Laparoscopic - assisted transpyelic rigid nephroscopy - simple alternative when flexible ureteroscopy is not available.

INTRODUCTION: In special situations such as malrotated or ectopic kidneys and UPJ stenosis treatment of renal lithiasis can be challenging. In these rare cases laparoscopy can be indicated. OBJECTIVE: Describe the Laparoscopic-assisted rigid nephroscopy performed via transpyelic approach and report the feasibility. PATIENTS AND METHODS: We present two cases of caliceal lithiasis. The first is a patient that ESWL and previous percutaneous lithotripsy have failed, with pelvic kidney where laparoscopic dissection of renal pelvis was carried out followed by nephroscopy utilizing the 30 Fr rigid nephroscope to remove the calculus. Ideal angle between the major axis of renal pelvis and the rigid nephroscope to allow success with this technique was 60-90 grades. In the second case, the kidney had a dilated infundibulum. RESULTS: The operative time was 180 minutes for both procedures. No significant blood loss or perioperative complications occurred. The bladder catheter was removed in the postoperative day 1 and Penrose drain on day 2 when patients were discharged. The convalescence was completed after 3 weeks. Patients were stone free without symptons in one year of follow-up. CONCLUSIONS: Laparoscopic-assisted rigid nephroscopy performed via tranpyelic approach can be done safely with proper patient selection and adherence to standard laparoscopic surgical principles. This approach is an alternative in cases where flexible endoscope is not available and when standard procedure is unlikely to produce a stone-free status.

Folic acid supplementation during early hepatocarcinogenesis: cellular and molecular effects.

Folic acid (FA) supplementation during carcinogenesis is controversial. Considering the impact of liver cancer as a public health problem and mandatory FA fortification in several countries, the role of FA supplementation in hepatocarcinogenesis should be elucidated. We evaluated FA supplementation during early hepatocarcinogenesis. Rats received daily 0.08 mg (FA8 group) or 0.16 mg (FA16 group) of FA/100 g body weight or water (CO group, controls). After a 2-week treatment, animals were subjected to the "resistant hepatocyte" model of hepatocarcinogenesis (initiation with diethylnitrosamine, selection/promotion with 2-acetylaminofluorene and partial hepatectomy) and euthanized after 8 weeks of treatment. Compared to the CO group, the FA16 group presented: reduced (p < 0.05) number of persistent and increased (p < 0.05) number of remodeling glutathione S-transferase (GST-P) positive preneoplastic lesions (PNL); reduced (p < 0.05) cell proliferation in persistent GST-P positive PNL; decreased (p < 0.05) hepatic DNA damage; and a tendency (p < 0.10) for decreased c-myc expression in microdissected PNL. Regarding all these parameters, no differences (p > 0.05) were observed between CO and FA8 groups. FA-treated groups presented increased hepatic levels of S-adenosylmethionine but only FA16 group presented increased S-adenosylmethionine/S-adenosylhomocysteine ratio. No differences (p > 0.05) were observed between experimental groups regarding apoptosis in persistent and remodeling GST-P positive PNL, and global DNA methylation pattern in microdissected PNL. Altogether, the FA16 group, but not the FA8 group, presented chemopreventive activity. Reversion of PNL phenotype and inhibition of DNA damage and of c-myc expression represent relevant FA cellular and molecular effects.

Maternal undernutrition during lactation leads to reduction in skull size and thickness of adult-aged Wistar rats.

INTRODUCTION: It is known that the quality and quantity of milk is directly related to the dietary habits of the mother. Despite that, the rates of maternal malnutrition during lactation are increasing in several countries; thus, observing its effects on the offspring is relevant. The present study aims to verify the effects of maternal malnutrition during breastfeeding on the skulls of adult-aged Wistar rats. MATERIAL AND METHODS: Thirty-six newborn rats were divided in three groups: the control group, in which the mother received a regular commercial diet containing 23% protein in unlimited amounts; the protein-energy restriction group, in which the dam received a commercial diet containing 8% protein in unlimited amounts; the energy restricted group, in which the dam received a commercial diet containing 23% of protein in limited amounts. After weaning, all rats received the same diet as the control group until 180 days of age. Then, the rats were euthanized, and their crania were excised and measured in radiographic images. Afterwards, their skull was decalcified with nitric acid (5%) and histological samples were obtained and the thickness of the diploe was verified. Descriptive statistics and ANOVA followed by the Newman-Keuls test were performed for comparison purposes. RESULTS: It was observed that the skull from the protein-energy restriction and energy-restriction groups was smaller and thinner than that of the control group in several parameters. CONCLUSIONS: Maternal malnutrition during the lactation period caused long-term effects in skull morphology of Wistar rats. These effects could not be reversed after regulation of the diet.

