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Journal of Clinical Medicine Nov 2023First described in 1760 by the anatomist Morgagni, coarctation of the aorta (CoA) is a congenital heart defect characterized by narrowing the aorta, typically distal to... (Review)
Review
First described in 1760 by the anatomist Morgagni, coarctation of the aorta (CoA) is a congenital heart defect characterized by narrowing the aorta, typically distal to the left subclavian artery. It accounts for approximately 5-8% of all congenital heart diseases, with an incidence estimated at 4 per 10,000 live births. In 1944, the Swedish surgeon Clarence Crafoord achieved the first successful surgical CoA repair by performing an aortic end-to-end anastomosis on two patients aged 12 and 27 years old. Presently, the most prevalent techniques for surgical repair, particularly in infants and neonates with isolated coarctation, involve resection with end-to-end anastomosis (EEA) and the modified Crafoord technique (extended resection with end-to-end anastomosis (EEEA)). Subclavian flap aortoplasty (SCAP) is an alternative surgical option for CoA repair in patients under two years of age. In cases where the stenosis extends beyond resection and end-to-end anastomosis feasibility, patch aortoplasty (PP) employing a prosthetic patch can augment the stenotic region, especially for older patients. Despite advances in pediatric cardiology and cardiac surgery, recoarctation remains a significant concern after surgical or interventional repair. This comprehensive review aims to provide a thorough analysis of coarctation management, covering the pioneering techniques introduced by Crafoord using end-to-end anastomosis and now extending to the contemporary era marked by percutaneous interventions as well as the recoarctation rate associated with each type.
PubMed: 38068402
DOI: 10.3390/jcm12237350 -
Veterinary Sciences Aug 2023Guttural pouch endoscopy allows for both the visualization and treatment of many clinical problems in the equine retropharyngeal region. This area is extremely complex,...
Guttural pouch endoscopy allows for both the visualization and treatment of many clinical problems in the equine retropharyngeal region. This area is extremely complex, and its description remains a real challenge for veterinary anatomists and practitioners. Six clinically normal equine cadavers were employed. Conventional dissections of guttural pouches without penetrating the guttural pouch membrane were first performed, and each adjacent structure was identified. Then, a guttural pouch endoscopic exam of the dissected heads was performed in order to correctly map each visible underlying anatomic structure identified in the previous dissection. This allowed us to: 1-identify each structure visible on endoscopic examination of the guttural pouch; 2-create a representative map of all the structures accurately identified via endoscopy; and 3-describe a systematic guttural pouch endoscopic examination with practical keys to help identification of the underlying vital structures. Our investigation provides new practical information on guttural pouch endoscopic anatomy and has allowed us to identify structures that were not previously described. We believe that this information may help with an accurate diagnosis in some cases and also potentially reduce iatrogenic trauma to important structures.
PubMed: 37756064
DOI: 10.3390/vetsci10090542 -
Anatomical Sciences Education May 2024This paper discusses the historical context of collaborative research and authorship disputes, exemplified by the complex relationship between Dutch anatomist and... (Review)
Review
Analysis of the ethical issues in authorship of collaborative research. Observations inspired by the historical case study of Gerard L. Blaes' (Blasius) claim to sole authorship of 'Anatome medullae spinalis'.
This paper discusses the historical context of collaborative research and authorship disputes, exemplified by the complex relationship between Dutch anatomist and physician Gerard L. Blaes and his East-Central European mentee, Daniel Gödtke, during the study of medulla spinalis. The study employs historical analysis to unravel the dynamics of scholarly collaboration, emphasizing the significance of mentorship in scientific progress and the communal nature of knowledge exchange. This historical analysis is based on primary sources and historical records. It underscores Blaes's strategy to circumvent public confrontations regarding the authorship of the seminal work 'Anatome medullae spinalis, et nervorum inde provenientium' (1666). As a teacher, he facilitated his student's participation in a public disputation to avert public authorship conflicts over the book. This ultimately led to the publication of two distinct versions of 'Anatome medullae spinalis.' The first one was co-authored by the mentor and his mentee, while the latter was solely attributed to the mentor. This historical narrative raises essential questions about attributing individual contributions in medical sciences, echoing concerns still pertinent in contemporary academia. Additionally, it makes visible the power dynamics inherent in faculty-students relationships and the potential repercussions of authorship disputes on scholars' reputations. By drawing parallels between historical and modern authorship dilemmas, this study contributes to ongoing discussions on equitable authorship in scientific research and publishing. It not only highlights a historical precedent for the complex dynamics of mentor-mentee collaborations and authorship disputes but also illuminates how these practices continue to influence contemporary academic and publishing customs.
