Prótesis de recubrimiento en húmero proximal: ¿Cuál es la indicación hoy en día? / Proximal humeral resurfacing. What's today indication?

Resumen: Introducción: Los resultados funcionales de las prótesis de superficie en el húmero proximal son aceptables, pero con grandes diferencias en la tasa y causa de revisión según las diferentes series. El objetivo de nuestro trabajo fue analizar los resultados clínicos obtenidos en nuestro centro y tratar de definir al paciente ideal para este implante. Material y métodos: Estudio retrospectivo de 19 casos. Seguimiento de 31 (12-61) meses. La cirugía se indicó en casos de artrosis primaria o secundaria. Se analizaron datos demográficos, escala de Constant normalizada, cuestionario DASH, complicaciones y satisfacción. Hubo tres pérdidas durante el seguimiento por fallecimiento sin relación con la cirugía. Resultados: Edad media de 56 (25-80) años. La puntuación en la escala de Constant normalizada fue 73 (23-104) puntos y en el cuestionario DASH 31 (7-84) puntos. Noventa y cuatro por ciento de los pacientes retomaron sus actividades de ocio. En siete casos se objetivó radiológicamente colocación en varo del implante generando un conflicto inferior en la glena. Se produjo una capsulitis adhesiva resuelta de forma conservadora, tres reintervenciones por usura glenoidea sintomática y una por dolor incontrolable. Los pacientes sin lesión del manguito rotador presentaron mejor puntuación en los cuestionarios funcionales. Todos los pacientes refirieron estar satisfechos con la mejoría sintomática respecto a la situación previa. Conclusiones: Los resultados funcionales obtenidos son similares a los publicados previamente. Creemos que la prótesis de superficie debe ser considerada una opción en los casos de artrosis primaria o secundaria sin lesión del manguito rotador, independientemente de la edad.

Abstract: Introduction: Data published in the literature about humeral resurfacing prostheses are not conclusive with good functional results but with large differences in the revision rate. The aim of our study was to evaluate the clinical and functional outcomes in patients operated at our center. Material and methods: Retrospective study of 19 cases in 18 patients. Follow-up of 31 (12-61) months. Surgery was indicated in cases of primary or secondary osteoarthritis. Demographic data, Constant scale, DASH questionnaire, complications and satisfaction were analyzed. Three patients were lost to follow-up due to death unrelated to surgery. Results: Mean age of 56 (25-80) years. Constant normalized of 73 (23-104) points. DASH questionnaire of 31 (7-84) points. Ninety four percent of the patients resumed their recreational activities and 81% sports activities. In seven cases, inferior conflict in the glenoid with varus implant was observed radiologically. There were five complications; a conservatively resolved capsulitis, three reinterventions due to symptomatic inferior glenoid usury and another to uncontrollable pain in a conservative way. Patients without rotator cuff lesion presented better scores on the functional questionnaires. All patients were satisfied with the symptomatic improvement over the previous situation and would be operated again if necessary. Conclusions: The functional outcomes reported are similar to those previously published and, based on them, we believe that the resurfacing prosthesis is an option to be considered in cases of primary or secondary osteoarthritis when there is no rotator cuff injury, regardless of age.

[Proximal humeral resurfacing. Whats today indication?] / Prótesis de recubrimiento en húmero proximal: ¿Cuál es la indicación hoy en día?

INTRODUCTION: Data published in the literature about humeral resurfacing prostheses are not conclusive with good functional results but with large differences in the revision rate. The aim of our study was to evaluate the clinical and functional outcomes in patients operated at our center. MATERIAL AND METHODS: Retrospective study of 19 cases in 18 patients. Follow-up of 31 (12-61) months. Surgery was indicated in cases of primary or secondary osteoarthritis. Demographic data, Constant scale, DASH questionnaire, complications and satisfaction were analyzed. Three patients were lost to follow-up due to death unrelated to surgery. RESULTS: Mean age of 56 (25-80) years. Constant normalized of 73 (23-104) points. DASH questionnaire of 31 (7-84) points. Ninety four percent of the patients resumed their recreational activities and 81% sports activities. In seven cases, inferior conflict in the glenoid with varus implant was observed radiologically. There were five complications; a conservatively resolved capsulitis, three reinterventions due to symptomatic inferior glenoid usury and another to uncontrollable pain in a conservative way. Patients without rotator cuff lesion presented better scores on the functional questionnaires. All patients were satisfied with the symptomatic improvement over the previous situation and would be operated again if necessary. CONCLUSIONS: The functional outcomes reported are similar to those previously published and, based on them, we believe that the resurfacing prosthesis is an option to be considered in cases of primary or secondary osteoarthritis when there is no rotator cuff injury, regardless of age.

