Occurrence of depression and assessment of functional capacity in patients with vascular diseases admitted to a Vascular Surgery Service.

Background: Vascular diseases are associated with significant sequelae and clinical repercussions for the lives of affected patients, which are more serious among the elderly. The consequences of vascular disease, such as limb loss, chronic pain, prolonged hospitalization, and polypharmacy, reduce these patients' autonomy and independence, influencing their wellbeing and quality of life. Objectives: To determine the prevalence of depression and assess functional capacity in patients with vascular diseases admitted to a Vascular Surgery Service. Methods: This is a descriptive, cross-sectional study, carried out at the Vascular Surgery Service of a tertiary hospital with a non-random sample of patients selected consecutively. The geriatric depression scale short form (GDS-15) was used to assess depression and the Katz scale was used for functional assessment. Results: The prevalence of depression in these patients was 60.6%. Associations were observed between depression and consultation with a family doctor in the last 12 months, alcoholism, claudication, diabetes, and individuals who had had an amputation. Individuals' Katz index functional capacity scores were significantly associated with sociodemographic variables, conditions related to vascular disease, and hospitalization. Conclusions: There was a high prevalence of depression in patients with vascular diseases admitted to a vascular surgery service and important reductions in functional capacity in some groups, such as individuals with low educational levels, those who had chronic pain in the lower limbs, patients with diabetes, and those who had had an amputation.

Ocorrência de depressão e avaliação da capacidade funcional em pacientes com doenças vasculares internados em um serviço de cirurgia vascular / Occurrence of depression and assessment of functional capacity in patients with vascular diseases admitted to a Vascular Surgery Service

Resumo Contexto As doenças vasculares estão associadas a importantes sequelas e repercussões clínicas nas vidas dos pacientes acometidos e, em maior relevância, entre os idosos. Consequências da doença vascular como a perda de um membro, dor crônica, internamentos prolongados e a polifarmácia geram, nesses pacientes, perda de autonomia e um grau de dependência, que vão influenciar o bem-estar e a qualidade de vida. Objetivos Determinar a ocorrência de depressão e avaliar a capacidade funcional em pacientes com doenças vasculares internados em um serviço de cirurgia vascular. Métodos Trata-se de um estudo observacional, transversal, prospectivo, realizado no serviço de cirurgia vascular de um hospital terciário, com uma amostra não aleatória selecionada de forma consecutiva. Para avaliar a depressão, foi utilizada a escala de depressão geriátrica resumida e, para a avaliação funcional do indivíduo, foi utilizada a escala de Katz. Resultados A prevalência de depressão nesses pacientes foi de 60,6%. Foi observada associação entre depressão e: consulta com médico do Programa de Estratégia de Saúde da Família nos últimos 12 meses, etilismo, claudicação, diabetes e indivíduos que sofreram amputação. Já em relação à capacidade funcional do indivíduo avaliado através do índice de Katz, ocorreram associações significativas entre variáveis sociodemográficas, condições relacionadas a doença vascular e internamento. Conclusões Existem uma alta prevalência de depressão em pacientes com doenças vasculares internados em um serviço de cirurgia vascular e uma redução importante da capacidade funcional em alguns grupos, como os indivíduos de baixa escolaridade, os que sentiam dor crônica nos membros inferiores, os diabéticos e aqueles que sofreram amputação.

Abstract Background Vascular diseases are associated with significant sequelae and clinical repercussions for the lives of affected patients, which are more serious among the elderly. The consequences of vascular disease, such as limb loss, chronic pain, prolonged hospitalization, and polypharmacy, reduce these patients' autonomy and independence, influencing their wellbeing and quality of life. Objectives To determine the prevalence of depression and assess functional capacity in patients with vascular diseases admitted to a Vascular Surgery Service. Methods This is a descriptive, cross-sectional study, carried out at the Vascular Surgery Service of a tertiary hospital with a non-random sample of patients selected consecutively. The geriatric depression scale short form (GDS-15) was used to assess depression and the Katz scale was used for functional assessment. Results The prevalence of depression in these patients was 60.6%. Associations were observed between depression and consultation with a family doctor in the last 12 months, alcoholism, claudication, diabetes, and individuals who had had an amputation. Individuals' Katz index functional capacity scores were significantly associated with sociodemographic variables, conditions related to vascular disease, and hospitalization. Conclusions There was a high prevalence of depression in patients with vascular diseases admitted to a vascular surgery service and important reductions in functional capacity in some groups, such as individuals with low educational levels, those who had chronic pain in the lower limbs, patients with diabetes, and those who had had an amputation.

