Estudio descriptivo sobre el aprendizaje anatómico y satisfacción de estudiantes de fisioterapia tras la disección de articulaciones animales / A descriptive study of anatomical learning and satisfaction of physiotherapy students after dissection of animal joints

Introducción Los fisioterapeutas necesitan amplios conocimientos anatómicos para valorar y tratar lesiones musculoesqueléticas. Las analogías entre las articulaciones humanas y porcinas son adecuadas para utilizar estas en la enseñanza de la anatomía humana. El objetivo es desarrollar una estrategia docente manipulativa, valorando su impacto en el aprendizaje anatómico y la satisfacción de los estudiantes. Materiales y métodos Cuarenta y cinco alumnos de 1.o de Fisioterapia realizan, dirigidos por un docente, la disección de piezas de cadera y rodilla de cerdo observando la morfología y características físicas tras la desarticulación, resección y secciones. Estudio observacional transversal que evalúa los resultados académicos después de la actividad, la satisfacción con la estrategia, la autopercepción de aprendizaje y el reconocimiento de las características físicas de las estructuras anatómicas. Resultados Los resultados tras la estrategia educativa son superiores a los obtenidos previamente (M=7,31; DE=2,31 vs. M=3,73; DE=2,29), siendo la diferencia estadísticamente significativa (t=−5,62; p=0,00; d de Cohen=0,50). Se determinan los valores descriptivos de cada ítem y las correlaciones entre los resultados académicos y la satisfacción (r=0,53; p=0,000), la autopercepción del conocimiento adquirido (r=0,33; p=0,028) y el reconocimiento de las características físicas (r=0,37; p=0,013). Conclusión La manipulación de estructuras animales permite conocer el elemento real sobre el que el fisioterapeuta va a ejercer su ejercicio profesional, mejorando los resultados académicos. Además, la estrategia resulta satisfactoria, por lo que puede recomendarse para el estudio de anatomía en el grado de Fisioterapia (AU)

Introduction Physiotherapists need extensive anatomical knowledge to assess and treat musculoskeletal injuries. The analogies between human and porcine joints are suitable for teaching human anatomy. The objective is to develop a manipulative teaching strategy assessing its impact on anatomical learning and satisfaction. Materials and method Forty-five physiotherapy 1st-year students perform, led by a teacher, the dissection of pig hip and knee pieces, observing the morphology and physical characteristics after disarticulation, resection and sections. A cross-sectional study that evaluates academic results after the activity, satisfaction with the strategy, the self-perception of learning, and the recognition of the physical characteristics of the anatomical structures. Results The results after the educational strategy are superior to those obtained previously (M=7.31; D.S=2.31 vs. M=3.73; D.S=2.29), the difference being statistically significant (t=-5.62; p=0.00; d of Cohen=0.50). The descriptive values of each item and the correlations between academic results and satisfaction (r=0.53; p=0.000), self-perception of acquired knowledge (r=0.33; p=0.028) and recognition of physical characteristics (r=0.37, p=0.013) are determined. Conclusion The manipulation of animal structures allows knowing the authentic element on which the physiotherapist will exercise his professional practice, improving academic results. In addition, the strategy is satisfactory so that it can be recommended for studying anatomy in the physiotherapy degree (AU)

Antimicrobial susceptibility of cinnamon and red and common thyme essential oils and their main constituent compounds against Streptococcus suis.

Streptococcus suis is an emerging zoonotic pathogen causing different diseases, in both humans and pigs. Generally, the control of this pathogen is based on antimicrobial therapy, but the development of bacterial resistance has led one to look for new options. In this sense, the essential oils (EOs) constitute a promising alternative. The activity of cinnamon, common thyme and red thyme EOs and their main active compounds (cinnamaldehyde and thymol) against S. suis isolates from pigs (n = 50) and humans (n = 6) was determined by the broth microdilution method. MIC50-90, MBC50-90 and the bactericidal index (BI) (minimal bactericidal concentration (MBC)/minimal inhibitory concentration (MIC)) were calculated. Also, the time-kill curve of each product against the S. suis P1/7 European reference strain was determined. No differences in the MIC or MBC values were observed between all the tested products, which suggest a homogeneous behaviour of S. suis, independently of their origin, organ of isolation or resistance profile. All the products showed a concentration-dependent and time-dependent killing activity and achieved the virtual eradication of S. suis at supra-inhibitory concentrations within the first 5 min of exposure, except cinnamaldehyde that showed only bacteriostatic effect. It suggests that these products could be utilized as antimicrobials in veterinary medicine for the control of this zoonotic pathogen.

