Elbow Extensor Muscles in Humans and Chimpanzees: Adaptations to Different Uses of the Upper Extremity in Hominoid Primates.

The anatomical and functional characteristics of the elbow extensor muscles (triceps brachii and anconeus) have not been widely studied in non-human hominoid primates, despite their great functional importance. In the present study, we have analyzed the muscle architecture and the expression of the myosin heavy chain (MHC) isoforms in the elbow extensors in humans and chimpanzees. Our main objective was to identify differences in these muscles that could be related to the different uses of the upper extremity in the two species. In five humans and five chimpanzees, we have analyzed muscle mass (MM), muscle fascicle length (MFL), and the physiological cross-sectional area (PCSA). In addition, we have assessed the expression of the MHC isoforms by RT-PCR. We have found high MM and PCSA values and higher expression of the MHC-IIx isoform in the triceps brachii of chimpanzees, while in humans, the triceps brachii has high MFL values and a higher expression of the MHC-I and MHC-IIa isoforms. In contrast, there were no significant differences between humans and chimpanzees in any of the values for the anconeus. These findings could be related to the participation of the triceps brachii in the locomotion of chimpanzees and to the use of the upper extremity in manipulative functions in humans. The results obtained in the anconeus support its primary function as a stabilizer of the elbow joint in the two species.

Abordaje multiprofesional del paciente con úlcera de pie diabético y presencia de osteomielitis. Casos clínicos / Multidisciplinary approach of the patient with diabetic foot ulcer and presence of osteomyelitis. Clinical cases

La osteomielitis del pie diabético puede presentar al clínico grandes desafíos diagnósticos y terapéuticos. La infección en pacientes con úlceras de pie diabético ocasiona una gran morbimortalidad. Las tasas de mortalidad, sobre todo cardiovascular, tras una úlcera y la amputación son muy elevadas, casi un 60% de las personas fallecen en el transcurso de 5 años tras una amputación y casi un 40% en el caso de las úlceras. El objetivo del artículo es describir el procedimiento con el que se aborda la osteomielitis en pacientes con úlceras de pie diabético a través de un equipo multiprofesional. METODOLOGÍA: A través de dos casos clínicos, se expone el planteamiento quirúrgico y médico para el abordaje de la osteomielitis. RESULTADOS: La resolución tanto de la osteomielitis como de la cicatrización de la úlcera se apoya tanto en la especialización de los profesionales a nivel clínico como en garantizar la continuidad asistencial en los niveles de atención existentes, evitando la variabilidad y garantizando la prestación de los recursos necesarios de manera eficiente. CONCLUSIONES: El abordaje quirúrgico o médico de la osteomielitis precisa de un equipo cualificado que pueda plantear ambas estrategias de atención, consiguiendo la resolución del caso

Osteomyelitis of the diabetic foot can present the clinician with great diagnostic and therapeutic challenges. Infection in patients with diabetic foot ulcers causes great morbidity and mortality. Mortality rates, especially cardiovascular, after an ulcer and amputation are very high, almost 60% of people die within 5 years after amputation and almost 40% in the case of ulcers. The objective of the article is to describe the procedure with which osteomyelitis is approached in patients with diabetic foot ulcers through a multiprofessional team. METHODOLOGY: Through two clinical cases, the surgical and medical approach for the osteomyelitis approach is exposed. RESULTS: The resolution of both osteomyelitis and ulcer healing relies both on the specialization of professionals at a clinical level, and on ensuring continuity of care at existing levels of care, avoiding variability and guaranteeing the provision of Necessary resources efficiently. CONCLUSIONS: The surgical or medical approach of osteomyelitis requires a qualified team that can propose both strategies of care, obtaining the resolution of the case

A possible new etiology for ophthalmic varicose veins: disseminated intracranial hyperostosis

We wanted to see if cranial anatomical alterations could influence the vascularization of the eyeball, particularly in the production of ophthalmic varicose veins. Orbital dissection of 85 years old woman (who suffered from Alzheimer's disease and respiratory failure).We observed, when performing a horizontal section of the skull to access the roof of the orbit, that the intracranial surface of the anterior and middle cranial fossae was partially covered by bony outgrowths, with the optical aperture and superior orbital fissure included. Also, when removing the roof of the orbits and beginning to extract the orbital fat we saw a dark, bilateral mass in the upper part of the orbital cavity corresponding to very dilated vessels. Bone alteration of the internal face of the skull was a diffuse intracranial hyperostosis and the dark dilated masses were superior ophthalmic varicose veins.Our hypothesis is that the origin of these ophthalmic varicose veins was the narrowing of the superior orbital fissure due to excessive bone proliferation. Intracranial hyperostosis produces a difficulty in draining orbital venous blood and, consequently, venous dilation. For this reason, we should consider this in the differential diagnosis

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Human Digital Meissner Corpuscles Display Immunoreactivity for the Multifunctional Ion Channels Trpc6 and Trpv4.

