Meta-analysis of Distribution Frequency of Traditional Chinese Medicine Syndrome in Primary Osteoporosis / 中国实验方剂学杂志

ObjectiveTo systematically evaluate the distribution of traditional Chinese medicine（TCM） syndromes of primary osteoporosis（POP） in China by using evidence-based medicine methods， and to understand the distribution law of the syndromes. MethodChina National Knowledge Infrastructure（CNKI）， VIP Chinese Science and Technology Journal Database（VIP）， WanFang Data Knowledge Service Platform（WanFang） and China Biology Medicine（CBM） were searched to obtain representative literature， and each database was searched from the 1994 World Health Organization defined diagnostic criteria for osteoporosis until May 1， 2023. Two researchers independently screened literature according to the criteria， extracted data， and cross-checked them. Meta analysis was conducted using R4.1.3， and subgroup analysis was performed. ResultA total of 56 Chinese papers were included， involving 14 415 patients. After standardized classification of syndromes， 11 articles were excluded， and Meta analysis results of the ultimately included 45 Chinese articles showed that the distribution frequencies of liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome in 12 723 patients were 27%［95% confidence interval（CI） 0.24-0.31］， 32%（95% CI 0.29-0.36）， 36%（95% CI 0.30-0.42）. Subgroup analysis showed that there was a statistically significant difference in the distribution of the three TCM syndromes in the north and south（P<0.05）. In addition， the incidence of TCM syndrome fractures in different types of POP was 15%（95% CI 0.09-0.24） for liver-kidney Yin deficiency syndrome， 20%（95% CI 0.12-0.30） for spleen-kidney Yang deficiency syndrome， and 31%（95% CI 0.25-0.39） for kidney deficiency and blood stasis syndrome. ConclusionThe distribution of syndromes in POP patients is mainly kidney deficiency， accompanied by liver and spleen dysfunction. Liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome are all the main syndromes of POP and osteoporotic fractures， and kidney deficiency and blood stasis syndrome is most closely related to the development of osteoporotic fractures. The reference standards for syndrome determination among the included studies are inconsistent， and in the future， it is necessary to focus on their determination standards to obtain consensus research results， at the same time， conduct large-scale syndrome research to obtain representative research results， providing a basis for clinical practice and research.

MODALITIES OF TREATMENT OF PELVIC ORGAN PROLAPSE IN A TERTIARY CARE HOSPITAL (GMCH) AND ITS SHORT TERM FOLLOW UP

Pelvic organ prolapse is an increasingly common condition seen in women with advancing age. The objective of this study is to observe the different modalities of treatment of pelvic organ prolapse and evaluate its outcome. In this study, all patients with pelvic organ prolapse, attending Gynae OPD or admitted in GMCH were included. In this study, 45(22.5%) patients were advised to use vaginal tampon, 9(4.5%) patients were advised Kegel's Results: exercise, 125(62.50%) patients were treated with VH + PFR, , 15 (7.5%) patients underwent vaginal hysterectomy (VH), 4(2%) patients underwent VH + PFR + Sacrospinous ?xation and 2 (1%) patients were treated with Fothergills' surgery. The feedback received revealed that 118(59%) were satis?ed and responded well to the treatment, 26 (13%) patients were not satis?ed and from the remaining 56(28%) patients, no feedback had been received. It was observed that satisfaction was higher in patients who had surgical intervention.

Organophosphorus poisoning: study of evaluation of clinically relevant indicators

Background:POP scale andserum cholinesterase estimation are purported to be meaningful indicators for mortality prediction in the cases of organophosphorus poisoning. The present study was undertaken to substantiate the correlation ofPOP scale score and serum cholinesterase levels in acute OP poisoning with mechanical ventilation requirement and mortality in our setting. Methods:Data of 150 eligible participants was collected, with POP scale andserum cholinesterase levels being assessed during initial presentation in each of them. Clinical course of the cases was monitored anddocumented. Results:The observed case fatality rate was 32.7%. POP scale scoring revealed 30out of 75 patients to be from moderate group and 19 out of 22 patients to be from severe group. Forty nine outof 75 in moderate group & all patients in severe group required ventilator support. With respect to Serum Cholinesterase level; 20 out of 23 and 29 out of 77 patients died in the severe & moderate poisoning categories respectively. Forty eight out of 77 in moderate poisoning andall patients in severe poisoning required ventilator support. Conclusions: POP scale scoring and serum Cholinesterase level assessments are clinically relevant indicators in acute OP poisoning cases and are of great utility towards assessment ofmechanical ventilation requirement and mortality prediction.

