ABSTRACT This article summarizes the clinical practice guideline (CPG) for the management of acute pancreatitis in the Social Security of Peru (EsSalud), to provide evidence-based clinical recommendations for the management of acute pancreatitis in EsSalud. A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant-primary studies were carried out in PubMed during 2022. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice, and the corresponding ow charts. Finally, the CPG was approved with Resolution No. 105-IETSI-ESSALUD-2022. This CPG addressed 7 clinical questions on buid therapy, start of enteral nutrition, analgesia, type of nutrition, antibiotic, and surgical treatment. Based on these questions, 8 recommendations (1 strong and 7 conditional), 13 BPCs, and 1 flowchart were formulated. This article summarizes the methodology and evidence-based conclusions of the CPG for the management of acute pancreatitis in EsSalud.

RESUMEN El presente artículo resume la guía de práctica clínica (GPC) para el manejo de la pancreatitis aguda en el Seguro Social del Perú (EsSalud). Su objetivo es proveer recomendaciones clínicas basadas en evidencia para el manejo de la pancreatitis aguda en EsSalud. Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 7 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en PubMed durante el 2022. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y flujogramas correspondientes. Finalmente, la GPC fue aprobada con Resolución N° 105-IETSI-ESSALUD-2022. La presente GPC abordó 7 preguntas clínicas sobre fluidoterapia, momento de inicio de nutrición enteral, analgesia, tipo de nutrición, tratamiento antibiótico y quirúrgico. En base a dichas preguntas se formularon 8 recomendaciones (1 fuerte y 7 condicionales), 13 BPC, y 1 flujograma. El presente artículo resume la metodología y las conclusiones basadas en evidencia de la GPC para el manejo de la pancreatitis aguda en EsSalud.

■ ABSTRACT Keloids and hypertrophic scars are lesions formed from the abnormal fibroproliferative response to the wound healing process, generating excessive collagen proliferation in the lesions. They generally predominate in female patients and individuals with darker skin tones. The therapeutic approach to these scars can be indicated according to criteria such as functional deficit, size, and wound healing time. In this sense, the present study aimed to conduct a descriptive review of the literature, seeking evidence of treatment over the last five years. The review was carried out based on the PRISMA guideline, using the databases PubMed, LILACS, Cochrane Library, SCOPUS, Web of Science, and Grey Literature between 2018 and 2022. Seven hundred forty articles were found, of which 16 randomized clinical trials were selected. It was demonstrated that keloid management presents a multimodal approach, with no gold standard of treatment with a low recurrence rate. Furthermore, combined therapy with different agents appeared superior to the isolated therapeutic methods in treating these injuries.

■ RESUMO Queloides e cicatrizes hipertróficas são lesões formadas a partir da resposta fibroproliferativa anormal ao processo de cicatrização de feridas, gerando uma proliferação excessiva do colágeno nas lesões. Geralmente, predominam em pacientes do sexo feminino e em indivíduos com tons de pele mais escuros. A abordagem terapêutica dessas cicatrizes pode ser indicada de acordo com alguns critérios, como déficit funcional, tamanho e tempo de cicatrização da ferida. Nesse sentido, o presente estudo objetivou realizar uma revisão descritiva da literatura, buscando as evidências de tratamento dos últimos cinco anos neste tema. A revisão foi realizada com base no guideline PRISMA, utilizando as bases de dados PubMed, LILACS, Cochrane Library, SCOPUS, Web of Science e Grey Literature, entre os anos de 2018 e 2022. Foram encontrados 740 artigos, dos quais 16 ensaios clínicos randomizados foram selecionados. Foi evidenciado que manejo do queloide apresenta abordagem multimodal, não havendo um padrão-ouro de tratamento, com taxa de recorrência baixa. Além disso, a terapia combinada de diferentes agentes pareceu ser superior ao uso isolado de métodos terapêuticos no tratamento dessas lesões.

