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In teaching medicine, resident physicians play a very important role, as on many occasions they are the ones who have to teach the medical students, undergraduate rotary interns and residents of other years. Sometimes his preparation as teachers is not adequate, so it is very important to include this topic in his academic curriculum, in order to professionalize the teacher. The Graduate Division of the School of Medicine of the National Autonomous University of Mexico (UNAM in spanish) included in the Single Program of Medical Specializations (PUEM in spanish) since 1994, the Seminar of Medical Education and for two years this seminar is carried online, has mandatory character for both resident doctors and teachers. However, it is necessary to give greater importance to the training of resident physicians as teachers, this action will lead to better preparation of undergraduate students, rotary interns, residents themselves and will encourage teachers to improve and professionalize their teaching character.
The study of our genome has played an important role in the field of personalized medicine and clinical practice becoming a useful tool to assist the medical community in the early diagnosis and treatment of countless diseases; osteoarthritis (OA) is a complex chronic degenerative joint disease, despite the high prevalence of this disease and its great impact on public health, little is currently known about its etiology and risk of progression. The purpose of this review is to show the advances in genetics in the study of osteoartrosis.
The present is a review of the literature of the different aspects in which genetics has developed in the study of osteoartrosis, its scopes and its possible impact on prevention and treatment.
The identification of a high number of candidate genes confirms the complex nature of the disease, it seems clear that the degree of expression of different genes is altered between an arthrosic patient and a healthy one. A deeper understanding of the link between the entire genome sequence and the association with well-characterized OA phenotypes will enable the development of biomarkers, report the risk of disease progression and allow better guidance of treatments.
The identification of a high number of candidate genes confirms the complex nature of the disease, it seems clear that the degree of expression of different genes is altered between an arthrosic patient and a healthy one. A deeper understanding of the link between the entire genome sequence and the association with well-characterized OA phenotypes will enable the development of biomarkers, report the risk of disease progression and allow better guidance of treatments.Lumbar degenerative spondylolisthesis is the result of the progression from degenerative changes in the intervertebral disc and facet joints that lead to destabilizing one or more vertebral segments. It is characterized by the anterior sliding of the vertebral body secondary to the sagittalization of the facet joints. Wiltse, Newman, and Macnab classified it as type III. It is a pathology typical of elderly patients that predominate in women with a ratio of 51 compared to men; the most affected segment is L4-L5, the listhesis rarely exceeds 30% slip. selleckchem It may or may not generate clinical manifestations, and the severity of these does not always correlate with the degree of sliding. The cardinal symptom is lumbar pain with or without radicular pain. Neurogenic claudication occurs in 75% of patients; it is caused by blood hypoperfusion secondary to the compression of the nerve roots, manifesting as pain in the lower limbs with variable walking distances. For the diagnosis of degenerative spondylolisthesis, comprehensive evaluation with static, dynamic radiographic studies in a standing position and magnetic resonance imaging are essential. The conservative treatment is the first-line therapy; it includes analgesics, anti-inflammatories, physiotherapy.
Turf-Toe includes a wide variety of traumatic injuries of the metatarsophalangeal joint of the first toe (MTF1). It is a potentially severe injury and there is no consensus for surgical management. The objective of this case report was to describe a patient with traumatic Turf-Toe injury grade III with a sesamoid fracture treated surgically.
24-year-old male with motorcycle fall with hyperflexion of the MTF1 joint, presented pain, edema and functional limitation; the radiographs showed soft tissue edema, lateral displacement of lateral sesamoid with fracture. Traumatic Turf-Toe was established. The ultrasound of the MTF1 joint showed breakage of the plantar plate and collateral ligaments. Patient was surgically managed with sesamoid reduction and plantar plate repair; postoperative evolution was satisfactory. At 8 weeks the patient was assessed with the AOFAS forefoot scale, obtaining 82 points, SF-12 with 87% and VAS of two and returned to his daily activities.
We describe a patient with traumatic Turf Toe grade III injury, not related to sports practice; first report in the literature of the use of ultrasound in the evaluation of patients with lesion of the metatarso-phalangic joint of the first toe.
We describe a patient with traumatic Turf Toe grade III injury, not related to sports practice; first report in the literature of the use of ultrasound in the evaluation of patients with lesion of the metatarso-phalangic joint of the first toe.Chondrosarcoma is a malignant tumor which often affects the pelvic ring and its symptomathology is non-specific and insidious. We display a case of a right iliopubic branch chondrosarcoma in a 62-year-old male whose first sing was a four-year history of sporadic macroscopic haematuria, related to efforts. After being studied by the Urology Department by cystoscopy and biopsy of bladder tumor, chondral cells were appreciated. Further study with imaging tests diagnosed low-grade chondrosarcoma with bladder infringement. The case is assessed by Musculoskeletal Tumors Committee and a multidisciplinary approach is carried out through en bloc resection and pelvic floor reconstruction. Currently the patient remains asymptomatic.
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