A study to correlate serum pseudocholinesterase and serum creatine phosphokinase levels in acute organophosphorus poisoning with respect to Peradeniyaorganophosphorus poisoning scale

Background: Organophosphorus insecticides are one of the most common causes of poisoning in India. It has a high mortality rate and accounts for a third of suicidal deaths in south-east Asia.Methods: The objectives were to estimate serum pseudocholinesterase and creatine phosphokinase (CPK) levels in organophosphorus poisoning and correlate them with theseverity and prognosis described by the Peradeniya organophosphorus poisoning (POP) scale at initial presentation.This was a cross-sectional study conducted over 18 months. A total of 180 organophosphorus-poisoning subjects were divided into mild, moderate and severe grades based on POP scale at admission. Serum pseudocholinesterase and CPK levels were estimated at admission. The outcome was noted, and the results were statistically analysed.Results:It was found that 112 (62.2%), 51 (28.3%) and 17 (9.4%) patients had mild, moderate and severe poisoning, respectively, according to POP scale. Mean pseudocholinesterase level (units/litre) was 2393.29, 1104.37 and 638.18 and mean serum CPK level (units/litre) was 153.41,344.94 and 280.53 in mild, moderate and severe poisoning, respectively. ICU and ventilator were required for 84 (46.75%) and 72 (40%) patients, respectively. Mortality was 17.8%. Negative, weak and significant correlation was seen between POP score and pseudocholinesterase (r=-0.265, p=0.00). Positive, moderate and significant correlation was seen between POP score and CPK levels (r=0.449, p=0.00).Conclusions: POP scale applied at admission along with serum pseudocholinesterase and CPK levels serve as a simple and effective system to determine early need for ventilation and mortality in rural, peripheral centres in developing nations.

Chemical profile, acetylcholinesterase, butyrylcholinesterase, and prolyl oligopeptidase inhibitory activity of Glaucium corniculatum subsp. refractum

Abstract Papaveraceae is one of the prominent alkaloid-containing families, and plants of the genus Glaucium (Papaveraceae) are known for their bioactive alkaloids. Glaucium species have been used in traditional medicine in Turkey as an analgesic, narcotic, sedative, and antitussive. In this study, it was planned to evaluate the inhibitory activity of an alkaloidal extract of Glaucium corniculatum subsp. refractum on acetylcholinesterase (AChE), butyrylcholinesterase (BuChE) and prolyl oligopeptidase (POP), as well as exploring the chemical profile of the plant by using Gas Chromatography-Mass Spectrometry (GC-MS). The AChE, BuChE and POP inhibition activities of the alkaloidal extract of G. corniculatum subsp. refractum were determined spectrophotometrically. A rapid GC-MS method was used to identify alkaloids that could be responsible for these inhibition activities. In total, eleven alkaloids were identified in the alkaloid extract of the plant by GC-MS. Allocyptopine (52.92%) and protopine (25.38%) were found as the major constituents. The alkaloidal extract of G. corniculatum subsp. refractum showed potent AChE inhibitory activity (IC50:1.25 µg/mL) and BuChE inhibitory activity (IC50: 7.02 µg/mL). The extract also showed a remarkable inhibitory effect on POP with an IC50 value of 123.69 µg/mL. This study presents the first GC-MS investigation and POP inhibitory activity of G. corniculatum subsp. refractum.

A Study to Assess the Utility of Peradeniya Organophosphorous Poisoning (POP) Scale, Poisoning Severity Score (PSS) and Glasgow Coma Scale (GCS) in Predicting Severity and Treatment Outcome in Acute Organophosphorous Poisoning

