Sensado bioeléctrico de abordajes de inducción sobre el sistema fascial: intervención y regulación de las fascias en la dinámica de movimiento

El sistema fascial es un entramado de membranas de tejido conectivo que envuelve, sostiene y comunica todas las estructuras del cuerpo. En este trabajo buscamos probar el compromiso de la activación de las fascias durante el movimiento, a través del sensado bioeléctrico, aplicando distintos abordajes de inducción fascial. Buscamos comparar los resultados obtenidos con la instancia de ejecución del movimiento libre no inducido fascialmente, sensando distintos niveles de la anatomía de las fascias sometidos a la influencia de los abordajes de inducción fascial, diseñando para ello diferentes momentos o instancias de sensado.O sistema fascial é uma rede de membranas de tecido conjuntivo que envolve, suporta e comunica todas as estruturas do corpo. Neste trabalho procuramos testar o comprometimento da ativação fascial durante o movimento, através do sensoriamento bioelétrico, aplicando diferentes abordagens de indução fascial. Procuramos comparar os resultados obtidos com a instancia de execução de movimentos livres nao induzidos fascialmente, detetando diferentes níveis da anatomia das fáscias submetidas a influencia de abordagens de indução fascial, desenhando diferentes momentos ou instancias de deteção para o efeito.The fascial system is a connective tissue membranes network which surrounds supports and communicates all the structures of the body. In this work we seek to test the commitment of fascial activation during movement, through bioelectric sensing, when we apply different fascial induction approaches. We seek to compare the results obtained with the instance of the execution of free movement not fascially induced, sensing different levels of fascial anatomy subjected to the influence of fascial induction approaches, designing for this purpose different moments and instances of sensing.Facultad de Arte

El cierre temporal de la cavidad abdominal: una revisión

ResumenEl cierre temporal de la cavidad abdominal forma parte del tratamiento de situaciones en las que existe riesgo de desarrollo o presencia de un síndrome compartimental abdominal o de infecciones intraabdominales severas, y se utiliza también en la cirugía de control de daños y ante grandes defectos de la pared abdominal. Aunque puede resultar enormemente beneficioso, no está exento de complicaciones, lo que se ha traducido en la búsqueda de técnicas que minimicen o excluyan las consecuencias del abdomen abierto, objetivo aún no alcanzado. En el presente trabajo hemos realizado una revisión de las diferentes indicaciones y métodos utilizados para el cierre temporal y el cierre definitivo de la fascia, con sus posibles ventajas e inconvenientes, mostrando la situación actual en este campo.AbstractAs part of the treatment procedure when there is a risk or presence of compartment syndrome or serious intraabdominal infection, the abdominal cavity may need to be temporarily closed. Temporary abdominal closure may also be required during trauma surgery for a large abdominal wall defect or damage control. However, this procedure, although extremely useful, is not without complications and this has prompted the search for a technique that will somehow avoid or minimize the consequences of an open abdomen. In this paper, we review the state of the topic including different indications and methods used for both temporary and definitive closure of the fascia, and discuss their possible benefits or shortcomings

Eficacia de la técnica de normalización de la aponeurosis cervical profunda en pacientes con trastornos craneomandibulares. Propuesta de protocolo de intervención

