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PURPOSE: We evaluated the long-term safety, mobility and complications of cervical total disc arthroplasty with the Baguera®C prosthesis over 10 years. METHODS: We included 91 patients treated by arthroplasty for cervical degenerative disc disease. A total of 113 prostheses were implanted (50 one-level, 44 two-level and 19 hybrid constructs). They were assessed for complications, clinically, with NDI and SF-12 questionnaires and by independent radiologists for ROM, HO, disc height and adjacent level degeneration. RESULTS: No spontaneous migration, loss of fixation, subsidence, vascular complication or dislocation were observed. The reoperation rate was 1%. About 82.7% of the patients were pain free. About 9.9% were taking occasional grade I painkillers. Motricity and sensitivity were preserved in 98.8% and 96.3%. The NDI showed an average functional disability of 17.58%, 26% lower than preoperatively. The SF-12 scores were close to normal health. The average ROM at the treated level was 7.4°. Motion was preserved in 86.6%. Lack of motion was observed in 13.4%. Grades II and III H0 were present in 53.7% and 31.7%, respectively, Grade IV was present in 13.4%. Motion was preserved in 100% of the grades 0-III. The preoperative adjacent level disc height of 4.3 mm remained stable during all the follow-ups at 4.4 mm and 4.2 mm, respectively, at 5 and 10 years. CONCLUSIONS: After 10 years, cervical arthroplasty with the Baguera®C prosthesis presents excellent safety and functional results and low complications. Motion was preserved in 86.6%, with a 7.4° ROM. Although common, HO did not hinder motion. Adjacent disc height preservation confirms some adjacent level degeneration protection.
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Degeneración del Disco Intervertebral , Reeemplazo Total de Disco , Humanos , Estudios de Seguimiento , Resultado del Tratamiento , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/cirugía , Artroplastia/métodos , Prótesis e Implantes , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/cirugía , Reeemplazo Total de Disco/efectos adversos , Reeemplazo Total de Disco/métodos , Rango del Movimiento ArticularRESUMEN
Early cognitive changes due to Alzheimer's disease (AD) include difficulties in semantic access and working memory. Using a computerized cognitive test developed by our group, called the Memory for Semantically Related Objects test (MESERO), we evaluated if cognitively unimpaired carriers of an autosomal dominant AD (ADAD) mutation performed worse on this test than non-carrier family members. 35 cognitively unimpaired ADAD mutation carriers and 26 non-carrier family members from a Colombian ADAD cohort took the MESERO on a laptop computer. Cognitively unimpaired ADAD carriers had significantly worse MESERO total scores than non-carrier family members, driven by worse performance in semantically-related object sets; group performances did not differ on semantically unrelated object sets. Findings suggest that MESERO performance may be sensitive to subtle cognitive changes associated with AD. Future MESERO research should examine performances between healthy older adults and people at risk for sporadic AD.
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Enfermedad de Alzheimer , Humanos , Anciano , Enfermedad de Alzheimer/psicología , Mutación/genética , Pruebas Neuropsicológicas , ColombiaRESUMEN
In the past decade, new strategies have been developed to control the Aedes aegypti (Diptera: Culicidae) mosquito vector, as well as a broad range of arboviral agents. Vector control surveillance programmes in Puerto Rico and Australia have implemented the Centers for Disease Control and Prevention autocidal gravid ovitrap (AGO), which has had an impact on vector density and, consequently, the epidemiology of arboviral infections. Colombia intends to establish the AGO as a new tool for the surveillance and control of the A. aegypti vector. AGOs were evaluated in a hyperendemic area for dengue virus during an 8-week period in Villavicencio city, eastern Colombia. The results indicated that the AGOs detect a high density of A. aegypti, with positive results for these traps of over 80% and an average catch of six individuals per trap per week. Acceptance of AGOs in the community exceeded 95%, and adherence was around 89%. This study's results demonstrate, for the first time in Colombia, that traps are a useful tool for the surveillance of A. aegypti. Future studies must consider the implementation of AGOs in the region.
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Aedes , Control de Mosquitos/métodos , Aedes/virología , Animales , Colombia/epidemiología , Dengue/transmisión , Virus del Dengue , Mosquitos Vectores/virologíaRESUMEN
The author list was incomplete. The complete list of authors is the following: D. Noriega, F. Rodrίguez-Monsalve, R. Ramajo, I.Sánchez-Lite, B. Toribio, F. Ardura. The corresponding author regrets sincerely this error. The original article got update.
