Factores de riesgo de reluxación de cadera en pacientes post-quirúrgicos de luxación congénita de cadera, en un hospital del seguro social / Risk factors of hip relaxation in post-surgical patients of congenital hip luxation, in a social security hospital

Introducción: La reluxación postquirúrgica, es la segunda complicación más frecuente luego de una reducción abierta correctiva de luxación congénita de cadera, por qué y cómo se producen aún no han sido resueltos. Objetivo: identificar los factores de riesgo de este evento en el servicio de C.O.T. del H.B.A.A.A. Material y métodos: se realizó un estudio Observacional, Analítico, Transversal y Retrospectivo; con diseño Casos y Controles. La población fue todo paciente que fuera intervenido por el diagnostico de Luxación congénita de cadera codificado por los CIE-10: Q65,0, Q65,1 o Q65,2 en el servicio de C.O.T. del H.B.A.A.A. en el periodo 2010 ­ 2015, se realizó muestreo por Epidat 3.1, ordenando 2 controles por cada caso: 28 casos y 56 controles. La definición de caso fue todo paciente perteneciente a la población descrita y que presenta reluxación de la cadera intervenida. Se realizó descripción de frecuencias, pruebas de contrastación de hipótesis y finalmente modelos lineales generalizados para calcular el Odds-ratio como medida de asociación, con el paquete estadístico STATA 13. Resultados: Se logró contar con 26 casos y 51 controles, la osteotomía femoral Desrotatoria presenta OR 2,88; p<0,05 IC:95%; las osteotomía femorales Desrotatoria y Varizante en una misma cirugía presentan OR 1,75; p>0,05 IC:95% y la osteotomía pélvica tipo Klissic presenta OR 1.5; p>0,05 IC: 95% Conclusión: nuestra investigación identifica en orden descendente como factores de riesgo: el uso osteotomía femoral Desrotatoria y Varizante, osteotomía pélvica tipo Dega , técnica de Klissic y procedimiento de retiro total del labrum.

Double-hit lymphomas: clinical, morphological, immunohistochemical and cytogenetic study in a series of Brazilian patients with high-grade non-Hodgkin lymphoma.

BACKGROUND: Double-hit lymphomas (DHL) are rare high-grade neoplasms characterized by two translocations: one involving the gene MYC and another involving genes BCL2 or BCL6, whose diagnosis depends on cytogenetic examination. This research studied DHL and morphological and/or immunophenotypic factors associated with the detection of these translocations in a group of high-grade non-Hodgkin lymphoma cases. METHOD: Clinical and morphological reviews of 120 cases diagnosed with diffuse large B-cell lymphoma and Burkitt lymphoma were conducted. Immunohistochemistry (CD20, CD79a, PAX5, CD10, Bcl6, Bcl2, MUM1, TDT and Myc) and fluorescence in situ hybridization for detection of MYC, BCL2 and BCL6 gene translocations were performed in a tissue microarray platform. RESULTS: Three cases of DHL were detected: two with translocations of MYC and BCL2 and one with translocations of MYC and BCL6, all leading to death in less than six months. Among 90 cytogenetically evaluable biopsies, associations were determined between immunohistochemistry and fluorescence in situ hybridization for MYC (p = 0.036) and BCL2 (p = 0.001). However, these showed only regular agreement, indicated by Kappa values of 0.23 [0.0;0.49] and 0.35 [0.13;0.56], respectively. "Starry sky" morphology was strongly associated with MYC positivity (p = 0.01). The detection of three cases of DHL, all resulting in death, confirms the rarity and aggressiveness of this neoplasm. CONCLUSIONS: The "starry sky" morphological pattern and immunohistochemical expression of Myc and Bcl2 represent possible selection factors for additional cytogenetic diagnostic testing.

Dipyrone has no effects on bone healing of tibial fractures in rats.

OBJECTIVE: To evaluate the effect of dipyrone on healing of tibial fractures in rats. METHODS: Fourty-two Wistar rats were used, with mean body weight of 280g. After being anesthetized, they were submitted to closed fracture of the tibia and fibula of the right posterior paw through manual force. The rats were randomly divided into three groups: the control group that received a daily intraperitoneal injection of saline solution; group D-40, that received saline injection containing 40mg/Kg dipyrone; and group D-80, that received saline injection containing 80mg/Kg dipyrone. After 28 days the rats were sacrificed and received a new label code that was known by only one researcher. The fractured limbs were then amputated and X-rayed. The tibias were disarticulated and subjected to mechanical, radiological and histological evaluation. For statistical analysis the Kruskal-Wallis test was used at a significance level of 5%. RESULTS: There wasn't any type of dipyrone effect on healing of rats tibial fractures in relation to the control group. CONCLUSION: Dipyrone may be used safely for pain control in the treatment of fractures, without any interference on bone healing. Level of Evidence II, Controlled Laboratory Study.

