CETP gene polymorphisms and haplotypes are explanatory variables for HDL cholesterol level in sickle cell disease

Variations in lipid profile have been observed in sickle cell disease (SCD) and understanding their relationship with disease severity is crucial. This study aimed to investigate the association of polymorphisms of the CETP gene and laboratory markers of disease severity with lipid profile in a pediatric population with SCD. Biochemical and anthropometric analyses and CETP and alpha-thalassemia genotyping were performed. The study included 133 children and adolescents with sickle cell anemia (SCA) or hemoglobin SC disease (SCC), in steady-state. The SCA and no hydroxyurea (no HU) groups had higher values of ApoB, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) compared to the SCC and HU groups. However, there were no significant differences in ApoA1 and HDL-C levels between the groups based on genotype. Furthermore, the groups with altered levels of ApoA1, HDL-C, and the triglyceride/HDL ratio exhibited lower hemoglobin (Hb) levels and higher white blood cell counts. Hb level was associated to HDL-C levels. Analysis of CETP gene variants showed that the minor alleles of rs3764261 (C>A), rs247616 (C>T), and rs183130 (C>T), as well as the TTA haplotype, are explanatory variables for HDL-C levels. These findings suggested that dyslipidemia in SCD, specifically related to HDL-C levels, may be influenced by individual genetic background. Additionally, further investigation is needed to determine if clinical manifestations are impacted by CETP gene variants.

Presence of complete or incomplete septa in human jugular foramens / Presencia de septos completos o incompletos en forámenes yugulares humanos

SUMMARY: The objective of this study was to determine the occurrence of anatomical variants in the exocranial surface of the jugular foramen, specifically, the presence of single or double and complete or incomplete septation. A cross-sectional anatomical study was performed using 96 Brazilian dry human skulls (53 male and 43 female). One examiner determined the number (single or double) and type (i.e. complete or incomplete) of osseous septation at the outer surface of jugular foramens. Data went through statistical analysis on GraphPad Prism 6.01. Our results shown that Male individuals where more likely to present normal jugular foramens (male = 71.69%, female = 34.88%; p = 0.003). However, one incomplete septation occurred more often on the right side of female individuals (1 incomplete septation, male = 16.98%; 1 incomplete septation, female = 34.88%; p = 0.044). Similarly, one complete septation (i.e. the presence of two fully divided jugular compartments) also occurred more often on the right side of female individuals (1 complete septation, male = 9.43%; 1 complete septation, female = 25.58%; p = 0.038). Anatomical variants of the jugular foramen regarding single or double complete or incomplete septations were more likely to be found on the right side of female individuals, whose also presented a higher rate of jugular foramens with any type of septation than regular non-altered jugular foramens.

RESUMEN: El objetivo de la presente investigación fue determinar la presencia de variaciones anatómicas en la superficie exocraneal del foramen yugular, especificamente, la presencia de septos únicos o dobles, completos o incompletos. El estudio fue realizado en 96 cráneos secos (53 masculinos y 43 femeninos) de indivíduos Brasileños. Se determinaron septos óseos completos o incompletos y número de ellos. Los resultados obtenidos fueron tratados estadísticamente con el programa GraphPad Prism 6.01. Los sujetos de sexo masculino fueron más propensos a presentar forámenes yugulares normales (sexo masculino: 71,69%; sexo femenino: 34,88%, p= 0,003). Sin embargo, se observaron septos incompletos con mayor frecuencia en el lado derecho y en el sexo femenino (sexo masculino: 16,98%; sexo femenino: 34,88%, p=0,044). Adicionalmente, una septación completa (presencia de dos compartimientos yugulares, divididos completamente), se presentaron más frecuentemente en el lado derecho de indivíduos femeninos (sexo masculino: 9,43%; sexo femenino: 25,58%, p= 0,038). Las variantes anatómicas del foramen yugular, en relación a septos simples o dobles, completos o incompletos, se encontraron con mayor frecuencia en el lado derecho de las mujeres, las que presentaron un alto rango de forámenes yugulares con algún tipo de septos respecto a los forámenes yugulares regulares no alterados.

Clinical and radiographic examination compared to microscopic examination in the detection of anatomical features of mesiobuccal canals in maxillary first molars: a diagnostic study / Comparación entre examen radiológico y clínico con examen microscópico en la detección de características anatómicas de los canales mesiobucales en los primeros molares maxilares: un estudio diagnóstico

SUMMARY: The aim of the present study was to determine the accuracy, sensitivity, and specificity of the clinical and radiographic examination (CRE) method compared to the examination with the dental operating microscope (DOM) on the detection of anatomical features of mesiobuccal canals in maxillary first molars. One hundred maxillary first molars were selected to assess the number of canals orifice entrances, accessibility, and ending of their mesiobuccal canals using the CRE method and the examination with the DOM. The diagnostic tests of the CRE exhibited, in general, high levels of accuracy, sensitivity, and specificity. However, low levels of these outcomes occurred, mainly, on the detection of the number of canals entrance orifices of the mesiobuccal root. The statistically significant differences (p<0.05) occurred for accessibility and ending of canals in 61 of the 62 cases (out of 100) when two of them were present: 2 accessible root canals (48 cases; 77.42 %), and 1 accessible and 1 inaccessible canals (13 cases; 20.97 %); 1 foramen after fusion (18 cases; 29.03 %), 2 foramens (30 cases; 48.39 %), and 1 foramen and 1 blind foramen (13 cases; 20.97 %). This study proves that the clinical and radiographic method (still the most commonly used worldwide) can't be trusted absolutely in situations of complex internal anatomy regarding the mesiobuccal root canals of maxillary first molars.

RESUMEN: El objetivo del presente estudio fue determinar la precisión, sensibilidad y especificidad del método de examen clínico y radiográfico (ECR) en comparación al examen con el microscopio quirúrgico dental (MQD) en la detección de características anatómicas de los canales mesiovestibulares en primeros molares maxilares.Se seleccionaron 100 primeros molares maxilares para evaluar el número de entradas de los canales, la accesibilidad y la terminación de sus canales mesiovestibulares utilizando el método ECR y el examen con el MQD.Las pruebas de diagnóstico del ECR exhibieron, en general, altos niveles de precisión, sensibilidad y especificidad. Sin embargo, también hubo niveles bajos de estos resultados, principalmente, en la detección del número de orificios de entrada a los canales de las raíces mesiovestibulares. Hubo diferencias estadísticamente significativas (p<0,05) para la accesibilidad y terminación de los canales en 61 de los 62 casos (del total de 100), cuando dos de ellos estaban presentes: 2 canales radiculares accesibles (48 casos, 77,42 %), y 1 accesible y 1 inaccesible (13 casos, 20,97 %). Después de la fusión, un orificio (18 casos, 29,03 %), 2 orificios (30 casos, 48,39 %) y 1 orificio más otro, ciego (13 casos, 20,97 %). Este estudio demuestra que no se puede confiar plenamente en el método clínico y radiográfico (todavía el más utilizado en todo el mundo), cuando existe una anatomía interna compleja de los canales de la raíz mesiovestibular de los primeros molares superiores.

