Honores a Sir Ernest Shackleton en Sanidad Militar / Honors to Sir Ernest Shackleton in Military Health / Honras a Sir Ernest Shackleton em Saúde Militar

Ernest Shackleton ha sido en la historia, un personaje que dejó huella como ejemplo de resiliencia y liderazgo. En 1914 realizó como jefe de expedición su segundo viaje antártico, frustrado por el hundimiento de su buque insignia. La operación de rescate del grueso de la tripulación varada en el continente más meridional lo llevó a recalar en Montevideo. Desde este puerto partió el buque Instituto de Pesca N°1, con tripulación de Uruguay y Shackleton incluido, no logrando completar el salvamento. De esta acción nació el aprecio hacia la persona del explorador por parte del gobierno de la República. En su postrer travesía, ya fallecido llegó a las Islas Georgia del Sur y a su cuerpo se le realizó un proceso de conservación para ser traído a nuestro país y continuar viaje al puerto de origen en Inglaterra. Es en esa circunstancia que el gobierno del doctor Baltasar Brum solicitó a la Comisión Permanente del Parlamento, se le rindieran honores fúnebres de Ministro de Estado. El embalsamado del cuerpo fue realizado el 30 de enero de 1922, por parte de personal médico y técnico del Hospital Militar, así como los honores que le rindieron por el Servicio de Sanidad del Ejército y la Armada.

Ernest Shackleton has been in history, a character who left his mark as an example of resilience and leadership. In 1914, as expedition leader, he made his second Antarctic voyage, frustrated by the sinking of his flagship. The operation to rescue the bulk of the crew stranded on the southernmost continent led him to Montevideo. The Instituto de Pesca N°1, with Uruguayan crew and Shackleton included, departed from this port, but was unable to complete the rescue. From this action was born the appreciation of the explorer by the government of the Republic. In his last voyage, when he died, he reached the South Georgia Islands and his body underwent a preservation process to be brought to our country and continue his voyage to the port of origin in England. It is in this circumstance that the government of Dr. Baltasar Brum requested the Permanent Commission of the Parliament to pay him the funeral honors of a Minister of State. The embalming of the body was carried out on January 30, 1922, by medical and technical personnel of the Military Hospital, as well as the honors rendered by the Army and Navy Health Service.

Ernest Shackleton deixou sua marca na história como um exemplo de resiliência e liderança. Em 1914, ele fez sua segunda viagem à Antártica como líder da expedição, frustrado pelo naufrágio de seu navio principal. A operação para resgatar a maior parte da tripulação encalhada no continente mais ao sul o levou a Montevidéu. O Instituto de Pesca N°1, com tripulação do Uruguai e Shackleton incluído, partiu desse porto, mas não conseguiu concluir o resgate. Essa ação deu origem ao reconhecimento do explorador pelo governo da República. Em sua última viagem, quando morreu, chegou às Ilhas Geórgia do Sul e seu corpo foi preservado para que pudesse ser trazido ao nosso país e continuar sua viagem até o porto de origem na Inglaterra. Foi nessa circunstância que o governo do Dr. Baltasar Brum solicitou ao Comitê Permanente do Parlamento que lhe prestasse as honras fúnebres de um Ministro de Estado. O embalsamamento do corpo foi realizado em 30 de janeiro de 1922, pela equipe médica e técnica do Hospital Militar, bem como as honras prestadas a ele pelo Serviço de Saúde do Exército e da Marinha.

Efficacy of Embalming Mixture Containing Formalin, Methanol and Water on Early Stage of Decomposition: A Validation Study

