Análisis histológico de la inserción del fascículo superior del músculo pterigoideo externo al disco articular

The inclusion of the fascicle higher external pterygoid muscle (Lateral Pterigoid) disk articulate occurs from the middle third of the central region and contributes to the displacement of the disc and its alteration help discal displacement. On the insertion, there are differences of opinion; some consider that only a small portion of fiber is inserted into the anterior capsule and thus directly and indirectly to the disk; other researchers point out that it is directly inserted the disk and the condyle or only on the anterior edge of the capsule and the disc. The objective of the study was a histological analysis of the insertion of this muscle to differentiate the type of fibres that reach the disk articulate (proportion of collagen fibers and muscle fibers) and determine the type of union between the muscle and the disc articulate. The sample of this study of transverse and exploratory type, was constituted by prepared diesiseis anatomical joint, temporomandibular, proceding for his histological reading with stains Hematoxylin and Eosin, Van Guiesson and Mallory, having found that the largest proportion of fibers reaching insert disk articulate are collagen and type of Union between the muscle and the disc articulate is sandwiched in a longitudinal way.La inserción del fascículo superior del músculo pterigoideo externo (Pterigoideo Lateral) en el disco articular se presenta a partir del tercio medio de la región central de este y contribuye al desplazamiento del disco y su alteración contribuiría al desplazamiento discal. Sobre la inserción existen diferencias de opinión; unos consideran que solo una pequeña porción de fibras se inserta en la parte anterior de la cápsula y por ende directa e indirectamente al disco; otros investigadores señalan que se encuentra directamente insertado al disco y al cóndilo o solo en el borde anterior de la cápsula y el disco. El objetivo del estudio fue realizar un análisis histológico de la inserción de este músculo para diferenciar el tipo de fibras que llegan al disco articular (proporción de fibras colágenas y fibras musculares) y determinar el tipo de unión entre el músculo y el disco articular. La muestra de este estudio de tipo transversal y exploratorio estuvo constituido por diesiséis preparados anatómicos de articulaciones temporomandibulares, procesándose para su lectura histológica, con colorantes hematoxilina y eosina, Van Guiesson y Mallory, habiéndose encontrado que la mayor proporción de fibras que llegan a insertarse en el disco articular son colágenas y el tipo de unión entre el musculo y el disco articular es en forma intercalada en forma longitudinal

Inserción posterior del fascículo superior del músculo pterigoideo externo en preparados anatómicos

This study aimed to determine the prevalence of posterior insertion of the superior fasciculus of the external pterygoid muscle (Lateral Pteridoideo) in anatomical preparations of adult corpses. 4 dead between 25 and 60 years was selected, was dissected up to the zygomatic fossa to expose the lateral pterygoid muscle and the components of the ATM. Subsequent insertion ratio upper lateral pterygoid muscle bundle with respect to the disc joint, joint capsule and condylar identified, being said insert was articular disk. Macroscopically, the upper bundle insertion lateral pterygoid muscle at condyle neck was observed.Este trabajo tuvo como objetivo determinar la prevalencia de inserción posterior del fascículo superior del músculo pterigoideo externo (Pteridoideo Lateral), en preparados anatómicos de cadáveres de adultos. Se seleccionó 4 cadáveres entre 25 y 60 años, se procedió a la disección hasta llegar a la fosa zigomática para exponer el músculo pterigoideo externo y los componentes de la ATM. Se identificó la relación de inserción posterior del fascículo superior del músculo pterigoideo externo con respecto al disco articular, cápsula articular y cóndilo mandibular, encontrándose que dicha inserción fue en el disco articular. Macroscópicamente no se observó inserción del fascículo superior del músculo pterigoideo externo a nivel del cuello de cóndilo

Naturaleza y cultura en Ámerica Latina

La concreción del XVIII Foro de Estudiantes Latinoamericanos de Antrología y Arqueología: Cultura y naturaleza en América Latina: escenarios para un modelo de desarrollo no civilizatorio, efectuado en Quito desde el 17 al 23 de julio del 2011, se constituyó en un acontecimiento sumamente significativo para la antropología latinoamericana debido a dos motivos. Primero porque coincidió con la emergencia del movimiento universitario estudiantil latinoamericano que expresaba sus tendencias, propuestas y exigencias de cambios tanto de las prácticas académicas como de los patrones civilizatorios que rigen las relaciones actuales. Segundo, porque se inscribía en un contexto de consolidación de las nuevas democracias de los países andinos, de carácter antineoliberal y basadas en los sujetos de derecho entre los cuales se incluye la naturaleza. Estos contextos determinaron que el Foro no ponga en escena certidumbres teóricas o metodológicas, ni se preste al exhibicionismo estéril de los avances disciplinares. Más bien, la convocatoria de la antropología y la arqueología fue apenas un pretexto para hablar, con su lenguaje, de nosotros mismos, de lo que somos, de lo que pensamos, de lo que aspiramos y sentimos sobre nuestra Latinoamérica. Lo que hemos visto, oído y compartido, en realidad, no han sido solamente ideas o conceptos sino opciones y toma de posiciones respecto a múltiples encrucijadas. Posición ante situaciones que amenazan la vida, la justicia y los derechos de todos, un desafío epistemológico todavía en ciernes y que no termina de cuajar aún en nuestras prácticas académicas

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London