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En el presente artículo se hace una revisión sistemática o evaluativa de carácter descriptivo-exploratorio donde se buscaron los estudios más relevantes de forma sistematizada en relación a la terminología anatómica, se abordó su historia, su evolución hasta el presente y las dificultades existentes para su correcta aplicación y difusión(AU)
In the present article a systematic or evaluative review of descriptive-exploration nature is made, where the most relevant studies searched in a systematic way in relation to the anatomic terminology, its history, its evolution to the present and the existing difficulties for its correct application and dissemination were addresse(AU)
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Humanos , Terminología , Disección , Anatomía/educación , Disciplinas de las Ciencias Biológicas , Fuentes de InformaciónRESUMEN
ABSTRACT Objective: To evaluate the surgical anatomy of the kidney collecting system through a narrative review of the literature, highlighting its importance during diagnosis and its approach during surgical procedures for the treatment of renal stones. Material and Methods: We carried out a review about the anatomy of the kidney collecting system. We analyzed papers published in the past 40 years in the databases Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials and opinions of specialists. Results: Renal collecting system could be divided in four groups: A1 - kidney midzone (KM), drained by minor calyx that are dependent on the superior or the inferior caliceal groups; A2 - KM drained by crossed calyx, one draining into the superior caliceal group and another draining into the inferior caliceal group; B1 - KM drained by a major caliceal group independent of both the superior and inferior groups; and B2 - KM drained by minor calyx entering directly into the renal pelvis. Some details and anatomic variations of the collecting system are related to clinical and radiological aspects, particularly perpendicular calyces, interpyelocalyx space, position of calyces in relation to renal border, classification of the renal collecting system, infundibular diameter and the angle between the lower infundibulum and renal pelvis. Conclusion: The knowledge of intra-renal collecting system divisions and variations as the angle between the renal pelvis and lower infundibula, position of the calices in relationship with renal edge and the diameter and position of the calyces are important for the planning of minimally invasive renal surgeries.
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SUMMARY: The quest for aesthetic procedures is experiencing a steady increase in popularity, concomitant with the expanding array of available treatment options. Of notable interest is the burgeoning trend in the use of minimally invasive techniques. Among the various aspects of facial anatomy, the platysma stands as a pivotal element that significantly influences the aesthetic appearance of the neck region. It has garnered particular attention as a strategic focal point in various treatments geared towards enhancing the neck's visual appeal. Additionally, the versatility of the platysma extends beyond the realm of cosmetic improvements. Its functional significance is recognized in reconstructive surgical procedures, where it may be harnessed for specific maneuvers. Furthermore, the muscle serves as a critical access point for minimally invasive endoscopic surgeries in the neck region. While these developments hold great promise, it is crucial to underscore that safety should always take precedence in any medical or surgical approach. This applies equally to the neck region, which presents a complex and intricate anatomical landscape. An in-depth understanding and meticulous investigation of the platysma in all its diverse aspects are paramount to ensuring the success and safety of any procedure conducted in this region. This comprehensive review aspires to provide a contemporary understanding of the platysma, offering an in-depth analysis that encompasses its intricate anatomy, histological characteristics, and multifaceted clinical implications. By delving into these diverse dimensions, it aims to equip healthcare professionals and researchers with a robust foundation for informed decision-making and practice.
La búsqueda de procedimientos estéticos ha experimentado un aumento constante en popularidad, junto con la creciente gama de opciones de tratamientos disponibles. De notable interés es la creciente tendencia en el uso de técnicas mínimamente invasivas. Entre los diversos aspectos de la anatomía facial, el platisma destaca como un elemento fundamental que influye significativamente en la apariencia estética de la región del cuello. Ha ocasionado especial atención como punto focal estratégico en varios tratamientos orientados a mejorar el atractivo visual del cuello. Además, la versatilidad del platisma se extiende más allá del ámbito de las mejoras cosméticas. Su importancia funcional se reconoce en procedimientos quirúrgicos reconstructivos, donde se puede aprovechar para maniobras específicas. Además, el músculo sirve como punto de acceso crítico para cirugías endoscópicas mínimamente invasivas en la región del cuello. Si bien estos avances son muy prometedores, es fundamental subrayar que la seguridad siempre debe tener prioridad ante cualquier abordaje médico o quirúrgico. Esto se aplica igualmente a la región del cuello, que presenta un aspecto anatómico complejo e intrincado. Una comprensión profunda y una investigación meticulosa del platisma en todos sus diversos aspectos son fundamentales para garantizar el éxito y la seguridad de cualquier procedimiento realizado en esta región. Esta revisión integral aspira a proporcionar una comprensión contemporánea del platisma, ofreciendo un análisis en profundidad que abarca su intrincada anatomía, características histológicas e implicaciones clínicas multifacéticas. Al profundizar en estas diversas dimensiones, su objetivo es dotar a los profesionales e investigadores de la salud de una base sólida para la toma de decisiones y la práctica informadas.
