Adhesion to the monitoring of newborns from VDRL positive mothers / Adesão ao acompanhamento dos recém-nascidos de mães soropositivas para o treponema pallidum

OBJECTIVE: Treponema pallidum is the etiological agent of congenital syphilis, which results from fetal contamination by the infected mothers, who were not treated or were inadequately treated during pregnancy. METHODS: An observational, prospective and longitudinal study, was performed (2010-2014), through the evaluation of 428 newborns during 18 months in a syphilis clinic from a Philanthropic Maternity Hospital in Aracaju, capital city of the Northeastern state of Sergipe, Brazil. The findings were statistically expressed as descriptive data and the statistical program used was SPSS (Statistical Package for Social Sciences). RESULTS AND CONCLUSIONS: The prevalence of congenital syphilis was 10.02/1,000 live births. A total of 120 (28%) of newborns did not attend the first appointment. During the observational period, at 18 months, the rate of abandonment was 75%. The average interval of healing of the newborns was 4.25 months. A high prevalence of congenital syphilis was found with low adhesion to the first consultation and monitoring period; 67.1% of newborns were treated with Crystalline Penicillin (Penicillin G) and only 3% of them required a repeat treatment.

OBJETIVO: A sífilis congênita tem como agente etiológico o Treponema pallidum e resulta da contaminação do feto pela gestante infectada sem tratamento ou com tratamento inadequado. MÉTODO: Foi realizado um estudo observacional, prospectivo, longitudinal, com a participação de 428 recém-nascidos que foram acompanhados durante 18 meses em um ambulatório de sífilis de uma Maternidade Filantrópica em Aracaju. Os achados foram estatisticamente expressos de maneira descritiva e o programa estatístico utilizado foi o SPSS. RESULTADOS E CONCLUSÕES: A prevalência de sífilis congênita para 1000 nascidos vivos foi de 10,02 casos. Não compareceram à primeira consulta 28,2% dos recém-nascidos. Durante o acompanhamento, aos 18 meses, o percentual de abandono foi de 75%. O intervalo médio de cura dos recém-nascidos foi de 4,25 meses. Foi encontrada uma alta prevalência de sífilis congênita com baixas adesões à primeira consulta e ao acompanhamento; 67,1% foram tratados com penicilina cristalina e apenas 3% necessitaram repetir o tratamento.

Climacteric Women’s Life Quality with Urinary Incontinence in Aracaju City.

Introduction: Climacteric is the biological cycle period in women characterized by loss of ovarian follicular activity, causing innumerous emotional, physical and endocrinal changes. In this period, which starts at the age of 40 and finishes at 60, some women undergo profound existential experience in their interpersonal relations, in their conjugal, professional, spiritual, social and cultural life. Objective: Assess the impact of urinary incontinence in women's quality of life into climacteric period, registered at health units in the city of Aracaju, Sergipe/ Brazil. Materials and Methods: A retrospective observational study was conducted on 476 women from 41 health care units in the national family health strategy program. A specific questionnaire, King’s Health Questionnaire (KHQ), validated in Brazil by Tamamani et al. (2006), was used to collect data. The data collected was divided into categories. Frequency distribution and cross tabulation, with determination of confidence intervals for each frequency, were applied. The descriptive analysis was carried out through the measure of dispersion and measures of central tendency by the software Microsoft Excel 2007. Data were described by simple and proportions. Results: 476 climacteric women were interviewed, aged 40 to 59 years old. Among those, 32% reported complaint of urinary incontinence, at least once a week, for at least three months in the last year. The most affected domains of KHQ were: Impact of urinary incontinence, followed by general perception of health and measurements of gravity with average above 50%. The sample was calculated from the formula proposed by Barbeta (2001). Conclusions: Although other domains had average below 50, the influence of urinary incontinence in the life quality of climacteric women in Aracaju/SE was not discarded, as the presented data pointed that most women interviewed showed at least minor discomfort in the everyday activities, physical and social limitations, compromising personal relations like relationship with their partners and sexual life, emotions, sleep, disposition and measurements of gravity.

