Total hip arthroplasty with second generation dual mobility system as a treatment for primary coxarthrosis, medium-term results. / Artroplastia total de cadera con sistema de doble movilidad de segunda generación como tratamiento de coxartrosis primaria, resultados a mediano plazo.

INTRODUCTION: Osteoarthritis is a disabling pathology characterized by joint pain and stiffness. A prevalence of coxarthrosis of 7.4% is reported in our country. Total hip joint replacement is indicated in advanced stages, a procedure that is not free of complications, the most frequent being prosthetic dislocation, which can be prevented with dual mobility systems. The following study aims to determine the rate of complications and clinical outcomes in dual mobility systems in primary coxarthrosis. MATERIALS AND METHODS: A retrospective study included 120 cases in 114 patients diagnosed with grade III coxarthrosis, mean age was 62.43 years, with a mean follow-up of 4.5 years. Joint replacement was performed by Hardinge approach. All cases were assessed clinically using the Harris Hip Score (HHS) and radiologically to demonstrate mid-term results. RESULTS: The preoperative value on the HHS scale had a mean of 56.45, postoperative at one month 74.23; 6 months 85.40; 1 year 94.01 and at 5 years 94.84 points, representing a functional improvement of 17.78 postoperative month; 28.95 at 6 months postoperative; 37.56 at one year postoperative and 38.39 points at 5 years postoperative. A complication rate of 3.44%; 0.86% of complications were associated with the prosthetic components. CONCLUSION: The dual mobility system should be considered as a therapeutic option in primary hip joint replacement due to excellent functional results and low complication rates. EVIDENCE LEVEL: IV. Retrospective observational case series study.

Reinsertion of Posterior Meniscal Root for Management of Hypermobile Lateral Meniscus: Description of a Surgical Technique.

Lateral meniscus hypermobility is a special condition in which the posterior horn of the lateral meniscus exhibits excessive mobility. This condition can cause pain and locking in the knee, especially during kneeling, deep flexion, or squatting. In this article, we present a surgical technique for the reinsertion of the posterior root of the external meniscus in cases of hypermobility without detachment. The objective is to increase the tension of the meniscotibial and meniscal popliteal ligaments to achieve meniscal stability. The procedure involves suturing the meniscal root and fixation using a knotless implant through a transosseous tunnel. This technique has proven to be effective in stabilizing the lateral meniscus in patients with hypermobility.

Hipermovilidad del tercio posterior del menisco lateral secundario a lesión de los ligamentos meniscotibiales. Estudio cadavérico / Hypermobility of the posterior third of the lateral meniscus secondary to injury to the meniscotibial ligaments. Cadaveric study

Introducción: Los meniscos son estructuras semilunares formadas por fibrocartílagos, localizadas entre el fémur y la tibia. El menisco externo es más móvil, debido a sus inserciones a través de los ligamentos meniscotibiales y poplíteomeniscales. El menisco interno tiene un desplazamiento de 2-3 mm comparado con un desplazamiento de 9-10 mm del menisco externo. Se ha descripto en la literatura mundial que la hipermovilidad meniscal es secundaria a lesión de ligamentos poplíteomeniscales (principales estabilizadores), sin embargo, se realizó un estudio cadavérico donde se evidenció que los ligamentos poplíteomeniscales desempeñan un papel secundario. El objetivo de este estudio es demostrar que la lesión de los ligamentos meniscotibiales es la causante de la hipermovilidad meniscal externa.Materiales y métodos: se realizó un estudio cadavérico en 2022 en Arthrex, Naples, Florida, Estados Unidos. Previo a la valoración artroscópica se efectuó la sección de ligamentos meniscotibiales en el tercio posterior del menisco externo, manteniendo los ligamentos poplíteomeniscales y la inserción de la raíz posterior. Posteriormente, se efectuó la valoración artroscópica en la que se vio traslación anterior y superior del tercio posterior del menisco externo y se realizó la fijación meniscal.Resultados: mediante la fijación del tercio posterior del menisco lateral con técnica transósea, en una falla o insuficiencia de los ligamentos meniscotibiales, se logra estabilidad completa del menisco.Conclusión: la estabilidad principal del tercio posterior del menisco lateral está dada por la inserción periférica de los ligamentos meniscotibiales, por lo que la hipermovilidad meniscal externa no se debe a lesión de los ligamentos poplíteomeniscales. Nivel de Evidencia: IV

