Spacer Domain in Hepatitis B Virus Polymerase: Plugging a Hole or Performing a Role?

Hepatitis B virus (HBV) polymerase is divided into terminal protein, spacer, reverse transcriptase, and RNase domains. Spacer has previously been considered dispensable, merely acting as a tether between other domains or providing plasticity to accommodate deletions and mutations. We explore evidence for the role of spacer sequence, structure, and function in HBV evolution and lineage, consider its associations with escape from drugs, vaccines, and immune responses, and review its potential impacts on disease outcomes.

Endoscopic treatment of spondylodiscitis: systematic review.

BACKGROUND: Spondylodiscitis is a severe condition where standalone antibiotic therapy resolves most cases. In refractory infections, open surgery may aid with infection debulking. However, significant morbidity can occur. Nowadays, endoscopic approaches are emerging as an alternative. However, until now, only small-scale studies exist. Being so, we carried the first systematic review on spondylodiscitis endoscopic debridement indications, technique details, and outcomes. METHODS: Search for all English written original studies approaching the spondylodiscitis endoscopic treatment was performed using PubMed and EBSCO host. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and a pre-specified protocol was registered at PROSPERO (CRD42020183657). RESULTS: Fourteen studies involving 342 participants were included for analysis. Data overall quality was fair. Indications for the endoscopic approach were poorly defined. The most consensual indication was refractory infection to conservative treatment. Spinal instability or neurological deficits were common exclusion criteria. All authors described similar techniques, and despite the frequent severe co-morbidities, procedure morbidity was low. Re-interventions were common. Microorganism identification varied from 54.2 to 90.4%. Treatment failure among studies ranged from 0 to 33%. Pain, functional status, and neurological deficits had satisfactory improvement after procedures. CONCLUSIONS: The endoscopic debridement of spondylodiscitis seems to be an effective and safe approach for refractory spondylodiscitis. A novel approach with initial endoscopic infection debulking and antibiotic therapy could improve the success of spondylodiscitis treatment.

Malaria hospitalisation in East Africa: age, phenotype and transmission intensity.

BACKGROUND: Understanding the age patterns of disease is necessary to target interventions to maximise cost-effective impact. New malaria chemoprevention and vaccine initiatives target young children attending routine immunisation services. Here we explore the relationships between age and severity of malaria hospitalisation versus malaria transmission intensity. METHODS: Clinical data from 21 surveillance hospitals in East Africa were reviewed. Malaria admissions aged 1 month to 14 years from discrete administrative areas since 2006 were identified. Each site-time period was matched to a model estimated community-based age-corrected parasite prevalence to provide predictions of prevalence in childhood (PfPR2-10). Admission with all-cause malaria, severe malaria anaemia (SMA), respiratory distress (RD) and cerebral malaria (CM) were analysed as means and predicted probabilities from Bayesian generalised mixed models. RESULTS: 52,684 malaria admissions aged 1 month to 14 years were described at 21 hospitals from 49 site-time locations where PfPR2-10 varied from < 1 to 48.7%. Twelve site-time periods were described as low transmission (PfPR2-10 < 5%), five low-moderate transmission (PfPR2-10 5-9%), 20 moderate transmission (PfPR2-10 10-29%) and 12 high transmission (PfPR2-10 ≥ 30%). The majority of malaria admissions were below 5 years of age (69-85%) and rare among children aged 10-14 years (0.7-5.4%) across all transmission settings. The mean age of all-cause malaria hospitalisation was 49.5 months (95% CI 45.1, 55.4) under low transmission compared with 34.1 months (95% CI 30.4, 38.3) at high transmission, with similar trends for each severe malaria phenotype. CM presented among older children at a mean of 48.7 months compared with 39.0 months and 33.7 months for SMA and RD, respectively. In moderate and high transmission settings, 34% and 42% of the children were aged between 2 and 23 months and so within the age range targeted by chemoprevention or vaccines. CONCLUSIONS: Targeting chemoprevention or vaccination programmes to areas where community-based parasite prevalence is ≥10% is likely to match the age ranges covered by interventions (e.g. intermittent presumptive treatment in infancy to children aged 2-23 months and current vaccine age eligibility and duration of efficacy) and the age ranges of highest disease burden.

