Human Anatomy in Cinema / La Anatomía Humana en el Cine

SUMMARY: A corpse is the body's final destination and, as a social construction, it challenges Western cultural taboos and practices around the corpse, having been shown in cinema. The present paper aims to analyze 17 films that portray Human Anatomy, identifying which themes specifically related to morphological sciences are addressed, namely: a) reactions to first contact with a cadaver, b) medical school and dissection classes, c) origin of cadavers, d) anatomy and suspense or horror movies, e) romance, drama and comedy, f) body snatchers/ resurrectionists, g) anatomical techniques, h) racism, prejudice and anatomy. This is a critical review of films in which, after thorough triple- blind analysis by the authors, it was observed that the encounter with the cadaver provides a series of emotions to the characters participating in the practical anatomy classes shown in the films, such as apprehension, fear, disgust, curiosity, etc. Generally, this surprising contact between the living and the dead is associated with the practice of dissection, which often results in the accentuation of emotions previously reported. From all this, it is concluded that the history of the teaching of Human Anatomy has been interestingly portrayed in cinema from different points of view.

Un cadáver es el destino final del cuerpo y, como construcción social, desafía los tabúes y prácticas culturales occidentales en torno al cadáver, habiendo sido mostrado en el cine. El presente trabajo tuvo como objetivo analizar 17 películas que retratan la Anatomía Humana, identificando qué temas específicamente relacionados con las ciencias morfológicas se abordan, a saber: a) reacciones al primer contacto con un cadáver, b) clases de medicina y disección, c) origen de los cadáveres, d) anatomía y películas de suspenso o terror, e) romance, drama y comedia, f) ladrones de cuerpos/resurreccionistas, g) técnicas anatómicas, h) racismo, prejuicio y anatomía. Se trata de una revisión crítica de películas en las que, tras un minucioso análisis triple ciego por parte de los autores, se observa que el encuentro con el cadáver proporciona una serie de emociones a los personajes que participan en las clases prácticas de anatomía que se muestran en las películas, tales como aprensión, miedo, repugnancia, curiosidad, etc. Generalmente, este sorprendente contacto entre vivos y muertos se asocia con la práctica de la disección, lo que muchas veces resulta en la acentuación de las emociones anteriormente relatadas. De todo ello se concluye que la historia de la enseñanza de la Anatomía Humana ha sido interesantemente retratada en el cine desde diferentes puntos de vista.

La cuestión del afrontamiento cadavérico en anatomía y la necesidad de una educación inclusiva / The question of coping with the cadavera in anatomy and the need for an inclusive education

El material cadavérico (MC) humano en la cursada de Anatomía de la carrera de Medicina es el recurso didáctico más antiguo y completo para la enseñanza. Este elemento conlleva importantes significaciones y múltiples atravesamientos (legales, éticos, procedimentales, culturales) que, a partir de la mitad del siglo XX tuvo cuestionamientos y posicionamientos pedagógicos antagónicos en cuanto a su uso. Su utilización genera reacciones emocionales en los estudiantes, a veces negativas, que son procesadas por los mecanismos de defensa y las estrategiasde afrontamiento con que el sujeto cuente. Cuando éstos son sobrepasados puede aparecer un cortejo sindromático que constituye el afrontamiento cadavérico negativo, el cual es un factor que ubica al alumno en un estado de vulnerabilidad con alteraciones en lo académico. Consideramos necesario para este grupo de estudiantes, como para aquellos en su proceso de afrontamiento, estrategias didácticas que los secunden en el proceso y tiendan a una educación inclusiva para que el afrontamiento cadavérico negativo no sea causal de deserción o riesgosidad.

SUMMARY: The human cadaveric material (CM) in the course of Anatomy of the Medicine career is the oldest and most complete didactic resource for teaching. This element carries important meanings and multiple crossings (legal, ethical, procedural, cultural) that, from the middle of the 20th century, had questions and antagonistic pedagogical positions regarding its use. Its use generates emotional reactions in students, often negative, which are processed by the defense mechanisms and coping strategies available to the subject. When these are exceeded, a syndromic courtship may appear that constitutes negative cadaveric coping, which is a factor that places the student in a state of vulnerability with academic alterations. We consider it necessary for this group of students, as well as for those in their coping process, didactic strategies that support them in the process and tend to an inclusive education so that negative cadaverous coping is not a cause of desertion or risk.

