Mechanisms underlying the diabetes-induced hyporeactivity of the rabbit carotid artery to atrial natriuretic peptide

Abstract Atrial natriuretic peptide (ANP) plays an important role in the pathophysiology of the vascular complications in diabetes. The working hypothesis was that diabetes might modify the vascular actions of ANP in isolated rabbit carotid arteries and the mechanisms involved in these actions. ANP (10 −12 –10 −7  M) induced a relaxation of precontracted carotid arteries, which was lower in diabetic than in control rabbits. In arteries from both groups of animals, endothelium removal increased the ANP-induced relaxation. Isatin inhibited the relaxation to ANP both in arteries with and without endothelium. Carotid arteries from diabetic rabbits showed a decreased natriuretic peptide receptor…

Encondroma en fémur proximal, una localización poco frecuente. Necesidad de pedir pruebas complementarias ante una fractura patológica de cadera sobre una lesión de apariencia benigna.

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Abstract Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in su…

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

Abstract Objective To describe a technique for treating acute injuries of the scapholunate ligament (SLL) by performing an arthroscopic reinsertion of the SLL and dorsal capsulodesis and to present the results obtained. Methods The study deals with an analytical, prospective clinical study that included 19 consecutive patients with acute injury of the SLL. The range of joint motion, grip strength, pain according to the visual analog scale, functional outcomes according to the Mayo Wrist Score (MWS), and the QuickDASH Score were studied preoperatively and 6 and 12 months postoperatively. The complications and necessary reinterventions were recorded. Results Nineteen patients with acute injur…

Evaluación funcional de los pacientes con rotura del ligamento cruzado anterior. Estudio analítico transversal

Resumen Objetivo Evaluar, mediante un analisis biomecanico, la alteracion funcional de la marcha y del equilibrio de pacientes con rotura del ligamento cruzado anterior (LCA). Material y metodo Estudio analitico transversal en 64 sujetos, 27 sujetos sanos y 37 pacientes con lesion de LCA. A todos los sujetos se les realizo un analisis biomecanico de la marcha mediante 4 pruebas: 1) prueba cinematica de la marcha, para caracterizar el patron de marcha; 2) prueba de analisis cinetico de la marcha, para analizar las caracteristicas de las fuerzas ejercidas contra el suelo, la duracion de las pisadas, la simetria entre ambas extremidades y la repetitividad del gesto analizado; 3) prueba de la m…

Utilización del ácido tranexámico tópico en la artroplastia total primaria de cadera. Eficacia y seguridad. Nuestra experiencia

Resumen Antecedentes y objetivo El acido tranexamico por via intravenosa ha demostrado que disminuye el sangrado y la necesidad de transfusiones en la artroplastia total de cadera, aunque tiene un riesgo teorico de producir fenomenos tromboembolicos. Recientemente, se han publicado algunos trabajos con la aplicacion del acido tranexamico topico, sin haberse definido todavia cual es el protocolo de administracion ideal. El objetivo de este trabajo fue demostrar que nuestro protocolo de administracion topica de acido tranexamico es eficaz y seguro. Materiales y metodos Recogida de datos de una serie prospectiva de 80 artroplastias primarias de cadera, en las que se utilizo un protocolo de aci…

Osteotomías distales de los metatarsianos menores realizadas por cirugía abierta vs cirugía percutánea en el tratamiento de las metatarsalgias.

Objetivo. Comparar los resultados clínicos y radiológicos de las osteotomías distales de los metatarsianos menores realizadas por cirugía abierta y por cirugía percutánea en el tratamiento de las metatarsalgias Material y método. Revisión retrospectiva de 44 metatarsalgias: 22 en cada grupo. Recogida de datos epidemiológicos, clínicos y medición de parámetros radiográficos. Resultados. Se consiguieron modificaciones en los parámetros radiográficos con ambas técnicas, con mayor corrección con la cirugía abierta. Las fórmulas metatarsales postoperatorias continuaron siendo no armónicas en ambos grupos. Todos los pacientes mejoraron clínicamente. La cirugía abierta tuvo más complicaciones. Con…

Diabetes impairs the atrial natriuretic peptide relaxant action mediated by potassium channels and prostacyclin in the rabbit renal artery.

Diabetes is associated with increased prevalence of hypertension, cardiovascular and renal disease. Atrial natriuretic peptide (ANP) plays an important role in cardiovascular pathophysiology and is claimed to have cardioprotective and renoprotective effect in diabetic patients. The working hypothesis was that alloxan-induced diabetes might modify the vascular effects of ANP in isolated rabbit renal arteries and the mechanisms involved in such actions. Plasma ANP levels were higher in diabetic rabbits than in control rabbits. ANP (10(-12)-10(-7)M) induced a relaxation of precontracted renal arteries, which was lower in diabetic than in control rabbits. In arteries from both groups of animals…

Bloqueo IPACK asociado a bloqueo del canal de los aductores frente a bloqueo femoral, calidad analgésica y uso de rescate tras artroplastia total de rodilla.

Total knee arthroplasty and its postoperative period can be very painful. Usually patients undergoing locoregional or general anesthetic techniques to which peripheral nerve blocks are associated for postoperative analgesia, within which femoral nerve block is the most widespread an adequate analgesic quality of the anterior compartment of the knee. It is widely described in the literature that blockage of the adductor canal or Hunter confers an analgesic quality similar to that achieved with the femoral block without objectifying that motor block that can limit its use for rapid rehabilitation. Recently also described in the literature, the blockade that is defined as IPACK (Infiltration b…

Use of topical tranexamic acid in primary total hip arthroplasty. Efficiency and safety. Our experience.

Abstract Background and aim Intravenous tranexamic acid has been shown to reduce bleeding and the need for transfusions in total hip arthroplasty, although it has a theoretical risk of producing thromboembolic phenomena. Recently some papers have been published using the topical application of tranexamic acid, but the ideal administration protocol has not yet been clearly defined. The aim of this paper was to demonstrate that our protocol of topical tranexamic acid is effective and safe. Methods Prospective data collection from a case series of 80 primary hip arthroplasties, in which the following topical tranexamic acid protocol is used: 1.5 g diluted to a total volume of 60 ml were admini…

Functional evaluation of patients with anterior cruciate ligament injury. A transversal analytical study.

Abstract Objective To evaluate, by means of biomechanical analysis, functional alterations of gait and balance of patients with anterior cruciate ligament (ACL) injury. Material and methods Transversal analytical study on 64 people, 27 health subjects and 37 patients with ACL injury. Biomechanical analysis of gait in all individuals was performed by means of four tests: (1) kinematic test, to characterize gait pattern; (2) kinetic test, to characterize forces against the floor, duration of treads, symmetry of both legs, and the reproducibility of the gait; (3) pivot-shift test, to analyze the rotational stability of the knee on the sagittal axis; and (4) equilibrium test. Results Alteration…

Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children.

The choice of orthopedic or surgical treatment for Gartland type II supracondylar humeral fractures remains controversial. The aim of this study was to retrospectively compare the outcomes in orthopedic and surgical treatment in type II supracondylar humeral fractures in children treated in the Orthopedic and Traumatology Children Unit of our tertiary hospital over the period between 2007 and 2010. This study suggests that orthopedic treatment is a valid option for the treatment of this type of fractures, with radiological and functional results as good as those obtained with surgical treatment, avoiding surgical complications and decreasing the hospital stay.