[Rehabilitation of hip fractures. Systematic review]. / Rehabilitación de las fracturas de cadera. Revisión sistemática.

INTRODUCTION: Hip fractures are considered among one of the most disabling injuries in patients older than 60 years of age. This fractures are associated with a high incidence of mortality and it is the leading cause of hospital admission that requires surgical treatment in Orthopaedic Trauma Centers. METHODS: This systematic review aimed to group, classify and report the best level of evidence of physical therapy and rehabilitation of patients that have been treated with osteostynthesis after trochanteric or subtrochanteric fracture. The outcomes of efficacy and safety were return to activities of daily living, independence and rate of complications. RESULTS: We identified 3,889 abstracts from PubMed, and 1,567 abstracts from other sources, after eliminating duplicates, and posterior to a thorough screening 378 abstracts were read. From these, 316 abstracts were excluded, and 62 articles were considered eligible. After reading for relevant outcomes 41 articles were excluded. Synthesis was based in 21 studies. CONCLUSIONS: Long term results of specialized physical therapy, appear to be crucial in the first months after surgery, and not that important after the four months after surgery. Recent literature supports that the differences of daily activities and independence of the patients that survive a hip fracture tend to be similar with no difference in the type of physical therapy.

INTRODUCCIÓN: Las fracturas de cadera se consideran entre las lesiones incapacitantes más comunes en mayores de 60 años. Se asocian a un alto índice de mortalidad y es la causa más frecuente de internamiento que requiere tratamiento quirúrgico en unidades médicas dedicadas a la traumatología. MÉTODOS: Esta revisión sistemática tiene como objetivo agrupar, clasificar y reportar el mejor nivel de evidencia en el manejo de terapia física y rehabilitación en los pacientes con fractura pertrocantérica y subtrocantérica de cadera después de la cirugía de osteosíntesis en desenlaces de actividades de la vida diaria, independencia y complicaciones. RESULTADOS: Se identificaron 3,389 resúmenes y a través de otras fuentes 1,567 resúmenes, se eliminaron duplicados en la búsqueda y posterior a un cribado se obtuvieron 378 artículos para la eliminación adicional. De los 62 ensayos restantes se incluyeron 21 y 41 fueron excluidos. CONCLUSIONES: Los resultados a largo plazo de la terapia física especializada parecen ser cruciales en los primeros meses y no tan importantes al cabo de cuatro meses. La literatura actual sostiene que las diferencias en las capacidades de la vida diaria e independencia de los pacientes que sobreviven, el tratamiento de una fractura de cadera tiende a ser similar independientemente del programa de rehabilitación que se tenga.

Association between allergic rhinitis, bottle feeding, non-nutritive sucking habits, and malocclusion in the primary dentition.

AIM: To determine the association between allergic rhinitis, bottle feeding, non-nutritive sucking habits, and malocclusion in the primary dentition. METHODS: Data were collected on 1160 children aged 4-5 years, who had been longitudinally followed since the age of 4 months, when they were admitted to nurseries in a suburban area of Tampico-Madero, Mexico. Periodically, physical examinations were conducted and a questionnaire was given to their parents or tutors. RESULTS: Malocclusion was detected in 640 of the children (51.03% had anterior open bite and 7.5% had posterior cross-bite). Allergic rhinitis alone (adjusted odds ratio = 2.87; 95% CI 1.57 to 5.25) or together with non-nutritive sucking habits (adjusted odds ratio = 3.31; 95% CI 1.55 to 7.09) had an effect on anterior open bite. Bottle feeding alone (adjusted odds ratio = 1.95; 95% CI 1.07 to 3.54) or together with allergic rhinitis (adjusted odds ratio = 3.96; 95% CI 1.80 to 8.74) had an effect on posterior cross-bite. Posterior cross-bite was more frequent in children with allergic rhinitis and non-nutritive sucking habits (10.4%). CONCLUSIONS: Allergic rhinitis alone or together with non-nutritive sucking habits is related to anterior open bite. Non-nutritive sucking habits together with allergic rhinitis seem to be the most important factor for development of posterior open bite in children under the age of 5 years.

