169,773 research outputs found
Revisão da literatura de detecção precoce do deslocamento incudomallear por imagens tomográficas
Get PDFIntroducción: Esta revisión hace énfasis en la luxación incudomaleolar. Aunque poco frecuente, es una patologÍa con gran relevancia clÍnica debido a la afectación de la audición a corto y mediano plazo en los pacientes, afectando asÍ su calidad de vida, por lo que es necesario un diagnóstico oportuno para un tratamiento temprano y eficaz. Objetivo: describir los hallazgos imagenológicos e identificar los diferentes mecanismos etiológicos de la luxación incudomaleolar. MetodologÍa: Se realizó una revisión bibliográfica en PubMed de los artÍculos publicados hasta febrero de 2015 con las palabras claves: "Ear ossicles "; "Temporal bone "; "Bone "; "Fractures "; "Dislocation "; "Conductive hearing loss ". Se encontraron 352 artÍculos de los cuales se seleccionaron aquellos donde se menciona la luxación incudomaleolar. Resultados: Se revisaron los abstracts de los 352 artÍculos, encontrando 20 donde mencionaban la definición, la epidemiologÍa, la clÍnica y el diagnóstico imagenológico de la luxación incudomaleolar, los cuales fueron utilizados para la elaboración de esta revisión. Conclusiones: La principal causa de daño en la cadena de huesecillos es la fractura del hueso temporal y dentro de las patologÍas que puede generar está la luxación incudomaleolar, por lo que es de interés el diagnóstico temprano a todos los pacientes con sospecha clÍnica para llegar a prevenir complicaciones. La revisión de la literatura permite concluir que la técnica más eficaz para la identificación de la luxación Incudomaleolar es la tomografÍa computarizada, la cual requiere una adecuada identificación en los diferentes cortes multiplanares, o en las reconstrucciones 3D para poder diagnosticarla. [Lubinus-Badillo F, Zuñiga-Hadechni E, Reyes-álvarez LY, Plata-Cano IF, Plata-Cano JF. Revisión bibliográfica de la detección temprana de luxación incudomaleolar mediante imágenes tomográficas. MedUNAB 2016; 18(3): 213-217].Introduction: This research emphasizes in the incudomallear dislocation. Although it is rare, it is a disease with great clinical relevance due to the short and long term involvement of patients' hearing so that it affects their quality of life, so it is very important a timely diagnosis for an early and effective treatment. Objective: To describe the imaging findings and identify the different etiologic mechanisms of incudomallear dislocation. Methodology: A literature review was carried out in PubMed about articles published until February 2015 with the keywords: "Ear ossicles"; "Temporal bone"; "Bone," "Fractures"; "Dislocation"; "Conductive hearing loss" finding 352 articles and selecting those that mentioned the incudomallear dislocation. Results: The abstracts of 352 articles were examined and 20 of them mentioned the definition, epidemiology, clinical and imaging diagnosis of incudomallear dislocation, and they were used to prepare this research. Conclusions: The main cause of damage to the ossicles is the temporal bone fracture, and among the diseases that this can produce, there is the incudomallear dislocation, therefore it is of great interest a timely diagnosis to all patients with clinical suspicion to prevent complications. The literature review allows us to conclude that the most effective technique to identify the incudomallear dislocation is computed tomography, which requires proper identification in different multiplanar cuts, or 3D reconstructions to diagnose it. [Lubinus-Badillo F, Zuñiga-Hadechni E, Reyes-álvarez LY, Plata-Cano IF, Plata-Cano JF. Literature Review of Early Detection of Incudomalleolar Dislocation by Using Tomographic Imaging. MedUNAB 2016; 18(3): 213-217].Introdução:Estarevisãoenfatizaodeslocamento incudomallear. Embora seja raro, é uma doença de grande relevância clínica por causa do envolvimento da audição em pacientes a curto e a longo prazo, afetando sua qualidade de vida, por isso é muito importante o diagnóstico e assim poder realizar o tratamento precoce e eficaz. Objetivos:Descrever o diagnostico da imagem e identificar os diferentes