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Exposición a radiación ionizante en médicos residentes de ortopedia en un hospital de referencia. 参考医院骨科住院医生的电离辐射暴露。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000644
Suemmy Gaytán-Fernández, Rodolfo G Barragan-Hervella, Jorge Quiroz-Williams, Carlos L Rodríguez Palacios, Gilberto Sánchez-González

Objective: To describe and analyze the exposure to ionizing radiation of orthopedic residents.

Method: A prospective study was carried out to evaluate the degree of exposure to ionizing radiation with a bandage dosimeter placed under the lead apron for medical residents for 10 months. An online survey measured the degree of knowledge about radiation safety.

Results: 54 resident physicians participated. 55.6% report having knowledge of the existence of radiological protection equipment and 40.7% report that they had previous training in its use. 77.8% use the leaded apron and 31.5% use thyroid protection. 81.5% were positioned less than 1 meter from the source of the X-ray production of the arc in C. The total mean radiation exposure was 2.9 ± 2.17 mSv (95% confidence interval: 1.25-14.28; p = 0.424).

Conclusions: Orthopedic residents present radiation doses below the International Commission on Radiological Protection recommended limit. However, there is a lack of knowledge of radiation protection and as well as a lack of interest and ignorance of the adverse effects of radiation.

目的:描述和分析骨科住院医师电离辐射暴露情况。方法:采用前瞻性研究方法,对住院医师在铅围裙下放置的绷带剂量计进行为期10个月的电离辐射暴露程度评估。一项在线调查测量了人们对辐射安全的了解程度。结果:54名住院医师参与。55.6%的人表示他们知道放射防护设备的存在,40.7%的人表示他们以前接受过放射防护设备的使用培训。77.8%的人使用含铅围裙,31.5%的人使用甲状腺防护。81.5%的人位于距离c区x射线弧产生源不到1米的位置,总平均辐射暴露为2.9±2.17 mSv(95%可信区间:1.25-14.28;P = 0.424)。结论:骨科住院医师的辐射剂量低于国际放射防护委员会推荐的限值。然而,人们缺乏辐射防护知识,对辐射的不良影响也缺乏兴趣和无知。
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引用次数: 0
Prevalencia de glucosa alterada en ayuno y dislipidemia entre pacientes mexicanos con VIH naïve a tratamiento antirretroviral. 墨西哥naive hiv患者接受抗逆转录病毒治疗时禁食血糖改变和血脂异常的患病率。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000594
César I Elizalde-Barrera, Carlos V Juárez-Mendoza, Andrea Maliachi-Díaz, Ismar A Rosado-Arenas, Stephania Sandoval-Ocampo, Luis E Tinoco-Montes

Background: Metabolic complications have become more relevant in the care of patients with HIV. However, little is known about the incidence and risk factors for these disorders among HIV-infected antiretroviral treatment naïve (ARTn) patients.

Objective: To recognize the prevalence of Impaired Fasting Glucose (IFG) and dyslipidemia among HIV-infected ARTn Mexican individuals and identify associated risk factors.

Method: A retrospective study was conducted in HIV-1-infected ART-N patients, referred for attention to a general hospital in Mexico City, between 2009 and 2019. We collected information for anthropometric, clinical, biochemical and HIV status variables.

Results: We included 221 patients, 97% were males, mean age 30 years (interquartile range [IQR]: 25-38); median CD4 count was 250 cells/mm3 (IQR: 120.25-391) and median log10 HIV viral load was 4.69 HIV-1 RNA copies/ml (IQR: 3.64-5.25). Prevalence of IFG was 22.6% and was associated with overweight-obesity (odds ratio [OR]: 2.75; 95% confidence interval [95% CI]: 1.36-5.55; p-value < 0.05). Hypoalphalipoproteinemia was the most frequent dyslipidemia: 69.46%. An association between count CD4 < 250 and lower HDL cholesterol levels was found (OR: 3.23; 95CI%: 1.61-6.5; p-value < 0.05).

Conclusions: IFG and dyslipidemia are highly prevalent among HIV-infected ART-naïve Mexican patients, therefore, screening for glucose and lipids abnormalities always should be considered among ARTn patients.

