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41.
Christian Allende Agustín Paz Gonzalo Altube Hernán Boccolini Alejandro Malvarez Bartolomé Allende 《International orthopaedics》2014,38(4):899-903
Purpose
The objective of this study was to evaluate the results achieved after revision with plates of humeral nonunions secondary to failed intramedullary nailing.Methods
We retrospectively evaluated 32 patients with humeral nonunions secondary to failed intramedullary nailing, treated by internal fixation with plates between 1998 and 2012. Nonunions were diaphyseal in 19 cases, they were located in the proximal humeral metaphysis in nine cases, and in the distal humeral metaphysis in four cases. There were 11 atrophic nonunions and 21 oligotrophic nonunions. Initial treatment was performed with static locked nails in 12 cases, nails with expansive locking systems in 11 cases, and using thin elastic nails in nine cases. The nails were placed antegrade in 18 cases and retrograde in 14 cases. Time between initial surgery and revision surgery averaged 14.5 months. In seven diaphyseal nonunions, the intramedullary nail was left in-situ. Bone graft was added in 25 cases.Results
Follow-up averaged 35 months. Union was achieved in all cases, after an average of 3.8 months. Disabilities of the Arm, Shoulder and Hand (DASH) score at last follow-up averaged 14 points, and Constant’s score averaged 82 points. The analogue scale of pain averaged 0.8 points. Out of seven patients with radial nerve compromise, six recovered completely and one needed tendon transfers.Conclusions
Revision with plates after failed intramedullary humeral nailing achieved union and good predictable objective and subjective results in all cases. Adequate implant selection and meticulous surgical technique are necessary to achieve successful osteosynthesis and bony union. 相似文献42.
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44.
José Alberto de Agustín José Juan Gómez de Diego Pedro Marcos-Alberca Patricia Mahía José Luis Rodrigo María Luaces Iván Javier Núñez-Gil Joaquín Ferreiros Ana Bustos Beatriz Cabeza Miguel Ángel García-Fernández Carlos Macaya Leopoldo Pérez de Isla 《Revista espa?ola de cardiología》2018,71(2):105-109
Introduction and objectives
Multidetector computed tomography (MDCT) has been demonstrated as a feasible alternative to invasive coronary angiography (ICA). However, contradictory results have been reported regarding the effect of coronary artery calcium score (CS) on the diagnostic accuracy of MDCT. Our aim was to assess the agreement of MDCT and ICA and to evaluate the influence of CS on this agreement.Methods
We enrolled 266 consecutive patients who underwent evaluation with 64-slice MDCT and ICA. Standard CS software tools were used to calculate the Agatston score. Stenosis was qualitatively classified as mild, moderate, or severe by 1 blinded observer and the results were compared with those of ICA, which was used as the gold standard.Results
The mean age of the patients was 65.4 ± 11.2 years, and 188 patients (70.3%) were men. A total of 484 segments with coronary stenosis ≥ mild were qualitatively evaluated and quantified with MDCT. Noninvasive measurements were concordant with ICA in 402 stenoses (83.05%; Kappa, 0.684), with no significant differences between vessels and with no statistically significant influence of CS on this agreement (OR, 0.93; 95%CI, 0.76-1.09; P = .21). Multidetector computed tomography had high sensitivity, specificity, positive predictive value, and negative predictive value on a per-segment, per-vessel, and per-patient basis.Conclusions
Non-ICA using MDCT showed good agreement with ICA in the qualitative quantification coronary stenosis and CS had no significant impact on this agreement.Full English text available from: www.revespcardiol.org/en 相似文献45.
