Evaluación de los Niveles de Mercurio en Productos Pesqueros en Costa Rica, Durante 2003-2013, como insumo para recomendar una ingesta semanal tolerable / Evaluation of Mercury Levels in Fishery Products in Costa Rica, During 2003-2013, as an Input to recommend a tolerable weekly intake

ResumenLos peces y mariscos pueden acumular mercurio en sus tejidos. En este trabajo se establecen recomendaciones de consumo de productos pesqueros para los residentes de Costa Rica, a partir de la evaluación de los niveles de mercurio en pescados y mariscos analizados durante los años 2003-2013.Objetivo: Evaluar los niveles de mercurio (en mg/kg) en muestras de productos pesqueros, analizadas por el Laboratorio Nacional de Servicios Veterinarios (LANASEVE) del Servicio Nacional de Salud Animal (SENASA) de Costa Rica, durante el período 2003-2013, para sugerir un valor de Ingesta Semanal Tolerable Recomendada (ISTR) de pescados y mariscos.Materiales y métodos: Los ensayos de mercurio se realizaron, bajo un esquema de análisis de riesgo determinado por el Programa Nacional de Residuos del SENASA, en pescados y mariscos. Las muestras de músculo fueron recolectadas por personal del SENASA y enviadas al LANASEVE para evaluar los niveles de Hg. Las concentraciones de mercurio fueron luego comparadas con los dos valores límite establecidos por la normativa nacional e internacional para productos pesqueros: 1 mg Hg/kg para pescados depredadores y 0,5 mg Hg/kg para otros productos pesqueros.Resultados: Se encontró que aproximadamente el 85 % de las muestras de pescados depredadores cumplió con el valor límite de 1 mg Hg/kg. Por su parte, el 93 % de los otros productos pesqueros evaluados, mostraron niveles de mercurio por debajo de 0,5 mg Hg/kg.Conclusión: Para mujeres embarazadas se establecieron valores de ISTR de 171 g de pescados depredadores o 889 g de otros productos pesqueros, en tanto para niños los ISTR recomendados fueron 100 g de pescados depredadores y 519 g de otros productos pesqueros.

AbstractFish and seafood can accumulate mercury in their tissues. This work establishes fishery products intake recommendations for the residents of Costa Rica, based upon the evaluation of mercury levels on fish and seafood analyzed during years 2003-2013.Objective: To evaluate mercury levels (in mg/kg) in fishery samples, as analyzed by the National Veterinary Services Laboratory (LANASEVE) of the National Animal Health Service (SENASA) of Costa Rica, during the 2003-2013 period, to suggest a Tolerable Weekly Intake Recommendation (TWIR) for fish and seafood.Methods: Mercury assays were performed, under a risk-analysis scheme determined by the National Residue Program of SENASA, in fish and seafood. Muscle samples were collected by SENASA staff and sent to LANASEVE for evaluation of Hg contents. Mercury concentrations were then compared to two limit values established by national and international regulations for seafood: 1 mg Hg/kg for predatory fish, and 0,5 mg Hg/kg for other fishery products.Results: It was found that, approximately, 85 % of predatory fish samples complied with the 1 mg Hg/kg limit value. Meanwhile, 93 % of the other fishery products analyzed, showed mercury levels below 0,5 mg/kg.Conclusion: For pregnant women TWIR values were established at 171 g for predatory fish and 889 g for other fishery products, while for children the TWIR values were 100 g for predatory fish and 519 g for other fishery products.

Can wedge osteotomy correct depression of the lateral tibial plateau mimicking posterolateral rotatory knee instability?

BACKGROUND: The literature suggests rotatory knee instability (pseudolaxity) can be associated with depressions of the lateral tibial plateau in patients despite an intact arcuate ligament complex. Correcting this bone deformity by an open-wedge osteotomy of the lateral tibia plateau, elevating the depressed bone may restore knee stability. QUESTIONS/PURPOSES: We therefore asked whether: (1) knee stability is restored after this procedure; (2) Lysholm functional scores improve after this treatment; and (3) the limb alignment changes. PATIENTS AND METHODS: We retrospectively evaluated 12 patients who underwent a subchondral open-wedge osteotomy of the lateral tibial plateau combined with a knee arthroscopic procedure for the treatment of a knee rotational instability secondary to a lateral compartment bone deficit between 2000 and 2007. Eleven patients with a mean age of 35 years were available for followup at a minimum of 2 years (average, 5.4 years; range, 2-9 years). Preoperatively and at last followup, patients were clinically and radiographically evaluated by the Lysholm score and with comparative knee radiographs. Complications were recorded. RESULTS: At last followup all patients rated their knees as stable. All osteotomies healed uneventfully. The Lysholm score improved from 62 to 87. Followup radiographs showed no changes in the femorotibial axis as result of the osteotomy. CONCLUSIONS: Patients with chronic depression of the posterolateral tibial plateau may exhibit symptoms of posterolateral knee instability, a sort of pseudolaxity. In these patients, an open-wedge osteotomy of the lateral tibia plateau, elevating the depressed bone, and tensioning posterolateral structures improves this secondary posterolateral knee instability. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Do patients with traumatic recurrent anterior shoulder instability have generalized joint laxity?

