Comments on: Implications of structural variations in the human sacrum: why is an anatomical classification crucial?

We sincerely appreciate the work done by Mahato [1] in which a qualitative classification of the sacrum is done to determine the number of segments, position of auricular surfaces, symmetry and abnormalities. This work is of the utmost importance since it is crucial for several surgical interventions and at the same time correlates certain pathologies with the morphology, mostly low back pai

Genetic Stasis of Dominant West Nile Virus Genotype, Houston, Texas

The accumulation and fixation of mutations in West Nile virus (WNV) led to the emergence of a dominant genotype throughout North America. Subsequent analysis of 44 isolates, including 19 new sequences, from Houston, Texas, suggests that WNV has reached relative genetic stasis at the local level in recent years

Morphometry of the aortic arch and its branches. A computed tomography angiography-based study

Background: The current study aims to determine the prevalence of variations of the aortic arch using computed tomography angiography (CTA), as well as morphometries and gender correlations.Materials and methods: A retrospective, transverse, observational and descriptive study of 220 CTA was performed. The branching pattern, most cranial vertebral level of the aortic arch, area of the proximal, middle and distal segments of the arch, area of each branch, and the path of atypical arteries were recorded. Results were analysed and stratified by gender.Results: The typical aortic arch branching pattern was present in 77.7% without statistical significance between genders. The most common variant was a two-branch pattern with a common trunk and a left subclavian (13.6%), followed by a typical branching pattern with an added left vertebral artery (7.3%). T3 was the most frequent cranial level (32.3%), followed by T2–T3 (26.8%), and T3–T4 (23.2%). The mean areas of the aortic arch were 685.5 ± 183.9, 476.1 ± 124.1, and 445.0 ± 145.1 mm2 for the proximal, middle and distal segments, with statistical difference between men and women in the middle and distal segments. Three paths of atypical arteries were identified: bifurcated vertebral artery (0.5%), aberrant right subclavian artery (0.5%), and left subclavian ostium obstruction (0.5%).Conclusions: Mexican population has one of the highest prevalence of variations in the aortic arch branching pattern. The high probability of finding these should be taken into consideration when assessing patients. A standardised classification method would contemplate future un-reported findings, without causing confusion by the different numbers assigned by each author

Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip

To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and crosssectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve

Modifications to the delivery of a gross anatomy course during the COVID-19 pandemic at a Mexican medical school

The Coronavirus disease was declared a pandemic this year, causing an impact on medical education. Following the World Health Organization’s (WHO) recommendations, Universities around the world implemented social distancing and the use of online platforms. Anatomists lead medical students, most of which are part of Generation Z. Different technological tools have been used in the gross anatomy course in combination with face-toface classes, but now are forced to move exclusively online. The Human Anatomy Department in the Medical School of the Universidad Autonoma de Nuevo León (UANL) implemented asynchronous sessions as a short-term resolution, transformed to synchronous sessions as the pandemic progressed. It is important to consider the adaptability of the student, the near-peer teacher, and academic staff, with the creation of innovative ideas to facilitate the learning for the student and to maintain the quality of the course. Their role in this modality should be assessed, as it may change medical education and the way to teach in the future for the new generation of medical students. Professors’ roles are changing and it is necessary to adapt to new situations

Palabra impresa y salud mental: el papel de los medios

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Morphometric variants of the paranasal sinuses in a Mexican population: expected changes according to age and gender

Background: There are developmental variations in the paranasal sinuses. Our objective is to determine their dimensions and volume stratified by age and sex and define the expected growth pattern. Materials and methods: A retrospective, observational study was performed including computed tomography (CT) of patients between 1 and 20 years of age. The volumes of the frontal, sphenoid, and maxillary sinuses were obtained. Results: A total of 210 CT were included with a mean age of 10±6.1 years, 106(50.5%) were female. Groups were categorized in ranges of 5 years. Spearman correlation coefficients between the right and left sides were 0.843, 0.711, 0.916 for the frontal, sphenoid and maxillary sinuses. Post-hoc for the categorical age groups demonstrated statistically significant differences with values of p < 0.01, except between age groups 11-15 against ≥ 16 years of age (p = 0.8). Gender-related differences were evident with a higher air volume in girls in the 5-10-year-old group, while boys predominated in the rest of the groups. Conclusions: CT is ideal for pre-surgical sinus assessment. The maximum volume of paranasal sinuses is reached at age 15. There is a clear volumetric difference between age and gender groups. There is a direct relationship between a volume and its contralateral counterpart

The adenylyl cyclase Rv2212 modifies the proteome and infectivity of Mycobacterium bovis BCG

All organisms have the capacity to sense and respond to environmental changes. These signals often involve the use of second messengers such as cyclic adenosine monophosphate (cAMP). This second messenger is widely distributed among organisms and coordinates gene expression related with pathogenesis, virulence, and environmental adaptation. Genomic analysis in Mycobacterium tuberculosis has identified 16 adenylyl cyclases (AC) and one phosphodiesterase, which produce and degrade cAMP, respectively. To date, ten AC have been biochemically characterized and only one (Rv0386) has been found to be important during murine infection with M. tuberculosis. Here, we investigated the impact of hsp60-driven Rv2212 gene expression in Mycobacterium bovis Bacillus Calmette-Guerin (BCG) during growth in vitro, and during macrophage and mice infection. We found that hsp60-driven expression of Rv2212 resulted in an increased capacity of replication in murine macrophages but an attenuated phenotype in lungs and spleen when administered intravenously in mice. Furthermore, this strain displayed an altered proteome mainly affecting proteins associated with stress conditions (bfrB, groEL-2, DnaK) that could contribute to the attenuated phenotype observed in mice. © 2014, Institute of Microbiology, Academy of Sciences of the Czech Republic, v.v.i