Dr. Juan Agustín Valcarce León

Dr. Juan Agustín Valcarce León
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domingo, 26 de enero de 2014

Discusión entre pares. MASCULINO DE 16 AÑOS CON SECUELAS DE DISPLASIA DEL DESARROLLO DE CADERA IZQUIERDA



MASCULINO DE 16 AÑOS CON SECUELAS DE DISPLASIA DEL DESARROLLO DE CADERA IZQUIERDA. DOLOR EN CADERA IZQUIERDA DE 8 MESES DE EVOLUCION QUE LIMITA MARCHA PROLONGADA. SE OBSERVA DESCOBERTURA EN TECHO DE CADERA IZQUIERDA.
OSTEOTOMIA TIPO CHIARI CADERA IZQUIERDA CON VARIANTE SPITZY FUNAYAMA PARA RECUBRIMIENTO ANTERIOR.




Discusión entre pares / Masculino de 48 años con Lesion por proyectir por arma de fuego

Masculino de 48 años con Lesion por proyectir por arma de fuego, cursa con fractura expuesta multifragmentada de femur distal manejado con Placa LCP de femur deslizada por tecnica minima invasiva.







sábado, 25 de enero de 2014

CASO DUPLICACION DE PULGAR

CASO DUPLICACION DE PULGAR
MASCULINO DE 2 AÑOS CON DUPLICACION POSTAXIAL DE PULGAR WASSEL II, CIRUGIA REALIZADA RESECCION DE PULGAR ACCESORIO POSTAXIAL Y RECONSTRUCCION DE LIGAMENTO COLATERAL LATERAL.







viernes, 24 de enero de 2014

Cuidado con los males neuromusculares

 
Cuidado con los males neuromusculares
El Occidental
21 de enero de 2014

Isaura López Villalobos/El Occidental

GUADALAJARA, Jalisco(OEM-Informex).- Las enfermedades neuromusculares afectan a niños y niñas en edad temprana sin ser diagnosticadas a tiempo, en el marco del XVI Congreso Internacional Avances en Medicina Hospital Civil de Guadalajara se estará abordando este tema en el módulo de rehabilitación, a fin de que los pediatras diagnostiquen a tiempo este padecimiento.

En México existe una prevalencia de 100 niños afectados de cada 100 mil habitantes, algunos padecimientos que se presenta en este sector son la distrofia muscular de Duchenne y la atrofia espinal muscular.

La debilidad y problemas del desarrollo en la población infantil no es por falta de vitaminas, puede tratarse de una enfermedad neuromuscular, informó el jefe del servicio de Medicina de Rehabilitación en el Hospital Civil de Guadalajara Fray Antonio Alcalde, José de Jesús González Jaime.

Este tipo de enfermedad es causa frecuente de morbilidad pediátrica, con una amplia variedad de motivos de consulta, lo que dificulta en ocasiones la aproximación diagnóstico inicial.

"Desafortunadamente se manifiesta por debilidad muscular gradual progresiva que puede afectar el desarrollo de los niños, es un grupo diverso de enfermedades que afecta las neuronas, los nervios, afecta los músculos, que bueno debe ser debidamente diagnosticada".

Lamentablemente, dijo los padres de familia no llevan a los niños de manera oportuna a la consulta y los pediatras tratantes no diagnostican a tiempo el padecimiento: "Existe tal desinformación en este tema que no hacen mucho porque piensan simplemente que es un niño más flojito, que no es igual que los otros hermanitos, y muchas veces los médicos también desconocen este grupo de enfermedades".

Los trastornos musculares constituyen un grupo de enfermedades que afectan cualquiera de los componentes de la unidad motora, es decir, la unidad funcional constituida por el cuerpo de la motoneurona del asta interior de la médula espinal, su axón (nervio periférico) y todas las fibras musculares inervadas por esta motoneurona. 

A la consulta infantil un alto porcentaje de los niños son llevados por sus padres o tutores, al apreciar que no logran sostener la cabeza no rueda, no gatean o no hacen algunas cosas, sin embargo se cree que este tipo de problemas motores es por una mala nutrición o falta de alguna vitamina.

Una de las enfermedades comunes, hereditarias y rápidamente progresivas es la distrofia muscular de Duchenne con una incidencia de uno por cada tres mil 500 varones nacidos vivos. En el Hospital Civil Fray Antonio Alcalde son diagnosticados y tratados al menos tres pacientes cada mes.

En el módulo de rehabilitación del Congreso Internacional Avances en Medicina se estarán además abordando temas como el papel de la rehabilitación en las diversas enfermedades cardiovasculares y rehabilitación en las diferentes enfermedades neuromusculares.

El magno evento médico será los días 28 y 29 de febrero y 1 de marzo en las instalaciones de Expo Guadalajara.

Ask Well: Is Jogging Bad for Older People?

http://well.blogs.nytimes.com/2014/01/10/ask-well-is-jogging-bad-for-older-people/?_php=true&_type=blogs&emc=edit_tnt_20140110&tntemail0=y&_r=0


Ask Well: Is Jogging Bad for Older People?

By GRETCHEN REYNOLDS
Getty Images

Is there any scientific study to substantiate the claim that older people (over 45) should limit high impact exercises such as jogging, sprinting, etc.?

