Estudio antropométrico de la glena humana en una población española normal / Anthropometrical study of the human glenoid in a normal Spanish population

Objetivo: El objetivo de este estudio es evaluar el tamaño de la glena en una población española normal, compararla con resultados previos en otras poblaciones y relacionarlo con los tamaños de implante que se comercializan para la artroplastia invertida de hombro. Material y métodos: Estudio antropométrico de la glena humana utilizando tomografías computarizadas de 154 pacientes con edades superiores a 30 años, realizados entre enero de 2015 y diciembre de 2017. Se valoran tomografías computarizadas de hombro con cortes de 2mm de grosor y 0mm de intervalo entre cortes, en algoritmo óseo y de partes blandas, realizándose reconstrucción 3D sobre la cual se obtienen mediciones de longitud y anchura de la glena. El punto superior de la glena se determinó en la zona superior del ovoide de la glena, en el tubérculo supraglenoideo, justo por debajo del reborde circunferencial que rodea la glena. El punto inferior se determinó como el punto más alejado del punto superior en el contorno de la glena, a nivel superior del reborde circunferencial que rodea la glena. Los puntos anterior y posterior fueron determinados como los extremos del eje transversal mayor en un plano perpendicular al eje superoinferior, por dentro del reborde circunferencial que rodea la glena. Las diferencias entre sexos, edad, altura, peso y relaciones de tamaños fueron evaluados. Resultados: La glena tiene un eje longitudinal medio de 28,78mm y una anchura de 20,27mm. Los valores del tamaño de la glena son significativamente diferentes en hombres y mujeres, siendo mayor en hombres. El tamaño de la glena está bien correlacionado con la estatura del paciente, existiendo una asociación positiva entre la estatura y la longitud y anchura de la superficie glenoidea. Las metaglenas circulares disponibles hoy en el mercado presentan tamaños no inferiores a 24-25mm de diámetro. Conclusión: La población del sur de España presenta un tamaño de la superficie glenoidea inferior a la población americana y semejante a la cohorte asiática. Los datos antropométricos expresados pueden ser útiles para la elección de la metaglena más apropiada en la población del sur de España

Objective: To evaluate the size of the glenoid in a southern Spanish population, to compare it with previous results from other populations and determine the size of the implants that are marketed for shoulder arthroplasty. Material and methods: Between January 2015 and December 2017, an anthropometrical study of the human glenoid was performed using computed axial tomography scans (CT) of 154 patients over 30 years old. The glenoid dimensions were analysed 3-dimensionally using 2mm interval thicknesses, determining the average height and width of the glenoid. The upper point of the glenoid geometry was determined as the supraglenoid tubercle of the ovoid glenoid surface, where the long head of the biceps tendon is thought to originate. The lower point was then positioned at the furthest point from the upper point on the glenoid contour. Anterior and posterior points were determined such that the 3-dimensional anterior-posterior distance was maximized on the plane perpendicular to the upper-lower axis. Sex differences and correlations between sides and among the respective parameters in the glenohumeral dimensions were also evaluated. Results: The glenoid had an average height of 28.78mm and width of 20.27mm. The values were significantly different between the men and the women, being greater in the men. The glenoid size is well correlated with the patient's size. Direct correlations exist between the glenoid height and width and the glenoid size and the patient's height. The available metaglenoids currently on the market are no bigger than 25-24mm. Conclusion: In comparison, the southern Spanish population have a glenoid size similar to the Caucasian population, but smaller than that of the American population. The data shown could be useful to improve the design of shoulder prostheses for the southern Spanish population

Anthropometrical study of the human glenoid in a normal Spanish population. / Estudio antropométrico de la glena humana en una población española normal.