背景:代谢并发症在HIV患者的护理中变得越来越重要。然而,对艾滋病毒感染抗逆转录病毒治疗naïve (ARTn)患者中这些疾病的发生率和危险因素知之甚少。目的:了解墨西哥hiv感染者中空腹血糖受损(IFG)和血脂异常的患病率,并确定相关的危险因素。方法:对2009年至2019年在墨西哥城一家综合医院转诊的hiv -1感染ART-N患者进行回顾性研究。我们收集了人体测量、临床、生化和HIV状态变量的信息。结果:纳入221例患者,97%为男性,平均年龄30岁(四分位数间距[IQR]: 25-38);中位CD4计数为250个细胞/mm3 (IQR: 120.25-391),中位log10 HIV病毒载量为4.69 HIV-1 RNA拷贝/ml (IQR: 3.64-5.25)。IFG患病率为22.6%,与超重肥胖相关(优势比[OR]: 2.75;95%置信区间[95% CI]: 1.36-5.55;p值< 0.05)。低脂蛋白血症是最常见的血脂异常,占69.46%。计数CD4 < 250与较低的HDL胆固醇水平之间存在关联(OR: 3.23;95 ci %: 1.61 - -6.5;p值< 0.05)。结论:IFG和血脂异常在hiv感染ART-naïve墨西哥患者中非常普遍,因此,在ARTn患者中始终应考虑筛查葡萄糖和血脂异常。
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引用次数: 0
Breve comentario sobre el origen de la toracotomía anterolateral para el tratamiento quirúrgico de las heridas cardíacas. 在这篇文章中,我们介绍了一种用于心脏损伤手术治疗的前外侧胸切开术的起源。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000540
Yoandy López-De la Cruz, Rodolfo Morales-Valdés
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引用次数: 0
Escrutinio para el cáncer de colon: ¿cuál fue el impacto en los primeros 2 años de la pandemia de COVID-19? Experiencia en una clínica privada ambulatoria. 结肠癌筛查:COVID-19大流行前两年的影响是什么?在私人门诊诊所的经验。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000564
Óscar T Teramoto-Matsubara, Sergio Sobrino-Cossío, Juan M Abdo-Francis, Francisco De la Vega-González, Gualberto Mateos-Pérez

Background: COVID-19 pandemic had a negative impact on colorectal cancer (CRC) screening programs.

Objective: The care strategy was modified throughout the pandemic, this paper evaluates its impact and short-term consequences.

Methods: A retrospective, descriptive and cross-sectional study was carried out in a private ambulatory endoscopic center, in average risk subjects. The study compared two periods: pre-pandemic and pandemic (subdivided into pre-vaccination and vaccination).

Results: During this period, 54.4% of scheduled colonoscopies were due to the screening program. The average age was 60.4 ± 7 years. Women were 52.0%. The overall cancellation rate was 41.1%, higher during pre-vaccination period. There were no differences in the degree of colonic cleansing, colonoscope exit time, and patient satisfaction. The adenoma detection rate (38.4% vs. 42.8% vs. 36.4%; p = 0.8) and the total number of adenomas (p = 0.02) was statistically significant during the pre-vaccination period. The rate of adenoma/patient showed a higher trend during this period (p = 0.06). The number of colorectal cancers was 10, without differences between periods.

Conclusion: In conclusion, the impact of the decrease in screening colonoscopy procedures for CRC detection was similar to what was seen worldwide. In this period no increase in cancer cases, although this effect may be observed in the long term.

