Fly and treat: Endovascular treatment of ruptured aneurysms at an insular tertiary center.

(Objectives) Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition associated with poor outcomes. Early intervention is critical, particularly in low-volume hospitals, which are advised to transfer aSAH patients to high-volume centers. This study examines a novel protocol implemented in 2016 at Região Autónoma da Madeira, a Portuguese island. It involves the mobilization of experienced neurointerventionalists from high-volume hospitals to provide aSAH treatment. (Methods) We conducted a retrospective analysis on 30 aSAH patients who underwent endovascular treatment at the island center between November 2016 and April 2022. Additionally, we included a comparison group of 74 aSAH patients, treated with the endovascular approach at Hospital de Braga (high volume center at Portugal mainland). (Results) There was no statistical difference in patients' clinical severity between both hospitals (median WFNS score of 1). Although 90 % of patients in the novel protocol group received treatment within 3 days, we observed a significant delay compared to Hospital de Braga. Rates of aneurysm occlusion and intra-procedure complications between the two groups were similar. At the 3-months follow-up, there were no statistically significant differences between groups regarding patients that achieved a modified Rankin score of 2 or less. However, the island center exhibited a significantly higher mortality rate. (Conclusions) Overall, our results suggest that making the neurointerventionalist fly to an insular center is feasible and allows most patients to be treated within the first 72 h, as recommended. We highlight some potential recommendations for implementing this model and discuss possible causes that might justify the high mortality rate.

Physical-hydric attributes in Latossolo Amarelo under systems of use in the Cerrado/Caatinga ecotone areas in Piauí State, Brazil.

The Cerrado/Caatinga transition region in Piauí State has a high potential for production of food, fiber and energy, representing about 19% of the total area of the State. This work aimed to evaluate physical and hydraulic attributes under different crops in Latossolo Amarelo Distrófico (Oxisol) in cerrado/caatinga transition areas, in the Southwest of Piauí. In this study five areas with different crops were evaluated as follows: areas under pasture crop with Andropogon gayanus grass with three and six years of crop, area under intensive crop of Pennisetum purpureum grass, area under orchard of Annona squamosa L., area under intensive crop irrigated with central pivot and area under native vegetation of cerrado/caatinga ecotone representing a condition of equilibrium. Soil attributes evaluated were: soil density, total porosity, macroporosity, microporosity, unsaturated pores, blocked pores, saturation humidity, effective saturation, water readily available, void index, mechanical resistance of soil and saturated field hydraulic conductivity. The intensive crop of napier grass for five consecutive years and the pivot irrigated area under intensive crop for four years presented the greatest negative impacts on soil density, total porosity, macroporosity, saturation humidity, effective saturation, water readily available and index of voids.

Soil macrofauna associated with cover crops in an Oxisol from the southwest of Piauí state, Brazil / Macrofauna edáfica associada a plantas de cobertura em um Latossolo Amarelo do sudoeste do estado do Piauí, Brasil

The soil macrofauna is fundamental for the maintenance of soil quality. The aim of this study was to characterize the soil macrofauna under different species of cover crops, including monoculture or intercropping associated to two types of soil management in the southwest region of Piauí state. The study was carried out in an Oxisol (Latossolo Amarelo, according to Brazilian Soil Classification System) in the municipality of Bom Jesus, Piauí, distributed in 30 m2 plots. Testing and evaluation of the soil macrofauna were conducted in a 9 × 2 strip factorial design, with combinations between cover crops/consortia and soil management (with or without tillage), with four replications. Soil monoliths (0.25 × 0.25 m) were randomly sampled in each plot for macrofauna at 0‒0.1, 0.1‒0.2, and 0.2‒0.3 m depth, including surface litter. After identification and counting of soil organims, the relative density of each taxon in each depth was determined. The total abundance of soil macrofauna quantified under cover crops in the conventional and no-tillage system was 2,408 ind. m-2, distributed in 6 classes, 16 orders, and 31 families. The results of multivariate analysis show that grass species in sole cropping systems and no-tillage presents higher macrofauna density, in particular the taxonomic group Isoptera. No-tillage also provided higher richness of families, where Coleoptera adult were the second more abundant group in no-tillage and Hemiptera in conventional tillage.(AU)

