Septal branches of the anterior ethmoidal artery: anatomical considerations and clinical implications in the management of refractory epistaxis

Epistaxis is a commonly presenting complaint. In severe cases, nosebleeds may occur despite antero-posterior nasal packing and often in the absence of identifiable sources of bleeding. In such cases, epistaxis may occur from septal branches of the anterior ethmoidal artery (sbAEA). The purposes of this study are to highlight the clinical role of the sbAEA in different fields of endoscopic endonasal surgery and to evaluate the efficacy and safety of their selective endoscopic endonasal ligation in the management of refractory epistaxis.A retrospective review was performed of all patients presenting with epistaxis who underwent endoscopic endonasal coagulation of sbAEA in three Italian tertiary-care referral centers between October 2010 and October 2017.A total of 30 patients met the inclusion criteria. Sixteen patients had never experienced nosebleeds before, while 14 patients recalled previous epistaxes. Seventeen patients were treated under local anesthetic, while 13 required general anesthesia. No intra- or post-operative complications were observed and none of the patients received nasal packing after the procedure. In all cases the coagulation was effective in controlling the bleeding, with only two relapses in the series (2/30, 6.7%).The sbAEA are of great interest in endoscopic endonasal surgery, both as surgical landmarks and as feeding vessels for a variety of pedicled nasal flaps. What is more, they can be crucial for the management of refractory epistaxis. Their selective endoscopic coagulation represents an effective and safe procedure in cases of difficult-to-control epistaxis from the upper nasal fossa, with several advantages over nasal packing

Genetics, surnames, grandparents' nationalities, and ethnic admixture in Southern Brazil: Do the patterns of variation coincide?

A total of 2,708 individuals from the European-derived population of Rio Grande do Sul, divided into seven mesoregions, and of 226 individuals of similar origin from Santa Catarina were studied. Seventeen protein genetic systems, as well as grandparents' nationalities, individuals' surnames, and interethnic admixture were investigated. The alleles which presented the highest and lowest differences were GLO1*2 (16%) and PGD*A (2%), respectively, but in general no significant genetic differences were found among mesoregions. The values observed were generally those expected for individuals of European descent, with the largest difference being a lower prevalence (34-39%) of P*1. Significant heterogeneity among mesoregions was observed for the other variables considered, and was consistent with historical records. The Amerindian contribution to the gene pool of European-derived subjects in Rio Grande do Sul was estimated to be as high as 11%. Based on the four data sets, the most general finding was a tendency for a northeast-southwest separation of the populations studied. Seven significant phenotype associations between systems were observed at the 5% level (three at the 0.1% level). Of the latter, the two most interesting (since they were also observed in other studies) were MNSs/Duffy and Rh/ACP

Genetics, surnames, grandparents' nationalities, and ethnic admixture in Southern Brazil: Do the patterns of variation coincide?

A total of 2,708 individuals from the European-derived population of Rio Grande do Sul, divided into seven mesoregions, and of 226 individuals of similar origin from Santa Catarina were studied. Seventeen protein genetic systems, as well as grandparents' nationalities, individuals' surnames, and interethnic admixture were investigated. The alleles which presented the highest and lowest differences were GLO1*2 (16%) and PGD*A (2%), respectively, but in general no significant genetic differences were found among mesoregions. The values observed were generally those expected for individuals of European descent, with the largest difference being a lower prevalence (34-39%) of P*1. Significant heterogeneity among mesoregions was observed for the other variables considered, and was consistent with historical records. The Amerindian contribution to the gene pool of European-derived subjects in Rio Grande do Sul was estimated to be as high as 11%. Based on the four data sets, the most general finding was a tendency for a northeast-southwest separation of the populations studied. Seven significant phenotype associations between systems were observed at the 5% level (three at the 0.1% level). Of the latter, the two most interesting (since they were also observed in other studies) were MNSs/Duffy and Rh/ACP

