Modified 'Stent-Graft Sandwich' Technique for Treatment of Isolated Common Iliac Artery Aneurysm in Patient With Marfan Syndrome

Isolated iliac artery aneurysms are rare in the general population (0.03%) and represent 2% of all abdominal aneurysms, and the association with Marfan syndrome is even rarer. We report a Marfan syndrome case with an isolated common iliac artery aneurysm treated by using a modified 'stent-graft sandwich' technique, with preservation of the internal iliac artery perfusion. The modified 'stent-graft sandwich' technique involves building an appropriate proximal neck just in the common iliac artery for fittingly housing two new stent-grafts inside, both deployed simultaneously and each one going to both distal iliac arteries (internal and external).

O papel do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática dos membros inferiores

O diagnóstico da trombose venosa profunda sintomática está bem estabelecido com o uso do mapeamento dúplex, que apresenta sensibilidade de 100% e especificidade de 98%, para trombose venosa profunda proximal, e sensibilidade de 94% e especificidade de 75%, para distal. Na trombose venosa profunda recente e assintomática, o diagnóstico com o mapeamento dúplex ainda não está bem estabelecido, mostrando uma queda na acurácia desse método diagnóstico. Essa queda é devida ao fato de o trombo recente não ser oclusivo, apresentar a mesma ecogenicidade do sangue e uma consistência diminuída, prejudicando o teste da compressibilidade, que é o mais sensível para diagnóstico da trombose venosa profunda. Nesta revisão, serão revistos artigos publicados que avaliaram a acurácia do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática.

Scintigraphic validation of AC Biosusceptometry to study the gastric motor activity and the intragastric distribution of food in humans

Abnormal intragastric distribution of food (IDF) and a phasic contractility in the proximal stomach have been related to dyspeptic symptoms. Thus, the behaviour of the stomach and the proximal region, in particular, continues to attract attention and demand for reliable and comfortable techniques. The aims of this study were to employ AC Biosus-ceptometry (ACB) and scintigraphy to evaluate IDF and gastric motor activity in humans. Fifteen healthy volunteers ingested 60 mL of yogurt containing 2 mCi of Tc-99m and 4 g of ferrite. Each volunteer had gastric motility and IDF evaluated twice on separate days; on one occasion by ACB and another by scintigraphy. Digital signal processing was performed in MatLab (Mathworks Inc., Natick, MA, USA). Results were expressed as mean +/- SD. Similar results of distal accumulation time (P < 0.001) were obtained for scintigraphy (6.93 +/- 3.25 min) and for ACB (7.04 +/- 3.65 min). Fast Fourier Transform revealed two dominant frequencies (P > 0.9). Besides the well-know frequency of 3 cpm, our results showed identical frequencies in proximal stomach recordings (P < 0.001) for scintigraphic (1.01 +/- 0.01 cpm) and ACB (0.98 +/- 0.06 cpm). In summary, our data showed that scintigraphy and ACB are promising techniques to evaluate several aspects of gastric motility. Moreover, ACB is non-invasive, radiation-free and deserves the same importance as conventional methods for this kind of analysis.

AC Biosusceptometry Technique to Evaluate the Gastrointestinal Transit of Pellets under Influence of Prandial State

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Trombectomia na angioplastia primária em ponte de safena

O emprego da trombectomia na angioplastia primária demonstra bons resultados clínicos e angiográficos imediatos, por meio de redução da embolização distal e do fenômeno do no-reflow e otimização da perfusão miocárdica. Essa técnica, principalmente usada em artérias coronárias, em raras oportunidades é descrita quando empregada em pontes de safena aortocoronarianas. Relatamos o caso de um paciente de 67 anos com infarto agudo do miocárdio relacionado a oclusão de ponte de safena e submetido a trombectomia com bons resultados.

Restoration of sensitivity after removal of the sural nerve: a new application of lateroterminal neurorraphy

Os autores propõem o emprego da neurorrafia término-lateral do coto distal do nervo sural na face lateral do nervo fibular superficial para evitar anestesia ou hipoestesia na face lateral do pé após a retirada do nervo sural para enxertia. A proximidade anatômica entre os nervos em questão tornam o procedimento simples, sem aumentar o tempo cirúrgico. A neurorrafia término-lateral proposta não prejudica as estruturas inervadas pelo nervo doador .