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En la asignatura de anatomía aún existen estudiantes que no se encuentran motivados con su propio proceso de aprendizaje. El rol del docente es un factor extrínseco clave que contribuye a dicha vinculación afectiva. El Diseño Universal para el Aprendizaje (DUA) es un modelo educativo que propone una serie de pautas de aplicación docente para poder activar en los alumnos sus redes neuronales afectivas, asociadas con la formación de estudiantes decididos y motivados. El objetivo de este estudio es crear una propuesta de intervención, basada en el uso selectivo de las pautas de compromiso afectivo del DUA, para mejorar la práctica docente y la motivación de los estudiantes en anatomía. Es una investigación acción que utiliza el modelo de Whitehead, implicando el cruce conceptual y metodológico entre las pautas de compromiso afectivo del DUA y las fases y factores que determinan la motivación. Corresponde a la programación de seis sesiones de laboratorio de anatomía, los instrumentos para la recopilación de la información y las técnicas de análisis de la misma. La propuesta de intervención presenta un valor teórico ya que fue diseñada a partir de un análisis exhaustivo del DUA y de las publicaciones existentes sobre la motivación, y un valor práctico que se sustenta en su aplicabilidad directa y recursiva en los laboratorios de anatomía y en la incorporación del DUA en el currículum de una asignatura de educación superior. La motivación es el motor de la educación, ya que impulsa y mantiene el quehacer académico tanto a nivel estudiantil como docente. El DUA permite que los docentes aborden la desmotivación de los estudiantes de una forma accesible, precisa y confiable, lo que llevó a considerarlo como uno de los pilares de la propuesta de intervención.
SUMMARY: In anatomy courses there are still students who are not motivated by their own learning process. The teacher´s role is a key extrinsic factor that contributes to this bonding process. Universal Design for Learning (UDL) is an educational model that proposes a series of teaching application guidelines to activate students' affective neural networks, associated with the formation of motivated students. The objective of this study is to create an intervention proposal, based on the selective use of the UDL affective commitment guidelines, to improve teaching practice and student motivation in anatomy. It is an action research that uses Whitehead's model, involving the conceptual and methodological intersection between the UDL's affective commitment guidelines and the phases and factors that determine motivation. It corresponds to the programming of six anatomy laboratory sessions, the instruments for collecting information and the techniques for analyzing it. The intervention proposal has a theoretical value since it was designed based on an exhaustive analysis of the UDL and existing publications on motivation, and a practical value that is based on its direct and recursive applicability in anatomy laboratories and in the incorporation of the UDL in the curriculum of a higher education subject. Motivation is the driving force of education, since it drives and maintains academic work at both the student and teacher level. The UDL allows teachers to address student lack of motivation in an accessible, precise and reliable way, considering this one of the pillars of the intervention proposal.
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SUMMARY: The thyrohyoid muscle is one of the four infrahyoid muscles. Its role in vocalization and deglutition could be often overlooked, despite its crucial participation in these processes. Unlike other infrahyoid muscles, the thyrohyoid muscle receives innervation from the first cervical spinal nerves which contributes to its unique function. Its primary action involves hyolaryngeal elevation during swallowing, contributing to the opening of the upper esophageal sphincter. In conjunction with other muscles, it also protects the airway and facilitates the passage of food into the esophagus. Variations in the muscle's thickness may exist, and its function can be influenced by chewing habits. Weakened muscles involved in swallowing are often associated with dysphagia, a common complication in stroke and brain-injured patients. Advanced imaging techniques and sleep studies have provided insights into the dynamics and frequency of swallowing. This review explores the anatomic structures, function in action, diagnosis and clinical implications of this muscle. Overall, understanding the significance of the thyrohyoid muscle enhances our comprehension of the intricate interplay of laryngeal muscles during vocalization and deglutition.
El músculo tirohioideo es uno de los cuatro músculos infrahioideos. A menudo podría pasarse por alto su papel en la vocalización y la deglución, a pesar de su participación crucial en estos procesos. A diferencia de otros músculos infrahioideos, el músculo tirohioideo recibe inervación de los primeros nervios espinales cervicales, lo que contribuye a su función única. Su acción principal implica la elevación hiolaríngea durante la deglución, contribuyendo a la apertura del esfínter esofágico superior. Junto con otros músculos, también protege las vías respiratorias y facilita el paso de los alimentos al esófago. Pueden existir variaciones en el grosor del músculo y su función puede verse influenciada por los hábitos de masticación. Los músculos debilitados involucrados en la deglución a menudo se asocian con disfagia, una complicación común en pacientes con accidente cerebrovascular y lesión cerebral. Las técnicas de imagen avanzadas y los estudios del sueño han proporcionado información sobre la dinámica y la frecuencia de la deglución. Esta revisión explora las estructuras anatómicas, la función en acción, el diagnóstico y las implicaciones clínicas de este músculo. En general, comprender la importancia del músculo tirohioideo mejora nuestra comprensión de la intrincada interacción de los músculos laríngeos durante la vocalización y la deglución.
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Aprendizajes en anatomía humana tradicionalmente han sido evaluados a través del reconocimiento de estructuras anatómicas. A pesar de su popularidad, pueden tener un componente subjetivo y memorístico. El Examen Práctico Objetivo Estructurado (EPOE) se ha presentado como una manera más global de evaluación. El objetivo de este estudio fue evidenciar el efecto en el rendimiento académico tras la implementación del EPOE en pasos prácticos. En el estudio 2312 estudiantes fueron divididos: Metodología Tradicional (n=1155) y Metodología EPOE (n=1157). A su vez, los estudiantes fueron identificados según carrera: Enfermería (n=1182); Fonoaudiología (n=185); Kinesiología (n=514) y Terapia Ocupacional (n=431). Se mantuvieron las condiciones de la asignatura en ambos grupos con tres evaluaciones prácticas. Se analizaron las calificaciones obtenidas. Evaluaciones 1 y 2 no presentaron diferencias entre grupos. Evaluación 3, que evaluó sistema nervioso, mostró disminución significativa de 0,5 puntos en el grupo EPOE. El factor tipo de metodología resultó ser significativo en evaluación 3 (p < 0,001; h2p = 0,029) y promedio de las 3 evaluaciones (p < 0,029; h2p = 0,002). El factor carrera resultó ser significativo para las tres evaluaciones. La interacción de ambos factores no mostró significancia estadística. El análisis post hoc mostró diferencias significativas entre estudiantes de Enfermería con las demás carreras, ya que obtuvieron mejores calificaciones en todas las evaluaciones (p < 0,05). Metodología EPOE no produjo drásticos cambios en el rendimiento académico de los estudiantes y tiene un amplio potencial de desarrollo por su naturaleza de evaluación integral no invasiva ni traumática. Se debe considerar la naturaleza de los contenidos en el diseño de la metodología de enseñanza-aprendizaje y en la metodología de evaluación, alineando a nivel microcurricular estos aspectos fundamentales de la formación de nuevos profesionales de la salud.