Resumo Objetivo: Avaliar a capacidade da PET/CT FDG detectar a zona epileptogênica, com injeção da FDG realizada tanto no período interictal como perto de uma crise epiléptica. Materiais e Métodos: Foram avaliados pacientes com epilepsia de difícil controle que realizaram PET/CT FDG. A zona epileptogênica foi definida pelo follow up/anatomopatológico ou eletroencefalogramas (EEGs) seriados, telemetria e ressonância magnética. PET/CT FDG foi realizada independentemente se o paciente tinha crise epiléptica durante a monitoração com EEG ou no período interictal. Os resultados foram definidos como concordantes ou discordantes, comparando com a zona epileptogênica. Resultados: Foram incluídos no estudo 110 pacientes: 10 no grupo pós-ictal (injeção de FDG depois da crise) e 100 no grupo interictal. A PET/CT FDG foi concordante com a zona epileptogênica em nove pacientes do grupo pós-ictal (90%) e 60 pacientes do grupo interictal (60%). Entre os nove pacientes concordantes do grupo pós-ictal, quatro mostraram hipermetabolismo (44,4%) e cinco mostraram hipometabolismo na zona epileptogênica (55,6%). Conclusão: Nossos resultados confirmaram que a PET/CT FDG é uma ferramenta útil na localização da zona epileptogênica e a monitoração com EEG é muito importante para correlacionar os achados. Além disso, PET/CT FDG realizada no período pós-ictal é capaz de identificar a zona epileptogênica, mostrando tanto hipometabolismo como hipermetabolismo.

Abstract Objective: To evaluate the performance of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography ( 18F-FDG PET/CT) in localizing epileptogenic zones, comparing 18F-FDG injection performed in the traditional interictal period with that performed near the time of a seizure. Materials and Methods: We evaluated patients with refractory epilepsy who underwent 18F-FDG PET/CT. The reference standards for localization of the epileptogenic zone were histopathology and follow-up examinations (in patients who underwent surgery) or serial electroencephalography (EEG) recordings, long-term video EEG, and magnetic resonance imaging (in patients who did not). The 18F-FDG injection was performed whether the patient had an epileptic seizure during the EEG monitoring period or not. The 18F-FDG PET/CT results were categorized as concordant or discordant with the reference standards. Results: Of the 110 patients evaluated, 10 were in a postictal group (FDG injection after a seizure) and 100 were in the interictal group. The 18F-FDG PET/CT was concordant with the reference standards in nine (90%) of the postictal group patients and in 60 (60%) of the interictal group patients. Among the nine postictal group patients in whom the results were concordant, the 18F-FDG PET/CT showed hypermetabolism and hypometabolism in the epileptogenic zone in four (44.4%) and five (55.6%), respectively. Conclusion: Our data indicate that 18F-FDG PET/CT is a helpful tool for localization of the epileptogenic zone and that EEG monitoring is an important means of correlating the findings. In addition, postictal 18F-FDG PET/CT is able to identify the epileptogenic zone by showing either hypometabolism or hypermetabolism.

ABSTRACT. Phytophagous mites can cause economic losses in many crops, including grapevines. The changes in their population levels may be associated with changes in the predator-prey relationship. Knowledge of the distribution of mites in plants is important for planning sampling strategies and facilitating control decisions. The aims of this study were to (i) evaluate the abundances of Tetranychus urticae (Tetranychidae) and Neoseiulus californicus (Phytoseiidae), and the correlations between them and environmental factors; (ii) determine their distribution on the top, middle, or base strata of the evaluated grapevines (Vitis vinifera, Chardonnay cultivar) and, additionally, report the first occurrence of damage caused by T. urticae in grapevine leaves in the state of Rio Grande do Sul, Southern Brazil. Sixteen samplings were conducted, divided between the 2018 and 2019 seasons. In each sampling, three leaves from the three strata of the plant (top, middle, and base) were collected from 20 plants, totaling 60 leaves per sampling. The predator-prey relationship and their association with environmental variables were evaluated with multivariate correlation, whereas the number of mites per plant leaf strata was compared using a generalized linear mixed model in R software. It was possible to observe the symptoms of damage caused by T. urticae attacks on grapevines in Southern Brazil, characterized by the presence of yellow spots and general yellowing of the vineyard. Our findings indicate that T. urticae and N. californicus individuals are strongly associated with each other regardless of the environmental variables, and such relationship occurs mainly on the lower strata (middle and base leaves) of grapevines. Thus, by taking into account the damage on the leaves of grapevines and the occurrence of T. urticae and N. californicus majorities on specific strata of these vineyards, we suggest that the lower strata of grapevines should be the priority targets for management strategies to control such mites.

