Morphometric evaluation of the linea alba in fresh corpses.

Purpose: Diastasis recti abdominis is an increase in the distance between the medial borders of the two rectus muscles. It is most often triggered after intra-abdominal pressure increases, such as postpartum or in obesity. Most publications are based on radiological studies or are done in certain subgroups, without unanimous reference values of the distance between the rectus abdominis or standardization. Methods: Forty-one cadavers were studied. Exclusion criteria: signs of abdominal trauma, major burns, presence of scar from previous abdominal surgery, clinical signs of abdominal hernia, and identification of hernia during cadaver dissection. Linea alba (LA) length, width, and thickness were measured with a flexible tape measure and digital caliper. Anatomical landmarks were established, and subdivisions were described based on them to compare the cadavers. Results: Sex and age had little effect on LA width, thickness, or length. Obesity (compared to normal weight) was the only variable that promoted an increase in the LA width (p < 0.01). The supraumbilical length varied with the total height of the evaluated cadavers (p < 0.01), but the infraumbilical length did not (p = 0.11). Conclusion: The general statistical results of this study, regarding the evaluation of LA measurements in cadavers, showed that ethnicity, sex, and age have little effect on the width, thickness, or length of the LA. LA width differed significantly with abdominal circumference.

Bone anchor as fixation method for abdominal wall reconstruction. A case report about a ten times recurred inguinal hernia.

INTRODUCTION: While the use of bone anchor fixation for abdominal wall reconstruction for supra-pubic incisional hernia is well described (Yee et al., 2008 [1]), we show in this case report, written in line with the SCARE criteria (Agha et al., 2020 [2]), a novel use of this tool as an adjunct in the repair of a ten time recurrent inguinal hernia. CASE REPORT: A 65 years old multiparous, diabetic non-obese female, with previous abdominoplasty was submitted for left inguinal hernia for ten times, between multiples complications between infection, more than one mesh excision by anterior approach and laparoscopic approach. The wide range of procedures culminated in a destruction of the abdominal wall, making it impossible for a usual fixation of mesh in the region. Therefore, a multidisciplinary approach was planned for the patient with a bone anchor as a mesh fixation method. With a year follow up we did not observe a local hernia recurrence. CLINICAL DISCUSSION: Hernia itself is a multifactorial disease. As a anatomical defect, surgery is the only effective treatment. Our report brings a novel approach to a challenging case with many previous unsuccessful applications of conventional surgeries. Hence, we stimulate the multidisciplinary discussion for enhancing post operatory outcomes and a better point of care for the patient.

Metabolic effects of exercise in the golden fish Salminus maxillosus "dourado" (Valenciennes, 1849).

Strenuous exercise in fish is usually a consequence of migration, reproduction, and spawning. Varying among fishes, this kind of stress is associated with blood glucose and lactate increase, in relation to which two major groups are distinguishable: the "lactate releasers" and "non-lactate releasers". Unlike strenuous exercise, sustained swimming imposes a variety of effort that results in distinct kinetic types of blood lactate and glucose. Compared to Platichthys stellatus and Oncorhynchus mykiss, blood lactate of Salminus maxillosus (dourado) was lower after exercise, whereas recovery time was greater. Great demands were made of white muscle, and dourado is not a lactate releaser. Two different metabolic tendencies were observed in sustained and intense swimming. Gluconeogenesis was observed during recovery, as well as the alanine cycle which recomposes the lactate tissue pattern. Full recovery after intensive exertion required more than 24 hours.

Metabolic effects of exercise in the golden fish Salminus maxillosus "dourado" (Valenciennes, 1849)

Exercício intenso em peixes normalmente é conseqüência de migração, reprodução e desova. Esse tipo de esforço está associado ao aumento de glicose sangüínea e de lactato, o qual varia entre as diferentes espécies de peixes. Dois grupos são conhecidos, os "liberadores" e os "não liberadores" de lactato. Diferentemente do exercício intenso, o exercício contínuo impõe certo esforço que resulta em distintos tipos de cinética de lactato e glicose. A concentração de lactato plasmático em Salminus maxillosus é menor após o exercício quando comparada à Platichthys stellatus e Oncorhynchus mikyiss, mas o tempo de recuperação é maior. A musculatura branca é particularmente requisitada e o dourado apresenta-se como um "não liberador" de lactato. Duas tendências metabólicas distintas foram observadas para o exercício contínuo e intensivo. A gliconeogênese, que foi observada durante a recuperação, e o ciclo da alanina, que recompôs o padrão tissular de lactato. O período de completa recuperação do exercício intenso foi maior que 24 horas.

Hypertension and economic activities in São Paulo, Brazil.

A study of the prevalence of hypertension was undertaken among workers in 10 subsectors of the economy in São Paulo, a major urban-industrial area of Brazil. Included in the study were 5500 subjects 15-65 years of age, employed in 57 randomly selected firms. Hypertension rates (DBP greater than or equal to 90 mm Hg) were higher among males up to 44 years of age. There was a decreasing gradient from mild to moderate and severe forms in all groups. Severity tended to increase with age in all groups. Black males showed higher rates than whites (29.2% vs 16.7%, p less than 0.05), the excess being partially accounted for by moderate and severe forms (40% vs 20%). Subjects who overworked showed a trend toward higher hypertension rates. Higher rates in four subsectors (metallurgy, finance, transport, and journalism), aside from the distribution of known risk factors and job selection, may reflect a variety of work-related stressors.