of sterile flies to reduce the reproduction of the wild population. As noted in different Tephritidae, the performance of sterile males may be affected by the assimilation of nutrients under mass-rearing conditions. In the wild, the fly's life cycle suggests the acquisition of different organisms that could modulate its fitness and physiology. For A. obliqua, there is no information regarding microorganisms other than bacteria. This study analyzed bacteria, fungal, and archaea communities in the A. obliqua gut through denaturing gradient gel electrophoresis (DGGE) profiles of 16S (using a different set of primers for bacteria and archaea) and 18S ribosomal DNA markers. We found that wild flies presented higher microbial diversity related to fructose assimilation than laboratory species, suggesting that microorganisms have led to a specialized metabolism to process nutrients associated with an artificial diet. We identified species that have not been previously described in this fruit fly, especially actinobacteria and archaea, by employing different primer sets aimed at the same molecular marker but targeting diverse hypervariable regions of 16S rDNA. The possibility that Archaea affect fly fitness should not be ignored. This report on the intestinal microbial (bacteria, archaea, and fungi) composition of A. obliqua contributes to our understanding of the role of microorganisms in the development and physiology of the flies.
Subject(s)
Gastrointestinal Microbiome , Tephritidae , Animals , Archaea , Bacteria , Fungi , MaleABSTRACT
Although the bulking agent is categorized as 'inert', it could modify protein bioavailability and nutritional quality. In this study, the main goal was to determine if the bulking agent modified the protein:carbohydrate (P:C) ratio and bioconversion from diet biomass to larval biomass of Anastrepha ludens. The diet was altered only by modifying the type of bulking agent (corncob powder, coconut fiber, carrot fiber, oatmeal) added without changing the composition and concentration of the other components in the formulation. This allowed reclassification of the food matrices according to P:C ratios of 1:30, 1:35, 1:64, and 1:93. A food matrix with a high P:C ratio promoted a high protein and carbohydrate content in the larval hemolymph and immediately influenced the life-history traits of the larva or delayed them in the adult. The present study indicated a positive relationship between the P:G+T (glucose+trehalose) ratio in the larval hemolymph and the P:C ratio in the larval diet. Our results highlight the importance of including the optimum and real P:C ratio in whole fresh larval diets, since considering only the theoretical concentration of the formulation is not enough to understand the variation in key life-history traits. In addition, the bioconversion index should be included as an indicator of the efficacy of larval diets for mass rearing insects. A diet with high cost-effectiveness should be evaluated by taking into account flying flies as the end product of the mass rearing process to enhance operational SIT programs.
Subject(s)
Tephritidae , Animals , Carbohydrates , Cost-Benefit Analysis , Diet , LarvaABSTRACT
Few studies have focused on how nutrition affects the bioavailability and investment of protein during the metamorphosis of tephritids. Our study allowed us to observe how the type and particle size of the bulking agent affected the protein composition in the hemolymph of the larva and adult of Anastrepha obliqua. Results indicated that, true protein bioavailability and protein profile was greatly modified by the bulking agent and its particle size. The physical structure of the food matrix affected the content of crude fiber (F), crude protein (P), F/P ratio, non-protein nitrogen, ammoniacal nitrogen, and α-amylase and trypsin inhibitors. Results from SDS-PAGE revealed 45 fractions with well-defined bands ranging from ~28 to ~401 kDa in larvae and adults, we found the main differences between the samples from different food matrices within the 75-100 kDa range. Hemolymph of adults from the coarse coconut fiber food matrix treatment showed a single band with a molecular weight close to 250 kDa, probably associated with a storage protein such as lipophorins. The food matrix with a coarse bulking agent had a high concentration of ammoniacal nitrogen, suggesting high microbial activity. In conclusion, the particle size of the bulking agent of the food matrix changes the bioavailability of protein in hemolymph in the adult regardless of the total concentration of protein. Also, when the particle size of the bulking agent favored the F/P ratio, higher larval density resulted in higher individual larval weight, larval yield, and adult emergence.