Sustancias psicoactivas, alumnos de anatomía y prepandemia COVID-19: prevalencia de uso y comparación de estudios transversales del periodo 2011-2019 / Psychoactive substances, anatomy and pre-pandemic COVID-19 students: prevalence of use and comparison of cross-sectional studies from the period 2011-2019

En estudios preliminares objetivamos alta prevalencia de uso de sustancias psicoactivas (SP) entre alumnos de Anatomía, con mayor impacto entre los recursantes o aquellos con actividades laborales. La causa del uso es multifactorial, pero se destacan factores de riesgo y precipitantes como la carga horaria de la currícula, exigencias de estudio, el distrés por el afrontamiento cadavérico negativo, el nuevo contexto educativo y la cantidad de horas de sueño. El objetivo fue comparar la prevalencia de uso de SP entre las cohortes de 2011-2019, con focalización en los factores determinantes conductuales. Estudio observacional, transversal y comparativo mediante encuesta estandarizada y anónima en 945 alumnos (año 2011= 122; año 2013= 158; año 2015=204; año 2017= 228; año 2019= 233). Se aplicaron parámetros estadísticos, se definió la significación como p -0.84; AA: r> -0.71). En el caso de ansiolíticos benzodiacepínicos, se asoció con falta de sueño y distrés por el afrontamiento negativo al estudio con cadáveres. En las cohortes comparadas por el lapso de 9 años hallamos alta prevalencia de uso de sustancias psicoactivas con tendencia al incremento. Las variables actividad laboral y recursante fueron determinantes para el uso de sustancias, y se asociaron cuestiones relativas a la adaptabilidad universitaria y afrontamiento de estudio negativo con el cadáver; todos con incidencia pedagógica en el proceso de enseñanza y aprendizaje.

SUMMARY: In preliminary studies, we observed a high prevalence of the use of psychoactive substances (PS) among Anatomy students, with a greater impact among recurrent students or those with work activities. The cause of use is multifactorial, but risk and precipitating factors stand out, such as the workload of the curriculum, study demands, distress due to negative cadaveric coping, the new educational context and the number of hours of sleep. The objective was to compare the prevalence of SP use between the 2011-2019 cohorts, with a focus on behavioral determinants. Observational, cross-sectional and comparative study using a standardized and anonymous survey in 945 students (year 2011= 122; year 2013= 158; year 2015=204; year 2017= 228; year 2019= 233). Statistical parameters were applied, significance was defined as p -0.84; AA: r> -0.71). In the case of benzodiazepine anxiolytics, it was associated with lack of sleep and distress due to negative coping with the study with cadavers. In the cohorts compared for a period of 9 years, we found a high prevalence of psychoactive substance use with an increasing trend. The variables work activity and recurrence were determinants for the use of substances, and issues related to university adaptability and negative study coping with the corpse were associated; all with pedagogical impact on the teaching and learning process.

Laboratorios tradicionales versus nuevas tecnologías para el estudio de anatomía humana en estudiantes de medicina: revisión sistemática y meta análisis / Traditional laboratories versus new technologies for the study of human anatomy in medical students: a systematic review and meta-analysis

RESUMEN: El estudio de la anatomía humana, ha transcendido con diversos recursos y escenarios. El objetivo fue compararlos estudios publicados sobre prácticas de laboratorio tradicionales con nuevas tecnologías para el estudio del cuerpo humano en estudiantes de medicina. Se realizó revisión sistemática y meta-análisis. Cuatro revisores efectuaron búsqueda sistemática y exhaustiva de la literatura, a partir de la localización y selección de 54 estudios primarios publicados en diez bases de datos, tres revisores cegados evaluaron calidad metodológica de 33 estudios, con listas de chequeo para la evaluación crítica de la validez interna, según tipo de estudio y el cuarto revisor cegado, calculó grado de acuerdo entre revisores con Kappa de Fleiss y valoró riesgo de sesgo, sensibilidad, heterogeneidad y análisis combinado a través del Software RevMan 5.4. Se obtuvo revisión sistemática cualitativa y combinación mediante métodos estadísticos de los resultados con meta-análisis de siete estudios primarios, con muestra de 465 participantes, 260 expuestos a laboratorios tradicionales y 205 a nuevas tecnologías. Encontrando satisfacción del proceso y resultados positivos de aprendizaje comprensión y aplicación con favorabilidad inicial a las prácticas tradicionales no significativa al valorar los intervalos de confianza. Así, el contraste entre métodos para estas prácticas reveló desenlaces relacionados con reacciones físico-emocionales, focalización en el constructo rendimiento académico y con los procesos de aprendizaje. Concluyendo que los laboratorios con nuevas tecnologías para estudio de anatomía, no impactan en forma prerrogativa a los estudiantes, dada su experiencia favorable con los laboratorios tradicionales, y pueden emplearse como una estrategia útil complementaria.

SUMMARY: The study of human anatomy has transcended with various resources and scenarios. The objective was to compare published studies on traditional laboratory practices with new technologies for the study of the human body in medical students. A systematic review and meta-analysis were carried out. Four reviewers carried out a systematic and exhaustive search of the literature, based on the location and selection of 54 primary studies published in ten databases, three reviewers evaluated the methodological quality of 33 studies, with checklists for the critical evaluation of internal validity, according to type of study. The fourth blinded reviewer, calculated degree of agreement between reviewers with Kappa de Fleiss and assessed risk of bias, sensitivity, heterogeneity and combined analysis using RevMan 5.4. A qualitative systematic review and combination by statistical methods of the results were obtained with meta-analysis of seven primary studies, with a sample of 465 participants, 260 exposed to traditional laboratories and 205 to new technologies. Finding satisfaction with the process and positive results of learning, understanding and application, with initial favorability to traditional practices not significant when assessing the confidence intervals. Thus, the contrast between methods for these practices revealed outcomes related to physical-emotional reactions, focus on the academic performance construct and with the learning processes. Concluding that laboratories with new technologies for the study of anatomy do not prerogatively impact students, given their favorable experience with traditional laboratories, and can be used as a useful complementary strategy.