Ventral incisional hernia case report: A therapeutic challenge.

Incisional hernias are a very common condition and they still are considered to be a surgical challenge due to their recurrence rate. Smoking, obesity and age are risk factors for developing these abdominal wall defects. Despite recent advances in hernia repairs, the recurrence rates of hernias did not significantly diminished, even after the introduction of meshes. The aim of this article is to report a case of a ventral incisional hernia in a 37-year-old man and its successful treatment with a procedure known as the Alcino-Lázaro technique repair. This procedure has been shown to be very effective in incisional hernias, especially in obese patients. Furthermore, it is as cheap as it is reliable, since it can be performed without technological aid or expensive materials (mesh); thus, patients in low-income countries can greatly benefit from this procedure.

Synthesis of Reduced Graphene Oxide as a Support for Nano Copper and Palladium/Copper Catalysts for Selective NO Reduction by CO.

Copper and palladium/copper nanoparticles supported on reduced graphene oxide catalysts were synthesized and evaluated for the selective NO reduction by CO. The catalysts were characterized by XRD, nitrogen adsorption-desorption, TGA, XPS, TPR, in situ XRD, STEM, and HRTEM. The STEM and HRTEM results showed high metal oxide dispersions on the rGO. XPS results showed the presence of Cu and Pd oxide species. The reduction of copper supported on the rGO occurred in two steps for CuO x /rGOc, while that for CuO x -PdO y /rGOc occurred in one step for temperatures lower than 350 °C. Noteworthy is that the in situ XRD results showed that the rGO structure was not affected after reduction at 350 °C. The in situ XRD of reduction revealed the appearance of new phases for copper during the reduction. The catalysts were evaluated in NO reduction by CO. The tests showed that the reduced catalysts presented high performance with NO conversions and N2 selectivity above 85% at 350 °C.

The olecranon aperture of the humerus: a meta-analysis with anthropological and clinical discussion.

The olecranon aperture is an anatomical variant of the humerus that communicates the olecranon fossa with the coronoid fossa. It is also known as the supratrochlear foramen. Older anatomical textbooks refer to it as a rare variation caused by the perforation of the thin bony plate which separates both fossae. This anatomical variant may be confused as an osteolytic lesion of the humerus in radiographic images. The present work aims to perform a meta-analysis of the olecranon aperture. Heterogeneity between studies was evaluated using I2 estimation and the Cochran Q statistic test. A random effect model was used for all analyses. A total of sixty-one studies (20,338 humeri) were included in this meta-analysis. The pooled prevalence of the olecranon aperture was 21.9% (95% confidence interval: 18.6% to 25.3%). This variant was more commonly found in female than in male bones (statistically significant difference). The olecranon aperture is a common anatomical variant among the general population, although individuals from Africa possess a higher predisposition to develop it. The name supratrochlear foramen is incorrect, as foramina are conduit to vessels or nerves, as such, we propose the term olecranon aperture.

The artery of Mouchet: blood supply of the septomarginal trabecula in 50 human hearts.

The septomarginal trabecula is a muscular structure which transmits the right branch of the atrioventricular bundle. It is usually supplied by a branch from the second anterior septal artery. Anastomoses between the right and left coronary arteries may happen on the septomarginal trabecula. They are of great significance in order to prevent ischemia during a myocardial infarction. Surgeries such as Konno's and Ross' procedures implies in knowledge of these vessels anatomy. The coronary arteries of 50 human hearts were injected with latex and subsequentely dissected with the purpose of identifying the arterial branch that supplied the septomarginal trabecula. The trabecular branch arose from the second anterior septal artery in 38% of cases, and the branch arose from the first anterior septal artery in 26%. One of the hearts had its septomarginal trabecula supplied by the conus arteriosus arteryliterature. Anastomoses between the right and left coronary arteries were found inside the septomarginal trabecula. The right branch of the atrioventricular bundle is subject to a great number of clinical conditions and is often manipulated during surgery, thus, the study of the septal branches of the coronary arteries and the trabecular branch is essential.

Vitamin A and beta-carotene inhibitory effect during 1,2-dimethylhydrazine induced hepatocarcinogenesis potentiated by 5-azacytidine.

