Evaluation of water quality in fee-fishing ponds located in Guarapirangas sub basin, Upper Tietê River basin, São Paulo State / Avaliação da qualidade da água de pesqueiros localizados na Sub-Bacia Guarapiranga, Alto Tietê, SP

Abstract This study intended to characterize the fee-fishing ponds located in Guarapiranga's sub-basin both in terms of structure and environmental conditions. The studied region was mapped and 15 out of 24 georeferenced fee-fishing ponds had their owners interviewed through semi-structured questionnaires. In addition to that, samples were collected from the seven fee-fishing ponds closest to the reservoir throughout a seasonal cycle divided in four sample collections carried out between November 2013 and August 2014, aiming at measuring the following variables in situ: water flow rates, pH, turbidity, electrical conductivity and dissolved oxygen concentration in affluents and effluents. Other samples were taken in order to assess total phosphorus (TP) and total nitrogen (TN) concentrations. Our results show a decrease in dissolved oxygen concentration along with an increase in TP and TN concentration in effluents, as compared to affluents. TP e TN concentrations exceeded the permitted values established by CONAMA 357/2005 - Class II resolution in all effluents at least during part of the year. High nutrient levels were observed in affluents, condition with which basins that have been affected by population growth are commonly met. It was verified, by interviewing the owners regarding venture management and by analyzing the collected samples, that there is significant correlation between the daily feeding and the TP and TN levels (p=0.021 and p=0.045, respectively), with the ponds where feeding is more intense having showed the highest nutrient levels in their effluents. The results highlight the importance of mitigation measures such as educating the owners on proper water management, the installation of pond aerators in conjunction with tanks the filters of which shall be composed of aquatic macrophytes in their effluents, as well as awareness campaigns aiming to reduce the usage of dough by fishermen in order to minimize detrimental impacts on Guarapiranga's sub-basin.

Resumo Este estudo objetivou caracterizar, em termos estruturais e ambientais pesqueiros localizados na sub-bacia da Guarapiranga. A região de estudo foi mapeada, e do total de 24 pesque-pague georreferenciados, 15 foram entrevistados com os proprietários através de questionários semi-estruturados e, nos sete pesque-pagues com tributários mais próximos da represa, foram coletadas amostras de água em um ciclo sazonal divididas em quatro coletas entre novembro de 2013 a agosto de 2014. Foram medidos in situ: vazão, pH, turbidez, condutividade elétrica e oxigênio dissolvido nos afluentes e efluentes, e também foram coletadas amostras de água para determinação da concentração de fósforo total (PT) e nitrogênio total (NT). Os resultados mostraram que há uma diminuição nas concentrações de oxigênio dissolvido e aumento nas concentrações de PT e NT nos efluentes em relação aos afluentes. Os efluentes apresentaram valores de PT e NT acima dos limites permitidos pela resolução CONAMA 357/2005 - Classe II, ao menos em um período do ano. Também foram identificados afluentes com cargas elevadas de nutrientes, característica de bacias impactadas pelo adensamento populacional. Através do questionário aplicado aos proprietários sobre o manejo dos empreendimentos e pelas análises de água verificou-se que houve correlação significativa entre o arraçoamento diário e as cargas de PT e de NT (p=0,021 e p=0,045, respectivamente), sendo que nos locais onde o arraçoamento foi mais intenso, a carga de nutrientes nos efluentes foi maior. Os resultados evidenciam a importância de medidas mitigadoras como orientações aos proprietários para o manejo adequado dos lagos, projetos de educação ambiental com os usuários para diminuir do uso de ceva para a captura dos peixes, além da instalação de aeradores artificiais nos lagos e tanques com filtros compostos de macrófitas aquáticas nos seus efluentes, minimizando os impactos na sub-bacia do Guarapiranga.

Evaluation of water quality in fee-fishing ponds located in Guarapiranga's sub basin, Upper Tietê River basin, São Paulo State.

This study intended to characterize the fee-fishing ponds located in Guarapiranga's sub-basin both in terms of structure and environmental conditions. The studied region was mapped and 15 out of 24 georeferenced fee-fishing ponds had their owners interviewed through semi-structured questionnaires. In addition to that, samples were collected from the seven fee-fishing ponds closest to the reservoir throughout a seasonal cycle divided in four sample collections carried out between November 2013 and August 2014, aiming at measuring the following variables in situ: water flow rates, pH, turbidity, electrical conductivity and dissolved oxygen concentration in affluents and effluents. Other samples were taken in order to assess total phosphorus (TP) and total nitrogen (TN) concentrations. Our results show a decrease in dissolved oxygen concentration along with an increase in TP and TN concentration in effluents, as compared to affluents. TP e TN concentrations exceeded the permitted values established by CONAMA 357/2005 - Class II resolution in all effluents at least during part of the year. High nutrient levels were observed in affluents, condition with which basins that have been affected by population growth are commonly met. It was verified, by interviewing the owners regarding venture management and by analyzing the collected samples, that there is significant correlation between the daily feeding and the TP and TN levels (p=0.021 and p=0.045, respectively), with the ponds where feeding is more intense having showed the highest nutrient levels in their effluents. The results highlight the importance of mitigation measures such as educating the owners on proper water management, the installation of pond aerators in conjunction with tanks the filters of which shall be composed of aquatic macrophytes in their effluents, as well as awareness campaigns aiming to reduce the usage of dough by fishermen in order to minimize detrimental impacts on Guarapiranga's sub-basin.