Objetivos: Comprobar que la técnica de normalización de la aponeurosis cervical profunda (TNACP) combinada con la técnica neuromuscular (TNM) del masetero incrementa la movilidad cervical alta, aumenta el umbral del dolor a la presión de los músculos maseteros, temporales, escalenos y suboccipitales, así como aumenta la máxima apertura oral en pacientes con disfunciones craneomandibulares. Hipótesis: La técnica de normalización de la aponeurosis cervical profunda (TNACP) combinada con la técnica neuromuscular (TNM) del masetero, incrementa la movilidad cervical alta, aumenta el umbral del dolor a la presión de los músculos maseteros, temporales, escalenos y aumenta la apertura de la boca en pacientes con trastornos craneomandibulares. Material y métodos: Estudio experimental aleatorizado y cegado con dos grupos, GC (Grupo control) y GE (Grupo Experimental). Se realizaron el test NDI y el test de Fonseca, se tomaron medidas inclinométricas de flexión y extensión cervical, medidas algométricas en los músculos maseteros, temporales, escalenos y suboccipitales bilateralmente, así como medidas de la máxima apertura de la boca. La muestra fue de 49 pacientes (n=49) con criterios positivos de trastornos temporomandibulares,TTM, 23 de ellos (n=23) en el GC y 26 (n=26) pacientes en el GE. Resultados: La movilidad cervical suboccipital en la flexión mejora considerablemente en el grupo experimental frente al grupo control (p0,05, y en el caso del grupo experimental, todas las variables presentan significación estadística, lo cual nos revela que todas mejoran, p<0,05. En el análisis de las diferencias de las variables entre grupo experimental y control, existe mejoría en todas las variables en el grupo experimental frente al control excepto en la EXT_SUB, donde no mejoran más en el experimental. Y en el caso de la máxima apertura oral (MAO) la diferencia se aproxima a la significación estadística p=0,057. En cuanto a los resultados de los pacientes catalogados con NDI en categoría leve y moderada y el test de Fonseca como TTM moderado mejoran más significativamente que los otros grupos. Conclusiones: La aplicación de la técnica miofascial (TNACP) junto con la técnica neuromuscular del masetero (TNM) aumentan la movilidad cervical alta, el umbral de dolor a la presión de los músculos maseteros, temporales, escalenos y suboccipitales, así como aumenta la máxima apertura oral en pacientes con trastornos craneomandibulares. La aplicación de la TNM junto a la TNACP es eficaz, aunque los incrementos en dichas variables son mayores al añadir la TNACP.Objectives: To verify that subjects with craniomandibular disorders according to the Fonseca test have a positive correlation with the subjects classified as Cervical Dysfunction according to the Neck Disability Index (NDI) To verify that the technique of normalization of the deep cervical aponeurosis (TNACP) combined with the masseter neuromuscular technique (TNM) increases the high cervical mobility, increases the pain threshold to the trigger point pressure of the masseter, temporal, scalene and suboccipital As well As increases the maximum opening of the mouth in patients with craniomandibular dysfunctions. Hypothesis: Subjects who present craniomandibular alterations according to the Fonseca test also have positive criteria in the NDI (neck disability index). The technique of normalization of the deep cervical aponeurosis (TNACP) combined with the masseter neuromuscular technique (TNM), increases the cervical mobility, increases the pain threshold to the trigger point pressure of the masseter, temporal, scalene and increases Opening of the mouth in Patients with craniomandibular disorders. Material and methods: Experimental and blinded experimental study with two groups, GC (Control group) and GE (Experimental Group). The NDI test and the Fonseca test were performed, inclinometric measurements of flexion and cervical extension, algometric measurements were performed on the masseter, temporal, scalene and suboccipital muscles bilaterally, as well as measures of vertical opening of the mouth. The sample consisted of 49 patients (n = 49) with positive criteria for temporomandibular disorders, TMD, 23 of them (n = 23) in the CG and 26 (n = 26) patients in the SG. Results: Suboccipital cervical mobility in flexion significantly improved in the experimental group compared to the control group (p <0.047), while no significant improvement was observed in suboccipital extension movement. In the intragroup analysis in the control group, we assumed post-intervention improvement in the control group to almost all variables except the pain threshold in right masseter, right temporal, right scalene and left scalene (UDP_MASTER_D, UDP_MASTER_D, UDP_MASTER_D) With values of p> 0.05, and in the case of the experimental group, all variables present statistical significance, which reveals that all of them improve, p <0.05. In the analysis of the differences of the variables between experimental group and control, there is improvement in all the variables in the experimental group against the control except in the EXT_SUB, where they do not improve any more in the experimental one. And in the case of maximum oral opening (MAO) the difference approaches the statistical significance p = 0.057. As for the results of patients classified with NDI in the mild and moderate category and the Fonseca test as moderate TMD, they improved more significantly than the other groups. Conclusions: The techniques applied in both the experimental and control groups produce significant changes in suboccipital mobility, the threshold of pain to pressure on muscular triggers as the vertical opening of the mouth, both protocols are valid, but they improve Given the protocol of the experimental group. The technique of normalization of the deep cervical aponeurosis TNACP is a good choice for the treatment of patients with TMD

