The cerebrovascular accidents are one of the most frequent causes of morbimortality. Most of them are caused for the break of aneurysms in communicating arteries. The weak structure of these vessels ...explain the reason of these accidents.
The reason of this paper is study the organization of communicating arteries as cause of this fragility. Material and methods. The material of this study is composed of 61 human cerebral communicating arteries, grouped in decades. The study has been carried out by histological routine.
In general the structure of cerebral communicating arteries is characterized for the thinness and irregularity of the wall. In the childhood the internal elastic membrane and tunica media show thicker, while in young and adult people appear elastic fibers and reticulin as well as smooth muscle cells in tunica media. In adulthood (50 60 years) collagen in adventicia occupies tunica media, and adventicia is weaked. There are frequent media defects in these communicating arteries, that are usually repaired for conjunctive tissue stopper with abundance of collagen fibers. Starting from 4th decade the internal elastic membrane shows a great number of fenestrae through muscle and fiber tissue of media occupying subintimal space. Doubtless media defects mean the most severe threat of vascular outbreak.
The structural evolution with the age of communicating arteries, with predominance of collagen over elastin and reticulin, could be their reason of fragility.
Describir la clínica, radiología, diagnóstico y tratamiento en los niños afectados por un brote de tuberculosis en una guardería de Zaragoza.
El caso índice fue una cuidadora que fue diagnosticada ...tardíamente de tuberculosis activa. Se realizó Mantoux a todos los niños, a los positivos se hizo radiografía de tórax. En aquéllos con radiografía patológica se procedió al diagnóstico microbiológico.
De todos los niños de la guardería, 11 presentaron un Mantoux positivo. La radiografía fue patológica en 10. De ellos, 7 (70 %) estaban sintomáticos. Las imágenes radiológicas mostraban en 9 (90 %) casos una condensación parenquimatosa y en 5 (50 %) una adenopatía parahiliar. Tres niños (30 %) presentaron atelectasia lobular y precisaron broncoscopia y administración posterior de corticoides. La baciloscopia fue positiva solamente en un niño, el cultivo en siete y la detección de muestra directa para el complejo tuberculosis en otros siete. Únicamente en un niño toda la investigación fue negativa.
El diagnóstico de tuberculosis en la infancia es difícil, y a veces debe hacerse en base a unos criterios clínicos, radiológicos y epidemiológicos en niños con Mantoux positivo. Los test de detección de muestra directa para el complejo tuberculosis tienen una sensibilidad muy alta y proporcionan resultados muy rápidos. La aparición de brotes epidémicos continúa siendo un hecho frecuente en nuestro medio. El estudio de contactos en los mismos presenta un elevado rendimiento en el control de los brotes.
To describe the clinical and radiological features, diagnosis, and treatment of an epidemic outbreak of tuberculosis in a daycare centre in Zaragoza.
The index case was a teaching assistant with a late diagnosis of bacilliferous tuberculosis. Mantoux testing was carried out in all children. In those with a positive Mantoux test, a chest X-ray was performed. Children with an abnormal chest X-ray underwent microbiological investigations.
Among all the children in the daycare center, the Mantoux test was positive in 11 children. Chest X-ray was abnormal in 10 children. Of these, seven (70 %) were symptomatic. Chest X-ray showed dense opacification in nine children (90 %) and mediastinal lymph adenopathy in five (50 %). Three children (30 %) had lobar atelectasis requiring bronchoscopy and subsequent steroid therapy. Bacilloscopy was positive in only one child. Gastric juice culture was positive in seven children and the amplified
Mycobacterium tuberculosis direct test was positive in a further seven. All microbiological investigations were negative in only one child.
Establishing a definitive diagnosis of tuberculosis in children remains difficult and frequently relies on a constellation of clinical findings, radiology and epidemiology in children with a positive Mantoux test. The amplified
Mycobacterium tuberculosis direct test has high sensitivity and provides fast results. Epidemic outbreaks continue to be frequent in Spain. Study of contacts shows high efficiency in controlling outbreaks.