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This pilot monocenter study in 30 patients with painful osteoporotic vertebral compression fractures compared two vertebral augmentation procedures. Over a 3-year post-surgery follow-up, pain/disability/quality of life remained significantly improved with both balloon kyphoplasty and SpineJack® techniques, but the latter allowed better vertebral body height restoration/kyphosis correction. INTRODUCTION: Patient follow-up rarely exceed 2 years in trials comparing vertebral augmentation procedures for the treatment of painful osteoporotic vertebral compression fractures (VCFs). This pilot, investigator-initiated, prospective study aimed to compare long-term results of SpineJack® (SJ) and balloon kyphoplasty (BKP). Preliminary results showed that SJ resulted in a better restoration of vertebral heights and angles, maintained over 12 months. METHODS: Thirty patients were randomized to SJ (n = 15) or BKP (n = 15). Clinical endpoints were analgesic consumption, back pain intensity (visual analog scale (VAS)), the Oswestry Disability Index (ODI), and quality of life (EQ-VAS score). They were recorded preoperatively, at 5 days (except EQ-VAS), 1, 3, 6, 12, and 36 months post-surgery. Spine X-rays were taken 48 h prior to the procedure and 5 days, 6, 12, and 36 months after. RESULTS: Clinical improvements were observed with both procedures over the 3-year period without significant inter-group differences, but the final mean EQ-5Dindex score was significantly in favor of the SJ group (0.93 ± 0.11 vs 0.81 ± 0.09; p = 0.007). Vertebral height restoration/kyphotic correction was still evident at 36 months with a greater mean correction of anterior (10 ± 13% vs 2 ± 8% for BKP, p = 0.007) and central height (10 ± 11% vs 3 ± 7% for BKP, p = 0.034) and a larger correction of the vertebral body angle (- 5.0° ± 5.1° vs 0.4° ± 3.4°; p = 0.003) for SJ group. CONCLUSIONS: In this study, both techniques displayed very good long-term clinical efficiency and safety in patients with osteoporotic VCFs. Over the 3-year follow-up, vertebral body height restoration/kyphosis correction was better with the SpineJack® procedure.
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Fracturas por Compresión/cirugía , Cifoplastia/métodos , Fracturas Osteoporóticas/cirugía , Fracturas de la Columna Vertebral/cirugía , Anciano , Dolor de Espalda/cirugía , Femenino , Estudios de Seguimiento , Humanos , Cifosis/cirugía , Masculino , Persona de Mediana Edad , Dimensión del Dolor/métodos , Proyectos Piloto , Calidad de Vida , Resultado del TratamientoRESUMEN
Acute respiratory tract infections are one of the main causes of airway inflammation, frequently triggered by viruses. Upper airway infections are highly prevalent in children, causing hospitalization in patients under 4 years of age. On the contrary acute bronchial infections are more frequent in adults and they are one of the major causes of consultation in emergency units and health centers. They include a wide spectrum of diseases ranging from self-limited diseases of short duration, to an airway obstruction potentially fatal.
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Acute respiratory infections (ARI), like pneumonia, are the second leading cause of years of live lost and a leading cause of morbidity and mortality in developing countries (WHO). Statistical data show that ARI causes the 30% and 60% of pediatric consultations and represents the 20-40% of pediatric hospital admissions. They account for 63.8% of overall infections treated in emergency department of which, approximately, one quarter involve lower respiratory tract. The most frequent respiratory infections in emergencies, acute bronchitis, COPD flares, bronchiectasis and pneumonia, are analyzed in this protocol.
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UNLABELLED: Clinical performance and safety of two percutaneous vertebral cement augmentation (VA) procedures (SpineJack® and Kyphx Xpander® balloon) were compared in patients with osteoporotic compression fractures. Both techniques were safe, efficient, and led to a rapid and marked improvement in clinical signs; nevertheless, SpineJack showed better restoration of vertebral heights and angles, maintained over time. INTRODUCTION: In patients with osteoporotic vertebral compression fractures (VCFs), both SpineJack® (SJ) and balloon kyphoplasty (BKP) led to a rapid and marked improvement in clinical signs. This pilot, monocentric, investigator-initiated, prospective study aimed to compare two percutaneous vertebral augmentation procedures in the painful osteoporotic VCF treatment. METHODS: Thirty patients were randomized to receive SJ (n = 15) or BKP (n = 15). Analgesic consumption, back pain intensity (visual analog scale (VAS)), and Oswestry Disability Index (ODI) scores were recorded preoperatively, at 5 days and 1, 3, 6, and 12 months post-surgery. Quality of life (EQ-VAS score) was evaluated at 1, 3, 6, and 12 months. Spine X-rays were taken 48 h prior to procedure and 5 days and 6 and 12 months after. RESULTS: SpineJack® led to a significantly shorter intervention period (23 vs 32 min; p < 0.001), a strong, rapid, and long-lasting decline in pain (94 vs 82 % at 12 months) and in functional disability (94 vs 90 % at 12 months), a greater and sustainable mean correction of anterior (12 ± 13 vs 0 ± 7 % for BKP, p = 0.003) and central height (12 ± 10 vs 2 ± 6 % for BKP, p = 0.001) at 12 months, and a larger restoration of the vertebral body angle still evident 12 months after implantation (-4.4° ± 5.8° vs 0.2° ± 3.0° for BKP; p = 0.012). CONCLUSIONS: This pilot study showed that both techniques were safe and efficient for the osteoporotic VCF treatment. Radiological results indicate that the SpineJack® procedure has a higher potential for vertebral body height restoration and maintenance over time.
