The ankle-foot axis is a complex structure, whose biodynamics allow efficient march. Anatomical variants can alter this biodynamic and be the cause of chronic pain. However, they are frequently not taken into account in the assessment of ankle pain, being overlooked in the radiological assessment, implying diagnostic delays that affect the patient's quality of life and decrease the quality of care.
validar los criterios STOPP/START y los criterios de Beers en el contexto colombiano, de manera que estos puedan ser aplicados a futuro en la práctica clínica en el país.
se utilizó la técnica Delphi que buscó un consenso de expertos alrededor de los criterios STOPP/START y los criterios de Beers.
instituciones de salud de la ciudad de Medellín, Colombia.
la técnica Delphi se desarrolló con médicos de diferentes especialidades y vinculados a diferentes instituciones de salud.
el desarrollo del estudio se llevó a cabo en 2 etapas. La primera fue la adaptación lingüística, para la cual se realizó la traducción oficial de ambos criterios, y para la segunda etapa se desarrolló una consulta a expertos sobre la aplicabilidad de estos criterios en Colombia.
con relación a la fase de adaptación lingüística, se recibieron observaciones de forma y precisión en los criterios STOPP/START, los cuales fueron tenidos en cuenta en la versión final de este documento y en la fase de la técnica Delphi. Los expertos consideran que los criterios son aplicables al contexto colombiano, que los medicamentos allí descritos son utilizados dentro de los planes de salud en este país.
la aplicación de estos criterios explícitos podría contribuir a disminuir los errores de la medicación desde el ámbito de la prescripción segura y adecuada para el adulto mayor.
To validate the STOPP/START criteria and the Beers criteria in the Colombian context, so that they can be applied in the future in clinical practice in the country.
The Delphi technique was used, which sought a consensus of experts around the STOPP/START criteria and the Beers criteria.
Health institutions of the city of Medellín, Colombia.
The Delphi technique was developed with doctors from different specialties and linked to different health institutions.
The development of the study was carried out in two stages. The first was the Linguistic Adaptation, for which the official translation of both criteria was carried out, and for the second stage, a consultation with experts was developed on the applicability of these criteria in Colombia.
In relation to the linguistic version adaptation phase, observations of form and precision were observed in the STOPP/START criteria, which were taken into account at the end of this document and in the Delphi technique phase. The experts consider that the criteria are applicable to the Colombian context, that the medicines described there are used within the health plans in this country.
The application of these explici
Desmoid tumor is a locally aggressive fibromatosis with a slow and progressive onset. It usually occurs in women of childbearing age and has predilection for the abdominal wall. Therefore, it can be considered as a sarcoma with very low virulence, unpredictable clinical course and high rates of local recurrence.
Diagnostic errors play an important role in patient safety, being this one of our values as doctors. Although in some cases they can "only" suppose a delay in the improvement of the patient, in many others, they can lead to a torpid evolution of the disease or even to a fatal outcome. This article presents the case of a 19-year-old girl, who is a professional dancer and who was treated on several occasions for symptoms in the left foot and ankle, in the last two years, always accusing the clinic of her daily activity. It is in the last medical appointment, after extending the imaging studies, when a tibial osteochondroma is diagnosed. Due to performing a retrospective of the multiple previous radiographies, it was observed that the tumor was visible from the first one. In this case, it was a benign pathology with surgical resolution, but it could have been a malignant or incurable disease at the time of diagnosis. Hence the importance of always reviewing all the data and complementary tests available in a case, regardless of whether they may have been previously assessed by other colleagues.
To determine the risk factors associated with gestational diabetes mellitus in northern México.
Observational, analytical case-control study.
Family Medicine Unit No. 33 in Reynosa, Tamaulipas, México.
Pregnant women between 24 to 28 gestational weeks.
363 cases and 587 controls underwent a one-step test with an oral intake of 75 grams of glucose with basal determination, at one hour and 2 hours to determine the presence or absence of gestational diabetes. From the electronic medical record; sociodemographic, anthropometric, gynecologic, obstetric, pathological and non-pathological variables were collected.
A univariate exploratory analysis was performed using the sample mean and standard deviation to find out the centrality and dispersion. Subsequently, a bivariate analysis was performed to determine association and correlation of the variables of interest with the presence or absence of gestational diabetes mellitus. Lastly, an integral logistic model was performed with the independent variables to determine its effects and statistical significance.
Age of the cases was 30.46 years, 4 years older than the controls; weight of 78.82 kilograms, 10 kilograms more than controls. Obstetric risk of 6.34 in cases and 4.69 in controls. Age older than 30 years had an OR 5.15 (CI 1.77-15) for gestational diabetes. Overweight OR 4.53 (CI 2.56-8.03), obesity class I OR 10.03 (CI 5.59-18), obesity class II OR 16.11 (CI 8.36-31.04) and obesity class III OR 16.91 (CI 6.86-41.68).
Women with gestational diabetes have a higher age, weight and obstetric risk. The main risk factors associated with gestational diabetes were age and obesity.
Endocervicosis is an uncommon and unknown disease. It is a benign pathology. It is an alteration of the endocervical glands outside their location, specifically in the bladder.
We present a case of bladder endocervicosis in a postmenopausal woman detected by clinical ultrasound at the health care centre. We discuss the etiology, differential diagnóstico and treatment of this pathology and the relevance of clinical ultrasound in primary care for early diagnóstico.
This disease could simulate malignancy, being a diagnostic challenge for the anatomopathologist. It is important to know about this disease to avoid invasive treatments for the patient.
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