Incarcerated hernia in a trocar site following laparoscopic gastric bypass

This paper reports a case of small bowel occlusion due to the herniation of an ileal ansa at the site of the insertion of a 12-mm trocar. A 28-year-old obese female patient underwent laparoscopic surgery for gastric bypass, the skin incisions of the trocar insertion sites were closed with absorbable sutures. Small bowel occlusion occurred on post-operative day 6 and the patient again underwent laparoscopic surgery. Laparoscopic exploration confirmed the suspected presence of the incarcerated hernia of an ileal ansa at the site of the trocar insertion which was freed without any need for bowel resection. The fascial defect was successfully closed under direct vision with the use of a special system of fascial sutures

Plantar fascia evaluation with a dedicated magnetic resonance scanner in weight-bearing position: our experience in patients with plantar fasciitis and in healthy volunteers.

Purpose. This study assessed the usefulness of upright weight-bearing examination of the ankle/hind foot performed with a dedicated magnetic resonance (MR)imaging scanner in the evaluation of the plantar fascia in healthy volunteers and in patients with clinical evidence of plantar fasciitis. Materials and methods. Between January and March 2009, 20 patients with clinical evidence of plantar fasciitis (group A) and a similar number of healthy volunteers (group B) underwent MR imaging of the ankle/hind foot in the upright weight-bearing and conventional supine position. A 0.25-Tesla MR scanner (G-Scan, Esaote SpA, Genoa, Italy) was used with a dedicated receiving coil for the ankle/hind foot. Three radiologists, blinded to patients’ history and clinical findings, assessed in consensus morphological and dimensional changes and signal intensity alterations on images acquired in both positions, in different sequences and in different planes.Results. In group A, MR imaging confirmed the diagnosis in 15/20 cases; in 4/15 cases, a partial tear of the plantar fascia was identified in the upright weight-bearing position alone. In the remaining 5/20 cases in group A and in all cases in group B, the plantar fascia showed no abnormal signal intensity. Because of the increased stretching of the plantar fascia, in all cases in group A and B, thickness in the proximal third was significantly reduced (p<0.0001) under upright weight-bearing compared with the supine position Conclusions. Imaging the ankle/hind foot in the upright weight-bearing position with a dedicated MR scanner and a dedicated coil might enable the identification of partial tears of the plantar fascia, which could be overlooked in the supine position