Dipirona não tem efeito sobre consolidação das fraturas da tíbia de ratos / Dipyrone has no effects on bone healing of tibial fractures in rats

Avaliar os efeitos da dipirona na consolidação de fraturasda tíbia de ratos. Métodos: Foram utilizados 42 ratos da linhagem Wistar, com peso médio de 280 g. Após serem anestesiados, osanimais foram submetidos à fratura da tíbia e fíbula da pata posteriordireita por força manual. Os ratos foram divididos, por sorteio, emtrês grupos: o grupo-controle, que recebeu uma injeção intraperitonealdiária de solução salina; o grupo D-40, que recebeu soluçãosalina com dipirona na concentração de 40 mg/Kg; e o grupo D-80,que recebeu solução salina contendo dipirona na concentração de80 mg/Kg. Após 28 dias os ratos foram sacrificados e receberam novacodificação, conhecida apenas por um dos pesquisadores. Os membrosfraturados foram então amputados e radiografados. As tíbiasforam desarticuladas e submetidas à avaliação mecânica, radiográficae histológica. Na análise estatística foi utilizado o teste de Kruskal--Wallis e estabelecido o nível de significância de 5%. Resultados: Nãofoi verificado nenhum tipo de efeito da dipirona na consolidação dasfraturas das tíbias dos ratos estudados em relação ao grupo controle.Conclusão: Dipirona pode ser utilizada com segurança no controleda dor no tratamento de fraturas, sem interferência na consolidaçãoóssea. Nível de Evidência II, Estudo Laboratorial Controlado...

To evaluate the effect of dipyrone on healing of tibialfractures in rats. Methods: Fourty-two Wistar rats were used, withmean body weight of 280 g. After being anesthetized, they weresubmitted to closed fracture of the tibia and fibula of the rightposterior paw through manual force. The rats were randomlydivided into three groups: the control group that received a dailyintraperitoneal injection of saline solution; group D-40, thatreceived saline injection containing 40 mg/Kg dipyrone; andgroup D-80, that received saline injection containing 80 mg/Kgdipyrone. After 28 days the rats were sacrificed and receiveda new label code that was known by only one researcher. Thefractured limbs were then amputated and X-rayed. The tibiaswere disarticulated and subjected to mechanical, radiologicaland histological evaluation. For statistical analysis the Kruskal--Wallis test was used at a significance level of 5%. Results:There wasn’t any type of dipyrone effect on healing of rats tibialfractures in relation to the control group. Conclusion: Dipyronemay be used safely for pain control in the treatment of fractures,without any interference on bone healing. Level of Evidence II,Controlled Laboratory Study...

[Guía latinoamericana para el diagnóstico y tratamiento de alergia a las proteínas de la leche de vaca (GL-APLV)].

Cow's milk allergy (CMA) is an immune-based disease that has become an increasing problem. The diagnosis and management of CMA varies from one clinical setting to another and represents a challenge in pediatric practice. In addition, because nonallergic food reactions can be confused with CMA symptoms, there is an overdiagnosis of the disease. In response to these situations, pediatric specialties from recognized institutions throughout Latin America decided to develop a clinical guideline for diagnosis and management of cow's milk allergy. These guidelines include definitions, epidemiology, pathophysiology overview, clinical and evidencebased recommendations for the diagnosis and treatment of CMA. They also include prevention and prognosis sections and identify gaps in the current knowledge to be addressed through future research.

