Are Chiari Malformation and Basilar Invagination Associated with Jugular Foramen Stenosis?

OBJECTIVE: We compared the diameter of the jugular foramen (JF) between normal individuals and those with a diagnosis of craniovertebral junction abnormalities, such as Chiari malformation type I (CMI) and/or basilar invagination (BI). METHODS: This cross-sectional analytical study measured the diameter of the right and left JF on magnetic resonance imaging scans of patients divided into 4 groups: 68 with combined CMI and BI (CMI+BI), 42 with isolated BI, 45 with isolated CMI, and 102 control cases. The t test determined sex differences, and univariate analysis of variance with Tukey's post hoc test assessed JF differences between groups. RESULTS: Considering all combinations of laterality and sex, the CMI+BI group had a JF narrower than their respective control groups. The JF was bilaterally narrower in the BI group than in the control group only in the women. Regardless of laterality, the CMI group had a wider JF than did the CMI+BI group in men and did not differ from that of the control group. In the female patients with CMI, the right JF did not differ from that of the controls and was wider than that in the CMI+BI group. Also, the left JF was narrower than that in the control group and did not differ from that in the CMI+BI group. CONCLUSIONS: JF narrowing is associated with CMI and BI when combined in the same patient. When CMI or BI are detected separately, they do not imply evident changes in JF morphometry. It is expected that these findings could bring empiric substrate to support theories that claim a possible role of intracranial pressure disturbances as a triggering factor for CMI.

Cranio-vertebral transition assessment by magnetic resonance imaging in a sample of a northeast Brazilian population / Avaliação da transição crânio-vertebral por ressonância magnética em uma amostra da população do nordeste brasileiro

ABSTRACT Platybasia and basilar invagination are important alterations of the cranial-vertebral transition. Neuroimaging-based platybasia parameters include the Welcker basal angle, distance between the apex of the odontoid and Chamberlain's line, and the clivus-canal angle. This study aimed to measure and correlate these parameters in a sample from northeast Brazil. Methods Cross-sectional analysis of craniometric parameters from individuals submitted to magnetic resonance at an outpatient imaging center between 2011 and 2012. Results Of 181 analyzed cases, the Welcker basal angle averaged 128.96º (SD 6.51), median distance between apex of the odontoid and Chamberlain's line was 2.27 mm (IQR -1.23-4.47) and the median clivus-canal angle was 150.5º (IQR 143.2-157.3). The Welcker basal angle was inversely correlated to the clivus-canal angle, and correlated to the distance between the apex of the odontoid and Chamberlain's line. Conclusion There was a tendency to platibasia, basilar invagination and narrowing of the cranio-vertebral transition.

RESUMO Platibasia e invaginação basilar são importantes alterações da transição craniovertebral. Existem parâmetros importantes obtidos pela neuroimagem, como o ângulo basal de Welcker, distância do ápice do odontoide à linha de Chamberlain e o ângulo clivo-canal. Este estudo procurou medir e correlacioná-los em uma amostra do Nordeste Brasileiro. Métodos Estudo transversal com medidas de indivíduos submetidos a ressonância magnética craniana em um centro de diagnóstico por imagem entre 2011 e 2012. Resultados Dos 181 casos analisados, o ângulo basal de Welcker teve média 128.96º (DP 6.51), a distância do ápice do odontoide à linha de Chamberlain obteve mediana 2.27 mm (IIQ -1.23-4.47) e o ângulo clivo-canal mediano foi 150.5º (IIQ 143.2-157.3). O ângulo basal de Welcker foi inversamente correlacionado com o ângulo clivo-canal e diretamente correlacionado com a distância do ápice do odontoide à linha de Chamberlain. Conclusão Houve uma tendência a platibasia, invaginação basilar e estreitamento da transição craniovertebral, que poderiam ser influenciados pela natureza multirracial e por fatores antropológicos da população estudada.

