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During an ordinary dissection, a cadaver showed a bilateral anomalous origin of the deep brachial artery, where this vessel appeared like a branching of the subscapular artery with common trunk, which included the posterior circumflex humeral artery. The course and distribution of the deep brachial artery in the back compartment were relatively consistent with previous reports. Arterial variations can be damaged through iatrogenic means if not properly documented. The knowledge of this case is very important in clinical medicine and in surgeries in this compartment to prevent any injury.Durante dissecação em prática usual, um cadáver apresentou origem anômala da artéria braquial profunda, na qual este vaso apareceu como um ramo da artéria subescapular com um tronco comum, que incluiu a artéria circunflexa posterior do úmero. O curso e a distribuição da artéria braquial profunda no compartimento posterior foram relativamente coincidentes com relatos prévios. Variações arteriais podem ser danificadas de maneira iatrogênica se não forem adequadamente documentadas. O conhecimento desse caso é muito importante na prática clínica e em cirurgias nesse compartimento para prevenção de qualquer injúria.

O sucesso do atendimento a uma vítima de PCR é determinado pelo reconhecimento precoce da ausência dos sinais vitais e da pronta instituição do suporte básico e avançado de vida. Objetivo:. identificar a conduta e a capacitação do profissional de enfermagem frente uma reanimação cardiorrespiratória na emergência. Metodologia:. Pesquisa de campo, descritiva com abordagem quantitativa. Aplicou-se questionários contendo dez perguntas objetivas sobre RCP a enfermeiros que atuam no setor de emergência do hospital municipal Souza Aguiar, sendo quantificados os erros e acertos obtidos em cada questão e os dados foram analisados por teste estatístico. Resultados:. A capacitação dos profissionais de enfermagem na atuação em uma reanimação cardiopulmonar é insatisfatória, sendo que somente 40,7% tiveram um percentual geral de acertos. Conclusão:. Programas de educação continuada são fundamentais para que a equipe de enfermagem possa manter-se atualizada em relação a novos conhecimentos e protocolos. Descritores: Parada cardíaca, Ressuscitação Cardiopulmonar, Enfermagem em Emergência.

Introduction: We investigated the biomechanical behaviour of different fixations of the tibial posterior malleolus (TPM), simulating distinct situations of involvement of the tibiotalar articular surface (TTAS) through a finite element model (FEM). Material and methods: A 3D computer-aided design model of the left ankle was obtained. The materials used were divided according to their characteristics into ductile and non-ductile, and all materials were assumed to be linear elastic, isotropic, and homogenous. Three different fracture lines of the TPM were defined, with sagittal angles of 10°, 25°, and 45°. For biomechanical comparison, different constructions using a trans-syndesmotic screw (TSS) only (Group T), a one-third tubular plate only with (Group PT) and without (Group PS) a TSS, and a locked compression plate with (Group LCPT) and without (Group LCPS) a TSS were tested. FEM was used to simulate the boundary conditions of vertical loading. Load application regions were selected in the direction of the 700 N Z-axis, 90% on the tibia and 10% on the fibula. Data on the displacement and stress in the FEM were collected, including the total principal maximum (MaxT) and total principal minimum (MinT) for non-ductile materials, total displacement (desT), localized displacement at the fragment (desL), localized displacement at syndesmosis (desS), and Von Mises equivalent stress for ductile materials. The data were analysed using ANOVA and multiple comparison LSD tests were used. Results: For TPM fractures with sagittal angles 10° and 25°, desL in the PT and LCP groups was significantly lower, as well as Von Mises stress in Group LCPT in 10°, and PT and LCPT groups in 25°. For TPM fractures with a sagittal angle of 45°, desL in the LCP group and Von Mises stress in Group LCPS and LCPT were significantly lower. We found that any TPM fracture may indicate instability of the distal tibiofibular syndesmosis, even when the fragment is small. Conclusion: Our study showed that in fragments involving 10% of the TTAS, the use of a TSS is sufficient, but when the involvement is greater than 25% of the TTAS, either a non-locked or locked plate must be used to buttress the TPM. In posterior fragments affecting 45% or more of the TTAS, the use of a locking plate is recommended.

Introduction The clitoris is partially responsible for sexual arousal. The integrity of the extracellular matrix is essential for clitoral erection. Sexual dysfunction is a phenomenon associated with age. Material and methods The clitoris of cadavers of 20- to 80-year-old women was excised and histologically processed. Stereological analysis was performed to quantify the volumetric density of collagen, elastic fibers, and smooth muscle. Results A significant increase in collagen and a decrease in smooth muscle and elastic fibers were observed in older women. Conclusions In short, these changes caused by aging could contribute to female sexual dysfunction concerning clitoral orgasm.