Dr. Fermím Mearin MD Agustín Balboa MD Juan-Ramón Malagelada MD 《Digestive diseases and sciences》1994,39(9):1877-1881
Summary Congenital tracheoesophageal fistulas are usually recognized during early life and are associated with severe esophageal dysmotilities that supposedly persist after fistula repair. We present the case of a patient with abdominal distension diagnosed to result from congenital tracheoesophageal fistula at the age of 17 years. Prior to surgery, manometry showed aperistalsis in the esophageal body that gradually improved during the 14 months of post-operative follow-up. We hypothesized that the dysmotility was due to increased gastroesophageal reflux or to intragastric distension. Therefore, we studied: (1) the correlation between motility and gastroesophageal reflux before and after surgery, and (2) the effect of isotonic gastric distension on esophageal motility. Our studies demonstrated that one year after surgery gastroesophageal acid reflux remained abnormal and that acute experimental gastric distension had no effect on esophageal motility. In summary, esophageal dysmotility in congenital tracheoesophageal fistula may return to normal after surgical repair; neither acute gastric distension nor gastroesophageal reflux are responsible for the reversible esophageal motor abnormalities. 相似文献
46.
Adrián Báez-Ruiz Dalia Luna-Moreno Agustín Carmona-Castro René Cárdenas-Vázquez Mauricio Díaz-Muñoz Vania Carmona-Alcocer 《Nutritional neuroscience》2014,17(1):31-36
Obesity is a world problem that requires a better understanding of its physiological and genetic basis, as well as the mechanisms by which the hypothalamus controls feeding behavior. The volcano mouse Neotomodon alstoni develops obesity in captivity when fed with regular chow diet, providing a novel model for the study of obesity. Females develop obesity more often than males; therefore, in this study, we analysed in females, in proestrous lean and obese, the differences in hypothalamus expression of receptors for leptin, ghrelin (growth hormone secretagogue receptor GHS-R), and VPAC, and correlates for plasma levels of total ghrelin. The main comparisons are between mice fed ad libitum and mice after 24 hours of fasting. Mice above 65 g body weight were considered obese, based on behavioral and physiological parameters such as food intake, plasma free fatty acids, and glucose tolerance. Hypothalamic tissue from obese and lean mice was analysed by western blot. Our results indicate that after ad libitum food access, obese mice show no significant differences in hypothalamic leptin receptors, but a significant increase of 60% in the GHS-R, and a nearly 62% decrease in VPAC2 was noted. After a 24-hour fast, plasma ghrelin increased nearly two fold in both lean and obese mice; increases of hypothalamic leptin receptors and GHS-R were also noted, while VPAC2 did not change significantly; levels of plasma free fatty acids were 50% less after fasting in obese than in lean animals. Our results indicate that in obese N. alstoni mice, the levels of orexigenic receptors in the hypothalamus correlate with overfeeding, and the fact that lean and obese females respond in different ways to a metabolic demand such as a 24-hour fast. 相似文献
47.
Vílchez-Oya Francisco Sánchez-Schmidt Julia María Agustí Anna Pros Ana 《Clinical rheumatology》2020,39(5):1693-1698
Clinical Rheumatology - Eosinophilic fasciitis (EF) is a rare disorder involving chronic inflammation of the fascia and connective tissue of unknown aetiology and poorly understood pathogenesis. We... 相似文献
48.
49.
Evelio Rafael González Dalmau Carlos Cabal Mirabal Giselle Saurez Martínez Agustín Lage Dávila José Carlos Ugarte Suárez Ricardo Cabanas Armada Gretel Rodriguez Cruz Daniel Darias Zayas Martha Ríos Castillo Luis Valle Garrido Luis Quevedo Sotolongo Mercedes Monzón Fernández 《Pediatrics international》2014,56(1):43-46
50.
Raquel Almodovar Juan C. Torre Alonso Enrique Batlle Concepción Castillo Eduardo Collantes-Estevez Eugenio de Miguel Senén González Jordi Gratacós Azucena Hernández Xavier Juanola Luis F. Linares Manuel J. Moreno Mireia Moreno Victoria Navarro-Compán Carlos Rodríguez Lozano Jesus Sanz Agustí Sellas Estíbaliz Loza Pedro Zarco 《Reumatología clinica》2018,14(3):155-159