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Objetivou-se investigar ex vivo o diâmetro anatômico e conicidade do canal mesiopalatino de primeiros molares superiores. Para tanto, trinta e três primeiros molares superiores humanos foram acessados, explorados para confirmação da existência do canal mesiopalatino, identificados, suas raízes mesiovestibulares seccionadas transversalmente em três níveis e, então, os fragmentos foram fotografados com microscópio digital, que permitiu a realização das determinações dos diâmetros anatômicos deste canal em cada amostra. Os resultados foram calculados em função dos valores médios e de desvio padrão dos diâmetros em cada nível, obtendo-se respectivamente 0,20 mm e ±0,09 mm (nível cervical), 0,20 mm e ±0,08 mm (nível médio) e 0,17 mm e ±0,06 mm (nível apical). Nas condições deste estudo, de acordo com caráter atrésico e baixa conicidade do conduto mesiopalatino, sugere-se a necessidade de uso de instrumentos de diâmetro de ponta mínimo de 0,25 mm e conicidade 0,03 para o seu preparo.
The aim was to investigate ex vivo the anatomical diameter and taper of the mesiopalatine canal of maxillary first molars. To this end, thirty-three human maxillary first molars were accessed, explored to confirm the existence of the mesiopalatine canal, identified, their mesiobuccal roots transversely sectioned at three levels and then the fragments were photographed using a digital microscope, which allowed the anatomical diameters of this canal to be determined in each sample. The results were calculated according to the mean and standard deviation values of the diameters at each level, obtaining 0.20 mm and ±0.09 mm (cervical level), 0.20 mm and ±0.08 mm (middle level) and 0.17 mm and ±0.06 mm (apical level) respectively. Under the conditions of this study, given the atresic nature and low taper of the mesiopalatine canal, it is suggested that instruments with a minimum tip diameter of 0.25 mm and a taper of 0.03 should be used for its preparation.
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Raíz del Diente , Preparación del Conducto Radicular , Endodoncia , Anatomía , Diente MolarRESUMEN
Quillay (Quillaja saponaria Molina) and peumo (Cryptocarya alba [Molina] Looser) are two tree species endemic to Chile that grow in Mediterranean climate zones, characterized by a summer season with high temperatures, high solar radiation, and low soil water availability. A study was conducted with 2-year-old Q. saponaria and C. alba plants and two substrate water conditions: well-watered and controlled water restriction. At the end of the study, anatomical leaf modifications were analyzed. The tissues were anatomically described in transverse sections of juvenile and adult leaves, measuring leaf thickness, cuticle thickness, and cell density of the mesophyll parenchymal tissues. In the young leaves of Q. saponaria plants undergoing water restriction treatment, an increase in cuticle and leaf thickness and a decrease in the density of the palisade and spongy parenchyma were observed. In contrast, a significant reduction in leaf thickness was observed in adult leaves of both species with water restriction treatment. The anatomical changes in the leaves of Q. saponaria and C. alba suggest an adaptation to adverse environmental conditions, such as water restriction.
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Within Xenarthra (Eocene-Recent), Folivora developed (late Eocene-Recent) a remarkable diversity with respect to ecology and taxonomy over its evolutionary history. Knowledge of the diversity achieved by members of this clade in high-altitude areas of South America (i.e., Altiplano and Puna regions of Peru, Bolivia, and northwestern Argentina) has been improved in recent decades. A particular example involves the late Neogene Mylodontidae Simomylodon uccasamamensis, known mostly from multiple specimens recovered from the Bolivian Altiplano. Although several anatomical descriptions of this ground sloth have been published, almost nothing is known about its ontogenetic development and the associated morphological changes. Here we describe and compare new specimens of S. uccasamamensis from the upper level of the Tafna Formation (Pliocene) in the eastern Puna (ca. 3800 masl), Argentina, representing the southernmost record of this species. The new material is represented by specimens showing different ontogenetic stages, from infant to adult. One subadult specimen reached an estimated body mass of ca. 232 kg. The comparative study of external and internal morphology (the latter obtained from CT scans and radiography) shows remarkable changes in the mandible and molariforms associated with ontogeny; in addition, evidence suggests that the mfs2-3 are the first functional teeth, followed by mf1 and cf1. Based on our body mass estimates (ca. 232 kg.), we inferred an average lifespan of 14 years, 9-month gestation time, and sexual maturation at 4.1 years, quite similar to the values we obtained based on estimated body masses of adult specimens from Bolivia published by previous authors. Along its latitudinal distribution (ca. 14° S-21° S) S. uccasamamensis co-occurred with other ground sloths (e.g., Megatheriinae, Thalassocninae, and Scelidotheriinae), suggesting niche partitioning. The presence of this medium-sized ground sloth is consistent with the similarity between the faunas of eastern Puna and the Bolivian Altiplano during the Pliocene, which is also concordant with what was observed in other clades, such as Rodentia and Notoungulata.
