A Systematic Review and Single-Arm Meta-Analysis on the Efficacy of High-Intensity, Focused Ultrasound for Benign Prostatic Hyperplasia Treatment: A Forgotten Option?

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of prostate tissue, commonly affecting older men. This condition leads to lower urinary tract symptoms (LUTS), which significantly affect the quality of life. Over time, extensive research has been conducted regarding BPH treatment, exploring various treatment options. High-intensity focused ultrasound (HIFU) is a non-invasive treatment modality that has shown promise in initial studies. However, evidence regarding its long-term efficacy and safety remains inconclusive. This study evaluates HIFU's safety and efficacy for BPH treatment, identifying gaps for future research. The study conducted comprehensive searches across the PubMed, Google Scholar, Cochrane Central, and ClinicalTrials.gov databases, covering English-language articles from 1994 to 2023. Inclusion criteria focused on peer-reviewed studies, with more than 10 patients utilizing ultrasound image-guided HIFU for BPH while excluding other HIFU modalities lacking ultrasound image guidance. Data extraction targeted primary outcomes (peak flow rate, International Prostate Symptom Score (IPSS), postvoid residual volume) and secondary outcomes (treatment time, follow-up duration). Statistical analysis utilized a random effects model with heterogeneity assessed by I² statistics and the Q test, alongside subgroup analysis based on study design. The risk of bias assessment employed the Cochrane Collaboration tool for randomized controlled trials and the methodological index for nonrandomized studies. Among 560 identified articles, 12 studies with 522 patients met the inclusion criteria. Primary outcomes showed improvements in Qmax (1 month: 2.50 ml/s, 12 months: 6.22 ml/s) and IPSS (1 month: -9.37 points, 12 months: -11.60 points). Reported complications included transient hematuria, hematospermia, and urinary retention. HIFU presents significant clinical improvements in treating BPH, albeit with slow progression attributed to specific techniques and the ablative approach. Manageable complication profiles are observed, yet study design flaws hinder a comprehensive evaluation of HIFU efficacy. The authors suggest areas for clinical optimization, emphasizing the necessity of further research.

Effectiveness of Cognitive Functional Therapy Versus Core Exercises and Manual Therapy in Patients With Chronic Low Back Pain After Spinal Surgery: Randomized Controlled Trial.

OBJECTIVE: Our aim was to investigate whether cognitive functional therapy (CFT) was more effective than core exercises and manual therapy (CORE-MT) in improving pain and function for patients with chronic low back pain after spinal surgery. METHODS: This study was a randomized controlled superiority trial in a university hospital and a private physical therapist clinic in Santa Catarina, Brazil. Eighty participants who were 18 to 75 years old and had chronic low back pain after spinal surgery received 4 to 12 treatment sessions of CFT or CORE-MT once per week for a maximum period of 12 weeks. Primary outcomes were pain intensity (numeric pain rating scale, scored from 0 to 10) and function (Patient-Specific Functional Scale, scored from 0 to 10) after intervention. RESULTS: We obtained primary outcome data for 75 participants (93.7%). CFT was more effective, with a large effect size, than CORE-MT in reducing pain intensity (mean difference [MD] = 2.42; 95% CI = 1.69-3.14; effect size [d] = 0.85) and improving function (MD = -2.47; 95% CI = -3.08 to -1.87; effect size = 0.95) after intervention (mean = 10.4 weeks [standard deviation = 2.17] after the beginning of treatment). The differences were maintained at 22 weeks for pain intensity (MD = 1.64; 95% CI = 0.98-2.3; effect size = 0.68) and function (MD = -2.01; 95% CI = -2.6 to -1.41; effect size = 0.81). CONCLUSION: CFT was more effective than CORE-MT, with large effect sizes, and may be an option for patients with chronic low back pain after spinal surgery. IMPACT: CFT reduces pain and improves function, with large effect sizes, compared with CORE-MT. The difference between CFT and CORE-MT was sustained at the midterm follow-up. Treatment with CFT may be an option for patients with chronic low back pain after spinal surgery.

The Value of CXCL1, CXCL2, CXCL3, and CXCL8 as Potential Prognosis Markers in Cervical Cancer: Evidence of E6/E7 from HPV16 and 18 in Chemokines Regulation.