Changes on physiological parameters of tambaqui (Colossoma macropomum) fed with diets supplemented with Amazonian fruit Camu camu (Myrciaria dubia) / Alterações em parâmetros fisiológicos de tambaqui (Colossoma macropomum) alimentados com dietas suplementadas com fruta amazônica camu camu (Myrciaria dubia)

Abstract The physiological responses of juvenile tambaqui (Colossoma macropomum) fed commercial feed supplemented with different concentrations of camu camu (Myrciaria dubia) were evaluated. The design was completely randomized, with treatments arranged in a factorial design with three proportions of camu camu (15%, 30% and 45%) and a control treatment (100% commercial diet), with four replicates per treatment. A total of 96 tambaqui specimens were used, with a mean initial weight of 11.69 ± 2.68 g and a mean length of 7.06 ± 0.44 cm. After 30 days, hematological parameters, metabolic variables, growth and fish swimming performance were evaluated. The different proportions of camu camu in the diet did not cause significant changes to the tambaqui's hematological parameters during the feeding period, except for hemoglobin (Hb) concentration and mean corpuscular hemoglobin concentration (MCHC) after the 30th day, and hematocrit (Ht) after the swimming stress test, which increased significantly (p < 0.05). The significant increases in metabolic variables, such as cortisol, glucose, proteins and triglycerides, and in hematologic variables after the Ucrit test reflect, respectively, biochemical adaptations for maintenance of the energy mobilization process and a regulatory necessity in tissue oxygen demand during intense exercise. Fish fed 15% and 30% camu camu gained the most weight and achieved the best swimming performance, respectively. The results for camu camu concentrations above 30% suggest a saturation of its intrinsic properties in the diet at this level and a loss of nutrients from the commercial feed replaced by the fruit, reducing productive performance and nutritional assimilation.

Resumo As respostas fisiológicas de juvenis de tambaqui (Colossoma macropomum) alimentados com ração comercial suplementada com diferentes concentrações de camu camu (Myrciaria dubia) foram avaliados. As amostras analisadas foram inteiramente casualizadas, com os tratamentos arranjados em esquema fatorial com três proporções de camu camu (15%, 30% e 45%) e um tratamento controle (ração comercial 100%), com quatro repetições por tratamento. Um total de 96 amostras de tambaqui foram utilizadas, com um peso médio inicial de 11,69 ± 2,68 g e um comprimento médio de 7,06 ± 0,44 cm. Após 30 dias, foram avaliados os parâmetros hematológicos, variáveis ​​metabólicas, crescimento e desempenho natatório de peixes. As diferentes proporções de camu camu na dieta não causou alterações significativas nos parâmetros hematológicos dos tambaquis durante o período de alimentação, com exceção de hemoglobina (Hb) e concentração de hemoglobina corpuscular média (CHCM), após o 30º dia, e hematócrito (Ht), após o teste de natação de estresse, que aumentou de forma significativa (p <0,05). Os aumentos significativos nas variáveis ​​metabólicas, como o cortisol, glicose, proteínas e triglicerídeos, e nas variáveis ​​hematológicas após o teste Ucrit reflete, respectivamente, adaptações bioquímicas para a manutenção do processo de mobilização de energia e uma necessidade de regulamentação na demanda de oxigênio nos tecidos durante o exercício intenso. Os peixes alimentados com 15% e 30% de camu camu obtiveram mais peso e melhor desempenho natatório, respectivamente. Os resultados para as concentrações camu camu superiores a 30% indicam uma saturação das suas propriedades intrínsecas na dieta, a este nível e uma perda de nutrientes a partir da ração comercial substituído pelo fruto, reduzindo o desempenho produtivo e assimilação nutricional.

Reduced late urinary toxicity with high-dose intensity-modulated radiotherapy using intra-prostate fiducial markers for localized prostate cancer

