[Functional evaluation with the KSS (Knee Society Score) scale at 3 and 6 months after ligament reconstruction in patients with multi-ligament knee injuries in a third level hospital]. / Evaluación funcional con la escala KSS (Knee Society Score) a tres y seis meses de la reconstrucción ligamentaria en pacientes con lesiones multiligamentarias de rodilla en un hospital de tercer nivel.

Multiligament injuries of the knee joint are characterized by the involvement of two or more major ligaments, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), lateral collateral ligament (LCL), posteromedial corner (PMC) and posterolateral corner (PLC). Statistically, multiligament injuries are rare as they are found in less than 0.02% of all traumatic knee injuries; however, different aggregate injuries are what make this pathology a serious health and functional condition. Taking into account that most of the patients are young people of highly productive age, it is of vital importance to observe their short and long term evolution, as well as their reincorporation to their daily life. It has been reported that vascular lesions are present in approximately 32% of cases, meniscal lesions in 35% and up to 60% with some type of bone lesion. These injuries mainly affect the male sex most commonly between the third and fourth decade of life, which makes this type of injury of great importance, since this group of patients are in their greatest period of labor production. The main objective of the treatment of these injuries, in addition to resolving the aggregate damage that usually aggravates the state of health, is to achieve a speedy recovery and subsequent reincorporation to their work activities and in some cases sports.

Las lesiones multiligamentarias de la articulación de la rodilla se caracterizan por la afección de dos o más ligamentos principales, ligamento cruzado anterior (LCA), ligamento cruzado posterior (LCP), ligamento colateral medial (LCM), ligamento colateral lateral (LCL), esquina posteromedial (EPM) y esquina posterolateral (EPL). Estadísticamente, las lesiones multiligamentarias son poco frecuentes, ya que se encuentran en menos de 0.02% de todas las lesiones traumáticas de rodilla; sin embargo, diferentes lesiones agregadas son las que hacen de esta patología un estado grave para salud y funcionalidad. Tomando en cuenta que la mayoría de los pacientes son personas jóvenes en edad altamente productiva, es de vital importancia observar la evolución de los mismos a corto y largo plazo, así como su reincorporación a su vida cotidiana. Se ha descrito que las lesiones vasculares se presentan aproximadamente en 32% de los casos, lesiones meniscales en 35% y hasta 60% con algún tipo de lesión ósea. Estas lesiones afectan principalmente al sexo masculino con más frecuencia entre la tercera y cuarta década de la vida, lo cual hace a este tipo de lesiones de gran importancia, ya que este grupo de pacientes se encuentran en su mayor período de producción laboral. El objetivo principal del tratamiento de estas lesiones, además de resolver los daños agregados que suelen ser los agravantes del estado de salud, es lograr una pronta recuperación y posterior reincorporación a sus actividades laborales y en algunos casos deportivas.

Functional dyspepsia and dyspepsia associated with Helicobacter pylori infection: Do they have different clinical characteristics? / Dispepsia funcional y dispepsia asociada a infección por Helicobacter pylori: ¿son entidades con características clínicas diferentes?

BACKGROUND: Helicobacter pylori causes motor, secretory, and inflammatory gastrointestinal disorders and therefore the term "functional" has been questioned when referring to dyspepsia associated with this bacterium. Patients with dyspepsia and Helicobacter pylori infection could have clinical characteristics that differentiate them a priori from those with true functional dyspepsia. AIMS: To determine whether there are clinical differences between patients with functional dyspepsia and Helicobacter pylori-associated dyspepsia that enable their a priori identification and to know the prevalence of Helicobacter pylori infection in patients with functional dyspepsia. PATIENTS AND METHODS: A total of 578 patients with dyspepsia with no significant lesions detectable through endoscopy were divided into 2 groups according to the presence of Helicobacter pylori. The clinical characteristics, medical history, comorbidities, and use of health resources were compared between the two groups. A sub-analysis pairing the groups by age and sex in a 1:1 ratio was carried out to reduce bias. RESULTS: A total of 336 patients infected with Helicobacter pylori were compared with 242 non-infected patients. The prevalence of infection in the patients with dyspeptic symptoms and no endoscopically detectable lesions was 58%. The initial analysis showed that the cases with dyspepsia and Helicobacter pylori infection were more frequently associated with overweight, obesity, high blood pressure, diabetes mellitus, and metabolic syndrome, but the paired analysis nullified all these differences. CONCLUSIONS: The patients with dyspepsia infected with Helicobacter pylori had similar clinical characteristics to the non-infected patients and could not be differentiated a priori. The prevalence of Helicobacter pylori infection in patients with functional dyspepsia was 58% and increased with age.

Usefulness of oil lubrication during colonoscopy: A comparative study with the conventional technique.

BACKGROUND: The different forms of lubrication are among the most simple, accessible, and economic techniques that have been implemented for improving the diagnostic performance of colonoscopy. AIM: To determine whether the use of oil improved the number of complete colonoscopies, facilitated the procedure, reduced pain, or improved the study's diagnostic performance, compared with the conventional lubrication technique. PATIENTS AND METHODS: One hundred and seventy-five patients referred for colonoscopy were alternately allocated to receive treatment with the standard lubrication method with chlorhexidine gel (group 1) or lubrication with corn oil administered through the working channel (group II). The number of complete colonoscopies, the length of time needed to reach the cecum, the degree of difficulty estimated by the endoscopist and the assistant, the level of pain at the end of the study estimated by the patient, and the endoscopic findings were all determined. RESULTS: Eighty-eight patients made up group I and 87 made up group II. No statistically significant differences were found between the two groups in relation to general characteristics, the number of complete colonoscopies (93 vs. 97%, respectively), the time needed to reach the cecum (8:00 vs. 8:41min, respectively), the level of pain at the end of the study, or the detection of polyps. The degree of difficulty was slightly lower in group II, but with no statistical significance. CONCLUSIONS: Lubrication with oil during colonoscopy did not improve the number of complete colonoscopies, did not facilitate the study, nor did it reduce pain or increase the diagnostic performance of the study, when compared with the conventional technique.