Descripción y análisis del patrón de normalidad de flujo dinámico y morfológico de las arterias principales de la muñeca y mano en población sana española / Description and analysis of the dynamic and morphological flow pattern of the main arteries of the wrist and hand in a healthy spanish population

ANTECEDENTES Y OBJETIVO: La anatomía vascular de la mano ya ha sido ampliamente descrita a nivel macroscópico. Sin embargo, existen muy pocos trabajos que estudien el patrón de normalidad de la vascularización in vivo y describan y analicen las arterias principales de la mano. El objetivo de este trabajo es realizar un estudio que sirva de referencia para los valores normales de tamaño y flujo de la arteria radial y ulnar a nivel de la muñeca y de las arterias digitales radiales y ulnares a nivel de los dedos. MATERIAL Y MÉTODO: Estudio descriptivo observacional de corte trasversal sobre 200 manos en 100 voluntarios sanos entre 20-30 años. Se realizó ecografía Doppler-color de las arterias ulnar y radial en la muñeca, así como de las arterias digitales radial y ulnar de cada dedo. Una vez tomadas las medidas se llevó a cabo un análisis comparativo de forma general y también teniendo en cuenta la lateralidad, la dominancia y el género. RESULTADOS: Se observó que existe un mayor tamaño de la arteria radial sobre la ulnar a nivel de la muñeca; sin embargo, es la arteria ulnar la que presentó dominancia de flujo a este nivel. A nivel de los dedos, en los tres primeros fue la arteria digital ulnar la que presentó un mayor tamaño y mayor flujo. No obstante, en el cuarto y quinto dedos fue la arteria digital radial la que presentó un mayor tamaño y dominancia de flujo. CONCLUSIÓN: Ha quedado confirmado que la dominancia de flujo, pero no de tamaño, a nivel de la muñeca es de la arteria ulnar. A nivel de los dedos, existe un mayor tamaño y flujo de las arterias en las zonas de los dedos más protegidas de las lesiones (arteria digital ulnar en los tres primeros y radial en el cuarto y quinto)

BACKGROUND AND AIM: The vascular anatomy of the hand has already been widely described macroscopically. However, there are very few papers that study the pattern of normality of in vivo vascularisation that describe and analyse the main arteries of the hand. The aim of this paper was to carry out a study to serve as a reference for the normal values of size and flow of the radial and ulnar artery at the level of the wrist, and the digital radial and ulnar arteries at the level of the fingers. MATERIAL AND METHOD: A descriptive observational cross-sectional study on 200 hands in 100 healthy volunteers aged between 20-30 years. Doppler-colour ultrasound was performed on the ulnar and radial arteries in the wrist, as well as on the radial and ulnar digital arteries in each finger. Once the measurements had been taken, a general comparative analysis was performed also taking laterality, dominance and gender into account. RESULTS: It was observed that the radial artery is larger in size than the ulnar at wrist level, however, it was the ulnar artery that showed flow dominance at this level. At finger level, the arteries are greater in size and flow in the areas of the fingers more protected from injury (digital ulnar artery in the first three and radial artery in the fourth and fifth digits)

Description and analysis of the dynamic and morphological flow pattern of the main arteries of the wrist and hand in a healthy spanish population. / Descripción y análisis del patrón de normalidad de flujo dinámico y morfológico de las arterias principales de la muñeca y mano en población sana española.

BACKGROUND AND AIM: The vascular anatomy of the hand has already been widely described macroscopically. However, there are very few papers that study the pattern of normality of in vivo vascularisation that describe and analyse the main arteries of the hand. The aim of this paper was to carry out a study to serve as a reference for the normal values of size and flow of the radial and ulnar artery at the level of the wrist, and the digital radial and ulnar arteries at the level of the fingers. MATERIAL AND METHOD: A descriptive observational cross-sectional study on 200 hands in 100 healthy volunteers aged between 20-30years. Doppler-colour ultrasound was performed on the ulnar and radial arteries in the wrist, as well as on the radial and ulnar digital arteries in each finger. Once the measurements had been taken, a general comparative analysis was performed also taking laterality, dominance and gender into account. RESULTS: It was observed that the radial artery is larger in size than the ulnar at wrist level, however, it was the ulnar artery that showed flow dominance at this level. At finger level, the arteries are greater in size and flow in the areas of the fingers more protected from injury (digital ulnar artery in the first three and radial artery in the fourth and fifth digits).

Bocio congénito. A propósito de un caso / Congenital goiter

Introducción. La incidencia del hipotiroidismo congénito es de 1:3.000 a 1:4.000 recién nacidos. El bocio congénito no es una forma de presentación común. Caso clínico. Se presenta el caso de una recién nacida con consanguinidad de primer grado entre los padres, que nace mediante cesárea electiva a las 38 semanas. La somatometría es congruente con la edad gestacional. Es hija de una madre diabética pregestacional con buen control metabólico y función tiroidea previa normal. Se presenta con hipotonía, soplo cardíaco y masa cervical anterior en el tercer día de vida. Se sospecha un hipotiroidismo congénito, diagnóstico que se confirma mediante los datos analíticos (tirotropina elevada con tiroxina indetectable) y la ecografía tiroidea. Se inicia tratamiento sustitutivo con tiroxina de forma inmediata con una notable mejoría clínica y analítica. Comentarios. Se revisan las entidades etiológicas del hipotiroidismo congénito, y se discuten las correlaciones clínicas entre diferentes entidades. Además, se enfatiza la necesidad del tratamiento sustitutivo precoz para asegurar un desarrollo neurocognitivo óptimo(AU)

Introduction. Congenital hypothyroidism occurs in approximately 1:3,000 to 1:4,000 newborns. Congenital goiter is not a common presentation of this disease. Case report. We report the case of a female infant born from first-degree consanguineous parents at 38 weeks of gestational age via elective cesarean section. Somatometry was according to her gestational age. The mother had pre-gestational diabetes mellitus with good metabolic control, and normal thyroid function. The newborn was found to have mild hypotonia, a cardiac murmur, and an anterior cervical mass on the third day of life. Congenital hypothyroidism was suspected; the diagnosis was confirmed by elevated thyrotropin and low free thyroxin, and thyroid sonography. Levothyroxin was started immediately, resulting in a significant clinical improvement. Comments. The causes of congenital hypothyroidism are reviewed, and clinical correlations between the different etiologies are discussed. The need for immediate treatment with levothyroixine to ensure an optimal neurocognitive outcome is emphasized(AU)

Dual-energy x-ray absorptiometry in the diagnosis of osteoporosis: a practical guide.

OBJECTIVE: The purpose of this essay is a quick and comprehensive review of dual-energy x-ray absorptiometry in the diagnosis of osteoporosis that shows how to achieve the best performance in three steps. CONCLUSION: The three-step procedure for dual-energy x-ray absorptiometry includes image acquisition emphasizing proper patient positioning and regions of interest; analysis, including areas to scan and detection of artifacts that should be excluded from the analysis and noted in the report because they can necessitate additional imaging; and interpretation of results.