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Resumen Objetivo: Evaluar y describir la prevalencia de variantes anatómicas arteriales hepáticas observadas en una serie multicéntrica de pacientes con patologías hepatobiliares. Método: Estudio retrospectivo de anatomía arterial según la clasificación de Michels de angiografías digitales y tomografías computadas helicoidales abdominales realizadas entre febrero de 2009 y diciembre de 2020 en tres hospitales del Área Metropolitana de Buenos Aires. Resultados: Se incluyeron 275 pacientes en el estudio. Edad mediana 58,5 años. Sexo masculino 73,1%. Variante anatómica tipo 1 (normal) de la arteria hepática en 192 casos (69.8%); tipo 2 en 18 casos (6.5%); tipo 3 en 19 casos (6.9%); tipo 4 en 7 casos (2.5%); tipo 5 en 4 casos (1.5%); tipo 6 en 3 casos (1.1%); tipo 7 en 2 casos (0.7%); tipo 8 en 7 casos (2.5%); tipo 9 en 17 casos (6.2%) y otros tipos fuera de la clasificación de Michels en 6 casos (2.2%). También hallamos la presentación de 3 casos (1.1%) con arco de Bühler. Conclusiones: En nuestra serie se observaron variantes anatómicas no clásicas de la arteria hepática aproximadamente en un tercio de los casos. El conocimiento de las variantes anatómicas fue esencial para los procedimientos radiológicos y quirúrgicos en el tratamiento de tumores hepáticos, determinando la técnica de abordaje de las arterias involucradas.

Abstract Objective: To evaluate and describe the prevalence of hepatic artery anatomical variants observed in a multicenter series of patients with hepatobiliary pathologies. Method: Retrospective study of arterial anatomy according to Michels classification of digital angiographies and abdominal helical computed tomography performed between February 2009 and December 2020 in three hospitals of the Buenos Aires Metropolitan Area. Results: 275 patients were included in the study. Median age 58.5 years. Male sex 73.1%. Type 1 (normal) variant of hepatic artery anatomy in 192 cases (69.8%); type 2 in 18 cases (6.5%); type 3 in 19 cases (6.9%); type 4 in 7 cases (2.5%); type 5 in 4 cases (1.5%); type 6 in 3 cases (1.1%); type 7 in 2 cases (0.7%); type 8 in 7 cases (2.5%); type 9 in 17 cases (6.2%), and other types out Michels classification in 6 cases (2.2%). We also found 3 cases (1.1%) with Bühler’s arch. Conclusions: In our series, non-classical anatomical variants of the hepatic artery were observed in approximately one third of cases. Knowledge of anatomical variants was essential for radiological and surgical procedures in the treatment of liver tumors, determining the approach technique of the arteries involved.

https://doi.org/10.24875/rar.22000008

Diálisis de albúmina de paso único (SPAD) como soporte hepático extracorpóreo en paciente COVID-19 crítico. Caso clínico
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Ramírez-Guerrero, Gonzalo

; Zurita-Poza, Anita

; Baghetti-Hernández, Romyna

; Villagrán-Cortés, Francisco

; Segovia-Hernández, Bárbara

; Aguirre-Adones, Lisette

; Garay, Osvaldo

Revista médica de Chile

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nov 2022, Volume 150 N. 11 Pages 1540 - 1544

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Liver transplantation is the only effective therapy to reduce the high mortality associated with acute liver failure and acute on chronic liver failure (ACLF). Single-pass albumin dialysis (SPAD) is an extracorporeal supportive therapy used as a bridge to liver transplantation or regeneration. We report a 44-year-old man with alcoholic cirrhosis admitted for critical COVID-19 pneumonia that evolves with ACLF. SPAD technique was performed completing six sessions, with a reduction of bilirubin and ammonia levels. He evolved with severe respiratory failure and refractory septic shock, dying. SPAD is a safe and efficient technique aimed to eliminate liver toxins, preventing multiorgan damage interrupting the process known as the "autointoxication hypothesis". It is easy to implement in any critical patient unit and has lower costs than other extracorporeal liver support therapies.

Un muerto sin tumba, un santo sin nombre: elaboración del pasado, memoria y resistencia en la ruralidad del noroeste argentino
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GARAY, Luis G.