Background/purpose. To evaluate the impact of intensity-modulated radiotherapy (IMRT) with intra-prostate fiducial markers image-guided radiotherapy (IGRT) on the incidence of late urinary toxicity compared to 3D conformal radiotherapy (3DCRT) for patients with prostate cancer (PC). Methods and materials. We selected 733 consecutive patients with localized PC treated with dose-escalation radiotherapy between 2001 and 2014. Eligibility criteria were radiation dose >72.0 Gy, no pelvic RT and minimum follow-up 24 months. 438 patients were treated with 3DCRT and 295 with IMRT. Acute and late urinary complications were assessed using the EORTC/RTOG and CTCAEs v3.0 definition. The Cox regression model was used to compare grade ≥2 urinary toxicity between both techniques. The median follow-up was 75 months (range 24-204). Results. The median isocenter radiation dose was 78.7 Gy for 3DCRT and 80.7 Gy for IMRT/IGRT (p < 0.001). The 5-year incidence of late grade ≥2 urinary toxicity was 6.4% for IMRT and 10.8% for 3DCRT [hazard ratio (HR) 0.575, p = 0.056]. The corresponding 5-year estimates of late grade ≥2 hematuria were 2% for IMRT and 5.3% for 3DCRT (HR 0.296, p = 0.024). On multivariate analysis, the antecedent of prior transurethral resection of the prostate was also a strong predictor of a higher risk of urinary complications (HR 2.464, p = 0.002) and of hematuria (HR 5.196, p < 0.001). Conclusion. Compared with 3DCRT, high-dose IMRT/IGRT is associated with a lower rate of late urinary complications in spite of higher radiation dose (AU)

No disponible

Changes on physiological parameters of tambaqui (Colossoma macropomum) fed with diets supplemented with Amazonian fruit Camu camu (Myrciaria dubia)

Abstract The physiological responses of juvenile tambaqui (Colossoma macropomum) fed commercial feed supplemented with different concentrations of camu camu (Myrciaria dubia) were evaluated. The design was completely randomized, with treatments arranged in a factorial design with three proportions of camu camu (15%, 30% and 45%) and a control treatment (100% commercial diet), with four replicates per treatment. A total of 96 tambaqui specimens were used, with a mean initial weight of 11.69 ± 2.68 g and a mean length of 7.06 ± 0.44 cm. After 30 days, hematological parameters, metabolic variables, growth and fish swimming performance were evaluated. The different proportions of camu camu in the diet did not cause significant changes to the tambaqui's hematological parameters during the feeding period, except for hemoglobin (Hb) concentration and mean corpuscular hemoglobin concentration (MCHC) after the 30th day, and hematocrit (Ht) after the swimming stress test, which increased significantly (p 0.05). The significant increases in metabolic variables, such as cortisol, glucose, proteins and triglycerides, and in hematologic variables after the Ucrit test reflect, respectively, biochemical adaptations for maintenance of the energy mobilization process and a regulatory necessity in tissue oxygen demand during intense exercise. Fish fed 15% and 30% camu camu gained the most weight and achieved the best swimming performance, respectively. The results for camu camu concentrations above 30% suggest a saturation of its intrinsic properties in the diet at this level and a loss of nutrients from the commercial feed replaced by the fruit, reducing productive performance and nutritional assimilation.

Resumo As respostas fisiológicas de juvenis de tambaqui (Colossoma macropomum) alimentados com ração comercial suplementada com diferentes concentrações de camu camu (Myrciaria dubia) foram avaliados. As amostras analisadas foram inteiramente casualizadas, com os tratamentos arranjados em esquema fatorial com três proporções de camu camu (15%, 30% e 45%) e um tratamento controle (ração comercial 100%), com quatro repetições por tratamento. Um total de 96 amostras de tambaqui foram utilizadas, com um peso médio inicial de 11,69 ± 2,68 g e um comprimento médio de 7,06 ± 0,44 cm. Após 30 dias, foram avaliados os parâmetros hematológicos, variáveis metabólicas, crescimento e desempenho natatório de peixes. As diferentes proporções de camu camu na dieta não causou alterações significativas nos parâmetros hematológicos dos tambaquis durante o período de alimentação, com exceção de hemoglobina (Hb) e concentração de hemoglobina corpuscular média (CHCM), após o 30º dia, e hematócrito (Ht), após o teste de natação de estresse, que aumentou de forma significativa (p 0,05). Os aumentos significativos nas variáveis metabólicas, como o cortisol, glicose, proteínas e triglicerídeos, e nas variáveis hematológicas após o teste Ucrit reflete, respectivamente, adaptações bioquímicas para a manutenção do processo de mobilização de energia e uma necessidade de regulamentação na demanda de oxigênio nos tecidos durante o exercício intenso. Os peixes alimentados com 15% e 30% de camu camu obtiveram mais peso e melhor desempenho natatório, respectivamente. Os resultados para as concentrações camu camu superiores a 30% indicam uma saturação das suas propriedades intrínsecas na dieta, a este nível e uma perda de nutrientes a partir da ração comercial substituído pelo fruto, reduzindo o desempenho produtivo e assimilação nutricional.

Feasibility of Typha latifolia for high salinity effluent treatment in constructed wetlands for integration in resource management systems.