Effects of magnesium sulfate and dioctyl sodium sulfosuccinate on fecal hydration, output and systemic hydration in healthy horses / [Efeitos do sulfato de magnésio e do dioctil-sulfossuccinato de sódio na hidratação e eliminação fecal e sobre a hidratação sistêmica de cavalos saudáveis]

Magnesium sulphate (MS) and dioctyl sodium sulphosuccinate (DSS) are laxative drugs frequently used for the treatment of impactions. The aim of this study was to compare the effects of MS and DSS in fecal hydration, output and systemic hydration in healthy horses. Five healthy horses received 3 treatments with a 21-day interval. Treatment 1 was performed with administration of 4 liters of warm water; treatment 2: administration of 4 liters of warm water associated with 1g/kg of MS; and treatment 3: administration of 4 liters of warm water associated with 20mg/kg DSS. General and specific physical examination of the digestive system were performed, alongside with packed cell volume and total plasma protein measurement, abdominal ultrasonography and quantification of the amount and hydration of feces, before and 6, 12, 24, 36 and 48 hours after the treatments. No adverse effects were observed. The administration of laxatives promoted greater fecal output and hydration without resulting in systemic dehydration, yet no differences were observed between treatments. The absence of adverse effects of DSS demonstrates the safety of its use as a laxative drug at a dose of 20mg/kg. Studies comparing the effects of the laxative drugs in horses with large colon impaction are needed.(AU)

O sulfato de magnésio (SM) e o dioctil-sulfossuccinato de sódio (DSS) são drogas laxativas frequentemente utilizadas no tratamento da compactação. O objetivo deste estudo foi comparar os efeitos do SM e do DSS na hidratação e eliminação fecal, e na hidratação sistêmica de cavalos saudáveis. Cinco cavalos receberam três tratamentos, com intervalo de 21 dias. O tratamento 1 consistiu na administração de quatro litros de água morna; o tratamento 2: administração de quatro litros de água morna associada a 1g/kg de SM; e o tratamento 3: administração de quatro litros de água morna associada a 20mg/kg de DSS. Foram realizados exames físicos gerais e específicos do trato digestivo, hematócrito e proteína plasmática total, ultrassonografia abdominal e mensuração da quantidade e hidratação das fezes antes e após seis, 12, 24, 36 e 48 horas dos tratamentos. Não foram observados efeitos adversos. A administração de ambos os laxantes promoveu maior produção fecal e hidratação, sem resultar em desidratação sistêmica, entretanto não houve diferença entre os tratamentos. A ausência de efeitos adversos do DSS demonstra a segurança de seu uso como medicamento laxante na dose de 20mg/kg. São necessários estudos que comparem o efeito dos laxantes em equinos portadores de compactação de cólon.(AU)

Carboxymethylcellulose and psyllium effects in sand output of horses with asymptomatic sand accumulation / [Efeitos da carboximetilcelulose e do psyllium sobre a eliminação de areia de cavalos com sablose assintomática]

The aim of this study was to evaluate the effects of Psyllium (PSY) and Carboxymethylcellulose (CMC) administration on fecal elimination of sand in horses with asymptomatic sand accumulations. Eight horses were selected from sandy areas and randomly divided into 2 groups of four animals. The subjects were treated either with CMC or PSY. The presence of intestinal sand was confirmed through radiography and glove sedimentation test. The study was performed in two phases, with a 7-day interval. In phase I, all the animals received 8 liters of warm water; in phase II, the CMC group received 8 liters of water + 1g/kg of CMC, whereas the PSY group received 8 liters of water + 1g/kg of PSY. All administrations were performed through nasogastric intubation and fractionated in 2 equal volume administrations with an interval of two hours. General and specific physical examination of the digestive system were performed in conjunction with abdominal ultrasonography before the administrations and after 6, 12, 24, 36 and 48 hours, aiming to evaluate intestinal motility and presence of sand. All the feces eliminated by the animals within the 72 hours following the administrations were quantified, diluted and sedimented in order to calculate the sand output (g/kg of feces). All the animals were also subjected to radiographic examination to quantify sand accumulation prior to phase I and after 72 hours of phases I and II. No adverse effects were observed after the treatments. It was possible to notice higher sand elimination in both groups during the phase I, whereas no difference was observed in sand elimination rates between the groups in phase II. The radiographic scores presented differences between the initial timepoint and 72h in phases I and II for both groups. Based on the sand elimination rates and radiographic score, this study demonstrated that sand output was greater after administration of water alone, compared to CMC and Psyllium, leading to the inference that removal of the sandy environment and prevention of sand re-ingestion are effective measures for the elimination of sand from the colon of horses with asymptomatic sand accumulations.(AU)

O objetivo deste estudo foi avaliar os efeitos da administração do psyllium (PSY) e da carboximetilcelulose (CMC) sobre a eliminação fecal de areia em equinos com sablose assintomática. Oito equinos com confirmação radiográfica de sablose assintomática foram divididos em dois grupos (grupo CMC e grupo PSY). O estudo foi realizado em duas fases, com intervalo de sete dias. Na fase 1, todos os animais receberam 8L de água; na fase 2, o grupo CMC recebeu 8L de água + 1g/kg de CMC e o grupo PSY recebeu 8L de água + 1g/kg de PSY. Antes da administração de cada solução e após seis, 12, 24, 36 e 48 horas, foram realizados exame físico e ultrassonografia abdominal. Todas as fezes eliminadas em 72 horas foram avaliadas para quantificar a eliminação de areia (g/kg de fezes). Antes da fase 1 e após 72 horas das fases 1 e 2, o exame radiográfico foi realizado para quantificar o escore de acúmulo de areia. Houve maior eliminação de areia após a administração de água em comparação com a administração de CMC, e não se observou diferença entre a CMC e o PSY. Uma redução significativa nos escores radiográficos de acúmulo de areia foi observada após a administração de água, bem como a manutenção dos escores após a administração da CMC e do PSY. Com base na produção de areia e no escore radiográfico, este estudo sugere que a remoção do ambiente arenoso, impedindo a reingestão de areia, é uma medida eficaz para a eliminação da areia do cólon de cavalos com acúmulos de areia assintomáticos.(AU)

Efeito da suplementação com óleo de avocado (Persea americana Mill) na temperatura superficial corpórea de equinos antes e após exercício em esteira / [Effect of supplementation with avocado oil (Persea americana Mill) on body surface temperature of horses before and after exercise on treadmill]

Oito equinos foram distribuídos em delineamento randomizado cruzado, sendo um grupo sem suplementação (GC) e outro grupo suplementado com óleo de avocado (GOAv) por um período de sete semanas. Ao fim da sexta semana, os animais foram submetidos a teste padrão de exercício progressivo (TPEP) e, após sete dias, a teste de baixa intensidade e longa duração (BILD). Após o primeiro ciclo, houve período de descanso "washout" de 30 dias para troca de grupos para o segundo ciclo, que seguiu o protocolo do primeiro. A termorregulação foi avaliada com base na temperatura retal e na temperatura superficial corpórea, obtidas por termografia, de 15 regiões de interesse. A temperatura retal e as imagens termográficas foram obtidas antes, um minuto e 15 minutos após o exercício. Não houve diferença entre os grupos GC e GOAv em nenhum momento. Os resultados obtidos neste estudo revelaram que a suplementação de 5% da matéria seca (MS) com óleo de avocado por seis e sete semanas não influenciou na termorregulação com base na temperatura superficial corpórea dos equinos submetidos ao teste padrão de exercício progressivo (TPEP) e ao exercício de baixa intensidade e longa duração (BILD), respectivamente.(AU)

Eight equines were distributed in a randomized crossover design, one control group (CG) without supplementation and another group supplemented (SG) with avocado oil for a period of six weeks. At the end of the sixth week, the animals were submitted to standard exercise test (SET) and after seven days to the low intensity test (LIT). After the first cycle, there was a 30-day washout rest period to exchange groups for the second cycle, which followed the protocol of the first one. Thermoregulation was evaluated based on rectal temperature and body surface temperature of 15 regions of interest obtained by thermography. Rectal temperature and thermographic images were obtained before, one minute and 15 minutes after exercise. There was no difference between the CG and SG at any time. The results obtained in this study revealed that the supplementation of 5% of dry matter with avocado oil for six and seven weeks did not influence the thermoregulation based on the body surface temperature of the horses submitted to SET and LIT, respectively.(AU)