Introduction: The Caroticoclinoid Foramen (CCF) is a variation found in the sphenoid. It gives passage to the internal carotid artery and it is a surgically significant structure when dealing with the cavernous sinus. There is debate, however, regarding its prevalence, especially in populations from South America. Aim: To assess the prevalence and size of the CCF in a Brazilian sample. Materials and Methods: This was a cross-sectional study carried out for a period of 10 months during March 2019 and January 2020. The present study was conducted in 365 dry human skulls from two Universities in the Southeast region of Brazil. The caroticolinoid foramen was observed and if present, measured. Results: Of the 365 skulls examined, the foramen was present in 101 (prevalence of 27.6%). The foramen was bilateral in 88 cases, while 13 skulls presented this variation unilaterally (7 on the right and 6 on the left side). Regarding its classification, out of 190 CCF analysed, 69 were pertaining to the complete type, while 120 cases were classified as incomplete and 1 from the contact type. The mean anteroposterior diameter was 4.87±0.69 mm (right side) and 4.86±0.79 mm (left side), and the Transverse Diameter (TD) was 4.85±0.75 mm (right side) and 4.74±0.73 mm (left side). Sixty-nine skulls had data regarding sex and age. The age ranged from 1 month old to 104-year-old (mean of 37.79±21.85-year-old). The male to female ratio was 2:1, being the only relation with statistical significance (p

Abstract The right subclavian artery may originate from the left portion of the aortic arch. This aberrant vessel is known as the arteria lusoria. Its course to its usual site runs behind the esophagus, which may cause a disease known as dysphagia lusoria, responsible for symptoms of discomfort. This artery is often associated with other anomalies, such as the non-recurrent laryngeal nerve and the bicarotid trunk, and with diseases such as aneurysms, congenital heart defects, and even genetic syndromes. During routine dissection of a male cadaver fixed in 10% formalin solution, an arteria lusoria was found. This article reports the variation and discusses its embryological, clinical and surgical aspects.

Introduction: Malnutrition is a world health problem and has high incidences in developing countries. It is known that the nutritional status of the mother during gestation and lactation affects the growth and development of its child. Maternal malnutrition during breastfeeding has been shown to cause alterations of thyroid function and bone tissue. Aim: The present study aimed to evaluate the chronic effects in bone tissue of energy-protein restriction in rats during lactation period through a histological and morphometric analysis of the cortical mass of the femur. Materials and Methods: At parturition, Wistar rat dams were divided in three groups: (1) Control group - which received 23% protein diet without restrictions; (2) Protein-Energy restriction group - which received 8% protein diet; (3) Energy restriction group - which received 23% protein diet in limited amounts, according to the ingestion of the second group. Each group had 12 pups. After weaning, all pups were separated from its dams and received free access to 23% protein diet until 180 days and then euthanized. Afterwards, the femur of these specimens were excised and fixed in 4% formaldehyde solution and decalcified by EDTA. 10 µm thick transverse sections on the middle third of the femur diaphysis were performed. Then, the tissue was stained with Haematoxylin/Eosin and analysed under a microscope. Results: The cortical area of the control, energy restriction and protein-energy restriction groups were, respectively: 6.54±0.23 µm, 5.51±0.29 µm and 6.18±0.19 µm, while the medullary cavity showed the following results: 3.65±0.16 µm, 4.1±0.20 µm and 3.53±0.12 µm. Reduction of the cortical area and an increase of medullary zone were observed on the protein-energy restriction group. Conclusion: Maternal malnutrition during lactation has negative effects on femur growth even after normalization of the diet in adult aged Wistar rats.

Abstract Parkes-Weber syndrome is a congenital vascular disease that comprises capillary, venous, lymphatic, and arteriovenous malformations. Although Parkes-Weber syndrome is a clinically distinct entity with serious complications, it is still frequently misdiagnosed as Klippel-Trenaunay syndrome, which consists of a triad of malformations involving the capillary, venous, and lymphatic vessels, without arteriovenous fistulas. Both syndromes are generally diagnosed with Doppler ultrasound and confirmed by magnetic resonance angiography. The aim of this study is to describe one case of Klippel-Trenaunay syndrome, in a 36-year-old patient, and one case of Parkes-Weber syndrome, in a 21-year-old patient. We review the literature in order to discuss the possible causes and consequences of these diseases related to venous hypertension and angiodysplasia, taking a clearer approach to their differences, and discussing their treatment.