Case report: Rare convexity meningeal chondroma mimicking a meningioma.

BACKGROUND: Intracranial chondromas account for 0.2-0.3% of all intracranial neoplastic lesions and less than a quarter arise in the convexity or falx. Despite its benign nature, exceedingly rare malignant transformations exist. The misdiagnosis with meningiomas is frequent and may be related with chondromas' similar insidious clinical presentation and imaging features. Standalone surgery is advised and complete resection provides the definitive treatment. CASE DESCRIPTION: A 44-year-old female presents with insidious headache, visual disturbances, and papilledema. The imaging studies were compatible with frontal parasagittal meningioma. Surgery revealed a meningeal based mass, mostly avascular and with a well-demarked surgical plane from the brain parenchyma. Complete resection with meningeal margins was achieved and the histopathologic examination revealed a chondroma. The patient symptoms subsided and no surgical complications existed. CONCLUSION: Intracranial convexity chondromas constitute a rare differential diagnosis for meningiomas. The present case reinforces the current scarce data and serves as reminder for clinicians diagnosing and treating intracranial tumors.

Increased quality of in natura and cryopreserved semen of water buffaloes supplemented with saturated and unsaturated fatty acids from the palm oil industry.

Ruminant energy supplementation with vegetable oils or fats has been standing out worldwide and oil palm processing has been receiving growing interest. This study assessed the effect of supplementation with saturated and unsaturated fatty acids from the palm oil industry on the lipid profile of seminal plasma and of the sperm membrane, as well as on the morphological and functional characteristics of raw and cryopreserved buffalo semen. Twelve purebred Murrah bulls (Bubalus bubalis) were assigned to the experimental groups and fed diets for 120 days with no added lipids (CONT, four bulls), or with an extra amount of 3% lipids from crude palm oil (PALM, four bulls), or from palm oil deodorizer distillate (PODD, four bulls). Semen was collected and cryopreserved every 15 days. The lipid composition of membranes and semen quality were determined after collections. Lipid supplementation did not impact feed intake (P>0.05). Diet enrichment with PALM increased the linoleic acid (C18:2,ω6) in seminal plasma. Lipid supplementation did not increase the polyunsaturated fatty acids in the sperm membrane composition, but significantly increased the lignoceric acid (C24:0). Cryopreserved semen of the supplemented bulls presented higher progressive motility (60.2 vs. 67.9 vs. 65.2%; P<0.05) and sperm viability detected by eosin-nigrosin staining (61.1 vs. 69.4 vs. 67.8%; P<0.05). Palm oil reduced major sperm defects in both raw (12.2 vs. 9.3 vs. 13.2%; P<0.0001) and cryopreserved semen (12.4 vs. 9.4 vs. 11.2%; P<0.0001). The lipids added to the diet did not impact the population of spermatozoa with intact plasma and acrosomal membranes (PI-/PSA-), but significantly increased the percentage of spermatozoa with high mitochondrial potential (25.6 vs. 31.5 vs. 32.0%; P=0.008). The results suggest that lipid supplementation based on crude palm oil or palm oil deodorizer distillate can be safely used to feed buffalo bulls and may increase sperm attributes related to male fertility.