背景:COVID-19大流行对结直肠癌(CRC)筛查计划产生了负面影响。目的:在大流行期间对护理策略进行了修改,本文评估了其影响和短期后果。方法:回顾性,描述性和横断面研究在私人门诊内镜中心进行,在平均风险受试者。该研究比较了两个时期:大流行前和大流行(细分为疫苗接种前和疫苗接种)。结果:在此期间,54.4%的结肠镜检查是由于筛查计划。平均年龄60.4±7岁。女性占52.0%。总体取消率为41.1%,在接种前阶段较高。两组在结肠清洁程度、结肠镜检查结束时间和患者满意度方面均无差异。腺瘤检出率(38.4% vs. 42.8% vs. 36.4%;P = 0.8)和腺瘤总数(P = 0.02)在接种前有统计学意义。腺瘤/患者发生率在此期间呈上升趋势(p = 0.06)。结直肠癌病例数为10例,两期无差异。结论:总之,减少结肠镜筛查结直肠癌的影响与世界范围内的情况相似。在此期间,癌症病例没有增加,尽管这种影响可能会长期观察到。
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引用次数: 0
Inteligencia artificial en la colonoscopia de tamizaje y la disminución del error. 人工智能在结肠镜筛查和减少误差中的应用。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000446
Elymir Galvis-García, Francisco J de la Vega-González, Fabian Emura, Óscar Teramoto-Matsubara, Juan C Sánchez-Robles, Gonzalo Rodríguez-Vanegas, Sergio Sobrino-Cossío

Artificial Intelligence (AI) has the potential to change many aspects of healthcare practice. Image discrimination and classification has many applications within medicine. Machine learning algorithms and complicated neural networks have been developed to train a computer to differentiate between normal and abnormal areas. Machine learning is a form of AI that allows the platform to improve without being programmed. Computer Assisted Diagnosis (CAD) is based on latency, which is the time between the captured image and when it is displayed on the screen. AI-assisted endoscopy can increase the detection rate by identifying missed lesions. An AI CAD system must be responsive, specific, with easy-to-use interfaces, and provide fast results without substantially prolonging procedures. AI has the potential to help both, trained and trainee endoscopists. Rather than being a substitute for high-quality technique, it should serve as a complement to good practice. AI has been evaluated in three clinical scenarios in colonic neoplasms: the detection of polyps, their characterization (adenomatous vs. non-adenomatous) and the prediction of invasive cancer within a polypoid lesion.

人工智能(AI)有可能改变医疗保健实践的许多方面。图像识别和分类在医学中有许多应用。机器学习算法和复杂的神经网络已经被开发出来,用来训练计算机区分正常和异常区域。机器学习是人工智能的一种形式,它允许平台在没有编程的情况下进行改进。计算机辅助诊断(CAD)基于延迟,即从捕获图像到显示在屏幕上的时间。人工智能辅助内镜可以通过识别漏诊病变来提高检出率。一个人工智能CAD系统必须反应灵敏,具体,具有易于使用的界面,并提供快速的结果,而不会大大延长程序。人工智能有潜力帮助训练有素和见习的内窥镜医师。它不应该作为高质量技术的替代品,而应该作为良好实践的补充。人工智能在结肠肿瘤的三种临床情况下进行了评估:息肉的检测,其特征(腺瘤性与非腺瘤性)以及息肉样病变内浸润性癌症的预测。
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引用次数: 0
MSH-5: malignant knee tumors timely detection index. MSH-5:膝关节恶性肿瘤及时发现指标。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000907
Gustavo Rivera-Saldívar, Rubén Torres-González, Alejandra Cario-Méndez, Romeo Técualt-Gómez, Rubén A Amaya-Zepeda, Armando Alcántara-Corona, Silvestre Fuentes-Figueroa

Background: Bone neoplasms are usually misdiagnosed causing a delay in their treatment. Bone neoplasms are usually confused with tendinitis, 31% of the cases corresponds to osteosarcomas and in 21% to Ewing's sarcomas.

Objective: To create a clinical-radiographic instrument of high diagnostic suspicion of knee bone neoplasms to prevent a delay in diagnosis.

Method: A clinimetric study (sensitivity, consistency and validity) was performed in the bone tumor service, Hospital de Ortopedia de la Unidad Médica de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, in México City.

Results: Characteristics of 153 patients were collected. For the sensitivity phase, 3 domains (signs, symptoms, and radiology) and 12 items were included. Consistency was evaluated with ICC (0.944), 95%CI (0.865-0.977), p < 0.001 and a-Cronbach (0.863). Index obtained a sensitivity of 0.80 and a specificity of 0.882 were obtained. The positive predictive value of the test was 66.6% and the negative predictive value was 93.75%. The positive likelihood ratio was 6.8 and the negative likelihood ratio was 0.2. Validity was evaluated using r-Pearson (0.894; p < 0.001).