; MARTÍNEZ, Guillermo

Trabajo y sociedad

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oct 2022, Volume 23 N. 39 Pages 11 - 24

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

RESUMO Este artigo propõe uma reflexão sobre as formas de elaboração do passado. As formas estudadas têm origem no interior do noroeste da Argentina e estão ligadas ao desaparecimento forçado de pessoas durante o terrorismo de Estado. Este artigo parte da tese de que a pesquisa das formas de elaboração do passado ajuda a compreender o terrorismo de Estado. Mostra como o terrorismo de Estado tem utilizado contextos de produção do esquecimento para consolidar suas tecnologias de poder desde os tempos coloniais. Isso busca desnaturar os atuais modos de reprodução dessa dominação histórica. Esses modos ultrapassam os limites cronológicos da execução material do terrorismo de Estado. Este artigo trata do aparecimento do cadáver de Francisco Toconás no interior da província de Santiago del Estero. Permite a análise das formas e expressões simbólicas da cultura popular e da religiosidade que têm ajudado a dar sentido comunitário às mortes causadas pelo terrorismo de Estado. Com base nessa análise, distingue as características das memórias de resistência, originadas em contextos de produção do esquecimento, em comparação com as memórias originadas numa era de reparação judicial e democrática.

RESUMEN Este artículo propone una reflexión sobre los modos de elaboración del pasado que surgieron en la ruralidad del noroeste argentino vinculados a la desaparición forzada de personas durante el terrorismo de Estado. Partiendo de la tesis que postula que la indagación en las formas de elaboración del pasado que surgieron en contextos de producción del olvido ayudan a dar cuenta de cómo el terrorismo de Estado se ha servido, para consolidar sus tecnologías de poder, de prácticas que se han establecido desde la época colonial. Con esto se busca desnaturalizar los modos actuales de reproducción de esa dominación que es histórica y exceden los límites cronológicos de la ejecución material del terrorismo de Estado. Se arriba al caso de la aparición sin vida del cuerpo de Francisco Toconás en el monte del interior santiagueño, con el objetivo de analizar las formas simbólicas y las expresiones de la cultura y la religiosidad popular que sirvieron para dotar de sentido comunitario las muertes producidas por el terrorismo estatal. En base a este análisis se intenta distinguir las características de las memorias de resistencia, surgidas en contextos de producción de olvido en relación a las memorias surgidas en etapas de reparación judicial y democrática.

ABSTRACT This article proposes a reflection on the ways of elaborating the past. The ways studied originated in the countryside of northwestern Argentina, and were linked to the forced disappearance of people during State terrorism. This article is based on the thesis that the research of the ways of elaboration of the past helps to comprehend State terrorism. It shows how State terrorism has used contexts of production of oblivion to consolidate its technologies of power since colonial times. This seeks to denature the current modes of reproduction of that historical domination. These ways exceed the chronological limits of the material execution of State terrorism. This article deals with the appearance of corpse of Francisco Toconás in the countryside of Santiago del Estero province. It analyzes the symbolic forms and expressions of popular culture and religiosity that served to give a sense of community to the deaths caused by State terrorism. Based on this analysis, it distinguishes the characteristics of memories of resistance, originated in contexts of oblivion production, in comparison with memories originated in an age of judicial and democratic reparation.

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COVID-19, shock séptico refractario y terapia extracorpórea de purificación sanguínea con OXIRIS®
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Ramírez-Guerrero, Gonzalo

; Baghetti-Hernández, Romyna

; Godoy-Tello, Cristian

; Villagrán-Cortés, Francisco

; Torres-Cifuentes, Vicente

; Garay-Coloma, Osvaldo

Revista médica de Chile

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feb 2022, Volume 150 N. 2 Pages 266 - 270

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Sepsis is one of the leading causes of death in critically ill patients with COVID-19 and blood purification therapies have a role to immunomodulate the excessive inflammatory response and improve clinical results. One of the devices designed for these therapies is the oXiris® filter, allowing to perform renal replacement therapy combined with selective adsorption of endotoxins and cytokines. We report a 55-year-old male with COVID who developed a septic shock secondary to a sepsis caused by Pseudomona aeruginosa, refractory to the usual management. A veno-venous continuous hemofiltration was started using the oXiris® filter for 48 hours. Subsequently, there was an improvement in clinical perfusion parameters and a reduction in inflammatory markers. The patient was discharged from the intensive care one month later.

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Factores de riesgo asociados a fuga anastomótica intestinal en cirugía electiva
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Bolívar-Rodríguez, Martín A.

; Magaña-Olivas, Francisco

; Cázarez-Aguilar, Marcel A.

; Pamanes-Lozano, Adrián

; Osuna-Wong, Benny A.

; Peraza-Garay, Felipe de J.