PubMed: 38750636
DOI: 10.1002/ase.2435 -
Annals of Anatomy = Anatomischer... Feb 2024The teaching and learning of human anatomy by dissection has existed for thousands of years. Over the centuries, evolving ethical considerations for the sourcing of... (Review)
Review
The teaching and learning of human anatomy by dissection has existed for thousands of years. Over the centuries, evolving ethical considerations for the sourcing of human bodies for dissection have resulted in a transition from the use of unconsented individuals to that of body donors and the institution of body donation programmes around the world. However, major challenges on the African continent have resulted in the continued use of unconsented or unclaimed bodies and the ethical dilemma for African anatomy departments regarding their use. Some of the key difficulties in sourcing donor bodies which exist on the African continent emanate from religious, cultural, societal trust and other confounding factors. This manuscript explores the challenges and suggests ways in which some of these constraints may be overcome.
Topics: Humans; Human Body; Cadaver; Dissection; Tissue Donors; Africa; Anatomy
PubMed: 38065269
DOI: 10.1016/j.aanat.2023.152196 -
The Western Journal of Emergency... Jan 2024Despite the inclusion of both diagnostic and procedural ultrasound and regional nerve blocks in the original Model of the Clinical Practice of Emergency Medicine (EM),...
INTRODUCTION
Despite the inclusion of both diagnostic and procedural ultrasound and regional nerve blocks in the original Model of the Clinical Practice of Emergency Medicine (EM), there is no recommended standardized approach to the incorporation of ultrasound-guided regional anesthesia (UGRA) education in EM training.
METHODS
We developed and implemented a structured curriculum for both EM residents and faculty to learn UGRA in a four-hour workshop. Each Regional Anesthesia Anatomy and Ultrasound Workshop was four hours in length and followed the same format. Focusing on common UGRA blocks, each workshop began with an anatomist-led cadaveric review of the relevant neuromusculoskeletal anatomy followed by a hands-on ultrasound scanning practice for the blocks led by an ultrasound fellowship-trained EM faculty member, fellow, or a postgraduate year (PGY)-4 resident who had previously participated in the workshop. Learners identified the relevant anatomy on point-of-care ultrasound and reviewed how to conduct the blocks. Learners were invited to complete an evaluation of the workshop with Likert-scale and open-ended questions.
RESULTS
In the 2020 academic year, six regional anesthesia anatomy and ultrasound workshops occurred for EM faculty (two sessions, N = 24) and EM residents (four sessions, N = 40, including a total of five PGY4s, 10 PGY3s, 12 PGY2s, and 13 PGY1s). Workshops were universally well-received by both faculty and residents. Survey results found that 100.0% of all responding participants indicated that they were "very satisfied" with the session. All were likely to recommend this session to a colleague and 95.08% of participants believed the session should become a required component of the EM curriculum.
CONCLUSION
The use of UGRA is increasing, and and it critical in EM. An interdisciplinary approach in collaboration with anatomists on an interactive, nerve block workshop incorporating both gross anatomy review and hands-on scanning was shown to be well-received and desired by both EM faculty and residents.
Topics: Humans; Curriculum; Anesthesia, Conduction; Nerve Block; Emergency Medicine; Ultrasonography, Interventional
PubMed: 38205993
DOI: 10.5811/westjem.59793 -
The Clinical Teacher Oct 2023Sonography is increasingly integrated into medical curricula to prepare students for clinical practice. In 2022, we conducted a systematic review to explore the degree...
BACKGROUND
Sonography is increasingly integrated into medical curricula to prepare students for clinical practice. In 2022, we conducted a systematic review to explore the degree to which ultrasound skill acquisition is incorporated into undergraduate medial education in the United Kingdom.
METHODS
A search of Medline and Embase databases from 2003 to 2022 identified 15 relevant articles. Studies were included if they described ultrasound skills training in UK undergraduate medical education.