Relationship between Water Temperature and Floating Time of Aquatic Cadavers / 法医学杂志

OBJECTIVES@#To study the relationship between water temperature and floating time of aquatic cadavers, providing a reference for more precise positioning and searching for floating corpses.@*METHODS@#The floating model of guinea pig after drowning at 17-30 ℃ was established, and the floating times of carcasses were recorded. The collected data of 32 floating corpse cases in the Pearl River were sorted out and analyzed according to the floating time of corpses corresponding to each degree of water temperature. The relationship models between water temperature and the floating time of guinea pig carcass, and between that and the floating time of real cases were established.@*RESULTS@#The floating time of the cadaver was negatively correlated with water temperature. The power function fitting equation of the relationship between floating time and water temperature of guinea pig carcass was y=1×1015x-10.530(R2=0.871, P<0.01), and the power function fitting equation of the relationship between corpse floating time and water temperature was y=3×106x-3.467(R2=0.802, P<0.01).@*CONCLUSIONS@#It is found that average floating cadaver time has a power function with water temperature, which provides a reference for locating floating cadavers and establishing search models.

La rigidez cadavérica, el espasmo cadavérico y tipos de fibras musculares / The cadaveric rigidity, the cadaveric spasm and types of muscle fibers

La rigidez cadavérica (rigor mortis) es un proceso no muy bien comprendido por la mayoría de los médicos. El conocimiento de la intimidad del proceso de la rigidez cadavérica es de vital importancia ya que es una de las variables que junto con las livideces (livor mortis) y la temperatura (algor mortis) del cadáver ayudan a determinar el cronotanatodiagnóstico, tanatocronodiagnóstico o intervalo postmortal del período inmediato de la muerte. Para entender el mecanismo de la rigidez y el espasmo cadavérico es preciso hacer un repaso de la contracción muscular fisiológica en el vivo. Hay que tener presente que el tipo de fibra muscular predominante modificará las características de la contracción muscular fisiológica en el vivo, y también la rigidez y el espasmo cadavérico. (AU)

The cadaveric rigidity (rigor mortis) is a process which is not very well understood by the majority of the doctors. The knowledge of the intimacy of the cadaveric stiffness process is of vital importance since it is one of the variables that, as well as the postmortem lividity (livor mortis) and the body temperature post mortem (algor mortis) help determine the chronotanatodiagnostic, tanatochronodiagnostic or postmortal interval of the immediate period of death. In order to understand the mechanism of stiffness and cadaveric spasm, it is necessary to review the physiological muscle contraction in vivo. We should keep in mind that the predominant type of muscle fiber will modify the characteristics of physiological muscle contraction in vivo, as well as stiffness and cadaveric spasm. (AU)

Morphometry and Frequency of the Pyramidalis Muscle in Adult Humans: A Pyramidalis Muscles Anatomical Analysis

OBJECTIVES: To verify the pyramidalis muscle's frequency (bilaterality, unilaterality, or absence) and morphometry (length of the medial border and width of its origin/base) in a sample of the Brazilian population and the anthropometric influence. METHODS: Dissection of 30 cadavers, up to 24h post-mortem. RESULTS: The pyramidalis muscle was present bilaterally and unilaterally in 83.33% and 3.33% of the cadavers, respectively, and absent in 13.33%. The muscles on the right and left sides were symmetrical in length but not in width; the pyramidalis muscles of men were longer, while those of the women were wider. We also found that there was greater variation in the dimensions (length and width) of the men's muscles. Finally, in this sample of the Brazilian population, the pyramidalis muscle's unilaterality was more prevalent than in other populations, and its complete absence was less prevalent. CONCLUSIONS: There were no cases of muscle duplication in one or both sides, as described in some studies. Despite all of its morphometric variation, the pyramidalis muscle maintained its triangular shape with longitudinal fibers in every case. Furthermore, no statistically significant correlation was noted between the muscles' dimensions and person's age, height, weight, or gender.

Review of Legal Codes Governing Administrative Death Investigations and Autopsy by Administrative Order / 대한법의학회지

Under current law, there are two paths for death investigations: administrative and judicial. A proper death investigation system is essential to the establishment and maintenance of the human rights of those involved and to enhance the credibility of the judicial system as a source of ensuring the security of society. These objectives are accomplished through the accurate, professional, and systematic management of death investigations by qualified experts. The present study aims at reviewing and uncovering the limitations of the current legal codes governing administrative death investigations and autopsy by administrative order. The main problem being that no clear legal statements exist regarding the qualifications of persons responsible for administrative postmortem inspections and administrative autopsies; the problem is the same for any death related to crime. At the conclusion of this paper, the authors propose that legal codes regarding the scope of postmortem inspections or autopsies to determine the cause and manner of death should be clearly defined, and that the qualification standards for experts examining any desceased individual should be legislated.