[A diagnostic instrument for allergic rhinitis]. / Instrumento diagnóstico para la rinitis alérgica.

AIMS: Allergic rhinitis is the most common chronic disease in the upper respiratory tract, requiring better diagnostic methodology to counteract its onslaught. MATERIAL AND METHOD: This study included 116 subjects by random election, sex indistinct, between 1 and 68 years old with an average of 24.6. Data were obtained by medical history, measure levels of circulating eosinophils, serum IgE, mucous nasal eosinophils and coproparasitoscopic test. The subjects were divided in two groups, 58 patients with allergic rhinitis and 58 health subjects. RESULTS: From total subjects, 56.3% were female, 18.9% showed high levels of circulating eosinophils and sera IgE. 24.1% had positive identification of eosinophils in nasal mocous and 25% suffered parasitosis. In the rhinitis group, the average time of evolution was 5.3 years, in 80% with perennial presentation, 37.9% showed environmental exposure to allergens at home (p = NS), 56.8% had family history of allergy, 60% had more than twice monthly acute crisis, 29.3% had risen above the upper level of circulating eosinophils (p = 0.0049), 25.8% had high levels of IgE (p = 0.0002), in 37.93% were found nasal mucous eosinophils (p = 0.0009) and in 10.34% were identified intestinal parasitosis (p = n.s.). CONCLUSION: In accordance with this work, it is necessary to promote a change in attitude, utilizing the medical history as a diagnostic instrument and do not restrict prevention and opportunity in treatment to laboratory results.

[Medical history: diagnostic tool for allergic rhinitis]. / La historia clínica: instrumento diagnóstico para la rinitis alérgica.

AIMS: To determine the diagnostic value of the medical history in the allergic rhinitis. MATERIAL AND METHOD: This study included 112 subjects, sex indistinct, between 2 and 31 years old, mean. We made 2 groups, one of the cases and another of control. Data were obtained by medical history, laboratory test and X-Ray of the upper respiratory tract. The gold standard of the diagnosis was the skin testing. We assessment, sensitivity (S), specificity (E), predictive value positive (VP+), and predictive value negative (VP-) RESULTS: From total subjects, 53.57% were female, the evolution mean time was 4 years, with 5 monthly acute crisis. In 80% of the cases was perennial the presentation. 57.14% had family history of allergy (S = 57%, E = 100%, p = 0.0001). Clinical dates obtained were: sneezing 75% of the cases (S = 75%, E = 100%, p = 0.0001), nasal congestion 50% (S = 50%, E = 100%, p = 0.0001). 30.35% had risen above the upper level of circulating eosinophils (S = 30.35%, E = 91%, p = 0.0049), 26.78% had high levels of IgE (S = 26%, E = 87.5% p = 0.0002), in 78.57% were found nasal mucous eosinophils (S = 39.28%, E = 89.28%, p = 0.0009) and in 10.34% were identified intestinal parasitosis (P = NS). CONCLUSION: In accordance with this work, it is necessary to promote a change in attitude, utilizing the medical history as a diagnostic instrument and do not restrict prevention and opportunity in treatment to laboratory results.

Dehydroepiandrosterone is a substrate for estradiol 17 beta-dehydrogenase from human placenta.

The enzyme estradiol 17 beta-dehydrogenase (17 beta-ED) [E.C.1.1.1.62] from human placenta was purified to homogeneity by the initial steps of a published procedure, followed by an affinity chromatography step in Reactive Blue 2-Sepharose, eluting with NADP. The pure enzyme is not specific for estrogenic substrates, it also catalyzes the oxidation-reduction of several androgens and progesterone (i.e. dehydroepiandrosterone, androstenedione, 5 alpha-dihydrotestosterone, and 20 alpha-dihydroprogesterone). The comparison of the kinetic parameters for these substrates, shows that dehydroepiandrosterone could be a physiological ligand of the enzyme, and consequently involved in the control of its function in estrogen metabolism.