SUMMARY: Learning in human anatomy has traditionally been assessed by recognizing anatomical structures. Despite their popularity, they can have a subjective component. The Objective Structured Practical Examination (EPOE) has been presented as a more global way of assessment. The aim of this study was to demonstrate the effect on academic performance after the implementation of the EPOE in practical activities. In this study 2312 students were divided into Traditional Methodology (n=1155) and EPOE Methodology (n=1157). In turn, students were identified according to career: Nursing (n=1182), Speech Therapy (n=185), Physical Therapy (n=514), and Occupational Therapy (n=431). Subject conditions were maintained in both groups with three practical evaluations. The grades obtained were analyzed. Assessments 1 and 2 showed no differences between groups. Evaluation 3, which evaluated the nervous system, showed a significant decrease of 0.5 points in the EPOE group. The type of methodology factor was significant in evaluation 3 (p < 0.001; ?2p = 0.029) and the average of 3 evaluations (p < 0.029; ?2p = 0.002). The career factor was significant for all three evaluations. The interaction of both factors did not show statistical significance. The post hoc analysis showed significant differences between nursing students and the other careers since they obtained better scores in all evaluations (p < 0.05). EPOE methodology did not produce drastic changes in students' academic performance and had a broad potential for development due to its non-invasive and non-traumatic comprehensive assessment nature. The nature of the contents should be considered in the design of the teaching-learning methodology and the evaluation methodology, aligning at the micro-curricular level with these fundamental aspects of training new health professionals.
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La presente revisión narrativa propone caracterizar las estrategias didácticas actualmente utilizadas en el Instituto de Anatomía, Histología y Patología (IAHP) de la Universidad Austral de Chile (UACh), para la enseñanza-aprendizaje de la anatomía humana en los alumnos de las escuelas de Enfermería, Kinesiología, Medicina, Obstetricia y Puericultura, Odontología y Terapia Ocupacional de su Facultad de Medicina. Se listan las diversas estrategias didácticas implementadas y se explica la manera en que se han venido aplicando en esta institución a fin de perfeccionar la enseñanza anatómica, considerando los retos y desafíos que demandan las generaciones actuales de estudiantes y la dinámica del mundo contemporáneo.
This narrative review aims to describe the didactic strategies currently employed by the Institute of Anatomy, Histology, and Pathology at the Universidad Austral de Chile (UACh) for teaching Human Anatomy to students in the Nursing, Kinesiology, Medicine, Obstetrics and Childcare, Dentistry, and Occupational Therapy programs of its Faculty of Medicine. The implemented teaching strategies for improving anatomical teaching in this institution are listed and explained, considering the challenges posed by current generations of students and the dynamics of the contemporary world.
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SUMMARY: This work investigated the morphology of the root canal system of the mandibular first molar in a Malaysian subpopulation. Using micro-computed tomography with an isotropic resolution of 22 µm, 140 mandibular first molars were scanned. MIMICS software was used for segmentation, 3-D reconstruction and analysis of the acquired images. The canal configuration was described using Vertucci [supported by the supplementary configurations proposed by Sert & Bayirli (2004)] and Ahmed et al. (2027), coding systems. The chi-square test was used to assess the association between qualitative variables. By non-considering intercanal communications, Vertucci types IV (17.1%) and I (76.4%) were the most frequently reported configurations in the mesial and distal roots, respectively. Of the reported configurations, 24.3% and 4.3% were non-classifiable by Vertucci system in the mesial and distal roots, respectively. Up to 63.6% and 9.3% of the reported configurations were non- classifiable, and type I was the most frequent when considering intercanal communications (7.1% and 76.4% in the mesial and distal roots, respectively). According to Ahmed et al., system, almost half of the sample had more than four digits (47.9%), followed by the 3-digits category (20.71%). In both systems, a significant association was found between the canal configuration and the root type (p<0.001). The mandibular first molar of this Malaysian subpopulation demonstrated a wide range of root canal morphology. When compared to the Vertucci system, the system developed by Ahmed et al., successfully classified all molars configurations despite their level of complexity. The complex canal anatomy of mandibular first molars in this subpopulation warrants special attention during root canal treatment procedures.
En este trabajo se investigó la morfología del sistema de conductos radiculares del primer molar mandibular en una subpoblación de Malasia. Utilizando tomografía microcomputada con una resolución isotrópica de 22 µm, se escanearon 140 primeros molares mandibulares. Se utilizó el software MIMICS para segmentar (enmascarar), reconstruir en 3D, visualizar y analizar las imágenes adquiridas. La configuración del canal se describió utilizando Vertucci respaldado por las configuraciones complementarias propuestas por Sert & Bayirli (2004)] y Ahmed et al. (2017, 2020), sistemas de codificación. Se utilizó la prueba de chi-cuadrado para evaluar la asociación entre variables cualitativas. Sin considerar las comunicaciones intercanales, los tipos Vertucci IV (17,1%) y I (76,4%) fueron las configuraciones reportadas con mayor frecuencia en las raíces mesiales y distales, respectivamente. De las configuraciones reportadas, el 24,3 % y el 4,3 % fueron no clasificables por el sistema de Vertucci en las raíces mesial y distal, respectivamente. Hasta el 63,6 % y el 9,3 % de las configuraciones reportadas fueron no clasificables, siendo la tipo I la más frecuente al considerar las comunicaciones intercanales (7,1 % y 76,4 % en las raíces mesiales y distales, respectivamente). Según Ahmed et al. (2017, 2020) en el sistema, casi la mitad de la muestra tenía más de cuatro dígitos (47,9 %), seguido por la categoría de 3 dígitos (20,71 %). En ambos sistemas se encontró una asociación significativa entre la configuración del canal y el tipo de raíz (p<0,001). El primer molar mandibular de esta subpoblación de Malasia demostró una amplia gama morfológica del conducto radicular. En comparación con el sistema Vertucci, el sistema desarrollado por Ahmed et al. (2017, 2020) clasificaron con éxito todas las configuraciones de los molares a pesar de su nivel de complejidad. La compleja anatomía del canal de los primeros molares mandibulares en esta subpoblación merece una atención especial durante los procedimientos de tratamiento de conducto.