Subject(s)
Hemolymph , Tephritidae , Animals , Hemolymph/metabolism , Larva/metabolism , Metamorphosis, Biological , Nitrogen/analysisABSTRACT
Diffuse cavernous hemangioma (DCH) is a rare benign vascular lesion. The rectosigmoid colon is the most common site of this disease. It affects mainly young adults. The most frequent symptom is chronic rectal bleeding which is painless, often begins in the infancy and sometimes is uncontrollable. Endoscopy is the diagnose method of choice and complete surgical excision with sphincter-saving procedure is the primary mode of treatment. A high index of suspicion and a correct diagnose is necessary. We present a 34-year-old male with a DCH of the rectum and anus who required an APR because of affection of dentate line.
El hemangioma cavernoso difuso (HCD) es un tumor vascular benigno raro. Su localización más habitual es el rectosigma. Se presenta en adultos jóvenes como rectorragia indolora y recurrente, que suele aparecer en la infancia y puede llegar a ser incontrolable. La endoscopia digestiva es el método diagnostico de elección. El único tratamiento eficaz consiste en la resección completa siendo deseable la realización de una técnica con conservación esfinteriana. Un alto índice de sospecha y un correcto diagnóstico son necesarios. Presentamos el caso de un varón de 34 años con un HCD del anorecto que requirió una resección abdominoperineal.
Subject(s)
Hemangioma, Cavernous , Rectal Neoplasms , Adult , Anal Canal , Colon , Hemangioma, Cavernous/diagnostic imaging , Hemangioma, Cavernous/surgery , Humans , Male , Rectal Neoplasms/diagnosis , Rectal Neoplasms/surgery , Rectum , Young AdultABSTRACT
For purposes of mass-rearing fruit flies, nutrient intake through artificial diets is a challenge, artificial food content and processing should promote sufficient absorption and availability to ensure fly fitness. Bulking agents play an essential role in creating a quality diet, but its physical characteristics, such as particle size, may establish a better microenvironment for feeding and development. Currently, there is a lack of information about protein metabolism in mass-reared fruit flies. Therefore, we evaluated whether the particle size of the bulking agent affects the absorption and excretion of the proteins, as well as their effect on the life-history traits of Anastrepha obliqua. We determined the protein content of hemolymph and feces, as well as the presence of nitrogen end-products as indicators of their level of absorption in a diet elaborated with coarse and fine corn cob particles as a bulking agent. The bromatological composition showed that coarse particles increased the bioavailability and content of crude, digestible, and soluble protein for the diet and hemolymph protein of larvae alike. We found an inverse relationship between the protein content of the hemolymph and feces of the larvae. Ammonium was determined to be a product of the catabolism of proteins. Also, A. obliqua improved its development (yield and pupal weight) and fitness (adult emergence and flight ability) when larvae were reared on a coarse particle diet. In conclusion, a diet elaborated with a coarse bulking agent features increased protein bioavailability and nutritional quality, which, in turn, increases the life-history traits of A. obliqua.
Subject(s)
Diet , Nutritional Status , Tephritidae , Animals , Blood/metabolism , Feces/chemistry , Larva/growth & development , Nutritional Status/physiology , Proteins/metabolism , Pupa/growth & development , Tephritidae/growth & development , Tephritidae/metabolism , Tephritidae/physiology , Uric Acid/metabolismABSTRACT
Introducción: El desgarro del ligamento cruzado anterior es una lesión frecuente en ortopedia y traumatología, presentando la reconstrucción artroscópica excelentes resultados. No obstante, pueden existir complicaciones tales como artritis séptica, hemartrosis, infección del sitio quirúrgico, hematomas o TVP, entre otras. El objetivo del trabajo es describir y evaluar las complicaciones a corto plazo de la reconstrucción artroscópica de la plástica del ligamento cruzado anterior con autoinjerto de isquiotibiales y analizar la frecuencia de aparición de las mismas en cuanto a edad y sexo. Material y Métodos: Se analizó de forma retrospectiva una serie de 631 pacientes con reconstrucción artroscópica del LCA operados en nuestro centro entre los años 2015 y 2019. Se agrupó a los pacientes según sexo (femenino-masculino) y rango etario (<20, 20-29, 30-39 y >40), evaluando las complicaciones encontradas luego de la plástica ligamentaria dentro de los primeros 45 días de postoperatorio. Resultados: Las complicaciones observadas fueron en el 6,5% del total de los pacientes. La proporción en varones