Conclusions: A high suspicion clinical-radiographic index was designed to detect malignant knee tumors with adequate sensitivity, specificity, appearance, content, criteria, and construct validity.

背景:骨肿瘤通常被误诊,导致治疗延误。骨肿瘤通常与肌腱炎混淆,31%的病例对应骨肉瘤,21%对应尤文氏肉瘤。目的:研制一种膝关节骨肿瘤高诊断怀疑度的临床x线仪,防止诊断延误。方法:采用临床计量学研究(敏感性、一致性和效度),在姆萨梅斯科市姆萨梅斯卡阿尔塔联合骨科医院(Hospital de la unidia de Alta especita)的vicio de la Fuente博士Narváez、墨西哥社会医学研究所(Instituto Mexicano del Seguro Social)骨肿瘤科进行研究。结果:收集了153例患者的特征。敏感期包括3个领域(体征、症状和放射学)和12个项目。一致性评价采用ICC(0.944)、95%CI(0.865 ~ 0.977)、p < 0.001和a-Cronbach(0.863)。该指标敏感性为0.80,特异性为0.882。阳性预测值为66.6%,阴性预测值为93.75%。阳性似然比为6.8,阴性似然比为0.2。效度采用r-Pearson (0.894;P < 0.001)。结论:设计了一种高怀疑度的临床放射学指标,以检测膝关节恶性肿瘤,具有足够的敏感性、特异性、外观、内容、标准和结构效度。
{"title":"MSH-5: malignant knee tumors timely detection index.","authors":"Gustavo Rivera-Saldívar,&nbsp;Rubén Torres-González,&nbsp;Alejandra Cario-Méndez,&nbsp;Romeo Técualt-Gómez,&nbsp;Rubén A Amaya-Zepeda,&nbsp;Armando Alcántara-Corona,&nbsp;Silvestre Fuentes-Figueroa","doi":"10.24875/CIRU.21000907","DOIUrl":"https://doi.org/10.24875/CIRU.21000907","url":null,"abstract":"<p><strong>Background: </strong>Bone neoplasms are usually misdiagnosed causing a delay in their treatment. Bone neoplasms are usually confused with tendinitis, 31% of the cases corresponds to osteosarcomas and in 21% to Ewing's sarcomas.</p><p><strong>Objective: </strong>To create a clinical-radiographic instrument of high diagnostic suspicion of knee bone neoplasms to prevent a delay in diagnosis.</p><p><strong>Method: </strong>A clinimetric study (sensitivity, consistency and validity) was performed in the bone tumor service, Hospital de Ortopedia de la Unidad Médica de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, in México City.</p><p><strong>Results: </strong>Characteristics of 153 patients were collected. For the sensitivity phase, 3 domains (signs, symptoms, and radiology) and 12 items were included. Consistency was evaluated with ICC (0.944), 95%CI (0.865-0.977), p < 0.001 and a-Cronbach (0.863). Index obtained a sensitivity of 0.80 and a specificity of 0.882 were obtained. The positive predictive value of the test was 66.6% and the negative predictive value was 93.75%. The positive likelihood ratio was 6.8 and the negative likelihood ratio was 0.2. Validity was evaluated using r-Pearson (0.894; p < 0.001).</p><p><strong>Conclusions: </strong>A high suspicion clinical-radiographic index was designed to detect malignant knee tumors with adequate sensitivity, specificity, appearance, content, criteria, and construct validity.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9774779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative complications and predictors of mortality in patients with COVID-19. COVID-19患者术后并发症及死亡率预测因素
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000512
Katya Bozada-Gutiérrez, Mario Trejo-Ávila, Mucio Moreno-Portillo

Background: There are limited data about the perioperative outcomes of coronavirus disease 2019 (COVID-19) patients that needed emergency general surgery. The aim of the present study was to describe the perioperative outcomes and mortality of patients with COVID-19 who underwent emergency surgery.

Materials and methods: Retrospective study of COVID-19 patients symptomatic versus asymptomatic from March 2020 to February 2022 that needed an emergency surgery in a national referral hospital.