Tegu (teiu) bite: Report of human injury caused by a Teiidae lizard

Lizards of the Teiidae family are large reptiles measuring up to 2 meters long. If threatened, they can demonstrate aggressive behavior by whipping their tail and occasionally biting. Here, we report a severe injury following a Teiidae lizard bite on the right index finger of a human. There was significant soft tissue damage and an avulsion fracture of the distal phalanx. He was treated with conservative wound care and prophylactic antibiotics. He developed no evidence of secondary infection and underwent delayed skin grafting.

The embracing end-to-side neurorrhaphy in rats

OBJETIVO: Comparar dois novos métodos com o método tradicional da neurorrafia término-lateral. MÉTODOS: Os ratos foram separados em quatro grupos. No grupo A-E o nervo peroneal foi seccionado e o coto distal foi suturado à lateral do nervo tibial com dois pontos de nylon 10-0. No grupo A-D duas abas de epi-perineuro abraçaram o nervo doador. No grupo B-D foi realizada sutura com um único ponto abraçando o nervo doador. O grupo B-E foi o controle. Após seis meses foram observados massa do músculo tibial cranial e morfometria do coto distal do nervo peroneal. RESULTADOS: Foi encontrada menor massa muscular nos grupos A-D, A-E e B-D quando comparados com o grupo B-E (p<0.0001) e mesma massa quando comparados entre si (p>0,05). Os grupos A-D, A-E e B-D apresentaram menor número de fibras nervosas quando comparados ao grupo B-E (p=0,0155; p=0,016; p=0,0021) e mesmo número quando comparados entre si. CONCLUSÃO: Os três tipos de neurorrafia não apresentaram diferenças relacionadas à massa muscular e número de fibras nervosas sugerindo que a sutura abraçante com apenas um ponto apresente grande potencial em áreas cirúrgicas mais profundas.

Estudos sedimentológicos e o contexto estrutural da formação Serra do Martins, nos platôs de Portalegre, Martins e Santana/RN

This dissertation deals with sedimentological and structural framework of the siliciclastic rock of the Serra do Martins Formation (FSM) in the Portalegre, Martins and Santana plateau, located to the south of Potiguar Basin, in the southwest and central Rio Grande do Norte state. This formation, regarded as of Oligo-Miocene age based on intrusive relations of the Miocene Macau volcanics, has a still disputable age due to the lack of appropriate bio and/or chronostratigraphic markers. The FSSM deposits crop out along 650 to 750 m high plateau, as a remanescent sedimentary cover directly overlying topographically uplifted pre-cambrian crystalline rocks. During the last decades, these deposits were interpreted according to a Tertiary paleoclimatic evolutionary model, associated to pedogenetic processes. The sedimentological characterization of the FSM was done through a detailed study of its facies, petrography and diagenetic features. The facies study was based on description of field relations, textures and structures, the piling up of the strata and their lateral variations. The FSM was deposited by an anastomosing to coarse-meandering fluvial system, including deposits of lag, cannel-fill, ouver-bank and flood plain. The petrographic composition of the sediments, coupled to their facies and paleocurrent directions, suggest a rather distal sourcearea, to the south of the present plateau. The diagenetic study identified an incipient grain mechanical compaction, pronounced dissolution of the framework, matrix and/or cement components, intense precipitation of kaolinite, silic and, eventually, iron oxides, besides mechanical infiltration of the clays. Most of these events, regarded in the literature as associated to near-surface conditions (eo or telodiagenesis), indicate the FSM sediments were never deeply buried. Topographic relations along longitudinal and transversal sections reaching the Potiguar Basin to the north identified regional dips that allow to discuss stratigraphic correlations between the FSM and the basin formations. The sedimentological features of the different units and the intrusive relations of the Macau volcanics were also considered in these correlations,which support the Oligo-Miocene age previously accepted for the FSM. Concerning the tectonic framework of the FSM, this work investigated the pre-cambrian to cretaceous heritage and the cenozoic deformation, allowing the recognition of pre-, sin and post-FSM structures. The crystalline basement, belonging to the Seridó Belt, displays NE and WNW foliation trends related to the Brasiliano-age ductile shear zones. In this terrain, brittle-ductile and brittle NE- and NW-trending structures, associated with extensional joints filled with pegmatites and quartz veins, are related to an E-W compression by the end of Brasiliano Cycle. The E-W joints and NE-trending fractures were reactivated by N-S to N-S to NW extension during late Jurassic to Cretaceous times, controlling the emplacement of the Rio Ceará-Mirim basic dyke swarm and the opening of the Potiguar rift basin