Biometría de los músculos extensor corto de los dedos y extensor corto del hallux en individuos brasileños: análisis anatómico para su uso como colgajo muscular en cirugías reconstructivas / Biometry of the extensor digitorum brevis and extensor hallucis brevis muscles in Brazilian individuals: anatomical analysis for use as a muscle flap in reconstructive surgeries

RESUMEN: El músculo extensor corto de los dedos (ECD) se sitúa junto con el músculo extensor corto del hallux (ECH) en la región dorsal del pie y están encargados de colaborar con la acción agonista de los músculos extensor largo de los dedos (ELD) y extensor largo del hallux (ELH), en la extensión de los cuatro dedos mediales en las articulaciones metatarsofalángicas. Esta condición complementaria permite su transferencia quirúrgica hacia otras regiones receptoras sin afectar la funcionalidad extensora de los dedos del pie motivo por el cual durante las últimas décadas se ha convertido en un tejido importante para la reconstrucción de lesiones tisulares, sin embargo, son escasos los estudios biométricos que lo describan en detalle. El objetivo de esta investigación fue establecer la longitud, ancho y área de extensión de estos músculos acompañada de la determinación de las distancias de éstos respecto a la cuña medial y la base del quinto metatarsiano para su uso quirúrgico. Sumado a lo anterior y posterior a la descripción de las variantes musculares encontradas se determinó los puntos motores de inervación de estos dos músculos. Para ello se estudiaron 36 miembros inferiores formolizados de individuos adultos brasileños pertenecientes a la Universidad Federal de Alagoas (UFAL), Maceió, Brasil. Las mediciones se realizaron con un cáliper marca Mitutoyo de 0,01 mm de precisión obteniendo una longitud, ancho y área de 6,89 ± 1,64 cm, 3,81 ± 0,42 cm y 31,98 ± 7,60 cm2 en el lado derecho de 6,91 ± 1,64 cm, 3,68 ± 0,46 cm y 30,75 ± 7,61 cm2 en el izquierdo respectivamente. En el 17 % de los casos hay presencia de tendones accesorios para el músculo ECD. La distancia desde el margen medial del músculo ECH respecto a la cuña medial y del margen lateral del músculo ECD a la base del quinto metatarsiano fue de 1,97 ± 0,43 y 1,72 ± 0,41 al lado derecho y de 2,01 ± 0,62 y 1,87 ± 0,36 al lado izquierdo respectivamente. Los puntos motores (Pm) predominaron en un 64 % en el tercio medio del músculo ECH y en un 64 % en el tercio proximal del músculo ECD. Estos resultados son un aporte significativo, tanto para quienes realizan cirugía ortopédica como para el conocimiento detallado de la anatomía dorsal del pie.

SUMMARY: The extensor digitorum brevis muscle (EDB) is located along with the extensor hallucis brevis (EHD) in the dorsal region of the foot and are responsible for collaborating with the agonist action of the extensor digitorum longus muscles (EDL) and extensor hallucis longus (EHL) in the extension of the four medial fingers in the metatarsophalangeal joints. This complementary condition allows its surgical transfer to other receptor regions without affecting the extensor functionality of the toes, which is why during the last decades it has become an important tissue for the reconstruction of tissue injuries, however, there are few studies biometrics that describe it in detail. The objective of this investigation was to establish the length, width and area of extension of these muscles accompanied by the determination of their distances from the medial wedge and the base of the fifth metatarsal for surgical use. In addition to the above and after the description of the muscle variants found, the innervation motor points of these two muscles were determined. To do this, 36 formalized lower limbs of Brazilian adult individuals belonging to the Federal University of Alagoas (UFAL), Maceió, Brazil, were studied. Measurements were made with a 0.01 mm precision Mitutoyo caliper obtaining a length, width and area of 6.89 ± 1.64 cm, 3.81 ± 0.42 cm and 31.98 ± 7.60 cm2 on the right side of 6.91 ± 1.64 cm, 3.68 ± 0.46 cm and 30.75 ± 7.61 cm2 on the left, respectively. In 17 % of cases there is presence of accessory tendons for the EDB muscle. The distance from the medial margin of the EHB muscle with respect to the medial wedge and the lateral margin of the EDB muscle to the base of the fifth metatarsal was 1.97 ± 0.43 and 1.72 ± 0.41 on the right side and 2,01 ± 0.62 and 1.87 ± 0.36 on the left side respectively. Motor points (Pm) predominated in 64 % in the middle third of the EHB muscle and in 64 % in the proximal third of the EDB muscle. These results are a significant contribution both for those who perform orthopedic surgery and for detailed knowledge of the dorsal foot anatomy.

Biometría del músculo grácil: pedículos vasculares e inervación en un grupo de individuos brasileños / Biometric characteristics of the gracilis muscle: vascular pedicles and innervation in a group of Brazilian individuals

El músculo grácil (MG) está ubicado en la cara medial del muslo, medial y posterior al aductor largo en su parte proximal. Se origina a nivel del pubis y se inserta en la cara medial de la tibia, en su parte superior. Como colgajo libre funcional ha sido uno de los injertos más utilizados en reconstrucciones diversas, tales como pene, perineo, vagina, pierna, plexo braquial, parálisis facial, lesiones rectales, entre otras. Basado en lo anterior, el objetivo de este estudio fue complementar la anatomía del MG tanto en sus dimensiones como en sus pedículos vasculares e inervación, estableciendo las relaciones biométricas existentes, contribuyendo a la anatomía quirúrgica, en su uso como injerto. Para ello, se utilizaron 30 miembros inferiores de 20 cadáveres de individuos adultos, brasileños, de sexo masculino, 14 derechos y 16 izquierdos; 17 fijados en formol y 13 en glicerina. Se dividió al muslo en 4 cuartiles enumerados de proximal a distal como C1,C2,C3 y C4. Se contabilizó el número de pedículos y se nombraron como pedículo principal (PP), pedículo menor 1 (Pm1), pedículo menor 2 (Pm2) y pedículo menor 3 (Pm3). La longitud media del GM fue de 42,25 cm ± 2,35 cm y su ancho promedio de 32,90 ± 4,86 mm. Con respecto a los pedículos vasculares se encontró un pedículo en 10/30 casos (33,3 %); un pedículo principal y uno menor en 10/30 (33,3 %); un pedículo principal y dos menores en 8/30 (26,7 %) y un pedículo principal y tres menores en 2/30 (6,7 %). Su inervación siempre procedió del ramo anterior del nervio obturador (RaNO). El punto motor se encontró a una distancia promedio de 7,94 mm proximal al ingreso del pedículo principal en el MG. Los registros biométricos están expresados en tablas. Los resultados obtenidos aportarán al conocimiento anatómico, pudiendo ser utilizados como soporte morfológico a los procedimientos quirúrgicos que involucren al músculo grácil.