Cirugía y cirujanos

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feb 2022, Volume 90 N. 1 Pages 84 - 89

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Background: The intestinal anastomotic leakage is the most feared surgical complication of a digestive surgery and is associated with a significant increase of morbidity, mortality and hospital stay. Objective: Analyze the risk factors to the intestinal anastomotic leakage in elective surgery. Method: Observational and retrospective study in which we include patients with intestinal anastomosis, in elective surgery at the second level hospital from January 2007 to January 2017. Results: 64 patients were included in the study, in which 7 presented anastomotic leakage. The statistically significant risk factors associated with anastomotic leakage were, cocaine use (p = 0.030), neoplasia as a primary pathology (p = 0.008), neoadjuvant treatment for neoplasia (p = 0.003), and end-to-end anastomosis (p = 0.037). Patients with a leakage had a longer hospital stay and a mortality of 14.3%. Conclusions: The risk factors associated with the presence of anastomotic leakage found in this study are consistent with the reported worldwide literature. However, in our results, it is worth highlighting the use of cocaine as a risk factor, with statistical significance.

Resumen Antecedentes: La fuga de una anastomosis intestinal es la complicación quirúrgica más temida de la cirugía digestiva y se asocia con un aumento significativo de la morbimortalidad y de la estancia hospitalaria. Objetivo: Analizar los factores de riesgo asociados a la fuga de anastomosis intestinal en cirugía electiva. Método: Estudio observacional y retrospectivo en el que se recabaron los expedientes de los pacientes operados de anastomosis intestinal en forma electiva en un hospital de segundo nivel de enero de 2007 a enero de 2017. Resultados: Se incluyeron 64 pacientes, de los cuales siete presentaron fuga de la anastomosis. Los factores de riesgo asociados a fuga anastomótica estadísticamente significativos fueron consumo de cocaína (p = 0.030), neoplasia como patología primaria (p = 0.008), tratamiento con neoadyuvantes para neoplasia (p = 0.003) y anastomosis término-terminal (p = 0.037). Los pacientes con fuga tuvieron una estancia intrahospitalaria más prolongada y una mortalidad del 14.3%. Conclusiones: Los factores de riesgo asociados con la presencia de fuga anastomótica encontrados en este estudio son consistentes con los reportados en la literatura mundial. Sin embargo, en nuestros resultados cabe destacar el uso de cocaína como factor de riesgo, con significancia estadística.

https://doi.org/10.24875/ciru.20001324 177 downloads

Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica
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Pavía-López, Abel A.

; Alcocer-Gamba, Marco A.

; Ruiz-Gastelum, Edith D.

; Mayorga-Butrón, José L.

; Mehta, Roopa

; Díaz-Aragón, Filiberto A.

; Aldrete-Velasco, Jorge A.

; López-Juárez, Nitzia

; Cruz-Bautista, Ivette

; Chávez-Mendoza, Adolfo

; Secchi-Nicolás, Nikos C.

; Guerrero-Martínez, Francisco J.

; Cossio-Aranda, Jorge E.

; Mendoza-Zubieta, Victoria

; Fanghänel-Salmon, Guillermo

; Valdivia-Proa, Martha

; Olmos-Domínguez, Luis

; Aguilar-Salinas, Carlos A.

; Dávila-Maldonado, Luis

; Vázquez-Rangel, Armando

; Pavia-Aubry, Vanina

; Nava-Hernández, María de los A.

; Hinojosa-Becerril, Carlos A.

; Anda-Garay, Juan C.

; Ríos-Ibarra, Manuel O. de los

; Berni-Betancourt, Ana C.

; López-Cuellar, Julio

; Araiza-Garaygordobil, Diego

; Rivera-Reyes, Romina

; Borrayo-Sánchez, Gabriela

; Tapia-Hernández, Mónica

; Cano-Nigenda, Claudia V.

; Guerra-López, Arturo

; Elías-López, Josué

; Figueroa-Morales, Marco A.

; Montaño-Velázquez, Bertha B.

; Velasco-Hidalgo, Liliana

; Rodríguez-Lozano, Ana L.

; Pimentel-Hernández, Claudia

; Baquero-Hoyos, María M.

; Romero-Moreno, Felipe

; Rodríguez-Vega, Mario

Archivos de cardiología de México

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2022, Volume 92 Suppl. 1 Pages 1 - 62

