sábado, 23 de septiembre de 2017

Artroplastia reversa de hombro en pacientes con artritis reumatoide: una revisión sistemática


Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Systematic Review

Fuente
Este artículo es originalmente publicado en:
De:
2017 Sep;9(3):325-331. doi: 10.4055/cios.2017.9.3.325. Epub 2017 Aug 4.
Todos los derechos reservados para:
Received 2016 Jun 30; Accepted 2017 Jun 4.
© 2017 by The Korean Orthopaedic AssociationThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
BACKGROUND:
There are limited data available regarding the results of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). We performed a systematic review of the literature to investigate the radiological and clinical outcomes after RSA in patients with RA.
CONCLUSIONS:
RSA in RA showed similar short- to mid-term results without higher complication rates as compared to RSA in cuff tear arthropathy. Although RSA can be considered a reliable treatment option in patients with RA, further large-scale studies are required to determine the long-term survival of the implant.
KEYWORDS:
Complication; Outcome; Reverse shoulder arthroplasty; Rheumatoid arthritis
Resumen
ANTECEDENTES:
Hay pocos datos disponibles sobre los resultados de la artroplastia reversa de hombro (RSA) en pacientes con artritis reumatoide (AR). Se realizó una revisión sistemática de la literatura para investigar los resultados radiológicos y clínicos después de RSA en pacientes con AR.
CONCLUSIONES:
RSA en la AR mostraron resultados similares a corto y mediano plazo sin mayores tasas de complicaciones en comparación con RSA en la artropatía del desgarro del manguito. Aunque RSA puede considerarse una opción de tratamiento confiable en pacientes con AR, se requieren estudios adicionales a gran escala para determinar la supervivencia a largo plazo del implante.
PALABRAS CLAVE:
Complicación; Resultado; Artroplastia reversa del hombro; Artritis reumatoide
PMID:  28861200  PMCID:  PMC5567028   DOI:   10.4055/cios.2017.9.3.325

Revisión a la Artroplastia Total de Hombro Reversa Restablece la Estabilidad para Pacientes con Prótesis de Hombro Inestable.


Revision to Reverse Total Shoulder Arthroplasty Restores Stability for Patients With Unstable Shoulder Prostheses.

Fuente
Este artículo es publicado originalmente en:
De:
2017 Aug 28. doi: 10.1007/s11999-017-5429-z. [Epub ahead of print]
Todos los derechos reservados para:

Copyright information

© The Association of Bone and Joint Surgeons® 2017

Abstract
BACKGROUND:
Instability after shoulder arthroplasty remains a complication with limited salvage options. Reoperation for instability with anatomic designs has led to high rates of persistent instability, therefore we aimed to evaluate the use of RSA for treatment of prosthetic instability.
QUESTIONS/PURPOSES:
(1) After revision shoulder arthroplasty to a reverse prosthesis (RSA), what is the survivorship free from dislocations at 2 and 5 years? (2) What factors are associated with dislocations? (3) What is the survivorship free from revision after revision to RSA? (4) From preoperation to postrevision to RSA, what are the clinical outcomes-the proportion of patients with moderate to severe pain, shoulder elevation and external rotation ROM, American Shoulder and Elbow Surgeons scores, and Simple Shoulder Test scores?
CONCLUSIONS:
Revision RSA for prosthetic instability after shoulder arthroplasty is associated with reasonable implant survival and few complications. Approximately one in seven patients will have a recurrent dislocation. In patients with persistent instability or with risk factors for instability, consideration should be given for use of larger glenospheres and increasing the lateral offset at the time of RSA.


Resumen
ANTECEDENTES:
La inestabilidad después de la artroplastia del hombro sigue siendo una complicación con limitadas opciones de rescate. La reintervención de la inestabilidad con diseños anatómicos ha conducido a altas tasas de inestabilidad persistente, por lo tanto, se trató de evaluar el uso de RSA para el tratamiento de la inestabilidad protésica.
PREGUNTAS / PROPÓSITOS:
(1) Después de una artroplastia de hombro de revisión a una prótesis inversa (RSA), ¿cuál es la supervivencia libre de dislocaciones a los 2 y 5 años? (2) ¿Qué factores están asociados con las dislocaciones? (3) ¿Cuál es la supervivencia libre de revisión después de la revisión a RSA? (4) De la preoperación a la postratamiento a RSA, ¿cuáles son los resultados clínicos-la proporción de pacientes con dolor moderado a severo, elevación del hombro y ROM de rotación externa, los resultados de American Shoulder and Elbow Surgeons y los resultados de Simple Shoulder Test?
CONCLUSIONES:
Revisión RSA para la inestabilidad protésica después de la artroplastia del hombro se asocia con una supervivencia razonable implante y pocas complicaciones. Aproximadamente uno de cada siete pacientes presentará una dislocación recurrente. En pacientes con inestabilidad persistente o con factores de riesgo de inestabilidad, se debe tener en cuenta el uso de glenosferas mayores y aumentar el desplazamiento lateral en el momento de RSA.
PMID:   28849539    DOI:  

jueves, 21 de septiembre de 2017

Todos con México

Septiembre 20, 2017. No. 2817-A



  


Los huracanes y los terremotos han golpeado a México una manera cruel. La devastación, la muerte y mil desgracias son el tema actual, y nosotros los Mexicanos nos hemos unido en gran apoyo a aquellos que han sido afectados por la Madre Naturaleza.

