CRECIMIENTO GUIADO EN EXTREMIDADES INFERIORES Sepúlveda, Matías Felipe; Ferrada, Paulina
Revista Médica Clínica Las Condes,
May-June 2021, 2021-05-00, Letnik:
32, Številka:
3
Journal Article
Recenzirano
Odprti dostop
El crecimiento guiado es una opción quirúrgica de uso creciente para la corrección de las deformidades angulares de extremidades inferiores en pacientes esqueléticamente inmaduros. Es posible de ...realizar en múltiples planos o segmentos, con excelentes resultados. Su uso más frecuente es en deformidades del plano coronal alrededor de la rodilla. La epifisiodesis permanente se puede realizar en pacientes dentro de los dos años previos al término del crecimiento longitudinal del segmento a tratar, considerando la epifisiodesis temporal para los pacientes con más de 2 años de crecimiento restante.
En casos leves a moderados las tasas de éxito llegan incluso al 100% en algunas series, en tanto, pacientes con enfermedad de Blount, obesidad, edad esquelética avanzada o deformidades severas, tienen menos posibilidades de lograr una corrección completa.
Independientemente de la técnica quirúrgica, es necesario una adecuada planificación preoperatoria, educación familiar y un seguimiento estricto para así minimizar las complicaciones y permitir una excelente corrección de la deformidad con una morbilidad mínima.
Guided Growth is a surgical option of increasing use for the correction of angular deformities of the lower extremities in skeletally immature patients. It is possible to perform in multiple planes or segments, with excellent results. Its most frequent use is in deformities of the coronal plane around the knee. Permanent epiphysiodesis can be performed in patients within 2 years before the end of longitudinal growth of the segment to be treated, considering temporary epiphysiodesis for patients with more than 2 years of remaining growth.
In mild to moderate cases, the success rates reach even 100% in some series, while patients with Blount's disease, obesity, advanced skeletal age or severe deformities are less likely to achieve a complete correction.
Regardless of the surgical technique, adequate preoperative planning, family education and strict follow-up are necessary to minimize complications and allow excellent correction of the deformity with minimal morbidity.
Resumen: El crecimiento guiado es una opción quirúrgica de uso creciente para la corrección de las deformidades angulares de extremidades inferiores en pacientes esqueléticamente inmaduros. Es ...posible de realizar en múltiples planos o segmentos, con excelentes resultados. Su uso más frecuente es en deformidades del plano coronal alrededor de la rodilla. La epifisiodesis permanente se puede realizar en pacientes dentro de los dos años previos al término del crecimiento longitudinal del segmento a tratar, considerando la epifisiodesis temporal para los pacientes con más de 2 años de crecimiento restante.En casos leves a moderados las tasas de éxito llegan incluso al 100% en algunas series, en tanto, pacientes con enfermedad de Blount, obesidad, edad esquelética avanzada o deformidades severas, tienen menos posibilidades de lograr una corrección completa.Independientemente de la técnica quirúrgica, es necesario una adecuada planificación preoperatoria, educación familiar y un seguimiento estricto para así minimizar las complicaciones y permitir una excelente corrección de la deformidad con una morbilidad mínima. Summary: Guided Growth is a surgical option of increasing use for the correction of angular deformities of the lower extremities in skeletally immature patients. It is possible to perform in multiple planes or segments, with excellent results. Its most frequent use is in deformities of the coronal plane around the knee. Permanent epiphysiodesis can be performed in patients within 2 years before the end of longitudinal growth of the segment to be treated, considering temporary epiphysiodesis for patients with more than 2 years of remaining growth.In mild to moderate cases, the success rates reach even 100% in some series, while patients with Blount's disease, obesity, advanced skeletal age or severe deformities are less likely to achieve a complete correction.Regardless of the surgical technique, adequate preoperative planning, family education and strict follow-up are necessary to minimize complications and allow excellent correction of the deformity with minimal morbidity.
