ABSTRACT
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.
Subject(s)
Humans , Male , Female , Jugular Foramina/anatomy & histology , Cross-Sectional Studies , Anatomic VariationABSTRACT
Los avances tecnológicos y los cuidados respiratorios no invasivos en el tratamiento de las afecciones respiratorias en pacientes con patologías neuromusculares han contribuido a una mejor calidad de vida y sobrevida de los pacientes con enfermedades neuromusculares. Además de la capacitación de los pacientes y sus cuidadores para facilitar la estadía de los mismos en el hogar sin depender de instituciones o cuidados de enfermería permanentes y promoviendo la autonomía e integración. El objetivo de este artículo es realizar una revisión de las estrategias y tratamientos brindados a los pacientes con enfermedades neuromusculares y afecciones respiratorias. Resulta esencial que los profesionales de la salud, conozcan todas las opciones terapéuticas posibles para ofrecer a sus pacientes y sus familias, de modo que a medida que la enfermedad avance ellos puedan expresar sus voluntades en forma anticipada y sin apremios derivados de eventos "inesperados". Además es necesario impulsar un cambio de paradigma en la forma en que los profesionales de la salud ven a estos individuos.
Technological advances and proper training for patients with neuromuscular diseases and respiratory problem, including their caregivers, facilitate their stay at home and promote their autonomy and integration, without depending on hospices or permanent nursing care. The objective of this article is to review all the strategies and treatment offered to the patients with neuromuscular diseases. It is essential for health care professionals to know all the therapeutic possibilities offering for their patients and their families, so as the disease progresses it would facilitate the conscious decision-making. Also it is necessary to promote a paradigm shift in the way health professionals approach to individuals with neuromuscular diseases.
ABSTRACT
Blood samples of 189 healthy Holstein cows classified as high-producers, low-producers, or dry cows, were collected with the purpose of establishing reference values for several biochemical analytes in Mexican dairy farms. Mean values were calculated for: 1) Energy profile: glucose, cholesterol, triglycerides, ß-hydroxybutyrate, and non-esterified fatty acids, 2) Protein profile: urea, albumin, globulin, and total protein, 3) Mineral profile: calcium, phosphorus, sodium, potassium, magnesium, chlorine, carbon dioxide, bicarbonate, and anion gap, and 4) Hepatic enzyme: γ-glutamyl transpeptidase. The resulting data set was analyzed using Gaussian distribution and descriptive statistics. Confidence intervals of 95% were established. The linear relationships between the biochemical analytes were quantified, and an analysis of variance was performed to compare the mean values between the three production groups. The overall concentrations of the described analytes are consistent with values reported by international literature. However, lower values were found for urea, calcium, and sodium; higher values were found for cholesterol, and γ-glutamyl transpeptidase. Negative correlations were found between ß-hydroxybutyrate and glucose or urea, γ-glutamyl transpeptidase and urea, and bicarbonate and urea or phosphorus or anion gap. Positive correlations were found between ß-hydroxybutyrate and cholesterol or anion gap, non-esterified fatty acids and anion gap, cholesterol and globulin, different analytes of mineral profile and anion gap or urea or glucose, and between sodium and calcium. Differences among the three production groups were observed for ß-hydroxybutyrate and cholesterol concentrations. The γ-glutamyl transpeptidase concentration was similar in high and low-producing cows but was higher in comparison to serum levels of dry cows. Calcium showed differences between high-producing cows and the other two groups, and sodium showed the highest concentration in dry cows. The outcomes of this work improve the accuracy of the metabolic profiles as a tool for assessing the nutritional and health status of dairy cows.
As amostras de sangue de 189 vacas da raça Holandesa clinicamente saudáveis, classificadas em alta produção, baixa produção ou vacas secas, foram coletadas com a finalidade de se estabelecerem valores de referência para vários analitos bioquímicos em rebanhos leiteiros mexicanos. Os valores médios foram calculados para: 1) perfil energético: glicose, colesterol, triglicerídeos, ß-hidroxibutirato, e ácidos graxos não esterificados, 2) perfil proteico: ureia, albumina, globulina e proteínas totais, 3) perfil mineral: cálcio, fósforo, sódio, potássio, magnésio, cloro, dióxido de carbono, bicarbonato e hiato aniônico, e 4) enzima hepática: γ-glutamil transpeptidase. O conjunto de dados resultante foi analisado utilizando-se distribuição gaussiana e estatística descritiva. Intervalos de confiança de 95% foram estabelecidos. As relações lineares entre os analitos bioquímicos foram quantificadas, e uma análise de variância foi realizada para se compararem os valores médios entre os três grupos de produção. As concentrações totais dos analitos descritos são consistentes com os valores relatados na literatura internacional. No entanto, os valores mais baixos foram encontrados para a ureia, o cálcio e o sódio; os valores mais elevados foram encontrados para o colesterol e o γ-glutamil transpeptidase. Correlações negativas foram encontradas entre ß-hidroxibutirato e glicose ou ureia, γ-glutamil transpeptidase e ureia, e entre bicarbonato e ureia ou fósforo ou hiato aniônico. Foram encontradas correlações positivas entre ß-hidroxibutirato e colesterol ou hiato aniônico, ácidos graxos não esterificados e hiato aniônico, colesterol e globulina, diferentes analitos de perfil mineral e hiato aniônico ou ureia ou glicose, e entre sódio e cálcio. As diferenças entre os três grupos de produção foram observadas para as concentrações de ß-hidroxibutirato e de colesterol. A concentração γ-glutamil transpeptidase foi semelhante em vacas de alta e baixa produção, mas foi maior em comparação com os níveis séricos de vacas secas. O cálcio mostrou diferenças entre vacas de alta produção e os outros dois grupos, e o sódio apresentou a maior concentração em vacas secas. Os resultados deste trabalho podem melhorar a precisão dos perfis metabólicos como uma ferramenta para avaliar o estado nutricional e de saúde das vacas leiteiras.