RESUMO O objetivo foi analisar o perfil das teses e seus artigos em relação às áreas de concentração do PPGEF/UFSC. Analisaram-se 103 teses e 196 artigos (2009-2019), das áreas: Biodinâmica do Desempenho Humano (BDH), Teoria e Prática Pedagógica (TPP) e Atividade Física e Saúde (AFS). Dentre as teses defendidas, predominaram as temáticas relacionadas às suas próprias áreas de concentração, pesquisas quantitativas, de campo, de levantamento e experimentais. Referente aos artigos, verificou-se maior publicação em periódicos de estrato A do WebQualis/CAPES e com fator de impacto especialmente na BDH e AFS. Conclui-se que o PPGEF/UFSC tem gerado conhecimento satisfatório e diversificado nas três áreas, com crescente defesa de teses e produção de artigos de qualidade.

ABSTRACT The aim was to analyze the profile of the dissertations and their articles in the PPGEF/UFSC areas of concentration. 103 dissertations and 196 articles (2009-2019) were analyzed, from the areas: Biodynamics of Human Performance (BHP), Theory and Pedagogical Practice (TPP) and Physical Activity and Health (PAH). Among the dissertations, themes related to their own areas of concentration, quantitative, field, survey and experimental research predominated. Regarding the articles, there was a greater publication in WebQualis/CAPES stratum A journals and with impact factor especially in BDH and AFS. It is concluded that the PPGEF/UFSC has generated satisfactory and diversified knowledge in the three areas, with increasing defense of dissertations and production of quality articles.

Resumen El objetivo fue analizar el perfil de las tesis y sus artículos en las áreas de concentración del PPGEF/UFSC. Se analizaron 103 tesis y 196 artículos (2009-2019), de las áreas: Biodinámica del Rendimiento Humano (BRH), Teoría y Práctica Pedagógica (TPP) y Actividad Física y Salud (AFS). Entre las tesis defendidas, predominaron los temas relacionados con sus propias áreas de concentración, investigaciones cuantitativas, de campo, encuesta e experimental. Con respecto a los artículos, hubo una mayor publicación en revistas del estrato A en WebQualis/CAPES y con factor de impacto en BDH y AFS. Se concluye que el PPGEF/UFSC ha generado un conocimiento satisfactorio y diversificado en las tres áreas, con una defensa cada vez mayor de tesis y la producción de artículos de calidad.

BACKGROUND Non-human primates contribute to the spread of the yellow fever virus (YFV) and the establishment of transmission cycles in endemic areas. OBJECTIVE To describe the severe histopathological aspects of YFV infection, 10 squirrel monkeys were infected with YFV and blood, brain, liver, kidney, spleen, heart, lung, lymph node and stomach were collected at 1-7, 10, 20 and 30 days post-infection (dpi). METHODS Histopathological analysis and detection of the genome and viral antigens and neutralising antibodies were performed by RT-PCR, immunohistochemistry and neutralisation test, respectively. FINDINGS Only one animal died from the experimental infection. The genome and viral antigens were detected in all investigated organs (1-30 dpi) and the neutralising antibodies from seven to 30 dpi. The brain contained perivascular haemorrhage (6 dpi); in the liver, midzonal haemorrhage and lytic necrosis (6 dpi) were observed. The kidney had bleeding in the Bowman’s capsule and tubular necrosis (6 dpi). Pyknotic lymphocytes were observed in the spleen (1-20 dpi), the lung had haemorrhage (2-6 dpi), in the endocardium it contained nuclear pyknosis and necrosis (2-3 dpi) and the stomach contained blood in the lumen (6 dpi). MAIN FINDINGS Squirrel monkeys reliably reproduced the responses observed in human cases of yellow fever and, therefore, constitute an excellent experimental model for studies on the pathophysiology of the disease.

