Unusual Combination of Lateral Condyle Mass Fracture and Olecranon Fracture in a Child: A Case Report.

Fractures of the lateral condyle and olecranon are two of the most common elbow injuries in the pediatric age group. However, their simultaneous occurrence is rare. Proper understanding and management of these injuries are essential to prevent long-term complications. This case report presents a patient who suffered both fractures, with surgical intervention for the condyle and non-surgical management for the olecranon. A two-year-old female child was brought to the emergency department following a fall from monkey bars, landing on her outstretched left arm. Clinical examination showed a markedly swollen and tender elbow with a restricted range of motion. No neurovascular deficit was noted. Plain radiographs revealed a displaced fracture of the lateral condyle and an associated non-displaced olecranon fracture. Given the displacement of the lateral condyle fracture, surgical intervention was deemed necessary. The patient underwent open reduction and internal fixation (ORIF) of the lateral condyle using Kirschner wires. The olecranon fracture, being non-displaced, was managed conservatively with a posterior splint. The patient's postoperative recovery was uneventful. The Kirschner wires were removed at six weeks of follow-up, and active mobilization was started. The patient achieved full range of motion at three months post-injury. At a one-year follow-up, she had no pain, restriction, or any deformity, and radiographs confirmed the complete union of both fractures. Simultaneous fractures of the lateral condyle and olecranon in children are rare. The mechanism of injury is complex and warrants a high index of suspicion for associated injuries. Surgical fixation of the lateral condyle and conservative management of the olecranon fracture can yield excellent outcomes.

Spontaneous rupture of chemotherapy catheter diagnosed using chest X-ray oblique projections: An interventional radiology approach.

Totally implanted central venous port systems are widely used to access central veins for patients needing long-term therapy. These devices have low rates of complications and are commonly used to administer medications like chemotherapeutic agents. Spontaneous rupture of a catheter segment is a rare mechanical complication, usually belatedly diagnosed and presenting with complications. We present a case of a spontaneously ruptured chemotherapy catheter diagnosed using a novel approach via oblique projections on chest X-rays and successfully removed using an endovascular approach.

Factores de riesgo en el fracaso de la reducción cerrada de cadera secundario a displasia de desarrollo de cadera en pacientes no ambulatorios / Risk factors in the failure of closed hip reduction secondary to developmental dysplasia of the hip in non-ambulatory patients

La miotomía selectiva de aductores más la reducción cerrada y Aplicación de yeso pelvipédico forma parte del Gold Standard de tratamiento de la Displasia de cadera. Este tratamiento se realiza usualmente después de un tratamiento fallido con dispositivo abductor de cadera, y que antecede al logro de la marcha independiente, evitando reducciones forzadas y posiciones extremas para disminuir principalmente el riesgo de necrosis avascular de cabeza femoral. El presente trabajo busca determinar factores de riesgo que condicionen el fracaso de la reducción cerrada de cadera en pacientes con displasia del desarrollo de la cadera Se revisaron 12 pacientes, con un total de 14 caderas (2 bilaterales) que se incluyeron en el presente estudio. A todos los pacientes se les realizó miotomía selectiva de aductores más Tenotomía de Psoas y posterior reducción cerrada más Aparato de yeso en primera posición, y posteriormente en Segunda Posición. En el seguimiento a 6 meses posterior a la reducción cerrada: 12 caderas mantuvieron su reducción y desarrollaron índice acetabular normal para la edad, 2 (14%) pacientes presentaron perdida de la reducción, ambos pacientes presentaban índice Acetabular elevados (42 y 39 grados) al momento de la reducción, así como luxación alta de cadera ( IHDI grado IV y Tonnis grado IV).El Índice acetabular óseo elevado, y la luxación alta de cadera ( IHDI y Tonnis grado IV ) son factores de riesgo a tomar en cuenta en la falla de la reducción cerrada de la Displasia del desarrollo de cadera.

Selective adductor myotomy plus closed reduction and pelvipedic cast application is part of the Gold Standard treatment of hip dysplasiañ; following a failed treatment with a hip abductor device, and prior to achieving independent walking; avoiding forced reductions and extreme positions to reduce the risk of avascular necrosis of the femoral head. The present work seeks to determine risk factors in the failure of closed reduction of the hip in patients with developmental dysplasia of the hip. Twelve patients were reviewed, with a total of 14 hips (2 bilateral) that were included in the present study. All patients underwent selective adductor myotomy plus Psoas Tenotomy and subsequent closed reduction plus plaster cast inmovilization in first position, and later in second position.In the 6-month follow-up after closed reduction: 12 hips maintained their reduction and developed normal acetabular index for age, 2 (14%) patients presented loss of reduction, both patients had high acetabular index (42 and 39 degrees) at the time of reduction, as well as high hip dislocation (IHDI grade IV and Tonnis grade IV).High acetabular bone index and high hip dislocation (IHDI and Tonnis grade IV) are risk factors to take into account in the failure of closed reduction of developmental dysplasia of the hip.