OBJECTIVE: To evaluate the size of the glenoid in a southern Spanish population, to compare it with previous results from other populations and determine the size of the implants that are marketed for shoulder arthroplasty. MATERIAL AND METHODS: Between January 2015 and December 2017, an anthropometrical study of the human glenoid was performed using computed axial tomography scans (CT) of 154 patients over 30 years old. The glenoid dimensions were analysed 3-dimensionally using 2mm interval thicknesses, determining the average height and width of the glenoid. The upper point of the glenoid geometry was determined as the supraglenoid tubercle of the ovoid glenoid surface, where the long head of the biceps tendon is thought to originate. The lower point was then positioned at the furthest point from the upper point on the glenoid contour. Anterior and posterior points were determined such that the 3-dimensional anterior-posterior distance was maximized on the plane perpendicular to the upper-lower axis. Sex differences and correlations between sides and among the respective parameters in the glenohumeral dimensions were also evaluated. RESULTS: The glenoid had an average height of 28.78mm and width of 20.27mm. The values were significantly different between the men and the women, being greater in the men. The glenoid size is well correlated with the patient's size. Direct correlations exist between the glenoid height and width and the glenoid size and the patient's height. The available metaglenoids currently on the market are no bigger than 25-24mm. CONCLUSION: In comparison, the southern Spanish population have a glenoid size similar to the Caucasian population, but smaller than that of the American population. The data shown could be useful to improve the design of shoulder prostheses for the southern Spanish population.

Resultados de la cirugía de refuerzo del manguito rotador con fascia lata autógena / Outcomes of rotator cuff augmentation surgery with autologous fascia lata

Objetivo: Evaluar si el injerto de refuerzo con fascia lata autógena mejora los resultados funcionales en las reparaciones del manguito rotador y si disminuye la tasa de rerroturas en comparación con las realizadas sin refuerzo. Material y métodos: Estudio prospectivo sobre una muestra piloto de 20 pacientes con una rotura completa sintomática del manguito de los rotadores. Los pacientes fueron intervenidos mediante un abordaje superior, realizándose una reparación completa sin tensión de la rotura mediante sutura reforzada con injerto autógeno procedente de fascia lata del propio paciente a 10 de ellos y sutura sin refuerzo a los otros 10. El tiempo de seguimiento fue de un año desde la intervención. Se han medido variables sobre la tipología de la lesión, la funcionalidad y el dolor mediante la escala de Constant-Murley, tanto basalmente como a los 6 y 12 meses de seguimiento. Se realizó un análisis descriptivo de todas las variables en ambos grupos de intervención y un análisis de normalidad. Se evaluó la incidencia de rerroturas al año en ambos grupos. Resultados: Hay una mejoría significativa de las puntuaciones medias de Constant-Murley y del dolor al año de seguimiento en ambos grupos de tratamiento respecto al inicio, pero sin cambios significativos entre los valores de dolor y función al año de seguimiento en ambos grupos de intervención. La mejoría del dolor en el grupo de no injertados se produce paulatinamente a lo largo del tiempo, mientras que en el grupo de injertados a los 6 meses ya se alcanzan valores medios por encima de 10 de la escala de Constant-Murley, que se mantienen hasta los 12 meses. Se produjo una rerrotura en el grupo con injerto y 2 en el grupo sin injerto, no apareciendo diferencias significativas. Conclusión: Nuestros resultados preliminares de la cirugía de refuerzo del maguito rotador con fascia lata autógena muestran una mejoría significativa del dolor a los 6 meses, que se mantiene en el tiempo respecto a los pacientes sin refuerzo quienes requirieron 12 meses para obtener los mismos valores y a pesar de no hallar diferencias significativas respecto a función ni cicatrización, los pacientes con refuerzo de fascia lata se benefician de una más rápida mejoría del dolor. El número de reroturas en el grupo sin injerto fue mayor que en el grupo con injerto, aunque la diferencia no fue significativa

