Few studies have evaluated resilience in an academic environment as it relates to academic success or failure. This work sought to assess resilience in regular and remedial students of gross anatomy during the first and second semesters of medical school and to correlate this personal trait with academic performance. Two groups of students were compared: the first group included first-year medical students in the regular course, and the second group included first-year medical students who did not pass the regular anatomy course and so were enrolled in the remedial course. Both groups completed anonymous surveys designed to gather demographic data and establish scores on the Connor-Davidson resilience scale, which includes 25 statements rated zero to four on a Likert scale (maximum score 100). The average resilience score was the same for both groups, 80 +/- 9. The average anatomy grades differed significantly between regular students (67+/- 15.0) and remedial students (61 +/- 12.0). While there was no overall correlation between resilience score and anatomy grade, regular students with resilience scores of 75 or greater showed slightly better academic performance than their classmates. Similarly, remedial students with resilience scores of 87 or greater faired better academically. Resilience does not predict academic performance in gross anatomy, and further work is necessary to identify those intrinsic and extrinsic factors that influence students' achievements.

SUMMARY:Knowing the dimensions of the vertebral elements is very important for the development of instrumentation related to the cervical spine. Ethnic variations have been reported in these dimensions and, to date, there have been no morphometric studies of this area performed on the Mexican population. We conducted a morphometric study of 150 cervical vertebrae (C3-C7) obtained from a northeastern Mexican population to determine the dimensions of the bodies, pedicles, laminae, spinous processes, and superior and inferior articular processes. We did not find significant differences (p<0.05) in measurements taken of the left and right sides. The dimensions of the vertebral bodies were larger at lower levels. The pedicles of the C3 vertebra were larger in all dimensions compared to the other vertebrae. The largest height of the laminae was observed at C7 and the largest transverse length was observed at C5. The dimensions of the bodies, spinous processes, and laminae increased from C3-C7, whereas the dimensions of the pedicles and superior and inferior articular process height decreased toward the lower cervical levels.

SUMMARY: Extraocular muscles are important references in strabismus surgery and in placement of intraorbital devices. We analyzed extraocular muscles morphometry and possible anatomical variances of 20 orbits. We report the length, width, and points of insertion of the extraocular muscles. No anatomical variations in length, width and points of insertion were found. With regard to the rectus muscles, it was found that the superior rectus and lateral rectus are the longest muscles and that the width difference between the superior and inferior rectus is greater than that between the medial and lateral rectus and that the point of insertion of the rectus muscles has a variable morphology. The superior oblique muscle was smaller in caliber than the inferior oblique, as consistent with previous anatomical studies. Knowledge of the detailed morphology of extraocular muscles is fundamental in strabismus surgery and represents a key factor for the innovation of surgical techniques and orbital procedures.