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Given the high prevalence of skeletal and mandibular diseases in the Patagonian Huemul, comprehensive anatomical studies are essential to understand the impact of nutritional deficiencies and support conservation efforts. The aim of this study is to provide a detailed anatomical characterisation of three exhumed mandibles of Patagonian huemul (Hippocamelus bisulcus) through three-dimensional reconstructions obtained from computed tomography data and semi-automatic segmentation, documenting their distinctive features. The findings revealed distinctive features in the mandible, consistent with the browsing habits of herbivores, such as a robust coronoid process, a wide and deep pterygoid fossa, a significantly lower mandibular condyle compared to other deer species and a unique configuration of the mandibular canal with a curved caudal portion and a straight rostral portion. These anatomical adaptations are likely related to the species' feeding habits and behaviour. The study also addressed the challenges of researching an endangered species, given that access to biological material is restricted by strict regulations in Chile and Argentina. These restrictions limited the available sample size and hindered the acquisition of additional specimens, which could affect the generalisation of the results. Despite these limitations, the research provides valuable anatomical insights that are fundamental for the biology, clinical practice and management of specimens. In conclusion, the mandibles of both juvenile and adult Patagonian huemul demonstrate distinctive features characteristic of browsing herbivores. The findings can serve as a basis for future comparative studies on mandibular anatomy and function in this endangered deer species as well as in other herbivorous deer.
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Ciervos , Mandíbula , Tomografía Computarizada por Rayos X , Animales , Mandíbula/anatomía & histología , Mandíbula/diagnóstico por imagen , Ciervos/anatomía & histología , Ciervos/fisiología , Argentina , Tomografía Computarizada por Rayos X/veterinaria , Chile , Masculino , Imagenología Tridimensional/veterinaria , FemeninoRESUMEN
Background and Aims: Clonality is characterized by the formation of independent individuals of the same genotype that are capable of reproducing and propagating vegetatively. Although clonality is an important mechanism that facilitates the persistence of a population, its extensive use can lead to negative impacts on sexual reproduction due to trade-offs in the investment of resources. Therefore, studies on the sexual reproduction of species that exhibit clonality can provide information about resilience to environmental changes, information about fecundity, the risk of the absence of pollinators and the ability to persist in unfavourable conditions and to successfully occupy new areas. Here, we investigated the role of clonal propagation and sexual reproduction in Daphnopsis filipedunculata (Thymelaeaceae), a dioecious species distributed only in Serra dos Carajás. Methods: We evaluated the extent of clonality in this species using molecular tools and anatomical analyses of the underground system responsible for developing new ramets. Furthermore, we analysed the sexual system and its contribution to reproductive success through morphometric analyses of floral types and pollination experiments in the field. Key Results: Overall, we found that clonal propagation plays an important role in maintaining the population of D. filipedunculata. Specifically, we demonstrated that this species presents functional male and female plants, indicating that D. filipedunculata is an obligate xenogamous species but has low reproductive success. We also showed that clonal vegetative propagation is the main form of asexual reproduction in this species, with roots responsible for clonal growth. Finally, our results indicated that this species presents an intermediate phalanx-guerrilla clonal architecture. Conclusions: Our study provides the first insights into sexual reproduction and clonal propagation in D. filipedunculata and can inform management practices, conservation and the restoration of endemic species.
