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BACKGROUND: Dermatological research has traditionally concentrated on evaluating mental comorbidities, neglecting positive concepts like happiness. Initial studies indicate that psoriasis and atopic dermatitis (AD) impair the happiness of those affected. Considering global happiness variations, this study aimed to explore the disease- and country-specific differences in disease-related quality of life and happiness, and potential influential factors on heuristic happiness among psoriasis and AD patients in Europe. METHODS: A cross-sectional multicentre study was conducted in dermatology departments of university-affiliated hospitals in eight European countries (Austria, Germany, Italy, Malta, Poland, Portugal, Romania and Ukraine) between October 2021 and February 2023. Adult psoriasis and AD patients completed a standardized questionnaire in their native languages, providing data on demographics, disease-related characteristics, disease-related quality of life (Dermatology Life Quality Index, DLQI), heuristic happiness, positive affect (PA), negative affect (NA) and satisfaction with life (SWL). Descriptive analysis and quantile regression were performed. RESULTS: Between psoriasis (n = 723) and AD (n = 316) patients almost no differences were observed in happiness, SWL and NA, except for DLQI and small differences in PA, with AD patients reporting greater impact than psoriasis patients. Country-wise variation emerged in DLQI, heuristic happiness, PA, NA and SWL with Austrian patients displaying the highest levels of happiness, satisfaction and positivity, coupled with higher treatment care and lower disease severity. Quantile regression revealed varying coefficients for predictor variables across quantiles, indicating, for example positive effects on heuristic happiness associated with current or previous receipt of systemic therapies at different quantiles. CONCLUSION: This study shows notable happiness differences across European countries and significant disease-related variations, particularly with AD patients being more impaired than psoriasis patients. The findings highlight the need for equality in treatment access and support the development of targeted positive psychological interventions to enhance happiness considering country-specific distinctions in future research and health policies for psoriasis and AD patients.
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Purpose of the article: The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged ≥ 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices.Materials and methods: A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged ≥ 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation.Results: The mean PASI score was 16.6 ± 9.4 at baseline and significantly decreased to 4.3 ± 5.2 after 4 weeks (p < 0.001), and 1.1 ± 1.7 after 16 week (p < 0.001). This level of improvement was maintained after 36 weeks (p < 0.001). PASI ≤2 was recorded in 36 (36.7%) at week 4, 68% and 69.4% at week 16 and 36, respectively. By week 16, 86/98 (87.8%) patients reached PASI75, 71/98 (72.4%) obtained PASI90, and 52/98 (53.1%) PASI100. Binary logistic regression tests showed a significant association of PASI100 by week 4 with lower PASI at baseline. PASI 100 at 16 or 36 weeks was not associated with baseline PASI, obesity, age, gender, previously naïve state, and presence of psoriatic arthritis. Patients naïve to biologics at baseline had similar response to bimekizumab as non-naïve subjects.Conclusions: Bimekizumab is a suitable option for elder patients as it is effective, tolerated and has a convenient schedule.
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Psoriasis , Índice de Severidad de la Enfermedad , Humanos , Psoriasis/tratamiento farmacológico , Psoriasis/patología , Estudios Retrospectivos , Masculino , Anciano , Femenino , Italia , Resultado del Tratamiento , Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/administración & dosificación , Anciano de 80 o más AñosRESUMEN
The content and the distribution of the glycoconjugate sugar residues were investigated in the human umbilical cord from normally grown pregnancies and from pregnancies complicated by intra-uterine growth retardation with absent or reversed flow in the umbilical artery. The gestational age range was 29-41 weeks. For this purpose, a battery of eight horseradish peroxidase conjugated lectins was used (ConA, WGA, PNA, SBA, DBA, LTA, UEA I, and OOA; see text). Our data showed that in both study groups ConA, WGA and PNA (after neuraminidase digestion) and LTA, UEA I, and OOA reacted with Wharton's jelly and vessels of the umbilical cord from the first weeks of gestation considered. SBA reactivity was observed only in the amniotic epithelial cells of the jelly and in the endothelial cells of the vessels. The reactivity with the most part of the lectins decreased or was lacking in the various components of the umbilical cord between 39 and 41 weeks of gestation in the normal group and between 36 and 37 weeks of gestation in the pathological one. Moreover, the intensity of reactivity with ConA, WGA and PNA (after neuraminidase digestion) and LTA, UEA I, and OOA in the normal group and with PNA (before and after neuraminidase digestion) and LTA and OOA in the pathological one was stronger in the peripheral portion of the jelly with respect to the adventitial one. The reactivity with ConA and UEA I was stronger in the vein than in the arteries in both study groups. Some hypotheses are reported on the role played by the sugar residues in the normal and pathological umbilical cords.
