Explaining Skeletal System Anatomy with Classical Method, Video Assisted Method and 3D Imaging Techniques and Comparison of Learning Levels Between Methods

SUMMARY: The aim of this research is to introduce the ideal lecture technique to the literature by explaining the anatomy of the skeletal system using the classical method, video-assisted method and 3D imaging techniques. The research was carried out with 180 students. The number of samples was determined by power analysis (a=0.05,b=0.20, effect size=0.25). Participants were pre-screened and divided into 4 groups with the closest group mean (group 1: control group: the group that did not take anatomy lessons, group 2: video-assisted anatomy education, group 3: 3D anatomy course, group 4: classical anatomy education group). The courses in the training groups were organised as 4 hours/day, 2 days/week for 5 weeks. At the end of the course, the students were re-examined and scaled to determine the difference in scores and self-efficacy between the groups. A one-way ANOVA test was performed because the data were normally distributed when comparing between groups. The mean scores were calculated as group 1=30.22±6.24, group 2=39.02±9.15, group 3=49.77±9.20 and group 4=59.28±8.95. In the post hoc comparison, in pairwise comparisons between all groups, the differences were highly significant (pgroup 3>group 2>group 1 (p<0.001). According to the results of this study, the laboratory method in skeletal anatomy teaching is the best alternative to 3D anatomy teaching.

El objetivo de esta investigación es introducir la técnica de lectura ideal en la literatura, explicando la anatomía del sistema esquelético, utilizando el método clásico, el método asistido por video y las técnicas de imágenes en 3D. La investigación se llevó a cabo con 180 estudiantes. El número de muestras se determinó mediante análisis de potencia (a=0,05, b=0,20, tamaño del efecto=0,25). Los participantes fueron preseleccionados y divididos en 4 grupos con la media de grupo más cercana (grupo 1: grupo de control: el grupo que no tomó lecciones de anatomía, grupo 2: educación de anatomía asistida por video, grupo 3: curso de anatomía 3D, grupo 4: grupo de educación en anatomía clásica). Los cursos en los grupos de formación se organizaron con 4 horas/día, 2 días/semana durante 5 semanas. Al final del curso, los estudiantes fueron reexaminados y escalados para determinar la diferencia en puntajes y autoeficacia entre los grupos. Se realizó una prueba de ANOVA de una vía debido a que los datos se distribuyeron normalmente al comparar entre grupos. Las puntuaciones medias se calcularon como grupo 1=30,22±6,24, grupo 2=39,02±9,15, grupo 3=49,77±9,20 y grupo 4=59,28±8,95. En la comparación post hoc, en comparaciones por pares entre todos los grupos, las diferencias fueron altamente significativas (pgrupo 3>grupo 2>grupo 1 (p<0,001). Según los resultados de este estudio, el método de laboratorio en la enseñanza de la anatomía esquelética es la mejor alternativa a la enseñanza de la anatomía en 3D.

Laringoscopia directa vs videolaringoscopia en la intubación del paciente con COVID-19 / Direct laryngoscopy versus videolaryngoscopy in COVID-19 patient intubation

Introducción: Muchos enfermos de COVID-19 requieren ser ventilados. La laringoscopia directa (LD) es el método tradicional empleado en el manejo de la vía aérea; sin embargo, la videolaringoscopia (VL) es una alternativa en estos pacientes. Objetivo: Comparar la laringoscopia directa y la videolaringoscopia en el manejo de la vía aérea en pacientes con COVID-19. Métodos: Se realizó un estudio observacional retrospectivo. El universo y la muestra estuvieron conformado por los pacientes intubados por médicos de la brigada Henry Reeve en hospitales de Cancún y Ciudad de México. Se conformaron dos grupos; el Grupo laringoscopia directa con 91 pacientes y el Grupo videolaringoscopia con 103. Las variables estudiadas fueron: edad, sexo, número de predictores de una vía respiratoria anatómicamente difícil (VRAD), visualización de la apertura glótica, intentos de intubación y las complicaciones de la intubación. El análisis estadístico de los datos se realizó con el paquete estadístico SPSS 23.0. Resultados: Los grupos fueron comparables en cuanto a edad, sexo y predictores de vía respiratoria anatómicamente difícil. La visualización glótica completa o parcial en el grupo videolaringoscopia fue de 97 por ciento, mientras que en el grupo laringoscopia directa fue de 86 por ciento. La intubación endotraqueal al primer intento superó el 70 por ciento en el grupo VL y el 50 por ciento en el grupo LD. Las principales complicaciones encontradas fueron la desaturación y la hipotensión arterial con una mayor frecuencia en el grupo LD (40,7 por ciento y 49,5 por ciento). Conclusiones: La videolaringoscopia mejoró la visualización glótica y la intubación endotraqueal al primer intento, con menos complicaciones en los pacientes estudiados(AU)

Introduction: Many COVID-19 patients require ventilation. Direct laryngoscopy is the traditional method used for airway management; however, videolaryngoscopy is an alternative in these patients. Objective: To compare direct laryngoscopy and videolaryngoscopy for airway management in COVID-19 patients. Methods: A retrospective observational study was carried out. The universe and the sample consisted of patients intubated by physicians from Henry Reeve brigade at hospitals in Cancun and Mexico City. Two groups were formed: the direct laryngoscopy group, with 91 patients, and the videolaryngoscopy group, with 103 patients. The variables studied were age, sex, number of predictors of an anatomically difficult airway, visualization of the glottic opening, intubation attempts, and intubation complications. Statistical analysis of the data was performed using the SPSS 23.0 statistical package. Results: The groups were comparable in terms of age, sex and predictors of an anatomically difficult airway. Complete or partial glottic visualization in the videolaryngoscopy group was 97 percent , while in the direct laryngoscopy group it was 86 percent . Endotracheal intubation at the first attempt exceeded 70 percent in the videolaryngoscopy group and 50 percent in the direct laryngoscopy group. The main complications observed were desaturation and arterial hypotension with a higher frequency in the direct laryngoscopy group (40.7 percent and 49.5 percent , respectively). Conclusions: Video laryngoscopy improved glottic visualization and endotracheal intubation at the first attempt, with fewer complications in the patients studied(AU)

Anatomorphometry of the brachial plexus under high-definition system: an experimental study in rats

Purpose: To study the anatomorphometry of the plexus brachialis (PB) of rats under a high-definition video system. Methods: Ten male Wistar rats discarded from other research that did not interfere in the morphology of the animal, respecting the principle of reduction, were used. All animals were submitted to the same protocol. Initially, the cervical region was shaved. The animals were placed in a dorsal position. A single elbow-to-elbow incision was performed and dissection started at the deltopectoral sulcus. The procedures were performed under a video system. To measure the structures, the Image J software was used. Results: All the PB evaluated originated from the C5-T1 spinal nerves. C5 and C6 converged to form the truncus superior, the root of C7 originated the truncus medius, and the confluence of C8 and T1 originated the truncus inferior. It was found the union of C7, C8, and T1 to form truncus inferomedialis instead of separate medial and inferior truncus. C8 (1.31 mm) was the thickest root, the truncus inferior (1.80 mm) and the nerve radialis (1.02 mm), were the thickest. Conclusions: The anatomy of the PB is comparable to humans, admitting variations. The videomagnification system is useful to perform microsurgical dissection.