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Chilean Laureliopsis philippiana has been used in traditional medicine by the Mapuche and their ancestors. To evaluate its pharmacological activity, Laureliopsis philippiana leaf ...essential oil extract (LP_EO) was chemically and biologically characterized in the present study. In vitro antioxidant potential was analyzed, and antitumor activity was evaluated in non-tumor and tumor cell culture lines. Caenorhabditis elegans was used as a model for evaluating toxicity, and the chemical composition of the essential oil was analyzed using gas chromatography–mass spectrometry. The oil contains six major monoterpenes: eucalyptol (27.7 %), linalool (27.6 %), isozaphrol (19.5 %), isohomogenol (12.6 %), α-terpineol (7.7 %), and eudesmol (4.8 %). Based on quantum mechanical calculations, isosafrole and isohomogenol conferred in vitro antioxidant and antimicrobial activity to LP_EO. In addition, LP_EO showed antimicrobial activity against clinical Helicobacter pylori isolates (MIC 64 and MBC > 128 μg·mL−1), Staphylococcus aureus (MIC 32 and MBC > 64 μg·mL−1), Escherichia coli (MIC 8 and MBC 16 μg·mL−1) and Candida albicans (MIC 64 and > 128 μg·mL−1). LP_EO could selectively inhibit the proliferation of epithelial tumor cell lines but showed low toxicity against Caenorhabditis elegans (0.39 to 1.56 μg·mL−1). Therefore, LP_EO may be used as a source of bioactive compounds in novel pharmacological treatments for veterinary and human application, cosmetics, or sanitation.
Background
Obesity and rapid weight loss after bariatric surgery (BS) are independent risk factors for development of cholelithiasis (CL), a prevalent disease in the Chilean population. This study ...aimed to determine the incidence of CL in obese Chilean patients 12 months after BS and identify risk factors for development of gallstones.
Methods
Retrospective study of patients who underwent BS in 2014. Patients with preoperative negative abdominal ultrasound (US) for CL and follow-up for at least than 12 months were included. Patients underwent US at 6 months and 12 months. We analyzed sex, age, hypertension, dyslipidemia, type 2 diabetes mellitus, body mass index (BMI), surgical procedure, percentage of excess BMI loss (%EBMIL) at 6 months, and BMI at 6 months.
Results
Of 279 patients who underwent bariatric surgery during 2014, 66 had previous gallbladder disease and 176 met the inclusion criteria (82.6%), while 54.6% were female. The mean age was 37.8 ± 10.5 years and preoperative BMI was 37.5 kg/m
2
. BMI and %EBMIL at 6 months were 27.8 ± 3.3 kg/m
2
and 77.9 ± 33.6%, respectively. At 12 months after BS, CL was found in 65 patients (36.9%). Hypertension turned out to be protective against occurrence of gallstones at 1 year with an OR 0.241.
Conclusions
Incidence of CL was up to one-third of the patients followed up for 12 months after BS. Excessive weight loss and other variables studied did not increase risk. Hypertension seems to be protective against gallstone formation, but this result needs further analysis.
Due to a metadata tagging error the name of author Andrés Esteban San Martín was indexed incorrectly. The author’s given name is Andrés Esteban and his family name is San Martín.
Background
Obesity is a global health problem that also affects older adults. In Chile, as in most of the developing countries, more than half of older adults are overweight or obese, and bariatric ...surgery may be riskier for this group. The aim of this study is to compare our experience in patients over 60 years of age with a control group to determine associated surgical morbidity and mortality.
Methods
Case-control study of bariatric surgeries performed between 2006 and 2017 in our institution. Patients aged ≥ 60 years for the case group versus control group for patients ≤ 50 years selected randomly, matched by body mass index, type 2 diabetes, hypertension, dyslipidemia, surgical technique, and gender (ratio 1:2). Primary endpoint was surgical morbidity, 30-day readmission, and mortality.
Results
Seventy-two patients in case group were matched with 144 patients in control group. Surgical complications rate was the same for both groups. No differences were observed in the conversion to open surgery rate or 30-day readmission rate. There was no mortality in this series.
Conclusion
In this case-control study, being elderly does not increase the risk of morbidity and mortality associated with bariatric surgery.
DNA-based methods using informative markers such as single nucleotide polymorphism (SNPs) are suitable for reliable species identification (SI) needed to enforce compliance with seafood labelling ...regulations (EU No.1379/2013). We developed a panel of 10 highly informative SNPs to be genotyped by PCR-High resolution melting (HRM) for SI in the Mytilus genus through in silico and in vitro stages. Its fitness for purpose and concordance were assessed by an internal validation process and by the transference to a second laboratory. The method was applicable to identify M. chilensis, M. edulis, M. galloprovincialis and M. trossulus mussels, fresh, frozen and canned with brine, oil and scallop sauce, but not in preserves containing acetic acid (wine vinegar) and tomato sauce. False-positive and negative rates were zero. Sensitivity, expressed as limit of detection (LOD), ranged between 5 and 8 ng/μL. The method was robust against small variations in DNA quality, annealing time and temperature, primer concentration, reaction volume and HRM kit. Reference materials and 220 samples were tested in an inter-laboratory assay obtaining an “almost perfect agreement” (κ = 0.925, p < 0.001). In conclusion, the method was suitable for the intended use and to be applied in the seafood industry.