The gracilis muscle (GM) is located in the medial aspect of the thigh, medial and posterior to the long adductor in its proximal part. It originates at the pubic level and is inserted in the medial face of the tibia, in its upper part. As a functional free flap, it has been one of the most co mmonly used grafts in various reconstructions, such as penis, perineum, vagina, leg, brachial plexus, facial paralysis, rectal lesions, among others. Based on the above, the objective of this study was to complement the anatomy of the GM both in its dimensions and in its vascular pedicles and innervation, establishing the existing biometric relationships, contributing to the surgical anatomy, in its use as a graft. For this, 30 lower limbs of 20 bodies of adult, Brazilian, male, 14 right and 16 left individuals were used; 17 fixed in formaldehyde and 13 in glycerin. The thigh was divided into 4 quartiles listed from proximal to distal such as C1, C2, C3 and C4. The number of pedicles was counted and they were named as principal pedicle (PP), minor pedicle 1 (mP1), minor pedicle 2 (mP2) and minor pedicle 3 (mP3). The average length of the GM was 42.25 cm ± 2.35 cm and its average width was 32.90 ± 4.86 mm. With respect to vascular pedicles, a pedicle was found in 10/30 cases (33.3 %); one PP and one mP in 10/30 (33.3 %); one PP and two mP in 8/30 (26.7 %) and one PP and three mP in 2/30 (6.7 %). Its innervation always came from the anterior branch of the obturator nerve (aBON). The motor point was found at an average distance of 7.94 mm proximal to the entry of the PP in the GM. Biometric records are expressed in tables. The results obtained will contribute to anatomical knowledge, and can be used as morphological support for surgical procedures that involve the GM.

Fibras musculares cardíacas en las cúspides de la valva atrioventricular izquierda humana / Cardiac muscle fibers at the cusps of the human left atrioventricular valve

Las valvas cardíacas y especialmente la valva atrioventricular izquierda (VAVI) ha sido considerada por largo tiempo, como una estructura pasiva. Sin embargo, han surgido nuevas teorías que reconocen a esta estructura como una "valva viva", con un funcionamiento de mayor autonomía y dinámico. En esta línea, existen estudios en donde se ha concluido que la ausencia de tejidos contráctiles en una valva, generan ondulaciones no fisiológicas. Por el contrario, se ha señalado la presencia de tejido contráctil en la valva, lo que refleja una activación ondulante. Basado en lo anterior, el objetivo del presente estudio fue determinar la presencia de fibras musculares cardíacas en las cúspides de la VAVI. Se utilizaron 12 cúspides, 6 anteriores y 6 posteriores, de 7 cadáveres adultos (4) y lactantes (3) de distintas edades, sin patologías cardíacas. Las muestras pertenecían a la Facultad de Medicina de la Universidad Estadual de Ciencias da Saúde de Alagoas, Maceió, Brasil. Estas muestras fueron tratadas con procesamiento histológico de rutina. Los hallazgos morfológicos a un aumento de 4x mostraron células musculares que fueron visibles principalmente por el lado atrial en la totalidad de las cúspides, tanto inmersas en el tejido conectivo denso del anillo fibroso como en el tejido conectivo laxo. Al verificar la naturaleza de las fibras con un aumento mayor (100x), se detectaron estrías transversales en todas las muestras estudiadas, lo cual afirma la presencia de fibras musculares estríadas cardíacas en la VAVI. Los resultados obtenidos aportan al conocimiento de la microestructura y tejido contráctil de las cúspides de la VAVI. Por lo tanto, resulta de gran relevancia seguir profundizando en los conocimientos morfológicos de la VAVI, para sentar una base sólida sobre la microestructura contráctil en los diferentes estadíos del ser humano.

Cardiac valves and particularly, the left atrioventricular valve (LAVV) have long been considered passive structures. Nonetheless, there are more recent hypothesis that recognize this structure as a "living valve", with greater autonomy and dynamic function. Along these lines, some studies have concluded that the absence of contractile tissues in a valve, generates non-physiological undulations. In contrast, the presence of contractile tissue in the valve has been reported, reflecting a waving activation. Based on the above, the objective of the present study was to determine the presence of cardiac muscle fibers in the cusps of the LAVV. 12 cusps, 6 anterior and 6 posterior. Therefore, 7 adult (4) and lactating (3) bodies of different ages without cardiac pathologies were used. The samples belonged to the Faculty of Medicine of the Universidade de Ciencias da Saude de Alagos, Maceió, Brazil. The samples were treated with routine histological processing. Morphological findings at an increase of 4x showed muscle cells that were visible mainly from the atrial side in all the cusps, both immersed in the dense connective tissue of the fibrous ring and in loose connective tissue. Transverse striations were detected in all samples studied, when verifying the nature of the fibers with greater increase (100x), confirming the presence of cardiac striated muscle fibers in the LAVV. The results obtained contribute to the knowledge of the microstructure and contractile tissue of the LAVV cusps. Therefore it is relevant to further morphological knowledge of this valve, in order to build a solid foundation on the contractile microstructure in the different stages of the human development.

Origen del nervio subescapular inferior, patrones de ramificación y su contribución a la inervación del músculo subescapular / Origin of the inferior subscapular nerve, branching patterns and its contribution to the subscapular muscle innervation

El nervio subescapular inferior (NSI) inerva parcialmente al músculo subescapular (MSe) e inerva también al músculo redondo mayor (MRM). Diversas publicaciones determinan amplia variación en su origen en el Plexo Braquial (PB), pero existe poca evidencia de estas variaciones y del patrón de inervación del MSe y MRM en individuos latinoamericanos. El propósito de este estudio fue describir el origen del NSI en el PB, determinar número de ramos que le entrega al MSe y los patrones de ramificación. Se utilizaron 30 miembros superiores de individuos adultos, Brasileños; 13 del lado derecho y 17 del izquierdo, fijados en formaldehido al 10 %. Se disecaron las regiones axilares para exponer el fascículo posterior del plexo braquial (FPPB) y sus ramos. Se determinó si el origen del NSI era individual o procedía de un tronco común. Se cuantificó el número de ramos para el MSe, estableciendo patrones de ramificación. El NSI y sus ramos se agruparon según su origen y ramificación. En 3 de los casos (10 %) el NSI procedía de un tronco común con el nervio toracodorsal (NTD), 2 del lado izquierdo (6,6 %) y 1 del derecho (3,3 %); en 27 casos (90 %) procedía del nervio axilar (NAx), 15 del lado izquierdo (50 %) y 12 del derecho (40 %). En ningún caso, el origen fue directo del FPPB. Además, se cuantificó el número de ramos que aportaba a la inervación del MSe, observándose un promedio de 4 ramos (de 1 a 8 ramos) para el MSe. Se identificaron 4 patrones de ramificación del NSI hacia el MSe y el MRM. Tanto el origen como la distribución del NSI presentaron variaciones. Los datos aportados complementarán los conocimientos para la correcta enseñanza, el oportuno diagnóstico y la buena práctica quirúrgica de la zona axilar.

The inferior subscapular nerve (ISN) partially innervates the subscapular muscle (SbM) and also innervates the teres major muscle (TMM). Several publications determine wide variation in their origin from Brachial Plexus (BP), but there is little evidence of these variations and the innervation pattern of SbM and TMMin Latin American individuals. The purpose of this study was to describe the origin of the ISN from PB, to determine the number of branches that it gives to the SbM and the branching patterns. 30 upper limbs of cadavers of the Brazilian adult individuals were used; 13 on the right side and 17 on the left, fixed in 10 % formaldehyde. The axillary regions were dissected to expose the posterior fascicle of the brachial plexus (PFBP) and its branches. It was determined whether the origin of the NSI was individual or came from a common trunk. The number of branches for the SbM was quantified, establishing branching patterns. The ISN and its branches were grouped according to their origin and branching. In 3 of the cases (10 %) the ISN came from a common trunk with the thoracodorsal nerve (TDN), 2 from the left side (6.6 %) and 1 from the right side (3.3 %); in 27 cases (90 %) it came from the axillary nerve (AxN), 15 from the left side (50 %) and 12 from the right side (40 %). In no case, the origin was direct from the PFBP. In addition, the number of branches that contributed to the innervation of the SbM was quantified, with an average of 4 branches (from 1 to 8 branches) being observed for the SbM. Four branching patterns of the ISN towards the SbM and the TMM were identified. Both the origin and the distribution of the ISN presented many variations. The data provided will complement the knowledge for proper teaching, timely diagnosis and good surgical practice of the axillary area.

