Postmortem Retrograde Contrasted Infusion in Thoracic Duct Outflow: Imaging Effectiveness Analysis.

Background Thoracic duct (TD) anomaly can be quite variable and dangerous in surgical interventions in the neck region as there are numerous variations in its formation and topography. This highlights the importance of full knowledge about the TD and its anatomical variations. Thus, it is important to emphasize that the lack of anatomical-clinical knowledge or surgical skill during an intervention can significantly hamper successful results. The present study aimed to perform radiopaque contrast infusion into the TD of intact cadavers, either formalinized or refrigerated, to evaluate possible lymphatic architecture patterns via reverse lymphography. Methodology TD dissection was performed on 13 cadaveric specimens. After isolating the lymphatic vessel, it was cannulated with an nº 4 urethral probe fixed with cordonnet cotton. Then, a 10 mL syringe was attached to the urethral probe and the radiopaque iodinated contrast was injected into the TD under constant and gradual manual pressure. Results TD outflow was detected on the posterior surface of the junction between the internal jugular and the left subclavian veins, either as direct outflow (in 10 cases) or as an arc (in three cases). Reverse contrast progression was impossible in each of the attempts, probably due to valvular resistance and lumen obliteration, which completely prevented pressure infusion into the thoracic and abdominal parts of the TD. Conclusions We emphasize the impracticality of obtaining postmortem radiopaque images via retrograde contrast injection into the TD in formalinized or refrigerated bodies.

Aneurismas intracranianos: epidemiologia e análise morfológica por angiografia digital / Intracranial aneurisms: epidemiology and morphological analysis by digital angiography

Introdução: Aneurismas intracranianos (AIC) são dilatações vasculares de elevada prevalência que podem ser identificadas por angiotomografia, angiorressonância e por angiografia de subtração digital (ASD), exame considerado padrão-ouro. Para AIC não rotos, ainda inexiste consenso absoluto sobre padronização de conduta terapêutica, que depende, intrinsecamente, de aspectos morfológicos e topográficos ao exame angiográfico. Objetivo: Analisar características epidemiológicas, morfológicas e topográficas de AIC não rotos identificados por ASD e as correlacionar com fatores de risco. Método: Foram considerados 160 prontuários eletrônicos de pacientes com AIC não rotos diagnosticados por ASD entre 2014 e 2018. Variáveis consideradas foram aspectos epidemiológicos (gênero, idade e grupo étnico), morfológicos (formato, presença ou ausência de colo e tamanho), topografia, número de AIC por paciente e fatores de risco (hipertensão arterial sistêmica, tabagismo e etilismo), com análise estatística por correlação de Spearman. Resultados: De 160 pacientes, avaliaram-se 207 AIC não rotos. Houve predomínio do sexo feminino, da faixa etária de 60 a 69 anos e da etnia branca. Em relação a fatores de risco, 58,75% apresentavam hipertensão arterial sistêmica. A maioria dos pacientes apresentava um único aneurisma, e a localização mais prevalente foi artéria carótida interna direita. Predominaram aneurismas saculares, pequenos (menor que 7 mm) e de colo largo. Demonstrou-se correlação estatística entre tamanho e localização (p < 0,001), tamanho e tipo de colo (p = 0,0005) e entre formato e tipo de colo (p < 0,001). Conclusão: Houve prevalência de AIC não rotos em indivíduos do sexo feminino de meia idade, brancos e hipertensos, com predomínio de aneurisma sacular não lobulado, único, pequeno, de colo largo em artéria carótida interna direita. Presença de correlação estatística de AIC sacular com colo largo, AIC gigante em artéria carótida interna, e de AIC pequeno com colo largo. [au]

Introduction: Intracranial aneurysms (IA) are vascular dilations that are highly prevalent and that can be identified by angiotomography, angioresonance and digital subtraction angiography (DSA), an exam considered the gold standard. For unruptured IA, there is still no absolute onsensus on standardization of therapeutic conduct, which depends, intrinsically, on morphological and topographic aspects on angiographic examination. Objective: Analyze the epidemiological, morphological and topographic characteristics of unruptured IA identified by DSA and to correlate with risk factors. Method: 160 electronic medical records of patients with unruptured IA diagnosed by DSA between 2014 and 2018 were considered. Variables considered were epidemiological (gender, age and ethnic group), morphological aspects (shape, presence or absence of neck and size), topography, number of IA per patient and risk factors (systemic arterial hypertension, smoking and alcoholism), with statistical analysis by Spearman correlation. Results: Out of 160 patients, 207 unruptured IA were evaluated. There was a predominance of females, aged 60 to 69 years and white ethnicity. Regarding risk factors, 58.75% had systemic arterial hypertension. Most patients have a single aneurysm, and the most prevalent location was the right internal carotid artery. Saccular, small (less than 7 mm) and large-necked aneurysms predominated. There was a statistical correlation between size and location (p <0.001), size and type of neck (p = 0.0005) and between shape and type of neck (p <0.001).Conclusion: Prevalence of unruptured IA in middle-aged, white and hypertensive women, with a predominance of a single small non-lobulated saccular aneurysm with a large neck in the right internal carotid artery. Correlation of saccular IA with large neck, giant IA in internal carotid artery, and small IA with large neck. [au]

Coronary Artery Fistula: Association between Pathway Patterns, Clinical Features and Congenital Heart Disease. / Fístula da Artéria Coronária: Associação entre Padrões de Trajetos, Características Clínicas e Cardiopatias Congênitas.

