[Functional results of floating shoulder treatment]. / Resultados funcionales del tratamiento del hombro flotante.

INTRODUCTION: The floating shoulder has an incidence of 0.1% of all fractures, the result of high-energy trauma. There is still no consensus in the literature on the best treatment: surgical versus conservative. MATERIAL AND METHODS: Patients with floating shoulder diagnosis were evaluated from January 2013 to December 2018, collecting initial data from the electronic file. The morphological types of fractures were described using the Allman and AO classifications. Patients were evaluated using the UCLA scale for shoulder functionality. RESULTS: From 14 patients, 4 were excluded due to lack of follow-up. Of the remaining 10, 9 were men, 1 woman. The average age was 29 years (range 15-42 years). Three patients had left injury, and 7 patients, right; 6 patients hurt the dominant limb. The most common morphological pattern was glenoid neck fracture + clavicle fracture in 7 patients. Surgical treatment was indicated in 7 patients; and in 3, conservative. Of the 7 patients treated surgically, 6 were with clavicle and scapula osteosynthesis; 1 just the clavicle. Patients with conservative management used a universal shoulder immobilizer for 4-8 weeks. There were no cases of consolidation delay, pseudoarthrosis, or vicious consolidation. Rehabilitation began in the first 4 weeks, and lasted up to 8 weeks. CONCLUSION: Surgical treatment was predominant due to instability. Conservative treatment was used when injuries are minimally displaced. Both treatments generate a favorable functional result.

INTRODUCCIÓN: El hombro flotante tiene una incidencia de 0.1% de todas las fracturas, resultado de traumatismos de alta energía. Aún no existe consenso en la literatura sobre el mejor tratamiento: quirúrgico versus conservador. MATERIAL Y MÉTODOS: Se evaluaron individuos con diagnóstico de hombro flotante, de Enero 2013 a Diciembre 2018, recabando datos iniciales del archivo electrónico. Los tipos morfológicos de fracturas se describieron utilizando las clasificaciones de Allman y AO. Se valoraron los pacientes mediante la escala de la UCLA para la funcionalidad del hombro. RESULTADOS: De 14 pacientes, se excluyeron cuatro por falta de seguimiento. De los 10 restantes, nueve fueron hombres, una mujer. La edad promedio fue de 29 años (rango 15-42 años). Tres pacientes con lesión izquierda y los otros siete, derecha; seis de ellos se lesionaron la extremidad dominante. El patrón morfológico más común fue fractura de cuello de glenoides + fractura de clavícula en siete pacientes. En siete pacientes se indicó tratamiento quirúrgico; y en tres, conservador. De los siete individuos tratados quirúrgicamente, en seis se fijaron clavícula y escápula; en uno, solamente clavícula. Los pacientes con manejo conservador utilizaron inmovilizador universal de hombro por 4-8 semanas. No hubo casos de retardo en la consolidación, pseudoartrosis, ni consolidación viciosa. La rehabilitación inició en las primeras cuatro semanas y se prolongó hasta ocho semanas. CONCLUSIÓN: El tratamiento quirúrgico fue el predominante por inestabilidad. El tratamiento conservador se usó cuando las lesiones están poco desplazadas. Ambos tratamientos generan un resultado funcional favorable.

Arbuscular mycorrhizal fungal assemblages in biological crusts from a Neotropical savanna are not related to the dominant perennial Trachypogon.

Knowledge of the arbuscular mycorrhizal fungal assemblages in the Trachypogon savanna ecosystems is very important to a better understanding of the ecological processes mediated by this soil microbial group that affects multiple ecosystem functions. Considering the hypothesis that the biocrusts can be linked to vegetation through the arbuscular fungi mycelial network, the objectives proposed in this study were to determine (i) whether there are arbuscular mycorrhizal fungi (AMF) in the biocrusts (ii) whether arbuscular mycorrhizal fungal assemblages are linked to the Trachypogon patches, and (iii) whether the composition of the assemblages is related to soil properties affected by microbiological activity. The community structure of the AMF was investigated in three habitats: rhizospheric soil and roots of Trachypogon vestitus, biological soil crusts, and bare soil. The canonical correspondence analysis showed that two soil properties related to enzymatic activity (protease and ß-glucosidase) significantly affected the community composition of the AMF. The biocrusts in the Venezuelan savanna are colonized by an AM fungal community linked to that of the bare soil and significantly different from that hosted by the roots of the surrounding T. vestitus, suggesting that assemblages of AMF in biocrusts might be related more closely to those of annual plant species appearing in favorable conditions.

spaP gene of Streptococcus mutans in dental plaque and its relationship with early childhood caries.

