bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transporte sobre clavo respetando la membrana de Masquelet en defectos segmentarios severos. Serie de casos
Authors: Quesada Agustín , Videla Ávila Fabricio , Horué Pontoriero Gastón , Filisetti Jorge E. 
Published: February 2023

Introducción: El adecuado tratamiento de los defectos óseos se presenta como un desafío para el cirujano ortopedista, en cuanto a la dificultad en la restitución de un miembro alineado, sin discrepancia ni infección. Se han descrito múltiples técnicas para reconstruir estos defectos, como el injerto óseo autólogo o de banco, la técnica de membrana inducida, la osteogénesis por distracción y los cilindros de titanio trabecular, pero ninguna ha demostrado ser significativamente superior a otra.
Materiales y Métodos: Entre 2018 y 2021, 10 pacientes con defectos óseos de la tibia fueron tratados mediante transporte óseo guiado con osteosíntesis endomedular. Se realizó un estudio retrospectivo descriptivo analizando la magnitud de los defectos, el tiempo de transporte, las complicaciones y cirugías adicionales durante el proceso, si hubo consolidación y las deformidades residuales. Al final del proceso, se midió el puntaje de la ASAMI (óseo y funcional).
Resultados: La longitud promedio de los defectos tratados fue de 9,75 cm y el índice de fijación externa promedio, de 40,62 días/cm. El 50% tenía un puntaje de la ASAMI óseo bueno; el 10%, excelente y el 40%, pobre al final del proceso reconstructivo. El 20% tenía un puntaje de la ASAMI funcional excelente; el 30%, bueno y el 50%, pobre.
Conclusiones: El uso de tutores externos guiados mediante osteosíntesis es un método fiable para tratar defectos óseos, al mismo tiempo que se trata la infección de manera local y sistémica, acortando los tiempos de tutor externo y, por lo tanto, de internación y reintervención.
Pie diabético y pandemia de la COVID-19: adaptación al uso de la Telemedicina por los especialistas de pie y tobillo de los Servicios de Traumatología de la Argentina
Authors: Parise Ana Cecilia , Coria Hernán E. , López Valeria , Santini Araujo María Gala 
Published: February 2023

Introducción: La telemedicina fue la recomendación internacional durante la pandemia de COVID-19 para las consultas médicas de los pacientes con pie diabético. El objetivo de este estudio fue analizar el empleo de la telemedicina como herramienta en pacientes con pie diabético, por parte de especialistas en pie y tobillo de la Argentina. Como objetivos secundarios se planteó valorar la satisfacción percibida por los profesionales con el uso de esta herramienta, evaluar qué estrategias se usaron para realizar la consulta médica remota y determinar la permanencia al retornar a la actividad asistencial habitual.
Materiales y Métodos: Se enviaron tres encuestas a los socios de la Sociedad Argentina de Medicina y Cirugía de la Pierna y Pie, entre mayo 2020 y abril de 2022.
Resultados: La función más valiosa de la consulta remota fue la prevención (75% de los encuestados), el seguimiento clínico (54,1%), el seguimiento posoperatorio (41,6%) y el diagnóstico (29,1%). El recurso más utilizado fue la conversación telefónica, seguida del envío de imágenes por mensajería instantánea. Solo el 37,5% utilizó las plataformas de historia clínica virtual.
Conclusiones: Los recursos más utilizados para la consulta remota fueron la conversación telefónica, seguida del envío de imágenes por mensajería instantánea. El 33,4% estaba conforme con la consulta por telemedicina en mayo de 2020, mientras que, en julio, la conformidad ascendió al 46,7%. En abril de 2022, solo el 13% continuaba con las consultas remotas.
Análisis de las características demográficas de 94 pacientes con fracturas articulares de calcáneo
Authors: Seletti Maximiliano , Pendino Ana , Lombardo Ernesto 
Published: February 2023

