Concepciones de la geometría de estudiantes de pedagogía y profesores básicos en ejercicio

Nuestro taller es parte del Proyecto ECOS que desarrollamos equipos de didactas de la Pontificia Universidad Católica de Valparaíso y del equipo DIDIREM de la Universidad de Paris VII. Este Proyecto se inscribe en la línea de investigación de comparación de sistemas educativos a través de la geometría considerando estudiantes de pedagogía para la Enseñanza Media o Liceo y Profesores de Escuela Básica sin formación en Matemáticas. Hemos encuestado a estudiantes avanzados de Pedagogía en Matemáticas, y a profesores de enseñanza básica. El objetivo de la encuesta era obtener una visión del significado de enseñar y aprender geometría. Para ello se pidió nombrar tres adjetivos y tres verbos que la caracterizaran. El análisis de los resultados se apoya en el marco teórico propuesto por Alain Kuzniak y Catherine Houdement

Phylogenetic inferences of Atelinae (Platyrrhini) based on multi-directional chromosome painting in Brachyteles arachnoides, Ateles paniscus paniscus and Ateles b. marginatus

We performed multi-directional chromosome painting in a comparative cytogenetic study of the three Atelinae species Brachyteles arachnoides, Ateles paniscus paniscus and Ateles belzebuth marginatus, in order to reconstruct phylogenetic relationships within this Platyrrhini subfamily. Comparative chromosome maps between these species were established by multi-color fluorescence in situ hybridization ( FISH) employing human, Saguinus oedipus and Lagothrix lagothricha chromosome-specific probes. The three species included in this study and four previously analyzed species from all four Atelinae genera were subjected to a phylogenetic analysis on the basis of a data matrix comprised of 82 discrete chromosome characters. The results confirmed that Atelinae represent a monophyletic clade with a putative ancestral karyotype of 2n = 62 chromosomes. Phylogenetic analysis revealed an evolutionary branching sequence \{Alouatta \{Brachyteles \{Lagothrix and Ateles\}\}\} in Atelinae and \{Ateles belzebuth marginatus \{Ateles paniscus paniscus \{Ateles belzebuth hybridus and Ateles geoffroyi\}\}\} in genus Ateles. The chromosomal data support a re-evaluation of the taxonomic status of Ateles b. hybridus. Copyright (C) 2005 S. Karger AG, Basel

Early use of immunoglobulin and risk of coronary abnormalities in patients with Kawasaki's disease

Indexación: ScieloAntecedentes: La enfermedad de Kawasaki es una vasculitis sistémica de vasos de mediano calibre, que afecta principalmente a las arterias coronarias, provocando dilatación y aneurismas coronarios en un 15 - 25% de los casos no tratados. El tratamiento recomendado actualmente es el uso de inmunoglobulina intravenosa antes del décimo día de enfermedad, lo cual reduce el riesgo de aneurismas coronarios de un 20% a un 4%. Objetivos: Determinar la relación entre el tratamiento oportuno con inmunoglobulina y el riesgo de presentar alteración coronaria en la ecocardi ografía en pacientes con Enfermedad de Kawasaki. Métodos: Se revisó la base de datos de Cardiología Infantil del hospital, identificando 66 pacientes que presentaron la enfermedad entre los años 1994 y 2014. Se determinó el momento en que se inició el tratamiento con inmunoglobulina y se analizó el hallazgo ecocardiográfico de alteraciones coronarias durante el período de hospitalización. Resultados: 52 niños (79%) recibieron tratamiento precoz, antes de 10 días del comienzo de la enfermedad; en el resto el tratamiento fue tardío. El tratamiento precoz se asoció a un menor riesgo de presentar aneurismas coronarios (5.8% vs 50% de los casos, p<0.01). Conclusión: En la enfermedad de Kawasaki es de suma importancia el diagnóstico y tratamiento oportuno con inmunoglobulina intravenosa para reducir el riesgo de formación de aneurismas coronarios.Background: Kawasaki’s disease is a systemic vasculitis of the mediumsized blood vessels, primarily affecting the coronary arteries, causing coronary dilation and aneurysms in 15 - 25% of untreated children. Use of Intravenous immunoglobulin within the first 10 days of illness is the recommended treatment, redugin the risk of coronary artery aneurysm develo-pment from 20% to 4%. Objective: To determine the association of early treatment to risk of echocardiographic coronary changes on patients with the disease. Methods and Results: A review of the institutional Pediatric Cardiology Database, allowed the identification of 66 patients who had Kawasaki’s disease between 1994 and 2014. The echocardiographic findings at follow up were related to the time of treatment initiation in relation to the beginning of the disease. Treatment with im-munoglobulin within 10 days was associated to coronary artery aneurysms in 5.8% of patients, as opposed to 50% in those with a delayed initiation of therapy. Conclusión: Early treatment with immunoglobulins (within 10 days of illness) significantly reduces the short term risk of developing coronary aneurysms in patients with Kawasaki’s disease.http://www.scielo.cl/pdf/rchcardiol/v34n3/art04.pd

Relevance of Glenoid Version in Reverse Total Shoulder Arthroplasty: Insights from Retrospective Analysis of Patients with Retroverted Glenoids (B1-B3) treated with a monoblock central tapered screw fixation.