AIM: Streptococcus mutans and Streptococcus sobrinus are the main pathogens associated with the development of dental caries in humans. Recently, the real-time polymerase chain reaction (qPCR-TR) has been used for fast and exact quantification of these bacteria species. This molecular biology method has made the detection of these bacteria in saliva and dental plaque possible; additionally, it aids the development of illness risk prediction. The purpose of this prospective, analytic, transversal, observational and unicenter study was to quantify the spaP gene of the Streptococcus mutans and its correlation with caries in a group of children using isolated DNA from plaque samples processed through qPCR-TR, using specific oligonucleotides for this gene detection. MATERIALS AND METHODS: The cariogenic potential of Streptococcus mutans in the dental plaque was analysed in a group of patients aged 12 to 46 months. A descriptive statistical analysis was performed. The Spearman's correlation coefficient was used to establish the correlation between caries (dmft) index (decayed/missing/filled primary teeth), spaP gene and age group. The Wilcoxon test was used to compare MSB cultivation technique and qPCR-TR. RESULTS: In the molecular trials, a close association between caries prevalence in childhood and the presence and high proportion of the spaP gene of S. mutans was found. The average caries prevalence was 3.71, and it increased as age range increased. The highest caries prevalence was observed in female patients and in the oldest age range studied (40 46 months) which contrasts with the 12-18 months age that had a caries (dmft) index of zero. The amplification using as initiator the gene spaP of the nucleic acids extracted from the S. mutans resulted positive in 91.3% of the cases. Every child with caries was positive for the spaP and only 8.75% were negative, this group included children without caries. CONCLUSION: In conclusion, there was a correlation with infant caries prevalence and S. mutans.

Asociación sobrepeso-obesidad y tiempo de ver televisión en preescolares. Ciudad fronteriza Noreste de México / Obesity-overweight and tv-watching time associations in north eastern border pre-school mexican children

Introducción: En diversos estudios se ha encontrado asociación con el tiempo en que los niños pasan frente al televisor y la obesidad. Objetivo: Conocer la asociación de tiempo viendo la televisión y la prevalencia de sobrepeso y obesidad de niños preescolares que residen en una ciudad fronteriza de México. Método: Estudio correlacional, con 124 preescolares de ambos sexos, se obtuvieron sus datos antropométricos y a los padres se les aplicó una encuesta sobre hábitos televisivos de sus hijos. Estadística descriptiva y de asociación. Resultados: El 9.8% de los niños tenía sobrepeso y 16.1% eran obesos El 99.2% de ellos veían televisión. El tiempo dedicado a ver televisión fue: una a dos horas por día 75.8%, y de tres a cuatro horas, 20.2%. El 23.4% de los niños tenían videojuegos. Conclusiones: La cuarta parte de los niños presentó sobrepeso y obesidad. Se encontró un mayor riesgo y asociación en niños con sobrepeso-obesidad versus niños con peso normal con: a) horas de ver televisión (OR = 2.79, p= 0.045) y b) comer cuando se ve televisión (OR = 2.87, p = 0.021).

Introduction: In Several studies of obesity has found association with the time that children spend watching TV. Aim: To know the association of time watching television and the prevalence of overweight and obesity in preschool children living in a border town in Mexico. Method: correlational study, 124 preschool children male and female, anthropometric data were obtained of them and their parents were surveyed about television habits of their children. It was applied descriptive statistics and of association. Results: 9.8% of children were overweight and 16.1% were obese. 99.2% of them watched television; the time spent watching television was: one to two hours per day, 75.8% and three to four hours per day, and 20.2%. 23.4% of children had video games. Conclusions: A quarter of children were overweight and obesity. It was found an increased risk and association in overweight and obesity children versus normal weight children with a) time of watch TV (OR = 2.79, p = 0.045) and b) eat when the children watch TV (OR = 2.87, p = 0.021).