5-Azacytidine is being used for reactivation of tumor suppressor genes. However, its administration during DNA repair pontentiates hepatocarcinogenesis. We observed chemopreventive activities by vitamin A and beta-carotene during early hepatocarcinogenesis. Thus, in the present study we evaluated vitamin A and beta-carotene chemopreventive potential during early hepatocarcinogenesis potentiated by 5-azacytidine. Wistar rats received vitamin A (VAA group), beta-carotene (betaCA group) or corn oil (CO and COA groups). After three weeks of treatment, all animals were initiated with 1,2-dimethylhydrazine. Twelve hours later VAA, betaCA and COA groups received a single dose of 5-Azc. Hepatocytes were selected/promoted by 2-acetylaminofluorene and 70% partial hepatectomy. All animals were sacrificed six weeks after initiation. Compared to CO group (without 5-azacytidine), COA group presented higher (p<0.05) nodule multiplicity, larger (p<0.05) gamma-GT positive lesions that occupied a larger (p<0.05) area of liver section. Compared to COA group, VAA group presented decreased (p<0.05) nodule multiplicity while betaCA group tended to present smaller gamma-GT positive lesions and to decrease occupied liver section. These results reinforce vitamin A and beta-carotene chemopreventive potential. Considering that 5-azacytidine potentiates hepatocarcinogenesis, more studies are needed to elucidate the efficacy and safety of this drug for cancer control.

Giant iatrogenic pseudoaneurysm of the brachial artery: A case report.

INTRODUCTION: Pseudoaneurysms are a pulsatile hematoma caused by hemorrhage on soft tissues. It is an uncommon condition with many different etiologies. We report a case of a giant pseudoaneurysm caused by iatrogenic injury on the brachial artery. PRESENTATION OF CASE: A 42 year-old male was submitted to our Vascular Surgery service with an enlargement of the right upper limb and a history of myocardial infarction. 60days before the patient reached our service, he was submitted to a cardiac catheterization performed by another medical team, since the catheter was placed on the right brachial artery near the cubital fossa, we suspected an iatrogenic pseudoaneurysm, which was confirmed by his clinical history and physical exam. It was opted to treat the pseudoaneurysm with an implant of polytetrafluoroethylene prosthesis. There were no complications whatsoever and the patient was discharged. DISCUSSION: Pseudoaneurysms are more common after interventional procedures than diagnostic procedures, although brachial artery pseudoaneurysms are rare. Complications of pseudoaneurysms can cause serious threat to the afflicted limb and the patient's life. The management of any pseudoaneurysm is dependent on its size, location and pathogenesis. CONCLUSION: Pseudoaneurysms develop slowly and should be diagnosed as early as possible in order to avoid complications and a better outcome. Due to an increase in recent endovascular procedures and the fact that brachial artery puncture is being performed more routinely, incidence of brachial artery pseudoaneurysms among overall population may rise.

Klippel-Trenaunay and Parkes-Weber syndromes: two case reports.

Parkes-Weber syndrome is a congenital vascular disease that comprises capillary, venous, lymphatic, and arteriovenous malformations. Although Parkes-Weber syndrome is a clinically distinct entity with serious complications, it is still frequently misdiagnosed as Klippel-Trenaunay syndrome, which consists of a triad of malformations involving the capillary, venous, and lymphatic vessels, without arteriovenous fistulas. Both syndromes are generally diagnosed with Doppler ultrasound and confirmed by magnetic resonance angiography. The aim of this study is to describe one case of Klippel-Trenaunay syndrome, in a 36-year-old patient, and one case of Parkes-Weber syndrome, in a 21-year-old patient. We review the literature in order to discuss the possible causes and consequences of these diseases related to venous hypertension and angiodysplasia, taking a clearer approach to their differences, and discussing their treatment.

A síndrome de Parkes-Weber é uma doença vascular congênita que consiste em malformações capilares, venosas, linfáticas e arteriovenosas. Embora seja uma entidade clinicamente distinta com complicações graves, essa síndrome ainda é frequentemente diagnosticada erroneamente como síndrome de Klippel-Trenaunay, que consiste em uma tríade de má formação nos vasos capilares, venosos e linfáticos, sem fístula arteriovenosa. Ambas as síndromes são geralmente diagnosticadas através de ultrassom Doppler e confirmadas pela angiografia por ressonância magnética. O objetivo deste estudo é descrever um caso de síndrome de Klippel-Trenaunay em um paciente de 36 anos de idade e um caso de síndrome de Parkes-Weber em uma paciente de 21 anos. A literatura foi revisada com o objetivo de discutir as possíveis causas e consequências dessa doença e sua associação à hipertensão venosa e angiodisplasia. O presente trabalho também levanta discussão a respeito das diferenças sintomatológicas de ambas as síndromes e seus respectivos tratamentos.

