Anatomical variations of recurrent laryngeal nerve: a systematic review and meta-analyses.

PURPOSE: The aim of this systematic review and meta-analysis was to systematically review and perform a meta-analysis on the anatomical variations of the RLN. METHODS: We performed online research for studies that addressed anatomical variations of the RLN and laterality, published between 2015 and 2021. We found 230 articles, and nine were included. RESULTS: Eight variations were found, with Type I prevailing (41.17%; 95% CI 19.44-64.88), extra laryngeal divergence of the RLN. The other types were: II-fan shape; III-distance greater than 5 mm to the cricothyroid joint; IV-thickening and adipopexy in the elderly; V-non-recurrent laryngeal nerve; VI-intracranial branch; VII-tortuous ascending RLN; and VIII-combination between the inferior branch of the NV and the ascending trunk of the RLN. Types I (p = 0) and III (p < 0.01) prevailed on the left and types II (p < 0.01) and V (p < 0.01) on the right. CONCLUSIONS: It was observed that variations occurred due to the path of the RLN to the entrance to the larynx, its shape, and the age of the evaluated individual. The most frequent variation and side were, respectively, Type I, extra laryngeal divergence and left.

Tranexamic acid in bleeding reduction and operative time of nasal surgeries: systematic review and meta-analysis.

PURPOSE: Our study goal is to review the efficacy of tranexamic acid in reducing blood loss and operative time in nasal surgeries. METHODS: We included randomized clinical trials using oral or intravenous tranexamic acid, excluded non-randomized studies, topic administration, coagulopathy, and using other drugs interfering in the coagulation cascade. Online databases, National Library of Medicine (MEDLINE-PubMED), Latin American and Caribbean Literature on Health Sciences (Lilacs), Cochrane Library, Embase and Google Scholar were used to perform the search. The review was registered in PROSPERO by no CRD42022310977. Two authors, independently, selected the articles meeting the inclusion criteria. They extracted the data and used RevMan 5 software to perform the meta-analysis. RESULTS: Our search resulted in 16 RCTs that were included in the meta-analysis totalizing 1108 patients. Studies were evaluated resulting in a low risk of bias for the five domains. The use of tranexamic acid resulted in significant reduction in duration of surgery (DOS) and intraoperative blood loss (IBL) had significant reduction. The level of evidence according to GRADE System was high in all studies and variables. CONCLUSION: Tranexamic acid has an important role in reducing intraoperative blood loss and duration of surgery. Our study has some limitations due to the low number of RCTs available in the literature.

Características de carcaça, órgão vomeronasal, concentrações séricas de testosterona e IGF-I em machos Nelore com ductos incisivos bloqueados / Characteristics of carcass, vomeronasal organ, serum testosterone andIGF-I concentrations in Nellore males with blocked incisor ducts

Objetivou-se avaliar características quali - quantitativas da carcaça em machos Nelore, submetidos ao bloqueio dos ductos incisivos no período pré puberal. Além disso, objetivou-se avaliar as concentrações séricas de testosterona e do hormônio do crescimento semelhante a insulina do tipo I (IGF-I), e a arquitetura histológica do órgão vomeronasal (OVN). Trinta e quatro machos, no período pré puberal, foram divididos em três grupos experimentais: inteiros – animais controle sem qualquer procedimento (n = 11); bloqueados - animais com os ductos incisivos bilateralmente obstruídos (n = 10); castrados - animais com orquiepididectomia bilateral (n = 13). O OVN foi obtido no abate, ao final do experimento, para avaliação histomorfométrica. As coletas de sangue foram realizadas a cada três meses, em dois turnos (manhã e tarde), totalizando cinco avaliações. Observaram-se maiores (P0,05). Registrou-se redução da altura do epitélio neuro sensitivo do OVN nos bloqueados e castrados (P<0,05). Foi registrada menor concentração de testosterona nos bloqueados nas coletas quatro e cinco à tarde (P<0,05). Conclui-se que a obstrução dos ductos incisivos reduziu os estímulos sensoriais para o OVN, que por sua vez, promoveu alteração na concentração sérica de testosterona, sem alterar o ganho de peso dos animais, porém, não promoveu melhoria na qualidade da carcaça nas condições deste estudo.

A total of 34 prepuberal Nellore males were divided into three groups: control – animals without any procedure (n = 11); blocked - with bilaterally incisors ducts obstructed (n = 10); castrated - with bilateral orchiectomy (n = 13). This study aimed to evaluate the effect of blocking the vomeronasal organ (VNO) in qualitative and quantitative characteristics of the carcass. Also, this study aimed to evaluate testosterone and insulin-like growth factor (IGF-I) serum concentration, and the histological architecture of the OVN. Blood samples were taken every three months during two daily collections (morning and afternoon), totalizing five evaluations. It was observed higher (P 0.05). It was observed a reduction (P<0.05) of the VNO sensory epithelium height in blocked and castrated groups compared with control group. It was registered lower (P<0.05) serum testosterone concentration in blocked group at the fourth and fifth blood collection (afternoon). It was concluded that the obstruction of the incisive ducts reduced the sensorial stimuli for the OVN, which, in turn, promoted a change in the serum concentration of testosterone, without altering the weight gain of the animals, but did not promote improvement in the quality of the carcass under the conditions of this study.

