Macroscopic Anatomy and Brain Vascularization in the Greater Rhea (Rhea americana americana)

Background: The Rhea americana americana is a wild bird belonging to the group of Ratites, and is important from the scientific point of view given their adaptability to captivity. Considering that information about its morphology is important for the viability of domesticating the species, the aim of this study was to macroscopically identify the brain regions, as well as the cerebral arteries and the cerebral arterial circuit in order to establish the cerebral vascular pattern and systematization.Materials, Methods & Results: Twenty one brains from young and adult Greater Rheas of both sexes were used from animals that had died due to natural causes and were then kept in a freezer. The specimens were thawed and incised in the cervical region to allow exposure of the left common carotid artery, which was cannulated. The vascular system was rinsed with 0.9% saline solution, then perfused with latex Neoprene 650 stained with red pigment. The animals were subsequently fixed in 3.7% aqueous formaldehyde solution for 72 h, and then they were dissected by removing the bones from the skull cap. The brains were analyzed, and the structures were identified, photographed, schematized and denominated. Morphometric measurements were performed on the basilar and cerebellar ventral caudal arteries, recording the values of length and width in millimeters with the aid of a digital caliper. The brain was divided into: telencephalon, diencephalon, brainstem and cerebellum; while externally, the observed structures are: olfactory bulbs, optical lobes, optic nerves, optic chiasm, pituitary and pineal glands. Vascularization was performed by the following arteries: ventral spinal artery, basilar artery, ventricular cerebellar arteries, medium ventricular cerebellar arteries, caudal branches of the carotid arteries of the brain, ventral mesencephalic artery, cerebral caudal arteries, rostral branches of the carotid arteries of the brain, middle cerebral arteries, cerebroethmoidal arteries, rostral intercerebral anastomosis, rostral cerebral arteries, ethmoidal arteries, internal ophthalmic arteries, inter-hemispheric artery, pituitary arteries, dorsal mesencephalic tectal arteries, dorsal cerebellar arteries, occipital, pineal and dorsal hemispherical branches. The cerebral arterial circuit was both caudally and rostrally closed in 100.0% of the samples, being composed of the arteries: basilar artery, caudal branches of the carotid brain, rostral branches of the brain carotid, cerebroethmoidal arteries and rostral intercerebral anastomosis.Discussion: Encephalon classification regarding the presence or absence of gyri is a characteristic associated to evolutionary aspects among vertebrates, being respectively considered as lisencephalon or girencecephalus when it presents or does not present convolutions. In Greater Rheas, the telencephalon was quite developed, with a relatively rounded shape and the absence of sulci and convolutions in the cortex, which allowed it to be classified as a lisencephalon. Such findings resemble those described for the ostrich and in a comparative study involving kiwis, emus, owls and pigeons, although different sizes and forms of telencephalon development were observed in the latter. Regarding the cerebral arterial circuit, this structure in Rheas was complete and both caudally and rostrally closed in 100.0% of the specimens. Our findings differ from those observed for ostriches, in which a rostrally open behavior has been described, while it is caudally closed in 20.0% of cases and opened in 80.0%. Regarding the vascular type of the brain, in the Rhea it was observed that there was only contribution of the carotid system, similar to that found for birds such as ostriches and turkeys which confer a type I encephalic vascularization