fue de hasta 5-8:1. El mayor número de complicación se presentó en pacientes menores de 20 años con un 8,1%. Se observó en el total de la muestra derrame con requerimiento de artrocentesis evacuadora en 2,69%, celulitis resuelta con antibióticos en 2,06% y artritis séptica en 1,42%, habiendo un porcentaje menor al 1% de hematoma resuelto con antibióticos y TVP. Conclusiones: Consideramos importante la evaluación de factores inmodificables como el sexo y la edad para un seguimiento más cercano de estos pacientes en las primeras etapas del postoperatorio, así como también conocer las complicaciones más frecuentes a corto plazo que se presentan en este tipo de intervención que nos permitirá su correcto abordaje y tratamiento. Nivel de Evidencia: IV
Subject(s)
Young Adult , Postoperative Complications , Arthroscopy , Age Factors , Anterior Cruciate Ligament Reconstruction , AutograftsABSTRACT
Introducción: El objetivo del trabajo es evaluar y comparar de manera retrospectiva la tasa de artritis séptica (AS) postquirúrgicas en reconstrucción de LCA entre dos grupos de estudio: A, sin el uso local de vancomicina en el injerto autólogo de isquiotibiales, versus grupo B, con profilaxis antibiótica local.Materiales y métodos: se trabajaron dos grupos compuestos por 683 pacientes en total, con diagnóstico primario de ruptura de LCA. Grupo A, operados entre 2016 y 2017, en los que no se utilizó profilaxis antibiótica del autoinjerto; y el grupo B, intervenidos entre 2018 y 2019, donde se sumergió el autoinjerto de isquiotibiales en 500 mg de vancomicina en 100 ml de solución fisiológica como profilaxis local. En ambos grupos se llevó a cabo el protocolo usual pre, intra y postquirúrgico. Resultados: se analizó la relación entre presencia de infección y las diferentes variables estudiadas, se observó que el uso local de vancomicina en el injerto autólogo de isquiotibiales está asociado a menor infección (p <0.05). La edad, el sexo y el sanatorio donde se realiza la cirugía no condicionan necesariamente la presencia de infección (p >0.05).Conclusión: presentamos este trabajo como prueba en nuestro medio del claro beneficio que se obtuvo, ya que los pacientes que fueron sometidos a la profilaxis local de vancomicina del autoinjerto mostraron una disminución notable de artritis séptica.Tipo de estudio: Artículo Original Descriptivo-transversal. Nivel de evidencia: III
Introduction: The aim of the study is to evaluate and retrospectively compare the rate of postoperative septic arthritis (SA) in ACL reconstruction, between two study groups: A without local use of vancomycin in autologous hamstring graft versus group B with local antibiotic prophylaxisMaterials and methods: two groups composed of 683 patients in total, with a primary diagnosis of ACL rupture, were studied. Group A, operated on in 2016 and 2017, in which antibiotic prophylaxis of the autograft was not used; and the second group B, between 2018 and 2019, where the hamstring autograft was submerged in 500 mg of vancomycin in 100 ml of physiological solution as local prophylaxis. Preoperative intravenous antibiotic prophylaxis was carried out in both groups as the usual protocol.Results: it was obtained as a result that in group A, the two years that they worked without "pre-soaking" of antibiotics in the autograft and the relationship between the presence of infection and the different variables studied was analyzed, where they found that the use Local vancomycin in the autologous hamstring graft is associated with a minor infection (p <0.05). However, age, sex and the sanatorium where the surgery is performed do not necessarily determine the presence of infection (p >0.05)Conclusion: we present this work as proof in our environment of the clear benefit that we obtained, since the patients who underwent local prophylaxis of vancomycin of the autograft, showed a notable decrease in septic arthritis.Type of study: Original Article - Descriptive-cross-sectional. Level of Evidence: III
Subject(s)
Vancomycin/therapeutic use , Arthritis, Infectious/prevention & control , Antibiotic Prophylaxis , Anterior Cruciate Ligament ReconstructionABSTRACT
