ABSTRACT
INTRODUCCIÓN: la lesión de los vasos subclavios durante la cirugía de clavícula es una situación rara, de suceder podría resultar incluso mortal; conocer su ubicación es indispensable para minimizar ese riesgo.OBJETIVO: determinar la ubicación y la distancia de la AS y VS respecto a la clavícula. Secundariamente, identificar las características particulares que influencien la ubicación y la distancia. MATERIALES Y MÉTODO: estudio retrospectivo, AngioTAC de tórax y cuello entre 2012 y 2017; se midió la longitud de la clavícula, distancia y dirección de los vasos subclavios en cada tercio de la clavícula, como también la angulación entre una horizontal y el centro de los vasos subclavios. Resultados: 39 AngioTC, 78 hombros. Distancia AS/clavícula tercio proximal, medio y distal 32,8mm (20,3-46,3), 15,4mm (6,8-28,0) y 62,7mm (37,0-115,4) respectivamente. La distancia VS/clavícula tercio proximal, medio y distal fue: 7,4mm (1,0-19,2), 16,2mm (6,7-34,7) y 67,1mm (29,7-117,0) respectivamente. La ubicación de AS y VS con respecto a la clavícula es posterosuperior en el tercio proximal, posteroinferior en el tercio medio e inferior en el tercio distal. CONCLUSIÓN: En el tercio proximal la vena puede estar solo a 1mm de la clavícula y la arteria a 6mm en dirección antero-posterior, resultando esa zona la más peligrosa. En el tercio medio la distancia es mayor, pudiendo estar arteria y vena a solo 6mm, la dirección de brocado más peligrosa es antero-inferior con una inclinación promedio de 45° caudal. El tercio distal es el más seguro, los vasos están al menos a 30mm de distancia hacia caudal. Nivel de evidencia III.
BACKGROUND: injury to the subclavian vessels during clavicle surgery is a rare situation, if it happens it could even be fatal; knowing their location is essential to minimize that risk. OBJECTIVE: determine location and distance of the AS and VS with respect to the clavicle. Secondarily identify particular characteristics that influence location and distance. MATERIAL AND METHODS: retrospective study, AngioTAC of thorax and neck between 2012 and 2017; it was measured the length of the clavicle, distance and direction of the subclavian vessels in each third of the clavicle and angulation between a horizontal and the center of the subclavian vessels were measured. Results: 39 AngioTC, 78 shoulders. AS / clavicle third proximal, middle and distal distance 32.8mm (20.3-46.3), 15.4mm (6.8-28.0) and 62.7mm (37.0-115.4) respectively. Distance VS / clavicle third proximal, middle and distal was: 7.4mm (1.0-19.2), 16.2mm (6.7-34.7) and 67.1mm (29.7-117.0) respectively. The location of AS and VS with respect to the clavicle is posterosuperior in the proximal third, posteroinferior in the middle third and inferior in the distal third. CONCLUSION: In the proximal third the vein can be only 1mm from the clavicle and the artery to 6mm in the anterior-posterior direction, this zone is the most dangerous. In the middle third the distance is greater, artery and vein can be only to 6mm, the most dangerous drilling direction is antero-inferior with an average inclination of 45° caudal. The distal third is the safest, the vessels are at least 30mm away from the vessels. Level of evidence III.
Subject(s)
Humans , Male , Female , Subclavian Artery/diagnostic imaging , Subclavian Vein/diagnostic imaging , Clavicle/blood supply , Subclavian Artery/anatomy & histology , Subclavian Vein/anatomy & histology , Sex Factors , Retrospective Studies , Computed Tomography AngiographyABSTRACT
There is little information on the humoral response of sheep experimentally infected with Echinococcus granulosus. Thus, the objective of this study was to evaluate this response and measure its evolution. Doses of 10, 100, 1000 and 10000 E. granulosus eggs were prepared and inoculated via intraruminal puncture. Blood samples were obtained before inoculation and every 48 h after inoculation, until they became seropositive. Thereafter, they were taken monthly for the first year and then every three months until 1700 days of observation had been completed. An ELISA test, with total hydatid fluid antigen, was used for immunodiagnosis. The average optical density of the 12 inoculated sheep was found to be above the mean cutoff value 10 days after inoculation, went on increasing until 180 days after inoculation and remained above the cutoff level until the end of the observation period. This confirms that the antibody response of sheep to E. granulosus infection occurs before production of hydatid fluid and that activation, mobilization and establishment of oncospheres in the tissues generates a persistent response from the host's immune system.