Arquitetura deposicional e evolução tectono-estratigráfica das sequências pré-rifte e rifte, na porção central do Vale do Cariri, Bacia do Araripe, NE do Brasil

A complex depositional history, related to Atlantic rifting, demonstrates the geological evolution during the late Jurassic and early Neocomian periods in the Araripe Basin NE Brazil. Based on outcrop, seismic and remote sensing data, a new model of the tectono-stratigraphic evolution of the section that covers the stages Dom João, Rio da Serra and Aratu (Brejo Santo, Missão Velha and Abaiara formations) is presented in this paper. In the stratigraphic section studied, ten sedimentary facies genetically linked to nine architectural elements were described, representing depositional systems associated with fluvial, aeolian and deltaic environments. Based on the relationship between the rates of creation of accommodation space and sediment influx (A / S) it was possible to associate these depositional systems with High and Low accommodation system tracks. These system tracks represent two tectono-sequences, separated by regional unconformities. The Tectono-sequence I, which includes lithotypes from the Brejo Santo Formation and is related to the pre-rift stage, is bounded at the base by the Paleozoic unconformity. This unit represents only a High Accommodation System Track, composed by a succession of pelitic levels interbedded with sandstones and limestones, from a large fluvial floodplain origin, developed under arid climatic conditions. The Tectono-sequence II, separated from the underlying unit by an erosional unconformity, is related to the rift stage, and is composed by the Missão Velha and Abaiara Formation lithotypes. Changes in depositional style that reflect variations in the A / S ratio, and the presence of hydroplastic deformation bands, make it possible to divide this tectonosequence into two internal sequences. Sequence IIA, which includes the lower portion of the Missão Velha Formation and sequence IIB, is composed by the upper section of the Missão Velha and Abaiara Formations The Sequence IIA below, composed only by the Low Accommodation System Track, includes crossbedding sandstones interbedded with massive mudstones, which are interpreted as deposits of sandy gravel beds wandering rivers. Sequence IIB, above, is more complex, showing a basal Low Accommodation System Track and a High Accommodation System Track at the top, separated by an expansion surface. The lower System Track, related to the upper portion of the Missão Velha Formation, is composed by a series of amalgamated channels, separated by erosion surfaces, interpreted as deposits of a belt of braided channels. The High Accommodation System Track, correlated with the Abaiara Unit, is marked by a significant increase in the A / S, resulting in the progradation of a system of braided river deltas with aeolic influence. Regarding tectonic evolution, the stratigraphic study indicates that the Tectonosequence Rift in the Araripe basin was developed in two phases: first characterized by a beginning of rifting, related to Sequence IIA, followed by a phase of syndepositional deformation, represented by sequence IIB. The first phase was not influenced by the development of large faults, but was influenced by a sharp and continuous decrease of accommodation space that permitted a change in depositional patterns, establishing a new depositional architecture. In turn, the stage of syndepositional deformation allowed for the generation of enough accommodation space for the preservation of fluvial-lacustrine deposits and conditioned the progradation of a braided river-dominated delta system.

Desenvolvimento de dobras e falhas em ambiente distensional: Aplicação da modelagem física