Treatment of bilateral popliteal artery aneurysms.

Popliteal artery aneurysms are the most frequent type of peripheral aneurysm, accounting for 85% of the all of these aneurysms. Usually asymptomatic, they are generally diagnosed during clinical examination. Incidence is higher among males and seniors. They are bilateral in 50% of the cases and 60% are associated with abdominal aortic aneurysms. This paper describes a 72-year-old male patient who presented with two bilateral pulsatile masses, one in each popliteal region, was otherwise asymptomatic, and had a history of hypertension and dyslipidemia. Clinical examination and ultrasound imaging confirmed a diagnosis of bilateral aneurysms of the popliteal arteries. Popliteal artery aneurysms can be treated with open bypass surgery, with or without aneurysm resection, or with endovascular surgery. This Therapeutic Challenge discusses these possibilities.

Anxiety and depression in patients with peripheral arterial disease admitted to a tertiary hospital.

BACKGROUND: Anxiety and depression are highly prevalent neuropsychiatric conditions and are associated with chronic diseases, pain, loss of autonomy, dependence on others to perform routine activities, and loneliness. Depression often has a cause-and-effect relationship with other diseases, such as: acute myocardial infarction (AMI), systemic arterial hypertension (SAH), diabetes mellitus (DM) and peripheral arterial disease (PAD). OBJECTIVES: To estimate the frequency of anxiety and depression in patients of both sexes with PAD admitted to a tertiary hospital. METHODS: This is a descriptive, cross-sectional study, with a non-random sample selected consecutively. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression, and the ankle-brachial index (ABI) was used to assess PAD. RESULTS: The prevalence of anxiety in these patients was 24.4%, with associations between anxiety and monthly family income, smoking, and SAH. The prevalence of depression was 27.6%, with associations between depression and the female gender, being married or in a stable relationship, living on a family income of one minimum wage or less, not being an alcoholic, and having hypertension. CONCLUSIONS: There are high prevalence rates of anxiety and depressive disorders among patients with PAD, which are underdiagnosed and, hence, not properly treated.

Pain characteristics and its influence in the labor activities in northeastern Brazilian farmers / Características da dor e sua influência nas atividades laborais em agricultores do nordeste do Brasil

Introduction: Agricultural work is considered a dangerous activity with physical and mental stress. Pain is one of the most common disabilities among agricultural workers. Objective: To determine the incidence, intensity, characteristic of pain and its impact on labor activities in farmers. Methods: Transversal study, pain evaluations consist of: 1) presence / intensity; 2) characteristic of painful experience; 3) episode of pain in the last 30 days and 4) interference of pain at work. Validated and specific pain scales were used, and descriptive statistics were applied. Results: 157 rural farmers were recruited, 128 farmers, 40.4 (11.4) years, participated in the study, 25% of the farmers reported pain at the time of evaluation with mean of 5.5 (0.47) intensity. The predominant pain characteristic was the evaluative type (34%), followed by affective (30%), 83 (65%) of farmers reported pain in the last four weeks, and 60% of these farmers reported pain interference in work activity. Conclusion: Pain, according to farmers in this study, is the main cause of absence and poor performance at work. To accurately assess the intensity of work-related pain, instruments may need to be applied over a continuous period of time, preferably during work day. (AU)

Introdução: O trabalho agrícola possui elevada carga de estresse físico e mental. A dor é uma das incapacidades mais relatadas, compreender esse fenômeno e sua interferência no trabalho é fundamental para intervenções eficazes na saúde do trabalhador. Objetivo: Determinar a incidência, intensidade, característica da dor e seu impacto no trabalho em agricultores. Métodos: Estudo transversal, as avaliações da dor contemplaram: 1) presença/intensidade; 2) característica da experiência dolorosa; 3) dor no último mês e, 4) interferência da dor no trabalho. Todas as escalas eram validadas e específicas para cada objetivo e a análise estatística foi descritiva. Resultados: 157 agricultores foram recrutados, participaram 128 agricultores, 40,4 (11,4) anos, 25% dos agricultores referiram dor no momento da avaliação com intensidade média 5,5 (0,47). A característica da dor predominante foi do tipo avaliativa (34%), seguida pela afetiva (30%). 83 agricultores (65%) referiram ocorrência de dor no último mês, e 60% destes relataram interferência da dor no trabalho. Conclusão: A dor, segundo os agricultores, é causadora de ausência e mau rendimento no trabalho. Avaliar com precisão a intensidade da dor relacionada ao trabalho talvez necessite de instrumentos aplicados em um período contínuo no tempo, durante a jornada de trabalho. (AU)