Objectives: Bisphosphonates have become the gold standard treatment for osteoporosis, since they reduce the incidence of fractures. Recently, several papers described the occurrence of low-energy atypical femoral fractures associated with the use of bisphosphonates. The objective of this study was to compare the average time to healing of atypical femoral fractures in patients who received bisphosphonates and in a control group. Materials and Methods: We retrospectively evaluated 34 patients with atypical femoral fractures, 16 of whom had received treatment with bisphosphonates for at least 5 years, between 2006 and 2017, and whose fractures were stabilized with a cephalomedullary nail. They were compared with a control group of similar characteristics. Results: All the patients were female, with an average age of 74 years. Twenty-two fractures were subtrochanteric, while 12 involved the femoral shaft. Fourteen percent (14%) of the patients who received bisphosphonates and surgical management required a revision surgery, while 5.5% of the control group did not. The average time to bone healing was longer in those treated with bisphosphonates (8.5 months vs. 6 months), which was statistically significant (p <0.001). Conclusions: The benefits of using bisphosphonates for fracture prevention outweigh the risk of atypical fractures. However, it is important to evaluate the risk-benefit ratio in each patient at the beginning of the treatment and during the course of it, since, despite the benefits, healing time is longer.

Introducción: Los bifosfonatos evolucionaron como el pilar para el tratamiento de la osteoporosis, reduciendo la incidencia de fracturas. Recientemente, varias publicaciones describieron la aparición de fracturas atípicas de fémur de baja energía asociadas con el uso de bifosfonatos. El objetivo de este estudio fue evaluar el tiempo promedio de consolidación de las fracturas atípicas de fémur asociadas al tratamiento con bifosfonatos comparado con el de un grupo de control. Materiales y Métodos: Se evaluó, en forma retrospectiva, a 34 mujeres (edad promedio 74 años) con fracturas atípicas; 16 de ellas habían recibido bifosfonatos, al menos, por cinco años. Fueron tratadas entre 2006 y 2017, y estabilizadas con un clavo cefalomedular. Este grupo fue comparado con un grupo de control de similares características. Resultados: Veintidós tenían fracturas subtrocantéricas y 12, diafisarias. El 14% de las que tomaron bifosfonatos y fueron operadas requirió una revisión frente al 5,5% del grupo de control. El tiempo promedio de consolidación fue mayor en las tratadas con bifosfonatos (8.5 vs. 6 meses), con una diferencia estadísticamente significativa (p <0,001). Conclusiones: El beneficio del tratamiento con bifosfonatos en la prevención de fracturas es superior al riesgo de fracturas atípicas; sin embargo, es importante evaluar la relación riesgo-beneficio en cada paciente al comienzo y durante el tratamiento, teniendo en cuenta que, pese a esto, el tiempo de curación es más largo.

Resumo Resíduos de bambu (Bambusa vulgaris) foram utilizados como matéria-prima para a produção de carvão ativado (CA). Os materiais foram coletados e transformados em CA mediante processos de carbonização (500°C, 1,67°C min-1, 60 min) e ativação (800°C, 10°C min-1, 60 min) com CO2 (100 mL min-1). O material obtido (CA CO2) foi caracterizado pelo seu rendimento, análise elementar, teor de cinzas, área superficial (SBET), método titulométrico de Boehm, microscopia eletrônica de varredura e utilizado como adsorvente para remoção dos contaminantes azul de metileno e fenol. Os modelos de isotermas de Langmuir e de Freundlich foram selecionados para entender o processo de adsorção. O CA CO2 produzido apresentou rendimento de 21,6%, teor de carbono de 82,13% e SBET de 856,78 m2 g-1, apresentando uma remoção rápida e elevada capacidade de adsorção para o azul de metileno (298,82 mg g-1) e fenol (558,29 mg g-1).

Abstract Bamboo (Bambusa vulgaris) wastes were used as raw material for producing activated carbon. The materials were collected and turned into activated carbons by carbonization (500 °C, 1.67 °C.min-1, 60 min) and activation (800 °C, 10 °C.min-1, 60 min) processes with CO2 (100 mL.min-1). The obtained material (CO2 AC) was characterized by its yield, elemental analysis, ash content, surface area (SBET), Boehm titration method, scanning electron microscopy and used as adsorbent for removing the methylene blue and phenol contaminants. The Langmuir and Freundlich isotherm models were selected for understanding the adsorption process. CO2 AC produced showed yield of 21.6%, carbon content of 82.13% and SBET of 856.78 m2.g-1, presenting rapid removal and high adsorption capacity for methylene blue (298.82 mg.g-1) and phenol (558.29 mg.g-1).