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Introdução: O estudo explora a cirurgia de contorno corporal em pacientes submetidos a cirurgias bariátricas. Nos últimos anos, esse tipo de intervenção cirúrgica ganhou destaque devido ao aumento na busca por procedimentos reparadores após significativa perda de peso. O texto enfatiza a importância da flancoplastia, técnica que visa melhorar o contorno corporal. Métodos: Foi realizada revisão da literatura para elucidação da anatomia da gordura profunda da fáscia toracolombar, e feito um paralelo com a técnica de flancoplastia utilizada em nosso serviço em pacientes pós-bariátricos submetidos a abdominoplastia 360° ou 270° no Hospital Daher Lago Sul, em Brasília- DF. Resultados: A lipoaspiração profunda dos flancos, muitas vezes necessária em cirurgias de contorno corporal, pode não ser suficiente para retirar a gordura profunda à fáscia toracolombar e durante esse procedimento observa-se risco aumentado de lesões retroperitoneais. No entanto, a flancoplastia, que envolve a ressecção da gordura profunda à fáscia toracolombar, demonstrou proporcionar resultados satisfatórios e minimizar esses riscos. Conclusão: O estudo enfoca a importância do conhecimento anatômico preciso, destacando a relevância da flancoplastia como uma técnica valiosa para melhorar os resultados estéticos e reduzir complicações em pacientes pós-bariátricos, complementando a cirurgia bariátrica e melhorando a qualidade de vida do paciente.
Introduction: The study explores body contouring surgery in patients undergoing bariatric surgery. In recent years, this type of surgical intervention has gained prominence due to the increase in the search for reparative procedures after significant weight loss. The text emphasizes the importance of flankplasty, a technique that aims to improve body contour. Methods: A literature review was carried out to elucidate the anatomy of the deep fat of the thoracolumbar fascia, and a parallel was made with the flankplasty technique used in our service in post-bariatric patients undergoing 360° or 270° abdominoplasty at Daher Lago Sul Hospital, in Brasília-DF. Results: Deep liposuction of the flanks, often necessary in body contouring surgeries, may not be sufficient to remove fat deep into the thoracolumbar fascia and during this procedure, there is an increased risk of retroperitoneal injuries. However, flankplasty, which involves resection of fat deep into the thoracolumbar fascia, has been shown to provide satisfactory results and minimize these risks. Conclusion: The study focuses on the importance of precise anatomical knowledge, highlighting the relevance of flankplasty as a valuable technique to improve aesthetic results and reduce complications in post-bariatric patients, complementing bariatric surgery and improving the patient's quality of life.
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Silvopastoral systems are an important strategy for sustainable livestock production. However, to expand their implementation, it is crucial to identify and develop forage materials that maintain good production and quality while being tolerant to shade conditions as well as other biotic and abiotic stresses. A field trial was conducted to evaluate the morpho-anatomical and agronomic responses of two Urochloa hybrids (Camello and Talisman) under two light conditions: shade (28 % light intensity) and full exposure. The trial followed a randomised complete block design with split-plot arrangement, where each treatment corresponded to a plot with three replications. Morphological and anatomical parameters were recorded in three technical replicates of each replication. Histological leaf sections were analysed for the percentage of adaxial epidermis, abaxial epidermis, vascular tissue, colourless parenchyma, Kranz sheath, bulliform cells, sclerenchyma, and chlorenchyma. Measurements in leaf included relative chlorophyll concentration, leaf area, leaf length, and leaf width. Evaluations in plant included height and number of tillers. Agronomic parameters such as plant cover and dry biomass were recorded for each plot. Additionally, six leaf imprints were made on the leaf undersides to observe stomatal morphology, and their length was recorded. Furthermore, plants from each treatment were grown in soil-filled tubes within the same plots. Root system photographs were taken, and in three replications per treatment, root length, root diameter, root volume, root surface area, and the depth at which 95 % of roots were concentrated (D95) were determined. These data can be utilised by the scientific community and breeders to conduct analyses and meta-analyses to identify shade tolerance mechanisms and develop genetic materials tolerant to changing climatic conditions while being optimal for use in silvopastoral systems.