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Background: Cardiovascular diseases are the leading cause of mortality worldwide and Mexico is no exception. The epidemiological data obtained in 1990 showed that cardiovascular diseases represented 19.8% of all causes of death in our country. This figure increased significantly to 25.5% for 2015. Some national surveys suggest that more than 60% of the adult population has at least one risk factor for cardiovascular disease (obesity or overweight, hypertension, smoking, diabetes, dyslipidemias). On the other hand, data from the Pan American Health Organization have linked the process of atherosclerosis as the first cause of premature death, significantly reducing life expectancy, which has enormous social repercussions. Objective: This document constitutes the Clinical Practice Guide (CPG) prepared at the initiative of the Mexican Society of Cardiology in collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican Society of Angiology and Vascular and Endovenous Surgery, AC, Mexican Institute of Research Nephrological, AC and the Mexican Academy of Neurology, A.C.; with the methodological support of the Ibero-American Agency for the Development and Evaluation of Health Technologies, in order to establish recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. The objective of this document is to provide evidence-based recommendations to help decision makers in the diagnosis and treatment of dyslipidemias in our country. Material and methods: This document complies with international quality standards, such as those described by the Institute of Medicine of the USA, the Institute of Clinical Excellence of Great Britain, the Scottish Intercollegiate Guideline Network and the Guidelines International Network. A multidisciplinary group of clinical experts and methodologists with experience in systematic reviews of the literature and the development of clinical practice guidelines was formed. A scope document was agreed upon, relevant clinical questions were established, the best available evidence critically evaluated in systematic literature reviews was exhaustively identified, and clinical recommendations were developed. The modified Delphi Panel methodology was used to achieve an adequate level of consensus in each of the recommendations contained in this CPG. Results: 23 clinical questions were agreed upon which gave rise to their respective clinical recommendations. Conclusions: We consider that this document contributes to better clinical decision-making and becomes a point of reference for clinicians and patients in the management of dyslipidemias and this contributes to reducing the morbidity and mortality derived from atherosclerotic cardiovascular events in our country.

https://doi.org/10.24875/acm.m22000081 1458 downloads

Reconstrucción del ligamento cruzado posterior en un paciente adulto mayor con lesión multiligamentaria de rodilla
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Guillén Morales, Julio César

; Garay Rojas, Francisco Martín

; Torres Manrique, Arturo David

Anales de la Facultad de Medicina

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oct 2021, Volume 82 N. 4 Pages 326 - 330

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT The multiligamentary knee injuries are complex high-energy trauma with a devastating prognosis. This injury is rare in older adults whose treatment is controversial. Surgical treatment in older adults may present similar functional results as in younger patients. Present the case of a 75-year-old woman with total posterior cruciate ligament (PCL) rupture, total medial collateral ligament (MCL) rupture and partial anterior cruciate ligament (ACL) rupture with <50% thickness in the right knee. The surgery performed was an arthroscopic reconstruction of the PCL with a posterior tibial allograft and repair of the superficial MCL. The preoperative KOS-ADL score was 42.9% and the postoperative was 81.4% at 18 months of follow-up. The reconstructive surgery in multiligamentary knee injuries is clinically feasible in older adult patients with an acceptable and satisfactory clinical outcome.

RESUMEN Las lesiones multiligamentarias de rodilla son traumatismos complejos de alta energía cuyo pronóstico puede ser devastador. Esta lesión es infrecuente en adultos mayores cuyo tratamiento es controversial. El tratamiento quirúrgico en adultos mayores puede presentar resultados funcionales similares que en pacientes jóvenes. Presentamos el caso de una mujer de 75 años, quien presentó ruptura total del ligamento cruzado posterior (LCP), ruptura total del ligamento colateral medial (LCM) y ruptura parcial del ligamento cruzado anterior (LCA) con < 50% de espesor en la rodilla derecha. La cirugía realizada fue una reconstrucción artroscópica del LCP con aloinjerto de tibial posterior y reparación del LCM superficial. El score KOS-ADL preoperatorio fue de 42,9% y el postoperatorio fue de 81,4% a los 18 meses de seguimiento. Por tanto, la cirugía reconstructiva en lesiones multiligamentarias de rodilla es clínicamente factible en pacientes adultos mayores con un resultado clínico aceptable y satisfactorio.

https://doi.org/10.15381/anales.v82i4.20824

Panthera Onca Corridors: A Spatially Explicit Analysis of Habitat Change Drivers and Potential Conservation Areas in the Bajo Magdalena, Colombia
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Toro-Garay, Giselle Helena

; Otero, Maria Paula

; Valderrama-Ardila, Carlos

; Escobedo, Francisco Javier

Trilogía Ciencia Tecnología Sociedad

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jun 2021, Volume 13 N. 24 Pages 79 - 97

