Revisiones_bibliográficas TyO

lunes, 31 de julio de 2017

Prevención, tratamiento y rehabilitación de lesiones del ligamento cruzado anterior en niños

http://www.ortopediapediatricaisunza.com.mx/academia/prevencion-tratamiento-y-rehabilitacion-de-lesiones-del-ligamento-cruzado-anterior-en-ninos/

Prevention, treatment, and rehabilitation of anterior cruciate ligament injuries in children

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28652828

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476725/

https://www.dovepress.com/prevention-treatment-and-rehabilitation-of-anterior-cruciate-ligament–peer-reviewed-article-OAJSM

De:

Lang PJ1,2,Sugimoto D1,2,3,Micheli LJ1,2,3

Open Access J Sports Med.

2017 Jun 12;8:133-141. doi: 10.2147/OAJSM.S133940. eCollection 2017.

https://www.dovepress.com/terms.php

and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Abstract

As more children and adolescents participate in competitive organized sports, there has been an increase in the reported incidence of anterior cruciate ligament (ACL) injuries in these age groups. ACL injuries in skeletally immature athletes present a challenge, as reconstruction must preserve the physis of the distal femur and of the proximal tibia to avoid growth disturbances. Historically, a skeletally immature athlete with an ACL injury was treated with a brace and activity modification until skeletal maturity, with ACL reconstruction being performed at that time in the “non-copers” who experienced instability. More recently, evidence has shown that delayed reconstruction may lead to increased damage to the meniscus and articular cartilage. As a result, early reconstruction is favored to protect the meniscus and allow continued physical activity. While adolescents at or those near skeletal maturity may be treated with standard reconstruction techniques, they may result in growth disturbances in younger athletes with significant growth remaining. In response to the growing need for ACL reconstruction techniques in skeletally immature individuals, physeal-sparing and physeal-respecting reconstruction techniques have been developed. In addition to the advancements in surgical technique, ACL injury prevention has also gained attention. This growing interest in ACL prevention is in part related to the high risk of ACL re-tear, either of the ACL graft or of the contralateral ACL, in children and adolescents. Recent reports indicate that well-designed neuromuscular training programs may reduce the risk of primary and subsequent ACL injuries.

KEYWORDS:

neuromuscular training; physeal-sparing; skeletally immature; surgical techniques

Resumen

A medida que más niños y adolescentes participan en deportes organizados competitivos, ha habido un aumento en la incidencia reportada de lesiones del ligamento cruzado anterior (ACL) en estos grupos de edad. Las lesiones del LCA en atletas esqueléticos inmaduros presentan un desafío, ya que la reconstrucción debe preservar la fisis del fémur distal y de la tibia proximal para evitar trastornos del crecimiento. Históricamente, un atleta esqueleto inmaduro con una lesión de ACL se trató con una ortesis y la modificación de la actividad hasta la madurez esquelética, con la reconstrucción de LCA se realiza en ese momento en el “no copers” que experimentó la inestabilidad. Más recientemente, la evidencia ha demostrado que la reconstrucción tardía puede conducir a un mayor daño al menisco y cartílago articular. Como resultado, se favorece la reconstrucción temprana para proteger el menisco y permitir la actividad física continua. Mientras que los adolescentes en o cerca de la madurez esquelética pueden ser tratados con técnicas de reconstrucción estándar, pueden dar lugar a trastornos del crecimiento en atletas más jóvenes con un crecimiento significativo restante. En respuesta a la creciente necesidad de técnicas de reconstrucción de LCA en individuos esqueléticamente inmaduros, se han desarrollado técnicas de reconstrucción que salvan fósforo y que respetan fieles. Además de los avances en la técnica quirúrgica, ACL prevención de lesiones también ha ganado la atención. Este creciente interés en la prevención del LCA se relaciona en parte con el alto riesgo de re-rasgón del LCA, ya sea del injerto del ACL o del ACL contralateral, en niños y adolescentes. Informes recientes indican que los programas de entrenamiento neuromuscular bien diseñados pueden reducir el riesgo de lesiones primarias y posteriores del LCA.

PALABRAS CLAVE:
Entrenamiento neuromuscular; Preservación fisis; Esqueleto inmaduro; Técnicas quirúrgicas

PMID: 28652828 PMCID:

PMC5476725

DOI:

10.2147/OAJSM.S133940

Free PMC Article

#Entrenamiento neuromuscular #fisis #esqueléto inmaduro #técnicas quirúrgicas

Revisión de una hemiartroplastia fallida de hombro a una artroplastia total reversa: análisis de 157 implantes revisados

http://www.lesionesdeportivas.com.mx/academia/revision-de-una-hemiartroplastia-fallida-de-hombro-a-una-artroplastia-total-reversa-analisis-de-157-implantes-revisados/

Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28751094

http://www.jshoulderelbow.org/article/S1058-2746(17)30387-7/fulltext

De:

Merolla G1,Wagner E2,Sperling JW2,Paladini P3,Fabbri E4,Porcellini G3.

J Shoulder Elbow Surg.

2017 Jul 24. pii: S1058-2746(17)30387-7. doi: 10.1016/j.jse.2017.06.038. [Epub ahead of print]

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Abstract

BACKGROUND:

There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulderarthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA.

CONCLUSION:

Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes.