BACKGROUND: Coronary artery fistula (CAF) is a direct connection of one or more coronary arteries to cardiac chambers or a large vessel; it may be associated with congenital heart disease. OBJECTIVE: To establish CAF pathway patterns from echocardiographic data and to correlate them with clinical aspects and congenital heart disease. METHODS: A total of 7.183 medical records of children under the age of five years with cardiac disease submitted to color Doppler echocardiography and Spearman's Correlation test were used to associate signs and symptoms and cardiopathy to CAF with a significance level of 5%. RESULTS: Twenty six children (0.0036%) presented CAF: from the right coronary artery (RCA) to the right ventricle (RV) 26.92%, from the left coronary artery (LCA) to the RV 23.08%, from the anterior interventricular branch (AIVB) to RV 23.08%, RCA to right atrium (RA) 11.54%, LCA for pulmonary trunk (PT) 7.69% or AIVB for PT 7.69%. In 57.69% of the patients, there was a positively correlated symptomatology to CAF with p=0.445 related to dyspnea or cyanosis (53.84%); in 96.15%, congenital heart disease associated with CAF, mainly interventricular communication (IVC) or interatrial communication (IAC) in 34.62% positively correlated to CAF with p=0.295. CAF pathway was represented in three dimensions by software modeling, texturing and animation Cinema 4D R19. CONCLUSION: CAF is an uncommon anatomical entity that presents a clinical picture compatible with dyspnea and cyanosis, and this is associated with congenital heart disease, mainly with IVC or IAC. According to echocardiographic analyzes, fistulas in RCA, LCA, or AIVB represent about one-third of the patients, with a priority pathway for right heart chambers.

FUNDAMENTO: A fístula da artéria coronária (FAC) é uma conexão direta entre uma ou mais artérias coronárias e câmaras cardíacas ou um grande vaso; pode estar associada à cardiopatia congênita. OBJETIVO: Estabelecer os padrões de trajetos de FAC a partir de dados ecocardiográficos e correlacioná-los com aspectos clínicos e cardiopatias congênitas. MÉTODOS: Um total de 7.183 prontuários médicos de crianças menores de 5 anos de idade com cardiopatia submetidas a ecodopplercardiograma colorido foram analisados utilizando o teste de correlação de Spearman para associar sinais, sintomas e cardiopatia à FAC, com nível de significância de 5%. RESULTADOS: Vinte e seis crianças (0,0036%) apresentaram FAC, nos seguintes trajetos: da artéria coronária direita para o ventrículo direito (26,92%), da artéria coronária esquerda para o ventrículo direito (23,08%), do ramo interventricular anterior para o ventrículo direito (23,08%), da artéria coronária direita para o átrio direito (11,54%), da artéria coronária esquerda para o tronco pulmonar (7,69%) e do ramo interventricular anterior para o tronco pulmonar (7,69%). Em 57,69% dos pacientes, houve uma correlação positiva entre sintomas e a FAC (p = 0,445), relacionada à dispneia ou cianose (53,84%). Em 96,15%, a cardiopatia congênita estava associada à FAC; principalmente, a comunicação interventricular e a comunicação interatrial, em 34,62% dos casos, correlacionaram-se positivamente com a FAC (p = 0,295). O trajeto da FAC foi representado em três dimensões pelo software de modelagem, texturização e animação Cinema 4D R19. CONCLUSÃO: A FAC é uma entidade anatômica incomum que apresenta quadro clínico compatível com dispneia e cianose e está associada a cardiopatias congênitas, principalmente com a CIV ou a CIA. De acordo com as análises ecocardiográficas, as fístulas na ACD, na ACE ou no RIVA representam aproximadamente um terço dos pacientes, com trajeto prioritário para as câmaras cardíacas direitas.