Caracterización del binomio adulto mayor-familiar de convivencia / Characterization of binomial older adult-relative of coexistence

Introducción: El incremento de población adulto mayor exige responsabilidad sanitaria y familiar para que el aumento en años de vida sea de vida saludable. Objetivo: Identificar las características del adulto mayor y del familiar de convivencia como base para las acciones. Metodología: Estudio descriptivo; transversal con 96 binomios adulto mayor-familiar de convivencia. Cuestionario de datos biográficos y de salud para el adulto mayor y datos socios demográficos para el familiar; aplicados mediante entrevista en los hogares. Se utilizó el Programa Estadístico SPSS Versión 17. Resultados: Relación significativa en edad y sexo entre adultos mayores y familiares de convivencia. Media de edad 70 y 45; sexo; mujeres 59.4% y 67.7%; casados o en unión libre 56.3% y 72.9%; respectivamente. Familiar de convivencia hijo/a (54 %) y esposo/a (32%) mayoría mujeres con bajo nivel de escolaridad (65%) y ocupación labores del hogar (64%). La convivencia es favorable para la salud porque hay un mayor control de las conductas de riesgo. Relevancia de las características del binomio adulto mayor-familiar de convivencia para las acciones de promoción y prevención en los hogares; orientadas a fortalecer la relación y desarrollar habilidad en la atención al adulto mayor.

Abstract Nurses have sensitivity, knowledge and experience to attend the binomial older adult-relative of coexistence in family context. The purpose of the study was to identify characteristics of the older adult and the relative of coexistence as base to plan actions. The study was descriptive, cross-sectional with 96 binomials adult major-relative of greater coexistence. Biographical data and health questionnaire for the older adult and demographic data for the relative applied by means of interview in the homes. We used the statisti-cal program SPSS version 17. Age and sex had significant relation between older adults and relatives of coexistence. Age average, 70 and 45; woman, 59. 4% and 67.7%; ma-rried, 56.3% and 72.9, respectively. Relative of coexistence was child (54%) and wife or husband (32%), majority were woman with low level of education (65%) and occupation of the household work (64%).The coexistence is favorable for the health because there is a greater control of the risk conducts. Relevance of the characteristics of the binomial older adult-relative of coex-istence for promotion and prevention actions in the homes, oriented to fortify the relation and to develop ability in the at-tention to the older adult.

Satisfacción con el cuidado de Enfermería del adulto mayor hospitalizado / Satisfaction with the nursing healthcare on hospitalizaed older adults

Los adultos mayores hospitalizados son un grupo vulnerable que requiere cuidado de Enfermería de calidad; esta conlleva satisfacción valorada a través de: relación Enfermera-paciente, comunicación efectiva, información oportuna y habilidad técnica profesional. Para identificar satisfacción de adultos mayores con cuidado de Enfermería se realizó un estudio descriptivo transversal con 45 adultos mayores hospitalizados en Medicina Interna y Cirugía de dos instituciones de salud. Mediante entrevista se aplicó una escala de Likert de 23 reactivos con cinco categorías: De completo acuerdo (5) a total desacuerdo (1). A mayor puntuación mayor satisfacción. Procesamiento y análisis con programa estadístico SPSS. Resultados: Edad media 71 años, escolaridad media 6 años. Completo acuerdo: Enfermera agradable con el paciente (62.2%), debería ser más atenta (60.0%), se siente mejor al platicar con ella (75.6%), le explica en lenguaje sencillo (73.3%), brinda información sobre exámenes (68.9%). Total desacuerdo: Le molesta cuando la Enfermera le habla como si fuera niño (60.0%). Alta puntuación (85%) en evaluación general de satisfacción con el cuidado de Enfermería. Coincidente con estudios previos en que a mayor edad mayor satisfacción con el cuidado de Enfermería.

Older adults hospitalized are a vulnerable group that require quality nursing care ; this imply satisfaction valued through patient-nursing relationship, effective communication and information and professional technical competence. In order to identify older adults' satisfaction with nursing care it was carried out a transactional descriptive study with 45 hospitalized older adults in medical and surgical wards of two health institutions. Through interview it was applied a Likert scale of 23 items and five categories: Complete agree (5) to total disagree (1). Instrument was translated and validated , it was obtained Cronbach's alpha coefficient from .78 (12). Results. Age mean 71, years of school mean 6. Complete agree: Nursing pleasant with patient (62.2%), she should be more attentive with patient (60.0%), the patient feels better when nurse talks with him(75.6%), nurse explains to patient in sample language (73.3%), nurse gives information about exams (68.9%). Total disagree: Patient gets angry when nurse talks him like a child (60.0%). High score (85%) in general evaluation about satisfaction with nursing care. This study is coincident with previous studies about to higher age higher satisfaction with nursing care.