Os organismos da macrofauna edáfica são fundamentais para a manutenção da qualidade do solo. O objetivo deste trabalho foi caracterizar a macrofauna edáfica sob diferentes espécies de plantas de cobertura, incluindo monocultura ou cultivo consorciado associados a dois tipos de manejo do solo no sudoeste do Piauí. O estudo foi realizado em Latossolo Amarelo (Sistema Brasileiro de Classificação de Solos) no município de Bom Jesus, Piauí, distribuídos em parcelas de 30 m2. O experimento e avaliação da macrofauna edáfica foram conduzidos em um ensaio fatorial em faixas 9 × 2, com combinações entre culturas /consórcios de cobertura e manejo do solo (com ou sem preparo), com quatro repetições. Os monólitos de solo (0,25 × 0,25 m) foram retirados aleatoriamente de cada parcela, para contagem da macrofauna, nas camadas de 0‒0,1, 0,1‒0,2, e 0,2-0,3 m de profundidade, inclusive liteira de superfície. Após a identificação e contagem dos organismos, foi determinada a densidade relativa de cada táxon em cada profundidade. A abundância total da macrofauna edáfica quantificada no experimento foi de 2.408 ind.m-2, distribuídos em 6 classes, 16 ordens e 31 famílias. Os resultados da análise multivariada revelaram que espécies de gramíneas em sistemas de cultivo solteiro e plantio direto favoreceram maior densidade da macrofauna, em especial do grupo taxonômico Isoptera. A ausência de preparo também proporcionou maior riqueza de famílias, destacando-se o grupo taxonômico Coleoptera adulto em plantio direto e Hemiptera em plantio convencional.(AU)

Soil Physical Quality in Agricultural Systems on the Cerrado of Piauí State, Brazil.

Soil quality is essential for maintaining the sustainability of agro-ecosystems and ecosystem services provided by this natural resource. The present study aimed to assess the physical quality of soil through the characterization of the physical properties in grain production systems in the Southwest region of Piauí State, Brazil. The study was carried out in the Cerrado region of Piauí in four cities in areas of expansion of the agricultural frontier of the state: Baixa Grande do Ribeiro, Sebastião Leal, Uruçuí and Bom Jesus. Soil samples were collected in April 2012, in areas of grain production under conventional and no-tillage systems. Adjacent areas with native vegetation were also sampled as reference. Bulk density, effective saturation, hydraulic conductivity, penetration resistance, porosity and aggregation were measured. Regardless of the type of soil management used, agricultural systems degrade soil physical quality. No-tillage showed higher bulk density, penetration resistance and aggregation, with lower total porosity, macroporosity and hydraulic conductivity. The physical quality of soil in the agricultural areas of the Cerrado region of Piauí was dependent on the soil texture, while silt, clay and organic matter were determinant for soil aggregation, mechanical resistance, total porosity and microporosity.

Pure laparoscopic augmentation ileocystoplasty.

INTRODUCTION: Guillain-Barre syndrome is an acute neuropathy that rarely compromises bladder function. Conservative management including clean intermittent catheterization and pharmacotherapy is the primary approach for hypocompliant contracted bladder. Surgical treatment may be used in refractory cases to improve bladder compliance and capacity in order to protect the upper urinary tract. We describe a case of pure laparoscopic augmentation ileocystoplasty in a patient affected by Guillain-Barre syndrome. PRESENTATION: A 15-year-old female, complaining of voiding dysfunction, recurrent urinary tract infection and worsening renal function for three months. A previous history of Guillain-Barre syndrome on childhood was related. A voiding cystourethrography showed a pine-cone bladder with moderate post-void residual urine. The urodynamic demonstrated a hypocompliant bladder and small bladder capacity (190 mL) with high detrusor pressure (54 cmH2O). Nonsurgical treatments were attempted, however unsuccessfully.

Métodos de controle de plantas daninhas no cafeeiro afetam os atributos químicos do solo / Effects of weed control methods on coffee crop on soil chemical attributes

Nos ecossistemas agrícolas sob cafeeiro, nos quais o manejo do solo se resume, basicamente, à aplicação de corretivos, fertilizantes e controle de plantas daninhas, faz com que alternativas de manejo que preservam ou aumentam os teores de matéria orgânica no solo, a exemplo de alguns métodos de controle de plantas daninhas, sejam consideradas, quando se busca a sustentabilidade da cultura. Neste estudo o objetivo foi avaliar o efeito de alguns métodos comumente utilizadas na cultura do cafeeiro sobre os atributos químicos de um Latossolo Vermelho distroférrico sob cafeeiro, durante 15 anos. Os tratamentos avaliados consistiram de sete métodos de controle, envolvendo o uso de roçadora (RC), grade (GR), enxada rotativa (ER), herbicida de pré-emergência (HPRE), herbicida de pós-emergência (HPOS), capina manual (CM) e uma testemunha sem capina (TEST). Foram determinados, nas profundidades de 0-0,15m e 0,15-0,30m, os teores de P, K+, Ca2+ + Mg2+, soma de bases (SB), saturação por bases (V), CTC efetiva (t) e potencial (T). Os resultados mostraram que o tratamento sem capina (TEST) influenciou, positivamente, os teores de P, K+, Ca2+ + Mg2+, valores de CTC efetiva, potencial e V, enquanto o HPRE exerceu um efeito contrário, ou seja, de redução nos valores das variáveis analisadas. Demais métodos RC, GR, ER, HPOS e CM apresentam um comportamento intermediário entre os métodos TEST e HPRE sobre as condições de fertilidade do solo.