Cefalohematoma bilateral tras parto domiciliario no asistido. Estudio de un caso / Bilateral cephalohematoma after unassisted domiciliary childbirth. Case report

El cefalohematoma es una colección hemática localizada en el espacio subperióstico del neonato, sobre la región parietal, frecuentemente unilateral, que aparece durante las horas o días posteriores al parto. Los partos prolongados, traumáticos o instrumentalizados favorecen su aparición, aunque también se puede producir espontáneamente. Su evolución es satisfactoria, con reabsorción completa en las primeras semanas de vida. La posibilidad de complicaciones es pequeña, aunque se debe vigilar su aparición. Se presenta el caso de una paciente con un cefalohematoma bilateral tras un parto en domicilio sin asistencia sanitaria durante el expulsivo (AU)

Cephalohematoma is a blood collection localized in the subperiosteal space over the parietal region of the newborn, frequently unilateral, which appears during the hours or days after childbirth. Prolonged, traumatic or instrumented births facilitate its appearance, although it may also occur spontaneously. Its evolution is satisfactory, with complete resorption during the first weeks of life. Complications are uncommon but they should be monitored. Bilateral cephalohematoma after a domiciliary childbirth without health care during the expulsive period is presented (AU)

Índice de sustitución en patología herniaria: estudio comparativo / Hernia substitution index: a comparative study

La monitorización y evaluación mediante el índice de sustitución (IS) de la cirugía herniaria debería formar parte de la gestión clínica de las Unidades de Cirugía Mayor Ambulatoria (CMA) en un Servicio de Cirugía General y Digestivo (CGD). En este estudio se evalúa la tendencia evolutiva del Índice de Sustitución (IS) en el proceso hernial en el Servicio de CGD del Hospital Universitario Santa Cristina (HUSC), en comparación con los Indicadores Clave nacionales y autonómicos. Material y métodos: Diseño: estudio descriptivo observacional y comparativo de indicadores del Servicio de CGD del HUSC, con respecto a indicadores de la media de hospitales nacionales y de la Comunidad de Madrid. Análisis estadísticos: todas las variables comparadas son proporciones, por lo que en el análisis estadístico se ha utilizado el método del Chi cuadrado (Chi 2) para comparación de proporciones de muestras independientes. La significación estadística se ha establecido para contraste a dos colas (alpha = 0,05; Beta = 0,2). Resultados: se analizan 5.506 procedimientos de hernias inguinales (hernias inguinales simples, bilaterales y recidivadas) intervenidas en el Servicio de Cirugía General del HUSC en los últimos 9 años (2006-2014). El IS medio fue del 72%. Específicamente, la hernia inguinal unilateral simple alcanzó un IS del 82%. Respecto al indicador clave ‘cirugía ambulatoria de la hernia`, en el HUSC se obtienen resultados superiores a indicadores nacionales (p < 0,05) y de la Comunidad de Madrid. Conclusiones: La CMA en el HUSC está más desarrollada que en promedio del SNS en relación al IS la patología herniaria, situándose como un referente nacional en este capo de la CMA. Existen oportunidades de mejora en el cambio de la modalidad anestésica, incrementando el uso de técnicas anestésicas que permitan una recuperación más rápida, como la anestesia local asociada a sedación (AU)