Exposição ocupacional a fluidos biológicos em acidentes com perfurocortantes na equipe de enfermagem hospitalar / Occupational exposure to biological fluids in accidents with profiling on the hospital nursing team

Objetivo: Determinar a ocorrência de exposição ocupacional a fluidos biológicos em acidentes com perfurocortantes na equipe de enfermagem hospitalar. Métodos: Avaliou-se 747 profissionais, com base em questionários para acidentes de trabalho, mediante entrevista. Resultados: Dos 747 entrevistados, 53,9% sofreram acidentes com perfurocortantes. O risco aumentado de sofrer acidentes relacionou-se com o sexo feminino, horário diurno de trabalho e profissões técnico e auxiliar de enfermagem. Grande parte dos acidentes ocorreu por reencape de agulhas e descarte inadequado dos materiais, por falta de atenção. Mais de um terço dos acidentados não comunicou o acidente. Conclusão: Os profissionais estudados mantêm posturas de risco que devem ser combatidas com políticas de educação em saúde, reforçando a importância da comunicação das ocorrências.

Objective: To determine the occurrence of occupational exposure to biological fluids in sharps injuries in the hospital nursing team. Methods: A total of 747 professionals were interviewed, based on questionnaires for work accidents. Results: Of the 747 interviewees, 53.9% suffered accidents by sharp instruments. The increased risk of accidents was related to the female sex, daytime work hours and nursing technician and assistant professions. A large part of the accidents occurred due to needle recapping and inadequate disposal of materials, due to lack of attention. More than a third of the victims did not report the accident. Conclusion: The studied professionals have attitudes of risk that must be tackled with policies of health education, reinforcing the importance of the communication of occurrences.

Objetivo: Exposición ocupacional a fluidos biológicos en accidentes con punzocortantes en el equipo de enfermería hospitalaria. Métodos: Se evaluaron 747 profesionales, con base en cuestionarios para accidentes de trabajo, mediante entrevista. Resultados: De los 747 entrevistados, 53,9% sufrieron accidentes con punzocortantes. El riesgo aumentado de sufrir accidentes se relacionó con el sexo femenino, horario diurno de trabajo y profesiones técnicas y auxiliares de enfermería. Gran parte de los accidentes ocurrió por reencape de agujas y descarte inadecuado de los materiales, por falta de atención. Más de un tercio de los accidentes no comunicó el accidente. Conclusión: Los profesionales estudiados mantienen posturas de riesgo que deben ser combatidas con políticas de educación en salud, reforzando la importancia de la comunicación de las ocurrencias.

The Effects of Phonation Into Glass, Plastic, and LaxVox Tubes in Singers: A Systematic Review.

The present study aimed to perform a systematic literature review to assess the effects of phonation therapy on voice quality and function in singers. The systematic search was performed in February and updated in October 2017. No restriction of year, language, or publication status was applied. The primary electronic databases searched were LILACS, SciELO, PubMed, and Cochrane. Kappa coefficient was used to assess the agreement between examiners in judging article eligibility. The eligible articles were analyzed based on their risk of bias using the tools proposed by the Joanna Briggs Institute. Mendeley Desktop 1.13.3 software package (Mendeley Ltd, London, UK) was used to standardize the references of identified articles. The general sample consisted of 1965 articles screened out of the electronic databases. Two examiners analyzed the sample in the search for eligible articles. The agreement between examiners reached excellent outcomes (kappa coefficient = 0.88). After the selection, phase 6 articles remained eligible. Together, the eligible studies accounted 141 subjects (65 men and 76 women) aged between 18 and 72 years old. Electroglottography was considered as the most common method (83.33%) of assessment of the effects of phonation therapy in singers. The most prevalent exercises within the therapies were phonation into straws and phonation into glass tubes. The phonation into glass tubes immersed in water, straws, and LaxVox tubes promoted positive effects on the voice quality in singers, such as more comfortable phonation, better voice projection, and economy in voice emission.