Objetivo: Analizar las características demográficas de los pacientes con fracturas articulares de calcáneo en relación con el mecanismo del trauma y los patrones fracturarios según las clasificaciones de Sanders y Essex-Lopresti.
Materiales y Métodos: Se evaluó retrospectivamente a 94 pacientes (111 fracturas articulares de calcáneo). Se analizaron las siguientes variables: edad, sexo, lado fracturado, mecanismo del trauma y lesiones asociadas. Al ingresar, se tomaron radiografías de pie, de frente y perfil, y se realizó una tomografía computarizada con reconstrucción multiplanar. Se analizaron los datos demográficos combinándoloscon los tipos de fracturas.
Resultados: Se evaluó a 94 pacientes (78 hombres y 16 mujeres) que tenían 105 fracturas intrarticulares de calcáneo (11,7% bilaterales). La edad promedio era de 40.1 ± 12.5 años. El 79,8% de las fracturas se había producido por caída de altura y el 20,1%, por accidente de tránsito. El 9,5% tenía lesiones asociadas. Los pacientes con fracturas bilaterales tenían más lesiones asociadas (p = 0,0123) y el mismo patrón fracturario y tipo de Sanders en ambos pies. No hubo relación entre la clasificación de Sanders y los patrones de Essex-Lopresti con la edad, el sexo y el mecanismo del trauma.
Conclusiones: Las fracturas de calcáneo son más frecuentes en hombres y en pacientes jóvenes, y el mecanismo del trauma más común es una caída de altura. Los pacientes con fracturas bilaterales tienen una tasa más alta de lesiones asociadas y el mismo tipo de fractura según la clasificación de Sanders y el patrón fracturario de Essex-Lopresti en ambos pies.
Clinical Outcomes Associated With Intranasal Dexmedetomidine Sedation in Children
Authors: Tsze Daniel S. , Rogers Amber P. , Baier Nicole M. , Paquin Joanna R. , Majcina Ryan , Phelps Janey R. , Hollenbeck April , Sulton Carmen D. , Cravero Joseph P. 
Published: February 2023

OBJECTIVES
We aimed to describe the quality of sedation and additional clinically-meaningful outcomes associated with different intranasal dexmedetomidine-based regimens in children undergoing nonpainful procedures.

METHODS
A multicenter prospective observational study of children aged 2 months to 17 years undergoing intranasal dexmedetomidine sedation for MRI, auditory brainstem response testing, echocardiogram, EEG, or computed tomography scan. Regimens varied by dose of dexmedetomidine and use of adjunct sedatives. Quality of sedation was assessed using the Pediatric Sedation State Scale and by determining proportion of children who achieved an acceptable sedation state. Procedure completion, time-based outcomes, and adverse events were assessed.

RESULTS
We enrolled 578 children across 7 sites. Median age was 2.5 years (interquartile range 1.6–3) and 37.5% were female. The most common procedures were auditory brainstem response testing (54.3%) and MRI (22.8%). The most common dose was 3 to 3.9 mcg/kg (55%), with 25.1% and 14.2% of children receiving oral or intranasal midazolam, respectively. Acceptable sedation state and procedure completion was achieved in 81.1% and 91.3% of children, and mean time to onset of sedation and total sedation time were 32.3 and 114.8 minutes, respectively. Twelve interventions were performed in 10 patients in response to an event; no patients required a serious airway, breathing, or cardiovascular intervention.

CONCLUSIONS
Intranasal dexmedetomidine-based regimens can achieve acceptable sedation states and high rates of procedure completion in children undergoing sedation for nonpainful procedures. Our findings delineate clinical outcomes associated with intranasal dexmedetomidine-based sedation that can be used to guide the implementation and optimization of such regimens.
Assessment of Emergency Medical Services Personnel Compliance with Escalating Airway Algorithm Protocol
Authors: Duncan Leah , Falahat Michael , Hartpence Connor , Ruddle Deryk , Ofei-Dodoo Samuel 
Published: February 2023

