1.Pectoralis Major Tendon as Landmark for Proximal Humerus Surgery: A Cadaveric Study on the Adult Filipino Population
Patrick M. Dizon ; Daniel William T. Yu ; Donnel Alexis T. Rubio
Acta Medica Philippina 2021;55(3):290-293
OBJECTIVE: It is common to get lost during a comminuted proximal humerus surgery, and the pectoralis major insertion is always a constant. Therefore, this study aimed to do a cadaveric study on the Filipino population to assess the distance from the pectoralis major tendon to the top of the humeral head (PMT) as a reference during proximal humerus surgery.
METHODS: This study dissected the shoulders of cadavers. The distance from the pectoralis major tendon insertion to the top of the humeral head (PMT) was measured using a caliper. This PMT distance was also correlated to the cadaver's height and sex.
RESULTS: This study dissected 110 shoulders (55 cadavers | 24 females, 31 males). The median PMT was 5.40 cm for males and 4.90 cm for females, with a combined value of 5.40 cm overall. There was a direct and moderate correlation between the PMT with overall height. Height and PMT of both the left and right shoulder were significantly longer among males compared to females. The study showed that for every centimeter increase in the height of males, there was a corresponding 0.02 cm increase in the PMT, adding the constant factor of 1.83. A corresponding 0.04 cm increase in the PMT for females added the constant factor of -0.81.
CONCLUSION; The pectoralis major tendon insertion is a consistent landmark that can accurately restore humeral length when reconstructing complex proximal humerus fractures where landmarks are otherwise lost because of comminution.
Pectoralis Muscles
;
Humerus
;
Tendons
;
Fractures, Bone
2.The rotator cuff footprint in Filipinos: A cadaveric study
Patrick M. Dizon ; Karissa Arielle F. Genuino-Regalado ; Donnel Alexis T. Rubio ; Rowena F. Genuino ; Julius Bryan C. Abesamis
Acta Medica Philippina 2023;57(10):65-70
Introduction:
Rotator cuff tears are one of the common etiologies of shoulder pain. Rotator cuff repair is recommended for a patient who failed conservative treatment. Proper knowledge of the rotator cuff footprint is needed in restoring correct anatomy during the repair. The size of the footprint is important in determining the kind of repair.
Objective:
This study aimed to define the average measurements of the rotator cuff footprint on the humerus in Filipino cadavers.
Methods:
This is a descriptive, cross-sectional study of preserved human cadaver upper extremity specimens. We measured the length, width, and shape of the supraspinatus, infraspinatus, subscapularis, and teres minor.
Results:
We obtained 27 upper extremity specimens. The median age of the source cadavers was 50.5 years with the equal male-to-female distribution. The mean measurement of the supraspinatus is 22.92 mm in length and 10.17 mm in width. The shape of the supraspinatus was found to be trapezoidal. The infraspinatus length was found to be 17.20 mm and the width at 10.72 mm. Its shape was found to be trapezoidal. The teres minor length was measured at 15.15 mm and the width at 11.04 mm. The shape was mostly trapezoidal but some were triangular. Finally, the subscapularis length was 17.68 mm while the width was 11.26 mm. The shape was trapezoidal or comma-shaped.
Conclusion
The average measurement of the rotator cuff footprint was found to be smaller in our study than reported in terms of length and width. The footprint shape was similar to the studies reported.
Rotator Cuff
3.Treatment of osteosarcoma patients in the Philippine General Hospital during the COVID-19 outbreak
Czar Louie L. Gaston ; Hazel Valerie Yu ; Emileo Dacanay ; Cesar Cipriano Dimayuga ; Jochrys Estanislao ; Pamela Fajardo ; Albert Jerome Quintos ; Donnel Alexis Rubio ; Edward Wang ; Ana Patricia Alcasabas
Acta Medica Philippina 2021;55(2):242-246
Objectives. The ongoing Coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems worldwide. This study aimed to document the effect of COVID-19 on osteosarcoma treatment pathways in the Philippine General Hospital (PGH) and determine if there were any delays.
Method. A retrospective review of osteosarcoma patients treated at the PGH from January 1, 2019 – January 1, 2020 (pre-COVID-19) was compared to those treated during the COVID-19 pandemic from March 1, 2020 – September 1, 2020. Rates of diagnosed osteosarcoma, admission for chemotherapy, admission for surgery, treatment abandonment, metastatic disease on presentation, 1-year mortality, and amputation were calculated and compared between the two groups.
Results. From March to September 2020, 11 newly diagnosed osteosarcoma patients sought consult at the PGH. Only one patient sought consult during the initial 3-4 months of the study, suggesting that patients delayed seeking healthcare during the period of enhanced community quarantine. Patients seen during the pandemic had a higher rate of metastatic disease on presentation, reflecting the delay in diagnosis. Due to COVID-19 restrictions early in the pandemic, osteosarcoma patients were coordinated and referred to outside hospitals for intravenous chemotherapy and surgery. Normalization of services (hospital admissions, limb salvage surgeries) were seen at the later stages of the study, corresponding to the loosening of the quarantine.
Conclusions. Osteosarcoma patients experienced delays in seeking consult, diagnosis, and treatment at the PGH due to the COVID-19 pandemic. Early indicators suggest worse outcomes for these patients due to the delays. Strategies employed during the pandemic, such as networking of care and telemedicine, may help in future outbreaks.