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Fracturas por Compresión/cirugía , Cifoplastia , Fracturas Osteoporóticas/cirugía , Fracturas de la Columna Vertebral/cirugía , Anciano , Cementos para Huesos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Calidad de Vida , Resultado del TratamientoRESUMEN
PURPOSE: To evaluate the long-term outcomes of the classical Cloward procedure in single-level cervical spondylosis. METHODS: A retrospective study of 28 patients who were affected by cervical degenerative spondylosis at C4-C7 segments and treated by the Cloward technique at a single level from 1985-1995 was conducted. The average follow-up period was 22 years (range, 17-27 years). Preoperative clinical complaints were recorded and compared to the current clinical status. Preoperative, 3-6 months postoperative and a current radiographic study were analysed by evaluating the segmental and global sagittal alignment of the cervical spine as well as the occurrence of adjacent disc degeneration. RESULTS: The most frequently operated segment was C5-C6 (57.1 %), followed by C6-C7 (32.1 %) and C4-C5 (7.1 %). Pain relief and symptom recovery experienced 3-6 months following the surgery was maintained at the most recent follow-up in 85 % of patients. Adjacent disc degeneration was detected in a total of 17 cases (60.7 %). Overall, a group of 14 cases (50 %) had increased lordosis at C2-C7 at the most recent follow-up, with a mean gain of 1.5º Cobb. According to Odom's criteria, 17 patients (60.8 %) presented with excellent clinical outcome, 6 (21.4 %) presented with good outcome, 5 had a (17.8 %) fair outcome, and none had a poor outcome. CONCLUSIONS: The Cloward technique provided excellent long-term clinical outcome in the treatment of single-level cervical degenerative spondylosis. There were no major alterations of the cervical sagittal balance, and the development of adjacent segment disease (ASD) was not specifically associated with the previous surgery.
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Vértebras Cervicales/cirugía , Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/cirugía , Radiculopatía/cirugía , Espondilosis/cirugía , Adulto , Distribución por Edad , Vértebras Cervicales/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Factores Sexuales , Fusión Vertebral/métodos , TiempoRESUMEN
La enfermedad de Fabry (EF) es una patología genética rara ligada al cromosoma X, de depósito lisosomal, por la deficiencia de la enzima alfa-galactosidasa A, que produce la acumulación de globotriaosilceramida, ocasionando afectación renal, cardiaca, oftalmológica y del sistema nervioso. Objetivo: Realizar un análisis descriptivo de las manifestaciones oftalmológicas en pacientes mexicanos con EF. Material y métodos: Se incluyeron 13 pacientes con diagnóstico clínico y bioquímico de EF. Resultados: La córnea verticilata se encontró en el 57% de varones y en el 33% de portadoras. Conclusión: La córnea verticilata es la manifestación oftalmológica más frecuente en varones afectados y portadoras de EF en México(AU)
Fabry disease (FD) is a rare X-linked genetic lysosomal storage disease caused by a deficiency of the enzyme alpha-galactosidase A, that produces accumulation of globotriaosylceramide. There is a multisystemic involvement, including renal, cardiac, eye, and nervous system manifestations. Aim: To perform a descriptive analysis of the ophthalmological manifestations in Mexican patients with FD. Material and methods: We studied 13 patients with clinical and biochemical diagnostic of FD. Results: Cornea verticillata was found in 57% of men and 33% carriers. Conclusion: Cornea verticillata was the most common ocular manifestation in males and carriers of FD in Mexico(AU)
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Humanos , Masculino , Femenino , Enfermedad de Fabry/complicaciones , Enfermedad de Fabry/diagnóstico , Oftalmopatías/complicaciones , Oftalmopatías/diagnóstico , Catarata/complicaciones , Oftalmopatías/fisiopatología , Córnea/metabolismo , Córnea/patología , Enfermedades de la Córnea/fisiopatologíaRESUMEN
UNLABELLED: Fabry disease (FD) is a rare X-linked genetic lysosomal storage disease caused by a deficiency of the enzyme α-galactosidase A, that produces accumulation of globotriaosylceramide. There is a multisystemic involvement, including renal, cardiac, eye, and nervous system manifestations. AIM: To perform a descriptive analysis of the ophthalmological manifestations in Mexican patients with FD. MATERIAL AND METHODS: We studied 13 patients with clinical and biochemical diagnostic of FD. RESULTS: Cornea verticillata was found in 57% of men and 33% carriers. CONCLUSION: Cornea verticillata was the most common ocular manifestation in males and carriers of FD in Mexico.