High salinity wastewaters have limited treatment options due to the occurrence of salt inhibition in conventional biological treatments. Using recirculating marine aquaculture effluents as a case study, this work explored the use of Constructed Wetlands as a treatment option for nutrient and salt loads reduction. Three different substrates were tested for nutrient adsorption, of which expanded clay performed better. This substrate adsorbed 0.31 mg kg(-1) of NH4(+)-N and 5.60 mg kg(-1) of PO4(3-)-P and 6.9 mg kg(-1) dissolved salts after 7 days of contact. Microcosms with Typha latifolia planted in expanded clay and irrigated with aquaculture wastewater (salinity 2.4%, 7 days hydraulic retention time, for 4 weeks), were able to remove 94% NH(4+)-N (inlet 0.25 +/- 0.13 mg L(-1)), 78% NO2(-)-N (inlet 0.78 +/- 0.62 mg L(-1)), 46% NO3(-)-N (inlet 18.83 +/- 8.93 mg L(-1)) whereas PO4(3-)-P was not detected (inlet 1.41 +/- 0.21 mg L(-1)). Maximum salinity reductions of 52% were observed. Despite some growth inhibition, plants remained viable, with 94% survival rate. Daily treatment dynamics studies revealed rapid PO4(3-)-P adsorption, unbalancing the N:P ratio and possibly affecting plant development. An integrated treatment approach, coupled with biomass valorization, is suggested to provide optimal resource management possibilities.

The use of an endostapler in the treatment of supralevator abscess of intersphincteric origin.

AIM: This technical note describes the use of an endostapler for the definitive treatment of supralevator abscess upward from an intersphincteric origin. METHOD: A two-stage treatment was performed. First an endoanal drainage was performed by inserting a mushroom catheter in the supralevator abscess cavity. In the second stage transanal unroofing of the fistula was performed with an endostapler. RESULTS: Since 2011, three patients have been treated in this way. After 2 years of follow up, none of the patients had recurrence of the abscess or been referred for anal incontinence. CONCLUSION: The use of an endostapler in the treatment of supralevator abscess of intersphincteric origin may be an alternative to decrease the risk of recurrence and incontinence.

In vitro anthelmintic activity of aqueous leaf extract of Annona muricata L. (Annonaceae) against Haemonchus contortus from sheep.

Despite the overall progress of sheep farming in Brazil, infections with the gastrointestinal parasite Haemonchus contortus represent one the most important problems in sheep production, aggravated by the increasing resistance of nematodes to traditional anthelmintic drugs caused by inadequate sheep flock management by breeders. Ethnopharmacological data indicate Annona muricata as a promising alternative for the control of gastrointestinal nematodes because of its general anthelmintic properties. The aim of this work was to evaluate the in vitro anthelmintic effects of A. muricata aqueous leaf extract against eggs, infective larvae and adult forms of parasitic nematode H. contortus. At higher doses, A. muricata extract showed 84.91% and 89.08% of efficacy in egg hatch test (EHT) and larval motility test (LMT), respectively. In the adult worm motility test, worms were completely immobilized within the first 6-8h of nematode exposition to different dilutions of extract. Phytochemical analysis indicated the presence of phenolic compounds in A. muricata aqueous leaf extract that may be responsible for the anthelmintic effects observed. Moreover those results validate the traditional use of A. muricata as a natural anthelmintic and then the pharmacological potential of its compounds for future in vivo investigations.

Anestesia local y sedoanalgesia para la colecistectomía transcilíndrica / No disponible

Introducción: La colecistectomía transcilíndrica (CTC) bajo anestesia local y sedoanalgesia (AL + S) se plantea como una alternativa a la colecistectomía la paroscópica en CMA. El objetivo del estudio es estimar los resultados obtenidos con este método. Material y método: A lo largo de 20 meses en el Hospital Siberia-Serena (Talarrubias, Badajoz) pacientes ASA I-III fueron programados para CTC bajo AL + S. El procedimiento se inicia con la monitorización del paciente y una infusión de midazolam y remifentanilo para obtener una sedación de 2-3 en la escala de Ramsay y/o un valor de BIS de 70 a 85 antes de la aplicación de la anestesia local. Para la anestesia del campo quirúrgico se utilizan 300-500 mg de mepivacaína al 1% en el borde costal, región epigástrica derecha, bloqueando los nervios intercostales VII-IX. Resultados: Ochenta y ocho de los 124 casos realizados fueron completados bajo AL + S. En los 36 casos restantes hubo que recurrir a la anestesia general (29 por dificultades técnicas relacionadas con la alteración de la anatomía, 4 por corpulencia excesiva y 3 por intolerancia al procedimiento).Conclusiones: Según nuestra observación en este grupo de pacientes, la técnica de CTC es susceptible de realizarse en 2/3 de pacientes bajo AL + S con alto grado de aceptación por parte de los pacientes y con la única selección de cumplir con los criterios de CMA (AU)