Características de carcaça, órgão vomeronasal, concentrações séricas de testosterona e IGF-I em machos Nelore com ductos incisivos bloqueados / Characteristics of carcass, vomeronasal organ, serum testosterone and IGF-I concentrations in Nellore males with blocked incisor ducts

Objetivou-se avaliar características quali - quantitativas da carcaça em machos Nelore, submetidos ao bloqueio dos ductos incisivos no período pré puberal. Além disso, objetivou-se avaliar as concentrações séricas de testosterona e do hormônio do crescimento semelhante a insulina do tipo I (IGF-I), e a arquitetura histológica do órgão vomeronasal (OVN). Trinta e quatro machos, no período pré puberal, foram divididos em três grupos experimentais: inteiros ­ animais controle sem qualquer procedimento (n = 11); bloqueados - animais com os ductos incisivos bilateralmente obstruídos (n = 10); castrados - animais com orquiepididectomia bilateral (n = 13). O OVN foi obtido no abate, ao final do experimento, para avaliação histomorfométrica. As coletas de sangue foram realizadas a cada três meses, em dois turnos (manhã e tarde), totalizando cinco avaliações. Observaram-se maiores (P<0,05) pesos corporais finais (inteiros = 494,1 ± 28,71; bloqueados = 500,6 ± 23,6 e castrados = 468,3 ± 21,8 Kg) nos inteiros e bloqueados. O acabamento da carcaça foi maior nos castrados (P<0,05) em relação aos inteiros e bloqueados, enquanto o rendimento de carcaça não apresentou diferenças entre os três tratamentos (P>0,05). Registrou-se redução da altura do epitélio neuro sensitivo do OVN nos bloqueados e castrados (P<0,05). Foi registrada menor concentração de testosterona nos bloqueados nas coletas quatro e cinco à tarde (P<0,05). Conclui-se que a obstrução dos ductos incisivos reduziu os estímulos sensoriais para o OVN, que por sua vez, promoveu alteração na concentração sérica de testosterona, sem alterar o ganho de peso dos animais, porém, não promoveu melhoria na qualidade da carcaça nas condições deste estudo.

A total of 34 prepuberal Nellore males were divided into three groups: control ­ animals without any procedure (n = 11); blocked - with bilaterally incisors ducts obstructed (n = 10); castrated - with bilateral orchiectomy (n = 13). This study aimed to evaluate the effect of blocking the vomeronasal organ (VNO) in qualitative and quantitative characteristics of the carcass. Also, this study aimed to evaluate testosterone and insulin-like growth factor (IGF-I) serum concentration, and the histological architecture of the OVN. Blood samples were taken every three months during two daily collections (morning and afternoon), totalizing five evaluations. It was observed higher (P<0.05) final body weight (control= 494.1 ± 28.71; blocked = 500.6 ± 23.6; castrated = 468.3 ± 21.8 kg) at the control and blocked groups. Carcass finishing was higher in castrated animals (P <0.05), while carcass yield did not differ between treatments (P> 0.05). It was observed a reduction (P<0.05) of the VNO sensory epithelium height in blocked and castrated groups compared with control group. It was registered lower (P<0.05) serum testosterone concentration in blocked group at the fourth and fifth blood collection (afternoon). It was concluded that the obstruction of the incisive ducts reduced the sensorial stimuli for the OVN, which, in turn, promoted a change in the serum concentration of testosterone, without altering the weight gain of the animals, but did not promote improvement in the quality of the carcass under the conditions of this study.

Leprosy simulating lichenoid eruption: case report and literature review.

Leprosy is associated with the occurrence of various skin lesions such as macules, papules, plaques, nodules, and even diffused infiltration, depending on the patient's immune response. Its clinical presentation is often different from the usual pattern, leading to confusion in diagnosis. The present article describes a rare case of leprosy simulating lichenoid eruption and explores different aspects of the clinical manifestations, diagnosis, and treatment of this nosologic entity.

Hanseníase simulando erupção liquenóide: relato de caso e revisão de literatura / Leprosy simulating lichenoid eruption: case report and literature review

A hanseníase relaciona-se à formação de grande variedade de lesões cutâneas, desde manchas, pápulas, placas e nódulos, até infiltração difusa, dependendo da resposta imune do indivíduo. A apresentação clínica foge, muitas vezes, do padrão habitual, fazendo com que especialistas confundam o diagnóstico. O artigo descreve um caso raro de hanseníase, simulando erupção liquenoide, abordando os diferentes aspectos das manifestações clínicas, do diagnóstico e do tratamento desta entidade nosológica.

Leprosy is associated with the occurrence of various skin lesions such as macules, papules, plaques, nodules, and even diffused infiltration, depending on the patient's immune response. Its clinical presentation is often different from the usual pattern, leading to confusion in diagnosis. The present article describes a rare case of leprosy simulating lichenoid eruption and explores different aspects of the clinical manifestations, diagnosis, and treatment of this nosologic entity.