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Retardo del Crecimiento Fetal/fisiopatología , Lectinas/metabolismo , Arterias Umbilicales/fisiopatología , Cordón Umbilical/metabolismo , Concanavalina A/metabolismo , Diástole , Femenino , Edad Gestacional , Histocitoquímica , Humanos , Maclura/química , Neuraminidasa/metabolismo , Aglutinina de Mani/metabolismo , Lectinas de Plantas/metabolismo , Embarazo , Venas Umbilicales/metabolismo , Aglutininas del Germen de Trigo/metabolismoRESUMEN
A workshop in the clinical anatomy of the female pelvic viscera has been part of the training program for the first year residents in Gynecology and Obstetrics at the University of Padova since the 1999-2000 academic year. The purpose of the workshop is to offer a direct experience of practical anatomy despite a shortage of cadavers. It is designed for six residents who work in three teams on three specimens. The anatomical specimens are unembalmed, unfixed, female pelvic visceral blocs that are harvested from the cadavers 24 hr after death. They are stored at -12 degrees C and removed from the freezer 12 hr before the workshop. The workshop is 3 hr in length and has two parts: one on theory and one practical. In the theoretical section (30 min), the teacher presents the topographical anatomy of the specimens and the residents analyze a clinically oriented worksheet. In the practical section (2 hr), the residents identify viscera, vessels, and nerves through inspection and palpation, and then a step-by-step dissection is carried out. In the last section (30 min), the workshop includes presentations on the three specimens that illustrate anatomical variability and assess knowledge of topographical anatomy. For many residents, this is the first practical experience of the anatomy of the female pelvic viscera because the anatomical courses for medical students do not include direct dissection by students. The unfixed viscera preserves the natural characteristics of the different tissues that exhibit the aspects of living organs, such as color, softness, and pliability, enhancing the knowledge of anatomy. The worksheet is structured as a guide to the anatomical basis of physical examination through inspection and palpation of the viscera. It also introduces the residents to the surgical anatomy of the female pelvis through a brief and selective dissection focused on the relationship between the different regional systems.
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Anatomía/educación , Educación , Ginecología/educación , Internado y Residencia , Obstetricia/educación , Cadáver , Disección , Femenino , Humanos , Pelvis/anatomía & histologíaRESUMEN
The oligosaccharide distribution of the glycoconjugates was investigated in placental tissue of pregnancies complicated by intrauterine growth retardation (IUGR) with absent or reversed flow in the umbilical artery (ARED), between the 29 and the 37 weeks of pregnancy. Placentae of a gestational age-matched group of normally grown pregnancies was also selected as control group. For this purpose a battery of seven HRP-conjugated lectins was used (DBA, SBA, PNA, ConA, WGA, LTA and UEA I). Our data showed that alpha-D-mannose (ConA), N-acetyl-D-glucosamine (WGA), beta-N-acetyl-D-galactosamine (SBA), alpha-L-fucose (LTA and UEA I) were present in less amount or were not present in the trophoblast and/or in the endothelial cells of the pathological group compared to the control one. The trophoblast basement membrane and/or basal plasma membrane of the pathological placentae were characterized by the presence of alpha-D-mannose (ConA), N-acetyl-D-glucosamine (WGA), sialic acid and D-galactose-(beta1-->3)-N-acetyl-D-galactosamine (neuraminidase-PNA), only in some tracts, in all the weeks of gestation. In the control placentae these sugar residues were present in the whole basement membrane and/or basal plasma membrane from 31 or 35 weeks. The Hofbauer cells of the pathological placental tissue showed a less amount or lack of alpha-D-mannose (ConA), beta-N-acetyl-D-galactosamine (SBA) and alpha-L-fucose (UEA I) compared to the control ones. These results suggest that a less amount or lack of some sugar residues may contribute to restricted placenta growth and development and thus reduced efficiency in maternal-fetal exchanges of gases and metabolites.
