BackgroundThe aim of this study was to evaluate the leptin levels in the serum and peritoneal fluid (PF) and the protein expression in three different peritoneal ectopic implants in patients who underwent surgery for deep infiltrating endometriosis.MethodsAll patients had been treated at the Department of Gynecology of the Pedro Ernesto University Hospital, Rio de Janeiro. The study group consisted of 15 patients who underwent surgery for adnexal masses and infertility, while the control group consisted of ten women who underwent surgery for tubal ligation. Peritoneal fluid and samples tissues were collected during surgery. Serum samples were obtained before anesthesia. In this study, the leptin levels in the serum and peritoneal fluid (PF) were evaluated by ELISA. The protein expression of leptin and its receptors (ObR) and aromatase enzyme were evaluated by Western blot analysis of the intestine, uterosacral ligament and vaginal septum in the ectopic implants. The t-test and one-way ANOVA with Holm-Sìdak post-test were used, and p < 0.05 was considered to be statistically significant.ResultsCompared to the controls, the serum leptin levels (control = 14.7 ng/mL ± 2.63, endometriosis = 19.2 ng/mL ± 1.84, p < 0.0001) were increased, while in PF, there was no difference (control = 6.68 ng/mL ± 0.43, endometriosis = 7.71 ng/mL ± 0.59, p = 0.18). Comparing women with and without ovarian implants, the leptin levels in both the serum and PF were significantly higher in women without ovarian implants (serum: with ovarian implant = 15.85 ± 1.99; without ovarian implant = 23.14 ± 2.60; ng/mL, p = 0.04; PF: with ovarian implant = 4.28 ± 1.30; without ovarian implant = 11.18 ± 2.98;ng/mL, p = 0.048). The leptin, ObR and aromatase protein expression levels were increased in lesions in the vaginal septum and were decreased in the intestine lesions.ConclusionThis study reports several interesting associations between the leptin levels in serum, peritoneal fluid, and tissue samples and the localization of the ectopic endometrium. Although this study does not provide a clear picture of the role of leptin in the development and progression of peritoneal implants, it contributed new data that might be useful to elucidating the enigma that is the role of leptin in endometriosis disease.

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The supracondylar process is a hook shaped projection of the humerus. It is located superior to its medial epicondyle. This anatomic variation is often presented together with the Struther's ligament, a fibrous arcade that connects the supracondylar process to the medial epicondyle. Both structures have been associated with neurovascular bundle compression on the distal third of the arm, as the median and ulnar nerves and the brachial and ulnar arteries may pass through the osteofibrous canal that these variants create. The SciElo, Pubmed, Scopus, TRIP, MEDLINE, COCHRANE and ScienceDirect databases were searched with the term "supracondylar process" or "supracondyloid process" with the purpose of performing a meta-analysis of this bony spur. Heterogeneity between studies was evaluated using I2 estimation and the Cochran Q statistic test. A random effect model was used for all analysis. A total of twenty articles (26.415 humeri) were included in this meta-analysis. The pooled prevalence of the supracondylar process was 0.68 % (95 % Confidence Interval: 0.47 % to 0.92 %). This variant was more commonly found in women than in men (statistically significant difference) and more commonly found on the left side than the right. The presence of the supracondylar process alone may induce neurovascular bundle compression. It can also be injured in traumatic or stress fractures. Knowledge of this variation and its prevalence may reduce misdiagnosis in radiographic images.

Introduction: The Caroticoclinoid Foramen (CCF) is a variation found in the sphenoid. It gives passage to the internal carotid artery and it is a surgically significant structure when dealing with the cavernous sinus. There is debate, however, regarding its prevalence, especially in populations from South America. Aim: The aim of this study was to assess the prevalence and size of the CCF in a Brazilian sample. Materials and Methods: This was a cross-sectional study carried out for a period of 10 months during March 2019 and January 2020. The present study was conducted in 365 dry human skulls from two Universities in the Southeast region of Brazil. The caroticolinoid foramen was observed and if present, measured. Results: Of the 365 skulls examined, the foramen was present in 101 (prevalence of 27.6%). The foramen was bilateral in 88 cases, while 13 skulls presented this variation unilaterally (7 on the right and 6 on the left side), thus reaching a total of 189 foramina. The mean anteroposterior diameter was 4.87±0.69 mm (right side) and 4.86±0.79 mm (left side), and the Transverse Diameter (TD) was 4.85±0.75 mm (right side) and 4.74±0.73 mm (left side). Sixty-nine skulls had data regarding sex and age. The age ranged from 1 month old to 104-year-old (mean of 37.79±21.85-year-old). The male to female ratio was 2:1, being the only relation with statistical significance (p<0.05). Conclusion: The CCF can be a common variation depending on the population analysed. Thus, the surgeon should always be concerned of its presence, as its misidentification may lead to a negative surgical outcome.

FERNANDES, R. M. P.; LAZZOLI, J. K.; MANAIA, J.H. M. & BABINSKI, M. A. Bilateral absence of superior gemellus muscle in elderly cadaver. Int. J. Morphol., 31(3):902-904, 2013. SUMMARY:The superior gemellus muscle (SGM) normally arises from the outer surface of the spine of the ischium, blends with the upper part of the tendon of the obturator internus, and is inserted with it into the medial surface of the greater trochanter. In this paper, we describe an anatomical variation in which the SGM is absent bilaterally. Therefore, as there are not many cases in literature, our attention has been drawn to the importance about absence of SGM, in order to improve anatomical and clinical knowledge about this finding.