Results: Forty-four patients were included in this study. Patients with symptomatic COVID-19 have higher ICU admissions and prolonged length of stay (LOS) as compared with asymptomatic COVID-19 patients. The 90-day survival probability of the entire cohort was 70.1% (60.3-79.9) and was significantly lower in patients with COVID-19 symptomatic 63.4% (50.5-76.2). The cut-off preoperative values for the prediction of mortality: Ferritin ≥ 438.5 ng/mL (Area under the curve [AUC] = 0.908), C-reactive protein (CRP) ≥ 12.5 mg/dL (AUC = 0.715), leukocyte ≥ 13.8 × 103/mL (AUC = 0.706), and albumin ≤ 2.78 g/dL (AUC = 704). Furthermore, a cut-off value of CRP of ≥ 12.5 mg/dL yielded an accuracy of 82.9% for the prediction of postoperative complications (p < 0.001).

Conclusion: Patients with symptomatic COVID-19 who needed emergency surgery have higher ICU admissions, prolonged LOS, and decreased 90-day survival as compared with asymptomatic COVID-19 patients. Preoperative ferritin, CRP, leukocytes, and albumin could be used as predictors of mortality.

背景:关于冠状病毒病2019 (COVID-19)患者需要急诊普通手术的围手术期结局的数据有限。本研究的目的是描述接受急诊手术的COVID-19患者的围手术期结局和死亡率。材料与方法:回顾性研究2020年3月至2022年2月在某国家级转诊医院急诊手术的COVID-19有症状和无症状患者。结果:44例患者纳入本研究。有症状的COVID-19患者比无症状的COVID-19患者有更高的ICU入院率和更长的住院时间。整个队列的90天生存率为70.1%(60.3-79.9),有COVID-19症状的患者的90天生存率为63.4%(50.5-76.2),显着降低。预测死亡率的术前截止值:铁蛋白≥438.5 ng/mL(曲线下面积[AUC] = 0.908)、c反应蛋白(CRP)≥12.5 mg/dL (AUC = 0.715)、白细胞≥13.8 × 103/mL (AUC = 0.706)、白蛋白≤2.78 g/dL (AUC = 704)。此外,CRP临界值≥12.5 mg/dL预测术后并发症的准确率为82.9% (p < 0.001)。结论:有症状的COVID-19患者与无症状的患者相比,需要急诊手术的患者ICU入院率更高,LOS延长,90天生存率降低。术前铁蛋白、CRP、白细胞和白蛋白可作为死亡率的预测因子。
{"title":"Postoperative complications and predictors of mortality in patients with COVID-19.","authors":"Katya Bozada-Gutiérrez,&nbsp;Mario Trejo-Ávila,&nbsp;Mucio Moreno-Portillo","doi":"10.24875/CIRU.22000512","DOIUrl":"https://doi.org/10.24875/CIRU.22000512","url":null,"abstract":"<p><strong>Background: </strong>There are limited data about the perioperative outcomes of coronavirus disease 2019 (COVID-19) patients that needed emergency general surgery. The aim of the present study was to describe the perioperative outcomes and mortality of patients with COVID-19 who underwent emergency surgery.</p><p><strong>Materials and methods: </strong>Retrospective study of COVID-19 patients symptomatic versus asymptomatic from March 2020 to February 2022 that needed an emergency surgery in a national referral hospital.</p><p><strong>Results: </strong>Forty-four patients were included in this study. Patients with symptomatic COVID-19 have higher ICU admissions and prolonged length of stay (LOS) as compared with asymptomatic COVID-19 patients. The 90-day survival probability of the entire cohort was 70.1% (60.3-79.9) and was significantly lower in patients with COVID-19 symptomatic 63.4% (50.5-76.2). The cut-off preoperative values for the prediction of mortality: Ferritin ≥ 438.5 ng/mL (Area under the curve [AUC] = 0.908), C-reactive protein (CRP) ≥ 12.5 mg/dL (AUC = 0.715), leukocyte ≥ 13.8 × 10<sup>3</sup>/mL (AUC = 0.706), and albumin ≤ 2.78 g/dL (AUC = 704). Furthermore, a cut-off value of CRP of ≥ 12.5 mg/dL yielded an accuracy of 82.9% for the prediction of postoperative complications (p < 0.001).</p><p><strong>Conclusion: </strong>Patients with symptomatic COVID-19 who needed emergency surgery have higher ICU admissions, prolonged LOS, and decreased 90-day survival as compared with asymptomatic COVID-19 patients. Preoperative ferritin, CRP, leukocytes, and albumin could be used as predictors of mortality.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynamic changes and clinic significance of serum high mobility group box 1 in patients with total hip arthroplasty. 全髋关节置换术患者血清高迁移率组1的动态变化及临床意义。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000238
Guangfu Zhou, Mao Liu, Xulin Wu, Bensen Tang

