Facial nerve hemangioma of the lateral portion of the internal acoustic canal : a case report and a review of literature

Introduction facial nerve hemangiomas (FNH) are rare tumors. Although it can occur in any portion of the nerve, it predominantly appears near the geniculate ganglion. We present a case of facial nerve hemangioma of an unusual location. Case Report A 30-year-old woman presented with right-sided severe hearing loss and progressive facial palsy. Magnetic resonance showed a 5 mm lesion in the lateral portion of the right internal auditory canal. Due to facial palsy, the patient was submitted to a translabyrinthine approach and a total tumor resection, followed by hypoglossal-facial nerve anastomosis. Discussion The facial nerve is susceptible in its path to expansive lesions, which have high morbidity. FNH is a rare and difficult-to-diagnose lesion. Computerized tomography and nuclear magnetic resonance can be used in its diagnosis. The differential diagnosis of FNH includes, in addition to schwannomas, meningiomas, cholesteatomas, paragangliomas, and other temporal bone tumors. There is no well-established consensus on the best approach. Because of its slow growth and benign behavior, some studies suggest conservative treatment and serial imaging. However, surgery is the cornerstone of treatment, as it is the only curative option. Conclusion FNHs are often small but very symptomatic. Its high morbidity demands early diagnosis and, sometimes, surgical treatment

BRONCOESPASMO INDUZIDO POR EXERCÍCIO

O broncoespasmo induzido por exercício (BIE), ou asma induzida por exercício (AIE), é uma obstrução das vias aéreas após vários minutos de exercício. Esta síndrome está presente em 90% dos indivíduos asmáticos, em 30 a 40% dos alérgicos não asmáticos e em 3 a 10% dos atletas de várias modalidades, interferindo diretamente na prática esportiva destes. As hipóteses da perda de calor e água das vias respiratórias, da deficiência simpatoadrenal e da hiperemia reativa, as quais tentam explicar o mecanismo de desencadeamento do BIE, possuem pontos ainda não esclarecidos. Na relação asma/exercício, as particularidades tais como, tipo, intensidade, duração e forma de execução do exercício, são colocadas ora como provocadoras, ora como fatores preventivos do BIE, criando uma situação paradoxal a qual merece futuras pesquisas face às dúvidas que ainda permanecem nesta área

Blood doping in sports

“Doping” sangüíneo é a infusão ou reinfiisão de sangue no organismo de um atleta. Seu princípio fisiológico é que após a flebotomia o organismo do atleta é exposto a uma hipoxia, que induz uma eritrocitemia, gerando, assim, a produção de novos eritrócitos. Após a infusão ou reinfiisão sangüínea têm-se como conseqüência uma elevada concentração de hemoglobina plasmática seguida de uma melhora da “performance” Este procedimento pode ser realizado utilizando-se o sangue da mesma pessoa (reinfusãoautóloga) ou de outra pessoa (infusão-heteróloga). A eritrocitemia pode ser induzida também através da injeção de eritropoietina recombinante humana (rhEPO). Este hormônio age sobre as colônias formadoras de unidades de eritróides desencadeando a formação de novos eritrócitos. Espera-se que indivíduos tratados com rhEPO melhorem sua capacidade de realizar exercícios físicos prolongados. Existe a suspeita de que alguns atletas das provas de resistência aeróbia têm se beneficiado deste recurso. Apesar de estarem sendo pesquisadas algumas formas de detecção, não existem, ainda, métodos analíticos de detecção desta forma de “doping” que possam ser confiáveisBlood doping is the infusion or reinfusion of blood in the athlete’s body. Its physiological basis is that after bloodletting the athlete’s organism is exposed to a hypoxic condition that induces erythrocythaemia, and consequently new erythrocytes are produced. After blood infusion or reinfusion, a high concentration of plasmatic hemoglobin takes place followed by an increase in performance. This procedure may be done by using either the subject’s own stored blood (autologous reinfiision) or blood donated by another person (heterologous infusion). Moreover, erythrocythaemia may be induced by injection of recombinant human erythropoietin (rhEPO). This hormone operates on colony forming erythroid units inducing new erythrocytes formation. It is expected that the capacity to perform endurance exercise of subjects treated with rhEPO increases. Blood doping has aroused interest in the sports community because it cannot be detected in standard doping control tests. Although some methods of detection have been proposed, a reliable analytic method to detect blood doping has not been discovered ye

ERITROPOIETINA E EXERCÍCIO FÍSICO

O objetivo deste trabalho é abordar, através de revisão de literatura, a relação da EPO com o exercício físico. Para tal, será apresentada, num primeiro momento, a ação da EPO no organismo. Em seguida, será discutida a relação da EPO com o exercício físico, com base nos estudos realizados nessa área

