Caucasian Mediterranean patients seeking rhinoplasty-Anthropometric measurements and prevalence of major deformities.

OBJECTIVE: To describe the average values of the nasal anthropometric measurements of Caucasian Mediterranean patients seeking rhinoplasty and evaluate the major nasal deformities. DESIGN: Prospective, observational and cross-sectional study. SETTING: Centro Hospitalar do Porto. PARTICIPANTS: A 100 Caucasian Mediterranean patients seeking rhinoplasty. OUTCOMES: Standardized photography was used to obtain nasal anthropometric measurements and to evaluate the major nasal defects. Data regarding age, gender, skin type and Fitzpatrick scale were also collected. RESULTS: There was a statistically significant difference in the means values of palpebral fissure, intercanthal width, upper lip height, nasal root width, morphological nose width, nose height, nasal tip projection and nasofrontal-hump and nasofrontal-supratip angles between females and males. The major nasal deformity was dorsal hump (78.0%), followed by rinomegalia (53.0%) and boxy bulbous tip (47.0%). CONCLUSION: The present study shows statistically significant gender differences between anthropometric nasal measurements and the mean values are greater than standard values obtained on general population. This might be one of the reasons why Caucasian Mediterranean patients seek aesthetical rhinoplasty. On both genders, dorsal hump, rinomegalia and boxy bulbous tip were the major nasal defects. This emphasize the importance of rhinoplasty techniques designed to reconstruct nasal dorsum and nasal tip on Caucasian Mediterranean patients. To the best of our knowledge, our study is the first study of digital anthropometric nasal analysis and evaluation of major nasal defects specifically in Caucasian Mediterranean patients who applied for rhinoplasty. With this results, we provide a reference material for the evaluation of the Caucasian and Mediterranean patient when planning a cosmetic nasal surgery.

Predictive factors for the appearance of myringosclerosis after myringotomy with ventilation tube placement: randomized study.

Myringotomy with the insertion of ventilation tubes is the most frequent surgical procedure performed in children, and the appearance of myringosclerosis is one of its most frequent long-term complications. The objective of this study is to identify clinical factors and technique variations that may have a relation with the appearance of myringosclerosis, after tube insertion. Patients submitted to myringotomy with transtympanic short-term tube insertion were studied in a longitudinal prospective and analytical cohort study with the prospective randomized open, blinded endpoint (PROBE) methodology, to study the influence of the location of myringotomy (anterior-inferior quadrant or posterior-inferior), directions of the incision (radial or non-radial) and aspiration or not of the middle ear. Our study included 156 patients (297 ears). Myringosclerosis was observed in 35.7 % of the operated ears. It appeared more often in patients with greater number of otitis (p = .001) and with greater number of otorrhea episodes (p = .029) and in patients in whom the tympanogram after the tube extraction was type A (according to Jerger´s classification) (p = 0.016). We identified myringosclerosis in less patients, if the tube was in the tympanic membrane for less than 12 months (p = .009). Myringosclerosis was present more extensively if the tympanic incision was located in the anterior-inferior quadrant, with tympanic involvement superior to 25 % (p = .015). The results observed prove that, underlying the appearance of myringosclerosis, there exists an early inflammatory or infectious process and a final cicatricial process. It was also found that when myringotomy is made in the anterior-inferior quadrant, myringosclerosis appears in a higher percentage of the tympanic membrane; therefore, it is not recommended to do the incision in this quadrant, because it may lead to a reduction of the tympanic membrane vibration.

Spare Roof Technique: A Middle Third New Technique.

To our knowledge, the spare roof technique (SRT) is the first technique that is based on a complete skeletonization/preservation of the upper lateral cartilages. This technique is used to keep the natural roof of the nose's middle third, while dehumping and/or correcting the crooked septum. From January 2014 till March 2015, a total of 40 rhinoplasties were performed through the SRT: 28 reduction rhinoplasties, 6 complex crooked noses (with extracorporeal septoplasty), and 6 mixed cases. The SRT is an excellent middle third technique. The natural roof was kept and fitted the accurate new position in almost all cases with no surgical complexity. It is an easy technique with many applications and it is also very useful in the classical humpectomy of the Caucasian nose and correction of the crooked nose.

LOGISTICS AND RESULTS OF A COLORECTAL CANCER SCREENING PROGRAM IN A MUNICIPALITY IN THE HINTERLAND OF ALAGOAS.