RESUMEN:La arteria radial (AR) es utilizada en la práctica médica para la realización de diversos procedimientos quirúrgicos, entre los que destaca la cirugía de revascularización miocárdica. En la literatura actual hay poca información acerca de la compatibilidad de esta arteria con otros conductos vasculares. El objetivo fue determinar las características anatómicas, morfométricas y distribución de la arteria radial en el antebrazo. Se disecó la arteria radial de 10 antebrazos de cadáveres embalsamados; se identificaron y registraron los ramos musculares y vasa nervorum emitidos por la arteria, se midió la longitud total y obtuvieron tres muestras (proximal, media y distal) de cada una para ser procesadas mediante técnicas histológicas y se determinaron los grosores de la túnica media y los diámetros. Se observaron modas de 8 ramos arteriales para el músculo braquiorradial, 4 para los músculos flexor superficial de los dedos y flexor radial del carpo, un ramo arterial único para el músculo pronador cuadrado y una moda de 1 vasa nervorum para el ramo superficial del nervio radial. La longitud total de la arteria fue de 21,94 cm (±3,34). Los grosores encontrados fueron de 196,16 µm (±72,35), 148,25 µm (±40,40) y 158,96 µm (±45,74) en los segmentos proximal, medio y distal respectivamente. Los diámetros luminales mostraron una media de 1,48 mm (±0,70) en la región proximal, 1,01mm (±0,35) en la media y 1,43 mm (±0,47) en la distal. Considerando las características morfométricas, la arteria radial es una opción que satisface los criterios de longitud, diámetro luminal y grosor para ser utilizada como injerto.PALABRAS CLAVE: Morfometría; Arteria Radial; Cirugía de revascularización miocárdica. INTRODUCCIÓNCada año a nivel mundial, se realizan cerca de 1 millón de procedimientos quirúrgicos para la revascularización miocárdica en pacientes con cardiopatías isquémicas (Nezic et al., 2006). La cirugía de bypass coronario es el procedimiento más utilizado en enfermedades cardiacas avanzadas. A la fecha se ha demostrado que este tipo de cirugía provee excelentes resultados a corto y mediano plazo; sin embargo los resultados a largo plazo están fuertemente influenciados por el conducto vascular empleado como injerto. De 5 a 7 años después de la cirugía, los pacientes tienen un mayor riesgo de sufrir complicaciones isquémicas relacionadas con el injerto utilizado (Verma et al., 2004).Los injertos de la vena safena magna (VSM) fueron los primeros que se utilizaron en el bypass coronario (Favaloro, 1968) y en la actualidad siguen siendo una opción para los cirujanos. A pesar de tener un acceso relativamente fácil, de poseer una adecuada longitud y un diámetro correcto; su permeabilidad disminuye con el tiempo (Tatoulis et al., 2002), lo cual se le atribuye a una combinación de hiperplasia en la túnica íntima y a una acelerada aterosclerosis (Verma et al.). Posteriormente comenzaron a utilizarse conductos arteriales (Tatoulis et al., 2004) entre los que destacan las arterias torácica interna izquierda, torácica interna derec...

A 73-year-old male came to our institution with a history of right ptosis and intermittent double vision of 1 week's duration. He had been diagnosed with diabetes mellitus 5 years earlier and had chronic smoking and alcohol abuse history. Physical examination revealed right ptosis and outward ocular deviation with no evidence of pupillary asymmetry. There were no others abnormal findings on neurologic examination. With these finding, a third nerve palsy caused by an ischemic lesion of the nerve because of diabetes was suspected. Emergent computed tomography (CT) of the head revealed cortical-subcortical atrophy and no ischemic lesions. A cranial magnetic resonance showed a mass with a soft tissue component invading the right cavernous sinus. The mass displace the carotide and the intraselar structures (Figs. 1 and 2). With these results, a tumoral disease was suspected and for thus extensive systemic workup was initiated. Chest X-ray, routine blood values, and urinalysis results were normal. The serum PSA level was elevated (1000 ng/mL). Abdomen and chest CT detected hepatic and bone metastases. Findings on bone scintigraphy were compatible with extensive diffuse metastases throughout the skeleton, including the cranial lesion. Prostatic FNAB was indicated based on these findings, the result of which was prostatic adenocarcinoma (Fig. 3). Hormone therapy treatment was initiated with LH-RH agonist and Flutamide followed by Bifosfonates.Prostate carcinoma can metastasize to any organ especially bone but cranial nerve palsies secondary to metastatic prostate to the base of the skull are uncommon situations, most of them presented several years after the diagnosed is made. 1 The cause of the neuropathy is the direct compression of nerves by tumor in this strategic location. The involvement of the cavernous sinus area by malignant neoplasm may occur generally through local extension of a nearby locally advanced primary head and neck tumor or more rarely, through hematogenus spread of tumors located outside including breast and prostate cancer. 2 In most of the previous reports the cranial nerve palsy appears in the context of a widespread metastatic prostate disease diagnosed several years before. 3 The initial diagnosed is usually established by magnetic resonance images. 3 Treatment of skull metastases depends largely of patient symptoms as well as the radiologic findings. Two therapeutic approaches can be performed: systemic treatment with hormonal therapy; and a local therapy with surgery or radiotherapy. It has been reported that hormone therapy treatment can decrease the mass and improve the symptoms. 4 Radiation therapy often is performed in an attempt to palliate symptoms and surgery is occasionally necessary. 3 In conclusion, we describe an uncommon presentation of a metastatic prostate cancer. It should be mention that as more effective therapy for advanced prostate cancer becomes available and patients live longer, skull metastases can be expected to be encountered more frequently. Clinicians caring for pat...