Image-guided temporal bone dissection course

Introduction: Temporal bone anatomy is complex and demands a profound anatomical knowledge. Association between surgery and imaging helps in the process of learning three-dimensional (3D) anatomy and surgical techniques. High definition temporal bone imaging can play an important role in dissection training. Objective: To describe a computed tomography (CT) image-guided temporal bone dissection course for surgical training in otolaryngology and to verify the satisfaction level of the students with the course. Methods: Descriptive research. The course took place at a research laboratory, with three experienced temporal bone surgeons. The participants were 12 otolaryngology residents. The laboratory has 7 modern workstations with microscope and monitors linked with a computerized video system. Cadaveric temporal bones were donated to the university. Imaging acquisition of the cadaveric temporal bones used in the course was performed in a multislice CT scanner. The CT images of cadaveric temporal bones were available with real-time access on the laboratory monitor's screens during dissections. Results: A total of 13 temporal bones were included for dissection. Students had the opportunity to view on the same screen, simultaneously, both the dissection video and the respective CT images of their temporal bone anatomical specimens. This allowed correlating surgical and imaging aspects of temporal bone anatomy. At the end of the course, participants answered a satisfaction survey. Conclusion: Considering imaging methods are routinely used during most otologic surgeries, detailed knowledge of CT imaging should be explored in conjunction with the temporal bone anatomical dissection

Magnetic resonance imaging findings of the posterior fossa in 47 patients with mucopolysaccharidoses : a cross-sectional analysis

Background: Mucopolysaccharidoses (MPS) is a group of hereditary multisystemic lysosomal disorders. Most neuroimaging studies in MPS have focused on the supratentorial compartment and craniocervical junction abnormalities, and data regarding posterior fossa findings are scarce in the literature. Thus, our purpose is to describe posterior fossa findings on magnetic resonance imaging (MRI) of MPS patients. Methods: We reviewed routine MRI scans of MPS patients being followed up at our institution (types I, II, III, IV, and VI), focusing on posterior fossa structures. Results: Forty-seven MPS patients were included. MRI-visible perivascular spaces were commonly found in the midbrain and adjacent to the dentate nuclei (85% and 55% of patients, respectively). White-matter lesion was not identified in most cases. Its most frequent localizations were in the pons and cerebellum (34% and 30% of patients, respectively). Enlargement of cerebrospinal fluid (CSF) spaces in the posterior fossa was present in 55% of individuals and was more frequent in neuronopathic patients (73% vs 40%; P = .02). Cerebellar volume was classified as normal, apparent macrocerebellum, atrophic, and hypoplastic in 38%, 38%, 21%, and 3% of patients, respectively. A depression of the posterior fossa floor in the midline sagittal plane was found in 22 patients (47%), which was statistical significantly associated with enlargement of CSF spaces (P = .02) and with apparent macrocerebellum (P = .03). Conclusion: The present study compiled the main posterior fossa findings in MPS patients. Classically described in the supratentorial compartment, MRI-visible perivascular spaces, white matter lesions, and enlarged perivascular spaces were also found in the posterior fossa. However, atrophy, which commonly affects cerebral hemispheres, was not the most frequent cerebellar morphology found in our study. Moreover, potential findings for future research were described

Effects of acute fatigue on the volitional and magnetically-evoked electromechanical delay of the knee flexors in males and females

Neuromuscular performance capabilities, including those measured by evoked responses, may be adversely affected by fatigue; however, the capability of the neuromuscular system to initiate muscle force rapidly under these circumstances is yet to be established. Sex-differences in the acute responses of neuromuscular performance to exercise stress may be linked to evidence that females are much more vulnerable to ACL injury than males. Optimal functioning of the knee flexors is paramount to the dynamic stabilisation of the knee joint, therefore the aim of this investigation was to examine the effects of acute maximal intensity fatiguing exercise on the voluntary and magnetically-evoked electromechanical delay in the knee flexors of males and females. Knee flexor volitional and magnetically-evoked neuromuscular performance was assessed in seven male and nine females prior to and immediately after: (i) an intervention condition comprising a fatigue trial of 30-seconds maximal static exercise of the knee flexors, (ii) a control condition consisting of no exercise. The results showed that the fatigue intervention was associated with a substantive reduction in volitional peak force (PFV) that was greater in males compared to females (15.0%, 10.2%, respectively, p < 0.01) and impairment to volitional electromechanical delay (EMDV) in females exclusively (19.3%, p < 0.05). Similar improvements in magnetically-evoked electromechanical delay in males and females following fatigue (21%, p < 0.001), however, may suggest a vital facilitatory mechanism to overcome the effects of impaired voluntary capabilities, and a faster neuromuscular response that can be deployed during critical times to protect the joint system