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Humanos , Cavidad Pulpar/diagnóstico por imagen , Microtomografía por Rayos X , Diente Molar/diagnóstico por imagen , Cavidad Pulpar/anatomía & histología , Malasia , Diente Molar/anatomía & histologíaRESUMEN
En el arco posterior del atlas se describe una variación de tejido óseo denominada Ponticulus posticus (PP), la cual se ha relacionado con el desarrollo de dolor cervical. El objetivo de este estudio fue determinar la frecuencia de PP en telerradiografías laterales digitales. Este estudio correspondió a un estudio observacional descriptivo, donde se analizaron 450 telerradiografías laterales digitales obtenidas de la base de datos del Servicio de Imagenología Oral y Maxilofacial de la Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile. Se analizó la presencia de PP en cada cefalograma, y se utilizó la clasificación de Cederberg y Stubbs para determinar los grados de osificación. Se aplicó la prueba de Chi-cuadrado para establecer una asociación entre la presencia de PP con el sexo y la edad. De las 450 telerradiografías laterales el 42,4 % presenta PP, con una mayor prevalencia entre el rango de 21-40 años. En cuanto al grado de osificación, el grado 2 fue el tipo más prevalente (25 %), seguido del grado 4 (9,5 %), el grado 3 (8 %). No se encontró asociación entre la presencia de PP con edad y género (P > 0,05). La PP es frecuente en la población y se observa a diferentes edades sin predilección por sexo.
SUMMARY: A bony tissue variation called Ponticulus posticus (PP) is described in the posterior arch of the atlas, which has been associated with the development of cervical pain. The aim of this study was to determine the frequency of PP in digital lateral cephalograms. This study was an observational descriptive study, in which 450 digital lateral cephalograms obtained from the database of the Oral and Maxillofacial Imaging Service of the Faculty of Dentistry of the Andrés Bello University, Viña del Mar, Chile, were analyzed. The presence of PP was analyzed in each cephalogram, and the Cederberg and Stubbs classification was used to determine the degrees of ossification. The Chi-square test was applied to establish an association between the presence of PP with gender and age. Of the 450 lateral cephalograms, 42.4 % presented PP, with a higher prevalence in the 21-40 year range. In terms of the degree of ossification, grade 2 was the most prevalent type (25 %), followed by grade 4 (9.5 %), and grade 3 (8 %). No association was found between the presence of PP with age and gender (P > 0.05). PP is common in the population and is observed at different ages without a sex preference.
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Atlas Cervical/diagnóstico por imagen , Cráneo/diagnóstico por imagen , Telerradiología , Distribución de Chi-Cuadrado , Estudios Retrospectivos , Distribución por Edad y SexoRESUMEN
La presente revisión narrativa trata de caracterizar como ha sido el proceso de enseñanza de la anatomía en la Universidad Austral de Chile (UACh), presentando una visión histórica desde los inicios de la Universidad a los tiempos actuales y una reflexión sobre el futuro de la Anatomía Humana. Se describen los orígenes del Instituto de Anatomía de la UACh, primeros académicos, logros institucionales, convenios interinstitucionales; además, se detallan los métodos y estrategias educativas utilizadas en la actualidad para la enseñanza anatómica y se presenta una visión panorámica del porvenir como instituto de docencia e investigación en el campo de la Anatomía humana.
SUMMARY: This narrative review tries to characterize how the anatomy teaching process has been carried out at the Universidad Austral de Chile (UACh), presenting a historical vision from the beginnings of the University to the present time and a reflection on the future of Human Anatomy. The origins of the Human Anatomy Institute at the UACh, first academics, institutional achievements, inter-institutional agreements are described; in addition, the educational methods and strategies currently used for anatomical teaching are detailed and a panoramic vision of the future as a teaching and research institute in the field of human anatomy is presented.
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Humanos , Historia del Siglo XX , Historia del Siglo XXI , Universidades/historia , Anatomía/educación , Anatomía/historia , ChileRESUMEN
Abstract The aim of this study was to assess the centralization and dentin thickness of mesial root canals of the first mandibular molars by microcomputed tomography (micro-CT). Material and methods: Ninety-nine mandibular molars of Vertucci's type IV canals were scanned by micro-CT. The mesiodistal deviation and centroid were assessed, in both mesiobuccal (MB) and mesiolingual (ML) canals, for the apical 4mm and the full canal length. Results: The dentin thickness was similar for both MB and ML canals. The narrowest thickness was in the distal wall of an MB canal (0.07mm), while the widest was found in the mesial wall of an MB canal (2.46mm). In centroid analysis, both the MB and ML canals exhibited deviations when compared to the root centroid, along the full canal length and the apical 4mm. For the MB canal, the mean deviation was 0.83mm (0.02 mm-2.30 mm) for the full canal and 0.18mm (0.01 mm-1.01 mm) for apical 4mm. Similarly, for the ML canal, the mean deviation measured 0.83 mm (0.05mm-3.99mm) for the full canal and 0.21 mm (0.01mm-1.01mm) for the apical 4 mm. Overall, deviations were observed towards the mesial of the roots, with 69% for MB and 57% for ML canals for the full canal, and 51% for MB canals within the 4 mm. The exception was the ML canal, which exhibited a higher deviation towards distal in the apical 4mm, accounting for 52% of cases. The dentin thickness was consistent between the mesial canals of mandibular molars. However, there is no centrality of mesial canals in their roots, with frequent deviation to mesial.
