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Background: There is a great discrepancy between the rates of recurrent instability reported after arthroscopic Bankart repair in relation to the follow-up time. Purpose: To analyze the rate of recurrences after arthroscopic Bankart repair in the long term, emphasizing whether a minimum follow-up of 2 years is adequate to assess this outcome. Study Design: Case series; Level of evidence, 4. Methods: Between January 2008 and April 2013, a total of 356 athletes underwent arthroscopic Bankart repair for anterior glenohumeral instability at our institution. Return to sports, the Rowe score, the Subjective Shoulder Value (SSV), and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. We analyzed the proportion of recurrences before and after 4 years of follow-up. Additionally, we performed a Kaplan-Meier analysis to evaluate recurrence-free time in patients with a recurrence. Results: The mean follow-up was 10.5 ± 1.6 years, and the mean age was 20.8 ± 3.9 years. In total, 90% of patients were able to return to sports; of these, 91% returned to their preinjury level of play. The Rowe, SSV, and ASOSS scores showed a statistical improvement after surgery ( P < .01). The proportion of patients with a recurrence during the follow-up period was 25% (95% CI, 20%-31%; n = 70), and the mean time until a recurrence was 3.8 ± 2.6 years. Only 39% of the recurrences (95% CI, 30%-48%) occurred in the first 2 years after surgery, while 61% (95% CI, 50%-73%) occurred in the first 4 years after surgery. Conclusion: In our study, the effectiveness of Bankart repair to stabilize the shoulder decreased significantly over time. Indeed, less than half of the recurrences occurred after 2 years of follow-up. Therefore, we propose that the recommended minimum follow-up should be 4 years; otherwise, it is very likely that the actual rate of recurrences will be significantly underestimated.

ObjectiveDescribe the clinical and respiratory characteristics of critical patients with coronavirus disease 2019 (COVID-19).DesignObservational and retrospective study over 6 months.SettingIntensive care unit (ICU) of a high complexity hospital in Buenos Aires, Argentina.PatientsPatients older than 18 years with laboratory-confirmed COVID-19 by reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 were included in the study.Variables of interestDemographic characteristics such as sex and age, comorbidities, laboratory results, imaging results, ventilatory mechanics data, complications, and mortality were recorded.ResultsA total of 168 critically ill patients with COVID-19 were included. 66% were men with a median age of 65 years (58-75. 79.7% had at least one comorbidity. The most frequent comorbidity was arterial hypertension, affecting 52.4% of the patients. 67.9 % required invasive mechanical ventilation (MV), and no patient was treated with non-invasive ventilation. Most of the patients in MV (73.7%) required neuromuscular blockade due to severe hypoxemia. 36% of patients were ventilated in the prone position. The length of stay in the ICU was 13 days (6-24) and the mortality in the ICU was 25%.ConclusionsIn this study of critical patients infected by SARS-CoV-2 in a high-complexity hospital, the majority were comorbid elderly men, a large percentage required invasive mechanical ventilation, and ICU mortality was 25%.

Se cuantificaron y compararon los melanomacrófagos (MM) y la actividad de la enzima Glutatión S−Transferasa (GST) en hígados de ejemplares adultos de Leptodactylus  chaquensis (Anura, Leptodactylidae) colectados en un cultivo de arroz (CA) (siete días posteriores a la aplicación de clorpirifos, CPF) y en un sitio de referencia (SR) en el departamento San Javier, provincia de Santa Fe (Argentina). El análisis histológico reveló una mayor cantidad (p = 0.028) y área ocupada por MM (p = 0.017) y se registró una inhibición en la actividad de la GST (p = 0.030) en individuos del CA respecto a los del SR. Los efectos descriptos evidencian el riesgo ecotoxicológico para los anuros en los cultivos de arroz con aplicaciones de CPF.

Introduction: Pandemics pose a major challenge for public health preparedness, requiring a coordinated international response and the development of solid containment plans. An early and accurate identification of high-risk patients in the course of the actual COVID-19 pandemic is vital for planning and for making proper use of available resources. Objective: The purpose of this study was to identify the key variables to create a predictive model that could be used effectively for triage. Method: A narrative literature review of 651 articles was conducted to assess clinical, laboratory and imaging findings of COVID-19 confirmed cases. After screening, 10 articles met the inclusion criteria and a list of suggested variables was gathered. A modified Delphi process analysis was performed to consult experts in order to generate a final list of variables for the creation of the predictive model. Results: The modified Delphi process analysis identified 44 predictive variables that were used for building a severity prediction score, the COVID-19 Severity Index. Conclusion: Specifically designed for current COVID-19 pandemic, COVID-19 Severity Index could be used as a reliable tool for strategic planning, organization and administration of resources by easily identifying hospitalized patients with higher risk of transfer to Intensive Care Unit (ICU).

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Objetivo: Medición de la eficacia y relevamiento de las complicaciones asociadas a la a realización de traqueostomía percutánea (TP) guiada por videobroncoscopia en un hospital universitario de alta complejidad. Materiales y métodos: Estudio observacional retrospectivo realizado entre mayo de 2017 y agosto de 2019. El criterio para la indicación de TP fue desvinculación prolongada de la ventilación mecánica en todos los casos. Incluyó pacientes mayores de 18 años en que se realizó TP electiva guiada por videobroncoscopia. Se registraron variables demográficas, APACHE II y días de ventilación mecánica previos a la TP. La eficacia del procedimiento fue evaluada en base a la tasa de éxito en la ejecución, la necesidad de conversión a técnica abierta. Asimismo, se registraron las complicaciones observadas. Resultados: Se evaluaron 235 procedimientos (149 hombres y 86 mujeres) en pacientes con edad media de 61 años ± 19, un score APACHE II 18 ± 8. La TP pudo ser ejecutada en forma rápida y satisfactoria en todos los pacientes sin requerimiento de conversión a técnica abierta. Se presentaron complicaciones tempranas en el 3,8% (9) de los casos. El sangrado menor fue la complicación más frecuentemente observada en 5 casos (2,1%), hipotensión en 3 casos (1,3%) e hipoxemia transitoria en un caso (0,4%). Asimismo el 2,1% (5) de los casos registró complicaciones tardías. Conclusión: La realización de TP mediante la técnica de dilatador único guiada por videobroncoscopia se describe como un procedimiento efectivo y seguro, que puede realizarse en unidades de cuidados intensivos con baja tasa de complicaciones.