Ansiedade e depressão em pacientes com doença arterial periférica internados em hospital terciário / Anxiety and depression in patients with peripheral arterial disease admitted to a tertiary hospital

Ansiedade e depressão são afecções neuropsiquiátricas altamente prevalentes e estão associadas a doenças crônicas, dor, perda de autonomia, dependência para realização de atividades rotineiras e solidão. A depressão, muitas vezes, possui relação de causa-consequência com outras doenças, como infarto agudo do miocárdio, hipertensão arterial sistêmica (HAS), diabetes mellitus e doença arterial periférica (DAP). Objetivos Estimar a frequência de ansiedade e depressão em pacientes de ambos os sexos com DAP, internados em hospital terciário. Métodos Trata-se de um estudo descritivo, transversal, com uma amostra não aleatória selecionada de forma consecutiva. Para avaliar a ansiedade e a depressão, foi utilizada a Escala Hospitalar de Ansiedade e Depressão (HADS) e, para a DAP, foi utilizado o índice tornozelo-braquial (ITB). Resultados A prevalência de ansiedade nesses pacientes foi de 24,4%, havendo associação entre ansiedade e renda familiar mensal, tabagismo e HAS. Já a prevalência de depressão foi de 27,6%, sendo verificadas associações entre depressão e sexo feminino, em união estável ou casada, que sobrevive com até um salário mínimo, não etilista e hipertensa. Conclusões É possível perceber que há uma alta prevalência de transtornos de ansiedade e depressão nos pacientes com DAP. Esses transtornos são subdiagnosticados e, consequentemente, não são devidamente tratados

Anxiety and depression are highly prevalent neuropsychiatric conditions and are associated with chronic diseases, pain, loss of autonomy, dependence on others to perform routine activities, and loneliness. Depression often has a cause-and-effect relationship with other diseases, such as: acute myocardial infarction (AMI), systemic arterial hypertension (SAH), diabetes mellitus (DM) and peripheral arterial disease (PAD). Objectives To estimate the frequency of anxiety and depression in patients of both sexes with PAD admitted to a tertiary hospital. Methods This is a descriptive, cross-sectional study, with a non-random sample selected consecutively. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression, and the ankle-brachial index (ABI) was used to assess PAD. Results The prevalence of anxiety in these patients was 24.4%, with associations between anxiety and monthly family income, smoking, and SAH. The prevalence of depression was 27.6%, with associations between depression and the female gender, being married or in a stable relationship, living on a family income of one minimum wage or less, not being an alcoholic, and having hypertension. Conclusions There are high prevalence rates of anxiety and depressive disorders among patients with PAD, which are underdiagnosed and, hence, not properly treated

True dorsalis pedis artery aneurysm: case report.

A true aneurysm of the dorsal artery of the foot is a rare medical finding and its principal causes and clinical manifestations are not well known. A 49-year-old female patient presented with a pulsatile mass on the dorsal part of her right foot. Clinical and ultrasound examinations confirmed a diagnosis of aneurysm. The aneurysm was resected after dissection, exposure and isolation of the proximal and distal stumps of the dorsalis pedis artery. Simple ligature and resection of the aneurysm is proving to be a safe treatment option in patients with a patent plantar arch.

Quality of life in patients with peripheral artery disease.

BACKGROUND: Vascular diseases have a direct influence on quality of life (QoL) and directly affect patients' biopsychosocial aspects. Quality of life is therefore an important element for evaluation of vascular interventions. OBJECTIVE: To assess QoL in inpatients with peripheral arterial disease at a vascular surgery service in a charitable tertiary hospital. METHODS: This is an exploratory study, with a cross-sectional design, conducted at a vascular surgery service in a charitable tertiary hospital, assessing patients with peripheral arterial disease using two questionnaires, one on quality of life (the WHOQOL-Bref short form) and the other on sociodemographic conditions. RESULTS: It was observed that the physical domain, environment domain and total QoL scores were the lowest for the whole sample of 127 interviewees. Additionally, an intragroup analysis showed that men scored higher in all domains when compared with women, with the exception of the social relationships domain. CONCLUSIONS: Women with peripheral arterial disease exhibited lower scores than men in all domains of the QoL questionnaire, except for social relationships.