Fístula da Artéria Coronária: Associação entre Padrões de Trajetos, Características Clínicas e Cardiopatias Congênitas / Coronary Artery Fistula: Association between Pathway Patterns, Clinical Features and Congenital Heart Disease

Resumo Fundamento A fístula da artéria coronária (FAC) é uma conexão direta entre uma ou mais artérias coronárias e câmaras cardíacas ou um grande vaso; pode estar associada à cardiopatia congênita. Objetivo Estabelecer os padrões de trajetos de FAC a partir de dados ecocardiográficos e correlacioná-los com aspectos clínicos e cardiopatias congênitas. Métodos Um total de 7.183 prontuários médicos de crianças menores de 5 anos de idade com cardiopatia submetidas a ecodopplercardiograma colorido foram analisados utilizando o teste de correlação de Spearman para associar sinais, sintomas e cardiopatia à FAC, com nível de significância de 5%. Resultados Vinte e seis crianças (0,0036%) apresentaram FAC, nos seguintes trajetos: da artéria coronária direita para o ventrículo direito (26,92%), da artéria coronária esquerda para o ventrículo direito (23,08%), do ramo interventricular anterior para o ventrículo direito (23,08%), da artéria coronária direita para o átrio direito (11,54%), da artéria coronária esquerda para o tronco pulmonar (7,69%) e do ramo interventricular anterior para o tronco pulmonar (7,69%). Em 57,69% dos pacientes, houve uma correlação positiva entre sintomas e a FAC (p = 0,445), relacionada à dispneia ou cianose (53,84%). Em 96,15%, a cardiopatia congênita estava associada à FAC; principalmente, a comunicação interventricular e a comunicação interatrial, em 34,62% dos casos, correlacionaram-se positivamente com a FAC (p = 0,295). O trajeto da FAC foi representado em três dimensões pelo software de modelagem, texturização e animação Cinema 4D R19. Conclusão A FAC é uma entidade anatômica incomum que apresenta quadro clínico compatível com dispneia e cianose e está associada a cardiopatias congênitas, principalmente com a CIV ou a CIA. De acordo com as análises ecocardiográficas, as fístulas na ACD, na ACE ou no RIVA representam aproximadamente um terço dos pacientes, com trajeto prioritário para as câmaras cardíacas direitas.

Abstract Background Coronary artery fistula (CAF) is a direct connection of one or more coronary arteries to cardiac chambers or a large vessel; it may be associated with congenital heart disease. Objective To establish CAF pathway patterns from echocardiographic data and to correlate them with clinical aspects and congenital heart disease. Methods A total of 7.183 medical records of children under the age of five years with cardiac disease submitted to color Doppler echocardiography and Spearman's Correlation test were used to associate signs and symptoms and cardiopathy to CAF with a significance level of 5%. Results Twenty six children (0.0036%) presented CAF: from the right coronary artery (RCA) to the right ventricle (RV) 26.92%, from the left coronary artery (LCA) to the RV 23.08%, from the anterior interventricular branch (AIVB) to RV 23.08%, RCA to right atrium (RA) 11.54%, LCA for pulmonary trunk (PT) 7.69% or AIVB for PT 7.69%. In 57.69% of the patients, there was a positively correlated symptomatology to CAF with p=0.445 related to dyspnea or cyanosis (53.84%); in 96.15%, congenital heart disease associated with CAF, mainly interventricular communication (IVC) or interatrial communication (IAC) in 34.62% positively correlated to CAF with p=0.295. CAF pathway was represented in three dimensions by software modeling, texturing and animation Cinema 4D R19. Conclusion CAF is an uncommon anatomical entity that presents a clinical picture compatible with dyspnea and cyanosis, and this is associated with congenital heart disease, mainly with IVC or IAC. According to echocardiographic analyzes, fistulas in RCA, LCA, or AIVB represent about one-third of the patients, with a priority pathway for right heart chambers.

Análise epidemiológica clínico-cirúrgica pós-herniorrafia inguinal bilateral

Introdução: Hérnia inguinal é um defeito anatômico resultante de evaginação de estruturas intra-abdominais para o interior do canal inguinal. Em casos bilaterais, abordagem cirúrgica depende da extensão do defeito herniário e pode se associar a taxa de recidiva maior que a do reparo unilateral. Objetivo: Analisar variáveis epidemiológicas, clínicas e cirúrgicas em pós-operatório de pacientes submetidos a herniorrafia inguinal bilateral. Métodos: Estudo retrospectivo de 51 prontuários de pacientes submetidos a herniorrafia inguinal bilateral no Hospital Estadual João Paulo II de São José do Rio Preto (SP), de 2006 a 2016. Resultados: Os participantes do estudo apresentaram média de idade de 51,6 anos, em sua maioria eram do sexo masculino (84%), brancos (86,36%), tabagistas (62,86%) e lavradores (21,43%). Em 100% dos casos, procedeu-se à raquianestesia e uso da técnica livre de tensão (Lichtenstein), com permanência intra-hospitalar por 1 a 4 dias. Durante média de 4 anos de seguimento pós-operatório, não houve complicações em 43 pacientes (84,31%); recidiva unilateral ocorreu em 7,84% dos casos, e seroma em 3,92%. Tempo médio de retorno às atividades pós-cirurgia foi de 58 dias. Houve associação significativa entre hérnia inguinal e sexo masculino, raça branca, profissão como lavrador e tabagismo, mas sem associações com períodos de internação, de retorno às atividades diárias e de seguimento pós-operatório. Conclusão: Hérnia inguinal bilateral tende a acometer homens caucasianos de meia-idade, tabagistas e com atividade laboral intensa. Para sua abordagem, raquianestesia e técnica cirúrgica de Lichtenstein têm sido amplamente aceitas. Ainda que recidiva unilateral possa estar presente, associa-se a fatores intrínsecos ou a intercorrências cirúrgicas. Reparo bilateral de hérnia inguinal não apresenta morbidade maior do que correção unilateral, e retorno a atividades de vida diária tende a ser semelhante.