In agricultural ecosystems under coffee cultivation, soil management is based on liming, fertilizers and weed control. Alternatives that preserve or increase soil organic matter content are considered when the sustainability is the goal. This study was conducted to evaluate the chemical attributes of a dystroferric Red Latosol (Oxisols) under coffee cultivation submitted to 15 years of weed control methods. Seven interrows coffee plant weed control methods were used; a mower (RC), tanden disk harrow (GR), rotative hoe (ER), pre-emergence herbicide (HPRE), post-emergence herbicide (HPOS), hand hoe (CM) and no interrows control (TEST). The P, K+, Ca2++ Mg2+, sum of bases (SB), base saturation (V), effective (t) and potential (T) cation exchange capacity (CEC) were determined in soil depth from 0-0.15m and 0.15-0.30m. TEST treatment affected positively the P, K+, Ca2+ + Mg2+ content, and effective and potential CEC and V values, while the HR inversely reduced analyzed variable values. Others interrows methods RC, GR, ER, HPOS e CM presented an intermediary conduct among the TEST and HPRE methods on soil fertility.

Teores de nutrientes na parte aérea da batateira em resposta ao boro / Nutrient contents of the potato shoot plants in response of to the boron levels

O trabalho foi desenvolvido com o objetivo de avaliar as alterações nos teores e acúmulo de nutrientes da parte aérea da batateira, em função de doses de boro em amostras de um Latossolo Vermelho (LV) e de um Cambissolo (CX). O delineamento experimental foi em blocos casualizados (DBC) em esquema fatorial 4 x 2, constituído de quatro doses de B (0,0; 0,75; 1,50 e 3,0 mg dm-3) e duas cultivares de batata (Asterix e Monalisa), 2 tipos de solos (Latossolo e Cambissolo) e três repetições. Foram avaliados os teores de N, P, P Ca, Mg, S, B, Cu,Fe, Mn, e Zn nas folhas e acúmulo na parte aérea de cada cultivar. Os tratamentos de forma individual e/ou em interação influenciaram tanto os teores como o acúmulo dos nutrientes na batateira. Dependendo do tipo de solo e cultivar, houve influencia sobre os teores de Mg, P e Mn nas folhas e o acúmulo de N, P, K, Ca, Mg, S, B, Cu, Fe, Mn e Zn na parte aérea. As doses de B, independentemente das cultivares, elevaram o teor e acúmulo de B e reduziram os de S, Cu, Fe e Zn, conforme o tipo de solo. Promoveram também, conforme o tipo de solo, aumento nos teores K, B e Fe e acúmulo de S na cultivar Asterix e, aumento nos teores de P e B, acúmulo de N, Cu, e Zn e redução nos teores de K, Ca, Mn e Fe na cultivar Monalisa.

The study was carried out to evaluate the nutrient content alterations of the potato shoots submitted to boron rates. The experiment had a randomized blocks outline in 4 x 3 factorial arrangement, using four boron rates (0.0, 0.75; 1.50 and 3.0 mg dm-3) and two potato cultivars (Asterix and Monalisa) with three replicates. Two soil types were used, Latosol and Cambisol. Leaf and shoots N, P, K, Ca, Mg, S, Fe, Cu, Mn, Zn and B contents of each cultivar were evaluated. The treatments as in individual or in interaction form influenced the potatoes nutrient content and its nutrient accumulation on the plant. Depending on the soil type Mg, P and Mn content were influenced on the leaves and the N, P, K, Ca, Mg, S, B, Cu, Fe, Mn and Zn accumulation content on the aerial part. Depending on soil type and cultivar there was influence on the Mg, P and Mn content on the leaves and accumulation of the N, P, K, Ca, Mg, S, B, Cu, Fe, Mn and Zn in aerial part. The B rates independely from cultivars elevated the boron content and accumulation and reduced the S, Cu, Fe and Zn contents according to soil type. They also promoted according to soil type, increases on K, B and Fe and S accumulation on Asterix cultivar and, increases on and P and B content, and accumulation of N, Cu, and Zn and content reduction on K, Ca, Mn and Fe, on Monalisa cultivar.