BACKGROUND: Colorectal cancer (CRC) has high mortality rates worldwide. In Brazil, it is the second most common cancer in both sexes. Delay in detecting premalignant lesions contributes to increased morbidity and mortality. In this scenario, the Piranhas project was created to track CRC in a low-income population in the hinterland of Alagoas. OBJECTIVE: The study aimed to establish the main strategies and verify the feasibility of implementing a CRC tracking program and demonstrate the results obtained in the CRC Prevention Campaign in Piranhas/AL. METHODS: The program took place in Piranhas, Alagoas, Brazil, through public-private partnerships. Individuals aged between 50 and 70 years of age were included for screening with a fecal occult blood test (FOBT) and colonoscopy in positive cases. Patient data were collected on standard forms. RESULTS: A total of 2152 patients, aged between 50 and 70 years, were screened, 130 of which underwent colonoscopy. Several preneoplastic lesions were detected in 58 patients. The adenoma detection rate (ADR) was 33.85%. CONCLUSION: The study proved to be effective and viable since 44.6% of the program participants, who underwent screening with FOBT, followed by colonoscopy in positive cases, had some type of preneoplastic lesion. In addition, the program generated a significant social impact on the population of Piranhas due to the opportunity to diagnose and treat CRC precursor lesions.

Blend of essential oils can reduce diarrheal disorders and improve liver antioxidant status in weaning piglets.

OBJECTIVE: This study was to assess the effects of different doses of an essential oil blend (EOB) on growth performance, diarrhea occurrence (DO), hematological and blood biochemical profile, intestinal morphometry, morphology and microbiology, relative weight and length of organs, digestive content pH, and liver antioxidant status in weaning piglets. METHODS: A total of 135 barrows (7.09±0.29 kg body weight) were allotted randomly in a randomized complete block design based on body weight with nine replications and three animals per pen. Dietary treatments were a negative control (NC): basal diet; positive control (PC): NC plus 125 mg performance-enhancing antibiotic (enramycin 8%)/kg diet; NC plus 100 mg EOB/kg diet (EO100); NC plus 200 mg EOB/kg diet (EO200); and NC plus 400 mg EOB/kg diet (EO400). Diarrhea occurrence was monitored daily, and performance at the end of each phase. RESULTS: Gain to feed ratio was greater (p<0.05) in starter II pigs fed EO400 and EO200 than in those fed EO100. Pigs fed EO400 had lower (p<0.05) DO than those fed NC and EO100 in the total period. Pre-starter II pigs fed NC had (p<0.05) lower serum total protein and plasma protein than pigs fed PC. Pigs fed EO100 showed smaller (p<0.05) mean corpuscular volume (MCV) than pigs fed EO400. Starter II pigs fed EO400 had (p<0.05) greater MCV and lower mean corpuscular hemoglobin and erythrocytes than those fed EO100. There was a greater concentration (p<0.05) of band cells for PC, similar to EO400 and EO200. Performance-enhancing antibiotic and EOB to diets increased (p<0.05) liver superoxide dismutase activity. CONCLUSION: Adding 200 and 400 mg EOB/kg diet decreased DO and was advantageous to hematological and blood biochemical profile and liver antioxidant status without being detrimental to growth performance and gastrointestinal health in nursery pigs.

Triatoma brasiliensis Neiva, 1911 and Triatoma pseudomaculata Corrêa and Espínola, 1964 (Hemiptera, Reduviidae, Triatominae) in rural communities in Northeast Brazil.

Chagas disease is an important endemic morbidity in Latin America affecting millions of people in the American continent. It is caused by the protozoan Trypanosoma cruzi, and transmitted through the feces of the insect vector belonging to the subfamily Triatominae. The present conducted an entomological survey of triatomines and analyzed entomological indicators, such as the rate of infestation, colonization, triatomine density and natural infection in rural communities in the municipality of Campinas do Piaui, Piaui State, in the Northeast region of Brazil. Data on the search of triatomines performed in 167 domiciliary units (DUs), harvested during the period of February to July 2019, in 12 rural communities were analyzed. The capture of triatomines occurred in all studied communities, being 76 the number of positive DUs, of the 167 surveyed, presenting a global rate of infestation of 45.51%. Two triatomines species were collected: Triatoma brasiliensis (98.49%) and T. pseudomaculata (1.51%), the first was found in the domiciliary and peridomiciliary areas, while the second was captured only in peridomiciliary areas. The index of colonization was 17.1%. Natural infection was observed only in 5.44% of T. brasiliensis samples. The entomological survey was conducted in rural communities, showingthe risk of transmission of Chagas disease to the local population, requiring continuous entomological surveillance and vector control.