Resumo O objetivo deste trabalho foi avaliar a centralização e a espessura da dentina dos canais radiculares mesiais de primeiros molares inferiores por meio de microtomografia computadorizada (micro-CT). Material e métodos: Noventa e nove molares inferiores com canais tipo IV de Vertucci foram escaneados por micro-TC. O desvio mesiodistal e o centroide foram avaliados para os canais mesiovestibular (MB) e mesiolingual (ML), nos 4mm apicais e em todo o comprimento do canal. Resultados: A espessura da dentina foi semelhante para os canais MB e ML. A espessura mais estreita foi encontrada na parede distal de um canal MB (0,07mm), enquanto a mais larga foi encontrada na parede mesial de um canal MB (2,46mm). Na análise centroide, tanto o canal MB quanto o ML exibiram desvios quando comparados ao centroide da raiz, ao longo de todo o comprimento do canal e nos 4 mm apicais. Para o canal MB, o desvio médio foi de 0,83mm (0,02mm-2,30mm) para canal inteiro e 0,18mm (0,01mm-1,01mm) para o apical de 4mm. Da mesma forma, para o canal ML, o desvio médio mediu 0,83 mm (0,05 mm-3,99 mm) para o canal inteiro e 0,21 mm (0,01 mm-1,01 mm) para os 4 mm apicais. No geral, foram observados desvios em direção mesial das raízes, sendo 69% para canais MB e 57% para canais ML para canal inteiro, e 51% para canais MB dentro dos 4 mm. A exceção foi o canal ML, que apresentou maior desvio para distal nos 4mm apicais, representando 52% dos casos. A espessura da dentina foi consistente entre os canais mesiais dos molares inferiores. Entretanto, não há centralidade dos canais mesiais em suas raízes, com frequente desvio para mesial.
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ABSTRACT The anatomy of the femoral triangle is explored in various approaches, ranging from pulse verification to invasive catheterization procedures. Within the femoral triangle, the deep femoral artery is one of the vessels reported to present several anatomical variations that must be considered before clinical or surgical interventions. Here, we are reporting a unique bilateral variation of the deep femoral artery for medical education purposes and reflecting on its applied, surgical, and clinical anatomy. During the dissection of the femoral triangle, we observed that the deep femoral artery originated in the vicinity of the inguinal ligament and ran in parallel with the femoral artery in a superficial trajectory on both sides of the donor. On the right side, the DFA continued superficial for 8.8 cm, with an origin of 1.2 cm inferior to the inguinal ligament. On the left side, it presented a similar anatomical arrangement, though with an origin of 1.6cm inferior to the inguinal ligament and a superficial course of 5cm. The position of the lateral circumflex femoral vein posterior to the deep femoral artery played a role in this distinctive, lengthy, and superficial presentation of the deep femoral artery. This anatomical variation directly affects surgical procedures, diagnostics, and endovascular interventions. A deep femoral artery with such a lengthy superficial trajectory can be mistakenly used for catheterization instead of the femoral artery or be injured, disrupting the main blood supply of the thigh muscles.
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ABSTRACT The purpose of this review is to highlight the most important aspects of the anatomical and functional uniqueness of the human brain. For this, a comparison is made between our brains and those of our closest ancestors (chimpanzees and bonobos) and human ancestors. During human evolution, several changes occurred in the brain, such as an absolute increase in brain size and number of cortical neurons, in addition to a greater degree of functional lateralization and anatomical asymmetry. Also, the cortical cytoarchitecture became more diversified and there was an increase in the number of intracortical networks and networks extending from the cerebral cortex to subcortical structures, with more neural networks being invested in multisensory and sensory-motor-affective-cognitive integration. These changes permitted more complex, flexible and versatile cognitive abilities and social behavior, such as shared intentionality and symbolic articulated language, which, in turn, made possible the formation of larger social groups and cumulative cultural evolution that are characteristic of our species.
RESUMO Esta revisão se propõe a relatar os aspectos mais importantes da singularidade anatômica e funcional do cérebro humano. Para isso, faz-se uma comparação entre o nosso cérebro e os de nossos parentes evolutivos mais próximos (chimpanzés e bonobos) e os ancestrais humanos. Durante a evolução humana ocorreu aumento absoluto do tamanho do cérebro e do número de neurônios corticais cerebrais, maior grau de lateralização funcional e assimetria anatômica cerebral, citoarquitetura cortical mais diversificada e aumento das redes neurais intracorticais e do córtex cerebral para as estruturas subcorticais acompanhada de mudança em direção ao investimento de redes neurais na integração multissensorial e sensório-motora-afetiva-cognitiva. Essas mudanças possibilitaram capacidades cognitivas e comportamentos sociais complexos, flexíveis e versáteis, destacando-se a intencionalidade compartilhada e a linguagem articulada simbólica, que permitiram a formação de grupos sociais maiores e a evolução cultural cumulativa característica de nossa espécie.
