MAURO FIGUEIREDO CARVALHO DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
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conferenceObject Deltoid muscle innervation in cadaveric specimens: A statistical analysis of the axillary nerve entering sites-preliminary results(2019) HARA, Lucas; AKAMATSU, Flavia Emi; LIMA, Larissa Barbosa; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo LuizconferenceObject Histopathologic changes in gastric mucosa after experimental gastric restriction(2017) MOTA FILHO, Guilherme; ITEZEROTE, Ana Maria; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; MARTINEZ, Carlos Augusto Real; AKAMATSU, Flavia Emi; JACOMO, Alfredo LuizconferenceObject Non-ablative radiofrequency enhance collagen content on the injured Achilles tendon after one year in rats(2017) AKAMATSU, Flavia Emi; ITEZEROTE, Ana Maria; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; TEODORO, WalcyconferenceObject Colonic mucosa is affected by gastric restriction in an animal model(2017) FONTES, Luiz Gustavo; ITEZEROTE, Ana; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; MARTINEZ, Carlos Augusto Real; AKAMATSU, Flavia Emi; JACOMO, Alfredo Luiz- Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle(2017) AKAMATSU, Flavia Emi; YENDO, Tatiana Mina; RHODE, Ciro; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; HSING, Wu Tu; JACOMO, Alfredo LuizMyofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs). We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females). We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Students f-test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.
- Anatomical Study of the Innervation of the Masseter Muscle and Its Correlation with Myofascial Trigger Points(2020) PINHEIRO, Roberto Procopio; GAUBEUR, Matheus Aquesta; ITEZEROTE, Ana Maria; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo Luiz; AKAMATSU, Flavia EmiBackground and Purpose: Myofascial pain syndrome (MPS) is widely prevalent in the general population; some reports estimate its prevalence ranges from 9 to 85%. Among the different locations where MPS may arise, pain related to the masseter muscle is referred as masticatory myofascial pain. MPS is characterized by myofascial trigger points (MTPs), which represent tender anatomical areas of a muscle where painful symptoms are elicited whenever stimulated. Previous publications have found MTPs to coincide with neuromuscular junctions at the motor end plate, at the innervation zone (IZ). Our study aimed to describe the innervation of the masseter muscle and relate it to clinically described myofascial trigger points (MTPs). Materials and Methods: We mapped the nerve fiber distribution into the masseter muscles from 16 cadavers by anatomical dissection. We divided the muscle into six regions, three superior (I-III) and three inferior (IV-VI), and classified the nerve's branches distribution according to these predetermined areas. Statistical analyses was made by Poisson distribution and logarithm link function followed by Bonferroni multiple comparisons (P<0.05). Results: All six areas received branches from the masseteric nerve. Areas I and II (upper posterior and upper intermediate, respectively) had a significant higher number of nerve entries as compared to the remaining areas. Conclusion: The penetration areas of the masseteric nerve have been established and MTPs are found in the innervation zones, clinicians should focus initially on the regions of the penetration points, for diagnostics and therapeutic measures, such as injections, dry needling and soft tissue interventions. Anatomical study of nerve supply to the masseter muscle can provide useful additional knowledge to further understanding masticatory myofascial pain and to direct therapeutic interventions and diagnostic studies of temporomandibular junction dysfunction.