Introduction: The menisci are semilunar structures formed by fibrocartilage, located between the femur and the tibia. The lateral meniscus is more mobile due to its insertions through the tibial meniscus and popliteal meniscal ligaments. The medial meniscus has a displacement of 2-3 mm compared to a displacement of 9-10 mm for the external meniscus. It has been described in the world literature that meniscal hypermobility is secondary to injury to the popliteal meniscal ligaments (main stabilizers), however a cadaveric study was carried out where it was shown that the meniscal popliteal ligaments play a secondary role. The objective of this study is to demonstrate that injury to the meniscotibial ligaments is the cause of external meniscal hypermobility.Materials and methods: the cadaveric study was carried out in 2022 at Arthrex, Naples, Florida, United States. Prior to the arthroscopic evaluation, section of the meniscotibial ligaments was performed in the posterior third of the lateral meniscus, maintaining the popliteal meniscal ligaments and the posterior root insertion. Subsequently, the arthroscopic assessment is performed, showing anterior and superior translation of the posterior third of the external meniscus, and meniscal fixation is performed.Results: by fixing the posterior third of the lateral meniscus with a transosseous technique, in a failure or insufficiency of the meniscotibial ligaments, complete stability of the meniscus is achieved. Conclusion: the main stability of the posterior third of the lateral meniscus is given by the peripheral insertion of the meniscotibial ligaments, so external meniscal hypermobility is not due to injury to the popliteal meniscal ligaments. Level of Evidence: IV

Hydrocharis laevigata in Europe.

Hydrocharis laevigata (Humb. & Bonpl. ex Willd.) Byng & Christenh. [= Limnobium laevigatum (Humb. & Bonpl. ex Willd.) Heine], Hydrocharitaceae, is a floating-leaf aquatic plant that is native to inland South America. It is an invasive species in several parts of the world. Reports of its presence in Europe have been recently published: naturalised populations occur in three locations on the Iberian Peninsula. The literature also contains records of the species in Hungary and Poland. In addition, it has been observed in Sweden, Belgium, and the Netherlands. H. laevigata is highly adaptable and can profoundly transform habitat conditions in its invasive range, causing major issues for ecosystem conservation and human activities. Until recently, H. laevigata was not to be found in natural environments in Europe. Factors explaining its spread include its use as an ornamental plant, the eutrophication of inland waters, and the effects of global warming. With a focus on Europe, this short communication provides information on the species' distribution, taxonomy, biology, habitat, and negative impacts.

A horizon scan exercise for aquatic invasive alien species in Iberian inland waters.

As the number of introduced species keeps increasing unabatedly, identifying and prioritising current and potential Invasive Alien Species (IAS) has become essential to manage them. Horizon Scanning (HS), defined as an exploration of potential threats, is considered a fundamental component of IAS management. By combining scientific knowledge on taxa with expert opinion, we identified the most relevant aquatic IAS in the Iberian Peninsula, i.e., those with the greatest geographic extent (or probability of introduction), severe ecological, economic and human health impacts, greatest difficulty and acceptability of management. We highlighted the 126 most relevant IAS already present in Iberian inland waters (i.e., Concern list) and 89 with a high probability of being introduced in the near future (i.e., Alert list), of which 24 and 10 IAS, respectively, were considered as a management priority after receiving the highest scores in the expert assessment (i.e., top-ranked IAS). In both lists, aquatic IAS belonging to the four thematic groups (plants, freshwater invertebrates, estuarine invertebrates, and vertebrates) were identified as having been introduced through various pathways from different regions of the world and classified according to their main functional feeding groups. Also, the latest update of the list of IAS of Union concern pursuant to Regulation (EU) No 1143/2014 includes only 12 top-ranked IAS identified for the Iberian Peninsula, while the national lists incorporate the vast majority of them. This fact underlines the great importance of taxa prioritisation exercises at biogeographical scales as a step prior to risk analyses and their inclusion in national lists. This HS provides a robust assessment and a cost-effective strategy for decision-makers and stakeholders to prioritise the use of limited resources for IAS prevention and management. Although applied at a transnational level in a European biodiversity hotspot, this approach is designed for potential application at any geographical or administrative scale, including the continental one.

Modified Dynamic Anterior Stabilization and Labroplasty for Anterior Shoulder Instability With Concomitant SLAP Lesion.

Several arthroscopic techniques to treat anterior shoulder instability have been described. Bankart repair may be insufficient in cases with some degree of bone loss, and arthroscopic Latarjet is technically challenging. It is not rare to find at the time of surgery a more extensive labral tear (SLAP lesion) or an insufficient anterior capsulolabral tissue. We describe for those cases a dynamic anterior stabilization where using the long head of the biceps we are treating the SLAP lesion and at the same time it provides the "sling effect" of a Latarjet procedure for the anterior instability.