The study of the structure in the arterial wall has been essential to use vessels in the coronary and cerebral bypass. The superficial temporal artery, owing to its high elastic content and its ...topography, close to the middle cerebral artery, has made possible the revascularization surgery in cerebral areas with ischemia. AIM. The purpose of this study is define the structure of the superficial temporal artery.
The material of the present study are 60 arteries from medico legal necropsies without apparent vascular pathology. Pieces were fixed in 10% formol, embedded in Paraplast, sectioned in sequence of 7 mm and were stained to detect elastic, collagen and reticulin fibers. Histochemical techniques have been done too.
The superficial temporal artery shows a high elastic content, above all in the middle outer of the tunica media. The negative aspect is the great quantity of collagen in this tunica, that produces the progressive hardness of this vessel with the increase of the age. Histochemistry shows how the accumulation of acid mucosubstances interferes in the correct nourishing of the internal elastic membrane, that is disorganized in the cushions.
The superficial temporal artery is an appropriate vessel to the coronary and cerebral bypass, due to its high elastic content in this tunica and the limitants. It have not been observed in our material zones without internal elastic membrane. Histochemistry shows abundant acid mucosubstances that difficult the nourishing in the arterial wall.
To obtain further knowledge on the morphogenesis of the articulations in the tympanic ossicular chain in humans.
In 25 temporal bones of human fetuses the structural development of incudomallear, ...incudostapedial and stapediovestibular articulations was studied. The chronological ages were between the 7th week (21 mm) and the 29th week (270 mm).
Incudomallear articulation showed diarthrosis and sellar joint characteristics. It showed a homogenous interzone in the 7th week of development, a three-layered interzone in the 8th week, the first cavitation signs in the 9th week and the presence of an articular cavity in the 10th week. The presence of a hyaline cartilage covering articular surfaces was observed starting in the 20th week of development. Incudostapedial articulation showed typical characteristics of a diarthrosis and spheroidal joint with a homogenous interzone at the 7th week, showing similar characteristics for 12 weeks, and completed its cavitation at the 16th week. We observed hyaline cartilage on articular surfaces from 29 weeks. Stapediovestibular articulation showed typical characteristics of syndesmosis. The annular ligament primordium derived from cartilage differentiation, both from stapedial footplate and from the surrounding otic capsule, into mesenchyme and its subsequent transformation into fibrous tissue, reaching definitive characteristics from the 12th week.
The objective was to determine the percentage of patients with peripheral arterial disease (PAD) with good control of their cardiovascular risk factors (CVRF) (LDL cholesterol, blood pressure and ...smoke cessation).
Cross-sectional multicentre study. The location was Primary Care and other clinics that typically treat patients with peripheral arterial disease (Internal Medicine, Vascular Surgery, Cardiology, Endocrinology and Nephrology). The first 10 patients with peripheral arterial disease were systematically selected by 440 researchers from all regions.
The study included 4087 patients. Blood pressure was controlled in 29.5% of the cases. The frequency of patients with optimal control was significantly better in primary care (p<.01). There was an optimal control of LDL-C levels in 30.4% of patients. Factors associated with optimal control of LDL-C was, being diabetic, stage I of La Fontaine, and being seen by a doctor that was not the primary care physician. Control was worse in women and in smokers.
Primary care physicians better manage patients with hypertension. Patients seen in by a specialist as opposed to primary care are more likely to achieve optimal control of CVRF. The situation is far from the ideal, only 6% achieved optimal control of all CVRF.
The effect of a 12-week high-intensity intermittent exercise program on fiber type composition and the oxidative capacity of rectus femoris skeletal muscle from 20 male Wistar rats (Trained,
n=10; ...Sedentary,
n=10) was histochemically determined. The training exercise program was developed in a motorized treadmill. It consisted of four running bouts of 2 min duration at 48 m/min, alternated with recovery intervals of 4 min. Training increased relative cross-sectional area of oxidative fibers (I, IIA, IIX) and decreased the same parameter in type IIB non-oxidative fibers (
P<0.001). Our results suggest that this type of strength exercise program is enough to induce changes in muscle fiber composition. This opens a possibility to use this kind of exercise in preventing and treating muscle atrophy.