BACKGROUND: A number of studies suggest a relationship between generalized joint laxity (GJL) and increased risk of some musculoskeletal injuries. However, there are conflicting data on the association between GJL and traumatic recurrent shoulder instability (RSI). QUESTIONS/PURPOSES: We therefore asked whether the incidence of GJL in patients with RSI was greater than that in a control group. METHODS: We preoperatively determined GJL with a Beighton score in 100 male patients arthroscopically treated for RSI. The mean age of the patients was 25 years. We identified a control group of 100 individuals, matched for age and gender, with no known history of instability of the shoulder, knees, or ankles and obtained the same score. Those patients with a Beighton score greater than six points were considered lax (representing GJL). RESULTS: We identified no difference in the rate of GJL in the two groups: 13 of the 100 patients versus nine of the 100 control subjects. CONCLUSION: Our data add to the literature suggesting GJL does not predispose to RSI. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Incidence of deep infection in aseptic revision THA using vancomycin-impregnated impacted bone allograft.

The addition of antibiotic to cement is a frequent practice in aseptic revision hip surgery There is concern about adding vancomycin to cement due to potential effects on mechanical properties and prolonged elution of subtherapeutic levels antibiotic. Bone allografts can store and provide high levels of vancomycin to surrounding tissues. We analyzed the incidence of infection after one-stage aseptic revision hip reconstruction utilizing acetabular and/or femoral vancomycin-impregnated impacted bone allograft and a THA fixed with cement containing no antibiotic. We hypothesized that the infection rate may be similar to that reported in the literature following traditional impaction grafting using antibiotic loaded cement. Seventy five consecutive patients (80 hips) with a preoperative Merle D'Aubigné and Postel functional score averaging 4.8 points were followed up for a mean of 36 months (range 24 - 59 months). The incidence of infection was 1.25% (CI 95%=96.26-100%). A deep infection (thought to be haematognous in origin) occurred in 1 patient 2 years after the index surgery. The average postoperative Merle D´Aubigne score was 16.2 points. The last radiographic evaluation demonstrated a less than 5 mm acetabular migration and a less than 5 mm femoral subsidence in all cases. Vancomycin-supplemented allografts restored bone stock and provided sound fixation with a low incidence of infection. This incidence of deep sepsis is similar to that reported with antibiotic-loaded PMMA but without the reported mechanical and pharmacological disadvantages.

Tratamiento artroscópico de condromatosis sinovial en el hombro: reporte de 3 casos / Arthroscopic treatment of shoulder synovial chondromatosis: three cases reports

La ostecondondromatosis sinovial es una patología infrecuente que afecta las articulaciones, produciendo nódulos cartilaginosos que ocasionan dolor y disminución de la movilidad: ante el avance del cuadro, el tratamiento quirúrgico con la resección de los cuerpos libres y la sinovectomía está indicado. Se presentan 3 casos de condromatosis sinovial del hombro tratados en forma artroscópica.

Tratamiento artroscópico de condromatosis sinovial en el hombro: reporte de 3 casos / Arthroscopic treatment of shoulder synovial chondromatosis: three cases reports

La ostecondondromatosis sinovial es una patología infrecuente que afecta las articulaciones, produciendo nódulos cartilaginosos que ocasionan dolor y disminución de la movilidad: ante el avance del cuadro, el tratamiento quirúrgico con la resección de los cuerpos libres y la sinovectomía está indicado. Se presentan 3 casos de condromatosis sinovial del hombro tratados en forma artroscópica.(AU)

Lesiones de los corredores en la rodilla / Runner`s knee injuries

Correr es una de las actividades deportivas más populares en nuestro país y en el mundo. Están bien demostrados sus efectos beneficiosos relacionados con la salud. Sin embargo, deben reconocerse ciertos tipos de lesiones que pueden asociarse a esta actividad; la mayoría ocurren en el miembro inferior, con gran predominancia de la rodilla. Las lesiones más frecuentes en la rodilla de los corredores incluyen el síndrome de dolor femororotuliano, el síndrome de fricción de la fascia lata, los síndromes meniscales, y las fracturas por stress. El objetivo de este trabajo es realizar una actualización de estos 4 temas relacionados específicamente con la rodilla de los corredores.

Lesiones de los corredores en la rodilla / Runner`s knee injuries

Correr es una de las actividades deportivas más populares en nuestro país y en el mundo. Están bien demostrados sus efectos beneficiosos relacionados con la salud. Sin embargo, deben reconocerse ciertos tipos de lesiones que pueden asociarse a esta actividad; la mayoría ocurren en el miembro inferior, con gran predominancia de la rodilla. Las lesiones más frecuentes en la rodilla de los corredores incluyen el síndrome de dolor femororotuliano, el síndrome de fricción de la fascia lata, los síndromes meniscales, y las fracturas por stress. El objetivo de este trabajo es realizar una actualización de estos 4 temas relacionados específicamente con la rodilla de los corredores.