RESUMO
BACKGROUND: The paraspinal, posterolateral, or Wiltse approach is an old technique that observes the principles of an MIS procedure. The aim of this study was to provide a step-by-step description from the literature of the Wiltse paraspinal approach and analyze its main advantages and limitations. METHODS: Here, we provide a step-by-step description of the Wiltse approach. Utilizing PubMed and Lilacs and the Mesh terms "Wiltse approach," "paraspinal approach," "muscle sparing approach," and "lumbar spine," we identified 10 papers. We then put together, based on these publications, a step-by-step analysis of the preparation, patient positioning, skin incision, fascial opening, dissection, bone identification, retractors, deperiostization, decompression, discectomy, instrumentation, arthrodesis, and closure for the Wiltse technique. RESULTS: Most papers underscored the minimally invasive aspects of the typical Wiltse approach. Advantages included minimal intraoperative bleeding, a shorter hospital length of stay, and a low infection rate. CONCLUSION: The classical approach described by Wiltse is essentially minimally invasive, sparing both the muscle planes and soft tissues, allowing for ample far lateral lumbar decompression, including discectomy and fusion, with a low complication rate.
RESUMO
A Pasteuria isolate associated with a population of the lance nematode Hoplolaimus galeatus was discovered in Peru. The infective propagules adhered to adult stages and juveniles and were found filling the bodies of males and females. The endospore and central core diameters measured 4.5 +/- 0.4 pm and 1.9 +/- 0.2 mum, respectively, which differed from those reported for other Pasteuria isolates found iu North America on the same host. Examinations of endospore ultrastructure with scanning electron microscopy showed the presence of a thin layer of parasporal fibers surrounding the central core, a thin reduced layer of parasporal fibers in contact with the host's cuticle, and a putative basal core ring.
RESUMO
The authors report the case of a female newborn infant, who had seizures and vesicles at the nose and inferior lip since the fifth day of life. CSF changes suggested an encephalitis. Signs of neurologic and respiratory deterioration were followed by death. Partial cranial autopsy showed a necrohemorrhagic temporal encephalitis without intranuclear inclusions. Immunohistochemical examination by the avidin-biotin-peroxidase technique with polyclonal antibodies against Herpes simplex type 1 and type 2 was positive to type 2 Herpes simplex virus.