INTRODUCCIÓN: Los resultados funcionales de las prótesis de superficie en el húmero proximal son aceptables, pero con grandes diferencias en la tasa y causa de revisión según las diferentes series. El objetivo de nuestro trabajo fue analizar los resultados clínicos obtenidos en nuestro centro y tratar de definir al paciente ideal para este implante. MATERIAL Y MÉTODOS: Estudio retrospectivo de 19 casos. Seguimiento de 31 (12-61) meses. La cirugía se indicó en casos de artrosis primaria o secundaria. Se analizaron datos demográficos, escala de Constant normalizada, cuestionario DASH, complicaciones y satisfacción. Hubo tres pérdidas durante el seguimiento por fallecimiento sin relación con la cirugía. RESULTADOS: Edad media de 56 (25-80) años. La puntuación en la escala de Constant normalizada fue 73 (23-104) puntos y en el cuestionario DASH 31 (7-84) puntos. Noventa y cuatro por ciento de los pacientes retomaron sus actividades de ocio. En siete casos se objetivó radiológicamente colocación en varo del implante generando un conflicto inferior en la glena. Se produjo una capsulitis adhesiva resuelta de forma conservadora, tres reintervenciones por usura glenoidea sintomática y una por dolor incontrolable. Los pacientes sin lesión del manguito rotador presentaron mejor puntuación en los cuestionarios funcionales. Todos los pacientes refirieron estar satisfechos con la mejoría sintomática respecto a la situación previa. CONCLUSIONES: Los resultados funcionales obtenidos son similares a los publicados previamente. Creemos que la prótesis de superficie debe ser considerada una opción en los casos de artrosis primaria o secundaria sin lesión del manguito rotador, independientemente de la edad.

Effect of diet on carboxylesterase activity of tadpoles (Rhinella arenarum) exposed to chlorpyrifos.

An outdoor microcosm was performed with tadpoles (Rhinella arenarum) exposed to 125µgL-1 chlorpyrifos and fed two types of food, i.e., lettuce (Lactuca sativa) and a formulated commercial pellet. Acetylcholinesterase (AChE) and carboxylesterase (CbE) activities were measured in liver and intestine after 10 days of pesticide exposure. Non-exposed tadpoles fed lettuce had an intestinal AChE activity almost two-fold higher than that of pellet-fed tadpoles. No significant differences were observed, however, in liver AChE activity between diets. Likewise, intestinal CbE activity - measured using two substrates, i.e. 1-naphthyl acetate (1-NA) and 4-nitrophenyl valerate (4-NPV) - was higher in tadpoles fed lettuce than in those fed pellets. However, the diet-dependent response of liver CbE activity was opposite to that in the intestine. Chlorpyrifos caused a significant inhibition of both esterase activities, which was tissue- and diet-specific. The highest inhibition degree was found in the intestinal AChE and CbE activities of lettuce-fed tadpoles (42-78% of controls) compared with pellet-fed tadpoles (<60%). Although chlorpyrifos significantly inhibited liver CbE activity of the group fed lettuce, this effect was not observed in the group fed pellets. In general, intestinal CbE activity was more sensitive to chlorpyrifos inhibition than AChE activity. This finding, together with the high levels of basal CbE activity found in the intestine, may be understood as a detoxification system able to reduce intestinal OP uptake. Moreover, the results of this study suggest that diet is a determinant factor in toxicity testing with tadpoles to assess OP toxicity, because it modulates levels of this potential detoxifying enzyme activity.

