SAP Rehabilitation and Sports Medicine (Journal)
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Geriatric hip fractures treated with AO plate. Clinical and surgical Evolution
Full text linkIntroduction: Hip fracture in the elderly generates negative connotations at a functional level, in addition to the repercussions on mortality. Objective: To identify the clinical and epidemiological profile of older adults with hip fracture operated on with hemiarthroplasty by posterior approach. Method: Observational, longitudinal, ambispective and descriptive research, carried out at the "Abel Santamaría" Hospital; between 2020 and 2023. The sample consisted of 180 older adult patients with Garden III and IV hip fracture and who underwent hemiarthroplasty by the Osborne technique. For statistical analysis, the absolute and percentage frequency, the mean and the standard deviation were used. Results: 81.1% were 70 years of age or older, 62.8% were female. HBP and diabetes mellitus were present in 60.0% and 24.4% of the patients. Extracapsular fractures occurred in 61.7%; the most affected limb was the left with 59.4%; 62.2% of the patients underwent surgery within 24 hours of the event. While the Austin Moore prosthesis was implanted in 78.3%; pain and anemia were the most frequent complications. 95.6% of the patients were discharged alive, meanwhile, 68.6% had an adequate evolution 12 weeks after surgery. Conclusions: The findings described in this research reaffirm that hip fracture is an important health problem originating in older adults, and hemiarthroplasty offers high levels of satisfaction, by quickly integrating them into daily activities
Predictors of mortality in older adults with hip fracture
Full text linkThe incidence of established mortality predictors that link patients with hip fracture older than 60 years with an increase in mortality, who underwent surgery at the General Hospital "Abel Santamaría Cuadrado" from 2020 to 2022, was determined. A descriptive, prospective and longitudinal study was carried out from clinical records, data collected through the Report Information System - FCA used in the National Hip Program, from outpatient follow-up, from reports from the statistics department of the General Hospital Abel Santamaría Cuadrado and the Provincial Health Directorate. With a universe of 764 patients of which 512 entered the study, of this 68% of the sample was represented by the female sex, where the most representative age group were patients from 80 to 89 years old, which constituted 41% of the sample. The most represented comorbidities were Arterial Hypertension (88%) and Diabetes Mellitus (54%); 74% of patients underwent surgery within 24 hours and 72% were independent before surgery. The age group was 80 to 89 years, with a predominance of females, with a wide range of comorbidities, including high blood pressure and diabetes mellitus. There was a close relationship between age and mortality. Validity and family support influenced the evolution, related to the appearance of complications such as infections, thromboembolism, among others. Evidencing concatenation between some of the predictors in elderly patients operated on
Assessment of thromboembolic risk and preventive strategies in major orthopaedic surgery
Full text linkIntroduction: Venous thromboembolic disease (VTD), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), was one of the main causes of preventable mortality in hospitalized patients. Its incidence increased significantly in those who underwent hip (THA) and knee (TKA) arthroplasty, which led to the development of effective prevention strategies.Development: Risk factors associated with both the patient and the surgical procedure were identified. The Caprini scale was used to stratify them, including in orthopedic patients. In terms of pharmacological prophylaxis, anticoagulants such as low molecular weight heparins (LMWH), direct oral anticoagulants (DOAC) and aspirin (ASA) were compared. Different studies showed that ASA was similarly effective to LMWH in low-risk patients, with advantages such as lower cost and better tolerance. However, DOACs offered a slight superiority in efficacy, although with a higher risk of bleeding. Current recommendations favored a combination of pharmacological and mechanical measures such as early ambulation and the use of compression stockings.Conclusion: The prevention of VTE in major orthopedic surgery required an individualized and evidence-based approach. Aspirin emerged as a valid alternative in certain cases, without completely replacing other anticoagulants in high-risk patients. Further research was considered essential, especially in local contexts such as Argentina, to adapt strategies according to the needs of the health system
McCune-Albright syndrome case report
Full text linkIntroduction: McCune Albright syndrome (SMA) is considered a rare genetic disease, characterized by bone dysplasia, endocrine disorders and hyperpigmentary skin lesions. In SMA, postzygotic somatic mutations occur in the Gs protein gene (GNAS1) and an increase in cAMP, modifying the formation of osteoblasts and increasing bone resorption by osteoclasts, denying the hereditary nature of this disease and the possibility of rapid bone consolidation.Objective: To point out the need to deepen the knowledge of the disease for early detection and multidisciplinary care in order to avoid the consequences.Method: Retrospective observational study of the clinical history of a patient treated in the orthopedic service of the San Isidro General Hospital in Tocoa, Honduras.Results: A 13-year-old patient was admitted to the orthopedic service due to a pathological fracture of the right humerus, in which lytic lesions were observed in the humerus, radius, femur and tibia on the same side, as well as varus deformity of the right hip; café-au-lait spots on the chest and abdomen that did not respect the midline; Tanner 4 breast and pubic bone, vaginal bleeding at 3 months of age, hyperthyroidism and microprolactinoma; pathological fractures of the neck of the femur and right tibia on two occasions at 3 years of age and surgery at 6 years of age. It is interesting to note that the patient\u27s mother had café-au-lait spots on the dorsal region. Plaster treatment of the humerus fracture was performed, achieving bone consolidation at 10 weeks.The asymmetric appearance of the spots in the patient and the rapid bone consolidation are rare clinical aspects of the syndrome. The irregular treatment of her illness and its complications generated sequelae in the patient, which limited her quality of life, highlighting the need for early detection of the disease and multidisciplinary care