Logistíca e resultados de um programa de prevenção do câncer colorretal em um município do Sertão de Alagoas / Logistics and results of a colorectal cancer screening program in a municipality in the hinterland of alagoas

ABSTRACT Background: Colorectal cancer (CRC) has high mortality rates worldwide. In Brazil, it is the second most common cancer in both sexes. Delay in detecting premalignant lesions contributes to increased morbidity and mortality. In this scenario, the Piranhas project was created to track CRC in a low-income population in the hinterland of Alagoas. Objective: The study aimed to establish the main strategies and verify the feasibility of implementing a CRC tracking program and demonstrate the results obtained in the CRC Prevention Campaign in Piranhas/AL. Methods: The program took place in Piranhas, Alagoas, Brazil, through public-private partnerships. Individuals aged between 50 and 70 years of age were included for screening with a fecal occult blood test (FOBT) and colonoscopy in positive cases. Patient data were collected on standard forms. Results: A total of 2152 patients, aged between 50 and 70 years, were screened, 130 of which underwent colonoscopy. Several preneoplastic lesions were detected in 58 patients. The adenoma detection rate (ADR) was 33.85%. Conclusion: The study proved to be effective and viable since 44.6% of the program participants, who underwent screening with FOBT, followed by colonoscopy in positive cases, had some type of preneoplastic lesion. In addition, the program generated a significant social impact on the population of Piranhas due to the opportunity to diagnose and treat CRC precursor lesions.

RESUMO Contexto: O câncer colorretal (CCR) possui altas taxas de mortalidade em todo mundo. No Brasil é o segundo câncer mais comum em ambos os sexos. O atraso na detecção de lesões pré-malignas contribui com o aumento da morbimortalidade. Neste cenário, o projeto Piranhas foi criado para rastrear o CCR em uma população carente do sertão alagoano. Objetivo: O estudo teve como meta estabelecer as principais estratégias e verificar a viabilidade da implementação de um programa de rastreamento do CCR, assim como demonstrar os resultados obtidos na Campanha de prevenção de CCR no município de Piranhas/AL. Métodos: O programa aconteceu em Piranhas, Alagoas, Brasil, através de parcerias público-privadas. Foram incluídos indivíduos entre 50 e 70 anos para triagem com pesquisa de sangue oculto nas fezes (PSOF) e colonoscopia dos casos positivos. Os dados dos pacientes foram coletados em formulários padrão. Resultados: Foram rastreados um total de 2152 pacientes com idade entre 50 e 70 anos, sendo destes, 130 submetidos à colonoscopia. Várias lesões pré-neoplásicas foram detectadas em 58 pacientes. A taxa de detecção de adenoma foi de 33,85%. Conclusão: O estudo demonstrou-se eficaz e viável, uma vez que 44,6% dos participantes do programa que realizaram a triagem com PSOF seguido de colonoscopia nos casos positivos apresentava algum tipo de lesão pré-neoplásica. Além disso, o programa gerou grande impacto social na população de Piranhas, pela oportunidade de diagnóstico e tratamento de lesões precursoras do CCR.

Efeito da suplementação de própolis verde no câncer de pâncreas: um relato de caso / Effect of green propolis supplementation on pancreas cancer: a case report

Introdução: O aumento da incidência de doenças crônicas não transmissíveis e a mortalidade associada a estas causas têm se destacado mundialmente. Entre essas doenças, destaca-se o câncer de pâncreas, que é caracterizado por tendência à evolução com metástase e baixa sobrevida. Relato de caso: As terapias oncológicas podem afetar a qualidade de vida e o estado nutricional dos pacientes e, por essa razão, a utilização de terapias alternativas e complementares, como o uso da própolis, podem auxiliar na melhoria da qualidade do tratamento, através da diminuição na proliferação de células neoplásicas e dos efeitos tóxicos da quimioterapia, devido às características epigenéticas, antitumorais, apoptóticas, antioxidantes e imunomodulatórias. Este relato de caso aborda o acompanhamento clínico e nutricional de um paciente idoso do sexo masculino, portador de câncer pancreático em tratamento quimioterápico, sob aconselhamento nutricional associado à suplementação de extrato hidroalcoólico de própolis verde. Conclusão: Observou-se com este relato de caso, a melhora da qualidade de vida e aumento da taxa de sobrevida do paciente de 12 meses para três anos e meio, além de estabilização da progressão tumoral. (AU)