Objective: To evaluate whether augmentation grafts using autologous fascia lata improve functional results for rotator cuff repairs and reduce the retear rate compared to those without augmentation. Material and methods: This is a prospective evaluation comprising 20 patients with a complete symptomatic rotator cuff tear. The operations were carried out from a superior approach performing a total cuff repair, for 10 patients we used a suture augmented with an autologous graft taken from their own fascia lata while unaugmented sutures were used for the other 10 patients. The follow-up period lasted for one year post-intervention. We measured variables for tear type, functionality and pain, both baseline and at 6 and 12-month follow ups. We evaluated retear incidence in each group as well as each group's pain and functionality response. Results: The improved pain levels in the non-graft group evolved gradually over time. Conversely, in the group with the augmentation grafts, average Constant-Murley shoulder outcome scores at six months were already above 10 and were maintained at 12 months. One retear occurred in the graft group and 2 in the group without grafts, thus presenting no significant differences. There were no significant changes in pain and function values at the one year follow up in either group. Conclusion: Our preliminary results regarding rotator cuff augmentation surgery with autologous fascia lata showed a significant improvement in pain levels after 6 months compared to the patients with no augmentation, who required 12 months to reach the same values. After a year of follow up, there were no differences between the mean Constant and pain scores in either intervention group The number of retears in the non-graft group was greater than that in the group with grafts although the difference was not significant

Outcomes of rotator cuff augmentation surgery with autologous fascia lata. / Resultados de la cirugía de refuerzo del manguito rotador con fascia lata autógena.

OBJECTIVE: To evaluate whether augmentation grafts using autologous fascia lata improve functional results for rotator cuff repairs and reduce the retear rate compared to those without augmentation. MATERIAL AND METHODS: This is a prospective evaluation comprising 20 patients with a complete symptomatic rotator cuff tear. The operations were carried out from a superior approach performing a total cuff repair, for 10 patients we used a suture augmented with an autologous graft taken from their own fascia lata while unaugmented sutures were used for the other 10 patients. The follow-up period lasted for one year post-intervention. We measured variables for tear type, functionality and pain, both baseline and at 6 and 12-month follow ups. We evaluated retear incidence in each group as well as each group's pain and functionality response. RESULTS: The improved pain levels in the non-graft group evolved gradually over time. Conversely, in the group with the augmentation grafts, average Constant-Murley shoulder outcome scores at six months were already above 10 and were maintained at 12 months. One retear occurred in the graft group and 2 in the group without grafts, thus presenting no significant differences. There were no significant changes in pain and function values at the one year follow up in either group. CONCLUSION: Our preliminary results regarding rotator cuff augmentation surgery with autologous fascia lata showed a significant improvement in pain levels after 6 months compared to the patients with no augmentation, who required 12 months to reach the same values. After a year of follow up, there were no differences between the mean Constant and pain scores in either intervention group The number of retears in the non-graft group was greater than that in the group with grafts although the difference was not significant.

La osteotomía patelar coronal de la faceta externa asociada a liberación del retináculo lateral mejora los resultados clínicos de la liberación lateral aislada en el síndrome de compresión lateral de rótula / Coronal patellar osteotomy of the external facet combined with the release of the lateral retinaculum improves the clinical outcomes of isolated lateral release in lateral knee compartment syndrome