Síndrome destructivo en fémur proximal en adolecentes; revisión bibliográfica y reporte de caso clínico / Destructive syndrome in proximal femur in adolescents; bibliographical review and clinical case report

El término síndrome de destrucción ósea engloba patologías que causan alteraciones estructurales, produciendo deformidad con afectación mecánica. Dentro de las patologías que se encuentran en esta definición están la infecciosa, tumoral y metabólica. La osteomielitis es una patología infecciosa de afectación en cualquier grupo etáreo y cualquier segmento óseo; l El diagnóstico de estas entidades es importante para el tratamiento y pronóstico del paciente; el término síndrome de destrucción ósea propone un esquema protocolizado encaminado a mejorar el pronóstico del paciente, así como su pronto tratamiento. Presentamos el caso de un varón de 14 años que refiere dolor a nivel de cadera derecha y dificultad para deambular de 1 mes de evolución. En la radiografía de pelvis se aprecia una secuencia destructiva a nivel del trocánter menor que fue corroborada con la consiguiente confirmación tomográfica que pone en duda al equipo médico-quirúrgico de la presencia de un proceso destructivo correspondiente a una etiología patológica tumoral vs infecciosa. Los estudios paraclínicos y laboratoriales no son concluyentes en relación con enfermedad infecciosa, metabólica, tumoral, inflamatoria o neurológica. El paciente es intervenido mediante desbridamientos quirúrgicos seriados con toma y envío de cultivo no concluyentes para tuberculosis y otras bacterias atípicas. Los informes anatomopatológicos se reportan compatibles con osteomielitis crónica y se reporta una serología positiva para brucella. Posteriormente paciente es sometido a tratamiento antibiótico especifico, desbridamiento y fijación con placa a fémur proximal. El paciente fue dado de alta hospitalaria con controles periódicos por consulta externa presentando remisión de patología infecciosa

The term bone destruction syndrome encompasses pathologies that cause structural alterations, producing deformity with mechanical involvement. The most common causes found in this definition are infectious, tumoral and metabolic. Osteomyelitis is an infectious pathology that affects any age group and any bone segment; The diagnosis of these entities is important for the treatment and prognosis of the patient; the term bone destruction syndrome proposes a protocolized scheme aimed at improving the patient's prognosis, as well as prompt treatment. We present the case of a 14-year-old male who reported pain in the right hip and difficulty walking for 1 month. The pelvic X-ray shows a destructive sequence at the level of the lesser trochanter that was corroborated with CTScan matching the presence of a destructive process corresponding to a tumor vs. infectious pathological aetiology. Paraclinical and laboratory studies are not conclusive in relation to infectious, metabolic, tumoral, inflammatory or neurological disease. The patient underwent surgery with serial debridement with culture taking. The anatomopathological reports are compatible with chronic osteomyelitis and a positive serology for brucella is reported. Subsequently, the patient is treated with antibiotics, debridement and plate fixation the proximal femur. The patient was discharged from the hospital with regular check-ups by outpatient clinic, presenting remission of infectious pathology.

Searching glycolate oxidase inhibitors based on QSAR, molecular docking, and molecular dynamic simulation approaches.

Primary hyperoxaluria type 1 (PHT1) treatment is mainly focused on inhibiting the enzyme glycolate oxidase, which plays a pivotal role in the production of glyoxylate, which undergoes oxidation to produce oxalate. When the renal secretion capacity exceeds, calcium oxalate forms stones that accumulate in the kidneys. In this respect, detailed QSAR analysis, molecular docking, and dynamics simulations of a series of inhibitors containing glycolic, glyoxylic, and salicylic acid groups have been performed employing different regression machine learning techniques. Three robust models with less than 9 descriptors-based on a tenfold cross (Q2 CV) and external (Q2 EXT) validation-were found i.e., MLR1 (Q2 CV = 0.893, Q2 EXT = 0.897), RF1 (Q2 CV = 0.889, Q2 EXT = 0.907), and IBK1 (Q2 CV = 0.891, Q2 EXT = 0.907). An ensemble model was built by averaging the predicted pIC50 of the three models, obtaining a Q2 EXT = 0.933. Physicochemical properties such as charge, electronegativity, hardness, softness, van der Waals volume, and polarizability were considered as attributes to build the models. To get more insight into the potential biological activity of the compouds studied herein, docking and dynamic analysis were carried out, finding the hydrophobic and polar residues show important interactions with the ligands. A screening of the DrugBank database V.5.1.7 was performed, leading to the proposal of seven commercial drugs within the applicability domain of the models, that can be suggested as possible PHT1 treatment.