INTRODUCTION: The evidence currently available from enhanced recovery after surgery (ERAS) programmes concerns their benefits in the immediate postoperative period, but there is still very little evidence as to whether their correct implementation benefits patients in the long term. The working hypothesis here is that, due to the lower response to surgical aggression and lower rates of postoperative complications, ERAS protocols can reduce colorectal cancer-related mortality. The main objective of this study is to analyse the impact of an ERAS programme for colorectal cancer on 5-year survival. As secondary objectives, we propose to analyse the weight of each of the predefined items in the oncological results as well as the quality of life. METHODS AND ANALYSIS: A multicentre prospective cohort study was conducted in patients older than 18 years of age who are scheduled to undergo surgery for colorectal cancer. The study involved 12 hospitals with an implemented enhanced recovery protocol according to the guidelines published by the Spanish National Health Service. The intervention group includes patients with a minimum implementation level of 70%, and the control group includes those who fail to reach this level. Compliance will be studied using 18 key performance indicators, and the results will be analysed using cancer survival indicators, including overall survival, cancer-specific survival and relapse-free survival. The time to recurrence, perioperative morbidity and mortality, hospital stay and quality of life will also be studied, the latter using the validated EuroQol Five questionnaire. The propensity index method will be used to create comparable treatment and control groups, and a multivariate regression will be used to study each variable. The Kaplan-Meier estimator will be used to estimate survival and the log-rank test to make comparisons. A p value of less than 0.05 (two-tailed) will be considered to be significant. ETHICS AND DISSEMINATION: Ethical approval for this study was obtained from the Aragon Ethical Committee (C.P.-C.I. PI20/086) on 4 March 2020. The findings of this study will be submitted to peer-reviewed journals (BMJ Open, JAMA Surgery, Annals of Surgery, British Journal of Surgery). Abstracts will be submitted to relevant national and international meetings. TRIAL REGISTRATION NUMBER: NCT04305314.
Subject(s)
Colorectal Neoplasms , Quality of Life , Cohort Studies , Colorectal Neoplasms/surgery , Humans , Length of Stay , Multicenter Studies as Topic , Neoplasm Recurrence, Local , Observational Studies as Topic , Postoperative Complications/epidemiology , Prospective Studies , State MedicineABSTRACT
The West Indian fruit fly, Anastrepha obliqua (Macquart), is the second most important tephritid fruit fly in Mexico, infesting mango, hog plum and guava fruits. To control this pest, the Mexican government has implemented the use of the sterile insect technique (SIT), which involves the mass production, sterilization and release of flies. However, the A. obliqua laboratory males used in SIT are selected to a lesser extent by the wild females during competitiveness tests. The objective of this study was to compare the effects of males fed on fruit fly food enriched with Providencia rettgeri to those in males fed on food alone, assessing male mating competitiveness, capture of females using traps baited with males fed with the enriched diet and sex pheromone components. The results indicated that males fed with the diet enriched with P. rettgeri had increased mating competitiveness and captured more females in the field cage tests. However, no difference was observed in the proportion of volatile sex pheromone components identified during the calling of A. obliqua males. The results suggest the value of incorporating bacteria into the mass rearing technique of A. obliqua adults in order to improve the sexual competitiveness of males from the laboratory compared to wild males.
ABSTRACT
The design of neuromorphic chips aims to develop electronic circuits dedicated to executing artificial neural networks, mainly by exploring parallel processing. Unsupervised learning models, such as Self-organizing Maps (SOM), may benefit from massively concurrent hardware-based implementations to meet the requirements of real-time and embedded applications. This work first presents a theoretical analysis of the algorithms implemented in hardware to compute SOM learning and recall phases. This is important because, albeit similar, the processing steps executed in hardware are not necessarily identical to those executed in software. Then, the proposed FPGA architecture entitled SOMprocessor is shown in detail. The circuit of the processor explores two different computational strategies for increasing the performance of current state-of-the-art works. These computational strategies aim to improve the data flow through the processor and its flexibility to implement different network topologies. Finally, this work presents the application of the SOMprocessor to a video categorization task. The results show that topographic and quantization errors are similar between hardware and software implementations, as well as the overall accuracy. Moreover, the proposed FPGA architecture achieves acceleration of 3 to 4 orders of magnitude as compared to CPU executions.