Clinical discussion of the arteria lusoria: a case report.

The right subclavian artery may originate from the left portion of the aortic arch. This aberrant vessel is known as the arteria lusoria. Its course to its usual site runs behind the esophagus, which may cause a disease known as dysphagia lusoria, responsible for symptoms of discomfort. This artery is often associated with other anomalies, such as the non-recurrent laryngeal nerve and the bicarotid trunk, and with diseases such as aneurysms, congenital heart defects, and even genetic syndromes. During routine dissection of a male cadaver fixed in 10% formalin solution, an arteria lusoria was found. This article reports the variation and discusses its embryological, clinical and surgical aspects.

Em alguns casos, a artéria subclávia direita pode se originar da porção esquerda do arco aórtico. Esse vaso aberrante é conhecido como artéria lusória. Para chegar em sua região, essa artéria passa posteriormente ao esôfago, e pode ser, portanto, causa de uma doença conhecida como disfagia lusória, desencadeando sintomas desconfortantes. A artéria lusória está frequentemente associada com outras anomalias, como o nervo laríngeo não recorrente e o tronco bicarotídeo, assim como pode estar em associação com aneurismas, defeitos cardíacos congênitos e até síndromes genéticas. Durante dissecação cadavérica de rotina, foi observada a presença dessa artéria em um cadáver do sexo masculino fixado em uma solução de formalina a 10%. O objetivo deste trabalho é relatar a variação conhecida como artéria lusória e trazer destaque para seus aspectos embriológicos, clínicos e cirúrgicos.

Corona Mortis: anatomical and surgical description on 60 cadaveric hemipelvises.

OBJECTIVE: to report the prevalence of arterial corona mortis and to describe its surgical and clinical applicabilities. METHODS: We dissected 60 hemipelvises (50 men and 10 women) fixed in a 10% formalin solution for the purpose of gathering information on corona mortis. We measured the caliber and length of the obturator artery and its anastomotic branch with the aid of a digital caliper and submitted the data to statistical analyzes and comparisons with the GraphPad Prism 6 software. RESULTS: arterial corona mortis was present in 45% of the studied sample. The most common origin of the obturator artery was the internal iliac artery; however, there was one exceptional case in which it originated from the femoral artery. The caliber of the anastomotic branch was on average 2.7mm, whereas the caliber of the obturator artery was 2.6mm. CONCLUSION: the vascular connections between the obturator, internal iliac, external iliac and inferior epigastric arterial systems are relatively common over the upper pubic branch. The diameter and a trajectory of the anastomotic artery may vary. Thus, iatrogenic lesions and pelvic and acetabular fractures can result in severe bleeding that puts the patient's life at risk.

De Garengeot's hernia in an 82-year-old man: a case report and clinical significance.

The presence of the appendix within a femoral hernia (FH) sac is known as Garengeot's hernia (GH). We report on current study a rare case of an elderly man with a combined inguinal and Garengeot's hernia and discuss the clinical aspects. An 82-year-old man clinically stable, presented history of pain at the right inguinal region for over a week, without vomit, nausea, fever or any alteration of intestinal or urinary eliminations. Clinical examination revealed a FH and the ultrasonography confirmed the hernia sac. During the surgery, the appendix was recognized within the sac, and then, the patient underwent appendectomy and hernia repair. In conclusion, the presence of the vermiform appendix in a FH sac is rare, thus, requiring knowledge of the surgeon regarding this clinical entity. Prompt diagnosis and appropriate surgical treatment is the key to avoid complications.

Rare origin of the obturator artery from the external iliac artery with two obturator veins.

The obturator artery is a branch of the internal iliac artery, although there are reports documenting variations, with origin from neighboring vessels such as the common iliac and external iliac arteries or from any branch of the internal iliac artery. It normally runs anteroinferiorly along the lateral wall of the pelvis to the upper part of the obturator foramen where it exits the pelvis by passing through said foramen. Along its course, the artery is accompanied by the obturator nerve and one obturator vein. It supplies the muscles of the medial compartment of the thigh and anastomoses with branches of the femoral artery on the hip joint. We report a rare arterial variation in a Brazilian cadaver in which the obturator artery arose from the external iliac artery, passing beyond the external iliac vein toward the obturator foramen, and was accompanied by two obturator veins with distinct paths. We also discuss its clinical significance.