Automedicação entre acadêmicos de medicina de Fernandópolis ­ São Paulo / Self medication among medical students: analysis of variable related

Objetivo: buscou-se investigar a automedicação por acadêmicos de curso de graduação em Medicina de instituição privada e analisar possíveis variáveis relacionadas. Métodos: trata-se de um estudo transversal realizado com 320 discentes dos quatro primeiros anos do curso de Medicina da Universidade Brasil, campus Fernandópolis-SP. Foi aplicado questionário validado com variáveis sociais e de consumo de medicamentos, seguido de análise estatística por regressão linear simples. Resultado: como resultado, a automedicação foi considerada uma opção em 309 dos participantes, a maioria deles do sexo feminino, idade entre 21 a 23 anos, solteiros, sem curso superior prévio, com convênio médico e conscientes de eventuais riscos à Saúde, mesmo após acesso a bulas ou a pesquisas on-line. O quadro clínico precedente à automedicação incluiu, principalmente, cefaleia e mialgia. Houve preferência por fármacos anteriormente utilizados com consumo médio (por 1 a 2 dias), principalmente de analgésicos e anti-inflamatórios. Estar mais próximo ao término do curso (p = 0,006) e possuir convênio médico (p = 0,046) se relacionaram com automedicação. Conclusão: o hábito da automedicação aumenta, gradativamente, ao decorrer

Objective: we sought to investigate self-medication by Medicine undergraduated students in a private institution of Medicine and to examine possible related variables. Methods: it is a cross-sectional study conducted with 320 students of the first four years of medical school at Universidade Brasil, Fernandópolis-SP campus. Validated questionnaire was applied taking into account social variables and medicine consumption, being followed by statistical analysis with simple linear regression. Results: as a result, self-medication was considered an option to 309 of the participants, the majority of women, aged 21-23 years old, single, without higher education, with health insurance and aware of possible risks to health even after access to bulls or online research. Clinical symptoms prior to self-medication included headache and myalgia. There was a preference for drugs previously used with an average consumption (from 1 to 2 days), especially analgesics and anti-inflammatories. It was verified that being related to self-medication was more likely to happen among those students closer to the end of the course (p = 0.006) and to those who have health insurance (p = 0.046). Conclusion: the habit of self-medication gradually increases over the undergradution, therefore, it is suggested to implement an educational pedagogical proposal on this subject in medical school curriculum.

Evidências do efeito da terapia fotodinâmica sobre a Propionibacterium acnes / Evidence of the effect of photodynamic therapy on Propionibacterium acnes

Introdução: A Propionibacterium acnes é uma bactéria causadora da acne. Devido aos efeitos colaterais ou à falta de resposta ao tratamento da acne, foi proposta a terapia fotodinâmica como um tratamento alternativo para a acne. Objetivo: O objetivo foi evidenciar a ação fotodinâmica do LED vermelho 660 nm e do fotossensibilizador azul de metileno sobre Propionibacterium acnes in vitro. Métodos: Os ensaios foram constituídos por quatro grupos: 1. controle (sem aplicação de luz e sem fotossensibilizador); 2. com aplicação de luz; 3. com fotossensibilizador e sem aplicação de luz; 4. com fotossensibilizador e com aplicação de luz. Os ensaios foram submetidos a aplicação de luz por 4 ciclos de 5 minutos com intervalos de 3 minutos. Resultados: Houve redução estatisticamente significante (p<0,05) nas médias dos grupos 1, 2 e 4, ainda que o grupo 3 não tenha apresentado significância estatística, mas houve redução detectada nas médias. Conclusão: A ação fotodinâmica é eficiente para a destruição do material biológico por irradiação a 660nm atribuída ao processo de fotossensibilização pela presença do fotossensibilizador.(AU)

Introduction: Propionibacterium acnes is a bacterium that causes acne. Due to the side effects or the lack of response to acne treatment, photodynamic therapy was proposed as an alternative treatment for acne. Objective: To demonstrate the photodynamic action of the 660 nm red LED and the methylene blue photosensitizer on Propionibacterium acnes in vitro. Methods: Four groups were studied: 1. control (without light application and without photosensitizer); 2. with light application; 3. with photosensitizer and without light application; 4. with photosensitizer and light application. The assays were subjected to light application for 4 cycles of 5 minutes at 3 minute intervals. Results: There was a statistically significant reduction (p <0.05) in the means of groups 1, 2 and 4, although group 3 did not present statistical significance, but there was a reduction detected in the means. Conclusion: The photodynamic action is efficient for the destruction of the biological material by irradiation at 660nm attributed to the process of photosensitization by the presence of the photosensitizer.(AU)

Photodynamic action of the red laser on Propionibacterium acnes.