Restoration and conservation of anatomic pieces / 대한해부학회지

In this study, a restoration process was developed with potassium hydroxide (KOH), in order to improve each of the structures for their posterior fixation, through the use of new methods such as the Chilean conservative fixative solution (SFCCh), with exceptional results. Restore anatomical pieces corresponding to corpse and organs, being these last set with the SFCCh. In this work dealt with processes of restoration with potassium hydroxide, sodium chloride, and sodium hypochlorite, the process began with the cleanliness and suture of the structures for subsequent fixing in Chilean conservative fixative solution, making use of a corpse and different anatomical parts. Work based on items found in the database, Elsevier, Science Direct, ProQuest, and MEDLINE. At the end of the process of restoration and conservation of the anatomical pieces, was observed an improvement in muscle pigment with decrease of rigidity in the specimen, additionally a recovery of appearance in the vascular-nervous elements was achieved. The organs were much more malleable and the structures facilitate the identification of specific details, its subsequent immersion in SFCCh allows the longer preservation of the obtained results. The restoration with potassium hydroxide allows the improvement in the appearance of the different anatomical structures and simultaneously to facilitate its study. The SFCCh is an alternative that replaces partially the use of formaldehyde. In addition, it presents toxicity reduction.

Determination of Place of Residence Using the Gene Information of Plants Carried by the Human Body / 法医学杂志

Objective To identify the plant species using the DNA sequence of plant pollen from lung tissues of a unidentified body, infer the possible long-term places of residence of the deceased according to the distribution area of the pollen in the lung tissues, therefore narrow the scope of criminal investigation and provide clues for case solving. Methods Lung tissues were extracted from the deceased, total DNA was extracted by the mCTAB method. Gene fragments of the two plant DNA barcodes, matK and rbcL, were acquired using specific primers for amplification, then sequenced. The DNA sequences of target gene fragments were acquired through bioinformatics analysis. The sequences were combined with reference sequence data. Phylogenetic analysis was made to identify the species that the DNA sequences belonged to. The places where the deceased could have lived for a long time were inferred, according to the distribution information of plant species. Results Gene fragments of 32 plant species which belonged to 31 genera of 27 families were in the lung tissues of the deceased. Among them, plants of 9 genera that had certain indicative function were mainly endemic plants from Hainan, Guangdong, Guangxi and Yunnan. These results showed that the deceased may have stayed in these areas for a long time before death. After further investigation, the victim was confirmed to have come from a county in southern Guangxi, which was in accordance with the research results. Conclusion The method of using gene information of plants from lung tissues of human bodies to infer places of residence can assist inference of the places where the deceased could have lived for a long time. The present study may also provide new ideas for locating sources of the corpses in cases with unidentified victims.

Effect of Corpse Cryopreservation on Forensic Pathological Identification / 法医学杂志

Because cryopreservation can effectively slow down the putrefaction and prolong the preservation time of corpses, it has become the main way of corpse preservation in China. However, it may cause a certain degree of non-specific effects on the corpses and thus interfere with forensic pathological identification. This paper summarizes relevant problems reported in domestic and foreign literature reports and practical identification, and analyzes the effects of cryopreservation on corpses from aspects of anatomical findings, histomorphology, postmortem biochemistry, and postmortem imaging, therefore to provide Chinese forensic workers assistance on problems in their practice of forensic pathology.

Lack of Corpses for Teaching and Research / A Falta de Cadáveres para Ensino e Pesquisa

ABSTRACT The aim of this study is to address the importance of providing unclaimed corpses and cadavers donated for use in studies, focusing on the training of health professionals, the improvement of professionals already trained in this area and the advance of research, mainly in surgical techniques, in the scope of educational and research institutions, both public and private. It seems unanimous, among the authors who deal with the matter, the view that the use of corpses is irreplaceable in technical training and professional development. There is, however, a lack of the material in question, which in turn is due to a series of difficulties raised here, such as the lack of regulation centers that manage the flow of capture and distribution of cadavers and the decrease in the number of unclaimed corpses. The following problem is thus defined: on the one hand, there is a clear need to obtain human remains for basic education in the health area - fundamentally in the disciplines of Anatomy - for the improvement of professionals in this area and for research - such as the disciplines of surgical techniques -; on the other hand, the lack of cadaveric material is evident, a fact that, by consequence, has been compromising the final quality of health services, especially those of surgical nature. A bibliographic survey was carried out aiming to know the state of the art on the current legislation and on the Bills currently submitted to the National Congress. It was found that, despite the existence of legislation concerning this matter, it is necessary to have legislative-normative improvement to encompass the several demands, including those of the emerging technologies. The legislative process is very slow, taking into account the need indicated here, considering the significant increase in the number of courses in the health area. It is necessary, therefore, that urgent measures be taken to supply the needs in the area, which must necessarily take place through legal and regulatory norms.

