The supporting role of the teres major muscle, an additional component in glenohumeral stability? An anatomical and radiological study

Muscle coordination plays an important role in glenohumeral stability. The rotator cuff and the long head of the biceps are considered the primary dynamic stabilizers muscles. However, the fact that a subgroup of patients with a massive tear in the rotator cuff were able to keep a normal function, should make us question this traditional view. We hypothesize that the teres major which is also a monoarticular scapulohumeral muscle, although it is not part of the conjoined tendon of the rotator cuff, can play a role in glenohumeral stability by a direct support of the humeral head generated by the particular posteroanterior location of this muscle under the humeral head and which, as far as we know, has not been written up previously. This particular effect could appear while the arm is being lifted and the humeral head could be leaning on against the teres major muscle belly underneath it. An anatomical a radiological study was carried out to substantiate our hypothesis. Two cadaver specimens were used for the anatomical study. Frist body was studied through conventional dissection. The second body was analysed through sectional anatomy. Then a radiological study was carried out using magnetic resonance imaging in a healthy male volunteer. Both anatomically and radiologically, the anteroinferior surface of the humeral head was showed firmly resting against the muscle belly of the teres major, to the point of misshaping it from 110 degrees of arm elevation with external rotation. The specific contribution of this effect to the glenohumeral stability needs to be confirmed by further studies and can help us to prevent the high incidence of glenohumeral dislocations

Epidemiology of bacterial co-infections and risk factors in COVID-19-hospitalized patients in Spain: a nationwide study

Background: We performed a nationwide population-based retrospective study to describe the epidemiology of bacterial co-infections in coronavirus disease 2019 (COVID-19)-hospitalized patients in Spain in 2020. We also analyzed the risk factors for co-infection, the etiology and the impact in the outcome. Methods: Data were obtained from records in the Minimum Basic Data Set (MBDS) of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health and annually published with 2 years lag. COVID-19 circulated in two waves in 2020: from its introduction to 31st June and from 1st July to 31st December. The risk of developing a healthcare-associated bacterial co-infection and the risk for in-hospital and intensive care unit (ICU) mortality in co-infected patients was assessed using an adjusted logistic regression model. Results: The incidence of bacterial co-infection in COVID-19 hospitalized patients was 2.3%. The main risk factors associated with bacterial co-infection were organ failure, obesity and male sex. Co-infection was associated with worse outcomes including higher in-hospital, in-ICU mortality and higher length of stay. Gram-negative bacteria caused most infections. Causative agents were similar between waves, although higher co-infections with Pseudomonas spp. were detected in the first wave and with Haemophilus influenzae and Streptococcus pneumoniae in the second. Conclusions: Co-infections are not as common as those found in other viral respiratory infections; therefore, antibiotics should be used carefully. Screening for actual co-infection to prescribe antibiotic therapy when required should be performed.This work was supported by Instituto de Salud Carlos III (COV20/00491, PI18/01238, CIBERINFEC CB21/13/00051), Junta de Castilla y León (VA321P18, GRS 1922/A/19, GRS 2057/A/19), Consejería de Educación de Castilla y León (VA256P20) and Fundación Ramón Areces (CIVP19A5953). L. Sánchez-de Prada received a Río Hortega grant (CM20/00138) from Instituto Carlos III (Co-funded by European Regional Development Fund/European Social Fund ‘A way to make Europe’/’Investing in your future’).S

