Browsing by Author "Besa, Pablo"

Now showing 1 - 13 of 13
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    Anterior and distal tunnel orientation for anatomic reconstruction of the medial patellofemoral ligament is safer in patients with open growth plates
    (SPRINGER, 2020) Irarrazaval, Sebastian; Besa, Pablo; Fernandez, Francisco; Fernandez, Tomas; Tuca, Maria; Lira, Maria J.; Orrego, Mario
    Purpose In patients with open growth plates, the direction of tunneling that avoids distal femoral physis (DFP) damage in anatomic reconstructions of the medial patellofemoral ligament (MPFL) has been a topic of discussion. The objective of this study was to determine the ideal orientation for anatomic reconstructions of MPFL tunneling that minimized DFP damage while avoiding breaching the intercondylar notch. Methods Eighty magnetic resonance images of patients aged 10 through 17 were obtained, randomly sampled from the institutional database. A de novo software was developed to obtain 3D models of the distal femur and DFP. In each model, the anatomical insertion point of the MPFL was determined as defined by Stephen. A 20-mm-depth drilling was simulated, starting from the insertion point at every possible angle within a 90 degrees cone using 5-, 6- and 7-mm drills. Physeal damage for each pair of angles and each drill size was determined. Damage was expressed as a percentage of total physis volume. Statistical analysis was conducted using Student'sttest and one-way ANOVA. Results Maximum physeal damage (5.35% [4.47-6.24]) was obtained with the 7-mm drill when drilling 3 degrees cephalic and 15 degrees posterior from insertion without differences between sexes (n.s.). Minimal physeal damage (0.22% [0.07-0.37]) was obtained using the 5-mm drill aimed 45 degrees distal and 0 degrees anteroposterior, not affected by sex (n.s.). Considering intra-articular drilling avoidance, the safest zone was obtained when aiming 30 degrees-40 degrees distal and 5 degrees-35 degrees anterior, regardless of sex. Conclusion Ideal femoral tunnel orientation, avoiding physeal damage and breaching of the intercondylar notch, was obtained when aiming 30 degrees-40 degrees distal and 5 degrees-35 degrees anterior, regardless of sex. This area is a safe zone that allows anatomic MPFL reconstruction of patients with an open physis.
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    Automatic quantification of fat infiltration in paraspinal muscles using T2-weighted images: An OsiriX application
    (ELSEVIER SCI LTD, 2020) Arrieta, Cristobal; Urrutia, Julio; Besa, Pablo; Montalba, Cristian; Lafont, Nelson; Andia, Marcelo E.; Uribe, Sergio
    Fat infiltration of paraspinal muscles has been related with low back pain and quantified using T2w MR images and manual segmentation techniques. This methodology is time consuming and has low reproducibility. Moreover, the accuracy of T2w images to quantify fat has not been validated. This paper presents the development and validation of an OsiriX application to semi-automatically segment infiltrated fat on T2w images. This software was also utilized to validate the quantification of muscle fat infiltration with T2w images, considering Dixon fat images assessments as a gold standard.
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    Case Report of Frostbite with Delay in Evacuation: Field Use of Iloprost Might Have Improved the Outcome
    (2018) Irarrazaval, Sebastian; Besa, Pablo; Cauchy, Emmanuel; Pandey, Prativa; Vergara Leyton, Jorge
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    Finite element modeling of multiple density materials of bone specimens for biomechanical behavior evaluation
    (2021) Irarrazaval, Sebastian; Ramos Grez, Jorge; Perez, Luis Ignacio; Besa, Pablo; Ibanez, Angelica
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    Inter and intra-observer agreement evaluation of the AO and the Tronzo classification systems of fractures of the trochanteric area
    (2015) Urrutia Escobar, Julio Octavio; Zamora Helo, Tomás; Besa, Pablo; Zamora Helo, Maximiliano; Schweitzer, Daniel; Klaber Rosenberg, Ianiv
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    Is a single-level measurement of paraspinal muscle fat infiltration and cross-sectional area representative of the entire lumbar spine?
    (2018) Urrutia Escobar, Julio Octavio; Besa, Pablo; Lobos, Daniel; Andía Kohnenkampf, Marcelo Edgardo; Arrieta, Cristobal; Uribe Arancibia, Sergio A.
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    Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients
    (2018) Urrutia Escobar, Julio Octavio; Besa, Pablo; Lobos, Daniel; Campos Daziano, Mauricio Andrés; Arrieta, Cristobal; Andía Kohnenkampf, Marcelo Edgardo; Uribe Arancibia, Sergio A.
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    Simulation-based training program for peripherally inserted central catheter placement. Randomized comparative study of in-person training with synchronous feedback versus distance training with asynchronous feedback
    (2024) Corvetto, Marcia A.; Kattan, Eduardo; Ramirez, Gaspar; Besa, Pablo; Abbott Cáceres, Eduardo Francisco; Zamorano Rivera, Elga del Carmen; Contreras Ibacache, Víctor; Altermatt, Fernando R.