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Vellosidades Coriónicas/metabolismo , Retardo del Crecimiento Fetal/metabolismo , Lectinas/metabolismo , Trofoblastos/metabolismo , Adulto , Vellosidades Coriónicas/química , Diástole , Femenino , Retardo del Crecimiento Fetal/diagnóstico por imagen , Edad Gestacional , Humanos , Inmunohistoquímica , Lectinas/análisis , Intercambio Materno-Fetal/fisiología , Embarazo , Trofoblastos/química , Ultrasonografía Prenatal , Arterias Umbilicales/diagnóstico por imagenRESUMEN
Morphologic and morpho-functional heart differences between healthy young athletes and healthy young subjects who do not practice agonistic sport have been studied using Color Doppler Echography (CDE). Overall, 68 subjects were enrolled in the study (age range: 19-26 yrs). Of them, 34 subjects (17 men and 17 women) were practicing sport agonistically; the 34 controls (17 men and 17 women) did not practice any sport on a regular basis. In each subject, age, height, weight, body mass index, practiced sport, systolic and diastolic blood pressure were recorded. CDE measures included telediastolic left and right ventricular diameters (LVDd and RVDd, respectively), interventricular septum thickness (IVSd), posterior wall thickness of the left ventricle (PLVWd), left and right atrium diameters during ventricular systole (LAD and RAD respectively), and continence of each heart valve (mitral; tricuspid; aortic; pulmonic). In women, LADd was significantly higher in the athletes than in the controls (35.04+/-4.13 vs 31.81+/-3.34; p<0.02). Physiological regurgitation in at least one heart valve was observed in 15 out of 17 (88.2%) of the athletes; in 12 cases only one valve was involved: the mitral valve presented physiological regurgitation in 8 women, the tricuspid in 4, the aortic in 2 and the pulmonic in 6. In the control female population (17 persons), only 2 women showed evidence of regurgitation. In men, except for RVDd, CDE measurements were all significantly higher in the athletes than in the controls: LVDd (49.4+/-3.13 vs 46.02+/-4.46; p<0.02); IVSd (9.79+/-1.24 vs 8.59+/-0.91; p<0.003); PLVWd (8.63+/-1.29 vs 7.48+/-0.66; p<0.002). Physiological regurgitation through one or more heart valves was demonstrated in all the 17 male athletes studied; in 9 cases (52.9%) only one valve was involved. Mitral regurgitation was ob- served in 8 cases (47%); tricuspid in 6 (35.3%). No physiological regurgitation through the aortic valve was found, while 15 cases (88.2%) presented a pulmonic regurgitation. Among male controls, physiological regurgitation was demonstrated only in 2 persons out of 17 (11.8%), both involving the pulmonic and the aortic valve. In the total population of athletes compared to controls, analyzing men and women jointly, we found that LAD (p<0.001),RAD (p<0.001), LIVD (p<0.01) were significantly larger in cases than in controls, while for RVD, IVSd and PLVWd such a difference did not reach statistical significance. No relationship was fouhd between CDE data and either age, height, weight or blood pressure.