Introduction: The increase in the incidence of chronic noncommunicable diseases has been highlighted in terms of worldwide mortality rates. Among these diseases, pancreatic cancer stands out, which is characterized by a tendency towards the evolution of metastasis and low survival. Weight loss is associated with increased basal energy expenditure, decreased energy consumption and malabsorption of nutrients. Case report: Oncological therapies can affect to quality of life and nutritional status of individuals, due to the toxic and immunosuppressive effects. For this reason, the use of alternative and complementary therapies, such as the use of propolis, can help to improve the quality of treatment, by decreasing the proliferation of neoplastic cells and the toxic effects of chemotherapy, due to the epigenetic, antitumor, apoptotic characteristics, antioxidants and immunomodulatory. This case report addresses the clinical and nutritional monitoring of an elderly male patient, with pancreatic cancer undergoing chemotherapy, under nutritional advice associated with the supplementation of hydroalcoholic extract of green propolis. Conclusion: There was an improvement in the quality of life and an increase in the patient’s survival rate from 12 months to three years, in addition to stabilization of tumor progression. (AU)

Ocular metastasis as first presentation of renal cell carcinoma: report of 2 cases.

Authors report the cases of 2 patients who had an ocular lesion as the first sign leading to diagnosis of renal cell carcinoma, an uncommon presentation of this neoplasm. The first patient was a 59-year-old man presented with a mass in the right eye. The histological and immunohistochemical profile of the biopsy showed a probable renal cell carcinoma. A CT scan showed a solid mass in the left kidney. The patient underwent radical nephrectomy and excision of the ocular lesion and had an uneventful evolution. The second patient was a 72-year-old man presenting with an ulcerated lesion on the right inferior tarsal conjunctiva. An excisional biopsy of the lesion showed histological and immunohistochemical patterns of a clear cell carcinoma. Abdominal tomography disclosed a right peripheral renal tumor. A right radical nephrectomy was performed. Renal cell carcinoma may present atypically with metastases to quite uncommon organs. Nephrectomy may be of value in selected cases; the ocular metastases are usually excised for aesthetic and functional reasons.

The effect of cold water immersion on pain, muscle recruitment and postural control in athletes / Efeito da imersão em água fria sobre dor, recrutamento muscular e controle postural em atletas / Efecto de la inmersión en agua fría sobre el dolor, el reclutamiento muscular y control postural en atletas

ABSTRACT Introduction Numerous recovery strategies have been used to minimize performance loss related to delayed onset muscle soreness in athletes, and are part of prevention programs and training of most high-level sports. Objective To analyze the effects of cold-water immersion on delayed-onset muscle soreness, muscle recruitment, and postural control in soccer players. Objective The maximum load of the quadriceps femoris muscle strength was determined. After three days, the pain scale was used to measure the subject's pain intensity. The recruitment of the quadriceps muscle was determined at the moment of the kick, and was associated with postural control. Methods Randomized, blinded clinical trial study. Two repeated series of maximum load sets at 60% MVC, performed in a knee extension chair, were used to induce quadriceps fatigue in the athletes. Participants Twenty-eight soccer players were allocated to four intervention groups: cold water immersion (CWIG, n = 7), thermoneutral water immersion (TWIG, n = 7), active recovery (ARG, n = 7), and rest (RG, n = 7), with each intervention being carried out for ten minutes. Revaluations were carried out after 24, 48, and 72 hours of the fatigue protocol. Results Pain intensity in the CWIG returned to baseline after 72 hours, while the TWIG, ARG, and RG continued to feel greater pain. For the other outcomes, no differences were found between the groups. Conclusion With regard to muscle recruitment and postural control at the time of the kick, no significant differences were found for the time periods or intervention established. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals.