Background: Management of deformed glenoids is a challenge in shoulder arthroplasty surgery. How it should be managed is unclear, and there is no universal consensus regarding optimal baseplate position. Posterior osteoarthritic erosion of the glenoid fossa, resulting in glenoid retroversion, is commonly encountered in reverse total shoulder arthroplasty (rTSA), and has previously been seen as a negative predictor of outcomes. Surgical techniques such as bony-increased offset RSA (BIO-RSA) can be used to restore bone stock and allow the glenoid baseplate to be positioned in a more neutral version, thereby, improving bone-implant contact. However, it is important to first establish if this is always necessary; studies thus far do not provide an agreement on if and how retroversion should be corrected. Implant loosening is a known complication of rTSA, yet also not clearly correlated with worse glenoid retroversion. Methods: This study calculates the degrees of correction used for various degrees of glenoid retroversion in a consecutive series of eight patients who underwent rTSA for osteoarthritis. By determining the amount of intraoperative correction at the level of the glenoid baseplate needed at different degrees of glenoid retroversion, this study seeks to determine if preoperative glenoid retroversion directly correlates with the correction applied, and whether correction was always required. A more neutral baseplate version implies greater bone-implant contact surface area. Cases of loosening are identified and discussed in the context of glenoid version and change applied. Computed tomography (CT) images are used to measure glenoid version preoperatively, and axillary and anteroposterior X-ray views are used to measure glenoid version postoperatively. Pearson’s correlation is used to calculate correlation. Results: Mean preoperative glenoid version was 16.8°. Mean correction applied was 9.7°. Mean postoperative glenoid version was 8.4°. There was a strong correlation between preoperative glenoid retroversion and correction applied (r = 0.86). There was a weak negative correlation between the preoperative glenoid version and postoperative glenoid version (r = 0.39). Three patients received BIO-RSA to restore bone stock where glenoid retroversion was &gt;20.5°. There was one case of aseptic loosening which occurred in the patient with a preoperative retroversion of 21° who received BIO-RSA where a correction of 19° was applied, resulting in postoperative version of 2.0°. Conclusions: There is a range of literature looking at the impact of glenoid retroversion in rTSA yet no definitive conclusion to guide surgical technique. Recent research suggests no prognostic implication of glenoid or baseplate retroversion. In this study, the amount of correction applied to the glenoid strongly correlated with the degree of glenoid retroversion preoperatively, indicating that abnormal glenoid morphology is usually addressed, with the glenoid baseplate being placed in a more neutral glenoid version where possible. One case of aseptic loosening was observed where a significant correction of 19° was applied using BIO-RSA. Therefore, correction to a more neutral glenoid version is not always required and reduced bone-implant contact may be acceptable without detriment to implant stability. Without expanding the data set, a correlation cannot be inferred, and an expansion of this study is warranted

Current research on Patient-Reported Outcome Measures (PROMs): A Scoping Review

Background: Patient- reported outcome measures (‘PROMs’), a quality-of-life reporting tool, is routinely used pre- and post-operatively over a vast array of medical and surgical specialities. Current research is highly specific for total knee and/or total hip arthroplasty, many of which are country specific. There is very little research into the true challenges and benefits of PROMs use in elective orthopaedic surgery on a generalised global scale. This scoping review was completed to determine these benefits and challenges, among other areas, and to provide recommendations for future practice. &nbsp; Methods: The PRISMA Extension for Scoping Review (PRISMA-ScR) checklist was utilised for this scoping review. The initials steps identified key words and their relevant synonyms, which were combined with Boolean Operators, producing a vast array of journal articles across three databases. The articles were rigorously reviewed against eligibility criteria, and the final papers put through a 6-step process to generate major and minor themes in a thematic analysis ensuring all data was extracted. &nbsp; Results: A total of 892 journal articles were discovered from the keyword search string across three data sites. These articles were filtered against the inclusion and exclusion criteria from which 7 final papers were included in this scoping review. The inclusion criteria consisted of papers that were published in English, within the last ten years and papers relating to PROMs data from orthopaedics specifically, among others. The exclusion criteria included papers which were systematic reviews or pilot review, papers published for a specific country and papers focussing on a specific patient subgroup, alongside other criteria. The majority of the papers were published around 2020, but there was a vast array of article genres with no clear predominance. These papers included randomised control trials and narrative reviews, among others. The final 7 papers were coded, from which major and minor themes were drawn. The major themes in the final scoping review are the application of PROMs, PROMs in the digital age and PROMs on a global scale. The two aforementioned major themes were further explored with 4 minor themes each. &nbsp; &nbsp; Conclusions: This scoping review examined the current global and generalised literature on PROMs, an area which has expanded in research. Three major themes were identified, which included the application of PROMS, PROMs in the digital age and finally PROMS on a global scale. The application of PROMs and PROMS in a digital age were further expanded with four minor themes each. The papers found several benefits, challenges and patient and clinician engagement factors when applying PROMs to practice. For example, the shortened versions of PROMS which have been designed to increase completion and engagement from patients. The digital era of PROMs was examined, yielding results which highlighted the status of electronic PROMS (e-PROMs) and their benefits, challenges and future steps. The international standpoint for PROMs integration requires further investigation as there was limited information presented. Ultimately, the research surrounding PROMs is vital to the current shift in medical practice whereby patients and their experiences are the focus, and prospective studies should draw on conclusions in published literature to further their development and integration. Keywords: Elective Orthopaedic Surgery | Patient Reported Outcome Measure