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Ecocardiografía Doppler en Color , Corazón/anatomía & histología , Corazón/fisiopatología , Aptitud Física/fisiología , Deportes/fisiología , Adulto , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/fisiopatología , Presión Sanguínea/fisiología , Peso Corporal/fisiología , Femenino , Atrios Cardíacos/anatomía & histología , Atrios Cardíacos/diagnóstico por imagen , Tabiques Cardíacos/anatomía & histología , Tabiques Cardíacos/diagnóstico por imagen , Válvulas Cardíacas/anatomía & histología , Válvulas Cardíacas/diagnóstico por imagen , Válvulas Cardíacas/fisiopatología , Ventrículos Cardíacos/anatomía & histología , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Masculino , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/fisiopatología , Insuficiencia de la Válvula Pulmonar/diagnóstico por imagen , Insuficiencia de la Válvula Pulmonar/fisiopatología , Valores de Referencia , Caracteres Sexuales , Insuficiencia de la Válvula Tricúspide/diagnóstico por imagen , Insuficiencia de la Válvula Tricúspide/fisiopatologíaRESUMEN
We measured by ultrasound the spleen, the kidneys, the pancreas in 323 children (age 0-12), the thyroid in 60 children of same age range, and all these organs in 180 adults (in adults we measured additionally the testis, the gallbladder and the choledochus). Children and adults were all healthy, without evidence of pathologies potentially involving these organs. The children have been selected looking at clinical and hematological parameters, while the adults have been selected among a military population, that is the most significant sample of healthy young adults. We measured the length, the transversal diameter and the thickness of the spleen, kidneys, pancreas, testis and thyroid, the diameter of the choledochus and the maximum length of the gallbladder (pre and post stimulus). We found a good correlation between age and dimensions for pancreas, kidneys and spleen in children, representing the progressive growth of these organs. Our data represent an assessment of the normal dimensions of these organs in vivo by means of ultrasound, and therefore they are an useful tool to discriminate pathologically enlarged or reduced organs, both in children and in adults.
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Conducto Colédoco/diagnóstico por imagen , Vesícula Biliar/diagnóstico por imagen , Riñón/diagnóstico por imagen , Páncreas/diagnóstico por imagen , Bazo/diagnóstico por imagen , Testículo/diagnóstico por imagen , Adolescente , Adulto , Envejecimiento , Niño , Preescolar , Conducto Colédoco/anatomía & histología , Conducto Colédoco/crecimiento & desarrollo , Femenino , Vesícula Biliar/anatomía & histología , Vesícula Biliar/crecimiento & desarrollo , Humanos , Lactante , Recién Nacido , Riñón/anatomía & histología , Riñón/crecimiento & desarrollo , Masculino , Páncreas/anatomía & histología , Páncreas/crecimiento & desarrollo , Valores de Referencia , Bazo/anatomía & histología , Bazo/crecimiento & desarrollo , Testículo/anatomía & histología , Testículo/crecimiento & desarrollo , UltrasonografíaRESUMEN
The distribution and the characteristics of A and B synoviocytes were investigated using scanning and transmission electron microscopy in the study of the three types of synovial membranes (fibrous, areolar, adipose) of the rabbit knee joint. The scanning electron microscope showed that the B-synoviocytes had dendritic processes and were separated by wide spaces in the fibrous synovium. The areolar synovium was covered by numerous B-synoviocytes of fibroblastoid-shape. The B-synoviocytes of the adipose synovium were characterized by short cytoplasmic processes. The transmission electron microscope revealed that the B-cells showed signs of intense synthetic activity such as the presence of an evident rough endoplasmic reticulum, the Golgi apparatus and many peripheric vesicles. Our study also revealed that cells with morphological and ultrastructural characteristics of macrophages, the so-called A-synoviocytes, were present in the areolar membrane. We concluded that B-synoviocytes can show variable shape under normal conditions: in particular, dendritic morphology seems to be a normal characteristic of the synoviocytes of the fibrous membrane. Moreover, our results demonstrate that A and B synoviocytes are ultrastructurally and morphologically distinct cells and that each type has different functions.