Introduction: Organophosphate compounds are often usedfor homicidal and suicidal purposes. It accounts for about80% of pesticide related hospital admissions. Study aimed toassess the severity of OP poisoning by POP scale, PSS andGCS and to compare POP scale, PSS and GCS in predictingthe treatment outcome in OP poisoning.Material and Methods: 100 patients of OP compoundpoisoning were included in the study. POP score, PSS andGCS were assessed at the time of presentation and weregrouped based on the severity. These scores were individuallyevaluated in predicting the ventilator requirement andmortality in OP compound poisoning and the scores werecompared with each other, as to asses which score was betterin predicting the severity of OP poisoning.Results: Ventilator requirement and mortality was found tobe in 43% and 16% of patients respectively. Intubation ratesand mortality rates were higher in patients with severe gradesof POP score, PSS and GCS with a significant p value (0.00),than in patients with mild to moderate grades. All three scorescorrelated well in predicting the requirement of ventilatorysupport and mortality in OP compound poisoning cases.Conclusion- The three scoring systems are simple andeffective tool that can be assessed based on the clinicalexamination. For a resource limited country, like India, any ofthe three scoring systems can be applied at the primary caresetting level which helps in making timely decision regardingneed for ventilatory support and timely shifting of patient tothe ICU care setting.

Analytical study to evaluate the relation between vaginal Birth Order and pelvic organ prolapse quantification stages

Background: Pelvic organ Prolapse (POP) is the downward displacement of central pelvic organs that are normally located at the level of or adjacent to the vaginal vault. These conditions are common and affect a progressively larger percentage of women as age advances especially in the postmenopausal years.Methods: Data were collected as a retrospective study. Thorough history was taken and physical examination was done. Demographic details of each patient were recorded including age, residence type, education and socio- economic status. A detailed history of all the patients was obtained included parity, live birth and nutrition status.Results: Most of the patients belong to birth order 4 or more than that [73 (62.9%)] followed by birth order 3 [26 (22.4%)] and 2 [16 (13.8%)] whereas 38 (32.7%) patients had birth order >4. In patients with birth order ≥4 and 3 had higher distribution of POPQ stage III and IV respectively.Conclusions: From Present study it can be concluded that vaginal childbirth plays a major role in development of POP. POPQ stages were statistically significant with high birth order.

Uma etnografia da atenção à saúde mental de sujeitos em situação de rua / An ethnography of the street subject when living psychic suffering

Este artigo propõe uma reflexão sobre a intersecção entre duas questões: a atenção à saúde mental e aos sujeitos em situação de rua. Na confluência dessas questões, o sujeito em situação de rua coloca um significativo desafio para os serviços de saúde mental sobre como contemplálos de forma integral, considerando e respeitando suas singularidades. A partir disso, temos como objetivo principal, nesta pesquisa, delinear e problematizar, na visão dos sujeitos em situação de rua, como a atenção em saúde mental, a partir das políticas públicas, contemplam suas especificidades de demandas e necessidades e como essas proposições se efetivam, ou não, na prática de um serviço de saúde mental. O território escolhido foi o Centro de Referência Especializado para a População em Situação de Rua (Centro Pop). Como estratégia para o trabalho de campo, utiliza-se a perspectiva etnográfica como orientadora do estar no campo. Evidenciaram as nossas conversas que os sujeitos em condição de desabrigo, em sua maioria, raramente procuram o serviço de saúde mental e apresentam o testemunho de como o serviço de saúde mental não conseguiu deslocar a hegemonia das práticas orientadas pelo modelo médico tradicional para o modelo psicossocial de atendimento.(AU)

This article proposes a reflection on the intersection between two issues: attention to mental health and the homeless. At the confluence of these issues, the homeless person poses a significant challenge to mental health services on how to fully address them, considering and respecting their uniqueness. From this, we have as main objective, in this research, to delineate and problematize, in the view of the homeless subjects, how mental health care, based on public policies, contemplates its specificities of demands and needs and how these propositions are or not, in the practice of a mental health service. The chosen territory was the Specialized Reference Center for the Homeless Population (Centro Pop). As a strategy for fieldwork, the ethnographic perspective is used to guide being in the field. It was evident from our conversations that most homeless subjects rarely seek mental health services and bear witness to how the mental health services failed to shift the hegemony of practices guided by the traditional medical model to the psychosocial model.(AU)

Short-term efficacy of pectopexy in the treatment of middle pelvic defects / 中国实用妇科与产科杂志