Asked by Kenneth K • 1251 votes
Actually, much of the recent science about high-impact exercise by “older people” like me — I prefer the term “seasoned,” by the way — reaches the opposite conclusion, suggesting that in many cases high-impact exercise can be beneficial for those middle aged and beyond. A seminal 2003 study of people aged 30 to past 70, for instance, found that while sedentary adults lost about 10 percent of their maximal endurance capacity every decade, young and middle-aged athletes who regularly engaged in intense and high-impact exercise, such as running intervals, experienced a much slower decline, losing only about 5 percent of their capacity per decade until age 70, when the loss of capacity accelerated for everyone.
There is also little evidence to support the widespread belief that high-impact exercise speeds the onset of arthritis. In a 2013 study , adult runners, including many aged 45 or older, had a lower incidence of knee osteoarthritis and hip replacement than age-matched walkers, with the adults who accumulated the most mileage over the course of seven years having the lowest risk, possibly, the study’s author speculated, because running improved the health of joint cartilage and kept them lean as they aged. Similarly, a 2006 review of studiesabout jogging and joints concluded that “long-distance running does not increase the risk of osteoarthritis of the knees and hips for healthy people who have no other counter-indications for this kind of physical activity,” and “might even have a protective effect against joint degeneration.
Running and similar high-impact activities likewise have a salutary effect on bone density, said Dr. Michael Joyner, an exercise physiologist at the Mayo Clinic in Rochester, Minn., and an expert on aging athletes, of whom he is one.Over all, he continued, he is “skeptical” of the idea that older people should avoid high-impact activities. “A lot of concerns about age-appropriate exercise modalities have turned out to be more speculative than real over the years,” he said, adding that during his research and personal workouts, he’s seen many seasoned adults pounding the pavement without ill effects.

Do you have a health question? Submit your question to Ask Well .
A version of this article appears in print on 01/14/2014, on page D4 of the NewYork edition with the headline: Ask Well.

Minnesota Wild Lose Koivu To Broken Ankle

http://blog.anklefootmd.com/2014/01/08/minnesota-wild-lose-koivu-to-broken-ankle/


Minnesota Wild Lose Koivu To Broken Ankle

January 8, 2014
Mikko KoivuThe Minnesota Wild will be without captain Mikko Koivu for four weeks after the center fractured his right ankle during Saturday’s game against the Capitals.
The injury is a tough break for the Wild, as Koivu led the team in both points and assists.
“He’s a tough competitor, he’s clearly one of our best players and he’s our leader for a reason,” said general manager Chuck Fletcher. “It’s a big blow.”
Koivu proved just how tough he was Saturday after suffering the injury. Although he needed to be helped to the bench after taking a blocked shot to the ankle, Koivu returned to the game and tallied two assists that proved key in a 5-3 win.
“If there’s any question about his character or how high his competitive level is, I think this incident certainly should answer that,” Fletcher said.

Opts For Surgery

Koivu underwent surgery to address the fracture on Monday. The Wild said his surgery was successful, and they believe his timetable for return is approximately four weeks.
Team doctors said the fracture would have healed correctly without surgery, but Koivu wouldn’t have been able to skate for six weeks while he recovered. By pursing surgery, Koivu will be able to return to the ice quicker and with a more stabilized bone, both of which are good news for a team jostling for one of the final playoff spots at the halfway point of the season.
Assuming the timeline is accurate, Koivu could return to the lineup for a couple games before the three-week Olympic break, which begins February 7.

Olympic Status

Don’t be surprised if Koivu tries to get back on the ice before the Olympic break, as he expects to play a pivotal role for Team Finland in the upcoming Winter Games. Fletcher said the final decision would be up to Koivu.
“I don’t even know if that’s really our call,” Fletcher said. “If he’s healthy, he’s eligible to go. I anticipate he’ll be healthy before the Olympics, but we’ll see how the recovery and the rehab goes. Sometimes these things are unpredictable.”
Koivu was the captain of the Finnish team that took the gold medal at the 2011 Men’s World Ice Hockey Championships, and many believe he will be asked to captain the team in Sochi.

Dr. Silverman comments

It sounds like Koivu is getting the right kind of care at the hands of the team physicians.
Fractures from direct blows are tough to manage. Many are taken care of non-surgically, but in this case, doctors decided to preform the operation to help Koivu get back on the ice quicker. I’m sure it is very important to Koivu that he plays for his home country in the Olympics, so I’m not surprised he decided to have the surgery.
There are two main reasons a doctor will recommend surgery for a direct blow fracture:
  • If they occur on a weight-bearing bone; or
  • If they caused a displaced fracture.
I don’t have access to the X-rays, but I wouldn’t be surprised if one of the above factors was present in addition to Koivu’s wishes to return as soon as possible.
The big problem with direct blow fractures is the skin near injured area. To break the bone, the skin and the tissues beneath it had to absorb some energy. That energy damages the tissue, which leads to blistering, bruising, and in some circumstances, skin necrosis (death). I’m sure his doctors will handle his break and the surrounding area effectively.
Related source: Pioneer Press.

Will you need surgery after an ACL tear?