ABSTRACT Elephant grass (Pennisetum purpureum Schumach) is regarded as a promising feedstock for second generation ethanol production, due to its high cellulose content, biomass production and rapid growth. The yeast Kluyveromyces marxianus CCT 7735 is capable of producing ethanol from agroindustrial residues, such as lignocellulosic biomass. Therefore, this study aimed to establish the optimal conditions for ethanol production by K. marxianus CCT 7735 from elephant grass. Five factors were evaluated: temperature (35-45 ºC), pH (4.5-5.8), agitation (50-150 rpm), cellulase concentration (7.5-22.5 FPU/mL) and elephant grass biomass (8-16% w/v). Enzymatic concentration (22.5 FPU/mL), biomass concentration (16% w/v) and temperature (38 ºC) were the significant optimized factors. K. marxianus CCT 7735 produced a high ethanol concentration (around 45.5 g/L) under these optimized conditions, which is considered feasible in terms of energy requirements in the distillation step.

Abstract INTRODUCTION: Dengue is an important mosquito-borne disease in tropical and subtropical regions. Adhesion molecules have not been systematically characterized in the renal tissue of patients with severe dengue (SD). The objective of this study was to detect viral antigens in samples from patients that evolved with SD, correlating with the expression of ICAM-1, VCAM-1, VE-cadherin, and E-selectin to contribute to a better understanding of the pathophysiology of SD. METHODS: Kidney specimens from patients with SD were selected according to clinical and laboratorial data and submitted to histological and immunohistochemistry analysis. A semiquantitative evaluation was performed considering positive immunostaining in 20 glomeruli. RESULTS: Viral antigens were mainly detected in distal tubules. The intense immunostaining of VCAM-1 and ICAM-1 was observed. The expression of E-selectin was discrete, and VE-cadherin expression varied from mild to moderate. VCAM-1 was slightly intense in the glomerular capsule; the expression of ICAM-1 was diffuse. E-selectin was diffuse, and VE-cadherin varied from mild to moderate. The most frequent histological findings were glomerular congestion, mild glomerulitis, acute renal injury, and glomerular atrophy. CONCLUSIONS: The results appear to demonstrate an imbalance between vascular endothelial permeability regulating events in renal lesions in SD. The increase in the expression of ICAM-1 and VCAM-1 is an in-situ indicator of higher permeability with a consequent influx of cells favoring the inflammation of the endothelium. These molecules are important in the pathophysiology of the disease and provide the possibility of developing new markers for the evaluation, clinical follow-up, and therapeutic response of patients with SD.

ABSTRACT An experiment was carried out to verify the response to the Ca reduction levels of diets with different vitamin D sources on performance, bone mineral deposition, serum concentrations, digestibility, carcass characteristics, and meat quality of broiler chickens in the period from 1 to 42 days reared in thermoneutral environment. A total of 504 male broilers with one day of age and average weight of 43.27±1.08 g were housed in climatic chambers and distributed in a completely randomized design. The study consisted of a 4 × 2 factorial, with four Ca reduction levels (0, 10, 20, and 30%) and two vitamin D sources (2760 IU of D3 or 25-OH-D3). The performance of animals at 21 and 42 days of age was not affected by Ca reduction by up to 30%, regardless of the vitamin source used. Dietary reduction from 10% decreased serum Ca concentrations. The use of vitamin D3 provided a serum P level greater than the 25-OH-D3. Calcium reduction decreased serum 25-OH-D3 levels. No effect of vitamin source or Ca levels on broiler carcass characteristics was observed at 42 days. The vitamin source did not influence meat quality, while Ca reduction of the diet provided lower losses by thawing and cooking and higher initial pH values. The b* color was reduced in diets with lower Ca levels of the diet. Reducing Ca up to 30% does not affect the performance and carcass characteristics, regardless of the vitamin D source used. The quality of broiler meat is improved with the Ca reduction in the diet, but the vitamin used has no effect on such characteristics. We can conclude, based on the results of performance, blood, and bone, that the performance variables are not adequate to determine the actual requirement of Ca, since as it is a priority to maintain performance, bone mineral mobilization occurs, which may compromise the carcass quality of the birds.