In Silico Searching for Alternative Lead Compounds to Treat Type 2 Diabetes through a QSAR and Molecular Dynamics Study.

Free fatty acid receptor 1 (FFA1) stimulates insulin secretion in pancreatic ß-cells. An advantage of therapies that target FFA1 is their reduced risk of hypoglycemia relative to common type 2 diabetes treatments. In this work, quantitative structure-activity relationship (QSAR) approach was used to construct models to identify possible FFA1 agonists by applying four different machine-learning algorithms. The best model (M2) meets the Tropsha's test requirements and has the statistics parameters R2 = 0.843, Q2CV = 0.785, and Q2ext = 0.855. Also, coverage of 100% of the test set based on the applicability domain analysis was obtained. Furthermore, a deep analysis based on the ADME predictions, molecular docking, and molecular dynamics simulations was performed. The lipophilicity and the residue interactions were used as relevant criteria for selecting a candidate from the screening of the DiaNat and DrugBank databases. Finally, the FDA-approved drugs bilastine, bromfenac, and fenofibric acid are suggested as potential and lead FFA1 agonists.

Risk of thyroid cancer among Caribbean Hispanic patients with familial adenomatous polyposis.

Familial adenomatous polyposis (FAP) is an inherited form of colorectal cancer characterized by hundreds of adenomatous polyps in the colon and rectum. FAP is also associated with thyroid cancer (TC), but the lifetime risk is still unclear. This study reports the standardized incidence ratio (SIR) of TC in Hispanic FAP patients. TC incidence rates in patients with FAP between the periods of January 1, 2006 to December 31, 2013 were compared with the general population through direct database linkage from the Puerto Rico Central Cancer Registry (PRCCR) and the Puerto Rico Familial Colorectal Cancer Registry (PURIFICAR). The study population consisted of 51 Hispanic patients with FAP and 3239 with TC from the general population. The SIR was calculated using the Indirect Method, defined as observed TC incidence among patients with FAP in PURIFICAR's cohort (2006-2013) divided by the expected TC incidence based on the PR population rates (2006-2010). SIR values were estimated by sex (male, female, and overall). This study received IRB approval (protocol #A2210207). In Hispanic patients with FAP, the SIR (95% CI) for TC was 251.73 (51.91-735.65), with higher risk for females 461.18 (55.85-1665.94) than males 131.91 (3.34-734.95). Hispanic FAP patients are at a high risk for TC compared to the general population. Our incidence rates are higher than previous studies, suggesting that this community may be at a higher risk for TC than previously assumed. Implementation of clinical surveillance guidelines and regular ultrasound neck screening in Hispanic FAP patients is recommended.

Apuntes para un estudio comparativo entre torcidas organizadas e hinchadas / Apontamentos para um estudo comparativo entre torcidas organizadas e hinchadas / Notes for a comparative study between supporter groups from Brazil (torcidas organizadas) and Argentina (hinchadas)

En el presente estudio se propone una primera aproximación comparativa entre torcidas organizadas e hinchadas. El texto presenta una descripción densa que señala similitudes y diferencias, en términos sincrónicos y diacrónicos, entre ambos colectivos de espectadores futbolísticos. Se focalizará en los contextos de surgimiento, los encuadramientos organizacionales, las lógicas de pertenencia y las prácticas y representaciones más significativas de cada uno de los objetos empíricos analizados. Finalmente, explicitaremos algunos aportes para la construcción de una sociología pú- blica del deporte regional.

The present study proposes an initial approach to a comparative study between supporter groups from Brazil (torcidas organizadas) and Argentina (hinchadas). The text presents a thick description that points to similarities and differences, in synchronic and diachronic terms, between both groups of football spectators. The paper focuses on each group’s emergence, organizational framings, logics of belonging, and most significant practices and representations. Finally, it illustrates the contributions of this research to the construction of a public sociology of regional sport.

No presente estudo se propõe uma primeira aproximação comparativa entre torcidas organizadas e hinchadas. O texto apresenta uma descrição densa que aponta semelhanças e diferenças, em termos sincrônicos e diacrônicos, entre ambos grupamentos de espectadores de futebol. Se focalizará os contextos de surgimento, os enquadramentos organizacionais, as lógicas de pertencimento e as práticas e representações mais significativas de cada um dos objetos empíricos analisados. Finalmente explicitaremos alguns aportes para a construção de uma sociologia pública do esporte regional.