Purpose To validate the knee, shoulder, and virtual Fundamentals of Arthroscopic Training (FAST) modules on a virtual arthroscopy simulator via correlations with arthroscopy case experience and ...postgraduate year. Methods Orthopaedic residents and faculty from one institution performed a standardized sequence of knee, shoulder, and FAST modules to evaluate baseline arthroscopy skills. Total operation time, camera path length, and composite total score (metric derived from multiple simulator measurements) were compared with case experience and postgraduate level. Values reported are Pearson r ; alpha = 0.05. Results 35 orthopaedic residents (6 per postgraduate year), 2 fellows, and 3 faculty members (2 sports, 1 foot and ankle), including 30 male and 5 female residents, were voluntarily enrolled March to June 2015. Knee : training year correlated significantly with year-averaged knee composite score, r = 0.92, P = .004, 95% confidence interval (CI) = 0.84, 0.96; operation time, r = −0.92, P = .004, 95% CI = −0.96, −0.84; and camera path length, r = −0.97, P = .0004, 95% CI = −0.98, −0.93. Knee arthroscopy case experience correlated significantly with composite score, r = 0.58, P = .0008, 95% CI = 0.27, 0.77; operation time, r = −0.54, P = .002, 95% CI = −0.75, −0.22; and camera path length, r = −0.62, P = .0003, 95% CI = −0.8, −0.33. Shoulder : training year correlated strongly with average shoulder composite score, r = 0.90, P = .006, 95% CI = 0.81, 0.95; operation time, r = −0.94, P = .001, 95% CI = −0.97, −0.89; and camera path length, r = −0.89, P = .007, 95% CI = −0.95, −0.80. Shoulder arthroscopy case experience correlated significantly with average composite score, r = 0.52, P = .003, 95% CI = 0.2, 0.74; strongly with operation time, r = −0.62, P = .0002, 95% CI = −0.8, −0.33; and camera path length, r = −0.37, P = .044, 95% CI = −0.64, −0.01, by training year. FAST : training year correlated significantly with 3 combined FAST activity average composite scores, r = 0.81, P = .0279, 95% CI = 0.65, 0.90; operation times, r = −0.86, P = .012, 95% CI = −0.93, −0.74; and camera path lengths, r = −0.85, P = .015, 95% CI = −0.92, −0.72. Total arthroscopy cases performed did not correlate significantly with overall FAST performance. Conclusions We found significant correlations between both training year and knee and shoulder arthroscopy experience when compared with performance as measured by composite score, camera path length, and operation time during a simulated diagnostic knee and shoulder arthroscopy, respectively. Three FAST activities demonstrated significant correlations with training year but not arthroscopy case experience as measured by composite score, camera path length, and operation time. Clinical Relevance We attempt to validate an arthroscopy simulator that could be used to supplement arthroscopy skills training for orthopaedic residents.
Introducción: La segmentectomía lateral izquierda es el procedimiento más empleado para la cirugía del donante en trasplante hepático con donante vivo adulto-pediátrico (THDVA-P), y ha demostrado ser ...seguro y reproducible. Sin embargo, la información aún es escasa respecto al abordaje laparoscópico. El objetivo de este artículo es dar a conocer los resultados postoperatorios de la segmentectomía lateral izquierda laparoscópica (SLI-L) para THDVA-P. Materiales y método: Realizamos un estudio retrospectivo, observacional, de un solo centro, Hospital del Salvador; con vasta experiencia en trasplante hepático y en resecciones hepáticas laparoscópicas. Se ofreció realizar el procedimiento de SLI-L para la cirugía del donante vivo. Se describe la técnica quirúrgica y los resultados postoperatorios de los donantes. Resultados: Entre abril 2015 y enero 2021, 36 pacientes, 25 de ellos hombres, fueron sometidos a SLI-L. El 86% eran madre o padre del receptor, con una mediana de 30 años (19-45). Mediana de tiempo operatorio de 360 min (240-480). Hubo conversión en un caso debido a sangrado venoso de difícil manejo y en dos oportunidades se utilizó técnica mano asistida por la misma causa. Morbilidad Clavien-Dindo III en un paciente debido a fuga biliar precoz, manejada con colangiopancreatografía retrógrada endoscópica exitosamente. La mediana de hospitalización fue de 4 días (3-12) y no hubo mortalidad. Conclusión: La SLI-L ha evolucionado, desde un procedimiento innovador hasta convertirse en el actual procedimiento estándar para THDVA-P. Los buenos resultados en términos de morbimortalidad sugieren que podría ser una técnica segura y reproducible en contextos similares al del centro.