Molecular gas at supernova local environments unveiled by EDGE

CO observations allow estimations of the gas content of molecular clouds, which trace the reservoir of cold gas fuelling star formation, as well as to determine extinction via H$_2$ column density, N(H$_2$). Here, we studied millimetric and optical properties at 26 supernovae (SNe) locations of different types in a sample of 23 nearby galaxies by combining molecular $^{12}$C$^{16}$O (J = 1 $\rightarrow$ 0) resolved maps from the EDGE survey and optical Integral Field Spectroscopy from the CALIFA survey. We found an even clearer separation between type II and type Ibc SNe in terms of molecular gas than what we found in the optical using H$\alpha$ emission as a proxy for current SF rate, which reinforces the fact that SNe Ibc are more associated with SF-environments. While A$_V$ at SN locations is similar for SNe II and SNe Ibc, and higher compared to SNe Ia, N(H$_2$) is significantly higher for SNe Ibc than for SNe II and SNe Ia. When compared to alternative extinction estimations directly from SN photometry and spectroscopy, we find that our SNe Ibc have also redder color excess but showed standard Na I D absorption pseudo-equivalent widths ($\sim$1 \AA). In some cases we find no extinction when estimated from the environment, but high amounts of extinction when measured from SN observations, which suggests that circumstellar material or dust sublimation may be playing a role. This work serves as a benchmark for future studies combining last generation millimeter and optical IFS instruments to reveal the local environmental properties of extragalactic SNe.Comment: MNRAS accepted, 17 pages, 8 Figures, 4 Table

Insights on the stellar mass-metallicity relation from the CALIFA survey

We use spatially and temporally resolved maps of stellar population properties of 300 galaxies from the CALIFA integral field survey to investigate how the stellar metallicity (Z*) relates to the total stellar mass (M*) and the local mass surface density ($\mu$*) in both spheroidal and disk dominated galaxies. The galaxies are shown to follow a clear stellar mass-metallicity relation (MZR) over the whole 10$^9$ to 10$^{12}$ M$_{\odot}$ range. This relation is steeper than the one derived from nebular abundances, which is similar to the flatter stellar MZR derived when we consider only young stars. We also find a strong relation between the local values of $\mu$* and Z* (the $\mu$ZR), betraying the influence of local factors in determining Z*. This shows that both local ($\mu$*-driven) and global (M*-driven) processes are important in determining the metallicity in galaxies. We find that the overall balance between local and global effects varies with the location within a galaxy. In disks, $\mu$* regulates Z*, producing a strong $\mu$ZR whose amplitude is modulated by M*. In spheroids it is M* who dominates the physics of star formation and chemical enrichment, with $\mu$* playing a minor, secondary role. These findings agree with our previous analysis of the star formation histories of CALIFA galaxies, which showed that mean stellar ages are mainly governed by surface density in galaxy disks and by total mass in spheroids.Comment: 6 pages, 3 figures, accepted for publication in ApJ

Fractura-Luxación de Monteggia en el Adulto: tratamiento con clavo cerrojado

Las lesiones traumáticas del antebrazo son cada día más frecuentes. Una variante tradicionalmente conocida como de Monteggia ofrece la particularidad en el adulto de la controversia en el tratamiento entre el yeso, la placa a compresión o el enclavado endomedular. En un intento de mejora de resultados hemos testado clínicamente un nuevo clavo cerrojado para el cúbito. Se han seguido prospectivamente 7 pacientes afectos de fractura de Monteggia durante un año como mínimo y dos como promedio. Todos los pacientes consolidaron sus fracturas en un plazo inferior a 4 meses, con un promedio de 2.5 meses. Siguiendo la cotación propia de los autores se han encontrado 3 buenos y 4 muy buenos resultados. La sencillez y la bondad del método hace aconsejable su uso extensivo a las fracturas diafisarias de cúbito.Traumatic lesions of the forearm are increasingly common. One variant of these, traditionally known as Monteggia fracture, has the particularity in adults of displaying controversy with respect to whethe r it should be treated with plaster, a compression plate or endomedullary nailing. In an attempt to improve the results, the authors tested clinically a new locking nail for the ulna. Seven patients with Monteggia fractures wer e followed over a minimum their fractures in less than 4 months, with a mean of 2.5 months. Following the authors' rating, 3 patients had good and 4 patients very good results. The simplicity and suitability of the method counsel its extensive us e in diaphyseal fractures of the ulna