RESUMO O estudo tem como objetivo abordar a importância da disponibilização de cadáveres não reclamados e de cadáveres doados para utilização em estudos, com foco na formação de profissionais da área da saúde, no aperfeiçoamento de profissionais já formados nessa área e no avanço de pesquisas sobretudo em técnicas cirúrgicas, no âmbito de instituições de ensino e pesquisa, tanto públicas como privadas. Parece unânime, entre os autores que versam sobre a matéria, a opinião de que a utilização de cadáveres é insubstituível na formação técnica e no aperfeiçoamento do profissional. Verifica-se, entretanto, a falta do material em questão, o que, por sua vez, se deve a uma série de dificuldades aqui levantadas, como a falta de centrais de regulação que administrem o fluxo de captação e distribuição de cadáveres e a diminuição do número de cadáveres não reclamados. Configura-se, assim, o seguinte problema: por um lado, tem-se a clara necessidade de obtenção de restos mortais humanos para o ensino básico na área da saúde - em se tratando fundamentalmente das disciplinas de Anatomia -, para o aperfeiçoamento de profissionais dessa área e para pesquisa - a exemplo das disciplinas de técnicas cirúrgicas -; por outro lado, é flagrante a carência de material cadavérico, fato que, por via de consequência, vem comprometendo a qualidade final dos serviços de saúde, em especial os de caráter cirúrgico. Realizou-se aqui levantamento bibliográfico visando conhecer o estado da arte sobre a legislação vigente e os projetos de lei em tramitação no Congresso Nacional. Verificou-se que, apesar da existência de legislação concernente à matéria, é necessário haver aperfeiçoamento legislativo-normativo para contemplar as diversas demandas, incluídas as tecnologias que vêm surgindo. O processo legislativo é muito lento em face da necessidade aqui apontada, considerado o expressivo aumento do número de cursos na área da saúde. É mister, pois, que sejam tomadas medidas urgentes para suprir o passivo na área, o que deve realizar-se necessariamente por meio de regulamentação legal e normativa.

Perfil e motivos de negativas de familiares para doação de órgãos e tecidos para transplante / Perfil y motivos de las negativas de los familiares para donación de órganos y tejidos para trasplante / Profile and reasons for denying the donation of organs and tissues for transplants by familiars

Objetivo descrever o perfil de familiares e de potenciais doadores e os motivos de negativas para doação de órgãos e tecidos para transplantes. Método estudo quantitativo, transversal, com coleta de dados por meio do formulário de entrevista familiar, realizado de 2008 a 2014, no Sul do Brasil. Resultados o potencial doador predominantemente era do sexo masculino, entre 41 e 60 anos, casado, doador de córneas, e o familiar, de primeiro grau. Houve negativa familiar para doação de órgãos em 74,9% do total de 630 prontuários. Entre as 472 negativas: 20,8% por desconhecimento da vontade do potencial doador, 17,6% pela convicção prévia de não ser um doador e 13,8% por desacordo familiar. Conclusão a descrição do perfil de familiares e de potenciais doadores e a identificação dos principais motivos da não doação podem contribuir para o planejamento e desenvolvimento de intervenções que estimulem a doação de tecidos e órgãos.

Objetivo describir el perfil de los familiares y de potenciales donadores y los motivos que los llevan a no donar órganos y tejidos para trasplantes. Métod estudio cuantitativo, transversal, cuya recolecta de datos se hizo a través de un formulario de entrevista familiar, realizado de 2008 a 2014, en el Sur de Brasil. Resultados el potencial donador era, predominantemente, del sexo masculino, entre 41 y 60 años, casado, donador de córneas, así como el familiar de primer grado. Hubo una negativa familiar para la donación de órganos en un 74,9% del total de los 630 informes médicos. Entre las 472 negativas: el 20,8% lo hace por desconocimiento de la voluntad de ser un potencial donador, el 17,6% por la convicción previa de no ser un donador y, el 13,8% por desacuerdo familiar. Conclusión la descripción del perfil de los familiares y de potenciales donadores, así como la identificación de los principales motivos para no donar, pueden contribuir para el planeamiento y el desarrollo de intervenciones que estimulen la donación de tejidos y órganos.

Objective describe the profile of family members and potential donors, and the negative motives for organ and tissue donation for transplants. Method quantitative, cross-sectional study with data collection through the family interview form, carried out from 2008 to 2014, in Southern Brazil. Results the predominant potential donor was male, between 41 and 60 years, married, donor of corneas, and the first degree family member. There was a family denial for organ donation in 74.9% of the total of 630 medical records. Among the 472 denials were: 20.8% due to lack of knowledge of the willingness of the potential donor, 17.6% due to the previous conviction of not being a donor, and 13.8% due to family disagreement. Conclusion describing the profile of family members and potential donors and identifying the main reasons for non-donation can contribute to the planning and development of interventions that stimulate the donation of tissues and organs.

