Evaluation of the subscapularis split created with passive rotation during arthroscopic dynamic anterior stabilization (DAS): A cadaveric study.

Abstract Introduction The purpose of the present study was to analyze the ability to create a subscapularis split by passive rotation of the arm during dynamic anterior stabilization (DAS) and to analyze the new geometry of the long head of the biceps LHB. Hypothesis The hypothesis was that this passive simple technique can create subscapularis split without additional dissection giving rise to new position of LHB with a new stabilization function. Material and methods A technique of subscapularis split using the LHB was used in 12 fresh-frozen human cadaveric shoulders. A subscapularis split was created by passive rotation of the arm after the LHB is shuttled into the joint during DAS. The length of the subscapularis split, post-DAS position and length of the LHB, and the angulation of the LHB relative to bicipital groove were measured after DAS and if this new geometry can give a new dynamic effect on subscapularis muscle. Results The mean length of the subscapular split after maximal rotation was 20.4 ± 6.0 mm (range: 10–32 mm). The mean elongation of the LHB was 0.6 ± 1.4 mm (range: −1 to +3 mm). The final angle of the LHB relative to the bicipital groove was 45 ± 5 degrees (range: 41 to 55 degrees). Discussion There is no need to create a distinct split prior to DAS. Additionally, DAS maintains the length-tension relationship of the LHB. The post-procedure medial angulation of the LHB relative to the bicipital groove may provide a lowering of the subscapularis, helping explain the anterior reinforcement of this technique. Level of evidence Basic science study, cadaver study

Rugby and shoulder trauma: a systematic review

Rugby is a popular contact sport worldwide. Collisions and tackles during matches and practices often lead to traumatic injuries of the shoulder. This review reports on the epidemiology of injuries, type of lesions and treatment of shoulder injuries, risk factors, such as player position, and return to sport activities. Electronic searches through PubMed (Medline), EMBASE, and Cochrane Library retrieved studies concerning shoulder injuries in rugby players. Data regarding incidence, type and mechanisms of lesion, risk factors and return to sport were extracted and analyzed. The main reported data were incidence, mechanism of injury and type of lesion. Most of the studies report tackle as the main event responsible for shoulder trauma (between 50% and 85%), while the main lesions reported were Bankart lesions, Superior Labral tear from Anterior to Posterior (SLAP tears), anterior dislocation and rotator cuff tears. Open or arthroscopic repair improve clinical outcomes. Shoulder lesions are common injuries in rugby players. Surgical treatment seems to be effective in for rotator cuff tears and shoulder instability. More and better designed studies are needed for a higher Level of Evidence analysis of this topic

The mitochondrial protease OMA1 acts as a metabolic safeguard upon nuclear DNA damage

The metabolic plasticity of mitochondria ensures cell development, differentiation, and survival. The peptidase OMA1 regulates mitochondrial morphology via OPA1 and stress signaling via DELE1 and orchestrates tumorigenesis and cell survival in a cell- and tissue-specific manner. Here, we use unbiased systems-based approaches to show that OMA1-dependent cell survival depends on metabolic cues. A metabolism-focused CRISPR screen combined with an integrated analysis of human gene expression data found that OMA1 protects against DNA damage. Nucleotide deficiencies induced by chemotherapeutic agents promote p53-dependent apoptosis of cells lacking OMA1. The protective effect of OMA1 does not depend on OMA1 activation or OMA1-mediated OPA1 and DELE1 processing. OMA1-deficient cells show reduced glycolysis and accumulate oxidative phosphorylation (OXPHOS) proteins upon DNA damage. OXPHOS inhibition restores glycolysis and confers resistance against DNA damage. Thus, OMA1 dictates the balance between cell death and survival through the control of glucose metabolism, shedding light on its role in cancerogenesis

Estrategias para facilitar el acompañamiento de estudiantes entre pares

Se muestra el desarrollo y los resultados de dos proyectos de Innovación Docente desarrollados durante los cursos 2021-22 y 2022-23 en la Universidad Autónoma de Madrid, en el que han participado 17 docentes, 18 asignaturas y 8 grados. En estos se diseñaron una serie de herramientas y estrategias para que los y las estudiantes con más dificultades a la hora de superar las asignaturas correspondientes, pudiesen alcanzar los resultados de aprendizaje esperados y no caer en la apatía e, incluso, en el abandono de dicha materia. Para ello ha sido fundamental la labor de sus compañeros, quienes ejerciendo la labor de “mentores” acompañado a sus “telémacos” durante todo el proceso enseñanza-aprendizaje, a lo que hay que sumar el seguimiento y planificación por parte de los docentes implicados. Los resultados son óptimos y plantean la aplicación de la metodología de forma generalizada

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Hybrid school Altadis arquitectura, Reciclaje cultural, Escuela de Arquitectura en Fábrica de Tabacos,Sevilla : PFG septiembre, 2017, Tribunal 6.05

Universidad de Sevilla. Grado en Arquitectur

Bankart augmentation for capsulolabral deficiency using a split subscapularis tendon flap

Traumatic anterior shoulder instability is a frequent problem and often requires surgical management. In the absence of significant bone deficiency, arthroscopic capsulolabral repair is associated with low recurrence rates and good functional outcome. However, capsulolabral deficiency, particularly after multiple previous attempts at repair, may preclude traditional arthroscopic Bankart techniques. Previous reports have described the use of autograft or allograft augmentation or coracoid transfer in the treatment of this difficult problem. The purpose of this report is to describe a novel technique of arthroscopic Bankart augmentation of capsulolabral deficiency using a split subscapularis tendon flap to reinforce a damaged capsule. In the absence of bone deficiency, this technique can restore anterior shoulder restraint without excessively constraining the glenohumeral joint

Stylohyoid Complex (Eagle) Syndrome Starting in a 9-Year-Old Boy

Background There are only four previous pediatric reports of the glossopharyngeal neuralgic form of the stylohyoid complex syndrome. Stylohyoid complex has merely been described as cases of glossopharyngeal neuralgia in children. Case Report A 12-year-old boy came to our hospital because of recurrent episodes of severe cranial pain (9/10) lasting for 5 to 15 minutes. Pain affected the right tonsillar fossa, ear, and mastoid region. Since the start at the age of 9 years, the frequency of painful episodes has progressively increased: when admitted to our clinics 3 years later, the child was having up to five episodes daily in spite of analgesic, antiepileptic, and antidepressant drugs; he had abandoned school and leisure. Between episodes, neurological examination detected only discomfort to pressure on the right tonsillar fossa. Three-dimensional computed tomography images of the skull base showed an elongated right styloid process and bilateral calcification of the stylohyoid ligament. After surgical excision of the right styloid process and of part of the stylohyoid ligament, the glossopharyngeal painful episodes ceased. The patient remains asymptomatic seven years later. Conclusion In spite of its rarity in childhood, this debilitating but treatable syndrome should be kept in mind for the differential diagnosis of recurrent cranial pain in the pediatric population

A Reproducible Technique for Creation of the Subscapularis Split During Dynamic Anterior Stabilization for Shoulder Instability

The subscapularis split is a required difficult step of several instability procedures. We propose creating a subscapularis split using the shuttled long head of the biceps by simple passive external rotation of the arm during dynamic anterior stabilization. This technique simplifies one of the technically demanding steps of dynamic anterior stabilization, making the split quicker and more reproducible