BACKGROUND Serological evidence of West Nile virus (WNV) infection has been reported in different regions of Brazil from equine and human hosts but the virus had never been isolated in the country. OBJECTIVES We sought to identify the viral etiology of equine encephalitis in Espírito Santo state. METHODS We performed viral culture in C6/36 cells, molecular detection of WNV genome, histopathology and immunohistochemistry from horse cerebral tissue. We also carried out sequencing, phylogenetic analysis and molecular clock. FINDINGS Histopathologic analysis from horse cerebral tissue showed injury related to encephalitis and WNV infection was confirmed by immunohistochemistry. The virus was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) from brain tissue and subsequently isolated in C6/36 cells. WNV full-length genome was sequenced showing the isolated strain belongs to lineage 1a. The molecular clock indicated that Brazilian WNV strain share the same common ancestor that were circulating in US during 2002-2005. MAIN CONCLUSIONS Here we report the first isolation of WNV in Brazil from a horse with neurologic disease, which was clustered into lineage 1a with others US WNV strains isolated in beginning of 2000’s decade.

Abstract Pasture is the main food source for more than 200 million cattle heads in Brazil. Although Brazilian forage breeding programs have successfully released well-adapted, high-yielding cultivars over the years, the use of genomic tools in these programs is currently limited. These tools are required to tackle the main challenges for tropical forage breeding in Brazil. In this context, this notes lists the main research priorities raised at the workshop “Breeding Forages in the Genomic Era”, which are necessary to accelerate the use of genomic tools for next-generation breeding of tropical forages and allow breeders to increase genetic gains. Additionally, an online discussion forum (hosted at http://www.cnpgl.embrapa.br/genfor) has been launched to strengthen collaborations among research groups. The research priorities and more synergistic collaborations will assist researchers and decision-makers in delivering a sustainable increase in production of animal products, especially beef and milk, which are required to feed a rising world population.

Abstract: Introduction: The hypertension (HT) is a public health problem worldwide. This disease is a risk factor for heart diseases and, cerebrovascular and renal failure, which are considered the main causes of mortality. Objective: This study aimed to describe factors associated with a previous diagnosis of HT in a group of Yaqui adults from Sonora, Mexico. Material and methods: We conducted a cross-sectional epidemiological study in which 108 individuals ≥ 18 years of age were included. HT was considered as prior diagnosis. In addition, anthropometric assessment, medical history and sociodemographic questionnaires were also applied. The sex- and age adjusted prevalence was estimated using the direct method of standardization using the studied sample as the standard population. The factors associated with previous diagnosis of HT were determined using multiple logistic regression analysis. Results: The sex- and age-adjusted prevalence of a previous diagnosis of HT was 12.0% (95% CI: 6.3-17.6) in the overall population. The age-adjusted prevalence in men was 7.1%, and it was 14.0% in women with no significant difference between genders. The independent factors associated with HT were increased waist circumference (cm) (OR: 1.07, 95% CI: 1.01-1.14) and a previous diagnosis of diabetes (OR: 4.14, 95% CI: 1.03-16.61). Conclusions: The prevalence of a previous diagnosis of HT was high, and it could be higher after confirmation of new diagnosis cases in the population. The identification of factors associated with HT may be useful for creating programs to prevent chronic diseases in this ethnic group.