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El rango de distribución de Panthera onca se ha reducido debido a la transformación de hábitat a gran escala, caza intensiva, tráfico ilegal, fragmentación y la construcción de carreteras e infraestructuras. Como consecuencia, la población de jaguares ha disminuido, lo que ha generado que la especie haya cambiado de categoría vulnerable a especie amenazada. Debido a la importancia ecológica de esta especie, organizaciones como la Red Colombiana de Seguimiento de Fauna Atropellada han propuesto el establecimiento de corredores de vida silvestre. Pero se sabe poco sobre qué está impulsando estos cambios de hábitat y dónde deberían establecerse estos corredores. Para abordar esta falta de información, determinamos en un grado espacial la distribución actual y el acceso al hábitat de P. onca y evaluamos si estos factores están siendo impulsados por deforestación, conflicto armado, expansión agrícola, urbanización y construcción de carreteras en el área del Bajo Magdalena en Colombia. Con estos resultados identificamos áreas potenciales para proponer corredores de conservación. Para hacer esto, utilizamos la información geoespacial disponible sobre la distribución de P. onca en las áreas vigiladas por la Corporación Autónoma Regional en los municipios de Puerto Salgar, Caparrapí y Guaduas, así como la red de transporte, la unidad administrativa y los datos de deforestación de 2010 a 2018. También calculamos las distancias del hábitat a los centros donde se encuentra la población y la distribución de P. onca en relación con las carreteras. Nuestros hallazgos sugieren que la población urbana y las carreteras afectan el 83 % del área total de su distribución; la deforestación aumentó en 47.9 km2 en el área de estudio de 105.24 km2 con 5.6 km2 solo en el hábitat de P. onca. Por tanto, concluimos que las iniciativas de conservación deben implementarse dentro del rango de distribución y las zonas de amortiguamiento de P. onca. En particular, la urbanización y la construcción de carreteras fueron variables muy influyentes asociadas con la pérdida del hábitat de P. onca. Además, se deben tomar en cuenta precauciones a lo largo de la carretera principal que conecta Puerto Salgar y Guaduas para mantener el flujo genético y el movimiento de la población de P. onca, ya que afecta a 87 km de este corredor propuesto.

Abstract The distribution range of Jaguar (Panthera onca) is being reduced due to multi-scale habitat conversion, intensive hunting, illegal trafficking, habitat fragmentation, and the construction of highways and other infrastructure. Because of the decrease in population, this species’ listing has changed from vulnerable to a threatened category. Due to the ecological importance of this species, organizations like Red Colombiana de Seguimiento de Fauna Atropellada have proposed the establishment of wildlife corridors. But little is known as to recognize the driving forces in these habitat changes and where these corridors should be established. To address this lack of information, we determined the spatial extent to which the current distribution and access to P. onca habitat is being driven by deforestation, armed conflict, agriculture expansion, urbanization and the construction of highways in the Bajo Magdalena area of Colombia. We then identified potential areas for proposing conservation corridors. To do this, we used available geospatial information on P. onca distribution in the Corporación Autónoma Regional areas in the municipalities of Puerto Salgar, Caparrapí and Guaduas, as well as transportation network, administrative unit, and deforestation data from 2010 to 2018. We also calculated habitat distances to population centers and the distribution of P. onca relative to roads. Our findings suggest that urban population and highways affect 83 % of the total area of its distribution; deforestation increased by 47.9 km2 in the 105.24 km2 study area with 5.6 km2 alone left as P. onca habitat. We concluded that conservation initiatives must be implemented inside P. onca’s distributional range and buffer zones. Urbanization and the construction of highways were highly influential variables associated with the loss of P. onca habitat. Further, we propose that precautions along the principal road that connects Puerto Salgar and Guaduas should be taken into consideration to maintain the genetic flow and movement of the P. onca population as it affects 87 km of this proposed corridor.

https://doi.org/10.22430/21457778.1641

Eucalyptus globulus bark valorization: Production of fibers by Neutral Sulphite Semi-Chemical Process for Liner Paper Manufacture
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Andrade, Andrea

; Herrera, Orlando Espinoza

; Reyes-Contreras, Pablo

; Pereira, Miguel

; Vásquez-Garay, Francisco

Floresta e Ambiente

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2021, Volume 28 N. 2 elocation e20200048

Abstract: En | Text: En | PDF: En

Abstract Eucalyptus globulus is the second most important economic forest species in Chile. Its main use is in the kraft pulp industry, where large amounts of bark waste are generated. Due to its fibrous characteristics, E. globulus bark is proposed as an alternative source of fibres for papermaking. This study focuses on obtaining fibres for liner paper manufacture. A neutral sulphite semi-chemical (NSSC) process was performed, varying the sodium sulphite (5% to 16%) and the sodium carbonate (2% and 4%) concentrations using two reaction temperatures (160°C and 170°C). The NSSC process at 170°C, 16% of sulphite, and 2% of sodium carbonate proved to be the best condition to obtain higher mechanical performance of papers. As the pulping conditions become more drastic, the yield drops, and the physicomechanical properties of paper increases. Results showed that pulps from E. globulus bark could turn into source of fibres for papermaking and other related products.

https://doi.org/10.1590/2179-8087-floram-2020-0048 260 downloads

10.