PURPOSE: To perform a quantitative assessment of different types of pelvic ureter tissues with chronic dilation in adults, using stereological methods. METHODS: We analyzed fragments of dilated pelvic ureters obtained from 6 patients aged between 35 and 67 years (mean, 46 years) who underwent ureteral reimplantation surgery for different reasons. The obstruction duration ranged from 27 to 180 days (mean, 93 days). The control group included fragments of normal pelvic ureters obtained during nephrectomy in 7 kidney transplant donors (age: range, 25-51 years; mean, 36 years). The volumetric density of collagen in the ureter, elastic fibers, and smooth muscle fibers was assessed. RESULTS: The volumetric density (Vv) of collagen showed no significant difference between the two groups (control: 45.3 ± 6.1; dilated: 40.8 ± 6.9; P = 0.23). A statistically significant increase in Vv of elastic fibers was observed in the dilated ureters (control: 18.4 ± 1.2; dilated: 24.6 ± 5.4; P = 0.03). A statistically significant increase in the Vv of smooth muscle fibers was observed in the dilated ureter (control: 42.0 ± 6.0; dilated: 56.2 ± 6.1; P = 0.001). CONCLUSION: The chronically dilated pelvic ureters had significantly more elastin and smooth muscle contents than the controls.

O conhecimento das variações anatô- micas é importante para procedimentos cirúrgicos e radiológicos e tem um significado prático e teórico para a pesquisa experimental e a prática cirúrgica em animais domésticos. O objetivo deste estudo foi descrever a origem, esqueletopia e medida da artéria celíaca em gatos. As dissecções foram realizadas em 30 cadáveres de gatos adultos, 15 machos e 15 fêmeas, com média do comprimento rostro-sacral de 47,9cm e 46,6 cm respectivamente. Os gatos foram posicionados em decúbito lateral direito e feita uma incisão torácica para remoção da 6ª e 7ª costelas para canulação da porção torácica da aorta. Em seguida, o sistema vascular foi lavado com solução salina, fixado com solução de formaldeido a 10% e preenchidos com solução de Petrolátex S-65 corado. Após cinco dias imersos em solução de formaldeido a 10%, todos os animais foram lavados em água corrente. A artéria celíaca foi dissecada e medida “in situ”. A artéria celíaca surgiu como uma artéria única em 15 (100%) fêmeas examinadas. Nos machos a artéria celíaca surgiu como uma artéria única em 12 (80%) gatos; em três (20%) gatos foi observada a presença do tronco celíaco-mesentérico. O comprimento médio da artéria celíaca nas fêmeas foi de 1,32 cm, emergindo em nível da 13ª vértebra torácica em dois (13,3%) animais, entre a 13ª vértebra torácica e a 1ª vértebra lombar em um (6,7%) animal, em nível da 1ª vértebra lombar em seis (40%) animais, e entre a 1ª e 2ª vértebra lombar em seis (40%) animais. O comprimento médio da artéria celíaca no sexo masculino foi de 1,27 cm, emergindo em nível da 13ª vértebra torácica em três (20%) animais, entre 13ª vértebra torácica e 1ª vértebra lombar em três (20%) animais, em nível da 1ª vértebra lombar em quatro (26,7%) animais, entre a 1ª e 2ª vértebra lombar em um (6,7%) e em nível da 2ª vértebra lombar em quatro (26,7%) animais. Não foi observada relação entre o comprimento da arté- ria celíaca em função do comprimento rostro-sacral. A origem da artéria celíaca independe do sexo.

OBJETIVO: Investigar os efeitos da desnutrição proteica materna durante a lactação sobre as fibras elásticas da traqueia de filhotes de ratos Wistar. MÉTODOS: Ao nascimento, 12 filhotes machos de duas ratas Wistar foram igualmente divididos em dois grupos: grupo controle, cuja mãe recebeu água e dieta padrão de laboratório ad libitum durante a lactação, e grupo restrição proteica (RP), cuja mãe recebeu água ad libitum e dieta isoenergética com RP (8% de proteína). Aos 21 dias de vida, os filhotes foram sacrificados, e suas traqueias foram ressecadas. As fibras elásticas foram coradas pelo método de resorcina-fucsina de Weigert (precedido de oxidação) e avaliadas sob microscopia óptica. As determinações morfométricas foram feitas por estereologia, utilizando o método de contagem de pontos, e expressas em densidade volumétrica. RESULTADOS: As fibras elásticas foram identificadas abaixo da mucosa traqueal, sendo a maioria em distribuição longitudinal. Além disso, camadas circulares bem definidas de fibras elásticas envolviam as superfícies interna e externa do anel cartilaginoso. Não houve diferenças entre os grupos quanto à organização e distribuição das fibras elásticas. A densidade volumétrica das fibras elásticas dos filhotes nos grupos controle e RP foi de, respectivamente, 2,46 ± 0,99% e 3,25 ± 1,13% (p < 0,01). CONCLUSÕES: Nossos resultados sugerem que a densidade volumétrica de fibras elásticas é maior em filhotes de ratos alimentados por fêmeas submetidas a dieta com RP do que naqueles de mães recebendo dieta normal.OBJECTIVE: To investigate the effects of maternal protein malnutrition during lactation on the elastic fibers in the tracheas of Wistar rat pups. METHODS: At delivery, 12 male pups of two Wistar rat dams were equally divided into two groups: control, in which the dam received water and standard rat chow ad libitum during lactation; and protein-restricted (PR), in which the dam received water ad libitum and an isoenergetic PR diet (8% protein). At 21 days of age, the pups were killed and their tracheas were excised. The elastic fibers were stained with Weigert's resorcin-fuchsin (after oxidation) and evaluated under light microscopy. Morphometric determinations were performed by stereology, with the point-counting method, and expressed as volumetric densities. RESULTS: Elastic fibers, most having a longitudinal distribution, were identified beneath the tracheal mucosa. In addition, well-defined circular layers of elastic fibers were found around the inner and outer surfaces of the cartilaginous ring. There were no differences between the groups regarding the organization and distribution of the elastic fibers. The volumetric density of the elastic fibers of the pups in the control and PR groups was 2.46 ± 0.99% and 3.25 ± 1.13%, respectively (p < 0.01). CONCLUSIONS: The volumetric density of elastic fibers appears to be greater in rat pups breastfed by dams receiving a PR diet than in those breastfed by dams receiving a normal diet.