KEYWORDS:

Shoulder; failed hemiarthroplasty; glenoid wear; reverse total arthroplasty; revision; rotator cuff

Resumen

ANTECEDENTES:

Sigue habiendo una escasez de estudios que examinan la conversión de la hemiartroplastia fallida (HA) a una artroplastia total del hombro reversa (RTSA). Por lo tanto, el propósito de este estudio fue examinar una gran serie de revisión HA a RTSA.

CONCLUSIÓN:

Los pacientes experimentan un alivio satisfactorio del dolor y una recuperación de la función razonable del hombro después de la revisión RTSA de una HA fallida. Hubo una tasa de revisión relativamente baja, siendo las causas más comunes el aflojamiento glenoideo y la inestabilidad.

PALABRAS CLAVE:
Hombro; Hemiartroplastia fallida; Desgaste glenoide; Artroplastia total reversa; revisión; Manguito rotador

PMID: 28751094 DOI:

10.1016/j.jse.2017.06.038

#hombro #hemiartroplastia fallida #glenoide #artroplastia total reversa #manguito rotador

Mas de salud y viajes aereos / More on health and air travel

Julio 31, 2017. No. 2766

Manejo de emergencias médicas en vuelo: ¿están preparados los estudiantes de medicina para responder a esta necesidad de la comunidad?

Management of in-flight medical emergencies: are senior medical students prepared to respond to this community need?

Katzer RJ1, Duong D2, Weber M1, Memmer A3, Buchanan I4.

West J Emerg Med. 2014 Nov;15(7):925-9. doi: 10.5811/westjem.2014.9.22569. Epub 2014 Oct 21.

Abstract

INTRODUCTION: In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medicalemergencies. METHODS: A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions) and perceived ability to respond to in-flight medical emergencies. RESULTS: 229 participants completed the survey (75% response rate). The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. CONCLUSION: This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flightmedical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medicaleducation.

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¿Es seguro el transporte aéreo para aquellos con enfermedades pulmonares?

Is air travel safe for those with lung disease?

Coker RK1, Shiner RJ, Partridge MR.

Author information

Abstract

Airlines commonly report respiratory in-flight emergencies; flight outcomes have not been examined prospectively in large numbers of respiratory patients. The current authors conducted a prospective, observational study of flight outcomes in this group. UK respiratory specialists were invited to recruit patients planning air travel. Centres undertook their usual pre-flight assessment. Within 2 weeks of returning, patients completed a questionnaire documenting symptoms, in-flight oxygen use and unscheduled healthcare use. In total, 616 patients were recruited. Of these, 500 (81%) returned questionnaires. The most common diagnoses were airway (54%) and diffuse parenchymal lung disease (23%). In total, 12 patients died, seven before flying and five within 1 month. Pre-flight assessment included oximetry (96%), spirometry (95%), hypoxic challenge (45%) and walk test (10%). Of the patients, 11% did not fly. In those who flew, unscheduled respiratory healthcare use increased from 9% in the 4 weeks prior to travel to 19% in the 4 weeks after travel. However, when compared with self-reported data during the preceding year, medical consultations increased by just 2%. In patients flying after careful respiratory specialist assessment, commercial air travel appears generally safe.

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Cuestiones de salud de los viajes aéreos.

Health issues of air travel.

DeHart RL1.

Annu Rev Public Health. 2003;24:133-51. Epub 2002 Oct 23.

Abstract

Every day in the United States the airline industry boards over 1.7 million passengers for a total of 600 million passengers per year. As these passengers enter the cabin of their aircraft few are aware of the artificial environment that will protect them from the hazards of flight. Passengers are exposed to reduced atmospheric pressure, reduced available oxygen, noise, vibration, and are subject to below zero temperatures that are only a quarter inch away-the thickness of the aircraft's skin. Over the past decade there have been both technical and lay articles written on the perception of poor cabin air quality. Studies have, in part, supported some of those concerns, but, in general, the air quality exceeds that found in most enclosed spaces on terra firma. Since the events of September 11th, passengers have not only been exposed to the physical stress of flight, but also to social and emotional stress preceding departure. There has been a significant increase in air rage on board aircraft, which poses a threat to flight safety and a fear of harm to passengers and crew. The phrase "economy class syndrome" has received popular press attention and refers to the possibility of deep vein thrombosis (DVT) in the tight confines of an aircraft cabin. Studies have been conducted that demonstrate DVT can occur in flight just as it occurs in other modes of transportation or with prolonged sitting. In part, because of the stress related to commercial flight it is not a mode of transportation for everyone. Certain cardiovascular, pulmonary, and neuropsychiatric conditions are best left on the ground. Although medical problems and death are rare in flight, they do occur, and one major airline reported 1.52 medical diversions per billion revenue passenger miles flown. To provide medical support at 36,000 ft (11,000 m) most airlines now carry on-board medical kits as well as automatic external defibrillators. A recent survey conducted by a major airline revealed that there was at least one physician on 85% of all its flights. Both passenger and cargo aircraft have proven to be vectors of disease in that they transport humans, mosquitoes, and other insects and animals who, in turn, transmit disease. Transmission to other passengers has occurred with tuberculosis and influenza. Vectors for yellow fever, malaria, and dengue have been identified on aircraft. Although there are numerous health issues associated with air travel they pale in comparison to the enormous benefits to the traveler, to commerce, to international affairs, and to the public's health.

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XIV Congreso Virtual Mexicano de Anestesiología 2017

Octubre 1-Diciembre 31, 2017

Información / Information

California Society of Anesthesiologists

Reuniones / Events

Informacion / Information