Cervical cancer (CC) is a serious global health issue, and it is well-known that HPV infection is the main etiological factor that triggers carcinogenesis. In cancer, chemokine ligands and receptors are involved in tumor cell growth, metastasis, leukocyte infiltration, and angiogenesis; however, information on the role played by E6/E7 of HPV16/18 in the modulation of chemokines is very limited. Therefore, this study aimed to determine whether chemokines are differentially expressed in CC-derived cell lines; if E6/E7 oncoproteins from HPV16 and 18 are capable of mediating chemokine expression, what is the expression profile of chemokines in tissues derived from CC and what is their impact on the overall survival of patients with this pathology? For this purpose, RNA sequencing and real-time PCR were performed on SiHa, HeLa, and C33A tumorigenic cell lines, on the non-tumorigenic HaCaT cells, and the E6/E7 HPV-transduced HaCaT cell models. Furthermore, chemokine expression and survival analysis were executed on 304 CC and 22 normal tissue samples from The Cancer Genome Atlas (TCGA) repository. The results demonstrate that CXCL1, CXCL2, CXCL3, and CXCL8 are regulated by E6/E7 of HPV16 and 18, are overexpressed in CC biopsies, and that their higher expression is related to a worse prognostic survival.

A very rare case of an intrathoracic pancreatic pseudocyst.

Pancreatic pseudocysts are mostly located in the peripancreatic region, but extra-abdominal intrathoracic extensions can occur and mimic respiratory and ischemic symptoms. Mediastinal location is an example that can present with dyspnea and retrosternal chest pain. Pancreatic-pleural fistulas can form from pseudocysts, often resulting in large and recurrent pleural effusions. In the described case, a 50-year-old man with a previous subdiaphragmatic pseudocyst presented an acute episode of respiratory symptoms and was diagnosed with a newly organized collection located intrathoracically adjacent to the previous one, formed by the fistulization of the abdominal pseudocyst. No similar cases have been described or published in indexed PubMed databases until the year 2023.

Characterization of Latin American migrants at risk for Trypanosoma cruzi infection in a non-endemic setting. Insights into initial evaluation of cardiac and digestive involvement.

BACKGROUND: Trypanosoma cruzi causes Chagas disease (CD), a potentially fatal disease characterized by cardiac disorders and digestive, neurological or mixed alterations. T. cruzi is transmitted to humans by the bite of triatomine vectors; both the parasite and disease are endemic in Latin America and the United States. In the last decades, population migration has changed the classic epidemiology of T. cruzi, contributing to its global spread to traditionally non-endemic countries. Screening is recommended for Latin American populations residing in non-endemic countries. METHODS: The present study analyzes the epidemiological characteristics of 2,820 Latin American individuals who attended the International Health Service (IHS) of the Hospital Clinic de Barcelona between 2002 and 2019. The initial assessment of organ damage among positive cases of T. cruzi infection was analyzed, including the results of electrocardiogram (ECG), echocardiogram, barium enema and esophagogram. RESULTS: Among all the screened individuals attending the clinic, 2,441 (86.6%) were born in Bolivia and 1,993 (70.7%) were female. Of individuals, 1,517 (81.5%) reported previous exposure to the vector, which is a strong risk factor associated with T. cruzi infection; 1,382 individuals were positive for T. cruzi infection. The first evaluation of individuals with confirmed T. cruzi infection, showed 148 (17.1%) individuals with Chagasic cardiomyopathy, the main diagnostic method being an ECG and the right bundle branch block (RBBB) for the most frequent disorder; 16 (10.8%) individuals had a normal ECG and were diagnosed of Chagasic cardiomyopathy by echocardiogram. CONCLUSIONS: We still observe many Latin American individuals who were at risk of T. cruzi infection in highly endemic areas in their countries of origin, and who have not been previously tested for T. cruzi infection. In fact, even in Spain, a country with one of the highest proportion of diagnosis of Latin American populations, T. cruzi infection remains underdiagnosed. The screening of Latin American populations presenting with a similar profile as reported here should be promoted. ECG is considered necessary to assess Chagasic cardiomyopathy in positive individuals, but echocardiograms should also be considered as a diagnostic approach given that it can detect cardiac abnormalities when the ECG is normal.