mecanismos etiológicos da luxação incudomallear. Metodologia: Arevisão da literatura foi realizada no PubMed para artigos publicados até fevereiro de 2015, com as palavras-chave: "ossículos do ouvido"; "Osso temporal"; "Osso", "fraturas"; "Deslocamento"; "A perda auditiva condutiva" foram encontrados 352 artigos e selecionadosaquelesquemencionamodeslocamento incudomallear. Resultados:Foram revisados os resumos de 352 artigos e se encontrou que 20 artigos mencionavam a definição, epidemiologia, diagnóstico clínico e de imagem de incudomallear deslocamento, que foram utilizados para a preparação desta revisão. Conclusões:Aprincipal causa de danosaosossículoséafraturadoossotemporaleo deslocamentoincudomallearéumadaspatologiasque poderia ocorrer, por esta causa é muito importante obter o diagnostico oportunamente e fazer o respectivo tratamento evitando então, graves complicações. Arevisão da literatura permite-nosconcluirquedatécnicamaiseficazparaa identificação de deslocamento incudomallear é a tomografia computadorizada, o que exige uma identificação adequada nos diferentes cortes multiplanares, ou reconstruções 3D para diagnosticar. [Lubinus-Badillo F, Zuñiga-Hadechni E, Reyes-Álvarez LY, Plata-Cano IF, Plata-Cano JF. Revisão da literatura de detecção precoce do deslocamento incudomallear por imagens tomográficas. MedUNAB2016; 18(3): 213-217
Lesiones testiculares benignas: hallazgos ecográficos
Get PDFResumenLa ecografía doppler color testicular es el examen de elección para el estudio de masas intraescrotales, cuando se presentan síntomas como dolor testicular sin causa aparente, también en pacientes con trauma testicular o para diferenciar una torsión de un proceso infeccioso. En este artículo se realiza una revisión de las lesionesbenignas que pueden afectar los testículos, incluyendo los hallazgos ultrasonográficos que en algunos casos son de diagnóstico incidental pero de gran importancia, ya que de acuerdo a la etiologíay su diferenciación con procesos patológicos malignos, dependerá en gran parte la preservación de este órgano, indispensable para lafertilidad masculina.[Lubinus Badillo F, Buitrago Aguilar C. Lesiones testáculares benágnas: hallazgos ecográfácos. jedrNAB 2MM6; 9: N2M-N27z].Palabras clave: Lesiones testiculares benignas, ecografía testicular quistes testiculares
The Lubinus patellofemoral arthroplasty
No full text We present a prospective review of the outcome of 76 Lubinus patellofemoral arthroplasties carried out in 59 patients between 1989 and 1995. At a mean follow-up of 7.5 years, 62 knees in the 48 patients were reviewed; 11 patients (14 knees) had died. None was lost to follow-up. The clinical outcome using the Bristol Knee Scoring system was satisfactory in 45% of the cases. Maltracking of the patella, resulting in lateral tilt, subluxation and polyethylene wear, was the most common complication (32%). Revision surgery was carried out in 21 knees (28%) giving a cumulative survival rate of 65% (confidence interval (CI) 49 to 77) at eight years. The survival rate for revision and moderate pain was 48% (CI 36 to 59) at six years. Progression of arthritis was seen in seven cases (9%). In five of these (6.5%), the symptoms were severe enough to need revision surgery. Due to the high proportion of unsatisfactory results, we have discontinued the use of this prosthesis. </jats:p
Excellent results with the cemented Lubinus SP II 130-mm femoral stem at 10 years of follow-up
Get PDFBackground and purpose - The Lubinus SP II stem is well documented in both orthopedic registries and clinical studies. Worldwide, the most commonly used stem lengths are 150 mm and 170 mm. In 1995, the 130-mm stem was introduced, but no outcome data have been published. We assessed the long-term survival of the Lubinus SP II 130-mm stem in primary total hip arthroplasty. Patients and methods - In a retrospective cohort study, we evaluated 829 patients with a Lubinus SP II primary total hip arthroplasty (932 hips). The hips were implanted between 1996 and 2001. The primary endpoint was revision for any reason. The mean follow-up period was 10 (5-15) years. Results - Survival analysis showed an all-cause 10-year survival rate of the stem of 98.7% (95% CI: 99.7-97.7), and all-cause 10-year survival of the total hip arthroplasty was 98.3% (95% CI: 99.3-97.3). Interpretation - Excellent long-term results can be achieved with the cemented Lubinus SP II with the relatively short 130-mm stem. This stem has potential advantages over its 150-mm and 170-mm siblings such as bone preservation distal to the stem, better proximal filling around the prosthesis, and easier removal