Lisfranc Arthrodesis in Posttraumatic Chronic Injuries.

Chronic injuries at the tarsometatarsal joint represent a wide array of painful malunions ranging from isolated instability to complex three-dimensional deformities with rapid development of posttraumatic arthritis. Deformity correction and arthrodesis of the symptomatic joints leads to significant pain reduction and functional improvement provided that realignment of the anatomic axes is achieved. Arthrodesis should be limited to the first to third tarsometatarsal joints, whereas interposition arthroplasty is preferred for symptomatic arthritis of the fourth to fifth tarsometatarsal joints. For complex deformities and instability, the intercuneiform and naviculocuneiform joints may need to be included into corrective fusion.

Does the Physiological Response of a Triathlete Change in the Use or Absence of Drafting?

BACKGROUND: Currently, tactics play an important and decisive role in sprint distance triathlons. One of the most decisive tactical elements is drafting in the cycling sector, depending on whether or not it is allowed by the test regulations. The objective was to analyze the physiological responses in running, in relation to drafting in the cycling sector, according to level and sex. METHODS: To do this, a total of n = 44 subjects were divided into two levels (elite: they got a podium in the national championship, 15.68 ± 0.82 years; amateurs: they compete at the regional level, 15.68 ± 1.62 and 37.9 ± 1.74 years), undergoing two training sessions of four cycling-running multitransitions with variability in the permissibility of drafting were analyzed. A descriptive analysis of the variables was carried out, together with an inferential analysis to know the relationships and associations between the dependent and independent variables. RESULTS: The results showed significant differences in the parameters, as related to running technique, heart rate, speed, and displacement (both between levels and sex). CONCLUSIONS: This study concludes that drafting in the cycling sector generates decisive physiological responses for the running sector.

Terrestrial Morphotypes of Aquatic Plants Display Improved Seed Germination to Deal with Dry or Low-Rainfall Periods.

In temporary ponds, seed germination largely determines how well aquatic plant assemblages recover after dry periods. Some aquatic plants have terrestrial morphotypes that can produce seeds even in dry years. Here, we performed an experiment to compare germination patterns for seeds produced by aquatic and terrestrial morphotypes of Ranunculus peltatus subsp. saniculifolius over the course of five inundation events. During the first inundation event, percent germination was higher for terrestrial morphotype seeds (36.1%) than for aquatic morphotype seeds (6.1%). Seed germination peaked for both groups during the second inundation event (terrestrial morphotype: 47%; aquatic morphotype: 34%). Even after all five events, some viable seeds had not yet germinated (terrestrial morphotype: 0.6%; aquatic morphotype: 5%). We also compared germination patterns for the two morphotypes in Callitriche brutia: the percent germination was higher for terrestrial morphotype seeds (79.5%) than for aquatic morphotype seeds (41.9%). Both aquatic plant species use two complementary strategies to ensure population persistence despite the unpredictable conditions of temporary ponds. First, plants can produce seeds with different dormancy periods that germinate during different inundation periods. Second, plants can produce terrestrial morphotypes, which generate more seeds during dry periods, allowing for re-establishment when conditions are once again favorable.

Nutritional quality of wild Iberian red deer (Cervus elaphus hispanicus) meat: Effects of sex and hunting period.

The proximate composition, energetic value, minerals, B-group vitamins and pH value of the loin (longissimus thoracis) of 71 wild Iberian red deer (Cervus elaphus hispanicus), were evaluated in stags and hinds hunted in autumn and winter. In autumn, meat had a higher content of moisture, K, Na, Zn and thiamine when compared to winter, in which higher content of proteins and P were detected. Meat from stags had a higher moisture, Na, Zn and folic acid content, while hinds provided optimal pH values (<5.8) in higher proportions than stags. Considering European Unions nutrition and health claims, deer loin has a high content of proteins, Zn, vitamin B12 (cyanocobalamin), and a low content of fat and sodium/salt, being a source of P, Fe, Cu and vitamins B2 (riboflavin) and B3 (niacin). Additionally, health claims related to children's development could be attributed to this meat, which may increase the interest on deer meat from consumers.

Climatic Niche Shift during Azolla filiculoides Invasion and Its Potential Distribution under Future Scenarios.