Introduction: Trans-cylindrical cholecystectomy (TC) underlocal anaesthesia plus sedation (LA + S) is proposed as an alternative to laparoscopic cholecystectomy for ambulatory surgery. The study objective was to estimate the results obtained using this method. Material and method: Over a 20 month period 124 cases of TC were operated on at the Hospital Siberia-Serena (Talarrubias,Badajoz) in patients ASA I-III. In 88 patients the procedure was performed under LA + S and in the remaining patients, undergeneral anesthesia. The procedure begins with the monitoring of the patient and an infusion of remifentanil and midazolam for sedation of 2-3 on the Ramsay scale and/or a BIS value of 70-85 before the application of local anesthesia. For surgical anesthesia 300-500 mg of 1% mepivacaine were administered at the costalmargin in the right epigastric region, blocking the intercostal nerves VII-IX. Results: Out of the 124 cases attempted, 88 were completed under LA + S. In the remaining 36 cases, general anaesthesia had to be resorted to (29 due to technical difficulties related to an alteration of the anatomy, excessive girth in four, and in three because of intolerance to the procedure). Conclusions: According to our observation in this group of patients, the technique of TC is likely to be completed in two thirds of patients under LA + S, with excellent acceptance by patients (AU)

Resultados globales sobre cirugía mayor ambulatoria y de corta estancia en un hospital de alta resolución / No disponible

Objetivo: Analizar la labor realizada sobre CMA y cirugía de corta estancia en la especialidad de cirugía general y del aparato digestivo en un hospital de alta resolución. Material y método: A lo largo de 26 meses se han realizado1.063 intervenciones (826 de CMA y 237 de cirugía menor) en157 sesiones operatorias, acompañadas de 2.381 primeras visitas y 2.024 sucesivas. La colelitiasis es tratada por colecistectomía transcilíndrica (CTC) bajo anestesia local y sedación (AL + S). La reparación herniaria es selectiva dependiendo del tipo de hernia, pero siempre con prótesis de polipropileno y AL + S; las eventraciones son tratadas con malla intraperitoneal de Parietex composite®. La ligadura elástica o hemorroidectomía, la esfinterotomía lateral interna (ELI) y la fistulotomía, responden de la patologíaperianal también bajo AL + S. La safenectomía del muslo para las varices y diversas resecciones de tejido mamario completan nuestro catálogo de procedimientos. Resultados: De 118 CTC, 104 se iniciaron bajo AL + S y 28 requirieron conversión a anestesia general; no hubo complicaciones destacables. De 298 reparaciones herniarias la técnica de Rives fue la más practicada (191 reparaciones). En 41 pacientes se realizó la inserción de una malla intraperitoneal para la reparación de la eventración. Se practicó hemorroidectomía en 31 pacientes76 y ligadura elástica en otros 19; ELI en 20 y fistulotomía en 23. A ocho pacientes se les practicó tumorectomía mamaria o mastectomía,a 17 safenectomía. Se practicaron además dos lobectomías tiroideas. Conclusión: La satisfacción de los pacientes ha sido elevada lo que atribuimos al hecho de realizar los procesos con el menor número posible de desplazamientos. La reducción de la lista de espera quirúrgica en nuestra área de salud ha sido notable (AU)

Objective: The goal of this presentation is to analyze ambulatory surgery and short stay surgery in the department of general and digestive tract surgery in a “high resolution” hospital. Material and method: Over 26 months we performed 1,063 operations (826 as ambulatory surgery and 237 as minorsurgery) in 157 operating theatre sessions, produced by 2,381 first visits and 2,024 postoperative visits. Cholelithiasis was treatedby transcylindrical cholecystectomy (CTC) under local anaesthesia and sedation (AL + S). Inguinal hernia repair was selective, depending on the type of hernia, but always with aprosthetic mesh of polypropylene (Prolene® 15 x 15 cm) (AL +S); incisional ventral hernias were treated with an intraperitonealmesh of Parietex composite®. Elastic band ligation or haemorrhoidectomy, lateral internal sphincterotomy (ELI) and fistulotomy were performed for anal pathology (AL + S). Safenectomy of the thigh in varicose veins and various mammary resections completed the procedures. Results: Of the 118 CTC, 104 began as AL + S and in 28they needed conversion to general anesthesia, without important complications. Of 298 hernia repairs, Rives's technique was the most employed (191 repairs). In 41 patients we carried out the insertion of an intraperitoneal mesh for the repair of an incisionalhernia. Haemorrhoidectomy was performed in 31 patients, elasticb and in 19; ELI in 20 and fistulotomy in 23. Eight patients underwent tumorectomy or mastectomy; 17, safenectomy and 2, thyroid lobectomies. Conclusion: Patient satisfaction was high and we believe thatit is the result of performing the whole procedure with a minimum number of displacements and minimum discomfort to the patient. The reduction of the waiting-list has been notable (AU)

Transcylindrical cholecystectomy under local anesthesia plus sedation. A pilot study.

