Incidences of HL subtypes differed in relation to socioeconomic conditions in Mexico. In the south, the incidence of mixed cellularity was higher and there was an earlier peak of presentation.
We analyzed clinical and epidemiological characteristics of Burkitt lymphoma (BL) in two defined socioeconomic regions in Mexico: high socioeconomic region (HSER; with two political jurisdictions) and low socioeconomic region (LSER; with three jurisdictions). Of the 63 cases registered in the Childhood Cancer Registry (1996-2013), 45 (71.4%) were from HSER and 18 (28.6%) from LSER. The incidence was higher in the LSER (3.1 vs. 1.4 cases per million children/year). The sporadic form and Stages III/IV predominated in both regions. Only one post-renal transplant (HSER) was found. The male/female ratio was higher in the LSER (5.0 vs. 1.4). The peak incidence was in the 1-4 age group for LSER, and in the 5-9 age group for HSER. This difference in the sporadic BL by socioeconomic regions may be related to different exposure factors.
There was a trend toward a reduced incidence, for some lymphoma subtypes, in particular for NOS lymphomas, which may be the result of improvement in diagnostic techniques.
Artículo original RESUMEN. Introducción: La calidad de reducción en las fracturas de húmero proximal es posible valorarla a través de criterios radiográficos (ACD = ángulo cervicodiafisario; OM = offset medial; DTC = distancia tuberosidadcabeza y ES = espacio subacromial), los cuales predicen la funcionalidad. Sin embargo, estos criterios establecidos para otros implantes no están descritos para el clavo centromedular. Material y métodos: Estudio de cohorte observacional y retrospectivo en pacientes > 18 años con osteosíntesis con clavo centromedular (durante el período de 2014 a 2017), en donde se evaluaron las características demográficas, severidad de lesión (clasificación de Neer) y las mediciones radiográficas progresivas y complicaciones. Resultados: Se analizaron 84 casos, cuya edad en promedio fue de 65 ± 2 años y la media de seguimiento de 13.9 meses. Por clasificación de Neer: 40.4% fueron grado II; 29.7%, grado III y 29.7%, grado IV. La consolidación en varo aumenta 10.7% al final del seguimiento, siendo aquellos pacientes Neer grado III y IV los más frecuentes. La deformidad > 140 o predomina para Neer grado II (n = 15/34). En 30.9%, se presenta un cambio de ACD (ΔACD) ≥ 10 o. En general, 86.9% tiene cambios de DTC < 5 mm. En los casos Neer grado III/IV, 32% tiene una alteración de ES > 5 mm. La complicación más frecuentemente es la necrosis avascular (NAV) con 44% de los casos. Conclusiones: Las ABSTRACT. Introduction: The quality of reduction in proximal humerus fractures is valuable with radiographic criteria (Neck-shaft angle [NSA]; medial offset [MO]; distance head tuberosity [DHT] and subacromial space [SS]) that predict functionality. These criteria set for other implants are not described for the intramedullary nail. Material and methods: Observational cohort study, retrospective, with patients > 18 years, with osteosynthesis with intramedullary nail (2014 to 2017), evaluating demographic characteristics, severity of injury (Neer classification), progressive radiographic measurements and complications. Results: 84 cases with an average age of 65 ± 2 years and an average follow-up of 13.9 months were analyzed. By Neer rating 40.4% were grade II, 29.7% grade III and 29.7% grade IV. Consolidation in varus increases to 10.7% at the end of follow-up, with Neer III and IV patients. The >140 o deformity is prevalent for Neer II (n = 15/34). 30.9% have a change of neck-shaft angle of ≥ 10 o. Overall 86.9% has HTD changes < 5 mm. Cases Neer III/ IV 32% has alteration of SS > 5 mm. The most common complication is avascular necrosis (AVN) with 44% of cases. Conclusions: Radiographic measurements have changes in long-term follow-up. Alterations in NSA (> 10 o) and SS (> 5 mm) occur in higher proportion of Neer III/IV patients, according to the severity of the fracture, favoring Nivel de evidencia: IV Alteración de mediciones radiográficas en osteosíntesis de húmero proximal con clavo centromedular Alteration of X-ray measurements in proximal humerus osteosynthesis with intramedullary nail
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