الملخص
Kummel's disease is a crush fracture of a vertebral body caused by a minor trauma, with the most accepted etiology being avascular necrosis. It is more frequent in individuals with risk factors such as osteoporosis or prolonged treatment with corticosteroids. Initially, it usually has normal radiological tests and an asymptomatic period, followed by a progressive onset of pain along with probable kyphosis and a sign of void or fluid abscess on radiological tests, which may create nerve/spinal involvement. The case is presented of a 76-year-old man, who was admitted to this center for the differential diagnosis of a single vertebral lesion. After imaging tests and biopsy, the definitive diagnosis of Kummel's disease was reached. The confirmatory diagnosis was reached by vertebral biopsy, but given its invasive nature, imaging techniques can play a significant role. As regards metabolic imaging tests, bone scintigraphy has shown to be one of the most sensitive tools to detect ischemia in earlier stages or to determine if it affects other locations. The whole body scan with diphosphonates shows an increase in activity in relation to bone remodeling activity in this condition. The 3-phase study makes it possible to differentiate whether it is an acute/subacute or chronic process, and can influence the therapeutic decision. Knowledge of this disease is important to make a differential diagnosis with tumour or infectious pathology, with emphasis on performing imaging tests in the event of persistent pain with a normal initial plaque.
La enfermedad de Kummel es una fractura-aplastamiento de un cuerpo vertebral precedida por un traumatismo menor, cuya etiología más aceptada es la necrosis avascular. Es más frecuente en individuos con factores de riesgo como osteoporosis o tratamiento prolongado con corticoides. Inicialmente, suele presentar pruebas radiológicas normales y un periodo asintomático, con aparición progresiva del dolor junto a probable cifosis y signo del vacío o absceso líquido en las pruebas radiológicas, pudiendo llegar a crear compromiso nervioso/medular. Presentamos el caso de un varón de 76 arios que ingresa en nuestro centro para el diagnóstico diferencial de una lesión única vertebral; tras la realización de las pruebas de imagen y biopsia se llega al diagnóstico definitivo de enfermedad de Kummel. El diagnóstico de confirmación de esta enfermedad se alcanza mediante la biopsia vertebral, pero dada su naturaleza invasiva, las técnicas de imagen toman un papel relevante. En relación con las pruebas de imagen metabólicas, la gammagrafía ósea ha demostrado ser una de las herramientas más sensibles para detectar isquemia en fases más tempranas o para conocer si afecta a otras localizaciones. El rastreo corporal de cuerpo completo con difosfonatos muestra un aumento de actividad en relación con la actividad ósea remodelativa en este cuadro. El estudio de tres fases permite diferenciar si se trata de un proceso agudo/subagudo o crónico, lo que influye en la decisión terapéutica. Es importante el conocimiento de esta enfermedad para realizar diagnóstico diferencial con patología tumoral o infecciosa e insistir en la realización de pruebas de imagen ante la persistencia del dolor con una placa inicial normal.
الموضوعات
Humans , Male , Aged , Bone Diseases , Radionuclide Imaging , Musculoskeletal Diseases , Embryophyta , Diagnostic Techniques and Procedures , Carum , Diagnosis , Eukaryota , Femur Head Necrosisالملخص
Abstract A transect was used to examine the environmental and biological descriptors of a compact vegetation mosaic in the Chapada Diamantina in northeastern Brazil, including the floristic composition, spectrum of plant life forms, rainfall, and soil properties that defined areas of cerrado (Brazilian savanna), caatinga (seasonally dry tropical forest thorny, deciduous shrub/arboreal vegetation) and cerrado-caatinga transition vegetation. The floristic survey was made monthly from April/2009 to March/2012. A dendrogram of similarity was generated using the Jaccard Index based on a matrix of the species that occurred in at least two of the vegetation types examined. The proportions of life forms in each vegetation type were compared using the chi-square test. Composite soil samples were analyzed by simple variance (ANOVA) to examine relationships between soil parameters of each vegetation type and the transition area. The monthly precipitation levels in each vegetation type were measured and compared using the chi-square test. A total of 323 species of angiosperms were collected distributed in 193 genera and 54 families. The dendrogram demonstrated strong difference between the floristic compositions of the cerrado and caatinga, sharing 2% similarity. The chi-square test did not demonstrate any significant statistical differences between the monthly values of recorded rainfall. The organic matter and clay contents of the soilsin the caatinga increased while sand decreased, and the proportions of therophyte, hemicryptophyte, and chamaephyte life forms decreased and phanerophytes increased. We can therefore conclude that the floristic composition and the spectrum of life forms combined to define the cerrado and caatinga vegetation along the transect examined, with soil being the principal conditioning factor determining the different vegetation types, independent of precipitation levels.