Introduction: To monitor and to evaluate the Hernia Substitution Index (SI) should be part the clinical management of the Major Ambulatory Surgery (MAS) Units in a General and Digestive Surgery Service. In this study the temporal trend of the SI in hernia process at the General Surgery Service of Santa Cristina University Hospital (SCUH) is evaluated compared with the national and regional key indicators. Material and methods: Design: Observational, descriptive and comparative study of SCUH indicators with respect to Key Indicators of the average of the national and region of Madrid hospitals. Statistical analysis: All variables compared are proportions; consequently, the statistical analysis was based on the chi-square method (Chi 2) to compare proportions of independent samples. Statistical significance was established for two-tailed contrast (alpha 0 0,05; Beta = 0,2). Results: The 5.506 inguinal hernia procedures (simple unilateral, bilateral and recurrent inguinal hernia ) performed by the General Surgery Service of SCUH during the last nine years (2006-2014) were analyzed. The average SI was 72%. Specifically simple unilateral inguinal hernia IS reached 82%. Regarding the Key Indicator `outpatient hernia surgery` the General Surgery Service of SCUH indicators are above those of national (p < 0,005) and the Madrid region. Conclusions: The MAS at General Surgery Service of the SCUH is more developed than the average of the national hospitals regarding the SI of hernia pathology, fact that position the General Surgery Service of SCUH as a national reference in this MAS field. There are opportunities for improvement in the change of anesthetic modality, increasing the use of techniques that allow earlier anesthetic recovery as local anesthesia associated with sedation (AU)

Synthesis and structural study of precursors of novel methylsilanediols by IR and Raman spectroscopies, single-crystal X-ray diffraction and DFT calculations.

On the way towards the development of a synthetic route aimed at obtaining new methylsilanediol derivatives with an aminocarbonyl group in ß to silicon (which may have a potential biological interest), we have synthesized, isolated and purified five diphenylic possible precursors, namely chloromethyl(methyl)diphenylsilane, 2-{[methyl(diphenyl)silyl]methyl}-1H-isoindole-1,3(2H)-dione, N-[(methyl(diphenyl) silanyl)-methyl]-benzamide, N-[(methyl(diphenyl)silyl)-methyl]-acetamide and N-[(methyl(diphenyl)silyl)-methyl]-formamide. The conformational landscape of the five species in this study are explored by means of DFT calculations at the B3LYP/6-311++G(∗∗) level. The theoretical molecular structures predicted are confirmed by the reproduction of their respective IR and Raman spectral profiles, that are completely assigned. Some evidence in the vibrational spectra points to the occurrence of conformational mixtures in the samples. Further, single-crystal X-ray diffraction has allowed the elucidation of the crystalline structure of 2-{[methyl(diphenyl)silyl]methyl}-1H-isoindole-1,3(2H)-dione.

Irving Lichtenstein, maestro de la cirugía inguinal: semblanza de su vida y obra / Irving Lichtenstein, master of inguinal surgery: a profile of his life and work

El Dr. Irving Lichtenstein fue un reconocido cirujano de origen estadounidense que a lo largo de su vida desarrolló diferentes estudios enfocados a la patología inguinal; describió una de las técnicas de reparación con material protésico más utilizadas en todo el mundo. La reparación inguinal libre de tensión, descrita por Lichtenstein, presentaba además un porcentaje más bajo de recidivas, menor estancia hospitalaria, reducción de riesgos anestésicos, reincorporación temprana a la vida laboral y menores costos. El Maestro Lichtenstein no sólo describió técnicas quirúrgicas para hernias inguinales en su variante directa o indirecta: aportó conocimientos para el tratamiento de protrusiones femorales, recurrencias, incisionales, semilunares, gigantes y de la pared posterior abdominal (hernias de Grynfeltt y Petit), comparó sus propias técnicas y de manera paulatina formó un selecto ejército de médicos cirujanos seguidores a nivel mundial, que bajo sus preceptos se sienten seguros al reparar un defecto herniario.

Exostosis tibial: osteocondroma / Tibial exostoses: osteochondroma

El osteocondroma o exostosis cartilaginosa es el tumor óseo más frecuente, representando el 10-15% de la totalidad. Alrededor del 3% de la población lo padece. Es un tumor propio de individuos jóvenes con ligero predominio en varones. Puede ser solitario o múltiple, formando parte del síndrome de exostosis múltiple hereditaria. Suele ser un hallazgo accidental, normalmente asintomático, cuya localización más frecuente es la rodilla, aunque puede aparecer en otras localizaciones. El diagnóstico se realiza por imagen radiográfica, que suele ser patognomónica, y el tratamiento definitivo consiste en la extirpación quirúrgica (AU)

