Revisiones_bibliográficas TyO

lunes, 13 de marzo de 2017

Transferencia de aloinjertos osteocondrales para el tratamiento de lesiones osteocondrales del talus: una revisión sistemática.

http://www.ortopedistaseguro.com.mx/academia/transferencia-de-aloinjertos-osteocondrales-para-el-tratamiento-de-lesiones-osteocondrales-del-talus-una-revision-sistematica/

Osteochondral Allograft Transfer for Treatment of Osteochondral Lesions of the Talus: A Systematic Review.

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27546173

http://www.arthroscopyjournal.org/article/S0749-8063(16)30366-8/abstract

De:

VanTienderen RJ1,Dunn JC2,Kusnezov N2,Orr JD2.

Arthroscopy.

2017 Jan;33(1):217-222. doi: 10.1016/j.arthro.2016.06.011. Epub 2016 Aug 18.

Elsevier

Abstract

PURPOSE:

The purpose of this study is to present a systematic review of the literature regarding the use of fresh bulk osteochondralallograft transfer for treatment of large osteochondral lesions of the talus (OCLT) in an effort to characterize the functional outcomes, complications, and reoperation rates.

CONCLUSIONS:

Fresh bulk allograft transplantation can substantially improve functional status as well as effectively prevent or delay the eventual need for ankle arthrodesis or replacement. However, patients must be carefully selected and counseled on the morbidity of the procedure as well as the high incidence of clinical failure (13%) and need for reoperation (25%) and revision surgery (8.8%).

Resumen

PROPÓSITO:

El propósito de este estudio es presentar una revisión sistemática de la literatura sobre el uso de la transferencia de aloinjerto osteocondral a granel para el tratamiento de grandes lesiones osteocondrales del astrágalo en un esfuerzo por caracterizar los resultados funcionales, las complicaciones y las tasas de reoperación.

CONCLUSIONES:

El trasplante de aloinjerto a granel fresco puede mejorar sustancialmente el estado funcional así como prevenir o retrasar efectivamente la eventual necesidad de artrodesis o reemplazo de tobillo. Sin embargo, los pacientes deben ser cuidadosamente seleccionados y asesorados sobre la morbilidad del procedimiento, así como la alta incidencia de fracaso clínico (13%) y necesidad de reoperación (25%) y cirugía de revisión (8,8%).

LEVEL OF EVIDENCE:

Level IV, systematic review of Level IV studies.

Published by Elsevier Inc.

PMID: 27546173 DOI:

10.1016/j.arthro.2016.06.011

#aloinjertos osteocondrales #lesiones osteocondrales #talus

Tratamiento de la Neuritis Cubital en el Codo de los Jugadores de Béisbol Adolescentes: Factores Asociados con los Pobres Resultados

http://www.mishuesosyarticulaciones.com.mx/academia/tratamiento-de-la-neuritis-cubital-en-el-codo-de-los-jugadores-de-beisbol-adolescentes-factores-asociados-con-los-pobres-resultados/

Treatment for Ulnar Neuritis Around the Elbow in Adolescent Baseball Players: Factors Associated With Poor Outcome

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27940806

http://journals.sagepub.com/doi/abs/10.1177/0363546516675169?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&

De:

Maruyama M^1,², Satake H³, Takahara M⁴, Harada M⁴, Uno T³, Mura N², Takagi M³.

Am J Sports Med. 2016 Dec 9. pii: 0363546516675169. [Epub ahead of print]

Ulnar neuritis around the elbow is one of the injuries seen in throwing athletes. Outcomes of nonsurgical treatment and factors associated with failure outcomes have not been reported.

PURPOSE:

To investigate the outcomes of treatments for ulnar neuritis in adolescent baseball players.

STUDY DESIGN:

Case series; Level of evidence, 4.

CONCLUSION:

Hand numbness on the ulnar side, ulnar nerve subluxation, and UCL injury are strong predictors of poor outcomes after nonsurgical treatment for ulnar neuritis, and surgery provides excellent results.

KEYWORDS:

baseball; elbow; nonsurgical treatment; ulnar collateral ligament injury; ulnar nerve subluxation; ulnar neuritis

Resumen

ANTECEDENTES:

La neuritis cubital alrededor del codo es una de las lesiones que se ven en los atletas que lanzan. No se han informado los resultados del tratamiento no quirúrgico y los factores asociados con los resultados de la falla.PROPÓSITO:Investigar los resultados de los tratamientos para la neuritis cubital en jugadores de béisbol adolescentes.DISEÑO DEL ESTUDIO:

Series de casos; Nivel de evidencia, 4.