Suicídio na Velhice - Um Estudo de Revisão Integrativa da Literatura / Suicide in Old Age - An Integrative Review of Literature Study / Suicidio en la vejez - Un estudio de revisión

Resumo Este estudo objetivou realizar uma revisão integrativa da literatura sobre suicídio e velhice nas bases de dados Scielo, Pepsic, LILACS e Index Psi no período de 2007 a 2017, publicados nos idiomas Português, Inglês e Espanhol. Dentre os achados foram recuperados 873 artigos, em que 864 foram eliminados devido os critérios de inclusão e exclusão que compuseram o processo de triagem da pesquisa. Os principais critérios foram: artigos que fugiam do tema, idiomas, artigos repetidos nas bases de dados ou fora do período selecionado. Após a leitura na íntegra dos 9 artigos filtrados, emergiram três categorias temáticas, a) Fatores de Risco, b) Relações Familiares e c) Suicídio na Velhice e Saúde Pública. Conclui-se que há uma escassez frente às publicações que abordam o suicídio na velhice. Percebe-se ainda, a necessidade de se aprofundar as discussões que articulam os processos de envelhecimento e os desafios biopsicossociais durante o prolongamento da vida para que se promova melhor qualidade de vida na velhice.

Abstract This study aimed to realize an integrative review of the literature about suicide and old age based on data from Scielo, Pepsi, LILACS, and Index Psi during the period of 2007 to 2017, published in Portuguese, English and Spanish languages. Among the findings were recovered 873 articles, wherein 864 were eliminated due to the inclusion and exclusion which composed the process of research screening. The main criteria were: articles that missed the point, languages, repeated articles in databases or out of the selected period. After reading in full the 9 articles filtrated, three thematic categories emerged: a) Risk Factors, b) Family Relationships and c) Suicide in Old Age and Public Health. It is concluded that there is a shortage of publications that approach suicide in old age. It is perceived the necessity of deepening discussion that articulate the process of aging and the biopsychosocial challenges throughout life.

Resumen Este estudio tuvo como objetivo realizar una revisión integradora de la literatura sobre suicidio y vejez en las bases de datos Scielo, Pepsi, LILACS e I Index Psi en el período de 2007 a 2017, publicados en los idiomas Portugués, Inglés y Español. Entre los hallazgos fueron recuperados 873 artículos, de los cuales se eliminaron 864 debido a los criterios de inclusión y exclusión que compusieron el proceso de selección de la investigación. Los principales criterios fueron: artículos que se alejaban del tema, en idiomas diferentes al portugués, español e Inglés, repetidos en las bases de datos o fuera del período seleccionado. Tras la lectura en su totalidad de los nueve artículos filtrados, emergieron tres categorías temáticas: a) Factores de Riesgo, b) Relaciones Familiares y c) Suicidio en la vejez y Salud Pública. Se concluye que hay una escasez de publicaciones que abordan el suicidio en la vejez. Se percibe aún, la necesidad de profundizar las discusiones que articulan los procesos de envejecimiento y los desafíos biopsicosociales durante el prolongamiento de la vida para que se promueva mejor calidad de vida en la vejez.

Adjustable Strabismus Surgery under Topical Anesthesia: Alignment in Supine vs Seated Position.

PURPOSE: To compare ocular deviation in the operating room depending on whether the patient is in supine decubitus or seated after single-stage adjustable strabismus surgery under topical anesthesia. MATERIAL AND METHOD: We performed a prospective observational study of 30 patients with horizontal and/or vertical strabismus who underwent single stage adjustable strabismus surgery under topical anesthesia. Both distance and near deviation were evaluated before surgery, during surgery in both positions (seated and supine), and at 1 day, 1 month, and 3 months after surgery. A final horizontal deviation <10 pd and a vertical deviation <5 pd without diplopia was considered to be a good outcome (3 months after surgery). RESULTS: The mean age of the sample was 55 years and 76.7% were women. Most had esotropia (70%). The most frequently used surgical combination was the medial rectus and lateral rectus (36.7%). Surgical adjustment was necessary in 40% of cases. Mean preoperative deviation was 21.9 ± 12.63 pd (distance) and 20.66 ± 4.76 (near). Deviation with the patient supine was 8 ± 8.25 pd (distance) and 7.26 ± 5.81 (near). Deviation with the patient seated was 8.13 pd±8.38 (distance) and 8.5 ± 7.41 (near). There was no significant difference between the positions. Outcome was favorable in 70% of patients; this percentage increased to 83.33% at 1 day, 1 month, and 3 months after surgery. CONCLUSIONS: No statistically significant differences were found between ocular deviations in the seated or supine position in the operating room. Outcome was favorable in most cases 3 months after surgery. Intraoperative ocular deviation was not a predictor of outcome.