Qualidade de vida em pacientes com doença arterial periférica / Quality of life in patients with peripheral artery disease

As doenças vasculares influenciam a qualidade de vida (QV) e afetam de forma direta o aspecto biopsicossocial dos indivíduos. Sendo assim, a QV é uma importante forma de avaliação das intervenções vasculares. Objetivo: Avaliar a QV em pacientes com doença arterial periférica internados no serviço de cirurgia vascular em um hospital terciário beneficente. Métodos: Trata-se de um estudo exploratório, com desenho transversal, em um serviço de cirurgia vascular em um hospital terciário beneficente, no qual pacientes com doença arterial periférica foram avaliados através de dois questionários, sendo um a respeito de qualidade de vida (versão abreviada WHOQOL-Bref) e outro sobre as condições sociodemográficas. Resultados: Foi observado que os domínios físico, meio ambiente e QV total obtiveram os menores escores entre os 127 entrevistados. Além disso, uma análise intragrupo demonstrou que os homens obtiveram pontuação maior em todos os domínios quando comparados às mulheres, com exceção do domínio de relações sociais. Conclusão: As mulheres com doença arterial periférica apresentaram uma menor pontuação em todos os domínios do questionário de QV, exceto no de relações sociais, quando comparadas aos homens.

Vascular diseases have a direct influence on quality of life (QoL) and directly affect patients' biopsychosocial aspects. Quality of life is therefore an important element for evaluation of vascular interventions. Objective: To assess QoL in inpatients with peripheral arterial disease at a vascular surgery service in a charitable tertiary hospital. Methods: This is an exploratory study, with a cross-sectional design, conducted at a vascular surgery service in a charitable tertiary hospital, assessing patients with peripheral arterial disease using two questionnaires, one on quality of life (the WHOQOL-Bref short form) and the other on sociodemographic conditions. Results: It was observed that the physical domain, environment domain and total QoL scores were the lowest for the whole sample of 127 interviewees. Additionally, an intragroup analysis showed that men scored higher in all domains when compared with women, with the exception of the social relationships domain. Conclusions: Women with peripheral arterial disease exhibited lower scores than men in all domains of the QoL questionnaire, except for social relationships.

Aneurisma verdadeiro de artéria dorsal do pé: relato de caso / True dorsalis pedis artery aneurysm: case report

O aneurisma verdadeiro da artéria dorsal do pé é um achado médico raro, e suas principais causas e manifestações clinicas são pouco conhecidas. Paciente do sexo feminino, 49 anos de idade, apresentou-se com uma massa pulsátil no dorso do pé direito. O exame clínico e a imagem ultrassonográfica confirmaram o diagnóstico de um aneurisma. O aneurisma foi ressecado após dissecação, exposição e isolamento dos cotos proximal e distal da artéria dorsal do pé. A ligadura simples e a ressecção do aneurisma vêm se mostrando um tratamento seguro quando o arco plantar se mantém pérvio.

A true aneurysm of the dorsal artery of the foot is a rare medical finding and its principal causes and clinical manifestations are not well known. A 49-year-old female patient presented with a pulsatile mass on the dorsal part of her right foot. Clinical and ultrasound examinations confirmed a diagnosis of aneurysm. The aneurysm was resected after dissection, exposure and isolation of the proximal and distal stumps of the dorsalis pedis artery. Simple ligature and resection of the aneurysm is proving to be a safe treatment option in patients with a patent plantar arch.

Prevalence of depressive symptoms among medical students taught using problem-based learning versus traditional methods.

OBJECTIVE: To compare depressive symptoms among medical students taught using problem-based learning (PBL) and the traditional method. MATERIAL AND METHODS: Beck's Depression Inventory was applied to 215 medical students. The prevalence of depression was calculated as the number of individuals with depression divided by the total number in the sample from each course, with 95% confidence intervals. The statistical significance level used was 5% (p ≤ .05). RESULTS: Among the 215 students, 52.1% were male and 47.9% were female; and 51.6% were being taught using PBL methodology and 48.4% using traditional methods. The prevalence of depression was 29.73% with PBL and 22.12% with traditional methods. There was higher prevalence among females: 32.8% with PBL and 23.1% with traditional methods. The prevalence of depression with PBL among students up to 21 years of age was 29.4% and among those over 21 years, 32.1%. With traditional methods among students up to 21 years of age, it was 16.7%%, and among those over 21 years, 30.1%. The prevalence of depression with PBL was highest among students in the second semester and with traditional methods, in the eighth. CONCLUSIONS: Depressive symptoms were highly prevalent among students taught both with PBL and with traditional methods.

