Causas anatómicas de compresión del nervio ciático en la pelvis. Síndrome piriforme / Anatomical causes of compression of the sciatic nerve in the pelvis. Piriform syndrome

Objetivo: El síndrome piriforme constituye una de las causas de dolor pélvico debido al atrapamiento del nervio ciático por el músculo piriforme. En la actualidad es un síndrome de difícil diagnóstico. El objetivo de este estudio es conocer la prevalencia de variaciones anatómicas en nuestra población que puedan contribuir a la aparición del síndrome piriforme. También se estudian medidas antropométricas del músculo piriforme y el nervio ciático para su posible aplicación en procedimientos de la región glútea. Material y método: El estudio se realizó en 59 pelvis de 32 cadáveres criopreservados. Las variaciones anatómicas del músculo piriforme y del nervio ciático encontradas se describieron según la clasificación de Beaton y Anson. Se realizaron mediciones antropométricas de ambas estructuras con referencia al trocánter mayor del fémur. Resultados: El nervio ciático y el músculo piriforme presentaban una variación anatómica en un 28,13%. La variación más frecuente fue la de tipo II (21,64%) y la de tipo III (6,49%). La inserción observada con mayor frecuencia fue un tendón independiente del músculo piriforme insertado en la fosa trocantérea, con un 53,85%. Conclusión: La incidencia de variaciones anatómicas en la población estudiada indica que son importantes como diagnóstico diferencial de posibles dolores en la región glútea ya que los síntomas y signos del síndrome piriforme se asemejan a la patología discal vertebral con afectación radicular. Además, el conocimiento anatómico de esta región puede ser útil en la interpretación con técnicas de imagen, especialmente cuando se realizan inyecciones guiadas por ecografía

Objective: The piriformis syndrome is one of the etiologies of pelvic pain due to the sciatic nerve's entrapment by the piriformis muscle. Nowadays this syndrome might be difficult to be diagnosed. The aim of this study is to know the prevalence of anatomic variations in our population that may contribute to the appearance of piriformis syndrome. Furthermore, anthropometric measurements of the piriformis muscle and the sciatic nerve procedures are studied for a possible application in the gluteal region. Material and method: The study was carried out in 59 pelvis of 32 cryopreserved bodies. The anatomical variations of piriformis and sciatic nerve founded were described following the Beaton and Anson's classification. Anthropometric measurements of both structures with reference to the greater trochanter of the femur were performed. Results: The sciatic nerve and the piriformis had an anatomical variation in a 28.13%. The most frequent variation found was tipus II (21.64%) and tipus III (6.49%).Insertion most frequently observed was an independent piriformis tendon inserted into the trochanteric fossa with 53.85%. Conclusion: The anatomic variations' incidence in the population studied indicates that those have to be evaluated as a differential diagnosis of gluteal region pain due to the symptoms and signs resemblance with the vertebral disc pathology involving nerve root injury. In addition, anatomical knowledge of this region can be useful for the interpretation of imaging techniques, especially when ultrasound-guided injections are performed

Anatomical causes of compression of the sciatic nerve in the pelvis. Piriform syndrome. / Causas anatómicas de compresión del nervio ciático en la pelvis. Síndrome piriforme.

OBJECTIVE: The piriformis syndrome is one of the etiologies of pelvic pain due to the sciatic nerve's entrapment by the piriformis muscle. Nowadays this syndrome might be difficult to be diagnosed. The aim of this study is to know the prevalence of anatomic variations in our population that may contribute to the appearance of piriformis syndrome. Furthermore, anthropometric measurements of the piriformis muscle and the sciatic nerve procedures are studied for a possible application in the gluteal region. MATERIAL AND METHOD: The study was carried out in 59 pelvis of 32 cryopreserved bodies. The anatomical variations of piriformis and sciatic nerve founded were described following the Beaton and Anson's classification. Anthropometric measurements of both structures with reference to the greater trochanter of the femur were performed. RESULTS: The sciatic nerve and the piriformis had an anatomical variation in a 28.13%. The most frequent variation found was tipus II (21.64%) and tipus III (6.49%).Insertion most frequently observed was an independent piriformis tendon inserted into the trochanteric fossa with 53.85%. CONCLUSION: The anatomic variations' incidence in the population studied indicates that those have to be evaluated as a differential diagnosis of gluteal region pain due to the symptoms and signs resemblance with the vertebral disc pathology involving nerve root injury. In addition, anatomical knowledge of this region can be useful for the interpretation of imaging techniques, especially when ultrasound-guided injections are performed.

Ampliación del cribado neonatal a la detección de inmunodeficiencias combinadas graves. Un imperativo moral / Extending neonatal screening to the detection of severe combined immunodeficiencies. A moral imperative

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Links between obesity, diabetes and ethnic disparities in breast cancer among Hispanic populations.

Breast cancer is the most prevalent malignancy in women worldwide and is a growing concern due to rising incidence and ongoing ethnic disparities in both incidence and mortality. A number of factors likely contribute to these trends including rising rates of obesity and diabetes across the globe and differences in genetic predisposition. Here, we emphasize Hispanic populations and summarize what is currently known about obesity, diabetes and individual genetic predisposition as they relate to ethnic disparities in breast cancer incidence and mortality. In addition, we discuss potential contributions to breast cancer aetiology from molecular mechanisms associated with obesity and diabetes including dyslipidemia, hyperglycaemia, hyperinsulinaemia, endocrine dysfunction and inflammation. We propose that unique differences in diet and lifestyle coupled with individual genetic predisposition and endocrine/immune dysfunction explain most of the ethnic disparities seen in breast cancer incidence and mortality.