E6/E7 from Beta-2-HPVs 122, 38b, and 107 possess transforming properties in a fibroblast model in vitro.

Beta-2 Human papillomaviruses 38b, 107, and 122 have been frequently found in cervical cancer samples in western Mexico. Because their E6/E7 genes functions are not fully elucidated, we deepen into their transformation capabilities. To achieve this goal, primary human fibroblasts (FB) were transduced with E6/E7 genotype-specific viral particles. Additionally, E6/E7 from HPVs 16 and 18 were included as controls. All E6/E7-cell models increased their lifespan; however, it is important to highlight that FB-E6/E7-122 showed growth as accelerated as FB-E6/E7-16 and 18. Furthermore, both FB-E6/E7-38b and 122 exhibited abilities to migrate, and FB-E6/E7-122 presented high invasive capacity. On the other hand, ΔNp73 expression was found in all cell models, except for FB-pLVX (empty-vector). Finally, RNAseq found differentially expressed genes enriched in signaling pathways related to cell cycle, epithelial-mesenchymal transition, and cancer, among others. This study shows for the first time, the great transformative potential that genotypes of the Beta-2 also possess, especially HPV122. These Beta-2 HPVs can modulate some of the genes that are well known to be regulated by Alpha-HPVs, however, they also possess alternative strategies to modulate diverse signaling pathways. These data support the idea that Beta-2 HPVs should play an important role in co-infections with Alpha-HPV during carcinogenesis.

Cognitive functional therapy (CFT) compared with core training exercise (CTE) in patients with failed back surgery syndrome (FBSS): A study protocol for a randomized controlled trial.

OBJECTIVE: This study aims to investigate the efficacy of cognitive functional therapy (CFT) compared to core training exercise (CTE) on pain and specific disability of patients with failed back surgery syndrome (FBSS). DESIGN: This will be a randomized controlled clinical trial of two groups with blinded evaluators. SETTING: The study will be conducted at the Federal University of Santa Catarina (UFSC) and a private clinic in Florianópolis, SC, Brazil. PARTICIPANTS: A total of 80 participants, of both sexes, with FBSS. INTERVENTION: Subjects will be randomized into two groups: one group receiving CFT or CTE. Individuals will be assisted once a week, for a maximum period of 12 weeks, with four being the minimum number of visits and 12 being the maximum number of visits. MEASUREMENTS: The primary outcomes will be pain and specific disability. CONCLUSIONS: This is the first study investigating whether CFT is efficacious for patients with FBSS and chronic low back pain. The study's sample size was calculated to detect the effect of clinically relevant treatment with a low risk of bias. This clinical trial was designed to be able to reproduce an approach as a physiotherapist trained in CFT would do. That is, in a pragmatic way, increasing the significance of this study. CTE comprises a strategy widely used by physiotherapists to treat low back pain. Given that the scientific evidence of its efficacy for pain management is limited, the findings of this study will assist physiotherapists in their clinical decision-making.

El Estigma Social Asociado a la Enfermedad de Chagas

Resumen Objetivos: identificar a partir de relatos individuales y familiares los componentes del estigma social asociado a un diagnóstico de Chagas positivo. Métodos: el estudio recopila los testimonios de tres familias a través de entrevistas a profundidad que fueron grabadas, cuyo contenido fue estructurado y luego compartido entre los investigadores a través de un proceso de triangulación. Resultados: se identificaron las diferentes formas de estigma social, experimentado, percibido, anticipado, así como el autoestigma, el estigma por asociación y comportamientos de discriminación; lo que conlleva el aislamiento social, refuerza los miedos tradicionalmente relacionados a esta enfermedad, y provoca tensiones intrafamiliares. El estigma social y el silencio que lo acompaña son serias barreras de acceso a la consulta médica y al tratamiento antiparasitario. Conclusiones: Es importante tomar en cuenta aspectos de tipo psico-socio-cultural en las estrategias de atención integral de Chagas, principalmente en los programas de información, educación, comunicación (IEC) y durante la consulta médica. Para romper el estigma y el silencio que lo acompaña, es indispensable integrar las personas afectadas por Chagas y otros actores de la sociedad civil en el diseño de esas estrategias.