Estudo anatômico do sistema arterial dorsal da mão

Historically, the dorsal arterial system of the hand received less attention than the palmar system. The studies concerning dorsal arterial anatomy present some controversies regarding the origin and presence of the dorsal metacarpal artery branches. Knowledge of the anatomy of dorsal metacarpal arteries is especially applied in the surgical planning for flaps taken from the dorsum of the hand. The purpose of this study is to analyze the arterial anatomy of the dorsum of the hand, compare our observations with those of previous studies from the literature, and therefore to define parameters for surgical planning for flaps supplied by the dorsal metacarpal arteries. METHOD: Twenty-six dissections were performed at the dorsum of the right hand of 26 cadavers by making a distal-based U-shaped incision. After catheterization of the radial artery at the wrist level, a plastic dye solution with low viscosity and quick solidification was injected to allow adequate exposure of even small vessels. The radial artery and its branches, the dorsal arterial arch, the dorsal metacarpal arteries, the distal and proximal communicating branches of the palmar system, and the distal cutaneous branches were carefully dissected and identified. RESULTS: The distal cutaneous branches originating from the dorsal metacarpal arteries were observed in all cases; these were located an average of 1.2 cm proximal from the metacarpophalangeal joint. The first dorsal metacarpal artery presented in 3 different patterns regarding its course: fascial, subfascial, and mixed. The branching pattern of the radial artery at the first intermetacarpal space was its division into 3 branches. We observed the presence of the dorsal arterial arch arising from the radial artery in 100% of the cases. The distance between the dorsal arterial arch and the branching point of the radial artery was an average of 2 cm. The first and second dorsal metacarpal arteries were visualized in all cases. The third and fourth dorsal metacarpal arteries were visualized in 96.2% and 92.3% of cases, respectively. There was proximal and distal communication between the dorsal arterial arch and the palmar system through the communicating branches contributing to the dorsal metacarpal artery formation. CONCLUSION: At the dorsum of the hand there is a rich arterial net that anastomoses with the palmar arterial system. This anatomical characteristic allows the utilization of the dorsal aspect of the hand as potential donor site for cutaneous flaps.Historicamente o sistema arterial dorsal da mão recebeu menos atenção em relação ao palmar. Os trabalhos que abordam a anatomia arterial dorsal apresentam pontos divergentes no que se refere a origem, a freqüência e a presença de ramos das artérias metacarpais dorsais. Este conhecimento se aplica, em especial, no planejamento cirúrgico de retalhos que tenham como área doadora o dorso da mão. O objetivo deste trabalho é o de estudar a anatomia do sistema arterial dorsal da mão, confrontando estes achados com os da literatura e desta maneira, definir parâmetros para o planejamento dos retalhos supridos pelas artérias metacarpais dorsais da mão. CASUÍSTICA E MÉTODO: Foram realizadas 26 dissecções na região dorsal da mão direita de 26 cadáveres, através de uma incisão em forma de U de base distal. Após a cateterização da artéria radial a nível do punho, foi injetado um corante plástico de baixa viscosidade e rápida solidificação que permitiu adequada visibilização até mesmo de pequenos vasos. A artéria radial e seus ramos, o arco dorsal, as artérias metacarpais dorsais, os ramos comunicantes distais e proximais do sistema palmar e os ramos cutâneos distais, foram cuidadosamente dissecados e identificados. RESULTADOS: Os ramos cutâneos distais provenientes das artérias metacarpais dorsais foram observados em todos os casos, em média, a 1,2 cm proximal a articulação metacarpo-falangeana. A primeira artéria metacarpal dorsal apresentou três padrões diferentes em relação ao seu trajeto no primeiro espaço intermetacarpal: fascial, subfascial e misto. O padrão de ramificação da artéria radial, no primeiro espaço intermetacarpal, foi o de sua divisão em três ramos. Observamos a presença do arco arterial dorsal em 100% dos casos, com sua origem na artéria radial. A distância entre a emergência do arco dorsal e o ponto de ramificação da artéria radial foi em média de 2 cm. As artérias primeira e segunda metacarpais dorsais estiveram presentes em todos os casos. As artérias terceira e quarta metacarpais dorsais estiveram presentes em 96,2% e 92,3% dos casos, respectivamente. Constatamos que houve uma comunicação proximal e distal do arco dorsal com o sistema palmar, através de ramos comunicantes que contribuíram para a formação das artérias metacarpais dorsais. CONCLUSÃO: Existe uma rica rede arterial no dorso da mão, que apresenta um grande número de anastomoses com o sistema arterial palmar, permitindo a utilização desta região como uma fonte potencial de retalhos cutâneos

Primeras experiencias de sensado con Wimumo del grupo FascialArt

Este ensayo difunde los primeros resultados de la aplicación del dispositivo WiMuMo en el sensado de movimiento humano. A través de la técnica de Fascia Dance & Movement que explora la conexión del movimiento corporal con la memoria del tejido fascial. La hipótesis considera que la técnica de Fascia dance & movement puede equilibrar al sistema fascial tal como lo hacen otras terapias. Los primeros resultados indican que los estímulos sensoriales y la apelación a la imaginación permitirían generar movimiento y estimular una conciencia propioceptiva y, a la vez, evocar recuerdos guardados en la memoria no declarativa.Este ensaio apresenta os primeiros resultados da aplicação do dispositivo WiMuMo na detecção de movimento humano. Por meio da técnica Fascia Dance & Movement, explora-se a conexão entre o movimento corporal e a memória do tecido fascial. A hipótese considera que a técnica Fascia Dance & Movement pode equilibrar o sistema fascial, assim como outras terapias fazem. Os primeiros resultados indicam que estímulos sensoriais e apelo a imaginação podem gerar movimento e estimular a consciência proprioceptiva e, ao mesmo tempo, evocar memórias armazenadas na memória não declarativa.This essay presents the first results of the application of dispositive WiMuMo in human motion sensing. Through the Fascia Dance & Movement technique, it explores the connection between body movement and the memory of fascial tissue. The hypothesis considers that the Fascia Dance & Movement technique may balance the fascial system, just as other therapies do. The initial results indicate that sensory stimuli and the appeal to imagination could generate movement and stimulate proprioceptive awareness while, at the same time, evoking memories stored in non-declarative memory.Facultad de Arte