Montagem e aplicação de modelo de baixo custo de dissecção venosa

Objetivo: Desenvolver e aplicar modelo de baixo custo para treinamento de dissecção venosa para acadêmicos de Medicina. Métodos: O modelo foi elaborado com custo fixo de 35 reais (10,5 dólares) e mais 50 centavos a cada reposição, tendo sido aprovados por 6 cirurgiões vinculados ao curso de Medicina da Universidade de Fortaleza e utilizados durante curso teórico prático. Os alunos responderam a um teste pré e pós-atividade, foram avaliados durante a prática através de check list e responderam questionário de percepção sobre o modelo. Resultados: Foi notado crescimento teórico, porém, percebeu-se a necessidade de mais treinamento procedural, o que é viável com nosso modelo de baixo custo. Em relação aos questionários de percepção, 91,95% dos alunos concordaram que os modelos mantinham boa correlação anatômica, 89,96% que o material utilizado é de boa qualidade, 95,40% que o modelo permitiu o aprendizado da dissecção venosa e 96,55% que o modelo pode ser utilizado para ensino do procedimento, números que reafirmam a eficácia e viabilidade do modelo. Conclusões: É possível a criação de modelo realista, de boa qualidade e viável para o ensino, apenas com materiais de baixo custo para treinamento de dissecção venosa.Objective: We aim to develop and apply a low cost model for venous dissection training for medical students. Methods: The model was elaborated with a fixed cost of 35 reais (10,5 dollars) and 50 cents at each replacement, and was approved by 6 surgeons tied to the Medicine course of the Universidade de Fortaleza and used during practical theoretical course. The students answered a pre and post activity test, were evaluated during the practice through check list and answered the perception questionnaire about the model. Results: We noticed a theoretical growth, however, we noticed the need for more procedural training, which is feasible with our low cost model. Regarding the perception questionnaires, 91.95% of the students agreed that the models maintained good anatomical correlation, 89.96% that the material used was of good quality, 95.40% that the model allowed the learning of the venous dissection and 96.55% that the model can be used for teaching the procedure, numbers that reaffirm the effectiveness and feasibility of the model. Conclusions: It is possible to create a realistic model, of good quality and feasible for teaching, only with low cost materials for venous dissection training

Clinical and echocardiographic parameters associated with low chronotropic index in non-elderly patients

FUNDAMENTO: Apesar das inúmeras evidências de aumento da morbimortalidade, a incompetência cronotrópica (IC) ainda não é um diagnóstico rotineiro e bem definido nos protocolos de avaliação cardiológica e sua importância clínica ainda é subestimada. OBJETIVO: Avaliar os parâmetros clínicos e ecocardiográficos associados à IC em pacientes não idosos submetidos à ecocardiografia sob estresse físico (EEF). MÉTODOS: Foram avaliados 1.798 pacientes com idade média de 48,4 ± 7,5 anos submetidos à EEF entre Janeiro/2000 e Agosto/2009. Pacientes com índice cronotrópico menor que 0,8 foram considerados incompetentes cronotrópicos e comparados aos competentes quanto às características clínicas e ecocardiográficas. RESULTADOS: A duração do esforço físico foi em média de 9,3 ± 2,4 minutos. Duzentos e setenta (15%) pacientes eram incompetentes cronotrópicos. O índice cronotrópico de tal grupo foi de 0,7 ± 0,1 vs. 1,0 ± 0,1 para os competentes. A análise de regressão logística multivariada identificou os seguintes parâmetros como independentemente associados à IC: dispneia no exame [odds ratio (OR) = 4,27; p < 0,0001], dor torácica prévia na história clínica (OR = 1,51; p = 0,0111), maiores valores de índice de massa do ventrículo esquerdo nos incompetentes (IMVE) (OR = 1,16; p = 0,0001), equivalentes metabólicos (METs) (OR = 0,70; p = 0,0001), infradesnivelamento do segmento ST (OR = 0,58; p = 0,0003) e elevação da pressão arterial sistólica (ΔPAS) (OR = 0,87; p = 0,0011). Isquemia miocárdica não se associou à IC. CONCLUSÃO: A IC está associada a parâmetros funcionais, tais como: dispneia ao esforço, história de dor torácica e menores valores de METS. Está também associada ao parâmetro estrutural índice de massa do ventrículo esquerdo. Além disso, incompetência cronotrópica não parece aumentar a chance de isquemia miocárdica em pacientes não idosos. _________________________________________________________________________________________ ABSTRACT: BACKGROUND: Despite abundant evidence of increased morbidity and mortality, chronotropic incompetence (CI) is not a routine diagnosis well defined in protocols of cardiac evaluation and its clinical importance is still underestimated. OBJECTIVE: To evaluate the clinical and echocardiographic parameters associated with HF in non-elderly patients submitted to stress echocardiography (SE). METHODS: One thousand seven hundred ninety-eight patients with a mean age of 48.4 ± 7.5 years, who underwent SE between January/2000 and August/2009 were evaluated. Patients with chronotropic index smaller than 0.8 were considered chronotropic incompetent as compared to competent patients as to clinical and echocardiographic characteristics. RESULTS: The duration of the exercise was 9.3 ± 2.4 minutes on average. Two hundred and seventy (15%) patients were chronotropic incompetent. The chronotropic index of this group was 0.7 ± 0.1 vs. 1.0 ± 0.1 for competent patients. Multivariate logistic regression analysis identified the following parameters as independently associated with HF: dyspnea on examination [odds ratio (OR) = 4.27, p <0.0001], previous chest pain on medical history (OR = 1.51; p = 0.0111), higher left ventricular mass rate in incompetent patients (LVMI) (OR = 1.16, p = 0.0001), metabolic equivalents (METs) (OR = 0.70, p = 0 , 0001), ST segment depression (OR = 0.58, p = 0.0003) and high systolic blood pressure (ΔSBP) (OR = 0.87, p = 0.0011). Myocardial ischemia was not associated with HF. CONCLUSION: HF is associated with functional parameters, such as dyspnea on exertion, history of chest pain and lower METS. It is also associated with structural benchmark index of left ventricular mass. In addition, chronotropic incompetence does not appear to increase the chance of myocardial ischemia in non-elderly patients