Localización biométrica de los puntos motores del músculo cuádriceps femoral de individuos brasileños / Biometric localization of the motor points of the femoral quadriceps muscle of Brazilian individuals

El músculo cuadríceps femoral es un músculo que participa principalmente en los movimientos de la rodilla y también en la cadera, pudiendo ser afectado por alteraciones en el trofismo muscular, tras lesiones de estas articulaciones o afecciones en el tono muscular, como la espasticidad, tras lesiones cerebrovasculares. Cada una de sus cabezas está inervada por ramos del nervio femoral. El presente estudio tuvo por objetivo la identificación y medición de la distancia de los puntos motores (Pm) del músculo cuadríceps femoral, en relación a estructuras anatómicas de relevancia clínica. Se utilizaron 30 miembros inferiores de 23 cadáveres formolizados, de individuos brasileños adultos. El estudio fue realizado en la Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, Brasil. Se realizó la disección por planos en la zona medial, anterior y lateral del muslo, identificando a los ramos del nervio femoral para cada componente, músculos recto femoral (mRf), vasto medial (mVm), vasto intermedio (mVint) y vasto lateral (mVlat), localizando cada uno de los Pm. Las mediciones se realizaron con un cáliper marca Mitutoyo de 0,05 mm de precisión. Los datos obtenidos fueron tratados estadísticamente, utilizando para ello, el software STATA (versión 14.1). El mRf, tuvo un promedio de 2,45 ± 1,39 Pm, estando la gran mayoría de los Pm (63 %), en la zona distal del tercio proximal del muslo; el mVm presentó 4,42 ± 2,74 Pm en promedio, encontrándose el 41 % de ellos en el tercio medio del muslo, zona distal; el mVint tuvo 3,99 ± 2,34 Pm en promedio y el 58 % de ellos, se localizaron en la zona proximal del tercio medio del muslo; el mVlat presentó un promedio de 3,88 ± 2,37 Pm y el 50 % de éstos se encontraron en del tercio proximal del muslo. La localización biométrica de los Pm se informa en resultados. La ubicación biométrica de los Pm, favorecerá el quehacer, tanto clínico como quirúrgico, de la zona anterior del muslo.

The quadriceps femoris muscle is a muscle that participates mainly in the movements of the knee and also in the hip, being able to be affected by alterations in muscle trophism, after injuries of these joints or muscular tone conditions, such as spasticity, after injuries cerebrovascular. Each of its heads is innervated by branches of the femoral nerve. The objective of this study was to identify and measure the distance of the motor points (MP) of the quadriceps femoris muscle, in relation to anatomical structures of clinical relevance. Thirty lower limbs of 23 formolized corpses of adult Brazilian individuals were used. The study was conducted at the State University of Ciências da Saúde de Alagoas (UNCISAL), Maceió, Brazil. The dissection was performed by planes in the medial, anterior and lateral thigh, identifying the femoral nerve branches for each component, rectus femoris muscles (Rfm), medial vastus (mVm), vastus intermedius (intVm) and vastus lateralis ( latVm), locating each of the MP. The measurements were made with a Mitutoyo caliper of 0.05 mm accuracy. The data obtained were treated statistically, using the STATA software (version 14.1). The Rfm had an average of 2.45 ± 1.39 MP, the great majority of the MP (63 %) being in the distal area of the proximal third of the thigh; the mVm presented 4.42 ± 2.74 MP on average, with 41 % of them in the middle third of the thigh, distal zone; the intVm had 3.99 + 2.34 MP on average and 58 % of them were located in the proximal area of the middle third of the thigh; the latVm presented an average of 3.88 ± 2.37 MP and 50 % of these were found in the proximal third of the thigh. The biometric localization of the MP is reported in results. The biometric location of the MP, will favor the task, both clinical and surgical of the anterior thigh area.

Cervical vertebral osteomyelitis secondary to Streptococcus equi infection in an adult horse - case report / Osteomielite vertebral cervical secundária à infecção por Streptococcus equi em um cavalo adulto - relato de caso

A 15-year-old, mixed breed, male horse was attended with a history of multiple abscesses in the cervical region with a three-year evolution. Upon admission, three fistulous tracts with drainage of purulent secretions in the cervical region, low body score, restriction of cervical movements, and painful sensitivity to palpation were observed. The horse was diagnosed with osteomyelitis secondary to Streptococcus equi infection. The initial treatment was antibiotic therapy and local curative. Owing to the lack of response, surgical debridement was performed. An initial favorable response was observed; however, after 4 months, drainage recurred, and the animal was euthanized. A post-mortem computed tomography scan was performed to obtain details of the injury. Cervical osteomyelitis is rare, and its occurrence through hematogenous spread in adult horses and the tomographic findings had not been reported previously. The long period of evolution, difficulty in performing an aggressive debridement, and the presence of multi-drug resistant bacteria contributed to the negative outcome.(AU)

Um equino macho, sem raça definida, de 15 anos de idade, foi atendido com histórico de múltiplos abscessos cervicais com evolução de três anos. Na admissão, foram observados: três trajetos fistulosos com drenagem de material purulento na região cervical; baixo escore corporal; restrição de movimentos cervicais; e sensibilidade dolorosa à palpação da região. Foi diagnosticada osteomielite vertebral cervical secundária à infecção por Streptococcus equi. O tratamento inicial consistiu na administração de antibióticos e curativo local. Na ausência de resposta à terapia, realizou-se o debridamento cirúrgico. Inicialmente, obteve-se uma resposta favorável, entretanto, após quatro meses, houve recidiva da lesão e o animal foi submetido à eutanásia. Realizou-se tomografia computadorizada no post mortem para detalhamento da lesão. A osteomielite vertebral cervical é rara, e sua ocorrência por meio de disseminação hematógena em animais adultos não foi previamente reportada. O longo período de evolução, aliado à dificuldade de realização de um debridamento agressivo, e a característica multirresistente do agente etiológico contribuíram para o desfecho negativo do caso.(AU)

Effects of tenectomy of the medial head of the deep digital flexor on the hindlimbs of healthy horses / Efeitos da tenectomia da cabeça medial do tendão flexor digital profundo nos membros posterior de cavalos saudáveis

The tenectomy of the medial head of the deep digital flexor (TMHDDF) is a minimally studied surgery used in cases of dorsal subluxation of the proximal interphalangeal joint of the hindlimb in horses. The TMHDDF was evaluated in six healthy horses by the degree of lameness, perimeter of the surgical site, the angle of the distal articular joints, and the linear and angular measures of the hoof. Thus, TMHDDF of the right hindlimb was performed and the contralateral limb was used as a control. Both, right and left limbs were evaluated before surgery, as well as at 15, 30, and 60 days after surgery aiming to evaluate the effects of the surgical procedure in healthy limbs. Data were compared by analysis of variance regarding days and limbs. Values below the significant level (P< 0.05) were analyzed using the Tukey's test. TMHDDF caused a mild increase of the toe length and the height of lateral heel (0.2cm in both), as well as a decrease of the angle of the proximal interphalangeal joint (2°) when comparing the left hindlimb to the right hindlimb, 30 and 60 days after surgery. Overall, TMHDDF did not cause significant changes in the evaluated variables up to the 60 days of surgery.(AU)