OBJECTIVE: To explore the short-term clinical effect and safety of pectopexy in the treatment of female middle pelvic defects.METHODS: Collect the clinical data and follow-up information of 32 patients,who underwent pectopexy due to pelvic prolapse with POP-Q score aboveⅡ in the Third Affiliated Hospital of Zhengzhou University and Shengjing Hospital of China Medical University from August 2018 to January 2019.The objective clinical efficacy and the results of PFDI-20 and PFIQ-7 questionnaires for pelvic floor dysfunction were evaluated by comparing the locations of Aa,Ba,Ap,Bp,C and TVL indicators of quantitative pelvic organ prolapse(POP-Q)scale before operation,1 month and 3 months after operation.RESULTS: The 32 patients completed pectopexy in 52-75 minutes,the average time being(59.22 ± 29.21)minutes;intraoperative bleeding was 10-400 mL,the average being(83.75 ± 78.89)mL;indwelling catheter days were 1-5 days,the average being(2.24±0.83)days;residual urine was 0-100 mL,the average being(32.79±29.81)mL;postoperative hospitalization days were 5-12 days,the average being(7.41±1.59)days.There was 1 case(3.13%)of asymptomatic venous thrombosis in the lower extremity during the perioperative period and 1 case(3.13%)of hypostatic pneumonia,and they were cured after active treatment.No complications occurred in the otherpatients during the perioperative period.During the follow-up period,pelvic discomfort occurred in 1 case(3.13%),which was relieved after active treatment,andno complications occurred in the rest of the patients.There was no significant difference(P>0.05)between TVL preoperatively and postoperatively at 1 and 3 months[(7.94±0.84)cm vs.(7.73±0.60)cm vs.(7.61±0.58)cm].There were significant differences in Aa[(0.94±1.92)cm vs.-(2.81±0.40)cm vs.-(2.81±0.40)cm],Ba[(2.28±2.62)cm vs.-(2.78±0.42)cm vs.-(2.78±0.42)cm],Ap[-(2.00±1.41)cm vs.-(2.92±0.26)cm vs.-(2.91±0.30)cm],Bp[-(0.91±2.78)cm vs.-(2.25±0.44)cm vs.-(2.25±0.44)cm]and C[(3.58±2.47)cm vs.-(7.72±0.58)cm vs.-(7.56±0.58)cm]among the other indicators(P<0.05).There were significant differences in PFIQ-7[(77.56±40.87)vs.(7.87±10.92)]and PFDI-20[(68.55 ± 35.05)vs.(7.66 ± 6.50)]scores before and 3 months after operation(P<0.05).CONCLUSION: Pectopexy provides new ideas and options for the treatment of pelvic defects.At present,large sample data and longterm follow-up are still needed to further observe the long-term efficacy.

A study on serum cholinesterase level in organophosphorus poisoning and its correlation with severity of organophosphorus poisoning

Background: There has been a steady increase in the use of organophosphates (OPs) as pesticides in most of the developing countries including India for more than 50 years. OPs tend to be the commonest cause of poisoning worldwide and are persistently and deliberately used in suicides in Agrarian areas. As stated by WHO, 3 million cases of pesticide poisoning occur every year, of these about 1 million are accidental and 2 million are suicidal poisonings, resulting in more than 0.25 million deaths per year. As there is limited availability of facilities and resources in developing countries, all OP poisoning patients are not managed in intensive care units. Hence it is important to understand the clinical features and other factors that indicate severity of poisoning which should be identified in the initial examination.Methods: It was a hospital based prospective study of 100 OP poisoning patients that were attending to casualty of BIMS Hospital and Medical College Belagavi, India. Over a period, patients fulfilling inclusion criteria were included and patients were categorized according to Peradeniya Organophosphorus Poisoning (POP) scale. Serum cholinesterase level measured at the time of admission.Results: The patients were in the age group of 18 to 70 years. Majority of the patients were in the age group of 21-30 years (51%). Sixty nine percent of the patients were from rural areas and 38% of them were farmers. Sixty nine percent of patients were from low socioeconomic stratum. Major route of intake of poison was ingestion. Eighty four percent of patients consumed poison with a suicidal intent. In this study, authors observed that there is a significant correlation between the severity of poisoning categorized by the POP scale and the serum cholinesterase at the time of initial presentation of the patients (P<0.001).Conclusions: Present study concluded that significant correlation between the degree of derangement in serum cholinesterase level and severity of poisoning at the initial presentation. Higher the score on the POP scale, the greater was the degree of derangement in the serum cholinesterase level.