Anemias em crianças de dois serviços de saúde de Recife, PE (Brasil) Anemias in children from two health centers in Recife (Brazil)

Foi estudada a prevalência de anemia em 1.306 crianças, com idade compreendida entre 6 e 60 meses, de duas unidades de saúde, em Recife, PE, (Brasil). Na clientela pediátrica do Centro de Saúde Lessa de Andrade, mantido pelo Governo do Estado, a ocorrência de anemias era quase duas vezes superior à encontrada no Posto de Assistência Médica de Areias, pertencente ao Instituto Nacional de Assistência Médica e Previdência Social (INAMPS). A prevalência de valores baixos de hemoglobina predominava nas crianças abaixo de 2 anos de idade, variando de 41% a 77% nos extratos amostrais distribuídos nesta faixa etária. Além da relação com a idade, observou-se associação estatística entre ocorrência de anemias e estado nutricional definido pela classificação de Gomez e ainda, com a renda "per capita" das famílias das crianças examinadas. O trabalho faz parte de um estudo colaborativo sobre as anemias, em estados do nordeste do Brasil.<br>The prevalence of anemias in preschool children at two health centers in Recife, Pernambuco, Brazil, was investigated. A total of 1,306 children, aged 6-60 months, were selected. The prevalence of anemias was almost twice as high in the children at the Health Center Lessa de Andrade, supported by the state government, as that found at the Health Center in Areias, belonging to the Federal Health service (INAMPS). The low hemoglobin levels, which varied from 41 to 77% in the sample of this age group, was found to be higher in children under two years of age. Besides being related to the age, and to the per capita income of the families, of the children under study, a statistical association was detected between anemia and nutritional status assessed by Gomez's classification

Anemia em pessoas da cidade de Caceres/MT e suas relações com renda per capita

Foram estudadas a anemia e suas relações com a renda per capita em 1178 pessoas na cidade de Cáceres, Maio Grosso, Brasil nas faixas etárias de 6 a 14 anos (ambos os sexos), 15 a 45 anos do sexo feminino e 15 a 45 anos do sexo masculino. Encontrou-se maior prevalência de pessoas anêmicas nas faixas de renda < 1/4 do salário mínimo e 1/4 - 1/2 do salário mínimo nas três faixas etárias estudadas. Observou-se associação estatística entre a renda per capita e as médias de hemoglobina para as três faixas etárias

New genetic data on Amerindians from the Paraguayan Chaco

New data on 17 blood group and protein genetic systems obtained among the Ayoreo and Lengua Indians of Paraguay are presented. They include the first report on the red cell band-3 protein investigated among South American Indians. This information was integrated with previous results available for these two and four other groups. Five of the six populations reside in the Chaco area, while the sixth was included as an outgroup living elsewhere in Paraguay. Four of the five Chaco tribes exhibit good genetic homogeneity, but the Ayoreo are somewhat different. The results confirm the Chaco as a distinct biological (as well as cultural and economic) region, which should be considered in evaluations of genetic variability among South American Indians

Genetic relationships between amerindian populations of Argentina

A total of 495 individuals from five different Argentinian tribes was examined for variation in 23 blood group and protein genetic systems, and the results were integrated with previous data on some of these systems. These tribes generally present RH * R1, PGM1 * 1, and ACP * A frequencies lower and RH * R2, ESD * 1, and GLO * 1 prevalences higher than those observed in other South American Indian groups. Earlier studies with mitochondrial DNA showed that haplogroup A was present in low frequencies in these tribes, but haplogroup B showed a high prevalence among the Mataco. Average heterozygosities are very similar in the five tribes, while estimates of non-Indian ancestry are generally low. Both the blood group and protein, as well as the mtDNA data sets, divide the five tribes into two groups, and the relationships obtained with the blood group and protein systems are exactly those expected on the basis of geography and language. However, the topology obtained with the mtDNA results was different, possibly due to sampling effects or diverse patterns of exchange between the groups related to sex