Objetivo. Descripción de una nueva osteotomía coronal de la faceta externa de la rótula y valorar si los resultados del tratamiento del síndrome de compresión lateral de la rótula (SCLR) con nuestra osteotomía junto a la liberación del retináculo lateral externo son mejores que la liberación aislada del retináculo lateral. Material y métodos. Estudio prospectivo con 2 años de seguimiento, donde tratamos 70 pacientes diagnosticados de SCLR y distribuidos en 2 grupos: un primer grupo de 50 pacientes en los que se realizó la liberación del retináculo lateral asociada a osteotomía, y un segundo grupo de 20 pacientes en los que se realizó una liberación aislada del retináculo lateral. Se midió la escala funcional de Werner de forma preoperatoria y a los 3, 12 y 24 meses. Resultados. Existen diferencias significativas en el estado funcional global postoperatorio entre grupos (mejor el grupo de osteotomía en todos los intervalos, p<0,05). La mejoría, que es progresiva hasta los 12 meses, experimenta un ligero retroceso a los 24, aunque los valores siguen siendo mejores que los preoperatorios en ambos grupos. Todas las variables muestran valores mejores en el grupo de la osteotomía. La variable con mayor mejoría es aparición del dolor. Los pacientes con SCLR con signos degenerativos presentaron un beneficio en todos los casos. Conclusión. Los resultados muestran que la técnica de osteotomía rotuliana descrita asociado a la liberación del retináculo lateral mejora de forma significativa el dolor y la escala funcional de pacientes con SCLR a los 2 años de seguimiento, en mayor grado que lo hace la liberación aislada del retináculo lateral, incluso en aquellos en los que existe evidencia de signos degenerativos (AU)

Objective. To describe a novel coronal osteotomy of the external facet of the patella, and to evaluate if the outcomes of the treatment of lateral knee compartment syndrome (LKCS) with this osteotomy, combined with the release of the external lateral retinaculum, are better than the isolated lateral retinacular release. Material and methods. A prospective study with a 2 year follow up that included 70 patients diagnosed with LKCS, distributed into 2 groups. The first group included 50 patients on whom the lateral retinacular release combined with osteotomy was performed, and a second group on whom an isolated retinacular release was performed. Measurements were made using the Werner functional scale before the surgery and at 3, 12, and 24 months follow-up. Results. There were significant differences in the overall functional state between the two groups after the surgery (better in the osteotomy group at all the intervals, P<.05). The improvement, which was progressive up to 12 months, was slightly less at 24 months, although the values were still better than the pre-surgical ones in both groups. Pain was the variable that showed most improvement. The patients with LKCS with degenerative signs showed a benefit in all cases. Conclusion. The results demonstrate that the described patellar osteotomy technique, combined with lateral retinacular release, significantly improves the pain and the functional scale score of patients with LKCS after 2 years of follow-up, to a greater extent than isolated lateral retinacular release, including those in which there was evidence of degenerative signs (AU)

Coronal patellar osteotomy of the external facet combined with the release of the lateral retinaculum improves the clinical outcomes of isolated lateral release in lateral knee compartment syndrome. / La osteotomía patelar coronal de la faceta externa asociada a liberación del retináculo lateral mejora los resultados clínicos de la liberación lateral aislada en el síndrome de compresión lateral de rótula.

OBJECTIVE: To describe a novel coronal osteotomy of the external facet of the patella, and to evaluate if the outcomes of the treatment of lateral knee compartment syndrome (LKCS) with this osteotomy, combined with the release of the external lateral retinaculum, are better than the isolated lateral retinacular release. MATERIAL AND METHODS: A prospective study with a 2 year follow up that included 70 patients diagnosed with LKCS, distributed into 2 groups. The first group included 50 patients on whom the lateral retinacular release combined with osteotomy was performed, and a second group on whom an isolated retinacular release was performed. Measurements were made using the Werner functional scale before the surgery and at 3, 12, and 24 months follow-up. RESULTS: There were significant differences in the overall functional state between the two groups after the surgery (better in the osteotomy group at all the intervals, P<.05). The improvement, which was progressive up to 12 months, was slightly less at 24 months, although the values were still better than the pre-surgical ones in both groups. Pain was the variable that showed most improvement. The patients with LKCS with degenerative signs showed a benefit in all cases. CONCLUSION: The results demonstrate that the described patellar osteotomy technique, combined with lateral retinacular release, significantly improves the pain and the functional scale score of patients with LKCS after 2 years of follow-up, to a greater extent than isolated lateral retinacular release, including those in which there was evidence of degenerative signs.