Background: Stabbing with kitchen knife is a common method of homicide in Nigeria; and embalming of decomposing stabbed cadavers has been a challenge for morticians in Nigeria, because of the impairment of embalming fluid through the damaged arteries. The aim of this study is to investigate the effectiveness of an embalming mixture containing formalin, methanol and water on stabbed early decomposing carcasses using porcine analogues. Methods: Two infant pigs were used for this study. Animals were sacrificed and allowed to reach the early stage of decomposition before embalming. Cervical arterial and hypodermic embalming techniques were employed. Post-embalming changes were observed and scored. A Pearson correlation analysis was used to determine the relationship between the outcome of embalmment and the embalming mixture. Results: There was a statistically significant moderate positive correlation (r = .576, n = 42, p = .001) between outcome of embalming, and duration of embalming; a statistically significant strong negative correlation (r = -.623, n = 42, p = .001) with volume of embalming fluid; and a statistically significant moderate negative correlation (r = -.528, n = 42, p = .001) with room temperature. There was a statistically insignificant very weak positive correlation (r = .186, n = 42, p = .239) between outcome of embalming and humidity; and a statistically insignificant very weak negative correlation (r = -.141, n = 42, p = .375) with atmospheric temperature. Conclusions: This study validated the embalming methodology and fluid suitable for arresting early decomposition process of stabbed infant carcasses in Nigeria. More so, an embalming mixture containing formalin, methanol and water in equal proportion is suitable for arresting early decomposition of stabbed cadavers.

Preservation of histology by phenol-based fixative: mini review of recent findings / Preservación de la histología mediante un fijador basado en fenol: una mini revisión de los hallazgos recientes

SUMMARY: In surgical and anatomical training, use of cadaver remains the most ideal technique. Standard formaldehyde solution preserves cadaveric tissues for an extended period comparing to the unfixed tissues. However, it fails to retain the natural texture, color, and biomechanical features. Phenol based soft embalming methods were developed to maintain these properties, while simultaneously decreasing the biohazard risk. Soft embalming techniques have made the bodies more 'lifelike' and wellfitted for training. Though phenol fixation displays rewarding morphological maintenance, we have scanty evidences on the histological preservation. This mini review primarily discussed the latest reports regarding the effect of phenol-based fixation on the tissue histology. Published literatures revealed phenol-based fixation displayed comparable histological preservation to that ofgold standard paraformaldehyde-based solution. It was concluded that phenol-based solution is an excellent fixative used to preserve tissues for microscopic analysis.

RESUMEN: En el entrenamiento quirúrgico y anatómico, el uso de cadáveres sigue siendo la técnica más ideal. La solución estándar de formaldehído conserva los tejidos cadavéricos durante un período prolongado en comparación con los tejidos no fijados. Sin embargo, no conserva la textura, el color y las características biomecánicas naturales. Se desarrollaron métodos de embalsamamiento blando a base de fenol para mantener estas propiedades y, al mismo tiempo, disminuir el riesgo biológico. Las técnicas de embalsamamiento suaves han hecho que los cuerpos sean más "realistas" y estén mejor preparados para la enseñanza. A pesar que la fijación de fenol muestra un buen mantenimiento morfológico, existe evidencia escasa sobre la preservación histológica. Esta mini revisión se refirió principalmente a los últimos informes sobre el efecto de la fijación en base de fenol en la histología del tejido. La literatura publicada reveló que la fijación a base de fenol mostró una preservación histológica comparable a la de la solución a base de paraformaldehído. Se concluyó que la solución a base de fenol es un excelente fijador utilizado para preservar tejidos para análisis microscópico.

Effect Of Formalin On C Reactive Protein And Pulmonary Function Tests In Undergraduate Medical Students In Anatomy Dissection Laboratory

Introduction: Formalin is the commonest fixative chemical used for preserving cadavers by embalming andother biological specimens which is commonly used in Medical colleges in Anatomy Dissection hall. C reactiveProtein is an annular pentameric protein found in blood plasma. CRP is synthesised by the liver and itsconcentration increases rapidly during inflammatory processes. The aim of the present study is to reveal thecorrelation between exposure to formalin and changes in pulmonary function tests in undergraduate medicalstudents and to find out the correlation between exposure to formalin and C reactive protein.Materials and Methods: The study was conducted on eighty (40 girls and 40 boys) first year undergraduatemedical students of both the gender between 18-22 years of age in Department of Anatomy and Physiology, ACSMedical college, Chennai. Pulmonary function tests was carried out by Computerised Spirometer before andafter two hours exposure to formalin in the Anatomy dissection hall. Blood sample for serum CRP level estimationwas also taken.Results: There is decrease in values of FVC, FEV1, FEV1/FVC, PEFR and FEF25-75 after 2 hours exposure to formalin.There is decrease in values of FVC, FEV1, FEV1/FVC, PEFR and FEF25-75 in the male participants after 2 hoursexposure to formalin and the only parameter which is statistically significant is PEFR in the female participantsafter exposure to formalin. The values of FEV1 and FEV1/FVC are statistically significant in male and femaleparticipants before exposure to formalin. The values of FEV1/FVC, PEFR and FEF25-75 are statistically significantin male and female participants after exposure to formalin. About 64 students have CRP range of 10.1-40.0mg/l (80%). About 4 students have more increased levels of CRP within the range of 40.1-80.0 mg/l (5%).Conclusion: There is great impact of formalin on CRP and Pulmonary function tests in first year undergraduatemedical students who are constantly exposed to formalin in Anatomy dissection laboratory. To avoid this, eitherprotective measures or alternative measures should be taken.