Subject(s)
Animals , Female , Cattle , Blood Chemical Analysis/veterinary , Metabolism , Mexico , Reference ValuesABSTRACT
The trigeminal nerve, fifth equal of cranial nerves, a mixed nerve is considered by possessing motor and sensitive components. The sensitive portion takes to the Nervous System Central somesthesics information from the skin and mucous membrane of great area of the face, being responsible also for a neural disease, known as the Trigeminal Neuralgia. The aim of this study was to review the literature on the main characteristics of Trigeminal Neuralgia, the relevant aspects for the diagnosis and treatment options for this pathology. This neuralgia is characterized by hard pains and sudden, similar to electric discharges, with duration between a few seconds to two minutes, in the trigeminal nerve sensorial distribution. The pain is unchained by light touches in specific points in the skin of the face or for movements of the facial muscles, it can be caused by traumatic sequels or physiologic processes degenerative associate the vascular compression. Prevails in the senior population, frequently in the woman. In a unilateral way it attacks more the maxillary and mandibular divisions, rarely happens in a simultaneous way in the three branches of trigeminal nerve three branches.
Subject(s)
Humans , Male , Female , Facial Pain , Face/anatomy & histology , Trigeminal Nerve/physiopathology , Trigeminal Neuralgia/diagnosis , Trigeminal Neuralgia/etiology , Trigeminal Neuralgia/rehabilitationABSTRACT
The aim of this study was to evaluate the incidence as well morphometry of the foramen of Vesalius in humanskulls and analyzing their clinical importance. Dry human skulls (n = 80) and with gender distinction wereused (40 male and 40 female). The results demonstrates an total incidence of 40%, 13.75% skulls with thebilateral presence of the foramen, 26.25% skulls with the unilateral presence of the foramen, 31.25% skullswith foramen only of the right side, 22.50% skulls with foramen only of the left side, 25% masculine skulls withat least 1 foramen and 52.25% skulls with at least 1 foramen. The morphometry showed an average diameterof 1.457 ± 1.043 mm on the right and 1592 ± 0938 mm to the left. The average distance to the foramenovale was 1.853 ± 0.303 mm on the right side and 2.464 ± 0.311 mm on the left. It can be concluded that adeepened anatomical study of the foramen of Vesalius collaborates not only for anatomical knowledge of thisstructure, but also in clinical situations involving this foramen.
Subject(s)
Humans , Skull/anatomy & histology , Facial Bones , Foramen Magnum/anatomy & histology , Sinus Thrombosis, Intracranial , Veins , Neurosurgery , Skull BaseABSTRACT
The ossified pterygoalar ligament is formed between the lateral lamina of the pterygoid process and theinfratemporal surface of the sphenoid bone or its greater wing and was not connected to the sphenoid spine.The aim of this study was to evaluate the incidence of the ossified pterygoalar ligament in Brazilian humanskulls and analyzing its clinical importance. 183 Brazilian adult (between 30 to 60 years old) dry human skullswere evaluated. Was evaluated the incidence of skulls with complete or partial ossification of the pterygoalarligament, bilaterally and unilaterally and in the presence on the right and left sides. Were found 5 skulls had theossified pterygoalar ligament, resulting in an overall incidence of 2.73%. There was 1 skull in the presence ofthe incomplete ossification of the pterygoalar ligament, unilaterally and on the left side resulting in incidence of0.54%. There were 4 skulls in the presence of the complete ossification of the pterygoalar ligament, unilaterallyand on the right side resulting in incidence of 2.18%. The ossified pterygoalar ligament is a major cause of theentrapment of the lingual nerve or a branch of the mandibular nerve and may cause mandibular neuralgia. Theincidence of the ossified pterygoalar ligament and the pterygoalar foramen is low in the Brazilian population.However, these structures have clinical significance as this ligament establish relationships with the ovaleforamen and difficulty in accessing in this foramen in a therapeutic approach.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Ligaments, Articular , Ligaments/anatomy & histology , Muscle Development , Facial Bones/anatomy & histology , Facial Bones/physiology , Pterygoid Muscles , Brazil , IncidenceABSTRACT
The morphological characteristics obtained by craniometry may be the key to sex determination and enable us to identify unknown individuals in anywhere in the world. Aims: The purpose of this study was to evaluate the effectiveness of the linear morphometry of foramen magnum to verify the morphological characteristics for gender determination in human skulls of Brazilian individuals. Methods: With a digital caliper, were made three non-consecutive measurements of the foramen magnum in 215 human skulls (139 male and 76 female), from the collection of the Department of Morphology and Descriptive Topography UNIFESP/SP with registered data on nationality, gender, and age. The craniometric measurements were made in accordance with the protocol defined by Günay and Altinkõk (2000). The data were submitted to intraclass correlation coefficient (ICC) and Student t-test with significance level of 5%. Results: There were no statistically significant differences (chi-square, p > 0.05) between the ethnic groups within each gender. The ANOVA and Tukey tests showed that the gender influenced the width of the foramen magnum. The FM is higher in males (30.3 ± 0.20) than in females (29.4 ± 0.23), but not in length (p < 0.05). Conclusion: The morphometric linear method of the foramen magnum (width) was able to determine the morphological differences between sexes and can be used in conjunction with other anthropological techniques to gender determination of unknown individuals.
