Arthroscopic Medial Meniscal Root Reconstruction With Gracilis Autograft Is Safe and Improves 2-Year Postoperative Patient-Reported Outcomes.

Purpose: To describe patient-reported clinical outcomes and complications of anatomic medial meniscal root reconstruction with gracilis autograft. Methods: Data on patients who underwent arthroscopic medial meniscal root reconstruction with gracilis autograft were prospectively collected between 2017 and 2021 and retrospectively reviewed. The inclusion criteria were symptomatic posterior medial meniscal LaPrade type 2 root tears with no more than Outerbridge grade 2 chondrosis of any knee compartment with a minimum follow-up period of 1 year. Patients with ligamentous instability and those with Workers' Compensation status were excluded. Patient-reported outcomes (12-item Short Form Survey [SF-12], visual analog scale [VAS], Western Ontario and McMaster Universities Arthritis Index [WOMAC], and Lysholm scores) were collected prospectively and analyzed retrospectively and were scored and recorded both preoperatively and at postoperative intervals. Data were analyzed using cubic spline regression models. The study was approved by the University of South Carolina Institutional Review Board. Results: A consecutive series of 27 patients treated by a single surgeon were evaluated. Twenty-one patients were included for data analysis (4 were excluded per criteria and 2 were lost to follow-up) with an average age of 48.1 years (range, 16-63 years). There were 18 female and 3 male patients. The average follow-up time was 25.2 months (range, 12-42 months). At the postoperative time points captured by the data examined, improvements in Lysholm, WOMAC, VAS, and SF-12 physical component summary scores were found to be statistically significant (P < .001, 95% confidence interval). Improvements in SF-12 mental component summary scores, however, did not reach the level of statistical significance (P = .262). Body mass index greater than 35 and age greater than 50 years were not found to be negative predictors of outcomes. Average patient-reported outcomes at 2 years' follow-up improved from preoperatively as follows: Lysholm score, from 50 to 82.9; WOMAC score, from 53.9 to 87.4; and VAS score, from 5.1 to 1.2. No serious complications were observed. Conclusions: Patients undergoing posterior medial meniscal root reconstruction showed statistically significant improvements in Lysholm, WOMAC, SF-12 physical component summary, and VAS scores but not SF-12 mental component summary scores at short-term follow-up. No serious complications or clinical failures occurred, and no patients required revision surgery. Level of Evidence: Level IV, case series.

Aproximación al aprendizaje pedagógico en la discapacidad intelectual leve / An approach to pedagogical learning in mild intellectual disability

Este trabajo presenta una reflexión actualizada de métodos y estrategias eficaces para el aprendizaje del cálculo, la escritura y lectura en sujetos con discapacidad intelectual leve. Conforme con el análisis de las investigaciones abordadas, se puede concluir que, si bien los propósitos de la atención pedagógica a los sujetos con déficit intelectual vienen enmarcados bajo los principios de la educación inclusiva, se evidencia una gran diferencia entre las intenciones de la educación inclusiva y la realidad de las instituciones educativas. Así, los niños con discapacidad intelectual leve, pese a ser integrados en el aula regular, no logran recibir la atención educativa requerida para fortalecer los aprendizajes pedagógicos de lectoescritura y cálculo; situación que se relaciona con el desconocimiento, por parte de los docentes, de las estrategias pedagógicas para abordar las particularidades educativas de esta población. El resultado del análisis, evidencia la existencia de diversas técnicas; indica, al mismo tiempo, que no existe un método específico para el aprendizaje de habilidades académicas en los sujetos con deficiencias intelectuales leves, sugiere identificar el interés y la necesidad de los estudiantes para así establecer flexibilizaciones en las planeaciones pedagógicas y metodológicas del currículo que favorezcan el proceso de aprendizaje

This work presents an updated reflection of effective methods and strategies for learning calculation, writing and reading in subjects with mild intellectual disabilities. According to the analysis of the analyzed researches we can concluded that, although the purposes of pedagogical attention to subjects with intellectual deficits are framed under the principles of inclusive education, there is evidence of a great difference between the intentions of inclusive education and the reality of educational institutions. Thus, children with mild intellectual disabilities, despite being integrated into the regular classroom, do not manage to receive the educational attention required to strengthen the pedagogical learning of literacy and numeracy. A situation that is related to the ignorance, from teachers, of the pedagogical strategies to address the educational particularities of this population. The result of the analysis shows the existence of various techniques, indicates, at the same time, that there is no specific method for learning academic skills in subjects with mild intellectual deficiencies, we suggest identifying the interest and need of students in order to do so, establishing flexibilities in the pedagogical and methodological planning of the curriculum that favor the learning process.Keywords: Learning; Intellectual deficit; Intellectual disability; Inclusive education; Teaching; Reading/writing; Mathematics; Pedagogy.

Testosterone increases GLUT4-dependent glucose uptake in cardiomyocytes.

Testosterone exerts important effects in the heart. Cardiomyocytes are target cells for androgens, and testosterone induces rapid effects via Ca(2+) release and protein kinase activation and long-term effects via cardiomyocyte differentiation and hypertrophy. Furthermore, it stimulates metabolic effects such as increasing glucose uptake in different tissues. Cardiomyocytes preferentially consume fatty acids for ATP production, but under particular circumstances, glucose uptake is increased to optimize energy production. We studied the effects of testosterone on glucose uptake in cardiomyocytes. We found that testosterone increased uptake of the fluorescent glucose analog 2-(N-(7-nitrobenz-2-oxa-1, 3-diazol-4-yl)amino)-2-deoxyglucose and [(3) H]2-deoxyglucose, which was blocked by the glucose transporter 4 (GLUT4) inhibitor indinavir. Testosterone stimulation in the presence of cyproterone or albumin-bound testosterone-induced glucose uptake, which suggests an effect that is independent of the intracellular androgen receptor. To determine the degree of GLUT4 cell surface exposure, cardiomyocytes were transfected with the plasmid GLUT4myc-eGFP. Subsequently, testosterone increased GLUT4myc-GFP exposure at the plasma membrane. Inhibition of Akt by the Akt-inhibitor-VIII had no effect. However, inhibition of Ca(2+) /calmodulin protein kinase (CaMKII) (KN-93 and autocamtide-2 related inhibitory peptide II) and AMP-activated protein kinase (AMPK) (compound C and siRNA for AMPK) prevented glucose uptake induced by testosterone. Moreover, GLUT4myc-eGFP exposure at the cell surface caused by testosterone was also abolished after CaMKII and AMPK inhibition. These results suggest that testosterone increases GLUT4-dependent glucose uptake, which is mediated by CaMKII and AMPK in cultured cardiomyocytes. Glucose uptake could represent a mechanism by which testosterone increases energy production and protein synthesis in cardiomyocytes.