Psicanálise e cultura pop: os mitos no contemporâneo / Psychanalyse et culture pop: les mythes dans la contemporanéité / El psicoanálisis y la cultura pop: los mitos en la contemporaneidad / Psychoanalysis and pop culture: myths in the contemporary era

Resumo O que a cultura pop tem a dizer sobre os sujeitos de nosso tempo? Neste ensaio, os autores propõem uma via de leitura das produções da cultura pop apostando que, na contemporaneidade, ela floresce, no território tradicionalmente reservado à mitologia, como enunciante dos modos de subjetivação. Retomando a abordagem psicanalítica dos mitos a partir de Freud e Lacan, observa-se que a função de recobrir o Real do desamparo, em um tempo que se crê racionalista, passa a ser desempenhada por ficções que deixam rastros e possibilitam, através da variância e da repetição, desvelar a estrutura subjacente que lhes engendra. Por fim, propõe-se que, se essas produções são consumidas com tamanha voracidade, é porque dizem algo sobre os sujeitos que a elas se lançam - ou seja, sobre a subjetividade desta época.

Résumé Qu'est-ce que la culture pop peut dire sur les sujets de notre temps ? Dans cet essai, les auteurs proposent une voie de lecture des productions de la culture pop en pariant que, dans la contemporanéité, elle fleurit dans le territoire traditionnellement réservé à la mythologie comme énonciateur des modes de subjectivation. Si l'on reprend l'approche psychanalytique sur les mythes à partir de Freud et Lacan, on observe que la fonction de recouvrir le Réel de la détresse, dans un temps qu'on croit rationaliste, est accomplie par des fictions qui laissent des traces et permettent, grâce à la variance et à la répétition, de révéler la structure sous-jacente qui les engendre. Enfin, on propose que, si ces productions sont consommées avec une telle voracité, c'est parce qu'elles disent quelque chose sur les sujets qui sur elles se lancent - c'est-à-dire sur la subjectivité d'une époque.

Resumen ¿Qué tiene que decir la cultura pop sobre los sujetos de nuestro tiempo? En este ensayo, los autores proponen una vía de lectura de las producciones de la cultura pop asumiendo que, hoy en día, ella florece, en el territorio reservado tradicionalmente a la mitología, como enunciante de los modos de subjetivación. Al reanudar el enfoque psicoanalítico de los mitos de Freud y Lacan, se observa que la función de recubrir lo real del desamparo, en un tiempo que se cree racionalista, pasa a ser desempeñada por ficciones que dejan huellas y hacen posible, a través de la varianza y la repetición, develar la estructura subyacente que las engendra. Por último, se propone que, si estas producciones se consumen con tanta voracidad, es porque dicen algo sobre los sujetos que a ellas se arrojan, es decir, sobre la subjetividad de esta época.

Abstract What does pop culture have to say about the subjects of our time? In this article, the authors propose a way of reading the productions of pop culture betting that, in the contemporaneity, it flourishes, in the territory traditionally reserved for mythology, as enunciator of the modes of subjectivation. In the psychoanalytic approach of myths from Freud and Lacan, the function of covering the Real of the helplessness, in a rationalist era, is played by fictions that leave traces and make it possible, through variance and repetition, to unveil the underlying structure that engenders them. Finally, it is proposed that if these productions are consumed with such voracity, it is because they say something about the subjects who are targeted - that is, about the subjectivity of this time.

Vocal Exercises for Reducing Vocal Damages Caused by Breathy Phonation in Pop Singing

Pop singers frequently use breathy voice to express diverse emotion. Such method is the major factor that divides vocalization in pop and classical music. Using breathy voice too much for a long time could make singer short-winded, which might cause the voice injured. In order to prevent the problem, singers need to find resonance balance between high notes and low notes and among vowels. Moreover, they should take more attention when producing resonance in consonants with much air flow. Along with finding resonance balance, if skilled at controlling the volume of voice, singers can use the breathy voice selectively at the desired part, adjusting close quotient freely. Through this kind of approach, pop singers can develope their unique style of vocalization and avoid the vocal damage.