BACKGROUND: Photodynamic therapy is a therapeutic modality that has consolidated its activity in the photooxidation of organic matter, which arises from the activity of reactive oxygen species. OBJECTIVE: To evaluate the effect of red laser 660nm with the photosensitizer methylene blue on Propionibacterium acnes in vitro. METHOD: The experimental design was distributed into four groups (1 - control group without the application of light and without photosensitizer, 2 - application of light, 3 - methylene blue without light, and 4 - methylene blue with light). Tests were subjected to red laser irradiation 660nm by four cycles of 5 minutes at 3-minute intervals. RESULTS: It was evidenced the prominence of the fourth cycle (20 minutes) groups 2, 3 and 4. STUDY LIMITATIONS: Despite the favorable results, the laser irradiation time photosensitizer associated with methylene blue were not sufficient to to completely inhibit the proliferation of bacteria. CONCLUSION: Further studies in vitro are recommended to enable the clinical application of this photosensitizer in photodynamic therapy.

Photodynamic action of the red laser on Propionibacterium acnes

Abstract: Background: Photodynamic therapy is a therapeutic modality that has consolidated its activity in the photooxidation of organic matter, which arises from the activity of reactive oxygen species. Objective: To evaluate the effect of red laser 660nm with the photosensitizer methylene blue on Propionibacterium acnes in vitro. Method: The experimental design was distributed into four groups (1 - control group without the application of light and without photosensitizer, 2 - application of light, 3 - methylene blue without light, and 4 - methylene blue with light). Tests were subjected to red laser irradiation 660nm by four cycles of 5 minutes at 3-minute intervals. Results: It was evidenced the prominence of the fourth cycle (20 minutes) groups 2, 3 and 4. Study limitations: Despite the favorable results, the laser irradiation time photosensitizer associated with methylene blue were not sufficient to to completely inhibit the proliferation of bacteria. Conclusion: Further studies in vitro are recommended to enable the clinical application of this photosensitizer in photodynamic therapy.

Technological Devices Improving System of Translating Languages: What About their Usefulness on the Applicability in Medicine and Health Sciences?

ABSTRACT INTRODUCTION: In a world in which global communication is becoming ever more important and in which English is increasingly positioned as the pre-eminent international language, that is, English as a Lingua Franca refers to the use of English as a medium of communication between peoples of different languages. It is important to highlight the positive advances in communication in health, provided by technology. OBJECTIVE: To present an overview on some technological devices of translating languages provided by the Web as well as to point out some advantages and disadvantages specially using Google Translate in Medicine and Health Sciences. METHODS: A bibliographical survey was performed to provide an overview on the usefulness of online translators for applicability using written and spoken languages. RESULTS: As we have to consider this question to be further surely answered, this study could present some advantages and disadvantages in using translating online devices. CONCLUSION: Considering Medicine and Health Sciences as expressive into the human scientific knowledge to be spread worldwidely; technological devices available on communication should be used to overcome some language barriers either written or spoken, but with some caution depending on the context of their applicability.

Neurorrhaphy techniques: comparative stereological and experimental axonal study / Técnicas de neurorrafia: estudio experimental estereológico axonal comparativo

There is a great variety of injuries that affect peripheral nerves derived from acquired or congenital degenerative diseases affecting the central nervous system that cause loss of sensorimotor functions. The objective of this work was to perform an end-to-side or side-to-side experimental axonal stereological study in order to compare volume density of axons, endouneuro and myelin sheath (and muscle mass) in peroneal and tibial nerves, with anastomosis contact from 0.25 cm to 0.50 cm. After approval of the Ethics Committe, 20 male Wistar rats were divided into four groups of five rats each (G1= end-to-side neurorrhaphy; G2= side-to-side neurorrhaphy of 0.25 cm; G3= side-to-side neurorrhaphy of 0 cm and G4= Control of normality). After 180 days, fragments of peroneal and tibial nerves were collected for histological and stereological study. In comparative stereological experimental study between neurorraphies, the volume density of axons, myelin sheath of tibial and fibular nerves, as well as the post-surgical muscle mass, remains the same in end-to-side and side-to-side neurorraphies, regardless of contact area of anastomosis. It can be inferred, as surgical repair options, both end-to-side neurorrhaphy to recover and prevents atrophy of the endplate as side-to-side neurorraphy that is independent of the distance between the nerve stumps.