Subject(s)
Computers , Image Processing, Computer-Assisted/methods , Machine Learning , Software , Electronics , Image Processing, Computer-Assisted/instrumentationABSTRACT
The spotted wing drosophila, Drosophila suzukii Matsumura, has emerged as a major invasive insect pest of small and stone fruits in both the Americas and Europe in the last decade. Females oviposit in ripening fruit, and significant economic losses can occur. Control measures are mainly associated with the use of pesticides, but the sterile insect technique (SIT), an ecologically friendly pest-specific method, could be used against this species. The objective of this study was to estimate the mass rearing, quality control parameters, and bioconversion using four artificial larval diets and their economic aspects oriented to the SIT application. Diets were based on the combination of coconut fiber, corncob powder, Brewer's and Torula yeast and were used as oviposition substrate and larval development. We found that a life cycle is completed in 10.19 ± 0.35 d and that adults live an average of 33.67 ± 0.76 d. The highest number of pupae per gram of diet and the maximum bioconversion (6%) were associated with flies developed in the coconut fiber + Brewer's yeast diet. Under our conditions, the establishment of D. suzukii required at least four generations. The use of 30 × 40 × 30 cm Plexiglas cages, each loaded with 5,000 adults and stocked with 500 g of coconut fiber and Brewer's yeast diet distributed in 15 × 5 × 10 cm plastic trays with a diet layer 3-cm thick, allows a minimum production of 84,000 pupae of D. suzukii per day.
Subject(s)
Drosophila , Oviposition , Animals , Europe , Female , Insect Control , Larva , PupaABSTRACT
An important problem that hinders the use of supervised classification algorithms for brain imaging is that the number of variables per single subject far exceeds the number of training subjects available. Deriving multivariate measures of variable importance becomes a challenge in such scenarios. This paper proposes a new measure of variable importance termed sign-consistency bagging (SCB). The SCB captures variable importance by analyzing the sign consistency of the corresponding weights in an ensemble of linear support vector machine (SVM) classifiers. Further, the SCB variable importances are enhanced by means of transductive conformal analysis. This extra step is important when the data can be assumed to be heterogeneous. Finally, the proposal of these SCB variable importance measures is completed with the derivation of a parametric hypothesis test of variable importance. The new importance measures were compared with a t-test based univariate and an SVM-based multivariate variable importances using anatomical and functional magnetic resonance imaging data. The obtained results demonstrated that the new SCB based importance measures were superior to the compared methods in terms of reproducibility and classification accuracy.
Subject(s)
Brain Mapping/methods , Brain/diagnostic imaging , Machine Learning , Magnetic Resonance Imaging/methods , Algorithms , Brain Mapping/trends , Humans , Machine Learning/trends , Magnetic Resonance Imaging/trends , Reproducibility of Results , Support Vector Machine/trendsABSTRACT
Mass rearing fruit flies of the genus Anastrepha for the sterile insect technique involves the use of artificial larval diets that commonly contain corn cob powder as a bulking agent. Corn cob powder varies in quality, and larval diets that contain it can be reaching at high temperatures (>34°C), which subsequently has a negative effect on pupal weight and adult survival. In addition, corn cob powder is susceptible to contamination by mycotoxins, which can inhibit larval development and cause high larval mortality. The objective of this work was to develop a low-cost artificial larval diet for mass rearing Anastrepha spp. fruit flies using coconut fiber, a nonconventional bulking agent, and to evaluate its effects on the quality parameters for A. ludens wild-type, A. ludens Tap-7 GS-strain, A. obliqua, A. serpentina, and A. striata. The coconut fiber diet resulted in an increase in the larval and pupal weight of A. ludens Tap-7 GS-strain and A. obliqua, an increase in the larval weight of A. ludens wild-type, an increase in the flight ability of A. obliqua and A. serpentina and an increase in adult eclosion in A. ludens Tap-7 GS-strain. The coconut fiber diet resulted in increased production and quality of the mass-reared flies, reduced the cost of the diet by 15 and 20% for A. ludens and A. obliqua, respectively, and led to further cost savings through reduced labor processes.