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Articulación de la Rodilla/ultraestructura , Membrana Sinovial/ultraestructura , Animales , Microscopía Electrónica , Microscopía Electrónica de Rastreo , ConejosRESUMEN
The aim of this study was to assess any possible correlation between villous tree architecture and its vascularization, and absent or reversed end-diastolic flow velocity (ARED) in the umbilical artery. The study group included seven pregnancies complicated by IUGR (estimated fetal weight < 10th percentile) and absent end-diastolic flow velocity in the umbilical artery. A gestational-age matched group of seven normally grown pregnancies was selected as control group. At delivery, the placenta was weighed and immersed in 10% neutral buffered formalin. A stratified random sampling procedure was used to obtain 12 blocks of full-thickness tissue per organ. A single random section was cut from each block. The following morphometric parameters were evaluated in each section: mean vessel diameter, volume density of the villous tissue, stem villi and terminal villi. Measurements were performed using a computerized Video Image Analysis system. No significant difference in mean vessel diameter was found between the two groups (37.1 microns versus 36.1 microns; p = 0.1). There was a significant reduction in the proportion of total villous tissue in the ARED group (43% versus 52%): this was due to a significant reduction in the volume of tissue occupied by the terminal villi (14.1% versus 18.4%). No significant difference was found in the proportion of villous tissue occupied by the stem villi (42% versus 40%). Several studies have investigated the anatomical and/or vasomotor bases of absent end diastolic flow velocity in the umbilical artery of fetuses with severe IUGR. Our observations of a significant reduction in the proportion of villous tissue occupied by the peripheral villi are consistent with the theory that failure of normal development of the terminal villous is responsible for the increased vascular resistance in IUGR pregnancies with ARED.
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Retardo del Crecimiento Fetal/fisiopatología , Placenta/irrigación sanguínea , Insuficiencia Placentaria/fisiopatología , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Arterias Umbilicales/patología , Arterias Umbilicales/fisiopatología , Vellosidades Coriónicas/patología , Vellosidades Coriónicas/fisiopatología , Femenino , Humanos , Placenta/fisiopatología , Insuficiencia Placentaria/diagnóstico por imagen , Embarazo , Complicaciones Cardiovasculares del Embarazo/diagnóstico por imagen , Flujo Sanguíneo Regional/fisiología , Ultrasonografía , Arterias Umbilicales/diagnóstico por imagenRESUMEN
The width of the articular space of the lateral atlantoaxial joint was measured to evaluate normal range values and possible variations according to age and sex. The study was based on X-rays of the lateral atlantoaxial joint of 52 females (age range: 18-82 ys) and 50 males (age range: 20-82 ys). The radiograms were taken using a semiautomatic computerized morphometric system (Videoplan II, Image Analysis system-Kontron, Munich, Germany). The articular space width of the lateral atlantoaxial joint was measured on both sides, at the medial, lateral and median levels. The mean value at these levels, on both sides, was calculated. Regression analysis was performed to evaluate the relationships between the width of the articular space at the three different levels and the patient's age and gender. No significant differences were found in the mean values of the articular space width at the three levels as regards gender. However, a significant inverse correlation was found between the articular space width and the patients' age in both males and females. Comparative analysis of regression lines showed that the slope of these lines was not significantly different when the sexes were compared. On the contrary, the intercept of the regression lines at the medial and median levels was significantly higher in the females than in the males; the contrary was encountered at the lateral level. This feature is probably due to the different types of inclination of the articular facets of the axis or of those of the atlas in the two sexes.