A artéria obturatória é um ramo da artéria ilíaca interna, embora haja grande variabilidade a respeito de sua origem, pois tal vaso pode surgir de diversas artérias vizinhas, como a artéria ilíaca comum e a artéria ilíaca externa, assim de como qualquer ramo da artéria ilíaca interna. Normalmente, a artéria obturatória corre anteroinferiormente pela parede lateral da pelve até a porção superior do forame obturatório, ponto em que sai da pelve. No seu trajeto, a artéria é acompanhada pelo nervo e veia obturatórios. Ela supre os músculos do compartimento medial da coxa e possui anastomoses com ramos da artéria femoral na articulação do quadril e coxa. Este trabalho visa relatar e discutir os aspectos clínicos de uma variação incomum na artéria obturatória, na qual ela se origina da artéria ilíaca externa acompanhada de duas veias obturatórias com trajetos distintos.

Anatomical and Radiological Aspects of the Supratrochlear Foramen in Brazilians.

INTRODUCTION: The supratrochlear foramen is an anatomic variation of great clinical and anthropologic interest. Although many studies addressed this subject in different ethnic groups, there are no studies regarding Brazilians. AIM: To verify the incidence and morphometric measures of the supratrochlear foramen in Brazilian humeri. MATERIALS AND METHODS: A total of 330 dry humeri were analysed and divided in three groups: bones presenting the supratrochlear foramen (Group 1), bones displaying a translucent foramen (Group 2) and humeri without the foramen (Group 3). The aperture was measured with a digital vernier caliper. Radiographic pictures with different incidences were taken. RESULTS: Our analysis showed that 22.5% of humeri belonged in Group 1, 41.2% in Group 2, and 36.3% in Group 3. The mean vertical diameter and the mean horizontal diameter of the supratrochlear foramen on the left side were 2.779±2.050 mm and 2.332±1.23 mm, respectively. The mean vertical diameter and the mean horizontal diameter of the foramen on the right side were 2.778±2.197 mm, and 2.365±1.396 mm, respectively. The student's t-test showed that there was no significant difference regarding the size of the foramen between both sides. The best X-ray machine setup was 50 kilo voltage and 0.08 milliamperage per second, associated with a slight increase in the distance of the x-ray tube. CONCLUSION: The aperture seems to be the key point during the pre-operative planning of intramedullary fixation, since it has direct relation to the size of the intramedullary canal, thus, being an entity of clinical, anatomical, anthropological, radiological, and surgical interest.

Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries.

The posterior tibial artery normally arises from tibial-fibular trunk at the popliteal fossa, together with the fibular artery. The classic course of the posterior tibial artery is to run between the triceps surae muscle and muscles of the posterior compartment of the leg before continuing its course posteriorly to the medial malleolus, while the fibular artery runs through the lateral margin of the leg. Studies of both arteries are relevant to the fields of angiology, vascular surgery and plastic surgery. To the best of our knowledge, we report the first case of an anastomosis between the posterior tibial artery and the fibular artery in their distal course. The two arteries joined in an unusual "X" format, before division of the posterior tibial artery into plantar branches. We also provide a literature review of unusual variations and assess the clinical and embryological aspects of both arteries in order to contribute to further investigations regarding these vessels.

A artéria tibial posterior e a artéria fibular se originam do tronco tibiofibular, na fossa poplítea. A trajetória clássica da artéria tibial posterior é correr entre o tríceps sural e os músculos do compartimento posterior da perna, e, então, seguir posteriormente ao maléolo medial. Já a artéria fibular corre na margem lateral da perna, seguindo profundamente aos músculos. O estudo dessas artérias é relevante para o campo da angiologia, cirurgia vascular e cirurgia plástica. O presente trabalho é o primeiro relato de caso de uma anastomose entre ambas artérias, na porção distal de suas trajetórias. Tais artérias se anastomosaram em formato de "X", antes da divisão da artéria tibial posterior em ramos plantares. Foi feita uma revisão de literatura das variações de tais artérias, dando ênfase ao aspecto clínico e embriológico, de modo a contribuir para novas investigações sobre esses vasos.

Onset of psychosis at age 81? With regard to frontal lobe syndromes.