In order to prevent future biological invasions, it is crucial to know non-native species distributions. We evaluated the potential global distribution of Azolla filiculoides, a free-floating macrophyte native to the Americas by using species distribution models and niche equivalency tests to analyze the degree of niche overlap between the native and invaded ranges of the species. The models were projected under two future emission scenarios, three global circulation models and two time periods. Our results indicate a possible niche shift between the distribution ranges of the species, indicating that A. filiculoides can adapt to novel environmental conditions derived from climatic differences during the invasion process. Our models also show that the future potential distribution of A. filiculoides will decrease globally, although the species could colonize new vulnerable regions where it is currently absent. We highlight that species occurrence records in the invaded area are necessary to generate accurate models, which will, in turn, improve our ability to predict potential invasion risk areas.

Mentoría en medicina crítica / Mentoring in critical medicine

INTRODUCCIÓN. Emergencia y Terapia Intensiva son especialidades relativamente nuevas que han evolucionado de forma rápida. A nivel mundial se necesita tener más experiencia en mentoría en estas áreas en personal médico, ya que a diferencia de las áreas quirúrgicas y en enfermería, apenas en estos últimos años se disponen de reportes y estudios que muestran beneficio en la capacitación en medicina crítica OBJETIVO. Fue identificar experiencias en la capacitación y formación con mentoría y los beneficios de su aplicación en médicos de medicina crítica. MATERIALES Y MÉTODOS. Buscadores bibliográficos de estudios observacionales y revisiones sistemáticas sobre mentoría en medicina crítica. CONCLUSIÓN. La escasa evidencia demostró mejoría no solo en la enseñanza, comunicación y bienestar de estos profesionales de salud, sino también beneficios para los familiares de los pacientes.

INTRODUCTION. Emergency and Intensive Therapy are relatively new specialties that have evolved rapidly. Worldwide it is necessary to have more experience in mentoring in these areas in medical personnel, since unlike the surgical and nursing areas, only in recent years there are reports and studies that show benefit in the training in Critical Medicine. OBJECTIVE. It was to identify experiences in mentoring training and the benefits of its application in doctors of critical medicine. MATERIALS AND METHODS. Bibliographic search engines for observational studies and systematic reviews on mentoring in critical medicine. CONCLUSION. The scarce evidence showed improvement not only in the teaching, communication and wellbeing of these health professionals, but also benefits for the relatives of the patients.

A new delimitation of the Afro-Eurasian plant genus Althenia to include its Australasian relative, Lepilaena (Potamogetonaceae) - Evidence from DNA and morphological data.

Althenia (Potamogetonaceae) is an aquatic plant genus disjunctly distributed in the southern- (South Africa's Cape Floristic Region: CFR) and northern- (Mediterranean Eurasia) hemispheres. This genus and its Australasian relative, Lepilaena, share similar floral characters yet have been treated as different genera or sections of Althenia sensu lato (s.l.) due to the isolated geographic distribution as well as the differences in sex expression, stamen construction, and stigma morphology. The diagnostic characters, however, need reevaluation over the boundaries between the entities. Here we tested the taxonomic delimitation between the entities, assessed synapomorphies for evolutionary lineages, and inferred biogeographic history in a phylogenetic framework. Our results indicated that Lepilaena was resolved as non-monophyletic in both plastid DNA and nuclear PhyC trees and Althenia was nested within it. As Althenia has nomenclatural priority, we propose a new delimitation to recognize Althenia s.l., which can be diagnosed by the female flowers with 3-segmented perianths and male flowers with perianths. The previously used diagnostic characters are either autapomorphies or synapomorphies for small lineages within Althenia s.l., and evolutionary transitions to sessile female flowers and narrow leaves characterize larger clades. Biogeographic analyses suggested a Miocene origin of Althenia s.l. in Australasia and indicated at least one inter- and one intra-specific inter-continental dispersal events among Australasia, Mediterranean Eurasia, and CFR need to be hypothesized to explain the current distribution patterns.

Reconstruction of chronic tearing of the distal triceps using the double-row configuration: technical note.

Tearing of the distal triceps is uncommon and may be difficult to diagnose, especially in situations of partial tearing. Imaging methods such as ultrasonography and magnetic resonance imaging should be used to confirm the diagnosis and define the extent of the injury. The preferred treatment for complete tearing of the triceps is surgical, unlike in cases of partial tearing, in which the treatment depends on factors such as pain, functional deficit and the patient's expectations. Here, we describe the case of a patient with partial tearing of the distal triceps after falling to the ground, which was not diagnosed at the time of first attendance and evolved with pain and great functional loss. The surgical procedure was performed nine months after the injury, with reconstruction of the triceps by means of reinforcement using the tendon of the ipsilateral semitendinosus and fixation in the olecranon using the double-row configuration. The patient remained immobilized using a sling for one week and then gains in passive range of motion (ROM) were introduced. Three weeks later, the patient was released for gains in active ROM. Muscle strengthening was started after 12 weeks. Six weeks after the surgical procedure, the patient was free from pain and presented complete ROM, grade V elbow extension force and hypertrophy of the triceps. The technique described here was shown to be useful for treating tears of the tendon of the distal triceps.