Técnicas de apertura del cadáver / Corpse opening techniques

La autopsia consiste en el estudio post mortem de un cuerpo. Este proceso que tiene comienzo desde el levantamiento del cadáver, consiste en un examen externo y un examen interno. El examen externo consiste en la inspección minuciosa del cadáver recogiendo todas las particularidades que puedan proporcionar indicios relativos a la identificación y causa de la muerte.El examen interno consiste en un estudio detallado de las posibles anormalidades anatómicas del cuerpo. Este estudio interno se hace en primera instancia mediante una observación macroscópica, si bien se puede completar con estudio microscópico, toxicológico, bioquímico, o inmunológico si fuera indicado.Para poder realizar el examen interno del cadáver se emplean técnicas de disección con la finalidad de obtener la causa y naturaleza de la muerte, así como la identidad del individuo en los casos que se desconozca.Dependiendo del estado del cuerpo, se emplearán unas técnicas determinadas. Estas técnicas tienen como fundamento el conocimiento de la anatomía normal y patológica, de la forma y estructura de los órganos y vísceras, de la relación topográfica entre los sistemas y aparatos que componen el cuerpo humano.El objetivo de este trabajo es realizar una revisión de las técnicas de apertura del cadáver, teniendo en cuenta que son de suma importancia en una autopsia, sea clínica o judicial, y no menos importante, por el respeto hacia al cadáver en la realización de las incisiones.

The autopsy is the post mortem study of a body. The process begins at the scene of death, and consists in an external and internal examination.The external examination is a thorough inspection of the cadaver collecting any particularity that may provide information regarding the identification and the cause of death.The internal examination consists in a detailed study of the possible anatomic abnormalities of the body. This internal study it´s performed firstly by a macroscopic observation that can be complemented with a microscopic, toxicological, biochemical or immunological study if indicated.To carry out the inner examination of the corpse, different dissection techniques are used in order to obtain the cause and manner of death, as well as the identity of the deceased when unknown. Depending on the etiology of death, different proceedings will be carried out. Those techniques are based on the knowledge of normal and pathological anatomy of organs and viscera morphology, and topographic relation between apparatus and systems that compound the human body.The aim of this paper is to review the techniques of cadaver opening, considering that are critical in the autopsy process, whatever clinical or judicial, and not least, by the respect for the corpse when practicing the incisions.

Study of mortality from infectious diseases in Brazil from 2005 to 2010: risks involved in handling corpses / Estudo da mortalidade no Brasil por doenças infecciosas, de 2005 a 2010: riscos envolvidos no manejo de cadáveres

Abstract In the wake of disasters, the lack of information on how to handle and dispose of corpses leads the professionals involved in emergency operations to uncertainty about associated risks and safety precautions. The article seeks to establish the risks of the etiologic agents involved in Brazilian mortality due to infectious diseases and identify and discuss the main protection measures for professionals involved in handling of corpses in disaster situations. It involved a survey of deaths by infectious diseases in Brazil between 2005 and 2010, using data from the Mortality Information System. Of the 171,223 deaths analyzed, the pathogens leading to the greatest number of deaths were: HIV, Mycobacterium tuberculosis and Trypanosoma cruzi. 59% belonged to risk class 3 and 40.6% to risk class 2. Eight deaths were caused by risk class 4 pathogens, which represent high risk. The professionals involved in the handling of corpses may be exposed to chronic risks, such as viruses transmitted via blood, gastrointestinal infections and tuberculosis. These findings indicate the importance of investment in the preparation of measures to reduce the risk of infection associated with the handling of corpses.

Resumo Após os desastres, a falta de informações claras sobre como gerenciar a disposição dos cadáveres, resultam em incertezas entre os profissionais envolvidos no atendimento emergencial, de quais são os riscos associados e as medidas de segurança no manejo dos corpos. O artigo objetiva determiner o risco dos agentes etiológicos envolvidos na mortalidade brasileira por doenças infecciosas, identificar e discutir as principais medidas de proteção para os profissionais envolvidos no manejo de cadáveres em situações de desastres. Levantamento dos óbitos por doenças infecciosas, no Brasil, de 2005 a 2010, utilizando-se os dados do Sistema de Informações sobre Mortalidade. Dos 171.223 óbitos analisados, os patógenos causadores de maior número de mortes foram: HIV, M. tuberculosis e T cruzi. Dos agentes, 59% pertencem à classe de risco 3 e 40,6% à classe 2. Oito óbitos identificados foram causados por patógenos da classe 4, que representam alto risco. Os profissionais envolvidos no manejo de corpos podem estar expostos aos riscos crônicos, como os vírus transmitidos pelo sangue, infecções gastrointestinais e tuberculose. Estes resultados demonstram a importância no investimento na elaboração de medidas para reduzir o risco de infecção associada ao manejo de cadáveres.

