ABSTRACT
Abstract The postoperative outcome of rectal cancer has been improved after the introduction of the principles of total mesorectal excision (TME). Total mesorectal excision includes resection of the diseased rectum and mesorectum with non-violated mesorectal fascia (en bloc resection). Dissection along themesorectal fascia through the principle of the "holy plane" minimizes injury of the autonomic nerves and increases the chance of preserving them. It is important to stick to the TME principle to avoid perforating the tumor; violating the mesorectal fascia, thus resulting in positive circumferential resection margin (CRM); or causing injury to the autonomic nerves, especially if the tumor is located anteriorly. Therefore, identifying the anterior plane of dissection during TME is important because it is related with the autonomic nerves (Denonvilliers fascia). Although there are many articles about the Denonvilliers fascia (DVF) or the anterior dissection plane, unfortunately, there is no consensus on its embryological origin, histology, and gross anatomy. In the present review article, I aim to delineate and describe the anatomy of the DVF inmore details based on a review of the literature, in order to provide insight for colorectal surgeons to better understand this anatomical feature and to provide the best care to their patients.
Resumo O resultado pós-operatório do câncer retal foi melhorado após a introdução dos princípios da excisão total do mesorreto (TME, na sigla em inglês). A excisão total do mesorreto inclui a ressecção do reto e do mesorreto afetados com fáscia mesorretal não violada (ressecção em bloco). A dissecção ao longo da fáscia mesorretal pelo princípio do "plano sagrado" minimiza a lesão dos nervos autônomos e aumenta a chance de preservá-los. É importante seguir o princípio da TME para evitar: a perfuração do tumor; a violação da fáscia mesorretal, resultando em margem de ressecção circunferencial (CRM) positiva; ou a lesão aos nervos autônomos, especialmente se o tumor estiver localizado anteriormente. Portanto, a identificação do plano anterior de dissecção durante a TME é importante, pois está relacionada comos nervos autonômicos (fáscia de Denonvilliers). Embora existammuitos artigos sobre a fáscia de Denonvilliers (DVF, na sigla em inglês) ou o plano de dissecção anterior, infelizmente não há consenso sobre sua origem embriológica, histologia e anatomia macroscópica. No presente artigo de revisão, retendo delinear e descrever a anatomia da DVF em mais detalhes com base em uma revisão da literatura, a fim de fornecer subsídios para os cirurgiões colorretais entenderemmelhor esta característica anatômica e fornecer o melhor cuidado para seus pacientes.
Subject(s)
Rectal Neoplasms , Fascia/anatomy & histology , Rectum/anatomy & histology , Rectum/surgery , Rectum/pathologyABSTRACT
La falla intestinal (FI) se define como la disminución de la función del intestino por debajo de lo mínimo necesario para la absorción de los macronutrientes y / o agua y electrolitos, de tal manera que se requiere de la suplementación intravenosa (SIV) para mantener la salud y el crecimiento. Desde el punto de vista funcional se clasifica en tres tipos. FI tipo I: condición aguda, de corto duración y generalmente auto limitada, FI tipo II: estado agudo prolongado, a menudo en pacientes metabólicamente inestables, que requieren cuidado multidisciplinario y SIV durante períodos de una semana o meses, acompañada de complicaciones sépticas, metabólicas y nutricionales y FI tipo III: condición crónica, en pacientes metabólicamente estables, que requieren SIV durante meses o años. Su manejo requiere de terapia nutricional y en casos seleccionados cirugía autóloga de reconstrucción(AU)
Intestinal failure (FI) is defined as the decrease in intestinal function below the minimum necessary for the absorption of macronutrients and / or water and electrolytes, in such a way that intravenous supplementation (IVS) is required to maintain health and growth. From a functional point of view, it is classified into three types. FI type I: acute condition, of short duration and generally self-limited, FI type II: prolonged acute state, often in metabolically unstable patients, requiring multidisciplinary care and SIV for periods of a week or months, accompanied by septic, metabolic and nutrition and FI type III: chronic condition, in metabolically stable patients, who require SIV for months or years. Its management requires nutritional therapy and in selected cases autologous reconstruction surgery(AU)
Subject(s)
Short Bowel Syndrome/therapy , Intestinal Diseases/complications , Intestinal Diseases/diagnosis , Intestinal Diseases/etiology , Quality of Life , Chronic Disease , Dietary Supplements , Intestinal Failure , Ischemia/complicationsABSTRACT