The generation of a simian adenoviral vectored HCV vaccine encoding genetically conserved gene segments to target multiple HCV genotypes.

BACKGROUND: Hepatitis C virus (HCV) genomic variability is a major challenge to the generation of a prophylactic vaccine. We have previously shown that HCV specific T-cell responses induced by a potent T-cell vaccine encoding a single strain subtype-1b immunogen target epitopes dominant in natural infection. However, corresponding viral regions are highly variable at a population level, with a reduction in T-cell reactivity to these variants. We therefore designed and manufactured second generation simian adenovirus vaccines encoding genomic segments, conserved between viral genotypes and assessed these for immunogenicity. METHODS: We developed a computer algorithm to identify HCV genomic regions that were conserved between viral subtypes. Conserved segments below a pre-defined diversity threshold spanning the entire HCV genome were combined to create novel immunogens (1000-1500 amino-acids), covering variation in HCV subtypes 1a and 1b, genotypes 1 and 3, and genotypes 1-6 inclusive. Simian adenoviral vaccine vectors (ChAdOx) encoding HCV conserved immunogens were constructed. Immunogenicity was evaluated in C57BL6 mice using panels of genotype-specific peptide pools in ex-vivo IFN-ϒ ELISpot and intracellular cytokine assays. RESULTS: ChAdOx1 conserved segment HCV vaccines primed high-magnitude, broad, cross-reactive T-cell responses; the mean magnitude of total HCV specific T-cell responses was 1174 SFU/106 splenocytes for ChAdOx1-GT1-6 in C57BL6 mice targeting multiple genomic regions, with mean responses of 935, 1474 and 1112 SFU/106 against genotype 1a, 1b and 3a peptide panels, respectively. Functional assays demonstrated IFNg and TNFa production by vaccine-induced CD4 and CD8 T-cells. In silico analysis shows that conserved immunogens contain multiple epitopes, with many described in natural HCV infection, predicting immunogenicity in humans. CONCLUSIONS: Simian adenoviral vectored vaccines encoding genetic segments that are conserved between all major HCV genotypes contain multiple T-cell epitopes and are highly immunogenic in pre-clinical models. These studies pave the way for the assessment of multi-genotypic HCV T-cell vaccines in humans.

Reducing HIV infection in people who inject drugs is impossible without targeting recently-infected subjects.

OBJECTIVE: Although our understanding of viral transmission among people who inject drugs (PWID) has improved, we still know little about when and how many times each injector transmits HIV throughout the duration of infection. We describe HIV dynamics in PWID to evaluate which preventive strategies can be efficient. DESIGN: Due to the notably scarce interventions, HIV-1 spread explosively in Russia and Ukraine in 1990s. By studying this epidemic between 1995 and 2005, we characterized naturally occurring transmission dynamics of HIV among PWID. METHOD: We combined publicly available HIV pol and env sequences with prevalence estimates from Russia and Ukraine under an evolutionary epidemiology framework to characterize HIV transmissibility between PWID. We then constructed compartmental models to simulate HIV spread among PWID. RESULTS: In the absence of interventions, each injector transmits on average to 10 others. Half of the transmissions take place within 1 month after primary infection, suggesting that the epidemic will expand even after blocking all the post-first month transmissions. Primary prevention can realistically target the first month of infection, and we show that it is very efficient to control the spread of HIV-1 in PWID. Treating acutely infected on top of primary prevention is notably effective. CONCLUSION: As a large proportion of transmissions among PWID occur within 1 month after infection, reducing and delaying transmissions through scale-up of harm reduction programmes should always form the backbone of HIV control strategies in PWID. Growing PWID populations in the developing world, where primary prevention is scarce, constitutes a public health time bomb.