Contribution towards the anatomy of the esophageal hiatus and its relationship with the presence of bundles of collagen fibers in its margins / Contribución a la anatomía del hiato esofágico y su relación con la presencia de haces de fibras colágenas en sus márgenes

The aim was to detect the presence of bundles of collagen fibers in the margins of the esophageal hiatus and establish if there is any relationship of these bundles with the anatomy of the hiatus. Ten adult male cadavers, with no gross anatomical alteration caused by trauma, surgery or disease, upon the esophageal hiatus were used in the study. A piece of anatomical structure comprising the diaphragm with the esophageal hiatus and adjacent tissues was removed, dissected and 10 percent formol embedding. With the aid of a digital caliper, measurements of the perimeter of the esophageal hiatus were done both in the abdominal and thoracic sides. For the structural study each margin was divided in six sections. Staining techniques of Masson and Picrosirius-hematoxilin were used. Collagen fibers bundles had been found in 8/10 studied cadavers, distributed in 13 margins of the hiatus, of which 7 to left and 6 to the right. The muscle fibers originating from the right pillar had participated in forming both margins of the esophageal hiatus in 60 percent of cadavers, while in 40 percent, the fibers of the left pillar had formed the medial side of the right margin. The right margin was statistically thicker than the left. It did not have a correlation between the measures of the vertices of the angles superior/inferior and the transversal measure of the esophageal hiatus. The measures between the vertices of the angles superior/inferior, respectively, with the central tendon and median arcuate ligament, had presented thoracic values that tended to the double, in relation to the abdominal ones, and had been statistically significant. These distances were smaller in cadavers who possessed bundles of collagen fibers in the margins of the esophageal hiatus. Bundles of collagen fibers bundles were found in 65 percent of the 20 margins of the esophageal hiatus. The margins of the esophageal hiatus were predominantly...

El objetivo fue detectar la presencia de haces de fibras de colágeno en los márgenes del hiato esofágico y establecer si existe relación de éstos con la anatomía del hiato. Fueron utilizados 10 cadáveres de individuos adultos de sexo masculino, sin alteraciones anatómicas evidentes causadas por trauma, cirugía o enfermedad, sobre el hiato esofágico. Fue retirada y disecada una sección anatómica que contendía el diafragma con el hiato esofágico y los tejidos adyacentes y luego fijada en formol 10 por ciento. Las medidas del perímetro del hiato esofágico se realizaron con ayuda de un caliper digital en los lados abdominal y torácico. Para el estudio estructural cada margen fue dividido en seis secciones y teñidos con Tricómico de Masson y Picrosirius-hematoxilina. En 8/10 cadáveres estudiados fueron encontrados haces de fibras colágenas, distribuidos en 13 márgenes del hiato esofágico, 7 izquierdos y 6 derechos. Las fibras musculares que originaban el pilar derecho participaron en la formación de ambos márgenes del hiato esofágico en 60 por ciento de los cadáveres, mientras que en el 40 por ciento, las fibras del pilar izquierdo habían formado el lado intermedio del margen derecho. El margen derecho fue estadísticamente más grueso que el izquierdo. No se encontró correlación entre las medidas de los vértices de los ángulos superior/inferior y la medida transversal del hiato esofágico. Las medidas entre los vértices de los ángulos superior/inferior, respectivamente, con el tendón central y el ligamento arqueado mediano, presentaron valores torácicos que fueron casi el doble em relación a los abdominales, y fueron estadísticamente significativos. Estas distancias eran más pequeñas en los cadáveres que tenían haces de fibras de colágeno en las márgenes del hiato esofágico. Los paquetes de fibras de colágeno fueron encontrados en 65 por ciento de los 20 márgenes del hiato del esófago. Los márgenes del hiato esofágico fueron formados principalmente por fibras...