Background: Deeper understanding on the risk factors and seeking potential predicted biomarkers for prognosis of total hip arthroplasty (THA) patients are of great significance. Limited researches focused the correlation between high mobility group box protein-1 (HMGB1) and the prognosis of THA patients.

Objective: The objective of this study was to investigate the role of HMGB1 and inflammatory factors in patients underwent total hip arthroplasty (THA).

Methods: The present prospective study enrolled 208 THA patients who went to our hospital during January 2020 to January 2022. Serum levels of HMGB1, C-reactive protein (CRP), interleukin-1b (IL-1β), and IL-6 were detected at the admission, 1 day, 3 days, 7 days, 30 days, and 90 days after surgery. The levels of Harris score, Fugl-Meyer, 36-item short-form health survey (SF-36), and Pittsburgh sleep quality index (PSQI) were detected on 90 days after surgery in two groups. Receiver operating characteristic curve (ROC) was performed for analyzing the diagnostic value of HMGB1 and logistic regression model was used for identifying the risk factor for poor prognosis of THA patients.

Results: Serum levels of HMGB1 and inflammatory factors increased after surgery compared with the baselines. A positive correlation was found between HMGB1 and CRP on 1 day after surgery, and positive correlations were found among HMGB1, IL-1β, and IL-6 on 3 day after surgery. Besides, low HMGB1 reduced the incidence of post-operative complications and improved prognosis of THA patients.

Conclusion: Serum HMGB1 was correlated with inflammatory factors and the prognosis of THA patients.

背景:深入了解全髋关节置换术(THA)患者的危险因素,寻找潜在的预测预后的生物标志物具有重要意义。有限的研究集中在高迁移率群盒蛋白-1 (HMGB1)与THA患者预后的相关性。目的:本研究的目的是探讨HMGB1和炎症因子在全髋关节置换术(THA)患者中的作用。方法:本前瞻性研究纳入2020年1月至2022年1月在我院就诊的208例THA患者。分别于入院时、术后第1天、第3天、第7天、第30天、第90天检测血清HMGB1、c反应蛋白(CRP)、白细胞介素-1b (IL-1β)、IL-6水平。检测两组患者术后90天Harris评分、Fugl-Meyer、36项健康问卷调查(SF-36)和匹兹堡睡眠质量指数(PSQI)水平。采用受试者工作特征曲线(Receiver operating characteristic curve, ROC)分析HMGB1的诊断价值,采用logistic回归模型识别THA患者预后不良的危险因素。结果:术后血清HMGB1及炎性因子水平较基线升高。术后第1天HMGB1与CRP呈正相关,术后第3天HMGB1与IL-1β、IL-6呈正相关。此外,低HMGB1降低了THA患者术后并发症的发生率,改善了预后。结论:血清HMGB1与THA患者的炎症因子及预后相关。
{"title":"Dynamic changes and clinic significance of serum high mobility group box 1 in patients with total hip arthroplasty.","authors":"Guangfu Zhou,&nbsp;Mao Liu,&nbsp;Xulin Wu,&nbsp;Bensen Tang","doi":"10.24875/CIRU.22000238","DOIUrl":"https://doi.org/10.24875/CIRU.22000238","url":null,"abstract":"<p><strong>Background: </strong>Deeper understanding on the risk factors and seeking potential predicted biomarkers for prognosis of total hip arthroplasty (THA) patients are of great significance. Limited researches focused the correlation between high mobility group box protein-1 (HMGB1) and the prognosis of THA patients.</p><p><strong>Objective: </strong>The objective of this study was to investigate the role of HMGB1 and inflammatory factors in patients underwent total hip arthroplasty (THA).</p><p><strong>Methods: </strong>The present prospective study enrolled 208 THA patients who went to our hospital during January 2020 to January 2022. Serum levels of HMGB1, C-reactive protein (CRP), interleukin-1b (IL-1β), and IL-6 were detected at the admission, 1 day, 3 days, 7 days, 30 days, and 90 days after surgery. The levels of Harris score, Fugl-Meyer, 36-item short-form health survey (SF-36), and Pittsburgh sleep quality index (PSQI) were detected on 90 days after surgery in two groups. Receiver operating characteristic curve (ROC) was performed for analyzing the diagnostic value of HMGB1 and logistic regression model was used for identifying the risk factor for poor prognosis of THA patients.</p><p><strong>Results: </strong>Serum levels of HMGB1 and inflammatory factors increased after surgery compared with the baselines. A positive correlation was found between HMGB1 and CRP on 1 day after surgery, and positive correlations were found among HMGB1, IL-1β, and IL-6 on 3 day after surgery. Besides, low HMGB1 reduced the incidence of post-operative complications and improved prognosis of THA patients.</p><p><strong>Conclusion: </strong>Serum HMGB1 was correlated with inflammatory factors and the prognosis of THA patients.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9811336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Apendicitis aguda dentro de una hernia de Spiegel: un caso infrecuente de una patología infrecuente. 明镜疝中的急性阑尾炎:一种罕见病理的罕见病例。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.21000783
Guadalupe K Peña-Portillo, Aarón Zaraín-Rodríguez, Victoria Rendón-Camarillo, Gabriela Ayala-Hernández, Iván Marín-Pardo, Elías Ballesteros-Suárez