Introduction. When emergency medical service (EMS) personnel respond to emergencies, the decisions they make can often mean life or death for the patient. This is especially true in the case of advanced airway management. Protocols are set in place to ensure that the least invasive airway management techniques are used initially before more invasive techniques. The purpose of this study was to determine how often EMS personnel followed this protocol, while adequately achieving the goals of appropriate oxygenation and ventilation.
Methods. This retrospective chart review was approved by the Institutional Review Board of The University of Kansas Medical Center. The authors reviewed the Wichita/Sedgewick County EMS system for cases in which patients required airway support. We examined de-identified data to determine if invasive methods were applied in sequence. Cohen's kappa coefficient (κ) and immersion-crystallization approach were used to analyze the data.
Results. A total of 279 cases were identified in which EMS personnel used advanced airway management techniques. In 90% (n = 251) of cases, less invasive techniques were not used prior to more invasive techniques and in 80% (n = 222) of cases, the more invasive technique was used alone. A dirty airway was the most common reason for the EMS choice using more invasive approaches in achieving the goals of appropriate oxygenation and ventilation.
Conclusions. Our data showed that EMS personnel in Sedgwick County/Wichita, Kansas often deviate from the advanced airway management protocols when caring for patients in need of respiratory intervention. Dirty airway was found to be the main reason for using a more invasive approach in achieving the goals of appropriate oxygenation and ventilation. It is important to fully understand reasons why deviations in protocol are occurring to ensure that current protocols, documentation, and training practices are effective in producing the best possible patient outcomes.
Expectativas y creencias del alumnado rural sobre su futuro profesional y académico
Authors: Lorenzo Lacruz Juan , Domingo Cebrián Virginia , Tomé Fernández María 
Published: February 2023

RESUMENActualmente las escuelas rurales están siendo modelos alternativos de enseñanza en muchos puntos de España. Estas escuelas presentan ventajas educativas que no tienen las escuelas urbanas. ¿Pero qué opinan los alumnos de estas escuelas sobre su futuro académico y profesional? A pesar de que las investigaciones en este tema son escasas, en este estudio se pretenden conocer las expectativas y creencias del alumnado rural en cuanto a su futuro profesional y académico. Para ello, a través de un muestreo no probabilístico se seleccionó a 270 estudiantes correspondientes a escuelas rurales de Aragón, Cataluña y Andalucía. Para evaluar el objetivo planteado se elaboró un cuestionario ad hoc. Los resultados obtenidos se analizaron mediante el software estadístico SPSS en su versión 17. Entre estos resultados se encuentra que el 57, 8% de los estudiantes evaluados considera que tendrán éxito en su futuro académico y a más del 50% le gustaría trabajar en un empleo perteneciente al sector servicios. Por último, entre las conclusiones más relevantes se halla que el número de habitantes de los pueblos en donde los alumnos viven influye en la creencia que los estudiantes tienen de ellos mismos y en el trabajo que creen que desempeñarán.Palabras Clave: Escuela rural, creencias, expectativas, estudiantes rurales, pueblos españoles.ABSTRACTNowadays, many Spanish rural schools have become alternative teaching models. These schools have several advantages over urban schools. Our interest lies in the opinions of the rural students on their academic and professional future. Thus, we intend to know their expectations and beliefs through a probabilistic sampling over 270 students of rural schools of several Spanish regions (Aragon, Cataluña and Andalucia). For that purpose we designed a questionnaire and the results were analyzed with SPSS statistic software. Among the results we came across that 57,8% of the students think they will be successful in their academic future and more than 50% would like to work in a profession related to tertiary sector. Finally, we found that there is a straight relationship between the population of the villages and the beliefs and expectations the students have of themselves.Keywords: Rural school, students’ beliefs, expectations, students, Spanish villages.
The effect of tranexamic acid on blood loss after vaginal delivery and caesarian section
Authors: Tiwari Nisha , Kumari Nisha , Maurya Divya 
Published: February 2023