Existe pouca informação sobre a resposta imune humoral de ovinos experimentalmente infectados por Echinococcus granulosus. O objetivo deste estudo é avaliar a resposta imune por anticorpos em ovinos infectados. Os ovinos receberam doses de 10, 100, 1.000 e 10.000 ovos de E. granulosus por via intrarruminal. Amostras de sangue foram colhidas antes e após infecção, a cada 48 horas, até a detecção de anticorpos anti-E. granulosus e após, colheram-se amostras mensal e trimestralmente, no primeiro ano até 1.700 dias de infecção. No imunodiagnóstico, utilizou-se o ensaio imunoenzimático indireto (ELISA-teste) e como antígeno total, líquido hidático. Na detecção de anticorpos anti-E. granulosus no soro das 12 ovelhas, a densidade ótica esteve acima do ponto de corte, após 10 dias de infecção, aumentando até 180 dias pós-infecção, e permanecendo acima desses dias até o final do experimento. Isso confirma que a resposta por anticorpos em ovinos infectados por E. granulosus antecede a produção de líquido hidático, e que a ativação, mobilidade e permanência das oncosferas nos tecidos possibilita a resposta imune dos hospedeiros.
Subject(s)
Animals , Echinococcus granulosus , Echinococcosis/veterinary , Immunity, Humoral , Sheep Diseases/immunology , Sheep Diseases/parasitology , Animal Experimentation , Echinococcosis/immunology , Random Allocation , SheepABSTRACT
Echinococcus granulosus es el agente causal de la hidatidosis clásica o equinococcosis quística. En América del Sur el ciclo más extendido es el que involucra al perro y la oveja al existir condiciones ideales para la existencia del parásito. En la Provincia de la La Pampa mantiene una presencia endémica con notificación de casos de infección humana y perros infectados con E. granulosus. En el presente trabajo se evalúa la prevalencia y distribución en el Departamento Maracó, Provincia de La Pampa. Perros de 36 establecimientos ganaderos fueron evaluados con bromhidrato de arecolina a la dosis de 3,5 mg/kg. En 27 establecimientos se detectó Taenia sp. y en tres E. granulosus. Se tomaron muestras de sangre de todos los habitantes de los establecimientos ganaderos las que fueron procesadas por enzmoinmunoensayo (ELISA). Asimismo, se efectuó un estudio retrospectivo sobre casos de hidatidosis tratados en el hospital General Pico y dos clínicas privadas. Once casos humanos fueron tratados en período 96/97 (tasa de incidencia 6,79 x 100000). La Provincia de La Pampa parece mantener una presencia endémica con notificación de casos y perros infectados. A consecuencia de ello es de interés sanitario ampliar las investigaciones a otros departamentos provinciales a los efectos de delimitar el área endémica de distribución y organizar sistemas de vigilancia epidemiológica de la enfermedad
Subject(s)
Animals , Dogs , Echinococcosis/epidemiology , Echinococcus/isolation & purification , Argentina/epidemiology , Dogs/parasitologyABSTRACT
Hydatidosis situation in the General Acha area (La Pampa province) is described herein. The work comprises a retrospective compilacion of new hydatidosis in human population, and investigation on dog echinococosis granulosus infection prevalence carried out on the basis of arecoline bromhydrate application. Sicteen human cases were detected during 1994 (incidence rate: 26,7/100,000) founding a serological prevalence of 1,3 percent. Studies on dog echinococosis have shown a prevalence rate of 2,3 percent. The epidemiological situation of hydatidosis is analyzed by comparison with values from other endemic areas. These results suggest the necessity of completing surveys in the whole provincial territory, and the implementation of educational and sanitary measures aimed to controlling this zoonosis.