BACKGROUND AND STUDY AIM: The practice of laparoscopic cholecystectomy under local anesthesia is almost anecdotal. For 15 years we have been using a "transcylindrical cholecystectomy" technique for the treatment of cholelithiasis, cholecystitis, and choledocholithiasis. The present study was undertaken to assess the feasibility of transcylindrical cholecystectomy under local anesthesia through a prospective and longitudinal efficacy study. PATIENTS AND METHODS: Transcylindrical cholecystectomy is performed gas-free through a single cylinder 3.8 cm in diameter and 10.0 cm in length. In 60 patients suffering from cholelithiasis (mean age 52.6 years, range 31-83 years; men/women 13/47; body mass index 29.6 kg/m(2), range 24-44 kg/m(2)), transcylindrical cholecystectomy was planned and started under local anesthesia. Patients were reviewed 5 days after surgery; pain was assessed using a visual analog scale (VAS) and procedure satisfaction was assessed following completion of a patient questionnaire. RESULTS: Surgery was satisfactorily completed through the cylinder in all patients. In 13 patients (21.7 %) local anesthesia was converted to general anesthesia due to technical difficulties in 11 patients (two related to patient body volume), respiratory depression in one patient, and poor patient tolerance in one patient. Postoperative complications were: wound infection (n = 1, 1.7 %), wound seromas (n = 2, 3.3 %), and nausea (n = 3, 5 %). After surgery, only three patients experienced pain at rest with VAS values of 0.5, 1.5, and 2.9, respectively. All but two patients were discharged from hospital on the day of surgery, and all patients were satisfied with the procedure. CONCLUSIONS: Transcylindrical cholecystectomy under local anesthesia is a feasible technique that builds on the benefits of laparoscopic cholecystectomy, and confers an economic advantage and improved safety for patients.

Alteraciones del metabolismo del fierro post by pass gástrico / Metabolic iron disorders post gastric by pass

A complication of bariatric surgery and especially gastric bypass are nutritional deficiencies that occur in the long term, being very important iron deficiency and anemia. Several mechanisms influence this, highlighting the exclusion of the duodenum and part of jejunum. Is in these places which have been described the presence of the iron transporter, which is over expressed in situations of iron deficiency. Special adaptation mechanisms may explain the maintenance of iron homeostasis in these patients. Associated with this, they require a specific nutritional management including diet and special supplements, however, despite this there is a proportion of patients who will develop the deficit and in some cases even become a major problem. Today we know several pathways, proteins and transporters involved in iron metabolism, mainly at the level of absorption, but little is known about the changes that occur at this level in people undergoing deficit, such as patients undergoing gastric bypass and the changes that occur here to optimize it metabolism. Here you will see a review of the iron metabolism and then a description of the changes that occur in its physiology following a gastric bypass.

Investigations into the application of a combination of bioventing and biotrickling filter technologies for soil decontamination processes--a transition regime between bioventing and soil vapour extraction.

Bioventing has emerged as one of the most cost-effective in situ technologies available to address petroleum light-hydrocarbon spills, one of the most common sources of soil pollution. However, the major drawback associated with this technology is the extended treatment time often required. The present study aimed to illustrate how an intended air-injection bioventing technology can be transformed into a soil vapour extraction effort when the air flow rates are pushed to a stripping mode, thus leading to the treatment of the off-gas resulting from volatilisation. As such, a combination of an air-injection bioventing system and a biotrickling filter was applied for the treatment of contaminated soil, the latter aiming at the treatment of the emissions resulting from the bioventing process. With a moisture content of 10%, soil contaminated with toluene at two different concentrations, namely 2 and 14 mg g soil(-1), were treated successfully using an air-injection bioventing system at a constant air flow rate of ca. 0.13 dm(3) min(-1), which led to the removal of ca. 99% toluene, after a period of ca. 5 days of treatment. A biotrickling filter was simultaneously used to treat the outlet gas emissions, which presented average removal efficiencies of ca. 86%. The proposed combination of biotechnologies proved to be an efficient solution for the decontamination process, when an excessive air flow rate was applied, reducing both the soil contamination and the outlet gas emissions, whilst being able to reduce the treatment time required by bioventing only.

Biological treatment of a contaminated gaseous emission from a leather industry in a suspended-growth bioreactor.

A suspended-growth bioreactor (SGB) was operated for the treatment of a gaseous stream mimicking emissions generated at a leather industrial company. The main volatile organic compounds (VOCs) present in the gaseous stream consisted of 1-methoxy-2-propanol, 2,6-dimethyl-4-heptanone, 2-butoxyethanol, toluene and butylacetate. A microbial consortium able to degrade these VOCs was successfully enriched. A laboratory-scale SGB was established and operated for 210-d with an 8h cycle period and with shutdowns at weekends. Along this period, the SGB was exposed to organic loads (OL) between 6.5 and 2.3 x 10(2) g h(-1) m(-3). Most of the compounds were not detected at the outlet of the SGB. The highest total VOC removal efficiency (RE) (ca 99%) was observed when an OL of 1.6 x 10(2) g h(-1) m(-3) was fed to the SGB. The maximum total VOC elimination capacity (1.8 x 10(2) g h(-1) m(-3)) was achieved when the OL applied to the SGB was 2.3 x 10(2) g h(-1) m(-3). For all the operating conditions, the SGB showed high levels of degradation of toluene and butylacetate (RE approximately equal to 100%). This study also revealed that recirculation of the gaseous effluent improved the performance of the SGB. Overall, the SGB was shown to be robust, showing high performance after night and weekend shutdown periods.

SPG11 compound mutations in spastic paraparesis with thin corpus callosum.