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Articulación Atlantoaxoidea/anatomía & histología , Articulación Atlantoaxoidea/diagnóstico por imagen , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Rango del Movimiento Articular/fisiología , Valores de Referencia , Análisis de RegresiónRESUMEN
PURPOSE: The structure of the retroperitoneal connective tissue of the female pelvis was evaluated to determine whether its spatial arrangement may have a role in supporting the pelvic viscera. MATERIALS AND METHODS: After in situ formalin fixation the pelvic viscera with the surrounding connective tissue were removed together with the pelvic floor from 18 female cadavers 48 to 68 years old. Serial macrosections of the bladder base, cervix, lower rectum and pelvic floor complex, cut in coronal (4 cases) and horizontal (10 cases) planes, were stained with azan-Mallory, and the remaining 4 were cut in the horizontal plane and plastinated using von Hagens E12 technique. Morphometry of the retroperitoneal connective tissue was performed using a computerized system for image analysis connected through a black and white television camera to an optic microscope. The diameters of the adipose lobules and density of the connective tissue were evaluated in the proximity of the visceral adventitia and the parietal pelvic fascia, respectively. RESULTS: The retroperitoneal connective tissue of the female pelvis consists of varying amounts of adipose tissue divided into small lobules by thin connective laminae. These laminae are connected to the visceral and parietal layers of the pelvic fascia, and are closely connected to the vascular and nervous bundle sheaths crossing the pelvis. At the level of the sacrouterine and cardinal ligaments we were unable to find any connective ligamentous structure. Only an areolar tissue was seen, which after removal of the lipids demonstrated a fibrillar structure. The mean area of the adipose lobules was smaller (average of 1.41 mm.2) near the viscera with respect to the lateral retroperitoneal connective tissue (average of 1.73 mm.2) due to greater ramification of the connective laminae. CONCLUSIONS: In the absence of real connective ligaments the retroperitoneal connective tissue forms a 3-dimensional network of thin connective laminae that are connected to the visceral adventitia, parietal layer of the pelvic fascia and neurovascular bundles crossing the pelvis. These connective laminae are bounding adipose lobules of different size (smaller near the viscera, larger at the periphery). Overall, the retroperitoneal connective tissue constitutes an anatomical structure that, beyond the functional limits of any individual ligament, may have supporting properties.
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Tejido Conectivo/trasplante , Pelvis/cirugía , Anciano , Cadáver , Tejido Conectivo/anatomía & histología , Femenino , Humanos , Persona de Mediana EdadRESUMEN
The width of the articular space of the acromioclavicular (AC) joint was investigated to evaluate normal range values and any possible variations in relation to age and sex. Radiographs of the AC joints of 72 males and 28 female (age range: 38-83 yrs) were studied. The articular space width of the AC joint was measured using a semiautomatic computerized system. The measurements were performed bilaterally at the level of smallest distance between the articular surfaces in all the radiograms. The mean value of the articular space width was calculated for all the subjects as a single group, for that of the males and for that of the females. The films were then divided into four groups according to age (< 50; 50-59; 60-69; > 70 yrs) and the mean value per group was calculated. The values obtained were studied using variance analysis. No significant difference were found in the mean values of the articular space width when males and females were compared as regards to age. However, even if the articular space width diminished, in both sexes, with an increase in age, the differences between age classes were not statistically significant.
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Articulación Acromioclavicular/anatomía & histología , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Caracteres SexualesRESUMEN
The sacroiliac (SI) joint is the point of articulation between the sacrum and the innominate bone of the pelvis. The anterior portion is synovial, and the posterosuperior portion is a typical syndesmosis. The SI joint may be affected by inflammatory or degenerative changes which include narrowing, minor sclerosis and erosion. Alterations in the anatomy of this joint may be involved in causing lower back pain. Radiodiagnosis of the width of the articular space is one of the tools utilized to evaluate the normal state of any joint. Scanty data is available on the morphometric characteristics of the SI joint. Therefore, the articular width space of the SI joint was measured to define its normal size in relation to age and sex. The study included 198 x-rays of the abdomen, in anteroposterior projection, of 112 males and 86 females (age range: 17 to 91 yrs). Individual films were divided into four classes according to age (< 50; 50-59; 60-69; > 70). The articular space of the SI joint is made up of a lateral and a medial part: the first representing the anterior articular space; the latter the posterior one. The anterior articular space of both the right and left joint, which was more easily visible and measurable was measured at the medium and inferior levels. Measurements were taken from the radiograms using a semiautomatic computerized system (Videoplan II, Image Analysis system-Kontron). The mean value of the articular space width a the medium and inferior levels, according to age group, was measured in both the males and females. The values obtained were studied using variance analysis. No significant differences were found in the mean values of the articular space width at the SI joint, when males and females were compared in relation to age. Moreover, the articular space width diminished with increasing the age. This fact was not always statistically significant.