Hurricanes and earthquakes have hit México in a crude way. Devastation, death and a thousand misfortunes are the current theme, and we Mexicans have united in great support for those who have been affected by Mother Nature. 

Furacões e terremotos atingiram o México de uma maneira grosseira. A devastação, a morte e mil desgraças são o tema atual, e nós, os mexicanos, nos unimos em grande apoio para aqueles que foram afetados pela Mãe Natureza.

Enlaces para donar / Links to donate
Larga duración del movimiento de tierra en el valle paradigmático de México.
Long Duration of Ground Motion in the Paradigmatic Valley of Mexico.
Sci Rep. 2016 Dec 9;6:38807. doi: 10.1038/srep38807.
Evacuación de hospitales durante un desastre, establecimiento de un hospital de campo y comunicación.
Evacuation of Hospitals during Disaster, Establishment of a Field Hospital, and Communication.
Abstract
Eurasian J Med. 2017 Jun;49(2):137-141. doi: 10.5152/eurasianjmed.2017.16102. Epub 2017 Apr 28.
The buildings, working personnel, and patients and their relatives may directly or indirectly be affected by the disasters. Here we will discuss evacuation, establishing a field hospital, communication, the role of the media in disasters, and defending against sabotage. The affected individuals should be evacuated and transferred to secure zones safely and rapidly. How the decision for evacuation should be made and how the evacuation triage should be performed are important issues. Field hospitals should be established within the bounds of possibility for continuation of the treatments of evacuated people. The standards for the field hospitals and its sections that may be created according to the needs will be explained. Undoubtedly, since one of the most important subjects in disasters is communication, the types of communication in disasters and their significance will be mentioned. How the relationships with the media should be an aspect of communication and how they can be beneficially used will also be mentioned. As in all organizations and institutions, sabotage attempts may also be present concerning health facilities. For this reason, during the preparation of the hospital disaster plan, defending against sabotage will be discussed, and what should be done at that stage will be mentioned.
KEYWORDS: Disaster; evacuation; field hospital
Comprensión de la detección de animales de los sonidos precursores del terremoto.
Understanding Animal Detection of Precursor Earthquake Sounds.
Animals (Basel). 2017 Aug 31;7(9). pii: E66. doi: 10.3390/ani7090066.
Abstract
We use recent research to provide an explanation of how animals might detect earthquakes before they occur. While the intrinsic value of such warnings is immense, we show that the complexity of the process may result in inconsistent responses of animals to the possible precursor signal. Using the results of our research, we describe a logical but complex sequence of geophysical events triggered by precursor earthquake crustal movements that ultimately result in a sound signal detectable by animals. The sound heard by animals occurs only when metal or other surfaces (glass) respond to vibrations produced by electric currents induced by distortions of the earth's electric fields caused by the crustal movements. A combination of existing measurement systems combined with more careful monitoring of animal response could nevertheless be of value, particularly in remote locations.
KEYWORDS: animal behavior; earthquake prediction; electrophonics; infrasound; sound detection
Desastres naturales e indicadores de cohesión social.
Natural disasters and indicators of social cohesion.
PLoS One. 2017 Jun 7;12(6):e0176885. doi: 10.1371/journal.pone.0176885. eCollection 2017.
Abstract
Do adversarial environmental conditions create social cohesion? We provide new answers to this question by exploiting spatial and temporal variation in exposure to earthquakes across Chile. Using a variety of methods and controlling for a number of socio-economic variables, we find that exposure to earthquakes has a positive effect on several indicators of social cohesion. Social cohesion increases after a big earthquake and slowly erodes in periods where environmental conditions are less adverse. Our results contribute to the current debate on whether and how environmental conditions shape formal and informal institutions.
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Anestesiología y Medicina del Dolor

52 664 6848905

Luxación de codo / Elbow dislocation


Fuente
Este artículo es originalmente publicado en:
De:
2017 Mar 9. pii: S1138-3593(17)30031-X. doi: 10.1016/j.semerg.2017.01.005. [Epub ahead of print]
Todos los derechos reservados para:
Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.Resumen
La luxación de codo es la luxación más frecuente en extremidad superior tras la luxación glenohumeral. La reducción cerrada en aquellas luxaciones en que no hay lesión ósea asociada es un procedimiento realizable en el ámbito extrahospitalario, por lo que presentamos un repaso de las diferentes técnicas posibles.
Abstract
Elbow dislocation is the most frequent dislocation in the upper limb after shoulder dislocation. Closed reduction is feasible in outpatient care when there is no associated fracture. A review is presented of the different reduction procedures.
Palabras clave
Codo, Luxación, Atención extrahospitalaria
Keywords
Elbow, Dislocation, Outpatient care
PMID:  28285907    DOI: 10.1016/j.semerg.2017.01.005