Septo-optic dysplasia (Morsier syndrome)
Get PDFSe presentan dos casos de displasia septoóotica o Síndrome de Morsier, una entidad del sistema nervioso que sólo se puede confirmar por medio de neuroimágenes. Estas consisten en ausencia de septum pellucidum, agenesia de cuerpo calloso, atrofia cerebelosa, porencefalia, dilatación ventricular y lipomas o quistes cerebrales, junto con neurohipófisis ectópica, aplásica o hipoplásica. El cuadro clínico es variable, dependiendo del grado de compro-miso del nervio óptico, la función hipotalamica y las alteraciones asociadas. El pronóstico en general es bueno. [Lubinus F, Castillo CE. Displasia septoóptica (Sindrome de Morsier).Two cases of septootic dysplasia or Morsier Syndrome are presented, an entity of the nervous system that can only be confirmed through neuroimaging. These consist of absence of septum pellucidum, agenesis of the corpus callosum, cerebellar atrophy, porencephaly, ventricular dilation and cerebral lipomas or cysts, together with ectopic, aplastic or hypoplastic neurohypophysis. The clinical picture is variable, depending on the degree of optic nerve involvement, hypothalamic function and associated alterations. The general prognosis is good. [Lubinus F, Castillo CE. Septo-optic dysplasia (Morsier syndrome)
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Increased risk for postoperative periprosthetic fracture in hip fracture patients with the Exeter stem than the anatomic SP2 Lubinus stem
No full textBACKGROUND: The purpose of this study was to compare the cumulative incidence of postoperative periprosthetic fracture (PPF) in a cohort of femoral neck fracture (FNF) patients treated with two commonly used cemented stems: either a collarless, polished, tapered Exeter stem or the anatomic Lubinus SP2 stem. METHODS: In this retrospective multicenter cohort study of a consecutive series of patients, we included 2528 patients of age 60 years and above with an FNF who were treated with either hemiarthroplasty or total hip arthroplasty using either a polished tapered Exeter stem or an anatomic Lubinus SP2 stem. The incidence of PPF was assessed at a minimum of 2 years postoperatively. RESULTS: The incidence of PPF was assessed at a median follow-up of 47 months postoperatively. Thirty nine patients (1.5%) sustained a PPF at a median of 27 months (range 0-96 months) postoperatively. Two of the operatively treated fractures were Vancouver A (5%), 7 were Vancouver B1 (18%), 10 were Vancouver B2 (26%), 7 were Vancouver B3 (18%), and 13 were Vancouver C (32%). The cumulative incidence of PPF was 2.3% in the Exeter group compared with 0.7% in the SP2 group (p < 0.001). The HR was 5.4 (95% CI 2.4-12.5, p < 0.001), using the SP2 group as the denominator. CONCLUSIONS: The Exeter stem was associated with a higher risk for PPF than the Lubinus SP2 stem. We suggest that the tapered Exeter stem should be used with caution in the treatment of FNF. TRIAL REGISTRATION: The study was registered at clinicaltrials.gov (identifier: NCT03326271).Originally included in thesis in manuscript form</p
The design of the cemented stem influences the risk of Vancouver type B fractures, but not of type C: an analysis of 82,837 Lubinus SPII and Exeter Polished stems
