Characterization of the human ridged and non-ridged skin: a comprehensive histological, histochemical and immunohistochemical analysis

The structure of the human skin is directly dependent on its location and the mechanical forces to which it is subjected. In the present work, we have performed a comprehensive analysis of the human ridged and non-ridged skin to identify the differences and similarities between both skin types. For this purpose, human skin samples were obtained from dorsal hand skin (DHS), palmar hand skin (PHS), dorsal foot skin (DFS) and plantar foot skin (PFS) from the same cadaveric donors. Histological, histochemical and semiquantitative and quantitative immunohistochemical analyses were carried out to evaluate the epidermis, dermis and basement membrane. Results show that the epithelial layer of ridged skin had larger cell number and size than non-ridged skin for most strata. Melanocytes and Langerhans cells were more abundant in non-ridged skin, whereas Merkel cells were preferentially found in ridged skin. The expression pattern of CK5/6 was slightly differed between non-ridged and ridged skin. Involucrin expression was slightly more intense in non-ridged skin than in ridged skin. Collagen was more abundant in foot skin dermis than in hand skin, and in ridged skin as compared to non-ridged skin. Elastic fibers were more abundant in DHS. Biglycan was more abundant in foot skin than in hand skin. No differences were found for blood and lymphatic vessels. The basement membrane laminin was preferentially found in foot skin. These results revealed important differences at the epithelial, dermal and basement membrane levels that could contribute to a better knowledge of the human skin histology.This work was partially supported by Award no. AC17/00013 (NanoGSkin) by ISCIII thorough AES 2017 and within the EuroNanoMed framework

Nutrición parenteral periférica hipocalórica (N.P.P.H.) en el postoperatorio de cirugia del tracto digestivo : estudio clínico

Reducción altaUniv. de Granada, Fctd. de Medicin

Ankle arthrodesis: Comparative results using a variety of techniques

Nivel de evidencia IVINTRODUCTION: Ankle arthrodesis in an intervention that may be performed using a variety of surgical approaches. The joint may be stabilized using diferent systems, with or without bone graft. MATERIAL AND METHODS: Retrospective study that collected the results of 40 patients who underwent ankle arthrodesis; the complications that arose were analyzed, results according to the AOFAS clinical rating system, global patient satisfaction and the relationship with the articular approach route, the !xation system or the usage of grafts.RESULTS: 55% of the patients presented one or more complication that motivated a total of 12 re-interventions in 10 patients (excludes removal of osteosynthesis material). The absence of consolidation, which required a new arthrodesis was more frequent in patients where osteosynthesis was not used (two out of three cases) than in those using screws (four out of 24 cases), while there was no register of this in 13 patients in which intramedullary pin. The use of the distal extreme of the fibula or the iliac crest as bone graft has failed to improve the consolidation. Arthroscopic approaches avoid the appearance of soft tissue complications, although the consolidation disorders were more frequent. The average score on the AOFAS clinical rating system was 56.4±21.2 and 55% of the patients were satisfied. CONCLUSIONS: Although the case histories fail to provide significant results, it is a demanding intervention, with an elevated complication rate. Intramedullary pins seem to favor improved consolidation.YesINTRODUCCIÓN: La artrodesis de tobillo es una intervención que puede ser realizada a través de diferentes abordajes quirúrgicos. La unión puede estabilizarse con diferentes sistemas, utilizando o no injertos óseos. MATERIAL Y METODOS: Estudio retrospectivo en el que se recogen los resultados de 40 pacientes a los que se realizó una artrodesis del tobillo, analizando las complicaciones surgidas, resultado según escala de la AOFAS y satisfacción del paciente, de forma global y en relación a la vía de abordaje articular, el sistema de fijación o la utilización de injerto. RESULTADOS: El 55% de los pacientes presentó una o más complicaciones, que obligaron a un total de 12 reintervenciones en 10 pacientes (excluidas retiradas de material de osteosíntesis). La ausencia de consolidación, que requirió una nueva artrodesis fue más frecuente en los pacientes en los que no se utilizó osteosíntesis (dos de tres casos), que en los que se utilizaron tornillos (cuatro de 24 casos), mientras que no se registró en los 13 pacientes en los que se usó un clavo intramedular. El uso del extremo distal del peroné o la cresta iliaca como injerto óseo no ha demostrado mejorar la consolidación. Los abordajes artroscópicos evitaron la aparición de complicaciones de las partes blandas, aunque los trastornos de la consolidación fueron más frecuentes. La puntuación media en la escala AOFAS fue de 56,4±21,2 y se encontraban satisfechos el 55% de los pacientes. CONCLUSIONES: Aunque la casuística no permite resultados signifcativos, se trata de una intervención exgente, con una alta tasa de complicaciones. Los clavos intramedulares parecen favorecer una mejor consolidación

Analysis of Pressure Pain Hypersensitivity, Ultrasound Image, and Quality of Life in Patients with Chronic Plantar Pain: A Preliminary Study.

To evaluate widespread pressure pain in patients with chronic plantar heel pain compared with that in healthy controls and to investigate the differences in ultrasound imaging and quality of life between these two groups. A total of 22 patients (11 female) with chronic plantar heel pain and the same number of healthy patients, matched according to age and gender, were included in this pilot study. Pressure pain thresholds (PPTs) were bilaterally assessed over the calcaneus bone, the plantar fascia, the first and fifth metatarsals, the soleus muscle, the second metacarpal, and the zygapophyseal joint of C5-C6. Plantar fascia thickness was measured via ultrasound imaging. In addition, quality of life and physical function were assessed using the Short-Form 36 (SF-36) questionnaire and the Foot and Ankle Ability Measure (FAAM) questionnaire, respectively. Analysis of covariance (ANCOVA) results showed significant differences in the PPTs at all points between the groups (P  Patients suffering from chronic plantar heel pain showed widespread and bilateral hypersensitivity, increased thickness of the plantar fascia in the affected foot, and deterioration in quality of life and physical functioning compared with matched controls

Ghrelin and adipose-derived mesenchymal stromal cells improve nerve regeneration in a rat model of epsilon-caprolactone conduit reconstruction

Objective. Attempts have been made to improve nerve conduits in peripheral nerve reconstruction. We investigated the potential therapeutic effect of adipose-derived mesenchymal cells (ASCs) and ghrelin (GHR), a neuropeptide with neuroprotective, trophic, and developmental regulatory actions, on peripheral nerve regeneration in a model of severe nerve injury repaired with nerve conduits. Material and methods. The right sciatic nerves of 24 male Wistar rats were 10-mm transected unilaterally and repaired with Dl-lactic-ε-caprolactone conduits. Rats were then treated locally with saline, ASCs, or GHR. At 12 weeks post-surgery, we assessed limb function by measuring ankle stance angle and percentage muscle mass reduction and evaluated the histopathology, immunohistochemistry, ultrastructure, and morphometry of myelinated fibers. Main Results. Rats receiving GHR or ASCs showed no significant increased functional recovery in ankle stance angle (p=0.372) but a higher nerve area (p=0.015), myelin area (p=0.046) and number of myelinated fibers (p=0.012) in the middle and distal segments of operated sciatic nerves in comparison to saline-treated control animals. Conclusion. These results suggest that utilization of ghrelin or ASCs may improve nerve regeneration using Dl-lactic-ε-caprolactone conduits