Remarkably high antibody levels and protection against P. falciparum malaria in Aotus monkeys after a single immunisation of SPf66 encapsulated in PLGA microspheres.

Single dose immunisation is a major goal in vaccine design. The purpose of this study was the development of a single dose delivery system for the SPf66 malaria vaccine, based on this antigen's microencapsulation in PLGA microspheres by double emulsion method. Results indicate that a single immunisation in mice and monkeys with the SPf66 malaria vaccine, encapsulated in a mixture of two formulations of PLGA microspheres, induced a remarkably high and long-lasting immune response as assessed by ELISA and Western Blott. This immune response was associated with a good protective capacity in Aotus monkeys, after experimental challenge, indicating that antigen integrity lasted following the microencapsulation process. PLGA biodegradable microspheres thus serve as an effective delivery system for the design of a single dose immunisation vaccine, such as the SPf66 synthetic malaria vaccine.

Aedes albopictus in Allende City, Nuevo Léon, Mexico.

Nuevo León was the only 1 of the 3 northeastern states of Mexico where Aedes albopictus previously had not been shown to occur. However, of 195 samples of larval Aedes received during 1997 from the State Health Laboratory for identification from the 7th Sanitary District, Allende City, Nuevo León, 53 (27.2%) were identified as Ae. albopictus.

Temporal pattern in the effect of postnatal blood lead level on intellectual development of young children.

To determine the temporal pattern of the effect of postnatal blood lead level on the General Cognitive Index (GCI) of the McCarthy Scales of Children's Abilities, we used data from 112 children of the Mexico City Prospective Lead Study with complete evaluations from 36 to 60 months of age at 6-month intervals. We measured blood lead level every 6 months from 6 to 54 months. We controlled for 5-min Apgar, birth weight, birth order, sex, socioeconomic level, maternal IQ, and maximum maternal educational level in a repeated measures ANCOVA using child blood lead level grouped by 6-18 month (geometric mean 10.1 microg/dl, range 3.5-37.0 microg/dl), 24-36 month (geometric mean 9.7 microg/dl, range 3.0-42.7 microg/dl), and 42-54 month (geometric mean 8.4 microg/dl, range 2.5-44.8 microg/dl) averages. There were significant interactions between the 6-18 month blood lead level and age with GCI as the endpoint and between 24-36 month blood lead level and age. The regression coefficient of blood lead at 6-18 months became more negative with age until 48 months, when the rate of decline moderated (linear polynomial contrast p=0. 047). The regression coefficient of blood lead at 24-36 months with CGI became more negative as well from 36 to 48 months but then started decreasing toward zero from 48 to 60 months (quadratic polynomial contrast p=0.019). Significant between-subjects lead effects on GCI were found for 24-36 month blood lead level at 48 months (p=0.021) and at 54 months (p=0.073). The greatest effect (at 48 months) was a 5.8-point GCI decrease with each natural log unit increase in blood lead. Significant between-subjects lead effects on GCI were found for 42-54 month blood lead level at 54 months (p=0. 040) and at 60 months (p=0.060). The effect of postnatal blood lead level on GCI reaches its maximum approximately 1-3 years later, and then becomes less evident. Four to five years of age appears to be a critical period for the manifestation of the earlier postnatal blood lead level effects.

Blood lead secular trend in a cohort of children in Mexico City. II. 1990-1995.