Bioecology and movements of bull sharks, Carcharhinus leucas, caught in a long-term longline survey off northeastern Brazil

A robust understanding of habitat usage by coastal shark species, and how it overlaps with human presence in densely-populated regions is needed to inform the development of efficient conservation strategies for these important top predators. An intensive longline survey conducted in nearshore waters off northeastern Brazil from 2004 through 2014 caught a total of 18 bull sharks (Carcharhinus leucas) (male-female ratio = 0.63:1), which can be dangerous to humans. Although most sharks were sexually mature, there was no evidence that this region could be used as a parturition or nursery area. Prey items identified in the guts of the sharks comprised teleosts, mollusks and elasmobranchs. Additionally, one satellite-tagged bull shark covered a great distance (> 3,000 km) in 75 days at liberty, making most use of shallow waters (< 20 m depth) and presumably also entering an estuarine area. Although bull sharks are not an important fishery resource in this region, such a reduced abundance coupled with its affinity for coastal and inshore habitats highlights the potential vulnerability of C. leucas to deleterious anthropic interferences off northeastern Brazil.(AU)

Um melhor entendimento sobre a utilização de hábitat das espécies de tubarões costeiros, e como ela se sobrepõe à presença humana em regiões altamente populosas, se faz necessário a fim de subsidiar o desenvolvimento de eficientes medidas de conservação para esses importantes predadores de topo. Um estudo intensivo utilizando espinhel, conduzido em águas costeiras do nordeste do Brasil entre os anos de 2004 e 2014, capturou um total de 18 tubarões cabeça-chata (Carcharhinus leucas) (proporção macho-fêmea = 0,63:1), os quais podem ser perigosos para humanos. Apesar da maioria dos tubarões estarem sexualmente maduros, não houve evidências de que essa região esteja sendo utilizada como uma área de parto ou berçário. Entre os itens alimentares identificados foram encontrados teleósteos, moluscos e elasmobrânquios. Além disso, um tubarão cabeça-chata marcado com um transmissor satélite percorreu uma grande distância (> 3.000 km) em 75 dias em liberdade, fazendo o uso de águas superficiais (< 20 m profundidade) e presumivelmente entrando em uma área estuarina. Apesar de os tubarões cabeça-chata não corresponderem a um recurso pesqueiro importante nessa região, tal reduzida abundância juntamente com a sua afinidade por hábitats costeiros reforçam a potencial vulnerabilidade de C. leucas às interferências antrópicas deletérias ao longo da costa nordeste do Brasil.(AU)

Impact of Sacrospinous Colpopexy Associated with Anterior Colporrhaphy for the Treatment of Dome Prolapse on all Three Vaginal Compartments / Resultados da colpofixação sacroespinal associada a colporrafia anterior para o tratamento do prolapso de cúpula vaginal

Objective To evaluate the results of sacrospinous colpopexy surgery associated with anterior colporrhaphy for the treatment of women with post-hysterectomy vaginal vault prolapse. Methods This prospective study included 20women with vault prolapse, PelvicOrgan Prolapse Quantification System (POP-Q) stage≥2, treated between January 2003 and February 2006, and evaluated in a follow-up review (more than one year later). Genital prolapse was evaluated qualitatively in stages and quantitatively in centimeters. Prolapse stage < 2 was considered to be the cure criterion. Statistical analysis was performed using the Wilcoxon test (paired samples) to compare the points and stages of prolapse before and after surgery. Results Evaluation of the vaginal vault after one year revealed that 95% of subjects were in stage zero and that 5% were in stage 1. For cystocele, 50% were in stage 1, 10% were in stage 0 (cured) and 40% were in stage 2. For rectocele, three women were in stage 1 (15%), one was in stage 2 (5%) and 16 had no further prolapse. The most frequent complication was pain in the right buttock, with remission of symptoms in all three cases three months after surgery. Conclusions In this retrospective study, the surgical correction of vault prolapse using a sacrospinous ligament fixation technique associatedwith anterior colporrhaphy proved effective in resolving genital prolapse. Despite the low complication rates, there was a high rate of cystocele, which may be caused by posterior vaginal shifting due to either the technique or an overvaluation by the POP-Q system.