When the frontal lobe of the brain is affected important behavioral changes may occur mainly at the level of executive functioning, i.e., planning, decision-making, judgment and self-perception. However, the behavioral changes may be of different nature with marked indifference and apathy. We report a clinical case of an 81-year-old patient with sudden onset of behavioral changes that were initially interpreted as an acute confusional episode of infectious etiology, but actually they were due to an ischemic lesion in the frontal lobe.

Pharyngoesophageal Obstruction on the Killian-Laimer Triangle by Zenker's Diverticulum: Case Report and Clinical Significance.

Zenker's diverticulum is a form of esophageal and pharyngeal obstruction located at the Killian-Laimer triangle. It is relatively common in elderly man (seventh or eighth decade of life), and its pathophysiology is not completely understood, albeit theories regarding dysfunction of the upper esophageal sphincter were reported. The main symptoms are dysphagia and odynophagia, but it can complicate to aspiration and perforation of the pharyngeal pouch; also, it can be asymptomatic. Diagnosis is provided through a barium esophagogram. Treatment can be performed through endoscopic surgery, diverticulopexy and myotomy of the cricopharyngeus muscle, although there is no consensus among surgeons regarding the treatment of choice. We report a case of pharyngeal obstruction due to Zenker's diverticulum which caused massive weight loss in a 76-year-old male.

A meta-analysis of the supracondylar process of the humerus with clinical and surgical applications to orthopedics / Metaanálisis del proceso supracondíleo del húmero con aplicaciones clínicas y quirúrgicas para ortopedia

SUMMARY: The supracondylar process is a hook shaped projection of the humerus. It is located superior to its medial epicondyle. This anatomic variation is often presented together with the Struther's ligament, a fibrous arcade that connects the supracondylar process to the medial epicondyle. Both structures have been associated with neurovascular bundle compression on the distal third of the arm, as the median and ulnar nerves and the brachial and ulnar arteries may pass through the osteofibrous canal that these variants create. The SciElo, Pubmed, Scopus, TRIP, MEDLINE, COCHRANE and ScienceDirect databases were searched with the term "supracondylar process" or "supracondyloid process" with the purpose of performing a meta-analysis of this bony spur. Heterogeneity between studies was evaluated using I2 estimation and the Cochran Q statistic test. A random effect model was used for all analysis. A total of twenty articles (26.415 humeri) were included in this meta-analysis. The pooled prevalence of the supracondylar process was 0.68 % (95 % Confidence Interval: 0.47 % to 0.92 %). This variant was more commonly found in women than in men (statistically significant difference) and more commonly found on the left side than the right. The presence of the supracondylar process alone may induce neurovascular bundle compression. It can also be injured in traumatic or stress fractures. Knowledge of this variation and its prevalence may reduce misdiagnosis in radiographic images.

RESUMEN: El proceso supracondíleo es una proyección en forma de gancho del húmero. Se encuentra superior a su epicóndilo medial. Esta variación anatómica a menudo se presenta junto con el ligamento de Struther, una arcada fibrosa que conecta el proceso supracondíleo con el epicóndilo medial. Ambas estructuras se han asociado con la compresión del paquete neurovascular en el tercio distal del brazo, ya que los nervios mediano y ulnar y las arterias braquial y ulnar pueden pasar a través del canal osteofibroso que crean estas variantes. Se realizaron búsquedas en las bases de datos SciElo, Pubmed, Scopus, TRIP, MEDLINE, COCHRANE y ScienceDirect con el término "proceso supracondíleo" o "proceso supracondiloide" con el objetivo de realizar un metanálisis de este espolón óseo. La heterogeneidad entre los estudios se evaluó mediante la estimación I2 y la prueba estadística Cochran Q. Se utilizó un modelo de efectos aleatorios para todos los análisis. Un total de veinte artículos (26.415 húmeros) se incluyeron en este metanálisis. La prevalencia combinada del proceso supracondíleo fue del 0,68 % (intervalo de confianza del 95 %: 0,47 % a 0,92 %). Esta variante se encontró más comúnmente en mujeres que en hombres (diferencia estadísticamente significativa) y se encuentra más comúnmente en el lado izquierdo que en el derecho. La presencia del proceso supracondíleo solo puede inducir la compresión del paquete neurovascular. También puede lesionarse en fracturas traumáticas o por estrés. El conocimiento de esta variación y su prevalencia puede reducir el diagnóstico erróneo en imágenes radiográficas.