No full textBackground and purpose — In total hip replacements, stem design may affect the occurrence of periprosthetic femoral fracture. We studied risk factors for fractures around and distal to the 2 most used cemented femoral stems in Sweden. Patients and methods — This is a register study including all standard primary Lubinus SPII and Exeter Polished stems operated in Sweden between 2001 and 2009. The outcome was any kind of reoperation due to fracture around (Vancouver type B) or distal to the stem (Vancouver type C), with use of age, sex, diagnosis at primary THR, and year of index operation as covariates in a Cox regression analysis. A separate analysis of the primary osteoarthritis patient group was done in order to evaluate eventual influence of the surgical approach (lateral versus posterior) on the risk for Vancouver type B fractures. Results — The Exeter stem had a 10-times (95% CI 7–13) higher risk for type B fractures, compared with the Lubinus, while no statistically significant difference was noticed for type C fractures. The elderly, and patients with hip fracture or idiopathic femoral head necrosis, had a higher risk for both fracture types. Inflammatory arthritis was a risk factor only for type C fractures. Type B fractures were more common in men, and type C in women. A lateral approach was associated with decreased risk for Type B fracture. Interpretation — Stem design influenced the risk for type B, but not for type C fracture. The influence of surgical approach on the risk for periprosthetic femoral fracture should be studied further
Variation in the diagnosis by Doppler ultrasound of venous valve insufficiency of the lower limbs, standing and semi-sitting, using the Valsalva maneuvers and distal compression
Get PDFResumenObjetivo: Determinar las diferencias en el diagnostico de insuficiencia venosa por ecografÌa doppler color en dos posiciones (semisentado y de pie) utilizando maniobras Valsalva y compresión distal. MetodologÍa: Se estudiaron 98 pacientes con insuÞciencia venosa grado 1 a 3. En todos los pacientes se evaluó la presencia de reßujo estando semisentado más Valsalva, semisentado y compresión distal, de pie más Valsalva, y de pie con compresión distal. Resultados: Hay diferencias en los resultados entre las tÈcnicasevaluadas. Para compromiso proximal hay mayor frecuencia de reßujo en posición semisentado más Valsalva; para compromiso medio las pruebas son similares: para compromiso distal, hay mayor frecuencia de reßujo con el paciente de pie más compresión distal. Conclusión: Dependiendo del grupo venoso a evaluar, es necesario adecuar la técnica de evaluación con ultrasonido doppler color utilizada.[Sáenz WL, Evan JD, Mantilla JC, Lubinus FG, Rey JJ. Variación en el diagnóstico por ecografÍa doppler de insuÞciencia valvular venosa de miembros inferiores, de pie y semisentados utilizando las maniobras de valsalva y compresión distal. MedUNAB 2007; 10:13-18].Palabras clave: Insuficiencia venosa, ecogafÌa doppler color, cirugÍa vascular.Objectives: To determine differences in diagnosis of valvular insuffi ciency by color doppler ultrasonography in standing or semi-Fowler position and Valsalva maneuver or distal compression. Methodology: 98 patients with 1-3 degreee valvular insuffi ciency were studied All of thew were evaluated by doppler ultrasonography in booth positions and maneuvers. Results: There were differences between the different techniques. In upper segments, a higher frequency of refl ux was found with semi-Fowler plus Valsalva´s maneuver; in intermediate segments there were similar refl ux prevalences using both positions; and, in lower segments, there was more refl ux using standing position plus Valsalva´s maneuver. Conclusion. Depending on the venous group to evaluate, it is necessary to adapt the evaluation technique used with Doppler ultrasound color test
Mitomycin C in highly myopic eyes - Author reply
No full textOphthalmology. 2005 Feb;112(2):208-18; discussion 219.
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E.
SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Abstract
PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.
DESIGN: Prospective, double-masked, randomized clinical trial.
PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.
METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).
MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.
RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).
CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Comment in
Ophthalmology. 2006 Feb;113(2):357; author reply 357-8
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