Absorption levels and morphological features of fetal organs in wistar rats treated with lead acetate / Niveles de absorción y características morfológicas de los órganos fetales en ratas wistar tratadas con acetato de plomo

Lead is one of the heavy metals most used in industry. Poisoning due to long-term lead exposure is known as saturnism, and is an occupational illness that has been known for many years. Lead is highly toxic and can compromise the structural and functional patterns of organs and systems. The aim of this study was to examine the lungs and kidneys of fetuses from female Wistar rats exposed to lead acetate. In this study, the lungs and kidneys of 20 fetuses from female rats that had previously been treated with lead acetate were dissected, fixed, embedded in paraffin and stained with hematoxylin and eosin. Macroscopic changes to the shape, color and consistency of organs from fetuses treated with this heavy metal were observed, in comparison with organs from control fetuses. Microscopic lesions characterized by vascular sclerosis, cell atrophy or hyperplasia, progressive interstitial fibrosis, inclusion bodies containing lead acetate and glomerular sclerosis were found in the kidneys. The lesions found in the lungs consisted of destructuring of the parenchyma, impregnation with lead acetate, formation of fibrosis, extravasation of vascular fluids, reduction of the alveolar spaces and formation of alveolar edema. These changes were correlated with the level of lead acetate absorption, as determined using atomic spectrophotometry.

El plomo es un metal pesado utilizado en la industria. El envenenamiento debido a la exposición prolongada por plomo es una enfermedad profesional conocida por muchos años. La toxicidad del plomo es muy expresiva y puede poner en peligro el modelo estructural y funcional de los órganos y sistemas. El objetivo de este estudio fue examinar los pulmones y riñones de fetos de ratas Wistar expuestos al acetato de plomo. En este estudio, 20 fetos de ratas Wistar previamente tratados con acetato de plomo durante la gestación, tuvieron sus órganos disecados, fijados, incluidos en parafina y teñidos con hematoxilina y eosina. Macroscópicamente, los órganos fetales tratados por este metal fueron comparados con los órganos de fetos controles en relación a forma, color y consistencia. Microscópicamente, se encontraron lesiones en el riñón que se caracterizaron por esclerosis vascular, atrofia o hiperplasia de células, fibrosis intersticial progresiva, presencia de cuerpos de inclusión que contenían acetato de plomo y esclerosis glomerular. En el pulmón se observó desorganización del parénquima impregnado con acetato de plomo, formación de fibrosis, líquido intersticial, reducción de los espacios alveolares y edema alveolar. Estos cambios se correlacionaron con el nivel de absorción de acetato de plomo, determinado por espectrometría atómica.

Prevalence of peripheral occlusive arterial disease in patients with chronic renal failure

Contexto: A doença arterial obstrutiva periférica tem sido reconhecida como um sensível marcador de aterosclerose sistêmica e preditora de eventos cardiovasculares. Apesar da alta prevalência da doença cardiovascular, há poucos estudos sobre a doença arterial obstrutiva periférica em pacientes com insuficiência renal crônica em tratamento hemodialítico. Objetivo: Determinar a prevalência de doença arterial obstrutiva periférica em pacientes com insuficiência renal crônica em uma clínica de referência para tratamento hemodialítico no estado de Sergipe. Métodos: Trata-se de um estudo transversal, realizado no período de junho a novembro de 2008, em uma clínica de referência para tratamento de pacientes com insuficiência renal crônica. Foram caracterizados como portadores de doença arterial obstrutiva periférica os pacientes que apresentavam índice tornozelo-braquial (ITB) ≤ 0,9. Resultados: De uma população de 239 pacientes com insuficiência renal crônica, foram avaliados 201. Destes, 28 (14 por cento) apresentavam insuficiência arterial periférica com ITB ≤ 0,9. A idade variou de 24 a 82 anos, com média de 52 anos. A hipertensão e a dislipidemia foram os fatores de risco mais frequentes. Dos pacientes com doença arterial obstrutiva periférica, 89 por cento eram dislipidêmicos, 71 por cento hipertensos e 29 por cento tinham coronariopatias. Conclusão: A prevalência de doença arterial obstrutiva periférica em doentes com insuficiência renal crônica foi de 14 por cento.