A tenectomia da cabeça medial do flexor digital profundo (TCMFDP) é uma técnica cirúrgica pouco estudada, indicada para equinos com subluxação dorsal da articulação interfalângica proximal do membro pélvico. A TCMFDP foi avaliada em seis equinos hígidos no grau de claudicação; na perimetria da área operada; nos ângulos articulares distais; e nas medidas lineares e angulares de parâmetros dos cascos. Nesse sentido, foi realizada a TCMFDP do membro pélvico direito, permanecendo o esquerdo como controle. Ambos os membros foram avaliados nos momentos pré-operatório (0) e 15, 30 e 60 dias após a cirurgia, sendo objetivo avaliar os efeitos do procedimento cirúrgico em membros hígidos. Para comparação dos dados entre momentos e membros, foi realizada análise de variância. Os valores inferiores ao de significância (P<0,050) foram submetidos ao teste de Tukey. A TCMFDP provocou discreto aumento (0,2cm, em ambos) do comprimento de pinça e da altura do talão lateral e redução no ângulo da articulação interfalângica proximal (2°) na comparação com o membro pélvico esquerdo aos 30 e 60 dias após a cirurgia no contralateral. Em geral, a TCMFDP não causou alterações influentes nos aspectos avaliados até 60 dias do experimento.(AU)

Recurrent laryngeal neuropathy secondary to nerve compression by melanomas - case report / Neuropatia laríngea recorrente secundária à compressão por melanomas - relato de caso

Recurrent laryngeal neuropathy (RLN) etiology can be acquired, iatrogenic or idiopathic. There are no previous reports of RLN caused by recurrent laryngeal nerve compression by melanomas. This report describes a horse presenting severe dyspnea and progressive weight loss. Physical exam demonstrated tachycardia, tachypnea, inspiratory dyspnea at rest, neck extension and mydriasis. Temporary tracheotomy was performed and videoendoscopic examination diagnosed grade IV laryngeal paralysis. The animal came suddenly to death by suppurative bacterial pneumonia. At necropsy, it was possible to observe multiple melanotic epithelioid melanoma nodules compressing the recurrent laryngeal nerve, alongside with lung and parotid metastasis. This finding emphasizes the importance of establishing a differential diagnosis for tumor mass compression in the etiology of RLN, especially melanomas in gray horses, with or without cutaneous manifestations of masses.(AU)

A neuropatia laríngea recorrente (NLR) pode apresentar etiologia adquirida, iatrogênica ou idiopática. Não há relatos prévios da ocorrência da NLR causada pela compressão do nervo laríngeo recorrente por melanomas. Este relato descreve um equino apresentando dispneia grave e perda de peso progressiva. O exame físico demonstrou taquicardia, taquipneia, dispneia inspiratória em repouso, extensão do pescoço e midríase. Foi realizada traqueotomia temporária e exame videoendoscópico, mediante o qual se diagnosticou paralisia laríngea grau IV. O animal veio a óbito por pneumonia bacteriana supurativa. Na necropsia, foi possível observar múltiplos nódulos de melanoma epitelioide amelanótico comprimindo o nervo laríngeo recorrente, juntamente com metástases pulmonares e parotídeas. Este achado enfatiza a importância de estabelecer um diagnóstico diferencial nos casos de NLR, pensando-se na compressão nervosa por massas tumorais, especialmente melanomas em cavalos tordilhos, com ou sem manifestações cutâneas de massas.(AU)

Inervación del músculo extensor radial largo del carpo en individuos brasileños: biometría de su origen y distribución / Innervation of the extensor carpi radialis longus muscle in Brazilian individuals: biometry of its origin and distribution

El músculo extensor radial largo del carpo (MERLC) es un músculo localizado en el compartimiento posterior (extensor-supinador) del antebrazo y tiene gran importancia en el cierre del puño. Hay pocos estudios biométricos con respecto al punto de origen de sus ramos de inervación, así como sobre la distribución de los mismos. Basado en lo anterior, se estudiaron 30 miembros superiores, formolizados, de individuos adultos Brasileños, de la Facultad de Medicina de la Universidad Estadual de Ciencias da Saúde de Alagoas, Maceió, Brasil. Luego de localizar el nervio, se midió la distancia entre el origen del ramo primario y el de los puntos motores respecto a la línea biepicondílea (LBE), los cuales fueron visualizados y disecados utilizando una lupa. El nervio en cuestión, se observó a nivel del brazo o proximal a LBE en 28 casos (93 %) y los 2 restantes a nivel de esta línea (7 %). Los ramos para el ERLC se originaron a partir del nervio radial, observando un ramo primario en 20 miembros (80 %), y en los restantes 10 (20 %) se observaron 2 ramos primarios, promediando 1,3 ramos (DS 0,5). El origen más proximal del primer ramo primario (RP) independiente de que si existían 1 o 2 fue en promedio 3 cm (DS 1,0) proximal a LBE. El PM más distal, se ubicó distal a LBE en 24 casos con un promedio de 1,9 cm (DS 1,0); localización a nivel de LBE en 3 casos. Sólo en 3 casos el PM más distal se encontró proximal a LBE, en un promedio de 0,8 cm (DS 0,5). La distribución de puntos motores fue variable, ya que muchas veces los RP se bifurcaban en ramos secundarios y éstos, a su vez se dividían hasta 6 veces en ramos terciarios que penetraban en el músculo. El conocimiento biométrico del origen del nervio del MERLC, así como su distribución, es un aporte importante al área anátomo-quirúrgica, así como, su utilización en bloqueos nerviosos, transferencias nerviosas y zonas de ubicación de electrodos con propósitos de estimulación eléctrica en pacientes que necesiten rehabilitar la acción de musculatura extensora radial lesionada.

The extensor carpi radialis longus muscle (ECRLm) is located in the posterior compartment (extensorsupinator) of the forearm and has great importance in the closure of the hand. There are few biometric studies with respect to the point of origin of their branches of innervation, as well as on the distribution of them. For this study, 30 upper limbs, formalized, of Brazilian adult individuals were used, from the Faculty of Medicine of the Universidad Estadual de Ciencias da Saúde de Alagoas, Maceió, Brazil. After locating the nerve, we measured the distance between the origin of the primary branch and that of the motor points with respect to biepicondilar line (BEl), which were visualized and dissected using a magnifying glass. The nerve in question was observed at the level of the arm or proximal to BEl in 28 cases (93 %) and the remaining 2 at the level of this line (7 %). The branches for the ECRLm originated from the radial nerve, observing a primary branch in 20 limbs (80 %), and in the remaining 10 (20 %) two primary branches were observed, averaging 1.3 branches (SD 0.5). The most proximal origin of the first primary branch (PB) independent of whether there was 1 or 2 was on average 3 cm (SD 1.0) proximal to BEl. The most distal MP was distal to BEl in 24 cases with an average of 1.9 cm (SD 1.0); location at the BEl level in 3 cases. Only in 3 cases was the most distal MP found proximal to BEl, an average of 0.8 cm (SD 0.5). The distribution of motor points was variable, since many times the PB bifurcated into secondary branches and these, in turn, could divide up to 6 times in tertiary branches that penetrated in the muscle. The biometric knowledge of the origin of the nerve of the ECRLm, as well as its distribution, is an important contribution to the anatomo-surgical area, as well as its use in nerve blocks, nerve transfers and electrode placement areas for purposes of electrical stimulation in patients they need to rehabilitate the action of injured radial extensor musculature.

