Revisiones_bibliográficas TyO

lunes, 20 de marzo de 2017

Reconstrucción anatómica de la cabeza humeral con aloinjerto de talus osteocondral fresco para inestabilidad glenohumeral recurrente con lesión de Hill-Sachs inversa

http://www.mihombroycodo.com.mx/academia/reconstruccion-anatomica-de-la-cabeza-humeral-con-aloinjerto-de-talus-osteocondral-fresco-para-inestabilidad-glenohumeral-recurrente-con-lesion-de-hill-sachs-inversa/

Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion

Fuente
Este artículo es originalmente publicado en:

http://www.arthroscopytechniques.org/article/S2212-6287%2816%2930199-2/fulltext#.WLz5SmvuKgo.twitter

De:

Matthew T. Provencher, M.D.Correspondence information about the author M.D. Matthew T. Provencher

George Sanchez, B.S., Katrina Schantz, P.A.-C., Marcio Ferrari, M.D., Anthony Sanchez, B.S.,

Salvatore Frangiamore, M.D., Sandeep Mannava, M.D., Ph.D.

Artículo en PRENSA

DOI: http://dx.doi.org/10.1016/j.eats.2016.10.017

The treatment of recurrent glenohumeral instability, especially with a concomitant bony lesion, remains challenging. This is especially true in the case of posterior instability given its less common incidence. Moreover, the presence of an engaging reverse Hill-Sachs lesion in combination with posterior instability will result in the need for a more aggressive treatment option. In comparison with a Hill-Sachs lesion, a reverse Hill-Sachs lesion features greater chondral deficiency that must be addressed during treatment. We propose the talus allograft as a potential allograft for treatment of an engaging reverse Hill-Sachs lesion. The superior articular surface of the talus may be used to reconstruct the articular surface of the humeral head. In this technical note, we describe our preferred primary technique for treatment of an engaging reverse Hill-Sachs lesion with recurrent glenohumeral instability through use of a fresh osteochondral talus allograft, as well as discuss the advantages and disadvantages of this allograft option.

El tratamiento de la inestabilidad glenohumeral recurrente, especialmente con una lesión ósea concomitante, sigue siendo un reto. Esto es especialmente cierto en el caso de la inestabilidad posterior dada su incidencia menos común. Además, la presencia de una lesión inversa Hill-Sachs inversa en combinación con la inestabilidad posterior resultará en la necesidad de una opción de tratamiento más agresiva. En comparación con una lesión de Hill-Sachs, una lesión inversa de Hill-Sachs presenta una mayor deficiencia de condral que debe ser abordada durante el tratamiento. Proponemos el aloinjerto del astrágalo como un posible aloinjerto para el tratamiento de una lesión de Hill-Sachs inversa. La superficie articular superior del astrágalo se puede utilizar para reconstruir la superficie articular de la cabeza humeral. En esta nota técnica describimos nuestra técnica primaria preferida para el tratamiento de una lesión inversa de Hill-Sachs inversa con inestabilidad glenohumeral recurrente mediante el uso de un aloinjerto de talud osteocondral fresco, así como discutir las ventajas y desventajas de esta opción de aloinjerto.

Articles in Press

#Hill-Sachs Lesion #Glenohumeral Instability #Osteochondral Talus Allograft #Anatomic Humeral Head Reconstruction #Reconstrucción anatómica #cabeza humeral #aloinjerto #talus osteocondral #inestabilidad glenohumeral

Llegando y a cirugía la urgencia Findmed, Ortospine

http://www.clinicadeartroscopia.com.mx/academia/llegando-y-a-cirugia-la-urgencia-findmed-ortospine/

#cirugía de columna #columna vertebral #urgencia #hernia

Abordaje anterolateral para fractura del pilón

http://www.cirugiadepieytobillo.com.mx/academia/abordaje-anterolateral-para-fractura-del-pilon/

Anterolateral Approach for Pilon fracture

Fuente
Este artículo es originalmente publicado en:

https://vimeo.com/147857113

Courtesy: The Orthopaedic Trauma Association

Planning to attend the OTA2016 Meeting at Maryland, USA?
Visit, www.ota.org

Anterior Lateral Approach Pilon – Lindsay E. Hickerson, MD from Orthopaedic Trauma Association on Vimeo.

Anterior Lateral Approach Pilon - Lindsay E. Hickerson, MD from Orthopaedic Trauma Association on Vimeo.

#fracturas #pilón tibial #abordaje #anterolateral

Sepsis en el anciano / Sepsis in elderly patients

Marzo 19, 2017. No. 2633

Sepsis e inmuno senescencia en el paciente anciano. Una revisión

Sepsis and Immunosenescence in the Elderly Patient: A Review.

Martín S1, Pérez A1, Aldecoa C2.

Front Med (Lausanne). 2017 Feb 28;4:20. doi: 10.3389/fmed.2017.00020. eCollection 2017.

Abstract

Sepsis is a prevalent, serious medical condition with substantial mortality and a significant consumption of health-care resources. Its incidence has increased around 9% annually in general population over the last years and specially in aged patients group. Several risk factors such as comorbidities, preadmission status, malnutrition, frailty, and an impared function in the immune system called immunosenescence are involved in the higher predisposition to sepsis in the elderly patients. Immunosenescence status consists in a functional impairment in both cell-mediated immunity and humoral immune responses and increases not only the risk for develop sepsis but also lead to more severe presentation of infection and may be is also related with a higher mortality. There is a also a concern about to admit patients in the intensive care units taking into account that the outcome of elderly patients is poorer compared to younger people. Nevertheless, the management of septic elderly patients does not differ substantially from younger people. In addition, the quality of life in septic elderly survivors is also lower than in younger people. But age, as alone factor, should not be used to determine treatment options because the poorer outcomes is thought to be due to the increased comorbidities and frailty in this group of patients.

KEYWORDS: elderly patients; immunosenescence; outcome; quality of life; sepsis

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Disminución del músculo esquelético como factor de riesgo en ancianos con sepsis. Estudio retrospectivo de cohortes

Decreasing skeletal muscle as a risk factor for mortality in elderly patients with sepsis: a retrospective cohort study.

Shibahashi K1, Sugiyama K1, Kashiura M1, Hamabe Y1.

J Intensive Care. 2017 Jan 11;5:8. doi: 10.1186/s40560-016-0205-9. eCollection 2017.

Abstract

BACKGROUND: Older patients account for the majority of patients with sepsis. The objective of this study was to determine if decreased skeletal muscle mass is associated with outcomes in elderly patients with sepsis. ,, CONCLUSIONS: Less skeletal muscle mass is associated with higher in-hospital mortality in elderly patients with sepsis. The results of this study suggest that identifying patients with low muscularity contributes to better stratification in this population.

KEYWORDS: Intensive care; Mortality; Sarcopenia; Sepsis

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