Influence of dental erosion on shear bond strength of ceramic brackets bonded with two different adhesive systems: an in vitro study

This study aimed to analyze the shear bond strength (SBS) of ceramic orthodontic brackets bonded with two different adhesive systems to intact and eroded teeth. Ceramic brackets were bonded to 72 bovine central incisors divided into four groups, defined by two study factors: enamel condition (control group, kept in artificial saliva; and experimental group, eroded by using immersion cycles in Coke™ for 90 seconds, every six hours for five days), and adhesive system type (Transbond™ XT or Transbond™ Plus Color Change). Polycrystalline ceramic brackets were adhesively fixed on all specimens using the same light curing protocol. SBS was tested using 0.5 mm/min and the failure mode was classified. SBS data was analyzed using two-way ANOVA followed by Tukey test. The adhesive remnant index (ARI) scores were analyzed using Kruskal-Wallis test with Dunn's post-hoc pairwise comparison (α=0.05). Percentages of ARI scores between the groups were compared by Fisher’s exact test. Spearman's correlation coefficient was applied to investigate the correlation between ARI scores and SBS values. Only the adhesive system factor had significant effect on SBS (p=0.014), Transbond™ Plus Color Change showing higher values. No significance was found for enamel condition (p=0.665) or the interaction between adhesive system and enamel condition (p=0.055). ARI scores frequencies differed between groups (p<0.001). The median ARI scores were statistically different for most comparisons among the groups. However, no significant correlation was found between ARI scores and SBS. In conclusion, the type of adhesive system affected the SBS of ceramic brackets to dental enamel, but the enamel condition, intact or eroded, had no significant effect. There was no correlation between ARI scores and SBS values, although eroded enamel tended to retain more adhesive after bracket removal

Avaliação dos parâmetros ambientais e fisiológicos para frangos de corte linhagem caipira em diferentes fases de criação na Amazônia Ocidental / Evaluation of environmental and physiological parameters for free-range broilers in different productive phases in the Western Amazon

Objetivou-se com este trabalho avaliar a influência do ambiente em diferentes períodos do dia sobre os parâmetros fisiológicos de frangos caipira da linhagem Label Rouge em diferentes fases de criação (inicial, crescimento e terminação) na Amazônia Ocidental. Foram utilizados 300 pintinhos da linhagem Caipira Label Rouge, distribuídos em vinte cinco boxes de 12 animais cada. Semanalmente foram coletados dados de temperatura de bulbo seco, temperatura de ponto de orvalho, temperatura de globo negro e umidade relativa no interior do galpão, em três pontos (início, meio e fim) e em diferentes horários, 09:00, 15:00 e 21:00 horas. A partir da coleta das variáveis climáticas foram calculados os índices de conforto térmico: índices de temperatura e umidade e o índice de temperatura de globo e umidade. Os parâmetros fisiológicos foram avaliados em cada fase de criação (inicial, crescimento e final), nas idades de 21, 42 e 63 dias, considerando as variáveis, temperatura cloacal, temperaturas superficiais (cabeça, pescoço, dorso, asa e pernas) e frequência respiratória. Os resultados dos índices bioclimáticos demonstraram que em todas fases de criação os animais se encontravam fora da faixa de conforto térmico de temperatura e umidade relativa, sendo os maiores índices (p&lt;0,05) observados no período da tarde. Para os parâmetros fisiológicos, foi possível observar que houve incremento (p&lt;0,05) em todas as temperaturas mensuradas, como também, na frequência respiratória (p&lt;0,05) no período da tarde nas fases inicial e crescimento. Sendo assim, conclui-se que as altas temperaturas associadas a alta umidade no período da tarde aumentaram os índices bioclimáticos e o desconforto dos animais, alterando as temperaturas superficiais e frequência respiratória de frangos caipiras Label Rouge criados na Amazônia Ocidental. 

