Técnicas actuales de reparación nerviosa / Current techniques in peripheral nerve repair

Las lesiones del sistema nervioso periférico son uno de los retos terapéuticos de nuestra especialidad, no sólo por la dificultad técnica e instrumental necesaria para resolverlas, sino por la importancia de sus secuelas y los pobres resultados obtenidos con una deficiente técnica quirúrgica. Para obtener un óptimo resultado, es preceptivo, no sólo realizar un correcto diagnóstico, sino además, conocer y dominar las distintas opciones terapéuticas. El objetivo de la presente revisión es abordar las distintas indicaciones y técnicas quirúrgicas usadas actualmente para el tratamiento de las lesiones nerviosas

The injuries of the peripheral nervous system are one of the therapeutic challenges in our speciality given their technical and instrumental difficulty, the importance of the disability and the few results obtained with a deficient surgical technique. For an optimum result, a correct diagnosis is needed as well as to know and to dominate the different therapeutics options. The objetive of the current review is to deal with the different indications and surgery techniques currently used for the treatment of the nervous injuries

Neuroanatomía del trastorno por déficit de atención/hiperactividad: correlatos neuropsicológicos y clínicos / The neuroanatomy of attention deficit hyperactivity disorder: neuropsychological and clinical correlates

Introducción. El desarrollo de la resonancia magnética estructural y de nuevos métodos de análisis ha permitido examinar, como nunca antes, las bases neuroanatómicas del trastorno por déficit de atención/hiperactividad (TDAH). No obstante, poco se sabe todavía sobre la relación de los síntomas clínicos y las disfunciones neuropsicológicas características del TDAH con las alteraciones neuroanatómicas observadas. Objetivo. Explorar la relación entre neuroanatomía, clínica y neuropsicología en el TDAH. Desarrollo. A nivel de grupo, existen diferencias marcadas entre el cerebro de niños adolescentes y adultos con TDAH y el cerebro de personas con desarrollo típico. Estas diferencias se observan transversal y longitudinalmente en todas las medidas, tanto de la sustancia gris como de la sustancia blanca. Aunque todavía escasa, cada vez existe mayor evidencia que señala que estas diferencias se relacionan con los síntomas nucleares del trastorno y con el grado de disfunción clínica. También parecen asociarse con el funcionamiento cognitivo (principalmente, atención y control inhibitorio). Conclusiones. La relación entre los distintos niveles de análisis de estudio del TDAH acerca la investigación a la clínica y permite comprender y tratar mejor el trastorno. Aunque el avance en este campo es innegable, todavía son muchas las cuestiones que hay que explorar y profundizar en mayor detalle. Se requiere comprender mejor la asociación entre las medidas neuroanatómicas y cada dimensión sintomatológica, y la relación con otros procesos neuropsicológicos también implicados en el trastorno (AU)

Introduction. The development of structural magnetic resonance scanning and new methods of analysis has made it possible to explore, in a hitherto unknown way, the neuroanatomical bases of attention deficit hyperactivity disorder (ADHD). Yet, little is known about the relation between the clinical symptoms and the neuropsychological dysfunctions characterising ADHD and the neuroanatomical alterations that are observed. Aim. To explore the relation between neuroanatomy, clinical features and neuropsychology in ADHD. Development. At group level, there are a number of marked differences between the brain of children, adolescents and adults with ADHD and the brain of subjects with a typical development. These differences are observed cross-sectionally and longitudinally in all the measurements, both in the grey matter and in the white matter. Although still scarce, there is an increasing body of evidence showing that these differences are related with the core symptoms of the disorder and with the degree of clinical dysfunction. They also appear to be associated with cognitive functioning (mainly attention and inhibitory control). Conclusions. The relation among the different levels of analysis in the study of ADHD bring research closer to the clinical features and allows a better understanding and management of the disorder. Although progress is undoubtedly being made in this field, there are still many questions that need exploring in greater depth. There is a need for a better understanding of the association between the neuroanatomical measurements and each dimension of the symptoms, and their relationship with other neuropsychological processes that are also involved in the disorder (AU)

Challenges in reconciling different views of neuroanatomy in a reference ontology of anatomy.

A fundamental requirement for integrating neuroscience data is a well-structured ontology that can incorporate, accommodate and reconcile different neuroanatomical views. Here we describe the challenges in creating such ontology, and, because of its principled design, illustrate the potential of the Foundational Model of Anatomy to be that ontology.

Custom views of reference ontologies.

Generating "views" over reference ontologies allows them to be customized for use within specific application contexts. In this project we investigated the operations necessary to generate one such custom ontology view. We catalogued the involved operations as a first step in defining the requirements of a formal view definition language.

Problems and solutions with integrating terminologies into evolving knowledge bases.

We have merged two established anatomical terminologies with an evolving ontology of biological structure: the Foundational Model of Anatomy. We describe the problems we have encountered and the solutions we have developed. We believe that both the problems and solutions generalize to the integration of any legacy terminology with a disciplined ontology within the same domain.

The evolving neuroanatomical component of the Foundational Model of Anatomy.

In order to meet the need for an expressive ontology in neuroinformatics, we have integrated the extensive terminologies of NeuroNames and Terminologia Anatomica into the Foundational Model of Anatomy (FMA). We have enhanced the FMA to accommodate information unique to neuronal structures, such as axonal input/output relationships.

Foundational model of neuroanatomy: implications for the Human Brain Project.

In order to meet the need for a controlled terminology in neuroinformatics, we have integrated the extensive terminology of NeuroNames into the Foundational Model of anatomy. We illustrate the application of foundational principles for the establishment of an inheritance hierarchy, which accommodates anatomical attributes of neuroanatomical concepts and provides the foundation to which other information may be linked.