El cadáver humano en el arte y la bioética: la Pietà Rondanini de Miguel Ángel / The human corpse in arts and bioethics: Michelangelo´s Pietà Rondanini

According to bioethics, life is a fundamental but not an absolute good. Therefore the value of a person resides in being alive, no matter in which state such person is. The concept of brain death is legally and ethically accepted as the definition of death. In artworks, human beings are revealed as they are. Michelangelo’s Pietà Rondanini captures and captures what a human corpse is, in its most intimate appearance. The artist boldly reveals its essence.

Desaparecidos: uma história de dor / The missing ones: a history of pain / Desaparecidos: una historia de dolor / Disparus: une histoire de douleur

Assombrado pela extensa lista de desaparecidos que as ditaduras latino-americanas impingiram a pais, mães e companheiros, o autor relê uma das obras fundadoras da civilização ocidental - a Ilíada - e tenta compreender por que os gregos e os troianos lutam furiosamente para reaver o corpo de seus mortos. Desrespeitar um cadáver indigna os próprios deuses. Não poder lhe render as homenagens fúnebres é uma hipótese nem sequer cogitada. O quase impossível trabalho do luto requer o corpo, afirma o autor. Sem ele, não se criam os sonhos nem as narrativas. Nem a melancolia pode se instalar. Cria-se no espírito um buraco negro que, como um parasita, atrai para si o pensamento e os afetos e impede a vida de prosseguir. No plano da cultura e da história ocorrerá a mesma deformação que se abate sobre os destinos individuais.

Horrified by the extensive list of missing people that the Latin American dictatorships imposed to parents, spouses and domestic partners, the author rereads one of the founding works of Western civilization - The Iliad - and tries to understand why the Greeks and the Trojans fight furiously in order to get back the bodies of their dead ones. Disrespecting a corpse outrages the Gods themselves. Not being able to deliver a proper eulogy and funeral is not even a ventured hypothesis. The almost impossible grief work requires the body, the author writes. Without it, dreams and narratives are not created. Neither melancholy can take place. A black whole is created in the spirit; as a parasite, this black whole attracts thought and affections to itself, and it does not let life go on. In the cultural and historical fields, there will be the same deformation that impacts their individual destinies.

Asombrado por la extensa lista de desaparecidos que las dictaduras latinoamericanas endosaron a padres, madres y compañeros, el autor relee una de las obras fundadoras de la civilización occidental - la Ilíada - e intenta comprender por qué griegos y troyanos luchan furiosamente para recuperar el cuerpo de sus muertos. La falta de respeto hacia el cadáver causa indignación a los propios dioses. No rendirle los homenajes fúnebres es una hipótesis fuera de cogitación. El casi imposible trabajo de luto requiere el cuerpo, afirma el autor. Sin él, no se crean sueños ni narrativas. Ni siquiera se puede instalar la melancolía. Se crea un agujero negro en el espíritu que -como un parásito- atrae hacia sí el pensamiento y los afectos impidiendo que la vida prosiga. En los planos de la cultura y de la historia sucederán las mismas deformaciones que se abaten sobre los destinos individuales.

Étonné par la longue liste de disparus que les dictatures latino-américaines ont imposé aux pères, mères et compagnons, l'auteur relit une des œuvres fondatrices de la civilisation occidentale - l'Iliade - et essaye de comprendre pourquoi les grecs et les troyens se battent furieusement pour reprendre le corps de leurs morts. Violer un cadavre dégoûte les propres dieux. Ne pas pouvoir lui rendre les hommages funèbres est une hypothèse pas même pensée. Le presque impossible travail du deuil requiert le corps, déclare l'auteur. Sans lui, on ne crée pas les rêves ni les récits. Ni même la mélancolie ne peut s'installer. On crée dans l'esprit un trou noir qui, comme un parasite, lui attire la pensée et les affects et qui empêche la vie de poursuivre. Sur le plan de la culture et de l'histoire aura lieu la même déformation qui s'abat sur les destins individuels.

Identificação endonasal do ápice orbitário / Endonasal orbital apex identification

Introdução: As doenças que envolvem a órbita representam um complexo problema cirúrgico, principalmente as localizadas no ápice orbitário, por onde passam estruturas críticas e um espaço pequeno. O uso do endoscópio por via endonasal para abordagem cirúrgica das lesões do ápice orbitário é uma técnica recente, com poucas citações na literatura. É necessário o estudo de referências anatômicas objetivas que tornem a cirurgia mais segura. Objetivo: Descrever os parâmetros anatômicos utilizados na abordagem cirúrgica endonasal endoscópica, assim como avaliar a concordância entre os hemicrânios do mesmo cadáver e as diferenças conforme o gênero. Casuística e métodos: Estudo anatômico em 30 cadáveres adultos, ambas as fossas nasais foram dissecadas (n=60 hemicrânios). Sob visibilização endoscópica endonasal, realizou-se a dissecção do ápice orbitário. Mensuramos a distância entre a crista etmoidal e o arco coanal para o forame óptico e para a fissura orbitária superior. Os resultados foram registrados na ficha de protocolo do estudo. Resultados: Foram dissecados 30 cadáveres, 60 hemicrânios ou lados. O sexo masculino foi mais prevalente, representando 63,3% dos cadáveres (19/30), enquanto o sexo feminino representou 36,7% (11/30). 43,3% dos cadáveres eram da raça branca (13/30), 20%, pardos (6/30), e 36,7%, negros (11/30). A correlação entre os valores conforme o lado nas seguintes aferições foi observada: Crista etmoidal - Forame óptico, (r=0,748, p=0.0001); Crista etmoidal - Fissura Orbitária Superior (r=0.785, p=0.0001), Arco coanal - Forame óptico (r=0,835, p=0.0001); Arco coanal - Fissura orbitária superior (r=0.820, p=0.0001). Foi obtido um Kappa de 0,444 na avaliação da concordância entre os lados em relação ao posicionamento da artéria etmoidal anterior no forame óptico. Conclusões: A sistematização da abordagem do ápice orbitário facilita seu acesso cirúrgico e a compreensão da anatomia. A crista etmoidal e o arco coanal se mostraram...

