Evolutionary adaptations in the flexor digitorum profundus muscle in Tamandua mexicana (Xenarthra,Myrmecophagidae)

The northern tamandua (Tamandua mexicana) is a neotropical mammal of the order Pilosa, suborder Vermilingua, and family Myrmecophagidae. This species has anatomical and functional adaptations in its forelimb for semiarboreal quadrupedal locomotion. Several studies have reported that the medial head of the triceps brachii and flexor digitorum profundus muscles are fused in species belonging to the family Myrmecophagidae. However, there is no reference to the innervation in these. The triceps brachii muscle is commonly innervated by the radial nerve and the flexor digitorum profundus muscle by the ulnar and median nerves. This study aims to describe the gross anatomy of the flexor digitorum profundus muscle in Tamandua mexicana with respect to the shape, origin, insertion, innervation, and arterial supply. Both forelimbs of nine specimens were used, which were dissected from superficial to deep layers. The formalin-fixed caudomedial forearm muscles were weighed, and the weight percentages of individual forearm muscle specimens were calculated. The flexor digitorum profundus had the highest weight among the forearm muscles and consisted of five heads (three humerals, one radial, and one ulnar). These heads were innervated by median and ulnar nerves; therefore, based on the innervation pattern, we concluded that the medial head of the triceps brachii muscle is not fused with the flexor digitorum profundus. Therefore, the flexor digitorum profundus muscle is highly developed in Tamandua and occupies the caudal part of the arm and forearm, which is an evolutionary adaptation that could have occurred during evolution from the common ancestor of Tamandua and Myrmecophaga.     

Dangerous liaisons: Bacteria,antimicrobial therapies,and allergic diseases

Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy. Microbial therapies, such as probiotics, have been studied in the prevention and treatment of allergic diseases, but evidence remains limited due to studies with high heterogeneity, strain-dependent effectiveness, and variable outcome measures. In this review, we sketch the relation of microbiota with allergic diseases, the overuse and rationale for the use of antimicrobial agents in allergic diseases, and current knowledge concerning the use of bacterial products in allergic diseases. We urgently recommend 1) limiting antibiotic therapy in pregnancy and early childhood as a method contributing to the reduction of the allergy epidemic in children and 2) restricting antibiotic therapy in exacerbations and chronic treatment of allergic diseases, mainly concerning asthma and atopic dermatitis. Future research should be aimed at antibiotic stewardship implementation strategies and biomarker-guided therapy, discerning those patients that might benefit from antibiotic therapy.     

Valores de referencia de la translucencia intracraneal

Objective

To determine reference ranges for intracranial translucency (ICT) in our population.

Material and methods

To assess the relationship between crown-rump length (CRL) and ICT, we performed a linear regression analysis of 471 singleton pregnancies without associated anomalies.

Results

ICT was measured in 98.9%. ICT had a normal distribution with a standard deviation of 0.4139. The mean was 2.0502 mm (0,9-3.6 mm), and the 5% and 95% percentiles corresponded to 1.4 mm and 2.7 mm. ICT had a linear correlation with CRL (ICT: 0.0125 + 1.2628 * CRL; R2: 0,055 P <.0001). The estimated ICT was calculated for the 5th percentile (1.2628 + 0.0125 * LCC) − 0.6505. The intraclass correlation coefficient was 0,816 (0606-0921 CI: 95%).

Conclusions

Measurement of the fourth ventricle during first trimester ultrasound examination is feasible and is simple to perform. An extended neurological evaluation should be carried out if measurements are above the 95th percentile or below the 9th percentile.     

La colposacropexia laparoscópica en el tratamiento del cistocele

Objective

To study the results of sacrocolpopexy in our hospital for the treatment of cystoceles.

Material and methods

A total of 77 patients were treated by laparoscopic sacrocolpopexy. With a minimum mean follow-up of 6 moths, a clinical examination was performed to detect symptoms of prolapse or urinary, sexual and rectal symptoms. Objective cure was defined as < grade 2 prolapse in the Baden-Walker classification.

Results

The mean age was 53.8 + 8.9 years. The mean operating time was 193.6 + 44 minutes. Intra-operative and post-operative complications rates were 11.6% and 19.4%, respectively. The mean length of hospital stay was 2.7 (1-8) days. With a mean follow-up of 15.3 + 12.8 months, the subjective cure rate was 89.6% and the improvement rate was 6.4%. The rate of anatomical recurrence of cystocele was 11.6%. Seventy-five patients reported they were satisfied or moderately satisfied (97.7%)

Conclusion

Laparoscopy sacrocolpopexy appears to be an effective method for the treatment of cystocele.     

Cribado de cáncer cervical con citología y test del virus del papiloma humano cada 5 años: una realidad

Objective

To analyze screening for cervical cancer with a combination of cytology and HPV testing in women older than 35 years every 5 years and to determine whether the application of this protocol delays diagnosis of cervical cancer.