Identification of bacterial and fungal species in human cadavers used in anatomy teaching / Identificación de especies bacterianas y fúngicas en cadáveres humanos utilizados en la enseñanza de la anatomía

Within the framework of undergraduate and postgraduate medical education, cadavers have been used to teach anatomy by dissection or by using prosected specimens. To accomplish this, an appropriated preservation process must guarantee that the cadaver is kept safe for harm, destruction, and decomposition. Embalming fluid contains fixatives, disinfectants, surfactants, buffers, salt, and water, making the cadaver safe for teaching anatomy. However, it remains unclear if there is any risk of dissemination of microorganisms during anatomy teaching, research, and dissection procedures on fixed cadavers. The purpose of this study is to identify bacterial and fungal species in fixed cadaveric material used in anatomy teaching. Samples of cadavers and anatomical sections were cultured and biochemical tests and molecular identification by polymerase chain reaction (PCR) were performed to identify the microorganisms. The results indicate that fixed cadaveric material has viable bacteria on its surfaces and almost all these correspond to gram-negative bacilli of the Enterobacteriaceae family. In conclusion, fixed cadavers could be a reservoir of bacteria. This study underscores the importance of generating safe manipulation protocols to avoid eventual contamination and disease.

Dentro del curriculum de los programas de postgrado y pregrado de las carreras de la salud, los cadáveres han sido utilizados para la enseñanza de la anatomía mediante la disección o utilizando preparados anatómicos. Para poder llevar a cabo esto, el cadáver debe pasar por un adecuado proceso de preservación; en el que se utilizan fluidos que contienen fijadores, desinfectantes, surfactantes, buffers, sal y agua, los cuales lo protegen del deterioro y la descomposición. Las soluciones fijadoras y conservadoras contienen desinfectantes, surfactantes, fijadores, buffers, sal y agua, que hacen que el cadáver sea seguro para la enseñanza de la anatomía. Sin embargo, no está claro si existe algún riesgo de diseminación de microorganismos durante la enseñanza, investigación y/o disección en estos cadáveres. El propósito del estudio es identificar especies bacterianas y/o fúngicas en material cadavérico previamente fijado, usado en la enseñanza de la anatomía. Se realizaron cultivos y técnicas de identificación molecular mediante reacción en cadena de polimerasa de muestras tomadas desde material cadavérico para identificar los microorganismos encontrados. Los resultados indican que el material cadavérico previamente fijado posee bacterias en sus superficies, la mayoría corresponde a bacilos gram negativos de la familia de las Enterobacteriaceae. En conclusión, los cadáveres previamente fijados pueden ser reservorio de bacterias. Este estudio destaca la importancia de generar protocolos de manipulación con el fin de evitar una posible contaminación y enfermedad.

