Obesity and SARS-CoV-2 infection have both been associated with renal injury through inflammatory, endothelial, and microvascular mechanisms. Whether a history of COVID-19 modifies renal trajectories after metabolic surgery remains unclear. To evaluate the association between prior COVID-19 infection and renal outcomes 12 months after laparoscopic Roux-en-Y gastric bypass (LRYGB). We conducted a prospective cohort study including 38 adults with severe obesity (BMI ≥ 35 kg/m² with comorbidities or ≥ 40 kg/m²) and preserved baseline kidney function who underwent LRYGB between January 2022 and January 2024. Participants were stratified according to a history of laboratory-confirmed COVID-19 infection. Renal outcomes included measured and estimated glomerular filtration rate, creatinine and urea clearance, 24-h proteinuria, albuminuria, and urine albumin-to-creatinine ratio (ACR). KDIGO combined G/A risk categories were assessed at baseline and 12 months. Longitudinal changes were explored using within-group analyses and between-group comparisons of trajectories. Eighteen patients (47
Obesity is a progressive, multifactorial disease, associated to serious health complications such as type 2 diabetes, cardiovascular disease, and obstructive sleep apnea (OSA). OSA, prevalent in up to 71
Background:Lateral extra-articular tenodesis (LET) has gained popularity as a supplementary method for ACL reconstruction (ACL-R) to reduce the risk of graft rupture in adults. However, information on the effectiveness and safety of this procedure in pediatric and adolescent patients remains limited. This study aimed to evaluate the functional outcomes and complications of lateral extra-articular tenodesis associated with ACL-R in adolescents at a minimum follow-up of 2 years.Methods:A consecutive series of patients aged <= 18 years who underwent ACL-R + LET in a 6-year period was retrospectively analyzed. Outcome measures included participants' return to sports, complications, concomitant or subsequent surgical procedures, and patient-reported outcome measures such as the Single Assessment Numeric Evaluation (SANE), Pediatric International Knee Documentation Committee (Pedi-IKDC), and HSS Functional Activity Brief Scale (HSS Pedi-FABS).Results:Forty-two patients were included in the final analysis. The mean follow-up duration was 41 months, with a mean patient age of 16.1 +/- 2 years (range: 13 to 18 y); 81% were male. Thirty-nine patients (93%) participated in organized sports such as soccer, rugby, or volleyball. Autologous hamstring tendon grafts were used in 100% of cases. At a mean follow-up of 41 months (range: 24 to 66 mo), the median SANE, Pedi-IKDC, and HSS-Pedi FABS scores were 89.1, 94.3, and 26.7 points, respectively. A 100% successful return to sport (RTS) was observed at a mean of 10.2 months, with 89.7% of patients returning to their preinjury or a higher level of sport. Three patients (7%) underwent additional ipsilateral knee surgical procedures, comprising 2 meniscal surgeries and one arthroscopic lysis of adhesions. No graft injuries were observed during the study period.Conclusion:The findings of this study suggest that ACL-R associated with LET in high-risk adolescent patients is associated with favorable patient-reported outcomes, a high return to sports, and a low rate of complications, including graft rupture, at an average follow-up of 3.5 years.Study Design:Case series.Level of Evidence:Level IV.
Introducción: en pacientes pediátricos con fisis abierta y patela alta que presentan inestabilidad patelofemoral (IPF) recurrente, la reconstrucción del ligamento patelofemoral medial (RLPFM) ha demostrado ser una técnica quirúrgica eficaz, pero su efecto sobre la altura rotuliana aún no ha sido claramente establecido. Objetivo: evaluar si la reconstrucción aislada del LPFM en pacientes pediátricos con patela alta y fisis abierta modifica la altura patelar y se correlaciona con los resultados clínicos y funcionales. Nuestra hipótesis fue que la reconstrucción aislada del LPFM podría asociarse a una disminución de la altura patelar y a mejores resultados funcionales en esta población. Materiales y métodos: desarrollamos un estudio observacional, retrospectivo y analítico que incluyó a 26 pacientes de ≤16 años con patela alta, fisis abierta e IPF tratados mediante RLPFM. Se evaluaron los puntajes de Lysholm, Tegner e IKDC, y se calcularon los valores umbral clínicamente importantes (MCID y PASS). Se analizó el índice de Caton-Deschamps en radiografías laterales pre y postoperatorias. El nivel de significancia se fijó en p <0.05. Resultados: de los 32 pacientes incluidos inicialmente, 26 completaron un seguimiento mínimo de 24 meses. Se observaron mejoras significativas en los puntajes funcionales: Lysholm (43.7 ± 4.7 a 87.1 ± 3.6; p <0.0001; IC 95 % 38.7–44.9); Tegner (2.8 ± 0.8 a 8.8 ± 0.8; p <0.0001; IC 95 % 5.7–6.1) e IKDC subjetivo (52.3 % ± 6.4 a 91.6 % ± 5.2; p <0.0001; IC 95 % 38.1–44.5). El índice de Caton-Deschamps disminuyó significativamente. No se registraron recurrencias ni complicaciones postoperatorias. Conclusión: la reconstrucción aislada del ligamento patelofemoral medial en pacientes esqueléticamente inmaduros con inestabilidad patelofemoral y patela alta leve se asoció a una disminución significativa del índice de Caton-Deschamps y a una mejoría funcional clínicamente relevante, sin recurrencias ni complicaciones, lo que respalda su uso como opción eficaz y segura en casos seleccionados. Nivel de evidencia: IV. Estudio de Cohorte Retrospectiva
Introduction: The Allurion® gastric balloon (AGB) is an innovative option for treating overweight individuals and those with grade I obesity, or as a bridging treatment for bariatric surgery, or for patients who do not desire surgical intervention. This study aimed to evaluate the efficacy and safety of the AGB in a multicentric cohort. Materials and Methods: A retrospective analysis of consecutive cases treated with AGB (≥18 years old with body mass index [BMI] ≥27) was performed in eight centers in three countries in Latin America (Argentina, Chile, and Perú), between September 2021 and September 2022, with a 12-month follow-up. Results: In total, 402 patients were included (median BMI of 32.81 kg/m2). Mean total weight loss percentage was 8.3%, 11.6%, and 14.9% at 3, 6, and 12 months, respectively, with a follow-up of 93.03%, 75.37%, and 40.54%. The adverse event rate was 1.24% (n = 5). During the first 7 days, 34.58% (n = 139) experienced concomitant symptoms, and 1.99% (n = 8) asked for endoscopic balloon extraction because of intolerance. The complication rate was 6.46% (n = 26). Readmission index was 4.97% (n = 20), and reintervention was 2.23% (n = 9). Balloon elimination was experienced by 5.7% of patients in the first 14 days, 29.10% (n = 117) before the third month, and 62.68% (n = 252) after the 16th week. Early deflation rate was 2.73% (n = 11). Digestive track elimination was perceived by 26.61%. Conclusions: AGB is a safe and effective option for the treatment of overweight and obesity in Latin America. Lifestyle changes and continuous support with a multidisciplinary team are essential to achieving good mid- to long-term outcomes.