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The Mabuyinae subfamily exhibits remarkable diversity, encompassing 26 genera and 236 currently recognized species. Traditionally, the entire range of the group was attributed to the single genus Mabuya, which had a wide distribution along tropical regions of the Planet. In recent studies, phylogenetic hypotheses based on molecular data have identified four major groups, which have been further divided into geographically distinct clades. At least two phylogenetically distinct lineages of Mabuyinae are distributed in the Neotropical Region: Trachylepis atlantica and the remaining 16 genera within the Mabuyinae clade from the mainland and the Caribbean islands. Our understanding of Mabuyinae osteology is still quite limited, particularly concerning interspecific variation. This lack of information hinders our ability to make strong contributions to the phylogenetic relationships within this group or even to confirm the existence of certain new taxa considering their relatively conserved external morphology. This work provides a comprehensive anatomical reference for the adult skull of Neotropical Mabuyinae lizards, highlighting osteological features that might be useful for delimiting each genus. This descriptive guide includes illustrations and employs multiple techniques, such as dry preparation, clearing and staining, and high-resolution computerized microtomography. Our results provide additional diagnostic characteristics that include specific cranial bone arrangements, dental patterns, and cranial adaptations, such as dorsoventral head flattening, and their functional implications for bite force and cranial biomechanics. This study reinforces the importance of cranial morphology in understanding the phylogenetic relationships and evolutionary trajectories of New World Mabuyinae lizards, advocating for broader morphological sampling to enrich our understanding of these diverse reptiles.
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Little is known about the biology of pygmy sperm whales, Kogia breviceps (De Blainville, 1838), being that most anatomical descriptions for the species derive from necropsy after stranding or from osteological material preserved in museums. This species is rarely seen despite its wide distribution, and its reproductive behaviour is still being investigated. The eventual occurrence of pregnant female strandings and the collection and description of foetuses can give clues about the organisms' mostly unknown early development. However, this type of biological material is extremely rare, limiting anatomical analysis due to the risk of damage or loss. Here, we describe the external and internal anatomy of an 84 cm long K. breviceps foetus. The methods utilised were non-intrusive, meaning that no incisions were made on the specimen. The foetus was analysed using computed tomography images and a three-dimensional reconstruction of the skeleton. A great number of features were observed, such as axial and appendicular skeletal structures, internal organs, echolocation apparatus and umbilical cord, as well as diagnostic characters of the species, such as the asymmetrical skull, spermaceti chamber and false gill pigmentation. We suggest that more specimens on different stages of development should be analysed by the same technique, as well as further comparison with specimens from other taxa, in order to facilitate more comparative studies on embryonic and foetal development of cetaceans.
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INTRODUCTION: Knowledge of anatomical variants that affect the hepatic duct (HD) are of particular clinical relevance during hepatobiliary surgical procedures. More specifically, the aberrant anatomy of the common HD is the most common anatomical variation affecting the biliary tree. Below, we describe different classifications of anatomical variants that affect this canal. According to Huang's classification, variations are determined depending on the insertion of the right posterior hepatic duct (RPHD). MATERIALS AND METHODS: Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases were investigated until January 2024. The methodological quality was assessed with an anatomical studies assurance tool (AQUA). Pooled prevalence was estimated using a random effects model. For the subgroup analysis, Student's T-test was used. RESULTS: The prevalence rate of aberrant hepatic duct (AHD) was 15% (confidence interval [CI] of 7-22%). The first subgroup had cadavers and images. For the cadavers, the prevalence was 15.83% (CI: 11.22-18.3%), while the images had a prevalence of 22.06% (CI: 18.12-25.33%). This subgroup analysis showed no statistically significant difference between these groups (p = 0.127). The second subgroup comprised the continents where the included studies were from. In this subgroup, no statistically significant differences were found (p = 0.613). Finally, regarding the right or left laterality of the HD variant, there were no statistically significant differences (p = 0.089). CONCLUSION: A AHD corresponds to a finding that can occur in a significant percentage of our society, which could be an accidental discovery during surgeries or present asymptomatically throughout life and be a cadaveric discovery later. We believe it is important for surgeons to have prior knowledge of the possible variants of HD to prevent possible complications during and after surgery.