AVALIAÇÃO DA AUTOPERCEPÇÃO DA SAÚDE BUCAL DE IDOSOS EM UM ABRIGO NA CIDADE DO RECIFE

The objective of this study was to analyze the self-perception of the oral health of elderly people residing at Abrigo Lar Batista para Anciões. This is a cross-sectional study, which is part of the extension project entitled “Oral Health for the elderly: a welcoming proposal in the promotion of oral health”. Ten elderly people aged between 60 and 91 years old, of both sexes, residing in the shelter were included. The assessment categories included sociodemographic data and clinical intraoral characteristics. Data related to self-perception of oral health were collected using the modified Geriatric Oral Health Assesment Index(GOHAI) standard. Among those surveyed, 80% were female, 20% male with a mean age of 78.6 years. In 50% of the sample, self-perception was evaluated as “poor”, 30% as “excellent” and 20% as “regular”. The main factors associated with the negative evaluation were the difficulty of swallowing and discomfort in eating some foods, concern about an oral problem and tooth sensitivity. Female elderly, with less use of prostheses and greater tooth loss were more sensitive to the negative impacts of oral health. In the group that had a positive self-perception of oral health, it is highlighted by more elderly males, greater use of dentures, less tooth loss and older age. The self-perception of oral health was considered “poor” according to the GOHAI index.O objetivo deste estudo foi analisar a autopercepção da saúde bucal de idosos residentes no Abrigo Lar Batista para Anciões. Trata-se de um estudo transversal, no qual faz parte do projeto de extensão intitulado “Saúde Bucal para anciões: uma proposta acolhedora na promoção da saúde bucal”. Foram incluídos 10 idosos na faixa etária de 60 a 91 anos de idade, de ambos os sexos, residentes no abrigo. As categorias avaliadas incluíram os dados sociodemográficos e características clínicas intraorais. Os dados relativos à autopercepção da saúde bucal foram coletados através do questionário Geriatric Oral Health Assesment Index (GOHAI) modificado. Dentre os pesquisados, 80% eram do sexo feminino, 20% do sexo masculino com idade média de 78,6 anos. Em 50% da amostra a autopercepção foi avaliada como “ruim”, 30% como “ótima” e 20% como “regular”. Os principais fatores associados com a avaliação negativa foram a dificuldade de engolir e desconforto em comer alguns alimentos, preocupação com algum problema bucal e sensibilidade dentária. Os idosos do sexo feminino, com menor uso de prótese e maior perda dentária foram mais sensíveis aos impactos negativos da saúde&nbsp;bucal. No grupo que houve uma autopercepção positiva da saúde bucal é destacado por mais idosos do sexo masculino, maior uso de prótese, menor perda dentária e idade mais avançada. A autopercepção da saúde bucal foi considerada “ruim” de acordo com o índice GOHAI

Prognostic value of exercise echocardiography in diabetic patients

Background Coronary artery disease (CAD) is the leading cause of death in diabetic patients. Although exercise echocardiography (EE) is established as a useful method for diagnosis and stratification of risk for CAD in the general population, there are few studies on its value as a prognostic tool in diabetic patients. The purpose of this investigation was to evaluate the value of EE in predicting cardiac events in diabetics. Methods 193 diabetic patients, 97 males, 59.8 ± 9.3 yrs (mean ± SD) were submitted to EE between 2001 and 2006 and followed from 7 to 65 months with median of 29 months by phone calls and personal interviews with patients and their primary physician, and reviewing medical records and death certificates. The end points were cardiac events, defined as non-fatal myocardial infarction, late myocardial revascularization and cardiac death. Sudden death without another explanation was considered cardiac death. Survival free of end points was estimated by the Kaplan-Meier method. Results Twenty-six cardiac events were registered in 24 individuals during the follow-up. The rates of cardiac events were 20.6 and 7% in patients with positive and negative EE, respectively (p < 0.001). Predictors of cardiac events included sedentary lifestyle, with RR of 2.57 95%CI [1.09 to 6.02] (P = 0.03) and positive EE, with RR 3.63, 95%CI [1.44 to 9.16] (P = 0.01). Patients with positive EE presented higher rates of cardiac events at 12 months (6.8% vs. 2.2%), p = 0.004. Conclusion EE is a useful method to predict cardiac events in diabetic patients with suspected or known CAD