Morphological Analysis on the Occipital Condyles and Review of the Literature / Análisis Morfológico de los Cóndilos Occipitales y Revisión de la Literatura

Most anatomical and biomechanical studies on the craniovertebral junction have involved morphological or morphometric analysis on the occipital condyles. Some of these studies have provided important findings based on different surgical procedures. The shape, size and angle of the occipital condyles and the locations of the intracranial and extracranial orifices of the hypoglossal canal are highly important because they may affect the lateral approaches to the craniovertebral junction. To determine the frequency of occurrence of different morphological types of occipital condyle. 214 occipital condyles in 107 dry human skulls were analyzed and the classification of their morphological types was determined through assessing digitized photographic images. Among the 107 skulls analyzed, 59.8 % were male and 40.2 % were female. Their ages ranged from 11 to 91 years, with a mean of 57.56 years. Of the total of 10 morphological types of occipital condyle that were found, more than 50 % were of the "8", "S" and ring types. Condyles of "8" and "S" shape were the main types found in male skulls: the "8" shape prevailed on the left side and the "S" shape on the right side. However, in female skulls, these two types had equal bilateral distribution.

La mayor parte de los estudios anatómicos y biomecánicos de la unión cráneo-vertebral han sido realizados sobre el análisis morfológico o de la morfometría de los cóndilos occipitales. Algunos de estos trabajos tienen previsto importantes hallazgos basados en diferentes procedimientos quirúrgicos. De tal forma, el tamaño y ángulo del cóndilo occipital bien como su localización de los orificios intracraneales y extracraneales del canal hipogloso son de gran importancia, ya que pueden afectar a los enfoques laterales de la unión cráneo-vertebral. El objetivo del estudio fue determinar la prevalencia de los tipos morfológicos de cóndilos occipitales. Fueron analizados 214 cóndilos de 107 cráneos secos de humanos y la clasificación de los tipos morfológicos fue determinada a partir de los análisis de estudio de imágenes fotográficas digitalizadas. De los 107 cráneos que fueron analizados, 59,8 % eran de sexo masculino y 40,2 % de sexo femenino, cuyas edades comprendidas entre 11 y 91 años con una media de 57.56 años. De un total de 10 tipos morfológicos de los cóndilos occipitales encontrados, más del 50 % eran de tipo ocho, S y anillo. Los cóndilos en forma de "8" y "S" fueron los principales tipos encontrados, en el sexo masculino, la forma en "8" prevaleció en el lado izquierdo, y el tipo morfológico en "S", en el lado derecho del cráneo. Mientras que en el sexo femenino esos dos tipos tuvieron una equitativa distribución bilateral.

True Aneurysm of the Dorsal Artery of the Foot: Case Report and Review of the Literature.

True aneurysm of the dorsal artery of the foot is extremely rare, and its clinical manifestations are little known. A case of a true dorsalis pedis artery aneurysm in a 51-year-old man, with no history of local trauma or injury on his foot, is presented. Clinical examination and ultrasonic imaging confirmed the aneurysm. Dorsalis pedis artery aneurysm after this had been exposed, the proximal and distal stumps of the dorsal artery of the foot were isolated and ligated, and the aneurysm was resected.

Median artery of the forearm in human fetuses in northeastern Brazil: anatomical study and review of the literature.

