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Intracavernous injection (ICI) therapy is an effective treatment for erectile dysfunction (ED) that has been used since 1982. Intracorporeal needle breakage is a rare complication of this procedure, with a few case reports in the literature. Thus, we present a case of a 54-year-old man with needle breakage during routine application. The precise location of the needle was confirmed by radiography and ultrasonography. This patient was successfully treated with surgical exploration and needle withdrawal. No postoperative complication was reported and he maintained his usual response to intracavernous vasoactive agents. Although rare, it can be solved with immediate surgical exploration with no long-term complications.

Intestinal mucositis is a common complication associated with 5-fluorouracil (5-FU), a chemotherapeutic agent used for cancer treatment. Troxerutin (TRX), a semi-synthetic flavonoid extracted from Dimorphandra gardneriana, has been reported as a potent antioxidant and anti-inflammatory agent. In the present study, we aimed to evaluate the effect of TRX on 5-FU-induced intestinal mucositis. Swiss mice were randomly divided into seven groups: Saline, 5-FU, TRX-50, TRX-100, TRX-150, Celecoxib (CLX), and CLX + TRX-100. The weight of mice was measured daily. After treatment, the animals were euthanized and segments of the small intestine were collected to evaluate histopathological alterations (morphometric analysis), levels of malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), mast and goblet cell counts, immunohistochemical analysis, and cyclooxygenase-2 (COX-2) activity. Compared to the saline treatment, the 5-FU treatment induced intense weight loss and reduction in villus height. TRX treatment (100 mg/kg) prevented the 5-FU-induced histopathological changes and decreased oxidative stress by decreasing the MDA levels and increasing GSH concentration. TRX attenuated inflammatory process by decreasing MPO activity, intestinal mastocytosis, and COX-2 expression. TRX also reversed the depletion of goblet cells. Our findings suggest that TRX at a concentration of 100 mg/kg had chemopreventive effects on 5-FU-induced intestinal mucositis via COX-2 pathway.

Playfulness is an important tool in the process of teaching and learning anatomy. The playful is an environment that allows pleasure, play fun and playfulness thus promoting meaningful learning. Ba...

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 2006 to 2017. For this, we performed a bibliographic review by means of 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.

Introduction: Congenital diaphragmatic hernia is a poor forma - tion 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 dia - phragmatic 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. Conclusion This case illustrates a rare case of diaphragmatic hernia with intestinal changes of clinical and surgical importance.

Resumen Introduccion La nefrectomia laparoscopica en ninos se ha convertido en una alternativa razonable a la nefrectomia abierta y ha sustituido a la cirugia abierta en muchas enfermedades renales. El objetivo de nuestro estudio es evaluar los procedimientos videolaparoscopicos transperitoneales en las enfermedades renales benignas en comparacion con el abordaje quirurgico abierto. Pacientes y metodo 34 ninos de edades comprendidas entre los 17 dias y los 15 anos (media, 6,14 anos) fueron divididos en dos grupos de nefrectomia; el primero fue sometido a nefrectomia videolaparoscopica transperitoneal y estaba compuesto por 21 pacientes (12 mujeres y 9 varones) con edades comprendidas entre los 2 meses y los 15 anos (media, 7,42 anos). El segundo grupo fue sometido a nefrectomia abierta y estaba compuesto por 13 pacientes (6 mujeres y 7 varones) con edades comprendidas entre los 17 dias y los 11 anos (media, 3,91 anos). Los grupos se compararon respecto al tiempo de anestesia, el tiempo operatorio, la duracion de la estancia hospitalaria, el dolor postoperatorio y el tiempo de reinstauracion de la ingesta oral. Tambien se evaluaron las complicaciones a corto y largo plazo. El analisis estadistico se llevo a cabo mediante la prueba de la t de Student, y se estimo significativo el valor de p Resultados Se observaron diferencias estadisticamente significativas solo en cuanto a la variable duracion de la estancia hospitalaria. Ningun caso del grupo a laparoscopia se convirtio en cirugia abierta. No se observaron complicaciones inmediatas ni tardias. La perdida de sangre fue insignificante y no fue necesario administrar transfusiones. Conclusiones Segun nuestra experiencia, la nefrectomia videolaparoscopica transperitoneal presenta resultados similares a los de la nefrectomia abierta, excepto en lo que respecta al tiempo de hospitalizacion.

Purpose: We present our experience with kidney transplantation in children weighing 20 kg. or less. Surgery was done via extraperitoneal access while preserving the peritoneal cavity intact with special attention given to technical feasibility and the complication rate.Materials and Methods: Included in our study were 46 children with a median age of 7 years weighing 20 kg. or less (mean 16.6), of whom 16 weighed less than 15 kg. (median 13.2). The 25 boys and 21 girls underwent a total of 49 kidney transplants, including 2 in 3 during the study. Donors were living related in 44 cases and cadaveric in 5. Surgical access was obtained by making a J-shaped pararectal incision in a curvilinear fashion from the symphysis pubis to near the costal border.Results: Mean hospital stay was 22.9 days (range 6 to 83) and mean followup was 55.8 months (range 12 to 131). All patients received water on day 1 and food on day 2 postoperatively. In 6 patients 7 surgical complications developed, including urinary fistula in ...