Resultados clínicos de pacientes operados de meniscectomía parcial artroscópica en el HNAAA de 2002 a 2008

Actualmente la preservación del menisco es la regla y múltiples factores pueden determinan sobre los resultados clínicos de los pacientes operados de meniscectomía parcial artroscópica. Objetivo. Conocer los resultados clínicos de los pacientes operados de meniscectomía parcial artroscópica en el Hospital Nacional Almanzor Aguinaga Asenjo durante el 2002 al 2008. Material y Método. Los datos fueron recolectados a través de un formulario de recopilación de datos y a través del test Lysholm. Las variables se analizaron utilizándose la prueba de ji cuadrado. Resultados. La cirugía artroscópica promedio fue de 6,7% por año. La edad media fue de 41,9 años y fue más frecuente en hombres que en mujeres 2,1: 1. La lesión de menisco se asoció con lesión condral en el 44,78%. En el estudio encontró que el curso clínico en relación con la puntuación de Lysholm, el 70,17% tenía resultados excelentes, el 16,41% bueno, el 4,47% regular y 8,95% malo. Conclusiones. El aumento en la puntuación de cartílago de Outerbridge en el momento de la cirugía se relaciona con los resultados clínicos pobres en la cirugía artroscópica.(AU)

[Catalonian surgery in the twentieh century]. / Presencia Catalana en la cirugía del siglo XX.

In order to round it off, I would like to say that the development of surgery during these last hundred years has been quicker than throughout the history of mankind. And, as far as the Catalonian Health Service is concerned, it must be said that its doctors have played an extremely important role not only in the general practice of medicine and surgery but also in all specialization. Surgeons here have followed the French school passionately and have widened their knowledge by going deeply into Central European sources. All these hospitals I have mentined have been, are and will be the pride of those who consider being a doctor an "art". They are there to offer what society demands as the most coveted asset: health. Please, allow me to dedicate this speech to those from whom we learned not only the theory and practice of medicine but also the ethics, aesthetics and art of life.

Evaluation of estrogen receptor alpha and beta and progesterone receptor expression and correlation with clinicopathologic factors and proliferative marker Ki-67 in breast cancers.

To elucidate the molecular profile of hormonal steroid receptor status, we analyzed ER-alpha, ER-beta, and PGR mRNA and protein expression in 80 breast carcinomas using reverse transcriptase polymerase chain reaction (RT-PCR), quantitative RT-PCR, and immunohistochemical analysis. Qualitative analysis revealed positive expression of ER-alpha, ER-beta, and PGR mRNA in 48%, 59%, and 48% of the breast carcinomas, respectively. ER-alpha, ER-beta, and PGR transcript overexpression was observed in 51%, 0%, and 12% of the cases, respectively, whereas moderate or strong protein expression was detected in 68%, 78%, and 49% of the cases, respectively. Tumor grade was negatively correlated with transcript and protein levels of ER-alpha (P = .0169 and P = .0006, respectively) and PGR (P = .0034 and P = .0005, respectively). Similarly, proliferative index Ki-67 was negatively associated with transcript and protein levels of ER-alpha (P = .0006 and P < .0001, respectively) and PGR (P = .0258 and P = .0005, respectively). These findings suggest that ER-alpha and PGR expression are associated with well-differentiated breast tumors and less directly related to cell proliferation. A significant statistical difference was observed between lymph node status and ER-beta protein expression (P = .0208). In ER-alpha-negative tumors, we detected a correlation between ER-beta protein expression and high levels of Ki-67. These data suggest that ER-beta could be a prognostic marker in human breast cancer.

[Hospitals and surgeons: Madrid 1940]. / Hospitales y cirujanos: Madrid 1940.

The history of the hospitals and general surgeons that best represent the centres in Madrid are here in reviewed, comprising the period between 1940 and the closure of the Hospital Clinico (1957) as well as the Hospital General (General Hospital) (1967), both in Atocha. Other hospitals which are reviewed and highlighted are: the H. de la Princesa (the Princess Hospital), the H. del Nifio Jesus (Hospital of the Child Jesus), the H. Militar (Military Hospital) and the Cruz Roja (Red Cross). Data is provided on the permanent surgeons in the following centres: H. General: J. Goyanes, J. Die, J. de la Villa, T. Rodriguez, E. Diaz, G. Bueno e H. Huerta; H. Clinico: L. de la Peña, L. Cardenal, L. Olivares, R. Argüelles, J. Estella y M. F. Zumel; H. Militar: M. G. Ulla, M. Bastos, M. G. Durán, J. S. Galindo, y A. G. Durán; Hospital de la Cruz Roja: V. M. Noguera, L. Serrada, F. Luque y L. L. Durán; H. de la Princesa: P. Cifuentes, P. G. Duarte, L. Estella y R. Aiguabella; H. del Niño Jesús: J. Garrido Lestache; H. Clinico, last time, Atocha: F. M. Lagos, R. Vara y A. de la Fuente.