Ramos de inervación y distribución del nervio femoral en el músculo cuádriceps femoral de individuos brasileños / Innervation branches and distribution of the femoral nerve in the quadriceps femoral muscle in Brazilian individuals

El nervio femoral (NF) se describe originándose desde el plexo lumbar (L2, L3 y L4) y en su recorrido emite ramos destinados a cada una de las porciones del músculo cuádriceps femoral (mCF), los cuales nacen de forma aislada o bien, a partir de troncos comunes. El detalle de la distribución del NF en el mCF, permite disminuir riesgos asociados a diferentes intervenciones quirúrgicas llevadas a cabo en la zona anterior del muslo. Con el propósito describir la distribución del NF en los componentes del mCf. Se utilizaron 15 miembros inferiores formolizados, 10 del lado izquierdo y 5 del lado derecho, de individuos adultos, Brasileños, localizados en los Laboratorios de Anatomía de la Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, Brasil. El NF se clasificó en cuatro tipos de acuerdo a su ramificación y distribución. El Tipo II se subdividió en 3 subtipos y se presentó en 60 % de las muestras y el tipo III en 20 %. El NF se dividió de medial a lateral hasta en 5 ramos (R1,R2,R3,R4,R5), donde el R1 fue el más medial. El R1 dio origen en promedio a 2,47 ramos secundarios (Rs) y a 2,58 ramos terciarios (Rt), en 13,3 % el R1 no emitió Rs. En 73,3 % inervó a sólo a un componente del mCF; el R2 dio origen en promedio a 3,93 Rs y a 3,58 Rt. En 26,7 % inervó a sólo a un componente del mCF; el R3 dio origen en promedio a 3,33 Rs y a 2,0 Rt. En 80 % inervó a sólo a un componente del mCF. La distribución de R4 y R5 se muestran en el texto. Resultados biométricos de origen, diámetro y longitud de los ramos mencionados son mostrados en tablas. Los datos obtenidos en esta investigación complementan el conocimiento de la anatomía regional, pudiendo ser utilizados por la clínica quirúrgica y para efectuar tratamientos que mejoren trastornos neurológicos que afectan a la región.

The femoral nerve (FN) is described as originating from the lumbar plexus (L2, L3 and L4) and in its course it emits branches destined to each one of the quadriceps femoral muscle (QFm), which are originated in an isolated way or, from common trunks. The detail of the distribution of the FN in the QFm, allows to diminish risks associated with different surgical interventions carried out in the anterior thigh area. With the purpose of describing the distribution of FN in the QFm components. Fifteen formalized lower limbs were used, 10 on the left side and 5 on the right side of adult individuals, Brazilians, located in the Anatomy Laboratories of the State University of Ciências da Saúde de Alagoas (UNCISAL) , Maceió, Brazil. The FN was classified into four types according to its branch and distribution. Type II was subdivided into 3 subtypes and presented in 60 % of the samples and type III in 20 %. The FN was divided from medial to lateral in 5 branches (B1, B2, B3, B4, B5), where B1 was the most medial. The B1 gave rise to an average of 2.47 secondary branches (sB) and to 2.58 tertiary branches (tB), in 13.3 % the B1 did not emit sB. In 73.3 %, only one component of the QFm was invested; B2 gave rise to an average of 3.93 sB and 3.58 tB. In 26.7 %, it invested only one component of the QFm; B3 gave rise to an average of 3.33 sB and 2.0 tB. In 80 %, it invested only one component of the QFm. The distribution of B4 and B5 are shown in the text. Biometric results of origin, diameter and length of the mentioned branches are shown in tables. The data obtained in this research complements the knowledge of the regional anatomy, being able to be used by the surgical clinic and to carry out treatments that improve neurological disorders that affect the region.

Estudo da técnica de venografia dos dígitos de vacas / Study of Venography technique in digits of cows

O objetivo deste estudo foi descrever a técnica de venografia retrógrada podal em vacas, comparando os acessos da veia digital dorsal comum III com a digital comum II ou IV, nos membros torácicos e pélvicos, mediante a administração de dois diferentes volumes de contraste. Foram utilizados 53 membros torácicos e pélvicos de 14 vacas, com o torniquete de borracha posicionado a 5cm proximal aosparadígitos. Administraram-se 10mL do diatrizoato de meglumina em 24 membros (grupo 1), sendo 13 na veia digital dorsal comum III pelo acesso 1 (A1) e 11 na digital II ou IV no acesso 2 (A2). No grupo 2, administraram-se 20mL em 29 membros, sendo 15 pelo A1 e 19 pelo A2. Após a administração do contraste, as radiografias foram repetidas a cada 20 segundos até 120 segundos. O grau de preenchimento vascular foi maior no grupo 2, não diferindo entre membros e acessos venosos. Conclui-se que a administração de 20mL de contraste apresentou melhor preenchimento vascular e radiopacidade, não havendo diferença entre 20 e 120 segundos após a administração do contraste na qualidade radiográfica, independentemente do acesso venoso.(AU)

The aim of this study was to describe the technique of retrograde venography foot in cows, comparing the approaches of the dorsal common digital vein III with the digital commons II or IV, thoracic and pelvic by administering two different volumes of contrast members. Fifty three fore and hindlimbs of 14 cows were used, a rubber tourniquet was placed at 5cm above accessory digit. Diatrizoatemeglumine was administered at 10mL to 24 members (group 1), 13 dorsal common digital vein III for access 1 (A1), and 11 digital II or IV access 2 (A2). In group 2 20mL was administered to 29 members, 15 by 19 in A1 and A2. After contrast administration, the radiographs were repeated every 20 seconds until 120 seconds. The degree of vascular filling was greater in group 2, independent of venous access, member or moment. There was no significant difference in the degree of radiopacity of radiographic images when compared to the venous access, time and a member of both groups. We conclude that administration of 20mL of contrast showed better vascular filling and radiopacity, with no difference between 20 and 120 seconds after contrast administration in independent radiographic quality venous access.(AU)

Localización biométrica de los puntos motores en el músculo tríceps braquial de individuos brasileños / Biometric location of motor points in the brachial triceps muscle of Brazilian individuals

RESUMEN: El músculo tríceps braquial, es el motor primario para el movimiento de extensión de codo, por lo que una lesión que afecte su función perjudicaría enormemente la calidad de vida de los afectados. El conocimiento de su inervación y la localización biométrica de sus puntos motores, es una herramienta útil en terapias de electro estimulación muscular. El objetivo del estudio fue determinar el número y localización de los puntos motores de este músculo. Para ello, se utilizaron 30 miembros superiores de individuos brasileños, a los cuales se les realizó una disección detallada del compartimiento posterior del brazo. Se registró el número de ramos, puntos motores y localización biométrica de cada uno de los ramos destinados a las cabezas del músculo triceps braquial. Se utilizó como punto de referencia una Línea biepicondilar, trazada entre los epicóndilos humerales. En todos los casos este músculo estaba inervado por el nervio radial. El promedio de puntos motores (PM) para la cabeza larga del músculo (CL) fue de 3,9 ± 1,4; 4,8 ± 1,2 para la cabeza medial (CM) y 4,1 ± 1,4 para la cabeza lateral (CLat). Los puntos motores se concentraron preferentemente en el tercio medio del brazo, tanto a nivel general, como también por cada cabeza. Los datos biométricos aportados complementarán el conocimiento de la inervación de este músculo y favorecerá una mejor comprensión y elección de tratamientos frente a una patología.

