A case study of ileal metaplasia and neoplasia in a patient with an ileal-rectal anatomosis / Um caso de estudo de metaplasia ileal e neoplasia em paciente com anastomose ileal-retal

ABSTRACT A clear link between ulcerative colitis and the formation of dysplasia and neoplasia has been described. This increased risk remains even after subtotal colectomy and ileo-rectal anastomosis, necessitating life-long surveillance of the remaining ano-rectum. This case study highlights the importance in long-term follow up in this population, including proximal to the anastomosis as dysplastic changes can occur in the distal ileum.

RESUMO Uma ligação clara entre colite ulcerativa e a formação de displasia e neoplasia tem sido descrita. Ese risco aumentado permanece mesmo após colectomia subtotal e ileo-retal, necesitando de uma vigilância ao longo da vida do ano-recto restante. Este caso de estudo realça a importância no acompanhamento a longo prado dessa população, incluindo áqueles próximos à anastomose já que podem ocorrer alteraçoes displásicas no íleo distal.

Local technicians in long-term research projects: evaluation of 25 years experience in an active tropical research station

Most field ecology is conceived and financed by scientists from urban areas but is actually carried out in rural areas. Field staff can either be imported from urban areas or recruited from local residents. We evaluated the advantages and disadvantages of involving rural residents as local technicians over a 25- year period at active field research site in Costa Rica. We defined "local technicians" as local residents with no university education who acquired significant experience in field data collection, data management and/or laboratory work. We analyzed the experiences of incorporating these technicians into field research In developing countries from the points of view of scientist and of the local technicians themselves. Primary data were written responses from to a standardized survey of 19 senior scientists and Ph.D. students, and results from standardized personal interviews with 22 local technicians. Researchers highlighted the advantages of highly-skilled technicians with minimal staff turnover, as well as the technicians’ knowledge of local ecological conditions. Local technicians considered the primary advantages of their jobs to be opportunities for continuing education training in science as well as cultural enrichment through interactions with people of different cultures. The main challenges identified by researchers were the lack of long-term funding for projects and extended training required for local technicians. Local technicians can be of great benefit to research projects by providing high-quality data collection at reasonable costs with low staff turnover. Over the last 25 years the research model at the field station we studied has evolved to the point that most long-term projects now depend heavily on local technicians. This model of involving local technicians in long-term research has multiple benefits for the researchers, the technicians and the local community, and could be adapted to a variety of settings in rural areas of developing countries. Rev. Biol. Trop. 59 (4): 1455-1462. Epub 2011 December 01.

Trace elements, vitamins and antioxidants in neonatology / Trazar elementos, vitaminas y antioxidantes en neonatología

Vitamin needs have historically been estimated from the amount of milk consumed by breastfed infants. This approach may be limited by the fact that the milk consumption of breastfed infants is lower than formula-fed infants and the biovallability of the various vitamins may be different human milk compared to formula. For now, using the recommendations of AAPCON as well as clinical observation and experience will determine the appropriate vitamin needs of the population. The maternal diet strogly influences the concentration of certain watersoluble vitamins in human milk. Multivitamin supplements should be given to breast fed infants of malnourished mothers. Overt clinical deficiency of the ninne water-soluble vitamins is not observed in full-term, breast-fed infants of adequately nourished mothers or in commercial formula-fed infants. Vitamins and minerals are incorporate into processed formulas to help provide an essentially complete diet for infants. Most commercial infant formulas contain adequate quantities of vitamins to meet the recommended dally allowances if the infant consumes 750 ml of formula. According to standards recommended by the AAPCON, infants consuming adequate amounts of commercial iron-containing formulas do not need vitamin and mineral supplementation in the first 6 months of life if formula continues to be used with appropriately fortified solid foods. The exact vitamin needs of the preterm infant are unknown. These needs are proportionately greater than term infants due to low stores at birth, sometimes delayed nutritional intervention, increased demands of more rapid growth rate and less complete intestinal digestion and absorption. When fed human milk, the preterm may not receive adequate amounts of some vitamins. Thus human milk supplemented with water-soluble vitamins should be given to preterm infants. It has been recommended by AAPCON to continue this vitamin supplement until the infant's intake exceeds 300 kcal/day or until the infant's acheives a body weight of 2.5 kg

Dolor torácico de origen desconocido

En este interesante artículo los autores establecen los puntos claves de la historia, del cuadro clínico y de los resultados de laboratorio para establecer un adecuado diagnóstico diferencial en el paciente con dolor torácico de origen no aclarado, y pasan revista a los primeros pasos en el tratamiento.