Hepatitis D is considered to be the most severe form of viral hepatitis. This virus requires hepatitis B for its life cycle and it is estimated that at least 5% of hepatitis B virus infected patients are also infected with hepatitis D, counting for 15 million infections worldwide most optimistically. Hepatitis D has a similar transmission pattern to hepatitis B and hepatitis C viruses. However, there is less information about the virus of hepatitis D than aboutthe other agents of viral hepatitis. In particular, there is total lack of information on hepatitis D in the setting of dental diseases and management. To our knowledge, there are only few reports on hepatitis D of dental health care workers (DHCW), the association of hepatitis D with oral conditions and on the role of oral fluid in transmission of hepatitis D. The present report reviews current knowledge of hepatitis D for dentists and dental personnel. Therefore, epidemiology, transmission modes, sign and symptoms, diagnostic methods and treatment options of hepatitis D are discussed under relevant subheadings
ABSTRACT
Neste estudo qualitativo objetivamos investigar como a temática planejamento de ensino vem sendo tratada na produção científica da Área de Conhecimento da Educação Física (EF). Foi realizada uma revisão de literatura em periódicos nacionais de estrato A1 a B2 do Qualis CAPES para a "Área de Avaliação Educação Física", que compreendeu o período de 2001 até 2016. Foi possível inferir que os estudos são pautados por reflexões e problematizações que enfatizam a necessidade de planejar coletivamente, a importância de vincular o planejamento à proposta do Projeto Político-Pedagógico, a coerência entre o que se planeja e a visão de sociedade e de aluno que queremos, e ainda a possibilidade que o exercício de planejar oferece no sentido de respaldar a EF como importante componente curricular. Destacamos que o planejamento participativo, embora não seja uma temática nova, vem ganhando força nos estudos encontrados, sobretudo no que se refere à participação ativa dos alunos na sua construção.
This qualitative study aimed to investigate the theme of education planning has been treated in the scientific production of the Knowledge Area of Physical Education (PE). It was made a reviwe in national journals literature with stratum A1 to B2 of the Qualis CAPES to the "Physical Education Evaluation Area", which covered the period 2001 to 2016. It was possible to infer that the studies are guided by reflections and problematizations that emphasize the need to plan collectively, the importance of linking planning the proposal of the political-pedagogical project, coherence between what is planned and the company's vision and student we want, and the possibility that the exercise plan offers towards to support the EF as important curricular component. We highlight that participatory planning, although not a new theme, is gaining strength in the studies found, especially as regards the active participation of students in their construction.
Este estudio cualitativo tuvo como objetivo investigar el tema de la planificación de la educación ha sido tratado en la producción científica del área de conocimiento de Educación Física (PE). Fue realizada una revisión en revistas nacionales de la literatura estrato A1 a B2 del Qualis CAPES fue hecho a la "zona de Evaluación de la Educación Física", que abarcaba el período de 2001 a 2016. Fue posible inferir que los estudios son guiados por reflexiones y problematizaciones que enfatizan la necesidad de planificar colectivamente, la importancia de vincular la planificación de la propuesta del proyecto político-pedagógico, la coherencia entre lo que se planifican y la visión y el estudiante que queremos de la compañía, y la posibilidad de que el plan de ejercicios ofrece hacia para apoyar la EF como componente curricular importante. Destacamos que la planificación participativa, aunque no es un tema nuevo, está ganando fuerza en los estudios encontrados, especialmente en lo que se refiere a la participación activa de los estudiantes en su construcción.
Subject(s)
Physical Education and Training/organization & administration , Teaching/organization & administration , Curriculum/standards , Faculty/educationABSTRACT
Implant material, implant design, surface quality, status of the bone, surgical technique, and implant loading conditions were regarded as prerequisites for osseointegration which is a prime condition for implant success. The aim of this review paper was to investigate the survival rate of single implants in relation to the prerequisites for osseointegration. Fifty-eight papers reporting survival rates of single implants were selected by use of the 'PubMed' and hand searching. The survival rate of single implants were assessed with reference to factors influencing osseointegration. The results showed that single implants in general showed a high survival rate except a few failures in certain extreme conditions and early stages. Those failures and complications such as screw loosening and esthetic problem were almost solved with the development of implant components and surgical techniques and a better understanding of biology around a single implant. Single-tooth implant-replacement is now considered as a reliable and predictable treatment option for a single missing tooth and its application seems to expand to compromised situations which were previously thought to be impossible for single implant therapy.