A descriptive study of traumatic lower limb amputees from the Hospital Hel Trabajador: clinical evolution from the accident until rehabilitation discharge.

The purpose of the study was to describe the demographics, the causes of amputations, the amputation levels, the clinical outcomes, the durability of prostheses in unilateral lower limb amputee among workers entitled to non-state related work insurance, the ACHS, Chile, between 1974 and 2001. It was a retrospective descriptive study based on selected clinical files. One hundred files, with the minimal data required, were selected with a diagnosis of traumatic lower limb amputation, the levels ranging from Boyd's foot amputation to hip disarticulation, as defined by the Occupational Accidents Act from 1974 to December 2001. The mean age was 35.5 years, 96% were males, with an average follow-up of 7.7 years. In 50% of the cases the education level did not exceed elementary school. Ninety-eight percent were blue collar workers. The traumatic injury resulting in amputation took place during work in 89% of the cases the main causes being crushing injury (50%), traffic accident (19%), run over by car (14%) and burns (6%). The most common amputation levels were trans-femoral (40%) and trans-tibial (47%). Amputations were performed within the first 24 h in 49% of the cases. The hospitalization stay reached 8 weeks in 56.7%. Early complications were dehiscence (9.4%), superficial infection, (14.6%) and deep infection (26%). Late complications detected were soft tissue lesions (34.1%), exostosis (3.6%), painful neuroma (12.5%) and phantom limb pain (12.5%). Prostheses durability was on average 3 years. The average period to resume work was 1 year for 60% of the cases.

Acidos biliares en orina y colestasia intrahepática del embarazo / Urine bile acid and intrahepatic cholestasis of pregnancy

Se estudió 123 pacientes embarazadas, agrupadas en: normales n = 78 y con diagnóstico clínico de colestasia intrahepática del embarazo (CIE) n = 45, con el objeto de determinar la utilidad de la determinación de ácidos biliares urinarios (ABU). Se encontró diferencia estadísticamente significativa en los niveles de ABU entre ambos grupos. La sensibilidad de los ABU fue de 30 por ciento y la especificidad de 97 por ciento frente al diagnóstico clínico de CIE. La determinación de ABU en pacientes con CIE podría ser de utilidad clínica para identificar los fetos de mayor riesgo