Ion channels are at the basis of the sensory processes including mechanosensing. Some members of the transient receptor potential (TRP) ion channel superfamily have been proposed as mechanosensors, but their putative role in mechanotransduction is controversial. Among them there are TRP canonical 6 (TRPC6) and TRP vanilloid 4 (TRPV4) ion channels, which are known to cooperate in mechanical hyperalgesia. Here, we investigated the occurrence, distribution, and possible colocalization of TRPC6 and TRPV4 in human digital Meissner sensory corpuscles using immunohistochemistry and double immunofluorescence (associate with markers for specific corpuscular constituents). TRPC6 immunoreactivity was restricted to the axon of Meissner corpuscles, whereas TRPV4 was detected in the axon but also in the lamellar cells. Moreover, axonal colocalization of TRPV4 and TRPC6 was found in the digital Meissner corpuscles. Present results demonstrate for the first time the occurrence and colocalization of two ion channels candidates to mechanosensors in human cutaneous mechanoreceptors. The functional significance of these ion channels in that place remains to be clarified, but should be related to different properties of mechanosensitivity. Anat Rec, 300:1022-1031, 2017. © 2016 Wiley Periodicals, Inc.

[Music therapy and regional anesthesia in orthopedic surgery]. / Musicoterapia y anestesia locorregional en cirugía ortopédica.

OBJECTIVE: To evaluate the sedative effects, intra-operation, of music therapy in orthopedic surgery patients with locoregional anesthesia in the Hospital Clínic i Provincial of Barcelona. EQUIPMENT AND METHODS: Prospective comparative study on a random sample of 110 patients undergoing or not music therapy. The degree of anxiety was assessed with the Questionnaire STAIC. The application of the music was done with a MP3 player and headphones. The collected data were analyzed with Excel. For the statistical analysis we used the SPSS-18 software and Chi-square test to test the hypothesis of whether there was relationship between the level of peace and music therapy. RESULTS: After the analysis, the results of Chi-square were in the group of no sedation with/without music Chi2 = 2.01, P = 0.35. The statistical significance level was p < 0.05. CONCLUSIONS: No relationship was found between hearing music or not and the patient's comfort level. Most patients recommend listening to music in the operating room despite the sounds around do not bother them.

Musicoterapia y anestesia locorregional en cirugía ortopédica / Therapy and regional anesthesia in orthopedic surgery

Objetivo. Valorar los efectos sedantes, intraoperatorios, de la musicoterapia en pacientes intervenidos de cirugía ortopédica con anestesia locorregional, en el Hospital Clínic i Provincial de Barcelona. Material y métodos. Estudio comparativo prospectivo sobre una muestra aleatoria de 110 pacientes, sometidos o no a musicoterapia. El grado de ansiedad se valoró con el Cuestionario STAIC (State-Trait Anxiety Inventory for Children). La aplicación de la música se hizo con un reproductor de MP3 y auriculares. Los datos recogidos se analizaron con el programa Excel. Para el estudio estadístico se ha utilizado el programa SPSS-18 y la prueba de Chi-cuadrado para verificar la hipótesis de si hay relación entre el nivel de tranquilidad y la musicoterapia. Resultados. Tras el análisis, los resultados de Chi-cuadrado fueron en el grupo de no sedación con/sin música de X2 = 2.01, p = 0.35, siendo el nivel de significación estadística de p < 0.05. Conclusiones. No se ha encontrado relación entre la audición o no de música y el nivel de tranquilidad del paciente. La mayoría de los pacientes recomiendan oír música en el quirófano a pesar de que no les molestan los sonidos del entorno (AU)