SUMMARY: The triceps brachii muscle is the primary motor for elbow extension movement, so a lesion that affects its function would greatly harm the quality of life of those affected. The knowledge of its innervation and the biometric localization of its motor points is a useful tool in electro-stimulation muscular therapies. The objective of the study was to determine the number of branches and location of the motor points of this muscle. To this end, 30 superior members of Brazilian individuals were used, to whom a detailed dissection of the posterior compartment of the arm was performed. The number of branches, motor points and biometric location of each of the branches destined for the three heads of the brachial triceps muscle was recorded. A biepicondilar line, traced between the humeral epicondyles, was used as a reference point. In all cases, this muscle was innervated by the radial nerve. The average motor points for the long head of the muscle (LH) was 3.9 + 1.4; for the medial head (MH) was 4.8 + 1.2 and for the lateral head (LatH) was 4.1+1.4. The motor points were concentrated mainly in the middle third of the arm, both at a general level, and also for each head. The biometric data provided will complement the knowledge of the innervation of this muscle and will favor a better understanding and choice of treatments for a pathology.

Nervio interóseo anterior: trayecto, distribución e implicancias clínicas / Anterior interosseous nerve: course, distribution and clinical implications

El principal ramo del nervio mediano en el antebrazo es el nervio interóseo anterior (NIA), el cual inerva la mayoría de los músculos del plano profundo del compartimiento anterior del antebrazo. Existen diferentes descripciones sobre el punto de origen y su trayecto del NIA, así como también respecto a ramos comunicantes de este, con otros nervios del antebrazo. Algunas de estas descripciones concuerdan de que el NIA pueda atraparse en su tránsito por los arcos formados en las cabezas de origen de los músculos pronador redondo y flexor superficial de los dedos. El objetivo fue determinar el punto de origen, trayecto, músculos inervados y presencia de ramos comunicantes del NIA con otros nervios del antebrazo. Se utilizaron 30 antebrazos de cadáveres adultos brasileños fijados en formalina pertenecientes al laboratorio de anatomía de la UNCISAL, Maceió, Brasil. El punto de origen del NIA alcanzó un promedio de 46 mm con una desviación estándar de 17,54 mm, distal a la línea biepicondilar. En un 37 % de los casos, este nervio se originó en el tramo existente entre los arcos musculares mencionados y en un 23 % surgió proximal a la ubicación de estos. En todos los casos, el NIA inervó a los músculos flexor profundo de los dedos y pronador cuadrado y en un 93 % también inervó al músculo flexor largo del pulgar. Un caso presentó ramo comunicante entre el NIA y el nervio ulnar. En el 10 % de los casos, presentó la variante muscular cabeza accesoria del músculo flexor largo del pulgar. Todos estos hallazgos deben considerarse al momento de diagnosticar correctamente los diferentes síndromes de atrapamiento que afectan tanto al NIA como al nervio mediano en la región cubital y en el antebrazo. Así mismo, el éxito de procedimientos quirúrgicos de estas regiones está supeditado a un conocimiento detallado del trayecto y distribución de estos nervios.

The main branch of the median nerve in the forearm is the anterior interosseous nerve (NIA), which innervates most of the muscles of the deep plane of the anterior compartment of the forearm. There are different descriptions about the point of origin and its course, which can determine a potential entrapment of it in its transit through the arcs formed in the heads of origin of the pronator round and flexor digitorum of the fingers muscles, as well as with regard to communicating branches of the NIA with other nerves of the forearm. The aim was to determine the point of origin, course, innervated muscles and presence of communicating branches of the NIA with other nerves of the forearm. 30 forearms of Brazilian adult corpses fixed in formalin belonging to the UNCISAL anatomy laboratory were used, Maceió, Brazil. The point of origin of the NIA reached an average of 46 mm with a standard deviation of 17.54 mm, distal to the biepicondilar line. In 37 % of the cases, this nerve originated in the existing section of the muscular arches mentioned and in 23 % it arose proximal to the location of these. In all cases, the NIA inervated the flexor digitorum profundus and pronator quadratus and 93 % also inervated the flexor pollicis longus. One case presented a communicating branch between the NIA and the ulnar nerve. In 10 % of the cases, he presented the variant muscle accessory head of the flexor pollicis longus. All these findings should be considered at the time of correctly diagnosing the different entrapment syndromes that affect both the NIA and the median nerve in the ulnar region and the forearm. Likewise, the success of surgical procedures in these regions is subject to a detailed knowledge of the course and distribution of these nerves.

Inervación del músculo extensor radial corto del carpo en individuos brasileños: biometría de su origen y distribución / Innervation of the extensor carpi radialis brevis muscle in Brazilian individuals: biometry of its origin and distribution

El ramo de inervación para el músculo extensor radial corto del carpo (MERCC) ha sido utilizado para restablecer funciones de la musculatura del miembro superior en pacientes con lesiones medulares, del plexo braquial o de sus ramos terminales. El origen del nervio para el MERCC es variable, pudiendo originarse desde el tronco del nervio radial (NR), del ramo profundo de este nervio (RPNR) o del ramo superficial del mismo (RSNR). Con el propósito de complementar la anatomía sobre el origen y distribución del ramo para el MERCC, se utilizaron 30 miembros superiores, formolizados, de cadáveres de individuos Brasileños, localizados en los laboratorios de Anatomía de la Universidad Estadual de Ciencias da Saude, Maceió, Brasil. A través de disección se localizó el músculo y su inervación, determinando su origen, así como su distribución. Para efectuar la biometría, se consideró como referencia una línea transversal que pasaba entre las partes más prominentes de los epicóndilos lateral y medial del húmero (LBE), registrando la distancia entre esta línea y el punto de origen de este ramo muscular, así como la distancia entre la LBE y los puntos motores. El nervio para el MERCC se originó del RPNR en 50 % de los casos; desde el tronco principal del NR en 26, 7 % y desde el RSNR en 23, 3 %. La distancia entre el origen del ramo en estudio y la LBE fue en promedio de 23 ± 12 mm; la distancia entre el 1º, 2º y 3º punto motor respecto a la LBE fue de 55 ± 17 mm, 66 ± 17 mm y 79 ± 11 mm, respectivamente. La distribución de la inervación fue clasificada en 4 tipos en relación a sus puntos motores. Los resultados obtenidos son un importante aporte al conocimiento anatómico, así como a la neurocirugía en las transferencias nerviosas con propósitos de restauración de las funciones de músculos lesionados en el miembro superior.

The branch of the innervation for the extensor carpi radialis brevis muscle (ECRBm), has been used to reestablish muscle functions in the upper limbs of patients who have spinal cord injury, of the brachial plexus or its terminal branches. The origin of the ECRBm varies, and can originate from the trunk of the radial nerve (RN), from the deep branch of the radial nerve (DBRN), or from the superficial branch of the radial nerve (SBRN). In order to further complement the anatomy related to the origin and distribution of the ECRBm branch, 30 formolized upper limbs from Brazilian individuals, from the Universidad Estadual de Ciencias da Saude, Maiceió, Brazil were used. Through dissection, the muscle and its innervations was located, determining the origin of the branch as well as distribution. To determine biometry, a transversal reference line, which passed through the most prominent areas of the epicondyles of the humerus (BEL) was considered. The nerve for ECRBm originated from DBRN in 50 % of cases; from the main trunk of RN in 26.7 % and from SBRN in 23.3 %. The distance from the origin of the branch studied and the BEL was an average of 23 ± 12 mm; the distance from the first, second and third motor point to the BEL was 55 ± 17 mm, 66 ± 17 mm and 79±11 mm, respectively. The distribution of the innervation was classified in four types in relation to the motor points. The results are an important contribution to anatomical knowledge, as well as neurosurgery during nerve transfers to restore functions of damaged muscles in the upper limb.