Objetivo Avaliar os resultados da cirurgia de colpofixação sacroespinal associada a colporrafia anterior, para o tratamento de mulheres com prolapso de cúpula vaginal pós-histerectomia. Métodos Estudo prospectivo que incluiu 20 mulheres com prolapso de cúpula em estágio≥2 de acordo com o Sistema de Quantificação do Prolapso Genital (POP-Q) tratadas no período de janeiro de 2003 a fevereiro de 2006 e avaliadas emrevisão tardia (maior que um ano). O prolapso genital foi avaliado qualitativamente em estágios e, quantitativamente, emcentímetros. Como critério de cura, consideramos prolapso em estágio < 2. Para análise estatística, foi utilizado teste de Wilcoxon (amostras pareadas) para comparar os pontos e estágios dos prolapsos antes e depois da cirurgia. Resultados Na cúpula vaginal a avaliação após um ano mostrou 95% em estágio zero e 5% em estágio 1. Cistocele: 50% em estágio 1, 10% em estágio zero (curadas) e 40% emestágio 2. Retocele: trêsmulheres apresentavamestágio 1 (15%), uma emestágio 2 (5%) e dezesseis não apresentavam prolapso posterior. As complicações mais frequentes foramdor no glúteo direito com remissão do sintoma emtodos os três casos após três meses da cirurgia. Conclusões Neste estudo retrospectivo, a cirurgia de correção do prolapso de cúpula pela técnica de fixação no ligamento sacroespinal, associada à colporrafia anterior, se mostrou efetiva na resolução do prolapso genital com baixa taxa de complicações; porém com alta taxa de cistocele - o que pode ter sido decorrente do desvio vaginal posterior pela técnica, ou ainda uma supervalorização pelo sistema POP-Q.

Perception of Medical Students towards Artificial Bones and POP Models of Viscera.

Background: In learning of anatomy, bones and viscera are very important. Now days, artificial bones are replacing the original bones for study purpose due to unavailability. Original viscera are available for students only at dissection hours. So we have tried to find out perception of medical students towards artificial bones and POP models of viscera. Materials and Methods: We had prepared a questionnaire consisting of 20 questions, 10 related to bones and 10 related to the POP models of viscera and asked 150 students of 1st year MBBS to answer it. Results: All the 150 students agreed that bones are necessary for study but only 36 students have bone set (14 original & 22 artificial). Maximum students get the bones only when made available from department. While 107 (71%) students said they would prefer original specimen of viscera, over POP models, for studying; but still 126 (84%) wanted to keep the POP models of viscera while studying its relations from text book. Conclusions: Good quality artificial bones should be promoted for students, if original bones are not available. It will be better than having nothing. POPmodels of viscera cannot replace original viscera but due to its handy quality will be helpful for understanding.

Short-term movements and habitat preferences of sailfish, Istiophorus platypterus (Istiophoridae), along the southeast coast of Brazil

Pop-up satellite archival tags (PSATs) were deployed on four sailfish, Istiophorus platypterus, in the coastal waters of Rio de Janeiro State in southeast Brazil during January and February of 2009 (sailfish I and II) and between November 2010 and January 2011 (sailfish III and IV). The total number of days monitored (i.e., time that the tags remained attached) were 12 (sailfish I), 51 (sailfish II), 16 (sailfish III) and 43 days (sailfish IV). The results indicate a clear pattern of vertical habitat utilization with the majority of the time spent concentrated near the uniform sea surface layer occupying a relatively narrow temperature range. Despite the clear preference for epipelagic surface waters, sailfish regularly undertook vertical excursions into deeper waters (>50 m) within three to six hour intervals. "Most Probable Tracks" (estimated from raw geolocations using the state-space Kalman filter model) and linear displacements suggested that tagged sailfish did not move significant distances from the tagging site. In brief, our report provides information regarding the biology of sailfish in the southwestern Atlantic and how vertical distributions during the day and night are influenced by water temperature and how this information can improve sailfish stock assessments in southwestern Atlantic Ocean.

Quatro exemplares de agulhão-vela foram marcados com marcas eletrônicas monitoradas por satélite ('Pop-up satellite archival tags - PSATs') nas águas costeiras do Rio de Janeiro, sudeste do Brasil, durante janeiro e fevereiro de 2009 (agulhão-vela I e II) e entre novembro de 2010 e janeiro de 2011 (agulhão-vela III e IV). O número total de dias monitorados (ou seja, o tempo que as marcas permaneceram implantadas nos peixes) foram 12 (agulhão-vela I), 51 (agulhão-vela II), 16 (agulhão-vela III) e 43 dias (agulhão-vela IV). Os resultados demonstram um padrão claro de utilização do hábitat com a maior parte do tempo despendido predominantemente próximo à superfície do mar ocupando águas com uma faixa de temperatura restrita. Apesar da preferência por águas superficiais, os agulhões frequentemente realizaram mergulhos para águas mais profundas (ca. > 50 m) em intervalos de três a seis horas. A "rota mais provável" estimada a partir dos dados brutos de geolocalização e o modelo 'State-Space Kalman Filter' sugerem que os agulhões marcados não realizaram migrações significativas a partir do local de marcação. Em resumo, nossos resultados apresentam informações sobre a biologia da espécie no Atlântico Sudoeste e como as migrações verticais durante o dia e a noite são influenciadas pela temperatura da água e como essa informação pode auxiliar as avaliações de estoques de agulhão-vela no sudoeste do Atlântico.