small-for-gestational-age (SGA) newborns present a higher morbidity and mortality rate when compared to infants born appropriate for gestational age (AGA), as well as insufficient growth, with height ...far from their target and in some cases a low final height (< -2 SDs).
the aim of this study was to determine when catch-up growth (CUG) in height occurs in these children, and which factors are associated with lack of CUG.
this is a retrospective study of SGAs born between 2011 and 2015 in a secondary hospital. Anthropometric measurements were taken consecutively until CUG was reached, and fetal, placental, parental, newborn, and postnatal variables were studied.
a total of 358 SGAs were included from a total of 5,585 live newborns. At 6 and 48 months of life, 93.6 % and 96.4 % of SGAs achieved CUG, respectively. By subgroups, symmetric SGAs performed worse than asymmetric SGAs with CUG in 84 % and 92 % at 6 and 48 months of life, respectively. The same occurred in the subgroup of preterm SGAs with respect to term SGAs, with worse CUGs of 88.2 % and 91.2 % at 6 and 48 months of life, respectively. Prematurity, symmetrical SGA, intrauterine growth retardation (IUGR), preeclampsia, previous child SGA, perinatal morbidity, and comorbidity during follow-up were associated with absence of CUG.
the majority of SGAs had CUG in the first months of life. The worst outcomes were for preterm and symmetric SGAs.
The aim of this study was to evaluate the commercial chair-side assays Saliva-Check Mutans and ClinproTM Cario L-PopTM in high microbiological caries-risk dental students compared with conventional ...semi-quantitative colony counting culture-based technique as the reference method. Saliva samples from 93 subjects of both sexes aged 18-26 years were seeded (Köhler and Bratthall method) on plates containing SB-20M culture medium method and 12 subjects with high caries risk were selected. These 12 individuals were subjected to determination of caries risk using two commercial rapid detection chair-side assays (Saliva-Check Mutans and ClinproTM Cario L-PopTM) according to the manufacturers' instructions. The results were analyzed by the Kappa correlation test using SAS statistical software. There was a perfect agreement (Kappa=1) among the three caries risk evaluation methods - chair-side assays and semi-quantitative CFU count (control) - in all subjects. The results suggest that the commercial chair-side assays evaluated in this study may be practical and useful to identify high microbiological caries-risk subjects.
Resumo O objetivo do estudo foi avaliar os testes comerciais de consultório Saliva-Check Mutans e ClinproTM Cario L-PopTM, em estudantes de Odontologia de alto risco à cárie, comparado à técnica convencional semi-quantitativa baseada em contagem de colônias, como método de referência. Amostras de saliva de 93 estudantes de ambos os sexos, entre 18 e 26 anos de idade, foram semeadas em placas contendo meio de cultura SB-20M e 12 pacientes de alto risco à cárie foram selecionados. Estes 12 indivíduos foram submetidos à determinação de risco à cárie por dois testes comerciais de rápida detecção (Saliva-Check Mutans e ClinproTM Cario L-PopTM), seguindo as instruções dos fabricantes. Os resultados foram analisados pelo teste de correlação Kappa, por meio do software estatístico SAS. Houve uma concordância perfeita (Kappa=1) entre os três métodos de avaliação de risco á cárie - testes comerciais e contagem semi-quantitativa de UFC (controle) - em todos os pacientes. O resultado sugere que os testes comerciais de consultório avaliados neste estudo podem ser práticos e úteis para identificar indivíduos de alto risco microbiológico à cárie.
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