BACKGROUND: Autosomal recessive hereditary spastic paraparesis with thin corpus callosum (ARHSP-TCC) is being increasingly recognized as a variety of spastic paraplegia with mental retardation. SPG11 gene mutations have been reported to be associated with ARHSP-TCC. METHODS: As an independent group, we investigated SPG11 gene involvement in four individuals not previously described with either recessive or sporadic HSP-TCC presentation. RESULTS: Chromosome 15q13-15 segregating autosomal disease haplotypes were different across the kindreds and sequencing of SPG11 identified four novel frameshift/nonsense segregating mutations and the R2034X mutation, which were in heterozygous compound status. The affected examined had decreased thalamic and bilateral paracentral frontal lobe metabolism on (18)F-flurodeoxyglucose PET. CONCLUSIONS: Loss-of-function SPG11 mutations are the major cause of autosomal recessive hereditary spastic paraparesis with thin corpus callosum in Southern Europe, even in apparently sporadic cases. Decreased thalamic metabolism was consistently a phenotypical SPG11 mutation hallmark.

Influência da universidade aberta da terceira idade (UATI) e do programa de revitalização (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos / Influence of the Open University for the Third Age (UATI) and the revitalization program (REVT) on quality of life in middle-aged and elderly adults

OBJETIVO: Foi avaliada a influência da Universidade Aberta da Terceira Idade - Fundação Educacional de São Carlos (UATI-FESC) e do Programa de Revitalização Geriátrica (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos. MÉTODO: Participaram deste estudo 70 indivíduos do primeiro ano da UATI e do REVT. Os critérios de inclusão foram ter 50 anos ou mais e ser capaz de preencher os questionários. A UATI é um programa interdisciplinar com seis disciplinas (uma vez por semana cada), três de atividades físicas: Tai Chi Chi Kung, Expressão Corporal, Fisioterapia e Promoção da Saúde; e três de promoção social e cultural: Educação Musical, Arte, Cidadania e Terceira Idade, além de atividades comemorativas e turismo cultural. O REVT teve 48 sessões de atividade física, três vezes por semana, com duração de 50-55 minutos cada. Todos os participantes foram avaliados por meio dos instrumentos de qualidade de vida World Health Organization Quality of Life (WHOQOL-bref) e Short-Form 36 - Medical Outcomes Study (SF36) no início e ao término da intervenção de 16 semanas. Para análise dos dados, foi utilizada ANOVA com medida repetida. RESULTADOS: Não houve diferença entre os grupos. Ambos os grupos apresentaram melhora significativa do nível de qualidade de vida de acordo com o resultado geral do WHOQOL-bref e também nos domínios psicológico, meio ambiente e questões iniciais: "Como você avaliaria sua qualidade de vida?" e "Quão satisfeito(a) você está com a sua saúde?" do WHOQOL-bref. Também houve melhora significativa do domínio Estado Geral de Saúde do SF36. Para os domínios Físico e Relações Sociais do WHOQOL-bref e outros domínios do SF36 não houve melhora significativa. CONCLUSÃO: Esses programas melhoraram a qualidade de vida segundo o WHOQOL-bref e EGS-SF36.

OBJECTIVE: The influence of the Open University of the Third Age (São Carlos Educational Foundation) (UATI-FESC) and the Geriatric Revitalization Program (REVT) on the quality of life of middle-aged and elderly adults was evaluated. METHOD: Seventy individuals in their first year at UATI and REVT participated in this study. The inclusion criteria were that the subjects had to be at least 50 years old and be capable of filling out questionnaires. UATI had an interdisciplinary program comprising six lectures (once a week each). Three were on physical activities: Tai Chi Chi Kung, Body Expression and Physical Therapy and Health Promotion; three on social and cultural promotion: Musical Education, Art and Citizenship in the Third Age; and there were also commemorative activities and cultural tourism. REVT had 48 physical activity sessions, three times a week, lasting 50-55 minutes each. All the participants were evaluated using the World Health Organization Quality-of-Life (WHOQOL-bref) and Short-Form 36 Medical Outcomes Study (SF36) questionnaires at baseline and at the end of the 16-week intervention. The data were analyzed using ANOVA with repeated measurements. RESULTS: There were no differences between the groups. Both groups showed significant improvement in quality of life according to the overall result from WHOQOL-bref and also in the Psychological and Environmental domains and the initial questions: "How would you rate your quality of life?" and "How satisfied are you with your health?", in WHOQOL-bref. There was also a significant improvement in the General Health domain of SF36. For the Physical and Social Relations domains of WHOQOL-bref and other domains of SF36, there was no significant improvement. CONCLUSIONS: These programs improved quality of life according to WHOQOL-bref and the General Health domain of SF36.

A double-blind, controlled, multicenter, randomized study comparing the antihypertensive effectiveness and tolerance of a daily dose of two nifedipine formulations: nifedipine microgranules versus nifedipine osmotic pump.