Abstract Objectives: to identify the components of social stigma associated with a positive diagnosis of Chagas disease based on individual and family accounts. Methods: The study compiles the testimonies of 3 families through in-depth interviews that were recorded, the content of which was structured and then shared among the researchers through a process of triangulation. Results: different forms of social stigma, experienced, perceived, anticipated, as well as self-stigma, stigma by association and discriminatory behaviours were identified, leading to social isolation, reinforcing traditional fears associated with the disease, and causing intra-familial tensions. Social stigma and the silence that accompanies it are serious barriers to access to medical consultation and deworming treatment. Conclusions: It is important to take into account psycho-socio-cultural aspects in strategies for comprehensive care of Chagas disease, especially in information, education and communication (IEC) programmes and during the medical consultation. Also, to break the stigma and the silence surrounding it, it's essential to integrate people affected by Chagas and other civil society actors into the conception of these programs.

Aerobic Exercise Decreases Lung Inflammation by IgE Decrement in an OVA Mice Model.

Aerobic exercise (AE) reduces lung function decline and risk of exacerbations in asthmatic patients. However, the inflammatory lung response involved in exercise during the sensitization remains unclear. Therefore, we evaluated the effects of exercise for 2 weeks in an experimental model of sensitization and single ovalbumin-challenge. Mice were divided into 4 groups: mice non-sensitized and not submitted to exercise (Sedentary, n=10); mice non-sensitized and submitted to exercise (Exercise, n=10); mice sensitized and exposed to ovalbumin (OVA, n=10); and mice sensitized, submitted to exercise and exposed to OVA (OVA+Exercise, n=10). 24 h after the OVA/saline exposure, we counted inflammatory cells from bronchoalveolar fluid (BALF), lung levels of total IgE, IL-4, IL-5, IL-10 and IL-1ra, measurements of OVA-specific IgG1 and IgE, and VEGF and NOS-2 expression via western blotting. AE reduced cell counts from BALF in the OVA group (p<0.05), total IgE, IL-4 and IL-5 lung levels and OVA-specific IgE and IgG1 titers (p<0.05). There was an increase of NOS-2 expression, IL-10 and IL-1ra lung levels in the OVA groups (p<0.05). Our results showed that AE attenuated the acute lung inflammation, suggesting immunomodulatory properties on the sensitization process in the early phases of antigen presentation in asthma.

Tradução e adaptação transcultural da versão brasileira da Spinal Cord Independence Measure - Self-Reported Version (brSCIM-SR) / Translation and cross-cultural adaptation of the Brazilian version of the Spinal Cord Independence Measure - Self-Reported Version (brSCIM-SR)

OBJETIVO: O objetivo deste estudo foi realizar a validação transcultural de um instrumento de autorrelato utilizado para avaliar o nível de independência funcional nas atividades de vida diária em pessoas com lesão da medula espinal (LME), a Spinal Cord Independence Measure? Self-Reported Version (SCIM-SR) para a língua portuguesa do Brasil. MÉTODOS: Duas traduções independentes da versão original do instrumento em inglês e síntese de uma versão em português foram realizadas, seguidas pela consulta de um painel de profissionais de reabilitação e confecção da versão pré-final, pré-teste (n = 13), retrotradução para a língua original e aprovação da autora original do instrumento. RESULTADOS: A comparação do instrumento original com a retrotradução e aprovação garantiu que a equivalência semântica e a manutenção do conteúdo do instrumento tenham sido adequadamente mantidas. CONCLUSÃO: A brSCIM-SR foi adequadamente validada transculturalmente ao português e pode ser utilizada como um instrumento de autorrelato para avaliar o nível de indepen-dência das pessoas com LME no Brasil.

OBJECTIVE: The objective of this study was to do the cross-cultural validation of a self-reported instrument used to evaluate the functional independence in the activities of daily living in people with spinal cord injury (SCI), the Spinal Cord Independence Measure? Self-Reported Version (SCIM-SR) into Portuguese of Brazil. METHODS: Two independent translations of the original version in English and the synthesis of a Portuguese version has been made, followed by a panel consensus of rehabilitation professionals and confection of a prefinal version, pretest (n = 13), back-translation to the English and original instrument author approval. RESULTS: The comparison of the original with the back-translation version and its approval ensured that the semantic equivalence and the content of the instrument were maintained. CONCLUSION: The brSCIM-SR was cross-culturally validated to the Portuguese and can be used as a self-report instrument to assess the level of independence in people with SCI in Brazil.