A study of pent-up demand in ophthalmology: Divinolândia Hospital/Unicamp / Estudo da demanda reprimida em Oftalmologia: hospital de Divinolândia/Unicamp

OBJECTIVE: To assess the waiting time for eye care identifying the number of patients with each complaint; to investigate how the waiting time may worsen the patient's condition; to check the screening of urgent cases for effectiveness; and to devise means of increasing the medical-surgical care capacity. METHODS: A retrospective descriptive survey was conducted using data obtained on 12 occasions during collaborative team visits to provide eyecare services. These initiatives were designed to decrease the waiting time and to treat urgent cases that occurred on each occasion; eyecare services were provided every Saturday, in the period from June to August 2006, in 16 cities of the region covered by Conderg (Consortium for the Development of the São João da Boa Vista Administrative Region). RESULTS: Referrals used 1,743 (87.1%) of the 2,000 places available. The most frequent diagnoses were refractive errors, with 683 cases, corresponding to 39.1% of the total, followed by cataracts, with 296 cases, corresponding to 20.9%. Of the 238 surgeries indicated, 54.6% were phakectomies. Thirty-five (2.0%) cases were considered urgent. CONCLUSION: The most common diagnoses made during the team visits to manage the excess demand for eyecare were refractive errors and cataracts, which, together, accounted for the majority of the cases. The Divinolândia Hospital has the necessary human and material resources to meet the demand left unattended by the local SUS network. Immediate referral of urgent cases by the primary units' screeners proved effective.

OBJETIVO: Avaliar a fila de espera pelo atendimento oftalmológico detectando os problemas oculares; estudar o agravo que esta espera pode acarretar ao paciente; verificar a eficácia na triagem dos casos de urgência e averiguar a possibilidade de aumento da capacidade de atendimento clínico e cirúrgico. MÉTODOS Foi realizada pesquisa retrospectiva e descritiva dos dados obtidos durante 12 mutirões de atendimento oftalmológico. Os mutirões foram realizados com a intenção de diminuir a fila de espera e atender as urgências que surgiram nos dias de atendimento; ocorreram aos sábados durante os meses de junho a agosto no ano de 2006, em 16 municípios da região do Conderg(Consórcio de Desenvolvimento da Região de Governo de São João da Boa Vista). RESULTADOS: Das 2.000 vagas disponibilizadas, foram utilizadas 1.743 (87,1%) dos encaminhados. Nos diagnósticos realizados se destacam os vícios de refração com 683 casos, correspondendo a 39,1 % seguido de catarata com 296, correspondendo a 20,9. Das 238 cirurgias indicadas, 54,6% foram de facectomia. Foram detectados 35 casos (2,0%) considerados como urgência. CONCLUSÃO: Nos diagnósticos realizados durante os mutirões de atendimento à demanda reprimida, destacaram-se os vícios de refração e catarata; que somados representaram a maioria dos problemas detectados. O Hospital de Divinolândia tem recursos humanos e materiais para atender a demanda gerada, e não absorvida pelo SUS local. O encaminhamento imediato das urgências pelos triadores dos postos de saúde mostrou-se eficaz.

Helicobacter pylori has no influence on distal gastric cancer survival.