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AIM: To evaluate the agreement between six currently available periapical radiography-based methods for measuring the root canal curvatures in mesial roots of mandibular first molars, assessed by two examiners with different proficiency levels. METHODOLOGY: Non-endodontically treated mesial roots of 41 human mandibular first molars were radiographed using the parallelling technique. Two independent observers (a specialist in endodontics and radiology and a final-year dental student) assessed their root canal curvature using the methodologies described by Schneider (1971, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 32, 271), Weine (1982, Endodontic therapy), Berbert and Nishiyama (1994, Revista Gaúcha de Odontología, 356), Luiten et al. (1995, Journal of Endodontics, 21, 26), Hankins and ElDeeb (1996, Journal of Endodontics, 22, 123) and Pettiette et al. (1999, Journal of Endodontics, 25, 230). Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient. The differences in curvature angle measured by the different methods were compared using the one-way anova for repeated measures test, followed by Tukey's post hoc analysis. The effect was calculated using the Cohen's d method. To determine the agreement between methods, the Bland-Altman analysis was used. The significance level was set at 5%. RESULTS: Agreement for the observers was excellent (>0.81) for the six methods considered. For the angle comparisons between methods, the maximum differences were for Schneider versus Weine (35.77°) and Luiten versus Hankins (35.14°), whilst the highest percentage of angles with a difference >10° were Weine versus Luiten and Berbert versus Pettiette (90%) and the comparison Weine versus Hankins presented with the lowest frequency (15%). Excellent agreement was found for five comparisons: Weine versus Luiten (0.940), Berbert versus Pettiette (0.917), Weine versus Pettiette (0.907), Luiten versus Pettiette (0.904) and Berbert versus Luiten (0.812). Compared to Schneider's method, the other methods showed a tendency of increasing difference as the angles became more acute. The other methods exhibited linear differences, remaining constant for smaller and larger angles. CONCLUSIONS: Reliability was excellent for all methods assessed separately. Maximum differences in curvature angles were found when comparing Schneider versus Weine and Luiten versus Hankins. Excellent agreement was found for Weine versus Luiten, Berbert versus Pettiette, Weine versus Pettiette, Luiten versus Pettiette and Berbert versus Luiten. In the presence of dilacerations, the method by Schneider was less sensitive.
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INTRODUCTION: Myomodulation is a technique aimed at enhancing the dynamics of muscle contraction and relaxation through methods like hyaluronic acid (HA) injection. Achieving optimal outcomes depends on the precise placement of the injected product within the targeted anatomical plane. This is particularly important in the forehead, an area with elevated vascular risk. The selected treatment techniques must ensure both efficacy and safety. This study aims to assess the anatomical precision of HA injections in the forehead using different techniques and devices. METHODS: Four fresh frozen specimens were injected with HA by five experienced board-certified plastic surgeons using three different techniques/devices: (1) a 50 mm, 22G microcannula; (2) a 13 mm, 27G needle with the bevel down at a 45-degree angle; and (3) the same needle positioned at a 90-degree angle. Ultrasound analysis was used to evaluate the precision of each approach. RESULTS: Both the cannula technique and the needle technique with the bevel down at a 45-degree angle consistently delivered the filler to the supraperiosteal layer in 100% of cases without spreading. However, the 90-degree needle technique, despite correct placement on the periosteum, resulted in filler dispersion across multiple layers. CONCLUSION: The accuracy of filler placement in the forehead is influenced by the choice of device and its angulation. It is recommended to use a cannula with the entry point at the frontalis crest or a needle angled at 45 degrees to the skin. The use of a needle at a 90-degree angle should be avoided to ensure precise placement and avoid filler migration. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Lateral lumbar interbody fusion (LLIF), developed by Dr. Luiz Pimenta in 2006, allows access to the spinal column through the psoas major muscle. The technique has many advantages, such as reduced bone and muscular tissue damage, indirect decompression, larger implants, and lordosis correction capabilities. However, this technique also has drawbacks, with the most notorious being the risk of spinal pathologies due to indirect injury of the lumbar plexus, but with low rates of persistent injuries. Therefore, several groups have proposed classifications to help identify patients at a greater risk of presenting with neurological deficits. The present work proposes a classification system that relies on simple observation of easily identifiable key structures to guide lateral L4-L5 LLIF decision-making. Patients aged > 18 years who underwent preoperative magnetic resonance imaging (MRI) between 2022 and 2023 were included until 50 high-quality images were acquired. And excluded as follow Anatomical changes in the vertebral body or major psoas muscles prevent the identification of key structures or poor-quality MRIs. Each anatomy was classified as type I, type II, or type III according to the consensus among the three observers. Fifty anatomical sites were included in this study. 70% of the L4-L5 anatomy were type I, 18% were type II, and 12% were type III. None of the type 3 L4-L5 anatomies were approached using a lateral technique. The proposed classification is an easy and simple method for evaluating the feasibility of a lateral approach to-L4-L5.