Effects of gamma-hydroxybutyrate (liquid ecstasy) on the eye development of the chick embryo

Gamma-hydroxybutyrate (GHB), a precursorto gamma aminobutyric acid (GABA), wasinitially employed as an anesthetic. As a relativelynovel drug, few people are aware of itsharmful effects and few studies have beenundertaken to investigate its long-term effectsor its action on developing tissues.We performed an experimental study onthe action of GHB on the developing eye, anorgan very closely related to the developmentof the CNS. Chick embryos were treated with20% or 30% dilutions of 100 ìl GHB at 7(30-31 HH) and 11 (37 HH) days of incubation(i.e., two doses per group), and the effectswere observed at 21 days of incubation (45HH). An ophthalmologic ultrasonographydevice (Hondex A/B SCAN IS-500) was usedto measure different eye parameters (cornealthickness; posterior surface of cornea – anteriorsurface of lens; anteroposterior diameter oflens; anteroposterior diameter of eye).We observed significant differencesbetween the treated and control groups asregards the thickness of the cornea and lens,and in the anteroposterior diameter of the eye.The present results demonstrate a possibleeffect of GHB on development (AU)

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Effects of gamma-hydroxybutyrate (liquid ecstasy) on the development of the chick cranium

Gamma-hydroxybutyrate (GHB), a precursorto gamma aminobutyric acid (GABA), is currentlyone of the widest used drugs of abuse, with devastating effects. GHB produces a transient rise in the concentration of dopamine in the brain, inducing a stimulating effect. However, GHB can produce hallucinations, delirium, somnolence, hypotonia, confusion, and loss of balance. There may besubsequent progression to coma, with severerespiratory alterations due to CNS depression.The effects of GHB on humans are unpredictable,and its impact on the embryo and fetus is completely unknown. The purpose of our study was to contribute experimental data regarding the effects of GHB on development.Groups of chick embryos received 100 ìl ofGHB at dilutions of either 20% (GHB-A) or 30% (GHB-B) at 7 or 11 days of incubation,a further group serving as controls. After hatching, different cranial measurements were made using a Mitutoyo 500-331 series slidegauge in order to investigate possible effects ofthe drug on cranial development. At both doses studied, GHB significantly altered the transverse and vertical cranial measurements in comparison with vehicletreatedcontrols, suggesting a possible harmful effect on cranial development (AU)

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Plastination in the teaching of Neuroanatomy

The development of plastination has allowedthe introduction of novel tools into Anatomyteaching. The plastinated specimen is dry,odourless, durable and non-toxic. The aim ofthe present study was to compare the value ofplastinated and formalin-preserved specimensin the teaching of Neuroanatomy. A surveywas conducted of Neuroanatomy studentsconcerning the use of plastinated and formalin-preserved specimens, investigating whichtechnique preserved better, which allowedlonger use of the specimen, and which producedspecimens that were more faithful toreality and easier to handle, and also whichtechnique was preferred by the students,establishing the degree of satisfactionobtained with each. The results were subjectedto statistical analysis.Plastination was considered to preservespecimens better by 88% of the study population,and 99% reported that the plastinatedspecimens were faithful to reality. They wereconsidered equally realistic by 46%, whereas37% thought plastinated specimens weremore realistic. Plastinated specimens wereconsidered by 99% of the students to offer easierhandling by 99% of the students and werepreferred to formalin-preserved ones by 92%of the study population, providing a higherdegree of satisfaction. Plastination is a highlyvaluable tool for the teaching of Neuroanatomy (AU)

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Efectos de los campos magnéticos de baja y extremadamente baja frecuencia sobre el desarrollo del globo ocular en el embrión de pollo / Effects of low and extremely low-frequency magnetic fields on eye development in chick embryo