Osteochondroma, also known as osteocartilaginous exostoses, is the most common bonetumor, representing 10-15% of them. According to research, around 3% of the population suffers from this disease. This tumor is common among young people and it has a small predominance in males. Its radiologic features are often pathognomonic. Osteochondromas can be either solitary or multiple. They are connected with hereditary multiple exostoses. And usually reveal themselves as incidental, mostly located in knees. Surgical excision is the definitive treatment for this pathology (AU)

Linitis plástica intestinal, metástasis tardía de adenocarcinoma gástrico en anillo de sello / Intestinal linitis plastica, late metastases in signet-ring gastric adenocarcinoma

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Carcinoma papilar de tiroides sobre conducto tirogloso persistente / Papillary thyroid carcinoma arising in a thyroglossal duct cyst

La malignización de los quistes del conducto tirogloso es infrecuente y corresponde fundamentalmente, a carcinomas papilares del tejido tiroideo que los constituye. En este trabajo se describe un carcinoma papilar que se asienta sobre el conducto tirogloso en una mujer de 40 años intervenida previamente de bocio multinodular que tenía una biopsia con aguja fina preoperatoria de carcinoma papilar de tiroides (AU)

Malignant transformation of thyroglossal duct cysts is uncommon and usually corresponds to papillary carcinoma of the thyroid tissue constituting the cyst. We report a case of papillary thyroid carcinoma originating in a thyroglossal duct cyst in a 40-year-old woman who had previously undergone surgery for goitre with a prior diagnosis of papillary carcinoma by fine needle punch biopsy (AU)

Circuito de recetas crónicas: algo (todavía) por explotar / Circuit of chronic prescriptions: something still to be developed

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[Historical evolution of inguinal hernia treatment]. / Evolución histórica del tratamiento de la hernia inguinal.

Hernia (know breuk in Dutch, rompure in French, keal in Greek and rupture in English) has plagued humans throughout recorded history and descriptions of hernia reduction date back to the Ebers papyrus in Egypt. In medicine it is difficult to find historical periods, but we found two eras of uneven time: pre-technique and technique. The first was distinguished by a blend of empiricism and magic, and the second for greater comprehension of the human body; however much of modern surgical techniques result from contributions of early surgeons. Nonetheless, it was not until the late 19th century that hernia surgeon Eduardo Bassini published his work Nuovo Metodo per la Cura Radiacale dell"Ernia Inguinale (in 1889). Among the most notable contemporany classic hernia repairs are the Bassini, Halsted, Shouldice, and Tension-free repair techniques.

Uptake and clearance of PCB congeners in Chamaelea gallina: response of oxidative stress biomarkers.

PCB uptake and clearance by clams, Chamaelea gallina, were studied in specially designed flow-through channels. After 8 weeks exposure to 10 ppb Aroclor 1254 in water, clams were depurated for 10 weeks, in the same exposure channel or after transfer to clean systems. Accumulation of the 20 congeners studied depended on its initial abundance and physicochemical properties. A linear relationship was found between log bioconcentration factor and log octanol/water partition coefficient of each form. Clearance of each PCB depended also on its initial load and solubility, being faster in clams transferred to clean systems. Exposure significantly enhanced catalase and 6-P-gluconate dehydrogenase activities, but not other antioxidative enzymes. Superoxide dismutase, low during the exposure phase, increased seven-fold during depuration. Aroclor-treated clams had higher GSH levels than controls, but decreased to 15-35% after 2 days clearance, rose to 150% after 12 days, and declined to low levels by the end of the experience. Biotransformation of PCBs to quinones and redox cycling-promoted oxidative stress might explain the increased antioxidative defenses. The biochemical changes observed at the beginning of clearance could be attributed to clam handling, by adaptation to and recovery from hypoxic/anoxic stress.

Biological activity of Guatteria cardoniana fractions.

Methanolic extract of leaves and twigs of Guatteria cardoniana R.E. Fries (Annonaceae), a plant from the Venezuelan rain forest, was separated in alkaloid rich fractions and their biological effect on baby hamster kidney (BHK) cell line was studied. The initial plant extract (FA) induced cell proliferation, cytotoxicity as well as antiviral activity, depending on the concentration used. Further separation of this methanolic extract allowed us to separate these biological activities. The fraction with the highest antiviral activity (F7) was chromatographed and three of the nine alkaloid-rich fractions obtained, retained this activity. One of them (F(7)11) exhibited the highest inhibitory effect against a neurotropic Sindbis virus (NSV).