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Vértebras Lumbares , Imagen por Resonancia Magnética , Fusión Vertebral , Humanos , Fusión Vertebral/métodos , Vértebras Lumbares/cirugía , Vértebras Lumbares/anatomía & histología , Imagen por Resonancia Magnética/métodos , Femenino , Masculino , Persona de Mediana Edad , Anciano , AdultoRESUMEN
Cadmium (Cd) is a heavy metal that is highly toxic to plants and animals and can accumulate in the environment as a result of industrial activities and agricultural application of some types of phosphate fertilizer. This study aimed to assess the role of sodium nitroprusside (SNP), as a source of nitric oxide (NO) in alleviating Cd stress in maize plants. Maize plants were kept in soil saturated with 40%-strength nutrient solution in a greenhouse, and cadmium nitrate, Cd(NO3)2, was applied at different concentrations, (0, 10, and 50 µM). Sodium nitroprusside, [Fe(CN)5NO]·2H2O, at concentrations of 0.05, 0.1, and 0.2 µM. Growth, leaf gas exchange, and leaf anatomy analyses were performed. The experimental design was completely randomized in a 3 × 3 factorial arrangement with five replicates. The highest concentrations of Cd and SNP reduced the total dry mass and leaf and stem dry mass but increased the allocation of biomass to the roots and stem, but the leaf allocation did not change. The application of Cd and SNP promoted an increase in gas exchange and leaf area, in addition to an increase in leaf tissue thickness and stomatal density. The presence of SNP at low concentrations reduces the toxicity of Cd, but at high concentrations, this compound can generate negative effects and even toxicity in maize plants.
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In medical education, traditional anatomy labs have relied heavily on the hands-on dissection of cadavers to teach the complex spatial relationships within the human body. However, the advent of virtual reality (VR) technology offers the potential for significantly enhancing this traditional approach by providing immersive, interactive 3D visualizations that can overcome some of the limitations of physical specimens. This study explores the integration of VR into a traditional gross anatomy lab to enrich the learning experience for medical students. Methods included the deployment of a VR application developed to complement the dissection process, featuring detailed 3D models of human anatomy that students could manipulate and explore digitally. Approximately 60 s-year medical students participated in the lab, where they engaged with both traditional dissection and the VR application. Results indicated that the VR integration not only increased engagement and satisfaction but also improved the students' ability to understand anatomical structures and their spatial relationships. Moreover, feedback from students suggested more efficient learning and retention than with traditional methods alone. We conclude that VR technology can significantly enhance medical anatomy education by providing an adjunct to traditional dissection, potentially replacing certain aspects of physical specimens with digital simulations that offer repeatable, detailed exploration without the associated logistical and ethical constraints.
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Endometriosis impacts millions of women globally, making precise assessment essential for effective surgical planning and clinical management. Despite advances in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) for diagnosis and staging, many radiologists still overlook the evaluation of lateral pelvic anatomical structures. Understanding the lateral compartment's involvement is vital for accurate disease staging and achieving optimal surgical outcomes. This pictorial review provides a thorough examination of the lateral pelvic compartment anatomy using TVUS and MRI, complemented by surgical correlations. It offers detailed discussions on pelvic ligaments, parametrium, and adjacent structures, such as nerves, vessels, and ureters. The review provides practical guidance for identifying critical anatomical structures in imaging exams and emphasizes the importance of standardized terminology. Enhancing imaging precision and diagnostic accuracy for lateral compartment endometriosis is crucial for optimal surgical planning and improved patient outcomes.
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BACKGROUND: Neuromodulator injections in the US increased by 24% from 2021 to 2022. This rise is attributed to new products and growing acceptance of minimally invasive aesthetic treatments. Recent studies emphasize the importance of facial anatomy for precision and, consequently, a higher efficacy of neuromodulator treatments. This study aims to evaluate the clinical efficacy of a novel previously proposed injection technique targeting the depressor anguli oris (DAO) muscle to improve oral commissure position. This clinical, prospective study included 34 volunteers from the Shinobu Clinic, São Paulo, Brazil. Patients received 3 units of onabotulinumtoxinA per side, injected mid-distance between the oral commissure and jawline, following the labiomandibular sulcus (LMS). Standardized photographs and assessments using the Oral Commissure Severity Scale (OCSS) and Global Aesthetic Improvement Scale (GAIS) were conducted before and 30 days post-treatment. Statistical analyses included t-tests, Wilcoxon Signed Rank test, and generalized linear models. The average increase in commissural height was 5.22% (p < 0.001). OCSS ratings improved significantly from baseline (clinician: 1.21 to 0.72, p < 0.001; patient: 0.93 to 0.69, p < 0.001). However, GAIS scores indicated no significant change (patient: 0.32, observer: 0.38; p = 0.491). The proposed injection technique improves perioral aesthetics objectively and subjectively. However, the lack of significant change in GAIS scores suggests that perceived improvements may not be clinically meaningful to patients. Future studies should focus on patient-centered evaluation methods to better assess aesthetic outcomes.