CONTEXT: There is some evidence that Helicobacter pylori correlates with distal gastric cancer genesis. However, few studies analyzed the survival related to H. pylori infection. OBJECTIVE: To correlate gastric cancer survival and H. pylori infection. METHODS: Sixty-eight patients with distal gastric cancer that underwent subtotal gastrectomy were studied. Minimal follow-up was 1 month. H. pylori infection was confirmed by biopsy. RESULTS: Thirty-four patients (19 males (55.9%), mean age 60.9 ± 14.03, range 33-82 years) were H. pylori positive. Thirty-four patients (16 males (47.1%), mean age 57.9 ± 13.97, range 27-85 years) were H. pylori negative. Groups were comparable in regards to age (P = 0.4), gender (P = 0.5), stage [T (P = 0.2), N (P = 0.6) and M (P = 0.9)]. Survival was not different when groups were compared [P = 0.1616 (hazard ratio 0.6834, 95% CI 0.4009 to 1.1647)]. CONCLUSIONS: H. pylori infection does not affect distal gastric cancer survival.

Helicobacter pylorihas no influence on distal gastric cancer survival / A infecção por Helicobacter pylori não influencia a sobrevida no câncer gástrico distal

CONTEXT: There is some evidence that Helicobacter pylori correlates with distal gastric cancer genesis. However, few studies analyzed the survival related to H. pylori infection. OBJECTIVE: To correlate gastric cancer survival and H. pylori infection. METHODS: Sixty-eight patients with distal gastric cancer that underwent subtotal gastrectomy were studied. Minimal follow-up was 1 month. H. pylori infection was confirmed by biopsy. RESULTS: Thirty-four patients (19 males (55.9 percent), mean age 60.9 ± 14.03, range 33-82 years) were H. pylori positive. Thirty-four patients (16 males (47.1 percent), mean age 57.9 ± 13.97, range 27-85 years) were H. pylori negative. Groups were comparable in regards to age (P = 0.4), gender (P = 0.5), stage [T (P = 0.2), N (P = 0.6) and M (P = 0.9)]. Survival was not different when groups were compared [P = 0.1616 (hazard ratio 0.6834, 95 percent CI 0.4009 to 1.1647)]. CONCLUSIONS: H. pylori infection does not affect distal gastric cancer survival.

CONTEXTO: Há evidência que a infecção por Helicobacter pylori correlacione-se com a etiologia do câncer gástrico distal. Há, entretanto, poucos estudos que analisam a sobrevivência relacionada ao H. pylori. OBJETIVO: Correlacionar a sobrevida do câncer gástrico distal com a infecção por H. pylori. MÉTODOS: Sessenta e oito pacientes com câncer gástrico distal submetidos a gastrectomia subtotal foram estudados. O tempo mínimo de seguimento foi de 1 mês. A infecção por H. pylori foi confirmada por biopsia. RESULTADOS: Trinta e quatro pacientes (19 homens (55,9 por cento), idade média de 60,9 ± 14,03, variação 33-82 anos) tinham confirmação de infecção por H. pylori. Trinta e quatro pacientes (16 homens (47,1 por cento), idade média de 57,9 ± 13,97, variação 27-85 anos) eram H. pylori negativo. Os grupos eram comparáveis considerando idade (P = 0.4), gênero (P = 0.5) e estágio [T (P = 0.2), N (P = 0.6) e M (P = 0.9)]. Sobrevivência não foi diferente quando os grupos foram comparados (P = 0.1616 (Hazard ratio 0.6834, 95 por cento CI 0.4009-1.1647)). CONCLUSÕES: Infecção por Helicobacter pylori não afeta a sobrevida no câncer gástrico distal.

Óculos de baixo custo: experiência em Divinolândia (SP) / Low-price glasses: Divinolândia (SP) experience

INTRODUÇÃO: Em Divinolândia (SP), o "Consórcio de Desenvolvimento da Região de Governos de São João da Boa Vista" (CONDERG), em parceria com a Universidade Estadual de Campinas (UNICAMP), fundou uma óptica com finalidade de confeccionar óculos de baixo custo e distribuílos gratuitamente para seus usuários. O objetivo é avaliar a evolução e o funcionamento da óptica do CONDERG nos seus 13 anos de funcionamento. MÉTODOS: Foi realizado um estudo retrospectivo com dados coletados dos arquivos do CONDERG, abrangendo o período de 1988 até 2001. Foram pesquisados registros sobre quantidade de óculos confeccionados, aumento da capacidade de produção e a viabilidade de funcionamento da óptica. RESULTADOS: Em 13 anos de funcionamento ininterruptos, foram fornecidos gratuitamente 16.500 óculos. Atualmente são distribuídos 400 óculos por mês, sendo 200 pagos com verba do SUS e 200 com recursos do próprio CONDERG. CONCLUSÃO: O funcionamento da Óptica CONDERG por 13 anos, o fornecimento gratuito de 16.500 óculos e o aumento da capacidade produtiva, mostram a exequibilidade do modelo instalado.