Gran variedad de lesiones atingen a los nervios periféricos, derivadas de enfermedades adquiridas o degenerativas congénitas que afectan la parte central del sistema nervioso y que ocasionan pérdida de funciones sensoriomotoras. El objetivo de ese trabajo fue realizar un estudio experimental estereológico axonal post neurorrafias termino-lateral o latero-lateral para comparar densidad de volumen de axones, endoneuro y vaina de mielina (así como masa muscular) en nervios fibular y tibial, con unión de contacto entre 0,25 cm y 0,50 cm. Tras la aprobación del comité de ética, fueran utilizados 20 ratones machos de la raza Wistar divididos en cuatro grupos de 5 ratones cada uno (G1= Neurorrafia término lateral; G2= Neurorrafia latero lateral de 0,25 cm; G3= Neurorrafia latero lateral de 0,50 cm y G4= Control). Posteriormente, fragmentos de los nervios tibiales y fibulares fueron procesados para estudios histológicos y estereológicos. En el estudio experimental estereológico comparativo entre neurorrafias termino-lateral y latero-lateral, la densidad de volumen de axones, endoneuro y vaina de mielina de nervios tibial y fibular y también la masa muscular post quirúrgica se mantuvo equitativa, independientemente del área de unión de contacto. Podemos inferir como opciones de reparación quirúrgica, que el tratamiento de la neurorrafia termino-lateral y latero-lateral previnen la atrofia de placa motora, independiente de la distancia entre los muñones nerviosos.

Clinical and therapeutic correlations in patients with slight acute pancreatitis.

BACKGROUND: Acute pancreatitis is an inflammatory disease of the pancreas due to enzymatic autodigestion which can cause necrosis or multiple organ failure; its pathophysiology is not fully known yet. AIM: To evaluate the correlation between clinical and therapeutic data in patients with mild acute pancreatitis. METHODS: A retrospective study in 55 medical records of patients admitted with acute mild pancreatitis was realized to analyze the association between age, leukocytosis, serum glutamic-oxaloacetic transaminase and lactate dehydrogenase, glucose, antibiotics, time admission and Ranson's scores. RESULTS: There was a positive association between less intensive care (strict hydration, analgesia and monitoring of vital signs), early antibiotic therapy (monotherapy), early return to diet after 48 hours and laboratory control of the serum amylase and lipase (high in the first week and decreasing after 10 days, without any prognostic value). CONCLUSIONS: Changes in the management of patients with mild acute pancreatitis, such as enteral nutrition, rational use of lower spectrum antibiotics and intensive care, have contributed significantly to the reduction of hospitalization time and mortality.

Technological Devices Improving System of Translating Languages: What About their Usefulness on the Applicability in Medicine and Health Sciences?

INTRODUCTION: In a world in which global communication is becoming ever more important and in which English is increasingly positioned as the pre-eminent international language, that is, English as a Lingua Franca refers to the use of English as a medium of communication between peoples of different languages. It is important to highlight the positive advances in communication in health, provided by technology. OBJECTIVE: To present an overview on some technological devices of translating languages provided by the Web as well as to point out some advantages and disadvantages specially using Google Translate in Medicine and Health Sciences. METHODS: A bibliographical survey was performed to provide an overview on the usefulness of online translators for applicability using written and spoken languages. RESULTS: As we have to consider this question to be further surely answered, this study could present some advantages and disadvantages in using translating online devices. CONCLUSION: Considering Medicine and Health Sciences as expressive into the human scientific knowledge to be spread worldwidely; technological devices available on communication should be used to overcome some language barriers either written or spoken, but with some caution depending on the context of their applicability.

Clinical and therapeutic correlations in patients with slight acute pancreatitis / Correlações clínico-terapêuticas em pacientes com pancreatite aguda leve

BACKGROUND: Acute pancreatitis is an inflammatory disease of the pancreas due to enzymatic autodigestion which can cause necrosis or multiple organ failure; its pathophysiology is not fully known yet. AIM: To evaluate the correlation between clinical and therapeutic data in patients with mild acute pancreatitis. METHODS: A retrospective study in 55 medical records of patients admitted with acute mild pancreatitis was realized to analyze the association between age, leukocytosis, serum glutamic-oxaloacetic transaminase and lactate dehydrogenase, glucose, antibiotics, time admission and Ranson´s scores. RESULTS: There was a positive association between less intensive care (strict hydration, analgesia and monitoring of vital signs), early antibiotic therapy (monotherapy), early return to diet after 48 hours and laboratory control of the serum amylase and lipase (high in the first week and decreasing after 10 days, without any prognostic value). CONCLUSIONS: Changes in the management of patients with mild acute pancreatitis, such as enteral nutrition, rational use of lower spectrum antibiotics and intensive care, have contributed significantly to the reduction of hospitalization time and mortality. .