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Abstract This study aimed to compare the quality of root canal obturation (ratio of area occupied by gutta-percha (G), sealer (S), and presence of voids (V)) in different anatomical irregularities (intercanal communications, lateral irregularities, and accessory canals) located at different thirds of the root canal system of mandibular molar replicas. Sixty-seven 3D printed replicas of an accessed mandibular molar were prepared using ProGlider and ProTaper Gold rotatory systems. Three specimens were randomly selected to be used as controls and did not receive further treatment. The rest were randomly distributed in 4 experimental groups to be obturated using either cold lateral compaction (LC), continuous wave of condensation (CW), and core-carrier obturation (ThermafilPlus (TH) or GuttaCore (GC)) (n=16 per group). AHPlus® sealer was used in all groups. The three controls and a specimen from each experimental group were scanned using micro-computed tomography. The rest of the replicas were sectioned at the sites of anatomical irregularities and examined at 30× magnification. The G, S, and V ratios were calculated dividing the area occupied with each element by the total root canal area and then compared among groups using the Kruskal-Wallis test. Voids were present in all obturation techniques with ratios from 0.01 to 0.15. CW obtained a significantly higher G ratio in the irregularity located in the coronal third (0.882) than LC (0.681), TH (0.773), and GC (0.801) (p<0.05). TH and GC achieved significantly higher G ratios in those located in the apical third (p<0.05). The worst quality of obturation was observed in the loop accessory canal with all obturation techniques. Whitin the limitations of this study, it can be concluded that CW and core-carrier obturation are respectively the most effective techniques for obturating anatomical irregularities located in the coronal and the apical third.
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Abstract Objective: To determine the branching patterns of the inferior mesenteric artery (IMA) and to describe the clinical applicability of computed tomography (CT) angiography in the evaluation of these vessels to facilitate the planning of colorectal cancer surgery. Materials and Methods: We included 100 patients who underwent CT angiography of the abdomen and pelvis. The branching patterns of the IMA were examined and classified as type 1 (bifurcated), including 1A (sigmoid and left colic arteries arising from a common trunk), 1B (sigmoid and superior rectal arteries arising from a common trunk) and 1C (sigmoid arteries arising from both trunks); type 2 (trifurcated); and type 3 (no left colic branch). Results: Among the 100 patients evaluated, we found the variant to be type 1A in 9%, type 1B in 47%, type 1C in 24%, type 2 in 16%, and type 3 in 4%. Conclusion: Preoperative CT angiography for evaluating the IMA branching pattern could inform decisions regarding the surgical approach to colorectal cancer.
Resumo Objetivo: Determinar os padrões de ramificação da artéria mesentérica inferior (AMI) e descrever a aplicabilidade clínica da angiografia por tomografia computadorizada na avaliação desses vasos na elaboração das estratégias pré-operatórias de cirurgia de câncer colorretal. Materiais e Métodos: Foram incluídos 100 pacientes submetidos a angiografia por tomografia computadorizada abdominal e pélvica. Os padrões de ramificação da AMI foram examinados e classificados como tipo 1 (bifurcado), incluindo 1A (artérias sigmoide e cólica esquerda originando-se de um tronco comum), 1B (artérias sigmoide e retal superior originando-se de um tronco comum) e 1C (artérias sigmoide originando-se de ambos os troncos); tipo 2 (trifurcado); e tipo 3 (sem ramo cólico esquerdo). Resultados: Do total de participantes incluídos no estudo, a variante do tipo 1A foi observada em 9%, a do tipo 1B em 47%, e a do tipo 1C em 24%. Com relação à variante tipo 2, esta foi observada em 16% dos pacientes, e a do tipo 3, em 4% dos casos. Conclusão O uso da angiografia por tomografia computadorizada pré-operatória para avaliar o padrão de ramificação da AMI pode ajudar a escolher a abordagem cirúrgica no câncer colorretal.
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RESUMO Introdução: A anatomia humana desempenha um papel central na formação de profissionais de saúde, fornecendo a base fundamental para compreender o corpo humano e suas complexidades. Isso é particularmente relevante no contexto do ensino médico, sobre o qual as Diretrizes Curriculares Nacionais (DCN) de 2014 mencionam a importância do conteúdo curricular relacionado à estrutura, de modo a influenciar a execução da anamnese, do exame físico e do diagnóstico nosológico. Desenvolvimento: Quanto ao currículo, o ensino de anatomia vem passando por mudanças significativas nas últimas décadas, buscando equilibrar abordagens tradicionais e ativas, promover a integração curricular e ampliar perspectivas bioéticas e biopsicossociais no estudo. O ensino da anatomia tem evoluído, mas ainda é frequentemente baseado em aulas expositivas e práticas em laboratório de dissecação, com foco na memorização. No entanto, há um consenso crescente de que abordagens mais interativas, práticas e integradas são necessárias, incluindo o uso de tecnologias educacionais. Sobre os métodos de aprendizagem, os recursos de estudo incluem livros-texto, atlas, peças anatômicas, tecnologias digitais e softwares especializados, e a dissecação em cadáveres e peças anatômicas naturais ainda é altamente valorizada, mas enfrenta desafios logísticos e bioéticos. Os desafios da aprendizagem incluem a grande quantidade de informações a serem memorizadas, a complexidade da nomenclatura anatômica, a necessidade de disponibilidade de horários para práticas, o aumento e a diversificação das avaliações, e a intervenção na falta de motivação discente em relação ao estudo de anatomia. Ainda, há iniciativas de integração do ensino, pesquisa e extensão na anatomia que devem ser incentivadas para os estudantes se envolverem em projetos de pesquisa desde o início do curso e desenvolverem atividades com a comunidade, como a partir de museus de ciências da vida. Considerações Finais: O ensino de anatomia está em constante evolução, e as tendências investigativas contemporâneas têm o potencial de melhorar significativamente os processos de ensino e aprendizagem da morfologia humana. A pesquisa em ensino de anatomia, especialmente no contexto brasileiro, é essencial para entender a evolução dessa disciplina e adaptá-la às mudanças nas perspectivas educacionais e tecnológicas.