Background: Peripheral occlusive arterial disease has been found to be a sensitive marker of systemic atherosclerosis and a predictor of other cardiovascular diseases. In spite of the high prevalence of the cardiovascular diseases, there are few studies about peripheral occlusive arterial disease in patients with chronic renal failure under hemodialysis treatment. Objective: To determine the prevalence of peripheral occlusive arterial disease in patients with chronic renal failure under hemodialysis treatment at a center of excellence in the State of Sergipe, Brazil. Methods: A cross-sectional study was conducted from June to November 2008 at a center of excellence for the treatment of patients with chronic renal failure. Those patients with the ankle-brachial index (ABI) ≤ 0.9 were diagnosed as having peripheral occlusive arterial disease. Results: From a population of 239 individuals with chronic renal failure, 201 were evaluated. Of that, 28 (14 percent) had peripheral arterial insufficiency with ABI ≤ 0.9. Their age ranged from 24 to 82 years (mean age = 52 years). Hypertension and dyslipidemia were the more frequent risk factors. Among the patients with peripheral occlusive arterial disease, 89 percent had dyslipidemia; 71 percent had high blood pressure; and 29 percent had coronary diseases. Conclusion: The prevalence of peripheral occlusive arterial disease in patients with chronic renal failure was 14 percent.

Origin of the tendon of the long head of the biceps brachii muscle and its relationship with glenoid labrum in human foetuses / Origen del tendón de la cabeza larga del bíceps braquial y sus relaciones con el labro glenoideo en fetos humanos

We dissected the shoulders of 20 human foetuses to anatomical study. The purpose of this study was to characterize the anatomical origin of the long head tendon of the muscle biceps brachii (LHBBT) in human foetuses and its relationships with the glenoid labrum of the scapula. The results had shown that in approximately 95 percent of the cases the tendon of the long head of the biceps brachii inserts in the region of the glenoid labrum. This origin seems to form, together with the glenoid labrum, an anatomical complex. We conclude that the almost totality of the LHBBT was originated in the glenoidal labrum. For us, this furthermore reinforce the importance and necessity of better clarifying the anatomical and clinical implications of the biceps/labrum complex.

Fueron disecados los hombros de 20 fetos humanos con el propósito de hacer un estudio anatómico. El objetivo de este estudio fue cdeterminar el origen del tendón de la cabeza larga del músculo bíceps braquial en fetos humanos y sus relaciones con el labro glenoideo. Los resultados demostraron que, en cerca del 95 por ciento de los casos, el tendón de la cabeza larga del músculo bíceps braquial estaba originándose en la región del labro glenoideo. Este origen parece formar junto, con el labro glenoideo, un complejo anatómico. Concluimos que casi todos de los tendones del músculo bíceps braquial están insertados en el labro glenoideo. Esto es importante conocer para una mejor clarificación de las implicaciones clínico-anatómicas del complejo del bíceps/labro.