We report a case of persistent skenitis that was initially misdiagnosed and treated as a urinary infection. Despite an adequate course of antibiotics, the symptoms failed to improve. The case was ultimately resolved with surgical intervention, which resulted in its prompt and complete resolution.

A shortage of organs for transplantation has forced surgeons to optimize the use of marginal organs, such as kidneys with arterial disease. We present a retrospective study of the outcome of donors with renal artery disease and recipients of kidneys from living related and unrelated donors.Kidneys with vascular abnormalities from healthy living donors were grafted into 11 recipients. These kidney transplants comprised 1.8% of those performed at our institution. The vascular abnormalities were aneurysms in 3 cases, atherosclerotic lesions in 4 and fibromuscular dysplasia in 4. After nephrectomy all abnormalities were corrected under hypothermic conditions during bench surgery except in 3 cases of ostial atherosclerotic plaque, which was left in the donors. The renal artery was anastomosed to the external iliac artery in 5 cases and to the internal iliac artery in 6. The ureter was reimplanted using an extravesical technique.All patients had immediate diuresis and no delayed post-transplant graft dysfunction was observed. One patient died of an unrelated cause and 3 had post-transplant graft function loss due to acute vasculopathy in 1, post-diarrhea with acute arterial thrombosis in 1 and recurrence of the hemolytic-uremic syndrome in 1. All remaining patients are well with median serum creatinine of 1.4 mg./dl. (normal 0.4 to 1.4). All donors are well and normotensive with normal renal function.The use of kidneys with arterial disease from living donors with unilateral disease is safe. Complete informed consent regarding the risks and benefits by donor and recipient is mandatory.

Purpose: Lower urinary tract symptoms are numerous, but the specific impact of each of these symptoms on the quality of life (QoL) has not been evaluated in community-dwelling men. An assessment of these symptoms and their effects on QoL was the focus of this study. Methods: We performed a cross-sectional study with 373 men aged > 50 years from a community setting. Patients completed the International Prostate Symptom Score questionnaire, which includes questions on each of the specific urinary symptoms and a question addressing health-related QoL that are graded from 0 to 5. We used the Pearson correlation test to assess the impact of each symptom on QoL. Results: Nocturia (58.9%) was the most prevalent urinary symptom. The mean score was 0.9 ± 1.4 for incomplete emptying, 1.0 ± 1.5 for frequency, 0.9 ± 1.3 for intermittency, 0.8 ± 1.3 for urgency, 1.0 ± 1.5 for weak stream, 0.5 ± 1.0 for straining, and 2.0 ± 1.6 for nocturia. Nocturia and frequency were the only symptoms associated with poorer QoL, with nocturia showing a stronger association. Conclusions: Nocturia affects 50% of community dwelling men aged > 50 years, and is the lower urinary tract symptom with the greatest negative impact on QoL.

We report a case of a 32-year-old man, who presented to the emergency department with severe abdominal pain, with radiation to his back. An ultrasound examination revealed mild hydronephrosis bilaterally. A non-enhanced computer tomography was then performed and showed a 9 mm hyperdense image in the left ureter topography along together with an 8-mm hyperdense image in the right ureter topography, allowing us to establish the diagnosis of bilateral ureterolithiasis. The patient was taken to the operating room in order to perform ureteroscopy for endoscopic removal of the stones.

A total of 117 differentiated thyroid adenocarcinomas that had been removed by total thyroidectomy were studied. Seventy (60%) were papillary, 36 (30%) were follicular, and 11 (10%) were Hürthle cell adenocarcinomas. The mean length of follow-up was 57.7 months. Adverse prognostic factors according to multivariate analysis were adjacent tissue infiltration (p = 0.0004), histologic type (p = 0.0049), and patient age (p = 0.033). The nuclear DNA content of tumor cells and of morphologically normal adjacent tissue was assessed by image cytometry, and correlations between nuclear DNA content and prognostic factors were examined. Fifty-four (75%) adenocarcinomas were classified as aneuploid, 9 (13%) as diploid, and 9 (12%) as borderline. Thirty-four (60%) specimens of morphologically normal adjacent tissue were classified as aneuploid, 18 (32%) as diploid, and 5 (8%) as borderline. The correlation between tumor ploidy and selected prognostic factors was statistically significant for patient age (p = 0.004) and histologic type (p = 0.033). Despite the fact that ploidy could not be identified as a prognostic factor, we suggest that, because of its correlation with age and histologic type, it might prove prognostic if the number of patients were increased. We also emphasize the importance of evaluating morphologically normal adjacent tissue because of the high rates of aneuploidy in these areas.