Objective. To evaluate the sedative effects, intra-operation, of music therapy in orthopedic surgery patients with locoregional anesthesia in the Hospital Clínic i Provincial of Barcelona. Equipment and methods. Prospective comparative study on a random sample of 110 patients undergoing or not music therapy. The degree of anxiety was assessed with the Questionnaire STAIC. The application of the music was done with a MP3 player and head-phones. The collected data were analyzed with Excel. For the statistical analysis we used the SPSS-18 software and Chi-square test to test the hypothesis of whether there was relationship between the level of peace and music therapy. Results. After the analysis, the results of Chi-square were in the group of no sedation with/without music X2 = 2.01, P = 0.35. The statistical significance level was p < 0.05. Conclusions. No relationship was found between hearing music or not and the patient’s comfort level. Most patients recommend listening to music in the operating room despite the sounds around do not bother them (AU)

Pattern of neurofilament expression in the developing cochleovestibular ganglia in vivo, and modulation by neurotrophin 3 in vitro / Patrón de expresión de neurofilamentos en los ganglios cocleo-vestibulares en desarrollo in vivo y modulación por neurotrofina 3 in vitro

Neurofilaments are the cytoskeletal intermediate filaments in neurons. They consist of three proteins (NFPs) with estimated molecular masses of 68, 160 and 200 kDa. The expression of NFPs by cells is regarded as a hallmark of neuronal differentiation and evolution. In the present study we analyzed the pattern of NFP expression in the neurons of the chicken cochleo-vestibular ganglion (CVG) during development and early post-hatching stages. We also investigated the expression of NFPs "in vitro" and their regulation by the neurotrophic factor NT3 to assess the participation of NFPs in neurotrophin-induced effects. The occurrence of NFP immunoreactivity (IR) "in vivo" and "in vitro" was studied using both Western-blot and immunohistochemistry on whole mount embryos, tissue sections and primary cultures. The 68 kDa NFP subunit was expressed as from stage E4 to E10, while the 160 kDa NFP subunit was found in all developmental stages and on the early post-hatching days (P10). The 200 kDa NFP subunit was observed at later developmental stages from E10 to P30. The immunoreactivity for each NFP subunit detected in inner ear sections was consistent with the data obtained by immunoblotting. NFPs were localized in the neuronal perikarya and their processes, allowing us to establish the temporal pattern of innervation of the sensory neuroepithelia located in the inner ear. Primary cultures with NT3 reproduced the "in vivo" pattern of NFP expression. The present results demonstrate that NFP subunits are developmentally regulated, suggesting that they may be specifically involved in the maturation of CVG neurons. Furthermore, the findings obtained in cultured neurons point to a regulation of NFP expression by neurotrophin-3 (AU)

Los neurofilamentos son los filamentos intermedios citoesqueléticos en las neuronas. Constan de tres proteínas (NFPs) con masas moleculares estimadas de 68, 160 y 200 kDa. La expresión de NFPs por las células se considera típica de la diferenciación y evolución neuronal. En este estudio analizamos el patrón de expresión de NFP en las neuronas del ganglio cocleo-vestibular (GCV) del pollo durante la fase de desarrollo y la fase temprana post-eclosión. También investigamos la expresión de NFPs in vitro y su regulación por el factor neurotrófico NT3 (neurotrofina 3) para evaluar la participación de NFPs en los efectos inducidos por la neurotrofina. La presencia de inmunorreactividad (IR) a las NFPs in vivo e in vitro se estudió utilizando tanto el método de Western-blot como la inmunohistoquímica sobre preparaciones completas de embriones, secciones tisulares y cultivos primarios. La subunidad de NPF de 68kDa fue expresada a partir de la fase E4 hasta la E10, mientras que la subunidad de NPF de 160 kDa se encontró en todas las fases de desarrollo y en los días tempranos post-eclosión (P10). La subunidad de NFP de 200 kDa se observó en fases posteriores de desarrollo a partir de E10 hasta P30. La inmunorreactividad hacia cada subunidad detectada en secciones del oído interno fue consistente con los datos obtenidos con la inmunotransferencia. Los NFPs estaban localizados en los pericarion neuronales y sus procesos, permitiéndonos establecer el patrón temporal de inervación de los neuroepitelios sensoriales ubicados en el oído interno. Los cultivos primarios con NT3 reprodujeron el patrón “in vivo” de expresión de NFP. Los resultados aquí obtenidos demuestran que las subunidades de NFP son reguladas según su grado de desarrollo, lo cual sugiere que es posible que estén implicadas específicamente en la maduración de neuronas del GCV. Además, los hallazgos encontrados en neuronas en cultivo apuntan hacia una regulación de la expresión de NFP por la neurotrofina 3 (AU)