PPH is most common cause of maternal death, contributing to approximately 35% of maternal death all over the world. WHO (2017) recommended that tranexamic acid should be considered as a standard comprehensive PPH treatment package and must be used in all cases of PPH regardless of the cause of PPH.To evaluate the effectiveness and safety of intravenous Tranexamic acid (TA) for reduction of postpartum blood loss after vaginal delivery and LSCS and to record any adverse effects following its administration.This study was conducted as a randomized, double blind, placebo controlled trial on females at high risk of PPH and delivered vaginally or via LSCS at our Institute. All the participants were randomly categorized into two groups study group (tranexamic acid) and control group. The two groups were compared with respect to efficacy (amount of blood loss and incidence of PPH) and safety (vitals and side effects). Mean blood loss from the delivery of placenta to the end of delivery and from end of delivery to 2 hours postpartum was significantly lower in study group as compared to control group (p&#60;0.05). Incidence of PPH was significantly higher in control group (p&#60;0.05). There was no statistically difference in the vital at the time of delivery between two groups (p&#62;0.05). Most common side effect due to tranexamic acid in study group was nausea (16%) followed by vomiting and diarrhea in 9% and 1% respectively. Tranexamic acid is an effective drug that can be used safely for prophylactic management of PPH regardless of its cause. This antifibrinolytic agent significantly reduce blood loss and incidence of PPH irrespective of type of delivery. Though, the drug is associated with minor side effects such as nausea, vomiting and diarrhea, it was not associated with major complications, thromboembolic phenomenon and maternal or perinatal morbidity and mortality.
Effect of intrauterine instillation of autologous platelet-rich plasma on endometrial thickness and pregnancy outcome
Authors: Desai Freya , Desai Kokila , Sharma Hariom , Bambhaniya Hitesh , Sharma Shreyansh 
Published: February 2023

Every year numerous females are detected infertile as infertility becomes a major problem in reproductive lives, worldwide. The purpose of this study is to evaluate the effectiveness of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile women undergoing frozen embryo transfer cycles with suboptimal endometrium. A total of 61 women between 22 to 40 years of age were included in the study. Based on hysteroscopy findings they were divided into group A (Normal hysteroscopy findings) and group B (Abnormal hysteroscopy findings). Intrauterine instillation of autologous PRP was done in women having an endometrial thickness of ≤7 even after giving Estradiol valerate therapy. After 48 and 72 hours of PRP infusion, an increase in EMT was evaluated. Embryo transfer was performed when the endometrium reached an optimal pattern in terms of thickness, appearance, and vascularity.EMT increased significantly (p 0.05) in Group B compared to Group A. Between both groups, there were no apparent changes in CPR, IR, or LBR (p 0.001). Overall, clinical pregnancy and LBR increased respectively. Autologous platelet-rich plasma increases endometrial thickness and success rate in pregnancy after PRP administration in patients with low EMT undergoing IVF treatment and patients having two or more previous IVF failures.
A longitudinal cross-sectional study on awareness of contraception
Authors: Thakur Srishti , Mohi Manjit Kaur , Pathak Nayana , Sandhu Kandy 
Published: February 2023

Contraception is a method or a way to stop or prevent pregnancy. Since from ancient times birth control has its prevalence but the safest and most efficient methods of contraception was only introduced in 20th century. An ideal contraceptive is considered when it is user-friendly, effective and reversible with less or zero side effects and lesser adverse complications and more importantly one which is easily available. There are wide range of contraception or birth control methods currently available which includes traditional methods, barriers, oral contraceptives pills (OCP), implants, Intra Uterine Devices (IUDs) and Surgical methods along with injectable. The United States Center for Disease Control and Prevention jointly with World Health Organization has provided with guidelines on the safety of contraception for women with specific medical condition. According to another report documented by World Health organization, which stated that most effective and safest methods of contraception is sterilization by means of vasectomy in males and in cases of females by means of tubal linguation, intra uterine devices and implantable birth control. This data of safest birth control method also includes vaginal rings, oral pills, patches and injections. World Health Organization Department of Reproductive Health and Research has also stated that less effective methods includes physical barriers & spermicide and the least effective methods of contraception is traditional or natural method.A longitudinal cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Gyan Sagar Medical College and Hospital in Punjab, India. Ethical approval was taken from the committee before commencing of this study. To determine the prevalence of awareness of Contraception and to determine the most commonly used contraceptive method among subjects. We hereby conclude our longitudinal cross-sectional study by indicating the fact that prevalence of awareness of contraception is higher in urban and educated classes of our society. We thereby wanted to spread one message through our study so that special initiative on birth control method should be mandated by Government in various medical colleges and hospitals in India to create awareness in rural sections and interior villages, social awareness of safe sexual practice could be spread each and every section of our country because contraception does not only prevent pregnancy it also protects the mankind and save one’s life from HIV and other sexually transmitted infections. As is always quoted correctly that “Prevention is better than cure”.
Clinicopathological evaluation of patients with postmenopausal bleeding in a tertiary care center
Authors: Hemalatha S V  , Thenmozhi G , Manickadevi M. S. 
Published: February 2023