Rupturas do tríceps distal são incomuns e podem ser de difícil diagnóstico, especialmente as parciais. Métodos de imagem, como USG e RNM, devem ser usados para a confirmação diagnóstica e para definição da extensão da lesão. O tratamento de escolha para as rupturas completas do tríceps é o cirúrgico, diferentemente das parciais, que dependem de fatores como dor, déficit funcional e expectativas do paciente. Descrevemos o caso de um paciente com ruptura parcial do tríceps distal após queda ao solo. Não foi diagnosticado no momento do primeiro atendimento e evoluiu com dor e grande perda funcional. O procedimento cirúrgico foi feito após nove meses do trauma, com a reconstrução do tríceps por meio de reforço com o tendão do semitendíneo ipsilateral e fixação no olécrano sob a configuração de dupla fileira. O paciente permaneceu imobilizado com tipoia por uma semana e iniciou-se, a partir daí, o ganho de amplitude de movimento (ADM) passiva. Após três semanas foi liberado para o ganho de ADM ativa. O fortalecimento muscular iniciou-se após 12 semanas. Após seis meses do procedimento cirúrgico o paciente apresenta-se sem dor, ADM completa, força de extensão do cotovelo grau V e hipertrofia do tríceps. A técnica descrita se mostrou útil para o tratamento de rupturas do tendão do tríceps distal.

Adaptación de la Escala de Afectividad Positiva y Negativa (PANAS) a la población de adultos de la ciudad de Córdoba: análisis psicométricos preliminares / Adaptation of Positive and Negative Affectivity Scale (PANAS) to adults in Cordoba city: Preliminary psychometric analysis

El afecto o emoción como tema de investigación científica ha despertado un gran interés en los últimos años, sin embargo, en nuestro medio no se cuenta con instrumentos psicométricos que permitan una medición válida y confiable. El presente trabajo tuvo por objetivo realizar una adaptación psicométrica de la Escala de Afectividad Positiva y Negativa ([PANAS], Watson, Clark & Tellegen, 1988) a la población de adultos de la ciudad de Córdoba, Argentina. Los estudios de estructura interna sugieren la existencia de dos dimensiones subyacentes homogéneas (α= 0.73; α= 0.82) que explican un 39 % de la variabilidad de la prueba. Asimismo, los estudios de correlación ítem-total, de discriminación de ítem y de contrastación de grupos resultaron semejantes a los reportados por trabajos antecedentes. En conjunto, los resultados obtenidos son promisorios y avalan el uso del PANAS en el contexto cordobés.

The affect or emotion as a topic of scientific investigation has been of great interest in recent years, however in our environment there are no psychometric instruments which allow a valid and reliable measurement. The object of this work was to create a psychometric adaptation of the Positive and Negative Affectivity Scale ([PANAS], Watson, Clark & Tellegen, 1988) for the adult population of the city of Cordoba, Argentina. The internal structure studies suggest the existence of two subjacent homogenous dimensions (α= 0.73; α= 0.82) which explain 39% of the variability of the test. Studies of the correlation item total, of item discrimination and contrasted groups resulted similar to those reported in previous works. Altogether, the results obtained are promising and support the use of PANAS in Cordoba.

Efectividad del protocolo para colocación de la sonda de nutrición enteral a nivel postpilórico

La nutrición parenteral temprana produce resultados benéficos en los pacientes en estado crítico. Para dicho efecto lo más conveniente es colocar la sonda de nutrición enteral (SNE) a nivel del intestino delgado; pues disminuyen los riesgos de neumoaspiración. En el paciente estudio encontramos nuestra experiencia y grado de efectividad para avanzar la SNE más allá del píloro, a través de la vía nasal, con la técnica de Zaloga modificada; aplicando a una muestra de 30 pacientes ingresados a UTI del Hospital Carlos andrade Marín y que requirieron nutrición enteral temprana. Encontramos que el presente protocolo tiene una efectividad del 93.3 por ciento lo que hace recomendable su uso en todos aquellos pacientes que requieran de soporte nutricional.