A persistent median artery is a rare anomaly. It accompanies the median nerve along its course in the forearm and is of variable origin. It is associated with other local anatomical variations and may contribute significantly towards formation of the superficial palmar arch. In embryos, it is responsible mainly for the blood supply to the hand. The objective of this study was to research the frequency, type (forearm or palmar) and origin of the median artery in fetuses, correlating its presence with sex and body side. Red-colored latex was injected into 32 brachial arteries of human fetuses until its arrival in the hand could be seen. Twenty-four hours after the injection, the median arteries were dissected without the aid of optical instruments. Among the 32 forearms dissected, the median artery was present in 81.25 % (26) of the cases, and it was found more frequently in females and on the left side. Regarding origin, most of the median arteries originated in the common interosseous artery (38.5 %) and anterior interosseous artery (34.6 %). The mean length of the median arteries was 21.1 mm for the palmar type and 19.8 mm for the forearm type. The median artery has a high rate of persistence. It is important to be aware of this anatomical variation, since its presence may give rise to difficulties during routine surgical procedures on the wrist. Its presence may cause serious functional complications in the carpal tunnel, anterior interosseous nerve, round pronator syndromes, and ischemia of the hand.

Anterolateral Ligament of the Fetal Knee: An Anatomic and Histological Study.

BACKGROUND: The anterolateral ligament (ALL) of the knee has recently been described in detail. Most studies of the ALL have been conducted in adults; therefore, little is known about the anatomy and histology of the ALL in younger patients, and nothing is known about the fetal presence of the ALL. PURPOSE: To evaluate the ALL in human fetuses to determine its presence or absence and to describe its microscopic anatomy and histological features compared with the findings of studies conducted in adults. STUDY DESIGN: Descriptive laboratory study. METHODS: Twenty human fetal cadaveric specimens were used. The mean age of the fetuses was 28.64 ± 3.20 weeks. The ALL was dissected in the anterolateral region of the knee, and its anatomic parameters, including its origin, insertion, and path in relation to known adjacent anatomic landmarks, in addition to its length, width, and thickness over the path toward the tibia, were measured. After dissection, the ALL was removed en bloc with a portion of the lateral meniscus for histological analysis of 4-µm sections, hematoxylin and eosin staining, and immunohistochemical staining for type I collagen. RESULTS: The ALL was located in all dissected knees. Its origin was located at a mean distance of 1.87 mm from the origin of the lateral collateral ligament, with variations from the center of the lateral epicondyle to posterior and proximal to it, and it exhibited an anterior-inferior path toward the tibia, an insertion in the lateral meniscus approximately 2.08 mm anterior to the popliteal tendon, and another insertion in the tibia between the Gerdy tubercle and the fibular head at 2.46 mm below the articular cartilage. The histological sections of the ALL showed well-organized, dense collagenous tissue fibers with elongated fibroblasts (mean, 1631 fibroblasts/mm2) and a predominance of type I collagen. CONCLUSION: The ALL is present during fetal development, with anatomic and histological features similar to those of the adult ALL. CLINICAL RELEVANCE: The findings of this study help to better understand the ALL's anatomy and histology from the fetal period to adulthood. The study presents the existence of the ALL since fetal development, emphasizes the characterization of the ALL, and brings important information to future pediatric ALL lesion studies.

Adhesion to the monitoring of newborns from VDRL positive mothers / Adesão ao acompanhamento dos recém-nascidos de mães soropositivas para o treponema pallidum

OBJECTIVE: Treponema pallidum is the etiological agent of congenital syphilis, which results from fetal contamination by the infected mothers, who were not treated or were inadequately treated during pregnancy. METHODS: An observational, prospective and longitudinal study, was performed (2010-2014), through the evaluation of 428 newborns during 18 months in a syphilis clinic from a Philanthropic Maternity Hospital in Aracaju, capital city of the Northeastern state of Sergipe, Brazil. The findings were statistically expressed as descriptive data and the statistical program used was SPSS (Statistical Package for Social Sciences). RESULTS AND CONCLUSIONS: The prevalence of congenital syphilis was 10.02/1,000 live births. A total of 120 (28%) of newborns did not attend the first appointment. During the observational period, at 18 months, the rate of abandonment was 75%. The average interval of healing of the newborns was 4.25 months. A high prevalence of congenital syphilis was found with low adhesion to the first consultation and monitoring period; 67.1% of newborns were treated with Crystalline Penicillin (Penicillin G) and only 3% of them required a repeat treatment.

