Rigid iatrogenic hallux varus: a decades' worth experience with arthrodesis of the metatarsophalangeal joint.

PURPOSE: Arthrodesis of the first ray metatarsophalangeal joint (MPJ) is the gold standard in iatrogenic hallux varus (IHV) in the presence of stiffness and osteoarthritis. The purpose of this study is to collect clinical and radiographic results and complications of MPJ arthrodesis in rigid iatrogenic HV. METHODS: A retrospective evaluation of rigid iatrogenic HV undergoing arthrodesis with a minimum follow-up (FU) of two years was performed. The clinical parameters assessed were visual analog scale (VAS), the AOFAS Hallux Metatarsophalangeal-Interphalangeal Scale score and the satisfaction scale. The radiological parameters evaluated the first to second metatarsal angle (IMA) and the angle of hallux valgus (HVA). Complications were also analysed. RESULT: A total of 18 patients (19 procedures) with a mean FU of 5.5 ± 2.5 years were included. The mean VAS improved from 7.3 ± 1.6 to 1.3 ± 1.2 (p < 0.05) at the last FU. Similarly, the AOFAS Hallux Metatarsophalangeal-Interphalangeal scale score significantly improved to 82 ± 9.2 (p < 0.05). Radiological evaluation demonstrated a 1-2 IMA improvement from 4.4 ± 2.2° preoperatively to 8.9 ± 2.4° at 3 months post-operatively. Similarly, there was a significant (p < 0.05) improvement of the HVA from - 22.7 ± 4.1° to 13.1 ± 4.1° at three months post-operative (p < 0.05). No signification loss of correction was noted at the last follow-up (p > 0.05). In one case, a delayed fusion at the arthrodesis site required surgical revision to promote fusion. No patient experienced pain with stress from the first MTP joint arthrodesis site or identified the arthrodesis site as a source of pain. No patient required implant removal. Re-operation and revision rates were 5.3%. The overall complications rate was 15.8%. CONCLUSIONS: MPJ fusion effectively corrects Iatrogenic Hallux Varus in cases of rigid and fixed deformities in the medium- to long-term follow-up, with lasting improvements in AOFAS and VAS scores. The procedure is characterised by a non-negligible risk of complications, reoperations and revisions. LEVEL OF EVIDENCE: Level IV, case series.

Información, percepción de riesgo y comportamientos en relación con las zoonosis en adultos de la ciudad de Córdoba / Information, risk perception and behaviors in relation to zoonoses in adults in the city of Córdoba

INTRODUCCIÓN Muchas de las actuales enfermedades emergentes y re-emergentes en seres humanos son transmitidas por animales. OBJETIVOS Analizar la información, percepción y comportamientos en relación con las zoonosis en adultos de 18 años o más en la ciudad de Córdoba. MÉTODOS Se realizó un estudio mixto cuanti-cualitativo. Para la etapa cuantitativa se diseñó un estudio transversal y correlacional, mediante la realización de una encuesta para recabar datos sociodemográficos, factores de riesgo, información y comportamientos en relación con las zoonosis. El muestreo fue aleatorio, polietápico y estratificado. El análisis de datos se realizó de forma descriptiva y mediante análisis bivariado. Para la etapa cualitativa se utilizó la teoría fundamentada, a los fines de indagar los argumentos que explican la percepción y/o comportamientos de riesgo de las enfermedades zoonóticas. Los datos fueron recabados mediante entrevista en profundidad y observación participante y para el análisis de datos se utilizó el Método Comparativo Constante. RESULTADOS Se observó que el 91% percibe que es riesgo para la salud la presencia de aguas estancadas y el 62% considera que es alto, presentando asociación significativa con NE alto; el 93% percibe como riesgo la presencia de basura acumulada y el 69% la considera de alto riesgo; el 59% declaró tener mascotas. La mayoría de los encuestados dijo tener conocimiento sobre las enfermedades zoonóticas, aunque, a excepción de rabia, no sabían explicar como ocurría el contagio. De los resultados cualitativos se puede observar que, si bien el nivel de información es importante ante comportamientos de cuidados preventivos para las zoonosis, existen otros factores ligados a los valores, nociones y creencias que influyen en ellos. Discusión El conocimiento sobre las enfermedades zoonóticas resulta fundamental, constituyendo la base de las medidas de intervención para la salud. Estos resultados constituyen un insumo para la formulación de acciones de promoción de la salud y prevención de enfermedades zoonóticas.

Effect on seroprevalence of anti-poliovirus antibodies and on vaccination coverage of the implementation of a DTwP-IPV-Hib vaccination programme in a South American city.

Vaccination coverage and seroprevalence of poliovirus antibodies were assessed in Argentinean children (aged 8-12 and 19-21 months) living in Cordoba City pre-/post-implementation of a DTwP-IPV-Hib vaccination programme, and compared to those of controls from neighbouring populations receiving a full oral poliovirus vaccine schedule. Vaccination coverage was higher in control areas pre-intervention; this increased post-intervention in Cordoba (>90%) but not in control areas. Poliovirus types 1 and 2 seroprotection rates were >97% in all groups pre-/post-intervention. Type 3 seroprotection rates were generally lower, but increased post-intervention in Cordoba becoming significantly higher than control rates. Anti-type 1 and 3 antibody titres increased twofold and sevenfold, respectively, post-intervention, whereas anti-type 2 antibody titres decreased ~40% in the 8-12 months group. All titres increased in the 19-21 months post-intervention group. The introduction of a three-dose primary DTwP-IPV-Hib schedule maintained protection against poliovirus types 1 and 2, and increased protection against type 3, while vaccine coverage in the study area increased.

[Omega benzodiazepine receptor subtypes and new ligands]. / Sottotipi recettoriali omega per le benzodiazepine e nuovi ligandi.

Pharmacological and biochemical studies indicate that for many receptors, distinct subtypes exist; the multiplicity and diversity of signal reception proteins increase the information-handling capacity of neurons, thus contributing to neural plasticity. This is also the case for the allosteric modulatory-centre omega of the GABA-A receptor. Binding studies suggest the presence of at least two pharmacologically distinct omega receptors in the human brain; furthermore, molecular biological studies have confirmed the existence of genes encoding different omega subtypes. As omega receptors are the site of action of benzodiazepines and other anxiolytic compounds, this knowledge may be useful for developing new subtype-specific drugs, with more selective therapeutic effects.