A cascading rainfall–landslide–tsunami event occurred on June 29th, 2022, in Todos los Santos Lake, located in southern Chile, affecting the tourist town of Petrohué. The event took place after ...several days of heavy rain during an extratropical cyclone. Important data were collected during a field survey, including hillslope 3D scans, lake–river bathymetry, orthomosaic photos, and an assessment of damage to public infrastructure. The analysis showed that the landslide had an estimated length, width, and depth of 175 m, 40 m, and 1.5 m, respectively, which resulted in a total volume of 10,500 m
3
. The underwater runout distance of the landslide was estimated at 40 m, with a final water depth of 12 m. The initial tsunami wave was observed to be ~1 m, and since the distance from the landslide to the town was ~500 m, an arrival time of ~1 min was observed. Despite the small tsunami amplitudes, the pedestrian bridge of the floating pontoon collapsed due to the flow current and vertical oscillations. The results of the numerical simulation of the tsunami supported the observed data. They showed that the impact of the tsunami was only in the near field and was influenced by the bathymetry, such that refraction and edge waves were observed. The landslide occurred in an area where previous debris flows took place in 2013 and 2015. The main finding of the present research is that the occurrences of this and previous landslides were controlled by the presence of the Liquiñe–Ofqui fault zone, which generates broad areas of structural damage, with mechanical and chemical weathering significantly reducing rock strength. These observations provide a warning regarding the susceptibility of similar regions to other trigger events such as earthquakes and rainfall. This recent landslide highlights the need for a more comprehensive hazard assessment, for which probabilistic analysis could be focused on large active strike-slip fault systems. It also highlights the importance of community awareness, particularly in areas where tourism and real estate speculation have significantly increased urban development.
The non-responders (NRs) after exercise training have been poorly studied in populations with morbid obesity. The purpose of this study was to determine the NR prevalence after 20 weeks of concurrent ...training of morbidly obese women with a high or low number of metabolic syndrome (MetS) risk factors. Twenty-eight women with morbid obesity participated in an exercise training intervention and were allocated into two groups distributed based on a high (≥3,
n
= 11) or low number (<3,
n
= 17) of MetS risk factors. The main outcomes were waist circumference (WC), fasting plasma glucose (FPG), high-density lipids (HDL-c), triglycerides (Tg), and systolic (SBP) and diastolic (DBP) blood pressure, and secondary outcomes were body composition, anthropometric and physical fitness, determined before and after 20 weeks of concurrent training. NRs were defined as previously used technical error cut-off points for the MetS outcomes. Significantly different (all
p
< 0.05) prevalences of NRs between the H-MetS vs. L-MetS groups (respectively) in WC (NRs 18.2 % vs. 41.1 %,
p
< 0.0001), SBP (NRs 72.7 % vs. 47.0 %,
p
= 0.022), DBP (NRs 54.5 % vs. 76.4 %,
p
< 0.0001), FPG (NRs 100% vs. 64.8 %,
p
< 0.0001), and HDL-c (NRs 90.9 % vs. 64.7 %,
p
= 0.012) were observed. In addition, the H-MetS group evidenced significant changes on ΔSBP (−10.2 ± 11.4 mmHg), ΔFPG (−5.8 ± 8.2 mg/dl), ΔHDL-c (+4.0 ± 5.9 mg/dl), and ΔTg (−8.8 ± 33.8 mg/dl), all
p
< 0.05. The L-MetS group only showed significant changes in ΔWC (−3.8 ± 5.0 cm,
p
= 0.009). Comparing H-MetS vs. L-MetS groups, significant differences were observed in ∆FPG (−5.8 ± 8.2 vs. +0.3 ± 3.2 mg/dl,
p
= 0.027), but not in other MetS outcomes. In conclusion, 20 weeks of concurrent training promotes greater beneficial effects in morbidly obese patients with a high number of MetS risk factors. However, the NR prevalence for improving MetS outcomes was significantly superior in these more-diseased groups in SBP, FPG, and HDL-c, independent of their major training-induced effects.
Due to a metadata tagging error the name of author Andrés Esteban San Martín was indexed incorrectly. The author’s given name is Andrés Esteban and his family name is San Martín.
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