Vera Lúcia Corrêa Feitosa

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.

Optical anisotropy of a pig tendon under compression

The proximal region of the superficial digital flexor tendon of pigs passes under the tibiotarsal joint, where it is subjected to compressional and tensional forces. This region was divided into a surface portion (sp), which is in direct contact with the bone and into a deep portion (dp), which is the layer opposite the articulating surface. The purpose of this work was to analyse the distribution and organisation of the collagen bundles and proteoglycans in the extracellular matrix in sp and dp. Toluidine‐blue‐stained sections were analysed under a polarising microscope. Strong basophilia and metachromasia were observed in sp, demonstrating accumulation of proteoglycan in a region bearing compression, but the intensity was reduced the further layers were from the bone. Linear dichroism confirmed that the glycosaminoglycan molecules were disposed predominantly parallel to the longest axis of the collagen fibrils. Birefringence analysis showed a higher molecular order and aggregation of the collagen bundles in areas where the tension was more prominent. The crimp pattern was more regular in dp than in sp, probably as a requirement for tendon stretching. The optical anisotropy exhibited by the collagen bundles also confirmed the helical organisation of the collagen bundles in the tendon. Hyaluronidase digestion caused a decrease in the basophilia, but this was not eliminated, supporting the idea that in the matrix, proteoglycans are not completely available to the enzyme action.

Evaluation of agreement between clinical and histopathological data for classifying leprosy

BACKGROUND The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy. METHODS A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients. RESULTS The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively. CONCLUSION Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.

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

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%.

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

Durante una diseccion de rutina, se encontro un musculo soleo accesorio, en la pierna izquierda de un cadaver masculino. El musculo se localizaba posteromedialmente en la pierna, entre los musculos flexor largo de los dedos y largo del halux. Su origen estaba en el tercio superior de la fascia anterior del musculo soleo y su insercion se realizaba, a traves de un tendon en la superficie anteromedial del hueso calcaneo

Absorption Levels and Morphological Features of Fetal Organs in Wistar Rats Treated with Lead Acetate

El plomo es un metal pesado utilizado en la industria. El envenenamiento debido a la exposicion prolongada por plomo es una enfermedad profesional conocida por muchos anos. La toxicidad del plomo es muy expresiva y puede poner en peligro el modelo estructural y funcional de los organos y sistemas. El objetivo de este estudio fue examinar los pulmones y rinones de fetos de ratas Wistar expuestos al acetato de plomo. En este estudio, 20 fetos de ratas Wistar previamente tratados con acetato de plomo durante la gestacion, tuvieron sus organos disecados, fijados, incluidos en parafina y tenidos con hematoxilina y eosina. Macroscopicamente, los organos fetales tratados por este metal fueron comparados con los organos de fetos controles en relacion a forma, color y consistencia. Microscopicamente, se encontraron lesiones en el rinon que se caracterizaron por esclerosis vascular, atrofia o hiperplasia de celulas, fibrosis intersticial progresiva, presencia de cuerpos de inclusion que contenian acetato de plomo y esclerosis glomerular. En el pulmon se observo desorganizacion del parenquima impregnado con acetato de plomo, formacion de fibrosis, liquido intersticial, reduccion de los espacios alveolares y edema alveolar. Estos cambios se correlacionaron con el nivel de absorcion de acetato de plomo, determinado por espectrometria atomica.

Estudo histomorfométrico de anastomoses primárias de cólon em coelhos, com e sem preparo intestinal

Colon laudering is used in many colon surgeries. The LIATO, that promotes cleanness of colon, demonstrates an increase of the surgical time and increase risk of infection. This study compares colonic anastomosis with and without preparation, through histomorfometric analysis. 30 rabbits were submitted to the surgery treatment and had been evaluated and divided in groups: group 1 (control) and group 2 (LIATO). Carried through statistical study with the program Prism® 4 for p< 5%. The analisis found acute inflammatory infiltrated with discrete bigger average in the anastomoses of group 2. Chronic inflammatory infiltrated with average of 1,9 in the anastomoses of group 2 and of 2,1 in the ones without preparation. Necrosis in 15,7% in the LIATO against 13,5% in the group without preparation. Calcium deposit in 43% of the anastomoses with preparation and in 30%, of the ones without preparation. Bigger colagen concentration were met in the anastomoses made with the intestinal laudering. Incidence of interlaced colagen fibres was observed in 86% of the anastomoses of the searched one and in 70% in the control group. We conclude that the LIATO presents better incidence of interlaced colagen fibres and fibre concentration resulting in better anastomosis.

