Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
Trials. 2017 Mar 16;18(1):127. doi: 10.1186/s13063-017-1868-9.
Abstract
BACKGROUND: Currently, patients older than 60 years of age represent 25% of the population and are at an increased risk during surgery. Therefore, reducing postoperative morbidity and mortality is a major concern in medical research and practice. Dependence on caregivers and cognitive impairment represent two major risk factors in the elderly, especially in frail patients after surgery under general anesthesia. In this context, continuous monitoring of the depth of anesthesia using a bispectral index (BIS) sensor may reduce the occurrence of impairments by gaining better control of the anesthetic depth. The first aim of this study is to compare manual versus automated administration of intravenous anesthetics with regard to 6-month functional decline in persons aged 70 years and older. The secondary objective includes an evaluation of the influence of the frail phenotype on self-sufficiency in elderly patients after general anesthesia. METHODS/DESIGN: After receiving ethical committee approval and written consent, a complete preoperative assessment of physiological reserve and self-sufficiency will be performed on patients more than 70 years old who are scheduled for surgery under general anesthesia. This evaluation will determine the patient's frailty status in three categories: robust, pre-frail, and frail. Then, patients will be randomized into two groups: manual administration of anesthetics guided by BIS sensor (manual group) or automated administration (automated group) with recording of the anesthesia. A second examination will be scheduled after 6 months to assess changes in functional abilities, cognitive functions, and frailty status. A priori calculation of sample size gives a population of 430 patients to be included in this multicenter trial. DISCUSSION: This clinical study is designed to detect any postoperative complications and deaths related to the performance of the general anesthesia guided by the BIS sensor and the preoperative functional status of the elderly: robust, pre-frail, or frail.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT02524327 . Registered on 10 August 2015.
¿Es efectivo un esquema antibiótico acortado para el tratamiento de la faringoamigdalitis bacteriana en niños? Rojas-Ramírez C; Kramer-Urrutia T; Cifuentes L (Chile) Medwave2017;17(Suppl1):e6873
¿Es efectiva la prevención primaria con anticonvulsivantes en tumores o metástasis cerebrales? Diego Lobos-Urbina, Lucas Kittsteiner-Manubens, José Peña (Chile). Medwave2017;17(Suppl1):e6871
ESTUDIO PRIMARIO
Asociación del antecedente transfusional antes de 1994 con hepatitis vírica tipo C en mujeres Christian Ramos Flores, Ernesto Echeagaray, Guadalupe Castañeda, Maria de Lourdes Vargas, Raúl Montes-González, Susana Luna, Laura Díaz, Oscar Torres (México) Medwave 2017 Mar;17(2):e6886
EDITORIAL
Colaboración íbero-americana en Medwave a propósito del Día Mundial del Corazón Alberto Morales Salinas, Adrian Baranchuk, Antoni Bayés de Luna (Internacional) Medwave 2017 Mar;17(2):e6883
CARTAS A LA EDITORA
Cartas al editor en investigación medica Irina Suley Tirado Pérez, Andrea Carolina Zárate Vergara (Colombia) Medwave 2017;17(2):e6881
Running is one of the most popular sports worldwide, with running events attracting hundreds of thousands of runners of all age groups. Running is an effective way to improve health but is also associated with a high risk of injuries. Up to 50% of regular runners report having more than one injury each year. Some injuries are caused by an accident but most are caused by overuse. The most frequent diagnoses are patellofemoral pain syndrome, tibial stress syndrome (shin splint), Achilles tendinopathy, iliotibial band friction syndrome (runner’s knee), plantar fasciitis and stress fractures of the metatarsals and tibia. The knee is the most frequently injured joint in runners at all distances. Hamstring injuries are typically acute resulting in a sudden, sharp pain in the posterior thigh. Hip injuries are less common but it can be more difficult to make the correct diagnosis and treatment is more complex. Clinicians confronted by runners with shin pain must distinguish between stress fractures of the tibia, tibial stress syndrome (shin splints) and chronic exertional compartment syndrome. Foot and ankle injuries are the most common injuries reported by long distance and marathon runners. Excess body weight and the number of kilometers run per week are high risk factors for injuries. The roles of other factors, such as shoes, stretching and biomechanics are less clear. A detailed anamnesis and physical examination are important for the correct diagnosis or the necessity for further diagnostic imaging and subsequent therapy.
KEYWORDS:
Compartment syndrome; Injuries; Nail injuries; Risk factors; Running
Resumen
Correr es uno de los deportes más populares por todo el mundo, con los acontecimientos corrientes que atraen a centenares de millares de corredores de todas las edades. Correr es una manera efectiva de mejorar la salud, pero también está asociada con un alto riesgo de lesiones. Hasta el 50% de los corredores reportan tener más de una lesión cada año. Algunas lesiones son causadas por un accidente pero la mayoría son causadas por el uso excesivo. Los diagnósticos más frecuentes son el síndrome de dolor patelofemoral, el síndrome de estrés tibial, la tendinitis de Aquiles, el síndrome de fricción de la banda iliotibial (rodilla del corredor), la fascitis plantar y las fracturas por estrés de los metatarsianos y la tibia. La rodilla es la articulación más frecuentemente lesionada en los corredores a todas las distancias. Las lesiones en el tendón de la corva son típicamente agudas, dando como resultado un dolor repentino y agudo en el muslo posterior. Las lesiones de cadera son menos comunes, pero puede ser más difícil hacer el diagnóstico correcto y el tratamiento es más complejo. Los clínicos confrontados por corredores con dolor de tibia deben distinguir entre fracturas por estrés de la tibia, síndrome de estrés tibial (férulas de la espinilla) y síndrome compartimental crónico del ejercicio. Las lesiones de pie y tobillo son las lesiones más comunes reportadas por corredores de larga distancia y maratón. El exceso de peso corporal y el número de kilómetros recorridos por semana son factores de alto riesgo de lesiones. Las funciones de otros factores, como los zapatos, el estiramiento y la biomecánica, son menos claras. Una anamnesis detallada y un examen físico son importantes para el diagnóstico correcto o la necesidad de imágenes diagnósticas adicionales y terapia subsiguiente.
PALABRAS CLAVE: Síndrome compartimental; Lesiones; Lesiones por clavos; Factores de riesgo; Corriendo