ABSTRACT Introduction: human anatomy plays a central role in the training of healthcare professionals, providing the fundamental basis for understanding the human body and its complexities. This is particularly relevant in the context of medical education, where the 2014 National Curricular Guidelines (DCN) mention the importance of structure-related curricular content, influencing the execution of anamnesis, physical examination and nosological diagnosis. Development: as far as the curriculum is concerned, anatomy teaching has undergone significant changes in recent decades, seeking to balance traditional and active approaches, promote curricular integration and expand bioethical and biopsychosocial perspectives in the study. Anatomy teaching has evolved, but is still often based on lectures and practical classes in the dissection laboratory, with a focus on memorization. However, there is a growing consensus that more interactive, practical and integrated approaches are needed, including the use of educational technologies. In terms of study methods, resources include textbooks, atlases, anatomical pieces, digital technologies and specialized software; dissection on cadavers and natural anatomical pieces remains highly valued, but is faced with logistical and bioethical challenges. Learning challenges include the large amount of information to be memorized, the complexity of anatomical nomenclature, the need to have time available for practices, increased and diversified assessments and interventions in the lack of student motivation in relation to the study of anatomy. Furthermore, there are initiatives to integrate teaching, research and community outreach in anatomy that should be encouraged for students to involve themselves in research projects from the start of the course and develop activities with the community, such as life science museums. Final Considerations: anatomy teaching is constantly evolving, and contemporary investigative trends have the potential to significantly improve the teaching and learning processes of human morphology. Research into anatomy teaching, especially in the Brazilian context, is essential to understand the evolution of this discipline and adapt it to changes in educational and technological perspectives.
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Abstract Objective: Evaluate osteoarthritis incidence in patients that undergone ACL reconstruction using the transtibial technique, with a minimum of 5 years of follow up, with isolated ACL injury. Methods: Patients who underwent ACL reconstruction by the same surgeon using the transtibial technique with hamstrings graft and with a minimum of 5 years of follow-up, without other injuries during the surgical procedure, were selected to undergo imaging exams of the operated knee to assess the incidence of osteoarthritis. The obtained data were evaluated by descriptive statistics. Results: Forty-two patients (44 knees) were evaluated, with a mean age of 31 years old (SD: 8), being 23 right knees and 28 male patients. Mean time from surgery to imaging evaluation was 94.1 months (ranging from 60 to 154 months; SD: 28). Of the evaluated knees, 37 did not have osteoarthritis (83.3%) and 7 had (16.7%). Conclusion: ACL reconstruction with femoral tunnel performed through the transtibial technique in patients without other associated injuries in the operated knee, using hamstrings graft, with a minimum of 5 years of follow up, showed an osteoarthritis incidence of 16.7% in a mean follow-up of 94.1 months. Level Of Evidence V; Case Series.
Resumo Objetivo: Avaliar a incidência de osteoartrite em pacientes submetidos à reconstrução do LCA pela técnica transtibial, com seguimento mínimo de 5 anos, com lesão isolada do LCA. Métodos: Pacientes que passaram por reconstrução LCA pelo mesmo cirurgião usando a técnica transtibial com enxerto de tendão dos músculos isquiotibiais e que foram acompanhados por no mínimo 5 anos, sem outras lesões durante o procedimento cirúrgico, foram selecionados para realizar exames de imagem do joelho operado a fim de avaliar a incidência de osteoartrite. Os dados obtidos foram avaliados por meio de estatísticas descritivas.. Resultados: Foram avaliados 42 pacientes (44 joelhos), com idade média de 31 anos (DP: 8), sendo 23 joelhos direitos e 28 pacientes do sexo masculino. O tempo médio entre a cirurgia e a avaliação por imagem foi de 94,1 meses (variando de 60 a 154 meses; DP: 28). Dos joelhos avaliados, 37 não apresentavam osteoartrite (83,3%) e 7 apresentavam (16,7%). Conclusão: A reconstrução do LCA com túnel femoral realizado por meio da técnica transtibial em pacientes sem outras lesões associadas no joelho operado, utilizando enxerto dos tendões isquiotibiais, com um acompanhamento mínimo de 5 anos, apresentou uma incidência de osteoartrite de 16,7% em um acompanhamento médio de 94,1 meses. Level of Evidence V; Case Series. Nível de Evidência V; Série de casos
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Abstract Understanding morphological and physiological changes under different light conditions in native fruit species in juveniles' stage is important, as it indicate the appropriate environment to achieve vigorous saplings. We aimed to verify growth and morphophysiological changes under shade gradient in feijoa (Acca sellowiana (O. Berg) Burret) to achieve good quality saplings adequate to improve cultivation in orchards. The saplings were grown for twenty-one-month under four shading treatments (0%, 30%, 50%, and 80%). Growth, photosynthetic pigments, gas exchanges, chlorophyll fluorescence, and leaf anatomy parameters were evaluated. Saplings under full sun and 30% shade had higher height and diameter growth and dry mass accumulation due to higher photosynthesis rate. As main acclimatization mechanisms in feijoa saplings under 80% shade were developed larger leaf area, reduced leaf blade thickness, and enhanced quantum yield of photosystem II. Even so, the net CO2 assimilation and the electron transport rate was lower and, consequently, there was a restriction on the growth and dry mass in saplings under deep shade. Therefore, to obtain higher quality feijoa saplings, we recommend that it be carried out in full sun or up to 30% shade, to maximize the sapling vigor in nurseries and, later, this light environment can also be used in orchards for favor growth and fruit production.