Characterization of hearing impairments due to exposure to industrial noise in generator set operators in Pinar del Río
Full text linkNoise-induced sensorineural hearing loss is the consequence of multifactorial damage to the auditory structures, which is why the need for this work arose. Objective: To characterize hearing disorders due to exposure to industrial noise in generator set operators in Pinar del Río in the period 2021-2023. Methods: A longitudinal, prospective, descriptive and observational study was carried out, which was validated using theoretical, empirical and statistical methods. Results: a universe of (n-65) and a sample of (n-26) workers, with a predominance of the age group between 41 and 50 years, detecting 26 cases with hearing loss for 40% of the total workers exposed to noise, with a predominance of the male sex for 100%, the hearing impaired detected are directly exposed to noise with an intensity measured between 93 and 95 decibels. Mild hearing loss was present in 50% of the affected (n-13). The use of individual protection equipment against the harmful effects of noise was deficient; it was found that only 26.92% of the workers used them (n-7). Conclusions: all the generator sets were identified as sources of high noise emissions with measured levels higher than the internationally established values. Regarding the characteristics of the audiometric curves, there was a predominance of mild and moderate hearing loss, and the partial existence of the protective equipment was found, as well as their poor use by the workers
Relationship between school furniture design and musculoskeletal problems in children: an ergonomic approach
Full text linkIntroduction: Ergonomics of school furniture is a priority issue, since mismatches between desks and children\u27s anthropometric diversity generate forced postures, discomfort and musculoskeletal problems that affect health and performance. In Peru, where obsolete furniture persists, the situation exposes to preventable risks and requires rethinking educational design from an ergonomic approach.Objective: to describe the relationship between school furniture design and musculoskeletal problems in primary school children, from an ergonomic approach, with special reference to the context of Banda de Shilcayo, Peru.Method: This literature review was developed using a qualitative approach of documentary analysis, compiling studies and official documents on school furniture, ergonomics and children\u27s musculoskeletal problems, based on searches in databases such as PubMed, Scopus, Web of Science, SciELO and Google Scholar.Development: School furniture has moved from rigid and collective benches to designs that incorporate ergonomic criteria and international standards. However, mismatches persist between the dimensions of the furniture and children\u27s anthropometry, which generates problems with progressive consequences: in the short term they cause discomfort and distraction, in the medium term they generate chronic postural alterations, and in the long term they predispose to lumbago, hernias and scoliosis. Studies in several countries report high rates of mismatch and its association with back pain and risk of spinal deformities. Conclusions: Incorrectly designed dimensions of school furniture have significant effects on the musculoskeletal health of schoolchildren; they generate immediate discomfort, postural alterations and health risks if not corrected
Prevention of falls in older adults: analysis of effective interventions
Full text linkoai:ri.ageditor.ar:article/4Background: Accidental falls in older adults represent a phenomenon of recurrence and considerable severity since they affect the loss of independence and reduce the person\u27s mobility capabilities, which contributes to premature admission of older adults to nursing homes in the short or long term. long term. It is imperative to study the effective prevention of these events to improve the quality of life of this population. The objective is to analyze effective interventions to prevent accidental falls and their physical consequences to improve the quality of life of older adults and sociodemographically identify samples of collected studies, determine influential risk factors in accidental falls, characterize types of preventive interventions and specify effectiveness. of these interventions. Material and methods: The methodology applied was a systematic review of the bibliography, retrospective, prospective and qualitative, carried out using a data registration form obtained from academic articles published from 2019 to 2024 according to inclusion criteria. The material used was 11 studies or systematic reviews related to the stated inclusion criteria. Results: The influencing risk factors are internal, such as cognitive and neuronal conditions mostly, which affects both men and women over 60 years of age. The most effective preventive interventions are multicomponent ones (exercise+cognitive therapy+professional education+technology) and comprehensive physical exercise, with a high level of fall reduction and noticeable physical improvement in the individual. Other interventions generate relative effects conditioned by time of application, age or preferences of the older adult. Conclusion: The effectiveness of preventive interventions for falls in older adults in association with the risk factors that influence these accidents should be further explored.