The geological modeling allows, at laboratory scaling, the simulation of the geometric and kinematic evolution of geological structures. The importance of the knowledge of these structures grows when we consider their role in the creation of traps or conduits to oil and water. In the present work we simulated the formation of folds and faults in extensional environment, through physical and numerical modeling, using a sandbox apparatus and MOVE2010 software. The physical modeling of structures developed in the hangingwall of a listric fault, showed the formation of active and inactive axial zones. In consonance with the literature, we verified the formation of a rollover between these two axial zones. The crestal collapse of the anticline formed grabens, limited by secondary faults, perpendicular to the extension, with a curvilinear aspect. Adjacent to these faults we registered the formation of transversal folds, parallel to the extension, characterized by a syncline in the fault hangingwall. We also observed drag folds near the faults surfaces, these faults are parallel to the fault surface and presented an anticline in the footwall and a syncline hangingwall. To observe the influence of geometrical variations (dip and width) in the flat of a flat-ramp fault, we made two experimental series, being the first with the flat varying in dip and width and the second maintaining the flat variation in width but horizontal. These experiments developed secondary faults, perpendicular to the extension, that were grouped in three sets: i) antithetic faults with a curvilinear geometry and synthetic faults, with a more rectilinear geometry, both nucleated in the base of sedimentary pile. The normal antithetic faults can rotate, during the extension, presenting a pseudo-inverse kinematics. ii) Faults nucleated at the top of the sedimentary pile. The propagation of these faults is made through coalescence of segments, originating, sometimes, the formation of relay ramps. iii) Reverse faults, are nucleated in the flat-ramp interface. Comparing the two models we verified that the dip of the flat favors a differentiated nucleation of the faults at the two extremities of the mater fault. V These two flat-ramp models also generated an anticline-syncline pair, drag and transversal folds. The anticline was formed above the flat being sub-parallel to the master fault plane, while the syncline was formed in more distal areas of the fault. Due the geometrical variation of these two folds we can define three structural domains. Using the physical experiments as a template, we also made numerical modeling experiments, with flat-ramp faults presenting variation in the flat. Secondary antithetic, synthetic and reverse faults were generated in both models. The numerical modeling formed two folds, and anticline above the flat and a syncline further away of the master fault. The geometric variation of these two folds allowed the definition of three structural domains parallel to the extension. These data reinforce the physical models. The comparisons between natural data of a flat-ramp fault in the Potiguar basin with the data of physical and numerical simulations, showed that, in both cases, the variation of the geometry of the flat produces, variation in the hangingwall geometry

O graben de Palestina: contribuição à estratigrafia e estrutura do estágio rifte na bacia do Araripe, nordeste do Brasil

The Palestina Graben is one of the NE-trending asymmetric grabens of the Araripe Basin. This basin rests on the precambrian terrains of the Transversal Zone, Borborema Province, immediately to the south of the Patos Lineament. It is part of the Interior Basins province of Northeastern Brazil, being related to the fragmentation of the Gondwana supercontinent and the opening of the South Atlantic ocean. The Palestina Graben trends NE-SW and presents an asymmetric geometry, controled by the NW extensional eocretaceous strain. The graben borders display distinct geometries. The SE border is a flexural margin, characterized by the non conformity of the eopaleozoic Mauriti Formation (the oldest unit of the basin) overlying the crystalline basement, but also affected by normal faults with small displacements. On the opposite, the NW border is continuous and rectilinear, being marked by normal faults with major displacements, that control the general tilting of the layers to the NW. In this sense, the Mauriti Formation is overlain by the Brejo Santo, Missão Velha (which also occurs in the Brejo Santo-Mauriti horst, to the NW of the fault border) and Abaiara formations, the latter restricted to the graben. The interpretation of available gravity data and a seismic line indicates that the main fault has a variable dip slip component, defining two deeper portions within the graben, in which the sedimentary column can reach thicknesses of up to 2 km. Regarding to the stratigraphy of Araripe Basin in the study area, the sedimentary package includes three distinct tectonosequences. The Paleozoic Syneclisis Tectonosequence is composed by the Mauriti Formation, deposited by a braided fluvial system. The Jurassic Tectonosequence, whose tectonic setting is still debatable (initial stage of the Neocomian rift, or a pre-rift syneclisis ?), is represented by the Brejo Santo Formation, originated in a distal floodplain related to ephemeral drainages. The Rift Tectonosequence, of neocomian age, includes the Missão Velha Formation, whose lower section is related to a braided to meandering fluvial system, outlining the Rift Initiation Tectonic Systems Tract. The upper section of the Missão Velha Formation is separated from the latter by a major unconformity. This interval was originated by a braided fluvial system, overlain by the Abaiara Formation, a deltaic system fed by a meandering fluvial system. Both sections correspond to the Rift Climax Tectonic Systems Tract. In the area, NE-trending normal to oblique faults are associated with NW transfer faults, while ENE to E-W faults display dominant strike slip kinematics. Both NE and E-W fault sets exhibit clear heritage from the basement structures (in particular, shear zones), which must have been reactivated during the eocretaceous rifting. Faults with EW trends display a dominant sinistral shear sense, commonly found along reactivated segments of the Patos Lineament and satellyte structures. Usually subordinate, dextral directional movements, occur in faults striking NNW to NE. Within this framework bearing to the Palestina Graben, classical models with orthogonal extension or pull-apart style deserve some caution in their application. The Palestina Graben is not limited, in its extremeties, by E-W transcurrent zones (as it should be in the case of the pull-apart geometry), suggesting a model close to the classic style of orthogonal opening. At the same time, others, adjacent depocenters (like the Abaiara-Jenipapeiro semi-graben) display a transtensional style. The control by the basement structures explains such differences