Effects of High-Intensity Swimming on Lung Inflammation and Oxidative Stress in a Murine Model of DEP-Induced Injury.

Studies have reported that exposure to diesel exhaust particles (DEPs) induces lung inflammation and increases oxidative stress, and both effects are susceptible to changes via regular aerobic exercise in rehabilitation programs. However, the effects of exercise on lungs exposed to DEP after the cessation of exercise are not clear. Therefore, the aim of this study was to evaluate the effects of high-intensity swimming on lung inflammation and oxidative stress in mice exposed to DEP concomitantly and after exercise cessation. Male Swiss mice were divided into 4 groups: Control (n = 12), Swimming (30 min/day) (n = 8), DEP (3 mg/mL-10 µL/mouse) (n = 9) and DEP+Swimming (n = 8). The high-intensity swimming was characterized by an increase in blood lactate levels greater than 1 mmoL/L between 10th and 30th minutes of exercise. Twenty-four hours after the final exposure to DEP, the anesthetized mice were euthanized, and we counted the number of total and differential inflammatory cells in the bronchoalveolar fluid (BALF), measured the lung homogenate levels of IL-1ß, TNF-α, IL-6, INF-Ï«, IL-10, and IL-1ra using ELISA, and measured the levels of glutathione, non-protein thiols (GSH-t and NPSH) and the antioxidant enzymes catalase and glutathione peroxidase (GPx) in the lung. Swimming sessions decreased the number of total cells (p<0.001), neutrophils and lymphocytes (p<0.001; p<0.05) in the BALF, as well as lung levels of IL-1ß (p = 0.002), TNF-α (p = 0.003), IL-6 (p = 0.0001) and IFN-Ï« (p = 0.0001). However, the levels of IL-10 (p = 0.01) and IL-1ra (p = 0.0002) increased in the swimming groups compared with the control groups, as did the CAT lung levels (p = 0.0001). Simultaneously, swimming resulted in an increase in the GSH-t and NPSH lung levels in the DEP group (p = 0.0001 and p<0.002). We concluded that in this experimental model, the high-intensity swimming sessions decreased the lung inflammation and oxidative stress status during DEP-induced lung inflammation in mice.

Pré-operatório: abordagem estratégia na humanização do cuidado de enfermagem / Pre-operatorio: la estrategia de enfoque en la humanización de los cuidados de enfermería / Pre-operative: approach strategy in humanizing nursing care

Discutir ações de humanização no cuidar da equipe de enfermagem durante o pré-operatório imediato;conhecer as ações da enfermagem realizadas no período Pré-operatório, na ótica do cliente e apontar estratégias de abordagem humanizada ao paciente cirúrgico. Métodos: Trata-se de uma abordagem qualitativa que utilizouentrevistas com 10 clientes em pré-operatório, com roteiro contendo questões abertas e fechadas que possibilitou traçar o perfil dos mesmos. Resultados: Obteve as seguintes categorias de análise: O cliente não reconhece as ações de enfermagem; o cliente conhece a enfermagem pelas ações técnicas pontuais; a necessidade de Adoção de atitude informativa; o estabelecimento de comunicação e vínculo com o cliente; e a necessidade de a enfermagem fazer-se presente. Conclusão: Este estudo possibilitou a ampliação dos conhecimentos adquiridos durante a academia,constatando com os dados colhidos dos questionários aplicados em clinica cirúrgica SUS e particular inexistência de diferenças nas ações de enfermagem prestadas aos mesmos, mostrou também a ausência do vínculo da equipe de enfermagem com o paciente/cliente, a falta de informação e a necessidade de atenção e diálogo com o mesmo, nosentido de minimizar a ansiedade, angústia e estresse da hospitalização e avaliação global da saúde geral do paciente.