Técnica de embalsamiento de cadáver según Thiel: un método valioso para entrenar y mejorar las destrezas quirúrgicas en el campo de la otorrinolaringología / Thiel embalming technique for cadáver preservation: an overview of a valuable method for training and improvement of the surgical skills in otolaryngology

RESUMEN Los tiempos modernos nos obligan a que la formación de un médico cirujano no se base sólo en conocimientos teóricos, sino que adquiera las mayores habilidades quirúrgicas para así evitar riesgos innecesarios en una sociedad altamente exigente. La disección y el entrenamiento de los procedimientos quirúrgicos juegan un papel primordial para cumplir este objetivo, por lo que recientemente se ha promovido una forma de preservación cadavérica que permite realizar mediante situaciones bastantes realistas dichos adiestramientos. Se realizó una búsqueda bibliográfica electrónica, restringida al idioma inglés en Pubmed, Scopus y WOS donde se pretende describir y analizar las aplicaciones de esta técnica. La revisión ofreció artículos de relevancia que demuestran la aplicación de esta técnica novedosa en la preservación de cadáveres y sus posibles aplicaciones en el campo de otorrinolaringología.

ABSTRACT Nowadays, it is not possible to train a healthcare professional only based on theoretical knowledge, but acquiring the highest surgical skills to avoid unnecessary risks in a highly demanding society, therefore dissection and training of surgical procedures play a key role in fulfilling this objective, which is why a form of cadaveric preservation has recently been promoted, which allows realizing such training through realistic situations. An electronic literature search was carried out, restricted to the English language in MEDLINE, where it is intended to describe and analyze the applications of this technique. The review offered articles of relevance that demonstrate the application of this novel technique in the preservation of corpses and their possible applications in the field of otorhinolaryngology.

Body Donation vis-à-vis the Anatomist - Be Proactive, Vigilant and Safe.

Background: Most medical schools are facing a shortage of cadavers. The general attitude and propensity is to procure more cadavers for the Institute. In their efforts to procure bodies for dissection most anatomists ignore measures which ensure their own safety. Methods: In order to assess the attitudes of the anatomists towards the donated body and its management a structured questionnaire was framed in light of the literature. Results: The trends and results indicate that a lot needs to be done to inculcate ‘safe practices’ and develop a ‘seasoned etiquette’ and ‘mindset’ towards handling of bodies received in anatomy departments. Conclusion: Standard precautions should be taken during every moment of contact with cadaver. The donated bodies must immediately be categorized on receipt and bodies unsuitable for embalming must be refused by the institution. Hepatitis B vaccination is recommended for all personnel likely to come into contact with dead bodies. Formaldehyde levels must not exceed .1ppm for closed spaces.

Walter Thiel's embalming method: review of solutions and applications in different fields of biomedical research / Método de embalsamamiento de Walther Thiel: revisión de las soluciones y sus aplicaciones en diferentes campos de investigación biomédica

Walter Thiel developed the method that enables preservation of the body with natural colors in 1992. It consists in the application of an intravascular injection formula, and maintaining the corps submerged for a determinate period of time in the immersion solution in the pool. After immersion, it is possible to maintain the corps in a hermetically sealed container, thus avoiding dehydration outside the pool. The aim of this work was to review the Thiel method, searching all scientific articles describing this technique from its development point of view, and application in anatomy and morphology teaching, as well as in clinical and surgical practice. Most of these studies were carried out in Europe. We used PubMed, Ebsco and Embase databases with the terms "Thiel cadaver", "Thiel embalming", "Thiel embalming method" and we searched for papers that cited Thiel`s work. In comparison with methods commonly used with high concentrations of formaldehyde, this method lacks the emanation of noxious or irritating gases; gives the corps important passive joint mobility without stiffness; maintaining color, flexibility and tissue plasticity at a level equivalent to that of a living body. Furthermore, it allows vascular repletion at the capillary level. All this makes for great advantage over the formalin-fixed and fresh material. Its multiple uses are applicable in anatomy teaching and research; teaching for undergraduates (prosection and dissection) and for training in surgical techniques for graduates and specialists (laparoscopies, arthroscopies, endoscopies).