Postmenopausal bleeding (PMB) is frequent finding in 5-10% of women in gynaecology clinic. About 10% of these patients have primary or secondary malignancy. PMB requires complete assessment to ensure the absence of malignancy and to identify and treat high risk patients such as those with endometrial hyperplasia.The aim of this study is to investigate the clinical significance and endometrial pathology in patients with PMB.A retrospective study on postmenopausal women visiting a tertiary care center between 2016 January to 2017 December was taken up for study. About 80 patients with PMB were selected and these patients were evaluated by pelvic USG, Endometrial biopsy and Endometrial histopathology.Maximum patients with PMB belonged to age group of 46-50 years (31.25%). 57.5% were multiparous (parity&#62;2). About 53.75% had PMB 1 to 5 years after menopause. Endometrial thickness (ET) was &#62; 4mm in 86.25%. Majority had ET between 5-10mm (58.75%). Histopathological analysis of endometrial curettings showed Proliferative phase in 35%, disordered proliferative phase in 17.5%, Atrophic Endometrium in 13.75% and endometrial carcinoma in 11.25%.Postmenopausal bleeding is an important symptom which requires evaluation to eliminate possibility of malignancy. Transvaginal sonography (TVS) is the first mode of investigation for PMB but Histopathology of Endometrium serves as gold standard for definitive diagnosis.
COVID-19 y Errores innatos de la inmunidad, enfermedades autoinmunes e inmunosupresión
Authors: Lugo Reyes Saul Oswaldo , Medina Torres Edgar Alejandro , Espinosa-Padilla Sara Elva 
Published: February 2023

La pandemia de COVID-19 llegó a cinco olas en tres años con más de 6.5 millones de muertes en todo el mundo. Conocer la susceptibilidad diferencial al nuevo betacoronavirus ha permitido comprender mejor la fisiopatología y sus complicaciones inflamatorias, así como disecar la respuesta inmunitaria. En este proceso, destaca el papel de linfocitos T CD8+ y NK, así como sensores virales, interferones tipo 1, inflamación exagerada a cargo de NLRP3 y tormenta de citocinas IL-6 e IL-18. La secuenciación de todo el exoma ha permitido identificar varios genes con variantes germinales patogénicas en pacientes con COVID-19 grave; dichos genes explicarían alrededor del 5% de los casos graves. Además, hasta el 20% de adultos hospitalizados albergan autoanticuerpos contra interferones. Estos hallazgos traducen nuevas etiologías genéticas y los autoanticuerpos explican el peor pronóstico en ancianos, asociado al fenómeno inflammaging. En general, a los pacientes con inmunodeficiencias que adquirieron la COVID-19 no les fue peor, con una supervivencia global mayor al 80% y un predominio de cuadros leves. La excepción fueron pacientes con inmunodeficiencia combinada grave o con síndrome poliglandular autoinmune 1, estos últimos porque desarrollan autoanticuerpos contra interferón. En pacientes con enfermedades autoinmunes o trastornos autoinflamatorios tampoco se ha reportado mayor gravedad. Sin embargo, aquéllos que reciben inmunosupresores suelen tener un cuadro prolongado. Los pacientes con ganancia de función de NLRP3 y STAT1 pueden ser especialmente susceptibles a complicaciones inflamatorias sistémicas. En esta revisión documental resumimos la experiencia global en la atención de pacientes con alteraciones inmunitarias que se infectaron por SARS-CoV-2.