RACIONAL: Pancreatite aguda consiste de doença inflamatória do pâncreas por autodigestão enzimática que pode ocasionar necrose ou mesmo falência múltipla de órgãos e de fisiopatologia ainda não totalmente conhecida. OBJETIVO: Avaliar as correlações existentes entre dados clínicos e terapêuticos em pacientes com pancreatite aguda leve. MÉTODOS: Foi realizado estudo retrospectivo em 55 prontuários de pacientes internados por pancreatite aguda leve para análise de associação entre idade, leucocitose, dosagem sérica de transaminase glutâmico-oxalacética e de desidrogenase lática, glicemia, antibioticoterapia, tempo de internação e escores de Ranson. RESULTADOS: Houve associação positiva entre cuidados intensivos menores (hidratação rigorosa, analgesia e monitorização de sinais vitais), antibioticoterapia precoce (monoterapia), retorno precoce da dieta após 48 horas e controle laboratorial dos níveis séricos de amilase e lipase (elevados na primeira semana e decrescentes após 10 dias, porém sem valor prognóstico). CONCLUSÕES: Mudanças no manejo de pacientes com pancreatite aguda leve, tais como nutrição enteral, uso racional de antibióticos de menor espectro e cuidados intensivos têm contribuído significativamente para a redução do tempo de internação e mortalidade. .

End-to-side loop neurorrhaphy: axonal comparative stereological study / Neurorrafia de blucle termino-lateral: estudio axonal estereológico comparativo

Accidents or diseases can affect the peripheral part of the nervous system, which raises clinical and surgical therapies, among others. In this context, the technique of end-to-side neurorrhaphy is a treatment option, yet its modification loop needs some additional efficacy studies. The purpose of this study was to compare, among rats, stereological results (axons volume density) after end-to-side neurorrhaphy and after end-to-side loop neurorrhaphy. Thirty Wistar rats were used, divided into six groups (five animals per group), consisting of two control groups (for the fibular and tibial nerves), two study groups for the fibular nerve (one with an end-to-side neurorrhaphy, and the other with an end-to-side loop neurorrhaphy) and two study groups for the tibial nerve (with an end-to-side neurorrhaphy and the other one with an end-to-side loop neurorrhaphy). After 180 days, all groups were sacrificed for axonal stereological analysis (volume density) in distal nerve stumps. There was significant maintenance of neuronal-axonal density in the distal stumps to neurorrhaphy (p<0.005) compared with the normal stumps. The end-to-side loop neurorrhaphy is a therapeutic option as suture technique after complete nerve section, in order to restore most of the axonal functional integrity.

Accidentes o enfermedades pueden afectar a la parte periférica del sistema nervioso, lo que plantea terapias clínicas y quirúrgicas, entre otras. En este contexto, la técnica de neurorrafia término-lateral es una opción terapéutica, sin embargo, su modificación en bucle necesita algunos estudios adicionales de eficacia. El objetivo de este estudio fue comparar, en ratas, resultados estereológicos (densidad de volumen axonal) después de la neurorrafia término-lateral y de la neurorrafia en bucle término-lateral. Fueron utilizadas 30 ratas Wistar, divididas en seis grupos (cinco animales por grupo), siendo dos grupos control (para los nervios fibular y tibial), dos grupos estudio del nervio fibular (uno con neurorrafia término-lateral y otro con neurorrafia en bucle termino-lateral) y dos grupos estudio del nervio tibial (uno con neurorrafia término-lateral y otro con neurorrafia en bucle término-lateral). Después de 180 días, todos los grupos fueron eutanasiados y se realizó el análisis estereológico axonal (densidad de volumen) en muñones nerviosos distales. Hubo un mantenimiento significativo de la densidad neuronal-axonal en los muñones distales a la neurorrafia (p<0,005) en comparación con los muñones normales. La neurorrafia en bucle término-lateral es una opción terapéutica como técnica de sutura después de la sección completa del nervio, con el fin de restaurar la mayoría de la integridad funcional axonal.

Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program--IQIC.

INTRODUCTION: Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. OBJECTIVE: To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. METHODS: The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. RESULTS: Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. CONCLUSION: It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases.

Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program - IQIC / A tecnologia da informação implementando a globalização nas estratégias de qualidade para o atendimento às crianças submetidas à cirurgia cardíaca: o Programa de Colaboração Internacional - IQIC

Introduction: Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. Objective: To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. Methods: The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Results: Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. Conclusion: It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases. .