Produção e qualidade da batata em resposta ao boro / Yield and quality of the potato in response of boron levels

O trabalho foi desenvolvido com o objetivo de avaliar a produtividade e qualidade de tubérculos de batata em resposta ao boro em amostras de um Latossolo Vermelho (LV) e de um Cambissolo (CX). O delineamento experimental foi o de blocos casualizados, em esquema fatorial 4 x 2, constituído de quatro doses de boro (0,0; 0,75; 1,50 e 3,0 mg dm-3) e duas cultivares de batata (Asterix e Monalisa), com três repetições. Foram avaliados a produtividade, a massa seca, teores de amido, açúcares redutores e açúcares totais dos tubérculos. As doses crescentes de boro aumentaram a produtividade principalmente para a cultivar Asterix, cultivada no LV com a dose de 2,19 mg dm-3 de boro. No LV, a cultivar Asterix também apresentou maiores porcentagens de massa seca e amido nos tubérculos, enquanto os teores de açúcares redutores reduziram-se com o aumento de boro nas duas cultivares. No CX, a produtividade foi menor que no LV, provavelmente, devido ao alto teor de silte do solo que dificultou a formação dos tubérculos. A Asterix foi 108 por cento mais produtiva e 37 por cento mais exigente em boro, quando comparada à Monalisa.

The experiment was carried out in a greenhouse, using two soils Latosol (LV) and Cambisol (CX) to evaluate the effects of boron rates on yield and tubers quality for two potato cultivars, Asterix and Monalisa. The experimental design was a randomized blocks in a 4 x 2 factorial arrangement with three replications, using four boron rates (0.0, 0.75; 1.50 and 3.0 mg dm-3) and two potato cultivars (Asterix and Monalisa). Two soil types were used; Latosol and Cambisol. Yield, dry matter, starch, reducing sugars and total sugars tuber contents were evaluated. Increasing boron rates improved tuber yield, reaching maximum yield on Red Latosol at 2.19 mg dm-3 of boron. For Asterix cultivar, also presented the highest percentages of dry matter and starch in tubers on a Red Latosol. Reducing sugar content decreased with boron rates in Red Latosol. For both cultivars, in Cambisol, yield was lower than Red Latosol, due to the high silt content in Cambisol, making difficult tuber formation. Asterix cultivar presented 108 percent greater yield than Monalisa in Cambisol, although requiring 37 percent more boron.

Colelitíase associada à anemia falciforme na infância / Cholelithiasis related to sickle cell disease in childhood

A colelitíase na infância é considerada uma situação rara. É mais comun em crianças do sexo feminino, entre 8 e 12 anos de idade. As causas mais comuns de coleitíase na crinça são as anemias hemolíticas, por causa das altas taxas de excreção da bilirrubina, devido à hemólise. No mundo, 40 por cento das crianças com anemia falciforme tem colelitíase. Os autores apresentam um caso de colelitíase associado à anemia faciforme em uma criança do sexo masculino, com 7 anos de idade, atendida no serviço de Cirurgia Pediátrica do HULW-UFPB. Após exame clínico, laboratorial e ultrassonografia, foi confirmado a colelitíase. Foi submetida à colecistectomia convencional, recebendo alta no quinto dia pós-operatório, evoluindo sem intercorrências

Tricobezoar gástrico / Gastric tricobezoar

Os autores relatam 02 casos de tricobezoar gástrico em uma menina de 04 anos de idade e uma adolescente de 18 anos, internadas em hospital público, com dor epigástrica e tumoração palpável no epigástrico e hipocôndrio esquerdo, onde em um dos casos, se irradiava para a fossa ilíaca esquerda, sugerindo tumor de ovário esquerdo. Perda de peso. Fraqueza e anemia eram outros sintomas relatados. O exame físico, a ultrasonografia do abdome e a tomografia computadorizada do abdome, foram fundamentais para a indicação cirúrgica. Não foram realizados radiografia contrastada do estômago e endoscopia digestiva para o diagnóstico. A gastrotomia foi a cirurgia indicada para a retirada dos tricobezoares em todos os casos, com resultados excelentes. As pacientes tiveram alta hospitalar no 5§ dia PO, sem complicações e encaminhadas ao Serviço de Neuropsiquiatria, afim de evitar recidiva da patologia