Subject(s)
Tephritidae , Animals , Cocos , Diet , Larva , PupaABSTRACT
Introducción: El objetivo del trabajo es evaluar y comparar de manera retrospectiva los resultados de una serie de pacientes laborales y no laborales con lesiones meniscales, tratadas mediante meniscectomía parcial artroscópica. Material y métodos: Se evaluaron 60 pacientes tratados en nuestro centro, entre junio 2016 y mayo 2017, los cuales presentaban lesiones meniscales agudas que no respondieron a tratamiento conservador. Todas las lesiones fueron diagnosticadas con RM previa. Se trataba de 30 pacientes laborales y 30 no laborales, 53 de sexo masculino y 7 de sexo femenino. La edad fue entre 18 y 45 años. Treinta y seis meniscos internos y veinticuatro meniscos externos. El seguimiento promedio fue 18 meses. Se realizó score de Lysholm y EVA. Resultados: De los 30 pacientes no laborales 28 evolucionaron favorablemente, con mejoría en el score de Lysholm de 53 a 93 puntos y EVA de 7 a 1 puntos en promedio, con retorno a la actividad previo a la lesión. Dos de ellos continuaron con molestias leves, sin afectar sus rutinas diarias. En los pacientes laborales 14 evolucionaron favorablemente, con mejoría en el score de Lysholm de 48 a 74 puntos y EVA 7 a 2 puntos en promedio con retorno a su actividad laboral habitual. Dieciséis de ellos presentaban dolor moderado con retorno laboral parcial o requirieron cambio de tareas. Conclusión: Los resultados de la meniscectomía parcial en pacientes no laborales fueron excelentes a buenos, con retorno a sus actividades cotidianas en un 96%. En cuanto a los pacientes laborales se obtuvieron resultados regulares, con retorno a su actividad laboral habitual en un 53%. Tipo de estudio: Serie de casos. Nivel de evidencia: IV
Introduction: The aim of the study is to evaluate and compare retrospectively the results of arthroscopic partial meniscectomy for meniscus tears in working compensation vs. non-working compensation patients Material and methods: Sixty patients treated in our institution between June 2016 and May 2017 with the diagnosis of acute meniscus tears that did not respond to conservative treatment were evaluated. All lesions were diagnosed with previous MRI. There were 30 patients under working compensation insurance and 30 under another insurance system (53 men, and 7 women). The age ranged between 18 and 45 years. Thirty-six tears were located in the internal menisci and twenty-four in the external menisci. The average follow-up was 18 months. Lysholm and EVA scores were obtained. Results: Of the 30 non-working compensation patients, 28 evolved favorably with an improvement in the Lysholm score of 53 to 93 points and EVA of 7 to 1 points on average and returned to activity prior to the injury. Two of them continued with mild discomfort, without affecting their daily routines. In working compensation, patients 14 evolved favorably, with improvement in the Lysholm score of 48 to 74 points and EVA 7 to 2 points on average and return to their usual work activity. Sixteen of them presented moderate pain with partial job return or required change of tasks. Conclusion: The results of partial meniscectomy in non-work-related patients were excellent to good, with 96% return to daily activities. Regarding work-related patients, regular results were obtained, with a return to their usual work activity of only 53%. Type of study: Case series. Level of evidence: IV
Subject(s)
Adult , Arthroscopy/methods , Tibial Meniscus Injuries/surgery , Meniscectomy , Knee Injuries , Occupational DiseasesABSTRACT
Introducción: El objetivo del trabajo es evaluar y analizar de manera retrospectiva los resultados funcionales y complicaciones de la reconstrucción del ligamento cruzado anterior, en una serie de pacientes mayores de 40 años al momento de la cirugía. Material y métodos: Se evaluaron 22 pacientes con lesión de LCA asociada a inestabilidad sintomática de rodilla entre los años 2013 y 2017. Catorce de sexo masculino y ocho de sexo femenino. Con edades de entre 43 y 63 años. El injerto utilizado fue semitendinoso y recto interno cuádruple fijado con botón cortical. El seguimiento promedio fue de 4 años utilizando para su evaluación los scores de Lysholm, Tegner y