Clinical variables associated with disability in leprosy cases in northeast Brazil

INTRODUCTION The clinical outcomes of leprosy include complications such as physical disabilities and deformities that vary according to the degree of impairment of nerve trunks. Knowledge of the factors that lead to the development of these complications is important for disability prevention programs. This study aimed to evaluate clinical factors associated with the occurrence of physical disability in leprosy cases. METHODOLOGY This was a retrospective study of 2,358 cases of leprosy in Aracaju, northeast Brazil, between 2001 and 2011. Analysis was done using the Chi-square test and logistic regression model. RESULTS Significant factors associated with disability were found to be male gender, having more than two affected nerves, multibacillary leprosy classification, leprosy reaction, and lepromatous leprosy. The multivariate analysis revealed that the associated factors included having more than two affected nerves, leprosy reaction (adjusted odds ratio [aOR]: 2.02, 95% confidence interval [CI]: 1.36 to 3.01), the multibacillary form (aOR: 2.74, 95% CI: 1.84 to 4.08), and lepromatous leprosy (aOR: 4.87, 95% CI: 2.86 to 16.08). CONCLUSIONS The number of affected nerves, leprosy reaction, operational classification, and clinical presentation were identified as the main factors associated with the development of disability in leprosy patients.

Improvement of wound tissue repair by chitosan films containing (-)-borneol, a bicyclic monoterpene alcohol, in rats.

The aim of this study was to investigate the wound‐healing activity of (–)‐borneol (BOR) incorporated in chitosan film on healing protocol in rodents. To assess the BOR wound‐healing potential, male Wistar rats were subjected to a full‐thickness excisional wound. The animals were divided into three groups: dressed with chitosan‐based film (QUIN); dressed with chitosan‐based film containing 0·5% BOR (QUIBO05); or dressed with chitosan‐based film containing 1% BOR (QUIBO1). Dressing the wound areas and histological analysis were performed on the 3rd, 7th, 14th, and 21st days. The myeloperoxidase (MPO) activity was assessed on the third and seventh days after surgical procedures. Wounds dressed with chitosan‐based film containing BOR reduced significantly the MPO activity (P < 0·001), showed significantly larger wound retraction rates (7 days, P < 0·05), improved the granulation reaction, and also provided better collagenisation density and arrangement during wound healing. It is suggested that BOR modulates the wound‐healing process and is a promising compound to be used in wound care. This product may be quite useful in improving wound healing and could be a new biotechnological product with healing properties and clinical application. Further ongoing studies will enable us to understand the precise mechanisms whereby BOR improves the wound‐healing process.

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

A persistencia da arteria isquiatica e uma variacao anatomica rara cujo curso clinico e potencialmente grave, pois o diagnostico ocorre quando ja estao presentes complicacoes clinicas. Essas complicacoes advem do fato de a parede da arteria isquiatica ter uma tendencia a degeneracao ateromatosa com formacao aneurismatica, podendo evoluir para uma oclusao ou para um tromboembolismo. Este artigo relata o caso de um paciente do sexo feminino, com queixas de dor intensa secundaria a compressao extrinseca do nervo isquiatico pela dilatacao aneurismatica no membro inferior direito e pulsatilidade na nadega ipsilateral, apresentando uma massa hiperpulsatil nessa localizacao. Foi realizado exame angiografico, que revelou persistencia da arteria isquiatica a direita, do tipo completo e com aneurisma. A paciente foi submetida a procedimento cirurgico, sendo utilizada uma abordagem transglutea, e uma protese de dacron terminoterminal foi interposta entre os colos proximal e distal do aneurisma. Os aspectos tecnicos e revisao da literatura sobre o diagnostico e a terapeutica dessa variacao anatomica sao discutidos neste trabalho.