[Nitric oxide in dengue pathology]. / Oxido nítrico en la patología del dengue.

Nitric oxide (NO) is a multifunctional molecule that is involved in citotoxic as well as citoprotective processes, it's synthesis is highly regulated by the cell because an alteration in NO production is associated with a variety of pathologies, such as Septic, Anaphylactic and Hemorrhagic Shock. The clinical feature of dengue virus infection has a spectrum that goes from mild, dengue fever, to a severe disease, dengue hemorrhagic fever/dengue shock. Here, some evidences are discussed that links NO with the pathology of the severe disease cause by dengue virus.

Lectin-mediated, nonopsonic phagocytosis of type 1 Escherichia coli by human peritoneal macrophages of uremic patients treated by peritoneal dialysis.

Human peritoneal macrophages isolated from uremic patients undergoing peritoneal dialysis bind type 1 fimbriated Escherichia coli in the absence of opsonins. The number of bacteria bound per macrophage was 6.9, as determined by microscopic examination. Methyl alpha-mannoside (0.1 mM) and p-nitrophenyl alpha-mannoside (0.01 mM) inhibited this binding by about 66%. The ability of peritoneal macrophages to bind E. coli in a mannose-specific manner was confirmed in further experiments using an enzyme-linked immunosorbent assay (ELISA) with an antibacterial antibody, radiolabelled E. coli, and counts of colony-forming units (CFU). The number of bacteria bound per macrophage was 7 to 12 in the ELISA and 5.5-8.5 in the CFU assay. Methyl alpha-mannoside caused 70% inhibition of binding in the ELISA and 84% in the CFU assay, whereas p-nitrophenyl alpha-mannoside showed inhibition of 79% and 90%, respectively. Most bound bacteria (76-80%) were subsequently killed. Nonfimbriated E. coli 827 bound poorly to the macrophages (approximately 22%) as compared to that of the fimbriated bacteria. Although this binding was not inhibited by methyl alpha-D-mannoside or p-nitrophenyl alpha-mannoside, the percentage of bacteria killed was similar to that of the fimbriated phenotype. The peritoneal macrophage is thus able to phagocytose E. coli in the absence of opsonins. This may explain the relative rarity of E. coli as an etiologic agent of peritoneal infections in the dialysed patient.

Membrane glycoproteins of human polymorphonuclear leukocytes that act as receptors for mannose-specific Escherichia coli.

Type 1 fimbriated (mannose-specific) Escherichia coli cells bind to mannose residues on human polymorphonuclear leukocytes (PMN); this leads to phagocytosis of the bacteria. To identify the mannose-containing receptors on the PMN, the cells were surface labeled with 125I and lysed in 0.5% Nonidet P-40, and the lysate was fractionated by affinity chromatography on a column of Sepharose-bound fimbriae. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography of the material eluted from the column with 500 mM methyl-alpha-mannoside revealed two radioactive bands of Mr 70,000 to 80,000 (gp70-80) and 100,000 (gp100). Another weak band of Mr 150,000 (gp150) was observed after prolonged exposure of the gel. Upon blotting of the glycoproteins separated by polyacrylamide gel electrophoresis and overlaying of the blots with concanavalin A, gp150 appeared as the major band. Membrane preparations of the PMN were enriched in gp70-80, gp100, and gp150, in comparison with the cell homogenates, further suggesting that these glycoproteins are surface components. Fractionation of the membrane preparations on the immobilized fimbriae followed by concanavalin A overlay of blots of the methyl-alpha-mannoside-eluted material revealed that gp150 was the major component in this fraction. The eluted fraction, obtained from a cell lysate (4.4 micrograms/ml), inhibited by 70% the agglutination of yeasts by the intact bacteria. Our results suggest that the three surface glycoproteins isolated by us serve as receptors for mannose-specific E. coli on PMN and may be involved in the lectin-mediated phagocytosis of the bacteria.