Resumo Foi estabelecida uma transecção para examinar descritores ambientais e biológicos em uma área compacta de vegetação em mosaico na Chapada Diamantina, Nordeste do Brasil. A composição florística, espectro de formas de vida, precipitação e propriedades do solo foram avaliadas na transecção entre cerrado (savana brasileira) e caatinga (floresta tropical sazonalmente seca espinhosa, vegetação arbustivo-arbórea decídua), separados por vegetação de transição cerrado-caatinga. O levantamento florístico foi realizado mensalmente de abril de 2009 a março de 2012. Foi feita análise de agrupamento a fim de determinar a similaridade entre as fisionomias de cerrado, a caatinga e a transição cerrado-caatinga. As proporções de formas de vida foram comparadas utilizando o teste qui-quadrado. Amostras compostas de solo foram analisadas por variância simples (ANOVA) testando a existência de diferenças entre os solos de cada tipo de vegetação. A precipitação mensal em cada tipo de vegetação foi mensurada e os resultados comparados com o teste qui-quadrado. Coletamos 323 espécies de angiospermas pertencentes a 193 gêneros e 54 famílias. A análise de agrupamento demostrou diferença entre a composição florística do cerrado e da caatinga, com apenas 2% de similaridade. O teste qui-quadrado não demonstrou diferença estatística entre os valores registrados para cada mês. À medida que os conteúdos de matéria orgânica e argila aumentaram e o de areia diminuiu na caatinga, a proporção das formas de vida terófito, hemicriptófito e caméfito diminuiu e a de fanerófitos aumentou. Podemos considerar que a composição florística e o espectro de formas de vida delimitaram o cerrado e a caatinga na transecção estudada e que o solo foi o principal fator condicionante para determinação dos diferentes tipos de vegetação, independentemente da precipitação.
الموضوعات
Soil/classification , Forests , Embryophyta/classification , Rain , Brazil , Statistics as Topic , Ecosystem , Parks, Recreational/statistics & numerical dataالملخص
The Atlantic Forest, which has a vast epiphytic richness, is a priority area for preservation, listed as one of the five most important world hotspots. Vascular epiphyte richness, composition and community structure were studied in two fragments, one of the ombrophilous (29º43'42"S and 50º22'00"W) and the other of the seasonal (29º40'54"S and 51º06'56"W) forest, both belonging to the Atlantic Forest biome in the Sinos River basin, Rio Grande do Sul, Brazil. In each fragment, 40 trees, divided into four ecological zones, were analyzed. In each zone, the occurrence of the species was recorded, and the importance value of each species was calculated according to the frequency of phorophytes and intervals, and cover scores. The Shannon index was calculated for the two communities. In the fragment of the ombrophilous forest (F1), 30 epiphytic species were recorded, and in the seasonal forest (F2), 25. The highest importance value was found for
A Floresta Atlântica apresenta uma grande riqueza de epífitos e é considerada uma área prioritária para preservação listada entre os cinco mais importantes
الموضوعات
Biodiversity , Embryophyta/physiology , Forests , Brazilالملخص
Considerando a importância da família Annonaceae Jussieu do ponto de vista de sua composiçäo quÝmica e atividades biológicas, foram levantadas informaçöes sobre os componentes químicos já isolados de espécies desta família.