Lumbar hernia is defined as the presence of failure in the transverse fascia or in the aponeurosis of the transverse abdominal muscle that results in the extrusion of intra or extra peritoneal organs through the discontinuity of the postero lateral abdominal wall. The aim of this study was to conduct a methodical review of the anatomy of the hernia form grynfelt dated from 1985 to 2016. For this, we performed a bibliographic review through electronic databases like SciELO, PubMed, Science Direct, LILACS and Bireme to get better approach to the subject. It has been found that the lumbar hernia is a disease little known by doctors whose diagnostics are often performed in the wrong way and for surgical correction needs a good anatomical knowledge. Lumbar hernias, although rare, must be taken into account, since ischemia of herniated intestinal segments can lead to the death of the patient, especially in the elderly. Knowledge about the anatomy of the lumbar region is of vital importance because it makes surgery safe and reduces risks of complications and recidivating of the hernia.
Formaldehyde (FA) is commonly used in cadaver fixation for years. FA vapors are released during the dissection process and macroscopic study of preserved anatomical pieces, raising their concentration in the Anatomy laboratory, causing greater exposure for students and teachers. Therefore, the objective of this study was to investigate toxic reactions in 37 students, through a questionnaire, produced by exposure to FA used for preservation of cadaveric material used in Anatomy, Morphofunctional Department, Faculdades Integradas de Patos (FIP), Brazil. Of the 37 interviewees, 26 (70.3%) were affected by the unpleasant and irritating smell of FA, 10 (27%) had no problems, and 1 (2.7%) did not tolerate an irritation produced by FA, not participating in the laboratory practical classes. Exposure to FA was followed by several symptoms: excessive lacrimation (54%), itchy eyes (48.5%), redness of the eyes (40.6%), coryza or congested nose (35.2%) and respiratory distress (29.7%), with persistent symptoms during the permanence in the laboratory for 32.5% of the students. All students wear a lab coat for individual protection. However, only 8% used mascara and did not wear glasses, increasing the risk of contamination. Medical schools should encourage the use of Personal Protective Equipment (PPE) for the manipulation of FA, ensuring the protection of students and teachers in the Anatomy laboratory. Besides finding alternatives for the replacement of FA in the conservation of corpses.
Relatamos o caso de uma paciente em terapia anticoagulante oral com Warfarin, apresentando obstrução intestinal aguda. A tomografia computadorizada revelou hematoma intramural duodenal. O tratamento baseou-se na correção das provas de coagulação e medidas expectantes. Este caso ilustra o valor da tomografia computadorizada e da abordagem conservadora nos pacientes em terapia anticoagulante com obstrução aguda do intestino delgado.
Introduction: Congenital diaphragmatic hernia is a poor formation of the diaphragm characterized by the presence of an intestinal malrotation, It is related to abnormal position of the intestine in the thorax. Objective and Result:This case report a stillborn at 32 weeks, that was observe anatomical abnormalities associated with congenital diaphragmatic hernia, which occurred in the left antero-posterior region, such as intestinal malrotation, hepatomegaly and nephromegaly, with the presence of a hernial ring that occupied 80% of the left side of the diaphragm, besides a hypertrophied heart, deviated to the right, bilateral pulmonary hypotrophy. ConclusionThis case illustrates a rare case of diaphragmatic hernia with intestinal changes of clinical and surgical importance.
incidence of gemcitabine induced HUS in our population of pancreatic cancer patients receiving adjuvant treatment and to ascertain potential risk factors. Methods: We reviewed 187 patients on adjuvant gemcitabine for pancreatic carcinoma. We collected data about haemoglobin, platelets, white cells count, creatinine clearance before each cycle. We calculated the maximum drop between baseline and minimum level of haemoglobin and creatinine clearance for all these patients. Results: We found that two patients developed HUS (1.06%). 185 patients developed a maximum drop in haemoglobin of 22% (18-27%) and around 19% in creatinine clearance (10-45%). The HUS patients had a drop in haemoglobin of 37% and 34% and a drop in creatinine clearance of 41% and 31%. We carried out a logistic regression analysis. This showed that a drop in haemoglobin >25% and in creatinine clearance >30% from baseline, increased significantly the chances of developing HUS (p 0.0001). Conclusion: Our data point to a significant drop in hemoglobin and creatinine clearance as two significant risk factors to develop HUS induced by gemcitabine. We recommended that in cases with high index of suspicion, gemcitabine should be stopped or delayed until we receive the results of extra tests such as haptoglobin, lactate dehydrogenase, test de Coombs, to confirm or rule out this diagnosis.
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