Introduction: Spigelian hernia is a rare entity, with higher improbability of acute appendicitis within it.

Case report: A 75-year-old female with a 30-year evolution hernia, abdominal pain, and fever of 1 week of onset, in whom was found an acute appendicitis within a Spigelian hernia.

Discussion: Spigelian hernia comprises 0.12-2% of all abdominal hernias. Presurgical diagnosis is stablished only in 50% of cases, with an hernial ring less than 2 cm and hidden localization. There isn't statistics of this complication because of the lack of case reports.

简介:Spigelian疝是一种罕见的实体,其内发生急性阑尾炎的可能性更高。病例报告:一名75岁的女性,患有30年的演进性疝,腹痛,发病1周后发烧,在Spigelian疝气内发现急性阑尾炎。讨论:Spigelian疝占所有腹部疝的0.12-2%。术前诊断只有50%的病例是稳定的,疝环小于2厘米和隐藏的定位。由于缺乏病例报告,没有关于这种并发症的统计数据。
{"title":"Apendicitis aguda dentro de una hernia de Spiegel: un caso infrecuente de una patología infrecuente.","authors":"Guadalupe K Peña-Portillo,&nbsp;Aarón Zaraín-Rodríguez,&nbsp;Victoria Rendón-Camarillo,&nbsp;Gabriela Ayala-Hernández,&nbsp;Iván Marín-Pardo,&nbsp;Elías Ballesteros-Suárez","doi":"10.24875/CIRU.21000783","DOIUrl":"10.24875/CIRU.21000783","url":null,"abstract":"<p><strong>Introduction: </strong>Spigelian hernia is a rare entity, with higher improbability of acute appendicitis within it.</p><p><strong>Case report: </strong>A 75-year-old female with a 30-year evolution hernia, abdominal pain, and fever of 1 week of onset, in whom was found an acute appendicitis within a Spigelian hernia.</p><p><strong>Discussion: </strong>Spigelian hernia comprises 0.12-2% of all abdominal hernias. Presurgical diagnosis is stablished only in 50% of cases, with an hernial ring less than 2 cm and hidden localization. There isn't statistics of this complication because of the lack of case reports.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population. 墨西哥老年人群血液透析通道动静脉瘘的临床结果分析。
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.24875/CIRU.22000217
Emmanuel Contreras-Jimenez, Gabriel Lopez-Pena, Christopher Ruben-Castillo, Santiago Mier Y Teran-Ellis, Cesar Cuen-Ojeda, Luis H Arzola-Flores, Javier E Anaya-Ayala, Carlos A Hinojosa

Objective: The increased survival rates of end-stage renal disease (ESRD) patients have impacted directly in the proportion of elderly patients requiring a reliable hemodialysis (HD) access; this group clearly demands an individualized approach. We aim to analyze maturation and patency rates of arteriovenous fistulas (AVF) in elderly patients.