RESUMO Introdução Numerosas estratégias de recuperação têm sido usadas para minimizar a perda de desempenho decorrente de dor muscular de início tardio em atletas e fazem parte de programas de prevenção e treinamento da maioria dos esportes de alto nível. Objetivos Analisar os efeitos da imersão em água fria sobre a dor muscular tardia, o recrutamento muscular e o controle postural de jogadores de futebol. Métodos Estudo clínico randomizado e cego. Determinou-se a carga máxima da força muscular do quadríceps femoral. Depois de três dias, empregou-se a escala de dor para avaliar a intensidade da dor dos indivíduos. O recrutamento do quadríceps femoral foi determinado no momento do chute e associado ao controle postural. Duas séries repetidas de conjuntos de carga máxima a 60% da CVM, realizadas em uma cadeira extensora de joelho, foram usadas para induzir fadiga do quadríceps nos atletas. Vinte e oito jogadores de futebol foram randomizados em quatro grupos de intervenção: imersão em água fria (GIAF, n = 7), imersão em água termoneutra (GIAT, n = 7), recuperação ativa (GRA, n = 7) e repouso (GR, n = 7), sendo cada intervenção realizada por dez minutos. As reavaliações ocorreram depois de 24, 48 e 72 horas do protocolo de fadiga. Resultados A intensidade da dor no GIAF voltou para o valor basal após 72 horas, enquanto GIAT, GRA e GR continuaram a sentir dor acentuada. Não foram encontradas diferenças entre os grupos com relação aos outros desfechos. Conclusão Com relação ao recrutamento muscular e ao controle postural no momento do chute, não foram encontradas diferenças significativas para os períodos ou intervenções estabelecidas. Nível de evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significante, mas com intervalos de confiança estreitos.

RESUMEN Introducción Se han utilizado numerosas estrategias de recuperación para minimizar la pérdida de rendimiento relacionada con el dolor muscular de aparición tardía en los atletas y son parte de programas de prevención y entrenamiento de la mayoría de los deportes de alto nivel. Objetivos Analizar los efectos de la inmersión en agua fría sobre el dolor muscular tardío, el reclutamiento muscular y el control postural en jugadores de fútbol. Métodos Estudio clínico aleatorizado y ciego. Se determinó la carga máxima de la fuerza muscular del cuádriceps femoral. Después de tres días, se usó la escala de dolor para evaluar la intensidad del dolor de los individuos. El reclutamiento del cuádriceps femoral se determinó en el momento de la patada y se asoció con el control postural. Se utilizaron dos series repetidas de conjuntos de carga máxima al 60% de la CVM en una silla de extensión de rodilla para inducir fatiga del cuádriceps en atletas. Veintiocho jugadores de fútbol fueron asignados al azar en cuatro grupos de intervención: inmersión en agua fría (GIAF, n = 7), inmersión en agua termoneutra (GIAT, n = 7), recuperación activa (RA, n = 7) y descanso (GD, n = 7), con cada intervención realizada durante diez minutos. Las reevaluaciones ocurrieron después de 24, 48 y 72 horas después del protocolo de fatiga. Las revaluaciones ocurrieron después de 24, 48 y 72 horas del protocolo de fatiga. Resultados La intensidad del dolor en el GIAF volvió a la línea de base después de 72 horas, mientras que GIAT, GRA y GD continuaron experimentando dolor intenso. No se encontraron diferencias entre los grupos con respecto a otros resultados. Conclusión Con respecto al reclutamiento muscular y el control postural en el momento de la patada, no se encontraron diferencias significativas para los períodos o la intervención establecida. Nivel de evidencia I; Ensayo clínico aleatorizado de alta calidad con o sin una diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.

A busca pelos saberes sociais na formação de professores de educação física: uma análise das atividades complementares dos egressos da FEFD / The search for social knowledge in physical education teacher training: analysis of additional activities of trained students of FEFD / La búsqueda del conocimiento social en la maestro education en la educación física: análisis de actividades adicionales de estudiantes graduados en la FEFD

Este texto apresenta o resultado de uma pesquisa que analisou as atividades complementares dos alunos do curso de Licenciatura em Educação Física da Universidade Federal de Goiás. Para isso, realizou-se uma Pesquisa Documental em que foram analisados os certificados dos alunos egressos desta instituição. Notou-se que a maioria das horas contabilizadas faziam parte de eventos acadêmicos/científicos, seguido das atividades de extensão e de cunho político, de forma que os eventos fitness foram a minoria das atividades complementares buscadas pelos mesmos. Conclui-se que as atividades complementares desenvolvidas pelos alunos cumprem ao seu propósito no currículo prescrito ao ampliar a formação nos aspectos acadêmicos, científicos e culturais. Além disso, percebeu-se que estas atividades são realizadas em sua maioria na própria UFG.