RS3PE associated with tuberculosis Nicolás-Sánchez, F J; Rozadilla Sacanell, J R; Gort Oromí, A M ...
Anales de medicina interna (Madrid, Spain : 1984)
24, Številka:
10
Journal Article
Recenzirano
The remitting seronegative symmetrical synovitis with pitting edema of the elderly patient with edema and fovea (RS3PE), characterizes for the appearance of one polyarthritis symmetrical with fovea ...in the back of the hands, and negative reumatoideal factor. The association to tuberculosis had not been described before. One presents the case of a 89-year-old patient who consulted for anorexia of month and a half of evolution accompanied of edema in hands and feet, with negative reumatoideal factor. He was presenting a pulmonary infiltrated, which microbiological study revealed the infection for Mycobacterium tuberculosis.
The purpose of this report is to contribute to the knowledge of the morphogenesis of the human stapedius muscle. We have studied the stapedius structure development in 17 temporal bones from human ...fetuses. Chronological ages were from 48 days (21 mm) to 29 weeks (270 mm). Samples were fixed in 10% formol, decalcified with 2% nitric acid, embedded in Paraplast, sectioned in sequence of 7 microns and were stained with haematoxylin & eosin and Martins' trichrome. Four maturation stages were observed in the development of the stapedius muscle structure. First, the formation of the 'primordium muscularis' in the mesenchyme of the tympanic cavity (promyoblasts) was observed in a 36-mm embryo. Second, its differentiation into myoblasts, and its next cellular fusion to form muscle tubes, was seen in a 99-mm foetus. In the third stage, myofibrogenesis phenomena were developed, to synthesize, the myotube myoblasts, myofilaments, phenomena we observed that took place during the 14th to 17th weeks of development. The last stage was characterized by the presence of striated muscle fibres, at first intermingled with myotubes (18th to 26th weeks), until in the 29th week fetuses (270 mm) the skeletal muscle fibre was completely differentiated. We conclude that in the 29th week of development (270 mm) the stapedius muscle structure is completely differentiated, although the functional development is not complete until birth.
We studied the effect of resistance running on left cardiac ventricle size and rectus femoris muscle fiber composition. Ten male Wistar rats were trained on a treadmill 6 days per week for 12 weeks. ...Ten rats remained sedentary and served as controls. A higher endurance time (40%) and cardiac hypertrophy in the trained animals were indicators of training efficiency. Morphometric analysis of the left ventricle cross-sectional area, left ventricular wall, and left ventricular cavity were evaluated. The endurance-running group demonstrated a hypertrophy of the ventricular wall (22%) and an increase in the ventricular cavity (25%); (p<0.0001). Semi-quantitative analysis of rectus femoris fiber-type composition and of the oxidative and glycolytic capacity was histochemically performed. Endurance running demonstrated a significant (p<0.01) increase in the relative frequency of Type I (24%), Type IIA (8%) and Type IIX (16%) oxidative fibers, and a decrease in Type IIB (20%) glycolytic fibers. There was a hypertrophy of both oxidative and glycolytic fiber types. The relative cross-sectional area analysis demonstrated an increase in oxidative fibers and a decrease in glycolytic fibers (p<0.0001). Changes were especially evident for Type IIX oxidative-glycolytic fibers. The results of this study indicate that the left ventricle adapts to endurance running by increasing wall thickness and enlargement of the ventricular cavity. Skeletal muscle adapts to training by increasing oxidative fiber Type. This increase may be related to fiber transformation from Type IIB glycolytic to Type IIX oxidative fibers. These results open the possibility for the use of this type of exercise to prevent muscular atrophy associated with age or post-immobilization.
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