[A young child with acute abdomen and iron deficiency anemia]

The case of a 20 month-old girl that was admitted to the emergency ward because of worsening of her general condition in the setting of acute non-bloody gastroenteritis is reported. The clinical examination revealed signs of severe dehydration and a prominent tender abdomen. Laboratory evaluation showed leucocytosis, elevated C-reactive protein and severe hypochromic microcytic anemia. Abdominal X-ray revealed diffuse meteorism. The child underwent laparascopic evaluation. A perforated Meckel's diverticulum was found. Perforation and anemia due to occult bleeding are unusual presentations of Meckel's diverticulum. The differential diagnosis of children presenting with an acute abdomen with special focus on Meckel's diverticulum is discussed.

Acute abdomen caused by a perforated inflammatory myofibroblastic tumor of the jejunum

Inflammatory myofibroblastic tumors are rare pseudosarcomatous tumors found in virtually all anatomic sites. Our case report describes an elderly female patient with an inflammatory myofibroblastic tumor in the proximal jejunum, accidentally discovered at laparotomy for an acute abdomen. The localization in the jejunum is a very rare finding, and perforation has not been described before.

Endoscopic ultrasound of the canine abdomen

The aim of this study was to develop a standardized procedure for examination of the canine abdomen using endoscopic ultrasound and to describe the organs and structures that could be identified transgastrically. The abdomen of four healthy dogs and two cadavers were examined with endoscopic ultrasound. Five anatomic landmarks were used for standardized imaging of the cranial abdomen. These were the portal vein, splenic head and body, duodenum, left kidney, and aorta. High-resolution images of the following organs and structures could be made: distal esophagus, gastric wall from the cardia to the pylorus, liver, caudal vena cava, hepatic lymph nodes, liver hilus, and associated vessels, trifurcation of the celiac artery as well as the path of its branches and the left pancreatic limb and body. Structures that were more difficult to image were the distal duodenum and right pancreatic limb, the entire jejunum, ileum, and cecum as well as the tail of the spleen. Endoscopic ultrasound allowed excellent visualization of the gastric wall and regional structures without interference with gas artefacts. Centrally located organs such as the pancreas could be well examined transgastrically with endoscopic ultrasound without interference by overlying intestinal segments as is common with transabdominal ultrasound.

Secondary breast reconstruction with deepithelialized free flaps from the lower abdomen for intractable capsular contracture and maintenance of breast volume

Although surgical techniques and the quality of mammary prostheses have been improved significantly in recent years, capsular contracture attendant on prosthetic mammary reconstruction remains a major flaw. Although rarely, some patients are confronted with recurrent and intractable capsular contractures with resultant breast deformity, even after multiple attempts at capsulectomies and implant exchange. Patients with recurrent capsular contracture often do not want replacement with a new prosthesis, but desire the maintenance of their breast volume with a safe alternative. In an attempt to maintain breast volume and to improve the aesthetic appearance, secondary breast reconstruction using bilateral deepithelialized free flaps from the lower abdomen was performed in a series of seven patients. Three bilateral muscle-sparing TRAM flaps, two bilateral DIEP flaps, one bilateral SIEA flap, one unilateral SIEA flap, and one unilateral DIEP flap (a total number of 14 flaps) were used following implant removal, total capsulectomy, and prophylactic subcutaneous mastectomy. The early postoperative course was uneventful, and all flaps survived completely with no complications. There were no donor-site problems, except in one patient (case 5), who had partial skin necrosis of the abdominal flap. The long-term results (mean follow-up: 4.8 years) demonstrated an aesthetically satisfactory appearance of the breasts, with no major donor-site problems. Several advantages, as well as drawbacks, are highlighted with this technique.

Penetrating injuries of the thorax and abdomen: Type of medical-care institution and case fatality

The purpose of this study was to determine, for penetrating injuries (gunshot, stab) of the chest/abdomen, the impact on fatality of treatment in trauma centers and shock trauma units compared with general hospitals. Medical records of all cases of penetrating injury limited to chest/abdomen and admitted to and discharged from 7 study facilities in Baltimore city 1979-1980 (n = 581) were studied: 4 general hospitals (n = 241), 2 area-wide trauma centers (n = 298), and a shock trauma unit (n = 42). Emergency center and transferred cases were not studied. Anatomical injury severity, measured by modified Injury Severity Score (mISS), was a significant prognostic factor for death, as were cardiovascular shock (SBP $\le$ 70), injury type (gunshot vs stab), and ambulance/helicopter (vs other) transport. All deaths occurred in cases with two or more prognostic factors. Unadjusted relative risks of death compared with general hospitals were 4.3 (95% confidence interval = 2.2, 8.4) for shock trauma and 0.8 (0.4, 1.7) for trauma centers. Controlling for prognostic factors by logistic regression resulted in these relative risks: shock trauma 4.0 (0.7, 22.2), and trauma centers 0.8 (0.2, 3.2). Factors significantly associated with increased risk had the following relative risks by multiple logistic regression: SBP $\le$ 70 (RR = 40.7 (11.0, 148.7)), highest mISS (42 (7.7, 227)), gunshot (8.4 (2.1, 32.6)), and ambulance/helicopter transport (17.2 (1.3, 228.1)). Controlling for age, race, and gender did not alter results significantly. Actual deaths compared with deaths predicted from a multivariable model of general-hospital cases showed 3.7 more than predicted deaths in shock trauma (SMR = 1.6 (0.8, 2.9)) and 0.7 more than predicted deaths in area-wide trauma centers (SMR = 1.05 (0.6, 1.7)). Selection bias due to exclusion of transfers and emergency center cases, and residual confounding due to insufficient injury information, may account for persistence of adjusted high case fatality in shock trauma. Studying all cases prospectively, including emergency center and transferred cases, is needed. ^