Diagnóstico e tratamento de aneurisma da artéria isquiática persistente: relato de caso e revisão da literatura / Diagnosis and treatment of persistent sciatic artery aneurysm: case report and review of the literature

A persistência da artéria isquiática é uma variação anatômica rara cujo curso clínico é potencialmente grave, pois o diagnóstico ocorre quando já estão presentes complicações clínicas. Essas complicações advêm do fato de a parede da artéria isquiática ter uma tendência à degeneração ateromatosa com formação aneurismática, podendo evoluir para uma oclusão ou para um tromboembolismo. Este artigo relata o caso de um paciente do sexo feminino, com queixas de dor intensa secundária a compressão extrínseca do nervo isquiático pela dilatação aneurismática no membro inferior direito e pulsatilidade na nádega ipsilateral, apresentando uma massa hiperpulsátil nessa localização. Foi realizado exame angiográfico, que revelou persistência da artéria isquiática à direita, do tipo completo e com aneurisma. A paciente foi submetida a procedimento cirúrgico, sendo utilizada uma abordagem transglútea, e uma prótese de dácron terminoterminal foi interposta entre os colos proximal e distal do aneurisma. Os aspectos técnicos e revisão da literatura sobre o diagnóstico e a terapêutica dessa variação anatômica são discutidos neste trabalho.

Persistent sciatic artery is a rare anatomical variation whose clinical course is potentially serious, since diagnosis is performed when clinical complications are already present. Such complications are a consequence of the fact that sciatic artery walls have a tendency to atherosclerotic degeneration with aneurysmal formation and may evolve to occlusive thrombosis or to thromboembolism. This article reports the case of a female patient with complaint of intense pain secondary to extrinsic compression of the sciatic nerve by aneurysmal dilatation of the right lower member and hyperpulsatile ipsilateral buttock. Angiographic examination was carried through, showing complete persistent sciatic artery to the right lower member with an aneurysm. The patient was submitted to a surgical procedure using a transgluteal approach and a termino-terminal Dacron graft was interposed between the proximal and distal necks of the aneurysm. The technical aspects and review of literature on diagnosis and therapeutic approach of this anatomical variation are discussed in this work.

Metric measurements and attachment levels of the medial patellofemoral ligament: an anatomical study in cadavers

OBJECTIVE: To determine the metric measurements and to verify the attachment levels of the medial patellofemoral ligament in human cadavers. METHODS: Seventeen knees (eight right and nine left knees) from 10 cadavers (nine male and one female) were dissected and stored in a 10 percent formaldehyde solution. All of the knees were whole and did not show any macroscopic signs of injuries. RESULTS: The medial patellofemoral ligament was present in 88 percent of the knees studied, localized transversally between the medial femoral epicondyle and the medial margin of the patella. Its dimensions were quite variable, even between the knees of the same individual. The width of the patellar insertion ranged from 16 to 38.8 mm, with a mean of 27.90 mm, and its mean length was 55.67 mm. The margins of the ligament were concave or rectilinear. At the upper margin, the concave form predominated and was better characterized, while at the lower margin, the rectilinear form predominated. CONCLUSIONS: The medial patellofemoral ligament is a very distinct structure with variable anatomical aspects and is always located in a plane inferior to the vastus medialis obliquus muscle.

Estudo histomorfométrico de anastomoses primárias de cólon em coelhos, com e sem preparo intestinal / Histomorfometric analysis of colonic anastomosis in rabbits with and without intestinal preparation

O preparo intestinal é muito utilizado em cirurgias do cólon. A LIATO (lavagem intestinal anterógrada trans-operatória) promove limpeza do cólon, conferindo incremento de tempo ao ato cirúrgico e maior risco de infecção pela maior manipulação do conteúdo intestinal .Este estudo compara confecção de anastomoses colônicas com e sem preparo intestinal, pela análise histomorfométrica. Foram submetidos à cirurgia 30 coelhos divididos em 2 grupos: grupo 1, controle e grupo 2, que submeteu-se a LIATO, e comparados os seus resultados. A presença de infiltrado inflamatório agudo teve média discretamente maior nas anastomoses do grupo 2. Infiltrado inflamatório crônico obteve média de 1,9 nas anastomoses do grupo 2 e de 2,1 nas sem preparo. Necrose esteve presente em 15,7 por cento dos casos onde se realizou LIATO contra 13,5 por cento no grupo sem preparo. Calcificações foram encontradas em 43 por cento das anastomoses com preparo e em 30 por cento das sem preparo. Observou-se maior quantidade de colágeno nas anastomoses feitas com a lavagem intestinal. O padrão entrelaçado das fibras colágenas foi observado em 86 por cento das anastomoses do grupo 2 e 70 por cento no 1. Estudo estatístico foi realizado com programa Prism® 4 para p<0,05. Neste estudo que a LIATO apresenta melhor padrão de cruzamento e concentração de fibras colágenas, resultando possivelmente em melhor cicatrização.