Subject(s)
Humans , Male , Female , Young Adult , Middle Aged , Bone and Bones , Foramen Magnum , Foramen Magnum/anatomy & histology , Brazil , Cephalometry , Forensic AnthropologyABSTRACT
La remodelación de la vía aérea es un proceso continuo de cambio caracterizado principalmente por el engrosamiento de la membrana que sostiene la mucosa respiratoria. Diversas moléculas y agentes han sido descritos como responsables de ello. En el presente artículo se desarrolla el concepto inflamación y su relación con el fenómeno de remodelación en asma, describiendo los grupos de riesgo que existen, el rol de las diversas interleukinas descritas, el rol de la edad de inicio, y finalmente las consecuencias de la introducción precoz de esteroides inhalados en niños. Si bien existen muchos aspectos claros, aún queda mucho por responder.
Subject(s)
Humans , Child , Asthma/physiopathology , Asthma/drug therapy , Inflammation/prevention & control , Airway Obstruction/physiopathology , Airway Obstruction/prevention & control , Anti-Inflammatory Agents/therapeutic use , Adrenal Cortex Hormones/therapeutic useABSTRACT
The determination of gender of unknown persons is of vital importance in forensic investigations, such as anthropologic,medical and dental forensic studies, mainly in cases where only fragments of the skull remain and there is no possibility of identification based on the dental arch. The aim of the present study was to develop a mathematical method based on logistic regression analysis capable of determining the gender of individuals using measurements of the frontal sinus. The right and left areas and the maximum height and width of the frontal sinus were determined in 100 radiographs taken by the Caldwell technique of 50 women and 50 men between 20 and 30 years old, with the help of the prog ram SIARCS 3.0 (EMBRAPA). The mean values of the frontal sinus were greater in males and the left area was larger than the right area, based on Students t-test at the 5% level of significance. The mathematical model based on logistic regression analysis gave a concordanceindex for gender of 79.7% in the cases studied. The areas of the frontal sinus and the logistic regression technique proved to be useful in the determination of gender. (Logit = 1.6905 0.5383* left area).
Subject(s)
Humans , Male , Female , Adult , Skull/anatomy & histology , Forensic Dentistry , Forensic Sciences , Models, Theoretical , Paranasal Sinuses , Reference Standards/analysis , Sex Determination by Skeleton , Frontal Sinus/anatomy & histology , Frontal Sinus , Paranasal Sinuses , Brazil , Forensic Anthropology , Logistic ModelsABSTRACT
Presentamos 16 pacientes sometidas a Histerectomía vaginal con o sin Plastia vaginal portadoras de IUE, en que efectuamos la técnica tipo TVT Obturador entre abril y julio de 2003 en nuestra Unidad. La edad promedio fue de 49 años. Nueve pacientes tienen IUE y 7 mixta. Diez pacientes presentan miomatosis -adenomiosis y 5 prolapso genital. Un caso corresponde a una paciente histerectomizada previamente. El tiempo operatorio promedio fue de 12 minutos. La estadía postoperatoria fue de 2,4 días. Quince pacientes relatan continencia total y una parcial. No se registraron complicaciones en ésta casuística.
Subject(s)
Female , Hysterectomy, Vaginal , Urinary Incontinence, Stress/surgery , Minimally Invasive Surgical Procedures/methods , Vagina/surgery , Prospective StudiesABSTRACT
Podemos concluir que en nuestro grupo de IIH el mayor riesgo está dado por factores que son propios del paciente, como la edad y la patología de base. La tasa de ataque de un 2% es baja, pero real, de acuerdo con el estudio de prevalencia hecho el mismo año. Estos resultados se explican por el cumplimiento de las normativas, que son propias de cada establecimiento; consideramos fundamental, al respecto, la técnica aséptica al ejecutar, especialmente, los procedimientos invasivos. El uso del lavado de mano constituye una rutina, y se han incorporado las precauciones universales con sangre y fluidos. Se cuenta con un número adecuado de camas para aislamiento. Estos dos factores: cumplimiento de las normativas y una planta física adecuada, hacen que el número de IIH en nuestro hospital sea bajo