This study is the result of a research that analyzed the complementary activities of the students of the Physical Education graduation from the Federal University of Goiás. For this, the certificates of the graduates were analyzed. It was noted that most of the activities recorded were part of academic and scientific events, followed by extension and political activities, the fitness events were the minority of complementary activities pursued by students. It was also noticed that these complementary activities are carried out mostly on own UFG.

Este estudio es el resultado de una investigación que analizó las actividades complementarias de los alumnos de Licenciatura en Educación Física de la Universidad Federal de Goiás. Se realizó una investigación documental en los certificados académicos de los egresados de esta institución. Se observó que la mayor parte de las horas registradas eran parte de eventos académicos/científicos, seguido de las actividades de extensión y naturaleza política, los eventos de fitness eran la minoría de las actividades complementarias. Por otra parte, se dio cuenta de que estas actividades adicionales se llevan a cabo principalmente en la propia UFG.

Resistência a antirretrovirais nas gestantes infectadas pelo HIV: revisão sistemática / Antiretroviral resistance in HIV-infected pregnant women: systematic review

A Aids é uma das doenças mais importantes do mundo, sendo a transmissão vertical um dos problemas mais temidos e combatidos. Com a introdução da terapia antirretroviral, a taxa de transmissão é reduzida para menos de 1%. Alguns estudos dizem que a resistência materna é algo grave, pois o feto nasceria com uma cepa resistente, mas evidências científicas não comprovam isso. Observa-se que cada país tem uma forma padrão utilizada no manejo das gestantes infectadas pelo HIV, levando-se em consideração, por exemplo, a carga viral, período gestacional, ou uso prévio de terapia medicamentosa. Mesmo com recomendações padronizadas a resistência pode aparecer, sendo a resistência à nevirapina a mais comum, por esse motivo inúmeros estudos vêm mostrando medidas alternativas para evitar esse evento que tanto amedronta os clínicos.(AU)

AIDS is one of the most important diseases in the world, and the vertical transmission is the problem more feared and fought. By the introduction of antiretroviral therapy, the vertical transmission rate is reduced to less than 1%. Some studies say the maternal resistance is something serious, because the fetus would be born with a resistant strain, but scientific evidence does not prove it. It is observed that each country has a standard form used in the management of HIV infected pregnant women, taking into consideration, for example, the viral load, pregnancy period or previous use of drug therapy. Even with standardized recommendations, the resistance may appear, and resistance to nevirapine the most common, for this reason many studies have shown alternative measures to prevent this event that both frightens the clinicians.(AU)

Fast track em cirurgia cardíaca: quando e como fazer / Fast track in heart surgery: when and how to perform

Durante muito tempo, a anestesia em cirurgia cardíaca baseou-se em altas doses de opioides e outras drogas de meia-vida prolongada. Associada à circulação extracorpórea (CEC), heparinização e hipotermia, a recuperação anestésica mostrava-se extremamente prolongada, com uso de próteses ventilatórias e ventilação controlada por longo período após o término da cirurgia. Nos últimos anos, com a tendência à redução de custos e morbidade relacionada a essa recuperação prolongada e uso de agentes anestésicos de meia-vida mais curta, passou-se a considerar a possibilidade de despertar precoce, com extubação e retorno à ventilação espontânea em curto período de tempo após o término da cirurgia.

For a long time, cardiac anesthesia was based upon the use of high doses of opioids and long half-time drugs. Associated to the heart-lung by-pass, full heparinization and hypothermia, post-anesthetic recovery was extremely long, with the use of respiratory protesis and mechanical ventilation. During the last few years, the need to reduce intrahospitalarcosts and the morbidity related to those long recovery times, associated with the new coming of short half-time drugs, fast wake up times, with extubation and return to normal breathing are now being considered.

Ocular metastasis as first presentation of renal cell carcinoma: report of 2 cases

Os autores apresentam dois casos de metástase ocular como o primeiro sinal que levou ao diagnóstico de carcinoma renal, uma apresentação incomum desta neoplasia.