Objectives: To discuss the actions of humanization in the care of nursing staff during pre-operatively, to know thenursing actions performed during pre-operative, from the viewpoint of the customer and point out strategies toapproach the patient humanized cirúrgico. Methods: This is a qualitative approach that uses interviews with 10 clients in pre-operative, with a script containing open and closed questions that allowed profiling of the same. Results: Got the following categories of analysis: The client does not recognize the nursing actions; the client knows the nursing actions for specific techniques, the need to Adopt the attitude information and the establishment of communication and relationship with the client, and the need for nursing to make present. Conclusion: This study enabled us to expand the knowledge during the academy and thus we saw with the data collected from questionnaires applied inclinical and surgical SUS particular, reported no differences in the nursing actions given to them, which also showed the absence of the bond of the nursing staff with patient / client, the lack of information the need for attention and dialogue with it, in order to minimize the anxiety, anguish and stress of hospitalization and overall assessment of the patient's general health.

Discutir las acciones de humanización en la atención de personal de enfermería durante el pre-operatorio,para conocer las acciones de enfermería durante el pre-operatorio, desde el punto de vista del cliente y señalarestrategias para abordar el cirúrgico. Métodos: Humanizada del paciente: Se trata de un enfoque cualitativo queutiliza entrevistas con 10 clientes en el pre-operatorio, con un guión con preguntas abiertas y cerradas que permitieron perfiles de los mismos. Resultados: Tienes las siguientes categorías de análisis: El cliente no reconoce las acciones de enfermería; el cliente sabe que las acciones de enfermería para las técnicas específicas, la necesidad de adoptar laactitud de la información y el establecimiento de la comunicación y la relación con el cliente, y la necesidad de la enfermería para hacer presente. Conclusión: Este estudio nos ha permitido ampliar el conocimiento en la academia y así vimos con los datos obtenidos de los cuestionarios aplicados en el SUS particular, clínicos y quirúrgicos, informó que no hubo diferencias en las acciones de enfermería que se les da, que también mostró la ausencia del vínculo delpersonal de enfermería con el paciente / cliente, la falta de información la necesidad de atención y el diálogo con él, con el fin de minimizar la ansiedad, la angustia y el estrés de la hospitalización y la evaluación general de la salud general del paciente.

La cheqanchada : caminos y sendas de desarrollo en los municipios migrante de arbieto y toco

Este documento nos muestra aspectos para comprender las realidades y alcances de la relación entre migración internacional y desarrollo social. La investigación también nos ofrece una riqueza de descripciones e interpretaciones que inspiran a imaginar todas las realidades como lo que es deseable. El libro transmite al lector algo de espíritu de superación que caracteriza a aquellos emigrantes que vuelven.

No llores, prenda, pronto volveré: Migración, movilidad social, herida familiar y desarrollo

Contiene: Pronto volveré; Decir adiós a la boliviana; El valle extendido; Migracion, prácticas y movilidad social; Volveré para regar el campo; Migración transnacional y economía familiar; "Hacienda Airlington": Remesas y productividad; Migración, herida familiar y debates sobre la calidad de vida

Fractura expuesta de pierna asociada a traumatismo grave de cráneo. Presentación de un caso / Open fracture of the leg associated to severe head trauma: case report

Se presenta el caso de un paciente de 19 años de edad, de sexo masculino, quien sufrió un accidente en motocicleta. como consecuencia tuvo un grave traumatismo de cráneo con pérdida de conocimiento y una fractura expuesta de pierna izquierda (Gustilo grado IIIA). En virtud del estado de como y severo compromiso del estado general se debió tratar la fractura expuesta con premura. La evolución favorable del cuadro neurológico no anticipada en un primer momento, determinó la necesidad de tratar la fractura de pierna con una nueva osteosíntesis en condiciones más planificadas

Fractura expuesta de pierna asociada a traumatismo grave de cráneo. Presentación de un caso / Open fracture of the leg associated to severe head trauma: case report

Se presenta el caso de un paciente de 19 años de edad, de sexo masculino, quien sufrió un accidente en motocicleta. como consecuencia tuvo un grave traumatismo de cráneo con pérdida de conocimiento y una fractura expuesta de pierna izquierda (Gustilo grado IIIA). En virtud del estado de como y severo compromiso del estado general se debió tratar la fractura expuesta con premura. La evolución favorable del cuadro neurológico no anticipada en un primer momento, determinó la necesidad de tratar la fractura de pierna con una nueva osteosíntesis en condiciones más planificadas