    Simulation training that includes deliberate practice is effective for procedural skill training. Delivering feedback remotely and asynchronously has been examined for more cost-efficient training. This prospective randomized study aimed to compare 2 feedback techniques for simulation training: synchronous direct feedback versus asynchronous distance feedback (ASYNC). MethodsForty anesthesia and internal medicine residents were recruited after study approval by the institutional ethics committee. Residents reviewed instructional material on an online platform and performed a pretraining assessment (PRE) for peripherally inserted central catheter (PICC) placement. Each resident was then randomly assigned to 1 of 2 training types, practice with synchronous direct feedback (SYNC) or practice with ASYNC. Training consisted of four, 1-hour practice sessions; each was conducted once per week. Both groups underwent posttraining evaluation (POST). The PRE and POST assessments were videotaped and evaluated by 2 independent, blinded reviewers using a global rating scale. ResultsThirty-five residents completed the training program and both evaluations. Both groups had significantly improved global rating scale scores after 4 sessions. The SYNC group improved from 28 to 45 points (P < 0.01); the ASYNC group improved from 26.5 to 46 points (P < 0.01). We found no significant between-group differences for the PRE (P = 0.42) or POST assessments (P = 0.13). ConclusionThis simulation-based training program significantly improved residents' peripherally inserted central venous catheter placement skills using either modality. With these results, we are unable to demonstrate the superiority of synchronous feedback over ASYNC. Asynchronous feedback training modality represents a new, innovative approach for health care procedural skills training.
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    Skyline view of the patella does not increase fracture detection: A non-inferiority diagnostic study
    (2023) Gonzalez, Nicolas; Besa, Pablo; Correa, Ignacio; Guiloff, Benjamin; Irarrazaval, Sebastian
    Purpose: Patella fractures are frequent injuries in the adult population. Initial study is made by plain radiographs and the standard set includes the skyline view of patella. Recommendation for use of this projection is variable among the experts, without data that support its performance in the diagnosis of patella fractures. The main purpose of this study was to determine the sensitivity of the antero-posterior and lateral view of the knee, without skyline view, in the diagnosis of patella fracture.
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    The META score for differentiating metastatic from osteoporotic vertebral fractures : an independent agreement assessment
    (2018) Besa, Pablo; Urrutia Escobar, Julio Octavio; Campos Daziano, Mauricio Andrés; Mobarec Katunaric, Sebastián Ignacio; Cruz, Juan Pablo; Cikutovic Molina, Pablo Andrés; Díaz, Gonzalo
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    Tibial Cut Accuracy in Mechanically Aligned Total Knee Arthroplasty Using Extensor Hallucis Longus Tendon to Determine Extramedullary Tibial Guide Position
    (2022) Besa, Pablo; Vega, Rafael; Ledermann, Gerardo; Calvo, Claudio; Angulo, Manuela; Lira, Maria Jesus; Vidal, Catalina; Orrego, Mario; Irribarra, Luis; Espinosa, Julio; Vial, Raimundo; Irarrazaval, Sebastian
    This study aimed to determine the tibial cut (TC) accuracy using extensor hallucis longus (EHL) tendon as an anatomical landmark to position the total knee arthroplasty (TKA) extramedullary tibial guide (EMTG), and its impact on the TKA mechanical alignment (MA). We retrospectively studied 96 TKA, performed by a single surgeon, using a femoral tailored intramedullary guide technique. Seventeen were prior to the use of the EHL and 79 used the EHL tendon to position the EMTG. We analyzed preoperative and postoperative standing total lower extremity radiographs to determine the tibial component angle (TCA) and the correction in MA, comparing pre-EHL use and post-EHL technique incorporation. Mean TCA was 88.89 degrees and postoperative MA was neutral in 81% of patients. Pre- and postoperative MAs were not correlated. As a conclusion of this study, using the EHL provides a safe and easy way to determine the position of EMTG.
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    Validación de medidas de resultados informados por los pacientes en ortopedia y traumatología
    (2022) Vidal Olate, Catalina Victoria; Lira Salas, María Jesús; Besa, Pablo; Carmona, Maximiliano; Irarrazaval Dominguez, Sebastian
    En los últimos años, ha habido un aumento en la aplicación de cuestionarios diseñados para la medición de resultados (o desenlaces) clínicos en la práctica médica. Para aplicar un cuestionario en una población distinta a la cual fue originalmente creado y diseñado, es necesario llevar a cabo un proceso riguroso de adaptación, con una determinada metodología. El objetivo de esta guía metodológica es describir el proceso de traducción, adaptación transcultural y validación de medidas de resultados informados por los pacientes (MRIPs) en Ortopedia y Traumatología.