INTRODUCTION: Controlled clinical studies have clearly established the advantages of blood pressure (BP) reduction. However, optimal control of BP in the population is still not adequate. Monotherapy is ineffective in the majority of hypertensive patients, and multidrug therapy increases costs. OBJECTIVE: The objective of the study was to assess to what extent and how uniformly BP can be controlled with two different 24-hour drug-releasing formulations of nifedipine, used as monotherapy. METHODS: One hundred ninety-two patients of both genders, aged 18 to 65 years, with mild to moderate (Stage 1 and 2) essential hypertension with systolic BP <200 mm Hg and diastolic BP between 90 and 115 mm Hg were randomized in a double-blind, double-dummy fashion to receive sustained-release formulations of 30 mg nifedipine/day either as microgranules (NMG) or via osmotic pump (NOP) for 8 weeks. Office BP was measured at baseline (after 2 weeks of placebo) and after the third to fourth week of treatment. If at the third to fourth week the systolic BP/diastolic BP did not reach values of <140/<90 mm Hg, the dose was doubled to 60 mg/day. Monotherapy that did not yield these BP values at 8 weeks was considered a failure. Ambulatory monitoring of blood pressure (AMBP) was also performed after the placebo period and at the end of treatment. Smoothness index (SI) and trough/peak ratio (T/P) were calculated and their correlation was checked. RESULTS: The initial systolic/diastolic BP values were similar at baseline and decreased significantly after the third to fourth week of treatment, with no difference between the groups. The proportions of patients reaching the goal BP (<140/<90 mm Hg) were similar in the two groups: NMG, 71%, and NOP, 78% (P = 0.12). There were no changes in the heart rate in either group. There was no difference between groups in the reduction in mean arterial pressure measured by AMBP. The frequency of SI values >1.4 and T/P ratios of >0.5 was similar in both groups. An important correlation was found between the SI and T/P values. The incidence of adverse effects was low and similar in both groups. CONCLUSIONS: Target BP was reached in more than 70% of patients receiving monotherapy with either formulation. Both formulations were tolerated well.

Synergistic effect of Glomus intraradices and Frankia spp. on the growth and stress recovery of Alnus glutinosa in an alkaline anthropogenic sediment.

The presence of actinorhizas and arbuscular mycorrhizas may reduce plant stresses caused by adverse soil conditions. A greenhouse experiment was conducted using a sediment with a high pH, resulting from the disposal of waste originated at an acetylene and polyvinylchloride factory, in which Black alder (Alnus glutinosa) seedlings were inoculated either with Glomus intraradices BEG163 (originally isolated from the same sediment), Frankia spp. or both symbionts. After a 6-month growth period, plants inoculated with both symbionts had significantly greater leaf area, shoot height and total biomass when compared with the uninoculated control, the Frankia spp. and the G. intraradices treatments alone. In dual inoculated plants the N and P leaf content was significantly increased. A defoliation experiment was performed to evaluate the stress recovery of A. glutinosa and plants inoculated with both symbionts had a faster leaf regrowth and produced greater numbers of leaves. The dual inoculation resulted in greater numbers of and larger root nodules than when inoculated with Frankia spp. alone. The length and NADH diaphorase activity of the extraradical mycelium of G. intraradices was also significantly greater when dual inoculation was performed. The inoculation with Frankia spp. alone was shown to improve A. glutinosa growth, whereas G. intraradices alone had no positive effect under these environmental conditions. However, when the two symbionts were inoculated together a synergistic effect was observed resulting in a greater benefit for the plants and for both symbionts. The relevance of these findings for the phytorestoration of anthropogenic stressed sediments with high pH is discussed.

[The Andalusia Epilepsy Society's Guide to Epilepsy Therapy 2005: IV. General principles of antiepileptic polytherapy and therapeutic strategies in refractory epilepsy]. / Guía terapéutica en epilepsia de la Sociedad Andaluza de Epilepsia 2005: IV. Principios generales de politerapia antiepiléptica y estrategias terapéuticas en epilepsia refractaria.

AIMS: The objective of this work was to produce a scientific evidence-based guide to clinical practice dealing with the basic questions concerning the treatment of epilepsy. DEVELOPMENT: A committee of 11 experts belonging to the Andalusia Epilepsy Society, made up of six neurologists, three neuropaediatricians, one neurosurgeon and a pharmacologist, all of whom were deeply involved and experienced in epilepsy, conducted a thorough review of the literature in search of all the evidence available on the proposed subject matter. The following databases were used: MEDLINE, Cochrane Library and the databases of several clinical practice guidelines (National Guideline Clearinghouse, National Institute of Clinical Excellence and the American Academy of Neurology's Clinical Guidelines). The Guide was set out in seven sections and was published in four parts. From a total number of 187 relevant documents, the committee found 63 examples of scientific evidence and 91 therapeutic recommendations. These were tabulated and classified according to the European Federation of Neurological Societies' criteria for producing Clinical Practice Guidelines. CONCLUSIONS: The results of this survey provide scientific evidence-based clinical guidelines that are useful, simple and applicable at different levels of health care.