Marco Antonio Prado Nunes

MEtRIC MEASuREMEntS And AttACHMEnt lEvElS of tHE MEdIAl PAtEllofEMoRAl lIgAMEnt: An AnAtoMICAl Study In CAdAvERS

OBJECTIVE To determine the metric measurements and to verify the attachment levels of the medial patellofemoral ligament in human cadavers. METHODS Seventeen knees (eight right and nine left knees) from 10 cadavers (nine male and one female) were dissected and stored in a 10% formaldehyde solution. All of the knees were whole and did not show any macroscopic signs of injuries. RESULTS The medial patellofemoral ligament was present in 88% of the knees studied, localized transversally between the medial femoral epicondyle and the medial margin of the patella. Its dimensions were quite variable, even between the knees of the same individual. The width of the patellar insertion ranged from 16 to 38.8 mm, with a mean of 27.90 mm, and its mean length was 55.67 mm. The margins of the ligament were concave or rectilinear. At the upper margin, the concave form predominated and was better characterized, while at the lower margin, the rectilinear form predominated. CONCLUSIONS The medial patellofemoral ligament is a very distinct structure with variable anatomical aspects and is always located in a plane inferior to the vastus medialis obliquus muscle.

Internações por pé diabético: comparação entre o custo direto estimado e o desembolso do SUS

This study aimed to analyze costs for treating patients with diabetic foot cared by the public Brazilian Health System (SUS), comparing the estimated cost with the amount of SUS reimbursement. A cohort prospective study carried out in hospitals that provide services for the Unified Health System in Sergipe, involving 109 hospitalization episodes of patients with diabetes and foot ulcers. We follow these patients day by day and estimated the hospital direct cost and the SUS reimbursement. All patients had type 2 diabetes and the majority of ulcers (64,2%) were classified as Wagner 4 or 5. Forty-three (39,4%) healed without amputation and fifty-two (47,7%) healed with amputation. Fourteen (12,8%) patients died. Hospital direct cost ranged from R

Fatores predisponentes para amputação de membro inferior em pacientes diabéticos internados com pés ulcerados no estado de Sergipe

943.72 to R

Prevalência da doença arterial obstrutiva periférica em doentes com insuficiência renal crônica

16,378.85; with an average of R

The Accessory Soleus Muscle: Case Report and a Review of the Literature

4,461.04. The SUS reimbursement varied from R

Diagnóstico e tratamento de aneurisma da artéria isquiática persistente: relato de caso e revisão da literatura

96.95 to R

Origin of the Tendon of the Long Head of the Biceps Brachii Muscle and its Relationship with Glenoid Labrum in Human Foetuses

2,410.18, with an average of R

Venous drainage of the soleus muscle.

633.97, usually seven times low. Smaller difference between costs occurred in patients from the Beneficent hospital and higher rates occurred in those treated with minor amputation.

chronic renal failure

OBJETIVO: Determinar os fatores predisponentes para a amputacao de membros inferiores nos doentes internados com diabetes melito e ulceras nos pes. METODOS: Foram acompanhados os pacientes diabeticos com ulceras nos pes internados no periodo de 6 meses e analisadas as amputacoes nesses doentes em relacao a idade, sexo, amputacao previa, numero de ulceracoes, tempo de diagnostico do diabete, tempo de ulceracao, tempo medio de internacao, gravidade das lesoes, presenca de pulso. RESULTADOS: Verificou-se que 55% (44/80) dos doentes evoluiram para algum tipo de amputacao de membros inferiores; a mediana das idades foi de 61 anos, porem a ocorrencia de amputacao foi significativamente maior na faixa etaria dos 60 aos 90 anos (P = 0,03). Nao se observou uma variacao significativa da mediana do tempo de diagnostico do diabetes, do tempo de ulceracao e do tempo medio de internacao em relacao ao grupo de pacientes que foram amputados. Entretanto, as lesoes mais graves, quando avaliadas pela classificacao de Wagner (P <0,001) e pela ausencia de deteccao dos dois pulsos distais (P <0,001) dos membros inferiores, revelaram-se bastante significativas com relacao ao desfecho de amputacao. CONCLUSAO: Foram considerados fatores predisponentes para a ocorrencia de amputacao nesses doentes a gravidade das lesoes, a ausencia de pulsos e as idades acima de 60 anos.

Prevalncia da doena arterial obstrutiva perifrica em doentes com insuficincia renal crnica

Background: Peripheral occlusive arterial disease has been found to be a sensitive marker of systemic atherosclerosis and a predictor of other cardiovascular diseases. In spite of the high prevalence of the cardiovascular diseases, there are few studies about peripheral occlusive arterial disease in patients with chronic renal failure under hemodialysis treatment. Objective: To determine the prevalence of peripheral occlusive arterial disease in patients with chronic renal failure under hemodialysis treatment at a center of excellence in the State of Sergipe, Brazil. Methods: A cross-sectional study was conducted from June to November 2008 at a center of excellence for the treatment of patients with chronic renal failure. Those patients with the ankle-brachial index (ABI) ≤ 0.9 were diagnosed as having peripheral occlusive arterial disease. Results: From a population of 239 individuals with chronic renal failure, 201 were evaluated. Of that, 28 (14%) had peripheral arterial insufficiency with ABI ≤ 0.9. Their age ranged from 24 to 82 years (mean age = 52 years). Hypertension and dyslipidemia were the more frequent risk factors. Among the patients with peripheral occlusive arterial disease, 89% had dyslipidemia; 71% had high blood pressure; and 29% had coronary diseases. Conclusion: The prevalence of peripheral occlusive arterial disease in patients with chronic renal failure was 14%.