CONCLUSIÓN:

El entumecimiento de la mano en el lado cubital, la subluxación del nervio cubital y la lesión del ligamento colateral cubital (UCL) son fuertes predictores de resultados pobres después del tratamiento no quirúrgico de la neuritis cubital y la cirugía proporciona excelentes resultados.© 2016 Autor (es).

PALABRAS CLAVE:

béisbol; codo; Tratamiento no quirúrgico; Lesión del ligamento colateral cubital; Subluxación del nervio cubital; Neuritis cubital

PMID: 27940806 DOI:

10.1177/0363546516675169

#béisbol #codo #Tratamiento no quirúrgico #Lesión del ligamento colateral cubital #Subluxación del nervio cubital #Neuritis cubital

Líquidos intravenosos / IV fluids therapy

Marzo 12, 2017. No. 2626

El dilema hemodinámico en la atención de emergencia: ¿Es la respuesta al fluido la solución? Una revisión sistemática.

The haemodynamic dilemma in emergency care: Is fluid responsiveness the answer? A systematic review.

Elwan MH1,2, Roshdy A3,4, Elsharkawy EM5, Eltahan SM5, Coats TJ6.

Scand J Trauma Resusc Emerg Med. 2017 Mar 6;25(1):25. doi: 10.1186/s13049-017-0370-4.

Abstract

BACKGROUND: Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED. METHODS: MEDLINE, Embase and the Cochrane library were searched for relevant peer-reviewed studies published from 1946 to present. RESULTS: A total of 249 publications were retrieved of which 22 studies underwent full-text review and eight relevant studies were identified. Only 3 studies addressed clinical outcomes - including 2 randomised controlled trials and one feasibility study. Five articles evaluated the diagnostic accuracy of fluid responsiveness techniques in ED. Due to marked heterogeneity, it was not possible to combine results in a meta-analysis. CONCLUSION: High quality, adequately powered outcome studies are still lacking, so the place of fluid responsiveness in ED remains undefined. Future studies should have standardisation of patient groups, the target response and the underpinning theoretic concept of fluid responsiveness. The value of a fluid responsiveness based fluid resuscitation protocol needs to be established in a clinical trial.

KEYWORDS: Cardiac output; Emergency; Fluid responsiveness; Fluid therapy; Haemodynamics; Resuscitation; Shock

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Líquidos en shock séptico. ¿Qué fluidos deben de utilizarse?

Fluid therapy for septic shock resuscitation: which fluid should be used?

[Article in English, Portuguese]

Corrêa TD1, Rocha LL1, Pessoa CM1, Silva E1, de Assuncao MS1.

Einstein (Sao Paulo). 2015 Jul-Sep;13(3):462-8. doi: 10.1590/S1679-45082015RW3273. Epub 2015 Aug 21.

Abstract

Early resuscitation of septic shock patients reduces the sepsis-related morbidity and mortality. The main goals of septic shock resuscitation include volemic expansion, maintenance of adequate tissue perfusion and oxygen delivery, guided by central venous pressure, mean arterial pressure, mixed or central venous oxygen saturation and arterial lactate levels. An aggressive fluid resuscitation, possibly in association with vasopressors, inotropes and red blood cell concentrate transfusion may be necessary to achieve those hemodynamic goals. Nonetheless, even though fluid administration is one of the most common interventions offered to critically ill patients, the most appropriate type of fluid to be used remains controversial. According to recently published clinical trials, crystalloid solutions seem to be the most appropriate type of fluids for initial resuscitation of septic shock patients. Balanced crystalloids have theoretical advantages over the classic solutions, but there is not enough evidence to indicate it as first-line treatment. Additionally, when large amounts of fluids are necessary to restore the hemodynamic stability, albumin solutions may be a safe and effective alternative. Hydroxyethyl starches solutions must be avoided in septic patients due to the increased risk of acute renal failure, increased need for renal replacement therapy and increased mortality. Our objective was to present a narrative review of the literature regarding the major types of fluids and their main drawbacks in the initial resuscitation of the septic shock patients.

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