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BACKGROUND: Rotational abnormalities of the hip have been implicated in the etiology of diseases, such as hip dysplasia, osteoarthritis, and femoroacetabular impingement. Despite the extensive literature on hip morphology, there is a gap in knowledge regarding variations in the Hispanic population. PURPOSE: To describe the bony anatomy variations of the acetabulum in a Hispanic population. MATERIAL AND METHODS: This is a cross-sectional study. We studied 182 computed tomography (CT) images in patients aged older than 21 years, who had undergone pelvic CT for any condition, except hip fracture. Measurements of acetabular version, anterior and posterior acetabular sector angles (AASA/PASA) and horizontal acetabular sector angles (HASA) were made. Acetabular variations were then compared to weight and sex data. RESULTS: The mean acetabular anteversion was greater in women (P < 0.001). Women exhibited a greater PASA (P < 0.05); however, men had a greater AASA (P < 0.05). Underweight individuals had a smaller PASA (P < 0.01) and HASA (P < 0.05) than individuals with a normal weight. CONCLUSION: The Hispanic hip is morphologically similar to other populations previously reported in the literature; however, Hispanic men have less coverage of the femoral head by the posterior acetabular wall when compared to women of the same ethnicity. These abnormalities have a direct impact on management and surgical approach in patients treated for femoroacetabular impingement and hip dysplasia.
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Acetábulo , Hispánicos o Latinos , Tomografía Computarizada por Rayos X , Humanos , Femenino , Masculino , Acetábulo/diagnóstico por imagen , Acetábulo/anatomía & histología , Estudios Transversales , Adulto , Tomografía Computarizada por Rayos X/métodos , Persona de Mediana Edad , Anciano , Adulto Joven , Anciano de 80 o más AñosRESUMEN
The superficial musculoaponeurotic system (SMAS) is a complex fibrous network connecting facial muscles to the dermis, with varying morphological characteristics across different facial regions. Recent studies have identified five distinct types of SMAS morphology, highlighting the need for region-specific interventions in facial rejuvenation. This pictorial essay explores ultrasound imaging of the SMAS using ultra-high frequency (24-33 MHz) probes, known as U-SMAS. Analysis of 186 full-face U-SMAS scans revealed consistent patterns in the facial and neck layers, with regional variations aligning with the Sandulescu classifications: type I (preparotideal); type II (chin and lip); type III (eyelid); type IV (temporal and parotideal); and type V (cervical). Understanding these morphological differences is crucial for accurate interpretation of ultrasound images and for optimizing pre-procedural assessments to ensure that aesthetic treatments are safe and effective. Knowledge of the SMAS architecture enhances the ability to visualize facial and neck anatomy accurately, particularly through U-SMAS imaging, ensuring comprehensive patient care in rejuvenation procedures.
O sistema musculoaponeurótico superficial (SMAS) é uma rede fibrosa complexa que conecta os músculos faciais à derme, com características morfológicas variadas em diferentes regiões faciais. Estudos recentes identificaram cinco tipos distintos de morfologia do SMAS, destacando a necessidade de intervenções específicas em cada região para a rejuvenescimento facial. Este ensaio iconográfico explora a imagem por ultrassom do SMAS usando transdutores de ultra-alta frequência (24-33 MHz), conhecidas como U-SMAS. A análise de 186 exames de ultrassom de rosto completo revelou padrões consistentes nas camadas faciais e do pescoço, com variações regionais alinhadas com as classificações de Sandulescu: tipo I (preparotideal), tipo II (queixo e lábio), tipo III (pálpebra), tipo IV (temporal e parotideal) e tipo V (cervical). Compreender essas diferenças morfológicas é crucial para uma interpretação precisa do ultrassom e para otimizar avaliações pré-procedimento para tratamentos estéticos seguros e eficazes. O conhecimento da arquitetura do SMAS melhora a capacidade de visualizar com precisão a anatomia facial e do pescoço, especialmente por meio de imagens de ultrassom, garantindo cuidados abrangentes ao paciente em procedimentos de rejuvenescimento.