Consecuencias vasculares del traumatismo astragalino: estudio anatómico, clínico y angiogr fico / Vascular alterations after injuries of the talus: anatomic, clinical and angiographic study

La incidencia de necrosis avascular en el astrágalo luego de una lesión grave ha dado lugar al concepto de que su aporte sanguíneo es inadecuado porque 3/5 partes de su superficie están cubiertas por cartílago y porque carece de inserciones musculares. Wildenauer describió una irrigación abundante a partir de la arterias tibial posterior, pedia y peronea. Realizamos un estudio clínico, radiológico, angiográfico y anatómico para corroborar las afirmaciones de Wildenauer y comprobar la alteración del aporte vascular postraumático. En 20 pacientes operados entre 1988 y 1998 por fracturas y/o luxaciones del astrágalo se valoraron: edad, sexo, tiempo transcurrido desde la lesión hasta el tratamiento, clasificación y complicaciones. Se realizaron 5 disecciones anatómicas y 9 angiografías, comparando pacientes con lesiones astragalinas con un grupo control. Se corroboró la importante contribución vascular proveniente de la red perióstica medial, de las arterias del seno y del conducto del tarso. Se puede concluir que la intensidad del traumatismo está relacionada con la probabilidad de necrosis avascular debido a la interrupción de la circulación intraósea (por compresión y conminución del hueso en el momento del impacto) y la desinserción de los tejidos blandos que proveen el aporte circulatorio

Consecuencias vasculares del traumatismo astragalino: estudio anatómico, clínico y angiográfico / Vascular alterations after injuries of the talus: anatomic, clinical and angiographic study

La incidencia de necrosis avascular en el astrágalo luego de una lesión grave ha dado lugar al concepto de que su aporte sanguíneo es inadecuado porque 3/5 partes de su superficie están cubiertas por cartílago y porque carece de inserciones musculares. Wildenauer describió una irrigación abundante a partir de la arterias tibial posterior, pedia y peronea. Realizamos un estudio clínico, radiológico, angiográfico y anatómico para corroborar las afirmaciones de Wildenauer y comprobar la alteración del aporte vascular postraumático. En 20 pacientes operados entre 1988 y 1998 por fracturas y/o luxaciones del astrágalo se valoraron: edad, sexo, tiempo transcurrido desde la lesión hasta el tratamiento, clasificación y complicaciones. Se realizaron 5 disecciones anatómicas y 9 angiografías, comparando pacientes con lesiones astragalinas con un grupo control. Se corroboró la importante contribución vascular proveniente de la red perióstica medial, de las arterias del seno y del conducto del tarso. Se puede concluir que la intensidad del traumatismo está relacionada con la probabilidad de necrosis avascular debido a la interrupción de la circulación intraósea (por compresión y conminución del hueso en el momento del impacto) y la desinserción de los tejidos blandos que proveen el aporte circulatorio

Efectos radiográficos de la cocaína aspirada sobre los senos paranasales / Radiographic effects of the aspirated cocaine by paranasal sinuses

La cocaína es un compuesto aromático lipofílico, derivado de las hojas de ERITROXYLON COCA, su abuso produce una vasculitis necrosante con la consiguiente formación de granulomas en el tabique nasal que pueden conducir a la perforación del tabique e inflamación de la mucosa nasal. El objetivo de esta investigación es evaluar las alteraciones radiográficas consecuentes al abuso de la cocaína aspirada el los senos paranasales. Para efectuar esta investigación se tomaron 32 pacientes consumidores de cocaína aspirada que ingresaban a los centros de rehabilitación suspendiendo el hábito y se les realizó un estudio de senos paranasales (Waters, Cadwell y lateral); se repitió el estudio de senos paranasales a 15 pacientes en un intervalo de 10 a 12 semanas, y se compararon entre sí utilizando tablas de frecuencia. Los resultados indican que el proceso inflamatorio Etmoidal, el proceso inflamatorio Maxilar, y el septum nasal sinuoso, son las patologías que mas incidencia presentan en el primer estudio radiográfico; sin que se produzcan otros cambios en el segundo estudio radiográfico.