INTRODUCTION: This study aimed to compare the degree of posterior malleolar exposure, the tension of the flap containing the posteromedial neurovascular bundle (NVB), and the distance between the surgical incision and the NVB using three different posteromedial ankle approaches. METHODS: Three approaches were compared: medial posteromedial (MePM) modified posteromedial (MoPM) and posteromedial (PM). We measured the minimal tension of the flap containing the NVB that allowed proper exposure. In the second stage, an axial cut was performed, and we measured the degree of posterior malleolar exposure and the distance between the incision and the NVB RESULTS: There were significant differences between the three approaches examined regarding the degree of posterior malleolar exposure and distance from the incision to the NBV,favoring the PM approach (71,00% ± 1.83 and 25.50 mm ± 4.20). The PM approach provided a significantly lower tension to the flap containing the posteromedial NVB (6.18 N ± 1.28) compared to the other two approaches CONCLUSION: The PM approach achieved the highest degree of posterior malleolar exposure, the lowest tension to the posteromedial NVB, and the greatest distance between the incision and the NBV. Thus, we believe it should be considered the approach of choicefor large fractures of the posteromedial aspect of the PM.
Acute bacterial tonsillopharyngitis in children has been classically treated with long courses of antibiotic, usually 10 days, with the intention to prevent the occurrence of complications. However, it has not been clarified whether a shortened treatment could be equally effective in fulfilling that purpose. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases. We identified five systematic reviews including 59 randomized trials overall. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded that a shortened antibiotic regimen is probably similar, or with minimal differences, to a longer course, and might not make any difference regarding complications related to Streptococcus group A infection.
La faringoamigdalitis aguda bacteriana en niños ha sido clásicamente tratada con cursos largos de antibiótico, generalmente de 10 días, a modo de prevenir la aparición de complicaciones. Sin embargo, no ha sido esclarecido si un tratamiento acortado pudiese ser igualmente efectivo en cumplir dicho propósito. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples bases de datos, identificamos cinco revisiones sistemáticas que en conjunto incluyen 59 estudios controlados aleatorizados. Extrajimos los datos, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que un esquema antibiótico acortado es probablemente similar, o con diferencias mínimas, con un esquema más largo en cuanto a la erradicación, y podría no hacer diferencias en cuanto a las complicaciones del estreptococo grupo A.
Anti-Bacterial Agents/administration & dosage , Pharyngitis/drug therapy , Streptococcal Infections/drug therapy , Tonsillitis/drug therapy , Anti-Bacterial Agents/therapeutic use , Child , Drug Administration Schedule , Humans , Pharyngitis/microbiology , Randomized Controlled Trials as Topic , Streptococcal Infections/microbiology , Streptococcus pyogenes/isolation & purification , Tonsillitis/microbiology , Treatment Outcome
Oxygen therapy is used for the treatment of acute coronary syndrome without further discussion. However, the support of this practice in clinical research is scarce, ignoring the true effects of its implementation. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified five systematic reviews including 12 studies overall, five of which were randomized trials. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded that using oxygen probably does not decrease pain, and might not make any difference in mortality during an acute coronary syndrome.
La oxigenoterapia es utilizada para el tratamiento del síndrome coronario agudo sin mayor discusión. Sin embargo, el sustento de esta práctica en investigación clínica es escaso, desconociéndose los verdaderos efectos que trae su implementación. Para responder esta interrogante utilizamos la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples fuentes de información, e identificamos cinco revisiones sistemáticas que en conjunto incluyen doce estudios, de los cuales cinco son estudios aleatorizados. Extrajimos los datos, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de oxígeno probablemente no disminuye el dolor, y podría no hacer ninguna diferencia en la mortalidad durante un síndrome coronario agudo.
Acute Coronary Syndrome/therapy , Oxygen Inhalation Therapy/methods , Oxygen/administration & dosage , Humans , Pain/etiology , Randomized Controlled Trials as Topic