The authors determined the secular trend in blood lead levels in a cohort of 91 children born in Mexico City between 1987 and the beginning of 1993. The authors grouped children by calendar year in which they reached 36 mo of age (i.e., 1990-1995), and their blood lead levels were measured every 6 mo during a 66-mo period. The overall geometric mean blood lead level was 8.6 microg/dl (range = 1.0-61.0 microg/dl). A repeated measures analysis of variance revealed a significant downward linear trend in blood lead levels by year (p < .001)--from an estimated marginal geometric mean of 14.2 microg/dl in 1990 to 6.3 microg/dl in 1995. There was also a significant linear age effect (p < .001); blood lead levels generally fell during the 36th-66th mo. Family use of lead-glazed pottery significantly elevated blood lead levels (p = .006), and the effect magnified as age increased (Age x Pottery Interaction [p = .014]). Although the overall downward trend in blood lead levels during the time period described corresponded to a reduction in various sources of lead exposure, there was no alteration in production, distribution, or use of leaded pottery. Currently, use of lead-glazed ceramic pottery is one of the most profound sources of lead exposure in the Mexican population.

Role of prostaglandins in hypertension.

The role of prostaglandins (PGs) in hypertension (HT) is reviewed, emphasising their biochemical characteristics, physiological effects and functions, especially in the cardiovascular area, and the current evidence of their participation in the antihypertensive activity of a balanced mechanism to maintain normal blood pressure. Also, the clinical use of PGs and the future of such autacoids in the treatment of HT and other diseases or conditions is mentioned.

Pre- and postnatal lead effect on head circumference: a case for critical periods.

We examined the association of maternal prenatal [range of median blood lead level 7.5-9.0 microg/dl (0.36-0.43 micromol/l) during pregnancy] and child postnatal blood lead level [range of median blood lead level from birth to 48 months 7.0-10.0 microg/dl (0.34-0.48 micromol/l)] with head circumference in from 119 to 199 children from the Mexico City Prospective Lead Study. We used repeated multiple regression modeling with a standard set of control variables, entering blood lead level last. Using Bonferroni-corrected probability values to control for inflation of Type I error due to multiple testing at each age, we found significant negative associations (p<0.05, two-tailed) between 6-month head circumference and 36-week maternal blood lead level, and 36-month head circumference and 12-month blood lead level. Over the 25-75% interquartile range of measured blood lead, head circumference decreased around 0.4 cm. Over the 1-35 microg/dl (0.05-1.68 micromol/l) range of maternal blood lead at 36 weeks, the estimated reduction in 6-month head circumference was 1.9 cm (95% CI = 0.9-3.0 cm). These results suggest that children are more vulnerable to certain effects of lead exposure at specific age ranges, and that the effect of lead on head circumference only becomes evident for brief periods in the first 4 years of life. We discuss various artifacts as well as possible mechanisms by which lead might have produced the observed pattern of results. We suggest that higher lead exposure prevalent several decades ago might have subtly influenced published normative human growth data.

Secular trend in blood lead levels in a cohort of Mexico City children.

We determined the secular trend in blood lead levels in a cohort of 104 children born in Mexico City between 1987 and 1993. We grouped children by the calendar year in which they reached 6 mo of age and measured blood lead levels every 6 mo until they attained 36 mo of age. The overall geometric mean blood lead level was 9.6 microg/dl (range = 1.5-59.5 microg/dl). A repeated measures analysis of variance revealed a highly significant linear trend in blood lead level with year (p < .001); there was a maximum decrease of 7.6 microg/dl between 1989 and 1993. There was a highly significant quadratic age effect (p < .001); blood lead levels rose between 6 and 18 mo of age and decreased thereafter. There was a marginally significant interaction between age of the child and year. Family use of lead-glazed pottery significantly elevated blood lead levels (p = .028). The downward trend in blood lead levels during the time period of study corresponded to the reduction in various sources of lead exposure.

Acrodysostosis in two generations: an autosomal dominant syndrome.

Acrodysostosis is a rare syndrome characterized by growth retardation, peripheral dysostosis and mental deficiency. X-rays reveal generalized shortening of metacarpals, metatarsals and phalanges, hyperplasia of the first ray of the feet and premature skeletal maturation. Occasionally abnormal interpedicular spinal spaces, increased mandibular angle and hearing loss have been observed. We report a 19-year-old woman and her daughter examined at birth and subsequently at 6 years of age. The clinical and radiological characteristics are those of acrodysostosis. The syndrome is easily recognized at birth. The generalized corporal shortening is progressive and could be due to premature closing of epiphyses. The finding of an affected mother and her daughter support the postulate that acrodysostosis is inherited as an autosomal dominant syndrome.