Revisiones_bibliográficas TyO

lunes, 7 de agosto de 2017

Primera técnica quirúrgica del fémur: un procedimiento inteligente no basado en computadoras para lograr la anteversión combinada en la artroplastia total primaria de cadera.

http://www.reemplazoprotesico.com.mx/academia/primera-tecnica-quirurgica-del-femur-un-procedimiento-inteligente-no-basado-en-computadoras-para-lograr-la-anteversion-combinada-en-la-artroplastia-total-primaria-de-cadera/

Femur first surgical technique: a smart non-computer-based procedure to achieve the combined anteversion in primary total hip arthroplasty.

Femur first surgical technique: a smart non-computer-based procedure to achieve the combined anteversion in primary total hip arthroplasty.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28764697

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539744/

https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1688-9

De:

Loppini M^1,², Longo UG³, Caldarella E⁴, Rocca AD⁴, Denaro V³, Grappiolo G⁴.

Copyright © The Author(s). 2017

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/

), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.AbstractBACKGROUND:

The relevance of prosthetic component orientation to prevent dislocation and impingement following total hip arthroplasty (THA) has been widely accepted. We investigated the use of a non-computer-based surgery to address the reciprocal orientation of the acetabular and femoral components.

CONCLUSIONS:

Femur first technique allows the surgeon to achieve a combined anteversion ranging from 25° to 50° with a cup inclination ranging from 30° to 50°. The cup is positioned according to the functional plane of the patient regardless the preoperative pelvic tilt.

KEYWORDS:

Acetabular inclination; Arthroplasty; Combined anteversion; Femur first; Hip

Resumen

ANTECEDENTES:
La relevancia de la orientación de los componentes protésicos para prevenir la dislocación y el choque después de la artroplastia total de cadera (THA) ha sido ampliamente aceptada. Se investigó el uso de una cirugía no basada en computadoras para abordar la orientación recíproca de los componentes acetabular y femoral.

CONCLUSIONES:
La primera técnica del fémur permite al cirujano lograr una anteversión combinada que oscila entre 25 ° y 50 ° con una inclinación de copa que oscila entre 30 ° y 50 °. La copa se posiciona de acuerdo con el plano funcional del paciente independientemente de la inclinación pélvica preoperatoria.

PALABRAS CLAVE:
Inclinación acetabular; Artroplastia; Anteversión combinada; Fémur primero; Cadera

PMID: 28764697 PMCID: PMC5539744 DOI: 10.1186/s12891-017-1688-9

Free PMC Article

Fuente:reemplazoprotesico.com.mx

#fémur #cadera #Inclinación acetabular #artroplastia #Anteversión combinada

Más de insensibilidad congénita al dolor/ More on congenital insensitivity to pain

Agosto 6, 2017. No. 2772

Indiferencia congénita al dolor

Congenital Indifference to Pain Adelaida Álvarez C.*, Simón P. Aristizábal L.**, Luis E

Rev. Col. Anest. Noviembre 2010 - enero 2011. Vol. 38 - No. 4: 528-535

Resumen

Introducción. En la fase aguda, el dolor ejerce un mecanismo natural de protección. No obstante, existen dos trastornos congénitos cuya característica principal es una baja o nula reactividad al trauma: la insensibilidad congénita al dolor y la indiferencia congénita al dolor. Esta última es una condición poco común en la que a pesar de no existir anormalidades neurológicas en las vías del dolor, el individuo carece de una respuesta emocional a la lesión tisular. Objetivos. Presentar el caso de una niña con indiferencia congénita al dolor y hacer revisión de la fisiopatología y una aproximación diagnóstica. Metodología y resultados. Presentación de caso clínico. Conclusiones. El diagnóstico de indiferencia congénita al dolor es básicamente un diagnóstico de exclusión y dado que aún no se conoce cura para este trastorno, la prevención, la educación y el tratamiento interdisciplinario son lo primordial en estas entidades.

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Las mutaciones NaV1.9 del canal de sodio asociadas con la insensibilidad al dolor disminuyen la excitabilidad neuronal.

Sodium channel NaV1.9 mutations associated with insensitivity to pain dampen neuronal excitability.

Huang J1, Vanoye CG2, Cutts A3, Goldberg YP3, Dib-Hajj SD1, Cohen CJ3, Waxman SG1, George AL Jr2.

J Clin Invest. 2017 Jun 30;127(7):2805-2814. doi: 10.1172/JCI92373. Epub 2017 May 22.Abstract

Voltage-gated sodium channel (NaV) mutations cause genetic pain disorders that range from severe paroxysmal pain to a congenital inability to sense pain. Previous studies on NaV1.7 and NaV1.8 established clear relationships between perturbations in channel function and divergent clinical phenotypes. By contrast, studies of NaV1.9 mutations have not revealed a clear relationship of channel dysfunction with the associated and contrasting clinical phenotypes. Here, we have elucidated the functional consequences of a NaV1.9 mutation (L1302F) that is associated with insensitivity to pain. We investigated the effects of L1302F and a previously reported mutation (L811P) on neuronal excitability. In transfected heterologous cells, the L1302F mutation caused a large hyperpolarizing shift in the voltage-dependence of activation, leading to substantially enhanced overlap between activation and steady-state inactivation relationships. In transfected small rat dorsal root ganglion neurons, expression of L1302F and L811P evoked large depolarizations of the resting membrane potential and impaired action potential generation. Therefore, our findings implicate a cellular loss of function as the basis for impaired pain sensation. We further demonstrated that a U-shaped relationship between the resting potential and the neuronal action potential threshold explains why NaV1.9 mutations that evoke small degrees of membrane depolarization cause hyperexcitability and familial episodic pain disorder or painful neuropathy, while mutations evoking larger membrane depolarizations cause hypoexcitability and insensitivity to pain.

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¿Podemos compartir un dolor que nunca sentimos? Correlaciones neuronales de empatía en pacientes con insensibilidad congénita al dolor.

Can we share a pain we never felt? Neural correlates of empathy in patients with congenital insensitivity to pain.

Danziger N1, Faillenot I, Peyron R.

Neuron. 2009 Jan 29;61(2):203-12. doi: 10.1016/j.neuron.2008.11.023.

Abstract

Theories of empathy differ regarding the relative contributions of automatic resonance and perspective taking in understanding others' emotions. Patients with the rare syndrome of congenital insensitivity to pain cannot rely on "mirror matching" (i.e., resonance) mechanisms to understand the pain of others. Nevertheless, they showed normal fMRI responses to observed pain in anterior mid-cingulate cortex and anterior insula, two key regions of the so-called "shared circuits" for self and other pain. In these patients (but not in healthy controls), empathy trait predicted ventromedial prefrontal responses to somatosensory representations of others' pain and posterior cingulate responses to emotional representations of others' pain. These findings underline the major role of midline structures in emotional perspective taking and understanding someone else's feeling despite the lack of any previous personal experience of it--an empathic challenge frequently raised during human social interactions.

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Dolor emocional sin dolor sensorial - ¿Sueño?

Emotional pain without sensory pain--dream on?

Borsook D, Becerra L.

Neuron. 2009 Jan 29;61(2):153-5. doi: 10.1016/j.neuron.2009.01.003.

Abstract

The article by Danziger and colleagues in this issue of Neuron evaluates empathy in a unique population--individuals with congenital insensitivity to pain. As such, it provides insights into the brain's ability to evaluate others' feeling to observed pain without having a specific sensory experience of pain itself.

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XIV Congreso Virtual Mexicano de Anestesiología 2017

Octubre 1-Diciembre 31, 2017

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California Society of Anesthesiologists

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