Introducción: Realizamos un estudio experimental sobre los efectos que pueden provocar los CEM (campos electromagnéticos) en el desarrollo del globo ocular. Material y método: Montamos dos bobinas de Heltmholtz (generador CEM homogéneo) entre las cuales colocamos la incubadora (Masalles 65). El material biológico de estudio es el embrión de Gallus Domesticus, expuesto a los CEM, los 21 días de incubación. Hacemos tres experiencias con sus correspondientes grupos controles con 1 microtesla de intensidad y frecuencias de 30, 50 y 100 Hz, haciendo extracciones en los días 15 y 21 de incubación. Resultados: Los resultados significativos a los 15 días de incubación son: aumentos del grosor cornea en tratados con 30-50 Hz; distancia cara posterior cornea y cara anterior cristalino en tratados con 100 Hz; grosor cristalino en tratados con 50-100 Hz.E l eje antero posterior globo ocular se encuentra disminuido en tratados con 100 Hz. Los extraídos en día 21, disminuyen de manera significativa: grosor de cornea en tratados con 30 Hz; distancia cornea cristalino en tratados con 50 Hz; y grosor cristalino en tratados con 30 Hz. Mientras que el eje antero posterior globo ocular es significativamente mayor en tratados con 30 Hz(AU)

Ultrasound analysis of the eye of chick embryos exposed to low-frequency magnetic fields / Análisis ultrasonográfico del ojo de embriones de pollo expuestos a campos magnéticos de baja frecuencia

Ultrasonography was used to measure different ocular parameters in chick embryos exposed to low-frequency (50Hz) magnetic fields with flow intensities of 1 ?T, 0.1 mT, 0.5 mT, or 1 mT throughout their incubation. In comparison with unexposed control embryos, a significant reduction was observed in corneal thickness and in the anteroposterior diameter of the lens at 21 days of incubation (hatching) during exposure to the highest intensities (0.5 mT and 1 mT). By contrast, there was an increase in the anteroposterior diameter of the anterior eye chamber in embryos exposed to the lower magnetic field intensities (1 ?T and 0.1 mT). The anteroposterior diameter of the eye was smaller at 21 days of incubation in all the embryos exposed to magnetic fields as compared with the controls. The anteroposterior diameter of the lens was significantly smaller in embryos exposed to intensities of 0.5 mT and 1 mT in comparison with the controls (AU)

En nuestro estudio, se han usado medios ecográficos para medir diferentes parámetros oculares en embriones sometidos a campos magnéticos de baja frecuencia (50 Hz) con intensidades de 1mT, 0.1mT, 0.5mT, ó 1mT durante su incubación. Al comparar con embriones controles no expuestos se observó una reducción significativa en el grosor corneal y en el diámetro anteroposterior del cristalino en el día 21 de incubación en los embriones expuestos a las intensidades más altas (0.5mT y 1mT). Sin embargo, hubo un incremento en el diámetro anteroposterior de la cámara anterior del ojo en los embriones expuestos a las intensidades más bajas (1mT y 0.1mT). Observamos que el diámetro anteroposterior del ojo era menor a los 21 días de incubación en todos los embriones expuestos a campos magnéticos al compararlos con los controles. El diámetro anteroposterior del cristalino fue significativamente más pequeño en los embriones expuestos a intensidades de 0.5mT y 1mT con respecto a los controles (AU)

Action of ethanol on different skull and brain parameters in the chick embryo.

Fifty microliters of ethanol diluted in 50 microl of distilled water were injected into the air chamber of chick eggs immediately before their incubation, and modifications in a series of parameters were recorded. The somatic weight of the ethanol-treated embryos was lower compared with control and vehicle-administered embryos during days 13, 15, 17, and 19 of incubation, but was the same on day 21. The brain weight was lower in the ethanol-treated embryos on all the days studied (days 13, 15, 17, 19, and 21 of incubation). Skull measurements showed that the transverse anteroposterior and sagittal diameters were significantly smaller in ethanol-treated embryos compared with control and vehicle-administered embryos on days 17, 19, and 21 of incubation.