Introduction: Diseases that affect the orbit pose a complex surgical challenge, particularly those involving the orbital apex, a small space through which critically important structures course. Endoscopic endonasal approaches to the surgical treatment of orbital apex lesions are a recent technique, with few citations in the literature. Research is still needed into objective anatomic landmarks that can improve surgical safety. Objective: To describe the anatomic landmarks used in endoscopic endonasal surgical approaches and assess agreement between placement of these landmarks in midsagittal sections of cadaver skulls and potential gender differences. Materials and methods: In this anatomic study, the nasal fossae of 30 adult cadavers were dissected (n=60 half-skulls). The orbital apex was dissected under endoscopic endonasal visualization. The distances between the ethmoidal crest and choanal arch to the optic foramen and to the superior orbital fissure were measured and recorded. Results: Overall, 30 cadavers were dissected for a total of 60 half-skulls or sides. The sample was predominantly male (63.3%, 19/30 cadavers); females accounted for the remaining 36.7% (11/30). Regarding skin color, 43.3% of cadavers were white (13/30), 20% were brown (6/30), and 36.7% were black (11/30). The following correlations between measurements according to side were observed: ethmoidal crest to optic foramen, r=0.748 (p=0.0001); ethmoidal crest to superior orbital fissure, r=0.785 (p=0.0001); choanal arch to optic foramen, r=0.835 (p=0.0001); choanal arch to superior orbital fissure, r=0.820 (p=0.0001). Analysis of the agreement of ophthalmic artery location within the optic foramen between skull halves revealed a kappa of 0.444. Conclusions: The approach systematization to the orbital apex will facilitate surgical access and improve understanding of the anatomy. In the cadavers studied in this sample, the ethmoidal crest and choanal arch were relevant structures and...

Las prácticas corporales en la educación corporal / Corporal practices in Corporal Education / Práticas corporais na educação corporal

Este trabajo tiene como propósito abordar la motricidad a partir de prácticas corporales como el danzar, jugar y caminar, así como el gesto y las sensaciones kinestésicas en el horizonte de la Educación Corporal. Interesa mostrar la Motricidad como esa experiencia que nosotros mismos hacemos del cuerpo (leiblich) para establecer una relación con la Educación. La motricidad, en el horizonte de la Educación Corporal, realza las prácticas corporales no con el fin de prescribir prácticas institucionalizadas o normalizadas sino con la pretensión de favorecer experiencias para disponer estados de afección, como ese pathos que sucede ocurriendo, afectando, tocándonos y actuando sobre nosotros, lo cual supone una mirada de la Educación bajo la figura del acontecimiento, que no pretende planificar lo sensible ni normativizar la experiencia.

This work aims to approach the movement based on corporal practices such as dance, play and walk, as well as gesture and kinesthetic sensations on the perspective of Corporal Education. It is interested in showing the movement as the experience that we ourselves make about the corpse (leiblich) to establish a relationship with the Education. Movement, on the perspective of Corporal Education, enhance corporal practices not to prescribe institutionalized or standardized practices, but with the aim of encouraging experiences to provide affection states, like pathos that happens taking place, affecting, touching and acting on us, which assumes a view of Education in the form of the event, which does not intend to plan the sensitive or establishing experience.

Este trabalho tem como objetivo abordar a motricidade a partir de práticas corporais, como dançar, jogar e caminhar, assim como o gesto e as sensações cinestésicas no horizonte da Educação corporal. Interessa mostrar a Motricidade como essa experiência que nós mesmos fazemos do Corpo (leiblich) para estabelecer uma relação com a Educação. A motricidade, no horizonte da Educação Física, realça as práticas corporais não com o fim de prescrever práticas institucionalizadas ou normatizadas, mas com a pretensão de favorecer experiências, e como este pathos ocorre, afetando, tocando-nos e atuando sobre nós mesmos, o que pressupõe examinar a Educação à luz do acontecimento, que não pretende planejar o sensível nem normatizar a experiência.