Elbow Dislocation with No Associated Fractures: A Systematic Review of the Current Practice

Background: A simple elbow dislocation (SED) is defined as an elbow dislocation with no associated fracture. It is the second most dislocated joint after the shoulder and represents 25% of all elbow injuries. Currently, treatment protocols are varied and yield inconsistent outcomes. The objective of this study was to conduct a systematic review on published literature to analyse the clinical outcomes of different rehabilitation protocols in both conservative and surgical treatments, aiming to identify which approach yields the best clinical outcomes.&nbsp; &nbsp;Methods: The systematic review was conducted using protocols from PRISMA for systematic reviews and Cochrane Handbook for Systematic Review of Interventions. Following PICO analysis and identification of Medical Subject Headings (MeSH), keywords were used with Boolean operators to search for literature from online medical databases. Studies were selected using title-abstract and full-text screening based on inclusion-exclusion criteria. Only peer-reviewed literature was included. Quality assessment methods including Cochrane Risk of Bias tool, Coleman score, MINORS, and AMSTAR were used to validate the methodology of the included studies. Data extracted included outcome measures such as clinical outcome scores (MEPS, OES, Q-DASH), elbow range of motion (ROM), time return to work, pain scores. Outcomes were categorised into conservative or surgical and further subdivided based on time of immobilisation and incorporation of physiotherapy. Data illustration was performed in Excel and followed by comparative analysis.&nbsp; &nbsp;Results: A total of 18 studies, involving 3,278 patients were included. Studies were primarily retrospective cohort studies and systematic reviews. Quality of evidence for non-randomised studies ranged from moderate to high, low-quality studies were excluded from the data extraction and analysis. Randomised studies had low risk of bias. The conservative management group comprised of 2,629 patients, 904 had early mobilisation at ≤ 7 days and 1,725 were mobilised at &gt; 7 days. This was followed with variations in use of physiotherapy. Respectively, mean MEP score was 95.3 and 93.7, with mean elbow flexion-extension ROM of 135.7° and 133.1°. Surgical treatment was ligament repair or&nbsp;&nbsp;reconstruction and comprised of 649 patients. Post-surgery 282 had variations of early physiotherapy and 367 without. Respectively, mean MEP score was 93.4 and 91.6, with mean elbow flexion-extension ROM of 129.7° and 120°. Given inadequate reporting and varying follow-up durations between studies, the impact on recovery time was not established.&nbsp; Conclusions: Shorter durations of immobilisation consistently demonstrated the most favourable outcomes, particularly when coupled with physiotherapy. Regardless, all treatment groups demonstrated good functional outcomes, suggesting management should be tailored according to patient needs and personal recovery goals. Future research should adopt unified reporting methods, particularly in follow-up timing and outcome measurement units. Additional data is needed to evaluate the impact of rehabilitation protocols after surgical treatment for SEDs.&nbsp

Reverse total shoulder replacement for patients with "weight-bearing" shoulders.

Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years and is indicated for a wide variety of shoulder pathologies. However, use of rTSA in patients with "weight-bearing" shoulders that support wheelchair use or crutches has higher risk. The aim of this study was to assess the results of rTSA in such patients. Between 2005 and 2014, 24 patients (30 shoulders) with weight-bearing shoulders were treated with rTSA at our unit. Patients had cuff arthropathy (n=21), rheumatoid arthritis (n=3), osteoarthritis (n=1), acute fracture (n=3), or fracture sequela (n=2). Postoperatively, patients were advised not to push themselves up and out of their wheelchair for 6 weeks. The study surgeries were performed in 2016, and 21 patients (27 shoulders) who were available for a mean follow-up of 5.6 years (range, 2-10 years). The mean age on surgery day was 78 years (range, 54-90 years). Constant-Murley score improved from 9.4 (range, 2-26) preoperatively to 59.8 (range, 29-80) at the final follow-up (P=0.001). Pain improved from 2/15 (range, 0-8) to 13.8/15 (range, 9-15) (P=0.001). Patient satisfaction (Subjective Shoulder Value) improved from 0.6/10 to 8.7/10 (P=0.001) at final follow-up. Significant improvement in mean range of motion from 46° to 130° of elevation, 13° to 35° of external rotation, and 29° to 78° internal rotation was recorded (P=0.001). Final mean Activities of Daily Living External and Internal Rotation was 32.4/36 (range, 16-36). There were three patients with Sirveaux-Nerot grade-1 (10%) glenoid notching and three with grade 2 (10%). rTSA can be used for treatment of patients with weight-bearing shoulders. Such patients reported pain free movement, resumed daily activities, and high satisfaction rates