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Articulación Sacroiliaca/anatomía & histología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Articulación Sacroiliaca/diagnóstico por imagen , Caracteres SexualesRESUMEN
The composition of the prostatic capsule is important from a clinical point of view, since it is considered to be a barrier against the spread of prostatic tumours. Clinical follow-up demonstrates that apparently intracapsular tumours, particularly in the posterosuperior region of the gland, are frequently understaged at clinical diagnosis. The morphology of the prostatic capsule was studied in 6 cadavers. In each case the prostate was obtained in one block together with the basal portion of the bladder, the seminal vesicles, the anterior wall of the rectum and the periprostatic connective tissue. Part of the material was plastinated, while the remainder was studied using histological and immunohistochemical methods. The prostate was found to be surrounded by connective tissue abundant with smooth muscle cells, and continuous with the stromal septa which subdivide the glandular tissue. A rich network of blood vessels was identifiable. In some regions, particularly in the posterosuperior region, a real capsule was not identifiable. The connective tissue seemed to constitute a continuum between the prostate gland and neighbouring organs, in particular, a connective tissue barrier between the prostate and the seminal vesicles was completely absent. Therefore, due to the absence of a capsular barrier and to the presence of a rich vascular network a prostatic tumour which begins in the posterior region of the gland should be considered as potentially extracapsular.
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Próstata/anatomía & histología , Adulto , Anciano , Cadáver , Tejido Conectivo/anatomía & histología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/patología , Vesículas Seminales/anatomía & histologíaRESUMEN
The collateral circles and their hemodynamic significance in distal lower limb arterial occlusion have been described in an elderly population. Overall 40 subjects (20 men and 20 women; age range 66-83) with symptomatic lower limb arteriopathy (Fontaine's stage II) have been studied combing Contrast Angiography and Color Doppler Echography of the lower limb arterial district. In our population, the results showed that the tibialis arteries were the vessels most often involved in arterial occlusion (posterior tibialis a., 15 cases = 37.5%, posterior tibialis a., 12 cases = 30%), followed by the peroneal a. (8 cases = 20%) and by the popliteal a. (5 cases, 12.5%). In the occlusion of the popliteal artery the collateral circle was mainly established through the deep femoral a., the great anastomotic a., the recurrent posterior tibialis a., and from the articular supero-lateral a. In the occlusion of the anterior tibialis artery the collateral circulation was ensured through the collateral posterior tibialis as. and through the collateral perineal as. In the occlusion of the posterior tibialis a., the collateral circle was established through the great anastomotic a., through the branchers of the arterial circle of the ankle and from the perforating plantar as. (anterior tibial a.). Finally, in the occlusion of the peroneal a., the collateral circulation was only represented by branches of the arterial circle of the ankle. The hemodynamic compromission, measured by the Windsor Index, was the highest for popliteal occlusions (mean IW = 34.3%). Occlusions of the anterior tibialis a. (mean IW. = 35.48%), of the peroneal a. (mean IW = 44.71%), and of the posterior tibialis a. (mean IW = 55.44%) showed progressively lower hemodynamic compromission. Gender differences in hemodynamic significance at each level of occlusion were not significant.
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Arteriopatías Oclusivas/fisiopatología , Circulación Colateral/fisiología , Pierna/irrigación sanguínea , Ultrasonografía Doppler en Color/métodos , Anciano , Anciano de 80 o más Años , Arteriopatías Oclusivas/diagnóstico por imagen , Femenino , Humanos , Pierna/diagnóstico por imagen , MasculinoRESUMEN
The Symphysis Pubis (SP) joint was investigated by X-ray in 96 adults without any history of disease of the joints. We evaluated the width of this joint by measuring the distance between the two articular surface at three points. We calculated the mean for the three interpubic distances and carried out statistical analysis so as to evaluate if there is a significative difference between the four age classes (< 50; 50-59; 60-69; > 70) and between males and females. We did not found statistically-significative differences between males and females, and between the age classes; nevertheless, it is to be noted that a slight widening of the SP joint can be seen in the elderly, which is thus not significant. We also noted that the medium part of the SP joint undergoes a larger widening in older people: this is probably due to degenerative changes in the fibrocartilagineous disc and the ligaments.