Cervical human papillomavirus infection in Mexican women with systemic lupus erythematosus or rheumatoid arthritis.

Cervical human papillomavirus (HPV+) infection is associated with an increased risk of cervical dysplasia. Although the frequency of HPV+ in systemic lupus erythematosus (SLE) has been investigated in some races its prevalence in Hispanic women is still unknown. This cross-sectional study evaluated the prevalence of cervical HPV+ in Mexican women with SLE (n = 34) or rheumatoid arthritis (RA) (n = 43) and in healthy controls (n = 146). These women were interviewed about risk factors for sexually transmitted infections and cervical cytology analysis was performed. HPV+ viral types were identified using PCR: HPV+ was observed in 14.7% of SLE, 27.9% of RA and 30.8% of controls. High-risk HPV types were observed in 11.7% of women with SLE, 27.9% of women with RA, and in 26% of the controls. High-risk viral types 58, 35 and 18 were the most frequently identified in SLE. Two women with SLE had a high-grade squamous intraepithelial lesion and one had cervical cancer. An association was observed between methotrexate utilization, longer duration of therapy with prednisone, and HPV+ in RA or SLE. Thus, there is a high prevalence of cervical HPV infection in Mexican women with SLE or RA, and physicians must be vigilant in preventing the development of cervical dysplasia.

Bioavailability of PAHs in the Biobio river (Chile): MFO activity and biliary fluorescence in juvenile Oncorhynchus mykiss.

Cytochrome P450-dependent monooxygenase (MFO) activity and levels of bile PAH metabolites were measured in fish (Oncorhynchus mykiss) exposed to Biobio river (Chile) water. Experiments were performed simultaneously in both the field and laboratory to investigate whether the river water contained notable bioavailable PAH fractions. The field experiment was conducted using fish caged for 41 days at La Mochita (Biobio river mouth) whereas the laboratory experiment involved a 21-day exposure treatment with water collected in the same area. Induction of hepatic MFO, assayed by benzo(a)pyrene monooxygenase activity (BaPMO), and levels of PAH metabolites in the bile were measured in groups of eight (field experiment) and four specimens (laboratory experiment) sampled after 5, 10, 21 and 41 days of exposure. BaPMO was induced by a factor of 23 and 25 in fish caged for 21 and 41 days, respectively. Likewise, a significant BaPMO induction was found in the fish group experimentally exposed to river water for 21 days. Biliary fluorescence measurements, recorded by fixed wavelength fluorescence (FF) and synchronous fluorescence spectroscopy (SFS), revealed significantly high levels of PAH metabolites in bile samples of fish caged for 21 and 41 days. A positive relationship was found between BaPMO activity and biliary PAH metabolites. This study provides evidences that (i) Biobio river water contains a significant bioavailable PAH fraction in terms of marked effects on fish and (ii) the biological indicators MFO activity and bile PAH metabolites represent an excellent screening methodology to assess PAH exposure.

[Acute appendicitis in the first 3 years of life: presentation of 72 cases and review of the literature]. / Apendicitis aguda en los primeros tres años de la vida: presentación de 72 casos y revisión de la literatura.

The appendicitis in infants, including premature and newborn are exceptional. In smallers of three years is few frequently and plenty they are driving to fulfill the laparotomy. Diagnostic is hard for the atypical clinical picture and the rapid evolution toward appendicular boring and generalized peritonitis, modified or not for antibiotics use. The main symptoms of appendicitis finding in this study were: fever, vomitus, pain and abdominals distention. To research the muscular resistance become generalized, the McBurney signs and bonce. There were leucocytosis, urine alterations and the "X"-rays films showed occlusion signs and paralytic ileo. The ultra-sound scan were of great utility in the diagnostic of acute appendicitis and its complications, abscess of walls of intraperitoneal. There surgery was be urgent. The insiction for right half supra and infraumbilical become more frequently, next with appendicectomy of Oschner. Were utilized drain pipe in perforating or abscess cases. The post-operative complications more frequent seen were infection on the surgical hurt. The supured and gangrened appendicitis and perforated and abscessed walls were treated with antibiotics. The mortality rate were zero in this analyzed group.