Traumatismo accidental con estallido del globo ocular / Accidental trauma with eyeball popping-up

Paciente masculino de 27 años de edad, trabajador agrícola, que fue ingresado en el Hospital Militar Central "Dr. Carlos J. Finlay" por haber sufrido una herida penetrante por arma de fuego, producida por la impulsión retrógrada del percutor al disparar una escopeta artesanal de cacería, que provocó estallido del globo ocular izquierdo, fractura de la pared externa de la órbita y heridas palpebrales. Se retiró el cuerpo extraño, se completó la evisceración del ojo izquierdo, se recolocó el fragmento fracturado de la órbita en posición anatómica, se regularizaron los tejidos blandos intra y periorbitarios, preparando la cavidad orbitaria para la colocación posterior de la prótesis; y se realizó la hemostasia, la exploración de la cavidad neoformada por el cuerpo extraño en los tejidos blandos de la región fronto-temporal y la plastia palpebral. Se logró con éxito la reconstrucción palpebral y con posterioridad, la rehabilitación con fines estéticos mediante prótesis ocular.

A 27 year-old male farmer patient was admitted to "Dr. Carlos J. Finlay" Central Military Hospital suffering a penetrating gunshot wound, caused by the retrograde hammer when shooting a handmade hunting shotgun. This injured caused his left eyeball burst, fracture of the outer wall of the orbit and eyelid injuries. Foreign matter was removed. His left eye evisceration was completed. The fractured orbit fragment was repositioned in anatomical position. Intra and periorbital soft tissues were regularized, preparing the orbital cavity for the subsequent placement of prosthesis; and hemostasis was performed, as well as exploration the newly formed cavity by foreign matter in the soft tissues of the frontal-temporal region and eyelid plasty. Eyelid reconstruction and further rehabilitation for aesthetic purposes by ocular prosthesis was successfully achieved.

Ultrasound Characteristics of Patients with Urinary Stress Incontinence with or without Genital Prolapse

PURPOSE: The study purpose was to evaluate the clinical and ultrasound characteristics of women with urinary stress incontinence (USI) with or without genital prolapse (GP). MATERIALS AND METHODS: A total of 268 patients who underwent ultrasound perineal evaluation were divided into two groups: isolated USI (n=132) and USIGP (n=136) with USI/GP stage I/II. The latter group was additionally divided into two subgroups: USIGP(A) (n=78) with USI/GP stage I and USIGP(B) (n=58) with USI/GP stage II. RESULTS: Point Aa (pelvic organ prolapse quantification system), which is the projection of the bladder neck (BN) on the anterior vaginal wall, was situated higher in the rest position (RP) but moved lower during a Valsalva maneuver (VM) in the USI group than in the USIGP group (pV and angle of rotation (rho), which were significantly higher in the USI group than in the USIGP group during VM. CONCLUSIONS: According to the clinical and ultrasound findings, we can conclude that the BN is situated higher during the RP but moved lower during a VM in patients with isolated USI compared with those with concomitant USI/GP, which could be explained by the cystocele-immobilizing effect on the BN during the VM in the latter group but also by the deteriorated pubo-urethral ligaments in the former group.

Benign symmetric lipomatosis (madelung’s disease): A case report of new variant.

Benign symmetric lipomatosis (BSL) is characterized by the presentation of numerous symmetric non-tender fatty tumors in the neck, suboccipital region, proximal extremities and upper parts of the trunk, typically noted as a “pseudoathletic” appearance. The etiology of BSL remains unknown but mitochondrial mutations have been found in some patients. The mitochondrial cytopathy was suggested to be studied in all BSL patients especially those with neuropathy. We have presented a case of BSL with reverse fat distribution, which we named the “Pop-eye” appearance in which the fatty tumor was distributed at both the distal part of the upper extremities and the proximal part of the lower extremities. A study of the mitochondrial tRNA lysine gene did not reveal mutation at position 8344.