In the study 30 specimens of adult New Zealand rabbits, 13 males and 17 females were used. After fixed with 10% formaldehyde solution and performing the injections with latex solution stained with pigment, the animals were dissected to identify the disposition of the lienal arteries. The statistical analysis was made by the Qui-square (X2) test, with a 5% level of significance, to test if the nullity hypothesis is true for the of lienal artery main ramifications. The relations between the lienal artery and spleen length with rostrum-sacral length were calculated by the correlation coefficient “r” varying between -1 and +1, that is, -1 ? r ?+1. The mean length of the lienal artery was 5.96 cm. In all (100%) dissected rabbits the lienal artery, originated directly from the celiac artery as an only one artery giving different numbers of branches to the spleen: one branch in seven (23.3%) animals, two branches in seven (23.3%) animals, three branches in 10 (33.3%) animals, four branches in four (13.3%) animals and five branches in two (6.7%) animals. From the spleen, the lienal artery gave different numbers of branches to the stomach greater curvature: one branch in seven (23.3%) animals, two in four (13.3%) animals, three in five (16.7%) animals, four in three (10%), and five in only one (3.3%) animal. Positive correlation was observed between the lienal artery and spleen length with the rostrum-sacral length. The number of lienal artery branches is not gender dependent.Na presente pesquisa foram utilizados 30 espécimes de coelhos adultos Nova Zelândia, 13 machos e 17 fêmeas. Após fixação com solução de formaldeido a 10% e preenchimento do sistema arterial com solução de látex corado procedeu-se a dissecção para a observação da disposição das artérias lienais. A análise estatística foi realizada através teste do X2 (Qui-quadrado), ao nível de significância de 5%, para testar se a hipótese de nulidade é verdadeira para o número de ramificações principais da artéria lienal. As relações do comprimento da artéria lienal e do baço em função do comprimento rostro-sacral foram calculadas através do coeficiente de correlação “r”, que pode variar entre -1 e +1, isto é, -1 £ r £ +1. A média do comprimento da artéria lienal foi de 5,96 cm. Em todos os coelhos dissecados (100%) a artéria lienal se originou diretamente da artéria celíaca como uma artéria única, emitindo diferentes ramos para o baço: um ramo em sete (23,3%) animais, dois ramos em sete (23,3%) animais, três ramos em 10 (33,3%) animais, quatro ramos em quatro (13,3%) animais e cinco ramos em dois (6,7%) animais. Do baço a artéria lienal emitiu diferentes números de ramos para a grande curvatura do estomago: um ramo em sete (23,3%) animais, dois em quatro (13,3%) animais, três em cinco (16,7%) animais, quatro em três (10%), e cinco em apenas um (3,3%) animal. Foi observada correlação positiva entre o comprimento do baço e da artéria lienal em função do comprimento rostro-sacral. O número de ramificações da artéria lienal independe do sexo do animal.

ABSTRACT The first cervical vertebra is subject to numerous anatomical variations. One of these is posterior arch agenesis, which is classified into five distinct morphological types. Together, all types of posterior arch agenesis comprise only 4% of atlas variations. Furthermore, complete agenesis of the posterior arch associated with the presence of the posterior tubercle is rare. This work reports a case of posterior arch agenesis with the presence of the posterior tubercle in a 33 year-old male victim of a motor vehicle collision. Despite being asymptomatic, this anatomical variation can present with headaches and neck pain. It is mostly found as an incidental finding in imaging studies performed by the emergency team and, as a result, it is often misdiagnosed as a C1 fracture. Knowledge of the variations relating to the first cervical vertebra is therefore essential to avoid delays in diagnosis and treatment of polytraumatized patients. Level of evidence V; Case report.