Role of age, bowel function and parity on anorectocele pathogenesis according to cinedefecography and anal manometry evaluation.

OBJECTIVE: The study aimed to verify the role of parity, age and bowel function in the pathogenesis of anorectocele. METHOD: A cross-sectional study was conducted regarding age, obstetrical history, Cleveland Clinic Constipation Score (CCCS), cinedefecography and anal manometry findings. Forty-five adult women complaining of obstructed defecation were evaluated; the median age was 46 years and median CCCS, 13. Fifteen patients were nulliparous and 23 multiparous (median parity 2). Eighteen had a history of episiotomy, fourteen delivered large babies and two had forceps-assisted delivery. Statistical analysis was performed using Spearman's correlation test and Fisher's exact test. RESULTS: Anal hypertonia was found in 14 (31.1%) patients, anal hypotonia in eight (17.8%), anismus in 13 (28.9%) and anorectoceles in 34 (75.6%) [median size 2.8 cm (0-6.4)]. There were no correlations between anorectocele and anal hypertonia (P = 0.7171), anismus (P = 0.4666), parity comparing nulliparous and multiparous patients (P = 1.000), episiotomy (P = 1.0000), forceps assistance (P = 1.0000), delivery of a large baby (P = 1.0000) anal resting pressure (P = 0.0883), anal voluntary pressure (P = 0.7327), parity (P = 0.4987) and age (P = 0.8603). There were correlations between anorectocele and the CCCS (P = 0.0082) and anal hypotonia (P = 0.0141). CONCLUSION: Anorectocele is not correlated with parity, age, episiotomy, delivery of a large baby and anismus. It was more frequent in patients with severe constipation and less common in patients with anal hypotonia.

[Brazil 500 years. A Jesuit anatomical nomenclature at the time of discovery]. / Brasil 500 anos. Nomenclatura anatômica de um jesuíta no tempo do descobrimento.

The purpose of rendering easier for priests to hear confessions from Brazilian indians, in the beginning of the colonization of Brazil by the Portuguese, and in order to serve indians for better communication led Pero de Castilho, a jesuit born in Vila do Esp¿rito Santo, to prepare a list of names of parts of the human body. Such a list of tupi (language of the native indians) and portuguese terms of anatomical structures, in alphabetical order, seems to be the first Nomina Anatomica published in Brazil. Such a bilingual vocabulary constitutes a subsidy for the study of both languages spoken soon after the discovery of Brazil and represents a religious related document that contributes to the history of anatomy and medicine.

Brasil 500 anos: nomenclatura anatômica de um jesuíta no tempo do descobrimento / Brazil 500 years: a jesuit anatomical nomenclature soon after the discovery

Com o fito de facilitar aos padres as confissões de indígenas brasileiros, no início da colonização do Brasil pelos Portugueses e para auxiliar os índios em sua comunicação, PERO de CASTILHO, um jesuíta nascido em Vila do Espírito Santo, foi levado a preparar uma lista de nomes de partes do corpo humano. Essa lista, de termos Tupis (na língua nativa dos índios) e portugueses, das estruturas anatômicas, em ordem alfabética, parece ser a primeira Nomina Anatomica publicada no Brasil. Tal vocabulário bilingüe constitui um subsídio para o estudo de ambas as línguas faladas logo após o descobrimento do Brasil, e representa um documento de caráter religioso que contribui para a história da anatomia e da medicina.