Methods: This was retrospective review of a database of patients that underwent AVF creation in our institution. The maturation and patency rates were analyzed divided in groups based on age (equal and greater of 65 years, and patients under 65 years). Patency rates were compared using Kaplan-Meier analysis.

Results: Twenty patients ≥ 65 years old (mean 73, SD ± 5.4) were analyzed. The overall maturation rate in this group was 75% compared to 84.1% (p = 0.33) in the younger group (mean age 48 years, SD ± 17). The primary patency at 6 and 12 months for the ≥ 65 years group was 93% and 86%, respectively, compared with 85% and 81% for the younger group (p = 0.77).

Conclusion: Autogenous AVF remains the preferred and durable option for elderly patients. We found no difference in terms of maturation and patency rates compared to younger patients. Standardized protocols are needed to optimally select vascular accesses.

目的:终末期肾病(ESRD)患者生存率的提高直接影响到需要可靠血液透析(HD)途径的老年患者比例;这个群体显然需要个性化的方法。目的分析老年动静脉瘘(AVF)的成熟率和通畅率。方法:本研究是对我院接受AVF创建的患者数据库进行回顾性分析。成熟率和通畅率按年龄分组(65岁及以上,65岁以下)进行分析。采用Kaplan-Meier分析比较通畅率。结果:20例患者≥65岁(平均73岁,SD±5.4)。该组的总成熟率为75%,而年轻组(平均年龄48岁,SD±17)为84.1% (p = 0.33)。≥65岁组6个月和12个月的原发性通畅率分别为93%和86%,而年轻组为85%和81% (p = 0.77)。结论:自体房颤仍是老年患者的首选和持久的选择。我们发现,与年轻患者相比,在成熟和通畅率方面没有差异。需要标准化的方案来最佳地选择血管通路。
{"title":"Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population.","authors":"Emmanuel Contreras-Jimenez,&nbsp;Gabriel Lopez-Pena,&nbsp;Christopher Ruben-Castillo,&nbsp;Santiago Mier Y Teran-Ellis,&nbsp;Cesar Cuen-Ojeda,&nbsp;Luis H Arzola-Flores,&nbsp;Javier E Anaya-Ayala,&nbsp;Carlos A Hinojosa","doi":"10.24875/CIRU.22000217","DOIUrl":"https://doi.org/10.24875/CIRU.22000217","url":null,"abstract":"<p><strong>Objective: </strong>The increased survival rates of end-stage renal disease (ESRD) patients have impacted directly in the proportion of elderly patients requiring a reliable hemodialysis (HD) access; this group clearly demands an individualized approach. We aim to analyze maturation and patency rates of arteriovenous fistulas (AVF) in elderly patients.</p><p><strong>Methods: </strong>This was retrospective review of a database of patients that underwent AVF creation in our institution. The maturation and patency rates were analyzed divided in groups based on age (equal and greater of 65 years, and patients under 65 years). Patency rates were compared using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Twenty patients ≥ 65 years old (mean 73, SD ± 5.4) were analyzed. The overall maturation rate in this group was 75% compared to 84.1% (p = 0.33) in the younger group (mean age 48 years, SD ± 17). The primary patency at 6 and 12 months for the ≥ 65 years group was 93% and 86%, respectively, compared with 85% and 81% for the younger group (p = 0.77).</p><p><strong>Conclusion: </strong>Autogenous AVF remains the preferred and durable option for elderly patients. We found no difference in terms of maturation and patency rates compared to younger patients. Standardized protocols are needed to optimally select vascular accesses.</p>","PeriodicalId":50990,"journal":{"name":"Cirugia Y Cirujanos","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9477337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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