Avance tendinoso no convencional para lesiones en las zonas I y II de Verdan. Nueva técnica quirúrgica
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Garay, Alberto L

; Martínez, Carlos E

; Patiño, Juan M

; Tonetto, Germán

; López Bustos, Francisco

Revista de la Asociación Argentina de Ortopedia y Traumatología

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dec 2020, Volume 85 Suppl. 1 Pages 12 - 18

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Objective: To report a new surgical technique and the comparative clinical outcomes in patients with primary tenorrhaphy rupture or chronic flexor digitorum profundus (FDP) injuries in Verdan zones I and II, treated with non-conventional tendon advancement. Materials and Methods: The study population consisted of 13 patients over 18 years (averaging 29 years) who had had injuries in Verdan zones I and II and at least a 36-month follow-up. Patients were divided into two groups according to injury type (7 cases of primary tenorrhaphy rupture and 6 cases of chronic FDP injuries) and surgical technique (Z-plasty lengthening plus end-to-end suture or lateral suture to an adjacent undamaged FDP tendon at zone-V level, respectively). The results were evaluated according to Strickland’s scoring system. Results: The average follow-up was 51 months. Time period between injury and surgery averaged 11.7 weeks (range, 2-24 weeks). Strickland scoring system results: excellent in 8 patients, good in 4 patients, and poor in 1 patient. Study average tendon advancement was 20.5mm. Conclusions: Non-conventional tendon advancement for primary tenorrhaphy ruptures or chronic FDP injuries in Verdan zones I and II proved to be a reproducible and effective treatment.

Resumen Objetivo: Presentar una nueva técnica quirúrgica y los resultados clínicos comparativos de pacientes con roturas de tenorrafia primaria o lesiones crónicas del flexor profundo en las zonas I y II de Verdan, tratados con avance tendinoso no convencional. Materiales y Métodos: Se incluyó a pacientes >18 años, con antecedente de lesiones en las zonas I y II de Verdan y un seguimiento mínimo de 36 meses. La serie estaba formada por 13 pacientes (edad promedio 29 años) que fueron divididos en dos grupos según el tipo de lesión (7 con roturas de tenorrafia primaria y 6 con lesiones crónicas del flexor profundo) y la técnica quirúrgica utilizada (alargamiento en Z más sutura término-terminal y sutura lateral del tendón alargado a un flexor vecino indemne en la zona V, respectivamente). Se empleó la Clasificación de Strickland para la evaluación. Resultados: El seguimiento promedio fue de 51 meses. El intervalo promedio entre la lesión y la cirugía fue de 11.7 semanas. Según la Clasificación de Strickland, 8 pacientes tuvieron resultados excelentes; 4, buenos y uno, pobre. El avance tendinoso promedio fue de 20,5 mm en ambos grupos. Conclusiones: El avance tendinoso no convencional para lesiones en las zonas I y II de Verdan, sea en roturas de tenorrafia primaria o lesiones crónicas del flexor profundo, resultó un tratamiento reproducible y eficaz.

https://doi.org/10.15417/issn.1852-7434.2020.85.4s.1173 69 downloads

11.

LA FORMACIÓN DE LOS SUJETOS DISCURSIVOS LECTORES EN EL POSTDESARROLLO
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Garay Álvarez, Leydy

Lingüística y Literatura

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jun 2020, N. 77 Pages 370 - 385

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen: En este estudio se reflexionó en torno al significado e implicaciones de la formación de los sujetos discursivos lectores en el postdesarrollo, a partir de la revisión de los aspectos teóricos y conceptuales tratados en el marco del Doctorado Interinstitucional en Educación (DIE) de la Universidad Distrital Francisco José de Caldas, con Énfasis en Lenguaje y Educación y la Línea de Investigación Didáctica del Lenguaje y las Matemáticas.

Abstract: This study reflected on the meaning and implications of the formation of discursive reader subjects in post development, based on the revision of the theoretical and conceptual aspects treated in the framework of the Inter-Institutional Doctorate in Education (DIE) of the Francisco José de Caldas District University, in the emphasis of Language and Education and the Research Line Didactics on Language and Mathematics.

https://doi.org/10.17533/udea.lyl.n77a16 20 downloads

12.

Resultados funcionales y radiográficos de la prótesis reversa y la reinserción del troquíter en pacientes con fracturas de húmero proximal
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Patiño, Juan Martín

; Martínez, Carlos E

; Andres, Bernardo

; López Bustos, Francisco

; Ruiz, César

; Fiminella, Hernán

; Ferro, Julio

; Garay, Alberto

Revista de la Asociación Argentina de Ortopedia y Traumatología

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jun 2020, Volume 85 N. 2 Pages 133 - 138