Coronavirus
;
COVID-19
;
Coronavirus Infections
;
Pandemics
;
Osteosarcoma
4.Evaluation of modified thiel soft-embalmed cadavers as a novel teaching model for musculoskeletal ultrasound and anatomy among rehabilitation medicine residents
Christopher S. Constantino ; Rafael C. Bundoc ; Jose V. Tecson, III ; Donnel Alexis T. Rubio
Acta Medica Philippina 2023;57(10):45-51
Objective:
This study aimed to determine the perceptions of rehabilitation medicine resident trainees on using modified Thiel soft-embalmed cadavers as a learning tool in acquiring knowledge on musculoskeletal ultrasound (MSK-UTZ) and anatomy.
Methods:
This descriptive cross-sectional study used total enumeration to recruit residents in training under the rehabilitation medicine department of a tertiary referral hospital. An online survey tool was self-administered to determine their perceptions on the use of MSK-UTZ on Thiel-embalmed cadavers. Pre- and post-test scores were compared to determine if their knowledge has improved.
Results:
Fifteen participants were recruited, who answered the pre- and post-test, and the online survey. The mean pre-test score of participants was 5.87 (±1.68), and the mean post-test score was 6.87 (±2.00). There was no statistically significant difference (P = 0.20) using a paired t-test. At an arbitrary passing rate of 70%, only 5/15 participants passed the pre-test while 10/15 passed the post-test. A chi-square test of independence showed that there was no significant association between the number of participants who passed or failed on the pre- and posttest, X2 (1, N = 15) = 3.3, p = .0.068. Most of the perceptions of the participants were positive in terms of the use of modified Thiel soft-embalmed cadavers as a learning tool, its relevance in the training of a rehabilitation medicine resident, and the overall experience on its use.
Conclusion
Thiel-embalmed cadavers as a learning tool was well-accepted, having generally positive perceptions from the participants mainly in terms of perceived enhancement of the understanding of the anatomical basis of musculoskeletal ultrasound, perceived improvement in skills in performing musculoskeletal ultrasound, and most even recommended that it be part of their training as rehabilitation medicine residents. In terms of acquiring knowledge on musculoskeletal ultrasound (MSK-UTZ) and anatomy, no significant improvement in knowledge was noted. Further studies with larger sample sizes are recommended to yield more statistically significant improvement in knowledge and to observe trends in the perceptions of participants.
Education, Medical
;
Anatomy
5.Learner preference on the teaching modalities in musculoskeletal anatomy in the new normal: A cross-sectional study comparing dissection educational videos and self-directed manual to proctor-assisted cadaver dissection
Donnel Alexis T. Rubio ; Jose V. Tecson, III ; Rafael C. Bundoc ; Christopher S. Constantino
Acta Medica Philippina 2023;57(10):71-78
Abstract
Education, Medical
;
Anatomy
6.Student evaluation of a Learning Enhancement in Anatomy Program (LEAP) during the COVID-19 pandemic: A retrospective study
Jose V. Tecson, II ; Rafael C. Bundoc ; Abdel Jeffri A. Abdulla ; Ronnie E. Baticulon ; Ryner Jose D. Carrillo ; Christopher S. Constantino ; Karen June P. Dumlao ; Rowena F. Genuino ; Blesile Suzette S. Mantaring ; Jose Leonard R. Pascual ; Donnel Alexis T. Rubio ; Kenny S. Seng ; Florida F. Taladtad ; Sylvia Karina L. Alip ; Joannes Luke B. Asis ; Pio Renato F. Villacorta ; Charlotte M. Chiong
Acta Medica Philippina 2023;57(10):79-88
Background and Objective:
The pandemic acted as an accelerator for the development of online teaching formats in anatomy and histology worldwide. The authors introduce a bridging program that reinforces the knowledge and understanding of gross and correlative anatomy and histology acquired in a virtual environment in preparation for its future clinical application. The study aims to evaluate the Learning Enhancement in Anatomy Program (LEAP) conducted among first-year medical students at the College of Medicine, University of the Philippines Manila.
Methods:
This descriptive cross-sectional study aims to determine the initial experience of implementing a learning enhancement program and assess areas for its improvement. An internally validated questionnaire was given to students after the program to gauge students’ reactions (Kirkpatrick Level 1 evaluation). Pre- and post-tests were administered to evaluate knowledge acquisition (Kirkpatrick Level 2 evaluation). Short-term behavioral peer evaluation (Kirkpatrick Level 3 evaluation) was also instituted.
Results:
One hundred fifty-two (152) students participated in the study. General reactions from students to the LEAP were consistently positive, with a steady majority of the students rating ‘5’ or a ‘Strongly Agree’ to positive statements regarding the program. Higher ratings for more traditional teaching methods, such as cadavers, formalinized specimens, and bones, compared to virtual systems were apparent. However, inter-student variation in preference for teaching modalities was observed. All stations of the LEAP were evaluated satisfactorily, with most gross anatomy stations rated higher than histology stations. A significant increase was noted in the total post-test scores compared to pre-test scores. This improvement in test scores was observed in the anatomy and histology subcategories and in six of the seven organ system modules. Perceived behavioral outcomes were also generally positive.
Conclusion
The LEAP is a worthwhile endeavor, garnering overwhelmingly positive reactions and a
significant improvement in test scores. Future studies are necessary to fine-tune teaching and training in a
blended learning environment.
Anatomy
;
COVID-19
;
Education, Medical
;
Program Evaluation