FINDINGS
A range of teaching methods were reported including didactic demonstrations, hands-on experience and combinations thereof. Portable machines were more common than cart-based machines, and most demonstrators were ultrasound-trained clinicians. Ultrasound teaching is well received, with improvements in confidence using ultrasound, motivation to learn anatomy and retention of knowledge.
DISCUSSION
Obstacles to integration were noted including training, cost, curriculum time constraints and the issue of incidental pathology. One study demonstrated that anatomists with appropriate training could provide ultrasound teaching, reducing the need for clinicians or sonographers. Costs may be reduced by renting machines or purchasing portable/hand-held devices. Allowing access to machines during student's free time may address scheduling difficulties. A final recommendation is to pre-scan volunteers prior to the teaching session.
CONCLUSION
We have outlined approaches to ultrasound skills teaching and the inherent hurdles to this, as well as potential solutions. This may aid educators wishing to augment their curricula. Although there are relatively few studies from the United Kingdom, there is consensus that students enjoy the incorporation of ultrasound practice and believe it complements existing teaching, especially in a small group setting.
Topics: Humans; Curriculum; Students; Education, Medical; Learning; Ultrasonography
PubMed: 37655446
DOI: 10.1111/tct.13635 -
Anatomical Sciences Education 2024Anatomists are facing a new generation of learners who will study and work in a technology-rich environment. Indeed, digital technologies are tremendously changing how... (Review)
Review
Anatomists are facing a new generation of learners who will study and work in a technology-rich environment. Indeed, digital technologies are tremendously changing how information and knowledge are communicated and retrieved. However, it remains unclear whether an anatomy assessment can be designed to promote contextual learning through integrating a digital communication strategy. To investigate this, assessment methods were diversified in the first-year neuroanatomy and third-year regional anatomy curricula through implementing a multimedia human anatomy group assignment integrating digital literacies and scientific communication. Through completing this multimedia assignment, students demonstrated their anatomy knowledge transfer using a range of approaches. The main mode of presentations chosen in the two anatomy units were non-animated video presentations (~50%), animated video presentations (~30%), storyboards (~10%), podcasts (~3%), and filmed videos (~3%). A 5-point Likert scale learning and teaching survey was conducted for a total of 195 undergraduate health science students to evaluate students' perception of this group assignment. The majority of students (70-80%) strongly agreed or agreed that the multimedia group assignment helped their teamwork skills. Students who produced animated videos significantly outperformed those who adopted the non-animated presentations during the end-of-semester theory examination (p < 0.05). This study demonstrates that an anatomy group assignment integrating digital literacy and scientific communication is an effective assessment strategy associated with a positive learning experience and outcome. This inquiry-based assignment promotes learning through assessment, allowing students to not only consolidate and extend anatomy knowledge but also developing effective digital communication skills, providing new insights into non-didactic anatomy assessments.
Topics: Humans; Multimedia; Literacy; Anatomy; Learning; Communication
PubMed: 37614080
DOI: 10.1002/ase.2331 -
Journal of the History of the... 2023On October 20, 1924, at the Waldorf-Astoria Hotel in New York City, two medical graduates of the University of Sydney delivered the John B. Murphy Oration to the...
On October 20, 1924, at the Waldorf-Astoria Hotel in New York City, two medical graduates of the University of Sydney delivered the John B. Murphy Oration to the American College of Surgeons on the topic of sympathetic ramisection for the treatment of spastic paralysis. The surgery was regarded as a triumph. The triumph, however, was short-lived, when one of the speakers, John Irvine Hunter, a promising anatomist, died prematurely. Norman Royle, an orthopedic surgeon, continued the research program and continued to perform these operations. Within a few short years, however, the theory of the dual nerve supply of skeletal muscle, which underpinned the procedure, and the results of surgery for spastic paralysis came under question. Nevertheless, Royle's sympathectomy found another indication and became the treatment of choice for peripheral vascular disease for several decades thereafter. Although Hunter and Royle's original work was discredited, their research turned their sorry saga into a scientific awakening of the sympathetic nervous system.
Topics: Humans; Muscle Spasticity; Sympathectomy; Paralysis
PubMed: 37155935
DOI: 10.1080/0964704X.2023.2204336