Material and methods

Cervical cancer screening strategies have been applied in our hospital since 2005. HPV testing was introduced in 2010 for women older than 35 years. We performed a retrospective study of 500 women attended in our hospital. We studied whether we had correctly applied the strategy and the recommended time interval of the next review. We analyzed cervical cancers diagnosed in our hospital since 2005.

Results

The strategy was correctly applied in 100% of the women. Screening was performed with both cytology and HPV testing in 45.6% and with cytology alone in 23.2%; no screening was performed in 31.2%. The recommended interval until the next review was 5 years in 26% of the patients. The implementation of the strategy did not delay the diagnosis of cancer. Cervical cancer was diagnosed in 27 women since 2005. Only one woman with adenocarcinoma had been correctly screened (before the introduction of HPV testing). In the last 2 years, four microinvasive carcinomas were diagnosed with this strategy.

Conclusions

A combination of cytology and HPV testing can be applied in women older than 35 years and screening intervals can be increased to 5 years in routine clinical practice. This protocol does not delay the diagnosis of cervical cancer and optimizes resources by lengthening the interval between screening tests in healthy women.     

Obstetric care in a migrant population with free access to health care

Objective

To evaluate differences in obstetric care between immigrant and native women in a country with free access to health care.

Methods

A cross-sectional study was carried out of immigrant mothers delivering in one of the four public hospitals in the Porto, Portugal, metropolitan area between February and December 2012. The comparison group included native Portuguese mothers who delivered in the same institutions. The participants (89 immigrant mothers and 188 Portuguese mothers) were recruited by telephone and completed a written questionnaire during a home visit.

Results

Immigrant women were more likely to have their first pregnancy appointment after 12 weeks of pregnancy (27.0% vs 14.4%, P = 0.011) and to have fewer than three prenatal visits (2.2% vs 0.0%, P < 0.001). They were also more likely to have had a cesarean delivery (48.3% vs 31.4%, P = 0.023), perineal laceration (48.8% vs 11.6%, P < 0.001), or postpartum hemorrhage (33.5% vs 12.3%, P < 0.001).

Conclusion

Migrants were more prone to late prenatal care and to intrapartum complications. Unsatisfactory interactions with healthcare staff may play an important role in these findings.     

Metabolic disorder and obesity in 5027 Brazilian postmenopausal women

Objectives: To evaluate the frequency of obesity in postmenopausal women and assess the potential effects of increased body mass index (BMI) on lipoprotein profile and on risk factors for arterial hypertension and diabetes.

Design: A cross-sectional study was conducted with 5027 postmenopausal Brazilian women. Analyses were performed of BMI and cardiovascular factors (systemic blood pressure [BP], total cholesterol, low-density lipoprotein, high-density lipoprotein [HDL-C], triglyceride, and fast glucose). The statistical analysis included the chi-square and Mann-Whitney tests. The significance level was set at 5%.

Results: Obesity (BMI >30) in our study characterized approximately 30% of the 5027 postmenopausal women. The comparison of patients with normal BMI and those with high BMI showed that high BMI had a significant negative effect on BP, as evidenced by the increased frequency of hypertension in overweight and obese patients (>25) (p?p?p?Conclusion: Our data showed the high frequency of obesity in our population and of the cardiovascular risks (glucose, systemic arterial hypertension, and low HDL-C) associated with high BMI.     

Treatment of simple and complex endometrial non-atypical hyperplasia with natural progesterone: response rate to different doses

The aim of this study is to evaluate the response rate to natural progesterone in non-atypical endometrial hyperplasia and to identify the lowest effective dose. A total of 197 patients of childbearing age with simple or complex hyperplasia were retrospectively identified. The women were treated with a cyclic administration of progesterone at different dosages (100 versus 200 versus 300?mg daily). Endometrial biopsies were performed at 6, 12, 18 months. In comparing progesterone to a regimen of no therapy, a significantly higher remission rate was observed in the progesterone group than in the latter (95 versus 75%, p?=?0.05 for simple hyperplasia; 89 versus 35%, p?相似文献   

Rhinovirus C and Respiratory Exacerbations in Children with Cystic Fibrosis

To investigate a possible role for human rhinovirus C in respiratory exacerbations of children with cystic fibrosis, we conducted microbiologic testing on respiratory specimens from 103 such patients in São Paulo, Brazil, during 2006–2007. A significant association was found between the presence of human rhinovirus C and respiratory exacerbations.     

Overview and update on molecular testing in non-small cell lung carcinoma utilizing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples

Lung carcinoma remains one of the most frequent and aggressive human neoplasms. Fortunately, in the last decades, the increasing knowledge of the molecular mechanisms leading to cancer development has allowed the use of targeted therapies with improvement of prognosis in many patients. Clinical management has also changed after the introduction of endobronchialultrasonographic bronchoscopy that allows a conservative staging of lung tumors, avoiding the need of mediastinoscopy for lymph node staging. Lung pathologists and cytopathologists are facing the challenge of giving the more comprehensive prognostic and predictive information with ever smaller tissue or cytological samples. The aim of this review is to summarize the molecular testing for non-small cell lung carcinoma and how pathologists can contribute to the patient's outcome with a conscious management of biological samples.