OBJETIVO: A sífilis congênita tem como agente etiológico o Treponema pallidum e resulta da contaminação do feto pela gestante infectada sem tratamento ou com tratamento inadequado. MÉTODO: Foi realizado um estudo observacional, prospectivo, longitudinal, com a participação de 428 recém-nascidos que foram acompanhados durante 18 meses em um ambulatório de sífilis de uma Maternidade Filantrópica em Aracaju. Os achados foram estatisticamente expressos de maneira descritiva e o programa estatístico utilizado foi o SPSS. RESULTADOS E CONCLUSÕES: A prevalência de sífilis congênita para 1000 nascidos vivos foi de 10,02 casos. Não compareceram à primeira consulta 28,2% dos recém-nascidos. Durante o acompanhamento, aos 18 meses, o percentual de abandono foi de 75%. O intervalo médio de cura dos recém-nascidos foi de 4,25 meses. Foi encontrada uma alta prevalência de sífilis congênita com baixas adesões à primeira consulta e ao acompanhamento; 67,1% foram tratados com penicilina cristalina e apenas 3% necessitaram repetir o tratamento.

Morphometric study on the infraorbital foramen in relation to sex and side of the cranium in northeastern Brazil.

Detailed knowledge of the possible anatomical and morphometric variations of the infraorbital foramen (IOF) is important for ensuring safe and successful regional anesthesia, and for avoiding iatrogenic nerve injuries during surgery on the middle third of the face. To conduct a morphometric study on the IOF, correlating this with sex and side of the cranium. Two hundred forty-two crania were used (148 male and 94 female). Measurements were made with the aid of digital calipers with precision to 0.01 mm. Presence of foramina and their multiplicity was also observed. The data were analyzed descriptively and analytically. Statistical significance was stipulated as 5% (P≤0.05). The IOF was found bilaterally in all the crania, and 26 of them presented multiplicity. The distance from the IOF to the anterior nasal spine was greater in males on both sides (P<0.001). Statistical differences between the sexes were also seen in relation to the following morphometric variables: height of the left IOF (P=0.007), width of the right IOF (P=0.004), and width of the left IOF (P=0.008), and the measurements were also larger among males. The IOF was present in all the crania and on both sides. It was morphometrically larger in males, on both sides.

Ocorrência de sintomas depressivos em médicos que trabalham no programa de saúde da família / Occurrence of depressive symptoms in physicians working in family health program

Objetivo Avaliar a ocorrência de depressão entre os médicos que trabalham nas Unidades de Saúde da Família (USF) em Aracaju. Métodos Em uma amostra de 83 médicos, foram utilizados o Inventário de Depressão de Beck (IDB) para rastreamento dos sintomas depressivos e um questionário elaborado pelos pesquisadores para coletar informações sociodemográficas. Foram realizadas estatística descritiva e análise por meio do qui-quadrado e regressão logística. Resultados A prevalência de sintomas depressivos na amostra foi de 27,7% (IC 95% 19,3-37,3). Observou-se que as variáveis que tiveram associação com o aparecimento dos sintomas (p < 0,05) foram: problemas de relacionamento, grau de satisfação com o trabalho e o número de consultas em relação à hora de trabalho. Após ajuste de regressão logística múltipla, foi observado que os médicos que tinham problemas de relacionamento e os insatisfeitos com o trabalho apresentaram, respectivamente, 5,63 e 4,59 vezes mais sintomas depressivos quando comparados àqueles que não possuíam esses sintomas Conclusões . A prevalência de sintomas depressivos em médicos que trabalham nas USF de Aracaju é alta e provavelmente está associada ao trabalho e a problemas de relacionamento. .

Objective To evaluate the occurrence of depression among physicians working in the Family Health Units (FHU) in Aracaju. Methods In a sample of 83 physicians it was used the Beck Depression Inventory (BDI) for screening of depressive symptoms and a questionnaire developed by the researchers to collect sociodemographic information. Descriptive statistics and analysis through the chi-square and logistic regression were performed. Results The prevalence of depressive symptoms in the sample was 27.7% (95% CI 19.3 to 37.3). It was observed that the variables that were associated with the onset of symptoms (p < 0.05) were: relationship problems, satisfaction with the job and the number of queries in relation to the work hour. After adjustment multiple logistic regression it was observed that those who had relationship problems and the ones who were not satisfied with the job had respectively, a risk of 5.63 and 4.59 times more likely to develop depressive symptoms compared with those who did not. Conclusions The prevalence of depressive symptoms in doctors working in Aracaju’s FHU is high and is probably associated with work and relationship problems. .