Dissecação e Capacitação de Habilidades eCompetências Gerais na Formação Médica / Dissection and Training of Skills and General Competences in Medical Education

Relacionar o ensino e a aprendizagem da disciplinade Dissecação na Anatomia Topográfica com a capacitaçãodas habilidades gerais instituídas pelas Diretrizes CurricularesNacionais dos Cursos de Medicina: atenção à saúde, tomadade decisões, comunicação, liderança, administração egerenciamento, e educação permanente. Materiais eMétodos: Trata-se de um estudo seccional que envolveuuma população de 270 alunos do curso de Medicina daFaculdade de Medicina Nova Esperança e da UniversidadeFederal da Paraíba, ambas em João Pessoa - PB. A amostrafoi selecionada aleatoriamente e incluiu 132 graduandos, queresponderam a um questionário estruturado desenvolvidopelos autores. Resultados: Não houve diferença significativaquanto ao sexo dos alunos entrevistados, tendo sido a médiade idade de 21,7 anos. Dos 132 graduandos, houve o relatode que, frequente ou muito frequentemente, ocorreu odesenvolvimento de: capacidade de tomar decisões – 57,2%,liderança – 57,7%; administração e gerenciamento – 74,3%,comunicação – 87,1%, educação continuada – 76,0%,atenção à saúde – 59,8%. Conclusão: A dissecação temimportância na capacitação das habilidades gerais no ensinode Anatomia Topográfica e, portanto, pode contribuir com aformação do perfil do profissional médico preconizado pelasDiretrizes Curriculares Nacionais dos Cursos de Medicina...

To associate teaching and learning in the subjectDissection within the field of topographical anatomy withthe training of general skills established by the NationalCurriculum Guidelines for Medical Courses: health care,decision making, communication, leadership, administrationand management, and continuing education. Material andMethods: This was a cross-sectional study involving apopulation of 270 students of Medicine, Nova EsperançaFaculty of Medicine and the Federal University of Paraíba,both in the city of Joao Pessoa - PB. The sample wascomposed of 132 undergraduates randomly selected, whoanswered a structured questionnaire developed by theauthors. Results: There was no significant difference in thegender of the students interviewed, which had mean age of21.7 years. Of the 132 undergraduate students, often orvery often, there was the development of: decision-makingabilities – 57.2%, leadership qualities - 57.7%; administrationand management - 74.3%, communication – 87.1%, continuingeducation - 76.0%, health care attention - 59.8%. Conclusion:Anatomic dissection is important in the training of generalskills in the teaching of Topographical Anatomy and hencecan contribute to the formation of the medical profilerecommended by the National Curriculum Guidelines forMedical Courses...

Análise histológica do ovário de ratas submetidas à ausência de luz / histological analysis of the ovary of female rats submitted to light absence

Objetivo: Obter informações da histologia e do desenvolvimento dos folículos ovarianos de ratas mantidas na ausência de luz. Material e Métodos: Foram utilizadas 10 ratas albinas, as quais foram divididas em dois grupos de cinco animais: GRUPO I - ratas mantidas no ciclo claro/escuro 12/12h, por três meses (Controle), e GRUPO II - ratas mantidas na ausência de luz por três meses. Resultados: Nos animais do grupo II foi observado, na região cortical aos ovários, predominância de corpos lúteos e alguns folículos ovarianos em fase inicial de desenvolvimento, enquanto que na região medular foram evidenciadas poucas células intersticiais dispersas no estroma ovariano. Conclusão: A ausência de luz pode acarretar um aumento do nível de melatonina circulante no sangue e consequentemente, parece contribuir para a manutenção de corpos lúteos e diminuir a atividade de síntese de esteróides das células intersticiais do ovário.

Objective: This study had the objective of acquiring information about the histology and development of ovarian follicles of female rats kept in the absence of light. Material and Methods: 10 albino female rats were used and divided into two groups of five: GROUP I - Female rats kept in the dark-light cycle 12/12 hours, for three months (Control), and GROUP II - female rats kept in the absence of light for three months. Results: in the rats of group II, a predominance of corpus luteum and some ovarian follicles in the initial phase of development was observed in the cortical area to the ovaries, while few dispersed interstitial cells were evidenced in the ovarian stroma, in the medullar area. Conclusion: The absence of light can bring about an increase in the level of melatonin in the blood and consequently, it can contribute to the maintenance of corpus luteum and reduce the activity of synthesis of steroids present in the interstitial cells of the ovary.