Resumen: Introducción: La hipertensión arterial (HTA) es un problema de salud pública a nivel mundial. Esta enfermedad es un factor de riesgo para enfermedades del corazón, cerebrovasculares y falla renal, las cuales son consideradas entre las principales causas de mortalidad. Objetivo: Describir factores asociados con el diagnóstico previo de HTA en un grupo de adultos Yaquis de Sonora, México. Material y métodos: Llevamos a cabo un estudio epidemiológico con diseño transversal donde fueron estudiados 108 individuos ≥ 18 años de edad. La HTA fue considerada como diagnóstico previo, se hizo una evaluación antropométrica y se aplicaron cuestionarios de historial clínico y sociodemográficos. La prevalencia de HTA ajustada por edad y sexo se estimó por el método directo de estandarización utilizando la población estudiada como población estándar. Los factores asociados con el diagnóstico previo de HTA fueron obtenidos mediante análisis de regresión logística múltiple. Resultados: La prevalencia de diagnóstico previo de HTA fue 12.0% (IC 95%, 6.3-17.6) en la población total. La prevalencia ajustada por edad en hombres fue 7.1 y 14.0% en mujeres; sin diferencias significativas entre sexo. Los factores asociados de manera independiente con HTA fueron una mayor circunferencia de cintura (cm) (RM: 1.07; IC 95%, 1.01-1.14) y el diagnóstico previo de diabetes (RM: 4.14; IC 95%, 1.03-16.61). Conclusiones: La prevalencia de diagnóstico previo de HTA fue alta y podría incrementar con la confirmación de diagnóstico de casos nuevos en la población. La identificación de factores asociados con HTA puede servir para crear programas de prevención de enfermedades crónicas en este grupo étnico.

Introduction: The purpose of this study was to analyze the clinical and radiological outcomes of a series of patients treated with pedicled distal radius vascularized bone graft for recalcitrant ulnar nonunions. Methods: A retrospective study was performed. The inclusion criteria were patients with diaphyseal or proximal ulnar nonunions with bone defects <6 cm, at least three previous surgeries and a minimum follow-up of 2 years, treated with pedicled vascularized bone graft of distal radius. The number of previous surgeries was recorded. Elbow and wrist range of motion, comparative grip strength, and pain using the Visual Analogue Scale, QuickDASH questionnaire and Mayo Clinic score for elbow were evaluated. Results: Seven patients were included. The mean age was 42 years (range 26-64). The average number of previous surgeries was 4 (range 3-7). The mean follow-up was 31 months (range 24-43). All pseudoarthrosis consolidated. The Mayo Clinic score was good in 4 patients, excellent in 2 patients and moderate in one patient. The mean postoperative Quick- DASH score was 13 (range 0-29). Flexion-extension arch of the wrist was 81% of the contralateral. The elbow range of motion was >100° in 5 patients and 50°- 100° in 2 patients. Conclusion: The pedicled vascularized bone graft of the distal radius is an effective alternative for the treatment of recalcitrant ulnar nonunions.

Introducción: El objetivo de este trabajo es presentar los resultados clínicos y radiológicos de una serie de pacientes tratados con injerto óseo vascularizado pediculado del radio distal para seudoartrosis recalcitrantes de cúbito diafisario o proximal. Materiales y Métodos: Se realizó un estudio retrospectivo que incluyó a pacientes con seudoartrosis del cúbito diafisario o proximal con defectos <6 cm y, al menos, tres cirugías previas y un seguimiento mínimo de dos años tratados con injerto óseo vascularizado pediculado del radio distal. Se registró la cantidad de cirugías previas. Se evaluaron el rango de movilidad del codo y la muñeca, la fuerza de puño comparativa, el dolor mediante la escala analógica visual, el cuestionario QuickDASH y el puntaje de la Clínica Mayo para codo. Resultados: Se incluyó a siete pacientes. La edad media fue de 42 años (rango 26-64). El número promedio de cirugías previas fue 4 (rango 3-7). El seguimiento medio fue de 31 meses (rango 24-43). Todas las seudoartrosis consolidaron. El puntaje de la Clínica Mayo fue bueno en 4 pacientes, excelente en 2 pacientes y moderado en uno. El puntaje QuickDASH posoperatorio promedio fue de 13 (rango 0-29). El arco de flexo-extensión de la muñeca fue del 81% del contralateral. El rango de movilidad del codo fue >100° en 5 pacientes y de 50°-100° en 2 pacientes. Conclusión: El injerto óseo vascularizado pediculado del radio distal es una alternativa eficaz para el tratamiento de la seudoartrosis del cúbito.