Aspectos importantes de la anatomía funcional del abdomen para la actividad física

El propósito de ésta ponencia es analizar cuestiones que posiblemente estén estrechamente vinculadas con una problemática que actualmente sufre gran parte de la población, que son los dolores lumbares y cómo profesionales del campo de la Educación física, podemos aportar análisis, ideas y ejercicios concretos para su prevención. Pasando por una breve introducción de anatomía descriptiva y funcional de la zona, me enfocaré tanto en la filogénesis, como en la óntogenesis del ser humano y, a partir de allí, me detengo en destacar el papel fundamental que desarrollan los músculos intrínsecos, de sostén y estabilizadores del complejo lumbo pélvico y el hecho de generar engramas motores que anticipen la contracción (protección) de dichos músculos antes de cualquier movimiento en el que se requiera movimiento de grandes masas musculares

Aspectos importantes de la anatomía funcional del abdomen para la actividad física

El propósito de ésta ponencia es analizar cuestiones que posiblemente estén estrechamente vinculadas con una problemática que actualmente sufre gran parte de la población, que son los dolores lumbares y cómo profesionales del campo de la Educación física, podemos aportar análisis, ideas y ejercicios concretos para su prevención. Pasando por una breve introducción de anatomía descriptiva y funcional de la zona, me enfocaré tanto en la filogénesis, como en la óntogenesis del ser humano y, a partir de allí, me detengo en destacar el papel fundamental que desarrollan los músculos intrínsecos, de sostén y estabilizadores del complejo lumbo pélvico y el hecho de generar engramas motores que anticipen la contracción (protección) de dichos músculos antes de cualquier movimiento en el que se requiera movimiento de grandes masas musculares

Aspectos importantes de la anatomía funcional del abdomen para la actividad física

El propósito de ésta ponencia es analizar cuestiones que posiblemente estén estrechamente vinculadas con una problemática que actualmente sufre gran parte de la población, que son los dolores lumbares y cómo profesionales del campo de la Educación física, podemos aportar análisis, ideas y ejercicios concretos para su prevención. Pasando por una breve introducción de anatomía descriptiva y funcional de la zona, me enfocaré tanto en la filogénesis, como en la óntogenesis del ser humano y, a partir de allí, me detengo en destacar el papel fundamental que desarrollan los músculos intrínsecos, de sostén y estabilizadores del complejo lumbo pélvico y el hecho de generar engramas motores que anticipen la contracción (protección) de dichos músculos antes de cualquier movimiento en el que se requiera movimiento de grandes masas musculares

Mutations in the rotated abdomen locus affect muscle development and reveal an intrinsic asymmetry in Drosophila.

In bilateral animals, the left and right sides of the body usually present asymmetric structures, the genetic bases of whose generation are still largely unknown [CIBA Foundation (1991) Biological Asymmetry and Handedness, CIBA Foundation Symposium 162 (Wiley, New York), pp. 1-327]. In Drosophila melanogaster, mutations in the rotated abdomen (rt) locus cause a clockwise helical rotation of the body. Even null alleles are viable but exhibit defects in embryonic muscle development, rotation of the whole larval body, and helical staggering of cuticular patterns in abdominal segments of the adult. rotated abdomen is expressed in the embryonic mesoderm and midgut but not in the ectoderm; it encodes a putative integral membrane glycoprotein (homologous to key yeast mannosyltransferases). Mesodermal cells defective in O-glycosylation lead to an impaired larval muscular system. We propose that the staggering of the adult abdominal segments would be a consequence of the relaxation of intrinsic rotational torque of muscle architecture, preventing the colateral alignment of the segmental histoblast cells during their proliferation at metamorphosis.

Aprendizaje asistido por pares cercanos como estrategia para el desarrollo de un curso de anatomía humana de abdomen

La demanda de matrícula para ingresar a estudiar la carrera de medicina ha aumentado sustancialmente, además de ser siempre una carrera muy atractiva para la población estudiantil. Esta demanda ha hecho que aumenten las presiones sociales para que las universidades públicas abran más espacios e incrementen la matricula, sin considerar la necesidad de cambios en la infraestructura y el aumento que genera en la plantilla docente. Teniendo en cuenta estas presiones sociales y siguiendo la directriz de lo que hoy en día es la visión 2020 de la Universidad Autónoma de Nuevo León, la cual se sustenta en un eje transversal basado en la innovación académica, con grupos pequeños y con atención personalizada para el alumno, y con dos ejes estructuradores en donde la educación se centra en el aprendizaje y las competencias, nos vemos obligados a considerar técnicas de enseñanza con la intención de cubrir las necesidades elementales para dicho fin. Lo anteriormente expuesto parece indicar que vamos en direcciones opuestas, pues por un lado se incrementa la matrícula y por el otro se implementan grupos pequeños centrados en la atención personalizada del alumno, además la infraestructura de las escuelas públicas no crece de acuerdo a esta demanda y se tiene el mismo número de maestros...