Detection of Streptococcus agalactiae colonization in pregnant women by using combined swab cultures: cross-sectional prevalence study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

DNA damage and aberrant crypt foci as putative biomarkers to evaluate the chemopreventive effect of annatto (Bixa orellana L.) in rat colon carcinogenesis

Chemoprevention opens new perspectives in the prevention of cancer and other degenerative diseases. Use of target-organ biological models at the histological and genetic levels can markedly facilitate the identification of such potential chemopreventive agents. Colon cancer is one of the highest incidence rates throughout the world and some evidences have indicated carotenoids as possible agents that decrease the risk of colorectal cancer. In the present study, we evaluate the activity of annatto (Bixa orellaria L.), a natural food colorant rich in carotenoid, on the formation of aberrant crypt foci (ACF) induced by dimethy1hydrazine (DMH) in rat colon. Further, we investigate, the effect of annatto on DMH-induced DNA damage, by the comet assay. Male Wistar rats were given s.c. injections of DMH (40 mg/kg body wt.) twice a week for 2 weeks to induce ACE They also received experimental diets containing annatto at 20, 200 or 1000 ppm for five 5 weeks before (pre-treatment), or 10 weeks after (post-treatment) DMH treatment. In both protocols the rats were sacrificed on week 15th. For the comet assay, the animals were fed with the same experimental diets for 2 weeks. Four hours before the sacrifice, the animals received an s.c. injection of DMH (40 mg/kg body wt.). Under such conditions, dietary administration of 1000 ppm annatto neither induce DNA damage in blood and colon cells nor aberrant crypt foci in rat distal colon. Conversely, annatto was successful in inhibiting the number of crypts/colon (animal), but not in the incidence of DMH-induced ACF, mainly when administered after DMH. However, no antigenotoxic effect was observed in colon cells. These findings suggest possible chemopreventive effects of annatto through their modulation of the cryptal cell proliferation but not at the initiation stage of colon carcinogenesis. (c) 2005 Elsevier B.V. All rights reserved.

Protective action of propolis on the rat colon carcinogenesis

Propolis is a honeybee product with several biological and therapeutical properties. Its effect on the process of colon carcinogenesis and DNA damage were evaluated in the male Wistar rats using the aberrant crypt foci (ACF) assay and the comet assay, respectively. For both tests, animals were treated with the colon carcinogen 1,2 dimethylhydrazine (DMH, 40 mg/kg, s.c.) for 2 weeks (two injections/week) in order to induce both DNA damage and ACF. The animals were divided into groups that received propolis (ethanolic extract) at three different doses (10, 30, and 90 mg/kg b.w., by gavage), either simultaneously or after DMH treatment. For the comet assay, peripheral blood samples were collected 4 h after the last DMH treatment. All animals were sacrificed at the 5th week for evaluation of ACF. The results show that only the intermediate dose (30 mg/kg) of propolis, administered after DMH initiation, is significantly associated to a smaller number of aberrant crypts in the distal colon. No effect on DNA damage in peripheral blood cells, however, was verified by the comet assay. These data suggest that propolis has a protective influence on the process of colon carcinogenesis, suppressing the development of preneoplastic lesions, and probably exerts no protection against the initiation of carcinogenesis.