Colon laudering is used in many colon surgeries. The LIATO, that promotes cleanness of colon, demonstrates an increase of the surgical time and increase risk of infection. This study compares colonic anastomosis with and without preparation, through histomorfometric analysis. 30 rabbits were submitted to the surgery treatment and had been evaluated and divided in groups: group 1 (control) and group 2 (LIATO). Carried through statistical study with the program Prism® 4 for p< 5 percent. The analisis found acute inflammatory infiltrated with discrete bigger average in the anastomoses of group 2. Chronic inflammatory infiltrated with average of 1,9 in the anastomoses of group 2 and of 2,1 in the ones without preparation. Necrosis in 15,7 percent in the LIATO against 13,5 percent in the group without preparation. Calcium deposit in 43 percent of the anastomoses with preparation and in 30 percent, of the ones without preparation. Bigger colágen concentration were met in the anastomoses made with the intestinal laudering. Incidence of interlaced colagen fibres was observed in 86 percent of the anastomoses of the searched one and in 70 percent in the control group. We conclude that the LIATO presents better incidence of interlaced colagen fibres and fibre concentration resulting in better anastomosis.

The Accessory Soleus Muscle: Case Report and a Review of the Literature / El Músculo Soleo Acesorio: Reporte de Caso y Revisión de la Literatura

Durante una disección de rutina, se encontró un músculo soleo accesorio, en la pierna izquierda de un cadáver masculino. El músculo se localizaba posteromedialmente en la pierna, entre los músculos flexor largo de los dedos y largo del hálux. Su origen estaba en el tercio superior de la fascia anterior del músculo soleo y su inserción se realizaba, a través de un tendón en la superficie anteromedial del hueso calcáneo.

An accessory soleus muscle was found in the left leg of a male cadaver in the dissecting room. The muscle was situaded posteromedially, between the soleus muscle and the flexor digitorum longus and flexor hallucis longus. The origin of the muscle was in the superior third of the anterior fascia of the soleus muscle and the insertion, was attached with separate tendon, in the anteromedial surface of calcaneus bone.

Physicochemical and structural analysis of three regions of the deep digital flexor tendon of pigs

Few studies have discussed the relationship between the molecular organization and the physicochemical and biomechanical properties of pig tendons. In this work, we examined the extracellular matrix of the deep digital flexor tendon of pigs, which was subjected to tensional (proximal region) and compressive (distal and terminal regions) forces. The three regions of the tendon were used for swelling tests and their glycosaminoglycan content was determined. Longitudinal sections of the tendon were stained and observed using polarized light microscopy. The distal and terminal regions were swole more in water than the proximal region. After staining with toluidine blue the metachromasy was more intense in the distal and terminal regions, indicating an accumulation of proteoglycans in these regions. Analysis of the glycosaminoglycans by agarose gel electrophoresis showed that dermatan sulfate was present in all regions, whereas chondroitin sulfate occurred only in the regions of compression. The shape of the fibroblasts changed along the tendon: rounded cells occurred in regions under compression, while in the region under tension, elongated cells predominated. The organization and distribution of the collagen bundles were different for each region. Birefringence analysis revealed a more regular crimp pattern in the region under tension than in the regions under compressive forces. The elastic fibers also showed a different distribution in each region. These results indicate that the regional differences in the structure and composition of the deep digital flexor tendon of pigs are related to the biomechanical properties of the tendon.