conferenceObject ABDUCTOR HALLUCIS MUSCLE HAS ONE MORE MUSCLE INSERTION POINT(2018) WADA, Juliano; AKAMATSU, Flavia Emi; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo Luiz- Lymph drainage of the upper limb and mammary region to the axilla: anatomical study in stillborns(2018) CUADRADO, Guilherme de Arruda; ANDRADE, Mauro Figueiredo Carvalho de; AKAMATSU, Flavia Emi; JACOMO, Alfredo LuizPurpose We studied the lymphatic drainage of the upper limb and mammary region directing to the axilla to investigate whether independent pathways can be observed or whether anastomoses and shared drainage occur between them. This analysis aimed to assess the safety of axillary reverse mapping (ARM) in breast cancer treatment and to understand the development of lymphedema after sentinel lymph node biopsy (SLNB) alone. Methods Seven unfixed stillborn fetuses were injected with a modified Gerota mass in the peri-areolar area, palm and dorsum of the hands, formalin fixed, and then submerged in 10% hydrogen peroxide solution. Microsurgical dissection was then performed on the subcutaneous cellular tissue of the upper limb, axillary region, and anterior thorax to expose the lymphatic vessels and lymph nodes. Results The dye injected into the upper limb reached either the lateral axillary group, known to be exclusively responsible for upper limb drainage, or the anterior group, which is typically related to breast drainage. There was great proximity among the pathways and lymph nodes. Communicating lymphatic vessels among these groups of lymph nodes were also found in all studied cases. Discussion Lymphedema remains a challenging morbidity in breast cancer treatment. ARM and SLNB aim to avoid unnecessary damage to the lymphatic drainage of the upper limb. However, our anatomical study suggests that ARM may have potential oncological risks because preserved lymph nodes may harbor malignant cells due their proximity, overlapping drainage pathways, and connecting lymph vessels among lymph nodes.
- Is there something new regarding triceps brachii muscle insertion?(2020) AKAMATSU, Flavia Emi; NEGRAO, Jose Renato; RODRIGUES, Marcelo Bordalo; ITEZEROTE, Ana Maria; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo LuizPurpose: Previous studies have questioned whether the triceps brachii muscle tendon (TBMT) has a double or single insertion on the ulna. Aiming to provide an answer, we describe the anatomy of the TBMT and review a magnetic resonance imaging (MRI) series of the elbow. Methods: Forty-one elbows were dissected to assess the details of the triceps brachii insertion. Elbow plastination slices were analyzed to determine whether there was a space on the TBMT. Magnetic resonance imaging from the records of the authors were also obtained to demonstrate the appearance of the pre-tricipital space on MRI. Results: A virtual space on the medial aspect near the TBTM insertion site in the olecranon was consistently found on anatomic dissections. It was a distal pre-tricipital space. Magnetic resonance imaging demonstrated the appearance of the pre-tricipital space on MRI, and its extension was measured longitudinally either in elbow flexion or extension. There was no statistically significant difference between the measurements of this space in the right and left elbows or between flexion and extension (p > 0.05). The coefficient of variation was <10% for all measurements. Conclusion: Knowledge of this structure may be essential to avoid incorrect diagnosis and unnecessary therapeutic interventions.
conferenceObject Paradigm change in clinical anatomical learning: lessons from students' evaluations(2013) JACOMO, Alfredo Luiz; AKAMATSU, Flavia Emi; ANDRADE, MauroTeaching and learning processes are constantly changing as medical knowledge increases exponentially and general students’ behavior demands a continuous improvement of techniques and approaches. The University of São Paulo Medical School has a systematic evaluation of each discipline where students grade 38 different topics ranging to physical conditions to the quality of the classes, allowing the course coordinators to redirect to adjust the course format as needed. We analyzed the changes in the Anatomy course from 1994 to the present and their impact based on the students’ evaluations. In this study, the different methods to teach Anatomy to 2nd. And 3rd. year students of Medicine employed from 1994 to 2012 were confronted to the students’ evaluations, comparing the general appreciation of the course in different teaching approaches and, in addition, comparing with simultaneous basic disciplines, evaluated by the same questionnaire. Significant difference in students’ evaluation was observed when the course changed from Problem Based Learning technique to a more formal approach with theoretical classes and practical demonstrations. A still better evaluation was obtained as the practical demonstrations focused aspects showed in theoretical classes given by specialists trained in Anatomy. A similar improvement was not seen in other disciplines. Continuous feedback from students is essential to adequate teaching strategies to modern challenges to obtain the best results in courses of Clinical Anatomy.