Comprehensive management of osteitis pubis in high performance sports
Full text linkOsteitis pubis was described as a painful inflammation of the pubic symphysis, common in athletes who performed repetitive movements such as kicking, turning and changing direction. Symptoms included pain in the front of the pelvis, radiating to the groin and difficulty with activities such as running or climbing stairs. Its diagnosis was based on clinical evaluations and imaging studies, such as X-rays and magnetic resonance imaging. Treatment required a multidisciplinary approach combining relative rest, physiotherapy, physical therapies, anti-inflammatory medication and, in severe cases, surgery. In Argentina, this condition significantly affected athletes, especially in disciplines such as soccer, rugby and hockey, so prevention and rehabilitation programs were implemented in sports centers
Intervention of the Rehabilitation Nurse in Person after Stroke: Case Report
Full text linkIntroduction: In Portugal, one of the main causes of incapacity and disability is Cerebrovascular Diseases, constituting one of the main causes of death and morbidity.Objective: To describe the benefits of implementing a Rehabilitation Nursing plan in a person with sequelae of a Stroke.Case Report: This is a case report that you followed the EQUATOR Network Case Report Guidelines. With the implementation of the Rehabilitation Program, there were improvements in the patient with Stroke at various levels, namely in body balance, muscle strength and self-care capacity.Conclusion: The functional recovery of a patient with a stroke is directly related to the intervention of the Rehabilitation Nurse, promoting their autonomy and independence in daily life activities
Pharmacological prophylaxis of choice in venous thromboembolic disease in major orthopedic surgery: aspirin vs LMWH and other anticoagulants
Full text linkIntroduction: Venous thromboembolic disease, deep vein thrombosis and pulmonary embolism are important causes of long-term morbidity and mortality, and are preventable. The risk of VTE is established in patients who will undergo major orthopedic surgery, given by factors such as the duration of surgery and reduced perioperative mobility.Studies show that without pharmacological thrombo prophylaxis, VTE rates are significant. For this reason, it is essential to establish an effective thrombo prophylaxis protocol to prevent VTE without significantly increasing the risk of bleeding. There is no evidence with strong results regarding the drug of choice for thrombo prophylaxis, but currently meta-analyses and systematic reviews establish aspirin as an effective, accessible and low-cost option, with low risk of postoperative bleeding in low-risk patients.Aspirin is an easy-to-administer drug, does not require blood monitoring and is well tolerated, with an excellent safety profile. However, there are some theories that newer oral agents may have higher risks of bleeding, such as major hemorrhages and complications from postsurgical wounds. Therefore, there is still considerable debate about which agents should be preferred in terms of effectiveness and lower risk of bleeding.Objectives: To establish the drug of choice for thromboprophylaxis in VTE in patients undergoing major orthopedic surgery.Materials and methods: A bibliographic search and analysis was carried out, only 15 articles were suitable for the research, articles from international databases such as PubMed, Scopus and Cinahl were used.Results: There were no significant differences in the risk of VTE (OR = 0.93; 95% CI: 0.69-1.26; p = 0.64), DVT (OR = 0.72; 95% CI: 0.43-1.20; p = 0.21) or PTE (OR = 1.13; 95% CI: 0.86-1.49; p = 0.38) between the groups that received LMWH prophylaxis and those that received aspirin. Nor were significant differences found in mortality (p = 0.30), bleeding (p = 0.22), or surgical wound complications (p = 0.85) between the two groups.Conclusion: aspirin is at least as safe and effective a drug for thromboprophylaxis as OACs and LMWH