EVA. Resultados: En el seguimiento final, se obtuvieron resultados satisfactorios en el 81% de los pacientes evaluados. La puntuación fue en promedio del score Lysholm de 49 a 92 puntos, Tegner 5 a 5 y EVA 7 a 2. Se observaron los puntajes más bajos en pacientes que presentaban asociación de lesiones meniscales y osteocondrales. Dos pacientes fueron reintervenidos quirúrgicamente por lesiones meniscales. Hubo una re ruptura de causa traumática. No hubo infecciones, no se presentaron TVP, ni se vio intolerancia al material. Conclusión: Los pacientes mayores de 40 años de edad logran resultados clínicos satisfactorios después de la reconstrucción de LCA. Estos se ven afectados cuando se asocian a lesiones meniscales u osteocondrales. Es importante conocer la expectativa inicial del paciente y la aceptación de modificar la intensidad o el tipo de actividad luego de la lesión. Tipo de estudio: Serie de casos. Nivel de evidencia: IV
Introduction: The objective of the work is to evaluate and retrospectively analyze the functional results and complications of anterior cruciate ligament reconstruction in a series of patients over 40 years of age at the time of surgery. Material and methods: 22 patients with anterior cruciate ligament injury associated with symptomatic knee instability were evaluated between 2013 and 2017. It involved 14 male and 8 female patients. The average age was between 43 and 63 years. The graft used was semitendinosus and quadruple internal rectum fixed with cortical button. The presence of associated meniscal and osteochondral lesions was considered and treated. The average follow-up was 4 years. Lysholm, Tegner and EVA scores were performed. Results: In the final follow-up, satisfactory results were obtained in 81% of the patients evaluated. The average score was the Lysholm score of 49 to 92 points, Tegner 5 to 5 and EVA 7 to 2. The lowest scores were observed in patients with association of meniscal and osteochondral lesions. Two patients were reoperated for meniscal tears. There was a rupture for traumatic cause. There were no infections, no DVT and nor material intolerance. Conclusion: Patients over 40 years of age achieve satisfactory clinical results after ACL reconstruction. These are affected when they are associated with meniscal tears and osteochondral lesions. It is important to know the initial expectation and the acceptance of modifying the intensity or type of activity after the injury. Type of study: Case series Level of evidence: IV
Subject(s)
Adult , Middle Aged , Anterior Cruciate Ligament/surgery , Plastic Surgery Procedures , Anterior Cruciate Ligament Injuries/surgery , Knee Injuries/surgery , Treatment OutcomeABSTRACT
The mango fruit cv. 'Ataulfo' niño is an underdeveloped fruit that has a split on the back and a pronounced peak, and among the current total supply of commercialized mangoes cv. 'Ataulfo', approximately 2% are classified as 'Ataulfo' niño, which are strongly infested by Anastrepha ludens (Loew) (Diptera: Tephritidae) and Anastrepha obliqua Mcquart. The objective of this study was to determine the tolerance to 150-Gy generic irradiation for fruit flies of the Anastrepha genus in comparison to the development of a hot water treatment (HWT) as phytosanitary treatments for mango fruits cv. 'Ataulfo' niño infested by A. ludens and A. obliqua. The results indicated that both treatments were effective; 150-Gy irradiation and HWT at 46.3-47°C for 51 min did not result in significant effects on the external and internal color, total sugar content, firmness, pH, or weight. The sensorial quality described by the appearance, flavor, color, and odor did not show any significant differences between treatments. For both A. ludens and A. obliqua, the third larval instar was the most thermotolerant. The efficacy test was conducted with an immersion time of 47 min. A. ludens did not survive, but for A. obliqua, three larvae out of a total of 6,890 did survive and pupate. Consequently, the confirmatory test consisted of submerging mangoes infested with third-instar A. ludens and A. obliqua in water at 46.3-47°C for 51 min. In total, 67,392 A. ludens and 22,086 A. obliqua larvae were treated, and no surviving larvae were observed.