En 1992, Walter Thiel desarrolló el método que permite la preservación del cuerpo con colores naturales. Consiste en la aplicación de una fórmula de inyección intravascular y el mantenimiento del cuerpo sumergido en pileta, en una solución de inmersión específica, durante un período determinado de tiempo. Después de la inmersión, es posible mantener el cuerpo en un recipiente herméticamente sellado, evitando así la pérdida del líquido fijador, fuera de la pileta. El objetivo de este trabajo fue revisar el método de Thiel, buscando todos los artículos científicos que describen esta técnica desde el punto de vista de su desarrollo, y su aplicación en la enseñanza de la anatomía y morfología, así como en la práctica clínica y quirúrgica. La mayoría de estos estudios se realizaron en Europa. Utilizamos las bases de datos PubMed, Ebsco y Embase con los términos "Thiel cadaver", "Thiel embalsamamiento", "método de embalsamamiento de Thiel" y se buscaron los documentos que citan el trabajo de Thiel. En comparación con los métodos comúnmente utilizados con altas concentraciones de formaldehído, este método carece de emanación de gases nocivos o irritantes; Da al cuerpo una movilidad articular pasiva importante sin rigidez; Manteniendo el color, la flexibilidad y la plasticidad del tejido a un nivel equivalente al de un cuerpo vivo. Además, permite la repleción vascular a nivel capilar. Todo esto hace una gran ventaja sobre el material fijado con formalina y fresco. Sus usos múltiples son aplicables en la enseñanza y la investigación de la anatomía; (prosección y disección) y para la formación en técnicas quirúrgicas para graduados y especialistas (laparoscopias, artroscopias, endoscopias).

Incapability of Formalin Based Fixative to Kill Maggot in Mutilated Human Carrion.

Background: Embalming is a process used to temporarily preserve a human cadaver to forestall decomposition and make it suitable for display at funerals; thus, are agents that prevent autolysis and putrefaction. The outbreak of maggots from a heap of inadequately embalmed bodies due to deep cuts and bodies involved in inferno, necessitated the need to re-investigate the efficacy of formalin based embalming fluid and its inability to kill maggots. Methodology: Various strength of Formaldehyde, Xylene, Kerosene, and, Lime fluid, Isopropanol, Gamalin 20, Potassium ferrocyanide, and Physiological saline as control were used in the investigation. In the present investigation, Two maggots under the same atmospheric condition were put in each of the ten selected chemical reagents/solutions, including Lime, Kerosene, and the Gamalin 20 that are naturally available were initially dispensed into ten glass universal containers. Maggot movements in each reagent solution were critically observed. Result: Maggots death occurred within the first ten minutes in test number three groups III that contains Concentrated Formalin and Xylene andMaggots died after fifteenminute of the experiment, butmaggots did not died until about eight hours after the test in two of the experiment. Discussion: Results of this investigation showed clearly thatMaggots were not killed as soon as expected by the embalmerwhen ordinary ten percent alcoholic formalin embalming fluid is used. Equal volume of concentrated formalin plus Xylene was found out to be effective at killing maggot instantly. Conclusion: It is therefore advisable to use Xylene plus Conc. Formalin when preserving cadaver infested with Maggot and this could at the same time prevent the occurrence ofMaggots Infestation and better preservation of mass of burnt mutilated corpses in our Mortuary.

Evaluation of Techniques for Cleaning Embalmed Cadaver Bones.

Objective: The present study was conducted to find new technique for development of bone specimens from cadavers. Material andmethods: Long bones, skull and other bones from embalmed cadaver were taken and cleansed by variousmethods. Fourmethods were employed for preparing specimens. In 1stmethod boneswere boiled in tap water for 7-8 hours on gas stove. In 2nd method bones were immersed in water with addition of detergent at constant temperature. In 3rd method bones were kept at constant temperature in water without addition of detergent. In 4th method bones were buried for onemonth under superficial surface of soil during rainy season after boiling the bones for 7-8 hours Observations: Use of detergent in warmwater (65oC) was good for cleaning long bones while best result for long bones as well as skull was seen with boiling followed by burial of embalmed specimens. Results were found as expected. Time consumed in the present study was less than old classical methods. Bones specimens formed were of high quality. Conclusions: Preparation of bone specimen by embalmed cadaver can be of immense value and time saver for many research institutes to get their self-prepared specimens. There are many more ways which has to be modified or rediscovered in this area of research, which has been neglected so far.