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Objective: To report functional and radiologic outcomes of reverse shoulder arthroplasty (RSA) in patients with complex proximal humeral fractures. A second objective was to assess the relation between the greater tuberosity healing and the range of motion (ROM) and the American Shoulder and Elbow Surgeons (ASES) score. Materials and Methods: Sixteen patients treated between 2013 and 2017, older than 65 years old, operated before 4 weeks after the trauma, and with a minimum of 2-year follow-up were included. ASES scores and active ROMs were recorded. Greater tuberosity and the prosthesis position and healing were radiologically evaluated, and the complications and treatment were recorded. Results: The median age was of 74.5 years (IQR 66-78.5), 11 patients were females (69%). According to Neer classification, 11 cases were four-part fractures and 5 were four-part fracture-dislocations. The average time between trauma and surgery was 9.4 days, and the average follow-up was of 29.5 months. The greater tuberosity was healed in 9 cases (56%). Internal rotation: 5 patients (31.25%) were able to reach up with their thumbs to gluteal level, 4 (25%) to T12, 3 (18.75%) to T7, and 4 (25%) to L3. The medians for external rotation and forward flexion were 30° (IQR 17.5°-40°) and 100° (IQR 87.5°-160°). The average ASES score was of 78.3 (IQR 63.3-87.4). There was no significant statistical relation between greater tuberosity healing and forward flexion or ASES score (P=0.24 and P=0.52, respectively). Conclusion: The use of reverse prostheses for complex fractures with greater tuberosity reattachment could lead to good functional outcomes, low complication rates and reoperations. There was no significant statistical relation between ASES score and greater tuberosity healing or failure to heal.

Objetivo: Comunicar los resultados funcionales y radiográficos de pacientes tratados con prótesis reversa por fracturas complejas. El objetivo secundario fue determinar la relación entre rangos de movilidad y puntaje ASES con la evolución radiográfica del troquíter. Materiales y Métodos: Se incluyeron 16 pacientes >65 años, tratados con prótesis reversa y reinserción del troquíter, entre 2013 y 2017, operados antes de las 4 semanas del trauma y con un seguimiento mínimo de 2 años. Se consignaron el puntaje ASES y el rango de movilidad activa. En las radiografías, se evaluaron la posición y la consolidación del troquíter, y se registraron las complicaciones y su tratamiento. Resultados: La media de la edad fue 74.5 años (RIC 66-78.5), 11 (69%) eran mujeres. Once fracturas (69%) eran a 4 fragmentos y 5, luxofracturas a 4 fragmentos. La media entre el trauma y la cirugía fue 9.4 días y el seguimiento, 29.5 meses. En 9 casos (56%), el troquíter presentó consolidación. Rotación interna: 5 pacientes alcanzaron la región glútea con el pulgar; 4, la vértebra T12; 4, la vértebra L3; 3, la T7. Las medianas de rotación externa y flexión anterior fueron 30° (RIC 17,5-40) y 100° (RIC 87,5-160). El puntaje ASES promedio fue 78,3 (RIC 63,3-87,4). No hubo una asociación estadísticamente significativa entre la evolución del troquíter y la flexión anterior y el puntaje (p = 0,24 y 0,52, respectivamente). Conclusión: La prótesis reversa en fracturas agudas con reinserción de las tuberosidades puede llevar a buenos resultados funcionales. No se encontró relación entre la consolidación del troquíter y el puntaje ASES.

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13.

Angioplastias da Artéria Mamária Interna Esquerda e Direita em Paciente de 3 Anos com Doença de Kawasaki e Falha na Cirurgia de Revascularização do Miocárdio
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Hameau, René

; Springmuller, Daniel

; Garay, Francisco

; Fuensalida, Alberto

; Martinez, Gonzalo

Arquivos Brasileiros de Cardiologia

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may 2020, Volume 114 N. 5 Pages 846 - 848

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20190904 671 downloads

14.

FRECUENCIA, CLASIFICACIÓN Y PATOLOGÍA DE LOS TUMORES DE MEDIASTINO
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Arce-Aranda, Carlos

; Ayala-Guzmán, José Domingo

; Cuevas-Zapata, José Francisco

; Duarte-González, Andrea Leticia

; Garay-Gómez, Christian David

; Gutiérrez-Codas, Gabriel María

; Lee, Chong

; Adé-Torrent, Miguel

; Leiva, Alejandro

; Soskin-Reidman, Ana

Cirugía paraguaya

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aug 2018, Volume 42 N. 2 Pages 17 - 22

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Primary mediastinal tumors are a rare entity, representing only 3% of the thoracic pathology. They can be manifested by a variety of symptoms, depending on their effect on adjacent organs and structures according to their location. The objective of this work is to establish the frequency and characteristics of this type of tumors in the San Jorge Hospital. Materials and Methods: Observational, descriptive, retrospective cross-sectional study. All the patients who underwent surgery in the Thoracic Surgery Service were included in the period from July 2013 to June 2018. Results: Of the 476 patients operated on in the Service, 45 patients suffered from mediastinal tumor pathologies (frequency of 9.4 %); 30 patients being women (67%), between 51 and 60 years old. The most frequent topographic location corresponds to the anterior mediastinum (83%). The most frequent histological types were Hodgkin's lymphomas with 31%. Conclusions: The frequency of mediastinal tumors in our series corresponds to 9.4%. The most frequent location was in the anterior mediastinum, a greater number of cases was found in the female sex. The most frequent histological type is Hodgkin's lymphoma, the most commonly used approach was thoracotomy.