INTRODUCTION: In Divinolândia (SP), the Consortium of Development of São João da Boa Vista Region Policy (CONDERG), in partnership with State University of Campinas (UNICAMP), has founded an eyeglass store to produce low cost glasses to distribute freely to their customers. The purpose is to analyze the evolution and working process of CONDERG eyeglass store in the last 13 years, since its foundation. METHODS: Data were collected from CONDERG store files from 1988 to 2001. Data regarding the amount of spectacles produced per year, ability to increase the production and store feasibility were analyzed. RESULTS: In 13 years, 16,500 spectacles were supplied. Currently, 400 spectacles are delivered per month, being 200 supported by SUS and the other 200 by CONDERG's own resources. CONCLUSION: The 13-year operation of CONDERG eyeglass store, the free provision of 16,500 spectacles and the increase productive ability have shown this model feasibility.

Bilateral posterior fracture-dislocation of the shoulder: Report of two cases.

Bilateral posterior fracture-dislocation of the shoulder is a very rare injury. Almost 50% of bilateral posterior dislocations are due to a convulsive seizure, rising to 90% if the dislocations are associated with fractures. Electric shock accounts for less than 5% of bilateral posterior dislocations of the shoulder. A systematization of the clinical and radiological approach, followed by an early diagnosis and proper surgical treatment is essential. Authors report 2 cases of bilateral posterior fracture-dislocation of the shoulder, one caused by a convulsive seizure and the other by an electric shock. A review of literature and a treatment protocol are also presented.

Perfurações traumáticas do esôfago / Traumatic esophageal perforation

As perfurações esofágicas ainda representam um desafio quanto ao diagnóstico e tratamento. Objetivo - Descrever a experiência do serviço no tratamento das perfurações de esôfago...

Perforation of the esophagus remains a diagnostic and therapeutic challenger. Aim - To review our experience in the management of esophageal perforation...

Efeito do volume do tanque-rede na produtividade de tambaqui (Colossoma macropomum) durante a recria / Effect of cage volume on productivity of tambaqui (Colossoma macropomum) during second growth phase

O objetivo desta nota foi avaliar o efeito do volume do tanque-rede na produtividade de juvenis de tambaqui durante a recria. Juvenis de tambaqui foram criados por 60 dias, na densidade de 300 peixes/m³, em tanques-rede de dois diferentes volumes: 1 e 6 m³. Foram avaliados parâmetros de crescimento e de produtividade final. Não houve diferença no crescimento em peso e em comprimento. O coeficiente de variação do comprimento foi significativamente menor para os peixes do tanque-rede pequeno. A sobrevivência, produção por volume e o ganho de peso não diferiram entre os tratamentos. Os peixes do tanque de maior volume foram significativamente mais eficientes na conversão alimentar. A recria pode ser realizada em tanques dos dois volumes testados sem prejuízo zootécnico para o criador.

Agenesis of the posterior arch of the atlas

PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomatic, atlantoaxial instability and neurological deficits may occur because of structural instability. Computerized tomography provides a means of assessing the extent of this abnormality and can help evaluate the integrity of neural structures. Although considered to be rare entities, defects of the posterior arch of the atlas may be discovered as incidental asymptomatic findings in routine cervical radiographs. Familiarity with this abnormality may aid medical professionals in the correct management of these cases