Comparisons in soft-tissue thicknesses on the human face in fresh and embalmed corpses using needle puncture method / Comparación en el grosor del tejido blando de la cara, con el método de punción con aguja, en cadáveres frescos y conservados

The aim of the present study is to analyze the differences in the soft facial tissue thicknesses measured in corpses without fixing, with recent death, and in embalmed corpses. 30 male human corpses were used; they were divided into two groups according to the presence or absence of a conservation method. Fifteen bodies, without any method of conservation, with an average age of 38.6 years (SD 8.37) and Fifteen preserved bodies by means of the intravascular injection technique of fixing conservative solution on the basis of formaldehyde, with an average age of 38.4 years (SD 7.67). In each one of them the thickness was measured in eight medium and six bilateral paramedium landmarks, using the needle-punction method. The descriptive statistical ones were calculated and the t test was applied with 95 percent of significance. All the landmarks, except for right exocanthion and left and right gonion, presented bigger thickness in the cadavers embalsamed. You differ significant they were in the Trichion, glabella, nasion, pogonion, right superciliare, right supraorbital, right infraorbital, right gonion, left superciliare, left supraorbital, right infraorbital landmarks.

El propósito de este estudio fue analizar las diferencias en el grosor tisular facial entre cadáveres frescos y conservados. Se utilizaron 30 cadáveres de sexo masculino, 15 de los cuales presentaron una data de muerte media de (SD) y los otros 15 fueron cadáveres conservados mediante inyección intravascular de solución fijadora conservadora en base a formol. En cada uno de ellos fueron medidos los grosores en 8 puntos medianos y 6 puntos paramedianos bilaterales, utilizando el método de punción con aguja. Se calcularon los estadísticos descriptivos y luego se aplicó el t test con un 95 por ciento de significancia. Todos los puntos, con excepción de Exocanthion derecho y Gonion derecho e izquierdo, presentaron grosores mayores en los cadáveres conservados. Diferencias significativas se encontraron en los puntos Trichion, Glabela, Nasion, Pogonion, Superciliar derecho, Supraorbitario derecho, Infraorbitario derecho, Gonion derecho, Superciliar izquierdo, Supraorbitario izquierdo, Infraorbitario derecho.

Emergency Procedure Training of Residents Using Lightly Embalmed Cadavers; 3-year Experience

PURPOSE: Emergency procedures are highly dependent on the skill and experience of the physician performing them. Recent advances in light embalming techniques have enabled us to train students on more "realistic" cadavers. The purpose of this study was to report on or 3-year experience with lightly embalmed cadaver-based training and evaluate the student satisfaction with this approach. METHODS: Lightly embalmed cadavers were prepared by the Department of Anatomy. The course was held every March for 3 years. In 2007, we held a 6-hour course for 16 first-year emergency medicine residents from various hospitals. We had procedure and demonstration stations for airway management, tube thoracostomy, central venous catheterization, venous cutdown, pericardiocentesis, intraosseous insertion, open thoracostomy, and lumbar puncture. We evaluated the students' level of satisfaction with the course by giving pre- and post-course evaluations to all students. RESULTS: Based on our experience from the two prior courses, the 2007 curriculum was divided into three parts: didactic lecture, procedure stations and demonstration stations. Pre- and post-course scores were compared for the following: knowledge of the indications and contraindications for the procedures; ability and confidence in performing the procedures; and the ability to perform procedures on actual patients. For 26 items out of a total of 32 items(81.3%), the scores from the post-course evaluation were statistically higher than the scores from the pre-course evaluation. CONCLUSION: Lightly embalmed cadavers are excellent training models for emergency procedures. From our 3-year experience with this method, we were able to develop a training course that was satisfactory to students.

Toxic effects of embalming fluid on medical students and professionals.

Vapours of embalming fluid in the dissection room are a perennial cause of irritation to the mucous membranes of the pharynx, upper respiratory tract and eyes. We made an attempt to assess the discomfort level produced by formalin and that produced by the standardized embalming fluid used in our department. A list of twenty symptoms was made and circulated among students attending dissection and students were asked to grade the severity of each symptom experienced on a scale of 1 to 4. Individual scores of each symptom were statistically compared and summated, and the same reflected the general acceptability of the embalming fluid.