RESUMO
Advances in radiotherapy technology during the last 25 years have significantly improved both dose conformation to tumors and the preservation of healthy tissues, achieving almost real-time feedback by means of high-precision treatments and theranostics. Owing to this, developing high-performance systems capable of coping with the challenging requirements of modern ionizing radiation is a key issue to overcome the limitations of traditional dosimeters. In this regard, a deep understanding of the physicochemical basis of gel dosimetry, as one of the most promising tools for the evaluation of 3D high-spatial-resolution dose distributions, represents the starting point for developing new and innovative systems. This review aims to contribute thorough descriptions of the chemical processes and interactions that condition gel dosimetry outputs, often phenomenologically addressed, and particularly formulations reported since 2017.
RESUMO
La disrupción anatómica del esfínter es el mecanismo más común de incontinencia fecal. La creación de un mecanismo esfinteriano con control voluntario permite mantener la contracción en el reposo o durante los movimientos y es uno de los principios fisiológicos y quirúrgicos para la continencia. Esta corrección puede realizarse mediante la transposición de músculo glúteo mayor alrededor del ano y recrear así un esfínter voluntario. La gluteoplastía dinámica consiste en la colocación de un marcapasos que permite la estimulación eléctrica crónica intermitente del músculo esquelético, resultando en la adaptación de la contractilidad basal. El objetivo del trabajo consiste en el estudio anatómico de la longitud in situ y esqueletizado del fascículo inferior del músculo glúteo máximo, de su principal pedículo nervioso, la altura en la cual penetra al músculo desde el cóccix, y la longitud de su rama más distal para finalmente, proponer variantes técnicas para este procedimiento. Se disecaron 21 regiones glúteas de ambos lados de cadáveres frescos y formolizados al 10% de ambos sexos. La longitud del fascículo muscular sin esqueletizar osciló entre 17,8 y 19,65 cm, y esqueletizado entre 23,9 y 20.7 cm. La distancia de penetración del nervio principal fue entre 11,25 10,2 cm y la del nervio más medial se situó promedialmente entre 8,72 y 5,97 cm. La máxima longitud adquirida por el nervio principal hasta su rama más distal, osciló entre 10,4 y 9,2 cm. El fascículo inferior posee una longitud final que permite rodear completamente al ano e incluso, llegar al isquion contralateral hechos que apoyan el uso de este músculo en las transposiciones para la corrección de las incontinencias anales, sin la necesidad de realizar abordajes desmedidos y lejanos, permitiendo a su vez, el uso de un músculo de la región, evitando tracciones del pedículo neurovascular y la consiguiente isquemia luego del procedimiento quirúrgico. Se proponen tres técnicas para ...
The anatomical disruption of the sphincter is the most common mechanism of fecal incontinence. The creation of an sphincter mechanism with voluntary control allows to maintain the contraction during rest or movements and is one of the physiological and surgical principles of continence. This correction can be made by the gluteus maximus muscle transposition around the anus recreating a voluntary sphincter. The dynamic gluteoplasty consists in the positioning of a nerve stimulator that allows the intermittent chronic electrical stimulation of the skeletal muscle resulting in the adaptation of the basal contractility. The objective of the work is the anatomic study of the inferior fascicle of the gluteus maximus muscle (its length in situ and squeletized) and of its main nervous pedicle (the height in which penetrates the muscle from coccyx, and the length of its distal branch) so as to propose technical changes for the procedure. Twenty and one gluteus regions of both sides from fresh and formalized cadavers of both sexes were dissected. The length of muscular fascicle without squeletized oscillated between 17.8 and 19.65 cm, and squeletized between 23.9 and 20.7 cm. The distance of penetration of the main nerve was between 11.25 and 10.2 cm and the one of the most internal nerve was located promedially between 8.72 and 5.97 cm. The maximun length acquired by the main nerve until its distal branch oscillated between 10.4 and 9.2 cm. The inferior fascicle has a final length that allows to surround completely the anus or even to reach the contralateral isquion, facts which support the use of this muscle in the transpositions for the correction of the anal incontinence, without making excessive or distant boardings, allowing as well the use of a muscle from the region, avoiding tractions of neurovascular pedicle and the consequent isquemia after the surgical procedure. Three technical changes for the rotation of flap are proposed.