RESUMO
OBJECTIVE: Many disorders produce similar or overlapping patterns of bone marrow edema in the ankle. Bone marrow edema may present in a few hindfoot bones simultaneously or in a single bone. The purpose of this pictorial essay is to provide guidelines based on clinical history and specific MRI patterns and locations to accurately identify the cause of ankle bone marrow edema. We will first focus on bone marrow edema in general disease categories involving multiple bones, such as reactive processes, trauma, neuroarthropathy, and arthritides. A discussion of bone marrow edema in individual bones of the ankle and hindfoot including the tibia, fibula, talus, and calcaneus will follow. Helpful hints for arriving at the correct diagnosis will be provided in each section. CONCLUSION: After review of this article, radiologists should be able to use their knowledge of clinical history and specific MRI patterns and locations to accurately distinguish between the various causes of bone marrow edema in the ankle and hindfoot.
Assuntos
Tornozelo , Doenças da Medula Óssea/diagnóstico , Edema/diagnóstico , Pé , Imageamento por Ressonância Magnética/métodos , Doenças da Medula Óssea/etiologia , Doenças da Medula Óssea/patologia , Edema/etiologia , Edema/patologia , HumanosRESUMO
OBJETIVO: Testar a eficácia da construção de válvulas colônicas após a ressecção retoanal em ratos, para se obter retardo do fluxo intestinal. MÉTODO: Análise clínico-evolutiva, radiológica e anatomopatológica de 31 ratos submetidos a duas seromiotomias circunferenciais transversais no cólon com invaginação sero-serosa e ressecção retoanal, com colostomia perineal. RESULTADOS: Sete ratos morreram no pós-operatório e, necropsiados, apresentavam impactação fecal. Houve redução do peso corporal e fecal no pós-operatório imediato (estatisticamente não significante), seguida de aparente normalização dos valores. Fecalitos aderidos uns aos outros foram freqüentes. Dos 24 animais radiografados, em oito, ao menos uma das válvulas estava visível. Após a necropsia de 21 ratos, constatou-se o predomínio absoluto de fezes a montante das válvulas. Macroscopicamente, nem sempre as válvulas foram identificadas. Na microscopia, encontrou-se hipertrofia das fibras musculares e interrupção da camada muscular com alteração na disposição das fibras e fibrose nos locais da seromiotomia. CONCLUSÕES: A operação foi tecnicamente viável. A presença das fezes a montante das válvulas, a eliminação de fezes aderidas, a hipertrofia e a interrupção da camada muscular reforçam a hipótese de que a seromiotomia age como mecanismo frenador, retardando o trânsito intestinal. O modelo experimental não permite aferir sobre continência fecal.
BACKGROUND: The present study intend to test the efficacy of colonic valves construction after the anorectal resection in rats, in order to obtain retardation of the intestinal flow. METHOD: Clinical, radiological and anatomopathological analysis, ranging from 31 rats, submited to a series of two colonic transversal-circunferential seromiotomies, followed by serous-serous invagination and anorectal resection, and a perineal colostomy. RESULTS: Seven rats have died in the post-operatorium and, when necropsied, they presented faecal impactation. There was reduction in both body and faecal weight in the immediate post-operatorium period (statistically not significant), followed by an apparent normalization of the values. Small stool were found frequently joined together. In eight animals, from twenty-four which underwent radiograph, at least one valve was visible. After the necropsy of 21 rats, there was a major predominance of faeces above the valves. Macroscopically, the valves were not identified quite often. Microscopically, hipertroph in muscle fibers and interruption in muscle lay with alteration in fibers disposition and fibrosis in the places of seromiotomy, were commomly found. CONCLUSIONS: The operation can be considered as being tecnically viable. The presence of faeces above the valves, the elimination of joined stools, the hipertrophy and interruption of muscle layer, all emphasize the hypothesis that seromiotomy acts as a braking mechanism, retarding the intestinal flow. The experimental model adopted does not allow us to make any gauging regarding to faecal continence.
RESUMO
Resumo: Esta pesquisa foi delineada para buscar informações complementares ao processo de avaliação dos cursos de pós-graduação da Faculdade de Medicina da Universidade de Minas Gerais. Questionários foram elaborados e encaminhados aos 399 egressos do período 1979-95. Um dos objetivos foi avaliar as disciplinas consideradas básicas para a formação pedagógica e de instrumentação em metodologia de pesquisa: Didática Médica, Epidemiologia Humana, Bioestatística, Metodologia Científica e Normalização Bibliográfica. A população que responderam os questionários foi de 260 (65,8%). Cerca de 60% dos egressos avaliaram as disciplinas com o conteúdo "adequado", carga horária "suficiente", didática entre "ótima e boa", recursos audiovisuais entre "excelentes e satisfatórios" e aproveitamento "suficiente". Os dados remetam a uma reavaliação das disciplinas.
Abstract: This research aimed at gathering supplementary information for the evaluation process focusing on graduate courses at the School of Medicine of the federal University in Minas Gerais. Questionnaires were prepared and submitted to the 399 alumni from the period 1979-95. One of the objectives was to evaluate what are considered basic courses for training in teaching and research methodology: Medical Teaching, Human Epidelilogy, Biostatistics, Scientific Methodology, and Bibliographical Standarzation. A total of 260 alumni (65.8%) answered the questionnaire, 60% of whom evaluate the courses as having "adequate" content, "sufficient" course hours, didactics ranging from "fine" to "good", audiovisual resources ranging from "excellent" to "satisfactory" and "sufficient" yield. The data suggest the need for a review of the courses.