RESUMEN Introducción: Los tumores primarios de mediastino son una entidad poco frecuente, que representa sólo el 3% de la patología torácica. Pueden manifestarse por una variedad de síntomas, según sea su efecto sobre los órganos y estructuras adyacentes de acuerdo a su localización. El objetivo de este trabajo es establecer la frecuencia y características de este tipo de tumores en el Hospital San Jorge. Materiales y Métodos: Estudio observacional, descriptivo, retrospectivo de corte transversal. Fueron incluidos todos los pacientes intervenidos quirúrgicamente en el Servicio de Cirugía Torácica en el periodo comprendido entre julio de 2013 a junio de 2018. Resultados: De los 476 pacientes intervenidos en el Servicio, 45 pacientes padecían patologías tumorales de mediastino (frecuencia de 9,4%); siendo 30 pacientes mujeres (67%), entre 51 y 60 años. La localización topográfica más frecuente corresponde al mediastino anterior (83%). Los tipos histológicos más frecuentes fueron los linfomas de Hodgkin con un 31 %. Conclusiones: La frecuencia de tumores de mediastino en nuestra serie corresponde al 9,4%. La localización más frecuente fue en el mediastino anterior, se halló un mayor número de casos en el sexo femenino. El tipo histológico más frecuente es el linfoma de Hodgkin, la vía de abordaje más utilizada fue la toracotomía.

https://doi.org/10.18004/sopaci.2018.agosto.17-22 1385 downloads

15.

Increasing doses of potassium increases yield and quality of muskmelon fruits under greenhouse
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Preciado-Rangel, Pablo

; Salas-Pérez, Lilia

; Gallegos-Robles, Miguel Á

; Ruiz-Espinoza, Francisco H

; Ayala-Garay, Alma V

; Fortis-Hernández, Manuel

; Murillo-Amador, Bernardo

Horticultura Brasileira

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jun 2018, Volume 36 N. 2 Pages 184 - 188

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O potássio (K) influencia as variáveis que determinam a qualidade dos frutos e a concentração de fitonutriente para a saúde humana e, portanto, as preferencias do consumidor. O objetivo desse estudo foi avaliar o efeito de diversas concentrações de K na solução nutritiva (5, 7, 9 e 11 mM de K) sobre o rendimento e qualidade de frutos de melão Cantaloupe em casa de vegetação. O experimento foi realizado em vasos, em delineamento experimental completamente casualizado, com 15 repetições. Foram analisadas a variância, correlação, regressão e comparação múltipla de médias (Tukey p<0,05). Obtiveram-se valores maiores de produtividade, peso médio de frutos, diâmetro equatorial, espessura da polpa, firmeza da polpa, teor de sólidos solúveis totais, teor de compostos fenólicos e capacidade antioxidante dos frutos nas concentrações de 9 e 11 mM de K. Todas variáveis, com exceção de diâmetro polar dos frutos, tiveram seus valores aumentados, com concentrações crescentes de K, evidenciando tendência linear positiva e significativa, indicando que a dose ótima de K em melão é superior a 11 mM. Assim, sugere-se para pesquisas futuras, avaliar concentrações acima de 11 mM..

ABSTRACT Potassium (K) influences the variables that determine quality of fruit and the concentration of phytonutrients to human health and therefore consumer preferences. The objective of this study was to evaluate the effect of different concentrations of K in the nutrient solution (5, 7, 9 and 11 mM of K) on yield and quality of Cantaloupe fruits under greenhouse conditions. The experiment was conducted in pots using a completely randomized design with 15 replications. Analysis of variance, correlation, regression and multiple comparisons among means (Tukey p<0.05) were performed. Results showed higher values of yield, average fruit weight, equatorial diameter, pulp thickness, fruit firmness, soluble solids content, phenolic content and antioxidant capacity of fruits at the concentrations of 9 and 11 mM of K. All variables, except equatorial diameter, increased their values as K concentrations increased, showing a lineal, positive and significant trend, which evidences that the optimal dose of K in muskmelon is higher than 11 mM, being suggested for future research, to evaluate concentrations above this value.

https://doi.org/10.1590/s0102-053620180206 1352 downloads

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