Reparació de l'espina bífida fetal amb tècniques no agressives

La malformació congènita que suposa l'espina bífida comporta trastorns i lesions irreversibles que dificultaran el desenvolupament d'una vida normal en l'afectat, podent fins i tot morir en els seus primers anys de vida. Per als casos d'espina bífida, s'ha considerat la interrupció legal de l'embaràs o la intervenció quirúrgica en el moment del naixement, encara que en les últimes dècades s'ha optat per la reparació intrauterina. Aquest treball suposa un avenç en aquest aspecte, ja que proposa un mètode per tancar la lesió medul·lar en el fetus sense recórrer als punts de sutura, gràcies a una làmina de material inert fixada amb una cola sintètica.La malformación congénita que supone la espina bífida acarrea trastornos y lesiones irreversibles que dificultarán el desarrollo de una vida normal en el afectado, pudiendo incluso perecer en sus primeros años de vida. Para los casos de espina bífida, se ha considerado la interrupción legal del embarazo o la intervención quirúrgica en el momento del nacimiento, aunque en las últimas décadas se ha optado por la reparación intrauterina. El presente trabajo supone un adelanto en este aspecto, puesto que propone un método para cerrar la lesión medular en el feto sin recurrir a los puntos de sutura, gracias a una lámina de material inerte fijada con un pegamento sintético

Muscular and glenohumeral changes in the shoulder after brachial plexus birth palsy: an MRI study in a rat model

<p>Abstract</p> <p>Background</p> <p>Shoulder abnormalities are the major cause of morbidity in upper brachial plexus birth palsy (BPBP). We developed a rat model of upper trunk BPBP and compared our findings to previously reported animal models and to clinical findings in humans.</p> <p>Methods</p> <p>Forty-three 5-day-old newborn rats underwent selective upper trunk neurectomy of the right brachial plexus and were studied 3 to 20 weeks after surgery. The passive shoulder external rotation was measured and the shoulder joint was assessed bilaterally by a 7.2T MRI bilaterally.</p> <p>Results</p> <p>We found a marked decrease in passive shoulder external rotation, associated with a severe subscapularis muscle atrophy and contracture. None however developed the typical pattern of glenohumeral dysplasia.</p> <p>Conclusions</p> <p>In contradiction with previous reports, our study shows that the rat model is not adequate for preclinical studies of shoulder dysplasia. However, it might serve as a useful model for studies analyzing shoulder contracture occurring after upper BPBP.</p

Muscular and glenohumeral changes in the shoulder after brachial plexus birth palsy : an MRI study in a rat model

Shoulder abnormalities are the major cause of morbidity in upper brachial plexus birth palsy (BPBP). We developed a rat model of upper trunk BPBP and compared our findings to previously reported animal models and to clinical findings in humans. Forty-three 5-day-old newborn rats underwent selective upper trunk neurectomy of the right brachial plexus and were studied 3 to 20 weeks after surgery. The passive shoulder external rotation was measured and the shoulder joint was assessed bilaterally by a 7.2T MRI bilaterally. We found a marked decrease in passive shoulder external rotation, associated with a severe subscapularis muscle atrophy and contracture. None however developed the typical pattern of glenohumeral dysplasia. In contradiction with previous reports, our study shows that the rat model is not adequate for preclinical studies of shoulder dysplasia. However, it might serve as a useful model for studies analyzing shoulder contracture occurring after upper BPBP