Introdução: Doenças cardíacas congênitas são consideradas o maior defeito ao nascimento, afetando uma em cada 120 crianças. Noventa por cento destes recém-nascidos encontram-se em áreas onde os cuidados médicos são inadequados ou indisponíveis. Objetivo: Compartilhar o conhecimento e a experiência en tre um centro de excelência internacional em cirurgia cardíaca pediátrica e um programa correlato no Brasil. Métodos: Estratégia utilizada pelo programa foi baseada em modelos de suporte tecnológico e educacional a longo termo advinda daquele centro, contribuindo para criação e efetivação de novos programas. Foi utilizada plataforma de Telemedicina para transmissão mensal em tempo real dos temas. Um progra ma de chat foi utilizado para a interação entre os membros par ticipantes e o grupo do centro de excelência. Resultados: Os profissionais especializados no cuidado des sa população tiveram a oportunidade de participar do conheci mento transmitido. Conclusão: Pode-se observar que os recursos tecnológicos que implementam a globalização do conhecimento humano fo ram efetivos na disseminação e aprimoramento da equipe no que diz respeito ao cuidado às crianças com cardiopatias congênitas. .

Acupuncture in De Quervain's disease: a treatment proposal.

De Quervain's disease is a painful stenosing tenosynovitis of the first dorsal compartment of the hand affecting the tendons of the abductor pollicis longus and extensor pollicis brevis, caused mainly by overuse. Conventional treatments include rest, immobilisation, oral anti-inflammatory drugs, corticosteroid injection and even surgery, but none of these is established as clearly effective. Acupuncture is rarely mentioned and the points suggested are rather general-regional, tender and ah shi points. Tendinopathy is almost always associated with problems in the relevant muscles and this paper calls attention to the correct identification and needling of the affected muscles, in order to increase the specificity of acupuncture treatment.

[Echoendoscopy in digestive subepithelial lesions: review of the literature]. / Ecoendoscopia nas lesões subepiteliais do trato digestório: artigo de revisão.

Injury or bulging subepithelial mucosal lesions are covered with normal mucosa, usually asymptomatic. Most are diagnosed in radiology or endoscopy, which may correspond to any layer of the body wall (intramural) or non-belonging to the wall (extramural). This article describes studies for analysis of endoscopic ultrasonography (EUS) as a diagnostic method with high accuracy on the finding of subepithelial lesion. The authors review the literature on the endoscopic ultrasound features of subepithelial lesions and differentiation in intra-or extramural, source layer, echogenicity, vascularity, size and margins, fine needle aspiration (FNA) and needle biopsies of type "trucut" for histological analysis. The EUS has the best combination of accuracy in the diagnosis of gastrointestinal wall layer compromised by lesions or masses, besides studying the echogenicity of the lesion, which helps in differential diagnosis. EUS is safe and detailed, considered the best imaging for definitive diagnosis and therapeutic planning of subepithelial lesions.

Ecoendoscopia nas lesões subepiteliais do trato digestório: artigo de revisão / Echoendoscopy in digestive subepithelial lesions: review of the literature

Lesões subepiteliais ou abaulamentos da mucosa são recobertas por mucosa normal e geralmente assintomáticas. Sua maioria é diagnosticada em exames radiológicos ou de endoscopia digestiva e podem corresponder a qualquer camada da parede do órgão (intramural) ou serem extramurais. Este artigo descreve estudos para análise da ultrassonografia após ecoendoscopia (USE) como método diagnóstico de elevada acurácia diante do achado de lesão subepitelial. Trata-se de trabalho de revisão de literatura sobre as características ecoendoscópicas das lesões subepiteliais e diferenciação em intra ou extramurais, camada de origem, ecogenicidade, vascularização, margens e dimensões, punção aspirativa por agulha fina (PAAF) ou biópsias com agulha do tipo trucut. Ambas as formas são aceitáveis) para análise histológica. A ultrassonografia endoscópica tem melhores índices de acurácia no diagnóstico da camada da parede gastrointestinal comprometida por lesões ou massas, além de estudar a ecogenicidade da lesão. A ultrassonografia endoscópica é um método seguro e detalhado, considerado o melhor exame de imagem para diagnóstico definitivo e programação terapêutica das lesões subepiteliais.

Injury or bulging subepithelial mucosal lesions are covered with normal mucosa, usually asymptomatic. Most are diagnosed in radiology or endoscopy, which may correspond to any layer of the body wall (intramural) or non-belonging to the wall (extramural). This article describes studies for analysis of endoscopic ultrasonography (EUS) as a diagnostic method with high accuracy on the finding of subepithelial lesion. The authors review the literature on the endoscopic ultrasound features of subepithelial lesions and differentiation in intra-or extramural, source layer, echogenicity, vascularity, size and margins, fine needle aspiration (FNA) and needle biopsies of type "trucut" for histological analysis. The EUS has the best combination of accuracy in the diagnosis of gastrointestinal wall layer compromised by lesions or masses, besides studying the echogenicity of the lesion, which helps in differential diagnosis. EUS is safe and detailed, considered the best imaging for definitive diagnosis and therapeutic planning of subepithelial lesions.