Resumo A verificação de mudanças morfológicas e fisiológicas sob diferentes condições luminosas em espécies frutíferas nativas em estágio juvenil é importante, uma vez que indicam o ambiente adequado para a formação de mudas com alto vigor. Objetivou-se verificar o crescimento e as alterações morfofisiológicas sob gradiente de sombreamento em mudas de feijoa (Acca sellowiana (O. Berg) Burret) para obter mudas de boa qualidade, adequadas para fomentar os plantios da espécie em pomares. As mudas foram cultivadas por vinte e um meses sob quatro tratamentos de sombreamento (0%, 30%, 50% e 80%). Foram avaliados parâmetros de crescimento, pigmentos fotossintéticos, trocas gasosas, fluorescência da clorofila e anatomia foliar. Mudas a pleno sol e 30% de sombra apresentaram maior crescimento em altura, diâmetro e acúmulo de massa seca, devido à maior taxa de fotossíntese. Como principais mecanismos de aclimatação sob 80% de sombra, as mudas desenvolveram maior área foliar, redução da espessura do limbo foliar e aumento do rendimento quântico do fotossistema II. Mesmo assim, a assimilação líquida de CO2 e a taxa de transporte de elétrons foram menores e, consequentemente, houve restrição ao crescimento e acúmulo de massa seca das mudas no maior nível de sombreamento. Portanto, para a obtenção de mudas de feijoa de maior qualidade, recomendamos que seja realizada a pleno sol ou até 30% de sombra, para maximizar o vigor das mudas em viveiros e, posteriormente, este ambiente de luz também pode ser utilizado em pomares para favorecer o crescimento e a produção de frutos.
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Myrtaceae , Feijoa , Fotosíntesis , Hojas de la Planta , Aclimatación , LuzRESUMEN
Abstract Understanding morphological and physiological changes under different light conditions in native fruit species in juveniles stage is important, as it indicate the appropriate environment to achieve vigorous saplings. We aimed to verify growth and morphophysiological changes under shade gradient in feijoa (Acca sellowiana (O. Berg) Burret) to achieve good quality saplings adequate to improve cultivation in orchards. The saplings were grown for twenty-one-month under four shading treatments (0%, 30%, 50%, and 80%). Growth, photosynthetic pigments, gas exchanges, chlorophyll fluorescence, and leaf anatomy parameters were evaluated. Saplings under full sun and 30% shade had higher height and diameter growth and dry mass accumulation due to higher photosynthesis rate. As main acclimatization mechanisms in feijoa saplings under 80% shade were developed larger leaf area, reduced leaf blade thickness, and enhanced quantum yield of photosystem II. Even so, the net CO2 assimilation and the electron transport rate was lower and, consequently, there was a restriction on the growth and dry mass in saplings under deep shade. Therefore, to obtain higher quality feijoa saplings, we recommend that it be carried out in full sun or up to 30% shade, to maximize the sapling vigor in nurseries and, later, this light environment can also be used in orchards for favor growth and fruit production.
Resumo A verificação de mudanças morfológicas e fisiológicas sob diferentes condições luminosas em espécies frutíferas nativas em estágio juvenil é importante, uma vez que indicam o ambiente adequado para a formação de mudas com alto vigor. Objetivou-se verificar o crescimento e as alterações morfofisiológicas sob gradiente de sombreamento em mudas de feijoa (Acca sellowiana (O. Berg) Burret) para obter mudas de boa qualidade, adequadas para fomentar os plantios da espécie em pomares. As mudas foram cultivadas por vinte e um meses sob quatro tratamentos de sombreamento (0%, 30%, 50% e 80%). Foram avaliados parâmetros de crescimento, pigmentos fotossintéticos, trocas gasosas, fluorescência da clorofila e anatomia foliar. Mudas a pleno sol e 30% de sombra apresentaram maior crescimento em altura, diâmetro e acúmulo de massa seca, devido à maior taxa de fotossíntese. Como principais mecanismos de aclimatação sob 80% de sombra, as mudas desenvolveram maior área foliar, redução da espessura do limbo foliar e aumento do rendimento quântico do fotossistema II. Mesmo assim, a assimilação líquida de CO2 e a taxa de transporte de elétrons foram menores e, consequentemente, houve restrição ao crescimento e acúmulo de massa seca das mudas no maior nível de sombreamento. Portanto, para a obtenção de mudas de feijoa de maior qualidade, recomendamos que seja realizada a pleno sol ou até 30% de sombra, para maximizar o vigor das mudas em viveiros e, posteriormente, este ambiente de luz também pode ser utilizado em pomares para favorecer o crescimento e a produção de frutos.
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The treatment of glioblastoma, the most prevalent malignant tumor in the central nervous system, poses considerable challenges. Glioblastoma multiforme, classified as a grade Ⅳ highly malignant brain glioma by the World Health Organization, is typically managed through a combination of surgery, postoperative chemotherapy, and radiotherapy. The treatment of glioblastoma is complicated by its infiltrative nature, genetic heterogeneity, and presence of the blood-brain barrier. Almost all cases of glioblastoma experience recurrence despite aggressive therapy, exploring the development of updated molecular treatment strategies that can improve overall efficacy. A crucial aspect in modern neurosurgery is the precise delineation of brain regions in terms of their anatomy and function. It serves as the fundamental basis for investigating variations in the distribution of brain gliomas. Hence, this review will elucidate the origin of glioblastomas and analyze the potential factors contributing to the spatially specific distribution of gliomas on the basis of a theoretical framework of brain connectomics research. Molecular characteristics, information pathways, tumor microenvironment landscape, and immunology will inform the analysis. We aim to identify novel biomolecular targets and therapeutic pathways to gain scientific insights for effective glioblastoma treatment.